Young internal migrants' major health issues and health seeking barriers in Shanghai, China: a qualitative study.

BACKGROUND: China is experiencing a sizeable rural-urban flow, which may influence the health of internal migrant youth deeply. Disadvantages in the city are highly likely to contribute to health issues among the young internal migrant population. The current qualitative study is to explore how internal migrant young people view the health issues they face, and the services and opportunities they could seek in their host community. METHODS: Data were collected from 90 internal migrant youth aged between 15 and 19 years old and 20 adult service providers who worked with them in a community of Shanghai, where the population of internal migrants was relatively large. Four types of qualitative research methods were used, including key informant interviews with adults, in-depth interviews with adolescents, a photovoice activity with adolescents and community mapping & focus group discussions with adolescents. Guided by the ecological systems framework and the acculturation theory, thematic analysis was conducted using ATLAS.Ti 7.0 software. RESULTS: While younger migrants had a limited understanding of health, elder migrant youths were more sensitive to societal and political factors related to their health. Mental health and health risk behaviors such as smoking, violence and premarital unsafe sex were thought as major health issues. Internal migrant youths rarely seek health information and services initiatively from formal sources. They believed their health concerns weren't as pressing as the pressure coming from the high cost of living, the experience of being unfairly treated and the lack of opportunities. Participants also cited lack of family and social support, lack of awareness and supportive policies to get access to community and public services as impacting health factors. CONCLUSIONS: The study's findings provide the insight to the social contexts which influence the health experience, health seeking behaviors, and city adaptation of young internal migrants in their host community. This research stresses the importance of understanding social networks and structural barriers faced by migrant youth in vulnerable environments. A multidimensional social support is essential for internal migrant youth facing present and potential health risks.

Gender role attitudes, awareness and experiences of non-consensual sex among university students in Shanghai, China.

BACKGROUND: Non-consensual sex (NCS) among young people, an important subject with public health and human rights implications, was less studied in China. This study is to investigate the NCS awareness and victimization of university students in Shanghai, China and whether they were associated with adolescent gender-role attitudes. METHODS: Gender-role attitudes, awareness and victimization of different forms of NCS were examined among 1099 undergraduates (430 males and 669 females) in four universities in Shanghai using computer-assisted self-interview approach. RESULTS: University students held relatively egalitarian attitude to gender roles. Gender difference existed that girls desired to be more equal in social status and resource sharing while more endorsed the submissiveness for women in sexual interaction than boys. They held low vigilance on the risk of various forms of NCS, with the mean score on perception of NCS among boys (5.67) lower than that among girls (6.37). Boys who adhered to traditional gender norms were less likely to aware the nature of NCS (ß = - 0.6107, p = 0.0389). Compared with boys, higher proportion of girls had been the victims of verbal harassment, unwanted touch, fondling, and penetrative sexual intercourse. Multivariable analysis revealed that girls who held more traditional gender-role attitudes were more vulnerable to physical NCS (OR = 1.41, p = 0.0558). CONCLUSIONS: The weakening but still existing traditional gender norms had contributions in explaining the gender difference on the low vigilance of NCS and higher prevalence of victimization among university students in Shanghai, China. Interventions should be taken to challenge the traditional gender norms in individual and structural level, and promote the society to understand the nature of NCS better as well as enhance negotiation skills of adolescents and young people that prevent them from potentially risky situations or relationships.

Single or double semen samples: the dilemma in epidemiological studies on semen quality.

STUDY QUESTION: Is it necessary to collect more than one semen sample from each individual in epidemiological studies? SUMMARY ANSWER: Single semen samples can be used in model construction as long as the model adjusts for major relevant covariates. WHAT IS KNOWN ALREADY: If a series of semen samples are taken from one individual at different times, significant intra-individual variation may exist. STUDY DESIGN, SIZE, DURATION: A population-based cross-sectional study was conducted from 1 December 2000 to 20 November 2002. A total of 1010 volunteers, aged between 20 and 60 years old, were recruited. PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 998 subjects were included for statistical analysis. Of these, 332 men provided single semen samples (group 1) and 666 men provided two samples (group 2). Semen parameters, including semen volume, sperm concentration, total sperm number, progressive motility, vitality, and sperm morphology, were analyzed with standardized methods according to the World Health Organization (WHO) laboratory manual for the examination of human semen and sperm-cervical mucus interaction (3rd edition). MAIN RESULTS AND THE ROLE OF CHANCE: Rapidly progressive motility of semen from group 1 was lower than that of group 2, but other parameters were not significantly different. The differences in mean values between the double samples were small on all semen parameters. The correlations between the two ejaculates were high, but the agreements were poor except for sperm vitality and normal morphology. Model selection and validation analysis supported the premise that the regression model from the first samples was applicable for the second samples. The large sample size with extensive quality control provides robust parameter estimation and promises good applicability for model selection and validation. LIMITATIONS, REASONS FOR CAUTION: The results are valid for healthy men in China, not for subfertile or infertile men. WIDER IMPLICATIONS OF THE FINDINGS: The overall semen quality of a given group of healthy men will not vary significantly in the short term. Single semen samples can be used in model building as long as major relevant covariates are considered. Utilizing multiple semen donations may actually cause the samples to be less representative. STUDY FUNDING/COMPETING INTERESTS: This research was supported by a grant from Shanghai Science and Technical Committee (02DJ14053) and a grant from Ministry of Science and Technology, China (9902). All authors have no competing interests.

Association between environmental exposure to cadmium and human semen quality.

Cadmium (Cd) is a heavy metal with toxicant to reproductive functions. The aim of this study was to explore the effects of environmental exposure to Cd on human semen quality. A total of 587 men from the general population, aged from 20 to 59 years old, and without occupational exposure to Cd were recruited from three provinces in China to participate in the study. The median of serum Cd was 1.9 µg/L (P25-P75:1.1-2.9). In case Cd was less than or equal to 6.3 µg/L (P95) and the semen parameters were logarithmically transformed, the inverse associations between Cd and semen volume (-0.03 ± 0.007), progressive motility (-0.01 ± 0.004), and sperm morphology (-0.04 ± 0.004) were found across the whole group, after adjusting for age group, occupation, season of semen sample collection, abstinence intervals, smoking, alcohol drinking, and body mass index. Our findings indicate that higher Cd may reduce the semen volume, progressive motility, and morphology among men without occupational exposure to Cd.

Exposure to bisphenol A (BPA) in Wistar rats reduces sperm quality with disruption of ERK signal pathway.

Bisphenol A (BPA) is an estrogenic environmental toxin widely used in the production of plastics and ubiquitous human exposure to this chemical has been proposed to be a potential risk to human health. Exposure to BPA can negatively impact sperm quality. However, the mechanism remains largely unknown. The objectives of this study were to assess the role of BPA on sperm quality and explore the possible mechanisms. The Wistar male rats (aged 28 days) were administered BPA by oral gavage for 28 days at dose of 50, 100 and 200 mg/kg/day; meanwhile, the negative control with corn oil (0 mg/kg/day BPA) and positive control with E2 at the dose of 100 µg/kg/day. The sperm density, sperm activity and sperm survival rate were analyzed byCASA system, and the sperm abnormality rate was analyzed by improved Papanicolaou stained. The protein expression levels of Src/p-Src, ERK1/2, p-ERK1/2 and CREB/p-CREB were detected by Western bolt. The results showed that the body weight gain, testes weight, testis coefficient, sperm density, sperm activity, sperm survival rate and protein expression levels of p-ERK1, p-ERK2 and p-CREB decreased, but the sperm abnormality rate increased with increasing BPA concentrations. There were positive correlations between sperm density, sperm activity and sperm survival rate with protein expression levels of p-ERK1, p-ERK2 and p-CREB, and negative correlations between sperm abnormality rate with the protein expression levels of p-ERK1, p-ERK2 and p-CREB. Results from the structural equation model demonstrated that BPA retained a significant negative effect to p-ERK, whereas p-ERK retained a significant positive effect to sperm quality and acted as the mediate variable. This study provides a novel insight regarding the potential role of p-ERK1 and p-ERK2 protein kinase on reproductive toxicity of BPA. The adverse effects of BPA on adult male sperm quality may be through the induction of the disruption of ERK signal pathway. However, additional research is needed to confirm our findings and to further test the suggested potential mechanisms.

Sexual orientation and risk factors for suicidal ideation and suicide attempts: a multi-centre cross-sectional study in three Asian cities.

PURPOSE: Despite robust empirical and theoretical evidence for higher rates of suicide among lesbian, gay, and bisexual (LGB) youths, little is known about the relationship between suicide and sexual orientation among Asian youths. This study examined differences in prevalence of suicidal ideation and suicide attempts between LGB and heterosexual youths in the cities of Hanoi, Shanghai, and Taipei, China. METHODS: The data are from a community-based multi-centre cross-sectional study conducted from 2006 to 2007, with a sample of 17 016 youths aged 15-24 years from Hanoi, Shanghai, and Taipei. Chi-square test and logistic regression were used to evaluate correlates of suicidal ideation and suicide attempts. RESULTS: The overall prevalence of suicidal ideation and suicide attempts in the preceding 12 months in LGB youths were both higher than in heterosexual youth (12.8% vs. 8.1% and 4.0% vs. 2.4%, respectively). Stratified by city, the prevalence of suicidal ideation was lowest in Hanoi (2.2%), followed by Shanghai (8.0%) and Taipei (17.0%). Similar trends were observed in the prevalence of suicide attempts, which was lowest in Hanoi (0.3%), followed by Shanghai (1.2%) and Taipei (2.5%). Of note, however, multivariate logistic regression results revealed that LGB youth were at a higher risk for suicidal ideation than heterosexual youth only in Taipei (odds ratio 1.65). CONCLUSIONS: Suicidality is common among Asian youth, with higher prevalence observed in urbanized cities. LGB youths are at greater risk of suicidal ideation than their heterosexual counterparts in Taipei than in the other two examined cities.

Sexual orientation and smoking history: results from a community-based sample of youth in Shanghai, China.

OBJECTIVE: Cigarette smoking has been found to be more prevalent among adults and youths with a minority sexual orientation (lesbian, gay, bisexual, LGB) than among the general population, while less is known about smoking among LGB youth in low- and middle-income countries. The goal of the study was to examine cigarette smoking in relation to sexual orientation in a community-based sample of youth in Shanghai, China. METHODS: A multi-center cross-sectional survey of 17,016 youth aged 15-24 years was conducted in rural and urban areas of Hanoi, Vietnam; Taipei, Taiwan; and Shanghai, China in 2006. In this article, analysis was restricted to the 6,299 respondents in Shanghai. Assessments included ever smoking, age at first smoking, frequency of smoking, and number of cigarettes smoked daily. Logistic regression was used to estimate the association between sexual orientation and cigarette smoking. RESULTS: Nine percent (594/6,299) of eligible participants considered themselves as LGB youths; 34.2% ever smoked, 14.81% initiated smoking before age 13, 15.9% smoked in the past 30 days, and 14.1% were moderate or heavy smokers. LGB identity predicted moderate or heavy smoking (OR 2.2, 95% CI 1.3, 3.9). Male LGB youth smoked more cigarettes daily (OR 2.2, 95% CI 1.3, 3.9) whilst female LGB youth reported less any prior cigarette use (OR 0.7, 95% CI 0.5, 1.0). CONCLUSIONS: Few meaningful disparities in cigarette smoking were related to sexual orientation, except male LGB youth consumed more cigarettes daily. Prevention and cessation should target this population, especially male LGB youth.

An Empirical Analysis of the Impact of Recruitment Patterns on RDS Estimates among a Socially Ordered Population of Female Sex Workers in China.

Respondent-driven sampling (RDS) is a method for recruiting "hidden" populations through a network-based, chain and peer referral process. RDS recruits hidden populations more effectively than other sampling methods and promises to generate unbiased estimates of their characteristics. RDS's faithful representation of hidden populations relies on the validity of core assumptions regarding the unobserved referral process. With empirical recruitment data from an RDS study of female sex workers (FSWs) in Shanghai, we assess the RDS assumption that participants recruit nonpreferentially from among their network alters. We also present a bootstrap method for constructing the confidence intervals around RDS estimates. This approach uniquely incorporates real-world features of the population under study (e.g., the sample's observed branching structure). We then extend this approach to approximate the distribution of RDS estimates under various peer recruitment scenarios consistent with the data as a means to quantify the impact of recruitment bias and of rejection bias on the RDS estimates. We find that the hierarchical social organization of FSWs leads to recruitment biases by constraining RDS recruitment across social classes and introducing bias in the RDS estimates.

Effects of manganese on routine semen quality parameters: results from a population-based study in China.

BACKGROUND: Manganese (Mn) is an essential element in humans but its effect on semen quality is unclear. This study therefore aimed to assess the effects of Mn on semen quality in healthy men with no occupational exposure to Mn. METHODS: Semen samples were obtained from healthy Chinese men 20-59 years old who were recruited from six provinces in China. Individuals with urogenital tract diseases, tuberculosis, or occupational exposure to heavy metals were excluded. A questionnaire survey was conducted, and the external genitalia, semen quality, and serum Mn levels were examined. RESULTS: A total of 1,179 volunteers were enrolled in this study. The median serum Mn concentration was 8.2 µg/L (25th percentile (P25)=3.7 µg/L, P75=16.2 µg/L). After adjusted area (six provinces), abstinence interval, season, registered residence, age of subjects, education level, income, smoking, and drinking, the risk of teratospermia was increased at serum Mn concentrations >19.40 µg/L (P80) group, with an adjusted odds ratio of 2.27 (95% confidence interval: 1.18-4.37). CONCLUSION: High serum Mn levels appeared to have harmful effects on sperm morphology and motility among healthy men with no occupational exposure to Mn.

[Investigation and study on influencing factors of overweight and obesity of children aged 10 to 14 in Wuxi].

OBJECTIVE: To learn the prevalence of overweight and obesity of children aged 10 to 14 in Wuxi and to analyze its potential influencing factors. METHODS: With a stratified cluster random sampling method, 2870 children aged 10 to 14 in three districts of Wuxi were surveyed by means of questionnaire and physical examination. RESULTS: The incidence of overweight was 11.39% (Boys' was 10.03% and girls' was 1.36%) and that of obesity was 2.23% (Boys' was 1.64% and girls' was 0.59%). The incidence of overweight and obesity of boys was much higher than that of girls (P < 0.01). The result of multiple linear regression analysis indicated the influencing factors of BMI in childhood might include birth weight, BMI of father and mother and preference for fried foods. CONCLUSION: The prevalence of overweight and obesity of children aged 10 to 14 in Wuxi was between the rich rural areas and small and middle-sized cities in China. To prevent overweight developing to obesity is an important measure. Birth weight, BMI of father and mother, preference for fried foods were the main factors affecting children's BMI. A comprehensive prevention and control measure of family intervention should be taken.

In utero exposure to bisphenol-A and anogenital distance of male offspring.

BACKGROUND: Bisphenol-A (BPA) is an endocrine disruptor with widespread human exposure. The effect of in utero BPA exposure on human offspring remains largely unknown. METHODS: Anogenital distance (AGD) of sons of workers who did or did not have occupational BPA exposure during pregnancy were compared in an occupational cohort study. Parental BPA exposure level during the index pregnancy was estimated through a job-exposure matrix based on personal air sampling measurement. Maternal exposure was considered direct in utero exposure to the fetus, whereas paternal exposure was considered indirect in utero exposure. RESULTS: A total of 153 boys were included in the final analysis, among them 56 with parental occupational exposure during pregnancy and 97 without. After controlling for the boys' ages and weights using linear regression, parental occupational exposure to BPA during pregnancy was associated with shortened AGD in male offspring. The association was stronger for maternal exposure (p < 0.01). There was also a dose-response relationship with increased BPA exposure levels in pregnancy associated with greater magnitude of shortened AGD in male offspring, with a statistically significant trend for the association (p = 0.008). CONCLUSION: Our findings provide the first epidemiologic evidence that in utero BPA exposure may adversely affect male genital development.

[Effect of bisphenol A exposure on sex hormone level in occupational women].

OBJECTIVE: To explore the effect of bisphenol A (BPA) exposure on sex hormone levels in occupational women. METHODS: 51 women workers with at least a year of BPA exposure and 104 women workers without BPA exposure were chosen to do a case; control study. The information in general population characteristics, exposure, menstruation state, etc and the venous blood samples on an empty stomach were collected for the two groups. The endocrine hormones levels of follicle stimulating hormone (FSH), prolactin (PRL) , progesterone (P), estradiol (E2), luteinizing hormone (LH) were detected by RIA analysis. RESULT: The PRL level in the BPA exposure group was significantly higher to that in the control group (t = 2.127, P = 0.047). It was found that the proportion of abnormal PRL in the exposure group was significantly higher to the control group (chi2 = 4.924, P = 0. 026). In the age class of more than 30 years, the proportion of abnormal PRL in the exposure group was significantly higher to the control group (chi2 = 5.131, P = 0.023) and the proportion of abnormal progesterone in the exposure group was significantly to the control group (chi2 = 4.665, P = 0.031)in the same age class. In the people of no taking vitamin, the proportion of abnormal PRL in the exposure group was significantly higher to the control group (chi2 = 6.541, P = 0.011). The proportion of abnormal progesterone in the group of less than 5 years exposure was significantly higher to the group of more than 5 years exposure (chi2 = 3.938, P = 0. 047). The multivariate analysis found that BPA exposure was the independent risk factor to effect serum PRL (OR = 2.623, P = 0.030) of occupational women. Effect of BPA on FSH, E2, LH level couldn't be found through this study. CONCLUSION: BPA occupational exposure of women maked PRL level set up and effected progesterone level. After adjusting for age, exposure age and other potential confounding factors, BPA exposure is an independent risk factor to arise the level of serum PRL in occupational women.

Mifepristone-induced abortion and duration of third stage labour in a subsequent pregnancy.

To evaluate the impact of mifepristone-induced abortion (MA) on the duration of third stage labour in a subsequent pregnancy, an observational cohort study was conducted from 1998 to 2001 at antenatal clinics in Shanghai, Beijing and Chengdu, China. A total of 4925 pregnant women with no history of induced abortion (NA) and 4931 pregnant women with one previous MA were enrolled and followed until delivery. Of these, 5139 women who delivered singletons vaginally were used in the present analyses, including 2614 with NA and 2525 with a history of MA. Maternal characteristics, labour duration and other obstetric and gynaecological information were obtained. The incidence rates of prolonged third stage of labour were 1.55% and 1.49% in NA and MA, respectively. After adjusting for age at delivery, maternal education, maternal occupation, area of residence, duration of gestational, type of delivery and pregnancy-induced hypertension, MA was not associated with the risk of prolonged third stage of labour (odds ratios = 0.92, 95% confidence interval 0.58, 1.44). Subgroup analysis of women with MA showed similar results regardless of gestational age at abortion, woman's age at abortion, subsequent curettage/complications and the interpregnancy interval. In conclusion, the data did not provide evidence that one MA was associated with the risk of prolonged third stage of labour in a subsequent pregnancy in primiparae.

Effects of caesarean section on maternal health in low risk nulliparous women: a prospective matched cohort study in Shanghai, China.

BACKGROUND: Rates of caesarean section are progressively increasing in many parts of the world. As a result of psychosocial factors there has been an increasing tendency for pregnant women without justifiable medical indications for caesarean section to ask for this procedure in China. A critical examination of this issue in relation to maternal outcomes is important. At present there are no clinical trials to help assess the risks and benefits of caesarean section in low risk women. To fill the gap left by trials, this indication-matched cohort study was carried out to examine prospectively the outcomes of caesarean section on women with no absolute obstetric indication compared with similar women who had vaginal delivery. METHODS: An indication-matched cohort study was undertaken to compare maternal outcomes following caesarean section with those undergoing vaginal delivery, in which the two groups were matched for non-absolute indications. 301 nulliparous women with caesarean section were matched successfully with 301 women who delivered vaginally in the Maternal and Children's Hospitals (MCHs) in Shanghai, China. Logistic regression model or binomial regression model was used to estimate the relative risk (RR) directly. Adjusted RRs were calculated adjusting for propensity score and medical indications. RESULTS: The incidence of total complications was 2.2 times higher in the caesarean section group during hospitalization post-partum, compared with the vaginal delivery group (RR = 2.2; 95% CI: 1.1-4.4). The risk of haemorrhage from the start of labour until 2 hours post-partum was significantly higher in the caesarean group (RR = 5.6; 95% CI: 1.2-26.9). The risk of chronic abdominal pain was significantly higher for the caesarean section group (RR = 3.6; 95% CI: 1.2-10.9) than for the vaginal delivery group within 12 months post-partum. The two groups had similar incidences of anaemia and complicating infections such as wound complications or urinary tract infection. CONCLUSIONS: In nulliparous women who were at low risk, caesarean section was associated with a higher rate of post-partum morbidity. Those requesting the surgical procedure with no conventional medical indication, should be advised of the potential risks.

Mifepristone-induced abortion and placental complications in subsequent pregnancy.

BACKGROUND: The aim of the study was to explore the effect of first-trimester mifepristone-induced abortion (MA) on placental complications in subsequent pregnancy. METHODS: Two cohorts of nulliparous pregnant women were recruited in China during early pregnancy, one with a history of one MA and the other with no abortion (NA). Women were followed up until delivery. RESULTS: The incidence proportions of abruptio placenta, placenta previa, placenta accreta and retained placenta in the MA group (4673) and NA group (4690) were, respectively, 0.5 and 0.3, 0.8 and 0.9, 0.5 and 0.5, and 0.7 and 0.8% (all differences non-significant). After adjustment for center, age, education, occupation, residence, income, BMI and type of delivery, the incidence rates of placenta previa, accreta and retained placenta in the MA and NA groups showed no significant differences. The risk of abruptio placenta in women with a MA was nearly double that of women with no abortion, although this apparent increased risk was not statistically significant. Furthermore, this increased risk of abruptio placenta was found only in those with a gestational age >6 weeks at abortion (aOR: 2.46; 95% CI: 1.00-6.04), a curettage after abortion (aOR: 3.00; 95% CI: 1.25-7.20) or a longer inter-pregnancy interval (P-value for trend: 0.022). CONCLUSIONS: Mifepristone-induced abortion itself is not associated with placental complications in subsequent pregnancy, but other factors related to medical abortion-such as a gestational age >6 weeks at abortion, a curettage after abortion, and a longer interpregnancy interval-may increase the risk of abruptio placenta.

Gender differences in cigarette smoking and alcohol drinking among adolescents and young adults in Hanoi, Shanghai, and Taipei.

OBJECTIVE: This study aimed to examine gender differences in smoking and alcohol drinking behaviors in three Asian cities of Hanoi, Shanghai, and Taipei, and to assess the magnitude of gender differences across the three cities. METHODS: A total of 17,016 adolescents (age: 15-19 years) and young adults (age: 20-24 years) were selected using multi-stage sampling methods and surveyed in face-to-face interviews. A total of 16,554 unmarried respondents were included in this analysis. RESULTS: Gender differences were significant for smoking only, drinking only, and both behaviors in each city. Male respondents were 30.66 times more likely to report smoking only than female respondents in Hanoi, followed by Shanghai and Taipei. This pattern was similar for drinking only and both smoking and drinking behaviors. CONCLUSIONS: The magnitude of gender differences in smoking only, drinking only, and both behaviors widely varies across the three cities. Further research can examine how these differences may be used to prevent and reduce smoking and drinking in the adolescent and young adult population.

Do reproductive hormones explain the association between body mass index and semen quality?

AIM: To examine whether reproductive hormones play a role in the association between body mass index (BMI) and semen quality. METHODS: Semen quality and testosterone (T), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and estradiol (E(2)) were evaluated in 990 fertile males with age 38.9 +/- 9.7 (mean +/- SD) years recruited from the Chinese general population in 2001 and 2002. RESULTS: Semen quality was reduced among underweight (BMI < 18.5) compared with normal (BMI 18.5-24.9) and overweight (BMI 25.0-29.9), but the associations were independent of reproductive hormones. After adjustment for the potential confounders, underweight men had reductions in sperm concentration (22.4 X 10(6)/mL), total sperm count (52.9 X 10(6)) and percentage of normal sperm forms (6.9%) compared with men with normal BMI. Being underweight may be a risk factor for low sperm concentration (OR: 4.68, 95% confidence intervals [CI]: 2.01-10.91). Otherwise, being overweight may be a protected factor for low sperm concentration (OR: 0.25; 95% CI: 0.08-0.83) and low total sperm count (OR: 0.37, 95% CI: 0.15-0.87). CONCLUSION: Low BMI was associated with reduced semen quality. The associations between BMI and semen quality were found statistically significant even after adjustment for reproductive hormones. Reproductive hormones cannot explain the association between BMI and semen quality.

Joint effects of the CYP1A1 MspI, ERalpha PvuII, and ERalpha XbaI polymorphisms on the risk of breast cancer: results from a population-based case-control study in Shanghai, China.

Estrogen-metabolizing gene and estrogen receptor (ER) genes are the possible risk factors implicated in the initiation and development of breast through estrogen tumorigenesis pathway. We examined whether CYP1A1 MspI, ERalpha PvuII, and ERalpha XbaI genetic polymorphisms could increase the risk of breast cancer among Chinese women and gene-gene joint effect on the breast cancer risk in a subset from a population-based case-control study conducted in urban Shanghai from January 1, 1998 and November 31, 2001. PCR-RFLP method based on buccal cells was used to examine the three candidate polymorphisms in 282 breast cancer cases and 298 controls. Compared with CYP1A1 MspI m1/m1, the risk of breast cancer was doubled for genotypes CYP1A1 MspI m1/m2 [odds ratio (OR), 1.83; 95% confidence interval (95% CI), 1.24-2.69] and CYP1A1 MspI m2/m2 (OR, 2.22; 95% CI, 1.26-3.85). The association seemed to be stronger among cases diagnosed older than 45 years and women without a family history of breast cancer. ERalpha PvuII pp and ERalpha XbaI xx polymorphisms, which are in possible linkage disequilibrium, were both associated with a nonsignificantly elevated risk in all subjects; the associations seemed to be stronger among women with a family history of breast cancer. There seems to be a joint effect on the breast cancer risk between CYP1A1 MspI and ERalpha XbaI genotypes (m2/m2 and xx; OR, 5.87; 95% CI, 1.38-24.98), between CYP1A1 MspI and ERalpha PvuII genotypes (m2/m2 and pp; OR, 2.39; 95% CI, 0.81-7.07), and among all three genotypes (m2/m2, pp, and xx; OR, 8.07; 95% CI, 1.45-44.77). Results of this study indicate that estrogen-metabolizing genes and estrogen receptor may jointly play a role in the etiology of breast cancer.

Do Ureaplasma urealyticum infections in the genital tract affect semen quality?

UNLABELLED: To investigate the relationship between Ureaplasma urealyticum (UU) infection and semen quality. METHODS: From 2001 to 2003, 346 eligible patients aged 20-45 years were invited from two hospitals in Shanghai, China, to participate in an investigation which included questionnaires about general and reproductive health, an external genital tract examination, UU culture and semen analysis. Multiple linear regression models were used to examine whether UU had a significant effect on semen quality after adjustment for confounding factors. RESULTS: Findings suggested that UU infection was associated with higher semen viscosity and lower semen pH value. Sperm concentration was lower in UU positive subjects than that in UU negative subjects (54.04 X 10(6)/mL vs.70.58 X 10(6)/mL). However, UU did not significantly affect other semen quality indexes. CONCLUSION: UU infection of the male genital tract could negatively influence semen quality.

[Association between endogenous hormones, hormone receptors and cervical cancer].

OBJECTIVE: To explore the relationship between the levels of estrogen (E2) and progestogen (P), expression of estrogen receptor (ER) and progesterone receptor (PR) and cervical cancer. METHODS: A case-control study with hospital and community controls was employed. The levels of serum estrogen and progesterone were detected by enzyme linked immunosorbent assay (ELISA) for 141 cervical cancer cases, 137 uterine myoma patients as controls and 129 health women as controls. ER and PR were measured by immunohistochemistry sABC in cervix tissues from patients with cervical cancer and uterus myoma as well. RESULTS: The levels of estrogen (47.49 ng/mL) and progesterone (2.34 pg/mL) in cases were significantly higher than those in both control groups. The association between estrogen and cervical cancer was significant both before and after menopause-adjusted, with over 89% of attributable risk percentage (ARP), and showed a dose-response relation. Using the lowest value of 2 pg/ml in follicular phase as cut off point for progesterone, there were no statistically significant difference between cases and controls, and neither in progesterone nor in premenopausal. The expressions of ER and PR in cases were lower than those in controls, even after being menopause-adjusted. CONCLUSION: The high level of endogenous estrogen and progestogen might increase the risk of cervical cancer. Compared with progestogen, estrogen showed a higher risk that was not influenced by menopause. In some sense, ER and PR may exert certain protective effect on progressing of cervical carcinogenesis.