An optimization method of weighted network module partition based on TCM theory of "monarch, minister, assistant and guide" / 中国中药杂志

The disease-gene-drug multi-level network constructed by network pharmacology can predict drug targets and has been widely used in the study of material basis and mechanism of action of Chinese medicinal prescriptions. However, most of the current studies have normalized the efficacies of Chinese herbal medicines in the compounds during the construction of the network. There is also a lack of in-depth exploration of the mechanism of synergy among multiple components. This study proposed a network module partition method based on group collaboration and the pharmacological network was weighed according to the traditional Chinese medicine(TCM) theory of "monarch, minister, assistant and guide". Taking the Tanyu Tongzhi Prescription as an example, we constructed its pharmacological network for the treatment of myocardial ischemia-reperfusion injury. The group collaboration module in the network was identified and the network changes before and after the weighting were compared based on the network topology analysis to explore a new method to find the core nodes of the network as well as the core drugs that affected the efficacy of the compounds. The results showed that the module partition method based on group collaboration could be used to identify and partition group collaboration mo-dules in pharmacological networks of compounds. The proposed weighted network based on the TCM theory of "monarch, minister, assistant, and guide" could identify and partition the modules based on the characteristics of the pharmacological network. The identification and partition results of modules of Tanyu Tongzhi Prescription in the weighted network were superior to those in the unweighted network. The weighted closeness centrality(WCC) evaluation method was conducive to finding key nodes and relations in the network as compared with traditional methods, thereby providing a basis for analyzing the core components of drugs and extracting more accurate drug components and targets.

Study on the establishment of international comparable chinese hospital management survey system / 中国卫生政策研究

To understand the management level and international positioning of Chinese hospitals, we devel-oped a comprehensive survey instrument of chinese hospital management survey following the well-adapted methodolo-gy of world management survey which has been widely used internationally. The survey was conducted on 20 manage-ment practices covering four major management dimensions including operations management, performance manage-ment, target management and talent management respectively. Based on the CHMS structure and setting, the four-di-mension and twenty-item management model was analyzed with construct validity test. From the test, the middle level managers were recruited from more than 400 chinese national representative hospitals. The results showed that the chi-square/degree of freedom (CMIN/DF) is 2. 209, and RMSEA (root mean square error approximate) is 0. 039, indicating a good model fitting. The further indications of model fit such as GFI, IFI and CFI were all above 0. 9 which is the typical benchmark for model acceptance. This study provides evidence for correspondence between con-ceptual and empirical hospital management and the insight of model fitting on the current data. The results conclude that CHMS has satisfied validation in Chinese hospital management practices, and can be used as an effective sur-vey method to assess the level of Chinese hospital management and to provide a general platform for international comparison.

Clinical application study of low kVp with iterative reconstruction in spiral computed tomography of lumbar vertebrae in young soldiers / 医疗卫生装备

Objective To evaluate the clinical value of low kVp with iterative reconstruction in multislice spiral computed tomography of lumber vertebrae in young soldiers. Methods Sixty young soldiers who suffered from lumbar diseases were randomly divided into a control group(120 kVp)and a test group(100 kVp),who underwent CT examination with 120 kVp tube voltage in the control group and 100 kVp tube voltage in the test group.The control group went through filtered back projection (FBP)for image reconstruction.The test group applied FBP or sinogram-affirmed iterative reconstruction(SAFIRE)based on image reconstruction requirements,and then were divided into FBP test group and SAFIRE test group.The noise and SNR (signal to noise ratio)of the images were measured in each group.Meanwhile two experienced radiologists evaluated the quality of images.CTDIvol,DLP and ED were used to measure the scan dose in each group.Mean tube current was recorded by CARE Dose 4D.The data were analyzed with SPSS.Results There were no significant difference between the objective and subjective image evaluations in SAFIRE test group and the control group (P>0.05),while there were statistical differences between FBP test group and the control group or between the two test groups(P<0.05).The radiation doses in the test groups were both lower significantly than that in the control group,and the ED values in the test groups were decreased by 43% when compared with the control group. The test groups had the tube voltages not obviously different from that in the control group (P>0.05). Conclusion The radiation dose in the lumbar multislice spiral CT examination of young soldiers is decreased significantly when the tube voltage falls to 100 kVp,the same image quality as that by conventional 120 kVp tube voltage can be obtained by combining iterative reconstruction.

Whole Genome Analysis Reveals New Insights into Macrolide Resistance in Mycoplasma pneumoniae / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Mutations in 23S rRNA gene are known to be associated with macrolide resistance in Mycoplasma pneumoniae (M. pneumoniae). However, these mutations alone do not fully explain the high resistance rates in Asia. The aim of this study was to investigate other possible mutations involved in macrolide resistance in M. pneumoniae.</p><p><b>METHODS</b>The whole genomes of 10 clinical isolates of M. pneumoniae with macrolide resistance were sequenced by Illumina HiSeq2000 platform. The role of the macrolide-specific efflux transporter was assessed by efflux-pump inhibition assays with reserpine and carbonyl cyanide m-chlorophenyl-hydrazone (CCCP).</p><p><b>RESULTS</b>A total of 56 single nucleotide polymorphisms (SNPs) were identified in 10 clinical isolates in comparison to the reference strains M129 and FH. Strikingly, 4 of 30 SNPs causing non-synonymous mutations were clustered in macrolide-specific efflux system gene macB encoding macrolide-specific efflux pump protein of the ATP-binding cassette transporter family. In assays of the minimal inhibitory concentrations (MIC) of macrolide antibiotics in the presence of the efflux pump inhibitors caused a significant decrease of MICs, even under detectable levels in some strains.</p><p><b>CONCLUSION</b>Our study suggests that macrolide efflux pump may contribute to macrolide resistance in M. pneumoniae in addition to the common point mutations in 23S rRNA gene.</p>

A single tube modified allele-specific-PCR for rapid detection of erythromycin-resistant Mycoplasma pneumoniae in Beijing / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Mycoplasma pneumoniae (M. pneumoniae) is one of the common pathogens causing atypical pneumonia. In recent years, resistance to macrolides has become more common, especially in China. Previous studies have confirmed that the mutation at position 2063 in domain V of the 23S rRNA is the most prevalent, followed by the mutation at position 2064. Reported molecular detection methods for the identification of these mutations include direct sequencing, restriction fragment length polymorphism analysis, real-time polymerase chain reaction (PCR) with high-resolution melt analysis, and nested PCR-linked with capillary electrophoresis, etc. The most commonly used method for monitoring resistance-conferring mutations in M. pneumoniae is direct DNA sequencing of PCR or nested PCR products. However, these methods are time-consuming, labor-intensive or need expensive equipments. Therefore the development of rapid and sensitive methods is very important for monitoring the resistance globally.</p><p><b>METHODS</b>In this study, we reported a fast and cost-effective method for detecting 2063 and/or 2064 macrolide resistant mutations from specimens using a modified allele-specific PCR analysis, and all results were compared with the sequencing data. We also analyzed the clinical courses of these samples to confirm the modified allele-specific PCR results.</p><p><b>RESULTS</b>Among 97 M. pneumoniae specimens, 88 were found to possess mutations by this method, and all modified allele-specific PCR analysis results were consistent with the sequencing data. The data of the clinical courses of these 97 cases showed that they suffered from severe pneumonia. Erythromycin showed better efficacy on cases from which no macrolide resistance mutation was found on their specimens. However, in some cases from which mutations were detected, erythromycin monotherapy had poor efficacy, and on these patients severe symptoms improved only when azithromycin was added to the treatment.</p><p><b>CONCLUSIONS</b>The drug-resistant M. pneumoniae is very common in Beijing, China. Our modified allele-specific PCR analysis can identify erythromycin resistant mutations more rapidly from specimens than any other method currently available. Erythromycin is still effective for treating patients infected with the mutation negative M. pneumoniae, but this treatment fails to work on mutant organisms. This method can facilitate clinicians in selecting appropriate therapy within short timescales.</p>

Study on the pathogens correlated to sexually transmitted diseases in 285 pre-pubertal girls with vulvovaginitis in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the relationship between vulvovaginitis in pre-pubertal girls and pathogens as Chlamydia trachomatis (Ct), N. gonorrhoeae (Ng), Mycoplasma, Ureaplasma urealyticum (Uu), Mycoplasma hominis (Mh), M. genitalium (Mg), M. fermentans (Mf) and M. penetrans (Mpe), as well as to find out the proportion of mycoplasma which is correlated to sexually transmitted diseases (STD) and AIDS. METHODS Vulvae swab specimens from 285 pre-pubertal girls with vulvovaginitis (case group) and 128 healthy girls (control group) were collected and detected by nested polymerase chain reaction (nPCR) to identify the existence of pathogens as Ct, Ng, Uu, Mh, Mg, Mf and Mpe. nPCR with both high specificity and sensitivity, would not be influenced by the amount of pathogens in specimens or inactivated during the process of storage or transportation.</p><p><b>RESULTS</b>The rate of detection on pathogens was 59.65% in the 285 specimens from case group including 'one kind of pathogen in one specimen' as 37.54% and 'two kinds' as 16.84% and 'three kinds' as 5.26%. However, in the 128 specimens from control group, the detectable rate of pathogen was 6.25%. Relationships were found between Ng (P < 0.01), Ct (P < 0.01), Uu (P < 0.01), Mg (P < 0.01), Mf (P < 0.05), Mpe (P < 0.01) and vulvovaginitis in pre-pubertal girls. In control group the pathogens were detected from 7 specimens including 5 Uu and 2 Mh.</p><p><b>CONCLUSION</b>Some of the pathogens were correlated to STD and were important in causing vulvovaginitis in pre-pubertal girls. Vulvovaginitis might have been caused by more than one kind of pathogen in pre-pubertal girls. The locations of Mg, Mf and Ng in outer genital tracts were correlated to seasonal change. Macrolide seemed to be quite effective clinically in treating urogenital tract infection caused by mycoplasma and Ct.</p>