Exploring China’s Global Strategy in the New Era

Since the 18th National Congress of the Communist Party of China(CPC)in 2012,China’s diplomacy has been forging ahead and has accomplished achievements of historic significance under strong leadership of the CPC Central Committee with Comrade Xi Jinping at its core.Xi has repeatedly pointed out that“the world today is undergoing profound transformation unseen in a century”and that“although both opportunities and challenges we face are unprecedented in scale,the opportunities outweigh the challenges in general.”1 Under new historical conditions,establishing major-country diplomacy with national characteristics has become the strategic thinking of the CPC central leadership.2 As a significant major country on the world stage,China should adopt a strategic path different from that of the established powers,and pursue major-country diplomacy with Chinese characteristics on the basis of managing well its internal and external affairs.China’s strategic goal is never to seek global hegemony,nor to expand its geopolitical and economic space,but to meet the Chinese people’s growing needs for a better life and then build a community with a shared future for mankind.Fostering global partnerships,exploring new global development paradigms,and advancing global governance reform are all strategies with a common goal-the well-being of the Chinese people and shared prosperity with the international community.

TRAIL-induced apoptosis of hepatocellular carcinoma cells is augmented by targeted therapies

AIM:To analyze the effect of chemotherapeutic drugs and specific kinase inhibitors,in combination with the death receptor ligand tumor necrosis factor-related apoptosis inducing ligand(TRAIL),on overcoming TRAIL resistance in hepatocellular carcinoma(HCC)and to study the efficacy of agonistic TRAIL antibodies,as well as the commitment of antiapoptotic BCL-2 proteins, in TRAIL-induced apoptosis. METHODS:Surface expression of TRAIL receptors (TRAIL-R1-4)and expression levels of the antiapoptotic BCL-2 proteins MCL-1 and BCL-xL were analyzed by flow cytometry and Western blotting,respectively. Knock-down of MCL-1 and BCL-xL was performed by transfecting specific small interfering RNAs.HCC cellswere treated with kinase inhibitors and chemotherapeutic drugs.Apoptosis induction and cell viability were analyzed via flow cytometry and 3-(4,5-Dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. RESULTS:TRAIL-R1 and-R2 were profoundly expressed on the HCC cell lines Huh7 and Hep-G2. However,treatment of Huh7 and Hep-G2 with TRAIL and agonistic antibodies only induced minor apoptosis rates.Apoptosis resistance towards TRAIL could be considerably reduced by adding the chemotherapeutic drugs 5-fluorouracil and doxorubicin as well as the kinase inhibitors LY294002[inhibition of phosphoinositol- 3-kinase(PI3K)],AG1478(epidermal growth factor receptor kinase),PD98059(MEK1),rapamycin(mam- malian target of rapamycin)and the multi-kinase inhibitor Sorafenib.Furthermore,the antiapoptotic BCL-2 proteins MCL-1 and BCL-xL play a major role in TRAIL resistance:knock-down by RNA interference increased TRAIL-induced apoptosis of HCC cells.Additionally, knock-down of MCL-1 and BCL-xL led to a significant sensitization of HCC cells towards inhibition of both c-Jun N-terminal kinase and PI3K.CONCLUSION:Our data identify the blockage of survival kinases,combination with chemotherapeutic drugs and targeting of antiapoptotic BCL-2 proteins as promising ways to overcome TRAIL resistance in HCC.

Palatability Testing of Oral Chewables in Veterinary Medicine for Dogs

For veterinary medications administered per os, animal health companies strive to develop highly palatable dosage forms that are voluntarily accepted by animals to improve compliance and convenience. Achieving high palatability is often complex and difficult even without the presence of an active ingredient. This work compared acceptance and preference studies, as standardized methods are not established for informing formulation development or for more routine testing. Formulation development was followed by an acceptance study completed with laboratory Beagle dogs. One acceptance study and one preference study were completed in mixed breed dogs, also laboratory-housed, to gain wider representation of dog breed and age. Through these studies, we have evaluated both formulation parameters and palatability study conduct. In general, more complex palatants that have appealing taste, smell, and mouth feel enhance voluntary uptake. However, dosage forms that are too chewy may not be freely consumed even with complex palatants. The addition of aroma can entice dogs to prehend the tablet, as observed in one preference study. Preference studies in the veterinary pharmaceutical field identify the preferred first choice or first prehend, but not which product will be routinely voluntarily and fully consumed. Acceptance studies with cross-over treatment groups are used to quantify the full consumption of a dosage form when a dog is not given two choices at once. Since all dogs in acceptance studies are offered all treatment groups throughout the study, a comparison between degrees of consumption could suggest that one formulation might be preferred over another.

Measurement of Tryptophan Metabolites in Healthy Old Men and Patients of Type 2 Diabetes Mellitus (T2DM)

Background: Plasma levels of tryptophan (TRP) metabolites have not been measured extensively in patients of type 2 diabetes mellitus (T2DM). Methods: Metabolites analysis was performed by a liquid chromatograph tandem mass spectrometer, the LCMS-8060 quadrupole mass spectrometer combined with Nexera X2 liquid chromatograph system (Shimadzu Corporation, Kyoto, Japan). Body mass index (BMI) and TRP metabolites have been measured in healthy old men (n = 20) and patients of T2DM (n = 20). TRP metabolites were measured by using the ultrahigh speed liquid chromatography-mass spectros-copy (Shimadzu Corporation). Results: The plasma levels of 5-hydroxytryptophan (5-HTRP), 5-hydroxyindoleacetic acid (5-HIAA), kynurenic acid (KNA), 3-hydroxykynurenine (3-HKN), and 3-hydroxyanthranilic acid (3-HAA) were higher in patients of T2DM than healthy old men. Since 5HTRP and 5-HIAA belong to the serotonin pathway, and KNA, 3-HKN, and 3-HAA belong to the KN pathway of TRP metabolism, these pathways were activated more in the patients of T2DM. Since plasma levels of Indole-3-acetic acid were not elevated in T2DM, that pathway was not activated more in T2DM. Serotonin levels were not increased but 5-HIAA levels were increased in the plasma of T2DM patients, which may mean that serotonin was quickly metabolized to 5-HIAA in the patients of T2DM. Conclusion: Plasma levels of tryptophan metabolites in serotonin and kynurenine pathways increased in T2DM patients. Obesity expressed by BMI may not influence tryptophan metabolism in healthy old men and T2DM patients. These results indicate that our new method of the simultaneous measurements of all the tryptophan metabolites is the powerful measure to identify factor related to endogenous stresses seen in DM.

What the AIIB Can Do for the Multilateral System

The Asian Infrastructure Investment Bank has witnessed early success with its expanding membership. There have also been signs of innovation in its governance and operations that could usefully inform and migrate over to the other multilateral development institutions.

Differences of Plasma Levels of Tryptophan, Serotonin, 5-Hydroxyindole Acetic Acid, and Kynurenine between Healthy People and Patients of Major Monopolar Depression at Various Age and Gender

Background: It is not well analyzed whether there are differences in plasma levels of tryptophan (TRP) metabolites between healthy control people (HC) and patients of major monopolar depression (MMD). Methods: Ultra high-speed liquid chromatography/mass spectrometry has been used for the simultaneous determination of plasma levels of tryptophan metabolites in depressive patients. Results: There are no significant differences between plasma levels of TRP between HC and MMD. Plasma levels of TRP of HC are higher in young men, young women, old men, and old women in this order. Serotonin (5-HT) levels are higher in MMD than HC. Plasma levels of 5-HIAA of HC are also higher than those of patients of MMD. Plasma levels of kynurenine (KYN) of healthy old men and old women are higher than those of young men and old women. Plasma levels of KYN are higher in old women and young men of MMD than those of HC. Conclusion: Plasma levels of 5-HT are higher in patients of MMD than those of HC, which may suggest that use of drugs inhibiting the 5-HT transportation may increase plasma levels of 5-HT in MMD.

Hidden risks associated with conventional short intermittent hemodialysis:A call for action to mitigate cardiovascular risk and morbidity

The development of maintenance hemodialysis(HD)for end stage kidney disease patients is a success story that continues to save many lives.Nevertheless,intermittent renal replacement therapy is also a source of recurrent stress for patients.Conventional thrice weekly short HD is an imperfect treatment that only partially corrects uremic abnormalities,increases cardiovascular risk,and exacerbates disease burden.Altering cycles of fluid loading associated with cardiac stretching(interdialytic phase)and then fluid unloading(intradialytic phase)likely contribute to cardiac and vascular damage.This unphysiologic treatment profile combined with cyclic disturbances including osmotic and electrolytic shifts may contribute to morbidity in dialysis patients and augment the health burdenof treatment. As such, HD patients are exposed to multiple stressors including cardiocirculatory,inflammatory, biologic, hypoxemic, and nutritional. This cascade of events can be termed thedialysis stress storm and sickness syndrome. Mitigating cardiovascular risk and morbidityassociated with conventional intermittent HD appears to be a priority for improving patientexperience and reducing disease burden. In this in-depth review, we summarize the hidden effectsof intermittent HD therapy, and call for action to improve delivered HD and develop treatmentschedules that are better tolerated and associated with fewer adverse effects.

Cetuximab plus irinotecan in pretreated metastatic colorectal cancer patients:The ELSIE study

AIM:To evaluate the efficacy and safety of cetuxim-ab plus irinotecan in irinotecan-refractory metastatic colorectal cancer (mCRC) patients from South-East Asia and Australia. METHODS:In this open-label,phase Ⅱ study,the main eligibility criteria were epidermal growth factor receptor-positive mCRC with progressive disease within 3 mo of an irinotecan-based regimen as the most recent chemotherapy. Patients received cetuximab 400 mg/m2 initially,then 250 mg/m2 every week,with the same regimen of irinotecan on which the patients had progressed (4 pre-defined regim-ens allowed). The prim-ary objective was evaluation of progression-free survival (PFS) at 12 wk. Secondary objectives included a further investigation of PFS,and an assessment of the overall response rate (ORR),duration of response,time to treatment failure (TTF),overall survival and the safety profile. RESULTS:One hundred and twenty nine patients were enrolled from-25 centers in the Asia-Pacific region and of these 123 received cetuximab plus irinotecan. The most common recent irinotecan regimen used was 180 mg/m2 every 2 wk which had been used in 93 patients (75.6%). The PFS rate at 12 wk was 50% (95% confidence interval (CI,41-59) and m-edian PFS tim-e was 12.1 wk (95% CI:9.7-17.7). The ORR was 13.8% (95% CI:8.3-21.2) and disease control rate was 49.6% (95% CI:40.5-58.8). Median duration of response was 31.1 wk (95% CI:18.0-42.6) and median overall survival was 9.5 mo (95% CI,7.5-11.7). The median TTF was 11.7 wk (95% CI:9.1-17.4). Treatment was generally well tolerated. The most common grade 3/4 adverse events were diarrhea (13.8%),neutropenia (8.9%),rash (5.7%) and vomiting (5.7%).CONCLUSION:In patients from Asia and Australia,this study confirm-s the activity and safety of cetuxim-ab plus irinotecan observed in previous studies in Europe and South America.

层层叠叠看远山——埃斯基谢希尔RIXOS水疗中心及温泉酒店

这是一家精品酒店,坐落于土耳其埃斯基谢希尔。埃斯基谢希尔拥有悠久的历史背景,它曾被多种不同文明统治过数十年,如赫梯人、弗里吉亚、亚历山大、罗马、拜占庭、塞尔柱安纳托利亚和奥斯曼帝国等都曾占领过这里。埃斯基谢希尔拥有Porsuk河及丰富的矿产资源,而Odunpazari地区还拥有未开发的自然地质,具有巨大的旅游市场开发潜力,埃斯基谢希尔RIXOS水疗中心及温泉酒店便是因此而建。

Identification and Enumeration Method of Both Eukaryotic and Prokaryotic Microorganisms in Food Sample

The method to analyze both eukaryotic and prokaryotic microorganisms without preliminary microbial information of sample seemed to be useful not only for research and investigation of microorganisms but also for industry using microorganisms. In the present manuscript, preparation of a new DNA primers, new reference database for 18S rDNA for our newly developed method [1]- [3], and analyses of eukaryotic and prokaryotic microorganisms in fermentation products were presented. In komekouji, Aspergillus spp., was enumerated to be 46.5 × 106 MPN g-1, and Penicillium spp., was enumerated to be 1.5 × 106 MPN g-1. In dry yeast, Saccharomyces group, were enumerated to be 8600 × 106 MPN g-1. In komekouji-miso, no eukaryotic microorganism was detected, while the other Bacillus spp., was numerically dominant (21.5 × 106 MPN g-1) as prokaryotic microorganisms, followed by B. subtilis group (4.65 × 106 MPN g-1), and the other Firmicutes (3.7 × 106 MPN g-1). The komekouji-miso included lower number of Actinobacteria (0.15 × 106 MPN g-1), Burkhokderia sp. (1.5 × 106 MPN g-1), and the other α,β,γ-proteobacteria (0.12 × 106 MPN g-1). In sake-kasu, both prokaryote and eukaryote were not detected by the method. Present results indicated that using both universal primers for eukaryotic and prokaryotic microorganisms, each groups of prokaryotic and eukaryotic microorganisms were enumerated without any preliminary information nor setting up standard curve, which were required for real time PCR.

Comparison of four non-alcoholic fatty liver disease detection scores in a Caucasian population

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is a common disorder,with an estimated prevalence ranging from 20%to 35%in the general population.Several scores based on easily measurable biochemical and clinical parameters,including the fatty liver index(FLI),hepatic steatosis index(HSI),lipid accumulation product(LAP),and NAFLD liver fat score(LFS),have been developed for the detection of NAFLD.However,comparative information regarding the efficacy of these scores for predicting NAFLD in population-based samples comprising normal and high-risk individuals is lacking.AIM To evaluate four NAFLD detection scores in two samples with different NAFLD risks.METHODS NAFLD screening was performed in a population-based sample of 50-year-old individuals in Uppsala,Sweden[n=310;Prospective investigation of obesity,energy and metabolism(POEM)study]and a high-risk population comprising patients with a body mass index>25 kg/m2 and either high plasma triglycerides(≥1.7 mmol/L)or type 2 diabetes(n=310;EFFECT studies).NAFLD was defined as liver fat>5.5%using magnetic resonance imaging-proton density fat fraction.FLI,HSI,LAP,and NAFLD LFS were assessed.A logistic regression model was used to evaluate the effectiveness of the different scores.RESULTS The prevalence of NAFLD was 23%in POEM.FLI showed the highest receiver operating characteristic area under the curve(ROC AUC;0.82)and was significantly better than the LAP score(P=0.005 vs LAP,P=0.08 vs LFS,P=0.12 vs HSI)for detection of NAFLD.The other three indices performed equally in POEM(0.77-0.78).The prevalence of NAFLD was 74%in EFFECT;LFS performed best(ROC AUC 0.80)in this sample.The ROC AUC for LFS(0.80)was significantly higher than that for FLI(P=0.0019)and LAP(P=0.0022),but not HSI(P=0.11).We performed a sensitivity analysis with stratification for the two high-risk subgroups(patients with diabetes or hypertriglyceridemia)from the EFFECT studies.LAP performed best in patients with hypertriglyceridemia.No major differences were observed between the other scores.CONCLUSION The four investigated NAFLD scores performed differently in the populationbased vs high-risk setting.FLI was preferable in the population-based setting,while LFS performed best in the high-risk setting.

Comparison of Plasma Levels of Tryptophan Metabolites between Healthy People and Patients of Bipolar Depression at Various Age and Gender

Background: It is not well analyzed whether there are differences in plasma levels of tryptophan (TRP) metabolites between healthy control people (HC) and patients of type II bipolar depression (BDII). Methods: Ultra high-speed liquid chromatography/mass spectrometry has been used for the simultaneous determination of plasma levels of tryptophan metabolites in depressive patients. Results: Plasma levels of TRP are not different between HC and patients of BDII. Serotonin (5-HT) levels are higher in BDII than HC. Plasma levels of 5-HIAA of HC are higher than those of old women of BDII, but lower in young women of BDII. Plasma levels of kynurenine (KYN) of HC are not different from those of patients of BDII. Conclusion: Plasma levels of 5-HT are higher in patients of BDII than those of HC, which may suggest that use of drugs inhibiting the 5-HT transportation and lower transporter biding may increase plasma levels of 5-HT in patients of BD.

Effects of Gender, Age, and Clot Formation on the Measurements of Tryptophan Metabolites in Blood

Background: Tryptophan metabolism plays important roles in health and diseases. Although simultaneous measurements of tryptophan metabolites are successfully measured, influences of age, gender, and clot formation on the measurements have not been reported. Methods: We took blood from young and old Japanese men and women and compared plasma levels of tryptophan metabolites. We also took plasma and serum from the blood of middle-aged men (n = 10). Metabolites analysis was performed by a liquid chromatograph tandem mass spectrometer, the LCMS-8060 quadrupole mass spectrometer combined with Nexera X2 liquid chromatograph system (Shimadzu Corporation, Kyoto, Japan). Body mass index (BMI) and TRP metabolites have been measured in healthy young men (n = 48), young women (n = 47), old men (n = 44), and old women (n = 39). TRP metabolites were measured by using the ultrahigh speed liquid chromatography-mass spectroscopy (Shimadzu Corporation). Results: Tryptophan and its metabolites such as serotonin, 5-hydroxyindole acetic acid, indole-3-acetic acid, kynurenine, anthranilic acid, were higher in young women and old men than young men and old women. Plasma levels of 3-hydroxykynurenine and xanthurenic acid were lower in young women and old men. Comparison of plasma and serum indicates that most of metabolites were higher in serum than plasma except for 3-hydroxy-kynurenine and quinolinic acid. Conclusion: Metabolites of the upper stream of degradation of tryptophan were higher in young women and old men than young men and old women, which suggests that the degradation of tryptophan was accelerated in young men and old women than young women and old men. Serum preparation may activate tryptophan degradation resulting in higher levels of metabolites in serum than in plasma.

Characteristics of Prostate Cancers Missed by Biopsies: Evaluation of Cumulative Tumor Volume Missed According to Cancer True Prevalence

Purpose: To characterize missed prostate tumors and their cumulative volume with various biopsy regimens to determine optimal biopsy schemes. Methods: We performed 6, 12 and 18-core needle biopsies on 165 and 36-core biopsies on 47 autopsy prostates, respectively. The 6-core biopsy included 6 cores from the mid peripheral zone (MPZ), the 12-core biopsy included 6 cores from the MPZ and lateral PZ (LPZ), and the 18-core biopsies included 6 cores from the MPZ, LPZ and central zone (CZ). The 36-core biopsies included 12 cores in each of these 3 areas. We analyzed the sensitivity of biopsies at each site and evaluated the cumulative volume of cancers and tumor foci missed. Results: Whole-mount analysis identified 59 cancers, 110 tumor foci, and a total cumulative tumor volume of 43 cm3. The percentage of tumor foci and corresponding cumulative volume missed with 6, 12, 18 and 36-core biopsies were of 79% and 58%, 64% and 48%, 57% and 26%, and 42% and 17%, respectively (p 0.05). 12-core biopsies from the MPZ and LPZ performed best for clinically significant cancers detection. However, increasing the number of cores over the 6-core biopsy cutoff increased solely the detection of tumor foci 0.5 cm3. Conclusion: Twelve biopsies from the MPZ and LPZ detected most of the clinically significant cancers while missing most of the tumor foci. These missed tumors represented only a small amount of the overall cancer volume.

Double Blinded,Randomized and Controlled Comparative Study Evaluating the Cleaning Activity of Two Ear Cleaners in Client-Owned Dogs with Spontaneous Otitis Externa

Ear cleaning is a therapeutic component in the management of otitis externa in dogs. The objectives of this study were to evaluate the in vivo efficacy and safety of a new ear cleanser, Sonotix? against EpiOtic? Advanced for the management of canine otitis externa. Eighteen clients owned dogs with a diagnosis of erythemato-ceruminous or purulent otitis externa were prospectively included and randomized to two treatment group: EpiOtic? Advanced and Sonotix?. Cytology and video-otoscopic examination (erythema, amount of cerumen and thickness and surface of ear canal covered by cerumen) of all affected ears were done at D0, both before (T0) and 30 minutes (T0 + 30 min) after ear cleaning. Then an ear medication was applied (Aurizon?, Vetoquinol). Owners were instructed to clean affected ears daily and apply the ear medication 30 minutes later for 5 days (D1-D5). Dogs were seen again at D6 for cytology and video-otoscopic examination. At T0, no significant differences were found between both ear cleansers groups regarding macroscopic and microscopic scorings. At T0 + 30 min and D6 cytological and video-otoscopic scores were significantly decreased (Wilcoxon test;p < 0.01) compared to baseline in both groups. However, the cleaning activity of Sonotix? was statistically superior to Epiotic? as evidenced by the median global scores of video-otoscopic examination at T0 + 30 min (Mann Whitney Test, p < 0.01). Effective ear cleaning is an essential part of any treatment scheme because it favours the contact between the ointment and the lining ear epidermis and speeds resolution by the removal of cerumen, microbial organisms and cellular debris. In our study, the important reductions in yeast, cocci, and rod-shaped organism counts were demonstrated in smears at T0 + 30 min and D6 in both groups. Video-otoscopic examination performed 30 minutes after ear cleaning suggests that Sonotix? seems to be more effective in removing cerumen than EpiOtic? Advanced.

Incorporating the Istanbul-Ankara high-speed railway into the Belt and Road Initiative:Negotiation,institutional alignment and regional development

This article contributes to a small but growing body of multi-sited and multi-scalar research on the Belt and Road Initiative.We focus on relations at the national,regional and international scales,and present original research from China and Turkey,to show how the Istanbul-Ankara high-speed railway has served as a testing ground for China's Belt and Road Initiative(BRI).Its construction was initially funded by the European Investment Bank,but it is now part of the backbone of the Turkish Government's Middle Corridor plan which enhances west-east connectivity and integration with the Caucasus and Central Asia.We show that in contrast to multinational corporations from the OECD that seek to remain footloose,Chinese state-owned enterprises(SOEs)seek to adapt to,apprehend and ultimately shape local institutions.In the case of Turkey this proved difficult given its institutional alignment with the European Union.Thus,while the railway project was completed successfully by a consortium led by a Chinese SOE,Turkey's dynamic and complex regulatory environment discourages Chinese SOEs in the infrastructure sector.We conclude that the Turkish and Chinese governments are currently pursuing complementary territorial visions yet their cooperation is project-based and pragmatic.

Human-caused increases in reactive nitrogen burial in sediment of global lakes

Human activities have increased reactive nitrogen(Nr)input to terrestrial ecosystems compared with the pre-industrial era.However,the fate of such Nr input remains uncertain,leading to missing sink of the global nitrogen budget.By synthesizing records of Nr burial in sediments from 303 lakes worldwide,here we show that 9.6±1.1 Tg N year^(-1)(Tg=10^(12) g)accumulated in inland water sediments from 2000 to 2010,accounting for 3%-5% of global Nr input to the land from combined natural and anthropogenic pathways.The recent Nr burial flux doubles pre-industrial estimates,and Nr burial rate significantly increases with global increases in human population and air temperature.Sediment ratios of C:N decrease after 1950 while N:P ratios increase over time due to increasingly elevated Nr burial and other related processes in lakes.These findings imply that Nr burial in lakes is overlooked as an important global sink of Nr input to terrestrial ecosystems.

Prioritizing Strategies for Building the Resilience of Public Health Systems to Disasters Across Multiple Communities and Countries

The COVID-19 pandemic highlighted the urgent need to strengthen public health systems.In response,the United Nations Disaster Risk Reduction(UNDRR) Public Health System Resilience Scorecard(Scorecard) was applied in workshops across multiple countries.The aim of our research was to explore the workshop findings to develop priority strategies for strengthening public health system resilience.We conducted a workshop from 14 to 16 March 2023,at the UNDRR Global Education and Training Institute in Incheon,Republic of Korea.A sequential modified Delphi method was utilized to develop a set of prioritized resilience strategies.These were drawn from 70 strategies identified from 13 distinct workshops in eight countries.After two surveys,23 strategies were finalized.Ten received ratings of "High" or Very High" from89% of participants.These related to the inclusion of public health risks in emergency plans,integrating multidisciplinary teams into public health,enabling local transport mechanisms,and improving the ability to manage an influx of patients.The Scorecard provides an adaptable framework to identify and prioritize strategies for strengthening public health system resilience.By leveraging this methodology,our study demonstrated how resilience strategies could inform disaster risk reduction funding,policies,and actions.

Biofilm delays wound healing: A review of the evidence

Biofilm is the predominant mode of life for bacteria and today it is implicated in numerous human diseases. A growing body of scientific and clinical evidence now exists regarding the presence of biofilm in wounds. This review summarizes the clinical experiences and in vivo evidence that implicate biofilm in delayed wound healing. The various mechanisms by which biofilm may impede healing are highlighted, including impaired epithelialization and granulation tissue formation, and reduced susceptibilities to antimicrobial agents and host defenses. Strategies to manage biofilm and encourage progression to wound healing are discussed;these include debridement and appropriate antimicrobial therapies which may be improved upon in the future with the emergence of anti-biofilm technologies.

Export Dependence and Sustainability of Growth in China

This paper examines the contribution of exports to growth in China since the early years of the decade. It is estimated that, despite a high import content ranging between 40 and 50 percent, approximately one-third of Chinese growth before the global crisis was a result of exports, due to their phenomenal growth of some 25 percent per annum. This figure increases to 50percent if spillovers to consumption and investment are allowed for. The main reason for excessive dependence on foreign markets is underconsumption. This is due not so much to a high share of household savings in GDP as to a low share of household income and a high share of profits. It is argued that China can no longer maintain such high growth rates for its exports, and, therefore, needs to turn to consumption-led growth by expanding the share of wages and household income in GDP and accelerating public spending in social infrastructure.