Kaposi's sarcoma-associated herpesvirus (KSHV) is the primary etiological agent of Kaposi's sarcoma, primary effusion lymphoma and muticentric Castleman's disease. In common with the other herpesviruses, KSHV exhibits both latent and lytic life cycles, both of which are characterized by distinct gene expression profiles and programs. KSHV encodes proteins which play essential roles in the inhibition of host adaptive and innate immunity, the inhibition of apoptosis, and the regulation of the cell cycle. KSHV also encodes several proteins which have transforming and intrcellular signalling activity.

In the process of responding to public health emergencies,the conflicts between the principles of management and ethics are constantly revealed.Combining with a unit's practical experiences of participating in several major public health emergencies,this paper put forward that it should take into account both the rescue and notification to achieve the unity of effective rescue and informed consent;take into account both the enforcement and obedience to achieve the unity of the interest of groups and individuals;take into account both the equality and priority to achieve the unity of urgency priority and equal opportunity;take into account both the rescuing and suf-fering to achieve the unity of interest between the rescuers and the victims,and thus to provide references for the reasonable solution of the ethical conflicts in the process of responding to public health emergencies.

Objective:To evaluate the role of esophagogastric junction contractile index (EGJ-CI) in distinguishing patients with refractory gastroesophageal reflux disease (RGERD) from functional heartburn (FH).Methods:From March 2014 to January 2018, 82 patients with proton pump inhibitor (PPI) refractory heartburn and/or regurgitation, who visited the Outpatient Department of Gastroenterology at The First Affiliated Hospital with Nanjing Medical University were enrolled, among them 50 patients with RGERD (RGERD group) and 32 patients with FH (FH group). EGJ-CI of RGERD group and FH group were compared. The sensitivity and specificity of EGJ-CI to distinguish RGERD from FH patients. The correlation between EGJ-CI and high resolution esophageal manometry parameters, baseline impedance level and 24 h impedance-pH monitoring parameters were analyzed. Mann-Whitney U test, receiver operator characteristic curve analysis and Spearman correlation analysis were used for statistical analysis. Results:The EGJ-CI of RGERD group was lower than that of FH group (25.8 mmHg·cm (14.1 mmHg·cm, 35.9 mmHg·cm)(1 mmHg=0.133 kPa) vs. 39.2 mmHg·cm (23.0 mmHg·cm, 60.8 mmHg·cm)), and the difference was statistically significant ( Z=-2.833, P=0.005). When the cut-off value of EGJ-CI was 35.8 mmHg·cm, the sensitivity and specificity to distinguish RGERD from FH were 76.0% and 62.5%, respectively; area under the curve was 0.69 (95% CI 0.57 to 0.81). EGJ-CI was positively correlated with lower sphincter resting pressure, integrated relaxation pressure, distal contractile integral, distal esophageal pressure, and mean nocturnal baseline impedance ( r=0.812, 0.631, 0.451, 0.490 and 0.401, all P<0.01). EGJ-CI was negatively correlated with DeMeester score, acid exposure time, total reflux episodes, acid reflux episodes, long reflux episodes and longest reflux time ( r=-0.363, -0.372, -0.346, -0.318, -0.300 and -0.291, all P<0.01). Conclusions:EGJ-CI can help to distinguish patients with FH from RGERD.

Objective To determine the modality of Leptospira interrogans invading human and murine mononuclear-macrophages and diversity of leptospiral phagocytotic vesicle formation. Methods Transmission electron microscopy was applied to observe the invasion of L. interrogans serogroup Icterohaemorrhagiae serovar Lai strain Lai into murine mononuclear-macrophage-like cell line J774A. 1 and PMA-activated human monocyte line THP-1 and the formation of leptospiral phagocytotic vesicles. By using immunofluorescence plus either laser confocal microscopy or fluorescence spectrophotometry, the changes of intracellular leptospiral numbers in J774A. 1 and PMA-activated THP-1 cells before and after block with endocytosis inhibitors monodansylcadaverin (MDC), phenylarsine oxide (PAO) and clathrin antibody were investigated. Results The leptospires in J774A. 1 cells were located in phagocytotic vesicles while the leptospires in THP-1 cells had no package with phagocytotic vesicle membrane. Both MDC and PAO presented the effect inhibiting endocytosis of L. interrogans into J774A. 1 and THP-1 cells in dose-dependent manner. The numbers of leptospires in J774A. 1 and THP-1 cells that pre-blocked with 10 μmol/L or above MDC and 1 μmol/L or above PAO were significantly less than that in the two cells untreated with MDC and PAO (P＜0.05＝. After J774A. 1 and THP-1 cells were blocked with clathrin antibody, the numbers of intracellular leptospires were also remarkbly decreased ( P<0.05 ).Conclusion Leptospira interrogans can invade into both human and murine mononuclear-macrophages through the way of clathrin-dependent endocytosis. There is an opposite diversity of leptospiral phagocytotic vesicle formations in human and murine mononuclear-macrophages, which may result in the difference of pathogenesis in human and mice after infected with L. interrogans.

OBJECTIVE: To evaluate the effect of microwave polymerization and water-bath heat polymerization on accuracy and flexural strength of denture base resin. METHODS: Ten maxillary complete dentures were prepared and divided into microwave polymerization and water-bath heat polymerization groups according to random number table, with 5 dentures in each group. In the microwave polymerization group, the dentures were heated for 9 minutes with 40% firepower, natural cooled, the pressure of flasking at 4.5 kg/mm~2. In the water-bath heat polymerization group, the temperature increased from room to 70℃, sustained for 1.5 hours, then rise to 100℃ for 0.5 hour. The dentures were maintained at 25℃ thermostatic water bath for a week. The denture base, as well as standard cast was cut down at posterior border of the second molar. Dimensional accuracy between the posterior border of upper complete denture and standardized cast at five different positions was measured by digital microscope. Specimens with 64 mm× 10 mm×2.5 mm were made for measuring flexural strength.RESULTS: ①The posterior border gaps between the upper complete denture and standardized cast was (141±78) urn and (147±74) μm cured by microwave polymerization and water-bath heat polymerization, which has no statistical difference. The flexural strength of denture base resin cured by the microwave polymerization and water-bath heat polymerization was (81.60±14.04) MPa and (84.24±17.65) MPa, and there was no statistical difference (P > 0.05). CONCLUSION: There is no significantly difference in the accuracy and flexural strength cured by microwave polymerization and by water-bath heat polymerization, but the microwave polymerization takes shorter time than that by water-bath heat polymerization.

OBJECTIVE:To prepare nanostructured lipid carrier of adefovir dipivoxil(ADV-NLC),and optimize the formula-tion. METHODS:Using stearic acid and glycerin monostearate as solid lipid,oleic acid as liquid lipid,Gemini surfactant and poly-sorbate 80 as emulsifier,sodium dodecyl sulfate (SDS) as stabilizer,solvent dispersion ultrasonic method was used to prepare ADV-NLC. And using particle size,polydispersity index,Zeta potential,encapsulation efficiency as indexes,single factor test was conducted to screen Gemini surfactant-polysorbate 80 ratio,emulsifier dosage(ratio of emulsifier to water phase),drug-lipid ratio, solid-liquid lipid ratio. RESULTS:The formula was as follow as 3% emulsifier (Gemini surfactant-polysorbate 80 ratio of 1:2), 4.5% drug-lipid ratio,solid-liquid lipid ratio of 6:5. The average particle size of the prepared ADV-NLC was(48.83±2.65)nm, polydispersity index<0.3,Zeta potential was(-28.7±1.8)mV,encapsulation efficiency was(77.65±0.03)%(n=3). CONCLU-SIONS:ADV-NLC is successfully prepared,and the formulation is reasonable and feasible.

Objective To analyze the clinical efficacy of psychological nursing on patients with pregnancy-induced hypertension (PIH) combined with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods 96 patients with pregnancy-induced hypertension (PIH) combined with OSAHS from January 2009 to July 2012 were admitted.They were randomly divided into the experimental group and the control group with 48 cases in each group.All patients were given routine drug therapy,based on this,the control group received routine care,and the experimental group was given routine care and psychological nursing.The anxiety and depression score and the treatment effect were compared between the two groups.Results After eight-week treatment,in the experimental group,the scores of SAS,SDS declined obviously and the levels of blood pressure were significantly decreased compared with those in the control group.The difference was statistically significant.Conclusions Psychological nursing for patients with pregnancy-induced hypertension(PIH) combined with OSAHS played a positive role in nursing of these patients,it can remit their anxiety and depression emotion and also can significantly decrease the patients'blood pressure.

Objective To observe the changes of serum myostatin (MSTN) level in patients with gastric carcinoma-associated cachexia and to investigate the relationship between MSTN and tumor necrosis factor α (TNF-α) preliminarily.Methods Eighty patients with gastric cancer were divided into two groups based on their Patient-Generated Subjective Global Assessement (PG-SGA) scores:gastric carcinoma-associated cachexia group (GCC group,32 cases; PG-SGA stage C) and gastric carcinoma non-cachexia group (GCNC,48 cases; PG-SGA stage A + B).The serum MSTN and TNF-α levels were measured by enzyme linked immunosorbent assay,and relevant parameters including height,weight,albumin,hemoglobin,and C-reactive protein were also recorded before operation.Eighty healthy adults were chosen as the control group.Results The serum MSTN level in the GCC group [(1.36 ±0.50) μg/L] was significantly higher than that in the GCNC group [(0.91 ±0.49) μg/L; x2 =14.67,P =0.00],whereas the serum MSTN level in the GCNC group was significantly higher than that in the control group [(0.70 ± 0.37) μg/L; x2 =36.45,P =0.00].Serum MSTN level was not correlated with TNF-α in the GCC group (r=0.18,P=0.31),GCNC group (r=0.08,P=0.58),or control group (r=-0.16,P＝0.16).Conclusions Serum MSTN level is elevated in patients with gastric carcinoma-associated cachexia.However,it is not correlated with serum TNF-α.

Objective To analyze the clinical efficacy of nursing intervention on patients who were suffering from pregnancy-induced hypertension syndrome combined with obstructive sleep apnea hypopnea syndrome(OSAHS). Methods From April 2010 to December 2011,58 patients with pregnancy-induced hypertension combined with OSAHS were selected.They were randomly divided into the experimental group and the control group with 29 cases in each group.The control group received routine care and drug treatment,based upon this,the experimental group received pertinent nursing of OSAHS.The treatment effect was compared between the two groups. Results The total effective rate of the experimental group was significantly higher than the control group. Conclusions Pertinent nursing of OSAHS for patients with pregnancy-induced hypertension combined with OSAHS played a positive role in nursing of these patients,it can significantly decrease the blood pressure of patients.

Objective To determine the change of expression level of Leptospira interrogans sph2 gene, and hemolytic and cell apoptosis-inducing activities of sphingomyelinase hemolysin Sph2. Methods Entire sph2 gene fragment was amplified by PCR from genomic DNA of L. Interrogans serovar serogroup Icterohaemorrhagiae serovar Lai strain Lai, and sequenced after T-A cloning. Subsequently, a prokaryotic expression system of sph2 gene was constructed. The expression of target recombinant Sph2( rSph2 ) was examined by SDS-PAGE and the expressed rSph2 was extracted by Ni-NTA affinity chromatogaphy. The hemolytic activity of rSph2 was measured by hemolytic test in sheep blood agar plate and spectrophotometry-based hemoglobin measurement, and the apoptosis-inducing activity of rSph2 to murine mononuclear-macrophagelike cell line(J774A. 1) and hepatic cell line(IAR20) was determined by flow cytometry. A real-time fluorescence quantitative RT-PCR was applied to detect the change of sph2 mRNA levels before and after L. Interrogans strain Lai infecting J774A. 1 and IAR20 cells. Results The cloned sph2 gene had 100% sequence identity to the corresponding gene in GenBank. The constructed prokaryotic expression system was able to efficiently express rSph2. The rSph2 could lyse sheep erythrocytes in concentration-dependent pattern. 10μg/ml rSph2 could induce the apoptosis of J774A. 1 cells and IAR20 cells, and the peak apoptotic rates were 23.96% and 32.92%, respectively. The mRNA level of sph2 gene was significantly elevated within 0.5-2 h of L. Interrogans strain Lai infecting either J774A. 1 or IAR20 cells, and then the mRNA level was quickly descended. Conclusion The sph2 gene of L. Interrogans strain Lai has a transient expression when the microbe contacts host cells. rSph2 possesses activities of sheep erythrocyte lysis and inducing macrophage and hepatocyte apoptosis, indicating Sph2 as an important virulence factor during pathogenic process of Leptospira.