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Previous studies have demonstrated that patients with type 2 diabetes mellitus (T2DM) often had the problems of fecal microbiota dysbiosis, and were usually accompanied with psychiatric comorbidities (such as depression and anxiety). Here, we conducted a randomized clinical study to analyze the changes in gut microbiota, serum metabolism and emotional mood of patients with T2DM after consumption of a high-fiber diet. The glucose homeostasis of participants with T2DM was improved by the high-fiber diet, and the serum metabolome, systemic inflammation and psychiatric comorbidities were also altered. The increased abundances of Lactobacillus , Bifidobacterium and Akkermansias revealed that the proportions of beneficial gut microbes were enriched by the high-fiber diet, while the abundances of Desulfovibrio , Klebsiella and other opportunistic pathogens were decreased. Therefore, the current study demonstrated that the intestinal microbiota alterations which were influenced by the high-fiber diet could improve the serum metabolism and emotional mood of patients with T2DM.

Linear regression, inverse distance weighting analyses, and Budyko’s hypothesis were applied to the Shiyang River Basin. The spatial and temporal characteristics of runoff from the main stream and tributaries in the Shiyang River Basin from 1959 to 2017 were analyzed. Furthermore, the contributions of climate change and human activities to runoff in the Shiyang River Basin were quantitatively resolved. The annual runoff showed a decreasing trend (0.06 × 108 m 3 /10a), with a spatial distribution pattern decreasing from southwest to northeast. Runoff in the Shiyang River Basin accelerated significantly after 1990, and the growth rate was most significant in the main stem. In addition, precipitation and potential evapotranspiration increased at a rate of 7.44 and 8.46 mm/10a, respectively. The areas of farmland and urban land increased to different degrees, whereas the areas of the remaining land types decreased. The construction of hydropower stations was concentrated in the period 2004–2011. Finally, the contributions of climate change and human activity to runoff in the upper reaches were 81.17 and 18.83%, and the main factor of runoff change is climate change. The contributions of climate change and human activity to runoff in the middle and lower reaches were 15.83 and 84.17%, respectively. The main factor affecting runoff change was human activity. Climate change and human activity are the main factors affecting runoff from inland river basins in arid regions. The results provide parameter support for quantifying the impacts of climate change and human activities on inland river basin runoff and for modeling. The findings also provide a scientific basis for the rational allocation, planning, and management of water resources and the sustainable development of arid inland river basins.

Porcine reproductive and respiratory syndrome virus (PRRSV) is considered a promising viral vector for the expression and delivery of foreign genes for the development of a new generation of multi-valent vaccines against PRRSV and other porcine viruses, as well as for analyses of the immune response against PRRSV and anti-PRRSV component screening. In the present study, the junction site between nsp1β and nsp2 in the PRRSV genome was tested for the insertion and expression of foreign genes. Three foreign genes, including eGFP, iLOV3, and TEVp, were inserted into the intergenic junction between nsp1β and nsp2 and expressed by the respective recombinant PRRSVs (rPRRSV-SH01-eGFP, rPRRSV-SH01-iLOV3, and rPRRSV-SH01-TEVp) in vitro in mammalian cells. Analysis of the growth kinetics of the rescued recombinant PRRSVs showed no significant differences between the recombinant PRRSVs and their parental viruses. The inserted genes were consistently present in the viral genome during serial passage in vitro (for at least 20 passages). In addition, rPRRSV-SH01-eGFP can be used as a reporter virus for rapid detection of neutralizing antibodies against PRRSV through a fluorescent focus unit reduction-based assay. These data demonstrate that the junction between nsp1β and nsp2 is a new site that is suitable for the insertion and expression of foreign genes, providing a new option to express and deliver foreign genes using PRRSV-based vectors for different purposes, such as the development of multi-valent vaccines against PRRSV and other porcine viruses.

Background Early postoperative enteral nutrition via jejunostomy tube is recommended for patients undergoing esophagectomy, especially for elderly patients. However, there are limited research on the safety of routine intraoperative jejunostomy in elderly patients undergoing minimally invasive esophagectomy (MIE). This study analyzes the safety and feasibility of intraoperative jejunostomy in elderly patients undergoing (MIE) to provide a reference for clinical practice. Methods A retrospective analysis was performed with 143 patients aged over 70 years who underwent MIE with intraoperative jejunostomy from January 2021 to December 2023. Among them, 73 patients with a mean age of 71.9 (age range: 70–74) years in Group A and 70 patients with a mean age of 78.5 (age range: 75–93) years in Group B. The preoperative clinical characteristics, surgical approaches, postoperative complications, jejunostomy tube-related complications, and enteral nutrition-related clinical features were analyzed. Results Patients in Group B had a statistically significant lower BMI compared to Group A, the Length of ICU stay in Group B was longer than Group A and the incidence of chyle leakage was higher in Group B, the differences were statistically significant. The two groups were similar in terms of tube-related complications, with no significant statistical difference. Regarding the comparison of enteral nutrition-related clinical features, Group A had a longer duration on parenteral nutrition time and delayed first defecation after surgery. However, for hospital stay after surgery, duration of home enteral nutrition, and duration of jejunostomy tube placement after discharge, Group B had longer durations than that in Group A, and the differences were statistically significant. Conclusion Intraoperative jejunostomy has been confirmed to be a safe and feasible procedure in elderly patients undergoing MIE. Furthermore, for patients aged 75 and above, the jejunostomy tube offers a reliable and sufficient route for postoperative enteral nutrition support during prolonged hospital stays.

Drug shortages were a complex global problem. The aim of this study was to analyze, characterize, and assess the drug shortages, and identify possible solutions in Shaanxi Province, western China. A qualitative methodological approach was conducted during May-June 2015 and December 2015-January 2016. Semi-structured interviews were performed to gather information from representatives of hospital pharmacists, wholesalers, pharmaceutical producers, and local health authorities. Thirty participants took part in the study. Eight traditional Chinese medicines and 87 types of biologicals and chemicals were reported to be in short supply. Most were essential medicines. Five main determinants of drug shortages were detected: too low prices, too low market demands, Good Manufacturing Practice (GMP) issues, materials issues, and approval issues for imported drugs. Five different solutions were proposed by the participants: 1) let the market decide the drug price; 2) establish an information platform; 3) establish a reserve system; 4) enhance the communication among the three parties in the supply chain; and 5) improve hospital inventory management. Western China was currently experiencing a serious drug shortage. Numerous reasons for the shortage were identified. Most drug shortages in China were currently because of \"too low prices.\" To solve this problem, all of the stakeholders, especially the government, needed to participate in managing the drug shortages.

Japanese encephalitis virus (JEV) genotype I (GI) replicates more efficiently than genotype III (GIII) in birds, and this difference is considered to be one of the reasons for the JEV genotype shift. In this study, we utilized duck embryo fibroblasts and domestic ducklings as in vitro and in vivo models of a JEV amplifying avian host to identify the viral determinants of the differing replication efficiency between the GI and GIII strains in birds. GI strains induced significantly lower levels of interferon (IFN)-α and β production than GIII strains, an effect orrelated with the enhanced replication efficiency of GI strains over GIII strains. By using a series of chimeric viruses with exchange of viral structural and non-structural (NS) proteins, we identified NS5 as the viral determinant of the differences in IFN-α and β induction and replication efficiency between the GI and III strains. NS5 inhibited IFN-α and β production induced by poly(I:C) stimulation and harbored 11 amino acid variations, of which the NS5-V372A and NS5-H386Y variations were identified to co-contribute to the differences in IFN-α and β induction and replication efficiency between the strains. The NS5-V372A and NS5-H386Y variations resulted in alterations in the number of hydrogen bonds formed with neighboring residues, which were associated with the different ability of the GI and GIII strains to inhibit IFN-α and β production. Our findings indicated that the NS5-V372A and NS5-H386Y variations enabled GI strains to inhibit IFN-α and β production more efficiently than GIII strains for antagonism of the IFN-I mediated antiviral response, thereby leading to the replication and host adaption advantages of GI strains over GIII strains in birds. These findings provide new insight into the molecular basis of the JEV genotype shift.

Viral replicons are efficient tools to understand the mechanisms of viral replication and screen antiviral drugs. In this study, a viral-cDNA-based replicon of Japanese encephalitis virus (JEV), which is the causative agent of Japanese encephalitis, was constructed by replacing the viral structural proteins with a green fluorescent protein (JEV-GFP replicon). The resulting JEV-GFP replicon was used as a tool to screen antiviral drugs targeting JEV nonstructural proteins, and the five compounds JNJ-A07, HZ-1157, NITD-2, quinine, and NITD008 were obtained, which significantly inhibited the replication of the JEV-GFP replicon and JEV in vitro, and the properties of these five compounds were also analyzed. The CC50, EC50, and SI indices of these five compounds were analyzed. In addition, the JEV-GFP replicon was used as a tool to identify the residues of viral nonstructural proteins involved in RNA replication, and the cysteine residue at position 4 of nonstructural protein 1 was found to be essential for JEV RNA replication. These data suggested that the noninfectious JEV-GFP replicon could be used as tool for different purposes, such as antiviral drug screening and gene function studies.

In this study, the temporal and spatial characteristics of extreme climate from 1961 to 2017 were analyzed using daily precipitation and temperature data from 24 meteorological stations in the Qilian Mountain area, northwestern China. The results showed that warming accelerated considerably after 1985, particularly during the 1990s. The warming trend then increased after 2000 and further increased after 2010. The Qilian Mountains and the Hexi and Qaidam Inland River Basins greatly affected the Atlantic Multidecadal Oscillation (AMO), Northern Tropical Atlantic Index (NTA), Caribbean sea-level surface temperature (SST) Index (CAR), South China Sea Summer Monsoon Index (SCSSMI), and South American Summer Monsoon Index (SAMSMI). The circulation index on the extreme temperature warm index was stronger than that of the extreme temperature cold index. There were greater increases in all extreme indexes in the central part of the Qilian Mountain area, and the region of increase decreased from inside to outside. The interannual change in the warming index of extreme temperature was similar to that of the cold index of extreme temperature. TX10, TN10, ice days (ID), and frost days (FD) showed significant negative correlations with altitude, whereas TXN and TNN showed significant positive correlations with altitude. Changes in TX10, TN10, TXN, TNN, ID, FD, and diurnal temperature range were most noticeable in high-altitude areas (> 2500 m), whereas changes in TN90, TX90, TXX, TNX, and growing season length were most noticeable in low altitude areas (< 2500 m). The Qilian Mountain area and the Hexi and Qaidam Inland River Basins were greatly affected by the AMO, NTA, CAR, SCSSMI, and SAMSMI; however, they were only slightly affected by the Nino4, Northern Atlantic Oscillation, North Pacific model, Southern Oscillation Index, Arctic Oscillation, and Multiple ENSO Index. The effect of the circulation index of Atlantic Multidecadal Oscillation, Tropical Northern Atlantic Index, Tropical Southern Atlantic Index, North Tropical Atlantic SST Index, and CAR on the extreme temperature warm index was stronger than that of the extreme temperature cold index.

To assess the availability and affordability of oral anti-diabetic medicines in Shaanxi Province, Western China. In 2015, the prices and availability of 8 anti-diabetic medicines covering 31 different dosage forms and strengths were collected in six cities of Shaanxi Province. A total of 72 public hospitals and 72 private pharmacies were sampled, using a modified methodology developed by the World Health Organization (WHO) and Health Action International (HAI). Medicine prices were compared with international reference prices to obtain a median price ratio. For urban residents, affordability was assessed as the lowest-paid unskilled government workers to purchase cost of standard treatment in days' wages; for rural residents, days' net income was used. The mean availabilities of originator brands (OBs) and generics were 34.3% and 28.7% in public hospitals, and 44.1% and 64.4% in the private pharmacies. OBs and the lowest priced generics (LPGs) were procured at 12.38 and 4.52 times the international reference price in public hospitals, and 10.26 and 2.81 times the international reference prices in private pharmacies. Treatments with OBs were unaffordable even for urban residents. The affordability of the LPGs was good, except for acarbose, repaglinide and pioglitazone. Most anti-diabetic medicines cannot met the WHO's availability target (80% availability) in Shaanxi Province. The high prices of OBs had severely influenced the affordability of medicines, especially for the rural residents. Effective policies should be initiated to ensure the Chinese people a better access to more affordable anti-diabetic medicines.

Probiotics are commonly applied to maintain the balance of gut microbiota and regulate the intestinal metabolic function of companion animals. In the present study, complex probiotics (Bacillus coagulans SNZ-1969, Bacillus subtilis, and Bacillus licheniformis) were added into the basal diet of domestic cats to investigate their influence on the intestinal microbiome and metabolic characteristics. Results revealed that the alpha diversity of the gut microbiota in the probiotic group was enhanced when compared to the control group. The beta diversity of the gut microbiota was also altered by the oral consumption of the complex probiotics. Compared to the control group, the relative abundance of beneficial microbes (such as Clostridium, Bacteroides, Phocaeicola, and Ruminococcus) in the probiotic group was enhanced, while the relative abundance of opportunistic pathogens (such as Escherichia, Gallibacter, Corynebacterium) was decreased. Additionally, the intestinal metabolic characteristics of domestic cats were also changed. The metabolomic analysis identified 408 differential metabolites between the two groups, and the KEGG function pathway analysis proved that the dominant pathway related to the differential metabolites were the amino acid metabolism, lipid metabolism, carbohydrate metabolism, energy metabolism, endocrine system, digestive system, immune system, and other metabolic pathways. Spearman’s correlation analysis revealed that the beneficial microbes had positive correlations with the differential metabolites. In conclusion, the current study demonstrated that oral administration of complex probiotics could regulate overall health and well-being in domestic cats through modulating the gut microbiome and metabolic characteristics.