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 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.

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.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Respiratory Tract Diseases ; diagnostic imaging ; Tomography, Spiral Computed ; methods

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 compare the prevalence of tobacco advertisement before and after implementation of the new edition of Advertising Law of the People's Republic of China and evaluate the effects of implementation of the new Advertising Law. Methods · Tobacco sales places, public places, and streets in Shanghai were randomly selected to observe tobacco advertisement and complete the survey. The survey was carried out in 10 districts of Shanghai in June 2015 with 10 tobacco sales places selected in each district, and in 4 districts of Shanghai in June 2016 with 25 tobacco sales places selected in each district. Sales places included convenient stores, tobacco stores, supermarkets, and kiosks. In addition, public transport waiting points, public transport vehicles, hospitals, shopping centers, restaurants, bars, and Internet cafes were selected into survey in 2016. Results · In 2016, the proportion of tobacco sales places having tobacco advertisement was lower than that in 2015, but the proportion of tobacco promotion behaviors was higher. In 2016, 128 public places and streets were investigated and only 1 had outdoor tobacco advertisement. Conclusion · The new edition of Advertising Law has significant effect on controlling tobacco advertisement, but tobacco sales places still have tobacco advertisement with various disguised promotion forms. Tobacco sales places have diversified business styles and minors often enter these places. It is recommended that a clear definition of disguised forms of tobacco advertisement should be made, tobacco advertisement at tobacco sales places needs to be supervised, the release of tobacco advertisement should be strictly reviewed, and existing tobacco advertisement should be severely punished, so as to prevent minors from exposing to tobacco advertisement and information luring smoking.

Objective To explore the relationship between preoperative serum pro-adrenomedullin (pro-ADM) in the patients with closed rupture of small intestine,and postoperative secondary abdominal infection,and to study the value of postoperative serum pro-ADM in assessment of severity of postoperative secondary abdominal infection of this patients.Methods Eighty-five patients with closed rupture of small intestine treated in the emergency surgery from June 2014 to May 2015 were selected.According to the presence of postoperative abdominal infection or not,these patients were divided into infection group and non-infection group.The infection group was further divided into SIRS,sepsis,severe sepsis,septic shock subgroups as per the severity of infection.The levels of serum pro-ADM,interleukin-6 (IL-6),C-reactive protein (CRP) were determined and the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was calculated at admission and the first day、the second day and the third day after operation.Comparisons of these biomarkers were carried out to find out the factors associated with postoperative abdominal infection.In addition,ROC curve was used to verify the factors for predicting the abdominal infection of these patients after operation.The relationship between serum levels of pro-ADM and APACHE Ⅱ score after operation was analyzed.The severity of abdominal infection after operation was assessed with laboratory findings.Results Compared with non-infection group,preoperative and postoperative serum pro-ADM (P =0.03,P ＜ 0.01),IL-6 (P =0.02,P ＜0.01) levels and APACHE Ⅱ scores (P ＜ 0.01,P ＜ 0.01) were significantly higher in infection group (P ＜ 0.05).In the infection groups,the postoperative levels of serum pro-ADM and APACHE Ⅱ scores were increased with the severity of infection increased (r =0.924),and the difference between the groups was statistically significant (P ＜ 0.05),but there were no significant differences in IL-6 and CRP levels between two groups.Conclusion (1) The serum levels of pro-ADM before operation has value in predicting the genesis of abdominal infection in these patients after operation.(2) The serum levels of pro-ADM after operation has value in severity assessment of abdominal infection in these patients after operation.

Objective To investigate the effects of fracture displacement and operation method on perioperative blood loss of femoral neck fractures. Methods From December 2013 to October 2014, 130 cases (58 males and 72 females, aged from 18 to 91 years, with an average age of 71.1±12.9 years) with femoral neck fractures were retrospectively analyzed for the periopera?tive blood loss. The degree of displacement was described according to Garden's grades. According to the degree of fracture dis?placement, the patients were divided into two groups:GardenⅠ-Ⅱgroup and Garden Ⅲ-Ⅳgroup, and patients' preoperative hidden blood loss was compared between two groups. According to the degree of fracture displacement and the method of opera?tion, the patients were divided into four groups:Group 1 indicates the group in which patients received cannulated screws fixation for Garden gradeⅠ-Ⅱ;Group 2 in which patients received hemiarthroplasty for Garden gradeⅠ-Ⅱ;Group 3 in which patients received cannulated screws fixation for Garden grade Ⅲ-Ⅳ; Group 4 in which patients received hemiarthroplasty for Garden grade Ⅲ-Ⅳ; and variation in the following four parameters was analyzed: the dominant blood loss, postoperative hidden blood loss, total hidden blood loss, total blood loss in the four different groups. Results For the Garden gradeⅢ-Ⅳfemoral neck frac?ture group, the preoperative hidden blood loss was significantly higher than that of the Garden gradeⅠ-Ⅱfemoral neck fracture group (t=2.267, P=0.001). The dominant blood loss volume, postoperative hidden blood loss volume, total hidden blood loss vol?ume and total blood loss volume of hemiarthroplasty groups (402.1 ± 36.8 ml, 641.3 ± 53.2 ml, 880.7 ± 61.7 ml, 1 246.1 ± 76.7 ml) were higher than those of the cannulated screws fixation group (45.8±34.9 ml, 301.9±50.6 ml, 436.6±58.6 ml, 478.5±72.9 ml). Conclusion The perioperative hidden blood loss is mainly related with the degree of fracture displacement, the greater the de?gree of fracture displacement, the more the preoperative hidden blood loss. While the dominant blood loss volume, postoperative hidden blood loss volume, total hidden blood loss volume and total blood loss volume are mainly related to the method of operation, the blood loss in which patients received hemiarthroplasty should be increased significantly.

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.