[Characteristics and Risk Assessment of Antibiotic Contamination in Oujiang River Basin in Southern Zhejiang Province].

Antibiotic pollution in the environment has a negative impact on ecosystem security. Taking the Oujiang River Basin as an example,high-performance liquid chromatography mass spectrometry(LC-MS)was used to detect the concentration of six classes of 35 antibiotics in the surface water of the southern Zhejiang River Basin. The concentration level and spatial distribution of antibiotics were analyzed,the risk of antibiotics to ecology and human health were assessed using relevant models,and the sources of antibiotics were discussed. The results showed that in 20 sampling sites,a total of four classes of 12 antibiotics were detected,including sulfonamides,quinolones,tetracyclines,and lincosamides. The total concentration was ND-1 018 ng·L-1. The highest detection rate was that of Lincomycin(90.48%),followed by that of sulfapyridine(38.10%). The three antibiotics with the highest average concentrations were ofloxacin(12.49 ng·L-1),Lincomycin(11.08 ng·L-1),and difloxacin(7.38 ng·L-1). Antibiotics in the basin showed mainly spotty pollution,which had large spatial differentiation. The average concentration of antibiotics in the upstream(54.39 ng·L-1)was higher than that mid-downstream(46.64 ng·L-1). The degree of antibiotic pollution from upstream to downstream showed a characteristic of being "sparse in the upstream and dense in the downstream. " This indicated that the concentration of antibiotics in the upstream was significantly different,whereas the pollution degree of antibiotics in the downstream was uniform. The upstream was mainly polluted by health,livestock,and poultry breeding wastewater emissions,and downstream pollution was mainly caused by densely populated activities and the rapid development of economy,trade,and industry. The ecological risk assessment results showed that the upstream site H6 had the highest risk quotient,ofloxacin and enrofloxacin had high risk levels, and lincomycin had a moderate risk level. Health risk assessment results showed that the Oujiang River surface water antibiotics posed no risk to human health.

[Clinical comprehensive evaluation of Houyanqing Oral Liquid in treatment of acute pharyngitis].

This study systematically combed the existing evidence of Houyanqing Oral Liquid in the treatment of acute pharyngitis from the "6+1" dimensions of safety, effectiveness, economy, innovation, suitability, accessibility, and characteristics of traditional Chinese medicine(TCM) and carried out qualitative and quantitative analysis of the data from each dimension. The multi-criteria decision analysis(MCDA) model and CSC v2.0 were used to evaluate the clinical value of this drug, so as to provide evidence for the selection of essential drugs in the department of otolaryngology and for medical and health decision-making. The dimensions are graded A, B, C, or D. The adverse reactions of Houyanqing Oral Liquid in the treatment of acute pharyngitis were mainly manifested as abdominal pain, diarrhea, rash, etc., which were relieved after drug withdrawal. In terms of safety, it was considered that Houyanqing Oral Liquid had controllable risk and high safety, which was rated as grade B. Compared with ribavirin aerosol alone, Houyanqing Oral Liquid combined with ribavirin aerosol can significantly improve the total response rate, shorten the time to abatement of fever and di-sappearance of throat pain and mucosal congestion, and alleviate mucosal congestion and cough with sputum. With medium-quality evidence, the effectiveness was rated as grade B. Compared with ribavirin aerosol alone, Houyanqing Oral Liquid combined with ribavirin aerosol had cost-effectiveness advantages in the treatment of acute pharyngitis, and its economy was rated as grade C with the evidence of general quality. For acute pharyngitis, Houyanqing Oral Liquid can shorten the disease course and obviously relieve sore throat. Moreover, it can be used for the treatment of radioactive pharyngitis and oral ulcer, and thus its innovation was rated as grade B. With convenient and simple administration and standard and complete drug information, the suitability of this drug was rated as grade B. Houyanqing Oral Liquid is derived from the folk prescription in Hunan province and has been subjected to real-world studies, and thus the TCM characteristics was rated as grade B. According to the ratings of all the dimensions, the comprehensive value of Houyanqing Oral Liquid in the clinical treatment of acute pharyngitis was determined as grade B, with sufficient evidence and clear results. It is suggested that the results should be conditionally converted into relevant policy of clinical basic drug management according to procedures.

Evaluation of carbon emission efficiency based on urban scaling law: take 308 cities in China as an example.

The development of urban low carbonization is an important foundation for achieving the goal of "dual carbon." The differences in spatial differences based on scientific methods revealing the characteristics of urban carbon emissions and its efficiency are of great significance for shaping the green low-carbon land space pattern. This article uses urban standard models and scale adjustments to the urban index (SAMIs) identification in 2006-2017 308 Chinese urban carbon discharge standards and efficiency time and space evolution pattern and their characteristics. The results of the study show that there is a stable secondary relationship between carbon emissions and urban population scale, which means that the growth rate of urban carbon emissions is significantly lagging behind the growth of urban systems. The analysis of urban carbon emission efficiency based on SAMI values shows significant spatial heterogeneity: the carbon emission efficiency of cities in North China, East China, and Northeast China is lower than that of other regions. In terms of temporal changes, there was a phenomenon of SAMI high-value cities moving north and low-value cities moving south between 2006 and 2017, and △SAMIs showed a pattern of hot in the west and cold in the east. This study broadens the applicability of urban scaling law models in urban environmental research, providing a new perspective for evaluating urban carbon emission efficiency and China's energy conservation and emission reduction work.

Epidemiology, clinical presentation, pathophysiology, and management of long COVID: an update.

The increasing number of coronavirus disease 2019 (COVID-19) infections have highlighted the long-term consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection called long COVID. Although the concept and definition of long COVID are described differently across countries and institutions, there is general agreement that it affects multiple systems, including the immune, respiratory, cardiovascular, gastrointestinal, neuropsychological, musculoskeletal, and other systems. This review aims to provide a synthesis of published epidemiology, symptoms, and risk factors of long COVID. We also summarize potential pathophysiological mechanisms and biomarkers for precise prevention, early diagnosis, and accurate treatment of long COVID. Furthermore, we suggest evidence-based guidelines for the comprehensive evaluation and management of long COVID, involving treatment, health systems, health finance, public attitudes, and international cooperation, which is proposed to improve the treatment strategies, preventive measures, and public health policy making of long COVID.

[Lean strategy for data mining and continuous improvement of Chinese pharmaceutical process: a case study of sporoderm-removal Ganoderma lucidum spore powder].

In the digital transformation of Chinese pharmaceutical industry, how to efficiently govern and analyze industrial data and excavate the valuable information contained therein to guide the production of drug products has always been a research hotspot and application difficulty. Generally, the Chinese pharmaceutical technique is relatively extensive, and the consistency of drug quality needs to be improved. To address this problem, we proposed an optimization method combining advanced calculation tools(e.g., Bayesian network, convolutional neural network, and Pareto multi-objective optimization algorithm) with lean six sigma tools(e.g., Shewhart control chart and process performance index) to dig deeply into historical industrial data and guide the continuous improvement of pharmaceutical processes. Further, we employed this strategy to optimize the manufacturing process of sporoderm-removal Ganoderma lucidum spore powder. After optimization, we preliminarily obtained the possible interval combination of critical parameters to ensure the P_(pk) values of the critical quality properties including moisture, fineness, crude polysaccharide, and total triterpenes of the sporoderm-removal G. lucidum spore powder to be no less than 1.33. The results indicate that the proposed strategy has an industrial application value.

Occurrence, risk assessment, and in vitro and in vivo toxicity of antibiotics in surface water in China.

Antibiotics have been widely detected in the water environment and thus pose a potential threat to human health. Although antibiotics have health-promoting properties, whether and how they affect health at environmental concentrations remains uncharacterised. We detected antibiotics in surface water and groundwater in China. Sulfonamides (851 ng/L) and tetracyclines (1322 ng/L) showed the highest concentrations in surface water, while the highest concentration of sulfonamides detected in groundwater was 250 ng/L. We analysed the distribution of four classes of antibiotics (sulfonamides, tetracyclines, macrolides, and quinolones) and evaluated the associated health risks in the surface water of seven cities. We found that antibiotic pollution caused health risks to the 0-3-months age group, but not to other age groups. We further demonstrated that simulated long-term exposure to environmental concentrations of antibiotics had concentration-dependent toxic effects on L-02 hepatocytes, affected cell proliferation, and induced oxidative damage and DNA damage. Chronic exposure to mixed sulfonamides affected growth, caused liver damage, and reduced the abundance of intestinal flora in mice. Under exposure to antibiotics, the abundance of Helicobacter pylori in the gut flora significantly increased and posed a health risk to humans. These results indicated that exposure to antibiotics at environmental concentrations can cause oxidative damage and inflammation both in vitro and in vivo. These findings add to the body of basic data on the distribution of antibiotics in the water environment, and provide a scientific basis for the evaluation of antibiotic toxicity.

GIS-based spatial suitability assessment for pacific oyster Crassostrea gigas reef restoration: A case study of Laizhou Bay, China.

The oyster reef restoration has raised concerns worldwide due to the advantage of alleviating eutrophication and other ecosystem services. The necessary prerequisite for oyster restoration is identifying suitable sites. A restoration suitability index model for C. gigas reefs was built by combining the Monte Carlo simulation, analytic hierarchy process, hydrodynamic modelling and geographic information systems and applied in Laizhou Bay (LZB), China. The model outputs and sensitivity analysis showed that the east coastal area, the southern part, and the western part of LZB were restoration sites with the maximum suitability, accounting for 15.3 % of LZB. The middle and northern parts of LZB were unsuitable sites restricted by water depth and flow velocity. Ship waterways and marine industries were the major factors causing degradation of the historically recorded oyster reefs. This model can support oyster restoration planning, and can be applied to other oyster species with adjusted indicator system.

Health Risk Assessment of Inhalation Exposure to Airborne Particle-Bound Nitrated Polycyclic Aromatic Hydrocarbons in Urban and Suburban Areas of South China.

Airborne particulates (PM2.5 and TSP) were collected from outdoor and indoor areas at urban (Haizhu District) and suburban (Huadu District) sites from 2019 to 2020 in Guangzhou. Three nitro-polycyclic aromatic hydrocarbons (nitro-PAHs) in the airborne particulates were identified by a gas chromatograph equipped with a triple-quadrupole mass spectrometer. In the Haizhu District and Huadu District, the nitro-PAH concentrations in PM2.5 and TSP did not show a significant decrease from winter to summer. From 2019 to 2020, the difference in the average concentration of nitro-PAHs in PM2.5 and TSP in Guangzhou was relatively low and had no statistical significance. The diagnostic ratios of 2-nitrofluorene (2-NF)/1-nitropyrene (1-NP) in TSP are less than five, while for 2-NF/1-NP in outdoor PM2.5 in the summer of 2019 and 2020 are more than five, which indicates that nitro-PAHs in the atmospheric PM2.5 in Guangzhou during summer mainly originated from the secondary formation of atmospheric photochemical reactions between parent PAHs and oxidants (·OH, NO3, and O3). 9-Nitroanthracene (9-NT) made the most significant contribution to the total nitro-PAH concentration. The incremental lifetime cancer risks (ILCRs) of nitro-PAHs in PM2.5 and TSP by inhalation exposure indicated low potential health risks in the urban-suburban of Guangzhou.

Needs of patients with early psychosis: A comparison of patient's and mental health care provider's perception.

Background: Needs define the capacity of a patient to benefit from health care services and a systematic assessment of needs allows planning and delivery of effective treatment to suit patients. This study aimed to understand the (a) needs felt by patients and those perceived by the care providers (CPs), (b) agreement between patients and CPs in the identified needs and (c) factors associated with unmet needs. Methods: Participants (N = 215) were recruited through convenience sampling from the Early Psychosis Intervention Programme (EPIP). Data was captured from patients and CPs using the Camberwell Assessment of Needs Short Appraisal Schedule (CANSAS). Results: Patients and CPs identified an average of 4.06 and 3.84 needs, respectively. The highest number of unmet needs were identified for the social (50% of patients and CPs) and health domains (31.13% of patients' vs. 28.30% of CPs). Company, intimate relationships, psychotic symptoms, money, sexual expression and psychological distress, information and benefits were the unmet needs identified by patients, whereas company, intimate relationships, physical health, and daytime activities were identified by CPs. The concordance between patients and CPs was low with majority of the items scoring slight to fair agreement (Cohen's kappa = 0-0.4). Older age, depression, severe anxiety and having Obsessive-Compulsive Disorder (OCD) were positively associated with unmet needs in patients. Conclusion: While there was an overall consensus on the total needs and met needs between patients and CPs, the level of agreement between the two groups on various items were low. Different perceptions regarding unmet needs were noted between the groups. A holistic approach that takes into account different facets of the needs of patients together with strategic planning to address unmet needs might improve treatment outcomes and satisfaction.

Dietary exposure and risk assessment of phthalic acid esters through a total diet study in Shenzhen, South China.

Phthalic acid esters (PAEs) are typical endocrine disruptors which are ubiquitous contaminants. Human exposure to PAEs is through multiple routes of which the diet is recognised as the main source of daily intake. The aim of this study was to evaluate the dietary exposure to PAEs of residents in Shenzhen (China) through a total diet study and assess the potential health risk. A total of 16 different phthalate esters in samples of 12 composite food groups were determined by GC-MS. The main dietary sources of PAE exposure among adult residents in Shenzhen were potatoes (21%), eggs (21%), meat (15%) and aquatic products (14%). The median total dietary exposure to PAEs in Shenzhen residents was 7780 ng kg-1 bw d-1, and the hazard quotients (HQ) of dimethyl phthalate (DMP), diethyl phthalate (DEP), di-isobutyl phthalate (DIBP), dibutyl phthalate (DBP) and di-2-ethylhexyl phthalate (DEHP) were 0.09, 0.06, 0.07, 0.10 and 0.03, respectively. Therefore, the risks from dietary PAE exposure were low. However, with the increasing use of PAEs and their accumulation in the environment, the probability of PAEs entering the food chain is gradually increasing and, therefore, PAEs should be strictly controlled and regularly monitored.

Assessment of the effect of perineural dexmedetomidine on oxidative stress during peritoneal dialysis catheter insertion: a randomized, controlled trial.

PURPOSE: This study aimed to evaluate the effect of the addition of dexmedetomidine to ropivacaine on oxidative stress during transversus abdominis plane (TAP) and rectus sheath (RS) blockades for patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis (PD) catheter insertion. METHODS: Sixty patients with ESRD undergoing PD catheter insertion to receive left ultrasound-guided TAP and RS blockades were randomly divided into two groups: the dexmedetomidine plus ropivacaine group (25 mL of 0.3% ropivacaine + 1 µg/kg dexmedetomidine) and the ropivacaine group (25 mL of 0.3% ropivacaine). Primary outcomes were oxidative stress marker levels during the procedure. RESULTS: A total of 60 patients (30 patients in each group) were evaluated. Compared with the ropivacaine group, the dexmedetomidine plus ropivacaine group had significantly lower serum malondialdehyde levels (P < 0.05) and increased glutathione peroxidase (P < 0.01) and superoxide dismutase levels at 24 h after the procedure (P < 0.01). CONCLUSION: The addition of 1 µg/kg of dexmedetomidine to ropivacaine for ultrasound-guided TAP and RS blockades could inhibit oxidative stress in patients with ESRD undergoing PD catheter insertion. Trial registration This study was registered at www.chictr.org.cn on June 7, 2021 (ChiCTR2100047050).

Assessing the Equity of Accessibility to Urban Green Space: A Study of 254 Cities in China.

Urban green space has environmental benefits of purifying the air, reducing the heat island effect and providing the social and economic benefits of rest places and social platforms. An integrated and organized green space system is important for fully realizing the positive functions of an urban ecosystem. Previous studies have considered green space supply and demand, but few studies have examined large-scale, diverse and small-scale systems, making it difficult to conduct a comparative study of urban green space accessibility and equity under the same conditions (such as data sources and calculation methods). Using the two-step floating catchment area method, this study evaluates the equity of 254 urban green spaces in China within four ranges of accessibility: 1 km, 2.5 km, 5 km and 10 km. The study also considers urban house price in the research. The results show the following: (1) There are large differences in the accessibility of green space between different cities in China. Within the accessibility threshold of 10 km, the city with the most accessible urban green spaces has an accessibility level that is 27,813 times that of the city with the lowest accessibility. (2) Within the range of walking/cycling, there are significant inequalities in green space access in the 254 cities; the inequality of green space accessibility in most of the studied cities is at the "dangerous" level. (3) The two-step floating catchment area method indicates that the social superiority (high social class) represented by high housing prices is associated with a greater opportunity to access urban green space services. This paper highlights the main problems associated with the accessibility of urban green space in China and proposes targeted development recommendations. These recommendations provide a reference for urban managers to develop effective green space development policies and realize the optimal allocation of urban green space.

Disease Progression Stages and Burden in Patients with Duchenne Muscular Dystrophy Using Administrative Claims Supplemented by Electronic Medical Records.

INTRODUCTION: This study aims to identify stages of Duchenne muscular dystrophy (DMD) and assess the disease burden by progression stage using real-world administrative claims supplemented by relevant electronic medical record (EMR) data. METHODS: Claims and EMR data from the Decision Resources Group's Real World Data Repository (2011-2020) were used to identify patients with DMD by diagnosis code and to stratify them into four disease stages by diagnosis and procedure markers reflective of DMD progression. Clinical and medical history data from the Cooperative International Neuromuscular Research Group (CINRG) were used to validate the developed claims-based staging algorithm. The distribution and drivers by disease stage, as well as disease burden, were examined. RESULTS: A total of 938 (94%) of patients with DMD identified in claims/EMR data had sufficient information for stage classification. Patients were classified by stage based on patient characteristics and the presence or absence of progression markers such as genetic testing, wheelchair usage, scoliosis treatment, or ventilation assistance. Average ages at stages 1-4 are 7, 13, 18, and 23 years, respectively. Using natural history data, the claims-based staging algorithm was validated with high sensitivity and specificity rates. Both healthcare resource utilization and medical charges increased by stage. For example, the average annualized total charges were $17,688 (stage 1), $36,868 (stage 2), $72,801 (stage 3), and $167,285 (stage 4). CONCLUSIONS: Large-scale claims data supplemented by EMR data can be used to characterize DMD progression and evaluate disease burden which may inform the design of future real-world studies about DMD.

The relationship between urologic cancer outcomes and national Human Development Index: trend in recent years.

OBJECTIVES: To describe the influence of the socioeconomic development on worldwide age-standardized incidence and mortality rates, as well as mortality-to-incidence ratio (MIR) and 5-year net survival of urologic cancer patients in recent years. METHODS: The Human Development Index (HDI) values were obtained from the United Nations Development Programme, data on age-standardized incidence/mortality rates of prostate, bladder and kidney cancer were retrieved from the GLOBOCAN database, 5-year net survival was provided by the CONCORD-3 program. We then evaluated the association between incidence/MIR/survival and HDI, with a focus on geographic variability as well as temporal patterns during the last 6 years. RESULTS: Urologic cancer incidence rates were positively correlated with HDIs, and MIRs were negatively correlated with HDIs. Prostate cancer survival also correlated positively with HDIs, solidly confirming the interrelation among cancer indicators and socioeconomic factors. Most countries experienced incidence decline over the most recent 6 years, and a substantial reduction in MIR was observed. Survival rates of prostate cancer have simultaneously improved. CONCLUSION: Development has a prominent influence on urologic cancer outcomes. HDI values are significantly correlated with cancer incidence, MIR and survival rates. HDI values have risen along with increased incidence and improved outcomes of urologic caner in recent years.

Assessing the transition from intravenous to subcutaneous delivery of rituximab: Benefits for payers, health care professionals, and patients with lymphoma.

Subcutaneous (SC) administration of rituximab provides an opportunity for reduced patient treatment burden and increased healthcare efficiencies as an alternative to intravenous (IV) rituximab. There is minimal evidence comparing costs associated with SC and IV rituximab in a US setting. This research assessed the impact of transitioning patients from IV to SC rituximab for treatment of non-Hodgkin's lymphoma (NHL) from the US payer, provider, and patient perspective. We developed a model to estimate cost differences for transitioning 20% of a patient cohort from IV to SC rituximab. We included patients with incident diffuse large B-cell lymphoma, incident and recurrent follicular lymphoma, and incident and recurrent chronic lymphocytic leukemia. In the model, each patient received the same number of doses and that there was no difference in discontinuation between cohorts due to non-inferior efficacy and a similar safety profile. Model inputs were collected from published literature and publicly available data. Scenario analyses tested the impact of availability of low-cost biosimilars. In the base case (1,000,000 covered lives), we estimated a total of 157 patients, with 769 total drug administrations. A transition of 20% of patients from IV to SC was projected to generate $153,000 in payer savings, increase provider capacity by 270 hours, and free 470 hours of patient time. Scenario analyses suggest SC administration will be cost saving for payers even with a market where biosimilars approach 50% market share. A 20% transition to SC rituximab in a single cohort of patients has the potential to generate significant US health system value in the form of payer savings, increased practice capacity, and patient time.

Assessment of anti-PD-(L)1 for patients with coexisting malignant tumor and tuberculosis classified by active, latent, and obsolete stage.

BACKGROUND: It is not a rare clinical scenario to have patients presenting with coexisting malignant tumor and tuberculosis. Whether it is feasible to conduct programmed death-(ligand) 1 [PD-(L)1] inhibitors to these patients, especially those with active tuberculosis treated with concurrent anti-tuberculosis, is still unknown. METHODS: This study enrolled patients with coexisting malignancy and tuberculosis and treated with anti-PD-(L)1 from Jan 2018 to July 2021 in 2 institutions. The progression-free survival (PFS), objective response rate (ORR), and safety of anti-PD-(L)1 therapy, as well as response to anti-tuberculosis treatment, were evaluated. RESULTS: A total of 98 patients were screened from this cohort study, with 45 (45.9%), 21 (21.4%), and 32 (32.7%) patients diagnosed with active, latent, and obsolete tuberculosis, respectively. The overall ORR was 36.0% for anti-PD-(L)1 therapy, with 34.2%, 35.5%, and 41.2% for each subgroup. Median PFS was 8.0 vs 6.0 vs 6.0 months (P=0.685) for each subgroup at the time of this analysis. For patients with active tuberculosis treated with concurrent anti-tuberculosis, median duration of anti-tuberculosis therapy was 10.0 (95% CI, 8.01-11.99) months. There were 83.3% (20/24) and 93.3% (42/45) patients showing sputum conversion and radiographic response, respectively, after anti-tuberculosis therapy, and two patients experienced tuberculosis relapse. Notably, none of the patients in latent and only one patient in obsolete subgroups showed tuberculosis induction or relapse after anti-PD-(L)1 therapy. Treatment-related adverse events (TRAEs) occurred in 33 patients (73.3%) when treated with concurrent anti-PD-(L)1 and anti-tuberculosis. Grade 3 or higher TRAEs were hematotoxicity (n = 5, 11.1%), and one patient suffered grade 3 pneumonitis leading to the discontinuation of immunotherapy. CONCLUSIONS: This study demonstrated that patients with coexisting malignant tumor and tuberculosis benefited equally from anti-PD-(L)1 therapy, and anti-tuberculosis response was unimpaired for those with active tuberculosis. Notably, the combination of anti-PD-(L)1 and anti-tuberculosis therapy was well-tolerated without significant unexpected toxic effects.

DUSTBot: A duplex and stealthy P2P-based botnet in the Bitcoin network.

As the root cause of illegal cyber activities, botnets are evolving continuously over the last two decades. Current researches on botnet command and control mechanism based on blockchain network suffer from high economic cost, single point of failure, and limited scalability. In this paper, we present DUSTBot, a novel P2P botnet model based on Bitcoin transactions to prepare for new cyber threats. Specifically, a covert, duplex, and low-cost command and control (C&C) channel in the Bitcoin network is presented in our work. DUSTBot uses the Bitcoin main network as the downstream channel while using the Bitcoin testnet as the upstream channel. Furthermore, the peer list exchange algorithm based on the Ethereum block hash proposed in this paper is effective against routing table poisoning attack and P2P botnet crawling. The robustness of DUSTBot against node removal is studied through constructing the botnet with a P2P simulator. We deploy the implementation of DUSTBot on cloud platforms to test its feasibility and performance. Moreover, the stealthiness of DUSTBot and the effectiveness of the proposed peer list exchange algorithm are evaluated. The results demonstrate the feasibility, performance, stealthiness, and robustness of DUSTBot. In the end, possible countermeasures are discussed to mitigate similar threats in the future.

Molecular evolution of influenza B virus during 2011-2017 in Chaoyang, Beijing, suggesting the free influenza vaccine policy.

Two influenza B virus lineages, B/Victoria and B/Yamagata, are co-circulating in human population. While the two lineages are serologically distinct and TIV only contain one lineage. It is important to investigate the epidemiological and evolutionary dynamics of two influenza B virus lineages in Beijing after the free influenza vaccine policy from 2007. Here, we collected the nasopharyngeal swabs of 12657 outpatients of influenza-like illness and subtyped by real-time RT-PCR during 2011-2017. The HA and NA genes of influenza B were fully sequenced. The prevalence is the highest in the 6-17 years old group among people infected with influenza B. Yamagata-lineage virus evolved to two inter-clade from 2011-2014 to 2014-2017. The amino acids substitutions of HA1 region were R279K in strains of 2011-2014 and L173Q, M252V in strains of 2014-2017. Substitutions L58P, I146V were observed in HA1 region of Victoria-lineage virus in 2011-2012 and I117V, N129D were showed in 2015-2017. Phylogenetic analysis of NA showed Yamagata-Victoria inter-lineage reassortant occurred in 2013-2014. Influenza B mainly infect the school-aged children in Beijing and the free influenza vaccine inoculation does not seem to block school-age children from infection with influenza B. The antigen characteristics of circulating influenza B were different to the recommended vaccine strains. We concluded that the Victoria-lineage vaccine strain should been changed and the free influenza vaccine should be revalued.

[Studies on the methodology for quality control in Chinese medicine manufacturing process based on knowledge graph].

According to the requirements for developing the quality control technology in Chinese medicine( CM) manufacturing process and the practical scenarios in applying a new generation of artificial intelligence to CM industry,we present a method of constructing the knowledge graph( KG) for CM manufacture to solve key problems about quality control in CM manufacturing process.Based on the above,a " pharmaceutical industry brain" model for CM manufacture has been established. Further,we propose founding the KG-based methodology for quality control in CM manufacturing process,and briefly describe the design method,system architecture and main functions of the KG system. In this work,the KG for manufacturing Shuxuening Injection( SXNI) was developed as a demonstration study. The KG version 1. 0 platform for intelligent manufacturing SXNI has been built,which could realize technology leap of the quality control system in CM manufacturing process from perceptual intelligence to cognitive intelligence.

Longitudinal Self-Management and/or Transition Readiness per the TRxANSITION Index among Patients with Chronic Conditions in Pediatric or Adult Care Settings.

OBJECTIVE: To evaluate the roles of key individual, family, and illness characteristics on the levels of and gains in longitudinal healthcare transition (HCT) readiness in the pediatric setting and/or self-management skills (SMS) in the adult-focused setting, we used a large dataset with longitudinal measurements from 2006 to 2015. STUDY DESIGN: This longitudinal observational study followed 566 adolescents and young adults with chronic conditions at University of North Carolina Hospitals. TRxANSITION Index measurements, which represent learning outcomes rather than health outcomes, were collected multiple times per patient and analyzed using a novel application of an education-based approach. RESULTS: Levels of and gains in HCT/SMS scores increased with age (P < .001) with smaller increases at older ages. Mastery of skills varied by age with self-management achieved after 20 years of age. Scores varied positively by father's education and negatively by mother's education and duration of diagnosis. Gains in scores further varied positively with private insurance and negatively with mother's education and duration of diagnosis. CONCLUSIONS: We found diminishing positive increases in HCT/SMS scores as patients become older and smaller levels of and gains in readiness among younger patients with more educated mothers. Risk factors for absolute level of HCT/SMS readiness and inadequate longitudinal gains are not always the same, which motivates a deeper understanding of this dynamic process through additional research. This information can guide providers to focus HCT/SMS preparation efforts on skills mastered at particular ages and to identify patients at risk for inadequate development of HCT/SMS skills.