Rescue vehicles and nursing unit drug stock are important in the clinical rescue process.Strengthening the management of rescue vehicles and nursing unit drug stock is conducive to ensuring the safety of clinical medication and impro-ving the quality of medical services.Based on scientificity,universality,guidance,and operability principles,the standard prepa-ration team revealed relevant national policy documents,domestic and foreign standards specifications,and literature.It sorted the key contents of rescue vehicles and base drug management.After several rounds of opinion collection and expert argumentation,the social organization standard Pharmacy administration and pharmacy practice in healthcare institutions—Part 3-7-3:Pharma-ceutical supply services—Key drugs management—Rescue vehicle and nursing unit drug stock management was proved.The main content of the standard includes 10 elements from 3 key parts:basic requirements,management processes,and quality manage-ment and evaluation improvement,to provide guidance in allocating,storing,and managing rescue vehicles and nursing unit drug stock.

Rescue vehicles and nursing unit drug stock are important in the clinical rescue process.Strengthening the management of rescue vehicles and nursing unit drug stock is conducive to ensuring the safety of clinical medication and impro-ving the quality of medical services.Based on scientificity,universality,guidance,and operability principles,the standard prepa-ration team revealed relevant national policy documents,domestic and foreign standards specifications,and literature.It sorted the key contents of rescue vehicles and base drug management.After several rounds of opinion collection and expert argumentation,the social organization standard Pharmacy administration and pharmacy practice in healthcare institutions—Part 3-7-3:Pharma-ceutical supply services—Key drugs management—Rescue vehicle and nursing unit drug stock management was proved.The main content of the standard includes 10 elements from 3 key parts:basic requirements,management processes,and quality manage-ment and evaluation improvement,to provide guidance in allocating,storing,and managing rescue vehicles and nursing unit drug stock.

Dynamic changes in gut dysbiosis and metabolomic dysregulation are associated with immune-complex glomerulonephritis(ICGN).However,an in-depth study on this topic is currently lacking.Herein,we report an ICGN model to address this gap.ICGN was induced via the intravenous injection of cationized bovine serum albumin(c-BSA)into Sprague-Dawley(SD)rats for two weeks,after which mycophenolate mofetil(MMF)and losartan were administered orally.Two and six weeks after ICGN establishment,fecal samples were collected and 16S ribosomal DNA(rDNA)sequencing and untargeted metabolomic were conducted.Fecal microbiota transplantation(FMT)was conducted to determine whether gut normali-zation caused by MMF and losartan contributed to their renal protective effects.A gradual decline in microbial diversity and richness was accompanied by a loss of renal function.Approximately 18 genera were found to have significantly different relative abundances between the early and later stages,and Marvinbryantia and Allobaculum were markedly upregulated in both stages.Untargeted metabolomics indicated that the tryptophan metabolism was enhanced in ICGN,characterized by the overproduction of indole and kynurenic acid,while the serotonin pathway was reduced.Administration of losartan and MMF ameliorated microbial dysbiosis and reduced the accumulation of indoxyl conjugates in feces.FMT using feces from animals administered MMF and losartan improved gut dysbiosis by decreasing the Firmicutes/Bacteroidetes(F/B)ratio but did not improve renal function.These findings indicate that ICGN induces serous gut dysbiosis,wherein an altered tryptophan metabolism may contribute to its pro-gression.MMF and losartan significantly reversed the gut microbial and metabolomic dysbiosis,which partially contributed to their renoprotective effects.

Objective:To compare the differences in the results of 24-hour urine citric acid, oxalic acid, and phosphoric acid detection between thymol and concentrated hydrochloric acid preserved urine.Methods:Urine samples were collected from 50 patients with upper urinary tract stones who were admitted to the Second Affiliated Hospital of Zhengzhou University from July 2023 to August 2023. There were 38 males and 12 females, with the age of (45.52 ± 13.68) years old. On the second day of admission, patients were required to empty their bladders in the morning and collect urine over a 24-hour period. The urine was evenly divided and stored in two sealed plastic containers. In one container, concentrated hydrochloric acid (15 ml, concentration of 6 mmol/L) was added as a preservative, forming the hydrochloric acid group. In the other container, 2 g of thymol was added as a preservative, forming the thymol group. The concentration of oxalic acid, citric acid, and phosphoric acid in urine were measured, and the measurement results were multiplied by the total amount of urine to obtain the final measurement results. The differences in the measurement results of citric acid, oxalic acid, and phosphoric acid between two groups were compared.Results:In the concentrated hydrochloric acid group, the median value of citric acid was 160.87(95.37, 245.61) mg/24h, the median value of oxalic acid was 33.09(26.32, 39.37) mg/24h, and the mean value of phosphoric acid was (731.06 ± 240.62) mg/24h. In the thymol group, the median value of citric acid was 340.40(166.56, 561.77) mg/24h, the median value of oxalic acid was 33.91(26.51, 44.56) mg/24h, and the mean value of phosphoric acid was (759.07 ± 273.23) mg/24h. Compared with the thymol group, the citric acid level in the concentrated hydrochloric acid group was significantly lower ( Z=4.31, P< 0.001), but there was no significant difference in oxalic acid ( Z=0.85, P=0.393) and phosphoric acid ( t=1.65, P=0.106) between the two groups. Conclusions:Compared with thymol, the results of 24 h urine citric acid with concentrated hydrochloric acid as preservative is lower, but there is no significant difference between oxalic acid and phosphoric acid.The use of thymol as a preservative may be more suitable than concentrated hydrochloric acid for the detection of citric acid, oxalic acid and phosphoric acid in 24-hour urine metabolism analysis.

Biapenem is a carbapenem antibiotic， and can be used for the treatment of sepsis， pneumonia， lung abscess， chronic respiratory lesions secondary infection， complex urinary tract infection and pyelonephritis， etc. This article reviewed the studies on the pharmacokinetics， pharmacodynamics and therapeutic drug monitoring （TDM） of biapenem. The pharmacokinetic parameters of biapenem are not significantly different in healthy subjects， and there is no accumulation after multiple doses of biapenem. However， there are large differences in pharmacokinetic parameters in patients with severe disease and patients with abnormal renal function compared with healthy subjects， which leads to conventional treatment regimens not achieving the desired outcome. In terms of pharmacodynamics， biapenem can improve the rate of reaching the target value by increasing the frequency of administration and prolonging the infusion time. For patients with anuria in end-stage renal disease， dosing intervals can be extended to avoid drug accumulation. However, for patients with severe infection, a daily dose of 1.2 g still can not control infections caused by Acinetobacter baumannii or Pseudomonas aeruginosa, which limits its use in patients with severe disease. It is recommended to implement TDM in severe patients and patients with abnormal renal function， and explore the best dosing regimen for biapenem in combination with pharmacokinetic models to ensure that the time that the free blood concentration of biapenem remains above minimum inhibitory concentration as a percentage of the time between doses （%fT＞MIC） is within the effective range，so that biapenem can exert a greater efficacy in severe patients and patients with abnormal renal function. For medical institutions that cannot carry out TDM， the efficacy of biapenem can be maximized by increasing the frequency of administration and prolonging the infusion time. For infections caused by P. aeruginosa， A. baumannii and Serratia marcescens with high drug resistance rates， it is recommended to combine or replace other antibiotics.

Extracorporeal membrane oxygenation (ECMO), a kind of life support technology that can replace lung and heart function, is widely used in critical respiratory and circulatory exhaustion. Because of the serious diseases and the use of interventional catheters, patients receiving ECMO life support are often administrated with broad-spectrum antimicrobial agents, which increase the risk of fungal infection. Fungal infection during ECMO can increase mortality. How to effectively control fungal infection is a thorny problem faced by clinicians. During the treatment of ECMO, the patient's physiological status, ECMO oxygenation membrane, circulation pipeline and other factors may change the pharmacokinetic profiles of antifungal drugs, thereby affect the clinical efficacy of drugs. This artical reviews the pharmacokinetic characteristics of antifungal drugs during ECMO support, in order to provide references for clinical antifungal treatment.

As a common disease in nervous system, epilepsy is possessed of characteristics of high incidence, suddenness and recurrent seizures. Timely prediction with corresponding rescues and treatments can be regarded as effective countermeasure to epilepsy emergencies, while most accidental injuries can thus be avoided. Currently, how to use electroencephalogram (EEG) signals to predict seizure is becoming a highlight topic in epilepsy researches. In spite of significant progress that made, more efforts are still to be made before clinical applications. This paper reviews past epilepsy studies, including research records and critical technologies. Contributions of machine learning (ML) and deep learning (DL) on seizure predictions have been emphasized. Since feature selection and model generalization limit prediction ratings of conventional ML measures, DL based seizure predictions predominate future epilepsy studies. Consequently, more exploration may be vitally important for promoting clinical applications of epileptic seizure prediction.
Electroencephalography ; Epilepsy/diagnosis* ; Humans ; Machine Learning ; Seizures/diagnosis* ; Signal Processing, Computer-Assisted

A 43-year-old female patient received Fuyanshu capsules 1.6 g orally thrice daily for pelvic inflammation. The traditional Chinese medicine decoction was added 1 week later. After 10 days of combination therapy, the patient developed fatigue, which was gradually aggravated, and yellowish skin and sclera appeared. Seven days later, laboratory tests showed alanine aminotransferase (ALT) >1 000 U/L, aspartate aminotransferase (AST) >750 U/L, gamma-glutamyltransferase (γ-GT) 148 U/L, alkaline phosphatase (ALP) 153 U/L, and total bilirubin (TBil) 56.3 μmol//L. After excluding viral hepatitis, autoimmune liver disease, obstructive jaundice, and other causes, liver injury caused by Fuyanshu capsules combined with traditional Chinese medicine decoction was considered. After Fuyanshu capsules and traditional Chinese medicine decoction were discontinued, reduced glutathione, glycyrrhizic acid preparation, and ursodeoxycholic acid were given. Seven days later, the patient′s symptoms were improved obviously and laboratory tests showed ALT 323 U/L, AST 125 U/L, γ-GT 149 U/L, ALP 109 U/L, and TBil 35.8 μmol/L. Twenty-seven days later, the patient′s symptoms disappeared and laboratory tests showed ALT 62 U/L, AST 42 U/L, γ-GT 67 U/L, ALP 67 U/L, and TBil 18.7 μmol/L. There are 7 same components in Fuyanshu capsule and traditional Chinese medicine decoction. It was considered that the liver injury was related to the increase of hepatotoxicity caused by the combination of the two drugs.

A 43-year-old female patient received Fuyanshu capsules 1.6 g orally thrice daily for pelvic inflammation. The traditional Chinese medicine decoction was added 1 week later. After 10 days of combination therapy, the patient developed fatigue, which was gradually aggravated, and yellowish skin and sclera appeared. Seven days later, laboratory tests showed alanine aminotransferase (ALT) >1 000 U/L, aspartate aminotransferase (AST) >750 U/L, gamma-glutamyltransferase (γ-GT) 148 U/L, alkaline phosphatase (ALP) 153 U/L, and total bilirubin (TBil) 56.3 μmol//L. After excluding viral hepatitis, autoimmune liver disease, obstructive jaundice, and other causes, liver injury caused by Fuyanshu capsules combined with traditional Chinese medicine decoction was considered. After Fuyanshu capsules and traditional Chinese medicine decoction were discontinued, reduced glutathione, glycyrrhizic acid preparation, and ursodeoxycholic acid were given. Seven days later, the patient′s symptoms were improved obviously and laboratory tests showed ALT 323 U/L, AST 125 U/L, γ-GT 149 U/L, ALP 109 U/L, and TBil 35.8 μmol/L. Twenty-seven days later, the patient′s symptoms disappeared and laboratory tests showed ALT 62 U/L, AST 42 U/L, γ-GT 67 U/L, ALP 67 U/L, and TBil 18.7 μmol/L. There are 7 same components in Fuyanshu capsule and traditional Chinese medicine decoction. It was considered that the liver injury was related to the increase of hepatotoxicity caused by the combination of the two drugs.

Objective To evaluate the short-term efficacy of combination of 125 I seed brachytherapy and cetuximab in postoperation recurrent rectum cancer.Methods From July 2014 to June 2018,at Affiliated Hospital of Shandong Academy of Medical Sciences,57 patients with postoperation recurrent rectal cancer were recruited.According to therapy the patients were divided into two groups:the radiotherapy group (30 cases) treated with radioactive 125I seeds alone and the combination treatment group (27 cases) treated with combination of radioactive 125I seeds and cetuximab.The tumor size,pain relief and adverse reactions were observed in both groups.Chi-square test were performed for statistical analysis.Results After treatment for six months,the total efficacy rate and local control rate of combination treatment group were 54.2％ (13/24) and 87.5％ (21/24),respectively;and which were higher than those of radiotherapy group (17.9％,5/28 and 39.3％,11/28),and the differences were statistically significant (x2 =15.01 and 2.55,both P ＜ 0.05).At one month after treatment,the pain relief rate of radiotherapy group and combination treatment group was 70.0％ (21/30) and 85.2％ (23/27),respectively,and there was no statistically significant difference between the two groups (P ＞ 0.05).After treatment for six months,the rates of adverse reactions of radiotherapy group and combination treatment group were 46.7 ％ (14/30) and 63.0％ (17/27),respectively,there was no statistically significant difference between the two groups (P ＞ 0.05).The symptoms of patients with radiation injury significantly improved after symptomatic treatment.Conclusion The short-term efficacy of combination of 125 I seed brachytherapy and cetuximab is better than that of 125 I seed brachytherapy alone in patients with postoperation recurrent rectum cancer.