The relationships of school-based sexuality education, sexual knowledge and sexual behaviors-a study of 18,000 Chinese college students.

BACKGROUND: A growing prevalence of unexpected pregnancies and younger age of sexual debut is observed among Chinese young people, while they lack formal sexuality education from schools and parents. It is necessary to measure their knowledge level of sexual and reproductive health, and how such knowledge associates with their sexual behaviors and reproductive health outcomes, which would shed light on the effectiveness of sexuality education in China. METHODS: An Internet-based questionnaire survey was conducted from January to August, 2015. 130 colleges were selected from eastern, central, and western parts China with a good balance of geographic distributions. The survey link was subsequently delivered to the focal points in each college for voluntary participation, targeting on undergraduates aged 18 ~ 25. Information on demographics, experience of school-based sexuality education (defined as any course introducing information on sexual and reproductive health) and SRH knowledge quiz was collected. Multivariate linear regression and logistic regression were applied to explore the relationship between students' SRH knowledge, sexual behaviors and reproductive health outcomes, such as sexual intercourse (penetrative sex by vaginal or anal), unprotected sex, pregnancy and abortion, etc. RESULTS: A total sample of 17,966 Chinese college students (mean age = 20.2, 60.4% female) eventually entered the analysis. Only 55.6% of the respondents self-reported having received sexuality education before, and they scored significantly higher (2.33/4.00) in the SRH knowledge quiz than those who had not (1.75/4.00). Among the sexually experienced students (n = 3639, 20.2%), both males and females with higher SRH knowledge were less likely to report having experience of (partner's) pregnancy or abortion (OR < 1, p < 0.05). In the group of sexually experienced males, those with higher SRH knowledge had a slightly later age of sexual debut (coefficient = 0.28, p < 0.001), and were less likely to have unprotected sex during the last or in most sexual intercourses (OR = 0.82, 95%C.I.: 0.69 ~ 0.96). CONCLUSION: Students' experience of school-based sexuality education may be positively associated with their SRH knowledge level as well as with their sexual behaviors and reproductive health outcomes, but such associations were stronger among males than females. A more effective implementation of school-based sexuality education needs to be scaled up, and a gender-sensitive education strategy to different needs is desirable for SRH promotion among Chinese young people.

Factors associated with spontaneous abortion: a cross-sectional study of Chinese populations.

BACKGROUND: Spontaneous abortion (SA) is one of the prevalent negative reproductive outcomes among women around the world, which is a great challenge faced by maternal health promotion. The present study is aimed to explore the association between SA and socioeconomic status (SES) and provides reference for policy makers to improve strategies on maternal health promotion. METHODS: A cross-sectional analysis was conducted with baseline data from a large-scale population-based cohort study of 0.5 million people from 10 geographically diverse areas of China recruited from 2004 to 2008. The study collected data from 84,531 women aged 35-45 years old in the baseline survey of China Kadoorie Biobank. Participants were interviewed using a standardized questionnaire, and information on demographic-socioeconomic as well as reproductive health status was collected. Odds ratios (OR) with 95% CI, estimated by a multistep logistic regression, were used to approximate the associations between SA occurrence and characteristics of SES. A stratification analysis was also applied to find out how SES influenced women's reproductive health outcomes differently between rural and urban areas. The model was adjusted for age at study date, tea consumption, alcohol consumption, cigarette smoking, and number of induced abortion. RESULTS: The risk of SA in rural was 1.68 times greater than in urban (AOR = 1.68, 95%CI: 1.54-1.84). Women with high income had a decreased risk of SA when compared with that of women with low income (AOR = 0.90, 95%CI: 0.84-0.97). Compared with women in low educational attainment, women in higher educational attainment had a lower prevalence of SA (AOR = 0.90, 95%CI: 0.82-0.98). The risk of SA only reduced in factory worker (AOR = 0.59, 95%CI: 0.53-0.66) and professional worker (AOR = 0.75, 95%CI: 0.66-0.84) compared with agriculture and related workers. After stratifying by rural/urban, the association between income and SA in urban (AOR = 0.88, 95%CI: 0.78-0.99) was stronger than that in rural (AOR = 0.92, 95%CI: 0.84-1.00). Association between education and SA was found in urban (AOR = 0.66, 95%CI: 0.55-0.78) but not in rural (AOR = 1.05, 95%CI: 0.34-1.17), and there was no difference on how occupation impacted SA among women between the two subgroups. CONCLUSIONS: Generally women with lower SES status had a higher risk of SA. Lower income and educational attainment were inversely associated with the risk of SA. Women with agricultural and related work had a significantly higher prevalence of SA. Interventions could be targeted more on women with low SES to increase both health profits as well as economic gains for health programs.

Subamolide B Isolated from Medicinal Plant Cinnamomum subavenium Induces Cytotoxicity in Human Cutaneous Squamous Cell Carcinoma Cells through Mitochondrial and CHOP-Dependent Cell Death Pathways.

Subamolide B is a butanolide isolated from Cinnamomum subavenium, a medicinal plant traditionally used to treat various ailments including carcinomatous swelling. We herein reported for the first time that subamolide B potently induced cytotoxicity against diverse human skin cancer cell lines while sparing nonmalignant cells. Mechanistic studies on human cutaneous squamous cell carcinoma (SCC) cell line SCC12 highlighted the involvement of apoptosis in subamolide B-induced cytotoxicity, as evidenced by the activation of caspases-8, -9, -4, and -3, the increase in annexin V-positive population, and the partial restoration of cell viability by cotreatment with the pan-caspase inhibitor z-VAD-fmk. Additionally, subamolide B evoked cell death pathways mediated by FasL/Fas, mitochondria, and endoplasmic reticulum (ER) stress, as supported by subamolide B-induced FasL upregulation, BCL-2 suppression/cytosolic release of cytochrome c, and UPR activation/CHOP upregulation, respectively. Noteworthy, ectopic expression of c-FLIPL or dominant-negative mutant of FADD failed to impair subamolide B-induced cytotoxicity, whereas BCL-2 overexpression or CHOP depletion greatly rescued subamolide B-stimulated cells. Collectively, these results underscored the central role of mitochondrial and CHOP-mediated cell death pathways in subamolide B-induced cytotoxicity. Our findings further implicate the potential of subamolide B for cutaneous SCC therapy or as a lead compound for developing novel chemotherapeutic agents.