As a tumor suppressor, p53 is activated by numerous cellular and environmental signals, and plays a criticalrole in the cell cycle regulation, cell apoptosis and senenscence. The murine double minute (MDM)2 and double minute mu?rine 4 (MDMX) are two important regulators. MDMX is a p53 binding protein with strong sequence homology to MDM2, but lacks ubiquitin ligase activity, and which is unable to target p53 for proteasomal degradation. MDMX regulates p53 activity through its binding with p53 and its postranscriptional modification. MDMX in the closed and open structure binds to p53 to regulate its activity. As the main partner of MDMX, casein kinase 1 alpha (CK1α) disrupts the intramolecular binding in MD?MX in the cooperation to regulate p53 activity. The process of MDMX and CK1αin the regulation of p53 is multi-step and complicated. In this paper the mechanism of MDMX and CK1αin the regulation of p53 protein was reviewed.

Objective To evaluate correlations between left atrial(LA) and left ventricular(LV) function in patients with hypertension by acoustic quantification(AQ) technique. Methods Forty-eight hypertensive patients and twenty control subjects were studied. Patients with hypertension were divided into two groups by left ventricular mass index(LVMI),normal LVMI group(32 cases) and left ventricular hypertrophy(LVH) group(16 cases). Left atrial ejection fraction(LAEF),atrial emptying volume(AE),conduit volume(CV) and reservoir volume(RV) were measured with AQ technique. Results RV and AE significantly increased in normal LVMI subgroup and LVH subgroup;CV and LAEF respectively decreased or increased in LVH subgroup. LA booster pump function positively correlated to onset atrial emptying volume and RV,negatively correlate to CV and LV diastolic function. LA conduit function positively correlated to LV diastolic function,negatively correlated to LAEF and AE,RV as well as onset atrial emptying volume. LA reservoir function positively correlated to onset atrial emptying volume and LAEF,negatively correlated to CV. There was no significant correlation between LA reservoir function and LV diastolic function. Conclusions LV diastolic dysfunction induces decreased LA conduit function and increased reservoir function,which may facilitate early diastolic filling of the left ventricle. The changes of LA conduit function and reservoir function may increase of LA preload. Enhancement of LA preload and LA systole makes increased LA booster pump function,which facilitate late diastolic filling of left ventricle.

Objective To evaluate the efficiency and safety of Percusurge guardwire distal protection system in coronary intervention in patients with acute myocardial infarction. Methods Three male patients with acute myocardial infarction were enrolled in the study. Primary angioplasty was performed for 2 of them, 2 and 7 hours after onset of the infarction symptom, respectively. Selective angioplasty was performed 17 days after infarction for the third case. Percusurge guardwire system was used during the procedure. Results Procedure success was achieved for all of the 3 cases. Lot of thrombus was sucked out. The infarct-related arteries had TIMI 3 flow at the end of the procedures. The patients′ symptoms were resolved soon after the procedure. Minor dissection was seen in one case which did not obstruct the distal flow and was left alone. Conclusion Percusurge guardwire system can be used safely and effectively in coronary intervention in the thrombus-laden arteries such as acute myocardial infarction.

Objective To summarize the effect and safety of percutaneous coronary intervention (PCI) for CHD in patients with single patent coronary artery. Methods We collected the data of CHD in 10 patients with single patent coronary artery who underwent PCI and analyzed them retrospectively. Results All patients with single patent coronary artery had successful PCI. Symptoms of all the CHD patients had been significantly relieved after PCI. No major adverse cadiac events occurred in hospitalization. Conclusion The data suggest that the patients with single patent coronary artery might be treated with PCI effectively and safely.

Background At present,researches about retinitis and acquired immunodeficiency syndrome (AIDS) mainly focus on observation and analysis of the cytomegalovirus (CMV)-induced ocular complication.To screen the effective drugs is very important for the treatment of AIDS-related CMV-induced retinitis.Objective This study was to describe the clinical features,diagnosis and treatment outcome of CMV-induced retinitis with BAY 38-4766 and evaluate the relationship between CMV retinitis and AIDS.Methods This was a case observational study.A total of 154 eyes of 84 patients with CMV retinitis and AIDS were enrolled in this study.Before the definitive diagnosis of CMV retinitis,the AIDS course of these patients were 4-26 months.In the initial examination,the visual acuity ranged from finger counting to 0.4,and the number of CD4+ T-lymphocyte was 0-30 cells/μl.The survival time in the patients ranged from 3 weeks to 18 months.BAY 38-4766 was used in 117 eyes of 62 patients,and 102 eyes of 53 patients showed the srinked of retinal lesion and improvement of vision (0.1-0.7).BAY 38-4766 was used to treat the CMV retinitis in 117 eyes of 62 patients with the initial intravenous dose of 5 mg/kg,twice per day for consecutive 2 weeks and followed by oral dose 1 gram per day.The follow-up duration was 2 weeks to 18 months.The fundus feature,visual acuity and CD4+ T-lymphocyte counts were analyzed.This study proposal was approved by Ethic Committee of the 474th Hospital of PLA,and written informed consent was obtained from each patient prior to entering this study.Results The numbers of CD4+T-lymphocytes increased to 12-402 eells/μl after administration of BAY 38-4766.The CMV retinitis aggravated and the vision decreased in the untreated 22 patients with the CD4+T-lymphocytes 0-30 cells/μl.Conclusions CMV retinitis is the most common intraocular complication in patients with AIDS.Diagnosis of CMV retinitis is based on the characteristics of necrotizing retinitis,which is typically associated with retinal hemorrhage and vasculitis.BAY 38-4766 is an effective drug for the treatment of CMV retinitis.

Objective To investigate the incidence of postoperative hepatic metastasis,clinicolpathological characteristics and the prognosis for pancreatic cancer. Methods Totally 83 cases with pancreatic cancer admitted in our hospital during January 2007 to September 2012 was retro?spectively analyzed according to clinicolpathological data. Results Postoperative liver metastasis occurred in 31 cases with a metastatic rate of 37.3%. The size(χ2=9.606;P=0.002),vascular invasion(χ2=4.794,P=0.029)and UICC stage(χ2=5.318,P=0.021)were correlated with he?patic metastasis. Univariate analysis revealed the poor prognosis in pancreatic cancer patient with hepatic metastasis(χ2=9.967,P=0.002). Cox re?gression analysis revealed hepatic metastasis as an independent prognostic factor(P=0.001). Conclusion Pancreatic cancer has a high possibility of hepatic metastasis. Postoperative hepatic metastasis was one of the independent factors for the prognosis of pancreatic cancer. Tumor size,vascular invasion and UICC stages were risk factors for postoperative liver metastasis of pancreatic cancer.

The aim of this paper is to report the synthesis of the mPEG-PCL-g-PEI copolymers as small interfering RNA (siRNA) delivery vector, and exploration of the siRNA delivery potential of mPEG-PCL-g-PEI in vitro. The diblock copolymers mPEG-PCL-OH was prepared through the ring-opening polymerization. Then, the hydroxyl terminal (-OH) of mPEG-PCL-OH was chemically converted into the carboxy (-COOH) and N-hydroxysuccinimide (NHS) in turn to prepare mPEG-PCL-NHS. The branched PEI was reacted with mPEG-PCL-NHS to synthesize the ternary copolymers mPEG-PCL-g-PEI. The structure of mPEG-PCL-g-PEI copolymers was characterized with Fourier transform infrared spectroscopy (FTIR), nuclear magnetic resonance (NMR) and gel permeation chromatography (GPC). The mPEG-PCL-g-PEI/siRNA nanoparticles were prepared by complex coacervation, and the nanoparticles size and zeta potential were determined, separately. The cytotoxicities of mPEG-PCL-g-PEI/siRNA nanoparticles and PEI/siRNA nanoparticles were compared through cells MTT assays in vitro. The inhibition efficiencies of firefly luciferase gene expression by mPEG-PCL-g-PEI/ siRNA nanoparticle at various N/P ratios were investigated through cell transfection in vitro. The experimental results suggested that the ternary (mPEG5k-PCL(1.2k))1.4-g-PEI(10k) copolymers were successfully synthesized. (mPEG(5k)-PCL(1.2k))1.4-g-PEI(10k) could condense siRNA into nanoparticles (50-200 nm) with positive zeta potential. MTT assay results showed that the cytotoxicity of (mPEG(5k)-PCL(1.2k))1.4-g-PEI(10k)/siRNA nanoparticles was significantly lower than that of PEI(10k)/siRNA nanoparticles (P < 0.05). The expression of firefly luciferase gene could be significantly down-regulated at a range of N/P ratio from 50 to 150 (P < 0.01), and maximally inhibited at the N/P ratio of 125. The mPEG-PCL-g-PEI polymers could delivery siRNA into cells to inhibit the expression of target gene with very low cytotoxicity, which suggested that mPEG-PCL-g-PEI could serve as a new type of siRNA delivery vector.

Objective To introduce the processes of vascularized parathyroid gland reservation and parathyroid autotransplantation applied in thyroidectomy. Methods In 46 cases who underwent total/near total thyroidectomy, in situ vascularized parathyroid gland reservation was performed in 24 cases,isolated parathyroid autotransplantation was performed in 5 cases, in situ vascularized parathyroid gland reservation of 1～2 parathyroid glands combined with immediately transplantation of the remaining isolated parathyroid glands were performed in 17 cases. Results Five cases suffered from transient hypocalcaemia, including 2 cases of vascularized parathyroid gland reservation and 3 cases of vascularized parathyroid gland reservation in 1～2 parathyroid glands combined with immediately transplantation of other parathyroid glands. Two cases who received parathyroid autotransplantation suffered from hypocalcaemia and received conservative treatment with activated vitamin D3 and caleium for 4 weeks or 8 weeks. Permanent hypoparathyroidism occurred in 1 case of 46 cases which undergone the total/near total thyroidectomy(2.2%). Conclusion Application of vascularized parathyroid gland reservation and parathyroid autotransplantation in total/near total thyroidectomy could reduce the incidence rate of post-operative hypoparathyroidism.

Objective To investigate the association of serum angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) with myocardial reperfusion in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). Methods A total of 103 consecutive STEMI patients who received primary PCI were enrolled in this study. The patients were divided into two groups according to ST-segment resolution (STR) at 2 h after PCI:STR ≥ 50%group (n=69) and STR<50%group (n=34). Serum concentrations of Ang-1, Ang-2 and Ang-2 to Ang-1 ratios (Ang-2/Ang-1) before and immediately after PCI, 2 h, 6 h, 24 h after PCI were compared. Predictors of poor STR were identiifed by multivariable logistic regression analysis. Results The patients with STR≥50%had significant higher serum Ang-1 levels (P < 0.05) and lower Ang-2/Ang-1 ratios (P < 0.01) from before PCI to 6 h after PCI than those with STR < 50%;Ang-1 and Ang-2/Ang-1 at 24 h after PCI, and Ang-2 at all time points were not signiifcantly different between the two groups (P>0.05). In multivariable logistic regression analysis, Ang-2/Ang-1 before PCI was independently associated with STR < 50%;Other independent predictors were pain to balloon time, infarct related artery (LAD), and TIMI flow grade<Ⅲafter PCI. Conclusions Higher Ang-2/Ang-1 is an independent predictor of poor myocardial reperfusion in STEMI patients after PCI.

Objective To explore the clinical therapeutic effects of Ⅰ-stage or delayed Ⅰ-stage cervical plexus reinnervation for recurrent laryngeal nerve(RLN)injuries. Methods During the process of neck dissection of papillary thyroid carcinoma,18 cases with recurrent laryngeal nerve deficit underwent cervical plexus reinnervation on Ⅰ-stage or delayed Ⅰ-stage RLN prosthosis basis.Therapeutic effects were evaluated by fibrolaryngoscope and voice evaluation preoperatively and postoperatively. Results All the cases were followed-up for 3 months to 2 years(average 8 months).Abductory motion of the vocal cords of 16 patients totally or partly restored,and not improved in 2 patients,with the recovery rate of abductory motion of the paralyzed vocal cords of 88.9%(16/18).Patient's phonation was restored totally or partially in 16 cases and the hoarseness was ameliorated significantly. Conclusions Cervical plexus-RLN reinnervation should be considered as a suitable treatment for unilateral vocal cord paralysis.One stage or delayed one stage cervical plexus reinnervation for recurrent laryngeal nerve injury is convenient and easy to perform.Postoperatively the abductory motion of vocal cord could be restored by this reinnervation satisfactorily.