INTRODUCTION: In a subset of adults with non-rapid eye movement (NREM) parasomnias, clinical variants might be violent in nature and can potentially result in unintentional but considerable harm. As such, there is substantial interest on the forensic ramifications of these sleep behaviours. METHODS: This review examined the diagnostic criteria for parasomnias established in the context of international classification systems; medicolegal case reports; legal frameworks; and court cases in and outside of Singapore, to provide an overview of the implications of NREM parasomnias. RESULTS: Violent or injurious behaviours that occurred in the context of somnambulism, otherwise known as sleepwalking, have challenged traditional legal theories of criminal culpability. Yet little has changed in the application of sleep science to criminal responsibility. In Singapore, the defence of somnambulism has hitherto not been directly raised. Nonetheless, sleep medicine practitioners may increasingly be requested to render their opinions on legal issues pertaining to violent or injurious behaviours allegedly arising during sleep. Although the understanding of NREM parasomnias has improved, there is still a dearth of evidence to support both medical and legal decisions in this area. CONCLUSION NREM parasomnias come with disquieting legal and forensic implications for adjudicating criminal responsibility. There is a need to critically examine legal perspectives on behaviours occurring during sleep. More reliable empirical studies investigating the pathophysiology of NREM parasomnias can offer clearer diagnostic guidelines and address complex behaviours of NREM that often come with medicolegal implications.
Adult ; Humans ; Parasomnias/diagnosis* ; Singapore ; Sleep/physiology* ; Somnambulism/diagnosis*

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Disasters ; Earthquakes ; statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Transportation of Patients ; Wounds and Injuries ; complications ; surgery ; therapy

OBJECTIVETo construct an expression plasmid of siRNA against activator protein 4(AP-4) gene and to investigate its biological behavioral effect on human colon carcinoma cell line SW480.

METHODSThe specific siRNA target exon 7 of AP-4 gene was constructed and transfected into SW480 cells by liposome. Expression levels of AP-4 mRNA and protein from SW480 after transfection were examined by RT-PCR and Western blot respectively. Cell proliferation was detected by cell counting and MTT assay. Flow cytometry(FCM) and Western blot were used to detect cell apoptosis and cell cycle. The invasiveness of SW480 cells in vitro was measured quantitatively by the matrigel invasion assay.

RESULTSAfter AP-4 siRNA transfection into SW480 cells for 96 hours, the cell AP-4 mRNA reduced by 57.8% and the AP-4 protein concentration in culture supernatant decreased by 75.2%. The cell growth was significantly inhibited by 61%-78%. The apoptosis rate of SW480 cells was significantly higher in AP-4 siRNA group than that in negative control group[(21.7 +/- 2.51)% vs. (2.31 +/- 0.14)%, P<0.01]. Cells in G0-G1 phase increased by 22.43% and in G2-M phase decreased by 14.52% (P<0.05). AP-4 siRNA significantly inhibited AP-4-induced invasion of SW480 cells to matrigel (P<0.05).

CONCLUSIONSSilencing AP-4 gene by the siRNA technology can actively suppress the expression of AP-4 gene, and then inhibit the growth and proliferation of SW480 cell, and induce apoptosis of SW480 cell. The successful application of AP-4 siRNA extends the list of available therapeutic modalities in the treatment of human colon cancer.

Cell Line, Tumor ; Colonic Neoplasms ; DNA-Binding Proteins ; genetics ; Gene Expression ; Gene Silencing ; Genetic Vectors ; Humans ; RNA, Small Interfering ; Transcription Factors ; genetics ; Transfection

BACKGROUNDHepatic fibrosis is the key stage of the pathological progress from hepatic injury to cirrhosis. Ursodeoxycholic acid (UDCA) has been known as having significant clinical therapeutic effects on chronic liver diseases. Our research aimed to study the effect of UDCA on the signaling pathway of transforming growth factor beta1 (TGFbeta1)/Smad and discuss its possible molecular mechanisms of inhibiting hepatic fibrosis.

METHODSRat hepatic stellate cells were cultured in vitro and randomly assigned to 4 groups. Group A was control group, with only DMEM culture medium applied, and groups B, C, D were experimental groups, with different doses of UDCA (1.0 mmol/L, 0.5 mmol/L and 0.25 mmol/L respectively) added into their DMEM culture medium for further culture of 24 hours and 48 hours. The protein expressions of TGFbeta1, TGF type I receptor, Smad3, Smad4 and Smad7 were measured by Western blotting, as well as the expressions of TGFbeta1, Smad3, Smad7 and cAMP response element (CREB) binding protein (CBP) mRNA by real-time PCR. SPSS 11.5 statistical package was adopted for data analyses.

RESULTSCompared with control group, the mRNA expressions of TGFbeta1 in the high and middle UDCA dose groups for 24 hours and 48 hours significantly decreased (P < 0.05), the protein expressions of TGFbeta1 in the two above groups for 48 hours and in the high dose group for 24 hours significantly decreased (P < 0.05). The protein and mRNA expressions of Smad3 in each UDCA dose group for 24 hours and 48 hours significantly decreased, with significant difference among different UDCA dose groups and between that of 24 hours and 48 hours observed (P < 0.05). The protein and mRNA expressions of Smad7 in the high and middle UDCA dose groups for 24 hours and 48 hours significantly increased. The CBP mRNA expression in each UDCA dose group for 24 hours and 48 hours significantly decreased (P < 0.05), with significant difference among different UDCA dose groups observed (P < 0.05).

CONCLUSIONUDCA could curb the development of hepatic fibrosis through affecting the signaling pathway of TGFbeta1/Smad by inhibiting the expressions of TGFbeta1, Smad3 and CBP and increasing the expression of Smad7.

Animals ; Blotting, Western ; Cells, Cultured ; Cholagogues and Choleretics ; pharmacology ; Cyclic AMP Response Element-Binding Protein ; genetics ; Hepatic Stellate Cells ; drug effects ; metabolism ; Humans ; Polymerase Chain Reaction ; Rats ; Receptors, Transforming Growth Factor beta ; metabolism ; Signal Transduction ; drug effects ; Smad Proteins ; metabolism ; Smad3 Protein ; genetics ; metabolism ; Smad4 Protein ; metabolism ; Smad7 Protein ; metabolism ; Transforming Growth Factor beta1 ; metabolism ; Ursodeoxycholic Acid ; pharmacology

OBJECTIVETo explore natural herbs to maintain the bactericidal activity of hydrogen peroxide (H).

METHODSEighteen extracts of Chinese herbs were prepared complying with the standard protocol. Each of the solutions was then mixed with 1% H2O2. The mixtures were handled with two approaches: autoclaved daily for one, two or three times; stored at room temperature from one through five years. Then the bactericidal activity were evaluated by assaying the minimal bactericidal concentration (MBC) and minimal inhibitory concentration (MIC) against Gram positive (Staphylococcus aureus, ATCC25923) and Gram negative (Escherichia coli, ATCC12421) bacteria.

RESULTSWhile mixed with 1% H2O2, 10 out of 18 kinds of assessed Chinese herbs displayed MBC values at 1:12800 or higher after three times of autoclaving, and 8 of them preserved such level of MBC value after stored at room temperature for three years. Some Chinese herbs, i.e. R. Scutellariae, R. Coptidis, R. Bupleuri, H. Epimedii, C. Phelledendri and F. Chrysanthemi, can significantly maintain the bactericidal activity of diluted H2O2.

CONCLUSIONSCertain Chinese herbs can effectively stabilize the bactericidal activity of H2O2 undergoing autoclave or long-term storage. This paper reported a brandnew pharmaceutical function of Chinese herbs and provided experimental data for the potential enhancement of H2O2 usage while its stability level is promoted.

Anti-Bacterial Agents ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Escherichia coli ; drug effects ; Hydrogen Peroxide ; pharmacology ; Microbial Sensitivity Tests ; Staphylococcus aureus ; drug effects ; Sterilization ; Time Factors

OBJECTIVETo construct a recombinant lentiviral vector for p38 MAPK and establish a human prostatic carcinoma cell line that stably expresses p38 MAPK.

METHODSEGFP/p38 fusion gene was subcloned into the lentiviral vector pTYF- EF1α-IRES-EGFP. The recombinant lentiviral vector pTYF-EF1α-EGFP/p38 was indentified by restriction enzyme digestion, and packaged in HEK 293T cells using lipofectamintm2000 with the packaging plasmid psPAX2 and envelope plasmid pMD2.G. The viral titer was tested according to the expression level of GFP. The resulting recombinant lentiviral vector was transduced into human prostatic carcinoma DU145 cells, and stably transduced cells were selected by limiting dilution analysis. The intracellular expression level of total p38 was detected by Western blotting and the cell growth curve was drawn.

RESULTSDNA restriction enzyme digestion demonstrated that the recombinant lentiviral vector of the fusion gene EGFP/p38 (pTYF-EF1α-EGFP/p38) was constructed successfully. The recombinant lentiviral vector was packaged in 293T with a viral titer of 4.7×10(6) TU/ml. A stable cell line, EGFP/p38-DU145, was established, which stably expressed exogenous EGFP/p38 MAPK fusion protein as detected by Western blotting and showed a lowered growth rate compared to the control cells.

CONCLUSIONWe have successfully constructed a recombinant lentiviral vector of the fusion gene EGFP/p38 and established a stable cell line EGFP/p38-DU145. Overexpression of p38 has a significant inhibitory effect on the proliferation of DU145 cells in vitro.

Cell Line, Tumor ; Cloning, Molecular ; Genetic Vectors ; genetics ; Green Fluorescent Proteins ; genetics ; HEK293 Cells ; Humans ; Lentivirus ; genetics ; metabolism ; Male ; Prostatic Neoplasms ; metabolism ; pathology ; Recombinant Proteins ; biosynthesis ; genetics ; Transfection ; p38 Mitogen-Activated Protein Kinases ; biosynthesis ; genetics

OBJECTIVETo study the effects of post-discharge formula (PDF) for preterm infants, breast milk (BM) and term infant formula (TF) on increase rates of body weight, length and head circumference in preterm and low-birth-weight infants (PLBWIs) from discharge to 3 months after birth, and to provide a reference for the choice of feeding pattern for PLBWIs.

METHODSA total of 407 PLBWIs discharged from the newborn departments of ten hospitals in Guangzhou City and Foshan City in Guangdong Province, China were chosen for this study. According to feeding pattern, they were assigned to three groups: PDF-fed (n=258), BM-fed (n=58) and TF-fed (n=91). Their body weight, length and head circumference were measured at 3 months after birth, and the increase rates of growth indices relative to baseline values (at birth) were calculated and compared.

RESULTSAt 3 months after birth, the PDF-fed group had significantly greater body weight, length and head circumference than the BM-fed and TF-fed groups (P<0.05). The increase rates of body weight and length were significantly higher in the PDF-fed group than in the BM-fed and TF-fed groups (P<0.05).

CONCLUSIONSCompared with those fed with BM and TF after discharge, the PDF-fed PLBWIs have higher increase rates of body weight and length and show greater body weight and length at 3 months after birth. However, further study is needed to investigate the long-term effects.

Body Height ; Body Weight ; Breast Feeding ; Feeding Behavior ; Female ; Humans ; Infant ; Infant Formula ; Infant, Low Birth Weight ; growth & development ; Infant, Newborn ; Infant, Premature ; growth & development ; Male

OBJECTIVETo examine the incidence of congenital heart disease (CHD) in children aged 0-3 years in the rural areas of Chongqing, and to determine the suitable "screening-diagnosis-follow-up" system and screening indicators for CHD in these areas.

METHODSChildren aged 0-3 years from rural areas of the Fuling Disctrict of Chongqing were selected by cluster sampling. Using the "screening-diagnosis-evaluation system" employed at the levels of village/town, district/county, and province/city, the children were screened for seven indicators, i.e., family history of CHD, dyspnea, cyanosis, unique facial features, other congenital malformations, heart murmurs, and blood oxygen saturation (SpO<95%). Children who were positive for one or more indicators accepted echocardiography (ECG) for the diagnosis of CHD. CHD patients were evaluated for disease progression, given guided treatments, and followed-up by pediatric cardiologists.

RESULTSScreening was performed for 10 005 out of the 10 281 children enrolled in the study (97.32% response rate). Among the 175 children who were positive for the indicators, 166 underwent ECG and 60 (0.6‰) were diagnosed with CHD, including 46 cases of simple CHD (76.65%), 11 cases of combined CHD (18.33%), and 3 cases of complex CHD (5.00%). Of the 7 screening indicators, heart murmur had the largest area under the ROC curve for the diagnosis of CHD. In addition, a combination of screening indicators (heart murmur, unique facial features, and other congenital malformations) was most effective for screening out CHD. The CHD patients were given surgical or intervention treatments, and followed up for 6 to 18 months. Ten patients improved without treatment, 13 patients received interventional or surgical treatment, 1 patient died of non-cardiac reasons. The remaining 36 patients were subjected to further follow-up.

CONCLUSIONSHeart murmur alone and in combination with unique facial features and other congenital malformations are valuable tools for CHD screening in children aged 0-3 years. The "village/town-district/county-province/city" screening-diagnosis-evaluation systems are useful for the early detection, diagnosis, and treatment of CHD in infants and young children from the rural areas of Chongqing.

Child, Preschool ; Female ; Follow-Up Studies ; Heart Defects, Congenital ; diagnosis ; Heart Murmurs ; diagnosis ; Humans ; Infant ; Infant, Newborn ; Male ; Oxygen ; blood

Objective:To investigate the effect of Comprehensive Reminder System Based on Health Belief Model (CRS-HBM) on health knowledge, belief, behaviors, utilization of health services and clinical outcomes in stroke patients after discharge. Methods:From February, 2015 to March, 2016, 174 stroke patients with hypertension were divided into control group (n = 87) and intervention group (n = 87). The control group received routine stroke health education, and the intervention group received the CRS-HBM program in addition. They were investigated with Stroke Knowledge Questionnaire (SKQ), Short Form Health Belief Model Scale for Stroke Patients (SF-HBMS-SP), Health Behavior Scale for Stroke Patients (HBS-SP), and the utilization of health services and clinical outcomes (emergency, re-hospitalization, recrudescence and death) were recorded six months after discharge. Results:A total of 75 cases in the control group and 76 in the intervention group finished the research. The total scores of SKQ (U = 903.000), SF-HBMS-SP (t = -9.099) and HBS-SP (t = -7.786) were more in the intervention group than in the control group (P < 0.001). The outpatient re-visit rate was more in the intervention group (97.37%) than in the control group (76.00%) (P < 0.001). The incidence of emergency, re-hospitalization, recrudescence and death were not significantly different between the two groups (P > 0.05). Conclusion:The application of CRS-HBM can improve the health knowledge, belief, behaviors for stroke patients after discharge, but there are not enough effects on clinical outcomes.

A series of new oxime and oxime ethers compounds were designed and virtually screened with target using the Molecular Operating Environment (MOE) software. Twelve unreported compounds including 4 oximes and 8 oxime ethers were synthesized with benzene, toluene, methoxybenzene and chlorobenzene as initial raw materials. Structures of compounds were elucidated by ¹H NMR, ¹³C NMR and MS. The results of bioactive screening showed that a part of compounds displayed obviously anti-HBV activities. Inhibitory activities of compounds 4B-2 in secretion of HBsAg and HBeAg were IC_{50 HBsAg}=81.15 μmol·L^-1, SI_HBsAg=9.20 and IC_{50 HBeAg}=90.66 μmol·L^-1, SI_HBeAg8.24, respectively. Preliminary structure-activity relationship study shows that methyl oxime ethers displayed better anti-HBV activities than the oximes.