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.

Pyroptosis is a programmed death of inflammatory cells triggered by pathogen invasion,dependent on caspase activation,through both classical and non-classical pyroptosis pathways.Cell pyroptosis is related to the occurrence and development of a variety of animal infectious diseases caused by microbial infection.After microorganisms invading,cells are stimulated by pathology-re-lated molecular patterns,causing strong immune response,stimulating inflammatory signaling pathways,and then activating inflammasome,leading to pyroptosis.The immune system has e-volved multiple mechanisms to fight microbial infections and regulate inflammatory responses.The innate immune system,by recognizing microbial molecules in pathogens and responding quickly by producing inflammasome and activating pyroptosis,helps clear pathogens to prevent infection and maintain the normal functioning of the body.A thorough study of the pathogenesis and immune es-cape mechanism of cell pyroptosis in animal infectious diseases will provide a new direction for the treatment of animal infectious diseases.

Background Air pollution is a major public health concern. Air Quality Health Index (AQHI) is a very important air quality risk communication tool. However, AQHI is usually constructed by single-pollutant model, which has obvious disadvantages. Objective To construct an AQHI based on the joint effects of multiple air pollutants (J-AQHI), and to provide a scientific tool for health risk warning and risk communication of air pollution. Methods Data on non-accidental deaths in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces from January 1, 2013 to December 31, 2018 were obtained from the corresponding provincial disease surveillance points systems (DSPS), including date of death, age, gender, and cause of death. Daily meteorological (temperature and relative humidity) and air pollution data (SO₂, NO₂, CO, PM_2.5, PM₁₀, and maximum 8 h O₃ concentrations) at the same period were respectively derived from China Meteorological Data Sharing Service System and National Urban Air Quality Real-time Publishing Platform. Lasso regression was first applied to select air pollutants, then a time-stratified case-crossover design was applied. Each case was matched to 3 or 4 control days which were selected on the same days of the week in the same calendar month. Then a distributed lag nonlinear model (DLNM) was used to estimate the exposure-response relationship between selected air pollutants and mortality, which was used to construct the AQHI. Finally, AQHI was classified into four levels according to the air pollutant guidance limit values from World Health Organization Global Air Quality Guidelines (AQG 2021), and the excess risks (ERs) were calculated to compare the AQHI based on single-pollutant model and the J-AQHI based on multi-pollutant model. Results PM_2.5, NO₂, SO₂, and O₃ were selected by Lasso regression to establish DLNM model. The ERs for an interquartile range (IQR) increase and 95% confidence intervals (CI) for PM_2.5, NO₂, SO₂ and O₃ were 0.71% (0.34%–1.09%), 2.46% (1.78%–3.15%), 1.25% (0.9%–1.6%), and 0.27% (−0.11%–0.65%) respectively. The distribution of J-AQHI was right-skewed, and it was divided into four levels, with ranges of 0-1 for low risk, 2-3 for moderate risk, 4-5 for high health risk, and ≥6 for severe risk, and the corresponding proportions were 11.25%, 64.61%, 19.33%, and 4.81%, respectively. The ER (95%CI) of mortality risk increased by 3.61% (2.93–4.29) for each IQR increase of the multi-pollutant based J-AQHI , while it was 3.39% (2.68–4.11) for the single-pollutant based AQHI . Conclusion The J-AQHI generated by multi-pollutant model demonstrates the actual exposure health risk of air pollution in the population and provides new ideas for further improvement of AQHI calculation methods.

Objective:To investigate the difference of adverse events in patients with chronic obstructive pulmonary disease (COPD) who underwent on-pump coronary artery bypass grafting (ONCABG) and off-pump coronary artery bypass grafting (OPCABG).Methods:The clinical data of COPD patients undergoing CABG surgery admitted to Beijing Anzhen Hospital affiliated to Capital Medical University from January 2021 to December 2021 were retrospectively analyzed. According to whether they received cardiopulmonary bypass or not, they were divided into ONCABG group (64 cases) and OPCABG group (154 cases). The preoperative and postoperative clinical data were analyzed. The whole group was divided into 4 subgroups (ON1、ON2、OP1、OP2) according to whether receiving cardiopulmonary bypass or not and FEV160% as the cut-off point, to investigate the difference of postoperative adverse events.Results:A total of 218 patients were included, ranging in age from 45 to 76 years old, with a mean age of (63.81±7.72) years, including 149 males (68.35%). There was no significant difference in the incidence of postoperative adverse events between the ONCABG and OPCABG groups ( P>0.05). In subgroup analysis, the incidence of postoperative pulmonary infection (72.73% vs. 45.65%, P<0.05) and postoperative atrial fibrillation (59.09% vs. 32.61%, P<0.05) was higher in ON1 (FEV1≤60% ONCABG, 22 cases) group than in OP1 (FEV1≤60% OPCABG, 46 cases) group. Conclusion:The incidence of postoperative pulmonary infection and atrial fibrillation in COPD patients with FEV1≤60% was higher in ONCABG than in OPCABG.

Objective To improve the efficiency of blood collection in hemodialysis patients by inventing and applying new blood collection needles.Methods One hundred and eighty cases of hemodialysis patients were randomly divided into control group 1(CG1),control group 2(CG2),experimental group(EG). Comparison of the three groups in time of blood collection,the number of operation that had the risk of acupuncture injury and the number of the blood samples that had been contaminated. Results There were statistically significant difference (P<0.05)in three groups.The number of times of blood collection in the number of operations that had the risk of acupuncture injury,and the number of the blood sample that had been contaminated. CG1 had the longest blood collection time(12.55 min),EG had the shortest blood collection time(5.09 min);the risk of acupuncture injury was the highest in CG2 and the lowest in the EG.The number of contamination of blood samples and the amount of inaccurate sample in CG1 were the highest,and the lowest in the EG. Conclusions The working efficiency of transfer type anti-acupuncture needle(TTAN)during blood sample collection in hemodialysis patients is signifi-cantly better than that of traditional blood collection method,and it is helpful to reduce the risk of acupuncture injury and the risk of contamination in blood samples,which is worthy of promotion.

Objective To study the effect of Corylin on A375 cells melanin synthesis,and explore its mechanism.Methods The cells were randomly divided into the control group, the estradiol group, and corylin group including 10-3μmol/L, 10-2μmol/L, 10-1μmol/L, 1μmol/L, 10μmol/L, 100μmol/L. Estradiol estradiol intervention group were given 10-3 mol/L. Corylin group (10-3μmol/L, 10-2μmol/L, 10-1μmol/L, 1μmol/L, 10μmol/L,100μmol/L) were given 10-3μmol/L, 10-2μmol/L, 10-1μmol/L, 1μmol/L, 10μmol/L, 100μmol/L corylin intervention. The activity of proliferation were detected by MTT, NaOH method, dopa oxidation , both melanin content and tyrosinase activity (tyrosinase, TYR). TYR, yrosinase related protein (tyrosinase related protein, TRP)-1 and TRP-2 expression levels of mRNA were determined by RT-PCR.Results Compared with the control group, 10, 100μmol/L of Corylin group cell proliferation rate significantly decreased (P<0.01). The 1μmol/L, 10-1μmol/L, 10-2μmol/L of Corylin group cell melanin content, TYR significantly decreased (P<0.01 or P<0.05). The 1μmol/L corylin group TYR (0.303 ± 0.003vs. 0.628 ± 0.012), TRP-1 (0.313 ± 0.008 vs. 0.677 ± 0.022), TRP-2 (0.456 ± 0.028vs. 0.687 ± 0.020) mRNA expression level significantly decrease (P<0.01).Conclusions The results showed that Corylin could inhibit melanin synthesis, which worked probably through inhibiting the activity of TYR and cutting the mRNA expressions of TYR,TRP-1/2.

This paper summarized nursing care of a case with hepatic ectopic pregnancy treated by laparoscopy with preservation of liver.Nursing key points included:psychological nursing,medication guidance before surgery,prevention of hepatorrhexis,close observation and monitoring of changes in condition,pipeline nursing,monitoring of liver function and blood HCG after surgery.The operation was successful and the patient had good compliance with all treatment.The patient recovered from the surgery and was discharged nine days after operation.

Objective: To investigate the efficacy and safety of IA regimen which contains idarubicin (IDA) 8 mg/m², 10 mg/m² or 12 mg/m² as induction chemotherapy for adult patients with de-novo acute myeloid leukemia (AML) . Methods: A total of 1 215 newly diagnosed adult AML patients, ranging from May 2011 to March 2015 in the First Affiliated Hospital of Soochow University and other 36 clinical blood centers in China were enrolled in the multicenter, single-blind, non-randomized, clinical controlled study. To compare the response rate of complete remission (CR) , adverse events between different dose idarubicin combined with cytarabine (100 mg/m²) as induction chemotherapy in newly diagnosed patients of adult AML. Results: Of 1 207 evaluable AML patients were assigned to this analysis of CR rate. The CR rates of IDA 8 mg/m² group, IDA 10 mg/m² group and IDA 12 mg/m² group were 73.6% (215/292) , 84.1% (662/787) and 86.7% (111/128) , respectively (P<0.001) . After adjusted for age, blast ratio of bone marrow, FAB classification and risk stratification, the odds ratios (95% CI) of IDA 10 mg/m² group and IDA 12 mg/m² group were 0.49 (0.34-0.70) and 0.36 (0.18-0.71) , as compared with the IDA 8 mg/m² group (P<0.001, P=0.003) . In the intermediate and favorable groups, CR rates was 76.5% (163/213) , 86.9% (506/582) and 86.1% (68/79) in different doses of IDA (P=0.007) . Interestingly, IA regimen with IDA 10 mg/m² was the only beneficial factor affecting CR in this group after adjusted for age, blast ratio of bone marrow and FAB classification[OR=0.47 (95% CI 0.31-0.71) , P<0.001]. CR rates in adverse group was 50.0% (18/36) , 60.6% (43/71) and 81.8% (18/22) respectively (P=0.089) . However, the odds ratios (95% CI) of IDA 12 mg/m² when compared with the IDA 8 mg/m² was 0.22 (0.06-0.80) , after adjusted for age, blast ratio of bone marrow and FAB classification. The median time (days) of neutrophil count less than 0.5×10⁹/L in IDA 8 mg/m² group, IDA 10 mg/m² group and IDA 12 mg/m² group were 14 (11-18) , 15 (11-20) and 18 (14-22) , respectively (P=0.012) and of platelet count lower than 20×10⁹/L were 14 (7-17) , 15 (11-20) and 17 (15-21) , respectively (P=0.001) . The incidences of lung infection in the three groups were 9.8%, 13.5% and 25.2%, respectively (P<0.001) . Conclusions For young adult patients (aged 18-60 years) with AML in China, intensifying induction therapy with idarubicin 10 mg/m² is clinically superior to IDA 8 mg/m² and IDA 12 mg/m² in favorable intermediate AML subgroup. However, idarubicin 12 mg/m² is more suitable to adverse AML subgroup.

AIM:To identify and quantify the expression of IL-1βand IL-17 in mast cells ( MCs) in different types of human pericapical diseases using double immunofluorescence staining .METHODS: The specimens ( n=102 ) , including healthy control ( n=35 ) , periapical cyst ( n=35 ) and periapical granuloma ( n=32 ) , were involved in the present study .The tissue samples were fixed in 10% buffered formalin for at least 48 h and then embedded in paraffin . Serial 5-μm-thick sections were deposited onto SuperFrost/Plus microscope glasses .Routine staining of the sections using hematoxylin&eosin ( HE) was performed for morphological evaluation .The number of IL-1βand IL-17 positive MCs was identified by double immunofluorescence staining .RESULTS:Compared with the healthy controls , the inflammation score of periapical lesions was significantly increased in the periapical patients (P<0.01).The density of IL-1βand IL-17 posi-tive MCs in the periapical lesions were obviously higher than that in the healthy controls (P<0.01).However, no signifi-cant difference between periapical cyst and periapical granuloma was observed .The Pearson correlation analysis showed that there was a positive correlation between the density of IL-1βand IL-17 double positive MCs and inflammation score in dif-ferent groups of specimens (P<0.01).CONCLUSION:There is significantly increased number of MCs , along with in-creased density of IL-1βand IL-17 positive MCs in human periapical lesions .The increased density of IL-1βand IL-17 positive MCs has the similar tendency as the severity of tissue inflammation in human periapical lesions , suggesting that IL-1βand IL-17 positive MCs may play an important role in the pathogenesis of human periapical diseases .

OBJECTIVETo evaluate the postoperative complications of microscopic and conventional Palomo varicocelectomy in the treatment of varicocele in army personnel.

METHODSA total of 260 army personnel with varicocele were randomized to receive microscopic varicocelectomy (group A, n=130) and conventional Palomo varicocelectomy (group B, n=130). The postoperative recurrence and complications (scrotal edema, testicular pain and testicular atrophy) were compared between the two groups.

RESULTSAfter 1 year of follow-up, the recurrence rates in groups A and B were statistically comparable (5.3% vs 3.8%, P>0.05). The incidences of testicular atrophy and scrotal edema were significantly lower in group A than in group B (0.7% vs 3.1%, P<0.05; 3.1% vs 14.6%, P<0.05), and the rate of testicular pain relief was significantly higher in group A (90.7% vs 67.7%, P<0.05).

CONCLUSIONMicroscopic varicocelectomy can be a good choice in the treatment of varicocele in army personnel.

Adolescent ; Adult ; Groin ; surgery ; Humans ; Male ; Microsurgery ; adverse effects ; methods ; Postoperative Complications ; Treatment Outcome ; Urogenital Surgical Procedures ; adverse effects ; Varicocele ; surgery ; Young Adult