Prospective predictors of quitting behaviours among adult smokers in six cities in China: findings from the International Tobacco Control (ITC) China Survey

AIMS

To examine predictors of quitting behaviours among adult smokers in China, in light of existing knowledge from previous research in four western countries and two southeast Asian countries.

DESIGN

Face-to-face interviews were carried out with smokers in 2006 using the International Tobacco Control (ITC) China Survey, with follow-up about 16 months later. A stratified multi-stage cluster sampling design was employed.

SETTING

Beijing and five other cities in China.

PARTICIPANTS

A total of 4732 smokers were first surveyed in 2006. Of these, 3863 were re-contacted in 2007, with a retention rate of 81.6%.

MEASUREMENTS

Baseline measures of socio-demographics, dependence and interest in quitting were used prospectively to predict both making quit attempts and staying quit among those who attempted.

FINDINGS

Overall, 25.3% Chinese smokers reported having made at least one quit attempt between waves 1 and 2; of these, 21.7% were still stopped at wave 2. Independent predictors of making quit attempts included having higher quitting self-efficacy, previous quit attempts, more immediate intentions to quit, longer time to first cigarette upon waking, negative opinion of smoking and having smoking restrictions at home. Independent predictors of staying quit were being older, having longer previous abstinence from smoking and having more immediate quitting intentions.

CONCLUSIONS

Predictors of Chinese smokers' quitting behaviours are somewhat different to those found in previous research from other countries. Nicotine dependence and self-efficacy seem to be more important for attempts than for staying quit in China, and quitting intentions are related to both attempts and staying quit.

Reduction malarplasty using an L-shaped osteotomy through intraoral and sideburns incisions

The slender, oval-shaped face is considered to be attractive in East Asia. To obtain the ideal contour of the midface, reduction malarplasty has been popularized in oriental countries in recent years. This report describes a surgical technique for reduction of the zygomatic body and arch. After labiobuccal vestibular incisions are made, the anterior zygomatic body and lateral orbital rim are exposed by subperiosteal dissection. Thereafter, an L-shaped osteotomy is performed. Two parallel horizontal osteotomies are made in the anterior part of the zygomatic body, and the middle bone segment is removed. The zygomatic arch root is fractured through a small sideburn incision just anterior to the articular tubercle. Finally, the freed zygomatic complex is medially repositioned and fixed with one or two bicortex screws. Operations on 32 patients demonstrated that this technique may be a sound method for malar complex reduction, with the advantages of simple manipulation, stable fixation, and less risk of a drooping face.

Abstract P5-06-04: Nicastrin Reveals Gamma-Secretase Independent Function in Breast Cancer Cells and Can Be Targeted by a Blocking Monoclonal Antibody To Reduce Breast Cancer Cell Proliferation and Invasion

BACKGROUND: Nicastrin (NCT) is a structural and functional part of the gamma-secretase (GS) enzyme, implicated in tumorigenesis and resistance to treatment in multiple cancer types. However, its mechanism(s) of action and biological functions are poorly understood. We investigated functional and biological effects of inhibiting NCT in breast cancer (BC)cells by means of gene silencing and blocking antibodies, as well as the prognostic value of NCT expression in BC tissue. METHODS: NCT siRNA (Dahrmacon) was used at 40nM. A polyclonal antibody (pcAb) against NCT extracellular domain was developed at Biogenes (GE), and anti-NCT monoclonal antibodies (mAbs) at Genovac (GE). We tested the Abs for their ability to recognize endogenous NCT in BC cells by FACS and Western blot. Best Abs were tested in vitro, using a transwell cell invasion assay and proliferation assay. Anti-NCT Ab (Sigma, N1660) was used for immunohistochemistry (IHC) staining of BC tissues (n = 1050). Cases were scored as NCT negative (0), 1+, 2+ or 3+. Kaplan Meier analysis was used to investigate impact of NCT expression on survival. Illumina (Agilent) oligonucleotide arrays were used to investigate NCT siRNA effects on gene expression in BC cells. Both PcAb and mAbs recognized endogenous NCT in BC cells. In vitro, blocking NCT in MDA-MB231 BC cells with the PcAb, reduced cell proliferation in a dose dependent manner; by 50% and 70% at concentrations of 50μg/ml and 100μg/ml, respectively. mAbs reduced proliferation by 50% (clones 2H6 and 10C5) and 70% clone 10C11, (P<0.01). In transwell cell invasion assay, anti-NCT pcAb induced a dose dependent reduction of invasion, by 35% at the 5μg/ml, peaking at > 60% reduction at 50μg/ml (P<0.001). mAbs reduced cell invasion by 40-50% (clone 10C5 and 10C11) and by >65% (clone 2H6) (P<001). IHC data showed that NCT was highly expressed (2+, 3+) in 47.5% of BC tissues. High NCT expression correlated with worse overall survival (OS) in ERnegative patients (p=0.05). To elucidate the effects of NCT loss, compared to those induced by GSIs or silencing Notch receptors, we examined cDNA from MDA231 treated independently with NCT, Notch1, Notch2, Notch4 siRNAs and GSI MK-003, on Illumina expression arrays. Thirteen of the 18 genes maximally affected by GSI were similarly affected by NCT siRNA. NCT knockdown also affected 1745 other genes that by large were not affected by GSI or Notch knockdowns. This suggests that NCT has GS-and Notch-independent cellular functions and may have different biological properties as a therapeutic target than GS. Among NCT siRNA affected genes, some are tumor suppressors: CST4 increased 8 fold; pro-invasive genes like GNG11 decreased 4 fold; cell adhesion genes: CTGF increased 4.5 fold etc.

CONCLUSIONS: NCT is overexpressed in 47.5% of BC cases where it infers adverse OS in the ER-vecohort of patients. Anti-NCT mAbs recognize endogenous NCT in BC cells and reduce BC cell proliferation and invasion. Silencing NCT in invasive BC cells induces extensive gene expression changes that only partially overlap with those caused by GSIs or Notch siRNAs. We conclude that NCT has GS-independent functions in BC cells and that an anti-NCT mAb may be a promising therapeutic approach for invasive BC.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-06-04.

Regulation of pancreatic islet gene expression in mouse islets by pregnancy

Pancreatic β cells adapt to pregnancy-induced insulin resistance by unclear mechanisms. This study sought to identify genes involved in β cell adaptation during pregnancy. To examine changes in global RNA expression during pregnancy, murine islets were isolated at a time point of increased β cell proliferation (E13.5), and RNA levels were determined by two different assays (global gene expression array and G-protein-coupled receptor (GPCR) array). Follow-up studies confirmed the findings for select genes. Differential expression of 110 genes was identified and follow-up studies confirmed the changes in select genes at both the RNA and protein level. Surfactant protein D (SP-D) mRNA and protein levels exhibited large increases, which were confirmed in murine islets. Cytokine-induced expression of SP-D in islets was also demonstrated, suggesting a possible role as an anti-inflammatory molecule. Complementing these studies, an expression array was performed to define pregnancy-induced changes in expression of GPCRs that are known to impact islet cell function and proliferation. This assay, the results of which were confirmed using real-time reverse transcription-PCR assays, demonstrated that free fatty acid receptor 2 and cholecystokinin receptor A mRNA levels were increased at E13.5. This study has identified multiple novel targets that may be important for the adaptation of islets to pregnancy.

Systemic treatment with strontium ranelate promotes tibial fracture healing in ovariectomized rats

Systemic treatment with strontium ranelate (SR) was performed on ovariectomized (OVX) rats with fractured tibiae. Callus quality was assessed by radiographic, histological, micro-computerized tomography, and biomechanical examinations at 4 and 8 weeks after fracture. Results revealed that systemic applied SR promoted osteoporotic fracture healing.

INTRODUCTION

Several studies have demonstrated the dual effect of SR on osteoporotic and undisturbed bone. However, reports of their effect on osteoporotic fracture healing are limited. This study was designed to investigate the effects of SR on bone regeneration in OVX rats with fractured tibiae.

METHODS

Three months after being OVX, female Sprague-Dawley rats accepted bilateral osteotomy on proximal tibiae fixed with intramedullary wires and were divided into two groups: OVX and OVX + SR (625 mg/kg/day). Callus quality was evaluated at 4 and 8 weeks postfracture.

RESULTS

Compared with OVX group, SR treatment significantly increased bone formation, BMD, biomechanical strength, and improved microstructural properties of the callus. The ultimate load was increased by 211.0% and 61.4% (p<0.01), and the total bone volume of callus by 74.8% and 79.3% (p<0.01) at 4 and 8 weeks postfracture, respectively. SR treatment also promoted healing progress with increased osteogenesis at 4 weeks; more mature and tightly arranged woven or lamellar bone at 8 weeks across the fracture gap in histological analysis.

CONCLUSION

This study suggests that systemic treatment with strontium ranelate could promote tibial fracture healing in OVX rats.

Individual-level factors associated with intentions to quit smoking among adult smokers in six cities of China: findings from the ITC China Survey

BACKGROUND

Over 350 million smokers live in China, and this represents nearly one-third of the smoking population of the world. Smoking cessation is critically needed to help reduce the harms and burden caused by smoking-related diseases. It is therefore important to identify the determinants of quitting and of quit intentions among smokers in China. Such knowledge would have potential to guide future tobacco control policies and programs that could increase quit rates in China.

OBJECTIVE

To identify the correlates of intentions to quit smoking among a representative sample of adult smokers in six cities in China.

METHODS

Data from wave 1 (2006) of the International Tobacco Control (ITC) Policy Evaluation Project China Survey, a face-to-face survey of adult Chinese smokers in six cities: Beijing, Shenyang, Shanghai, Changsha, Guangzhou and Yinchuan, was analysed. Households were sampled using a stratified multistage design. About 800 smokers were surveyed in each selected city (total n=4815).

RESULTS

Past quit attempts, duration of past attempts, Heaviness of Smoking Index (HSI), outcome expectancy of quitting, worry about future health and overall opinion of smoking were found to be independently associated with intentions to quit smoking, but demographic characteristics were not.

CONCLUSIONS

The determinants of quit intentions among smokers in China are fairly similar to those found among smokers in Western countries, despite the fact that interest in quitting is considerably lower among Chinese smokers. Identifying the determinants of quit intentions provides possibilities for shaping effective policies and programs for increasing quitting among smokers in China.

Relationship between response to risperidone, plasma concentrations of risperidone and CYP3A4 polymorphisms in schizophrenia patients

In this study, we examined the relationships between plasma concentrations of risperidone and 9-hydroxyrisperidone and polymorphisms of CYP3A4. All 130 schizophrenia patients (45 men, 85 women, age 15-60 years) who met DSM-IV criteria were given risperidone for 8 weeks. Clinical efficacy was determined using the Positive and Negative Syndrome Scale (PANSS). CYP3A4*1G was found to be associated with the change in total PANSS scores (Kruskal-Wallis test, P = 0.021), which was not significant on adjusting for multiple testing. Our study has, for the first time, conducted a genetic association study of the CYP3A4 gene with risperidone response. Further studies on larger groups and on the effects of the longer term risperidone treatment are needed to confirm these results.

Association of nuclear factor κB expression with a poor outcome in nasopharyngeal carcinoma

The aim of this study was to determine the relationship between nuclear factor κB and the prognosis of patients with nasopharyngeal carcinoma. We used immunohistochemical studies to examine nuclear factor κB expression in 42 patients with nasopharyngeal carcinoma. The results showed that tumors positive for nuclear factor κB were associated with an increased relapse potential, poor disease-free survival, and reduced overall survival in nasopharyngeal carcinoma. Our study indicates that nuclear factor κB could be an independent molecular marker for predicting poor prognosis among patients with nasopharyngeal carcinoma. Understanding the biology of nuclear factor κB-mediated pathways may lead to the development of novel therapeutic strategies for nasopharyngeal carcinoma.

Clinical study of mini-nutritional assessment for older Chinese inpatients

BACKGROUND

Malnutrition is a common problem in older patients. Early detection of malnutrition is an important task in clinical practice. The MNA has become an extensively used tool to evaluate nutritional status in European countries and the United States.

OBJECTIVE

We evaluated the Mini-Nutritional Assessment (MNA) test and the short-form MNA (MNA-SF) test as screening tools for malnutrition in older Chinese inpatients and focused on finding an optimal cutoff point for MNA total score and MNA-SF score.

DESIGN

One hundred eighty-four older Chinese inpatients were enrolled in this study from July to August 2006. Nutritional assessment included MNA, anthropometric measurements, and biochemical markers.

RESULTS

According to the original cutoff point of the full MNA, 19.6% of those assessed were malnourished, 53.2% were at risk of malnutrition and 27.2% were well nourished. Correlations were found between MNA, MNA-SF and body mass index, triceps skinfold thickness, serum albumin, lymphocyte count, hemoglobin, lymphocyte ratio. With the most proper cutoff point lower than 19 indicating malnutrition, when using serum albumin (< 35.0 g/L) as the indicator, the sensitivity and specificity of the MNA total score were 0.6286 and 0.7466; when using BMI (< 18.5 kg/m2) as the indicator, the sensitivity and specificity were 0.8636 and 0.7469. The incidence rate of malnutrition was 32.6%. The most proper cutoff point of MNA-SF was lower than 12.

CONCLUSION

The MNA and MNA-SF were useful tools to identify older Chinese inpatients with malnutrition. However, the cutoff point of the MNA should be modulated for this population.

Methods of the International Tobacco Control (ITC) China Survey

This paper describes the design features, data collection methods and analytical strategies of the ITC China Survey, a prospective cohort study of 800 adult smokers and 200 adult non-smokers in each of six cities in China. In addition to features and methods which are common to ITC surveys in other countries, the ITC China Survey possesses unique features in frame construction, a large first phase data enumeration and sampling selection; and it uses special techniques and measures in training, field work organisation and quality control. It also faces technical challenges in sample selection and weight calculation when some selected upper level clusters need to be replaced by new ones owing to massive relocation exercises within the cities.

Sapap3 and pathological grooming in humans: Results from the OCD collaborative genetics study

SAP90/PSD95-associated protein (SAPAP) family proteins are post-synaptic density (PSD) components that interact with other proteins to form a key scaffolding complex at excitatory (glutamatergic) synapses. A recent study found that mice with a deletion of the Sapap3 gene groomed themselves excessively, exhibited increased anxiety-like behaviors, and had cortico-striatal synaptic defects, all of which were preventable with lentiviral-mediated expression of Sapap3 in the striatum; the behavioral abnormalities were also reversible with fluoxetine. In the current study, we sought to determine whether variation within the human Sapap3 gene was associated with grooming disorders (GDs: pathologic nail biting, pathologic skin picking, and/or trichotillomania) and/or obsessive-compulsive disorder (OCD) in 383 families thoroughly phenotyped for OCD genetic studies. We conducted family-based association analyses using the FBAT and GenAssoc statistical packages. Thirty-two percent of the 1,618 participants met criteria for a GD, and 65% met criteria for OCD. Four of six SNPs were nominally associated (P < 0.05) with at least one GD (genotypic relative risks: 1.6-3.3), and all three haplotypes were nominally associated with at least one GD (permuted P < 0.05). None of the SNPs or haplotypes were significantly associated with OCD itself. We conclude that Sapap3 is a promising functional candidate gene for human GDs, though further work is necessary to confirm this preliminary evidence of association.