Acid sphingomyelinase (aSMase) is an important enzyme in sphingolipid metabolism. Studies concerning the relationship between aSMase and tumor are relatively rare. However, the relationship between aSMase and the development and progression of tumors has already been demonstrated in previously published research. In this review, the mechanism of aSMase activation and the role of aSMase in the development and progression of tumors as well as its application value are summarized. Copyright © 2012 by TUMOR.

Objective To investigate the hygienic quality of drinking water in rural areas of Xiamen and to provide scientific bases for the improvement of drinking water quality and protection of human health.Methods The well water samples were sampled randomly according to the proportion and the water quality was analysed and the incidences of water-borne diseases were investigated in Xiamen rural areas.Results Water sources for drinking water in most parts of Xiamen rural areas are shallow-layer ground-water.As being polluted by surface ranoff water,the indices of total bacte-rial count and coliform bacteria in the well water were heavily over the standard with the over standard rates61.6%and85.1%respectively.The contents of fluoride in drinking water were at the higher levels(the highest one was1.6mg /L)in some villages and still there were more villages where the iodine contents in drinking water was at the lower level.The iodine content in well water,spring water and tap water was11.1,2.5and4.45?g /L respectively,in which the unqualified rate was48.3%,90%and58.1%respectively.The incidence of dental fluorosis in school-age children was70%in the high fluoride areas and the incidence of endemic goiter was20.9%in the low iodine areas.Conclu-sion The main hygienic problem of drinking water in rural areas of Xiamen was biological pollution and lower iodine contents and higher fluoride contents in water in some areas.In order to eliminate the water-borne diseases,the most important rural sanitary measures need to be taken:improving the sanitary conditions around the wells,repairing the well wall s and using deep ground-water or drinking water and developing centralized water supply in the areas with unbal-anced health-related microelemeuts in drinking water if possible in some villages.

[Objective]To compare the neurological improvement of the patients with spinal cord injury without radiographic abnormality (SCIWORA)after primary treatment including operation via anterior/posterior approach and conservative management,and to discuss about evaluating standard for this kind of patients.[Method]Eighty adult cervical SCIWORA patients,72 males and 8 females with an average age of 52.7 years(34 to 74 years)and a follow up period of 53 weeks (48 to 60 weeks),were retrospectively studied. They were divided into the anterior operated,posterior operated and conservative treated groups. The motor and sensory scores and impairment scale of each patient were obtained at least three times by international standard for the neurological classification of spinal cord injury (ASIA standard),and those of their first and final visits to the hospital were retrieved and analyzed. Mann-Whitney U Test and Wilcoxon Rank Sum Test were used in statistic study.[Result]All the patients achieved an average increase of 2 to 5 points of motor scores (P

[Objective]To analyze the clinical characteristics and treatment methods of upper-middle thoracic fractures with spinal cord injury.[Method]Forty patients with upper-middle thoracic fracture were retrospectively reviewed.Hanley-Eskay classification was used:compression fractures in 4,burst fractures in 11,fracture-dislocations in 23,and burst dislocation in 2 cases.Neurologicall function(according to the ASIA classification):A in 29,B in 3,C in 4,D in 0,and E for 4 cases.Four cases without spinal cord injury received conservative treatment.Thity-six cases with spinal cord injury underwent laminectomy and reduction followed by posterior fusion with bone graft and pedicular screw instrumentation.All 36 cases received early rehabilitation.[Result]All 40 cases were evaluated clinically,radiographically,and functionally during the follow-up(mean,32 months).Conservative group:one case developed delayed kyphosis deformity with neurological deficit and underwent anterior-posterior surgical treatment 16 months tater.Surgical group:the correction in 3 patients was not complete on radiographs after operation.No loose screw or breakage was found,and the grafted bone was completely fused.Among the patients with spinal cord injury,one case in ASIA A improved to ASIA B,one case in ASIA B improved to ASIA C,two cases in ASIA C improved to ASIA D.All of the 4 cases with hemorrhage less than 4 mm(MIRI) increased 1 grade of ASIA.Activities of daily living(ADL)scores were increased (average,22.53?6.25)at early rehabilitation in all cases.[Conclusion]The upper-middle thoracic fractures are involved in multipla spine vertebral levels,high dislocation incidence,serious spinal cord injury(most cases were complete injury),poor prognosis.Presence of hemorrhage less than 4 mm (MRI) was associated with good prognosis.Posterior approach decompression and reduction followed by fusion with bone grafting and pedicle screws instrumentation are ideal surgical methods for patients with fresh fractures.Early rehabilitation may improve daily life ability and prevent complications.

Objective: To explore the effect of artesunate (Art) on Akt/GSK-3β/β-catenin signal pathway.Methods: Art at different concentrations (0, 12.5, 25, 50 μg·ml-1) was used to treat human hepatic stellate cells (LX-2), and CCK-8 assay was used to detect the cell proliferation to determine the optimal concentration.Art inhibitor (MK-2206) at different concentrations (0~8 μmol·L-1) was given to LX-2 cells, and a Western Blot method was applied to determine the optimal inhibition concentration.Art, MK-2206 and MK-2206+Art were respectively given to LX-2 cells, and a Western Blot method was used to detect the levels of Akt, p-Akt, GSK-3β, p-GSK-3β and β-catenin proteins.Results: CCK-8 assay was used to detect the cell survival rate, and the survival rate was 80% after the 24-hour treatment with 25 μg·ml-1 Art.The results of Western Blot showed that MK-2206 at 6 μmol·L-1 could effectively inhibit the expression of p-Akt.Compared with those of the control group, the levels of Akt, p-Akt, p-GSK-3β and β-catenin protein were significantly different (P＜0.05) in Art (25 μg·ml-1) group, MK-2206 (6 μmol·L-1) group and MK-2206 (6 μmol·L-1) + Art (25 μg·ml-1) group.The expression of GSK-3β and Akt in MK-2206+Art group had no significant difference when compared with that in Art group and MK-2206 group (P＞0.05), while the levels of p-Akt, p-GSK-3β and β-catenin were significantly reduced (P＜0.01).Conclusion: Art exhibits the influence on the relative factors in Wnt/β-catenin signal pathway by Akt/β-catenin, subsequently inhibits the cell proliferation and alleviates the liver fibrosis process.

Objective To explore the moves that creating magnetic work environment in hospital, in order to improve the nurses job satisfaction and reduce the turnover rate then stable the nursing team. Methods Through a series of measures such as the establishment of scientific rational allocation of human resources, implementing fair performance evaluation and allocation mechanism, carrying out the nurse grading management system to create magnetic nursing work environment, the nurse job satisfaction and turnover rate were compared before and after the measures. Results In January 2014 a total of 520 questionnaireswere issued, 519 valid questionnaires, and the effective recovery rate was 99.81%(519/520);And 559 were valid of 577 issued questionnaires, which was 96.88% (559/577). The overall score of nurses′job satisfaction increased from (3.20±0.46) points in 2013 to (3.41±0.52) points in 2014 (t=9.40, P= 0.000); The nurse turnover rate fell to 1.97%(13/661) from 5.13% (30/585) (χ2= 10.27, P= 0.003). Conclusions That is very important for remain stable and high quality nursing team to carry out scientific and fine management according to the demand of nurses, so as to create a safe, harmonious, positive, cooperative magnetic nursing work environment which have development direction and space.

Objective:To analyze therapeutic effect of rosuvastatin on inflammatory factor levels ,insulin resistance (IR) and vascular endothelial function in patients with hypertension complicated dyslipidemia .Methods:A total of 136 outpatients with hypertension complicated dyslipidemia were selected .According to random number table ,they were divided and equally into routine treatment group (received routine therapy ) and rosuvastatin group (received rosuvastatin based on routine treatment ) .Serum levels of C reactive protein (CRP) ,interleukin‐6 (IL‐6) and IL‐8 , IR and vascular endothelial function were compared between two groups before and after treatment .Results:Com‐pared with before treatment ,there were significant reductions in serum levels of CRP ,IL‐6 and IL‐8 ,homeostasis model‐insulin resistance index (HOMA‐IR) and number of endothelial microparticles (EMPs) ,significant rise in in‐sulin sensitivity index (ISI) and flow‐mediated dilation of brachial artery (FMD) after treatment , P< 0.05 all . Compared with routine treatment group ,there were significant reductions in serum levels of CRP [ (67.27 ± 7.51) mg/L vs .(37.11 ± 6.32) mg/L] ,IL‐6 [ (87.58 ± 7.21)μg/L vs .(60.17 ± 5.45)μg/L] and IL‐8 [ (121.31 ± 8.57)μg/L vs .(84.44 ± 5.21)μg/L] ,HOMA‐IR [ (3.08 ± 0.51) vs .(2.31 ± 0.47)] and number of EMPs [ (852.18 ± 115.37) /μl vs .(573.29 ± 72.18)/μl] ,and significant rise in ISI [(-4.39 ± 0.61) vs .(-3.42 ± 0.53)] and FMD [ (4.35 ± 0.52)% vs .(5.82 ± 0.69)% ] in rosuvastatin group after treatment ,P<0.05 all .Conclusion:Rosuvasta‐tin could reduce inflammatory factor levels ,relieve insulin resistance and improve vascular endothelial function in patients with hypertension complicated dyslipidemia .

Objective To explore the patients satisfaction with participation in medical and nursing decision making and the influencing factors among cancer patients, and to provide a basis for developing better medical care services. Methods Totally 159 cancer patients were recruited from Beijing Cancer Hospital, and then were investigated with the general information questionnaire, the patients′ expectation for participation in clinical decision making scale, the patients′ competence for participation in clinical decision making scale, and the patients′satisfaction with participation in medical and nursing decision making questionnaires. Results The total score of patients′satisfaction with participation in medical and nursing decision making were (45.92±3.91) and (34.25±3.31) respectively. Compared with female patients, male patients had higher satisfaction with medical decision making (46.45±3.24&44.87±4.84) and nursing decision making (34.68 ± 2.93&33.42 ± 3.84) (t=2.416, P=0.017;t=2.275, P=0.024);and compared with melanoma patients, lung cancer patients had higher satisfaction with medical decision making (46.51 ± 2.69&43.33 ± 7.07, P=0.002);compared withⅢstage patients, Ⅳstage patients had higher satisfaction with nursing decision making(34.97±2.24&32.40±4.56, P<0.01). Meanwhile, the satisfaction with participation in decision making was significantly positively associated with patients′ expectation and competence for participation in clinical decision making. Conclusions Patients′satisfaction for decision making may vary from different gender, tumor types, disease stages, and patients′expectation and competence. Health care providers still further strength patients′ knowledge and initiative of decision making, and then improve patients′satisfaction with participation in decision making.

ObjectiveTo investigate the husband and wife psychological and behavioral intervention on high-risk pregnant women,pregnancy outcome and negative emotions.Methodsin line with the number of highrisk pregnancy diagnostic criteria for pregnant women into the group of order packets were completed by the clinical observation of high-risk pregnant women in the intervention group (A) 31 cases,32 cases of high-risk pregnant women in the control group (group B),spouses of pregnant women in the intervention group (Group C) 31 spouses of pregnant women in the control group ( group D).Pregnant women in group A and group B underwent outpatient conventional high-risk pregnancy management,group A,group C received 16 weeks of husband and wife jointly participate in the key psychological problems,negative emotion coping skills to learn,couples communication skills,learning,family and social support operations,rehabilitation and faith strengthening and other intervention as the core content.Quality delivery of newborns,asphyxia,anxiety and depression in pregnant women and their spouses before and after intervention the overall incidence of anxiety and self-assessment scale(SAS) score,the score of the Self-Rating Depression Scale (SDS),the Family APGAR Index Questionnaire score (observation of high-risk pregnancy APGAR) and other changes.ResultsThe average body weight of newborns:the intervention group A (3.12 ± 0.69) kg,than in group B (2.29 ± 0.78) kg,a statistically significant difference ( t =2.3148,P =0.024) ;asphyxia:group A was 12.9％ and 34.4％ in group B,the difference was statistically significant (x2 =4.0018,P=0.0455) ;natural birth rate:58.1％ in group A,group B 25％,a statistically significant difference (x2 =7.1023,P=0.0077) ;the rate of cesarean section:29.0％ in group A,group B,59.4％,a statistically significant difference ( x2 =5.8713,P =0.0154 ) ; anxiety and depression in pregnant women:the total incidence after the intervention group A was 19.4％,46.9％ in Group B,the difference was significant (x2 =5.3664,P=0.0205) ;maternal spouse anxiety and depression:in the overall incidence of A group of 9.7％ after the intervention group B 31.2％,the difference was statistically significant (x2 =4.4745,P =0.0344 ) ;APGAR score:after the intervention of high-risk pregnant women in group A (9.42 ± 1.53),Group B (7.71 ± 1.56),group A better than group B,the difference was statistically significant ( t =4.3910,P =0.000),intimacy,emotional degree,the growth degree,cooperation degree,adapt to the degree of five factor scores in group A than group B,a statistically significant difference (P ＜ 0.05,P ＜ 0.01 ).ConclusionHigh-risk pregnant women and their spouses have a severe negative emotional reaction,the husband and wife psychological and behavioral intervention on the improvement of high-risk pregnant women,pregnancy outcome and negative emotions have an important role.

Objective To investigate the relationship between the non-homonymy single nucleotide polymorphism(SNP)of C19170G,C30799G in the coding area of class Ⅱ transaetivator(CII TA)and the different clinical phenotypes of chronic hepatitis B virus(HBV)infection.Methods Six hundred and twenty-seven patients with chronic HBV infection and 101 healthy blood donors were enrolled in this study.Genotyping of C19170G,C30799G in C Ⅱ TA gene coding region were done by sequence-specific primer polymerase chain reaction(PCR-SSP).Hardy-Weinberg balance of the genotypes was analyzed using chi-square test.Differences between two sets were tested by contingency table chi-square test and unconditional Logistic regression was performed. Results The frequencies of G allele and GG+GC genetypes at 19170 site were significantly higher in patients with liver cirrhosis than those with non-progressive liver diseases(X2=7.128,P=0.008;X2=6.404,P=0.011,respectively).There were significantly differences of the allele frequencies between patients with liver cirrhosis and non-progressive liver diseases(OR:0.742,95%CI:0.552～0.998,P=0.048),and the main differences were observed in G dominant model(OR:0.581,95% CI:0.353～0.954,P=0.032).The frequencies of C allele and CC genotype at 30799 site were significantly higher in patients with hepatocellular carcinoma than those in patients with liver cirrhosis(X2=4.861,P=0.027;X2=4.993,P=0.025).There were significant differences of the genotype frequencies at 30799 site between patients with liver cirrhosis and hepatocellular carcinoma(OR:0.557,95% CI:0.334～0.930,P=0.025),and the differences were mainly observed in C recessive model(OR:0.491,95% CI:0.269～0.898,P=0.021).Conclusions The polymorphisms at 19170 site are associated with liver cirrhosis in chronic HBV infection,and the G allele carriers are prone to progress into liver cirrhosis.The polymorphisms at 30799 site are associated with hepatocellular carcinoma in chronic HBV infection,and CC genotype carriers are prone to progress into hepatocellular carcinoma.