Mycophenolic acid (MPA), the active moiety of both mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS), serves as a primary immunosuppressant for maintaining solid organ transplants. Therapeutic drug monitoring (TDM) enhances treatment outcomes through tailored approaches. This study aimed to develop an evidence-based guideline for MPA TDM, facilitating its rational application in clinical settings. The guideline plan was drawn from the Institute of Medicine and World Health Organization (WHO) guidelines. Using the Delphi method, clinical questions and outcome indicators were generated. Systematic reviews, Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence quality evaluations, expert opinions, and patient values guided evidence-based suggestions for the guideline. External reviews further refined the recommendations. The guideline for the TDM of MPA (IPGRP-2020CN099) consists of four sections and 16 recommendations encompassing target populations, monitoring strategies, dosage regimens, and influencing factors. High-risk populations, timing of TDM, area under the curve (AUC) versus trough concentration (C₀), target concentration ranges, monitoring frequency, and analytical methods are addressed. Formulation-specific recommendations, initial dosage regimens, populations with unique considerations, pharmacokinetic-informed dosing, body weight factors, pharmacogenetics, and drug‍-‍drug interactions are covered. The evidence-based guideline offers a comprehensive recommendation for solid organ transplant recipients undergoing MPA therapy, promoting standardization of MPA TDM, and enhancing treatment efficacy and safety.
Mycophenolic Acid/administration & dosage* ; Drug Monitoring/methods* ; Humans ; Organ Transplantation ; Immunosuppressive Agents/administration & dosage* ; Delphi Technique

Objective:To evaluate the efficacy and safety of baricitinib combined with ruxolitinib cream in the treatment of progressive nonsegmental vitiligo.Methods:Clinical data were retrospectively collected from patients with progressive nonsegmental vitiligo in Boao Super Hospital. All the patients were treated with oral baricitinib daily (2 mg/day for patients weighing ≤ 50 kg; 4 mg/day for those > 50 kg) in combination with topical application of ruxolitinib cream twice daily for 24 consecutive weeks. Disease severity was assessed using the facial vitiligo area scoring index (F-VASI) and total body VASI (T-VASI) at baseline, week 12, and week 24. Adverse reactions were monitored throughout the treatment course.Results:Six patients with progressive nonsegmental vitiligo were collected, including 3 males and 3 females, aged 26 - 42 years, with the disease duration ranging from 0.5 to 25 years. At week 12, 3 patients achieved a 50% ~ < 75% improvement in facial vitiligo lesions (F-VASI 50), 1 patient achieved F-VASI 75 (75% ~ < 90% improvement), and 1 patient achieved T-VASI 50; at week 24, 4 patients achieved F-VASI 50, 1 patient achieved F-VASI 75, 1 patient achieved F-VASI 90 (≥ 90% improvement), and 3 patients achieved T-VASI 50. During the treatment, upper respiratory infection occurred in 1 patient, acne in 1 patient, pruritus in 2 patients, elevation of total cholesterol levels in 2 patients, and increase of high-density lipoprotein levels in 2 patients. No severe adverse events were observed during the treatment.Conclusion:The combination therapy with baricitinib and ruxolitinib cream may have potential efficacy and safety in the treatment of progressive nonsegmental vitiligo.

Electroencephalogram(EEG)refers to the electrical activity generated by neuronal discharges in the human brain,conventionallyrecorded on the scalp of the brain.EEG technology enables the non-invasive detection of electrophysiological activity in neuronal populations within the cerebral cortex,capturing millisecond-level changes in brain potentials with high temporal resolution.In recent years,lots of international researchers have leveraged EEG technology to investigate smoking addiction and further explore the millisecond-level electrophysiological changes in the brains of smokers.This review synthesizes recent advances in resting-state EEG and task-evoked event-related potential research among smokers,summarizing the electrophysiological activity changes associated with smoking addiction.Future researches will employ both longitudinal tracking and machine learning algorithms to further reveal the relationship between EEG signatures and smoking behaviors,thereby providing a scientific foundation for early intervention and treatment strategies targeting smoking addiction.

Electroencephalogram(EEG)refers to the electrical activity generated by neuronal discharges in the human brain,conventionallyrecorded on the scalp of the brain.EEG technology enables the non-invasive detection of electrophysiological activity in neuronal populations within the cerebral cortex,capturing millisecond-level changes in brain potentials with high temporal resolution.In recent years,lots of international researchers have leveraged EEG technology to investigate smoking addiction and further explore the millisecond-level electrophysiological changes in the brains of smokers.This review synthesizes recent advances in resting-state EEG and task-evoked event-related potential research among smokers,summarizing the electrophysiological activity changes associated with smoking addiction.Future researches will employ both longitudinal tracking and machine learning algorithms to further reveal the relationship between EEG signatures and smoking behaviors,thereby providing a scientific foundation for early intervention and treatment strategies targeting smoking addiction.

Objective:To evaluate the efficacy and safety of baricitinib combined with ruxolitinib cream in the treatment of progressive nonsegmental vitiligo.Methods:Clinical data were retrospectively collected from patients with progressive nonsegmental vitiligo in Boao Super Hospital. All the patients were treated with oral baricitinib daily (2 mg/day for patients weighing ≤ 50 kg; 4 mg/day for those > 50 kg) in combination with topical application of ruxolitinib cream twice daily for 24 consecutive weeks. Disease severity was assessed using the facial vitiligo area scoring index (F-VASI) and total body VASI (T-VASI) at baseline, week 12, and week 24. Adverse reactions were monitored throughout the treatment course.Results:Six patients with progressive nonsegmental vitiligo were collected, including 3 males and 3 females, aged 26 - 42 years, with the disease duration ranging from 0.5 to 25 years. At week 12, 3 patients achieved a 50% ~ < 75% improvement in facial vitiligo lesions (F-VASI 50), 1 patient achieved F-VASI 75 (75% ~ < 90% improvement), and 1 patient achieved T-VASI 50; at week 24, 4 patients achieved F-VASI 50, 1 patient achieved F-VASI 75, 1 patient achieved F-VASI 90 (≥ 90% improvement), and 3 patients achieved T-VASI 50. During the treatment, upper respiratory infection occurred in 1 patient, acne in 1 patient, pruritus in 2 patients, elevation of total cholesterol levels in 2 patients, and increase of high-density lipoprotein levels in 2 patients. No severe adverse events were observed during the treatment.Conclusion:The combination therapy with baricitinib and ruxolitinib cream may have potential efficacy and safety in the treatment of progressive nonsegmental vitiligo.

Background/Aims: The aim of this study was to analyze the chronological changes in postoperative complications in surgical ulcerative colitis patients over the past decade in China and to investigate the potential parameters that contributed to the changes. Methods: Ulcerative colitis patients who underwent surgery during 2008–2017 were retrospectively enrolled from 13 hospitals in China. Postoperative complications were compared among different operation years. Risk factors for complications were identified by logistic regression analysis. Results: A total of 446 surgical ulcerative colitis patients were analyzed. Fewer short-term complications (24.8% vs. 41.0%, P=0.001) and more laparoscopic surgeries (66.4% vs. 25.0%, P<0.001) were found among patients who received surgery during 2014–2017 than 2008–2013. Logistic regression suggested that independent protective factors against short-term complications were a higher preoperative body mass index (odds ratio [OR], 0.870; 95% confidence interval [CI], 0.785–0.964; P=0.008), laparoscopic surgery (OR, 0.391; 95% CI, 0.217–0.705; P=0.002) and elective surgery (OR, 0.213; 95% CI, 0.067–0.675; P=0.009). The chronological decrease in short-term complications was associated with an increase in laparoscopic surgery. Conclusions Our data revealed a downward trend of short-term postoperative complications among surgical ulcerative colitis patients in China during the past decade, which may be due to the promotion of minimally invasive techniques among Chinese surgeons.

Objective:To provide references for the vestibular function stability training of military pilots by evaluating the stability of vestibular function of military pilots.Methods:An electric swivel chair was used to train the vestibular function stability of military pilots. According to the order of admission, they were divided into 21-30 years old, 31-40 years old, 41-50 years old and ≥51 years old group, with 30 pilots in each group. The changes of excellent rate, good rate, qualified rate, unqualified rate and tolerance time of the stability of vestibular function by training were compared among different age groups, and the correlation between age and tolerance time was analyzed.Results:There were significant differences of unqualified rate in pilots aged 31-40 and ≥51 years group before and after training ( χ2=4.32, 4.80, Ρ=0.038, 0.028). The failure rate after training was lower than that before training, with a significant difference ( χ2=13.02, P<0.001). The total tolerance time was higher than that before training, and the difference was statistically significant ( t=17.61, P<0.001). The stability tolerance time of pilots in different age groups after vestibular function training were increased compared with that before training, and the differences were statistically significant ( t=6.50, 8.82, 9.48, 13.56, all P<0.001). The stability of vestibular function of military pilots gradually declined with the increase of age, and there was a negative correlation between age and training tolerance time ( r=-0.38, P<0.001). Conclusions:The training of electric swivel chair can improve the vestibular function stability of military pilots, increase the tolerance time, and enhance the tolerance ability of military pilots when vestibular function is stimulated.

Objective:To provide references for the vestibular function stability training of military pilots by evaluating the stability of vestibular function of military pilots.Methods:An electric swivel chair was used to train the vestibular function stability of military pilots. According to the order of admission, they were divided into 21-30 years old, 31-40 years old, 41-50 years old and ≥51 years old group, with 30 pilots in each group. The changes of excellent rate, good rate, qualified rate, unqualified rate and tolerance time of the stability of vestibular function by training were compared among different age groups, and the correlation between age and tolerance time was analyzed.Results:There were significant differences of unqualified rate in pilots aged 31-40 and ≥51 years group before and after training ( χ2=4.32, 4.80, Ρ=0.038, 0.028). The failure rate after training was lower than that before training, with a significant difference ( χ2=13.02, P<0.001). The total tolerance time was higher than that before training, and the difference was statistically significant ( t=17.61, P<0.001). The stability tolerance time of pilots in different age groups after vestibular function training were increased compared with that before training, and the differences were statistically significant ( t=6.50, 8.82, 9.48, 13.56, all P<0.001). The stability of vestibular function of military pilots gradually declined with the increase of age, and there was a negative correlation between age and training tolerance time ( r=-0.38, P<0.001). Conclusions:The training of electric swivel chair can improve the vestibular function stability of military pilots, increase the tolerance time, and enhance the tolerance ability of military pilots when vestibular function is stimulated.

OBJECTIVE To establish a quantitative analysis method for the quality control components in Tenghuang jiangu capsules， and predict the possible action mechanism of the quality control components. METHODS Seven key quality control components in Tenghuang jiangu capsules were quantitatively analyzed by UHPLC-Q-Orbitrap HRMS. The “component-target” network was constructed based on network pharmacology， and the Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis and gene ontology （GO） function enrichment analysis were further conducted to find the key signaling pathways. RESULTS The average contents of succinic acid， hyperoside， gallic acid， kaempferol， naringin， naringenin and protocatechuic acid in 20 batches of Tenghuang jiangu capsules were 520.92， 67.67， 129.48， 4.74， 397.45， 5.66 and 376.62 μg/g， respectively. The results of network pharmacology showed that the 62 key target genes of the quality control components of the drug included AKT1， TNF， VEGFA， MMP9， PTGS2， etc. They were mainly enriched in cytokine receptor interaction， nuclear factor， tumor necrosis factor， interleukin 17， rheumatoid arthritis， Toll-like receptor and other signal pathways， involving inflammatory reaction， signal transduction， protein phosphorylation and other biological processes， kytoplasm， cell membrane and other cell components， as well as enzyme activity， energy activity and other molecular functions. CONCLUSIONS The established UHPLC- Q-Orbitrap HRMS method can be used for the quantitative analysis of the quality control components of Tenghuang jiangu capsule. Its quality control components may be mapped to inflammatory pathways related to bone diseases such as rheumatoid arthritis and Toll-like receptors through AKT1， TNF， VEGFA and other key targets， so as to play a therapeutic role.

Objective:To explore the quantitative effect of smoking on pilots′ physical fitness.Methods:According to smoking index, 215 fighter pilots were chosen as subjects and divided into non-smoking group (143 cases), low smoking-index group (23 cases), moderate smoking-index group (20 cases) and high smoking-index group (29 cases). Subjects were asked to rest on the power bicycle for 3 min, then start warm up at a speed of 60 r/min (no-load, low-level exercise at 60 r/min) for 3 min, and then execute continuously exercise at a constant speed with a power increase of 25 W/min. The load exercise was stopped immediately when the maximum exercise level was reached. Age and body mass index (BMI) were recorded, and cardiopulmonary function indexes such as exercise time, exercise power and respiratory exchange rate (RER) were measured.Results:There was no significant difference on age, BMI and RER among the 4 groups ( P>0.05), but there were significant differences in exercise time and exercise power ( F=6.02, 6.25, P=0.001, P<0.001). Under the condition of the same RER, the exercise time and exercise power of the moderate and high smoking-index group (472.1±54.6 s, 456.9±60.4 s and 197.2±23.1 W, 190.2±24.4 W) were significantly less than those of the non-smoking group (506.3±65.5 s and 211.1±26.9 W) ( P<0.05). Conclusions:This study showed that the exercise time and exercise power of moderate and high smoking-index pilots in increasing power bicycles were significantly lower than those of non-smoking pilots. If the pilots were with moderate-high smoking index their cardiopulmonary function would be affected.