Health Insurance Coverage and Hypertension Control in China: Results from the China Health and Nutrition Survey

Background

China has rapidly expanded health insurance coverage over the past decade but its impact on hypertension control is not well known. We analyzed factors associated with hypertension and the impact of health insurance on the management of hypertension in China from 1991 to 2009.

Methods and Findings

We used individual-level data from the China Health and Nutrition Survey (CHNS) for blood pressure, BMI, and other socio-economic variables. We employed multi-level logistic regression models to estimate the factors associated with prevalence and management of hypertension. We also estimated the effects of health insurance on management of hypertension using propensity score matching. We found that prevalence of hypertension increased from 23.8% (95% CI: 22.5–25.1%) in 1991 to 31.5% (28.5–34.7%) in 2009. The proportion of hypertensive patients aware of their condition increased from 31.7% (28.7–34.9%) to 51.1% (45.1–57.0%). The proportion of diagnosed hypertensive patients in treatment increased by 35.5% in the 19 years, while the proportion of those in treatment with controlled blood pressure remained low. Among diagnosed hypertensives, health insurance increased the probability of receiving treatment by 28.7% (95% CI: 10.6–46.7%) compared to propensity-matched individuals not covered by health insurance.

Conclusions

Hypertension continues to be a major health threat in China and effective control has not improved over time despite large improvements in awareness and treatment access. This suggests problems in treatment quality, medication adherence and patient understanding of the condition. Improvements in hypertension management, quality of medical care for those at high risk, and better health insurance packages are needed.     

Combined Effect of Textured Patterns and Graphene Flake Additives on Tribological Behavior under Boundary Lubrication

A ball-on-plate wear test was employed to investigate the effectiveness of graphene (GP) nanoparticles dispersed in a synthetic-oil-based lubricant in reducing wear. The effect by area ratio of elliptically shaped dimple textures and elevated temperatures were also explored. Pure PAO4 based oil and a mixture of this oil with 0.01 wt% GP were compared as lubricants. At pit area ratio of 5%, GP-base oil effectively reduced friction and wear, especially at 60 and 100°C. Under pure PAO4 oil lubrication, the untextured surfaces gained low friction coefficients (COFs) and wear rates under 60 and 100°C. With increasing laser—texture area ratio, the COF and wear rate decreased at 25 and 150°C but increased at 60 and 100°C. Under the GP-based oil lubrication, the textured surface with 5% area ratio achieved the lowest COF among those of the area ratios tested at all test temperatures. Meanwhile, the textured surface with 20% area ratio obtained the highest COF among those of the area ratios. With the joint action of GP and texture, the textured surface with 10% area ratio exhibited the best anti-wear performance among all of the textured surfaces at all test temperatures.     

Monocyte Trafficking,Engraftment, and Delivery of Nanoparticles and an Exogenous Gene into the Acutely Inflamed Brain Tissue – Evaluations on Monocyte-Based Delivery System for the Central Nervous System

The ability of monocytes and monocyte-derived macrophages (MDM) to travel towards chemotactic gradient, traverse tissue barriers, and accumulate precisely at diseased sites makes them attractive candidates as drug carriers and therapeutic gene delivery vehicles targeting the brain, where treatments are often hampered by the blockade of the blood brain barrier (BBB). This study was designed to fully establish an optimized cell-based delivery system using monocytes and MDM, by evaluating their homing efficiency, engraftment potential, as well as carriage and delivery ability to transport nano-scaled particles and exogenous genes into the brain, following the non-invasive intravenous (IV) cell adoptive transfer in an acute neuroinflammation mouse model induced by intracranial injection of Escherichia coli lipopolysaccharides. We demonstrated that freshly isolated monocytes had superior inflamed-brain homing ability over MDM cultured in the presence of macrophage colony stimulating factor. In addition, brain trafficking of IV infused monocytes was positively correlated with the number of adoptive transferred cells, and could be further enhanced by transient disruption of the BBB with IV administration of Mannitol, Bradykinin or Serotonin right before cell infusion. A small portion of transmigrated cells was detected to differentiate into IBA-1 positive cells with microglia morphology in the brain. Finally, with the use of superparamagnetic iron oxide nanoparticles SHP30, the ability of nanoscale agent-carriage monocytes to enter the inflamed brain region was validated. In addition, lentiviral vector DHIV-101 was used to introduce green fluorescent protein (GFP) gene into monocytes, and the exogenous GFP gene was detected in the brain at 48 hours following IV infusion of the transduced monocytes. All together, our study has set up the optimized conditions for the more-in-depth tests and development of monocyte-mediated delivery, and our data supported the notion to use monocytes as a non-invasive cell-based delivery system for the brain.     

β-arrestin 2 attenuates cardiac dysfunction in polymicrobial sepsis through gp130 and p38

Sepsis is an exaggerated systemic inflammatory response to persistent bacteria infection with high morbidity and mortality rate clinically. β-arrestin 2 modulates cell survival and cell death in different systems. However, the effect of β-arrestin 2 on sepsis-induced cardiac dysfunction is not yet known. Here, we show that β-arrestin 2 overexpression significantly enhances animal survival following cecal ligation and puncture (CLP)-induced sepsis. Importantly, overexpression of β-arrestin 2 in mice prevents CLP-induced cardiac dysfunction. Also, β-arrestin 2 overexpression dramatically attenuates CLP-induced myocardial gp130 and p38 mitogen-activated protein kinase (MAPK) phosphorylation levels following CLP. Therefore, β-arrestin 2 prevents CLP-induced cardiac dysfunction through gp130 and p38. These results suggest that modulation of β-arrestin 2 might provide a novel therapeutic approach to prevent cardiac dysfunction in patients with sepsis.     

高通量测序分析DNA提取引起的对虾肠道菌群结构偏差

【目的】通过高通量测序技术,评价不同DNA试剂盒提取引起的对虾肠道菌群结构偏差,了解健康凡纳滨对虾肠道菌群结构特征。【方法】分别以细菌、粪便和组织DNA试剂盒3次重复提取凡纳滨对虾肠道总DNA(分别编号为SIB,SIS和SIT),检测DNA含量、纯度及其16S r DNA V4区可扩增性,进一步采用Illumina Mi Seq高通量测序比较SIB和SIS样品菌群组成和多样性。【结果】细菌试剂盒提取的虾肠总DNA效果最好,粪便试剂盒次之,而组织试剂盒所提DNA含量低且难以被扩增。从SIB和SIS样品分别获得52151±5085和55296±5147条有效序列,同一(46800条)测序深度下,SIS样品OTU(operational taxonomic unit)数量和Shannon多样性指数均显著高于SIB的,而SIB样品间OTU重复性则优于SIS样品间的。从SIB和SIS样品鉴定的优势门一致,均包括变形菌门(Proteobacteria)、厚壁菌门(Firmicutes)、拟杆菌门(Bacteroidetes)、浮霉菌门(Planctomycetes)、放线菌门(Actinobacteria)和蓝细菌门(Cyanobacteria),但不同分类水平上绝大多数优势菌群丰度在两种样品间差异明显。【结论】高通量测序分析表明对虾肠道菌群结构因DNA提取方法不同而呈现显著偏差;本研究健康凡纳滨对虾肠道核心菌群主要由发光杆菌属(Photobacterium),乳球菌属(Lactococcus),弧菌属(Vibrio),Aliivibrio和3个分类未定属构成。     

靶向铜绿假单胞菌(Pseudomonas aeruginosa)粘肽合成酶PBP3的抗菌先导化合物的虚拟筛选及活性研究

【目的】开发出与铜绿假单胞菌粘肽合成酶PBP3有高亲和力,具有全新结构的先导化合物。【方法】以铜绿假单胞菌粘肽合成酶PBP3为靶点,通过分子对接软件DOCK6.5,对含有104万个小分子化合物的数据库进行了大规模虚拟筛选,选取结构相对简单的中选化合物进行合成,得到先导化合物,并验证其抑菌活性。【结果】通过grid score进行第一轮初筛,筛选出grid score分值小于–30 kcal/mol的6万个化合物,接着以amber score进行第二轮筛选,筛出amber score分值小于–20 kcal/mol的化合物约200个。最终,经过观察分析,从中挑选出4种打分高并且结构新颖的小分子化合物作为先导化合物。合成出的先导化合物及其衍生物对铜绿假单胞菌等常见微生物的最小抑菌浓度(MIC)在175–275μg/m L之间,对革兰氏阴性菌和阳性菌均有效,MIC值比作为阳性对照的磺胺嘧啶更低,说明先导化合物具有较好的抗菌活性。【结论】这些先导化合物可以进一步开发为新型抗菌药物,用于解决铜绿假单胞菌的耐药性问题。     

生防菌密旋链霉菌Act12中SPA7074缺失突变株的构建及其次级代谢产物鉴定

【目的】通过基因工程手段构建生防菌Act12转录调控因子SPA7074缺失突变株,并挖掘其中活性次级代谢产物资源和探讨其活性机理。【方法】利用同源重组方法敲除Act12基因组中可能的Tet R家族转录调控因子编码基因spa7074(accession number:KU955325),平板实验检测缺失突变株发酵液抑菌活性的变化,并通过HPLC比较代谢图谱,然后通过质谱及核磁共振对差异峰对应化合物进行结构鉴定。【结果】SPA7074缺失突变株对几种病原真菌的拮抗活性显著增强,比较代谢图谱表明出现数个差异峰,将最显著差异峰所对应化合物进行分离纯化鉴定,结果为寡霉素D。【结论】本研究通过基因工程手段敲除生防菌株Act12中的负转录调控转录因子,使得突变菌株抑菌活性显著增强,并获得了产量达野生型菌株7倍的寡霉素D高产菌株Δspa7074。