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Objective To compare diagnostic value of four fungal scoring methods in invasive Candida infection,provide evidence for early diagnosis and treatment of invasive Candida infection.Methods High-risk patients with invasive Candida infection in the intensive care unit(ICU) in a hospital from 2011 to 2016 were analyzed retrospectively.According to diagnostic criteria,patients were divided into four groups:non-infection group,suspected infection group,clinically diagnosed group,and confirmed group,patients were conducted multi-diseases risk assessment (MDRA) score,invasive fungal infections risk scoring system (IFIRSS) score,Sevilla score,and Candida score,diagnostic value of four scoring methods for invasive Candida infection were evaluated.Results There were 275 high-risk patients,138 in non-infection group,63 in suspected infection group,and 74 in infection group(clinically diagnosed group:n =64;confirmed group:n =10).The age and length of hospital stay in the infection group were all higher than non-infection group (both P＜0.05).74 strains of Candida were isolated from 74 infected patients,mainly Candida albicans (n =60,81.1％).Positive rates for MDRA score,Candida score,Sevilla score,and IFIRSSscore were 41.5％(n =114),30.2％(n =83),15.3％(n =42),and 8.4％ (n =23) respectively.Of four MDRA scoring methods,MDRA had the higher sensitivity(Se,59％) but lowest specificity(Sp,66％);IFIRSS had higher Sp(91％) but very low Se (9％);Sevilla score had the highest Sp (96％)and higher Se(45％);Candida score had the highest Se(68％) and higher Sp (90％).Conclusion Sevilla score has higher Se and Sp,which can be used in early diagnosis of invasive Candida infection;Candida score has the highest coincidence with clinical diagnostic criteria for invasive Candida infection,both Se and Sp are high,which is of great value for early diagnosis of invasive Candida infection.
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<p><b>OBJECTIVE</b>To establish a BALB/c nude mouse model with the huamanized chronic myeloid leukemia (CML) for the study of human CML.</p><p><b>METHODS</b>The BALB/c nude mice aged 4 weeks pretreated by splenectomy, the cyclophosphamide intraperitoneal injection and sublethal irradiation (SLI) were transplanted intravenously with bone marrow mononuclear cells from CML patients. The SLI-pretreated nude mice were divided into 2 groups: group A, in which the nude mice were injected with 0.3 ml PBS; group B, in which the nude mice were infused intravenously with 4.5×10mononuclear cells from CML patients. Then the changes of body weight and appetite were observed, the hemogram and cell morphology were determined, the expressions of human CD13 and CD45 were detected by flow cytometry, the pathologic analysis of bone, liver and intestine were performed by biopsy, and the BCR/ABL fusion gene was detected by RT-PCR.</p><p><b>RESULTS</b>The mice in group B displayed weakness, auantic, less foodintake and instabiligy of gait as time want on. The average survival time was 46.2±4.2 d (45-57 d). On the third week, the CD13CD45cells accounted for 0.56±0.05% and 2.56±0.36% respectively in group A and B. While on the sixth week, the CD13CD45cells accounted for 0.44±0.07% and 4.97±0.43% in A and B groups respectively, these results showed that cell count in B group was significantly higher than that in A group(P<0.05). Pathological examination showed that the leukemic cells were found in bone marrow of group B. The BCR/ABL fusion gene could be detected in bone marrow.</p><p><b>CONCLUSION</b>BALB/c nude mouse model with huamanized chronic myeloid leukemia(CML) model has been established by pretreating mice with SLI. The survival time of mice in this model has been long, and the cost to establish the model is low.</p>
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<p><b>OBJECTIVE</b>To study relationship between daunorubicin (DNR) pharmacokinetics and efficacy and toxicity in children with acute leukemia.</p><p><b>METHODS</b>(1) The concentration of DNR in plasma of children with acute leukemia was determined by high performance liquid chromatography (HPLC)-fluorescence detection method. Plasma was sampled frequently from the start of the infusion till the end of 24 h. DNR pharmacokinetics was studied by determination of the concentrations. (2) Efficacy and toxicity were monitored in each period after chemotherapy. Laboratory studies included examination of bone marrow, white blood cell count, electrocardiogram, echocardiogram, myocardial enzymogram, the liver and kidney function.</p><p><b>RESULTS</b>(1) DNR was eliminated from plasma in a two-compartment manner. The maximum concentration was seen 1 - 3 h after infusion. Cmax was 63.50 microg/L. Tmax was 1.45 h. The concentration decreased quickly to a low level of about 11.52 microg/L from the end of 2 hours infusion. There was a large inter-individual difference in pharmacokinetic parameters of DNR. The difference of CL was 9-fold, AUC was 8-fold, Cmax was 5-fold. (2) CL of male patients [57.99 L/(h.m(2))] was significantly lower than that of female patients [93.71 L/(h.m(2))] (P < 0.05). Tmax of children older than 6 years was 1.1 h, and that of children younger than 6 years was 1.8 h (P < 0.05); Cmax of children older than 6 years was 90.77 microg/L, younger than 6 years was 57.44 microg/L (P < 0.05).</p><p><b>CONCLUSION</b>(1) There is a large inter-individual difference in pharmacokinetic parameters of DNR in children. It may predict individual variety of efficacy and toxicity. Therapeutic drug monitoring is important. (2) Male patients and children older than 6 years had a higher bioavailability and lower metabolism, toxicity may easily occur in such children, therefore they may need lower dose.</p>