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Critical care medicine is a medical specialty engaging the diagnosis and treatment of critically ill patients who have or are likely to have life-threatening organ failure. Sepsis, a life-threatening condition that arises when the body responds to infection, is currently the major cause of death in intensive care units (ICU). Although progress has been made in understanding the pathophysiology of sepsis, many drawbacks in sepsis treatment remains unresolved. For example, antimicrobial resistance, controversial of glucocorticoids use, prolonged duration of ICU care and the subsequent high cost of the treatment. Recent years have witnessed a growing trend of applying traditional Chinese medicine (TCM) in sepsis management. The TCM application emphasizes use of herbal formulation to balance immune responses to infection, which include clearing heat and toxin, promoting blood circulation and removing its stasis, enhancing gastrointestinal function, and strengthening body resistance. In this paper, we will provide an overview of the current status of Chinese herbal formulations, single herbs, and isolated compounds, as an add-on therapy to the standard Western treatment in the sepsis management. With the current trajectory of worldwide pandemic eruption of newly identified Coronavirus Disease-2019 (COVID-19), the adjuvant TCM therapy can be used in the ICU to treat critically ill patients infected with the novel coronavirus.

Hydropower plant operation changes river habitats in various aspects, and thus affects the community composition of the river ecosystem. As a result, the river health is adversely affected. The influence of a hydropower plant cascade on river continuity is even more pronounced. In this study, benthic macroinvertebrates and environmental factors were sampled from the Jingbohu Hydropower Plant to the Shiyan Hydropower Plant, along the Mudan River, and the influence of a hydropower plant cascade on the longitudinal distribution of benthic macroinvertebrates was analyzed. The results demonstrate that the hydropower plant cascade affected several environmental variables and led to changes in the community composition of benthic macroinvertebrates in the Mudan River. Significant differences were observed between sites upstream and downstream of the hydropower plants, with more sensitive species downstream of the hydropower plants. "Run-of-river" hydropower plants exert less adverse influence on benthic macroinvertebrates than dam-type plants. The influence of hydropower plants decreases along the longitudinal direction of the river, with the density and richness of benthic macroinvertebrates increasing.

RIV1Q is the stand-alone water quality program of CE-QUAL-RIV1, a hydraulic and water quality model developed by U.S. Army Corps of Engineers Waterways Experiment Station. It utilizes an operator-splitting algorithm and the advection term in governing equation is treated using the explicit two-point, fourth-order accurate, Holly-Preissmann scheme, in order to preserve numerical accuracy for advection of sharp gradients in concentration. In the scheme, the spatial derivative of the transport equation, where the derivative of velocity is included, is introduced to update the first derivative of dependent variable. In the stream with larger cross-sectional variation, steep velocity gradient can be easily found and should be estimated correctly. In the original version of RIV1Q, however, the derivative of velocity is approximated by a finite difference which is first-order accurate. Its leading truncation error leads to the numerical error of concentration which is related with the velocity and concentration gradients and increases with the decreasing Courant number. The simulation may also be unstable when a sharp velocity drop occurs. In the present paper, the derivative of velocity is estimated with a modified second-order accurate scheme and the corresponding numerical error of concentration decreases. Additionally, the stability of the simulation is improved. The modified scheme is verified with a hypothetical channel case and the results demonstrate that satisfactory accuracy and stability can be achieved even when the Courant number is very low. Finally, the applicability of the modified scheme is discussed.

Copeptin reflects the individual stress level, and is correlated with outcomes of critical illness. This study was designed to evaluate its relationship with disease severity, local complications, organ failure and mortality of severe acute pancreatitis (SAP). Seventy-eight SAP patients and 78 sex- and age-matched healthy individuals were recruited. Plasma samples were obtained on admission from SAP patients and at study entry from healthy individuals. Copeptin concentration was determined using enzyme-linked immunosorbent assay. Plasma copeptin level was obviously higher in patients than in healthy individuals, was identified as an independent predictor of local complications, organ failure and in-hospital mortality, was highly associated with traditional predictors of disease severity and mortality including the Acute Physiology and Chronic Health Care Evaluation II score, Ranson score, multiple organ dysfunction score, sequential organ failure assessment score, and predicted local complications, organ failure, and in-hospital mortality of SAP patients with high areas under receiver operating characteristic curve. Furthermore, its predictive value was similar to the traditional predictors’. However, it could not improve these traditional predictors’ predictive values. Therefore, increased plasma copeptin level is associated with disease severity and identified as a novel prognostic marker of local complications, organ failure and mortality after SAP.

Due to large topography slopes in natural rivers, pollutant concentration embodies a property of three-dimensional distribution when wastewater is discharged from effluents along the bank. With the sigma coordinate along the vertical dimension fitted to both the moving free surface and the bed topography, a three-dimensional numerical model was developed in the present work to address pollutant transport processes in the above-mentioned cases. To avoid the reduction in accuracy caused by spurious diffusion in the case of steep bottom slopes, a formula for horizontal diffusion in the sigma coordinate system was derived. A case study for the side discharge into a straight open-channel flow shows that numerical results are verified well by experimental data. Furthermore, the present model is also verified by the simulation of discharging wastewater from Fuling Phosphorus Factory effluent into the Three Gorges Reservoir and the agreement between the numerical simulation results and field observation data is satisfactory. The change of the mixing zone scope in the water surface versus the layers along the vertical dimension was also discussed in detail. The study shows that a more realistic calculation for pollutant discharge has been provided by the present model than by the depth-average model which predicts an unrealistically smaller mixing zone.