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Persistent pulmonary hypertension of the newborn (PPHN) is characterized by pulmonary arterial remodeling mainly because of apoptosis resistance and excessive proliferation of pulmonary artery smooth muscle cells (PASMCs). Sildenafil is a phosphodiesterase-5 inhibitor. Some reports have shown that sildenafil exerts protective effects against PPHN. However, the function of sildenafil in PPHN and the underlying molecular mechanisms is not clear. Here, we revealed that sildenafil effectively suppressed hypoxia-induced PASMC proliferation and apoptosis inhibition (P< 0.05). Also, sildenafil obviously reduced ventricular hypertrophy, and inhibited pulmonary vascular remodeling in the PPHN model (P< 0.05). Moreover, sildenafil treatment significantly attenuated the induction of Notch3 and Hes1 induced by hypoxia treatment (P< 0.05). Furthermore, overexpression of Notch3 abolished the reduction of PASMC proliferation and promotion of PASMC apoptosis induced by sildenafil under hypoxia (P< 0.05), whereas knockdown of Notch3 had an opposite effect (P< 0.05). Together, our study demonstrates that sildenafil shows a potential benefit against the development of PPHN by inhibiting Notch3 signaling, providing a strategy for treating PPHN in the future.

Using survey data from China (1989–2015), we investigate the impact of the number of siblings and treated water on educational attainment of children and its effect on their earnings when they join the labor force. Instrumental variables (IV) estimation shows that increase in the number of male siblings can increase the educational attainment of females. However, the effect of an increase in the number of female siblings on educational attainment of either males or females is statistically insignificant. Access to treated water during the childhood period (0–16 years) has a positive effect on educational attainment of boys. The estimated returns to education for females (6.6%) are higher than males (5.3%). The low fertility rate in China since the introduction of one-child policy led to fewer brothers, which contributed to a decrease in educational attainment of females. Improved public facilities (e.g., availability of treated water in rural areas) can increase the educational attainment of boys and thus reduce the gender earnings gap. With higher returns to education, extension of the compulsory education to senior secondary stage and loosening of the one-child policy is likely to yield relatively higher benefits to females.

This article investigates the effect of physical and human capital formation on the productivity growth of China. We focus on the market reform factors including ownership shifts, population policy, openness and fiscal expenditures on education, and the convergence of productivity growth within the traditional four economic regions of China. We find that Chinese economic miracle is mainly pushed by the (physical) capital service rather than human capital. The physical capital inputs contribute even more to the economic growth of China since the returns to education decrease with the education expansion and increasing tuition fees after 1994. The four economic regions of China show different growth patterns. The capital inputs mostly help the labour productivity (LP) growth of the West region and the wage growth of the interior region, but human capital formation contributes to the total factor productivity (TFP) of all four regions. Moreover, provinces within each region present strong evidence of convergence of productivity growth. The convergence is most prominent for the provinces within the Northeast and Coastal regions for LP and TFP growth, suggesting fast technology spillovers within these regions.

Objective To assess the rural–urban disparity in caesarean section rates using electronic health records from hospitals located in the Province of Inner Mongolia, which is a minority area in Northeastern China.Methods The study examined the electronic health records of women that gave birth in three major public hospitals between January 2012 and December 2016. Multinomial regression analyses were used to estimate rural–urban disparities in caesarean section rates.Results Data from 61 903 women were examined. Caesarean section rates increased slightly over the study period and the rate was significantly higher in rural compared with urban hospitals (48% versus 38%). This disparity consistently increased over time. Multinomial regression analyses showed that maternal age, ethnicity, health insurance type, employment status, reproductive history and the newborn’s sex were significant risk factors associated with caesarean section rate. Furthermore, stratified analysis of first-time pregnancies, minorities and different age groups showed that the odds of undergoing an emergency caesarean section was lower in the rural hospital, but the odds of undergoing a planned caesarean section was higher in the rural hospital.Conclusions Caesarean section rates have increased in rural areas and the disparity in rural–urban areas has increased substantially over the years.

Mastocytosis is an accumulation of clonal mast cells within tissues and it is most commonly caused by an activating mutation in the KITgene. In this study, we report a neonatal case who presented with diffuse cutaneous mastocytosis (CM) at birth. In China, nine other cases of neonatal-onset CM have been reported in the literature since 2006. In those cases, diffuse CM and urticaria pigmentosa were the main symptoms, and mutations in exon 17 at codon 816 in KIT were identified.