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The ecological and human health risks of heavy metal(loid)s (HMs) in soils around tungsten (W) mining sites have often disregarded the presence of W. In this study, we aimed to investigate the concentrations of 10 HMs (including W and other accompanying elements) in 18 agricultural soil samples obtained around a W mining site in southern Jiangxi, China. Furthermore, we determined the contamination status, source identification, and ecological and health risks of HMs in soils. Our findings revealed that HMs were extensively accumulated in soils within the study area, with the highest mean concentrations of W found. W concentrations were above background values at all sites. Multivariate analysis revealed that W mining activities, including extracting and transporting W ore, were the primary source of HMs in the soil (61.40%). The ecological risk assessment revealed that the potential ecological risk across the survey area exhibited a high risk, and the cadmium (Cd) and W should be prioritised as control pollutants for soils around the W mine site. The human health risk assessment displayed that 73.43% of children with an unacceptable non-carcinogenic risk, and W contributed the most to the overall non-carcinogenic risk (42.32%), followed by Cd and arsenic (As). In addition, 22.03% of children and 13.4% of adults were under a significant carcinogenic risk. Overall, our findings emphasise the importance of considering element W in future studies investigating the contamination of HMs around W mining areas. As such, we calculated a safe limit value for element W in soil (141.01 mg/kg) to facilitate the conservation and development of soils in W mining areas in China. Our study provides valuable information for pollution prevention and soil contamination risk mitigation in W mining areas. [ABSTRACT FROM AUTHOR]

Objective: Real-word data on long-acting luteinizing hormone-releasing hormone (LHRH) agonists in Chinese patients with prostate cancer are limited. This study aimed to determine the real-world effectiveness and safety of the LHRH agonist, goserelin, particularly the long-acting 10.8-mg depot formulation, and the follow-up patterns among Chinese prostate cancer patients. Methods: This was a multicenter, prospective, observational study in hormone treatment-naïve patients with localized or locally advanced prostate cancer who were prescribed goserelin 10.8-mg depot every 12 weeks or 3.6-mg depot every 4 weeks with or without an anti-androgen. The patients had follow-up evaluations for 26 weeks. The primary outcome was the effectiveness of goserelin in reducing serum testosterone and prostate-specific antigen (PSA) levels. The secondary outcomes included testosterone and PSA levels, attainment of chemical castration (serum testosterone <50 ng/dL), and goserelin safety. The exploratory outcome was the monitoring pattern for serum testosterone and PSA. All analyses were descriptive. Results: Between September 2017 and December 2019, a total of 294 eligible patients received = 1 dose of goserelin; 287 patients (97.6%) were treated with goserelin 10.8-mg depot. At week 24 ± 2, the changes from baseline [standard deviation (95% confidence interval)] in serum testosterone (n = 99) and PSA (n = 131) were -401.0 ng/dL [308.4 ng/dL (-462.5, -339.5 ng/dL)] and -35.4 ng/mL [104.4 ng/mL (-53.5, -17.4 ng/mL)], respectively. Of 112 evaluable patients, 100 (90.2%) achieved a serum testosterone level < 50 ng/dL. Treatment-emergent adverse events (TEAEs) and severe TEAEs occurred in 37.1% and 10.2% of patients, respectively. The mean testing frequency (standard deviation) was 1.6 (1.5) for testosterone and 2.2 (1.6) for PSA. Conclusions: Goserelin 10.8-mg depot effectively achieved and maintained castration and was well-tolerated in Chinese patients with localized and locally advanced prostate cancer. [ABSTRACT FROM AUTHOR]

Background: The interparental conflict has been associated with an increased adolescents' engagement in risk-taking behaviors. However, few studies have examined the potential mediation of deviant peer affiliation and the potential moderation of school climate. Grounded in the ecological system theory, this study aimed to explore the mediating role of deviant peer affiliation and the moderating role of school climate between the association of interparental conflict and risk-taking behavior. Methods: This study conducted a longitudinal design (3 time points, 3 months apart) with the sample comprising 550 middle school students in southeastern China (52.91% males; mean age at Time 1 = 15.37). The performed measurements encompassed interparental conflict (T1), deviant peer affiliation (T2), school climate (T3), risk-taking behavior (T1/T2/T3), and demographic information. Results: The moderated mediation model revealed that after controlling for T1/T2 risk-taking behavior, T1 interparental conflict was longitudinally and positively correlated with T3 risk-taking behavior through T2 deviant peer affiliation. Furthermore, moderated mediation analysis demonstrated that a positive school climate ameliorated the adverse impact of deviant peer affiliation on risk-taking behavior, thereby mitigating the indirect effect of interparental conflict on risk-taking behavior among adolescents. Conclusions: Our findings propose a nuanced explanation of the processing mechanisms between interparental conflict and risk-taking behaviors among Chinese adolescents. The theoretical and practical implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

Background: Primary healthcare professionals were overworked and psychologically overwhelmed during the COVID-19 pandemic. Resilience is an important shield for individuals to cope with psychological stress and improve performance in crises. This study aims to explore the association of individual resilience with organizational resilience, perceived social support and job performance among healthcare professionals in township health centers of China during the COVID-19 pandemic. Methods: Data from 1,266 questionnaires were collected through a crosssectional survey conducted in December 2021 in Shandong Province, China. Descriptive analysis of individual resilience, organizational resilience, perceived social support, and job performance was conducted. Pearson correlation analysis was used to examine the correlations among these variables, and structural equation modeling was performed to verify the relationships between these variables. Results: The score of individual resilience was 101.67 ± 14.29, ranging from 24 to 120. Organizational resilience (β = 0.409, p < 0.01) and perceived social support (β = 0.410, p < 0.01) had significant direct effects on individual resilience. Individual resilience (β = 0.709, p < 0.01) had a significant direct effect on job performance. Organizational resilience (β = 0.290, p < 0.01) and perceived social support (β = 0.291, p < 0.01) had significant indirect effects on job performance. Conclusion: During the COVID-19 pandemic, the individual resilience of healthcare professionals in township health centers was at a moderate level. Organizational resilience and perceived social support positively affected individual resilience, and individual resilience positively affected job performance. Furthermore, individual resilience mediated the effect of organizational resilience and perceived social support on job performance. It is recommended that multiple stakeholders work together to improve the individual resilience of primary healthcare professionals. [ABSTRACT FROM AUTHOR]

Aim: We investigated the relationship between the sarcopenia-indicating Ishii test scores and pneumonia risk in stable schizophrenia patients. Methods: This prospective investigation involves schizophrenic inpatients from two mental health centers in western China. Patient baseline information was gathered over 1 month from September 1 to 30 in 2020. All pneumoniarelated patient information, including diagnosis and treatment, was acquired over 1 year between October 2020 and October 2021. Patients with schizophrenia were screened for sarcopenia utilizing a threshold value established by Ishii et al. Using regression analysis, the link between Ishii test scores and pneumonia risk in schizophrenia patients was investigated. Result: This study recruited 232 males and 107 females with schizophrenia over the age of 50 and older. During a 1-year follow-up period, four patients (3 males and 1 female) acquired pneumonia within 1 week of relapse in schizophrenia; therefore, these patients were excluded from the study. Finally, data were collected for 335 patients. The pneumonia incidences were 29.3% in males and 14.2% in females. Our analysis confirmed that compared to the male schizophrenia patients with Ishii test scores < 105 (non-sarcopenia), those with Ishii test scores ≥ 105 (sarcopenia) exhibited an elevated pneumonia risk (OR = 2.739, 95%CI: 1.406-5.333). Following confounders adjustment, Ishii test scores ≥ 105 remained a risk factor for pneumonia (OR = 2.064, 95%CI: 1.029-4.143). Among females with schizophrenia, the Ishii test scores were not associated with pneumonia risk. Conclusion: In conclusion, our results demonstrated that the Ishii test scores ≥ 105 were strongly associated with pneumonia risk in stable schizophrenic male patients. [ABSTRACT FROM AUTHOR]

Background and aims: The epidemiological characteristics of MAFLD and its relationship with atrial fibrillation (AF) are limited in China. Therefore, we explored the epidemiological characteristics of MAFLD from adults along with the association of MAFLD and 12-ECG diagnosed AF in a nationwide population from health check-up centers. Methods: This observational study used cross-sectional and longitudinal studies with 2,083,984 subjects from 2009 to 2017. Age-, sex-, and regionalstandardized prevalence of MAFLD was estimated. Latent class analysis (LCA) was used to identify subclusters of MAFLD. Multivariable logistic regression and mixed-effects Cox regression models were used to analyze the relationship between MAFLD and AF. Results: The prevalence of MAFLD increased from 22.75% to 35.58% during the study period, with higher rates in males and populations with high BMI or resided in northern regions. The MAFLD population was clustered into three classes with different metabolic features by LCA. Notably, a high proportion of MAFLD patients in all clusters had overweight and prediabetes or diabetes. The MAFLD was significantly associated with a higher risk of AF in the crosssectional study and in the longitudinal study. In addition, the coexistence of prediabetes or diabetes had the largest impact on subsequent AF. Conclusion: Our findings suggested a high prevalence of MAFLD and a high prevalence of other metabolic diseases in the MAFLD population, particularly overweight and glucose dysregulation. Moreover, MAFLD was associated with a significantly higher risk for existing and subsequent subclinical AF in the Chinese population. [ABSTRACT FROM AUTHOR]

Aim: Here, we investigate the relationship between mid-upper arm circumference (MUAC) and calf circumference (CC) screening indicators of sarcopenia and the risk of pneumonia in stable patients diagnosed with schizophrenia. Method: The study is prospective and includes inpatients with schizophrenia from two mental health centers in Western China. The studied screening indicators, MUAC and CC were assessed in standing patients. The relationship between MUAC and CC as sarcopenia screening indicators with the risk of pneumonia in patients with schizophrenia was analyzed by performing a statistical logistic regression analysis. Result: For this study, 339 patients with schizophrenia, aged 50 years and over were recruited. Moreover, four patients with pneumonia that occurred within 1 week of the relapse of schizophrenia were excluded. As a result, only 335 patients were included in the analysis. Pneumonia has been reported in 82 (24.5%) of all included patients with schizophrenia. Our data analysis confirmed that in the male patients, the higher CC was associated with a lower risk of pneumonia (odds ratio [OR] = 0.751, 95% CI: 0.635-0.889). We have divided men into two cohorts following the values of CC. Our analysis further showed that the patients with CC = 34cm had a lower risk of pneumonia in men (OR = 0.36, 95% CI: 0.163-0.795). Conclusion: We demonstrate that CC is associated with pneumonia risk in stable men with schizophrenia. [ABSTRACT FROM AUTHOR]

Greenspace ecological networks (GENs) optimization is an effective way to prevent landscape fragmentation and promote ecological processes. Built land sprawl is an important factor affecting this optimization. However, few studies have specifically analyzed the encroachments caused by existing built land on GENs. Given the insights from China’s total built land control policy, this study proposed a new idea of linking GENs optimization into urban expansion planning through land transformation. This idea was implemented in the Su-Xi-Chang area and integrated a series of methods, emphasizing the importance of built land encroachments removal for restoring the connectivity and quality of GENs. We identified that the built land encroached on GENs. Furthermore, we proposed to transfer the scattered rural/industrial land, whose amount was set as the land quota for urban expansion planning. Four scenarios of urban expansion were simulated based on China’s land use policies/practices and assessed by landscape metrics. The land transformation happened between rural and urban land. The main findings indicated that more inclusive urban expansion planning with consideration of the GENs optimization can be obtained. This study has practical contributions regarding GENs optimization and urban expansion planning for policymakers and our ideas of land transformation provide a reference for similar studies. [ABSTRACT FROM AUTHOR]

The disposal of automotive shredder residue (ASR) directly affects China's goal of achieving a 95% recycling rate for end-of-life vehicles. Pyrolysis and gasification have gradually become the most commonly used thermochemical technologies for ASR recycling. To obtain more hydrogen-rich syngas, it is necessary to determine the optimal process parameters of the ASR pyrolysis and gasification process. The main process parameters of the two-stage ASR pyrolysis and gasification process were studied using the established Aspen Plus model. Through analyzing the effects of process parameters, such as the temperature, equivalence ratio, and mass ratio of steam to ASR feedstock, on the product distribution and product characteristics of ASR pyrolysis and gasification, the optimal process parameters were determined. A series of comparative experiments under different conditions were conducted. The experimental results verified the accuracy and reliability of the Aspen Plus simulation model for the ASR pyrolysis and gasification processes and verified the practical feasibility of the process parameters obtained from the simulation analysis. [ABSTRACT FROM AUTHOR]

Background: Avian paramyxoviruses (APMVs), also termed avian avulaviruses, are of a vast diversity and great significance in poultry. Detection of all known APMVs is challenging, and distribution of APMVs have not been well investigated. Methods: A set of reverse transcription polymerase chain reaction (RT-PCR) assays for detection of all known APMVs were established using degenerate primers targeting the viral polymerase L gene. The assays were preliminarily evaluated using in-vitro transcribed double-stranded RNA controls and 24 known viruses, and then they were employed to detect 4,346 avian samples collected from 11 provinces. Results: The assays could detect 20-200 copies of the double-stranded RNA controls, and detected correctly the 24 known viruses. Of the 4,346 avian samples detected using the assays, 72 samples were found positive. Of the 72 positives, 70 were confirmed through sequencing, indicating the assays were specific for APMVs. The 4,346 samples were also detected using a reported RT-PCR assay, and the results showed this RT-PCR assay was less sensitive than the assays reported here. Of the 70 confirmed positives, 40 were class I Newcastle disease virus (NDV or APMV-1) and 27 were class II NDV from poultry including chickens, ducks, geese, and pigeons, and three were APMV-2 from parrots. The surveillance identified APMV-2 in parrots for the first time, and revealed that prevalence of NDVs in live poultry markets was higher than that in poultry farms. The surveillance also suggested that class I NDVs in chickens could be as prevalent as in ducks, and class II NDVs in ducks could be more prevalent than in chickens, and class II NDVs could be more prevalent than class I NDVs in ducks. Altogether, we developed a set of specific and sensitive RT-PCR assays for detection of all known APMVs, and conducted a large-scale surveillance using the assays which shed novel insights into APMV epidemiology. [ABSTRACT FROM AUTHOR]

The Belt and Road Initiative (BRI) represents present economic and foreign policy of the People's Republic of China (PRC). However, while the BRI provides the PRC a great potential for its national development, it also causes uncertainty, anxiety, and criticism from other countries. For years, research has been examining the BRI from economic, foreign policy, political, or military perspective, very few of them explore it from the perspective of intercultural communication. Because the BRI itself is a process of intercultural communication, this paper attempts to examine it from five perspectives of intercultural communication, including cultural values, intercultural adaptation, intercultural relationship, cultural flow and media, and intercultural communication competence. Finally, two concepts, i.e., Chinese "World View" and "China Model", related to the BRI and the future of the BRI due to the impact of COVID-19 are also discussed. [ABSTRACT FROM AUTHOR]

Background: The outbreak of the coronavirus disease-19 (COVID-19) has caused enormous stress among the public in China. Intellectual input from various aspects is needed to fight against COVID-19, including understanding of the public's emotion and behaviour and their antecedents from the psychological perspectives. Drawing upon the cognitive appraisal theory, this study examined three cognitive appraisals (i.e., perceived severity, perceived controllability, and knowledge of COVID-19) and their associations with a wide range of emotional and behavioural outcomes among the Chinese public.Methods: Participants were 4607 citizens (age range: 17-90 years, Mage = 23.71 years) from 31 provinces in China and they took part in a cross-sectional survey online.Results: The results showed that the public's emotional and behavioural reactions were slightly affected by the outbreak of COVID-19. Moreover, the public had limited participation in the events regarding COVID-19 but actively engaged in precautionary behaviour. In addition, results of structural equation model with latent variables revealed that the three appraisals were differentially related to the outcome variables (i.e., negative emotion, positive emotion, sleep problems, aggression, substance use, mobile phone use, social participation, and precautionary behaviour).Conclusions: The findings highlight the utility of cognitive appraisal, as a core process of coping stress, in explaining the public's emotion and behaviour in the encounter of public health concern. Practically, the findings facilitate the government and practitioners to design and deliver targeted intervention programs to the public. [ABSTRACT FROM AUTHOR]

Starches from sixteen cassava germplasms harvested at the same time in the Hainan region were evaluated for their physicochemical and structural properties. The granule morphology of all the isolated cassava starch samples showed round, bell or oval shapes and exhibited the same A-type crystalline pattern. The crystallinity range was 26.6-30.8%. The selected cassava germplasms showed a wide variation in granule size distribution: The D[4,3] (the average particle size) ranged from 13.49 µm to 306.27 µm. The water absorption capacity (192.6-226.7%), oil absorption capacity (185.-0-216.9%) and transparency (6.8-16.5%) indices varied significantly among the cassava germplasms. However, the retrogradation rates of the cassava starch pastes increased rapidly during the first 1 h and then stabilized. The solubility of starch increased with the temperature. In addition, the FTIR (Fourier Transform Infrared Spectrometer) ratios of 1045/1022 cm-1 and 1022/995 cm-1 of the sixteen cassava starches varied in the range of 1.06-1.78 and 0.78-1.04, respectively. These results indicated that the granule size, relative crystallinity, degree of short-range order, water and oil absorption capacities, solubility and transparency of the cassava starches were greatly influenced by the variety of cassava, which could help in determining the advantages of these starches for applications in different food and nonfood industries. [ABSTRACT FROM AUTHOR]

Ottelia fengshanensis, a new species (Hydrocharitaceae) from southwest China is here described and illustrated. Comparing its morphological features to putative close relatives O. guanyangensis, it has 3-4 flowers (vs. 2-5) each spathe, hexagonal-cylindric fruit, white styles (vs. yellow), green leaves (vs. dark green) and fruit tiny winged (vs. winged obviously). Molecular phylogenetic investigation of four DNA sequences (ITS, rbcL, trnK5' intron and trnS-trnG) and the Poisson Tree Processes model for species delimitation (PTP) analysis, further resolves O. fengshanensis as a new species that is close to O. guanyangensis with distinct support. [ABSTRACT FROM AUTHOR]

Brasenia schreberi J.F. Gmelin (Cabombaceae), an aquatic herb that occurs in fragmented locations in China, is rare and endangered. Understanding its genetic diversity and structure is crucial for its conservation and management. In this study, 12 microsatellite markers were used to estimate the genetic diversity and variation in 21 populations of B. schreberi in China. A total of 61 alleles were found; assessment of allelic richness (Ar = 1.92) and observed and expected heterozygosity (HO = 0.200, HE = 0.256) suggest lower genetic diversity compared to some endangered species, and higher variation was observed within populations (58.68%) rather than among populations (41.32%). No significant correlation between geographical and genetic distance among populations was detected (Mantel test, r = 0.0694; P = 0.7985), which may have likely resulted from barriers to gene flow (Nm = 0.361) that were produced by habitat fragmentation. However, Bayesian and neighbor-joining cluster analyses suggest a population genetic structure consisting of two clusters (I and II) or four subclusters (I-1, 2 and II-1, 2). The genetic structure and distribution of B. schreberi in China may have involved glacial refugia that underwent range expansions, introgression, and habitat fragmentation. The findings of the present study emphasize the importance for both in situ and ex situ conservation efforts. [ABSTRACT FROM AUTHOR]

Tropospheric delay has always been an important issue in Global Navigation Satellite System (GNSS) processing. Empirical tropospheric delay models are difficult to simulate complex and volatile atmospheric environments, resulting in poor accuracy of the empirical model and difficulty in meeting precise positioning demand. In recent years, some scholars proposed to establish real-time tropospheric product by using real-time or near-real-time GNSS observations in a small region, and achieved some good results. This paper uses real-time observing data of 210 Chinese national GNSS reference stations to estimate the tropospheric delay, and establishes ZWD grid model in the country wide. In order to analyze the influence of tropospheric grid product on wide-area real-time PPP, this paper compares the method of taking ZWD grid product as a constraint with the model correction method. The results show that the ZWD grid product estimated based on the national reference stations can improve PPP accuracy and convergence speed. The accuracy in the north(N), east(E) and up(U) direction increase by 31.8%,15.6% and 38.3%, respectively. As with the convergence speed, the accuracy of U direction experiences the most improvement. [ABSTRACT FROM AUTHOR]

Lobelia hongiana, a new species of Campanulaceae from Guangxi, South China, is described and illustrated here. This new species is most similar to L. chinensis and L. loochooensis, but differs by its ellipticobovate or oblanceolate leaf, 2.5-3 mm long greenish-carmine hypanthium, 5 or 6 calyx lobes, purplishwhite corolla, with yellowish-green blotches at the base of lower lobes, glabrous filaments, 7-8 mm long broadly obconic capsule. Molecular phylogenetic analysis has been conducted based on ITS and two chloroplast sequences (atpB and rbcL) and 14 taxa in Lobelia are included. L. hongiana is well supported as a new species by the evidence from both morphology and molecular phylogeny. [ABSTRACT FROM AUTHOR]

This essay presents Mainland New Confucianism (MNC) as diverse but distinctive, as still in a process of maturation but already with a clear direction. According to Chen, MNC is a rejection of the twin modernist narratives of the left (revolution) and the right (enlightenment) in favor of a narrative that downplays the ruptures associated with the May Fourth Movement and instead seeks to reconnect to China's past values and traditions. [ABSTRACT FROM AUTHOR]

Based on the theoretical and clinical development of modern medicines, gene therapy has been a promising treatment strategy for cancer and other diseases. The practice of gene therapy is nearly 27 years old, since the first authorized gene transfer study took place at the National Institute of Health in 1989. However, gene therapy was not readily adopted worldwide, until recently. Several gene therapy clinical trials have been carried out in China since 1998, and medical research in China has flourished. In this report, we review the history of gene therapy in China, focusing on treatment protocol, the administration cycle, dosage calculation, and the evaluation of therapeutic effects, in order to provide more information for the additional development of this promising treatment strategy. [ABSTRACT FROM AUTHOR]

Background: Carbapenem-resistant Acinetobacter baumannii poses a significant threat to hospitalized patients, as few therapeutic options remain. Thus, we investigated the molecular epidemiology and mechanism of resistance of carbapenem-resistant A.baumannii isolates in Beijing, China.Methods: Carbapenem-resistant A.baumannii isolates (n = 101) obtained between June 2009 and November 2014 were used. Multilocus sequence typing (MLST) and PCR assays for class C and D β-lactamase were performed on all isolates. S1 nuclease pulsed-field gel electrophoresis (PFGE) and Southern blot hybridization were performed to identify the resistance gene location.Results: All 101 A.baumannii isolates were highly resistant to frequently used antimicrobials, and were considered multidrug resistant. A total of 12 sequence types (STs) were identified, including 10 reported STs and 2 novel STs. Eighty-seven isolates were classified to clonal complex 92 (CC92), among which ST191 and ST195 were the most common STs. The bla OXA-23 gene was positive in most (n = 95) of the A.baumannii isolates. Using S1-nuclease digestion PFGE and Southern blot hybridization, 3 patterns of plasmids carrying bla OXA-23 were confirmed. ST191 and ST195 (both harboring bla OXA-23 ) caused outbreaks during the study period, and this is the first report of outbreaks caused by ST191 and ST195 in north China.Conclusion: bla OXA-23 -producing A.baumannii ST191 and ST 195 isolates can disseminate in a hospital and are potential nosocomial outbreak strains. Surveillance of imipenem-resistant A.baumannii and antimicrobial stewardship should be strengthened. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical efficacy and toxicity of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) in patients with esophageal squamous cell carcinoma (ESCC) in Chinese population.Patients and Methods: Patients with ESCC, who received SIB-IMRT from September 2011 to January 2013 were retrospectively analyzed. The SIB-IMRT plans were designed to deliver primary gross tumor volume at 60-64.4 Gy in 28-30 fractions, and planning target volume at 50.4-56 Gy in 28-30 fractions. Treatment-related toxicities were estimated based on Common Terminology Criteria for Adverse Events version 4.0, and tumor response after the treatment was estimated according to Response Evaluation Criteria in Solid Tumors version 1.0. Overall survival (OS), locoregional progression-free survival (LPFS), and progression-free survival (PFS) were estimated with Kaplan-Meier.Results: All patients completed definitive radiotherapy, 54 (78.3%) received combined chemotherapy, of which 31 (44.9%) were concurrent chemoradiotherapy and 23 (33.3%) were sequential chemotherapy. The objective response rate is 82.6% (56/69), with complete response 11 (15.9%), partial response 45 (65.2%), stable disease 8 (11.6%), and progressive disease 5 (7.2%). The 1-, 2- and 3-year LPFS was 74.4%, 57.8%, and 55.6%, respectively. The 1-, 2- and 3-year PFS was 62.3%, 41.0%, and 34.2%, respectively, and the 1-, 2-, and 3-year OS was 73.8%, 57.4%, and 41.0%, respectively, with a median OS of 27.1 months (4.5-54.9 m). For those who received concurrent chemotherapy, the 1-, 2-, and 3-year OS was 75.9%, 69.0%, and 55.2%, respectively, better than those who had sequential chemotherapy or radiotherapy alone (χ2 = 3.115, P = 0.078). Radiation esophagitis occurred in 63.8% and 14.5% with Grade 2 and 3, respectively. No patients occurred ≥ Grade 3 radiation pneumonia.Conclusions: It is safe and effective using SIB-IMRT technology to treat patients with ESCC. More prospective clinical studies should be needed. [ABSTRACT FROM AUTHOR]

China's market with a huge demand and limited supply has been attracting international companies since 1976. This study examines the impact of cultural cringe on consumer behavior in the P.R. China by using Nike and L-Ning, representing a Western and a Chinese sports brand respectively, as examples of the comparison. An online questionnaire survey with 36 questions is conducted in a comprehensive college in the P.R. China. Participants are 314 students from different majors. Results show that the increase of cultural cringe leads to the increasing likelihood of buying Nike's products. Limitations of the study and the direction for future research are also discussed. [ABSTRACT FROM AUTHOR]

Phase-II Project of Deep Water Channel Construction of Yangtze River(2014-2015), including the Yi-Zheng Segment, enables the water depth of Yangtze River Channel between Nanjing and Nantong arrive 12.5 meters. This thesis analyzes the sedimentation movement of Yi-Zheng Segment with mathematical model, makes prediction of the sediment's strength and space-time distribution. The simulation results indicate that the yearly dredging quantity of 1998 and 2010, two typical hydrological years, are 1.528 million m3 and 0.499 million m3 separately. The main maintenance months are October, November and December during the dry season, while the main maintenance parts are the channel from Dadaohe to Majiakou, the channel from Majiakou to Qibaidu, the channel from Qibaidu to Longmenkou in the right branch of Shiyezhou. These results could be helped to provide support of later dredging operation for keeping deep water Channel of Yi-Zheng Segment. [ABSTRACT FROM AUTHOR]

Background: Although various pancreaticojejunal duct-to-mucosa anastomosis methods have been developed to reduce the postoperative risks of pancreaticoduodenectomy, pancreatic fistula remains the most serious complication with a high incident rate. The aim of this study is to compare the safety and effectiveness of one-layer and two-layer duct-to-mucosa pancreaticojejunostomy in patients undergoing pancreaticoduodenectomy.Methods/design: In this study, adult patients who sign consent forms will be recruited and scheduled for elective pancreaticoduodenectomy. One hundred and fourteen patients will be included and randomized before pancreaticojejunal reconstruction and after resection of the lesion from the pancreatic or periampullary region. The primary efficacy endpoint is the incident rate of postoperative pancreatic fistula. Statistical analysis will be based on the intention-to-treat population. Patients will be followed up for 3 months by monitoring for complications and other adverse events.Discussion: This prospective, single-center, randomized, single-blinded, two-group parallel trial is designed to compare one-layer with two-layer duct-to-mucosa anastomosis for pancreaticojejunal anastomosis during elective pancreaticoduodenectomy.Trial Registration: Clinical Trials.gov: NCT02511951 . Registered on 29 July 2015. [ABSTRACT FROM AUTHOR]

Background: Previous studies have demonstrated that elevated admission and fasting glucose (FG) is associated with worse outcomes in patients with acute myocardial infarction (AMI). However, the quantitative relationship between FG levels and in-hospital mortality in patients with AMI remains unknown. The aim of the study is to assess the prevalence of elevated FG levels in hospitalized Chinese patients with AMI and diabetes mellitus and to determine the quantitative relationship between FG levels and the in-hospital mortality as well as the optimal level of FG in patients with AMI and diabetes mellitus.Methods: A retrospective study was carried out in 1856 consecutive patients admitted for AMI and diabetes mellitus from 2002 to 2013. Clinical variables of baseline characteristics, in-hospital management and in-hospital adverse outcomes were recorded and compared among patients with different FG levels.Results: Among all patients recruited, 993 patients (53.5 %) were found to have FG ≥100 mg/dL who exhibited a higher in-hospital mortality than those with FG < 100 mg/dL (P < 0.001). Although there was a high correlation between FG levels and in-hospital mortality in all patients (r = 0.830, P < 0.001), the relationship showed a J-curve configuration with an elevated mortality when FG was less than 80 mg/dL. Using multivariate logistic regression models, we identified that age, FG levels and Killip class of cardiac function were independent predictors of in-hospital mortality in AMI patients with diabetes mellitus.Conclusions: More than half of patients with AMI and diabetes mellitus have FG ≥100 mg/dL and the relationship between in-hospital mortality and FG level was a J-curve configuration. Both FG ≥ 100 mg/dL and FG <80 mg/dL were identified to be independent predictors of in-hospital mortality and thus the optimal FG level in AMI patients with diabetes mellitus appears to be 80-100 mg/dL. [ABSTRACT FROM AUTHOR]

The rapid development of the Internet in China has influenced every aspect of Chinese netizens' life. Because computer-mediated communication (CMC), especially the Internet, has become a significant means of interpersonal communication, it is high time to more systematically explore the impact of CMC in Chinese society. This paper attempts to explore the influence of identity style on Internet usage motives of Chinese netizens. Survey results show significant relationships between two dimensions of identity style and some Internet usage motives. Limitations and future directions are also discussed. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated that betaine supplements increase lean body mass in livestock and improve muscle performance in human beings, but evidence for its effect on human lean mass is limited. Our study assessed the association of circulating betaine with lean mass and its composition in Chinese adults. A community-based study was conducted on 1996 Guangzhou residents (weight/mass: 1381/615) aged 50-75 years between 2008 and 2010. An interviewer-administered questionnaire was used to collect general baseline information. Fasting serum betaine was assessed using HPLC-MS. A total of 1590 participants completed the body composition analysis performed using dual-energy X-ray absorptiometry during a mean of 3.2 years of follow-up. After adjustment for age, regression analyses demonstrated a positive association of serum betaine with percentage of lean mass (LM%) of the entire body, trunk and limbs in men (all P <0.05) and LM% of the trunk in women (P=0.016). Each SD increase in serum betaine was associated with increases in LM% of 0.609 (whole body), 0.811 (trunk), 0.422 (limbs), 0.632 (arms) and 0.346 (legs) in men and 0.350 (trunk) in women. Multiple logistic regression analysis revealed that the prevalence of lower LM% decreased by 17% (whole body) and 14% (trunk) in women and 23% (whole body), 28% (trunk), 22% (arms) and 26% (percentage skeletal muscle index) in men with each SD increment in serum betaine. Elevated circulating betaine was associated with a higher LM% and lower prevalence of lower LM% in middle-aged and elderly Chinese adults, particularly men. [ABSTRACT FROM AUTHOR]

To reveal the role of climate oscillations of the Quaternary in forming the contemporary plant diversity in the temperate Sino-Japanese Floristic Region of mainland China, we assess the phylogeographical patterns of four Sagittaria species in the region using sequence data from plastid DNA non-coding regions (psbA-trnH, the rpl16 intron and trnC-ycf6) and the internal transcribed spacers of nuclear ribosomal DNA (nrITS). Based on both datasets, the divergence time among the four studied species was estimated to fall in the Late Tertiary (plastid DNA: 7.1-13.7 Mya; ITS: 11.1-16.1 Mya). The ancestral distribution analyses revealed that regions with a great diversity in topography, climate and ecological conditions, e.g. the Hengduan Mountains, Central China and East China, were the areas where the endemics originated. Mismatch distribution analyses revealed that each species had experienced a range expansion in response to Quaternary climatic oscillations. Our findings contradict the hypothesis of Quaternary origins of the endemic Sagittaria spp.; we support the view that modern species in the Northern Hemisphere originated mostly during the Tertiary. Range expansion may have profoundly modified the current distribution ranges of Sagittaria species in the Sino-Japanese Floristic Region. [ABSTRACT FROM AUTHOR]

Background: Current evidence shows that the CD40-CD40 ligand (CD40-CD40L) system plays a crucial role in the development, progression and outcome of systemic lupus erythematosus (SLE). The aim of this study was to investigate whether a CD40 gene single nucleotide polymorphism (SNP) is associated with SLE and CD40 expression in the Chinese population. We included controls (n = 220) and patients with either SLE (n =205) in the study. Methods: The gene polymorphism was measured using Snapshot SNP genotyping assays and confirmed by sequencing. We analyzed three single nucleotide polymorphisms of CD40 gene rs1883832C/T, rs1569723A/C and rs4810485G/T in 205 patients with SLE and 220 age-and sex-matched controls. Soluble CD40 (sCD40) levels were measured by ELISA. Results: There were significant differences in the genotype and allele frequencies of CD40 gene rs1883832C/T polymorphism between the group of patients with SLE and the control group (P < 0.05). sCD40 levels were increased in patients with SLE compared with controls (P < 0.01). Moreover, genotypes carrying the CD40 rs1883832 C/T variant allele were associated with increased CD40 levels compared to the homozygous wild-type genotype in patients with SLE. The rs1883832C/T polymorphism of CD40 and its sCD40 levels were associated with SLE in the Chinese population. Conclusions: Our results suggest that CD40 gene may play a role in the development of SLE in the Chinese population. [ABSTRACT FROM AUTHOR]

Burkholderia thailandensis infection in humans is uncommon. We describe a case of B. thailandensis infection in a person in China, a location heretofore unknown for B. thailandensis. We identified the specific virulence factors of B. thailandensis, which may indicate a transition to a new virulent form. [ABSTRACT FROM AUTHOR]

Objective: Endothelial dysfunction which is induced by serum saturated fatty acids increasing is one of pathogenesis of diabetic retinopathy (DR). The intestinal fatty acid binding protein-2 (FABP2) Ala54Thr polymorphism results in serum saturated fatty acids elevating. In the present study, we assessed the association of FABP2 gene polymorphism (Ala54Thr) with DR in Chinese population. Materials/Methods: In this case-control association study, 810 T2DM patients were recruited. 420 patients with retinal neovascularization, microneurysms and hemorrhages were considered as cases (DR) and 390 patients with T2DM and no clinical signs of retinopathy (DNR), were recruited as controls. Genotypes for FABP2(Ala54Thr) polymorphisms were assessed with the PCR-RFLP method. Results: A significant difference in genotype distribution and allele frequency was observed between cases and controls. Patients with DR had significantly higher frequency of the Ala/Thr + Thr/Thr genotypes compared to DNR group [62.6% vs. 46.2%; OR (95% CI), 1.95 (1.48-2.59); p < 0.001]. The DR group showed a significantly higher frequency of the the Thr allele compared to the DNR group [39.5% vs. 29.4%; OR (95% CI), 1.56 (1.16-2.09); p = 0.003]. Binary logistic analyses showed FFA levels (p = 0.014) and Ala54Thr (p = 0.011) were independent correlates of the presence of DR. Conclusions: We examined that FABP2 polymophism on the Ala54Thr is significant and independent associated with DR. [ABSTRACT FROM AUTHOR]

Background Rhynchocypris oxycephalus is a cold water fish with a wide geographic distribution including the relatively warm temperate regions of southern China. It also occurs in second- and thirdstep geomorphic areas in China. Previous studies have postulated that high-altitude populations of R. oxycephalus in southern China are Quaternary glacial relics. In this study, we used the mitochondrial gene Cytb and the nuclear gene RAG2 to investigate the species phylogeographical patterns and to test two biogeographic hypotheses: (1) that divergence between lineages supports the three-step model and (2) climatic fluctuations during the Quaternary resulted in the present distribution in southern China. Results Phylogenetic analysis detected three major matrilines (A, B, and C); with matrilines B and C being further subdivided into two submatrilines. Based on genetic distances and morphological differences, matriline A potentially represents a cryptic subspecies. The geographic division between matrilines B and C coincided with the division of the second and third geomorphic steps in China, suggesting a historical vicariance event. Pliocene climatic fluctuations might have facilitated the southwards dispersal of R. oxycephalus in matriline C, with the subsequent warming resulting in its split into submatrilines C1 and C2, leaving submatriline C2 as a relic in southern China. Conclusions Our study demonstrates that geological events (three steps orogenesis) and climate fluctuations during the Pliocene were important factors in shaping phylogeographical patterns in R. oxycephalus. Notably, no genetic diversity was detected in several populations, all of which possessed unique genotypes. This indicates the uniqueness of local populations and calls for a special conservation plan for the whole species at the population level. [ABSTRACT FROM AUTHOR]

The article reports on a study which evaluated the potential threat of influenza virus subtype H6 viruses to human health. The researchers conducted a systematic serologic study in Chinese populations occupationally exposed to H6 viruses. They found that 63 out of 15,689 serum samples tested positive for the H6 virus, despite the lack of reports of human infection with influenza H6 virus.

Knowledge of the subduction to postcollision tectonic transition in response to oceanic closure is crucial for tracking the final stage of orogenic evolution. Here, we report new geochronology, geochemistry, and isotopic data for Carboniferous magmatism in East Junggar (NW China), southwestern Central Asian orogenic belt, which may record such processes following the closure of the Kalamaili Ocean (a branch of the Paleo-Asian Ocean). The early Carboniferous calc-alkaline volcanic rocks (dominated by basalt and basaltic andesite) yielded zircon U-Pb ages of ca. 340-330 Ma and are characterized by arc-like trace-element patterns showing enrichment of light rare earth elements (LREEs) and large ion lithophile elements (LILEs; e.g., Pb) but depletion of high field strength elements (HFSEs; e.g., Nb, Ta, and Ti). Combined with their variable Ba/Nb (9.80-454) and low Nb/La (0.21-0.54) and Sm/Yb (1.77-3.08) ratios as well as depleted mantle-like Sr-Nd-Pb-Hf (whole-rock 87Sr/86Sri = 0.7037-0.7040; eNd[t] = +3.5 to +5.9; 206Pb/204Pbi = 17.728-17.996; zircon eHf[t] = +11.8 to +18.8) isotopic values, we suggest that they were produced by melting of a lithospheric mantle wedge fluxed by slab-derived fluids under spinel-facies conditions. With whole-rock 40Ar/39Ar dating of ca. 320 Ma, the late Carboniferous mafic dikes have geochemical features and Sr-Nd-Pb (87Sr/86Sri = 0.7039-0.7041; eNd[t] = +6.6 to +6.8; 206Pb/204Pbi = 17.905-17.933) isotopic compositions similar to those of the early Carboniferous volcanics, but they show less pronounced Pb anomalies and negative Nb and Ta anomalies. They are interpreted to have formed by partial melting of a spinel-bearing lithospheric mantle metasomatized by limited influx of subduction-related fluids. The late Carboniferous felsic volcanic rocks (dacite and rhyolite) yielded zircon U-Pb ages of ca. 305 Ma and are geochemically equivalent to those of A2-type granites in East Junggar. They have juvenile isotopic compositions (eNd[t] = +4.5 to +6.8; eHf[t] = +13.3 to +18.7) and relatively young Nd and Hf model ages that roughly coincide with the ages of the ophiolites in the area, suggesting that they could have originated from melting of a juvenile basaltic lower crust. Whole-rock geochemistry, assimilation-fractional crystallization (AFC), and isotopic mixing modeling argue for insignificant crustal contamination for the Carboniferous magmatism. We suggest that the early Carboniferous lavas erupted in an island-arc setting related to the northward subduction of the Kalamaili oceanic crust, whereas the late Carboniferous magmatism formed in a postcollisional extensional regime in response to slab breakoff or lithospheric delamination. Combined with regional geological information, we propose that a rapid tectonic transition from oceanic subduction to postcollisional extension may have occurred in East Junggar during the Carboniferous, marking the final closure of the Kalamaili Ocean, which most likely took place ca. 330-320 Ma. This study provides overall geochronological and petrogeochemical evidence to better constrain the amalgamation of the southwestern Central Asian orogenic belt and may be of great importance for understanding the final stage of orogenic evolution elsewhere. [ABSTRACT FROM AUTHOR]

Interparental conflict is a risk factor for adolescent problematic internet use (PIU), but little research has investigated the processing mechanisms underlying this association. Based on the future time perspective theory, this study tested the idea that interparental conflict would be associated with adolescent PIU via restraining the protective effect of future positive time perspective (FPTP) and boosting the deleterious effect of future negative time perspective (FNTP). Moreover, drawing upon the ecological system theory, this study also investigated the interplay between interparental conflict and teacher-student relationship in relation to future time perspective and further to PIU. Using three-wave longitudinal data, with each time point spanning three months apart, this study examined the aforesaid questions in 523 Chinese adolescents (276 boys, M age = 14.64 years). Results of moderated mediation model found that after controlling for T1 PIU, T1 interparental conflict was associated with T3 PIU through T2 FNTP. Moreover, a stronger teacher-student relationship played a protective role for adolescents less exposed to interparental conflict. These findings provide nuanced explanation about h ow and for whom interparental conflict is associated with PIU in adolescents. The results also shed light on effective prevention and intervention strategies to mitigate adolescent PIU in the Chinese context. • Interparental conflict was positively correlated with adolescent problematic Internet use. • Future negative time perspective mediated the link between Interparental conflict and problematic Internet use. • Teacher-student relationship would moderate the mediation effect of future negative time perspective. [ABSTRACT FROM AUTHOR]

To systematically evaluate the clinical efficacy of 14 oral Chinese patent medicines combined with Azithromycin in the treatment of mycoplasma pneumonia in children with network Meta-analysis. Computer retrieval was performed for such databases as CNKI, VIP, Wanfang, CBM, PubMed, EMbase and Cochrane Library to screen out randomized controlled trials of oral Chinese patent medicines combined with Azithromycin in the treatment of mycoplasma pneumonia in children from the time of database establishment to September 2020. The included studies were evaluated by the Cochrane Risk Assessment tool. Stata 14.0 and Review Manager 5.3 software were used for data statistical analysis. A total of 60 RCTs were included in this study, involving 14 oral Chinese patent medicines. The efficacy ranking based on network Meta-analysis was as follows:(1)in terms of total effective rate, top five Chinese patent medicines in surface under the cumulative ranking curve(SUCRA) were Xiao'er Xiaoji Zhike Oral Liquid, Xiao'er Chiqiao Qingre Granules, Xiao'er Feike Granules, Pudilan Xiaoyan Oral Liquid and Lanqin Oral Liquid;(2)in terms of antifebrile time, top five Chinese patent medicines in SUCRA were Huaiqihuang Granules, Xiao'er Magan Granules, Xiao'er Kechuanling Granules/Oral Liquid, Shuanghuang-lian Oral Liquid for children and Xiao'er Xiaoji Zhike Oral Liquid;(3)in terms of cough disappearance time, top five Chinese patent medicines in SUCRA were Xiao'er Magan Granules, Huaiqihuang Granules, Xiao'er Chiqiao Qingre Granules, Xiao'er Feire Kechuan Oral Liquid and Xiao'er Kechuanling Granules/Oral Liquid;(4)in terms of rale disappearance time, top five Chinese patent medicines in SUCRA were Xiao'er Magan Granules, Huaiqihuang Granules, Xiao'er Feire Kechuan Oral Liquid, Shuanghuanglian Oral Liquid for children and Yupingfeng Granules. The results showed that on the basis of the use of Azithromycin, combined administration with oral Chinese patent medicines could improve the overall clinical efficacy in the treatment of mycoplasma pneumonia in children. However, due to the large differences in the quality and the number of included studies among various therapeutic measures, the ranking results of SUCRA of Chinese patent medicines need to be verified by high-quality multi-center, large-sample, randomized double-blind trials in the future.

Rationale: Thyroid hormone resistance syndrome (THRS) is an inherited condition characterized by reduced responsiveness of target tissues to thyroid hormone. Due to their nonspecific symptomatic manifestations, these patients can be misdiagnosed. This study reports a pedigree with THRS caused by a mutation in the thyroid hormone receptor β (THRβ) gene., Patient Concern: The proband, a 36-year-old woman at 19+4 weeks of gestation, was referred to our hospital because of abnormal thyroid function results. She was diagnosed with hyperthyroidism in October 2015, and had been treated with methimazole until her pregnancy., Diagnosis: The proband and 2 of her children were diagnosed with THRS based on genetic analysis. Sequence analysis of the THRβ gene showed a heterozygous mutation C>A located at exon 10. The mutation results in a change in proline for threonine at amino acid position 453, P453T., Interventions: No treatment will fully and specifically correct the defect. All 3 patients were in normal metabolic status, and thus treatment was not required., Outcomes: During a 2-year follow-up period, none of them had any complaints. The 20-year-old son (167 cm in height) and the 18-year-old daughter (150 cm in height) both had low academic performance., Lessons: Elevated serum thyroid hormone (TH) levels associated with nonsuppressed thyroid-stimulating hormone (TSH) levels usually leads to the diagnosis of THRS. Genetic analysis provides a short cut to diagnosis and the treatment should be based on the patient's clinical manifestations.

Patients with lung cancer are presumed to be at high risk from COVID-19 infection due to underlying malignancy. A total of 31 COVID-19 patients with pre-diagnosed lung cancer and 186 age and sex matched COVID-19 patients without cancer in 6 hospitals in Wuhan, China were identified in our study. There was a significantly higher level of IL-6 in lung cancer group showed by multifactorial analysis. The restricted mean survival time in 10, 20, and 53 days in COVID-19 patients with lung cancer were ealier than non-cancer COVID-19 patients in the same observation time (all P values < 0.05). Our results indicated that pre-diagnosed lung cancer was associated with higher morbidity and mortality in COVID-19 patients.

The origin and population history of the endangered golden snub-nosed monkey (Rhinopithecus roxellana) remain largely unavailable and/or controversial. We here integrate analyses of multiple genomic markers, including mitochondrial (mt) genomes, Y-chromosomes, and autosomes of 54 golden monkey individuals from all three geographic populations (SG, QL, and SNJ). Our results reveal contrasting population structures. Mt analyses suggest a division of golden monkeys into five lineages: one in SNJ, two in SG, and two in QL. One of the SG lineages (a mixed SG/QL lineage) is basal to all other lineages. In contrast, autosomal analyses place SNJ as the most basal lineage and identify one QL and three SG lineages. Notably, Y-chromosome analyses bear features similar to mt analyses in placing the SG/QL-mixed lineage as the first diverging lineage and dividing SG into two lineages, while resembling autosomal analyses in identifying one QL lineage. We further find bidirectional gene flow among all three populations at autosomal loci, while asymmetric gene flow is suggested at mt genomes and Y-chromosomes. We propose that different population structures and gene flow scenarios are the result of sex-linked differences in the dispersal pattern of R. roxellana. Moreover, our demographic simulation analyses support an origin hypothesis suggesting that the ancestral R. roxellana population was once widespread and then divided into SNJ and non-SNJ (SG and QL) populations. This differs from previous mt-based "mono-origin (SG is the source population)" and "multiorigin (SG is a fusion of QL and SNJ)" hypotheses. We provide a detailed and refined scenario for the origin and population history of this endangered primate species, which has a broader significance for Chinese biogeography. In addition, this study highlights the importance to investigate multiple genomic markers with different modes of inheritance to trace the complete evolutionary history of a species, especially for those exhibiting differential or mixed patterns of sex dispersal., (© The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Aim: To investigate the association of PNPLA3 polymorphisms with concurrent chronic hepatitis B (CHB) and nonalcoholic fatty liver disease (NAFLD)., Methods: A cohort of Han patients with biopsy-proven CHB, with or without NAFLD (CHB group, n = 51; CHB + NAFLD group, n = 57), and normal controls (normal group, n = 47) were recruited from Northern (Tianjin), Central (Shanghai), and Southern (Zhangzhou) China. Their PNPLA3 polymorphisms were genotyped by gene sequencing. The association between PNPLA3 polymorphisms and susceptibility to NAFLD, and clinical characteristics of NAFLD were evaluated on the basis of physical indices, liver function tests, glycolipid metabolism, and histopathologic scoring. The association of PNPLA3 polymorphisms and hepatitis B virus (HBV) load was determined by the serum level of HBV DNA., Results: After adjusting for age, sex, and body mass index, we found that four linked single nucleotide polymorphisms (SNPs) of PNPLA3, including the rs738409 G allele (CHB + NAFLD group vs CHB group: odds ratio [OR] = 2.77, 95% confidence interval [CI]: 1.18-6.54; P = 0.02), rs3747206 T allele (CHB + NAFLD group vs CHB group: OR = 2.77, 95%CI: 1.18-6.54; P = 0.02), rs4823173 A allele (CHB + NAFLD group vs CHB group: OR = 2.73, 95%CI: 1.16-6.44; P = 0.02), and rs2072906 G allele (CHB + NAFLD group vs CHB group: OR = 3.05, 95%CI: 1.28-7.26; P = 0.01), conferred high risk to NAFLD in CHB patients. In patients with both CHB and NAFLD, these genotypes of PNPLA3 polymorphisms were associated with increased susceptibility to nonalcoholic steatohepatitis (NASH) (NAFLD activity score ≥ 3; P = 0.01-0.03) and liver fibrosis (> 1 Metavir grading; P = 0.01-0.04). As compared to those with C/C and C/G at rs738409, C/C and C/T at rs3747206, G/G and G/A at rs4823173, and A/A and A/G at rs2072906, patients in the CHB + NAFLD group with G/G at rs738409, T/T at rs3747206, A/A at rs4823173, and G/G at rs2072906 showed significantly lower serum levels of HBV DNA (P < 0.01-0.05)., Conclusion: Four linked SNPs of PNPLA3 (rs738409, rs3747206, rs4823173, and rs2072906) are correlated with susceptibility to NAFLD, NASH, liver fibrosis, and HBV dynamics in CHB patients.

Background: Accumulating evidence suggests that low concentrations of serum 25(OH)D is coupled with increased risks of hypertension, obesity, and cardiovascular disease. However, this relationship has not been established in populations with very low levels of 25(OH)D. Therefore, the aim of our study was to clarify the associations between 25(OH)D and blood pressure, obesity, sex, and lipid profiles in the Kazak ethnic population, who have an extremely low level of 25(OH)D., Material/methods: A multistage-cluster sampling survey was carried out for residents with Kazak ethnicity in Xinjiang, China. Anthropometric measurements of each participant were taken and the concentrations of 25(OH)D, calcium, alkaline phosphatase, and lipid profiles were measured. Individuals were classified into different groups in terms of vitamin D status, degree of adiposity, presence of hypertension, and other comorbidities., Results: The madian concentration of 25(OH)D was 16.2 (11.8-20.5) ng/mL and the prevalence of vitamin D deficiency was 72.4% in this Kazak population (n=928, 59.0% women). Females had a lower 25(OH)D concentration than males - 14.6 (10.5-19.4) ng/mL vs. 17.7 (14.8-22.5) ng/mL, P<0.001. The subjects were classified into 3 groups according to their vitamin D status. There were significant differences in BMI (P=0.046), waist circumference (P=0.037), hip circumference (P=0.003), systolic BP (P=0.035), and LDL cholesterol (P=0.008) among the groups after adjustment for sex and age. On the other hand, there was no significant difference in vitamin D levels between groups with or without hypertension (P=0.586), and groups with or without obesity (P=0.639). A multifactor-regression analysis revealed that every increment of 1mg/dL in LDL cholesterol was associated with a 1.0 ng/mL decline in serum 25(OH)D., Conclusions: The insufficiency of vitamin D is highly prevalent in Kazaks. Sex, LDL cholesterol, and hip circumference are 3 variables strongly associated with serum 25(OH)D concentration. In a population with low levels of 25(OH)D, the negative relationship between obesity and serum 25(OH)D, a common finding from most previous studies, could not be established.