Search

Basic medical laboratory courses (BMLCs) play an important role in medical educational courses helping the student acquire three important skills of surgical operating, collaborative learning, and problem solving. The outcome-based student assessment (OBSA) is a learning evaluation method that establishes specific evaluation points based on performance of students in three aspects: surgical operating, collaborative learning, and problem solving in the BMLC curriculum practices. The purpose of the present randomized controlled trial study is to explore the efficiency of OBSA program in BMLCs. The 233 students attending BMLCs were randomly divided into 2 groups, 118 in the OBSA group and 115 in the control group. We conducted multiple-choice examination questions (MCQs) test and two questionnaires with the method of two-sample t test for statistics. The results of MCQs in total eight BMLC blocks showed that the academic performance of the OBSA group was significantly better than that of the control group (P < 0.05). In addition, the average scores of direct observation of procedural skills (DOPS) and mini-experimental evaluation exercise in OBSA group were significantly higher than those in control group (P < 0.05). The majority of the medical students preferred the OBSA and considered OBSA could effectively improve their surgical operating skills (83.9%), collaborative learning skills (92.1%), and problem-solving skills (91.1%). From the above, OBSA is an effective evaluation method for the implementation of the BMLC curriculum

Background: EEG reactivity is a predictor for neurological outcome in comatose patients after cardiac arrest (CA); however, its application is limited by variability in stimulus types and visual assessment. We aimed to evaluate the prognostic value of the quantitative analysis of EEG reactivity induced by standardized electrical stimulation and for early prognostication in this population. Methods: This prospective observational study recruited post-CA comatose patients in Xuanwu Hospital, Capital Medical University (Beijing, China) between January 2016 and June 2023. EEG reactivity to electrical or traditional pain stimulation was randomly performed via visual and quantitative analysis. Neurological outcome within 6 months was dichotomized as good (Cerebral Performance Categories, CPC 1–2) or poor (CPC 3–5). Results: Fifty-eight post-CA comatose patients were admitted, and 52 patients were included in the final analysis, of which 19 (36.5%) had good outcomes. EEG reactivity induced with the electrical stimulation had superior performance to the traditional pain stimulation for good outcome prediction (quantitative analysis: AUC 0.932 vs. 0.849, p = 0.048). When using the electrical stimulation, the AUC of EEG reactivity to predict good outcome by visual analysis was 0.838, increasing to 0.932 by quantitative analysis (p = 0.039). Comparing to the traditional pain stimulation by visual analysis, the AUC of EEG reactivity for good prognostication by the electrical stimulation with quantitative analysis was significantly improved (0.932 vs. 0.770, p = 0.004). Conclusions: EEG reactivity induced by the standardized electrical stimulation in combination with quantitative analysis is a promising formula for post-CA comatose patients, with increased predictive accuracy. [ABSTRACT FROM AUTHOR]

Physical activity (PA) may prevent depressive symptoms, however, PA fluctuations may have different effects. Using three waves of nationally representative data, this study aimed to examine the effects of PA fluctuations on depressive symptoms. Participants comprised 7633 adults free of depressive symptoms at the first two waves (M age = 45.26, 54.70 % males). They completed the China Family Panel Study in 2016 (T1), 2018 (T2), and 2020 (T3), respectively. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression (CES–D) scale using a cutoff of 16. Participants' PA levels were split into regular PA or infrequent PA groups. Changes in PA levels between T1 and T2 were classified into four groups: maintained infrequent PA, initiated regular PA, ceased regular PA, and persisted regular PA. The incidence of depressive symptoms was 20.22 % (19.05 % possible and 1.17 % severe depression). After multivariate adjustment, Poisson regression showed that persistent regular PA had 17.8 % (95 % CI: 0.724, 0.934) lower risks of incident depressive symptoms compared to maintained infrequent PA. And adults who ceased regular PA were more likely to experience depressive symptoms than those who persisted in regular PA (RR = 1.188, 95 % CI: 1.010, 1.398). All items were self-reported. CES–D only examined self-diagnosed depressive symptoms, not medical diagnoses. Adults who persisted in regular PA may have a lower possibility of developing depressive symptoms. The finding might serve as an empirical reference to depression prevention. • The incidence of depressive symptoms was 20.22 % (19.05 % possible and 1.17 % severe depression). • 31.55 % of adults in China changed their PA levels over a two-year period. • Persistent regular PA has lower incidence of depressive symptoms than maintenance infrequent PA. • Ceasing regular PA has higher incidence of depressive symptoms than persistent adults. • Initiating regular PA has no statistically significant antidepressant effect. [ABSTRACT FROM AUTHOR]

In this paper, the stochastic frontier gravity model is applied to analyze the trade potential between China and Nepal and the prospects of Lanzhou-Kathmandu South Asian rail-road freight trains (LKSARFT). Based on the statistical data, we test the Exports Efficiency (EE), Bilateral Trade Efficiency (BTE), Exports Trade Potential (ETP), Bilateral Trade Potential (BTP), Extended Exports Trade Potential (EETP), Extended Bilateral Trade Potential (EBTP), Improved Exports Trade Potential (IETP) and Improved Bilateral Trade Potential (IBTP) between China and Nepal, the following analysis results can be found: for the bilateral trade model, the bilateral non-efficiency factor decreasing at a rate of 0.057 with time increasing, bilateral trade increasing at a rate of 0.057 with time increasing. For the exports model, the exports non-efficiency factor increasing at a rate of 0.004 with time increasing, exports trade decreasing at a rate of 0.057 with time increasing. The BTE between China and Nepal increases when time changes, the EE from China to Nepal remains constant changing during the 18 years. The changing range of BTE is 0.002–0.05; the changing range of EE from China to Nepal is over 0.1, larger than the BTE. The BTE and EE ranking among the eight South Asian countries are ranking fifth and fourth during the 18 years. exports trade resistance from China to Nepal is larger than bilateral trade resistance; The import trade potential from Nepal to China is huge, the focus of bilateral trade between China and Nepal may be changed, there are more goods may be exported from Nepal to China, and China may become trade deficit when trading with Nepal. Then, the development bottlenecks of the LKSARFT are analyzed. Finally, we give policy directions to boost bilateral trade efficiency and tap the potential of bilateral trade between China and Nepal. [ABSTRACT FROM AUTHOR]

To evaluate the health economics of using continuous subcutaneous insulin infusion (CSII) therapy versus multiple daily injections (MDI) therapy in children and adolescent patients with type 1 diabetes (T1D) in Qingdao, China. A long-term cost-effectiveness analysis was conducted using the IQVIA Core Diabetes Model (CDM). The baseline characteristics of the simulated cohorts were obtained from 213 pediatric T1D patients who received care with CSII(104 cases) or MDI(109 cases) in Qingdao from 1 January 2015 to 31 March 2019. In the essential case, the expenditure of the complications and treatment of the disease with both therapies were evaluated in Chinese currency from the perspective of healthcare system. In a secondary analysis, the model used a 70-year time horizon, and a discount rate of 5% was applied to all future health outcomes and costs. A one-way sensitivity analysis was conducted on delta HbA1c, different prices of insulin pump, price of each upgrade cycle rates and different discount rates. Uncertainty was also evaluated by the probability sensitivity analysis and scenario analysis. In the base-case analysis, the lifetime total costs were lower for CSII group at ¥630,871 per patient compared with ¥672,672 for MDI group. The quality-adjusted life years (QALYs) gained were 11.612 and 11.197 for patients treated with CSII group and MDI group, respectively. The CSII group was cost-saving compared to MDI group. The feasibility of CSII group being cost-effective was 100% under the threshold of 3 times per capita GDP of China in 2019 (¥212,676) which was indicated from the probabilistic sensitivity analysis. Regarding scenario analysis, the ICER of the CSII group compared to MDI was between −151,583 and 153,366 RMB/QALYs, which is cost-effective. This economic evaluation compared CSII therapy versus MDI therapy for T1D children and adolescent patients in China and findings indicate that CSII should be considered a preferred treatment modality to MDI. [ABSTRACT FROM AUTHOR]

We reconstructed the Holocene climate in the study area using data from a BZ section in the Baiyangdian paleo-lake. Samples were analyzed for multiple proxies for climate conditions, including grain size, magnetic susceptibility (MS), and carbonate content, which were combined with accelerator mass spectrometry (AMS) 14C data. The results show that from 10.0 to 6.3 kyr BP, the study area experienced an interval of increasing precipitation and rising water level at Lake Baiyangdian. For a very short period, ~ 8.4 kyr BP, the extent of the lake reached the sampling point. The climate during this stage was relatively humid. The water level dropped abruptly at 6.5 kyr BP as a result of a weak monsoon event. From 6.3 to 2.9 kyr BP the climate became humid once again. The continuous lacustrine sediment of the strata indicated that the water level of Lake Baiyangdian expanded rapidly during this period and reached the sampling point. After 2.9 kyr BP, the climate in the region changed again from humid to dry. The abrupt increase in MS after ~1 kyr BP (993 AD) is consistent with records of human activities in local chronicles, which indicates that the environment in the study area was influenced by human activities. Through a comparison of the BZ section and the East Asian summer monsoon (EASM) records, we found that precipitation in the study area was controlled by the EASM. A series of cold Holocene events were clearly recorded by the sediment in the BZ section, and these events are synchronous with the North Atlantic ice-rafting events (IRD). The connection between the characteristics of the BZ section and the EASM and IRD indicate that climate evolution in the study area was strongly affected by EASM and IRD. [ABSTRACT FROM AUTHOR]

Marine litter pollution poses a significant threat to offshore ecosystems, eliciting widespread concern. We investigated seafloor litter patterns in the Pearl River Estuary and adjacent coastal waters of China in 2023 via bottom trawl survey. Average number and weight densities were found to be 154.34 ± 30.95 n/km2 and 2384.63 ± 923.98 g/km2, respectively. Plastic was the most abundant material by number density (79.07 %), and rubber the highest by weight density (22.93 %). Overall number density varied from 40.50 ± 22.50 to 221.13 ± 52.44 n/km2, with the highest in Daya Bay and the lowest in Guanghai Bay. Weight density varied from 189.93 ± 71.94 to 5386.70 ± 3050.30 g/km2, with the highest in Qiao Island and the lowest in Honghai Bay. The main source was plastic bags and wrappers. The Pearl River Delta and Daya Bay were identified as seafloor litter distribution hotspots. Controlling plastic waste input is crucial for reducing seafloor litter in the Pearl River Estuary. [Display omitted] • Seafloor litter distribution and composition in Pearl River Estuary and adjacent coastal waters were found in concentrations up to 154.34 ± 30.95 n/km2 and 2384.63 ± 923.98 g/km2 • Plastic and rubber were the most common by number and weight density, accounting for 79.07% and 22.93%, respectively • Qiao Island waters showed the highest litter number and weight density, which were probably derived from human activity and nearshore currents • Take-out consumer items was the most abundant class of seafloor litter found in DYW [ABSTRACT FROM AUTHOR]

Paleoclimatic records from the East Asian summer monsoon (EASM) margin are regarded as a direct reflection of the intensity and northern extent of the EASM. Here, we focus on reconstructing climatic evolution over the past 1800 years from two alkaline lakes, Chagan Nuur and Sangin Dalai Nuur, in southern Inner Mongolia. With age control provided by 13 Accelerator Mass Spectrometry radiocarbon ages and 210Pb/137Cs dating, analyses of grain size, X-ray diffraction, magnetic susceptibility, carbonate content, total nitrogen, total organic carbon and the stable isotopic composition of carbon (δ13C) and nitrogen (δ15N) in sedimentary organic matter and calculation of organic carbon to nitrogen atomic ratios have been performed to investigate hydrodynamic processes, ecological conditions and corresponding lake-level fluctuations, in response to climate change. Our results show that the lake level of Changan Nuur frequently fluctuated since 546 CE, with four centennial-scale intervals of lake expansion at around 755, 1178, 1350 CE, and after 1950 CE, and one interval of lake recession from 1593 to 1782 CE. Sangin Dalai Nuur experienced mainly low-amplitude lake-level fluctuations since 212 CE, except for severe lake shrinkage from 1417 to 1872 CE. A regional comparison shows that three warm and humid intervals (640–800 CE, 1088–1288 CE, and after 1950 CE) and one cold and dry interval (1417–1872 CE) recognized from our records could correspond to the Sui-Tang Warm Period, the Medieval Climate Anomaly, the Current Warm Period and the Little Ice Age, respectively. Moreover, our results are roughly synchronous with moisture conditions revealed by proxy records from monsoonal northern China, demonstrating that the highly variable lake levels and climatic conditions in southern Inner Mongolia were controlled by centennial-scale variations in EASM over the past 1800 years. [ABSTRACT FROM AUTHOR]

Background Community-acquired pneumonia (CAP) is a leading infectious cause of hospitalization and death worldwide. Knowledge about the incidence and etiology of CAP in China is fragmented. Methods A multicenter study performed at 4 hospitals in 4 regions in China and clinical samples from CAP patients were collected and used for pathogen identification from July 2016 to June 2019. Results A total of 1674 patients were enrolled and the average annual incidence of hospitalized CAP was 18.7 (95% confidence interval, 18.5–19.0) cases per 10000 people. The most common viral and bacterial agents found in patients were respiratory syncytial virus (19.2%) and Streptococcus pneumoniae (9.3%). The coinfections percentage was 13.8%. Pathogen distribution displayed variations within age groups as well as seasonal and regional differences. The severe acute respiratory syndrome coronavirus 2 was not detected. Respiratory virus detection was significantly positively correlated with air pollutants (including particulate matter ≤2.5 µm, particulate matter ≤10 µm, nitrogen dioxide, and sulfur dioxide) and significantly negatively correlated with ambient temperature and ozone content; bacteria detection was opposite. Conclusions The hospitalized CAP incidence in China was higher than previously known. CAP etiology showed that differences in age, seasons, regions, and respiratory viruses were detected at a higher rate than bacterial infection overall. Air pollutants and temperature have an influence on the detection of pathogens. [ABSTRACT FROM AUTHOR]

Fractured tight sandstone reservoirs are dual-pore systems including matrix pores and natural fractures, which both contribute to the system permeability. However, most previous studies either calculated the matrix permeability or obtained the fracture permeability to represent the system permeability in the logging evaluation of fractured tight sandstones because existing logging methods cannot distinguish the two types. In this study, a novel method is proposed to estimate the system permeability in fractured tight sandstones using geophysical logs. First, the fracture characteristics in the Upper Triassic Chang 8 member of the Yanchang Formation, southwest Ordos Basin, China, were analyzed. Based on the hydraulic flow unit approach, the formation classification criteria and the corresponding permeability–porosity models were established; then, the pure matrix permeability in the dual-pore system was calculated using geophysical logs. Based on the fracture characteristics, the relative pure fracture permeability was obtained using the Sibbit and Faivre method. By applying the Parsons' model in boreholes, the system permeability was then calculated by coupling the relationship between the two permeabilities. Finally, two field applications in the study area demonstrate the feasibility of the proposed method, and the logging responses, application effects and applicable conditions of this method are discussed in detail. These applications indicate that the proposed method is suitable for tight reservoirs with fracture widths less than 200 μm, and considered to be dual-pore systems. [ABSTRACT FROM AUTHOR]

Research on abrupt paleoclimatic and paleoenvironmental change provides a scientific basis for evaluating future climate. Because of spatial variability in monsoonal rainfall, our knowledge about climate change during the mid‐ to late‐Holocene in southern China is still limited. We present a multi‐proxy record of paleoclimatic change in a crater lake, Lake Shuangchi. Based on the age‐depth model from 210Pb, 137Cs and AMS14C data, high‐resolution mid‐ to late‐ Holocene climatic and environmental records were reconstructed using multiple indices (TOC, TN, C/N, δ13C and grain size). Shuangchi underwent a marked change from a peat bog to a lake around 1.4 kaBP. The C3 plants likely dominated during 7.0–5.9 ka and 2.5–1.4 kaBP, while C4 plants dominated between 5.9–3.2 and 3.0–2.5 kaBP. Algae were dominant sources of organic matter in the lake sediments after 1.4 kaBP. Several intervals with high concentrations of coarser grain sizes might be due to flood events. These results reveal that several abrupt paleoclimatic events occurred around 6.6 ka, 6.1 ka, 5.9 ka, 3.0 ka, 2.5 ka and 1.4 kaBP. The paleoclimatic change recorded in the lake may be related to the migration of the Intertropical Convergence Zone (ITCZ) and El Niño ‐ Southern Oscillation (ENSO) activity. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to evaluate and update the current prevalence of and risk factors for chronic kidney disease (CKD) and diabetic kidney disease (DKD) in a central Chinese urban population.Methods: From December 2017 to June 2018, a total of 5231 subjects were randomly enrolled from 3 communities in 3 districts of Zhengzhou. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min.1.73m2 or urinary albumin to creatinine ratio ≥ 30 mg/g (albuminuria). Diabetic subjects with systolic blood pressure > 140 mmHg, albuminuria or an eGFR less than 60 mL/min/1.73 m2 were classified as having DKD. Participants completed a questionnaire assessing lifestyle and relevant medical history, and blood and urine specimens were taken. Serum creatinine, uric acid, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein and urinary albumin were assessed. The age- and sex-adjusted prevalences of CKD and DKD were calculated, and risk factors associated with the presence of reduced eGFR, albuminuria, DKD, severity of albuminuria and progression of reduced renal function were analyzed by binary and ordinal logistic regression.Results: The overall adjusted prevalence of CKD was 16.8% (15.8-17.8%) and that of DKD was 3.5% (3.0-4.0%). Decreased renal function was detected in 132 participants (2.9, 95% confidence interval [CI]: 2.5-3.2%), whereas albuminuria was found in 858 participants (14.9, 95% CI: 13.9-15.9%). In all participants with diabetes, the prevalence of reduced eGFR was 6.3% (95% CI = 3.9-8.6%) and that of albuminuria was 45.3% (95% CI = 40.4-50.1%). The overall prevalence of CKD in participants with diabetes was 48.0% (95% CI = 43.1-52.9%). The results of the binary and ordinal logistic regression indicated that the factors independently associated with a higher risk of reduced eGFR and albuminuria were older age, sex, smoking, alcohol consumption, overweight, obesity, diabetes, hypertension, dyslipidemia and hyperuricemia.Conclusions: Our study shows the current prevalence of CKD and DKD in residents of Central China. The high prevalence suggests an urgent need to implement interventions to relieve the high burden of CKD and DKD in China. [ABSTRACT FROM AUTHOR]

This report provides an overview of China's publishing industry in 2018, including the number of publishing houses, the total volume of books published and the structure of publications. As for China's best sellers in 2018, the segment generally showed a steady trend of growth, and the fixed prices of the best sellers made greater contribution to the overall fixed prices of publications. There were over 400 books with over 200,000 copies sold, far more than the figure in the previous years. As for the retail market in 2018, the sales of printed books kept growing, with a fall after rise. The online and offline sales were uneven, and online bookstores contributed significantly to the overall growth. The best-performing category of books was different from those in the previous years, while the teaching aids and teaching materials grow faster than other categories. New books were not popular enough, while the classics and the themed publications sold well. [ABSTRACT FROM AUTHOR]

The relationship between air pollution and stroke has been extensively studied, however, the evidence regarding the association between air pollution and hospitalization due to stroke and its subtypes in coastal areas of China is limited. To estimate the associations between air pollution and hospitalizations of stroke and its subtypes in the Beibu Gulf Region of China. We conducted a time-stratified case-crossover study in 15 cities in Beibu Gulf Region in China from 2013 to 2016. Exposures to PM 1 , PM 2.5 , PM 10 , SO 2 , NO 2 , O 3 , and CO on the case and control days were assessed at residential addresses using bilinear interpolation. Conditional logistic regressions were constructed to estimate city-specific associations adjusting for meteorological factors and public holidays. Meta-analysis was further conducted to pool all city-level estimates. There were 271,394 case days and 922,305 control days. The odds ratios (ORs) for stroke hospitalizations associated with each interquartile range (IQR) increase in 2-day averages of SO 2 (IQR: 10.8 µg/m3), NO 2 (IQR: 11.2 µg/m3), and PM 10 (IQR: 37 µg/m3) were 1.047 (95 % CI [confidence interval]: 1.015–1.080), 1.040 (95 % CI: 1.027–1.053), and 1.018 (95 % CI: 1.004–1.033), respectively. The associations with hospitalizations of ischemic stroke were significant for all seven pollutants, while the association with hemorrhagic stroke was significant only for CO. The associations of SO 2 , NO 2 , and O 3 with stroke hospitalization were significantly stronger in the cool season. Short-term increase in SO 2 , NO 2 , and PM 10 might be important triggers of stroke hospitalization. All seven air pollutants were associated with ischemic stroke hospitalization, while only CO was associated with hemorrhagic stroke hospitalization. These results should be considered in public health policy. [Display omitted] • Short-term SO 2 , NO 2 , and PM 10 exposure was associated with stroke hospitalization. • The associations of air pollution with hospitalization vary across stroke subtypes. • Stronger associations were observed in the cool season. [ABSTRACT FROM AUTHOR]

Objective: Although generalized convulsive status epilepticus (GCSE) is a life-threatening emergency, evidence-based data to guide initial drug treatment choices are lacking in the Chinese population. We conducted this prospective, randomized, controlled trial to evaluate the relative efficacy and safety of intravenous phenobarbital and valproate in patients with GCSE.Methods: After the failure of first-line diazepam treatment, Chinese adult patients with GCSE were randomized to receive either intravenous phenobarbital (standard doses, low rate) or valproate (standard). Successful treatment was considered when clinical and electroencephalographic seizure activity ceased. Adverse events following treatment, as well as the neurological outcomes at discharge and 3 months later, were also evaluated.Results: Overall, 73 cases were enrolled in the study. Intravenous phenobarbital was successful in 81.1% of patients, and intravenous valproate was successful in 44.4% of patients (p < 0.05). The relapse rate of status epilepticus within 24 h of receiving phenobarbital (6.7%) was significantly lower than that in patients receiving valproate (31.3%), and the total number of adverse events did not differ significantly between the two groups (p > 0.05). In the phenobarbital group, two patients (5.4%) required ventilation and two patients (5.4%) developed serious hypotension. The neurological outcomes of the phenobarbital group were generally better than those of the valproate group; however, no significant differences were observed between phenobarbital and valproate with respect to mortality (8.1 vs. 16.6%) at discharge, or mortality (16.2 vs. 30.5%) and post-symptomatic epilepsy (26.3 vs. 42.8%) at 3-month follow-up.Conclusions: Intravenous phenobarbital appears to be more effective than intravenous valproate for Chinese adult patients with GCSE. The occurrence of serious respiratory depression and hypotension caused by phenobarbital was reduced by decreasing the intravenous infusion rate; however, even at a lower infusion rate than typically used in other institutions, intravenous phenobarbital resulted in more serious adverse events than intravenous valproate. The better outcomes in the phenobarbital group compared with the valproate group suggest that phenobarbital should be considered for the early successful treatment of GCSE. [ABSTRACT FROM AUTHOR]

Lung cancer is the leading cause of cancer deaths. Non-small-cell lung cancer (NSCLC) is the major type of lung cancer. The aim of this study was to characterize the expression profiles of miRNAs in adenocarcinoma (AC), one major subtype of NSCLC. In this study, the miRNAs were detected in normal, adjacent, and tumor tissues by next-generation sequencing. Then the expression levels of differential miRNAs were quantified by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). In the results, 259, 401, and 389 miRNAs were detected in tumor, adjacent, and normal tissues of pooled AC samples, respectively. In addition, for the first time we have found that miR-21-5p and miR-196a-5p were gradually upregulated from normal to adjacent to tumor tissues; miR-218-5p was gradually downregulated with 2-fold or greater change in AC tissues. These 3 miRNAs were validated by qRT-PCR. Lastly, we predicted target genes of these 3 miRNAs and enriched the potential functions and regulatory pathways. The aberrant miR-21-5p, miR-196a-5p, and miR-218-5p may become biomarkers for diagnosis and prognosis of lung adenocarcinoma. This research may be useful for lung adenocarcinoma diagnosis and the study of pathology in lung cancer. [ABSTRACT FROM AUTHOR]

Background: The clinical and prognostic significance of benign perihepatic lymph nodes enlargement (PLNE) from patients with hepatocellular carcinoma (HCC) remains unclear. The objective of this study is to evaluate the relative frequency, incidence and locations of benign PLNE, and the impact on long-term survival of the patients.Methods: A total of 219 consecutive patients who underwent curative resection of HCC between July 2006 and March 2012 in our single institution were divided into two groups according to the presence of PLNE: PLNE group (n = 76), and control group (n = 143). The long-term outcomes were evaluated and compared between the two groups.Results: The 1-, 3-, and 5-year recurrence-free survival rates were 77.2, 60.0, and 38.1 % in the PLNE group and 71.3, 42.5, and 25.0 % in the control group (p = 0.080). Corresponding overall survival rates were 96.0, 84.8, 67.1 % and 93.5, 72.4, 46.9 % respectively (p = 0.041). Patients with benign PLNE were associated with a higher rate of centrally located HCCs or tumors adjacent to the major branch of vascular vessels. Multivariate analysis revealed that benign PLNE was an independent positive prognostic factor affecting the overall survival.Conclusions: According to our analysis, patients of HCC with benign PLNE after curative resection can be expected to have better long-term survival. It is also associated with a lower risk of tumor recurrence, but not significant. This finding may provide new insights into daily clinical practice and the pathophysiological characteristics of HCC development. [ABSTRACT FROM AUTHOR]

Summary: Runoff in Haihe River Catchment of China is steadily declining due to climate change and human activity. Determining abrupt changes in runoff could enhance identification of the main driving factors for the sudden changes. In this study, the sequential Mann–Kendall test analysis is used to determine abrupt changes in runoff in eight sub-catchments of Haihe River Catchment, while trend analysis via the traditional Mann–Kendall test for the period 1960–1999 is used to identify the basic trend of precipitation and runoff. The results suggest an insignificant change in precipitation and a significant decline in runoff in five of the eight sub-catchments. For most of the sub-catchments, abrupt changes in runoff occurred in 1978–1985. Through correlation comparisons for precipitation and runoff for the periods prior to and after abrupt runoff changes, human activity, rather than climatic change, is identified as the main driving factor of runoff decline. It is also noted that abrupt decline in runoff was actually at the beginning of China’s 1978–1985 land reform. Given that the land reform motivated farmers to productively manage their reallocated lands, agricultural water use therefore increased. Hence percent agricultural land is analyzed in relation to land use/cover pattern for the late 1970s and early 1980s. The analysis shows that when cultivated farmland exceeds 25% of a sub-catchment area, an abrupt decline in runoff occurs. It is therefore concluded that high percent agricultural land and related agricultural water use are the most probable driving factors of runoff decline in the catchment. [Copyright &y& Elsevier]

A correction notice is presented to the article "Population Movement, City Closure in Wuhan, and Geographical Expansion of the COVID-19 Infection in China in January 2020" which appeared in the previous issue of the periodical.

Orthotopic liver transplantation is currently the best treatment option for selected patients with hepatocellular carcinoma ( HCC). From 1980 to 2011, 8874 patients with HCC in China underwent liver transplantation. The organ donation classification criteria of China ( China criteria), which are established by the Government of China, are divided into three parts: China criteria I, donation after brain death; China criteria II, donation after cardiac death and China criteria III, donation after dual brain-cardiac death. Data from the China Liver Transplant Registry (CLTR) System shows that patients within the Milan criteria have higher survival rates than those who are beyond these criteria. Based on CLTR data, altogether 416 patients received living-donor liver transplantation (LDLT) in China. Their 1-year and 3-year survival rates were significantly higher than those of the non- LDLT recipients. The most common early stage (<30 days after liver transplantation) complications include pleural effusion, diabetes, peritoneal effusion or abscess, postoperative infection, hypertension and intraperitoneal hemorrhage; while the most common late stage (≥30 days after liver transplantation) complications were diabetes, hypertension, biliary complications, postoperative infection, tacrolimus toxicity and chronic graft rejection. The incidence of vascular complication, which is the main reason for acute graft failure and re-transplantation, was 2.4%. Liver transplantation is an effective treatment for patients with HCC in China. [ABSTRACT FROM AUTHOR]

The interaction between agricultural water use efficiency (WUEc) and change in vegetation dynamics (mainly crops coverage) was analyzed to assess the ecological effect of the implementation of China's Grain to Green Program (GGP) and to further analyze the impact of the policy on agriculture on a long-term scale from an ecosystem perspective. Remote sensing data (e.g., gross primary productivity, GPP; evapotranspiration, ET; and the normalized difference vegetation index, NDVI) were used to investigate the spatiotemporal characteristics of WUEc in the Loess Plateau during three periods: 1982–2015, 1982–2001, and 2001–2015. The results indicated that, first, the average and the trend of WUEc showed strong spatial heterogeneity over 1982–2015, a period that shows a strip distribution. The average value increased from the northwest to the southeast while the multiyear trend value decreased from the northwest to the southeast, and a positive slope prevailed (p < 0.05). Second, statistically significant positive trends (p < 0.001) in the annual mean WUEc for 1982–2015, with a value of 7.11 × 10−3 g C kg−1 H 2 O yr−1, indicate that the rate of carbon sequestration in the agricultural ecosystem was faster than that of water loss. Finally, the GGP was conducive to the improvement of WUEc in this arid and semiarid area, with interannual trend values of WUEc from 1982 to 2001 of 4.26 × 10−3 g C kg−1 H 2 O, and 9.88 × 10−3 g C kg−1 H 2 O (p < 0.05) after the GGP. Our analyses explored how the changes in WUEc after the GGP were more sensitive to the NDVIc (the subscript c stands for cropland) trends, which means that NDVIc was an important controller influencing GPPc and ETc tendency and thus further influencing WUEc in response to the GGP. This study contributes to a better understanding of the variations of agricultural carbon-water coupling and provides references and theories for the development of water-saving agriculture in an ecological restoration area. • Spatiotemporal variations of WUEc before and after Grain to Green Program (GGP) were explored. • GGP was conducive to the improvement of agricultural water use efficiency. • The changes of WUEc after the GGP was more sensitive to NDVIc trends. [ABSTRACT FROM AUTHOR]

• Ambient exposure to PM 2.5 and PM c were associated with mortality from IHD and COPD. • Exposure to PM 2.5 exerted larger effects on mortality of IHD and COPD than PM c. • Substantial mortality burden of IHD and COPD could be attributable to PM 2.5 exposure. Both inhalable particles (PM 10) and fine particles (PM 2.5) are regulated in various countries mainly due to their adverse health effects. However, there is increasing evidence that PM 2.5 might be responsible for these effects and coarse particles (PM c) plays little role in adverse health effects, if so, it might be not necessary to monitor PM 10. In this study, we conducted a time-series analysis using a generalized additive model to explore the effects of PM 2.5 , PM c , and PM 10 on mortality from ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) in 96 Chinese cities during 2013–2016. The mortality number and attributable fraction were further estimated using the national air quality standard and WHO's guideline as the reference. We observed significant effects of PM 2.5 on IHD and COPD mortality; each 10 ug/m3 increase in lag 01 PM 2.5 was associated with a 0.26% (95% CI: 0.17%, 0.34%) increase in IHD mortality and a 0.19% (95% CI: 0.09%, 0.29%) increase in COPD mortality. We also found significant effects of PM c and PM 10 on mortality from IHD and COPD, but the magnitudes of effects were weaker than those of PM 2.5. The results were robust when adjusting for co-pollutants and altering model parameters. We further estimated that about 1.27% (95% CI: 0.29%, 2.30%) of IHD mortality and 1.25% (95% CI: 0.08%, 2.46%) of COPD mortality could be attributable to PM 2.5 exposure using WHO's guideline (25 ug/m3) as a reference, corresponding to 15,337 (95% CI: 3,375, 27,842) mortalities from IHD and 5,653 (95% CI: 379, 11,152) COPD mortalities in the 96 cities. Across all of China, almost fifty thousand cases of IHD mortality and twenty thousand cases of COPD mortality might be avoidable if the PM 2.5 concentration declined to the WHO guideline. Our study indicates that short-term exposure to PM 2.5 could be an important risk factor of mortality from IHD and COPD, and substantial cardiopulmonary mortality could be avoidable by reducing daily PM 2.5 concentrations. It is nonnegligible to consider the role of PM c in triggering in cardiopulmonary mortality. And it could be necessary to continue monitoring PM 10 in the study regions due to the adverse effects of PM c. [ABSTRACT FROM AUTHOR]

• Spatial-temporal dynamics of cropland ecosystem water-use efficiency was evaluated based on MODIS products. • We attribute the variation in WUEc to the trend in climate change and human activities. • Increased WUEc covered 97.25 % of the cropland area, with a trend of 0.017 g C kg−1 H 2 O yr−1. • The relative contribution of human activities to ETc before and after the water saving project was 26.3 % and 77.5 %. To deal with serious water resources crisis, the Shiyang River Basin (SRB) of Hexi Corridor in Northwestern China has been experiencing rehabilitation for water-saving since 2006. Water-use efficiency in cropland (WUEc) is a critical indicator to understand the response of carbon-water interactions. Because we currently lack a clear picture of how WUEc responds to climate and human activities factors in the SRB, here we applied Moderate Resolution Imaging Spectroradiometer (MODIS) satellite images to obtain a regional estimation of gross primary productivity in cropland (GPPc) and actual evapotranspiration in cropland (ETc), and analyzed the variations in WUEc and climate and human activities factors, then we evaluated the annual WUEc responses to climate and human activity factors and discussed major driving factors underlying the interannual variability (IAV) of WUEc from 2000 to 2014 in the SRB. Finally, we clarified the implications of the water saving project (WSP) on the water cycle. Results indicated that increased WUEc covered 97.25 % of the cropland area, with a trend of 0.017 g C kg−1 H 2 O yr-1. ETc decreased at 0.41 mm yr-1. ETc decreasing pixel mainly occurred in the irrigation districts of WSP completed by 2010. The IAV of WUEc was mainly determined by ETc (68 %) rather than GPPc (6%). The relative contribution of human activities factors in the WSP to ETc was 77.5 %, while that of climate factors was 22.5 %. Which further proved water availability increase was mainly artificially controlled, an effect of the WSP rather than that of climate factors. [ABSTRACT FROM AUTHOR]

• We explored the spatiotemporal patterns of ET, GPP, and WUE across cropland in the SRB. • An increasing pattern for WUEc was detected during the past 15 years from 1.40 to 1.80 g C kg−1 H 2 O. • After water saving project, ETc reduced by 23 mm (7.3%). WUEc increased by 7.2%. • WUEc was mainly determined by ETc rather than GPPc. Water use efficiency over crop area (WUEc), defined as the ratio of carbon gain (i.e., gross primary productivity over crop area; GPPc) to water consumption (i.e., evapotranspiration over crop area; ETc) at the agroecosystems scale, is a critical variable linking the carbon and water cycles. In this study, the spatiotemporal patterns and trend characteristics of ETc, GPPc, and WUEc in agroecosystems over the period of 2000–2014 across the Shiyang River Basin in northwestern China were assessed with Moderate Resolution Imaging Spectroradiometer (MODIS) global products, and the impact of a water-saving project on WUEc is discussed. Results indicate that the spatiotemporal variability of ETc, GPPc, and WUEc were very common and similarly related to climatic variables and water allocation laws. It suggests that variations in climatic factors and the water-saving project controlled photosynthesis and ETc simultaneously; they changed the hydrological cycle by adjusting ETc. Based on a 15-year assessment, 97.25% of the basin showed a positive trend for WUEc. After the water-saving project launched in 2006, ETc was reduced by 23 mm yr−1 (7.3%), while WUEc increased by 0.11 g C kg−1H 2 O (7.2%). The WUEc was significantly correlated with precipitation, and it was mainly determined by ETc rather than GPPc. The limitation of this research is the fact that the driving factors are not quantitatively characterized, especially at the basin scale. However, this research will not only aid in predictions about the influence of climate change and human activity on carbon and water fluxes but also provide scientific guidance to regulate water resources allocation, and this guidance can be applied to other arid regions around the world. [ABSTRACT FROM AUTHOR]

Intravenous phenobarbital is frequently offered to patients with generalized convulsive status epilepticus (GCSE) in China, but its long-term benefits are unclear. We aimed to evaluate the long-term effects of intravenous phenobarbital on adult patients with GCSE. This randomized clinical trial with a 12-month follow-up was performed in Xuanwu Hospital, Capital Medical University (Beijing, China) between February 2011 and December 2021. After the failure of intravenous diazepam treatment, adult patients with GCSE were randomized to receive either intravenous phenobarbital or valproate. Neurological outcome within 12-month was dichotomized as good (modified Rankin scale, mRS 0–2) or poor (mRS 3–6). Cognitive function was measured by mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA). Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were tested for mood disorders. We consecutively recruited 166 patients with GCSE. After excluding individuals with termination after intravenous diazepam (n = 61), and with other exclusion criteria (n = 7), 98 patients were included and 88.0% (66/75) of survivors achieved seizure freedom at 12-month. Forty-five patients (45.92%) had good outcomes at 3-month and 57 patients (58.16%) had good outcomes at 12-month. And 46.67% (35/75) of survivors showed mRS improvement at 12-month (phenobarbital group, n = 17 vs. valproate group, n = 18, P = 0.321). Despite there was no significant difference with respect to good outcomes at 3-month (54.0% vs. 37.5%, P = 0.101), the rate of good outcomes in phenobarbital group was higher than valproate group at 12-month (68.0% vs. 47.92%, P = 0.044). A total of 43 patients successfully participated cognitive and emotional tests. Mild cognitive impairment was found in 7.14% of phenobarbital group and 50.0% in valproate group (P = 0.026). In addition, there were no significant differences with respect to anxiety (36.36% vs. 38.10%) and depression (31.82% vs. 47.62%) between the phenobarbital and valproate groups. Combined with long term conventional therapy, intravenous phenobarbital group had more good outcomes than intravenous valproate group in Chinese adult patients with GCSE up to 12-month follow-up. This finding may prompt the option of intravenous phenobarbital especially in patients with limited access to new antiseizure drugs. • The majority of survivors achieved seizure freedom and nearly half survivors showed mRS improvement with 12-month follow-up. • Phenobarbital group showed more favorable mRS outcomes and less mild cognitive impairment than valproate group at 12-month. • Anxiety and/or depression may occur in patients after GCSE. [ABSTRACT FROM AUTHOR]

As a ubiquitous environmental pollutant in China, triazophos (TP) is known to have neurotoxicity, oxidative stress, and reproductive toxicity to mussels. To investigate the molecular mechanisms of TP toxicity, metabolic changes in the digestive glands of Perna viridis in different sexes were examined after treated with 35 μg/L TP. Notably, 158 significant different metabolites (SDMs) were detected in TP-treated mussels and more than half of the SDMs were lipids and lipid-like molecules, which suggested that TP disturbed the lipid metabolism of P. viridis. In addition, metabolites associated with neurotoxicity and reproductive disturbance were also detected in female and male mussels. Moreover, a larger number of SDMs were found in male mussels (120 SDMs) than females (99 SDMs), and 60 common metabolites exhibited consistent variation tendency and similar magnitude in both sexes. The metabolic alternations in female and male mussels displayed similar protective mechanisms and also sex-specific responses, male mussels were more sensitive to TP exposure. This research provided new data about the molecular mechanisms of TP toxicity and the gender specific changes in mussels after treated by chemicals. [Display omitted] • The metabolic responses to triazophos in mussel digestive glands were sex-specific. • Triazophos induced a more pronounced metabolic response in male mussels. • Triazophos induced lipid metabolism disorder in the digestive glands of mussel. • Triazophos caused reproductive disturbance and neurotoxicity. [ABSTRACT FROM AUTHOR]

• An ArcGIS toolbox and FRESF model can measures flood related indices. • It is a practical tool for ecosystem services conservation planning. • The study provided here show the usability and credibility of proposed toolbox. River floods are globally the most damaging and costliest natural disasters. The functions of nonstructural flood mitigation measures (e.g., water retention by vegetation and soil) provide critical regulation ecosystem services to human beings. For example, the Sponge Cities are national watershed management projects in China to increase the nonstructural flood regulation services, aiming to enable the urban ecosystem to absorb, infiltrate, and retain storm water to mitigate pluvial flooding. Decision-makers need to acquire critical areas for the supply, demand, and flow of flood regulation ecosystem services, which would affect the delivery of services and the distribution of any benefits among stakeholders. However, relatively few empirical studies present this information. One reason is the lack of appropriate methods and tools for a rapid assessment of flood regulation ecosystem services that do not require substantial resources or rely heavily on hydrological process data. This article presents the Flood Regulation Ecosystem Service Flow (FRESF) model to address this gap. FRESF is an open-access and open-source ArcGIS script toolbox for an integrated evaluation of flood regulation ecosystem services' supply, demand, and flow. Based on a land surface process model and a generic framework quantifying ecosystem services flow, FRESF provides a rapid and serviceable assessment framework for the relevant ecosystem services at a relatively low cost and effort. The validation results suggest that the outputs are moderately consistent with the actual flood conditions, compared with the flood disaster of the Yangtze River in 2020. Its open codes and flexible inputs imply that ecologists, planners, decision-makers, and developers involved in ecosystem services would have the opportunity to test and apply the FRESF model in several contexts and even contribute further improvements. [ABSTRACT FROM AUTHOR]

Abstract: We performed a comprehensive safety assessment of a probiotic based on the whole genome sequence and corresponding phenotypes. This was performed on Lactobacillus plantarum JDM1, a widely used commercial probiotic strain in China. The minimal inhibitory concentrations (MICs) of sixteen antibiotics and the biogenic amine production of JDM1 were tested to supplement a traditional oral toxicity test. In total, fifty-one antibiotic resistance-associated genes, one hundred twenty-six virulence-associated genes, and twenty-three adverse metabolism-associated genes were found in JDM1. However, there were no toxin or hemolysin encoding genes, and safety-associated genes were rarely transferable. This approach can be generalized to provide a deep safety investigation of novel probiotic strains and greatly reveal the potential danger determinants and their molecular mechanisms. However, this kind of analysis reveals the theoretical maximum risk level as not all genes are efficient depending on environmental conditions. [Copyright &y& Elsevier]

Abstract: Since the late 1990s China has promoted the “Conversion of Cropland to Forest and Grassland Program” (CCFGP) as the largest environmental restoration program in the world. Because more water was required for established vegetation, it was assumed that evapotranspiration (ET) and water use in an older restored grassland would be greater than that in a younger restored grassland and that water shortages would then become more severe for further vegetation establishment in a semi-arid steppe due to the extraction of the established vegetation. To verify this hypothesis, a field experiment was carried out in 2008–2009 at seven sites of different ages after restoration. The hypothesis was tested using the Bowen ratio system together with other comparative methods. Results showed that less rainfall would infiltrate the deeper soil layer as the period of time after restoration increased and that the natural steppe site had the shallowest infiltration depth (10cm or less). However, the youngest restored grassland site had the deepest infiltration depth and the highest soil water content. These results also showed that transpiration and ET rates were higher in the natural steppe site and older restored sites than those in the younger restored sites. Furthermore, it was found that the ratio between soil evaporation and ET was generally lower for all seven sites, which indicated that transpiration was a dominant component in ET. These results indicated that more water was used for vegetation establishment in the older restored grassland than that in the younger restored grassland. Our hypothesis was proved to be true. Meanwhile, it was also found that the dominant species changed from annual herbs (species had lower drought tolerance ability) in the younger restored grassland to perennial grasses in the older restored grassland (species had higher drought tolerance ability). Therefore, it was concluded that the natural steppe was able to utilize more water for vegetation establishment and it used water more efficiently than the restored steppe, while the older restored steppe used water more efficiently than the younger restored steppe. Because changes of vegetation type from annual to perennial not only increased evapotranspiration, but also changed the water budget, more attention should be paid to water shortage when undertaking the CCFGP in semi-arid steppes. [Copyright &y& Elsevier]

Abstract: Ethnopharmacological relevance: The flowers of Gentiana veitchiorum has been widely used in decoction form in the traditional medicine of Tibet against tussis, tracheitis, angina for their anti-inflammatory, antimicrobial and alexipharmic properties. Aim of the study: The aim of current study was to evaluate the therapeutic effects of Feining, a Chinese herbal formula (national invention patent: ZL200510042636.3) against pulmonary injuries and to clarify the mechanisms involved. Materials and methods: Experimental pulmonary injuries were induced by bleomycin (BLM) in rats with or without subsequent treatment of Feining or prednisone as positive control. The pulmonary injuries were evaluated by histological analysis. Also, the levels of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione (GSH) and hydroxyproline (Hyp) in the lung tissue were determined. To clarify one of the possible active principles responsible for Feining, high performance liquid chromatography–diode array detector–mass spectrometry (HPLC–DAD–MS) method was applied to identify the components of Gentiana veitchiorum, one of major ingredients of Feining. Results: Feining significantly improved lung alveolitis scores and reduced the Hyp content of lungs, which is an index of collagen accumulation. Moreover, Feining played a role against the oxidative damages by decreasing the MDA level, whereas increasing SOD and GSH activity, which correlated with oxidation resistance and scavenging of free radicals. In addition, Feining alleviated inflammatory lung injury by decreasing tumor necrosis factor-α (TNF-α) expression. HPLC–DAD–MS analysis revealed that there was 1.97% gentiopicroside in Gentiana veitchiorum. Conclusion: Feining has certain therapeutic effects against pulmonary injuries. [Copyright &y& Elsevier]

Plastic film mulching has been widely applied in farmland around the world, which could complicate the mass and energy exchange between soil surface and atmosphere. Although previous studies suggested that film mulching reduced available energy (R n − G) and crop evapotranspiration (ET) in some crop growth stages, it was unclear how film mulching would influence energy partition, crop ET and crop coefficient (K c) during the entire growing season. A two-year field experiment in a mulched (FM) and a non-mulched (NM) seed–maize field under drip irrigation was conducted in Shiyang River Basin of northwest China to quantify the effects of FM on energy balance components, ET and K c , by measuring the net radiation (R n), the soil heat flux (G), the evaporation (E) on ground surface, the transpiration (T), and the soil water content along the soil profile. In particular, ET was obtained by a water balance method and a three-temperature (3T) model combined with remote sensing. Results showed that FM significantly decreased daily R n and daily G before jointing stage (i.e., the initial stage), which caused 19.0% reduction of the daily R n − G. The effects of FM on R n , G and R n − G diminished after jointing stage (i.e., the crop development, middle and late stages). The reduction of R n − G under FM treatment during the initial stage was accompanied with the decrease of ET during the initial stage, consequently 6.2% less total ET in the entire seed–maize growing season was recorded compared with NM treatment. FM had a significant effect on the partition of ET components, and E and T were 0.52 and 1.10 times of those under NM treatment, respectively. FM significantly reduced K c during the initial stage (K c-ini) by 55.3%, while in the middle (K c-mid) and late (K c-end) stages, it decreased by 5.7% and 9.7%, respectively, compared with NM treatment. The K c varied with the leaf area index (LAI) following the parabolic relationship for both treatments. A structural equation model (SEM) showed that among the soil and crop factors, FM and soil temperature (ST) were the main factors affecting R n − G , ET and K c during the initial stage; while during the crop development, middle and late stages, ST and LAI were the main factors affecting R n − G and ET , and K c was mainly affected by LAI. SEM further confirmed that the FM impact was more significant during the initial stage than during the crop development, middle and late stages. • FM significantly decreases R n − G and K c in initial stage, not in other stages. • K c varies with LAI following a quadratic parabola for both FM and NM. • ET obtained by water balance method and 3T model agree well. • SEM analysis show FM and soil temperature control R n − G , ET and K c in initial stage. • In other stages, soil temperature and LAI control R n − G and ET , and LAI controls K c. [ABSTRACT FROM AUTHOR]

• Transpiration and canopy cover of winter wheat was estimated using thermal infrared and visible imagery. • The spatial-temporal variation of transpiration rate and canopy cover under different fertilization levels were quantified and determined. • Relationship between transpiration rate and canopy cover under different fertilization levels was discussed. Food security has always been one of the most important goals for government at all levels in China. Although more fertilization is an effective solution, many other problems appeared with the overuse of fertilization, such as water pollution, soil compaction and so on. Thus, in order to provide suitable advice on fertilization, we used the combination of high-resolution thermal and visible images to evaluate the transpiration rate and canopy cover and identify the effects of fertilization on crop growth. Three different fertilization levels of: (A) 900 kg/ha, (B) 675 kg/ha, and (C) 450 kg/ha were designed for winter wheat. Spatial-temporal distribution of transpiration rate and canopy coverage under different growth stages were depicted based on three temperature model and canopy software. Results showed that: (1) the daily variation of canopy temperature (T c) and transpiration rate were both unimodal curve, and both of them reached their daily peak values at 14:00. Moreover, the spatial heterogeneity of land surface temperature (LST) and transpiration rate was quite obvious and common for all growth stages, and this spatial heterogeneity presented variation from pixel to pixel. (2) Fertilization had a significant effect on the growth of winter wheat. With the higher fertilization amount, the growth of winter wheat became more vigorous, the canopy cover and transpiration rate turned higher, and the T c was lower. For example during recovering stage, the canopy cover under treatment A、B and C were 78.7%, 52.5%, and 42.7%, respectively, as well as the peak values of transpiration rate for treatment A, B, and C were 0.45 mm/h, 0.29 mm/h, and 0.12 mm/h, respectively. The transpiration rate had a positive correlation with canopy cover, and the coefficients of determination R2 = 0.78. (3) The advancement in the crop growth led to the increase of canopy cover and transpiration rate for winter wheat under different fertilization levels. However, the difference of transpiration rate and canopy cover under different fertilization levels decreased gradually with crop growth. Our research accurately detected the effects of fertilization on crop growth based on high-resolution thermal and visible images, which will provide feasible assistance for rational fertilization and it is possible to foresee the broad application prospects in the future. [ABSTRACT FROM AUTHOR]

Background: Our objective was to explore whether a brain death determination (BDD) strategy with demonstration hospitals can accelerate the process of BDD in China., Methods: We proposed the construction standards for the BDD quality control demonstration hospitals (BDDHs). The quality and quantity of BDD cases were then analyzed., Results: A total of 107 BDDHs were established from 2013 to 2022 covering 29 provinces, autonomous regions, and municipalities under jurisdiction of the central government of the Chinese mainland (except Qinghai and Tibet). A total of 1,948 professional and technical personnel from these 107 BDDHs received training in BDD, 107 quality control personnel were trained in the quality control management of BDD, and 1,293 instruments for electroencephalography, short-latency somatosensory evoked potential recordings, and transcranial Doppler imaging were provided for BDD. A total of 6,735 BDD cases were submitted to the quality control center. Among the nine quality control indicators for BDD in these cases, the implementation rate, completion rate, and coincidence rate of apnea testing increased the most, reaching 99%., Conclusions: The strategy of constructing BDDHs to promote BDD is feasible and reliable. Ensuring quality and quantity is a fundamental element for the rapid and orderly popularization of BDD in China., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.)

The Patient-Reported Outcomes Measurement Information System 29-item Profile version 2.1 (PROMIS-29 V2.1) is a widely utilized self-reported instrument for assessing health outcomes from the patients' perspectives. This study aimed to evaluate the psychometric properties of the PROMIS-29 V2.1 Chinese version among patients with hematological malignancy. Conducted as a cross-sectional, this research was approved by the Medical Ethical Committee of the Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (registration number QTJC2022002-EC-1). We employed convenience sampling to enroll eligible patients with hematological malignancy from four tertiary hospitals in Tianjin, Shandong, Jiangsu, and Anhui province in China between June and August 2023. Participants were asked to complete a socio-demographic information questionnaire, the PROMIS-29 V2.1, and the Functional Assessment of Cancer Therapy-General (FACT-G). We assessed the reliability, ceiling and floor effects, structural, convergent discriminant and criterion validity of the PROMIS-29 V2.1. A total of 354 patients with a mean age of 46.93 years was included in the final analysis. The reliability of the PROMIS-29 V2.1 was affirmed, with Cronbach's α for the domains ranging from 0.787 to 0.968. Except sleep disturbance, the other six domains had ceiling effects, which were seen on physical function (26.0%), anxiety (37.0%), depression (40.4%), fatigue (18.4%), social roles (18.9%) and pain interference (43.2%), respectively. Criterion validity was supported by significant correlations between the PROMIS-29 V2.1 and FACT-G scores, as determined by the Spearman correlation test (P < 0.001). Confirmatory factor analysis (CFA) indicated a good model fit, with indices of χ 2 /df (2.602), IFI (0.960), and RMSEA (0.067). The Average Variance Extracted (AVE) values for the seven dimensions of PROMIS-29 V2.1, ranging from 0.500 to 0.910, demonstrated satisfactory convergent validity. Discriminant validity was confirmed by ideal √AVE values. The Chinese version of the PROMIS-29 V2.1 profile has been validated as an effective instrument for assessing symptoms and functions in patients with hematological malignancy, underscoring its reliability and applicability in this specific patient group., (© 2024. The Author(s).)

Background: Next-generation sequencing (NGS) might aid in the identification of causal pathogens. However, the optimal approaches applied to cerebrospinal fluid (CSF) for detection are unclear, and studies evaluating the application of different NGS workflows for the diagnosis of intracranial infections are limited., Methods: In this multicenter, prospective observational cohort study, we described the diagnostic efficacy of pathogen-targeted NGS (ptNGS) and metagenomic NGS (mNGS) compared to that of composite microbiologic assays, for infectious meningitis/encephalitis (M/E)., Results: In total, 152 patients diagnosed with clinically suspected M/E at four tertiary hospitals were enrolled; ptNGS and mNGS were used in parallel for pathogen detection in CSF. Among the 89 patients who were diagnosed with definite infectious M/E, 57 and 39 patients had causal microbial detection via ptNGS and mNGS, respectively. The overall accuracy of ptNGS was 65.1%, with a positive percent agreement (PPA) of 64% and a negative percent agreement (NPA) of 66.7%; and the overall accuracy of mNGS was 47.4%, with a PPA of 43.8% and an NPA of 52.4% after discrepancy analysis. There was a significant difference in the detection efficiency between these two methods both for PPA (sensitivity) and overall accuracy for pathogen detection (P < 0.05)., Conclusions: NGS tests have provided new information in addition to conventional microbiologic tests. ptNGS seems to have superior performance over mNGS for common causative pathogen detection in CSF for infectious M/E., Competing Interests: Declaration of Competing Interest The authors have declared no conflict of interest., (Copyright © 2024. Published by Elsevier Ltd.)

Accurate evaluation of fish stock biomass is essential for effective conservation management and targeted species enhancement efforts. However, this remains challenging owing to limited data availability. Therefore, we present an integrated modeling framework combining catch per unit effort with ensemble species distribution modeling called CPUESDM, which explicitly assesses and validates the spatial distribution of stock biomass for freshwater fish species with limited data, applied to Herzensteinia microcephalus. The core algorithm incorporates the Leslie regression model, ensemble species distribution modeling, and exploratory spatial interpolation techniques. We found that H. microcephalus biomass in the Yangtze River source area yielded an initial estimate of 113.52 tons. Our validation results demonstrate high accuracy with a Cohen's kappa coefficient of 0.78 and root mean square error of 0.05. Furthermore, our spatially-explicit, global, absolute biomass density map effectively identified areas with high and low concentrations of biomass distribution centers. Additionally, this study offers access to the source code, example raw data, and a step-by-step instruction manual for other researchers using field data to explore the application of this model. Our findings can help inform for future conservation efforts around fish stock biomass estimation, especially for endangered species., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: The predictive and protective effect of hardiness on mental health remains unclear among shift workers on non-24-h working schedules. The present study aimed to investigate the independent and joint trajectories of depression and anxiety symptoms and the role of hardiness during a prolonged period of non-24-h shift working schedule., Methods: Four hundred nine Chinese male sailors (working on 18-h watchstanding schedule) were recruited and completed all 5-wave tests through online questionnaires (at Day 1, 14, 28, 42, 55, respectively) during a 55-day sailing. The questionnaires included sociodemographic variables, hardiness, depression and anxiety symptoms. Independent and joint trajectories of depression and anxiety symptoms were estimated by latent growth mixture models. The effect of hardiness on trajectories was examined by logistic regression models., Results: 2 and 3 latent trajectories were identified for depression and anxiety symptoms, respectively. Based on initial levels and development trends, 3 distinct joint trajectories of depression and anxiety were identifed and named as: "Low-Inverted U" group (73.6%), "Moderate-Deterioration" group (6.9%), and "High-Stable" group (9.5%). Sailors with higher levels of hardiness were more likely to follow the "Low-Inverted U" trajectory of depression and anxiety symptoms (all p < 0.001)., Conclusions: There existed individual differences in the trajectories of depression and anxiety. Hardiness may have a protective effect that can prevent and alleviate depression and anxiety symptoms. Therefore, hardiness-based intervention programs are encouraged among the shift workers on non-24-h working and rest schedules., (© 2023. The Author(s).)

The mitigation of eutrophication in the Pearl River Estuary (PRE) has encountered numerous challenges in regards to source control. Herein, the isotope mixing model (SIAR) was used to quantify the primary nitrate sources in the PRE. The results showed that the nitrate levels were significantly higher in the high-flow season than in the low-flow season. Meanwhile, we found the most important nitrate sources were manure and sewage during the high-flow season, with a contribution ratio of 47 % in the low salt area (LSA) and 29 % in the high salt area (HSA). During the low-flow season, the primary nitrate sources were identified as reduced nitrogen fertilizer in the LSA and manure and sewage in the HSA, which accounted for 52 % and 44 %, respectively. Furthermore, we also suggest that a feasible measure might be to control the pollution caused in the PRE by manure and sewage as well as reduced nitrogen fertilizer., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

The awake prone position plays an important role in the treatment of hypoxemia and the improvement of respiratory distress symptoms in non-intubated patients. It is widely used in clinical practice because of its simple operation, safety, and economy. To enable clinical medical staff to scientifically and normatively implement prone position for awake patients without intubation, the committees of consensus formulation, guided by evidence-based methodology and Delphi method, conducted literature search, literature quality evaluation and evidence synthesis around seven topics, including indications and contraindications, evaluation, implementation, monitoring and safety management, termination time, complication prevention and health education of awake prone position. After two rounds of expert letter consultation, Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) was formulated, and provide guidance for clinical medical staff.

Tetrabromobisphenol A (TBBPA) and hexabromocyclododecanes (HBCDDs) have attracted extensive attention due to their strong persistence and toxicity. However, little has been known about their pollution status in fishing ports, which are typical sinks of land-sourced pollutants. In this study, we investigated the occurrence, distribution and ecological risk of TBBPA and HBCDDs in sediments from fishing ports along the coast of South China. The concentrations of TBBPA and ΣHBCDD (sum of α-, β-, and γ-HBCDD) in the fishing-port sediments were in the ranges of 0.02-21.5 ng/g dw and 1.06-14.1 ng/g dw, respectively. γ-HBCDD was the predominant diastereoisomer in most fishing-port sediments. The enantiomeric analysis indicated a preferential enrichment of (-)-enantiomers for α-, β-, and γ-HBCDD. The geographical location of fishing ports is a significant determinant of distribution for TBBPA and HBBCDs. The concentrations of TBBPA and HBCDDs in fishing-port sediments were strongly associated with local population density, but weakly correlated with total organic carbon content of the sediment. The mass inventories of TBBPA and ΣHBCDD were estimated to be 77.0 ng/cm 2 and 141 ng/cm 2 , respectively. The ecological risk assessment demonstrated that TBBPA and HBCDDs in fishing-port sediments exhibited low risks to marine organisms. This study contributes to the understanding pollution situation of fishing ports, and provides a reference for environmental safety assessment and environmental pollution control., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Ambient air pollution has been widely associated with increased mortality and years of life lost (YLL) from various diseases. However, no study has assessed that the effects of air pollution on overall YLL were due to increased number of mortalities or average YLL per death., Methods: We first conducted a time-series study from 2013 to 2016, covering six Chinese megacities. Generalized additive models with a Gaussian link were utilized to estimate the associations of fine particulate matter (PM 2.5 ) and nitrogen dioxide (NO 2 ) with daily overall YLL and average YLL per death from various causes, including non-accidental causes, cardiovascular diseases (CVD), respiratory diseases (RD), ischemic heart disease (IHD), chronic obstructive pulmonary diseases (COPD), stroke and acute myocardial infraction (AMI). The city-specific estimates were then pooled by random-effects meta-analysis., Results: A total of 1,586,741 deaths from non-accidental causes and 21,916,857 YLLs were recorded in the six cities, providing an average of 13.81 daily YLLs per death. Significant effects of PM 2.5 and NO 2 on daily overall YLL and daily mortality count were observed, but there were no significant effects on average YLL per death. At the pooled level, each 10 μg/m 3 increase in PM 2.5 and NO 2 was associated with increased YLL and higher mortality due to non-accidental causes [PM 2.5 : 5.45 years, 95% CI: 1.47, 9.42 and ERR (excess relative risk) = 0.25%, 95% CI: 0.14%, 0.35%; NO 2 : 20.46 years, 95% CI: 10.77, 30.15 and ERR = 1.13%, 95% CI: 0.63%, 1.63%]. Consistent results and patterns were observed for other cause-specific diseases, including IHD, COPD, stroke and AMI., Conclusions: Our study indicates observed associations between air pollution and YLL might be mainly induced by increasing mortality count, rather than increasing average life lost for each death. More relevant intervention should be performed to reduce the number of deaths due to air pollution., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Although low temperature and air pollution exposures have been associated with the risk of anxiety, their combined effects remain unclear., Objective: To investigate the independent and interactive effects of low temperature and air pollution exposures on anxiety., Method: Using a case-crossover study design, the authors collected data from 101,636 outpatient visits due to anxiety in three subtropical Chinese cities during the cold season (November to April in 2013 through 2018), and then built conditional logistic regression models based on individual exposure assessments [temperature, relative humidity, particulate matter (PM 2.5 , PM 10 ), sulfur dioxide (SO 2 ), and nitrogen dioxide (NO 2 )] and twelve cold spell definitions. Additive-scale interactions were assessed using the relative excess risk due to interaction (RERI)., Results: Both cold spell and air pollution were significantly associated with outpatients for anxiety. The effects of cold spell increased with its intensity, ranging from 8.98% (95% CI: 2.02%, 16.41%) to 15.24% (95% CI: 6.75%, 24.39%) in Huizhou. Additionally, each 10 μg/m 3 increase of PM 2.5 , PM 10 , NO 2 and SO 2 was associated with a 1.51% (95% CI: 0.61%, 2.43%), 1.58% (95% CI: 0.89%, 2.28%), 13.95% (9.98%, 18.05%) and 11.84% (95% CI: 8.25%, 15.55%) increase in outpatient visits for anxiety. Synergistic interactions (RERI >0) of cold spell with all four air pollutants on anxiety were observed, especially for more intense cold spells. For particulate matters, these interactions were found even under mild cold spell definitions [RERI: 0.11 (95% CI: 0.02, 0.21) for PM 2.5 , and 0.24 (95% CI: 0.14, 0.33) for PM 10 ]. Stratified analyses yielded a pronounced results in people aged 18-65 years., Conclusions: These findings indicate that both cold spell and air pollution are important drivers of the occurrence of anxiety, and simultaneous exposure to these two factors might have synergistic effects on anxiety. These findings highlight the importance of controlling air pollution and improving cold-warning systems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Due to strong endocrine disrupting effects, steroids in the environment have attracted substantial attention, with studies mostly focusing on the parent steroids. Here, we conducted the first investigation on the contamination profiles, possible sources, mass inventories, and ecological risks of 27 steroids and their metabolites in 15 typical fishing ports in Southeast China. Twelve steroids were detectable in the sediment samples with the total mean concentrations of 4.6-35 ng/g. High proportions of steroid metabolites were measured in the sediments and five metabolites were newly observed. Untreated municipal sewage and aquaculture wastes constitute the possible steroid sources in the studied fishing ports. The total inventories of steroids in fishing ports ranged from 2.1-16 mg/m 2 , with their metabolites being important contributors. The ecological risk analysis indicated high risks across all sampling sites mainly due to the contributions of parent steroids. Furthermore, our results found that progesterone is an acceptable chemical indicator for various steroids in sediments. This study provides the first evidence of steroid metabolites in the marine environment, calling for more studies in environmental behavior and ecotoxicology of steroid metabolites., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: The effects of ambient air pollution on specific mental disorders are rarely studied, and the reported results are inconsistent., Objective: To assess the short-term effect of ambient air pollution on the morbidity of mental disorders in three subtropical Chinese cities., Methods: Daily concentrations of air pollution were averaged from 19 fixed monitoring stations across each city, and data on patients were collected from three psychiatric specialty hospitals. A time-series study combined with a generalized additive Poisson model was conducted to investigate the association between air pollution and mental disorders. The exposure-response relationships were explored and stratified analyses by age and sex were conducted., Results: A total of 1,133,220 outpatient visits were recorded in three subtropical cities (Huizhou, Shenzhen, and Zhaoqing). The number of daily outpatient visits for mental disorders increased with higher air pollutant (PM 2.5 , PM 10 , SO 2 and NO 2 ) concentrations, and the effect of NO 2 appeared to be consistently significant across the three cities, with excess risk (ER) of 4.45% (95% CI: 2.90%, 6.04%) in Huizhou, 7.94% (95% CI: 6.28%, 9.62%) in Shenzhen, and 2.19% (95% CI: 0.51%, 3.89%) in Zhaoqing, respectively, at lag03. We also observed significant effect of PM 2.5 at lag0 (ER = 1.20%, 95% CI: 0.28%, 2.13%), PM 10 at lag0 (ER = 0.99%, 95% CI: 0.36%, 1.62%), and SO 2 at lag0 (ER = 10.74%, 95% CI: 3.20%, 18.84%) in Shenzhen. For specific mental disorders, significant associations were found in all the air pollutants except between SO 2 and affective disorder and between PM 2.5 and schizophrenia. In addition, we found that air pollution exhibited stronger effects for males and adults (≥18 years)., Conclusion: Acute exposure to air pollution, especially NO 2 , might be an important trigger of mental disorders., (Copyright © 2020 Elsevier Inc. All rights reserved.)

In the present study, there were 128, 263, and 139 differentially expressed genes (DEGs) from the ovary, pituitary, and hypothalamus, respectively, with the FecB B+/FecB ++ genotype. Results indicated that there was a synchronized, and differential increase in mRNA transcript abundances for genes encoding for ovarian steroidogenesis-signaling proteins in the ovary, TGF-β-signaling in hypothalamus, cAMP-signaling-transduction, and dopaminergic-synapse pathways in the pituitary. The values for these variables were associated with mean prolificacy in indigenous sheep and results provided indications for candidate regulator proteins that coordinate processes related to prolificacy in ewes. Furthermore, the results when there was evaluation of the FecB-genotype-specific co-expression modules implied that CYP17 was the hub gene connecting the pathways and for modulation of folliculogenesis and ovulation in the ewe with the FecB B+ genotype., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: The unprecedented outbreak of corona virus disease 2019 (COVID-19) infection in Wuhan City has caused global concern; the outflow of the population from Wuhan was believed to be a main reason for the rapid and large-scale spread of the disease, so the government implemented a city-closure measure to prevent its transmission considering the large amount of travel before the Chinese New Year., Methods: Based on the daily reported new cases and the population-movement data between 1 and 31 January, we examined the effects of population outflow from Wuhan on the geographical expansion of the infection in other provinces and cities of China, as well as the impacts of the city closure in Wuhan using different closing-date scenarios., Results: We observed a significantly positive association between population movement and the number of the COVID-19 cases. The spatial distribution of cases per unit of outflow population indicated that the infection in some areas with a large outflow of population might have been underestimated, such as Henan and Hunan provinces. Further analysis revealed that if the city-closure policy had been implemented 2 days earlier, 1420 (95% confidence interval, 1059-1833) cases could have been prevented, and if 2 days later, 1462 (1090-1886) more cases would have been possible., Conclusions: Our findings suggest that population movement might be one important trigger for the transmission of COVID-19 infection in China, and the policy of city closure is effective in controlling the epidemic., (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Background and Aim: Human milk has potential protective effects against bronchopulmonary dysplasia (BPD). However, studies on the association between the dose of human milk and BPD in China are limited. This study aimed to evaluate the dose-dependent effects of human milk on BPD and other neonatal morbidities in very low birth weight (VLBW) infants., Methods: This retrospective cohort study of preterm infants was conducted on preterm infants of gestational age ≤ 34 weeks and birth weight < 1500 g admitted to the multicenter clinical research database for breastfeeding quality improvement in Jiangsu province. The multivariate analysis was performed to compare the effect outcomes of daily graded doses [1-24 mL/(kg · day), 25-49 mL/(kg · day), and ≥ 50 mL/(kg · day) of body weight] of human milk on neonatal outcomes throughout the first 4 weeks of life versus a reference group receiving no human milk. The models were adjusted for potential confounding variables., Results: Of 964 included infants, 279 (28.9%) received exclusive preterm formula, 128 (13.3%) received 1-24 ml/(kg · day), 139 (14.4%) received 25-49 ml/(kg · day), and 418 (43.4%) received ≥50 ml/(kg · day) human milk for the first 4 weeks of life. Compared with infants receiving exclusive formula, those receiving the highest volume of human milk daily [≥50 mL/(kg · day)] had lower incidences of BPD [27.5% in ≥50 mL/(kg · day) vs 40.1% in 0 mL/(kg · day) human milk, P = 0.001)], moderate and severe BPD [8.9% in ≥50 mL/(kg · day) vs 16.1% in 0 mL/(kg · day), P = 0.004], necrotizing enterocolitis [NEC; 3.8% in ≥50 mL/(kg · day) vs 10.8% in 0 mL/(kg · day), P = 0.001], late-onset sepsis [LOS; 9.3% in ≥50 mL/(kg · day) vs 19.7% in 0 mL/(kg · day), P <0.01], and extrauterine growth retardation [EUGR; 38.5% in ≥50 mL/(kg · day) vs 57.6% in 0 mL/(kg · day), P <0.01)]. The logistic regression indicated that those receiving ≥50 ml/kg · day human milk had lower odds of BPD [adjusted odds ratio (AOR) 0.453; 95% confidence interval (CI): 0.309, 0.666], moderate and severe BPD (AOR 0.430; 95% CI: 0.249, 0.742), NEC (AOR 0.314; 95% CI: 0.162, 0. 607), LOS (AOR 0.420; 95% CI: 0.263, 0.673), and EUGR (AOR 0.685; 95% CI: 0.479, 0.979)., Conclusions: A daily threshold amount of ≥50 ml/(kg · day) human milk in the first 4 weeks of life was associated with lower incidence of BPD as well as NEC, LOS, and EUGR in VLBW infants., Trial Registration: ClinicalTrials.gov Identifier: NCT03453502 . Registration date: March 5, 2018. This study was retrospectively registered.

Genomic data can improve our understanding on the phylogenetic relationship among Tibetan highland fishes. The whole mitochondrial genome of Gymnocypris eckloni generated in this study is 16,784 bp in length, containing 22 transfer RNA genes, 13 protein-coding genes, two ribosomal RNA genes, and one non-coding control region (D-Loop). Phylogenetic analysis recovers a non-monophyetic population of G. eckloni in the Qaidam basin, representing two distinct lineages designated 'Qiadam A' and 'Qaidam B', within Qaidam A clustering with Chuanchia labiosa and Schizopygopisis pylzovi captured in the Yellow River and Qaidam B grouping with G. eckloni from the Yellow River. Our research may helpful to further reconsideration of clearer taxonomy and improvement of biodiversity conservation strategy of Tibetan highland fishes., (Copyright © 2020. Published by Elsevier Inc.)

Background: Little is known about the association between ambient temperature and cause-specific mental disorders, especially in subtropical areas., Objective: To investigate the effect of ambient temperature on mental disorders in subtropical cities., Method: Daily morbidity data for mental disorders in three Chinese cities (Shenzhen, Zhaoqing, and Huizhou) were collected from medical record systems of local psychiatric specialist hospitals, covering patients of all ages. Case-crossover design combined with a distributed lag nonlinear model (DLNM) was used to assess the nonlinear and delayed effects of temperatures on five specific mental disorders (affective disorders, anxiety, depressive disorders, schizophrenia, and organic mental disorders), with analyses stratified by gender and age. The temperature of minimum effect was used as the reference value to calculate estimates., Results: We observed inversed J-shaped exposure-response curves between temperature and mental morbidity and observed that low temperatures had a significant and prolonged effect on most types of mental disorders in the three cities. For example, the effect of the cold (2.5th percentile) on anxiety was consistently observed in the three cities with an odds ratio (OR) of 1.29 (95% CI: 1.06-1.57) in Zhaoqing, 1.26 (95% CI: 1.18-1.34) in Shenzhen, and 1.45 (95% CI: 1.17-1.81) in Huizhou. Low temperature was also associated with an increased risk of depressive disorders and schizophrenia. For the high temperature exposure (97.5th percentile), we only observed a significant, harmful effect on anxiety [OR = 1.30 (95% CI: 1.08, 1.58) in Shenzhen, OR = 1.16 (95% CI: 1.00, 1.34) in Zhaoqing], affective disorders [OR = 1.32 (95% CI: 1.08, 1.62) in Shenzhen], and schizophrenia [OR = 1.24 (95% CI: 1.03, 1.48) in Zhaoqing, OR = 1.03 (95% CI: 1.00, 1.06) in Huizhou]., Conclusions: Our study suggests that both low and high temperatures might be important drivers of morbidity from mental disorders, and low temperature may have a more general and wide-spread effect on this cause-specific morbidity than high temperature., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)