Objective:To construct a biospecimen bank of patient derived organoids (PDOs) from pancreatic cancer tissues and to explore the feasibility of PDOs drug sensitivity assay technology to guide chemotherapy drug selection for pancreatic cancer.Methods:Pancreatic cancer tissue specimens obtained after surgical resection and puncture biopsy from Mar 2020 to Dec 2022 at Drum Tower Hospital, Nanjing University School of Medicine were collected. Pancreatic cancer PDOs were cultured in vitro and histologically identified; PDOs were treated with gemcitabine, Nab-paclitaxel, fluorouracil, Oxaliplatin, and Irinotecan and cell viability was measured to analyze the correlation between PDOs drug sensitivity and the actual clinical treatment response.Results:The PDOs can reproduce the pathological features of corresponding tumor tissues; the sensitivity of different PDOs to the same chemotherapeutic drug is significantly different; The sensitivity of PDOs was highly consistent with the actual treatment effect of the corresponding patients 75.76% (25/33); organoid organ-based susceptibility testing had predictive value for the treatment response of patients (AUC=0.733, 95% CI: 0.546-0.919, P<0.05). Conclusion:A biobank of pancreatic cancer PDOs was successfully constructed, and the drug susceptibility test results were significantly correlated with the actual medication response of patients, suggesting that the drug susceptibility test technology based on PDOs has the potential to guide individualized chemotherapy for pancreatic cancer.

Objective:To compare the difference between breast bracket combined with polyurethane foam and single polyurethane foam in the accuracy of immobilization, providing a better immobilization for breast cancer radiotherapy.Methods:Fifty breast cancer patients who received radiotherapy in Sun Yat-sen University Cancer Center from March 2021 to July 2021 were selected. Among them, 25 patients were immobilized with polyurethane foam (foam group), and the other 25 patients were immobilized with polyurethane foam combined with breast bracket (combination group). All patients were scanned by CBCT once a week to obtain setup errors in the SI, LR and AP directions for t-test. The formula M PTV=2.5 Σ+0.7 σ was used to calculate the margin of the planning target volume(M PTV). Results:The setup errors in the foam group were SI (2.0±3.26) mm, LR (0.88±2.76) mm, AP (1.22±3.55) mm, Rtn -0.24°±0.85°, Pitch 0.16°±1.11°, Roll -0.32°±1.05°, and the M PTV were 6.75 mm, 8.46 mm and 8.73 mm, respectively. The setup errors in the combination group were SI (1.0±3.01) mm, LR (0.62±2.74) mm, AP (1.82±3.21) mm, Rtn 0.64°±0.59°, Pitch 0.71°±1.22°, Roll 0.29°±0.73°, and the M PTV were 6.35 mm, 7.47 mm, and 7.61 mm, respectively. After comparing the setup errors in the three-dimensional directions between two groups, the t value of LR, SI, AP and Rtn, Pitch, Roll was -4.304, -2.681, 1.384, and -9.457, -3.683, -5.323, respectively. And the differences in the LR, SI, Rtn, Pitch and Roll directions were statistically significant (all P<0.05). Conclusions:The immobilization effect of polyurethane foam combined with breast bracket is better and the M PTV is also smaller than those of polyurethane foam alone. Therefore, it is recommended to use polyurethane foam combined with breast bracket for immobilization in breast cancer radiotherapy.

Objective:To analyze the correlation between recessive obesity and lifestyle in physical examination population.Methods:A total of 1 026 people with body mass index (BMI) of 18.5<-24.9 kg/m 2 who completed physical examination in the Health Management Center of Affiliated Hospital of Qingdao University from March 1, 2019 to September 31, 2019 were included in this study. Inbody770 body composition analyzer was used to check the percent body fat, and the subjects were divided into recessive obesity group (405 cases) and control group (621 cases) with the results. The results of routine physical examination were compared between the two groups. The data of five dimensions including marital status, education level, income, occupation and dietary habits were obtained with lifestyle questionnaire. The correlation between recessive obesity and lifestyle was analyzed by binary logistic regression. Results:The proportion of women, BMI, total cholesterol, low density lipoprotein cholesterol and waist-hip ratio were significantly higher in the recessive obesity group than those in the control group [65.2% vs 27.1%, (21.83±1.63) vs (21.56±1.74) kg/m2, 4.68 (4.18, 4.22) vs 4.39 (4.13, 4.83) mmol/L, 2.54 (2.08, 3.00) vs 2.24 (2.13, 2.78) mmol/L, 0.87 (0.84, 0.90) vs 0.82 (0.80, 0.86)]; while the systolic blood pressure, albumin and aspartate aminotransferase were significantly lower [(114.99±11.49) vs (118.97±11.84) mmHg (1 mmHg=0.133 kPa), (45.13±2.83) vs (46.37±2.60) g/L, 15 (12, 18) vs 16 (14, 20) U/L] (all P<0.05). Unmarried ( OR=0.200, 95% CI: 0.123-0.325), eating less white meat [occasionally eating, OR=0.565, 95% CI: 0.304-1.053; rarely eating, OR=0.186, 95% CI: 0.094-0.368], eating less spicy food (occasionally eating, OR=0.298, 95% CI: 0.171-0.519; rarely eating, OR=0.828, 95% CI: 0.487-1.408), drinking more water (1 000-2 000 ml/d, OR=0.366, 95%CI: 0.218-0.615; ≥2 000 ml/d, OR=0.176, 95% CI: 0.087-0.356) were negatively correlated with the occurrence of recessive obesity (all P<0.05). Eating takeout food frequently ( OR=4.639, 95% CI: 2.412-8.923), eating too much edible oil ( OR=10.900, 95% CI: 4.376-27.148), drinking beer ( OR=3.702, 95% CI: 2.290-5.982) and infrequent physical exercise (occasional, OR=13.417, 95% CI: 6.907-26.066; rarely, OR=28.290, 95% CI: 13.532-59.142) were positively correlated with the occurrence of recessive obesity (all P<0.05). Conclusions:There is a correlation between recessive obesity and the lifestyle in physical examination population. Attention should be paid to control the intake of white meat, spicy food, edible oil and beer, ensure the amount of drinking water, reduce the frequency of takeout food, and increase physical exercise to prevent recessive obesity.

Objective:To observe the effect of team resuscitation with Pit-Crew cardiopulmonary resuscitation (CPR) mode on improving the quality of chest compression.Methods:A control method was conducted in this study. Sixty-four medical staffs in ICU and Emergency departments were divided into the role division group and non-role division group according to the ratio of doctors to nurses, with 8 teams in each group and 4 staffs in each team. A team leader was appointed in each team of the role division group to organize and coordinate the whole CPR process, and the non-role division group was not appointed. Each team performed chest compression for 8 min according to the recommendations of the 2020 AHA CPR Guideline under the monitoring of the CPR quality tracking system using a resuscitation manikin. CPR time, chest compression fraction (CCF), times of pressing interruption, times of pressing exceeding standard interruption (>10 s), pressing frequency, chest full recoil rate and other parameters were observed and recorded. The computer system recorded the above parameters, Student's t test and Mann-Whitney U test were used to compare the differences of indexes between the two groups. Results:After the training, the role division group achieved higher CCF [(69.13±1.55)% vs. (59.13 ± 6.08)%, P<0.05], and the total time was significantly shorter and times of overshoot interruptions was significantly less in the role division group compared with the non-role division group [(79.88±28.76) s vs. (135.25±32.99) s; 4 (3, 5) times vs. 2 (1, 2) times respectively; P<0.01]. There were no statistical differences in the total time of CPR and interruption numbers ( P>0.05). In addition, there were also no statistically significant differences in the pressing total numbers, correct times, pressing frequency, pressing depth, and the full rebound times of compression, as well as the substandard indicators of compression such as pressing too fast, too slow, too deep and insufficient rebound times of compression (all P>0.05). Conclusions:Pit-Crew CPR mode with designated team leader contributes to the implementation of high quality CPR, and the monitoring of CPR quality parameters and the applying of real-time feedback system can effectively improve the quality of chest compression.

ObjectiveTo identify the chemical constituents of Alismatis Rhizoma before and after processing with salt-water by ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry （UPLC-Q-TOF-MS）， and to investigate the changes of terpenoids in Alismatis Rhizoma before and after processing with salt-water. MethodUPLC-Q-TOF-MS was used to detect with 0.1% formic acid aqueous solution （A）-acetonitrile （B）as mobile phase for gradient elution （0-0.01 min， 20%B； 0.01-5 min， 20%-40%B； 5-40 min， 40%-95%B； 40-42 min， 95%B； 42-42.1 min， 95%-20%B； 42.1-45 min， 20%B）， electrospray ionization （ESI） was selected for collection and detection in positive ion mode with the scanning range of m/z 100-1 250 and ion source temperature at 500 ℃. The data were analyzed by PeakView 1.2.0.3， the components were identified according to the primary and secondary MS data， and combined with the reference substance and literature. After normalized treatment by MarkerView 1.2.1， the MS data were analyzed by principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA）， and then the differential components before and after processing were screened. The content changes of differential components were analyzed according to the relative peak area. ResultA total of 30 components were identified under positive ion mode， including 28 prototerpene triterpenes and 2 sesquiterpenes. The results of PCA and OPLS-DA showed that there were significant differences in components from Alismatis Rhizoma before and after processing with salt-water， and 10 differential components （alisol B 23-acetate， alisol I， alismol， 11-deoxy-alisol B 23-acetate， alisol B， alisol C， 11-deoxy-alisol B， alisol G， 11-deoxy-alisol C and alisol A） were screened， and the contents of alisol G and alisol A decreased significantly after processing. ConclusionUPLC-Q-TOF-MS can comprehensively and accurately identify the chemical constituents in raw and salt-processed products of Alismatis Rhizoma. It takes a great difference in the contents of chemical constituents before and after processing， and the difference of substituents is the main reason for this differences， which can provide reference for determining the material basis of efficacy changes of Alismatis Rhizoma before and after processing with salt-water.

Adolescent ; Adult ; Age Distribution ; Aged ; Basic Reproduction Number ; COVID-19/virology* ; China/epidemiology* ; Disease Outbreaks ; Female ; Humans ; Male ; Middle Aged ; SARS-CoV-2 ; Sex Ratio ; Young Adult

Objective:To explore the clinical characteristics and risk factors of pediatric patients with Wiskott-Aldrich syndrome (WAS).Methods:This was a case-control study. Clinical data of 165 cases of pediatric patients with WAS, who visited the Department of Rheumatology, Children′s Hospital of Chongqing Medical University between January 2007 and August 2020 were retrospectively analyzed and divided into death group and survival group (control group) according to the prognosis in the follow-up. Two independent samples t-test, Welch approximate t-test, Mann-Whitney U test, Pearson χ2 test, Yates corrected χ2 test, or Fisher exact probability test were used for comparison between groups. Risk factors were analyzed by multivariate Logistic regression analysis. Results:A total of 165 patients with Wiskott-Aldrich syndrome were enrolled in this study, including 40 cases in the death group and 125 cases in the survival group. The WAS score was (4.1±0.8) score in the death group and (3.1±1.2) score in the survival group. The age was 19 (9, 28) months in the death group and 60 (36,86) in the survival group. The episode rates of recurrent infection and (or) severe infection, intracranial hemorrhage and eczema in the death group were significantly higher than those in the survival group (95.0% (38/40) vs.32.0% (40/125),25.0% (10/40) vs. 2.4% (3/125), 90.0% (36/40) vs. 72.0% (90/125), χ2=48.253, 18.325, 5.440, all P<0.05). Infection (22 cases, 55.0%) and intracerebral hemorrhage (15 cases, 37.5%) were the main causes of death, 3 cases (7.5%) died of severe graft-versus-host disease after transplantation. The Logistic regression model indicated that repeated infection and (or) severe infection and non-use of intravenous immunoglobulin (IVIG) replacement therapy were risk factors for death in Chinese WAS patients ( OR values were 8.999 and 2.860, 95% CI were (2.041-39.667) and (1.375-5.950), respectively, all P<0.05). Conclusions:Recurrent and (or) severe infection is the main risk factor of death for WAS patietns. Regular IVIG treatment can improve the survival rate of patients with WAS.

Objective:To evaluate the clinical efficacy of the Kechuansan acupoint plaster combined with acupoint injection of Chuankezhi in treating bronchial asthma. Methods:A total of 65 patients with bronchial asthma, who met the inclusion criteria in Shanghai Municipal Hospital of TCM from June 2018 to September 2018, were selected anddivided into control group and observation group by random number table method, 32 in the control group and 33 in the observation group. The control group was treated with acupoint injection of Chuankezhi, while the observation group was treated with acupoint plaster of Kechuansan combined with acupoint injection of Chuankezhi. Both groups were treated for 6 weeks. TCM syndromes and frequency of acute attackin one year before and after the treatment was scored and recorded. The patients' quality of life was assessed by Asthma Control Test (ACT) and the fractional exhaled nitric oxide (FeNO) level was measured by Sunvou-p100 nakurun breath analyzer to evaluate the clinical efficacy. Results:Through out the treatment, there were 3 dropouts in the observation group and 2 dropouts in the control group. 30 cases were completed in each group. The total effective rate in the observation group was 93.3% (28/30), and the control group was 73.3% (22/30). The difference was statistically significant ( χ2=4.320, P=0.038). After the treatment, the scores of TCM syndromes and ACT in the observation groups were significantly higher than those of the control group ( t values were 4.834 and 5.642, respectively, all Ps<0.01). The FeNO in the observation group were significantly lower than those in the control group ( t=3.180, P=0.020). The frequency of acute attack in one year in the observation group was less than that ofthe control group ( t=5.466, P<0.01). Conclusions:Acupoint plaster Kechuansan combined with acupoint injection of Chuankezhi can relieve the clinical symptoms of asthma, reduce the frequency of asthma attack, improve the control ability of asthma, reduce airway inflammation, which is more effective than using acupoint injection therapy alone.

Objective:To explore the progress of microcirculation research in shock and sepsis from 2000 to 2019 based on knowledge visualization analysis.Methods:The literatures related to microcirculation of shock and sepsis published in Web of Science and Wanfang databases were collected from 2000 to 2019. Then, data collected was sorted out and used to make bar charts and curves reflecting the growth trend of the literatures using Excel software. The information about country, institution and author were extracted by CiteSpace 5.0 R1 for generating co-occurring network, to find the main research power and each cooperative relation. This software was also used to analyze the related-keywords and cited reference, so that the map of co-citation reference was drawn subsequently to explore the frontiers and hot spots in this field.Results:There were a total of 2 000 Chinese "papers" or "dissertations", 1 823 English "articles" or "reviews", collected preliminarily. The Chinese literatures were only statistically described for the amounts, institutions and authors, however, all retrieved English literatures were enrolled in the visualization analysis eventually. From 2009 to 2019, the number of English literatures rose steadily; however, the number of Chinese literatures had been sliding since 2011. On terms of quality, the impact factors of most literatures were under 6, lacking high quality ones, and the number remained stable every year. According to the analysis of English literatures, the top three countries that published related papers around the world were Germany ( n = 430), the United States ( n = 401) and Netherlands ( n = 223). In the aspect of research institutions, the University of Amsterdam (Netherlands) ranked first in the Web of Science ( n = 113), while the institution in China with the most publications was the Southern Medical University ( n = 71). According to the analysis of co-occurring author network, there were three major globe scientific groups in which Can Ince, Daniel De Backer and Jean-Louis Vincent contributed most to this research field. The top three authors who published most Chinese papers were Niu Chunyu ( n = 20), Zhao Zigang ( n = 18) and Duan Meili ( n = 13). By generating the co-occurring keyword mapping, the research hot spots mainly focused on "blood flow", "nitric oxide", "hemorrhagic shock" and "perfusion". However, these burst keywords, including "cardiogenic shock", "acute kidney injury", "fluid resuscitation", "sublingual microcirculation", "mortality", "oxidative stress", and "critically ill patient", represented the frontiers in microcirculation research of shock and sepsis field. Finally, the results of co-citation reference analysis showed that "sublingual microcirculation" and "mottling score" were most active, indicating that the research of microcirculation monitoring technology could be considered as a hot spot and also the frontier in this field, which was consistent with the results of co-occurring keywords network. Conclusions:Knowledge visualization analysis can visually exhibit the hot spot and trend of microcirculation research in shock and sepsis. The power was mainly focused on a few developed countries in Europe, and the trend was more inclined to the related microcirculation monitoring technology.

In patients being resuscitated successfully after cardiac arrest, electroencephalogram reactivity (EEG-R) is considered as a prognostic indicator. However, there are no clear guidelines on how to test EEG-R and exact definition of EEG-R. The International consensus on electroencephalogram reactivity testing after cardiac arrest on 2018, which is jointly developed by expert in relevant fields from many countries, reach a partial consensus on the test stimulation plan and definition of EEG-R. This paper interprets the main points of the consensus to provide reference for doctors majored in relevant fields in China.