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BackgroundMen who have sex with men are increasingly playing an important role in the HIV epidemic in China. Previous studies have disproportionately focused on the younger MSM population. However, limited studies in western nations have indicated that older MSM may still be sexually active in their late life, and at risk of HIV/STIs infection. We investigated sexual practices, HIV knowledge, HIV stigma, self-perceived HIV/STIs risk and accessibility of HIV prevention services and testing of middle aged and older MSM in Shenzhen, China.MethodsBoth qualitative and quantitative methods were employed in our study. We conducted anonymous in-depth interviews with a diverse sample of 20 MSM aged 45 and above. In addition, we conducted an anonymous community-based cross-sectional survey with a conventional sample of middle aged and older MSM in Shenzhen to explore HIV/STIs risk and accessibility of HIV/STIs prevention services and testing.ResultsIn the qualitative study, casual sex partners were more often reported than regular partners. The frequency of heterosexual behaviors was low and condom use in heterosexual behaviors was absent. Middle-aged and older MSM have limited access to HIV/STIs prevention services, which might be due to their low self-rated HIV risk. In the cross-sectional study, approximately one third of participants (n = 94, 31.1%) reported unprotected anal intercourse with male partners in the past 6 months. Correlates significantly associated with unprotected anal intercourse with male partners included self-perceived HIV risk score (OR=1.02; 95% CI: 1.01-1.04), HIV knowledge (OR=1.25; 95%CI: 1.07-1.45), used stimulant drug (OR=2.92; 95% CI: 1.22-6.99) and engaging in group sex in the past 6 months (OR=45.90; 95% CI: 10.01- 210.57). A total of 109 participants (36.1%) indicated they had accessed at least one HIV/STIs prevention service in Shenzhen, and 174 participants (57.6%) reported that they had been tested for HIV infection in Shenzhen. Correlates significantly associated with never accessing HIV/STIs prevention services included age (OR=1.07; 95% CI: 1.02-1.13), monthly income above 8,000 Yuan ($1250) (OR=0.39; 95% CI: 0.18-0.83), anticipated HIV stigma (OR=1.09; 95% CI: 1.01-1.17), and the number of sexual partners (2-5:OR=0.23; 95% CI: 0.10-0.50; 6 and above: OR=0.27; 95% CI: 0.12-0.63)). Never having HIV testing was associated with age (OR=1.06; 95% CI: 1.01-1.10), anticipated HIV stigma (OR=1.08; 95% CI: 1.00-1.16), and the number of same-sex partners (2~5 partners: OR=0.27; 95% CI: 0.12-0.62; >5 partners: OR=0.31; 95% CI: 0.13-0.73).ConclusionOur study indicates that a significant proportion of middle aged and older MSM engaged in different types of HIV-related risk behaviors. These data suggest the presence of HIV/STI risk within the aged group that needs adequate attention from both policy makers and researchers. Middle aged and older MSM also have limited access to HIV prevention services and testing. The findings call for the tailoring of current HIV prevention and testing efforts to meet the needs of middle aged and older MSM.

Market surveillance showed continuing circulation of avian influenza A(H5N6) virus in live poultry markets in Guangdong Province in 2017, despite compulsory vaccination for avian influenza A(H5Nx) and A(H7N9). We analyzed H5N6 viruses from 2014-2018 from Guangdong Province, revealing antigenic drift and decreased antibody response against the vaccine strain in vaccinated chickens.

A new oribatid mite species of the family Pediculochelidae, Paralycus nortoni sp. nov., is described and illustrated based on adult specimens collected from barks of dead Pinus massoniana Lamb. infested by Monochamus alternatus in Fuzhou city, China. This new species described here is the fourth species of the genus Paralycus in China. An updated key to the species of the genus Paralycus is provided., Acarologia, 60, 481-487

Supplemental Digital Content is available in the text., Background: Warfarin is an effective treatment for thromboembolic disease but has a narrow therapeutic index; optimal anticoagulation dosage can differ tremendously among individuals. We aimed to evaluate whether genotype-guided warfarin dosing is superior to routine clinical dosing for the outcomes of interest in Chinese patients. Methods: We conducted a multicenter, randomized, single-blind, parallel-controlled trial from September 2014 to April 2017 in 15 hospitals in China. Eligible patients were ≥18 years of age, with atrial fibrillation or deep vein thrombosis without previous treatment of warfarin or a bleeding disorder. Nine follow-up visits were performed during the 12-week study period. The primary outcome measure was the percentage of time in the therapeutic range of the international normalized ratio during the first 12 weeks after starting warfarin therapy. Results: A total of 660 participants were enrolled and randomly assigned to a genotype-guided dosing group or a control group under standard dosing. The genotype-guided dosing group had a significantly higher percentage of time in the therapeutic range than the control group (58.8% versus 53.2% [95% CI of group difference, 1.1–10.2]; P=0.01). The genotype-guided dosing group also achieved the target international normalized ratio sooner than the control group. In subgroup analyses, warfarin normal sensitivity group had an even higher percentage of time in the therapeutic range during the first 12 weeks compared with the control group (60.8% versus 48.9% [95% CI, 1.1–24.4]). The incidence of adverse events was low in both groups. Conclusions: The outcomes of genotype-guided warfarin dosing were superior to those of clinical standard dosing. These findings raise the prospect of precision warfarin treatment in China. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02211326.

Vitamin D deficiency is associated with numerous public health issues. Limited data are available for children in southern China, a region that receives abundant sunlight. We aimed to estimate the 25-hydroxyvitamin D (25(OH)D) levels in children in that area, and to determine seasonal variations in serum 25(OH)D levels. A total of 16,755 children aged 0 to 6 years, who visited the Guangdong Women and Children's Hospital for health examination between January 2016 and May 2017, were included in the present study. The serum 25(OH)D levels ranged from 10.5 to 307.4 nmol/L (mean ± standard deviation: 78.5 ± 26.3 nmol/L). The prevalence of vitamin D deficiency and insufficiency were 10.8% and 39.0%, respectively. The mean serum 25(OH)D level in spring (71.8 ± 24.9 nmol/L) was lower than that in other seasons. From January to April, we found a relatively high prevalence of vitamin D deficiency or insufficiency, both of which were also found to increase with age. Logistic regression analysis revealed that vitamin D deficiency and insufficiency were significantly associated with age and season. Deficiency and insufficiency of vitamin D are common among children in southern China, despite the area receiving sufficient sunlight.

In order to fully grasp the status quo and trend of patent development of LNG heat exchanger technology, based on the wisdom bud patent data platform, the application trend of global LNG heat exchanger technology patents, the distribution of source and destination countries, and the pattern of patent technology from 1987 to 2017 were searched and analyzed. It is found that: 1. Japan, France, the United States, Sweden, Denmark, Canada and other countries have strong technical reserves in this field; 2. China has become the world's largest target area for patent distribution in the field of LNG heat exchangers; 3. China is still in its infancy in the design and manufacture of LNG heat exchangers. There are many technical blanks and the market prospect is broad.

Objective Telomeres are specialized chromatin structures essential for maintenance of chromosomal integrity and stability. Obesity has been proposed to be associated with telomere shortening; however, epidemiologic evidence has been conflicting. We conducted a study to evaluate the associations of telomere length with various anthropometric indices of general and abdominal obesity, as well as weight change. Design and Methods The study included 2,912 Chinese women ages 40–70 years. Monochrome multiplex quantitative PCR was applied to measure relative telomere length. ANOVA and the Dunnett test were used to compare log-transformed relative telomere length. Tests for linear trend were performed by entering the ordinal exposure as continuous parameters in the models. Results There is an inverse association between telomere length and body mass index (BMI) (Ptrend = 0.005), waist circumference (Ptrend = 0.004), waist-to-height ratio (WHtR) (Ptrend = 0.004), weight (Ptrend = 0.010), and hip circumference (Ptrend = 0.026), but not waist-to-hip ratio (WHR) (Ptrend = 0.116) or height (Ptrend = 0.675). Weight change since age 50 was further evaluated among women over age 55. Women who maintained their weight within ±5% since age 50, particularly within a normal range (BMI = 18.5–24.9 kg/m2), or reduced their weight from overweight (BMI = 25–29.9 kg/m2) or obesity (BMI ≥30 kg/m2) to normal range, had a longer mean of current telomere length than women who gained weight since age 50 (Ptrend = 0.025), particularly those who stayed in obesity or gained weight from normal range or overweight to obesity (P = 0.023). Conclusion Our findings provide strong evidence supporting the hypothesis that telomere shortening is associated with obesity and that maintaining body weight within a normal range helps maintain telomere length.

Background: Hepatitis A was ranked first among all of the different types of viral hepatitis in China, which occurred an average of 500,000 cases annually during the 1980s. A live attenuated hepatitis A vaccine was applied in preventing of the disease in 1992, large scale used in vaccination program in 1995, and incorporated in the Expanded Program of Immunization in 2008 in China. Objective: The objective of this study was to determine whether, and to what extent, the decline in the incidence of hepatitis A in China was the result of hepatitis A (HA) vaccination. Materials and Methods: Official documents and longitudinal serological follow-up studies were reviewed to compare the incidence of HA before and after the introduction of the vaccine. Results: National trends in the incidence of HA in China saw rates decrease by 92.7% in 2009, compared to the levels seen in 1992. A mass vaccination program was carried out in 3-18 year old children (Wuhan City, China), and its protective efficacy was 85.4%. In a mass vaccination program of an entire population (Shenshi County, China), the annual HA incidence decreased from 359.7/100,000 to 17.7/100,000 (almost 20.3 times). There was a significant relationship found between vaccine coverage and the incidence of HA, the correlation of the negative regression was significant at the 1% (Kendall rank correlation, significant level P < 0.05). Conclusions: In summary, this study highlights the important role of implementing a vaccination program in decreasing the incidence of HA, and the large protective efficacy of such a strategy, as demonstrated in China

In some cities of China's central region (Anhui Province for example) the level of development is lower than in the east, and, as a result, its energy consumption is still fraught with waste. Through statistical analysis of energy-saving and consumption-reducing of cities in Anhui, it can be shown that the task of energy conservation and reduction of consumption in Anhui is greater than in other areas of China. An indicator system for the sustainable development of demand reduction in cities of Anhui province is developed to measure its level. The “Pressure-State-Response” (PSR) framework and principal component analysis are used for evaluation of the system. According to the analysis, some suggestions are obtained for achieving more energy-efficient production systems.

Influenza A(H7N9) virus emerged in eastern China in February 2013 and continues to circulate in this region, but its ecology is poorly understood. In April 2013, the Guangdong Provincial Center for Disease Control and Prevention (CDC) implemented environmental and human syndromic surveillance for the virus. Environmental samples from poultry markets in 21 city CDCs (n=8,942) and respiratory samples from persons with influenza-like illness or pneumonia (n=32,342) were tested; viruses isolated from 6 environmental samples and 16 patients were sequenced. Sequence analysis showed co-circulation of 4 influenza A(H7N9) virus strains that evolved by reassortment with avian influenza A(H9N2) viruses circulating in this region. In addition, an increase in human cases starting in late 2013 coincided with an increase in influenza A H7 virus isolates detected by environmental surveillance. Co-circulation of multiple avian influenza viruses that can infect humans highlights the need for increased surveillance of poultry and potential environmental sources.

Globally, the number of older people living with HIV (PLH) is growing. Additionally, older PLH are facing particular challenges related to accessing health care. The objective of this study is to investigate the older PLH's access to care and its relationship to emotional and tangible social support.A cross-sectional study was conducted among 225 PLH who were 50 years of age or older in Anhui, China. A computer-assisted personal interview was used to collect the participants' demographic characteristics, perceived health status, and access to care. The following two dimensions of social support were measured: emotional support and tangible support. The association between emotional/tangible support and access to care was calculated using Pearson's/point-biserial correlations and with multiple linear regression.Higher tangible support was reported by the participants who were married or living with a partner, those who had higher annual income levels, and those with better perceived health status. Emotional support was correlated with higher education, higher income, and better perceived health status. Multiple regression analyses showed that access to care was significantly associated with emotional support (β = 0.2807, p 0.0001) but not with tangible support (β = -0.0183, p = 0.7922).The study findings point to the importance of providing emotional support for older PLH. It is suggested that emotional support should be provided for older PLH in addition to tangible assistance, in order to engage them in treatment and care.

It is well known that before the commencement of the reform in 1978, China practiced a planned economic system (to be exact, an examination and approval economy). This system was characterized by its over‐centralization, the practice of planned management, exclusion of market mechanisms and neglect of the law of value. As a kind of exploration for the initial construction of the socialist state, this highly centralized planned economic system achieved notable results. It played a positive role in accelerating economic construction, especially industrial construction, by concentrating limited resources of a backward country in specific ways. However, with the development of socialist production and the expansion of the construction scale, the planned economy's defects of overlooking the law of value and the role of the market became greater with each passing day, it led to the irrational allocation of resources, low economic returns and serious hindrance to the enhancement of overall national strength, thereby restraining the vitality and vigor of socialism. The history of world economic development has proved that under state macro‐control, the market economic structure and operating mechanism based on the full development of commodity production and the law of value are so far the more effective economic structure and operating mechanism in human history that can properly realize the optimum allocation of social resources and promote the development of productive forces. Therefore, in China at the present stage, the replacement of the administrative economic system by the market economic structure is a major reform aimed to liberate and develop productive forces and bring about fuller development of the superiority of the socialist publicly owned economy.

BackgroundThe MSM (Men who have sex with men) population suffers from very high rates of concurrent psychosocial problems. Together, these problems comprise a syndemic that increases the risk of HIV infection for this community. The precise mechanisms through which this syndemic can raise the likelihood of HIV infection warrant further exploration.Methodology/principal findingsA total of 522 MSM were enrolled via a multiframe sampling approach and were asked to report psychosocial problems, risky sexual behaviors and HIV test results. A count of psychosocial health problems was calculated to test the additive relationship of these factors on HIV risk. Adjusting analysis and restriction analysis were used to determine a proposed intermediate pathway. Psychosocial health problems are highly concurrent and intercorrelated among urban MSM. Greater numbers of health problems are significantly and positively associated with HIV infection, which is mediated, at least partially, by risky sexual behaviors.Conclusions/significanceMSM experience concurrent psychosocial health problems that correlate with HIV infection in this community. We recommend the development of coping strategies for this population to deal with these psychosocial problems, both in prevention research and health policy.

To examine the phylogenetic information regarding the gene pool of AIV in domestic ducks in eastern China, the NA genes of twenty-six viruses isolated during 2002-2006, including two H1N1 strains, tenH3N1 strains and fourteen HSN1 strains, which reflected the predominant N1 subtype viruses were subjected to phylogenetic analysis. The results indicated that AIVs of N1 subtype circulating in domestic ducks in eastern China were undergoing a gradual evolution. Analysis of the deduced amino acid sequences revealed that NAs from all isolated H5N1 viruses had a 20-aa deletion in the stalk region (residues 49-68), whereas no deletion was seen in the NAs from other HA subtype viruses. The viruses of H3N1 and H1N1 might have a propensity for reassortment of NA genes, whereas no direct evidence of reassortment of NA gene was obtained in H5N1 viruses.