The impact of national centralized drug procurement on health expenditures for lung cancer inpatients: A difference-in-differences analysis in a large tertiary hospital in China.

The availability and affordability of medicines remain major health challenges around the world. In March 2019, the Chinese government introduced a pilot National Centralized Drug Procurement (NCDP) program in order to reduce drug prices and improve the affordability of effective and safe medicines. This study aimed to assess the impact of NCDP policy on health expenditures of cancer patients. Using inpatient discharge records from a large hospital in the pilot city, we performed a difference-in-differences design to estimate the change in health expenditures before and after the policy. We found that the implementation of NCDP was associated with a significant decrease in total expenditures (14.13%) and drug expenditures (20.75%) per inpatient admission. There were also significant reductions in non-drug-related expenditures, including a 7.65% decrease in health service expenditures, a 38.28% decrease in diagnosis expenditures, and a 25.31% decrease in consumable material expenditures per inpatient admission. However, the NCDP implementation was associated with a 107.97% increase in the traditional Chinese medicine expenditures. Overall, the study provided evidence that the NCDP policy has achieved its goals of high-quality and affordable healthcare. The drug expenditures of lung cancer patients revealed a continuous decline, and the policy may have spillover effects on other healthcare expenditures. Further studies are needed to evaluate the long-term effects of NCDP on policy-related expenditures and health outcomes.

Application of the Chinese Version of the Pittsburgh Sleep Quality Index in People Living With HIV: Preliminary Reliability and Validity.

Background: The Pittsburgh Sleep Quality Index (PSQI) has been a widely used instrument measuring sleep quality among people living with HIV (PLWH) in China while its psychometric properties have yet to be examined in this population. We aimed to assess the reliability and validity of the Chinese version of PSQI in PLWH and identify factors associated with sleep quality. Methods: This study was based on a longitudinal study of newly diagnosed PLWH, among whom the PSQI was used to measure sleep quality 5 years after HIV diagnosis (n = 386). To evaluate internal consistency, Cronbach's alpha and corrected item-total correlation were calculated. To assess construct validity, Pearson's correlation coefficients were calculated between PSQI scores and depression, anxiety, stress, and health-related quality of life (HRQoL). Known group validity was evaluated by comparing PSQI scores between participants with probable depression and those without. Binary logistic regression was conducted to identify factors associated with sleep disturbances. Results: The internal consistency Cronbach's alpha for the Chinese version of PSQI in PLWH was 0.713. Construct validity was established by significant relationships between PSQI and depression, anxiety, stress, and HRQoL. The PSQI scores in participants with probable depression were significantly higher than those without, indicating good known-group validity. Sleep disturbances were associated with less income, higher CD4 counts, antiretroviral treatment (ART) initiation, exercise, depression, and higher stress levels. Conclusions: The Chinese version of PSQI is feasible for use among Chinese PLWH. Over a third of PLWH reported sleep disturbances. More attention should be given to individuals with less income and on ART. Intervention aimed at improving mental health or facilitating exercise may improve sleep quality.

Evaluation of anxiolytic-like effect of aqueous extract of asparagus stem in mice.

There are few studies on the neuropharmacological properties of asparagus, which was applied in Chinese traditional medicine as a tonic and heat-clearing agent. The present study was designed to investigate the anxiolytic-like activity of the aqueous extract of asparagus stem (AEAS) using elevated plus maze (EPM) and Vogel conflict tests (VCT) in mice. AEAS significantly increased the percentage of time spent in open arms in EPM, when compared with control group. In the Vogel conflict drinking test, the numbers of punished licks increased to 177% and 174% by the treatment of AEAS at the doses of 1.5 and 3.0 g/kg (250 and 500 mg sarsasapogenin per kilogram of body weight), compared with control group. The serum cortisol level decreased significantly, at the same time. In conclusion, these findings indicated that the aqueous extract of asparagus stem exhibited a strong anxiolytic-like effect at dose of 1.5 and 3.0 g/kg (250 and 500 mg sarsasapogenin per kilogram of body weight) in experimental models of anxiety and may be considered an alternative approach for the management of anxiety disorder.

[Profile of soil microbial biomass carbon in different types of subtropical paddy soils].

The soil microbial biomass carbon (C(mic)), one of the most active components of soil organic carbon (C(org)), is an effective indicator of soil quality. In the present study, five subtropical paddy soils developed from different parent materials were selected, and the distribution of C(mic) through the profiles was studied, as well as the relationship of C(mic) with C(org) and soil nutrients. The results showed that the contents of C(org) and C(mic) decreased markedly with increasing soil depth, ranging from 2.45 g x kg(-1) to 26.19 g x kg(-1) and from 4.55 mg x kg(-1) to 1 691.75 mg x kg(-1), respectively. They mainly concentrated in the surface layer (plough horizon and plough pan). The content of C(mic) varied significantly in paddy soils developed from different parent materials, with the highest one in yellow clayey soil, and the lowest ones in alluvial sandy soil and reddish yellow clayey soil. This was on the contrary to the distribution of C(org) in the surface paddy soils, since the reddish yellow clayey soil and alluvial sandy soil showed higher contents while other types of paddy soils exhibited similar contents of C(org). Notwithstanding, C(mic) was still controlled by the quantity of C(org) and positively correlated with C(org). The ratio of C(mic) to C(org)(C(mic)/C((org)) decreased with increasing soil depth and differed in the plough horizon between different paddy soils, with lower values in alluvial sandy soil (2.11%) and reddish yellow clayey soil (1.37%) but higher value in reddish yellow clayey soil I (8.24%). It indicated that the microbial substrate availability in alluvial sandy soil and reddish yellow clayey soil was lower than those in reddish yellow clayey soils. The content of C(mic) was significantly positively correlated with total nitrogen, alkali-hydrolyzable N and Olsen-P, but was irrelevant to available K. It is implied that the C(mic) was not only controlled by C(org), but also complicatedly interacted with soil nutrients in paddy soils.

[Content of soil heavy metals and characteristics of environmental quality in tea plantations of Changsha Baili Tea Zone].

The distributing and changing characteristics and content of soil heavy metals was studied using methods of field survey and sampling, indoor analysis, and pollution index were used to investigate the soil environmental quality in the tea plantations of Changsha Baili Tea Zone. The results showed that the content of soil total Pb, Hg, Cd, Cr, As, Ni basically was in the soil background value, their averages were 42.7, 0.068, 0.074, 92.2, 12.4 and 19.5 mg/kg respectively. The content of heavy metals was lower than the standard of Environmental Qualification of Nuisance Free Tea Producing Area (NY 5020-2001). Simultaneity, soil environmental quality in tea plantations of Baili Tea Zone, it answered for the second grade of State Environmental Quality Standard for Soils (GB 15618-1995), achieved safe class, and the content of soil Hg, Cd, Ni accorded to the first grade of GB 15618-1995, these results showed the Changsha Baili Tea Zone were propitious to develop nuisance free tea production. Besides the single pollution index of Cr was 0.837 and in warning class at the tea plantation of Xiangfeng, the others were all less than 0.7, and in the safe class. The integrated index of 6 tea bases was all less than 0.7, in the safe class, the soil environmental quality was cleanness on the whole at Changsha Baili Tea Zone, and the soils were suitable for non-polluted agricultural production.

[Effects of Cd2+ on seedling growth and phytohormone contents of Glycine max].

A laboratory incubation experiment was conducted to study the effects of different Cd2+ concentrations on seedling growth and phytohormone contents of Glycine max through determining some physiological and biochemical indexes. The results showed as follows: (1) Different Cd2+ concentrations inhibited the synthesis of indoleacetic acid (IAA) and gibberellins (GA3) in roots and stimulated the synthesis of zeatin (Z) and abscisic acid (ABA) not only in roots but also in aerial parts of Glycine Max. Cd2+ stimulated the synthesis of IAA and GA3 in aerial parts at lower concentrations, but inhibited the synthesis of IAA and GA3 at higher concentrations. (2) Cd2+ stress for 84h increased the root vitality and the contents of chlorophyll a and b, but no significant difference was found in carotinoid contents compared with the control. (3) Cd2+ stress decreased POD activities and MAD contents atlower concentrations and increased POD activities and MAD contents at higher concentrations. With increasing Cd2+ concentrations, this increase became significant gradually. (4) Cd2+ stress with lower concentrations stimulated the physiological activity of Glycine max seedling in a short time. When Cd2+ concentration was 0.50 mg/L, the root vitality, IAA and GA3 contents of Glycine max were the highest, and POD activity was the lowest.