Objective To investigate the roles of ubiquitin-conjugating enzyme(UBC9)in HSCs activa-tion and liver fibrosis. Methods Western blot was used to analyze the expression of UBC9 under the stimulus of different concentrations of TGF-β1. The effective shRNA-targeting UBC9 gene was synthesized and HCSs were in-stantaneously transfected using lipofectamine method. Non-specific shRNA-transfected group cells and shRNA-tar-geting UBC9-transfected group cells were set up. The mRNA and protein levels of UBC9 were determined with Quantitative Real-Time PCR and Western blot. Western blot also used to examine the expression level of collagenⅠ,α-SMA and P-smad3 after transfection of UBC9 shRNA into HCSs and CCK-8 assay was used to detect cell proliferative capacity after transfection. Results UBC9 expression was significantly up-regulated in TGF-β1-treat-ed HSCs. Knockdown of UBC9 significantly inhibited TGF-β1-induced HSCs proliferation,as well as decreased the expression levels of a-SMA and collagen I. Furthermore ,knockdown of UBC9 attenuated the phosphorylation of Smad3 in the presence of TGF-β1. Conclusions UBC9 may function as a novel regulator to modulate HSC activa-tion,potentially by inhibiting the TGF-β1/Smad3 signaling pathway,which reveals novel mechanistic insights into the anti-fibrotic effect of UBC9.

The degree of satisfaction of the curriculum is related not only to the degree of the curriculum but also to the degree of the students' development. With the concept of teaching reform micro system engineering, using the SIMPP analysis of the degree of satisfaction of the curriculum, the relevant factors of the students are studied. The results show that, the learning state, learning objec-tives, and the education level of mother affect the students more easily on the curriculum satisfaction. Research shows, in the present curriculum condition, educators should guide the students to study hard, establish a clear and reasonable learning goal, give the students the introduction and analysis of the curriculum, can effectively improve the students on the curriculum satisfaction, enhance the enthusiasm of the study.

Medical Higher Mathematics,an important fundamental course,is important to improve the students' ability of innovation.According to the characteristics of the students at medical school,and considering the content abstract and the problems difficult to learn and understand,a new teaching model which can focus on absorbing some contents of Pharmacokinetics into Medical Higher Mathematics is dis cussed.At the same time the article discusses how to combine the both courses in three aspects:professional features,the background of the student's knowledge,and teaching method.

Objective To discuss the safety and curative effect of superior rectal artery chemoembolization in treating rectal cancer complicated by hepatic metastasis.Methods A total of 17 patients with rectal cancer complicated by hepatic metastases were treated with hepatic arterial chemoembolization together with subsequent superior rectal artery chemoembolization.Super-selective catheterization of superior rectal artery with a 3-F microcatheter was performed first,which was followed by perfusion of 5-Fu and oxaliplatin through the microcatheter,and then irinotecan and Lipiodol emulsion was injected.Results Technical success was obtained in all 17 patients.In 2-7 days after the treatment,the amount of faeces containing mucus,blood and pus was significantly increased,besides,obvious necrotic tissues could be observed in the faeces in some patients.Among the 3 patients who had complained of abdominal pain,the pain disappeared in 3 days (n=2) or in 5 days (n=1) after the treatment.One week after the treatment,anal pain disappeared in 5 patients and was remarkably improved in 2 patients;tenesmus feeling was significantly relieved in 7 patients although the improvement of tenesmus feeling was not obvious in other 4 patients.During the long period following-up,no intestinal perforation or local infection was observed.Conclusion For the treatment of rectal cancer associated with hepatic metastasis,superior rectal artery chemoembolization is safe and effective.It can quickly cause rectal tumor necrosis,which is an important therapeutic response in treating rectal cancer with comprehensive therapy.

Objective:To explore the clinical effect of multidisciplinary cooperative intervention in improving self-management and improving fluid retention in the elderly patients with chronic heart failure.Methods:Totally 130 cases of the elderly patients with chronic heart failure from January to December 2018 were enrolled and were divided into control group and observation group with 65 cases randomly. The control group received routine nursing instruction and telephone follow-up. The observation group was given multidisciplinary team guidance to patients self-management in addition to routine nursing instruction and telephone follow-up. After 3 months, the self-management and fluid retention of the two groups were compared.Results:After 3 months of intervention, the scores and total scores of the observation group in the four dimensions of drug management, diet management, psychological and social adaptation management, symptom management were 19.43±0.71,11.51±0.59,19.07±0.65,25.24±1.31, 72.65±7.16, the control group was 11.09±3.40, 6.05±1.71, 12.73±2.49, 15.72±4.18, 46.35±7.83. The scores and total scores of the observation group were better than those of the control group ( t value was 4.835-13.727, all P < 0.05).After intervention for 3 months, the proportion of severe edema, moderate edema and mild edema in the observation group was 4.61% (3/65), 13.85% (9/65), 81.54% (53/65), respectively, and the control group was 38.46% (25/65), 52.31% (34/65) and 9.23% (6/65) respectively. The degree of fluid retention in the observation group was better than that in the control group ( Z value was -2.373, all P < 0.05). Conclusion:Multidisciplinary cooperative intervention can improve self-management and improve fluid retention in elderly patients with chronic heart failure.