Mediation of smoking abstinence self-efficacy on the association of nicotine dependence with smoking cessation.

BACKGROUND: The nicotine dependence (ND) has negative and smoking abstinence self-efficacy (SASE) has positive effects on successful smoking cessation, but scant data is now available for what is the mediating role of SASE on the relationship between ND and successful smoking cessation. The aim of this study was to assess the abovementioned mediation. METHODS: A case-control study was conducted with 642 successful spontaneous quitters as the cases, and 700 failed spontaneous quitters as the controls. ND and SASE were evaluated by Fagerström Test for Nicotine Dependence (FTND) scale and SASE scale, respectively. Propensity score as covariate in the regression model was used to adjust for potential confounders of age, age of smoking initiation, occupation, educational level and marital status. Total effect was decomposed into direct and indirect (mediating) effect using logistic regression based on the KHB method proposed by Holm et al. RESULTS: After adjusting for the aforementioned potential confounders, the mediating effects among the total effect of ND on successful spontaneous smoking cessation were 32.90%, 12.14%, 35.64% and 83.03% for the total score of SASE and its three context-specific situation scores, i.e. positive/social situation, negative/affective situation and habit/addictive situation, respectively. CONCLUSIONS: This study indicates that SASE has a partial mediating effect on the association of ND with successful spontaneous smoking cessation. To boost the smokers' SASE could increase the probability of successful smoking cessation.

Interleukin-17, produced by lymphocytes, promotes tumor growth and angiogenesis in a mouse model of breast cancer.

Previous studies have suggested that interleukin-17 (IL-17), an inflammatory cytokine expressed predominantly by Th17 cells, is highly expressed in tumor tissue and may help tumors to evade immune surveillance. In this study, the significance of IL-17 expression in the tumors of murine models of breast cancer was explored. BALB/c mice were injected with MA782/5S28102 or 4T1 breast cancer cell lines to establish breast tumors. The expression of IL-17 in tumor tissue was detected by western blotting 1 and 4 weeks later, which revealed that it increased with tumor progression (P<0.05). Additionally, tumor cells and tumor-infiltrating lymphocytes were isolated from tumor tissues and cultured for 5 days with stimulation by phorbol-12-myristate-13-acetate (PMA), anti­CD3 antibody and anti-CD28 antibody. Culture media from stimulated tumor cells or tumor-infiltrating lymphocytes were harvested and their concentrations of IL-17 were tested by ELISA. Tumor cells secreted low levels of IL-17 into the media; however, lymphocytes from tumor tissues secreted high levels of IL-17, with 4T1 tumors secreting higher levels of IL-17 than MA782 tumors (P<0.05). To evaluate the effect of IL-17 on the proliferation of tumor cells, 4T1 cells were cultured in the presence or absence of recombinant IL-17 and cell numbers were counted on day 5 of culturing. Ectopic IL-17 did not promote the proliferation of tumor cells in vitro. To further understand the effect of IL-17 expression within tumors, 4T1 tumor-bearing mice were injected with recombinant IL-17 or saline via the tail vein. Tumor size was measured up to 21 days following the initial infusion of IL-17. IL-17 infusion resulted in an increased tumor volume and microvascular density (as measured by the immunohistochemical detection of CD34 expression in microvessels; P<0.05). Therefore, IL-17 expression within tumor tissues appears to originate from tumor-infiltrating lymphocytes and is likely to promote tumor growth by enhancing angiogenesis.

Association between mutations of the luteinizing hormone ß subunit and female infertility.

To explore the association between mutations of Trp8Arg and Ile15Thr in the luteinizing hormone (LH) gene and female infertility, primary female infertility patients (n=60) and normal healthy women (n=60) were screened for mutations Trp8Arg and Ile15Thr in the LH-ß subunit gene by polymerase chain reaction-restriction fragment length polymorphism, and associations were examined between the mutations and female infertility. The results showed that there were significant differences in the allele and genotype frequencies of Trp8Arg and Ile15Thr between the two groups (P<0.05). A significant difference was noted in the LH level among women with different genotypes (P<0.05), and the LH level was highest in women who were homozygous for both mutations. However, there were no significant differences in FSH level and FSH/LH ratio among subjects with different genotypes (P>0.05). In conclusion, polymorphisms of Trp8Arg and Ile15Thr in the LH-ß subunit gene occur in infertile women. The polymorphisms correlate with female infertility and may be a risk factor in the pathogenesis of female infertility.

Polymorphisms in estrogen receptor-α are associated with idiopathic female infertility.

To investigate the relationship between polymorphisms in the estrogen receptor-α (ERα) gene and unexplained female infertility, restriction fragment length polymorphism (RFLP) analysis of ERα was employed in 150 females with idiopathic infertility (study group) and 150 healthy, age-matched females of proven fertility (control group). The results showed that the ERα allele frequencies differed significantly between the study and control groups (P=0.001). The allele identified by PvuII (P) restriction was detected more frequently in the study group (49.0% of individuals) compared to the control group (31.0%; P=0.001), while the allele identified by XbaI (X) restriction was detected less frequently in the study group (19.7%) compared to the control group (35.7%, P=0.001). A similar phenomenon was observed for the distribution of the TA alleles. The TA13 allele was more common in the study group (24.7 vs. 6.7% in controls; P=0.001), while the TA15 allele was less common in the study group (15.3 vs. 27.3% in controls; P=0.034). To conclude, polymorphisms in the ERα gene are associated with idiopathic female infertility. In particular, the P and TA13 alleles may represent significant risk factors, while the X and TA15 alleles may be protective factors.

Health resource allocation and productive efficiency of Chinese county hospitals: data from 1993 to 2005.

This study aims to assess trends in the productive efficiency of China's county hospitals during the economic transition using data from 1993 to 2005. A data envelopment analysis (DEA) framework was used to calculate the efficiency score of county hospitals in all 31 provinces. A C²R model and a BC² model were devised to respectively calculate overall and scale efficiency and pure technical efficiency at the hospital's current scale. Models included four inputs (number of medical staff; number of beds; value of fixed capital; and hospital expenditures) and three outputs (outpatient and emergency visits, number of inpatients, and hospital revenue) in total. As the results, geographical disparities in health resource allocation and county hospital productivity were noted. From 1993 to 2005, the number of county hospitals increased and their inputs, e.g. fixed capital in particular, grew rapidly. However, the amount of both outpatient and inpatient services declined somewhat especially in the middle and the western regions. The overall efficiency at the national level decreased slightly. County hospitals in the eastern region tended to have better overall, scale, and technical efficiency in comparison to the middle and the western regions. In conclusion, county hospitals are inefficient due to their enlarged scale and the reduced amount of health care services they provide. This issue should be addressed especially in the middle and the western regions, where health resources are far more limited and yet wasted. The effects of ongoing health sector reform on the productivity of county hospitals must be monitored and evaluated.

Maternal and infant health prepayment schemes in Shandong, China: a survey of demand and supply.

Maternal and infant prepayment schemes (MIPSs) appeared in China in the early 1980s, as a way of helping women to set aside adequate funds for childbirth. The responsibility for design was devolved to the county level, and many different approaches have been applied. For this and other reasons, there has been no consensus on important matters such as the level of prepayment, the range of covered services, and whether township health centres or family planning stations should operate the schemes. We aimed to clarify some of the uncertainty by conducting combined analyses of cost, willingness to pay, and willingness to supply. We used structured survey instruments to interview 4271 households with children aged under one year, and 18 township health institutions. Our analyses suggest that the ideal prepayment should be higher and the range of covered services should be wider than the current average, and that health centres rather family planning stations should operate the schemes.