Maternal hypothyroidism during pregnancy alters the function of the retinol-binding protein 4-mediated mitochondrial permeability conversion pore in the kidneys of offspring rats

OBJECTIVES To determine the role of the RBP4/PiC/SIRT3 signaling pathway in the opening of the mitochondria permeability transition pore (mPTP) in offspring rats with hypothyroidism during pregnancy. METHODS Sixty Sprague-Dawley (SD) rats were employed in this study. Pregnancy was deemed successful when a sperm was found in the uterus. After one week of pregnancy, offspring rats were divided into the following groups: overall hypothyroidism group (OH group), subclinical hypothyroidism group (SCH group), and normal control group (CON group). The establishment of the hypothyroidism model was confirmed when the serum thyroid stimulating hormone (TSH) levels were higher than normal value and TT4 level was within the normal range. The renal mitochondria of offspring rats were extracted on the 14th postnatal day (P14) and 35th postnatal day (P35). RESULTS At P14, no significant differences in the degree of mPTP opening and expression of phosphoric acid carrier vector (PiC) were detected between the rats in the OH group and the SCH group. However, the expression level of silent mating-type information regulation 3 homolog (SIRT3) was markedly reduced. Retinol-binding protein 4 (RBP4) expression increased in the rats from the OH group, relative to that in those from the SCH group. At P35, the degree of mPTP opening and the expression levels of PiC and RBP4 in the OH group were higher than those in the SCH group. However, SIRT3 expression in the OH group was lower than that observed in the SCH group. CONCLUSION RBP4 plays an important role in early renal mitochondrial damage and renal impairment in rats suffering from hypothyroidism during pregnancy. The RBP4/PiC/SIRT3 pathway is thus involved in the opening of the renal mPTP in offspring rats with hyperthyroidism.

Is the health workforce distribution in Beijing, China perfectly equitable?

Background: The quantity and distribution of the health workforce is one of the most important aspects of a health care system. Inequality in the distribution of the health workforce is common in China and in many developing countries. This paper aimed to evaluate and discuss inequality in the distribution of the health workforce in Beijing, China, and explain the sources of the inequality. Methods: The study described and measured inequality in the distribution of the health workforce in Beijing using data from the Beijing Regional Statistical Yearbook 2017. The 16 districts of Beijing are divided into four divisions and the paper used methods from the economics literature, including the Lorenz curve, Gini coefficient and Theil L index, to measure inequality in the distribution of the health workforce at sub-provincial level in Beijing for three categories of health workers: doctors, nurses and all health workers. Results: There are inequalities in the densities of health workers at the district and division levels. In terms of the densities of all health workers, doctors and nurses, the Capital Core Functional Division is 3.95 times, 3.82 times and 4.13 times, respectively, higher than the Urban Development New Division. All the Gini coefficients are between than 0.2 to 0.3, which means that the health worker distribution is rather equitable. The Theil L index shows that the inequalities mainly come from the differences between the four divisions, and that nurses are more unequally distributed between divisions (0.28 for Gini coefficient and 0.380 for the Theil L index). Conclusions and recommendations: According to the study findings, the inequalities in health workforce distribution in Beijing could be addressed by increasing investment in the numbers and quality of nurses, as well as by establishing additional policies to attract more health workers to work in remote areas. Chinese governments need to think more carefully about the current distribution of health workers at the sub-provincial level