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Objective@#To investigate the efficacy and safety of micafungin (MCF) for pulmonary invasive fungal disease (PIFD) in pediatric patients with acute leukemia or post hematopoietic stem cells transplantation.@*Method@#Twenty-five neutropenic PIFD children with acute leukemia or post hematopoietic stem cells transplantation in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were selected from January 2012 to June 2015, including 12 males and 13 females, age range 2-15 (average 6.2±2.0) years. There were 12 cases of acute leukemia (AL) after chemotherapy, 4 cases of acute leukemia (AL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and 9 cases of β-thalassemia major after allo-HSCT. All children received MCM for the treatment of PIFD, the dosage of MCM was 3-4 mg/ (kg·d) , once a day. The children received 2 to 6 courses of treatment, individually with a course of 7 days. 1, 3-β-D glucan assay (G test), galactomannan antigen test (GM test), high-resolution CT and the biochemical indexes for organ functions were closely monitored.@*Result@#Twenty-five cases were diagnosed as PIFD, including 2 patients diagnosed as proven, 6 as probable and 17 as possible. Of the 25 cases, 1 was confirmed aspergillus by biopsy pathology and 1 was candida albicans by blood culture. The G and GM test with positive results was 5 and 2 respectively. Chest CT scans of the 25 cases had obvious lesions: air crescent sign and cavitation in 4 cases, diffuse ground glass change in 9 cases, double lung scattered patchy, small nodules and cord like high density shadow in 7 cases, unilateral or bilateral chest wall wedge-shaped consolidation edge in 5 cases and pleural effusion in 5 patients. The effective rate of MCF in treatment of PIFD was 68% (17/25), including 13 cases cured, 4 cases improved, 4 cases were improved clinically and in 4 cases the treatment was ineffective. Eight cases were effective in MCF monotherapy group (12 cases) and nine were effective in MCF combined therapy group(13 cases), respectively. Side-effects including allergies, gastrointestinal side effects, electrolyte disturbances, impairment of liver and kidney function, and myelosuppression were not found in those children treated with MCF.@*Conclusion@#Micafungin is effective and safe in the treatment of pulmonary invasive fungal disease in pediatric patients with acute leukemia or post hematopoietic stem cell transplantation.
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Objective To investigate the characteristics of everyday memory of adults with subjective memory complaints (SMC),and probe into the correlation between everyday memory function and life quality.Methods Through convenience sampling,150 adults with SMC were face-to-face interviewed by an investigator,with demographic characteristics collected,and the cognition function,everyday memory function and life quality were also assessed during the interview.Results Among the 150 adults with SMC,the impairment rate of everyday memory function reached 96％,and the median score of RBMT-II was 16.00 (interquartile range 6.00),indicating a low level of everyday memory function,with the Name andDelayed recall Story items having lower scores.All participants were divided into two groups according to cognitive status,with 67 (44.70％) adults having normal cognitive function and 83 (55.30％) impaired cognitive function.After comparison,significant differences were found in the total score of RBMT-II and scores ofFaces recognition andDelayed recall Story between the two groups (P＜0.05).In all dimensions of SF-36,the median score of general health dimension for the 150 adults was 55.00 (inter-quartile range 31.25).The Spearman rank correlation analysis showed that the scores of several dimensions in RBMT-II were positively correlated with the scores of several dimensions in SF-36 (P＜0.05).Conclusion Everyday memory function of people with SMC was positively CorTelated with their life quality.
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<p><b>OBJECTIVE</b>To evaluate antifungal combination strategy in children with hematologic diseases and invasive fungal disease( IFD).</p><p><b>METHODS</b>A retrospective clinical study was performed based on 67 childhood patients with hematologic diseases and IFD who firstly accepted combination antifungal therapy for ≥ 7 days during January 2012 and December 2014. Of them, 11 cases received combination of echinocandin with azole, 10 cases received combination of echinocandin with amphotericin B, and 46 cases received combination of azole with amphotericin B.</p><p><b>RESULTS</b>Overall response rate was 79.1%. Univariate analysis revealed that granulocyte recovery (P=0.031), status of underling disease (P=0.023) and the duration of the therapy (P=0.046) were significantly associated with efficacy. Multivariate analysis showed that the independent prognostic factor was the duration of combination antifungal therapy (OR=0.229, 95% CI 0.061- 0.863, P=0.029). The response rates of echinocandin combined with azole, echinocandin combined with amphotericin B and azole combined with amphotericin B were 81.8%, 60.0% and 82.6%, respectively (P>0.05), and 12-week survival rates were 81.8%, 80.0% and 86.5%, respectively (P>0.05). The drug- related adverse reactions occurred 59 times in 34 patients. BUN increasing, hypokalemia and abnormal liver functions were considered the main side effects.</p><p><b>CONCLUSION</b>For IFD in children with hematologic disease, to extend the duration of treatment (≥ 14 days) could significantly improve the curative effect. Combinations of echinocandin with azole, echinocandin with amphotericin B and azole with amphotericin B can be used as a combination treatment options. Combination of Azole with amphotericin B is efficacious, safe and economic treatment option considering efficacy, survival rate, cost and dosage form.</p>
Subject(s)
Child , Humans , Amphotericin B , Therapeutic Uses , Antifungal Agents , Therapeutic Uses , Drug Therapy, Combination , Echinocandins , Therapeutic Uses , Hematologic Diseases , Microbiology , Mycoses , Drug Therapy , Retrospective Studies , Survival Rate , Treatment OutcomeABSTRACT
Objective To explore the cognitive status of community-dwelling older adults with subjective memory complaints (SMC).Methods A total of 262 older adults with SMC were included based on convenience sampling.Face-to-face interview was conducted for demographic information collection and cognitive assessment.Statistical analyses Were undertaken using SPSS version 19.0.Results The participants with SMC had a low level of general cognitive function,with a mean score of 22.18±4.21 on the MoCA; the two cognitive domains of abstraction' and deIayed memory had the lowest scores,with an average score of 0.85±0.82 and 2.91± 1.50 respectively,and the average scoring rate lower than 60.00％.About 54.20％ of the older adults with SMC presented with cognitive impairment.The scores ofabstraction were low in the participants with and without cognitive impairment.In addition,the scores of visuospatial/executive function, language and delayed memory were low in the participants with cognitive impairment.The cognitive impairment of persons with SMC may be associated with age and marital status.The people over the age of 70 years and widowed ones are more likely to suffer from cognitive dysfunction.Conclusion The older adults with SMC have a low level of general cognitive function,and cognitive imPairment detection rate is higher.Advanced age and widowhood are important factors affecting their cognitive function.
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Objective To explore the epidemiological characteristics of nonalcoholic fatty liver disease (NAFL)and relationship with main chronic diseases in Xuanwu district community of the elderly.Methods 6 779in the elderly physical examination,unified health questionnaire,physical examination,measurement of body mass index,blood pressure,fasting blood glucose,liver function,blood lipids,abdominal B-ultrasound to calculate prevalence of NAFL rate,and its related factors were analyzed.Results NAFL prealence was 38.7％,NAFL group of overweight and obesity,diabetes,high blood pressure,dyslipidemia was significantly higher than the control group.Conclusion NAFL rate was high,and it has close relationship with the metabolic syndrome,NAFL should be placed in community mainly chronic diseases of prevention and control category.