miR-194通过调控相关靶向蛋白影响肝癌细胞的增殖和侵袭行为

目的:探讨miR-194通过调控相关靶向蛋白影响肝癌细胞的增殖和侵袭行为及其机制。方法:qPCR检测miR-194在肝癌组织和不同肝癌细胞株中的表达情况;Western blotting检测miR-194对钙粘蛋白表达水平的影响;划痕愈合实验和Transwell侵袭实验检测miR-194的表达对肝癌细胞的迁移和侵袭能力的影响;抑制miR-194的表达可以干扰肝癌细胞的生长发展进程。结果:与癌旁正常组织相比,miR-194在肝癌组织中的表达上调,miR-194在HepG2细胞株中表达水平相对较高;miR-194可直接调控相关钙粘蛋白的表达情况,抑制miR-194的表达后可以一定程度上抑制肝癌细胞的迁移和侵袭能力。结论:miR-194可以调控靶向蛋白的表达,影响肝癌细胞的迁移和侵袭行为。     

miR-202通过降低肝癌细胞ROCK1表达抑制其迁移和侵袭

目的：研究微小RNA-202（miR-202）对肝癌细胞迁移和侵袭能力的影响,并探讨其可能的分子机制。方法：通过实时定量PCR检测Hep3B、Huh7及HCCLM3人肝癌细胞和LO2人正常肝细胞中miR-202的表达水平。以miR-202表达水平最低的HCCLM3细胞为转染对象,转染miR-202模拟物或空白对照miRNA,以miR-202表达水平最高的Hep3B细胞为转染对象,转染miR-202抑制物或阴性对照miRNA,并利用实时定量PCR验证转染效率。采用Transwell迁移和侵袭实验检测过表达和敲低miR-202对肝癌细胞迁移和侵袭能力的影响。生物信息学网站检索并应用荧光素酶报告基因实验验证miR-202的靶基因。实时定量PCR和Western blot检测miR-202靶基因的表达水平。结果：与正常肝细胞LO2相比,miR-202在肝癌细胞的表达水平显著降低;HCCLM3细胞转染miR-202模拟物后,细胞miR-202的表达水平显著增加;过表达miR-202后,HCCLM3细胞的迁移和侵袭能力显著降低;Hep3B细胞转染miR-202抑制物后,细胞miR-202的表达水平显著降低;敲低miR-202后,Hep3B细胞的迁移和侵袭能力显著增强;生物信息学检索及荧光素酶报告基因证明ROCK1基因为miR-202的靶基因。过表达miR-202可明显降低肝癌细胞中ROCK1基因的表达,而敲低miR-202可明显增加肝癌细胞中ROCK1基因的表达。结论：miR-202在肝癌细胞中低表达,miR-202通过抑制ROCK1的表达抑制肝癌细胞的迁移和侵袭。     

银椴苷通过调控 miR-218/NEDD9轴影响肝癌细胞 增殖、迁移、侵袭和凋亡

摘要:目的 探讨银椴苷对肝癌细胞生物学行为的影响和分子机制。方法 采用不同浓度(0.1、0.2、0.4、0.8、1.6 mmol/L)的银椴苷分别处理肝癌细胞 Huh748h,通过四甲基偶氮唑蓝(MTT)法、流式细胞术、Transwell实验检测细胞 活力、凋亡率以及迁移、侵袭能力。实时荧光定量 PCR(qRT-PCR)检测 miR-218和神经元细胞表达发育下调基因 9 (NEDD9)mRNA 的表达水平,蛋白质印迹(Westernblot)检测 NEDD9 蛋白表达水平。双荧光素酶报告基因实验和 Westernblot验证 miR-218和 NEDD9的靶向调控关系。将 miR-218抑制物(anti-miR-218)转染 Huh7细胞,检测干扰 miR-218表达联合银椴苷处理对 Huh7细胞活力、凋亡、迁移和侵袭的影响。结果 与空白组比较,银椴苷处理组 Huh7 细胞活力、迁移和侵袭数、NEDD9mRNA 和蛋白表达显著降低,凋亡率、miR-218表达显著升高(均 P<0.05)。miR-218 可与 NEDD9直接结合。过表达 miR-218后 NEDD9表达水平降低(均 P<0.05),干扰 miR-218后 NEDD9表达水平升 高(均P<0.05)。干扰 miR-218表达可逆转银椴苷对 Huh7细胞增殖、迁移侵袭、凋亡的影响(均 P<0.05)。结论 银 椴苷可诱导肝癌细胞凋亡,抑制其增殖、迁移和侵袭,其机制可能是通过上调 miR-218/NEDD9轴实现的。     

miRNA-34a靶向Bcl-2对肝癌细胞HepG2的生长和迁移能力的影响

通过过表达miRNA-34a检测Bcl-2的表达及对肝癌细胞的生长和迁移能力的影响，为肝癌的治疗提供新靶点。方法 通过生物信息学方法预测miRNA-34a的潜在作用靶点；采用双荧光素酶报告实验检测miRNA-34a与Bcl-2的靶向调控关系；体外培养肝癌细胞，将肝癌细胞分为对照组（转染miRNA-34a阴性对照物mimic NC）及miRNA-34a转染组（转染miRNA-34a模拟物）。分别转染miR-34a模拟物和阴性对照，转染36 h后，CCK8检测细胞增殖，Trans-well检测细胞迁移能力，q-PCR和Western blot方法检测miRNA-34a对肝癌细胞中Bcl-2表达量的影响。结果 miRNA-34a对肝癌HepG2细胞的活力和迁移能力具有抑制作用（P＜0.01）；miRNA-34a可以直接靶向下调Bcl-2（P＜0.01）的表达。结论 miRNA-34a可靶向并负向调控Bcl-2,降低肝癌细胞HepG2的活力和迁移能力。     

miR-320靶向调控FoxM1对结肠癌SW480细胞增殖、侵袭的影响

目的分析miR-320对结肠癌SW480细胞增殖、侵袭的影响及其作用机制。方法将SW480细胞分为SW480组、mimic对照组、miR-320 mimic-/FoxM1 wt+/FoxM1 mut-组、miR-320 mimic+/FoxM1 wt+/FoxM1 mut-组、miR-320 mimic-/FoxM1 wt-/FoxM1 mut+组、miR-320 mimic+/FoxM1 wt-/FoxM1 mut+组、miR-320 mimic组、pcFoxM1组、miR-320 mimic+pc-FoxM1组;检测各组细胞内凋亡、增殖、侵袭等相关指标。结果 miR-320 mimic细胞表达miR-320量显著升高(P0.05),FoxM1表达量显著降低(P0.05),荧光素酶报告实验结果显示,与FoxM1 wt组比较,FoxM1 wt+miR-320组荧光素酶活性显著降低(P0.05);miR-320 mimic+pc-FoxM1组细胞细胞增殖数及PCNA蛋白表达水平均显著高于miR-320 mimic组(P0.05);与miR-320 mimic组相比,miR-320 mimic+pc-FoxM1组细胞cleaved Caspase-9表达水平显著降低(P0.05);与miR-320 mimic组相比,miR-320 mimic+pc-FoxM1组细胞迁移率显著升高(P0.05);与miR-320 mimic组相比,miR-320 mimic+pc-FoxM1组细胞侵袭数显著升高(P0.05)。结论 miR-320通过靶向调控FoxM1实现抑制结肠癌SW480细胞增殖、侵袭能力。     

miR-638靶向下调MACC1抑制胃癌细胞的恶性进展

目的 探究miR-638在胃癌中的生物学功能和具体分子机制.方法 采用qRT-PCR检测miR-638和MACC1在胃癌细胞中的mRNA表达,Western blot检测MACC1在胃癌细胞中的蛋白表达;双荧光素酶实验验证MACC1和miR-638靶向结合关系;采用CCK8法测定细胞增殖活性;用划痕愈合实验和Transwell实验评价其迁移和侵袭能力;流式细胞术检测细胞周期分布情况.结果 m i R-638在胃癌细胞中表达下调;过表达m i R-638抑制胃癌细胞的增殖、迁移、侵袭能力;MACC1在胃癌细胞中表达显著上调,miR-638靶向抑制MACC1的表达.miR-638是通过靶向下调MACC1抑制胃癌细胞的增殖、迁移和侵袭能力.结论 miR-638通过靶向下调MACC1抑制胃癌细胞的发生发展.     

miR-99a对乳腺癌细胞侵袭和迁移的负向调控机制研究

目的探讨miR-99a对乳腺癌细胞侵袭及迁移的影响,并初步分析其影响乳腺癌细胞侵袭及迁移的可能分子机制。方法利用荧光实时定量PCR检测乳腺癌细胞系MDA-MB-231和MCF-7中miR-99a的表达。运用脂质体介导的转染方法分别将miR-99a模拟物（miR-99amimics）、miR-99a抑制物（miR-99ainhibitors）以及相应对照miRNA转染MDA-MB-231和MCF-7细胞,通过Transwell侵袭实验检测细胞的侵袭力;采用Transwell迁移实验及划痕实验检测细胞的迁移能力;利用生物信息学方法预测miR-99a的靶基因,并对靶基因进行验证。结果（1）高转移潜能的MDA-MB-231细胞中miR-99a表达明显低于低转移潜能的MCF-7细胞,划痕实验中转染miR-99amimics的与转染controlmimics的MDA-MB-231细胞比较迁移能力显著减弱（P＜0.05）,而MCF-7细胞转染miR-99ainhibitors后迁移能力明显增强（P＜0.01）。（2）Transwell的侵袭及迁移实验显示,转染miR-99amimics后MDA-MB-231细胞的侵袭和迁移能力明显减弱（P＜0.01）;MCF-7细胞转染miR-99ainhibitors后迁移能力增强（P＜0.01）,而侵袭能力基本不变（P＞0.05）。（3）生物信息学方法预测微管相关蛋白（MTMR3）是miR-99a的靶点,实时定量PCR和3′UTR荧光素酶报告基因实验验证了该靶点。（4）干扰了MTMR3后MDA-MB-231细胞的迁移和侵袭能力明显减弱。结论（1）miR-99a对乳腺癌细胞的侵袭及迁移发挥负向调控作用。（2）miR-99a可能通过靶向于MTMR3发挥其对乳腺癌细胞迁移和侵袭的调控作用。     

白藜芦醇通过上调miR-186-5p表达抑制肝癌细胞迁移、侵袭和上皮-间质转化

目的：探讨白藜芦醇抑制肝癌细胞转移的分子机制。方法：利用CCK-8法检测白藜芦醇对肝癌细胞HepG2和Huh7存活率的影响,筛选后续实验适合的浓度;实时定量RT-PCR检测肝癌组织和肝癌细胞中miR-186-5p的表达;细胞划痕实验、Transwell小室实验和蛋白质印迹法分别检测白藜芦醇或miR-186-5p表达变化对肝癌细胞HepG2和Huh7迁移、侵袭和上皮-间质转化相关蛋白表达的影响。结果：6.25?μmol/L白藜芦醇对肝癌细胞HepG2和Huh7的存活率无显著影响,遂后续实验中白藜芦醇的浓度选择6.25?μmol/L。实验结果显示, 白藜芦醇可以抑制肝癌细胞的迁移和侵袭,并增加上皮钙黏素表达,降低波形蛋白和Twist1表达（均P<0.05）。与癌旁组织和正常肝细胞相比,肝癌组织和肝癌细胞中miR-186-5p表达均下调（均P<0.05）。白藜芦醇能诱导肝癌细胞中miR-186-5p的表达（均P<0.01）。上调miR-186-5p表达可显著抑制肝癌细胞的迁移、侵袭和上皮-间质转化（均P<0.05）,而敲低miR-186-5p表达能阻断白藜芦醇对肝癌细胞迁移、侵袭和上皮-间质转化的抑制作用。结论：白藜芦醇能体外抑制肝癌转移,其机制可能与上调miR-186-5p表达有关。     

miR-373在人肝细胞癌中的表达及其作用

目的探讨miR-373在肝细胞癌的表达及其作用。方法 qRT-PCR法检测80例肝癌及癌旁灶中miR-373的表达;qRT-PCR法检测人肝细胞癌细胞株BEL7402、HepG2、Hep3b、Huh7、SMMC7721中miR-373的表达情况,选择高表达miR-373的细胞株为后续研究对象;干扰miR-373表达后,Transwell检测细胞株体外迁移和侵袭能力;Western blot检测细胞内MMP2、MMP9蛋白的表达变化。结果人肝细胞癌细胞株BEL7402、HepG2、Hep3b、Huh7、SMMC7721中,HepG2细胞中miR-373的表达最高。用miR-373 inhibitor转染HepG2细胞后,细胞内miR-373表达水平明显下调(P<0.05)。转染miR-373 inhibitor后,细胞迁移和侵袭细胞数目均少于对照组,差异有统计学意义(P<0.05);转染miR-373inhibitor后,HepG2细胞内MMP2、MMP9表达下调,(P<0.05)。结论 miR-373上调MMP2、MMP9表达促进了肝细胞癌的转移,miR-373可能为... 更多     

miR-519d靶向CDKN1A/p21调控宫颈癌细胞增殖的初步研究

目的探讨miR-519d对人宫颈癌细胞中CDKN1A/p21基因的靶向调控作用以及对细胞增殖、周期的影响。方法通过荧光定量PCR技术检测miR-519d抑制物对其活性的调控作用。在宫颈癌He La和Si Ha细胞中下调miR-519d表达,利用MTT法检测细胞增殖能力,通过流式细胞术检测细胞周期的分布情况。将miR-519d mimic转染He La和Si Ha细胞,用荧光定量PCR、Western Blot分别检测p21 m RNA和蛋白水平的表达。利用双荧光素酶报告基因系统确认miR-519d与p21的靶向关系。结果 miR-519d抑制物能有效下调宫颈癌He La和Si Ha细胞内miR-519d的表达。MTT实验和细胞周期分析结果提示,下调细胞内miR-519d的表达能够显著降低细胞增殖活力,并使细胞周期阻滞于G1期。进一步通过双荧光素酶报告基因系统鉴定miR-519d能够结合p21 m RNA3′UTR有效抑制其表达。q RT-PCR和Western blot检测结果表明,过表达miR-519d能在m RNA和蛋白水平上抑制p21的表达。结论 p21是miR-519d的直接靶基因,miR-519d可能通过靶向p21调控宫颈癌细胞增殖。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.