Objective To report the diagnosis and treatment processes of a fungal keratitis case caused by Lasio-diplodia theobromae(L.theobromae),and enhance the diagnosis and treatment experience on fungal keratitis caused by this rare pathogen.Methods Corneal scraping specimen from a patient with fungal keratitis was collec-ted.Gram-staining and fluorescence staining were conducted on specimen,followed with direct microscopic observa-tion and isolation culture.The strain was identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS)technology and targeted DNA sequencing.Antimicrobial susceptibility testing was conducted.Literatures were summarized and clinical data on fungal keratitis caused by this pathogen were sorted out.Results Septal fungal hyphae could be seen on the corneal scraping specimen microscopically.The strain was identified as L.theobromae by both MALDI-TOF MS and targeted DNA sequencing after culture.Antimicrobial susceptibility testing(microdilution method)showed that the minimal inhibitory concentrations(MICs)of ampho-tericin B,vorionazole,itraconazole,posaconazole,fluconazole,5-fluorocytosine,micafungin,caspofungin,and anidulafungin against this strain were 1,0.25,＞8,0.25,＞256,8,16,2,and 0.25 μg/mL,respectively.Pa-tient recovered well after antifungal treatment plan was adjusted according to antimicrobial susceptibility testing re-sults.Conclusion L.theobromae is a rare pathogen that causes fungal keratitis.Laboratory tests provide rapid mi-croscopic examination results,and take MALDI-TOF MS and targeted DNA sequencing identification techniques as effective means to detect rare pathogen.In vitro antimicrobial susceptibility testing result can provide reference for clinicians to correctly use antifungal agents for treatment of infection due to this pathogen.

Objective To report a case of fungal keratitis caused by plant pathogens,evidenced by laboratory testing.Methods Specimens were collected by corneal scraping from a 52-year-old male patient for pathogen culture.The patient was treated at Qionghai People's Hospital for fungal keratitis.The isolates were identified and tested for antimicrobial susceptibility.PubMed,CNKI,Wanfang,and VIP database were searched using keywords Diaporthe or Diaporthe phaseolorum in English and Chinese from the establishment of the database to December 10,2024.A retrospective literature review was conducted on the cases of human infection caused by Diaporthe.Results The specimens from corneal scraping were directly examined under a microscope.Septate fungal hyphae were observed.The isolate was identified as Diaporthe phaseolorum by targeted DNA sequencing.Antimicrobial susceptibility testing by microdilution method showed that the minimum inhibitory concentrations(MIC)of fluorocytosine,fluconazole,amphotericin B,voriconazole,itraconazole,posaconazole,micafungin,caspofungin,and anidulafungin against this strain were＞64,64,0.5,0.12,2,0.06,0.03,＜0.03,and 0.12 mg/L,respectively.Clinicians adjusted the antifungal treatment plan timely based on the antimicrobial susceptibility testing results.The patient's vision was restored.Literature review found that of the 12 reported cases of infection worldwide,6 were localized skin or soft tissue infections,3 were peritonitis,and the remaining 3 cases were keratitis.Overall,9 patients were immunocompromised and 3 had normal immune function.Human infections caused by Diaporthe often occur in immunocompromised individuals.Invasive infections often lead to patient mortality.There are no established breakpoints for common antifungal agents against Diaporthe.The MICs against the strain were higher for flucytosine and fluconazole,but lower for azoles,echinocandins,and polyenes.Conclusions Fungal keratitis caused by D.phaseolorum is an emerging infection.The information in this case,including clinical symptoms,the morphology of D.phaseolorum under microscope after corneal scraping,the growth characteristics and antifungal susceptibility testing,targeted DNA sequencing,can inform the microbiology laboratory staff and clinicians of D.phaseolorum infections in the future.

Objective To report the diagnosis and treatment processes of a fungal keratitis case caused by Lasio-diplodia theobromae(L.theobromae),and enhance the diagnosis and treatment experience on fungal keratitis caused by this rare pathogen.Methods Corneal scraping specimen from a patient with fungal keratitis was collec-ted.Gram-staining and fluorescence staining were conducted on specimen,followed with direct microscopic observa-tion and isolation culture.The strain was identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS)technology and targeted DNA sequencing.Antimicrobial susceptibility testing was conducted.Literatures were summarized and clinical data on fungal keratitis caused by this pathogen were sorted out.Results Septal fungal hyphae could be seen on the corneal scraping specimen microscopically.The strain was identified as L.theobromae by both MALDI-TOF MS and targeted DNA sequencing after culture.Antimicrobial susceptibility testing(microdilution method)showed that the minimal inhibitory concentrations(MICs)of ampho-tericin B,vorionazole,itraconazole,posaconazole,fluconazole,5-fluorocytosine,micafungin,caspofungin,and anidulafungin against this strain were 1,0.25,＞8,0.25,＞256,8,16,2,and 0.25 μg/mL,respectively.Pa-tient recovered well after antifungal treatment plan was adjusted according to antimicrobial susceptibility testing re-sults.Conclusion L.theobromae is a rare pathogen that causes fungal keratitis.Laboratory tests provide rapid mi-croscopic examination results,and take MALDI-TOF MS and targeted DNA sequencing identification techniques as effective means to detect rare pathogen.In vitro antimicrobial susceptibility testing result can provide reference for clinicians to correctly use antifungal agents for treatment of infection due to this pathogen.

Objective To report a case of fungal keratitis caused by plant pathogens,evidenced by laboratory testing.Methods Specimens were collected by corneal scraping from a 52-year-old male patient for pathogen culture.The patient was treated at Qionghai People's Hospital for fungal keratitis.The isolates were identified and tested for antimicrobial susceptibility.PubMed,CNKI,Wanfang,and VIP database were searched using keywords Diaporthe or Diaporthe phaseolorum in English and Chinese from the establishment of the database to December 10,2024.A retrospective literature review was conducted on the cases of human infection caused by Diaporthe.Results The specimens from corneal scraping were directly examined under a microscope.Septate fungal hyphae were observed.The isolate was identified as Diaporthe phaseolorum by targeted DNA sequencing.Antimicrobial susceptibility testing by microdilution method showed that the minimum inhibitory concentrations(MIC)of fluorocytosine,fluconazole,amphotericin B,voriconazole,itraconazole,posaconazole,micafungin,caspofungin,and anidulafungin against this strain were＞64,64,0.5,0.12,2,0.06,0.03,＜0.03,and 0.12 mg/L,respectively.Clinicians adjusted the antifungal treatment plan timely based on the antimicrobial susceptibility testing results.The patient's vision was restored.Literature review found that of the 12 reported cases of infection worldwide,6 were localized skin or soft tissue infections,3 were peritonitis,and the remaining 3 cases were keratitis.Overall,9 patients were immunocompromised and 3 had normal immune function.Human infections caused by Diaporthe often occur in immunocompromised individuals.Invasive infections often lead to patient mortality.There are no established breakpoints for common antifungal agents against Diaporthe.The MICs against the strain were higher for flucytosine and fluconazole,but lower for azoles,echinocandins,and polyenes.Conclusions Fungal keratitis caused by D.phaseolorum is an emerging infection.The information in this case,including clinical symptoms,the morphology of D.phaseolorum under microscope after corneal scraping,the growth characteristics and antifungal susceptibility testing,targeted DNA sequencing,can inform the microbiology laboratory staff and clinicians of D.phaseolorum infections in the future.

The acupoint sensitization theory,a breakthrough in acupuncture and moxibustion over the past two decades,has greatly enhanced the understanding of meridians and acupoints while increasing the effectiveness of clinical diagnosis and treatment in acupuncture and moxibustion practices.The number of studies on surface sensitization site detection for different diseases is increasing.However,systematic sorting and a summary of the detection mode of surface sensitization points are lacking.Therefore,this study categorizes the method of surface sensitization point detection into two modes:pan-scanning and focused scanning.The classification is based on the characteristics of the openness of the research purpose,the precision of the target range,and the degree of variation during detection.The two modes have considerable differences in the exploration efficiency and the presentation of result.The pan-scanning mode can be further subdivided into holistic and localized pan-scanning modes,whereas the focused-scanning mode can be subdivided into fixed-and variable-focused scanning modes.This study analyzes the application scenarios,characteristics,advantages,and limitations of each detection mode and presents opinions on mode selection,mode innovation,and future development directions.This study aims to provide valuable insights and guidance for the follow-up research on surface sensitization site detection of various diseases.

Objective:To compare the seroprevalence of hepatitis B in Guangzhou in 2008 and 2018.Methods:According to the proportion of Guangzhou population size, two-stage cluster sampling was used to select the residents aged 1-59 years in the two surveys.Results:4 989 and 3 980 people aged 1-59 years were involved in 2008 and 2018, respectively. HBsAg prevalence was 9.50% (95% CI:7.34%-11.66%) in 2018 and 12.45% (95% CI:10.58%-14.33%) in 2008 among the people aged 1-59 years, with no significant difference statistically ( χ 2=18.302, P=0.075). The decrease of HBsAg prevalence was mainly in the population aged 7-16 years. For the people aged 7-16 years, the HBsAg prevalence was 0.88% (95% CI: 0.35%-1.42%) in 2018 and decreased by 80.62% as compared with the rate 4.54% (95% CI:2.71%-6.36%) in 2008, with statistically significant difference ( χ 2=34.144, P=0.000). Anti-HBs prevalence was 72.30% (95% CI:69.56%-75.04%) in 2018 and ascended by 11.35% as compared with the rate of 64.93% (95% CI:61.65 %-68.22%) in 2008 among the people aged 1-59 years, with statistically significant difference ( χ 2=51.618, P=0.001). The rise of anti-HBs prevalence was mainly in the population aged 17-59 years. For the people aged 17-59 years, the anti-HBs prevalence was 71.93% (95% CI: 68.90%-74.96%) and risen by 12.80% as compared with the rate of 63.77% (95% CI: 60.16%-67.37%) in 2008, with a statistically significant difference ( χ 2=28.422, P=0.001). HBV infection rate was 48.10% (95% CI: 43.20%-53.00%) in 2018 and decreased by 22.76% as compared with the rate of 62.27% (95% CI: 59.11%-65.44%) in 2008, with statistically significant difference ( χ 2=167.138, P=0.000). The HBV infection rates in the population aged 1-6 years, 7-16 years, and 17-59 years were 4.58%, 5.13%, and 56.56% (a decrease of 81.83%, 85.91%, and 18.47%), respectively. The infection rate of HBV was 48.87% (a decrease of 24.70%) in high epidemic areas and 28.81% (a decrease of 38.75%) in people with a history of hepatitis B immunization. Conclusion:The prevention and control of hepatitis B in Guangzhou have achieved remarkable results it already reached the national goal of reducing HBsAg prevalence to less than 1% among children under five years since 2008. However, the target goal of reducing the hepatitis B mortality rate is quite demanding. The neonatal hepatitis B vaccination and monitoring and screening in adults are still needed.

Objective:To explore the possible role of C5a in the pathogenesis of renal injury in TCE- sensitized mice, to analyze the impact of expression of neutrophil gelatinase-associated lipocalin (NGAL) and monocyte chemotactic protein-1 (MCP-1) in the presence or absence of C5a receptor antagonist (C5aRA) pretreatment.Methods:A total of 50 female specific pathogens free(SPF) BALB/c mice were randomly divided into blank control group ( n=5) , solvent control group ( n=5) , TCE group ( n=20) , and TCE+C5aRA group ( n= 20) . After one week for adaptive feeding, a mouse model of TCE-induced skin sensitization was established by treating with 50% TCE and 30% TCE in turn. The mice in solvent control group accept same reagents without TCE and the mice in blank control group underwent nothing. In TCE +C5aRA group, except for the TCE solution treatment, mice were intraperitoneally injected with 0.5 mg/kg C5aRA solution at the time of challenge. And the skin erythema and edema reaction were scored 24 h after the last challenge. The mice were divided into sensitization positive group and sensitization negative group according to the scoring result. The mice were aseptically sacrificed 72 h after the last challenge to obtain the kidneys. The structural damage of kidney was observed after histopathological staining. The levels of NGAL and MCP-1 mRNA and proteins were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC) , respectively. Results:The sensitization rate of mice in TCE group and TCE+C5aRA group was 45.0% (9/20) and 40.0% (8/20) , respectively. No skin lesions was found in the mice of blank control group and solvent control group. The results of histopathological staining showed that the TCE sensitization positive mice showed renal tubular dilatation, vacuolar degeneration of renal tubular epithelial cells, and infiltration of interstitial cells. The pathological damage of the kidney in TCE sensitization positive group was mild, and no inflammatory cell infiltration was seen. The data of qRT-PCR showed that the expression levels of NGAL and MCP-1 mRNA in the TCE sensitization positive group were significantly increased than in solvent control group and TCE sensitization negative group ( P<0.05) , while the levels of NGAL and MCP-1 mRNA in TCE+C5aRA sensitization positive group were decreased than TCE sensitization positive group ( P <0.05) . The results of IHC showed that the expression levels of NGAL and MCP-1 in TCE protein sensitization positive group were significantly higher than those in solvent control group and TCE sensitization negative group ( P<0.05) . After C5aRA pretreatment, the expression levels of NGAL and MCP-1 protein were decreased than the mice in TCE sensitization positive group ( P<0.05) . Conclusion:The regulation of C5a on the expression of MCP-1 and NGAL may participate in TCE- induced mice kidney damage, and pharmacological inhibition of C5a seems to be an effective way to protect the kidney injury in TCE-sensitized mice.

Objective:To explore the possible role of C5a in the pathogenesis of renal injury in TCE- sensitized mice, to analyze the impact of expression of neutrophil gelatinase-associated lipocalin (NGAL) and monocyte chemotactic protein-1 (MCP-1) in the presence or absence of C5a receptor antagonist (C5aRA) pretreatment.Methods:A total of 50 female specific pathogens free(SPF) BALB/c mice were randomly divided into blank control group ( n=5) , solvent control group ( n=5) , TCE group ( n=20) , and TCE+C5aRA group ( n= 20) . After one week for adaptive feeding, a mouse model of TCE-induced skin sensitization was established by treating with 50% TCE and 30% TCE in turn. The mice in solvent control group accept same reagents without TCE and the mice in blank control group underwent nothing. In TCE +C5aRA group, except for the TCE solution treatment, mice were intraperitoneally injected with 0.5 mg/kg C5aRA solution at the time of challenge. And the skin erythema and edema reaction were scored 24 h after the last challenge. The mice were divided into sensitization positive group and sensitization negative group according to the scoring result. The mice were aseptically sacrificed 72 h after the last challenge to obtain the kidneys. The structural damage of kidney was observed after histopathological staining. The levels of NGAL and MCP-1 mRNA and proteins were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC) , respectively. Results:The sensitization rate of mice in TCE group and TCE+C5aRA group was 45.0% (9/20) and 40.0% (8/20) , respectively. No skin lesions was found in the mice of blank control group and solvent control group. The results of histopathological staining showed that the TCE sensitization positive mice showed renal tubular dilatation, vacuolar degeneration of renal tubular epithelial cells, and infiltration of interstitial cells. The pathological damage of the kidney in TCE sensitization positive group was mild, and no inflammatory cell infiltration was seen. The data of qRT-PCR showed that the expression levels of NGAL and MCP-1 mRNA in the TCE sensitization positive group were significantly increased than in solvent control group and TCE sensitization negative group ( P<0.05) , while the levels of NGAL and MCP-1 mRNA in TCE+C5aRA sensitization positive group were decreased than TCE sensitization positive group ( P <0.05) . The results of IHC showed that the expression levels of NGAL and MCP-1 in TCE protein sensitization positive group were significantly higher than those in solvent control group and TCE sensitization negative group ( P<0.05) . After C5aRA pretreatment, the expression levels of NGAL and MCP-1 protein were decreased than the mice in TCE sensitization positive group ( P<0.05) . Conclusion:The regulation of C5a on the expression of MCP-1 and NGAL may participate in TCE- induced mice kidney damage, and pharmacological inhibition of C5a seems to be an effective way to protect the kidney injury in TCE-sensitized mice.

Objective: To analyze the impact of dual antiplatelet (DAPT) therapy combining with or without proton pump inhibitors (PPI) on the main outcomes after percutaneous coronary intervention (PCI). Methods: The PubMed, EMBASE and Cochrane Library were searched for relevant literature and the references obtained from these sources were retrieved manually from inception till September 2017. Inclusion and exclusion criteria were established follow the Cochrane review standard. A total of 977 literatures were included, 193 duplicates were excluded, 74 reviews, case reports, letters and systematic reviews were excluded, 667 literatures were excluded after reading the title and abstract, 34 literatures were excluded due to non-randomized control studies and unrelated outcome indicators, and 9 literatures were finally included with a total of 16 589 patients. RevMan 5.3 software was used to compare the incidence of major adverse cardiovascular events (MACE), cardiogenic death, recurrent myocardial infarction, target vessel revascularization, all-cause death, stent thrombosis, stroke, gastrointestinal bleeding and gastrointestinal events in patients with DAPT combining with or without PPI after PCI. Results: MACE was observed in 8 out of the 9 included literatures, and the results showed that MACE occurred in 561 out of 6 282 patients receiving DAPT combining with PPI therapy and in 951 out of 9 632 patients using DAPT alone (OR=1.15, 95%CI 0.88-1.51, P>0.05). Cardiogenic death was observed in 7 out of the 9 included literatures, and the results showed that cardiogenic death occurred in 172 out of 6 453 patients receiving DAPT combining with PPI treatment and in 321 out of the 9 839 patients using DAPT alone (OR=0.97, 95%CI 0.80-1.18, P>0.05). Recurrent myocardial infarction was observed in 7 out of the 9 included literatures, the results showed 416 out of 6 282 cases in DAPT combining with PPI therapy group experienced recurrent myocardial infarction and 691 out of 9 632 cases in DAPT group experienced recurrent myocardial infarction (OR=1.01, 95%CI 0.89-1.16, P>0.05). Four out of 9 literatures observed revascularization. The results showed that revascularization was performed in 64 out of 2 173 patients receiving DAPT combining with PPI therapy and in 105 out of the 2 770 patients using DAPT alone (OR=1.33, 95%CI 0.55-3.24, P>0.05). All-cause death was observed in 7 out of the 9 included literatures, and the results showed that all-cause death occurred in 172 out of the 6 453 patients in DAPT combining with PPI therapy group and in 321 out of the 9 839 patients using DAPT alone (OR=0.97, 95%CI 0.80-1.18, P>0.05). Three out of the 9 included articles observed stent thrombosis, and the results showed that stent thrombosis occurred in 99 out of 2 997 patients receiving DAPT combining with PPI therapy and in 245 out of the 6 198 patients treated with DAPT (OR=1.07, 95%CI 0.83-1.37, P>0.05). Stroke was observed in 2 out of the 9 included literatures. The results showed that stroke occurred in 5 out of 2 019 patients receiving DAPT combining with PPI therapy, and in 4 out of the 2 033 patients treated with DAPT (OR=1.00, 95%CI 0.29-3.49, P>0.05). Gastrointestinal bleeding was observed in 6 out of the 9 included literatures. The results showed that gastrointestinal bleeding occurred in 26 out of 3 517 patients receiving DAPT combined with PPI therapy, and in 93 out of the 3 506 patients treated with DAPT, gastrointestinal bleeding was significantly lower in the DAPT combining with PPI group than DAPT alone group (OR=0.27, 95%CI 0.17-0.41, P<0.01). Gastrointestinal events were reported in 6 out of the 9 included articles. Similarly, gastrointestinal events were observed in 51 out of 3 517 patients receiving DAPT combined with PPI therapy, and in 190 out of the 3 506 patients treated with DAPT alone, the incidence of gastrointestinal events in the DAPT combined with PPI group was significantly lower than DAPT alone group (OR=0.24, 95%CI 0.14-0.42, P<0.01). Conclusions The incidence of MACE, cardiogenic death, recurrent myocardial infarction, target vessel revascularization, all-cause death, stent thrombosis and stroke are not affected by DAPT combined with PPI therapy after PCI, while the incidence of gastrointestinal bleeding and gastrointestinal events could be reduced by adding PPI to DAPT in patients undergoing PCI.