Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths, characterized by highly hypoxic tumor microenvironment. Hypoxia-inducible factor-1α (HIF-1α) is a major regulator involved in cellular response to changes of oxygen levels, supporting the adaptation of tumor cells to hypoxia. Bruceine D (BD) is an isolated natural quassinoid with multiple anti-cancer effects. Here, we identified BD could significantly inhibit the HIF-1α expression and its subsequently mediated HCC cell metabolism. Using biophysical proteomics approaches, we identified inhibitor of β-catenin and T-cell factor (ICAT) as the functional target of BD. By targeting ICAT, BD disrupted the interaction of β-catenin and ICAT, and promoted β-catenin degradation, which in turn induced the decrease of HIF-1α expression. Furthermore, BD could inhibit HCC cells proliferation and tumor growth in vivo, and knockdown of ICAT substantially increased resistance to BD treatment in vitro. Our data highlight the potential of BD as a modulator of β-catenin/HIF-1α axis mediated HCC metabolism.

With the accelerating globalization and the implementation of "Belt and Road" initiative proposed by our government, communication and exchanges between China and foreign countries have become more and more frequent than before, and much more international students have chosen to study in China's universities as candidates of master of public health (MPH). However, because China only launched the MPH program in recent years, with the training models being highly similar to the program of master of science in China but quite different from those of main international MPH programs, hindering China's MPH program to become an international one. This paper systematically evaluated existing training models of MPH programs both at home and abroad through literature review and identified major differences and deficiencies of China's MPH program compared to those from other countries: (1) requirement for medical background only; (2) comparatively longer period to complete the program; (3) incomplete curriculum; (4) overemphasizing scientific research competencies but somewhat neglecting practical abilities; and (5) limited career choices, and put forward some suggestions to improve the MPH program of China, including removing requirement for medical background only, shortening the period of MPH program, improving the curriculum of MPH program, and enhancing the training of practical abilities.

Mediation analysis is mainly used to explore the causal mechanism between independent variable X and dependent variable Y. It determines whether mediator M plays a role and evaluate the role’s degree in the causal path by decomposing the causal path between the independent variable X and the dependent variable Y. However, the classical mediation analysis is generally used for single mediator. This paper introduces a new mediation analysis method for multiple mediators.

At present, traditional methods on statistics have limitations in controlling time- varying confounding. This paper introduces an analysis method, parametric g-formula, which would adjust time-varying confounding, and also exemplifies the steps of its implementation for purpose to provide a new reference for researchers to deal with long-term observational data.

As a metabolic disorder during pregnancy,gestational diabetes mellitus (GDM) has an important effects on fetal development,neonatal health and maternal long-term health,and is one of the pregnancy complications with high incidence.It is of great significance that we have an accurate understanding of the etiology and risk factors of GDM for its prevention and control.GDM is a complex disease with multiple etiologies.Current studies have shown that the occurrence of GDM may be the result of combined effect of heredity and environment,but the exact etiology is still unclear.In this paper,we summarized the possible etiologies and risk factors of GDM,so as to understand the occurrence and development of GDM better and to provide possible references for prevention and further etiological studies of GDM.

Objective:To explore the prognosis of posttraumatic stress disorder (PTSD) in flood survivors 13 years after they had been diagnosed with PTSD symptoms,and investigate the relationship between their personality traits and the prognosis of PTSD.Method:In this cross-sectional study,the survivors of Dongting Lake flood in 1998-1999 in Hunan in China,who were investigated and screened as PTSD symptoms positive in 2000 were selected as the target population,from which a sample of 200subjects was drawn using amulti-stage random sampling method.The Posttraumatic Stress Disorder Scale Civilian Version (PCL-C) was used to examine and re-screen the participants of PTSD symptoms in order to explore the prognosis of PTSD.Participants whose PCL-C scores were equal to 44 or higher were classified as the PTSD symptoms positive group,while those with PCL-C scores less than 44 were classified as the recovered group.Personality traits were then assessed,using the Revised Eysenck Personality Questionnaire Short Scale for Chinese (EPQ-RSC),in both the recovered group and the PTSD symptoms positive group.Finally,the multivariate logistic regression analysis was used to investigate the relationship between the prognosis of PTSD and personality traits.Results:Totally 200 subjects were eligible for this study and completed the questionnaires,but 16 of them had their questionnaires excluded from data analysis because they provided incomplete information.Thus,the response rate was 92.0％.According to the PCL-C's cut-off score,22 participants were still screened as PTSD symptoms positive and were classified as the PTSD symptoms positive group,whereas the other 162 participants were screened as PTSD symptoms negative and were classified as the recovered group.Compared with the recovered group,the EPQ-RSC extroversion scores for the PTSD symptoms positive group were significantly lower [(51.8 ± 10.7) vs.(45.1 ± 13.2),P ＜ 0.05] and their neuroticism scores were significantly higher [(46.5 ± 10.1) vs.(58.3 ± 12.2),P ＜ 0.05].The multivariate logistic regression analysis showed,after adjusting for the variables such as gender and age,that higher neuroticism (OR ＝ 3.63,95％ CI:1.05 -12.54) was a risk factor for the persistent PTSD symptoms in the flood survivors.Conclusions:It suggests that neuroticism is associated with prognosis of PTSD in flood survivors,those with higher neuroticism scores appear to have problems to recover from PTSD.

OBJECTIVE: To investigate the epidemiological situation and temporal-spatial clustering changes of hand-foot-mouth disease (HFMD) in Hunan.
 METHODS: Spatial autocorrelation and temporal-spatial clustering analysis were used to analyze the HFMD in Hunan.
 RESULTS: The incidence rates of HFMD ranged from 54.31/10 million to 318.06/10 million between 2009 and 2015 in Hunan. Cases mainly displayed in 5-year-old or even younger children and there were two epidemic periods each year. HFMD cases did not show a random distribution but with significant spatial aggregation. When local autocorrelation analysis was applied at the county/district level, 4 hot spots in Changsha, Yiyang, Loudi and Zhuzhou were discovered. The tendency for temporal and spatial clustering existed among HFMD cases in Hunan. The temporal dimension of HFMD was from April to July annually. Clustering areas gathered in the northern regions in 2009 and in the middle regions from 2010 to 2012. They moved to middle-southern regions in 2013 or 2014 and middle-western regions in 2015. 
 CONCLUSION The HFMD incidence from 2009 to 2015 in Hunan showed temporal and spatial clustering tendency, with the shifting trend of clustered areas toward south and west.
Cluster Analysis ; Hand, Foot and Mouth Disease ; Humans ; Incidence

OBJECTIVE: To analyze the sexual behavior characteristics of the sexually transmitted HIV-positive people and to estimate the secondary transmission rate.
 METHODS: Field investigation and literature review were conducted among sexually transmitted HIV-positive people to collect general information during the last 6 months before notification of HIV infection. A mathematical model was used to estimate the secondary transmission rate.
 RESULTS: A total of 769 HIV-positive people were recruited for the study, 186 of them were women, 286 were men who have sex with women (MSW), 242 were men who have sex with men (MSM) and 55 were men who have sex with men and women (MSMW). During 6 months, the average sex partner among these 4 groups were 2.29, 1.61, 3.32 and 4.10, respectively; the sexual behavior frequency were 26.03, 20.97, 14.77 and 25.51, respectively; the rates of non-use of condom were 74.14%, 73.53%, 59.60% and 72.06%, respectively; the secondary transmission rate were 0.0095, 0.0151, 0.1759 and 0.1985, respectively. Under constant conditions of other factors, the secondary transmission rates decreased by 30.13%-82.00%, 23.00%-49.51%, and 16.10%-19.09%, respectively, if there was a reduction in 1 sex partner, 1 time/month for the sexual frequency and 20% of rate for non-use of condom.
 CONCLUSION The HIV secondary transmission from MSMW HIV-positive people to general population was the highest. Change in sexual behavior of the HIV-positive people can decrease the HIV secondary transmission rate significantly.
Female ; HIV Infections ; Humans ; Male ; Models, Theoretical ; Sexual Behavior ; Sexual Partners

Cardiac Tamponade ; etiology ; Heart Neoplasms ; complications ; Hemangiosarcoma ; complications ; Humans ; Pericardial Effusion

OBJECTIVE: To constitute school sanitation standard using modified Delphi method, and to explore the feasibility and the predominance of Delphi method in the constitution of school sanitation standard. METHODS: Two rounds of expert consultations were adopted in this study. The data were analyzed with SPSS15.0 to screen indices of school sanitation standard. RESULTS: Thirty-two experts accomplished the 2 rounds of consultations. The average length of expert service was (24.69 ±8.53) years. The authority coefficient was 0.729 ±0.172. The expert positive coefficient was 94.12% (32/34) in the first round and 100% (32/32) in the second round. The harmonious coefficients of importance, feasibility and rationality in the second round were 0.493 (P<0.05), 0.527 (P<0.01), and 0.535 (P<0.01), respectively, suggesting unanimous expert opinions. According to the second round of consultation, 38 indices were included in the framework. CONCLUSION Theoretical analysis, literature review, investigation and so on are generally used in health standard constitution currently. Delphi method is a rapid, effective and feasible method in this field.
China ; Delphi Technique ; Feasibility Studies ; Hygiene ; standards ; Public Health Administration ; methods ; Schools ; standards