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Plant leaf morphological and photosynthetic physiological characteristics are key functional traits in the adaptability of plants to heterogeneous environments. Analysis of the correlation between leaf morphological traits and photosynthetic physiological characteristics of salt marsh plants is helpful to deepen our understanding of how salt marsh plants adjust their leaf structure and function to adapt to their environment. However, there have been few studies on the relationship between leaf morphology and photosynthetic physiological characteristics of plants in inland salt marshes under a habitat gradient. A Phragmites australis community was divided into three plots based on differences in the wetland habitat conditions: a remote water area (plot I, 400–550 m from the water margin), a middle water area (plot II, 200–350 m from the water margin) and a near water area (plot III, 0–150 m from the water margin). The relationship between leaf morphological traits and photosynthetic physiological parameters of P. australis in heterogeneous habitats was studied. The results showed that as the habitat conditions changed from plot I to plot III, the soil characteristics, above-ground characteristics of the community and the photosynthetically active radiation changed significantly (P < 0.05). Besides, there was a highly significant positive correlation (P < 0.01) between leaf dry weight (LDW) and net photosynthetic rate (P n), the effective quantum yield of PSII photochemistry (Y(II), actual photochemical efficiency of PSII) and photochemical quenching (QP); and between leaf area and P n, Y(II) and QP in the three habitats. Moreover, in plot I, P. australis tended to have small and thick leaves with a low LDW and specific leaf area. In plot III, leaves were large and thin to adapt to the change in habitat conditions. This study provides a scientific theoretical basis for understanding the ecological adaptation strategies of plants in the harsh environment of an inland salt marsh and the conservation and management of wetland plants. [ABSTRACT FROM AUTHOR]

Currently, the dynamic behavior of high-speed long-runout landslides triggered by earthquakes remains unclear due to the complexity of such phenomena. Degradation in the shear strength of rock masses is considered a primary factor contributing to the high velocities and long runout distances of these landslides. In this study, the strength degradation induced by changes in rock joint morphology is analyzed considering a numerical model of the Donghekou landslide, by using discontinuous deformation analysis (DDA). First, an exponential joint roughness degradation function (i.e., JRCm) that depends on displacement is incorporated with the nonlinear Barton–Bandis (B–B) shear strength criterion, and this modified B–B criterion is combined with the DDA. Moreover, a virtual joint is introduced in the DDA to model the propagation of cracks in intact rock masses, in order to simulate the dynamic phenomenon of earthquake-induced landslides. Subsequently, this improved DDA (IDDA) is validated via simulations of a shear test and a sliding block over an inclined plane. Finally, the IDDA is employed to simulate the Donghekou landslide, which was induced by the 2008 Wenchuan earthquake in China. Furthermore, the entire dynamic process of the landslide, including crack propagation, instability, initiation, and motion, is depicted. The simulated deposit patterns obtained via the IDDA are in good agreement with the results of field investigations. The simulation results also prove that the IDDA can reflect key movement behaviors of Donghekou landslide and that the degradation of rock joints significantly influences the long runout distance and high velocity of sliding mass. [ABSTRACT FROM AUTHOR]

Heat-soak and quick freezing could deteriorate the texture of vegetables. In this work, it was found that calcium chloride-sodium alginate (SA) could improve the appearance, brittleness, and chewiness of processed Heracleum moellendorffii (HM), a kind of popular nutritious wild vegetable in China. The effect resulted from the increase of calcium content in the vegetable, which was closely related to the ratio of calcium chloride to SA, the concentration of texture retaining agent, and soaking time significantly (P < 0.01). The best way to maintain the texture was to soak HM in 4 g/L of calcium chloride-SA (mass ratio 1 : 2) at 50°C for 30 minutes. The calcium content was increased to 71.56 mg/100g, and the brittleness and chewiness were 4630 gf and 2583.33 gf, respectively. The microstructure found that calcium could adhere to an inherent position on the cell membrane and protected the sample from cell damage and chloroplast spilling from the cell during thawing and quick freezing. The results showed that calcium chloride-SA treatment may be a promising method to improve the texture of vegetables during quick-frozen storage. [ABSTRACT FROM AUTHOR]

Whether the South China block (SCB) occupied an external or internal position in the Rodinia supercontinent remains controversial. The external model favors an accretion orogenic amalgamation setting, whereas the internal model assumes postcollisional extensional rifting in the Neoproterozoic. Recent geochronological data suggested that the SCB was assembled from several ancient nuclei or microcontinental fragments with various origins and geological histories during the early Neoproterozoic, and supported the external position model for the SCB in Rodinia. However, whether these ancient continental nuclei are hidden in the crust requires direct constraints such as those from seismic tomography. In general, these early ancient continental relicts preserved in the present-day crust tend to be characterized by high strength, high velocity, and weak attenuation. Compared with velocity, seismic attenuation tends to be more sensitive to ancient rigid continental fragments. Here, we constructed a high-resolution broadband crustal Lg attenuation model for the SCB and explored the existence and scale of the ancient continental fragments potentially hidden in the deep crust. Four extremely weak attenuation anomalies in the SCB indicate potential locations of these ancient continental relicts in the crust; one is in the Sichuan basin and the other three are beneath the Cathaysia block. The three ancient continental relicts in the Cathaysia block, which are closely corresponding to early surface lithological records, provide seismic evidence supporting an external position for the SCB in the Rodinia supercontinent. • A high-resolution broadband Lg attenuation model is constructed in South China. • High Q Lg values indicate stable and rigid ancient crust in the South China block. • Extremely high Q reveals three ancient continental relicts in the Cathaysia crust. [ABSTRACT FROM AUTHOR]

We report on a broad-band high-resolution attenuation model for the North China Craton and surrounding regions based on regional Lg-wave data. Vertical broad-band waveforms recorded at 39 stations from 176 crustal earthquakes are collected to extract the Lg-wave amplitude spectra between 0.05 and 10.0 Hz. We use the dual-station method to generate a preliminary QLg model and use it as the initial model. Then, we combine the dual- and single-station data together to jointly invert the QLg distribution and Lg source excitation functions. These inversions are conducted independently at individual frequencies without using any a priori assumption about the frequency dependences in QLg and source terms. The maximum spatial resolution is approximately 1° × 1° in well-covered areas for frequencies between 0.05 and 2.0 Hz. The QLg image is then used to determine the relationship between the attenuation and different geological structures. Results show an average Q0 (1 Hz QLg) of 374 for the entire North China Craton with an increasing trend from east to west. Average Q0 values are 337, 361 and 421 for the east, central and west blocks, respectively. For the surrounding regions, the Eastern Tibetan plateau has a very low Q0 of 188, while the Northeast China Plate and the Tianshan–Xingmeng fold belts are characterized by high Q0 values of 506 and 424, respectively. We also investigate regional variations of the Lg attenuation in low-frequency band between 0.2 and 1.0 Hz. [ABSTRACT FROM AUTHOR]

Two new resorcinol derivatives 2-methoxy-4-hydroxy-6-(8Z-pentadecenyl)-benzene-1-O-acetate (1) and 2-methoxy-4-hydroxy-6-pentadecyl-benzene-1-O-acetate (2), together with four known compounds 2-methoxy-4-hydroxy-6-tridecyl-benzene-1-O-acetate (ardisiphenol D, 3), 5-(8Z-pentadecenyl)resorcinol (4), 5-pentadecylresorcinol (5), 5-tridecylresorcinol (6), have been isolated from the roots of Ardisia brevicaulis in our previous work. In the present study, the inhibitory effect of 1-6 on the proliferation of human pancreatic PANC-1, human lung A549, human gastrointestinal carcinoma SGC 7901, human breast MCF-7, and human prostate PC-3 cancer cells was evaluated by the methyl thiazolyl tetrazolium method. Compounds 1-6 all showed inhibitory activities against the proliferation of PANC-1, A549, SGC7901, MCF-7, and PC-3 cancer cells. Compound 3, the most active agent and the main constituent with the highest yield, induced apoptosis of PANC-1 cells (the most sensitive cell line among the cell lines screened) via the activation of caspase-3 and caspase-9, up-regulation of the ratio of bax/bcl-2 protein expression. [ABSTRACT FROM AUTHOR]

[Display omitted] • The Shaquanzi mineralization stage may have been associated with magmatic hydrothermal fluids. • Ore-forming fluid is medium–high salinity fluid system, and evolved from high to medium temperature. • Shaquanzi is inferred to be a skarn-type Zn–Pb deposit. The Shaquanzi Zn–Pb deposit, located in the Central Tianshan Terrane, is mainly hosted by siliceous slates and carbonaceous marbles of the Mesoproterozoic Kawabulake Group, and its mineralization / alteration can be divided into skarn period (I: early skarn stage, II: late skarn stage), quartz-sulfide period (III: early sulfide stage, IV: late sulfide stage and V: quartz-calcite stage) and supergene period (VI: supergene alteration stage). The W-type fluid inclusions (FIs) were identified in the garnet, chlorite, quartz, and calcite in skarn and quartz-sulfide periods. Detailed fluid inclusion study shows temperature of fluids decreased from Stage I (510–520 °C) through, Stage III (481–507 °C), Stage IV (248–417 °C, peak at 280–400 °C) to Stage V (148–260 °C, peak at 200–220 °C), with salinities of 20.8–22.2 wt% NaCl eqv., 19.8–29.1 wt% NaCl eqv., 10.6–27.8 wt% NaCl eqv. (peaks at 20–23 wt%), and 21.6–29.9 wt% NaCl eqv. (peak at 23–27 wt%), respectively, indicating that the ore-forming fluids consisted of a high-medium salinity and Na-Mg-Fe-Ca-rich fluid system, and may have evolved from high-medium temperature to medium temperature. The H–O isotopic compositions varied from Stage III (δ18O H2O = 7.7 ‰–9.0 ‰ and δD H2O = − 105 ‰ to − 91 ‰) through Stage IV (δ18O H2O = 2.6 ‰ to 4.3 ‰ and δD H2O = − 114 ‰ to − 111 ‰) to Stage V (δ18O H2O = − 4.2 ‰ to − 3.7 ‰ and δD H2O = − 119 ‰ to − 96 ‰), suggesting that the ore-forming fluid sources may have evolved from magmatic fluids to meteoric water. The average δ34S H2O values of the early sulfide, late sulfide, and quartz-calcite stages are 5.7 ‰, 8.5 ‰ and 14.0 ‰, respectively, indicating that the sulfur in the early stage was mainly derived from magmatic hydrothermal sulfur, while the increase of the δ34S H2O values in the late stages is likely to be sourced from the Kawabulake Group through water–rock reaction. Above all, we propose that the Shaquanzi may have been a skarn-type Zn–Pb deposit. [ABSTRACT FROM AUTHOR]

The Nanling tungsten‑tin province in South China hosts numerous world-class quartz vein type tungsten deposits. The quartz-wolframite veins are generally spatially associated with granitic intrusions; however, their genetic relationship has been controversial. The Kuimeishan deposit (53,000 t WO 3 total resource) is one of the historically most important quartz vein type tungsten deposits in the Nanling region, and is underlain by a concealed granitic intrusion. Here we use a comprehensive geochronological approach, based on zircon and cassiterite U-Pb isotopic analysis, to assess the age relationship between granite and tungsten mineralization. Zircon from the concealed granite and cassiterite in hydrothermal quartz veins yielded U-Pb ages of 159.5 ± 0.6 Ma and 158.4 ± 1.9 Ma, respectively, confirming that magma emplacement and the formation of mineralized veins occurred synchronously. We conclude that the concealed granitic intrusion likely has an intimate genetic connection with the Kuimeishan vein type tungsten mineralization. The trace element composition of zircon shows distinct positive Ce anomalies which record a low-oxygen fugacity environment, which also indicates the ore potential of the granite. Zircon εHf(t) values from the granite vary mostly from −11.9 to −8.9 with Hf model ages (TDM2) ranging from 1.77 to 1.95 Ga. The granite likely represents reworked ancient continental crust without significant contributions of the mantle, typical of W mineralized granite. The concealed mineralized granite intrusion indicates potential for tungsten exploration at depth. • New cassiterite U-Pb gives age of 159.9 ± 1.4 Ma for the Kuimeishan W deposit. • Zircon U-Pb dating defines age of the concealed granitic intrusion at 159.5 ± 0.6 Ma. • A genetic link between concealed granite and W mineralization was established. • A speculative disseminated W mineralization may locate in concealed granite. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To assess the cross-sectional and longitudinal association of cigarette smoking with carotid atherosclerosis in middle-aged and older Chinese adults. Methods: The study population consisted of 1132 residents in Beijing (748 women and 384 men) aged 35 to 64 years. Information on baseline smoking characteristics, including smoking status and pack-years was collected in 1993–1994. The cohort was resurveyed in 2002 and common carotid artery intima–media thickness (CCA-IMT) and carotid plaques were measured by B-mode ultrasound. Results: The multivariable-adjusted mean CCA-IMT at resurvey was significantly associated with smoking status at both resurvey and baseline, and was 0.72 mm for consistent current smokers, 0.71 mm for former and inconsistent smokers, and 0.70 mm for consistent never smokers at both surveys, respectively (p-trend<0.01). The multivariable-adjusted odds ratio [OR, 95% confidence interval (CI)] of having carotid plaques was 1.5 (1.0–2.1) for consistent current smokers vs consistent never smokers. In addition, there was a significant dose-response relationship between baseline smoking pack-years and multivariable-adjusted mean CCA-IMT and risk of having carotid plaques at resurvey. Conclusion: Smoking is associated with carotid atherosclerosis in middle-aged and older Chinese adults both cross-sectionally and longitudinally. Smoking cessation may play a significant role in prevention and control of cardiovascular diseases in China. [Copyright &y& Elsevier]

Internet addiction is a major global concern and health burden, compounded by the advances of Internet Plus and artificial intelligence. There is controversy on the question of recognising some types of internet addiction as mental illness, largely because there is no consensus on its link to mental health outcomes. We investigated the associations between internet addiction severity and several mental health outcomes including four psychopathologies, serious mental illness, and suicidalities. In this cross-sectional study, all first-year undergraduate students enrolled in Sichuan University (Chengdu, China) during 2015–18 were invited to participate in the study survey. Participants were required to finish the whole questionnaire (online) by Oct 31 of their enrolment year. We excluded participants who did not respond completely, did not complete the questionnaire by the deadline, were not aged 15–23 years, or who provided obviously dishonest information (eg, selecting the same choice for all questions or several users having the same unique ID). The severities of internet addiction were categorised using Young's 20-item internet addiction test (normal 0–30 points, mild 31–49, moderate 50–79, and severe 80–100). The four psychopathologies were defined according to the recommended cutoff points of the 15-item Patient Health Questionnaire (high somatic symptom severity), the 9-item Patient Health Questionnaire (clinically significant depression), and the Symptom Checklist-90 (psychoticism and paranoia). Serious mental illness was screened using the 6-item Kessler Psychological Distress Scale (cutoff 12–13 points), and lifetime suicidal ideation, planning, and attempts were measured with the Suicidal Behaviours Questionnaire-Revised. Prevalence among student demographics or internet addiction severity groups was compared with the χ2 test, adjusted odds ratios (ORs) of mental health outcomes in addiction severity groups were compared using binary logistic regression adjusted for demographic confounders (ie, age, sex, and enrolment year), and interactions between psychopathologies were assessed using a two-tailed alpha of 0·05. 37 187 undergraduate students enrolled in the university during the study years. 34 140 (91·8%) of them agreed to participate and accessed the online survey system, and 32 269 (86.8%) responded fully. 12 254 (38·0%) students had mild internet addiction, 2057 (6·4%) had moderate addiction, and 67 (0·2%) had severe addiction. The prevalence and risks of the four psychopathologies and their comorbidities, serious mental illness, and suicidalities increased significantly with internet addiction severity (p values from 0·0003 to <0·0001), and most increments in risk were large (ORs increasing more than four times, except for suicidalities) for students with moderate and severe internet addiction. Prevalence of clinically significant depression, most strongly associated with internet addiction after adjustment for demographics and psychopathologies, increased from 1·0% (95% CI 0·9–1·2) for students with no addiction to 4·9% (4·5–5·3) for those with mild addiction, 24·8% (22·9–26.7) for those with moderate addiction, and to 56·7% (44·5–68·9) for those with severe addiction. Risk for the three addiction groups compared with the no-addiction group increased accordingly (OR 4·2 [95% CI 3·6–5·0] for mild, 18·9 [15·7–22·9] for moderate, and 59·9 [33·5–107·2] for severe addiction). Prevalence of the four psychopathologies increased from 4.1% (3·8–4·4) in students with no addiction to 36.8% (34·7–38·9) in those moderately addicted and to 67.2% (55·6–78·7) for those severely addicted. Similarly, prevalence increased from 25.0% (24·4–25·6) to 67·5% (65·6–69·6) and 71·6% (60·6–82·7) for suicidal ideation, from 2·6% (2·4–2·8) to 16·5% (14·9–18·1) and 32·8% (21·3–44·4) for suicidal plans, and from 0·5% (0·4–0·6) to 3·6% (1·1–1·5) and 11·9% (4·0–20·0) for suicidal attempts. Our study format does not allow us to identify possible causal relationships between internet addiction and mental health comorbidities, but allows us to compare the prevalence and risk of these outcomes through our large population size (to our knowledge, the largest to date in such a study) and methodology. Internet addiction was strongly associated with several adverse mental health outcomes, supporting the validity of defining moderate and severe, but not mild, internet addiction as mental illness. National Scientific and Technical Fund of China (grant 81571305), Department of Science and Technology of Sichuan Provincial Government (grant 2019YFS0153), and 1.3.5 Project for Disciplines of Excellence, West China Hospital. [ABSTRACT FROM AUTHOR]

The long-term safety and effectiveness of once-daily tadalafil is crucial, but limited data are available in Chinese patients with erectile dysfunction (ED). In this post-marketing, multicenter, randomized, open-label trial with 2-year follow-up, 635 ED cases were randomized to receive daily oral tadalafil 2.5 mg or 5 mg for 3 months, of whom 580 continued once-daily tadalafil 5 mg for 21 months. Treatment-emergent adverse events in the 12-month and 24-month period were similar, with the most common being viral upper respiratory tract infection, upper respiratory tract infection, and headache. Significant improvement from baseline in the International Index of Erectile Function-Erectile Function (IIEF-EF) score was detected at month 12 (least squares mean [LSM] change: 7.9, 95% confidence interval [CI]: 7.5-8.4, P < 0.001) and was maintained to month 24 (LSM change: 8.6, 95% CI: 8.1-9.0, P < 0.001). The proportions of patients regaining normal erectile function (IIEF-EF score ≥26) were 43.7% and 48.0% at months 12 and 24, respectively. Global Assessment Questionnaire results showed improved erection function in 97.5% of patients and improved ability to engage in sexual activity in 95.9% of patients at month 12; these values were 96.1% and 95.0% at month 24, respectively. The quality of sexual life score based on the Sexual Life Quality Questionnaire (SLQQ) was increased by 52.2% at month 12 and by 55.3% at month 24 (both P < 0.001). The treatment satisfaction score determined by SLQQ (mean ± standard deviation) was 62.4 ± 21.0 at month 12 versus 65.9 ± 20.2 at month 24. Two-year daily application of tadalafil 5 mg in Chinese men with ED showed a favorable safety profile and durable improvement in sexual performance and satisfaction., (Copyright © 2024 Copyright: © The Author(s)(2024).)

Background: Internet addiction (IA) is associated with adverse consequences, especially for younger people. Evidence indicates that IA is associated with depression, but no studies have yet investigated potential common vulnerability between them., Methods: IA (measured by the Young's 20-item Internet Addiction Test Scale) and depressive symptoms (measured by the Patient Health Questionnaire-9 Scale) among 12 043 undergraduates were surveyed at baseline and at a respective 12 month follow-up for each participant. Application of a cross-lagged panel model approach (CLPM) revealed an association between IA and depression after adjusting for demographic variables., Results: Rates of baseline IA and depression were 5.47% (95% CI: 5.07%, 5.88%) and 3.85% (95% CI: 3.51%, 4.20%), respectively; increasing to 9.47% (95% CI: 8.94%, 9.99%) and 5.58% (95% CI: 5.17%,5.99%), respectively, at follow-up. Rates of new-incidences of IA and depression over 12 months were 7.43% (95% CI: 6.95%, 7.91%) and 4.47% (95% CI: 4.09%, 4.84%), respectively. Models in the present analysis revealed that baseline depression had a significant net-predictive effect on follow-up IA, and baseline IA had a significant net-predictive effect on follow-up depression., Limitations: The follow-up survey response rate was moderate (54.69%) in this analysis of university students. Moreover, the IAT-20 scale did not allow differentiate between specific forms of Internet activity., Conclusions: Common vulnerability and bidirectional cross-causal effects may both contribute to the association between IA and depression, with common vulnerability likely playing a more significant role than cross-causal effects., (Copyright © 2021 Elsevier B.V. All rights reserved.)

More than 10% of women suffer from endometriosis (EMT) during their reproductive years. EMT can cause pain and infertility and requires further study from multiple perspectives. Previous reports have indicated that an increase inapolipoprotein E (ApoE) may be associated with a lower number of retrieved mature oocytes in older women, and an association between ApoE and spontaneous pregnancy loss may exist in patients with EMT. The purpose of this study was to investigate the existence of an increase in ApoE in follicular fluid (FF) and the possible relationship between ApoE and EMT in Chinese women. In the current study, 217 Chinese women (111 control subjects and 106 EMT patients) were included. The ApoE genotypes were identified by Sanger sequencing. We found that ApoE expression in FF was higher in patients with EMT than in the control group. In addition, a significant difference in ApoE4 carriers (ϵ3/ϵ4, ϵ4/ϵ4) was found between the control subjects and the patients with EMT. Furthermore, a nonparametric test revealed significant differences in the numbers of blastocysts and high-quality blastocysts, but not the hormone levels of FSH, LH, and E2, between the two groups. We also established a multifactor (BMI, high-quality blastocysts, and ϵ4) prediction model with good sensitivity for identifying patients who may suffer from EMT. Our results demonstrate that ApoE expression in FF is increased in EMT, the ApoE-ϵ4 allele is significantly linked to EMT, and a combined analysis of three factors (BMI, high-quality blastocysts, and ϵ4) could be used as a predictor of EMT., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Liu, Xing, Zong, Wang, Ji, Zhao, Xia, Wang, Shi, Ding, Wei, Qiao, Du and Cao.)

Background: The association of milk intake with cardiovascular disease (CVD) and cause-specific mortality remained controversial and evidence among the Chinese population was limited. We aimed to study the relationship between milk intake and CVDs among general Chinese adults., Methods: A total of 104,957 participants received questionnaire survey. Results of physical examination such as anthropometric measurements and biochemical tests during 2007 to 2008, demographic data and their information on milk intake were collected through standardized questionnaires. Cox proportional hazard regression models were used to calculate hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) of CVD incidence, cause-specific mortality and all-cause mortality related to milk intake. Restricted cubic splines (RCSs) were applied to examine dose-response associations., Results: Among the 91,757 participants with a median follow-up period of 5.8 years, we documented 3877 CVD cases and 4091 all-cause deaths. Compared with participants who never consumed milk, the multivariate-adjusted HRs (95% CIs) of CVD incidence for 1 to 150 g/day, 151 to 299 g/day, and ≥300 g/day were 0.94 (0.86-1.03) (P > 0.05), 0.77 (0.66-0.89) (P < 0.05), and 0.59 (0.40-0.89) (P < 0.05), respectively; each 100 g increase of daily milk intake was associated with 11% lower risk of CVD incidence (HR, 0.89; 95% CI: 0.85-0.94; P < 0.001), and 11% lower risk of CVD mortality (HR, 0.89; 95% CI: 0.82-0.97; P = 0.008) after adjustment for age, sex, residential area, geographic region, education level, family history of CVD, smoking, alcohol drinking, physical activity level, body mass index, and healthy diet status (ideal or not). RCS analyses also showed a linear dose-response relationship with CVD (P for overall significance of the curve <0.001; P for non-linearity = 0.979; P for linearity <0.001) and stroke (P for overall significance of the curve = 0.010; P for non-linearity = 0.998; P for linearity = 0.002) incidence, and CVD mortality (P for overall significance of the curve = 0.045; P for non-linearity = 0.768; P for linearity = 0.014) within the current range of daily milk intake., Conclusions: Daily milk intake was associated with lower risk of CVD incidence and mortality in a linear inverse relationship. The findings provide new evidence for dietary recommendations in CVD prevention among Chinese adults and people with similar dietary pattern in other countries.

Background: Acute kidney injury (AKI) frequently occurs in cardiopulmonary resuscitation patients. Studies comparing the effects of extracorporeal membrane oxygenation (ECMO) with conventional cardiopulmonary resuscitation (CCPR) on AKI were rare. This study aimed to compare the effects of ECMO with those of CCPR on survival rate and AKI and explore the underlying mechanisms in a swine model of cardiac arrest (CA)., Methods: Sixteen male pigs were treated with ventricular fibrillation to establish CA model and then underwent CCPR (CCPR group, n = 8) or ECMO during cardiopulmonary resuscitation (ECPR group, n = 8). The study endpoints were 6 h after return of spontaneous circulation (ROSC) or death. Serum and urine samples were collected at baseline and during the 6 h after ROSC. The biomarkers of AKI were detected by enzyme-linked immunosorbent assay. The apoptosis of renal tubular epithelial cells was discovered by transmission electron microscope (TEM) and terminal deoxynucleotidyl transferase dUTP nick end labeling assay. Apoptosis-related genes were detected by immune-staining and Western blotting. Data were compared by Student's t-test., Results: All pigs in ECPR group were successfully resuscitated with a higher 6-h survival rate (8/8) compared to CCPR group (6/8). The expressions of AKI biomarkers including neutrophil gelatinase-associated lipocalin (NGAL), tissue inhibitor of metalloproteinase2 (TIMP2), insulin-like growth factor-binding protein 7 (IGFBP7), liver fatty acid-binding protein (LFABP), and kidney injury molecule1 (Kim-1) were all increased along with the time after ROSC in both groups and lower in ECPR group compared with CCPR group. Especially, products of urinary TIMP and IGFBP levels (TIMP*IGFBP) were significantly lower at ROSC4 (0.58 ± 0.10 ng 2 /ml 2 vs. 1.18 ± 0.38 ng 2 /ml 2 , t = 4.33, P = 0.003) and ROSC6 (1.79 ± 0.45 ng 2 /ml 2 vs. 3.00 ± 0.44 ng 2 /ml 2 , t = 5.49, P < 0.001); urinary LFABP was significantly lower at ROSC6 (0.74 ± 0.06 pg/ml vs. 0.85 ± 0.11 pg/ml, t = 2.41, P = 0.033); and urinary Kim-1 was significantly lower at ROSC4 (0.66 ± 0.09 pg/ml vs. 0.83 ± 0.06 pg/ml, t = 3.99, P = 0.002) and ROSC6 (0.73 ± 0.12 pg/ml vs. 0.89 ± 0.08 pg/ml, t = 2.82, P = 0.016). Under light microscope and TEM, the morphological injures in renal tissues were found to be improved in ECPR group. Moreover, apoptosis was also alleviated in ECPR group., Conclusions: Compared with CCPR, ECMO improves survival rate and alleviates AKI in a swine model of CA. The mechanism of which might be via downregulating AKI biomarkers and apoptosis in kidney., Competing Interests: There are no conflicts of interest

Objective: High altitude is characterized by low oxygen pressure, resulting in multiple adaptive responses. Tibetans who have lived in the plateau for thousands of years have developed unique phenotypes, such as downregulation of the HIF pathway through EPAS1 and EGLN1 gene mutation. However, the changes of hemoglobin-oxygen affinity under hypoxia environment remain elusive., Methods: A blood cell analyzer and a blood oxygen analyzer were used to conduct routine blood tests and measure the oxygen affinity P 50 in in the Han population that rapidly entered the plateau (for 3-7 days), the plateau-acclimatized Han population (residing for 30 days on the plateau), the plateau Han population (more than 10 years on the plateau), and the Tibetan population., Results: The Han population that rapidly entered the plateau had increasing higher P 50 values, RBCs counts and hemoglobin (HGB) levels, while the acclimatized Han population, the plateau Han population and Tibetan all had significantly lower P 50 values. However, there were no significant differences in the RBCs counts and HGB levels between the plateau Han, Tibetan populations and the Han population of the plains., Discussion: The adaptability of the Tibetan and plateau Han populations to the plateau was mainly due to the strong affinity of HGB for oxygen, which provided sufficient oxygen for tissues and organs., Conclusions: The change of P 50 could be a feature of the adaptation to the plateau and to avoid altitude sickness, such as high-altitude polycythemia and dyspnea.

Objective: Spermatogenesis and oogenesis specific basic helix-loop-helix 1 (SOHLH1) and spermatogenesis and oogenesis specific basic helix-loop-helix 2 (SOHLH2) play essential roles for both spermatogenesis and oogenesis. The aim of this study was to evaluate the association of SOHLH1 and SOHLH2 single nucleotide polymorphisms (SNPs) with non-obstructive azoospermia (NOA) in the Chinese population., Study Design: In this study, we assessed 7 single nucleotide polymorphisms (SNPs) of SOHLH1 and SOHLH2 with Sequenom iplex technology in 361 NOA cases and 368 fertile controls., Results: We found that the SNPs rs1328626 and rs6563386 of SOHLH2 were significantly associated with NOA risk, of which, a protective effect of minor allele T of rs1328626 on NOA (P = 0.038, odds ratio [OR] = 0.799, 95% confidence interval [CI] = 0.645-0.988) and a significantly increased risk of the SNP rs6563386 with the minor allele G to NOA (P = 0.029, OR = 1.402, 95% CI = 1.034-1.9) were observed, respectively. Our data indicated that the haplotype GC of the variants rs1328626 and rs6563386 conferred a significantly increased risk of NOA (P = 0.031, OR = 1.397, 95% CI = 1.031-1.895). Moreover, we found the genotype distribution of rs1328641 was significantly associated with testes volume in the NOA patients (P = 0.022)., Conclusions: The polymorphisms rs1328626 and rs6563386 of the SOHLH2 gene would be the genetic risk factors for NOA in the Chinese population. The SNP rs1328641 might influence testes development in the NOA patients., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Background: Clinical trials assessing the effects of salt substitutes on blood pressure (BP) have reported mixed results., Objectives: A meta-analysis of randomized controlled trials was conducted to evaluate the effect of salt substitutes on BP, including systolic BP (SBP) and diastolic BP (DBP)., Design: Studies were identified via systematic searches of the PubMed, Embase, Cochrane Library, Wanfang Data, and the China National Knowledge Infrastructure databases through December 2013. Random-effects models were used to estimate pooled mean differences in SBP and DBP., Results: Six cohorts from 5 articles (1 trial enrolled 2 cohorts for independent intervention) consisting of 1974 participants were included. Pooled results showed that salt substitutes had a significant effect on SBP (mean difference: -4.9 mm Hg; 95% CI: -7.3, -2.5 mm Hg; P < 0.001) and DBP (mean difference: -1.5 mm Hg; 95% CI: -2.7, -0.3 mm Hg; P = 0.013). Significant heterogeneity was found for both SBP (I(2) = 76.7%) and DBP (I(2) = 65.8%). The sensitivity analysis indicated that the pooled effects of salt substitutes on SBP and DBP were robust to systematically dropping each trial. Furthermore, no evidence of significant publication bias from funnel plots or Egger's tests (P = 0.17 and 0.22 for SBP and DBP, respectively) was found., Conclusion: This meta-analysis showed that salt-substitution strategies are effective at lowering SBP and DBP, which supports a nutritional approach to preventing hypertension., (© 2014 American Society for Nutrition.)

Male infertility is a common and complex disease in urology and andrology, and for many years there has been no effective surgical treatment. With the emergence of microsurgery and assisted reproductive medicine (IVF/ICSI), rapid development has been achieved in the treatment of male infertility. The Center for Male Reproductive Medicine and Microsurgery at Weill Cornell Medical College of Cornell University has been playing an important leading role in developing microsurgical techniques for the management of male infertility. The development of microsurgical treatment of male infertility in China has experienced the 3 periods of emerging, making, and boosting ever since its systematic introduction from Weill Cornell Medical College 15 years ago. At present, many Chinese hospitals have adopted microsurgery in the management of male infertility, which has contributed to the initial establishment of a microsurgical treatment system for male infertility in China. However, some deficiencies do exist concerning microsurgical treatment of male infertility, as in normalized technical training programs for competent surgeons, unified criteria for evaluation of surgical outcomes, and detailed postoperative follow-up data. This article presents an overview on the 15-year development of microsurgical management of male infertility in China, points out the existing deficiencies, and offers some propositions for the promotion of its development.

Objective: To explore the optimal cut-off values of waist-to-height ratio (WHtR) for detecting the severe central obesity and low body weight in adult Chinese population., Methods: A total of 30 630 participants aged 35-59 years from different areas in mainland China were surveyed for cardiovascular diseases risk factors in two independent cross-sectional studies that carried out in 1992-1994 and 1998, respectively. Indices, such as sensitivity, specificity for hypertension, abnormal glucose, high serum total cholesterol, low serum high density lipoprotein cholesterol and clustering of risk factors (number ≥ 2) were calculated to evaluate the efficacy individual cut-off point of WHtR. The cut-off point value for obvious central obesity was fixed on the point whose specificity of the point was gathered more than 90%. And the cut-off point value to indicate low weight was determined by the percentile distribution of WHtR, at which the 5th percentile of point, both in male and female population. Based on the principle of convenient and practical for use, the optimal cut-off point values of WHtR for low weight and obvious central obesity were determined., Results: The cut-off values of WHtR to detect severe central obesity were 0.54 and 0.57 for men and women, respectively. Additionally, the cut-off points of WHtR for each of the 4 cardiovascular risk factors to evaluate the severity separately ranged from 0.54 to 0.55 in male, and ranged from 0.57 to 0.58 in female. The 5th percentile of WHtR, which was the point value of WHtR to indicate low body weight, was 0.40 in both male and female population., Conclusion: Our data suggest that the optimal cut-off value of WHtR for defining severe central obesity and low body weight should be 0.57 and 0.40, respectively.

Objective: To investigate the influence of uric acid on coronary artery calcification in the natural population in Beijing., Methods: From April to July 2012, 903 subjects from the natural population(aged 37-76 years for men, aged 42-76 years for women)in Xishan community, Beijing, were selected to accept a survey on the risk factors of cardiovascular. Blood tests and CT coronary artery calcium scans were carried out., Results: At the 1 Quartile(1 Q), 2 to 3 Quartile(2-3 Q)and 4 Quartile(4 Q)of uric acid levels, the prevalence rates of coronary artery calcium were 37.2% , 45.5% , 60.6% (P<0.001) and the coronary artery calcium scores were (109.7±333.1)AU, (133.9±356.9)AU, (200.8±459.4) AU (P < 0.001)respectively. Data from the univariate logistic regression analysis showed that with the increase of uric acid, the prevalence rates of coronary artery calcium also increased(OR2-3Q = 1.41, 95% CI:1.02-1.95, P = 0.040; OR4Q = 2.60, 95% CI:1.78-3.80, P < 0.001). However, the relationship between uric acid and coronary artery calcium disappeared when using the multivariate logistic regression analysis(OR2-3Q = 0.92, 95% CI: 0.60-1.43, P = 0.713;OR4Q = 1.38, 95% CI:0.80-2.39, P = 0.247)., Conclusion: Uric acid did not seem to be an independent risk factor for coronary artery calcium, although the prevalence and extent of coronary artery calcium increased along with the increasing trend of uric acid.

Objective: To perform genome-wide linkage analysis for an ethnic Han Chinese pedigree with schizophrenia in order to locate the susceptibility genes., Methods: Genomic DNA was extracted from 4 mL of peripheral blood using conventional phenol-chloroform method. Illumina Infinium Linkage 24 BeadChips chip was used for determining the genotypes through detection of single nucleotide polymorphisms (SNPs). After processing the raw data using Illumina BeadStudio software, two-point nonparametric linkage analysis and two-point parametric linkage analysis were performed with Merlin software., Results: By two-point nonparametric linkage analysis, 27 sites with high LOD scores (LOD=0.63-0.75, P U+003C 0.05) were identified. Among these, 3 SNPs(rs993694, rs992690 rs1861577) were located in 12p12.3 region, whilst the remainders were located in 4p12-q22 region. Two-point parametric linkage analysis under a dominant model has yielded almost identical results., Conclusion: Chromosomal regions 4p12-q22 and 12p12.3 probably contain susceptibility genes for schizophrenia.

Objective: To study the efficacy of waist circumference (WC) and waist-to-height ratio (WHtR) in predicting central obesity among the Chinese adult population., Methods: A total of 30 630 participants aged 35 - 59 from different areas in mainland China were surveyed for the risk factors of cardiovascular diseases (CVD) in two independent cross-sectional studies that were carried out in 1992 - 1994 and 1998, respectively. In subgroups with different heights, consistency analysis for central obesity diagnosed by WHtR (≥ 0.50) and WC (≥ 85 cm for men, ≥ 80 cm for women) were conducted. Sensitivity and specificity for predicting the clustering of risk factors (number ≥ 2) would include hypertension, abnormal glucose, high serum total cholesterol and low serum high density lipoprotein cholesterol and they were also calculated to evaluate the efficacy of prediction, with the two indices in the different height subgroups as well., Results: The consistency of diagnosis on central obesity by WC and WHtR was good in the whole population (the Kappa value was 0.805 in men and 0.816 in women), but poor (all Kappa values ≤ 0.6) for those with tall (men's height ≥ 180 cm and women's height ≥ 170 cm) or with short statures (men's height < 160 cm, and women's height < 150 cm). Sensitivity in the shorty subgroups and specificity in the tall subgroups appeared poor in both genders, by using WC criteria to predict the clustering of risk factors. However, the sensitivity (ranged from 56.1% to 64.1% for men and 64.7% to 73.2% for women) and specificity (from 70.0% to 74.5% for men, 59.2% to 75.9% for women) seemed good and stable in all the subgroups as well as in both genders by using the WHtR criteria., Conclusion: WC and WHtR could both be applied in predicting the clustering of risk factors of CVD and in evaluating the central obesity in the whole population. With satisfactory efficacy, WHtR seemed to be better than WC in the prediction of central obesity, both in men or women with tall or short statures.

Objective: To study the association between 5-HTTVNTR polymorphism and posttraumatic stress disorder (PTSD) in Chinese Han adolescents after the Wenchuan Earthquake, and investigation of the genetic mechanism of PTSD., Methods: Polymerase chain reaction (PCR) was used to detect the distributive frequency of 5-HTTVNTR polymorphism of 236 PTSD patients (patient group) and 234 normal people (control group), Plink version 1.07 was used to analyze the genotyping results., Results: The frequency of 5-HTTVNTR allele 12 in PTSD group was significantly higher than control group (93.2% vs. 88.9%, chi2 = 5.42, P = 0.020). The 12/12 genotype in PTSD group and control group was 88.1% and 79.7%; 10/12 genotype was 10.2% and 19.6%; 10/10 genotype was 1.7% and 1.7%. The distributive frequency of all three genotypes (12/12, 10/12, 10/10) showed statistically significant (P = 0.023)., Conclusion: The allele 12 of 5-HTTVNTR may increase the risk of PTSD in Chinese Han adolescents, 12/12 genotype may be the susceptibility gene, and heterozygote 10/12 may act as the protective factor of PTSD.

Objective: To explore the relationship between different blood pressure levels and peripheral arterial disease (PAD) assessed by ankle-brachial index (ABI)., Methods: Data including ABI,blood pressure, health history, medication use, blood biochemistry and physical examinations derived from 15 817 subjects from 9 areas throughout China were analyzed. Univariate and multivariate adjusted Logistic regression analyses were used for the data analyses., Results: Blood pressure levels were classified into 5 levels as normal blood pressure, high normal blood pressure, primary hypertension, secondary hypertension and the third grade of hypertension. With the increasing of blood pressure levels, the risk of PAD gradually increased (Ptrend<0.05). In comparison with normal blood pressure group, the ORs of PAD for the other groups were 1.10 (95%CI: 0.93-1.29), 1.17 (95% CI: 0.97-1.40), 1.91 (95% CI: 1.55-2.37), and 2.64 (95% CI: 1.99-3.49), respectively. After adjusting for gender(only for total population), age, urban/rural, smoke, obesity/overweight, the history of hypercholesterolemia and diabetes, the ORs were 1.11 (95%CI: 0.94-1.32), 1.13 (95% CI: 0.93-1.38), 1.85(95% CI: 1.47-2.33), and 2.66 (95% CI: 1.98-3.57) (Ptrend<0.05)., Conclusion: PAD risk increases in proportion with the increasing blood pressure level.

Objective: to explore the relationship between occupational physical activity and peripheral arterial disease (PAD)assessed by ankle-brachial index (ABI)., Methods: data including ABI, occupational physical activity intensity, health history, medication use, blood biochemistry and physical examinations derived from 16 446 subjects from 9 areas throughout China were analyzed. Univariate and multivariate adjusted logistic regression analysis were used for the data analyses., Results: occupational physical activity intensity was classified into 5 levels as jobless, very light, light, moderate and heavy intensity. With the increasing of physical activity intensity, the risk of PAD gradually decreased (P(trend) < 0.05). In comparison with jobless group, the ORs of PAD for other groups were 0.65 (95%CI: 0.52, 0.82), 0.70 (95%CI: 0.56, 0.87), 0.57 (95%CI: 0.44, 0.73), 0.65 (95%CI: 0.53, 0.80) respectively. After adjusting for gender, age, smoke, obesity/overweight, the history of hypertension, hypercholesterolemia, diabetes, cardiovascular disease and stroke, the ORs were 1.02 (95%CI: 0.80, 1.31), 0.91 (95%CI: 0.72, 1.15), 0.92 (95%CI: 0.70, 1.19), 0.90 (95%CI: 0.72, 1.12) (P(trend) < 0.05)., Conclusion: PAD risk reduced in proportion with increasing occupational physical activity.

Objective: To investigate the association between polymorphism of cytochrome P450 subfamily XIA polypeptide 1 (CYP11A1) gene and polycystic ovarian syndrome (PCOS) in Chinese population., Methods: From May 2005 to Dec. 2008, 290 PCOS cases treated in the First affiliated hospital of Anhui Medical University matched with 344 reproductive women as controls were enrolled in this study. Genotypes of 7 tagging single nucleotide polymorphisms (tSNP, rs12438594, rs4077582, rs9806234, rs16968477, rs4887139, rs1843090, rs11632698) covering CYP11A1 gene (r(2) > or = 0.8) and 3 microsatellite markers (D15S1547, D16S520, D15S1546) were chosed from the phase II database of Han population in HapMap data. Genotype and frequency of allele were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and haplotype of gene polymorphism were analyzed in 290 PCOS cases and 344 controls., Results: Among 7 tSNPs and 3 microsatellite markers, the frequency of rs4077582, D15S1547, D15S1546 and rs11632698 between two groups reached statistical difference (P = 0.010, 0.044, 0.018 and 0.026). The allele frequency of rs4077582, rs4887139, rs1843090, D15S1547 and D16S520 showed significant difference between two groups (P = 0.002, 0.048, 0.030, 0.001 and 0.024). Among 5 haplotype of CYP11A1 (ACGCA13/6/9AG, ACGTA16/6/11AA, GCACG12/8/8AA, GTACA14/4/7GG, GTGCA13/6/7AG), the frequency of GTACA14/4/7GG and ACGCA13/6/9AG were 7.8% (45/580) and 25.3% (147/580) in PCOS group and 11.9% and 19.6% in control group, which showed statistical difference (P < 0.05). There was no significant difference in the level of serum androgen at difference genotype from rs4077582 between two groups (P > 0.05)., Conclusion: The polymorphism of CYP11A1 gene was associated with PCOS, however, the relationship between gene sequence covered by tSNP/microsatellite markers and hyperandrogenism of PCOS should be further investigated.

Objective: To evaluate the association between resting heart rate (HR) and all-cause death and coronary heart disease (CHD) events in the Chinese cohort., Methods: Data were obtained from the PRC-USA Cooperative Study on Cardiovascular and Cardiopulmonary Epidemiology. Baseline screen surveys were conducted in 1983 and 1984 from people aged 35 to 59 years living in urban or rural areas of Beijing and Guangzhou. Follow-up visits were performed for end point events of all-cause death and first CHD events every two years till 2005. Resting HR was determined from 5 consecutive intervals between R waves on the 12-lead electrocardiogram., Results: A total of 9856 (4805 males) people were included in the study and the mean follow up duration was 16.2 years. There were 1523 deaths, including 200 CHD events during the follow up period. Mean resting HR was 67.9 beat per minute (bpm) in men and 71.6 bpm in women respectively which had a trend to increase with aging. Cox Proportional Hazards model indicated the relative risk of all-cause death increased constantly with the increase of HR percentile after control of age, fasting glucose, serum cholesterol, serum triglyceride, body mass index, systolic blood pressure and diastolic blood pressure. With HR 60-89 bpm as control group, the relative risk and 95% confidence interval in group HR < 50 bpm, 50 - 59 bpm, 90 - 99 bpm and > or = 100 bpm were 0.76 (0.49 - 1.17), 0.87 (0.75 - 1.02), 1.33 (1.06 - 1.68), 1.48 (1.03 - 2.14) respectively. However there was no significant correlation between HR and CHD events in studied population., Conclusion: The risk of total death increased significantly in people with HR > or = 90 bpm suggesting higher resting heart rate might be an independent risk factor for all-cause death in the Chinese population.

Objective: To investigate the epidemiological changes of erectile dysfunction (ED) patients in the past five years., Methods: In 2003 and 2008, we conducted two questionnaire investigations on the epidemiological changes of ED outpatients in 11 Chinese cities in such aspects as age, disease course, ED severity, smoking and drinking habits, accompanying hypertension, diabetes and coronary heart disease (CHD), and sexual intercourse satisfaction., Results: According to the valid copies of the questionnaire collected (808 in 2003 and 858 in 2008), the age pattern of the ED patients hardly changed in the past five years, over 60% aged 30 - 50 years. Compared with the results obtained in 2003, the second investigation showed obvious increases in the following numbers of the ED patients: by 13% in those with longer disease courses (5 - 10 yr), from 24.1 to 42.9% in those with moderate ED, from 20.4 to 29.9% in those with severe ED, by at least 10% in those with smoking and drinking habits, from 11.5 to 16.2% in those with hypertension, from 9.4 to 13.5% in those with diabetes, and from 57.6 to 73.3% in those without sexual satisfaction, while the number of those with CHD did not change significantly., Conclusion: Increased unhealthy living habits and erectile function impairing diseases have added to the incidence and severity of ED. There is still much work to be done in the prevention and early treatment of ED.

Objective: To better understand the similarities and disparities between the newly issued Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (CG) and exist relevant guidelines by comparing the actual effect on assessment of current clinical management of dyslipidemia in China, in order to promote the use of CG in clinical practice., Methods: Study participants included 2094 patients from the Second Multi-center Survey of Dyslipidemia Management in China. The goal attainment rate was defined as the proportion of participants who achieved their target low-density lipoprotein cholesterol (LDL-C) levels specified by CG, the Chinese Expert Recommendations on Prevention and Treatment of Dyslipidemia (CR), the updated Adult Treatment Panel III of the National Cholesterol Education Program (ATP III), respectively., Results: (1) The overall goal attainment rates were 62%, 34% and 50% according to CR, ATP III and CG, respectively. (2) With reference to the CG risk stratifications, the risk of nearly 40% of high risk patients and all very high risk patients were underestimated by CR, whereas the risk of more than 40% of patients in any risk groups were overestimated by ATP III. (3) The disparities in risk stratifications accounted for 90% of the difference in overall goal attainment rate (12%) between CR and CG, while the disparities in the risk stratifications and that in LDL-C target levels were responsible for 29% and 71% of the difference (16%) , respectively, between ATP III and CG., Conclusions: There were significant differences in goal attainment rates assessed by different clinical practice guidelines. CG is more aggressive in risk stratification than CR but simpler and easier to use than ATP III, and hence more appropriate to Chinese patients and should be widely promoted in China.

Objective: To explore the profile and related factors of carotid femoral pulse wave velocity (CFPWV) in a community-based Beijing population of middle and old age., Methods: A total of 1519 residents aged 44 - 79 years old from Shijingshan district, Beijing, were recruited for the cardiovascular risk factor survey and CFPWV measurements. One way ANOVA, pearson correlation and partial correlation, stepwise multi-linear regression were used for the data analysis., Results: (1) The age-adjusted mean value of CFPWV was significantly higher in men than that in women (11.4 vs. 11.1 m/s, P = 0.007). CFPWV increased significantly with age both for men and women (all P < 0.01). (2) After adjusting for age and gender, CFPWV was significantly higher in people with hypertension, diabetes and higher heart rate (> 70 beats/min) than people without these factors (P < 0.01). (3) CFPWV significantly correlated with age, systolic blood pressure, diastolic blood pressure, fasting blood glucose and heart rate (correlation coefficient ranged from 0.12 - 0.46, all P < 0.01). In female, CFPWV was positively correlated with total cholesterol and triglycerides (correlation coefficient 0.11 and 0.13, all P < 0.01). Multi-linear regression analysis showed age, gender, systolic blood pressure, diastolic blood pressure, fasting blood glucose and heart rate were independent predictors of CFPWV., Conclusion: In this middle and old age Chinese population, age, sex, systolic blood pressure, diastolic blood pressure, fasting blood glucose and heart rate but not HDL-cholesterol and body mass index were associated with CFPWV.

Objective: To investigate the correlation between Ureaplasma urealyticum infection and infertility in Chinese males., Methods: According to the results of the heterogeneity test, a comprehensive quantitative analysis was made of 49 papers on Ureaplasma urealyticum infection and Chinese male infertility by RevMan 4.2.2. The impacts of different sample volumes on the research findings were compared, and the sensitivities of culture and PCR detections analyzed respectively., Results: Ureaplasma urealyticum had a significant negative impact on Chinese male fertility. Based on different samples of literature, two rounds of screening and analysis were carried out and two different conclusions derived. The first was OR = 4.43 (95% CI: 3.77-5.22), with the OR values of culture and PCR detections as 4.25 (95% CI: 3.59-5.03) and 5.35 (95% CI: 3.37-8.47), and the second was OR = 4.28 (95% CI: 3.52-5.20), with the OR values of culture and PCR detections as 4.24 (95% CI: 3.41-5.28) and 4.42 (95% CI: 2.73-7.17)., Conclusion: There is a significant correlation between Ureaplasma urealyticum and Chinese male infertility. The conclusion of study is significantly influenced by the sample volume, which should be reasonably designed. The sensitivity of PCR detection is higher than that of culture detection.

Objective: To investigate the psychological stress in the survivors of the May 12, 2008 Wenchuan earthquake transferred to Guangzhou for treatment, and explore the association between the psychological stress and the physical injuries related to the earthquake to promote both the physical and psychological recoveries of the survivors., Methods: Fifty-five earthquake survivors, including 27 with 28 without physical injuries, were transferred in our hospital 1 week after the earthquake. The Posttraumatic Stress Disorder (PTSD) Checklist-Civilian version (PCL-C) and the Self Reporting Questionnaire (SRQ) were used to investigate the psychological stress in these survivors., Results: The earthquake caused serious psychological stress in these survivors, and 43.63% of the survivors had high PCL-C scores (50 or above) and 78.18% had high SRQ scores (over 7), with 41.82% having high scores for both PCL-C and SRQ. The survivors with physical injuries generally had high PCL-C and SRQ scores (49.780-/+14.503 and 12.110-/+4.619, respectively), which, however, were not statistically different from the scores of the survivors without injuries (44.460-/+13.206 and 10.460-/+5.000, respectively, P>0.05). The injured survivors showed high scores for the subscales of persistent avoidance symptoms and of anger and irritability, in which the item scores for "efforts to avoid activities or places that arouse recollections of the earthquake" and "feeling of detachment or estrangement from others" were significantly different between the survivor with physical injuries and those without (P=0.034 and 0.018, respectively)., Conclusion: The Wenchuan earthquake causes serious psychological stress in the survivors, and the wounded are more inclined to have persistent avoidance symptoms and enhanced irritability. In addition to the care of the physical injuries, psychological counseling and social support may help ameliorate the psychological trauma in the survivors and reduce the incidence of PTSD.

Objective: To assess the relationship between parental history and the incidence of stroke in Chinese populations., Methods: A total of 15,131 individuals (7015 men and 8116 women, aged from 35 to 59 years) in China were enrolled and followed up from 1992 to 2005. Information on the parental history of stroke of the participants was collected at baseline study under face to face interview. Individuals were divided into three groups according to their parental history of hypertension: those with no parental history of hypertension (Group 1), those with only one parent having the history of hypertension (Group 2) and those with both parents having the history of hypertension (Group 3). The hazard ratio and its 95% confidence interval were calculated using the Cox proportional hazard model., Results: There were 370 stroke events during 163 858 person-years of observation. After adjusting for age and sex, the hazard ratioon stroke for group 1, group 2 and group 3 were 1.00, 1.74 (1.33-2.29), 3.61 (1.86-7.01), respectively. After adjusting for age, sex, smoking, drinking, serum total cholesterol (TC), high density lipid cholesterol (HDL-C), fasting glucose, body mass index (BMI) and systolic blood pressure (SBP) in the model, the hazard ratio for stroke of those three groups were 1.00, 1.34 (1.02-1.77), 2.50 (1.29-4.87), respectively., Conclusion: Individuals with parental history of stroke had a higher risk of stroke, and this was especially true for those with both parents having the history of stroke.

Objective: To compare the clinical management of hyperlipidemia and goal attainment rate in year 2000 to year 2004 - 2006 in China., Method: Data from 2 retrospective surveys (2000 and 2004 - 2006) on clinical management of hyperlipidemia and goal attainment rate were analyzed. A total of 2136 patients were recruited in the 1st survey in year 2000 and 539 patients in the 2nd survey in year 2004 - 2006 from 25 and 21 tertiary hospitals of 12 metropolitan cities. Eligible patients had hyperlipidemia and received lipid-lowering therapy for more than 2 months at the time of survey. Serum lipid levels before and after treatment were analyzed and the goal attainment rate post therapy, defined according to the Chinese National Recommendations for Prevention and Treatment of Dyslipidaemia published in 1997, was calculated., Results: Clinical characteristics were comparable in patients from the 1st and 2nd survey: age (60.9 and 60.0 years), males (47.2% and 49.3%), type of lipid disorder (mixed hyperlipidemia 62.5% and 66.8%), and patients without coronary artery disease (CAD 61.2% and 68.6%). The percent of statins use was significantly higher in the 2nd survey than in the 1st survey (79.2% vs. 70.3%, P < 0.01). The goal attainment rate was significantly higher in the 2nd survey than in the 1st survey (39.9% vs. 26.6% for all patients, 40.2% vs. 28.8% for hypercholesterolaemia, 39.7% vs. 25.0% for mixed hyperlipidemia, 45.9% vs. 31.7 for patients without CAD, 26.7% vs. 16.6% for patients with CAD, 42.2% vs. 30.1% for patients using statins, and 38.5% vs. 28.3% for patients with diet control, all P value < 0.01)., Conclusions: Although the goal attainment rate has been significantly increased in treated hyperlipidemia patients over recent 5 years in China, it is still far from optimal as suggested by the recommendations. Further efforts should be made to increase the goal attainment rate in patients receiving lipid-lowering therapy.

Objective: To evaluate the applicability of developed prediction models of ischemic cardiovascular diseases (ICVD) in Chinese to other Chinese populations., Method: We used the independent prospective cohort established in early 1990's from China Multi-Center Collaborative Study of Cardiovascular Epidemiology (MUCA), as the validation cohort, to test the hypothesis. The area under ROC curve (AUC) based on the application of the Cox optimal model and the simplified model to the validation cohort were calculated and to test the ability of the prediction models to discriminate events from nonevents. Applicability was evaluated by comparing the mean probability estimates in each decile of probability in the validation cohort with the observed incidence with the Hosmer-Lemeshow test., Results: The validation cohort enrolled a total of 17 329 men and women aged 35 to 59 years baseline 1992 - 1994. In this paper, we used data from the remaining 15 100 participants after excluding 2229 subjects for at missing value of risk factors. During 11-year follow up of the cohort, there were 347 ICVD events (206 for men and 141 for women), including 83 coronary heart disease events (56 men and 27 women) and 268 ischemic strokes (154 men and 114 women). ROC curves for men and women showed good and almost identical discrimination for optimal model (the AUCs (95% CI) were 0.796 (0.762 - 0.829) for men and 0.791 (0.755 - 0.828) for women), simplified model (the AUCs (95% CI) were 0.792 (0.758 - 0.825) for men and 0.783 (0.746 - 0.821) for women) and score system (the AUCs (95% CI) were 0.791 (0.757 - 0.825) for men and 0.779 (0.741 - 0.817) for women) in the validation cohort. The predicted 10-year risk of ICVD by optimal models and observed incidence of ICVD in the validation cohort in each decile were compared. Hosmer-Lemeshow chi2 was 3.7 for men (P = 0.879) and 27.7 for women (P < 0.001). Whereas the largest difference between the observed rate and the predicted rate was only 1%., Conclusions: The prediction models for estimating 10-year risk of ICVD had satisfied predictive capability when they were applied to the validation cohort and are applicable to other Chinese populations.

Objective: To establish cut offs and risk stratification of dyslipidemia in Chinese adults., Methods: Data from 2 widely cited studies: the PRC-US Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology and the China Multi-Provincial Cardiovascular Cohort Study, with a total of 40 719 Chinese adults, age 35 to 64 at baseline, about half men and half women, followed up for a total of 345 140.5 person years, were used to analyze the relationship between dyslipidemia and ischemic cardiovascular diseases (ICVD, including coronary heart events and ischemic stroke events) using a common data analysis protocol co-developed by the scientists from the 2 studies. The relative risk was estimated with the Cox proportional hazard model adjusting for other conventional cardiovascular risk factors. The 10-year absolute risk of ICVD for a 50 years-old person at different risk factor combinations was used to develop the risk stratification., Results: (1) There was a continuous linear relationship between baseline TC (or LDL-C) and ICVD risk without a threshold; (2) The incidence (absolute risk) of ICVD was similar for LDL-C < 3.37 mmol/L (130 mg/dl) and for TC < 5.18 mmol/L (200 mg/dl); and similar for LDL-C < 4.14 mmol/L (160 mg/dl) and for TC < 6.22 mmol/L (240 mg/dl); (3) The absolute ICVD risk for TC > or = 6.22 mmol/L (240 mg/dl) was slightly less but close to that for grade 1 hypertension; (4) ICVD risk increased as HDL-C decreased; (5) No significant association was found between baseline TG and subsequent ICVD; (6) At any TC level, the absolute ICVD risk for those having only hypertension was higher than that for those having 3 other risk factors., Conclusion: The cut offs for diagnosis of dyslipidemia in Chinese adults can refer to those used in relevant international guidelines: TC < 5.18 mmol/L (200 mg/dl) [or LDL-C < 3.37 mmol/L (130 mg/dl)] as normal, TC 5.18 - 6.19 mmol/L (200 - 239 mg/dl) [or LDL-C 3.37 - 4.12 mmol/L (130 - 159 mg/dl)] as borderline high, and TC > or = 6.22 mmol/L (240 mg/dl) [or LDL-C > or = 4.14 mmol/L (160 mg/dl)] as high; HDL-C < 1.04 mmol/L (40 mg/dl) as low, 1.04 - 1.53 mmol/L (40 - 59 mg/dl) as normal and > or = 1.55 mmol/L (60 mg/dl) as optimal. In risk stratification scheme, hypertension plays a role that equals to that of any other 3 risk factors.

Objective: To examine the associations between physical activity measures [metabolic equivalents of energy expenditure (MET) per hour per day] and ischemic cardiovascular diseases (ICVD) in Chinese population., Methods: A survey on cardiovascular risk factors was conducted in different areas of China in fall 1998. People aged 35 to 59 but without a history of coronary heart and stroke at baseline were prospectively followed and 11 849 subjects whose information were complete at the end of second follow-up were valid. Cox regression was used to estimate the hazard ratios (HRs) for incident ischemic cardiovascular diseases and the different measures of physical activity., Results: During a mean follow-up period of 5.9 years, 84 incident ischemic cardiovascular events were ascertained. We examined the HRs of ischemic cardiovascular events for a 1-unit change in METs value, which were included in the models as continuous variable. There were negative association of METs values found with ischemic cardiovascular events in total, urban, rural, male and female subjects, and statistical significance in the urban (HRs = 0.22, 95% CI: 0.05-0.95) but the association was weakened after adjustment for demographic factors. When further adjustment for other intermediate factors, the significance in the urban was again attenuated. When the urban males and females, rural males and females were divided into 3 groups according to their respective tertiles and the combination of different population groups, the factors of male/female and urban/ rural were equally distributed in different groups, and no more adjustment in the Cox model. The multivariate - adjusted (age and education attainment) HRs associated with the tertiles, from lowest to highest, were: 1, 1.03 and 0.65 (P(trend) = 0.170) for the total, 1, 0.72 and 0.64 for the urban, 1, 1.49 and 0.72 for the rural, 1, 1.05 and 0.59 for men, 1, 0.90 and 0.84 for women., Conclusion: The totality of our findings pointed to METs per hour per day seemed to be weakly associated with a reduction in ischemic cardiovascular events incidence among urban middle-aged adults.

Objective: To assess the relationship between parental history of hypertension and the incidence of cardiovascular disease in Chinese populations., Methods: A total of 15 131 individuals (7015 men and 8116 women, aged from 35 to 59 years) in China were enrolled and followed up from 1992 to 2005. The information on the parental history of hypertension of the participants was collected. The individuals were divided into three groups according to their parental history of hypertension: those without parental history of hypertension (group 1), those with one parent history of hypertension (group 2) and those with both parents history of hypertension (group 3). The hazard ratio and its 95% confidence interval were calculated using the Cox proportional hazard model., Results: There were 448 cardiovascular events (including 82 cardiac events and 370 stroke events and 4 with both cardiac and stroke events) during the 163 858 person-years of observation. After adjusting for age, smoking and drinking, the hazard ratio for cardiovascular disease for group 1, group 2 and group 3 were 1.00, 1.34 (1.01 - 1.78), 2.58 (1.62 - 4.11) in men respectively and 1.00, 1.77 (1.27 - 2.45), 2.55 (1.44 - 4.54) in women respectively. After further adjusting for serum total cholesterol (TC), high density lipid cholesterol (HDL-C), fasting glucose, body mass index (BMI) and systolic blood pressure (SBP) in the model, the hazard ratio for cardiovascular disease for those three groups were 1.00, 1.01 (0.76 - 1.35), 1.72 (1.07 - 2.75) in men respectively and 1.00, 1.31 (0.94 - 1.84), 1.76 (0.98 - 3.15) in women respectively., Conclusion: The individuals with parental history of hypertension have a higher risk of cardiovascular disease, especially for those with both parents history of hypertension.

Objective: To determine the prevalence of impaired fasting glucose (IFG), diabetes mellitus(DM), rates of awareness, treatment and control of DM in 14 Chinese subpopulations and the trends of development in recent years., Methods: We collected data on history regarding DM and fasting serum glucose in 14 Chinese subpopulations aged 35 to 59 in 1998, under cluster sampling. In 4 out of the 14 subpopulation samples, a similar survey using same methods in 1993 - 1994 was carried out. IFG and DM were diagnosed according to the WHO criteria., Results: The age-standardized prevalence rates of IFG and DM were from 0.5% to 15.6% (mean: 4.8%) and from 0.2% to 10.6% (mean: 4.3%) for the whole 14 subpopulations in 1998 which were not different between men and women, but higher in urban than in rural (P < 0.01), but increased with age (P < 0.01). The rates of awareness,treatment and control of DM were from 0% to 46.2% (mean: 33.3%), from 0% to 46.2% (mean: 27.2%), and from 0% to 15.4% (mean: 9.7%), which were significantly higher in women than in men (P < 0.01), higher in urban than in rural (P = 0.031), and higher in older participants (P < 0.05), but not much different in the levels of education. The rate of treatment in patients with awareness of DM and the rate of control in patients with treated DM were 81.6% and 35.6% respectively, which were not different between men and women, urban and rural or among different age groups. The mean prevalence of DM increased from 3.8% in 1993 - 1994 to 4.6% in 1998 (P = 0.037). The rates of awareness, treatment and control of DM had an increasing trends but with no significant differences between years 1993 - 1994 and 1998., Conclusion: The prevalence of DM in 14 Chinese subpopulations exhibited no differences between men and women, but showing significant differences among areas and an increasing trend in the recent years. The rates of awareness, treatment, and control were still relatively low. To improve the efficacy of screening program and treatment seemed to be the two key issues in prevention and control of DM in China.

Objective: To assess the relationship between incidence of ischemic stroke and alcohol consumption., Methods: The information on alcohol consumption and other cardiovascular risk factors such as SBP, DBP, TC was collected among 10 populations in northern and southern parts of China according to the international standardized methods. A total number of 30 560 men and women aged 35 - 59 were enrolled and followed up for an average of 15.2 years. Complete data on 12,352 men was analyzed., Results: The risk on ischemic stroke incidence showed a graded association. Compared with nondrinkers, the relative risks of incidence of ischemic stroke for those who drank alcohol less then 15 gram per day, 15-30 gram per day, 30-60 gram per day, above 60 gram per day were 0.86 (95% confidence interval 0.57-1.27), 1.20 (0.87-1.65), 1.26 (0.86-1.84) and 1.96 (1.30-2.93), respectively., Conclusion: Our study revealed that in male Chinese, heavy alcohol intake significantly increased the risk while mild alcohol drinking did not increase the risk of ischemic stroke.

Objective: To understand full-length sequence of HBV isolated from high incidence hepatocellular carcinoma area-Longan county, Guangxi., Methods: The nested polymerase chain reaction (nPCR) was used for amplifying the whole HBV DNA in sera of asymptomatic carriers. The products were sequenced by clone sequencing and homological analysis., Results: This isolate contained 3 215 bases. The genotype was C and the serotype was adw. There were 40 point mutations in polymerase gene which made 11 amino acids change. There were 11,2 and 3 point mutations in PreS1, PreS2 and S gene respectively which made 3,1,1, amino acids change. Six point mutations including the double mutations (nt 1762 A to T, 1764 G to A) were found in X gene leading to 4 amino acids change. There were 13 point mutations in C gene which made 2 amino acids change. No mutation was found in a determinant and Pre C. The isolate was quite close to the isolate from Vietnamese in evolution while far from the genotype C isolates from Shanghai, Beijing and Tibet., Conclusion: No special sequence was found in the isolate from high incidence hepatocellular carcinoma area, Longan county, Guangxi.

Objective: The aim of the study was to investigate the association between tea consumption and stroke., Methods: A cross sectional study was conducted in autumn, 1998. The subjects were from 12 provinces in China. 15 groups of populations were selected by cluster randomized sampling and each group had about 1000 persons, aged from 35 to 60 years old. 14 212 subjects had complete data for analysis. Data regarding tea drinking would include drinking status, dose and type of teas. Logistic regression was used to analyze the association between tea consumption and stroke., Results: There was a strong inverse correlation between tea drinking and stroke after adjusting other risk factors of stroke (P < 0.05). The odds ratio (OR) of stroke was 0.60 [95% confidence interval (CI): 0.42 - 0.85] for subjects who drank tea compared to those who did not. Increased amount of tea consumption per month was associated with decreased stroke prevalence. The association for tea consumption over 150 gram per month and stroke was statistically significant (P < 0.05) with an OR value of 0.56 (95% CI: 0.36 - 0.89). Analytical results indicated that the OR value was 0.24 (95% CI: 0.06 - 1.01) for black tea and other tea (P = 0.05). The OR value was 0.35 (95% CI: 0.18 - 0.72) for green tea (P < 0.01), and 0.75 (95% CI: 0.51 - 1.11) for jasmine tea (P > 0.05)., Conclusion: Tea drinking was independently associated with prevalence of stroke which might play a role in the prevention of the disease.

Objective: To analyze the trends in prevalence, awareness, treatment, control of hypertension among middle-aged Chinese., Methods: The study comprised two cross-sectional surveys including urban and rural residents, manual workers, farmers and fishermen in different southern and northern parts of China. There were 13 populations under research with comparable data. 18 746 (in 1992 - 1994) and 13 504 (in 1998) participants, aged 35 through 59 years, equal number of men and women, were examined in each of the surveys, on blood pressure measurement, in 1992 - 1994 and in 1998. Hypertension was defined as systolic pressure >/= 140 mm Hg, and/or diastolic pressure >/= 90 mm Hg, and/or reported treatment with antihypertensive medications. Awareness and treatment on hypertension were assessed with standardized questions. Hypertension control was defined as measured blood pressure of less than 140/90 mm Hg. Awareness, treatment and control of hypertension were standardized according to the WHO world standard population., Results: In 1998, 24.0% of participants had hypertension, an increase of 2.3% from 1992 - 1994. Prevalence of hypertension was higher in urban area (25.4%), increasing with age, and higher in men among the younger groups and lower in women among the older groups. Overall, in 1998, 42.6% were aware of their hypertensive status (increase of 5.3%), 31.3% were treated (increase of 3.8%), and the rate under control was 6.0% (increase of 2.6%). The rates of awareness, treatment and control, which tended to increase with age except those aged above 55 years, which were higher in urban areas and women compared with rural areas and men. For people with treated hypertension, the rates of those under control were ranged from 12.7% in 1992 - 1994, to 19.9% in 1998., Conclusion: Prevalence of hypertension was increasing in China, while the rates of control, although improving, continued to be low. This implied that effective public measures needed to be developed to enhance the awareness and rates of treatment.

Background and Purpose: The goal of this article is to clarify the proportion of stroke subtypes in China, where stoke is the most common cause of death., Methods: A total of 16,031 first-ever strokes in subjects >or=25 years of age were identified in 1991 to 2000 from 17 Chinese populations through a community-based cardiovascular disease surveillance program in the China Multicenter Collaborative Study of Cardiovascular Epidemiology. World Health Organization diagnosis criteria were used for classification of stroke subtypes., Results: CT scan rate of stroke cases reached a satisfactorily high level only after 1996 in the study populations. In 8268 first-ever stroke events from 10 populations with CT scan rate >75% in 1996 to 2000, 1.8% were subarachnoid hemorrhage, 27.5% were intracerebral hemorrhage, 62.4% were cerebral infarction, and 8.3% were undetermined stroke. The proportion of intracerebral hemorrhage varied from 17.1% to 39.4% and that for cerebral infarction varied from 45.5% to 75.9% from population to population. The ratio of ischemic to hemorrhagic stroke ranged from 1.1 to 3.9 and averaged 2.0). The 28-day fatality rate was 33.3% for subarachnoid hemorrhage, 49.4% for intracerebral hemorrhage, 16.9% for cerebral infarction, and 64.6% for undetermined stroke., Conclusions: In our study, ischemic stroke was more frequent and its proportion was higher than hemorrhagic stroke in Chinese populations. Although hemorrhagic stroke was more frequent in Chinese than in Western populations, the variation in the proportion of stroke subtypes among Chinese populations could be as large as or larger than that between Chinese and Western populations.

Objective: To study the inter-population and inter-individual effect of education attainment on men's behavior of smoking in China., Method: A cross-sectional study of 7,415 men, aged 35-59 years, from 15 population samples was carried out in 1998. Information on education attainment and smoking was collected by standardized questionnaires. The population samples were divided into 2 groups according to the proportion of men with college or above education attainment: group I had an average 25.8% of men with college or above education attainment, and group II had an average 2.0% of men with college or above education attainment., Results: (1) In group I, the percent of ever smokers, current smokers, deeper smoker, and ever smokers with cessation due to disease and the average number of cigarettes per day for the smokers were significantly lower than in group II (66.2%, 56.4%, 34.4%, 47.8%, 17.2 cigarettes/day vs 75.8%, 64.4%, 40.3%, 58.4%, 20.4 cigarettes/day, respectively). (2) The percent of current smokers and the number of cigarettes decreased with increased education attainment in both groups. Taking the men with college or above education attainment in group I as reference, the odd ratio of smoking for those with high school education in group I was 1.8 (95% CI: 1.5-2.1), for those with middle school or lower education in group I was 2.0(95% CI: 1.7-2.5), for those with college or above education in group II was 1.4(95% CI: 0.9-2.1), for those with high school education in group II was 1.7(95% CI: 1.4-2.1), and for those with middle school or lower education in group II was 2.4 (95% CI: 2.1-2.8)., Conclusion: Smoking behavior was affected by both individual education attainment and population education level. Smoking cessation measures should be focused on the development of better anti-smoking environment, such as education development, health promotion, etc.