Protocol to detect OLA1 polyubiquitination by Aurora A in vivo and in vitro.

Aurora A is a critical kinase that functions in centrosome maturation and bipolar spindle assembly. On the other hand, Aurora A has E3 ubiquitin ligase activity and polyubiquitinates Breast cancer gene 1 (BRCA1)-interacting protein Obg-like ATPase 1 (OLA1), targeting it for proteasomal degradation. Here, we present a protocol to detect OLA1 ubiquitination. We describe steps for recovering frozen cells and protein purification. We then detail assays for both in vivo and in vitro ubiquitination of OLA1 by Aurora A. For complete details on the use and execution of this protocol, please refer to Fang et al.1.

Knockout of Brca1-interacting factor Ola1 in female mice induces tumors with estrogen suppressible centrosome amplification.

Obg-like ATPase 1 (OLA1) is a binding protein of Breast cancer gene 1 (BRCA1), germline pathogenic variants of which cause hereditary breast cancer. Cancer-associated variants of BRCA1 and OLA1 are deficient in the regulation of centrosome number. Although OLA1 might function as a tumor suppressor, the relevance of OLA1 deficiency to carcinogenesis is unclear. Here, we generated Ola1 knockout mice. Aged female Ola1+/- mice developed lymphoproliferative diseases, including malignant lymphoma. The lymphoma tissues had low expression of Ola1 and an increase in the number of cells with centrosome amplification. Interestingly, the proportion of cells with centrosome amplification in normal spleen from Ola1+/- mice was higher in male mice than in female mice. In human cells, estrogen stimulation attenuated centrosome amplification induced by OLA1 knockdown. Previous reports indicate that prominent centrosome amplification causes cell death but does not promote tumorigenesis. Thus, in the current study, the mild centrosome amplification observed under estrogen stimulation in Ola1+/- female mice is likely more tumorigenic than the prominent centrosome amplification observed in Ola1+/- male mice. Our findings provide a possible sex-dependent mechanism of the tumor suppressor function of OLA1.

Environment and social support for smoking cessation among community smokers in Beijing, China.

INTRODUCTION: This study investigated the relationship between environment support, social support and smoking cessation, to provide suggestions for the construction of environment and social support for tobacco control. METHODS: This was a secondary analysis based on two cross-sectional surveys of adult smokers who participated in the six-month community smoking cessation intervention projects in Beijing. The study subjects were divided into a successful group (n=159) and an unsuccessful group (n=253). The status of the environment support, community tobacco exposure, and social support were compared between groups. A structural equation model (SEM) was established for Confirmatory Factor Analysis. RESULTS: The univariate analysis showed that there were differences in smoking cessation outcomes among smokers with different home tobacco regulations, workplace tobacco regulations and number of smokers in the family. Differences in 6-month smoking reduction were also found with different promotion levels of anti-tobacco messaging and the frequency of smoking events at home. The logistic regression analysis indicated that home tobacco regulations (OR=1.30; 95% CI: 1.00-1.69), workplace tobacco regulations (OR=1.27; 95% CI: 1.05- 1.54), and frequency of smoking events at home (OR=1.15; 95% CI: 1.02-1.29), were associated with smoking cessation. The results of the SEM showed that environment support (ß=0.39; 95% CI: 0.05-0.73, p=0.026) and social support (ß=0.37; 95% CI: 0.05-0.68, p=0.022) had influence on smoking cessation. CONCLUSIONS: Environment support and social support are related to smoking cessation. Attention should be paid to the smoking regulations at home and workplace, anti-tobacco messaging, and social support by the family. TRIAL REGISTRATION: The study was registered on the official website of the China Clinical Trial Registration Center. Identifier: ChiCTR1900024991.

Prospective Exploratory Study of the Effects of Postoperative Endocrine Medication on the Endometrium in Breast Cancer Patients.

Objective: This study aimed to investigate the pathological effects of long-term postoperative endocrine medication on the endometrium in breast cancer patients. Methods: Data of 99 patients with primary breast cancer who underwent hysteroscopy and obtained endometrial biopsy from 1 June 2018 to 31 December 2021 at the Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital were prospectively collected. Results: Hysteroscopy was performed followed by endometrial histopathological examination in 99 breast cancer patients, including 44 taking tamoxifen (TAM), 26 taking other endocrine drugs, and 29 not taking endocrine drugs. The endometrial thickness in the TAM group was significantly higher than that in the other endocrine drug groups and the group not taking endocrine drugs (p=0.017). The receiver operating characteristic curves for the abnormal premenopausal endometrial thickening were plotted in this study; an endometrial thickness of 15.5 mm seen on ultrasound could be used as the most accurate ultrasound diagnostic threshold for the diagnosis of abnormal premenopausal endometrial hyperplasia, with an area under the curve of 0.888 (95% CI: 0.716, 1.000), a sensitivity of 100%, and a specificity of 75%, which was consistent with the results of our previous retrospective study. An endometrial thickness of ≥5 mm in postmenopausal women with breast cancer taking TAM was still used as the cut-off value for routine ultrasound diagnosis of abnormal postmenopausal endometrial hyperplasia. Conclusion: An ultrasound endometrial thickness (proliferative phase) of >15 mm in premenopausal patients can be used as the most accurate ultrasound diagnostic threshold for the diagnosis of abnormal endometrial hyperplasia. After menopause, an ultrasound endometrial thickness of ≥5 mm is still used as the criterion for diagnosing abnormal endometrial hyperplasia. Older patients should be monitored for signs of vaginal bleeding and fluid discharge, and hysteroscopy should be performed if necessary to ascertain the endometrial condition.

Aurora A polyubiquitinates the BRCA1-interacting protein OLA1 to promote centrosome maturation.

The BRCA1-interacting protein Obg-like ATPase 1 (OLA1) functions in centriole duplication. In this study, we show the role of the mitotic kinase Aurora A in the reduction of centrosomal OLA1. Aurora A binds to and polyubiquitinates OLA1, targeting it for proteasomal degradation. NIMA-related kinase 2 (NEK2) phosphorylates the T124 residue of OLA1, increases binding of OLA1 to Aurora A and OLA1 polyubiquitination by Aurora A, and reduces centrosomal OLA1 in G2 phase. The kinase activity of Aurora A suppresses OLA1 polyubiquitination. The decrease in centrosomal OLA1 caused by Aurora A-mediated polyubiquitination promotes the recruitment of pericentriolar material proteins in G2 phase. The E3 ligase activity of Aurora A is critical for centrosome amplification induced by its overexpression. The results suggest a dual function of Aurora A as an E3 ubiquitin ligase and a kinase in the regulation of centrosomal OLA1, which is essential for proper centrosome maturation in G2 phase.

Mechanism of community quitters' psychological traits on their smoking cessation effects: Based on a study of community intervention.

INTRODUCTION: We study the relationship between psychological traits of smokers and their smoking cessation effects, and provide more scientific evidence for smoking cessation intervention. METHODS: The study was conducted as a nested case-control study. Smokers who participated in the community smoking cessation intervention projects in Beijing in 2018-2020, were selected as the research participants and divided into two groups: a successful smoking cessation and unsuccessful smoking cessation group, according to their smoking cessation effects at 6 months. Psychological traits of quitters including smoking abstinence self-efficacy, willingness to quit smoking, and trait coping style, were compared between the two groups, and a structural equation model was established for confirmatory factor analysis to analyze their mechanisms. RESULTS: There were differences in smoking cessation results between the successful smoking cessation group and the unsuccessful smoking cessation group in terms of smoking abstinence self-efficacy and willingness to quit smoking. Willingness to quit smoking (OR=1.06; 95% CI: 1.008-1.118) is a risk factor, while smoking abstinence self-efficacy in habit/addiction situations (OR=0.77; 95% CI: 0.657-0.912) is a protective factor. The results of the structural equation model showed that smoking abstinence self-efficacy (ß=0.199, p=0.002) and trait coping style (ß= -0.166, p=0.042) could influence smoking cessation effects. The structural equation model was well fitted, which showed that smoking abstinence self-efficacy (ß=0.199, p=0.002) and trait coping style (ß= -0.166, p=0.042) might have influenced the effect of smoking cessation among smokers. CONCLUSIONS: Willingness to quit smoking has a positive impact on the smoking cessation effect, while smoking abstinence self-efficacy in habit/addiction situations and negative trait coping style have a negative impact. Smoking abstinence self-efficacy and trait coping styles can significantly affect smoking cessation outcomes.

An intervention study on a hospital-community integrated management model of tobacco dependence based on a community intervention trial.

Objective: To assess the effect of the hospital-community integrated management model of tobacco dependence on smoking cessation among community residents compared with a brief smoking cessation intervention. Methods: Our study recruited 651 smokers who were willing to quit in 19 communities in Beijing and conducted a 6-month smoking cessation intervention. The control group receiving a brief smoking cessation intervention and the pilot group receiving an integrated smoking cessation intervention. Intention-to-treat analysis (ITT) and generalized estimating equations were used to assess the effects of the integrated intervention and smoking cessation medication on average number of cigarettes smoked per day (ACSD) and smoking cessation rate. Results: Simple effects analysis showed that smokers taking medication had significantly lower ACSD than those not taking medication at follow-up, the control group reduced smoking by 3.270, 4.830, and 4.760 cigarettes in the first, third and sixth months, respectively, while the pilot group reduced by 6.230, 5.820, and 4.100 cigarettes. The integrated intervention significantly reduced ACSD among medication-taking smokers at 1st month (reduced by 3.420, P < 0.05) and 3rd month (reduced by 2.050, P < 0.05), but had no significant effect among non-medication taking smokers. The 3rd month smoking cessation rate among medication-taking smokers was 27.0%, which was significantly higher than the smokers with brief smoking cessation intervention. Conclusion: The integrated hospital-community intervention can significantly promote smoking cessation among smokers taking medication, but the issue of payment for medication and additional labor compensation for medical staff should be addressed before its popularization.

Torularhodin Alleviates Hepatic Dyslipidemia and Inflammations in High-Fat Diet-Induced Obese Mice via PPARα Signaling Pathway.

Torularhodin is a ß-carotene-like compound from Sporidiobolus pararoseus, and its protective effect against high-fat diet (HFD)-induced hepatic dyslipidemia and inflammation was investigated. Compared to mice of C57BL/6J fed on HFD, the addition of Torularhodin into the HFD (HFD-T) significantly reduced body weight, serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and the inflammatory mediators of TNF-α, IL-6, IL-1ß, and lipopolysaccharide (LPS). A significant increase of high-density lipoprotein cholesterol (HDL-c), which is beneficial to cholesterol clearance, was also observed in HFD-T group. Proteomic analysis showed HDL-C-c is highly correlated with proteins (e.g., CPT1A and CYP7A1) involved in lipid ß-oxidation and bile acid synthesis, whereas the other phenotypic parameters (TC, TG, LDL, and inflammatory cytokines) are highly associated with proteins (e.g., SLC27A4) involved in lipid-uptake. The up-regulated anti-inflammation proteins FAS, BAX, ICAM1, OCLN, GSTP1, FAF1, LRP1, APEX1, ROCK1, MANF, STAT3, and INSR and down-regulated pro-inflammatory proteins OPTN, PTK2B, FADD, MIF, CASP3, YAP1, DNM1L, and NAMPT not only demonstrate the occurrence of HFD-induced hepatic inflammation, but also prove the anti-inflammatory property of Torularhodin. KEGG signaling pathway analysis revealed that the PPARα signaling pathway is likely fundamental to the health function of Torularhodin through up-regulating genes related to fatty acid ß-oxidation, cholesterol excretion, HDL-Cc formation, and anti-inflammation. Torularhodin, as a new food resource, may act as a therapeutic agent to prevent hepatic dyslipidemia and related inflammation for improved health.

A Cost-Effectiveness Analysis of Comprehensive Smoking-Cessation Interventions Based on the Community and Hospital Collaboration.

Background: The prevalence of cigarette smoking in China is high and the utilization of smoking cessation clinics is very low. Multicomponent smoking cessation interventions involving community and hospital collaboration have the potential to increase the smoking cessation rate. However, the cost-effectiveness of this intervention model is unknown. Methods: We conducted a smoking cessation intervention trial in 19 community health service centers in Beijing, China. A cost-effectiveness analysis was performed from a societal perspective to compare three strategies of smoking cessation: no intervention (NI), pharmacological intervention (PI), and comprehensive intervention (CI) (PI plus online health promotion). A Markov model, with a time horizon of 20 years, was used to simulate the natural progression of estimated 10,000 male smokers. A cross-sectional survey was conducted to obtain data on costs and quality-adjusted life years (QALYs) by using the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire. Probabilistic sensitivity analysis was performed to explore parameters of uncertainty in the model. Results: A total of 680 participants were included in this study, including 283 in the PI group and 397 in the CI group. After 6 months of follow-up, the smoking cessation rate reached 30.0% in the CI group and 21.2% in the PI group. Using the Markov model, compared with the NI group, the intervention strategies of the PI group and the CI group were found to be cost-effective, with an incremental cost-effectiveness ratio (ICER) of $535.62/QALY and $366.19/QALY, respectively. The probabilistic sensitivity analysis indicated that the CI strategy was always the most cost-effective intervention. Conclusion: CI for smoking cessation, based in hospital and community in China, is more cost-effective than PI alone. Therefore, this smoking cessation model should be considered to be implemented in healthcare settings.

Relationships among smoking abstinence self-efficacy, trait coping style and nicotine dependence of smokers in Beijing.

INTRODUCTION: Psychological, physiological and social factors play an important role in the initiation, persistence, dependence and relapse of smoking behaviors, and coping style and smoking abstinence self-efficacy can all affect nicotine dependence. METHODS: A cross-sectional sample of 568 quitters from 19 communities in Beijing in 2019 was surveyed. Demographic information and psychological characteristics of smokers were collected by an interview questionnaire, and psychological traits scales including the Smoking Abstinence Self-Efficacy (SASE) and the Trait Coping Style Questionnaire (TCSQ). We compared differences in psychological traits across demographic information and explored the relationship between nicotine dependence and coping styles and self-efficacy in refusing to smoke. RESULTS: Significant differences were identified in self-efficacy in refusing to smoke and across dimensions among quitters by gender, job type, education level, and monthly income level (all p<0.05). Males had lower self-efficacy in the habitual/addictive context than females; retirees had better overall self-efficacy and self-efficacy in the negative/emotional context than business service workers and professionals; and high-educated, high-income quitters had lower self-efficacy in the negative/emotional context. There are significant differences in positive coping styles among quitters of different ages, levels of education, and types of work (all p<0.05). The results further showed that the underage population, highly educated population, and practitioners other than those in retirement, are less likely to use positive coping styles. Interventional effects analysis showed that a higher sense of self-efficacy in addictive contexts can counteract some of the negative coping styles that induce smoking. CONCLUSIONS: Self-efficacy played an indirect mediating role between negative coping style and nicotine dependence; individuals who used more negative coping styles were more likely to engage in smoking and therefore were more nicotine dependent. Hence, it is necessary to reduce the use of negative coping strategies and improve the self-efficacy of smoking abstinence in the face of addiction.

Killing cervical cancer cells by specific chimeric antigen receptor-modified T cells.

The aim is to investigate the in vivo and in vitro killing effect of mesothelin chimeric antigen receptor T cells (MESO-CAR-T) in cervical squamous cell carcinoma. MESO-CAR-T cells were successfully constructed. In vitro verification of the killing effect of MESO-CAR-T cells was evaluated in the presence of SiHa cells by the lactate dehydrogenase release assay and cytokine release assay. The in vivo experiments were performed in immunodeficient NCG mice. After successful tumor formation with the subcutaneous implantation of SiHa cervical cancer cells, the injections of MESO-CAR-T cells into the tumors at different doses and frequencies were performed. Subsequently, the growth rate and size of the tumors in NCG mice were observed. A 17-fold increase in the number of MESO-CAR-T cells and a 16-fold increase in the number of Con-CAR-T cells were observed. The result of marker detection in the prepared MESO-CAR-T cells showed that CD3+ T lymphocytes accounted for 97.0 % of all cells, indicating successful preparation of MESO-CAR-T cells. Expression of the membrane protein MESO was detected in 12.8 % of SiHa cells. When the ratio of MESO-CAR-T cells to SiHa cells was 20:1, the lysis of target cells was most significant and was observed in 22 % of the cells. In the presence of SiHa cells, the secretion of IL-4、IL-2、IL-5、TNF-α and IFN-γ in MESO-CAR-T cells was higher than that in the control group. The effect of two consecutive intratumoral injections of MESO-CAR-T cells was more obvious than that of one injection. The pharmacological effect of the injection was observed within 1 week. Our finding identified the certain in vivo and in vitro killing activity of MESO-CAR-T cells.

Use of mesothelin as a tumor-associated antigen in cervical squamous cell carcinoma.

AIM: To explore the feasibility of using mesothelin (MESO) as a tumor-associated antigen (TAA) in cervical squamous cell carcinoma and its function in the development of cervical cancer. METHODS: We collected eight cervical tissue samples of squamous cell carcinoma as the test group and eight samples of cervicitis as the control group from patients who underwent a hysterectomy because of a diagnosis of myoma. Then we used western blotting to screen for a potential TAA in cervical squamous cell carcinoma samples. In addition, Lentivirus-mediated RNAi was used to downregulate the expression of the MESO gene (MSLN) in SiHa cells. Fluorescence-activated cell sorting (FACS), 3­(4,5)-dimethylthiahiazo (-z­y1)­3,5­di­phenytetrazoliumromide (MTT), and wound healing were used to examine cell apoptosis, cell proliferation, and cell migration respectively. RESULTS: Results of the western blotting showed that the MESO protein expressed highly in the cervical squamous cell carcinoma and paracancerous tissues in contrast to the cervicitis tissue (p = 0.242). We used quantitative PCR to verify that the expression of MSLN was 21.6% in the cells undergoing knockdown compared to that in the control cells, and thus, decided to continue with further experiments. We confirmed by FACS that the apoptosis rate in the SiHa cell group undergoing MSLN knockdown (KD group) was significantly higher than that in negative control (NC) group of SiHa cells (p = 0.014). The proliferation of cells was examined by MTT and the difference between the KD and NC groups was found to be statistically significant (p = 0.002). However, since the difference was <20% we did not consider it to be clinically significant. Cell migration ability was verified by wound healing test and found to be 43% in the KD group and 38% in the NC group after 48 h, but the difference was not statistically significant (p > 0.05). CONCLUSIONS: MESO might be used as a TAA for diagnosing cervical squamous cell carcinoma. When MSLN was knocked down in SiHa cells, cell apoptosis increased, but no significant effects were observed on cell proliferation and migration. Thus, our study shows that MSLN plays a role in the apoptosis of cervical squamous cell carcinoma cells, and since this might affect tumor progression, further research is warranted to understand how MSLN plays this role.

A clinical analysis of small-cell neuroendocrine carcinoma of the gynecologic tract: report of 20 cases.

OBJECTIVE: The aim of this retrospective observational study was to analyze the clinical and pathological characteristics of small-cell neuroendocrine carcinoma of the gynecologic tract (SCNCGT). METHODS: Twenty patients with SCNCGT were enrolled and their clinic-pathological features were analyzed. All patients were treated at the Beijing Obstetrics and Gynecology Hospital, Capital Medical University, China, and were followed up until December 31, 2017. RESULTS: (1) Patient characteristics: The incidence of SCNCGT was 0.3% (20/6578) of gynecologic cancer in our hospital from January 1, 2007, to December 31, 2017. The average age of the patients was 42.0 ± 11.8 (23-63 years). Out of 20 patients enrolled, seven (35.0%) had lymph node metastasis. Out of 17 patients treated with complete surgery, 14 (82.4%) had lymph-vascular space invasion. (2) Treatment: Eleven out of the 14 patients with small-cell neuroendocrine carcinoma of the cervix (SCNCC) were treated with radical surgery; all the 11 patients received chemotherapy and radiotherapy postoperatively. The remaining three patients received comprehensive chemotherapy and/or radiotherapy instead of radical surgery. The six patients who had one or the other type of SCNCGT (involving the ovary, endometrium, or vagina) were all treated with comprehensive surgery. (3) Prognosis: The follow-up time for the study ranged from 8 to 87 months. Three (15.0%) of the 20 patients were diagnosed with distant metastasis at the beginning of the study. Eight (40.0%) patients died as of December 31, 2017, while the other 12 patients were in follow-up. The average survival time was 43.6 months (16-77 months). CONCLUSION: SCNCGT is a highly malignant tumor characterized by rare morbidity, a propensity for metastasis, and poor prognosis. Comprehensive treatment may be a good approach to prolong survival in some patients.

Analysis of short-term efficacy as defined by RECIST and pathological response of neoadjuvant chemotherapy comprised paclitaxel and cisplatin followed by radical surgery in patients with locally advanced cervical cancer: A prospective observational study.

The purpose of this study is to investigate short-term efficacy as defined by the Response Evaluation Criteria in Solid Tumors (RECIST) and pathological response of neoadjuvant chemotherapy (NACT) comprised of paclitaxel and cisplatin (TP) followed by radical surgery in patients with locally advanced cervical cancer (LACC).This is a prospective study involving 61 women with histologically confirmed LACC referred for NACT following radical surgery at Beijing Obstetrics and Gynecology Hospital between April 2013 and January 2015.The efficacy of NACT was evaluated by the RECIST. The total short-term efficacy of NACT was 91.8% (complete remission and partial remission). The cervical invasion ≤1/2 was 82.4% in the complete remission (CR) group, 46.2% in the partial remission (PR) group, and 20% in the stable disease (SD) group. The difference between groups was statistically significant (P = .012). The slides of all surgical specimens were reviewed and classified according to the Tumor Regression Grade (TRG). The good response was defined by good short-term efficacy (RECIST) and the difference between groups was statistically significant (P = .042). The route of administration of NACT is a factor predicting response to NACT. A significant higher response rate (P = .011) and lower chemotherapy-related adverse events (P < .05) were observed in the artery intervention (AI) group compared to those received NACT via intravenous (IV) route. All patients were followed-up to the last day of 2015 with the median follow-up time of 21.5 months for NACT. For the 61 patients referred for NACT in LACC, 2 patients had relapsed and 1 patient died from the disease.The study showed that the NACT comprised TP for LACC treatment had a significant local effect. It could reduce tumor myometrial invasion and regress tumor. The route of administrating NACT is a predicting factor to the NACT response; 2 cycles of NACT of AI treatment to LACC patients would obtain a desired response with low chemotherapy adverse events.

[Study of psychological distress and quality of life in patients with oral cancer].

PURPOSE: To explore the relationship between the status quo and influencial factors of oral cancer patients and their quality of life. METHODS: Using the Distress Themometer (DT) and the University of Washington Quality of Life Questionnaire (UW-QOL), 250 patients admitted to the First Affiliated Hospital of Zhengzhou University from October 2016 to September 2017 with oral cancer were investigated. Chi-square test, t test, logistic regression analysis and Spearman correlation analysis were used to analyze the data with SPSS20.0 software package. RESULTS: A total of 250 questionnaires were issued, 239 valid questionnaires were available for analysis. In 239 oral cancer patients, 139 (58.2%) had DT score ≥4. The average total score of UWQOL scale was 53.3±17.1, score <4 was noted in 100 patients (41.8%); the average UWQOL scale was 52.8±17.4. Univariate analysis showed that psychological distress was related to age, educational level, income level, pathological stage, jaw resection and recurrence (χ2 values were 5.12,21.31,34.2,10.69,31.3 and 7.84, respectively, P<0.05 ). Logistic regression analysis showed that age, jaw resection and relapse were the risk factors of psychological distress in patients with oral cancer (OR=4.06, 5.12 and 5.79, respectively; P<0.05). Spearman correlation analysis showed that the scores of pain, recreation, emotion and anxiety in UWQOL scale were negatively correlated with psychological distress scores (r=-0.58, -0.84, -0.66 and -0.69, respectively; P<0.05). CONCLUSIONS: Oral cancer patients have a higher incidence of psychological distress. Younger patients,and those with maxillectomy and recurrence have more serious symptoms of distress.

Actual causes of death in Chaoyang District of Beijing, China, 2007.

OBJECTIVES: To identify and quantify major external (non-genetic) factors that contribute to death in Chaoyang District of Beijing, China in 2007. METHODS: The death registration data reported to the Center of Disease Control and Prevention of Chaoyang District of Beijing, China, during the year 2007, were obtained. The analysis was conducted in 2009 using the health risk factors identified by the World Health Report 2002 and the population attributable fractions of mortality from Global burden of disease and risk factors. The estimates of actual causes of death attributable to each risk factor were calculated by multiplying the population attributable fractions of mortality by the corresponding number of deaths of the subgroup or total population. RESULTS: The five leading actual causes of death in Chaoyang District of Beijing, China in 2007 were high blood pressure (2159 deaths, 18%), smoking (990, 8%), low fruit and vegetable consumption (968, 8%), high cholesterol (891, 7%), and physical inactivity (629, 5%). The pattern and ordering of these leading causes vary with sex and age specific subgroups. CONCLUSIONS: More than half of the total number of deaths in Chaoyang District in 2007 could be attributed to a few major preventable risk factors. Although the study focused on only one district of Beijing in one single year, and is by no means comprehensive, its findings suggest that public health policies and programmes in China should address these public health concerns by focusing on these largely preventable risk factors for primary prevention.

The epidemiological study of women with urinary incontinence and risk factors for stress urinary incontinence in China.

OBJECTIVE: The aim of this study was to evaluate the prevalence and associated risk factors of urinary incontinence (UI) in Chinese women. METHODS: In the cross-sectional survey, 20,000 Chinese women 20 years or older were randomly selected and interviewed with modified Bristol Female Lower Urinary Tract Symptoms questionnaires to estimate population prevalence rates and identify potential risk factors. RESULTS: A total of 19,024 women were included in the analysis and 976 excluded; qualified rate is 95% (19,024/20,000). Of the Chinese women aged from 20 to 99 years (mean +/- SD, 45 +/- 16 y), the overall prevalence rate of UI was 30.9%. Estimates of stress urinary incontinence (SUI), urge urinary incontinence, and mixed urinary incontinence prevalence were 18.9%, 2.6%, and 9.4%, with a corresponding proportional distribution of 61%, 8%, and 31%, respectively. The prevalence of mixed urinary incontinence increased with aging, whereas the prevalence of SUI peaked in the group of women aged 50 years and that of urge urinary incontinence in the group of women aged 70 years. Only 25% of women have consulted doctors on this issue. Through multivariable logistic regression analysis, we identified age, vaginal delivery, multiparity, alcohol consumption, central obesity (women's waist circumference, >/=80 cm), constipation, chronic pelvic pain, history of respiratory disease, gynecological events, pelvic surgery, and perimenopause and postmenopause status as potential risk factors for SUI, among which age, vaginal delivery, and multiparity are three major risk factors. CONCLUSIONS: Our findings suggest that the prevalence of UI is high in China, with SUI as the most common subtype. Age, vaginal delivery, and others are risk factors for SUI.