Summary of the Best Evidence for the Evaluation and Management of Chemotherapy-Related Nausea and Vomiting in Cancer Patients

Objective: To summarize the best evidence for the evaluation and management of chemotherapy-related nausea and vomiting in cancer patients, so as to promote the standardized management of chemotherapy-related nausea and vomiting in cancer patients. Methods: A computer search was conducted for all evidence on chemotherapy-associated nausea and vomiting interventions, including guidelines, expert consensus, best clinical practice information booklet, recommended practice, evidence summary, and systematic review. The search period is from April 30, 2022. After the literature quality evaluation, the evidence extraction and summary of the literature meeting the quality standards. Results: A total of 16 literatures were included, including 9 guidelines, 5 systematic reviews and 2 expert consensus papers. 46 pieces of best evidence on the assessment and management of chemotherapy related nausea and vomiting in cancer patients were summarized, including 6 aspects including risk assessment and management, non-drug management, drug management, multidisciplinary cooperation, education and training, and health education. Conclusion: This study summarized the current best evidence on the assessment and management of chemotherapy-related nausea and vomiting in cancer patients. Clinical staff should apply evidence according to specific clinical scenarios, professional skills and patients’ wishes in order to reduce the degree and incidence of chemotherapy-related nausea and vomiting in cancer patients and improve the quality of care.

Distinct and relatively mild clinical characteristics of SARS-CoV-2 BA.5 infections against BA.2

Dear Editor,The global pandemic of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron variant has resulted in its continuous evolution and the emergence of numerous subvariants of Omicron(https://gisaid.org/).Currently,possibly owing to the increased evasion of neutralizing antibodies elicited by previous infection and vaccination and the higher transmissibility,the BA.5 variant has replaced BA.2 variant and dominated the pandemic.

Significant histological changes are not rare in indeterminate‐phase chronic hepatitis B patients with hepatitis B e antigen‐negative and normal alanine aminotransferase levels

Background&Objectives:The degree of liver injury in indeterminate chronic hepatitis B(CHB)infection patients with Hepatitis B e antigen(HBeAg)‐negative and persistently normal alanine aminotransferase(PNALT)levels is yet unclear.Therefore,we aimed to assess liver histological changes in such patients by liver biopsy and explore possible predictors.Methods:Overall,711 HBeAg‐negative CHB patients with PNALT levels who underwent liver biopsy from January 2017 to June 2022 were included in this retrospective study.The relationships between histological changes and predictors were assessed by smooth curve fitting and multivariate logistic regression analysis models.Data were also analyzed using American Association for the Study of Liver Disease(AASLD)modified alanine aminotransferase(ALT)criteria.Results:The proportion of significant histological changes in the indeterminate phase was higher than that in the inactive phase(53.97%vs.41.33%).The adjusted odds ratios(aORs)of significant necroinflammation and histological changes for the indeterminate phase were 2.05 and 1.43,respectively,when compared with the inactive phase by multivariate logistic regression analyses.Significant histological changes in the‐phase were positively associated with age,ALT,Aspartate aminotransferase(AST),Hepatitis B surface antigen(HBsAg),and Hepatitis B virus(HBV)DNA levels but negatively correlated with platelet(PLT)levels.HBV DNA≥5 log10 U/L and PLT<200�109/L were independent predictive factors for assessing histological changes in indeterminate‐phase patients.Similar analysis findings were obtained using the two sets of modified ALT criteria.Conclusions:Significant histological changes are not rare in indeterminatephase CHB patients and are higher than in the inactive phase,regardless of the ALT criteria.Histological investigation is strongly suggested for intermediate stage patients with HBV DNA>5 log10 U/L or PLT<200�109/L and antiviral therapy should be considered for such patients.