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The deterioration of water quality has become a primary environmental concern worldwide. Understanding the status of water quality and identifying the influencing factors are important for water resources management. However, reported analyses have mostly been conducted in small and focused areas. It is still unclear if factors driving spatial variation in water quality would be different in extended spatial scales. In this paper, we analyzed spatial pattern of inland surface water quality in China using a dataset with four water quality parameters (i.e., pH, DO, NH4+-N and CODMn) and the water quality level. We tested the effects of anthropogenic (i.e., land use and socio-economic) and natural (i.e., climatic and topographic) factors on spatial variation in water quality. The study concluded that the overall inland surface water quality in China was at level III (fair). Water quality level was strongly correlated with CODMn and NH4+-N concentration. In contrast to reported studies that suggested land use patterns were the determinants of inland surface water quality, this study revealed that both anthropogenic and natural factors played important roles in explaining spatial variation of inland surface water quality in China. Among the tested explanatory variables, mean elevation within watershed appeared as the best predictor for pH, while annual precipitation and mean air temperature were the most important explanatory variables for CODMn and DO, respectively. NH4+-N concentration and water quality level were most strongly correlated with the percent of forest cover in watershed. Compared to studies at smaller spatial scales, this study found different influencing factors of surface water quality, suggesting that factors may play different roles at different spatial scales of consideration. Therefore management policies and measures in water quality control must be established and implemented accordingly. Since currently adopted parameters for monitoring of inland surface water quality in China are largely influenced by natural variables, additional physicochemical and biological indicators are needed for a robust assessment of human impacts on water quality. [ABSTRACT FROM AUTHOR]

Hearing loss is the most common sensory impairment, but limited studies focused on the association of socioeconomic status (SES) with hearing loss among adults of working age. This paper aimed to fill this gap among Chinese adults. We obtained data from Ear and Hearing Disorder Survey conducted in four provinces of China in 2014–2015. The survey was based on WHO Ear and Hearing Disorders Survey Protocol and 25,860 adults aged 25 to 59 years were selected in this study. Trained local examiners performed pure tone audiometry to screen people with hearing loss, and those who were screened positively for hearing loss were referred to audiologists to make final diagnosis. SES was measured by occupation, education and income. Results show after adjusting for SES measures and covariates, in urban areas, compared with white-collar workers, blue-collar workers and the unemployed were more likely to have hearing loss, with an odds ratio of 1.2 (95%CI: 1.0, 1.3) and 1.2 (95%CI: 1.0, 1.4), respectively. Compared with people with education of senior high school or above, those with junior high school, primary school and illiteracy had 1.6 (95%CI: 1.4, 1.8), 2.1(95%CI: 1.7, 2.5) and 2.6 (95%CI: 1.9, 3.7) times as likely to have hearing loss, respectively. In rural areas, the unemployed had 1.5 (95%CI: 1.0, 2.3) times the risk of hearing loss compared with white-collar workers, and illiterates had 1.6 (95%CI: 1.6, 2.1) times the risk of hearing loss compared with people with education of senior high school or above, after SES variables and covariates were taken into considerations. Income was not significantly associated with hearing loss in urban and rural areas. In conclusion, SES, in the form of occupation and education, was associated with hearing loss among working-aged population, and further studies are needed to explore the mechanism of such association. [ABSTRACT FROM AUTHOR]

Circuity, defined as the ratio of the shortest network distance to the Euclidean distance between one origin–destination (O-D) pair, can be adopted as a helpful evaluation method of indirect degrees of train paths. In this paper, the maximum circuity of the paths of operated trains is set to be the threshold value of the circuity of high-speed train paths. For the shortest paths of any node pairs, if their circuity is not higher than the threshold value, the paths can be regarded as the reasonable paths. With the consideration of a certain relative or absolute error, we cluster the reasonable paths on the basis of their inclusion relationship and the center path of each class represents a passenger transit corridor. We take the high-speed rail (HSR) network in China at the end of 2014 as an example, and obtain 51 passenger transit corridors, which are alternative sets of train paths. Furthermore, we analyze the circuity distribution of paths of all node pairs in the network. We find that the high circuity of train paths can be decreased with the construction of a high-speed railway line, which indicates that the structure of the HSR network in China tends to be more complete and the HSR network can make the Chinese railway network more efficient. [ABSTRACT FROM AUTHOR]

This paper presents the development and evaluation of the train-the-trainer (TTT) workshop for lay resident leaders to be lay health promoters. The TTT workshop aimed to prepare the trainees to implement and/or assist in conducting a series of community-based family well-being activities for the residents in a public low rent housing estate, entitled “Learning Families Project”, under the FAMILY project. The four-hour TTT workshop was conducted for 32 trainees (72% women, 43% aged ≥ 60, 41% ≤ elementary school education). The workshop aimed to promote trainees’ knowledge, self-efficacy, attitude and practice of incorporating the positive psychology themes into their community activities and engaging the residents to join these activities and learn with their family members. Post-training support was provided. The effectiveness of the TTT was examined by self-administered questionnaires about trainees’ reactions to training content, changes in learning and practice at three time points (baseline, and immediately and one year after training), and the difference in residents’ survey results before and after participating in the community activities delivered by the trainees. The trainees’ learning about the general concepts of family well-being, learning family, leadership skills and planning skills increased significantly with medium to large effect sizes (Cohen’s d: 0.5–1.4) immediately after the training. The effects of perceived knowledge and attitude towards practice were sustained to one year (Cohen’s d: 0.4–0.6). The application of planning skills to implement community activities was higher at one year (Cohen’s d: 0.4), compared with baseline. At one year, the residents’ survey results showed significant increases in the practice of positive communication behaviours and better neighbour cohesions after joining the family well-being activities of LFP. Qualitative feedback supported the quantitative results. Our TTT workshop could serve as a practical example of development and evaluation of training programs for lay personnel to be lay health promoters. Trial registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

Since the economic transition, manufacturing in China has undergone profound changes not only in number of enterprises, but also in ownership structure and intra-urban spatial distribution. Investigating the changing manufacturing landscape from the perspective of ownership structure is critical to a deep understanding of the changing role of market and government in re-shaping manufacturing location behavior. Through a case study of Wuxi, a city experiencing comprehensive ownership reform, this paper presents a detailed analysis of the intra-urban spatial shift of manufacturing, identifies the location discrepancies, and examines the underlying forces responsible for the geographical differentiations. Through zone- and district-based analysis, a distinctive trend of decentralization and suburbanization, as well as an uneven distribution of manufacturing, is unveiled. The results of Location Quotient analysis show that the distribution of manufacturing by ownership exhibits distinctive spatial patterns, which is characterized by a historically-based, market-led, and institutionally-created spatial variation. By employing Hot Spot analysis, the role of development zones in attracting manufacturing enterprises of different ownerships is established. Overall, the location behavior of the diversified manufacturing has been increasingly based on the forces of market since the land marketization began. A proactive role played by local governments has also guided the enterprise location decision through spatial planning and regulatory policies. [ABSTRACT FROM AUTHOR]

Soil sealing (loss of soil resources due to extensive land covering for the purpose of house building, road construction etc.) and subsequent soil landscape pattern changes constitute typical environmental problems in many places worldwide. Previous studies concentrated on soil sealing in urbanized regions, whereas rural areas have not been given sufficient attention. Accordingly, this paper studies soil landscape pattern dynamics (i.e., landscape pattern changes in response to rural anthropogenic activities) in the Tiaoxi watershed (Zhejiang province, eastern China), in which surface sealing is by far the predominant component of human forcing with respect to environmental change. A novel approach of quantifying the impacts of rural anthropogenic activities on soil resources is presented. Specifically, quantitative relationships were derived between five soil landscape pattern metrics (patch density, edge density, shape index, Shannon’s diversity index and aggregation index) and three rural anthropogenic activity indicators (anthropogenic activity intensity, distance to towns, and distance to roads) at two landscape block scales (3 and 5 km) between 1985 and 2010. The results showed that the Tiaoxi watershed experienced extensive rural settlement expansion and high rates of soil sealing. Soil landscapes became more fragmented, more irregular, more isolated, and less diverse. Relationships between soil landscape pattern changes and rural anthropogenic activities differed with the scale (spatial and temporal) and variable considered. In particular, the anthropogenic activity intensity was found to be the most important indicator explaining social development intensity, whereas the other two proximity indicators had a significant impact at certain temporal interval. In combination with scale effects, spatial dependency (correlation) was shown to play a key role that should be carefully taken into consideration in any relevant environmental study. Overall, the findings of this work suggest that soil sealing can be a critical human forcing issue with considerable consequences deserving serious attention by the experts, the public and the government alike. [ABSTRACT FROM AUTHOR]

Objective: The paper examines whether out-of-pocket health care expenditure also has regional discrepancies, comparing to the equity between urban and rural areas, and across households. Method: Sampled data were derived from Urban Household Survey and Rural Household Survey data for 2011/2012 for Anhui Province, and 11049 households were included in this study. The study compared differences in out-of-pocket expenditure on health care between regions (urban vs. rural areas) and years (2011 vs. 2012) using two-sample t-test, and also investigated the degree of inequality using Lorenz and concentration curves. Result: Approximately 5% and 8% of total household consumption expenditure was spent on health care for urban and rural populations, respectively. In 2012, the wealthiest 20% of urban and rural population contributed 49.7% and 55.8% of urban and rural total health expenditure respectively, while the poorest 20% took only 4.7% and 4.4%. The concentration curve for out-of-pocket expenditure in 2012 fell below the corresponding concentration curve for 2011 for both urban and rural areas, and the difference between curves for rural areas was greater than that for urban areas. Conclusion: A substantial and increasing gap in health care expenditures existed between urban and rural areas in Anhui. The health care financing inequality merits ample attention, with need for policymaking to focus on improving the accessibility to essential health care services, particularly for rural and poor residents. This study may provide useful information on low income areas of China. [ABSTRACT FROM AUTHOR]

Effective and timely quantification of the spatiotemporal pattern of urban expansion in China is important for the assessment of its environmental effects. However, the dynamics of the most recent urban expansions in China since 2012 have not yet been adequately explained due to a lack of current information. In this paper, our objective was to quantify spatiotemporal patterns of urban expansion in China between 1992 and 2015. First, we extracted information on urban expansion in China between 1992 and 2015 by integrating nighttime light data, vegetation index data, and land surface temperature data. Then we analyzed the spatiotemporal patterns of urban expansion at the national and regional scales, as well as at that of urban agglomerations. We found that China experienced a rapid and large-scale process of urban expansion between 1992 and 2015, with urban land increasing from 1.22 × 104 km2 to 7.29 × 104 km2, increasing in size nearly fivefold and with an average annual growth rate of 8.10%, almost 2.5 times as rapid as the global average. We also found that urban land in China expanded mainly by occupying 3.31 × 104 km2 of cropland, which comprised 54.67% of the total area of expanded urban land. Among the three modes of growth—infilling, edge expansion, and leapfrog—edge expansion was the main cause of cropland loss. Cropland loss resulting from edge expansion of urban land totalled 2.51 × 104 km2, accounting for over 75% of total cropland loss. We suggest that effective future management with respect to edge expansion of urban land is needed to protect cropland in China. [ABSTRACT FROM AUTHOR]

Nowhere has the scale and scope of urbanization been larger than in China over the last few decades. We analyze Chinese city development between the years 1996 and 2014 using data for the urbanized components of prefecture-level cities. We show that, despite much variability and fast economic and demographic change, China is undergoing transformations similar to the historical trajectory of other urban systems. We also show that the distinguishing signs of urban economies—superlinear scaling of agglomeration effects in economic productivity and economies of scale in land use—also characterize Chinese cities. We then analyze the structure of economic change in Chinese cities using a variety of metrics, characterizing employment, firms and households. Population size estimates remain a major challenge for Chinese cities, as official numbers are often reported based on the Hukou registration system. We use the information in the residuals to scaling relations for economic quantities to predict actual resident population and show that these estimates agree well with data for a subset of cities for which counts of total resident population exist. We conclude with a list of issues that must be better understood and measured to make sense of present urban development trajectories in China. [ABSTRACT FROM AUTHOR]

In the past 40 years of reform and opening-up, China has developed from an economically closed country to a country that is highly dependent on foreign trade. From the perspective of spatiotemporal evolution, we analyze how port opening promoted China's reform and opening-up process. First, the port development process is divided into four periods. In the start-up period, the pilot open port policy created a platform for foreign cooperation and exchange. During the expansion period, port openings promoted the continuous optimization of the trade structure. In the cooperation period, port openings corresponded with the adjustment of China's overall industrial structure. During the optimization period, port openings provided guarantees for the implementation of a national development strategy. Second, we analyze the distribution of ports and their relationship with cross-border logistics and passenger flow. Based on data of foreign trade and passenger flow, a port openness degree measurement model includes port logistics intensity, passenger flow intensity and port city foreign-trade volume is constructed. There are significant types, geographical differences and grade differences of ports' openness. [ABSTRACT FROM AUTHOR]

Background: Ageing is becoming a considerable public health burden in China, which produces great societal development challenges. Healthy and active longevity could ease the ageing burden on families and communities. To date, most studies of the oldest-old distribution are focused on a simple scale from spatial perspective, and the multi-scale spatio-temporal clusters trend in the oldest-old population has not yet been determined. Thus, the objective in present study is to use a new method to evaluate the spatio-temporal pattern and detect the risk clusters in the oldest-old population from three scales. Methods: Individuals aged 65 years or older and individuals aged 80 years or older on three scales in China from 2000 to 2010 were used. The exploratory spatial data analysis was performed using Moran’s I statistic, and the pattern of the oldest-old clusters among humans was examined by using the spatial scan statistical method. Then, spatial stratified heterogeneity was used to explore the factors affecting the spatial heterogeneity of the oldest-old population. Results: The oldest-old index in the southeast coastal areas is higher than that in the northwest inland areas in China. A three-ladder terrain distribution of the oldest-old index from west to east is obvious. The overall pattern of the oldest-old index evolves from a “concave” shape to an “east-west uplift, and northern collapse” shape. Space-time analysis revealed that high-risk areas were concentrated in five regions: the Yangtze River Delta, the Pearl River Delta, the Southeast Coast, Sichuan and Chongqing, and the Central Plains. The oldest-old cluster at different scales shows a similar pattern, but local differences exist. The risk at the prefecture scale and county scale is greater than at the interprovincial scale; the sublevel can identify clusters that have not been identified at the previous level, especially the bordering areas of prefectures and counties; and more risk units and greater relative risk are found in urban areas than in rural areas. Conclusions: The results emphasized that spatial scan statistics can be used to estimate the spatial clusters of the oldest-old people. The detection of these clusters might be highly useful in the surveillance of the ageing phenomenon, thus helping local public health authorities measure the population burden at all locations, identifying geographical areas that require more attention, and evaluating the impacts of intervention programs. [ABSTRACT FROM AUTHOR]

Bosten Lake is an important region of Northwest China that has transformed from a freshwater lake to a saltwater lake since the 1970s. The water quality in the Bosten Lake basin is important for social and economic development, and nitrogen (N) and phosphorus (P) are the key indicators of water quality. The land use data, precipitation data and Digital Elevation Model (DEM) data with the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model were used to simulate the N and P exports of the Bosten Lake basin. The spatial and temporal dynamics of nitrogen and phosphorus exports, and the response of nitrogen and phosphorus exports to land use change and precipitation change were analyzed between 2000 and 2015. The results show that the amount of N and P exports increased during 2000–2015, and the N and P exports are mainly distributed around Bosten Lake. The N and P exports are greatly affected by cultivated land, built-up areas and grassland, while they are less affected by other land use types. The high precipitation areas with small exports of N and P are mainly distributed in mountain areas, while small precipitation areas with large exports of N and P are distributed in plains where the cultivated land and built-up areas are concentrated. The InVEST model can be used in Northwest China, and the statistical downscaling of reanalysis precipitation data can be used in the InVEST model to improve the simulation accuracy in the data scarce regions of Northwest China. [ABSTRACT FROM AUTHOR]

As part of the cultural landscape, administrative toponyms do not only reflect natural and sociocultural phenomena, but also help with related management and naming work. Historically, county-level administrative districts have been stable and basic administrative regions in China, playing a role in the country’s management. We explore the spatio-temporal evolutionary characteristics of the county-level administrative toponyms cultural landscape in China’s eastern plains areas. A Geographical Information System (GIS) analysis, Geo-Informatic Tupu, Kernel Density Estimation, and correlation coefficients were conducted. We constructed a GIS database of county-level administrative toponyms from the Sui dynasty onward using the Northeast China, North China, and Yangtze Plains as examples. We then summarized the spatio-temporal evolutionary characteristics of the county-level administrative toponyms cultural landscape in China’s eastern plains areas. The results indicate that (1) the number of toponyms has roughly increased over time; (2) toponym densities on the three plains are higher than the national average in the corresponding timeframe since the Sui; and (3) county-level administrative toponyms related to mountains and hydrological features accounted for more than 30% of the total in 2010. However, the percentage of county-level administrative toponyms related to natural factors on the three plains has decreased since the Sui. To explore the factors influencing this spatio-temporal evolution, we analyzed the correlations between the toponyms and natural factors and human/social factors. The correlation degree between toponym density and population density is the highest, and that between toponym density and Digital Elevation Model (DEM) the lowest. Temperature changes were important in toponym changes, and population changes have influenced toponym changes over the last 400 years in China. [ABSTRACT FROM AUTHOR]

The existing literature concentrates on the relationship between amenities and migrants or residents. However, only a few studies have focused on the role of city amenities in determining the intentions of rural–urban migrants. Such a relation is a key issue in Chinese urbanisation development. The current study investigates the effects of urban amenities on the settlement intentions of rural–urban migrants in China. We find that medical amenities have a significantly positive effect on rural–urban migrants’ intentions. We also indicate that educational amenities and transportation services attract rural–urban migrants to settle in cities. Furthermore, we explore the heterogeneous effects of amenities on different cohorts by education and age. High- and low-skilled rural–urban migrants focus on transportation amenities, while young and middle–aged migrants are attracted by urban educational amenities. Results suggest that increasing access to urban amenities for rural–urban migrants and improving urban amenities enhance the willingness of rural–urban migrants to stay in cities. [ABSTRACT FROM AUTHOR]

Miscanthus lutarioriparius is a native perennial Miscanthus species of China, which is currently used as raw material of papermaking and bioenergy crop. It also has been considered as a promising eco-bioindustrial plant, which can offer raw material and gene for the biomass industry. However, lack of germplasm resources and genetic diversity information of M. lutarioriparius have become the bottleneck that prevents the stable and further development of the biomass industry. In the present study, genetic diversity of 153 M. lutarioriparius individuals nine populations was studied using 27 Start Codon Targeted (SCoT) markers. High polymorphic bands (97.67%), polymorphic information content (0.26) and allele number (1.88) showed SCoT as a reliable marker system for genetic analysis in M. lutarioriparius. At the species, the percentage of polymorphic loci [PPL] was 97.2%, Nei’s gene diversity [H] was 0.36, Shannon index [I] was 0.54 and Expected Heterozygosity [He] was 0.56. Genetic variation within populations (84.91%) was higher than among populations (15.09%) based on analysis of molecular variance (AMOVA). Moderate level of genetic differentiation was found in M. lutarioriparius populations (Fst = 0.15), which is further confirmed by STRUCTURE, principal coordinates analysis (PCoA) and an unweighted pair group method with arithmetic mean (UPGMA) analysis that could reveal a clear separation between groups of the north and south of Yangtze River. The gene flow of the populations within the respective south and north of Yangtze River area was higher, but lower between the areas. There was no obvious correlation between genetic distance and geographic distance. The breeding systems, geographical isolation and fragmented habitat of M. lutarioriparius may be due to the high level of genetic diversity, moderate genetic differentiation, and the population, structure. The study further suggests some measure for conservation of genetic resources and provides the genetic basis for improving the efficiency of breeding based on the results of diversity analysis. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is the deadliest infectious disease globally. Current case finding approaches may miss many people with TB or detect them too late. Data and methods: This study was a retrospective, spatial analysis of routine TB surveillance and cadastral data in Go Vap district, Ho Chi Minh City. We geocoded TB notifications from 2011 to 2015 and calculated theoretical yields of simulated door-to-door screening in three concentric catchment areas (50m, 100m, 200m) and three notification window scenarios (one, two and four quarters) for each index case. We calculated average yields, compared them to published reference values and fit a GEE (Generalized Estimating Equation) linear regression model onto the data. Results: The sample included 3,046 TB patients. Adjusted theoretical yields in 50m, 100m and 200m catchment areas were 0.32% (95%CI: 0.27,0.37), 0.21% (95%CI: 0.14,0.29) and 0.17% (95%CI: 0.09,0.25), respectively, in the baseline notification window scenario. Theoretical yields in the 50m-catchment area for all notification window scenarios were significantly higher than a reference yield from literature. Yield was positively associated with treatment failure index cases (beta = 0.12, p = 0.001) and short-term inter-province migrants (beta = 0.06, p = 0.022), while greater distance to the DTU (beta = -0.02, p<0.001) was associated with lower yield. Conclusions: This study is an example of inter-departmental collaboration and application of repurposed cadastral data to progress towards the end TB objectives. The results from Go Vap showed that the use of spatial analysis may be able to identify areas where targeted active case finding in Vietnam can help improve TB case detection. [ABSTRACT FROM AUTHOR]

Drought and vegetation conditions within the Damqu River Basin, part of the Yangtze River Source Region (YRSR), are assessed here using the standardized precipitation index (SPI), the standardized precipitation evapotranspiration index (SPEI), the normalized difference vegetation index (NDVI), and the leaf area index (LAI). We utilized Sen’s method, least squares regression method, linear regression and Pearson’s correlation analysis to study variations in drought and vegetation indices and the drought effect on vegetation between 1988 and 2015. Results reveal that droughts occurred at a 25% frequency over this period; SPI and SPEI analyses show that 1994, 1999, 2005, and 2010 were change points and that the basin was characterized by varying drought and humidity trends. Subsequent to 2010, both SPI and SPEI decreased within the basin, while 1995, 2000, 2004, and 2010 were change points for NDVI and LAI while the watershed exhibited variable trends in vegetation reduction and increase. The NDVI-annual values of 63.36% regions and the LAI-summer values of 68.39% areas within the basin were decreased during 1988–2015 and 2000–2015, respectively. Subsequent to 2010, both NDVI and LAI decreased within the basin and significant positive correlations at inter-annual and inter-summer time scales were seen in both drought and vegetation indices; drought has exerted a lag effect on vegetation as shown by significant positive correlations between annual SPI/SPEI values and following year NDVI/LAI values. [ABSTRACT FROM AUTHOR]

Objective: To investigate medicine accessibility and antibiotic use in households in western China using World Health Organization (WHO) methodology as well as to identify the influencing factor of care-seeking outside the home and primary determinant factors that influence the use of antibiotics in Chinese residents. Methods: A cross-sectional household survey was conducted from March to July 2015, and 1200 households from six cities in Sichuan China were selected for a questionnaire survey using stratified multistage random cluster sampling. We used logistic regression models to identify the determinants of care-seeking outside the home and subsequent antibiotic use among the surveyed residents. Results: Overall, 1103 valid questionnaires were collected, and 458 households reported that they had had experienced at least one acute illness in the previous 2 weeks. Of these households, 97.2% of individuals with acute conditions sought care outside their homes and 40.1% of individuals who took medicine received antibiotics. Only 15.9% of the individuals with acute conditions reported that the medical insurance reimbursement covered at least one medicine. According to the multivariate analyses, women were less likely to seek care outside the home compared to men. Among those who sought outside care, fever and upper respiratory symptoms increased the odds of taking antibiotics, and visiting a private hospital also increased antibiotic use. Low-income households were less likely to receive antibiotics. Symptoms were strong determinants of antibiotic use when patients sought outside care. Conclusion: The accessibility of medicine for acute illness among households in western China was favorable; however, medical insurance reimbursement must be improved. The nature of the symptoms and patterns of care-seeking had the greatest influence on the decision to take antibiotics among residents with acute conditions. The percentage of antibiotic use in patients with acute illness has declined, but the indications for using antibiotics must be standardized. [ABSTRACT FROM AUTHOR]

Background: Postpartum Family Visits (PFVs) have been advocated as a way to improve health outcomes for puerperal women and their newborns. This study aimed to identify individual factors associated with the utilization of PFVs in rural Jiangsu Province, China. Methods: We employed responses of the household survey in Jiangsu province, part of the National Health Service Survey (NHSS), a nationally representative survey in China. The data analysis framework was designed based on Andersen’s behavioral model. The outcome variables included nonuse and deficient use of PFVs, and the explanatory variables were organized into three hierarchical levels: predisposing, enabling and need factors. Univariate analysis and multivariate logistic regression analysis were conducted to examine the impact of the three hierarchical levels on PFVs utilization. Results: A total of 884 rural women who had a childbearing history in the prior five years answered PFVs questions. About 23.4% of them had never received any PFVs, and 40.4% received <3 visits. In the results of multivariate logistic regression, educational level (OR = 0.43, 95% CI: 0.24–0.77), income (OR = 0.62, 95% CI: 0.43–0.88), the distance from the nearest hospital (OR = 1.49, 95% CI: 1.07–2.07) and parity (OR = 2.17, 95% CI: 1.54–3.05) had significant relationship with nonuse. Factors significantly associated with deficient use of PFVs included employment (OR = 0.62, 95% CI: 0.39–0.98), the distance from the nearest hospital (OR = 1.73, 95% CI: 1.26–2.36), level of delivery institution (OR = 1.57, 95% CI: 1.14–2.17), and parity (OR = 1.45, 95% CI: 1.03–2.05). Conclusion: The study found lower Social Economic Status (SES), long distance with primary health institutions, and the increased need for services stemming from multi-parity reduced the likelihood of nonuse or deficient use of PFVs in rural areas. Multiparous, low SES women and those living far away from primary health institutions should be paid more attention to assure the coverage of postpartum care. [ABSTRACT FROM AUTHOR]

As a huge threat to the public health, China’s air pollution has attracted extensive attention and continues to grow in tandem with the economy. Although the real-time air quality report can be utilized to update our knowledge on air quality, questions about how pollutants evolve across time and how pollutants are spatially correlated still remain a puzzle. In view of this point, we adopt the PMFG network method to analyze the six pollutants’ hourly data in 350 Chinese cities in an attempt to find out how these pollutants are correlated temporally and spatially. In terms of time dimension, the results indicate that, except for O3, the pollutants have a common feature of the strong intraday patterns of which the daily variations are composed of two contraction periods and two expansion periods. Besides, all the time series of the six pollutants possess strong long-term correlations, and this temporal memory effect helps to explain why smoggy days are always followed by one after another. In terms of space dimension, the correlation structure shows that O3 is characterized by the highest spatial connections. The PMFGs reveal the relationship between this spatial correlation and provincial administrative divisions by filtering the hierarchical structure in the correlation matrix and refining the cliques as the tinny spatial clusters. Finally, we check the stability of the correlation structure and conclude that, except for PM10 and O3, the other pollutants have an overall stable correlation, and all pollutants have a slight trend to become more divergent in space. These results not only enhance our understanding of the air pollutants’ evolutionary process, but also shed lights on the application of complex network methods into geographic issues. [ABSTRACT FROM AUTHOR]

Big data have contributed to deepen our understanding in regards to many human systems, particularly human mobility patterns and the structure and functioning of transportation systems. Resonating the recent call for ‘open big data,’ big data from various sources on a range of scales have become increasingly accessible to the public. However, open big data relevant to travelers within public transit tools remain scarce, hindering any further in-depth study on human mobility patterns. Here, we explore ticketing-website derived data that are publically available but have been largely neglected. We demonstrate the power, potential and limitations of this open big data, using the Chinese high-speed rail (HSR) system as an example. Using an application programming interface, we automatically collected the data on the remaining tickets (RTD) for scheduled trains at the last second before departure in order to retrieve information on unused transit capacity, occupancy rate of trains, and passenger flux at stations. We show that this information is highly useful in characterizing the spatiotemporal patterns of traveling behaviors on the Chinese HSR, such as weekend traveling behavior, imbalanced commuting behavior, and station functionality. Our work facilitates the understanding of human traveling patterns along the Chinese HSR, and the functionality of the largest HSR system in the world. We expect our work to attract attention regarding this unique open big data source for the study of analogous transportation systems. [ABSTRACT FROM AUTHOR]

Background: Pterygium is a common chronic ophthalmic condition, which may result in significant visual morbidity or lead to blindness in extreme cases. The prevalence of pterygium in China has not been reported at the sub-national level. Methods: In this study, we conducted a systematic review and meta-analysis to estimate the prevalence of pterygium in China. China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Biomedicine Literature Database (CBM-SinoMed), PubMed, Embase and Medline were searched before September 2016. We performed a multilevel mixed-effect meta-regression based on the included studies, our results showed that age, gender and latitude were significantly associated with pterygium prevalence. Based on the final model, the age and gender-specific prevalence of pterygium in 31 Chinese provinces (except Hongkong, Macau and Taiwan) and the whole country was generated. Results: In 2010, the overall prevalence of pterygium in Chinese people aged 15–84 years was 9.84% (95% CI: 6.72–14.14), and the number of pterygium cases in China was 108.65 million (95% CI: 74.23–156.13). Conclusions: In conclusion, the prevalence of pterygium in Chinese population in 2010 was estimated at both the national and provincial levels. The higher burden of pterygium across the country calls for efforts to advocate public health education encouraging people to take appropriate protective measures. [ABSTRACT FROM AUTHOR]

Employing the fundamental value of real estate determined by the economic fundamentals, a measurement model for real estate bubble size is established based on the panel data analysis. Using this model, real estate bubble sizes in various regions in Japan in the late 1980s and in recent China are examined. Two panel models for Japan provide results, which are consistent with the reality in the 1980s where a commercial land price bubble appeared in most area and was much larger than that of residential land. This provides evidence of the reliability of our model, overcoming the limit of existing literature with this method. The same models for housing prices in China at both the provincial and city levels show that contrary to the concern of serious housing price bubble in China, over-valuing in recent China is much smaller than that in 1980s Japan. [ABSTRACT FROM AUTHOR]

Extensive evidence has revealed that street greenery, as a quality-of-life component, is important for oxygen production, pollutant absorption, and urban heat island effect mitigation. Determining how green our streets are has always been difficult given the time and money consumed using conventional methods. This study proposes an automatic method using an emerging online street-view service to address this issue. This method was used to analyze street greenery in the central areas (28.3 km2 each) of 245 major Chinese cities; this differs from previous studies, which have investigated small areas in a given city. Such a city-system-level study enabled us to detect potential universal laws governing street greenery as well as the impact factors. We collected over one million Tencent Street View pictures and calculated the green view index for each picture. We found the following rules: (1) longer streets in more economically developed and highly administrated cities tended to be greener; (2) cities in western China tend to have greener streets; and (3) the aggregated green view indices at the municipal level match with the approved National Garden Cities of China. These findings can prove useful for drafting more appropriate policies regarding planning and engineering practices for street greenery. [ABSTRACT FROM AUTHOR]

The study of urban spatial interaction is closely linked to that of economic geography, urban planning, regional development, and so on. Currently, this topic is generating a great deal of interest among researchers who are striving to find accurate ways to measure urban spatial interaction. Classical spatial interaction models lack theoretical guidance and require complicated parameter-adjusting processes. The radiation model, however, as proposed by Simini et al. with rigorous formula derivation, can simulate directional urban spatial interaction. We applied the radiation model in China to simulate the directional migration number among 337 nationwide research units, comprising 4 municipalities and 333 prefecture-level cities. We then analyzed the overall situation in Chinese cities, the interaction intensity hierarchy, and the prime urban agglomerations from the perspective of migration. This was done to ascertain China’s urban spatial interaction and regional development from 2000 to 2010 to reveal ground realities. [ABSTRACT FROM AUTHOR]

The research on the grid size suitability is important to provide improvement in accuracies of gridded population distribution. It contributes to reveal the actual spatial distribution of population. However, currently little research has been done in this area. Many well-modeled gridded population dataset are basically built at a single grid scale. If the grid cell size is not appropriate, it will result in spatial information loss or data redundancy. Therefore, in order to capture the desired spatial variation of population within the area of interest, it is necessary to conduct research on grid size suitability. This study summarized three expressed levels to analyze grid size suitability, which include location expressed level, numeric information expressed level, and spatial relationship expressed level. This study elaborated the reasons for choosing the five indexes to explore expression suitability. These five indexes are consistency measure, shape index rate, standard deviation of population density, patches diversity index, and the average local variance. The suitable grid size was determined by constructing grid size-indicator value curves and suitable grid size scheme. Results revealed that the three expressed levels on 10m grid scale are satisfying. And the population distribution raster data with 10m grid size provide excellent accuracy without loss. The 10m grid size is recommended as the appropriate scale for generating a high-quality gridded population distribution in our study area. Based on this preliminary study, it indicates the five indexes are coordinated with each other and reasonable and effective to assess grid size suitability. We also suggest choosing these five indexes in three perspectives of expressed level to carry out the research on grid size suitability of gridded population distribution. [ABSTRACT FROM AUTHOR]

Cultural orientation is defined as an individual’s cultural preferences when encountering imported culture while still living in the native culture. Data was analyzed from 1305 Chinese university students attending universities in Beijing, Kunming, and Wuhan. Cultural orientation was assessed with the Chinese Cultural Orientation Questionnaire, which assesses both Western and Traditional Chinese cultural orientations. The analysis used hierarchical logistic regression with nondrinkers as the reference group and controlling for demographic factors (age, gender, and urban/rural background). Western cultural orientation was found to significantly increase the odds of recent drinking. The results indicated that higher Western cultural orientation was, after gender, the second most important factor associated with Chinese college student drinking frequency. Traditional Chinese cultural orientation was not associated with drinking frequency. This study highlights an unexpected outcome of globalization on students who have not left their home cultures. [ABSTRACT FROM AUTHOR]

Housing is among the most pressing issues in urban China and has received considerable scholarly attention. Researchers have primarily concentrated on identifying the factors that influence residential property prices and how such mechanisms function. However, few studies have examined the potential factors that influence housing prices from a big data perspective. In this article, we use a big data perspective to determine the willingness of buyers to pay for various factors. The opinions and geographical preferences of individuals for places can be represented by visit frequencies given different motivations. Check-in data from the social media platform Sina Visitor System is used in this article. Here, we use kernel density estimation (KDE) to analyse the spatial patterns of check-in spots (or places of interest, POIs) and employ the Getis-Ord method to identify the hot spots for different types of POIs in Shenzhen, China. New indexes are then proposed based on the hot-spot results as measured by check-in data to analyse the effects of these locations on housing prices. This modelling is performed using the hedonic price method (HPM) and the geographically weighted regression (GWR) method. The results show that the degree of clustering of POIs has a significant influence on housing values. Meanwhile, the GWR method has a better interpretive capacity than does the HPM because of the former method’s ability to capture spatial heterogeneity. This article integrates big social media data to expand the scope (new study content) and depth (study scale) of housing price research to an unprecedented degree. [ABSTRACT FROM AUTHOR]

Background: China is reforming and restructuring its health insurance system to achieve the goal of universal coverage. This study aims to understand the determinants of public, private and multiple insurance coverage among people of retirement-age in China. Methods: We used data from the China Health and Retirement Longitudinal Survey 2011 and 2013, a nationally representative survey of Chinese people aged 45 and over. Multinomial logit regression was performed to identify the determinants of public, private and multiple health insurance coverage. We also conducted logit regression to examine the association between public insurance coverage and demand for private insurance. Results: In 2013, 94.5% of this population had at least one type of public insurance, and 12.2% purchased private insurance. In general, we found that rural residents were less likely to be uninsured (Relative Risk Ratio (RRR) = 0.40, 95% Confidence Interval (CI): 0.34–0.47) and were less likely to buy private insurance (RRR = 0.22, 95% CI: 0.16–0.31). But rural-to-urban migrants were more likely to be uninsured (RRR = 1.39, 95% CI: 1.24–1.57). Public health insurance coverage may crowd out private insurance market (Odds Ratio = 0.55, 95% CI: 0.48–0.63), particularly among enrollees of Urban Resident Basic Medical Insurance. There exists a huge socioeconomic disparity in both public and private insurance coverage. Conclusion: The migrants, the poor and the vulnerable remained in the edge of the system. The growing private insurance market did not provide sufficient financial protection and did not cover the people with the greatest need. To achieve universal coverage and reduce socioeconomic disparity, China should integrate the urban and rural public insurance schemes across regions and remove the barriers for the middle-income and low-income to access private insurance. [ABSTRACT FROM AUTHOR]

Based on two chloroplast DNA sequences, psbA-trnH and trnT-trnF, phylogeographical patterns of a desert shrub, Ephedra przewalskii, were examined across most of its geographic range in northwestern China. A total of sixteen haplotypes were detected. There was a common haplotype in each basin, that was haplotype A in Tarim Basin, haplotype G in Junggar Basin, and haplotype M in Qaidam Basin. Genetic variance mainly occurred among populations, geographic regions, and eleven geographic groups subdivided by SAMOVA analysis. E. przewalskii likely had a smaller and more fragmented geographic range during the Last Glacial Maximum, which was determined based on ecological niche modelling. Three groups of E. przewalskii populations were detected to have experience range expansion, and this was based on significant values of Fu’s FS, Tajima’s D, and unimodel mismatch distributions. The cold and dry climate during the glacial period of the Quaternary is postulated to have been a driver for significant genetic isolation and divergence among populations or groups in E. przewalskii, whereas the warmer and wetter climate during the interglacial period is speculated to have provided favourable conditions for range expansion of the species. [ABSTRACT FROM AUTHOR]

Background: Tea is the world’s most popular non-alcoholic beverage. China and India are known to be the largest tea producing countries and recognized as the centers for the domestication of the tea plant (Camellia sinensis (L.) O. Kuntze). However, molecular studies on the origin, domestication and relationships of the main teas, China type, Assam type and Cambod type are lacking. Methodology/Principal Findings: Twenty-three nuclear microsatellite markers were used to investigate the genetic diversity, relatedness, and domestication history of cultivated tea in both China and India. Based on a total of 392 samples, high levels of genetic diversity were observed for all tea types in both countries. The cultivars clustered into three distinct genetic groups (i.e. China tea, Chinese Assam tea and Indian Assam tea) based on STRUCTURE, PCoA and UPGMA analyses with significant pairwise genetic differentiation, corresponding well with their geographical distribution. A high proportion (30%) of the studied tea samples were shown to possess genetic admixtures of different tea types suggesting a hybrid origin for these samples, including the Cambod type. Conclusions: We demonstrate that Chinese Assam tea is a distinct genetic lineage from Indian Assam tea, and that China tea sampled from India was likely introduced from China directly. Our results further indicate that China type tea, Chinese Assam type tea and Indian Assam type tea are likely the result of three independent domestication events from three separate regions across China and India. Our findings have important implications for the conservation of genetic stocks, as well as future breeding programs. [ABSTRACT FROM AUTHOR]

The early Cenozoic was characterized by a very warm climate especially during the Early Eocene. To understand climatic changes in eastern Asia, we reconstructed the Early Eocene vegetation and climate based on palynological data of a borehole from Wutu coal mine, East China and evaluated the climatic differences between eastern Asia and Central Europe. The Wutu palynological assemblages indicated a warm temperate vegetation succession comprising mixed needle- and broad-leaved forests. Three periods of vegetation succession over time were recognized. The changes of palynomorph relative abundance indicated that period 1 was warm and humid, period 2 was relatively warmer and wetter, and period 3 was cooler and drier again. The climatic parameters estimated by the coexistence approach (CA) suggested that the Early Eocene climate in Wutu was warmer and wetter. Mean annual temperature (MAT) was approximately 16°C and mean annual precipitation (MAP) was 800–1400 mm. Comparison of the Early Eocene climatic parameters of Wutu with those of 39 other fossil floras of different age in East China, reveals that 1) the climate became gradually cooler during the last 65 million years, with MAT dropping by 9.3°C. This cooling trend coincided with the ocean temperature changes but with weaker amplitude; 2) the Early Eocene climate was cooler in East China than in Central Europe; 3) the cooling trend in East China (MAT dropped by 6.9°C) was gentler than in Central Europe (MAT dropped by 13°C) during the last 45 million years. [ABSTRACT FROM AUTHOR]

In the past decade, developing countries have been experiencing rapid land use and land cover changes, including deforestation and cultivation of previously forested land. However, little is known about the impact of deforestation and land-use changes on the life history of malaria vectors and their effects on malaria transmission. This study examined the effects of deforestation and crop cultivation on the adult survivorship of major malaria mosquitoes, Anopheles sinensis and An. minimus in the China-Myanmar border region. We examined three conditions: indoor, forested, and banana plantation. Mean survival time of An. sinensis in banana plantation environment was significantly longer than those in forested environment, and mosquitoes exhibited the longest longevity in the indoor environment. This pattern held for both males and females, and also for An. minimus. To further test the effect of temperature on mosquito survival, we used two study sites with different elevation and ambient temperatures. Significantly higher survivorship of both species was found in sites with lower elevation and higher ambient temperature. Increased vector survival in the deforested area could have an important impact on malaria transmission in Southeast Asia. Understanding how deforestation impacts vector survivorship can help combat malaria transmission. [ABSTRACT FROM AUTHOR]

Background: Millions of people move from rural areas to urban areas in China to pursue new opportunities while leaving their spouses and children at rural homes. Little is known about the impact of migration-related separation on mental health of these rural migrants in urban China. Methods: Survey data from a random sample of rural-to-urban migrants (n = 1113, aged 18–45) from Wuhan were analyzed. The Domestic Migration Stress Questionnaire (DMSQ), an instrument with four subconstructs, was used to measure migration-related stress. The relationship between spouse/child separation and stress was assessed using survey estimation methods to account for the multi-level sampling design. Results: 16.46% of couples were separated from their spouses (spouse-separation only), 25.81% of parents were separated from their children (child separation only). Among the participants who married and had children, 5.97% were separated from both their spouses and children (double separation). Spouse-separation only and double separation did not scored significantly higher on DMSQ than those with no separation. Compared to parents without child separation, parents with child separation scored significantly higher on DMSQ (mean score = 2.88, 95% CI: [2.81, 2.95] vs. 2.60 [2.53, 2.67], p < .05). Stratified analysis by separation type and by gender indicated that the association was stronger for child-separation only and for female participants. Conclusion: Child-separation is an important source of migration-related stress, and the effect is particularly strong for migrant women. Public policies and intervention programs should consider these factors to encourage and facilitate the co-migration of parents with their children to mitigate migration-related stress. [ABSTRACT FROM AUTHOR]

Objective: To understand the disease burden due to Herpes Zoster (HZ) among people aged ≥50 years old in China and provide baseline data for future similar studies, and provide evidence for development of herpes zoster vaccination strategy. Methods: Retrospective cohort study was conducted in 4 townships and one community. A questionnaire was used to collect information on incidence and cost of HZ among people aged ≥ 50 years old. Results: The cumulative incidence rate was 22.6/1,000 among people aged ≥ 50 years old. The average annual incidence rate of HZ was 3.43/1,000 among people aged ≥ 50 years old in 2010–2012. Cumulative incidence and average annual incidence rate increased with age: the cumulative incidence of HZ among people aged ≥ 80 years old was 3.34 times of that among 50- years old (52.3/1000vs15.7/1,000); average annual incidence rate rises from 2.66/1,000 among 50- years old to 8.55/1,000 among 80- year old. Cumulative incidence and average annual incidence rate for females were higher than that for males (cumulative incidence, 26.5/1000vs18.7/1,000; annual incidence rate, 3.95/1000vs2.89/1,000). Cumulative incidence and average annual incidence rate in urban were higher than in rural (cumulative incidence, 39.5/1000vs 17.2/1,000; annual incidence rate, 7.65/1000vs2.06/1,000). The hospitalization rate of HZ was 4.53%. And with the increase of age, the rate has an increasing trend. HZ costs 945,709.5 RMB in total, corresponding to 840.6 RMB per patient with a median cost of 385 RMB (interquartile range 171.7–795.6). Factors associated with cost included the first onset year, area, whether hospitalized and whether sequelae left. Conclusion: Incidence rate, complications, hospitalization rate and average cost of HZ increase with age. We recommend that the HZ vaccinations should target people aged ≥50 years old if Zoster vaccine is licensed in China. [ABSTRACT FROM AUTHOR]

Aphis gossypii Glover (Hemiptera: Aphididae) is a serious pest of cotton in northern China. A microsatellite analysis was used to characterize the genetic structure of A. gossypii populations from different geographic, host plant, and seasonal populations in 2014. Among 906 individuals, 507 multilocus genotypes were identified, with genotypic richness values of 0.07–1.00 for the populations. We observed moderate levels of genetic differentiation among geographic populations (FST = 0.103; 95% confidence interval: 0.065–0.145) and host plant populations (FST = 0.237; 95% confidence interval: 0.187–0.296). A Mantel test of isolation by distance revealed no significant correlations between Slatkin’s linearized FST and the natural logarithm of geographic distance. A Bayesian analysis of population genetic structures identified three clusters. An analysis of molecular variance revealed significant differences among the three clusters (F = 0.26596, P < 0.0001), among seasons (F = 0.04244, P = 0.00381), and among host populations (F = 0.12975, P = 0.0029). Thus, the A. gossypii populations in northern China exhibit considerable genotypic diversity. Additionally, our findings indicated that the 31 analyzed populations could be classified as one of three host biotypes (i.e., cotton, cucumber, and pomegranate biotypes). There were also clear seasonal effects on population genetic structure diversity among aphids collected from Anyang. [ABSTRACT FROM AUTHOR]

Shale has been considered as good gas reservoir due to its abundant interior nanoscale pores. Thus, the study of the pore structure of shale is of great significance for the evaluation and development of shale oil and gas. To date, the most widely used approaches for studying the shale pore structure include image analysis, radiation and fluid invasion methods. The detailed pore structures can be studied intuitively by image analysis and radiation methods, but the results obtained are quite sensitive to sample preparation, equipment performance and experimental operation. In contrast, the fluid invasion method can be used to obtain information on pore size distribution and pore structure, but the relative simple parameters derived cannot be used to evaluate the pore structure of shale comprehensively and quantitatively. To characterize the nanoscale pore structure of shale reservoir more effectively and expand the current research techniques, we proposed a new method based on gas adsorption experimental data and the method of moments to describe the pore structure parameters of shale reservoir. Combined with the geological mixture empirical distribution and the method of moments estimation principle, the new method calculates the characteristic parameters of shale, including the mean pore size (), standard deviation (σ), skewness (Sk) and variation coefficient (c). These values are found by reconstructing the grouping intervals of observation values and optimizing algorithms for eigenvalues. This approach assures a more effective description of the characteristics of nanoscale pore structures. Finally, the new method has been applied to analyze the Yanchang shale in the Ordos Basin (China) and Longmaxi shale from the Sichuan Basin (China). The results obtained well reveal the pore characteristics of shale, indicating the feasibility of this new method in the study of the pore structure of shale reservoir. [ABSTRACT FROM AUTHOR]

Objective: The contribution of unhealthy dietary patterns to the epidemic of obesity has been well recognized. Differences in availability of foods may have an important influence on individual eating behaviors and health disparities. This study examined the availability of food stores and food service places by city characteristics on city level of income and urbanization. Methods: The cross-sectional survey was comprised of two parts: (1) an on-site observation to measure availability of food stores and food service places in 12 cities of China; (2) an in-store survey to determine the presence of fresh/frozen vegetables or fruits in all food stores. Trained investigators walked all the streets/roads within study tracts to identify all the food outlets. An observational survey questionnaire was used in all food stores to determine the presence of fresh/frozen vegetables or fruits. Urbanization index was determined for each city using a principal components factor analysis. City level of income and urbanization and numbers of each type of food stores and food service places were examined using negative binomial regression models. Results: Large-sized supermarkets and specialty retailers had higher number of fresh/frozen vegetables or fruits sold compared to small/medium-sized markets. High-income versus low-income, high urbanized versus low urbanized areas had significantly more large-sized supermarkets and fewer small/medium-sized markets. In terms of restaurants, high urbanized cities had more western fast food restaurants and no statistically significant difference in the relative availability of any type of restaurants was found between high- and low-income areas. Conclusions: The findings suggested food environment disparities did exist in different cities of China. [ABSTRACT FROM AUTHOR]

Background: In recent years, drug resistant tuberculosis (DR-TB) particularly the emergence of multi-drug-resistant tuberculosis (MDR-TB) has become a major public health issue. The most recent study regarding the prevalence of drug-resistant tuberculosis in mainland China was a meta-analysis published in 2011, and the subjects from the included studies were mostly enrolled before 2008, thus making it now obsolete. Current data on the national prevalence of DR-TB is needed. This review aims to provide a comprehensive and up-to-date assessment of the status of DR-TB epidemic in mainland China. Methods: A systematic review and meta-analysis of studies regarding the prevalence of drug-resistant tuberculosis in mainland China was performed. Pubmed/MEDLINE, EMBASE, the Cochrane central database, the Chinese Biomedical Literature Database and the China National Knowledge Infrastructure Database were searched for studies relevant to drug-resistant tuberculosis that were published between January 1, 2012 and May 18, 2015. Comprehensive Meta-Analysis (V2.2, Biostat) software was used to analyse the data. Results: A total of fifty-nine articles, published from 2012 to 2015, were included in our review. The result of this meta-analysis demonstrated that among new cases, the rate of resistance to any drug was 20.1% (18.0%–22.3%; n/N = 7203/34314) and among retreatment cases, the rate was 49.8% (46.0%–53.6%; n/N = 4155/8291). Multi-drug resistance among new and retreatment cases was 4.8% (4.0%–5.7%; n/N = 2300/42946) and 26.3% (23.1%–29.7%; n/N = 3125/11589) respectively. The results were significantly heterogeneous (p<0.001, I2 tests). Resistance to isoniazid was the most common resistance observed, and HRSE (H: isoniazid; R: rifampicin; S: streptomycin; E: ethambutol) was the most common form for MDR among both new and retreatment cases. Different drug resistance patterns were found by subgroup analysis according to geographic areas, subject enrolment time, and methods of drug susceptibility test (DST). Conclusions: The prevalence of resistance to any drug evidently dropped for both new and retreatment cases, and multi-drug resistance declined among new cases but became more prevalent among retreatment cases compared to the data before 2008. Therefore, drug-resistant tuberculosis, particularly multi-drug-resistant tuberculosis among retreatment TB cases is a public health issue in China that requires a constant attention in order to prevent increase in MDR-TB cases. [ABSTRACT FROM AUTHOR]