NEDD8 is a member of the ubiquitin-like proteins. The overall structure of NEDD8 is quite similar to ubiquitin. Covalent conjugation of NEDD8 to proteins at the post-translational level is called Neddylation. Neddylation occurs similarly to ubiquitination and need enzyme cascades involving E1, E2 and E3. Neddylation has been demonstrated to be essential to maintain the ubiquitin ligase activity of Cullin-Roc based E3 ligases. Compared with the ubiquitination which was widely studied in the past two decades, few substrates were identified for Neddylation and the physiological functions of Neddylation need further investigations. The current progress of function and regulation of protein Neddylation will be reviewed.

[Objective]To investigate whether syrinx should by treated before correction in patients with scoliosis complicated by syringomyelia without neurologic impairment. [Method]Thirty-five cases were divided into experimental group(group A,without preoperative surgical intervention to syrinx,15 cases)and control group(group B,with preoperative surgical intervention,20 cases) randomly. The coronal plane Cobb's angle,the length of syrinx,the position of syrinx,the biggest diameter of syrinx and S/C ratio were measured and compared between 2 groups.[Result]There was no significant difference in the correction rate and loss rate between two groups.The postoperative syrinx index(biggest diameter of syrinx,syrinx length and S/C ratio) was significantly smaller than that of preoperation(P

Objective To investigate the mechanism of Smad ubiquitination-related factor 2 (Smurf2)neddylation. Methods The Smurf2 protein level was tested by overexpression of Nedd8,while the method of immunoprecipitation(IP) and Western blotting were used to analyz Smurf2-Nedd8 modification.The GST-pulldown experiment was conducted to prove protein interactions.The protein was obtained by grinding mouse tissue and Western blotting was used to test the protein expression level.Results Over expression of Nedd8 could lead to the down regulation of the Smurf2′s protein level.Smurf1 and Smurf2 could interact in the GST-pulldown experiment. Smurf1 could enhance Smurf2-Nedd8 modification.The Smurf2′s protein level was up-regulated in mouse tissue of Smurf1 C426A.Conclusion There is some relationship and also difference between Smurf1 and Smurf2.Smurf1 can enhance Smurf2-Nedd8 modification.

Objective To evaluate the feasibility,safety and efficacy of percutaneous transluminal stenting angioplasty for severe complicated stenosis of vertebrobasilar system. Methods From November 2003 to February 2006,5 candidates underwent percutaneous transluminal stenting for severe complicated stenosis of vertebrobasilar system. Results Four out of 5 candidates,had occlusion of unilateral vertebral artery (VA),1 had severe bilateral proximal segmental stenosis of VA. There were 4 with severe proximal segmental stenosis of the VA associated with multiple segmental stenosis of intracranial VA and basilar artery (BA),and 1 with multiple segmental severe stenosis of intracranial VA and BA. Stenosis rate ranges from 80% ～95% with involved length from 10-20 mm. Technical success was achieved in all of the patient (100%),and residual stenosis rate was less than 20%. All the symptoms due to vertebrobasilar blood supply insufficiency disappeared. Follow-up with DSA 6-12 months later demonstrated no restenosis; showing satisfactory short term efficacy. Conclusions Percutaneous transluminal stenting for vertebrobasilar blood supply insufficiency is a safe and efficacious option with favorable short term outcome,especially with furthermore prevention of stroke.

Apoptosis action is primarily exerted at the level of mitochondira, in which Bcl-2 family of proteins play an important role in its regulation. Bcl-2 family consists of anti-apoptotic and pro-apoptotic members. The anti-apoptotic members usually exist in the outer mitochondrial membrane and inhibit cell death via interaction with pro-apoptotic counterparts BH3 domain. Pro-apoptotic members are commonly localize in the cytoplasm. A series of events occured, such as typical Bax conformational change, BAD and Bik phosphorylation as well as Bid and Bim proteolysis in response to several death stimuli. As a result, these pro-apoptotic proteins directly integrate to the outer mitochondrial membranes. Finally, mitochondrial permeability transition pore is opened, by followed the release of apoptogenic factors from the mitochondrial intermembrane space, including cytochrome c, apoptosis inducing factor(AIF) and Smac, then the activation of downstream caspases and execution of cell death.

Objective To explore the relationship between Nestin expression level and prognosis in osteosarcoma,and to provide a new idea for treatment.Methods Thirty patient with osteosarcoma who had received treatment were included this study according to the criteria.HE staining was applied to evaluate the response to chemotherapy,meanwhile immunohistochemistry was applied to evaluate Nestin expression levels before and after chemotherapy.Kaplan Meier survival curve was drawn to analyze the outcomes.Results The response of chemotherapy was good in 17 patients and poor in 13.24 cases were strongly positive in Nestin staining,five were weakly positive,and one was negative.The expression level of Nestin in osteosarcona was correlated to the chemotherapy response and prognosis (P ＜ 0.05),while higher level of Nestin expression referred to poorer response of chemotherapy and lower overall survival rate.Conclusions The expression level of Nestin in osteosarcoma tissue is associated with the effect of chemotherapy and prognosis;higher expression level of Nestin indicates poorer prognosis and efficacy of chemotherapy.

Objective To investigate the effect of posterior operation for thoracolumbar burst fractures combined with dislocation. Methods The study involved 22 patients with thoracolumbar burst fractures combined with dislocation admitted into our hospital from October 2005 to March 2008. There were 17 males and 5 females at age range of 18-56 years. The fractures were located at T12-L2. The fractured vertebrae lost its height by 1/4 to 3/4 of the normal height. The upper vertebral dislocation ex-tent was from 25% to 50%. All operations were accomplished within two weeks after injury. The patients were randomly divided into two groups, ie, Group Ⅰ (implanted with 4 pedicle screws in upper and lower vertebrae adjacent to the fractured vertebrae) and Group Ⅱ (implanted with 6 pedicle screws in 2 upper and 1 lower vertebrae adjacent to the fractured vertebrae). The operation time, volume of blood loss, ky-photic angle, neurological function and Low Back Outcome Score (LBOS) were compared between two groups. Results All patients were followed up for 12-36 months. The duration of operation in Group Ⅱ was longer than Group Ⅰ (P < 0.05), with no increase of intraoperative blood loss. Group ⅡI was su-perior to Group Ⅰ in aspects of correction rate, correction loss and implant failure rate (P < 0.05). There was no statistical difference in aspects of neurological function recovery and low back outcome score be-tween two groups. Conclusion Fixation with three vertebrae and six pedicle screws through posterior approach is an effective, feasible and safe procedure for treatment of thoracolumbar burst fractures com-bined with dislocation.

Calculous cholecystitis is a common disease in clinical practice. There are various therapies for this disease, mainly cholecystectomy, and laparoscopic cholecystectomy has always been considered the gold standard for the treatment of calculous cholecystitis. However, medication, percutaneous transhepatic gallbladder drainage, and gallbladder-preserving cholecystolithotomy can be selected based on patient age, conditions, comorbidities, and preference. This article briefly describes the features of medication, interventional treatment, and surgical treatment in patients with calculous cholecystitis and points out that the optimal treatment regimen should be selected based on the features of calculous cholecystitis in each patient. This article also proposes the individualized treatment mode for calculous cholecystitis.

HBV infection is highly prevalent in China, and patients with a high HBV-DNA load for a long time may progress to liver cirrhosis, which may lead to liver cancer. At present, surgery is still the main method for the treatment of hepatitis B-related liver cancer. Many studies have shown that HBV DNA load is an important influencing factor for the recovery of liver function after surgery, postoperative complications, recurrence of liver cancer, and the success of liver transplantation in patients with hepatitis B-related liver cancer. Its mechanism may be associated with high HBV DNA load and HBV reactivation. Maintaining a low HBV DNA load by antiviral therapy can improve the prognosis of patients with hepatitis B-related liver cancer. This article reviews the influence of HBV DNA load before and after surgery on the surgical outcome of hepatitis B-related liver cancer, in order to provide a reference for research on the treatment of patients with liver cancer.

Objective To clarify the effects of HBV co-infection on liver function of patients with different types of hepatic echinococcosis.Methods We recruited 409 patients diagnosed with hepatic echinococcosis at three hospitals in western regions in China from 2014 to 2015.Venous blood was withdrawn to detect to liver function indications.ELISA was performed to detect HBsAg.We analyzed liver function in patients stratified by different types of hepatic echinococcosis with or without HBV infection.Results The hepatic echinococcosis patients infected with HBV had more severe impairment in liver functions such as reduced albumin and increased transaminase.The patients with hepatic alveolar echinococcosis were more vulnerable to HBV infection compared with those with hepatic cystic echinococcosis (38.4％ vs.86.4％, P<0.05).In addition, liver injury was more severe in patients diagnosed with alveolar hepatic echinococcosis and HBV infection compared with those diagnosed with cystic hepatic echinococcosis and HBV infection (all P<0.05).Conclusion Hepatic alveolar echinococcosis patients co-infected with HBV have worse liver injury compared with those hepatic cystic with HBV. Therefore, they deserve special attention in clinical treatment.