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Nonpoint source pollution (NPSP) from human production and life activities causes severe destruction in river basin environments. In this study, three types of sediment samples (A, NPSP tributary samples; B, non-NPSP mainstream samples; C, NPSP mainstream samples) were collected at the estuary of the NPSP tributaries of the Jialing River. High-throughput sequencing of the fungal-specific internal transcribed spacer (ITS) gene region was used to identify fungal taxa. The impact of NPSP on the aquatic environment of the Jialing River was revealed by analysing the community structure, community diversity, and functions of sediment fungi. The results showed that the dominant phylum of sediment fungi was Rozellomycota, followed by Ascomycota and Basidiomycota (relative abundance > 5%). NPSP caused a significant increase in the relative abundances of Exosporium, Phialosimplex, Candida, Inocybe, Tausonia, and Slooffia, and caused a significant decrease in the relative abundances of Cercospora, Cladosporium, Dokmaia, Setophaeosphaeria, Paraphoma, Neosetophoma, Periconia, Plectosphaerella, Claviceps, Botrytis, and Papiliotrema. These fungal communities therefore have a certain indicator role. In addition, NPSP caused significant changes in the physicochemical properties of Jialing River sediments, such as pH and available nitrogen (AN), which significantly increased the species richness of fungi and caused significant changes in the fungal community β-diversity (P < 0.05). pH, total phosphorus (TP), and AN were the main environmental factors affecting fungal communities in sediments of Jialing River. The functions of sediment fungi mainly involved three types of nutrient metabolism (symbiotrophic, pathotrophic, and saprotrophic) and 75 metabolic circulation pathways. NPSP significantly improved the pentose phosphate pathway, pentose phosphate pathway, and fatty acid beta-oxidation V metabolic circulation pathway functions (P < 0.05) and inhibited the chitin degradation to ethanol, super pathway of heme biosynthesis from glycine, and adenine and adenosine salvage III metabolic circulation pathway functions (P < 0.05). Hence, NPSP causes changes in the community structure and functions of sediment fungi in Jialing River and has adversely affected for the stability of the Jialing River Basin ecosystem. [ABSTRACT FROM AUTHOR]

Under the background of government-oriented environmental governance in China, the environmental effect of local official turnover has become an important issue. How to improve governmental governance is an important issue that profoundly affects local environmental governance. Based on a literature analysis, this paper establishes an environmental-effect identification equation to deeply analyze the environmental effect of local official turnover on private enterprises. Then, this paper empirically analyzes the effect of local personnel turnover on the environmental pollution control of private enterprises and the persistence of this effect. The results show that the turnover of local officials has a positive effect on the pollution control investment of private enterprises, but the effect is not persistent. The interest collusion between local officials and private enterprises tends to be one main reason to explain the environmental effect, and two different types of interest collusions are determined: priority to self-interest and economic development. The reasons why the positive effect cannot last for long may be attributed to a lack of systematic and effective institutions or temporary administrative measures. It is important to make local officials fully realize the "green wealth" value of the ecosystems, to change their economic priorities. Finally, this paper proposes countermeasures for local governments on personnel affairs to promote environmental governance. [ABSTRACT FROM AUTHOR]

Copper (Cu) and zinc (Zn) are two heavy metal pollutants that pose a serious risk in the Jialing River. Cu and Zn are transported into the sediment primarily due to the activities of the mining and smelting industries. In this study, we employed the diffusive gradient in thin films (DGT) technique, sequential extraction, and two assessment methods to evaluate the remobilization, fractions, and environmental risk in the downstream section of the Jialing River. The total concentrations of Cu and Zn in the four study areas followed the order S3 > S2 > S4 > S1, and the assessment results indicated that Cu and Zn presented a low environmental risk in the study area. Cu and Zn were primarily bound to the Fe/Mn oxide fraction (F2) and the residual fraction (F4). The results of the DGT probe showed a clear vertical distribution of Cu and Zn in the sediment (from 3 to − 12 cm), and both elements showed obvious increasing trends at the bottom of the probe. The correlation analysis indicated that CDGT-Cu correlated well with CDGT-Zn (r = 0.834, p < 0.01). The flux results showed that the sediment in the downstream section of the Jialing River is a major source of Cu and Zn and that there is a potential risk of release to the overlying water. Further analysis found that CDGT-Fe was negatively correlated with CDGT-Cu and CDGT-Zn, indicating that Fe may influence the remobilization of these metals. In addition, a hotspot of CDGT-Cu and CDGT-Zn at the bottom of the probe corresponded with a dark area in the AgI gel measuring CDGT-S. These results indicate that Fe and S are factors that mitigate the release of Cu and Zn from sediments. [ABSTRACT FROM AUTHOR]

Eco-efficiency plays a significant role in expressing how efficient the economic activity consumes nature's goods and services. To accurately measure eco-efficiency, the method slack-based measure modified three-stage data envelopment analysis (DEA) is adopted to evaluate environmental conditions in China's 30 provinces from year 2004 to 2016. This study treats carbon emissions and three industrials wastes as undesirable outputs and excludes the influences from external environment and random errors when make adjustments. Based on the results, this study makes the following conclusions: Firstly, industrial structure, trade openness, and population have negative effects on eco-efficiency while technology investment, urbanization process, foreign direct investment, and fiscal decentralization have positive effects on eco-efficiency. Secondly, the eco-efficiency for most provinces after adjusted is lower than the pre-adjusted, which indicates the overestimation in eco-efficiency when using traditional approaches. Thirdly, the eco-efficiency in China showed a clear geographical step distribution, with the highest eco-efficiency in the east area, followed by the central, northwest, and southwest regions. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Symptomatic predictors of influenza could assess risks and improve decisions about isolation and outpatient treatment. To develop such predictors, we undertook a prospective analysis of pandemic (H1N1) 2009 and seasonal influenza (H3N2) in patients attending fever clinics. Methods: From 1 May 2009 to 1 January 2010, all adult patients admitted to fever clinics for suspected influenza, confirmed by real time RT-PCR, were enrolled. Predictors of influenza virus infection were selected with logistic regression models. Measures of sensitivity, specificity, positive and negative likelihood ratios (LRs) were calculated to identify the best predictors. Results: The clinical features and routine blood test results of influenza (H1N1) 2009 and seasonal influenza were similar. The positive and negative LRs of current US CDC influenza-like illness (ILI) criteria were modest in predicting influenza infection. Our modified clinic predictors improved the ability of the positive and negative LRs to recognize pandemic (H1N1) 2009 and seasonal influenza. The revised criteria are: fever ⩾38 °C accompanied by at least one of the following-cough, arthralgia or relative lymphopenia. Conclusion: Patients with symptoms and signs that meet the new criteria are likely to have influenza and timely antiviral therapy may be appropriate. In addition, physicians should ascertain if influenza is circulating within the community or if there is a contact history of influenza and combine this information with the newly developed criteria to clinically diagnose influenza. [Copyright &y& Elsevier]

The Jialing River is one of the largest tributaries of the Yangtze River and has the largest drainage area. Nickel (Ni) is a one of the most serious heavy metal contaminants in the downstream section of the Jialing River as a result of the prosperity of nearby chemical, electronic and mining industries. In the present work, sediment quality guidelines (SQGs), a Community Bureau of Reference (BCR) sequential extraction and the diffusive gradients in thin films (DGT) technique were applied to evaluate the environment risk, fractions and remobilization of Ni in the downstream Jialing River. The results indicated that the average total concentration of Ni (54.7 mg kg−1) at all sites was higher than the background values of soil in China and Sichuan (26.9 and 35.8 mg kg−1, respectively). Environment risk assessment with four types of SQG values found that at three sites, the Ni concentration was over two high guideline values (probable effect concentration, PEC; effect range median, ERM), indicating that Ni may frequently pose a threat to the local aquatic ecosystem. The DGT results showed that C DGT -Ni had an inverse variation trend with C DGT -Fe and presented a significant increasing trend at the bottom of the DGT probes. Flux results revealed that sediments at S1, S2 and S3 were the source for Ni release across the sediment-water interface (SWI), and only S4 was a sink for Ni. Two further studies found that C DGT -Ni presented a significant negative correlation with C DGT -Fe. In addition, the "hotspot" of C DGT -Ni at the bottom correlated well with the "dark area" of C DGT -S. These results indicated that Fe and S were factors that mitigated the release of Ni in the sediments. Image 1 • Ni may frequently pose an environment risk in the study area. • Ni was mainly bound to the residual fraction of the sediment. • The remobilization of Ni in the sediment was related to the release of Fe and S. [ABSTRACT FROM AUTHOR]

As a bottom-up approach, the effectiveness of the environmental information transparency policy hinges on a broad societal ecosystem, including elements such as the active mass media and the robust civil society. However, due to the lack of public participation and accountability mechanisms, it is still doubtful whether the Chinese environmental transparency program promoted corporate pollution mitigation efforts. In this study, we investigated the impacts of the Environmental Information Disclosure (EID) program, an important Chinese environmental transparency program, on corporate mitigation investments, by using the 2012 Chinese Private Enterprise Survey. Our Tobit-IV model provides robust evidence that transparency policy exerts significant influences only on non-politically connected polluters, while, by contrast, politically connected firms are less susceptible to the EID program. We suggest that the community should be empowered to deter the shelter effects of local governors to the connected firms, which deteriorate the effectiveness of the transparency program. Image 1 • We investigated the impacts of the Chinese Environmental Information Disclosure (EID) program. • EID exerts significant influences only on non-politically connected polluters, while, by contrast. • Politically connected firms are less susceptible. • The community should be empowered to deter the pollution shelter effects. [ABSTRACT FROM AUTHOR]

Fertilizers are important for agricultural production because they can effectively promote crop productivity. However, long-term fertilization can cause heavy metal accumulation in soils and crops. This study utilized sequential extraction, the diffusive gradient in the thin films (DGT) technique and risk assessment models to estimate the effects of the longest long-term fertilization (38 years) in China on cadmium (Cd) and arsenic (As) accumulation in soils. The treatments included no fertilization (CK); inorganic nitrogen, phosphorus, and potassium fertilization (NPK); manure fertilization (M); and NPK plus M cofertilization (NPKM). The results indicated that the soils treated with NPKM, M and NPK had significantly increased total and available concentrations of Cd and As after 38 years of long-term fertilization. Cd mainly originates from cattle manure, while As originates from phosphate fertilizer. Sequential extraction results indicated that the application of manure increased the acid/exchangeable fraction (F1) and organic matter-bound fraction (F3) of Cd and As. The risk assessment results showed that the environmental risks of both Cd and As increased during long-term fertilization, and Cd contamination in the soil was at a moderate-high level, while As remained at a relatively low level. According to the calculations of the maximum numbers of years of soil productivity and rice production, Cd was labile and accumulated in the soils, and As was more labile than Cd in terms of accumulating in rice, indicating that the true risk from As in rice is higher than that from Cd. Controlling the heavy metals in fertilizers, mitigating effective amendments, and identifying plant types that accumulate low amounts of contaminants may be good choices for cleaner crop production. [Display omitted] • 38 years long-term fertilization leaded to a significant increment of cadmium and arsenic in soils. • Manure and phosphate fertilizer were the sources for cadmium arsenic input. • Cadmium and arsenic posed a medium-strong and low environmental risk to the farmland respectively. • Cadmium tended to accumulate in soil and arsenic was labile to accumulate in rice seeds. [ABSTRACT FROM AUTHOR]

This study aimed to explore the effects of different disturbances on the fungal communities in the sediments of the Jialing River in order to provide scientific basis for the protection of the river ecosystem. The fungal community in the sediments of the main stream of the Jialing River was taken as the research object, and high-throughput sequencing and bioinformatics techniques were used to analyze the differences in the composition and function of fungal communities in river sediment of different types of disturbance （project disturbance, tributary disturbance, sand mining disturbance, and reclamation disturbance） and non-disturbance sections. The results showed that： ① The reclamation and project disturbances significantly inhibited the diversity and richness of fungal communities （ P <0.05）. The tributary disturbance increased the richness of fungal communities, whereas the impact of sand mining disturbance on sediment fungal communities was not significant. ② The diversity and composition of fungal communities tended to be similar at the different sampling sites in the section with low input of exogenous substances （non-disturbance and sand mining disturbance）, whereas there were obvious differences in the diversity of fungal communities at the different sampling sites of high input of external substances （tributary disturbance, project disturbance, and reclamation disturbance） sections. ③ Ascomycota, Rozellomycota, and Basidiomycota were the main dominant fungal phyla in the sediments of the Jialing River. The relative abundance of Rozellomycota was the highest in the sand mining interference section, and the relative abundance of Basidiomycota was the highest in the tributary interference section. Project disturbance significantly increased the relative abundance of saprotrophs, animal pathogens, plant pathogens, and dung saprotrophs, whereas other disturbances inhibited the relative abundance of fungal parasitic fungi, plant pathogens, and plant saprophytes. In conclusion, human disturbance has caused changes in fungal diversity, community structure, and function in the sediment of the Jialing River, and xenobiotic input was a key factor contributing to this phenomenon. The results can provide a reference for predicting and evaluating the ecological quality of river sediments.

Due to the fast pace of urbanization worldwide, industrial sand mining activities have imposed great pressure on the environment, and consequently, these activities have led to serious environmental problems in aquatic ecosystems. However, the current understanding of the effect of sand mining on heavy metal remobilization in river sediments remains incomplete. The present study employed sediment quality guidelines (SQGs) and the sequential extraction (SE) and diffusive gradients in thin films (DGT) techniques to comprehensively investigate the effect of sand mining on the remobilization process of heavy metals in the aquatic system of the Jialing River. The SQGs results indicated that stations (S1 to S4) with sand mining disturbance exhibited Pb and Cd accumulation in surface sediments. Both C total -Pb (61.78-122.04 mg·kg -1 ) and C total -Cd (0.85-3.96 mg·kg -1 ) were higher than CSQGI (60 mg·kg -1 for Pb and 0.5 mg·kg -1 for Cd) and TEC (35.8 mg·kg -1 for Pb and 0.99 mg·kg -1 for Cd) limitation in most of sand mining stations. Pb and Cd were mainly bounded in the acid-soluble/exchangeable fraction (F1) and oxidizable fraction (F3) of the surface sediments. At the four stations with sand mining disturbance, about 5-10 folds of DGT-labile Pb and Cd were released in deep sediments (-9 to -12 cm), and Pb and Cd exhibited a transport trend from the sediments into the overlying water, while the above phenomenon was not observed at the two stations without sand mining activities. Correlation analysis revealed that DGT-labile Pb and Cd were suitably correlated with the F1 and F3 fractions, indicating that the acid-soluble/exchangeable and oxidizable fractions were the main sources leading to Pb and Cd remobilization in the sediments. A potential mechanism explanation may be that (1) intense sediment stirring could result in remobilization of the weakly bound fraction, which is related to the contribution of the F1 fraction, and (2) Cd/Pb experienced a corelease process with sulfur due to O 2 introduction (elevation of the dissolved oxygen level) attributed to sediment evacuation, which is related to the contribution of the F3 fraction. The above results suggested that sand mining in the Jialing River should be paid high attention to prevent heavy metal pollution in aquatic ecosystem., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

The Jialing River is the tributary of the Yangtze River with the largest drainage area. In recent years, the Jialing River has suffered a series of environmental problems, such as discharge of industrial effluent and sand mining activities, which have severely threatened the aquatic ecosystem of the river. In the present study, we employed risk assessment indexes, sequential extraction and the diffusive gradients in thin films (DGT) technique to assess environmental risks and study the remobilization of cobalt (Co) in sediments. The potential ecological risk index and risk assessment code results demonstrated that Co may pose a low environmental and ecological risk to the local aquatic environment. However, BCR sequential extraction showed that the sum of the F1, F2 and F3 fractions of Co still accounted for over 50% of the Co in the study areas, indicating that sediments may be a source of Co release. The DGT results showed an increasing trend for DGT-labile Co in deep sediments (-8 cm to -12 cm), and the calculated flux values ranged from 0.08 to 15.54 ng cm 2 ·day -1 , indicating that Co tends to transfer across the sediment-water interface at all sampling sites. Correlation analysis showed that F1-Co, F2-Co and F3-Co are the fractions readily captured by DGT and can be used for predicting Co remobilization in sediment. Sand mining activities contribute substantially to the release of Co from the F1 and F3 fractions as a result of strong stirring of sediments and introduction of oxygen into the sediments. The reductive dissolution of iron (Fe) and manganese (Mn) hydroxides or oxides causes the release of Co and Fe/Mn in the sediment, which leads to Co release from the reducible fraction. The above work suggests that sand mining in the Jialing River should be reasonably regulated to prohibit illegal sand mining activities., (Copyright © 2022 Elsevier Inc. All rights reserved.)

The purpose of this study was to clarify the differences in soil bacterial community diversity in different land uses in the coastal zone of the Jialing River and to provide theoretical reference for reasonable land development and resource protection of the Jialing River basin. Based on second generation high-throughput sequencing technology, the diversity, structural composition, functional types, and influencing factors of soil bacterial communities in different land use types were analyzed. The results showed that:① there were some differences in soil physical and chemical properties among different land uses. The nutritional indexes of agricultural land and soil wetland were significantly higher than those of natural forest land and sandy soil wetland ( P <0.05). ②The Ace, Shannon, and Chao indexes of sandy soil wetland and soil wetland were significantly higher than those of natural forest land and agricultural land ( P <0.05). The Simpson index of soil bacteria in different land use types was significantly different ( P <0.05). ③ The dominant phyla of soil bacteria in the coastal zone of the Jialing River were Proteobacteria, Actinobacteriata, Acidobacteriata, and Chloroflexi, and the relative abundance accounted for more than 65%. The community structure of sandy soil wetland was similar to that of soil wetland and was significantly different from that of other land use types ( P <0.05). ④ Primary functional metabolism was the core function of the bacterial community, accounting for more than 75%. Agricultural activities had the greatest impact on the community function, which significantly improved the metabolism of amino acids and carbohydrates, enhanced the utilization of nitrogen and phosphorus, reduced the metabolism of energy and coenzyme vitamins, and weakened the resistance of bacterial community to environmental impact ( P <0.05). ⑤ Total phosphorus (TP) was the key influencing factor of the soil bacterial community. In conclusion, the construction of the wetland habitat in the Jialing River coastal zone is most conducive to the development of underground ecological diversity and the stability of the soil ecosystem.

The novel coronavirus (COVID-19) pandemic has provided a distinct opportunity to explore the mechanisms by which human activities affect air quality and pollution emissions. We conduct a quasi-difference-in-differences (DID) analysis of the impacts of lockdown measures on air pollution during the first wave of the COVID-19 pandemic in China. Our study covers 367 cities from the beginning of the lockdown on 23 January 2020 until April 22, two weeks after the lockdown in the epicenter was lifted. Static and dynamic analysis of the average treatment effects on the treated is conducted for the air quality index (AQI) and six criteria pollutants. The results indicate that, first, on average, the AQI decreased by about 7%. However, it was still over the threshold set by the World Health Organization. Second, we detect heterogeneous changes in the level of different pollutants, which suggests heterogeneous impacts of the lockdown on human activities: carbon monoxide (CO) had the biggest drop, about 30%, and nitrogen dioxide (NO 2 ) had the second-biggest drop, 20%. In contrast, ozone (O 3 ) increased by 3.74% due to the changes in the NO x /VOCs caused by the decrease in NO x , the decrease of O 3 titration, and particulate matter concentration. Third, air pollution levels rebounded immediately after the number of infections dropped, which indicates a swift recovery of human activities. This study provides insights into the implementation of environmental policies in China and other developing countries.

Objective: To examine the relations between factors of social capital and self-rated health among Chinese adults., Methods: Univariate and multivariate analyses were used, based on 33 610 respondents in cross-sectional data of Chinese Family Panel Studies implemented by Institute of Social Science Survey, Peking University., Results: In the study, 47.4% of the respondents reported "good" in self-rated health. The result of univariate analysis showed that those who took part in any organizations (P<0.001) or had frequent interaction with others (P<0.001) tended to report relatively higher level on self-rated health. After controlling the physical health and demographic factors, the social participation (P<0.01), social interaction (P<0.001) and perceived social equity (P<0.001) were all the correlates of self-rated health among Chinese residents., Conclusion: Factors of social capital are important correlates of self-rated health in China, controlling the physical health and demographic factors. self-rated health can indicate people's social health to certain extent.

Objective: Patient experience and satisfaction survey has been regarded as an important method of collecting patients' opinions on medical services and improving the quality of management. From 2005 to 2009, Australia Victorian patient satisfaction monitoring, VPSM, was introduced, localized and adopted by over 50 Chinese hospitals. To compare and analyze each localized applications of VPSM and submit suggestions for further applications., Methods: The paper adopted the way of document research. The researchers collected all of the published and unpublished investigation plans and monitoring reports during these five years, compared the operations and the results of investigations and indicated the advantages and weaknesses., Results: In respect of methods, they were similar but showed some small differences in details such as the questionnaire structure, the reminding letter and the organization of data acquisition and analysis. The localized VPSM was gradually moving towards standardization. The monitoring was able to find the changing of medical services and provided the referential information for management., Conclusion: The localization of VPSM is still on its way and it needs improving by means of extending application.

Objective: To describe the status of self-rated health (SRH) among the elderly and find out the relationship between SRH and other health measures such as two weeks prevalence and chronic disease prevalence., Methods: The data used was generated from cross-sectional household health survey conducted in the year of 2009 in Shunyi district, Beijing. SPSS software was used to conduct univariate and multivariate liner regression analysis with self-rated health., Results: The average score of self-rated health among the elderly is 72.49. Univariate analyses suggest that are age, sex, marital status, income level, education, employment, medical insurance type, self-perceived anxious or depression, disease state are all associated with poor SRH score. Multiple liner regression model shows that age, job, medical insurance, self-perceived anxious or depression, suffer from two-week illness and chronic disease had effects on SRH of the elderly., Conclusion: Physical and psychological unhealthy are independent risk factors of SRH among the elderly, disease status is the most influential predictor on SRH score. Thus, a single measurement of SRH question can be used in health status assessment of the elderly.

Objective: To describe the doctors' satisfaction of the doctor-patient relationship and find out the influencing factors of the patients, gathering evidence to improve the doctor-patient relationship., Methods: This study was a cross-sectional study, in which doctors and nurses in 10 hospitals of Beijing, Shandong and Chongqing were surveyed with structured questionnaires and in-depth interviews., Results: The mean score of the doctors' satisfaction of the doctor-patient relationship was 59.97, which was much lower than the patients'. The patients' socio-demographic characteristics, social economic status (SES) and behavior characteristics influence the interaction of the doctors and the patients. The doctors' satisfaction of the doctor-patient relationship was influenced by the patients' trust., Conclusion: The doctors' perspective is helpful to define the tension and the cause of the doctor-patient relationship. The patients' characteristics have important influence on the doctor-patient relationship. It's necessary to take action on the patients to improve the doctor-patient relationship.

Background: Epidemiologic features of Kawasaki disease in China is still not clear., Methods: A questionnaire form and diagnostic guidelines for Kawasaki disease were sent to hospitals in Shanghai, which provided with pediatric medical care. All patients with Kawasaki disease diagnosed during January 1998 through December 2002 were recruited in this study., Results: A total of 768 patients with Kawasaki disease were reported. The incidence rates of Kawasaki disease for each year were 16.79 (1998), 25.65 (1999), 28.16 (2000), 28.05 (2001), and 36.76 (2002) per 100,000 children under 5 years of age. The male/female ratio was 1.83:1. The age at onset ranged from 1 month to 18.8 years (median: 1.8 years). The disease occurred more frequently in spring and summer. Fever was the most common clinical symptom, followed by oral changes, extremities desquamate, rash, conjunctive congestion, lymphadenopathy, extremities swelling, and crissum desquamate. Cardiac abnormalities were found in 24.3% of patients. The most common cardiac abnormality was coronary artery lesions including dilatation (68%) and aneurysm (10%). The case-fatality rate at acute stage of the disease was 0.26%. A second onset of the disease occurred in 1.82% of patients., Conclusions: The incidence rate of Kawasaki disease in Shanghai is lower than that reported in Japan, but higher than those in western countries. The increasing trend in incidence, sex distribution and cardiac abnormalities are similar to those in previous reports. The seasonal distribution is similar to the report from Beijing and different from other reports.

Objective: To evaluate the epidemiologic picture of Kawasaki disease (KD) in Beijing and its suburbs., Methods: A questionnaire form and diagnostic guideline for KD were sent to all hospitals with pediatric inpatient beds throughout Beijing and its suburbs. Pediatricians were asked to review the medical records and report all patients with KD diagnosed during the 5-year period from January, 1995, to December, 1999., Results: A total of 710 patients with KD were reported from 37 (95%) of 39 hospitals with pediatric inpatient beds. The incidence rates of KD were 18.2 (1995), 21.1 (1996), 18.6 (1997), 30.6 (1998) and 27.8 (1999) per 100,000 children < 5 years of age. The male:female ratio was 1.7:1. The age at onset ranged from 1 month to 13.4 years (with median of 2.3 years), with 85.2% < 5 years old. The disease occurred more frequently in spring and summer and less frequently in autumn and early winter. Lymph node enlargement was the least common clinical sign, and its incidence decreased from 1995 to 1999. Cardiac abnormalities were found in 21.5% of patients and were more prevalent in patients diagnosed 10 days or longer after the onset. No patients died in the acute stage., Conclusions: The incidence of KD in Beijing is lower than that reported in Japan, similar to the incidence in the United States and higher than in those other Western countries. The age and gender distribution and increasing trend in incidence are similar to those in previous reports, but seasonal distribution is unique.