Transcription repressor ZHX2 is one of the members in ZHX protein family,which exists widely in human tissue and participates in the occurrence and development of various diseases.Researches show that ZHX2 is closely related to the occurrence and development of cancers,such as liver cancer,multiple myeloma,gastric cancer and colorectal cancer,which has the potential value of tumor treatment.

Notch signaling is an important evolutionarily conserved pathway involving the fate of cells translation. Additional?ly, this pathway also plays an important role in cartilage formation and maintenance of chondrocytes phenotype, regulation of the prolif?eration, maturation and balance of cartilage matrix metabolism. This paper reviews the composition and activation process of notch sig?naling, and its specific role in cartilage formation.

Objective To evaluate the value of echocardiography in investigation the failure of interventional therapy of VSDs and to increase the successful rate. Methods 15 cases with failure of VSD closure through interventional approach were undertaken measurement of major parameters of the defect on left ventriculography and then followed by Philips 5500 color Doppler US for repeated multi-direction tangential measuring of the size, morphologic change, relation with peripheral structure and individual valvular regurgitation. Results (1) Marginal membranous VSD 10 cases; membranance aneurysm 8 cases, ≥2 outlets 6 cases. Width of basal part of membranous aneurysm was 8 ～ 18 (10 ?2) mm with depth of 3 ～ 10 (6 ? 2) mm, distance from aortic valve was 0 ～ 6 (2 ? 1) mm and from tricuspid valve was 2 ～ 5 (2 ?1) mm; associated with slight tricuspid valvular regurgitation. Aortic valvular regurgitation 5 cases showed slight to mild amount and without membranous aneurysm occurred in 2 cases. (2) Intracristal VSD 5 cases showed the size of defect as 6 ～ 10 (7 ? 1) mm, with distances of 2 ～ 3 (1 ? 0.8) mm from pulmonary valve and 1 ～ 2 (1 ? 0.6) mm from aortic valve associated with slight regurgitation in 4 cases, slight tricuspid valvular regurgitation in 5 cases and aortic valvular prolapse in 4 cases. Conclusions Many factors can influence the direction tangential continuous scanning should be taken for accurate localization and measurement of VSD in order to select the very sight occludor providing high successful rate of occlusion and long term efficacy.

BACKGROUND:Anterior cruciate ligament (ACL) injury is a commonly sport-induced knee joint injury that does serious harm to the knee stability. ACL reconstruction is a commonly used treatment method, but researches on 1/2 peroneus longus tendon (PLT) graft are rarely reported. OBJECTIVE: To investigate the clinical outcomes of removing the autologous ipsilateral 1/2 PLT under arthroscopy for ACL reconstruction. METHODS:106 patients with complete ACL rupture in the Affiliated Hospital of Traditional Chinese Medicine, Southwest Medical University from December 2010 to December 2014 were enrolled, and autologous ipsilateral 1/2 PLT was removed under arthroscopy for ACL reconstruction. At baseline, 3, 6 and 12 months postoperatively, the knee stability was evaluated manually through the anterior drawer test, Lachman test, and pivot-shift test, and the knee function was evaluated by Tegner activity scale, Lysholm and International Knee Documentation Committee scores. RESULTS AND CONCLUSION: Postoperative anterior drawer test, Lachman test, and pivot-shift test tests were negative in all patients. In terms of Tegner activity scale, Lysholm and International Knee Documentation Committee scores, there were significant differences at baseline and postoperative 3 months as compared with postoperative 6 months (P < 0.05); the scores at baseline and postoperative 3 months showed significant differences compared with 12 months postoperatively (P < 0.05); the scores showed no significant difference between 6 and 12 months postoperatively (P > 0.05). These results indicate that autologous ipsilateral 1/2 PLT is a good choice for ACL reconstruction under arthroscopy, achieving rapid and satisfactory functional recovery of the knee joint, which is not only minimally invasive and easy to operate, but also exhibits good therapeutic efficacy.

BACKGROUND: Greater tuberosity of humerus, as the attachment point of rotator cuff, plays a vital role in shoulder.Neer and AO classification for proximal humeral fractures have been accepted extensively. However, the classification for single greater tuberosity fractures of the proximal humerus is little reported, and its fixation method remains controversial.OBJECTIVE: To explore the curative efficacy of the double-row suture anchors under arthroscopy for avulsion-type greater tuberosity fractures (Mutch type Ⅰ) METHODS: Clinical data of 24 patients with avulsion-type greater tuberosity fractures (Mutch type Ⅰ) undergoing double-row suture anchors under arthroscopy were analyzed retrospectively. The displacement distance of the greater tuberosity of humerus was measured on CT before and after fixation. The shoulder joint was evaluated by Constant-Murley Score and the University of California, Los Angeles score at baseline, 1, 3, 6 and 12 months postoperatively. Besides, the visual analogue scale scores were detected at baseline and 12 months postoperatively.RESULTS AND CONCLUSION: (1) Double-row suture anchors effectively improved the displacement of greater tuberosity and rotator cuff injury. (2) The patients accompanied by rotator cuff injury accounted for 79.16%. (3) The Constant-Murley Score and the University of California, Los Angeles scores were significantly improved at each time point (P < 0.05). The visual analogue scale scores after fixation were significantly superior to those before fixation (P < 0.05). (4) These results suggest that the double-row suture anchors under arthroscopy can effectively improve the displacement of greater tuberosity and alleviate the pain. Moreover, it is conductive for early recovery of the shoulder function with little trauma, so it is a good choice for avulsion-type greater tuberosity fractures (Mutch type Ⅰ).

OBJECTIVE:To investigate the effects of 3 types of antihypertensive drugs on cognitive function in elderly hyper-tensive patients after acetabular surgery. METHODS:Ninety hypertensive patients receiving antihypertensive drugs for a long term (not changed antihypertensive drugs within 2 weeks before surgery)undergoing selective acetabular surgery were included sequen-tially and divided into angiotensin receptor blocker(ARB)group,angiotensin converting enzyme inhibitor(ACEI)group and cal-cium channel blocker(CCB)group according to the types of antihypertensive drugs,with 30 cases in each group. All patients re-ceived acetabular surgery under epidural anesthesia. The cognitive function of patients was evaluated by using MMSE 1 d before sur-gery(T0),1 d after surgery(T2)and 3 d after surgery(T3). The concentration of S100β protein serum was determined 1d before surgery (T0),immediately after surgery (T1) and 1 d after surgery (T2). RESULTS:Compared with T0,MMSE score of ARB group at T2,those of ACEI group and CCB group at T2 and T3 were decreased significantly,with statistical significance(P<0.05). Compared with ARB group,MMSE score of ACEI group and CCB group at T2,T3 were decreased significantly,with statistical sig-nificance(P<0.05). Compared with ACEI group,MMSE score of CCB group at T2,T3 were decreased significantly,with statisti-cal significance(P<0.05). Compared with T0,the concentration of S100β protein in serum 3 groups were increased significantly, with statistical significance (P<0.05). Compared with ARB group,the concentration of S100β protein serum in ACEI group and CCB group were increased significantly,with statistical significance(P<0.05). Compared with ACEI group,the concentration of S100β protein serum in CCB group at T1,T2 were increased significantly,with statistical significance(P<0.05). The incidence of cognitive dysfunction was in ascending order of ARB group (30%)

Objective To investigate the correlation between elasticity obtained with acoustic radiation force impulse(ARFI) and blood perfusion obtained with contrast enhanced ultrasound(CEUS) in renal carcinoma.Methods Tweenty-four patients with renal carcinoma confirmed by operation and pathology underwent ARFI and CEUS sequentially,got preliminary information of elasticity,size and border with virtual touch tissue imaging (VTI),shear wave velocity (SWV) of tumor and renal cortex at least 2centimeters from the tumor margin were measured with virtual touch tissue quantification (VTQ),and then the imaging characteristics were analyzed with time intensity curve (TIC).The elasticity obtained with ARFI were compared with the blood perfusion obtained with CEUS.ResultsTotally 24 cases included 18 renal cell carcinomas,3 papillary renal cell carcinomas,2 chromophobe cell renal carcinomas and 1 rena1collecting duct carcinoma.In VTI,18 appeared darker,4 appeared brighter,and 2 had the same brightness as renal cortex.The SWV of tumor and renal cortex were (2.47±0.61)m/s,(2.10±0.94) m/s,respectively,19 were stiffer than renal cortex (79.2％),among which 18 appeared hyper-enhancement and 1 appeared hypo-enhancement;5 were softer than renal cortex (20.8％),among which 2 appeared hyper-enhancement and 3 appeared hypo-enhancement in CEUS.Tumors with different elasticity had different enhancement,stiff cases appeared hyper-enhancement,soft cases appeared hypo-enhancement (P ＜ 0.05).Conclusions There is correlation between elasticity obtained with ARFI and blood perfusion obtained with CEUS in renal carcinoma

Objective To discuss the effective factors and metastasis rules of cervical lymph node of papillary thyroid microcarcinoma,aimed to provide references for indications and range of lymph node dissection.Methods Reviewed the clinical information and pathological material of primary treatment of 1 180 cases of papillary thyroid microcarcinoma patients in China-Japan Union Hospital of Jilin University from June 2008 to December 2011 by retrospective analysis,futher summared cervical lymph node metastasis rules and effective factors.Results The lymph node metastasis rate of 1 180 patients with papillary thyroid microcarcinoma was 29.6％,which of these of the central and lateral region were 26.4％ and 15.2％.Central region lymph nodes metastasis rates in male and female were respectively 44.9％,21.8％ (P ＜ 0.05),and were 39.8％,9.0％ in lateral region (P ＜ 0,01).Lymph node metastasis rates of patients whose age ≤45years old and ＞45 years old were 30.3％,17.9％ (P ＜0.05).The lymph mode metastasis rate which diameter of tumour(D) ≤0.5 cm or 0.5 cm ＜ D ≤ 1 cm in central region were 20.2％,33.2％ (P ＜ 0.05).The lymph node metastasis rate of single and more nidi respectively were 15.7％,45.0％ in central region.The lymph node metastasis rate of tumors invasion or not were 44.4％ and 14.2％ in central region (P ＜0.05).The metastasis rates were 45.5％ and 4.3％ in the lateral region when the lymph node infringe or not in central region.Conclusions Lymph node metastasis happens relatively more common in papillary thyroid microcarcinoma patients with the factors such as male,young age,multiple nidi,long diameter of tumor and invasion of tumor envelope.So when doctors establish the indications and range of lymph node dissection,it's need to pay attention to the high risk factors seriously which effect lymph node metastasis of papillary thyroid carcinoma,and establish the lymph node dissection strategy individually.

Objective To evaluate the clinical capability of young general practitioners (GPs) in communities in Shanghai.Methods A cross-sectional survey on clinical ability of young GPs was adopted from October to December 2014.Total 211 GPs aged (31 ± 2) years (25-35) from 17 districts of Shanghai participated in the study.Written examination and objective structured clinical examination (OSCE) was applied in the evaluation.Results All 211 GPs (63 male and 148 females) completed the assessment.The overall score of the assessment was (602 ± 83) and the pass rate was 62.6％ (132/211).In written examination the average score was (64 ±7) and the pass rate was 72.1％ (152/211).In OSCE,the highest score (80 ± 15) and pass rate (92.9％,196/211) was in CPR skill,followed by communication skill [average score:(76 ± 15) and pass rate:85.8％ (181/211)].The lowest average score was physical examination (47 ± 15) with a pass rate of 26.1％ (55/211),followed by electrocardiogram reading [average score:(84 ±31) and pass rate:39.8％ (84/211)].In basic operation station,the lowest score was using funduscope and gynecologial examination (29.8％ and 45.4％,respectively).Conclusion Young GPs in Shanghai communities basically master clinical skills,but also have some deficiencies,the training in certain skills need to be strengthened.

Objective To assess community health service ability of general practitioners (GPs) with the Standardized General Practitioner Training(SGPT) in Shanghai.Methods One hundred and four GPs receiving SGPT and matched 102 GPs without SGPT were enrolled in this retrospective cohort study from September to November in 2014.Community health service ability,including abilities in basic medical service and public health service were assessed and compared between two groups.Written examination was applied in the public health services ability assessment.Objective structured clinical examination (OSCE) was applied for evaluation of basic medical service abilities.Results The scores of written examination in GPs with SGPT were higher than those without SGPT[(66 ±4) vs.(62 ±7),P ＜0.01].The OSCE scores in GP with SGPT were higher than those without SGPT [(494 ± 78) vs.(448 ± 80),P ＜ 0.01].GPs with SGPT also abtained the higher scores in consultation competence and clinical skills assessment [(245 ± 44) vs.(225 ±40),P＜0.01;(252 ±59) vs.(225 ±61),P ＜0.01].In OSCE,GPs with SGPT got higher score than those without SGPT in 5 stations (medical history collection,doctor-patient communication,basic operation,ECG interpretation,and CPR) (all P ＜ 0.01);however,no significant differences were observed in 3 stations (physical examination,case analysis and X-ray interpretation) between two groups (all P ＞ 0.05).Conclusions GPs with SGPT have better basic medical service and public health service ability.But some aspects of basic medical service ability need to be strengthened in the training and practice.