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The hierarchical integration of Cu2Se and CuInSe2 phases at nano- and micron-scale induces electronic band structure hybridization leading to a large increase in the electrical conductivity and carrier density of (1 − x)Cu2Se/(x)CuInSe2 composites.

Family resilience plays an important role in the healthy family development of adolescents with depression, but few studies have explored the specific process of family resilience. This study aims to explore the dynamic processes of family resilience from parents of adolescents with depression. Data were collected from 14 Chinese parents of adolescents with depression by interpretative phenomenological analysis method. Four themes and 12 sub-themes emerged: (1) decompensation phase: (i) misinterpretations of illness, (ii) heavy psychological burden, (iii) chaotic rhythms in family; (2) launch phase: (i) potential influences of labeling, (ii) we must cure my child anyway, (iii) begin adjusting to family roles; (3) recovery phase: (i) family reflection, (ii) subsequent reorganization of family resources, (iii) ultimately establishing a new balance; (4) normality phase: (i) adaption for medical seeking process, (ii) actively lower expectations, (iii) concerns of future needs. Mental health professionals could provide targeted suggestions to help the parents achieve family resilience by assessing its different phases.

This study aimed to assess whether the serum levels of vitamin A, vitamin D and vitamin E are associated with respiratory distress syndrome (RDS) in preterm infants.This retrospective research included 179 neonates born before 35 weeks of gestation in Jiaxing Maternity and Child Health Care Hospital from January 2020 to December 2020. Depending on whether or not they had RDS, participants were classified into the RDS group (59 neonates) and the control group (120 neonates). The 1:1 propensity score matching (PSM) analysis was performed to balance the baseline confounding factors and then the groups were compared in terms of serum vitamin levels and RDS morbidity.A total of 34 pairs of preterm infants were involved after PSM. There were significant differences in vitamin D level (12.13 (8.44-17.85) ng/mL vs. 16.84 (10.75-25.83) ng/mL), vitamin D deficiency rate (85.3% vs. 55.9%), as well as vitamin A level (134.91 (105.01-156.74) ng/mL vs. 152.46 (120.06-200.00) ng/mL) in the two groups. However, the vitamin A deficiency rate, vitamin E status, as well as vitamin E deficiency rate did not differ significantly between the two groups. Logistic analysis showed that a low level of vitamin D was an independent risk factor for RDS in preterm neonates (OR 0.917, 95%CI 0.851-0.989).Low serum vitamin D levels may contribute to the development of RDS in preterm infants, but no significant effect of serum vitamin A and vitamin E levels was found.

Objective. The infusion room is the last part of an outpatient visit, with high patient density, large staff mobility, and a wide variety of conditions. In addition, most patients are accompanied by their families during infusion, and nursing staff in infusion rooms have to face more trivial and miscellaneous tasks than nursing staff in other treatment departments, which are more complex. The purpose of this research is to explore the impact of the Six Sigma method and CI strategy on the quality of nursing management in infusion rooms, so as to provide reference for clinical research. Methods. A total of 2142 patients treated in our outpatient infusion rooms from June 2019 to June 2020 was included into this retrospective analysis. Of these, 1105 patients admitted before 2020 received routine care management services and were considered as the control group. Another 1037 patients were admitted after 2020 and received the Six Sigma method combined with CI strategic care management and were considered as the research group. The incidence of adverse events during treatment was counted in both groups, and patients’ compliance behavior and psychology were investigated. After treatment, patients’ evaluation of the quality of nursing and their satisfaction with the nursing were investigated. Results. The incidence of adverse events during infusion in the research group was dramatically lower than that in the control group, while the compliance behavior scores were higher ( P < 0.05 ). In addition, SAS and SDS in the research group were lower than those in the control group, while the quality of nursing were higher ( P < 0.05 ). It was also clear that the research group had 93.39% satisfaction with nursing, which was also higher than the control group ( P < 0.05 ). Conclusion. Implementation of infusion room nursing management according to the Six Sigma method with CI strategic plan can avoid adverse events and improve infusion nursing satisfaction. It also helps reduce the incidence of dispute events.

Owing to the diversity of composition and excellent transport properties, the ternary I–III–VI2 type diamond-like chalcopyrite compounds are attractive functional semiconductors, including as therm...

Anbing Zhang,1,&ast; Xiuqiong Xia,1,&ast; Xiaoling Yuan,1 Yuxia Liu,2 Haiming Niu,2 Yinying Zhang,1 Jianping Liang1 1Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, People’s Republic of China; 2Department of Intensive Care Unit, Zhongshan People’s Hospital, Zhongshan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jianping Liang, Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, No. 2, Sunwen East Road, Zhongshan, 528400, People’s Republic of China, Tel +86-1587-602-6693, Fax +86-760-8988-0256, Email ljpzhongshan@163.comPurpose: To explore the clinical characteristics, diagnosis, and treatment of severe Chlamydia psittaci pneumonia complicated by rhabdomyolysis and to improve the success rate of treatment.Patients and Methods: The clinical characteristics, diagnosis, treatment, and outcomes of four patients with severe C. psittaci pneumonia complicated by rhabdomyolysis diagnosed by metagenomic next-generation sequencing (mNGS) in our hospital were analyzed retrospectively.Results: All four patients were male, aged 46– 64 years, and all had a history of bird contact. All patients had fever, fatigue, tea-colored urine, myalgia, and two patients were unable to walk. C. psittaci DNA was found by mNGS of the bronchoalveolar lavage fluid of all four patients. Their creatine kinase was > 1000 U/L, and myoglobin, C-reactive protein, procalcitonin, and brain natriuretic peptide were significantly increased. The McMahon score of three patients was > 6 points, of whom one patient suffered from acute kidney injury; he was treated with continuous renal replacement therapy and eventually died. After diagnosis, three patients were treated with doxycycline and quinolones and were discharged after recovery.Conclusion: Psittacosis complicated by rhabdomyolysis is characterized by fever, fatigue, myalgia, and tea-colored urine, with significant increases in creatine kinase and myoglobin. The McMahon score should be applied early to assess the risk of acute kidney injury, and renal replacement therapy and renal protection therapy should be initiated in the early stage. Among severely ill patients, early use of empirical antibiotics, including quinolones, may improve the prognosis.Keywords: Chlamydia psittaci, severe pneumonia, rhabdomyolysis, metagenomic next-generation sequencing

Owing to the diversity of composition and excellent transport properties, the ternary I-III-VI

Background Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major health threat, but the economic impact of carbapenem resistance in K. pneumoniae infections remains largely uninvestigated. Methods We constructed a retrospective cohort of all patients hospitalized at West China Hospital in 2017 who had CRKP- or carbapenem-susceptible K. pneumoniae (CSKP)-positive clinical samples. Propensity score matching (PSM) was used to control the impact of potential confounding variables, including demographics, comorbidities, and treatment, and to observe the impact of factors other than length of stay (LOS). Patients who survived were subjected to subgroup analyses stratified by infection type. Results There were 267 patients with CRKP and 1328 with CSKP. Patients with CRKP had a higher crude in-hospital mortality rate (14.61% vs 5.65%, P < .05) and longer LOS (median, 31 vs 19 days; P < .05). PSM for demographics, comorbidities, and treatment generated 237 pairs. Patients with CRKP had higher medical costs than those with CSKP during the entire hospitalization (median, in US dollars, $22962 vs $11755, respectively; P < .05) and during the period after infection (median, $9215 vs $6904, respectively; P < .05). When LOS was matched, patients with CRKP still had high excess costs compared to those with CSKP (median, $22917 vs $13851, respectively, for the entire hospitalization, P < .05; $9101 vs $7001, respectively, after infection, P < .05). For infection type, the sample size generated sufficient power to compare only the patients with pneumonia. For surviving patients, high excess costs were observed in those with pneumonia caused by CRKP as compared to CSKP ($21890 vs $11698, respectively, for the entire hospitalization, P < .05; $9773 vs $5298, respectively, after infection, P < .05). Medicines other than antibacterial agents and nonmedicinal therapies contributed most (57.8%) of the excess costs associated with CRKP. Conclusions Carbapenem resistance in K. pneumoniae was associated with increased medical costs not accounted for by the cost of antimicrobial therapy.

Jiajiang Xie,1,2,* Zhongxiong Fan,2,* Yang Li,2,* Yinying Zhang,2 Fei Yu,3 Guanghao Su,4 Liya Xie,5 Zhenqing Hou2 1Xiamen Xianyue Hospital, Xiamen, China; 2Research Center of Biomedical Engineering of Xiamen, Key Laboratory of Biomedical Engineering of Fujian Province, Fujian Provincial Key Laboratory for Soft Functional Materials Research, Department of Biomaterials, College of Materials, Xiamen University, Xiamen, China; 3College of Medicals, Xiamen University, Xiamen, China; 4Children’s Hospital of Soochow University, Suzhou, China; 5The First Affiliated Hospital of Xiamen University, Xiamen, China *These authors contributed equally to this work Aim: We designed acid-labile methotrexate (MTX) targeting prodrug self-assembling nanoparticles loaded with curcumin (CUR) drug for simultaneous delivery of multi-chemotherapeutic drugs and combination cancer therapy. Methods: A dual-acting MTX, acting as both an anticancer drug and as a tumor-targeting ligand, was coupled to 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[aldehyde(polyethylene glycol)-2000] via Schiff’s base reaction. The synthesized prodrug conjugate (DSPE-PEG-Imine-MTX) could be self-assembled into micellar nanoparticles (MTX-Imine-M) in aqueous solution, which encapsulated CUR into their core by hydrophobic interactions (MTX-Imine-M-CUR). Results: The prepared MTX-Imine-M-CUR nanoparticles were composed of an inner hydrophobic DSPE/CUR core and an outside hydrophilic bishydroxyl poly (ethyleneglycol) (PEG) shell with a self-targeting MTX prodrug corona. The imine linker between 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[aldehyde(polyethyleneglycol)-2000] and MTX, as a dynamic covalent bond, was strong enough to remain intact in physiological pH, even though it is rapidly cleaved in acidic pH. The MTX-Imine-M-CUR could codeliver MTX and CUR selectively and efficiently into the cancer cells via folate receptor-mediated endocytosis followed by the rapid intracellular release of CUR and the active form of MTX via the acidity of endosomes/lysosomes. Moreover, the MTX-Imine-M-CUR resulted in significantly higher in vitro and in vivo anticancer activity than pH-insensitive DSPE-PEGAmide-MTX assembling nanoparticles loaded with CUR (MTX-Amide-M-CUR), MTX unconjugated DSPE-PEG assembling micellar nanoparticles loaded with CUR (M-CUR), combination of both free drugs, and individual free drugs. Conclusion: The smart system provided a simple, yet feasible, drug delivery strategy for targeted combination chemotherapy. Keywords: pH-sensitive prodrug, self-assembly, targeting, combination therapy, nanoparticles

The transport and magnetic properties of LaAlO3/SrTiO3 (LAO/STO) heterostructure have been studied during cooling and warming. The strain gradient perpendicular to the surface of the heterostructure increases with the thickness of LAO film. The conductivity accelerated recoveries (CAR) are found at 80 K and 176 K in the interface of LAO/STO sample with millimeter scale, and are more obvious for thicker LAO layers during warming. These two recovering temperatures correspond to the migrating energies of oxygen single vacancy and divacancy trapped by polarized domain walls, separately. This indicated that domain walls diffuse along the longitudinal direction and expand to larger area due the strain gradient perpendicular to the interface. The stable and precise accelerating recovering temperatures make the sample at a larger scale a potential widely applied temperature standard reference. The magnetization measurements reveal the coexistence of paramagnetic and diamagnetic in the LAO/STO samples at whole temperature from 2 K to 300 K. The abnormal electric resistance rise is observed with the decreasing temperature below 25 K for the samples of 7 and 15 LAO layers. This anomaly is attributed to the Kondo effect below 25 K and weak anti-localization below 5 K due to the weightier paramagnetic content. The larger diamagnetic content suppresses these contributions in 25 LAO layers sample. This work provided an insightful view that the strain modified structure domain leads to the enhancement of CAR effect, which helps to achieve a better understanding of domain related physics in the LAO/STO system.

Nanoparticles (NPs) functionalized with targeting ligands have shown promise, but are still limited by their nonspecific uptake by certain healthy tissues and cells that express low or even comparable levels of receptors. To increase their accumulation at tumor sites while decreasing the unintended toxicity, a possible solution is the involvement of two separate tumor-specific ligands in the localization. In this study, a dual tumor-targeting drug-loaded NP system was self-assembled by the amphiphilic conjugate of methotrexate-hyaluronic acid-octadecylamine (MTX-HA-OCA) with curcumin (CUR) encapsulated within the hydrophobic core (designated as MTX-HA-OCA/CUR NPs). The advantages of this nanosystem are that the anticancer drug MTX can be utilized as a tumor-targeting ligand toward folate receptors due to its structural similarity to folic acid (FA), and HA can serve as another tumor-targeting ligand toward CD44 receptors. The MTX-HA-OCA/CUR NPs are ∼70 nm in diameter and have sustained/controlled drug release behavior. An in vitro cellular uptake and competition inhibition study exhibited that MTX-HA-OCA/CUR NPs could significantly enhance the internalization efficiency in HeLa cells via folate/CD44 receptor-mediated endocytosis as compared to HA-OCA/CUR NPs. More importantly, the in vitro cytotoxicity of MTX-HA-OCA/CUR NPs was significantly enhanced as compared to those of the HA-OCA/CUR NPs, both free drugs, and individual free drug. Furthermore, the real-time in vivo and ex vivo fluorescence imaging of HeLa tumor-bearing mice showed that MTX-HA-OCA/CUR NPs could more efficiently enhance their accumulation and improve the penetration at the tumor site as compared to HA-OCA/CUR NPs. Therefore, these dually folate/CD44 receptor-targeted self-assembled HA NPs for the co-delivery of both anticancer drugs might provide a promising strategy for dual-targeted combination cancer therapy.

The transport and magnetic properties of LaAlO

Combinational cancer therapy has been considered as a promising strategy to achieve synergetic therapeutic effects and suppression of multidrug resistance. Herein, we adopted a combination of methotrexate (MTX), an antimetabolite acting on cytoplasm, and 10-hydroxycamptothecin (HCPT), an alkaloid acting on nuclei, to treat cancer. Given the different solubilities, membrane permeabilities, and anticancer mechanisms of both drugs, we developed a dual-targeting delivery system based on 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-hyaluronic acid (a principal ligand of CD44 receptors)-MTX (a selective ligand of folate receptors) nanoparticles, which was exploited to carry HCPT-MTX conjugate for synergistically boosting dual-drug co-delivery. The HCPT-MTX conjugate was synthesized by a blood-stable yet intracellularly hydrolysable ester bond. The core-shell-corona DSPE-HA-MTX nanoparticles encapsulating HCPT-MTX (HCPT-MTX@DHM) exhibited high drug entrapment efficiency (∼91.8%) and pH/esterase-controlled release behavior. Cellular uptake studies confirmed significant increase in the efficiency of selective internalization of HCPT-MTX@DHM via CD44/folate receptors compared with those of DSPE-HA nanoparticles encapsulating HCPT-MTX (HCPT-MTX@DH), both drugs, or each individual drug. Furthermore, in vivo near-infrared fluorescence and photoacoustic dual-modal imaging indicated that DiR-doped HCPT-MTX@DHM nanoparticles efficiently accumulated at the tumor sites through passive-plus-active targeting. Finally, the synergistic active targeting and synchronous dual-drug release at a synergistic drug-to-drug ratio resulted in highly synergetic tumor cell-killing and tumor growth inhibition in MCF-7 tumor-bearing mice. Therefore, HCPT-MTX@DHM nanoparticles can be an efficient and smart platform for tumor-targeting therapy.

The aim was to evaluate the effects of tetrahydropalmatine (THP) enantiomers on the activity of five cytochrome P450 (CYP450) isozymes in vivo. A liquid chromatography / mass spectrometric (LC-MS) method was developed for simultaneous determination of five specific probe substrates including metoprolol (2D6), caffeine (1A2), dapsone (3A4), chlorzoxazone (2E1), and tolbutamide (2C9) in rat plasma. Analytes were separated with the mobile phase consisting of 0.1% acetic acid aqueous solution and acetonitrile in a gradient elution. The mass spectrometric detection via selected ion monitoring (SIM) was operated in both positive ion mode (for metoprolol m/z 268, caffeine m/z 195, and dapsone m/z 249) and negative ion mode (for chlorzoxazone m/z 168 and tolbutamide m/z 269) in the same run. Linear correlation was obtained (r2 > 0.99) over the concentration range of 0.050–25.0 µg/mL for caffeine and dapsone, 0.025–10.0 µg/mL for metoprolol, 0.050–50.0 µg/mL for chlorzoxazone, and 0.25–100.0 µg/mL for tolbutamide. Intra- and interday precision were less than 12.09%. The matrix effect ranged from 87.50% to 109.25% and the absolute recoveries were greater than 70%. The method was successfully applied to evaluate the effect of THP enantiomers on the activity of CYP450 isozymes by a cocktail approach. The pharmacokinetic results of five probe drugs indicated that there were stereoselective differences between the two THP enantiomers, i.e., d-THP had the potential to inhibit the activities of CYP2D6 and CYP1A2 isozymes, while l-THP inhibited CYP1A2 isozyme and induced CYP3A4 and CYP2C9 isozymes. Chirality 27:551–556, 2015. © 2015 Wiley Periodicals, Inc.

Tumor-targeting combination chemotherapy is an important way to improve the therapeutic index and reduce the side effects as compared to traditional cancer treatments. However, one of the major challenges in surface functionalization of nanoparticle (NP) is accomplishing multiple purposes through one single ligand. Upon such consideration, methotrexate (MTX), an anticancer drug with a targeting moiety inspired by the similar structure of folate, could be used to covalently link with lipid-polymer conjugate (DSPE-PEG) via a pH-sensitive dynamic covalent imine (CH═N) bond to synthesize the acid-induced function "targeting-anticancer" switching DSPE-PEG-CH═N-MTX. We hypothesize that using this kind of MTX prodrug to functionalize NP's surface would be conductive to combine the early phase active targeting function and the late-phase anticancer function in one nanosystem. Herein, a nanococktail is programmed for codelivery of epirubicin (EPI) and MTX by co-self-assembly of acid-dissociated EPI-phospholipid (PC) complex and acid-cleavable DSPE-PEG-CH═N-MTX conjugate. The obtained nanococktail (MTX-PEG-EPI-PC NPs) could not only actively target folate receptors-overexpressing tumor cells but also respond to acidic endo/lysosomes for triggering the on-demand release of pharmaceutically active EPI/MTX. The intracellular drug distribution also demonstrated that the system could codeliver two drugs to individual target sites of action, inducing the significant synergistic anticancer efficiency based on different anticancer mechanisms. More importantly, the in vivo tumor accumulation and anticancer efficacy of MTX-PEG-EPI-PC NPs (via cleavable imine bond) were significantly enhanced as compared to the individual free drug, both free drugs, PEG-EPI-PC NPs, and MTX-PEG-EPI-PC NPs (via the uncleavable amide bond). This self-synergistic tumor-targeting therapy might represent a promising strategy for cancer treatment.

Direct lineage conversion is a promising approach to generate therapeutically important cell types for disease modeling and tissue repair. However, the survival and function of lineage-reprogrammed cells in vivo over the long term has not been examined. Here, using an improved method for in vivo conversion of adult mouse pancreatic acinar cells toward beta cells, we show that induced beta cells persist for up to 13 months (the length of the experiment), form pancreatic islet-like structures and support normoglycemia in diabetic mice. Detailed molecular analyses of induced beta cells over 7 months reveal that global DNA methylation changes occur within 10 d, whereas the transcriptional network evolves over 2 months to resemble that of endogenous beta cells and remains stable thereafter. Progressive gain of beta-cell function occurs over 7 months, as measured by glucose-regulated insulin release and suppression of hyperglycemia. These studies demonstrate that lineage-reprogrammed cells persist for >1 year and undergo epigenetic, transcriptional, anatomical and functional development toward a beta-cell phenotype.

The aim was to evaluate the effects of tetrahydropalmatine (THP) enantiomers on the activity of five cytochrome P450 (CYP450) isozymes in vivo. A liquid chromatography / mass spectrometric (LC-MS) method was developed for simultaneous determination of five specific probe substrates including metoprolol (2D6), caffeine (1A2), dapsone (3A4), chlorzoxazone (2E1), and tolbutamide (2C9) in rat plasma. Analytes were separated with the mobile phase consisting of 0.1% acetic acid aqueous solution and acetonitrile in a gradient elution. The mass spectrometric detection via selected ion monitoring (SIM) was operated in both positive ion mode (for metoprolol m/z 268, caffeine m/z 195, and dapsone m/z 249) and negative ion mode (for chlorzoxazone m/z 168 and tolbutamide m/z 269) in the same run. Linear correlation was obtained (r(2) 0.99) over the concentration range of 0.050-25.0 µg/mL for caffeine and dapsone, 0.025-10.0 µg/mL for metoprolol, 0.050-50.0 µg/mL for chlorzoxazone, and 0.25-100.0 µg/mL for tolbutamide. Intra- and interday precision were less than 12.09%. The matrix effect ranged from 87.50% to 109.25% and the absolute recoveries were greater than 70%. The method was successfully applied to evaluate the effect of THP enantiomers on the activity of CYP450 isozymes by a cocktail approach. The pharmacokinetic results of five probe drugs indicated that there were stereoselective differences between the two THP enantiomers, i.e., d-THP had the potential to inhibit the activities of CYP2D6 and CYP1A2 isozymes, while l-THP inhibited CYP1A2 isozyme and induced CYP3A4 and CYP2C9 isozymes.

In this paper, an epidemic model involving a nonlinear birth in population and stage structure was studied. The stability of disease-free equilibrium was verified by Routh-Hurwitz criterion and LaSalle's invariance principle. We researched the existence of Hopf bifurcation and obtained the stability and direction of the Hopf bifurcation by using the normal theory and the center manifold theorem. In the end, numerical simulations were carried out to illustrate the main theoretical results and a brief discussion was given to conclude this work.

This paper studies the entrepreneurial environment of college students in China currently and analyzes advantages and disadvantages of college students' entrepreneurship under the current complicated situation, which are problems to be faced by entrepreneurial education and are conducive to more effective implementation of college students' entrepreneurship. This paper establishes a quantitative indicator evaluation system according to practical conditions of entrepreneurial environment in Shaanxi based on macro-environment (PEST). The research and evaluation allow students to know dominant factors and secondary factors influencing entrepreneurial environment and their degree of influence so as to draw a clear distinction between the primary and the secondary and shoot the arrow at the target during the implementation of entrepreneurship. It is also good for the government and colleges and universities to improve entrepreneurial environment to the maximum extent under the environment of resource constraint.

The characterization and quantification of the metabolites of chiral drugs still remain a great challenge due to the complexity of the metabolites and most of them are not commercially available. In this study, a practical approach based on the combinatory liquid chromatography-mass spectrometric techniques has been proposed for the evaluation of metabolism profiles and urinary excretion kinetics of chiral drugs and their metabolites. Racemic tetrahydropalmatine (rac-THP), a biologically active ingredient isolated from a traditional Chinese herb Rhizoma Corydalis, was chosen as the model chiral drug. Ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS) was applied to characterize the metabolites of THP enantiomers in rat urine after administration of (+)-THP or (-)-THP. Accurate mass measurement was used to determine the elemental composition of metabolites and thus to confirm the proposed structures of these metabolites. More than 30 potential metabolites were found in rat urine, most of which were identified for the first time, and the metabolic pathways in vivo were involved in demethylation, oxidation, glucuronide conjugation and sulfation, etc. And the tridesmethlyzed metabolite and didesmethlyzed coupled with oxidation metabolite were found only in (+)-THP treated rats. Afterwards, a liquid chromatography tandem mass spectrometry (LC-QqQ/MS) assay was developed and validated for the determination of the urine level of THP enantiomers and their metabolites. Semi-quantification of three phase I metabolites and two phase II metabolites were performed. Enantiomeric (-/+) cumulative urinary excretion ratios of THP and its five metabolites were obtained, which indicated the stereoselective aspects of metabolites of THP enantiomers in vivo. The study demonstrated the enormous potential of this strategy for the qualitative characterization, quantitative assay and the stereoselectivity of chiral drugs and their metabolites.

Since 2003, China has experimented in some of the country's counties with the private administration of the New Cooperative Medical Scheme (NCMS), a publicly subsidized health insurance scheme for rural populations. Our study compared the effectiveness and efficiency of private vs public administration in four counties in one of China's most affluent provinces in the initial stage of the NCMS's implementation. The study was undertaken in Ningbo city of Zhejiang province. Out of 10 counties in Ningbo, two counties with private administration for the NCMS (Beilun and Ninghai) were compared with two others counties with public administration (Zhenhai and Fenghua), using the following indicators: (1) proportion of enrollees who were compensated for inpatient care; (2) average reimbursement–expense ratio per episode of inpatient care; (3) overall administration cost; (4) enrollee satisfaction. Data from 2004 to 2006 were collected from the local health authorities, hospitals and the contracted insurance companies, supplemented by a randomized household questionnaire survey covering 176 households and 479 household members. In our sample counties, private administration of the NCMS neither reduced transaction costs, nor improved the benefits of enrollees. Enrollees covered by the publicly administered NCMS were more likely to be satisfied with the insurance scheme than those covered by the privately administered NCMS. Experience in the selected counties suggests that private administration of the NCMS did not deliver the hoped-for results. We conclude that caution needs to be exercised in extending private administration of the NCMS.

Tetrahydroberberine (THB), a racemic mixture of (+)- and (-)-enantiomer, is a biologically active ingredient isolated from a traditional Chinese herb Rhizoma corydalis (yanhusuo). A chiral high performance liquid chromatography method has been developed for the determination of THB enantiomers in rat plasma. The enantioseparation was carried out on a Chiral®-AD column using methanol:ethanol (80:20, v/v) as the mobile phase at the flow rate 0.4 ml/min. The ultraviolet detection was set at 230 nm. The calibration curves were linear over the range of 0.01-2.5 μg/ml for (+)-THB and 0.01-5.0 μg/ml for (-)-THB, respectively. The lower limit of quantification was 0.01 μg/ml for both (+)-THB and (-)-THB. The stereoselective pharmacokinetics of THB enantiomers in rats was studied after oral and intravenous administration at a dose of 50 and 10 mg/kg racemic THB (rac-THB). The mean plasma levels of (-)-THB were higher at almost all time points than those of (+)-THB. (-)-THB also exhibited greater C(max), and AUC(0-∞), smaller CL and V(d), than its antipode. The (-)/(+)-enantiomer ratio of AUC(0-∞) after oral and intravenous administration were 2.17 and 1.43, respectively. These results indicated substantial stereoselectivity in the pharmacokinetics of THB enantiomers in rats.

Nat. Biotechnol. 32, 1223–1230 (2014); published online 17 November 2014; corrected after print 14 May 2015 In the version of this article initially published, Yingying Zhang's name was spelled Yinying Zhang. The error has been corrected in the HTML and PDF versions of the article.