OBJECTIVE:To systematically review the efficacy of fluconazole in the treatment of candida infections in different parts,and provide evidence-based reference. METHODS:Cochrane library,Medline,EMBase,PubMed,CBM,CJFD,VIP data-base and Wanfang database were retrieved to collect the randomized controlled trial(RCT)of fluconazole(test group)vs. other an-tifungal agents(control group)in the treatment of candida infections in different parts. After information collection and quality eval-uation,the Meta-analysis was performed by Rev Man 5.1 software. RESULTS:There were totally 6 literatures included,involving 1 966 patients. Meta-analysis results showed that the effectiveness in test group was lower than control group in the treatment of can-didemia [OR=0.48,95%CI(0.29,0.77),P=0.003];compared with control group,there were no significant differences in the effec-tiveness in the treatment of esophagus candidemia [OR=1.15,95%CI(0.74,1.78),P=0.52]. CONCLUSIONS:The efficacy of flu-conazole in the treatment of candidemia is no better than anidulafungin and equivalent with amphotericin B;the efficacy of flucon-azole in the treatment of esophageal candidiasis is equivalent with itraconazole,voriconazole,anidulafungin and micafungin. Due to the limit of included studies,it remains to be further verified by high-quality,large-sample and long follow-up RCTs.

Objective To observe the effect of exogenous insulin on the expression of P-glycoprotein (P-gp)and the secretion of insulin in pancreatic beta cells (INS-1 832/13).Methods Insulinoma cells (INS-1 832/13) were cultured with 0.5 μmol/L exogenous insulin for 30 days.MTT assay was used to measure cell viability.Quantitative RT-PCR and western blot were used to detect the expression of P-gp mRNA and protein respectively,and glucose stimulated insulin secretion (GSIS) were measured by radioimmunoassay.Results Compared with control group,0.5 μmol/L exogenous insulin promoted the viability of INS-1 832/13 cells [(102.00±12.99) vs (356.00±35.51),P<0.05] and accelerated P-gp expression [(107.50±17.08) vs (307.50±44.25)] both at mRNA and protein levels [(105.00±12.91) vs (192.50±35.94),P<0.05].Glucose stimulated insulin secretion was positively correlated with P-gp expression level,but had no significant effect on basal insulin secretion.Conclusion Exogenous insulin can promote the secretion function of INS-1 832/13 cells,and the mechanism may be related to the expression of P-gp.

Objective To analyse the effects of high insulin on the expression and function of P-glycoprotein (P-gp), and preliminarily investigate the influence of insulin on chemotherapeutic sensitivity in MCF-7/ADR cells. Methods MCF-7/ADR cells were cultured with different concentrations of insulin(0.001, 0.005, 0.01, 0.05 and 0.1μmol/L). Real-time PCR was used to detect the expression of P-gp mRNA. Western blot assay was used to detect the expression level of P-gp. Rhodamine 123 was used to detect the efflux function level of P-gp. Cell viability and chemotherapeutic sensitivity were detected by MTT assay. Results High concentration of insulin (0.1 μmol/L) promoted the proliferation of MCF-7/ADR cells. The concentration of insulin (0.05 and 0.1 μmol/L) accelerated P-gp mRNA and protein expression, which also augmented the efflux function of P-glycoprotein and reduced the chemotherapeutic sensitivity to epirubicin. Conclusion High concentration of insulin may influence the drug resistance of breast cancer cells by promoting the expression and function of P-glycoprotein of MCF-7/ADR cells.

Objective To observe the role of mulberry flavone on the expression of insulin receptor substrate(IRS)in HepG2 cells with insulin resistance, and to explore the possible molecular mechanism that mulberry flavone improves insulin resistance. Methods HepG2 cells were cultured to establish insulin-resistance cell model in high concentration of insulin, and then incubated with mulberry flavone. Effect of mulberry flavone on the HepG2 cell model of glucose incorporation rate was observed. Western blot was used to observe the variety of IRS protein expression. Results Mulberry flavone increased the glucose incorporation rate of (33. 9 ± 1.0)higher than that of Conclusions Mulberry flavone can improve insulin resistance. Furthermore, IRS protein expression increasing is the possible molecular mechanism that mulberry flavone improves insulin resistance.

This study was aimed to evaluate the effects ofYao-Tong-Ning Capsule (YTNC) whole formula, dissembled YTNC formulas, and their active fractions on cell proliferation, immunity, anti-inflammation and osteocytes repair. According to the formulating principle of YTNC and combinatorial chemistry concepts, six samples were prepared by combining different active fractions. Half-maximal effective concentrations (EC50) or half-maximal inhibitory concentrations (IC50) were applied to evaluate the effects of samples on promoting the secretion of IL-1β, IL-6 and TNF-α in macrophage (Ana-1) cells, on inhibiting the production of lipopolysaccharide (LPS)-induced PGE2 in Ana-1 cells, on promoting the cell proliferation induced by IL-1β and glycosaminoglycan (GAG) synthesis, on influencing synoviocytes proliferation induced by IL-1β, and on promoting the secretion of IL-6, respectively. The interactions among the active fractions in these samples were investigated by comparing the additive EC50 (or IC50) values with their experimental EC50 (or IC50). The results showed that pharmacological activities of the six samples were different in the same cell model. Some pharmacological activities of a few dissembled YTNC formulas were superior or significantly superior to the YTNC whole formula. However, the YTNC whole formula was good at promoting cell immunity, anti-inflammation and osteocytes repair. The YTNC’s vehicle Chinese rice wine played an important role on strengthening the activity of YTNC. It was concluded that the synergistic effects between active fractions in YTNC were the material foundation that YTNC had comprehensive efficacy of strengthening immunity, anti-inflammation and promoting osteocytes repair.

Objective To explore the sleep characteristics of submariners during a long-term voyage, so as to provide scientific evidence for ensuring submariners with good sleep during long-term voyages. Methods The sleep status of submariners who participated in a long-term voyage was tested by Self-Rating Scale of Sleep (SRSS) before the voyage, and before and after each voyage section during the voyage. The sleep status variation of submariners who performed different types of tasks, from the beginning to the end of each voyage section and of each resting-on-the-sea section was analyzed respectively. Comparison of sleep scores was performed between submariners and surface ship crew in the second voyage section. Numbers of submariners with sleep problem were compared in each voyage section. Results Generally speaking, submariners' sleep status at the end of voyage section was significantly worse than that at the beginning of voyage section and that before the whole voyage (P<0.001, P<0.01), and the sleep status at the beginning of the third voyage section was significantly worse than that before the whole voyage (P<0.05). Submariners had a steady sleep status when taking a resting-on-the-sea before starting their first voyage section, which was no significant difference from that before the whole voyage (P>0.05). After finishing a voyage section and taking a resting-on-the-sea, submariners' sleep status returned to the level of pre-voyage (P>0.05), and was significantly better than that before the resting-on-the-sea (P<0.05, P<0.01). After finishing two voyage sections and then taking a resting-on-the-sea, the submariners' sleep status showed no obvious variation (P>0.05). Compared with that of surface ship crew who accomplished the same voyage section, submariners had an obviously better sleep status after taking a resting-on-the-sea (P<0.05). Meanwhile, submariners who finished a voyage section showed a significantly worse sleep status than those resting on the sea (P<0.01) and surface ship crew who finished a same voyage section (P<0.05). In each voyage section, submariners with sleep problems who finished resting-on-the-sea were significantly less than those who finished navigation (P<0.001, P<0.05). There was no significant difference in the number of submariners with sleep problems between those who taking non-resting and taking resting-at-dock after finishing the first voyage section (P>0.05), but the latter was significantly more than the former when the second voyage section was finished (P<0.05). During the resting-on-the-sea period, the numbers of submariners with sleep problems in both the second and the third voyage section were significantly more than those in the first voyage section (P<0.05, P<0.01). The numbers of submariners with sleep problems who implemented the third voyage section were significantly more than those who implemented the first and the second voyage section (P<0.01). Conclusions Generally, the sleep quality of submariners is significantly worse after accomplished a voyage section task, and the degree of sleep problems may be accumulated to worse and worse along with the increase of long-term voyage time. Whereas, submariners may have a significantly better sleep status after taking a resting-on-the-sea, implying that resting-on-the-sea is an effective way to ensure submariners a good sleep during a long-term voyage.

OBJECTIVE:To optimize enzymatic extraction technology of polysaccharide from Schisandra chinensis. METH-ODS:Using pH value of enzymatic extraction solution,the amount of enzyme,extraction temperature as response factor,S. chi-nensis polysaccharide as response value,on the basis of single-factor experiments,3-factor,5-level central composite experimental design was adopted for the experiment. Validation test was also conducted. RESULTS:The optimal extraction technology was as pH value of 5.7,enzyme dosage of 1.3%,extraction temperature of 53 ℃. In validation test,the extraction rate of S. chinensis polysaccharide was 14.30%(RSD=1.84%,n=6). CONCLUSIONS:The optimized extraction technology is simple,reasonable and stable,and can be used for the extraction of polysaccharide from S. chinensis.

Objective:To explore the formula and preparation technology parameters of Shengmai dispersible tablets. Methods:With the granulation status, disintegration time, friability, taste and and so on as the testing indices, the formula and preparation tech-nology of Shengmai dispersion tablets were optimized by uniform design. Results:The optimized formula of Shengmai dispersible tab-lets was as follows:25% extract powder, 58% MCC, 8% CCMC-Na, 4% CMS-Na, 2% L-HPC, 2% magnesium stearate and 1%sweetener. L-HPC and magnesium stearate were added after the granulation, and the tablet hardness was controlled at 25N. The opti-mized dispersible tablets could disintegrate uniformly within 3 min. Conclusion: The optimization of the prescription and preparation process parameters of Shengmai dispersing tablets is stable and reliable, and has good repeatability, and the process is feasible.

Objective: To explore the effectiveness of family therapy on adolescent school refusal. Methods: One hundred outpatient adolescents with school refusal were selected. All the patients were divided into two groups through random number table method. The intervention group (50 patients) received family therapy combined with cognitive therapy, and the control group (50 patients) received no intervention. Cognitive therapy was evaluated by the Self-Rating Anxiety Scale (SAS), Severity Impression Scale (CGI-S), Family Dynamics Self-Assessment Scale, and information on going back to school was collected. Results: After intervention, score in SAS, CGI-S, CBCL (father-reported), CBCL (mother-reported), family atmosphere, logic family, disease awareness, and personality significantly decreased (P<0.05). No significant differences were found before intervention. However, the intervention group showed lower scores in all the above indicators and higher rates of going back to school (92% vs 70%)(χ2=7.86, P<0.05). Conclusion Family therapy can effectively improve emotions such as anxiety and depressive symptoms and help going back to school in adolescents with school refusal.

Objective To investigate the boosting efficiency of a subunit vaccine consisting of the fusion protein Ag85B-Mpt64190-198-Mth8.4 (AMM) , dimethyl-dioctyldecyl ammonium bromide (DDA) and BCG polysaceharide nucleic acid (BCG-PSN) on the primed inoculation with BCG. Methods The AMM subunit vaccine was composed of fusion protein AMM, adjuvant DDA and BCG-PSN. The first mouse experi-mental group was immunized with BCG first, then boosted with the AMM subanit vaccine in the 10th week. The second experimental group was boosted with the AMM subunit vaccine in the 8th week and the 10th week respectively with a two weeks interval after the primed with BCG. Two control groups were treated re-spectively with physiological saline alone and BCG alone. After the primed inoculation, ELISPOT and ELISA were used for the detection of the cell-mediated and humoral immune response in week 14 and week 22 re-spectively. Furthermore, the immunized mice were challenged with live BCG to mimic tuberculosis infection in the 22nd week after the primed inoculation. Subsequently the T cell typing and humoral response were de-tected by flow cytometry and ELISA, respectively. Results ( 1 ) The level of secreting IFN-γ: 14 weeks af-ter the primed inoculation,with the stimulation of the specific antigen-Ag85B, the number of cells secreting IFN-γ in the second experimental group (135±14) was more than BCG alone immunized group (19±16), t = 10. 98, P < 0.01. In the 22nd week, the number of cells secreting IFN-γ in the second experimental group (208±11) was still more than BCG alone group (57±18), t =6.43, P <0.01. (2) The level of humoral immune response: the IgG1 antibody titer in the second experimental group was obviously higher than that in the first experimental group. However, the ratio of IgG2a to IgG1, as the index reflecting the Thl-type immune response, in the experimental group 2 was lower than that in the experimental group 1. (3) The contents of CD4+ CD25+ T cells after challenged with live BCG strain: the first and the second ex-perimental groups were both higher than the BCG alone group (t1 = 3.08, t2 = 3.16, P < 0.05 ). Conclu-sion Boosting the BCG-pfimed mice with tuberculosis AMM subunit vaccine twice can induce higher level of cell-mediated and humoral immune response than BCG alone, which could activate the regulative immune response at the same time.