Objective　To explore the risk factors for neuropsychological impairment in patients with sleep-related hypermotor epilepsy (SHE).Methods　We conducted a retrospective analysis consecutive patient with SHE from the epilepsy center of Tiantan Hospital Affiliated to Capital Medical University and Beijing Fengtai Hospital between May 2015 and May 2019.Patients were divided into two groups:neuropsychological impairment (n=31) and non-neuropsychological impairment (n=37).Patient demographics,clinical data were recorded and analyzed.Multinomial logistic regression analysis was performed to determine the independent risk factors for neuropsychological impairment in patients with SHE.Results　We found that patients in the neuropsychological impairment group had a lower age of onset,a higher seizure frequency,a higher proportion of patients with more interictal epileptiform discharges (IEDs) in sleep than in waking periods,and a higher proportion of patients with potential brain disorder,these differences were statistically significant（P<0.05）.Multivariate logistic regression analysis showed that patients with more IEDs in sleep than in waking periods（OR=17.315，95%CI 3.304~90.746，P=0.001）,a higher seizure frequency（OR=7.493，95%CI 1.416~39.665，P=0.018） were independently associated with neuropsychological impairment in patient with SHE.The higher age of onset（OR=0.862，95%CI 0.777~0.957，P=0.005） was protective factors associated with neuropsychological impairment in patient with SHE（P<0.05）.Conclusion　The patients with a lower age of onset,a higher seizure frequency,a higher proportion of patients with more IEDs in sleep than in waking periods were independently associated with neuropsychological impairment in patient with SHE.Early identification of related risk factors affecting neuropsychological impairment in patient with SHE have great clinical significance for improving their quality of life.

OBJECTIVE:To prepare Dexzopiclone orally disintegrating tablets (DODT),and to optimize its formulation.METHODS:Direct powder compression method was used to prepare DODT.Using repose angle of material,disintegration time and taste evaluation as indexes,single factor test was used to screen the types or amount of bulking agent,disintegrating agent,glidant and flavoring agent;using disintegration time as index,orthogonal experiment was applied to optimize the proportion of bulking agent,the amount of disintegrating agent,glidant and flavoring agent.Then the hardness and main component contents of DODT prepared by optimal formulation were determined.RESULTS:The optimal formulation was as follows as the ratio of mannitol-MCC 1 ∶ 4,the amount of disintegrating agent PVPP was 15％,the amount of glidant magnesium stearate was 1.0％,the amount of flavoring agent stevia was 3.0％.Three batches of prepared DODT were smooth in surface and good in taste;their disintegration time were(26.7 ± 1.2),(26.7 ± 0.6),(27.6 ± 0.9)s,hardness were (3.59 ± 0.19),(3.49 ± 0.18),(3.27 ± 0.16) kg,and contents were (99.47 ± 0.15) ％,(99.53 ± 0.05)％,(99.46 ± 0.20) ％,respectively (all RSDs≤0.87％,n=3).CONCLUSIONS:Prepared DODT are all in line with the quality requirements of orally disintegrating tablets.

Objective To observe Hedgehog signaling pathways of liver cancer cell growth and the influence of the metastatic potential targeted inhibit Hedgehog.Methods Construction of Smo shRNA plasmid,The stable and low-expressed Smo-expressing HCC QGY-7701 cell line was screened after lipofection.The stable and low-expressed Smo-expressing HCC QGY-7701 cell line was screened,The cell cycle,apoptosis,invasion and metastasis of QGY-7701 cells were detected by Western blot,flow cytometry,CCK8 and transwell assay.Subcutaneous implantation of hepatocarcinoma cells in nude mice.Study on the growth and metastasis of hepatocarcinoma cells with low expression of Smo in.The ultrastructural changes of hepatoma cells with low expression of Smo were observed under electron microscope.Results RT-PCR and Western blot showed stable shR-Smo cell line was successfully constructed.Cell cycle test showed that compared with the control group,G0/G1 cells increased in shR-Smo,cells in S phase decreased;apoptosis,CCK8 and Transwell tests showed that Smo-gene silencing could significantly increase the apoptosis percentage of the hepatic cancer cells to (5.46％ ± 1.46％),proliferation activity decreasedand and the migration rates reduced to (7.82％ ±2.14)％;nude mice model showed that Smo-gene silencing could inhibit the growth of hepatocellular carcinoma cells in vivo,electron microscopy revealed that lysosomes increased significantly in Smo-gene silence cells.Conclusions Blocking Hh signaling pathways,liver cancer cells in vitro malignant degree of decline.Hedgehog in treating liver cancer have hidden meaning.

Objective: To investigate the effect of AKT1 deSUMOylation induced by Ubc9 silencing on the proliferation and metastasis of hepatocellular carcinoma (HCC) cells. Methods: The Ubc9 gene was silenced using RNA interference, and the expression levels of Ubc9, SUMO1 and AKT1 protein were detected by Western blot. Cell proliferation and cell cycle was analyzed by MTT and flow cytometry. Wound healing and transwell assays were used to detect the cell migration ability. Furthermore, the xenograft model was established, and tumor growth curves were drawn. The in situ apoptotic rates was measured using TUNEL Apoptosis Assay. The expression of proliferating cell nuclear antigen (PCNA), matrix metalloproteinase (MMP)-2 and MMP-9 were evaluated by immunohistochemical staining. Results: Knockdown of Ubc9 gene significantly decreased the protein expression levels of Ubc9, conjugated SUMO1, free SUMO1 and AKT1 in HCC cells (P<0.05 for all). In control, siR-neg and siR-Ubc9 groups, the cell proliferation indexes were 53.19%, 54.25% and 39.17%, respectively. Moreover, cell migration distance and migrating cells per low power field for all these three groups were (59.47±4.66) μm and 89.44±8.36, (56.56±5.37) μm and 93.84±8.79, as well as (34.57±6.61) μm and 41.67±5.39, respectively. In the xenograft model, the weights of subcutaneous tumors for these three groups were (3.78±0.69) g, (3.72±0.72) g and (2.09±0.61) g, respectively. The corresponding apoptotic cell rates were (7.79±2.21)%, (6.45±2.48)% and (33.59±5.44)%, respectively. The expression levels of PCNA, MMP-2 and MMP-9 protein were significantly decreased in siR-Ubc9 group (P<0.05). Conclusions Ubc9 silencing in HCC cells induces AKT1 deSUMOylation, and then inhibits the proliferation and metastasis. These results provide a new therapeutic strategy for liver cancer in the future.

Objective To investigate the efficacy and safety of different optimal therapy strategies for hepatits B e antigen (HBeAg) positive chronic hepatitis B (CHB) patients with suboptimal response to peginterferon-α-2a (peg-IFN-α-2a) at 24 weeks.Methods This open-label,single-center and prospective clinical observational study was conducted in Department of Infectious Diseases at Shanghai Changhai Hospital between January 2009 and December 2011.The cases of HBeAg-positive CHB with suboptimal response to peg-IFN-α-2a at week 24 were enrolled.Based on virological markers and patient preference,patients were treated with either peg-IFN-α-2a add-on adefovir dipivoxil (ADV) or switch-to telbivudine (LdT).Hepatitis B virus (HBV) virological and serological data were collected at week 12,24 and 48 after the initiation of optimal therapy.Adverse reactions were also monitored.Therapeutic efficacy was compared between two groups of patients before and after treatment by x2 test.Kruskall Wallis test and Mann-Whitney test were used for analysis of continuous variables.Results Among 193 HBeAg positive CHB patients treated with interferon,67 had suboptimal response and were enrolled.Forty five cases received peg IFN-α-2a add-on ADV treatment and 22 cases received switch-to LdT treatment.After 48 weeks of optimized therapy,the total tBeAg seroconversion rate was 25.3 ％.The rates of HBeAg loss,HBV DNA negative and alanine aminotransferase normalization were 26.8％,73.1％ and 83.5％,respectively.The peg-IFN-α-2a switch-to LdT strategy had better HBV DNA inhibition efficiency compared with the peg-IFN-α-2a add-on ADV strategy at week 12,24 and 48 (P=0.00,0.00 and 0.01,respectively).However,there was no significant difference of HBV DNA negative rate between two groups at week 48 (x2 =0.01,P=0.89).The obviously intolerable adverse reaction was not reported in two optimized strategy groups.Conclusions The 48-week optimized treatment for HBeAg positive CHB with suboptimal response to peg-IFN-α-2a at week 24 could achieve a higher HBeAg seroconversion rate.The switch-to LdT strategy may have better HBV DNA inhibition efficiency.Both strategies show satisfactory safety and tolerance.

Objective: The soybean has long been an important protein source for approximately 5000 years in Oriental countries. Therefore, soy protein has been widely investigated for its variety of function. However, the side effects had been reported for its close structure of the female hormone, estrogen. In this report, we prepare a new soy peptide derivative and focus on the potency, with special attention to the linkage of peripheral leukocytes in number, emotional hormone and brain blood flow.
Method: Dried powder of soybean-protein or peptide were administered orally at dosage 8g (dry weight) suspension, the blood sample was collected before and after one week at the same hour and served for assessment in order to avoid circadian rhythm.
Results: The cell numbers were up-regulated in the group that had a smaller number of leukocytes before the test, but in the larger number group before the test, they were down-regulated in the soybean-protein and peptide. Therefore, when the number of all subjects were totaled and make mean, indicating no difference. As for the leukocyte subsets, lymphocyte numbers of CD_11b⁺ cells, and CD₅₆⁺ cells significantly increased after ingestion of a single gradient in the soybean-peptide group. On the contrary, only CD₁₉⁺ cell counts were down regulated. In the soybean-peptide group, the adrenalin level in serum, which is regarded as one of the emotional hormones, was down regulated, and another emotional hormone, dopamine, was up regulated. There were no change of CD positive cells and emotional hormones in the soy protein and placebo group. In NIRS, a significant increase in amplitude of all the frequency bands was observed in the peptide group just after 5 min of administration by the sample, peptide.
Conclusion: These results indicate that the soybean peptides can regulate the leukocyte subsets and emotional hormones are also closely related with the change of the brain blood flow in healthy young volunteers.

ObjectiveTo investigate the effects of the imbalance between regulatory T cells (Treg) and T helper 17 cells (Th17) in patients with chronic hepatitis B virus (HBV) infection.MethodsThe serum concentration of Treg/Th17 differentiation-related cytokines in 34 patients with chronic hepatitis B (CHB),20 patients with HBV related acute on chronic liver failure (ACHBLF),and 20 healthy controls (NC) were measured by enzyme-linked immunosorbent assay (ELISA) and proportion of peripheral Th17 and Treg cells were analyzed by flow cytometry.Numeration data was analyzed by Fisher's exact propability method and measurement data was tested by one-factor analysis of variance or Turkey multiple comparison.Results The levels of Th17 differentiation-related cytokines,II-1β (3.97±2.85) pg/mL,IL-6 (12.75±-8.87) pg/mL,and IL-21 (360.0±335.7) pg/ mL in patients with ACHBLF were significantly increased than those in NC,which were (1.87 ±0.94) pg/mL(q=4.559,P＜0.01),(5.28±0.72) pg/mL(q=7.309,P＜0.01) and (46.68±20.17) pg/mL(q=6.946,P＜0.01 ),respectively.The proportion of Th17 increased markedly in patients with ACHBLF than that in NC(q=3.972,P＜0.05).However,compared to NC and patients with ACHBLF,the Treg differentiation-related cytokine,TGF-β,in patients with CHB,increased significantly (q=4.536 and 5.323,respectively; both P＜0.01).And the population of Treg also increased markedly in CHB patients.The level of IL-17A which was the characteristic effector cytokine of Th17 was the highest in patients with ACHBLF.The peripheral Th17 cell proportion was positively correlated with the level of serum total bilirubin in patients with ACHBLF (γ=0.74,P＜0.01).Conclusions Th17 and Treg imbalance including cytokine profiles and cell numbers exists in patients with chronic HBV infection.The Th17 are active in patients with ACHBLF and Treg are active in patients with CHB.

Objective To determine the value of preoperative clinical, biochemical, cross-sec-tional imaging features and results of fine-needle aspiration for predicting malignancy in cystic neo-plasms of the pancreas (CNP). Methods The medical records of 69 patients receiving operations for CNP between 1994 and 2008 in our hospital were reviewed retrospectively. The predictive effect of va-rious preoperative factors such as sex, location, clinical manifestation, maximum diameters, tumor marker, pancreatic duct obstruction and calcification on the malignant potential of CNP was evaluated by Single and multi-factor analysis, fine needle aspiration (FNA) and intraoperative frozen-section ex-amination of the pancreatic transection margin was investigated. Results All the 69 patients were con-firmed pathologically. Of the 69 patients, 13 suffered from serous cystic neoplasms, 30 from mucinous cystic neoplasms,7 from intraductal papillary mucinous neoplasms,12 from solid pseudopapillary neo-plasms and 7 from cystic neoplasms. Forty-four lesions were diagnosed as malignant or borderline.Univariate analysis should that jaundice, raised CEA and/or CA19-9, maximum diameters and solid component of cystic neoplasmshad were of statistical significance for the risk of malignancy in CNP.The sensitivity was 34.1% (15/44), 47.7 % (21/44), 88.6%(39/44),72.7%(32/44) and specificity 96% (24/25), 84% (23/25), 68% (17/25),72% (18/25), respectively. The last three were identified as independent predictive factors for malignancy by multivariate analysis. Three cases were accurately diagnosed out of the 9 undergoing FNA preoperatively. One of 7 patients with intraductal papillary mucinous neoplasms (IPMN) undenwent total pancreatetomy for transection margin positivity.Conclusion Most malignant CNP can be accurately diagnosed preoperatively from a typical clinical,biochemical and cross-sectional imaging picture. FNA is only used in the patients who are potential candidates for nonoperative management. Margin analysis is necessary for pancreatic resection.

BACKGROUND: Schwann cells play an important role in axonal growth and myelin sheath formation of the peripheral nerve. Whether Schwann cells play the same role in the spinal cord had attracted considerable attention. Microencapsulation technology as an effective immune isolation technique can effectively keep Schwann cell activity to play the repair effect of Schwann cell in the spinal cord.OBJECTIVE: To observe the changes of myelin sheath in the injured transection of rats after transplantation of the alginic acid microencapsulated Schwann cells.DESIGN, TIME AND SETTING: The randomized controlled animal experiment was performed at the Basic Medical School of Nanchang University from March 2005 to February 2008.MATERIALS: Sciatic nerve trunk was obtained from adult rabbits to harvest Schwann cells in vitro using repeatedly differential velocity adherent technique, and to prepare Schwann cell suspension and microencapsulated Schwann cell suspension.METHODS: A total of 146 adult Sprague Dawley rats were used to establish models of right hemi-transection damage at T_(10) level and randomly assigned to four groups: simple injury group (n=44), cell transplantation group (n=44), microencapsulated cell transplantation group (n=44) and normal control group (n=14). At 1, 3, 7,14 and 28 days following surgery, 8 rats were selected from each group at each time point (2 from the normal control group) for perfusion and fixation. Spinal cord tissue was collected to make paraffin section, and then subjected to hematoxylin-eosin staining and Loyez myelin staining. In addition, 2 rats were selected from each group at 2 and 8 weeks. The spinal cord tissue was fixed, embedded in Epon816, stained using uranyl acetate and aluminum citrate, and then observed using an electron microscope.MAIN OUTCOME MEASURES: Neuron number and survival were observed surrounding the damaged region. Structural changes in the myelin sheath from spinal cord white substance at the damage site were measured.RESULTS: At 1 and 3 days following spinal cord injury, spinal neurons were degenerated and necrotic at damaged site, with reduced number of myelin sheath, loose structure, but above-mentioned was rare in the cell transplantation and microencapsulated cell transplantation groups. At 7 days, the reduced number of myelin sheath, with damaged structure was seen. The microencapsulated cell transplantation group was light. At 14 days, number of neurons was increased, with increased cell body, especially in the microencapsulated cell transplantation group. At 28 days, neurons gradually recovered, myelin sheath was gradually complete, with increased number in the microencapsulated cell transplantation group. There were significant differences compared with the simple injury and cell transplantation groups (P < 0.01). At 8 weeks, abundant myelin sheath was repaired, with new myelin sheath in the microencapsulated cell transplantation group.CONCLUSION: Microcapsule has immune isolation effects. Microencapsulated rabbit Schwann cells can promote the repair of rat spinal cord neurons and axonal myelinization.

We have simultaneously proved that cell populations taking charge of immunity in human peripheral blood can be regulated quantitatively by acupuncture. Now we investigated the effect of acupuncture qualitatively on cytokine production by lymphocyte cells in human peripheral blood.
The number of IL-1β, IL-4 and IFN-γ containing cells, which are closely associated with macrophage, humoral immunity and cellular immunity respectively, were measured by FACScan. We found a significant increase in IFN-γ containing cells after acupuncture. According to this result together with previous results, the enhancement of CD4⁺ and CD56⁺ cell counts, the treatment of acupuncture can promote the activity of cellular immunity as well as NK cell.