Objective:In the era of precision medicine, there is an urgent need for a preclinical evaluation method with a high cost-benefit ratio to improve the effectiveness and value of clinical trials.Methods:Taking clinical needs and scientific research purposes as the starting point, the platform focused on four aspects of project management, information retrieval, quality control, and practical application, and introduced in detail the management practice of building a patient-derived xenograft model platform system.Results:With the support of the institutional system, quality control system, and information system, the patient-derived xenograft model platform was formed with standardization as the core. With the assistance of this platform and scientific research management, as of December 2021, there are 48 animal models of patient-derived xenograft in the database. In total of 6 SCI scientific and technological articles were published using these animal models, with a total impact factor of 36.77 (the highest single article was 7.333). In total of 6 direct industrial projects, 6 clinical trial-related projects, and 4 NSFC projects were approved with a total research fund of 1.5 million yuan.Conclusions:Continuous construction and improvement of the existing platform will help promote the development of basic research translation and clinical research in the field of oncology, and accelerate the development of new oncological diagnosis and treatment models, thereby benefiting more patients.

With the wide application of tyrosine kinase inhibitor (TKI), to obtain treatment-free remission (TFR) has gradually become the long-term goal for patients with chronic myelogenous leukemia (CML). Self-renewing leukemia stem cells during disease progression are related with the recurrence, and surveillance of residual leukemic cells is hypothesized to be one of the critical factors in successful TFR. On the way to obtain TFR, many breakthroughs have been made in innate and adaptive immunity of CML cells. This paper reviews the immune function of CML patients, the role of the immune markers in maintaining TFR, and the exploration of TKI combined with new immunomodulator therapy to achieve a greater degree of TFR.

Objective:To compare the performance of the severity-of-illness score for toxic epidermal necrolysis (SCORTEN) and ABCD-10 (age, bicarbonate, cancer, dialysis, 10% body surface area) scoring systems in predicting death in patients with Stevens-Johnson syndrome (SJS) /toxic epidermal necrolysis (TEN) .Methods:Clinical data were collected from 85 patients with SJS/TEN who were hospitalized in Sichuan Provincial People′s Hospital from January 2010 to April 2021, and retrospectively analyzed. The predicted mortality and actual mortality were compared at each score level of SCORTEN and ABCD-10. The receiver operating characteristic (ROC) curve and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the predictive power and calibration of SCORTEN and ABCD-10 on mortality.Results:Among the 85 patients, 37 were males and 48 were females, and their ages were 52.36 ± 19.31 years (range, 14 - 88 years) . There were 61 cases of SJS, 6 of SJS/TEN overlap, and 18 of TEN. Ten patients died in hospital and the fatality rate was 11.76%. Among the SCORTEN and ABCD-10 components, age > 40 years or ≥ 50 years, epidermal exfoliation > 10% body surface area on the 1st day after admission, heart rate > 120 beats per minute, serum urea nitrogen level > 10 mmol/L and serum bicarbonate level < 20 mmol/L were significantly correlated with death ( χ2 = 4.46, 6.18, 25.50, 15.13, 7.59, 8.38, respectively, all P < 0.05) , while malignancies, serum glucose level > 14 mmol/L, and pre-hospital dialysis were not significantly correlated with death ( χ2 = 0.35, 0.10, 1.38, respectively, all P > 0.05) . There were no significant differences between the predicted mortality and actual mortality at every score level of SCORTEN and ABCD-10 (all P > 0.05) . The ROC curve showed that both SCORTEN and ABCD-10 had good predictive power for death (areas under the curve: 0.874 and 0.867, 95% CI: 0.758 - 0.990, 0.773 - 0.962, respectively) , but the model goodness-of-fit of SCORTEN was superior to that of ABCD-10 ( P = 0.944, 0.048, respectively) . Conclusion:Both SCORTEN and ABCD-10 scoring systems could accurately predict mortality of SJS/TEN patients at early stage, but SCORTEN showed more favourable predictive power and calibration.

ObjectiveIn this study， the two different origins of Lycii Cortex in the 2020 edition of Chinese Pharmacopoeia were determined to analyze their chemical consistency by comparing their main chemical composition. MethodThirty representative batches of Lycii Cortex were collected， content determination and fingerprint analysis methods were established by ultra performance liquid chromatography-photodiode array detector （UPLC-PDA） combining with multivariate statistical analysis to evaluate the similarities and differences between two origins of Lycii Cortex. Respectively by the mobile phase of acetonitrile （A）-0.15% trifluoroacetic acid aqueous solution （B） and the mobile phase of acetonitrile （A）-0.1% formic acid aqueous solution （B） for gradient elution （0-4 min， 5%-12%A； 4-8 min， 12%A； 8-12 min， 12%-14%A； 12-15 min， 14%-30%A； 15-17 min， 30%-40%A； 17-18 min， 40%-90%A）， and the detection wavelength was set at 280 nm. ResultThis established content determination and fingerprint methods had good precision， stability and repeatability. The similarities of 30 batches of Lycii Cortex were above 0.90 by comparing with the control fingerprint， and the eight common peaks in fingerprints of Lycii Cortex from Lycium barbarum and L. chinense were all phenolic amides， which were kukoamine B， N-（4，9，13-triazatridecan-1-yl）-3，4-dihydroxybenzenepropanamide， feruloylputrescine， N₁，N₅-bis （dihydrocaffeoyl） spermidine or N₅，N₁₀-bis （dihydrocaffeoyl） spermidine， N₅-caffeoyl-N₁₀-dihydrocaffeoylspermidine， N₅-dihydrocaffeoyl-N₁₀-caffeoylspermidine， N₁，N₅-bis （caffeoyl） spermidine and lyciumin A. Among them， the content ranges of kukoamine B in Lycii Cortex from L. chinense and L. barbarum were 1.22%-8.18%， 2.52%-12.24%， respectively. ConclusionThe established UPLC analysis method can be used for the content determination and fingerprint analysis of Lycii Cortex. This study indicates that chemical contour of Lycii Cortex from L. barbarum and L. chinense are similar， there are no significant differences in kukoamine B content， and they have consistency in the chemical composition.

Chronic myelogenous leukemia (CML) is a myeloproliferative disease characterized by heterotopic Ph chromosome. Tyrosine kinase inhibitor (TKI) has significantly improved the prognosis of patients with CML. Cytogenetic and molecular monitoring for assessing the therapeutic efficacy of TKI to guide disease management has become an important component of CML therapy. However, the expanded genomic analysis of the disease diagnosis, transformation and drug resistance has not been fully explored in CML research. The paper reviews the frequency and type of gene mutations at initial diagnosis and the time of treatment failure and transformation, and investigates the relationship between genetic mutations and the prognosis of CML patients in the diagnosis and treatment.

Objective:To investigate the application value of ultrasound-guided selective pudendal nerve block during vestibular gland resection.Methods:Ninety patients who underwent vestibular gland resection in Lishui Maternal and Child Health Hospital from January 2017 to January 2020 were included in this study. These patients were divided into a control group and an observation group ( n = 45/group) according to the order of admission. Patients in the control group underwent blind nerve block and those in the observation group underwent ultrasound-guided selective pudendal nerve block. Hemodynamics before and after anesthesia, anesthetic effects, pain severity, and the incidence of complications were compared between the control and observation groups. Results:There were no significant differences in hemodynamics and pain severity between the control and observation groups (both P > 0.05). Systolic blood pressure [(124.37 ± 8.12) mmHg], diastolic blood pressure [(91.68 ± 5.44) mmHg] and heart rate [(74.62 ± 3.56) beats/min] were significantly lower than those in the control group [(128.62 ± 9.27) mmHg, (95.24 ± 6.17) mmHg, (76.12 ± 3.32) beats/min, t = 2.248, 2.903, 2.067, all P < 0.05]. In the observation group, pain scores at 2 and 24 hours after surgery were (3.06 ± 0.25) points and (4.21 ± 0.52) points, respectively, which were significantly lower than those in the control group [(3.28 ± 0.24) points and (4.54 ± 0.48) points, t = 2.618, 3.128, both P < 0.05). Anesthetic effect in the observation group was superior to that in the control group, and incidence of complications in the observation group was significantly lower than that in the control group ( χ2 = 12.869, 4.285, 4.864, 3.920, all P < 0.05). Conclusion:Ultrasound-guided selective pudendal nerve block in vestibular gland resection exhibits better anesthetic effect, has no obvious effect on hemodynamics, and has good analgesic effect with low incidence of complications. Therefore, it deserves clinical popularization.

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2018 to December 2019. Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 14 778 bacterial strains were collected from 50 hospitals, of which 4 117 (27.9%) were Gram-positive bacteria and 10 661(72.1%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.2%), Klebsiella pneumoniae (17.0%), Staphylococcus aureus (9.7%), coagulase-negative Staphylococci (8.7%), Pseudomonas aeruginosa (3.7%), Enterococcus faecium (3.4%), Acinetobacter baumannii(3.4%), Enterobacter cloacae (2.9%), Streptococci(2.8%) and Enterococcus faecalis (2.3%). The the prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus were 27.4% (394/1 438) and 70.4% (905/1 285), respectively. No glycopeptide-resistant Staphylococcus was detected. More than 95% of S. aureus were sensitive to amikacin, rifampicin and SMZco. The resistance rate of E. faecium to vancomycin was 0.4% (2/504), and no vancomycin-resistant E. faecalis was detected. The ESBLs-producing rates in no carbapenem-resistance E. coli, carbapenem sensitive K. pneumoniae and Proteus were 50.4% (2 731/5 415), 24.6% (493/2001) and 35.2% (31/88), respectively. The prevalence of carbapenem-resistance in E. coli and K. pneumoniae were 1.5% (85/5 500), 20.6% (518/2 519), respectively. 8.3% (27/325) of carbapenem-resistance K. pneumoniae was resistant to ceftazidime/avibactam combination. The resistance rates of A. baumannii to polymyxin and tigecycline were 2.8% (14/501) and 3.4% (17/501) respectively, and that of P. aeruginosa to carbapenem were 18.9% (103/546). Conclusions:The surveillance results from 2018 to 2019 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while E. coli was the most common pathogen, and ESBLs-producing strains were in majority; the MRSA incidence is getting lower in China; carbapenem-resistant E. coli keeps at a low level, while carbapenem-resistant K. pneumoniae is on the rise obviously.

ObjectiveTo analyze the articles on endoscopic retrograde cholangiopancreatography (ERCP), an important method for minimally invasive treatment of biliary and pancreatic diseases, published worldwide, and to investigate the status, hotspots, and development trends in this field. MethodsThe web of science core collection database in Web of Science platform was selected to search by the subject words “TS = (Cholangiopancreatography, Endoscopic Retrograde)”, for the articles published from January 1, 2015 to December 31, 2019, and the literature type was selected as “article”. CiteSpace 5.6.R2 (64-bit) was used to analyze the authors, key words, institutions, countries (regions), and references and plot visualized maps. ResultsA total of 1535 articles on ERCP were included. The analysis showed that Hiroyuki Isayama had the highest number of published articles, followed by Yousuke Nakai and Takeshi Ogura, and University of Tokyo had the highest number of published articles, followed by Shanghai Jiao Tong University and University of Ulsan College of Medicine. Moreover, the US, Japan, and China were the top three countries from the aspect of the number of published articles in the recent 5 years, and ERCP, complication, and risk factor were the key words with the highest frequency in the recent 5 years. The most frequently cited articles mainly focused on the complications of ERCP and related consensus or guidelines. ConclusionThe main research hotspots and trends in the field of ERCP are related factors and clinical prevention of ERCP-related complications.

Objective:To determine the dose-effect relationship of norepinephrine in the treatment of hypotension after spinal anesthesia in cesarean section.Methods:Ninety American Society of Anesthesiologists physical status Ⅰ or Ⅱ parturients who were at full term with a singleton fetus, body mass index of 20-35 kg/m 2, blood pressure 100-140 mmHg, heart rate 60-100 beats/min, scheduled for elective cesarean section, were divided into 6 different doses of norepinephrine groups (NE2, NE4, NE6, NE8, NE10 and NE12 groups) using a random number table method, with 15 cases in each group.The maternal basal systolic blood pressure was measured after entering the operating room.Anesthesia was performed by injecting hyperbaric bupivacaine 9 mg into the subarachnoid space over 45 s. When hypotension occurred for the first time after anesthesia (systolic blood pressure was lower than 80% of the baseline value), norepinephrine 2, 4, 6, 8, 10 and 12 μg (diluted to 5 ml in normal saline) were intravenously injected in NE2, NE4, NE6, NE8, NE10 and NE12 groups, respectively.Systolic blood pressure was measured at 60 s after completion of injection.The effective treatment of hypotension was defined as the recovery of systolic blood pressure to more than 80% of the baseline value.The logistic regression analysis method was used to draw the dose-effect curve of norepinephrine in treating hypotension after spinal anesthesia in cesarean section.The median effective dose (ED 50), 95% effective dose (ED 95) and 95% confidence interval (CI) were calculated.The time to first hypotension, effective treatment of hypotension, and occurrence of bradycardia and nausea and vomiting after intravenous injection of norepinephrine were recorded.The Apgar scores of the neonates at 1 and 5 min after birth were recorded.The umbilical artery blood samples of neonates were collected immediately after cutting the cord for blood gas analysis. Results:There was no significant difference in the incidence of maternal basal systolic blood pressure, time to first hypotension, bradycardia, and nausea and vomiting among the six groups ( P>0.05). The rate of effective treatment of hypotension increased with the increase of the dose in the six groups ( P<0.05). There was no significant difference in Apgar score and indexes of umbilical artery blood gas analysis at 1 and 5 min after birth among the six groups ( P>0.05). The ED 50 (95% CI) of norepinephrine in the treatment of hypotension after spinal anesthesia in cesarean section was 4.0 (3.0 to 5.0) μg, and the ED 95 (95% CI) was 11.8 (8.9-20.4) μg. Conclusion:The ED 50 and ED 95 of norepinephrine are 4.0 and 11.8 μg, respectively, when used for treating hypotension after spinal anesthesia in cesarean section.

Objective: To study convention MRI compared with conventional MRI combined with diffusion-weighted imaging (DWI) in the evaluation of T-staging of gallbladder carcinoma, and to determine the relationship between the apparent diffusion coefficient (ADC) value and histological grading. Methods: Fifty-one patients with gallbladder carcinoma confirmed by surgery and pathology were enrolled into this study. The T-staging was performed according to conventional MRI or with conventional MRI combined with DWI and the results were compared with pathological studies. Results: The ADC value of tumor was measured to determine the correlation with T staging, pTNM staging and pathological tumor differentiation. For conventional MRI, the T-staging rate was 84.3%, which was consistent with the pathological T scoring (Kappa value 0.7580). After DWI, the T staging coincidence rate was 92.2% and the Kappa value was 0.8813. A comparison between conventional MRI versus conventional MRI combined with DWI T-staging compliance rates was performed using the Chi-square test (χ²=1.5111, P>0.05). The ADC values correlated with the T-staging, pTNM staging, and pathological tumor differentiation (r=-0.672, -0.749, 0.707, respectively, all P<0.05). Conclusions Conventional MRI helped in the diagnoses of T-staging in gallbladder cancer. MRI combined with DWI helped to improve the coincidence rate of T-staging. The ADC values correlated with the T-staging, pTNM staging, and pathological tumor differentiation. Conventional MRI combined with DWI better evaluated the T-staging of gallbladder cancer, and could better guide the choice of treatment methods.