<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">cardiovascular</journal-id><journal-title-group><journal-title xml:lang="ru">Кардиоваскулярная терапия и профилактика</journal-title><trans-title-group xml:lang="en"><trans-title>Cardiovascular Therapy and Prevention</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1728-8800</issn><issn pub-type="epub">2619-0125</issn><publisher><publisher-name>«SILICEA-POLIGRAF» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15829/1728-8800-2019-2233</article-id><article-id custom-type="elpub" pub-id-type="custom">cardiovascular-2233</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>РАЗНОЕ</subject></subj-group></article-categories><title-group><article-title>Взаимосвязь активности теломеразы с показателями углеводного обмена и параметрами сосудистой стенки</article-title><trans-title-group xml:lang="en"><trans-title>Relationship between telomerase activity and parameters of carbohydrate metabolism and vascular wall</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1216-0787</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Браилова</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Brailova</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Браилова Наталия Васильевна — кандидат медицинских наук, н.с. лаборатории возрастных метаболических эндокринных нарушений.</p><p>Москва.</p><p>Тел.: +7 (909) 690-59-57</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">n.kokshagina@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7891-6850</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дудинская</surname><given-names>Е. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Dudinskaya</surname><given-names>E. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дудинская Екатерина Наильевна — кандидат медицинских наук, заведующая лабораторией возрастных метаболических эндокринных нарушений.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">katharina.gin@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4193-688X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ткачева</surname><given-names>О. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Tkacheva</surname><given-names>O. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ткачева Ольга Николаевна — доктор медицинских наук, профессор, директор.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">Tkacheva@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6465-4842</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шарашкина</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Sharashkina</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шарашкина Наталья Викторовна — кандидат медицинских наук, старший научный сотрудник лаборатории общей гериатрии и нейрогериатрии.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">sharashkina@inbox.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3657-0676</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Стражеско</surname><given-names>И. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Strazhesco</surname><given-names>I. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Стражеско Ирина Дмитриевна — кандидат медицинских наук, ведущий научный сотрудник отдела возраст-ассоциированных заболеваний.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">istrazhesko@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0694-7062</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Акашева</surname><given-names>Д. У.</given-names></name><name name-style="western" xml:lang="en"><surname>Akasheva</surname><given-names>D. U.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Акашева Дарига Уайдинична — кандидат медицинских наук, врач-кардиолог Центра телемедицины, старший преподаватель группы по разработке и реализации профильных образовательных программ отдела организационно-методического управления и анализа качества медицинской помощи.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">dariga-akasheva@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5057-127X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шестакова</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Shestakova</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шестакова Марина Владимировна — доктор медицинских наук, профессор, академик РАН, директор.</p><p>Москва.</p></bio><bio xml:lang="en"><p>Moscow.</p></bio><email xlink:type="simple">nephro@endocrincentr.ru</email><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Российский геронтологический научно-клинический центр” ФГБОУ ВО “Российский национальный исследовательский медицинский университет им. Н. И. Пирогова” Минздрава России</institution></aff><aff xml:lang="en"><institution>Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University</institution></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ОП “Медицинский научно-образовательный центр” ФГБОУ ВО “Московский государственный университет имени М.В. Ломоносова”</institution></aff><aff xml:lang="en"><institution>Medical Research and Educational Center, Moscow State University</institution></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр профилактической медицины Минздрава России</institution></aff><aff xml:lang="en"><institution>National Medical Research Center for Preventive Medicine</institution></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр эндокринологии Минздрава России</institution></aff><aff xml:lang="en"><institution>National Medical Research Center of Endocrinology</institution></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>29</day><month>10</month><year>2019</year></pub-date><volume>18</volume><issue>6</issue><fpage>33</fpage><lpage>39</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Браилова Н.В., Дудинская Е.Н., Ткачева О.Н., Шарашкина Н.В., Стражеско И.Д., Акашева Д.У., Шестакова М.В., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Браилова Н.В., Дудинская Е.Н., Ткачева О.Н., Шарашкина Н.В., Стражеско И.Д., Акашева Д.У., Шестакова М.В.</copyright-holder><copyright-holder xml:lang="en">Brailova N.V., Dudinskaya E.N., Tkacheva O.N., Sharashkina N.V., Strazhesco I.D., Akasheva D.U., Shestakova M.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://cardiovascular.elpub.ru/jour/article/view/2233">https://cardiovascular.elpub.ru/jour/article/view/2233</self-uri><abstract><sec><title>Цель</title><p>Цель. Изучить взаимосвязь активности теломеразы с параметрами углеводного обмена и состоянием сосудистой стенки в зависимо­сти от наличия сахарного диабета 2 типа (СД-2).</p></sec><sec><title>Материал и методы</title><p>Материал и методы. В исследование включены 50 пациентов с СД-2 и 139 пациентов без СД и без клинических проявлений сер­дечно-сосудистых заболеваний. У всех участников оценивались углеводный обмен, хроническое воспаление: С-реактивный белок (СРБ), фибриноген, эндотелиальная дисфункция, дуплексное сканирование сонных артерий с определением толщины комплекса интима-медиа и количества атеросклеротических бляшек, каротидно-феморальная скорость распространения пульсовой волны, длина теломер лейкоцитов и активность теломеразы.</p></sec><sec><title>Результаты</title><p>Результаты. У пациентов с СД-2 активность теломеразы оказалась ниже (р=0,039), длина теломер короче (р=0,031), а уровень СРБ выше (р=0,031) чем у лиц без СД. Все пациенты были разделены по медиане активности теломеразы. В группе низкой активности теломеразы у пациентов с СД 2 были выше значения СРБ (р=0,016), скорости распространения пульсовой волны (р=0,010), толщины комплекса интима-медиа (р&lt;0,001), количество атеросклеротических бляшек (р=0,014) в сравнении с пациентами без СД. При сравнении групп с высокой активностью теломеразы указанных разли­чий не обнаружено. В группе пациентов с СД-2 и без СД установлена независимая обратная связь активности теломеразы с гликированным гемоглобином (p=0,035), глюкозой плазмы натощак (p=0,003), артериальной жесткостью (p=0,044) и прямая связь с уровнем фибриногена (p=0,027) и СРБ (p=0,042).</p></sec><sec><title>Заключение</title><p>Заключение. Изменения сосудистой стенки, хроническое воспа­ление и клеточное старение более выражены у пациентов с СД-2. Установленная взаимосвязь активности теломеразы с показателя­ми углеводного обмена, хронического воспаления и сосудистой жесткостью могут свидетельствовать о важной роли активности теломеразы в развитии сердечно-сосудистых заболеваний у пациентов с СД-2.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Aim</title><p>Aim. To study the relationship between telomerase activity and parameters of carbohydrate metabolism and vascular wall depending on the type 2 diabetes (T2D).</p></sec><sec><title>Material and methods</title><p>Material and methods. The study included 50 patients with T2D and 139 healthy volunteers. All subjects were assessed for carbohydrate metabolism, chronic inflammation (C-reactive protein (CRP), fibrinogen), endothelial dysfunction, carotid intima-media thickness and number of atherosclerotic plaques by duplex scanning, carotid-femoral pulse wave velocity, lymphocyte telomere length and telomerase activity.</p></sec><sec><title>Results</title><p>Results. In T2D patients, telomerase activity was lower (p=0,039), telomeres were shorter (p=0,031) and CRP level was higher (p=0,031) than in patients without T2D. All patients were divided by telomerase activity. T2D patients with low telomerase activity had higher values of CRP (р=0,016), pulse wave velocity (р=0,010), carotid intima-media thickness (р&lt;0,001) and number of atherosclerotic plaques (р=0,014) than in patients without T2D. There were no significant differences in high telomerase activity group. In the group of patients with/without T2D, there were independent negative relationship between telomerase activity and glycated hemoglobin (p=0,035), fasting plasma glucose (p=0,003), arterial stiffness (p=0,044) and independent positive relationship between telomerase activity and fibrinogen (p=0,027), CRP (p=0,042).</p></sec><sec><title>Conclusion</title><p>Conclusion. Vascular changes, chronic inflammation and cell aging were weightier in patients with T2D. The established relationship between telomerase activity and parameters of carbohydrate metabolism, chronic inflammation and vascular stiffness may indicate the important role of telomerase activity in the development of cardiovascular diseases in T2D patients.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>активность теломеразы</kwd><kwd>сахарный диабет</kwd><kwd>угле¬водный обмен</kwd><kwd>сосудистая стенка</kwd><kwd>хроническое воспаление</kwd></kwd-group><kwd-group xml:lang="en"><kwd>telomerase activity</kwd><kwd>diabetes</kwd><kwd>carbohydrate metabolism</kwd><kwd>vascular wall</kwd><kwd>chronic inflammation</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Коллектив авторов благодарит Кругликову А. С., Озерову И. Н., Гомыранову Н. В. (ФГБУ “Национальный медицинский исследовательский центр профилактической медицины” Минздрава России) и Скворцова Д. А. (Институт физико-химической биологии им. А. Н. Белозерского, ФГБОУ ВО “Московский государственный университет имени М. В. Ломоносова”) за помощь в проведении исследования.</funding-statement><funding-statement xml:lang="en">The authors are grateful to Kruglikova A. S., Ozerova I. N., Gomyranova N. V. (National Medical Research Center for Preventive Medicine) and Skvortsova D. A. (A. N. Belozersky Institute Of Physico-Chemical Biology, Moscow State University) for support in conducting the study.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Nilsson PM. Hemodynamic aging as the consequence of structural changes associated with Early Vascular Aging (EVA). Aging Dis. 2014;5:109-13. doi:10.14336/AD.2014.0500109.</mixed-citation><mixed-citation xml:lang="en">Nilsson PM. Hemodynamic aging as the consequence of structural changes associated with Early Vascular Aging (EVA). Aging Dis. 2014;5:109-13. doi:10.14336/AD.2014.0500109.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Rajendran P, Rengarajan T, Thangavel J, et al. The Vascular Endothelium and Human Diseases. Int J Biol Sci. 2013;9(10):1057-69. doi:107150/ijbs.7502.</mixed-citation><mixed-citation xml:lang="en">Rajendran P, Rengarajan T, Thangavel J, et al. The Vascular Endothelium and Human Diseases. Int J Biol Sci. 2013;9(10):1057-69. doi:107150/ijbs.7502.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Tzanetakou IP, Nzietchueng R, Perrea DN, et al. Telomeres and their role in aging and longevity. Curr Vasc Pharmacol. 2014;12(5):726-34.</mixed-citation><mixed-citation xml:lang="en">Tzanetakou IP, Nzietchueng R, Perrea DN, et al. Telomeres and their role in aging and longevity. Curr Vasc Pharmacol. 2014;12(5):726-34.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Зверева М. Э., Щербакова Д. М., Донцова О. А. Теломераза: структура, функции и пути регуляции активности. Успехи биологической химии. 2010;50:155-202.</mixed-citation><mixed-citation xml:lang="en">Zvereva ME, Shcherbakova DM, Dontsova OA. Telomerase: structure, functions and pathways of regulating activity. Uspekhi biologicheskoi khimii. 2010;50:155-202. (In Russ).</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Morgan G. Telomerase regulation and the intimate relationship with aging. Research and Reports in Biochemistry. 2013;3:71-8. doi:10.2147/RRBC.S28603.</mixed-citation><mixed-citation xml:lang="en">Morgan G. Telomerase regulation and the intimate relationship with aging. Research and Reports in Biochemistry. 2013;3:71-8. doi:10.2147/RRBC.S28603.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Murillo-Ortiz B, Albarran-Tamayo F, Arenas-Aranda D, et al. Telomere length and type 2 diabetes in males: a premature aging syndrome. Aging Male. 2012;15(1):54-8. doi :10.3109/13685538.2011.593658.</mixed-citation><mixed-citation xml:lang="en">Murillo-Ortiz B, Albarran-Tamayo F, Arenas-Aranda D, et al. Telomere length and type 2 diabetes in males: a premature aging syndrome. Aging Male. 2012;15(1):54-8. doi :10.3109/13685538.2011.593658.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Shah AS, Dolan LM, Kimball TR, et al. Influence of duration of diabetes, glycemic control, and traditional cardiovascular risk factors on early atherosclerotic vascular changes in adolescents and young adults with type 2 diabetes mellitus. J Clin Endocrinol Metab. 2009;94(10):3740-5. doi:10.1210/jc.2008-2039.</mixed-citation><mixed-citation xml:lang="en">Shah AS, Dolan LM, Kimball TR, et al. Influence of duration of diabetes, glycemic control, and traditional cardiovascular risk factors on early atherosclerotic vascular changes in adolescents and young adults with type 2 diabetes mellitus. J Clin Endocrinol Metab. 2009;94(10):3740-5. doi:10.1210/jc.2008-2039.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Cawthon RM. Telomere length measurement by a novel monochrome multiplex quantitative PCR method. Nucleic Acids Res. 2009;37(3):e21. doi: 10.1093/nar/gkn1027.</mixed-citation><mixed-citation xml:lang="en">Cawthon RM. Telomere length measurement by a novel monochrome multiplex quantitative PCR method. Nucleic Acids Res. 2009;37(3):e21. doi: 10.1093/nar/gkn1027.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Gardano L. Using PCR coupled to PAGE for detection and semiquantitative evaluation of telomerase activity. Methods Mol Biol. 2013;1054:283-93. doi:10.1007/978-1-62703-565-1_19.</mixed-citation><mixed-citation xml:lang="en">Gardano L. Using PCR coupled to PAGE for detection and semiquantitative evaluation of telomerase activity. Methods Mol Biol. 2013;1054:283-93. doi:10.1007/978-1-62703-565-1_19.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Kuhlow D, Florian S, von Figura G. Telomerase deficiency impairs glucose metabolism and insulin secretion. Aging (Albany NY). 2010;2(10):650-8. doi: 10.18632/aging.100200.</mixed-citation><mixed-citation xml:lang="en">Kuhlow D, Florian S, von Figura G. Telomerase deficiency impairs glucose metabolism and insulin secretion. Aging (Albany NY). 2010;2(10):650-8. doi: 10.18632/aging.100200.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Ma D, Yu Y, Yu X, et al. The changes of leukocyte telomere length and telomerase activity after sitagliptin intervention in newly diagnosed type 2 diabetes. Diabetes Metab Res Rev. 2015;31(3):256-61. doi:10.1002/dmrr.2578.</mixed-citation><mixed-citation xml:lang="en">Ma D, Yu Y, Yu X, et al. The changes of leukocyte telomere length and telomerase activity after sitagliptin intervention in newly diagnosed type 2 diabetes. Diabetes Metab Res Rev. 2015;31(3):256-61. doi:10.1002/dmrr.2578.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Qi Nan W, Ling Z, Bing C. The influence of the telomere telomerase system on diabetes mellitus and its vascular complications. Expert Opin Ther Targets. 2015;19(6):849-64. doi:10.1517/14728222.2015.1016500.</mixed-citation><mixed-citation xml:lang="en">Qi Nan W, Ling Z, Bing C. The influence of the telomere telomerase system on diabetes mellitus and its vascular complications. Expert Opin Ther Targets. 2015;19(6):849-64. doi:10.1517/14728222.2015.1016500.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Rentoukas E, Tsarouhas K, Kaplanis I. Connection between telomerase activity in PBMC and markers of inflammation and endothelial dysfunction in patients with metabolic syndrome. Plos One. 2012;7(4):e35739. doi:10.1371/journal.pone.0035739.</mixed-citation><mixed-citation xml:lang="en">Rentoukas E, Tsarouhas K, Kaplanis I. Connection between telomerase activity in PBMC and markers of inflammation and endothelial dysfunction in patients with metabolic syndrome. Plos One. 2012;7(4):e35739. doi:10.1371/journal.pone.0035739.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Effros RB. Telomere/telomerase dynamics within the human immune system: effect of chronic infection and stress. Experimental gerontology. 2011 ;46(2-3): 135-40. doi:10.1016/j.exger.2010.08.027.</mixed-citation><mixed-citation xml:lang="en">Effros RB. Telomere/telomerase dynamics within the human immune system: effect of chronic infection and stress. Experimental gerontology. 2011 ;46(2-3): 135-40. doi:10.1016/j.exger.2010.08.027.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Duong MT, Sahin E. RAP1: protector of telomeres, defender against obesity. Cell Rep. 2013;3(6):1757-8. doi:10.1016/j.celrep.2013.06.011.</mixed-citation><mixed-citation xml:lang="en">Duong MT, Sahin E. RAP1: protector of telomeres, defender against obesity. Cell Rep. 2013;3(6):1757-8. doi:10.1016/j.celrep.2013.06.011.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
