Based on the theory of 'spleen governing the containment of blood' in The Classic of Difficult Issues （《难经》）， it is proposed that medication toxicity damaging the middle jiao （焦） and failure of the spleen to contain blood constitute the core pathogenesis of cancer therapy induced thrombocytopenia （CTIT）. It is believed that the anti-tumor drug toxicity directly hits middle jiao， leading to spleen qi depletion， impairment of transportation and transformation， and insufficiency of the source of blood production. Consequently， the vessels and collaterals are deprived of nourishment and become structurally damaged. Blood fails to be contained and stored within the vessels， resulting in extravasation beyond the vascular system. Persistent retention of drug toxicity may further cause stasis due to blood deviating from its normal pathway and gradually consume the essence. In view of this root deficiency with branch excess， it is proposed that the treatment should focus on fortifying spleen， boosting qi and containing blood， with the aim of restoring spleen and stomach transportation functions， repairing vascular damage， and recovering the spleen's blood-containing function. According to individual syndrome patterns， prescriptions may be supplemented with herbs that stabilize vessels and consolidate collaterals， remove stasis and promote regeneration， and replenish essence and nourish marrow， providing new perspectives for the prevention and treatment of CTIT with traditional Chinese medicine.

Objective To evaluate the accuracy of 6 commercial antibiotic susceptibility testing methods in detecting the sensitivity of carbapenems-resistant Klebsiella pneumoniae(CRKP)to tigecycline,and to provide an evidence for clinical laboratory to select the appropriate tigecyline susceptibility tests.Methods Non-duplicate CRKP clinically isolated from Aerospace Center Hospital from June 2023 to February 2024 were collected.60 cases of tigecycline intermediated CRKP[minimal inhibitery concentration(MIC)=4μg/ml]and 60 cases of drug-resistant CRKP(MIC≥8μg/ml)were screened by Vitek-2.The sensitivity of CRKP to tigecycline was detected by different methods.With the MIC test strip(MTS)as the reference method,the methodological evaluation of Vitek-2,commercial broth dilution method,E-test,Kirby-Bauer disk diffusion(KB)and disk combined with resensitization bufferwas carried out under the interpretation standards of the U S Food and Drug Administration(FDA)and the European Commission for Drug Susceptibility Testing(EUCAST),respectively.Results For the intermediate strains,under the FDA criteria,both the commercial broth dilution method and the disk combinedwith resensitization buffer method showed high consistency with the MTS method and were acceptable,whereas under the EUCAST criteria,all five methods were unacceptable.For the resistant strains,no matter what standard was,CA of all five methods were less than 90%,which were unacceptable.For all strains as a whole,the results were consistent with those of the resistant ones.Conclusion Under the current sample size,none of the five methods met the acceptable standards,especially not suitable for the recheck of strains with higher MICs.Commercial broth dilution method have the highest consistency with MTS,and it is worth expanding the sample size for further study.

Objective To evaluate the accuracy of 6 commercial antibiotic susceptibility testing methods in detecting the sensitivity of carbapenems-resistant Klebsiella pneumoniae(CRKP)to tigecycline,and to provide an evidence for clinical laboratory to select the appropriate tigecyline susceptibility tests.Methods Non-duplicate CRKP clinically isolated from Aerospace Center Hospital from June 2023 to February 2024 were collected.60 cases of tigecycline intermediated CRKP[minimal inhibitery concentration(MIC)=4μg/ml]and 60 cases of drug-resistant CRKP(MIC≥8μg/ml)were screened by Vitek-2.The sensitivity of CRKP to tigecycline was detected by different methods.With the MIC test strip(MTS)as the reference method,the methodological evaluation of Vitek-2,commercial broth dilution method,E-test,Kirby-Bauer disk diffusion(KB)and disk combined with resensitization bufferwas carried out under the interpretation standards of the U S Food and Drug Administration(FDA)and the European Commission for Drug Susceptibility Testing(EUCAST),respectively.Results For the intermediate strains,under the FDA criteria,both the commercial broth dilution method and the disk combinedwith resensitization buffer method showed high consistency with the MTS method and were acceptable,whereas under the EUCAST criteria,all five methods were unacceptable.For the resistant strains,no matter what standard was,CA of all five methods were less than 90%,which were unacceptable.For all strains as a whole,the results were consistent with those of the resistant ones.Conclusion Under the current sample size,none of the five methods met the acceptable standards,especially not suitable for the recheck of strains with higher MICs.Commercial broth dilution method have the highest consistency with MTS,and it is worth expanding the sample size for further study.

Perioperative neurocognitive disorders(PND)is a common central nervous system com-plication during the perioperative period.The diagnosis and treatment methods for PND are scarce,and the incidence rate remains high.The pathogenesis and treatment of PND have become one of the future research directions in the perioperative period.Currently,the research shows that disturbance of gut microbiota may be involved in the occurrence and development of PND through the microbiota-gut-brain axis.This article re-views the multiple factors affecting gut microbiota composition during perioperative period,the potential mechanisms of dysbiosis participating in PND,the prediction of the occurrence and development of PND by specific microbiota,and corresponding preventive interventions,so as to provide new concepts for periopera-tive brain health.