Search

Background To better address the problems and challenges facing primary health care services in China, China's National Health Commission and the Gates Foundation have been collaborated to implement primary health care projects in areas such as Shanxi Province, Hubei Province, and part of the rural areas of Henan Province from 2017 to 2022. The overall goal of the project is to explore an effective model for basic health care services and to contribute to health poverty alleviation, which will enhance experience sharing within China and benefit other developing countries. Objective To summarize the experience of implementing person-centered integrated health management project in rural populations with priority diseases, represented by hypertension and diabetes. Methods The collection of information and data for the person-centered integrated health management project encompassed multiple sources, including hospital information system, statistical reporting information, basic public health information system, qualitative interviews, patient surveys, physician surveys and quality surveys of medical records. Descriptive statistical analysis as well as before-and-after comparisons were used as the main evaluation methods. Results The proportion of patients with hypertension and diabetes under standardized management increased steadily, the average hospitalization cost of inpatients decreased, with a gradual increase in healthy living behaviors and a significant improvement medication adherence. In terms of health outcomes, the control rate of hypertension improved significantly but the control rate for blood glucose did not change significantly. Conclusion The service concept and capacity of person-centered integrated health management for priority diseases have been significantly improved. The relevant measures have been transformed into policies to be promoted and implemented in the project areas. Various types of experts are the key factors in promoting the implementation of the project, the sustainability of the measures needs to be maintained.

Objective·To investigate the evolution of sarcoma antigen 1 (SAGE1), a member of the cancer-testis antigen (CTA) family, in three representative primate species—Macaca mulatta (Rhesus), Callithrix jacchus (Marmoset), and Microcebus murinus (Mouse Lemur), as well as the conservation of its interaction with INTS3, a subunit of the integrator complex.Methods·The interaction between INTS3 and SAGE1 in these primates and the interaction between INTS3 and human SAGE1 mutants were first validated in HEK293T cells by using co-immunoprecipitation (Co-IP). Truncated proteins were then tagged with His-SUMO and GST, respectively, and expressed in Escherichia coli, followed by a series of purification steps to obtain the target proteins. Surface plasmon resonance (SPR) was used to measure the binding affinity of the target proteins, and size exclusion chromatography with multi-angle light scattering (SEC-MALS) was used to determine the stoichiometry of the complex. Additionally, molecular docking was employed to predict the binding model of the truncated SAGE1 and INTS3. Mutations were performed on human SAGE1 key interface residues to analyze their binding to INTS3 by Co-IP.Results·The interaction between the full-length human-derived INTS3 and the full-length SAGE1 from the three primate species was confirmed by Co-IP. Truncated proteins were purified through multiple steps of tandom chromatography. The dissociation constants of the three pairs of truncated INTS3-SAGE1 were measured via SPR, and the SEC-MALS results demonstrated that the binding ratio of INTS3-SAGE1 was 2∶1. Furthermore, molecular docking predicted a structural model of the truncated INTS3-SAGE1 complex and the binding interface was extensively constituted with hydrophobic contacts assisted by some hydrophilic interactions. The interaction between the mutant SAGE1 and INTS3 full-length protein was significantly weakened.Conclusion·There is a conserved interaction between INTS3 and SAGE1 across Rhesus, Marmoset, and Mouse lemur.

Background Hypertension and diabetes are two major chronic diseases affecting population health, and need to be controlled through chronic diseases follow-up. However, there is currently insufficient understanding of the impact of different chronic diseases follow-up forms and contents on disease control and healthy behaviors of patients. Objective To explore the impact of the chronic diseases follow-up on health behaviors and blood pressure/glucose control of patients with hypertension and diabetes in the context of treatment-prevention integration. Methods Yiyang County in Henan Province, Xianfeng County in Hubei Province and Yangqu County in Shanxi Province were selected as study sites to collect data from the basic public health information system from 2017-01-01 to 2022-06-30. Patient survey was conducted in July 2022 to collect information on basic public health follow-up receiving, health behaviors and disease control of patients. Finally, 102 769 patients with hypertension and 26 586 patients with diabetes were obtained from the basic public health information system, the data of 1 172 patients with hypertension and 456 patients with diabetes were obtained through patient surveys. Multivariate Logistic regression was used to analyze the effects of the standard-reaching frequency of follow-up, follow-up forms and contents on health behaviors and disease control of patients. Results In 2021, the standard-reaching rates of follow-up frequency of patients with hypertension and diabetes were 90.83% (67 709/74 545) and 83.35% (13 390/16 065) , with frequency≥4 times/year as the standard. The follow-up forms included household follow-up〔25.74% (408/1 585) 〕, follow-up at institutional visits〔58.80% (932/1 585) 〕, telephone or network follow-up〔15.46% (245/1 585) 〕. The follow-up contents included blood pressure and blood glucose measurements〔91.15% (1 484/1 628) 〕, lifestyle guidance〔74.14% (1 207/1 628) 〕, disease inquiry〔70.02% (1 140/1 628) 〕, and drug use understanding〔69.29% (1 128/1 628) 〕. Multivariate Logistic regression analysis showed that patients with higher standard-reaching rates of follow-up frequency had higher rates of blood pressure control (OR=1.09, P

Background The free training for rural order-oriented medical students has trained a large number of primary health personnel for the central and western regions of China. By the summer of 2021, the first order-oriented medical graduates had completed their compulsory service and face the choice of staying or leaving. The income is an important influencing factor of their choices, however, there are still few studies on the income of order-oriented medical graduates. Objective The panel data of order-oriented medical graduate cohort study was used to compare and analyze the change trend of the income of order-oriented medical graduates and general clinical graduates in the early career, and to explore the influencing factors of the change of income. Methods Qinghai University, Guangxi Medical University, Jiujiang Medical University and Gannan Medical University were selected to establish the order-oriented medical graduate cohort every year from 2015 to 2019, matching the general clinical graduates of the same grade as controls. The baseline survey was conducted, including basic information and family information. A total of four follow-up surveys were conducted in 2016, 2017, 2018 and 2020, including the status of standardized resident training (hereinafter referred to as "standardized training") , passing of medical licensing examination, working conditions and other information. Fixed effects model was used to explore the factors influencing the income of order-oriented medical graduates and general clinical graduates, and propensity score matching (PSM) was used to test the stability of the results. Results In the first two years after graduation, the income of order-oriented medical graduates was higher than general clinical graduates, and the difference was statistically significant (P

Light field images (LFI) record rich 3D structural and textural details of target scenes, which have great advantages in a wide range of computer vision tasks. However, LFI captured under low-light conditions always suffer from low brightness and strong noise, which may seriously degrade the quality of LFI. In this paper, a low-light LFI enhancement method by fusing multi-scale light field (LF) structural features is proposed , which adopts digital single-lens reflex camera (DSLR) images to supervise the generated enlightened LFI. To explore and exploit light field structural features, angular and spatial Transformers are introduced to extract LF structural features from LFI at different scales, i.e., the complementary information between sub-views and local and long-range dependencies within each sub-view. A recurrent fusion module is proposed to preserve the long-term memory of features at diffe-rent scales by using a long-short-term memory network, while adaptively aggregating LF structural features in the entire feature space through local and global fusion layers. A 4D residual reconstruction module is designed to reconstruct target LFI sub-views from the aggregated features. In additional, a dataset of low-light LFI and normal-light DSLR image pairs is constructed to train the proposed network. Extensive experiment demonstrates that the proposed network can effectively improve the quality of low-light LFI, and it obviously outperforms other state-of-the-art methods.