Orientation of the peptidoglycan chains in the sacculus of Escherichia coli

The organization of chains of oligopeptidoglycan in the saccular wall is of critical importance in the study of the mechanism and physiology of prokaryotic wall growth. The electron microphotographs of De Pedro et al, present new findings and can be used to negate or at least raise questions about the previously accepted conclusion that the glycan chains are oriented transversely to the axis of rod-shaped Escherichia coli. This suggests caution in assuming that the glycan chains in the murein structure are parallel to each other and are perpendicular to the axis of the cell.These results should reopen the question of not only the orientation of the peptidoglycan chains, but the possibility of variability in orientation. Three classes of hypotheses about wall growth are reconsidered and problems with them are presented. The new results from De Pedro's laboratory and the experimental glycan chain length distribution argue against proposed systematic models. These include models that postulate belts or hoops stretched around the circumference of the cell and mechanisms that insert new chains of the length of presumptive “docking” strands in the stress-bearing wall. They are consistent, however, with the surface stress theory that proposes that random enzyme action together with physical forces are involved in the elongation of the rod-shaped Gram-negative wall.     

中学生考试焦虑问题的综述研究

目的中学生由于必须面对中考、高考等与自身前途命运密切相关的重大考试．考试焦虑问题也就显得尤为突出。本文旨在探讨中学生考试焦虑的成因及其干预策略。方法采用综述研究法。结果本文将相关理论研究更为系统化．将其更加密切地纳入心理学的理论体系之中．并将理论结合中学教育实践进行探索与研究。结论只要学生掌握了这些考试焦虑的调试方法，就能很好地调整自身考试状态，预防考试过度焦虑。     

Pancreatic glucagonoma with and without syndrome

Summary In five patients single or multiple glucagonomas were characterized by immunocytochemistry. Two large single glucagonomas were associated with the glucagonoma syndrome, which completely dissappeared after removal of the tumours. The morphologic findings in these patients are compared with 48 others collected from literature.In the other three patients, the glucagonomas were not associated with a clinical syndrome and were detected by chance (one accompanying an insulinoma; the other in pancreases of patients suffering from multiple endocrine neoplasia I; MEN I). These tumours appeared by their histological, immunocytochemical and ultrastructural features better organized than the glucagonomas with syndrome.Glucagonomas not producing a syndrome can be classified into (a) solitary, often malignant endocrine pancreatic tumours, (b) glucagonomas associated with insulinomas and other tumours, (c) multiple glucagonomas in MEN I and (d) single microglucagonomas in elderly patients. It is emphasized that only immunohistology allows clear identification of these tumours as glucagonomas.     

Intraparenchymal pulmonary lymph node: case report and literature review

Summary A case of a 44-year-old woman with a solitary pulmonary coin lesion is presented. Histologic study of this nodule revealed a normal intraparenchymal pulmonary lymph node. A review of the literature discusses the incidence and characteristics of this entity.

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Nud lymphatique intrapulmonaire: revue de la littérature. A propos d'un cas

Résumé L'observation d'un cas de lésion nodulaire du poumon est rapportée chez une femme de 44 ans. L'étude histologique du nodule a révélé un nud lymphatique intrapulmonaire normal. La revue de la littérature apprécie l'incidence et les caractéristiques de cette localisation.

     

以重点监控药品管理促进合理用药水平提升

通过开展以“合理用药”为核心的重点监控药品管理,促进合理用药水平提升。采取事后处方点评及处方前置审核,建立和完善重点监控药品管理方案,对不合理用药进行拦截、宣教、绩效处罚、限量采购、约谈等,实现了重点监控药品规范化管理。实践后,不合理医嘱减少,处方点评合格率提升,辅助用药种类减少。认为建立重点监控药品管理的相关制度及流程,对提升合理用药水平有一定促进作用。     

提质增量,卓越发展:《国家科学评论》办刊实践与进展

【目的】 介绍《国家科学评论》(National Science Review,NSR)的办刊实践,以期促进我国英文科技期刊办刊经验的交流。【方法】 以NSR为研究对象,结合办刊特色及发展实践,探讨建设高水平期刊的策略与举措。【结果】 NSR在重要研究成果组约和发表、访谈和论坛举办、学术质量控制、学术影响提升等方面开展了大量卓有成效的工作,有效地提高了期刊的品牌声誉,较好地服务了学术传播与交流。【结论】 NSR初步实现了全方位、多角度反映中外自然科学研究重要成就的定位和目标,学术指标和影响力得到快速提升,其办刊实践可为我国科技期刊的高质量发展提供参考与借鉴。     

The History and Future of the “ISPOR Value Flower”: Addressing Limitations of Conventional Cost-Effectiveness Analysis

ObjectivesSince its publication as part of the 2018 ISPOR Special Task Force (STF) on US Value Assessments, the “ISPOR value flower,” with its petals highlighting elements that may be overlooked or underappreciated in conventional drug value assessments, has been discussed and debated. We review the history of the value flower, describe recent developments, and consider implications for future value assessments.MethodsWe discuss various antecedents to the value flower, as well as conceptual and empirical articles published in the past 4 years.ResultsSince the publication of the ISPOR STF report, researchers have provided more rigorous theoretical and mathematical foundations for certain novel value elements (eg, severity of illness, value of insurance, value of hope) through “generalized risk-adjusted cost-effectiveness analysis,” which incorporates risk aversion in people’s preferences and uncertainty in treatment outcomes. Empirical estimates are also emerging to support key elements, such as insurance value, real option value, value of hope, and value of knowing. Although health technology assessment bodies have applied or are considering certain elements (eg, severity modifiers to cost-effectiveness thresholds), other elements have yet to gain traction.ConclusionsFive years after the STF began its work, the development of novel value measures continues to evolve. Although it is encouraging to see supporting empirical studies emerging, more are needed. Additional efforts are also needed to illustrate how the estimates can be used in the deliberative processes that are integral to health technology assessments.     

Toward Better Data Dashboards for US Drug Value Assessments

ObjectivesTo explore the use of data dashboards to convey information about a drug’s value, and reduce the need to collapse dimensions of value to a single measure.MethodsReview of the literature on US Drug Value Assessment Frameworks, and discussion of the value of data dashboards to improve the manner in which information on value is displayed.ResultsThe incremental cost per quality-adjusted life-year ratio is a useful starting point for conversation about a drug’s value, but it cannot reflect all of the elements of value about which different audiences care deeply. Data dashboards for drug value assessments can draw from other contexts. Decision makers should be presented with well-designed value dashboards containing various metrics, including conventional cost per quality-adjusted life-year ratios as well as measures of a drug’s impact on clinical and patient-centric outcomes, and on budgetary and distributional consequences, to convey a drug’s value along different dimensions.ConclusionsThe advent of US drug value frameworks in health care has forced a concomitant effort to develop appropriate information displays. Researchers should formally test different formats and elements.     

慢性病护理质量评价指标体系研究现状及启示

对国内外慢性病护理质量评价指标体系构建的理论框架、方法以及构建范围进行归纳总结,认为我国慢性病护理质量评价指标体系中应加强对患者结局指标的关注,应注意指标体系构建方法的科学性,还应积极探索多病种慢性病护理质量评价指标体系,构建统一的适合我国国情的慢性病护理质量评价指标体系。