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Background: As multimorbidity becomes common that imposes a considerable burden to patients, but the extent to which widely-used multimorbidity indexes can be applied to quantify disease burden using primary care data in China is not clear. We applied the Chinese Multimorbidity-Weighted Index (CMWI) to health check-ups data routinely collected among older adults by primary care, to examine its validity in measuring multimorbidity associated risks of disability and mortality in annual follow-ups., Methods: The study utilized data from annual health check-ups of older adults, which included information on individual age, sex, and 14 health conditions at primary care in a district of Guangzhou, Guangdong, China. The risk of CMWI for mortality was analysed in a total sample of 45,009 persons 65 years and older between 2014 and 2020 (average 2.70-year follow-up), and the risk for disability was in a subsample of 18,320 older adults free of physical impairment in 2019 and followed-up in 2020. Risk of death and disability were assessed with Cox proportional hazard regression and binary logistic regression, respectively, with both models adjusted for age and sex variables. The model fit was assessed by the Akaike information criterion (AIC), and C-statistic or the area under the receiver operating characteristic curve (AUC)., Results: One unit increase in baseline-CMWI (Median= 1.70, IQR: 1.30-3.00) was associated with higher risk in subsequent disability (OR = 1.12, 95%CI = 1.05,1.20) and mortality (OR = 1.18, 95%CI = 1.14, 1.22). Participants in the top tertile of CMWI had 99% and 152% increased risks of disability and mortality than their counterparts in the bottom tertile. Model fit was satisfied with adequate AUC (0.84) or C-statistic (0.76) for both outcomes., Conclusions: CMWI, calculated based on primary care's routine health check-ups data, provides valid estimates of disability and mortality risks in older adults. This validated tool can be used to quantity and monitor older patients' health risks in primary care., (© 2024. The Author(s).)

Premature ejaculation (PE), despite its wide prevalence, is largely underdiagnosed and undertreated. Being a multifactorial dysfunction with strong cultural characteristics, PE requires skillful attitudes in the psychosexological support, necessary to manage the patient's and the couple's expectations, as well as in the medical treatment. Dapoxetine is a short-acting selective serotonin reuptake inhibitor approved for use in lifelong and acquired PE in a number of countries. Opinions, not always generated by the evidence-based medicine, impacted the attitudes of Western andrologists, as a nocebo effect which produced a drug's Waterloo, characterized by low prescription rates much more built on the patients' and doctors' expectations than on costs, side effects, and efficacy. In the present study, we retrospectively reviewed real-life data from eight Andrology and Sexual Medicine Public Centers in China to assess the prevalence of PE among attending patients, its association with erectile dysfunction, its subtype, and the proposed treatments. In 2019, among 156,486 patients coming to the centers, 32,667 visits having PE as the chief complaint were performed (20.9%). Almost all patients received treatment prescriptions (32,641 patients, 99.92%); 23,273 patients came back for a follow-up visit in the subsequent 12 months (71.2% of those who initially received treatment). Dapoxetine, either alone or in combination with another therapy, was the most prevalent treatment, prescribed to 22,767 patients (69.7% of treated patients), followed by traditional Chinese medicine (TCM) (39.4%). At follow-up, 8174 patients were unsatisfied with treatment, and a new treatment was proposed (35.12%). Dapoxetine was the best treatment, with an overall 27.1% switching rate when used either alone or in combination: Although the switching rate for Dapoxetine alone was 44.2%, the association of the same drug with psychotherapy resulted in much lower rates (19.5%) and reached a minimum of 12% when also combined with TCM demonstrating how cultural aspects and medical attitudes may dramatically impact on the therapy of a multifaceted, complex, and culture-grounded sexual symptom such as PE. In conclusion, taking switching rates as surrogate markers of treatment failure, this real-life study-the largest in the field-shows that in a more patient-oriented (as in Chinese medical culture), and less symptom-oriented (as in Western medical attitudes), Dapoxetine is a successful treatment for PE patients, with higher reliability when used alone or as part of combined and integrated therapies., (© 2023 The Authors. Andrology published by Wiley Periodicals LLC on behalf of American Society of Andrology and European Academy of Andrology.)

Isotemporal substitution model is a powerful tool to explore the real association between physical behavior and health outcomes, which has the potential of the application in large-scale cohort study. This paper systematically introduces the principle of isotemporal substitution model and its implementation method in specific analysis to provide analytical ideas for the epidemiological research related to physical behavior in China. The baseline data of Regional Ethic Cohort Study in Northwest China conducted in Shaanxi province were used to analyze the relationship between physical behavior and cardiovascular disease with single-factor model, partition model and isotemporal substitution model. The advantages and disadvantages of different models were compared, and the advantages of isotemporal substitution model in quantifying physical activity health risk were introduced. Isotemporal substitution model could qualify physical behavior and health outcomes, which has wide application value in epidemiological research.

Objectives: To establish a predictive equation for commonly used pulmonary ventilation function parameters in children aged 6-<16 years in northeast China., Methods: A total of 504 healthy children from Liaoning, Jilin, and Heilongjiang provinces of China were selected for the prospective study, among whom there were 242 boys and 262 girls. The JAEGER MasterScreen Pneumo spirometer was used to measure pulmonary ventilation function. With the measured values of 10 parameters, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ), FEV 1 /FVC ratio, and back-extrapolated volume (BEV), as dependent variables and age, body height, and body weight as independent variables, the stepwise multivariate regression method was used to establish the regression equation for children of different sexes. The mean of relative prediction error was used to evaluate the applicability of the predictive equation., Results: The boys aged 9-<10 years and 15-<16 years had significantly higher body height, FVC, and FEV 1 than the girls of the same age ( P <0.05), and the boys aged 9-<10, 10-<11, 11-<12, and 13-<14 years had a significantly lower FEV 1 /FVC ratio than the girls of the same age ( P <0.05). The correlation analysis showed that all parameters, except FEV 1 /FVC ratio and BEV/FVC ratio, were significantly positively correlated with age, body height, and body weight ( P <0.001). Further regression analysis showed that age and body height were the influencing factors for most parameters, while body weight was less frequently included in the regression equation. Compared with the predictive equations from previous studies, the regression equation established in this study had relatively good applicability in the study population., Conclusions: A new predictive equation for the main pulmonary ventilation function parameters has been established in this study for children aged 6-<16 years in northeast China, which provides a basis for accurate judgment of pulmonary function abnormalities in clinical practice.

Idiopathic pulmonary arterial hypertension (IPAH) is a rare vascular disease with a poor prognosis, and the mechanism of its development remains unclear. Further molecular pathology studies may contribute to a comprehensive understanding of IPAH and provide new insights into diagnostic markers and potential therapeutic targets. Iron deficiency has been reported in 43-63% of patients with IPAH and is associated with reduced exercise capacity and higher mortality, suggesting that dysregulated iron metabolism may play an unrecognized role in influencing the development of IPAH. In this study, we explored the regulatory mechanisms of iron metabolism in IPAH by bioinformatic analysis. The molecular function of iron metabolism-related genes (IMRGs) is mainly enriched in active transmembrane transporter activity, and they mainly affect the biological process of response to oxidative stress. Ferroptosis and fluid shear stress and atherosclerosis pathways may be the critical pathways regulating iron metabolism in IPAH. We further identified 7 key genes (BCL2, GCLM, MSMO1, SLC7A11, SRXN1, TSPAN5, and TXNRD1) and 5 of the key genes (BCL2, MSMO1, SLC7A11, TSPAN5, and TXNRD1) as target genes may be regulated by 6 dysregulated miRNAs (miR-483-5p, miR-27a-3p, miR-27b-3p, miR-26b-5p, miR-199a-5p, and miR-23b-3p) in IPAH. In addition, we predicted potential IPAH drugs-celastrol and cinnamaldehyde-that target iron metabolism based on our results. These results provide insights for further definition of the role of dysregulated iron metabolism in IPAH and contribute to a deeper understanding of the molecular mechanisms and potential therapeutic targets of IPAH., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Hua-Xi Zou et al.)

Background: Acute type A aortic dissection (ATAAD) and acute type A intramural hematoma (ATAIMH) are life-threatening diseases with high mortality. To better understand their clinical features in the Chinese population, we analyzed the data from the first Registry of Aortic Dissection in China (Sino-RAD) to promote the understanding and management of the diseases., Methods: All patients with ATAAD and ATAIMH enrolled in Sino-RAD from January 1, 2012 to December 31, 2016 were involved. The data of patients' selection, history, symptoms, management, outcomes, and postoperation complications were analyzed in the study. The continuous variables were compared using the Student's t test for normal distributions and the Mann-Whitney U test for non-normal distributions. Categorical variables were compared using the Chi-square test or Fisher exact test., Results: A total of 1582 patients with ATAAD and 130 patients with ATAIMH were included. The mean age of all patients was 48.4 years. Patients with ATAAD were significantly younger than patients with ATAIMH (48.9 years vs. 55.6 years, P < 0.001). For the total cohort, males were dominant, but the male ratio of patients with ATAAD was significantly higher compared to those with ATAIMH (P = 0.01). The time range from the onset of symptom to hospitalization was 2.0 days. More patients of ATAIMH had hypertension than that of ATAAD (82.3% vs. 67.6%, P < 0.05). Chest and back pain were the most common clinical symptoms. Computerized tomography (CT) was the most common initial diagnostic imaging modality. 84.7% received surgical treatment and in-hospital mortality was 5.3%. Patients with ATAAD mainly received surgical treatment (89.6%), while most patients with ATAIMH received medical treatment (39.2%) or endovascular repair (35.4%)., Conclusions: Our study suggests that doctors should comprehensively use clinical examination and genetic background screening for patients with ATAAD and ATAIMH and further shorten the time range from symptoms onset to intervention, achieving early diagnosis and treatment, thereby reducing the mortality rate of patients with aortic dissection in China. We should standardize the procedures of aortic dissection treatment and improve people's understanding. Meanwhile, the curing and transferring efficiency should also be improved., (Copyright © 2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

Objective: To provide the risk stratification method of hepatoblastoma (HB) suitable for implementation in China and explore the new treatment method for high-risk HB patients. Methods: A total of 100 cases of children and adolescents under 18 years old with newly diagnosed HB in Sun Yat-sen University Cancer Center and Sun Yat-sen University First Affiliated Hospital from September 2014 to September 2018 were included. According to the clinical stage, AFP level, pathological subtype and other factors, patients were stratified into four groups: extremely low-, low-, intermediate- and high-risk. The patients at very low risk were treated with surgery only and followed-up. The patients at very low risk were treated with C5V(Cisplatin+ 5-Fluroracil+ Vincristine) regimen for 4 courses. The patients at intermediate risk were treated with C5VD(Cisplatin+ 5-Fluroracil+ Vincristine+ Doxorubicin)regimen before and after surgery for 6-8 courses. The patients at high risk were treated with C5VD and IIV (ifoshamide+ irinotecan+ vincristine) alternately before and after surgery for 8 courses. Results: One hundred patients were stratified into extremely low-risk, low-risk, medium-risk and high-risk groups for 2, 10, 51 and 37 cases, respectively. Eighty three cases had evaluable lesions before chemotherapy. Among them, 65 patients achieved partial remission, stable disease and progressive disease were observed in 10, and 8 cases, respectively, with a response rate of 78.3%. During a median follow-up of 20 months, 30 patients experienced tumor relapse or progression, and 27 of them died. The 2-years progression-free survival (PFS) and overall survival (OS) rates were 69.2% and 72.0%, respectively. The 2-years PFS rates of patients with extremely low risk, low risk, medium risk and high risk were 100%, 88.9%, 75.3% and 43.2%, respectively. The 2-years OS rates were 100%, 100%, 81.0% and 44.8%, respectively. Conclusions: The novel HB risk classification is simple and feasible. With active comprehensive treatment, patients at extremely low-, low- and medium-risk have excellent outcomes. The survival rate of high-risk HB patients remains to be improved, and new treatment strategies need to be explored.

Amyotrophic lateral sclerosis (ALS), a specific neurodegenerative disease, imposed increased economic and utilizations burden on the healthcare system, especially with the progress of the diseases severity. However, the economic burden on Chinese ALS patients remained unclear. This study therefore was aimed to investigate medical cost and healthcare utilization for Chinese ALS patients.Longitudinal health data of over 20 million individuals, including military personnel and civilians, was collected from all Chinese military hospitals. We identified 480 patients with a first major diagnosis for ALS from 2015 to 2018, while matched 400 controlled patients on age, gender, ethnic group, geographic region, length of stay, year of diagnosis and comorbidity. Their medical cost and healthcare utilizations were then measured 1 year before, and 1 year after ALS diagnosis.The median annual medical cost of ALS patients was about 2-fold higher, 17,087 CNY during the index year than 1 year before, 7859 CNY. The highest increase in utilizations may account for medical costs on ALS patients, which was represented by hospitalizations (Odd Ratio (OR) = 4.26, 95% confidence interval (CI) 3.52, 5.15), electromyography (OR = 4.14, 95% CI 2.37, 7.22), nerve conduction velocity (OR = 3.26, 95% CI 2.23, 4.77).This study is the first one reporting direct economic burden on Chinese ALS patients. Efforts should be made to develop cost-effective diagnostic tools in order that sources of medical cost were more effectively allocated, and this disease was detected earlier.

Objective: To evaluate the safety of 23 Valent Pneumococcal Polysaccharide Vaccine (PPV23) among eldly people aged 60 and above in Shanghai. Methods: A total of 1 310 660 monitoring data of adverse events following immunization (AEFI) of PPV23 among people aged 60 and above were collected through the National AEFI Surveillance System from September 14, 2013 to December 31, 2017 in Shanghai. And the descriptive epidemiological methods were used for analysis. Results: 433 cases of AEFI were reported from September 14, 2013 to December 31, 2017, with the incidence rate of AEFI was 33.04/100 000 doses. The general reactions were reported as 392 cases (90.53%), with 17 cases of abnormal reactions (3.93%), 23 cases of coincidences (5.31%) and 1 case of psychogenic reactions (0.23%). The reported incidence rates of general reactions and abnormal reactions of free PPV23 inoculation among elderly people in urban areas were 41.31 per 100 000 doses and 1.91/100 000 doses, respectively, which were higher than those in suburban areas (24.18/100 000 doses, 1.32/100 000 doses) and exurban areas (27.84/100 000 doses, 0.59/100 000 doses). The reported incidence rate of general reaction in females (35.38/100 000 doses) was higher than that in males (24.06/100 000 doses), and the reported incidence rate of abnormal reaction in males (1.58/100 000 doses) was higher than that in females (1.03/100 000 doses). The reported incidence rates of general and abnormal reactions were the highest in 60-64 years old group (62.65/100 000 doses and 4.87/100 000 doses, respectively). In addition, all patients with general reactions or abnormal reactions were better or cured. Conclusion: PPV23 vaccination is safe among people aged 60 and above in Shanghai.

Evaluation of landscape aesthetic quality is a key step in the management system of forest resource. Color is an important component of autumn landscape forest, and quantitative analysis of color and scientific evaluation of landscape aesthetic quality are important for the management of autumn landscape forest. We assessed the aesthetic quality of autumn landscape forest using scenic beauty estimation and analyzed the effects of color characteristics on ornamental value of autumn landscape forest based on color composition and color spatial pattern according to human's visual characteristics. The results showed that the overall landscape quality of subalpine region of western Sichuan could be divided into five grades according to beauty value (I to V). About 71.5% of autumn landscape forests could be classified into grade I, II, and III, indicating that autumn landscape forests of subalpine region in western Sichuan had higher ornamental value. According to the scenic beauty estimation value, the landscape aesthetic quality of broadleaved mixed forests was higher than that of coniferous and broadleaved mixed forests and pure forests. In terms of the comprehensive index evaluation system of color elements, the index weight coefficient order was landscape patch heterogeneity factors>autumn main color factors>color saturation and brightness factors>color diversity and evenness factors. With cluster analysis, autumn landscape forests of western Sichuan could be divided into three types. The forests with higher ornamental value showed following characteristics: larger degree of patch fragmentation and heterogeneity, higher percentage of orange and yellow and lower percentage of green in autumn, higher percentage of color saturation and brightness, and higher color diversity and uniformity index. The communities with higher richness, species diversity and evenness index would have higher beauty values. We concluded that species diversity and fragmentation of colors should be considered in the construction of autumn landscape forests, and that aesthetic quality of autumn landscape forest could be improved by planting and cultivating tree species with various and bright autumn leaf colors.

Objective: To evaluate the safety of population based sequential vaccination schedule of inactivated poliovirus vaccines prepared with different strains. Methods: This randomized, parallel-group controlled trial was conducted from March, 2017 to May, 2018, in Shanghai. Adverse reaction data of Sabin strain inactivated polio vaccine (sIPV), wild strains inactivated polio vaccines (wIPV) and bivalent types Ⅰ and Ⅲ oral poliomyelitis vaccine (bOPV) were systematically collected through active observation in 1 917 infants in Shanghai after the vaccination at 2, 3, 4 months old. The eligible infants aged 2 months were divided into 4 groups: ①sIPV+sIPV+bOPV group; ②sIPV+wIPV+bOPV group; ③wIPV+sIPV+bOPV group; ④wIPV+wIPV+bOPV group. Results: The incidence of adverse reaction 30 days later after 3 basic dose vaccinations was 16.79% (946/5 633). No serious adverse reaction was reported. Local and systemic reactions were mainly mild. Common local reactions were pain, erythema, cutaneous nodule, etc .; and common systemic reactions were abnormal crying, drowsiness, diarrhea and appetite lost, etc .. The incidence of local reactions 30 days later after 3 basic dose vaccinations was 1.65% (93/5 633), and the incidence rates of grade 1-3 reactions were1.26% (71/5 633), 0.21% (12/5 633) and 0.20% (11/5 633) respectively. The incidence rate of systemic reactions 30 days later after 3 basic vaccinations was 15.14% (853/5 633), and the incidence rates of grade 1-3 reactions were 11.33% (638/5 633), 3.18% (179/5 633) and 0.64% (36/5 633) respectively. There were no significant differences in the rate of grade 3 reaction among different groups ( χ (2)=4.17, P =0.24). Conclusions: No severe adverse reactions related to sequential vaccination of different strain inactivated polio vaccines were observed, most of reactions were mild and all of them were cured. It is safe to use sIPV and wIPV simultaneously or alternately for childhood sequential vaccination.

Objective: To evaluate the immunogenicity of different strains of inactivated poliomyelitis vaccines (IPV) by sequential program. Methods: This parallel-group controlled trial was conducted in immunization clinics in Shanghai from March 2016 to September 2017. Sabin strains inactivated poliomyelitis vaccines (sIPV), WPV strains inactivated poliomyelitis vaccines (wIPV) and live poliomyelitis Type Ⅰ Type Ⅲ vaccine (bOPV) as the investigational vaccine were used at 2, 3, 4 months old in 325 infants in Shanghai. Infants vaccinated by four sequential program were divided into 4 groups: sIPV+sIPV+bOPV, sIPV+wIPV+bOPV, wIPV+sIPV+bOPV and wIPV+wIPV+bOPV. A total of 230 investigators' blood samples were collected before primary immunization and 163 investigators' blood samples were collected after primary immunization. A total of 151 investigators (36, 44, 30 and 41 in each group) finished primary immunization and blood sampling before and after the primary immunization. The geometric mean titer (GMT) of poliovirus typesⅠ and Ⅲ neutralizing antibody was tested and calculated, and the positive results of antibody before and after primary immunization were analyzed. Results: Among the 151 investigators, the age were (2.27±0.61) months and birth weight were (3.27±0.43) kg, and 70 were male. The positive rates of typeⅠwas 98.68% (149 cases), and type Ⅲ was 97.35% (147 cases); the number of investigators tested in each group was 36, 44, 30 and 41, respectively; the positive rates of typeⅠwas 97.22% (35 cases), 100.00% (44 cases), 96.67% (29 cases) and 100.00% (41 cases) ( P= 0.345); the positive rates of type Ⅲ were 97.22% (35 cases), 95.45% (42 cases), 96.67% (29 cases) and 100.00% (41 cases) ( P= 0.614). Conclusion: Using sIPV and wIPV simultaneously or alternately for sequential immunization of poliomyelitis vaccines showed good immunogenicity for infants at appropriate age.

Genome-wide association studies (GWASs) have revealed the worldwide heterogeneity of genetic factors in tuberculosis (TB) susceptibility. Despite having the third highest global TB burden, no TB-related GWAS has been performed in China. Here, we performed the first three-stage GWAS on TB in the Han Chinese population. In the stage 1 (discovery stage), after quality control, 691 388 SNPs present in 972 TB patients and 1537 controls were retained. After replication on an additional 3460 TB patients and 4862 controls (stages 2 and 3), we identified three significant loci associated with TB, the most significant of which was rs4240897 (logistic regression P = 1.41 × 10-11, odds ratio = 0.79). The aforementioned three SNPs were harbored by MFN2, RGS12 and human leukocyte antigen class II beta chain paralogue encoding genes, all of which are candidate immune genes associated with TB. Our findings provide new insight into the genetic background of TB in the Han Chinese population., (© The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Objective: Less surveys on the economic burden of hepatitis B (HB)-related diseases have been conducted in China, so the socioeconomic harm caused by the diseases is not clear and the key parameters for economic evaluation of hepatitis B prevention and treatment are lacking. This study aimed to analyze the direct, indirect and intangible expenditures of hospitalized patients with HB-related diseases during hospitalization and during a year in different areas of China. Methods: The hospitals for infectious diseases and the large general hospitals in 12 areas in China were selected in the study. All the inpatients with HB-related diseases were surveyed by cluster sampling of consecutive cases. The direct expenditure included direct medical cost and direct non-medical cost. The indirect expenditure, including work loss of patients and caregivers, were calculated by using human capital method for urban and rural populations in 12 areas. The intangible expenditure were reflected by willing to pay and stochastic tournament. The influencing factors of direct and indirect costs were identified by stepwise linear multi-variation regression analysis. Results: A total of 27 hospitals in 12 areas were included in the survey. A total of 4 718 cases were surveyed, the overall response rate was 77.7 % . The average hospital stay was 29.2 days (27-34) and the hospitalization expenditure was averagely 16 832.80 yuan (RMB) per case, in which the highest proportion (61.2 % ) was medicine fees [10 365.10 yuan (RMB)]. The average direct expenditure and indirect expenditure were consistent with the severity of illness, which were 18 336.10 yuan (RMB) and 4 759.60 yuan (RMB) respectively, with the ratio of 3.85 ∶ 1. The direct medical expenditure [17 434.70 yuan (RMB)] were substantially higher than the direct non-medical expenditure [901.40 yuan (RMB)]. It was found that the hospitalization expenses was highest in direct medical expenditure and the transportation expenses was highest in direct non-medical expenditures. Among the average indirect expenditure, the loss of income for the patients [3 832.50 yuan (RMB)] was higher than that for the caregivers [927.20 yuan (RMB)]. The total direct and indirect expenditure was highest for liver transplantation, followed by severe hepatitis, hepatocellular carcinoma and decompensated cirrhosis, acute hepatitis B, compensated cirrhosis and chronic hepatitis B. The influencing factors for both direct and indirect expenditure were high hospital level, severity of hepatitis B, living in urban area, antiviral therapy, long hospitalization and monthly income of family. For average 3.74 outpatient visits and 1.51 hospitalization, the average annual direct, indirect and intangible expenditure for HB-related diseases were 30 135.30, 6 253.80 and 44 729.90 yuan (RMB) [totally 81 119.00 yuan (RMB)], accounting for 37.3 % , 7.7 % and 55.0 % , respectively. Of the annual direct medical expenditure [28 402.80 yuan (RMB)], which were much higher than non-medical expenditure [1 732.50 yuan (RMB)], hospitalization expenditure [26 074.20 yuan (RMB)] was higher than outpatient visit expenditure [4 061.10 yuan (RMB)]. The annual indirect expenditures for outpatient visit and hospitalization were 763.60 and 5 490.10 yuan (RMB), respectively. Of the annual intangible expenditure, the highest was that for primary hepatocellular carcinoma, followed by cirrhosis, chronic hepatitis B, severe hepatitis B, liver transplantation and acute hepatitis B. Conclusions: A heavy economic burden has been caused by HB-related diseases in China, and patients are more likely to rely on medical service rather than non-medical service. It is necessary to take effective treatment measures to prevent the adverse outcome of HB related diseases and achieve significant economic benefits. The influence of HB related diseases on mental health of the people can be reflected by an economics term, intangible expenditure.

Cryptorchidism is one of the most common congenital anomalies and affects 2-4% of full-term new born boys. Its aetiology is poorly understood at present. HOXA10 plays a pivotal role in regulation of testicular descent. Male mice mutant for Hoxa10 exhibit unilateral or bilateral cryptorchidism as a result of impaired development of the gubernaculums. In this study, we performed mutation analysis of HOXA10 gene in a cohort of 98 cryptorchid patients. And we found a mutation (N27K) in a boy with unilateral cryptorchidism. The mutation was not detected in 106 healthy controls. Both in silico analyses and functional studies showed that the mutation affected the function of HOXA10. The results demonstrated that mutation in HOXA10 gene contributes to the pathogenesis of cryptorchidism, but may not be a common cause., (© 2016 Blackwell Verlag GmbH.)

Objective: To investigate the optimal anticoagulation methods and monitoring strategy for Chinese patients undergoing heart valve replacement, which is potentially quite different from western populations., Methods: In this multicenter prospective cohort study, the anticoagulation and monitoring strategy data was acquired from 25 773 in-hospital patients in 35 medical centers and 20 519 patients in outpatient clinic in 11 medical centers from January 1st, 2011 to December 31th, 2015., Results: As for in-hospital patients, mean age of study population was (48.6±11.2) years old; main etiology of valve pathology was rheumatic (87.5%) origin among study cohort; 94.8% of study population received mechanical valve implantation; international normalized ratio (INR) monitoring (in all the study centers) and low-intensity anticoagulation strategy (31 hospitals chose target INR range of 1.5-2.5, and actual values of INR among 89.2% of 100 069 in-hospital monitoring samples were 1.5-2.5), with mean actual INR values of 1.84±0.53, and warfarin dosage of (2.82±0.93) mg/d were widely adopted among the study centers; strategies of in-hospital warfarin administration were similar in all the study centers; complication rates of low-intensity anticoagulation strategy were low in severe hemorrhage (0.02%), thrombosis (0.05%), and thromboembolism (0.05%) events, without anticoagulation-related death.As for 18 974 outpatient clinic patients, the follow-up rate was 92.47%, with a total of 30 012 patient-years (Pty). Anticoagulation-related morbidity and mortality rates were 0.67% and 0.15% Pty; major hemorrhage morbidity and mortality rates were 0.25% and 0.13% Pty; thromboembolism morbidity and mortality rates were 0.45% and 0.03% Pty.The mean dosage of warfarin daily dosage was (2.85±1.23) mg/d and INR value was 1.82±0.57.No significant regional difference in the intensity of anticoagulation therapy was noted during the study., Conclusions: INR can be used as a normalized indicator for intensity of anticoagulation therapy in China.The optimal anticoagulation intensity with INR range from 1.5 to 2.5 is safe and effective for Chinese patients with heart valve replacement, and there is no significant regional difference in the intensity of anticoagulation therapy.

A growing demand for sustainable energy has led to an increase in construction of offshore windfarms. Guishan windmill farm will be constructed in the Pearl River Estuary, China, which sustains the world's largest known population of Indo-Pacific humpback dolphins (Sousa chinensis). Dolphin conservation is an urgent issue in this region. By using passive acoustic monitoring, a baseline distribution of data on this species in the Pearl River Estuary during pre-construction period had been collected. Dolphin biosonar detection and its diel, lunar, seasonal and tidal patterns were examined using a Generalized Linear Model. Significant higher echolocation detections at night than during the day, in winter-spring than in summer-autumn, at high tide than at flood tide were recognized. Significant higher echolocation detections during the new moon were recognized at night time. The diel, lunar and seasonal patterns for the echolocation encounter duration also significantly varied. These patterns could be due to the spatial-temporal variability of dolphin prey and illumination conditions. The baseline information will be useful for driving further effective action on the conservation of this species and in facilitating later assessments of the effects of the offshore windfarm on the dolphins by comparing the baseline to post construction and post mitigation efforts.

Air pollution from freshwater port is mainly caused by dust pollution, including material loading and unloading dust, road dust, and wind erosion dust from stockpile, bare soil. The dust pollution from a single dock characterized in obvious difference with air pollution from multiple scattered docks. Jining Port of Shandong Province was selected as a case study to get superposition impact contribution of air pollution for regional air environment from multiple scattered docks and to provide technical support for system evaluation of port air pollution. The results indicate that (1) the air pollution from freshwater port occupies a low proportion of pollution impact on regional environmental quality because the port is consisted of serveral small scattered docks; (2) however, the geometric center of the region distributed by docks is severely affected with the most superposition of the air pollution; and (3) the ADMS model is helpful to attain an effective and integrated assessment to predict a superposition impact of multiple non-point pollution sources when the differences of high-altitude weather conditions was not considered on a large scale.

Objective: To investigate the association of ten single nucleotide polymorphisms (SNPs) in the peroxisome proliferator-activated receptor (α, δ, γ) with obesity and the additional role of a gene-gene interaction among 10 SNPs., Methods: Participants were recruited within the framework of the PMMJS (Prevention of Multiple Metabolic Disorders and Metabolic Syndrome in Jiangsu Province)-cohort-population-survey in the urban community of Jiangsu province, China. 820 subjects (513 non obese subjects, 307 obese subjects) were randomly selected and no individuals were related to each other. Ten SNPs (rs135539, rs4253778, rs1800206, rs2016520, rs9794, rs10865710, rs1805192, rs709158, rs3856806, rs4684847) were selected from the HapMap database, which covered PPARα, PPARδ and PPARγ. Logistic regression model was used to examine the association between ten SNPs in the PPARs and obesity. Odds ratios (OR) and 95% confident interval (95%CI) were calculated. Interactions were explored by using the Generalized Multifactor Dimensionality Reduction (GMDR)., Results: A group of 820 participants (mean age was 50.05± 9.41) was involved. The frequency of the mutant alleles of rs2016520 in obese populations was less than that in non-obese populations (26% vs. 33%, P < 0.01). The frequency of the mutant alleles of rs10865710 in obese populations was more than that in non-obese populations (37% vs. 31%, P = 0.01). C allele carriers had a significantly lower obesity occurrence than TT homozygotes [OR (95%CI) = 0.63 (0.47 - 0.84)] for rs2016520 but no significant association was observed between other SNP and incident obesity. GMDR analysis showed a significant gene-gene interaction among rs2016520, rs9794 and rs10865170 for the three-dimension models (P = 0.0010), in which prediction accuracy was 0.5834 and cross-validation consistency was 9/10. It also showed a significant gene-gene interactions between rs2016520 and rs10865170 in all the two-dimensional models (P = 0.0010), in which predictive accuracy was 0.5746 and cross-validation consistency was 9/10., Conclusion: Our data showed that rs2016520 was associated with lower obesity risk, as well as interactions among rs2016520, rs9794 and rs10865170 on incident obesity.

Objective: To observe the expression of osteopontin (OPN) in hepatocytes of rats fed with corn baked by burning coal from fluorosis areas and a deficiency of calcium/protein intake following fluorosis., Methods: A total of 48 Wistar rats as objects were randomly assorted into four groups: dose-free fluorine group, which were mainly fed with fluorine-free corn (56% structurally), dose-free fluorine with biased dietary group, which were fed with lower contents of protein (119.41 g/kg) and calcium (0.68 g/kg), high-dose fluorine group (fluorine contents: 104.2 mg/kg), and high-dose fluorine with biased dietary group. After 180 days of cultivation, the contents of fluorine in the bones of rats were tested for the assessment of construction of fluorosis animal model. And the expression of OPN in hepatocytes of rats in different groups was detected with immunohistochemistry and reverse transcription polymerase chain reaction., Results: The present study validated the result that OPN was overexpressed in hepatocytes following fluorosis after oral intake of burning coal-baked corn. OPN was expressed most significantly in high fluorine with biased dietary group, and the high-fluorine group ranked the second most; and dose-free fluorine with biased dietary group ranked the third. The dose-free fluorine group expressed the least OPN., Conclusion: Overexpression of OPN in hepatocytes following fluorosis after excess fluorine intake was involved in liver damage process, which was enhanced by deficiency of calcium and protein intake. The results also demonstrated that the development of fluorosis in Guizhou province was correlated with local baking staple corn as a way of excess intake of fluorine and deficiency of calcium/protein intake.

Objective: To study the impact of dynamic change of waist circumference (WC) and body mass index(BMI) in two years on hypertension incidence in cohort populations., Methods: A perspective cohort study was conducted. The participants (5888 subjects) whose follow-time were 2 years or longer from the program Prevention of multiple metabolic disorders and metabolic syndrome (MS) in Jiangsu province were investigated. Amongst 5888 subjects, 4582 participants received the first follow-up investigation in January 2002. Among 4582 subjects who received first follow-up investigation and whose follow-time met 5 years, total 3847 participants received the second follow-up investigation in March 2006. Total 2778 free hypertension subjects were included in this analysis. Subjects with normal WC or BMI at baseline but abnormal WC or BMI at the first follow-up or subjects with abnormal WC or BMI both at baseline and the first follow-up were defined as non-control group. Subjects with abnormal WC or BMI at baseline but normal WC or BMI at the first follow-up or subjects with normal WC or BMI both at baseline and the first follow-up were defined as control group. The incidence of hypertension at second follow-up investigation was defined as the final variable(hypertension = 1, non-hypertension = 0). The association between dynamic change of WC or BMI and incident hypertension was analyzed by using Cox proportional hazards regression model. The OR, RR value and 95%CI were calculated through WC and BMI risk stratification., Results: Among 2778 participants without hypertension at baseline, 660 subjects developed hypertension. When both BMI difference value (D-value) and WC D-value were included in the regression model, WC D-value was associated with hypertension in both genders (males: OR = 1.04, 95%CI: 1.01 - 1.05; females: OR = 1.04, 95%CI: 1.02 - 1.06), but BMI D-value was not associated with hypertension in both men and women (males: OR = 1.04, 95%CI: 0.97 - 1.11; females: OR = 0.98, 95%CI: 0.93 - 1.03). Hypertension risk of WC non-control group was higher than that in WC control group in baseline normal and abnormal WC groups (normal baseline WC group: RR = 1.41, 95%CI: 1.01 - 2.39, abnormal baseline WC group: RR = 4.41, 95%CI: 1.66 - 9.80). But in baseline abnormal BMI group, there was no significant difference between BMI control and non-control group (RR = 1.33, 95%CI: 0.88 - 2.02). Whether BMI was controlled can not influence hypertension risk if WC was controlled (males: RR = 1.03, 95%CI: 0.36 - 2.96; females: RR = 1.02, 95%CI: 0.70 - 5.85), however, control WC could reduce hypertension risk obviously even though BMI was not controlled (males: RR = 4.03, 95%CI: 1.61 - 10.09; females: RR = 1.55, 95%CI: 1.13 - 3.60)., Conclusion: Both WC and BMI dynamic change were associated with change of hypertension. But reducing WC can decrease hypertension risk more than reducing BMI.

The distribution, mobility and potential risks of Cu, Zn, and Pb in four typical plant-sediment co-systems of the Quanzhou Bay estuary wetland in southeast China were investigated using a sequential extraction procedure. The results show that the sediments were moderately or heavily contaminated with Zn and Pb in all four plant communities, and the plant-sediment systems could act as a sink for the heavy metals. In all investigated sediments, only a small proportion of measured heavy metals were distributed in exchangeable fraction and carbonate fraction, while the reducible fraction contained the highest amount of Zn and Pb of the total readily bioavailable fractions, and the oxidizable fraction exhibited a higher retention capacity for Zn and Cu, but lower for Pb. Alternanthera philoxeroides had the best ability to accumulate heavy metals among the four species. Phragmites communis was quite tolerant to Zn and Pb and had a good capability to transfer Zn and Pb. Aegiceras corniculatum seems to be effective in resisting heavy metal pollution, and therefore cannot serve as an indicator of contamination. The urgent need for many local enterprises is to carry out high-tech cleaner production to reduce the emission of pollutants and achieve a resource-economical and environment-friendly development.

Decision-makers take non-point source pollution under control as well as possible results from enough information of risk trend of nonpoint source pollution on watershed scale. System normative indexes integration evaluation method about system risk trend was developed when focusing on that the probability values of some elements attributing to some trend of the system were more than one, and that the system evaluation needed a formula from the system structure. On the basis of analysis on aspects and characteristics of the system risk normalization, a new valuation method, the relationship between the normalization values of the system and the factors was established. The Lugu Lake Watershed in Southwest China was selected as study area to assess the risk of non-point source loss to surface water using this method. The results indicate that 1) the wholly risk of non-point source loss to surface water in this watershed is in a high level; 2) the system indexes integration evaluation method is an universal method to evaluate a quality or a trend of any system and shows a great power in comparing several systems; 3) the method is helpful to attain an effective and integrated assessment on a system when it is combined with other methods.

Background/aims: Hemorrhage occurs in 15-25% of duodenal ulcers, mostly on the posterior wall of the proximal duodenum. Erosion of the gastroduodenal artery is responsible for serious hemorrhages. Therefore, the relationship between bile duct and gastroduodenal artery should be discerned to prevent bile duct injury., Methodology: Cadavers from 52 Chinese adults (44 males, 8 females) were dissected for the anatomic relationships of the GDA and bile duct., Results: The gastroduodenal artery has many possible origins, with the common hepatic artery (92.3%) the most common. The mean distance between gastroduodenal artery and pylorus was 2.7 cm; arterial length (from its origin) was 1.2 cm. The relationships between gastroduodenal artery and bile duct could be divided into 4 anatomic types according to Prudhomme's classification. We found 22 samples (42%) of Type 1; 10 samples (19%) of Type 2; 14 samples (27%) of Type 3 (in 8 samples of Type 3, there was about 8mm thickness of pancreatic tissue between the artery and the bile duct); 6 samples (12%) of Type 4. In 12 cases (24%) there was no interposed pancreatic tissue., Conclusions: These anatomic variations could lead to injury during surgical intervention. Our study provides detailed information about anatomic variability in Chinese adults that may help avoid such injury to the common bile duct during duodenal bleeding hemostasis.

Background: To evaluate homemade and imported HbsAg ELISA kits on screening blood donors., Methods: Samples for evaluation included 120 HbsAg serum plates for the golden criteria and 400 sets of serum from blood donors in Dongguan. The samples underwent blind screening with homemade and imported ELISA kits respectively., Results: The sensitivity of homemade (Xinchuang) and imported (Diasorin) HbsAg ELISA kit were 85.71% (72/84) and 100% (84/84), respectively. Their specificity was 100% (436/436) and 96.55% (421/436) respectively. The consistency of two ELISA kits was 100%., Conclusion: The imported ELISA kit had the highest sensitivity, but its specificity was not as good as that of homemade ELISA kit. The two kinds of ELISA kits had good repetition. The combination of the two reagents may ensure the safety of blood transfusion.

Background: Studies comparing the growth of indigenous high-altitude Aymara children and children of low-altitude European descent who have been born and raised at high altitude in the Andes have provided evidence for genetically-determined differences in thorax growth, as well as for population differences in height, weight and other measures of overall size. Comparable studies now can be undertaken in Asia because of the growing number of Han Chinese who have been born and raised at high altitude on the Qinghai-Tibetan Plateau., Aim: The study compares the growth of indigenous Tibetan children and children of Han descent who have been born and raised at the same high altitudes, and under similar socio-economic conditions., Subjects and Methods: Measurements of stature, sitting height, weight, triceps and subscapular skinfolds, upper arm muscle area, transverse chest diameter, anterio-posterior chest diameter, and chest circumference were taken on 1439 Tibetan and Han males and females between the ages of 6 and 29 years who were born and raised 3200 m, 3800 m or at 4300 m in the high altitude province of Qinghai in western China., Results: Han-Tibetan differences in body size do not occur systematically for any measurement, for any age group, or for either gender; nor is there a systematic pattern of body size differences between 3200 m and 4300 m. This indicates that there are no differences in general growth between the two groups at high altitude in Qinghai, although both groups grow more slowly than urban children at low altitude in China. On the other hand, Tibetan males possess significantly deeper chests than Han males, and Tibetan females possess significantly wider chests than Han females. Tibetans of both sexes possess significantly larger chest circumferences than Han males and females., Conclusions: Although genetic similarities cannot be ruled out, comparable dietary stress is a likely explanation for the similar and slow morphological growth of Han and Tibetans at high altitude. However, Han-Tibetan differences in thorax dimensions are likely a consequence of population (genetic) differences in the response to hypoxia during growth., (Copyright 2004 Taylor and Francis Ltd.)

Background: In a detailed analysis of the palmar cutaneous branch of median nerve (PCN) in the Chinese adults, we tried to evaluate its anatomic variation and clinical significance., Methods: Observations were described in all the 60 specimens of the PCN at the wrist., Results: The PCN was present in all 60 specimens and in most cases (88.3%) it originated from the radial side of the median nerve and the average length from the palmaris longus was 1.4 cm; ulnarward (11.7%); only 5 cases (4.1%) were located at ulnar side and extended beyond the palmaris longus, the average distance being 0.3 cm. Its mean point of origin was 3.2 cm proximal to the distal wrist crease and the variations of the PCN in Lanz classification were: group 0 (31.7%), group 1 (40%), group 2 (15%), group 3 (0%) and group 4 (13.3%)., Conclusions: Longitudinal incision located 1 cm on the ulnar side from palmaris longus could avoid injury to the PCN during decompression for carpal tunnel syndrome.

This study describes the hemoglobin concentration ([Hb]) and hematocrit (HCT) of over 1,000 Tibetan and Han children, adolescents, and young adults who were born and raised at 3,200 m, 3,800 m, or 4,300 m in Qinghai Province, western China. At 3,200 m, no altitude effect is evident in the hematological characteristics of either group. At 3,800 m and 4,300 m, both groups show [Hb] and HCT values that are above low-altitude norms. At both altitudes, Tibetan and Han children show no differences in the pattern of hematological response up to age 13. Among adolescents and young adults, however, the [Hb] and HCT of Han males and females are elevated compared to Tibetans. This indicates that the adolescent period may involve a divergence in the responses to hypoxia made by some individuals in these two groups. Also, many other adolescents and young adults in both groups show similar hematological characteristics, indicating that many Tibetans and Han share similar hematological responses to hypoxia., (Copyright 2003 Wiley-Liss, Inc.)

The origin and course of the cystic artery related to the Calot triangle were studied in 72 autopsies. The cystic artery arises from many possible origins; the right hepatic artery is the most common origin (76.6%). The Calot triangle (hepatocystic triangle), which is an important imaginary referent area for biliary surgery, is bounded by the common hepatic duct (CHD), the cystic duct, and the cystic artery. Of all the cystic arteries, 86.1% coursed through the Calot triangle, and 100% of the cystic arteries originating from the right hepatic artery coursed through the Calot triangle. However, only 54% of the cystic arteries that originated from the left, bifurcation, proper, and common hepatic arteries ran through the triangle. None of the cystic arteries that originated from the gastroduodenal, celiac, superior mesentery, or superior pancreaticoduodenal arteries passed through the triangle. Furthermore, 72.7% of the cystic arteries that originated from the right hepatic artery ran beneath the CHD as they entered the Calot triangle; the others ran anterior to the CHD. Of the cystic arteries that arose from locations other than the right hepatic artery, 29.4% ran posterior to the CHD, and 11.8% ran anterior to the CHD. The current study provides detailed information about anatomic variance in Chinese adults that may help avoid injury during open or laparoscopic cholecystectomies.

The superficial temporal artery is important in head and neck surgery. Ethnologic variation may affect surgical procedure. In this study, we evaluated the variations of the artery in Chinese adults. We measured its bifurcating location, the diameter of its vessels, and its relationship to nearby structures. A total of 26 cadavers with 52 superficial temporal arteries were examined in 3 consecutive years. The superficial temporal artery ran 1.14 cm anteriorly to the bony external auditory canal. The average diameters of the superficial temporal artery, frontal branch, and parietal branch were 2.14, 1.61, and 1.68 mm, respectively. In 45 of 52 cases (86.5 percent), bifurcation of the artery occurred well above the zygomatic arch. The present study thus demonstrated that the superficial temporal artery in the Chinese adult differs from that in the Caucasian and has provided a detailed anatomic distribution analysis of the superficial temporal artery in Chinese adults, which should benefit the clinician in dealing with operation procedures related to this artery.

Three etiologically proven outbreaks of dengue fever and one etiologically confirmed epidemic of dengue haemorrhagic fever have occurred in south China since 1978. The first of these, an epidemic of dengue due to virus type 4 took place in Shiwan town, Foshan city, Guangdong Province, in 1978; the epidemic began in May and ended in November. The clinical manifestations of 583 hospitalized patients were observed from August to October. The majority (81.3%) of patients were aged 21-50 years (male:female = 1.2:1). The course of illness was about 1 week in most cases; three patients (0.5%) died. A local outbreak of dengue due to virus type 1 occurred in Shiqi town, Zhongshan County, Guangdong Province, from September to November 1979. The majority of patients were older children and adolescents. There was no marked difference between males and females in terms of the course of the illness, and there were no complications or deaths. A large epidemic of dengue due to virus type 3 occurred on Hainan Island in 1980. The clinical manifestations of 510 hospitalized patients (mostly adolescents and adults) were observed from April to September. Some patients developed rare complications, such as loss of hair, acute intravascular haemolysis, and multiple peripheral paralysis; there were four deaths (0.78%). The first known epidemic of dengue haemorrhagic fever in China occurred among 10-29-year-olds on Hainan Island in 1985 and 1986. There were no essential differences between males and females. Some cases had rare complications such as acute intravascular haemolysis, while others had diffuse intravascular coagulation and altered mental status; 10 patients (6.5%) died.

We describe a newly detected alpha-thalassemia-2 (alpha-thal-2) deletion characterized by a small -2.7-kb deletion involving the alpha 1 globin gene. This deletion has thus far been observed in only one Chinese subject with Hb H disease.

One hundred mandibles of adult Chinese cadavers of both sexes without missing teeth, alveolar bone resorption and malposition of teeth were studied. The anatomical location of each mandibular mental foramen was measured by using a combination of three previous methods. Our results showed that the location of the mental foramen below the apex of the lower second premolar (relation IV: 58.98%) was the most common. On average, the distance between the most anterior portion of the anterior border of the mental foramen and the mandibular symphysis was 28.06 mm, between the most anterior portion of the anterior border of the mental foramen and the posterior border of the ramus 74.14 mm, between the inferior border of the mental foramen and the lower border of the mandibular body 14.70 mm, between the superior border of the mental foramen and the bottom of the lower second premolar socket 2.50 mm. The distance across the mental foramen between the alveolar crest and the lower border of the mandibular body was 30.29 mm. Our results were compared with those of other investigators. The significance of identifying the anatomical location of the mental foramen in dental practice is discussed.

This article reports for the first time in China the results of serotyping and subgrouping of some rotavirus strains obtained from faecal fluids of cases with infant diarrhoea. Infant diarrhoea rotavirus serotype 1 (Wa strain)-specific and serotype 2 (KUN strain)-specific hyperimmune sera, and infant diarrhoea rotavirus serotype 3-specific, rotavirus subgroup I-specific and subgroup II-specific monoclonal antibodies were used in serotyping and subgrouping by means of enzyme-linked immunosorbent assay of 14 rotavirus strains which had been identified by electron microscopy. Results showed that three out of four Beijing strains in 1982 belonged to serotype 2 and subgroup I rotavirus, one belonged to serotype 3 and subgroup II rotavirus; one out of nine Beijing strains in 1984 belonged to serotype 1 and subgroup II rotavirus, seven belonged to serotype 2 and subgroup I rotavirus, one belonged to serotype 3 and subgroup II rotavirus; and one Kunming strain in 1984 belonged to serotype 3 and subgroup II rotavirus.

One hundred dry skulls of adult Chinese of both sexes were studied. They were homogeneous in the form of maxillary arch and having full eruption of the upper third molar, without missing teeth and malposition of teeth. Our findings revealed that the mean distance from the center of the greater palatine foramen (GPF) to the midsagittal plane of the hard palate was 16.00 mm, and to the posterior border of the hard palate, 4.11 mm. The location of the GPF related to the maxillary molars was expressed as percentage in 5 relations. We found that the most common location of the GPF was between the maxillary second and third molars (relation III: 48%), and less common was lingual to the maxillary third molar (relation IV: 33.5%). The usually accepted description of the GPF location was lingual to the second molar (relation II), but in our study this relative position occurred in only 17% of the skulls. The long axis of the greater palatine canal directing to the GPF in the oral cavity was found to be directed anteriorly in 181 openings (90.5%) of the 200 GPF, and only 19 openings (9.5%) directed vertically. The bilateral symmetry of GPF on both sides of each skull was remarkable. The discrepancy of our observations on the Chinese skulls from those on other ethnic groups was discussed. Our findings suggest, therefore, the existence of an ethnic variation and the necessity of a more accurate method of locating the GPF in clinical practice.

This paper deals with a method of using unknown serum as the first antibody to coat wells of the microtiter plate directly in application of the sandwich ELISA method with double antibodies for the assay of the antibody against adult diarrhoea rotavirus. This method was used for assay of the antibody against adult rotavirus in 1,380 sera of healthy adults obtained from some provinces and cities of China, of which 141 showed a positive result with a total positive rate of 10.2%. The infection rate varied in different regions. In order to confirm the accuracy of these results a blocking test was carried out on 25 positive specimens, and the results revealed that the P/N ratios after blocking were all lower than those before blocking. Seventeen of these 25 positive serum specimens were obtained from rural areas of Qian'an County, Hebei Province where epidemic adult diarrhoea had occurred two years ago. The antibody against adult diarrhoea rotavirus was not detected in 50 adult sera from Xizang Autonomous Region. Only one out of 50 adult sera from Hainan Island was positive for the antibody.