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The collaborative learning approach as a universal teaching strategy is widely used in online learning. It is proven that the group leader has an important impact on group collaborative knowledge construction in online collaborative learning (OCL). However, limited research is available on how leadership styles influence a group. Universal teaching strategy is widely used in online learning. This study, the authors adopted lag sequential analysis, epistemic network analysis, and social network analysis to explore the influence of divergent and convergent leadership styles on cognitive engagement in OCL groups. Compared with convergent leadership, divergent leadership strengthened online collaborative cognitive engagement through significant organizer and manager roles, triggered high-quality cognitive behavior transformation within the group, and promoted the balanced development of learners' cognitive structure.

Background: Spinal cord injury (SCI) is a severe central nervous trauma that can cause serious consequences. Cell death is emerging as a common pathogenesis after SCI. In the last two decades, numerous studies have been published in the field of cell death after SCI. However, it is still rare to find relevant bibliometric analyses. This bibliometric study aims to visually represent global research trends in the field of cell death after SCI. Methods: Bibliometric data were sourced from the Web of Science Core Collection (WoSCC) database. VOSviewer, CiteSpace, and R software ("bibliometrix" package) were used to analyze and visualize bibliometric data. Annual scientific production, countries/regions, institutions, authors, journals, highly cited papers, keywords, and literature co-citation were evaluated to determine research performance. Results: An analysis of 5,078 publications extracted from the WoSCC database revealed a fluctuating yet persistent growth in the field of cell death after SCI over the past 23 years. China and the United States, contributing 69% of the total publications, were the main driving force in this field. The Wenzhou Medical University from China contributed to the most papers. In terms of authors, Salvatore Cuzzocrea from the University of Messina had the highest number of publications. The "Journal of Neurotrauma" was the top journal in terms of the number of publications, however, the "Journal of Neuroscience" was the top journal in terms of the number of citations. The theme of the highly cited articles mainly focused on the mechanism of cell death after SCI. The keyword and literature co-citation analysis mainly focused on the mode of cell death, mechanism research of cell death, and functional recovery after SCI. Conclusion: This study analyzes the research hotspots, frontiers, and development trends in the field of cell death after SCI, which is important for future studies. [ABSTRACT FROM AUTHOR]

China has an exceptional diversity in Begonia, holding the second largest number of described species in this genus at the national level. Many new taxa need to be explored and described. This paper reports two new species, Begonia ruchengensis (B. sect. Reichenheimia) and B. auritalata (B. sect. Platycentrum), from Hunan province and Guizhou province, respectively. Besides the detailed morphology description, color illustrations, and line drawings, the diagnoses of these two species distinguished from their allied taxa are provided. Their conservation statuses are evaluated according to The Guidelines for Using the IUCN Red List Categories. [ABSTRACT FROM AUTHOR]

Stachys yingzuijieensis, a new species from western Hunan, China, is described and illustrated. Molecular phylogenetic analyses based on three nuclear ribosomal DNA loci (ETS, ITS and 5S-NTS) recovered S. yingzuijieensis within the Stachys clade and as a sister group of S. arrecta. The two species can be easily distinguished by the morphology of lamina, corolla and nutlet. A key to all species of Stachydeae from China is also provided. [ABSTRACT FROM AUTHOR]

Introduction: Zhixue Zhentong capsules (ZXZTCs) are a Tibetan medicine preparation solely composed of Lamiophlomis rotata (Benth.) Kudo. L. rotata is the only species of the genus Laniophlomis (family Lamiaceae) that has medicinal constituents derived from the grass or root and rhizome. L. rotata is one of the most extensively used folk medicines by Tibetan, Mongolian, Naxi, and other ethnic groups in China and has been listed as a first-class endangered Tibetan medicine. The biological effects of the plant include hemostasis, analgesia, and the removal of blood stasis and swelling. Purpose: This study aimed to profile the overall metabolites of ZXZTCs and those entering the blood. Moreover, the contents of six metabolites were measured and the hemostatic, analgesic, and anti-inflammatory effects of ZXZTCs were explored. Methods: Ultra-performance liquid chromatography-tandem quadrupole timeof-flight high-resolution mass spectrometry (UPLC-Q-TOF-MS) was employed for qualitative analysis of the metabolites of ZXZTCs and those entering the blood. Six metabolites of ZXZTCs were quantitatively determined via high-performance liquid chromatography The hemostatic, analgesic, and anti-inflammatory effects of ZXZTCs were evaluated in various animal models. Results: A total of 36 metabolites of ZXZTCs were identified, including 13 iridoid glycosides, 9 flavonoids, 9 phenylethanol glycosides, 4 phenylpropanoids, and 1 other metabolite. Overall, 11 metabolites of ZXZTCs entered the blood of normal rats. Quantitative analysis of the six main metabolites, shanzhiside methyl ester, chlorogenic acid, 8-O-acetyl shanzhiside methyl ester, forsythin B, luteoloside, and verbascoside, was extensively performed. ZXZTCs exerted hemostatic effects by reducing platelet aggregation and thrombosis and shortening bleeding time. Additionally, ZXZTCs clearly had an analgesic effect, as observed through the prolongation of the latency of writhing, reduction in writhing, and increase in the pain threshold of experimental rats. Furthermore, significant anti-inflammatory effects of ZXZTCs were observed, including a reduction in capillary permeability, the inhibition of foot swelling, and a reduction in the proliferation of granulation tissue. Conclusion: Speculative identification of the overall metabolites of ZXZTCs and those entering the blood can provide a foundation for determining its biologically active constituents. The established method is simple and reproducible and can help improve the quality control level of ZXZTCs as a medicinal product. Evaluating the hemostatic, analgesic, and anti-inflammatory activities of ZXZTCs can help reveal its mechanism. [ABSTRACT FROM AUTHOR]

Purpose: Drawing from identity threat theory, this study aims to understand how and when employee voice can lead to abusive supervision. It proposes and examines a theoretical model in which employee voice is linked to abusive supervision through the mediating effect of leader identity threat. Methods: We conducted a field study by collecting data from 93 supervisors and 533 subordinates in China at two different points in time. A structural equation model and Mplus software were used to examine the direct relationship between employee voice and abusive supervision, as well as the mediating effect of leader identity threat and the moderating effect of supervisor traditionality. Results: Our results showed that employee voice was positively related to leader identity threat and had an indirect effect on abusive supervision via leader identity threat. In addition, we found that supervisor traditionality moderated the relationship between employee voice and leader identity threat. Subordinates' voice increased perceptions of leader identity threat among supervisors with high traditionality, whereas supervisors with low traditionality did not make this association. Finally, the indirect effect of employee voice on abusive supervision via leader identity threat was moderated by supervisor traditionality. Discussion: First, this study broadens our understanding of the antecedents of abusive supervision by proposing that employee voice may induce abusive supervision. Second, it develops an identity threat perspective to explain why employee voice is positively related to abusive supervision. Finally, it enriches the research on implicit leadership theories by proposing that supervisors' cultural values can also influence supervisors' sense-making of subordinates' behaviors. [ABSTRACT FROM AUTHOR]

The microbial degradation of lignocellulose is the best way to treat straw, which has a broad application prospect. It is consistent with the idea of agricultural sustainable development and has an important impact on the utilization of biomass resources. To explore and utilize the microbial resources of lignocellulose degradation, 27 lignocellulose degrading strains were screened from 13 regions in China. ZJW-6 was selected because of its 49.6% lignocellulose weight loss rate. According to the theoretical analysis of the experimental results, the following straw degradation conditions were obtained by ZJW-6: nitrogen source input of 8.45 g/L, a pH of 8.57, and a temperature of 31.63°C, the maximum weight loss rate of rice straw could reach 54.8%. It was concluded that ZJW-6 belonged to Cellulomonas iranensis according to 16S rRNA-encoding gene sequence comparison and identification. ZJW-6 is a Gram-positive bacterium that grows slowly and has a small yellowish green colony. To explain the degradation mechanism of lignocellulose, the experiment of enzymatic properties of the strain was prepared and carried out. It was discovered that ZJW-6 has an excellent ability to degrade cellulose, hemicellulose, and lignin, with cellulose and hemicellulose loss rates reaching almost 50% in 4 days and lignin loss rates reaching nearly 30%. Furthermore, ZJW-6 demonstrated lignocellulose degradation under aerobic and anaerobic conditions, indicating the strain's broad application potential. ZJW-6 was found to be more effective than ordinary humic acid in improving rice soil (available phosphorus, available nitrogen, organic matter) and promoting rice growth in a rice pot experiment (increasing root-shoot ratio, root activity, chlorophyll content and net photosynthetic rate). ZJW-6 plays an important role in promoting the development and utilization of straw resources. It has important significance for the advancement of green agriculture. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MS) is a growing public health problem worldwide. The clinical impact of fecal microbiota transplantation (FMT) from healthy donors in MS patients is unclear, especially in southern Chinese populations. This study aimed to investigate the effect of washed microbiota transplantation (WMT) in MS patients in southern China. Methods: The clinical data of patients with different indications receiving 1-3 courses of WMT were retrospectively collected. The changes of BMI, blood glucose, blood lipids, blood pressure and other indicators before and after WMT were compared, such as fasting blood glucose (FBG), glycated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c)), high-density lipoprotein cholesterol (HDL-c), non-high-density lipoprotein (non-HDL-c), systolic blood pressure (SBP), diastolic blood pressure (DBP), etc. At the same time, comprehensive efficacy evaluation and atherosclerotic cardiovascular disease (ASCVD) grade assessment were performed on MS patients. Finally, 16S rRNA gene amplicon sequencing was performed on fecal samples of MS patients before and after transplantation. Results: A total of 237 patients were included, including 42 in the MS group and 195 in the non-MS group. For MS patients, WMT significantly improved the comprehensive efficacy of MS in short term 40.48% (p<0.001), medium term 36.00% (p=0.003), and long term 46.15% (p=0.020). Short-term significantly reduced FBG (p=0.023), TG (p=0.030), SBP (p=0.026) and BMI (p=0.031), and increased HDL-c (p=0.036). The medium term had a significant reduction in FBG (p=0.048), TC (p=0.022), LDL-c (p=0.043), non-HDL-c (p=0.024) and BMI (p=0.048). WMT had a significant short term (p=0.029) and medium term (p=0.011) ASCVD downgrading effect in the high-risk group of MS patients. WMT improved gut microbiota in MS patients. Conclusion: WMT had a significant improvement effect on MS patients and a significant downgrade effect on ASCVD risk in the high-risk group of patients with MS. WMT could restore gut microbiota homeostasis in MS patients. Therefore, the regulation of gut microbiota by WMT may provide a new clinical approach for the treatment of MS. [ABSTRACT FROM AUTHOR]

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The lack of a standardized reliable and valid instrument makes it difficult to measure attitudes toward lesbian women and gay men (ATLG) consistently and thus poses a challenge to compare and contrast intervention measures. This study aimed to validate Herek's ATLG scale among undergraduates in mainland China and identify factors associated with negative attitudes toward LG. A total of 6,036 eligible undergraduates conveniently drawn from 30 provinces across mainland China were randomly split in half. Item analysis was first used to select unrelated or redundant items for deletion. Exploratory factor analysis (EFA) were then conducted on the first half of the sample (n = 3,001), followed by confirmatory factor analysis (CFA) and reliability analysis in the second half (n = 3035). Logistic regression analyses were finally carried out to identify their determinants. Six items were removed from the item analysis. EFA supported the existence of two factors (ATL and ATG). CFA results indicated that the two-factor model fit the data better than the one-factor model. Logistic regression analyses indicated that being female, majoring in non-health-related disciplines, attributing homosexuality to uncontrollable causes, non-adherence to traditional gender norms and exposure to homosexual content were significantly associated with less negative attitudes toward both L and G. Urban students were marginally less likely to express negative attitudes toward L but not G, while nonheterosexuals and those who had prior personal contact with homosexuals exhibited less negative attitudes toward G but not L. However, grade showed no significant associations with either ATL or ATG. The retained 14-item version of Herek's ATLG scale has been proven to be a reliable and valid tool. Furthermore, ATL and ATG were determined by different factors and thus would be treated separately. In order to reduce negative attitudes toward LG among undergraduates in mainland China, a comprehensive intervention plan such as conducting comprehensive sex education and pushing the process of legalizing same-sex marriage should be designed, implemented and evaluated. [ABSTRACT FROM AUTHOR]

Fusarium head blight (FHB) of wheat is an important disease worldwide, affecting the yield, end-use quality and threatening food safety. Genetic resources or stable loci for FHB resistance are still limited in breeding programs. A panel of 265 bread wheat accessions from China, CIMMYTMexico and other countries was screened for FHB resistance under 5 field experiments in Mexico and China, and a genome-wide association analysis was performed to identify QTLs associated with FHB resistance. The major locus Fhb1 was significantly associated with FHB severity and Deoxynivalenol content in grains. FHB screening experiments in multiple environments showed that Fhb1-harbouring accessions Sumai3, Sumai5, Ningmai9, Yangmai18 and Tokai66 had low FHB index, disease severity and DON content in grains in response to different Fusarium species and ecological conditions in Mexico and China. Accessions Klein Don Enrique, Chuko and Yumai34 did not have Fhb1 but still showed good FHB resistance and low mycotoxin accumulation. Sixteen loci associated with FHB resistance or DON content in grains were identified on chromosomes 1A, 1B, 2B, 3A, 3D, 4B, 4D, 5A, 5B, 7A, and 7B in multiple environments, explaining phenotypic variation of 4.43–10.49%. The sources with good FHB resistance reported here could be used in breeding programs for resistance improvement in Mexico and China, and the significant loci could be further studied and introgressed for resistance improvement against FHB and mycotoxin accumulation in grains. [ABSTRACT FROM AUTHOR]

Background and Aims: Although fecal microbiota transplantation (FMT) from healthy donors has been shown to have hypoglycemic effects in animal models of diabetes, its clinical impact in patients with abnormal blood glucose metabolism is unclear, especially in southern Chinese populations. The aim of this study was to investigate the feasibility and efficacy of washed microbiota transplantation (WMT) in the treatment of abnormal blood glucose metabolism in a population in southern China. Methods: The clinical data of patients with different indications who received 1-3 treatments of WMT were retrospectively collected. The changes of blood glucose, blood lipids, blood pressure, liver function and blood routine before and after WMT were compared, such as fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), systolic blood pressure (SBP), white blood cells (WBC), lymphocytes (LY) and platelets (PLT), etc. Results: A total of 195 patients were included in the First Affiliated Hospital of Guangdong Pharmaceutical University, including 20 patients with high blood glucose and 175 patients with normal blood glucose. WMT has a significant effect in reducing short term blood glucose level (FBG) in patients with high blood glucose (p < 0.05). The fasting blood glucose (FBG) of 72.22% of patients with high blood glucose decreased to normal in a short term (about 1 month) (p < 0.001); In the medium term (about 2 months), there was a significant hypolipidemic (TG) (p = 0.043) effect, long term (about 6 months) significant blood pressure lowering (SBP, p = 0.048) effect. Overall, WMT significantly reduced the risk of high risk classes of Atherosclerotic Cardiovascular Disease (ASCVD) in the short term (p = 0.029) and medium term (p = 0.050). Conclusion: WMT can significantly improve blood glucose in patients with high blood glucose, and there is no long-term elevated risk of blood glucose and ASCVD. FBG levels were significantly reduced in both the short and medium term in patients with high blood glucose treated with WMT. Therefore, the regulation of gut microbiota by WMT may provide a new clinical approach for the treatment of abnormal blood glucose metabolism. [ABSTRACT FROM AUTHOR]

Spiradiclis liboensis L. Wu & W. J. Liu, a new species in tribe Ophiorrhizeae of Rubiaceae from limestone mountain areas of Guizhou, south-western China, is described and illustrated. It is similar to S. guangdongensis and S. jingxiensis, but differs from the latter two by the following traits: stipule triangular, inflorescence sessile or with peduncle up to 0.5 mm long, pedicel 0.8-2.2 mm long, corolla white, salverform, corolla tube 1.6-2.2 cm long, corolla tube of long-styled morph inside with a villous ring and stigmas positioned at the throat of the corolla tube. The conservation status is assessed as "Vulnerable" (VU) according to the IUCN Red List Categories and Criteria. [ABSTRACT FROM AUTHOR]

A new species of Rubiaceae, Spiradiclis detianensis is described from a limestone karst area of southwestern China. This new species is morphologically similar to S. cordata and S. spathulata. All of them have rosetted habit and long peduncles, but it differs from the former by the cuneate leaf bases (vs. basally cordate) and much longer corolla tubes (1.8-2.2 cm long vs. ca. 5 mm long), and from the latter mainly by its tubular-funnel shaped corolla (vs. slenderly salver shaped), 4.5-6.8 (vs. 1.5-2) mm in diam, inside throat and corolla densely puberulent (vs. glabrous except a ring of long hairs at the middle). It also resembles to S. tubiflora, but differs clearly by its subrosulate habit (vs. procumbent to creeping), longer leaf blades (7.0-10.5 cm vs. 0.5-2.5 cm) and longer corolla tubes (18-22 mm vs. 14-16 mm). At same time, color photos, illustrations, detailed descriptions and conservation status of the new species are provided. [ABSTRACT FROM AUTHOR]

Spiradiclis tubiflora, a new Rubiaceae species, is described from a limestone area of southern China. It is similar to Spiradiclis glandulosa and S. umbelliformis, but differs from the latter two in its linear stipule, short peduncle and tubular-funnelform corolla with a distinctively enlarged tube. The colour photograph, illustrations, detailed descriptions and conservation status of the new species are provided. [ABSTRACT FROM AUTHOR]

Improving resistance to Fusarium head blight (FHB) in wheat is crucial in the integrated management of the disease and prevention of deoxynivalenol (DON) contamination in grains. To identify novel sources of resistance, a genome-wide association study (GWAS) was performed using a panel of 213 accessions of elite wheat germplasm of China. The panel was evaluated for FHB severity in four environments and DON content in grains in two environments. High correlations across environments and high heritability were observed for FHB severity and DON content in grains. The panel was also genotyped with the 90K lllumina iSelect single nucleotide polymorphism (SNP) array and 11,461 SNP markers were obtained. The GWAS revealed a total of six and three loci significantly associated with resistance to fungal spread and DON accumulation in at least two environments, respectively. QFHB-2BL. 1 tagged by IWB52433 and QFHB-3A tagged by IWB50548 were responsible for resistance to both fungal spread and DON accumulation. In summary, this study provided an overview of FHB resistance resources in elite Chinese wheat germplasm and identified novel resistance loci that could be used for wheat improvement. [ABSTRACT FROM AUTHOR]

Spiradiclis karstana, a new species of Spiradiclis (Rubiaceae) collected from Yunnan, China, is described for the first time. It is morphologically close to S. jingxiensis, but differs from the latter mainly by its inflorescences with 5-9 flowers, its 1.5-2.4 mm long peduncles, its stipules shorter than 1 mm and the 5-12 pairs of secondary veins. The conservation status is assessed as "Vulnerable" (VU) according to the IUCN Red List Categories and Criteria. [ABSTRACT FROM AUTHOR]

Background: Adaptation to a new environment may have an uncertain influence on young employees, whose values are still being formed during early adulthood. To understand the current mental status and further improve the mental health level of the new employee population of People's Republic of China, we conducted a cross-sectional study to screen the prevalence and correlates of personality disorder (PD) traits in this population. Methods: This study included all male participants who were new employees (those who had started working in approximately the last three months) from 12 machinery factories in People's Republic of China. The Personality Diagnostic Questionnaire-4+ was used to evaluate the mental status of all participants. The Connor-Davidson Resilience Scale was used to assess the resilience of the study participants. Results: A total of 3,960 male participants were included in the analysis. The mean age of the study participants was 18.7±1.5 years. The mean values of all PD subtypes were scored from 0.74 to 2.90, with a total of 16.85. Of all 10 PD traits, obsessive--compulsive, histrionic, and narcissistic scored the highest. PD traits scored significantly higher among participants who had higher education levels, came from a single-parent (divorced or separated) family, were raised in a neglectful parental rearing pattern, were the only child of the family, were living in city areas, or had a lower family income. All subtype PD traits were significantly and negatively correlated with resilience. Conclusion: Education level, single-parent family, parental rearing pattern, only-child status, living place, and family income may influence the development of PD traits. Additional high-quality studies are needed to learn more about the mental health status of new employees. Optimal interventions are warranted to avoid potential adverse events in this population. [ABSTRACT FROM AUTHOR]

Social business moves beyond linear, process-driven organizations to create new, dynamic, networked businesses that focus on customer value. Enterprise network (EN) is used to support social business by maximizing current and future opportunities and facilitate network-enabled processes, which can lead to value co-creation. EN is a multi-level hypergraph model with enterprises, employees, products and other related entities. In this paper the authors refine the EN model and present the foundation of EN to support social businesses. Then they introduce a case study on China automobile supply network (CASN). For the similarity with social networks, they verify power-law and small world theories in EN with statistical results on this data set. These theories are fitful in EN, but some new characteristics exist. The structure of EN consists of star-shaped clusters and the authors extract ego networks taking suppliers and manufacturers as the ego respectively. With the structure and distribution features of EN, they present the enterprise business similarity analysis method based on common-neighbors. And they also introduce the tentative work to detect Dunbar circles in EN. To analyze the data in a more intuitional and effective way, the authors use some data visualization tools to process the data in EN. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate the awareness, treatment, control rate of type 2 diabetes and its risk factors among Chinese community elderly, and also examine the changing trend for the past decade.Methods: We conducted two population-based cross-sectional studies in a representative urban area of Beijing in 2001 and 2010 respectively, using with the same method. A total of 2,277 participants (943 male, 1,334 female) in 2001 and 2,102 participants (848 male, 1,254 female) in 2010 were recruited. All the participants diagnosed with diabetes were included in this study.Results: The prevalence of diabetes was 21.4% and 24.8% in 2001 and 2010 respectively. Among participants with diabetes, 74.2% were aware of the condition, 51.0% were treated, 20.1% well controlled the condition in 2001, and the corresponding rates were 78.5%, 69.3%,15.9% in 2010 respectively. Higher education level and a positive family history were related to better management of diabetes, while obesity and alcohol drinking showed a reverse direction.Conclusions: The prevalence and awareness of diabetes stayed high for the past decade. The treatment increased 18.3% while the control rate decreased among community elderly for the past 10 years. It's urgent to carry out effective measures to raise awareness, treatment, and control rate of diabetes in order to avoid growing disease burden in China. [ABSTRACT FROM AUTHOR]

Background: Tobacco use is one of the most common preventable causes of death, but more than half of the Chinese men still use tobacco products. Moreover, 63.6% of Chinese smokers have stated that they would not consider quitting. Specialized and intensive smoking-cessation services are too expensive and passive to have major clinical and public health impacts in developing countries like China. Smoking cessation medications are not covered by medical insurance, and their high price prevents Chinese smokers from using them. Brief interventions are needed to provide cost-effective and timesaving tobacco dependence treatments in China mainland. Methods/design: We describe a two-arm randomized controlled trial for smokers who have no intention to quit. The project will be conducted in outpatient clinics at a large hospital in Beijing, China. Both arms include one face-to-face interview plus five follow-up interventions. Each intervention will last approximately one minute. Subjects allocated to the smoking-reduction intervention arm (SRI) will be advised to reduce smoking consumption to at least half of their current consumption level within the next month. All subjects in the SRI will be warned to bear in mind that an attempt to reduce smoking is an intermediate step before complete cessation. Smokers who have successfully reduced their smoking consumption will be encouraged to completely cease smoking. Controls are subjects allocated to the exercise- and diet-advice arm (EDA) and will be given advice about healthy diet and physical activity, but the advice will not include smoking cessation or reduction. Data collection will be done at baseline and at each follow-up interview using standardized questionnaires. The primary outcomes include self-reported and biochemically verified 7-day point prevalence and prolonged abstinence rates at 12-month follow-up. Discussion: We expect that an intention to quit in smoking outpatients can be motivated by physicians in the clinic setting. If this very brief smoking-reduction intervention can be demonstrated to have a positive impact on long-term smoking cessation, this strategy has the potential to be a viable and acceptable approach and may be used widely in China and elsewhere. [ABSTRACT FROM AUTHOR]

OBJECTIVE It is unclear whether changes in BMI during rapid economic development influence subsequent mortality. RESEARCH DESIGN AND METHODS We analyzed whether BMI in 1976 and 1994 and changes in BMI during 1976-1994 predict cardiovascular disease (CVD) and all-cause mortality in a 35-year follow-up cohort of 1,696 Chinese (1,124 men and 572 women, aged 35-65 years) in Xi'an, China. Participants were categorized as underweight (<18.5 kg/m²), normal weight (18.5-24.9 kg/m²), and overweight (≥25.0 kg/m²). RESULTS During 51,611 person-years of follow-up, we identified 655 deaths from all causes and 234 from CVD. From 1976 to 1994, the prevalence of overweight rose from 9.2 to 27.8%. With each unit increment in 1976 BMI, multivariate hazard ratios (HRs) (95% CI) were 0.78 (0.72-0.84) for CVD and 0.91 (0.87-0.95) for all-cause mortality. In contrast, corresponding HRs were 1.14 (1.08-1.19) and 1.05 (1.01-1.08) in 1994 BMI. The HRs for each unit increment in BMI change from 1976 to 1994 were 1.35 (1.25-1.41) for CVD and 1.09 (1.05-1.13) for all-cause mortality. Compared with participants with stable normal weight in 1976 and 1994, HRs of all-cause mortality for those who had normal weight in 1976 but became overweight in 1994 and for those who were persistently overweight during 1976-1994 were 1.42 (1.12-1.80) and 1.80 (1.04-3.14), respectively. CONCLUSIONS Gaining weight with increased BMI at middle age in Chinese during economic development was associated with elevated risks of all-cause and CVD mortality. Higher BMI measured before economic development was associated with lower mortality risk, whereas BMI measured afterward was associated with increased mortality. [ABSTRACT FROM AUTHOR]