'Zhonghua' tobacco advertisement in Shanghai: a descriptive study.

OBJECTIVE: To document tobacco advertising practices of a popular, high-grade, domestic cigarette in China across a broad spectrum of channels. METHODS: Media monitoring and direct observations were conducted to assess tobacco advertisements for Zhonghua cigarettes in Shanghai, China, through the following channels: newspapers, TV, internet, outdoor advertisements and point-of-sale advertisements. RESULTS: Consistent with the national ban, no direct tobacco advertisements were found in newspapers or on TV. However, statements about counterfeit 'Zhonghua' cigarettes indirectly promoted Zhonghua tobacco through newspapers. Although no tobacco advertisements were found in Shanghai mainstream websites or in channels of national mainstream sites, a great amount of information was communicated about Zhonghua cigarettes via websites, using patriotic themes and associations with Chinese culture. Large outdoor tobacco advertisements of 'Loving my China' were found in downtown Shanghai. Zhonghua tobacco advertisements were present in almost all of the points-of-sale observed (95%). CONCLUSIONS: Zhonghua cigarettes are promoted directly and indirectly through a variety of channels. This study suggests there is an urgent need to establish comprehensive bans that prohibit all types of tobacco advertisements in China.

Efficacy of Lvpao Powder on Radiation Therapy-Induced Mucositis: A Retrospective Study of 114 Patients With Head and Neck Carcinoma.

Purpose: To compare the efficacy and safety of Kangfuxin solution and lvpao powder on mucositis induced by radiation therapy in head and neck carcinoma patients. We retrospectively analyzed 114 patients with head and neck malignant tumors in our center. Methods and Materials: Patients were given Kangfuxin solution to rinse the mouth or Lvpao powder sprayed on oral mucosa after the solution use. The side effect was evaluated by Common Terminology Criteria for Adverse Events version 4.0. Results: The grade 3 mucositis occurred in 32.9% (23/70) and 11.4% (5/44) in Kangfuxin solution group and Kangfuxin solution + lvpao powder group, respectively (P = .009). The pain score of the Kangfuxin solution group was significantly higher than that of the Kangfuxin solution and lvpao powder group, with 4.26 ± 0.81 versus 3.75 ± 1.03 (P = .007). The time of symptom relief in the combined group was significantly shorter than that in the single drug group, with 3 days versus 6 days (P = .000). The weight loss of the former groups was bigger than that of the latter group (6.67 ± 1.20 kg vs 5.95 ± 0.94 kg; P = .001). There was no statistical difference in the limitations in mouth opening (P = .164). Conclusions: Lvpao powder is safe and effective as a mucosal repair drug in accelerating the recovery of patients and reducing their body weight.

The role and mechanism of IFITM1 in developing acquired cisplatin resistance in small cell lung cancer.

Platinum-based chemotherapies, historically the cornerstone of first-line treatment for small-cell lung cancer (SCLC), face a major hurdle: the frequent emergence of chemoresistance, notably to cisplatin (CDDP). Current understanding of the mechanisms driving CDDP resistance in SCLC is incomplete. Notably, Interferon inducible transmembrane protein1 (IFITM1) has been identified as a key player in the distant metastasis of SCLC. Analysis of The Cancer Genome Atlas (TCGA) database revealed that IFITM1 expression is markedly elevated in tumor tissues as compared to that from adjacent normal tissues, correlating with a worse prognosis for patients with SCLC. Our research focused on investigating the role of IFITM1 in the acquisition of cisplatin resistance in SCLC. Further clinical sample analysis highlighted a significant increase in IFITM1 levels in SCLC tissues from cisplatin-resistant patients versus those were responsive to CCDP treatment, with similar trends observed in cisplatin-resistant SCLC cells. Crucially, overexpression of IFITM1 reduced the sensitivity of SCLC cells to cisplatin, while silencing IFITM1 enhanced chemosensitivity in cisplatin-resistant strains. Our in vivo studies further confirmed that silencing IFITM1 significantly boosted the efficacy of cisplatin in inhibiting growth of subcutaneous tumors of NCI-H466/CDDP cells (cisplatin-resistant SCLC cells) in a mouse model. Mechanistically, IFITM1 appears to foster cisplatin resistance through activation of the Wnt/ß-catenin pathway. In summary, our findings suggest that targeting IFITM1, alongside cisplatin treatment, could offer a promising therapeutic strategy to overcome resistance and improve outcomes for SCLC patients.

Awareness of tobacco advertising, perceived harms of smoking, and beliefs about tobacco control among a sample of Shanghainese in China.

This study aims to examine beliefs among residents of Shanghai, China concerning tobacco advertising and control policies concurrent with new restrictions on tobacco use and advertising in the city. A total of 518 residents of Shanghai completed a telephone interview survey. We found that 51% of participants had seen or heard of the Zhonghua cigarette brand's 'Love China' tobacco ad campaign in the past 2 years, 59% believed that the campaign would influence people to buy this specific cigarette brand as a gift, and 30% believed that it would encourage smoking. More than 75% of respondents would support legislation banning tobacco advertising in all public places, and 88% would support legislation prohibiting smoking in all public places. Multivariate analyses indicated that those who were female, more than 50 years, have accepted college and above education, and perceived greater benefits to smoking cessation were more likely to support banning tobacco advertising and prohibiting smoking in public places. Non-smokers were more likely to support prohibiting smoking in public places. The findings suggest that although tobacco advertising is widely prevalent in Shanghai, it is disliked by the public. Respondents showed high levels of support for tobacco control policies.

Super-enhancers and the super-enhancer reader BRD4: tumorigenic factors and therapeutic targets.

Transcriptional super-enhancers and the BET bromodomain protein BRD4 are emerging as critical drivers of tumorigenesis and therapeutic targets. Characterized by substantial accumulation of histone H3 lysine 27 acetylation (H3K27ac) signals at the loci of cell identity genes and critical oncogenes, super-enhancers are recognized, bound and activated by BRD4, resulting in considerable oncogene over-expression, malignant transformation, cancer cell proliferation, survival, tumor initiation and progression. Small molecule compound BRD4 BD1 and BD2 bromodomain inhibitors block BRD4 binding to super-enhancers, suppress oncogene transcription and expression, reduce cancer cell proliferation and survival, and repress tumor progression in a variety of cancer types. Like other targeted therapy agents, BRD4 inhibitors show moderate anticancer effects on their own, and exert synergistic anticancer effects in vitro and in preclinical models, when combined with other anticancer agents including CDK7 inhibitors, CBP/p300 inhibitors and histone deacetylase inhibitors. More recently, BRD4 BD2 bromodomain selective inhibitors, proteolysis-targeting chimera (PROTAC) BRD4 protein degraders, and dual BRD4 and CBP/p300 bromodomain co-inhibitors have been developed and shown better anticancer efficacy and/or safety profile. Importantly, more than a dozen BRD4 inhibitors have entered clinical trials in patients with cancer of various organ origins. In summary, super-enhancers and their reader BRD4 are critical tumorigenic drivers, and BRD4 BD1 and BD2 bromodomain inhibitors, BRD4 BD2 bromodomain selective inhibitors, PROTAC BRD4 protein degraders, and dual BRD4 and CBP/p300 bromodomain co-inhibitors are promising novel anticancer agents for clinical translation.

TTLL12 expression in ovarian cancer correlates with a poor outcome.

The tubulin-tyrosine ligase (TTLL) family is involved in the progression of many cancers. Tubulin-tyrosine ligase-like protein 12 (TTLL12), a member of the TTLL family, has functions of histone methylation and affects the activities of tubulin tyrosine ligase, which are often observed abnormally in many cancers. Recently, a TTLL12 isoform was reported as abnormal in many cancer cells, but the potential role of TTLL12 in ovarian cancer (OC) is still unknown. In this study, we used quantitative real-time RT-PCR and western blot to determine the expressions of TTLL12 in ovarian cancer cells and tissues and also performed immunohistochemical staining to examine the TTLL12 expression levels in 72 OC tissues and their matched adjacent normal ovarian tissues (ANOTs), to further explore the potential clinical features. The results showed that the TTLL12 expression level in OC tissues was significantly increased when compared to the ANOTs. In addition, TTLL12 expression was also remarkably upregulated in OC cell lines compared to the normal ovarian cell line. Furthermore, we found that the TTLL12 level was significantly associated with the clinical features of the FIGO stage (P=0.001) and peritoneal cytology (P=0.042). Moreover, TTLL12 is thought to be an independent risk factor for the overall survival (OS, P=0.022) and disease-free survival (DFS, P=0.040) of OC patients. In conclusion, this study identified TTLL12 as a potential molecular marker for predicting the invasion and progression of OC.

Genome-wide analysis of LXXLL-mediated DAX1/SHP-nuclear receptor interaction network and rational design of stapled LXXLL-based peptides to target the specific network profile.

The atypical orphan receptors DAX1 and SHP constitute the NR0B subgroup of human nuclear receptor (hNR) family; they play key roles in metabolism, reproduction, nutrition and steroidogenesis, and are involved in the pathogenesis of a variety of diseases such as cancer and adrenal hypoplasia. The two receptors lack the classical DNA-binding domain and act as the corepressors of other hNRs. The DAX1 and SHP contains three and two conserved LXXLL motifs, respectively, which can be recognized and bound by the activation function-2 (AF-2) domain of hNR proteins in agonist conformation. Here, we attempt to explore the systematic interaction profile between the five DAX1/SHP LXXLL motifs and all the 48 hNR AF-2 domains found in the human genome, to analyze the binding affinity and specificity of these motifs towards the complete domain array, and to design LXXLL-based, hydrocarbon-stapled peptides that can target the specific interaction profile for each motif. A weighted source-target network from motifs to domains is created based on the modeled domain-motif complex structures and calculated binding potencies, from which the specific interaction profile of each motif against the whole hNR array is depicted and clustered to measure the binding similarity and relationship among these motifs. Dynamics simulations reveal that the LXXLL-based peptides are highly flexible in free unbound state, thus unfavorable to be recognized and bound by AF-2 domains. Hydrocarbon-stapling technique is employed to help the constraint of these unstructured peptides to active helical conformation, thus largely improving their binding affinity to the hNR array. The hydrocarbon bridge is designed to point out of the domain's active pocket, which would not disrupt the direct interaction between the domain and peptide. Energetic decomposition imparts that the stapling has only a very modest influence on the interaction enthalpy and desolvation effect of domain-peptide binding, but can substantially reduce entropy penalty upon the binding. For a peptide ligand, the entropic reduction can be roughly regarded as a constant, which only improves (absolute) peptide binding affinity towards the whole domain array, but does not alter (relative) peptide binding specificity over different domains in the array. Overall, the stapled peptides can be considered as potent competitors to selectively target the specific interaction networks mediated by their parent LXXLL motifs in DAX1 and SHP proteins.

To be thin but not healthy - The body-image dilemma may affect health among female university students in China.

An increasing number of young girls have attached great importance to their body-image in China. Body-image dissatisfaction has resulted in increased weight loss behavior. The aim of this study was to investigate the factors that were associated with underweight body-image in female college students. Self-administered questionnaires were completed by 2,023 young female participants from eight Chinese universities. In addition, 160 participants were involved in a qualitative study. The ideal body-image and the factors that influence weight were determined using descriptive and analytical statistics. We found that 1,484 out of 2,023 participants (73.36%) had taken action to lose weight in the past six months. Among these participants, 618 (30.55%, out of 2023) participants were already underweight, and 1,161 (57.39%, out of 2023) would like to be much thinner, which would lead to more underweight individuals. Moreover, non-scientific physical activity and diets were found to lead participants to the underweight subgroup. The participants' Body Mass Index (BMI), peer advice and western culture influenced the problematic thin-ideal (ideal BMI < 18.5 was considered as the problematic thin-ideal) (P<0.05). Together, western influences leading to the "problematic thin-ideal" and "unhealthy weight-control behavior" have brought about an increased prevalence of desired underweight body-image among female college students in China, which might be harmful for their health.

Using films and television shows with a medical theme as a medium to accelerate the spread of medical humanities.

People have more visual experiences than ever before, and the same is true for situations in medicine. More mature films and television shows with a medical theme have been available over the past 20 years. In mainland China, the TV series "Angel Heart" has generated a wave of universal concern since it truly depicts the work of health care workers and it reflects the sharp distinction between doctors and patients to a certain extent. Riding this wave, many medical documentaries like The Human World have also been launched in China and have garnered sizable audiences. Such films and television shows with a medical theme strive to depict the lives of ordinary people. When watching these medical documentaries, audiences are able to better comprehend the work of health care workers in light of their life experiences and feelings towards current society. Audiences can gain a profound understanding of the medical humanities through films and television shows with a medical theme. We look forward to more such films and television shows with a medical theme that depict "hospitals-the realest place" on camera. Films and television shows with a medical theme can serve as a storytelling medium to accelerate the spread of medical humanities and to promote harmony among doctors, patients, and the public.

Preliminary thoughts on research in medical humanities.

Medical humanities (MH) is an interdisciplinary field of medicine which includes the humanities (literature, philosophy, ethics, history, and religion), social sciences (anthropology, cultural studies, psychology, sociology, and health geography), and the arts (literature, theater, film, and visual arts) and their application to medical education and practice. Studies of MH should not be limited to theoretical discussions. Research results must be translated into use of methodologies to formulate medical policies, guide clinical practices, and help resolve physical or mental problems. MH has a critical role in addressing medicine-related issues, such as human cloning legislation and the treatment of Ebola virus infection. Recently, MH has also been included in the "Healthy China 2030" project, indicating that MH has garnered more attention in China. Medical colleges, research institutes, and non-profit organizations are focusing on MH studies. Over the past few years, financial support for MH studies has also increased. Although the development of MH currently lags behind medicine and health sciences, MH has promise.

Measuring the preference towards patient-centred communication with the Chinese-revised Patient-Practitioner Orientation Scale: a cross-sectional study among physicians and patients in clinical settings in Shanghai, China.

OBJECTIVES: To adapt the Patient-Practitioner Orientation Scale (PPOS), to a Chinese context, and explore the preference towards patient-centred communication among physicians and patients with the Chinese-revised Patient-Practitioner Orientation Scale (CR-PPOS). DESIGN: A cross-sectional questionnaire-based study. SETTING: Clinical settings from eight medical units, including four community hospitals and four general hospitals, in Shanghai, China. PARTICIPANTS: 1018 participants, including 187 physicians and 831 patients, completed this study in two successive stages. OUTCOME MEASUREMENTS: Psychometric properties of the CR-PPOS and participants' score on the CR-PPOS. RESULTS: Compared with the original PPOS, the 11-item CR-PPOS obtained better psychometric indices. Physicians and patients scored differently on both the total CR-PPOS and its two subscales. Compared with physicians, the scores of patients were more influenced by their personal characteristics, such as age and education. CONCLUSIONS: The CR-PPOS is a better instrument in a Chinese context than the original translated version. The divergence in the extent to which patient-centred communication is preferred among Chinese physicians and patients should be noted. Adapting physicians' communication strategy to patients' preferences based on their personal characteristics can be a viable approach towards improving clinical efficiency.

[The relationship between HVRII mutation of mitochondrial DNA and squamous cell carcinoma of the lung].

BACKGROUND: Mitochondrial DNA (mtDNA) is the only hereditary substance besides nucleus, which is composed of a code region and a non-code D-loop region. The aim of this study is to investigate the hypervariable region II (HVRII) mutation of mtDNA in peripheral blood leucocyte, pericancerous tissues and cancer tissues of lung squamous cell carcinoma patients, and to explore its significance. METHODS: White blood cells, pericancerous tissues and cancer tissues were obtained from 15 cases of lung squamous cell carcinoma patients and mtDNA were extracted by one step method. HVRII fragments were amplified by PCR. Mutations were determined by DNA sequencing and the mutations of HVRII were analysed. RESULTS: In 15 lung squamous cell carcinoma patients, 14 patients showed mutation in HVRII(93.33%), 88 mutations were found totally. Eighty-seven mutations located in H-strand origin region, especially in the conserved sequence blocks and the mtTF1, 2 binding site (TFX and TFY). CONCLUSIONS: The results suggest that the mutation frequency of HVRII in cancer tissues of lung squamous cell carcinoma patients is very high and it might play an important role in carcinogenesis of the lung.

Clinical analyses of endometriosis after conservative surgery.

OBJECTIVE: To assess the remission rate and outcome of pregnancy of patients who had moderate and severe ovarian endometriosis after conservative surgery. We also wished to analyze the associated factors of recurrence. METHODS: Weconducted retrospective analyses of 199 cases with stage II-IV ovarian endometriosis who had preserved fertility under laparoscopic surgical treatment. Postoperatively, the 199 patients were divided into three groups: 43 cases underwent surgical treatment alone (group A); 47 were given a gonadotropin-releasing hormone agonist (GnRH-α) (group B), and 109 were given mifepristone (group C). Ten cases in group A were infertile, 26 cases in group B, and 38 cases in group C. All patients were followed up for 3 years. This study was approved by the Ethics Committee of Yangpu District Central Hospital. RESULTS: In groups A, B and C, the remission rate was 58.13%, 70.21% and 60.55% and the difference not significant (P=0.384); Recurrence rates were 27.90%, 12.76% and 24.77%, and the difference between them significant (P<0.05). The recurrence rate in group B was the lowest. The natural pregnancy rate after surgery in the three study groups (untreated, GnRH-α and mifepristone) was 30%, 34.61% and 28.94% but this difference was not significant. CONCLUSION: Surgery can improve the symptom remission rate and fertility of patients. Postoperative drug therapy does not improve the chance of pregnancy.