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.

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

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 compare the clinical value of Heidelberg retinal tomography (HRT-Ⅱ) and Heidelberg optical coherence tomography (HRA OCT) in discriminating healthy eyes and pre-perimetric glaucoma eyes.Methods A total of 33 patients with pre-perimetric glaucoma and 37 healthy subjects were included in this study.All individuals underwent imaging tests with HRT-Ⅱ and HRA OCT within 1-month period.ANOVA and Kruskal-Wallis test were used to compare all of the parameters from HRT-Ⅱ and HRA-OCT between pre-perimetric glaucoma eyes and normal eyes.Receiver operating characteristic curves (ROC) were calculated for all of the parameters to seek the best discriminant point of each instrument between pre-perinmetric glaucoma and healthy eyes.Results Statistically significant differences were found in most of the HRT-Ⅱ parameters except for disc area and height variation contour between pre-perimetric glaucomatous eyes and normal eyes (all P＜0.05),which showed that most of the HRT-Ⅱ parameters were capable of diagnosing preperimetic glaucoma except for the disc area and height variation contour (all P＜0.05).66.7％ of the areas under the receiver operating characteristic curves (AUC) from HRT-Ⅱ parameters were larger than 0.800 and 58.3％ of the AUC were larger than 0.900.Statistically significant differences were found in most of the HRA-OCT parameters except for the nasal retinal nerve fiber layer (RNFL)thickness between pre-perimetric glaucoma eyes and normal eyes (all P＜0.05),which showed that most of the HRA-OCT parameters were capable of diagnosing pre-perimetic glaucoma except for the nasal RNFL thickness (all P＜0.05).66.7％ of the AUC from HRA-OCT parameters were larger than 0.800 and 33.3 ％ of the AUC were larger than 0.900.No statistically significant difference was found between the AUC for the best parameter diagnosing pre-perimetic glaucoma from HRT Ⅱ (cup/disk area ratio,AUC =0.984) and HRA OCT (average RNFL thickness,AUC =0.940).No Statistically significant differences were found in specificity and sensitivity of diagnosing pre-perimetic glaucoma between the two best parameters cup/disk area ratio and average RNFL thickness (both P＞0.05).Conclusions Both HRT-Ⅱ and HRA-OCT can well reflect the damage of optic disc and retinal nerve fiber layer in eyes with pre-perimetric glaucoma.HRT-Ⅱ and HRA-OCT have higher accuracy and similar sensitivity and specificity for the diagnosis of pre-perimetric glaucoma.

Objective To observe the clinical efficacy of Ningmitai capsule combined with Tolterodine in the treatment of overactiver bladder after transurethral resection of the prostate(TURP).Methods 63 TURP patients with bladder disease (OAB) in our hospital from October 2012 to October 2012 were selected and randomly divided into a treatment group (n=32) and a control group (n=31). From the date of operation, the control group was treated with tolterodine 2 mg, 2 times a day, while the treatment group was additional treated with Ningmitai capsule 4mg, 3 times a day based on the control group. All patients stopped to take medicine 5 days after catheter removal. The pain frequency and duration of bladder spasm after TURP in catheterization period and the urine volume per time, the number of urgent incontinence, and the number of urgent micturition average day in automatic micturition period were scored by OABSS.Results The number of bladder spasm in the first postoperative day(3.5 ± 0.5vs.4.4 ± 0.8,t=2.650), the second day(1.5 ± 0.9vs.1.8 ± 0.2,t=2.350) and the third day (0.4 ± 1.6vs. 1.1 ± 1.8,t=2.210) of the treatment group were all less than the control group (P>0.05). The 24 h average frequency of urination after catheter removal (6.2 ± 1.3vs. 9.4 ± 1.8,t=2.710), the average number of nocturia (1.5 ± 0.4vs. 3.9 ± 1.0,t=2.580), the average number of 24h urinary urgency (1.1 ± 0.3vs. 3.2 ± 0.8,t=2.660), the average number of incontinence in 24 h (0.5 ± 0.2vs. 2.4 ± 0.6,t=2.700) and OABSS total score  (4.6 ± 1.2vs. 6.9 ± 2.1,t=2.470) of the treatment group were all better than the control group (P<0.05). Conclusion Ningmitai capsule combined with tolterodine in the treatment of overactiver bladder after TURP has significant clinical effect, helping patients recovery and improving quality of life.

Hepatitis B-related acute-on-chronic liver failure (ACLF) is a severe clinical syndrome characterized by jaundice, coagulopathy, ascites and hepatic encephalopathy and with a high mortality rate of 65% to 93%. It involves significant ethical issues when a randomized, double-blinded, placebo-controlled clinical study is conducted to such a serious disease. Therefore, a prospective cohort study design was utilized to explore a new treatment modality of applying integrated traditional Chinese and Western medicine.

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 study the effect of extract of cockroach on animals with acute hepatic injury and its antiviral action in vitro. Methods The animal models with hepar injury were established by CCl4, bcg vaccine and lipopolysaccharide (LPS) . And the activities of ALT and AST in serum were measured. Serum of ducks was separated after cockroach extract was administrated. The serum was added to the culture fluid of HBV-DNA transfected hepatic cancer cells-HepG2. Results After the cockroach extract was administrated, the activities of ALT and AST in mouse serum were reduced. Both the therapeutic indexes of cockroach extract and lamivudine were larger than 2. Conclusions Cockroach extract can improve the liver function of animals with acute hepatic injury, and inhibit the secretion of ALT and AST in serum.