Analysis of the Effcacy and Safety of Amivantamab in Non-small Cell Lung Cancer Patients with EGFR/MET Gene Abnormalities: A Single Center's Experience / 中国肺癌杂志

BACKGROUND@#Epidermal growth factor receptor (EGFR) and cellular-mesenchymal to epithelial transition factor (c-Met) are widely expressed on cancer cells. There is a synergistic effect of EGFR and HGF/c-Met pathways on proliferation, downstream activation of signal transduction and an additive effect. Studies show that combination of both signaling pathways could potentially be targeted in a synergistic fashion. Amivantamab, a bispecific monoclonal antibody targeting EGFR and c-Met, yielded robust and durable responses in a variety of clinicals trials. However, few researches have reported its efficacy in Chinese non-small cell lung cancer (NSCLC) patients. This study was conducted to evaluate the effectiveness and tolerance of Amivantamab in NSCLC patients with EGFR/MET gene abnormalities at Peking University Cancer Hospital.@*METHODS@#The study enrolled NSCLC patients who received Amivantamab in our hospital between August 2020 and December 2021, and analyzed the response, survival, and treatment-related adverse events.@*RESULTS@#Fifteen patients were enrolled in this research, and six of them received Amivantamab treatment and the other nine patients received Amivantamab plus Lazertinib treatment. The rates of partial response (PR), stable disease (SD), and progressive disease (PD) were 46.7% (7/15), 46.7% (7/15) and 6.7% (1/15), respectively. The overall response rate (ORR) and disease control rate (DCR) were 28.6% (2/7) and 100.0% (7/7) in seven patients with EGFR exon 20 insertion, respectively. The ORR and DCR were 40.0% (2/5) and 100.0% (5/5) in five post-osimertinib EGFR-mutant patients, respectively. After a median follow-up of 8.7 months, the median progression-free survival and overall survival were not reached. The most common treatment-related adverse events were rash (86.7%), paronychia (80.0%), and infusion-related reactions (60.0%), and most of them were graded as 1 to 2. Grade 3 to 4 adverse events included rash (33.3%), alanine aminotransferase elevation (13.3%), gamma-glutamyl transpeptidase elevation (13.3%), peripheral edema (6.7%), thromboembolism (6.7%), interstitial lung disease (6.7%), and thrombocytopenia (6.7%).@*CONCLUSIONS@#Amivantamab was effective in Chinese NSCLC patients with EGFR exon 20 insertion and post-Osimertinib EGFR-mutant patients, similar to the results of clinical trials conducted in western countries. Amivantamab was well tolerated and emphases should be put on adverse events such as rash, paronychia, and infusion-related reactions.

Epidemic characteristics and associated factors of pulmonary tuberculosis aggregation in school in Wuhan during 2017-2020 / 中国学校卫生

Objective@#To analyze the epidemiological characteristics and assoicated factors of tuberculosis (TB) aggregation in schools in Wuhan from 2017 to 2020, and to provide scientific basis for school based TB prevention and control strategies.@*Methods@#Questionnaire star was used to collect data on tuberculosis prevention and control in various schools in Wuhan. Multivariate logistic regression analysis was used to analyze the influencing factors of tuberculosis aggregation in schools.@*Results@#A total of 37 outbreaks of tuberculosis aggregation in schools were reported in Wuhan from 2017 to 2020, which involved 28 different schools, including 24 colleges and universities and 4 senior high schools, 176 cases were reported, among which 39 were positive for pathogens and 17 cases of rifampicin resistant, and the median duration of single cluster epidemic was 48 (28, 368) days, universities were more prone to cluster outbreaks than middle schools ( χ 2=75.27, P <0.01), the incidence in male was higher than that of in female in cluster outbreak ( χ 2=22.82, P =0.00). The results of multivariate Logistic regression analysis showed that boarding school ( OR =5.12), TB screening at school entry ( OR =3.27), etiology tracking and registrationin school ( OR =7.28), treatment and isolation of sick students on time ( OR =9.12), whether the dormitories and classrooms were often ventilated ( OR =4.97), and whether the management of school suspension and return was strictly implemented ( OR =4.68) were associated with the occurrence of TB cluster outbreak( P <0.05).@*Conclusion@#Schools should actively strive for policies and funding, strictly implement TB screening and physical examination for freshmen, as well as the management of contact tracing and registeration, targeted TB health education, guidance for teachers and students for cleaning, disinfection and hand hygiene, timely treatment and reporting of suspected symptoms, to prevent the occurrence of TB clustering outbreaks.

Delay in treatment and influencing factors of student tuberculosis patients in Wuhan from 2011 to 2018 / 中国学校卫生

Objective@#To understand delay in treatment student tuberculosis (TB) patients in Wuhan from 2011 to 2018, and to provide a reference for prevention and control measures of tuberculosis in schools.@*Methods@#The medical cases of students with tuberculosis in Wuhan recorded by the national tuberculosis management information system during 2011-2018 were analyzed for the delay and change trend of medical treatment of students with tuberculosis, and Logistic regression was used to analyze influencing factors.@*Results@#The median number of student TB patients seeking treatment in Wuhan was 9(3,21) days, and 51.14% of student TB patients were delayed. From 2011 to 2018, the overall delay rate of TB patients in students decreased slowly and then gradually increased, decrea sing from the highest rate (56.4%) in 2011 to the lowest one (45.6%) in 2014, and then gradually increased to 53.8% in 2018, there was no significant difference in the delay rate between the first and the second four years(χ2=2.84, P=0.09); The delay rate of different gender students was the same as that of the whole. The fluctuation of female students was slightly obvious, but the difference was not statistically significant(χ2=0.07, P>0.05); Among the students of different age groups, the delay rate of 13-18 years old was the lowest(χ2=87.23, P<0.01). The delay rate of 19-22 years old and university groups of different school levels showed a slow decline, while that of other age groups and other school level groups showed an overall upward trend. The results of multivariate logistic regression analysis showed that the main factors affecting the delay rate of medical treatment were the remote urban area(OR=1.84, 95%CI=1.56-2.16), the ethnic minorities (OR=2.73, 95%CI=1.46-5.09) and the age of 13-18(OR=0.57, 95%CI=0.33-1.00).@*Conclusion@#Delay in treatment of TB patients in Wuhan is not optimistic, with more than half of the students have delayed in treatment, the main factors that affect the high rate of TB patients’ treatment delay are the students in the far urban areas and ethnic minorities. It is very important to take targeted prevention and control measures to guide the students to actively seek medical treatment according to the time, the place and the person.

Modeling and analysis of triage in disaster rescue action executed by mobile medical unit using stochastic Petri net / 军事医学

Objective To analyze the process of triage in disaster rescue action performed by a mobile medical unit so that the rescue process can be improved , the efficiency of rescue enhanced , and the decision on health service in rescue action is supported.Methods The process of triage in disaster rescue action was modeled based on stochastic Petri net while the performance of the model was analyzed quantitatively .Results and Conclusion The critical factor which affects the efficiency of rescue work is obtained by analyzing the performance of the model .

Structural modeling and dynamic evolution analysis of hypoxia response networks / 军事医学

Objective To construct an executable model of a hypoxia response network (HRN) and to analyze the dynamic evolution mechanism of an HRN including randomness as well as concurrency based on computer simulation. Methods Specific evolution rules and Gillespie algorithm were adoped to study the dynamic evolution of the structural model based on the construction of a structural model of an HRN using stochastic Petri net ( SPN ) .Results Dynamic evolution laws of an HRN were obtained and the simulation results were consistent with laboratory results in response to descript switch-like behavior of an HRN .Conclusion A visualization model of the HRN can be achieved using SPN method.Simulation results achieved by executing the model based on stochastic simulation using specific kinetic parameters can serve as a nice complement to traditional laboratory results , which can help shed light on the structure and function characteristics of an HRN.

Effect of modern information technology on military medical evacuation / 军事医学

With the great progress in information technology , military medical evacuation has become an extremely important research topic about any information-based war.Thus, this paper aims to analyze the application and effect of modern information technology in military medical evacuation .This paper starts with the developments of modern military medical evacuation and the key areas of military medical evacuation research .Then, the effect of modern information technology on military medical evacuation is discussed regarding the search for and rescue of the wounded , medical treatment of the wounded ,and command and control system of military medical evacuation .Finally, the key technologies for the above tasks are introduced .

Construction of high altitude military medicine digital library based on Web 3 .0 / 军事医学

Objective To establisha high altitude military medicine digital library ( HAMMDL) in order to integrate high altitude military medicine ( HAMM ) digital resources and promote transformation of HAMM technology to health service application.Methods The solution of Web 3.0-basedHAMMDL was proposed.Ontology, the metadata and Wiki paradigm were used to manage and present resources , while the Model-View-Controller pattern was used in software design .Results Based on analysis of the functional requirements and key techniques of HAMMDL , design principles were proposed the hierarchical software architecture pattern was designed , the software supporting technology was provided and the construction method of HAMM ontologies was discussed .Conclusion With the synthesized application of relative technologies , smart utilization and socialized content management pattern of HAMM digital resources can be achieved .

Investigation Research on the Correlation between the Compliance of Using High Altitude Special Medicines and Incidence of Mountain Sickness / 中国药房

OBJECTIVE:To provide reference for health service support at high altitude area. METHODS:375 servicemen who rapidly entered high altitude area were investigated by questionnaire in 2013 to investigate the compliance of using high alti-tude special medicines and incidence of mountain sickness and analyze its correlation. RESULTS:375 questionnaires were distribut-ed and 324 questionnaires were collected with effective response rate of 86.4%. The utilization rate of Multivitamin tablet,Skin cream and Lip balm for high altitude area were 30.9%,13.3% and 40.1% respectively. The compliance of using high altitude spe-cial medicines had effect on the incidence of related mountain sickness. The incidence of mountain sickness of people who followed the physician’s instructions was significantly lower than those who did not. The difference was statistically significant(P<0.05). CONCLUSIONS:High altitude special medicines can relieve and prevent the mountain sickness. But the overall compliance of us-ing high altitude special medicines was not ideal. The education of high altitude special medicines should be strengthened,and dos-age forms and medicine instruction should be enhanced to improve its compliance and play better protective effect.

Expression and clinical significance of CN-Ⅱ in non-small cell lung cancer tissues / 中国肿瘤临床

Objective:Cytosolic 5'-nucleotidase (CN-Ⅱ), a nucleotide kinase, exhibits both 5'-nucleotidase and nucleoside phos-photransferase activities. Abnormal CN-Ⅱexpression may be correlated with the resistance of nucleoside analogs in anticancer drugs. This study was designed to investigate CN-Ⅱexpression in human non-small cell lung cancer (NSCLC) tissues and its correlation with the clinicopathological parameters as well as the prognosis of patients treated with gemcitabine. Methods:Immunohistochemistry was used to detect CN-Ⅱexpression in 116 cases of paraffin-embedded NSCLC samples. The correlations with the clinicopathological pa-rameters and the response to gemcitabine chemotherapy of CN-Ⅱwere analyzed through the Chi-square test. Log-rank test was used to determine whether or not CN-Ⅱexpression is correlated with the overall survival of patients. Results:The positive rate of CN-Ⅱwas 53.4% in 116 NSCLC tissues. No significant correlation existed between CN-Ⅱ expression and the clinicopathological parameters. Among the 67 of the 116 patients who received gemcitabine chemotherapy, those with tumor progression (positive rate of 57.6%) exhib-ited higher CN-Ⅱexpression than those with therapeutic efficacy (positive rate of 30.4%, P=0.008) and disease-control chemotherapy (positive rate of 36.7%, P=0.013). The progression-free survival was 4.5 and 5.5 months in the CN-Ⅱ-positive and CN-II-negative groups, respectively, with significant differences (95%CI:4.452 to 6.148, P=0.041). Correspondingly, the overall survival was 9.5 and 11.0 months in the two groups (95%CI:8.667 to 13.333, P=0.282). Conclusion:CN-Ⅱmay be a prognostic factor for gemcitabine chemotherapy in NSCLC patients.