Objective:Based on protection motivation theory(PMT),this study aimed to examine the current status of e-cigarette cessation intention and cessation behavior,as well as their associated factors,among adult e-cigarette users in China.Methods:This was a cross-sectional study.The data were de-rived from a nationwide"E-cigarette Use Survey"conducted in 2023,covering 31 provinces(municipali-ty,autonomous region)in China.A total of 550 current e-cigarette users aged 18-44 years were selec-ted as the study population.After adjusting for sociodemographic variables,multiple linear regression models were used to identify factors associated with e-cigarette cessation intention,while binary Logistic regression models were applied to examine factors associated with e-cigarette cessation behavior.In addi-tion,subgroup analyses were conducted according to smoking status to explore potential differences among exclusive e-cigarette users and dual users of e-cigarettes and combustible cigarettes.Results:The mean score of e-cigarette cessation intention was 3.52±0.96,and 31.64％of participants reported having at-tempted to quit e-cigarettes.After adjustment for covariates,cessation intention was associated with both the threat appraisal and coping appraisal pathways within the PMT framework.Specifically,in the threat appraisal pathway,severity(β=0.14)and vulnerability(β=0.12)were positively associated with ces-sation intention,whereas perceived extrinsic rewards(β=-0.12)were negatively associated.In the coping appraisal pathway,both response efficacy(β=0.26)and self-efficacy(β=0.28)were positive-ly associated with cessation intention.Regarding cessation behavior,only severity(OR=1.58)in the threat appraisal pathway was positively associated,and cessation intention was also positively associated with cessation behavior.Subgroup analyses further showed that,regardless of smoking status,cessation intention was positively associated with both the threat appraisal pathway(β=0.20,β=0.31)and the coping appraisal pathway(β=0.23,β=0.21).Conclusion:PMT provides a valuable theoretical framework for understanding e-cigarette cessation among adults.Factors related to the threat appraisal pathway are associated not only with cessation intention but also with actual cessation behavior.More-over,the associations of PMT-related factors vary across different smoking status subgroups.These findings suggest that future e-cigarette control policies and interventions could focus on enhancing risk perception and cognitive awareness,and develop more targeted cessation strategies for specific subgroups.

INTRODUCTION:While tobacco industry corporate social responsibility (CSR) activities as marketing strategies have been documented globally, the narrative mechanisms through which media coverage legitimizes tobacco industry charitable donations remain understudied, particularly within China's unique state-monopoly context. This study examines how tobacco industry donations function as marketing through media narratives. METHODS:We conducted a secondary systematic content and narrative analysis of news coverage documenting tobacco industry charitable donations recorded in the 2021 China Tobacco Yearbook. Using purposive sampling, we identified 85 news reports from 2020, through comprehensive online searches. Two trained coders independently analyzed all materials using a coding framework based on narrative theory, examining eight dimensions including narrator types, character construction, narrative perspectives, and framing strategies (Cohen's κ=0.85; 95% CI: 0.78-0.91). RESULTS:Analysis revealed systematic narrative strategies designed to enhance tobacco companies' public image. Key findings include: 82.35% (n=70) of headlines explicitly mentioned tobacco company names; reporting frames emphasized national policy alignment (37.65%; n=32), health benefits (34.12%; n=29), and corporate social responsibility (30.6%; n=26); tobacco companies appeared as primary actors in 97.6% (n=83) of reports; 100% (n=85) of coverage maintained positive valence toward donations. Chi-squared analysis demonstrated significant associations between character construction and framing strategies (χ2=42.84; degrees of freedom, df=4; p<0.001; Cramer's V=0.710). CONCLUSIONS:News coverage of tobacco industry donations employs sophisticated narrative strategies that function as a form of tobacco promotion and marketing with implications for World Health Organization Framework Convention on Tobacco Control (WHO FCTC) Article 13 implementation. These findings suggest the need for further research on regulatory approaches to address all forms of tobacco promotion, including charitable donations and their media coverage, to support effective WHO FCTC implementation.

Objective To elucidate the effects of miR-616 on the malignant biological processes of osteosarcoma and to preliminarily explore its potential mechanisms.Methods In situ hybridization(ISH)was employed to analyze miR-616 expression in 11 paraffin-embedded osteosarcoma specimens collected in our department during January 2018 to December 2019.Quantitative real-time PCR(qRT-PCR)was used to compare the mRNA expression level of miR-616 in the osteoblast cell line hFOB1.19 and osteosarcoma cell lines 143B and HOS.Stable cell lines with miR-616 knockdown or overexpression were established via lentiviral transfection in 143B and HOS cells.Cell proliferation and apoptosis were detected by flow cytometry,while cell invasion and migration were assessed using Transwell and colony formation assays,respectively.To evaluate the effect of miR-616 on tumor growth in vivo,10 female nude mice(4 weeks old,weighing 18～20 g)were randomized into a control group and a miR-616 overexpression group.After the xenograft tumor model was constructed,the growth of subcutaneous tumors was monitored.Finally,next-generation sequencing and a dual-luciferase reporter assay were performed to identify the target genes of miR-616.Results ISH results showed that miR-616 expression was up-regulated in osteosarcoma tissues than adjacent tissues,and primarily localized in the cytoplasm.qRT-PCR confirmed that miR-616 level was significantly higher in 143B and HOS cells than hFOB1.19 cells(P<0.05).In vitro experiments revealed that miR-616 overexpression enhanced the proliferation,migration and invasion,while suppressing apoptosis in 143B and HOS cells(P<0.01).Conversely,miR-616 knockdown weakened these malignant phenotypes(P<0.05),with miR-616-3p showing a stronger effect on apoptosis than miR-616-5p.Animal experiments demonstrated that the tumor weight in the miR-616 overexpression group was significantly greater than that of the control group(98.00±17.22 vs 33.60±8.08 mg,P<0.01).Furthermore,KLF2 was identified and confirmed as a direct target of miR-616.Conclusion MiR-616 promotes malignant biological behaviors in osteosarcoma,and its expression level indicates that it may serve as a potential therapeutic target.

INTRODUCTION:E-cigarette use among young adults represents a growing public health concern. This pilot randomized controlled trial evaluated the preliminary effects of Protection Motivation Theory (PMT)-based peer education on strengthening university students' cognition to refuse e-cigarette use in China, where tobacco control policies remain limited. METHODS:A total of 289 participants completed baseline assessment and were randomly assigned to an intervention group (n=144) and a control group (n=145). The intervention consisted of a 1-month peer education program in which trained peer educators delivered PMT-based messages through weekly one-on-one conversations via phone or messaging platforms. Intervention participants received messages addressing all seven PMT constructs, while control participants received only messages about health risks of two PMT constructs. Primary outcomes were four PMT-based cognitive appraisals measured at baseline, 1 month, and 3 months. Linear mixed-models examined group × time interactions, and effect sizes were calculated for all comparisons. RESULTS:No statistically significant between-group differences were observed for primary outcomes. Subgroup analysis revealed significant intervention effects at 3 months among participants with family or friends who used cigarettes/e-cigarettes: lower perceived rewards (mean difference= -0.55; 95% CI: -1.07 - -0.03, p=0.04) and greater perceived efficacy (mean difference=0.34; 95% CI: 0.06-0.62, p=0.02). CONCLUSIONS:While overall effects were not statistically significant, observed effect sizes and significant subgroup findings suggest PMT-based peer education may influence cognitive precursors to e-cigarette use, particularly among students with social exposure to tobacco use. Larger trials with extended follow-up periods are warranted to confirm these preliminary findings.

BACKGROUND:Tandem C2 domains, nuclear (TC2N) is a protein that has been characterized to contain C2A domain, C2B domain, and a short C-terminus with a WHXL motif. In previous studies, we have uncovered the oncogenic role and mechanisms of TC2N in lung cancer: TC2N achieves this by inhibiting the p53 signaling pathway and activating the NF-kappaB signaling pathway. Beyond that, its precise function in tumorigenesis is not fully understood. METHODS:TC2N-engineered mice model was used to assess the effect of TC2N knockout on normal lung and urethane-induced carcinogenesis. Tumor tissues of 395 lung cancer patients were subjected to tissue microarray and further assessed the associations of TC2N expression with tumor differentiation degree. The protein levels of TC2N and stem cell markers in cell lines and tissue specimens were monitored by WB and immunohistochemistry. In vitro cell assays were performed to assess the effect of TC2N ectopic expression on the stem cell-like characteristics of lung cancer cells. The downstream signaling pathway or target molecule of TC2N was mined using a combination of transcriptomics and proteomics, and the underlying mechanism was explored by WB and co-IP assays. RESULTS:Herein, TC2N appeared to have a strong effect in promoting lung tumorigenesis caused by urethane, whereas it seemed to lose its function in the normal lung. Meanwhile, we found that the functional differences of TC2N between lung tumor and normal lung were linked to its potential role in cancer cell stemness. Function-wise, TC2N overexpression maintained stem-like properties of lung cancer cell. Mechanism-wise, TC2N upregulated the phosphorylation of EGFR, ERK, STAT3 and FAK1 to activate these signaling pathways by the inhibition of DUSP3 phosphatase via a dual mechanism. Firstly, TC2N competes with EGFR, ERK, STAT3 and FAK1 for binding to DUSP3. This competition prevents these signaling molecules from being dephosphorylated by DUSP3, resulting in their sustained activation. Secondly, TC2N bind to DUSP3 and restrict the enzyme's ability to dephosphorylate the signaling molecules. CONCLUSIONS:Overall, this study revealed a previously unknown role and mechanism of TC2N in the regulation of tumorigenesis and stemness in lung cancer cells.

In the aging population, sarcopenia has become a major concern due to its association with increased risks of disability, including impairments in both activities of daily living (ADL) and instrumental activities of daily living (IADL). This relationship, however, has been rarely studied within the Chinese population. This study was conducted to assess the relationships of sarcopenia status and its components with the risk of developing ADL/IADL disability among Chinese community-dwelling elderly people. In this study, we used data from the China Health and Retirement Longitudinal Study. The ADL and IADL scales were used to assess an individual’s functional disability. Logistic regression models were used to assess the association between sarcopenia status and its components and the risk of developing ADL/IADL disability in the overall population. Sex-specific receiver operating characteristic (ROC) curves was used to evaluate the value of sarcopenia component indicators for predicting ADL/IADL disability. A total of 4,893 participants were included in the study, comprising 2,220 males and 2,673 females, with ages ranging from 60 to 102 years. There were greater IADL disability risks in the possible sarcopenia group (OR = 1.87, 95

Background:Tandem C2 domains, nuclear (TC2N) is a recently identified tumor-associated gene that has been confirmed to play important roles in various malignancies, including lung cancer, breast cancer, gastric cancer, glioma, and liver cancer. However, its biological functions and mechanisms in head and neck squamous cell carcinoma (HNSCC) remain unclear. In this study, we aimed to analyze the expression and methylation status of TC2N using public databases and preliminarily investigate the effects of TC2N on the malignant phenotypes of HNSCC cells and its potential mechanisms. Methods:Data from The Cancer Genome Atlas (TCGA) and multiple Gene Expression Omnibus (GEO) databases were analyzed to assess the expression levels of TC2N in HNSCC. Functional and signaling pathway analyses were conducted both in vitro and in vivo to evaluate the impact of TC2N on cell growth, invasion, and apoptosis. The role of TC2N in promoting cancer through mutant p53-mediated signaling was also explored. Results:The study found that TC2N was downregulated in HNSCC and its expression was correlated with the degree of promoter methylation. Both in vitro and in vivo experiments demonstrated that TC2N can stimulate cell growth and invasion, and inhibit apoptosis via mutant p53-R175-mediated pro-cancer signals. Conclusions:This study reports the expression pattern of TC2N in HNSCC and provides preliminary insights into the biological functions and mechanisms of this gene in this type of cancer, laying the experimental foundation for investigating the role and mechanism of TC2N in HNSCC.

ImportanceElectronic cigarettes (ECs) are often used by smokers as an aid to stopping smoking, but evidence is limited regarding their efficacy compared with nicotine replacement therapy (NRT), and no evidence is available on how their efficacy compares with that of varenicline.ObjectiveTo evaluate whether ECs are superior to NRT and noninferior to varenicline in helping smokers quit.Design, Setting, and ParticipantsThis was a randomized clinical trial conducted at 7 sites in China and including participants who were smoking at least 10 cigarettes per day and motivated to quit, not using stop-smoking medications or EC, and willing to use any of the study products. Participants were first recruited in May 2021, and data analysis was conducted in December 2022.InterventionsA cartridge-based EC (30 mg/mL nicotine salt for 2 weeks and 50 mg/mL after that), varenicline (0.5 mg, once a day for 3 days; 0.5 mg, twice a day for 4 days; and 1 mg, twice a day, after that), and 2 mg (for smokers of ≤20 cigarettes per day) or 4 mg (>20 cigarettes per day) nicotine chewing gum, all provided for 12 weeks and accompanied by minimal behavioral support (an invitation to join a self-help internet forum).Main Outcomes and MeasuresThe primary outcome was sustained abstinence from smoking at 6 months as validated by an expired-air carbon monoxide reading (<8 parts per million). Participants lost to follow-up were included as nonabstainers.ResultsOf 1068 participants, 357 (33.5%) were female, and the mean (SD) age was 33.9 (3.1) years. A total of 409 (38.3%), 409 (38.3%), and 250 (23.4%) participants were randomized to the EC, varenicline, and NRT arms, respectively. The 6-month biochemically validated abstinence rates were 15.7% (n = 64), 14.2% (n = 58), and 8.8% (n = 22) in the EC, varenicline, and NRT study arms, respectively. The quit rate in the EC arm was noninferior to the varenicline arm (absolute risk reduction, 1.47%; 95% CI, −1.41% to 4.34%) and higher than in the NRT arm (odds ratio, 1.92; 95% CI, 1.15-3.21). Treatment adherence was similar in all study arms during the initial 3 months, but 257 participants (62.8%) in the EC arm were still using ECs at 6 months, with no further use in the 2 other study arms. The most common adverse reactions were throat irritation (32 [7.8%]) and mouth irritation (28 [6.9%]) in the EC arm, nausea (36 [8.8%]) in the varenicline arm, and throat irritation (20 [8.0%]) and mouth irritation (22 [8.8%]) in the NRT arm. No serious adverse events were recorded.Conclusions and RelevanceThe results of this randomized clinical trial found that when all treatments were provided with minimal behavior support, the efficacy of EC was noninferior to varenicline and superior to nicotine chewing gum.Trial RegistrationChinese Clinical Trial Registry: ChiCTR2100048156

Importance:Electronic cigarettes (ECs) are often used by smokers as an aid to stopping smoking, but evidence is limited regarding their efficacy compared with nicotine replacement therapy (NRT), and no evidence is available on how their efficacy compares with that of varenicline. Objective:To evaluate whether ECs are superior to NRT and noninferior to varenicline in helping smokers quit. Design, Setting, and Participants:This was a randomized clinical trial conducted at 7 sites in China and including participants who were smoking at least 10 cigarettes per day and motivated to quit, not using stop-smoking medications or EC, and willing to use any of the study products. Participants were first recruited in May 2021, and data analysis was conducted in December 2022. Interventions:A cartridge-based EC (30 mg/mL nicotine salt for 2 weeks and 50 mg/mL after that), varenicline (0.5 mg, once a day for 3 days; 0.5 mg, twice a day for 4 days; and 1 mg, twice a day, after that), and 2 mg (for smokers of ≤20 cigarettes per day) or 4 mg (>20 cigarettes per day) nicotine chewing gum, all provided for 12 weeks and accompanied by minimal behavioral support (an invitation to join a self-help internet forum). Main Outcomes and Measures:The primary outcome was sustained abstinence from smoking at 6 months as validated by an expired-air carbon monoxide reading (<8 parts per million). Participants lost to follow-up were included as nonabstainers. Results:Of 1068 participants, 357 (33.5%) were female, and the mean (SD) age was 33.9 (3.1) years. A total of 409 (38.3%), 409 (38.3%), and 250 (23.4%) participants were randomized to the EC, varenicline, and NRT arms, respectively. The 6-month biochemically validated abstinence rates were 15.7% (n = 64), 14.2% (n = 58), and 8.8% (n = 22) in the EC, varenicline, and NRT study arms, respectively. The quit rate in the EC arm was noninferior to the varenicline arm (absolute risk reduction, 1.47%; 95% CI, -1.41% to 4.34%) and higher than in the NRT arm (odds ratio, 1.92; 95% CI, 1.15-3.21). Treatment adherence was similar in all study arms during the initial 3 months, but 257 participants (62.8%) in the EC arm were still using ECs at 6 months, with no further use in the 2 other study arms. The most common adverse reactions were throat irritation (32 [7.8%]) and mouth irritation (28 [6.9%]) in the EC arm, nausea (36 [8.8%]) in the varenicline arm, and throat irritation (20 [8.0%]) and mouth irritation (22 [8.8%]) in the NRT arm. No serious adverse events were recorded. Conclusions and Relevance:The results of this randomized clinical trial found that when all treatments were provided with minimal behavior support, the efficacy of EC was noninferior to varenicline and superior to nicotine chewing gum. Trial Registration:Chinese Clinical Trial Registry: ChiCTR2100048156.

Background Tandem C2 domains, nuclear (TC2N) is a C2 domain-containing protein that belongs to the carboxyl-terminal type (C-type) tandem C2 protein family, and acts as an oncogenic driver in several cancers. Previously, we preliminarily reported that TC2N mediates the PI3K-Akt signaling pathway to inhibit tumor growth of breast cancer (BC) cells. Beyond that, its precise biological functions and detailed molecular mechanisms in BC development and progression are not fully understood. Methods Tumor tissues of 212 BC patients were subjected to tissue microarray and further assessed the associations of TC2N expression with pathological parameters and FASN expression. The protein levels of TC2N and FASN in cell lines and tumor specimens were monitored by qRT-PCR, WB, immunofluorescence and immunohistochemistry. In vitro cell assays, in vivo nude mice model was used to assess the effect of TC2N ectopic expression on tumor metastasis and stemness of breast cancer cells. The downstream signaling pathway or target molecule of TC2N was mined using a combination of transcriptomics, proteomics and lipidomics, and the underlying mechanism was explored by WB and co-IP assays. Results Here, we found that the expression of TC2N remarkedly silenced in metastatic and poorly differentiated tumors. Function-wide, TC2N strongly inhibits tumor metastasis and stem-like properties of BC via inhibition of fatty acid synthesis. Mechanism-wise, TC2N blocks neddylated PTEN-mediated FASN stabilization by a dual mechanism. The C2B domain is crucial for nuclear localization of TC2N, further consolidating the TRIM21-mediated ubiquitylation and degradation of FASN by competing with neddylated PTEN for binding to FASN in nucleus. On the other hand, cytoplasmic TC2N interacts with import proteins, thereby restraining nuclear import of PTEN to decrease neddylated PTEN level. Conclusions Altogether, we demonstrate a previously unidentified role and mechanism of TC2N in regulation of lipid metabolism and PTEN neddylation, providing a potential therapeutic target for anti-cancer.

OBJECTIVE:To assess cigarette demand among Chinese smokers through a cigarette purchase task (CPT) and to evaluate cigarette prices under different hypothetical scenarios in order to meet the goals of smoking prevalence reduction in China.METHODS:In the study, 447 participants completed a hypothetical CPT at baseline assessments of a trial, thus, cigarette demand curves were individually fitted for each participant using an exponentiated version of the exponential demand model. Typically, five demand indices were derived, intensity (consumption when free), breakpoint (first price at which consumption is suppressed to 0), maximum output (Omax), maximum price (Pmax, price at which Omax occurred), and elasticity (the ratio of the change in quantity demanded to the change in price). A one-way analysis of variance was used to explore the correlations between the cigarette purchase task indices and socio-demographic and smoking characteristics. The one-way decay model was employed to simulate the smoking cessation rates and determine optimal cigarette prices in a series of scenarios for achieving 20% smoking prevalence.RESULTS:The price elasticity drawn from CPT was 0.54, indicating that a 10% price increase could reduce smoking by 5.4% in the participated smokers. Smokers with higher income were less sensitive to cigarette prices (elasticity=-2.31, P=0.028). Cigarette purchase task indices varied significantly among the smokers with different prices of commonly used cigarettes, tobacco dependence, and smoking volume. The smokers who consumed cigarettes of higher prices reported higher breakpoint, Omax and Pmax, but lower intensity (P=0.001). The smokers who were moderately or highly nicotine dependent reported higher intensity, breakpoint, Omax and Pmax, and they had lower intensity (P=0.001). The smokers who had a higher volume of cigarettes reported higher intensity and Omax, and lower intensity (P < 0.001). To achieve the goal of reducing smoking prevalence to 20% in mainland China, we estimated the desired increase on smoking cessation rate and prices accordingly in a series of scenarios, considering the gender variance and reduced smoking initiation. In scenario (a), to achieve a smoking prevalence goal of 20%, it would be necessary for 24.81% of the current smokers to quit smoking when there were no new smokers. Our fitting model yielded a corresponding value of 59.64 yuan (95%CI 53.13-67.24). Given the assumption in scenario (b) that only males quitted smoking, the desired cessation rates would be 25.82%, with a higher corresponding price of 62.15 yuan (95%CI 55.40-70.06) to induce desired cessation rates. In the proposed scenario (c) where 40 percent of the reduction in smoking prevalence came from reduced smoking initiation, and females and males equally quitted smoking due to increased cigarette prices, the price of a pack of cigarettes would be at least 37.36 yuan (95%CI 32.32-42.69) (equals to $ 5.20) per pack to achieve the cessation rate of 14.89 percent. In scenario (d) where only males quitted smoking due to increased cigarette prices considering the reduced smoking initiation, the respective smoking cessation rates should be 15.49% with the desired prices of 38.60 yuan (95%CI 33.53-44.02). After adjusting for education levels and income levels in scenario (c), the price of cigarettes would be at least 37.37 yuan/pack (equals to $ 5.20) (95%CI 30.73-44.94) and 37.84 yuan/pack (equals to $ 5.26) (95%CI 31.94-44.53), respectively.CONCLUSION:Cigarette purchase task indices are significantly associated with income levels and prices of commonly used cigarettes, levels of tobacco dependence, and smoking volume, which is inspiring in studying price factors that influence smoking behavior. It is suggested that higher cigarette prices, surpassing the current actual market level, is imperative in mainland China. Stronger policy stra-tegies should be taken to increase tobacco taxes and retail cigarette prices to achieve the Healthy China 2030 goal of reducing smoking prevalence to 20%.

The Health Action Process Approach (HAPA) is a two-stage (pre-intentional and post-intentional) behavioral change model that distinguishes between motivation and volition in behavior change process. This study aims to develop HAPA-based assessments for smoking cessation among current smokers. The HAPA-based measures were developed and the draft measures included nine constructs, namely, risk perception in smoking-induced cancer, risk perception in smoking-induced systemic disease, positive outcome expectancy, negative outcome expectancy, self-efficacy in quitting smoking, self-efficacy in maintaining, self-efficacy in re-initiating, quitting planning and coping planning in smoking cessation, with a total of 26 items. A cross-sectional survey was conducted in China in 2022. Principal Component Analysis was used for Exploratory Factor Analysis (EFA). Cronbach’s α coefficient was calculated to evaluate the internal consistency. Variables such as severity of smoking addiction were selected to evaluate the correlation between the HAPA scale and these variables. Of the 928 participants, 76.4% (709/928) were male and the median age was 35 years. Five factors were extracted by EFA. The factor loadings of each item were all greater than 0.60, and the cumulative variance contribution rate was 90.15%. The Cronbach’s α coefficient of each HAPA-based subscales was 0.929–0.986. The HAPA-based measurements are comprehensive, reliable and valid in the assessment of smokers’ smoking cessation cognition, which can be used to guide the design and implementation of intervention and the development of theory.

Introduction There is an urgent issue to relieve the burdens caused by tobacco use through feasible and effective smoking cessation interventions, particularly in a middle-income country with less accessible smoking cessation services and high demand for quitting smoking. Financial incentives have shown effective in changing health behaviours, thus needing to test its portability to a wider implementation and effectiveness of increasing smoking cessation rates.Methods and analysis This is a three-arm cluster randomised controlled trial. 462 eligible participants will be assigned to 2 financial incentive groups—rewards or deposits, or the control group. All participants including those in the control group will receive text messages to help quitting smoking developed by the US National Cancer Institute over a 3-month intervention period. In addition to text messages, reward group participants will be rewarded with CNY200 and CNY400 (CNY100 approximately US$15) for sustained smoking abstinence at 1 month and 3 months follow-up assessments; participants in the deposit group will accumulate CNY200 and CNY600 in the deposit accounts after verified smoking abstinence at 1 month and 3 months follow-up assessments, and all the deposits will be given at once right after the 3-month follow-up visit. The primary outcome is biochemically verified smoking abstinence rate sustained for 6 months after enrolment.Ethics and dissemination This trial protocol has been approved by the Ethics Committee of Peking University Health Science Centre (date: 23 February 2023; ethical approval number: IRB00001052-22172). Results and findings of this trial will be disseminated in peer-reviewed journals and professional conferences.Trial registration number ChiCTR-IOR-2300069631.

Objective:Culture and eating habits, which vary greatly across different ethnic groups, have a substantial impact on drinking behavior. This study aimed to examine whether the drinking patterns and reasons differ by ethnic groups, and provide useful insights for multi-ethnic areas that seek to cut down alcohol intake.Methods:We recruited excessive drinkers and collected the drinking patterns and motivations by questionnaire in a multi-ethnic society. Multiple linear regressions were used to evaluate the variations in drinking characteristics among different ethnic groups.Results:We recruited 1287 participants through convenience sampling (a non-probability sampling technique used in research where the researcher selects participants or units for a study based on their accessibility and proximity), among whom 439 excessive drinkers were eligible. The mean age was 38 years for the 439 participants, 92.9% were men, 36.0% were Han, and 64.0% were minorities mainly composed of the Yi. The majority of the participants were married (75.9%) and did physical work (58.1%). Ethnic minorities consumed more alcohol on a single occasion than Han people did (47.3 vs 41.8g/session) while drinking less frequently. For the minority and Han participants, 67% and 42% were not used to drinking with food, respectively. Peer pressure and fostering a good atmosphere were the most common drinking reasons for the minority and Han, respectively.Conclusion:We found substantial differences in drinking patterns and reasons between ethnic minorities and Han ethnicity, attributable to their culture and customs. Findings highlight the importance of drinking habits and motivations in exploring alcohol control education strategies in the context of ethnic integration and population immigration.

Objective Obesity is a well-established risk factor for disease. Controversy exists regarding the relative risk of morbidity and mortality in individuals who are overweight or underweight compared with individuals with a normal body mass index (BMI). In this study, we investigated the associations between BMI and three non-communicable diseases (hypertension, diabetes and heart disease) in older adults.Design Cohort study.Setting This study used data from the China Health and Retirement Longitudinal Study. The baseline survey was carried out in 2011, and follow-up surveys were conducted in 2013, 2015 and 2018.Participants Participants who reported having no doctor-diagnosed chronic disease at baseline were included in this study.Main outcome measures We analysed the association between baseline BMI and disease incidence using Cox proportional hazards models. Disease information included self-reported diagnosed conditions. BMI was categorised according to the standard Chinese criteria: underweight (<18.5 kg/m2), normal body weight (18.5–23.9 kg/m2), overweight (24.0–27.9 kg/m2) and obese (≥28.0 kg/m2).Results A total of 5605 participants were included at baseline. Based on the Kaplan-Meier estimation, the participants who were obese had the highest incidence of all three diseases. Compared with normal weight participants, overweight participants had a greater disease incidence (log-rank tests are p<0.01). Cox regression models showed that with increasing BMI, the HRs of diseases increased accordingly (eg, for hypertension, compared with the BMI group <18.5 kg/m2, the HRs for the BMI groups 18.5–23.9, 24.0–27.9 and ≥28.0 were 1.43 (95% CI 1.00 to 2.05), 2.19 (95% CI 1.51 to 3.18) and 2.89 (95% CI 1.91 to 4.36), respectively).Conclusion A higher BMI was associated with an increased risk of hypertension, diabetes and heart disease in the population aged 45 years and older. Even within normal BMI ranges, a higher BMI was associated with an increased risk of disease. Actions are urgently needed at the population level to address the growing public health challenge of excess weight in the context of an ageing population.

Background Although there is consistent evidence that smoking is a risk factor associated with tuberculosis (TB), whether smoking cessation improves treatment outcomes and reduces the risk of TB recurrence remains understudied. Methods We conducted a prospective cohort study with a seven-year follow-up in China. We recruited newly-diagnosed TB patients and classified them as non-smokers, ex-smokers, and current smokers. Current smokers were invited to participate in a smoking cessation intervention programme. We used a Cox proportional hazards model to assess the risk of death among TB patients and the risk of recurrence among successfully treated patients. Results In total, 634 (79.2%) patients completed anti-TB treatments and 115 (14.4%) patients died. We confirmed the existence of a dose-response relationship between smoking frequency and the risk of TB recurrence (the slope of the fitted line >0; P < 0.05). Compared to those who continued smoking, the risk of death and recurrent TB for the patients who quit smoking during treatment decreased. The HR of mortality for smokers who smoked 30 or more cigarettes was 2.943 (95% confidence interval (CI) = 1.035-8.368), while the HR of mortality for those who smoked 30 or more cigarettes, but quit during treatment was 2.117 (95% CI = 1.157-3.871). However, the risk of recurrence remained high for ex-smokers who had a smoking history of 25 years or more. Conclusions Our study provides further evidence supporting the World Health Organization's call for co-management of smoking and other risk factors as part of routine TB treatment.

Recent research has indicated that Long noncoding RNAs (LncRNAs) are crucial in many disorders, especially tumors. However, the exact role of LncRNA XLOC_006786 (LncRNA-SPIDR-2:1) in malignancies, especially in human osteosarcoma, is unclear. The results of RT‒qPCR, western blotting, CCK-8 assays, and Transwell assays showed that LncRNA XLOC_006786 inhibited osteosarcoma cell proliferation, invasion, and migration, indicating that it may be a tumor suppressor gene in osteosarcoma. We found that LncRNA XLOC_006786 negatively regulated NOTCH3, which is an oncogenic gene in osteosarcoma, as we previously reported. Bioinformatics analysis showed that miR-491-5p may be a direct target of LncRNA XLOC_006786, while NOTCH3 is a key target of miR-491-5p. Then, we verified that LncRNA XLOC_006786 could prevent lung metastatic osteosarcoma in vivo. Taken together, our research showed that LncRNA XLOC_006786 suppresses osteosarcoma proliferation, invasion, and metastasis through the NOTCH3 signaling pathway by targeting miR-491-5p.

Objectives Sedentary behaviour (SB) and physical activity (PA) have been shown to be associated with depression. However, behaviours, such as PA, occupy a portion of an individual’s 24-h day. Thus, an increase in time for one behaviour takes away time from another. Previous evidence suggests that it would be more appropriate to shift the focus to the importance of reallocating time spent in sedentary behaviour to time spent in physical activity. The aim of this study was to analyse the mutual replacement effect of different health behaviours on depressive tendencies by isotemporal substitution modelling (ISM) under the objective condition of considering a limited 24-h day. Second, we aimed to further explore the potential association between excessive or insufficient sleep duration and depressive symptoms. Methods A total of 10656 employees from 79 companies in four provinces of China participated in this survey. The Center for Epidemiological Studies Depression Scale (CES-D) was used to measure workers’ depressive tendencies. The duration of various types of physical activity was self-reported by workers based on the International Physical Activity Questionnaire (IPAQ). ISM was used to assess the associations of time spent in different activities on displacement of equivalent time spent on other activities with depression risk. Results A total of 10656 participants (89.5% of the sample) were included in the analysis. The ISM found that a 30-min unit of SB replaced with walking (OR, 95% CI: 0.83, 0.77–0.88), sleep (≤ 8 h) (OR, 95% CI: 0.77, 0.74–0.79), moderate physical activity (MPA) (OR, 95% CI: 0.87, 0.81–0.93) and vigorous physical activity (VPA) (OR, 95% CI: 0.91, 0.84–0.99) was significantly and negatively associated with the risk of depressive tendencies. When sleep duration was less than 8 h, each additional half hour of sleep time was significantly associated with a lower risk of depressive tendencies, and this association was no longer significant after 8 h. Conclusion Prolonged SB is common in the current workplace in China. Replacing an average of 30 min per day of SB with VPA and MPA, even walking is associated with less depression among workers. In addition, insufficient daily sleep is also an important risk factor for workers' depressive tendencies. These findings provide valuable evidence to promote mental health among occupational groups and support the development of healthy workplaces.

Hepatocellular carcinoma (HCC), one of the most prevalent types of cancer worldwide, has an exceedingly poor prognosis. Tandem C2 domain nuclear protein (TC2N) has been implicated in tumorigenesis and serves as an oncogene or tumor suppressor in different types of cancer. Here, we explore the possible regulatory activities and molecular mechanisms of TC2N in HCC progression. However, TC2N expression was significantly upregulated in HCC tissues and hepatoma cell lines, and this upregulation was positively correlated with tumor progression in HCC patients. The ectopic overexpression of TC2N accelerated the proliferation, migration, and invasion of HCC cells, whereas its knockdown showed the opposite effects. Bioinformatics analysis showed that TC2N participates in the regulation of the Wnt/β-catenin signaling pathway. Mechanistically, TC2N activated the Wnt/β-catenin signaling pathway by regulating the expression levels of β-catenin and its downstream targets CyclinD1, MMP7, c-Myc, c-Jun, AXIN2, and glutamine synthase. Furthermore, the deletion of β-catenin effectively neutralized the regulation of TC2N in HCC proliferation and metastasis. Overall, this study showed that TC2N promotes HCC proliferation and metastasis by activating the Wnt/β-catenin signaling pathway, indicating that TC2N might be a potential molecular target for the treatment of HCC.

Background:Emerging evidence supports the efficacy of mobile phone interventions for smoking cessation. However, behaviour changes of smokers who fail to reach abstinence and the related psychological mechanism are still understudied. We aimed to evaluate the efficacy of a behaviour change theory-based smoking cessation intervention delivered through personalised text messages from the perspective of smokers who fail to reach abstinence.Methods:We conducted a two-arm, double-blind, randomised controlled trial, with the intervention group receiving personalised text messages developed specifically for this study, and the control group receiving non-personalised ones related to smoking cessation. These messages were sent over a period of three months. We looked at three outcomes: changes in smoking frequency, in smoking amount, and in protection motivation theory (PMT) construct scores.Results:We obtained smoking cessation results for 722 participants who went through the randomisation process (intervention: 360, control: 362; block randomisation design). Overall, 32.3% of baseline daily smokers in the intervention group and 20.0% in the control group changed to weekly smokers during the follow-up period (P < 0.001), while 43.4% of consistent daily smokers in the intervention group and 32.8% in the control group continuously reduced their smoking amount (P < 0.001). We observed associations between the intrinsic rewards of smoking and changes from daily to weekly smoking, the perceived severity of smoking and reductions in smoking amount, as well as the self-efficacy of quitting and changes from daily to weekly smoking/reductions in smoking amount.Conclusions:We found that a personalised text message-based intervention was more likely to decrease the frequency and amount of smoking in smokers who failed to reach abstinence compared to a non-personalised one. We also explored the possible psychological mechanism of such positive effects. Here we provide evidence for countries to consider the promotion of smoking cessations using behaviour theory-driven personalised text messages, which may be more cost-effective than traditional approaches.Registration:Peking University: ChiCTR2100041942.