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Background: Pharmacist-led clinical pathways/order sets (PLCOs) were first applied for designated diseases and surgical operations, such as cancer. They were not used in pharmacotherapy until recently. After screening a large number of publications, we found that PLCOs were rarely accessible. Objective: To evaluate the effects and the changes of relevant medical outcomes of PLCOs. Methods: Articles from PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang database, and China Biology Medicine disc (CBM) were systematically retrieved. Clinical research comparing cancer patients' clinical effects with or without clinical pathway/order sets was performed. Two reviewers performed quality assessment, and the data were abstracted independently. A narrative synthesis of the extracted data was performed due to heterogeneity. Results: Nine studies were identified, including six uncontrolled before–after studies and three case-series studies. The scopes of PLCOs of included research can be divided into two types, one focusing on chemotherapy agents and the other on the managements of chemotherapy-induced complications. The PLCOs shortened hospital length of stay, decreased initial antibiotic time intervals in patients with febrile neutropenia, reduced medication error incidence, and increased physicians' adherence rate to clinical pathway/order sets. Moreover, three articles included economic effects showing positive savings on medication costs through PLCOs. Conclusion: PLCOs can have beneficial effects on medication effectiveness, safety, and economic outcomes. Nevertheless, clinical pathway/order sets need to be further optimized and expanded to other clinical areas. [ABSTRACT FROM AUTHOR]

A complete 28-GHz/50-kW gyrotron system was developed by the Institute of Applied Electronics, China Academy of Engineering Physics, Mianyang, China, as a plasma heating source for the EXL50 fusion device, a compact spherical tokamak constructed by the ENN Group in 2019. The gyrotron employs a triode magnetron injection gun, a TE02-mode cylindrical cavity, a built-in quasi-optical mode converter, a single-stage depressed collector, and a single-disk boron nitride window. The gyrotron system features a match optical unit, a superconducting magnet, a calorimetric dummy load, a high-voltage power supply system, and other auxiliary components, was delivered to the EXL50 site. In the acceptance test, five successive shots of each power over 50 kW were generated for 30 s at 28 GHz. An average power of 51 kW, a maximum power of 55 kW, and 46% overall efficiency were obtained. The gyrotron system was assembled in the EXL50 and applied to a plasma discharge experiment. The gyrotron is the first practical domestic gyrotron produced for fusion applications in China. The design and test results of this instrument are presented in this article. [ABSTRACT FROM AUTHOR]

The North Qilian Orogenic Belt is on the northeastern margin of the Tibetan Plateau. It is connected with the Alxa Block in the north and the Tethyan orogenic assemblage in the south. The Lower Silurian Angzanggou Formation, deposited in the northern area of the North Qilian Orogenic Belt, is the most important for revealing the architecture and orogenic processes of the North Qilian Belt. Provenance analysis of the Angzanggou Formation can reveal not only the tectonic evolution of the central orogenic belt of China but also Palaeozoic Asia plate reconstructions. Petrographic analysis indicated that the compositional and textural maturity of the sandstones was low. The detrital composition of the Angzanggou Formation samples consists of quartz (8–14 %), feldspar (6–29 %) and lithic fragments (56–86 %). The sandstones could be classified as litharenites or feldspathic litharenites. The detrital modal composition suggests that these sandstones were probably deposited in a fore-arc basin. The element ratios and some discrimination diagrams based on geochemistry indicate that felsic and intermediate rocks were the main source rocks. The SiO2/Al2O3 ratio, the index of chemical variability and the Th/Sc versus Zr/Sc discrimination diagram suggest that the compositional maturity and degree of recycling were moderate to low. The index of alteration (CIA) and the A–CN–K diagram indicate the intensity of weathering was moderate. The discrimination diagrams based on major and trace elements and petrographic discrimination diagrams imply that the Angzanggou Formation rocks were derived from a continental island arc, and a sedimentary cover probably overlaid the volcanic arc. Therefore, we infer that during Early Silurian time the North Qilian Belt sediments accumulated in a fore-arc basin. [ABSTRACT FROM AUTHOR]

The North Qilian orogenic belt is the key in the exploration of the formation and assembly of Asia. The Early–Middle Devonian Xueshan Formation, which is deposited in the north area of North Qilian Orogenic Belt, is the most important for revealing the evolution basin–mountain transition of the North Qilian Belt. In order to reveal the tectonic evolution of the central orogenic belt in China and Paleozoic global plate reconstruction, it is necessary to perform provenance analysis of the Xueshan Formation. Eighteen samples were collected from Yumen and Yongchang profiles in the west of North Qilian Belt (WN), and 16 samples were obtained from Gulang and Jingtai profiles in the east of North Qilian Belt (EN). The compositions of clastic conglomerates and the sandstones suggested that felsic volcanic was the main source of the WN Xueshan Formation deposits and that the sedimentary and metamorphic rocks were the main source of the EN sediments. According to major geochemistry indexes, such as Al2O3/SiO2 ratio ranging from 0.08 to 0.37 and the chemical index of alteration less than 80, the source rocks were moderately weathered and of moderately matured. The samples from the EN were relatively enriched in Cr, Ni, Sc, and V elements and depleted in Hf element. However, those from the WN were enriched in Hf without the enrichment of Cr, Ni, Sc, or V. The samples from WN showed a strong negative Eu anomaly, but the samples from EN showed a weak negative Eu anomaly or a positive Eu anomaly. All the above geochemical characteristics suggested the prominent input of felsic clasts with granitic rocks into the WN. Meanwhile, the discrimination diagrams of trace elements implied that WN rocks were derived from continental island arc and that the EN rocks were derived from orogenic belt and the passive continental margin. The North China Plate subducted southwards and formed subduction‐related arc magmatism along the southern margin of the North Qilian Terrane during the Early–Middle Devonian. In conclusion, the WN is a fore‐arc basin, but EN is a foreland basin. [ABSTRACT FROM AUTHOR]

Aims: A lot of medication risks related to high-dose methotrexate (HDMTX) therapy still remain to be identified and standardized. This study aims to establish an evidence-based practice guideline for individualized medication of HDMTX., Methods: The practice guideline was launched by the Division of Therapeutic Drug Monitoring, Chinese Pharmacological Society. The guideline was developed following the WHO handbook for guideline development and the methodology of evidence-based medicine (EBM). The guideline was initially registered in the International Practice Guidelines Registry Platform (IPGRP-2017CN021). Systematic reviews were conducted to synthesize available evidence. A multicentre cross-sectional study was conducted using questionnaires to evaluate patients' perception and willingness concerning individualized medication of HDMTX. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate the quality of evidence and to grade the strength of recommendations., Results: Multidisciplinary working groups were included in this guideline, including clinicians, pharmacists, methodologists, pharmacologists and pharmacoeconomic specialists. A total of 124 patients were involved to integrate patient values and preferences. Finally, the guideline presents 28 recommendations, regarding evaluation prior to administration (renal function, liver function, pleural effusion, comedications, genetic testing), pre-treatment and routine dosing regimen, therapeutic drug monitoring (necessity, method, timing, target concentration), leucovorin rescue (initial timing, dosage regimen and optimization), and management of toxicities. Of these, 12 are strong recommendations., Conclusions: We developed an evidence-based practice guideline with respect to HDMTX medication using a rigorous and multidisciplinary approach. This guideline provides comprehensive and practical recommendations involving the whole process of HDMTX administration to health care providers., (© 2021 British Pharmacological Society.)

A Gram-stain-negative, aerobic, nitrogen-fixing bacterium, designated strain L461 T , was isolated from leaves of Bryophyllum pinnatum growing at the South China Agricultural University. Phylogenetic analysis of the 16S rRNA gene sequence indicated it as a member of the genus Azotobacter closely related to Azotobacter beijerinckii JCM 20725 T (97.82 % similarity) and Azotobacter chroococcum ATCC 9043 T (97.34 %). Its major fatty acid components were C16 : 1 ω9c and C16 : 0. Its predominant isoprenoid quinone was Q-9. Its major polar lipids were phosphatidylethanolamine, phosphatidylglycerol, aminophospholipid, phospholipid and one unknown lipid. Its DNA G+C content was 64.9 mol% (Tm). DNA-DNA relatedness values between strain L461 T and the reference strains of A. beijerinckii and A. chroococcum were 46.43 and 28.23 %, respectively. Biological and biochemical tests, protein patterns, genomic DNA fingerprinting, and comparison of cellular fatty acids distinguished strain L461 T from the closely related Azotobacter species. Based on these data, the novel species Azotobacter bryophylli sp. nov. is proposed, with the type strain L461 T (=KCTC 62195 T =GDMCC 1.1250 T ).

A novel strain, designated K23C18032701 T , was isolated from a sample of forest soil collected from Dinghushan Biosphere Reserve, Guangdong Province, PR China. The strain was Gram-stain-negative, aerobic, motile and showed a shape change from a filamentous cell to coccobacilli. Phylogenetic analysis based on 16S rRNA gene sequences revealed that the novel strain belongs to the family Chitinophagaceae, and showed the highest similarities to Arvibacter flaviflagrans JCM 31293 T (95.0 %) and Filimonas aurantiibacter LMG 29039 T (94.4 %). The major cellular fatty acids included iso-C15 : 0, iso-C17 : 0 3-OH and iso-C15 : 1 G. The predominant polar lipid was phosphatidylethanolamine (PE). The predominant respiratory quinone was menaquinone-7. The major polyamine was sym-homospermidine. The draft genome size of strain K23C18032701 T was 5.84 Mb with a DNA G+C content of 47.2 mol%. Based on phenotypic, genotypic and phylogenetic analysis, strain K23C18032701 T represents a novel species of a new genus in the family Chitinophagaceae, for which the name Deminuibacter soli is proposed. The type strain is K23C18032701 T (=GDMCC 1.1403 T =KCTC 62913 T ). We also propose the reclassification of Filimonas aurantiibacter as Arvibacter aurantiibacter comb. nov. (type strain 1458 T =NRRL B-65305 T =LMG 29039 T ).

A Gram-stain-negative, rod-shaped and aerobic bacterium, designated K20C18050901 T , was isolated from forest soil collected on 11 September 2017 from Dinghushan Biosphere Reserve, Guangdong Province, PR China (23° 10' 24'' N; 112° 32' 10'' E). Phylogenetic analysis based on 16S rRNA gene sequences revealed that strain K20C18050901 T belongs to the genus Chitinophaga, and showed the highest similarities to Chitinophaga sancti NBRC 15057 T (98.6 %) and Chitinophaga oryziterrae JCM 16595 T (96.9 %). The major fatty acids (>10 %) were iso-C15 : 0, C16 : 1ω5c, summed feature 3 (C16 : 1ω6c and/or C16 : 1ω7c) and iso-C17 : 0 3-OH. The predominant respiratory quinone was menaquinone-7. The major polar lipid was phosphatidylethanolamine. The draft genome size of strain K20C18050901 T was 8.36 Mb with a DNA G+C content of 44.7 mol%. The digital DNA-DNA hybridization and average nucleotide identity values between strain K20C18050901 T and C. sancti NBRC 15057 T were 31.40 and 85.82 %, respectively. On the basis of phenotypic, genotypic and phylogenetic analysis, strain K20C18050901 T represents a novel species of the genus Chitinophaga, for which the name Chitinophagasilvisoli sp. nov. is proposed. The type strain is K20C18050901 T (=GDMCC 1.1411 T =KCTC 62860 T ).

Objective: To isolate myxobacteria and investigate their diversity in saline-alkaline soils from Akesu in Xinjiang., Methods: Conventional culture-dependent methods, e. g. baiting technique, water agar, soil extract agar and mineral agar, were used to isolate myxobacteria from 25 soil samples collected from Akesu areas of Xinjiang. Combining with physicochemical properties (acidity/alkalinity, salt concentration, vegetation and geographical locations) of the soil samples, myxobacterial diversity was studied., Results: In total 58 strains were isolated, and identified as belonging to 6 different genera, i.e. Myxococcus, Cystobacter, Corallococcus, Sorangium, Nannocystis and Polyangium of Myxococcales. The most frequent genus isolated was Myxococcus which may better adapt in harsh environments. Different myxobacterial diversity was detected in different habitat., Conclusion: Myxobacteria diversity was low in saline-alkaline soils of Akesu in Xinjiang.

Fifteen bacterial strains isolated from molasses grass (Melinis minutiflora Beauv.) were identified as nitrogen-fixers by using the acetylene-reduction assay and PCR amplification of nifH gene fragments. These strains were classified as a unique group by insertion sequence-PCR fingerprinting, SDS-PAGE protein patterns, DNA-DNA hybridization, 16S rRNA gene sequencing and morphological characterization. Phylogenetic analysis of the 16S rRNA gene indicated that these diazotrophic strains belonged to the genus Azospirillum and were closely related to Azospirillum lipoferum (with 97.5 % similarity). In all the analyses, including in addition phenotypic characterization using Biolog MicroPlates and comparison of cellular fatty acids, this novel group was found to be different from the most closely related species, Azospirillum lipoferum. Based on these data, a novel species, Azospirillum melinis sp. nov., is proposed for these endophytic diazotrophs of M. minutiflora, with TMCY 0552(T) (=CCBAU 5106001(T) = LMG 23364(T) = CGMCC 1.5340(T)) as the type strain.