Glutamine provides carbon and nitrogen to support the proliferation of cancer cells. However, the precise reason why cancer cells are particularly dependent on glutamine remains unclear. In this study, we report that glutamine modulates the tumor suppressor F-box and WD repeat domain-containing 7 (FBW7) to promote cancer cell proliferation and survival. Specifically, lysine 604 (K604) in the sixth of the 7 substrate-recruiting WD repeats of FBW7 undergoes glutaminylation (Gln-K604) by glutaminyl tRNA synthetase. Gln-K604 inhibits SCFFBW7-mediated degradation of c-Myc and Mcl-1, enhances glutamine utilization, and stimulates nucleotide and DNA biosynthesis through the activation of c-Myc. Additionally, Gln-K604 promotes resistance to apoptosis by activating Mcl-1. In contrast, SIRT1 deglutaminylates Gln-K604, thereby reversing its effects. Cancer cells lacking Gln-K604 exhibit overexpression of c-Myc and Mcl-1 and display resistance to chemotherapy-induced apoptosis. Silencing both c-MYC and MCL-1 in these cells sensitizes them to chemotherapy. These findings indicate that the glutamine-mediated signal via Gln-K604 is a key driver of cancer progression and suggest potential strategies for targeted cancer therapies based on varying Gln-K604 status.
Glutamine/metabolism* ; Myeloid Cell Leukemia Sequence 1 Protein/genetics* ; Humans ; Proto-Oncogene Proteins c-myc/genetics* ; Cell Proliferation ; Signal Transduction ; Neoplasms/pathology* ; F-Box-WD Repeat-Containing Protein 7/genetics* ; Cell Survival ; Cell Line, Tumor ; Apoptosis

Patient participation in patient safety serves as one of the objectives in patient safety management, and as a priority research area in patient safety, bearing critical importance in ensuring patient safety, and reducing or avoiding medical adverse events. Children′s Hospital of Fudan University has made active explorations to promote patients in patient safety by inviting patient participation. The measures taken include empowering the child patient families and encouraging their proactive awareness and involvement, especially in establishing an advisory council of child patient parents as a platform for patient participation in patient safety. The research found that as a doctor-patient communication and collaboration platform, the council proves highly effective. It can optimally integrate child patient families, medical institutions, and third-party supervisors, making worthy contributions to discovering patient safety hazards, improving patient safety issues, and promoting patient participation in patient safety.From patient perspectives, the council plays an important role in awareness advocating, suggestions, and communication assistance. At the same time, the three-level participation of the council provides new horizons for encouraging participation awareness of patients, broaden channels of participation and capabilities of patient participation.

AIMTo discuss the merits of "tubes treatment" for esophageal fistula (EF).

METHODSA 66-year-old female who suffered from a bronchoesophageal and esophagothoratic fistula underwent a successful "three tubes treatment" (close chest drainage, negative pressure suction at the leak, and nasojejunal feeding tube), combination of antibiotics, antacid drugs and nutritional support. Another 55-year-old male patient developed an esophagopleural fistula (EPF) after esophageal carcinoma operation. He too was treated conservatively with the three tubes strategy as mentioned above towards a favorable outcome.

RESULTSThe two patients recovered with the tubes treatment, felt well and became able to eat and drink, presenting no complaint.

CONCLUSIONTubes treatment is an effective basic way for EF. It may be an alternative treatment option.

Aged ; Chest Tubes ; Combined Modality Therapy ; Drainage ; instrumentation ; methods ; Enteral Nutrition ; methods ; Esophageal Fistula ; Female ; Humans ; Intubation, Intratracheal ; methods ; Male ; Middle Aged ; Suction ; instrumentation ; methods ; Treatment Outcome

OBJECTIVE: To observe the changes and significance of plasma CD40L and pregnancy-associated plasma protein-A (PAPP-A) in acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI) operation. METHODS: According to the occurrence of primary heart events or restenosis 6 months after the PCI, 68 patients were divided into the ACS group and the stable angina pectoris (SAP) group. Plasma CD40L and PAPP-A after the PCI operation were measured and compared. Thirty-six patients underwent repeated angiography after the PCI. Their baseline and follow up angiograms were compared by quantitative coronary angiography to assess the incidence of restenosis. RESULTS: CD40L and PAPP-A after the PCI operation were higher in the ACS group than that in the SAP group.The group having primary heart events within 6 months had higher level of PAPP-A after the PCI. The group having restenosis 6 months had higher level of PAPP-A after the PCI. The change of later loss index of coronary artery lumen diameter was correlated with PAPP-A level after the PCI. CONCLUSION CD40L and PAPP-A were higher in the ACS group, indicating the possible mechanism by which CD40L facilitates the plaque rupture via up-regulating the PAPP-A expression.Plasma PAPP-A level after the PCI possibly for cases the occurrence of primary heart events or restenosis within 6 months.
Acute Coronary Syndrome ; blood ; therapy ; Adult ; Aged ; Aged, 80 and over ; Angina, Stable ; blood ; CD40 Ligand ; blood ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Postoperative Period ; Pregnancy-Associated Plasma Protein-A ; metabolism

The Doctor Practical Technique Test is one of the two important parts in the Doctor Qualification Tests.The article expounds its importance and complication as well as how to grasp each point of the test.It also makes a statistic analysis of its test results in Chongqing,the feedback information of which will be an enlightenment and help to the reforms in medical education and the standarlized training of clinical residents.