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The correlation between mean surface air temperature and altitude is analyzed in this paper based on the annual and monthly mean surface air temperature data from 106 weather stations over the period 1961-2003 across the Qinghai-Tibet Plateau. The results show that temperature variations not only depend on altitude but also latitude, and there is a gradual decrease in temperature with the increasing altitude and latitude. The overall trend for the vertical temperature lapse rate for the whole plateau is approximately linear. Three methods, namely multivariate composite analysis, simple correlation and traditional stepwise regression, were applied to analyze these three correlations. The results assessed with the first method are well matched to those with the latter two methods. The apparent mean annual near-surface lapse rate is −4.8 °C /km and the latitudinal effect is −0.87 °C /latitude. In summer, the altitude influences the temperature variations more significantly with a July lapse rate of -4.3°C /km and the effect of latitude is only −0.28°C /latitude. In winter, the reverse happens. The temperature decrease is mainly due to the increase in latitude. The mean January lapse rate is −5.0°C /km, while the effect of latitude is −1.51°C /latitude. Comparative analysis for pairs of adjacent stations shows that at a small spatial scale the difference in altitude is the dominant factor affecting differences in mean annual near-surface air temperature, aided to some extent by differences of latitude. In contrast, the lapse rate in a small area is greater than the overall mean value for the Qinghai-Tibet Plateau (5 to 13°C /km). An increasing trend has been detected for the surface lapse rate with increases in altitude. The temperature difference has obvious seasonal variations, and the trends for the southern group of stations (south of 33° latitude) and for the more northerly group are opposite, mainly because of the differences in seasonal variation at low altitudes. For yearly changes, the temperature for high-altitude stations occurs earlier clearly. Temperature datasets at high altitude stations are well-correlated, and those in Nanjing were lagged for 1 year but less for contemporaneous correlations. The slope of linear trendline of temperature change for available years is clearly related to altitude, and the amplitude of temperature variation is enlarged by high altitude. The change effect in near-surface lapse rate at the varying altitude is approximately 1.0°C /km on the rate of warming over a hundred-year period. [ABSTRACT FROM AUTHOR]

Health sector reforms in China, instituted starting in 1985, have centred on cost recovery, with fee-for-service revenue replacing public budget funding. The share of public funding for maternal health services was reduced greatly, forcing an increasing proportion of pregnant women to pay for deliveries and treatment of pregnancy-related complications out of pocket, as most had no health insurance to cover these costs. This study aimed to identify socio-economic variables associated with utilisation of essential maternal health services and linked to health sector reforms in China, with a focus on cost recovery. A retrospective household survey (n=5756) was carried out in six counties in three provinces of Central China in 1995. Antenatal service utilisation continued to improve in 1990–95, but only in relation to the number of visits, which were pre-paid if the woman was participating in a maternal pre-payment scheme or covered by another health insurance scheme. Significant decreases were found in the utilisation of skilled attendance at delivery and hospital delivery, as well as differences in adverse pregnancy outcomes (miscarriages and stillbirths) between women paying out of pocket and those covered by insurance. This study confirms a strong association between utilisation of delivery services and financing variables of amount of savings in the bank, maternal pre-payment schemes and health insurance. It also shows the critical importance of out of pocket, fee-for-service payments for maternity care as a barrier to the utilisation of these services. Les réformes du secteur de la santé en Chine, commencées en 1985-89, se sont centrées sur la récupération des coûts, la rétribution des services remplaçant le financement public. Une enquête rétrospective auprès de ménages (n=5756) a été menée en 1995 dans six comtés de trois provinces de Chine centrale. L'utilisation des services prénatals a continué de s'améliorer en 1990-95, mais seulement par rapport au nombre de visites, qui étaient prépayées si la femme participait à un plan de prévoyance maternelle ou couvertes par une autre assurance maladie. Des diminutions notables ont été observées dans le recours à une aide qualifiée lors de l'accouchement et des services obstétriques hospitaliers, ainsi que des différences dans les issues négatives de la grossesse (fausses couches et mortinatalité) entre les femmes payant les soins de leur poche et celles qui étaient couvertes par une assurance. Cette étude confirme une nette association entre l'utilisation de services obstétriques et les variables financières que sont les comptes d'épargne, les plans de prévoyance maternelle et l'assurance maladie. Elle montre également que la rétribution personnelle des soins obstétriques est un obstacle à l'utilisation de ces services. Las reformas del sector salud instituidas en China a partir de 1985 se han centrado en la recuperación de costos, con el pago de honorarios por servicios prestados reemplazando el financiamiento público como fuente de ingresos. En 1995, se hizo una encuesta retrospectiva de hogares (n=5756) en seis condados en tres provincias de la China Central. La utilización de los servicios antenatales seguı́a mejorándose en 1990-95, pero solamente en relación al número de visitas, las cuales se pagaban con anticipación si la mujer participaba en un plan de pago prospectivo para los servicios de maternidad o si estaba cubierta por otro tipo de seguro de salud. Se encontraron reducciones significativas en la utilización de personal calificado para la atención de partos y para los partos en hospital, además de diferencias en los resultados de los embarazos (abortos espontáneos y nacidos muertos) entre las mujeres cubiertas por un seguro y aquellas que pagaban honorarios por su cuenta. Este estudio confirma que existe una fuerte asociación entre la utilización de los servicios de maternidad y los variables de financiamiento tales como cuentas de ahorro, planes de pago prospectivo, y seguros de salud. Muestra también que el pago de honorarios por los servicios de salud materna es un obstáculo crı́tico para la utilización de dichos servicios. [ABSTRACT FROM AUTHOR]

Vardenafil hydrochloride tablet is an inhibitor of phosphodiesterase type 5, primarily for the treatment of erectile dysfunction. This postprandial study evaluated the pharmacokinetics and bioequivalence of the test and reference formulations of vardenafil hydrochloride tablets in healthy Chinese volunteers. An open, randomized, single-center, single-dose, 2-period, 2-sequence bioequivalence test was conducted on 66 healthy subjects under fed conditions. Subjects were randomly assigned to a 20-mg test or reference formulation with a 7-day washout period. Venous blood samples (4 mL) were collected from each subject 25 times spanning predose (0 hour) to 24 hours after dosing. The plasma concentration of vardenafil was determined by high-performance liquid chromatography-tandem mass spectrometry. Sixty-two volunteers completed the study. Under fed conditions, the maximum plasma concentration was 29.1 ng/mL, the area under the concentration-time curve (AUC) from time 0 to the time of the last measurable concentration was 85.3 ng•h/mL, and AUC from time 0 to infinity was 87.1 ng•h/mL. The 90% confidence intervals of the geometric mean ratio of AUC time 0 to the time of the last measurable concentration and AUC from time 0 to infinity were within the bioequivalence acceptance range of 0.80-1.25. The test formulation was a bioequivalent alternative to the reference formulation when taken under fed conditions in healthy Chinese subjects., (© 2024, The American College of Clinical Pharmacology.)

This study aimed to evaluate the bioequivalence of two pazopanib tablet formulations in healthy Chinese subjects. A randomized, open-label, single-dose, two-period, two-sequence, crossover study was conducted under fasting conditions. A total of 32 eligible subjects were randomly administered a single dose of a 200-mg generic or branded pazopanib tablet with a 16-day washout period. Blood samples were collected before and up to 72 hours after dosing. Pharmacokinetic parameters were analyzed with noncompartmental analysis. Safety assessments included physical examinations, laboratory tests, and adverse events reporting. Maximum plasma concentration (C max ), area under the plasma concentration-time curve (AUC) from zero to the last quantifiable concentration (AUC 0-t ), and AUC from zero to infinity (AUC 0-∞ ) were similar between the generic and branded products (all P > .05). The 90% confidence intervals of the geometric mean ratio of the test/reference products for C max , AUC 0-t , and AUC 0-∞ were 89.1%-117.1%, 81.9%-108.5%, and 82.4%-109.6%, respectively. There were no serious adverse events during the study. The newly developed generic pazopanib tablet was bioequivalent to the reference product under fasting conditions. Both formulations were well tolerated in healthy Chinese volunteers., (© 2022, The American College of Clinical Pharmacology.)

Youkenafil is a novel selective phosphodiesterase type 5 inhibitor to treat erectile dysfunction. In order to study the drug-drug interactions of youkenafil, in vitro experiments were conducted with human liver microsomes and recombinant isoenzymes to identify the effect of cytochrome P450 (CYP) enzymes on the metabolism of youkenafil. Then two clinical studies were performed to investigate the effects of itraconazole and rifampicin (potent CYP3A4/5 inhibitor and inducer, respectively) on the pharmacokinetics of youkenafil and its main metabolite, N-desethyl youkenafil (M1). Each study enrolled thirty healthy male subjects. In study 1, subjects were given a single dose of youkenafil (50 mg on Days 1 and 13) and multiple doses of itraconazole (200 mg once daily from Days 6 to 14). In study 2, subjects were given a single dose of youkenafil (100 mg on Days 1 and 20) and multiple doses of rifampicin (600 mg once daily from Days 6 to 20). The results showed that youkenafil was mainly metabolized through CYP3A4/5 in vitro. Itraconazole increased youkenafil AUC and C max by about 12- and 6-fold, respectively, and increased M1 AUC and C max by 5- and 1.3-fold, respectively. Conversely, rifampicin reduced youkenafil AUC and C max both by about 98%. It did not change the AUC of M1 significantly, but increased the C max by 30%. All treatments were well tolerated by subjects in both studies. Therefore, co-administration of youkenafil with potent inhibitors or inducers of CYP3A4/5 should be avoided or carefully monitored., (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)

In this study, a simplified, sensitive and reliable LC-tandem mass spectrometry method was established and validated for the quantification of ulipristal acetate (UPA) in human plasma and for the investigation of pharmacokinetic profile of UPA following a single oral administration of ella (UPA 30-mg tablet) in healthy Chinese volunteers. Plasma samples were analyzed after being processed by protein precipitation with methanol. Chromatographic separation was performed on a Kinetex EVO C 18 column (2.1 × 50 mm, 2.6 μm) using gradient elution with a mobile phase composed of methanol and water containing 2 mm ammonium acetate and 0.3% formic acid at a flow rate of 0.3 mL/min. The chromatographic running time was 4.0 min per sample. The MS detection was performed via an LC system with the positive ion electrospray ionization interface in multiple reaction monitoring mode using the transition of m/z 476.2 → 134.1 for UPA and m/z 479.3 → 416.2 for UPA-d3 [internal standard (IS)], respectively. UPA and IS were monitored without severe interference from the biological matrices. The method was linear over the wide concentration range of 0.300-300 ng/mL. The intra- and inter-day precision and accuracy were well within the limits required for bioanalytical assays. The method was first used to describe the pharmacokinetic characteristic of UPA after a single oral administration of ella in healthy Chinese volunteers. Based on a between-study comparison, there were statistically significant differences (p < .05) between Chinese and Caucasian volunteers for the systemic exposure of UPA, suggesting that race seems to significantly impact the systemic exposure of UPA., (© 2020 John Wiley & Sons, Ltd.)