Objective To analyze Candida species causing vulvovaginal candidiasis in Qingdao and surrounding areas.Methods Vaginal discharge specimens were collected from 362 patients with suspected vulvovaginal candidiasis in the Affiliated Hospital of Qingdao University Medical College from May 2011 to November 2011,and subjected to routine fungal culture.The Candida isolates were identified by using Sabouraud dextrose agar,CHROMagar medium,germ tube test with serum,and API 20C AUX Clinical Yeast System.Results Totally,313 (86.46％) Candida strains were isolated from the specimens of 362 patients.Of these Candida strains,275 were identified as Candida albicans,38 as non-albicans Candida species,including 13 Candida glabrata strains,8 Candida parapsilosis strains,7 Candida tropicalis strains,5 Candida krusei strains,1 Candida lusitaniae strain,1 Candida dubliniensis strain,1 Rhodotorula mucilaginosa strain,1 Pichia ohmeri strain and 1 Trichosporon mucoides strain.Conclusions As far as vulvovaginal candidiasis is concerned,Candida albicans is still the most prevalent pathogen,and Candida glabrata appears to be the predominant species in pathogenic non-albicans Candida species.

Objective To investigate the effect of acupuncture at Baihui (DU20) and Zusanli (ST36) acupoints on the cognitive function and the oxidation protective mechanism of cortex in vascular cognitive impairment (VCI) rats, providing experimental evidence for the clinical treatment of VCI. Methods The VCI model was established by fluorescent microemboli injection through internal carotid artery. Randomly divided into the control group (n=12), the model group (n=12), the positive drug group (n=12), the acupuncture treatment group (n=12). Two weeks after modeling, the rats in the acupuncture treatment group were stimulated for 30 minutes with daily electroacupuncture at Baihui and Zusanli acupoints. The positive drug group was treated with donepezil hydrochloride 0.5206 mg/kg orally daily for 30 days. After the treatment, the water maze test was used to test the cognitive learning ability of rats. The content of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px) and hydrogen peroxide (H2O2) in the cortex of rats were detected by biochemical methods. Results Compared with the model group, the number of passing through the platform (7.5 ± 1.9, 6.8 ± 2.2 vs. 3.7 ± 1.0) of acupuncture treatment group and positive drug group were significantly higher (P<0.05), and the total distance in target quadrant (495.4 ± 89.4 cm, 487.6 ± 96.2 cm vs. 341.4 ± 67.3 cm) were significantly longer (P<0.05). In acupuncture treatment group and the positive drug group, the activity of SOD in the cortex (17.3 ± 3.3 U/mg, 15.1 ± 2.5 U/mg vs. 9.7 ± 4.9 U/mg) was significantly higher (P<0.05), but the MDA (9.1 ± 2.2 μmol/L, 8.4 ± 3.7 μmol/L vs. 15.2 ± 4.4μmol/L), and H2O2 (85.2 ± 16.2 μmol/L, 82.1 ± 13.2 μmol/L vs. 114.7 ± 24.8 μmol/L) were significantly lower (P<0.05). In acupuncture group, the activity of GSH-Px (14.5 ± 3.7 U/mg vs. 9.0 ± 2.5 U/mg) was significantly higher than that in control group (P<0.05). There was no significant difference between acupuncture group and positive drug (P>0.05). Conclusions Acupuncture at Baihui and Zusanli acupoints can improve the behavior scores of rats with VCI, increase the contents of total SOD and GSH-Px,decrease the content of MDA and H2O2 in brain,and enhance antioxidant effects, while inhibiting peroxidation, improve free radical metabolism.

Objective To investigate the clinical manifestations,imaging features,molecular genetic characteristics and possible pathogenic mechanisms of hereditary cerebral small vessel disease (CSVD) caused by heterozygous mutation of HtrA serine protease-1 (HTRA1) gene.Methods The clinical data of a Chinese Han family with CSVD carrying a heterozygous mutation of HTRA 1 gene,which came from the Department of Neurology,Henan Provincial People's Hospital in March 2018,were analyzed retrospectively.The clinical and radiographic features were summarized.Several high-throughput whole exon high-throughput sequencing was used to capture the mutation sites and the Sanger sequencing was used to validate the results.The family diagram was drawn and the 3D model construction and mutation function prediction were performed using silico tools.The relevant literature was reviewed and the pathogenesis was explored.Results The pedigree map showed that the family had an autosomal dominant inheritance pattern.Three generations of the family were investigated,and three family members in the same generation suffered from the disease.The first symptom of the proband was diplopia at the age of 39,accompanied by recurrent stroke,cognitive impairment and mood disorders,without alopecia.Head magnetic resonance imaging revealed bilateral diffuse,symmetric lesions,multiple lacunar infarcts,perivascular space,and microbleeds.The elder sister of the proband developed symptoms of left limb weakness at the age of 46,whose other clinical and imaging features were similar to those of the proband.The proband's mother died at the age of 59 due to repeated strokes.Whole exon sequencing indicated heterozygous missense mutation at c.821G＞A locus of HTRA1 gene in the proband and her 4th elder sibling,which was a new pathogenic mutation after consulting several mutation sites of databases.Function prediction suggested pathogenicity.Conclusions The heterozygous mutation of c.821G＞A in HTRA1 gene may lead to autosomal dominant CVSD.This genetic type should be given clinical attention.

【Objective】 To investigate HIV-1 subtype distribution and trend among Dalian blood donors between 2011 and 2020, in order to provide information to improve blood safety and HIV prevention. 【Methods】 HIV RNA was purified from plasma samples of Dalian blood donors with confirmed HIV infection, which were collected between 2011 and 2020. The HIV pol gene was amplified and sequenced. HIV-1 subtypes were determined by phylogenetic analysis. 【Results】 HIV RNA was successfully genotyped in 174 samples from HIV-infected donors. The main subtypes among Dalian blood donors were CRF01_AE(69.5%), CRF07_BC(17.2%), B(5.2%), CRF02_AG(2.9%), C(1.1%), CRF55_01B(1.1%), CRF08_BC(0.6%), CRF59_01B(0.6%) and CRF79_0107(0.6%). There were still 2 cases (1.1%) unclassified. Significant difference was observed when comparing with the published national data. The prevalence of CRF01_AE strains decreased over the years, while CRF07_BC increased significantly. CRF02_AG carriers differed from donors infected with other HIV subtypes by being mostly females (40.0% vs. 2.4%), aged (median: 35y vs. 26y) and lower educational background(junior school degree or below). And 96.7% of local CRF01_AE cases were related to HIV strains, which were reported to circulate in Northeast China and in the MSM population. 【Conclusion】 HIV-1 among Dalian blood donors had unique molecular epidemiology and the trends of 07_BC increasing and 01_AE decreasing lagged behind the overall national data. Donor education on blood safety and consultation services to high risk group before donation still need improvement.

【Objective】 To study the distribution and trend of HIV-1 drug resistance mutation in Dalian blood donors between 2011 and 2020. 【Methods】 The protease-reverse transcriptase (PR-RT) region was sequenced in Dalian blood donors tested HIV-1 positive between 2011 and 2020. Drug resistance mutation (DRM) rate and level of resistance to selected drugs were analyzed by the Stanford HIV Drug Resistance Database. 【Results】 DRM were detected in 17.2% (30/174) of samples, while transmitted drug resistance (TDR) was 5.7% (10/174). Between 2011 and 2020, DRM and TDR rates increased significantly in 2019 and reached their highest levels in 2020 (44.4% and 22.2%, respectively). DRM carriage was associated with people with college degree or above and with local residents (P<0.05). NNRTI DRMs were the most frequently detected (12.6%, 22/174), followed by PIs (5.7%, 10/174), with V179D/E/T and M46I being the main DRMs detected. Only one HIV-1 strain (0.57%, 1/174) carried a NRTI DRM (L74I). The overall rate of predicted high level resistance to antiretroviral drugs was 6.9% (12/174), with the highest proportion of NNRTI resistance (83.3%, 10/12). Two samples were classified as highly resistant to EFV and NVP, accounting for 1.1% (2/174). CRF55_01B strains showed a significantly higher DRM rate than strains of other HIV-1 genotypes (P<0.05). 【Conclusion】 Between 2011 and 2020, the rate of HIV-1 DRMs in blood donors in Dalian showed a significant upward trend, particularly in 2019—2020, with NNRTI resistance being the most common. The combination of DRMs detection before and after implementation of ART under the latest national ART treatment plan would improve the effectiveness of HIV-1 prevention and control locally.

OBJECTIVE To compare the efficacy and safety of new oral anticoagulants （NOACs） and warfarin in the treatment of left ventricular thrombus （LVT）， and to provide evidenced-based reference for rational drug use in clinic. METHODS Retrieved from PubMed， Cochrane Library， Embase， Ovid Medline， CNKI， Wanfang and VIP during the inceptions to March 2022， after screening the literature and extracting data， the quality of randomized controlled trials （RCTs） was evaluated by using bias risk evaluation tool recommended by Cochrane systematic evaluator manual. Newcastle Ottawa Scale was used to evaluate the quality of cohort studies， and RevMan 5.3 software was used for meta-analysis and bias risk analysis. RESULTS A total of 13 studies were included in the analysis， including 2 RCTs， 11 cohort studies and 2 261 patients； results of meta-analysis showed that there was no statistical significance in the incidence of complete LVT resolution [OR＝1.05， 95%CI（0.81，1.37）， P＝0.71]， the incidence of stroke/systemic embolism [OR＝0.89， 95%CI（0.67，1.18）， P＝0.42]， the incidence of massive haemorrhage [OR＝ 0.61， 95%CI（0.19，1.97）， P＝0.41]， the incidence of rehospitalization [OR＝0.84， 95%CI（0.49，1.46）， P＝0.54] or all-cause mortality [OR＝0.93， 95%CI（0.56，1.56）， P＝0.79] between 2 groups. The incidence of any bleeding event in trial group was significantly lower than that control group[OR＝ 025-80863493。0.65， 95%CI（0.45，0.93）， P＝0.02]. Subgroup analysis showed that complete LVT resolution of patients with follow-up ≤6 months in trial group was significantly higher than control group， and the incidence of any bleeding event was significantly lower in patients with follow-up ＞6 months and in the European region than control group （P＜0.05）. There was no statistically significant difference in the rate of complete LVT resolution in patients with follow-up＞6 months， the incidence of any bleeding event in patients from Asia and America， or the incidence of any bleeding event in the two groups included in the RCT or the cohort study （P＞0.05）. The publication bias analysis showed that publication bias was less likely in the rate of complete LVT resolution but more likely in the incidence of any bleeding event. CONCLUSIONS NOACs can eliminate thrombus faster in the early stage， but with the prolongation of anticoagulation time， the efficacy of NOACs is comparable to warfarin， and the safety of NOACs in any bleeding event is better than warfarin.