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.

Objective:To explore the effect of nursing intervention based on the health action process approach (HAPA) theory on follow-up compliance and blood glucose management of patients with diabetes retinopathy (DR) .Methods:From October 2022 to May 2023, 102 DR patients who visited the Diabetes Fundus Clinic of Shanxi Eye Hospital were selected by convenience sampling as participants. A total of 51 patients who visited from October 2022 to January 2023 were selected as control group, and 51 patients who visited from February to May 2023 were selected as observation group. Control group received routine nursing, while observation group received nursing intervention based on HAPA theory on this basis. The follow-up compliance, Chinese version of the Compliance with Annual Diabetic Eye Exams Survey (CADEES-C) score, fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG) and glycosylated hemoglobin (HbA1c) were compared between the two groups.Results:The compliance of DR patients in observation group after six months of follow-up was higher than that in control group, and the difference was statistically significant ( P<0.05). After six months, the CADEES-C dimension scores and total score of DR patients in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05). FBG and 2hPG of DR patients in observation group were lower than those in control group after three and six months, and the differences were statistically significant ( P<0.05). After six months of intervention, there was no statistically significant difference in HbA1c between observation group and control group ( P>0.05) . Conclusions:Nursing interventions based on HAPA theory can effectively improve the follow-up compliance of DR patients, enhance their health beliefs during follow-up, and improve their blood glucose.

Objective:To comprehensively search, analyze and integrate the best evidence on environmental factors for the prevention and management of myopia in children and adolescents, to provide reference for the formulation of scientific and complete myopia prevention and management programs.Methods:A comprehensive search about evidence on environmental factors prevention and management of myopia in children and adolescents was conducted in following databases: UpToDate, BMJ Best Practice, Cochrane Library, JBI Evidence-Based Health Care Center Database, Chinese Medical Ace Base, China Association of Chinese Medicine, Chinese Medical Association, American Academy of Ophthalmology, International Myopia Society, European Society of Ophthalmology, International Agency for the Prevention of Blindness, Brien Holden Vision Research Center, PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang, etc. Research types included guidelines, expert consensus, systematic review/Meta-analysis, evidence summary, best clinical practice.Results:A total of 23 articles were included, including 6 guidelines, 3 expert consensus articles and 14 systematic reviews. Evidence summarized 27 items from the following 4 aspects: prevention and management purpose, risk assessment, environmental prevention and management measures and health education.Conclusions:This study summarized the best evidence on environmental factors to prevent and manage myopia in children and adolescents. When the evidence is applied, appropriate environmental prevention and management measures should be selected to prevent and control the onset and progression of myopia in children and adolescents, based on the actual situation, to promote evidence-based practice.

Objective:To explore the characteristics and categories of self-management behavior of patients with diabetic retinopathy (DR) and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 200 patients who visited Diabetes Fundus Department of Shanxi Eye Hospital from October 2021 to June 2022 were selected as the research objects. The General Information Questionnaire, General Self-Efficacy Scale, Social Support Rating Scale, Chinese version of Mishel Uncertainty in Illness Scale-Adult and Diabetes Retinopathy Self-management Scale were used to investigate. Cluster analysis method was used to classify subgroups, and univariate analysis and ordered Logistic regression analysis were used to identify the influencing factors.Results:A total of 200 questionnaires were sent out in this survey, and 195 valid questionnaires were finally recovered, with an effective recovery rate of 97.5%. The self-management behaviors of DR Patients were divided into three categories, such as active practice type (19.5%, 38/195) , passive obedience type (33.8%, 66/195) and passive inaction type (46.7%, 91/195) . Logistic regression analysis showed that the duration of diabetes, degree of DR, self-efficacy, social support and disease uncertainty were the influencing factors of patients' self-management behavior ( P<0.05) . Conclusions:The self-management behavior of diabetic retinopathy patients is heterogeneous, which can be divided into three categories, such as active practice type, passive obedience type and passive inaction type. There are differences in the characteristics of patients in different categories. Clinical medical staffs should take targeted intervention measures according to different patient types to improve the self-management ability of patients.

The vagina contains at least a billion microbial cells,dominated by lactobacilli.Here we perform metagenomic shotgun sequencing on cervical and fecal samples from a cohort of 516 Chinese women of reproductive age,as well as cervical,fecal,and salivary samples from a second cohort of 632 women.Factors such as pregnancy history,delivery history,cesarean section,and breastfeeding were all more important than menstrual cycle in shaping the microbiome,and such information would be necessary before trying to interpret differences between vagino-cervical micro-biome data.Greater proportion of Bifidobacterium breve was seen with older age at sexual debut.The relative abundance of lactobacilli especially Lactobacillus crispatus was negatively associated with pregnancy history.Potential markers for lack of menstrual regularity,heavy flow,dysmenor-rhea,and contraceptives were also identified.Lactobacilli were rare during breastfeeding or post-menopause.Other features such as mood fluctuations and facial speckles could potentially be predicted from the vagino-cervical microbiome.Gut and salivary microbiomes,plasma vitamins,metals,amino acids,and hormones showed associations with the vagino-cervical microbiome.Our results offer an unprecedented glimpse into the microbiota of the female reproductive tract and call for international collaborations to better understand its long-term health impact other than in the settings of infection or pre-term birth.

To explore the effect of Naoshuming decoction on cerebral ischemic rats.
 Methods: The model of cerebral ischemia in rats was established via middle cerebral artery occlusion (MCAO). The MCAO model rats were randomly divided into a model group (n=36), a Naoshuming decoction at high dose group (n=36), a Naoshuming decoction at middle dose group (n=36) and a Naoshuming decoction at low dose group (n=36). In addition, a normal group (n=12) and a sham operation group (n=12) were included. Rats in each group were killed on the 3rd, 7th, and 14th day to detect relevant indicators. The Ayelet Levy 14 method was used to score the neurological function. Immunohistochemical method was used to detect the protein expression of nuclear factor kappa-B (NF-κB)/p50, NF-κB/p65, tumor necrosis factor-α (TNF-α), and IL-1β. The quantitative real-time PCR were used to detect the mRNA expression of NF-κB, TNF-α and IL-1β. 
 Results: Compared with the sham group, at each time point, the inflammation indexes in the model group and different dose of Naoshuming decoction groups were significantly enhanced, and all of them showed neurological dysfunction. But the inflammatory indexes and neurological function scores would were gradually improved with the pass of time. Compared with the model group, the neurological dysfunction, the protein levels of NF-κB/p50, NF-κB/p65, TNF-α and IL-1β, and the mRNA of NF-κB, TNF-α and IL-1β in the high, middle and low dose of Naoshuming decoction groups were reduced at 3, 7 and 14 d, with statistical difference (all P<0.05 or P<0.01). 
 Conclusion: Naoshuming decoction can alleviate the cerebral ischemic injury in rats.
Animals ; Brain Ischemia ; Infarction, Middle Cerebral Artery ; Inflammation ; Interleukin-1beta ; NF-kappa B ; Rats ; Tumor Necrosis Factor-alpha

Animals ; Blastocyst ; Embryo Loss ; HeLa Cells ; Humans ; Mice ; Nuclear Proteins ; deficiency ; genetics ; metabolism

Objective: To study the impact to operation safety of preoperative renal artery embolization for management of ≥10 cm renal cell carcinoma. Methods: The clinical data of 239 cases with ≥10 cm renal cell carcinoma which all had underwent operation in Department of Urology, Peking University First Hospital from January 2002 to December 2014 were retrospectively analyzed. Fifty-three patients underwent preoperative renal artery embolization (therapeutic group) and 186 patients did not (control group). The effect of embolization on operative time, transfusion requirements, hospitalization, ICU stay and perioperative complications were analyzed by comparing the two groups using rank sum test and χ² test or Fisher exact test. Results: Comparing the therapeutic group and control group, there was significant difference in tumor location (on the left or right). The mean age, sex, mean primary tumor size, and TNM stage were similar in both groups. Comparing the therapeutic group and control group, there were more open surgeries in therapeutic group (96.2% vs. 82.3%, χ²=6.438, P=0.013). There were no significant differences in mean operative time (238 (525) minutes vs. 208 (583) minutes, Z=-2.182, P=0.062). The mean blood transfusion (700 (1 900) ml vs. 925 (8 800) ml, Z=-1.064, P=0.006) had significant difference. The therapeutic group had a longer mean hospitalization (21 (50) days vs. 15 (79) days, Z=-4.322, P=0.000) and higher rate of intensive care unit stay (54.7% vs. 34.4%, χ²=6.103, P=0.027). There was no significant difference in perioperative complications between two groups (0 vs.3.2%, P=0.408). Conclusion Preoperative renal artery embolization in ≥10 cm renal cell carcinoma patients undergoing operation provides benefit in increasing operation safety and reducing perioperative death.

Objective: To investigate the clinical features and prognosis of rare subtypes of renal cell carcinoma. Methods: This retrospective study collected the data of 52 rare subtypes of renal cell carcinoma of patients who underwent surgery from January 2002 to December 2014 at Department of Urology, Peking University First Hospital. There were 12 patients with collecting duct carcinoma, 5 patients with Xp11.2 translocation renal cell carcinoma, 5 patients with mucinous tubular and spindle cell carcinoma, 30 patients with unclassified renal cell carcinoma. The study group included 25 male and 27 female patients, with mean age of 52 years. The mean tumour size was (6.5±3.9) cm (range: 1.5 to 21.0 cm). The basic clinical features, gross appearance, Fuhrman nuclear grade, TNM staging and prognosis of rare subtypes of RCC were studied. The OS curves were obtained for rare subtypes of renal cell carcinoma using the Kaplan-Meier method and compared using a Log-rank test. Results: The rate of lymph node and distant metastasis were 34.6% (18/52) and 17.3% (9/52). Malignancies were screened and detected by color Doppler ultrasonography or CT scan, however, no case was diagnosed before operation or aspiration, all cases were confirmed by the pathological examination. The average period of postoperative follow-up process was 65 months, and the mean survival time was (34±23) months. Conclusion The clinical features of rare subtypes of renal cell carcinoma are similar to those of clear cell renal cell carcinoma, while the imaging changes will be helpful for diagnosis before operation.

Objective:To detect the interleukin-6 (IL-6) levels and expressions of applipoprotein E (ApoE) in the Alzheimer's disease (AD) patients with different body-mass indexes (BMI),and to explore the diagnotic value of 11Pittsburgh comound-B (11C-PIB) combined with 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging in AD.Methods:A total of 58 AD patients were divided into four groups according to their BMI:low BMI group(BMI <18.5 kg·m-2,n=18),normal BMI group(18.5 kg·m-2≤BMI <24.9 kg·m-2,n=13),high BMI group(24.9 kg·m-2≤BMI <29.9 kg·m-2,n=12)and obese group(BMI ≥29.9 kg·m-2,n=15).All the patients underwent PET/CT imaging (11C-PIB and 18F-FDG).The sensitivity,specificity and accuracy rate,the expression rates of ApoE (ε2,ε3,and ε4) and the levels of serum IL-6 were detected.The relationship between BMI and the expression rates of ApoE and the serum levels of IL-6 were analyzed by Spearman analysis.Results:The sensitivity,specificity,and accuracy rate of the patients in low BMI group diagnosed by 11C-PIB and 18F-FDG PET/CT were 87.5%,80.0%,and 84.6%,which were higher than those diagnosed by 11C-PIB (55.6%,50.0%,and 53.8%) or 18F-FDG (42.9%,50.0%,and 46.2%)alone (P<0.05).The serum levels of IL-6 and BMI of the AD patients had a negative correlation(r=-0.407,P=0.002).The expression rate of ApoE ε4 allelic gene(60.3%) of the AD patients was higher than those of ε2(18.9%) and ε3 allelic genes(20.7%),but there was no correlation between the BMI and the expression rates of different ApoE allelic genes of the AD patients(r=-0.028,P=0.833).Conclusion:11C-PIB and 18F-FDG PET/CT has a high diagnotic value in the AD patients.11C-PIB and 18F-FDG combinated with serum IL-6 level and BMI could diagnose and evaluate AD more exactly.