One case of non-small cell lung adenocarcinoma patient developed severe liver injury(ALT 319.6 U·L-1,AST 103.3 U·L-1,ALP 586.8 U·L-1,DBIL 104.0 μmol·L-1,TBIL 172.3 μmol·L-1,IBIL 68.3 μmol·L-1),after multiple cycles of chemotherapy combined with camrelizumab.Subsequently,fever and jaundice on the face and sclera were noticed.Based on the previous medication,the RUCAM scale and the R value was used to evaluated the symptons,suggested a high likelihood of drug-induced cholestatic liver injury caused by camrelizumab.Clinical pharmacist proposed drug therapy recommendations for liver injury treatment and the selection of protective drugs.The physician adopted some of these therapeutic suggestions,and the patient was treated with methylprednisolone and hepatoprotective drugs.Although there was a temporary improvement in transaminase levels,bilirubin levels continued to rise.Later,the patient asked to discharge and passed away at home.Immune-related cholestatic liver injury caused by camrelizumab is insensitive to glucocorticoid therapy,clinicians should promptly consider adding immunosuppressants to enhance prognosis.Literature studies have shown that dual-molecule plasma adsorption system sequential plasma exchange has a certain therapeutic effect on immune-related cholestatic liver injury.

One case of non-small cell lung adenocarcinoma patient developed severe liver injury(ALT 319.6 U·L-1,AST 103.3 U·L-1,ALP 586.8 U·L-1,DBIL 104.0 μmol·L-1,TBIL 172.3 μmol·L-1,IBIL 68.3 μmol·L-1),after multiple cycles of chemotherapy combined with camrelizumab.Subsequently,fever and jaundice on the face and sclera were noticed.Based on the previous medication,the RUCAM scale and the R value was used to evaluated the symptons,suggested a high likelihood of drug-induced cholestatic liver injury caused by camrelizumab.Clinical pharmacist proposed drug therapy recommendations for liver injury treatment and the selection of protective drugs.The physician adopted some of these therapeutic suggestions,and the patient was treated with methylprednisolone and hepatoprotective drugs.Although there was a temporary improvement in transaminase levels,bilirubin levels continued to rise.Later,the patient asked to discharge and passed away at home.Immune-related cholestatic liver injury caused by camrelizumab is insensitive to glucocorticoid therapy,clinicians should promptly consider adding immunosuppressants to enhance prognosis.Literature studies have shown that dual-molecule plasma adsorption system sequential plasma exchange has a certain therapeutic effect on immune-related cholestatic liver injury.

Background::Genetic variants of dopaminergic transcription factor-encoding genes are suggested to be Parkinson’s disease (PD) risk factors; however, no comprehensive analyses of these genes in patients with PD have been undertaken. Therefore, we aimed to genetically analyze 16 dopaminergic transcription factor genes in Chinese patients with PD.Methods::Whole-exome sequencing (WES) was performed using a Chinese cohort comprising 1917 unrelated patients with familial or sporadic early-onset PD and 1652 controls. Additionally, whole-genome sequencing (WGS) was performed using another Chinese cohort comprising 1962 unrelated patients with sporadic late-onset PD and 1279 controls.Results::We detected 308 rare and 208 rare protein-altering variants in the WES and WGS cohorts, respectively. Gene-based association analyses of rare variants suggested that MSX1 is enriched in sporadic late-onset PD. However, the significance did not pass the Bonferroni correction. Meanwhile, 72 and 1730 common variants were found in the WES and WGS cohorts, respectively. Unfortunately, single-variant logistic association analyses did not identify significant associations between common variants and PD. Conclusions::Variants of 16 typical dopaminergic transcription factors might not be major genetic risk factors for PD in Chinese patients. However, we highlight the complexity of PD and the need for extensive research elucidating its etiology.

Objective:To explore the role of using laboratory critical values for active monitoring of serious adverse drug reactions (SADRs) in pharmacovigilance.Methods:Xingtai Central Hospital was used as a sentinel hospital. The reports containing critical value in blood routine, blood biochemistry, blood gas analysis, and coagulation function from July 2022 to December 2022 were collected by the laboratory information system in the hospital. The electronic medical records of patients involved in the reports were reviewed, and the correlation between therapeutic drugs and the critical values was evaluated. The critical values related to adverse drug reactions (ADRs) and SADRs, and the suspicious drugs were analyzed by descriptive statistics. The occurrence of ADRs and SADRs in outpatients/emergency patients and hospitalized patients were compared.Results:A total of 1 597 reports containing critical values were included in the analysis. In these reports, 174 (10.90%) were judged to be related to ADRs, of which 68 (39.1%) were related to SADRs. The proportion of reports containing critical values in the Inpatient Department was significantly higher than that in the Outpatient/Emergency Department [0.39% (1 114/288 541) vs. 0.16% (483/307 176), P<0.001]; the proportion of reports related to ADR in all laboratory reports of the Outpatient/Emergency Department was significantly higher than that of the Inpatient Department [14.29% (69/483) vs. 9.43% (105/1 114), P=0.004]; the proportion of reports involving SADRs in those involving ADRs [31.88% (22/69) vs. 43.81% (46/105)] and that in all reports [4.55% (22/483) vs. 4.13% (46/1 114)] both were similar between Outpatient/Emergency Department and Inpatient Department, and the differences were not statistically significant (all P>0.05). Six-eight reports of SADR involved 80 critical values, and the top 3 were leukopenia (mainly involving anticancer drugs), coagulation dysfunction (mainly involving anticoagulants) and electrolyte disorder (mainly involving antihypertensive drugs), some of which were induced by medication errors or improper drug use. Conclusions:Reporting laboratory critical values can effectively do some help in implement of active monitoring of SADRs in blood cells, blood biochemistry and coagulation function caused by drugs, which is conducive to the timely detection of SADRs in outpatient/emergency and hospitalized patients, as well as serious adverse events caused by medication errors and inappropriate treatments.

Objective:To explore the role of using laboratory critical values for active monitoring of serious adverse drug reactions (SADRs) in pharmacovigilance.Methods:Xingtai Central Hospital was used as a sentinel hospital. The reports containing critical value in blood routine, blood biochemistry, blood gas analysis, and coagulation function from July 2022 to December 2022 were collected by the laboratory information system in the hospital. The electronic medical records of patients involved in the reports were reviewed, and the correlation between therapeutic drugs and the critical values was evaluated. The critical values related to adverse drug reactions (ADRs) and SADRs, and the suspicious drugs were analyzed by descriptive statistics. The occurrence of ADRs and SADRs in outpatients/emergency patients and hospitalized patients were compared.Results:A total of 1 597 reports containing critical values were included in the analysis. In these reports, 174 (10.90%) were judged to be related to ADRs, of which 68 (39.1%) were related to SADRs. The proportion of reports containing critical values in the Inpatient Department was significantly higher than that in the Outpatient/Emergency Department [0.39% (1 114/288 541) vs. 0.16% (483/307 176), P<0.001]; the proportion of reports related to ADR in all laboratory reports of the Outpatient/Emergency Department was significantly higher than that of the Inpatient Department [14.29% (69/483) vs. 9.43% (105/1 114), P=0.004]; the proportion of reports involving SADRs in those involving ADRs [31.88% (22/69) vs. 43.81% (46/105)] and that in all reports [4.55% (22/483) vs. 4.13% (46/1 114)] both were similar between Outpatient/Emergency Department and Inpatient Department, and the differences were not statistically significant (all P>0.05). Six-eight reports of SADR involved 80 critical values, and the top 3 were leukopenia (mainly involving anticancer drugs), coagulation dysfunction (mainly involving anticoagulants) and electrolyte disorder (mainly involving antihypertensive drugs), some of which were induced by medication errors or improper drug use. Conclusions:Reporting laboratory critical values can effectively do some help in implement of active monitoring of SADRs in blood cells, blood biochemistry and coagulation function caused by drugs, which is conducive to the timely detection of SADRs in outpatient/emergency and hospitalized patients, as well as serious adverse events caused by medication errors and inappropriate treatments.