Effect of iron deficiency without anaemia on days alive and out of hospital in patients undergoing valvular heart surgery

Comprehensive evidence regarding the treatment of non-anaemic iron deficiency in patients undergoing valvular heart surgery is lacking. This study aimed to investigate the association between non-anaemic iron deficiency and postoperative outcomes in these patients. We retrospectively analysed 321 patients of which 180 (56%) had iron deficiency (defined as serum ferritin < 100 ng.ml^-1 or < 300 ng.ml^-1 with transferrin saturation < 20%). While the iron-deficient group had lower pre-operative haemoglobin levels than the non-iron deficient group (median (IQR [range]) 134 (127–141 [120–172]) g.l^-1, 143 (133–150 [120–179]) g.l^-1, p = 0.001), there was no between-group difference in allogeneic red blood cell transfusion. Median (IQR [range]) days alive and out of hospital at postoperative day 90 was 1 day shorter in the iron-deficient group (80 (77–82 [9–85]) days vs. 81 (79–83 [0–85]) days, p = 0.026). In multivariable analysis, only cardiopulmonary bypass duration (p = 0.032) and intra-operative allogeneic red blood cell transfusion (p = 0.011) were significantly associated with reduced days alive and out of hospital at postoperative day 90. Iron deficiency did not exert any adverse influence on secondary outcomes except length of hospital stay. Our findings indicate that non-anaemic iron deficiency alone is not associated with adverse effects in patients undergoing valvular heart surgery when it does not translate into an increased risk of allogeneic transfusion.     

A candidate multi-epitope vaccine against porcine reproductive and respiratory syndrome virus and Mycoplasma hyopneumoniae induces robust humoral and cellular response in mice

Porcine reproductive and respiratory syndrome virus (PRRSV) and Mycoplasma hyopneumoniae (M. hyopneumoniae, Mhp) are two of the most common pathogens involved in the porcine respiratory disease complex (PRDC) resulting in significant economic losses worldwide. Vaccination is the most effective approach to disease prevention. Since PRRSV and Mhp co-infections are very common, an efficient dual vaccine against these pathogens is required for the global swine industry. Compared with traditional vaccines, multi-epitope vaccines have several advantages, they are comparatively easy to produce and construct, are chemically stable, and do not have an infectious potential. In this study, to develop a safe and effective vaccine, B cell and T cell epitopes of PRRSV-GP5, PRRSV-M, Mhp-P46, and Mhp-P65 protein had been screened to construct a recombinant epitope protein rEP-PM that has good hydrophilicity, strong antigenicity, and high surface accessibility, and each epitope is independent and complete. After immunization in mice, rEP-PM could induce the production of high levels of antibodies, and it had good immunoreactivity with anti-rEP-PM, anti-PRRSV, and anti-Mhp antibodies. The anti-rEP-PM antibody specifically recognizes proteins from PRRSV and Mhp. Moreover, rEP-PM induced a Th1-dominant cellular immune response in mice. Our results showed that the rEP-PM protein could be a potential candidate for the development of a safe and effective multi-epitope peptide combined vaccine to control PRRSV and Mhp infections.     

中药饮片保质期与有效期文献计量学分析

目的：对中药保质期或有效期进行系统的调研，探讨中药饮片设定保质期或有效期的依据及其必要性，为提高中药饮片质量、保障临床用药安全提供技术支撑，为药品监管部门制定有关法规提供科学依据。方法：以国家知识基础设施数据库（CNKI）为数据来源，采用文献计量学研究方法，选用检索词为“中药材”并“有效期”“饮片”并“有效期”，“饮片”并“保质期”“中药材”并“保质期”“中药材”并“效期”和“饮片”并“效期”，利用CNKI平台工具以及Excel统计工具进行统计分析。结果：经数据库检索、筛选，获取中药材、饮片保质期或有效期或效期的相关有效文献共85篇，其中关于中药、饮片保质期的相关文献26篇，中药、饮片有效期或效期的相关文献59篇；在59篇关于中药有效期的文献中，74.58%的文献对于中药是否应该制定有效期、如何制定有效期等展开了讨论，25.42%的文献为中药有效期研究的实验性文献。结论：本文从中药材、饮片保质期与有效期的现状，质量评价指标，研究方法，饮片分类、保质期制定的必要性，及其存在的问题和建议等方面进行了梳理和归纳，为中药饮片保质期制定，提供了详实的文献依据。     

Zhang Weishen: A Pioneer in the Development and Industrial Production of Penicillin in New China

The research and development of penicillin started with difficulty before 1949 and achieved certain results. In 1951, after the founding of the People's Republic of China, Zhang Weishen, as the only Chinese scientist who had been trained and worked in a penicillin research and development center in the United States for many years, overcame many difficulties and returned to China. In 1953, with the efforts of Zhang Weishen and his colleagues, China realized the industrialized production of penicillin, alleviating the urgent needs of the masses. Antibiotics has also become the first discipline to achieve major scientific and technological achievements after the founding of the New China. In the mid-1950s, the technical breakthrough in the localization of lactose substitutes marked the localization of the raw materials of the penicillin-producing culture medium, which paved the way for the industrialized production of penicillin with Chinese characteristics. Antibiotics have become one of the most widely used and affordable drugs for hundreds of millions of patients in China, and China has since ended the humiliating history of the “Sick Man of East Asia".     

流动人口基层医疗卫生机构首诊现状及影响因素分析

目的:了解流动人口基层首诊现状及其影响因素,为推进流动人口分级诊疗提供实证参考依据。方法:基于2017年全国流动人口动态监测调查数据中82734名最近1次患病(负伤)流动人口数据,利用SPSS 25.0统计软件分析其基层首诊情况及影响因素。结果:82734名最近1次患病(负伤)流动人口中首选到基层医疗卫生机构就诊15936人,基层首诊率仅为19.3%;二分类logistic回归分析结果显示:年龄≥65岁、农业户口、流动时间0~5年、患慢性病、至少参加1项医疗保险,居住地到最近医疗服务机构所需时间≤15 min的流动人口患病后更愿意选择到基层首诊。学历大专及以上、家庭月均收入>10000元、市跨县、东北地区、不愿意落户、自评健康状况为不健康的流动人口患病后更不愿意选择到基层首诊。结论:流动人口患病(负伤)后选择到基层首诊率较低,年龄、受教育程度、户口类型、家庭月均总收入、流动时间、流动范围、流入地区域、落户意愿、自评健康状况、是否患慢性病、有无参加医疗保险、居住地到最近医疗服务机构所需时间是影响流动人口患病(负伤)后选择到基层首诊的主要因素。     

A High Order Bound Preserving Finite Difference Linear Scheme for Incompressible Flows

We propose a high order finite difference linear scheme combined with a high order bound preserving maximum-principle-preserving (MPP) flux limiter to solve the incompressible flow system. For such problem with highly oscillatory structure but not strong shocks, our approach seems to be less dissipative and much less costly than a WENO type scheme, and has high resolution due to a Hermite reconstruction. Spurious numerical oscillations can be controlled by the weak MPP flux limiter. Numerical tests are performed for the Vlasov-Poisson system, the 2D guiding-center model and the incompressible Euler system. The comparison between the linear and WENO type schemes, with and without the MPP flux limiter, will demonstrate the good performance of our proposed approach.