BackgroundDeep fungal infection is a type of life-threatening opportunistic infection. Its incidence has been increasing in recent years. This infection can affect the prognosis of patients, prolong hospital stays and raise costs for patients and their families.ObjectiveWe aimed to understand the current situation of deep fungal infections in the First Affiliated Hospital of Kunming Medical University and to provide a basis for the clinical diagnosis and treatment of deep fungal infections.MethodsThis was a retrospective analysis of 528,743 cases in the hospital from 2015 to 2019, including the epidemiological characteristics, treatment and prognosis of deep fungal infections.ResultsA total of 274 cases (0.05%) with deep fungal infections were identified, accounting for 0.05% of the total number of hospitalizations. The incidence of deep fungal infections in the hospital showed an increasing trend from 2015 to 2019. The most commonly infected site was the respiratory tract (93.07%). Among patients with deep fungal infections, 266 specimens were positive for fungal culture, by which 161 cultured Candida albicans (C. albicans), accounting for 60.53%, the main pathogen causing deep fungal infection. From 2015 to 2019, the percentage of C. albicans cases showed a downward trend, while that of non-C. albicans showed an opposite trend. Antibiotics were the most common predisposing factor for deep fungal infections (97.45%). Among the underlying diseases of patients with deep fungal infections, infectious diseases (59.49%) were the most common. Those with underlying diseases such as renal insufficiency and neurological diseases had a worse prognosis. Indwelling catheters, nervous system disease and tumors were risk factors for a poor prognosis.ConclusionsWe report for the first time the epidemiological data of deep fungal infections in a general hospital in southwestern China from 2015 to 2019. In the past 5 years, the number of patients with deep fungal infections in the First Affiliated Hospital of Kunming Medical University has been increasing. Although the clinical data are limited, these results can provide references for the diagnosis and treatment of deep fungal infections.
Objective The aim of this study was to investigate whether there is a causal relationship between different lipids and intervertebral disc degeneration, and to verify whether obesity and atherosclerosis mediate the relationship between lipids and intervertebral disc degeneration. Methods Instrumental variables and their associated data were extracted from the corresponding genome-wide association studies. Inverse variance weighted (IVW), Weighted Median Estimator (WME), MR-Egger regression method, Simple mode (SM) method, Leave-One-Out method and Weighted Mode (WM) method were used to perform Mendelian randomization (MR) statistical analysis of the instrumental variables of exposure and outcome, Sensitivity analyses were then performed using Cochrane's Q value and MR − Egger intercept. Results In the two-sample MR Analysis, HDL, ApoA-1 were protective for both cervical disc degeneration (CDD) and non-cervical disc degeneration (NCDD), BMI contributed to both CDD and NCDD, while AS only contributed to NCDD. In the multivariate MR Analysis, the protective effects of HDL and ApoA-1 on CDD and NCDD were not independent of each other, Meanwhile, AS and BMI were independent risk factors for NCDD. In mediating MR Analysis, both AS and BMI mediated the effect of HDL on NCDD (AS 32.58%, BMI 15.49%), both AS and BMI mediated the effect of ApoA-1 on NCDD (AS 19.35%, BMI 17.65%). Conclusion HDL, ApoA-1, BMI are causally associated with both CDD and NCDD. The protective effects of HDL and ApoA-1 on intervertebral disc degeneration were not independent of each other. AS is causally associated with NCDD. BMI and AS are independent association factors for NCDD. BMI and AS also play important mediating roles in NCDD.
Objective. Candida glabrata (C. glabrata) causes infections associated with severe sepsis and high mortality. This study describes the effects of micafungin (MCF), itraconazole (ICZ), and amphotericin B (AmB) on the function of macrophages during C. glabrata infection. Methods. RAW264.1 macrophages were treated with MCF, ICZ, or AmB and then challenged with C. glabrata. Cytokines from infected macrophage supernatants and the levels of superoxide dismutase (SOD) in macrophages were measured at different time points after phagocytosis. Results. The activity of SOD was significantly increased in RAW264.1 cells that phagocytized C. glabrata and reached a peak level at 6 hours ( P < 0.05 ). ICZ and AmB did not affect the SOD activity in cells that phagocytized C. glabrata versus that in untreated macrophage. C. glabrata stimulated macrophages to secrete cytokines. Neither ICZ nor AmB affected the secretion of interleukin-6 (IL-6), interleukin-8 (IL-8), or tumor necrosis factor-α (TNF-α) by C. glabrata-infected macrophages. However, MCF downregulated the secretion of TNF-α by infected macrophages and reduced the SOD activity of C. glabrata compared with those in untreated controls. Conclusion. Echinocandins may increase their antifungal efficacy by altering the innate immune response of macrophages and attenuating antioxidants of this organism.
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