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Background and purpose: This study was to investigate the prevalence and cardiovascular risk factors (CRFs) of asymptomatic intracranial atherosclerotic stenosis (aICAS) amongst middle‐aged and older adults living in rural communities in China. Methods: This population‐based study included 2019 subjects (aged ≥40 years, 52.3% women) who were free of stroke and living in rural communities in China. From October 2017 to May 2018, data on demographics, CRFs and health conditions were collected through face‐to‐face interviews, physical examination and laboratory tests. Asymptomatic ICAS was detected through a two‐phase procedure: a screening phase with transcranial Doppler ultrasound, followed by a diagnostic phase with magnetic resonance angiography examination. Multivariable logistic regression models were used to analyse CRFs associated with aICAS. Results: Of the 2019 participants, aICAS was detected in 153 persons. The overall prevalence of aICAS was 7.6%, and the prevalence of moderate‐to‐severe aICAS was 5.0%. The multi‐adjusted odds ratio (95% confidence interval) of aICAS associated with CRFs was 2.40 (1.56–3.69) for hypertension, 1.91 (1.32–2.76) for high hypersensitive C‐reactive protein, 1.68 (1.14–2.49) for diabetes and 1.61 (1.08–2.41) for overweight or obesity. When these four CRFs were aggregated, compared with participants without any of these factors, the multi‐adjusted odds ratios (95% confidence interval) of aICAS for persons concurrently having one, two and three or more of these factors were 1.14 (0.52–2.48), 2.91 (1.42–5.99) and 5.51 (2.64–11.50), respectively (P for linear trend <0.001). Conclusions: Asymptomatic ICAS is common amongst rural‐dwelling middle‐aged and older Chinese people. Hypertension, diabetes, overweight or obesity and high hypersensitive C‐reactive protein, especially when coexisting, are strongly associated with aICAS. [ABSTRACT FROM AUTHOR]

Background: Although numerous multicentre studies have estimated the association between ozone exposure and mortality, there are currently no nationally representative multicentre studies of the ozone-mortality relationship in China.Objective: To investigate the effect on total (nonaccidental) and cause-specific mortality of short-term exposure to ambient ozone, and examine different exposure metrics.Methods: The effects of short-term exposure to ozone were analysed using various metrics (daily 1-h maximum, daily 8-h maximum and daily average) on total (nonaccidental) and cause-specific (circulatory and respiratory) mortality from 2013 to 2015 in 34 counties in 10 cities across China. We used distributed lag nonlinear models for estimating county-specific relative risk of mortality and combined the county-specific relative rates by conducting a random-effects meta-analysis.Results: In all-year analyses, a 10 μg m-3 increase in daily average, daily 1-h maximum and daily 8-h maximum ozone at lag02 corresponded to an increase of 0.6% (95% CI: 0.33, 0.88), 0.26% (95% CI: 0.12, 0.39) and 0.37% (95% CI: 0.2, 0.55) in total (nonaccidental) mortality, 0.66% (95% CI: 0.28, 1.04), 0.31% (95% CI: 0.11, 0.51) and 0.39% (95% CI: 0.16, 0.62) in circulatory mortality, and 0.57% (95% CI: -0.09, 1.23), 0.11% (95% CI: -0.22, 0.44) and 0.22% (95% CI: -0.28, 0.72) in respiratory mortality, respectively. These estimates had a different seasonal pattern by cause of death. In general, the seasonal patterns were consistent with the times of year when ozone concentrations are highest.Conclusions: Our findings suggest that in China, the acute effects of ozone are more closely related to daily average exposure than any other metric. [ABSTRACT FROM AUTHOR]

Summary: One hundred and five fowl adenovirus (FAdV) strains were isolated in China from 2015 to 2016 from poultry with inclusion body hepatitis (IBH) and hydropericardium syndrome (HPS). Polymerase chain reactions determined that 68 were FAdV species C, five were FAdV species D, two were FAdV species E, and 30 contained two or more different FAdV strains. A phylogenetic analysis showed that the isolated FAdV strains clustered into three major groups: FAdV‐C, FAdV‐D and FAdV‐E. Based on a hexon gene sequencing analysis, these viruses were genetically related to FAdV‐4, FAdV‐7, FAdV‐8b and FAdV‐11, of which FAdV‐4 was dominant (93% of the strains). An epidemiological analysis showed that FAdVs had been circulating in broilers, domestic chickens, and layers, and co‐infections with other immunosuppressive pathogens, such as chicken infectious anaemia virus, Marek's disease virus and reticuloendotheliosis virus, were identified. To control FAdVs, strict biosecurity protection measures are necessary, and a continued surveillance of FAdVs is needed to increase our understanding of the epidemiology of the viruses that are associated with IBH and HPS. [ABSTRACT FROM AUTHOR]

The article discusses the emergence of a ST2570 Klebsiella pneumoniae isolate carrying mcr-1 and blaCTX-M-14 recovered from a bloodstream infection in China. Topics include the first identification of a clinical colistin-resistant K. pneumoniae isolate belonging to a rare sporadic clone recovered from the community- acquired bloodstream infection in China.

A major landslide in Zhouqu, China occurred on August 8, 2010 and caused widespread damage and over 1700 casualties. We study the deformation of the slopes over a time period of about three years prior to the landslide by an enhanced StaMPS-SB technique with 16 ascending ALOS/PALSAR images. In particular, the orbit error and stratified troposphere that were not well dealt with in the original StaMPS-SB method have been satisfactorily corrected by a novel phase ramp correction method. The deformation in four regions of the study area has been retrieved with a maximum of up to 70 mm/yr. In the Luojiayu–Sanyanyu valley, the slopes where the 2010 giant landslide occurred have been found to be quite unstable before the event. Deformation exceeding 30 mm/yr has been detected in the Suoertou slope, which is a well-known place for an ancient fault zone landslide. Fast movement larger than 40 mm/yr is observed in the Xieliupo slope, which poses threats of landslide dam and dammed lake to the Pai-lung River together with another slope deformation detected in the opposite slope. In the Nanshanqiaotou slope, the detected ~ 30 mm/yr deformation can be viewed as the prelude of the large landslide occurred in October 2010. More important, it is found that the slope deformation time series has strong correlation with the precipitation in the area as well as with the devastating Wenchuan earthquake that occurred in May 2008 whose epicenter is about 300 km away from Zhouqu. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a major global public health concern. Although the incidence of TB in China is declining, the country continues to face many challenges regarding TB control. This study aimed to develop an active case finding (ACF) strategy for high-risk populations in areas with high TB burden and evaluate the effectiveness of the ACF strategy for early TB detection in patients to reduce TB transmission. This was a descriptive study. From May to October 2019, active TB screening was conducted in Zhejiang Province, China. Overall, 24 high-burden townships were chosen as study sites. Residents aged ≥65 years, suffering from diabetes, diagnosed with HIV/AIDS, or with a history of TB were mobilized for screening. Chest radiography was performed for all participants in the community. Sputum specimens were collected for sputum smear tests and cultures at county-level TB-designed hospitals. A professional medical team performed the final diagnoses. Overall, 130,643 residents were included, accounting for 8.85% of the total population in the selected areas. After screening, 89 confirmed cases and 419 suspected cases were identified. The detection rates for suspected and confirmed cases were 320.72/100,000 and 68.12/100,000, respectively. Individuals with a history of TB accounted for a large proportion of detected cases, and the detection rate was higher among males than in females. This study identified 10.5% of reported cases in the selected areas in 2019. In Zhejiang province, compared with the previous year, the rates of TB notification in 2019 and 2020 declined by 7.0% and 7.4%, respectively, compared with the previous year. However, the TB notification rate in 2019 was almost the same as that in 2018 (a decline of 2.5%) but sharply declined in 2020 (14.4%) in the screened areas. Our findings suggest that the ACF strategy may have helped to maintain the downward trends in TB notification rates by detecting patients with TB and suspected cases in the short term. [ABSTRACT FROM AUTHOR]

Reports on the presence of Witches'-Broom disease on Chinese wingnut and the disease's link with a phytoplasma of aster yellows group in China. Research findings; Research applications; Implications on studies of plant diseases.

China-Kazakhstan pipeline is the first land import transnational crude oil pipeline in China. It is also the only long-distance crude oil channel connecting the resources in the west of Kazakhstan and the two refineries in the east of Kazakhstan and exports to China. It undertakes the dual responsibilities of crude oil supply of the two refineries in the east of Kazakhstan and the crude oil guarantee of refineries in Western China. At present, the annual throughput of China-Kazakhstan crude oil pipeline accounts for about 20% of China's onshore crude oil imports. Therefore, the pipeline's safe, stable and efficient operation plays an important role in ensuring the strategic security of energy in Western China. Since the China- Kazakhstan crude oil pipeline has commissioned, it has been found that there is slack flow in the pipeline under different working conditions, which has a great impact on the safe and stable operation of the pipeline and the measurement accuracy of commercial trade. In this paper, the causes of slack flow in China-Kazakhstan crude oil pipeline are studied, the potential location of slack flow is analyzed, and the boundary conditions of slack flow condition are defined. At the same time, control strategies to avoid slack flow under different conditions are formulated by using simulation technology. The research results will provide direct technical case support for reasonable formulation of operation scheme of China-Kazakhstan crude oil pipeline system and terminal station inlet pressure control strategy, so as to ensure safe, stable and efficient operation of the pipeline. [ABSTRACT FROM AUTHOR]

Both live attenuated (HA-L) and inactivated (HA-I) hepatitis A vaccine were licensed for routine use in China. Although phase 1, 2 and 3 clinical studies of both vaccines have been completed, further systematic evaluation of their immunogenicity and immunological persistence under phase 4 clinical studies in a wide range of conditions and involving large populations is necessary. A phase IV clinical trial (NCT02601040) was performed in 9000 participants over 18 months of age. Geometric mean concentrations (GMCs) and seroconversion rates (SRs) were compared at five time points during 3 years for 1800 individuals among them. The SRs of HA-L and HA-I were 98.08% (95% CI 95.59%–99.38%) and 99.64% (95% CI 98.93%–100.00%) respectively 28 days after administration of the first dose, and remained at 97.07% (95% CI 94.31%–98.73%) or above and 96.73% (95% CI 94.07%–98.42%) or above respectively during the following 3 years. The GMCs for both the HA-L and HA-I groups showed that both vaccines elicited high anti-HAV titres, considerably more than the threshold of protection needed against HAV infection in humans, and these titres were sustained. Hence, both HA-I and HA-L vaccines could provide an excellent long-term protective effect, and supported the routine use of both vaccines. [ABSTRACT FROM AUTHOR]

In developing countries with a large population and fast urbanization, High-rise Residential Buildings (HRBs) have unavoidably become a very common, if not the most, accommodation solution. The paradigm of HRB energy consumption is characterized by high-density energy consumption, severe peak effects and a limited site area for integrating renewable energy, which constitute a hindrance to the low-carbon transition. This review paper investigates low-carbon transition efforts in the HRB sector from the perspective of urban energy systems to get a holistic view of their approaches. The HRB sector plays a significant role in reducing carbon emission and improving the resilience of urban energy systems. Different approaches to an HRB low-carbon transition are investigated and a brief overview of potential solutions is offered from the perspectives of improving energy efficiency, self-sufficiency and system resilience. The trends of decarbonization, decentralization and digitalization in the HRB sector allow a better alignment with transitioning urban energy systems and create cross-sectoral integration opportunities for low-carbon transition. It is also found that policy tools are powerful driving forces in China for incentivizing transition behaviors among utilities, end users and developers. Based on a comprehensive policy review, the policy implications are given. The research is geared for the situation in China but could also be used as an example for other developing countries that have similar urbanization patterns. Future research should focus on quantitative analysis, life-cycle analysis and transdisciplinary planning approaches. • The role, approaches and impacts of low-carbon transition efforts in the HRB sector. • Interactive relationship between the HRB sector and urban energy systems. • Trends of decarbonization, decentralization and digitalization in the HRB sector. • Realistic low-carbon transition solutions for HRBs in China. • Policy implications for inherent planning of HRBs and urban energy systems. [ABSTRACT FROM AUTHOR]

Summary: Associations of adiposity indices with bone mineral density (BMD) and bone turnover markers were evaluated in Chinese participants. Body mass index, fat mass, and lean mass are positively related to BMD in both genders. Subcutaneous fat area was proved to be negatively associated with BMD and positively correlated with osteocalcin in postmenopausal females. Introduction: Obesity is highly associated with osteoporosis, but the effect of adipose tissue on bone is contradictory. Our study aimed to assess the associations of adiposity indices with bone mineral density (BMD) and bone turnover markers (BTMs) in the Chinese population. Methods: Our study recruited 5215 participants from the Shanghai area, evaluated related anthropometric and biochemical traits in all participants, tested serum BTMs, calculated fat distribution using magnetic resonance imaging (MRI) images and image analysis software, and tested BMD with dual-energy X-ray absorptiometry. Results: When controlled for age, all adiposity indices were positively correlated with BMD of all sites for both genders. As for the stepwise regression analysis, body mass index (BMI), fat mass, and lean mass were protective for BMD in both genders. However, subcutaneous fat area (SFA) was detrimental for BMD of the L1-4 and femoral neck ( β ± SE −0.0742 ± 0.0174; p = 2.11E−05; β ± SE −0.0612 ± 0.0147; p = 3.07E−05). Adiposity indices showed a negative correlation with BTMs adjusting for age, especially with osteocalcin. In the stepwise regression analysis, fat mass was negatively correlated with osteocalcin ( β ± SE −8.8712 ± 1.4902; p = 4.17E−09) and lean mass showed a negative correlation with N-terminal procollagen of type I collagen (PINP) for males ( β ± SE −0.3169 ± 0.0917; p = 0.0006). In females, BMI and visceral fat area (VFA) were all negatively associated with osteocalcin ( β ± SE −0.4423 ± 0.0663; p = 2.85E−11; β ± SE −7.1982 ± 1.1094; p = 9.95E−11), while SFA showed a positive correlation with osteocalcin ( β ± SE: 5.5993 ± 1.1753; p = 1.98E−06). Conclusion: BMI, fat mass, and lean mass are proved to be beneficial for BMD in both males and postmenopausal females. SFA is negatively associated with BMD and positively correlated with osteocalcin in postmenopausal females. [ABSTRACT FROM AUTHOR]

BackgroundWorldwide 350 million people suffer from major depression, with the majority of cases occurring in low- and middle-income countries. We examined the patterns, correlates and care-seeking behaviour of adults suffering from major depressive episode (MDE) in China.MethodA nationwide study recruited 512 891 adults aged 30–79 years from 10 provinces across China during 2004–2008. The 12-month prevalence of MDE was assessed by the Modified Composite International Diagnostic Interview-short form. Logistic regression yielded adjusted odds ratios (ORs) of MDE associated with socio-economic, lifestyle and health-related factors and major stressful life events.ResultsOverall, 0.7% of participants had MDE and a further 2.4% had major depressive symptoms. Stressful life events were strongly associated with MDE [adjusted OR 14.7, 95% confidence interval (CI) 13.7–15.7], with a dose–response relationship with the number of such events experienced. Family conflict had the highest OR for MDE (18.9, 95% CI 16.8–21.2) among the 10 stressful life events. The risk of MDE was also positively associated with rural residency (OR 1.5, 95% CI 1.4–1.7), low income (OR 2.3, 95% CI 2.1–2.4), living alone (OR 2.6, 95% CI 2.3–3.0), smoking (OR 1.4, 95% CI 1.3–1.6) and certain other mental disorders (e.g. anxiety, phobia). Similar, albeit weaker, associations were observed with depressive symptoms. Among those with MDE, about 15% sought medical help or took psychiatric medication, 15% reported having suicidal ideation and 6% reported attempting suicide.ConclusionsAmong Chinese adults, the patterns and correlates of MDE were generally consistent with those observed in the West. The low rates of seeking professional help and treatment highlight the great gap in mental health services in China. [ABSTRACT FROM PUBLISHER]

Objective: To assess the feasibility and performance of the first-trimester combined screening test for trisomy 21 in a resource-limited setting in mainland China.Design: Prospective observational cohort study.Setting: First Affiliated Hospital of Kunming Medical University, China.Population: Ten thousand four hundred and forty-two pregnant women requesting first-trimester screening.Methods: The combined screening test was performed from May 2012 to December 2014. Women with a high-risk result (≥1:600) were offered further confirmatory tests after counselling. The threshold for high risk was determined by Monte Carlo simulation to achieve a 5% false-positive rate according to the local age distribution. Pregnancy outcome and screening results were recorded for all women and monthly audits were conducted.Main Outcome Measures: Sensitivity, screen positive rate, cost per case of Down syndrome detected.Results: Six hundred and ten women (5.8% of the total screened) had a high-risk screening test, of whom 274 (44.9%) underwent a diagnostic test and 169 (27.7%) opted for a noninvasive prenatal screening test (NIPT); 160 (26.2%) declined further testing after counselling. The pregnancy outcome was available for 10 174 (97.4%) of the women. The observed incidence of Down syndrome was 0.13% (1/750). All 14 women with a trisomy 21 pregnancy had a high-risk screening test result. The cost per Down syndrome detected was RMB596 686 compared with RMB1.79 million if all had been screened by NIPT.Conclusions: The combined screening test appears to be a more cost-effective strategy in mainland China. Screening performance in China would be improved by adopting Chinese-specific models, external quality control and assurance, and establishing risk thresholds appropriate for the age distribution of the population.Tweetable Abstract: Combined first-trimester Downs screening in China was improved by adopting Chinese-specific models and external QC. [ABSTRACT FROM AUTHOR]

Landslide dams in mountainous areas are quite common. Typically, intense rainfalls can induce upstream flows along the sloping channel, which greatly affects the stability and failure modes of landslide dams. If a series of landslide dams are sequentially collapsed by an incoming mountain torrent (induced by intense rainfall), large debris flows can be formed in a short period of time. This also amplifies the magnitude of the debris flows along the flow direction. The catastrophic debris flows, which occurred in Zhouqu, China on August 8, 2010, were indeed caused by intense rainfall and the upstream cascading failure of landslide dams along the gullies. Experimental tests were conducted in a sloping channel to understand the dynamic process of cascading landslide dam failures and their effect on flow scale amplification. Similar to the Zhouqu conditions, the modeled landslide dams were distributed along a sloping channel and breached by different upstream flows. For each experiment, the front flows were sampled, the entrained grain sizes were analyzed, and the front discharge along the channel was measured. The results of these experiments show that landslide dams occurring along the channel can be destroyed by both high and low discharge flows, although the mechanisms are quite different for the two flow types. Regardless of flow type, the magnitude of the flows significantly increases after a cascading failure of landslide dams, resulting in an increase in both the diameter and the entrained coarse particles percentage. [ABSTRACT FROM AUTHOR]

Objectives To investigate the prevalence and the factors related to the sensitive skin in China. Methods A community-based study was undertaken in three major cities in China, Beijing, Shanghai and Guangzhou, from November 2009 to January 2010. The participants in the study were screened by cluster sampling, and were investigated by interview at their own homes. A questionnaire, including skin sensitivity, the occurrence of burning, prickling or irritating sensations correlated with the factors, history of skin diseases and skin types, was given to each participant aged over 15 years. Results Totally 9154 questionnaires were completed (3931 men and 5223 women). The mean prevalence of very sensitive and sensitive skin in three cities was 13% (17.12% in Beijing, 9.10% in Shanghai and 22.39% in Guangzhou.) The mean prevalence was 8.62% in men and 15.93% in women, with significant difference between men and women in three selected cities ( P < 0.001). The total prevalence of very sensitive and sensitive skin was 16.44% in <25 years group, 14.14% in 25-49 years group and 9.73% in ≥50 years group. Moreover, 18.54% of participants claimed with dry skin, 16.70% with greasy skin and 8.04% with normal skin claimed to have the symptoms of sensitive skin. Conclusions The prevalence of sensitive skin in the three cities of China is much lower than that in Europe and the United States. There was significant difference of the prevalence of sensitive skin among three cities located in different climatic and latitude regions and between men and women. The prevalence gradually decreased with the increasing age. The skin sensitivity was associated to the positive history of atopic dermatitis. [ABSTRACT FROM AUTHOR]

Peak bone mass is an important factor influencing the occurrence of osteoporosis and osteoporotic fracture in adulthood. We measured the areal bone mineral density (BMD) in a Chinese male infantry recruit group ranging in age from 17 to 23 years and subsequently assessed peak BMD at the lumbar vertebrae and hip. This study included 812 Chinese men of Han ethnicity from 11 provinces and municipalities of China. The BMD, bone mineral content and the bone area of the lumbar vertebrae (L1-4), left femoral neck and total hip were measured using dual-energy X-ray absorptiometry. Height, weight, waist and hip circumference were also measured at the same time. BMD at the lumbar vertebrae, femoral neck and total hip reached a plateau at 22 years of age. The peak value of BMD at these 3 sites was 1.209 ± 0.175, 1.098 ± 0.177 and 1.122 ± 0.151 (g/cm2 ), respectively. Stepwise regression analysis showed that age and weight most contributed to the variance in BMD (P < 0.001). The average age when reaching peak BMD in this study is earlier than the ages reported in previous studies, and the value of peak BMD is higher than that reported previously in Chinese males. This study provides the newest peak BMD data on Chinese men. [ABSTRACT FROM AUTHOR]

Xiong F, Sun M, Zhang X, Cai R, Zhou Y, Lou J, Zeng L, Sun Q, Xiao Q, Shang X, Wei X, Zhang T, Chen P, Xu X. Molecular epidemiological survey of haemoglobinopathies in the Guangxi Zhuang Autonomous Region of southern China. Accurate and up-to-date data on the frequency of haemoglobinopathies among the populations of Guangxi Zhuang Autonomous Region, where haemoglobinopathies are most endemic in China, are required. In our study, a total of 5789 samples obtained from members of the Han, Zhang, and Yao ethnic groups in six geographical areas of Guangxi Province were analysed systematically in terms of both haematological and molecular parameters. The results presented that the total heterozygote frequency of thalassaemias and other haemoglobinopathies was 24.51%, of which 17.55% was due to α-thalassaemia, 6.43% to β-thalassaemia, 0.38% to structural haemoglobin variants, and 0.16% to δ-thalassaemia. The mutational spectrum among the local population for each type of disorder was described, including the first report on the true prevalence of three silent α thalassemia defects, −α3.7/(4.78%), −α4.2/(1.61%) and Hb Westmead (αWSα/) (1.57%) and of δ-thalassemia resulting from five novel and two rare mutations never before identified in Chinese individuals. Comparison of the frequencies of α-globin mutations among the ethnic groups showed that there was a statistically significant difference between the Han (15.71%) and Zhuang (20.12%), and between the Han (15.71%) and Yao (20.84%) ethnic groups. In addition, we have performed the first extensive study of haematological parameters of the Hb Westmead mutation using a group of Chinese subjects with compound heterozygosity for this variant and an α-thalassaemia deletion. The knowledge gained in this study will enable us to estimate the health burden in this high-risk population and to elucidate the various genetic alterations that underlie haemoglobinopathies. [ABSTRACT FROM AUTHOR]

What dermatologists could do to cope with the novel coronavirus (SARS-CoV-2): a dermatologist's perspective from China Coronavirus disease, first emerged in Wuhan, China, rapidly spread all over the country since December 2019.[1] Up to now, the epidemic situation in China remains stable, while the global march of the virus is seemingly unstoppable, especially in South Korea, Iran and Italy.[2] Here, we reported what dermatologists could do to cope with novel coronavirus from a Chinese dermatologist's perspective. Skin lesions and possible immunosuppression may result in higher susceptibility of indirect contact transmission.[3] Dermatologists should tell patients which skin diseases are not necessarily treated immediately, and when they should ask dermatologists for help. [Extracted from the article]

Abstract: Numerous epidemiological studies have been carried out to clarify the health effects caused by indoor radon exposure. Some of passive monitors for radon are sensitive to thoron, and thus the results of measurements might be possibly overestimated as radon concentration. Recently, we developed a simple radon–thoron discriminative monitor by using two passive detectors and a special method for concentration measurements of thoron decay products, and applied them to field measurements in conducted in Chinese loess plateau where cave dwellings are widely distributed. Our new monitors revealed the presence of high thoron concentration there. The highest concentration of 1471 Bq/m3 was observed and the mean was 240 Bq/m3. The mean concentration of thoron decay products was 2.2 Bq/m3. It was very low, compared with the expected concentration from the equilibrium factor of 0.1 adopted by UNSCEAR 2000. On the other hand, the mean radon concentration was 73 Bq/m3. The effective dose estimated from our discriminative measurements was 2.4 mSv/year, which is below a half of 5.9 mSv/year estimated from the results of the nondiscriminative measurements. This means the significance of radon and thoron discriminative measurement and the direct measurement of thoron decay products. [Copyright &y& Elsevier]

Background: Colorectal cancer is the third most common cancer in the world, arising mostly from pre-existing adenomatous polyps (adenomas) of the large bowel. Patients with colorectal adenomas are at increased risk of colorectal cancer because of a high recurrence rate for adenomas. We followed a cohort of 1490 patients with rectal adenomas to determine whether recurrence might be related to pathologic characteristics of the initial adenomas.Methods: The patients were identified in Haining County, China, from 1977 through 1978 by means of examination with a 15-cm rigid sigmoidoscope. They were followed by endoscopic examination at years 2, 4, 6, 11, and 16 after their initial polypectomy. New adenomas in the rectum were identified in 280 patients in these follow-up examinations.Results: Statistically significant twofold to threefold elevated risks of metachronous (recurrent) adenomas were observed for patients who had more than two initial adenomas or whose most advanced initial adenoma was more than 1.0 cm in size, was of villous/tubulovillous type, or showed moderate to severe dysplasia. Much stronger associations were observed for advanced metachronous neoplasms, which are defined as cancers or adenomas with severe dysplasia, with multivariate adjusted relative risks (95% confidence interval) of 4.2 (1.8-9.9) for a large initial adenoma (>1.0 cm), 8.1 (4.2-15.6) for villous/tubulovillous architecture, and 14.4 (5.0-41.3) for severe dysplasia. In particular, patients who had a large (>1.0 cm) adenoma with severe dysplasia at baseline had a relative risk of 37 (7.8-174.7) of developing advanced metachronous neoplasms compared with patients who had small adenoma(s) with mild dysplasia.Conclusions: The risk of metachronous adenomas is closely related to the pathology of initial adenomas, thus allowing identification of a high-risk group of adenoma patients for close surveillance after their initial polypectomy. [ABSTRACT FROM AUTHOR]

For large-scale immunization of children with hepatitis A (HA) vaccines in China, accurately designed studies comparing the safety and immunogenicity of the live attenuated HA vaccine (HA-L) and inactivated HA vaccine (HA-I) are necessary. A randomized, parallel controlled, phase IV clinical trial was conducted with 6000 healthy children aged 18 months to 16 years. HA-L or HA-I was administered at a ratio of 1: 1 to randomized selected participants. The safety and immunogenicity were evaluated. Both HA-L and HA-I were well tolerated by all participants. The immunogenicity results showed that the seroconversion rates (HA-L versus HA-I: 98.0% versus 100%, respectively, p >0.05), and geometric mean concentrations in participants negative for antibodies against HA virus IgG (anti-HAV IgG) before vaccination did not differ significantly between the two types of vaccines (HA-L versus HA-I first dose: 898.9 versus 886.2 mIU/mL, respectively, p >0.05). After administration of the booster dose of HA-I, the geometric mean concentrations of anti-HAV IgG (HA-I booster dose: 2591.2 mIU/mL) was higher than that after the first dose (p <0.05) and that reported in participants administered HA-L (p <0.05). Additionally, 12 (25%) of the 48 randomized selected participants who received HA-L tested positive for HA antigen in stool samples. Hence, both HA-L and HA-I could provide acceptable immunogenicity in children. The effects of long-term immunogenicity after natural exposure to wild-type HA virus and the possibility of mutational shifts of the live vaccine virus in the field need to be studied in more detail. [ABSTRACT FROM AUTHOR]

Examines the extent of education-related health inequalities between men and women in northern rural areas in China. Health indicators; Social inequalities; Life styles; Health care services.