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.

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.

Induced abortion and breast cancer: results from a population-based case control study in China.

AIM: To determine whether induced abortion (IA) increases breast cancer (BC) risk. MATERIALS AND METHODS: A population-based case-control study was performed from Dec, 2000 to November, 2004 in Shanghai, China, where IA could be verified through the family planning network and client medical records. Structured questionnaires were completed by 1,517 cases with primary invasive epithelial breast cancer and 1,573 controls frequency- matched to cases for age group. The information was supplemented and verified by the family planning records. Statistical analysis was conducted with SAS 9.0. RESULTS: After adjusting for potential confounders, induced abortions were not found to be associated with breast cancer with OR=0.94 (95%CI= 0.79-1.11). Compared to parous women without induced abortion, parous women with 3 or more times induced abortion (OR=0.66, 95%CI=0.46 to 0.95) and women with 3 or more times induced abortion after the first live birth (OR=0.66, 95%CI =0.45 to 0.97) showed a lower risk of breast cancer, after adjustment for age, level of education, annual income per capita, age at menarche, menopause, parity times, spontaneous abortion, age at first live birth, breast-feeding, oral contraceptives, hormones drug, breast disease, BMI, drinking alcohol, drinking tea, taking vitamin/calcium tablet, physical activity, vocation, history of breast cancer, eating the bean. CONCLUSIONS: The results suggest that a history of induced abortions may not increase the risk of breast cancer.

Effect of interpregnancy interval after a mifepristone-induced abortion on neonatal outcomes in subsequent pregnancy.

BACKGROUND: The study evaluated effects of interpregnancy interval (IPI) on neonatal outcomes after mifepristone-induced abortion in the first pregnancy. STUDY DESIGN: This observational cohort study, conducted from 1998 to 2001 at antenatal clinics in Shanghai, Beijing, and Chengdu, China, included 4682 nulliparous women with one mifepristone-induced abortion in their first pregnancy, who were enrolled and followed up until delivery. We compared neonatal outcomes among women with different IPIs between their mifepristone-induced abortion and subsequent pregnancy. RESULTS: When compared to IPI of 18-24 months, there was an increased risk of the neonate being small for gestational age (SGA) [adjusted odds ratio (aOR): 2.01; 95% confidence interval (CI): 1.04-3.88] when IPI was <6 months; this risk was greater among women without a curettage history after abortion (aOR: 2.49; 95% CI: 1.13-5.50). The associations between IPI and preterm delivery (<37 weeks), low birth weight (<2500 g), mean birth weight and ponderal index were not statistically significant. CONCLUSIONS: The results indicate that an IPI <6 months after one mifepristone-induced abortion in first pregnancy is associated with an increased risk of SGA in the subsequent pregnancy.

[The influence of high birth weight on the blood pressure during childhood - a cohort study].

OBJECTIVE: To explore the effects of high birth weight (HBW) on blood pressure (BP) during childhood. METHODS: A total of 1435 couples with high or normal birth weight were selected from a birth cohort who were born between 1993 and 1995 in Wuxi, China and, followed between 2005 and 2007. A questionnaire survey was conducted, with their height, weight and blood pressure measured. RESULTS: The medians of systolic blood pressure (SBP) and diastolic BP (DBP) of HBW group were 100 mm Hg (Q(1)-Q(3): 90 - 110 mm Hg), 64 mm Hg (Q(1)-Q(3): 60 - 70 mm Hg) in the high birth weight group, respectively, while they were 100 mm Hg (Q(1)-Q(3): 90 - 108 mm Hg), 62 mm Hg (Q(1)-Q(3): 60 - 70 mm Hg) in the normal weight group. No statistical significant difference was found between the exposed and unexposed groups. The proportion of elevated BP, including pre-hypertension and hypertension, in exposed group was 13.66%, a bit higher than that (11.57%) of the unexposed group (P = 0.055). The relative risk (RR) of HBW on elevated BP was 1.06 (0.92 - 1.21), after adjusted the following parameters as BMI in childhood, sex, age during the follow-up period, age of mother at delivery, gestational age, type of feeding at infancy, dietary habit as well as the frequencies of exercise during childhood. CONCLUSION: No statistically significant correlation was found between high birth weight and blood pressure of children.

[The influence of smoking on the routine parameters of semen quality].

OBJECTIVE: To explore the effect and heaviness of smoking on the routine parameters of semen quality. METHODS: A total of 727 eligible subjects including 421 smokers and 306 nonsmokers were selected in 2004 - 2006 in Hebei, Shanxi, Guizhou, Zhejiang and Shandong provinces. Data on background information, general demographic characteristics, exposure to smoking and related confounding factors were obtained through a questionnaire survey. Semen samples of all the subjects were collected during the period of study. Parameters of semen were examined according to the manual recommended by WHO. RESULTS: Four models from the multiple logistic regression regarding the semen routine parameters were used as the dependent variables to be fitted in descending order respectively, while six confounders including area, age, abstinence time, education level, history of alcohol intake and the exposure to pesticides etc., were adjusted. RESULTS: showed that smoking could affect the sperm viability, with significantly higher proportion of abnormal sperm viability seen in the smoking group (OR = 1.77, 95% CI: 1.12 - 2.80). Proportions regarding the abnormal mobility and morphology of sperms in the smoking group were also significantly higher than in the control group, with OR values as 1.51 (95%CI: 1.00 - 2.27) and 2.55 (95%CI: 1.68 - 3. 88) respectively. The density of sperms was significantly decreased in the smoking groups who smoked more than 20 cigarettes per day (OR = 1.70, 95%CI: 1.05 - 2.76) or the total numbers of cigarette consumption exceeding 150 000 (OR = 1.84, 95% CI: 1.03 - 3.29). CONCLUSION: Smoking showed adverse effects on the quality of semen, especially for heavy or long-term smokers.

Mifepristone-induced abortion and vaginal bleeding in subsequent pregnancy.

BACKGROUND: The aim of this study is to explore the effect of first-trimester mifepristone-induced abortion on vaginal bleeding in subsequent pregnancy. STUDY DESIGN: This observational cohort study was conducted during 1998-2001 at antenatal clinics in Beijing, Chengdu, and Shanghai, China. The study enrolled 4,931 women with one previous mifepristone-induced abortion, 4,925 women with no history of induced abortion, and 4,800 women with one previous surgical abortion and followed them through pregnancy and childbirth. RESULTS: The rates of vaginal bleeding in pregnant women with a history of medical abortion, no abortion, and surgical abortion were 16.5%, 13.9%, and 17.3%, respectively. The women with medical abortion had a higher risk (adjusted relative risk (aRR)=1.17, 95% confidence interval (CI): 1.07, 1.29) of vaginal bleeding compared with those with no abortion but similar risk to prior surgical abortion. When the correlation between medical abortion and vaginal bleeding was examined by period, increased risk was observed only in the early period (<16 gestational weeks) (aRR=1.25, 95% CI: 1.12, 1.39). The comparison between subgroups of medical abortion and no abortion showed that the observed risks increased particularly in those with abortion at gestational age ≤ 7 weeks (aRR=1.33, 95% CI: 1.18, 1.49), those followed by a postabortion curettage (aRR=1.58, 95% CI: 1.37, 1.84) or complications (aRR=1.99, 95% CI: 1.67, 2.37). There was no difference between women with medical abortion and women with surgical abortion in the occurrence of vaginal bleeding for either period. CONCLUSIONS: One previous mifepristone-induced abortion increased the risk of vaginal bleeding in early gestation period of subsequent pregnancy compared with no abortion, especially if abortion occurred before 7 weeks of gestation and was followed by a curettage or complications.

Turning point of age for semen quality: a population-based study in Chinese men.

OBJECTIVE: To explore the relationship between age and semen quality in Chinese men. DESIGN: Population-based cross-sectional study. SETTING: The Department of Reproductive Epidemiology and Social Science, Shanghai Institute of Planned Parenthood Research, People's Republic of China. PATIENT(S): Healthy 20- to 60-year-old men. INTERVENTION(S): Standard World Health Organization procedures (3rd ed.) for semen analysis. MAIN OUTCOME MEASURE(S): Semen volume, sperm concentration, total sperm number, progressive motility, vitality, and sperm morphology. RESULT(S): Statistical analysis results of 998 subjects showed that age was negatively correlated with progressive motility, vitality, and percentage of normal sperm. No declining trend was found between age and parameters semen volume, sperm concentration, or total sperm number. Rapidly progressive motility and percentage of normal sperm began to decrease slowly at age 30 years, and progressive motility began to decrease at age 40 years. Compared with the 20- to 29-year age group, the values of the latter three parameters showed significant differences in men aged ≥35, ≥45, and ≥40 years. CONCLUSION(S): Increasing age mainly influences sperm motility, vitality, and normal morphology, but these parameters have turning points at different ages. Because of the large sample size, this information can be used to provide standard values for Chinese men, particularly in the age range 30-50 years. Further research would enroll a large sample of healthy 40- to 70-year olds to examine declining semen parameters in these age groups.

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 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.

[A case-control study on the association of RFC-1 polymorphism and cervical cancer].

OBJECTIVE: To evaluate the possible association between RFC-1 polymorphism and cervix carcinoma, as well as the interaction between polymorphism and human papilloma virus16 (HPV16). METHODS: Based on a hospital-based case-control study, 107 cases which were diagnosed as cervical cancer pathematologically and 107 controls with hysteromyoma, were selected by frequency, matched with age and habitation. HPV16 and RFC-1 A80G polymorphism were detected by special PCR and RFLP. RESULTS: (1) HPV16 infection rate in cases (56.07%) was higher than that in controls (31.78%) with the adjusted OR of 3.25 (95% CI: 1.74-6.08). (2) All the genotypes were tested by Hardy-Weinberg balance. (3) Compared with RFC-1 AA,RFC-1 GG had higher risk for cervical cancer with OR of 2.42 (95% CI: 1.01-5.81). (4) No statistical significance was noticed regarding the interaction between RFC-1 polymorphism and HPV16 in logistic regression method. CONCLUSION: The introduction of RFC-1 80GG gene type could increase the risk of cervical cancer.

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.

[Association between age and quality of semen in Chinese males with normal fertility].

OBJECTIVE: To explore the association between age and variables of semen in Chinese males with normal fertility. METHODS: The population size under study would consist of 946 fertile male volunteers from 6 provinces of China, aged between 20 and 59. Semen quality was analyzed by hand on site and background information was obtained through structured questionnaire. Trend chi-square test and multiple linear regression methods were used and 95%CI were calculated to serve as reference value of semen variables of different age group. RESULTS: The normal percent of motility and living sperm declined significantly while the ascending of age, they were 55.7% and 97.3% in age < 30 group when compared to 21.9% and 90.3% in the age 50 - 59 group respectively. Under control of confounding factors as for center and abstinence time, all semen variables except semen volume were significantly different among the age groups. Sperm concentration, percentage of sperm motility and normal morphology sperm decreased significantly after age 40 while percentage of living sperm decreased after age 50 - 59 group. Sperm concentration among the 50 - 59 year-old group appeared to be lower than the 40 - year-old group. CONCLUSION: The influence of age must be taken into account when evaluating the quality of semen.

Reference values of semen parameters for healthy Chinese men.

AIMS: To establish reference values of semen parameters in a residential, geographic, and age representative sample of healthy Chinese men. METHODS: From a national study of 1,191 healthy Chinese men, semen samples were analyzed from 105 subjects whose wives or partners were pregnant within the 12 months prior to the date when the semen sample was taken. RESULTS: The means, fifth percentiles, and percentages lower than the WHO criteria for semen parameters were, respectively: 75.8 x 10(6)/ml, 17.8 x 10(6)/ml, and 6.7% for sperm concentration; 206.9 x 10(6)/ejection, 26.3 x 10(6)/ejection, and 6.7% for total sperm count; 18.9, 3.0, and 79.1% for rapid progressive motility; 49.1, 25.3, and 52.4% for sperm progressive motility; 73.8, 49.3, and 45.7% for sperm viability, and 49.5, 25.2, and 9.5% for normal morphology. CONCLUSION: The values of semen parameters for Chinese men are lower than the WHO criteria, especially for rapid progressive motility, progressive motility, and sperm viability, and a different standard for Chinese may be needed.

Effectiveness of a school-based AIDS education program among rural students in HIV high epidemic area of China.

PURPOSE: To evaluate the feasibility and effectiveness of a life-planning skills training program using participatory methods among rural senior high school students in Shangcai County, Henan Province, China. METHODS: The study was a quasi-experimental study conducted in three Shangcai County senior high schools with comparable socioculture-economic and demographic characteristics (two interventions and one control). The intervention, a life-planning skills program that uses participatory training methods, combining information education with effective skills building, was provided to all first-grade students (14-18 years old; 87% of them are between 15 and 17 years old) in the intervention group from October 2003 to December 2003. In total, 717 students from the intervention group, and 457 from the control enrolled at baseline, and over 91% of these were followed up at posttest. RESULTS: Group x time interaction effects in ordinal logistic regression analysis were found on HIV/AIDS-related knowledge (p < .0001), attitudes toward daily contact with HIV-positive persons (p < .0001), and subjects' protection self-efficacy (p < .0001), suggesting the intervention increased subjects' knowledge significantly, changed their attitudes positively, and improved their protection self-efficacy. The intervention also significantly improved subjects' communication with teachers and peers on HIV/AIDS issues (p < .0001). However, no significant change was observed on respondents' attitudes toward premarital sex or their communication with parents between the two surveys (p > .05). CONCLUSIONS: Three months of short-term HIV/AIDS education through life-planning skills training was welcomed by students and positively influenced HIV/AIDS-related knowledge, attitudes, protection self-efficacy, and communication among senior high school students in a rural area with high HIV prevalence.

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.

[Analysis on the expression of human papillomavirus type 16 E2 and E6 oncogenes and disruption of E2 in cervical cancer].

OBJECTIVE: To evaluate the roles of expression and early protein E2 and E6 load of human papillomavirus type 16 (HPV16) on cervical cancer in order to explore the relation between disruption of E2 and development of cervical cancer. METHODS: A case-control study was conducted, including 141 cervical cancer patients as cases who had been diagnosed by cytological approaches and histological approaches in Shanxi province Tumor Hospital, China. Two type of controls including 137 hospital controls with hysteromyoma by cytology or histology and eligible 129 controls from 1582 healthy women in the community who took part in community-organized physical examination with neither CIN2-3 nor invasive cancer, nor other gynecologic diseases were recruited. HPV16 E2 and E6 oncogenes were detected by multiple polymerase chain reaction (multi-PCR). The levels of E2 and E6 were analyzed used Bio-1D+ + software provided by VILBER pattern formatter. RESULTS: The positive rates of HPV16 E6 in cancer cases (46.8%) were significantly higher than that in hysteromyoma group (24.1%) or healthy control group (2.3%) and accounted for 2.77 of OR (95% CI: 1.66-4.63) and 36.96 of OR(95% CI: 11.22-121.71) respectively. The expressions and loads of HPV16 E6 and E2 in cases were significantly higher than that in two control groups. Meanwhile, the expression or level of E6 was higher than that of E2 in each group. Disruption rate of E2 was 22.73% and the ratio of E6 to E2 was 1.24 in cervical cancer group. CONCLUSION: The positive rates and levels of HPV16 E6 or E2 found in cervical cancer were higher than that in hysteromyoma and healthy women. High expression of E6 and disruption of E2 might play an important role in the development of HPV-induced cervical cancer.

[Study on the effect of a community-based early education and service program regarding intelligence development of infants].

UNLABELLED: Study on the effect of a community-based early education and service program regarding intelligence OBJECTIVE: To assess the effect on a community-based early education and service programs regarding the development of infants' intelligence. METHODS: A community-based intervention study was carried out among 359 infants and their families. Base-line survey were carried out when infants reached their one month, where after infants and their families in the intervention group received instructions and services focused on baby fostering and intelligence development. When the infants reached their six-months and twelve-months of age, their families were informed to complete the follow-up surveys, using both questionnaire investigation and testing the infants' intelligence quotients. The infants' intelligence quotients were measured by Development Screening Test for children under six. By comparing intelligence quotients of infants in two study groups in the follow-up surveys, this paper evaluated the impacts of community intervention on the infants' intelligence development. RESULTS: During two follow-ups, no statistical difference had been detected between the two groups of infants in term of gender or delivery process. Baseline data showed that infants' mental index (MI) scored 98.26 in the intervention group and 101.79 in the control one, and development quotient (DQ) scored 94.50 and 99.36 in respective groups. Infants' MI score increased 6.07 and 8.86 at the six-month and twelve-month follow-up periods respectively in the intervention group compared during the baseline, higher than the MI increments of the control group at the two follow-up periods (-2.46 and 1.05 respectively). DQ score of infants in the intervention group increased 12.94 and 11.24 respectively in the two follow-up surveys, which were also higher than increments in the control group (-0.18 and 0.34). The group x time effect(interaction effect) of MI and DQ in six-month and twelve-month follow-ups were both significantly higher than that of the baseline level. CONCLUSION: The community-based early education and service programs could effectively improve the infants' intelligence.

[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.

Can the Internet be used effectively to provide sex education to young people in China?

PURPOSE: To assess the feasibility and effectiveness of sex education conducted through the Internet. METHODS: Two high schools and four colleges of a university in Shanghai were selected as the research sites. Half of these were assigned to the intervention group and the other half to the control group. The interventions consisted of offering sexual and reproductive health knowledge, service information, counseling and discussion to all grade one students in the intervention group. The intervention phase lasted for 10 months and was implemented through a special website, with web pages, online videos, Bulletin Board System (BBS) and expert mailbox. In total, 624 students from the intervention, and 713 from the control schools and colleges participated in the baseline survey, and about 97% of them were followed up in postintervention survey to assess changes that can be attributed to the sex education interventions provided through the Internet. RESULTS: The median scores of the overall knowledge and of each specific aspect of reproductive health such as reproduction, contraception, condom, sexually transmitted infections (STIs) and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) were significantly higher in the intervention group as compared with those in the control group at postintervention (p < .0001), although no significant differences were found between these two groups in the baseline survey (p > .05). Group by time interaction effects in ordinal logistic regression analysis were found on knowledge score (p < .0001) and in attitude of high school students toward sex-related issues (p < .05), suggesting that interventions increased subjects' knowledge significantly and changed high school students' attitudes to being less liberal toward sex. The intervention also had positive influence on students' attitudes toward providing contraceptive service for unmarried people. CONCLUSIONS: Providing sex education to students in Shanghai through the Internet was found feasible and effective. The Internet-based sex education program increased students' reproductive health knowledge effectively and changed their attitudes toward sex-related issues in terms of being less liberal toward sex and more favorable to providing services to unmarried young people. The Internet thus offers an important and hitherto untapped potential for providing sex education to students and young people in China.