Browsing by Author "Kong, Jiayi"

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    Adaptation of Enterococcus faecalis to Daptomycin Reveals an Ordered Progression to Resistance
    (American Society for Microbiology, 2013) Miller, Corwin A.; Kong, Jiayi; Tran, Truc T.; Arias, Cesar A.; Saxer, Gerda; Shamoo, Yousif
    With increasing numbers of hospital-acquired antibiotic resistant infections each year and staggering health care costs, there is a clear need for new antimicrobial agents, as well as novel strategies to extend their clinical efficacy. While genomic studies have provided a wealth of information about the alleles associated with adaptation to antibiotics, they do not provide essential information about the relative importance of genomic changes, their order of appearance, or potential epistatic relationships between adaptive changes. Here we used quantitative experimental evolution of a single polymorphic population in continuous culture with whole-genome sequencing and allelic frequency measurements to study daptomycin (DAP) resistance in the vancomycin-resistant clinical pathogen Enterococcus faecalis S613. Importantly, we sustained both planktonic and nonplanktonic (i.e., biofilm) populations in coculture as the concentration of antibiotic was raised, facilitating the development of more ecological complexity than is typically observed in laboratory evolution. Quantitative experimental evolution revealed a clear order and hierarchy of genetic changes leading to resistance, the signaling and metabolic pathways responsible, and the relative importance of these mutations to the evolution of DAP resistance. Despite the relative simplicity of this ex vivo approach compared to the ecological complexity of the human body, we showed that experimental evolution allows for rapid identification of clinically relevant adaptive molecular pathways and new targets for drug design in pathogens.
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    A Call for Medical Pluralism in America: Integrating Traditional Chinese Medicine and Western Medicine
    (Rice University, 2012) Kong, Jiayi
    China has adopted a unique policy of medical pluralism, whereby traditional Chinese medicine (TCM) and western biomedicine (WM) are both widely used in the health care system to provide optimal health outcomes to patients. Indeed, this fusion of traditional and western principles may seem contradictory, as there are fundamental differences in philosophy between TCM and WM. For example, TCM emphasizes the concepts of “Qi, Zang”, the “Yin-Yang” theory, “Shen”, and “Bianzheng lunzhi”. To the Chinese, health is viewed holistically, encompassing psychology, activity and diet. On the other hand, WM is much more concerned with intervention, focusing on the biological determinants of illness, and viewing health simply as the absence of disease. Despite these differences in theory, there are great advantages to combining TCM and WM, as illustrated in the successful integration seen in China since the 1950s. This integration improves health outcomes in chronic diseases. Furthermore, it also increases cost-effectiveness of health care. Finally, it meets an increasing demand for complementary medicine and cultural sensitivity. Indeed, research shows that the application of both TCM and WM in many cases would be more efficacious than the use of just one method alone. In the future, it is recommended that America combine TCM and WM through increased awareness of the benefits of medical pluralism and alternative medicine. Ultimately, Western practitioners should learn more about traditional medicine in organized settings such as medical schools, and be encouraged to accept new perspectives and philosophies about health care.