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Surgical resection, the mainstay for melanoma treatment, faces challenges due to high tumor recurrence rates and complex postoperative wound healing. Chronic inflammation from residual disease and the risk of secondary infections impede healing. We introduce an innovative, injectable hydrogel system that integrates a multifaceted therapeutic approach. The hydrogel, crosslinked by calcium ions with sodium alginate, encapsulates a blood clot rich in dendritic cells (DCs) chemoattractants and melanoma cell-derived nanovesicles (NVs), functioning as a potent immunostimulant. This in situ recruitment strategy overcomes the limitations of subcutaneous tumor vaccine injections and more effectively achieves antitumor immunity. Additionally, the hydrogel incorporates Chlorella extracts, enhancing its antimicrobial properties to prevent wound infections and promote healing. One of the key findings of our research is the dual functionality of Chlorella extracts; they not only expedite the healing process of infected wounds but also increase the hydrogel's ability to stimulate an antitumor immune response. Given the patient-specific nature of the blood clot and NVs, our hydrogel system offers customizable solutions for individual postoperative requirements. This personalized approach is highlighted by our study, which demonstrates the synergistic impact of the composite hydrogel on preventing melanoma recurrence and hastening wound healing, potentially transforming postsurgical melanoma management.

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The presence of aluminum (Al3+) and fluoride (F-) ions in the environment can be harmful to ecosystems and human health, highlighting the need for accurate and efficient monitoring. In this paper, an innovative approach is presented that leverages the power of machine learning to enhance the accuracy and efficiency of fluorescence-based detection for sequential quantitative analysis of aluminum (Al3+) and fluoride (F-) ions in aqueous solutions. The proposed method involves the synthesis of sulfur-functionalized carbon dots (C-dots) as fluorescence probes, with fluorescence enhancement upon interaction with Al3+ ions, achieving a detection limit of 4.2 nmol/L. Subsequently, in the presence of F- ions, fluorescence is quenched, with a detection limit of 47.6 nmol/L. The fingerprints of fluorescence images are extracted using a cross-platform computer vision library in Python, followed by data preprocessing. Subsequently, the fingerprint data is subjected to cluster analysis using the K-means model from machine learning, and the average Silhouette Coefficient indicates excellent model performance. Finally, a regression analysis based on the principal component analysis method is employed to achieve more precise quantitative analysis of aluminum and fluoride ions. The results demonstrate that the developed model excels in terms of accuracy and sensitivity. This groundbreaking model not only showcases exceptional performance but also addresses the urgent need for effective environmental monitoring and risk assessment, making it a valuable tool for safeguarding our ecosystems and public health.

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JOURNAL/nrgr/04.03/01300535-202501000-00031/figure1/v/2024-05-14T021156Z/r/image-tiff Early identification and treatment of stroke can greatly improve patient outcomes and quality of life. Although clinical tests such as the Cincinnati Pre-hospital Stroke Scale (CPSS) and the Face Arm Speech Test (FAST) are commonly used for stroke screening, accurate administration is dependent on specialized training. In this study, we proposed a novel multimodal deep learning approach, based on the FAST, for assessing suspected stroke patients exhibiting symptoms such as limb weakness, facial paresis, and speech disorders in acute settings. We collected a dataset comprising videos and audio recordings of emergency room patients performing designated limb movements, facial expressions, and speech tests based on the FAST. We compared the constructed deep learning model, which was designed to process multi-modal datasets, with six prior models that achieved good action classification performance, including the I3D, SlowFast, X3D, TPN, TimeSformer, and MViT. We found that the findings of our deep learning model had a higher clinical value compared with the other approaches. Moreover, the multi-modal model outperformed its single-module variants, highlighting the benefit of utilizing multiple types of patient data, such as action videos and speech audio. These results indicate that a multi-modal deep learning model combined with the FAST could greatly improve the accuracy and sensitivity of early stroke identification of stroke, thus providing a practical and powerful tool for assessing stroke patients in an emergency clinical setting.

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Ozone (O3) pollution has become a noticeable problem in the Chengdu-Chongqing Economic Circle in China. The April-September MDA8 O3 level increases significantly by 2.26 µg m-3 year-1 from 2015 to 2023, with meteorological factors occupying merely 18 % in line with multivariate linear regression. To reveal the impact of anthropogenic emissions on O3 increase, O3 production sensitivity is accurately diagnosed by deriving localized thresholds for satellite formaldehyde (HCHO) to NO2 ratio and validated by in-situ measurements and observation-based model. Tracking volatile organic compounds (VOCs) and NOx through satellite HCHO and NO2, the O3 responses to precursor changes are assessed for long-term and special cases, and appropriate precursor reduction ratios are inferred. The results present that the transition range of satellite HCHO/NO2 from VOC-limited to NOx-limited in the region ranges from 2.7 to 4.3. The VOC-limited regime is concentrated in the urban areas of Chongqing and Chengdu as well as the central of the neighboring cities such as Deyang, Mianyang, and Meishan. The relative incremental reactivity from in-situ observations and box model at three sites in August 2019 demonstrates that O3 is most sensitive to anthropogenic VOC at urban and suburban sites, consistent with satellite results. Satellite and surface NO2 decrease at an annual rate of -2.1 % and - 2.9 % between 2015 and 2023, with larger decreases in Chengdu and Chongqing. In contrast, the trend of satellite HCHO is insignificant, indicating effective reduction in NOx but no significant reduction in VOC. This inappropriate reduction results in an increase in urban O3. The three short-term cases further validate the need for synergistic NOx and VOC reductions. Based on the relationship between O3 and satellite NO2 and HCHO, the minimum and optimal reduction ratios of VOC to NOx are 0.4:1 and 2.4:1 for the entire region, with higher ratios in Chengdu and Chongqing.

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Tooth cracks, one of the most common dental diseases, can result in the tooth falling apart without prompt treatment; dentists also have difficulty locating cracks, even with X-ray imaging. Indocyanine green (ICG) assisted near-infrared fluorescence (NIRF) dental imaging technique can solve this problem due to the deep penetration of NIR light and the excellent fluorescence characteristics of ICG. This study extracted 593 human cracked tooth images and 601 non-cracked tooth images from NIR imaging videos. Multiple imaging analysis methods such as classification, object detection, and super-resolution were applied to the dataset for cracked image analysis. Our results showed that machine learning methods could help analyze tooth crack efficiently: the tooth images with cracks and without cracks could be well classified with the pre-trained residual network and squeezenet1_1 models, with a classification accuracy of 88.2% and 94.25%, respectively; the single shot multi-box detector (SSD) was able to recognize cracks, even if the input image was at a different size from the original cracked image; the super-resolution (SR) model, SR-generative adversarial network demonstrated enhanced resolution of crack images using high-resolution concrete crack images as the training dataset. Overall, deep learning model-assisted human crack analysis improves crack identification; the combination of our NIR dental imaging system and deep learning models has the potential to assist dentists in crack diagnosis.

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Determining the contaminants reduction rate by dissolved ferrous iron (Fe(II)aq) bound to iron oxides is curial for evaluating the abiotic attenuation of contaminants in aquifers. However, few studies have assessed the contaminants reduction rate controlled by thermodynamic parameters in heterogeneous systems with different iron oxides. In this study, a linear free energy relationship (LFER) was established between the nitrobenzene reduction rate and the thermodynamic driving force (reduction potential (EH) and pH) in Fe(II)aq-goethite-hematite co-existing systems. Results showed that the reduction rate of nitrobenzene correlated with the EH of the heterogeneous system. The standard reduction potential (EH0mix) of the mixed iron oxides could be obtained by a proportionate linear combination of the single iron oxide system EH0. Based on this, the EH of the heterogeneous systems could be calculated theoretically by combining EH0mix and the Nernst equation. Furthermore, a parallel LFER with the slope of 1 was established to associate the nitrobenzene reduction rate with EH and pH. The intercept term was related to the adsorption capacity of different iron oxides towards Fe(II)aq. The Fe(II)aq saturation adsorption capacity of hematite was 1.5 times higher than that of goethite. After normalizing the nitrobenzene reduction rate to the Fe(II)aq saturation adsorption capacity, the maximum difference in intercept terms was reduced from 37% to 15%. These findings would provide an important and feasible methodological support for the quantitative evaluation of abiotic attenuation of contaminants in groundwater.

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Desert rodent communities spread plant seeds through the group effect of "selection complementation" and "fate complementation," which promotes the recovery of plant populations and the reconstruction of plant communities in desert areas.

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Introducing nanotwins in thermoelectric materials represents a promising approach to achieving such a synergistic combination of thermoelectric properties and mechanical properties. By increasing configurational entropy, a sharply reduced stacking fault energy in a new nanotwinned high-entropy semiconductor AgMnGePbSbTe5 is reached. Dense coherent nanotwin boundaries in this system provide an efficient phonon scattering barrier, leading to a high figure of merit ZT of ≈2.46 at 750 K and a high average ZT of ≈1.54 (300-823 K) with the presence of Ag2Te nanoprecipitate in the sample. More importantly, owing to the dislocation pinning caused by coherent nanotwin boundaries and the chemical short-range disorder caused by the high configurational entropy effect, AgMnGePbSbTe5 also exhibits robust mechanical properties, with flexural strength of 82 MPa and Vickers hardness of 210 HV.

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Unimolecular micelles (UMs) are nano-sized structures that are composed of single molecules with precise composition. Compared to self-assembled polymeric micelles, UMs possess ultra-stable property even in complex biological environment. With the development of controllable polymerization and coupling chemistry, the preparation of narrowly monodispersed UMs with precise morphology and size has been realized, which further facilitates their multifunctional applications. After brief introduction, state-of-the-art advances in the synthesis and applications of UMs are discussed with an emphasis on their bioapplications. It is believed that these UMs have great potential in future fabrication of multifunctional nanoplatforms.

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With an electron-deficient rigid planar structure and excellent π-π stacking ability, hexaazatriphenylene (HAT) and its derivatives are widely used as basic building blocks for constructing covalent organic frameworks (COFs), components of organic light-emitting diodes and solar cells, and electrode materials for lithium-ion batteries (LIBs). Here, a HAT derivative, hexaazatriphenylenehexacarbonitrile, is explored as an anode material for LIBs. The HAT anode exhibited high initial reversible capacities of 672 mA h g-1 at 100 mA g-1 and 550 mA h g-1 at 400 mA g-1 and stable cycling with a capacity of 503 mA h g-1 after 1000 cycles at 400 mA g-1 corresponding to a capacity retention of 91.5%. Furthermore, the lithium storage mechanism and the cause of the first irreversible capacity loss of the HAT anode were investigated by X-ray photoelectron spectroscopy (XPS) analysis and density functional theory (DFT) calculations. We have carried out a series of analyses on the mechanism of initial capacity loss. This study provides new insight on initial capacity loss and provides valuable insights into the molecular design and the electrochemical properties of HAT-based anode materials.

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Aiming for clarifying the potential distribution characteristics of canopy rainfall partitioning of the loess area, we explored the process of rainfall partitioning across eight typical forest stands (Pinus tabuliformis forest, Robinia pseudoacacia forest, Platycladus orientalis forest, mixed forest of Robinia pseudoacacia-Pinus tabuliformis, mixed forest of Platycladus orientalis-Robinia pseudoacacia, Quercus wutaishanica forest, Populus davidiana forest, mixed forest of Quercus wutaishanica-Populus davidiana), and used boosted regression trees (BRT) to quantify the relative influences of stand structures and meteorological environment factors. We established multiple regression relationships according to the most influential factors extracted by BRT, and applied to the dataset of mining to verify the performance of the BRT-derived predictive model. The results showed that the percentages of throughfall (TF), stemflow (SF), and canopy interception (Ic) in total precipitation were 24.5%-95.1%, 0-13.6%, and 0.7%-55.7% among eight typical forest stands, respectively. For the individual rainfall threshold of TF, coniferous forest (3.06±1.21 mm) was significantly higher than broad-leaved forest (1.97±0.52 mm), but there was no significant difference between coniferous forest and broad-leaved mixed forest (3.01±0.98 mm). There was no significant difference in the individual rainfall threshold of SF among different composition stands. BRT analysis showed that stand structure factors accounted for a relatively small proportion for TF and SF, respectively. By contrast, stand structure factors dominated the Ic. Rainfall was the most important factor in determining TF and SF. Tree height was the most important factor in determining Ic, followed by rainfall, canopy area, diameter at breast height, and stand density. Compared with the general linear function and the power function, the prediction effect of BRT prediction model constructed here on TF and SF had been further improved, and the prediction of canopy interception still needed to explore. In conclusion, the BRT model could better quantitatively evaluate the effects of stand structure and meteorological environmental factors on rainfall partitioning components, and the performance of the BRT predictive model could satisfy and lay the foundation for the optimization strategy for stand configuration.

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Chelidonium majus L. (C. majus), commonly known as "Bai Qu Cai" in China, belongs to the genus Chelidonium of the Papaveraceae family. It has rich medicinal value, such as alleviating coughs, asthma, spasms and pain. Recent studies have demonstrated that C. majus is abundant in various alkaloids, which are the primary components of C. majus and have a range of pharmacological effects, including anti-microbial, anti-inflammatory, anti-viral, and anti-tumor effects. So far, 94 alkaloids have been isolated from C. majus, including benzophenanthridine, protoberberine, aporphine, protopine and other types of alkaloids. This paper aims to review the research progress in phytochemistry, pharmacology and toxicology of C. majus alkaloids, in order to provide a theoretical basis for the application of C. majus in the field of medicinal chemistry and to afford reference for further research and development efforts.

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BACKGROUND: Intracranial artery stenosis (ICAS) and cerebral small vessel disease (CSVD) are associated with a heavy socioeconomic burden; however, their longitudinal changes remain controversial. METHODS: We conducted a longitudinal analysis on 756 participants of Shunyi Cohort who underwent both baseline and follow-up brain magnetic resonance imaging (MRI) and MR angiography in order to investigate the risk factors for ICAS and CSVD progression in community population. Incident ICAS was defined as new stenosis occurring in at least one artery or increased severity of the original artery stenosis. CSVD markers included lacunes, cerebral microbleeds (CMB), and white matter hyperintensities (WMH). RESULTS: After 5.58 ± 0.49 years of follow-up, 8.5% of the 756 participants (53.7 ± 8.0 years old, 65.1% women) had incident ICAS. Body mass index (BMI) (OR = 1.09, 95% CI = 1.01-1.17, p = 0.035) and diabetes mellitus (OR = 2.67, 95% CI = 1.44-4.93, p = 0.002) were independent risk factors for incident ICAS. Hypertension was an independent risk factor for incident lacunes (OR = 2.12, 95% CI = 1.20-3.77, p = 0.010) and CMB (OR = 2.32, 95% CI = 1.22-4.41, p = 0.011), while WMH progression was primarily affected by BMI (ß = 0.108, SE = 0.006, p = 0.002). A higher LDL cholesterol level was found to independently protect against WMH progression (ß = -0.076, SE = 0.027, p = 0.019). CONCLUSIONS: Modifiable risk factor profiles exhibit different in patients with ICAS and CSVD progression. Controlling BMI and diabetes mellitus may help to prevent incident ICAS, and antihypertensive therapy may conduce to mitigate lacunes and CMB progression. LDL cholesterol may play an inverse role in large arteries and small vessels.

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PURPOSE: This study aimed to develop a Quality of Life (QOL) assessment scale for older patients with Neuro-co-Cardiological Diseases (NCCD) and to evaluate the reliability and validity of the scale. METHOD: The study participants were derived from the Elderly Individuals with NCCD Registered Cohort Study (EINCCDRCS), a multicenter registry of patients with NCCD. The preliminary testing of the questionnaire was conducted among 10 older individuals aged 65 years and older who had NCCD and were recruited from the registry. Other patients who met the inclusion criteria participated in the field testing. After verifying the unidimensionality, local independence, and monotonicity assumptions of the scale, we employed the Rasch model within Item Response Theory framework to assess the quality of the scale through methods including internal consistency, criterion validity, Wright map, and item functioning differential. Subsequently, we assessed the construct validity of the scale by combining exploratory factor analysis with confirmatory factor analysis. RESULTS: Based on well-validated scales such as the short-form WHOQOL-OLD, HeartQOL, IQCODE, and SF-36, an original Neuro-co-Cardiological Diseases Quality of Life scale (NCCDQOL) was developed. 196 individuals from the EINCCDRCS were included in the study, with 10 participating in the preliminary testing and 186 in the field testing. Based on the results of the preliminary testing, the original questionnaire was refined through item deletion and adjustment, resulting in an 11-item NCCDQOL questionnaire. The Rasch analysis of the field testing data led to the removal of 21 misfitting individuals. The NCCDQOL demonstrated a four-category structure, achieved by combining two response categories. This structure aligned with the assumptions of unidimensionality, local independence, and monotonicity. The NCCDQOL also exhibited good validity and reliability. CONCLUSION: The revised NCCDQOL questionnaire demonstrated good reliability and validity in the Rasch model, indicating promising potential for clinical application.

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Polyoxometalates (POMs) are a class of anionic metal-oxygen clusters with versatile biological activities. Over the past decade, an increasing number of POMs, especially Sb-rich POMs, have been proven to exert antitumor activity. However, the antitumor effects and mechanisms of POMs in the treatment of non-small cell lung cancer (NSCLC) remain largely unexplored. This study employed a Sb-rich {Sb21Tb7W56} POM (POM-1) for NSCLC therapy and investigated its mechanism of action. Our results demonstrated that POM-1 exhibited cytotoxicity against H1299 and A549 cells with IC50 values of 3.245 µM and 3.591 µM, respectively. The migration and invasion were also inhibited by 28.05% and 76.18% in H1299 cells, as well as 36.88% and 36.98% in A549 cells at a concentration of 5 µM. In a tumor xenograft mouse model, POM-1 suppressed tumor growth by 76.92% and 84.62% at doses of 25 and 50 mg kg-1, respectively. Transcriptomic analysis indicated the alteration of ferroptosis and apoptosis signaling pathways in POM-treated NSCLC cells. Subsequent experimentation confirmed the induction of ferroptosis, evidenced by 5.6-fold elevated lipid peroxide levels with treatment of 5 µM POM-1, alongside increased expression of ferroptosis-associated proteins. Additionally, the apoptosis induced by POM-1 was also validated by the 19.67% and 30.1% increase in apoptotic cells in H1299 and A549 cells treated with 5 µM POM-1, respectively, as well as the upregulated activation of caspase-3. In summary, this study reveals, for the first time, ferroptosis as the antitumor mechanism of Sb-rich POM, and that synergism with ferroptosis and apoptosis is a highly potent antitumor strategy for POM-based antitumor therapy.

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This study investigated the impact of packaging methods coupled with high barrier packaging loaded with titanium dioxide (TiO2) on the quality of chilled pork. The experiment consisted of three treatment groups: air packaging (AP), vacuum packaging (VP), and vacuum antibacterial packaging (VAP). Changes in total viable count (TVC), pH value, total volatile basic nitrogen (TVB-N) value, sensory attributes, and water holding capacity of pork were analyzed at 0, 3, 6, 9, and 12 d. TVC of the VAP group was 5.85 Log CFU/g at 12 d, which was lower than that of AP (6.95 Log CFU/g) and VP (5.93 Log CFU/g). The antibacterial film incorporating TiO2 effectively inhibited microorganism growth. The VAP group exhibited the lowest pH value and TVB-N value among all the treatment groups at this time. The findings demonstrated that the application of VAP effectively preserved the sensory attributes of pork, the hardness, cohesiveness and adhesiveness of pork in VAP group were significantly superior than those in AP group (p<0.05), but not significantly compared with VP group. On the 12 d, the CIE a* value of pork in VAP group was significantly higher (p<0.05). This exhibited that VAP could effectively maintain the freshness of chilled pork and extend the shelf life for 3 d compared to the AP group. These findings provide empirical evidence to support the practical implementation of TiO2-loaded packaging film in the food industry.

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BACKGROUND: Sitravatinib is a spectrum-selective tyrosine kinase inhibitor targeting TAM (TYRO3, AXL, MER), VEGFR-2, KIT, and MET. SAFFRON-104 (NCT03941873) was a multicohort phase Ib/II study investigating sitravatinib with/without tislelizumab, an anti-programmed cell death protein 1 (PD-1) antibody, in patients with advanced hepatocellular carcinoma (HCC) or gastric cancer/gastroesophageal junction cancer (GC/GEJC). METHODS: Eligible patients had histologically/cytologically confirmed advanced HCC or GC/GEJC. Phase I determined the recommended phase II dose (RP2D) of sitravatinib with/without tislelizumab. Phase II evaluated sitravatinib monotherapy in patients with pretreated HCC, and sitravatinib plus tislelizumab in anti-PD-(L)1-naïve or -treated HCC and anti-PD-(L)1-naïve GC/GEJC. Primary endpoints were safety/tolerability (phase I) and objective response rate (ORR) (phase II). RESULTS: At data cutoff (March 31, 2023), 111 patients were enrolled; 102 were efficacy-evaluable (median study follow-up 9.1 months [range: 0.7-36.9]). The RP2D of sitravatinib was determined as 120 mg orally once daily. In patients receiving sitravatinib monotherapy and sitravatinib in combination with tislelizumab, grade ≥ 3 treatment-related adverse events occurred in 14 (51.9%) and 42 (50.0%) patients, respectively. The ORR was 25% (95% confidence interval [CI]: 8.7-49.1) in patients with pretreated HCC receiving sitravatinib monotherapy. In patients receiving sitravatinib with tislelizumab, the ORR was 11.5% (95% CI 2.4-30.2) with anti-PD-(L)1-naïve HCC, 9.5% (95% CI 1.2-30.4) with anti-PD-(L)1-treated HCC, and 16.1% (95% CI 5.5-33.7) in patients with anti-PD-(L)1-naïve GC/GEJC. CONCLUSIONS: Sitravatinib with/without tislelizumab was generally well tolerated and showed preliminary antitumor activity in patients with advanced HCC and GC/GEJC.

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Molecular ferroelectrics have garnered significant attention due to their structural tunability, low synthesis temperature, and high flexibility. Herein, we successfully synthesized imidazole perchlorate (ImClO4) single crystals and high-quality, highly-oriented thin films on Si substrates. These films demonstrated a high inverse piezoelectric coefficient of 55.7 pm/V. Two types of domain bands were observed: type-I bands tilted ~60° relative to the horizontal axis, and type-II bands positioned perpendicular to the horizontal axis. Under a + 20 V bias, type-I bands showed a reduction and detachment of 180° domain walls to form a needle-like domain. It extended toward the band boundary after applying -20 V bias, which grew along the boundary upon contact. In contrast, type-II bands showed straight domain wall motion and displayed a higher piezoresponse than type-I bands. The growth of  high quality molecular ferroelectric thin films on Si substrates paves the way for the development of on-chip devices.

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BACKGROUND: Catheter-associated urinary tract infection (CAUTI) remains the most significant challenge among hospital-acquired infections (HAIs), yet still unresolved. The present study aims to evaluate the preventive effectiveness of JUC Spray Dressing (name of U.S. FDA and CE certifications, while the medical device name in China is Long-acting Antimicrobial Material) alone for CAUTI without combining with antibiotics and to evaluate the impact of bacterial biofilm formation on CAUTI results on the inserted catheters of patients. METHODS: In this multicenter, randomized, double-blind study, we enrolled adults who suffered from acute urinary retention (AUR) and required catheterization in 6 hospitals in China. Participants were randomly allocated 1:1 according to a random number table to receive JUC Spray Dressing (JUC group) or normal saline (placebo group). The catheters were pretreated with JUC Spray Dressing or normal saline respectively before catheterization. Urine samples and catheter samples were collected after catheterization by trial staff for further investigation. RESULTS: From April 2012 to April 2020, we enrolled 264 patients and randomly assigned them to the JUC group (n = 132) and the placebo group (n = 132). Clinical symptoms and urine bacterial cultures showed the incidence of CAUTI of the JUC group was significantly lower than the placebo group (P < 0.01). In addition, another 30 patients were enrolled to evaluate the biofilm formation on catheters after catheter insertion in the patients' urethra (10 groups, 3 each). The results of scanning electron microscopy (SEM) showed that bacterial biofilm formed on the 5th day in the placebo group, while no bacterial biofilm formed on the 5th day in the JUC group. In addition, no adverse reactions were reported using JUC Spray Dressing. CONCLUSION: Continued indwelling urinary catheters for 5 days resulted in bacterial biofilm formation, and pretreatment of urethral catheters with JUC Spray Dressing can prevent bacterial biofilm formation by forming a physical antimicrobial film, and significantly reduce the incidence of CAUTI. This is the first report of a study on inhibiting bacterial biofilm formation on the catheters in CAUTI patients.

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Objective: This paper utilizes data from the China Family Panel Studies (CFPS) to evaluate the impact of the "4 + 7" National Centralized Drug Procurement (NCDP) on Per Capita Household Health Care Expenditure (PCHHCE). Methods: The study applies the Differences-in-Differences (DID) methodology to analyze the effects of NCDP. Various robustness tests were conducted, including the Permutation test, Propensity Score Matching, alterations in regression methodologies, and consideration of individual fixed effects. Results: Research indicates that the implementation of NCDP led to a reduction of 10.6% in PCHHCE. The results remained consistent across all robustness tests. Additionally, the research identifies diversity in NCDP effects among various household characteristics, with a more significant impact on households residing in rural regions of China, enrolled in Basic Medical Insurance for urban and rural residents and urban workers, and having an income bracket of 25-75%. Conclusion: These findings carry policy implications for the future expansion and advancement of NCDP in China. The study highlights the effectiveness of NCDP in reducing healthcare expenditures and suggests potential areas for policy improvement and further research.

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