RESUMEN
The need for equitable access to primary healthcare services in the current global context has attracted widespread attention, prompting nations to continuously enhance their grassroots medical service levels. In response, China launched the "Healthy China" initiative, which prioritizes the enhancement of national health as a core goal of the healthcare system and uses this opportunity to deepen reforms aimed at strengthening primary care. However, in remote and rural areas, the optimization of medical resource allocation and the achievement of balanced service development remain critical challenges owing to limited resources. This study selected Liannan Yao Autonomous County, which is situated in the northwestern corner of Guangdong Province, as a case study due to its remote mountainous location, underdeveloped economy, and minority region characteristics. Through field research and interviews, this study thoroughly explored the needs of both supply and demand, factoring in elements such as the service capability of healthcare facilities and residents' travel thresholds to enhance the two-step floating catchment area model, thus making it more applicable to remote villages. By integrating electric bikes and cars, which are the primary means of transportation in rural areas, this study conducted a thorough analysis and comparison of the accessibility of medical services in Liannan Yao Autonomous County (Liannan County) . The results reveal significant disparities in healthcare accessibility, an uneven distribution of medical resources, and varying impacts of transportation conditions and facility service capabilities on accessibility. Notably, the study revealed that improving transportation conditions alone has limited effects in rural areas; the key lies in balancing medical service capabilities and the rationality of overall layouts. From the perspectives of equity and efficiency, this study employs the equitable coverage model and the efficiency-driven model to construct two scenarios, comparing accessibility changes in Liannan County under both conditions and proposing strategies to improve the spatial layout of local healthcare facilities. This research not only deepens the understanding of healthcare service accessibility in rural areas but also provides a scientific basis for optimizing resource allocation and enhancing primary medical services, offering valuable guidance and reference for Liannan County and other similar rural regions.
Asunto(s)
Accesibilidad a los Servicios de Salud , Atención Primaria de Salud , Servicios de Salud Rural , China , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/organización & administración , Atención Primaria de Salud/organización & administración , Humanos , Servicios de Salud Rural/organización & administración , Servicios de Salud Rural/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Estudios de Casos OrganizacionalesRESUMEN
The slow onset of traditional antidepressants has become an urgent clinical issue, researchers are constantly exploring new antidepressants with prompt action. Previous studies have found that zinc levels were decreased in serum and brain of depressed patients or animal models. Zinc treatment can improve depressive symptoms and enhance the antidepressant effects of monoamine antidepressants. However, its mechanism of action is still unclear. This present study aims to investigate whether the zinc can enhance the rapid action of traditional antidepressant imipramine and to explore the potential mechanisms of action through the rapid antidepressant targets CREB (cAMP-response element binding protein) and mTOR (mammalian target of the rapamycin). Drug treatment included intraperitoneal injection of imipramine or zinc alone and imipramine plus zinc. Zinc had a rapid enhanced antidepressive effect on the imipramine and achieved a rapid antidepressant effect similar to ketamine. Combination of zinc with imipramine rapidly enhanced the phosphorylation of mTOR Ser2448 and CREB Ser133, and increased the expression of mTOR and CREB, which were dependent on the activation of PKA. In conclusion, combination therapy with zinc and monoamine antidepressants may overcome the problem of slow-onset action of traditional antidepressants in clinical uses.
Asunto(s)
Antidepresivos/uso terapéutico , Proteínas Quinasas Dependientes de AMP Cíclico/metabolismo , Depresión/tratamiento farmacológico , Imipramina/uso terapéutico , Transducción de Señal/efectos de los fármacos , Zinc/uso terapéutico , Animales , Proteína de Unión a Elemento de Respuesta al AMP Cíclico/metabolismo , Depresión/metabolismo , Sinergismo Farmacológico , Desamparo Adquirido , Masculino , Ratas Sprague-Dawley , Serina-Treonina Quinasas TOR/metabolismoRESUMEN
A suitable animal model of CVA16 infection is crucial in order to understand its pathogenesis and to help develop antiviral vaccines or screen therapeutic drugs. The neonatal mouse model has a short sensitivity period to CA16 infection, which is a major limitation. In this study, we demonstrate that adult (60-day-old) gerbils are susceptible to CVA16 infection at high doses (108.0 TCID50). A clinical isolate strain of CVA16 was inoculated intraperitoneally into adult gerbils, which subsequently developed significant clinical symptoms, including hind limb weakness, paralysis of one or both hind limbs, tremors, and eventual death from neurological disorders. Real-time RT-PCR revealed that viral loads in the spinal cord and brainstem were higher than those in other organs/tissues. Histopathological changes, such as neuronal degeneration, neuronal loss, and neuronophagia, were observed in the spinal cord, brainstem, and heart muscle, along with necrotizing myositis. Gerbils receiving both prime and boost immunizations of alum adjuvant inactivated vaccine exhibited no clinical signs of disease or mortality following challenge by CVA16, whereas 80% of control animals showed obvious clinical signs, including slowness, paralysis of one or both hind limbs, and eventual death, suggesting that the CVA16 vaccine can fully protect gerbils against CVA16 challenge. These results demonstrate that an adult gerbil model provides us with a useful tool for studying the pathogenesis and evaluating antiviral reagents of CVA16 infection. The development of this animal model would also be conducive to screening promising CVA16 vaccine candidates as well as further vaccination evaluation.
Asunto(s)
Enterovirus/inmunología , Enterovirus/patogenicidad , Vacunas de Productos Inactivados/inmunología , Vacunas de Productos Inactivados/uso terapéutico , Vacunas Virales/inmunología , Vacunas Virales/uso terapéutico , Animales , Animales Recién Nacidos , Anticuerpos Neutralizantes/inmunología , Modelos Animales de Enfermedad , Femenino , Gerbillinae , Masculino , Carga Viral/inmunologíaRESUMEN
OBJECTIVE: To explore the relationship between air pollution and acute onset of cerebral hemorrhage in Hangzhou. METHODS: Time-stratified case-crossover study was used to analyze the effect of aerosol optical depth (AOD), PM(10), SO(2) and NO(2) on the acute onset of cerebral hemorrhage. Conditional logistic regression was used to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs) in relation to an increase of one unit of AOD and 10 microg/m(3) of air pollutants. RESULTS: After adjusted temperature and relative humidity, the ORs of acute onset of cerebral hemorrhage by a unit increase in AOD at a 2 day-lag were 1.727 (95%CI: 1.103 - 2.703) in first half year and 2.412 (95%CI: 1.230 - 4.733) at a 2 day-lag in spring. For a 10 microg/m(3) increase in SO(2), the ORs were 1.119 (95%CI: 1.019 - 1.229), 1.230 (95%CI: 1.092 - 1.386), 1.254 (95%CI: 1.076 - 1.460) in the whole year (2 day-lag), in first half year (2 day-lag) and in spring (2 day-lag), respectively. NO(2) exposure in first half year (2 day-lag) was associated with cerebral hemorrhage, with OR as 0.841 (95%CI: 0.734 - 0.964). However, there were no statistical significances for AOD, SO(2), NO(2) in the rest time-periods (P > 0.05). Additionally, no association was found between PM(10) and the acute onset of cerebral hemorrhage in any time-periods (P > 0.05). CONCLUSION: Our data showed that there was association between air pollution and the acute onset of cerebral hemorrhage, especially in spring and in the first half of the year.
Asunto(s)
Contaminantes Atmosféricos/efectos adversos , Contaminación del Aire/efectos adversos , Hemorragia Cerebral/etiología , Enfermedad Aguda , Aerosoles/efectos adversos , China , Intervalos de Confianza , Humanos , Modelos Logísticos , Dióxido de Nitrógeno/efectos adversos , Oportunidad Relativa , Material Particulado/efectos adversos , Dióxido de Azufre/efectos adversos , Factores de TiempoRESUMEN
OBJECTIVE: To explore the risk factors of injuries among school aged children from migrant workers' families, in Hangzhou. METHODS: A cross-sectional survey on 3582 students from eight separate schools in which, four were set for migrant workers' families and the other four were for families of permanent residents. Stratified cluster random sampling method was used. Data was analyzed by unconditional univariate and multivariate logistic regression methods under SPSS 13.0. RESULTS: The incidence rate of injury did not show statistical difference between children of migrant workers or from the permanent residents. The incidence rate of multiple injuries was higher in children from the migrant workers' families. The incidence rates on electric shock occurred at the primary school, drowning among boys at the secondary school and scald/crash/cutting by knives in girls at secondary schools were seen higher among children from the of migrant workers. Results from multivariate analysis showed that factors as gender (OR = 1.20), age (6 - 9 years: OR = 0.70, 10 - 12 years: OR = 1.45), fond of playing Pingpong (OR = 1.35), history of injuries by pets (OR = 1.41), skills on swimming (OR = 1.22), no history of being threatened (OR = 0.68), having harmonious family relations (OR = 0.69) and owning a house by family (OR = 0.76) appeared to be the major one that related to the occurrence of injury. CONCLUSION: Personal behavior as well as family and social environment seemed to be factors affecting the occurrence of injuries among children from the migrant workers' families.
Asunto(s)
Accidentes/estadística & datos numéricos , Relaciones Padres-Hijo , Migrantes/estadística & datos numéricos , Heridas y Lesiones/epidemiología , Factores de Edad , Niño , Conducta Infantil , China/epidemiología , Estudios Transversales , Familia/psicología , Femenino , Humanos , Incidencia , Modelos Logísticos , Masculino , Análisis Multivariante , Oportunidad Relativa , Factores de Riesgo , Factores Sexuales , Medio SocialRESUMEN
A conjugative plasmid, pMRV150, which mediated multiple-drug resistance (MDR) to at least six antibiotics, including ampicillin, streptomycin, gentamicin, tetracycline, chloramphenicol, and trimethoprim-sulfamethoxazole, was identified in a Vibrio cholerae O139 isolate from Hangzhou, eastern China, in 2004. According to partial pMRV150 DNA sequences covering 15 backbone regions, the plasmid is most similar to pIP1202, an IncA/C plasmid in an MDR Yersinia pestis isolate from a Madagascar bubonic plague patient, at an identity of 99.99% (22,180/22,183 nucleotides). pMRV150-like plasmids were found in only 7.69% (1/13) of the O139 isolates tested during the early period of the O139 epidemic in Hangzhou (1994, 1996, and 1997); then the frequency increased gradually from 60.00% (3/5) during 1998 and 1999 to 92.16% (47/51) during 2000 to 2006. Most (42/51) of the O139 isolates bearing pMRV150-like plasmids were resistant to five to six antibiotics, whereas the plasmid-negative isolates were resistant only to one to three antibiotics. In 12 plasmid-bearing O139 isolates tested, the pMRV150-like plasmids ranged from approximately 140 kb to 170 kb and remained at approximately 1 or 2 copies per cell. High (4.50 x 10(-2) and 3.08 x 10(-2)) and low (0.88 x 10(-8) to 3.29 x 10(-5)) plasmid transfer frequencies, as well as no plasmid transfer (under the detection limit), from these O139 isolates to the Escherichia coli recipient were observed. The emergence of pMRV150-like or pIP1202-like plasmids in many bacterial pathogens and nonpathogens occupying diverse niches with global geographical distribution indicates an increasing risk to public health worldwide. Careful tracking of these plasmids in the microbial ecosystem is warranted.
Asunto(s)
Conjugación Genética , Farmacorresistencia Bacteriana Múltiple/genética , Factores R/genética , Vibrio cholerae O139/efectos de los fármacos , Vibrio cholerae O139/genética , Yersinia pestis/efectos de los fármacos , Yersinia pestis/genética , Secuencia de Bases , China/epidemiología , Cólera/tratamiento farmacológico , Cólera/epidemiología , Cólera/microbiología , Cartilla de ADN/genética , ADN Bacteriano/genética , Brotes de Enfermedades , Escherichia coli/efectos de los fármacos , Escherichia coli/genética , Humanos , Datos de Secuencia Molecular , Peste/tratamiento farmacológico , Peste/epidemiología , Peste/microbiología , Factores R/aislamiento & purificación , Vibrio cholerae O139/aislamiento & purificaciónRESUMEN
The common respiratory viruses, including influenza A, influenza B, and newly emerging severe acute respiratory syndrome (SARS) viruses, may cause similar clinical symptoms. Therefore, differential diagnosis of these virus pathogens is frequently required for single clinical samples. In addition, there is an urgent need for noninfectious and stable RNA standards and controls for multivirus detection. In this study, reverse transcription-PCR (RT-PCR) targeting of the RNAs of influenza A and influenza B viruses and SARS coronavirus was performed, and the resulting products were spliced into a fragment which was packaged into armored RNA for use as a noninfectious, quantifiable synthetic substitute. Furthermore, in the present study we developed a multiplex real-time RT-PCR assay in which the armored RNA was used as an external positive control and the three RNA viruses could be detected simultaneously in a single reaction mix. The detection limit of the multiplex real-time PCR was 10 copies/microl of armored RNA.
Asunto(s)
Virus de la Influenza A/aislamiento & purificación , Virus de la Influenza B/aislamiento & purificación , ARN Viral , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo/aislamiento & purificación , Secuencia de Bases , Escherichia coli/genética , Escherichia coli/metabolismo , Escherichia coli/virología , Humanos , Virus de la Influenza A/genética , Virus de la Influenza B/genética , Gripe Humana/diagnóstico , Levivirus/genética , Levivirus/metabolismo , Datos de Secuencia Molecular , ARN Viral/análisis , ARN Viral/genética , Estándares de Referencia , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/normas , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo/genética , Síndrome Respiratorio Agudo Grave/diagnóstico , Ensamble de VirusRESUMEN
OBJECTIVE: To investigate the short-term effect of particulate matter in air on the mortality of stroke. METHODS: Using time-stratified case-crossover study design, an association was examined between stroke mortality and particulate matter with aerodynamic diameter of < 10 microm (PM10) of 2002 - 2004 in Hangzhou city. Meanwhile, the acute health effect of other gaseous pollutants (sulfur dioxide, SO2 and nitrogen dioxide, NO2) was also analyzed. RESULTS: A total of 9906 deaths of stroke were included. The crude stroke mortality was 83.54 per 100 000. After being adjusted for meteorological factors, when an increase of 10 microg/m3 in PM10, SO2 and NO2 in three days was noticed, it appeared that the increases of mortality of stroke were 0.56% (95% CI: 0.14%-0.99%), 1.62% (95% CI: 0.26% - 3.01%) and 2.07% (95% CI: 0.54% - 3.62%) respectively. There was no distinct association in multi-pollutant models. In sensitivity analysis, the associations were found in all single-pollutant models but not statistically significant in multi-pollutant models after replacing the missing values. CONCLUSION: It is suggested that the short-term elevation in PM10 as well as SO2 and NO2 daily concentrations were related to the increase of stroke mortality in Hangzhou city.
Asunto(s)
Contaminantes Atmosféricos/análisis , Material Particulado/análisis , Accidente Cerebrovascular/mortalidad , Anciano , Anciano de 80 o más Años , Causas de Muerte , China/epidemiología , Estudios Cruzados , Monitoreo del Ambiente , Monitoreo Epidemiológico , Femenino , Humanos , Modelos Teóricos , Dióxido de Nitrógeno/análisis , Accidente Cerebrovascular/epidemiología , Dióxido de Azufre/análisis , Factores de TiempoRESUMEN
BACKGROUND: The Chinese National People's Congress ratified the WHO Framework Convention on Tobacco Control (FCTC) on 27 August 2005, signaling China's commitment to implement tobacco control policies and legislation consistent with the treaty. This study was designed to examine attitudes towards four WHO FCTC measures among Chinese urban residents. METHODS: In a cross-sectional design study, survey data were collected from two Chinese urban cities involving a sample of 3,003 residents aged 15 years or older. Through a face-to-face interview, respondents were asked about attitudes toward four tobacco control measures developed by the WHO FCTC. Data on the four dependent measures were analyzed using multivariate logistic regression analyses. Using descriptive statistics, potential change in smoking behavior that smokers might make in response to increasing cigarette prices is also reported. RESULTS: 81.8% of the respondents in the study sample supported banning smoking in public places, 68.8% favored increasing the cigarette tax, 85.1% supported health warnings on cigarette packages, and 85.7% favored banning tobacco advertising. The likelihood to support these measures was associated with gender, educational level, and personal income. Smokers were less likely to support these measures than non-smokers, with decreased support expressed by daily smokers compared to occasional smokers, and heavy smokers compared to light smokers. The proportion of switching to cheaper cigarette brands, decreasing smoking, and quitting smoking altogether with increased cigarette prices were 29.1%, 30.90% and 40.0% for occasional smokers, respectively; and 30.8%, 32.7% and 36.5% for daily smokers, respectively. CONCLUSION: Results from this study indicate strong public support in key WHO FCTC measures and that increases in cigarette price may reduce tobacco consumption among Chinese urban residents. Findings from this study have implications with respect to policymaking and legislation for tobacco control in China.
Asunto(s)
Actitud Frente a la Salud , Cese del Hábito de Fumar/psicología , Fumar/epidemiología , Adolescente , Adulto , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fumar/economía , Fumar/legislación & jurisprudencia , Clase Social , Encuestas y Cuestionarios , Población UrbanaRESUMEN
We describe the isolation of Laribacter hongkongensis in Hangzhou City, People's Republic of China. One strain of bacterium, named LHHZ242, had many of the same phenotypic and genotypic characteristics as Laribacter hongkongensis described in previous publications. This discovery proves that Laribacter hongkongensis is also associated with community-acquired gastroenteritis outside Hong Kong.
Asunto(s)
Infecciones Comunitarias Adquiridas/microbiología , Gastroenteritis/microbiología , Infecciones por Neisseriaceae/microbiología , Neisseriaceae/clasificación , Neisseriaceae/aislamiento & purificación , China/epidemiología , Infecciones Comunitarias Adquiridas/epidemiología , Heces/microbiología , Gastroenteritis/epidemiología , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Neisseriaceae/genética , Infecciones por Neisseriaceae/epidemiología , Fenotipo , Filogenia , Reacción en Cadena de la Polimerasa/métodos , Análisis de Secuencia de ADNRESUMEN
OBJECTIVE: The China Seven Cities Study (CSCS) monitors geographic and temporal trends in tobacco use among adolescents and adults in seven cities throughout Mainland China: Harbin, Shenyang, Wuhan, Chengdu, Kunming, Hangzhou, and Qingdao. This article presents the methodology and prevalence data from the baseline survey of the CSCS, conducted in 2002. METHODS: Stratified random samples of middle schools, high schools, and colleges were selected within each city. Students and their parents completed self-report surveys of their tobacco use. Data were obtained from 6138 middle school students, 5848 academic high school students, 2448 vocational high school students, 2556 college students, and 25 697 parents. RESULTS: Smoking prevalence varied across age groups, school types, genders, and cities. Past-month smoking prevalence was 9% among middle school students, 8% among academic high school students, 26% among vocational high school students, 21% among college students, and 40% among parents. Smoking prevalence was higher among males than among females, with larger gender disparities among adults than among youth. Smoking also varied across cities, with higher smoking prevalence in southwestern cities and lower prevalence in coastal cities. Intraclass correlations of students within schools are presented to inform statistical power estimates for further research in China. CONCLUSIONS: These results provide a baseline for future longitudinal studies of smoking in these cities and identify demographic groups at risk for tobacco-related disease. Effective smoking prevention programmes for youth and smoking cessation programmes for adults are needed in China, especially in the lower-income southwestern cities and in vocational high schools throughout the country.