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Morels (Morchella spp.) are highly prized and popular edible mushrooms. The outdoor cultivation of morels in China first developed at the beginning of the 21st century. Several species, such as Morchella sextelata, M. eximia, and M. importuna, have been commercially cultivated in greenhouses. However, the detriments and obstacles associated with continuous cropping have become increasingly serious, reducing yields and even leading to a complete lack of fructification. It has been reported that the obstacles encountered with continuous morel cropping may be related to changes in the soil microbial community. To study the effect of dazomet treatment on the cultivation of morel under continuous cropping, soil was fumigated with dazomet before morel sowing. Alpha diversity and beta diversity analysis results showed that dazomet treatment altered the microbial communities in continuous cropping soil, which decreased the relative abundance of soil-borne fungal pathogens, including Paecilomyces, Trichoderma, Fusarium, Penicillium, and Acremonium, increased the relative abundance of beneficial soil bacteria, including Bacillius and Pseudomonas. In addition, the dazomet treatment significantly increased the relative abundance of morel mycelia in the soil and significantly improved morel yield under continuous cropping. These results verified the relationship between the obstacles associated with continuous cropping in morels and the soil microbial community and elucidated the mechanism by which the obstacle is alleviated when using dazomet treatment. [ABSTRACT FROM AUTHOR]

Coptis plants (Ranunculaceae) contain high levels of isoquinoline alkaloids and have a long history of medicinal use. Coptis species are of great value in pharmaceutical industries and scientific research. Mitochondria are considered as one of the central units for receiving stress signals and arranging immediate responses. Comprehensive characterizations of plant mitogenomes are imperative for revealing the relationship between mitochondria, elucidating biological functions of mitochondria and understanding the environmental adaptation mechanisms of plants. Here, the mitochondrial genomes of C. chinensis, C. deltoidea and C. omeiensis were assembled through the Nanopore and Illumina sequencing platform for the first time. The genome organization, gene number, RNA editing sites, repeat sequences, gene migration from chloroplast to mitochondria were compared. The mitogenomes of C. chinensis, C. deltoidea and C. omeiensis have six, two, two circular-mapping molecules with the total length of 1,425,403 bp, 1,520,338 bp and 1,152,812 bp, respectively. The complete mitogenomes harbors 68-86 predicted functional genes including 39-51 PCGs, 26-35 tRNAs and 2-5 rRNAs. C. deltoidea mitogenome host the most abundant repeat sequences, while C. chinensis mitogenome has the largest number of transferred fragments from its chloroplasts. The large repeat sequences and foreign sequences in the mitochondrial genomes of Coptis species were related to substantial rearrangements, changes in relative position of genes and multiple copy genes. Further comparative analysis illustrated that the PCGs under selected pressure in mitochondrial genomes of the three Coptis species mainly belong to the mitochondrial complex I (NADH dehydrogenase). Heat stress adversely affected the mitochondrial complex I and V, antioxidant enzyme system, ROS accumulation and ATP production of the three Coptis species. The activation of antioxidant enzymes, increase of T-AOC and maintenance of low ROS accumulation in C. chinensis under heat stress were suggested as the factors for its thermal acclimation and normal growth at lower altitudes. This study provides comprehensive information on the Coptis mitogenomes and is of great importance to elucidate the mitochondrial functions, understand the different thermal acclimation mechanisms of Coptis plants, and breed heattolerant varieties. [ABSTRACT FROM AUTHOR]

Common carp are among the oldest domesticated fish in the world. As such, there are many food and ornamental carp strains with abundant phenotypic variations due to natural and artificial selection. Hebao red carp (HB, Cyprinus carpio wuyuanensis), an indigenous strain in China, is renowned for its unique body morphology and reddish skin. To reveal the genetic basis underlying the distinct skin color of HB, we constructed an improved highfidelity (HiFi) HB genome with good contiguity, completeness, and correctness. Genome structure comparison was conducted between HB and a representative wild strain, Yellow River carp (YR, C. carpio haematopterus), to identify structural variants and genes under positive selection. Signatures of artificial selection during domestication were identified in HB and YR populations, while phenotype mapping was performed in a segregating population generated by HB×YR crosses. Body color in HB was associated with regions with fixed mutations. The simultaneous mutation and superposition of a pair of homologous genes (mitfa) in chromosomes A06 and B06 conferred the reddish color in domesticated HB. Transcriptome analysis of common carp with different alleles of the mitfa mutation confirmed that gene duplication can buffer the deleterious effects of mutation in allotetraploids. This study provides new insights into genotype-phenotype associations in allotetraploid species and lays a foundation for future breeding of common carp. [ABSTRACT FROM AUTHOR]

Although many studies have shown that housing wealth impacts household consumption behavior patterns, they have not incorporated housing characteristics into their research framework. Against the background of China's reformed housing system, this study therefore constructs a theoretical framework of housing differences, credit constraints, and household energy consumption by adopting sample data from China Family Panel Studies (CFPS) of 7064 households in 25 provinces, municipalities, and autonomous regions in China. Multiple regression methodology is used based on the emission peak and carbon neutrality goal proposed by the Chinese government in 2021. The results show that housing differences significantly impact household energy consumption; housing assets have a significant wealth effect on household energy consumption; energy consumption of house owners increases due to the appreciation of their housing; and that the housing proportion of a household's gross assets has a significant negative impact on household energy consumption. Furthermore, based on spatial distribution, it is found that the energy consumption level of households with housing properties in the developed regions of central and eastern China is significantly higher than that in the western regions. The study provides empirical evidence for China to build a linkage mechanism between energy policy and real estate policy and provides empirical support for the implementation of differentiated policies of energy consumption. [ABSTRACT FROM AUTHOR]

A comprehensive understanding of genetic background for rare species will provide an important theoretical basis for the future species management, monitoring and conservation. Tetraena mongolica is restrictedly distributed in the western Ordos plateau of China and has been listed as a national protected plant. We generated 13 chloroplast (cp) genomes of T. mongolica (size range of 106,062-106,230 bp) and conducted a series of comparative analyses of six Zygophyllaceae cp genomes. T. mongolica cp genome exhibited a quadripartite structure with drastically reduced inverted repeats (IRs, 4,315 bp) and undergone the loss of a suit of ndh genes and a copy of rRNAs. Furthermore, all the T. mongolica populations were divided into two genetic groups based on complete cp phylogenomics. In addition, notably variable genome size, gene order and structural changes had been observed among the six Zygophyllaceae cp genomes. Overall, our findings provide insights into the cp genome evolution mode and intraspecific relationships of T. mongolica, and provide a molecular basis for scientific conservation of this endangered plant. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to present our 10-year experience of pediatric intensive care unit (PICU) management with pediatric liver recipients and to understand the importance of close interdisciplinary cooperation in 2 hospitals. Methods: A retrospective chart review study was performed according to our hospital's medical records and the pediatric liver transplant database of Renji hospital. Results: A total of 767 patients received liver transplantation (LT) performed in Renji hospital between October 2006 and December 2016, of which 97 of them were admitted to PICU in our center for various complications developed after transplantation. 8.8% (16/208) and 14.4% (81/559) of patients were transferred to PICU in stages I and II, respectively, and was comparable in the 2 stages (P = .017). The majority of patients was late postoperative children (median 185 post-LT days) in stage I. More patients were transferred to PICU directly in stage II. PICU admitted more younger (median 8.2 months) and early postoperative patients in stage II. The median length of PICU stay was 11.0 (6.0-20.5) days. The median length of mechanical ventilation was 5.0 (0.0-12.0) days. The most frequent complications were pulmonary complications (52 [53.6%] patients), surgical complications (22 [22.7%] patients), sepsis (7 [7.2%]), and other miscellaneous complications (16 [16.5%] patients). The overall 28-day PICU mortality was 25.8% (n = 25) and 64.0% (n = 16) of the deaths happened in the early postoperative period. There was significant difference concerning mortality in children with surgical complications and medical problems (54.5% [12/22] vs 17.3% [13/75], P = .001). Multivariate analysis by regression showed that the pediatric risk of mortality III score was the only independent prognostic factor (P = .031). Conclusions: Multiple complications occur in children with LT. Although challenging, interdisciplinary cooperation between different hospitals is an effective mean to enable children to maximize the benefit gained from LT in China. [ABSTRACT FROM AUTHOR]

Idle rural residential land (IRRL) is an important manifestation of changes in the human-land relationship during rural development. Studies on this topic form an important field in the study of sustainable land use, but quantitative analyses of IRRL in the academic community are still lacking. In this paper, we take Pinggu District, a metropolitan suburb that has experienced rapid urbanization, to analyze the spatial differentiation of IRRL and explore the spatial differentiation in the impact of different factors on IRRL. Our findings showed that IRRL was a common phenomenon in Pinggu. There was a spatial pattern of "one belt, three cores" in Pinggu District, and its scale decreased from the southeast to the northwest. Industrial areas, semimountainous ecotourism areas and urban fringe areas were the high-incidence areas of IRRL, while the idle rate of rural residential land in mountainous areas and agricultural areas on the plain was relatively low. The IRRL was the result of a combination of different factors, and there were differences among the factors and regions. The transfer of rural labor, nonagriculturalization of the industrial structure and the mode of production and lifestyle caused by urbanization and industrialization were the major driving forces, and the lagging village planning and imperfect land use system increased the risk of IRRL at the management level. Our study contributes to filling the gap in quantitative research on IRRL to enrich the research regarding the land use system by exploring the interaction between humans and land in rural areas and thus has significance for the rural restructuring and sustainable use of land in China. • The transfer of rural labour, non-agriculturalization of the industrial structure and mode of production and lifestyle caused by urbanization and industrialization were the major driving forces. • Influence of different driving factors on idle rural residential land varies in different regions, and the leading factors in different regions are also different. • The government should enhance the positive interaction of industry, population and land to promote the coordinated development of urban and rural areas. [ABSTRACT FROM AUTHOR]

The article reports on the introduction of inactivated poliovirus vaccine (IPV) and its impact on the risk for vaccine-associated paralytic poliomyelitis (VAPP) in Beijing, China, from 2014 to 2016. The government introduced IPV into the city's Expanded Program on Immunization (EPI) in December 2014. Acute flaccid paralysis surveillance was used to identify VAPP cases in the city during the period.

Rehmannia is a non-parasitic genus in Orobanchaceae including six species mainly distributed in central and north China. Its phylogenetic position and infrageneric relationships remain uncertain due to potential hybridization and polyploidization. In this study, we sequenced and compared the complete chloroplast genomes of six Rehmannia species using Illumina sequencing technology to elucidate the interspecific variations. Rehmannia plastomes exhibited typical quadripartite and circular structures with good synteny of gene order. The complete genomes ranged from 153,622 bp to 154,055 bp in length, including 133 genes encoding 88 proteins, 37 tRNAs, and 8 rRNAs. Three genes (rpoA, rpoC2, accD) have potentially experienced positive selection. Plastome size variation of Rehmannia was mainly ascribed to the expansion and contraction of the border regions between the inverted repeat (IR) region and the single-copy (SC) regions. Despite of the conserved structure in Rehmannia plastomes, sequence variations provide useful phylogenetic information. Phylogenetic trees of 23 Lamiales species reconstructed with the complete plastomes suggested that Rehmannia was monophyletic and sister to the clade of Lindenbergia and the parasitic taxa in Orobanchaceae. The interspecific relationships within Rehmannia were completely different with the previous studies. In future, population phylogenomic works based on plastomes are urgently needed to clarify the evolutionary history of Rehmannia. [ABSTRACT FROM AUTHOR]

Background: Enterovirus (EV)-related hand, foot, and mouth disease/herpangina (HFMD/HA) has been prevalent in Guangdong Province, China, since 2010.Methods: Clinical data for EV-related HFMD/HA inpatients admitted to the Department of Paediatrics of Zhujiang Hospital from 2010 to 2013 were retrospectively reviewed. The corresponding EV serotypes were also determined by reverse transcription-polymerase chain reaction or BLAST analysis of the sequenced partial lengths of the viral protein1/5'-untranslated region.Results: A total of 867 eligible inpatients admitted during 2010-2013 were included in the study. Of these, the serotype of the responsible EV was successfully identified in 824 cases. The incidence of enterovirus 71 (EV71) infection amongst pediatric HFMD/HA inpatients decreased dramatically from 55.5 % in 2010 to 8.1 % in 2013, with a similar decrease recorded for coxsackievirus A16 (CVA16). However, the incidence of non-EV71/CVA16 infection increased from 30.0 % in 2010 to 83.8 % in 2013. We noted that the types of infection caused by different EV serotypes varied: EV71 was responsible for 100 % of the paralysis cases (26/26), 84.6 % of the deaths (11/13), and 84.1 % of cases with severe central nervous system involvement (SCNSI) (74/88); echovirus contributed to 16.4 % of the deaths (2/13) and 4.4 % of the SCNSI cases; and coxsackievirus accounted for only 2.2 % of the SCNSI cases (2/90). The clinical features of HFMD/HA cases varied greatly during the time period examined, with drastic changes in the hospitalization rates (45.1, 63.7, 36.4, and 19.1 % for 2010, 2011, 2012, and 21013, respectively), mortality rates (2.3, 0.9, 2.5, and 0.0 %, respectively), paralysis (5.1, 1.2, 5.4, and 0.0 %, respectively), SCNSI (16.8, 7.1, 12.7, and 2.2 %, respectively), and acute respiratory infection (21.1, 22.0, 45.9, and 59.0 %, respectively).Conclusions: The incidences of infection caused by different EV serotypes, along with the clinical features of HFMD/HA cases, changed drastically in Guangdong Province, China, from 2010 to 2013, with the biggest changes observed in 2013. The changed constituent ratios of the different EV serotypes might therefore be responsible for the differences in the observed clinical features of HFMD/HA during this period. [ABSTRACT FROM AUTHOR]

In recent decades, the area and proportion of planted forests have increased; thus, understanding the responses of planted and natural forests to drought are crucial because it forms the basis for forest risk assessments and management strategies. In this study, we combined the moderate-resolution imaging spectroradiometer (MODIS) enhanced vegetation index (EVI), meteorological aridity indices, and standardized precipitation evapotranspiration indices (SPEI) to identify the drought responses of planted and natural forests. In particular, we used the EVI standard anomaly (ESA) as a physiological drought indicator and analyzed the applicability of SPEIs at time scales of 1-30 months, thereby determining the optimal time scale for the SPEI (SPEIopt), i.e., the SPEI that best represents the drought responses of forests in Yunnan. Next, we employed the optimal SPEI and the ESA as indices to statistically analyze the response characteristics of planted and natural forests under different drought intensities. The results indicated the following: (1) The SPEI in June and a time scale of five months (i.e., SPEIJun,5) comprise the optimal meteorological aridity indicator for forests in Yunnan Province, which had the strongest correlation with the EVI standard anomaly (ESAJun). (2) All forest types were affected by drought in Yunnan, but their responses varied according to the forest type, elevation, and drought intensity. In general, natural forests are more vulnerable and sensitive to drought than planted forests, especially natural coniferous forests at low (0-2000 m) and moderate (2000-4000 m) altitudes, and natural mixed forest at low altitudes (0-2000 m). (3) The remote sensing-based ESA (ESAJun) is sensitive to the intensity of water stress, which makes it a good indicator for drought monitoring. In addition, the forests' inventory survey revealed that 8.05% of forests were affected by drought; thus, we used this as a guide to estimate an approximate threshold to map forest responses to drought across the region. Below this approximate threshold (i.e., ESAJun < -3.85), severe drought-induced effects on forests may occur. Given that natural forests are more vulnerable and sensitive to drought than the planted forests, natural forests need more careful management, especially in the context of projected increases in extreme drought events in the future. [ABSTRACT FROM AUTHOR]

Background: Several staging systems have been developed to evaluate patients with hepatocellular carcinoma (HCC), including the China Staging System (CS), the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging system, and seventh edition; the Barcelona Clinic Liver Cancer (BCLC) staging system, and Cancer of the Liver Italian Program (CLIP) staging system. The optimal staging system for to evaluate patients in China with HCC has not been determined. This study was designed to determine the optimal staging system for predicting patient prognosis by comparing the performances of these four staging systems in a cohort of Chinese patients with HCC.Methods: This study enrolled 307 consecutive Chinese patients with HCC in Shandong Province. The performances of the CS, TNM, BCLC, and CLIP staging systems were compared and ranked using a concordance index. Predictors of survival were identified using univariate and multivariate Cox model analyses.Results: The mean overall survival of the patient cohort was 12.08 ± 11.87 months. Independent predictors of survival included tumor size, number of lesions, tumor thromboses, cirrhosis, serum albumin level and serum total bilirubin level. Compared with the other three staging systems, the CS staging system showed optimal performance as an independent predictor of patient survival. The BCLC staging system showed the poorest performance; its treatment algorithm was not suitable for patients in this study.Conclusions: CS was the most suitable staging system for predicting survival of patients with HCC in China. [ABSTRACT FROM AUTHOR]

Background: A series of complications caused by enteroviruses, including meningitis, encephalitis, acute flaccid paralysis, acute cardiopulmonary failure, respiratory infection, and myocardial injury have been reported in hand, foot and mouth disease/herpangina (HFMD/HA). However, the complication of diarrhoea caused by enteroviruses has been neglected, and a summary of its clinical features and impact on HFMD/HA is unavailable.Methods: We included inpatients with HFMD/HA admitted to the Paediatric Department of Zhujiang Hospital during 2009-2012. We summarised and compared clinical data for cases with and without diarrhoea, and determined enterovirus serotypes by reverse transcriptase polymerase chain reaction and genotyping based on a partial-length fragment of viral protein 1 or the 5'-untranslated region.Results: There were 804 inpatients with HFMD/HA and 28 (3.5%) presented with diarrhoea. Gastrointestinal symptoms were mild in most cases of diarrhoea (82.1%), with high prevalence of no dehydration (82.1%), short duration of diarrhoea (78.6%) and watery stools (75.0%). The prevalence of multi-organ dysfunction syndrome (10.7 vs 0.40%) (p = 0.001), hepatic injury (14.3 vs 3.4%) (p = 0.019), myocardial injury (21.4 vs 6.1%) (p = 0.002) and convulsion (21.4 vs 7.2%) (p = 0.016) was significantly higher in the diarrhoea than no diarrhoea group. There was no significant difference between the two groups regarding prevalence of death, altered consciousness, paralysis, central nervous system involvement, or acute respiratory infection.Conclusions: Most patients with diarrhoea caused by enteroviruses circulating in Guangdong Province in 2009-2012 had mild or moderate gastrointestinal symptoms. Although enterovirus-related diarrhoea caused additional multi-organ dysfunction syndrome, hepatic injury and myocardial injury in children with HFMD/HA, timely intervention efficiently reduced disease severity and improved outcome. [ABSTRACT FROM AUTHOR]

Urban regeneration decision-making is a complicated system, which requires that stakeholder interests balance in aspects of the economy, society and environment. It is necessary to identify the key factors affecting urban regeneration and then construct an urban regeneration decision-making evaluation system to provide a basis for objective and comprehensive judgment for urban regeneration decision-making. Through constructing a fuzzy comprehensive evaluation model based on the entropy weight method, this paper attempts to provide a scientific evaluation method for the suitability of urban regeneration. An urban regeneration scheduling method by sorting the appropriate degree of the update of different areas in the large region, is proposed to achieve urban regeneration implementation in the sequence of time and space optimization. [ABSTRACT FROM AUTHOR]

Background What was the relationship of Fuzheng Huayu recipe (FZHY) inhibiting hepatocyte apoptosis and HSC activation at different stage of liver fibrosis? In order to answer this question, the study was carried out to dynamically observe FZHY's effect on hepatocyte apoptosis and HSC activation and further explored underling mechanism of FZHY against hepatocyte apoptosis. Methods Mice were randomly divided into four groups: normal, model, FZHY, and N-acetylcystein (NAC) groups. Acute hepatic injury and liver fibrosis in mice were induced by CCl4. Three days before the first CCl4 injection, treatment with FZHY powder or NAC respectively was started. In vitro, primary hepatocytes were pretreated with FZHY medicated serum or ZVAD- FMK and then incubated with ActD and TNF-α. Primary HSCs were treated with DNA from apoptotic hepatocytes incubated by Act D/TNF-α or FZHYmedicated serum. Liver sections were analyzed for HE staining and immunohistochemical evaluation of apoptosis. Serum ALT and AST levels and Alb content and TNF-α expression in liver tissue were detected. Hyp content was assayed and collagen deposition was visualized. Expressions of α-SMA and type I collagen were analyzed by immunofluorescence and immunoblotting. Flow cytometry, immunofluorescence, and DNA ladder for hepatocyte apoptosis and immunoblotting for TNF-R1, Bcl-2 and Bax were also analyzed. Results Mice showed characteristic features of massive hepatocytes apoptosis in early stage of liver injury and developed severe hepatic fibrosis in later phase. FZHY treatment significantly alleviated acute liver injury and hepatocyte apoptosis, and inhibited liver fibrosis by decreasing α-SMA expression and hepatic Hyp content. In vitro, primary hepatocytes were induced by TNF-α and Act D. The anti-apoptotic effect of FZHY was generated by reducing TNFR1 expression and balancing the expressions of Bcl-2 and Bax. Meanwhile, the nuclear DNA from apoptotic hepatocytes stimulated HSC activation in a dose dependent manner, and the DNA from apoptotic hepatocytes treated with FZHY or Z-VAD-FMK reduced HSC activation and type I collagen expression. Conclusion These findings suggested that FZHY suppressed hepatocyte apoptosis through regulating mediators in death receptor and mitochondrial pathways, and the effect of FZHY on hepatocyte apoptosis might play an important role in inhibiting liver fibrosis. [ABSTRACT FROM AUTHOR]

Quantifying the spatial pattern of large-scale forest biomass can provide a general picture of the carbon stocks within a region and is of great scientific and political importance. The combination of the advantages of remote sensing data and field survey data can reduce uncertainty as well as demonstrate the spatial distribution of forest biomass. In this study, the seventh national forest inventory statistics (for the period 2004-2008) and the spatially explicit MODIS Land Cover Type product (MCD12C1) were used together to quantitatively estimate the spatially-explicit distribution of forest biomass in China (with a resolution of 0.05°, ∼5600 m). Our study demonstrated that the calibrated forest cover proportion maps allow proportionate downscaling of regional forest biomass statistics to forest cover pixels to produce a relatively fine-resolution biomass map. The total stock of forest biomass in China was 11.9 Pg with an average of 76.3 Mg ha-1 during the study period; the high values were located in mountain ranges in northeast, southwest and southeast China and were strongly correlated with forest age and forest density. [ABSTRACT FROM AUTHOR]

Forests are one of the most important components of the global biosphere and have critical influences on the Earth's ecological balance. Regularly updated forest cover information is necessary for various forest management applications as well as climate modeling studies. However, map products are not widely updated at continental or national scales because the current land cover products have overly coarse spatial resolution or insufficiently large training data sets. This study presents the results of forests distribution and variation information over China using Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index (NDVI) time series data with the first layer of MODIS Land Cover Type product (MODIS LC-1). The NDVI time series histogram characteristic curves for forestland were estimated from MODIS LC-1 and MODIS NDVI time series data. Based on the differences of histograms among different forests, we obtained the 2001-2011 forests distribution for China at a spatial resolution of 500-m × 500-m. The overall accuracy of validation was 80.4%, an increase of 12.8% relative to that obtained using MODIS LC-1 data. The 2001-2011 forestland pure and mixed pixels of China accounted for an average of 33.72% of all pixels. There is a gradual increase in China's forestland coverage during 2001-2011; however, the relationship is not statistically significant. [ABSTRACT FROM AUTHOR]

As an easily noticeable fact in the development of modern Chinese language, Europeanization caused some difficulties for modern Chinese poetry. In the self-construction of modern Chinese poetry , the key point in the complex relationship between Europeanization and its opposite trend of indigenization lies in their holding an appropriate position in the self-construction of modern Chinese poetry. As a matter of fact, rather than sticking to such questions as whether there was Europeanization in the writing of new poems and Europeanization in poetry is justifiable or not, we can examine how Europeanization, as a historical fact, re-shaped the writing of Chinese poetry and what qualities of Chinese poetry has been changed. The effect of Europeanization has been manifested in the works of many representative modern poets. [ABSTRACT FROM AUTHOR]

Background: Chinese herbal medicine (CHM) has been used in China and some other countries for the treatment of patients with functional dyspepsia (FD). However, controlled studies supporting the efficacy of such treatments in patients with FD are lacking. In this trial, we aimed to assess the efficacy and safety of modified LiuJunZi decoction in patients with FD of spleen-deficiency and qi-stagnation syndrome. Methods: We performed a randomized, double-blind, placebo-controlled trial with patients from five centers. Patients with FD of spleen-deficiency and qi-stagnation syndrome (n = 160) were randomly assigned to groups given CHM modified LiuJunZi decoction or placebo in a 2:1 ratio. Herbal or placebo granules were dissolved in 300 ml of boiled water cooled to 70°C. Patients in both groups were administered 150 ml (50°C) twice daily. The trial included a 4-week treatment period and a 4-week follow-up period. The primary outcomes were dyspepsia symptom scores, measured by the total dyspepsia symptom scale and the single dyspepsia symptom scale at weeks 0, 1, 2, 3, 4 and 8. The secondary outcome was the change of radiopaque barium markers emptied from the stomach between week 0 and week 4 of treatment. Results: Compared with patients in the placebo group, patients in the CHM group showed significant improvements according to the scores of total dyspepsia symptoms and single dyspepsia symptoms obtained from patients (P < 0.01) and investigators (P < 0.01). They also showed an improvement in the number of radiopaque barium markers emptied from the stomach (P < 0.05). Conclusions: CHM modified LiuJunZi decoction appears to offer symptomatic improvement in patients with FD of spleen-deficiency and qi-stagnation syndrome. Trial registration: Chinese Clinical Trial Registry (ChiCTR): ChiCTR-TRC-10001074 [ABSTRACT FROM AUTHOR]

Human rabies is one of the major public-health problems in China. The number of human rabies cases has increased dramatically in the last 15 years, partially due to the poor understanding of the transmission dynamics of rabies and the lack of effective control measures of the disease. In this article, in order to explore effective control and prevention measures we propose a deterministic model to study the transmission dynamics of rabies in China. The model consists of susceptible, exposed, infectious, and recovered subpopulations of both dogs and humans and describes the spread of rabies among dogs and from infectious dogs to humans. The model simulations agree with the human rabies data reported by the Chinese Ministry of Health. We estimate that the basic reproduction number R02 for the rabies transmission in China and predict that the number of the human rabies is decreasing but may reach another peak around 2030. We also perform some sensitivity analysis of R0 in terms of the model parameters and compare the effects of culling and immunization of dogs. Our study demonstrates that (i) reducing dog birth rate and increasing dog immunization coverage rate are the most effective methods for controlling rabies in China; and (ii) large scale culling of susceptible dogs can be replaced by immunization of them. [ABSTRACT FROM AUTHOR]

Previous research on online consumer purchases has focused on increased purchases and neglected decreased purchases. However, factors impacting these purchases are different. Drawing on the two-factor theory, in this paper, the authors compare factors affecting increase and decrease in Chinese consumers' online purchases. The authors conducted separate group analyses with PLS. The results show that consumers' perception of service quality significantly affects increases in their online purchasing behavior whereas their perception of website quality significantly affects decreases in online purchasing. These results show that e-tailers must not only focus on factors that promote online shopping but also those that deter consumers from making online purchases. [ABSTRACT FROM AUTHOR]

Background: The cost of treating community-acquired pneumonia (CAP) in China is a heavy economic burden for the society. Objective: To investigate the costs of hospitalization of low-risk CAP patients and how hospitalization costs can be reduced through proper usage of hospital resources. Methods: Two hundred thirty-six patients with low-risk CAP who were hospitalized between January 2000 and December 2005 in a 1161-bed tertiary care teaching hospital were included in a retrospective cohort study. Their hospitalization costs and antibiotic therapy were analyzed. General linear model was utilized to determine correlative variables associated with total hospital costs. Results: The median length of hospital stay was 12 days and the median duration of intravenous (IV) antibiotic therapy was 10 days, they were correlated significantly ( P = 0.000, r = 0.81). The median total hospital cost was $556.50 (mean $705.60), of which 48.9% was for drugs, 21.9% for laboratory tests, 8.6% for radiology, 6.5% for medical staff, 6.3% for hospital beds, and 5.3% for examination. General linear model analysis determined that duration of IV antibiotic therapy, Pneumonia Severity Index class, age, and initial empirical antibiotic therapy failure were correlative factors of total hospital costs. Pathogens were identified in 106 patients (44.9%), Mycoplasma pneumoniae was the most common pathogen (19.9%), followed by Streptococcus pneumoniae (8.5%), and Haemophilus influenza (5.5%). The majority of patients accepted initial empirical β-lactam (37.3%) or fluoroquinolone (30.9%) monotherapy, the empirical treatment failure rates were 20.5% and 5.5%, respectively. Conclusions: Efforts to reduce duration of IV antibiotic therapy will have the most profound effect on reducing total hospital costs of low-risk CAP. The atypical pathogens should be considered for initial empirical antibiotics in low-risk CAP therapy in China. [ABSTRACT FROM AUTHOR]

The article presents a novel method of developing microwave distillation and solid-phase microextraction coupled with gas chromatography-mass spectrometry (MD-SPME/GC-MS) for the analysis of critical components in safflower. The safflower samples used in the experiment came from Beijing, China, while the SPME fibers used were polydimethylsiloxane, polydimethylsiloxane/divinylbenzene and carbowax/divinylbenzene. Results of the analysis proved that MD-SPME/GC-MS is an effective and simple method for determining the volatile components in safflower.

We used the "technique for order preference by similarity to ideal solution" model to measure port comprehensive strength and its spatial features on the basis of the concept of regional balanced development during the period of port resources integration. Using the panel data for coastal cities from 2001 to 2017, we built a spatial econometric model of port comprehensive strength to explore the effect of port comprehensive strength on economic growth and its spatial spillover effect. The study found the following: (1) The hierarchical structure of China's coastal ports has expanded toward a flat pyramid structure, the shift of which enlarges middle- and high-level ports and shrinks the low-level ones; China's coastal port groups present a "core-periphery structure," which focuses on international and national hubs. (2) China's coastal port comprehensive strength has a significant spatial spillover effect on the economic growth in local and neighboring cities; for every 1% increase in port comprehensive strength, the peripheral economic growth contributes by 0.08% and 0.04%. (3) The spatial spillover effect of coastal port comprehensive strength on the scale of the port group reflects a spatial conglomeration effect and regional differences: the coastal port comprehensive strength of the Pearl River Delta and the Southeast coastal area presents direct and indirect double spillover effects, the port groups in the Yangtze River Delta and Southeast coastal area have a direct spillover effect only, and the Southwest port groups have a double negative spillover effect. • This paper explores the hierarchical structure of China's coastal ports and spatial spillover effect. • China's coastal port comprehensive strength has a significant spatial spillover effect. • Obvious differences in the spatial spillover effect of the comprehensive strength of the five major port groups. [ABSTRACT FROM AUTHOR]

Introduction: Several techniques have been described to treat tibial fractures, which respectively remains defects. This article presents a novel intra- and extramedullary fixation technique: percutaneous external fixator combined with titanium elastic nails (EF-TENs system). The purpose of this study is to introduce this new minimally invasive surgical technique and selective treatment of tibial fractures, particularly in segmental fractures, diaphysis fractures accompanied with distal or proximal bone subfissure, or fractures with poor soft-tissue problems.Methods: Following ethical approval, thirty-two patients with tibial fractures were treated by the EF-TENs system between January 2010 and December 2012. The follow-up studies included clinical and radiographic examinations. All relevant outcomes were recorded during follow-up.Results: All thirty-two patients were achieved follow-ups. According to the AO classification, 3 Type A, 9 Type B and 20 Type C fractures were included respectively. According to the Anderson-Gustilo classification, there were 5 Type Grade II, 3 Type Grade IIIA and 2 Type Grade IIIB. Among 32 patients, 8 of them were segmental fractures. 12 fractures accompanied with bone subfissure. Results showed no nonunion case, with an average time of 23.7 weeks (range, 14-32 weeks). Among them, there were 3/32 delayed union patients and 0/32 malunion case. 4/32 patients developed a pin track infection and no patient suffered deep infection. The external fixator was removed with a mean time of 16.7 weeks (range, 10-26 weeks). Moreover, only 1/32 patient suffered with the restricted ROM of ankle, none with the restricted ROM of knee.Conclusion: This preliminary study indicated that the EF-TENs system, as a novel intra- and extramedullary fixation technique, had substantial effects on selective treatment of tibial fractures. [ABSTRACT FROM AUTHOR]

Medical waste management is of great importance due to its infectious and hazardous nature that can cause undesirable effects on humans and the environment. The objective of this study was to analyze and evaluate the present status of medical waste management in the light of medical waste control regulations in Nanjing. A comprehensive inspection survey was conducted for 15 hospitals, 3 disposal companies and 200 patients. Field visits and a questionnaire survey method were implemented to collect information regarding different medical waste management aspects, including medical waste generation, segregation and collection, storage, training and education, transportation, disposal, and public awareness. The results indicated that the medical waste generation rate ranges from 0.5 to 0.8kg/bed day with a weighted average of 0.68kg/bed day. The segregated collection of various types of medical waste has been conducted in 73% of the hospitals, but 20% of the hospitals still use unqualified staff for medical waste collection, and 93.3% of the hospitals have temporary storage areas. Additionally, 93.3% of the hospitals have provided training for staff; however, only 20% of the hospitals have ongoing training and education. It was found that the centralized disposal system has been constructed based on incineration technology, and the disposal cost of medical waste is about 580 US$/ton. The results also suggested that there is not sufficient public understanding of medical waste management, and 77% of respondents think medical waste management is an important factor in selecting hospital services. The problematic areas of medical waste management in Nanjing are addressed by proposing some recommendations that will ensure that potential health and environmental risks of medical waste are minimized. [Copyright &y& Elsevier]

Background: So far, there have been no published population studies on the relationship between a COVID-19 infection and public risk perception, information source, knowledge, attitude, and behaviors during the COVID-19 outbreak in China., Objective: This study aims to understand the relationships between COVID-19 infection; four personal nonpharmaceutical interventions (NPIs; handwashing, proper coughing habits, social distancing, and mask wearing); and public risk perception, knowledge, attitude, and other social demographic variables., Methods: An online survey of 8158 Chinese adults between February 22 and March 5, 2020, was conducted. Bivariate associations between categorical variables were examined using Fisher exact test. We also explored the determinants of four NPIs as well as their association with COVID-19 infection using logistic regression., Results: Of 8158 adults included, 57 (0.73%) were infected with COVID-19. The overwhelming majority of respondents showed a positive attitude (n=8094, 99.2%), positive risk perception (n=8146, 99.9%), and high knowledge levels that were among the strongest predictors of the four adopted NPIs (handwashing: n=7895, 96.8%; proper coughing: 5997/6444, 93.1%; social distancing: n=7104/8158, 87.1%; and mask wearing: 5011/5120, 97.9%). There was an increased risk of COVID-19 infection for those who did not wash their hands (2.28% vs 0.65%; risk ratio [RR] 3.53, 95% CI 1.53-8.15; P=.009), did not practice proper coughing (1.79% vs 0.73%; RR 2.44, 95% CI 1.15-5.15; P=.03), did not practice social distancing (1.52% vs 0.58%; RR 2.63, 95% CI 1.48-4.67; P=.002), and did not wear a mask (7.41% vs 0.6%; RR 12.38, 95% CI 5.81-26.36; P<.001). For those who did practice all other three NPIs, wearing a mask was associated with a significantly reduced risk of infection compared to those who did not wear a mask (0.6% vs 16.7%; P=.04). Similarly, for those who did not practice all or part of the other three NPIs, wearing a mask was also associated with a significantly reduced risk of infection. In a penalized logistic regression model including all four NPIs, wearing a mask was the only significant predictor of COVID-19 infection among the four NPIs (odds ratio 7.20, 95% CI 2.24-23.11; P<.001)., Conclusions: We found high levels of risk perception, positive attitude, desirable knowledge, as well as a high level of adopting the four NPIs. The relevant knowledge, risk perception, and attitude were strong predictors of adapting the four NPIs. Mask wearing, among the four personal NPIs, was the most effective protective measure against COVID-19 infection, with added preventive effect among those who practiced all or part of the other three NPIs., (©Hong Xu, Yong Gan, Daikun Zheng, Bo Wu, Xian Zhu, Chang Xu, Chenglu Liu, Zhou Tao, Yaoyue Hu, Min Chen, Mingjing Li, Zuxun Lu, Jack Chen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 13.11.2020.)