Objective To monitor the antifungal resistance of clinical isolates of Candida spp.in the East China region.Methods MALDI-TOF MS or molecular methods were used to re-identify the strains collected from January 2018 to December 2022.Antifungal susceptibility testing was performed using the broth microdilution method.The susceptibility test results were interpreted according to the breakpoints of 2022 Clinical and Laboratory Standards Institute(CLSI)documents M27 M44s-Ed3 and M57s-Ed4.Results A total of 3 026 strains of Candida were collected,65.33％of which were isolated from sterile body sites,mainly from blood(38.86％)and pleural effusion/ascites(10.21％).The predominant species of Candida were Candida albicans(44.51％),followed by Candida parapsilosis complex(19.46％),Candida tropicalis(13.98％),Candida glabrata(10.34％),and other Candida species(0.79％).Candida albicans showed overall high susceptibility rates to the 10 antifungal drugs tested(the lowest rate being 93.62％).Only 2.97％of the strains showed dose-dependent susceptibility(SDD)to fluconazole.Candida parapsilosis complex had a SDD rate of 2.61％and a resistance rate of 9.42％to fluconazole,and susceptibility rates above 90％to other drugs.Candida glabrata had a SDD rate of 92.01％and a resistance rate of 7.99％to fluconazole,resistance rates of 32.27％and 48.24％to posaconazole and voriconazole non-wild-type strains(NWT),respectively,and susceptibility rates above 90％to other drugs.Candida tropicalis had resistance rates of 29.55％and 26.24％to fluconazole and voriconazole,respectively,resistance rates of 76.60％and 21.99％to posaconazole and echinocandins non-wild-type strains(NWT),and a resistance rate of 2.36％to echinocandins.Conclusions The prevalence and species distribution of Candida spp.in the East China region are consistent with previous domestic and international reports.Candida glabrata exhibits certain degree of resistance to fluconazole,while Candida tropicalis demonstrates higher resistance to triazole drugs.Additionally,echinocandins resistance has emerged in Candida albicans,Candida glabrata,Candida tropicalis,and Candida parapsilosis.

Objective To evaluate the function of "high-dose methotrexate (HD-MTX) protocol" in the patients with HD-MTX-induced acute kidney injury (AKI).Methods The medical record data of patients with hematological malignancy received HD-MTX therapy in the First Affiliated Hospital of Soochow University from January 2013 to December 2016 were collected and retrospectively analyzed.The patients who received chemotherapy before the establishment of "HD-MTX protocol" were enrolled into the control group (between January 2013 to September 2014), and the patients who received chemotherapy after the establishment of "HD-MTX protocol" were enrolled into the observation group (between October 2014 to December 2016).The incidence of delayed MTX elimination and AKI between the 2 groups were compared.Results A total of 234 patients were enrolled in the study.There were 78 patients in the control group including 50 males and 28 females with the age 3 to 64 years and median age 25 years, of them, 57 patients with leukemia and 21 patients with lymphoma.There were 156 patients in the observation group including 92 males and 64 females with the age 6 to 64 years and median age 26 years, of them, 129 patients had leukemia and 27 patients had lymphoma.The percentage of patients with no-prehydration and no-preurine alkalinization in the control group was higher than that in the observation group[60.1% (47/78) vs.4.5% (7/156), 80.8% (63/78) vs.8.3% (13/156)], and the median volume of intravenous hydration was less than that in the observation group[0 (0-500) ml vs.1 750 (1 250-2 100) ml].The differences between the 2 groups were statistically significant (X2=91.168, P<0.001;X2=124.415, P<0.001;Z=-9.224, P<0.001).The incidence of delayed MTX elimination and AKI after MTX infusion in the control group was higher than that in the observation group [21.8% (17/78) vs.12.2% (18/156).20.5% (16/78) vs.10.3% (16/156)].The differences between the 2 groups were statistically significant (X2=4.300, P=0.038;X2=4.634, P=0.031).In the control group, there were 16 patients with AKI, the patients with grade Ⅰ, grade Ⅱ and grade Ⅲ were 6, 2 and 8 respectively.In the observation group, there were 16 patients with AKI, the patients with grade Ⅰ, grade Ⅱ and grade Ⅲ were 11, 4 and 1 respectively.The degree of kidney injury in the control group was higher than that in the observation group (Z=-2.286, P=0.022).Conclusion The "HD-MTX protocol" can significantly decrease the incidence of delayed MTX elimination and AKI, especially the incidence of grade Ⅲ AKI.

Objective To evaluate the function of "high-dose methotrexate (HD-MTX) protocol" in the patients with HD-MTX-induced acute kidney injury (AKI).Methods The medical record data of patients with hematological malignancy received HD-MTX therapy in the First Affiliated Hospital of Soochow University from January 2013 to December 2016 were collected and retrospectively analyzed.The patients who received chemotherapy before the establishment of "HD-MTX protocol" were enrolled into the control group (between January 2013 to September 2014), and the patients who received chemotherapy after the establishment of "HD-MTX protocol" were enrolled into the observation group (between October 2014 to December 2016).The incidence of delayed MTX elimination and AKI between the 2 groups were compared.Results A total of 234 patients were enrolled in the study.There were 78 patients in the control group including 50 males and 28 females with the age 3 to 64 years and median age 25 years, of them, 57 patients with leukemia and 21 patients with lymphoma.There were 156 patients in the observation group including 92 males and 64 females with the age 6 to 64 years and median age 26 years, of them, 129 patients had leukemia and 27 patients had lymphoma.The percentage of patients with no-prehydration and no-preurine alkalinization in the control group was higher than that in the observation group[60.1% (47/78) vs.4.5% (7/156), 80.8% (63/78) vs.8.3% (13/156)], and the median volume of intravenous hydration was less than that in the observation group[0 (0-500) ml vs.1 750 (1 250-2 100) ml].The differences between the 2 groups were statistically significant (X2=91.168, P<0.001;X2=124.415, P<0.001;Z=-9.224, P<0.001).The incidence of delayed MTX elimination and AKI after MTX infusion in the control group was higher than that in the observation group [21.8% (17/78) vs.12.2% (18/156).20.5% (16/78) vs.10.3% (16/156)].The differences between the 2 groups were statistically significant (X2=4.300, P=0.038;X2=4.634, P=0.031).In the control group, there were 16 patients with AKI, the patients with grade Ⅰ, grade Ⅱ and grade Ⅲ were 6, 2 and 8 respectively.In the observation group, there were 16 patients with AKI, the patients with grade Ⅰ, grade Ⅱ and grade Ⅲ were 11, 4 and 1 respectively.The degree of kidney injury in the control group was higher than that in the observation group (Z=-2.286, P=0.022).Conclusion The "HD-MTX protocol" can significantly decrease the incidence of delayed MTX elimination and AKI, especially the incidence of grade Ⅲ AKI.

Objective:The purpose of this study is to determine levels of Ghrelin,TNF-α,IL-1 and IL-6 in peripheral blood of patients with chronic hepatitis B,liver cirrhosis,and non-alcoholic fatty liver disease which diagnosed at different extent of damage,and based on it to have a further study on the relevance between Ghrelin and inflammatory cytokines in peripheral blood in above diseases.Methods:Ghrelin,TNF-α,IL-1 and IL-6 in peripheral blood were determined by ELISA method.Results:In patients with chronic hepatitis B andhepatic cirrhosis,Ghrelin level increased significantly as compared with that in normal control group (P＜0.05,P＜0.01).Ghrelin levels in decompensated liver cirrhosis (degree B and C)groups were much higher than in chronic hepatitis B group (P＜0.05). Ghrelin level in group of non-alcoholic fatty liver disease decreased significantly as compared with that in normal control group (P<0.01). Ghrelin and inflammatory cytokines,including TNF-α,IL-1 and IL-6 showed a positive relevances in groups of chronic hepatitis B and liver cirrhosis,but not in NAFLD group which showed a negative correlations.Conclusion:Ghrelin has a higher level in peripheral blood of patients with chronic hepatitis B and liver cirrhosis,but it has a lower level in patients with non-alcoholic fatty liver disease,suggesting correlation of Ghrelin level with the occurrence and the procession of chronic liver diseass.

Soft environment of opening laboratory in key subject will deeply affect the construction and development of disciplines.Developing and innovative academic team;scientific and rigorous running mechanism,healthy and concordant academic atmosphere,active and positive behavior mode,all of the above are the main factors of soft environment of laboratory.From now on,we need try our best to improve human rights,design more efficient aims,constitute impellingly guarantee system and fine mechanism of consistent of regulations and environment,apply modern managing instrument scientificly and improve managing efficiency.

OBJECTIVETo determine the combined effect of hypothermia and crystalloid hemodilution on blood solubility of volatile anesthetics.

METHODSTwo hundred and thirty ml blood samples obtained from each of twelve healthy male volunteers were adjusted to a hematocrit of 40% and then diluted with normal saline to hematocrits of 36%, 32%, 28%, 24%, and 20%. Blood/gas partition coefficients of desflurane, sevoflurane, isoflurane, enflurane and halothane were measured at 37 degrees C,33 degrees C, 29 degrees C, 25 degrees C, 21 degrees C and 17 degrees C using a two-stage headspace double equilibration method.

RESULTSAs the temperature decreased, the logarithm of the blood/gas partition coefficient increased linearly (P < 0.05). As the hematocrit decreased, the logarithm of the blood/gas partition coefficient decreased linearly (P < 0.05). The combined effect of hypothermia and crystalloid hemodilution on blood solubility of anesthetics was expressed by multiple linear regression equations as follows: Desflurane: log(e)lambda(B/G)=-0.0302 x T+0.0094 x HCT+0.119 R(2)=0.973. Sevoflurane: log(e)lambda(B/G)=-0.0295 x T+0.0092 x HCT+0.306 R(2)=0.961. Isoflurane: log(e)lambda(B/G)=-0.0382 x T+0.0154 x HCT+1.120 R(2)=0.997. Enflurane: log(e)lambda(B/G)=-0.0408 x T+0.0198 x HCT+1.408 R(2)=0.982. Halothane: log(e)lambda(B/G)=-0.0417 x T+0.0218 x HCT+1.649 R(2)=0.994. Where lambda(B/G) is the blood/gas partition coefficient, T is temperature (degrees C) and HCT is hematocrit (%).

CONCLUSIONSHypothermia increases, while crystalloid hemodilution decreases the blood solubility of volatile anesthetics. The combined effect of hypothermia and hemodilution on blood solubility at any cross point of temperature from 37 degrees C to 17 degrees C and hematocrit from 40% to 20% could be predicted by the multiple linear regression equations developed in this study.

Adult ; Anesthetics, Inhalation ; blood ; chemistry ; Cold Temperature ; Hematocrit ; Hemodilution ; Humans ; Hypothermia, Induced ; Isotonic Solutions ; Male ; Plasma Substitutes ; Solubility