Objective To analyze clinical characteristics and therapeutic strategies for patients with Trichosporon asahii(T.asahii)bloodstream infection(BSI),and provide reference for clinical diagnosis and treatment for such disease.Methods Diagnosis and treatment process of a patient with T.asahii BSI were reported.China National Knowledge Infrastructure(CNKI),Wanfang,PubMed,and Web of Science databases were retrieved using key-words:"Trichosporon asahii"and"bloodstream infection".Patients'age,gender,underlying diseases,immune status,treatment,and clinical outcome as well as antimicrobial susceptibility testing results of T.asahii were ana-lyzed retrospectively.Results The leukemia patient developed T.asahii BSI during chemotherapy,and showed clinical improvement after treatment with fluconazole+flucytosine.A total of 44 cases(43 from literature plus this index case)were analyzed.Among these cases,28 were males,the median age was 54.5 years old.The underlying diseases were predominantly hematological diseases.Catheter,urinary tract,and skin were identified as concurrent culture-positive sites.Azoles exhibited good antimicrobial activity in vitro,with voriconazole showing the strongest activity and associated with significantly higher survival rates.Under the guidance of antimicrobial susceptibility tes-ting results,patients with fluconazole treatment had a higher survival rate.At minimum inhibitory concentrations(MICs)of 4-8 μg/mL of fluconazole,fluconazole combined with other agents was predominantly required.Am-photericin B demonstrated good in vitro activity,but the overall survival rate of patients was low when amphotericin B was used as monotherapy without azoles.Catheters removal,surgical intervention,and neutrophil recovery were influencing factors for enhanced survival rates.Conclusion BSI caused by T.asahii primarily occurs in patients with hematological diseases,with neutropenia being a high-risk factor.Infection sites at catheter,urinary tract,and skin may be infection sources.Clearing the source of infection and promoting the recovery of neutrophils can help to improve survival rates of patients.For voriconazole-intolerant patients,fluconazole monotherapy or in combination with flucytosine/amphotericin B can be used alternatively based on antimicrobial susceptibility testing results.

Booster vaccinations are highly recommended in combating the SARS-CoV-2 Omicron variant and its subvariants. However, the optimal booster vaccination strategies and related immune mechanisms with different prior vaccinations are under-revealed. In this study, we systematically evaluated the immune responses in mice and hamsters with different prime-boost regimens before their protective efficacies against Omicron were detected. We found that boosting with Ad5-nCoV, S_WT-2P or S_Omicron-6P induced significantly higher levels of neutralization activities against Omicron variants than CoronaVac and ZF2001 by eliciting stronger germinal center (GC) responses. Specifically, S_Omicron-6P induced even stronger antibody responses against Omicron variants in CoronaVac and Ad5-nCoV-primed animals than non-Omicron-specific vaccines but with limited differences as compared to Ad5-nCoV and S_WT-2P. In addition, boosting with a specific vaccine has the potential to remodel the existing immune profiles. These findings indicated that adenovirus-vectored vaccines and mRNA vaccines would be more effective than other types of vaccines as booster shots in combating Omicron infections. Moreover, the protective efficacies of the vaccines in booster vaccinations are highly related to GC reactions in secondary lymphatic organs. In summary, these findings provide timely important information on prime-boost regimens and future vaccine design.

Objective To analyze clinical characteristics and therapeutic strategies for patients with Trichosporon asahii(T.asahii)bloodstream infection(BSI),and provide reference for clinical diagnosis and treatment for such disease.Methods Diagnosis and treatment process of a patient with T.asahii BSI were reported.China National Knowledge Infrastructure(CNKI),Wanfang,PubMed,and Web of Science databases were retrieved using key-words:"Trichosporon asahii"and"bloodstream infection".Patients'age,gender,underlying diseases,immune status,treatment,and clinical outcome as well as antimicrobial susceptibility testing results of T.asahii were ana-lyzed retrospectively.Results The leukemia patient developed T.asahii BSI during chemotherapy,and showed clinical improvement after treatment with fluconazole+flucytosine.A total of 44 cases(43 from literature plus this index case)were analyzed.Among these cases,28 were males,the median age was 54.5 years old.The underlying diseases were predominantly hematological diseases.Catheter,urinary tract,and skin were identified as concurrent culture-positive sites.Azoles exhibited good antimicrobial activity in vitro,with voriconazole showing the strongest activity and associated with significantly higher survival rates.Under the guidance of antimicrobial susceptibility tes-ting results,patients with fluconazole treatment had a higher survival rate.At minimum inhibitory concentrations(MICs)of 4-8 μg/mL of fluconazole,fluconazole combined with other agents was predominantly required.Am-photericin B demonstrated good in vitro activity,but the overall survival rate of patients was low when amphotericin B was used as monotherapy without azoles.Catheters removal,surgical intervention,and neutrophil recovery were influencing factors for enhanced survival rates.Conclusion BSI caused by T.asahii primarily occurs in patients with hematological diseases,with neutropenia being a high-risk factor.Infection sites at catheter,urinary tract,and skin may be infection sources.Clearing the source of infection and promoting the recovery of neutrophils can help to improve survival rates of patients.For voriconazole-intolerant patients,fluconazole monotherapy or in combination with flucytosine/amphotericin B can be used alternatively based on antimicrobial susceptibility testing results.

Objective To explore the predictive value of intradermal test on anaphylaxis induced by ceftriaxone sodium retrospectively. Methods Medical records of patients who underwent intradermal test before ceftriaxone sodium treatment in the First Hospital of Quanzhou Affiliated to Fujian Medical University from November 2013 to June 2015 were collected with random equidistant sampling and analyzed retrospectively. The patients were divided into the positive intradermal test group and the negative intradermal test group according to the results of intradermal test. The situation of medication in patients in the positive intradermal test group and the ages,onset time of anaphylaxis,clinical manifestations,and outcomes in patients with allergic reactions after ceftriaxone sodium treatment in the negative intradermal test group were analyzed,respectively. The difference between the incidence of anaphylactic reactions after ceftriaxone sodium treatment in the negative intradermal test group and the hypothetical incidence of anaphylactic reactions after ceftriaxone sodium treatment without intradermal test were calculated according to Poisson distribution principle. Results A total of 943 patients were enrolled in the study,including 30 patients (3.18%)in the positive intradermal test group and 913 patients (96.82%)in the negative intradermal test group. Neither the positive and negative control tests nor the provocative tests were performed in patients in the positive intradermal test group and no allergic reactions appeared in these patients in the following treatments with cefoperazone sodium and sulbactam sodium, ceftizoxime, azithromycin, levofloxacin, amoxicillin sulbactam, teicoplanin, and moxifloxacin, respectively. Ten (1.1%)of 913 patients in the negative intradermal test group developed anaphylaxis during the use of ceftriaxone sodium,the incidence of anaphylactic reaction was 1.10%,in whom male and female were 5 respectively,aged 10 months to 52 years,6 patients were 10 years old. Of the 10 patients with anaphylactic reactions,4 developed within 20 minutes and 6 developed 4 to 10 days,respectively after the administration. The main symptoms were rash and pruritus,which improved after drug withdrawal and symptomatic treatments. There were no significant difference (u＝0.288,P＝0.77)between the incidence of anaphylactic reactions in the negative intradermal test group (1.1%)and the hypothetical incidence of ceftriaxone sodium-induced anaphylactic reactions without intradermal test (1.0%). Conclusion The incidence of anaphylaxis did not decrease significantly in patients with negative intradermal test,suggesting that the intradermal test has no obvious value to predict the occurrence of ceftriaxone sodium-induced anaphylaxis.

Objective To explore the predictive value of intradermal test on anaphylaxis induced by ceftriaxone sodium retrospectively. Methods Medical records of patients who underwent intradermal test before ceftriaxone sodium treatment in the First Hospital of Quanzhou Affiliated to Fujian Medical University from November 2013 to June 2015 were collected with random equidistant sampling and analyzed retrospectively. The patients were divided into the positive intradermal test group and the negative intradermal test group according to the results of intradermal test. The situation of medication in patients in the positive intradermal test group and the ages,onset time of anaphylaxis,clinical manifestations,and outcomes in patients with allergic reactions after ceftriaxone sodium treatment in the negative intradermal test group were analyzed,respectively. The difference between the incidence of anaphylactic reactions after ceftriaxone sodium treatment in the negative intradermal test group and the hypothetical incidence of anaphylactic reactions after ceftriaxone sodium treatment without intradermal test were calculated according to Poisson distribution principle. Results A total of 943 patients were enrolled in the study,including 30 patients (3.18%)in the positive intradermal test group and 913 patients (96.82%)in the negative intradermal test group. Neither the positive and negative control tests nor the provocative tests were performed in patients in the positive intradermal test group and no allergic reactions appeared in these patients in the following treatments with cefoperazone sodium and sulbactam sodium, ceftizoxime, azithromycin, levofloxacin, amoxicillin sulbactam, teicoplanin, and moxifloxacin, respectively. Ten (1.1%)of 913 patients in the negative intradermal test group developed anaphylaxis during the use of ceftriaxone sodium,the incidence of anaphylactic reaction was 1.10%,in whom male and female were 5 respectively,aged 10 months to 52 years,6 patients were 10 years old. Of the 10 patients with anaphylactic reactions,4 developed within 20 minutes and 6 developed 4 to 10 days,respectively after the administration. The main symptoms were rash and pruritus,which improved after drug withdrawal and symptomatic treatments. There were no significant difference (u＝0.288,P＝0.77)between the incidence of anaphylactic reactions in the negative intradermal test group (1.1%)and the hypothetical incidence of ceftriaxone sodium-induced anaphylactic reactions without intradermal test (1.0%). Conclusion The incidence of anaphylaxis did not decrease significantly in patients with negative intradermal test,suggesting that the intradermal test has no obvious value to predict the occurrence of ceftriaxone sodium-induced anaphylaxis.

OBJECTIVE:To establish a method for the uncertainty evaluation of determining content of Lamivudine tablets by HPLC. METHODS:HPLC was established to determine the mathematical model of Lamivudine tablets contents,analyze the uncer-tainty sources in detail and evaluate each uncertainty components and combined uncertainty to obtain the expanded uncertainty. RE-SULTS:Uncertainty of Lamivudine tablets contents determined by HPLC was mainly from reference purity,weighing standard and glassware tolerance. Standard uncertainty was 0.21% and expanded uncertainty was 0.42%. The range of content determination was (99.76 ± 0.42)%,k=2. CONCLUSIONS:The method is suitable for uncertainty evaluation of Lamivudine tablets by HPLC,and provides reference for the quality control in laboratory and objective evaluation of Lamivudine tablets.