Brunonianines D-F, three new C19-diterpenoid alkaloids from the Delphinium brunonianum, with therapeutic effect on ovarian cancer in vitro and in vivo.

The current standard treatment for ovarian cancer consists of surgery to reduce the size of the tumor, followed by treatment with chemotherapeutic drugs, which have major side effects. Therefore, finding a new natural product drug with fewer side effects is a strategy. Delphinium brunonianum (D. brunonianum) is a traditional Tibetan medicine, mainly from southern Tibet, China, whereas the chemical constituents in this plant remain elusive. The major metabolites in the dichloromethane fraction of D. brunonianum were analyzed and purified by HPLC and various column chromatography techniques. Nine diterpenoid alkaloids (1-9) and one amide alkaloid (10) were isolated from D. brunonianum, including three novel C19-type diterpenoid alkaloids (Brunonianines D-F) (1-3). Their structures were elucidated by 1D/2D NMR, HR-ESI-MS and single-crystal X-ray diffraction analyses. All compounds were evaluated for toxicity in four tumor cell lines. Most of the compounds exhibited potent inhibitory effects on Skov-3 cell lines, with IC50 values ranging from 2.57 to 8.05 µM. The western blotting experiment was used to further analyze the expression levels of molecules in the Bax/Bcl-2/Caspase-3 signaling pathway for compound 1. Molecular docking was performed to predict the binding modes of Brunonianine D with target proteins. In vivo experiments were also performed and evaluated in real time by monitoring the size of the Skov-3 tumor. Additionally, tumor H&E staining and the TUNEL assay used to evaluate anti-tumor effects.

Chemical constituents of Rubia tibetica Hook. f. from Tibetan medicine and cytotoxic activity evaluation.

Two unprecedented quinone compounds Rubiaxylm A (1) and Rubiaxylm B (2), along with fifteen known anthraquinones (3-17) were isolated and characterized from the roots of Rubia tibetica in Tibetan medicine. Their structures were identified through comprehensive analyses of 1D/2D NMR as well as HR-ESIMS data. Furthermore, all separated compounds were evaluated for their cytotoxic activity on A549, Caco-2, MDA-MB-231 and Skov-3 cell lines. In particular, compound 2 effectively inhibited MDA-MB-231 cells with an IC50 value of 8.15 ± 0.20 µM. Subsequently, the anti-tumor mechanism of 2 was investigated by flow cytometry, JC-1 staining, cell scratching and cell colony. These results indicated that compound 2 could inhibit the proliferation of MDA-MB-231 cells by arresting cells in the G1 phase.

Association between exposure to tobacco information through mass media, smoking households and secondhand smoke exposure in adolescents: Survey data from South Korea.

INTRODUCTION: To explore the current situation of exposure of Korean adolescents to secondhand smoke (SHS) in households our study aimed to determine the relationship between family member smoking status, exposure to tobacco information through mass media, and household SHS exposure. METHODS: The present study uses pooled data from the Korean adolescent health behavior online survey conducted in 2015, 2018 and 2021, with 157944 participants. The regression models were used to explore the association between the smoking status of households, and exposure to tobacco information through mass media, and household SHS exposure in adolescents, controlling for potential confounding factors. RESULTS: SHS exposure duration of Korean adolescents in households was 0.88 days per week. The households with smokers including the father (ß=1.087; 95% CI: 1.0-1.126), mother (ß=1.461; 95% CI: 1.379- 1.543), siblings (ß=0.545; 95% CI: 0.493-0.597), grandparents (ß=0.224; 95% CI: 0.174-0.272), and other relatives (ß=0.170; 95% CI: 0.126-0.214), showed a positive association with SHS exposure in adolescents within the household. At the same time, information about anti-smoking ads on television (ß= -0.042; 95% CI: -0.069 - -0.015) and public transportation (ß= -0.031; 95% CI: -0.054 - -0.010), showed a negative association with SHS exposure in adolescents. However, broadcasts, online, and newspaper non-smoking ads were not associated with SHS exposure (p>0.05). In addition, regression models revealed that exposure to cigarette advertising in magazines (ß=0.131; 95% CI: 0.097-0.166), networks (ß=0.151; 95% CI: 0.127-0.175), convenience stores (ß=0.061; 95% CI: 0.035-0.087), and supermarkets (ß=0.133; 95% CI: 0.108-0.158) is associated with SHS exposure in adolescents. Finally, our study showed stronger ties between SHS exposure, family smoking, and tobacco ads in girls. The link between maternal smoking, supermarket ads, and adolescent SHS exposure intensified in 2021 compared to 2015. CONCLUSIONS: Family and media were identified as potential factors associated with SHS exposure in adolescents. Therefore, publicity and education regarding household SHS hazards, and smoking bans in media, can be helpful in protecting adolescents from SHS.

Corrigendum: Association between exposure to tobacco information through mass media, smoking households and secondhand smoke exposure in adolescents: Survey data from South Korea.

[This corrects the article DOI: 10.18332/tid/175705.].

Structures and Tumor Cell Lines Proliferation Activities of Triterpenes Isolated from Astilbe grandis.

A total of seven compounds, including four triterpene acids and three triterpene lactones, were isolated from the ethanolic extract of the roots of Astilbe grandis Stapf ex Wils. Two of the triterpene lactones (1-2) were never reported before and compounds 3-5 were isolated for the first time from the plant. The structures of these compounds were all identified by spectroscopic analysis. Compounds 1-2 were analyzed by 2D NMR and their absolute configurations were determined using experimental CD in comparison with calculated ECD values. The structure of compound 1 was also further confirmed by single crystal X-ray diffraction analysis. The cytotoxicity of compounds 1-7 on A549, Caco-2, H460 and Skov-3 tumor cells were all evaluated using CCK-8. They all exhibited positive inhibitory effects on Caco-2 tumor cells with IC50 less than10 µM, while the inhibitory effects on H460 tumor cells were more moderate. Unfortunately, they displayed little apparent cytotoxicity to the other two types of cells.

Brunonianines A-C, C20-diterpenoid alkaloids with cyano group from Delphinium brunonianum Royle.

Cyano tends to have better biological activity, but it is rarely reported in natural products, especially in the C20-diterpene alkaloids. Herein, three unprecedented C20-diterpenoid alkaloids, brunonianines A-C (1-3), possessing rare cyano functional group as well as an atisine backbone constructed from a phenethyl substituent and a tetrahydropyran ring, along with four C19-alkaloids (4-7) and one amide alkaloids (8), were isolated from the whole plant of Delphinium brunonianum Royle. Compounds 1-3 are also the first atisine type diterpenoid alkaloids with cyano group obtained from nature. The structures of the previously undescribed compounds were elucidated by HR-ESI-MS, 1D/2D NMR spectroscopic data and electronic circular dichroism calculations and single-crystal X-ray diffraction. Reasonable speculations have also been made regarding the biogenic synthetic pathways of compounds 1-3. In addition, the inhibitory activity of all compounds was also tested against four tumor lines: A549, Caco-2, H460 and Skov-3, where compound 2 (IC50 2.20 ± 0.21 µM) showed better inhibitory activity against Skov-3 cells than the hydroxycamptothecin. Using flow cytometry, cell staining, migration and invasion analysis, and Western blot, compound 2 was found to arrest cells in the G2/M phase and was able to effectively inhibit cell motility to achieve potent anti-tumor effects. In addition, compound 2 can effectively induce apoptosis by activating the Bax/Bcl-2/Caspase-3 signaling pathway.

Effects of bundle-care interventions on pressure ulcers in patients with stroke: A meta-analysis.

We conducted a meta-analysis to assess the effects of bundle-care interventions on pressure ulcers in patients with stroke to provide a basis for clinical work. Randomised controlled trials on the effects of bundle-care interventions in patients with stroke were identified using computerised searches of the PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, VIP and Wanfang databases, from the time of inception of each database to July 2023, supplemented by manual literature searches. Two researchers independently retrieved and screened the articles, extracted the data and evaluated the quality of the included studies. After reaching consensus, meta-analysis was performed using RevMan 5.4. Twenty-four papers were included, involving 3330 patients of whom 1679 were in the intervention group and 1651 were in the control group. The results showed that, compared with standard care, bundle-care interventions significantly reduced the incidence of pressure ulcers (3.28% vs. 14.84%, odds ratio [OR]: 0.19, 95% confidence interval [CI]: 0.14-0.26, p < 0.001), and aspiration (5.60% vs. 18.84%, OR: 0.25, 95% CI: 0.17-0.39, p < 0.001), and improved patient satisfaction with nursing care (96.59% vs. 84.43%, OR. 5.45, 95% CI: 3.76-7.90, p < 0.001). Current evidence suggests that care bundles are significantly better than conventional nursing measures in preventing pressure ulcers and aspiration, and improving patient satisfaction with nursing care in patients with stroke, and are worthy of clinical promotion and application.

Individual, Peer, and Family Correlates of Depressive Symptoms among College Students in Hong Kong.

In this study, an ecological model and developmental psychopathology theory focusing on an ontogenic system (hopelessness) and microsystems (peer alienation and childhood abuse and trauma) was adopted to examine the individual, peer, and family correlates of depressive symptoms among college Chinese students in Hong Kong, China. A cross-sectional survey research design with a convenience sampling procedure was used to examine a sample of college students (n = 786) aged 18 to 21 years old in Hong Kong. Among them, 352 respondents (44.8%) reported having depressive symptoms, with a Beck Depression Inventory-II (BDI-II) score of 14 or above. The results of this study indicated that childhood abuse and trauma, peer alienation, and hopelessness were positively related to depressive symptoms. The underlying arguments and implications were discussed. The study results provided further support for the ecological model and the developmental psychopathology theory on the predictive roles of individual, peer, and family correlates of adolescent depression.

The Effectiveness of an eHealth Family-Based Intervention Program in Patients With Uncontrolled Type 2 Diabetes Mellitus (T2DM) in the Community Via WeChat: Randomized Controlled Trial.

BACKGROUND: Intervention based on family support and risk perception can enhance type 2 diabetes mellitus (T2DM) patients' self-care activities. In addition, eHealth education is considered to improve family members' support for patients with T2DM. However, there is little evidence from rigorously designed studies on the effectiveness of an intervention combining these approaches. OBJECTIVE: This randomized controlled trial (RCT) aimed to assess the effectiveness of an eHealth family-based health education intervention for patients with T2DM to improve their glucose control, risk perception, and self-care behaviors. METHODS: This single-center, 2-parallel-group RCT was conducted between 2019 and 2020. Overall, 228 patients were recruited from Jiading District, Shanghai, and randomly divided into intervention and control groups. The intervention group received an eHealth family intervention based on community management via WeChat, whereas the control group received usual care. The primary outcome was the glycated hemoglobin (HbA1c) level of the patients with T2DM, and the secondary outcomes were self-management behavior (general and specific diet, exercise, blood sugar testing, foot care, and smoking), risk perception (risk knowledge, personal control, worry, optimism bias, and personal risk), and family support (supportive and nonsupportive behaviors). A 2-tailed paired-sample t test was used to compare the participants at baseline and follow-up within the control and intervention groups. An analysis of covariance was used to measure the intervention effect. RESULTS: In total, 225 patients with T2DM were followed up for 1 year. After intervention, they had significantly lower HbA1c values (ß=-.69, 95% CI -0.99 to -0.39; P<.001). They also had improved general diet (ß=.60, 95% CI 0.20 to 1.00; P=.003), special diet (ß=.71, 95% CI 0.34 to 1.09; P<.001), blood sugar testing (ß=.50, 95% CI 0.02 to 0.98; P=.04), foot care (ß=1.82, 95% CI 1.23 to 2.42; P<.001), risk knowledge (ß=.89, 95% CI 0.55 to 1.24; P<.001), personal control (ß=.22, 95% CI 0.12 to 0.32; P<.001), worry (ß=.24, 95% CI 0.10 to 0.39; P=.001), optimism bias (ß=.26, 95% CI 0.09 to 0.43; P=.003), and supportive behaviors (ß=5.52, 95% CI 4.03 to 7.01; P<.001). CONCLUSIONS: The eHealth family-based intervention improved glucose control and self-care activities among patients with T2DM by aiding the implementation of interventions to improve T2DM risk perceptions among family members. The intervention is generalizable for patients with T2DM using health management systems in community health centers. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1900020736; https://www.chictr.org.cn/showprojen.aspx?proj=31214.

Effects of stepped speech rehabilitation and psychological intervention on speech disorders and cognitive function in Parkinson disease patients.

To examine the impact of stepwise speech rehabilitation exercise therapy in the treatment of patients with Parkinson speech problems under psychological intervention on clinical results and cognitive functioning. Parkinson speech disorder patients who met the inclusion criteria were selected and divided into a control group and an observation group for training respectively. The control group used conventional nursing methods, including training in orofacial movement, vocalization, pitch, volume and breath control. The observation group used stepwise speech rehabilitation exercise intervention combined with psychotherapy nursing programme. In the statistical analysis, independent sample t-test and chi-square test were used to test the significance of the data processing methods. In the statistical analysis of baseline functional level (P > .05). The difference was not statistically significant. After 7 weeks of training, the mFDA level and speech intelligibility increased in both the observation and control groups. From the situation analysis of "modified drinking test" and the comparison of UPDRS-I scores, it can be seen that dysphagia and Parkinson dysphasia were reduced in both groups after training. The observation group spontaneous speech dimension was greater than the control group by around 0.07 in the aphasia comparison. Both groups displayed an upward trend in their MMSE and Montreal Cognitive Assessment (MoCA) when measuring cognitive function; the evaluation of P300, constructive function, and quality of life revealed this. The observation group P300 potential score was 0.13 points higher than that of the control group. The therapeutic training of stepped speech rehabilitation exercise care combined with psychological intervention has significant nursing effects on patients with Parkinson disease speech disorders, and the patients' cognitive functions have been effectively improved.

Understanding the relationship between distress intolerance and problematic Internet use: The mediating role of coping motives and the moderating role of need frustration.

INTRODUCTION: There is emerging research interest in exploring the relationship between distress intolerance and problematic Internet use, yet most of the existing studies are limited by cross-sectional design, convenience sampling method, and poor understanding of the potential mediating and moderating factors involved. Based on the distress intolerance theory of addictive behavior and the theory of compensatory internet use, this study investigated a moderated mediation model to explain the impact of distress intolerance on problematic Internet use in adolescents. METHODS: A three-wave longitudinal survey was conducted with 709 adolescents in Shanghai, China. The gender distribution was even, 50.2% were boys and 49.8% were girls. The mean age at T1 was 14.79 years (SD = 2.87). RESULTS: Distress intolerance at Time 1 was found to positively predict problematic Internet use at Time 3. This prospective relation was mediated by adolescents' coping motives for Internet use at Time 2. Further, the mediation effect of coping motives for Internet use was moderated by need frustration at Time 2. The moderated mediation model was statistically equivalent for both genders. CONCLUSIONS: Findings of this study contribute to new knowledge and have practical implications for prevention and intervention of adolescent problematic Internet use.

Childhood emotional abuse and adolescent flourishing: A moderated mediation model of self-compassion and curiosity.

BACKGROUND: Resilience and positive mental health may be negatively influenced by childhood maltreatment. While many scholars have noted that adolescents exposed to childhood emotional abuse could meet the criteria for flourishing, little research has investigated the mediating effect of self-compassion and the moderating effect of curiosity on the relationship between childhood emotional abuse and adolescent flourishing. OBJECTIVE: This study proposed and tested a moderated mediation model that attempted to explain the pathway from childhood emotional abuse to adolescent flourishing. PARTICIPANTS AND SETTING: The sample consisted of 315 female students (mean age 12.81 years, range 12-14 years) in a girls' secondary school in Hong Kong, China. METHODS: We conducted a three-wave study with six-month intervals. The participants completed self-administered questionnaires at school under the guidance of trained research assistants. RESULTS: Self-compassion at Time 2 mediated the relationship between childhood emotional abuse at Time 1 and adolescent flourishing at Time 3. Furthermore, the mediating effect was moderated by adolescent curiosity at Time 1 and Time 2. CONCLUSIONS: The findings of this study suggested that although childhood emotional abuse may hinder the development of self-compassion, reduced levels of self-compassion and curiosity (especially the stretch dimension of curiosity) could work together to promote flourishing in adolescents with a history of childhood emotional abuse. The results lent further support to the developmental psychopathology and resilience perspectives in explaining the relationship between childhood trauma and positive developmental outcomes.

A longitudinal study on the relationship among childhood emotional abuse, gratitude, and suicidal ideation of Chinese adolescents.

BACKGROUND AND OBJECTIVE: Suicidal ideation is a significant predictor of suicidal attempt. Based on the developmental psychopathology perspective and the resilience theory, this study examines whether trait gratitude mediates the relationship between childhood emotional abuse and adolescent suicidal ideation. PARTICIPANTS AND SETTING: A sample of 909 Grade 8 to Grade 9 adolescents aged 12-18 years in Hong Kong, a Special Administrative Region in China, was recruited from six secondary schools. METHOD: A two-wave longitudinal study was conducted. Participants completed the same measures on Gratitude Quesitonnaire-6, Suicidal Ideation Scale, emotional subscale of Child Abuse and Trauma Scale at two time points 12 months apart. RESULTS: Results of cross-lagged analyses showed that adolescents' suicidal ideation was positively associated with childhood emotional abuse and negatively associated with gratitude; further, the association between childhood emotional abuse and suicidal ideation was mediated by gratitude. CONCLUSIONS: Findings of this study implied that while exposure to parental emotional abuse might have an adverse impact on the development of gratitude, adolescents' current level of gratitude still exerts its protective effect by directly reducing their suicidal ideation. Gratitude or other resilience factors that might comprise additional mediating mechanisms from childhood emotional abuse to mental health problems in later life is worthy of further investigation.

Childhood Neglect and Adolescent Suicidal Ideation: a Moderated Mediation Model of Hope and Depression.

Using data collected on a two-wave longitudinal sample of 910 adolescents with mean age of 13.68 years in Hong Kong, China, this survey aimed to test a moderated mediation model to account for the developmental pathway from childhood experiences of neglect to suicidal ideation in adolescents. Results showed that adolescents who were neglected as children had higher levels of suicidal ideation; furthermore, this relation was mediated by adolescents' depressive symptoms, while the path between adolescents' depressive symptoms and suicidal ideation was moderated by adolescents' sense of hope. Findings of this study imply that intervention and services that help prevent childhood neglect, alleviate depression, and promote hope are potentially important to decrease adolescent suicidal ideation.

Yap regulates gastric cancer survival and migration via SIRT1/Mfn2/mitophagy.

Gastric cancer is the fifth most common cancer worldwide and Hippo-Yap is the novel signaling pathway which plays an important role in gastric cancer tumor development and progression. However, little insight is available to date regarding the specific role of Yes-associated protein (Yap) in gastric cancer. In the present study, we identified the mechanism through which Yap sustains gastric cancer viability and migration. Yap was greatly upregulated in gastric cancer cells and its expression promoted cellular migration and survival. Functional studies found that knockdown of Yap reduced the mitophagy activity, which subsequently caused mitochondrial apoptosis and cellular oxidative stress. The latter impaired adhesive protein expression, alleviated F-actin expression, blunted lamellipodium formation, leading to inhibition of cancer cell motility. Mechanistically, Yap preserved Sirtuin 1 (SIRT1) activity which manipulated mitofusin 2 (Mfn2) expression and subsequent mitophagy. Loss of Yap reduced SIRT1 expression and inhibited Mfn2-mediated mitophagy. Collectively, our results identified Hippo-Yap as a tumor promoter in gastric cancer that was mediated via activation of the SIRT1/Mfn2/mitophagy axis, with potential applications to gastric cancer therapy involving cancer survival and migration.

NR4A1-induced increase in the sensitivity of a human gastric cancer line to TNFα-mediated apoptosis is associated with the inhibition of JNK/Parkin-dependent mitophagy.

Tumor necrosis factor α (TNFα)-based immunotherapy is the vital host defense system against the progression of gastric cancer (GC) as a pro-inflammatory and pro-apoptotic cytokine. However, resistance limits its therapeutic efficiency. Therefore, an increasing number of studies are focusing on the development of drugs or methods with which to enhance the treatment efficacy of TNFα. Nuclear receptor subfamily 4 group A member 1 (NR4A1) has been shown to exert antitumor effects through several mechanisms, such as by inhibiting proliferation, as well as pro-apoptotic and potent pro-oxidant effects. In this study, we examined the effects and mechanisms of action of NR4A1 on the apoptosis of GC cells treated with TNFα, with particular focus on mitochondrial homeostasis. We found that TNFα treatment decreased NR4A1 expression. Moreover, the overexpression of NR4A1 in the presence of TNFα further increased GC cell apoptosis. Mechanistically, the overexpression of NR4A1 augmented caspase-9-dependent mitochondrial apoptosis, as evidenced by reduced mitochondrial membrane potential, reactive oxygen species (ROS) overproduction, mitochondrial permeability transition pore (mPTP) opening and the leakage of cytochrome c (Cyt-c) leakage. Moreover, NR4A1 overexpression also evoked mitochondrial energy disorder via the suppression of mitochondrial respiratory complex expression. Furthermore, we found that TNFα treatment activated Parkin-dependent mitophagy. Excessive Parkin-dependent mitophagy blocked mitochondrial apoptosis, undermining the toxic effects of TNFα on cells. However, NR4A1 overexpression suppressed Parkin-dependent mitophagy via the inhibition of c-Jun N-terminal kinase (JNK). Re-activation of the JNK/Parkin pathway abrogated the inhibitory effects of NR4A1 on mitophagy, eventually limiting cell apoptosis. Collectively, this study confirmed that NR4A1 sensitizes GC cells to TNFα-induced apoptosis through the inhibition of JNK/Parkin-dependent mitophagy.

A longitudinal study of the role of children's altruism and forgiveness in the relation between parental aggressive discipline and anxiety of preschoolers in China.

Using data collected over a 1-year period on a stratified random sample of 368 parents with children studying in nurseries (mean age=3.97years), this study assessed the predictive effects of parental corporal punishment, parental psychological aggression, preschoolers' altruism, and preschoolers' forgiveness on preschoolers' anxiety symptoms in Hong Kong, China. Results of hierarchical regression analyses showed that parental psychological aggression, preschoolers' altruism and preschoolers' forgiveness at Time 1 significantly predicted preschoolers' anxiety at Time 2, when controlling for the initial level of preschoolers' anxiety and important demographic variables that co-vary with preschoolers' anxiety. Moreover, preschoolers' altruism moderated the predictive effect of parental psychological aggression on preschoolers' anxiety symptoms. The study has several significant contributions. First, the study supports the predictive effect of parental aggressive discipline on preschoolers' anxiety. Second, we provide evidence that preschoolers' altruism and forgiveness negatively predict preschoolers' anxiety symptoms. Third, preschoolers' altruism and forgiveness are shown to protect them against parental psychological aggression. A dual-focus approach to intervention and prevention is proposed to reduce aggressive discipline by parents as well as to enhance altruism and forgiveness in children. Parent training programs could be provided to teach parents positive discipline strategies. Home-based or school-based interventions could be designed for preschool children to foster and enhance their altruism and forgiveness.

[Relationship between multi-gene proteins in colorectal carcinoma complicated with chronic schistosomiasis: an immunohistochemical study by using tissue microarray techniques].

OBJECTIVE: To investigate the relationship between p53, COX-2, Bax, c-myc genes and colorectal carcinoma complicated with chronic schistosomiasis. METHODS: One hundred and sixty patients with colorectal carcinoma were selected and divided into two groups; a schistosomiasis group (colorectal carcinoma complicated with chronic schistosomiasis, n = 80) and a non-schistosomiasis group (colorectal carcinoma uncomplicated with chronic schistosomiasis, n = 80). The tissue microarray techniques and immunohistochemistry method were used in all the patients to detect the expressions of p53, COX-2, Bax and c-myc proteins. RESULTS: The positive rate and level of p53 protein expression in the schistosomiasis group were lower than those in the non-schistosomiasis group, but there were no significant differences between the two groups (both P > 0.05). The COX-2 protein in both groups was positive, but the positive expression level of COX-2 in the schistosomiasis group was higher than that in the nonschistosomiasis group, and there was a significant difference between the two groups (P < 0.01). The positive rate and level of Bax protein expression were not significantly different between the two groups (both P > 0.05). The positive rate of c-myc expression in the schistosomiasis group was higher than that in the non-schistosomiasis group, with a significant difference (P < 0.01), but the positive expression level was lower than that in the non-schistosomiasis group, and there was a significant difference between the two groups (P < 0.01). CONCLUSIONS: Schistosome infection may impact on the deficiency of p53 of human colorectal cancer cells. It may promote the excessive expression of COX-2 protein, which is an indirect carcinogenic factor. The expression of Bax gene has no correlation with schistosome infection. The schistosome chronic infection may cause a persistent low level expression of c-myc gene.