Abstract Background stewart-treves syndrome (STS) is an angiosarcoma associated with chronic lymphedema. Objectives This article analyses the characteristics of twenty-two patients and proposes active intervention in lymphedema and the early diagnosis of STS. Methods Twenty-two patients with STS were diagnosed at the centre over an 11-year period. Clinical manifestations, a series of conventional analyses, and histopathology were used to study these cases retrospectively. Results The age range of 22 patients with STS was 15 to 78 years. The main clinical manifestations included multiple skin and subcutaneous nodules and scattered red or purplish-red rashes in the lymphoedematous limbs. These patients often showed clinical symptoms such as lymphedema, weakness, emaciation, pain, mass, lymphadenopathy and so on. The positive rates of ultrasonography, MRI and radionuclide imaging were 66.7% (6/9), 92.3% (12/13) and 18.2% (2/11), respectively. The main points regarding active intervention in lymphedema and early diagnosis of STS were summarized. Study limitations Since this was a retrospective study, the main points summarized by the author need to be further quantified in clinical work to guide the diagnosis of this kind of disease more conveniently. In addition, further clinical trials are needed to evaluate the role of lymphedema in the occurrence and development of malignant tumors. Conclusions STS can appear in lymphoedematous tissue many years after lymphedema onset. To avoid delays in the diagnosis and therapy of STS, physicians should actively look for signs or symptoms of malignant lymphedema during the follow-up period and promptly manage patients developing problems.

ABSTRACT Purpose: Oxidative stress and apoptosis contribute to the pathological basis of doxorubicin (DOX)-induced cardiotoxicity. Columbianadin (CBN) is one of the main bioactive constituents isolated from the root of Angelica pubescens. Herein, we intended to explore the potential role and molecular basis of CBN in DOX-induced cardiotoxicity. Methods: C57BL/6 mice were subjected to DOX (15 mg/kg/day, i.p.) to generate DOX-induced cardiotoxicity. CBN (10 mg/kg/day, i.p.) was administered for four week following DOX injection. Results: DOX administered markedly dampened cardiac function, increased cardiac injury, excessive reactive oxygen species (ROS) production, and cardiomyocyte loss. These alterations induced by DOX significantly alleviated by CBN treatment. Mechanistically, our results demonstrated that the CBN exerts cardioprotection role against DOX by up-regulating silent information regulator 1 (Sirt1) and decreasing acetylation of forkhead box O1 (FOXO1). Moreover, Sirt1 inhibition with Ex-527 significantly blunt the beneficial effect of CBN on DOX-induced cardiotoxicity, including cardiac dysfunction, ROS, and apoptosis. Conclusion: Collectively, CBN attenuated oxidative stress and cardiomyocyte apoptosis in DOX-induced cardiotoxicity through maintaining Sirt1/FOXO1 signaling pathway. Our results demonstrated that CBN might be used to treat DOX-related cardiotoxicity.

ABSTRACT Introduction: Severe fever with thrombocytopenia syndrome virus (SFTSV) is a newly emerged virus that poses a great threat to human health because of high fatality rate. Methods: To develop sensitive and specific sero-diagnostic systems for SFTSV infections, monoclonal antibodies (MAbs) against recombinant SFTSV nucleocapsid (rSFTSV-N) protein were developed by immunizing BALB/C mice with rSFTSV-N protein and fusing the spleen cells with SP2/0 myeloma cells. Three hybridoma cell lines secreting MAbs against rSFTSV-N were obtained. MAb based IgG sandwich enzyme linked immunosorbent assay (ELISA) and IgM capture ELISA systems were established by using the newly developed MAbs. One hundred fifteen clinical suspected SFTS patients serum samples were used to evaluate the newly established systems by comparing with the total antibody detecting sandwich ELISA system and indirect ELISA systems. Results: The MAbs based sandwich IgG ELISA was perfectly matched with that of the total antibody sandwich ELISA and the indirect IgG ELISA. IgM capture ELISA results perfectly matched with that of the total antibody sandwich ELISA while detecting eight additional positive samples missed by the indirect IgM ELISA. Conclusions: The MAbs against rSFTSV-N protein offer new tools for SFTSV studies and our newly developed MAb-based IgG and IgM capture ELISA systems would offer safe and useful tools for diagnosis of SFTS virus infections and epidemiological investigations.

Resumen: Éste es un estudio sobre la renormalización en la configuración de la localidad algebraica, que resalta el papel que los morfismos de la localidad pueden desempeñar para los propósitos de la renormalización. Después de describir el marco general para construir mapas de regularización de la localidad, ilustramos la renormalización mediante homomorfismos de álgebras de la localidad en tres ejemplos, la renormalización de las funciones zeta cónica en los polos, la definición de las funciones zeta ramificadas y su evaluación en los polos y, finalmente, los valores de las integrales iteradas derivadas del modelo de juguete de Kreimer.

Abstract: This is a survey on renormalisation in algebraic locality setup highlighting the role that locality morphisms can play for renormalisation purposes. After describing the general framework to build locality regularisation maps, we illustrate renormalisation by locality algebra homomorphisms on three examples, the renormalisation of conical zeta functions at poles, the definition of branched zeta functions and their evaluation at poles and finally the values of iterated integrals stemming from Kreimer's toy model.

Resumo Introdução: A rinite alérgica é uma doença inflamatória crônica que afeta um a cada seis indivíduos. A rinite alérgica perene é responsável por 40% dos casos de rinite alérgica. A ciclesonida é um dos corticosteroides intranasais mais novos para o tratamento dessa condição clínica. Objetivo: Avaliar a eficácia e segurança da ciclesonida no tratamento da rinite alérgica perene. Método: Uma busca foi feita nos bancos de dados Pubmed, Scientific Citation Index, Embase e Clinical Trial Registries por ensaios clínicos randomizados e Cochrane Central Register of Controlled Trials por estudos controlados randomizados que comparassem ciclesonida com placebo no tratamento da rinite alérgica perene. Resultados: Oito estudos foram incluídos. Em comparação com os grupos placebo, os grupos ciclesonida mostraram diminuição significante no escore do Reflective Total Nasal Symptom Score (DM = −0,56; IC 95%: −0,72 a −0,39, p < 0,00001) com heterogeneidade (p = 0,19, I2 = 24%), do Instantaneous Total Nasal Symptom Score (DM = −0,57; IC95%: −0,75 a −0,39, p < 0,00001) com heterogeneidade (p = 0,34, I2 = 11%). Um efeito significante no escore do Reflective Nasal Symptom Score Subtotal (DM = −0,15; IC 95%: −0,18 a −0,13, p < 0,00001) com heterogeneidade (p = 0,12, I2 = 24%) também foi demonstrado. O escore do Rhinoconjunctivitis Quality of Life Questionnaire score (RQLQs) (DM = −0,27; IC 95%: −0,39 a −0,15, p < 0,00001) com heterogeneidade (p = 0,58, I2 = 0%) também foi significantemente reduzido no tratamento com ciclesonida. Além disso, a diferença em relação aos eventos adversos emergentes do tratamento entre os dois grupos não foi significante. Conclusão: A ciclesonida pode melhorar a rinite alérgica perene sem aumentar os eventos adversos. Esse fármaco pode ser outra opção valiosa para a rinite alérgica perene no futuro.

Abstract Introduction: Allergic rhinitis is a chronic inflammatory disease which affects 1 out of 6 individuals. Perennial allergic rhinitis accounts for 40% of AR cases. Ciclesonide is one of the relatively new intranasal steroid for allergic rhinitis. Objective: The purpose of this study was to evaluate the efficacy and safety of ciclesonide in the treatment of perennial allergic rhinitis. Methods: We searched Pubmed, Scientific Citation Index, Embase, Clinical Trial Registries for randomized controlled trials and Cochrane Central Register of Controlled Trials to find out the randomized controlled Trial comparing ciclesonide with placebo for PAR. Results: Eight studies were included. In comparison with placebo groups, ciclesonide groups significantly decreased Reflective Total Nasal Symptom Score (MD = −0.56; 95% CI −0.72 to 0.39, p < 0.00001) with heterogeneity (p = 0.19, I2 = 24%), Instantaneous Total Nasal Symptom Score (MD = −0.57; 95% CI −0.75 to −0.39, p < 0.00001) with heterogeneity (p = 0.34, I2 = 11%). A significant effect for Reflective Nasal Symptom Score Subtotal (MD = −0.15; 95% CI −0.18 to −0.13, p < 0.00001) with heterogeneity (p = 0.12, I2 = 24%) was also demonstrated. Rhinoconjunctivitis quality of life questionnaire score (RQLQs) (MD = −0.27; 95% CI −0.39 to −0.15, p < 0.00001) with heterogeneity (p = 0.58, I 2 = 0%) in the treatment of ciclesonide was also significantly reduced. In addition, the difference in Treatment-Emergent Adverse Events between the two groups was not significant. Conclusion: Ciclesonide can improve perennial allergic rhinitis without increasing adverse events. Ciclesonide may be another valuable choice for perennial allergic rhinitis in the future.

SUMMARY: Matrigel is a basement membrane matrix extracted from the EHS mouse tumor containing extracellular matrix protein, its main components are laminin, type IV collagen, nestin, heparin sulfate, growth factor and matrix metalloproteinase.At room temperature, Matrigel polymerized to form a three dimensional matrix with biological activity. It can simulate the structure, composition, physical properties and functions of the cell basement membrane in vivo, which is beneficial to the culture and differentiation of the cells in vitro, and can be used for the study of cell morphology, biochemical function, migration, infection and gene expression. In this study, Matrigel three-dimensional culture model of bone marrow mesenchymal stem cells(BMSCs) was established, and its morphology, proliferation and survival were observed. BMSCs were isolated and cultured with whole bone marrow adherence method. The Second generation BMSCs with good growth condition were selected and mixed with Matrigel to form cell gel complexes. The morphology and proliferation of mesenchymal stem cells were observed by phase contrast microscope and HE staining,Live/Dead staining was used to evaluate the cell activity.Phase contrast microscopy showed that BMSCs were reticulated in Matrigel and proliferated well, After 7 days, the matrix gel gradually became soft and collapsed, a few cell reticular crosslinking growth was seen at 14 days; HE staining showed that the cytoplasm of the cells was larger on the fourth day and the cells were elongated and cross-linked on the seventh day; Live/dead staining showed that most cells showed green fluorescence with the prolongation of culture time, on the first, 4 and 7 days, the activity of bone marrow mesenchymal stem cells in Matrigel gradually increased, and the percentages were 92.57 %, 95.54 % and 97.37 %, respectively. Matrigel three-dimensional culture system can maintain the morphology, function and proliferation ability of bone marrow mesenchymal stem cells.

RESUMEN: Matrigel es una matriz de membrana basal extraída del tumor de ratón EHS que contiene proteína de matriz extracelular. Los componentes principales son laminina, el colágeno tipo IV, nestina, sulfato de heparina, factor de crecimiento y metaloproteinasa de matriz. A temperatura ambiente, Matrigel se polimerizó para formar una matriz tridimensional. Es posible simular la estructura, la composición, las propiedades físicas y las funciones de la membrana basal celular in vivo, lo que es beneficioso para el cultivo y la diferenciación de las células in vitro, y se puede utilizar para el estudio de la morfología celular, la función bioquímica, la migración, infección y expresión génica. En este estudio, se estableció el modelo de cultivo tridimensional Matrigel de células madre mesenquimales de médula ósea (BMSC), y se observó su morfología, proliferación y supervivencia. Las BMSC fueron aisladas y cultivadas con el método de adherencia de la médula ósea completa. Se seleccionaron las BMSC de segunda generación con buenas condiciones de crecimiento y se mezclaron con Matrigel para formar complejos de gel de células. La morfología y la proliferación de las células madre mesenquimales se observaron con microscopio de contraste de fase y se tiñó con Hematoxilina-Eosina (HE); para evaluar la actividad celular se usó la tinción Live/Dead. La microscopía de contraste mostró que las BMSC se reticularon en Matrigel y proliferaron bien. Después de 7 días, se observó que el gel de matriz gradualmente se volvió blando y colapsó, y se visualizó un cruce transversal de algunas células reticulares a los 14 días. La tinción mostró que la mayoría de las células mostraron una fluorescencia verde con la prolongación del tiempo de cultivo; en los primeros 4 y 7 días, la actividad de las células madre mesenquimales de la médula ósea en Matrigel aumentó gradualmente y los porcentajes fueron de 92,57 %, 95,54 % y 97,37 %, respectivamente. El sistema de cultivo tridimensional de Matrigel puede mantener la morfología, la función y la capacidad de proliferación de las células madre mesenquimales de la médula ósea.

ABSTRACT No-tillage and straw returning are important practices for preserving and improving soil quality for the sustainable management system. The experimental field was established in 2007 with conventional tillage (CT), conventional tillage with straw returning (CTS), no-tillage (NT), and no-tillage with straw returning (NTS) practice in rice (Oryza sativa L.)-rape (Brassica napus L.) cropping system. The soil samples were collected in 2013-2015 from 0-20 and 20-40 cm depth to investigate the effects on soil organic C (SOC), water-stable aggregation (> 5, 5-2, 2-1, 1.0-0.5, 0.25-0.5, and < 0.25 mm), and their stability in paddy soil of the central China. In the last year (2015), the integrative use of no-tillage and straw returning significantly increased SOC content and contribution of the macroaggregates in 0-20 cm and microaggregates in 20-40 cm depth. Compared with CT, SOC content, mean weight diameter (MWD), geometric mean diameter (GMD), and fractal dimensions (FD) under NTS were increased 25%, 21%, 19%, and 12%, respectively, in the 0-20 cm depth. In 20-40 cm depth, the soil micro-aggregates were higher under CTS treatment. Percentages of macroaggregates and microaggregates under NTS were increased 60% and 40% in the 0-20 cm depth. The SOC had positive linear relationship with MWD, GMD, > 5, 2-5, 1-2, and 0.25-0.5 mm aggregates. Thus, long-term combine use of NT with straw returning practices significantly improved SOC and water-stable aggregation. No-tillage and straw returning appeared to be promising and sustainable strategies to conserve SOC sequestration and stable soil aggregates in rice-rape cropping system.

MicroRNAs (miRNAs) have been reported to be associated with heart valve disease, which can be caused by inflammation. This study aimed to investigate the functional impacts of miR-27a on TNF-α-induced inflammatory injury in human mitral valve interstitial cells (hMVICs). hMVICs were subjected to 40 ng/mL TNF-α for 48 h, before which the expressions of miR-27a and NELL-1 in hMVICs were altered by stable transfection. Trypan blue staining, BrdU incorporation assay, flow cytometry detection, ELISA, and western blot assay were performed to detect cell proliferation, apoptosis, and the release of proinflammatory cytokines. We found that miR-27a was lowly expressed in response to TNF-α exposure in hMVICs. Overexpression of miR-27a rescued hMVICs from TNF-α-induced inflammatory injury, as cell viability and BrdU incorporation were increased, apoptotic cell rate was decreased, Bcl-2 was up-regulated, Bax and cleaved caspase-3/9 were down-regulated, and the release of IL-1β, IL-6, and MMP-9 were reduced. NELL-1 was positively regulated by miR-27a, and NELL-1 up-regulation exhibited protective functions during TNF-α-induced cell damage. Furthermore, miR-27a blocked JNK and Wnt/β-catenin signaling pathways, and the blockage was abolished when NELL-1 was silenced. This study demonstrated that miR-27a overexpression protected hMVICs from TNF-α-induced cell damage, which might be via up-regulation of NELL-1 and thus modulation of JNK and Wnt/β-catenin signaling pathways.

ABSTRACT Phytoene synthase (PSY) is the rate-limiting enzyme for carotenoid biosynthesis. To date, several studies focused on PSY genes in the context of abiotic stress responses. In this study, two phytoene synthase encoding genes, IbPSY1 and IbPSY2, were identified from a published transcriptome and bioinformatic analysis showed that they shared conserved domains with phytoene synthases from other plants. The IbPSY1 gene was cloned and carefully characterized. Digital gene expression profiling (DGE) showed that the highest transcription level of IbPSY1 was in young leaves, and the lowest level was in stems. In vivo expression levels of IbPSY1 under abiotic stress were observed to be highest in stems at day 11. Over-expression of IbPSY1 in Escherichia coli and yeast cells endowed the cells with better growth under salt and drought stress than the control cells. This study demonstrated that IbPSY1 not only played an important role in vivo, but also in E. coli and yeast to improve tolerance to salinity and drought stress. Thus, IbPSY1 may be aid in the development of transgenic plants with enhanced stress tolerance.

Previous studies suggested that chromodomain helicase DNA-binding proteins (CHDs), including CHD 1–8, were associated with several human diseases and cancers including lymphoma, liver cancer, colorectal cancer, stomach cancer, etc. To date, little research on CHD 9 in human cancers has been reported. In this study, we assessed the prognostic value of CHD 9 in patients with colorectal cancer (CRC). We screened for CHD 9 expression using immunohistochemical analysis in 87 surgical CRC specimens and found that the expression was upregulated in 81.5% of the cases, while 7.4% were decreased; in the remaining 11.1% of the cases, levels were not altered. Kaplan-Meier analysis showed that patients with high CHD 9 expression had better prognosis than those with low CHD 9 expression (54.5 vs 32.1%, P=0.034). Subsequently, Cox multi-factor survival regression analysis revealed that expression of CHD 9 protein was an independent predictor for CRC, with a hazard ratio of 0.503 (P=0.028). In addition, we found that CHD 9 expression was positively correlated with MSH2 (rs=0.232, P=0.036). We speculated that CHD9 might be a putative tumor suppressor gene, and could inhibit the development of CRC by participating in DNA repair processes. Our findings suggest that CHD 9 could be a novel prognostic biomarker and a therapeutic target for CRC. Further studies are needed to detect the effect of CHD 9 on cellular function and the expression of mismatch repair genes.

Abstract Physical-chemical and rheological properties of pork batters as affected by replacing pork back-fat with pre-emulsified sesame oil were investigated. Replacement of pork back-fat with pre-emulsified sesame oil, improved L* value, moisture and protein content, hardness, cohesiveness, and chewiness, declined a* value, fat content and energy, but not affect cooking yield. When used pre-emulsified sesame oil to replace pork back-fat 50%, the sample had the highest L* value and texture. According to the results of dynamic rheological, replaced pork back-fat by pre-emulsified sesame oil increased the storage modulus (G') values at 80 °C, and formed firm gel. The result of Low-field nuclear magnetic resonance (LF-NMR) shown that the batters with pre-emulsified sesame oil had higher water holding capacity than the control. Overall, the batters with pre-emulsified sesame oil enabled lowering of fat and energy contents, making the pork batter had better texture.

The Ordovician carbonatites of the Maigaiti slope have formed the conditions for the development of large oil and gas fields with karst reservoirs. This study systematically analyzed the isotopic characteristics of carbon, oxygen, and strontium and enrichment trace elements regularity to examine the geochemical features of the paleo-karstification products, various periods of paleo-karstification, and paleoenvironmental conditions of the Ordovician. Affected by terrigenous clasts, the Lianglitage Formation is composed of limestone with a relatively high 87Sr/86Sr value and a frequently fluctuating sea level, which exhibits an overall increasing-to-decreasing trend variation. Of all samples affected by the atmospheric freshwater leaching effect, δ18O values were negative, and δ13C values varied greatly toward both ends. The fissure/cave infills were rich in Fe and Mn but poor in Sr, and the Sr/Ba value was considerably less than 1, which confirms the existence of ancient weathered crust and the development of an atmospheric freshwater karst environment. Four different paleo-karstification periods were identified according to the carbon and oxygen isotopic characteristics of calcite. Combined with the trace element characteristics of the infills, the paleo-karstification in the Yingshan Formation was subdivided based on three hydrological environment conditions. Erosion modification of buried acid compaction-released water from late-period corrosion pores, caves, and fissures formed by syndiagenetic paleo-karstification and weathered crust bare paleo-karstification due to atmospheric freshwater leaching can significantly improve the reserving and permeability characteristics of the karst reservoir to develop a large paleokarst reservoir.

This study was conducted to assess the biocontrol efficacy of Bacillus subtilis (strain 4812) and Bacillus methylotrophicus (strain H8) individually or in combination with two plant defense inducers including Acetyl salicylic acid (ASA) and DL-Beta-aminobutyric acid (BABA) against tomato wilt caused by Ralstonia solanacearum. The pathogen was significantly inhibited by all treatments in the greenhouse and in vitro tests. The treatments H8+ASA and 4812+H8 were found to be the most effective treatments in in vitro tests. Applied on tomato seeds and as soil drenching, the disease was most inhibited by H8 whereas 4812+H8+ASA was the least effective treatment. High activity of phenylalanine ammonia-lyase was observed in the plants treated with 4812+H8, H8+ASA and 4812+H8+ASA. The highest expression of peroxidase and polyphenoloxidase enzymes was found in the plants treated with H8, 4812+H8 and H8+ASA. The result of real time PCR showed that concentration of the pathogen in stem tissues was significantly reduced in all treated plants and H8+ASA was the most effective treatment. This study revealed that combined application of Bacillus strains can be considered as a more effective biocontrol agent against tomato bacterial wilt. Furthermore, the synergistic effect of plant defense inducers was variable to different Bacillus strains.

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OBJECTIF: Évaluer la mise en œuvre du programme national des médicaments essentiels (PNME) en Chine rurale. MÉTHODES: Une enquête a été menée dans deux comtés/districts ruraux de trois provinces où le PNME a été mis en œuvre. Des informations ont été recueillies auprès du personnel du PNME, au niveau de la province, du comté/district, de la municipalité et du village. Les patients atteints de maladies chroniques ont également été interrogés. La prestation de services, les aspects financiers, les ordonnances, les dossiers des patients hospitalisés et les dépenses des patients avec certains diagnostics ont été étudiés dans les hôpitaux municipaux et les cliniques de village. Les résultats ont été comparés avec les données correspondantes, enregistrées avant le lancement du PNME. RÉSULTATS: Suite à la mise en œuvre du PNME, l'approvisionnement en médicaments dans chaque site faisant l'objet de l'étude a été systématisé. Les coûts totaux des médicaments ont diminué. Cela, ainsi qu'une amélioration de la prescription, a réduit les coûts des soins ambulatoires et hospitaliers et a conduit, apparemment, à une augmentation de l'utilisation des services de santé. Toutefois, les prix de certains médicaments ont augmenté et la disponibilité d'autres a diminué. L'indemnisation des prestataires de soins de santé pour compenser les réductions de revenus liées au PNME a été largement inefficace. Du fait du lancement du PNME, les établissements de santé dépendent davantage du financement public. De nombreux prestataires de soins se plaignent de charges de travail plus importantes et de revenus plus faibles. CONCLUSION: Bien qu'elle ait été correctement conçue, la mise en œuvre du PNME dans le système chinois de soins de santé, décentralisé et rémunéré à l'acte, n'a pas été simple. Il a mis en exergue les problèmes liés aux tentatives visant à moderniser les soins de santé et le financement de la santé au bénéfice des patients. Des mécanismes durables pour compenser la perte de revenu des fournisseurs de soins sont nécessaires pour assurer le succès du PNME.

OBJECTIVE: To evaluate implementation of the National Essential Medicines Scheme (NEMS) in rural China. METHODS: Two rural counties/districts in each of three provinces where NEMS had been implemented were surveyed. Information was collected from NEMS staff at the province, county/district, township and village levels; patients with chronic disease were also interviewed. Service provision, finances, prescriptions, inpatient records and the expenditures of patients with certain diagnoses were investigated in township hospitals and village clinics. The results were compared with the corresponding data recorded before NEMS was introduced. FINDINGS: Following the introduction of NEMS, drug procurement in each study location was systematized. Total drug costs declined. This, and improved prescribing, reduced the costs of outpatient and inpatient care and led, apparently, to increased uptake of health services. However, the prices of some drugs had increased and the availability of others had declined. The compensation of health-care providers for NEMS-related reductions in their incomes had been largely ineffective. As a result of the introduction of NEMS, health facilities relied more on public financing. Many health-care providers complained about higher workloads and lower incomes. CONCLUSION: Although it was well conceived, the introduction of NEMS into China's decentralized, fee-for-service system of health care has not been straightforward. It has highlighted the problems associated with attempts to modernize health care and health financing for patients' benefit. Sustainable mechanisms to compensate health-care providers for lost income are needed to ensure that NEMS is a success.

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OBJETIVO: Evaluar la puesta en práctica del Plan nacional de medicamentos esenciales (NEMS) en las zonas rurales de China. MÉTODOS: Se examinaron dos condados o distritos rurales en cada una de las tres provincias en las que se había implementado el NEMS. Se recogió información del personal del NEMS a nivel provincial, de condado/distrito, municipal y de aldea; también se entrevistó a pacientes con enfermedades crónicas. En los hospitales municipales y clínicas rurales se investigó la prestación de servicios, la situación económica, las recetas, los registros de pacientes hospitalizados y los gastos de los pacientes con ciertas enfermedades. Los resultados se compararon con los datos correspondientes registrados antes de la introducción del NEMS. RESULTADOS: Tras la introducción del NEMS se sistematizó la adquisición de medicamentos en cada lugar objeto de estudio y el precio de los medicamentos disminuyó. Esto, junto con una mejora en la prescripción de recetas, redujo los costes de la atención tanto a los pacientes ambulatorios como a los hospitalizados. Asimismo, condujo, al parecer, a una respuesta superior ante los servicios sanitarios. No obstante, el precio de algunos medicamentos aumentó y la disponibilidad de otros disminuyó. La remuneración a los proveedores de atención sanitaria por las reducciones salariales relacionadas con el NEMS ha sido en su mayor parte ineficaz. Como resultado de la introducción del NEMS, los centros de salud dependían más de la financiación pública y muchos proveedores de atención sanitaria se quejaban del aumento de la carga de trabajo y la reducción de los salarios. CONCLUSIÓN: Aunque bien concebida, la introducción del NEMS en el sistema de atención sanitaria descentralizado y de pago por servicios de China no ha sido sencilla. Han destacado los problemas relacionados con los intentos de modernizar la atención sanitaria y la financiación de la salud en beneficio de los pacientes. A fin de asegurar el éxito del NEMS, se necesitan mecanismos sostenibles para compensar a los proveedores de atención sanitaria por la pérdida de ingresos.

We evaluated the diversity of soil macrofauna communities inhabiting urban green spaces in Yancheng City, an urbanizing city located east of China. In the end of April 2011, the taxonomic richness, abundance and composition of soil macrofauna communities were assessed and compared among five types of green space (poplar forest, rapeseed farm, grassland in park, lawn and nursery garden) and three depth layers in the soil, with taxonomic resolution attained at the order level. Taxonomic richness (orders) and abundance were significantly different among green spaces. Diversity indices (Margalef's taxonomic richness R and Shannon-Weaver diversity index H') were higher in poplar forest, grassland in park and nursery garden than in rapeseed farm and lawn. Taxonomic richness (Chao 2) showed a similar trend. There were significant effects of green space type and soil layer, which showed a significant interaction affecting macrofauna composition. We recommend that urban green spaces can be used for maintaining biodiversity, not only for landscape purposes.

Evaluamos la diversidad de las comunidades de macrofauna del suelo que habitan los espacios verdes urbanos en la ciudad de Yancheng, una ciudad en proceso de urbanización situada al este de China. A fines de abril 2011, la riqueza taxonómica, abundancia y composición de comunidades de macrofauna del suelo fueron evaluadas y comparadas entre cinco tipos de espacio verde (bosque de álamos, granja de colza, pastizal de parque, césped y jardín vivero) y tres capas de profundidad del suelo, con resolución taxonómica a nivel de orden. La riqueza taxonómica (de órdenes) y la abundancia fueron significativamente diferentes entre los espacios verdes. Los indices de diversidad (riqueza taxonómica R de Margalef y diversidad H' de Shannon-Weaver) fueron mayores en el bosque de álamos, pastizal de parque y jardin vivero que en la granja de la colza y el césped. La riqueza taxonómica (Chao 2) mostró una tendencia similar. Hubo efectos significativos del tipo de espacio verde y capa del suelo, los cuales mostraron una interacción significativa afectando la composición de la macrofauna. Recomendamos que los espacios verdes urbanos se puedan utilizar para mantener la biodiversidad, y no solo con propósitos de paisaje.