The essential medicine——insulin cannot be easily accessed and afforded in many countries. To help address this issue, we evaluated the availability, affordability and price of insulin products in Nanjing, eastern China. Two cross-sectional studies were conducted in 2016 and 2018. A total of 56 hospital pharmacies were sampled, using a simplified and adapted World Health Organization/Health Action International (WHO/HAI) methodology. Prices were expressed as Median Price Ratios (MPRs) to Australian Pharmaceutical Benefit Scheme (PBS) prices. In addition, we investigated the price components of seven selected insulin products as a case study before and after the Online Centralized Procurement Policy for Hospital Drugs in May, 2018. Affordability was presented as the number of daily wages of the lowest paid unskilled government worker (LPGW) required to purchase 1000IU of insulin based on the average courses of treatment, approximately 30 days’ treatment. The availability of insulin products was very high in secondary hospitals and tertiary hospitals both in 2016 and 2018, but in community hospitals was very low. In 2018, the availability of prandial insulin products showed fluctuation compared to 2016. The availability of pre-mixed human insulin products was over 95% overall, and also very high (80%) in community hospitals in 2018. The prices of insulin products were much lower than PBS prices of Australian in this study, with the MPRs less than 1 (0.32 to 0.71 in 2016 vs. 0.30 to 0.68 in 2018) for all insulin types. But insulin products in Nanjing in 2016 and 2018 were considered unaffordable, because the number of daily wages of the LPGW needed to purchase for the 30 days treatment of insulin products ranged from 2.26 to 8.49 in 2016 and 1.88 to 7.09 in 2018. The manufacturers’ selling price contributed the main part (74.15% to 77.70% before and 74.86% to 91.51% after the implementation of the bidding policy) of the price components of target insulin brands. The availability of insulin products was high in secondary hospitals and tertiary hospitals, but lower in community hospitals. However, the affordability in community hospitals was better than other hospitals, but the insulin products were still unaffordable for patients on low incomes. Further improvements of the availability accessibility and affordability of medicines in advancing health insurance policies and lowering drug prices should be put forward.

It has been two months since Wuhan eased the lockdown and the people of Wuhan have been under great pressure during COVID-19. The psychological status among healthcare workers and residents were barely know due to the lack of research after Wuhan eased of the lockdown. The purpose of this study was to assess people’s mental health and the changes after Wuhan eased the lockdown. A cross-sectional online study among citizens in Wuhan was conducted. Among 1417 participants, 387(27.0%) were frontline healthcare workers and 1035(73.0%) were residents from the general public. Their COVID-19 psychological status was evaluated using Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), and the PTSD Checklist-Civilian Version (PCL-C). Results show that 16.1%,22.3% and 17.2% healthcare workers and 21.2%, 16.7% and 17.2% general public had symptoms of depression, anxiety and PTSD ranging from moderate to severe. Anxiety levels were not significantly different between healthcare workers and the general public. The decreased income and the frequent social media exposure are the risk factors for general public. Compared to the early COVID-19 epidemic period, the proportion of anxiety and depression among both the general public and health workers decreased after Wuhan eased the lockdown. Our finding can be used to help the government of Wuhan to develop psychological interventions to improve the mental health of the population and work as a reference of public health guidelines for other cities with severe COVID-19 outbreak.

Nitrogen (N) is an important element required for plant growth and development, which also affects plant yield and quality. Autophagy, a conserved pathway in eukaryotes, degrades and recycles cellular components, thus playing an important role in N remobilization. However, only a few autophagy genes related to N remobilization in rice ( Oryza sativa ) have been reported. Here, we identified a core autophagy gene in rice, OsATG8b , with increased expression levels under N starvation conditions. It was investigated the function of OsATG8b by generating three independent homozygous 35S-OsATG8b transgenic Arabidopsis thaliana lines. The overexpression of OsATG8b significantly enhanced autophagic flux in the transgenic Arabidopsis plants. It was also showed that over-expressing OsATG8b promoted growth and development of Arabidopsis, in which the rosette leaves were larger than those of the wild type (WT), and the yield increased significantly by 25.25%. In addition, the transgenic lines accumulated more N in seeds than in the rosette leaves. Further examination revealed that overexpression of OsATG8b could effectively alleviate the growth inhibition of transgenic Arabidopsis under nitrogen (N) stress. N partitioning studies revealed that nitrogen-harvest index (NHI) and nitrogen use efficiency (NUE) were significantly increased in the transgenic Arabidopsis, as well as the 15 N-tracer experiments revealing that the remobilization of N to seeds in the OsATG8b -overexpressing transgenic Arabidopsis was high and more than WT. Based on our findings, we consider OsATG8b to be a great candidate gene to increase NUE and yield, especially under suboptimal field conditions.