Detection of Rare Mutations in EGFR-ARMS-PCR-Negative Lung Adenocarcinoma by Sanger Sequencing

PURPOSE: This study aimed to identify potential epidermal growth factor receptor (EGFR) gene mutations in non-small cell lung cancer that went undetected by amplification refractory mutation system-Scorpion real-time PCR (ARMS-PCR). MATERIALS AND METHODS: A total of 200 specimens were obtained from the First Affiliated Hospital of Guangzhou Medical University from August 2014 to August 2015. In total, 100 ARMS-negative and 100 ARMS-positive specimens were evaluated for EGFR gene mutations by Sanger sequencing. The methodology and sensitivity of each method and the outcomes of EGFR-tyrosine kinase inhibitor (TKI) therapy were analyzed. RESULTS: Among the 100 ARMS-PCR-positive samples, 90 were positive by Sanger sequencing, while 10 cases were considered negative, because the mutation abundance was less than 10%. Among the 100 negative cases, three were positive for a rare EGFR mutation by Sanger sequencing. In the curative effect analysis of EGFR-TKIs, the progression-free survival (PFS) analysis based on ARMS and Sanger sequencing results showed no difference. However, the PFS of patients with a high abundance of EGFR mutation was 12.4 months [95% confidence interval (CI), 11.6−12.4 months], which was significantly higher than that of patients with a low abundance of mutations detected by Sanger sequencing (95% CI, 10.7−11.3 months) (p < 0.001). CONCLUSION: The ARMS method demonstrated higher sensitivity than Sanger sequencing, but was prone to missing mutations due to primer design. Sanger sequencing was able to detect rare EGFR mutations and deemed applicable for confirming EGFR status. A clinical trial evaluating the efficacy of EGFR-TKIs in patients with rare EGFR mutations is needed.

Effect of postoperative diet nursing with patient involved on nutritional status of the patients with rectal cancer / 中华临床营养杂志

Objective To explore the effect of postoperative diet nursing with patient invovled on nutri-tional status of the patients with rectal cancer. Methods A total of 88 patients with rectal cancer were randomly divided into observation group and control group, with 44 patients in each. The patients in the control group received routine nursing, and the patients in the observation group were involved in postoperative diet care on the basis of routine nursing. The anal exhaust time, defecation time, parenteral nutrition supply time, time of get out of bed, length of stay, defecation function score, and preoperative and one month postoperative prealbumin (PA), albumin (ALB), total protein (TP) and body mass index, the incidence of complications during hospitalization, the quality of life of one month after surgery were compared between the two groups. Results The anal exhaust time, defecation time, parenteral nutrition supply time, time of get out of bed, length of stay, defecation function score were lower in the observation group than in the control group ( P<0. 05) . There was no significant difference in PA, ALB, TP and BMI between the two groups ( P>0. 05) . At one month after surgery, there were no significant changes in the nutritional indexes of the observation group ( P>0. 05) , while those in the control group significantly decreased ( P<0. 05) , and the levels of PA, ALB, TP and BMI were higher in the observation group than in the control group ( P<0. 05) . The overall incidence of complications in the observation group was 13. 64%, which was lower than 31. 82% in the control group ( P<0. 05) . The overall score of postoperative quality of life was (84. 08±2. 31) points in the observation group, which was higher than (81. 28±2. 05) points in the control group (P<0. 05). Conclusions With the patients involved in rectal cancer postoperative diet care, patient’s prefer can be fully used to promote the patient’s post-operative intake, the required nutrition can be supplemented, postoperative recovery can be accelerated, the in-cidence of postoperative complications can be reduced and the improvement of quality of life can be promoted, thus it is worth promoting.

The inhibitory effects of hydrogen sulfide on the expression of NF-κBp65 in the treatment of atherosclerosis / 中国生化药物杂志

Objective Established the model of atherosclerosis (AS) cells.To explore Hydrogen sulfide donor (NaHS) in atherosclerosis model by oxidized low density lipoprotein (ox-LDL) induced of the NF-κBp65 factor expression.MethodsApplication concentration of 80ug/mL ox-LDL induced liver cancer cell HepG2 cells AS model, set up a control group and treatment group (10μmol/L、15μmol/L、30μmol/L、100μmol/L、500μmol/L、1000μmol/L), to observe hydrogen sulfide this cell model of the cell proliferation activity and the determination of TNF-α and IL-10 factors of the expression, through the RT-qPCR and Western-blot method for determining the expression of the NF-κBp65 expression situation.ResultsAt 24h the ox-LDL induced a large number of red-stained granules, free cholesterol and total cholesterol in HepG2 cells increased, and free cholesterol content was more than 50% of total cholesterol in HepG2 cells, indicating that AS cell model was established successfully.CCK8 method of cell proliferation activity test results showed that the NaHS in 30umol/L, duration of 48 h when the largest cell proliferation activity.The TNF-α cytokine by ELISA method for testing the results showed that the treatment group in 15umol/L and 30umol/L concentration compared with the control group decreased significantly (P<0.05), while the expression of IL-10 increased significantly (P<0.05), with statistical significance.RT-qPCR and Western-blot method results show that the NF-κBp65 factor expression significantly reduced compared with control group (P<0.05), with statistical significance.ConclusionH2S play a protective role in atherosclerotic lesions by reducing the NF-κBp65 factor expression, and provide a valuable reference for the development and clinical treatment of H2S donor-type drugs.

Effects of Heishun Tablets Combined with Rheum palmatum on the Pharmacokinetics of Hypaconitine in Rats / 中国药房

OBJECTIVE:To study the effects of Heishun tablets combined with Rheum palmatum on the pharmacokinetics of hypaconitine in rats. METHODS:Rats were randomly divided into single drug group(Heishun tablets decoction)and drug combi-nation group(Heishun tablets-R. palmatum mixture decoction),with 18 rats in each group. They were given relevant drugs intragas-trically,by 10 g(medicinal materials)/kg of Heishun tablets. 0.3 ml blood samples were collected before(0 h)and 0.083,0.167, 0.333,0.5,0.75,1,1.5,2,3,4,6,8,10 h after medication with 6 rats at each time point,respectively. The blood concentra-tion of hypaconitine was determined by HPLC-MS using palmatine hydrochloride as internal standard. DAS 2.0.1 software was used to calculate pharmacokinetic parameters. RESULTS:The linear range of hypaconitine was 0.102 4-100 ng/ml (r=0.998 7),and the limit of quantification was 0.1 ng/ml. The pharmacokinetic parameters of single drug group vs. drug combination group were as follows as tmax of (0.50 ± 0.086) h vs. (0.75 ± 0.132)h;t1/2 of (9.967 ± 1.123) h vs. (3.708 ± 0.507) h;AUC0-10 h of (26.087 ± 0.672) μg·h/L vs.(6.516 ± 1.135) μg·h/L;cmax of (6.124 ± 2.312) μg/L vs. (1.592 ± 0.051) μg/L. Compared with single drug group,t1/2,AUC0-10 h and cmax of hypaconitine were decreased in drug combination group,with statistical significance (P<0.05). CONCLUSIONS:R. palmatum can inhibit the absorption of hypaconitine in rats,and speed up the elimination of it in rats.

Use of Antibacterials in Pediatric Inpatients Before and After the Introduction of Guidelines for Clinical Use of Antibacterials / 中国药房

OBJECTIVE:To evaluate the practice of the Guidelines for Clinical Use of Antibacterials in our hospital. METHODS: 200 medical records of pediatric inpatients who had been discharged from our hospital were randomly sampled between June to December in 2003 (before intervention) and between June to December in 2005 (after intervention) for a statistical analysis in respect of the use of antibacterials in which the pre-designed questionaire on the contrast analysis of clinical application of Antibacterials were filled. RESULTS: After the introduction of the guidelines, the rate of using antibacterials decreased by 17.50%, the rate of combined use of antibacterials decreased by 32.10%, the rate of rational use increased by 22.05%, the rate of susceptibility test increased by 11.84%. The Drug Utilization Index for all the antibacterials was no more than 1 (≤1). CONCLUSION: The use of antibacterials in pediatric inpatients in our hospital tends to be rational, but the rational administration of antibacterials remains to be further improved.