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 conduct scoping review on relevant studies on the application of telehealth in the disease prevention of pre-diabetic patients, in order to identify the main forms, content elements and application effects of telehealth and provide evidence for medical workers to carry out relevant intervention.Methods:Relevant studies were systematically searched in PubMed, Web of Science, Embase, Cochrane Library, National Knowledge Infrastructure, VIP, Wanfang database and China Biology Medicine disc. The search time was from the establishment of the databases to December 6, 2023. The included studies were summarized and analyzed.Results:A total of 33 literatures were included. The results showed that the main forms of telehealth included network communication software, applications, portable electronic devices, website platforms and artificial intelligence. The contents of telehealth mainly involved health education, data monitoring, peer support, personalized programs and psychological guidance. The outcome indexes of telehealth were physiological indexes, disease management indexes, exercise indexes, diet indexes, experience indexes and psychological indexes.Conclusions:Network communication software and application programs are the main forms of telehealth for pre-diabetic patients and multi-element and all-round telehealth services can enhance the application experience of patients. The effect of telehealth has initially appeared, but it needs to be verified for a long time.

Objective:To evaluate the testing capability of urinary iodine laboratories in Gansu Province and analyze the existing problems.Methods:Z-score method and uncertainty analysis were used to analyze the external quality control assessment results of urinary iodine laboratories in Gansu Province from 2017 to 2021 (data were collected from Gansu Center for Disease Prevention and Control).Results:From 2017 to 2021, the participation rate in the assessment of urinary iodine laboratories in the province was 100.0% (473/473), the feedback rate was 99.8% (472/473), and the pass rate was 91.9% (434/472). The pass rates for assessment from 2017 to 2021 were 82.7% (62/75), 93.9% (93/99), 94.9% (93/98), 92.0% (92/100), and 94.0% (94/100), respectively. The pass rates for provincial, municipal, and county assessments were 5/5, 98.6% (69/70), and 90.7% (360/397), respectively. The proportions of │Z│≤2, 2 <│Z│ < 3, and│Z│≥3 between laboratories in the province were 84.5% (399/472), 9.3% (44/472), and 6.2% (29/472), respectively. The proportions of│Z│≤2, 2 <│Z│ < 3, and│Z│≥3 within the laboratories were 88.6% (418/472), 9.1% (43/472), and 2.3% (11/472), respectively. There was a significant difference in the composition of │Z│ scores between laboratories annually (χ 2 = 24.60, P = 0.002), the proportion of│Z│≤2 increased from 66.7%(50/75) in 2017 to 90.0% (90/100) in 2021. The│Z│ scores between and within provincial laboratories were both ≤2. The proportion of │Z│≤2 between municipal and county-level laboratories was 91.4% (64/70) and 83.1% (330/397), respectively, the proportion of│Z│≤2 within laboratories was 92.9% (65/70) and 87.7% (348/397), respectively. There was no difference in the composition of│Z│ scores between and within provincial, municipal, and county-level laboratories( P < 0.05). The proportion of two concentration quality control blind sample results in the province that were both within the uncertainty range was 89.2% (421/472). From 2017 to 2021, they were 81.3% (61/75), 91.9% (91/99), 84.7% (83/98), 92.0% (92/100), and 94.0% (94/100), respectively, with statistically significant differences (χ 2 = 9.69, P = 0.021); provinces, cities, and counties were 5/5, 95.7% (67/70), and 87.9% (349/397), respectively, with statistically significant differences (χ 2 = 23.60, P = 0.023). Conclusions:Through continuous external quality control assessments of all established urinary iodine laboratories in Gansu Province, the overall testing capacity of urinary iodine laboratories at all levels has been continuously improved. However, in the future, it is still necessary to strengthen laboratory testing capabilities and improve the level of urine iodine detection.

Objective To explore and validate the application value of a deep learning model based on the Huawei Cloud ModelArts platform in the diagnosis of atypical cervical cells in liquid-based cytology(LBC)and to evaluate its assistive effect for pathologists with different diagnostic experiences.Methods We retrospectively analyzed 1 044 cervical cytology specimens from Dongguan People's Hospital in 2020.The artifical intelligence(AI)-assisted diagnostic system developed on the Huawei Cloud ModelArts platform was compared with junior,intermediate,and senior pathologists for diagnosis.Sensitivity,specificity,precision,recall,and area under the receiver operating characteristic curve(AUC)were calculated to assess the diagnostic performance of the Al system and its assistive effect for pathologists with different levels of experience.The McNemar test was used to compare the differences between the Al system and manual diagnosis.P＜0.05 was considered statistically significant.Results For the 1 044 cervical exfoliated cytology specimens,the sensitivity and specificity of the AI system in detecting atypical cells was 98.96％and 89.15％,both of which were higher than those of junior doctors(81.95％and 91.81％,respectively).The overall diagnostic accuracy of the Al system was 93.68％,which was significantly higher than that of junior doctors(87.26％,P＜0.001).Al assistance could significantly improve junior doctors'ability to detect atypical cells,with the sensitivity and specificity increasing from 80.1％to 96.5％and from 85.6％to 92.3％,respectively.Conclusion The AI-assisted cervical cytology diagnostic system developed in this study demonstrated superior performance,particularly in significantly improving the diagnostic level of junior pathologists,showing promising clinical application prospects.

【Objective】 To investigate the role and mechanism of dapagliflozin (Dapa), a sodium glucose co-transporter 2 inhibitor, in acute liver injury. 【Methods】 Eight-week-old C57BL6/J mice were given a single intraperitoneal injection of CCl4 to induce acute liver injury. The mice were preventively given 5 mg/kg Dapa by gavage 24 h and 2 h before CCl4 injection, while those in the control group were given an equal volume of solvent gavage. After 24 h, the mice were anesthetized and sacrificed. H&E staining, plasma biochemistry, RT-qPCR, and Western blotting were used to detect the severity of liver injury and the expressions of macrophage-related genes. 【Results】 In the CCl4 group, hepatic infiltration of inflammatory cells increased, and liver and renal functions significantly deteriorated, which was further aggravated by Dapa. CCl4 could promote the expressions of M1 macrophages and fibrosis-related genes in the liver, but reduce those of M2 and antioxidant-related genes, and the latter was further inhibited by Dapa. In addition, the protein expression of arginase 1 decreased and that of SGLT2 increased after Dapa intervention, while NF-κB pathway did not change significantly, suggesting that Dapa might directly affect the energy metabolism homeostasis in the liver and aggravate acute liver injury induced by CCl4. 【Conclusion】 Dapa can exacerbate hepatic and renal damage in acute stage of liver injury, inhibit macrophages M2 polarization, and aggravate oxidative stress and inflammatory injury induced by CCl4.

Objective:To realize the accurate prediction of the fall risk of the elderly by a convolutional neural network prediction model.Methods:Stratified random cluster sampling was used from June 2019 to February 2020, Python′s Matlabplot library and Opencv library were used to perform data preprocessing on the plantar pressure data of 1 093 subjects who had come from medical institutionsand community or elderly care institutions of Chongqing and Nanjing, such as data visualization, compression and clipping, grayscale, Gaussian blur, etc., and then the data were divided into training set (983 cases) and verification set (110 cases), the training set data were used to train the convolutional neural network model, the verification set was used to verify the model, and the ReLU function was used to suppress overfitting to obtain the final prediction model.Results:The sensitivity of the fall warning model to the validation set for predicting falls was 91.2%, the specificity was 81.4%, the accuracy was 91.5%, and the AUC was 0.865.Conclusions:The fall prediction model can predict the fall risk of the elderly in a specific scenario. In the subsequent improvement, the software and hardware construction should be comprehensively improved to further improve the prediction accuracy.

Sarcopenia,also known as"oligomyositis""hypomyositis"and"muscle wasting",is an age-related geriatric syndrome characterized by decreased muscle mass,muscle strength and function decline.It can increase the risk of adverse out-comes such as physical disability,poor quality of life,and death.The pathogenic factors of sarcopenia mainly include older age,diseases,lack of exercise,malnutrition,etc.As one of the key factors affecting sarcopenia,the nutritional status of the body play an important role in the development of sarcopenia.Therefore,this paper reviews the role of nutrition in sarcopenia and nutritional interventions for patients with common chronic diseases combined with sarcopenia,aiming to provide a basis for the developing more scientific and rationalized nutritional intervention program for elderly patients with sarcopenia.

Objective:To explore the differences of clinical features and surgical efficacy between the elderly and the middle-aged and young patients with meningiomas in the central cortex area.Methods:Forty-three elderly patients with meningiomas in the central cortex area (≥60 years old) and 63 middle-aged and young patients with meningiomas in the central cortex area (18-59 years old), accepted surgery in Department of Neurosurgery, Guangdong 999 Brain Hospital from January 2011 to December 2020, were chosen. The differences of symptom, gross tumor volume, peritumoral edema degrees, intraoperative blood loss, tumor resection degrees, complications, and hospital stays between the 2 groups were analyzed.Results:The elderly patients had significantly higher proportion of preoperative muscle strength decline, lower proportion of preoperative headache, larger preoperative tumor volume, more severe peritumoral edema degrees before and after surgery, small volume of intraoperative blood loss, and longer hospital stays compared with the middle-aged and young patients ( P<0.05). However, no significant differences in distributions of tumor resection Simpson grades, proportion of new neurological dysfunction, incidence of postoperative complications, and proportions of reoperations and tumor recurrence were noted between the 2 groups ( P>0.05). Significant difference in distributions of peritumoral edema degrees among patients with different WHO grades was noted in the elderly group ( P<0.05), and significant difference in distribution of peritumoral edema degrees among patients with different tumor volumes was noted in the middle-aged and young group ( P<0.05). Conclusions:Although differences in clinical characteristics exist between the elderly and the middle-aged and young patients with meningiomas in the central cortex area, no significant difference in surgical efficacy is noted between the 2 groups. The peritumoral edema degree in the elderly patients is related to tumor pathological grades, while that in middle-aged and young patients is related to tumor volumes.

Objective:To investigate the workload of doctorsand its influencing factors in the outpatient department of a tertiary public hospital in Beijing, in order to provide references for further improvement of outpatient management.Methods:Data on outpatient workload and basic information of doctors in clinical departments of a tertiary public hospital in Beijing in 2022 were collected. Independent sample t-tests was used to analyze the differences in workload among doctors with different characteristics. Multiple linear regression analysis was conducted to identify the main factors influencing doctors′ outpatient workload. Results:In 2022, the number of patients treated by doctors in clinical departments per half day was 18.4±8.1, the duration of half-day treatment was 3.08±0.40 h, and the treatment time per visit was 11.93±5.19 min. The type of department was found to be a key factor affecting the number of patients, the duration of treatment, and the time per visit in outpatient care. The workload of surgical and internal medicine departments was significantly higher than that of other departments. The workload of doctors with less experience was significantly higher than that of more experienced doctors.Conclusions:The outpatient workload in tertiary comprehensive hospitals is heavy, and it is mainly influenced by the type of department and professional title. Different measures should be implemented for different department types by hospitals and health management departments to optimize the allocation of medical resources and effectively reduce the burden on doctors in tertiary public hospitals.

Abstract Vaccination is the most effective prevenative measure against infectious diseases. As guardians of minor children, parental attitudes have a decisive influence on children s vaccination. Therefore, it is very important to understand parental attitudes and preference towards the vaccination of minor children in COVID-19 for the successful implementation of vaccination. In this study, the current situation and associated factors of parental COVID-19 vaccine hesitancy for children. It was found that parental vaccine hesitation was mainly influenced by factors related to parents, children, vaccination and information process. Parents should be guided to obtain information through authoritative channels and treat vaccination correctly. At the same time, medical staff should play an important role in health education, submit correct immunisation information, reduce vaccine hesitancy, and promote herd immunity.