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We collected 599 policies related to medical treatment combination issued by local governments from October 2010 to December 2022 to study the differences and characteristics of medical treatment combination policies in different regions of China. Descriptive statistics and the structural topic model were used to compare medical treatment combination policies in four major economic regions (West, Central, East, Northeast) of China from three dimensions: the number of policies issued, policy types and policy topics. The study shows that: the structure of Chinese local medical treatment combination policy system was not balanced and was characterized by an emphasis on implementation rules rather than standard specifications; the construction of hierarchical diagnosis and treatment service system and the management model of medical treatment combination are hot topics, while the topics such as supporting measures and disease prevention and treatment have not received widespread attention. The construction of medical treatment combination in each region shows diversified exploration. The local government needs to issue relevant policies according to the regional differences, so as to supplement the shortcomings of the policy and promote the improvement of the policy system of the regional medical treatment combination. [ABSTRACT FROM AUTHOR]

Remote sensing technology is widely used to obtain evapotranspiration (ETa), but whether it can distinguish the differences in farmland energy balance components and ETa under different irrigation methods has not been studied. We used Landsat 8 data as the primary dataset to drive the METRIC model and inverted the surface parameters and ETa of the Shiyang River Basin from 2014 to 2018. After improving the METRIC model using Ta obtained by the regression method instead of interpolation to calculate the net radiation flux (Rn), R2 was improved from 0.45 to 0.53, and the RMSE was reduced from 61 W/m2 to 51 W/m2. The ETa estimation results on satellite overpass days performed well, with R2 equal to 0.93 and RMSE equal to 0.48 mm when compared with the Eddy covariance method (EC) observations. Subsequently, the different growth stages and daily average ETa estimates of maize were compared with three observations (water balance, WB; Bowen ratio and energy balance method, BREB; and EC). The daily estimates of ETa correlate well with the observations of BREB (R2BI = 0.82, R2DI = 0.92; RMSEBI = 0.46 mm/day, RMSEDI = 0.32 mm/day) and EC (R2BI = 0.85, R2DI = 0.92; RMSEBI = 0.45 mm/day, RMSEDI = 0.34 mm/day), and the estimation for drip irrigation was found to be better than for border irrigation. The total accuracy of the ETa estimation on the five-year overpass day of maize farmland reached R2 = 0.93 and RMSE = 0.48 mm. With sufficient remote sensing data, the 4-year average ETa of maize was 31 mm lower for DI than for BI, and the mean value of ETa obtained from the three observation methods was 40 mm. The METRIC model can be used to distinguish ETa differences between the two irrigation methods in maize farmlands. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence of atrial fibrillation (AF) and chronic kidney diseases highlights the need for a deeper comprehension of the molecular mechanisms linking them. Mutations in PKD1, the gene encoding Polycystin-1 (PKD1 or PC1), account for 85% of autosomal dominant polycystic kidney disease (ADPKD) cases. This disease often includes cardiac complications such as AF. In cardiomyocytes, PC1 deletion reduces hypertrophic response to pressure overload but promotes baseline ventricular dysfunction, while deletion in fibroblasts ameliorates post-myocardial infarction fibrosis. Despite its known cardiac impact, the role of PC1 in atrial cardiomyocytes and arrhythmias is less understood. Here, we sought to investigate the role of PC1 in AF., Methods: We used intracardiac programmed stimulation and optical mapping to evaluate AF inducibility in two mouse models, Pkd1 R3277C, which recapitulates human ADPKD progression, and cardiomyocyte-specific Pkd1 deletion, and their respective controls. Isolated adult mouse atrial cardiomyocytes, human iPSC-derived atrial cardiomyocytes (hiPSC-aCM), and HL-1 cells served as in vitro cellular models. Molecular mechanisms were evaluated using optical mapping and molecular and biochemical approaches., Results: Loss-of-function PC1 mutations significantly increased AF susceptibility in vivo and facilitated local reentry in ex vivo left atrial appendages. Comprehensive in vitro experiments supported a direct effect of PC1 in atrial cardiomyocytes. PC1-deficient monolayers exhibited increased arrhythmic events, escalating into reentrant spiral waves post-tachypacing. Transcriptomics analysis revealed PC1-dependent regulation of DNA repair, with PC1 deficiency leading to increased DNA damage under stress. PARP1 inhibitors or nicotinamide riboside, which counteract DNA damage-related metabolic consequences, reduced in vitro arrhythmias PC1-deficient monolayers. Overexpression of the C-terminus of PC1 had the opposite effects in DNA repair genes, suggesting its regulatory effects in atrial cardiomyocytes through retinoblastoma/E2F. Analyses of human atrial tissue from non-ADPKD patients showed reduced levels of mature PC1, suggesting a broader relevance of impaired PC1 in AF., Conclusions: Impaired PC1 increases in vivo AF inducibility under programmed electrical stimulation and promotes in vitro arrhythmias in hiPSC-aCM and HL-1 cells. Our findings indicate that PC1 protects against DNA damage to reduce AF susceptibility.