ent-Atisane Diterpenoids from Euphorbia helioscopia and Their Anti-inflammatory Activities.

Phytochemical investigation on the anti-inflammatory fraction extracted from the whole plant of Euphorbia helioscopia L. led to the isolation of three new ent-atisane diterpenoids (1-3) and five known analogues (4-8). The structures and absolute configurations of the new compounds were elucidated by comprehensive analysis of the NMR, MS, IR, ECD, and X-ray crystallography. It is worth mentioning that compound 3 belongs to a rare class of ent-atisane diterpenoid featuring a hydroxyl group at C-9. Bioactivity investigation showed that compounds 4, 7, and 8 exhibited significant inhibitory effects on LPS-induced NO production in a dose-dependent manner, which indicates their anti-inflammatory potential.

Jatrophane diterpenoids with cytotoxic activity from the whole plant of Euphorbia heliosocpia L.

Eight undescribed jatrophane diterpenoids, euphohelinoids A-H, along with 11 known analogues were isolated from the whole plant of Euphorbia heliosocpia L. Among them, euphohelinoids A and B contain a rare type of jatrophane diterpenoid skeleton with a 7,8-seco scaffold. To the best of our knowledge, only two such jatrophane diterpenoids have been reported. In addition, euphohelinoids G and H belong to a rare class of jatrophane diterpene possessing a ß-hydroxy group at C-11. Structure elucidation of these undescribed diterpenoids was performed by spectroscopic analysis, including NMR, HRESIMS, IR, electronic circular dichroism (ECD) and DP4+ analysis. The cytotoxicity of 17 abundant jatrophane diterpenes was evaluated against HepG2, HeLa, HL-60, and SMMC-7721 cell lines. Seven compounds presented potent cytotoxicity against the four tested cell lines with IC50 values from 8.1 to 29.7 µM. Moreover, preliminary structure-activity relationships for these jatrophane diterpenoids were discussed.

Quassinoids with Inhibitory Activities against Plant Fungal Pathogens from Picrasma javanica.

A bioactivity-guided study on the leaves of Picrasma javanica led to the isolation of 19 quassinoids, including 13 new compounds. The structures of the new compounds were elucidated by a combination of spectroscopic data analysis, X-ray crystallography studies, and electronic circular dichroism (ECD) data interpretation. Compounds 1-7 are rare examples of quassinoids with a keto carbonyl group at C-12. The biological activities of 11 of the more abundant isolates were evaluated against five phytopathogenic fungi in vitro, and several of them including 6 and 15 showed moderate inhibitory effects that were comparative to those of the positive control, carbendazim. In addition, the preliminary structure-activity relationships (SARs) of these quassinoids were also investigated.

A multi-center survey of HPV knowledge and attitudes toward HPV vaccination among women, government officials, and medical personnel in China.

OBJECTIVES: To assess knowledge of HPV and attitudes towards HPV vaccination among the general female population, government officials, and healthcare providers in China to assist the development of an effective national HPV vaccination program. METHODS: A cross-sectional epidemiologic survey was conducted across 21 urban and rural sites in China using a short questionnaire. 763 government officials, 760 healthcare providers, and 11,681 women aged 15-59 years were included in the final analysis. Data were analyzed using standard descriptive statistics and logistic regression. RESULTS: Knowledge of HPV among the general female population was low; only 24% had heard of HPV. Less than 20% of healthcare providers recognized sexually naive women as the most appropriate population for HPV vaccination. There was high acceptance of the HPV vaccine for all categories of respondents. Only 6% of women were willing to pay more than US $300 for the vaccine. CONCLUSIONS: Aggressive education is necessary to increase knowledge of HPV and its vaccine. Further proof of vaccine safety and efficacy and government subsidies combined with increased awareness could facilitate development and implementation of HPV vaccination in China.

A multi-center survey of age of sexual debut and sexual behavior in Chinese women: suggestions for optimal age of human papillomavirus vaccination in China.

OBJECTIVE: Cervical cancer is the second most common cancer among women worldwide, and over 85% of cervical cancers occur in developing countries such as China. Lack of resources for nationwide cervical cancer screening in China makes vaccination against oncogenic strains of HPV particularly important. Knowledge of age at sexual debut and sexual behavior is essential prior to implementation of a national vaccination program. METHODS AND MATERIALS: A cross-sectional epidemiologic survey was conducted across 21 urban and rural sites in China to assess age at sexual debut and sexual behavior. 98.6% of the 11,852 recruited women aged 15-59 years were included in the analysis. Data were collected using a short, nurse-administered questionnaire and analyzed using standard descriptive statistics and survival analysis. RESULTS: In urban areas, more than ten percent of the 15-19 year old age group were already sexually active at the time of interview; this number increased to nearly 44% in the 20-24 year old age group. Chinese young women with an occupation were more likely to be sexually active compared to female students of the same age, irrespective of area of residence. The crude median sexual debut age for the youngest age group was 17 years, earlier than the sexual debut age reported by older cohorts. Younger age cohorts had an earlier menarche age than older cohorts and were more likely to have more sexual partners than older women, and more likely to have partners with more than one female partner. CONCLUSION: There is a trend towards earlier sexual debut and riskier sexual behaviors in younger age groups of Chinese women. These findings suggest that HPV vaccination of women between the ages of 13 and 15 years, before the completion of national compulsory education, is likely to contribute to the prevention of HPV infection and cervical cancer in China.

[Culture and quality of life assessment in Chinese populations].

OBJECTIVE: To investigate the impact of cultural factors on quality of life (QOL) and to identify appropriate ways of dividing sub-populations for population norm-based quality of life assessment. METHODS: The WHOQOL-BREF was used as a QOL instrument. Another questionnaire was developed to assess cultural values. A cross-sectional survey was undertaken in 1090 Guangzhou residents, which included 635 respondents from communities and 455 patients who visited outpatient departments of hospitals. Cronbach's a coefficients and item-domain correlation coefficients were calculated to test the reliability and validity of the WHOQOL-BREF, respectively. Student t test, ANOVA and stepwise multiple linear regression analysis were performed to identify the variables that might have an impact on the QOL. Two regression models with and without including cultural variables were constructed, and the extent of impact exerted by the cultural factors was assessed through a comparison of the change of adjusted R square values. RESULTS: A total of 1052 (96%) valid questionnaire were returned. The Cronbach's alpha coefficients of the WHOQOL-BREF ranged from 0.67 to 0.78. Age, education, occupation and family income were correlated with all of the domains of the WHOQOL-BREF. Chronic condition was correlated with physical, psychological, and social relationship domains of the WHOQOL-BREF. Gender was correlated with physical and psychological domains of the WHOQOL-BREF. The multiple regression analysis showed that social and demographic factors contributed to 6.3%, 13.6%, 10.4% and 8.7% of the predicted variances for the physical, psychological, social relationship, and environment domains, respectively. Social support, horizontal collectivism, vertical individualism, escape acceptance, fear of death, health value, supernatural belief had a significant impact on QOL. However, social support was the only one factor that had an impact on all of the four QOL domains. CONCLUSION: It is necessary to divide sub-cultural populations for population norm-based QOL assessment. Further research is needed to develop a practical approach to the sub-cultural population division.

[Development of the system of quality of life instruments for cancer patients: colorectal cancer (QLICP-CR)].

BACKGROUND & OBJECTIVE: Based on the development of the general module of the system of quality of life instruments for cancer patients (QLICP-GM), this study was to develop and evaluate a quality of life scale for patients with colorectal cancer (QLICP-CR). METHODS: A quality of life scale for colorectal cancer patients that associated with Chinese cultural background was developed. The data from 110 patients with colorectal cancer were analyzed using statistical description, Pearson Correlation, Cluster analysis, and paired t-student test to assess the instrument. RESULTS: The test-retest reliability for the scale and 5 domains were all above 0.78. Internal consistency alpha for each domain was higher than 0.85 except for the social domain (0.66) and the symptom and side effect domain (0.63). Most of the correlation coefficients between each item and its domains were above 0.6. The differences in the scores of overall scale, general module, special domain, psychological domain, and symptom and side effect domain between pre-treatment and post-treatment were significant. CONCLUSION: The QLICP-CR is reasonably valid, reliable, and responsible, and can be used to assess quality of life for the patients with colorectal cancer.

[Development of the general module of the system of quality of life instruments for cancer patients: responsiveness analysis].

BACKGROUND & OBJECTIVE: The general module of the system of quality of life instruments for cancer patients, QLICP-GM, has been developed and its reliability and validity has been evaluated by us. This study was to analyze its responsiveness. METHODS: The quality of life of 600 patients with 5 kinds of cancer was measured using QLICP-GM before and after treatment. Traditional significance tests with some indices, such as effect size, standardized response mean and equivalence, were applied to evaluate responsiveness. RESULTS: The quality of life score changed significantly after treatment on 3 domains: physical function, psychologic function, and general symptoms and side effects. The standardized response mean of the overall instrument ranged from 0.16 to 0.67. Equivalence test showed no equivalence on quality of life score changes of these domains and the overall instrument. CONCLUSION: QLICP-GM possesses reasonable responsiveness and can be used in clinical measurement of quality of life for cancer patients.

[Development of the general module of the system of quality of life instruments for cancer patients: reliability and validity analysis].

BACKGROUND & OBJECTIVE: The general module of the system of quality of life instruments for cancer patients (QLICP-GM) has been developed by us, but its psychologic properties need to be evaluated. This study was to evaluate the reliability and validity of QLICP-GM. METHODS: The QOL data of 600 patients with lung cancer, breast cancer, colorectal cancer, gastric cancer, and head and neck cancer were analyzed by paired t-tests, correlation analysis, equivalence tests, and structural equation models to evaluate QLICP-GM. RESULTS: The test-retest reliability for all domains and the overall scale was above 0.85. Internal consistency alpha values for all domains except social function domain were above 0.70. The alpha value and split-half reliability of the overall scale were 0.88 and 0.93, respectively. Correlation analyses and structural equation models displayed good construction validity of the scale. It also showed good criterion-related validity when FACT-G was used as the criterion. CONCLUSION: QLICP-GM can be used to measure QOL for cancer patients with good reliability and validity.

[Development of the general module of the system of quality of life instruments for cancer patients: item selection and structure of the general module].

BACKGROUND & OBJECTIVE: The researches on quality of life (QOL) of cancer patients are concerned worldwide. Two QOL instrument systems for cancer patients, Functional Assessment of Cancer Therapy (FACT) and Quality of Life Questionnaires (QLQ), have been developed and used widely in the US and Europe, but no one has been developed in China. This study was to develop the general module of the system of quality of life instruments for cancer patients (QLICP-GM) used in China. METHODS: The structured group (nominal group and focus group) methods and the qualitative combined quantitative theory and methodology was used to develop rating scales. The items were preliminarily screened, evaluated, and modified. The QOL data of 448 cancer patients were analyzed by the methods of coefficient of variation, factor analysis, clustering analysis, and correlation analysis. RESULTS: QLICP-GM was developed and evaluated. The module, including 32 items, was consisted of 4 domains: physical function, psychologic function, social function, and general symptoms and side effects. CONCLUSION: QLICP-GM possesses a reasonable content validity because it reflects the WHO definition and connotation of QOL, and common issues of cancer patients as well.