A three-arm randomised controlled trial to evaluate the efficacy of a positive psychology and social networking intervention in promoting mental health among HIV-infected men who have sex with men in China.

AIMS: There is a lack of mental health promotion and treatment services targeting HIV-positive men who have sex with men (HIVMSM) in China. The aim of this study was to evaluate the mental health promotion efficacy of an online intervention that combined Three Good Things (TGT) with electronic social networking (TGT-SN) and an intervention that used TGT only (TGT-only), compared with a control group. METHODS: We conducted a randomised controlled trial among HIVMSM in Chengdu, China. The participants were randomly assigned to the TGT-SN, TGT-only, and control groups. The participants in the TGT-SN group were divided into five social network groups and asked to post brief messages to the group about three good things that they had experienced and for which they felt grateful. The participants in the TGT-only group were only required to write down their three good things daily without sharing them with others. The control group received information about mental health promotion once a week for a month. The primary outcome was probable depression. Secondary outcomes were anxiety, positive and negative affect, gratitude, happiness and social support. These outcomes were assessed at baseline, 1, 3, 6 and 12 months after the intervention. Repeated-measures analyses were conducted using generalised estimation equations. The study was registered with the Chinese Clinical Trial Registry (ChiCTR-TRC-13003252). RESULTS: Between June 2013 and May 2015, 404 participants were enrolled and randomly assigned to either the TGT-SN (n = 129), TGT-only (n = 139) or control group (n = 136). The main effects of TGT-SN (adjusted odds ratio (aOR) = 0.75, 95% CI 0.52-1.09; p = 0.131) and TGT-only (aOR = 0.83, 95% CI 0.57-1.21; p = 0.332) in reducing depression were statistically non-significant. The participants of the TGT-SN group showed significantly lower anxiety symptoms (aOR = 0.62, 95% CI 0.43-0.89; p = 0.009) and negative affect (ß = -1.62, 95% CI 2.98 to -0.26; p = 0.019) over time compared with those of the control group. No significant main effect was found for any secondary outcomes for the TGT-only group. CONCLUSIONS: The novel intervention combining the TGT exercise with electronic social networking was found effective in reducing anxiety and negative affect among HIVMSM.

Acceptability of HPV vaccines and associations with perceptions related to HPV and HPV vaccines among male baccalaureate students in Hong Kong.

OBJECTIVES: The highly infectious human papillomavirus (HPV) causes both genital warts and cervical cancer in women. In 2009, the prevalence of genital warts in Hong Kong was 203.7 per 100,000 person-years. Cervical cancer, more seriously, was the eight most common cancer among women and girls in Hong Kong, accounting for 2.3% of all new cancer cases in females in 2014. Cervical cancer is a significant global public health problem and HPV is a major risk factor leading to the development of cervical cancer. HPV is also the most common sexually transmitted disease among university students. This is the first study to examine the acceptability of HPV vaccines and associations with perceptions related to HPV and HPV vaccines among the male baccalaureate student population locally. METHODS: A self-administrative cross-sectional survey was used to assess whether male baccalaureate students from eight local Hong Kong universities intended to be immunized for HPV. The study also asked questions concerning how its subjects perceived HPV and HPV vaccines using the Health Belief Model. Data collection spanned from June to September 2015. A multiple stepwise regression model was used to examine associations between cognitive factors and subjects' intention to take up the HPV vaccine. RESULTS: A total of 1,004 (83.7%) students aged 18 and 26 participated in this study. 23.3% found vaccinating for HPV acceptable, a level correlating with a number of indicators. Subjects were more likely to find vaccinating acceptable if 1) they knew something about HPV vaccines; 2) they understood that men were susceptible to infection by HPV; 3) they realised they could benefit by HPV vaccination, and 4) they were aware of the arguments for and against HPV vaccination, as disseminated by either the media or peers. CONCLUSIONS: HPV remains a significant public health concern in Hong Kong and China more broadly. This study's findings show a disconnect between the perceived and actual risk of being infected with the HPV vaccine among male baccalaureate students. This disconnect may be bridged by informing young men of the benefits of their being vaccinated against HPV, by removing the psychological and financial barriers that prevent them from taking up the vaccine and by improving how primary healthcare providers motivate them to get immunized.

Physical Activity in People With Mental Illness in Hong Kong: Application of the Health Belief Model.

Physical activity is associated with various health benefits for people with mental illness (PMI). Very few studies to date have examined the factors associated with physical activity among PMI in the Chinese context. The present study examined the factors related to physical activity using the health belief model and the association between physical activity and perceived health among 443 PMI in Hong Kong using stratified sampling. Results from the structural equation modeling showed that among all the factors of the health belief model, self-efficacy was significantly related to higher levels of physical activity, and perceived barriers were significantly related to lower levels of physical activity. In addition, physical activity was significantly related to better perceived health and fewer health needs. Interventions to promote physical activity among PMI should aim to increase their self-efficacy in initiating and adhering to physical activity and to remove barriers to physical activity.

Influenza vaccination uptake and associated factors among elderly population in Hong Kong: the application of the Health Belief Model.

The impact of influenza on elderly can be severe and fatal. Influenza vaccination (IV) has been shown to be effective in reducing influenza-related complications, but the IV uptake among elderly in Hong Kong remains low. This study investigated the prevalence and factors associated with IV among Chinese elderly in Hong Kong using the Health Belief Model (HBM). A total of 1101 Chinese elderly aged over 65 was randomly selected and completed a phone interview. Background information, experience of and intention to receive IV and IV-related knowledge and perceptions based on the HBM were measured. Results showed that 48.5 and 49.5% of the participants have ever been vaccinated and intended to receive IV, respectively. Female gender, having chronic disease, and participating in community activities were significantly associated with previous IV. Knowledge of the fact that IV is required every year, lower perceived side effect, IV price lower than HK$150, and recommendations from health care providers was associated with both previous IV and intention to be vaccinated in the next year. Interventions promoting IV among elderly should disseminate knowledge regarding the necessity of IV and correct misconceptions about the side effects of IV.

MicroRNA-7 functions as an anti-metastatic microRNA in gastric cancer by targeting insulin-like growth factor-1 receptor.

Metastasis is a major clinical obstacle in the treatment of gastric cancer (GC) and it accounts for the majority of cancer-related mortality. MicroRNAs have recently emerged as regulators of metastasis by acting on multiple signaling pathways. In this study, we found that miR-7 is significantly downregulated in highly metastatic GC cell lines and metastatic tissues. Both gain-of-function and loss-of-function experiments showed that increased miR-7 expression significantly reduced GC cell migration and invasion, whereas decreased miR-7 expression dramatically enhanced cell migration and invasion. In vivo metastasis assays also demonstrated that overexpression of miR-7 markedly inhibited GC metastasis. Moreover, the insulin-like growth factor-1 receptor (IGF1R) oncogene, which is often mutated or amplified in human cancers and functions as an important regulator of cell growth and tumor invasion, was identified as a direct target of miR-7. Silencing of IGF1R using small interefering RNA (siRNA) recapitulated the anti-metastatic function of miR-7, whereas restoring the IGF1R expression attenuated the function of miR-7 in GC cells. Furthermore, we found that suppression of Snail by miR-7, through targeting IGF1R, increased E-cadherin expression and partially reversed the epithelial-mesenchymal transition (EMT). Finally, analyses of miR-7 and IGF1R levels in human primary GC with matched lymph node metastasis tissue arrays revealed that miR-7 is inversely correlated with IGF1R expression. The present study provides insight into the specific biological behavior of miR-7 in EMT and tumor metastasis. Targeting this novel miR-7/IGF1R/Snail axis would be helpful as a therapeutic approach to block GC metastasis.

How effective are physical activity interventions for alleviating depressive symptoms in older people? A systematic review.

BACKGROUND: The benefits of physical exercise in reducing clinically defined depression in the general population have been established, although a review of the evidence for older adults is needed. OBJECTIVES: To assess the efficacy of physical exercise for the treatment of depressive symptoms in older adults (>60 years). DATA SOURCES: We searched: MEDLINE (1966-May 2008); EMBASE (1980-May 2008); Cumulative Index to Nursing & Allied Health Literature (CINAHL; 1982-May 2008); PsycINFO (1966-May 2008), The Cochrane Library (Issue 2, 2008), and National Research Register (NRR; Issue 2, 2008). REVIEW METHODS: Randomized controlled trials and quasi-experimental studies of physical exercise interventions for depression were included where 80% or more of participants were >60 years. Abstracts were assessed to determine whether they met specified inclusion criteria. Primary analysis focused on the prevalence of diagnosable depressive disorder following intervention. Secondary outcome was depression or mood scores on standardized scales. RESULTS: Eleven randomized controlled trials with a total of 641 participants were included in the review. Short-term positive outcome for depression or depressive symptoms was found in nine studies, although the mode, intensity and duration of intervention varied across studies. Medium- to long-term effects of intervention were less clear. CONCLUSION: Physical exercise programmes obtain clinically relevant outcomes in the treatment of depressive symptoms in depressed older people. Exercise, though not appropriate for all in this population, may improve mood in this group. Further research is needed to establish medium- to long-term effects and cost-effectiveness.

A randomized, double-blind comparison of ampicillin/sulbactam and ceftriaxone in the prevention of surgical-site infections after neurosurgery.

BACKGROUND: The use of prophylactic antibiotics has been shown to decrease the rate of surgical-site infections after clean neurosurgical operations, although previous clinical trials have provided no evidence that one antibiotic is superior to another for this purpose. OBJECTIVE: This study was undertaken to compare the rates of postoperative infectious complications of neurosurgery with prophylactic ceftriaxone and ampicillin/sulbactam, a less-expensive antibiotic. METHODS: Consecutive patients undergoing neurosurgery between January and December 1998 were recruited for the study. Those who had an infectious disease for which antibiotics were required, who received antibiotics within 48 hours before surgery, were aged <12 or >85 years, had an indwelling catheter for the monitoring of intracranial pressure, or had a history of allergy to the study drugs were excluded. Before the operation, eligible patients were randomized to either ampicillin/sulbactam 3 g or ceftriaxone 2 g. Surgeons and patients were blinded to treatment assignment. The study drugs were administered by the anesthesiologist as an IV bolus after induction of general anesthesia. All patients were followed for 6 weeks postoperatively. If reoperation was required within 6 weeks of the original operation, the patient received the same antibiotic as during the first surgery, without further randomization. RESULTS: Over the 1-year study period, 180 consecutive patients undergoing neurosurgical operations were recruited. Surgical-site infection occurred in 2 (2.3%) patients in the ampicillin/sulbactam group and 3 (3.3%) in the ceftriaxone group; nonsurgical-site infection occurred in 25 (28.4%) patients in the ampicillin/sulbactam group and 15 (16.3%) in the ceftriaxone group. The between-group differences were not statistically significant, with the exception of surgical implantation of foreign material, which was performed sig- nificantly more frequently in the ceftriaxone group (P = 0.045). In addition, 2 of 3 surgical-site infections in the ceftriaxone group involved foreign-material implantation; however, if these operations are omitted from the analysis, the difference between treatments remains nonsignificant. CONCLUSIONS: The results suggest that ampicillin/sulbactam and ceftriaxone are of similar prophylactic efficacy in clean neurosurgical operations. Because the acquisition cost of 2 g ceftriaxone is approximately 3 times greater than that of 3 g ampicillin/sulbactam, the latter may be more cost-effective than the former for neurosurgical prophylaxis; however, other relevant hospital-related costs were not assessed in this study.

Atypical cellular chorangioma.

We describe an unusual, large atypical cellular chorangioma with abundant mitoses and focal necrosis. Other than premature birth, the prenatal and postpartum clinical course was unremarkable for both the mother and baby. Our case and a few similar cases reported in literature suggest that atypical cellular chorangioma is a benign tumor, despite its worrisome histopathologic features.

Effect of migration and related environmental changes on serum lipid levels in southwestern Chinese men.

To determine migration-related differences in serum lipid levels and to estimate the contribution of environmental factors to these differences, the authors conducted a cross-sectional study among 1,222 residents of southwestern China in 1988 and 1989: 521 Yi farmers living in a remote rural area, 340 Yi migrants to an urban setting, and 361 Han people living in the same urban setting. Serum total and high density lipoprotein cholesterol and serum triglyceride were measured after a 14-hour fast. Information on age, cigarette smoking, alcohol consumption, and physical activity was obtained by questionnaire. Diet was assessed by use of three 24-hour diet recalls. The Yi farmers had the lowest age-adjusted serum lipid levels among the three groups, white the Yi migrants and their Han counterparts had similar lipid levels. After adjustment for age, body mass index, cigarette smoking, alcohol drinking, and dietary nutrient intake, the difference in serum lipid profile between the Yi migrants and the Yi farmers was substantially reduced. These results indicate that rural-urban migration is associated with higher serum lipid levels. This migration-related difference in serum lipids can be partially explained by changes in lifestyle and dietary nutrient intake. The authors conclude that environmental factors are important determinants of population serum lipid levels in southwestern Chinese.

The contribution of urinary cations to the blood pressure differences associated with migration.

People living in unacculturated societies have a low average blood pressure and little rise in blood pressure with age. In a community-based survey in southwestern China, the authors assessed the contribution of urinary cation excretion to differences in blood pressure between an unacculturated group (Yi farmers) and migrants to an urban environment, as well as urban controls from a different ethnic group (Han). In March 1989, blood pressure and overnight urinary electrolyte levels were measured on 3 consecutive days in 313 Yi farmers, 265 Yi migrants, and 253 urban Han residents, all male. Of the urinary electrolytes, a higher sodium:potassium ratio best explained the higher blood pressure in the migrants. Yi farmers had lower systolic (106.7 mmHg vs. 114.8 mmHg, respectively) and diastolic (66.2 mmHg vs. 71.3 mmHg, respectively) blood pressures than Yi migrants. However, even after adjustment for age, body mass index, alcohol intake, and urinary sodium, potassium, calcium, and magnesium excretion, Yi farmers continued to have lower average blood pressures than Yi migrants. In pooled analyses of all three groups, urinary sodium and calcium were positively related and urinary potassium and magnesium were inversely related to blood pressure. Migration is associated with a higher blood pressure that is only partially explained by higher levels of adiposity and alcohol and sodium intake and lower levels of potassium and magnesium intake.

Oats and buckwheat intakes and cardiovascular disease risk factors in an ethnic minority of China.

The relationship of oats and buckwheat intake to cardiovascular disease risk factors was studied in 850 Yi people, an ethnic minority in southwest China. Blood pressure was measured on 3 consecutive days. Serum total cholesterol, high-density-lipoprotein (HDL) cholesterol, and triglycerides were measured after a 14-h fast. Oats and buckwheat intakes were assessed by questionnaire. In multiple-regression analysis, oats intake (100 g/d) was associated with lower body mass index (-0.25, in kg/m2; P < 0.05), systolic (-3.1 mm Hg, P < 0.001) and diastolic (-1.3 mm Hg, P < 0.01) blood pressure, and HDL cholesterol (-0.13 mmol/L, P < 0.001). Buckwheat intake (100 g/d) was associated with lower serum total cholesterol (-0.07 mmol/L, P < 0.01) and low-density-lipoprotein cholesterol (-0.06 mmol/L, P < 0.05) and a higher ratio of HDL to total cholesterol (0.01, P < 0.05). These findings suggest a role for oats and buckwheat consumption in the prevention and treatment of both hypertension and hypercholesterolemia.

Agreement between overnight and 24-hour urinary cation excretions in southern Chinese men.

Agreement between overnight and 24-hour urinary sodium, potassium, calcium, and magnesium excretion was studied in a sample of 63 normotensive Southwestern Chinese men: 30 Yi farmers and 33 urban residents in April 1989. Overnight (8-hour) and 24-hour urine specimens were collected on 3 consecutive days. Estimated correlation coefficients between 24-hour and overnight mean true values were 0.863 and 0.906 for sodium, 0.736 and 0.816 for potassium, 0.902 and 0.725 for calcium, and 0.733 and 0.703 for magnesium in Yi farmers and urban residents, respectively. Hourly overnight urinary sodium and potassium excretion rates were significantly lower than the corresponding hourly 24-hour urinary excretion rates: -0.60 and -1.99 mmol/hour for sodium, -1.24 and -0.48 mmol/hour for potassium (all p < 0.05) in Yi farmers and urban residents, respectively. In multiple regression analyses, the differences between 24-hour and overnight urinary sodium and potassium excretion rates were significantly and positively related to differences between 24-hour and overnight creatinine excretion rates. The ratios of intraindividual to interindividual variance were lower for 24-hour collections than for overnight collections for sodium and calcium, but the differences in these ratios for potassium and magnesium were small. For sodium and calcium, twice as many overnight as 24-hour collections were required to estimate the correlation between cations and blood pressure with the same accuracy; for potassium and magnesium, overnight and 24-hour collections were equally accurate. These results indicate that in normotensive populations such as the one studied, overnight urine collections may be used to estimate 24-hour cation excretion. The underestimate of cation excretion by assessments based on collection of overnight specimens may be due to either a lower creatinine clearance or a lower intake of cations at night.

Effect of dietary electrolytes upon calcium excretion: the Yi People Study.

OBJECTIVE: To investigate the relations of dietary sodium, potassium, calcium and magnesium with urinary calcium excretion. DESIGN: Cross-sectional epidemiologic study of 417 Chinese men with a wide variation of electrolyte intakes. METHODS: Three consecutive 24-h dietary recall data and three 24-h urinary samples were obtained on the same days. Urinary analyses included calcium, sodium, potassium, magnesium and creatinine. A fasting blood sample was obtained on the first morning, and serum analyses included electrolytes, creatinine and urea nitrogen. Correlation and regression analyses were used to examine the relation between electrolyte intake and calcium excretion. RESULTS: Whilst urinary calcium was not related to dietary calcium, it was significantly correlated with dietary sodium and potassium. A linear relationship was seen between dietary sodium, potassium and urinary calcium. After adjustment for age, body mass index, serum creatinine, dietary calcium intake and other electrolytes, urinary calcium was positively related to dietary sodium and negatively related to dietary potassium. This relation was seen at different levels of dietary calcium intake. The relation between magnesium intake and calcium excretion was inconsistent. CONCLUSION: These results suggest that sodium and potassium intake influence urinary calcium excretion in normotensive men.

Relation of serum zinc and copper to lipids and lipoproteins: the Yi People Study.

The relations of serum zinc (Zn) and copper (Cu) to serum total cholesterol (TC), low-density-lipoprotein and high-density-lipoprotein cholesterol (LDL-C and HDL-C) and triglycerides were investigated in a population-based sample of 399 men in Southern China. Serum Cu was inversely related to HDL-C (r = -0.21), while Zn/Cu ratio showed a positive association (r = 0.19). These relationships remained significant after adjusting for age, body mass index (kg/m2), physical activity, tobacco smoking and dietary cholesterol, fat, and fiber. While no significant association was observed between serum Cu and serum TC in univariate analysis, a significant negative association was observed in multivariate analysis, after adjustment for the above mentioned independent variables. No significant association between serum Cu and LDL-C was found. These observations, as well as those reported in other studies reviewed herein, suggest that Cu is implicated in the metabolism of HDL-C, although the mechanism involved is not fully understood. No significant associations were found between serum Zn and the lipid variables.

Migration, blood pressure pattern, and hypertension: the Yi Migrant Study.

Rural-urban migration provides an ideal opportunity to examine the effects of environment and genes on blood pressure. The effect of migration on the Yi people of China was studied. The Yi people live in a remote mountain area in southwestern China. In 1989, blood pressure was measured in 14,505 persons (8,241 Yi farmers, 2,575 urban Yi migrants, and 3,689 Han urban residents) aged 15-89 years. Different patterns were seen for men and women. Among the men, Yi farmers had the lowest mean blood pressure, the least rise in blood pressure with age (systolic blood pressure, 0.13 mmHg/year; diastolic blood pressure, 0.23 mmHg/year), and the lowest prevalence of hypertension (0.66%). In contrast, both Yi migrant men and Han men had higher levels of mean blood pressure, rise in blood pressure with age (Yi migrants: systolic pressure, 0.33 mmHg/year; diastolic pressure, 0.33 mmHg/year; Han: systolic pressure, 0.36 mmHg/year; diastolic pressure, 0.23 mmHg/year), and prevalence of hypertension (Yi migrants, 4.25%; Han, 4.91%). Among the women, however, mean systolic pressure was higher in Yi farmers than in Yi migrants or in Han. Diastolic pressure was similar among the three groups. However, the Yi farmer women's age-related rise in blood pressure (systolic pressure, 0.06 mmHg/year; diastolic pressure, 0.14 mmHg/year) and their prevalence of hypertension (0.33%) were lower than those in the other two groups. Yi migrant women had an intermediate rise in blood pressure with age (systolic pressure, 0.37 mmHg/year; diastolic pressure, 0.23 mmHg/year) and prevalence of hypertension (2.40%). Han women had the greatest rise in blood pressure with age (systolic pressure, 0.56 mmHg/year; diastolic pressure, 0.36 mmHg/year) and the highest prevalence of hypertension (4.76%). For both men and women, the above differences were only partially explained by age, body mass index, heart rate, smoking, and alcohol use. This study, using standardized methods, demonstrates an important effect of migration on rise in blood pressure with age and on the prevalence of hypertension.

Purification and properties of bilirubin oxidase from Myrothecium verrucaria.

Bilirubin oxidase was purified from a culture filtrate of Myrothecium verrucaria Mv 2, 1089 by DEAE-cellulose and Sephadex G-100 column chromatographies. The purified enzyme had a specific activity of 30 U/mg protein and showed a single band on polyacrylamide gel electrophoresis. Some of the general properties of this bilirubin oxidase were as follows: the optimum pH for the enzyme reaction was 7.5 and the optimum temperature was 50 degrees C. The enzyme was stable at pH ranging from 9.0 to 9.5. The mol wt was calculated to be 61,900-62,700 by SDS-PAGE and gel-filtration technique. The apparent Km value of the bilirubin oxidase was calculated to be 9.4 x 10(-5) mol/L. The enzyme activity was greatly reduced by incubation of bilirubin oxidase with Fe2+, Hg+, NaN3, NH+4, and Zn2+. The enzyme reaction was inhibited in the presence of Ca2+, Hg+, Zn2+, Fe2+, and BSA.