BACKGROUND:Matrix extracel ular phosphoglycoprotein phosphorylated extracel ular matrix glycoprotein (MEPE) gene plays an important role in bone mineralization and absorption as wel as the balance of osteoblasts and osteoclasts. Studies on the function and regulatory mechanism of MEPE can provide new ideas for the treatment of osteoporosis. OBJECTIVE:To analyze the regulatory effects of transcription factor Runx2 on MEPE promoter in mouse preosteoblasts, thereby preliminarily studying the Runx2 effects in the process of bone formation and development. METHODS:First of al , the Runx2 eukaryotic expression vector was built according to the gene sequence of Runx2 in Genebank;then the dual luciferase reporter assay was employed to analyze the effects of Runx2 on transcription activity of MEPE promoters with different lengths in order to determine the promoter region in which Runx2 has significant effect. Afterwards, the effects of Runx2 on transcipition activity of MEPE gene promoter which induced by three MAPK signaling pathway inhibitors were investigated. Final y, real-time PCR was used to analyze the expression activity of MEPE gene promoter regulated by Runx2. RESULTS AND CONCLUSION:We successful y constructed the Runx2 eukaryotic expression vector. Dual luciferase reporter assay showed that Runx2 could increase the transcription activity of MEPE gene promoter in preosteoblasts, and the fragment area in which Runx2 exhibited the more significant up-regulatory effectiveness was (-300 to+66)366 bp. Runx2 could increase the transcription activity of MEPE gene promoter by activating the MAPK single pathway. The real-time PCR verified that Runx2 increased the expression activity of MEPE gene promoter. These findings indicate that Runx2 can regulate the express of MEPE gene promoter by the MAPK single pathway, in order to build the basis for exploring the process of bone formation and development.

Objective To investigate the changes of serum homocysteine (Hcy) level before and after treatment in patients with colorectal cancer,and provide the reference for clinical therapeutic efficacy and prognosis.Methods Enzymatic circling assay was used to measure the serum Hcy levels in 50 controls and 58 patients with colorectal cancer before and after treatment with a.follow-up of 12 months.The changes of Hcy aud the relationship between Hcy and therapeutic efficacy or prognosis were analyzed.Results Scrum Hcy level in patients with colorectal cancer was significantly higher than that in controls [(16.90±5.35) μmol/L vs (10.23±3.06) μmol/L] (P ＜ 0.01),and it was closely associated with TNM stage.Serum Hcy level in patients of stage Ⅲ-Ⅳ was significantly higher than that of stage Ⅰ-Ⅱ [(18.49±5.13) μmol/L vs (15.20±4.86) μmol/L] (P ＜ 0.05).The Hcy level in patients at the end of treatment was significantly lower than that before treatment [(13.39±4.98) μmol/L vs (16.90±5.35) μmol/L] (P ＜ 0.01),and the Hcy level after the treatment for 3 month was significantly lower than that at the end of treatment [(10.23±3.17) μmol/L] (P ＜ 0.05).The Hcy level in patients with recurrence during 12 months after operation was significantly higher than that without recurrence [(17.18±4.82) μmol/L vs (12.36±3.19) μmol/L] (P ＜ 0.01).Conclusion Serum level of Hcy might be a useful marker for predicting therapeutic efficacy and prognosis in patients with colorectal cancer.

Objective To investigate the influence of hedysaryum polysaccharide (HPS)in the kidney function and expressions of Glut-1 mRNA and protein in kidney tissue of db/db mice with diabetic nephropathy (DN)and to elucidate its possible action mechanism.Methods 10 db/m mice were taken as normal control group(n=10);50 fueling animal model db/db mice with DN were randomly divided into model group,enalapril group and the low, middle and high doses of HPS groups(n=10).The mice in noral control group and model group were given physioloical saline by gavege;and the mice in the other groups were respectively given 10 mg·kg-1 ·d-1 enalapril, 100,200 and 400 mg·kg-1 ·d-1 HPS by gavage;lasted 8 weeks.Picric acid method was used to determine the serum creatinine(SCr)level of the mice,enzyme coupling rate method was used to determine the blood urea nitrogen (BUN)level,ELISA method was used to determine the urinary microalbumin(UMALB)level,RT-PCR method was performed to detect the expression of Glut-1 mRNA, and Western blotting and immunohistochemical methods were used to detect the expression of Glut-1 protein.Results Compared with model group,the levels of SCr, BUN, UMALB, the mRNA and protein of Glut-1 expressions were decreased, especially in 400 mg·kg-1 ·d-1 HPS and enalapril groups(P<0.01).The HE and Masson staining results showed that less inflammatory cells infiltration in glomerular of the mice were found, capillary lumens were unobstructed, and the collagen deposition was not obvious in 400 mg·kg-1 ·d-1 group.Conclusion HPS could improve the kidney function of the db/db mice and inhibit the Glut-1 mRNA and protein expressions obviously, which indicates that HPS could delay the development of DN by inhibiting the Glut-1 expression in the glomerular mesangial cell membrane.

Objective To analyse the influencing factors of quality of life (QOL)among postoperative children with congenital anorectal malformation (ARM), so as to provide evidence for developing comprehensive interventions and improve QOL of children with ARM.Methods The QOL of 100 children aged at 2 and 5 years old were evaluated by using the Chinese version of PedsQLTM4.0 scale, and the total and 4 dimensions scores of QOL were calculated.Univariate and multiple stepwise regression model was applied to analyse the influencing factors of the QOL.Results The results of univariate analysis among ARM children aged at 2 years old showed that the clinical classification, bowel disorders and family residence have different influence on QOL scores of the 4 dimensions and total scale (P ＜ 0.05).The results of univariate analysis among ARM children aged at 5 years old showed that the clinical classification, bowel disorders and maternal education had different influence on QOL scores of the 4 dimensions and total scale (P ＜ 0.05).The results of multiple stepwise regression model among ARM children aged at 2 years old showed that the major influence factor of QOL scores in physical function was family residence and bowel disorders(P ＜ 0.05), the major influence factor of QOL scores in social functioning was bowel disorders(P ＜ 0.05), the major influence factor of the total scores was bowel disorders and family residence(P ＜0.05).The results of multiple stepwise regression model among ARM children aged at 5 years old showed that the major influence factor of QOL scores in physical function was maternal occupation and clinical classification(P ＜ 0.05), the major influence factor of QOL scores in emotional functioning was bowel disorders(P ＜ 0.05) ,the major influence factor of QOL scores in social functioning was clinical classification and bowel disorders (P ＜ 0.05), the major influence factor of QOL scores in school performance was maternal occupation(P ＜ 0.05), the major influence factor of total scores was bowel disorders and clinical classification(P ＜ 0.05).Conclusion Family residence and bowel disorders have effct on QOL of ARM children aged at 2 years old.Maternal occupation, clinical classification and bowel disorders have effct on QOL of ARM children aged at 5 years old.We should take positive interventions on these influencing factors to improve QOL of children with ARM.

Objective To establish a method for the determination of nigeglanoside in seeds of Nigella glandulifera. Methods The content of nigeglanoside was determined by HPLC.The separation was performed on a C18column ( YMC-Pack ODS-A,250 mm×4.6 mm,5 μm) with a gradient elution system of acetonitrile and 0.017 5 mol·L-1acetic acid solution at the flow rate of 1.0 mL·min-1.The detection wavelength was set at 290 nm,and column temperature was 30 ℃. Results The linear range of nigeglanoside was 0.01-0.30 mg·mL-1(R2＝0.9991).The RSDs of precision,stability and repeatability were all less than 2%.The average recovery was 96.66% (RSD＝1.25%,n＝6). Conclusion The method is accurate and reproducible. It is effective in controlling the quality of seeds of Nigella glandulifera .

Objective To evaluate the effect of sexual health education for female nursing students. Methods Totals of 112 female nursing students were randomly selected from grade 2012.Their sexual knowledge was evaluated, and then were divided into three groups-high, medium and low, according to their sexual knowledge.The score of sexual health education was compared among groups.Results After the health education, the total score of sexual knowledge was (75.01 ±6.84), and the score of self-care, sexual transmitted disease, gynecological disease were (26.20 ±3.57), (18.15 ±3.45) and (30.66 ±4.50), which were significantly higher than (62.73 ±8.20), (20.25 ±3.75), (16.13 ±6.27) and (26.19 ±4.97) before the education, and the differences were significant (t=12.48, 12.09, 3.15, 7.80, respectively;P<0.05). The improvement of low score group was more significant compared with the medium and high score group, and the improvement of high score group was lower than medium and low score group, and there was a significant difference (F=38.38,P<0.05).There was no significant difference among different sexual education methods (F=0.35,P >0.05).Conclusions Sexual health education is an important way to enhance the sexual knowledge of female nursing students and it is necessary to develop various sexual health education methods in colleges and universities.

Objective:To select and obtain relevant evidence of chemotherapy-related constipation for cancer patients at home and abroad and summarize the best evidence.Methods:Chemotherapy-related constipation guidelines, systematic reviews, best practice information booklet, evidence summary and expert consensus for cancer patients were searched on British Medical Journal (BMJ) , National Guideline Clearinghouse (NGC) , National Institute for Health and Care Excellence (NICE) , Australia Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, Cochrane Library, Evidence-Based Medicine Guidelines, National Comprehensive Cancer Network, Scottish Intercollegiate Guidelines Network, China Biology Medicine disc, PubMed, CNKI and Wanfang Database by using the computers. The search period was from the construction of the database to May 17, 2019. Two to four researchers independently evaluated the quality of the literatures and extracted the documents that met the standards in combination with the judgment of professionals. The GRADE system was used to classify the quality level of evidence and the strength of recommendations.Results:A total of 6 literatures were included, including 3 guidelines, 2 systematic reviews and 1 summary of evidence. A total of 25 pieces of evidence were summarized from the 4 aspects of evaluation, prevention, management and medication of chemotherapy-related constipation.Conclusions:This study summarizes the best evidence for chemotherapy-related constipation in cancer patients and provides evidence-based evidence for the evaluation, prevention, management and medication of cancer patients with chemotherapy.

Objective To explore the value of OSCE system combined with intelligent network in-formation platform in clinical skills assessment of obstetrics and gynecology. Methods 112 clinical medi-cal students who participated in the practice of gynecology and obstetrics in Second Military Medical Uni-versity in 2017 were randomly divided into the experimental group (network information OSCE) and the control group (traditional OSCE). The teaching results were evaluated by the questionnaire survey of teachers and students and the examination results as well. The statistical analysis was made with the Chi-square test and the t test respectively. Results According to the questionnaire survey of two skills assessment methods, the satisfaction index of the experimental group was higher than that of the control group in both teachers and students, and the difference was statistically significant (P<0.05). The total time of examination in the experimental group was lower than that of the control group, and the difference was statistically significant (P<0.05). The final total score and the results of case analysis and clinical operation examination of experi-mental group were all higher than those of the control group, but there was no statistical difference (P>0.05). Conclusion OSCE combined with the network information system has an unparalleled advantage in the assessment of the obstetrics and gynecology department. The system will promote clinical education of ob-stetrics and gynecology and the evaluation of the clinical ability of the medical students to a new height, which deserves popularization.

Objective:To search, evaluate and summarize the evidence on prediabetes management in high-risk population with gestational diabetes mellitus (GDM).Methods:Two researchers independently screened the evidence according to the inclusion criteria and exclusion criteria. The quality of the included evidence was evaluated by the clinical guideline research and evaluation system (AGREE Ⅱ). The quality of the evidence and the strength of recommendation were graded by the GRADE system. According to the clinical nursing practice guidelines for gestational diabetes mellitus, the recommendations for GDM high-risk groups were extracted.Results:A total of 14 pieces of evidence were included, including 4 guidelines, 2 consensus, 5 practice guidelines and 3 diagnosis and treatment standards. 29 pieces of recommendations for prediabetes management of high-risk population with gestational diabetes mellitus were summarized from five aspects, including disease risk assessment, prenatal examination guidance, management objectives of gestational weight and blood glucose, diet guidance and exercise guidance.Conclusion:The evidence of prediabetes management of high-risk population with gestational diabetes mellitus is scientific and reliable.

Objective:To construct endocrinology nursing subspecialty model and explore its clinical effect.Methods:In December 2018, the organization structure of endocrinology nursing subspecialty was constructed in the Drum Tower Hospital Affiliated of Nanjing University Medical School and applied in clinic. In this model, the data of 2018 were taken as the data before application and the data of 2020 were taken as the data after application. The comprehensive ability of nurses, nurse satisfaction, related nursing workload and scientific research ability of nurses were compared before and after the application of the model.Results:After the application of subspecialty nursing mode, nurses′ comprehensive ability score was (92.00 ± 2.36) points. Compared with (84.25 ± 3.24) points before implementation, the difference was statistically significant ( t=-9.46, P<0.01); nurses′ satisfaction evaluations including specialty development (7.92 ± 1.41), self-quality improvement (8.00 ± 1.69), work pressure (6.42 ± 2.67), salary and welfare (3.96 ± 0.85), compared with (5.79 ± 2.31), (6.17 ± 2.82), (8.33 ± 1.50), (2.88 ± 1.59) before implementation, the difference was statistically significant ( t values were -3.86--2.73, all P<0.05). The annual workload of related nursing increased and the scientific research ability of nurses was improved. Conclusions:The application of endocrinology nursing subspecialty mode is beneficial to improve nurses′ comprehensive ability of clinical work, improve the level of specialized nursing, improve the quality of nursing service and promote the improvement of economic benefits, which is worthy of clinical promotion.