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Background. Cardiovascular disease (CVD) is a major cause of mortality in patients on haemodialysis. The development of a prediction model for CVD risk is necessary to help make clinical decisions for haemodialysis patients. This retrospective study aimed to develop a prediction model for the 5-year risk of CV events and all-cause mortality in haemodialysis patients in China. Methods. We retrospectively enrolled 398 haemodialysis patients who underwent dialysis at the dialysis facility of the General Hospital of Northern Theater Command in June 2016 and were followed up for 5 years. The composite outcome was defined as CV events and/or all-cause death. Multivariable logistic regression with backwards stepwise selection was used to develop our new prediction model. Results. Seven predictors were included in the final model: age, male sex, diabetes, his- tory of CV events, no arteriovenous fistula at dialysis initiation, a monocyte/lymphocyte ratio greater than 0.43 and a serum uric acid level less than 436 mmol/L. Discrimination and calibration were satisfactory, with a C-statistic above 0.80. The predictors lay nearly on the 45-degree line for agreement with the outcome in the calibration plot. A simple clinical score was constructed to provide the probability of 5-year CV events or all-cause mortality. Bootstrapping validation showed that the new model also has similar discrimination and calibration. Compared with the Framingham risk score (FRS) and a similar model, our model showed better performance. Conclusion. This prognostic model can be used to predict the long-term risk of CV events and all-cause mortality in haemodialysis patients. An MLR greater than 0.43 is an important prognostic factor. [ABSTRACT FROM AUTHOR]

Multiple clusters of human infections with novel avian influenza A(H7N9) virus have occurred since the virus was first identified in spring 2013. However, in many situations it is unclear whether these clusters result from person-to-person transmission or exposure to a common infectious source. We analyzed the possibility of person-to-person transmission in each cluster and developed a framework to assess the likelihood that person-to-person transmission had occurred. We described 21 clusters with 22 infected contact cases that were identified by the Chinese Center for Disease Control and Prevention from March 2013 through June 2015. Based on detailed epidemiological information and the timing of the contact case patients' exposures to infected persons and to poultry during their potential incubation period, we graded the likelihood of person-to-person transmission as probable, possible, or unlikely. We found that person-to-person transmission probably occurred 12 times and possibly occurred 4 times; it was unlikely in 6 clusters. Probable nosocomial transmission is likely to have occurred in 2 clusters. Limited person-to-person transmission is likely to have occurred on multiple occasions since the H7N9 virus was first identified. However, these transmission events represented a small fraction of all identified cases of H7N9 human infection, and sustained person-to-person transmission was not documented. [ABSTRACT FROM AUTHOR]

Phalaenopsis mannii, one of the native Phalaenopsis in China, is an important parent for breeding new varieties. However, its position has been unclear in Phalaenopsis. The obtained high-quality P. mannii chloroplast genome will provide useful information for phylogenetic and future breeding of Phalaenopsis. Herein, we reported a complete chloroplast genome of P. mannii from Yunnan, China. The sequencing data obtained from BGISEQ-500 platform were assembled. This sequence had a circular molecular length of 148,596 bp and contained a total of 127 genes with an average GC content of 36.7%. Phylogenetic analysis indicated that Phalaenopsis was monophyletic with strong support, in which the P.mannii was the sister-group of Phalaenopsis aphrodite subsp. formosas, Phalaenopsis 'TinyStar' and Phalaenopsis equestris. [ABSTRACT FROM AUTHOR]

An important horticultural moth orchid in China, Phalaenopsis lobbii, has small and lovely flowers with unique labial characteristics. We sequenced the chloroplast genome (cpDNAs) of P. lobbii and analyzed the structural characteristics of its complete cpDNAs sequence. The results showed that P. lobbii had a typical circular double-stranded tetrad structure with the average GC content of 36.60%, and its total length was 144,607 bp. The complete chloroplast was annotated with 125 genes, eight rRNAs and 38 tRNAs. Phylogenetic tree displayed that P. lobbii was closely related to P. equestris, P. aphrodite subsp. formosana, P. 'Tiny Star' and P. japonica. This published cpDNAs of P. lobbii will provide information for future phylogenetic and artificial breeding of Phalaenopsis. [ABSTRACT FROM AUTHOR]

In mainland China, most avian influenza A(H7N9) cases in the spring of 2013 were reported through the pneumonia of unknown etiology (PUE) surveillance system. To understand the role of possible underreporting and surveillance bias in assessing the epidemiology of subtype H7N9 cases and the effect of live-poultry market closures, we examined all PUE cases reported from 2004 through May 3, 2013. Historically, the PUE system was underused, reporting was inconsistent, and PUE reporting was biased toward A(H7N9)-affected provinces, with sparse data from unaffected provinces; however, we found no evidence that the older ages of persons with A(H7N9) resulted from surveillance bias. The absolute number and the proportion of PUE cases confirmed to be A(H7N9) declined after live-poultry market closures (p<0.001), indicating that market closures might have positively affected outbreak control. In China, PUE surveillance needs to be improved. [ABSTRACT FROM AUTHOR]

Background: Body energy homeostasis is largely regulated by the interactions between appetite-related brain regions and gut hormones. Objective: We hypothesized that the sensitivity of appetite-related brain regions [eg, hypothalamus, insula, thalamus, parahippocampal/ hippocampal cortex, caudate, putamen, amygdala, and orbitofrontal cortex (OFC)] varies for each macronutrient, and the differential sensitivity is associated with gut hormone concentrations in humans. Design: Brain activation responses to ingested fat, glucose, protein, and water in the above-mentioned 8 brain regions of 14 healthy men were investigated by using functional magnetic resonance imaging. Fasting and postprandial plasma glucose, insulin, ghrelin, cholecystokinin (CCK), and glucagon-like peptide 1 (GLP-1) concentrations were measured. The relation of the blood oxygen level-dependent (BOLD) signal with plasma glucose and hormone concentrations was assessed by using Pearson's correlation analysis. Results: Ingested macronutrients similarly reduced the BOLD signal in the middle insula, thalamus, parahippocampal cortex, caudate, and lateral OFC. Protein ingestion reduced the BOLD signal in the amygdala more effectively than did fat and glucose ingestion. BOLD signal changes were positively correlated with circulating ghrelin concentrations and were negatively correlated with circulating insulin, CCK, and GLP-1 concentrations. The findings indicate variations in the correlation between brain activation and plasma hormone concentrations after ingestion of different macronutrients. Conclusions: The middle insula, thalamus, parahippocampal cortex, caudate, and lateral OFC, but not the amygdala, have similar sensitivities, to isocaloric and isovolumetric macronutrient solutions. Differential correlations exist between BOLD signal changes in activated brain regions and postprandial changes in plasma concentrations' of different gut hormones in response to the ingestion of different macronutrients. [ABSTRACT FROM AUTHOR]

The article reports on the implications of the use of nuclear power in view of the long-term energy forecasts of Northeast Asian countries including Korea, Japan and China. It states the calculation of the replacement of nuclear with coal or liquefied natural gas (LNG) to reveal the potential role of nuclear power for the future control of emissions. It adds that a Northeast Asian Nuclear Council must be founded to enhance cooperation and promotion for safety of nuclear power in the future.

Background: Mainland China experienced pandemic influenza H1N1 (2009) virus (pH1N1) with peak activity during November-December 2009. To understand the geographic extent, risk factors, and attack rate of pH1N1 infection in China we conducted a nationwide serological survey to determine the prevalence of antibodies to pH1N1. Methodology/Principal Findings: Stored serum samples (n = 2,379) collected during 2006-2008 were used to estimate baseline serum reactogenicity to pH1N1. In January 2010, we used a multistage-stratified random sampling method to select 50,111 subjects who met eligibility criteria and collected serum samples and administered a standardized questionnaire. Antibody response to pH1N1 was measured using haemagglutination inhibition (HI) assay and the weighted seroprevalence was calculated using the Taylor series linearization method. Multivariable logistic regression analyses were used to examine risk factors for pH1N1 seropositivity. Baseline seroprevalence of pH1N1 antibody (HI titer ≥40) was 1.2%. The weighted seroprevalence of pH1N1 among the Chinese population was 21.5%(vaccinated: 62.0%; unvaccinated: 17.1%). Among unvaccinated participants, those aged 6-15 years (32.9%) and 16-24 years (30.3%) had higher seroprevalence compared with participants aged 25-59 years (10.7%) and ≥60 years (9.9%, P<0.0001). Children in kindergarten and students had higher odds of seropositivity than children in family care (OR: 1.36 and 2.05, respectively). We estimated that 207.7 million individuals (15.9%) experienced pH1N1 infection in China. Conclusions/Significance: The Chinese population had low pre-existing immunity to pH1N1 and experienced a relatively high attack rate in 2009 of this virus. We recommend routine control measures such as vaccination to reduce transmission and spread of seasonal and pandemic influenza viruses. [ABSTRACT FROM AUTHOR]

Background. Data on risk factors for severe outcomes from 2009 pandemic influenza A (H1N1) virus infection are limited outside of developed countries. Methods. We reviewed medical charts to collect data from patients hospitalized with laboratory-confirmed 2009 H1N1 infection who were identified across China during the period from September 2009 through February 2010, and we analyzed potential risk factors associated with severe illness (defined as illness requiring intensive care unit admission or resulting in death). Results. Among 9966 case patients, the prevalence of chronic medical conditions (33% vs 14%), pregnancy (15% vs 7%), or obesity (19% vs 14%) was significantly higher in those patients with severe illness than it was in those with less severe disease. In multivariable analyses, among nonpregnant case patients aged ⩾2 years, having a chronic medical condition significantly increased the risk of severe outcome among all age groups, and obesity was a risk factor among those <60 years of age. The risk of severe illness among pregnant case patients was significantly higher for those in the second and third trimesters. The risk of severe illness was increased when oseltamivir treatment was initiated ⩾5 days after illness onset (odds ratio, 1.42; 95% confidence interval, 1.20-1.67). For persons <60 years of age, the prevalence of obesity among case patients with severe illness was significantly greater than it was among those without severe illness or among the general population. Conclusions. Risk factors for severe 2009 H1N1 illness in China were similar to those observed in developed countries, but there was a lower prevalence of chronic medical conditions and a lower prevalence of obesity. Obesity was a risk factor among case patients <60 years of age. Early initiation of oseltamivir treatment was most beneficial, and there was an increased risk of severe disease when treatment was started ⩾5 days after illness onset. [ABSTRACT FROM AUTHOR]

Five-stage size-segregated ambient aerosol particles were collected during January 2003 until October 2004 at one urban and one suburban site of Beijing to investigate the seasonal size distributions of aliphatic and polycyclic aromatic hydrocarbons. The concentrations of total n-alkanes ranging from C11 to C35 varied between 2.1 and 2446 ngm3, with higher values at the urban site than suburban site. A seasonal fluctuation was clearly evident, with higher concentrations occurring during the colder period. The carbon preference index (CPI) of the n-alkanes displayed the highest values in the spring and apparently decreased in winter. Furthermore, smaller size airborne particle-bound n-alkanes tend to have lower CPI values. In addition, the presence of pristane, phytane, n-alkylcyclohexanes, hopanes, and steranes, together with the major unresolved complex mixture (UCM) of branched and cyclic compounds, confirmed the contribution from fossil fuel use in ambient aerosol particles of Beijing. The concentrations of 18 unsubstituted PAHs (18-PAH) varied from 0.84883 ngm3, with the content at the urban site 1.16.6 times higher than those for the suburban site. The seasonal variation of 18-PAH concentrations was as follows winter > autumn > spring > summer. About 6788 of the PAHs were associated with particles having an aerodynamic diameter 2.0 m. PAHs concentration diagnostic ratios reflect that the major source of fine particles is from fossil fuel utilization. [ABSTRACT FROM AUTHOR]

Background. Acts of suicide differ widely in the amount of planning preceding the act. Correlates of completed suicide in China identified in a previous investigation were re-examined to identify those that may be especially relevant to low-planned (impulsive) and high-planned suicidal behavior. The association of planning and method in completed suicide was also assessed.Method. A psychological autopsy study of 505 suicide decedents aged 18 years sampled to be representative of suicides in China was conducted. Multinomial regression analyses compared three levels of suicide planning (low, intermediate, high).Results. Women and younger individuals were more likely to carry out low-planned and intermediate-planned than high-planned acts of suicide. Greater acute stress distinguished low-planned from high-planned suicides. Ingestion of pesticides stored in the home was a more commonly employed method in low-planned than high-planned suicides.Conclusions. Low-planned suicides are more common in women, in younger individuals, and among those who are experiencing acute stress. Prevention strategies targeted at restricting access to pesticides may preferentially lower the rate of low-planned suicides. [ABSTRACT FROM AUTHOR]

Summary: Background: Suicide is the fifth most important cause of death in China, but the reasons fo1 the high rate and unique pattern of characteristics of those who kill themselves are unknown. Methods: We pretested, and then administered a comprehensive interview to family members and close associates of 519 people who committed suicide and of 536 people who died from other injuries (controls) randomly selected from 23 geographically representative sites in China. Findings: After adjustment for sex, age, location of residence, and research site, eight significant predictors of suicide remained in the final unconditional logistic regression model. In order of importance they were: high depression symptom score, previous suicide attempt, acute stress at time of death, low quality of life, high chronic stress, severe interpersonal conflict in the 2 days before death, a blood relative with previous suicidal behaviour, and a friend or associate with previous suicidal behaviour. Suicide risk increased substantially with exposure to multiple risk factors: none of the 265 deceased people who were exposed to one or fewer of the eight risk factors died by suicide, but 30% (90/299) with two or three risk factors, 85% (320/377) with four or five risk factors, and 96% (109/114) with six or more risk factors died by suicide. Interpretation: Despite substantial differences between characteristics of people who commit suicide in China and the west, risk factors for suicide do not differ greatly. Suicide prevention programmes that concentrate on a single risk factor are unlikely to reduce suicide rates substantially; preventive efforts should focus on individuals exposed to multiple risk factors. [ABSTRACT FROM AUTHOR]

Summary: Background: A wide range of suicide rates are reported for China because official mortality data are based on an unrepresentative sample and because different reports adjust crude rates in different ways. We aimed to present an accurate picture of the current pattern of suicide in China on the basis of conservative estimates of suicide rates in different population cohorts. Methods: Suicide rates by sex, 5-year age-group, and region (urban or rural) reported in mortality data for 1995-99 provided by the Chinese Ministry of Health were adjusted according to an estimated rate of unreported deaths and projected to the corresponding population. Findings: We estimated a mean annual suicide rate of 23 per 100 000 and a total of 287 000 suicide deaths per year. Suicide accounted for 3.6% of all deaths in China and was the fifth most important cause of death. Among young adults 15-34 years of age, suicide was the leading cause of death, accounting for 19% of all deaths. The rate in women was 25% higher than in men, mainly because of the large number of suicides in young rural women. Rural rates were three times higher than urban rates--a difference that remained true for both sexes, for all age-groups, and over time. Interpretation: Suicide is a major public-health problem for China that is only gradually being recognised. The unique pattern of suicides in China is widely acknowledged, so controversy about the overall suicide rate should not delay the development and testing of China-specific suicide-prevention programmes. [ABSTRACT FROM AUTHOR]

Since 2015, severe hydropericardium-hepatitis syndrome (HHS) associated with a novel fowl adenovirus 4 (FAdV-4) has emerged in China, representing a new challenge for the poultry industry. Although various highly pathogenic FAdV-4 strains have been isolated, the virulence factor and the pathogenesis of novel FAdV-4 are unclear. In our previous studies, we reported that a large genomic deletion (1,966 bp) is not related to increased virulence. Here, two recombinant chimeric viruses, rHN20 strain and rFB2 strain, were generated from a highly pathogenic FAdV-4 strain by replacing the hexon or fiber-2 gene of a nonpathogenic FAdV-4, respectively. Both chimeric strains showed similar titers to the wild-type strain in vitro. Notably, rFB2 and the wild-type strain induced 100% mortality, while no mortality or clinical signs appeared in chickens inoculated with rHN20, indicating that hexon, but not fiber-2, determines the novel FAdV-4 virulence. Furthermore, an R188I mutation in the hexon protein identified residue 188 as the key amino acid for the reduced pathogenicity. The rR188I mutant strain was significantly neutralized by chicken serum in vitro and in vivo, whereas the wild-type strain was able to replicate efficiently. Finally, the immunogenicity of the rescued rR188I was investigated. Nonpathogenic rR188I provided full protection against lethal FAdV-4 challenge. Collectively, these findings provide an in-depth understanding of the molecular basis of novel FAdV-4 pathogenicity and present rR188I as a potential live attenuated vaccine candidate or a novel vaccine vector for HHS vaccines. [ABSTRACT FROM AUTHOR]