Enhancing the management of cross-regional transfer of floating Tuberculosis cases by active follow-up and communication

Objectives: To analyse the effects of an intervention on cross-regional transfer of tuberculosis (TB) patients among floating population. Methods: On 1 October 2008, the 1-year intervention started by strengthening patients' health education, supervising medical treatments at critical phases, assisting in the transference of TB patients and persisting communication with TB dispensaries outside Shenzhen city. Data were collected from the TB patients' registry book and the TB transference and follow-ups recording book. Primary outcomes were compared at the pre-intervention (From 1 October 2007 to 30 September 2008) and intervention periods. Results: A total of 1131 floating tuberculosis cases were registered (594 at the intervention period). Compared with those at the pre-intervention period, the rate of patients' informing doctors before leaving Shenzhen increased significantly (61.8% vs. 39.4%), the rate of successful transference mildly improved (60.0% vs. 50.0%), while the rate decreased dramatically for the re-registered patients at TB dispensaries outside Shenzhen (51.5% vs. 93.6%). Conclusion: The intervention improves patients' adherence and enhances collaboration between TB dispensaries, establishes more practical mechanisms, which could be useful for TB control in China. However, more efforts should be directed towards improvement of TB control among floating population, especially advocating the economic perspective. Most of the floating populations live in poor conditions and hard occupational circumstances, and have difficulties to access health-care services as a result of limited health insurance coverage; thus, putting them at increased health risks. 9 On 1 October 2006, the project of Floating Population Tuberculosis Control was initiated, which was sponsored by the Fifth Round-China Global Fund TB program. The project was planned to be implemented partially in (120) counties from seven provinces in the eastern part of China-Tianjin, Shanghai, Jiangsu, Zhejiang, Fujian, Shandong and Guangdong. 10 As a result of the continuous movement of floating TB casesthe diagnosed TB patients moving back and forth between their new jobs and their homes-the cross-regional transference of TB cases occurred, which posed a major hurdle in treating TB. It was reported that all over China that the transferred-out rate was 3%, which accounted for 50% of unfavourable treatment outcomes. 13 In this article, we described the enhancing management methods in one of the eight districts of Shenzhen city (project city covered by the Global Fund to Fight AIDS, Tuberculosis and Malaria)-Nanshan district, and evaluate their effects on patients' transfer and collaboration between TB dispensaries. Methods Setting Nanshan district is located near Hongkong, with a population of 0.99 million, of which 0.49 million are migrants, and its GDP per capita has reached to 25 000 Dollars in 2009. 14 Also, Nanshan is a pilot site for TB control in China, and there are several In Nanshan, a three-tier TB fighting network is established: TB dispensaryHospitals-Community Health Centers (CHCs). All suspected pulmonary TB patients are diagnosed at a single government-owned TB dispensary, which is in charge of the district TB control. Hospitals and clinics refer the suspected patients to the TB dispensary. After being diagnosed, all patients are decentralized and treated in the closest CHCs by trained lay health professionals (HPs) using DOTs strategies. For the smear-positive cases, HPs at the CHCs directly observe the intake of medications during the whole course of treatment; while patients with smear-negative results are subjected to direct supervision over their intake of their medications during the intensive period, and later they commence to visit their HPs and receive medications on monthly basis in the continuous phase. Medications are free and consist of 6-month standard regimen for newly treated cases (2 months intensive phase of HRZEisoniazid, rifampicin, pyrazinamide and ethambutol, followed by 4 months of continuous phase of HR) and 8-month regimen for re-treated (2 months intensive phase of HRZE, followed by 6 months of continuous phase of HR). Supervisory physicians in the TB dispensary regularly distribute the medications to the CHCs, check the treatment cards (the concordance of medications remaining and records, the regularity of medication intake and timeliness of recording by HPs) and interview patients (query adverse drug reactions, remind timely revisiting their doctors and so on). European Journal of Public Health, 1-6 ß The Author 2011. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. doi:10.1093/eurpub/ckr154 The Europea

Full-Length Transcriptome Analysis Reveals Candidate Genes Involved in Terpenoid Biosynthesis in Artemisia argyi

Artemisia argyi is an important medicinal plant widely utilized for moxibustion heat therapy in China. The terpenoid biosynthesis process in A. argyi is speculated to play a key role in conferring its medicinal value. However, the molecular mechanism underlying terpenoid biosynthesis remains unclear, in part because the reference genome of A. argyi is unavailable. Moreover, the full-length transcriptome of A. argyi has not yet been sequenced. Therefore, in this study, de novo transcriptome sequencing of A. argyi's root, stem, and leaf tissues was performed to obtain those candidate genes related to terpenoid biosynthesis, by combining the PacBio single-molecule real-time (SMRT) and Illumina sequencing NGS platforms. And more than 55.4 Gb of sequencing data and 108,846 full-length reads (non-chimeric) were generated by the Illumina and PacBio platform, respectively. Then, 53,043 consensus isoforms were clustered and used to represent 36,820 non-redundant transcripts, of which 34,839 (94.62%) were annotated in public databases. In the comparison sets of leaves vs roots, and leaves vs stems, 13,850 (7,566 up-regulated, 6,284 down-regulated) and 9,502 (5,284 up-regulated, 4,218 down-regulated) differentially expressed transcripts (DETs) were obtained, respectively. Specifically, the expression profile and KEGG functional enrichment analysis of these DETs indicated that they were significantly enriched in the biosynthesis of amino acids, carotenoids, diterpenoids and flavonoids, as well as the metabolism processes of glycine, serine and threonine. Moreover, multiple genes encoding significant enzymes or transcription factors related to diterpenoid biosynthesis were highly expressed in the A. argyi leaves. Additionally, several transcription factor families, such as RLK-Pelle_LRR-L-1 and RLK-Pelle_DLSV, were also identified. In conclusion, this study offers a valuable resource for transcriptome information, and provides a functional genomic foundation for further research on molecular mechanisms underlying the medicinal use of A. argyi leaves

Triptolide Inhibits the Proliferation of Prostate Cancer Cells and Down-Regulates SUMO-Specific Protease 1 Expression

Recently, traditional Chinese medicine and medicinal herbs have attracted more attentions worldwide for its anti-tumor efficacy. Celastrol and Triptolide, two active components extracted from the Chinese herb Tripterygium wilfordii Hook F (known as Lei Gong Teng or Thunder of God Vine), have shown anti-tumor effects. Celastrol was identified as a natural 26 s proteasome inhibitor which promotes cell apoptosis and inhibits tumor growth. The effect and mechanism of Triptolide on prostate cancer (PCa) is not well studied. Here we demonstrated that Triptolide, more potent than Celastrol, inhibited cell growth and induced cell death in LNCaP and PC-3 cell lines. Triptolide also significantly inhibited the xenografted PC-3 tumor growth in nude mice. Moreover, Triptolide induced PCa cell apoptosis through caspases activation and PARP cleavage. Unbalance between SUMOylation and deSUMOylation was reported to play an important role in PCa progression. SUMO-specific protease 1 (SENP1) was thought to be a potential marker and therapeutical target of PCa. Importantly, we observed that Triptolide down-regulated SENP1 expression in both mRNA and protein levels in dose-dependent and time-dependent manners, resulting in an enhanced cellular SUMOylation in PCa cells. Meanwhile, Triptolide decreased AR and c-Jun expression at similar manners, and suppressed AR and c-Jun transcription activity. Furthermore, knockdown or ectopic SENP1, c-Jun and AR expression in PCa cells inhibited the Triptolide anti-PCa effects. Taken together, our data suggest that Triptolide is a natural compound with potential therapeutic value for PCa. Its anti-tumor activity may be attributed to mechanisms involving down-regulation of SENP1 that restores SUMOylation and deSUMOyaltion balance and negative regulation of AR and c-Jun expression that inhibits the AR and c-Jun mediated transcription in PCa

Purine biosynthetic enzyme ATase2 is involved in the regulation of early chloroplast development and chloroplast gene expression in Arabidopsis

To investigate the molecular mechanism of chloroplast biogenesis and development, we characterized an Arabidopsis mutant (dg169, delayed greening 169) which showed growth retardation and delayed greening phenotype in leaves. Newly emerged chlorotic leaves recovered gradually with leaf development in the mutant, and the mature leaves showed similar phenotype to those of wild-typewild-type plants. Compared with wild-type, the chloroplasts were oval-shaped and smaller and the thylakoid membranes were less abundant in yellow section of young leaves of dg169. In addition, the functions of photosystem II (PSII) and photosystem I (PSI) were also impaired. Furthermore, the amount of core subunits of PSII and PSI, as well as PSII and PSI complexes reduced in yellow section of young leaves of dg169. Map-based positional cloning identified that phenotype of dg169 was attributed to a point mutation of ATase2 which converts the conserved Ile-155 residue to Asn. ATase2 catalyzes the first step of de novo purine biosynthesis. This mutation resulted in impaired purine synthesis and a significant decrease in ATP, ADP, GTP and GDP contents. The analysis of ATase2-GFP protein fusion showed that ATase2 was localized to nucleoid of chloroplasts. Our results further demonstrated that the levels of PEP-dependent transcripts in yellow section of young leaves of dg169 were decreased while NEP-dependent and both PEP- and NEP-dependent transcripts and chloroplast DNA replications were increased. The results in this study suggest that ATase2 plays an essential role in early chloroplast development through maintaining PEP function

Prevalence of and Factors Associated with Club Drug Use among Secondary Vocational Students in China

To understand the prevalence of and factors associated with club drug use among Chinese secondary vocational students, a nationally representative survey was conducted. The multistage cluster sampling strategy was employed to select participants. A total of 9469 students from eleven secondary vocational schools in five cities completed self-reported questionnaires, which included information on club drug use, sociodemographic variables, individual factors, as well as peer and family related factors. The data were separately analyzed with Poisson regression models for female and male students. The overall lifetime prevalence of club drug use was 2.7% (258/9469), and male students had higher prevalence than female students (3.5% vs. 1.9%, p < 0.001). Female and male students shared four risk factors (i.e., having ever smoked, perceiving social benefit expectancies, peer drug using and perceiving peer’s approval of drug use) and one protective factor (i.e., having medium or high levels of refusal skills) for club drug use. Moreover, family drug using and having a part-time job were two additionally independent risk factors for club drug use among male students. These findings indicate that the problem of club drug use among Chinese secondary vocational students is worthy of attention. The prevention of club drug use should address multiple risks and protective factors on individual, peer and family levels

Underthrusting and duplexing beneath the northern Tibetan Plateau and the evolution of the Himalayan-Tibetan orogen

The Cenozoic Qilian Shan thrust belt is the northern margin of the Tibetan Plateau, which developed in part due to progressive India-Asia convergence during Himalayan-Tibetan orogeny. Available geologic observations suggest that this thrust belt started deforming shortly after initial India-Asia collision at 60-55 Ma, and thus its kinematic development is intrinsically related to the construction and evolution of the Tibetan Plateau. Here, we present new field observations from a geologic traverse across the Qilian Shan to elucidate the style of deformation across the active thrust belt. In particular, we infer protracted out-of-sequence deformation here that is consistent with this thrust system remaining a stationary northern boundary to the Tibetan Plateau since the early Cenozoic. We present a lithosphere-scale model for this region that highlights the following: (1) coupled distributed crustal shortening and underthrusting of the North China craton beneath Tibet, which explains the spatial and temporal distribution of observed crustal shortening and thickness, (2) this underthrusting exploited the south-dipping early Paleozoic Qilian suture paleo-subduction melange channel, and (3) development of a lower-crustal duplex at the lithospheric underthrusting ramp. This last inference can explain the relatively high elevation, low relief, and thickened crust of the central Qilian Shan, as well as the comparative aseismicity of the region, which experiences fewer earthquakes due to less upper-crustal faulting. Both the northern and southern margins of the Himalayan-Tibetan orogen appear to have developed similarly, with continental underthrusting and crustal-scale imbrication and duplexing, despite vastly different climatic and plate-velocity boundary conditions, which suggests that the orogen-scale architecture of the thrust belt is controlled by neither of these forcing mechanisms. Instead, strength anisotropies of the crust probably control the kinematics and style of deformation, including the development of northern Tibet, where thrust systems are concentrated along pre-Cenozoic suture zones

Purine biosynthetic enzyme ATase2 is involved in the regulation of early chloroplast development and chloroplast gene expression in Arabidopsis

To investigate the molecular mechanism of chloroplast biogenesis and development, we characterized an Arabidopsis mutant (dg169, delayed greening 169) which showed growth retardation and delayed greening phenotype in leaves. Newly emerged chlorotic leaves recovered gradually with leaf development in the mutant, and the mature leaves showed similar phenotype to those of wild-typewild-type plants. Compared with wild-type, the chloroplasts were oval-shaped and smaller and the thylakoid membranes were less abundant in yellow section of young leaves of dg169. In addition, the functions of photosystem II (PSII) and photosystem I (PSI) were also impaired. Furthermore, the amount of core subunits of PSII and PSI, as well as PSII and PSI complexes reduced in yellow section of young leaves of dg169. Map-based positional cloning identified that phenotype of dg169 was attributed to a point mutation of ATase2 which converts the conserved Ile-155 residue to Asn. ATase2 catalyzes the first step of de novo purine biosynthesis. This mutation resulted in impaired purine synthesis and a significant decrease in ATP, ADP, GTP and GDP contents. The analysis of ATase2-GFP protein fusion showed that ATase2 was localized to nucleoid of chloroplasts. Our results further demonstrated that the levels of PEP-dependent transcripts in yellow section of young leaves of dg169 were decreased while NEP-dependent and both PEP- and NEP-dependent transcripts and chloroplast DNA replications were increased. The results in this study suggest that ATase2 plays an essential role in early chloroplast development through maintaining PEP function

HPV vaccine acceptability and willingness-related factors among Chinese adolescents: a nation-wide study

Background Adolescents are the primary target population for human papillomavirus (HPV) vaccination. The objective of this study is to explore the acceptability of HPV vaccines and evaluate factors related to willingness to be vaccinated among Chinese adolescents. Methods A nation-wide survey was conducted across 14 schools in mainland China. The questionnaire consisted of questions relating to socio-demographic characteristics, knowledge of adolescent sexual health, cervical cancer, HPV and HPV-related disease, and students’ willingness to be vaccinated. Chi-square tests and multivariable logistic regression were conducted in the data analysis. Results A total of 4,062 students participated in this study. Among them, only 17.1% of students reported having heard of HPV vaccines; however, 67.3% were willing to receive the HPV vaccine. Multivariable regression analysis showed that students who were from rural areas, have received sexual health education, have heard of cervical cancer or HPV vaccine, have a positive attitude toward vaccination, reported they were at the risk of developing cervical cancer, and those who value their parents’ and teachers’ opinions were more willing to receive HPV vaccination. Conclusions Awareness about the HPV vaccine is low among Chinese adolescents. The factors that most related to willingness to vaccinate among Chinese adolescents were school location, education about vaccination, HPV, and HPV vaccines. Integrating health education on HPV vaccination into existing school-based sexual health curricula may be an effective way to increase HPV vaccination coverage in mainland China