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Given the rapid advancement in the natural gas market, the existing volume-based trading system falls short of accurately valuing this commodity. This study focuses on addressing the economic challenges in pipeline operations resulting from transitioning from volume to energy metering for natural gas. Based on the actual situation of China's natural gas market, a model is established for optimizing the operation of a multigas source pipe network under the energy metering system and volume metering system by considering the implementation plan of the energy metering system and the demand for natural gas from special users, and taking maximizing the profit of pipe operation as the goal, and taking the volume of gas supplied by the gas source and the way of boosting the pressure of the whole pipe as the decision-making variables. The model was applied to a long-distance pipe in China and solved by the GAMS/ANTIGONE solver. The results showed that the optimization results under different energy metering system implementation schemes were better than the actual operation schemes in the field, with a maximum profit increase of about 17.42%. User demand sensitivity analysis reveals that the highest profit difference under various user demand scenarios can reach 9%, and the profit variance under different gas source quality combinations can reach up to 10.56%. [ABSTRACT FROM AUTHOR]

At present, the existing influence evaluation algorithms often ignore network structure attributes, user interests and the time-varying propagation characteristics of influence. To address these issues, this work comprehensively discusses users' own influence, weighted indicators, users' interaction influence and the similarity between user interests and topics, thus proposing a dynamic user influence ranking algorithm called UWUSRank. First, we determine the user's own basic influence based on their activity, authentication information and blog response. This improves the problem of poor objectivity of initial value on user influence evaluation when using PageRank to calculate user influence. Next, this paper mines users' interaction influence by introducing the propagation network properties of Weibo (a Twitter-like service in China) information and scientifically quantifies the contribution value of followers' influence to the users they follow according to different interaction influences, thereby solving the drawback of equal value transfer of followers' influence. Additionally, we analyze the relevance of users' personalized interest preferences and topic content and realize real-time monitoring of users' influence at various time periods during the process of public opinion dissemination. Finally, we conduct experiments by extracting real Weibo topic data to verify the effectiveness of introducing each attribute of users' own influence, interaction timeliness and interest similarity. Compared to TwitterRank, PageRank and FansRank, the results show that the UWUSRank algorithm improves the rationality of user ranking by 9.3%, 14.2%, and 16.7%, respectively, which proves the practicality of the UWUSRank algorithm. This approach can serve as a guide for research on user mining, information transmission methods, and public opinion tracking in social network-related areas. [ABSTRACT FROM AUTHOR]

Purpose: Pyrotinib, a novel human epidermal growth factor receptor 2 (HER2)-targeted tyrosine kinase inhibitor (TKI), has led to remarkable survival outcomes in HER2-positive advanced breast cancer (ABC) in clinical trials and was approved for second-line standards of treatment for HER2+ ABC in China. However, the clinical trials could not fully reflect reality of clinical practice, and predictive factors were still lacking. This study aimed to assess the actual efficacy and safety of pyrotinib in HER2+ ABC in real-world setting. Patients and Methods: In this multicenter, retrospective, observational real-world study, we analyzed 171 patients with HER2+ ABC, who received pyrotinib-based treatment from November 2017 to November 2020. The primary end point was progression-free survival (PFS). Secondary end points included overall survival (OS), objective response rate (ORR), clinical benefit rate (CBR) and safety. Results: Up to November 30, 2021, the median PFS (mPFS) was 12.0 months for all patients. One hundred and sixty-two patients (94.7%) with measurable lesions had been included in efficacy assessment. The ORR and CBR were 45.1% and 81.5%, respectively. A significantly longer PFS was reported in patients who received pyrotinib as first-line treatment, had the ECOG-PS of 0– 1, as well as those who were lapatinib-naive. In addition, multivariable analysis indicated that ECOG-PS of 2– 4, positive hormone receptor (HR) status, and presence of visceral metastasis were independent negative predictors of PFS. As far as we know, this study first reported the survival outcome of pyrotinib cross-line treatment, with a mPFS of 5.0 months. All grades of adverse events (AEs) occurred in 171 patients (100%), and the most common AE was diarrhea (86.5%). Conclusion: This study further demonstrated the outstanding efficacy and safety of pyrotinib and reported the potential predictors of survival in HER2+ ABC. [ABSTRACT FROM AUTHOR]

Fritillaria is a perennial herb with medicinal properties. There are 158 Fritillaria species worldwide, 33 of which have reported therapeutic efficacy. Alkaloids are the principal constituents in Fritillaria. Fritillaria species growing at 2700–4000 m are the sources of extract namely Chuan Beimu (the Pharmacopoeia of the People's Republic of China, 2020 Edition), with low biomass, mainly containing more 5α-cevanine isosteroidal alkaloids with cis-configuration. In contrast, species growing below 1500 m are usually taller than 50 cm, and they mainly contain more trans-configuration isosteroidal alkaloids. There are two schemes of the biosynthetic pathways of steroidal alkaloids with different frameworks and catalytic reactions and combined high-throughput omics data. Based on the distributed elevations, Fritillaria species were divided into three major categories, which met classification features based on phylogenetic analysis or morphological features. Artificial or in vitro cultivations are effective strategies for balancing economical requirements and ecological protection. Fritillaria species growing at lower altitudes can be cultivated by bulb reproduction, but species growing at higher altitudes still rely mainly on gathering a large number of wild resources. Integration of asexual tissue culture and bulb reproduction with sexual artificial or imitated wild cultivation may create a very promising and effective way to maintain sustainable industrial development of Fritillaria. [ABSTRACT FROM AUTHOR]

Improving the performance and success rate of college students' new ventures has attracted increasing attention globally. In this study, a questionnaire survey was conducted among 1500 college students who were directly involved in entrepreneurial activities in 23 provinces in China. The study explores the effects of team management and risk prevention abilities on college students' entrepreneurial performance. The results show that risk prevention ability significantly increases university students' entrepreneurial performance (e.g., profit and loss status, capital flow, and staff flow). Team management ability enhances these entrepreneurial indicators to varying degrees, with a "threshold" effect of its impact on entrepreneurial performance. With a continued increase in team management ability, the effect of risk prevention ability on entrepreneurial performance becomes increasingly more significant. Specifically, when team management ability reaches a medium level and above, risk prevention ability significantly improves capital flow and staff stability; and when team management ability reaches a high level, risk prevention ability significantly improves enterprise profitability indicators. [ABSTRACT FROM AUTHOR]

The combined pollution of arsenic (As) and cadmium (Cd) are quite common in the polymetallic mining areas located in southern China. In the present study, field experiments were established for the purpose of exploring a simultaneous remediation strategy of rice variety-water management-contaminant immobilization on the As and Cd contamination in paddy soil. The obtained results revealed that the Maba Yinzhan was the best low-accumulation rice variety, with As and Cd concentrations of 0.54 and 0.16 mg kg−1, respectively, in the rice grains. On the basis of water management during heading stage, the treatment using 0.15 wt% lime plus 0.5 wt% ferro-ferric oxide (FO) decreased the As and Cd concentrations by 64.02% and 34.78%, respectively, in the grains. The results of this study potentially provide an effective remediation solution for the As/Cd contaminated soils in polymetallic mining areas. [ABSTRACT FROM AUTHOR]

The article discusses the damage caused by tornadoes and torrential rainstroms in China, providing images taken with the help of unmanned aerial vehicles (UAVs) and ground damage surveys. The tornadoes discussed include the July 23, 2016, Yancheng EF4 tornado, June 5, 2016, Wenchang tornado, and 2015 Typhoon Mujigae.

The Tarim Basin in western China has been receiving continuous marine to lacustrine deposits during the Cenozoic as a foreland basin of the Qinghai-Tibetan Plateau (QTP). Clay mineralogy and geochemical proxy data from these sedimentary archives can shed light on climate and tectonic trends. Here we report on an abrupt mineralogical and weathering shift at 17 Ma ± 1 Myr in the Miocene Qimugan section in the northwestern part of the Qinghai-Tibetan Plateau. The rapid shift involves decreasing trends of chemical weathering indices, Rb/Sr and Ba/Sr ratios, and of minor and immobile elements with respect to upper crust composition as well as increasing trends of Na/Al and Na/Ti ratios, smectite, chlorite, and calcite contents. We ascribe these trends to changing source rocks due to uplift of the northern part of the QTP leading to exposures of younger intrusive bodies and older gneisses, schists, and carbonate-rich rocks. These uplifts potentially caused regional aridification reducing chemical weathering. The dating is indirect via magnetostratigraphically dated ostracod biostratigraphy and detrital zircon chronology and currently not good enough to compare the shift accurately in time with the onset of the global middle Miocene Climate Optimum (MMCO) at 16.5 Ma. Nevertheless, regional tectonics seem to have dominated over global climate as the warmer MMCO is expected to have increased weathering indices and decreased Na/Al and Na/Ti, rather than the observed reverse trends. [ABSTRACT FROM AUTHOR]

To obtain a better understanding of climate change in south China in the Quaternary, a clay mineralogical study was undertaken on the red earth profile at Jiujiang, using X-ray diffraction ( XRD) and particle-size distribution analysis methods. The XRD results showed that the clay minerals of the Jiujiang red earth were mainly mixed-layer illite-smectite ( I/ S), illite, kaolinite and vermiculite, with trace amounts of mixed-layer kaolinite-smectite ( K/ S). Changes in clay mineral composition displayed a trend of three-stage evolution. The higher mixed-layer I/ S clays and kaolinite contents in the lower portion suggest extremely warm and humid climates over the period c. 700 to c. 350 ka ago. A gradual decrease in I/ S clays and kaolinite reveals a gradual climate change from warm/humid to cool/dry during the period c. 350 to c. 130 ka ago. The higher illite and vermiculite contents indicate a relatively cool and dry climate during the period since c. 130 ka ago. The particle-size distribution pattern of the upper section was similar to that of the Xiashu loess, while that of the middle to lower section was similar to those of fluvially reworked red earth. A rapid increase in the abundance of large grain-size components at 2.6 m depth indicates an intensification of the winter monsoon and a cool and dry climate during the period, in good agreement with results from the clay mineral composition and homogeneous structure. The red earth sequences in south China could probably be used to test the response of tropical to subtropical regions to global climate changes. [ABSTRACT FROM AUTHOR]

Abstract: The microstructure, particle size distribution, mineral and chemical compositions of both the white net-like veins and the red matrix of the Xuancheng laterite soil section in Anhui, south China, in the middle to lower reaches of the Yangtze River, were investigated using X-ray diffraction (XRD), X-ray fluorescence spectrometry (XRF), polarized light microscopy observation, and particle size distribution analysis. There was more quartz while less clay minerals in the white veins relative to the red matrix. In particle size distribution patterns the more abundant 5–20μm particle size component of the white veins resulted from their higher quartz content. Discrepancy in degree of weathering between the white veins and the red matrix was derived from the depletion of Fe2O3 (total) and MnO2 and the relative accumulation of SiO2 in the white veins. White veins across the lithological layers and inclusions of relict red matrix material in the white veins indicated that the net-like soils originated from an initial uniform red soil. The white spots or veins were derived from the long-term modification of the pre-existing soil or concurrent weathering soils. Hydrodynamic conditions of the groundwater exerted influence on the formation of white veins. The formation process of the white net-like veins was different from that of the red matrix, suggesting that the white vein materials reflected a hydrological imprint upon the result of these conditions. The net-like soils in south China were compatible to the mottled soils in Africa, Australia, India, and Brazil. However, much more intense depletion of Fe oxide and much better developed white veins in the net-like soils of south China suggest probably even warmer and more humid palaeoclimatic conditions relative to those in Africa, Australia, India, and Brazil during the period. [ABSTRACT FROM AUTHOR]

Background: Pulmonary embolism (PE) is a life-threatening condition. Few studies have evaluated the relationship between air pollution and PE, and these results have been inconsistent. Therefore, our study aimed to investigate the association between air pollutant exposure and the risk of hospitalization due to PE., Materials and Methods: Daily PE admissions, meteorological data, and ambient pollution data from January 1, 2015, to December 31, 2018, were collected in Beijing. A quasi-Poisson regression model combined with time-stratified case-crossover design and a distributed lag nonlinear model was used to determine the effect of air pollutant exposure on PE admission. To examine the stability of air pollutants' effects, multi-pollutant analyses were performed. Stratified analyses by age and sex were further conducted., Results: There were 5060 PE admissions during the study period, with an estimated incidence of 6.5 per 100,000. PM 2.5 , PM 10 , SO 2 , O 3 and CO exposures were significantly associated with elevated risk of PE hospitalization. The highest cumulative risks were observed at a lag of 0-28 days for PM 2.5 (relative risk [RR] = 1.056, 95% confidence intervals [CI]: 1.015-1.098), PM 10 (RR = 1.042, 95%CI: 1.010-1.075), and CO (RR = 1.466, 95%CI: 1.127-1.906), at a lag of 0-27 days for SO 2 (RR = 1.674, 95%CI: 1.200-2.335), and at a lag of 0-4 days for O 3 (RR = 1.019, 95%CI: 1.001-1.038). All associations mentioned above except O 3 remained significant in multi-pollutant models. Stratified analyses showed that women and those aged ≥65 years people were more sensitive to PM 10 and CO exposure than men and those aged <65 years. The effect of PM 2.5 exposure was statistically significant in all subgroups., Conclusions: Exposure to PM 2.5 , PM 10 , SO 2 , and CO showed a positive association with PE hospitalization. High-risk PE groups should take special precautions on days with poor air quality., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Vaccines are urgently needed to control the COVID-19 pandemic. To gradually increase the vaccination rate among residents, temporary vaccination clinic for COVID-19 plays an important role. It should be located in an area with convenient transportation and concentrated population. Functional zones including waiting and inquiry, registration and notification, injection, observation and emergency room should be established. All vaccine recipients' information should be uploaded to the national immunization information system. Medical staff at the temporary vaccination clinic should be professionally trained. A cautious disinfection and wiping are essential for the temporary vaccination clinic.

After spine surgery, venous thromboembolism (VTE) is not uncommon in aged patients. This study investigates time-to-event risk factors of postoperative VTE based on medical records of aged patients (age≥60 yr) between January 2013 and December 2018. All participants had undergone lower extremity ultrasonography pre- and postoperatively at the first, second, fourth, eighth, and twelfth weeks. Mann-Whitney U tests and chi-square tests were used for univariate analyses, and Cox regression was utilized for multivariate analyses. A total of 1620 cases were recruited, VTE group (N=382, 23.6%) and non-VTE group (N=1238, 76.4%), aged 67 (IQR 11) years and 65 (IQR 6) years, respectively. The univariate analyses indicated significant differences between the VTE and non-VTE groups regarding advanced age, VTE history, hypertension, fusion, hospital stay, FIB, HDL, D-dimer, and TC (all P<0.05). The Cox regression showed that advanced age (OR=1.108; 95% CI, 1.091-1.126), VTE history (OR=4.962; 95% CI, 3.849-6.397), and hypertension (OR=1.344; 95% CI, 1.084-1.667) were the risk factors for postoperative VTE (P<0.05). The time-to-event analyses indicated that the hazard of VTE formation was highest in the first postoperative week. In conclusion, advanced age, VTE history, and hypertension are main risks for VTE formation, particularly in the first postoperative week.

Purpose: To evaluate the safety and efficacy of implantation of a capsular tension ring (CTR) and posterior chamber intraocular lens (PCIOL) after lens extraction in subluxated cataracts., Setting: Department of Ophthalmology,General Hospital of PLA, Beijing, China., Design: Prospective case series., Methods: We selected 36 eyes in 34 patients with zonular dialysis <150°. After emulsification and removal of the residual cortex, we inserted a CTR into the capsular bag to center the PCIOL. We measured preoperative and postoperative best corrected visual acuity (BCVA), centration of the CTR and IOL, and perioperative complications., Results: No capsule collapseor fluctuationof the anterior chamber occurred. Most eyes (63.89%) had nuclear sclerosis of ≥ 3+. A CTR was implanted into the capsular bag without extension of zonular dialysis. A traumatic subluxated cataract was the most common cause (20 of 36 [55.56%]). We found a subluxated cataract in 3 eyes (3 of 36 [8.33%]) with previous acute angle-closure glaucoma. Mean follow up was 20.3 ± 2.4 months. Preoperatively, only 5 eyes (13.89%) had a BCVA of ≥ 20/40, compared with 30eyes at the last visit (83.33%, P<.001). Improved BCVA was achieved in 33 eyes (91.7%) in week 1, and visual acuity remained stable up to 1 year. The CTRs with PCIOL were well centered at 1 year., Conclusion: In patients with a subluxated hard cataract <120°, CTR implantation should be performed after lens extraction without extension of zonular dialysis and capsular destabilization. Maintaining anterior chamber depth and avoiding capsular bag collapse are critical.

Aims: To estimate the cumulative incidence of postoperative endophthalmitis, identify risk factors and determine clinical outcomes in China., Methods: Medical records were reviewed for all patients with acute-onset endophthalmitis after cataract surgery from January 2006 to December 2011 at eight eye centres of tertiary care hospitals in China., Results: Sixty-six cases of presumed endophthalmitis occurred after 201 757 cataract surgeries, yielding a cumulative incidence of 0.033% (95% CI 0.025 to 0.041). Logistic regression analysis revealed that the risk of endophthalmitis increased with intraoperative communication with vitreous (multivariate OR 9.96; 95% CI 4.54 to 21.84; p<0.001). After a median follow-up of 153 days, best-corrected visual acuity in the affected eye was more than 20/70 in 29/65 (44.6%) patients, and more than 20/40 in 20/65 (30.8%). A predictor of good visual acuity was baseline acuity of counting fingers or better (OR 6.25; 95% CI 2.13 to 18.33). Of 64 cases, 25 (39.1%) were culture positive. Coagulase-negative Staphylococcus and Pseudomonas species were the most common organisms isolated, accounting for 72.0% of the culture-positive cases (18/25). Two eye centres that used a combination of a high concentration vancomycin (1 mg/0.1 mL intracameral vancomycin injection or 100 µg/mL vancomycin in irrigating solution) and tobramycin as infection prophylaxis achieved a lower incidence of endophthalmitis than other centres (p<0.001)., Conclusions: The incidence of acute postoperative endophthalmitis after cataract surgery in tertiary care hospitals of China was 0.033%. Intraoperative communication with vitreous was a major risk factor for developing endophthalmitis. Prophylactic use of a high-concentration vancomycin and tobramycin may play a positive role in the prevention of postoperative endophthalmitis after cataract surgery.

Helicobacter pylori is one of the most common bacterial infections associated with an increased risk of gastric cancer, but its association with host factors, particularly polymorphisms of the immune response genes, such as human leukocyte antigen (HLA) genes, is still unclear. To investigate the role of HLA polymorphisms in the risk of gastric cancer among subjects with H. pylori infection, a case-control study involving 52 gastric cancer patients and 139 non-cancer controls was conducted in Linqu County, China, an area with a high incidence of gastric cancer. Polymorphisms of HLA class I and class II alleles were determined by PCR with sequence-specific primers (PCR-SSP). The information about H. pylori infection was obtained from previous records. Among 48 class I and 19 class II HLA alleles detected in this study, two alleles, CW*03 and DRB1*01, were found to be distributed significantly differently between patients and controls [odds ratio(OR)=1.95, 95% confidence interval (CI)=1.13-3.35, P=0.017 and OR=4.39, 95% CI=1.39-13.84, P=0.012, respectively). The OR of gastric cancer risk in individuals carrying CW*03/CW*03 or CW*03/CW*N was 2.06, 95% CI=1.05-4.02, P=0.035, while the OR was 3.49, 95% CI=1.0-12.4, P=0.04 for DRB1*01/DRB1*01 or DRB1*01/DRB1*N carriers. The analysis of the interaction between H. pylori infection and HLA risk genotypes of CW*03 or DRB1*01 revealed that the effect of CW*03 and DRB1*01 genotypes on gastric cancer risk was manifested stronger in H. pylori-positive individuals (OR=5.30, 95% CI=1.73-16.29, P=0.004 and OR=13.38, 95% CI=2.52-70.98, P=0.002, respectively) than in H. pylori-negative ones (OR=1.25, 95% CI=0.25-6.12, P=0.785 and OR=2.26, 95% CI=0.18-28.88, P=0.531, respectively). The combined effect of the two risk HLA genotypes on gastric cancer risk was also analysed. The result showed that the individuals carrying both the CW*03 and DRB1*01 alleles could only be found in cancer patients (5/52), and not in controls (0/139), further suggesting that CW*03 and DRB1*01 are risk alleles advancing the progression of tumorigenesis. These observations demonstrate that host HLA genotypes may play an important role in the risk of gastric cancer, especially among persons with H. pylori infection.

Background and Purpose: It is still controversial whether elevated plasma homocysteine and the C677T polymorphism of methylenetetrahydrofolate reductase (MTHFR) gene are risk factors for stroke. The aim of the present study was to investigate the association between the 2 factors and stroke in Chinese in a large case-control study., Methods: We recruited 1823 stroke patients (807 cerebral thrombosis, 513 lacunar infarction, 503 intracerebral hemorrhage) and 1832 controls. Total plasma homocysteine was determined by high-performance liquid chromatography. C677T polymorphism was genotyped by polymerase chain reaction and HinfI digestion., Results: Total plasma homocysteine levels were significantly higher in cases than controls (median, 14.7 versus 12.8 micromol/L; P<0.001) and associated with an increased risk of 1.87-fold (95% confidence interval [CI], 1.58 to 2.22) for overall stroke, 1.72-fold (95% CI, 1.39 to 2.12) for cerebral thrombosis, 1.89-fold (95% CI, 1.50 to 2.40) for lacunar infarction, and 1.94-fold (95% CI, 1.48 to 2.55) for intracerebral hemorrhage. The C677T mutation of the MTHFR gene was positively correlated with plasma homocysteine levels in both controls (beta=0.250, P<0.001) and cases (beta=0.272, P<0.001) and more frequently in cases than in controls (47.0% versus 44.2%, P=0.017). The TT genotype was associated with an increased risk for overall stroke (odds ratio, 1.27; 95% CI, 1.04 to 1.56) and thrombotic stroke (odds ratio, 1.37; 95% CI, 1.06 to 1.78)., Conclusions: The C677T polymorphism of the MTHFR gene was associated with increased risk of cerebral thrombotic stroke in Chinese. Total plasma homocysteine was correlated with both ischemic and hemorrhagic stroke, suggesting potential initiation of homocysteine-lowering therapy in this population.

Background and Purpose: It is still inconclusive whether high plasma lipoprotein(a) [Lp(a)] level is a risk factor for stroke. Small sample size and different ethnic groups and methodologies might be contributors to the conflicts in study results. The purpose of the present study was to investigate the association between plasma Lp(a) levels, pentanucleotide TTTTA repeat (PNTR) polymorphism of the apolipoprotein(a) [apo(a)] gene, and Chinese stroke in a case-control study., Methods: We recruited 1825 cases with stroke (44.3% cerebral atherothrombosis, 28.3% lacunar infarction, and 27.3% intracerebral hemorrhage) and 1817 controls from 7 centers in China. Lp(a) concentrations were quantified by enzyme-linked immunosorbent assay. The PNTR polymorphism of the apo(a) gene was determined by polymerase chain reaction-polyacrylamide gel electrophoresis. Conditional multivariate logistic regression analysis was used to identify independent risk factors for stroke and its subtypes., Results: Lp(a) levels were significantly higher in cases than in controls (median, 28.5 versus 23.1 mg/dL; P<0.001), leading to a 1.97-fold (95% CI, 1.64 to 2.37) increase in risk for overall stroke, 2.0-fold (95% CI, 1.59 to 2.52) increase for atherothrombotic type, 2.05-fold increase (95% CI, 1.59 to 2.63) for lacunar type, and 1.64-fold increase (95% CI, 1.21 to 2.21) for hemorrhagic type. The number of PNTR negatively correlated with Lp(a) levels. Low-number repeats (sum of both alleles <16) of apo(a) PNTR were associated with both atherothrombotic stroke (odds ratio, 1.41; 95% CI, 1.04 to 1.91) and hemorrhagic stroke (odds ratio, 1.62; 95% CI, 1.09 to 2.37)., Conclusions: Our results indicate for the first time that low numbers of apo(a) PNTR and plasma Lp(a) levels are independently associated with both ischemic and hemorrhagic stroke in Chinese.

Objective: Investigate the distribution and characteristics of 5'pentanucleotide TTTTA repeat (PNTR) polymorphism of apolipoprotein (a) [apo (a)] gene among Chinese patients with myocardial infarction (MI) and cerebral infarction, and its relationship to plasma lipoprotein (a) [Lp (a)] level., Methods: DNA was extracted from the peripheral blood of 438 patients with myocardial infarction (MI, documented angiographically) and 218 controls, and 809 patients with cerebral infarction (documented by CT) and 1 817 controls. Plasma Lp (a) level was measured by ELISA. PNTR polymorphism of apo (a) gene was determined by polymerase chain reaction (PCR) and subsequent polyacrylamide gel electrophoresis., Results: Eight alleles and 29 genotypes in apo (a) PNTR were detected in the four groups. The frequency of (TTTTA)(4 - 7) allele in the cerebral infarction group was 7.0%, significantly higher than that in control group (5.4%, P < 0.05). The frequency of genotype (TTTTA)(5/8) in MI group was 13.2%, significantly higher than that in the control group (7.8%, P < 0.05). No significant difference was seen in other alleles and genotypes among different groups (all P > 0.05). The level of triglyceride (TG) in patients with MI was 5.13 mmol/L +/- 1.15 mmol/L, significantly higher than that in controls (4.90 mmol/L +/- 0.99 mmol/L, P < 0.05). The level of TG in patients with cerebral infarction was 1.84 mmol/L +/- 1.36 mmol/L, not significantly different from that in controls (1.83 mmol/L +/- 1.51 mmol/L). The level of total cholesterol (TC) in patients with MI was 4.85 mmol/L +/- 1.04 mmol/L, significantly lower than that in controls (4.97 mmol/L +/- 1.00 mmol/L, P < 0.001). The level of TC in patients with cerebral infarction was 1.97 +/- 1.11 mmol/L, not significantly different from that in controls (1.79 mmol/L +/- 1.23 mmol/L). A negative correlation between the number of PNTR and Lp (a) level was observed in both MI group (P < 0.001) and cerebral infarction group (P < 0.01), and not in the control group. Small fragment repeat of apo (a) PNTR was correlated with cerebral infarction (OR = 1.4, 95% CI: 1.040 approximately 1.910), not significantly with MI (P > 0.05). Multiple logistic regression analysis showed that individuals with plasma Lp (a) > 300 mg/L had higher risk of MI (OR = 2.4, 95% CI: 1.630 - 3.594), and a higher risk of cerebral infarction (OR = 1.6, 95% CI: 1.013 - 2.021) after adjustment for age, sex, SBP, DBP, BMI, smoking, TC, TG, HDL-C, LDL-C and Glu., Conclusion: Plasma Lp (a) is an independent risk factor for MI and cerebral infarction. PNTR of apo (a) gene was negatively correlated with Lp (a) levels both in MI group and cerebral infarction group. Association with PNTR genotype was only found in cerebral infarction, but not in MI.