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Purpose: By reviewing policies on higher education for international students, this article aims to investigate the change of social-historical context, policy issue, and policy solution and provide implications for policymaking. Design/Approach/Methods: The study used qualitative text analysis. One hundred and twelve policy papers were collected from the PKULAW database and the Ministry of Education official website. Deductive categories were constructed under themes like social-historical context, policy issue, and policy solution separately. Findings: Four stages have emerged from the text analysis. The policy focus witnessed a shift from openness to expansion and then to quality. The policies made by the central government changed a lot accordingly. China is increasingly active in higher education internationalization and eager to make the education for international students an attractive brand with high quality. To realize this target, policies should be made based on different types of international students. Additionally, it is necessary that policies provide detailed guidance and accelerate capacity building in all majors. Originality/Value: This study contributes to existing knowledge of higher education for international students in China by providing qualitative policy text analysis, and the insights gained from this study may be of assistance to policymaking in the future.

Hydnum (Hydnaceae, Cantharellales), one of the edible ectomycorrhizal mushrooms, is of considerable ecological and economic importance. Although previous studies have focused on the genus in China, the diversity still remains incompletely understood. In the present study, in addition to the known species from China being reviewed, six phylogenetic species from the country were described/redescribed, which included a new species: H. erectum, and five known taxa: H. cremeoalbum, H. minus, H. orientalbidum, H. tenuistipitum, and H. treui; H. treui is new to China. Detailed descriptions, color photographs of fresh basidiomata, and line drawings of microstructures of them are presented. A key to the accepted species of Hydnum in China is also provided. [ABSTRACT FROM AUTHOR]

Objectives: We sought to evaluate the ability of the novel LA strain parameters to discriminate patients with heart failure with preserved ejection fraction (HFpEF) from individuals with risk factors of HFpEF. Methods and results: A total of n = 389 patients with risk factors for HFpEF finally was prospectively enrolled into the study, 66 of them were diagnosed with HFpEF by the 2021 ESC HF guidelines. Fifty‐five patients were undergone left ventricular catheterization and simultaneous transthoracic echocardiography was performed, 35 of them with elevated left ventricular end‐diastolic pressure (LVEDP). Left atrial reservoir strain (LASr) was measured in all patients. LA filling index was defined as the ratio of mitral E and LASr and LA stiffness index was calculated as E/e′/LASr. Compared with the patients in the normal LVEDP subgroup, those in the elevated LVEDP subgroup showed significantly higher LA filling index, LA stiffness index, and LAVI/LASr. The receiver‐operating characteristic curve (ROC) analysis showed LASr (area under curve [AUC].840), LA filling index (AUC.843), LA stiffness index (AUC.766), and LAVI/LASr (AUC.755) had good diagnostic accuracy for elevated LVEDP. Inter‐technique agreement analysis showed the novel algorithms with LA strain parameters had good agreement with the invasive LVEDP measurement, better than the 2016 ASE/SCAI algorithms (kappa.711 vs..101). Furthermore, compared with patients without HFpEF, LASr was lower in HFpEF, LA filling index, LA stiffness index, and LAVI/LASr was higher in patients with HFpEF. ROC analysis showed the novel LA strain parameters with good accuracy (AUC.756 to.821) non‐inferior to conventional echocardiographic parameters could identify HFpEF, and LA stiffness index (AUC.821) was the best one. Conclusion: The novel LA strain parameters could be of potential usefulness in estimating LVEDP and incorporated into the 2016 EACVI/ASE criteria would improve the diagnostic efficiency. The novel LA strain parameters with good accuracy non‐inferior to conventional echocardiographic parameters could discriminate HFpEF from patients with risk factors of HFpEF. [ABSTRACT FROM AUTHOR]

Background: Mycoplasma genitalium (MG) causes urogenital tract infections and is associated with reproductive morbidity. Although MG has been reported across many regions and population groups, it is not yet routinely tested for in China. Our study contributes to current research by reporting the prevalence and correlates of MG infection in patients attending a sexually transmitted infection (STI) clinic in Guangdong from Jan 2017-May 2018.Methods: Urethral (from 489 men) and endo-cervical (from 189 women) samples, blood samples, and patient histories (via questionnaires) were collected. Doctors clinically diagnosed anogenital warts (GW) during the examination (n = 678). The presence of MG was evaluated using an in-house via polymerase chain reaction protocol. We also tested all participants for herpes simplex virus-2 (HSV-2), Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), syphilis and HIV. Univariate and multivariate logistic regression were used to evaluate factors associated with MG.Results: MG was detected in 7.2% (49/678) of the patients (men, 7.4%; women, 6.9%). The MG positivity rate was 14.2% among symptomatic patients, and 5.6% for asymptomatic patients, respectively. Only 36.7% (18/49) Mg positive patients were symptomatic. Among the MG-infected patients, 10.2% were co-infected with CT, 6.1% with NG, 8.2% with HSV-2, 4.1% with syphilis and 22.4% with GW. Presentation with clinical symptoms was significantly associated with MG infection [OR = 2.52 (2.03-3.13)]. In our analysis, MG was not associated with other STIs.Conclusions: MG is a relatively common infection among individuals attending an STI clinic in Guangdong Province. Routine testing of symptomatic patients may be necessary, and more epidemiological studies are needed to provide evidence for future testing guidelines. [ABSTRACT FROM AUTHOR]

Aims: To investigate practice patterns in exit‐site care and identify the risk factors for exit‐site infection. Design: A quantitative cross‐sectional design. Methods: Data were collected in 12 peritoneal dialysis (PD) centres in 2018. Daily exit‐site care practice patterns and exit‐site status of patients receiving PD were assessed through interviews and questionnaires. Results/findings: Most of the 1,204 patients adhered with the protocols about main aspects of exit‐site care, such as cleansing agents selection, frequency of cleansing, catheter fixation, and following the catheter protective measures. However, their adherence levels on hand hygiene, mask wearing, observing exit site, examining secretion, and communicating with PD staff were rather low. Eighty‐four patients' exit sites were evaluated as problematic exit site (PES). And 186 patients had catheter‐related infection (CRI) history. After multivariable logistic regression analysis, diabetes (OR = 1.631), traction bleeding history (OR = 2.697), antibiotic agents use (OR = 2.460), compliance on mask wearing (OR = 0.794), and observing exit site (OR = 0.806) were influencing factors of CRI history. Traction bleeding history (OR = 2.436), CRI history (OR = 10.280), and effective communication (OR = 0.808) with PD staff were influencing factors for PES. Conclusions: The adherence levels on different aspects of exit‐site care were varied in patients having PD. Their self‐care behaviours did correlate with the exit‐site status. Impact: The adherence level of patients' exit‐site care practice needs attention of medical staff. Further studies about the optimal procedure in exit‐site care were warranted. [ABSTRACT FROM AUTHOR]

China is transitioning from the pursuit of growth at any cost to a stage in which the costs of growth and environmental sustainability have become a consideration. Career incentives for local government officials require them to simultaneously meet stringent targets for economic growth and environmental protection, but these goals are frequently in conflict. Against this backdrop, officials differentiate environment resources into two kinds: privileged and marginal, exploiting the latter to preserve the former. This 'green self-contradiction' is generated by two trade-offs: restriction–substitution relationship at the local level and supplement–compensation relationship at the national (trans-local) level. This trade-off framework is examined through two empirical cases: (1) a provincial policy of preservation of plain farmlands along with urbanization of outskirt hills in highland cities like Kunming and Yannan, and (2) a national scheme of stabilization for underground water in the Greater Beijing Region along with exploitation of cloud water from the distant Yangtze River provinces. We argue that these trade-offs embody the Chinese government's ideological use of technology to preserve certain 'green' goals while maintaining a foundational 'developmentalist' logic, which we call 'green developmentalism'. [ABSTRACT FROM AUTHOR]

Background: Prescribing errors may, influenced by some risk factors, cause adverse drug events. Most studies in this field focus on errors in prescriptions for hospital inpatients, with only a few on those for outpatients. Our study aimed to explore the incidence of prescribing errors in electronic prescriptions and illustrate the trend of prescribing workload and error rate over time.Methods: The cross-section study was performed between September, 2015 and November, 2015. Prescribing errors were intercepted by pharmacists using a prescription reviewing system under which prescriptions with errors were transferred to a specific computer and recorded by another pharmacist and the incidence of total prescribing errors and severe errors was then calculated. A subgroup analysis was conducted in accordance to the number of drug orders, the age group of patients, the seniority of physicians, the specialty of physicians, the working day when prescriptions were issued, and the prescribing workload of physicians. A time-series analysis was employed to analyze the trend of prescribing workload and error rate, and the correlation between them.Results: Totally, 65,407 patients were included in this study and 150,611 prescriptions with 294,564 drug orders (including 584 different drugs) were reviewed for identification of errors. A total of 534 prescribing errors (an error rate of 0.34%) were identified. Severe errors accounted for 13.62% of total errors. The subgroup analysis showed prescriptions of multiple drug orders, for pediatric patients aged 29 days to 12 years, from physicians specializing in ophthalmology and otorhinolaryngology, or prescribing on weekdays were more susceptible to errors. A time-series analysis demonstrated no correlation between prescribing workload and error rate which increased at the end of each working shift while prescribing workload decreased.Conclusion: Less than 1% of the studied prescriptions came with errors among which one in seven were severe ones. But prescribing errors were in no relation to workloads. What's more, further studies are needed to investigate pharmacist-led intervention to reduce prescribing errors. [ABSTRACT FROM AUTHOR]

Particulate matter pollution has become a widely-concerned issue in public health and led to a substantial loss of health. The study reports relationship between particulate matter with aerodynamic diameter <2.5 µm (PM2.5) and years of life lost (YLL) in Guangzhou. A retrospective burden analysis on annual mean PM2.5 data was conducted. Data on annual mortality were collected for 2009, from the Health Department of Guangzhou. Data on particulate matter were collected for period 2006–2009. Comparative risk assessment and exposure-response function were used to estimate attributable YLL. The exposure to PM2.5 was associated with a total of 454.6 YLLs (95% uncertainty interval 449.0–460.1) per 100,000 people in 2009. This study has confirmed the substantial adverse health effects of PM2.5 exposure in population with cardio-cerebrovascular disease and lung cancer. This study highlights the need to reduce ambient particulate pollution for better environmental health and lower burden of disease. [ABSTRACT FROM AUTHOR]

The high concentration of fluoride (F) in soils has become a rising concern for its toxicity to microbes, plants, animals and human health. In the present study, the spatial and vertical distribution, health risk assessment and anthropogenic sources of F in farmland soils in an industrial area dominated by phosphate chemical plants were studied. Concentrations of total fluoride (TF) and water soluble fluoride (WSF) in the surface soils decreased with distance within the range of 2500 m at the prevailing downwind of the industrial area. The soil TF and WSF concentrations in 0–40 cm profiles were higher than those in 40–100 cm layers in the industrial area. At the prevailing downwind of the industrial area within 700 m, the hazard quotient values of human exposure to surface soils were higher than 1, indicating that a potential risk may exist for human health in this area. The main exposure pathway for children and adults was oral ingestion and particulate inhalation, respectively. The source apportionment model of soil F was modified based on years' historical data and experimental data. The results showed that the proportion of anthropogenic sources of soil F was dustfalls (69%) > irrigation water (23%) > air (5%) > chemical fertilizers (3%) in the industrial area. The high F concentration of dustfalls was mainly due to the phosphate rock, phosphogypsum, and surface soils with high F contents from the factories. In order to safeguard human health and alleviate hazards of F to surroundings, the control of pollutants emission from factories was a basic and vital step to reduce F in the soils in industrial areas. Image 1 • Soil F concentration decreased with the distance from factories within 2500 m. • Soil F concentration decreased with depth of soil within 0–100 cm. • Potential risk may exist for human health in area within 700 m from factories. • Main exposure route of children and adults was ingestion and inhalation, respectively. • Dustfall was the main anthropogenic sources of soil F in industrial area. The modified source apportionment model of F in soils based on historical and experimental data showed that dustfall was the most important anthropogenic source of soil F in phosphate plant areas. [ABSTRACT FROM AUTHOR]

Abstract Background Daily exposure to ambient particulate matter with aerodynamic diameter <2.5 μ m (PM 2.5) increases deaths and is an important contributor to burden of disease in population. To better understand the disease burden associated with PM 2.5 , we examined the effects of PM 2.5 on daily years of life lost (YLL) in Guangzhou, China. Methods Using Guangzhou death registry, air pollution and meteorological database, we applied generalized additive models (GAM) to the relationships between YLL and PM 2.5. We then adjusted the models for age, gender, seasonality and meteorological variables. We also conducted within-data prediction of YLL while setting 2012–2014 as baseline. Results Over 2 million YLLs (800,137 YLLs for females and 1,212,040 YLLs for males) were observed during 2012–2016. YLL was higher for the elderly people. Mean daily average PM 2.5 concentration was 47.3 μ g / m 3 . In model comparisons, the GAM with six meteorological variables (sunshine hours, relative humidity, precipitation, atmospheric pressure, wind speed, evaporation) outperformed the others. The R2 and total deviance were 0.542 and 53.0%, respectively. Non-linear trends were observed for PM 2.5 and meteorological variables. Fitted daily YLL increased to the highest level, when PM 2.5 concentration reached 134.3 μ g / m 3 and atmospheric pressure reached 99.4 kPa. Within-data prediction supported the fitted GAM, where low mean absolute percentage errors were observed. Conclusions Daily PM 2.5 exposure has a nonlinear effect on YLL and increased levels of PM 2.5 may lead to increased YLL. This study highlights the urge to reduce ambient PM 2.5 pollution in Guangzhou, in order to promote environmental health. Highlights • We verified and quantified the link between multiple environmental factors and YLL. • The generalized additive model was used to bind the environmental factors with YLL. • PM 2.5 is an unneglectable environmental factor for disease burden in population. [ABSTRACT FROM AUTHOR]

Objective To estimate the lung cancer burden that may be attributable to ambient fine particulate matter (PM2.5) pollution in Guangzhou city in China from 2005 to 2013. Methods The data regarding PM2.5 exposure were obtained from the ‘Ambient air pollution exposure estimation for the Global Burden of Disease 2013’ dataset at 0.1 ° ×0.1 ° spatial resolution. Disability-adjusted life years (DALYs) were estimated based on the information of mortality and incidence of lung cancer. Comparative risk analysis and integrated exposure-response function were used to estimate attributed disease burden. Results The population-weighted average concentration of PM2.5 was increased by 34.6% between 1990 and 2013, from 38.37 μg/m 3 to 51.31 μg/m 3 . The lung cancer DALYs in both men and women were increased by 36.2% from 2005 to 2013. The PM2.5 attributed lung cancer DALYs increased from 12105.0 (8181.0 for males and 3924.0 for females) in 2005 to 16489.3 (11291.7 for males and 5197.6 for females) in 2013. An average of 23.1% lung cancer burden was attributable to PM2.5 pollution in 2013. Conclusion PM2.5 has caused serious but under-appreciated public health burden in Guangzhou and the trend deteriorates. Effective strategies are needed to tackle this major public health problem. [ABSTRACT FROM AUTHOR]

This paper uses the 2011 China Household Finance Survey data to estimate the effect of changes in housing value on homeowners’ labor force participation. Using the average housing capital gains of other homes in the same community as an instrument for the housing capital gains of a given household, we find that a 100,000 yuan increase in housing value leads to a 1.37 percentage point decrease in female homeowners’ probability of participating in the labor force and a 1.49 percentage point increase in their probability of becoming housewives. We find little effect on men's labor force participation. [ABSTRACT FROM AUTHOR]

Background: In China, most people tend to use hospitals rather than health centers for their primary care generally due to the perception that quality of care provided in the hospital setting is superior to that provided at the health centers. No studies have been conducted in China to compare the quality of primary care provided at different health care settings. The purpose of this study is to compare the quality of primary care provided in different types of health care facilities in China.Methods: A cross-sectional survey with patients was conducted in Guangdong province of China, using the validated Chinese Primary Care Assessment Tool (PCAT). ANOVA was performed to compare the overall and 10 domains of primary care quality for patients in tertiary, secondary, and primary health care settings. Multivariate analyses were used to assess the association between types of facility and quality of primary care attributes while controlling for sociodemographic and health care characteristics.Results: The final number of respondents was 864 including 161 from county hospitals, 190 from rural community health centers (CHCs), 164 from tertiary hospitals, 80 from secondary hospitals, and 269 from urban CHCs. Type of health care facilities was significantly associated with total PCAT score and domain scores. CHC was associated with higher total PCAT score and scores for first contact-access, ongoing care, comprehensiveness-services available, and community orientation than secondary and/or tertiary hospitals, after controlling for patients' demographic and health characteristics. Higher PCAT score was associated with greater satisfaction with primary care received. CHC patients were more likely to report satisfactory experiences compared to patients from secondary and tertiary facilities.Conclusions: The study demonstrated that CHCs provided better quality primary care when compared with secondary and tertiary health care facilities, justifying CHCs as a model of primary care delivery. [ABSTRACT FROM AUTHOR]

A recently isolated Fusarium population from maize in Belgium was identified as a new species, Fusarium temperatum. From a survey of Fusarium species associated with maize ear rot in nineteen provinces in 2009 in China, ten strains isolated from Guizhou and Hubei provinces were identified as F. temperatum. Morphological and molecular phylogenetic analyses based on the DNA sequences of individual translation elongation factor 1-alpha and β-tubulin genes revealed that the recovered isolates produced macroconidia typical of four-septate with a foot-shaped basal cell and belonged to F. temperatum that is distinctly different from its most closely related species F. subglutinans and others within Gibberella fujikuroi complex species from maize. All the strains from this newly isolated species were able to infect maize and wheat in field, with higher pathogenicity on maize. Mycotoxin determination of maize grains infected by the strains under natural field condition by ultra-high-performance liquid chromatography-tandem mass spectrometry and gas chromatography-mass spectrometry analyses showed that among fifteen mycotoxins assayed, two mycotoxins fumonisin B1 and B2 ranging from 9.26 to 166.89 μg/g were detected, with massively more FB2 mycotoxin (2.8- to 108.8-fold) than FB1. This mycotoxin production profile is different from that of the Belgian population in which only fumonisin B1 was barely detected in one of eleven strains assayed. Comparative analyses of the F. temperatum and F. subglutinans strains showed that the highest fumonisin producers were present among the F. temperatum population, which were also the most pathogenic to maize. These results suggested a need for proper monitoring and controlling this species in the relevant maize-growing regions. [ABSTRACT FROM AUTHOR]

Fusarium graminearum clade species are among the main causative agents of Gibberella ear rot (GER) in maize and responsible for the various trichothecene mycotoxins accumulated in contaminated maize grains. In this study, a total of 620 isolates from diseased maize ears collected from 59 districts in 19 provinces throughout China, previously identified morphologically as Fusarium graminearum clade, was genetically characterized at the species level based on SCAR (Sequence Characterized Amplified Region) and for their potential capability of mycotoxin production using the genetic chemotyping assay. The results showed that 359 isolates were F. asiaticum (SCAR 5), which consisted of 97% nivalenol (NIV)-chemotypes, 0.8% 3-acetyldeoxynivalenol (3-ADON)-producing isolates and 2.2% 15-acetyldeoxynivalenol (15-ADON) producers, whereas the remaining 261 isolates were identified as F. graminearum sensu stricto (SCAR 1), all of which produced 15-ADON mycotoxins. This high proportion of NIV producers present in F. asiaticum is different from the chemotype patterns in F. asiaticum populations isolated from wheat and barley, where DON and its acetylated chemotypes were the predominant mycotoxins. Moreover, the majority of NIV producers (59.1%) and all the 3-ADON-producing strains were derived from the warmer regions in southern China, whereas most of the 15-ADON-producing strains (78.4%) were isolated from the colder regions in northern China. Our study is the first report of NIV chemotypes of F. asiaticum and 15-ADON chemotypes of F. graminearum sensu stricto that were associated with the GER of maize in China. [ABSTRACT FROM AUTHOR]

Abstract: Based on the intergenic sequences of Tri5–Tri6 genes involved in the mycotoxin pathways of Fusarium species, a generic PCR assay was developed to detect a 300bp fragment of deoxynivalenol (DON)-chemotypes and a 360bp sequence of nivalenol (NIV)- chemotypes of Fusarium graminearum. Mycotoxin chemotypes identified by the PCR assays were confirmed by the chemical analyses of HPLC or GC/MS. Further analysis of 364 F. graminearum isolates from 12 provinces of China showed that 310 were DON-chemotypes and 54 were NIV-chemotypes. Sequence analyses revealed that DON-chemotypes display more variations than NIV-chemotypes. This PCR assay could be used to detect mycotoxin-producing Fusarium-species and may thus help to develop strategies to avoid or reduce mycotoxin contamination of cereals. Also this assay may provide useful alternatives to antibody-based mycotoxin tests. [Copyright &y& Elsevier]

Background: There is no consensus on the ventilation management during cardiopulmonary bypass (CPB), and the anesthesiologists or the surgeons usually ventilate the lungs with different ventilation strategies or keep them static. Better outcomes are more likely to occur when the ventilation is administered during CPB according to the existing literatures. However, the use of high fraction of inspired oxygen (FiO2) is debatable in cardiac surgery. And the potential effects of strategies combining low tidal volume (VT) ventilation with different FiO2 during CPB on postoperative pulmonary complications (PPCs) are unclear.Design: The VONTCPB trial is a single-center, prospective, double-blinded, randomized, controlled trial. We are going to recruit total 420 elective cardiac surgery patients with median sternotomy under CPB, who will be equally randomized into three different ventilation strategy groups: NoV, LOV and HOV. (1) The NoV group receives no mechanical ventilation during CPB; (2) the LOV group receives a low VT of 3-4 ml/kg of ideal body weight (IBW) with the respiratory rate (RR) of 10-12 acts/min, and the positive end-expiratory pressure (PEEP) of 5-8 cmH2O during CPB; the FiO2 is 30%; (3) the HOV group receives a low VT of 3-4 ml/kg of IBW with the RR of 10-12 acts/min, and the PEEP of 5-8 cmH2O during CPB; the FiO2 is 80%. The primary endpoints are the incidence of the composite of PPCs and the PPCs score. The secondary endpoints refer to the incidence of the oxygenation index (PaO2/FiO2 ratio) < 300 mmHg at three time points (the moment arriving in the ICU, 6 and 12 h after arrival in the ICU), the surgical incision healing grade, the intubation time, the stay of ICU, the length of hospital stay, and mortality at 30 days after the surgery.Discussion: The VONTCPB trial is the first study to assess the effects of strategies combining low tidal volume (VT) ventilation with different FiO2 during CPB on patients' outcomes.Trial Registration: ChiCTR1800015261 . Registered on 20 March 2018. [ABSTRACT FROM AUTHOR]

Imbalance of oxidative stress has been detected in a range of fibrotic diseases. Melatonin as an indoleamine hormone plays an important role in regulating the circadian rhythm of human, while in recent years, its antioxidant effect has also attracted increasing attention. This study aimed to perform a systematic review and meta-analysis to comprehensively evaluate the antioxidant effect of melatonin in animal models of fibrosis. The PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang database, China Science and Technology Journal Database (VIP), and SinoMed databases were searched from inception to March 1st, 2022 to retrieve eligible studies that evaluated the effect of melatonin supplementation on the levels of malondialdehyde (MDA), lipid peroxidation (LPO), nitric oxide (NO), superoxide dismutase (SOD), glutathione (GSH), glutathione peroxidase (GPx), and catalase (CAT) in animal models of fibrosis. A total of 64 studies were included in this meta-analysis. The results showed that melatonin supplementation significantly reduced the levels of oxidative indicators including MDA (P < 0.00001), LPO (P < 0.00001) and NO (P < 0.0001), and elevated the levels of antioxidant indicators including GSH (P < 0.00001), GPx (P < 0.00001) and SOD (P < 0.00001) in fibrotic diseases. Our research findings showed that melatonin supplementation could significantly reduce the levels of oxidative indicators including MDA, LPO and NO and elevate the levels of antioxidant indicators including GSH, GPx and SOD so as to correct oxidative stress in animal models of fibrosis. However, no significant changes were observed in CAT level. More clinical studies are needed to further confirm the beneficial role of melatonin in fibrotic diseases. [Display omitted] • The anti-oxidative stress effect of melatonin in animal models of fibrosis was assessed for the first time. • Melatonin has an improving effect on oxidative stress indicators in fibrotic diseases. • Melatonin can reduce the fibrosis levels in most organs. [ABSTRACT FROM AUTHOR]

Background: Syphilis has continuously posed a great challenge to China. However, very little data existed regarding the cost of syphilis. Taking Guangdong Initiative for Comprehensive Control of Syphilis area as the research site, we aimed to comprehensively measure the annual economic burden of syphilis from a societal perspective.Methods: Newly diagnosed and follow-up outpatient cases were investigated by questionnaire. Reported tertiary syphilis cases and medical institutions cost were both collected. The direct economic burden was measured by the bottom-up approach, the productivity cost by the human capital method, and the intangible burden by the contingency valuation method.Results: Three hundred five valid early syphilis cases and 13 valid tertiary syphilis cases were collected in the investigation to estimate the personal average cost. The total economic burden of syphilis was US $729,096.85 in Guangdong Initiative for Comprehensive Control of Syphilis sites in the year of 2014, with medical institutions cost accounting for 73.23% of the total. Household average direct cost of early syphilis was US $23.74. Average hospitalization cost of tertiary syphilis was US $2,749.93. Of the cost to medical institutions, screening and testing comprised the largest proportion (26%), followed by intervention and case management (22%) and operational cost (21%). Household average productivity cost of early syphilis was US $61.19. Household intangible cost of syphilis was US $15,810.54.Conclusions: Syphilis caused a substantial economic burden on patients, their families, and society in Guangdong. Household productivity and intangible costs both shared positive relationships with local economic levels. Strengthening the prevention and effective treatment of early syphilis could greatly help to lower the economic burden of syphilis. [ABSTRACT FROM AUTHOR]

Phytoplankton communities are crucial components of aquatic ecosystems, and since they are highly interactive, they always form complex networks. Yet, our understanding of how interactive phytoplankton networks vary through time under changing environmental conditions is limited. Using a 29-year (339 months) long-term dataset on Lake Taihu, China, we constructed a temporal network comprising monthly sub-networks using "extended Local Similarity Analysis" and assessed how eutrophication, climate change, and restoration efforts influenced the temporal dynamics of network complexity and stability. The network architecture of phytoplankton showed strong dynamic changes with varying environments. Our results revealed cascading effects of eutrophication and climate change on phytoplankton network stability via changes in network complexity. The network stability of phytoplankton increased with average degree, modularity, and nestedness and decreased with connectance. Eutrophication (increasing nitrogen) stabilized the phytoplankton network, mainly by increasing its average degree, while climate change, i.e., warming and decreasing wind speed enhanced its stability by increasing the cohesion of phytoplankton communities directly and by decreasing the connectance of network indirectly. A remarkable shift and a major decrease in the temporal dynamics of phytoplankton network complexity (average degree, nestedness) and stability (robustness, persistence) were detected after 2007 when numerous eutrophication mitigation efforts (not all successful) were implemented, leading to simplified phytoplankton networks and reduced stability. Our findings provide new insights into the organization of phytoplankton networks under eutrophication (or re-oligotrophication) and climate change in subtropical shallow lakes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Radioactive nuclides cesium (Cs) and strontium (Sr) possess long half-lives, with 135 Cs at approximately 2.3 million years and 87 Sr at about 49 billion years. Their persistent accumulation can result in long-lasting radioactive contamination of soil ecosystems. This study employed geo-accumulation index (I geo ), pollution load index (PLI), potential ecological risk index (PEPI), health risk assessment model (HRA), and Monte Carlo simulation to evaluate the pollution and health risks of Cs and Sr in the surface soil of different functional areas in a typical mining city in China. Positive matrix factorization (PMF) model was used to elucidate the potential sources of Cs and Sr and the respective contribution rates of natural and anthropogenic sources. The findings indicate that soils in the mining area exhibited significantly higher levels of Cs and Sr pollution compared to smelting factory area, agricultural area, and urban residential area. Strontium did not pose a potential ecological risk in any studied functional area. The non-carcinogenic health risk of Sr to the human body in the study area was relatively low. Because of the lack of parameters for Cs, the potential ecological and human health risks of Cs was not calculated. The primary source of Cs in the soil was identified as the parent material from which the soil developed, while Sr mainly originated from associated contamination caused by mining activities. This research provides data for the control of Cs and Sr pollution in the surface soil of mining city., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Mosquito transmitted viruses are responsible for an increasing burden of human disease. Despite this, little is known about the diversity and ecology of viruses within individual mosquito hosts. Here, using a meta-transcriptomic approach, we determined the viromes of 2,438 individual mosquitoes (81 species), spanning ~4,000 km along latitudes and longitudes in China. From these data we identified 393 viral species associated with mosquitoes, including 7 (putative) species of arthropod-borne viruses (that is, arboviruses). We identified potential mosquito species and geographic hotspots of viral diversity and arbovirus occurrence, and demonstrated that the composition of individual mosquito viromes was strongly associated with host phylogeny. Our data revealed a large number of viruses shared among mosquito species or genera, enhancing our understanding of the host specificity of insect-associated viruses. We also detected multiple virus species that were widespread throughout the country, perhaps reflecting long-distance mosquito dispersal. Together, these results greatly expand the known mosquito virome, linked viral diversity at the scale of individual insects to that at a country-wide scale, and offered unique insights into the biogeography and diversity of viruses in insect vectors., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Soil matrix infiltration is an important pathway for plantations to obtain water, which affects ecological benefits and water conservation function of plantations. The changes of soil matrix infiltration and its influencing factors in different growth stages of Chinese fir plantations remain unclear. We measured soil matrix infiltration process using a tension infiltrometer in Chinese fir plantations (5, 8, 11, and 15 years old) of Beijiang River Forest Farm in Rongshui, Guangxi, and analyzed soil basic physicochemical properties to identify the dominant factors influencing soil matrix infiltration. The results showed that initial infiltration rate, stable infiltration rate, and cumulative infiltration increased with stand ages. The ranges of different stand ages were 141-180 mm·h -1 , 109-150 mm·h -1 , and 188-251 mm, respectively. The initial infiltration rate, stable infiltration rate, and cumulative infiltration were significantly positively correlated with soil capillary porosity, soil organic matter, soil water stable macroaggregate, sand content, and clay content, while negatively correlated with soil bulk density and silt content. Early thinning had a positive effect on soil matrix infiltration, but thinning measures after 11 years did not enhance soil matrix infiltration further. Philip model was optimal for describing soil matrix infiltration process in this region. In conclusion, soil matrix infiltration capacity of Chinese fir plantations gradually increased from young to middle-aged stands, but matrix infiltration capacity tended to stabilize after 11 years old. Silt content and water stable macroaggregate were the dominant factors influencing matrix infiltration.

Objective: To explore the possible interaction between overweight/obesity and dyslipidemia and to provide some evidence for the interaction of the risk of hypertension with overweight/obesity and dyslipidemia., Methods: By using multi-stage stratified cluster random sampling method, the subjects of the study were randomly selected from Naqu city, Shannan city, and Ali prefecture, Tibet. A total of 4047 Tibetans with complete data were included. Investigators obtained relevant information on the subjects through questionnaire surveys, measured their height, body mass index, and blood pressure, and collected fasting venous blood samples. The multivariate logistic regression model was used to analyze the independent effects of overweight/obesity and dyslipidemia and hypertension. Stratified analysis and an additive interaction model were used to evaluate the effect of two-factor interaction on the risk of hypertension., Results: The overall prevalence of hypertension, overweight/obesity, and dyslipidemia among Tibetans living in Tibet was 29.3%, 46.2%, and 40.9%, respectively. Overweight/obesity (odds ratio [ OR ]=2.151) and dyslipidemia ( OR =1.240) were risk factors of hypertension. Evaluation results of the effect of additive interaction showed significant additive interaction of overweight/obesity and dyslipidemia on hypertension ( P =0.028), with the synergy index ( SI ) being 1.318., Conclusion: Overweight/obesity and dyslipidemia are risk factors for having hypertension and there is an additive interaction between dyslipidemia and overweight/obesity., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: Suicidal ideation is an important public health challenge among people living with HIV (PLWH) across the world and in China. HIV stigma, depression, and self-esteem have been associated with suicidal ideation. However, the underlying mechanisms remain not fully understood., Methods: Study data were derived from a sample of 465 PLWH in China. Suicidal ideation after HIV diagnosis was used as outcome variable. HIV stigma, depressive symptoms, and self-esteem were measured using reliable instruments and used as predictor, mediator, and moderator, respectively. Mediation and moderated mediation model were used for data analysis., Results: 31.6% of PLWH in China had suicidal ideation after HIV diagnosis. The association between perceived HIV stigma and suicidal ideation was partially mediated by depression (indirect effect = 0.02, 95% CI = [0.02, 0.03]) with the path from perceived HIV stigma to depressive symptoms being moderated by self-esteem (interaction effect =  - 0.02, 95% CI [- 0.03, - 0.01])., Conclusions: Study findings suggested a mediation mechanism of HIV stigma on suicidal ideation through depressive symptoms, and self-esteem might weaken the mediation mechanism by moderating the perceived HIV stigma-depressive symptoms pathway., (© 2022. W. Montague Cobb-NMA Health Institute.)

In this paper, the data of A-share non-financial listed companies from 2008 to 2019 are used to study the impact of the opening of high-speed railway on corporate financing constraints with the difference-in-differences model. The research results show that the opening of high-speed rail can effectively alleviate the financing constraints faced by enterprises. Through the analysis of its influence mechanism, it is found that the opening of high-speed rail can reduce the degree of information asymmetry and agency conflicts between enterprises and their stakeholders, and thereby ease corporate financing constraints. At the same time, the opening of the high-speed rail has a more significant effect on alleviating the financing constraints of non-state-controlled enterprises, technology-intensive enterprises, and enterprises in inland areas. This research is not only a supplement to the economic consequences related to the opening of the high-speed rail, but also a further expansion of the research on the factors affecting corporate financing constraints., Competing Interests: The authors have declared that no competing interests exist.

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are prevalent among men who have sex with men (MSM) in China. However, compared to syphilis and HIV, the testing rate for chlamydia and gonorrhea remains low. The purpose of this pilot study was to evaluate the feasibility for conducting rapid nucleic acid test for chlamydia and gonorrhea in MSM community-based organizations (CBO)., Method: We recruited our participants through an MSM CBO where free HV and syphilis testing were routinely provided. We collected data including social-demographic background, sexual history, chlamydia and gonorrhea testing history, and reasons for accepting this on-site rapid testing. Urine and/or anorectal swab samples were collected and tested for chlamydia and gonorrhea on-site and the testing results were delivered in about 1.5 h. Positive cases received on-site free treatment., Results: From August 2020 to October 2020, 634 MSM visited the CBO for syphilis and HIV testing and 158 (158/634, 24.9%) accepted the on-site chlamydia and gonorrhea rapid test, 135 were finally enrolled. The positive rate fo chlamydia was 16.3% (22/135) and 3.0% (4/135) for gonorrhea, respectively. Only 19.3% participants had previously undergone chlamydia and gonorrhea testing and 68.9% (93/135) participants reported that they had heard of gonorrhea, 47.4% (64/135) had heard of chlamydia. The main reason for testing was "free for charge" (66.2%), followed by "convenient, 'shorter waiting time" (45.2%) and "had high-risk sexual behavior recently" (16.3%)., Conclusions: This pilot study showed that the chlamydia and gonorrhea infection rate remains high among MSM, while the testing rate was low. On-site rapid testing is feasible and potentially preferred by MSM., (© 2022. The Author(s).)

Assessing the bacteria pathogens in the lakes with reclaimed water as major influents are important for public health. This study investigated microbial communities of five landscape lakes replenished by reclaimed water, then analyzed driven factors and identified health effects of bacterial pathogens. 16S rRNA gene sequence analysis demonstrated that Proteobacteria , Actinobacteria , Cyanobacteria , Firmicutes, and Verrucomicrobia were the most dominant phyla in five landscape lakes. The microbial community diversities were higher in June and July than that in other months. Temperature, total nitrogen and phosphorus were the main drivers of the dominant microbial from the Redundancy analysis (RDA) results. Various potential bacterial pathogens were identified, including Pseudomonas , GKS98&#95;freshwater&#95;group , Sporosarcina , Pseudochrobactrum , Streptomyces and Bacillus , etc, some of which are easily infectious to human. The microbial network analysis showed that some potential pathogens were nodes that had significant health effects. The work provides a basis for understanding the microbial community dynamics and safety issues for health effects in landscape lakes replenished by reclaimed water.

China's basic education and higher education are currently facing policies aimed at reducing and increasing the academic burden, respectively. In this context, we first review and assess the methods of measuring students' academic burden and then apply the implicit association test for the first time to the academic burden of Chinese students from primary school to university under a unified framework. The results demonstrates that students' academic burden increases with the school stage, and thus university students face a greater burden than primary and high school students, and that learning attitude fully mediates the relationship between objective and subjective views of academic burden. These results suggest the three policy approaches of implementing a management system for classifying academic burden, considering how to improve students' learning quality, and developing their mental health education, thus providing a reference and inspiration for research and practice in the field of academic burden.

Background: Cancer is an important focus of public health worldwide. This study aims to provide a comprehensive overview of temporal trends in incidence and mortality of leading cancer in Guangzhou, China from 2004 to 2015., Methods: Data were collected from the population-based registry in Guangzhou. Age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) were calculated and Joinpoint regression was used for evaluating the average annual percent changes (AAPC) among the entire study period and the estimated annual percent changes (EAPC) in time segments. The effects of age, period, and birth cohort were assessed by the age-period-cohort model., Results: The age-standardized incidence and mortality by the world standard population decreased significantly among males with AAPC of -1.7% (95% CI: -3.0%, 0.2%) and -2.7% (95% CI: -4.3%, -1.1%) for all malignancies during 2004-2015, while among females, the age-standardized incidence had a non-significant reduction with AAPC of -1.3% (95% CI: -2.8%, 0.2%) and the age-standardized mortality demonstrated a remarkable decline (AAPC -2.0%, 95% CI: -3.6%, -0.3%). For males, the most commonly diagnosed cancers were trachea, bronchus, and lung (TBL), liver, colorectal, nasopharyngeal, stomach, and prostate cancer. For females, breast, TBL, colorectal, liver stomach, and thyroid cancer ranked the top. Unfavorable trends were observed in ASIR of colorectal, thyroid, and prostate cancer. APC models yielded different ages, periods, and birth cohort effect patterns by cancer sites., Conclusions: Cancer burden remained a public health challenge in Guangzhou as the aging population and lifestyles changes, despite declines in incidence and mortality rates in some cancers. Surveillance of cancer trends contributed to valuable insights into cancer prevention and control., (© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Objectives: The moving epidemic method (MEM) has been well used for assessing seasonal influenza epidemics in temperate regions. This study used the MEM to establish epidemic threshold for influenza in Guangdong, a subtropical province in China., Methods: Influenza virology surveillance data from 2011/2012 to 2017/2018 seasons in Guangdong were used with the MEM to calculate the epidemic thresholds and timeously detect the 2018/2019 influenza season epidemic. The weekly positive proportion of influenza A(H1N1)pdm09, A(H3N2), B/Victoria-lineage and B/Yamagata-lineage were separately adapted to calculate the subtype-specific epidemic thresholds. The performance of MEM was evaluated using a cross-validation procedure., Results: For the 2018/2019 influenza season, the epidemic threshold of a weekly positive proportion was 15.08%. Epidemic detection for the 2018/2019 season was 1 week in advance. Influenza A(H1N1)pdm09, B/Yamagata-lineage and B/Victoria-lineage prevailed during winter and spring and their epidemic thresholds were 5.12%, 4.53% and 4.38%, respectively. Influenza A(H3N2) was active in the summer, with an epidemic threshold of 11.99%., Conclusions: Using influenza virology surveillance data stratified by types of influenza virus, the MEM was effectively used in Guangdong, China. This study provided a practical way for subtropical regions to establish local influenza epidemic thresholds., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic. We investigated the clinical characteristics and risk factors for liver injury in COVID-19 patients in Wuhan by retrospectively analyzing the epidemiological, clinical, and laboratory data for 218 COVID-19 patients and identifying the risk factors for liver injury by multivariate analysis., Aim: To investigate the clinical characteristics and risk factors for liver injury in COVID-19 patients in Wuhan., Methods: The 218 patients included 94 males (43.1%), aged 22 to 94 (50.1 ± 18.4) years. Elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were present in 42 (53.2%) and 36 (45.6%) cases, respectively, and 79 (36.2%) patients had abnormally elevated transaminase levels at admission. Patients with liver injury were older than those with normal liver function by a median of 12 years, with a significantly higher frequency of males (68.4% vs 28.8%, P < 0.001) and more coexisting illnesses (48.1% vs 27.3%, P = 0.002). Significantly more patients had fever and shortness of breath (87.3% vs 69.8% and 29.1% vs 14.4%, respectively) in the liver injury group. Only 12 (15.2%) patients had elevated total bilirubin. ALT and AST levels were mildly elevated [1-3 × upper limit of normal (ULN)] in 86.1% and 92.9% of cases, respectively. Only two (2.5%) patients had an ALT or AST level > 5 × ULN. Elevated γ-glutamyl transpeptidase was present in 45 (57.0%) patients, and 86.7% of these had a γ-glutamyl-transpeptidase level < 135 U/L (3 × ULN). Serum alkaline phosphatase levels were almost normal in all patients. Patients with severe liver injury had a significantly higher frequency of abnormal transaminases than non-severe patients, but only one case had very high levels of aminotransferases., Results: Multivariate analysis revealed that male sex, high D-dimer level, and high neutrophil percentage were linked to a higher risk of liver injury. The early stage of COVID-19 may be associated with mildly elevated aminotransferase levels in patients in Wuhan. Male sex and high D-dimer level and neutrophil percentage may be important predictors of liver injury in patients with COVID-19., Conclusion: Male sex and high D-dimer level and neutrophil percentage may be important predictors of liver injury in patients with COVID-19., Competing Interests: Conflict-of-interest statement: We have no financial relationships to disclose., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

The industrial and agricultural activities based on phosphorous can increase the F content in the surrounding area, causing a widespread adverse effect on the organisms. However, the current information on the superposed health risk posed by the multi-exposure to the F contamination in an area jointly affected by agricultural and industrial activities (DA) is limited. Herein, the F distribution in multi-environmental media and the exposure risk to humans by ingestion, inhalation, and dermal contact pathways are studied in an DA. The content of soil water-soluble fluorine (WF) was higher in the DA than in the area individually affected by agricultural activities (SA). This indicated a superposed contribution of the industrial and agricultural activities to increase the F toxicity in the soil. The correlation of the soil pH and the organic matter content with the soil WF concentration in DA suggested an inter-relationship between the soil physicochemical properties and the toxicity of F in the soil by industrial and agricultural activities. Irrigation water was not a major anthropogenic source of the cropland soil F. The large variation in F concentration in the crops (101.8-195.6%) might have originated from the discrepancies in the soil F content and air F concentration. The air F pollution (0.6-1.6 μg dm -2  d -1 ) in the area particularly influenced by intensive industrial activities should be important. The exposure of residents to F was mainly from the ingestion of F-enriched crops. The higher exposure of adults to F than that of children could be attributed to more industrial and agricultural outdoor activities, larger exposure area of the skin, and more daily ingestion of F-enriched food by adults. Overall, present insights into the distribution of and the multi-exposure to F may be beneficial for decreasing the adverse F effects on the residents in DAs worldwide., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Kidney transplantation (KT) correlates with an increased risk of developing several malignancies; however, the risk of colorectal cancer (CRC) after KT remains debatable and has been marginally explored. Hence, in this nationwide, retrospective, population-based cohort study, we aimed to examine the correlation between KT and CRC in a large-scale population-based Chinese cohort., Methods: We identified a total of 3739 regular hemodialysis patients undergoing KT (exposed cohort) and 42,324 hemodialysis patients not undergoing KT (non-exposed cohort) between 2000 and 2008 from Taiwan's National Health Insurance Research Database (NHIRD). Both cohorts were followed up from January 1, 2000, to the date of CRC diagnosis, death, or the end of 2013. Using Kaplan-Meier method, we measured the cumulative incidence of CRC in each cohort. Furthermore, Cox proportional hazards models were used to compute hazards ratios (HRs) and 95% confidence intervals (CIs) to estimate the correlation between KT and CRC in hemodialysis patients., Results: The Kaplan-Meier analysis revealed that the cumulative incidence of CRC was significantly higher in the exposed cohort than in the non-exposed cohort (log-rank test, P < 0.001). After adjusting for potential confounders, the exposed cohort exhibited a significantly increased risk of CRC compared with the non-exposed cohort (adjusted HR, 1.34; 95% CI, 1.11-1.62)., Conclusions: Hemodialysis patients undergoing KT have a significantly higher risk of CRC than those not undergoing KT. Cancer should continue to be a primary focus of prevention during KT.

Particulate matter pollution has become a widely-concerned issue in public health and led to a substantial loss of health. The study reports relationship between particulate matter with aerodynamic diameter <2.5 µm (PM 2.5 ) and years of life lost (YLL) in Guangzhou. A retrospective burden analysis on annual mean PM 2.5 data was conducted. Data on annual mortality were collected for 2009, from the Health Department of Guangzhou. Data on particulate matter were collected for period 2006-2009. Comparative risk assessment and exposure-response function were used to estimate attributable YLL. The exposure to PM 2.5 was associated with a total of 454.6 YLLs (95% uncertainty interval 449.0-460.1) per 100,000 people in 2009. This study has confirmed the substantial adverse health effects of PM 2.5 exposure in population with cardio-cerebrovascular disease and lung cancer. This study highlights the need to reduce ambient particulate pollution for better environmental health and lower burden of disease.

Purpose: This study differentiates patient and care delays of breast cancer and explores the related factors as well as the associations with the prognosis in Guangzhou, a southern city of China., Methods: A cohort of female incident breast cancer patients (n=1,551) was recruited from October 2008 to March 2012 and followed up until January 1, 2016 (n=1,374) in the affiliated hospitals of Sun Yat-sen University. The factors associated with patient and care delays were analyzed with multivariable logistic models. Cox proportional hazards regression models were constructed to estimate the impacts of the delays on the prognosis., Results: There were 40.4% patient delay (≥3 months) and 15.5% care delay (≥1 month). The patient delay, but not the care delay, was significantly related to the clinical stage and consequently worsened the prognosis of breast cancer (hazard ratio, 1.45; 95% confidence interval, 1.09 to 1.91 for progression-free survival). The factors related to an increased patient delay included premenopausal status, history of benign breast disease, and less physical examination., Conclusion: Patient delay was the main type of delay in Guangzhou and resulted in higher clinical stage and poor prognosis of breast cancer. Screening for breast cancer among premenopausal women may be an effective way to reduce this delay.

Background : China is undergoing an unprecedented rural-urban migration, which may deeply influence the health of internal migrants. Previous studies suggested that migrants are a selectively healthier population. This paper examines the evidence for and the changes of health selectivity among Chinese internal migrants. Methods : We use data from the China Labor-force Dynamics Survey (CLDS), a nationally representative survey conducted in 2012, 2014, and 2016, respectively. The health statuses of four groups of research subjects (out-migrants, returned migrants, rural residents, and urban residents) are measured by general health, physical health, and emotional health. Results : By comparing the health status of migrants with that of rural residents, we find supportive evidence for the Healthy Migrant Hypothesis that migrants exhibit better health than rural residents in their hometown. We also add strength to the Salmon Bias Hypothesis that migrants returning to their hometowns are less healthy than those still being outside. However, migrants present worse emotional health in both comparisons. The general and physical health gaps between migrants, rural residents, and returnees widened in all three rounds of the survey, which implies a possibly increasing trend of health selectivity. This study also suggests that bringing family to the destination requires better general and physical health, but not emotional health. Conclusions : Migrants are positively selected on general and physical health. The health selectivity in 2012-2016 is highly likely to increase, which means that there are increasing number of obstacles for migrants to overcome. Family migration's high requirement for health might also contribute to it. It is urgent to establish and improve primary health care service systems in rural areas in current circumstances.

Chronic exposure to fluoride is a public health problem worldwide. We explored the relationship between fluoride exposure, orthopedic injuries and bone formation markers alkaline phosphatase (ALP), bone Gla protein (BGP) in participants with coal-burning fluorosis in Hehua Village (coal-burning fluorosis endemic area) in Zhijin County of Guizhou Province and Zhangguan Village (non-fluoride contaminated area) in Anshun City of Guizhou Province. Environmental samples were collected and fluoride contents were examined using a fluoride ion-selective electrode. Dental fluorosis and skeletal fluorosis of 295 participants from Hehua Village and 85 participants from Zhangguan Village were diagnosed with informed consent. Urinary samples and peripheral blood samples were collected from the participants to determine urinary fluoride (UF), ALP acti-vity, and BGP content. The results showed that fluoride contents in rice, pepper, corn, drinking water, clay, vegetable-grown soil, coal and indoor and outdoor air were significantly higher than those in the control area, but lower than the previously reported values. With the increases of UF concentration, the ALP activity and BGP content significantly increased, the severity of skeletal fluorosis was greater, but with no significant changes in dental fluorosis. There was positive correlation between the severity of skeletal fluorosis and ALP activity, BGP content. These results indicated that low fluoride exposure could cause orthopedic injuries. ALP and BGP could be used to eva-luate the bone turnover in patients with skeletal fluorosis, which would be useful in the auxiliary diagnosis and therapeutic evaluation of skeletal fluorosis.

The thymic stromal lymphopoietin (TSLP)/TSLP receptor (TSLPR) axis is involved in multiple inflammatory immune diseases, including coronary artery disease (CAD). To explore the causal relationship between this axis and CAD, we performed a three-stage case-control association analysis with 3,628 CAD cases and 3,776 controls using common variants in the genes TSLP, interleukin 7 receptor ( IL7R ), and TSLPR . Three common variants in the TSLP/TSLPR axis were significantly associated with CAD in a Chinese Han population [rs3806933 T in TSLP, P adj  = 4.35 × 10 -5 , odds ratio (OR) = 1.18; rs6897932 T in IL7R, P adj  = 1.13 × 10 -7 , OR = 1.31; g.19646A>G A in TSLPR, P adj  = 2.04 × 10 -6 , OR = 1.20]. Reporter gene analysis demonstrated that rs3806933 and rs6897932 could influence TSLP and IL7R expression, respectively. Furthermore, the "T" allele of rs3806933 might increase plasma TSLP levels ( R 2  = 0.175, P  < 0.01). In a stepwise procedure, the risk for CAD increased by nearly fivefold compared with the maximum effect of any single variant ( P adj  = 6.99 × 10 -4 , OR = 4.85). In addition, the epistatic interaction between TSLP and IL33 produced a nearly threefold increase in the risk of CAD in the combined model of rs3806933 TT -rs7025417 TT ( P adj  = 3.67 × 10 -4 , OR = 2.98). Our study illustrates that the TSLP/TSLPR axis might be involved in the pathogenesis of CAD through upregulation of mRNA or protein expression of the referenced genes and might have additive effects on the CAD risk when combined with IL-33 signaling.

Contamination by fungal and bacterial species and their metabolites can affect grain quality and health of wheat consumers. In this study, sequence analyses of conserved DNA regions of fungi and bacteria combined with determination of trichothecenes and aflatoxins revealed the microbiome and mycotoxins of wheat from different silo positions (top, middle, and bottom) and storage times (3, 6, 9, and 12 months). The fungal community in wheat on the first day of storage (T₀) included 105 classified species (81 genera) and 41 unclassified species. Four species had over 10% of the relative abundance: Alternaria alternata (12%), Filobasidium floriforme (27%), Fusarium graminearum (12%), and Wallemia sebi (12%). Fungal diversity and relative abundance of Fusarium in wheat from top silo positions were significantly lower than at other silo positions during storage. Nivalenol and deoxynivalenol in wheat were 13⁻34% higher in all positions at 3 months compared to T₀, and mycotoxins in wheat from middle and bottom positions at 6 to 12 months were 24⁻57% higher than at T₀. The relative abundance of toxigenic Aspergillus and aflatoxins were low at T₀ and during storage. This study provides information on implementation and design of fungus and mycotoxin management strategies as well as prediction models.

Interleukin-13 (IL-13) has important functions in atherosclerosis, but its role in coronary artery disease (CAD) is unclear. Here, we studied the genetic role of IL-13 in CAD in a Chinese Han population using tag SNPs covering the whole IL13 gene (i.e., rs1881457, rs2069744 and rs20541) and a two-stage cohort containing 1863 CAD cases and 1841 controls. Traditional risk factors for CAD, such as age, BMI, and other factors, were used as covariates in logistic regression analysis. In the total population, we found that two haplotypes of IL13 (ATG and ATA, ordered rs1881457 C -rs2069744 T -rs20541 A ) significantly contributed to the risk of CAD with adjusted p values less than 0.05 (p adj  = 0.019 and p adj  = 0.042, respectively). In subgroup population analyses, the variant rs1881457 C was found to significantly contribute to a nearly two fold increase in the risk of CAD in men (p adj  = 0.023, OR = 1.91, 95% CI: 1.09-3.33). The variant rs1881457 C also significantly contributed to a nearly twofold risk of late-onset CAD (p adj  = 0.024, OR = 1.93, 95% CI: 1.09-3.42). In conclusion, IL13 might be involved in CAD via different mechanisms under different conditions in the Chinese Han population.

Background: Syphilis has continuously posed a great challenge to China. However, very little data existed regarding the cost of syphilis. Taking Guangdong Initiative for Comprehensive Control of Syphilis area as the research site, we aimed to comprehensively measure the annual economic burden of syphilis from a societal perspective., Methods: Newly diagnosed and follow-up outpatient cases were investigated by questionnaire. Reported tertiary syphilis cases and medical institutions cost were both collected. The direct economic burden was measured by the bottom-up approach, the productivity cost by the human capital method, and the intangible burden by the contingency valuation method., Results: Three hundred five valid early syphilis cases and 13 valid tertiary syphilis cases were collected in the investigation to estimate the personal average cost. The total economic burden of syphilis was US $729,096.85 in Guangdong Initiative for Comprehensive Control of Syphilis sites in the year of 2014, with medical institutions cost accounting for 73.23% of the total. Household average direct cost of early syphilis was US $23.74. Average hospitalization cost of tertiary syphilis was US $2,749.93. Of the cost to medical institutions, screening and testing comprised the largest proportion (26%), followed by intervention and case management (22%) and operational cost (21%). Household average productivity cost of early syphilis was US $61.19. Household intangible cost of syphilis was US $15,810.54., Conclusions: Syphilis caused a substantial economic burden on patients, their families, and society in Guangdong. Household productivity and intangible costs both shared positive relationships with local economic levels. Strengthening the prevention and effective treatment of early syphilis could greatly help to lower the economic burden of syphilis.

To evaluate microbial eukaryotic diversity and distribution in mesoscale processes, we investigated 18S rDNA diversity in a river plume and cyclonic eddy-influenced ecosystem in the southwestern South China Sea (SCS). Restriction fragment length polymorphism analysis was carried out using multiple primer sets. Relative to a wide range of previous similar studies, we observed a significantly higher proportion of sequences of pigmented taxa. Among the photosynthetic groups, Haptophyta accounted for 27.7% of the sequenced clones, which belonged primarily to Prymnesiophyceae. Unexpectedly, five operational taxonomic units of Cryptophyta were closely related to freshwater species. The Chlorophyta mostly fell within the Prasinophyceae, which was comprised of six clades, including Clade III, which is detected in the SCS for the first time in this study. Among the photosynthetic stramenopiles, Chrysophyceae was the most diverse taxon, which included seven clades. The majority of 18S rDNA sequences affiliated with the Dictyochophyceae, Eustigmatophyceae, and Pelagophyceae were closely related to those of pure cultures. The results of redundancy analysis and the permutation Mantel test based on unweighted UniFrac distances, conducted for spatial analyses of the Haptophyta subclades suggested that the Mekong River plume and cyclonic eddy play important roles in regulating microbial eukaryotic diversity and distribution in the southwestern SCS., (© 2015 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.)

Objective: The present retrospective study aimed to analyze the optimal time to initiate enteral nutrition (EN) in patients with severe acute pancreatitis at a single Chinese institution (China Medical University Hospital)., Methods: A total of 1196 patients with severe acute pancreatitis were admitted in the intensive care unit between November 2003 and June 2013; 1092 patients were selected and were divided into the early and delayed EN groups, according to their initial timing of EN., Results: Five hundred sixty-six patients were administered with the delayed EN, and 526 with the early EN. Both groups had similar severity of pancreatic necrosis, but organ failure developed in 81% patients of the delayed EN group and 21% in the early EN group (P < 0.01). The numbers of septic necrosis and morbidity were significantly higher in the delayed EN group than in the early EN (P < 0.01)., Conclusions: The early EN had significant benefits over the delayed EN in the decrease of organ failure and mortality; our findings suggested that the first 48 hours of administration in the intensive care unit was the optimal time to start EN.

Objective: To understand the changes of schistosomiasis endemic situation and water body security in the Changsha City section of the Xiangjiang River., Methods: The prevention and control measures of schistosomiasis, the status of Oncomelania hupensis snails in the marshlands, and the schistosome infection rates of residents on the both sides of the river and boat fishermen were investigated from 2003 to 2012. The schistosome infectivity of the water body was investigate by the method of sentry mice., Results: The snail area decreased from 471 hm(2) in 2003 to 28.81 hm(2) in 2012 with the decline rate of 93.88%. Through the environmental modification, no living snails were found in 9 marshlands among the 11 marshlands, and the density of snails was below 0.006/0.1 m(2) in the other 2 marshlands, but no infected snails were found for 7 years. The original snail habitats of Juzhou scenic area were completely modified and no living snails were found from 2008. In the area, no domestic animals were pastured and the schistosome infectivity of the water body was negative with the sentry mouse method for 10 years. In 2003, the schistosome infection rate was 3.63% in the residents, but no new infections were found in original residents after 2010., Conclusion: The endemic situation of schistosomiasis of the Changsha City section of the Xiangjiang River has reached the standards of schistosomiasis transmission controlled and the water body of Juzhou scenic area is safe.

Type II myosin is required for cytokinesis/septation in yeast and filamentous fungi, including Fusarium graminearum, a prevalent cause of Fusarium head blight in China. A type II myosin gene from the Chinese F. graminearum strain 5035, isolated from infected wheat spikes, was identified by screening a mutant library generated by restriction enzyme-mediated integration. Disruption of the Myo2 gene reduced mycelial growth by 50% and conidiation by 76-fold, and abolished sexual reproduction on wheat kernels. The Δmyo2 mutants also had a 97% decrease in their pathogenicity on wheat, and mycotoxin production fell to just 3.4% of the normal level. The distribution of nuclei and septa was abnormal in the mutants, and the septal ultrastructure appeared disorganized. Time-lapse imaging of septation provided direct evidence that Myo2 is required for septum initiation and formation, and revealed the dynamic behavior of GFP-tagged Myo2 during hyphal and macroconidia development, particularly in the delimiting septum of phialides and macroconidial spores. Microarray analysis identified many genes with altered expression profiles in the Δmyo2 mutant, indicating that Myo2 is required for several F. graminearum developmental processes and biological activities., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Diabetes has become a major public health problem in China nowadays. There are almost 97 million diabetic patients nationwide. Latent autoimmune diabetes in adults (LADA) is a subtype of autoimmune diabetes. Although it has been reported for about 20 years, the diagnostic criteria of this disease remain controversial. The discussion mainly focused on serum autoantibodies, period of insulin need and age of diagnosis. Besides, β cell function, metabolic parameters, genetic factors and cell immunity may also contribute to the formulation of the criteria. Here, we aim to review and discuss the diagnostic criteria of latent autoimmune diabetes in adults.

Professor XIAO Ji-fang, an experienced practitioner of Chinese medicine of Guangxi, is famous for his medical ethics, wide range of studies, comprehensive understanding of the classics, innovation, as well as u nique academic ideas. He focuses on mind-regulating in acupuncture and pulse diagnosis. At the same time, differentiation of syndromes, diseases and meridians are emphasized. The combination of acupuncture and moxibustion and integration of acupuncture and medicine are promoted. He is especially skilled at slow twisting needle insertion, Taiji needling therapy, scalp acupuncture and moxibustion with a herb prepared thread of Zhuang nationality, which all achieve remarkable effects.

Objective: To study a reliable, friendly environmental and sustainable Oncomelania snail control method in marshlands of the Xiangjiang River., Methods: According to the special characteristics of the marshlands of the Xiangjiang River, smoothing and cultivating in beaches were applied for snail control. In sections with scarce distribution of snails, lowering parts of 4.4 beaches and raising other parts were added., Results: Since 2003, the project has been practiced for 8 years. The average snail density declined by 99.83% with the simple smoothing beaches and then cultivation there. The average snail density declined by 100% with lowering parts of beaches and raising other parts and then cultivation. The schistosome infection rate was 0.31% with a declined rate of 93.84% in residents in 2006. The schistosome infection rate was 1.03% in 2010. The test result of water contamination was negative., Conclusions: The method of simple smoothing beaches and then cultivation can control the density of snails in marshlands and the method of lowering parts of beaches and raising other parts and then cultivation is more effective.