Objective] To sum up Pro. Li Saimei’s clinical experience in treating mental diseases. [Method] By following the teacher clinic and sorting out the related medical materials,the author summarizes professor Li Saimei 's academic experience of treatment of mental diseases ,and for proven cases. [Result] In professor Li Saimei's opinion,mental diseases are due to dysfunction of shaoyang's turning,and phlegm blocking the spirit orifices. Professor Li usually uses Chaihu related formulas to turn the Shaoyang,resolve the phlegm,open the three Jiao,regulate Yin and Yang.The notable clinical result has been observed.[Conclusion] Professor Li Saimei's experience is effective and worthy of inheritance and promotion.

[Objective] To guide the clinical application of Fuyang medicine through the study of San Jiao Theory of ZHENG Qin'an [Method] To study the foundation theory of ZHENG Qin'an and correlate the evidence with the concept of original yang, San Jiao, Emporer fire, Minister fire and middle earth. To explain the unity and inter-relation of San Jiao and the symptons of yang deficiency of San Jiao and the approach of the use of medicine with the support of case studies. [Result] Zheng Qin'an suggested that three Jiaos are of one Jiao. The yang of upper jiao is governed by Emperor fire while that of lower Jiao by Minister fire. The two fires are of one fire. The circulation of the two fires generates the middle earth. When the middle yang fails on circulating the upper and lower Jiaos cannot communicate. The root of original yang is the kidney which is nourished by the spleen. The unity of San Jiao, the use of lower yang as the root of upper and middle yang and the use of the circulation and root nourishing action of middle yang are the keys to application of medicine. [Conclusion] The use of medicine of ZHENG strongly adhered to the qi circulation of San Jiao. It showed to the later generations a simple but comprehensive thought of Chinese medicine. It was an important guidance for the use of Fuyang medicine.

Aim To investigate the effect of p38 MAPK AS-ODNs on the expression of GLT-1 during the induction of brain ischemic tolerance induced by cerebral ischemic preconditioning (CIP).Methods Eighty healthy male Wistar rats with permanent occlusion of the bilateral vertebral arteries were randomly divided into 6 groups: ①Sham group (n=10);②CIP group (n=10);③ischemic insult (Ⅱ) group (n=10);④CIP+Ⅱ group (n=10);⑤p38 MAPK AS-ODNs+CIP+Ⅱ group (n=30);⑥p38 MAPK S-ODNs+CIP+Ⅱ group (n=10).Group ⑤ was divided into 5 nmol, 10 nmol and 15 nmol subgroups according to the dose of p38 MAPK AS-ODNs (n=10).The dose of p38 MAPK S-ODNs was 15 nmol.All the rats were sacrificed 6 h and 2 d after the sham operation or the last time of global brain ischemia reperfusion.Western blot and immunohistochemistry analysis were used for detecting the expression of p-p38 MAPK and GLT-1 protein.Results CIP moderately up-regulated the expression of p-p38 MAPK and significantly up-regulated the expression of GLT-1 protein, inhibited the excessively up-regulation of p-p38 MAPK and the down-regulation of GLT-1 induced by ischemic insult.p38 MAPK AS-ODNs significantly inhibited the up-regulation of p-p38 MAPK and GLT-1 protein in a dose-dependent manner during the induction of brain ischemic tolerance by CIP.Conclusion p38 MAPK AS-ODNs inhibit the up-regulation of GLT-1 during the induction of brain ischemic tolerance induced by CIP.

Objective To establish and verify the personalized reference interval of blood cells.Methods The results of blood cells from 2 089 health subjects in 2014,2015 and 2016 were collected.The ratio of the later results to the previous results was defined as the fluctuation (λ).The ratio (λ1) of the results of 2015 to the results of 2014 was calculated and λ1 was analyzed statistically to establish the fluctuation reference interval (CIλ).The ratio (λ2) of the results of 2016 to the results of 2015 was calculated.λ2 was used to verify λ2.The personalized reference interval (CIp) was established by multiplying each result of 2015 and CIλ.CIp was verified by results of 2016.The ratio of the upper and lower limits of CIp was calculated.The ratio of the upper and lower limits of the reference interval (WS/T 405) was calculated.Results The values of CIλ were as follows:WBC (0.66 to 1.53),L(0.67 to 1.51),M (0.50 to 2.00),N(0.56 to 1.78),E(0.4 to 2.51),PLT(0.76 to 1.32),RBC(0.92 to 1.12),Hb(0.92 to 1.11),Hct(0.91 to 1.12),MCV(0.95 to 1.07),MCH(0.95 to 1.05)and MCHC(0.94 to 1.06).The validation tests of CIλ and CIp showed that both CIλ and CIp were suitable for this laboratory.Compared with the reference interval of professional criteria,the ratio of the upper and lower limits of the CIp was smaller than that of traditional criteria.Conclusion CIp for this laboratory was established and verified.Compared with traditional criteria,CIp should be more personalized and highly sensitive.

Objective:To examine the multiple mediating effects of cognitive fusion and network communication in the relationship between interpersonal relationship and mobile phone addiction tendency in college students.Methods:Questionnaire survey was conducted among 708 college students in a medical school using the mobile addiction tendency scale, E-communication inventory, Interpersonal relationship assessment scale and cognitive fusion questionnaire.SPSS 17.0 software was used for descriptive statistics and correlation analysis.Structural equation model was built with AMOS 21.0.The non parametric percentile bootstrap method with variance correction was used to test the significance of mediating effect.Results:(1) The sample mobile phone dependence detection rate was 13.56%.(2)There were statistical differences in conversation scores((3.49±1.85), (2.51±1.64)), making friends ((4.53±1.83), (3.21±1.72)), getting along with opposite gender((2.70±1.55), (2.01±1.60)), dealing with people disturbance(2.02(1.00, 3.00), 1.46(0.00, 2.00))between different mobile phone addiction tendency( t/ Z=2.752-5.072, P<0.05). There were statistical differences in cognitive fusion ((40.60±7.55), (33.91±7.95)) between different mobile phone addiction tendency( t/ Z=5.385, P<0.05). There were statistical differences in negative results of network communication((28.60±6.77), (23.31±7.03)), social perception of network communication((32.36±6.68), (29.17±7.82)), self exposure and emotional experience of network((23.36±6.61), (18.18±6.30)), cognition of network communication((28.19±6.85), (22.75±6.76)), entertainment of network ((6.74±1.81), (6.00±1.67)) between different mobile phone addiction tendency( t/ Z=2.647~5.195, P<0.05). (3) There was a statistically significant positive correlation between interpersonal relationship, mobile phone addiction tendency, cognitive fusion, and E-communication inventory scores ( r=0.226-0.423, P<0.01). (4) Multi-mediating model analysis showed that interpersonal relationship could affect mobile phone addiction tendency through cognitive fusion and network communication not only in a parallel way but also in a chain way.The direct effect from interpersonal relationship to mobile phone addiction tendency was 0.20, and the total indirect effect from interpersonal disturbance to mobile phone addiction tendency through cognitive fusion and network communication was 0.18.And the effects of cognitive fusion, network communication, and the chain mediating accounted for 50.0%, 33.3%, and 16.7% of the total indirect effect respectively.The 95% CI of the Bootstrap output were (0.04-0.19), (0.02-0.14)and(0.01-0.05). Conclusions:College students' interpersonal disturbances affect mobile phone addiction tendency through multiple mediations of cognitive fusion and online communication.

Ischemic stroke has a high incidence,mortality and morbidity.It was demonstrated that higher white blood cell and neutrophil counts were correlated with larger infarct volume and increased stroke severity in patients with acute ischemic stroke.Recently,neutrophil/lymphocyte ratio (NLR) was shown to be correlated with risk of ischemic stroke and outcome in patients with acute ischemic stroke.This article reviews the predictive roles of NLR in ischemic stroke.

Objective To observe the expression levels change and it's clinical significance of TNF-α, SP-A in chil-dren with varying degrees of pneumonia. Methods A total 195 cases of pneumonia children patients were divided into ordinary pneumonia and severe pneumonia patients , another 65 cases of non-pneumonic children patients as the con-trol group, ELISA assay was used to detect serum TNF-α and SP-A level. Results The levels of serum SP-A and TNF-αof pneumonia children group were higher than the control group's , and severe pneumonia patients ’ were high-er than ordinary pneumonia. Conclusion The expression level of TNF-α and SP-A increased significant in the patho-genesis of children with severe pneumonia which could reflect the degree of lung injury and as a indicator in clinical testing.

December 2019 witnessed the outbreak of COVID-19 in Wuhan and spread of the epidemic across the country. As a provincial designated hospital for critical patients, the First Affiliated Hospital of Zhejiang University responded rapidly since then by advocating the four-concentration principles, namely " concentrating patients, experts, resources and treatment" . In its rescue of critical patients, the hospital formulated comprehensive emergency plans, optimized hospital-wide resources, effectively arranged rescue spacing, established medical echelons, and implemented multi-disciplinary strategy. These efforts ensured efficient rescue and treatment, achieving a cure rate up to 98.7% of such patients, with no deaths.

Objective To establish and verify the fluctuation of reference intervals for biochestry parameters in routine physical exami-nation. Methods The results of biochemistry parameters,i.e., total protein (TP), albumin (Alb), total bilirubin (T-Bil), alanine aminotransferase (ALT), glucose (Glu), urea (Urea), creatinine (Cr), uric acid (UA), triacylglycerol (TG) and total cholesterol ( TC) from 2 089 healthy subjects in routine physical examination during consecutive 2014, 2015 and 2016 were randomly collected, in which all the results were within the reference range. The ratio (λ1) of the results of 2015 to those of 2014, and ratio (λ2) of the re-sults of 2016 to those of 2015 were calculated. λ1was analyzed statistically to establish the fluctuation of reference interval (CIλ). CIλ was verified by λ2.The personalized reference interval (CIp) was established by multiplying each result of 2015 and the upper and low-er limits of CIλ. The CIpwas verified by the results of 2016. The ratios of CIpto the upper and lower limits of conventional reference in-terval were calculated. Results The values of CIλwere as follows: TP: 0.91 to 1.08, Alb: 0.91 to 1.08, T-Bil: 0.58 to 1.74, ALT:0.49 to 1.99, Glu: 0.84 to 1.20, Urea: 0.67 to 1.50, Cr: 0.82 to 1.22, UA: 0.77 to 1.32, TG: 0.51 to 1.98 and TC: 0.80 to 1.26. Compared with conventional reference interval, the ratio of the upper and lower limits of CIp was lessened. Conclusion The personal-ized reference interval (CIp) which may increase the sensitivity of conventional reference intervals was established and verified.

Objective:The characteristics of women with false elevated testosterone were analyze and the literature was reviewed to provide reference for clinical laboratory identification of false elevated testosterone.Methods:The characteristics of three patients with false elevated testosterone in Peking Union Medical College Hospital were analyzed retrospectively, and the results of different detection platforms and methods for the determination of testosterone levels were compared. International and domestic literatures related to false elevation of testosterone and detection methods of testosterone were searched for a comprehensive analysis from PUBMED and CNKI.Results:The levels of testosterone in 3 female patients were elevated by immunoassay and normal by mass spectrometry. They were excluded from the diagnosis of hyperandrogenemia. A total of 38 literatures related to testosterone detection were retrieved, of which 9 case reports of pseudohyperandrogenemia, among which 12 cases of pseudohyperandrogenemia were reported in 2 domestic literatures in 2021. All cases were confirmed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Previous studies have clearly indicated that the result of routine immunoassay in clinical laboratory for the determination of female testosterone have poor correlation with the results of LC-MS/MS, with varying degrees of deviation.Conclusions:Immunoassay tests for female testosterone is susceptible to interference and lead to elevated false results. It is suggested that clinical laboratories evaluate the detection methods used and establish a identification program, and confirm samples with suspected pseudoelevated testosterone elevation using other immune platforms or LC-MS/MS.