Invasive fungal diseases (IFD) are important causes ot morbidity and mortality in children with hematological malignancies.Although Candida remains the most common fungal pathogen in oncology pa tients,the epidemiology has recently shifted toward non-albicans species.However,Aspergillus has also seen a recent rise.Early recognition and prompt antifungal treatment are key to the control of IFD.We provide clinicians with evidence-based recommendations on strategies for disease diagnosis and management in this review.

Objective: To explore the opportunity of electroencephalographic (EEG) evaluation and the prognostic value of the EEG patterns in comatose survivors after cardiopulmonary resuscitation (CPR). Methods: Sixty-four comatose survivors were selected for EEG evaluation after CPR. Acccording to the time intervals of the first EEG monitoring, the patients were divided into 1-3 day, 4-7 day, and >7 day groups. The EEG monitoring included generalized suppression, burst-suppression, alpha or theta coma, and slow wave increase patterns. The endpoint of clinical outcome (Glasgow Outcome Scale score) was evaluated at 6 months. The 4 types of EEG patterns were calculated respectively, and the prognostic sensitivity, specificity, positive predictive value, false positive rates, and total consistent rates during the 3 time intervals were predicted. Results: The generalized suppression pattern had a higher sensitivity (67%-80%) and specificity (100%) in predicting unfavorable prognosis within 7 days after CPR; the burst suppression pattern had a higher specificity (100%) in predicting unfavorable prognosis within 7 days, however, its sensitivity was low (6%-8%); The slow wave increase pattern had high sensitivity (100%) and specificity (91%-94%) in predicting favorable prognosis within 7 days; and the sensitivity was 3%-40%, and specificity was 50%-67% in predicting unfavorable prognosis in the alpha or theta coma pattern. Conclusion: The early (within 7 days) EEG after CPR may accurately and reliably show that both the generalized suppression and burst-suppression patterns predict the unfavorable prognosis; the slow wave increase pattern can accurately and reliably predict favorable prognosis; and the alpha or theta coma pattern cannot favorably predict prognosis.

Objective To explore the relationship between antifungal resistance and expression of a virulence factor phospholipase B1 in Candida albicans. Methods Total RNA was extracted from 15 fluconazole-resistant and 15 fluconazole-sensitive Candida albicans isolates. RT-PCR was performed to detect the expression of phospholipase B1 mRNA. Extracellular and intracellular proteins secreted by Candida albicans cells were concentrated using salting-out method and extracted by P0013B RIPA lysis buffer, respectively followed by Western-blotting analysis to detect the expression of extracellular and intracellular phospholipase B1 protein. Results The relative expression of phospholipase B1 mRNA was 0.6173 ± 0.1090 in fluconazoleresistant Candida albicans isolates, significantly higher than in fluconazole-sensitive isolates (0.2653 ± 0.0935,P ＜ 0.05). Increased expressions of extracellular and intracellular phospholipase B1 protein were noted in fluconazole-resistant Candida albicans isolates compared with fluconazole-sensitive isolates (0.4145 ± 0.2773 vs 0.2720 ± 0.2194, 0.1825 ± 0.1831 vs 0.2653 ± 0.0935, t = 2.703, 3.443, both P ＜ 0.05). Conclusions The expressions of phospholipase B1 mRNA and protein are elevated in fluconazole-resistant Candida albicans isolates, suggesting that the expression of phospholipase B1 may be associated with the occurrence of antifungal resistance in Candida albicans.

Objective To study the influence of carbon dioxide pneumoperitoneum on the pregnancy outcome and newborn rat malformation in pregnancy rats. Methods SD rats were randomly divided into control group (group A and group B) and the experimental group (group C; group D; group E). There were 10 rats in each group, the general situation,abortion rate, premature delivery rate,newborn rats numbers,weights and lengths and malformation rates were recorded. Results There was no malformation in newborn rats in all groups (P > 0. 05 ). Conclusion It was safe to undergo laparoscope operation in metaphase pregnancy with low CO2 pneumoperitoneum,which has no influence on abortion rate and malformation rate.

ObjectiveTo test the susceptibilities of Candida albicans to 5 antifungal agents including methylrosanilinium chloride and to estimate their relationship with the genotypes of C.albicans.MethodsThe susceptibilitiesof 67C.albicansisolatestomethylrosaniliniumchloride, fluconazole, amphotericinB,itraconazole and ketoconazole were determined by using a broth dilution method as described in the National Committee for Clinical Laboratory Standards(NCCLS) document M27-A2.DNA was extracted from the C.albicans isolates and subjected to the amplification of 25S ribosomal DNA(rDNA) introns by PCR.The C.albicans isolates were divided into A,B and C genotypes according to the amplicons.The relationship was analyzed statistically by exact probability test between the genotypes and antifungal susceptibility of C.albicans.ResultsOf the 67 C.albicans isolates,8.96％ were resistant to fluconazole,2.98％ to itraconazole,1.49％ to ketoconazole,and no resistance to amphotericin B was observed.The minimum inhibitory concentration (MIC) of methylrosanilinium chloride varied from 0.125 to 4 mg/L.Statistical analysis revealed no significant correlation between the genotypes and autifungal susceptibilities of C.albicans(all P ＞ 0.05).Conclusions More attention should be given to the increasing resistance to fluconazole and itraconazole in some isolates of C.albicans as well as to the favorable antifungal activity of methylrosanilinium chloride.The antifungal resistance shows no apparent correlation to the genotypes of C.albicans.

To observe the patients with type 2 diabetes who were injected premixed insulin analogues after short time continuous subcutaneous insulin infusion( CSII ) treatment.It was found that the patients needed premixed insulin analogue injection 2 times daily when the dosage of CSII was less than 45 U/d,and 3 times daily when the dosage was greater than 45 U/d.The relationship of dosages between premixed insulin analogue treatment ( Y ) and CSII treatment(X) was calculated by following equations:2 times daily premixed insulin analogue treatment:Y =13.093 +0.395X,3 times daily premixed insulin analogue treatment:Y =23.114+0.405X.

Objective To evaluate the brain function and predict the prognosis of hypoxic encephalopathy with multimodal evoked potentials. Methods Short-latency somatosensory evoked potential(SLSEP )and Brainstem auditory evoked potential( BAEP) were used to monitor 44 coma patients caused by post-cardiopulmonary resuscitation, hypotension and (or) hypoxemia, to compare simple modalities, multimodalities,and simple modalities with multimodalities according to Judson, Hall, Cant, Haupt standard. Results Simple modal and multimodal grading standards were closely related to the prognosis, the higher the grade, the poorer the prognosis . The accuracy of SLSEP (Judson standard is 84.1% )was higher than that of BAEP (Hall standard is 79.5%);and the accuracy of multimodal evoked potentials (Cant standard is 88.4%) was higher than that of the simple modality. Conclusion Multimodal evoked potentials might better indicate the degree of brain function of hypoxic encephalopathy. Cant standard might be easily carried out, which might highly show the accuracy of the prognosis, and suitably to be spread and applied in work.

Objective: To evaluate the effect of flotation therapy on the attention of undergraduates. Method: Subjects were 53 undergraduates (26 male, 27 female). They were randomly divided into 5 groups. Group 1,2,3 and group 4 were flotation groups and group 5 was control group. Each subject finished four therapies. Visual attention attribution and diversion (T5) and bilateral two- choice reaction time (T8) were used as the indexes. Result: As a whole, the T5 and T8 times of the subjects in the flotation groups were shortened in the course of the therapy. The promotion of attention in the male subjects was better than that in the female subjects. There was no significant difference between the changes of bilateral two-choice reaction time. The promotion in the flotation subjects was significantly better than that in the control subjects and it could not be explained totally by practice effect. Conclusion: The attention of the subjects can be promoted by flotation therapy. This study could not support the assumption that flotation therapy could promote the function of right brain as some prior studies declared.

目的观察75岁以上老年人急性心肌梗死(acute myocardial infarction,AMI)静脉溶栓治疗的疗效。方法48例75岁以上采用尿激酶溶栓治疗的患者与同期94例<75岁的AMI患者溶栓治疗做对照。结果≥75岁组的再通率为68.7%,<75岁组为72.3%;轻度出血分别为6.3%和5.3%,重度出血均为0%;心率失常分别为41.6%和49.9%;病死率为6.3%和5.3%。两组患者12h静脉溶栓治疗再通率无显著性差异,并发症及病死率也无显著性差异(P>0.05)。结论75岁以上老人静脉溶栓治疗是安全有效的。

Objectives To study a special pattern of electroencephalogram (EEG),regional attenuation without Delta in massive cerebral ischemic infraction and evaluate its clinical value.Methods All the 47 cases diagnosed as massive cerebral infraction were continuously observed and evaluated in the period of 2004 to 2006 for EEG,short-latency somatosensory evoked potential (SLSEP).Glasgow coma scale (GCS) and the National Institutes of Health Stroke Scale (NIHSS) were also rated.EEG monitoring was performed every 1 to 3 day,but at least one time for patient with deteriorated condition.The outcome was evaluated with Glasgow outcome scale (GOS).Results 47 cases were performed 70 times of EEG all together,among whom 32 cases (68.1%) showed RAWOD in EEG.The positive rate of RAWOD was 76.9% within 24 hours of onset,but it was 28.6% in CT in the same time.The GCS and NIHSS of two groups had significant differences (P