With the wide use of azoles,drug tolerance and cross tolerance of Candida albicands has seriously hampered the clinical treatments of Candida albicands.New antifungal agents(potent and effective) have been developed over the past years based on the discovery of many new target sites of Candida albicands.For example,Echinocandins(caspofungin and micafungin),aiming at the cell wall of Candida albicands,showed strong antifungal activities to fluconazole resistant candidas and fungal biofilm.Moreover,because ?-glucan synthase does not exist on the cell membrane of mammalian cells,Echinocandins has a low toxicity and a promising clinical future.Though the mechanism of Histatin(targeting fungal membrane) is not clear,it has strong activity not only on candida resistant of polyene and azole,but also to Candida parapsilosis,Candida krusei and Cryptococcus neoformans.Berberine and Ocimum gratissimum L.were also found to have prominent anti-fungi activities.Berberine extract can intensively inhibit 24-SMT in a dose-depended manner;besides,it has more potent inhibitory activity against the growth of mycelia than against that of yeast.Various new methods can be used to increase the susceptibility of Candida albicands to antifungal agents,such as altering fungi membrane composition,changing some genes,adopting the photodynamic inactivation method,employing hypersensitization agents and combining antifungal agents.This article reviews the newly-developed antifungal agents and newly-proposed target sites of Candida albicands.

Objective To explore the importance of diabetic education and hypoglycemia nursing for population with high risk of hypoglycemia through analysis of the personal factors influencing incidence of hypoglycemia of type 2 diabetic patients during initial use of insulin.Methods There were 257 cases of T2DM hospitalized patients during initial use of insulin,among whom 80 experienced hypoglycemia.They were divided into two groups,one was the hypoglycemia group,another was the non-hypoglycemia group.Firstly,we compared the different characteristics of the two groups such as gender,BMI and HbAlc,and so on.And then,the possible risk factors of hypoglycemia were analyzed by a Logistic regression model.Finally,the most significant factors were analyzed with the ROC curve.Results These two groups were obviously different in seven elements such as BMI,Scr,HbAlc and TG,and so on.BMI and HbAlc were the most primary causes for prevention of hypoglycemia.When patients got HbAlc＜8.65％ or BMI＜26.3 kg/m2,they had more opportunity to occur hypoglycemia.Conclusions BMI and HbAlc of patients are primary causes for hypoglycemia.It is of great significance for nurses to enhance diabetes education to the patients with HbAlc＜8.65％ or BMI＜26.3 kg/m2 to alleviate the incidence of hypoglycemia.

Objective To evaluate the effects of dexmedetomidine on the cellular immune function of the rats with scald.Methods Seventy-two healthy male Sprague-Dawley rats,weighing 200-220 g,aged 120-150 days,were randomly divided into 3 groups (n =24 each):normal control group (group C),scald group (group S) and dexmedetomidine group (group D).Thirty percent of the total body surface was shaved and then exposed to 94 ℃ water for 12 s in S and D groups.The rats were resuscitated according to Parkland formula after scald in S and D groups,and in addition,dexmedetomidine 30 μg/kg was also intraperitoneally injected immediately after scald in D group.Before the model was established (T1) and at 12 and 24 h after scald (T2,3),blood samples from the inferior vena cava were collected for determination of T lymphocyte subsets CD3 +,CD4 + and CD8 +,NK cell,C-reactive protein (CRP),interleukin-6 (IL-6),IL-10 and tumor necrosis factor-alpha (TNF-α) level.CD4+/CD8+ was calculated.Arterial blood samples were collected for blood gas analysis.Results Compared with C,the CD3+,CD4+ and NK cell levels,CD4+/CD8+,pH value,PaCO2 and PaO2 were significantly decreased,and CD8+ levels,IL-6,IL-10,TNF-α,CRP and BE negative value were increased at T2,3 in S and D groups.Compared with group S,the CD3+,CD4+,NK cell and IL-10 levels,CD4+/CD8+,pH value,PaCO2 and PaO2 were significantly increased,and CD8+ levels,IL-6,TNF-α,CRP and BE negative value were decreased at T2,3 in group D.Conclusion Dexmedetomidine can improve the cellular immune function of the rats with scald.

The target of rapamycin ( TOR) , a Ser/Thr protein kinase of PIKKs ( phosphatidylinositol kinase-related kinases ) , is the central factor of a highly conserved signaling pathway in eukaryotes , and regulates cell growth in response to nutrients , hor-mones, and stresses.It controls temporal growth by activating anabolic processes such as translation , ribosome biogenesis , protein syn-thesis, transportation of amino acid and metabolic enzymes .The advances in TOR pathway in the most pervasive human fungal patho-gen Candida albicans.

Objective To discuss clinical efficacy of shuxuetong in treatment of pulmonary fibrosis. Methods Selected 60 cases with pulmonary fibrosis and they were divided into control group of 30 cases treated by prednisone and study group of 30 cases treated by shuxuetong based on treatment of prednisone. Lung function, arterial blood gas and lung CT were compared. Results The efficiency of study group was higher than control group (P<0.01). FEV1 of study group after treatment was higher than before treatment, and was higher than control group after treatment(P all<0.05). PaO2 of study group after treatment improved apparently, and was higher than control group (P<0.05). Conclusion Clinical effi-cacy and lung function of mild, moderate pulmonary fibrosis patients are improved with treatment of shuxuetong based on prednisone.

Objective To discuss serum IL-13, TGF-β1, IL-8 levels in idiopathic pulmonary fibrosis and correlation with lung function. Methods A total of 60 cases with idiopathic pulmonary fibrosis were selected as pulmonary fibrosis group, and 60 healthy volunteers were selected as control group. Serum IL-13, TGF-β1, IL-8, arterial blood gas analy-sis and related indicators of lung function were detected. Results Serum IL-13, TGF-β1, IL-8 levels of idiopathic pul-monary fibrosis group were higher than the control group(P<0.01). TGF-β1, IL-8 were significantly negative correlation with FVC predicted percentage (P<0.01); TGF-β1, IL-13 were significantly negative correlation with FEV1 predicted percentage (P<0.01); TGF-β1 and PaO2 was significantly negative correlation, and TGF-β1, IL-8 were significantly positive correlation with P(A-a)O2 (P<0.01);IL-8 was significantly negative correlation with PaO2 and SaO2 (P<0.01). Conclusion Serum IL-13, TGF-β1, IL-8 levels in idiopathic pulmonary fibrosis increase significantly, and are nega-tive correlation with lung function.

Objective To evaluate the role of phosphatidylinositol 3?kinase(PI3K)∕serine?threo?nine kinase(Akt)signaling pathway in propofol?induced invasion of human liver cancer cell line HepG2. Methods HepG2 cells were cultured in RPMI 1640 medium supplemented with 10% fetal bovine serum in a 5% CO2incubator at 37℃. HepG2 cells at the logarithmic growth phase were divided into 6 groups(n=18 each)using a random number table: control group(group C), propofol group(group P), PI3K∕Akt signaling pathway agonist IGF?1 group(group IGF), PI3K∕Akt signaling pathway inhibitor LY294002 group(group LY), IGF?1 plus propofol group(group IGF+P)and LY294002 plus propofol group (group LY + P). Propofol 120 μg∕ml was added in group P. IGF?1 10 nmol∕L was added in group IGF. LY294002 10 μmol was added in group LY. In group IGF+P, 10 nmol∕L IGF?1 was added, cells were in?cubated for 24 h, and then 120 μg∕ml propofol was added. In group LY+P, 10 μmol LY294002 was add?ed, cells were incubated for 24 h, and then 120 μg∕ml propofol was added. The invasion of cells was measured by Transwell invasion assay at 24 h of incubation. The expression of PI3K and Akt mRNA in cells was determined by real?time polymerase chain reaction. The expression of Akt, PI3K and phosphorylated Akt(p?Akt)was detected by using Western blot. Results Compared with group C, the invasive cell count was significantly reduced, the expression of PI3K protein and mRNA was down?regulated, p?Akt∕Akt ratio was decreased, and the expression of Akt mRNA was down?regulated in P, P+IGF, LY and P+LY groups, and the invasive cell count was significantly increased, the expression of PI3K protein and mRNA was up?regulated, p?Akt∕Akt ratio was increased, and the expression of Akt mRNA was up?regulated in group IGF(P<0.05). Compared with group P, the invasive cell count was significantly increased, the expression of PI3K protein and mRNA was up?regulated, p?Akt∕Akt ratio was increased, and the expres?sion of Akt mRNA was up?regulated in group P+IGF, and the invasive cell count was significantly reduced, the expression of PI3K protein and mRNA was down?regulated, p?Akt∕Akt ratio was decreased, and the ex?pression of Akt mRNA was down?regulated in group P+LY(P<0.05). The invasive cell count was signifi?cantly reduced, the expression of PI3K protein and mRNA was down?regulated, p?Akt∕Akt ratio was de?creased, and the expression of Akt mRNA was down?regulated in group P+IGF as compared with group IGF (P<0.05)and in group P+LY as compared with group LY(P<0.05). Conclusion The mechanism by which propofol inhibits invasion of HepG2 cells is related to inhibiting activation of PI3K∕Akt signaling path?ways.

Four cases of Pentalogy of Cantrell were diagnosed by prenatal ultrasonography and confirmed by autopsy after labor induction.There were 1 case of complete Pentalogy of Cantrell and 3 cases of incomplete Pentalogy.In 3 cases of incomplete Pentalogy of Cantrell,1 case presented with high umbilical cord prolapse,extraspectoral heart,partial defect of the lower part of the sternum,partial defect of the pericardium,single umbilical artery and cervical lymphatic cyst;1 case presented with high umbilical cord prolapse,extraspectoral heart,thoracic fissure and ventricular septal defect;and 1 case presented with umbilical cord,extraspectoral heart,partial inferior sternal segment defect,ventricular septal defect and bilateral clubfoot varus.In l case of complete Pentalogy of Cantrell,there were high umbilical cord bulge,extraspectoral heart,chest fissure and inferior segment defect,anterior diaphragm and pericardium defect,total forebrain deformity,right 12th ribs loss and ventricular septal defect.Ectopic heart and omphalocele are typical echographic features of Pentalogy of Cantrel and prenatal ultrasonography is of important value in early diagnosis of this congenital malformation.