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.

ObjectiveThis paper analyzed the punishment situation of unlicensed medical practice in recent 7 years in Jinshan District of Shanghai， then suggested the countermeasures to prevent and combat unlicensed medical practice in the future. MethodsA total of 190 cases of unlicensed medical practice from 2016 to 2022 were investigated. The basic situation of the punishment，legal basis，subject distribution，clue source and individual characteristics were analyzed. ResultsThe case-filing number of unlicensed medical practice showed a decreasing trend，but the amount of fines increased obviously. The clues of investigation and punishment of unlicensed medicine practice were mainly found by inspection（32.11%） and transferred from other departments（28.42%）， while the number of complaints and clues reported from grassroots increased year by year. Medical and dental were the two major unlicensed practice，accounting for 35.79% and 33.16%， respectively. In addition， unlicensed medical cosmetology practice was increasing year by year. 78.62% of the unlicensed medical practioners are immigrants， 62.76% of them aged between 31 and 50 years old， among them 70.34% are men， and 62.76% of them have a fixed place. ConclusionThough the prevention and crack-down on unlicensed medical practice has achieved significant achievements，it is still necessary to enhance the responsibility of local administration，strengthen the inspection，investigate and deal with cases jointly by multiple departments，and implement the comprehensive supervision mechanism of the health care industry.

BACKGROUND: High-grade serous ovarian cancer (HGSOC) is the biggest cause of gynecological cancer-related mortality because of its extremely metastatic nature. This study aimed to explore and evaluate the characteristics of candidate factors associated with the metastasis and progression of HGSOC. METHODS: Transcriptomic data of HGSOC patients' samples collected from primary tumors and matched omental metastatic tumors were obtained from three independent studies in the National Center for Biotechnology Information (NCBI) Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were selected to evaluate the effects on the prognosis and progression of ovarian cancer using data from The Cancer Genome Atlas (TCGA) database. Hub genes' immune landscapes were estimated by the Tumor Immune Estimation Resource (TIMER) database. Finally, using 25 HGSOC patients' cancer tissues and 10 normal fallopian tube tissues, immunohistochemistry (IHC) was performed to quantify the expression levels of hub genes associated with International Federation of Gynecology and Obstetrics (FIGO) stages. RESULTS: Fourteen DEGs, ADIPOQ , ALPK2 , BARX1 , CD37 , CNR2 , COL5A3 , FABP4 , FAP , GPR68 , ITGBL1 , MOXD1 , PODNL1 , SFRP2 , and TRAF3IP3 , were upregulated in metastatic tumors in every database while CADPS , GATA4 , STAR , and TSPAN8 were downregulated. ALPK2 , FAP , SFRP2 , GATA4 , STAR , and TSPAN8 were selected as hub genes significantly associated with survival and recurrence. All hub genes were correlated with tumor microenvironment infiltration, especially cancer-associated fibroblasts and natural killer (NK) cells. Furthermore, the expression of FAP and SFRP2 was positively correlated with the International Federation of Gynecology and Obstetrics (FIGO) stage, and their increased protein expression levels in metastatic samples compared with primary tumor samples and normal tissues were confirmed by IHC ( P = 0.0002 and P = 0.0001, respectively). CONCLUSIONS This study describes screening for DEGs in HGSOC primary tumors and matched metastasis tumors using integrated bioinformatics analyses. We identified six hub genes that were correlated with the progression of HGSOC, particularly FAP and SFRP2 , which might provide effective targets to predict prognosis and provide novel insights into individual therapeutic strategies for HGSOC.
Humans ; Female ; Ovarian Neoplasms/pathology* ; Prognosis ; Gene Expression Profiling ; Transcriptome ; Tumor Microenvironment ; Receptors, G-Protein-Coupled/therapeutic use* ; Tetraspanins/genetics* ; Protein Kinases ; Integrin beta1/therapeutic use*

Objective To investigate the risk of fatal stroke mortality associated with short-term exposure to air pollution， and to determine the susceptible population. Methods In this study， daily stroke mortalities of adults between 2012 and 2014 in Songjiang District， Shanghai were collected. Time-stratified case-crossover approach was used to assess the association between daily concentrations of air pollutants and fatal stroke mortalities. Results This study included 514 patients who died from acute strokes. The average concentrations during the study period were 77.45 μg·m^-3 for PM_2.5， 21.22 μg·m^-3 for SO₂， and 57.59 μg·m^-3 for NO₂. The fatal stroke mortality of adults under the age of 65 was found to be significantly associated with NO₂. At the time of a Lag of 2 d and 03 d， a significantly higher risk of fatal stroke mortality in relation to NO₂ exposure was observed， and the OR values of ischemic stroke mortality for people were 3.86 （1.53-9.75） and 5.83 （1.40-24.34） respectively. People over the age of 65 were more sensitive to increased PM_2.5 concentrations， at the time of a Lag of 03 d， fatal strokes increased by 28% when PM_2.5 levels increased. A significantly higher risk of fatal stroke mortality in relation to increase of NO₂ concentration was observed among people who were overweight or obese. Conclusion A significantly higher risk of fatal stroke mortality is associated with the increase of PM_2.5 and NO₂. The results also suggest that the susceptible population should take additional precautions to avoid or reduce the risk of fatal strokes.

Objective:To explore the potential mechanism of Jiajian Xuezheng Decotion in infiltrative gastric cancer by network pharmacology and proteomics.Methods:The Traditional Chinese Medicine Systems Pharmacology Database (TCMSP) database was used to find the compounds and their targets of Jiajianxuezhengtang, and the targets of invasive gastric cancer were determined by high performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS). The predicted target gene of Jiajian Xuezheng Decotion and the target protein data of infiltrative gastric cancer were analyzed by Venny to obtain the target gene. The target gene set was analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment by the David. The protein interaction network diagram (PPI) was obtained by the String method, displaying the prescription-drug-compound-gene network in Cytoscape software.Results:69 active ingredients and 215 drug targets were screened from Jiajian Xuezheng Decotion; 660 proteins were significantly up-expressed in infiltrative gastric cancer, and 10 drug targets and gene targets were the common targets. There were 10 protein nodes in the PPI network, of which 3 core nodes were CASP3, BCL2L1 and STAT1. The 11 KEGG pathways were significantly enriched such as include PI3K-Akt signaling pathway, p53 signaling pathway, proteoglycan in cancer, apoptosis, Jak-STAT signaling pathway and other pathways.Conclusions:Jiajian Xuezheng Decotion plays an anti-infiltrative gastric cancer effect possibly regulated apoptosis through PI3K-Akt signaling pathway, p53 signaling pathway and Jak-STAT signaling pathway. This study provides a theoretical basis for further research on the mechanism of Jiajian Xuezheng Decotion in the treatment of invasive gastric cancer.

AIM: To establish a method to investigate pharmacokinetics and bioequivalence of buthlphthalide injection. METHODS: An open, randomized, and two-cycle crossover study was conducted in 24 healthy volunteers. Plasma concentrations of buthlphthalide were determined by LC-MS/MS after administering a single dose of reference drug or test drug. Main pharmacokinetic parameters were calculated by Phoenix WinNonlin 6.4 software. RESULTS: For the test drug and the reference drug, the main pharmacokinetic parameters of flurbiprofen were as follows: AUC

Objective To explore the efficacy of double low-profile visualized intraluminal support (LVIS) stent assisted embolization in the treatment of acute intracranial wide-neck aneurysms and its relation with levels of soluble intercellular adhesion molecule-1 (SICAM-1) and S100B. Methods A total of 114 patients with acute intracranial wide-neck aneurysms admitted to our hospital from June 2014 to December 2018 were collected. According to different treatment options, the patients in the study group (n=58) were treated with double LVIS stent-assisted embolization, while those in the control group (n=56) were treated with LVIS stent-assisted embolization. The embolization degrees of intracranial wide-necked aneurysms were evaluated by Raymond grading immediately after surgery, the efficacy of the patients was evaluated by modified Rankin scale (mRS) at discharge, and the serum SICAM-1 and S100B protein levels of the patients with different treatment methods and different curative effects before and after surgery were compared. Results As compared with those in the control group, the degrees of arterial embolization immediately after surgery and good therapeutic effect rate at discharge were significantly higher in the study group (P<0.05). After treatment, the serum levels of SICAM-1 and S100B were significantly lower in the study group than those in the control group (P<0.05). The levels of SICAM-1 and S100B in patients with good therapeutic effect ([147.5±9.8] mg/mL and [0.106±0.027] mg/mL) were significantly lower than those in the patients with poor therapeutic effect ([172.8 ±4.0] mg/mL and [0.158±0.002] mg/mL, P<0.05). Conclusions The embolization rate and therapeutic effect can be significantly improved in patients with acute intracranial wide-neck aneurysms after double-LVIS stent-assisted embolization. The serum levels of SICAM-1 and S100B are significantly increased in patients with poor therapeutic effect.

BACKGROUND:Early rehabilitation after total knee arthroplasty (TKA) can help the rapid functional recovery of knee,but some patients are fear of moving and refuse to do exercising because of kinesiophobia,thereby delaying functional recovery.Foreign study has confirmed that patients with cognitive behavioral therapy (CBT) can effectively alleviate kinesiophobia,but no related studies have been reported in China.OBJECTIVE:To explore the effectiveness of CBT on patients with kinesiophobia after TKA.METHODS:108 patients with kinesiophobia after TKA were recruited from Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,China between March 2014 and January 2015,and were then equivalently randomized into experimental and control groups using random number table.Both groups were subjected to conventional treatment,while the experimental group received extra CBT.The scores of Tampa Scale of Kinesiophobia and American Knee Society were evaluated immediately,1,3,and 6 months after hospital discharge;the hospitalization time and total hospitalization expenditure were compared between two groups immediately after discharge.RESULTS AND CONCLUSION:The scores of Tampa Scale of Kinesiophobia in the experimental group were significantly lower than those in the control group at different time points postoperatively (P ＜ 0.05).The scores of American Knee Society in the experimental group were significantly higher than those in the control group at 3 and 6 months after discharge and kept on rising (P ＜ 0.01),but showed no significant difference at discharge and 1 month after discharge (P ＞ 0.05).(2) The hospitalization time and total hospitalization expenditure in the experimental group were significantly lower than those in the control group (P ＜ 0.01).(3) To conclude,CBT cannot only shorten the hospitalization time and total hospitalization expenditure,but also relieve kinesiophobia,which is conductive for functional recovery of the knee.

Objective Currently, there are few articles about kinesiophobia in patients with total knee arthroplasty (TKA) in China.This study aims to investigate the incidence of kinesiophobia and its influencing factors in TKA patient, and provide evidence for the intervention of kinesiophobia.Methods A total of 298 TKA patients from our hospital were investigated by general information questionnaire, Tampa Scale of Kinesiophobia (TSK), Knee Self-Efficacy Scales, Simplified Coping Style Questionnaire and Social Support Rating Scale.Single-factor analysis and logistic regression analysis were conducted to explore influencing factors.Results The score of TSK was 38.50±13.52, and 31.88% of TKA patients reported kinesiophobia.Logistic regression analysis showed that duration of pain (OR=5.546, 95%CI: 2.143-14.353), education level (OR=0.145, 95%CI: 0.067-0.314), self efficacy(OR=0.606, 95%CI: 0.470-0.780), positive response (OR=0.784, 95%CI: 0.683-0.900), objective support (OR=0.807, 95%CI: 0.691-0.943) and utilization of social support (OR=0.507, 95%CI: 0.461-0.705) were factors influencing kinesiophobia in TKA patients.Conclusion Attention should be paid to the kinesiophobia in TKA patients, especially those influencing factors including duration of pain, education level, and objective support.Health care providers should encourage early stage rehabilitation exercise to improve the postoperative knee function of TKA patients.