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Background: The purpose of this study is to examine the development of healthcare services efficiency in China since the reform of the healthcare system. By examining the development environment of healthcare services in China and examining the driving factors affecting the efficiency of healthcare services, we provide a reference for the future high-quality development of healthcare services in China. Methods: A three-stage super-efficient slack-based measure (SBM) model with undesirable outputs was used to measure the efficiency of healthcae services in 31 Chinese provinces from 2009 to 2021, and a global Malmquist-Luenberger (GML) index was used to assess their spatiotemporal evolution characteristics and internal influencing mechanisms of healthcare services efficiency. Results: The empirical results showed that the efficiency of China's healthcare services changed significantly from 2009–2014 and then remained stable. During the study period, the efficiency of healthcare services in the eastern region was higher than the national level, while it was lower in the western region. The results of the analysis of environmental factors indicated that an increase in population density reduced the redundancy of healthcare input resources and that economic development as well as an increase in government subsidies, contributed to an increase in the redundancy of healthcare input resources. The main contribution to the growth of healthcare sercices efficiency in China came from the technological innovation effect, and the growth was most significant in the western region. Conclusion: From 2009 to 2021, the efficiency of national healthcare services generally showed a slow upward trend, and the efficiency of healthcare services varied widely among regions. Under the existing environmental constraints, relevant departments in each region should strengthen technological innovation in healthcare services, completely focus on the regional catch-up effect, and promote the balanced development of regional health. [ABSTRACT FROM AUTHOR]

Abstract: Selenium deficiency was suspected to be a factor in the aetiology of esophageal cancer in the Linxian and Cixian regions of the People’s Republic of China and vitamin trials in the Linxian area indicated that combined supplementation with β-carotene, vitamin E and Se reduced the mortality rate. In order to further evaluate the role of Se, the distribution of total Se in cultivated topsoils, grain, human hair and drinking water was studied in 15 villages in the Cixian area, People’s Republic of China, which in the 1980–1990s had one of the highest mortality rates from esophageal cancer in the world. This study demonstrated that total Se concentrations in drinking water, soil, grain and hair increase from the low esophageal cancer area to the high cancer area, contrary to the expected trend. This suggests that Se deficiency does not play a major role in the aetiology of esophageal cancer in the study area. Nitrate in drinking water is much higher in the area with high esophageal cancer mortality rate than in the low mortality rate area, and this may be a significant factor. Mycotoxins (especially fumonisin), nitrosamine and nitrosamine precursors in grain, in drinking water, and dietary β-carotene and Vitamin E remain as potential factors which need to be evaluated further. [Copyright &y& Elsevier]

Objective: The present study aimed to evaluate the operational efficiency of public hospitals in Fujian Province and the factors responsible for the inefficiency of these hospitals and provide relevant suggestions for health policymakers in allocating service resources., Method: In the first stage of the research, the variables affecting the efficiency of hospitals were extracted by qualitative and quantitative methods, including literature optimization, gray related analysis and gray clustering evaluation. In the second stage, the data envelopment analysis (DEA) method was used to evaluate the operational efficiency of 49 hospitals of different levels and types selected by sampling in 2020. Finally, a Tobit regression model with introduced institutional factors and background factors was established to study the main influencing factors of hospital inefficiency., Results: In the first stage, 10 input variables and 10 output variables necessary from the mangers' point of view were identified to test efficiency. In the second stage, the average comprehensive TE, PTE, and SE of 49 sample hospitals was 0.802, 0.888, and 0.902, respectively. 22.45% of these hospitals met the effective criteria, i.e., the overall effective rate was 22.45%. The low SE value of the hospital was the main reason hindering the improvement of the comprehensive efficiency value. The overall effective rate of secondary public hospitals (30.77%) was higher than that of tertiary public hospitals (19.44%), and the overall effective rate of public specialized hospitals (30%) was higher than that of general public hospitals (18.92%). Based on the third stage results, the bed occupancy rate (BOR) and the proportion of beds (POB) were major factors affecting the operation efficiency of grade III hospitals ( p < 0.01). However, the operating efficiency of grade II hospitals was significantly affected by POB and regional per capita GDP(GDPPC) ( p < 0.05). Moreover, the impact of BOR and GDPPC was positive, and POB was negatively correlated with hospital operation efficiency., Conclusions: The study results indicated that the overall operation efficiency of public hospitals in Fujian Province is low. This study revealed that intervention should be strengthened from a policy and management perspective to improve the operation efficiency of public hospitals., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Sun, Ye, Zhang, Xue and Shang.)

Lou onion (Allium fistulosum L. var. viviparum) is an abundant source of flavonols which provides additional health benefits to diseases. Genome-wide specific length amplified fragment (SLAF) sequencing method is a rapidly developed deep sequencing technologies used for selection and identification of genetic loci or markers. This study aimed to elucidate the genetic diversity of 122 onion accessions in China using the SLAF-seq method. A set of 122 onion accessions including 107 A.fistulosum L. var. viviparum Makino, 3 A.fistulosum L. var. gigantum Makino, 3 A.mongolicum Regel and 9 A.cepa L. accessions (3 whites, 3 reds and 3 yellows) from different regions in China were enrolled. Genomic DNA was isolated from young leaves and prepared for the SLAF-seq, which generated a total of 1,387.55 M reads and 162,321 high quality SNPs (integrity >0.5 and MAF >0.05). These SNPs were used for the construction of neighbor-joining phylogenetic tree, in which 10 A.fistulosum L. var. viviparum Makino accessions from Yinchuan (Ningxia province) and Datong (Qinghai province) had close genetic relationship. The 3 A.cepa L. clusters (red, white and yellow) had close genetic relationship especially with the 97 A.fistulosum L. var. viviparum Makino accessions. Population structure analysis suggested entire population could be clustered into 3 groups, while principal component analysis (PCA) showed there were 4 genetic groups. We confirmed the SLAF-seq approach was effective in genetic diversity analysis in red onion accessions. The key findings would provide a reference to the Lou onion germplasm in China., Competing Interests: The authors have declared that no competing interests exist.