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 understand the intensity and characteristics of acute toxicity of esculentoside A on mice and measure relevant parameters and observe its diuresis effect on rat. Methods After intraperitoneal injection of different concentrations of esculentoside A to mice, toxic reactions were observed. Rats with water load were intraperitoneally injected with different doses of esculentoside A. Total urine volume in six consecutive hours after the injection was determined. Results The LD50 of esculentoside A calculated by Bliss method was 26. 19 mg · kg-1 , and the 95% confidence interval was 23. 11-29. 85 mg·kg-1 . The mortality and acute toxicity of esculentoside A appeared to be dose-dependent while the blank control group had no abnormal reaction. The urine volume was significantly different between high dose group and the negative control group. No significant difference in urine volume was found between middle and the negative control group, and between low dose group and the negative control group. Conclusion Esculentoside A is poisonous to mice when single dose was intraperitoneally injected, and high dose of esculentoside A has diuresis effect on rat.

Objective To study the expression of tight junction factors in human placental tissues derived from assisted reproductive technology (ART) and natural pregnancy and its role in placental barrier.Methods Ten placental samples were collected from the women who had undergone ART treatment and 11 placenta were collected from control group.Transmission electron microscope (TEM) examination was utilized to detect the morphology of placental tight junctions.The mRNA of claudin (CLDN) 1,CLDN4,CLDN5,CLDN8,zonula occudens (ZO) 1 was detected by real-time PCR and the protein of CLDN4,CLDN8 and occludin (OCLN) were measured by western blot.Results TEM microscopy results showed that placenta samples derived both ART and control placenta had normal microscopic histological features of tight junctions,localized in the apical part of the syncytium and also between the cell-cell contacts of fetal blood vessel endothelial.The expression level of CLDN4 mRNA were 0.87 ±0.17 in ART group and 1.18 ± 0.30 in control group,respectively.The expression level of CLDN8 mRNA were 3.25 ± 2.32 in ART group and 1.08±0.41 in control group,respectively.The mRNA level of CLDN4 and CLDN8 were significantly differentially expressed in ART derived placenta when compared with control groups.The expression level of CLDN1,CLDN5,OCLN and ZO1 mRNA were 0.49 ± 0.44,0.80 ± 0.20,0.92 ± 0.18 in ART group and 1.09±0.82,1.21 ±0.78,0.80± 0.27 in control group,respectively,in which there were no significant differences between two groups.Western Blot analysis showed the protein levels of tight junctions CLDN4,CLDN8 and OCLN did not differ between groups.Conclusions Tight junction factors were expressed in human placental tissues.Tight junction derived from ATR platenta might have mild dysfunction.

This study was aimed to analyze changes of content and quantity of essential oil of processing drugs of Rhizome Atractylodes and to achieve the impact of pyrolysis characteristics for using excipients, in order to offer evi-dences for further research and its processing technology. Steam distillation was used to extract essential oil in the Rhizome Atractylodes. Infrared spectroscopy and gas chromatography were used in the qualitative and quantitative analysis on constituents of essential oil of processing products of Rhizome Atractylodes. Thermogravimetric analysis was used in the comparison of pyrolysis characteristics between Rhizome Atractylodes and its excipients. The results showed that the content of essential oil was declined after processing. However, after being processed, the content of atractylodin was increased at different degrees compared to crude product. The change of atractylodin showed differ-ent tendency in different processing drugs. The atractylodin content from high to low was in the order of products stir-baked to yellowish, products roasted by bran, products prepared with rice water, crude drug. At the temperature of more than 220oC, excipients had major impact for the pyrolysis characteristics of Rhizome Atractylodes. It was concluded that the essential oil declined, but atractylodin increased after Rhizome Atractylodes being processed. It also provided experimental basis for further research on processing technology, ormulation of quality standard and improvement of processing mechanism.

Aim To construct the stable hFcεRIα/RBL-2H3 cell line expressing human FcεRIα( hFcεRIα) . Methods The human FcεRIα gene was obtained by RT-PCR and cloned into the eukaryotic expression vector pCI-neo. Then, the pCI-neo-hFcεRIα vector was transfected into RBL-2H3 cells by lipo-somes, and the transfected cells were screened through G418 fil-tration subsequently. Finally, RT-PCR, Western blot and immu-nofluorescence assay were used to determine the result of trans-fection. Results According to the optimized transfection param-eters, the transfection efficiency reached 75. 38%. The results of Western blot, immunofluorescence and RT-PCR showed that hFcεRIα could be expressed in RBL-2H3 cells successfully. Conclusion HFcεRIα/RBL-2H3 cells were successfully con-structed,which will be the experimental basis for further study on the mechanism of IgE/FcεRI and drugs for allergy diseases.

Objective To explore the risk factors of cognitive impairment of elderly patients with cerebral infarction in order to provide the theoretical basis for the clinical intervention. Methods A total of 237 cases with senile cerebral infarction were selected as ours subjects who were hospitalized from Mar. 2010 to Jun. 2013 in Kailuan General Hospital Affiliated to Hebei United University. The general condition and medical history were recorded. The auxiliary examination was performed. Cerebral infarction was diagnosed based on the onset to diagnosis standard and MoCA scores of within 2 weeks. The patients with less than 26 MoCA score were diagnosed as cognitive dysfunction and otherwise were thought as normal. Single factor analysis methods and non conditional Logistic regression were applied to analyze the analysis. Results There was no significant difference in terms of incidence between patients with different gender. Patients with age more than 75 years old and lower education levels had the high incidence rate than those with younger age and high education levels( χ2=16. 661,5. 453;P﹤0. 05). The cognitive dysfunction incidence of patients with white collar was lower than those with blue collar(χ2 = 5. 458,P ﹤ 0. 05 ). And the cognitive dysfunction incidence of patients with hypertention,diabetes,heart disease and leukoaraiosis were higher than those without the above diseases(χ2 =28. 423,5. 621,7. 768,6. 070;P﹤0. 05). The incidence of patients smoking more was significantly higher than that of smoking less or no(χ2 =5. 045,P ﹤0. 05 ). Multiple factors and non conditional Logistic regression analysis showed that,67 Senile cerebral infarction patients occurred cognitive impairment within 2 weeks. The independent risk factors for its occurrence included age greater than 75 years( P=0. 000 ),diabetes mellitus( P=0. 043),hypertension(P=0. 000)and leukoaraiosis(P=0. 041). Conclusion There are many risk factors related to cognitive impairment after cerebral infarction occurred in the elderly. The intervention should take in many aspects and the risk factors should early found.

Objective:To investigate the effect of bundles of care on pediatric hypnosis by rectal chloral hydrate.Method:A total of 368 children aged 0 to 3 years old who were treated in Dalian Children′s Hospital from December 2018 to June 2019 and were treated with chloralhydrate enemas were randomly divided into the control group (routine nursing intervention) and observation groups (bundled Intervention) 184 cases each. The chloralhydrate enemas were inserted for sedation, and the observation group added sedation while chloralhydrate enemas for sedation. After admission, record the data of each patient, and do the Ramsay sedation score after sedation. According to the sedation score, the sedation failure rate of chloralhydrate enema was increased, and the proportion of each score in the group was compared.Results:Ramsay sedation scores of the observation group and the control group after enema were 5.42 ± 1.34 and 3.14 ± 1.21, respectively. There was significant difference between the two groups ( t value was 2.08, P<0.05). The failure rates in experimental group and control group were 13.59% (25/184) and 38.59% (71/184), respectively. There was a significant difference between two groups ( χ2 value was 29.82, P<0.05). Conclusion:Bundles of care could decrease the failure rate of rectal chloral hydrate hypnosis significantly, then reduce the suffering of children. It is worth being widely used in clinic.

Objective To evaluate clinical value of interventional radiology in difficult extraction of stuck tunnel hemodialysis catheter (TCC).Methods Maintenance hemodialysis patients who required removal of stuck TCC in our hospital from June 2015 to June 2017 were enrolled.Medical history and preoperative examinations were carefully evaluated.Patients were pulled rotationally the catheter under the fluoroscopy guidance and exchanged the TCC.The information and procedure-related complication were recorded.Balloon dilation or snare technique would be used when failed to remove the stuck catheter.Results A total of 22 patients were enrolled,with an average age of (67.2±18.5) years,a median dialysis time of 54(18,106) months,and catheter indwelling time of 37(14,82) months.All patients were successfully removed the stuck catheter,among which 18 cases (81.8％) had fibrin sheath and 13 cases with sheath calcification.TCC mainly stuck in the junction of internal jugular vein and innominate vein,middle and lower innominate vein and middle part of superior vena cava.No procedure-related major complication occurred.Sixteen cases (72.7％) complained of transient substernal extraction pain and 1 case occurred groin hematoma during operation.Conclusions Catheter incarceration problem should be alert to the hemodialysis patients with catheter indwelling time of more than 2-3 years.The minimally invasive interventional techniques including rotationally pull-out under fluoroscopy guidance and balloon angioplasty are safe and effective in removal of the stuck TCC.

Objective: To compare the diagnosis and treatment experience of brain abscesses and improve prognosis. Methods: The data of 302 patients of brain abscess at Department of Neurosurgery in Tianjin Medical University General Hospital from 1980 to 2014 was analyzed retrospectively. There were 215 male and 87 female patients aged from 11 to 82 years with mean age of (30±8) years. The patients was divided into 1980-2001 group and 2002-2014 group according to different diagnosis and the treatment methods. The therapy methods include operation and conservative treatment. There were 196 cases received operation, including 95 cases of excision, 89 cases of ventriculopuncture, 12 cases of excision after ventriculopuncture, 106 cases received drug conservative therapy. Two groups of information including clinical manifestation, abscess location, therapeutic effect and prognosis were compared by χ² test. Results: Compared to 1980-2001 group, adjacent infection incidence declined(χ²=8.000, P=0.005). The ratio of single abscess declined and multiple abscess increased(χ²=11.060, P=0.001), the infection proportion of frontal lobe and temporal lobe decreased(χ²=9.080, P=0.003; χ²=15.440, P=0.000). The ratio of headache and vomit and papilledema declined significantly(χ²=23.290, P=0.000; χ²=21.020, P=0.000; χ²=2.290, P=0.001). Total mortality of 302 patients were 23 cases and 5 cases of 1980-2001 group and 2002-2014 group (10.4% vs. 6.3%, χ²=1.180, P=0.277). However, there were statistical difference in postoperative mortality between both groups (14.4% vs. 4.0%, χ² =3.880, P=0.049). Conclusion With the application of antibiotics and the development of neurosurgical techniques, the prognosis of brain abscess has been improved.

miRNAs,as a class of endogenous small noncoding RNAs,have come to be a new treatment target for ischemic brain injury as many of them have been discovered to participate in multiple links of the injury.Autophagy,a catalysis process based on lysosomes,has become a current research hotspot because it has been found to participate in and regulate the pathological process of ischemic brain injury.As regulation of autophagy by miRNAs represents a new post-transcriptional regulatory mechanism,autophagy miRNAs after ischemic brain injury have attracted growing interest trom researchers worldwide.It is expected that the role of miRNAs in autophagy regulation can be clarified with the research progress and new therapeutic targets and directions can be found for the treatment of ischemic brain injury.This review gives a brief summary of the research progress conceming the role of miRNAs in regulating autophagy after ischemic brain injury,hoping the information may promote understanding of the important effects and potential therapeutic values of miRNAs-regulated autophagy in ischemic brain injury.