Sphingosine kinase (SphK), sphingosine-1-phosphate (S1P) and S1P receptor (S1PR) are involved in the tumor biological processes such as tumor cell proliferation and migration, and play an important role in the development of cancer. In recent years, researchers have increasingly focused on the interaction between cancer cells and the tumor microenvironment. The tumor microenvironment is genetically stable and can be induced to an antitumor phenotype, which has significant therapeutic advantages. Studies have shown that SphK/S1P/S1PR can regulate multiple aspects of the tumor microenvironment. This review summarizes the effects of SphK and S1P/S1PR signaling on the tumor microenvironment from four perspectives: tumor immune microenvironment, cancer associated fibroblasts, tumor angiogenesis and tumor hypoxic microenvironment, and also outlines potential drug research related to these signal molecules, aiming to elucidate the role of SphK/S1P/S1PR in tumor occurrence and development and provide new ideas for the research of anti-tumor drugs.

OBJECTIVETo observe the outcome after sacral canal injection in patients with disc herniation associated with without sciatica.

METHODSFrom December 2010 to June 2011, 65 patients with acute low back pain without sciatica due to lumbar disc herniation or bulging confirmed by CT or MRI were randomly divided into sacral canal injection group (experimental group) and lumbar oblique wrench group (control group): the experimental group had 35 cases, including 30 males and 5 females, with an average age of (43.90 +/- 1.14) years old ranging from 33 to 56 years old. The control group had 30 cases, including 27 males and 3 females,with an average age of (44.00 +/- 1.19) years old ranging from 34 to 57 years old. The course of morbidity was 1 to 3 days. All patients received sacral canal injection or lumbar oblique wrench method. The visual analog scale (VAS) scores before and at 30 min after treatment were compared between two groups.

RESULTSThe symptom of acute low back pain were relieved obviously. The average VAS scores before and after treatment in experimental group were decreased from 6.63 +/- 0.97 to 3.06 +/- 1.51,in control group were from 6.67 +/- 0.96 to 3.93 +/- 1.20 respectively. These two methods could improve the VAS score,but the effect of sacral canal injection group was better than that of lumbar oblique wrench group, there was statistically differences (P < 0.05).

CONCLUSIONIt is effective that the methods of sacral canal injection and lumbar oblique wrench applied to patients with acute low back pain without sciatica due to lumbar disc herniation or bulging confirmed, the former has better effect.

Adult ; Female ; Humans ; Injections, Spinal ; Intervertebral Disc Displacement ; drug therapy ; Lidocaine ; administration & dosage ; Lumbar Vertebrae ; Male ; Middle Aged ; Prednisone ; administration & dosage ; Sacrococcygeal Region ; Visual Analog Scale

Objective To evaluate the risks of vaccination operation in order to provide scientific basis for policy makings of vaccination operation.Methods The risk matrix and analytic hierarchy process approach were used to evaluate the risks of vaccination operation,including the possibility,severity,risk weight,and risk level.Results Seven items for the first level and thirty one items for the second level vaccination risk factors were determined.In the first level,E level risk (Extremely serious risk ) was vaccination implementation risk,and H level risk (high risk ) was the risks of pre -notification and health education and risks of vaccine and cold chain management.Vaccination implementation risk accounted the largest weight (weight coefficient=38.95%).In second level,E level risk was three inspection and seven verification before vaccination,and H level risk were personnel professional quality,personnel responsibility,pre -inspection,informed before vaccination, vaccination route, site and dose, vaccination operation, post vaccination notification and retention,and three inspection and seven verification before vaccination,accounted the largest weight (weight coefficient=10.14%).The weight of the logical consistency of the test results were satisfactory (consistency ratio<0.1 ).Conclusion The integrated application of risk matrix and analytic hierarchy process in risk assessment of vaccination operation helps to further regulate vaccination services and has application and promotion value.

BACKGROUNDBenign prostate hyperplasia is one of the most common diseases affecting the health of the aging males. Watchful waiting is an acceptable management strategy for benign prostate hyperplasia in which the patient is monitored by the physician but receives no active intervention. The epidemiological data on this are lacking in China. Our study was designed to evaluate the changes of signs and symptoms of patients with benign prostate hyperplasia during management by watchful waiting in China.

METHODSOne hundred and forty-five patients with benign prostate hyperplasia aged > 50 years were enrolled in management by watchful waiting. All the patients were visited every 6 months and were given an International Prostate Symptom Score and Quality of Life questionnaire to complete. They also had uroflowmetry and were assessed using ultrasonography to get the volume of prostate, transition zone and amount of residual urine. The Student's t test, the Chi-square test, and variance analysis were used in the statistical analysis.

RESULTSAll patients were visited after 6 months, the mean volume of transitional zone was found to have increased by 1.6 ml (P < 0.01), International Prostate Symptom Score was increased by 0.8 (P < 0.01) and Quality of Life was increased by 0.2 (P < 0.01), and there was no statistical change in other data. Among these patients, 17.9% (26/145) visited again after 12 months when the data failed to show a statistically significant difference among the three groups (0, 6, and 12 months).

CONCLUSIONSAfter one year's follow-up, the progression of benign prostate hyperplasia was slow and the clinical data did not undergo much change.

Aged ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; psychology ; therapy ; Quality of Life

OBJECTIVESTo investigate the level of AIDS knowledge among people concerned in Nanjing city in order to provide scientific evidence and constructive suggestions for the government to formulate relevant policies for AIDS control.

METHODSThree sets of questionnaires on AIDS knowledge were designed, the scores calculated, and the results evaluated.

RESULTSOf the 2,500 questionnaires issued to 4 different groups of people, 2,436 were collected back with effective answers, 991 from medical and health-related workers with the mean score of 58, 473 from college students with the mean score of 39.9, 524 from common city residents with the mean score of 42.3, and 448 from those working in high risk environment with the mean score of 47.

CONCLUSIONSThe level of AIDS knowledge among people concerned in Nanjing city was far below the requirement of the nation, especially among medical and health-related workers. Efforts must be made to raise the level of AIDS knowledge of people concerned so as to enhance the prevention and treatment of the disease.

Acquired Immunodeficiency Syndrome ; prevention & control ; Adolescent ; Adult ; China ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Risk Factors ; Surveys and Questionnaires

OBJECTIVETo discuss the mechanisms of electroacupuncture at "Neiguan" (PC 6) on p38 MAPK signaling pathway in rats with cardiac hypertrophy.

METHODSForty SD rats were randomly divided into four groups: a normal group, a model group, a model plus p38 MAPK inhibitor group, a model plus electroacupuncture group, ten rats in each group. The model rats were established by subcutaneous injection 3 mg/(kg x d) of Isoprenaline Hydrochloride; model plus p38 MAPK inhibitor group were injected 0.3 mg/(kg x d) of specific inhibitor SB 203580; model plus electroacupuncture group was treated by electroacupuncture at "Neiguan"(PC 6) with continuous-wave, 2 Hz and 1 mA for 20 minutes, once a day for 14 days. There was no treatment in other two groups. The contents of TNF-alpha and IL-1beta in heart tissue were detected by radioimmunoassay and the p38 MAPK, p-p38 MAPK by western blot.

RESULTSCompared with normal group, the contents of TNF-alpha, IL-1beta, p38 MAPK, p-p38 MAPK were significantly increased in model group (all P < 0.01). The contents of TNFalpha, IL-1beta, p38 MAPK, p-p38 MAPK were significantly decreased in model plus p38 MAPK inhibitor group and model plus electroacupuncture group, compared with model group, all P < 0.05; compared with normal group, P < 0.05, P < 0.01; but no significant difference between model plus p38 MAPK inhibitor group and model plus electroacupuncture group (P > 0.05).

CONCLUSIONElectroacupuncture at "Neiguan" (PC 6) can prevent the phosphorylation of p38 MAPK of myocardial hypertrophy, and the mechanism maybe adjust p38 MAPK signaling pathway by inhibiting the expression of TNF-alpha and IL-1beta.

Acupuncture Points ; Animals ; Cardiomegaly ; metabolism ; therapy ; Electroacupuncture ; Interleukin-1beta ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Tumor Necrosis Factor-alpha ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism

OBJECTIVE: To explore the value of transthoracic echocardiography (TTE) in transcatheter closure of atrial septal aneurysm (ASA) combined with secoundum-type atrial septal defect (ASD). METHODS: Fourteen patients (3 males and 11 females) who had ASA combined with secoundum-type ASD were diagnosed by TTE or transesophageal echocardiography. The ASA projected to the right atrium in all patients. The width of basilar part was 13 approximately 24 (18.5+/-3.9) mm, and the vertical extent was 7 approximately 11(9.7+/-1.8) mm. Ten patients combined with single hole ASD and 4 patients with multiple hole ASD. Blood shifting from the left atrium to the right atrium was displayed in color Doppler in all patients. All patients were treated by transcatheter closure under the guiding of X fluoroscopy and TTE, and examined with TTE during the follow-up. RESULTS: Transcatheter closure was successfully performed by 14 occluders in all patients. No residual shunt was detected immediately by TTE after the procedure in all patients. During the 6 approximately 12 month follow-up, no residual shunt or occluder shifting was found, the dimensions of the heart became normal in 11 patients (79%) and were significantly decreased in 4. CONCLUSION Transcatheter closure is feasible in patients with ASA combined with secoundum-type ASD, and extra attention must be paid to the specialty. TTE is very important in case selection before transcatheter closure, and it may be used to monitor and guide the procedure during transcatheter closure.
Adult ; Atrial Septum ; Balloon Occlusion ; methods ; Cardiac Catheterization ; Echocardiography ; Female ; Heart Aneurysm ; complications ; therapy ; Heart Septal Defects, Atrial ; complications ; therapy ; Humans ; Male ; Middle Aged ; Ultrasonography, Interventional ; Young Adult

The circadian clock is regulated at the molecular level by transcriptional-translational feedback loop of clock genes, which ensures that a variety of physiological processes have a-round 24 h circadian rhythms, including cell metabolism, cell proliferation, cell apoptosis and tumorigenesis, to maintain the homeostasis. Thus, the disturbance of circadian clock will disrupt homeostasis, causing various diseases, including neoplasm, metabolic syndrome, Parkinson's disease, COPD and cardiovascular diseases. Disturbance of circadian clock is closely related with tumorigenesis, and acts on various molecules and pathways leading to tumorigenesis, including oncogene and tumor suppressor gene, cell cycle, metabolic reprogramming, immune escape, endocrine disruption, alteration of gastrointestinal microbiome. This review focuses on changes in clock genes expression which disrupt cell cycle and may play a role in tumorigenesis, and epi-geneties, an important way to regulate gene expression, which can alter clock gene expression, thus playing an important role in the process of " the alternation of clock gene expression-disruption of cell cycle-tumorigenesis".

Objective To investigate the influence of mild hypothermia on the apoptotic protease activating factor-1 (Apaf-1) protein expression in the hippocampal CA1 area and learning and memory functions of rats after diffuse brain injury (DBI). Methods Forty-eight male Wistar rats were equally randomized into normal group, sham-operated group, brain injury group and mild hypothermia treatment group (n=12). Rats in the normal group did not receive any treatment; rats in the sham-operated group only received anesthesia, and incision and suture of scalp; rats in the brain injury group and mild hypothermia treatment group were induced the DBI models according to Marmarou method; and rats in the mild hypothermia treatment group were performed hypothermia with ice blanket and ice bag to control the rectal temperature within 30.0-31.0 ℃ for 2 h. After DBI for 2 weeks, the times of searching refuge platform and the protein expression of Apaf-1 were compared among the 4 groups. Results The times of searching refuge platform in the normal group, sham operated group, brain injury group and mild hypothermia treatment group were (10.1 ±1.9), (10.3±1.8), (3.8±2.3) and (6.9±1.1), respectively,with significant differences between each 2 groups (P<0.05). The protein expression of Apaf-1 in the brain injury group and mild hypothermia treatment group was obviously higher than that in the other groups (P<0.05), and significantly lower protein expression of Apaf-1 in the mild hypothermia rats was noted as compared with that in the brain injury rats (P<0.05). Conclusion Mild hypothermia might play a protective role by inhibiting neuronal apoptosis for rats with DBI through the Apaf-1 pathway,which can improve learning and memory abilities.

OBJECTIVETo evaluate the efficacy and safety of gonadotropin-releasing hormone analogue (GnRHa) triptorelin 11.25 mg 3-month sustained release formulations in the treatment of metastatic prostate cancer.

METHODSFrom January 2004 to March 2006, a randomized, parallel-controlled, multicenter clinical trial was conducted. One hundred and twenty-seven patients with documented metastatic prostate cancer were randomized to receive one injection of the 11.25 mg formulation triptorelin (n = 65) or three injections at 28-day intervals of the 3.75 mg formulation (n = 62). Changes from baseline of TPSA, prostate volume, testosterone, LH, FSH, PRL and estradiol were assessed over 3 months. Changes of the metastatic lesions were also observed and evaluated. The occurrences of adverse events were evaluated as well.

RESULTSAfter 3 months treatment, total PSA level decreased significantly from baseline both in 11.25 mg group and 3.75 mg group. At 30, 60 and 90 days, TPSA (median level) declined from 164.55 microg/L into 11.34, 4.12, 3.89 microg/L in 11.25 mg group, and from 101.38 microg/L into 6.88, 2.41, 2.57 microg/L in control group respectively. The patients ratio with over 90% decreasing from TPSA baseline were 78.6% and 75.5% respectively in two groups (P = 0.700). Prostate volume were also decreased significantly in both groups, median volume declined from 48.0 mm(3) into 21.5 mm(3) in 11.25 mg group and from 45.0 mm(3) into 21.0 mm(3) in 3.75 mg group. No significant differences were found between the two groups in changes of TPSA (P = 0.601) and prostate volume (P > 0.05). Both formulations were able to induce castration levels, 0.31 microg/L in 11.25 mg group and 0.26 microg/L in 3.75 mg group (P > 0.05). 13.8% and 17.7% of adverse events were recorded respectively in two groups, and no differences were found (P = 0.547).

CONCLUSIONAs a new long-acting sustained release formulation, triptorelin 11.25 mg is comparable to triptorelin 3.75 mg formulation in the aspect of efficacy and safety for the treatments of metastatic prostate cancer.

Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents, Hormonal ; administration & dosage ; therapeutic use ; Gonadotropin-Releasing Hormone ; analogs & derivatives ; therapeutic use ; Humans ; Male ; Middle Aged ; Prostatic Neoplasms ; drug therapy ; pathology ; Safety ; Treatment Outcome ; Triptorelin Pamoate ; administration & dosage ; therapeutic use