Objective To study the antifungal activity of a new series of triazole compounds with n-propyl side chain and disubstituted benzyl structure. Methods Eleven target compounds were designed and synthesized. The structures were confirmed by ¹H NMR, and some compounds were confirmed by ¹³C NMR or HRMS. Three fungal strains were selected as experimental strains, and the antifungal activity was tested in vitro according to the standardized antifungal sensitivity test method recommended by National Committee for Clinical Laboratory Standards (NCCLS). Results Compound B11 showed better activity against candida albicans SC5314 than fluconazole and was comparable to posaconazole; Compounds B10, B11 and B4 showed better activity against cryptococcus neoformanis H99 than fluconazole, while compounds B2, B3, B5, B6 and B7 showed similar activity to fluconazole against cryptococcus neoformanis H99; while all compounds showed poor activity against aspergillus fumigatus. Conclusion Some of the target compounds with n-propyl side chain and disubstituted benzyl group structure had certain antifungal activity and could be identified as potential lead antifungal drugs.

ObjectiveTo investigate the epidemiological characteristics and analyze the incidence trend of SARS-CoV-2 infection in Shanghai， China， and compare with the characteristics of the infection in Jilin Province of China during the same period in 2022 and Wuhan at the beginning of 2020. MethodsInformation of new locally-transmitted confirmed SARS-CoV-2 cases， imported confirmed COVID-19 cases， local asymptomatic SARS-CoV-2 carriers and imported asymptomatic SARS-CoV-2 carriers in Shanghai from March 1 to April 18， 2022 was collected for descriptive analysis. ResultsFrom March 1 to April 18， 2022， a total of 397 933 locally-transmitted SARS-CoV-2 cases were reported in Shanghai. Of those， 27 613 were clinically confirmed cases and 21 were severe cases. Ten deaths were related to COVID-19. The pathogen is Omicron variant BA.2 of SARS-CoV-2. The number of the infected subjects increased rapidly after March 24 and lead to a disease outbreak. Severe and deceased cases had severe comorbidity and were mostly unvaccinated with SARS-CoV-2 vaccines. Asymptomatic SARS-CoV-2 carriers accounted for 93.06%， which is significantly higher than that in Jilin Province during the same period （48.07%， P<0.001）. Daily increase in the number of clinically confirmed COVID-19 cases in Shanghai in 2022 was much lower than that in Wuhan， Hubei Province， in 2020. Number of daily newly imported confirmed COVID-19 cases and imported asymptomatic SARS-CoV-2 carriers declined during this period. ConclusionThe Omicron variant in Shanghai 2022 is highly infectious and less pathogenic. Omicron variant BA.2 replicates rapidly in asymptomatic carriers， which makes the carriers the major source of infection. Full-term vaccination of inactivated SARS-CoV-2 vaccine might decrease the pathogenicity and fatality of SARS-CoV-2 variants. SARS-CoV-2 of the Omicron BA2 strain is likely transmitted through aerosols and droplets， which poses a great challenge to the control of the COVID-19 pandemic in large cities with high population density and sophisticated public transportation.

Objective: To evaluate the risk factors in terms of clinical characteristics and sonographic features regarding solitairy thyroid papillary carcinoma (PTC) for the lateral cervical lymph node metastasis(LLNM) and then to establish nomogram model. Methods: All patients were confirmed to be solitary PTC in paraffin wax pathology after thyroidectomy in Fudan University Shanghai Cancer Center from January to September 2016. Meanwhile, the status of lateral cervical lymph node metastasis was determined referring to postoperative pathology. Clinical characteristics including gender, age, preoperative thyroid stimulating hormone (TSH), thyroglobulin (Tg), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb), central lymph node metastasis (CLNM) and sonographic features of the PTC lesion including maximum tumor diameter, location, aspect ratio, relation with thyroid capsule, echo, margin, acoustic halo, microcalcification were evaluated for the association with lateral cervical lymph node metastasis using univariate and multivariate logistic regression analyses. Then the nomogram model was established and its application value was evaluated using ROC. Results: Out of 1 174 patients, 125 patients (10.6%) presented lateral neck lymph node metastasis and 10 patients presented skipping metastasis.Univariate analysis showed gender, preoperative Tg and TGAb, CLNM, maximum tumor diameter, location, close to the thyroid tumor capsule, echo, aspect ratio, acoustic halo, microcalcification were associated with LLNM(P<0.05). Binomial logistic regression analysis indicated CLNM, maximum tumor diameter of larger than 10 mm, superior or multiple location, microcalcification were independent risk factors of LLNM. The AUC of the nomogram model was 0.865, the sensitivity was 88.0%, the specificity was 75.2%, and the accuracy was 76.6%. Conclusions As for patients with single focal PTC, CLNM, larger lesions, microcalcification, superior location are associated with lateral neck lymph node metastasis. The nomogram model can be tried for clinical application.

Objective: To compare the difference of diagnostic ability between ultrasound radiomics (USR) and different conventional imaging models of central neck (Ⅵ) lymph node metastasis in papillary thyroid carcinoma (PTC). Methods: A training set of 609 cases was set up. USR features were extracted and screened by USR method. A weighted formula was established to calculate the USR score of each patient by ultrasound image. The USR score of the best diagnostic ability was obtained by statistical method and set as the diagnostic criterion. A test set of 326 cases was established to compare the diagnostic ability of USR score with ultrasound (US), computed tomography (CT) and US combined CT. Results: The accuracy, sensitivity, specificity, area under ROC curve and Youden index of USR score in test set were 0.804, 0.867, 0.770, 0.766, 0.533, respectively, which were significantly higher than the corresponding values of US, CT and US combined CT(all P=0.000). Conclusions USR score obtained with USR method can effectively predict lymph node metastasis in Ⅵ region of PTC. The diagnostic efficiency and clinical value of USR score were significantly higher than those of conventional medical imaging models.

Objective To investigate the ultrasonographic features of different pathological types of phyllodes tumors ( PT ) of breast . Methods T he clinical manifestations and sonographic findings were analyzed retrospectively in 132 patients with 136 different subtype PT s . Ultrasonographic features of benign ,borderline and malignant types were compared . Results All the lesions were classified into benign ( 46/136 ,33 .8% ) ,borderline ( 62/136 ,45 .6% ) and malignant ( 28/136 ,20 .6% ) . On sonography ,most tumors were show n as oval or lobulated ( 77 .9% ) ,well‐defined margins ( 70 .6% ) ,and posterior echo enhancement ( 72 .1% ) . Cystic areas were observed in 36 lesions ( 26 .5% ) . No significant difference was observed in age ,lesion shape ,echo patterns ,posterior acoustic features or cystic area ( P ＞ 0 .05 ) . Large size ,indistinct margins and grade Ⅱ － Ⅲ vascularity were more frequent in borderline and malignant tumors ( P ＝0 .002 , P ＝0 .028 , P ＜0 .001 ,respectively ) . Conclusions Phyllodes tumors of breast have certain characteristics on ultrasonography .Large size ,unclear margins and rich blood flow signals may indicate malignancy .

Objective To evaluate the risk factors in terms of clinical characteristics ,serological indicators and sonographic features regarding thyroid papillary carcinoma ( PTC) for the central neck lymph node metastasis . Methods One thousand one hundred and seventy‐four patients accepted thyroid cancer surgery at Fudan University Shanghai Cancer Center from January to September 2016 were enrolled . All patients were confirmed to be solitary PTC in paraffin wax pathology after thyroidectomy .M eanwhile ,the status of central neck lymph node metastasis was determined referring to postoperative pathology . All features of the PTC lesion in terms of clinical ,serological and sonographic features were evaluated for the association with central neck lymph node metastasis using univariate and multivariate logistic regression analysis . Meanwhile ,a nomogram model was established for the determined risk factors . Results Out of 1 174 patients ,469 patients ( 39 .9% ) presented central neck lymph node metastasis ,univariate analysis showed that age , gender , preoperative thyroglobulin ( Tg ) and thyroid peroxidase antibody ( T POAb ) , maximum diameter ,location ,close to the thyroid capsule ,AP/T R ,echo ,acoustic halo ,and presence of microcalcification were related with CLNM ( P ＜ 0 .05 ) . M ultivariate logistic regression analysis demonstrated that less than 55 years‐old , male , Tg higher than 20 eg/L , T POAb less than 1 kU/L , maximum diameter larger than 10 mm ,and presence of microcalcification were independent risk factors for CLNM . T he nomogram was established based on independent risk factors determined by the logistic regression with the AUC 0 .714 ,specificity 73 .1% ,and sensitivity 59 .7% . Conclusions For patients with single focal PTC lesion , younger age , male , higher Tg , lower T POAb , and larger lesions containing microcalcificatin on ultrasound are associated with central neck lymph node metastasis .

Objective To compare the difference of diagnostic ability between ultrasound radiomics ( USR) and different conventional imaging models of central neck ( Ⅵ ) lymph node metastasis in papillary thyroid carcinoma ( PTC) . Methods A training set of 609 cases was set up . USR features were extracted and screened by USR method . A weighted formula was established to calculate the USR score of each patient by ultrasound image . T he USR score of the best diagnostic ability was obtained by statistical method and set as the diagnostic criterion . A test set of 326 cases was established to compare the diagnostic ability of USR score with ultrasound ( US ) ,computed tomography ( CT ) and US combined CT . Results T he accuracy ,sensitivity ,specificity ,area under ROC curve and Youden index of USR score in test set were 0 .804 ,0 .867 ,0 .770 ,0 .766 ,0 .533 ,respectively ,which were significantly higher than the corresponding values of US ,CT and US combined CT ( all P ＝ 0 .000 ) . Conclusions USR score obtained with USR method can effectively predict lymph node metastasis in Ⅵ region of PTC . T he diagnostic efficiency and clinical value of USR score were significantly higher than those of conventional medical imaging models .

Objective To explore the ultrasound-guided diffuse optical tomography (DOT) distribution difference and clinical characteristics of T 1-T3 breast carcinoma. Methods Four hundred and forty-seven breast cancer patients with 455 breast lesions were enrolled.The lesion maximal diameter and total hemoglobin concentration(THC) were obtained by ultrasound-guided DOT before breast surgery biopsy.The patients age,body mass index(BMI),and the distances from lesion to skin and nipple were measured,lymph node status were also assessed.According to the 7th Edition of the AJCC Cancer Staging, all tumors were divided into T1( ≤ 2 cm),T2(2 cm < lesion ≤ 5 cm),and T3( > 5 cm) three groups according to maximum diameter on ultrasound.Results Out of 455 breast cancer lesions,148 lesions were stage T1,251 lesions were stage T2,56 lesions were T3.The age,lesion size,lesion THC and the distances between lesions and nipples of breast cancer patients were found that there were significant differences among T1,T2 and T3(all P = 0.000). With T stages increasing,the age of breast cancers patients decreased,the distance between lesions and nipples decreased,the THC increased.THC of breast cancer T 2 [(221.0 ± 56.0)μmol/L] and T3[(233.1 ± 54.0)μmol/L] were significant higher than that of T1 [(181.6 ± 70.4)μmol/L](all P = 0.000).There were all no significant difference for BMI and the distancefrom lesion to skin among different stages T( P > 0.05).With T stages increasing,the ratio of lymph node metastasis increased(T1 26.4%,T2 49.8%,T3 55.4%; P =0.000).Conclusions With breast cancer T stages increasing,T HC increases,the age of the patients decreases,lymph node metastasis rate increases.

Objective To investigate the clinical value of conventional ultrasonographic ( US),US-guided diffuse optical tomography ( US-guided DOT ) and both combined to assess treatment response of breast cancer to neoadjuvant chemotherapy( NAC). Methods Eighty-eight breast cancer patients,totally 93 lesions were included in the study. Pre-and post-last chemotherapy,size,and total hemoglobin concentration ( THC) of each lesion were measured by conventional US and US-guided DOT before biopsy,the change of lesion Size( ΔSize) and the change of THC( ΔTHC) were calculated respectively.Based on the guidelines to evaluate the response to treatment in solid tumors,the responses to NAC were classified into complete response, partial response, static disease, progressive disease groups. The histological response to chemotherapy were categorised as partial pathological response and complete pathological response using Miller and Payne system. Results Of 93 breast cancers,the overall response rate was 81.7%,the cPR rate was 24.7%. According to ROC curve analysis,when ΔSize 42.6% and ΔTHC 23.9% as cutoff values to evaluate the complete response and partial response,the area under the curve ( AUC ) were 0.666 and 0.751,respectively,the AUC of US and US-guided DOT combined in parallel and in series were 0.680 and 0.737 respectively.When ΔSize 64.5% and ΔTHC 27.2% as cutoff values to evaluate complete pathologial response,the AUC were 0.690 and 0.728 respectively,the AUC of US and US-guided DOT combined in parallel and in series were 0.693 and 0.726 respectively. Conclusions US-guided DOT and US can be used to predict breast cancers response to NAC,US and US-guided DOT combined in parallel and in series can not improve response prediction comparing with US or US-guided DOT alone.

Objective To compare the clinical effects of high flow nasal cannula (HFNC) and non-rebreathing oxygen face mask (NRB) in post-extubation patients.Methods 88 critically ill patients with machinery ventilations were divided into HFNC group and NRB group randomly.Blood gas analysis and hemodynamic parameters were assessed 1 hour prior to extubation and 6 hours after extubation.The primary clinical outcomes measured were ventilation-free days,re-intubation patient numbers,length of stay in ICU (Intensive Care Unite),total duration of hospitalization and mortality.The scant of breath degree and comfortableness of patient were recorded according to the Visual analogue scale.The measurement data were described by mean ± standard deviation ((x) ± s) and analyzed with t test,enumeration data were described by number of cases and composition ratio and analyzed with X2test,P ＜ 0.05 was considered to have statistical difference.Results There was no significant difference in clinical features between the two groups,The oxygenation index of HFNC group is significantly higher than that of NRB group after extubation [(251.4 ±43.9) vs.(201.7 ±60.7),P =0.037)].There were more ventilator-free days in the HFNC group than NRB group [(4.2 ± 2.1) vs.(3.4 ± 2.8),P =0.037)] and fewer patients required reintubation (P =0.028).The rate of ventilator associated pneumonia is also lower than NRB group (P =0.024).The patients' scant of breath feeling were obviously allevated comparing with the NRB group [(2.9 ± 1.1) vs.(3.7 ± 1.8),P =0.042)].The oxygenation index of NRB group significantly decreased after extubation [(242.9 ±68.4vs.201.7 ±60.7 P =0.048)].The two groups demonstrated similar hemodynamic patterns before and after extubation.And there were no statistically significant clinical differences in PaCO2,length of ICU stay,total duration of hospitalization or mortality.Conclusions Compared with NRB,HFNC is a more safe and effective clinical tool in the prevention and treatment of critical adult patients with extubation failure.