Publications by authors named "Linlin Hu"

68 Publications

Integrating Health and Care in China: Lessons Learned and Future Outlook.

Int J Integr Care 2021 Oct-Dec;21(4):18. Epub 2021 Nov 8.

School of Health Policy and Management, Peking Union Medical College, Beijing 100730, China.

Background: An aging population is one of the key drivers reshaping health care systems. In China, the complex needs of its huge aging population require integration across the health and care sectors.

Policies And Progress: Over the past decade, the central government of China promulgated a series of policies to promote the establishment of aftercare facilities, specify approaches to integrate health and care service delivery at institutional and community levels, pilot long-term care insurance (LTCI) as a funding mechanism, and reform administrative structures in favor of integration. Progress has been made towards organizational and clinical integration of service delivery both at institutional and community levels. LTCI has been introduced as the financing mechanism covering long term care services.

Discussions And Conclusions: The experiences of China in the integration of health and care could be summarized as a top-down approach in policy formulation and implementation, the significant employment of pilots and demonstrations, and the activation of market forces. However, China is still in the initial stage of integrating health and care and is faced with system-level challenges in its financing, management, and workforce, and faces technical challenges, such as a lack of tools, and standards. In the future, these issues need to be addressed.
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http://dx.doi.org/10.5334/ijic.5681DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8588902PMC
November 2021

Icariin improves testicular dysfunction via enhancing proliferation and inhibiting mitochondria-dependent apoptosis pathway in high-fat diet and streptozotocin-induced diabetic rats.

Reprod Biol Endocrinol 2021 Nov 9;19(1):168. Epub 2021 Nov 9.

Clinical Anatomy and Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, 421001, China.

Background: Diabetes mellitus (DM), a chronic metabolic disease, severely impairs male reproductive function. However, the underpinning mechanisms are still incompletely defined, and there are no effective strategies or medicines for these reproductive lesions. Icariin (ICA), the main active component extracted from Herba epimedii, is a flavonoid traditionally used to treat testicular dysfunction. Whether ICA can improve male reproductive dysfunction caused by DM and its underlying mechanisms are still unclear. In this study, by employing metformin as a comparative group, we evaluated the protective effects of ICA on male reproductive damages caused by DM and explored the possible mechanisms.

Methods: Rats were fed with a high fat diet (HFD) and then intraperitoneally injected with streptozotocin (STZ) to induce diabetes. Diabetic rats were randomly divided into T2DM + saline group, T2DM + metformin group and T2DM + ICA group. Rats without the treatment of HFD and STZ were used as control group. The morphology of testicular tissues was examined by histological staining. The mRNA expression levels were determined by quantitative real-time PCR. Immunostaining detected the protein levels of proliferating cell nuclear antigen (PCNA), hypoxia-inducible factor 1-alpha (HIF-1α) and sirtuin 1 (SIRT1) in testicular tissues. TUNEL assay was performed to determine cell apoptosis in the testicular tissues. The protein expression levels of HIF-1α and SIRT1 in the testicular tissues were determined by western blot assay.

Results: ICA effectively improved male reproductive dysfunction of diabetic rats. ICA administration significantly decreased fasting blood glucose (FBG) and insulin resistance index (IRI). In addition, ICA increased testis weight, epididymis weight, sperm number, sperm motility and the cross-sectional area of seminiferous tubule. ICA recovered the number of spermatogonia, primary spermatocytes and Sertoli cells. Furthermore, ICA upregulated the expression of PCNA, activated SRIT1-HIF-1α signaling pathway, and inhibited intrinsic mitochondria dependent apoptosis pathway by upregulating the expression of Bcl-2 and downregulating the expression of Bax and caspase 3.

Conclusion: These results suggest that ICA could attenuate male reproductive dysfunction of diabetic rats possibly via increasing cell proliferation and decreasing cell apoptosis of testis. ICA potentially represents a novel therapeutic strategy against DM-induced testicular damages.
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http://dx.doi.org/10.1186/s12958-021-00851-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8576896PMC
November 2021

Spatial Structure Regulation: A Rod-Shaped Viologen Enables Long Lifetime in Aqueous Redox Flow Batteries.

Angew Chem Int Ed Engl 2021 Oct 14. Epub 2021 Oct 14.

State Key Laboratory for Mechanical Behavior of Materials, Shaanxi International Research Center for Soft Matter, Xi'an Jiaotong University, Xi'an, 710049, China.

A stable rod-like sulfonated viologen (R-Vi) derivative is developed through a spatial-structure-adjustment strategy for neutral aqueous organic redox flow batteries (AORFBs). The obtained R-Vi features four individual methyl groups on the 2,2',6,6'-positions of the 4,4'-bipyridine core ring. The tethered methyls confine the movement of the alkyl chain as well as the sulfonic anion, thus driving the spatial structure from sigmoid to rod shape. The R-Vi with weak charge attraction and large molecular dimension displays an ultralow membrane permeability that is only 14.7 % of that of typical sigmoid viologen. Moreover, the electron-donating effect of methyls endows R-Vi with the lowest redox potential of -0.55 V vs. SHE among one-electron-storage viologen-based AORFBs. The AORFB with the R-Vi anolyte and a K Fe(CN) catholyte exhibits an energy efficiency up to 87 % and extremely low capacity-fade rate of 0.007 % per cycle in 3200 continuous cycles.
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http://dx.doi.org/10.1002/anie.202110010DOI Listing
October 2021

Gradient H-Bonding Binder Enables Stable High-Areal-Capacity Si-Based Anodes in Pouch Cells.

Adv Mater 2021 Oct 5:e2104416. Epub 2021 Oct 5.

State Key Laboratory for Mechanical Behavior of Materials, Shaanxi International Research Center for Soft Matter, Xi'an Jiaotong University, Xi'an, 710049, China.

Alleviating large stress is critical for high-energy batteries with large volume change upon cycling, yet this still presents a challenge. Here, a gradient hydrogen-bonding binder is reported for high-capacity silicon-based anodes that are highly desirable for the next-generation lithium-ion batteries. The well-defined gradient hydrogen bonds, with a successive bond energy of -2.88- -10.04 kcal mol , can effectively release the large stress of silicon via the sequential bonding cleavage. This can avoid recurrently abrupt structure fracture of traditional binder due to lack of gradient energy dissipation. Certainly, this regulated binder endows stable high-areal-capacity silicon-based electrodes >4 mAh cm . Beyond proof of concept, this work demonstrates a 2 Ah silicon-based pouch cell with an impressive capacity retention of 80.2% after 700 cycles (0.028% decay/cycle) based on this gradient hydrogen-bonding binder, making it more promising for practical application.
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http://dx.doi.org/10.1002/adma.202104416DOI Listing
October 2021

The Influence of Patient and Hospital Characteristics on Inpatient Satisfaction at Beijing District-Level Hospitals.

Patient Prefer Adherence 2021 28;15:1451-1460. Epub 2021 Jun 28.

School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People's Republic of China.

Purpose: Patient satisfaction is a key indicator of healthcare quality and hospital performance. This study aims to assess inpatient satisfaction at district-level hospitals and explore the determinants of inpatient satisfaction.

Patients And Methods: A total of 1458 adults from inpatient departments of 47 district-level hospitals in 16 districts across Beijing were recruited with a multi-stage stratified sample at Beijing in 2019. Univariate analysis and multivariate logistic regression were used to identify the influence of patient and institutional characteristics on inpatient satisfaction in four domains - administrative process, hospital environment, medical care, hospitalization expenses, and overall satisfaction.

Results: Of the 1458 participants, 577 (39.6%) were men, 581 (39.8%) were over 60 years of age. The average value of satisfaction score measured by a 5-point Likert scale were 4.37, 4.00, 4.44, 3.89, and 4.33 for the four domains and overall satisfaction. Patient and institutional characteristics were strongly associated with inpatient satisfaction. Patients with higher educational level were more satisfied with administrative process (<0.05). Elder patients and patients with worse self-reported health status were less satisfied with hospital environment (<0.05). Female, higher monthly family income and Urban Employees Basic Medical Insurance were positively associated with patient satisfaction in hospitalization expenses (<0.05). And patients receiving care in suburban hospitals were less satisfied with administrative process, hospital environment and overall satisfaction (<0.05). Patients receiving care in Traditional Chinese Medicine hospitals were more satisfied with medical care and expenses but less satisfied with environment (<0.05). Chronic disease and hospital grade were not significantly associated with satisfaction in all domains.

Conclusion: Patient satisfaction was influenced by demographic characteristics and hospital features. These determinants should be considered in hospital evaluation.
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http://dx.doi.org/10.2147/PPA.S314910DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8253896PMC
June 2021

Evaluation of the immunoprotective effects of IF-2 GTPase and SSU05-1022 as a candidate for a subunit vaccine.

Future Microbiol 2021 07 5;16:721-729. Epub 2021 Jul 5.

State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei, 430070, China.

This study aims to develop a subunit vaccine with high cross-protection for . Four-week-old female BALB/c mice were first immunized with a single and mixed protein. Various indicators, such as antibody titers and various cytokine levels, were further analyzed. The results showed that purified recombinant proteins IF-2 and 1022 had a good protective effect against lethal doses of serotype 2 and serotype 9. This study showed immunization with recombinant proteins. IF-2 and 1022 can enhance cross-protection against serotypes 2 and 9.
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http://dx.doi.org/10.2217/fmb-2020-0232DOI Listing
July 2021

Effects of different household cooking methods on the biological properties of Chinese yam.

Food Chem 2021 Nov 30;363:130246. Epub 2021 May 30.

China-Canada Joint Lab of Food Nutrition and Health (Beijing), Beijing Engineering and Technology Research Center of Food Additives, School of Food and Health, Beijing Technology & Business University (BTBU), Beijing 100048, China. Electronic address:

Yam (Dioscorea opposite Thunb) is used as a staple food and a traditional medicine in China. This study investigated the effects of different household cooking methods on the bioactive components (phenolic compounds, diosgenin and allantoin) and their bioaccessibility as well as the biological properties (antioxidant activity, hypoglycemic activity, anti-angiotensin I-converting enzyme (ACE) or anti-acetylcholinesterase (AChE)) of Chinese yam using an in vitro simulated digestion model. The results demonstrated that cooking caused significant losses of total soluble phenolic compounds (lowest loss of 20% for boiling at atmospheric pressure) and diosgenin content (lowest loss of 27.37% for microwaving) but no changes in the allantoin content. The cooking methods affected the bioaccessibility of the bioactive components differently. Normal steaming resulted in the highest amount of bioaccessible phenolic compounds (71.21%) and allantoin (79.07%), whereas high-pressure boiling in the highest content of diosgenin (75.58%). The concentration of bioactive components in the digesta fluid was correlated with the antioxidant activity and enzymatic inhibitory activities. Overall, household cooking processes allow the biological activity of yam to be retained by changing the profile of bioactive components potentially available for intestinal absorption. Thus, a household cooking method such as normal pressure steaming appeared to be most suitable for achieving the expected health benefits of yam.
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http://dx.doi.org/10.1016/j.foodchem.2021.130246DOI Listing
November 2021

Dual Modal Imaging-Guided Drug Delivery System for Combined Chemo-Photothermal Melanoma Therapy.

Int J Nanomedicine 2021 18;16:3457-3472. Epub 2021 May 18.

Shandong Engineering Research Center for Smart Materials and Regenerative Medicine, Weifang, 261053, People's Republic of China.

Purpose: Malignant melanoma is one of the most devastating types of cancer with rapid relapse and low survival rate. Novel strategies for melanoma treatment are currently needed to enhance therapeutic efficiency for this disease. In this study, we fabricated a multifunctional drug delivery system that incorporates dacarbazine (DTIC) and indocyanine green (ICG) into manganese-doped mesoporous silica nanoparticles (MSN(Mn)) coupled with magnetic resonance imaging (MRI) and photothermal imaging (PI), for achieving the superior antitumor effect of combined chemo-photothermal therapy.

Materials And Methods: MSN(Mn) were characterized in terms of size and structural properties, and drug loading and release efficiency MSN(Mn)-ICG/DTIC were analyzed by UV spectra. Photothermal imaging effect and MR imaging effect of MSN(Mn)-ICG/DTIC were detected by thermal imaging system and 3.0 T MRI scanner, respectively. Then, the combined chemo-phototherapy was verified in vitro and in vivo by morphological evaluation, ultrasonic and pathological evaluation.

Results: The as-synthesized MSN(Mn) were characterized as mesoporous spherical nanoparticles with 125.57±5.96 nm. MSN(Mn)-ICG/DTIC have the function of drug loading-release which loading ratio of ICG and DTIC could reach to 34.25±2.20% and 50.00±3.24%, and 32.68±2.10% of DTIC was released, respectively. Manganese doping content could reach up to 65.09±2.55 wt%, providing excellent imaging capability in vivo which the corresponding relaxation efficiency was 14.33 mMs. And outstanding photothermal heating ability and stability highlighted the potential biomedical applicability of MSN(Mn)-ICG/DTIC to kill cancer cells. Experiments by A375 melanoma cells and tumor-bearing mice demonstrated that the compound MSN(Mn)-ICG/DTIC have excellent biocompatibility and our combined therapy platform delivered a superior antitumor effect compared to standalone treatment in vivo and in vitro.

Conclusion: Our findings demonstrate that composite MSN(Mn)-ICG/DTIC could serve as a multifunctional platform to achieve a highly effective chemo-photothermal combined therapy for melanoma treatment.
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http://dx.doi.org/10.2147/IJN.S306269DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8144848PMC
June 2021

Preparation of biochar-interpenetrated iron-alginate hydrogel as a pH-independent sorbent for removal of Cr(VI) and Pb(II).

Environ Pollut 2021 Oct 10;287:117303. Epub 2021 May 10.

Jiangsu Key Laboratory of Crop Genetics and Physiology/Jiangsu Co-Innovation Center for Modern Production Technology of Grain Crops/Agricultural College, Yangzhou University, Yangzhou, 225009, PR China.

Herein, a pH-independent interpenetrating polymeric networks (Fe-SA-C) were fabricated from graphitic biochar (BC) and iron-alginate hydrogel (Fe-SA) for removal of Cr(VI) and Pb(II) in aqueous solution. Fourier transform infrared spectroscopy (FTIR), Raman spectroscopy and scanning electron microscope (SEM) results demonstrated that graphitic BC interpenetration increased surface porosity and distorted surfaces of Fe-SA, which boosted availability of hydroxyl (-OH) group. Fe as a cross-linking agent of the alginate endowed Fe-SA-C with positive surfaces (positive zeta potential) and excellent pH buffering capacity, while excessive Fe was soldered on Fe-SA-C matrix as FeO(OH) and FeO. Cr(VI) removal at pH of 3 by Fe-SA-C (20.3 mg g) were 30.3% and 410.6% greater than that by Fe-SA and BC, respectively. Fe-SA-C exhibited minor pH dependence over pH range of 2-7 towards Cr(VI) retention. Greater zeta potential of Fe-SA-C over Fe-SA conferred a better electrostatic attraction with Cr(VI). FTIR and XPS of spent sorbents confirmed the reduction accounted for 98.5% for Cr(VI) removal mainly due to participation of -OH. Cr(VI) reduction was further favored by conductive carbon matrix in Fe-SA-C, as evidenced by more negative Tafel corrosion potential. Reductively formed Cr(III) was subsequently complexed with carboxylic groups originating from oxidation of -OH. Thus, Cr(VI) removal invoked electrostatic attraction, reduction, and surface complexation mechanisms. Pb(II) removal with excellent pH independence was mainly ascribed to surface complexation and possible precipitation. Thus, the functionalized, conductive, and positively-charged Fe-SA-C extended its applicability for Cr(VI) and Pb(II) removal from aqueous solutions in a wide pH range. This research could expand the application of hydrogel materials for removal of both cationic and anionic heavy metals in solutions over an extended pH range.
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http://dx.doi.org/10.1016/j.envpol.2021.117303DOI Listing
October 2021

Influences of intestinal flora disorder, inflammation, stress and glycolipid metabolism on depression patients.

Panminerva Med 2021 Apr 16. Epub 2021 Apr 16.

Sleep Medicine Center, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China -

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http://dx.doi.org/10.23736/S0031-0808.21.04317-2DOI Listing
April 2021

Increased structural defects of graphene oxide compromised reductive capacity of ZVI towards hexavalent chromium.

Chemosphere 2021 Aug 18;277:130308. Epub 2021 Mar 18.

College of Environmental Science and Engineering & Joint International Research Laboratory of Agriculture and Agri-Product Safety of Ministry of Education of China, Yangzhou University, Yangzhou, 225127, PR China; Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China. Electronic address:

Graphene oxide (GO) was treated with irradiation beams to understand the defective degree of carbon structure of GO in relation to electron transfer property of impregnated zerovalent iron (ZVI). The GO-supported ZVI (ZVI/GO) was synthesized and then characterized by an X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), Fourier transform infrared spectroscopy (FTIR) and Raman spectroscopy. The results showed that the oxygen-bearing functional groups, oxygen content and structural disorder were increased as a function of irradiation beam intensity. ZVI was dominant in the composites, but proportion of iron oxide increased with greater oxygen content. Batch sorption revealed that Cr(VI) removal decreased from 20.11 g kg to 2.30 g kg as solution pH rose from 3 to 9. Cr(VI) removal capacity was 26.39 g kg, 23.12 g kg and 12.35 g kg for ZVI/GO, ZVI/GO and ZVI/GO, respectively. The reduction capacity of sorbents followed similar trends as Cr(VI) sorption as per desorption experiment, which accounted for a major Cr(VI) detoxification mechanism by ZVI/GO composites. The electrochemical tests demonstrated that unfavorable electron transfer rate of ZVI/GO composites was aggravated by greater structural disorder of GO. Thus, higher dose of irradiations could create more disorder in graphitic carbon and promote oxidation of ZVI, which hindered Cr(VI) reduction.
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http://dx.doi.org/10.1016/j.chemosphere.2021.130308DOI Listing
August 2021

Valine Supplementation Does Not Reduce Lipid Accumulation and Improve Insulin Sensitivity in Mice Fed High-Fat Diet.

ACS Omega 2020 Dec 24;5(48):30937-30945. Epub 2020 Nov 24.

Institute of Animal Nutrition, Northeast Agricultural University, Harbin 150030, China.

Branched-chain amino acids (BCAAs), particularly leucine, were reported to decrease obesity and relevant metabolic syndrome. However, whether valine has a similar effect has rarely been investigated. In the present study, mice were assigned into four treatments ( = 10): chow diet supplemented with water (CW) or valine (CV) and high-fat diet supplemented with water (HW) or valine (HV). Valine (3%, w/v) was supplied in the drinking water. The results showed that valine treatment markedly increased serum triglyceride and insulin levels of chow diet-fed mice. The body weight, serum triglyceride level, white adipose tissue weight, and glucose and insulin intolerance were significantly elevated by valine supplementation in high-fat diet-fed mice. Metabolomics and transcriptomics showed that several genes related to fat oxidation were downregulated, and arachidonic acid and linoleic acid metabolism were altered in the HV group compared to the HW group. In conclusion, valine supplementation did not suppress lipid deposition and metabolic disorders in mice, which provides a new understanding for BCAAs in the modulation of lipid metabolism.
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http://dx.doi.org/10.1021/acsomega.0c03707DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726788PMC
December 2020

Dietary supplementation with aromatic amino acids decreased triglycerides and alleviated hepatic steatosis by stimulating bile acid synthesis in mice.

Food Funct 2021 Jan 10;12(1):267-277. Epub 2020 Dec 10.

Institute of Animal Nutrition, Northeast Agricultural University, Harbin, 150030, China.

Emerging evidence shows that amino acids can modulate lipid metabolism. Aromatic amino acids (AAAs) serve as important precursors of several neurotransmitters and metabolic regulators that play a vital role in regulating nutrient metabolism. But whether AAAs have a lipid-lowering function remains unknown. Here mice were fed amino acid-defined diets containing AAAs at 1.82% and 3.64% for 3 weeks. We demonstrated that double AAA intake significantly decreased the serum and hepatic triglycerides and serum low-density lipoprotein cholesterol, but increased the high-density lipoprotein cholesterol as well as insulin tolerance. Combined metabolomic and transcriptomic analysis showed that the hepatic acidic pathway of bile acid synthesis was responsible for the improvement in lipid metabolism by AAA treatment. This study suggests that AAAs have the potential to ameliorate steatosis and provides a new alternative to improve lipid metabolism.
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http://dx.doi.org/10.1039/d0fo02364gDOI Listing
January 2021

RcsB-dependent regulation of type VI secretion system in porcine extra-intestinal pathogenic Escherichia coli.

Gene 2021 Feb 10;768:145289. Epub 2020 Nov 10.

State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, Hubei, China; Key Laboratory of Preventive Veterinary Medicine in Hubei Province, The Cooperative Innovation Centre for Sustainable Pig Production, Wuhan, Hubei 430070, China. Electronic address:

Signal transduction system and specialized secretory devices are crucial for bacteria to sense and adequately adapt in adverse environmental conditions. Therefore, it's crucial for microbes to detect and respond to lethal attacks when envelope is perturbed so as to minimize and fix the damage in milieu. We investigated the adaptive response of porcine extra-intestinal pathogenic Escherichia coli PCN033 to polymyxin B challenge. Treatment with polymyxin B led to rapid and robust activation of Rcs system via RcsF, as well as the accumulation of reactive oxygen species. ExPEC T6SS expression was strongly induced by RcsB in Rcs system, resulting in the reduction in the damage to constitute a survival strategy. Finally, we show that T6SS of ExPEC is involved in its pathogenicity in mouse model. Compared with the wild type strain, the deletion of T6SS genes led to a decrease in the organ colonization ability, and the RcsFS2DM3Q mutant that caused Rcs activation had a stronger colonization ability than the wild type strain. In conclusion, Rcs system orchestrates Rcs cascade to trigger antioxidant defense of T6SS, and presents a typical model in which a bacterium reschedule its transcription network via the Rcs phosphorelay pathway in response to membrane perturbations for survival and pathogenesis.
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http://dx.doi.org/10.1016/j.gene.2020.145289DOI Listing
February 2021

Imaging Observation of Nano-Artificial Bone in the Repair of the Defect in Osteonecrosis of the Femoral Head.

J Nanosci Nanotechnol 2020 12;20(12):7775-7780

Department of Radiology, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang 157011, Heilongjiang, PR China.

To observe the effect of nano-artificial bone and bone marrow mesenchymal stem cells (BMSCs) in the treatment of femoral head osteonecrosis. The bilateral femoral head internal bone defect model was established and divided into three groups. Group A was used to make the defect without filling any material as the control, group B was only filled with nano-artificial bone, and group C was filled with composite materials of nano-artificial bone and bone marrow mesenchymal stem cells. The femoral head was examined using radiography and high-resolution focused 48-slice computed tomography (CT) at 12 weeks after implantation. A significant difference was found between groups B and C in the aspect of repairing the defect in osteogenesis of the femoral head as compared with the control group. Nano-collagen-based bone has strong osteogenic and osteogenic effects and is a good graft material for repairing bone defects of the femoral head. The use of bone marrow mesenchymal stem cells can promote the repair of bone defects, which is of great value in the treatment of osteonecrosis of the femoral head.
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http://dx.doi.org/10.1166/jnn.2020.18708DOI Listing
December 2020

BaeSR activates type VI secretion system expression in porcine extra-intestinal pathogenic Escherichia coli to enhance bacterial resistance to zinc stress.

Microb Pathog 2020 Oct 27;147:104357. Epub 2020 Jun 27.

State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, Hubei, China; Key Laboratory of Preventive Veterinary Medicine in Hubei Province, The Cooperative Innovation Centre for Sustainable Pig Production, Wuhan, Hubei, 430070, China. Electronic address:

The two-component system BaeSR is an extra-cytoplasmic stress response system in Escherichia coli, whose function is to be adapted to environmental stress. Recently, we have identified an active type VI secretion system in porcine extra-intestinal pathogenic Escherichia coli PCN033. DNA-protein interactions shows that BaeR directly binds to the promoter region of the T6SS and then induces its expression. Deletion of baeR/baeSR decreased zinc resistance of bacteria. Moreover, T6SS mutant Δhcp1/hcp2/hcp3 is more sensitive than wild type after exposure to external zinc, and complementation of hcp1 largely restored growth defect. Our study uncovers a new regulation mechanism of BaeSR system in response to metal stress. It reveals that BaeR-regulated T6SS is critical for bacteria survival under toxic zinc condition. In conclusion, T6SS contributes to zinc stress resistance in a BaeSR system-dependent manner.
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http://dx.doi.org/10.1016/j.micpath.2020.104357DOI Listing
October 2020

Threonine, but Not Lysine and Methionine, Reduces Fat Accumulation by Regulating Lipid Metabolism in Obese Mice.

J Agric Food Chem 2020 Apr 15;68(17):4876-4883. Epub 2020 Apr 15.

Institute of Animal Nutrition, Northeast Agricultural University, Harbin 150030, China.

Some amino acids (AAs) have been proven to suppress fat mass and improve insulin sensitivity. However, the impact of important essential AAs, threonine, lysine, and methionine, on obesity has not been clarified. In the present study, after an 8 week period of obesity induction, mice were grouped to receive either a high-fat diet (HFD) or HFD supplemented with lysine, threonine, or methionine (3% in drinking water) for another 10 weeks. The results showed that dietary supplementation with threonine significantly decreased body weight, epididymal and perirenal fat pad weights, serum concentrations of glucose, triacylglycerols, total cholesterol, and LDL-cholesterol compared to the HFD group. HOMA-IR and serum leptin and adiponectin were improved by threonine supplementation. In epididymal adipose tissue, threonine treatment significantly down-regulated the expression levels of lipogenesis and up-regulated expressions of lipolysis compared to the HFD group. Threonine addition stimulated the expression of UCP-1 and related genes in brown adipose tissue. However, lysine or methionine supplementation showed little effect on body weight, WAT weight, serum lipid profiles, and lipid-metabolism-related gene expressions of HFD-fed mice. These findings suggest that threonine inhibited fat mass and improved lipid metabolism of already obese mice, providing a potential agent in treating obesity.
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http://dx.doi.org/10.1021/acs.jafc.0c01023DOI Listing
April 2020

The Influence of Social Support on Physical Activity in Chinese Adolescents: The Mediating Role of Exercise Self-Efficacy.

Children (Basel) 2020 Mar 20;7(3). Epub 2020 Mar 20.

Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, Shenzhen 518061, China.

The purpose of this study was to examine the associations of social support and self-efficacy with physical Activity (PA) and the mediating effect of self-efficacy on the relationship between social support and PA in Chinese adolescents. Participants included a total of 2341 Chinese adolescents (aged 12.75 ± 1.46 years). Self-reported instruments, including the physical activity questionnaire for adolescents, the social support revalued scale and the exercise self-efficacy scale, were used to measure physical activity, social support and exercise self-efficacy. Results showed that social support (r = 0.29, < 0.05) and exercise self-efficacy (r = 0.43, < 0.05) were significant and positive predictors of PA among Chinese adolescents, and exercise self-efficacy was a significant mediator in the relationship between social support and PA (standardized effect size = 0.15, < 0.001). Such findings were evident with similar patterns in both male and female adolescents. The findings of this study have indicated the importance of social support and exercise self-efficacy on PA promotion in adolescents, which will aid the development of effective interventions in this population.
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http://dx.doi.org/10.3390/children7030023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7140834PMC
March 2020

Leucine and isoleucine have similar effects on reducing lipid accumulation, improving insulin sensitivity and increasing the browning of WAT in high-fat diet-induced obese mice.

Food Funct 2020 Mar;11(3):2279-2290

Institute of Animal Nutrition, Northeast Agricultural University, Harbin, 150030, China.

Branched chain amino acids (BCAAs), especially leucine (Leu), have been reported to decrease fat deposition. However, extensive studies have not been conducted to determine whether Leu and isoleucine (Ile) have the same effects in mice fed a high fat diet (HFD). Already obese mice induced by HFD were assigned to the following groups: HFD, HFD + Leu, HFD + Ile, and HFD + Leu + Ile. Chow diet was set as a negative control throughout the study. The results showed that adding Leu, Ile and their combination in drinking water significantly decreased relative white adipose tissue (WAT) weight and serum triglycerides, low-density lipoprotein, free fatty acid, and insulin compared with the HFD control. Insulin sensitivity and hepatic steatosis impaired by HFD were alleviated after Leu or Ile supplementation. Furthermore, lipid metabolism-related genes were modified, and the genes involved in the browning of WAT and beige selective markers were upregulated by dietary supplementation with Leu, Ile and their combination. Intestinal microbiota analysis showed that the ratio of Firmicutes-to-Bacteroidetes was decreased after Leu or Ile treatment. This study indicated that dietary supplementation with Leu or Ile reduced body weight and WAT weight by regulating lipid metabolism-related genes and browning of WAT, providing a new tool in the management of obesity and metabolic disorders.
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http://dx.doi.org/10.1039/c9fo03084kDOI Listing
March 2020

miR-130a alleviates neuronal apoptosis and changes in expression of Bcl-2/Bax and caspase-3 in cerebral infarction rats through PTEN/PI3K/Akt signaling pathway.

Exp Ther Med 2020 Mar 3;19(3):2119-2126. Epub 2020 Jan 3.

Department of Neurology, The Third People's Hospital of Wuxi, Wuxi, Jiangsu 214041, P.R. China.

Effect of micro ribonucleic acid (miR)-130a on neuronal apoptosis in rats with cerebral infarction (CI) was studied to explore whether phosphatase and tensin homolog deleted on chromosome ten (PTEN)/phosphatidylinositol 3-hydroxy kinase (PI3K)/protein kinase B (Akt) is involved in the regulation of neuronal apoptosis. Thirty-six Sprague-Dawley (SD) rats were randomly divided into blank control group, model group and miR-130a low-expression group. miR-130a was determined by quantitative polymerase chain reaction (qPCR), the content of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-10 was detected using the enzyme-linked immunosorbent assay (ELISA) kits, and the neuronal apoptosis level in each group was determined through terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining. The neurobehavioral score was significantly lower in model group than that in blank control group (P<0.01), while it was significantly higher in miR-130a low-expression group than that in model group (P<0.01). Compared with blank control group, the model group had obviously increased content of TNF-α and IL-6 (P<0.01), decreased content of IL-10 (P<0.01), more apoptotic neurons (P<0.01), higher expression of caspase-3 (P<0.01), and obviously lower Bcl-2/Bax (P<0.01). Moreover, expression of phosphorylated (p)-PTEN, PI3K and p-Akt in brain tissues was remarkably lower in the model group than those in the blank control group (P<0.01). The expression level of miR-130a in brain tissues of CI rats is significantly increased. miR-130a promotes the release of inflammatory factors and facilitates neuronal apoptosis through suppressing the PTEN/PI3K/Akt signaling pathway.
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http://dx.doi.org/10.3892/etm.2020.8415DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027342PMC
March 2020

Efficacy and Safety of High Vs Standard Daptomycin Doses Examined in Chinese Patients With Severe Burn Injuries by Pharmacokinetic Evaluation.

J Burn Care Res 2020 05;41(3):705-713

Department of Pharmacy, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.

Previous studies and the concentration-dependent antibacterial actions of daptomycin suggested that a high dose would be needed for difficult-to-treat infections in burn patients. Here, we evaluated the effects of administration of low and high doses of daptomycin in patients with severe burn injuries. The study retrospectively analyzed 10 patients with severe burn injuries, using pharmacokinetic (PK) and pharmacodynamic (PD) evaluations of daptomycin doses given to combat serious infections. Daptomycin was administered as a single dose or by multiple doses intravenously at a standard dose of 6 mg/kg/d or a high dose of 12 mg/kg/d for 7 to 14 days. The serum concentrations of daptomycin from patients were analyzed by liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS). Burn injury patients treated with high-dose daptomycin had a linear PK profile and a negative correlation between the AUC0-24 and Baux score (R2 = .953 and R2 = .801). The Cmax, AUC0-24, and t(h)½ increased significantly compared with patients given a standard dose. The efficacy of daptomycin against Staphylococcus aureus showed significantly higher rates of (AUC0-24)/MIC and Cmax/MIC after high-dose daptomycin compared with the standard dose, reflected in a significant correlation between a high dose and the Baux score (r = .976, P < .001). Positive S. aureus cultures from two of three high-dose and none of two daptomycin low-dose patients converted from positive to negative after therapy. No serious adverse events or discontinuation of the drug occurred during the treatment period. Daptomycin doses up to 12 mg/kg/d were well tolerated in Chinese patients with severe burn injuries, which were complicated by infections with S. aureus.
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http://dx.doi.org/10.1093/jbcr/iraa020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195552PMC
May 2020

[Correlation of cardiovascular risk factors with brain iron deposition: A magnetic resonance imaging study].

Zhejiang Da Xue Xue Bao Yi Xue Ban 2019 Dec;48(6):644-650

Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.

Objective: To study the correlation of common cardiovascular risk factors with brain iron deposition.

Methods: Eighty-four elderly subjects without neurological diseases or brain trauma were included in the study. The cardiovascular risk factors were comprehensively assessed. MRI examination was performed to obtain high-resolution T1-weighted images and enhanced susceptibility weighted angiography (ESWAN) images, and R2 figure was obtained by post-processing the ESWAN sequence. High definition T1 images were segmented using computer segmentation technique. After registration to the ESWAN image, R2 values of each region of interest were extracted. Multiple linear regression analysis was used to analyze the relationship of R2 values in each area of interest with gender, age and vascular risk factors.

Results: Smoking was associated with increased R2 values in the hippocampus, white matter and cortex (=0.244, 0.317, 0.277, <0.05 or <0.01). Hypertension was correlated with the increase of R2 in the putamen (=0.241, =0.027). Hyperglycemia was associated with the increase of R2 in the thalamus (=0.234, <0.05). In the thalamus, the R2 value of males was higher than that of females (=0.320, <0.05). Age was correlated with the R2 values of thalamus, caudate nucleus, pallidus, white matter and cortex (=-0.218、-0.254、0.216、-0.280 and -0.238, <0.05 or <0.01).

Conclusions: Common cardiovascular risk factors may lead to iron deposition in the brain, and the deposition patterns vary with the gender, age and different risk factors.
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December 2019

Satisfaction of family members with inpatient psychiatric care and its correlates: a national survey in China.

BMC Psychiatry 2019 12 30;19(1):427. Epub 2019 Dec 30.

Department of Psychiatry and Behavioral Sciences, Emory University, 12 Executive Park Drive NE, Suite 348, Atlanta, GA, USA.

Background: Measuring family members' satisfaction with inpatient psychiatric care may help improve the quality of healthcare in psychiatric hospitals. This survey aimed to investigate the satisfaction of family members with inpatient psychiatric care and to explore its associated factors, using a newly-developed 5-item questionnaire.

Methods: This study included 1598 family members of psychiatric inpatients in 32 tertiary public psychiatric hospitals in 29 provinces of China. Satisfaction and demographic data were collected by research staff while patient and hospital data were retrieved separately.

Results: We found that the overall satisfaction level was 93.84% (23.46/25). The total satisfaction score in Northeast China was the highest, followed by the East, Middle and West regions (p < 0.001). There was no significant sex difference in total family satisfaction scores. Family members with a lower educational background (elementary school or less) had significantly lower satisfaction. Family members of patients who were diagnosed with schizophrenia were significantly less satisfied with doctor-family communication. In different treatment response subgroups, the marked improvement subgroup had significantly higher total satisfaction scores and subscores. Meanwhile, lower self-payment expenses and a higher number of psychologic treatments offered per day were significantly associated with higher total satisfaction scores and all subscores. Logistic regression showed a higher educational background, more psychologic treatments offered per day, adequacy of professional staffing (higher doctor/bed, nurse/bed and psychologist/bed ratio) were all significantly associated with higher family satisfaction.

Conclusions: We suggest government and hospital managers recruit more mental health professions to improve family satisfaction. If feasible, providing more psychologic treatments to inpatients may also improve families' satisfaction and involvement.
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http://dx.doi.org/10.1186/s12888-019-2362-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937693PMC
December 2019

Downregulated miRNA-324-5p aggravates neuronal injury induced by oxygen-glucose deprivation via modulating RAN.

Exp Ther Med 2020 Jan 27;19(1):658-664. Epub 2019 Nov 27.

Department of Neurology, The Third People's Hospital of Wuxi, Wuxi, Jiangsu 214041, P.R. China.

Differentially expressed miRNAs in the GEO profile of ischemic stroke were analyzed to clarify the specific role of microRNA-324-5p (miRNA-324-5p) in ischemic stroke and the potential mechanism. After screening out miRNA-324-5p, its level in peripheral blood of stroke patients and oxygen-glucose deprivation (OGD)-induced primary rat neurons was determined by quantitative real-time polymerase chain reaction (qRT-PCR). Regulatory effects of miRNA-324-5p on viability, and apoptosis of OGD-induced neurons were evaluated by CCK-8 and Annexin V fluorescein isothiocyanate (FITC)/propidium iodide (PI) staining, respectively. Glucose uptake and caspase-3 activity in OGD-induced neurons transfected with miRNA-324-5p mimics or inhibitor were also examined. The binding of miRNA-324-5p to its target gene RAN was analyzed by dual-luciferase reporter gene assay and western blot analysis. By analyzing the data of GSE46266 profile, miRNA-324-5p expression was shown markedly lower in MCAO rats relative to controls. Identically, we also observed the downregulated miRNA-324-5p in peripheral blood of stroke patients and OGD-induced primary neurons. Overexpression of miRNA-324-5p accelerated viability, induced apoptosis and strengthened glucose uptake ability of OGD-induced neurons. Knockdown of miRNA-324-5p, conversely, obtained the opposite results. Furthermore, we confirmed the binding of miRNA-324-5p to RAN, the target gene that was negatively regulated by miRNA-324-5p. Importantly, RAN overexpression partially reversed the regulatory effect of miRNA-324-5p on viability and glucose uptake of OGD-induced neurons. miRNA-324-5p is downregulated after ischemic stroke, which aggravates the disease condition by inhibiting neuronal proliferation and glucose uptake via upregulating RAN.
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http://dx.doi.org/10.3892/etm.2019.8249DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913269PMC
January 2020

How Perceived Quality of Care Affects Outpatient Satisfaction in China: A Cross-Sectional Study of 136 Tertiary Hospitals.

Inquiry 2019 Jan-Dec;56:46958019895397

Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China.

Public hospitals are integral components of China's health care system, and improving quality of care and patient satisfaction has become of greater concern for these hospitals. The aim of this study was to assess outpatient satisfaction with tertiary hospitals and to explore the roles played by patient perceptions of specific aspects of care in overall satisfaction. We designed a questionnaire to assess patient satisfaction and perceived quality of care using a 5-point Likert scale. The survey was conducted in 136 hospitals across 31 provinces of China, and a total of 28 822 patients were interviewed. For statistical analysis, we conducted descriptive analysis, nonparameter tests, Spearman's rank correlation, and multivariate logistic regression. Stepwise logistic regression identified 12 variables of patient perception associated with overall satisfaction. Patients' perception of physicians' technical skills had the strongest association with satisfaction, followed by inquiries into medical history/current situation and availability of elevators. Other determinants included a feeling of respect, timely guidance when needed, and explanation of treatments and medications. Waiting times and hospital environment factors, such as cleanliness of bathrooms and drinking water supply, were also associated with patient satisfaction in a slightly less powerful way. This study revealed that Chinese outpatient satisfaction with tertiary hospitals was relatively high. As determinants of satisfaction, patients valued professional medical care and respect from the medical staff more than nonmedical aspects of care. This implied that Chinese hospitals should ensure quality of medical care and sufficient communication with patients, as well as pay more attention to humanism in health care. In the meantime, improvements should be made to nonmedical aspects of care, especially waiting times and physical environment. These findings are also useful for the rest of the low- and middle-income world in improving patient satisfaction.
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http://dx.doi.org/10.1177/0046958019895397DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937535PMC
June 2020

Influence of patient and hospital characteristics on inpatient satisfaction in China's tertiary hospitals: A cross-sectional study.

Health Expect 2020 02 22;23(1):115-124. Epub 2019 Oct 22.

School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

Background: Patient satisfaction has been seen as a key criterion when evaluating hospitals and is one of the main focuses of the current health-care reform in China. This paper aimed to explore patient- and hospital-level factors associated with inpatient satisfaction, which can provide policy implications for the evaluation and development of a patient-oriented health-care system.

Methods: The paper analyses data from the 2017 China National Patient Survey which includes 20 300 inpatients from 131 tertiary hospitals across 31 provinces. Descriptive analysis and multivariable logistic regressions are conducted to identify key factors related to satisfaction.

Results: Patient sociodemographic characteristics, including gender, age, income and insurance type, are found to be strongly associated with their satisfaction of inpatient experience. In terms of institutional characteristics, hospital type, size, staffing and financial performance are also significantly correlated with inpatient satisfaction. Patients are more satisfied with specialist hospitals and large hospitals measured by the number of beds and surgeries. Hospitals with higher nurse-to-bed ratio also receive more satisfaction. The financial performance of hospitals, however, is negatively associated with satisfaction.

Conclusion: Patient satisfaction contains unique information on service quality and thus should be incorporated into the matrix of hospital evaluation. Meanwhile, differences in patient composition must be adjusted to make fair comparisons across hospitals. Moreover, future reform needs to put greater efforts in the design of comprehensive public insurance scheme, efficient hospital structure and an overall well-functioning health-care delivery system in order to better serve patients in China.
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http://dx.doi.org/10.1111/hex.12974DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6978851PMC
February 2020

Job satisfaction and associated factors among psychiatric nurses in tertiary psychiatric hospitals: Results from a nationwide cross-sectional study.

J Adv Nurs 2019 Dec 6;75(12):3619-3630. Epub 2019 Nov 6.

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.

Aims: To investigate the job satisfaction among psychiatric nurses in China and to explore its associated factors.

Design: A cross-sectional survey among a nationwide sample from 32 tertiary psychiatric hospitals in 29 provincial capitals in China.

Methods: Nurses (N = 9.907) were targeted for this survey in December 2017. In all, 8,493 responded (response rate = 85.7%) and 7,881 (79.5%) were included in the analysis. An online questionnaire was used to collect demographics and factors related to the work environment. The short version of the Minnesota Satisfaction Questionnaire was used to assess job satisfaction. Multilevel regression was used to examine the association between job satisfaction and these factors.

Results: The mean job satisfaction score was 73.7. The multiple regression analysis indicated that self-rated health, monthly income, medical liability insurance coverage, perceived respect from patients, social recognition, nurse-physician collaboration, and trust were significantly associated with higher job satisfaction scores, while age, work hours, and directly experiencing patient-initiated violence were negatively associated with job satisfaction (p < .05).

Conclusion: Overall, Chinese psychiatric nurses are closer to satisfied than neutral and some demographics and factors related to stressful work environments were associated with nurses' job satisfaction scores.

Impact: This study examined factors associated with the job satisfaction of Chinese psychiatric nurses in a nationwide sample and indicated that to improve nurses' job satisfaction, the government and hospital administrators could consider ways to promote nurses' personal health and to modify the stressful work environments, such as improving income, reducing work hours, promoting the psychiatric nursing specialty in ways that increase the public's respect for it, increasing awareness of medical liability insurance coverage, and protecting nurses from patients' violence.
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http://dx.doi.org/10.1111/jan.14202DOI Listing
December 2019

Outpatient Satisfaction with Tertiary Hospitals in China: The Role of Sociodemographic Characteristics.

Int J Environ Res Public Health 2019 09 20;16(19). Epub 2019 Sep 20.

School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing 100730, China.

China's increasing attention to patient satisfaction evaluation is part of an international trend of patient-centered healthcare. Patient sociodemographic characteristics are important intrinsic factors that will influence satisfaction. This paper aims to better understand how sociodemographic factors affect Chinese patient satisfaction with tertiary outpatient services using data from the 2017 China National Patient Survey. A total of 28,760 outpatient survey responses were analyzed, spanning 136 tertiary hospitals across 31 provinces. Multilevel logistic regression with fixed hospital effects was used to examine the association of patient satisfaction across multiple healthcare domains with sociodemographic factors. Results show that patients who were of a migrant population, of highest income, most educated, and who had medical aid insurance reported the lowest levels of overall satisfaction. Specifically, increasing age was correlated with decreased satisfaction in process management and affordability domains, while high-income and high-education outpatients reported lower satisfaction scores in the hospital environment domain. Furthermore, migrant patients experienced lower satisfaction across several domains. These intricate findings suggest that hospitals should tailor their services and evaluation metrics to specific patient demographics, and that the government should adopt policies that reduce disparities in healthcare access and affordability to ultimately improve the satisfaction of vulnerable groups.
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http://dx.doi.org/10.3390/ijerph16193518DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801474PMC
September 2019

Patient experience of hospital care in China: major findings from the Chinese Patient Experience Questionnaire Survey (2016-2018).

BMJ Open 2019 09 20;9(9):e031615. Epub 2019 Sep 20.

School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Objectives: China launched the National Healthcare Improvement Initiative (NHII) in 2015 to improve patient experiences in healthcare. This study aimed to generate evidence of hospital care quality from the patients' perspective.

Design: This nationwide cross-sectional study interviewed participants from 31 provinces, municipalities and autonomous regions across China.

Setting: A total of 117 tertiary hospitals in mainland China.

Participants: 48 422 responses from outpatients and 35 957 responses from inpatients were included in this study.

Primary Outcome Measure: The scores of six predefined domains in the Chinese Patient Experience Questionnaire, five of which were designed to reflect specific dimensions of care, and one of which indicated the overall rating.

Results: More than 80% of the respondents viewed their care experiences as positive. The NHII seems to have had a positive impact, as indicated by the steady, although unremarkable, increase in the patient experience scores over the 2016-2018 period. The Chinese patients generally reported a positive experience with the clinical aspects of care, but reported a less positive experience with the environmental, interpersonal and social services aspects of care. The institutional factors, including region and type of hospital, and personal factors, such as gender, age, education and occupation, were factors affecting the patient experience in China. Humanistic care was the aspect of care with the greatest association with the overall patient experience rating in both the outpatient and inpatient settings.

Conclusions: The national survey indicated an overall positive patient perspective of care in China. Older age, higher education level and formal employment status were found to be correlated with positive care experiences, as were higher levels of economic development of the region, a more generous insurance benefits package and a higher degree of coordinated care. The interpersonal-related initiatives had substantial roles in the improvement of the patient experience. In the regions where farmers and users of traditional Chinese medicine services constitute a greater proportion of the population, improvement of patient experiences for these groups deserves special policy attention.
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http://dx.doi.org/10.1136/bmjopen-2019-031615DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6756435PMC
September 2019

Correlations of P-selectin and E-selectin gene polymorphisms with preeclampsia.

Panminerva Med 2021 Mar 8;63(1):93-94. Epub 2019 Jul 8.

Department of Gynecology and Obstetrics, Fujian Medical University 2nd Affiliated Hospital, Quanzhou, China.

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http://dx.doi.org/10.23736/S0031-0808.19.03672-3DOI Listing
March 2021
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