Telomeres are the unique structure at the end of chromosomes,which pose two special challenges for the cellular DNA replication and repair machinery.Because of the inability of lagging strand synthesis to fully replicate a linear template,the chromosome ends is progressively shortening at each replication cycle.The tandem DNA repeats must maintain enough length to allow the cell dividing and mitosing,otherwise the cells would lose the dividing ability and undergo replicative senescence.There are two special pathways to regulate telomere length,which consist of telomerase and alternative lengthening of telomeres(ALT).SUMO is an evolutionarily conserved protein,which is covalently attached to target proteins and alters their conformation,stability,interaction and localization.Currently,a lot of proteins have been proved to be the substrates of SUMOylation.A growing body of evidence implicate that SUMOylation plays a very important role to elongate telomeres in both telomerase and ALT.The Rad5 and Rad52,as well as BLM have been showed either to be modified by SUMO or to interact with SUMO.SUMOylation positively modifies the activity of telomere.

Objective To investigate the status of metabolic syndrome(MS),chronic metabolic disease and insulin resistance(IR) in dwellers over twenty years old in Wulian County,Shandong province.Method 2 127 dwellers over twenty years old were investigated in three towns with multistage stratified sampling and cross sectional methods.Questionnaire was delivered to all the subjects,while physical examination and biochemical test were carried out.Result The prevalent rate of chronic metabolic diseases in dwellers over twenty years old in Wulian County was 64.34%.The prevalent rate of overweight/obesity,diabetes,hypertension and hyperlipemia were 36.24%,3.24%,38.98% and 31.26,respectively.The prevalence of MS having more than three above diseases was 7.9%.The prevalent rate of IR in obesity,diabetes,hypertension,dyslipidemia and MS patients were 43.34%,78.26%,29.79%,33.23% and 64.28%,respectively.Conclusion Near two-thirds of the dwellers over twenty years old in Wulian suffered chronic metabolic disease.IR was common in MS and chronic metabolic disease,especially in diabetes and MS.

Obesity is a rapidly growing international health problem. The association of fat mass and obesity associated(FTO) gene and obesity is becoming the hot topic in the gene research. FTO is a member of the nonheme dioxygenase [Fe(Ⅱ) and 2-oxoglutarate-dependent dioxygenases]superfamily. FTO levels in the brain,especially in the hypothalamus,participate in the central control of food intake. The mutation of FTO gene accentuates body mass index,hip circumference and total weight,leading to obesity.

Objective To discuss the therapeutic method of extracranial athemsclerotic carotid artery stenosis . Methods A retrospective analysis was conducted in 51 patients with angiography confirmed carotid artery stenosis from January 2012 to June 2012 in our hospital.The carotid endarterectomy (CEA) was performed in 16 cases, while the carotid artery stenting (CAS) was performed in 35 cases. Results All the 51 operations were successfully completed .There were 1 case of transient ischemic attack ( TIA) 3 days after CEA operation , 1 case of postoperative stroke after CAS operation , and 1 case of carotid sinus pressure after CAS operation . The follow-up period of all the cases was 9-15 months, with an average of 13.6 months.Ultrasound review of the carotid artery found no restenosis. Conclusion According to medical information of the patients with extracranial carotid atherosclerotic stenosis , we tend to adopt the CAS treatment in patients with following situations: ①transient ischemic attack at least once within 6 months, with symptoms or signs lasting for more than 24 hours and the degree of carotid stenosis ≥70%;②mild than disabling stroke onset at least once within 6 months, with symptoms or signs lasting for more than 24 hours and the degree of carotid stenosis ≥70%; ③carotid artery stenosis ≥2 cm under neck vascular CTA and cerebral angiography .We tend to adopt CEA treatment in patients with following situations:①asymptomatic carotid stenosis with degree ≥70%;②symptomatic carotid stenosis with degree range from 50%to 69%;③asymptomatic carotid artery stenosis with degree <70%, but with instable situation of lesions under angiography or other examinations .

AIM:To determine notoginsenoside R_1 and ginsenoside Rg_1, Rb_1 in Zidan Huoxue Tablet by HPLC linear gradient elution (total saponins of Radix et Rhizoma Notoginseng). METHODS: Using HPLC method with Hypersil ODS2 C_ 18 column. A mobile phase consisted of acetonitrile-water 0-20 min (20∶80), 20-21 min(40-20∶60-80), 21-30 min(20∶80) gradient elution. The column temperature was at room temperature. The detection wavelength was at 203 nm. RESULTS: The linear ranges of R1, Rg1, Rb1 were 0.52-2.6 ?g (r= 0.999 9 ), 2.106 -10.53 ?g (r= 0.999 6 ) and 2.946-14.73 ?g (r= 0.999 6 ), respectively. The average recoveryies were 99.3% (RSD=1.1%), 100.0%(RSD=0.5%) and 99.7%(RSD=0.9%), respectively. CONCLUSION: The method is selective and reproducible for determination of notoginsenoside R_1 and ginsenoside Rg_1, Rb_1 in Zidan Huoxue Tablet.

Wilms tumor(WT) is one of the most common renal malignancies in children.Although several genetic loci such as the WT1,WT2,p53 and ?-catenin genes have been considered to be associated with WT,the causes of the tumor are still unknown.Recently the US researchers have identified a new tumor suppressor gene that is mutated in WT.The biological function of the protein encoded by WTX is yet unknown,however,the gene's location in the X chromosome is of particular interest.This review highlights the current study of the gene mutated in Wilms tumor.

Objective To investigate the existence of pulmonary vascular remodeling after left pneumonectomy in rats and the role of hypoxia inducible factor-lα( HIF-1α) and vascular endothelial growth factor ( VEGF) in pulmonary vascular remodeling.Methods Twenty-four healthy male Sprague-Dawley rats were randomly divided into experimental and control groups, 12 in each group.The rat models of pulmonary vascular remodeling were created by open-chest left pneumonectomy.After 12 weeks of feeding, the mean pulmonary artery pressure ( mPAP) and partial pressure of arterial oxygen ( PaO2 ) of each rat were measured.The ultrastructure of small arteries in the lung specimens were examined by e-lectron microscopy.Muscularized degree of three kinds of small pulmonary vessels ( muscularized artery MA, partially mus-cularized artery PMA, and non-muscularized artery NMA) were observed by light microscopy, and the percentage of each kind of pulmonary arteries ( MA%, PMA%, NMA%) were calculated.Arterial external diameter, media thickness of ves-sel ( MTV) , total vascular area, media area of vessel ( MAV) , MTV%and MAV%were calculated as indicators of pul-monary vascular remodeling.The expressions of HIF-1αand VEGF in artery were detected by immunohistochemistry.Re-sults The values of mPAP, MA%, PMA%, MTV, MAV, MTV% and MAV% in the experimental group were signifi-cantly higher than those in the control group (P<0.01), but the value of PaO2 and NMA%were significantly lower than those in the control group (P<0.01).The IOD value of HIF-1αand VEGF expressed in the pulmonary arterial wall of the experimental group were 26.47 ±4.16 and 42.04 ±3.79, respectively, significantly higher than those in the control group (6.12 ±2.14 and 11.53 ±2.29, P<0.01).Linear correlation analysis showed that the expression of HIF-1αand VEGF was positively correlated with MTV% and MAV%, negatively correlated with PaO2 , and the HIF-1αexpression was posi-tively correlated with VEGF expression.Conclusions A rat model of pulmonary vascular remodeling can be successfully established by left pneumonectomy.Hypoxia is a key factor in the development of pulmonary vascular remodeling, HIF-1αand VEGF may play an important role in its pathogenesis.

The authors report one case of primary hepatic neuroendocrine carcinoma associated with multiple liver metastases. A patient was a 41-year-old female. In 2010, B-ultrasound examination revealed that there were multiple space-occupying lesions in the liver, and hepatic hemangiomas was considered to be the diagnosis. Then, the patient was followed up regularly. In Aug. 2013, B-ultrasound examination indicated that the hepatic lesions were significantly enlarged. Multi-detector CT scanning and MRI examination were performed, and still the diagnosis of multiple hepatic hemangiomas was suggested. On CT and MRI the lesion presented as a well-circumscribed hypervascular tumor with “fast-in and slow-out” enhancement pattern. On MRI, the lesion was characterized by multiple nodules. Needle biopsy was carried out, and the pathological and immunohistochemical diagnosis was metastatic neuroendocrine tumor. Systemic examination did not find the primary lesion. Therefore, primary hepatic neuroendocrine carcinoma associated with intra- hepatic metastases was diagnosed. The patient was treated with transcatheter arterial chemoembolization. The drugs used were 100 mg Oxaliplatin+one bottle of gelatin sponge particles(300-500μm)+10 ml iodized oil, and micro-pump infusion of 100 mg oxaliplatin(99 mg/h) through catheter was also employed. Clinically, primary hepatic neuroendocrine carcinoma is extremely rare. In combination with the medical literatures, the authors attempt to make a preliminary discussion on the clinical characteristics, differential diagnosis, treatment and prognosis of primary hepatic neuroendocrine carcinoma.

Objective: To study the efficiency of silencing small ubiquitin-like modifier-1(SUMO-1) induced by siRNA in hepatocellular carcinoma cell line SMMC-7721 and the growth inhibition of SMMC-7721 thereof. Methods: The SUMO-1 siRNA was transfected into SMMC-7721 by means of lipofectamine~(TM) 2000. The silencing efficiency of SUMO-1 was examined by RT-PCR and western blot. The cell growth and cell cycle were examined by MTT and flow cytometry(FCM). The cell apoptosis was detected by DeadEnd~(TM) Colorimetric TUNEL System. Results: The siRNA could significantly silence the expression of SUMO-1 in SMMC-7721.The maximal silencing rate was utmost 73.43% at 48 hours after being transfected SUMO-1 siRNA. MTT assay revealed that the cell line grew more slowly. FCM result showed that the number of G_2 stage cells was increased significantly. But apoptosis cells were not found by TUNNEL assay. Conclusion: SiRNA is a good manner to silence the expression of SUMO-1 in SMMC-7721 in vitro. Owing to the growth inhibition induced by SUMO-1 siRNA, SUMO-1 plays an important role in development of SMMC-7721.

Objective:To explore the optimal postpartum nursing intervention method of elderly second-birth parturient based on the best evidence and evaluate its effect so as to improve the quality of clinical nursing.Methods:Based on the best evidence obtained from the previous study, the optimal nursing examination index of the elderly second parturient was established, and the evidence of best practice was obtained by using the evidence-based nursing method, and the 2017 revised version (the third edition of) Johns Hopkins evidence-based nursing practice model) was used to guide nurses to apply the evidence to clinical practice. During the period from March to May 2019, the baseline review was completed, including 82 pregnant women and 43 nurses. The evidence was incorporated into clinical practice in June 2019. From July to October 2019, the same indicators and inclusion and exclusion criteria were used to evaluate the effectiveness of evidence application in 43 nurses (including midwives) and 85 elderly second-child parturients in obstetric wards (including baby-friendly areas). The anxiety, depression, maternal satisfaction and nurses' correct implementation rate of the best evidence were compared before and after the application of evidence.Results:After the use of evidence-based intervention, the implementation rate of nurses was above 80%. The anxiety score of parturient decreased from 55.29±10.11 to 41.74±10.35, the difference was statistically significant ( t value was 8.55, P<0.001), and the depression score decreased from 57.77 ±8.32 to 47.86 ±9.33, the difference was statistically significant ( t value was 7.23, P<0.001). Maternal satisfaction increased from 92.68% (76/82) to 98.82% (84/85), the difference was statistically significant ( χ2 value was 3.92, P< 0.05). Conclusion:The result of practice shows that through evidence-based nursing intervention, we can further standardize the postpartum optimal nursing paradigm of elderly second-child parturients in China. Reduce postpartum anxiety and depression and improve maternal satisfaction. And quality review still needs to be continuously promoted and implemented in clinical practice in order to continuously improve the quality of nursing and ensure sustainability.