Characteristics and Clinical Implication of UGT1A1 Heterozygous Mutation in Tumor / 中国肺癌杂志

BACKGROUND@#The literature recommends that reduced dosage of CPT-11 should be applied in patients with UGT1A1 homozygous mutations, but the impact of UGT1A1 heterozygous mutations on the adverse reactions of CPT-11 is still not fully clear.@*METHODS@#A total of 107 patients with UGT1A1 heterozygous mutation or wild-type, who were treated with CPT-11 from January 2018 to September 2021 in Peking University Third Hospital, were retrospectively enrolled. The adverse reaction spectra of patients with UGT1A1*6 and UGT1A1*28 mutations were analyzed. Adverse reactions were evaluated according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) 5.0. The efficacy was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. The genotypes of UGT1A1*6 and UGT1A1*28 were detected by digital fluorescence molecular hybridization.@*RESULTS@#There were 43 patients with UGT1A1*6 heterozygous mutation, 26 patients with UGT1A1*28 heterozygous mutation, 8 patients with UGT1A1*6 and UGT1A1*28 double heterozygous mutations, 61 patients with heterozygous mutation at any gene locus of UGT1A1*6 and UGT1A1*28. Logistic regression analysis showed that the presence or absence of vomiting (P=0.013) and mucositis (P=0.005) was significantly correlated with heterozygous mutation of UGT1A1*28, and the severity of vomiting (P<0.001) and neutropenia (P=0.021) were significantly correlated with heterozygous mutation of UGT1A1*6. In colorectal cancer, UGT1A1*6 was significantly correlated to diarrhea (P=0.005), and the other adverse reactions spectrum was similar to that of the whole patient cohort, and efficacy and prognosis were similar between patients with different genotypes and patients treated with reduced CPT-11 dosage or not.@*CONCLUSIONS@#In clinical use, heterozygous mutations of UGT1A1*6 and UGT1A1*28 are related to the risk and severity of vomiting, diarrhea, neutropenia and mucositis in patients with Pan-tumor and colorectal cancer post CPT-11 therpy. In colorectal cancer, UGT1A1*6 is significantly related to diarrhea post CPT-11 use, efficacy and prognosis is not affected by various genotypes or CPT-11 dosage reduction.

Analysis of Distribution and Drug Resistance of Bloodstream Infection Pathogens in A Children ’s Hospital from Zhengzhou during 2014-2019 / 中国药房

OBJECTIVE：To analyze the distribution and drug resistance of bloodstream infection pathogens in a Children’s Hospital from Zhengzhou，and to provide reference rational selection of drugs in anti-infective treatment. METHODS：By retrospective analysis，128 318 blood culture specimens were collected from inpatients in the Affiliated Children’s Hospital of Zhengzhou University from Oct. 2014 to Sept. 2019. The positive rate，clinical symptoms and clinical diagnosis of children with bloodstream infection were analyzed statistically. WHONET 5.6 software was used to analyze pathogenic bacteria of positive specimen，the departments and the resistance of pathogens to the main clinical antibiotics. RESULTS：In 128 318 blood culture samples of inpatients，the positive rate was 2.14％ （2 746/128 318）；among 2 746 blood culture positive sample，the main Symptom of childrem with blood stream infection was fever（1 986/2 746）；main clinical diagnosis included sepsis（1 679/2 746）， bronchopneumonia（858/2 746），purulent meningitis（555/2 746）. The main departments included neonatal diagnosis and treatment center （1 090 strains，accounting for 39.69％） [neonatal intensive care unit （279 strains，accounting for 10.16％），neonatal surgery department （223 strains，accounting for 8.12％），neonatal internal medicine department （209 strains，accounting for 7.61％），infant pediatrics department（200 strains，accounting for 7.28％） and premature pediatrics department（179 strains， accounting for 6.52％）]，hematology oncology department （216 strains，accounting for 7.87％），cardio vascular medicine department（206 strains，accounting for 7.50％）. Gram-positive bacteria accounted for 72.80％，Gram-negative bacteria 24.21％， fugus 2.99％. Among Gram-positive bacteria，coagulase negative staphylococcus（1 414 strains）and Staphylococcus aureus（146 strains）were the most common. The resistance rate of the former to penicillin G，oxacillin and erythromycin was more than 80％， and that of the latter to penicillin G and erythromycin was more than 80％. Among Gram-negative bacteria，Klebsiella pneumoniae （183 strains） and Escherichia coli （172 strains） were the most common. The resistance rates of the former to ampicillin， piperacillin，ampicillin/sulbactam and cefazolin were more than 80％，and the latter to ampicillin and tetracycline were more than 80％. Among the fungus，Candida albicans（42 strains）and Candida parapsilosis（22 strains）were the most common，and the resistance rate to common antifungal drugs was less than 10％. CONCLUSIONS：The pathogens of bloodstream infection in the hospital are complex，mainly coagulase negative staphylococcus and K. pneumoniae，and the drug resistance is severe.

Application of CLSI EP12-A2 and EP15-A2 documents in the performance evaluation of Adenovirus IgM CLIA microparticles / 中华实验和临床病毒学杂志

Objective@#Application of Clinical and Laboratory Standards Institute evaluation protocols-12 approved guideline 2nd edition (CLSI EP12-A2) and EP15-A2 documents in the performance evaluation of Adenovirus IgM CLIA microparticles.@*Methods@#Referring to the EP15-A2 method , three samples of high and low concentration were selected. Each sample test was repeated 4 times one day for 5 days, and the total imprecision was calculated. Referring to the EP12-A2 method , samples of C50, C50-20% and C50+ 20% were prepared and repeated 40 times, to verify C50±20% bounds the C5~C95 interval. Compared with diagnostic accuracy criteria, the sensitivity and specificity were calculated. Compared with ELISA method , the concordance rate and Kappa value were calculated.@*Results@#The total imprecision CV (%) was less than 8%, lower than that announced by manufacturer. C50±20% concentration fall outside the C5~C95 interval. Compared with diagnostic accuracy criteria, the sensitivity was 100% (95%CI: 79.6%~100%), specificity was 97.8% (95%CI: 94.5%~99.1%), Kappa value was 0.871. Compared with ELISA method , the positive concordance rate was 66.7%(95%CI: 53.6%~77.7%), negative concordance rate was 97.4%(95%CI: 95.4%~98.5%)total concordance rate was 93.9%(95%CI: 91.6%~95.6%), Kappa value was 0.678.@*Conclusions@#The performance of Adenovirus IgM CLIA microparticles can meet clinical requirements.

Research development of human infection with H5N6 avian influenza virus / 军事医学

Avian influenza virus is a new recombinant virus , which can cause severe respiratory symptoms ,such as short course,acute disease,and a high mortality rate.The purpose of this paper was to summarize the current status of this virus in terms of its epidemiology ,genetic evolution and virulence .By introducing the advancement in the research of this subtype virus, we hope to provide data and evidence ,for effective surveillance and prevention of this virus .