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OBJECTIVE To explore the effects of posaconazole combined with proton pump inhibitors （PPI） on the blood concentration and the risk of invasive fungal disease （IFD） in patients with malignant hematological disorder. METHODS In accordance with the random number table method， 40 patients with malignant hematological disorders who were admitted to the hematology department of our hospital between December 2020 and December 2021 were chosen and divided into control group （20 cases） and observation group （20 cases）. The control group received Posaconazole oral suspension alone， while the observation group received Posaconazole oral suspension combined with PPI. The incidence of IFD， attainment rate of blood concentration， the time from the start of prophylaxis to IFD onset， the fatality associated with IFD， treatment of infected patients， and blood concentrations of posaconazole on 7th， 14th， 21st， and 28th day after posaconazole application were compared between 2 groups； the occurrence of adverse events during drug administration in the two groups was recorded. RESULTS The study was stopped because 2 patients in the observation group and 9 patients in the control group received hospital departures after taking posaconazole for fewer than 7 days. The incidence of IFD in the observation group was significantly higher than control group， and the attainment rate of blood concentration in the observation group was significantly lower than control group （P＜0.05）. There was no significant difference in the time from the start of prophylaxis to IFD onset， the fatality associated with IFD， treatment of infected patients and the incidence of adverse events （P＞ 0.05）. The blood concentration of posaconazole in the observation group was significantly lower than control group on 7th day of medication （P＜0.05）； there was no significant in blood concentration of posaconazole between 2 groups on the 14th day of medication （P＞0.05）. CONCLUSIONS Posaconazole combined with PPI can reduce the blood concentration of patients with malignant hematological disorders， increase the risk of IFD. Clinical practice should try to avoid the combination of the two or use them under the guidance of therapeutic drug monitoring.
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Objective:To systematically evaluate the dimensions and indexes of the credibility index system of medical institutions, for the purpose of providing reference for the development of the credibility evaluation index system of medical institutions.Methods:Literatures and government documents on " the credibility of medical institution" and its index system were collected from PubMed, Web of Science, CNKI, WanFang Data and VIP database, by means of literature retrieval. These data so retrieved were then extracted, classified and summarized. The retrieval time ranged from the founding time of the database to February 2020.Results:Thirteen literatures related to the credibility evaluation index system of medical institutions were included. The credibility rating index system of medical institutions involved a total of 57 dimensions. There were a total of 467 indexes, among which 168 were related to medical quality, operation management, practice review, medical expenses and comprehensive evaluation, while only 15 were selected for frequency≥3 times in each dimension.Conclusions:According to the literatures, only the indexes of professional qualification, medical quality and medical expenses were highly adopted, while others lacked the consistency. The problems result from huge differences in the index setting structure, unreasonable classification of index categories, gaps between government indexes and scientific research indexes, and the lack of detailed index description. Therefore, it is necessary to strengthen theoretical research on the credibility evaluation of medical institutions, clarify the policy background of the credibility evaluation of medical institutions, and further explain the indexes in detail.
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Objective@#To explore the efficacy and safety of recombinant human interleukin-11 (rhIL-11) in treatment of chemotherapy-induced thrombocytopenia of acute leukemia.@*Methods@#Acute leukemia patients with chemotherapy-induced thrombocytopenia [Platelets (Plt) < 50×109/L] in 6 centers nationwide from February 2016 to July 2016 were treated with rhIL-11 (2 mg/time, twice per day) by subcutaneous injection. Treatment lasted 7 days or at least until Plt≥ 50×109/L. The Plt recovery was observed during treatment.@*Results@#A total of 112 patients were enrolled, and 2 patients decided to drop out of study. The efficacy population consisted of 110 patients, and the total response rate reached 74.5% (82/110). The average variation of Plt during treatment was (70±54)×109/L, and recovery average time of Plt for the patients with favorable efficacy was (8.7±3.0) days. In treatment with severe thrombocytopenia, rhIL-11 alone could shorten the recovery time compared with rhIL-11 combined with Plt transfusion [(8.0±2.6) d vs. (9.6±3.5) d, t=2.17, P=0.03].@*Conclusion@#rhIL-11 twice a day of subcutaneous injection can effectively promote Plt recovery and reduce Plt transfusion with less adverse reactions, which is worthy of further application.
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<p><b>OBJECTIVE</b>To understand the time and area specific prevalence of HIV infection and syphilis, sexual behaviors and awareness of HIV/AIDS related knowledge among men who have sex with men (MSM) in the mainland of China during 2010-2013.</p><p><b>METHODS</b>All the published academic papers on the prevalence of HIV infection and syphilis among MSM in the mainland of China from 2010 to 2013 were collected from CNKI, Wanfang and PubMed databases. Meta-analysis was performed by using software Stata 12.0.</p><p><b>RESULTS</b>Sixty six papers were selected. From 2010 to 2013 the pooled prevalence of HIV infection were 7.7% among the MSM (95% CI: 7.2%-8.3% ) and increased year by year, but the pooled prevalence of HIV infection was highest in southwestern China (12.0%). The pooled prevalence of syphilis were 10.9% among the MSM (95% CI: 9.8%-12.1%), and the pooled prevalence of syphilis was highest in southern China (14.4%). The incidence of anal sex was high (84.2%) in the past 6 months, but the consistent condom use rate was low (44.8%). The AIDS related knowledge awareness was high in the MSM (88.4%).</p><p><b>CONCLUSION</b>The prevalence of HIV infection and syphilis were high among the MSM in the mainland of China during 2010-2013. It is necessary to explore the comprehensive intervention measures to promote condom use among MSM although they have high awareness of AIDS related knowledge.</p>
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Humanos , Masculino , Síndrome da Imunodeficiência Adquirida , China , Epidemiologia , Infecções por HIV , Epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina , Incidência , Prevalência , Sexo Seguro , Comportamento Sexual , Sífilis , EpidemiologiaRESUMO
Objective To determine retinal charges in newly diagnosed acute leukemia patients and to eval-uate the diagnostic value of retinal findings in patients with central nervous systerm leukemia(CNSL) and intracranial hemorrhage(IH). Methods 123 patients with acute leukemia(86 had myeloid leukemia and 37 had lymphoid leuke-mia) aged 14～77 years were examined with direct/indirect ophthalmoscopy for the presence of intraretinal hemorrha-ges (IRH), white-centred hemorrhages (WCH) and cotton-wool spots (CWS) within 5 days of diagnosis. Results CNSL and IH were more common in patients with retinopathy than those without (27.1% vs 9.1%, P=0.046; 29.2% vs 9.1%, P=0.029;respectively). Complete remission(CR) rate in patients with IRH was lower than those without(52.5% vs 80.5%, P =0.08). No association was found between the presence of WCH or CWS and CR rate. Conclusion The present study shows that patients with IRH is an indicator of poor prognosis in acute leukemia. Leukemic retinopathy usually is seen in patients with IH. Invasion of the eye by leukemia is not rare and indicates the need for early ophthalmological examination.