Transcription is a multi-stage process that coordinates several steps during the transcription cycle including pre-initiation,initiation and elongation.Recent advances by genome-wide study suggest that control of transcription elongation is a critical step for precise regulation of gene expression across species from Drosophila to mammals.Here we review the molecular mechanisms of how transcription elongation of RNA polymeraseⅡ(PolⅡ) is modulated by the major pausing factors-NELF,DSIF and the positive elongation factor P-TEFb,which is the key player in pause release.We also discuss the potential implications of regulation of transcription elongation in pathogenesis of cancer,inflammation and virus infection.

Objective To explore the relationship between TSLC-1 protein expression and the progression and carcinogenesis of human papillary thyroid carcinogenesis. Methods Expressions of TSLC-1 protein in 20 pieces of benign thyroid lesions and 40 pieces of papillary thyroid carcinoma tissues were examined by immunohistochemistry. Results The expression of TSLC-1 in papillary thyroid carcinoma (9/40) was lower than that in benign thyroid lesions (22.50% versus 90.00%, P < 0.05). Expression of TSLC-1 was significantly associated with lymph node metastasis and TNM in papillary thyroid carcinoma (P < 0.05). Conclusions Expression of TSLC-1 is closely related with carcinogenesis , lymph node metastasis , and clinical stage in papillary thyroid carcinoma.

Purpose:Occult carcinoma of thyroid ( OCT) is difficult to differentiate from benign thyroid nodules because it is small ( < 1 cm),often asymptomatic,shares similar ultrasonographic characteristics.The aim of this study was to retrospectively review the ultrasound diagnosis and pitfalls of ultrasound in OCT.Materials and Methods: The ultrasonography in 37 cases suspected of OCT were reviewed,analyzed and compared with histopathology.Results: 30/37 (81.1% ) cases (38 nodules) confirmed of OCT were found solid,hypoechogenic nodules in 97.4%,with irregular margins ( 33/38,86.8% ),longitudinal-to-transverse ratio = 1 ( 17/38,44.4% ),minute calcification (19/38,50.0%),decreased flow (36/38,94.7%),and resistance index < 0.7( 30/37,81.1%).7/37 (19.0%) cases of misdiag-nosis included 3 chronic lymphocytic thyroiditis with nodules,2 nodular goiter and 2 collagen nodules.They all had overlapping ultrasonographic features.Conclusion: Those ultrasonographic features were of certain value in OCT.

ObjectiveTo investigate the high risk factors,etiology,diagnosis,treatment and precaution of venous thromboembolism (VTE) in pregnancy and puerperium. MethodsData of 16 cases of VTE admitted in Department of Obstetrics and Gynecology,Peking Union Medical College Hospital from January 1992 to April 2011 were analyzed retrospectively.The differences of blood routine test and coagulation function between VTE patients (study group) and normal pregnant women (control group) were compared by paired t test in this case-control study.Results All patients were diagnosed by color Doppler ultrasound or CT pulmonary artery angiography.Five cases (31.2 ％) occurred before delivery and 11 (68.8 ％) occurred during postpartum.Two cases (12.5 ％)complicated by pulmonary thromboembolism,and one of them died.Six cases (37.5％) were older than or equal to 35 years old,and 12 cases (75.0％) had gestational complications.The hematocrit in study group were lower than that in control group (0.29±0.06 vs 0.39±0.02,t=4.56,P=0.01).There was no statistical difference between the coagulation function of the two groups.After anticoagulant therapy or surgery,15 cases recovered.One pulmonary thromboembolism patients complicated with rheumatic cardiac disease remained shock after anti-coagulants was administered,then died of hemorrhage of respiratory tract after inferior vena cava filter placement. Conclusions VTE is likcly to happen in puerperium than in pregnancy.There are no good screening indicators for thromboembolism during pregnancy and puerperium.Anticoagulation is recommended to be the first line therapy.For women with high risk of thromboembolism,it is suggested to prevent actively and treat early to decrease the complications and long-term sequelea.

Objective:To explore yhe therapeutic effect of Shenfu injection on patients of hepatic cirrhosis with seroperitoneum(yang de ciency of spleen and kidey synndrome).Methods:The 84 patients were divided into treatment group and control group,the patients in treatment group were treated with western medicine and Shenfu injection,only western medicine were used in control group,they were all treated for twenty-eight days.Results:The curative e ect,extinction time of seroperitoneum,amelioration of hepatic function and blood routine of the treatment group were better than those of control group.And there were statistical signi canc between two groups(P

Objective To analyze the clinical risk factors of type 2 diabetes complicated with cerebral infarction .Methods 508 patients with type 2 diabetes were selected and divided into two groups :group A (complicated with cerebral infarction ,n=240) and group B (without cerebral infarction ,n=268) .The basic clinical information of two groups were recorded .The coagulation indica‐tors and biochemical indicators (including blood glucose ,blood lipid ,HbA1c ,blood β2 microglobulin ,urineβ2 microglobulin ,urine microalbuminuria ,fasting insulin ,fasting C peptide etc) were detected respectively .Results There were significant differences in age ,age at onset of diabetes ,duration of hypertension and systolic blood pressure between group A and group B (P<0 .05) .The in‐cidence of hypertension and coronary heart disease in group A were higher than group B (P<0 .05) .Comparing with group B ,the levels of HbA1c ,ApoB ,fasting insulin ,fasting C‐peptide ,lipoprotein (a) ,Hcy ,blood β2 microglobulin ,urineβ2 microglobulin ,and urine microalbuminuria of group A were significantly different (P<0 .05) .The ATⅢ level of group A was significantly lower than that of group B (P<0 .05) .Conclusion The risk factors of type 2 diabetes complicated with cerebral infarction include age ,hyper‐tension ,HbA1c ,ApoB ,fasting insulin ,fasting C‐peptide ,lipoprotein (a) ,Hcy ,etc make diabetics be more prone to cerebral infarc‐tion ect .

Objective To compare the efficacy of pantoprazoh based short-term quadruple regimens in the treatment of Helicobacter pylori (H. Pylori) infection for 4 days,5 days or 7days. Methods 166 patients with H. Pylori associated severe gastritis were randomly divided into pantoprozole quadruple regimens of 4-day group (n =61) ,5-day group (n = 54) or 7-day group (n = 51). The regimen was pantoprazole 40 mg,bismuth potassium citrate 220 mg,elarithromycin 250 mg and amoxicillin 1 g twice daily. The patients received pantoprazole for 1 week, bismuth potassium citrate for 2 weeks,clarithromycin and amoxicillin for 4 days,5 days or 7 days respectively. The H. Pylori eradication and symptomatic relief was determinded by 13C-UBT at least 4 weeks after the therapy. Results The H. Pylori eradication rates of 4-day,5-day or 7-day panteprazole quadruple regimens were 73.8% (45/61) ,75.9% (41/54) and 80.4% (41/51) respectively. The pain relief rates were 82.4% (42/51) ,85.1% (40/47) and 88.9% (40/45) in 4-day,5-day and 7 day group. Conclusion The 4-day and 5- day pantoprazoh based quadrual therapy is a short- term, effective, safe and lower therapeutic- cost regimen for H. Pylori eradication.

Objective To investigate the relationship between abnormalities of maternal serum markers in Down syndrome screening in second trimester and adverse pregnancy outcome.Methods Totally,1935 pregnant women were screened for Down syndrome with maternal serum tri marker with time-resolved fluorescence assay,including alpha fetoprotein (AFP),free β-human chorionic gonadotropin (β-hCG) and unconjugated estriol (uE3),between 15 and 20+6 gestational weeks at Peking Union Hospital from January 1,2009 to January 31,2011,and were followed up till delivery.The relationship between incidence of adverse pregnancy outcomes and women with normal or abnormal levels of serum markers in Down syndrome screening was investigated.T-test or Chi-square test were applied for statistical comparison.Results (1) Among the 1935 pregnant women,normal levels of serum markers were found in 1255(normal group) and 680 were abnormal(abnormal group),in which 577 with only one abnormal serum marker,89 with two and 14 with three abnormal serum markers.According to the serum marker level,the 577 women with one abnormal serum marker were further divided into five groups,including high AFP group (n=17),low AFP group (n=114),high β-hCG group (n=242),low β-hCG group (n=139) and low uE3 group (n=65).The birth weight of infants in lower AFP group and the gestational age at delivery in low β-hCG group were greater than those in normal group [(61.3±9.1) kg vs (59.5±8.3) kg,(272.6±11.8) d vs (274.4±10.1) d,t=2.21 and 1.99,both P＜0.01].(2) The incidence of adverse pregnancy outcome in normal group was 42.8％(537/1255),while comparing with the abnormal group(43.7％,297/680),no statistical significance was shown (RR =1.02,P =0.71).While comparing with the normal group,the incidences of placenta previa [25.5％ (32/1255) vs 2/17,RR=4.61,P＜0.05] and abnormal placental morphology were higher in high AFP group [4.1％ (51/1255) vs 5/17,RR=7.24,P＜ 0.05],the incidence of gestational diabetes mellitus (GDM) was higher in low AFP group [8.1％ (101/1255) vs 14.4％(16/114),RR=1.74,P＜0.05],the incidence of placenta and membrane retention was higher in high β-hCG group [3.5％ (44/1255) vs 6.2％(15/242),RR=1.77,P＜0.05],the incidence of pre-eclampsia was higher in low β-hCG group [1.7％ (21/1255) vs 6.5％ (9/ 139),RR=3.87,P＜0.05].(3) There were 89 women with two abnormal serum markers.Comparing with the normal group,the incidences of small for gestional age (SGA) infants,oligohydramnios,abruptio placenta were higher in women with low AFP but high β-hCG [SGA infants:6.9％(2/29) vs 1.8％(22/1255),RR=3.94; oligohydramnios:20.7％(6/29) vs 6.4％(80/ 1255),RR=3.24; both P＜0.05],the incidences of oligohydramnios was higher in women with both low AFP and low uE3[3/14 vs 6.4％(80/1255),RR=3.36,P＜0.05],the incidence of premature birth and GDM were higher in women with both low β-hCG and low uE3 [premature birth:2/6 vs 4.3％(54/1255),RR=7.75; GDM:3/6 vs 8.0％ (101/1255),RR=6.21; both P＜0.05].(4) There were 14 women with three abnormal serum markers.The relationship between adverse outcome and abnormal serum markers did not show any statistical significance.Conclusions The abnormality of serum markers of Down syndrome screening is closely related to adverse pregnancy outcomes,and women with abnormal serum markers should be carefully monitored during pregnancy.

Objective To investigate the the relationship of a high risk serum screen for Down syndrome in second trimester and adverse pregnancy outcomes,and to evaluate the predictive value for adverse pregnancy outcomes.Methods The tri-marker second trimester maternal serum screening for Down syndrome (alpha-fetoprotein,free beta-hCG and unconjugated estriol)was performed on the pregnant women at Peking Union Medical Hospital from January 2009 to January 2011.The cutoff valvue was 1/270.Pregnancy outcomes were followed up.The general condition and pregnancy complications of the pregnant women with high risk (high-risk group) were compared to that of the pregnant women with low risk (low-risk group); and with 35 years old as a demarcation,the incidences of adverse pregnancy outcomes were calculated in the two groups.Results ( 1 ) A total of 1935 cases were collected.And 1784 cases were with low risk,and 151 cases were with high risk.The difference of weight and gestational age betweem the two groups was not statistically significant ( P ＞ 0.05 ) ; the difference of age between the two groups was statistically significant ( P ＜ 0.01 ).(2) Pregnancy complications were found in 791 cases.In high-risk group,the incidences of gestational diaetes mellitus (GDM,13.9％),neonatal asphyxia (4.0％ ) and small for gestational age infant ( SGA,4.6％ ) were higher than that in low-risk group ( 8.4％,1.0％,1.6％ ),the difference was statistically significant ( P ＜ 0.05 ).The incidences of gestational hypertension disease,premature labor,oligohydrammios,placenta previa,placenta abruption,fetal macrosomia in the two groups was not statistically different (P ＞0.05).(3) In 1705 cases aged less than 35 years,129 cases (7.6％) were GDM,43 cases ( 2.5％ ) were gestational hypertension disease,61 cases ( 3.9％ ) were premature labor; in 230 cases aged 35 years or more,41 cases (17.8％ ) were GDM,12 cases (5.2％) were gestational hypertension disease,15 cases (6.5％ ) were premature labor,and the difference between the two groups was statistically significant ( P ＜ 0.05 ).In ＜ 35 years old group,the incidences of GDM,neonatal asphyxia and SGA (12.3％,4.4％,5.3％ ) were higher in the high-risk group than that (7.2％,0.9％,1.6％ ) in the low-risk group,and the difference was statistically significant ( P ＜ 0,05 ).In ≥35 years old group,the incidences of GDM,neonatal asphyxia and SGA ( 18.9％,2.7％,2.7％ ) were slightly higher in the high-risk group than that (17.6％,1.6％,1.6％ ) in the low-risk group,the difference between the two groups was not statistically significant (P ＞ 0.05 ).Conclusions The present study revealed apparertt increase in the adverse pregnancy outcomes in women with a high risk of Down syndrome screening test.Advanced age is the most important risk factor for a high risk of Down syndrome screening test and adverse pregnancy outcomes.More attention should be attached to the patients whose age were ＜35 years old and with a high risk of Down syndrome screening test.

Objective To evaluate the diagnostic accuracy of dual-energy subtraction chest digital radiography(DR) for detecting coronary artery calcification as compared with multi-detector row CT(MDCT).Methods 35 patients underwent dual-energy subtraction chest DR and ECG-gated MDCT for detection of coronary artery calcifications.The radiation dose of both DR and CT were noted respectively.Two senior and two junior radiologists reviewed the radiogram and assessed the calcifications in LAD,LCX and RCA totaling 105 vessels.ROC curve plotting were used for evaluation with CAC calculated from MDCT as the gold standard.Paired t test was calculated to compare the different radiation dose between DR and CT.Results 27.6% vessels(29/105) showed calcification on DR.The positive incidence in LAD was 48.5%(17/35),LCX 22.8%(8/35),and RCA 11.4%(4/35).The ROC area was 0.866,0.854,0.725,0.642 respectively,with a CAC score of more than 300.The average radiation dose was 0.469?0.22 mGy for DR,and 12.29?1.40 mGy for MDCT,showing significant differences.Conclusion Chest DR with dual energy subtraction can be used for screening of coronary artery calcification with relatively higher sensitivity for LAD.