OBJECTIVETo analyze the incidence, clinical features and the predisposing factors of fungal septicemia, and investigate the risk factors for death due to fungal septicemia and the prognosis of the patients.

METHODSWe retrospectively analyzed the clinical data of 91 patients with fungal septicemia diagnosed in the last 17 years, including 60 patients with clinical cure or improvement, and 31 who die of the disease. Based on the results by univariate analysis, the data were analyzed using logistic multiple regression and Fisher's discriminant analysis.

RESULTSFungal septicemia had many predisposing factors with high mortality rate. Univariate analysis revealed significant differences between the cured/improved cases and the fatal cases for 12 variables, including advanced age, complication by bacterial infection, septic shock, multiple organ dysfunction syndrome (MODS), ICU patients, cortical hormone therapy, surgery, chemotherapy, use of immunopotentiating agents, length of hospital stay before antifungal therapy, time of anti-fungus therapy and types of invasive procedures. Logistic multiple regression analysis showed that the types of invasive procedures, MODS, surgery and prolonged hospital stay before antifungal therapy were the independent risk factors for fungal septicemia-related death. Fisher's linear discriminant equation was established for predicting the prognosis of the disease.

CONCLUSIONThe types of invasive procedure, MODS, surgery and prolonged hospital stay before antifungal therapy are the independent risk factors for fungal septicemia-related death, and the patients' prognosis can be predicted using Fisher's linear discriminant equation.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antifungal Agents ; therapeutic use ; Cause of Death ; Child ; Child, Preschool ; Female ; Fungemia ; diagnosis ; etiology ; mortality ; therapy ; Humans ; Infant ; Male ; Middle Aged ; Models, Theoretical ; Prognosis ; Regression Analysis ; Retrospective Studies ; Risk Factors ; Young Adult

OBJECTIVETo investigate the risk factors of fungal rhinosinusitis.

METHODSThe preoperative clinical data of 57 patients with a diagnosis of fungal rhinosinusitis confirmed pathologically using Gomori methenamine silver staining were analyzed statistically against the data of 57 age- and gender-matched control patients with chronic rhinosinusitis.

RESULTSCompared with chronic rhinosinusitis, fungal rhinosinusitis was characterized by a significantly shorter mean disease course (37.31 months vs 130.84 months, t = 5.59, P = 0.000). The factors related to fungal rhinosinusitis included nasal mucus, purulent nasal discharge, unilateral/bilateral sinus lesion and calcified plaque in CT scan , with odds ratios of 0.17 (0.04-0.62), 0.35 (0.15-0.80), 41 (12.50-100.00) and 91 (24.01-344.95), respectively. Conditional logistic regression identified calcified plaque in CT scan as the high-risk factor of fungal rhinosinusitis.

CONCLUSIONThe presence of calcified plaque in CT scan indicates high risk of fungal rhinosinusitis and may serve as an important evidence for diagnosis of this disease.

Case-Control Studies ; China ; epidemiology ; Female ; Fungi ; Humans ; Male ; Mycoses ; epidemiology ; Rhinitis ; epidemiology ; microbiology ; Risk Factors ; Sinusitis ; epidemiology ; microbiology

OBJECTIVETo investigate the pharmacokinetics of nalmefene after intravenous administration at a single or multiple doses in Chinese healthy volunteers.

METHODSThis open, randomized clinical trial involved 12 healthy volunteers, who received a single-dose (2 mg) nalmefene injection. Before and at different time points after the injection, blood sample were obtained from the subjects. After the single intravenous dose trial, 8 healthy volunteers received intravenous nalmefene at 2 mg once daily for 6 consecutive days, and the plasma drug concentrations were determined on the morning of days 4, 5 and 6 using liquid chromatography/tandem mass spectrometry and the pharmacokinetic parameters were calculated using PKS program.

RESULTSThe main pharmacokinetic parameters of nalmefene (Cmax, Tmax, T1/2, AUC0-48, and AUC0-infinity) after the single intravenous dose were 7.34-/+1.56 microg/L, 0.08 h, 12.01-/+2.20 h, 30.29-/+9.84 microg.L(-1).h, and 32.23-/+9.94 microg.L(-1).h, respectively; the parameters after multiple doses were 8.04-/+1.09 microg/L, 0.08 h, 12.43-/+1.44 h, 33.64-/+9.15 microg.L(-1).h and 35.98-/+9.23 microg.L(-1).h, respectively. The steady-state pharmacokinetic parameters including the degree of fluctuation (DF), AUCss and Cav were 4.69-/+1.29, 19.64-/+6.20 microg.L(-1).h and 1.64-/+0.52 microg/L, respectively.

CONCLUSIONNalmefene showed similar pharmacokinetics in Chinese healthy volunteers with those in the foreign testees, and can be safely administered in healthy volunteers without producing unmanageable pain.

Adult ; China ; Female ; Humans ; Injections, Intravenous ; Male ; Naltrexone ; administration & dosage ; analogs & derivatives ; pharmacokinetics ; Narcotic Antagonists ; administration & dosage ; pharmacokinetics

OBJECTIVEFurther investigation on the incidence and clinicopathologic features of bronchioloalveolar carcinomas (BAC) including: (1) BAC of strictly defined, (2) adenocarcinoma with bronchioloalveolar features, (3) other different histologic subtypes of lung adenocarcinomas.

METHODSSurgical specimens from 348 lung adenocarcinoma patients admitted in that hospital between 1998 - 2005 were included. And clinical data were collected at the same time. Patients of strictly defined BAC, BAC with focal invasion (BWFI), and adenomas with bronchioloalveolar features (AWBF) were followed-up. Data were analyzed using SPSS statistics software and Kaplan-Meier survival curves were constructed.

RESULTSThe resected lung adenocarcinomas consisted of different histologic subtypes. The most frequent one was adenocarcinoma of mixed subtypes (78.2%, 272/348), followed by the acinar type (8.1%, 28/348), the papillary type (4.0%, 14/348), the BAC (3.7%, 13/348), the mucinous (colloid) type (3.4%, 12/348) and the solid types (2.3%, 8/348). The fetal adenocarcinoma was the least component detected. There was no significant difference on the survival curves between groups BAC and BWFI. The survival rate of patients with AWBF was poorer than that of BAC and BWFI.

CONCLUSIONSSince patients with strictly defined (simple) BAC, BWFI, and AWBF have their own distinct clinicopathologic features and prognosis respectively, they should be strictly distinguished from other types of pulmonary adenocarcinomas.

Adenocarcinoma ; pathology ; Adenocarcinoma, Bronchiolo-Alveolar ; pathology ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kaplan-Meier Estimate ; Lung ; pathology ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; methods ; Prognosis ; Survival Rate

Objective To examine whether polymorphisms of histone deacetylase( HDACs) and environment factors can be implicated in type 2 diabetes mellitus ( T2DM) ，and to provide evidence for the prevention and treatment of T2DM． Methods In 2017，T2DM patients and controls were selected from 17 villages in Huadu District，Guangzhou． According the Diagnostic criteria for T2DM，the case group of T2DM was matched with control group from the population diagnosed as normal by gender，age no more than 5 years old，and from the same natural village． Conditional logistic regression model was used to analyze the effect of gene and environment and their interaction on T2DM． Results The average age of 499 cases group were ( 61．53±13．08) years old，and the average age of 499 controls group were ( 61．48±13．09) years old． There were no statistic difference between two groups． Furthermore，the two groups were gender－balanced too． In conditional logistic regression model，we found that glycerin trilau- rate ( TG) abnormalities ( OR= 2．410，95% CI: 1．755－3．310，P＜0．001) and cholesterol total ( TC) ab- normalities ( OR= 1．436，95% CI: 1．046－1．972，P = 0．025) were risk factors for T2DM． The subjects carries rs72792338 TC+TT genotype ( OR= 0．526，95% CI: 0．349－0．793，P= 0．002) had lower the risk to develop T2DM． Conclusions Abnormal TG and TC are risk factors for T2DM． Rs72792338 TT and TC genotype carryings decrease the risk of T2DM．