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.

ObjectiveTo analyze the monitoring data of schistosomiasis from 2004 to 2021 in Suzhou New District， Jiangsu Province， and to provide evidence for improving schistosomiasis elimination strategies. MethodsFollowing the Opinions on Prevention and Control of Schistosomiasis， Parasitic Diseases and Endemic Diseases in Suzhou and the Technical Plan for Prevention and Control of Schistosomiasis， Parasitic Diseases and Endemic Diseases in Suzhou， the monitoring of schistosomiasis in the population and snail habitats from 2004 to 2021 was conducted. The Mann-Kendall method and Joinpoint regression method were employed to analyze the trend of epidemic indicators （such as seropositive rate， prevalence of snail frames， etc.）. Time series analysis （exponential smoothing model） was conducted to predict snail occurrence. ResultsFrom 2004 to 2021， a total of 73 680 people were serologically tested for schistosomiasis， with a positive rate of 0.084%. The seropositivity rate showed statistically significant differences between different years （χ²=70.73， P<0.05）， but there was no significant trend over time. In addition， 3 053 fecal tests were conducted and no positive result was found. The snail habitats covered an area of 70.11 hm² and showed a decreasing trend （Z=-1.97， P<0.05）. A total of 30 093 frames were surveyed， of which 19.038% contained snails. The difference in the prevalence of snail frames between different years was statistically significant （χ²=7 203.09， P<0.05）， with a decreasing trend in the prevalence of snail frames （Z=-2.05， P<0.05）. A total of 26 296 live snails were seized and density of live snails was 0.874 snails per frame， showing a decreasing trend in the density of live snails （Z=-2.35， P<0.05）. A total of 12 391 snails were dissected and no infected snail was found. The areas treated with molluscicides remained stable at 264.60 hm². An area of 27.77 hm² achieved the goal of snail eradication through environmental modification， with a decreasing trend （Z=-2.44， P<0.05）. It is estimated that the prevalence of snail frames and snail density will remain relatively stable from 2022 to 2026， but the snail habitat area will fluctuate significantly， showing an increasing trend. ConclusionNo indigenous cases of schistosomiasis and no infected snails are reported， indicating the successful consolidation of schistosomiasis prevention and control measures. However， the snail habitat area fluctuates greatly with an increasing trend， suggesting the need for long-term Oncomelania snail monitoring in local areas.

AIM: In order to bridge the gap between pharmacogenomic research and its clinical application, we propose the concept of genetic electronic identity, named "GeneFace", and developed an electronic information system which integrated "drug-gene" interactions and recommendations for personalized medicine. METHODS: Based on the self-developed Precision Medicine knowledgebase, which concludes drug directions, guidelines or important literatures with high level of evidence, we developed GeneFace with Java-based open-resource application framework Spring Boot, further developed a mobile App with cross-platform framework Uni-APP. RESULTS: The App includes six modules: genetic testing appointment, genetic knowledge introduction, individualized medication advice, medication records, Geneface interpretation, and Precision Medicine knowledgebase. By detecting the genotype of more than 300 gene loci upon first use, users import the results to form a personal "drug-gene identity card". Then scan or enter the drug name in "GeneFace", the App would automatically give corresponding medication recommendations, including: risks for possible adverse drug reactions, risks for reducing the efficacy or even ineffectiveness, and possibility for dose adjustment, etc., which increase the safety of clinical drug use. People can obtain pharmacogenomics knowledge and basic drug information in the "GeneFace" app. CONCLUSION: Development as a digital therapeutic product, the expanded application of GeneFace can rapidly promote clinical applications of basic pharmacogenomics research and significantly improve drug use safety, which creating a new model for accelerating the clinical application of personalized medicine.

Objective: To describe the epidemiological characteristics of a cluster of COVID-19 cases reported in Baodi district of Tianjin as of 18 February, 2020, which might be associated with the exposure in a local department store, and provide suggestions for prevention and control strategy development. Methods: The basic characteristics, time and area distributions, clinical manifestations, epidemiological history and transmission mode of the COVID-19 cases associated with the department store exposure were analyzed. Results: A total of 40 COVID-19 cases were associated with the department store exposure, accounting for 75.47% of the total confirmed cases (53 cases) reported in Baodi district. The cases were mainly at the age of 60 years or older (35.00%) and farmers (40.00%). The main clinical manifestations included fever (95.00%), cough (35.00%), and diarrhea (15.00%). The proportion of confirmed severe cases was 32.50%. The incidence curve showed that the incidence peak occurred on 31 January, 2020. Among the 40 cases, 6(15.00%) were department store employees, 19(47.50%) were customers and 15(37.50%) were close contacts (secondary cases). The first case occurred on 21 January, 2020, this case was a department store employee who had a purchasing history at whole sale markets in other provinces and cities before the onset, and 3 employees were still on duty after symptom onsets. The median of the incubation period of customer cases was 6 days, and the median of the interval between onset and medical treatment of customer cases was 7 days. Conclusion This was a cluster epidemic of COVID-19, which might be associated with the exposure in the department store. By now, the current prevention and control measures have achieved satisfied effects.

Objective To evaluate the clinical implementation value of bedside ultrasound monitoring of gastric residual volume in the guidance of enteral nutrition (EN) in severe patients with mechanical ventilation. Methods One hundred and forty-three patients undergoing nasal feeding EN and mechanical ventilation ≥ 72 hours in the Department of Intensive Care Unit (ICU) of Jinhua People's Hospital from May 2017 to August 2018 were enrolled, and they were randomly divided into two groups: a traditional control group (71 cases) and an ultrasound monitoring group (72 cases). The traditional control group applied 50 mL syringe to withdraw gastric juice from gastric tube, once every 4 hours, and then the EN protocol based on the gastric residual volume was adjusted; the ultrasound monitoring group used bedside ultrasound to monitor the gastric residual volume once every 4 hours, and then the EN protocol was adjusted accordingly. The changes of EN tolerance indexes e.g. abdominal distension, reflux vomiting, diarrhea, bowel sound hyperactivity or disappearance, intra-abdominal pressure, etc, the changes of incidence of ventilator-associated pneumonia (VAP), mechanical ventilation time and ICU hospitalization time in these two groups were observed. Results The incidences of abdominal distension, reflux vomiting, diarrhea, intestinal hyperactivity or disappearance of bowel sounds were significantly lower in the ultrasound monitoring group than those in the traditional control group [abdominal distension: 23.6% (17/72) vs. 28.2% (20/71), reflux vomiting: 18.1% (13/72) vs. 22.5% (16/71), diarrhea: 13.9% (10/72) vs. 14.1% (10/71), bowel sounds hyperactivity or disappearance: 9.7% (7/72) vs. 11.3% (8/71), all P < 0.05], the intra-abdominal pressure was obviously lower in the ultrasound monitoring group than that in the traditional control group [mmHg (1 mmHg = 0.133 kPa): 8.9±5.6 vs. 9.6±6.1, P < 0.05], and the incidence of VAP was significantly lower in the ultrasound monitoring group than that in the traditional control group [19.7% (14/72) vs. 23.9% (17/71), P < 0.05], the mechanical ventilation time and ICU hospitalization time were also significantly shorter in the ultrasound monitoring group than those in the traditional control group [mechanical ventilation time (days): 10.1±3.1 vs. 12.2±3.4, ICU hospitalization time (days): 16.8±4.2 vs. 20.6±4.8, all P < 0.05]. Conclusion The bedside ultrasound monitoring gastric residual volume can improve EN tolerance, reduce VAP incidence, and shorten the mechanical ventilation time and ICU hospitalization time in patients with mechanical ventilation.

Objective:To optimize the alcohol extraction process of herbal pair puerarin-berberine.Methods:Based on the etha-nol reflux extraction,the extraction quantity of total flavonoids,total alkaloid,puerarin and berberine hydrochloride were used as the e-valuation index,and the independent variables included the drug particle,ratio of solid to liquid, ethanol concentration, reflux dura-tion and reflux times. Significance analysis was evaluated by Plackett-Burman design,and then the extraction process was optimized by Box-Behnken response surface methodology.Results:The optimal extraction conditions of drug pair puerarin-berberine were as follows:the drug particle was 80 mesh,the ratio of solid to liquid was 1:13,the ethanol concentration was 75%,the reflux time was 60 min, and the reflux times was 4. Under the above conditions, the extraction quantity of total flavonoids, alkaloid, puerarin and berberine hydrochloride was 120.34,56.99,109.63 and 39.26 mg ·ml-1, respectively.Conclusion: The extraction process of herbal pair puerarin-berberine is reasonable and feasible optimized by Plackett-Burman design and Box-Behnken response surface methodology.

Objective Intestinal ischemia-reperfusion (I-R) is a critical and triggering event in the development of distal organ dysfunction,frequently involving the lungs.In this study we investigated the effects of edaravone on the prevention of lung injury induced by intestinal I-R in rats.Methods Eighteen male SD rats were randomly divided into 3 groups: Sham operation group (group Sham),I-R group (group IR) and edaravone group (group E).After injecting 6 mg of edaravone or the same volume of 0.9% sodium chloride,the anterior mesenteric artery was clamped with a noninvasive microvascular clip for 120 min and then reperfusion for 120 min.Sham-operated animals underwent the same surgical procedures without clamping.Lung tissues were collected for pathology tested by HE dyed,blood as collected for the analysis of TNF-α and IL-6 concentration by ELISA,small lung tissues were collected for the analysis of lung myeloperoxidase (MPO) activity and malonialdehyde (MDA) concentration.Results Compared with group Sham,the alveolar epithelial cells in group IR was widespread edema,inflammatory cell infiltration,atectasis,disruption of alveolar,and pulmonary capillary hemorrhage.The pathological changes of lung tissue in group E were significantly improved compared with those in group IR,and that of alveolar inflammatory exudate was decreased.Pathological scoring of group E (2.1±0.7),which was significantly lower than that of group IR (5.7±1.1) and group sham (1.5±0.2) score (P<0.05),so the concentration of TNF-α,IL-6,MPO activity and MDA concentration of group E were less than those of group IR (P<0.01).Conclusion Edaravone ameliorated the lung injury induced by intestinal I-R.

OBJECTIVE:To study the effects of different drying technologies and slicing on the quality of Tetrastigma hemsley-anum,and optimize the drying methods for T. hemsleyanum. METHODS:2 treatment methods(slicing and no slicing)and 5 dry-ing methods(drying in the shade,drying in the sunlight,hot-air drying,microwave drying and freeze drying)were respectively ad-opted for the T. hemsleyanum root. After drying for 3.5-213.0 h,using the total flavonoids,total polyphenols,polysaccharides andβ-sitosterol as indexes,effects of different drying technologies on the quality of T. hemsleyanum were comparatively analyzed. RE-SULTS:Compared with no slicing,sliced T. hemsleyanum can shorten the drying time and reduce the loss of active ingredients. In the 5 drying methods,freeze drying was the best for keeping the active ingredients in T. hemsleyanum. After drying,the contents of total flavonoids,polysaccharides,total polyphenols and β-sitosterol were 18.5 mg/g,92.7 mg/g,9.19 mg/g and 0.344 mg/g respec-tively,followed by microwave drying,hot-air drying,drying in the shade and drying in the sunlight. The contents of active ingredi-ents had statistical significance by each drying methods (P<0.05 or P<0.01). CONCLUSIONS:Different drying technologies have obvious effects on the quality of T. hemsleyanum. Slicing and hot-air drying at 60 ℃ were suggested as suitable method for T. hemsleyanum in terms of cost,content of active ingredients and practicability.

Objective: As solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) share the same molecular genetics features, the 2016 WHO classification of central nervous system (CNS) tumors had created the combined term SFT/HPC and assigns three grades. This study aims to investigate the clinicopathologic characteristics, diagnosis, differential diagnosis and prognosis of CNS SFT/HPC. Methods: Seventy-one cases of CNS SFT and HPC were retrospectively reclassified and studied. Histopathological, immunohistochemical and imaging features were analyzed. The follow-up data were analyzed. Results: There were 37 male and 34 female patients. The median age was 48 years (range, 3-77 years). Twelve cases (17%) were WHO grade Ⅰ, 26 (37%) were WHO grade Ⅱ and 33 (46%) were WHO grade Ⅲ. Microscopically the tumor could show traditional SFT phenotype, HPC phenotype or mixed phenotype. Immunochemically, 97%(69/71) were positive for STAT6, with 96%(66/69)showing diffuse strong staining. Approximately 90% were diffusely positive for bcl-2, CD99 and vimentin. The expression rate of CD34 decreased with increasing tumor grade, and the mean expression rate was 78%. SSTR2a was variably expressed in 10% (7/71) of cases including one case showing strong cytoplasmic staining. A few cases expressed EMA, CD57 and S-100 focally. The Ki-67 index ranged from 1% to 50%. Thirty four patients were followed up for 8-130 months; 12 patients(35%)had recurrences, and two (6%) had liver metastases. Conclusions CNS SFT/HPC is relatively uncommon. There was significant morphological overlap or transition between different grades. STAT6 is a specific marker for the diagnosis of this tumor. Surgical resection is the preferred treatment. WHO grade Ⅱ and Ⅲ SFT/HPC show rates of local recurrence and systemic metastasis, with liver being the most common site of extracranial metastasis.

Objective To investigate the clinical efficacy of autologous fat transplantation in augmentation mammoplasty with two different methods of purification treatment .Methods Selected 86 patients undergoing autologous fat granule replant mammaplasty .They were randomly and equally divided into the centrifuge group and the static group .After extracting the body fat in the centrifuge group ,obtained the high purity granular fat by using the Centrifugal technique;After the extraction of autologous fat in the static group ,obtain the purified particle fat by using the natural static suspension and physiological saline washed the im‐purities .Respectively ,the processed fat was injected the breast of two groups with multi tunnels and multi layers .After 6 months compared the clinical efficacy of two groups by evaluating the survival rate of autologous fat in augmentation mammoplasty and pre‐operative and postoperative breast volume ,the change of breast shape and patient satisfaction .Results Two groups of patients were successfully completed surgery ,and postoperative wound healed well .After 6 months ,in the centrifuge group and the static group the survival rate of autologous fat was 74 .42 ± 6 .35 and 65 .12 ± 5 .83 (P<0 .05) ,the satisfaction rate was 88 .37% and 76 .74%(P<0 .05) ,respectively .Conclusion The augmentation mammoplasty by injecting autologous fat granules in will not produce im‐mune rejection and surgical scar ,the breast shape is good and can be repeated without satisfactory ,until the desired effect is a‐chieved .The Centrifugal autologous fat can increase the survival rate of fat and patients′satisfaction ,which is suitable for clinical application .