This paper summarizes Professor SHI Zaixiang's clinical experience in treating high fever caused by sepsis using Chaihu Guizhi Ganjiang Decoction （柴胡桂枝干姜汤）. He holds that the key pathogenesis of sepsis involves constrained heat in the shaoyang and internal accumulation of water and fluids. The clinical manifestations such as high fever， chills， and alternating sensations of cold and heat are attributed to pathogenic heat constrained in the shaoyang. Meanwhile， soft tissue edema and serous cavity effusions are due to shaoyang dysfunction and internal water retention. In clinical practice， treating sepsis-related high fever requires addressing both the shaoyang-constrained heat and the associated edema and effusions. The therapeutic approach focuses on harmonizing the shaoyang and resolving internal fluids， using Chaihu Guizhi Ganjiang Decoction as the base formula with flexible modifications. Professor SHI emphasizes that this formula shows a rapid antipyretic effect， particularly in cases where multiple anti-infective treatments have failed.

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

Allergic diseases are immune disorders caused by allergens, leading to inflammation or organ dysfunction. In the past decade, the prevalence of allergic diseases in China has increased dramatically, imposing a heavy economic burden on the health care system and society. In vitro diagnosis of allergic diseases plays a crucial role in the diagnosis, treatment, and prevention of such diseases. This article enumerates the in vitro tests and diagnostic techniques of allergic diseases, gives an advocacy for quality management of IgE-related tests, summarizes the clinical interpretation and relevant research progress, aiming to provide a reference for improving laboratory diagnosis of allergic diseases.

Allergic diseases are immune disorders caused by allergens, leading to inflammation or organ dysfunction. In the past decade, the prevalence of allergic diseases in China has increased dramatically, imposing a heavy economic burden on the health care system and society. In vitro diagnosis of allergic diseases plays a crucial role in the diagnosis, treatment, and prevention of such diseases. This article enumerates the in vitro tests and diagnostic techniques of allergic diseases, gives an advocacy for quality management of IgE-related tests, summarizes the clinical interpretation and relevant research progress, aiming to provide a reference for improving laboratory diagnosis of allergic diseases.

AIM: To evaluate the risk of drug-related dysphagia in elder people based on the FDA Adverse Event Reporting System (FAERS). METHODS: We collected the reports of dysphagia in elder people (Age≥65) from 2004 quarter 1 through 2022 quarter 2 of FAERS by Open Vigil 2.1 database. The reported odds ratio (ROR) and the proportional reported ratio (PRR) were calculated to detect the adverse reaction signal of drug-induced dysphagia in elder people. Signal generation standard of ROR: number of reports≥3 with the lower limit of 95% confidence interval (CI) of the ROR value>1, PRR≥2 and c

There are few clinical reports on the diagnosis and treatment of upper urinary tract stones secondary to urinary diversion. This study included 30 patients with upper urinary tract stones secondary to urinary diversion, and all of which were successfully managed. The individualized treatment with the ureteroscopy and/or percutaneous nephrolithotripsy with antegrade, retrograde, or a combination of antegrade and retrograde is safe and feasible.

The robustness of sliding mode control is utilized to improve the adaptability of the control system to changes in vascular mechanical properties of different patients.Adaptive sliding mode control is designed to adapt the controller to the needs of different virtual environment simulations through an adaptive mechanism,thereby weakening the chattering of sliding mode control.The extrapolation prediction algorithm is invoked under the adaptive sliding mode control to reduce the effects of delay on the control and improve force feedback transparency.The experimental results demonstrate that adaptive sliding mode predictive control can enhance system stability,force feedback control accuracy,and fidelity of force feedback control system for flexible surgical instruments.The study has important theoretical significance and practical value for the design of systems with flexible control objects and the improvement of force feedback fidelity.

Objective:To explore the effect of enhanced recovery after surgery model based on muti-disciplinary team in patients with interstitial cystitis.Methods:From January 2018 to December 2021, a total of 90 patients with interstitial cystitis in Urology Department of Beijing Chaoyang Hospital, Capital Medical University were selected as the research objects using the convenience sampling method, 44 patients from January 2018 to June 2019 were enrolled as the control group, 46 patients from July 2019 to December 2021 were enrolled as the observation group. The control group received traditional perioperative care model, and the observation group conducted enhanced recovery after surgery model based on multidisciplinary collaboration. The postoperative recovery status and scores of Visual Analogue Scale, Hamilton Anxiety Inventory (HAMA), Hamilton Depression Inventory (HAMD), General Quality of Life Questionnaire-74 (GQOL-74) and nursing satisfaction were compared between the two groups.Results:The time of postoperative first venting, feeding and postoperative hospitalization of the observation group were shorter than those of the control group, and the number of patients with postoperative gastrointestinal reaction was less than that of the control group, and the differences were statistically significant ( P<0.05). One, three day after surgery and at discharge, the scores of Visual Analogue Scale of the observation group were lower than that of the control group, and the differences were statistically significant ( P<0.05). At discharge, the scores of HAMA and HAMD of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05). At discharge, the scores of mental function, physical function, material life, social function and nursing satisfaction of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Enhanced recovery after surgery model based on muti-disciplinary team can reduce the negative emotions of patients with interstitial cystitis, shorten the length of hospital stay, improve nursing satisfaction and patients' quality of life, which is worthy of clinical application.

Objective:To establish a candidate reference procedure for the enumeration of cell particles in urine and applied to the multi-center performance evaluation of an automated urine formed elements analyzer.Methods:According to the standardized mannual microscopic examination of fresh non-centrifuged urine samples and the recommended reference method for enumeration of cell particles in urine published by ISLH, we established a candidate reference procedure for the enumeration of cell particles in urine. From four class A tertiary hospitals′ clinical laboratories, three rigorous trained technicians per hospital tested the same specimen respectively using the reference procedure. Each specimen was repeatedly counted 5 times, obtaining the quantitative results of cell particles were obtained in urine. Four hospitals used the established candidate reference measurement procedure and the automated urine formed elements analyzer to detect 40 to 60 urine specimens from September 2020 to January 2021, and evaluate the established reference method, meanwhile evaluate the accuracy and consistency of the each count from automated urinalysis analyzer.Results:Using the candidate reference measurement procedures, the coefficient of variation of results derived from three trained technicians per hospital was less than 6.98% (red blood cells), 6.99% (white blood cells), 13.94% (epithelial cells) and met the quality requirements. The performance evaluation results of automated urine formed elements analyzer showed that the accuracy of red blood cells, white blood cells and epithelial cells met the requirements (bias≤4.98%) and was well consistent with the reference measurement procedure ( R2≥0.989). Conclusions:A candidate reference measurement procedure for the enumeration of urine cell particles was successfully established with satisfactory precision and accuracy. This procedure was applied to multicenter performance evaluation of an automated urine formed elements analyzer with good accuracy and consistency.

Objective:To explore the predictive value of serum tissue inhibitor of metalloproteinases-2(TIMP-2), insulin-like growth factor-binding protein-7 (IGFBP-7), angiopoietin-2 (Ang-2) and laboratory examination indicators in patients with sepsis associated acute kidney injury (SAKI).Methods:Present study included 69 patients with sepsis, who were admitted to the emergency department of Peking University Third Hospital from April 2017 to August 2018. Within 72 hours of admission, 28 cases developed SAKI. General clinical features including sequential organ failure assessment (SOFA), acute physiological and chronic health status score Ⅱ (APACHE Ⅱ) and laboratory examination indicators including white blood cells (WBC), neutrophil/lymphocyte ratio (NLR), procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), D-dimer, fibrinogen (Fib), urea, uric acid (UA) were analyzed and serum samples were obtained to detect the levels of biomarkers TIMP-2, IGFBP-7, and Ang-2. Multivariate logistic regression analysis was performed to determine independent risk factors of SAKI, and the receiver operating characteristic (ROC) area under the curve (AUC) was used to assess the early predictive value of biomarkers and laboratory examination indicators for SAKI.Results:Compared with the non-SAKI group, patients in the SAKI group had higher SOFA score, higher incidence of septic shock, higher NLR, PCT, CRP, D-dimer, and UA levels (all P<0.05). The levels of TIMP-2, IGFBP-7, TIMP-2×IGFBP-7 and Ang-2 in the SAKI group were 23.5 (17.3, 30.3)ng/ml, (185.6±47.2)ng/ml, 3.98(2.89, 6.00) (ng/ml) 2/1 000, 1 953 (950, 2 239) pg/ml respectively, which were significantly higher than those in the non-SAKI group (16.4[13.5, 22.4] ng/ml, [139.4±34.7]ng/ml, 2.28[1.57, 4.03](ng/ml) 2/1 000, 576[334, 1 076] pg/ml, respectively, all P<0.05). Logistic regression analysis showed that IGFBP-7 ( OR=1.039, 95%CI 1.000-1.079, P<0.05) and SOFA ( OR=1.521, 95%CI 1.144-2.022, P<0.05) are independent risk factors of SAKI. ROC curve analysis showed that the AUC of IGFBP-7 and SOFA scores for early prediction of SAKI was 0.805 (sensitivity 78.6%,specificity 78.3%), 0.832 (sensitivity 67.9%,specificity 82.9%) respectively. Combined both biomarkers, the AUC increased to 0.893 (sensitivity 82.1%, specificity 87.8%), the diagnostic performance was superior to IGFBP-7 or SOFA alone ( P<0.05). Conclusion:Elevated IGFBP-7 and SOFA are independent risk factors for sepsis associated acute kidney injury, and combined assessment with IGFBP-7 and SOFA can increase the diagnostic performance on the early detection of high-risk patients with SAKI.