Strawberry (Fragaria × ananassa Duch), a fruit of economic and nutritional importance, is also a model species for fleshy fruits and genomics in Rosaceae. Strawberry fruit quality at different harvest stages is a function of the fruit's metabolite content, which results from physiological changes during fruit growth and ripening. In order to investigate strawberry fruit development, untargeted (GC-MS) and targeted (HPLC) metabolic profiling analyses were conducted. Principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) were employed to explore the non-polar and polar metabolite profiles from fruit samples at seven developmental stages. Different cluster patterns and a broad range of metabolites that exerted influence on cluster formation of metabolite profiles were observed. Significant changes in metabolite levels were found in both fruits turning red and fruits over-ripening in comparison with red-ripening fruits. The levels of free amino acids decreased gradually before the red-ripening stage, but increased significantly in the over-ripening stage. Metabolite correlation and network analysis revealed the interdependencies of individual metabolites and metabolic pathways. Activities of several metabolic pathways, including ester biosynthesis, the tricarboxylic acid cycle, the shikimate pathway, and amino acid metabolism, shifted during fruit growth and ripening. These results not only confirmed published metabolic data but also revealed new insights into strawberry fruit composition and metabolite changes, thus demonstrating the value of metabolomics as a functional genomics tool in characterizing the mechanism of fruit quality formation, a key developmental stage in most economically important fruit crops.

Leaf anatomy of C3 plants is mainly regulated by a systemic irradiance signal. Since the anatomical features of C4 plants are different from that of C3 plants, we investigated whether the systemic irradiance signal regulates leaf anatomical structure and photosynthetic performance in sorghum (Sorghum bicolor), a C4 plant. Compared with growth under ambient conditions (A), no significant changes in anatomical structure were observed in newly developed leaves by shading young leaves alone (YS). Shading mature leaves (MS) or whole plants (S), on the other hand, caused shade-leaf anatomy in newly developed leaves. By contrast, chloroplast ultrastructure in developing leaves depended only on their local light conditions. Functionally, shading young leaves alone had little effect on their net photosynthetic capacity and stomatal conductance, but shading mature leaves or whole plants significantly decreased these two parameters in newly developed leaves. Specifically, the net photosynthetic rate in newly developed leaves exhibited a positive linear correlation with that of mature leaves, as did stomatal conductance. In MS and S treatments, newly developed leaves exhibited severe photoinhibition under high light. By contrast, newly developed leaves in A and YS treatments were more resistant to high light relative to those in MS-and S-treated seedlings. We suggest that (1) leaf anatomical structure, photosynthetic capacity, and high-light tolerance in newly developed sorghum leaves were regulated by a systemic irradiance signal from mature leaves; and (2) chloroplast ultrastructure only weakly influenced the development of photosynthetic capacity and high-light tolerance. The potential significance of the regulation by a systemic irradiance signal is discussed.

Desertification is the result of complex interactions among various factors, including climate change and human activities. However, previous research generally focused on either meteorological factors associated with climate change or human factors associated with human activities, and lacked quantitative assessments of their interaction combined with long-term monitoring. Thus, the roles of climate change and human factors in desertification remain uncertain. To understand the factors that determine whether mitigation programs can contribute to desertification control and vegetation cover improvements in desertified areas of China, and the complex interactions that affect their success, we used a pooled regression model based on panel data to calculate the relative roles of climate change and human activities on the desertified area and on vegetation cover (using the normalized-difference vegetation index, NDVI, which decreases with increasing desertification) from 1983 to 2012. We found similar effect magnitudes for socioeconomic and environmental factors for NDVI but different results for desertification: socioeconomic factors were the dominant factor that affected desertification, accounting for 79.3% of the effects. Climate change accounted for 46.6 and 20.6% of the effects on NDVI and desertification, respectively. Therefore, desertification control programs must account for the integrated effects of both socioeconomic and natural factors.

BackgroundDespite the broad coverage of the healthcare insurance system in China, the imbalances in fairness, accessibility and affordability of healthcare services have hindered the universal healthcare progress. To provide better financial protection for the Chinese population, China’s new medical reform was proposed to link up urban employee basic medical insurance scheme (UEBMI), urban resident basic medical insurance scheme (URBMI), new rural cooperative medical system (NRCMS) and urban and rural medical assistance programs. In this paper, we focused on people’s expected healthcare insurance model and their willingness towards healthcare insurance integration, and we made a couple of relative policy suggestions.MethodsA questionnaire survey was conducted in four cities in China. A total of 1178 effective questionnaires were retrieved. Statistical analysis was conducted with SPSS and Excel. Chi-square test and logistic regression model were applied.Results and discussionThe payment intention and reimbursement expectation of the three groups varied with NRCMS participants the lowest and UEBMI participants the highest. In economic developed areas, rural residents had equal or even stronger payment ability than urban residents, and the overall payment intention showed a scattered trend; while in less developed areas, urban residents had a stronger payment ability than rural residents and a more concentrated payment intention was observed. The majority of participants favored the integration, with NRCMS enrollees up to 80.5%. In the logistic regression model, we found that participants from less developed areas were more likely to oppose the integration, which we conceived was mainly due to their dissatisfaction with their local healthcare insurance schemes. Also the participants with better education background tended to oppose the integration, which might be due to their fear of benefit impairment and their concern about the challenges ahead.ConclusionEven though there are many challenges for healthcare insurance integration, it has received strong support from the mass population. However, more emphasis shall be put on equal financing and equal benefit when making further policies. As the current healthcare policies share the same design concept, principle and method, the ultimate goal of establishing a universal healthcare system is promising.

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Introduction:Emerging from the epidemiological transition and accelerated aging process, China’s fragmentated healthcare systems struggle to meet the demands of the population. On Sept 1st 2017, China’s National Health and Family Planning Commission encouraged all cities to learn from the Luohu model of integration adopted in Luohu as an approach to meeting these challenges. In this paper, we study the integration process, analyze the core mechanisms, and conduct preliminary evaluations of integrated policy development in the Luohu model.Policy development:The Luohu hospital group was established in Aug 2015, consists of five district hospitals, 23 community health stations and an institute of precision medicine. The group adopted a series of professional, organizational, system, functional and normative strategies for integrated care, which was provided for the residents of Luohu, especially for the elderly population and patients with chronic conditions. According to a preliminary evaluation of the past two years, the Luohu model showed improvement in the structure and process towards integrated care. New preventive programs conducted in the hospital group resulted in changes of disease incidence. Residents were more satisfied with the Luohu model. However, spending exceeded the global budget for health insurance because of short-term increases in the demand for health care.Lessons learned:First, engagement of multiple stakeholders is essential for the design and implementation of reform. Second, organizational integration is a prerequisite for integrated care in China. Third, effective care integration requires alignment with payment reforms. Fourth, normative integration could promote collaboration in an integrated healthcare system.Conclusion:Core strategies and mechanisms of the Luohu model will promote integrated care in urban China and other countries facing the same challenges. However, it is necessary to study the effects of the Luohu model over the long term and continue to strive for integrated care.

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BackgroundLittle has been known regarding the relationship between ocular chemical injury and victims’ medical expenditure, income loss and socio-economic status changes. So we conduct this retrospective cross-sectional study in patients with ocular chemical burns in East China.MethodsFifty-six patients were enrolled and required to complete a self-report questionnaire consisting of the following contents: entire expenditure on medical treatment; the victims’ personal and household per capita income, and income loss caused by the injury; and the changes of socioeconomic status as well.ResultsThe median expense of medical treatment was CNY 40,000 (approximately US$5,900). The medical expenditure rose significantly with increased injury severity, prolonged hospital stay, and increased frequency of surgery. More than half victims (51.8 %, 29/56) paid all or the majority of medical expense by themselves. The expense of only 5 victims was mainly paid by medical insurance, accounting for less than ten percent (8.9 %, 5/56). The victims’ personal and household per capita income both decreased significantly after the injury, with the median reduction being CNY 24,000 and CNY 7,800 (approximately US$3600 and US$1200) per year respectively. The reduction amplitude of personal and household per capita income rose with increased injury severity and prolonged time of care required. The injury caused emotional depression or anxiety in 76.8 % (43/56) victims, and the relationship with their relatives got worse in 51.9 % (29/56) patients. Moreover, only 21.4 % (12/56) patients felt that the whole society gave them care and concern after the injury, whereas 46.4 % (26/56) and 28.6 % (16/56) felt indifference or discrimination from society as a whole (X2 = 16.916, P = 0.028).ConclusionsThe medical expense was a huge economic burden to most victims of ocular chemical burns, and personal and household per capita income of the victims decreased significantly after injury, both of which had a close relationship with the injury severity. Formal legislation was urgently needed to compel the employer to purchase injury or medical insurance and provide more compulsory protection to the population working in high risk occupations. In addition, psychological counseling and instruction shouldn’t be neglected in the aid and treatment of victims.