Objective:To understand the utilization of clinical services provided through hospital-at-home to the elderly in Xuzhou City, and analyze patient satisfaction.Methods:The stratified cluster sampling method was used to select community elderly people aged 60 and above in Xuzhou city to conduct a face-to-face questionnaire survey.Descriptive analysis was used to examine the utilization and evaluation of home-based clinical services for the elderly.Multiple linear regression analysis was used to analyze associated factors for the satisfaction of the elderly in this care setting.Results:A total of 203 elderly people who had received this type of services were investigated.The overall satisfaction of the elderly in Xuzhou City with home-based clinical services was 79.3%(161/203), and the average satisfaction score of the comprehensive evaluation was(4.11±1.03)points.Age( β=-0.011), marital status( β=0.164), informed consent for service( β=0.162), doctors' bed-side services( β=0.146), service fee( β=0.346), and the home hospital bed assembling process( β=0.257)were the influencing factors for satisfaction with family hospital bed services, according to the patients involved in the comprehensive evaluation(all P<0.05). Conclusions:The utilization and evaluation with clinical services by elderly people in the hospital-at-home setting in downtown Xuzhou is relatively good, with relatively high satisfaction.Comprehensive measures should be taken in response to factors related to satisfaction to promote sustainable development of clinical services through hospital-at-home in China.

Objective:In order to develop an appropriate care service system and care security system for the elderly in urban communities, it is necessary to gain a comprehensive understanding of their needs and utilization of care services, as well as the cost of care and the factors that influence it.This will provide a theoretical basis for developing effective countermeasures.Methods:A stratified random cluster sampling method was utilized to conduct a questionnaire survey on individuals aged 60 and above in the Xuzhou urban community.The survey aimed to gain insight into the needs, utilization, and expenditure of care services for the elderly.To analyze the factors influencing care expenditure, a single factor χ2 test and Tobit regression model were employed. Results:In our survey of 1 623 elderly individuals, it was found that 32.4%(526 people)had been bedridden for more than one day in the past year and were unable to care for themselves.Of the elderly who are bedridden, 393 individuals(74.7%)have received care services from professional institutions, with a focus on medical care(312 people, 79.4%)and rehabilitation care(95 people, 24.2%).In terms of financial expenditures, 91.7% of respondents(1 489 people)reported spending zero yuan in the past year, while 6.0%(96 people)spent between 1 and 4 999 yuan.Only 1.0%(17 people)reported spending between 5 000 and 9 999 yuan, and 1.3%(21 people)spent 10 000 yuan or more.The findings from the univariate analysis revealed that various factors, including marriage, age, medical expenses, and life satisfaction had a significant impact on the care expenses of the elderly(all P<0.05).Furthermore, the Tobit regression model demonstrated that certain variables were particularly influential in determining care expenses.Specifically, elderly individuals with higher monthly income(Me=3.114), advanced age(Me=3.458), knowledge of care insurance(Me=7.647), disability(Me=10.998), no spouse(Me=14.387), and dementia(Me=20.473)had significantly higher care expenses. Conclusions:The survey conducted in Xuzhou suggests that the demand for care services is high, yet the utilization rate remains low, leading to a significant burden of care costs.To address these challenges, we must prioritize the care needs of disabled, mentally retarded, and advanced-age elderly individuals.We should also focus on enhancing medical and rehabilitation care services, improving the overall quality of elderly care, and promoting the development of a comprehensive elderly care service system and care security system that caters to the specific needs and financial constraints of the elderly population.

The recent explosive outbreak of Zika virus (ZIKV) infection has been reported in South and Central America and the Caribbean. Neonatal microcephaly associated with ZIKV infection has already caused a public health emergency of international concern. No specific vaccines or drugs are currently available to treat ZIKV infection. The ZIKV helicase, which plays a pivotal role in viral RNA replication, is an attractive target for therapy. We determined the crystal structures of ZIKV helicase-ATP-Mn(2+) and ZIKV helicase-RNA. This is the first structure of any flavivirus helicase bound to ATP. Comparisons with related flavivirus helicases have shown that although the critical P-loop in the active site has variable conformations among different species, it adopts an identical mode to recognize ATP/Mn(2+). The structure of ZIKV helicase-RNA has revealed that upon RNA binding, rotations of the motor domains can cause significant conformational changes. Strikingly, although ZIKV and dengue virus (DENV) apo-helicases share conserved residues for RNA binding, their different manners of motor domain rotations result in distinct individual modes for RNA recognition. It suggests that flavivirus helicases could have evolved a conserved engine to convert chemical energy from nucleoside triphosphate to mechanical energy for RNA unwinding, but different motor domain rotations result in variable RNA recognition modes to adapt to individual viral replication.
Crystallography, X-Ray ; Protein Domains ; RNA Helicases ; chemistry ; RNA, Viral ; chemistry ; Viral Proteins ; chemistry ; Zika Virus ; enzymology

Selective occlusion of tumor vasculature has proven to be an effective strategy for cancer therapy. Among vascular coagulation agents, the extracellular domain of coagulation-inducing protein tissue factor, truncated tissue factor (tTF), is the most widely used. Since the truncated protein exhibits no coagulation activity and is rapidly cleared in the circulation, free tTF cannot be used for cancer treatment on its own but must be combined with other moieties. We here developed a novel, tumor-specific tTF delivery system through coupling tTF with the DNA aptamer, AS1411, which selectively binds to nucleolin receptors overexpressing on the surface of tumor vascular endothelial cells and is specifically cytotoxic to target cells. Systemic administration of the tTF-AS1411 conjugates into tumor-bearing animals induced intravascular thrombosis solely in tumors, thus reducing tumor blood supply and inducing tumor necrosis without apparent side effects. This conjugate represents a uniquely attractive candidate for the clinical translation of vessel occlusion agent for cancer therapy.