Invasive fungal infections (IFIs) have become prominent global health threats, escalating the burden on public health systems. The increasing occurrence of invasive fungal infections is due primarily to the extensive application of chemotherapy, immunosuppressive therapies, and broad-spectrum antifungal agents. At present, therapeutic practices utilize multiple categories of antifungal agents, such as azoles, polyenes, echinocandins, and pyrimidine analogs. Nevertheless, the clinical effectiveness of these treatments is progressively weakened by the emergence of drug resistance, thereby substantially restricting their therapeutic utility. Consequently, there is an imperative need to expedite the discovery of novel antifungal agents. This review seeks to present an exhaustive synthesis of novel antifungal drugs and candidate agents that are either under current clinical investigation or anticipated to progress into clinical evaluation. These emerging compounds exhibit unique benefits concerning their modes of action, antimicrobial spectra, and pharmacokinetic characteristics, potentially leading to improved therapeutic outcomes relative to conventional antifungal regimens. It is anticipated that these novel therapeutic agents will furnish innovative treatment modalities and enhance clinical outcomes in managing invasive fungal infections.

Objective:To explore the prevalence and risk factors of insomnia in Chinese Air Force servicemen deployed to highland areas.Methods:A total of 718 Air Force servicemen deployed to Qinghai-Tibetan plateau were recruited at May 2024.Sleep quality was assessed with the Pittsburgh Sleep Quality Index.Social-demograph-ic,military service,and psychological characteristics were measured with a self-administered general question-naire.Bivariable and multivariable logistic regressions were performed to identify independent risk factors.Missing data were handled by the multiple imputation.Results:The average sleep duration was(6.9±1.2)h and the aver-age PSQI score was(5.9±4.1).Totally 53.8％of participants experienced clinically significant insomnia.The multivariable analysis revealed that age≥35(aOR=4.07,95％CI=1.11-17.76),stressful event(aOR=3.27,95％CI=2.00-5.49),dysfunctional sleep beliefs and attitudes(aOR=2.59,95％CI=1.75-3.85),and caffeine product usage(aOR=1.69,95％CI=1.17-2.43)were risk factors for insomnia,while Tibetan-indigenous ethnic(aOR=0.44,95％CI=0.20-0.91),higher perceived social support(aOR=0.96,95％CI=0.96-0.99),and positive coping style(aOR=0.96,95％CI=0.93-0.99)were protective factors.Conclusion:Air force service-men deployed to highland areas have sufficient sleep time,but reduced sleep quality.Age,exposed to stress event during deployment,dysfunctional sleep beliefs and attitudes,and caffeine product usage are risk factors for insomni-a,while Tibetan-indigenous ethnic,higher perceived social support and positive coping style act as protective fac-tors.

Objective:To explore the prevalence and risk factors of insomnia in Chinese Air Force servicemen deployed to highland areas.Methods:A total of 718 Air Force servicemen deployed to Qinghai-Tibetan plateau were recruited at May 2024.Sleep quality was assessed with the Pittsburgh Sleep Quality Index.Social-demograph-ic,military service,and psychological characteristics were measured with a self-administered general question-naire.Bivariable and multivariable logistic regressions were performed to identify independent risk factors.Missing data were handled by the multiple imputation.Results:The average sleep duration was(6.9±1.2)h and the aver-age PSQI score was(5.9±4.1).Totally 53.8％of participants experienced clinically significant insomnia.The multivariable analysis revealed that age≥35(aOR=4.07,95％CI=1.11-17.76),stressful event(aOR=3.27,95％CI=2.00-5.49),dysfunctional sleep beliefs and attitudes(aOR=2.59,95％CI=1.75-3.85),and caffeine product usage(aOR=1.69,95％CI=1.17-2.43)were risk factors for insomnia,while Tibetan-indigenous ethnic(aOR=0.44,95％CI=0.20-0.91),higher perceived social support(aOR=0.96,95％CI=0.96-0.99),and positive coping style(aOR=0.96,95％CI=0.93-0.99)were protective factors.Conclusion:Air force service-men deployed to highland areas have sufficient sleep time,but reduced sleep quality.Age,exposed to stress event during deployment,dysfunctional sleep beliefs and attitudes,and caffeine product usage are risk factors for insomni-a,while Tibetan-indigenous ethnic,higher perceived social support and positive coping style act as protective fac-tors.

Objective:To explore the prognostic value of BRCA1-associated protein 1 (BAP1) expression loss in patients with malignant mesothelioma (MM) .Methods:A total of 82 MM patients from January 1998 to December 2017 in Zhejiang Province were selected to detect the expression of BAP1 protein by immunohistochemical analysis. Kaplan-Meier method was used to draw the survival curve, and multivariate Cox proportional risk model was used to analyze the factors affecting the survival rate.Results:Among 82 MM patients, 61 (74.4%) were female, aged (57±11) years. BAP1 protein expression was deficient in 39 patients (47.6%). The survival rate was correlated with the loss of BAP1 protein expression and age (χ 2=5.27, 5.66, P=0.022, 0.017). Subgroup analysis showed that loss of BAP1 protein expression was associated with better prognosis in MM patients <57 years of age, female, pleural MM, epithelial MM, and treated with drugs or surgery ( P<0.05). Multivariate model results showed that positive expression of BAP1 protein ( HR=3.75, 95% CI: 2.23-6.30, P<0.001) and age ≥57 years ( HR=1.66, 95% CI: 1.01-2.72, P=0.049) were risk factors for survival in patients with MM. Conclusion:Loss of BAP1 protein expression may be an independent prognostic factor in patients with MM, which is associated with longer survival.

Objective:To investigate the clinical effect of orbital septal fascia advancement in the correction of mild blepharoptosis.Methods:From December 2016 to January 2020, a total of 77 eyes of 56 patients with mild congenital ptosis who underwent double eyelid surgery were treated. The method of orbital septal fascia advancement was used to correct mild ptosis. Specifically, during double eyelid reconstruction, the orbital septum was opened and the orbital septal fascia about 2 mm in front of the fold was preserved. The posterior lip of the orbital septal fascia was pulled down to the upper part of the tarsal plate, and fixed on the tarsal plate with 3 stitches of 5-0 nylon suture, and appropriate adjustments were made to correct mild ptosis.Results:Patients (56 eyes of 40 cases) were followed up from 6 to 12 months (average 7.4 months), 46 eyes (82.1%) were satisfied with blepharoptosis correction, 8 eyes (14.3%) were basically satisfied with blepharoptosis correction, and 2 eyes (3.6%) were dissatisfied with blepharoptosis correction. 45 eyes (80.4%) were satisfied with blepharoplasty, 7 eyes (12.5%) were basically satisfied with blepharoplasty, and 4 eyes (7.1%) were dissatisfied with blepharoplasty. No double eyelid folds disappeared after surgery, and there were no complications such as incomplete closure, conjunctival prolapse, or exposed keratitis.Conclusions:The correction effect of blepharoptosis is good, and the reconstruction structure is stable with natural appearance, fast recovery and high satisfaction. Therefore, the method can be popularized.

[Objective]To summarize the thought process behind Chief QIU Shengliang's decision to dispel dampness in order to fortify the spleen and tonify the spleen Yang in clinical treatment of distention and fullness.[Methods]The clinical applications of the aforementioned dampness dispelling technique were compiled for future reference through experience gained via apprenticeship,gathered medical cases,Chief QIU's verbal account on the matter and relevant references.Proven clinical cases were also attached at the end of the report for verification.[Results]Living environment,fast-paced jobs and irregular diet nowadays are making people more prone to spleen-stomach dysfunction and inhibition of Qi movement throughout the middle-Jiao,which in turn leads to distention and fullness.Chief QIU often clinically treats distention and fullness using the aforementioned dampness dispelling technique,for which remarkable efficacy has been achieved.In the medical case reported in this study,the patient was admitted due to recurrent abdominal distension and frequent loose stool.the patient was diagnosed with abdominal distension featuring spleen deficiency and dampness excess by Chief QIU.After treated by strengthening the spleen,dispelling dampness,warming the spleen Yang,promoting digestion and tranquilizing the mind,the patient showed significantly improved condition.[Conclusion]Chief QIU treats distention and fullness by dispelling dampness with the view to fortify the spleen and tonifying the spleen Yang,whose therapeutic efficacy is worth extensive share and popularization.

Objective:To explore the prognostic value of BRCA1-associated protein 1 (BAP1) expression loss in patients with malignant mesothelioma (MM) .Methods:A total of 82 MM patients from January 1998 to December 2017 in Zhejiang Province were selected to detect the expression of BAP1 protein by immunohistochemical analysis. Kaplan-Meier method was used to draw the survival curve, and multivariate Cox proportional risk model was used to analyze the factors affecting the survival rate.Results:Among 82 MM patients, 61 (74.4%) were female, aged (57±11) years. BAP1 protein expression was deficient in 39 patients (47.6%). The survival rate was correlated with the loss of BAP1 protein expression and age (χ 2=5.27, 5.66, P=0.022, 0.017). Subgroup analysis showed that loss of BAP1 protein expression was associated with better prognosis in MM patients <57 years of age, female, pleural MM, epithelial MM, and treated with drugs or surgery ( P<0.05). Multivariate model results showed that positive expression of BAP1 protein ( HR=3.75, 95% CI: 2.23-6.30, P<0.001) and age ≥57 years ( HR=1.66, 95% CI: 1.01-2.72, P=0.049) were risk factors for survival in patients with MM. Conclusion:Loss of BAP1 protein expression may be an independent prognostic factor in patients with MM, which is associated with longer survival.

Objective:To explore the effect of handicraft training administered over the Internet on sensation disorders and on the mental status and life quality of stroke survivors.Methods:A total of 75 stroke survivors in the sequelae stage and with sensory disturbance were randomly divided into a general training group of 26 (group A), a handicraft training group of 26 (group B), and a handicraft training group of 23 using Internet instruction (group C). In addition to 40 minutes of routine physical and sensory training rehabilitation every morning, groups A and B were given traditional training and handicraft training, while group C was given handicraft training delivered over the Internet for 40 minutes every afternoon, five days a week for 4 weeks. The traditional training involved inserting wooden boards, plate grinding, as well as sorting beans. The handicraft training involved digital painting, making non-woven flowers, silk screening flowers and paper-rolling. Before and after the 4 weeks of treatment, all of the subjects were assessed using the Fugl-Meyer sensory assessment (FMA-S), the Hamilton Anxiety Scale (HAMA), the Modified Barthel Index (MBI), and the physical component summary scale (PCS) and mental component summary scale (MCS) of the 36-item short-form health survey.Results:After the treatment, significant improvement was observed in their average scores of all three groups in all of the assessments. Groups B and C showed significantly greater improvement in the average FMA-S, HAMA and MBI scores than group A. And the average HAMA and MCS scores of group C were significantly better than those of group B.Conclusion:Handicraft training delivered over the Internet can improve the sensory functioning, mental status and life quality of stroke survivors in the sequelae stage with sensory disturbance.

Objective:To investigate the relationship between double mutations of myosin heavy chain gene (MYH6) p.Gly743Arg and p.Glu1389Lys and the cardiac phenotype.Methods:Patients carrying double mutations in the MYH6 gene p.Gly743Arg and p.Glu1389Lys were screened from 52 unrelated left ventricular hypertrophy (LVH) who were admitted to the Second Hospital of Chongqing Medical University from 2015 to 2020, and the genetic testing of peripheral blood of patients by second-generation whole-exome sequencing assay technology and genomic DNA of their family members Sanger sequencing was performed to validate the genomic DNA of the family members. The cardiac phenotype was evaluated by electrocardiogram, coronary computed tomography angiography (CTA), echocardiography, and cardiac magnetic resonance imaging (MRI) as adjuncts.Results:All whole-exome gene were detected in 52 unrelated patients with LVH, of which 1 patient (1.9%) had double mutations in MYH6 gene p.Gly743Arg and p.Glu1389Lys (proband). Two members of the maternal line of this patient carried p.Glu1389Lys mutation, but there was no obvious clinical phenotype. Two members of the paternal line carried p.Gly743Arg mutation and had obvious clinical phenotype of bradycardia, but there was no LVH. The male proband, aged 21 years old, presented with LVH and sinus bradycardia but no coronary artery stenosis on CTA before treatment, MRI showed that the left ventricular end diastolic diameter was 58 mm. After treatment with angiotensin receptor-enkephalinase inhibitor (ARNI), electrocardiogram showed that the heart rate increased significantly (from 43 bpm to 72 bpm). Echocardiography showed that the left ventricular end diastolic diameter decreased significantly (from 60 mm to 49 mm).Conclusions:The p.Glu1389Lys mutation of the MYH6 gene may not manifest the phenotype of heart disease. MYH6 gene p.Gly743Arg mutation may be manifested asymptomatic sinus bradycardia, but there is no LVH phenotype. The cardiac disease phenotype caused by the double mutations of p.Gly743Arg and p.Glu1389Lys in the MYH6 gene is more obvious. Asymptomatic LVH and sinus bradycardia can appear in adolescence, but the LVH phenotype can be reversed in a short period of time after ARNI treatment.

Objective: To explore the application and effect evaluation of the new teaching mode of medical nursing based on mobile teaching platform. Methods: Taking 110 nursing undergraduates from 2015 grade as the control group, 105 nursing undergraduates from 2016 grade were selected as the experimental group. On the basis of the traditional classroom teaching method, the "teaching online" mobile teaching platform was designed and constructed by using WeChat. At the same time, the instructors of internal science theory were invited to join the platform to simultaneously synchronize online teachers, teachers and students, and upload teaching resources. The final examination results of the two groups were compared, and the satisfaction of nursing undergraduates with the teaching of internal medicine nursing was investigated at the end of the semester, and the difference between the new teaching mode and the traditional teaching mode was demonstrated through a comparative study. At the same time, through questionnaires, we can understand the satisfaction of teachers and students in assisting teaching on mobile teaching platforms. Results: The teachers and students had a positive attitude towards the application of mobile teaching platform to assist teaching and platform functions. 6/7 of teachers and 94.3% (99/105) of students supported the promotion of this auxiliary teaching mode. All teachers and most students (92.4%, 97/105) evaluated the participation of teachers in internal medicine theory to improve the teaching effect. After the application of "teaching online" mobile teaching platform, the satisfaction of nursing undergraduates with internal medicine nursing teaching was obviously improved, the overall evaluation of teaching satisfaction in the control group and the experimental group were (4.00±0.42) and (4.83±0.42) points (t =-22.306, P<0.01). The average scores of the final exam in the experimental group (80.90±5.11) points was significantly higher than (74.86±7.37) points in the control group (t=-7.000, P<0.05). Conclusion The interdisciplinary joint teaching model based on mobile teaching platform can stimulate the students′ enthusiasm for learning and improve teaching satisfaction and learning effect.