[A case of lymphatic vessel abnormality with chylous pneumonia]

Chylous pneumonia is a rare respiratory disease. The main clinical manifestation is coughing up chylous sputum with a variety of causes which can be clarified by lymphangiography. The lack of understanding of the disease, and infrequent lymphangiography have led to a high rate of misdiagnosis and missed diagnosis. Here, we reported a case of bronchial lymphatic fistula caused by lymphatic abnormality that led to the diagnosis and treatment of chylous pneumonia, with the aim of improving clinicians' understanding of this disease.

Descriptive analysis of poisoning cases involving attention deficit hyperactivity disorder medications in Hong Kong

INTRODUCTION

The number of poisoning cases involving attention deficit hyperactivity disorder (ADHD) medications has reportedly risen with their increased use. However, there is limited relevant evidence from Asia. We analysed the characteristics of poisoning events involving these medications in Hong Kong.

METHODS

We retrieved data regarding ADHD medication-related poisoning cases from the Hong Kong Poison Information Centre and conducted a descriptive analysis of the demographic information and poisoning information including sources of cases, exposure reason, exposure location, and outcome. The HKPIC data were linked with the Hospital Authority Clinical Data Analysis and Reporting System (CDARS) via de-identified Accident and Emergency numbers of public hospitals to investigate clinical characteristics. We also retrieved ADHD medication prescription records from the CDARS, then compared trends between poisoning cases and ADHD medication use.

RESULTS

We identified 72 poisoning cases involving ADHD medications between 2009 and 2019, of which approximately 70% occurred in the affected individual's residence; most were intentional poisoning events (65.3%). No statistically significant association was observed between ADHD medication prescription trends and poisoning events involving ADHD medications. Of the 66 cases (91.7%) successfully linked to CDARS, 40 (60.6%) occurred in individuals with ADHD (median age: 14 years); 26 (39.4%) occurred in individuals who lacked ADHD (median age: 33 years) but displayed higher rates of other mental disorders including depression and anxiety.

CONCLUSION

No significant correlation was evident between ADHD medication prescriptions and poisoning events involving ADHD medications. However, medication management and caregiver education must be emphasised to prevent potential poisoning events.

[Advances in algorithms for three-dimensional craniomaxillofacial features construction based on point clouds]

In light of the increasing digitalization of dentistry, the automatic determination of three-dimensional (3D) craniomaxillofacial features has become a development trend. 3D craniomaxillofacial landmarks and symmetry reference plane determination algorithm based on point clouds has attracted a lot of attention, for point clouds are the basis for virtual surgery design and facial asymmetry analysis, which play a key role in craniomaxillofacial surgery and orthodontic treatment design. Based on the studies of our team and national and international literatures, this article presented the deep geometry learning algorithm to determine landmarks and symmetry reference plane based on 3D craniomaxillofacial point clouds. In order to provide reference for future clinical application, we describe the development and latest research in this field, and analyze and discuss the advantages and limitations of various methods.

[Efficacy of decitabine combined with low dose chemotherapy on children with acute myeloid leukemia]

Objective: To evaluate the efficacy of decitabine combined with low dose chemotherapy (LDC) in the treatment of high-risk, refractory and relapsed pediatric acute myeloid leukemia (AML). Methods: Clinical data of 19 AML children treated with decitabine combined with LDC in the Department of Hematology, Children's Hospital of Soochow University from April 2017 to November 2019 were analyzed retrospectively. The therapeutic response, adverse effects and survival status were analyzed,and the outcomes of patients were followed up. Results: Among 19 AML cases, there were 10 males and 9 females. Five cases were high-risk AML, 7 cases were refractory AML, and 7 cases were relapsed AML. After one course of decitabine+LDC treatment, 15 cases achieved complete remission, 3 cases got partial remission, and only 1 case didn't get remission. All patients received allogeneic hematopoietic stem cell transplantation as consolidation therapy. The follow-up time of all cases was 46 (37, 58) months, 14 children had survived. The cumulative three-year overall survival rate was (79±9) %, events free survival rates was (68±11) %, and recurrence free survival rate was (81±10) %. The most common adverse effects related to the induction treatment were cytopenia (19 cases) and infection (16 cases).There were no treatment-related death during the therapy. Conclusion: Decitabine combined with LDC is a safe and effective option for high-risk, refractory and relapsed AML children, which provides an opportunity for HSCT.

[Investigation and influencing factors on pelvic floor muscle strength of 929 adult females in gynecological outpatient department]

Objective: To investigate the present situation of pelvic floor muscle strength, and to analyze the factors affecting pelvic floor muscle strength. Methods: The data of patients who were admitted into the general outpatient department of gynecology, Peking University People's Hospital from October 2021 to April 2022 were collected, and the patients who met the exclusion criteria were included in this cross sectional study. The patient's age, height, weight, education level, defecation way and defecation time, birth history, maximum newborn birth weight, occupational physical activity, sedentary time, menopause, family history and disease history were recorded by questionnaire. Morphological indexes such as waist circumference, abdomen circumference and hip circumference were measured with tape measure. Handgrip strength level was measured with grip strength instrument. After performing routine gynecological examinations, the pelvic floor muscle strength was evaluated by palpation with modified Oxford grading scale (MOS). MOS grade>3 was taken as normal group and ≤3 as decreased group. Binary logistic regression was used to investigate the related factors of deceased pelvic floor muscle strength. Results: A total of 929 patients were included in the study, and the average MOS grade was 2.8±1.2. By univariate analysis, birth history, menopausal time, defecation time, handgrip strength level, waist circumference and abdominal circumference were related to the decrease of pelvic floor muscle strength (all P<0.05). By binary logistic regression analysis, the level of handgrip strength (OR=0.913, 95%CI: 0.883-0.945; P<0.001) was correlated with normal pelvic floor muscle strength; waist circumference (OR=1.025, 95%CI: 1.005-1.046; P=0.016), birth history (OR=2.224, 95%CI: 1.570-3.149; P<0.001), sedentary time> 8 hours (OR=2.073, 95%CI: 1.198-3.587; P=0.009) were associated with the decrease of pelvic floor muscle strength. Conclusions: The level of handgrip strength is related to the normal pelvic floor muscle strength of females, while the waist circumference, birth history and sedentary time>8 hours are related to the decrease of pelvic floor muscle strength of females. In order to prevent the decrease of pelvic floor muscle strength, it is necessary to carry out relevant health education, enhance exercise, improve the overall strength level, reduce daily sedentary time, maintain symmetry, and carry out comprehensive overall intervention to improve pelvic floor muscle function.

Management of animal health data to inform policy in China

In the past ten years, with the development of computer and internet technology, the informatisation of animal health data management has continuously improved, thus strengthening the role of animal health information in supporting decision-making. This article outlines the legal basis, management system and collection procedure for animal health data in the mainland of China. Its development and application are also briefed, and its future development is envisioned based on the current situation.

[A case of orbital rhabdomyosarcoma combined with neurofibromatosis type 1 in a child]

This article presents a case of orbital rhabdomyosarcoma (RMS) in a child who also had neurofibromatosis type 1 (NF-1). Although NF-1 is a common neurogenetic disease, there are few reports of its combination with orbital RMS. The patient underwent surgical removal of the tumor at the age of one, but the cancer recurred after five years. Following pathological and genetic diagnosis, the patient was confirmed to have orbital RMS combined with NF-1. After surgical treatment and chemotherapy, the patient's eye condition has stabilized. This article focuses on analyzing the clinical manifestations of this case and reviews relevant literature to improve our understanding of this disease in children.

[Application and research progress of autologous soft tissue substitute materials in gingival augmentation of natural teeth]

Subepithelial connective tissue or free gingival grafts are often used in traditional mucogingival surgery to treat gingival recession and keratinized gingival insufficiency. However, due to the disadvantages of autologous soft tissue grafts, such as the preparation of the second surgical site, the limited amount of tissue in the donor site, and postoperative discomfort for patients, the research on autologous soft tissue substitute materials has attracted extensive attention. A variety of donor-substitute materials from different sources are currently used in membranous gingival surgeries, including platelet-rich fibrin, acellular dermal matrix, xenogeneic collagen matrix, etc. This paper reviews the research progress and application of several different types of substitute materials in soft tissue augmentation for natural teeth, providing a reference for the application of autologous soft tissue substitutes in clinical gingival augmentation surgery.

In vivo rAAV-mediated human TGF-β overexpression reduces perifocal osteoarthritis and improves osteochondral repair in a large animal model at one year

OBJECTIVE

Osteoarthritis (OA) is a serious consequence of focal osteochondral defects. Gene transfer of human transforming growth factor beta (hTGF-β) with recombinant adeno-associated virus (rAAV) vectors offers a strategy to improve osteochondral repair. However, the long-term in vivo effects of such rAAV-mediated TGF-β overexpression including its potential benefits on OA development remain unknown.

METHOD

Focal osteochondral defects in minipig knees received rAAV-lacZ (control) or rAAV-hTGF-β in vivo. After one year, osteochondral repair and perifocal OA were visualized using validated macroscopic scoring, ultra-high-field MRI at 9.4 T, and micro-CT. A quantitative estimation of the cellular densities and a validated semi-quantitative scoring of histological and immunohistological parameters completed the analysis of microarchitectural parameters.

RESULTS

Direct rAAV-hTGF-β application induced and maintained significantly improved defect filling and safranin O staining intensity and overall cartilage repair at one year in vivo. In addition, rAAV-hTGF-β led to significantly higher chondrocyte densities within the cartilaginous repair tissue without affecting chondrocyte hypertrophy and minimized subarticular trabecular separation. Of note, rAAV-hTGF-β significantly improved the adjacent cartilage structure and chondrocyte density and reduced overall perifocal OA development after one year in vivo.

CONCLUSIONS

rAAV-hTGF-β treatment improves long-term osteochondral repair and delays the progression of perifocal OA in a translational model. These findings have considerable potential for targeted molecular approaches to treat focal osteochondral defects.

Study on the Mechanism of Burr Formation by Simulation and Experiment in Ultrasonic Vibration-Assisted Micromilling

Due to the strong plasticity of Inconel 718 and the significant size effect of micromachining, a large number of burrs will be produced in traditional processing. The addition of ultrasonic vibration during machining can reduce the burr problem. The mechanism of burr generation in traditional micromilling (TMM) and ultrasonic vibration-assisted micromilling (UVAMM) was analyzed by simulation, and verified by corresponding experiments. It is found that applying high-frequency ultrasonic vibration in the milling feed direction can reduce cutting temperature and cutting force, improve chip breaking ability, and reduce burr formation. When the cutting thickness will reach the minimum cutting thickness hmin, the chip will start to form. When A/ƒ_z > 1/2, the tracks of the two tool heads start to cut, and the chips are not continuous. Some of the best burr suppression effects were achieved under conditions of low cutting speed (V_c), feed per tooth (ƒ_z), and large amplitude (A). When A is 6 μm, the size and quantity of burr is the smallest. When ƒ_z reaches 6 μm, large continuous burrs appear at the top of the groove. The experimental results further confirm the accuracy of the simulation results and provide parameter reference.

[Analysis of 15 cases of bronchial-pulmonary artery fistula]

Objective: To summarize the clinical characteristics of bronchial-pulmonary artery fistula and evaluate the effect of interventional closure of bronchial-pulmonary artery fistula. Methods: A retrospective case study was conducted. Fifteen children with hemoptysis who were diagnosed with bronchial-pulmonary artery fistula in Beijing Children's Hospital, Capital Medical University from January 2018 to March 2022 were selected. Their clinical symptoms and chest-enhanced CT findings were recorded. The children who failed to improve after anti-infection and hemostasis treatment were treated with transcatheter embolization through microparticles under digital subtraction angiography (DSA). The efficacy and post-operation recurrence were evaluated. Results: There were 15 children, including 9 males and 6 females, aged 9.8 (3.7, 12.1) years, weighing 35 (16, 55) kg. There was hemoptysis of varying degrees before surgery. Only 2 children had decreased hemoglobin. Chest enhanced CT showed that their bronchial arteries were thickened and tortuous, including 11 cases of single vessel disease and 4 cases of multivessel disease; 11 children had varying degrees of pneumonia and 4 children had atelectasis. Except for one case effectively treated with medical therapy, the remaining 14 cases were all treated with transcatheter interventional closure with embolic microparticles, among whom 12 had their fistula completely blocked with a single operation and the other 2 children underwent multiple operations because of too many fistulas. One child had extensive bronchial-pulmonary artery fistula which failed to be blocked completely even after multiple operations. Among the remaining 13 children, only 2 patients whose fistula was considered to be completely closed had recurrence presenting with hemoptysis at 3 months and 2 years after the operation, and no hemoptysis was found after the second closure. All children were discharged without chest pain, spinal cord paraplegia, or other serious complications. Fourteen children were followed up for 1.4 (0.9,2.9) years, among whom one still has intermittent mild hemoptysis due to incomplete closure and the rest had a satisfactory outcome. Conclusions: Hemoptysis is the first symptom of bronchial-pulmonary artery fistula. For children with failed medical treatment, transcatheter closure with an embolic pellet is effective, safe and feasible, with a low recurrence rate.

[Study on the consistency of IGF-1 and IGFBP-3 of peripheral whole blood and venous serum in children]

This study aimed to explore the consistency of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-binding protein-3 (IGFBP-3) by detecting peripheral whole blood and venous serum among children. As a cross-sectional study, children who were aged 0-14 as well as received physical examinations in the Child Healthcare Department of the Children's Hospital of Nanjing Medical University during January 2022 to April 2022 were enrolled in this study. Meanwhile, both of peripheral whole blood and venous serum samples were collected, and the levels of IGF-1 and IGFBP-3 were assayed individually via chemiluminescence immunoassay (CLIA). Additionally, linear regression equation was used to analyze the correlation of results between two categories of samples, while Inter-class Correlation Coefficient (ICC) was used to evaluate the consistency of test results among two types of samples. The change trends of IGF-1 and IGFBP-3 with age were analyzed at the same time. A total of 203 valid matched samples were collected, including 117 boys and 86 girls. Peripheral whole blood was well correlated with serum IGF-1 (r=0.986, P<0.001) and IGFBP-3 (r=0.974, P<0.001), and the linear regression equation is shown as follows: (IGF-1) _{venous serum} =1.047×(IGF-1) _{peripheral whole blood}-6.840; (IGFBP-3) _{venous serum}=0.924×(IGFBP-3) _{peripheral whole blood}+0.396. The correlation and consistency were still persisted after being stratified by sex and age. ICC of IGF-1 and IGFBP-3 were 0.983 and 0.967, respectively which provided an excellent strength of agreement. The levels of IGF-1 or IGFBP-3 in boys' and girls' peripheral whole blood and serum showed significant statistical differences among various age groups (all P<0.001), and also increased significantly with age (all P _trend<0.001). In conclusion, the results of IGF-1 and IGFBP-3 in peripheral whole blood and venous serum had positive comparability that could be mutually recognized. The detection of IGF-1 and IGFBP-3 in peripheral whole blood had great potential for young age children by providing guidance for nutritional intervention, growth and development assessment.

Malus toringoides (Rehd.) Hughes Ameliorates Nonalcoholic Fatty Liver Disease with Diabetes via Downregulation of SREBP-1c and the NF-κB Pathway In Vivo and In Vitro

Diabetic patients are more prone to developing nonalcoholic fatty liver disease (NAFLD) compared with healthy people. As a plant homologous to both medicine and food, Malus toringoides (Rehd.) Hughes has been used as an intervention for both NAFLD and diabetes. However, the effect and mechanism of M. toringoides on NAFLD on type 2 diabetes mellitus (T2DM) is unclear. The current investigation was designed to evaluate the ameliorative effects and mechanism of M. toringoides ethanol extract (CBTM-E375) on T2DM, and to identify the compounds in these extracts. The effects of CBTM-E375 on T2DM were verified using a high-fat diet-/streptozotocin-induced diabetic rat and free fatty acid (0.5 mM)-induced human hepatocellular carcinoma cell (HepG2) models. The components of CBTM-E375 were identified by high performance liquid chromatography-mass spectrometry/mass spectrometry. Our results demonstrate that CBTM-E375 ameliorated lipid accumulation (total cholesterol, triglyceride), oxidative stress (superoxide dismutase, catalase, malondialdehyde, glutathione peroxidase), and inflammation (tumor necrosis factor-α [TNF-α], interleukin [IL]-1β, IL-6, C-reactive protein [CRP]) in vivo and in vitro, these effects were associated with a CBTM-E375-mediated downregulation of SREBP-1c (sterol regulatory element binding protein 1c) and the NF-κB (nuclear factor κB) signaling pathway. A total of 20 chemical compounds were identified in CBTM-E375, including phlorizin, isoquercitrin, chlorogenic acid, quercetin, naringenin, and trigonelline, which have been reported to have positive effects on diabetes or on NAFLD.

[Identification and functional analysis of combined oxidative phosphorylation deficiency 28 gene mutation]

Objective: To report a case of combined oxidative phosphorylation deficiency 28 (COXPD28) in China, identified the pathogenic mutation and explored the pathogenic mechanism preliminarily. Methods: The clinical characteristics of a patient with COXPD28 were retrospectively analyzed and the pathogenic mutations were identified by mitochondrial gene sequencing and whole exome sequencing. The wild-type and mutant plasmids of pathogenic genes were constructed, and effect of mutation on protein expression by quantitative real-time PCR (qPCR) and Western blot were evaluated. Statistical methods mainly used one-way ANOVA and LSD test. Results: A 21 year old female patient presented with lactic acid poisoning due to repeated chest distress and wheezing since childhood. The sequencing of the whole exon group gene found that solute carrier family 25 member 26 (SLC25A26) gene had a compound heterozygous mutation (c.34G>C, p.A12P; c.197C>A, p.A66E), which was the first report in China. In vitro function test showed that the expression levels of SLC25A26 mRNA and S-adenosylmethionine carrier (SAMC) protein in cells transfected with SLC25A26 mutant plasmid were significantly lower than those transfected with wild type plasmid. The p.A66E mutant plasmid reduced the expression level of SLC25A26 mRNA and SAMC protein to 6% and 26% of wild type plasmids respectively (both P<0.001), while p.A12P mutant plasmid decreased to 62% and 82% of wild type plasmids respectively (P<0.001, P=0.044). When the double mutant (p.A66E+p.A12P) plasmids were co-transfected, the expression levels of SLC25A26 mRNA and SAMC protein decreased to 47% and 57% of the wild type plasmids, respectively (P<0.001, P=0.001). Conclusion: The pathogenic mutation gene of this patient with COXPD28 is SLC25A26 gene mutation (p.A66E, p.A12P), which causes the decrease of SLC25A26 expression level, mitochondrial oxidative phosphorylation dysfunction, and induces COXPD28.

[Some HBeAg-negative chronic hepatitis B patients treated with nucleos(t)ide analogue can achieve HBsAg loss after drug withdrawal: stop-to-cure may be coming]

Nucleoside/Nucleotide analogues (NAs) are widely used for the antiviral treatment of chronic hepatitis B (CHB), however, it is difficult to achieve serum hepatitis B surface antigen (HBsAg) loss with NAs therapy. In recent years, several prospective trails have reported that HBsAg loss (functional cure or clinical cure) also occurs in a small number of hepatitis B e antigen (HBeAg) negative CHB patients who discontinued long-term treatment with NAs. Accordingly, the "stop-to-cure" strategy is proposed. Although the mechanism has not been fully elucidated, the known factors related to serum HBsAg loss with NAs withdrawal include HBV genotype, duration of NAs treatment, serum HBsAg and HBV RNA levels at end-of-treatment, and ethnic differences. In the review, we discuss the best time to stop NAs therapy, the potential markers for predicting relapse after cessation of NAs and the possible mechanism of "stop-to-cure" in HBeAg-negative CHB patients, and propose some suggestions on the time of retreatment.

[Long-term outcomes and failure patterns of definitive radiotherapy for cervical esophageal carcinoma]

Objective: To evaluate the long-term outcomes, failure patterns and prognostic factors of definitive radiotherapy in patients with cervical esophageal carcinoma (CEC). Methods: We retrospectively reviewed the clinical data of 148 CEC patients who treated with definitive radiotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from January 2001 to December 2017. The median radiation dose was 66 Gy (59.4-70 Gy) and 33.1% of patients received concurrent chemotherapy. The Kaplan-Meier method was used to calculate survival rates. The log rank test was used for survival comparison and univariate prognostic analysis. The Cox model was used for multivariate prognostic analysis. Results: The median follow-up time was 102.6 months. The median survival time, 2- and 5-year overall survival (OS) were 22.7 months, 49.9% and 28.3%. The median, 2- and 5-year progression-free survival were 12.6 months, 35.8% and 25.8%. The 2- and 5-year locoregional recurrence-free survival were 59.1% and 50.8%. The 2- and 5-year distant metastases-free survival were 74.6% and 65.9%. Multivariate analysis showed that EQD(2)>66 Gy was the only independent prognostic indicator for OS (P=0.040). The median survival time and 5-year OS rate significantly improved in patients who received EQD(2)>66 Gy than those who received≤66 Gy (31.2 months vs. 19.2 months, 40.1% vs. 19.1%, P=0.027). A total of 87 patients (58.8%) developed tumor progression. There were 50 (33.8%), 23 (15.5%) and 39 (26.4%) patients developed local, regional recurrence and distant metastases, respectively. Eleven patients (7.4%) underwent salvage surgery, and the laryngeal preservation rate for entire group was 93.9%. Conclusions: Definitive radiotherapy is an effective treatment for cervical esophageal carcinoma with the advantage of larynx preservation. Local recurrence is the major failure pattern. EQD(2)>66 Gy is associated with the improved overall survival.

A new class of variable-radii diffraction optics for high-resolution x-ray spectroscopy at the National Ignition Facility (invited)

A new class of crystal shapes has been developed for x-ray spectroscopy of point-like or small (a few mm) emission sources. These optics allow for dramatic improvement in both achievable energy resolution and total throughput of the spectrometer as compared with traditional designs. This class of crystal shapes, collectively referred to as the Variable-Radii Spiral (VR-Spiral), utilize crystal shapes in which both the major and minor radii are variable. A crystal using this novel VR-Spiral shape has now been fabricated for high-resolution Extended X-ray Absorption Fine Structure (EXAFS) experiments targeting the Pb-L₃ (13.0 keV) absorption edge at the National Ignition Facility. The performance of this crystal has been characterized in the laboratory using a microfocus x-ray source, showing that high-resolution high-throughput EXAFS spectra can be acquired using this geometry. Importantly, these successful tests show that the complex three-dimensional crystal shape is manufacturable with the required precision needed to realize the expected performance of better than 5 eV energy resolution while using a 30 mm high crystal. An improved generalized mathematical form for VR-Spiral shapes is also presented allowing improved optimization as compared to the first sinusoidal-spiral based design. This new formulation allows VR-Spiral spectrometers to be designed at any magnification with optimized energy resolution at all energies within the spectrometer bandwidth.

Homogeneous, Micron-Scale High-Energy-Density Matter Generated by Relativistic Laser-Solid Interactions

Short-pulse, laser-solid interactions provide a unique platform for studying complex high-energy-density matter. We present the first demonstration of solid-density, micron-scale keV plasmas uniformly heated by a high-contrast, 400 nm wavelength laser at intensities up to 2×10^{21}  W/cm^{2}. High-resolution spectral analysis of x-ray emission reveals uniform heating up to 3.0 keV over 1  μm depths. Particle-in-cell simulations indicate the production of a uniformly heated keV plasma to depths of 2  μm. The significant bulk heating and presence of highly ionized ions deep within the target are attributed to the few MeV hot electrons that become trapped and undergo refluxing within the target sheath fields. These conditions enabled the differentiation of atomic physics models of ionization potential depression in high-energy-density environments.

[Mechanism and clinical significance of HBV reactivation after anti-HCV therapy]

Direct-acting antivirals (DAAs) can strongly inhibit the replication of hepatitis C virus (HCV) and effectively clear the infection, but it may cause hepatitis B virus (HBV) reactivation, leading to severe liver damage and fulminate hepatitis in patients with HCV/HBV coinfection. In this review, we summarized the different replication process of HCV and HBV in infected hepatocytes and consequent innate immune response, and then discussed the molecular mechanism and clinical significance of HBV reactivation, and put forward the clinical precaution.

iTRAQ-based proteomics revealed baicalein enhanced oxidative stress of Candida albicans by up-regulating CPD2 expression

Baicalein could inhibit the growth and biofilm formation of Candida albicans, the most common clinical fungal pathogen. However, the antifungal mechanism of baicalein has not been elucidated. In this study, isobaric tags for relative and absolute quantification (iTRAQ) was used to verify the mechanism of antifungal fluconazole and baicalein. A total of 58 common proteins were detected in cells treated with fluconazole. These proteins encompassed fluconazole-targeted sterol synthesis pathway, including Erg11p, Erg6p, Erg3p, Erg25p, Erg5p, Erg10p and Ncp1p. Next, iTRAQ was applied to the comparison of baicalein-treated C. albicans proteins, which detected 16 common proteins. The putative NADH dehydrogenase Cpd2p and the ATP-binding cassette transporter Snq2p were the most up-regulated proteins with the treatment of baicalein. Our results showed that CPD2 disruption elevated C. albicans resistance to baicalein significantly both in vitro and in vivo. Further in-depth studies revealed that CPD2 disruption reduced the activation of C. albicans metacaspase and partially restored the mitochondrial membrane potential reduction caused by the treatment of baicalein, which indicated that CPD2 was involved in the apoptosis induced by baicalein. Consistently, under the treatment of baicalein, CPD2Δ/Δ mutant produced lower reactive oxygen species (ROS) that was critical in causing oxidative damage and apoptosis in C. albicans. These results indicated that baicalein could increase intracellular oxidative damage by up-regulating the expression of Cpd2p so as to inhibit the growth of C. albicans, which provides new insights for investigating the antifungal target of baicalein.