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Analyzing the influence of tourism on carbon emission has significant implications for promoting the sustainable development of tourism. Based on the panel data of 31 tourist cities in China from 2005 to 2022, this study utilizes a structural equation model to explore the carbon reduction effect of tourism development and its influencing mechanism. The results show that: (1) The overall carbon emission efficiency of tourism cities first decreased and then increased, rised to a peak of 0.923 in 2022. (2) Tourism development has a significant positive impact on carbon emission efficiency, and there are three influence paths: tourism → environmental regulation → carbon emission efficiency, tourism → environmental regulation → industrial structure → carbon emission efficiency, and tourism → industrial structure → carbon emission efficiency. (3) The influence of tourism development on carbon emission efficiency mainly depends on the direct effect, and the development of tourism also indirectly affect the industrial structure. Environmental regulation also mainly depends on the direct effect on carbon emission efficiency. (4) Foreign direct investment lead to the reduction of carbon emission efficiency in both direct and indirect aspects. [ABSTRACT FROM AUTHOR]

Improving carbon emission efficiency is crucial for achieving carbon peak and carbon neutrality. This paper analyzes the carbon emission efficiency of Chinese cities using panel data from 275 prefecture-level cities between 2006 and 2020. The super-efficiency SBM (undesirable slacks-based measurement) model of undesired output, combined with kernel density estimation and exploratory data analysis, is employed. This study finds, firstly, from 2006 to 2020, the average efficiency of carbon emissions in Chinese cities declined from 0.53 to 0.48, indicating a downward trend. Secondly, from a temporal perspective, the level of dispersion in urban carbon emission efficiency has become increasingly distinct over time, coupled with a decrease in polarization. Thirdly, in terms of spatial analysis, urban carbon emission efficiency in China shows a positive correlation in a global context. In terms of local spatial correlation, it primarily exhibits high-high and low-low clusters, with a few instances of low–high and high-low clusters. Finally, based on the research findings, this paper proposes suggestions to improve urban carbon emission efficiency. [ABSTRACT FROM AUTHOR]

The greenhouse gas (GHG) footprints of oriented strand boards (OSB) have been gaining growing concern. China is one of the largest manufacturers and traders of OSB in the world. However, little data are available concerning the GHG footprint of Chinese OSB production. The purpose of this study is to quantify and compare the GHG footprints of three types of OSB produced in China. Cradle-to-gate GHG footprints assessment models were built for OSB according to PAS 2050 guidelines. The results showed that the cradle-to-gate GHG footprints of OSB/2, OSB/3, and OSB/4 were 142.7 kg CO2 e/m3, 173.2 kg CO2 e/m3, and 374.2 kg CO2 e/m3, respectively. Raw material acquisition was the largest contributor to GHG footprint for three types of OSB (52.6~57.6%), followed by the production process of OSB (25.6~27.3%) and transportation (15.3~20.1%). The consumption of wood, MDI, electricity, and the transportation of wood were main emission hotspots in Chinese OSB production. Ultimately, four feasible GHG emission reduction measures were put forward from the perspective of reducing the usage of wood and MDI adhesive, decreasing the electricity consumption, and shortening the transport distance of wood. [ABSTRACT FROM AUTHOR]

Past work in China has revealed that approximately 60% of young people in China consider themselves to be adults. However, no work, prior to this study, has been done examining either the views of Chinese parents regarding their children's adult status or the criteria that Chinese parents use in determining whether or not their children have reached adulthood. Participants included 92 unmarried college students, ages 18 to 25, and at least one of their parents (83 fathers, 84 mothers). Results revealed that (a) the majority of children and their parents did not yet view their children as adults, and (b) there was disagreement between emerging adult children and their parents in the emphasis they placed on various criteria for adulthood. Discussion will focus on how the traditional Chinese notion of "face" may play an important role in the criteria young people and their parents endorse as necessary for adulthood. (Contains 2 tables.)

New trends in Chinese higher education are attracting the attention of global educators. Since the establishment of Western-oriented modern universities at the end of nineteenth century, Chinese higher education has continued to evolve. Over the past two decades, however, tremendous economic development in China has stimulated reforms in higher education that have resulted in some remarkable changes. This article provides the details on the transformations undergone by the Chinese higher education system. [This article was produced by American Association of University Professors.]

Green economy is environmentally friendly economy, which is important for the sustainable economic development and environmental protection. Based on the panel data of 30 provinces and cities in China, a three-stage super-efficient SBM-DEA (slack-based model-data envelopment analysis) model is constructed to evaluate the efficiency of green economy and analyze its regional differences. The results show that, first, the random error factor and external environmental conditions significantly affect the efficiency of green economy. Second, the green economic efficiency in China from 2010 to 2019 is stable and needs to be further improved. Third, through regional comparison, it is found that the green economy efficiency in eastern China is higher than those in central and western China and the green economy efficiency in northeast China is the lowest. Finally, green economy efficiency does not simply depend on the economic development, the regional differences of green economy efficiency results from the combined effects of different geographical resources endowment, different economic development characteristics, and different environmental protection policies in different regions of China. Based on the research findings, corresponding policy suggestions are put forward to improve the efficiency of green economy. [ABSTRACT FROM AUTHOR]

Background: Recently, there has been an interest in the temporal relationship between contrast exposure (CM) and cardiac surgery suggesting that a "double hit" on the kidney function in close succession increases the risk of acute kidney injury (AKI) after cardiac surgery. However, data from young children is limited. The purpose of this study was to retrospectively evaluate the effects of preoperative CM exposure on postoperative AKI in infant and young children patients and to further analyze the influence of exposure time interval. Methods: Patients (age ≤ 3 years) who underwent diagnostic imaging within 14 days before on-pump cardiac surgery between 1 May 2017 and 31 May 2018 in Fuwai Hospital, Beijing, were analyzed. Kidney outcome was assessed according to Kidney Disease: Improving Global Outcomes creatinine-based criteria. Results: One thousand four hundred pediatric patients (192 CM and 1,248 non-CM) were identified. Postoperative AKI occurred in 57 (29.7%) of the 192 patients who were exposed to CM. Following propensity score adjustment, no difference in risk for AKI was observed between the CM and non-CM groups (RR 1.142, 95% CI 0.916–1.424; P = 0.264). Multivariable logistic regression of the CM group indicated that independent predictors of postoperative AKI were lower weight, lower preoperative creatinine level, and longer CPB duration. Time interval between CM exposure and on-pump cardiac surgery was not significantly associated with increased risk of AKI (OR 0.853, 95% CI 0.265~2.747; P = 0.790). Conclusions: For pediatric patients who are soon to undergo on-pump cardiac procedures, there appears to be no need to hesitate in performing the diagnostic imaging investigations requiring CM, or delay CPB after CM exposure. These patients may benefit from increased diagnostic utility without increasing their risk of postoperative AKI. [ABSTRACT FROM AUTHOR]

In China, baicalin is the main active component of Scutellaria baicalensis, which has been used in the treatment of inflammation-related diseases, such as inflammation-induced acute lung injury. However, its specific mechanism remains unclear. This study examined the protective effect of baicalin on LPS-induced inflammation injury of alveolar epithelial cell line A549 and explored its protective mechanism. Compared with the LPS-induced group, the proliferation inhibition rates of alveolar type II epithelial cell line A549 intervened by different concentrations of baicalin decreased significantly, as did the levels of inflammatory factors IL-6, IL-1β, prostaglandin 2 and TNF-α in the supernatant. The expression levels of inflammatory proteins inducible NO synthase (iNOS), NF-κB65, phosphorylated ERK (p-ERK1/2), and phosphorylated c-Jun N-terminal kinase (p-JNK1) significantly decreased, as did the protein expression of follistatin-like protein 1 (FSTL1). In contrast, expression of miR-200b-3p significantly increased in a dose-dependent manner. These results suggested that baicalin could significantly inhibit the expression of inflammation-related proteins and improve LPS-induced inflammatory injury in alveolar type II epithelial cells. The mechanism may be related to the inhibition of ERK/JNK inflammatory pathway activation by increasing the expression of miR-200b-3p. Thus, FSTL1 is the regulatory target of miR-200b-3p. [ABSTRACT FROM AUTHOR]

Xylotopus amamiapiatus (Sasa, 1990) is newly recorded from China. Illustrated redescription of adult male as well as the first DNA barcode of X. amamiapiatus are presented. Some morphological differences between the Chinese and Japanese specimens of the species are given. [ABSTRACT FROM AUTHOR]

Objective: High variabilities in tacrolimus (TAC) exposure are still problems that confuse physicians. TAC trough levels (TAC Cmin) fluctuated considerably after endoscopic retrograde cholangiopancreatography (ERCP) treatment in several liver transplant (LT) patients. We aimed to investigate the variation regularity of TAC Cmin post-ERCP and related factors. Methods: This study was a retrospective, observational study conducted at the First Affiliated Hospital of Zhejiang University in China. From October 2017 to January 2019, 26 LT patients that received ERCP were included (73 TAC Cmin measures). The absolute difference and the variation extent in TAC Cmin pre- and post-ERCP were analyzed. Patients were divided into mild and obvious variation groups, and the differences were compared. Results: The TAC Cmin in LT patients significantly increased in the first three days post-ERCP (p <0.05) and increased by more than 20% in 18 out of 26 (69.2%) patients. The mean extent of variation in TAC Cmin was 45.1% (95% confidence interval [CI]: 28.3–81.3%) and 31.4% (95% CI: 9.7–53.1%) on days 1 and 3 post-ERCP, respectively. The increasing TAC Cmin gradually returned to baseline within a week (p >0.05). The daily TAC dose and total bile acid (TBA) level were significantly higher (p <0.05) in patients with obvious variation in TAC Cmin. The differences in other demographics, clinical characteristics, variation in laboratory data, and serum amylase levels between the two groups were not significant. Conclusion: The TAC Cmin significantly increased in LT patients during the first three days after ERCP, and the level returned to baseline within a week. The daily TAC dose and TBA levels may be related to this increase. Frequent drug concentration monitoring should be executed in the early phase post-ERCP, especially in patients with related factors. [ABSTRACT FROM AUTHOR]

In this study, satellite meteorological products were used as important data sources to achieve rainfall-runoff simulation and flood dynamic monitoring in the Songhua River basin (below the Sancha estuary) in northeastern China. Satellite precipitation products CHIRPS (the Climate Hazards Group Infrared Precipitation with Stations) and satellite evapotranspiration products MODIS-ET (the Moderate Resolution Imaging Spectroradiometer-Evapotranspiration) were collected for the study area during 2010–2015. The accuracy of satellite meteorological products was validated by ground observation data in the same period. Then, combined with satellite meteorological products, a daily-scale rainfall-runoff model suitable for the study area was established. The daily river runoff (RR) and surface runoff depth (SRD) of the study area were obtained through this model. It is found that the overall performance of satellite meteorological products is good through verification. The annual average deviation of MODIS-ET and observation data is less than 1 mm. In tertiary basins of the study area, the correlation coefficient (CC) between CHIRPS and observation data is in the range from 0.59 to 0.71, and the root-mean-square error (RMSE) varies from 3.75 to 4.50 mm. The rainfall-runoff model based on satellite meteorological products can well simulate the variation characteristics of observed RR: the CC reach 0.83, and the Nash–Sutcliffe efficiency coefficient (NSE) reach 0.72. The established model was used to analyse a flood event in 2013. And the simulation results showed the changing process of the RR accurately. The dynamic changing process of the SRD was monitored by the established model during the flooding period. The model can be used to reflect the spatial distribution of potential inundation areas. This study validates the performance and deviation of CHIRPS and MODIS-ET, and proves that these satellite meteorological products have good applicability in rainfall-runoff simulation and flood dynamic monitoring. The output results, daily RR and SRD data with 0.05° grid unit, can provide the decision support for hydrological information monitoring and flood forecasting. [ABSTRACT FROM AUTHOR]

Purpose: To assess the use of eye care services in a rural population in North China and to analyze the factors associated with underuse of these services. Methods: In a cross-sectional population-based study, demographic, health and vision-related information including use of eye care services were determined during a face-to-face interview. A single visit to an eye care provider qualified as 'use' of eye care services. Results: Of 6612 participants, 754 (11.4%, 95% confidence interval, CI, 8.7-14.1%) had used eye care services. The most common reason cited for not seeing an eye care provider was 'no need' ( n = 5754). Of the 5754 who thought that there was no need to see an ophthalmologist, 3458 (60.1%) were found to have one or more type of eye disease, including glaucoma (56, 1.0%), cataract (1056, 18.4%), age-related macular degeneration (AMD; 164, 2.9%) and refractive error (3048, 53.0%). Also, 74 (1.3%) and 409 (7.1%) of the 5754 participants had visual impairment (<20/60) according to best-corrected visual acuity and presenting visual acuity, respectively. In a multiple regression model, participants who had glaucoma (adjusted odds ratio, OR, 4.0, 95% CI 3.0-5.4), AMD (adjusted OR 1.6, 95% CI 1.2-2.3) or refractive error (adjusted OR 1.4, 95% CI 1.1-1.8), were more likely to visit an eye care provider. Conclusion: A high proportion of the Chinese rural population had never used eye care services although three fifths had eye diseases. Further efforts towards better education of the general population about common eye problems as well as increasing the number of ocular health providers would be necessary in future. [ABSTRACT FROM AUTHOR]

Past work in China has revealed that approximately 60% of young people in China consider themselves to be adults. However, no work, prior to this study, has been done examining either the views of Chinese parents regarding their children’s adult status or the criteria that Chinese parents use in determining whether or not their children have reached adulthood. Participants included 92 unmarried college students, ages 18 to 25, and at least one of their parents (83 fathers, 84 mothers). Results revealed that (a) the majority of children and their parents did not yet view their children as adults, and (b) there was disagreement between emerging adult children and their parents in the emphasis they placed on various criteria for adulthood. Discussion will focus on how the traditional Chinese notion of “face” may play an important role in the criteria young people and their parents endorse as necessary for adulthood. [ABSTRACT FROM AUTHOR]

The article presents a comprehensive index for measuring investor sentiment of the stock market of Hong Kong, China. It highlights that the turnover variable of a stock market is positively related to market sentiment. It also examines how the performance of the world's two largest stock markets that is, U.S. and Japanese markets affect the Hong Kong market. The daily data which is the simple average of daily high, low and close prices has been used to construct the sentiment measure.

Purpose: To describe the rationale, design, methodology and baseline characteristics of the Handan Eye Study (HES), a population-based study to determine the prevalence and impact of visual impairment and major ocular diseases in Chinese adults living in a rural region north China. Methods: Population-based, cross-sectional study. 6830 Han people aged 30 years and older from 13 villages of Yongnian County, Handan city, Hebei province, China were recruited. The interviews covered demographic, behavioral, and ocular risk factors as well as health-related and vision-related quality of life. Ocular examination included measurement of visual acuity (VA), intraocular pressure, anterior and posterior segment examinations, visual field testing, and anterior segment, fundus and optic disc photography/imaging. Physical examination included measurement of height and weight, blood pressure, electrocardiogram, fasting blood glucose, lipid levels, urea nitrogen and creatinine as well as tests of physical function including walking speed. Results: Of the 7557 individuals eligible for the Handan Eye Study (HES), 6830 (90.4%) subjects participated the study. The majority of participants were female (53.6%), the average (± standard deviation) age was 52.3 (± 12.3) years, and 100% were self-identified Han people. In contrast to the non-participants, those who participated were more likely to be female, elderly, married, and had more years of education (P < 0.05). Conclusion: The HES successfully examined over 90% of eligible Han Chinese adults aged 30 and older from a rural region of north China. Results from the HES will provide key information about the prevalence, risk factors, impact, and trends of ocular disease in rural regions of China. [ABSTRACT FROM AUTHOR]

Scleractinian cold-water corals (CWCs) are one of the most important habitat engineers of the deep sea. Although the South China Sea (SCS) abuts the biodiversity center of scleractinian CWCs in the western Pacific, only a few sporadic records are available. We discovered new CWC sites by means of trawl sampling and video observation along the continental shelf of the northwestern SCS. All trawled scleractinian CWC specimens were identified to species level according to skeleton morphology and structure. The living CWCs and associated fauna recorded in the video were -identified to a higher level of classification. Scleractinian corals were identified to genus level, while non-scleractinian CWCs were identified to family level and given general names such as gorgonian corals, bamboo corals and black corals. Associated benthic dwellers were divided into major categories. A total of 28 scleractinian CWC species were identified to 7 families, 15 genera, and 1 additional subgenus. Among them, 13 species were colonial, including important habitat-forming species in the genera Eguchipsammia, Dendrophyllia and Cladopsammia. Non-scleractinian CWCs were identified to 7 families, including 4 families gorgonian corals, 1 family bamboo corals, and 2 families black corals. Gorgonian corals were the most abundant non-scleractinian CWCs in this region. Meanwhile, starfish, sea anemones, fish, gastropods, echinoderms, and other associated benthic fauna were recorded in the CWC habitats, with starfish belonging to the order Brisingida being most common. New scleractinian CWC assemblages were discovered along the continental seabed mounds in the northwestern SCS. This study highlights the remarkable diversity of cold-water scleractinian corals in the whole SCS, and shows the potential widespread distribution and conservation prospect of CWC habitats in this region. • The first study of cold-water corals was conducted in the South China Sea by the combined method of trawling and video observation. • New scleractinian CWC assemblages were discovered with high diversity along the continental seabed mounds. • The presence of CWC habitat was confirmed with many non-scleractinian CWCs and other associated benthic taxa. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of and factors associated with amblyopia in a rural Chinese population. Design: Population-based, cross-sectional study. Participants: Six thousand eight hundred thirty Han Chinese aged 30 years or more, recruited from Yongnian County, Handan, Hebei Province, China. Methods: Thirteen villages in the Yongnian County of Handan were selected randomly, and residents of these selected villages 30 years of age or older were invited to participate in the Handan Eye Study. Participants underwent a comprehensive eye examination, including standardized visual acuity (VA) tests using logarithm of the minimum angle of resolution charts. Prevalence rates were age- and gender-standardized to the 2000 China census. Main Outcome Measures: The proportion of rural Chinese population aged 30 years or older with amblyopia. Unilateral amblyopia was diagnosed if best-corrected VA (BCVA) was 20/32 or worse in the amblyopic eye and was not attributable directly to any underlying structural abnormality of the eye or visual pathway. Bilateral amblyopia was diagnosed if BCVA was 20/32 or less in both eyes and if there was a history of form deprivation during the sensitive period of visual development, such as media opacities or high, uncorrected ametropia. Results: Amblyopia was diagnosed in 205 participants, with an age- and gender-adjusted prevalence of 2.8%. Of these, 1.7% were unilateral cases and 1.1% were bilateral cases. Underlying causes included anisometropia (67.3%), strabismus (5.4%), mixed strabismus and anisometropia (4.4%), visual deprivation (9.8%), astigmatism association (9.8%), and other (3.4%). Of the amblyopia cases, 47.6% were hypermetropic. Conclusions: In this rural Chinese population, 2.8% of adults 30 to 80 years of age had amblyopia, a prevalence rate broadly consistent with that of most other studies. One third of the cases were bilateral, and anisometropia was the most common cause of this condition. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. [Copyright &y& Elsevier]

Purpose: To describe the prevalence and causes of low vision and blindness in a rural population in Northern China. Design: Population-based, cross-sectional study. Participants: A study of 6830 Han Chinese aged 30 years and older was conducted between October 2006 and October 2007 in rural Yongnian County in Handan, Northern China. Methods: Clustered samples of adults aged 30 years or more residing in 13 residential villages were selected randomly and were invited to participate the Handan Eye Study. Participants underwent a comprehensive eye examination, including standardized visual acuity (VA) tests using logarithm of the minimum angle resolution charts. Prevalence was age- and gender-standardized to the 2000 China Census. Main Outcome Measures: Low vision was defined as VA <20/60 but ≥20/400, and blindness was defined as VA <20/400 following the Modified World Health Organization (WHO) definitions. Primary causes of low vision and blindness were determined by study ophthalmologists according to WHO definitions. Results: Six thousand eight hundred thirty (90.4%) of 7577 eligible individuals participated in the study, and 6799 (89.7%) had VA data available. Population-weighted prevalence of presenting bilateral blindness was 0.6% and bilateral low vision was 4.7% for persons 30 years of age and older. Based on best-corrected visual acuity (BCVA), the corresponding prevalence of blindness was 0.5% and that of low vision was 1.0%. Blindness and low vision were strongly age related (P<0.05). Cataract was the predominant cause of presenting bilateral blindness (36.6%), whereas undercorrected refractive error was the predominant cause of presenting low vision (78.4%). After refractive correction, cataract became the first leading cause of blindness (41.9%), and low vision (48.2%), myopic retinopathy (16.1%), glaucoma (9.7%), and corneal opacity (9.7%) were other common causes of blindness defined using BCVA. Conclusions: A higher prevalence of blindness and low vision was seen in this rural Chinese sample than has been reported from urban Chinese populations. The estimated numbers with BCVA-defined low vision and blindness in 2020, based on best-corrected vision in rural Chinese adults aged 30 years or more, is expected to be 12.4 million and 2.9 million, respectively. Predominant causes of low vision and blindness in China are treatable. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article. [Copyright &y& Elsevier]

Aims: To designed a new model using pre-transplant data to predict post-transplant mortality for Chinese population and compared its performance to that of existing models., Methods: In this multicenter study, 544 recipients of liver transplants for non-tumor indications were enrolled in the training group and 276 patients in the validation group. The new Simplified Mortality Prediction Scores (SMOPS) model was compared to the MELD and four existing models using the C-statistic., Results: SMOPS model used 6 independent pre-transplantation risk factors screened from the training group (chronic liver failure/organ failure scores, fever > 37.6 ℃, ABO blood-type compatibility, arterial lactate level, leukocyte count and re-transplantation). The SMOPS accurately predicted patients' 30-day, 90-day and 365-day mortality following liver transplantation, and its' scores were more accurate than those of the other models. The SMOPS generated four levels of risk: low risk (<10 points), moderate risk (11-20 points), high risk (21-25 points) and futile risk (≥26 points). The survival within all risk levels was not different between MELD=40 and MELD<40. The survival within moderate-, high- or extreme-risk ALF was not different between ALF and non-ALF., Conclusion: The SMOPS model uses pre-transplant risk factors to stratify post-transplant survival and is superior to current models for Chinese population, and has the potential to contribute to improvements in organ-allocation policies., Competing Interests: Conflict of interest The authors declare that they have no conflict of interest., (Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

The outbreak of a sudden infectious epidemic often causes serious casualties and property losses to the whole society. The COVID-19 epidemic that broke out in China at the end of December 2019, spread rapidly, resulting in large groups of confirmed diagnoses, and causing severe damage to China's society. This epidemic even now encompasses the globe. This paper takes the COVID-19 epidemic that has occurred in China as an example, the original data of this paper is derived from 20 Chinese media reports on COVID-19, and the grounded theory is used to analyze the original data to find the risk transmission rules of a sudden infectious epidemic. The results show that in the risk transmission of a sudden infectious epidemic, there are six basic elements: the risk source, the risk early warning, the risk transmission path, the risk transmission victims, the risk transmission inflection point, and the end of risk transmission. After a sudden infectious epidemic breaks out, there are three risk transmission paths, namely, a medical system risk transmission path, a social system risk transmission path, and a psychological risk transmission path, and these three paths present a coupling structure. These findings in this paper suggest that people should strengthen the emergency management of a sudden infectious epidemic by controlling of the risk source, establishing an efficient and scientific risk early warning mechanism and blocking of the risk transmission paths. The results of this study can provide corresponding policy implications for the emergency management of sudden public health events., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Duan, Zhang and Zhang.)

Background: Disease activity indices (DAIs) including disease activity score 28 (DAS28), simplified disease activity index (SDAI), and clinical disease activity index (CDAI) have been widely used in clinical practice and research studies of rheumatoid arthritis (RA). The objective of our study was to evaluate the correlation and concordance among different DAIs in Chinese patients with RA., Methods: A cross-sectional study, including patients enrolled in the Chinese registry of rheumatoid arthritis from November 2016 to August 2018, was conducted. The correlations were evaluated using Spearman correlation coefficient and concordance with Bland-Altman plots, quadratic weighted kappa, and discordance rates in the crosstab. For other indices, the optimal cutoff points corresponding to SDAI remission were explored through receiver operating characteristic curve analysis., Results: A total of 30,501 patients were included, of whom 80.46% were women. Most individuals were with moderate disease activity or high disease activity. High correlations among DAS28-erythrocyte sedimentation rate (ESR) and DAS28-C-reactive protein (CRP), SDAI and CDAI were observed. Similarly, the weighted kappa value among the indices was high. In Bland-Altman plots, a positive difference between DAS28-ESR and DAS28-CRP was observed, with an absolute difference of >1.2 in 3079 (10.09%) patients. In crosstab, approximately 30% of the patients were classified into different groups. Concordance values between SDAI remission and the optimal cutoff points of DAS28-ESR, DAS28-CRP, and CDAI were 3.06, 2.37, and 3.20, respectively., Conclusions: Although DAIs had high correlations and weighted kappa values, the discordance between DAIs was significant in Chinese patients with RA. The four DAIs are not interchangeable., (Copyright © 2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

The genus Monopelopia Fittkau, 1962 is newly recorded from Oriental China. Monopelopia zhengi Lin sp. n., is described and illustrated based on an adult male from Jianfengling National Nature Reserve, Hainan, China. In addition, an updated key to adult males of Monopelopia is provided.

Micro-plastics (MPs) pollution has been a hotspot in soil environment. To explore the correlation of the vegetation cover and the distribution of MPs in Yellow River Delta wetland, the characters of MPs in the soil sampled at 16 sites where reed ( Phragmites communis , a low-salt dominant species) and Suaeda salsa (a high-salt dominant species) covered were investigated. The abundance of MPs here ranged to 80-4640 n·kg -1 , and the particle size ranged to 13 μm-5 mm. The main components of MPs with large size were polyethylene (PE), polyethylene terephthalate (PET) and polystyrene (PS), and the content of PET ranged to 0.22-1.16 μg·kg -1 . The barrier effect of reed on MPs was higher than that of Suaeda salsa . The average abundance of MPs and PET contents at the sites where reed covered were 1423 n·kg -1 and 0.62 μg·kg -1 , and they mainly consisted of small particles with a size less than 50 μm. The average abundance of MPs and PET contents at the site Suaeda salsa covered were 584 n·kg -1 and 0.33 μg·kg -1 , and they mainly consisted of fragments and fibers with a size ranged to 100-1000 μm. The abundance of MPs in the soil was significantly correlated with the growth statues of the vegetations ( P =0.001). Therefore, the distribution of MPs in the soil in the same area covered by different vegetation might be spatial different.

Background: Systemic lupus erythematosus (SLE) is a chronic, systemic autoimmune disease that commonly causes kidney damage. Therefore, we measured plasma levels of cytokines that may be related to renal dysfunction in SLE patients., Methods: To explore the differences between SLE patients with renal dysfunction and healthy volunteers, the levels of cytokines in plasma were screened using a human cytokine antibody array. Then, we chose fourteen of the elevated cytokines for verification with an expanded sample size by a human magnetic Luminex assay. Plasma samples were isolated from SLE patients ( n = 72) and healthy volunteers ( n = 8)., Results: Cytokine antibody array data showed elevated plasma cytokines in SLE patients with renal dysfunction compared with healthy volunteers. By using the human magnetic Luminex assay, we found that plasma levels of CHI3L1, GDF-15, IGFBP-2, MIF, ST2, TFF3, and uPAR were significantly higher in SLE patients than in healthy volunteers. Plasma levels of CXCL4 were significantly lower in the active group than in the inactive group, and plasma levels of CHI3L1, IGFBP-2, MIF, and MPO were significantly higher in the active group than in the inactive group. We also analyzed the correlation between plasma cytokine levels and the SLEDAI-2K, and our results showed that the plasma levels of the fourteen selected cytokines were weakly correlated or not correlated with the SLEDAI-2K. We further analyzed the correlation between cytokines and renal dysfunction. Plasma levels of GDF-15 and TFF3 were highly positively correlated with serum creatinine levels and 24-hour urine protein levels., Conclusion: Our data suggest that plasma levels of GDF-15 and TFF3 are potential renal dysfunction markers in SLE patients, but plasma levels of these cytokines are not correlated with the SLEDAI-2K. Further study is warranted to determine how these cytokines regulate inflammatory responses and renal dysfunction in SLE., Competing Interests: The authors indicate that there are no potential conflicts of interest., (Copyright © 2020 Chen Yan et al.)

Background: Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to the levels of disease severity (patient-assessed) and proportions of treatment cost to household income., Methods: This was a subgroup study of a cross-sectional study in patients with RA and their physicians. The patients were subdivided into different subgroups based on their self-assessed severity of RA and on the proportions of treatment cost to household income (<10%, 10-30%, 31-50%, and >50%). The Treatment Satisfaction Questionnaire for Medication version II was used to assess patients' treatment satisfaction., Results: When considering all medications, effectiveness, convenience, and global satisfaction scores were lower in the severe and moderate RA subgroups than those in the mild and extremely mild RA subgroups (all P < 0.001). Effectiveness, side effects, and convenience scores were higher in the <10% subgroup compared to those in the >50% subgroup (all P < 0.05). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup (F = 13.183, P = 0.004). For biological disease-modifying anti-rheumatic drugs, effectiveness and convenience scores were lower in the severe RA subgroup than those in the extremely mild RA subgroup (both P < 0.05). Convenience score was higher in the <10% subgroup compared to that in the 31% to 50% and >50% subgroups (F = 12.646, P = 0.005). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup (F = 8.794, P = 0.032)., Conclusion: Higher disease severity and higher financial burden were associated with lower patient satisfaction.

This study aimed to investigate the efficacy and safety of iguratimod (T-614) in combination with methotrexate (MTX) for active rheumatoid arthritis (RA) patients. Sixty active RA patients were enrolled according to the 2010 American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) classification criteria, and were randomized into MTX + T-614 group and MTX group. T-614 was orally administered at a dosage of 50 mg/day (25 mg twice daily) for 24 weeks. MTX was orally administered to RA patients at a stable weekly dosage of 10 mg/week for the first 4 weeks and subsequent 12.5 mg/week for the later 20 weeks. Clinical features at baseline and efficacy endpoints of the ACR 20 % response (ACR20), ACR50, ACR70, and adverse events at 24 weeks were evaluated, respectively. After 24 weeks of treatment, clinical features at baseline, including counts for tender joints and swelling joints, visual analog scale for pain, patient's and physician's global assessment, erythrocyte sedimentation rate, C-reactive protein, disease activity score 28, health assessment questionnaire, simplified disease activity index, and ACR50 in the MTX + T-614 group, showed statistically significant differences comparing with the MTX group (P < 0.05). There was no significant increase in adverse events in the MTX + T-614 group comparing with the MTX group (P > 0.05). The combination of MTX and T-614 therapy appeared to have a good efficacy and safety for active RA and was superior to MTX-alone therapy after 24 weeks of treatment.

Aim: To determine the value of computed tomographic angiography (CTA) for diagnosis and therapeutic planning in lower gastrointestinal (GI) bleeding., Methods: Sixty-three consecutive patients with acute lower GI bleeding underwent CTA before endovascular or surgical treatment. CTA was used to determine whether the lower GI bleeding was suitable for endovascular treatment, surgical resection, or conservative treatment in each patient. Treatment planning with CTA was compared with actual treatment decisions or endovascular or surgical treatment that had been carried out in each patient based on CTA findings., Results: 64-row CTA detected active extravasation of contrast material in 57 patients and six patients had no demonstrable active bleeding, resulting in an accuracy of 90.5% in the detection of acute GI bleeding (57 of 63). In three of the six patients with no demonstrable active bleeding, active lower GI bleeding recurred within one week after CTA, and angiography revealed acute bleeding. The overall location-based accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the detection of GI bleeding by 64-row CTA were 98.8% (249 of 252), 95.0% (57 of 60), 100% (192 of 192), 100% (57 of 57), and 98.5% (192 of 195), respectively. Treatment planning was correctly established on the basis of 64-row CTA with an accuracy, sensitivity, specificity, PPV and NPV of 98.4% (248 of 252), 93.3% (56 of 60), 100% (192 of 192), 100% (56 of 56), and 97.5% (192 of 196), respectively, in a location-based evaluation., Conclusion: 64-row CTA is safe and effective in making decisions regarding treatment, without performing digital subtraction angiography or surgery, in the majority of patients with lower GI bleeding.

This study examined the age structure of the Loach, Homatula pycnolepis through the otolith growth rings in 204 individual specimens collected from the Xiaomengtong River of the Nujiang River (Salween River) basin in April, 2008. There were only two different age classes, 1 and 2 years of age-no 3 year olds were detected. The age structure of H. pycnolepis was simple. The complete mitochondrial DNA cytochrome b gene sequences (1140) of 80 individuals from 4 populations collected in the Nujiang River drainage were sequenced and a total of 44 variable sites were found among 4 different haplotypes. The global haplotype diversity (Hd) and nucleotide diversity (Pi) were calculated at 0.7595, 0.0151 respectively, and 0, 0 in each population, indicating a consistent lack of genetic diversity in each small population. There was obvious geographic structure in both the Nujiang River basin (NJB) group, and the Nanding River (NDR) group. The genetic distance between NJB and NDR was calculated at 0.0356, suggesting that genetic divergence resulted from long-term isolation of individual population. Such a simple age structure and a lack of genetic diversity in H. pycnolepis may potentially be due to small populations and locale fishing pressures. Accordingly, the results of this study prompt us to recommend that the NJB, NDR and Lancang River populations should be protected as three different evolutionary significant units or separated management units.

Background: Cataract remains the leading cause of blindness and visual impairment in the world and in China. However, data on the prevalence of cataract based on standardized lens grading protocols from mainland China are limited. This paper estimated the age- and gender-specific prevalence and risk factor for cataract, Methods: In a population-based Chinese sample, participants underwent a comprehensive ophthalmic examination, including assessment of cortical, nuclear, posterior subcapsular (PSC) and mixed lens opacities from slit-lamp grading using the Lens Opacities Classification System III., Results: Of the 7,557 eligible subjects, 6,830 took part in the study (90.4% response rate), and 6,544 participants (95.8%, mean age 52.0 ± 11.8 years) had lens data for analyses. The prevalence of any cataract surgery in at least one eye was 0.8% (95% confidence interval [CI], 0.62, 1.06), with similar rates between men and women. The overall prevalence of any cataract or cataract surgery was 20.8% (95% CI, 19.8, 21.8), higher in women than in men after adjusting for age (23.6% vs 17.6%; OR: 1.78; 95% CI: 1.54-2.07). When distinct lens opacity was categorized in each eye as cortical, nuclear, PSC or mixed, based on one randomly selected eye, cortical cataract was the most common distinct subtype (12.3%), followed by mixed (3.2%), nuclear (1.7%), and PSC (0.2%) cataract. The prevalence of all lens opacities increased with age (P < 0.001). After excluding other causes for visual impairment, the proportion of people with best corrected visual acuity <20/60 was 21% among those with PSC, and 12% among those with mixed opacities in the better-seeing eye. In multivariable logistic regression models, myopia was associated with all cataract types, while higher fasting plasma glucose and diabetes were only associated with PSC cataract., Conclusions: Cataract affects 20% of the population aged 30 years and older living in rural China, with cortical cataract the most common subtype. Risk factors for cataract include myopia and diabetes.

Purpose: To describe the prevalence of age-related degeneration (AMD) in a rural Chinese population and to assess its associations with age, gender, and smoking., Design: Population-based cross-sectional., Participants: Persons aged 30+ years, recruited between October 2006 and October 2007, from Yongnian County, Handan, Hebei Province, China., Methods: All participants underwent a standardized interview and comprehensive eye examinations, including digital retinal photography of both eyes. Trained graders assessed the presence and severity of AMD lesions following the modified Wisconsin Age-related Maculopathy Grading System (WARMGS) used in the Blue Mountains Eye Study (BMES). Direct age standardization to the world population (year 2000) was performed to compare the prevalence across different populations., Main Outcome Measures: AMD and WARMGS., Results: Of 6830 participates, fundus photographs were gradable for 6581 persons (96.4%), including 4049 aged 50+ years. Early and late AMD prevalence rates were 3.0% and 0.1%, respectively, among participants. The age-standardized prevalence rates among participants aged 50+ years were 4.7% and 0.2%, respectively. After controlling for age, men had a higher prevalence of early (3.9% vs. 2.3%, odds ratio [OR] 1.7; 95% confidence interval [CI], 1.3-2.2) and late AMD (0.1% vs. 0.03%; OR 3.5; CI, 0.4-33.4) compared with women. Older age (sex-adjusted OR 1.7; CI, 1.3-2.2 per decade of age) and current smoking (age-sex-adjusted OR 1.4; CI, 1.0-2.1) were significantly associated with early AMD prevalence. The proportion of current smokers was substantially higher in men (58.7%) than in women (0.3%). The attributable risk of early AMD from smoking among Chinese men was 24.2%. After controlling for current smoking, the excess prevalence of early AMD in men compared with women reduced by 50% (OR 1.4; 95% CI, 0.9-2.0)., Conclusions: The prevalence of early AMD in this rural Chinese sample was similar to white persons in the BMES and Asian Malays in the Singapore Malay Eye Study. Late AMD prevalence, however, was lower. Higher prevalence rates for early and late AMD in men compared with women were largely attributed to substantially higher proportions of smokers in rural Chinese men than in women., (Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Purpose: To describe macular thickness measured by optical coherence tomography (OCT) in healthy eyes of adult Chinese persons., Design: Population-based cross-sectional study., Participants: Chinese adults aged 30+ years who were residents of Handan, North China., Methods: The Handan Eye Study is a population-based study of eye disease in Chinese persons. Eligible residents underwent a comprehensive ophthalmic examination including OCT (Stratus OCT, Carl Zeiss Meditec Inc., Jena, Germany). Fast macular thickness scans were performed over maculae within 6 mm in diameter, divided into 3 regions (central, inner, and outer, with a diameter of 1, 3, and 6 mm, respectively) and 9 quadrants (1 in the central region and 4 each in the inner and outer regions). Retinal thickness (means and standard deviations) was calculated by OCT mapping software, presented for foveal minimum, central macula (within 1 mm diameter), and inner and outer regions divided by 8 quadrants., Main Outcome Measures: Macular thickness measured by OCT., Results: Of the 6830 participants (90.4% response rate) examined, 2230 eyes of healthy subjects with high-quality OCT scans were selected (32.7% of participants; mean age, 46.4+/-9.9 years, 58.4% were women). The mean foveal minimum, central, inner, and outer macular thicknesses were 150.3 (18.1) microm, 176.4 (17.5) microm, 255.3 (14.9) microm, and 237.7 (12.4) microm, respectively (overall differences, P<0.001). The mean foveal volume was 0.139 (0.014) mm(3), and the mean total macular volume was 6.761 (0.516) mm(3). In the inner region, the nasal quadrant was thinner than the superior and inferior quadrants, and in the outer region, the nasal quadrant was the thickest (P<0.001). Age was positively correlated with foveal (beta coefficient = 3.582) and central macular (beta coefficient = 2.422) thicknesses. The foveal minimum, central, inner, and outer macular thicknesses were significantly greater in men than in women. Fasting plasma glucose was negatively correlated with central macular thickness (2.416 mm reduction per millimole/liter increase in glucose), and axial length was positively correlated with central macular thickness (2.138 mm increase per millimeter increase in axial length)., Conclusions: Normal macular thickness measurements using OCT in a large population-based sample of adult Chinese persons aged 30 to 85 years were generally thinner in the foveal and central macular areas than measurements reported in other populations. Age and axial length were positively correlated with macular thickness., (Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Objective: To observe the bacterial characteristic of orthopedic open wounds injured in Wenchuan earthquake and their drug-resistant pattern for reasonable application of antibiotics., Methods: A total of 340 secretion specimens isolated from 148 cases of orthopedic open wounds of earthquake victims were analyzed. Among the patients, 71 patients were male and 77 patients were female, ranging in age from 2 to 82 years, with an average of 40.4 years. Thirty-seven patients were detained under the ground ranged from 5 min to 102 h. The 340 specimens of exudation in the wound were collected for bacterial culture and drug sensitivity tests., Results: The infection rate of 148 cases was 66.2 percent. Two hundred and fifty-seven pathogens were isolated from 340 secretion specimen, including gram-negative bacteria accounted for 77.8%, gram-positive bacteria accounted for 20.6%. The most frequent pathogens isolated from secretion culture in Wenchuan earthquake survivors were Escherichia coli (16.3%), Acinetobacter baumannii (16.0%), Staphylococcus aureus (13.6%), Pseudomonas aeruginosa (12.5%) and Enterobacter cloacae (8.6%)., Conclusion: The drug sensitivity test of exudation as well as exact application of antibiotics should be highly payed attention to by doctors in order to reduce the occurrence of bacterial resistance.

Purpose: To determine the prevalence and association of epiretinal membranes (ERMs), as assessed by retinal photography and optical coherence tomography (OCT), in a Chinese population., Methods: The Handan Eye Study is a population-based study of eye disease in rural Chinese aged 30+ years. Eligible residents underwent a detailed ophthalmic examination including retinal photography and Stratus OCT. ERMs were defined by a combination of retinal photographs and OCT and classified as cellophane macular reflex (CMR) or preretinal macular fibrosis (PMF) based on retinal photographs characteristics., Results: Of the 6830 persons examined, 6565 (96.1%) had gradable retinal photographs and/or OCT. The mean age was 51.7 +/- 11.6 years. ERMs were present in 3.4% (95% CI: 2.9%-3.8%) of participants, bilateral in 20.3% of the cases. CMR was present in 2.2% and PMF in 0.7%, and ERMs were unclassified in 0.5% (detected by OCT only). ERM prevalence was similar in women and men (3.6% vs. 3.1%), strongly associated with increasing age (P for trend < 0.001). After adjustment for age and sex, primary ERM was associated positively with myopia (OR: 1.58, 95% CI: 1.12-2.23) and inversely with current smoking (OR: 0.61, 95% CI: 0.38-0.97, versus never smoked). Best corrected visual acuity was significantly worse in eyes with primary ERMs (mean LogMAR score lower by 0.07, 95% CI: 0.05-0.10) than eyes without ERMs, after adjustment for age, sex, and lens status., Conclusions: ERMs affect 3.4% of the population 30+ years of age and living in rural China. Idiopathic ERMs were associated with myopia, decreased visual acuity, and inversely associated with smoking.