Objective To investigate the susceptibility of Cryptococcus neoformans strains to antifungal drugs and examine the relevant clinical manifestations and laboratory test results in a tertiary hospital in Shanghai during the period from 2019 to 2023.Methods The isolates were identified by MALDI-TOF and biochemical identification cards.The minimum inhibitory concentration(MIC)values of 5-fluorocytosine,amphotericin B,fluconazole,voriconazole,and itraconazole against C.neoformans strains were measured using broth microdilution method.The corresponding clinical data were reviewed and compared.Results Majority(78.7％)of the 75 strains of C.neoformans were isolated from cerebrospinal fluid(CSF).The prevalence of wild type(WT)strains was the lowest(36.0％)for itraconazole and the highest(94.7％)for voriconazole.Cryptococcus capsular antigen test was positive in 62 strains.The results of Cryptococcus capsular antigen test was consistent with fungal culture in 96.9％of the cases.Conclusions Most of the C.neoformans strains were isolated from CSF.The prevalence of non-WT C.neoformans strains was the highest for itraconazole.The prevalence of WT C.neoformans strains was the highest for voriconazole.

Objective To investigate the susceptibility of Cryptococcus neoformans strains to antifungal drugs and examine the relevant clinical manifestations and laboratory test results in a tertiary hospital in Shanghai during the period from 2019 to 2023.Methods The isolates were identified by MALDI-TOF and biochemical identification cards.The minimum inhibitory concentration(MIC)values of 5-fluorocytosine,amphotericin B,fluconazole,voriconazole,and itraconazole against C.neoformans strains were measured using broth microdilution method.The corresponding clinical data were reviewed and compared.Results Majority(78.7％)of the 75 strains of C.neoformans were isolated from cerebrospinal fluid(CSF).The prevalence of wild type(WT)strains was the lowest(36.0％)for itraconazole and the highest(94.7％)for voriconazole.Cryptococcus capsular antigen test was positive in 62 strains.The results of Cryptococcus capsular antigen test was consistent with fungal culture in 96.9％of the cases.Conclusions Most of the C.neoformans strains were isolated from CSF.The prevalence of non-WT C.neoformans strains was the highest for itraconazole.The prevalence of WT C.neoformans strains was the highest for voriconazole.

Objective:To investigate the characteristics of the nasal cycle and the patterns of bilateral nasal airflow distribution in patients with obstructive sleep apnea (OSA).Methods:This cross-sectional study analyzed data from 29 healthy subjects (control group: 16 males, 13 females; age range 23-60 years, mean 31.03±8.67 years) and 41 patients with OSA (OSA group: 34 males, 7 females; age range 20-62 years, mean 39.73±11.27 years) who visited the Sleep Medicine Center of Beijing Tongren Hospital, Capital Medical University, between March 2022 and April 2025. Whole-night split-channel nasal airflow and polysomnography were performed to calculate nasal airflow laterality, nasal cycle duration, and the effects of severity, sleep stages, and body position on bilateral nasal airflow distribution during sleep were analyzed.Results:The nasal cycle duration in OSA patients was significantly shorter than in controls (179.5 min vs. 312.5 min, χ 2=14.01, P<0.001). Apnea-hypopnea index (AHI) and age were independent influencing factors. In the OSA group, the incidence of nasal cycle transitions within 10 minutes after wake [(observed)7/50 vs. 2/55(expected), χ 2=14.32, P<0.001], REM sleep [(observed)23/34 vs. 14/43(expected), χ 2=8.14, P=0.004], and position changes (21/36 vs. 11/46, χ 2=12.02, P<0.001) was higher, while, in the control group, it was only associated with REM sleep (15/15 vs. 8/22, χ 2=8.80, P=0.003). Nasal airflow lateralization in the OSA group showed a stronger correlation with body position. The nasal airflow lateralization in the supine position was significantly lower in OSA patients than in controls [REM stage: 0.626 (0.425, 0.743) vs. 0.781 (0.706, 0.857), Z=3.62, P<0.001; N3 stage: 0.526 (0.438, 0.600) vs. 0.716 (0.608, 0.853), Z=2.17, P=0.032; N1/2 stage: 0.702 (0.526, 0.787) vs. 0.747 (0.663, 0.820), Z=1.68, P=0.095]. Multiple linear regression revealed that AHI explained 31.3% of the variance in nasal airflow lateralization during supine REM sleep. Conclusions:The nasal airflow regulation during sleep in OSA patients differs from that in healthy individuals. Compared with healthy subjects, OSA patients exhibit shorter nasal cycle durations, reduced nasal airflow lateralization in the supine position, and a higher likelihood of nasal cycle transitions triggered by position changes or arousal. Healthy subjects demonstrate high and stable nasal airflow asymmetry during sleep, with minimal influence from sleep stages or body position.

Objective:To investigate the characteristics of the nasal cycle and the patterns of bilateral nasal airflow distribution in patients with obstructive sleep apnea (OSA).Methods:This cross-sectional study analyzed data from 29 healthy subjects (control group: 16 males, 13 females; age range 23-60 years, mean 31.03±8.67 years) and 41 patients with OSA (OSA group: 34 males, 7 females; age range 20-62 years, mean 39.73±11.27 years) who visited the Sleep Medicine Center of Beijing Tongren Hospital, Capital Medical University, between March 2022 and April 2025. Whole-night split-channel nasal airflow and polysomnography were performed to calculate nasal airflow laterality, nasal cycle duration, and the effects of severity, sleep stages, and body position on bilateral nasal airflow distribution during sleep were analyzed.Results:The nasal cycle duration in OSA patients was significantly shorter than in controls (179.5 min vs. 312.5 min, χ 2=14.01, P<0.001). Apnea-hypopnea index (AHI) and age were independent influencing factors. In the OSA group, the incidence of nasal cycle transitions within 10 minutes after wake [(observed)7/50 vs. 2/55(expected), χ 2=14.32, P<0.001], REM sleep [(observed)23/34 vs. 14/43(expected), χ 2=8.14, P=0.004], and position changes (21/36 vs. 11/46, χ 2=12.02, P<0.001) was higher, while, in the control group, it was only associated with REM sleep (15/15 vs. 8/22, χ 2=8.80, P=0.003). Nasal airflow lateralization in the OSA group showed a stronger correlation with body position. The nasal airflow lateralization in the supine position was significantly lower in OSA patients than in controls [REM stage: 0.626 (0.425, 0.743) vs. 0.781 (0.706, 0.857), Z=3.62, P<0.001; N3 stage: 0.526 (0.438, 0.600) vs. 0.716 (0.608, 0.853), Z=2.17, P=0.032; N1/2 stage: 0.702 (0.526, 0.787) vs. 0.747 (0.663, 0.820), Z=1.68, P=0.095]. Multiple linear regression revealed that AHI explained 31.3% of the variance in nasal airflow lateralization during supine REM sleep. Conclusions:The nasal airflow regulation during sleep in OSA patients differs from that in healthy individuals. Compared with healthy subjects, OSA patients exhibit shorter nasal cycle durations, reduced nasal airflow lateralization in the supine position, and a higher likelihood of nasal cycle transitions triggered by position changes or arousal. Healthy subjects demonstrate high and stable nasal airflow asymmetry during sleep, with minimal influence from sleep stages or body position.

The construction of clinical research management system in public hospitals is an important platform for China's clinical research workers to achieve new products conversion and application.At present,China have basically realized the informatization of clinical trial management process and scientific research project,improved the efficiency and quality of scientific research management,but there is still a large distance from the requirements of digital management platform.The core problem is that there is no unified standard for clinical data collection,disjointed management of the whole process,and backward communication and collaboration mode.The establishment of a standardized disease database has become an effective means to achieve standardized clinical data,and it is the basis for opening up the clogging point of the whole process management and realizing multi-department data sharing.

Objective: To investigate the sleep-related deglutition in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and its correlation with sleep stage and cortical arousals. Methods: From December 2015 to September 2017, simultaneous polysomnography and pharyngeal pressure monitoring were performed in 23 adult patients with OSAHS, Mann-Whitney U test were employed to analyze the following parameters: (1) the relationship between arousal and deglutition; (2) the effect of sleep stage on deglutition; (3) The relationship between the frequency of deglutition and the severity of OSAHS. Results: The subjects in this study aged (43±12) years, and the mean apnea-hypopnea index (AHI) was (49.2±27.7) times/hour. A total of 1 382 deglutition were recorded during sleep, with a median of 9.2[5.8, 13.8]times/person. There was a positive correlation between deglutition frequency and AHI(r=0.570, P=0.005) and negatively correlated with oxygen saturation (r=-0.639, P=0.001). The majority of the deglutition (73.7%) occurred after the respiratory event and in association with respiratory arousal. Deglutition occurred more in Non-rapid eye movement sleep stage 1 (N1) than N2, N3 and REM sleep (Z=-3.680, P<0.001; Z=-2.746, P=0.006; Z=- 3.490, P<0.001). Conclusions The occurrence of deglutition in patients with OSAHS is associated with cortical arousals. Deglutition frequency increased with the severity of apnea and affected by sleep staging.

OBJECTIVE We hypothesized that unstable ventilatory control(high loop gain, LG) could predict the short-term efficacy of positive airway pressure therapy in patients with obstructive sleep apnea(OSA). METHODS 42 adult patients with OSA, M/F=39/3, were studied. The stability of the ventilatory control system(LG) was quantified by fitting a simplified mathematical model to the spontaneous ventilatory pattern obtained via polysomnography. LG, pulmonary function test results, and other PSG parameters were analyzed in patients who had post-treatment AHI≥10 events/hr(non-responders) using auto-positive airway pressure therapy. RESULTS The subjects aged(40±8) years, apnea-hypopnea index(AHI) were 68.2[42.9,81.0]events/hr). Nine patients(34.6％) were non-responders. Twenty pat ients(47.6％) had residual AHI＜5 events/hr. Loop gain and pre-treatment mixed apnea index were higher in the non-responders versus responders(0.74 [0.62, 0.82] vs 0.49[0.37, 0.77], P =0.035) and(11.0[4.3, 22.9] vs 2.0[0.2, 5.3], P =0.004). In the 26 patients with LG＞0.6, nine(34.9％) had posttreatment 5 events/hr≤AHI＜10 events/hr. And all of the non-responders had LG(n=9, 34.9％). The difference was signif icant between the LG＞0.6 a nd LG＜0.6 group(P =0.007). CONCLUSION Loop gain and mixed apnea index was higher in patients with residual AHI＞10 events/hr after short-term auto-PAP therapy. Ventilatory control stability evaluation might have predictive value for PAP treatment efficacy in OSA patients.

Objective: To evaluate the auditory efficacy of Bonebridge implantation in patients with bilateral congenital malformation of external and middle ear. Methods: Eleven cases (6 males and 5 females) had unilateral Bonebridge implantation. The age ranged from 8 to 26 and the average age was 16.9. Seven to ten days after operation, the first fitting was undergone. In acoustic sound field, the average auditory thresholds were respectively measured for unaided ears and Bonebridge implanted ears by pure tone auditory (PTA, 0.25, 0.5, 1, 2 and 4 kHz). For the group over 12-year-old, MSTM was applied to evaluate speech discrimination score (SDS). For the other cases, MLNT was used as the test material. The auditory efficacy post Bonebridge implantation would be analyzed and evaluated by comparing the differences between unaided ears and Bonebridge implanted ears. Results: The bone conduction audibility threshold after Bonebridge implantation was as well as the preoperative. The auditory threshold with Bonebridge aided was improved to 25-35 dB HL, when compared to that of the unaided ears in the sound field. The SDS in the group over 12-year-old was improved about 50%; the efficacy was slightly limited for the other two cases (both less than 12 years old). Statistical analysis showed that there were significant differences between unaided ears and Bonebridge implanted ears in the sound field and SDS(P<0.05). Conclusions The auditory efficacy of Bonebridge is significant and noticeable in patients with bilateral congenital malformation of external and middle ear. Bonebridge provides a new and effective way for patient with congenital malformation of external and middle ear to reconstruct hearing.

BACKGROUND: Previous studies have shown that the complex of polyethylene glycol diacrylate and chitosan is biodegradable, has the anti-inflammation effect and can promote wound healing, with good biocompatibility.However, the composite material is brittle, and thus, it is necessary to develop a mechanical support material due to the anatomy of the nasal cavity.OBJECTIVE: To study the cytocompatibility of a novel degradable absorbable nasal packing material made of polyethylene glycol diacrylate composite hydrogel.METHODS: In our experiment, the composite hydrogel was formed by the combination of different ratios of polyethyleneglycol diacrylate, chitosan and polyvinyl alcohol using photo-crosslinking method. According to the international standard of medical devices, we used direct and indirect international standard experimental methods to evaluate the cytotoxicity of the materials. (1) Direct contact method: the polyethylene glycol acrylate composite hydrogel and mouse fibroblasts L929 were co-cultured for 24 hours to observe the morphological changes of cells. (2) Indirect extraction: mouse fibroblasts L929 were cultured in polyethylene glycol diacrylate composite hydrogel extracts (100, 50 μL) and RPMI1640 medium (100 μL), respectively, for 3 days to observe the proliferation and cytotoxicity by cell counting kit-8 assay.RESULTS AND CONCLUSION: (1) Direct contact method: the cells around the material formed a flat structure with fusiform or stellated protrudes. The material was confirmed to have good biocompatibility depending upon the presence of adherent cell growth, full and strong refraction, and the overall growth trend. (2) Indirect extraction method: with the increase of time, the number of cells in the hydrogel extract group increased, the relative proliferation rate of cells increased gradually, and the cytotoxicity was 0 to 1. To conclude, these experimental findings indicate that the polyethylene glycol acrylate composite hydrogel material has good cytocompatibility.