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While the initial outbreak of COVID-19 in China impacted Chinese international students' families' lives, the spread of the virus in the U.S. heavily influenced their own. Drawing upon the stress and coping model (Lazarus & Folkman, 1984), this qualitative study unpacks Chinese doctoral students' experiences and coping at one large research university in the U.S. during the pandemic. The open-ended interviews with eight Chinese international doctoral students revealed the stressors associated with the sudden changes in participants' personal, social and academic lives. Findings showed that participants experienced learning obstacles, health concerns, funding uncertainties, and limited social interactions. Participants mainly utilized emotion-focused strategies to cope with the daily life stressors, the tense political climate and hate speech targeting Chinese people in the U.S. This study contributes to the dialogue about stress coping in the pandemic and suggests education practitioners possible improvements in student services.

Lime mortars have played an important role in constructing ancient Chinese masonry structures, including city walls, buildings, and tombs. A tomb built with lime mortars and stones belonging a Ming high‐ranking official, Xu Jie, was discovered in Huzhou City of China. Eight different samples from Xu Jie's tomb, representing four types of lime‐mortar‐based materials: joint mortar between stone bricks, bedding mortar, grouting mortar, and plaster mortars were collected for analysis and comparison. The characterization of the construction materials has therefore become of primary importance. The function of each mortar was reported and studies into the micro‐textural features and mineralogical compositions of those mortars were performed via a multi‐analytical approach. The joint mortars were all found to be aerial lime mortars with predominately lime. The bedding mortar was found to consist of lime, soil and sand, typical of a tabia mortar. The grouting mortar was found to consist of lime and ground contact metamorphosed limestone. Analysis of plaster sample taken from the roof of the main tomb identified the presence of calcium stearate/palmitate, indicating the usage of plant‐based tung oil as an additive. The analytical results will promote our understanding of Ming architectural technology and craftsmanship, and provide critical information for the conservation of Xu Jie's tomb. [ABSTRACT FROM AUTHOR]

China's "Made in China (2025)" strategic plan aims to increase the industrial sector's ability to innovate independently. Cleaner production and green technology will also be used to build green industrial systems. To help achieve these goals, the Chinese government has implemented research and development (R&D) preferential policies. Over the years 2010–2020, this article examines how government subsidies and R&D spending will affect China's energy-intensive enterprises' energy efficiency using the CS-ARDL approach. It also evaluates the effectiveness of economic growth, urbanization, and financial resources on energy efficiency. The outcome reveals that R&D expenditures and economic growth contribute to energy efficiency. Likewise, the findings of urbanization, financial resources, and government subsidies are inversely associated with energy efficiency. Moreover, the panel causality test results show the bi-directional association between urbanization and energy efficiency, government subsidies and energy efficiency, and economic growth and energy efficiency. Likewise, the one-way causal association from R&D expenditures to energy efficiency and from financial resources to energy efficiency. The findings suggest the imperative policies to boost the level of energy efficiency. [ABSTRACT FROM AUTHOR]

Content analysis of Chinese nursing education curriculum and U.S. associate degree nursing curriculum revealed differences in course offerings, time allocation, clinical instruction, and clinical experience. Chinese curriculum emphasized physiology and disease and had minimal humanities and social sciences content. Limited clinical experiences throughout the program were a concern. (SK)

The proportion of fiscal revenue in GDP and the multiplier of fiscal expenditure are important economic benefit indicators in the framework of a common index system for budget performance evaluation. The correlation between fiscal expenditure and GDP constitutes an important indicator to measure fiscal scale, and the scale and structure of fiscal expenditure play a guiding role in the distribution of social renewable production. At the same time, there is a certain mutual promotion between the two. This paper selects the data of China's GDP and fiscal expenditure from 1998 to 2019, analyzes the trend, respectively, and then carries out correlation and regression analysis. On this basis, it scientifically calculates the scale of China's GDP in the next five years and puts forward suggestions to optimize fiscal expenditure. [ABSTRACT FROM AUTHOR]

Background: Ticks are ectoparasites that feed on blood of a broad taxonomical range of terrestrial and flying vertebrates and are distributed across a wide range of environmental settings. To date, the species identity, diversity, and relationships among the ticks on lizards in China have been poorly understood. Methods: In this study, 30 ticks, collected from the multi-ocellated racerunner (Eremias multiocellata) lizard in the Tarim Basin and adjacent Yanqi Basin of the Xinjiang Uygur Autonomous Region in China, were identified by morphological observation and confirmed by DNA-based techniques. The mitochondrially encoded 12S rRNA, 16S rRNA, and COI gene fragments of ticks were amplified and sequenced. To understand the genetic polymorphisms, 47 ticks collected from hedgehogs and 1 from brushwood in the Tarim Basin were also included. Species identification was based on both morphological and molecular characters. The median-joining network approach was used to evaluate the intraspecific genealogies of the ticks and their relatedness with the geographical origin or hosts. Results: The sequence similarity analysis confirmed that the 30 ticks belong to three genera and three species including 11 individuals of Hyalomma asiaticum, 3 of Rhipicephalus turanicus, and 16 of Haemaphysalis sulcata. A network approach revealed paraphyletic populations of R. turanicus and Hy. asiaticum at the intraspecies level regarding geographical origin and low host specificity. For R. turanicus and Hy. asiaticum, common ancestry was observed between COI sequences from lizards and other sequence types from different hosts and countries. Conclusions: To our knowledge, our study is the first to conduct a molecular survey of ticks from lizards in the arid regions of Xinjiang, China. Eremias multiocellata is an atypical host of the three tick species. Notably, two species of ticks, Hy. asiaticum and R. turanicus, have been collected and identified from lizards in China for the first time. Star-like networks suggest both of them might have experienced recent population expansion. The discoveries are closely related to the geographical environments in Xinjiang and will provide information for the control of ticks and tick-borne pathogens in Northwest China. [ABSTRACT FROM AUTHOR]

Tillage on hillslopes may not only induce severe soil erosion, but may also cause bedrock erosion under certain conditions. Yet, little is known about bedrock erosion by tillage in a hilly agricultural landscape, southwest China. The aim of this study is to quantify the translocation of rock fragments derived from bedrock fragmentation by hoeing under different conditions, including slope gradient, hoeing depth and soil‐covered thickness using a gravel tracing method. The reliability of the gravel tracing method was confirmed by the bedrock dyeing tracing method. Hoeing depth is a significant factor affecting the translocation rate of rock fragments (Qr). Meanwhile, under the condition of overlying soil layers (0.06−0.10 m thick), the values of Qr were significantly smaller with a reduction of 20.7−25.6%, compared with rock fragmentation by hoeing for bare bedrock. However, slope gradient was found to have insignificant effects on Qr. Fractured bedrock moved as individual small fragments, which was mainly controlled by the hitting force of the hoe, while soil moved in the shape of lumps, which was dominated by both drag force of the hoe and gravity. This study suggests that hoeing into soil‐covered bedrock can diminish bedrock erosion while providing soil matrix for shallow soil layers. Our work presents a quantitative assessment of bedrock erosion by hoeing and an underlying insight into characteristics of bedrock erosion by tillage operations in hilly agricultural regions with mudstone and shale, southwest China. © 2020 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Leishmaniasis caused by protozoan parasite Leishmania is a neglected disease which is endemic in the northwest of China. Reptiles were considered to be the potential reservoir hosts for mammalian Leishmaniasis, and Leishmania had been detected in lizards from the epidemic area in the northwest of China. To date, few studies are focused on the natural infection of snakes with Leishmania. Methods: In this study, 15 snakes captured from 10 endemic foci in the northwest of China were detected Leishmania spp. on the base of mitochondrial cytochrome b, heat shock protein 70 gene and ribosomal internal transcribed spacer 1 regions, and identified with phylogenetic and network analyses. Result: In total, Leishmania gene was found in 7 snakes. The phylogenetic inference trees and network analysis suggests that the species identification was confirmed as Leishmania donovani, L. turanica and L. (Sauroleishmania) sp. Conclusion: Our work is the first time to investigate the natural Leishmania spp. infection of snakes in the northwest of China. Mammalian Leishmania (L. donovani and L. turanica) was discovered in snakes and the reptilian Leishmania (Sauroleishmania sp.) was closely related to the clinical strains both prompt the importance of snakes in the disease cycle. To indicate the epidemiological involvement of snakes, a wide sample size in epidemic area and the pathogenic features of reptilian Leishmania promastigotes are recommended in the future research. [ABSTRACT FROM AUTHOR]

To quantify spatiotemporal variation in hydraulic properties of bank gully concentrated flow, a series of scour experiments were run under water discharge rates ranging from 30 to 120 l min−1. Concentrated flows were found to be turbulent and supercritical in the upstream catchment area and downstream gully beds. As discharge increased, values of the soil erosion rate, Reynolds number (Re), shear stress, stream power, and flow energy consumption (Δ E) increased while values of the Froude number (Fr) and the Darcy-Weisbach friction factor (resistance f ) did not. With the exception of gully headcut collapse under discharge rates of 60, 90, and 120 l min−1, a declining power function trend ( P < 0.05) in the soil erosion rate developed in the upstream catchment area, headcuts, and downstream gully beds. However, increasing trends were observed in temporal variations of hydraulic properties for downstream gully beds and the upstream catchment area. Despite significant differences in temporal variation between the soil erosion rate and hydraulic property values, relative steady state conditions of the soil erosion rate and Δ E were attained following an initial period of adjustment in the upstream catchment area, headcuts, and downstream gully beds under different discharge rates. A logarithmic growth of flow energy consumption per unit soil loss (Δ Eu) was observed in bank gullies and the upstream catchment area as the experiment progressed, further illustrating the actual reason behind the discrepancy in temporal variation between soil erosion rates and Δ E. Results demonstrate that Δ E can be used to estimate headcut erosion soil loss, but further quantitative studies are required to quantify coupling effects between hydraulic properties and vertical variation in soil mechanical properties on temporal variation for bank gully soil erosion rates. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper studies the emissions of SO and COD in China using fine-scale, countylevel data. Using a widely used spatial autocorrelation index, Moran's I statistics, we first estimate the spatial autocorrelations of SO and COD emissions. Distinct patterns of spatial concentration are identified. To investigate the driving forces of emissions, we then use spatial econometric models, including a spatial error model (SEM) and a spatial lag model (SLM), to evaluate the effects of variables that reflect level of economic development, population density, and industrial structure. Our results show that these explanatory variables are highly correlated with the level of SO and COD emissions, though their impacts on SO and COD vary. Compared to ordinary least square regression, the advantages of SLM and SEM are demonstrated as they effectively reveal the existence and significance of spatial dependence. The SEM, in particular, is chosen over the SLM as the role of spatial correlation is stronger in the error model than in the lag model. Based on the research results, we present some preliminary policy recommendations, especially for those high-high cluster regions that face significant environmental degradation and challenge. [ABSTRACT FROM AUTHOR]

Research on how tillage-induced soil redistribution affects soil properties is limited for complex slopes in nonmechanized agricultural areas. The objectives of this study are (1) to examine the vertical redistribution of soil organic C (SOC), extractable P and K induced by tillage on a complex slope, (2) to assess the effects of tillage erosion on soil profile properties, and (3) to elucidate the variations in soil properties induced by both vertical mixture and downslope transport of soil within the landscape. Simulated tillage was conducted in the Yangtze Three Gorges Reservoir Area, China. The 137Cs data showed that intense tillage caused the soil vertical mixture and downslope transport. The redistribution of 137Cs and soil constituents varied with the number of tillage passes and location in relation to curvature. SOC was completely depleted with the disappearance of soil profiles at the summit position, while SOC concentrations decreased by 26% for the till layer and increased by 29% for the sublayer at the toeslope position for the 15-tillage operation, as compared with those of pretillage. The vertical redistribution of extractable P and K followed a similar pattern to that of SOC. The gap and variation in soil constituents between the till layer and sublayer declined after tillage, suggesting that the mixing effect of tillage attenuates the variability of soil properties in the vertical direction. Net loss and gain of soil constituents occurred at the summit and toeslope positions, respectively, suggesting that the downslope transport of soil induced by tillage accentuates the variability of soil properties in the lateral direction. [ABSTRACT FROM AUTHOR]

The net effect of tillage erosion on soil properties would be associated with the spatial variation in soil constituents, and therefore plays an important role in ecological agriculture. We conducted a consecutive tillage by hoeing 15 times during a period with no rainfall in the two slope landscapes (a linear slope and complex slope) of the Yangtze Three Gorges reservoir areas, to examine the relationship between soil erosion rates and the variations in soil chemical properties and compare the effects of soil redistribution on SOC and nutrients between the linear and complex slopes. After the simulated tillage, notable changes in Cs inventories of the soil occurred in the summit and toeslope positions on the linear slope, while there were significant changes in Cs inventories at convex and concave positions on the complex slope. Soil profile disappeared at the summit slope boundary, with the exposure area of 16.0% and 7.6% of the experimental plot, respectively, for the linear and complex slopes due to no soil replacement. Soil organic C and nutrients were completely depleted with the disappearance of soil profiles at soil eroding zones, whereas a remarkable increase in SOC, total N and available nutrient concentrations of the post-tillage surface soil and a decrease in total nutrient concentrations (P and K) were found at depositional zones on the linear slope. For the complex slope, however, changes in SOC and nutrient concentrations of the post-tillage surface soil exhibited a pattern different from that on the linear slope, which showed a remarkable decrease in SOC and total nutrient concentrations but a slight increase in available nutrient concentrations after tillage in the toeslope position. Due to the gradual increase in soil depth from top to bottom of the slope, SOC and nutrient inventories in the soil profiles were significantly correlated with soil redistribution rates on both the linear and complex slopes. Tillage causes remarkable changes of soil chemical properties in the surface soil layer and soil profile, and increases SOC and nutrient inventories for the soil profile downslope in steeply sloping landscapes. [ABSTRACT FROM AUTHOR]

This study explores the role of a traditional tillage method, i.e., compensatory hoeing, for sustainable agro-ecosystem management in the hilly areas of the Chongqing municipality, south-western China. To validate the effects of compensatory tillage on the terraced slopes, the tillage method of noncompensatory hoeing was conducted on a linear slope. To acquire information about Cs inventories and soil texture, soil samples were collected by a core sampler with a 6.8-cm diameter at 5.0-m intervals along the toposequence and the linear slope in the dry season (March) of 2007. Meanwhile, a tillage erosion model was used for evaluating the spatial pattern of tillage erosion. The Cs data showed that on the terraced slope, soil was lost from the upper slope, and soil deposition occurred at the toe slope positions on each terrace. As a result, abrupt changes in the Cs inventories of soil were found over short distances between two sides of terrace boundaries. Results obtained from the tillage erosion model and the Cs data indicate that soil redistribution mainly results from tillage erosion in the terraced landscape. Consecutive non-compensatory tillage caused soil redistribution on the linear slope, resulting in thin soil profile disappearing at the top and soil accumulating at the bottom positions of the linear slope. This result further validates that compensatory tillage could avoid the complete erosion of the thin soil layer at the summit position. Therefore, this traditional tillage method, i.e., compensatory tillage, has maintained the soil quality at the summit of the slope in the past decades. [ABSTRACT FROM AUTHOR]

Abstract This article examines China’s collaborative initiatives with Western countries to assess the impact of globalization on Chinese nursing education, especially at the post-secondary level, in the post-Mao era. Through the theoretical framework of mutuality, it evaluates the outcomes of globalization in two broad domains: pedagogy and system-institution-program building. In addition, case studies on two collaborative projects between Chinese nursing programs and Western institutions were conducted to further illustrate the principles of mutuality. This qualitative assessment is primarily based on a systematic review of published studies on the multifaceted dimensions of globalization in Chinese post-secondary nursing education in both English and Chinese nursing literature since 1990. It is supplemented by unpublished documents and data obtained from a research trip to China in 2000. The study concludes that globalization has been, and will remain, one of the major forces underpinning Chinese nursing education (and the nursing profession in general), which is moving towards integration into the global nursing community. However, there is a significant imbalance in the knowledge transfer equation both in the national and international context. Great efforts need to be made to synthesize nursing knowledge in the East and West to achieve an integrative nursing science. [ABSTRACT FROM AUTHOR]

Abstract This article examines baccalaureate nursing education curricula in the People’s Republic of China. Three 5-year curricula and one 4-year curriculum were content analyzed and contrasted. Findings of this study suggested that: (i) the biomedical model dominated the three 5-year traditional curricula; (ii) political-ideological content permeated all four curricula; and (iii) the reformed curriculum at Peking Union Medical College was a genuine effort toward building a new nursing curriculum model that intended to differentiate nursing education from medical education. In addition, major themes of recent curriculum reforms were highlighted. Recommendations were suggested to improve the outcomes of future curriculum endeavors. Explicit as well as implicit comparisons with an ideal–typical American generic baccalaureate nursing curriculum were made when appropriate. [ABSTRACT FROM AUTHOR]

Water and tillage erosion processes are important contributors to the total soil erosion in steeply sloping farmland. Although these erosion processes and mechanisms are well understood separately, little is known about the impact of water erosion on the soil redistributed by tillage erosion on sloping fields. In this study, the magnetic tracing (MT) and terrestrial laser scanning (TLS) techniques were applied to perform tillage simulation experiments to ascertain the effect of surface rills on tillage erosion in the dry-hot valley region of southwestern China. The results of simulation experiments indicate that the mean soil flux (Q s) due to tillage on the single-rilled (double-rilled) hillslopes was 85.6 (109.9) kg/m for the mean soil loss rates (R s) of 21.0 (53.7) Mg/ha in simulated-rill areas, and that tillage erosion rates (R t) tended to increase with increasing R s. R t of the single-rilled (double-rilled) hillslopes increased by 1.7 (2.2) times averagely, compared with those of the non-rilled hillslopes. The greater the number and volume of rills, the more easily soil translocation occurred on steep slopes. R t were highly significantly and positively correlated with R s on the rilled hillslopes (P < 0.01). As slope gradient increased, the tillage displacement and Q s appeared to increase on the single-rilled hillslopes. A comparison of measurement results showed that the TLS technique was not only able to measure tillage-induced soil translocation with an accuracy similar to that of the MT technique, but also captured the change in the slope microtopography due to tillage operation. Our results indicated that surface rills remarkably influence tillage erosion and that Q s and R t enhance with increasing R s on the slopes. • Tillage displacement and tillage erosion were closely related to the development of rills by water erosion. • The greater the number and volume of rills were, the more easily tillage erosion occurred. • The 3D laser scanning technique was efficient for measuring tillage erosion rates due to time and energy saving. • Rill erosion was conducive to soil translocation by tillage erosion in the case of steep slopes. [ABSTRACT FROM AUTHOR]

Abstract: To investigate the lag effects and seasonal differences of urban air quality change on human health, we carried out a time-series analysis of daily general practitioner consultations for allergic rhinitis (AR) in Beijing, China. In earlier publications we had assessed the relative risks of air pollutants on AR in Beijing during the period 2009–2010. This article analyzes for the same time period the lag effects of air pollutants and the seasonal effects on daily number of outpatient with allergic rhinitis; differences among age groups and gender groups were also taken into consideration. The results show that, the largest effect RRs of PM10 were at lag01, lag0, lag01, lag01, and lag01 for the total population, male, female, young/middle aged people (20–60years age group), and old people (more than 60years age group), respectively. The largest associations of SO2 were observed at lag3, lag1, lag3, lag0 and lag0 for the total population, male, female, young people/middle aged people (20–60years age group), and old people (more than 60years age group), respectively. The strongest effects of NO2 were found at lag03 for the total population, female and the young/middle aged people; at lag0 for male and lag03 for elder people. RRs of the three pollutants for AR have shown a decreasing relevance from NO2 to PM10 to SO2. The seasonal effect models show that PM10, SO2, and NO2 had higher risk for AR in the warm season than in the cold season. [Copyright &y& Elsevier]

Focuses on a study which examined the effects of conservation management on soil erosion reduction in the Sichuan Basin of China. Materials and methods; Results and discussion.

Background: Antiphospholipid activity was reported to be increased in depressive patients, while the impact of antiphospholipid antibodies (aPLs) on post-stroke depression (PSD) is unclear. We aimed to investigate the associations of aPLs, including antiphosphatidylserine (aPS) and anticardiolipin (aCL) antibodies with depression after acute ischemic stroke., Methods: aPS and aCL were measured in 497 ischemic stroke patients recruited from 7 of 26 participating hospitals of China Antihypertensive Trial in Acute Ischemic Stroke. 24-item Hamilton Depression Rating Scale was used to evaluate PSD status at 3 months after stroke., Results: Compared with aPS-negative or aCL-negative, the adjusted odds ratios (ORs) [95% confidence intervals (CIs)] associated with aPS-positive or aCL-positive were 1.77 (1.07-2.92) or 2.06 (1.11-3.80) for risk of PSD. On continuous analyses, per 1-SD increment of aPS and aCL were associated with 29% (OR 1.29, 95% CI 1.06-1.58) and 30% (OR 1.30, 95% CI 1.06-1.60) increased risks for PSD, respectively. Adding aPLs to conventional risk factors models significantly improved risk reclassification for PSD (net reclassification improvement index = 21.87%, P = 0.016 for aPS; net reclassification improvement index = 32.24%, P = 0.0004 for aCL)., Limitations: aPLs levels were tested only at baseline without serial measurements, and we were unable to detect the association between aPLs changes and PSD., Conclusions: Higher aPS and aCL levels in the acute phase of ischemic stroke were associated with increased risk of 3-month PSD, suggesting that aPLs may play an important role in post-stroke depression prediction., (Copyright © 2019. Published by Elsevier B.V.)

Objectives: Sepsis-3 consensus suggests "the need to develop similar updated definitions for pediatric populations." Sequential organ failure assessment (SOFA) and systemic inflammatory response syndrome (SIRS) criteria are two systems widely used to define the status of infection. However, it is still unclear whether SOFA is more accurate than SIRS in predicting children mortality in low- and middle-income countries. Thus, we validated the accuracy of age-adapted SOFA and SIRS in predicating the poor prognosis of infected children in China's pediatric intensive care unit (PICU)., Methods: We performed a retrospective and observational cohort study of children admitted for infection to PICU in the hospital between January 1, 2009 and December 31, 2017. The indexes within 24 h after intensive care unit (ICU) admission were analyzed according to age-adapted SOFA and SIRS, and all data were sourced from the hospital's electronic health record database. The prognosis was illustrated with primary outcome and secondary outcome. Primary outcome referred to in-hospital mortality, and secondary outcome to in-hospital mortality or ICU length of stay ≥ 7 days. The predictive power of age-adapted SOFA and SIRS was compared using crude and adjusted area under the receiver operating characteristic curve (AUROC)., Results: Of 1,831 PICU-admitted children due to infection, 164 (9.0%) experienced primary outcome, and 948 (51.8%) secondary outcome. Of 164 deaths, 65.9% were males (median age of 7.53 months, range of 2.67-41.00 months). Children who scored ≥ 2 in age-adapted SOFA or met two SIRS criteria accounted for 92.5% and 73.3%, respectively. In addition, age-adapted SOFA score of ≥2 predicted adverse outcome more accurately than pediatric SIRS (adjusted AUROC, 0.753; 0.713-0.796 vs. 0.674; 0.631-0.702; P < 0.001)., Conclusion: Compared with SIRS criteria, age-adapted SOFA score of ≥ 2 enjoys a more accuracy in predicting in-hospital mortality of PICU-admitted children, and a higher sensitivity in identifying children with severe infection.

Background and Aims: We aimed to evaluate the ability of multiple novel biomarkers representing several pathophysiological pathways to improve risk prediction of post-stroke cognitive impairment., Methods: We conducted a prospective multicenter study in 638 ischemic stroke patients with elevated blood pressure based on a random subsample from China Antihypertensive Trial in Acute Ischemic Stroke and measured 12 circulating biomarkers in these participants. Cognitive impairment was assessed at 3 months after stroke with definitions of Mini-Mental State Examination (MMSE) score <27 or Montreal Cognitive Assessment (MoCA) score <25., Results: According to MMSE score, 1 SD increase of rheumatoid factor (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.02-1.46), matrix metalloproteinase-9 (OR 1.47, 95% CI 1.22-1.77) and total homocysteine (OR 1.22, 95% CI 1.01-1.49) after log transformation was significantly associated with the risk of post-stroke cognitive impairment. The ORs associated with their simultaneously high levels were 4.89 (95% CI, 2.31-10.35; p trend <0.001) and 3.09 (95% CI, 1.60-5.98; p trend <0.001) for cognitive impairment and the severity of cognitive impairment, respectively. Adding these 3 biomarkers to conventional model significantly improved the risk prediction of cognitive impairment (C statistic 0.729 vs. 0.688, p = 0.004; net reclassification improvement = 33.67%, p < 0.001; integrated discrimination index = 4.61%; p < 0.001). Similar significant findings were observed when cognitive impairment was defined by MoCA score., Conclusions: Combination of rheumatoid factor, matrix metalloproteinase-9 and total homocysteine can improve the risk prediction of cognitive impairment among ischemic stroke patients with elevated blood pressure. Further studies are warranted to validate our findings and explore their roles as potential therapeutic targets., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: The effect of serum rheumatoid factor (RF) on poststroke cognitive impairment remains unknown. We aimed to investigate the association of serum RF in the acute phase with cognitive impairment at 3 months after ischemic stroke onset., Methods: Our study was based on a random sample from the China Antihypertensive Trial in Acute Ischemic Stroke, a total of 582 patients from 7 of 26 participating sites of the trial with serum RF levels were included in this analysis. Cognitive impairment was defined as Mini-Mental State Examination less than 27 or Montreal Cognitive Assessment less than 25., Results: According to Mini-Mental State Examination score, the multivariate-adjusted odds ratio and 95% confidence interval of cognitive impairment for the highest tertile of serum RF was 1.79 (1.08-2.99) compared with the lowest tertile. Each standard deviation increase of log-transformed RF was associated with 33% (95% confidence interval: 7%-66%) increased risk of cognitive impairment, and a linear association between serum RF and risk of poststroke cognitive impairment was observed (P for linearity < .01). Adding log-transformed RF to a model containing conventional risk factors improved the predictive power for poststroke cognitive impairment (net reclassification improvement: 26.21%, P < .01; integrated discrimination index: 1.24%, P = .02). Similar significant findings were observed when cognitive function was defined by Montreal Cognitive Assessment score., Conclusions: Elevated serum RF levels in the acute phase were independently associated with 3-month cognitive impairment among ischemic stroke patients. Further studies are needed to replicate our findings and to clarify the potential mechanisms., (Copyright © 2019. Published by Elsevier Inc.)

Background: The impact of serum matrix metalloproteinases-9 (MMP-9) on cognitive impairment after ischemic stroke is unclear. We aimed to investigate the association between serum MMP-9 in the short-term acute phase of ischemic stroke and cognitive impairment at 3 months., Methods and Results: Our study was based on a subsample from the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke); a total of 558 patients with serum MMP-9 levels from 7 of 26 participating sites of the trial were included in this analysis. Cognitive impairment severity was categorized as severe, mild, or none (Mini-Mental State Examination score, <23, 23-26, or ≥27, respectively; Montreal Cognitive Assessment score, <20, 20-24, or ≥25, respectively). Cognitive impairment was defined as a score of <27 for Mini-Mental State Examination or <25 for Montreal Cognitive Assessment. According to Mini-Mental State Examination score, 143 participants (25.6%) had mild cognitive impairment and 153 (27.4%) had severe cognitive impairment at 3 months. After adjustment for age, National Institutes of Health stroke score, education, and other covariates, the odds ratio for the highest quartile of serum MMP-9 compared with the lowest quartile was 3.20 (95% confidence interval, 1.87-5.49) for cognitive impairment. Multiple-adjusted spline regression model showed a linear association between MMP-9 levels and cognitive impairment ( P <0.001 for linearity). Sensitivity and subgroup analyses further confirmed these results. Similar significant findings were observed when cognitive impairment was defined by Montreal Cognitive Assessment score., Conclusions: Increased serum MMP-9 levels in the short-term phase of ischemic stroke were associated with 3-month cognitive impairment, independently of established risk factors., (© 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.)

The single nucleotide polymorphisms (SNPs) in the promoter region of matrix metalloproteinase (MMP) genes may influence tumor occurrence and progression via modifying mRNA transcription and protein expression. The study aims to explore the association of the SNPs in MMP-1, 3 and MMP-9 promoters with susceptibility to adult brain astrocytoma in northern China. Genotyping for the MMP-1 -1607 2G/1G, MMP-3 -1171 5A/6A, and MMP-9 -1562 C/T SNPs were performed by PCR-RFLP methods among 236 adult astrocytoma patients and 366 healthy controls. The results showed that the overall distribution of the MMP-1 allelotype and genotype among astrocytoma patients and healthy controls was significantly different (P = 0.002 and P < 0.001, respectively). Compared with the 2G/2G genotype, the 1G/1G genotype significantly decreased the risk of astrocytoma development (adjusted OR = 0.58, 95% CI = 0.42-0.79). The similar results were obtained when stratified by gender and age at tumor diagnosis (< or =45 or >45 years). The association between MMP-3 -1171 5A/6A or MMP-9 -1562 C/T SNPs and susceptibility to astrocytoma was not observed in this study. However, MMP-1 1G-MMP-3 6A haplotype significantly reduced the risk of astrocytoma development when using MMP-1 2G-MMP-3 6A haplotype as a reference (OR = 0.45, 95% CI = 0.29-0.67). The present study suggested that, the MMP-1 -1607 1G/1G genotype and MMP-1 1G-MMP-3 6A haplotype may play protective role in the development of adult astrocytoma in northern Chinese, whereas the MMP-3 -1171 5A/6A and MMP-9 -1562 C/T polymorphisms may not be independent factors to influence susceptibility to adult astrocytoma in this population.

Objective: To assess the association between the C to T transition in the methylenetetrahydro folate reductase gene (MTHFR C677T) and the C to T transition in the serine hydroxymethyltransferase ( 1 )gene (SHMT ( 1 ) C1420T) and the increased risk of carcinogenesis of esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinoma (GCA) in a population of high incident region of Northern China., Methods: The polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphism and PCR-confronting two-pair primers analysis respectively among 1051 cancer patients (584 ESCC and 467 GCA) and 540 healthy controls., Results: The MTHFR 677T/T genotype significantly increased susceptibility to both ESCC and GCA compared with the C/C genotype, the adjusted OR was 2.13 (95% CI = 1.50-3.02) and 1.28 (95% CI = 1.07-1.53, respectively. For the SHMT ( 1 ) C1420T polymorphism, the C/C genotype was significantly associated with the increased risk of ESCC and GCA, compared with the C/T genotype (the adjusted OR = 1.43 and 1.35, 95% CI = 1.02-2.00 and 1.11-1.63, respectively). The interactive influence of the MTHFR and SHMT ( 1 ) polymorphisms in the risk of ESCC and GCA was also observed., Conclusion: The association between the MTHFR C677T and SHMT ( 1 ) C1420T polymorphisms and the risk of ESCC and GCA was demonstrated.

Purpose: To investigate the association of single nucleotide polymorphisms (SNP) in the promoter region of the matrix metalloproteinases-1 -1607bp1G/2G, matrix metalloproteinases-3 -1171bp5A/6A, matrix metalloproteinases-7 A-181G and matrix metalloproteinases-9 C-1562T with susceptibility to ovarian cancer in a population of North China., Experimental Design: We analyzed four different functional promoter polymorphisms in the respective genes by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) in a sample of patients with epithelium ovarian cancer and control women, all from North China., Results: No significant difference was detected between the patient and control groups in genotype and allelotype distribution of MMP-1, MMP-3, MMP-9 of the polymorphisms studied. However, the genotype and allelotype of the MMP-7 distribution in ovarian cancer patients were significantly different from that in healthy controls. The frequency of the -181G allele of MMP-7 in patients was significantly higher than that in healthy controls women (8.2% vs. 2.8%, P = 0.002). Compared to the A/A genotype, the genotypes with the -181G allele (A/G + G/G) significantly increased susceptibility to ovarian cancer, with adjusted odds ratio [OR] = 3.53 95% confidence interval [CI] [1.58 to 7.89]., Conclusions: The study suggested that a possible association between the MMP-7 A/G polymorphism with susceptibility to epithelium ovarian cancer, but there is no support for an association of the selected MMP-1 1G/2G, MMP-3 5A/6A, and MMP-9 C/T polymorphisms with the risk for ovarian cancer.

Background: Gene expression analyses indicate that there are 152 genes of which the expression differs significantly in esophageal squamous cell carcinoma (ESCC) cases with positive as opposed to those with negative family history of upper gastrointestinal cancer (FHUGIC) in the high-incidence area for ESCC in northern China. However, the question as to whether there is any difference of onset age or survival rates in the familial and sporadic cases of ESCC in the area is unknown., Aims: To investigate the differences of onset age or survival rates in the familial and sporadic cases of ESCC for surgically treated ESCC patients from the high-incidence area., Methods: Retrospective analyses were performed on the clinicopathologic and survival data of ESCC cases (N = 1715) who had undergone surgery alone from 1985 to 1994 in Hebei Cancer Center, a provincial cancer center established primarily to treat esophageal cancer in the high-incidence area, to investigate the differences. All the patients had been native residents of the high-incidence area in northern China. Student's t-test was used to test the difference of onset ages, and Cox Proportional Hazard Model was used to examine the differences of survival rates in the familial and sporadic cases of ESCC., Results: Although the familial cases of ESCC had had a significantly earlier onset than the sporadic cases (P < 0.00), they experienced relatively lower survival rates than the sporadic cases after surgery. The differences of survival rates in the familial and sporadic cases were significant for patients above the age of 50 years (P(Wald) = 0.04) and for the T(is, 1)N(0)M(0) group (P(Wald) = 0.04), the differences were bigger for early-staged than for the later-stage groups, and the differences persisted when adjusted for or stratified by confounding factors such as sex, age (under versus above the age of 50 years), smoking, drinking, cancer segment location, surgery year (calendar year), stage (UICC 4th Ed, 1987), and Resection category. Overall, cases under the age of 50 years old showed a higher survival curve than cases above the age of 50 years old, and this was especially true for the familial case group where the difference was significant (P(Wald) = 0.03)., Conclusion: The findings suggest that the familial ESCC may develop earlier, and may have a poorer prognosis than the sporadic ESCC. Both earlier onset and poorer outcome may be important features for the familial as opposed to the sporadic cases of ESCC. The association between younger onset age and higher survival rates found for the familial cases may indicate some survival benefit for early discovery for people with positive FHUGIC in the high-incidence area.

Matrix metalloproteinases (MMPs) are proteolytic enzymes that regulate various cell behaviors in cancer biology, via their basic function of degradation of proteins. Genetic variations in several MMP promoters may influence transcription and expression of MMPs. The aim of this study is to assess the effects of the two single nucleotide polymorphisms (SNPs), the guanine insertion polymorphism in the MMP1 promoter and the adenosine insertion polymorphism in the MMP3 promoter, on risk of the development and lymphatic metastasis of non-small cell lung carcinoma (NSCLC). The MMP1 and MMP3 SNPs were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis in 243 NSCLC patients and 350 control subjects in North China. The overall genotype and allelotype distribution of both the variants in cancer patients and controls was not significantly different (all P values are above 0.05). However, stratification analysis showed that smoking individuals with the MMP3 5A allele had a >1.5-fold increased risk to develop NSCLC, compared with those harboring the 6A homozygous [the age and gender adjusted odds ratio (OR) = 1.68, 95% confidence interval (CI) = 1.04-2.70]. In addition, the frequency of the MMP3 5A homozygote in NSCLC patients with lymphatic metastasis was significantly higher than that in lymph node negative ones (5.7 versus 0%, P = 0.04). Moreover, the MMP 1G/5A haplotype significantly increased the risk of lymphatic metastasis (OR = 3.36, 95% CI = 1.42-7.94), compared with the 2G/6A haplotype. The present result suggested that the MMP3 promoter polymorphism may modify susceptibility to NSCLC, and the MMP 1G/5A haplotype may predicate the risk of lymphatic metastasis of this tumor.

Polymorphisms in the untranslated regions (UTRs) of the thymidylate synthase (TS) gene, which may modulate TS transcription and expression, have been associated with susceptibility and prognosis of several tumors. However, their effects on the development and clinical staging of esophageal squamous cell carcinoma (ESCC) and gastric cardiac adenocarcinoma (GCA) have not been assessed so far. In this study, the 28-bp tandem repeat and the G/C single nucleotide polymorphism in the TS 5'UTR, the 6-bp deletion (6 bp-) polymorphism in the TS 3'UTR, were genotyped in 465 cancer patients (232 ESCC, 233 GCA) and 348 control subjects in North China. The genotype and allelotype distribution of the TS variants in ESCC, GCA patients and controls did not show significant difference. However, the frequency of the 6 bp-/2R haplotype in ESCC and GCA patients was marginally or significantly lower than that in controls (P = 0.05 and 0.006, respectively). Thus, the 6 bp-/2R significantly reduced the risk to ESCC and GCA, compared with the 6 bp-/3G haplotype [odds ratio (OR) = 0.61 and 0.48, 95% confidence interval (CI) = 0.37-1.00 and 0.28-0.81, respectively]. In addition, the 6 bp+/3G haplotype in ESCC patients was also significantly less common than in controls (P = 0.002). Compared with the 6 bp-/3G haplotype, the 6 bp+/3G significantly reduced the risk to ESCC (OR = 0.30, 95% CI = 0.14-0.67). Moreover, the TS 2R/3G genotype frequency in ESCC patients with and without lymphatic metastasis was significantly different (27.1 versus 4.9%, P < 0.001). Therefore, the 2R/3G genotype had an approximately 11-fold increase in the risk of lymphatic metastasis of ESCC, compared with the 3G/3G genotype (95% CI = 2.67-49.74). The results suggested that the TS polymorphisms might be associated with the susceptibility to ESCC and GCA, and the 2R/3G genotype might be a candidate marker to predict the potential of lymphatic metastasis in ESCC.

Purpose: Folate deficiency is considered to increase the risk of developing esophageal cancer. Methylenetetrahydrofolate reductase (MTHFR) is a key enzyme involved in folate metabolism. A single C --> T substitution at nucleotide 677 of the MTHFR cDNA influences enzyme activity. The purpose of this study is to compare the association of the MTHFR C677T polymorphism with susceptibility to esophageal squamous cell carcinoma (ESCC)., Methods: Using real-time PCR and melting curve analysis, the MTHFR C677T genotypes were determined in 430 patients with ESCC (241 German Caucasians and 189 northern Chinese) and 397 unrelated healthy controls (256 German Caucasians and 141 northern Chinese)., Results: A significant difference in MTHFR C677T genotype distribution was observed between German Caucasian controls (C/C, 41.8%, C/T, 44.9%, T/T, 13.3%) and northern Chinese controls (C/C, 17.7%, C/T, 38.3%, T/T, 44.0%) (chi(2)=52.19, P<0.001). The distribution of the MTHFR C677T genotypes among German ESCC patients (C/C, 39.0%, C/T, 48.1%, T/T, 12.9%) was not significantly different from that among healthy controls (chi(2)=0.531, P=0.767). In contrast, the frequency of the C/C genotype among Chinese ESCC patients (8.5%) was significantly lower than among Chinese healthy controls (17.7%) (chi(2)=6.37, P=0.012). The C/C genotype was correlated with a significantly reduced risk for the development of ESCC as compared to the combination of C/T and T/T genotypes (adjusted OR=0.38, 95% CI=0.16-0.88)., Conclusions: Our results suggest that, in contrast to German Caucasians, the MTHFR 677CC homozygous wild-type plays a protective role in the development of ESCC in the northern Chinese population.

NAD(P)H: quinone oxidoreductase 1 (NQO1) is an antioxidant enzyme, important in the detoxification of environmental carcinogens. A single base substitution (C --> T) polymorphism at nucleotide 609 (null-allele) of NQO1 gene impairs stability and function of the NQO1 protein. To investigate the association of this NQO1 polymorphism with susceptibility to esophageal squamous cell carcinoma (ESCC), the NQO1 C609T genotypes were determined by PCR-RFLP analysis in 450 patients with ESCC (257 German Caucasians and 193 northern Chinese) and 393 unrelated healthy controls (252 German Caucasians and 141 northern Chinese). Additionally, NQO1 protein expression was determined by immunohistochemistry in a subset of 74 ESCC (50 German, 24 Chinese). A significant difference in NQO1 C609T genotype distribution was observed between Caucasian healthy controls (C/C, 73.4%; C/T, 25.0%; T/T, 1.6%) and Chinese healthy controls (C/C, 34.0%; C/T, 49.7%; T/T, 16.3%) (chi(2) = 68.40, P < 0.001). The NQO1 T/T genotype significantly increased the risk for developing ESCC in both Caucasian subjects (OR = 4.62, 95% CI = 1.54-13.86) and Chinese subjects (OR = 1.81, 95% CI = 1.04-3.15), compared with the combined C/C and C/T genotypes. In Chinese subjects, this increased susceptibility was pronounced in patients with family history of upper gastrointestinal cancers (OR = 2.18, 95% CI = 1.14-4.17). Immunohistochemical analysis showed NQO1 protein expression in 53 carcinomas, whereas 21 carcinomas were negative. Negativity for NQO1 expression correlated strongly with the NQO1 genotype, being present in 8.6% of cases with C/C, 22.2% of cases with C/T and 100% of cases with T/T genotype (chi(2) = 16.60, P < 0.001). In summary, the association of the NQO1 C609T polymorphism with ESCC in genetically distinct populations makes a strong argument for its importance in carcinogenesis of ESCC in the German Caucasian and the northern Chinese population.