Objective To explore the relationship between viral encephalitis(VE)and Borna disease virus(BDV)infection,and discuss the clinical features of viral encephalitis patients infected by BDV.Methods The p24 gene fragment of BDV in cerebrospinal fluid mononuclear cells(CSFMC)from 32 patients with viral encephaliris and 34 healthy individuals were examined by fluorescence quantitative nested reverse transcriptase polymerase chain reaction(FQ-nRT-PCR),in which, β-actin was used as internal reference. The clinical manifestations of patients with positive BDV p24 were watched. And the gene sequence,homology and amino acid sequence of positive products were analyzed. Results The positive rate(4/32,12.5%)of BDV p24 in CSFMC of patients with viral encephalitis was significantly higher than that of healthy individuals(0/34,0%),P＜0.05,and the numbers of copies of BDV p24 in CSFMC of VE patients were more than 102/μl. Compared with the sequences of the standard strain Ⅴ and the virus strain H1766 of BDV from horse supplied by GenBank,the homology of the gene sequence of positive product of CSFMC was 95.35% and 98.84% with gene mutation in 4 sites(nt1649 T→C, nt1656 G→A,nt1670 C→T, nt1676 C→T). The genetic relationship between the positive product and the virus strain BDV from horse was the nearest. The clinical features of VE patients with positive BDV p24 were mainly by mental and behavior disorders. Conclusion The occurrence of VE patients in the city of Zunyi in Guizhou province may be associated with BDV infection. The clinical features of VE patients with positive BDV p24 were mainly mental and behavior disorders.

In resent years, the accounts about adults' sudden death without specific reason have been increased. The definition of cause of death was a hot potato to legal medical experts. With the deep - going of etiology to molecular level, clinical cardiac diseases' researches have confirmed that the arrhythmia has been resulted from a kind of " idiopathic disorder of cardiac action potential" that is related to cardiac sodium channel diseases by SCN5A mutation confirmed by using the techniques of molecular genetics. The paper reviewed the characteristic of SMDS ( Sudden Manhood Death Syndrome) in forensic science and some kinds of diseases' genotype and phenotype in clinical medicine, and hoped to acquire some revelation for further related research.

Objective To investigate the impact of enteral nutrition (EN) through jejunal feeding tube on the nutritional status and immunologic function of patients during chemotherapy after total gastrectomy.Methods Totally 86 patients with gastric cancer who had undergone total gastrectomy with radical resection and jejunostomy received adjuvant venous chemotherapy in our department from January 2009 to June 2010.They were divided into EN group ( n =43 ) and control group ( n =43 ) according to the hospitalization number.The EN group maintained the jejunostomy tube until the end of 6 courses of chemotherapy,and was given EN support for 7 days through jejunal tube during each course of chemotherapy; the control group removed the tube before chemotherapy without further dietary restriction or nutrition support.The nutritional and immunologic indicators on the 1 st day before chemotherapy and the 1st day after 6 chemotherapy courses were measured.ResultsThree patients in the EN group withdrew from the study because of catheter blockage or catheter loss and 2 patients in the control group failed to complete the trial because of chemotherapy side effects or economic reasons; 81 patients entered the final analysis.After 6 courses of chemotherapy,both groups experienced body weight loss,but the percentage is significantly lower in EN group than in control group (6.9％ ± 0.95％ vs.11.2％ ± 1.32％,P =0.0000).Compared with the nutritional status before the first chemotherapy,the prognosis nutritional index (PNI) in both groups declined after the 6th chemotherapy.Such decline was not statistically significant in EN group ( P =0.1534) but was significant in control group (P =0.0000).The PNI in EN group after chemotherapy was significantly higher than that in control group (P =0.0040).The levels of IgG,NK,CD4 +,and CD4 +/CD8 + were significantly higher in EN group than in control group ( P =0.0083,0.0143,0.0000,and 0.0000,respectively) after chemotherapy.ConclusionEN during postoperative chemotherapy may improve the nutritional status and immunologic function in gastric cancer patients after total gastrectomy.

Objective:To investigate the effect on proliferation and apoptosis of T-cell leukemia cells by silencing NRP-1 ( Jurkat cells).Methods:The lentivirus plasmid which expresses NRP1 gene specific shRNA was constructed in our preliminary ex-perimental.We transfected the lentivirus plasmid to human T-cell Lymphoma cells.The proliferation of Jurkat cells different groups and effect on cell proliferation after chemotherapy drug EPI-treated were found by CCK-8 kit.The proliferation level and apoptosis rate of the cells were detected by flow cytometry and Annexin-V-FITC/PI method.Results:The proliferation level of NRP-1 /shRNA interference group was decreased significantly in 48 h,72 h,96 h,which was compared with the control groups.The apoptosis rate of the NRP-1/shRNA interference group was increased compared with control groups.The chemotherapy drug sensitivity of epirubicin ( EPI ) test results showed that EPI concentration was 0.025,0.05,0.1,0.2,0.4 μg/ml,the NRP-1/shRNA interference group of cell growth inhibition rate was increased,the corresponding control group difference had statistical significance(P<0.05).We choose the drug con-centration of the EPI IC50 for next experiments.NRP-1/shRNA interference group cell apoptosis rate increased significantly after induction,compared with the control groups difference was statistically significant ( P<0.05 ).Compared with control group, the expression level of Bcl-2 protein was decreased and the expression level of bax protein was increased significantly after EPI induction.The percentage of cells at G0/G1 phase increased significantly,while those at S phase decreased significantly.Conclusion:Plasmid shRNA-NRP1 inhibited the expression of NRP1 in Jurkat cells and decreased the proliferation level of Jurkat cells and promote their apoptosis and enhance their drug sensitivity;the molecular mechanism may relate to down-regulation of Bcl-2 and up-regulation of Bax.and arrested the cell cycle at G0/G1 phase.

Objective To compare the EEG complexity between rats under awaking and differ-ent depth of anesthesia via analyzing sample entropy and fractal dimension.Methods Sixteen SD rats were intraperitoneally injected with urethane twice,first with 500 mg/kg and second with 800 mg/kg one hour later.The scalp EEG was collected in stage of awaking (W),light anesthesia (LA)and heavy anesthesia (HA).The sample entropy (SampEn)and fractal dimension (FD)were computed by MATLAB.The characteristic values were denoised by linear dynamic system method during the whole process.Results The value of SampEn and FD gradually dropped from awaking to heavy anes-thesia.The SampEn and FD in W was significantly higher than the value in LA or in HA (P <0.05). The SampEn and FD in HA was significantly lower than that in LA (P < 0.05 ).Conclusion The SampEn and FD of EEG could be used to monitor the depth of anesthesia.

Objective To improve the quality of life in gastric cancer patients after total gastrectomy by exogenous trypsin supplement.Method In this study 106 patients were divided into two groups,with 53 patients in each group,oral pancreatic enzyme capsule was given in comparison without in control group.Patients were asked to fill in EORTC QLQ-C30 questionnaire and Korenaga questionnaire at half a year postoperation,stool sample was collected at the same time for fecal fat assay.Results A total of 86 patients completed this test at postoperation half a year.With a comprehensive assessment of quality of life in patients by the scoring system of EORTC QLQ-C30 and Korenaga and the fecal fat contents measurement.Exogenous trypsin plays a positive role in preventing weight loss,improving emotional function,alleviating loss of appetite,insomnia,fatigue,postprandial fullness,nausea,vomiting and diarrhea,and improving intestinal tolerance to fat and the overall health status of patients.Conclusions Total gastrectomy causes exocrine pancreatic dysfunction,exogenous supplement of the enzyme improves postoperative quality of life in these patients.

Nonalcoholic steatohepatitis (NASH) is an important pathological stage of nonalcoholic fatty liver disease characterized by hepatocyte fatty degeneration, liver injury, and liver inflammation and can further develop into liver cirrhosis and hepatocellular carcinoma. The NOD-like receptor family, pyrin domain-containing protein 3 (NLRP3) inflammasome is a multi-protein complex in cells and can induce cell apoptosis and expand inflammatory response by activating caspase-1 and releasing mature inflammatory factors such as interleukin-1β and interleukin-18. Recent studies have found that NLRP3 inflammasome may participate in the development and progression of NASH. Therefore, this article summarizes the role of NLRP3 inflammasome in NASH, so as to provide a theoretical basis for future research and treatment.

Objective:To evaluate the influencing factors of carotid-femoral pulse wave velocity (CF-PWV) and its value to predict outcomes in peritoneal dialysis (PD) patients.Methods:Eligible patients undergoing PD in Renji Hospital of Shanghai Jiao Tong University between August 2016 and July 2018 were recruited and prospectively followed up until death, PD cessation, or to the end of the study. CF-PWV was measured by an arterial pulse wave velocity meter to assess arterial stiffness (July 31, 2020). Overhydration was measured by bioimpedance spectroscopy. The patients were divided into CF-PWV≤10 m/s group and CF-PWV>10 m/s group according to the measured value of CF-PWV. The influencing factors of elevated CF-PWV were analyzed by multivariate logistic regression. Survival curves were generated using the Kaplan-Meier method and multivariate Cox proportional hazards models were used to analyze the difference for all-cause mortality and cardiovascular disease (CVD) mortality between the two groups.Results:A total of 224 PD patients were enrolled, including 133 males (59.4%). The age was (55.2±13.4) years old, and median PD vintage was 22.3(6.5, 59.3) months. Among them, 47(21.0%) patients were comorbid with diabetes, and 37(16.5%) patients had CVD history. The median CF-PWV was 9.6(8.4, 11.4) m/s for the cohort, and 105(46.9%) participants had CF-PWV over 10 m/s. Compared with CF-PWV≤10 m/s group, CF-PWV>10 m/s group patients had older age, increased percentage of diabetes and CVD (all P<0.05). Multivariate logistic analysis showed that increased age ( OR=1.070, 95% CI 1.043-1.099, P<0.001), diabetes ( OR=3.693, 95% CI 1.646-8.287, P=0.002) and higher overhydration ( OR=1.238, 95% CI 1.034-1.483, P=0.020) were independent influencing factors for elevated CF-PWV in PD patients. After followed up for 37.4(25.6, 41.7) months, 24 patients died, including 19 cases of CVD-related deaths. Kaplan-Meier survival analysis showed that all-cause mortality and CVD mortality were significantly higher in the CF-PWV>10 m/s group than those in CF-PWV≤10 m/s group (Log-rank χ2=6.423, P=0.011; Log-rank χ2=6.243, P=0.012, respectively). Multivariate Cox proportional hazards models showed that increased age was an independent influencing factor for both all-cause mortality and CVD mortality ( HR=1.057, 95% CI 1.010-1.107, P=0.018; HR=1.062, 95% CI 1.009-1.118, P=0.022). Conclusions:Increased arterial stiffness is relatively common in PD patients. Higher CF-PWV in PD patients is associated with increased age, diabetes and higher overhydration, and it is probably a valuable predictor of outcome in PD patients.

OBJECTIVETo investigate the application of home enteral nutrition (HEN) in patients with advanced gastric cancer and its impact on the quality of life.

METHODSData of 60 consecutive patients with advanced gastric cancer, who could not underwent operation and had relapse metastasis, from June 2010 to June 2012 were retrospectively analyzed. According to familial nutritional pattern, these 60 patients were divided into HEN group (25 cases) receiving home enteral nutritional support and control group (35 cases). HEN patients were supported through jejunostomy tube or nasal gastric tube. Control patients were supported through total parental nutrition or purely eating respectively. All the patients received intravenous chemotherapy and evaluated by Karnofsky index and Spitzer system in the first, third, sixth and twelfth month. In the sixth month, patients were also examined by EORTC QLQ-C30.

RESULTSNo significant differences were found between the two groups according to 8 elements containing age, sex, BMI, etc. A total of 53 patients died within one year, including 21 in HEN group and 32 in control group. The Karnofsky scales showed that HEN group scored meanly 57.4, 39.6 and 28.2 in the third, sixth and twelfth month respectively, which were significantly higher than those of control group (45.3, 29.2 and 20.1, P=0.041, P=0.012 and P=0.015 respectively). The Spitzer scales showed that HEN group scored meanly 5.12, 4.04 and 2.54 on average in the third, sixth and twelfth month respectively, which were significantly higher than those of control group (4.32, 3.01 and 1.97, P=0.048, 0.035 and P=0.024 respectively). The EROTC QLQ-C30 scales showed that HEN group scored higher than control group in functional scales (P<0.05), and lower in the symptom scales of short breathing, pain and tired (P=0.025, P=0.044, P=0.036 respectively), while higher in diarrhea (P=0.047).

CONCLUSIONSThe quality of life of patients with advanced gastric cancer declines gradually with the nutritional status deteriorating. HEN can be applied to improve the nutritional status and quality of life.

Objective To establish genotyping methods for vitamin K epoxide reductase complex subunit 1 (VKORC1)and cytochrome P450 2C9(CYP2C9)based on pyrosequencing technique to detection of warfarin metabolizing enzyme related gene polymorphisms.Methods A total of 50 peripheral blood samples from healthy adults were collected and the whole blood genomic DNA was extracted.A set of biotin-labeled amplifi-cation primers and sequencing primers were designed respectively for three SNP sites:VKORC1 -1639 G>A,CYP2C9 430C> T and CYP2C9 1075A>C.After PCR amplification of the samples,pyrophosphoric acid se-quencing was conducted.And then the signal peaks form were combined to analyze and determine each sample genotype.Genotyping results were verified by Sanger sequencing,and the consistency of the two sequencing methods was compared.Results Genotypes of the three SNPs can be clearly determined according to the ba-ses and height of the signal peaks.Among the 50 samples,there were 41 AA and nine AG for VKORC1 -1639G>A,accounting for 82% and 12% respectively,and there were 45 *1/*1,five *1/*3 for CYP2C9, accounting for 90% and 10% respectively,no CYP2C9*2 allele detected.Genotype results detected by pyrose-quencing and Sanger sequencing were consistent with each other.Conclusion In SNP genotyping,Pyrose-quencing has the advantages of convenience,time-saving,cheap with accurate and reliable results,which can quickly determine the genotypes of CYP2C9 and VKORC1.