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Severe ozone (O3) pollution has been recorded in China in recent years. The key precursor, volatile organic compounds (VOCs), is still not well understood in Nanning, which is a less developed city compared to other megacities in China. In this study, a year-long measurement of VOCs was conducted from 1 October 2020 to 30 September 2021, to characterize the ambient variations and apportion the source contributions of VOCs. The daily-averaged concentration of VOCs was measured to be 26.4 ppb, ranging from 3.2 ppb to 136.2 ppb across the whole year. Alkanes and oxygenated VOCs (OVOCs) were major species, contributing 46.9% and 25.2% of total VOC concentrations, respectively. Propane, ethane, and ethanol were the most abundant in Nanning, which differed from the other significant species, such as toluene (3.7 ppb) in Guangzhou, ethylene (3.8 ppb) in Nanjing, and isopentane (5.5 ppb), in Chengdu. The positive matrix factorization (PMF) model resolved six source factors, including vehicular emission (contributing 33% of total VOCs), NG and LPG combustion (19%), fuel burning (17%), solvent use (16%), industry emission (10%), and biogenic emission (5%). This indicated that Nanning was less affected by industrial emission compared with other megacities of China, with industry contributing 12–50%. Ethylene, m/p-xylene, butane, propylene, and isoprene were key species determined by ozone formation potential (OFP) analysis, which should be priority-controlled. The variations in estimated OFP and observed O3 concentrations were significantly different, suggesting that VOC reactivity-based strategies as well as meteorological and NOx effects should be considered collectively in controlling O3 pollution. This study presents a year-long dataset of VOC measurements in Nanning, which gives valuable implications for VOC control in terms of key sources and reactive species and is also beneficial to the formulation of effective ozone control strategies in other less developed regions of China. [ABSTRACT FROM AUTHOR]

Objective: This study examined changes in wound symptoms and the health-related quality of life (HRQoL) of patients with newly diagnosed malignant fungating wounds, and explored the factors that impacted the changes in HRQoL. Method: This prospective longitudinal study included patients from three hospitals in China who had been diagnosed with malignant fungating wounds. Questionnaires were used to assess patients' HRQoL and their wound symptoms at the time of diagnosis (T0), as well as at one, three and six (T1, T2 and T3, respectively) months following the treatment period. Factors related to changes in HRQoL were analysed using generalised estimating equation models. Results: A total of 162 patients were included in the study. The patients reported low overall HRQoL. In three health-related dimensions (functional status, social relations and mental health), patients reported lower functional status at the time of wound diagnosis (T0), which then increased slowly with treatment over time. A lower QoL was associated with odour, exudate, bleeding, pruritus, a low performance status and the need for the dressing of wounds. Conclusion: The HRQoL of patients with malignant fungating wounds exhibited significant changes across different periods. It is thus of great importance to formulate pragmatic, patient and family-centred palliative wound care management strategies. [ABSTRACT FROM AUTHOR]

Proliferative enteropathy caused by Lawsonia intracellularis is an important economic associated disease to pig industry, but the knowledge about the prevalence of L. intracellularis in pig farms in China is limited. In addition, there is no complete genome sequence available for L. intracellularis isolates fromChina. In this study, we developed a TaqMan qPCR for the screening of L. intracellularis by targeting the bacterial 16S rDNA gene. Laboratory evaluations revealed a good sensitivity and specificity on detecting L. intracellularis nucleic acid. Using this method, we investigated 891 fecal samples from apparently healthy pigs in 47 farms. The results demonstrated a screening positive rate of 37.3% (95% CI, 34.1-40.5%) for the samples, and a farm screening positive rate of 93.6% (95% CI, 65.3-94.4%). The screening positive rate at herd level ranged from 6.67% (95% CI, 0.2-31.9%) to 40% (95% CI, 38-79.6%), while at animal level, the highest screening positive rate was found in 12-week-old pigs [85.7% (95% CI, 67.3-96.0%)]. Investigation of 705 diarrheal or bloody feces from symptomatic pigs revealed that the highest positive rate was found in replacement gilts which was 37.18% (95% CI, 45.1-89.5%). Secondly, we conducted the complete genome sequence of a L. intracellularis PPE-GX01-2022 from China through PacBio sequencing. The genome of PPE-GX01-2022 consisted of a chromosome of 1,439,110 bp in length and three plasmids of 193,063, 39,799, and 27,067 bp, respectively. This genome encoded 1,428 predicted proteins, 44 tRNAs, and 6 rRNAs. Sequence comparisons demonstrated that the genome sequence of PPE-GX01-2022 was highly homologous to those of two isolates from US, and these three isolates shared 1,378 core genes. The screening results suggest a high prevalence rate of L. intracellularis in Chinese pig farms. In addition, the genome sequence of the Chinese isolate was highly homologous to those of the field isolates from the US. [ABSTRACT FROM AUTHOR]

This paper attempts to study the dynamics and influencing factors of China-Argentina cooperation in the multilateral framework from a multidimensional theoretical perspective, in order to reveal the external thrust and internal logic of the development of Sino-Argentine relations. The four theories discussed in the paper are not opposed but complementary to each other. Together, they explain the factors that drive and hinder Sino-Argentine cooperation at the multilateral level. This article also presents a study of Sino-Argentine cooperation practices at three different levels of multilateral platforms, namely the UN General Assembly and Security Council, the G20 and the China-CELAC Forum. Cooperation between China and Argentina in multilateral mechanisms not only helps communication, understanding and coordination of positions between China and Argentina on major international issues, but also contributes to jointly enhancing the voice and influence of developing countries in international affairs. [ABSTRACT FROM AUTHOR]

Bamboo is one of the most important forest resources, widely distributed throughout subtropical and tropical regions. Many studies have focused on bamboo functional trait variation under different environmental conditions. However, the functional feature response of bamboo components to regional and climatic factors and associated coupling effects are less known. This study analyzed phenotypic plasticity and biomass accumulation and allocation processes in aboveground Pleioblastus amarus components (i.e., the culm, branch, and leaf) with principal component analysis (PCA) and partial least squares structural equation modeling (PLS-SEM) in three regions of China. Consequently, obvious regional differences were observed in phenotypic plasticity, biomass accumulation, and allocation processes. With decreasing latitude and increasing longitude, the internode length was longer for larger and rounder bamboo and the culm wall was thinner at a lower relative total height. Moreover, the number and width of crowns became greater, thicker, and longer. With increasing latitude, branch and leaf biomass decreased significantly, while biomass allocation to bamboo branches and leaves first decreased before increasing. And with increasing longitude, culm and total biomass reduced significantly along with culm biomass allocation, while total branch and leaf biomass allocation gradually decreased. Clearly, climatic factors, such as maximum temperature and mean annual temperature, directly affected the phenotypic plasticity of P. amarus and its associative biomass accumulation. Meanwhile, soil factors (i.e., soil available phosphorus, capillary porosity, field water holding capacity, and total nitrogen content) caused significant variation in phenotypic plasticity, indirectly affecting plant biomass accumulation and allocation processes. Collectively, these initial findings indicate that low-latitude and high-longitude stands promoted greater morphogenesis and more efficient biomass accumulation and allocation in aboveground P. amarus components, exhibiting superior morpho-plasticity and higher stand productivity. This study clarified regional differences in P. amarus morphological phenotypic plasticity and biomass accumulation and allocation. It is expected that the results can aid in provenance selection and the directional cultivation of high-yield bamboo stands. [ABSTRACT FROM AUTHOR]

Numerical simulations were performed to examine the driving mechanisms and their relative dominance in concentrating hydrothermal ore-forming fluid flow in the Chanziping ore district, South China. A numerical scheme was employed to provide realistic strain-dependent porosity and permeability during tectonic deformation. The results indicate that the buoyancy resultant from typical geothermal gradients alone during tectonically quiescent periods could not focus ore-forming fluids to the trap area for U precipitation. The extensional tectonic deformation in the late Yanshanian-early Himalayan period caused a broad downwelling flow in the red sandstone, channeling downwards along the regional fault to mix with the basement-derived upwelling reducing fluid driven by the buoyancy force. This leads to the ore genesis in the black shale below the fracture zone. The compressive deformation in the Indo-Chinese epoch would have essentially squeezed the basinal fluid and basal brine out of the basin, and hence would have been unfavorable for the formation of the Chanziping deposit. It was also observed that tectonic deformation always overwhelms the effect of buoyancy in driving hydrothermal flow, even if an extension or shortening of as little as 1% is applied. [ABSTRACT FROM AUTHOR]

Drought usually occurs as a result of an imbalance between water supply and demand. Drought indices, an important tool for studying drought, are commonly used for drought monitoring and drought risk assessment. The ground-based drought indices, with high accuracy, are limited in the area monitored. In contrast, the remotely sensed drought index covers a large area but with poor accuracy. Data-driven data fusion–based estimation of ground indices helps to fill this gap. The overall objective is to determine whether various remotely sensed drought factors can effectively monitor drought in arid and semi-arid northern China. In this study, the ground-based drought index SPEI was reconstructed by using remotely sensed drought factors, divided from the Global Precipitation Measuring Mission GPM, GLDAS, and MODIS satellite sensors as well as environmental covariates. Based on climate elements, soil elements, vegetation, and environmental covariate elements, a composite drought index CDIS was established in this study. In this study, the single drought index, multivariate linear integrated drought index, and bias-corrected random forest method were used as the prediction model. Based on ground truth historical climate data as reference data, the performance of the model-predicted composite drought index CDIS in drought monitoring was evaluated. Our results indicate that the drought index on 1-month time scale has no significant advantage over the maximum single drought index. The bias-corrected random forest model with drought index predictions outperformed multiple linear regression and single drought index, with higher prediction accuracy in semi-arid and semi-humid regions than in arid regions. Compared with the ground station drought indices, the drought map based on bias-corrected random forest shows visual and statistical consistency. Under the background of a non-homogeneous and complex surface environment, the model prediction results integrating environmental covariates performed best, and the method used in the study was effective and could be extended and applied. For areas where information is scarce, remote sensing data can be easily extended to regional scale monitoring, which can better achieve high-precision drought monitoring at the regional scale. [ABSTRACT FROM AUTHOR]

Background: The society is aging in China, and the cognitive level of elderly post-stroke patients gradually declines. Face-to-face cognitive functional training is no longer sufficient. Immersive virtual reality (IVR) is a promising rehabilitation training device. In this study, we developed an IVR-based puzzle game to explore its effectiveness, feasibility, and safety in elderly stroke patients with cognitive dysfunction. Methods: A total of 30 patients with mild post-stroke cognitive impairment after stroke were randomly assigned to a control or IVR group. Patients in both groups received routine rehabilitation therapy. Patients in the control group received traditional cognitive training, and those in the IVR group received IVR-based puzzle game therapy. Before and after treatment, Montreal cognitive assessment (MOCA), trail-making test-A (TMT-A), digit symbol substitution test (DSST), digital span test (DST), verbal fluency test (VFT), and modified Barthel index (MBI) were evaluated in both groups. In addition, the IVR group was administered a self-report questionnaire to obtain feedback on user experience. Results: There was no significant difference in the baseline data between the two groups. After six weeks of treatment, the cognitive assessment scores were improved in both groups. Moreover, the IVR group showed more improvements than the control group in the DSST (Z = 2.203, p = 0.028 < 0.05, η2 = 0.16); MOCA (T = 1.186, p = 0.246 > 0.05, d = 0.44), TMT-A (T = 1.791, p = 0.084 > 0.05, d = 0.65), MBI (T = 0.783, p = 0.44 > 0.05, d = 0.28), FDST (Z = 0.78, p = 0.435 > 0.05, η2 = 0.02), BDST (Z = 0.347, p = 0.728 > 0.05, η2 = 0.004), and VFT(Z = 1.087, p = 0.277 > 0.05, η2 = 0.039) did not significantly improve. The significant difference in DSST represents an improvement in executive function and visual–spatial cognitive characteristics. The other assessment scores did not show such features. Therefore, we did not observe significant differences through this measure. According to the results of the self-report questionnaire, most of the patients were satisfied with the equipment stability and training content. Several individuals reported mild adverse reactions. Conclusions: This pilot study suggests that IVR-based puzzle games are a promising approach to improve post-stroke cognitive function, especially executive cognitive function, and visual–spatial attention in older adults. [ABSTRACT FROM AUTHOR]

Traditional Chinese medicine (TCM) has long been used to treat diabetes mellitus and angina. It has also gained widespread clinical applications in China as a common adjuvant treatment. Although there is high-quality evidence that TCM is effective in regulating glucose and lipid metabolism, the cardiovascular protective effect of TCM in the treatment of diabetes mellitus has not been fully elucidated, especially in patients with both diabetes mellitus and coronary heart disease (CHD). We systematically assessed the efficacy and safety of TCM for the adjuvant treatment of patients with CHD and diabetes mellitus and examined the pharmacological effects and potential mechanisms of TCM medication/herbs on diabetes mellitus with CHD. We found that TCM could improve the control effect of conventional treatment on cardiac function, hemorheology, blood glucose, blood lipid, and inflammation, thus reducing the frequency of angina and the incidence of cardiovascular events and all-cause mortality. These findings indicate that TCM may be used as a complementary approach for patients with diabetes mellitus and CHD. Nevertheless, more rigorously designed randomized controlled trials and long-term evaluations are needed to support these findings. [ABSTRACT FROM AUTHOR]

Lumpy skin disease (LSD) is a devastating viral disease that occurs in cattle. In China, it was first detected in the Xin‐Jiang autonomous region, near the border with Kazakhstan, in August 2019. As there were no new occurrences of LSD in either country following the first detection, the initial introduction of the virus remains unknown. Arthropod vectors were considered as potential vectors. Consequently, to identify the arthropod vectors involved in transmitting LSD virus (LSDV), an insect surveillance campaign was launched at four different sites scattered along the border, and samples from 22 flying insect species were collected and subjected to PCR assays. Following the Agianniotaki LSDV vaccine and Sprygin's general LSDV assays, two kinds of non‐biting flies, namely, Musca domestica L and Muscina stabulans, were positive for LSDV. However, all the other insects tested negative. Viral DNA was only detected in wash fluid, implying body surface contamination of the virus. The negative test results suggest that non‐biting flies are the dominant insects involved in the observed local epidemic. Three genomic regions encoding RPO30, GPCR, and LW126 were successfully sequenced and subjected to phylogenetic analysis. The sequences shared high homology with LSDV/Russia/Saratov/2017, a recombinant vaccine‐like strain formerly identified in Russia, and clustered with LSDV vaccine strains in phylogenetic trees of RPO30 and LW126. However, the GPCR gene was seen to be solely clustered with LSDV field strains, implying differences in host affinity between these closely related vaccine‐like strains. Despite this, there is no direct evidence to support cross‐border transmission of the vaccine‐like LSDV. To our knowledge, this is the first report of vaccine‐like LSDV DNA detection in non‐biting flies in China. [ABSTRACT FROM AUTHOR]

Intracranial hemorrhage (ICH) is a devastating complication of immune thrombocytopenia (ITP). However, information on ICH in ITP patients under the age of 60 years is limited, and no predictive tools are available in clinical practice. A total of 93 adult patients with ITP who developed ICH before 60 years of age were retrospectively identified from 2005 to 2019 by 27 centers in China. For each case, 2 controls matched by the time of ITP diagnosis and the duration of ITP were provided by the same center. Multivariate analysis identified head trauma (OR = 3.216, 95%CI 1.296–7.979, P =.012), a platelet count ≤ 15,000/μL at the time of ITP diagnosis (OR = 1.679, 95%CI 1.044–2.698, P =.032) and severe/life-threatening bleeding (severe bleeding vs. mild bleeding, OR = 1.910, 95%CI 1.088–3.353, P =.024; life-threatening bleeding vs. mild bleeding, OR = 2.620, 95%CI 1.360–5.051, P =.004) as independent risk factors for ICH. Intraparenchymal hemorrhage (OR = 5.191, 95%CI 1.717–15.692, P =.004) and a history of severe bleeding (OR = 4.322, 95%CI 1.532–12.198, P =.006) were associated with the 30-day outcome of ICH. These findings may facilitate ICH risk stratification and outcome prediction in patients with ITP. [ABSTRACT FROM AUTHOR]

Emerging artemisinin resistance in Southeast Asia poses a significant risk to malaria control and eradication goals, including China's plan to eliminate malaria nationwide by 2020. Plasmodium falciparum was endemic in China, especially in Southern China. Parasites from this region have shown decreased susceptibility to artemisinin and delayed parasite clearance after artemisinin treatment. Understanding the genetic basis of artemisinin resistance and identifying specific genetic loci associated with this phenotype is crucial for surveillance and containment of resistance. In this study, parasites were collected from clinical patients from Yunnan province and Hainan island. The parasites were genotyped using a P. falciparum -specific single nucleotide polymorphism (SNP) microarray. The SNP profiles examined included a total of 27 validated and candidate molecular markers of drug resistance. The structure of the parasite population was evaluated by principal component analysis by using the EIGENSOFT program, and ADMIXTURE was used to calculate maximum likelihood estimates for the substructure analysis. Parasites showed a high prevalence of resistance haplotypes of pfdhfr and pfdhps and moderate prevalence of pfcrt. There was no mutation identified on pfmdr1. Candidate SNPs on chromosomes 10, 13, and 14 that were associated with delayed parasite clearance showed a low prevalence of mutants. Parasites from Southern China were clustered and separated from those from Southeast Asia. Parasites from Yunnan province were substructured from parasites from Hainan island. This study provides evidence for a genomic population with drug resistance in Southern China and also illustrates the utility of SNP microarrays for large-scale parasite molecular epidemiology. [ABSTRACT FROM AUTHOR]

To evaluate the association between ambient air pollution and hyperuricemia, we prospectively followed 1748 traffic police officers without hyperuricemia at baseline (2009–2014) from 11 districts in Guangzhou, China. We calculated six-year average PM10, SO2 and NO2 concentrations using data collected from air monitoring stations. The hazard ratios for hyperuricemia per 10 µg/m3 increase in air pollutants were 1.46 (95% CI: 1.28–1.68) for PM10, 1.23 (95% CI: 1.00–1.51) for SO2, and 1.43 (95% CI: 1.26–1.61) for NO2. We also identified changes in the ratio of serum uric acid to serum creatinine concentrations (ua/cre) per 10 µg/m3 increase in air pollutants as 11.54% (95% CI: 8.14%-14.93%) higher for PM10, 5.09% (95% CI: 2.76%-7.42%) higher for SO2, and 5.13% (95% CI: 2.35%-7.92%) higher for NO2, respectively. Long-term exposure to ambient air pollution was associated with a higher incidence of hyperuricemia and an increase in ua/cre among traffic police officers. [ABSTRACT FROM AUTHOR]

Karst and non-karst forests occur in the same region in south-west China, but the soil water and mineral nutrients availability are different between the forests. Our hypothesis was that the leaves of karst trees would be better adapted to dry, nutrient-poor conditions than those of trees in a nearby non-karst forest. We compared the gas exchange, anatomical characteristics and mineral nutrient concentrations in leaves from 21 tree species in a tropical karst forest and 19 species in a nearby non-karst forest in south-west China. We found that the leaves of karst trees had higher P concentrations, photosynthetic capacity and water use efficiency, and greater adaxial and abaxial epidermis thickness than leaves of non-karst forest trees. Evergreen and deciduous trees differed more significantly in leaf functional traits in the karst forest than in the non-karst forest. The leaf palisade : spongy mesophyll thickness ratio was positively correlated with stomatal conductance and negatively correlated with photosynthetic water use efficiency in the karst forest but not in the non-karst forest. Our findings indicate that karst forest trees are more conservative in water use, whereas soil P deficiency could be a major limiting factor for the growth of non-karst forest trees. Karst habitats cover extensive areas of south-west China; however, we know little about the adaptive mechanisms of plants there. We compared leaf functional traits between a karst forest and a nearby non-karst forest and found that karst trees had more conservative water use and higher leaf P concentrations. Our results show that trees in the karst forest are structurally and physiologically acclimated to the dry, nutrient-rich soil. [ABSTRACT FROM AUTHOR]

Background: Malaria reduction and future elimination in China is made more difficult by the importation of cases from neighboring endemic countries, particularly Myanmar, Laos, and Vietnam, and increased travel to Africa by Chinese nationals. The increasing prevalence of artemisinin resistant parasites across Southeast Asia highlights the importance of monitoring the parasite importation into China. Artemisinin resistance in the Mekong region is associated with variants of genes encoding the K13 kelch domain protein (pf13k), found in specific genetic backgrounds, including certain alleles of genes encoding the chloroquine resistance transporter (pfcrt) and multidrug resistance transporter PgH1 (pfmdr1). Methods: In this study we investigated the prevalence of drug resistance markers in 72 P. falciparum samples from uncomplicated malaria infections in Tengchong and Yingjiang, counties on the Yunnan-Myanmar border. Variants of pf13k, pfcrt and pfmdr1 are described. Results: Almost all parasites harboured chloroquine-resistant alleles of pfcrt, whereas pfmdr1 was more diverse. Major mutations in the K13 propeller domain associated with artemisinin resistance in the Mekong region (C580Y, R539T and Y493H) were absent, but F446I and two previously undescribed mutations (V603E and V454I) were identified. Protein structural modelling was carried out in silico on each of these K13 variants, based on recently published crystal structures for the K13 propeller domain. Whereas F446I was predicted to elicit a moderate destabilisation of the propeller structure, the V603E substitution is likely to lead to relatively high protein instability. We plotted these stability estimates, and those for all previously described variants, against published values for in vivo parasitaemia half-life, and found that quadratic regression generates a useful predictive algorithm. Conclusion: This study provides a baseline of P. falciparum resistance-associated mutations prevalent at the China-Myanmar border. We also show that protein modelling can be used to generate testable predictions as to the impact of pfk13 mutations on in vivo (and potentially in vitro) artemisinin susceptibility. [ABSTRACT FROM AUTHOR]

The outbreak of pseudorabies (PR) in many Bartha-K61 vaccinated farms in China in late 2011 has seriously damaged the pig industry of one of the largest producers of pork products in the world. To understand the epidemiological characteristics of the pseudorabies virus (PRV) strains currently prevalent in China, a total of 16,256 samples collected from pig farms suspected of PRV infection in 27 Provinces of China between 2012 and 2017 were evaluated for detection of PRV. Since the extensive use of gE-deleted PRV vaccine in China, the PRV-gE was applied for determining wild-type virus infection by PCR. Of the 16,256 samples detected, approximately 1,345 samples were positive for the detection of PRV-gE, yielding an average positive rate of 8.27%. The positive rates of PRV detection from 2012 to 2017 were 11.92% (153/1284), 12.19% (225/1846), 6.70% (169/2523), 11.10% (269/2424), 5.57% (147/2640), and 6.90% (382/5539), respectively. To understand the genetic characteristics of the PRV strains currently circulating, 25 PRV strains isolated from those PRV-gE positive samples were selected for further investigation. Phylogenetic analysis based on gB, gC, and gE showed that PRV strains prevalent in China had a remarkably distinct evolutionary relationship with PRVs from other countries, which might explain the observation that Bartha-K61 vaccine was unable to provide full protection against emergent strains. Sequence alignments identified many amino acid changes within the gB, gC, and gE proteins of the PRVs circulating in China after the outbreak compared to those from other countries or those prevalent in China before the outbreak; those changes also might affect the protective efficacy of previously used vaccines in China, as well as being associated in part with the increased virulence of the current PRV epidemic strains in China. [ABSTRACT FROM AUTHOR]

Major ion concentrations were measured in 22 groundwater samples collected from a coal bearing aquifer in Zhuxianzhuang coal mine, northern Anhui Province, and the ion source and geochemical characteristics were discussed by the methods such as traditional graphic and multivariate statistic analysis. The results showed the presence of three water types, i.e., HCO3-Na, Cl-Na and SO4-Na. The surrounding rock weathering and evaporation, both controlled the chemical characteristics of groundwater, evidenced by the Gibb's diagrams. In detail, the features of ion ratios such as Ca/Na, HCO3/Na and Mg/Na show that the evaporate dissolution and silicate weathering were the dominant water-rock interactions. Multivariate analysis, such as correlation analysis, cluster analysis and FA analysis were also conducted to reveal the ion source in groundwater, and the Ca2+ and Mg2+ were mainly released from the dissolution of gypsum and/or magnesium and/or anorthite; while the Na+ is influenced by the weathering of feldspar and halite, with the cation exchange in a certain extent. In contrast, the Cl-, HCO3 - and SO42- are also controlled by the halite dissolution, silicate mineral weathering and sulphate mineral dissolution, respectively. In addition, the SO42- in groundwater could be influenced by the oxidation of pyrite, which is abundant in the coal bearing aquifers. [ABSTRACT FROM AUTHOR]

The quantification of the effect of irrigation on crop yields and other non-marketed ecological services (ESs) is crucial to maintain a steady increase in agricultural production while minimizing negative environmental effects. We use the modified ES trade-off concept frame to analyze the interrelationships between crop yield income and nitrogen leaching, nitrous oxide emission, and soil organic carbon (SOC) sequestration by simulating crop output and other non-marketed ESs with a process-based denitrification–decomposition model. Results show that positive trade-offs and synergies exist between crop yield income and nitrogen leaching, nitrous oxide emission, and SOC sequestration at the loam site before the irrigation index reaches 0.7. Similarly, a positive trade-off exists between crop yield income and nitrogen leaching at the sandy soil site, and a positive synergy occurs between crop yield income and SOC sequestration at the loam site as the irrigation index increases from 0 to 1. The extended ES trade-off concept frame is a beneficial approach for optimizing current agricultural irrigation management strategies to maintain sustainable agricultural development. [ABSTRACT FROM AUTHOR]

The clinical therapeutics of traditional Chinese medicine (TCM) constitutes a complicated process which involves theory, diagnosis, and formula prescription with specific herbal dosage. Zhang Zhong-Jing's classic work, Treatise on Febrile and Miscellaneous Diseases, has been influencing TCM practice for almost 2000 years. However, during this extended period of time in Chinese history, the Chinese weight measurement system experienced noticeable changes. This change in the weight measurement system inevitably, and perhaps even negatively, affected TCM herbal dosage determination and treatment outcome. Thus, in modern society, a full understanding of the accuracy of herbal dose selection has a critical importance in the TCM daily practice of delivering the best treatment to the patients suffering from different illnesses. In the 973 Project of the Chinese National Basic Research Program, expert consensus on classic TCM formula dose conversion has been reached based on extensive literature review and discussion on the dose-effect relationship of classic TCM formulas. One ' liang' (两) in classic TCM formulas is equivalent to 13.8g. However, based on many TCM basic and clinical studies of variable herbal formula prescriptions and herbal drug preparations, the rule of one liang equals 13.8g should be adjusted according to different disease conditions. Recommended by the committee on TCM formula dose-effect relationship of the China Association of Chinese Medicine and the World Federation of Chinese Medicine Societies, the following expert consensus has been reached: (i) One liang converts to 6-9g for the severely and critically ill patients. (ii) One liang converts to 3-6g for the patients suffering from chronic diseases. (iii) One liang converts to 1-3g in preventive medicine. The above conversions should be used as a future TCM practice guideline. Using this recommended guideline should enhance the effectiveness of daily TCM practice. [ABSTRACT FROM AUTHOR]

Background: Lumbar puncture for spinal or epidural anesthesia is commonly performed by palpating bony landmarks, but identification of the desired intervertebral level is often inaccurate. It is unclear whether such inaccuracy is related to patient factors, such as body mass index and degree of lumbar flexion. We hypothesized that overweight patients and patients with less of an ability to hyperflex their lumbar spines are prone to inaccurate lumbar spinous intervertebral level identification. Methods: 52 adult volunteers were included in this study. 7 anesthesiologists with different years of experience identified and marked subjects' levels of the iliac crests, then marked the presumed interspaces. Lumbar X-ray was then performed with metal markers, and actual radiographic findings were identified and compared to the initial markings. Results: Patients with larger abdominal circumferences (mean (SD), 94.0(12.1) cm), higher body mass indices (25.9(3.9) kg/m2), and aged between 50 and 70 years old had lumbar interspaces that were higher than the presumed level; patients with smaller abdominal circumferences (82.8(13.5) cm) and lower body mass indices (21.6(4.1) kg/m2) had intervertebral levels that were lower than the presumed level. Cobb's angle, indicating the degree of lumbar flexion, did not affect the accuracy obtained. Conclusions: Patients' abdominal circumference, body mass index, and age are factors that may impact the accuracy of lumbar level identification. Tuffier's line, as identified by palpation, does not seem to be a reliable landmark for proper lumbar interspace identification in all cases. [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis (VL) was once a severe parasitic disease in China. Thanks to the great efforts of integrated control, VL was eliminated in most epidemic areas, except for certain western provinces (autonomous region) at the end of 1950s. From then on, VL gained less attention and has seemed to spread, especially in the last 15 years. Infants are the most important population threatened by VL. However, there have been few studies on the endemic characteristics of infantile VL in China. Methods: Infantile VL cases were collected from the online National Infectious Diseases Reporting System (NIDRS). Statistical description and inference was used to reveal the endemic characteristics in gender, age group, time and regionalism. Spatial analysis was carried out to explore the high risk area for infantile VL in China. Results: A total of 1093 infantile VL cases were reported from 2006 to 2012. There was no statistically significant difference in gender over time. The minimum, maximum and mean age of these cases was 1.1, 35.9 and 13.8 months, respectively. Among them 86.92% were under 2 years of age, and there was a statistically significant difference among age groups over time. An incidence peak appeared in 2008-2009, most cases were distributed in the months September to December, and there was a tail-raising effect in the coming two months of the next year. More than 98% of cases were reported in Xinjiang Uygur Autonomous Region, Gansu Province and Sichuan Province, accounting for 61.02%, 32.75% and 4.57%, respectively. A total of 56 counties reported infantile VL cases, with the cumulative incidence ranging from 0.02 to 24.57%. There were two main zones of high endemicity for infantile VL in China. The monthly incidence clearly coincides with the number of towns where infantile VL cases were reported. Three fatalities were reported during the study period, the case fatality rate was 2.75‰. Conclusions: The endemic situation of infantile VL is serious, and there are several active foci of infantile VL prevalence in China. VL has emerged as a severe threat to infants of endemic regions in China. [ABSTRACT FROM AUTHOR]

A prospective multicenter clinical trial was conducted to compare the beneficial effects of a Chinese herbal medicine formula Jiangzhuoqinggan (JZQG) and western antihypertension drug irbesartan. JZQG is mainly composed of rhubarb, coptis, cassia, and uncaria. A total of 240 patients with mild to moderate hypertension were enrolled in the trial. Patients were assigned into two groups after screening: JZQG group and the irbesartan group. After four weeks of treatment, we compared the changes in routine blood pressure, 24 h ambulatory blood pressure, and waist circumference. There was a significant reduction in systolic blood pressure and diastolic blood pressure in the JZQG group (both p < 0.01). There were no significant differences between the reduction of systolic and diastolic blood pressures in the two treatment groups. From the 24 h ambulatory blood pressure measurement, the JZQG group showed a greater reduction in both systolic and diastolic blood pressures (in both daytime and nighttime) than the irbesartan group. Furthermore, there was a significant difference in waist circumference in the JZQG group (1.51 cm reduction; P < 0.05) but not the irbesartan group (0.42 cm). Thus, the JZQG formula may have therapeutic value in patients with both hypertension and metabolic syndrome. [ABSTRACT FROM AUTHOR]

The article presents a study conducted to analyze the transmission of malaria in the Yangtze River located in China after the construction of three Gorges Reservoirs. In study six villages including Kaixian, Fengjie, Wanzhou were selected for investigating the transmission of malaria in the reservoir. It mentions that the transmission potential was estimated by the use of mathematical modeling and estimation of the local malaria situation. It reports that factors which influenced the transmission potential were analyzed by the Poisson regression analysis in combination with the Grey Systematic theory. The result revealed that the risk of malaria can be forecasted by transmission of malaria.

Background: Obesity has been shown to be a prognostic indicator of type 2 diabetes (T2D); however, the power of different obesity indicators in the detection of T2D remains controversial. This study evaluates the detecting power of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHTR) for the presence of T2D in undiagnosed diabetics among the Chinese population. Methods: Individuals were selected from an ongoing large-scale population-based Beijing Community Pre-Diabetes (BCPD) study cohort. The oral glucose tolerance tests (OGTT) were performed to diagnose diabetes. A total of 220 new cases of T2D and 1,868 normal blood glucose subjects were analyzed. ROC curve analyses were used to compare the association of different obesity indicators with T2D and determine the optimal cut-off points of the best predictor for identifying T2D in men and women. Results: All indicators positively correlated with presence of T2D in both men and women. In women, WC, WHR and WHTR were similar, but were better in identifying T2D when compared to BMI (P < 0.0001, P=0.0016 and P=0.0001, respectively). In men, WC, WHTR and BMI were similar, but WC and WHTR were better than WHR (P=0.0234, P=0.0101, respectively). For women, 86 cm was the optimal WC cut-off point, and its sensitivity and specificity were 0.714 and 0.616; for men, the optimal cut-off point was 90 cm, and its sensitivity and specificity were 0.722 and 0.571. Conclusion: Compared with BMI, WHR and WHTR, WC is a simple and accurate measure for predicting T2D in the Chinese population. [ABSTRACT FROM AUTHOR]

Abstract: Recently, variants (rs2568494, rs2869967 and rs3821104) in the IREB2, FAM13A and XRCC5 genes were found to be associated with chronic obstructive pulmonary disease (COPD) in non-Asian populations by genome-wide association study (GWAS) analysis. To evaluate whether variants in these genes are related to COPD in Chinese Han population, we investigated COPD patients of Chinese Han ethnicity from Mainland China. Significant differences in genotypic distributions (χ 2 =6.319, p =0.042 for rs2869967; χ 2 =6.062, p =0.048 for rs3821104) and allele distributions (χ 2 =4.014, p =0.045 for rs2869967; χ 2 =5.607, p =0.018 for rs3821104) were observed between patients and control subjects for variants rs2869967 and rs3821104, whereas no statistically significant associations for genotypic and allelic distribution between IREB2 rs2568494 and COPD phenotype (p >0.05) were identified. Our results support that FAM13A rs2869967 and XRCC5 rs3821104 are associated with COPD in Chinese Han population. [Copyright &y& Elsevier]

How to measure development of ecosystems is both a theoretical and practical question in ecology. Species richness and biomass accumulation are familiar figures of merit, but they cannot be instant watched. Self-organization is a tacit character. However, methods to measure the degree of self-organization of ecosystem are problematic. To this end have devised indicators of energy capture and dissipation so that self-organization defined via maximum energy dissipation can be quantified easily. Here the method is used to analyze long-term data (2004–2006) of a tropical seasonal rain forest included in the ChinaFLUX program. Three years of average self-organization values were clearly separated by seasonal variation. Reflection and long wave radiation are the main two pathways of energy loss. For tropical seasonal rain forest studied, long wave radiation contributed most to energy loss, and was negatively correlated with energy capture ability (Rn/DR). The nocturnal difference between canopy and air temperatures had a strong negative correlation with the long wave radiation loss ratio. However, the long wave radiation loss ratio was slightly lower than the reflection loss ratio in rainy season, when values were very low. Precipitation and wind had significant impact on energy dissipation ability in the hot dry season, but the correlation coefficients between precipitation and wind with thermal response numbers (TRNs) were very low. The results indicated that the self-organization estimation system based on “maximum energy dissipation theory” is applicable for tropical forest. [Copyright &y& Elsevier]

Background: Stunting and soil-transmitted helminth (STH) infections including ascariasis, trichuriasis and hookworm remain major public health problems in school-age pupils in developing countries. The objectives of this study were to determine the prevalence of stunting for children and its association with three major soiltransmitted helminths (STH) in rural areas of southern China. The study also aims to determine risk factors for stunting and to provide guidance on the prevention and control of stunting and STH infections for future studies in this field. Results: A cross-sectional survey was carried out in the poor rural areas in Guangxi Autonomous Regional and Hainan Province where STH prevalence was higher between September and November 2009. Pupils were from 15 primary schools. All the school-age pupils aged between 9 and 12 years old (mean age 11.2 ± 3.2 years), from grades three to six took part in this study. Study contents include questionnaire surveys, physical examination and laboratory methods (stool checking for eggs of three major STH infections and haemoglobin determination was performed for the anaemia test). Finally 1031 school-age pupils took part in survey. The results showed that the overall prevalence of stunting (HAZ < 2SD) was 25.6%, based on the WHO Child Growth Standards (2007). Risk factors for stunting based on logistic regression analyses were: (1) STH moderate-to-heavy intensity infections (OR = 1.93;95%CI:1.19,3.11); (2) anaemia (OR = 3.26;95%CI: 2.02,5.27); (3) education level of mother (OR = 2.13; 95%CI: 1.39,3.25). The overall prevalence of major STH infections was 36.7%, STH moderate-to-heavy intensity infections was 16.7%. The overall prevalence of ascariasis, trichuriasis, hookworm and co-infection were 18.5%, 11.2%, 14.7% and 9.1% respectively. The prevalence of anaemic children (HB < 12 g/dl) was 13.1%. Conclusion: The present study showed that stunting was highly prevalent among the study population and STH infection is one of the important risk factors for stunting, with moderate-to-heavy intensity infections being the main predictor of stunting. Hence, additional interventions measures such as to promote de-worming treatment, to enhance health education and to improve hygiene and sanitation in order to reduce stunting in this population, are needed throughout the primary school age group. [ABSTRACT FROM AUTHOR]

We provide a brief overview of the constructed wetland treatment technology and list two demonstration cases of its application in treating rural domestic sewage in Guangxi and its effect. Meanwhile, existing problems of the treatment technology are summarized. [ABSTRACT FROM AUTHOR]

The equation describing the transfer of radiant energy in semitransparent media is radiative transfer equation. In three-dimensional semitransparent media, radiative intensity is a function of 7 dimensions, which can only be solved through the numerical method in most circumstances. Numerical simulation has become an important way in the study and application of the theory of thermal radiative transfer in semitransparent media. This paper reviews the recent progress of Chinese scholars in the field of computational thermal radiative transfer, and proposes some important subjects in this field for future study. [ABSTRACT FROM AUTHOR]

Thermodynamics is a powerful tool for the study of system development and has the potential to be applied to studies of ecological complexity. Here, we develop a set of thermodynamic indicators including energy capture and energy dissipation to quantify plant community self-organization. The study ecosystems included a tropical seasonal rainforest, an artificial tropical rainforest, a rubber plantation, and two Chromolaena odorata (L.) R.M. King & H. Robinson communities aged 13 years and 1 year. The communities represent a complexity transect from primary vegetation, to transitional community, economic plantation, and fallows and are typical for Xishuangbanna, southwestern China. The indicators of ecosystem self-organization are sensitive to plant community type and seasonality, and demonstrate that the tropical seasonal rainforest is highly self-organized and plays an important role in local environmental stability via the land surface thermal regulation. The rubber plantation is at a very low level of self-organization as quantified by the thermodynamic indicators, especially during the dry season. The expansion of the area of rubber plantation and shrinkage of tropical seasonal rainforest would likely induce local surface warming and a larger daily temperature range. [Copyright &y& Elsevier]

Background: Malaria is endemic in Linzhi Prefecture in the Tibet Autonomous Region (TAR), but the vector for malaria transmission had never been identified. Methods: Adult Anopheles spp. were collected in Motuo County, Linzhi Prefecture on the Sino- Indian border in July and August, 2007. Multiplex PCR was adopted for species identification, and a nested PCR approach was used to detect sporozoites in the salivary glands of the mosquitoes. Results: 3,675 mosquitoes of the Anopheles maculatus group were collected and processed for species identification. Among them, 3,602 (98.0%) were Anopheles pseudowillmori and 73 (2.0%) were Anopheles willmori. The Plasmodium vivax SSUrDNA fragment was amplified in two of 360 pooled An. pseudowillmori samples. Conclusion: The local An. maculatus group comprises the species An. pseudowillmori and An. willmori. Anopheles pseudowillmori is considered the sole malaria vector in Motuo County in Linzhi Prefecture. [ABSTRACT FROM AUTHOR]

Abstract: Jørgensen [Jørgensen, S.E., 2002. Integration of Ecosystem Theories: A Pattern, 3rd ed. Kluwer Academic Publishers, The Netherlands] proposed: Ecosystem attempts to maximize their distance from a thermodynamic reference point by storing exergy. In this research a close relationship between energy storage strategies and caloric value was found. The caloric values of dominant plants in a 1-ha plot in a tropical seasonal rain forest (TSRF) and a 1-ha plot montane evergreen broad-leaved forest (MEBF) of Yunnan Province, southwest China were measured. We found plants growing in different environment and developing stage prefer different energy storage strategy. In the cold environment, plants prefer to condense energy in the limited volume which increases caloric value. And the same strategy is chosen by the top (sun) leaves, so they have higher caloric values than the bottom (shade) leaves. While in the warm environment, structure development dominates which abates caloric value. At the beginning of growth, plants prefer to develop structure. However after matured, they prone to condense energy in the full grown structure. So mature leaves maintain higher caloric values than young shoots do. On all accounts, the two exergy strategies – structural development that decreases caloric value and energy condensation that increases caloric value – interact each other to facilitate energy storage in plants. [Copyright &y& Elsevier]

Objective To carry out national surveys for ascertaining the current Status and trends of soil-transmitted nematode infections in China, providing scientific basis for further developing control strategies. Methods In 1988-1992 (hereinafter abbreriated as "survey in 1990"), a stratified cluster random sampling method was used in the survey. In 200 1-2004 (hereinafter abbreriated as "survey in 2003"), in order to compare with the survey in 1990, two-characteristic stratified cluster random sampling method was used and 687 investigation spots were sampled from the 2848 spots selected in the survey in 1990. Kato-Katz thick smear method was used to examine the eggs of soil-transmitted nematodes in fecal samples. Results The prevalence rates were 53.6% and 19.6% for soil-transmitted nematodes, 14.6% and 6.120% for hookworms, 44.6% and 12.7% for Ascaris lumbricoides, 17.4% and 4.630% for Trichuris trichiura in survey 1990 and survey 2003, respectively. The prevalence rates of soil-transmitted nematodes were higher in 13 provinces than the average level in China in the survey in 1990, and higher in 8 provinces than the average level in the survey in 2003. The prevalence of hookworms, Ascaris lumbricoides, Trichuris trichiura and the overall prevalence of soil-transmitted nematodes were higher in females than in males. It is estimated from the results of survey in 2003 that the number of persons with soil-transmitted nematode infections in the country is about 129 million, less than that in the survey in 1990. Conclusion The prevalence of soil-transmitted nematodes has declined considerably but is still relatively high in some provinces and autonomous regions. Control activities and socioeconomic development may have contributed to the decreased prevalence. [ABSTRACT FROM AUTHOR]

[Display omitted] Biliary tract carcinoma (BTC) is a group of malignant tumors that originate in the digestive system and occurs with a high incidence in China. Few consistent and comparable assessments of BTC disease burden have been conducted at national or subnational levels, and little is known about the demographic, temporal, and geographic patterns of epidemiological characteristics and disease burden of BTC in China. The incidence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs) due to premature death and years lived with disability (YLDs) of BTC were comprehensively examined by age, sex, and calendar year in the Chinese population, using the methodological framework and analytical strategies used for the 2021 Global Burden of Disease study. All-age incidence increased from 17,077 to 51,720 between 1990 and 2021, and the age-standardized incidence rate rose by 13.62%; all-age deaths increased from 17,251 to 37,833, but the age-standardized mortality rate fell by nearly one-fifth. The DALYs rose by 89.57% while the age-standardized DALY rate fell by 23.24%. Variations of the tendencies in BTC burden were found between sexes and age groups. Data for each provincial region indicate that coastal eastern provincial regions have higher incidence and YLD levels, whereas northern provincial regions have higher mortality, DALY, and YLL levels. The proportions of DALYs attributable to high body mass index (BMI) illustrate the growing attribution obesity has made, and high BMI usually puts more burden on northern provincial regions. These results provide evidence to support precise, targeted, and customed public health strategies aimed at enhancing biliary tract health among the Chinese population. [ABSTRACT FROM AUTHOR]

Air pollutant transport plays an important role in local air quality, but field observations of transport fluxes, especially their vertical distributions, are very limited. We characterized the vertical structures of transport fluxes in central Luoyang, Fen-Wei Plain, China, in winter based on observations of vertical air pollutant and wind profiles using multi-axis differential optical absorption spectroscopy (MAX-DOAS) and Doppler wind lidar, respectively. The northwest and the northeast are the two privileged wind directions. The wind direction and total transport scenarios were dominantly the northwest during clear days, turning to the northeast during the polluted days. Increased transport flux intensities of aerosol were found at altitudes below 400 m on heavily polluted days from the northeast to the southwest over the city. Considering pollution dependence on wind directions and speeds, surface-dominated northeast transport may contribute to local haze events. Northwest winds transporting clean air masses were dominant during clean periods and flux profiles characterized by high altitudes between 200 and 600 m in Luoyang. During the COVID-19 lockdown period in late January and February, clear reductions in transport flux were found for NO2 from the northeast and for HCHO from the northwest, while the corresponding main transport altitude remained unchanged. Our findings provide better understandings of regional transport characteristics, especially at different altitudes. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the knowledge, attitudes and willingness of nursing students to receive the coronavirus disease (COVID-19) vaccine and the influencing factors. Vaccination is one of the most effective measures to prevent COVID-19, but the vaccination acceptance rate varies across countries and populations. As trustworthy healthcare providers, nursing students' attitudes, knowledge and willingness to receive the COVID-19 vaccine may greatly affect the present and future vaccine acceptance rates of the population; however, studies related to the vaccine acceptance rates among nursing students are limited. A convenience sampling method was adopted to select two medical universities in China. Following the cluster sampling method, nursing college students who were eligible for the study were selected. A cross-sectional survey was conducted by asking nursing students to complete an online questionnaire from February to April 2021. Descriptive statistics, t -tests/one-way analysis of variance (normal distribution), U tests/H tests (skewness distribution) and multivariate linear regression were performed. A total of 1488 valid questionnaires were collected. The score rates of the attitude, knowledge and vaccination willingness dimensions were 70.07%, 80.70% and 84.38%, respectively. Attitude was significantly influenced by vaccination status of family members. The main factors influencing knowledge were gender, grade and academic background. In terms of willingness, gender, academic background, visits to high-risk areas, vaccination status of family members and the side effects experienced after receiving other vaccines were significant influencing factors. Nursing students showed satisfactory vaccine acceptance rates. However, more attention should be paid to male students, younger students, those with a medical background, those with low grades and those whose family members had not received the COVID-19 vaccine or had side effects from the vaccine. [ABSTRACT FROM AUTHOR]

Background: Over/under-estimating renal function may increase inappropriate dosing strategy associated adverse outcomes; however, previously reported equations to estimate renal function have limited accuracy in chronic kidney disease (CKD) patients. Consequently, we intended to develop a novel equation to precisely estimate renal function and subsequently guide clinical treatment for CKD patients. Methods: A novel approach, Xiangya-s equation, to estimate renal function for CKD patients was derived by linear regression analysis and validated in 1885 patients with measured glomerular filtration rate (mGFR) < 60 ml/min/1.73 m2 by renal dynamic imaging at three representative hospitals in China, with the performance evaluated by accuracy, bias and precision. In the meanwhile, 2,165 atrial fibrillation (AF) patients who initiated direct oral anticoagulants (DOACs) between December 2015 and December 2018 were identified and renal function was assessed by estimated creatinine clearance (eCrCl). Events per 100 patient-years was calculated. Cox proportional hazards regression was applied to compare the incidence of outcomes of each group. Results: Xiangya-s equation demonstrated higher accuracy, lower bias and improved precision when compared with 12 creatinine-based and 2 CysC-based reported equations to estimate GFR in multi-ethnic Chinese CKD patients. When we applied Xiangya-s equation to patients with AF and CKD prescribed DOACs, wide variability was discovered in eCrCl calculated by the Cockcroft-Gault (CG), Modification of Diet in Renal Disease Study (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Xiangya equation which we had developed for generally patients and Xiangya-s equations, which persisted after grouping by different renal function stages. Equation choice affected drug-dosing adjustments, with the formulas agreeing for only 1.19%, 5.52%, 33.22%, 26.32%, and 36.61% of potentially impacted patients for eCrCl cutoffs of <15, <30, 15–49, 30–49, ≥50 ml/min, respectively. Relative to CG equation, accordance in DOACs dosage was 81.08%, 88.54%, 62.25%, and 47.68% for MDRD, CKD-EPI, Xiangya and Xiangya-s equations for patients with CrCl < 50 ml/min (eCrCl cutoffs of <30, 30–49, ≥50 ml/min), respectively. Reclassification of renal function stages by Xiangya-s equation was significantly associated with stroke or systemic embolism, non-major clinically relevant bleeding and any bleeding events. Conclusion: Xiangya-s equation provides more accurate GFR estimates in Chinese CKD patients who need consecutive monitoring of renal function, which may assist clinicians in choosing appropriate drug dosages. [ABSTRACT FROM AUTHOR]

Background: The emergence and spread of artemisinin resistance in Plasmodium falciparum poses a threat to malaria eradication, including China's plan to eliminate malaria by 2020. Piperaquine (PPQ) resistance has emerged in Cambodia, compromising an important partner drug that is widely used in China in the form of dihydroartemisinin (DHA)-PPQ. Several mutations in a P. falciparum gene encoding a kelch protein on chromosome 13 (k13) are associated with artemisinin resistance and have arisen spread in the Great Mekong subregion, including the China–Myanmar border. Multiple copies of the plasmepsin II/III (pm2/3) genes, located on chromosome 14, have been shown to be associated with PPQ resistance. Methods: The therapeutic efficacy of DHA-PPQ for the treatment of uncomplicated P. falciparum was evaluated along the China–Myanmar border from 2010 to 2014. The dry blood spots samples collected in the efficacy study prior DHA-PPQ treatment and from the local hospital by passive detection were used to amplify k13 and pm2. Polymorphisms within k13 were genotyped by capillary sequencing and pm2 copy number was quantified by relative-quantitative real-time polymerase chain reaction. Treatment outcome was evaluated with the World Health Organization protocol. A linear regression model was used to estimate the association between the day 3 positive rate and k13 mutation and the relationship of the pm2 copy number variants and k13 mutations. Results: DHA-PPQ was effective for uncomplicated P. falciparum infection in Yunnan Province with cure rates > 95%. Twelve non synonymous mutations in the k13 domain were observed among the 268 samples with the prevalence of 44.0% and the predominant mutation was F446I with a prevalence of 32.8%. Only one sample was observed with multi-copies of pm2, including parasites with and without k13 mutations. The therapeutic efficacy of DHA-PPQ was > 95% along the China–Myanmar border, consistent with the lack of amplification of pm2. Conclusion: DHA-PPQ for uncomplicated P. falciparum infection still showed efficacy in an area with artemisinin-resistant malaria along the China–Myanmar border. There was no evidence to show PPQ resistance by clinical study and molecular markers survey. Continued monitoring of the parasite population using molecular markers will be important to track emergence and spread of resistance in this region. [ABSTRACT FROM AUTHOR]

Background: Vitamin D (VD) insufficiency or deficiency is a frequent comorbidity in Chinese women with postmenopausal osteoporosis (PMO). The present study aimed to investigate 25-hydroxyvitamin D [25(OH) D] improvement and calcium-phosphate metabolism in Chinese PMO patients treated with 70 mg of alendronate sodium and 5600 IU of vitamin D3 (ALN/D5600).Methods: Chinese PMO women (n = 219) were treated with 12-month ALN/D5600 (n = 111) or calcitriol (n = 108). Changes in 25(OH) D at month 12 were post hoc analyzed by the baseline 25 (OH) D status using the longitudinal analysis. The main safety outcome measures included serum calcium and phosphate and 24-h urine calcium, and the repeated measures mixed model was used to assess the frequencies of the calcium-phosphate metabolic disorders.Results: Absolute change in mean serum 25(OH) D level was the greatest in VD-deficient patients and least in VD-sufficient patients at months six and 12 (both, P < 0.01). Serum calcium level remained significantly lower in the ALN/D5600 treatment group than in the calcitriol treatment group throughout the 12 months. Mean 24-h urine calcium slightly increased in the ALN/D5600 treatment group and significantly increased in the calcitriol treatment group (+ 1.1 and + 0.9 mmol/L at months six and 12; both, P < 0.05). Calcitriol treatment was associated with more frequent hypercalciuria at month six (9.4% vs. 18.5%, P = 0.05), but not at month 12 (12.3% vs. 13.0%).Conclusion: Baseline VD status predicted 25(OH) D improvement in PMO patients on 12-month ALN/D5600 treatment. The daily use of 0.25 μg of calcitriol was associated with more frequent hypercalciuria at month six, compared to ALN/5600 treatment, necessitating the safety re-evaluation of calcitriol at a higher dosage. [ABSTRACT FROM AUTHOR]

Objective: To determine whether surgical treatment of cesarean scar diverticulum (CSD) reduced adverse outcomes during the subsequent pregnancy.Methods: A retrospective observational study was conducted using the medical records of pregnant women with CSD who attended a single hospital in Hangzhou, China, between January 1, 2014, and December 31, 2016. Baseline characteristics and pregnancy outcomes were compared between the surgery group and the no surgery group.Results: There were 106 patients included in the study, 83 in the surgery group and 23 in the no surgery group. The CSD size was greater in all dimensions for the surgery group versus the no surgery group: length (P<0.001), width (P=0.001), and depth (P=0.030). The remaining myometrium was thinner among women in the surgery group than those in the no surgery group (P=0.011). In all, 76 (91.6%) women in the surgery group were symptomatic. The incidence of live delivery pregnancy was higher (P=0.033) and the incidence of cesarean scar pregnancy was lower (P=0.019) in the surgery group versus the no surgery group. Surgery increased the thickness of the lower uterine segment (P<0.001); however, it did not reduce the risks of placenta previa or placenta accreta (P=0.683) and uterine dehiscence or uterine rupture (P=0.458).Conclusion: Surgical intervention reduced the incidence of cesarean scar pregnancy and increased the number of live deliveries. [ABSTRACT FROM AUTHOR]

[Display omitted] Rare but critical bleeding events in primary immune thrombocytopenia (ITP) present life-threatening complications in patients with ITP, which severely affect their prognosis, quality of life, and treatment decisions. Although several studies have investigated the risk factors related to critical bleeding in ITP, large sample size data, consistent definitions, large-scale multicenter findings, and prediction models for critical bleeding events in patients with ITP are unavailable. For the first time, in this study, we applied the newly proposed critical ITP bleeding criteria by the International Society on Thrombosis and Hemostasis for large sample size data and developed the first machine learning (ML)-based online application for predict critical ITP bleeding. In this research, we developed and externally tested an ML-based model for determining the risk of critical bleeding events in patients with ITP using large multicenter data across China. Retrospective data from 8 medical centers across the country were obtained for model development and prospectively tested in 39 medical centers across the country over a year. This system exhibited good predictive capabilities for training, validation, and test datasets. This convenient web-based tool based on a novel algorithm can rapidly identify the bleeding risk profile of patients with ITP and facilitate clinical decision-making and reduce the occurrence of adversities. [ABSTRACT FROM AUTHOR]

• The ratio between OH production from HONO and from (HONO+O3) lager than 90% before 12:00. • The source of HONO from combustion emission is ~26%. • NO 2 being converted to HONO under the conditions with high aerosol extinction coefficient and high relative humidity was a dominant factor for the secondary produce of HONO. • HONO mainly distributed near the surface and localized, and NO 2 mainly transmitted from north at ~ 0.6 km. Ground-based multi-axis differential optical absorption spectroscopy (MAX-DOAS) observations were operated from 02 to 21 December 2018 in Leshan, southwest China, to measure HONO, NO 2 and aerosol extinction vertical distributions, and these were the first MAX-DOAS measurement results in Sichuan Basin. During the measurement period, characteristic ranges for surface concentration were found to be 0.26–4.58 km−1 and averaged at 0.93 km−1 for aerosol extinction, 0.49 to 35.2 ppb and averaged at 4.57 ppb for NO 2 and 0.03 to 7.38 ppb and averaged at 1.05 ppb for HONO. Moreover, vertical profiles of aerosol, NO 2 and HONO were retrieved from MAX-DOAS measurements using the Heidelberg Profile (HEIPRO) algorithm. By analysing the vertical gradients of pollutants and meteorological information, we found that aerosol and HONO are strongly localised, while NO 2 is mainly transmitted from the north direction (city center direction). Nitrogen oxides such as HONO and NO 2 are important for the production of hydroxyl radical (OH) and oxidative capacity in the troposphere. In this study, the averaged value of OH production rate from HONO is about 0.63 ppb/hr and maximum value of ratio between OH production from HONO and from (HONO+O 3) is > 93% before12:00 in Leshan. In addition, combustion emission contributes to 26% for the source of HONO in Leshan, and we found that more NO 2 being converted to HONO under the conditions with high aerosol extinction coefficient and high relative humidity is also a dominant factor for the secondary produce of HONO. [Display omitted] [ABSTRACT FROM AUTHOR]

The relationship between PM 2.5 and metabolic diseases, including type 2 diabetes (T2D), has become increasingly prominent, but the molecular mechanism needs to be further clarified. To help understand the mechanistic association between PM 2.5 exposure and human health, we investigated short-term PM 2.5 exposure trajectory-related multi-omics characteristics from stool metagenome and metabolome and serum proteome and metabolome in a cohort of 3267 participants (age: 64.4 ± 5.8 years) living in Southern China. And then integrate these features to examine their relationship with T2D. We observed significant differences in overall structure in each omics and 193 individual biomarkers between the high- and low-PM 2.5 groups. PM 2.5 -related features included the disturbance of microbes (carbohydrate metabolism-associated Bacteroides thetaiotaomicron), gut metabolites of amino acids and carbohydrates, serum biomarkers related to lipid metabolism and reducing n-3 fatty acids. The patterns of overall network relationships among the biomarkers differed between T2D and normal participants. The subnetwork membership centered on the hub nodes (fecal rhamnose and glycylproline, serum hippuric acid, and protein TB182) related to high-PM 2.5 , which well predicted higher T2D prevalence and incidence and a higher level of fasting blood glucose, HbA1C, insulin, and HOMA-IR. Our findings underline crucial PM 2.5 -related multi-omics biomarkers linking PM 2.5 exposure and T2D in humans. [Display omitted] • Trajectory grouping in short-term PM 2.5 exposures effectively capture variations in microbiota composition. • Novel PM 2.5 -related multi-omics biomarkers well predicted higher T2D prevalence and incidence. • The crucial PM 2.5 -related biomarkers include fecal rhamnose and glycylproline, serum hippuric acid, and protein TB182. • The subnetwork correlation provides critical insights into the molecular mechanisms underlying PM 2.5 -related T2D impacts. [ABSTRACT FROM AUTHOR]

• Chemical constitutes in XNKC were holistically explored by UHPLC-Q-TOF-MS. • Fragmentation mechanism and fragmentation pathways of each type of compound were summarized. • 34 representative constitutes were used as quantitative markers for quality assessment by UHLC-TQ-MS. • Chemometric analysis was further used to screen out potential quality markers. • Puerarin and salvianolic acid B were the two other important potential quality markers for XNKC. Xin-Nao-Kang Capsule (XNKC), a well-known traditional Chinese medicine (TCM), is widely used for the treatment of angina pectoris, cerebral arteriosclerosis and coronary artery disease in China. However, the chemical components have not been holistically explored. In this study, a total of 173 chemical components including 48 flavonoids, 8 lactones, 35 acids, 12 phenanthraquinones, 8 monoterpene glycosides, 32 triterpenoids and 30 other compounds were identified, among which 37 were unambiguously characterized in comparison with their corresponding authentic standards using ultra-high performance liquid chromatography coupled with quadruple time-of-flight tandem mass spectrometry (UHPLC-Q-TOF-MS). To further elucidate the major representative constitutes of XNKC, a high performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry (UHPLC-TQ-MS) method was used for simultaneous quantitative analysis of 34 major representative constitutes in ten batches of XNKC samples, which was validated in terms of linearity, precision, accuracy, repeatability and recovery. Meanwhile, the results of chemometric analysis indicated that puerarin and salvianolic acid B might be the most potential quantitative markers for quality control of XNKC. Taken together, the chemical constitutes of XNKC were systematically identified and a reliable quantitative method coupled with chemometric analysis was successfully employed for evaluating the holistic quality of XNKC. This study will provide a robust foundation for the holistic quality assessment of XNKC. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China.Design: A prospective observational cohort study.Setting: Fourteen ICUs among 13 hospitals in Beijing, China.Patients: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay.Intervention: None.Measurements and Results: The mean age was 64 years. Sixty-three percent were male. New acute respiratory failure accounted for 85.5% of mechanical ventilation cases. Only 4.7% of the patients received mechanical ventilation for acute exacerbation of chronic obstructive pulmonary disease. The most widely used ventilation mode was the combination of synchronized intermittent mandatory ventilation and pressure support (43.6%). Use of lung-protective ventilation is widespread with tidal volumes of 7.1 mL/kg (2.1 mL/kg). The ICU/hospital mortality was 27.6%/29.3%, respectively (8.5%/9.7% for surgical patients and 41.3%/43.2% for medical patients, respectively). The mean level of ICU/hospital cost per patient was $15,271 (18,940)/$22,946 (25,575), respectively. The mean daily ICU cost per patient was $1,212.Conclusion: For the first time, we obtained a preliminary epidemiology data of mechanical ventilation in Beijing, China, through the study. Compared with the other nations, our patients are older, predominantly male, and treated according to prevailing international guidelines yet at a relatively high cost and high mortality. The expanding elderly population predicts increase demand for mechanical ventilation that must be met by continuous improvement in quality and efficiency of critical care services. [ABSTRACT FROM AUTHOR]

Reduction patterns of Plasmodium falciparum and P. vivax malaria transmission and the role of an integrated strategy of case management and vector control are compared between different ecological zones. The epidemiology of malaria in Hainan and Yunnan provinces was disparate, even though distinct malaria control strategies have been adapted to different situations based on risk group, vector behaviours, local health infrastructure, and environmental conditions. The island Hainan appears to be victorious in eliminating malaria. However, there is still a long way to go to prevent the reintroduction of malaria in Hainan province and eliminating malaria in the border areas of Yunnan province. This review of the experiences and challenges from malaria control to elimination in Hainan and Yunnan provinces of southern China will provide a basis for the future elimination of malaria in the whole country. [ABSTRACT FROM AUTHOR]

The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) supported a project on the control and elimination of malaria in People's Republic of China which was one of the biggest-scale international cooperation programmes to control malaria in the country during the past 10 years. The project promoted the effective implementation of the Chinese national malaria control programme. On the basis of epidemiologic data, an overview of the project activities and key performance indicators, the overall impact of the GFATM project was evaluated. We also reviewed relevant programme features including technological and management approaches, with a focus on best practice, innovations in implementation and the introduction of international standards. Last, we summarised the multi-stakeholder cooperation mechanism and comments on its sustainability in the post-GFATM period. Recommendations for the future management of the Chinese national malaria elimination programme are put forward after considering the challenges, shortcomings and lessons learnt during the implementation of the GFATM project in China to sustain past achievements and foster the attainment of the ultimate goal of malaria elimination for the country. [ABSTRACT FROM AUTHOR]