Gene mutation of Candida albicans is one of the main causes for azole drug resistance. Different types of variation play different roles in promoting the process of drug resistance. ERG series of gene mutations primarily affect the ergosterol synthesis pathway. When the regulatory factors TAC1 for CDR1 gene and Mrr1 for MDR1 gene generate mutations, the expression level of drug efflux pump protein in Candida albicans may be changed. In addition, gene copy number variation is also gaining attention. Therefore, the research of mutation resistance-associated genes has a positive meaning to explore the mechanism of drug resistance in Candida albicans.

Objective To describe the depression of premature infants′ mothers and discuss the related influence factors. Methods A total of 86 premature infants′ mothers completed Edinburgh Postnatal Depression Scale at 3-days postpartum in this descriptive study during August 2014 to January 2015 in Obstetrics and Gynecology Hospital of Fudan University. Results The prevalence of postpartum depression in premature infants′ mothers was 25.6% (22/86). Educational levels, family support, character, and number of abortion of mothers, pregnancy complication, gestational age, birth weight, Apgar score, length of hospitalization, and birth with abnormalities of premature infants were found significantly associated with postpartum depression (P<0.05). By Logistic regression, family support (OR=3.253, 95% CI=1.180-8.966) and length of hospitalization (OR=2.905, 95% CI=1.418-5.952) were the risk factors of the postpartum depression at 3-days after delivery. Conclusions Premature infants′mothers at 3-days postpartum presented with obvious postpartum depression. Psychological intervention should be focused on its influence factors.

Decision on mode of delivery (MOD) is a process involved by both clients and health care providers, based on specific clinical situations and women′s values. To help each woman obtain the best MOD is crucial for obstetric health professionals to provide women-centered high quality of care. There is a steep upward trend in cesarean sections in China due to the introduced advanced technologies, overused antenatal monitoring methods, flexible indications for cesarean sections, delayed childbearing ages and people′s misconceptions, etc.. Recently the conditional and comprehensive two-child policy have been implemented in China, which might initiate changes in fertility and birth intentions of many families, and in subsequent decisions on MOD. This review illustrates the pros and cons of MOD, decision process on MOD, influencing factors and strategies to promote decision on MOD, in order for the obstetric professionals to provide evidence-based best care for women and their families in the process of decision-making.

Objective To investigate the riskf actors associated with sepsis following surgery of con-genital heart disease in children, for early-recognizing and diagnosing, improving prognosis and decreasing mortality.Methods Retrospective study wa s employed,52 patients of sepsis and 104 patients of non-sepsis with similar age,sex,na d the same diseases were enrolled during Jan 2012 to Apr 2015 in cardiac intensive care unit.Variables such as age,sex,preoperative infection,delayed sternum closure,diaphragmatic paralysis, exploraot ry chest,cardiopulmonaryb ypass time, placed invasive catheter were included in the research fac-tors.The Logistic regression model was set up,OR and 95%CI were calculta ed.Results In sepsis group,the more shock and dysfunction organs,longre hospital stays,longer ICU stays and higher mortality were found compared to the non-sepsis group[25.32%vs.6.73%,3.5 ±1.1 vs.1.1 ±0.7,(35.1 ±11.2)d vs.(11.3 ±3.1)d,(21.3 ±7.1)d vs.(7.1 ±2.3)d,19.23%vs.4.81%,P<0.05].In the Logistic regres ion mod-e l,variables significantly associated with sepsisw ere preoperative infection,deal yed sternal closure,explorato-ry chest,and placed more invais ve duct,diahp ragmatic paralysis(P<0.05).OR value (95%CI) were 10.53 (1.73,64.2),26.66(2.69,263.83),19.47(1.87,203.02),4.99(1.36,18.31),8.32 (0.12,16.46 ), respectively.Conclusion Preoperative infection,delayed sternal closure,exploratory chest,placed more inva-sive duct,diaphragmatic paralysis are the risk factors of sepsis.Children with sepsis had poor clinical outcome compared to those without sepsis.

Objective To develop a three-stage standardized and systematic training program framework and indicator systems for clinical midwives.Methods Based upon literature review,Delphi technique was used to formulate index system and indicators for midwives' training program through tworound expert consultation among 29 experts.Results After two-round expert consultation,the response rates were 96.7％ and 100.0％,respectively.Experts' authority coefficient was 0.874.The training program framework consisted of a three-level index system.Average importance scores of the three-level indexes were 4.10 to 4.97,4.07 to 4.97,and 4.00 to 5.00,respectively.And their variance coefficients were 0.037 to 0.119,0.037 to 0.130,and 0 to 0.141,respectively.Then a progressive and integrated three-year standardized training framework and index system for clinical midwives was finally formed,which totally contained 5 first-level indicators or training modules,including professional competence and safety awareness,specialized and basic knowledge,specialized practical skills,emergency management,and basic capacity for teaching and research.Conclusions The three-level framework and indicators for clinical midwives' training program has been proved to be acceptable,reliable and scientific,thus providing a theoretical and referential basis for training clinical midwives and improving teaching quality.

Objective To observe the effect of Xin Guanxin Suhe Drop Pill(XGSDP) on isoprenaline (ISO)-induced acute myocardial ischemia (AMI).Methods Acute myocardial ischemia rats model were established by injection of ISO. Electrocardiogram (ECG) was observed, superoxide dismutase(SOD) activity, and the contents of malondialdehyde(MDA) and nitric oxide (NO) in the myocardial homogenate as well as serum and glutamate oxaloacetate transaminase (GOT) were observed after ISO injection. Results XGSDP could significantly increase NO content and SOD activity, decrease contents of MDA and GOT and reduce the positive rate of ECG( P

Objective To investigate the relationship between the C-reactive protein (CRP) and nonalcoholic fatty liver disease (NAFLD) prevalence.Methods In this study,63,486 workers who had participated in the Kailuan health examination from July 2012 to October 2013 and without history of drinking,myocardial infarction,stroke and cancer and without data incomplete were recruited.The observation population was divided into three groups according to the levels of CRP at baseline:group 1 (＜ 1 mg/L),group 2 (1-3 mg/ L) and group 3 (＞3 mg/L).The prevalence of NAFLD among three groups was observed.Multiple logistic regression was used to calculated relationship between the CRP and NAFLD prevalence.Results The prevalence of NAFLD in group 1,group 2 and group 3 were 26.9％,42.1％ and 49.3％,respectively,and the differences were significant (x2=2 192.31,P ＜ 0.01).Logistic model showed that after adjustment for age,gender,waist circumference and other confounders,the association between CRP and NAFLD was strong and the OR value (95％ CI) among the group 1,group 2 and group 3 were 1.00,1.49 (1.42-1.56),1.54 (1.45 -1.64),respectively.Conclusion CRP is independently associated with the nonalcoholic fatty liver disease.

Central South University began to implement the eight-year medical education in 2004, and has accumulated rich experience in the pre-medical education through continuous reform and improvement. Since 2012, Central South University has made a series of reformation, which is more conducive to the all-round development of medical students , on the pre-medical education . Through adding freshman courses, humanities courses, bilingual teaching courses, and applying aca-demic adviser institution, early scientific research training and open courses during the pre-medical education, Central South University has exercised and strengthened students' scientific research ability, the humanistic quality, English level, and made the pre-medical comprehensive examination for the shunt selection of students. Thus Central South University has improved the eight-year medical students' comprehensive quality, and provided an example of the reformation for medical education.

Mortality review is an important way to identify deficiencies and gaps in the healthcare system and can effectively improve the quality and safety of healthcare delivery.It analyzes and summarizes the relevant domes-tic and international literature and review the current development,methods and characteristics of different applica-tion areas of death case review at home and abroad,with a view to guiding healthcare departments or institutions to establish a scientific and standardized mortality review system.

Objective:To understand the genotype and genetic characteristics of rubella virus (RV) circulated in Qinghai province.Methods:The throat swabs were collected from suspected rubella cases in two cities of Qinghai province in 2010 and 2019, respectively. After nucleic acid detection and virus isolation, the target genotyping sequences (739 nucleotide fragments of E1 gene) of positive virus isolates were amplified and determined. The sequences of the viruses were compared with 32 reference strains of 13 genotypes recommended by World Health Organization(WHO) to determine the genotype, and the genetic relationship between Qinghai isolates and RV strains from other provinces of China was also analyzed.Results:In this study, four RV virus strains were isolated, and the genetic relationship analysis showed that these virus strains were classified into 1E-Cluster A sub-genotype and 2B-Cluster C sub-genotype, which was basically consistent with the epidemic trend of RV in other provinces of China. The four virus strains in Qinghai province were highly conserved at the amino acid level, but region-specific mutation sites were also found.Conclusions:This study provides some laboratory data for the formulation of rubella prevention and control strategy in Qinghai province..