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.

Ten compounds were isolated and purified by column chromatography over silica gel, preparative TLC, and Sephadex LH-20 from the whole plant of Solanum lyratum. The structures were elucidated on the basis of physico-chemical properties and spectral data as 1beta-hydroxy-1 ,2-dihydro-alpha-santonin (1) , boscialin (2) , blumenol C (3), 3beta-hydroxy-5alpha, 6alpha-epoxy-7-megastigmen-9-one(4), dehydrovomifoliol(5) , blumenol A(6), (1'S,2R,5S, 10R) -2-(1', 2'-dihydroxy-l1'-methylethyl) -6,10-dimethylspiro[4,5] dec-6-en-8-one(7) , (1'R,2R,5S,10R)-2-( 1',2'-dihydroxy-l '-methylethyl) -6,1 l0-dimethylspiro[4,5]dec-6-en-8-one( 8) , 2-(1',2'-dihydroxy-1 '-methylethyl) -6,1 0-dimethyl-9-hydroxyspiro [4,5] dec-6-en-8-one (9) , and grasshopper ketone (10). Compounds 1-10 were isolated from this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; Solanum ; chemistry ; Terpenes ; analysis ; isolation & purification

Objective To study the effects of CBL teaching mode on treatment plan making process among orthodontic postgraduates. Methods Totally 42 junior and senior orthodontic post-graduates were randomly divided into 2 groups (21 per group)named as experimental group and test group. Each group was further divided in to 3 teams involved in CBL and traditional teaching. Six cases of the same type malocclusion were selected each time;after 4 teaching cycle,test scores of two groups were analyzed with SPSS 19.0. Results were shown as mean ± standard deviation and t test andχ2 test were applied to evaluate the rationality and accuracy of treatment plan made by students. Survey questionnaire were issued to teachers and students after class and the assessment results of CBL teaching mode were summed up. Results Test scores were (88.61±8.34)in experimental group and (76.13±8.59)in control group with significant differences (t=3.16,P=0.01). Pass rate of two groups were 96.12%and 87.51%with significant differences (χ2=4.76,P=0.02). During the first teaching program, accurate rates of experimental group and control group were respectively 31.00% and 36.70% and ra-tionality were 33.31%and 33.30%. During the second teaching program,accurate rates of experimen-tal group and control group were 68.80%and 45.70%and rationality were 62.72%and 43.37%. During the third teaching program,accurate rates of experimental group and control group were 89.70% and 51.20%,and rationality were 95.00% and 66.70%. During the fourth program,accurate rates of ex-perimental group and control group were respectively 97.80% and 55.30% and rationality were 98.30% and 75.60%. Conclusions CBL teaching mode is helpful to improve the students' ability of analyzing clinical cases and making more accurate and rational treatment plan,however the increasing teaching cost and the course load are also involved.

Objective To compare the difference of therapeutic effect of surgical operation and non-operation for acute damnification of elbow ulnar collateral ligament in rabbits.Methods A total of 81 New Zealand rabbits were randomly and equally divided into three groups(27 rabbits per group),ie,Group A(control group):the ulnar collateral ligaments of right elbow joint were only enclosed;Group B:the ulnar collateral ligaments of right elbow joint were severed and sutured;Group C:the ulnar collateral ligaments of right elbow joint were severed,without suture.The biomechanics was detected at time intervals of 3 and 6 weeks.Results Twelve weeks after transplantation,the displacements of the ligaments in Groups B and C were(6.06±0.4)mm and(7.72±0.44)mm,with statistical difference(P ＜ 0.05).The displacement of the ligaments in Group A was(5.87±0.46)mm,which was similar to that of Group B(P＞0.05).The maximum loads of the ligaments of Groups B and C were(68.23±5.64)N and (42.45±3.66)N respectively,with statistical difference(P＜0.05).The maximum load of the ligaments of Group A was(72.86±2.99)N,which was similar to that of Group B(P ＞ 0.05).The rigidities of the ligaments of Groups B and C were(11.33±1.52)N/mm and(5.52±0.67)N/mm respectively,with significant difference(P ＜ 0.05).The rigidities of the ligaments of Group A was(12.49±1.44)N/mm,which was similar to that of Group B(P ＞ 0.05).The power consumption of the ligaments of Groups B and C were(0.206±0.017)J and(0.163±0.013)J respectively,with statistical difference(P＜0.05).The power consumption of the ligaments of Group A was(0.213±0.010)J,which was similar to that of Group B(P＞0.05).Conclusion Surgical operation is more effective than the non-operation in dealing with acute damnification of the ulnar collateral ligaments of elbow ulnar collateral ligament in rabbits.

Arrhythmogenic Right Ventricular Dysplasia ; diagnosis ; therapy ; Child, Preschool ; Diagnostic Errors ; Fatal Outcome ; Female ; Humans

Objective To evaluate the outcome of dorsal double locking compression plate (LCP) in treatment of stretched unstable distal radial fractures.Methods Fourteen cases of stretched unstable distal radial fractures were treated by reduction and internal fixation using straight or L-shaped anatomic LCP via dorsal approach.Wrist functional exercise was conducted immediately after operation.Follow up was made after operation to assess motion pain,functional score of wrist,and complication incidence at postoperative 12 weeks,24 weeks,and 1 year.Results Follow-up was lasted for 5-24 months.At postoperative 12 weeks,24 weeks and 1 year,mean visual analogue scale (VAS) was (1.88 ±0.26) points,(0.87 ± 0.14) points and (0.37 ± 0.06) points respectively and wrist functional score (Gartland-Werley score) was (6.45 ± 1.72) points,(2.73 ± 0.52) points and (2.10 ± 0.31) points respectively.According to Garfland-Werley score in the latest follow-up,the results were excellent in 10 cases,good in two,and fair in two.Besides,one case was combined with myotenositis of extensor pollicis longus muscle tendon and another case with myotenositis of extensor tendon.Conclusion Dorsal double LCP is one of the effective methods for stretched unstable distal radial fractures that can reconstruct anatomical structure of the wrist efficiently and attain satisfactory functional recovery,with no obvious pain.

By means of preparative HPTLC and column chromatography over silica gel and Sephadex LH-20, nine diterpenoids were isolated and purified from the whole plants of Scutellaria strigillosa. Based on the physico-chemical properties and spectral data, their structures were elucidated as: 6-O-acetyl-7-O-nicotinoylscutebarbatine G(1), 6-O-nicotinoyl-7-O-acetylscutebarbatine G(2), 6,7-di-O-nicotinoylscutebarbatine G(3), scutebarbatine K(4), scutebarbatine B(5), 6-O-acetylscutehenanine A(6), 6-O-nicotinoylbarba- tin A(7), 6,7-di-O-acetoxylbarbatin A(8), scutebarbatine F(9). Compound 1 is a new diterpenoid, and compounds 2-9 were isolated from Scutellaria strigillosa for the first time.
Diterpenes ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Scutellaria ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective:To retrospectively analyze the early mortality and related risk factors in adult patients with maintenance hemodialysis (MHD).Methods:Adult MHD patients from 2008 to 2018 were enrolled and divided into training data group and validation data group. In training data group, multivariate logistic regression was used to analyze the risk factors of early death within 120 days after hemodialysis and establish a prediction model. The receiver operating characteristic (ROC) curve was applied to evaluate the prediction ability of the model.Results:A total of 4 885 patients were included. The cumulative mortality within 120 days was 20.97/100 person years, and that within 365 days was 12.25/100 person years. A total of 3 603 patients in the training data group were analyzed. The following risk factors were correlated with early mortality (all P<0.05), including age at start of dialysis over 60 years old ( OR=1.792), non-chronic glomerulonephritis ( OR=2.214), cardio-cerebrovascular disease ( OR=2.695), plasma albumin less than 35 g/L ( OR=1.358), platelet count less than 120×10 9/L ( OR=2.194), serum creatinine less than 600 μmol/L ( OR=1.652), blood urea nitrogen over 30 mmol/L ( OR=1.887), blood phosphorus less than 1.13 mmol/L ( OR=1.783), pulse pressure over 55 mmHg(1 mmHg=0.133 kPa) ( OR=1.656), low density lipoprotein less than 1.5 mmol/L ( OR=1.873), and blood calcium over 2.5 mmol/L ( OR=1.876). Risk prediction model was established. The other 1 282 cases in the validation data group were verified. The area under ROC curve was 0.810, with sensitivity 85.7%, and specificity 62.5%. Conclusion:The mortality rate of adult MHD patients within 120 days after dialysis is high. The established prediction model can effectively predict the risk of early death.

ObjectiveTo investigate the application of rapid immunohistochemical staining technique in intraoperative frozen section diagnosis of thyroid neoplasm.Methods MaxVision one-step rapid immunohistochemical staining technique was used to detect the expression of CK19,HBME-1,and Gal-3 in frozen section of papillary thyroid carcinoma(PTC)andthyroid benign lesions.MaxVision conventional immunohistochemistry of frozen remaining tissue was served as control.ResultsMaxVision one-step rapid immunohistochemical staining technique could be completed in 20 minutes.The positive localizations of three markers detected by rapid immunohistochemistry were similar to conventional immunohistochemistry, in general.The expression of CK19 was located in cytoplasm and cellular membrane.Gal-3 and HBME-1 were mainly detected in follicular luminal border and/or surface of papilla. The staining intensity in rapid immunohistochemistry was stronger than that in conventional immunohistochemistry. The positive rates of CK19,HBME-1,and Gal-3 by rapid immunohistochemistry in frozen sections were: 0 (0/28),10.7 ％ (3/28),0 (0/28),respectively,for benign lesions (nodular goiter,Hashimoto thyroiditis,thyroid adenoma); and 94.9 ％(37/39),92.3 ％ (36/39),92.3 ％ (36/39),respectively,for PTC.The expression of three markers between thyroid benign lesions and PTC had a significant difference (x2 =59.326,55.861,44.605,all P ＜ 0.001).In benign lesions,the rate of same case with two and more positive markers was 0,while in PTC it was 100 ％ and significantly different (x2 =67.000,P ＜ 0.05).ConclusionMaxVision one-step rapid immunohistochemical staining technique could be applied in intraoperative frozen section diagnosis.Detecting CK19,HBME-1,and Gal-3 expression in intraoperative frozen section has an auxiliary value for diagnosis of PTC.

Objective To evaluate the efficacy of the treatment of hilar biliary malignant obstruc tion with multiple stent drainage.Methods One hundred and twenty-seven patients with malignant biliary hilar obstruction were enrolled.The obstructions at the common hepatic duct within less than 1 cm to the junction of the left and the right hepatic duct were found in 66 cases,at the proximal common hepatic duct and the left and the right hepatic ducts in 45 cases,at the right hepatic duct in 5 cases and at the both left and right hepatic duets in 11 cases.Sixty-six patients received stent placement through the right biliary ducts and the common bile duct by puncturing the right mid-axillary line.The other 37 patients received 2 stents placement (disposed"Y"style) through the left and the right hepatic duct punc turing routway.Seven patients received 2 stents placement (disposed"┌"style) through the right hepatic duct and the common bile duct with a stent placed between the left and the right hepatic duct.Three patients had right hepatic duct stent placed first,followed by right hepatic duct and common hepatic duct stent. Twelve patients had stents placed in the right hepatic duct with external drainage from the left hepatic duct. Two patients had multiple strictures at the right hepatic duct,who got multiple external drainages.The total serum bilirubin levels were measured pre-and post-operatively.Results One hundred and twenty-seven patients with bi[iary obstraction had internal stents placed for drainage.The average total bilirubin levels among 121 patients were (283.4?175.4 )?mol/L pre-operation and (63.2?11.8)?mol/L post-operation (P