Does High-Speed Rail Opening Affect the Health Care Environment?-Evidence From China.

Using the panel data of 280 prefecture-level cities in China from 2004 to 2014, this paper examines the effects of high-speed rail opening on health care environment based on Difference-in-Differences method (DID). Through an empirical analysis, the results proved that high-speed rail opening can significantly promote the health care environment and this effect is different in regions with different levels of economic development. Finally, we tested the mechanisms of how the high-speed rail opening affects the healthcare environment. High-speed rail opening improves the healthcare environment by increasing road accessibility and promoting economic development. Our results support the view that high-speed rail opening has an important contribution to the improvement of health care conditions.

Evaluation of the association between extravascular lung water and prognosis of sepsis: A protocol of systematic review.

BACKGROUND: The purpose of this study is to explore the association between extravascular lung water (EVLW) and prognosis of sepsis (PS). METHODS: We will carry out comprehensive literature search in electronic databases (PUBMED/MEDLINE, EMBASE, CENTRAL, WorldSciNet, PsycINFO, Allied and Complementary Medicine Database, CBM, and CNKI) and additional sources. All electronic databases will be searched from their initial to the present without language restrictions. Case-controlled studies reporting the association between EVLW and PS will be evaluated for inclusion. Outcomes of interest will include mortality rate, extravascular lung water index, pulmonary vascular permeability index, blood lactate clearance, oxygenation index, blood gas analysis, PaO2/FiO2, cardiac output index, global end diastolic volume index, intrathoracic blood volume index, systemic resistance index, acute physiology and chronic health scoring system II, and infection-related organ failure scoring system. Study quality will be evaluated using Newcastle-Ottawa Tool, and statistical analysis will be performed utilizing RevMan 5.4 software. RESULTS: This study will summarize the most recent evidence to investigate the association between EVLW and PS. CONCLUSIONS: The results of this study will provide an exhaustive view of the association between EVLW and PS. STUDY REGISTRATION OSF: osf.io/vhnxw.

Serologic Detection of SARS-CoV-2 Infections in Hemodialysis Centers: A Multicenter Retrospective Study in Wuhan, China.

RATIONALE & OBJECTIVE: Patients receiving maintenance hemodialysis (MHD) are highly vulnerable to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The current study was designed to evaluate the prevalence of SARS-CoV-2 infection based on both nucleic acid testing (NAT) and antibody testing in Chinese patients receiving MHD. STUDY DESIGN: Cross-sectional study. SETTING & PARTICIPANTS: From December 1, 2019, to March 31, 2020, a total of 1,027 MHD patients in 5 large hemodialysis centers in Wuhan, China, were enrolled. Patients were screened for SARS-CoV-2 infection by symptoms and initial computed tomography (CT) of the chest. If patients developed symptoms after the initial screening was negative, repeat CT was performed. Patients suspected of being infected with SARS-CoV-2 were tested with 2 consecutive throat swabs for viral RNA. In mid-March 2020, antibody testing for SARS-CoV-2 was obtained for all MHD patients. EXPOSURE: NAT and antibody testing results for SARS-CoV-2. OUTCOMES: Morbidity, clinical features, and laboratory and radiologic findings. ANALYTICAL APPROACH: Differences between groups were examined using t test or Mann-Whitney U test, comparing those not infected with those infected and comparing those with infection detected using NAT with those with infection detected by positive serology test results. RESULTS: Among 1,027 patients receiving MHD, 99 were identified as having SARS-CoV-2 infection, for a prevalence of 9.6%. Among the 99 cases, 52 (53%) were initially diagnosed with SARS-CoV-2 infection by positive NAT; 47 (47%) were identified later by positive immunoglobulin G (IgG) or IgM antibodies against SARS-CoV-2. There was a spectrum of antibody profiles in these 47 patients: IgM antibodies in 5 (11%), IgG antibodies in 35 (74%), and both IgM and IgG antibodies in 7 (15%). Of the 99 cases, 51% were asymptomatic during the epidemic; 61% had ground-glass or patchy opacities on CT of the chest compared with 11.6% among uninfected patients (P<0.001). Patients with hypertensive kidney disease were more often found to have SARS-CoV-2 infection and were more likely to be symptomatic than patients with another primary cause of kidney failure. LIMITATIONS: Possible false-positive and false-negative results for both NAT and antibody testing; possible lack of generalizability to other dialysis populations. CONCLUSIONS: Half the SARS-CoV-2 infections in patients receiving MHD were subclinical and were not identified by universal CT of the chest and selective NAT. Serologic testing may help evaluate the overall prevalence and understand the diversity of clinical courses among patients receiving MHD who are infected with SARS-CoV-2.

Drug-eluting balloons versus drug-eluting stents for small vessel coronary artery disease: a meta-analysis.

OBJECTIVE: We aimed to conduct a network meta-analysis of treatments for small vessels coronary artery disease between drug-eluting balloon (DEB) and drug-eluting stent (DES). METHOD: A meta-analysis comparing DEB and DES outcomes was performed using the Medline, Embase, and Cochrane databases. The primary outcome was target lesion revascularization (TLR) or target vessel revascularization (TVR), and myocardial infarction (MI), death and major adverse cardiovascular events (MACE) were secondary outcomes. A total of six studies on 1813 patients were included. RESULTS: There was no significant difference in rates of TLR or TVR in the patients treated with the DEB strategy compares with the DES strategy [odds ratio (OR) = 0.96, 95% confidence interval (CI) 0.57-1.61, P = 0.89] within a follow-up period of 9-24 months. There was a significant reduction in rates of MI and death in the patients treated with a DCB strategy compared with those treated with a DES strategy (3.7%, 17 of 460 vs 6.1%, 36 of 595; 2.4%, 11 of 460 vs 6.1%, 36 of 595, respectively), and this difference was statistically significant (OR = 0.53, 95% CI 0.29-0.96, P = 0.04; OR = 0.44, 95% CI 0.22-0.88, P = 0.02, respectively). There was no difference between DEB and DES strategies in rates of MACE (OR = 0.94, 95% CI 0.66-1.33, P = 0.73). CONCLUSION: In summary, this study demonstrates that treatment of small vessel (diameter ≤ 3 mm) coronary artery disease (CAD) with DEB may lead to improving outcomes compared with the use of DES within a follow-up period of 9-24 months. Further large clinical trials are needed to verify this conclusion.

Long-term in vivo study of biodegradable Zn-Cu stent: A 2-year implantation evaluation in porcine coronary artery.

In the present study, a novel biodegradable Zn-0.8Cu coronary artery stent was fabricated and implanted into porcine coronary arteries for up to 24 months. Micro-CT analysis showed that the implanted stent was able to maintain structural integrity after 6 months, while its disintegration occurred after 9 months of implantation. After 24 months of implantation, approximately 28 ±â€¯13 vol% of the stent remained. Optical coherence tomography and histological analysis showed that the endothelialization process could be completed within the first month after implantation, and no inflammation responses or thrombosis formation was observed within 24 months. Cross-section analysis indicated that the subsequent degradation products had been removed in the abluminal direction, guaranteeing that the strut could be replaced by normal tissue without the risk of contaminating the circulatory system, causing neither thrombosis nor inflammation response. The present work demonstrates that the Zn-0.8Cu stent has provided sufficient structural supporting and exhibited an appropriate degradation rate during 24 months of implantation without degradation product accumulation, thrombosis, or inflammation response. The results indicate that the Zn-0.8Cu coronary artery stent is promising for further clinical applications. STATEMENT OF SIGNIFICANCE: Although Zn and its alloys have been considered to be potential candidates of biodegradable metals for vascular stent use, by far, no Zn-based stent with appropriate medical device performance has been reported because of the low mechanical properties of zinc. The present work presents promising results of a Zn-Cu biodegradable vascular stent in porcine coronary arteries. The Zn-Cu stent fabricated in this work demonstrated adequate medical device performance both in vitro and in vivo and degraded at a proper rate without safety problems induced. Furthermore, large animal models have more cardiovascular similarities as humans. Results of this study may provide further information of the Zn-based stents for translational medicine research.

Molecular characterization of a peptidoglycan recognition protein from the cotton bollworm, Helicoverpa armigera and its role in the prophenoloxidase activation pathway.

Peptidoglycan recognition proteins (PGRPs), which are evolutionarily conserved from invertebrates to vertebrates, function as pattern-recognition and effector molecules in innate immunity. In this study, a PGRP (HaPGRP-A) from the cotton bollworm, Helicoverpa armigera was identified and characterized. Sequence analysis indicated that HaPGRP-A is not an amidase-type PGRP. Increased levels of HaPGRP-A mRNA were observed in the fat body and hemocytes of H. armigera larvae following the injection of microbes or Sephadex beads. Analysis using purified recombinant HaPGRP-A showed that it (i) could bind and agglutinate Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus, (ii) enhanced prophenoloxidase activation in the presence of microbes, (iii) promoted the formation of melanotic nodules in vivo, and (iv) enhanced the melanization of Sephadex beads in vivo. RNA interference assays were performed to further confirm the function of HaPGRP-A. When the expression of HaPGRP-A in H. armigera larvae was inhibited by dsHaPGRP-A injection, the phenoloxidase activity in larval hemolymph was significantly decreased and RNAi-treated insects infected with bacteria showed higher bacterial growth in hemolymph compared with infected control larvae. These results indicated that HaPGRP-A acts as a pattern recognition receptor and binds to the invading organism to trigger the prophenoloxidase activation pathway of H. armigera, and the activated phenoloxidase may participate in the melanization process of nodulation and encapsulation responses.

Rab3 is involved in cellular immune responses of the cotton bollworm, Helicoverpa armigera.

Rab3, a member of the Rab GTPase family, has been found to be involved in innate immunity. However, the precise function of this GTPase in innate immunity remains unknown. In this study, we identified a Rab3 gene (Ha-Rab3) from the cotton bollworm, Helicoverpa armigera and studied its roles in innate immune responses. Expression of Ha-Rab3 was upregulated in the hemocytes of H. armigera larvae after the injection of Escherichia coli or chromatography beads. The dsRNA-mediated knockdown of Ha-Rab3 gene in H. armigera larval hemocytes led to significant reduction in the phagocytosis and nodulation activities of hemocytes against E. coli, significant increase in the bacterial load in larval hemolymph, and significant reduction in the encapsulation activities of hemocytes toward invading chromatography beads. Furthermore, Ha-Rab3 knockdown significantly suppressed spreading of plasmatocytes. These results suggest that Ha-Rab3 plays important roles in H. armigera cellular immune responses, possibly by mediating spreading of hemocytes.

Identification and functional characterization of a peptidoglycan recognition protein from the cotton bollworm, Helicoverpa armigera.

Peptidoglycan recognition proteins (PGRPs) specifically bind to peptidoglycans, and play crucial roles as pattern recognition receptors (PRRs) in mediating innate immune responses. In this study, we identified and characterized a PGRP (HaPGRP-D) from the cotton bollworm, Helicoverpa armigera. Sequence analysis indicated that HaPGRP-D is an amidase-type PGRP. Expression of HaPGRP-D was upregulated in the hemocytes of H. armigera larvae after injecting Gram-negative Escherichia coli, Gram-positive Staphylococcus aureus, or chromatography beads. To test the biological activity of HaPGRP-D, purified recombinant protein was prepared. Subsequent analysis showed that rHaPGRP-D (i) could bind and agglutinate Gram-negative E. coli and Gram-positive S. aureus in a zinc-dependent manner, (ii) functioned as an amidase to degrade peptidoglycans in the presence of Zn(2+) , (iii) strongly inhibited the growth of E. coli and S. aureus in the presence of Zn(2+) , (iv) could bind to the surface of hemocytes, (v) increased the phagocytosis of E. coli cells by hemocytes in vitro, and (vi) promoted hemocyte encapsulation on chromatography beads in vitro. These results suggest that HaPGRP-D plays important roles as PRR, amidase, and opsonin in H. armigera humoral and cellular immune responses.

[Isolation and characterization of a halotolerant p-nitroaniline degrading strain S8].

A bacterial strain S8 was isolated from pesticide-contaminated sludge, which showed ability of utilizing p-nitroaniline as the sole source of carbon and nitrogen for growth. Based on the morphology, the physiological and biochemical characteristics, and the 16S rDNA sequence analysis, the strain was identified as Bacillus subtilis. Strain S8 showed high efficiency in p-nitroaniline degradation. 65.6% and 55.8% of p-nitroaniline (60 mg x L(-1) and 120 mg x L(-1)) were degraded by this strain within 72 hours under the optimal conditions of 31degrees C and pH 6.0. Besides, strain S8 degraded 49.5% p-nitroaniline in 7% NaCl and 27.4% p-nitroaniline in 10% NaCl (72 h), which showed that the strain S8 had a high salinity tolerance. When the LC-MS method was used for identification of the biodegradation products, six kinds of degradation products were found, two of which were identified as phenol and hydroquinone. To date, this is the first report on the degradation of p-nitroaniline by Bacillus subtilis. These results suggest that S8 could be a potential candidate for treating p-nitroaniline-contaminated saline wastewater.