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Objectives: The prevention of mother‐to‐child transmission of HIV has been a global success. But little is known about the growth parameters of infants delivered by mothers with HIV or the drug resistance of infants with HIV in China. The study aimed to assess growth parameters and drug resistance in Chinese infants exposed to HIV. Methods: We conducted an 18‐month longitudinal follow‐up study of 3283 infants (3222 without HIV; 61 with HIV) born to mothers with HIV in the Guangxi Zhuang Autonomous Region between January 2015 and December 2021. The weight and length of all participants was recorded. In addition, genetic subtypes and drug resistance analysis were performed for infants with HIV. Results: Compared with infants without HIV, those with HIV had significantly lower weight/length Z‐scores, except at 18 months of age. The length/age Z‐scores of infants with HIV was significantly reduced, except at 1 month of age. The weight/age Z‐scores of infants with HIV were significantly lower at all follow‐up time points. The weight/length Z‐scores of male infants without HIV were significantly lower than for female infants without HIV at all follow‐up time points. Male infants without HIV had lower length/age and weight/age Z‐scores than female infants at the remaining follow‐up points, except at 1 month of age. Of a total of 61 infants with HIV, subtype and drug‐resistance data were obtained from 37 (60.66%) samples. Infants with HIV were dominated by the CRF01_AE genotype and showed a diversity of mutation sites dominated by non‐nucleoside reverse transcriptase inhibitor resistance. Conclusion: Our study demonstrates the growth of infants exposed to HIV in southwest China and provides detailed information on subtype distribution and drug resistance of those with HIV. Nutritional support and drug‐resistance surveillance for infants exposed to HIV need to be strengthened. [ABSTRACT FROM AUTHOR]

High levels of self-reported trust in government found in China has invited skepticism about the authenticity of survey results. To address this question, we examine implicit political trust, an automatic, intuitive orientation toward government. Using the Single-Target Implicit Association Test, we found that the Chinese public holds an implicit trust in government that is unrelated to self-reported, explicit trust. Whereas early political socialization processes, represented by education and urban residency, increase implicit trust they also decrease explicit trust suggesting that agents of socialization have differential effects. Furthermore, performance evaluations, income, and social desirability affect explicit trust but have no effect on implicit trust. Controlling for explicit trust, we found that implicit trust matters for understanding various types of regime support including system justification, the social credit system, and government's ability to handle crises. Our results have important implications for understanding regime support in the world's largest authoritarian country. [ABSTRACT FROM AUTHOR]

We examined sensitive questions on political trust and regime support in China using indirect methods. We replicated previous list experiment results confirming that a majority trusts the central government despite overreports. We also conducted novel list experiments on trust in local government and support for removal of the presidential term limit and found evidence of overreporting for both. The point estimate for local government also suggests majority trust, but the central government is both more trusted and feared. However, we did not find evidence of majority support for removing the term limit at the time of the removal, indicating that the public may negatively evaluate government, albeit indirectly, in some circumstances. Last, examining self-monitoring, a personality trait for examining social desirability, we found that it only influenced overreporting trust in the central government. The results reveal meaningful variation in political trust and regime support in the world's largest authoritarian society. [ABSTRACT FROM AUTHOR]

In this study, a D‐galactose‐induced aging mouse model was established, and Syringa oblata Lindl. extract (SOLE) was administered orally to observe the effect and mechanism of SOLE on the running ability of aging mice. The role of SOLE was evaluated by H&E histopathological observation, detection of serum biochemical indices, and detection of mRNA expression levels by qPCR experiments. The experimental results showed that SOLE could increase the exhaustive running time of aging mice and reduce the oxidative aging of the liver and kidney. At the same time, the levels of BUN, lactic acid, GOT, GPT, MDA, iNOS, and TNF‐α in the serum of the mice were decreased, and the relative mRNA expression levels of nNOS, iNOS, TNF‐α and syncytin‐1 in the liver tissue and skeletal muscle tissue of the mice were downregulated. In addition, it increased the levels of CAT, GSH‐Px, and T‐SOD in mouse serum and upregulated the relative mRNA expression of Cu/Zn‐SOD, Mn‐SOD, and CAT in mouse liver tissue and muscle tissue. The analysis results showed that SOLE mainly contained rutin, isoquercitrin, ferulic acid, dihydroquercetin, and quercitrin. In summary, SOLE can enhance the running ability and exercise ability of aging mice and slow down aging. Practical applications: Clove is used as health tea or traditional Chinese medicine in China, but there is no relevant research and application on the improvement of human exercise ability. This study found this new function of clove, which accumulated a theoretical basis for further popularizing its application. [ABSTRACT FROM AUTHOR]

With the increase in extreme climate events, forest fires burn in much larger areas. Therefore, it is important to accurately predict forest fire frequencies. Precipitation is an important factor that affects the probability of future forest fires. Previous models used average precipitation values, but the attenuation of precipitation was not considered. In this study, a time-decaying precipitation algorithm was used to calculate the comprehensive precipitation index. This method can better represent the effect of precipitation in predicting the occurrence of forest fires. Moreover, observed fire spots were converted into a continuous density of fire spots. The structure of the prediction model is more realistic, which is conducive to obtaining higher-precision prediction results. Additionally, the support vector machine (SVM) regression model was used to construct a forest fire warning model. When the comprehensive precipitation index was compared with the average precipitation value, the accuracy of the four forest areas in central and northern China in the test set was improved by approximately 10%. The findings are relevant to forest ecologists and managers for future mitigation of forest fires, and also for successful prediction of other fire-prone areas. [ABSTRACT FROM AUTHOR]

Detection of out-of round (OOR) faults of metro vehicle wheels is very important to improve stationarity and stability in metro vehicles and avoid accidents caused by OOR faults. Diagnosis of OOR faults demands extracting useful information accurately from mass of vibration signals with poor signal-to-noise ratio (SNR) of metro vehicle wheels for complex running condition. In this paper, we proposed a diagnosis method on OOR faults of metro vehicle wheels combined with variational mode decomposition (VMD), kernel principal component analysis (KPCA), and deep belief network (DBN) to diagnose the OOR faults of metro wheels. Vibration signals of China metro vehicle wheels collected while the metro vehicle is running are used to train the diagnosis model and adjust parameters of DBN and KPCA based on testing accuracy. The different dimensions of KPCA, epoch number, and node number of DBN are compared, and the better parameters of diagnosis model based on vibration signals are concluded in this paper. The generalization of the diagnosis model is checked nine times by testing the calculation of each group of parameters and using an error declining process. The mean accuracy of diagnosis model proposed in this paper is 0.9136, and the diagnosis model presented in this paper is very significant to detect OOR faults online. [ABSTRACT FROM AUTHOR]

Governments around the world, particularly authoritarian ones, often deny inconvenient or unfavorable information, calling it fake news or false rumor, and yet what was denied often turns out to be true eventually. How will citizens react when the initial "fake news" is verified to be real? What are the consequences of false government denials on government credibility and citizen satisfaction? Using a survey experiment in China and a follow-up survey, we find that citizens can be persuaded by the authorities' denials and reduce their belief in a piece of news that has been declared "fake." But when the denied news turns out to be real, citizens will reduce their belief not only in the denial at hand but also in a similar denial in the future and reduce their satisfaction with the government. Thus, false denials have both immediate and lasting effects on government credibility and can erode citizen satisfaction with the government. [ABSTRACT FROM AUTHOR]

For a long time, since China's opening to the outside world in the late 1970s, admiration for foreign socioeconomic prosperity and quality of life characterized much of the Chinese society, which contributed to dissatisfaction with the country's development and government and a large-scale exodus of students and emigrants to foreign countries. More recently, however, overestimating China's standing and popularity in the world has become a more conspicuous feature of Chinese public opinion and the social backdrop of the country's overreach in global affairs in the last few years. This essay discusses the effects of these misperceptions about the world, their potential sources, and the outcomes of correcting misperceptions. It concludes that while the world should get China right and not misinterpret China's intentions and actions, China should also get the world right and have a more balanced understanding of its relationship with the world. [ABSTRACT FROM AUTHOR]

Climate change has caused an increase in extreme rainfall and snowfall in many parts of the world. For example, in the Three Gorges Reservoir area, annual precipitation has gradually increased and the occurrence of heavy precipitation events has become more frequent. As the reservoir water level rises in October, the high water combined with heavy precipitation creates a "special hydrological environment," which recently caused the Yanguan landslide. The Yanguan landslide is a large-scale soil landslide that has undergone two slides, pushed the Yanguan Road Bridge into the reservoir, and caused serious damage to roads and buildings. In the present study, the combined effects of high water and heavy precipitation on landslide deformation characteristics (movement patterns and evolution processes) have been analyzed and a stability evaluation was conducted through a field investigation and numerical simulation. To comparatively analyze these combined effects of high water and heavy precipitation, a two-dimensional finite element model was created, and four cases of the hydrological environment were calculated with the model. Results show that the factor of safety was maintained in the range of 1.013 to 1.059 before the precipitation conditions changed. However, as heavy precipitation increased in October 2017 (reaching 356.4 mm in 1 month), this "special hydrological environment" potentially decreased the FoS to 0.948, which is 9.6% lower than that observed under normal conditions, and helped drive the Yanguan landslide activity. The analysis of these various combined effects can also indicate the impacts of climate change on landslides in other areas of the Three Gorges Reservoir. [ABSTRACT FROM AUTHOR]

More than 5000 landslides or potential landslides have been identified in the Three Gorges Reservoir (TGR) region since its impoundment in 2003. These hazards seriously threaten the continuation of reservoir operations and the safety of dams, waterways, and local residents. Understanding the deformation characteristics and kinematic evolution of these landslides can be helpful for assessing their stability and providing long-term landslide predictions. In this study, the deformation characteristics, influencing factors, sliding mechanism, and threshold reservoir level of the Muyubao landslide are revealed. Data from a professional monitoring network implemented in 2006 reveal that the deformation of this landslide is in a stage of creep characterized by overall movement, and the rate of creep is gradually slowing. The deformation mechanism is investigated by combining meteorological, hydrological, and reservoir level data with displacement measurements from surface cracks, manual and automatic GPS monitoring records, and field investigations and drilling surveys. The reservoir level is the main driving factor of deformation, whereas the filling-drawdown rate is not directly related to the deformation of the landslide. Furthermore, rainfall can promote deformation during periods with high reservoir levels. The deformation of the landslide follows a very distinctive pattern featuring large displacements after the reservoir level rises to a high level (from late October to early March of the following year) and a rapid transition to constant deformation as the reservoir level drops. The results indicate that the reservoir level of 172 m is the general threshold reservoir level of the Muyubao landslide. At present, the deformation rate of the Muyubao landslide is gradually decreasing, and the probability of large-scale sliding is low; however, the monitoring system must be strengthened and additional research must be performed on the deformation mechanism. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) infections caused by different subtypes require different treatments; therefore, rapid and cost-effective genotyping methods for the diagnosis of HCV are greatly needed. In the present study, a new method to diagnose HCV subtypes that depends on a one-step quantitative reverse transcription PCR (RT-qPCR) and TaqMan fluorescence probe technique is described. Five pairs of primers and five probes were designed, which were able to detect five genotypes in three reaction tubes. One reaction was used to detect the 1b subtype, one was used to detect the 2a and 6a subtypes, and the other was used to detect the 3a and 3b subtypes. Rigorous performance validation was implemented for five aspects: Precision, sensitivity, accuracy, specificity and anti-interference. The HCV subtype that infected 289 patients was evaluated in the present study via RT-qPCR and verified by sequencing. The results revealed that the 1b subtype accounted for 45% of infections, the 2a subtype accounted for 9% of infections, the 3a subtype accounted for 13% of infections, the 3b subtype accounted for 18% of infections, and the 6a subtype accounted for 15% of infections. The analytical sensitivity for the detection of each of the five HCV subtypes was 1,000 IU/ml. The new method performed well in the performance validation mentioned above, indicating its effectiveness as a HCV genotyping method. RT-qPCR has mitigated some of the former challenges of existing HCV genotyping methods, including the time commitment, expense, and inaccuracy of such methods. The performance validation of this new method showed that RT-qPCR is reliable enough to be widely applied in China for HCV genotyping. [ABSTRACT FROM AUTHOR]

This paper examines the correlation between banks' ownership structure and lending behaviour in China using micro‐level data on China's banks during the 2003–2015 period to identify possible different patterns in bank lending supply responses to changes in the economic environment, with a focus on understanding whether bank lending patterns follow procyclical or countercyclical allocation rules. We analyse how different types of loans correlate with bank ownership and find that state‐owned banks and banks with relatively higher levels of government ownership follow more countercyclical lending allocation rules, which indicates that China's government uses the financial sector as an instrument to mitigate procyclicality in lending behaviour. We further find that the loan allocation patterns vary significantly for different types of loans in China. In particular, individual consumer loans and corporate loans exhibit clear countercyclical patterns—particularly among state‐owned banks—while residential mortgages show much smoother patterns over time and seem to be less affected by the business cycle. [ABSTRACT FROM AUTHOR]

In the past decades, Corporate Social Responsibility (CSR) has attracted increasing attention, with Corporate Environmental Responsibility (CER or Environmental CSR) playing an ever important role. This paper aims to study whether and how Chinese shareholders are sensitive to the disclosure of environmental violations. Specifically, the issue is measured by the performance of the Chinese stock market. In order to answer this question, the authors conduct a two-dimensional 'environment-as-a-resource' framework, which assumes that the pressure on stock price after an environmental violation is from both externalities and internalities. The external pressure comes from environmental regulations, media attention, customer sensitivity and so on. The internal pressure is rooted in firm level actions, for example, previous pollution control and previous CSR performance. The paper starts by addressing theories of corporate social responsibility, corporate environmental management and market value management, followed by the advancement of foreign and domestic research. Then, based on the events in the Shanghai and Shenzhen stock exchanges from 2002 to 2014, the authors calculate the events' cumulative abnormal return. The explanatory factors in the regression model include external impacts of time trend and media attention; together with internal impacts of previous pollution situations and CSR performance. Complementing the notion of 'environment-as-a-resource', the regression results reveal that, facing an environmental violation, Chinese shareholders react negatively. The negative reaction becomes weaker as time goes by, and is stronger in the years with heavier media environmental attention. Furthermore, some policy suggestions are proposed in light of the current CSR implementations by Chinese companies: 1) Strengthen the government's environmental scrutiny management to help the market punish environmental violators. 2) Encourage environmental accounting and environmental auditing for public companies. 3) Build up a broad environmental information platform comprising of interactions between the government, corporations and media. 4) Cultivate environmental awareness of company managers so it becomes worthy to invest in environment resources and gain better awareness of environmental responsibility. [ABSTRACT FROM AUTHOR]

Monitoring has been considered to be the most effective means of preventing and mitigating geo-hazards. Unmanned aerial vehicle (UAV) based remote sensing has been proven to be a viable method for monitoring relatively flat areas, but has typically encountered challenges on steep mountainous slopes. The Qinglingou Slope, which is located at the head of the Three Gorges Reservoir, China, was selected as a case study, and a UAV-based remote sensing method was applied to monitor this steep mountainous slope. The UAV, which was equipped with a camera, was used to acquire images on May 10 and Sept. 13, 2015. At the same time, a plan for establishing and measuring a detailed network of ground control points (GCPs) and check points was carefully designed and implemented, according to the local conditions. Georeferenced digital surface models (DSMs) and digital orthophotos were obtained by photogrammetric processing. Based on the results, a simple and quick method that identified and quantified slope deformation by calculating and analyzing the changes in the DSMs was developed. The results showed that the UAV-based remote sensing method was rapid, safe and effective, and it could be valuable for monitoring a large number of steep mountainous slopes in the Three Gorges Reservoir. [ABSTRACT FROM AUTHOR]

Why are Chinese people moving abroad in unprecedented numbers? Using unique experimental and survey data, this research finds that Chinese citizens with more positive perceptions and, especially, overestimation of foreign socioeconomic conditions are more interested in going abroad. Moreover, correcting socioeconomic overestimation of foreign countries reduces their interest in leaving China, indicating that there is a causal effect from rosier perceptions of foreign conditions to higher interest in going abroad, and emigration does not always represent well-informed “voting with the feet.” The relationship between international political knowledge and exit intentions, on the other hand, is not significant or consistent, suggesting that Chinese citizens’ interest in going abroad is more socioeconomic than political in nature. These results contribute to the study of citizen misinformation, challenge a prevalent assumption in the international migration literature, and help us understand one of the most important social trends in the world's largest developing and authoritarian country. [ABSTRACT FROM PUBLISHER]

The notion of ‘suzhi’ (素质), which roughly means human quality or character, features prominently in public and intellectual discourses in China about the country’s social and political development, including the prospects for democratization. Despite the pervasive use of the concept by both the government and society, few studies have analyzed whether suzhi is really the root cause of the myriad social issues that have been attributed to it. This article problematizes the notion of suzhi and shows through simple game-theoretic analyses of two heavily debated issues in China that such a predominant focus on suzhi is misguided and misses the crucial role of social expectations in multiple-equilibria social interactions. In fact, without good social expectations even ‘high suzhi’ people would behave as if they were of ‘low suzhi’, which perhaps best characterizes many social phenomena in contemporary China. The results of the study thus have critical implications for a successful social and political transition. [ABSTRACT FROM PUBLISHER]

In recent years, Chinese private companies have improved a lot in corporate social responsibility (CSR) performance, especially in the philanthropic area. However, private companies' awareness and performance of social responsibility still have a big disparity with SOEs. And private companies' policy of social responsibility is subjective and preferential. To explain this contradiction, this paper tries to introduce political connection and, based on stakeholder salience theory, to test how political connection changes managers' perception of stakeholders' relative importance and cause changes in stakeholders' satisfaction level of social responsibility requirement. The result shows that (1) political connection has positive influence on private companies' CSR; (2) companies with political connection are significantly better than the ones without political connection in society-oriented and customers-oriented responsibility; (3) two kinds of companies have no significant difference in investors-oriented responsibility; (4) as for government-oriented and employee-oriented responsibility, companies with political connection are worse than ones without political connection. These findings are significant for China's future construction of competition system and private companies' choice of stakeholders and future investment. [ABSTRACT FROM AUTHOR]

Do knowledge and information about foreign countries affect people’s evaluation of domestic situations? Using unique survey and experimental data, this research finds that Chinese citizens with more positive perceptions and especially overestimation of foreign socioeconomic conditions have more negative evaluations of China and the Chinese government. Moreover, correcting socioeconomic misinformation about foreign countries improves one’s evaluations of China, indicating that the causal direction is at least partly from rosier estimation of foreign conditions to lower domestic evaluations. The relationship between domestic evaluations and international political knowledge, as measured by familiarity with political affairs and figures in foreign countries, is typically not significant, although awareness of political instability in other countries can increase satisfaction with one’s own country. These results contribute both substantively and conceptually to the study of politically relevant knowledge and information, and shed new light on the nuances of information flow and opinion formation in changing societies. [ABSTRACT FROM PUBLISHER]

With the increase of extreme climate and global warming, forest fires have become more frequent. Therefore, it is important to accurately predict whether fires will occur in forest in the future. Precipitation is an important factor that affects the probability of the occurrence of forest fires in the future. Previous models selected annual average precipitation, monthly average precipitation or drought days as the precipitation value, which the attenuation of precipitation is not considered. In this study, a time fading model is used to calculate the comprehensive precipitation index, which is an exponential weight decay model. The earlier the precipitation time, the smaller the weight. This method can better represent the effect of precipitation in predicting the occurrence of forest fires. Moreover, in this study, discrete fire points are converted into a continuous fire-point density. The structure of the prediction model is more reasonable, which is conducive to obtaining higher-precision prediction results. Besides, the SVM regression model was used to construct a forest fire danger rating model. In the same area, considering the comprehensive precipitation index compared with the average precipitation value, the accuracy of the three forest areas in northeastern China in the test set has been improved by about 5%. The accuracy rates of 90.13%, 93.04% and 87.5% can be achieved respectively. • Using time fading model to calculate precipitation comprehensive index • The model used in this article has the great accuracy in predicating the forest fire danger rating. [ABSTRACT FROM AUTHOR]

How have local governments in China been able to break through central policy restrictions in a unitary and authoritarian political system? Why is China’s official discourse in the reform era often so conservative and unfavorable to reform? The author argues the two issues are components of a signaling game between China’s central government and local officials, in which local officials know that the center may be reformist, but the reformist center imitates the rhetoric of a conservative center to control the pace of local liberalization. The result is a gradualist reform of “signaling left, turning right,” with glaring incongruity of speech and actions in the process. [ABSTRACT FROM PUBLISHER]

This article investigates price transmission mechanism and volatility impact between Chinese cornstarch futures market and relevant markets through Johansen cointegration test, VEC model and GARCH model. The empirical results indicated that the Chinese cornstarch futures price could guide cornstarch spot price uni-directionally and there are long-term cointegration relationships between them. There is a co-integration and bi-directional lead relationship between cornstarch futures price and corn futures price. The launch of cornstarch futures market can slightly reduce volatility of domestic corn futures market. However, the launch of cornstarch futures market has no significant impact on the spot market. [ABSTRACT FROM AUTHOR]

Objectives: The aims of this study were to infer the phylogenetic relationship of OXA-232-producing Klebsiella pneumoniae (OXA232Kp) strains collected from a Chinese hospital and to determine the composition and genetic background of antimicrobial resistance genes (ARGs) among these strains., Methods: Three non-duplicate OXA232Kp strains were collected from a Chinese hospital. Whole-genome sequencing was used to determine their genome sequences and then a genomic comparison of ARG-carrying genetic elements from the three strains with related sequences was performed. Phylogenetic analysis was conducted by constructing a maximum-likelihood phylogenetic tree., Results: Compared with other Chinese sequence type 15 (ST15)-OXA232Kp strains, the three ST15-OXA232Kp strains in this study could be divided into a single subgroup in phylogenetic relationship. The composition and genetic background of ARGs were identical in the three strains. Three ARG-carrying genetic elements or multidrug resistance (MDR) regions were determined, including a truncated Tn2013-like IS-based transposition unit, a unit transposition Tn6867b and a 40.9-kb MDR region., Conclusion: This study reported clonal dissemination of ST15-OXA232Kp strains carrying multiple ARGs in a Chinese hospital. A comprehensive evolutionary and genomics analysis provided a deeper understanding of OXA232Kp. Further surveillance and study should be advocated to prevent the dissemination of OXA232Kp strains in China., Competing Interests: Competing interests None declared., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This study aims to evaluate the epidemiological characteristics of mother-to-child transmission (MTCT) of HIV and identify the possible factors leading to infant HIV infection using a retrospective cohort study of early infant diagnosis (EID). Information on a total of 3,145 exposed infant-mother pairs was collected from the EID platform from July 2014 to December 2019. The MTCT rate was 2.1%. Spatial-temporal maps showed that rates varied by year and by region, with four districts (Baise, Guigang, Guilin, and Hechi) maintaining rates of >2.0% in 2019. The rate of antiretroviral therapy (ART) use was 94.4%, with a gradual increase in prescriptions of highly active ART (HAART) from 83.0% in 2014 to 92.4% in 2019. A majority of 99.5% of infants were receiving artificial feeding. Factors associated with MTCT were ART use (odds ratio [OR] = 0.065, confidence interval [95% CI] = 0.035-0.121) and artificial feeding (OR = 0.091, 95% CI = 0.018-0.452). HAART was more helpful in decreasing the risk of MTCT compared with monotherapy (OR = 0.115, 95% CI = 0.014-0.933). ART during the postpartum period correlated with an increased risk (OR = 11.579, 95% CI = 1.402-95.960) compared with use of ART during pregnancy. This study indicates that MTCT rate of HIV is decreasing meaningfully in Guangxi. Some areas still face challenges in elimination of MTCT and need further resources and interventions. Future program planning should take into consideration the fact that ART use-in particular the use of HAART or ART during pregnancy-and replacement feeding may contribute to the prevention of MTCT.

Objectives: To report our experience with free-hand transperineal targeted biopsy with real-time transrectal ultrasound (TRUS) and multiparametric magnetic resonance imaging (mpMRI) fusion images for the diagnosis of prostate cancer (PCa)., Patients and Methods: A total of 62 consecutive patients suspicious of PCa at the mpMRI scan and PSA >4.0 ng/mL were recruited prospectively. Targeted biopsies (TBs) were carried out for each cancer-suspicious lesion and followed a 12-core systematic biopsy (SB) protocol. Pathological findings of TB and SB were analyzed., Results: The age of the patients was 68.38 ± 6.57 years (range 51-79 years). The preoperative PSA value was 10.21 ± 5.57 ng/mL (range 4.5-30.1 ng/mL). Preoperative prostate volume was 34.05 ± 9.86 mL (range 19-64 mL). The PCa patients detected by SB and/or TB were 34 (54.8%). Cancer-detected rates of SB and TB cores were 7.53 and 26.2%, respectively (P < 0.001). The positive core length of SB and TB cores was 3.71 ± 2.77 mm (range 1-14 mm) and 5.00 ± 3.04 mm (range 2-17 mm), respectively (P = 0.016). The positive core percent of SB and TB cores was 28.77 ± 20.13% (range 7-100%) and 35.76 ± 18.73 (range 11-100%), respectively (P = 0.048). Moreover, clinically significant PCa cores detected by the SB and TB were 19 cores (2.6%) and 48 cores (18.5%), respectively (P < 0.001)., Conclusions: Free-hand transperineal TB using real-time TRUS and mpMRI fusion imaging has the ability to improve sampling quality and detect more clinically significant PCa compared with SB.