Chronic Disease Patients Involved in Shared-decision Making in General Outpatient Care in the Community：Current Status and Associated Factors

BackgroundThe general practice clinic in community health centers is facing increasingly complex challenges to meet the medical needs of patients with chronic diseases. To improve chronic disease patients' health outcome and healthcare satisfaction, it will be of great significance to use shared decision-making (SDM) in the diagnostic and therapeutic process in the community, since SDM is a model based on doctor-patient mutual respect and cooperation and shows great promise as a possible major medical decision-making model.ObjectiveTo understand the status and associated factors of chronic disease patients involved in SDM in general outpatient care in the community, aiming to provide evidence for promoting the implementation of SDM in primary care.MethodsWe used cluster sampling to select seven general practitioners (GPs) in the clinic of Shuangyushu Community Health Center, Beijing, and 149 chronic disease patients seen by them between October 2019 and January 2020 as the participants. Through non-participant observation at the clinic, we used the Chinese version of the Observer OPTION 5 (OPTION-5) as an assessment tool to evaluate the extent to which GPs facilitated patient participating in SDM during the consultation. We used a self-developed general demographic questionnaire to collect patients' demographics, status of illness and treatment, as well as GPs' demographics. We compared the OPTION-5 score of the patients by demographic factors, and used stepwise multiple linear regression to explore the factors affecting patients' participation in SDM.ResultsThe mean visit length, and OPTION-5 score for the 149 patients were (4.1±2.7) minutes, and〔6.00 (3.00) 〕, respectively. The OPTION-5 score varied significantly across patients by age group and visit length (P<0.05) . Multiple linear regression analysis showed that patient visit length, prevalence of interruption of counseling due to other people, and prevalence of family member accompaniment to medical visits were associated with patients' participation in SDM (P<0.05) .ConclusionThe participation of these patients in SDM was relatively low. Prolonging GP-patient communication time, ensuring that the diagnosis and treatment process is not interrupted, and giving patients a private space during diagnosis and treatment process may be feasible interventions to improve the participation of chronic disease patients in SDM in primary care

Anticancer effect of a combination of cisplatin and matrine on cervical cancer U14 cells and U14 tumor-bearing mice, and possible mechanism of action involved

Purpose: To investigate the anticancer effects of cisplatin (DDP) in combination with matrine on cervical cancer U14 cell tumor-bearing mice. Methods: The cell proliferation of cervical cancer U14 cells treated with DDP (25, 20, 15, 10 and 5 μg/mL); matrine (2.5, 2.0, 1.5, 1.0 and 0.5 mg/mL); or DDP (15 μg/mL) + matrine (2.5, 2.0, 1.5, 1.0 and 0.5 mg/mL) was determined with MTT assay. The anticancer effect of DDP + matrine in U14 tumor-bearing mice was also investigated, based on expression of tumor suppressor lung cancer 1 (TSLC1) using quantitative real time-polymerase chain reaction (qRT-PCR) and immunohistochemistry. Results: The inhibition of proliferation of U14 cells ranged from 26.68–70.25, 10.20–61.73, and 51.89–89.75 % for DDP, matrine and DDP + matrine, respectively. In mice with U14 solid tumors, the DDP group had 12.3 % weight loss (p < 0.05). Treatment with DDP, matrine, and DDP + matrine reduced tumor growth by 64.56, 42.22–56.67, and 67.78–81.11 %, respectively (p < 0.01). Results from RT-qPCR and immunohistochemistry showed corresponding increases in expression levels of TSLC1. Conclusion: These results indicate that the anticancer activity of DDP + matrine is higher than that of a single treatment with either DPP or matrine. The likely mechanism of action might be related to promotion of TSLC1 expression. This finding provides a potential strategy for the management of cervical cancer

ELM of ELM-WD: An extremely low mass hot donor star discovered in LAMOST survey

The Extremely Low Mass White Dwarfs (ELM WDs) and pre-ELM WDs are helium core white dwarfs with mass $<\sim 0.3M_{\odot}$. They are formed in close binaries and have lost over half of their initial masses via Common Envelope (CE) ejection or stable Roche Lobe Over Flow (RLOF). Both evolution simulations and observations show that a lower mass limit for ELM WDs exists at $\approx0.14M_{\odot}$. Here we report the discovery of an extremely low mass ELM WD, ID70904216 in LAMOST survey, that may be lower than the ELM WD mass limit. Based on LAMOST and P200 spectroscopic observations, ID70904216 shows orbital period $P_{orb} =$ 0.219658 days and radial velocity semi-amplitude $K1=317.33km/s$, which gives the mass function of 0.73$M_{\odot}$, indicating the companion is a compact star. The low resolution spectra shows a F type star with $T_{\rm eff} \sim 7361K$ without emission features. The temperature is consistent with that derived from SED fitting($7440K$) and multi-color light curve solution($7400K$). The optical light curves, in ZTF g, r and i bands and Catalina V band, show ellipsoidal variability with amplitudes $\approx30\%$, suggesting that the visible companion is heavily tidal distorted. Combining with the distance from Gaia survey, the WD code modeling estimates that the mass of the visible star is $M1=0.08^{+0.06}_{-0.03}M_{\odot}$, and the mass of the invisible star is $M2=0.94^{+0.45}_{-0.10}M_{\odot}$. The radius of the visible donor is $R=0.29\pm0.01R_{\odot}$. The inclination angle is constrained between 60$^{\circ}$ and 90$^{\circ}$. The observations indicate the system is a pre-ELM WD + WD/NS binary system with an extremely low mass hot donor below the $0.14M_{\odot}$ theoretical limit.Comment: 16 pages, 10 figure

A novel of new class II bacteriocin from Bacillus velezensis HN-Q-8 and its antibacterial activity on Streptomyces scabies

Potato common scab is a main soil-borne disease of potato that can significantly reduce its quality. At present, it is still a challenge to control potato common scab in the field. To address this problem, the 972 family lactococcin (Lcn972) was screened from Bacillus velezensis HN-Q-8 in this study, and an Escherichia coli overexpression system was used to obtain Lcn972, which showed a significant inhibitory effect on Streptomyces scabies, with a minimum inhibitory concentration of 10.58 μg/mL. The stability test showed that Lcn972 is stable against UV radiation and high temperature. In addition, long-term storage at room temperature and 4°C had limited effects on its activity level. The antibacterial activity of Lcn972 was enhanced by Cu2+ and Ca2+, but decreased by protease K. The protein was completely inactivated by Fe2+. Cell membrane staining showed that Lcn972 damaged the cell membrane integrity of S. scabies. Scanning electron microscope (SEM) and transmission electron microscope (TEM) observations revealed that the hyphae of S. scabies treated with Lcn972 were deformed and adhered, the cell membrane was incomplete, the cytoplasm distribution was uneven, and the cell appeared hollow inside, which led to the death of S. scabies. In conclusion, we used bacteriocin for controlling potato common scab for the first time in this study, and it provides theoretical support for the further application of bacteriocin in the control of plant diseases

Orbital parameters for an ELM white dwarf with a white dwarf companion: LAMOST J033847.06+413424.2

Double white dwarf systems are of great astrophysical importance in the field of gravitational wave and Type Ia supernova. While the binary fraction of CO core white dwarf is about a few percents, the extremely low mass white dwarfs are all thought to be within binary systems. In this work, we report the orbital solution of a double degenerate system: J033847.06+413424.24, an extremely low mass He core white dwarf orbiting a CO core white dwarf. With LAMOST and P200, time domain spectroscopic observations have been made and spectral atmosphere parameters are estimated to be $T_{\rm eff}\sim22500$ K and log $g\sim5.6$ dex. Combining Gaia parallax, 3D extinction, and evolution tracks, we estimate a radius of $\sim0.12$ $R_{\odot}$ and a mass of $\sim0.22$ $M_{\odot}$. With the 37 single exposure spectra, the radial velocities are measured and the orbital parameters are estimated to be $P=0.1253132(1)$ days, $K1=289\pm4$ km/s and $V_{sys}=-41\pm3$ km/s. The radial velocity based system ephemeris is also provided. The light curves from several photometric surveys show no orbital modulation. The orbital solution suggests that the invisible companion has a minimum mass of about 0.60 $M_{\odot}$ and is $\sim0.79$ $M_{\odot}$ for an inclination of $60.0^{\circ}$, indicating most probably a CO core white dwarf. The system is expected to merge in about 1 Gyr. With present period and distance ($\sim596$ pc) it can not irradiate strong enough gravitational wave for LISA. More double degenerate systems are expected to be discovered and parameterized as the LAMOST survey goes on.Comment: 12 pages, 11 figure

Descope of the ALIA mission

The present work reports on a feasibility study commissioned by the Chinese Academy of Sciences of China to explore various possible mission options to detect gravitational waves in space alternative to that of the eLISA/LISA mission concept. Based on the relative merits assigned to science and technological viability, a few representative mission options descoped from the ALIA mission are considered. A semi-analytic Monte Carlo simulation is carried out to understand the cosmic black hole merger histories starting from intermediate mass black holes at high redshift as well as the possible scientific merits of the mission options considered in probing the light seed black holes and their coevolution with galaxies in early Universe. The study indicates that, by choosing the armlength of the interferometer to be three million kilometers and shifting the sensitivity floor to around one-hundredth Hz, together with a very moderate improvement on the position noise budget, there are certain mission options capable of exploring light seed, intermediate mass black hole binaries at high redshift that are not readily accessible to eLISA/LISA, and yet the technological requirements seem to within reach in the next few decades for China

Susceptibilities of Yersinia pestis to Twelve Antimicrobial Agents in China

Streptomycin is the preferred choice for therapy of plague in China and other countries. However, Yersinia pestis exhibiting plasmid-mediated antimicrobial agent–resistant traits had been reported in Madagascar. In this study, we evaluated the susceptibility of traditional or newer antimicrobial agents used for treatment and/or prophylaxis of plague. Following Clinical and Laboratory Standards Institute (CLSI) recommendations, the susceptibility of 12 antimicrobial agents was evaluated by the agar microdilution method in 1,012 strains of Y. pestis isolated from 1943 to 2017 in 12 natural plague foci in China. One clinical Y. pestis isolate (S19960127) was found to be highly resistant to streptomycin, while the strain was still sensitive to other 11 antibiotics, that is, ciprofloxacin, ofloxacin, kanamycin, chloramphenicol, ampicillin, ceftriaxone, cefuroxime, trimethoprim-sulfamethoxazole, tetracycline, spectinomycin and moxifloxacin. The remaining 1,011 Y. pestis strains in this study demonstrated susceptibility to the above-mentioned 12 antimicrobial agents. Antimicrobial sensitivity surveillance of Y. pestis isolates, including dynamic monitoring of streptomycin resistance during various clinical plague treatments, should be carried out routinely