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Objective:To establish a high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of voliconazole (VRC), posaconazole (PCZ), and linazolam (LNZ) in human serum.Methods:This study is a methodological validation by LC-MS/MS. The blood concentration results of VRC, PCZ, and LNZ in our hospital′s anti-infection patients were collected. Voriconazole, Posaconazole, and Linezolid were accurately weighed and prepared. Linezolid-[2H3] was used as the internal standard. After gradient elution on the ACE PFP column, the residuals were analyzed by LC-MS/MS in the positive electrospray ionization mode and multiple reaction monitor (MRM) mode. The method′s linearity, precision, lower limit of detection, and recovery rate were validated according to standard guidelines.Results:The linear correlation coefficient ( r) of the standard curve was above 0.99 ( r>0.99). The linear range of VRC and PCZ were 0.10 mg/L~10.00 mg/L, and the lower limit of detection were 0.01 mg/L. The linear range of LNZ was 0.50 mg/L~50.00 mg/L, and the lower limit of detection was 0.05 mg/L. The recoveries of VRC, PCZ and LNZ were 90.96%-103.18%, 91.84%-99.17%, and 97.04%-100.41%, respectively. Intra-and inter-batch precision (% CV) for VRC were less than 8.30%. Intra-and inter-batch precision (% CV) for PCZ was less than 9.78%. Intra-and inter-batch precision (% CV) for LNZ was less than 7.14%. Drug concentrations in 155 cases of VRC, 44 cases of PCZ, and 59 cases of LNZ were detected. Conclusion:We have established an LC-MS/MS method for the rapid, accurate, highly specific determination of VRC, PCZ, and LNZ concentrations in human serum. This method is suitable for analyzing large clinical sample sets.
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Objective To explore value of hemogram detection in diagnosis of leukemia .Methods 1 480 cases of common leuke-mia patients were selected from 1979 to 2013 ,and thier smears were checked again referring to the 2008 WHO morphology criteria . The detection situations and the characteristics of blood parameters of these common leukemia cases were compared by randomized double-blind method .136 cases of acute leukemia had both blood smear and bone marrow smear detections were chose to compare the leukemia cell counts of the two kinds of smears by double-blind method ,and the characteristics of blood smears were re-searched .59 cases of acute leukemia whose leukemia cell counts were over 20% were randomly selected and detected by blood smear or bone marrow smear using double-blind method ,and the results were compared .Results The WBC of immature acute myeloid leukemia(AML) ,mature AML ,acute monoblastic and monocytic leukemia and chronic lymphocytic leukemia(CLL) were mainly presented (>10-50)× 109/L ,that of acute promyelocytic leukemia (APL) and acute erythroid leukemia(AEL) were mainly ≤4 × 109/L ,that of chronic granulocytic leukemia(CGL) were mainly >100 × 109/L .Microscopic examination of peripheral blood smears found that almost all the leukemia cells in peripheral blood smear was more mature than bone marrow smears .When the leukemia cell counts were over 20% both in blood smear and bone marrow smear ,there was no significant difference of the correct diagnosis rates between single blood smear and single bone marrow smear detection(P> 0 .05) .Conclusion Blood routine parameters can suggest leukemia .and blood smears examination could identify leukemia subtypes .When the leukemia cell count is high in blood smear ,single blood smear detection has a high correct diagnosis rate .