AIM:The purpose of this paper is to study whether the precise administration of vanco-mycin under the guidance of the model can achieve better clinical treatment effect by imple-menting the precise medication model in Sichuan Provincial People's Hospital,so as to promote its wide application in practice.METHODS:A prospec-tive cohort study was conducted.The experimental group was patients who used the Model-informed Precision Dosing to determine the vancomycin dos-ing regimen,and the control group was patients who only decided the vancomycin dosing regimen based on the existing diagnosis and treatment pro-cess.Two sets of data were matched to compare whether there were significant differences be-tween the two groups of patients in the TDM steady-state trough concentration or the steady-state AUC compliance ratio,and to evaluate the ap-plication value of the model software.RESULTS:Ac-cording to the inclusion and exclusion criteria,the steady-state blood concentration data of vancomy-cin in a total of 280 patients were used for analysis.The final result of the experiment was that the number of people in the experimental group was 10,and the compliance rate was 62.50％.There were 64 cases in the control group,and the compli-ance rate was 24.24％(P=0.002).CONCLUSION:The study found that the model-guided precise dos-ing regimen can more accurately control the blood concentration of vancomycin in patients,and signif-icantly improve the patient's steady-state trough concentration compliance rate.Therefore,it is rec-ommended to increase the research on the pro-gram and promote its wide application in clinical practice.

Objective:To investigate the characteristics of gut microbiota in patients with type 2 diabetes (T2DM) complicated by nonalcoholic fatty liver disease (NAFLD).Methods:A total of 74 patients first diagnosed with T2DM at the Endocrinology Department of Peking Union Medical College Hospital from April 2021 to October 2023 were included. Among them, 28 patients had concurrent NAFLD while 46 patients did not. Additionally, 51 healthy controls were matched (HC group). Clinical laboratory parameters were collected, and 16S rRNA sequencing with fecal samples was conducted to compare the differences in gut microbiota across the groups.Results:Compared to the group with T2DM, patients with concurrent T2DM and NAFLD were younger, had higher level of insulin resistance as assessed by the homeostatic model assessment of insulin resistance, higher body mass index (BMI), and higher triglyceride levels. There was no difference in α-diversity across the three groups ( P>0.05), while there was a significant difference in β-diversity ( P=0.03). The Eubacterium coprostanoligenes, Fusicatenibacter, Parasutterella and Tyzzerella 3 were enriched in the group with concurrent T2DM and NAFLD as shown by the relative abundance, while the relative abundance of Flavonifractor was decreased in this group. Tyzzerella 3 abundance was positively correlated with triglyceride and albumin levels and negatively correlated with high-density lipoprotein cholesterol (HDL-C) levels. Conclusion:Patients with T2DM complicated by NAFLD exhibit dysbiosis in gut microbiota composition and specific genera abundance, with Flavonifractor identified as a potential protective factor for T2DM complicated by NAFLD.

AIM:The purpose of this paper is to study whether the precise administration of vanco-mycin under the guidance of the model can achieve better clinical treatment effect by imple-menting the precise medication model in Sichuan Provincial People's Hospital,so as to promote its wide application in practice.METHODS:A prospec-tive cohort study was conducted.The experimental group was patients who used the Model-informed Precision Dosing to determine the vancomycin dos-ing regimen,and the control group was patients who only decided the vancomycin dosing regimen based on the existing diagnosis and treatment pro-cess.Two sets of data were matched to compare whether there were significant differences be-tween the two groups of patients in the TDM steady-state trough concentration or the steady-state AUC compliance ratio,and to evaluate the ap-plication value of the model software.RESULTS:Ac-cording to the inclusion and exclusion criteria,the steady-state blood concentration data of vancomy-cin in a total of 280 patients were used for analysis.The final result of the experiment was that the number of people in the experimental group was 10,and the compliance rate was 62.50％.There were 64 cases in the control group,and the compli-ance rate was 24.24％(P=0.002).CONCLUSION:The study found that the model-guided precise dos-ing regimen can more accurately control the blood concentration of vancomycin in patients,and signif-icantly improve the patient's steady-state trough concentration compliance rate.Therefore,it is rec-ommended to increase the research on the pro-gram and promote its wide application in clinical practice.

Gut microbiota is considered as the cornerstone of maintaining the health of human host, because it not only helps to obtain nutrition and energy from the food, but also regulates the energy metabolism through the metabolites produced, which plays an important role in the occurrence and development of various metabolic diseases. In recent years, with the development of science and technology, hypoglycemic treatment has been gradually promoted, safer and more efficient hypoglycemic drugs have been emerging, including sulfonylureas, biguanides, glinides, α-glucosidase inhibitors, dipeptidyl peptidase Ⅳ inhibitors, glucagon like peptide-1 receptor agonists, sodium glucose cotransporter 2 inhibitors and various types of insulin preparations. A large number of studies have proved that intestinal flora may be one of the targets for hypoglycemic drugs to control blood glucose. In this article, we aim to review the effects of hypoglycemic drugs on the composition of intestinal flora and the regulation of nutrition and energy metabolism, and provide reference for future researches on mechanism and target of new antidiabetic drugs.

Objective To explore the difference of gut microbiota between type 2 diabetes mellitus (T2DM) and non-diabetic population in Beijing. Methods 83 T2DM patients were selected as T2DM group and 64 non-diabetic subjects were selected as control group. Fecal samples were collected from all the subjects. The intestinal flora was detected by metagenome sequencing technology. Results 11 bacterialphyla were detec-ted in the two groups, there were significant differences in species diversity of Actinobacteria (P=0. 013), Firmicutes (P=0. 005), Fusobacteria (P=0. 001), Proteobacteria (P<0. 001) between the two groups. Actinobacteria, Fusobacteria and Proteobacteria were all enriched in the T2DM group, Firmicutes were enriched in the control group. 152 bacterial genera were detected in the two groups with 31 bacterial genera ofsignificant differences. In T2DM group, the levels of Roseburia, Eubacterium and Faecalibacterium decreased, while the levels of Bifidobacterium, Lactobacillus and Escherichia increased. Conclusion There are significant differ-ences in the composition of gut microbiota between T2DM patients and non-diabetic population. Regulation of gut microbiota in T2DM patients may be helpful to improve the condition of T2DM.