Stakeholder Analysis of the Application of Artificial Intelligence in the Field of Primary Health Care / 中国医学科学院学报

The application of artificial intelligence in the field of primary health care can effectively improve diagnosis and treatment,avoid over-examination and over-medication,and make up for the shortage of high-quality medical resources in primary medical and health institutions.Focusing on the application of artificial intelligence in the field of primary health care,this paper analyzes the existing application modes and typical cases,studies its main stakeholders,interest demands and problems,and provides corresponding suggestions.

Understanding mAb aggregation during low pH viral inactivation and subsequent neutralization.

Monoclonal antibodies (mAbs) and related recombinant proteins continue to gain importance in the treatment of a great variety of diseases. Despite significant advances, their manufacturing can still present challenges owing to their molecular complexity and stringent regulations with respect to product purity, stability, safety, and so forth. In this context, protein aggregates are of particular concern due to their immunogenic potential. During manufacturing, mAbs routinely undergo acidic treatment to inactivate viral contamination, which can lead to their aggregation and thereby to product loss. To better understand the underlying mechanism so as to propose strategies to mitigate the issue, we systematically investigated the denaturation and aggregation of two mAbs at low pH as well as after neutralization. We observed that at low pH and low ionic strength, mAb surface hydrophobicity increased whereas molecular size remained constant. After neutralization of acidic mAb solutions, the fraction of monomeric mAb started to decrease accompanied by an increase on average mAb size. This indicates that electrostatic repulsion prevents denatured mAb molecules from aggregation under acidic pH and low ionic strength, whereas neutralization reduces this repulsion and coagulation initiates. Limiting denaturation at low pH by d-sorbitol addition or temperature reduction effectively improved monomer recovery after neutralization. Our findings might be used to develop innovative viral inactivation procedures during mAb manufacturing that result in higher product yields.

Achievements on tuberculosis control in Shandong province—a population-based survey in 2010 / 中华流行病学杂志

Objective To study the prevalence and trend of tuberculosis for related policy development in Shandong.Methods The population under the current study was randomly sampled,using both stratified clustering sampling and proportional population sampling methods,following the national survey protocol.A total of 35 clusters including about 1500 subjects per cluster were established,representing a population of 9.31 million.Questionnaire interview and chest X-ray exam were applied to all inhabitants above 15 years of age.Sputum microscopy and culture were given to all suspected cases with cough longer than 2 weeks or having abnormal X-ray results.Results In total,54 279 subjects were interviewed and examined,accounting for 95.78％ of eligible population.Of them,183 active pulmonary tuberculosis cases were identified,with 60.11％ asymptomatic.Two of the 35 (5.71％) clusters had no active tuberculosis cases found,and 24(68.57％) did not show smear positive results.The standardized prevalence rates of active,smear positive and bacteriologic positive pulmonary tuberculosis cases were 270.87/105,17.45/105 and 29.57/105,with the estimated case numbers as 211 900 (170 100-253 600),13 600 (5800-21 500) and 23 100 (13 200-33 000)respectively.Compared to the survey in 2000,the rates on smear positive and bacteriologic positive tuberculosis had decreased significantly,at a rate of 81.63％,and 75.56％ respectively.The rates in urban areas and in women decreased quickly than those in rural areas and in men.People living in the rural areas,being elderly or males,had significantly higher prevalence rates of tuberculosis.Conclusion Remarkable reduction of tuberculosis prevalence had been achieved despite the fact that tuberculosis remained a major public health problem in Shandong province.Symptomatic patients should be under more serious concern in order to improve the detection of early cases.More efforts should be given to rural population,especially elderly,male population.

Observations of cell size dynamics under osmotic stress.

Cultured mammalian cells [e.g., murine hybridomas, Chinese hamster ovary (CHO) cells] used to produce therapeutic and diagnostic proteins often exhibit increased specific productivity under osmotic stress. This increase in specific productivity is accompanied by a number of physiological changes, including cell size variation. Investigating the cell size variation of hyperosmotically stressed cultures may reveal, in part, the basis for increased specific productivity as well as an understanding of some of the cellular defense responses that occur under hyperosmotic conditions. The regulation of cell volume is a critical function maintained in animal cells. Although these cells are highly permeable to water, they are significantly less permeable to ionic solutes. Appropriate cell-water content is actively maintained in these cells by regulation of ion and osmolyte balances. Transport appropriate to extracellular conditions, leading to accrual or release of these species, is activated in response to acute cell volume changes. Osmotically induced regulatory volume increases (RVI) and regulatory volume decreases (RVD) are known to occur under a variety of conditions. We observed the time evolution of size variation in populations of two CHO cell lines under hyperosmotic conditions. Observations were made using multiple instruments, multiple cell lines, and multiple cell culture conditions. Size variation of CHO A1 was gauged by flow cytometry using an LSRII® flow cytometer while CHO B0 cells were quantified using a Cedex® cell analyzer. Hyperosmotic stress had a dose-dependent effect on the regulatory control of cell volume. Stressed cultures of CHO cells grown in suspension exhibited a shift in mean cell diameter. This shift in mean was not due to a change in the whole population, but rather to the emergence of distinct subpopulations of cells with larger cell diameters than those in the bulk of the population.

Study on molecular characteristics regarding DNA genotype of Mycobacterium tuberculosis clinical strains in Shandong / 中华流行病学杂志

Objective To establish the molecular characteristics of Mycobacterium tuberculosis and on factors influencing the recent transmission of drug resistant isolates in Shandong. Methods Mycobacterium tuberculosis isolated from active pulmonary tuberculosis patients of 13 counties were genotyped by mycobacterial interspersed repetitive units (MIRU) methods. Results 12 loci of MIRU were detected in 558 isolates and a total of 143 MIRU patterns were confirmed. 66 isolates had distinct patterns,and 481 (86.2%) strains were in clusters. Shandong cluster included 177 strains with 74.6% of the isolates belonged to Beijing family. The recent transmission index of multi-drug resistance strains was in lower level,comparing to the susceptible strains. Conclusion Our results showed that the Shandong cluster isolates had capacities of facilitating person-to-person transmission and high level of drug resistance.