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As one of the key materials used in the civil engineering industry, concrete has a global annual consumption of approximately 10 billion tons. Cement and fine aggregate are the main raw materials of concrete, and their production causes certain harm to the environment. As one of the countries with the largest production of industrial solid waste, China needs to handle solid waste properly. Researchers have proposed to use them as raw materials for concrete. In this paper, the effects of different lithium slag (LS) contents (0%, 10%, 20%, 40%) and different substitution rates of recycled fine aggregates (RFA) (0%, 10%, 20%, 30%) on the axial compressive strength and stress-strain curve of concrete are discussed. The results show that the axial compressive strength, elastic modulus, and peak strain of concrete can increase first and then decrease when LS is added, and the optimal is reached when the LS content is 20%. With the increase of the substitution rate of RFA, the axial compressive strength and elastic modulus of concrete decrease, but the peak strain increases. The appropriate amount of LS can make up for the mechanical defects caused by the addition of RFA to concrete. Based on the test data, the stress-strain curve relationship of lithium slag recycled fine aggregate concrete is proposed, which has a high degree of agreement compared with the test results, which can provide a reference for practical engineering applications. In this study, LS and RFA are innovatively applied to concrete, which provides a new way for the harmless utilization of solid waste and is of great significance for the control of environmental pollution and resource reuse. [ABSTRACT FROM AUTHOR]

In this paper, a daily gridded observation data across China from 1961 to 2022 were used to calculate daily potential evapotranspiration (PET). The observed variables included daily temperature, sunshine hours, average wind speed, and average relative humidity. PET was determined using the Penman-Monteith method recommended by the Food and Agriculture Organization (FAO). The long-term trend of PET was investigated in six regions of China during different seasons. To further compressed the influence of various meteorological factors on the PET trend, the contribution of each meteorological element to the long-term trend of PET was analyzed. The results indicate the following: (1) PET reaches its peak during summer which values from 145 to 640 mm, while it is lowest during winter from 21 to 244 mm. (2) The spatial patterns of PET trend changes are relatively similar across the four seasons, characterized by a decrease in the eastern regions and an increase in the western regions. The reduction is most significant during the summer and the range of trend is from -2.04 to 1.48 mm/day, while the increase becomes more pronounced in the winter which trend is from -0.34 to 0.53 mm/day. (3) The contribution of factors varies significantly across different regions. In spring and autumn, RH and U have little difference in contribution from other factors. But tsun is varies different from regions, the contribution value is largest in the northwest and smallest in the northeast. However, during summer, tsun become the most significant contributor in the YZ and SE regions, while in winter, Tm emerges as the most significant contributor to the PET trend in all six subregions. In SW, the contribution from U2 is the smallest in all seasons, with RH and Tm being the two crucial factors determining the PET trend in this region. [ABSTRACT FROM AUTHOR]

Background: The purpose of this paper is to explore the relationship between subjective well-being, social class identity, and Self-rated health among older persons,. Focusing on the mediating role of health and the impact of epidemic infectious diseases on these relationships. Methods: Based on the 2018 and 2021 China General Social Survey (CGSS) databases, the data were screened, and processed. Using Stata17, we employed ordered probit regression to examine the relationships among variables and Bootstrap methods to assess mediation effects, and the CGSS data for 2018 and 2021 were compared and analyzed. Results: Our results revealed that factors such as social class identity, health status, and personal income significantly positively impact older persons' subjective well-being (P<0.01). Notably, there was a partial mediating effect of health status between the subjective well-being of the elderly and social class identity. And findings showed that when older adults were affected by epidemic diseases, their subjective well-being, social class identity, and Self-rated health remained significantly positively correlated. Subjective well-being, social class identity. What is more noteworthy is that when affected by epidemic infectious diseases, older adults' subjective well-being, social class identity, and Self-rated health remained significantly positively correlated. The mediating role of self-rated health in older adults' subjective well-being and social class identity increased from 9.6% to 12.4%. Conclusions: In the face of epidemic infectious diseases, we need to pay more attention to the Self-rated health of the elderly, and the Chinese government should take effective measures to improve their health level, which will in turn improve the subjective well-being of the elderly and realize the goal of healthy aging. [ABSTRACT FROM AUTHOR]

Against the backdrop of the COVID-19 pandemic and China's pursuit of the "double circulation" strategy, scholars are increasingly focusing on ensuring high-quality economic development in China. In this regard, digital inclusive finance and consumer consumption are of utmost significance. This study employs panel data from 30 provinces and cities spanning 2011 to 2020 to explore the impact of digitized inclusive finance on consumer consumption and high-quality economic development through a spatial econometric model. Our findings indicate that integrating digital finance with consumer consumption and economic development fosters high-quality economic growth. Furthermore, our semi-parametric spatial lag model suggests a nonlinear relationship between digital inclusive finance and high-quality economic growth, shaped like an inverted "U". Additionally, we examine the mediating effect of consumer consumption on the relationship between digital inclusive finance and high-quality economic development. Our results reveal a substitution effect between digital inclusive financing and consumer consumption in promoting high-quality economic development. Therefore, it is essential to promote the development of digital inclusive finance, harness its positive spillover effects between regions, and encourage an increase in consumer consumption to optimize the consumption structure, upgrade and adjust the industrial structure, and spur growth in emerging industries. [ABSTRACT FROM AUTHOR]

Objective: The effectiveness of sugemalimab vs. placebo in post-chemoradiotherapy patients with locally advanced, unresectable stage III NSCLC has been demonstrated and approved by China National Medical Products Administration. The purpose of this study was to assess the cost-effectiveness of sugemalimab vs. placebo for consolidation treatment of stage III NSCLC from the perspective of the Chinese healthcare system. Methods: A 3-state Markov model with a 3-week cycle length was performed to appraise the incremental cost-utility ratio (ICUR) of sugemalimab consolidation therapy based on the GEMSTONE-301 clinical trial over a 10-year time horizon. Only direct medical costs, including costs of drug (maintenance and subsequent treatment), routine follow-up, best supportive care, and terminal care in end of life were considered in this model. Costs and health utilities were obtained from local databases and published articles. Sensitivity and scenario analyses were adopted to evaluate the model uncertainty. Internal and external data sources were used to justify the plausibility of the extrapolated portion of the survival model chosen. Results: In comparison with the placebo, sugemalimab consolidation therapy was not cost-effective as it yielded an ICUR value of $90,277 and $49,692 for the concurrent chemoradiotherapy (cCRT) and the sequential chemoradiotherapy (sCRT) population at the willingness-to-pay (WTP) threshold of $37,663/QALYs, respectively. When taking the sugemalimab patient assistance program (PAP) into consideration, sugemalimab consolidation therapy was cost-effective with an ICUR dramatic decreases below the WTP. Sensitivity analyses demonstrated that the ICUR was most sensitive to the discount rate and subsequent treatment. However, none of the sensitive parameters could affect the cost-effective conclusions without or with PAP. Scenario analyses revealed that the model was particularly affected by assumptions regarding discount in sugemalimab, time horizon, mean duration of sugemalimab maintenance treatment. Conclusions: From the perspective of Chinese healthcare system, sugemalimab consolidation therapy was not a cost-effective strategy in cCRT and sCRT patients with unresectable stage III NSCLC. Given that the sugemalimab PAP was available, sugemalimab consolidation therapy became a cost-effective option. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to examine the factors influencing China's new retail industry on corporate performance. We mainly design the adjustment effect of the internationalization of its new retail industry on corporate performance and proprietary assets. Design/Methodology/Approach: The framework is based on dynamic panel data of 590 listed companies in China's new retail industry from 2007 to 2019. Findings: We apply the concept of big data for the analysis and investigation, including the DOI explanatory variable for the degree of internationalization, Tobin's Q explained variable, and adjusted variable of proprietary assets (R&D intensity RDI, marketing intensity MI, and capital intensity CI). We found that the degree of internationalization of the new retail industry has a positive impact on corporate performance. Research limitations/implications: The resultant findings only reflect the setting of China's new retail marketplace. With the research model developed here in, future research can target cross-country studies of various forms of online and offline market sites to determine regional differences in the development of new retail activities. Originality/Value: The results show that the major new retail industry is a multi-channel concept that affects overall corporate performance. The authors focus on corporate performance, which is a moderating effect based on proprietary assets. [ABSTRACT FROM AUTHOR]

Under the context of global warming, compound dry and hot events (CDHEs) will increase and bring serious losses to society and the economy. The projection of CDHEs is of great significance for policy-making and risk assessment. In this paper, two large ensemble simulations, CanESM2-LE and CESM-LE, are used to estimate the risk of extreme CDHEs under different warming scenarios in China. First, the biases of the model in the simulation of the temperature and precipitation over the China region are corrected, and the index of CDHEs is established based on a copula function. The results show that extreme CDHEs will occur more often in China with the increase in global warming and the more severe extreme CDHEs are, the greater the risk will be in the future with higher uncertainties. Events that would be attained once every 50 and 100 years in the current climate from CESM-LE (CAanESM2-LE) will be 1.2/1.6 (1.1/1.5) times and 1.3/2.3 (1.5/2.0) times more likely to occur in a 1.5°C/2.0°C warmer climate, respectively. Northwestern China will experience the greatest increase in the risk of extreme CDHEs. Extreme CDHEs expected once every 100 years in the current period over NW China are expected to occur approximately every 5 and 4 years under a 4.0°C warmer world in CanESM2-LE and CESM-LE, respectively. [ABSTRACT FROM AUTHOR]

Objective: To assess the cardiovascular safety of celecoxib compared to non-selective non-steroid anti-inflammatory drugs or placebo. Methods: We included randomized controlled trials of oral celecoxib compared with a non-selective NSAID or placebo in rheumatoid arthritis and osteoarthritis patients. We conducted searches in EMBASE, Cochrane CENTRAL, MEDLINE, China National Knowledge Infrastructure, VIP, Wanfang, and Chinese Biomedical Literature Database. Study selection and data extraction were done by two authors independently. The risk of bias was assessed using Cochrane's risk-of-bias Tool for Randomized Trials. The effect size was presented as a risk ratio with their 95% confidence interval. Results: Until July 22nd, 2021, our search identified 6279 records from which, after exclusions, 21 trials were included in the meta-analysis. The overall pooled risk ratio for Antiplatelet Trialists Collaboration cardiovascular events for celecoxib compared with any non-selective non-steroid anti-inflammatory drugs was 0.89 (95% confidence interval: 0.80–1.00). The pooled risk ratio for all-cause mortality for celecoxib compared with non-selective non-steroid anti-inflammatory drugs was 0.81 (95% confidence interval: 0.66–0.98). The cardiovascular mortality rate of celecoxib was lower than non-selective non-steroid anti-inflammatory drugs (risk ratio: 0.75, 95% confidence interval: 0.57–0.99). There was no significant difference between celecoxib and non-selective non-steroid anti-inflammatory drugs or placebo in the risk of other cardiovascular events. Conclusion: Celecoxib is relatively safe in rheumatoid arthritis and osteoarthritis patients, independent of dose or duration. But it remains uncertain whether this would remain the same in patients treated with aspirin and patients with established cardiovascular diseases. [ABSTRACT FROM AUTHOR]

In boreal regions, the frequency of forest fires is increasing. In this study, thermogravimetric analysis was used to analyze the pyrolysis kinetics of dead surface combustibles in different forest types within the Daxing'an Mountains, China. The results show that the combustible material load of forest types, the Larix forest (LG) is relatively high. Base on the E of kinetic parameters, the LG, and Quercus forest (QM) forest types had relatively high combustibility values and comprehensive combustibility values for 1-, 10-, and 100-h time lags. According to the obtained P values, the pyrolysis of dead surface fuels with 1-, 10-, and 100-h time lags is relatively difficult in the Larix / Betula mixed forest (L-B) and QM forest types. Therefore, mixed forests of the LG, L-B, and QM tree species can be established as fire-resistant forests to establish a fire barrier, reduce the combustibility of forest stands, and reduce the possibility of forest fires. [ABSTRACT FROM AUTHOR]

Sufficient samples of extreme precipitation events are needed in order to obtain reliable estimates of the probability of their occurrence. Here, we use a large ensemble simulation with 50 members from the Canadian Earth System Model (CanESM2) under the representative concentration pathway 8.5 (RCP8.5) scenario to give future projection of the intensity and frequency of extreme precipitation events under different warming levels relative to the current climate over China. A bias-correction method based on quantile mapping is first used to remove systematic biases in the ensemble. The return value and return period are obtained by fitting enough annual maximum precipitation samples with the generalized extreme value to represent the intensity and frequency of extreme events, respectively. The results show that the average intensity of extreme precipitation in China will increase by nearly 8% per 1°C of global warming, which closely follows the Clausius–Clapeyron relation. Rarer extreme events will experience greater changes in frequency, especially under higher warming. The nationally averaged extreme precipitation events, presently expected to occur every 50 years (100 years) under the current climate conditions, are expected to occur approximately every 41 years (82 years), 32 years (62 years), 22 years (42 years) and 15 years (29 years) under warming levels of 1.5, 2.0, 3.0 and 4.0°C, respectively. Northwestern China (NW), southwestern China (SW) and the Yangtze River valley (YZ) exhibit the greatest increase in probability ratio (PR) under future climate condition. The risk of extreme precipitation events, currently expected to occur once every 50 years, will be nearly 11 (21) times more likely to occur under a climate warming by 3.0°C (4.0°C). Limiting warming to 1.5°C will help avoid approximately 40%-50%, 70%-80% and over 90% of the increase in the risk of extreme events in almost all subregions if the global mean surface temperature (GMST) continues warming to 2.0°C, 3.0°C and 4.0°C, respectively. Our study provides a useful information for the understanding the impact of climate change on the future risk of extreme events over China. [ABSTRACT FROM AUTHOR]

Background: The prevalence of human immunodeficiency virus (HIV) varies markedly among different risk groups in China, spreading fromhigh-risk populations to the general population. Indeed, China is in a critical period of HIV/acquired immunodeficiency syndrome (AIDS) prevention and control; however, data regarding HIV testing, infection and coinfection among infertile couples are lacking. This study aimed to estimate the HIV/AIDS prevalence to identify risk factors among infertile couples in Hunan, China. Methods: A cross-sectional hospital-based study was conducted to evaluate the prevalence of HIV/other infections (hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, and Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium (MG) infections) among 338,432 infertile individuals in Hunan, China, from 2012 to 2018. We calculated linear trends in prevalence using bivariate linear regression. Results: The overall prevalence rates of HIV, chlamydia, gonorrhea, MG, syphilis, and HBV and HCV antibody positivity in this study were 0.04%, 1.73%, 0.05%, 2.60%, 2.15%, 12.01% and 0.56%, respectively. The predominant infection was HBV, followed by MG, syphilis, and chlamydia. Only 1.13% of the participants (382/338432) reported sexually transmitted disease (STD) signs and symptoms suggesting genital tract infection. However, from 2012–2018, the variation in HIV prevalence was not significant (β = 0.000, PTREND = 0.907). The characteristics of the HIV-infected infertile population have not shifted dramatically, with women accounting for 32.56% of HIV cases in China. Overall, 87.60% of HIV-infected individuals have a relatively low education. In total, 37.98% of HIV-positive patients engage in high-risk behaviors. Conclusions: This study expands upon existing knowledge of HIV prevalence in the infertile Chinese population. However, much work is needed to achieve popularization of prevention knowledge and change concept. Routine HIV screening is urgently needed for all adults with high-risk behaviors. [ABSTRACT FROM AUTHOR]

Objectives: While the effect of physical activity on knee osteoarthritis (KOA) remains controversial, how sitting and sleep durations affect KOA is unknown. We evaluated the association between durations of physical activity, sitting and sleep, and incidence of total knee replacement (TKR) due to severe KOA. Methods: We used data from the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese, aged 45–74 years at recruitment from 1993–1998. Height, weight, lifestyle factors, hours of sitting and sleep per day, and hours of moderate activity, strenuous sports or vigorous work per week were assessed through in-person interviews using structured questionnaires. Incident cases of TKR were identified via record linkage with nationwide hospital discharge database. Results: Compared to those with <0.5 hour/week of moderate physical activity, participants with ≥5 hour/week had increased risk of TKR risk [hazard ratio (HR) 1.16, 95% confidence interval (CI) 1.00–1.35]. Conversely, duration of sitting activities, especially sitting at work, was associated with reduced risk in a stepwise manner. Compared to <4 hour/day of sitting, those with ≥12 hour/day had the lowest risk (HR 0.76, 95% CI 0.60–0.96, p for trend = 0.02). Sleep duration was inversely associated with reduced risk of TKR in a dose-dependent manner; compared to those with sleep ≤ 5 hour/day, participants with ≥ 9 hour/day had the lowest risk (HR 0.55, 95% CI) 0.43–0.70, p for trend <0.001). Conclusion: While prolonged sitting or sleeping duration could be associated with reduced risk of severe KOA, extended duration of physical activity could be associated with increased risk. [ABSTRACT FROM AUTHOR]

Introduction: The study aimed to explore the gap of prevalence of healthy lifestyle behaviors including smoking cessation, quitting drinking, physical activity and healthy eating between Chinese adults with and without cardiovascular diseases (CVDs). Methods: This study is a cross-sectional component of Prospective Urban Rural Epidemiology (PURE)-China study, which recruited ~46,000 participants from 70 rural and 45 urban communities between 2005 and 2009. Participants were divided into disease (with CVDs) and control (without any diseases) groups. The adjusted rates were estimated for different strata by the generalized, linear mixed-effects model, including community as a random effect with additional adjustment for age, sex, education and income. Results: Among 40,490 participants, <10% had all four healthy lifestyle behaviors (disease group versus control group: urban areas: 7.8% versus 8.1%; rural areas: 3.4% versus 3.2%). The rates of smoking cessation and quitting drinking were significantly higher in disease group for both urban and rural residents (P<0.001). In urban areas, higher rates were observed in all other three healthy lifestyle behaviors except physical activity in low-income regions (P<0.05). Similarly, the higher trends were observed for stopping smoking and drinking while opposite trends for healthy eating among rural residents from low-income regions (P<0.05). Conclusions: Our study showed that the prevalence of adopting all four behaviors was low among Chinese adults. Individuals with CVDs were more likely to follow healthy lifestyle behaviors, but it still indicated a large gap between the actual and ideal adoption of healthy lifestyle behaviors, which called for the promotion of population-wide strategies to modify lifestyle behaviors in addition to individual health-care intervention strategies. [ABSTRACT FROM AUTHOR]

In China, Fusarium head blight is caused mainly by the Fusarium graminearum species complex (FGSC), which produces trichothecene toxins. The FGSC is divided into three chemotypes: 3-acetyldeoxynivalenol (3-ADON), 15-acetyldeoxynivalenol (15-ADON), and nivalenol (NIV). In order to predict the geographical changes in the distribution of these chemotype populations in major winter wheat-producing areas in China, the biological characteristics of twenty randomly selected isolates from each of the three chemotypes were studied. No significant difference was exhibited in the growth rate of 3-ADON, 15-ADON, and NIV isolates at 15°C. At 20°C and 25°C, the growth rate of 15-ADON isolates was the highest. At 30°C, the growth rate of NIV and 3-ADON isolates was significantly higher than that of 15-ADON isolates. The 15-ADON isolates produced the highest quantities of perithecia and two to three days earlier than the other two populations at each temperature, and released more ascospores at 18°C. The aggressiveness test on wheat seedlings and ears indicated there was no significant difference between the 3-ADON and 15-ADON isolates. However, the aggressiveness of NIV isolates was significantly lower than that of the 3-ADON and 15-ADON isolates. The DON content in grains from heads inoculated with the 3-ADON isolates was higher than the content of 15-ADON and NIV isolates. The results showed that 15-ADON population had the advantage in perithecia formation and ascospore release, and the 3-ADON population produced more DON in wheat grains. We suggested that distribution of these three chemotype populations may be related to these biological characteristics. [ABSTRACT FROM AUTHOR]

Enterocytozoon bieneusi is an obligate eukaryotic intracellular parasite that infects a wide variety of vertebrate and invertebrate hosts. Although considerable research has been conducted on this organism, relatively little information is available on the occurrence of E. bieneusi in captive Asiatic black bears. The present study was performed to determine the prevalence, genetic diversity, and zoonotic potential of E. bieneusi in captive Asiatic black bears in zoos in southwestern China. Fecal specimens from Asiatic black bears in four zoos, located in four different cities, were collected and analyzed for the prevalence of E. bieneusi. The average prevalence of E. bieneusi was 27.4% (29/106), with the highest prevalence in Guiyang Zoo (36.4%, 16/44). Altogether, five genotypes of E. bieneusi were identified among the 29 E. bieneusi-positive samples, including three known genotypes (CHB1, SC02, and horse2) and two novel genotypes named ABB1 and ABB2. Multi-locus sequence typing using three microsatellites (MS1, MS3, and MS7) and one minisatellite (MS4) revealed V, III, V, and IV genotypes at these four loci, respectively. Phylogenetic analysis showed that the genotypes SC02 and ABB2 were clustered into group 1 of zoonotic potential, the genotypes CHB1 and ABB1 were clustered into a new group, and the genotype horse2 was clustered into group 6 of unclear zoonotic potential. In conclusion, this study identified two novel E. bieneusi genotypes in captive Asiatic black bears, and used microsatellite and minisatellite markers to reveal E. bieneusi genetic diversity. Moreover, our findings show that genotypes SC02 (identified in humans) and ABB2 belong to group 1 with zoonotic potential, suggesting the risk of transmission of E. bieneusi from Asiatic black bears to humans and other animals. [ABSTRACT FROM AUTHOR]

Azithromycin is used as an alternative medicine in patients with syphilis who are intolerant to penicillin. Nevertheless, the report of treatment failure of azithromycin for patients with syphilis has raised concerns in China in the past years. In this study, 178 patients with early syphilis, who were treated in sexually transmitted infections clinics in four cities in Guangxi Zhuang Autonomous Region were enrolled to investigate the regional prevalence of Treponema pallidum strain resistant to azithromycin. Nested PCR was performed to amplify the 23S ribosomal RNA (23SrRNA) gene. The point mutation of A2058G in 23SrRNA, which confers Treponema pallidum resistance to azithromycin, was measured by endonuclease digestion of PCR amplification products using MboII. A2058G point mutation was detected in 91.0% (162/178; 95% CI, 86.8%, 95.2%) of the specimens, but no difference in prevalence of azithromycin resistance was found between the patients who had taken antibiotics before enrollment and the patients who had not (91.8% vs. 89.4%), nor between the patients with and without past sexually transmitted infections (87.1% vs. 93.1%). We concluded that azithromycin may not be suitable for syphilis as a treatment option in Guangxi Zhuang Autonomous Region because of the extremely high prevalence of resistance in the general syphilis population. [ABSTRACT FROM AUTHOR]

A single Cryptosporidium isolate from a squirrel monkey with no clinical symptoms was obtained from a zoo in Ya’an city, China, and was genotyped by PCR amplification and DNA sequencing of the small-subunit ribosomal RNA (SSU rRNA), 70-kDa heat shock protein (HSP70), Cryptosporidium oocyst wall protein, and actin genes. This multilocus genetic characterization determined that the isolate was Cryptosporidium hominis, but carried 2, 10, and 6 nucleotide differences in the SSU rRNA, HSP70, and actin loci, respectively, which is comparable to the variations at these loci between C. hominis and the previously reported monkey genotype (2, 3, and 3 nucleotide differences). Phylogenetic studies, based on neighbor-joining and maximum likelihood methods, showed that the isolate identified in the current study had a distinctly discordant taxonomic status, distinct from known C. hominis and also from the monkey genotype, with respect to the three loci. Restriction fragment length polymorphisms of the SSU rRNA gene obtained from this study were similar to those of known C. hominis but clearly differentiated from the monkey genotype. Further subtyping was performed by sequence analysis of the gene encoding the 60-kDa glycoprotein (gp60). Maximum homology of only 88.3% to C. hominis subtype IdA10G4 was observed for the current isolate, and phylogenetic analysis demonstrated that this particular isolate belonged to a novel C. hominis subtype family, IkA7G4. This study is the first to report C. hominis infection in the squirrel monkey and, based on the observed genetic characteristics, confirms a new C. hominis genotype, monkey genotype II. Thus, these results provide novel insights into genotypic variation in C. hominis. [ABSTRACT FROM AUTHOR]

Urbanization is proceeding rapidly in several developing countries such as China. This accelerating urbanization alters the existing land use types in a way that results in more Non-Point Source (NPS) pollution to local surface waters. Reasonable land use planning is necessary. This paper compares seven planning scenarios of a case study area, namely Wulijie, China, from the perspective of NPS pollution. A System Dynamics (SD) model was built for the comparison to adequately capture the planning complexity. These planning scenarios, which were developed by combining different land use intensities (LUIs) and construction speeds (CSs), were then simulated. The results show that compared to scenario S1 (business as usual) all other scenarios will introduce more NPS pollution (with an incremental rate of 22%-70%) to Wulijie. Scenario S6 was selected as the best because it induced relatively less NPS pollution while simultaneously maintaining a considerable development rate. Although LUIs represent a more critical factor compared to CSs, we conclude that both LUIs and CSs need to be taken into account to make the planning more environmentally friendly. Considering the power of SD in decision support, it is recommended that land use planning should take into consideration findings acquired from SD simulations. [ABSTRACT FROM AUTHOR]

Freshwater fisheries are central to food security in China and this remains one of the most important priorities for the growing human population. Thus, combining ecosystem restoration with economics is pivotal in setting successful conservation in China. Here, we have developed a practical management model that combines fishery improvement with conservation. For six years, a ban on fertilizer and a reduction of planktivorous fish stocking along with the introduction of both mandarin fish Siniperca chuatsi and Chinese mitten crab Eriocheir sinensis was apparent in Wuhu Lake, a highly eutrophic lake located in the middle reaches of the Yangtze River. Annual fish yield decreased slightly after the change in management, whereas fisheries income increased 2.6 times. Mandarin fish and Chinese mitten crab accounted for only 16% of total fisheries production but for 48% of total fisheries income. During this six year period, water clarity increased significantly from 61 cm to 111 cm. Total nitrogen, total phosphorus and chlorophyll decreased significantly from 1.14 to 0.84 mg/L, 0.077 to 0.045 mg/L, and 21.45 to 11.59 μg/L respectively, and macrophyte coverage increased by about 30%. Our results showed that the ecological status of shallow lakes could be rapidly reversed from eutrophic to oligotrophic using simple biomanipulation, whilst maintaining fisheries economic value. It also offers a better approach to shallow fisheries lake management in Asia where traditionally the stocking of Chinese carp and use of fertilizers is still popular. [ABSTRACT FROM AUTHOR]

Nitrogen (N) deposition has increased significantly globally since the industrial revolution. Previous studies on the response of gaseous emissions to N deposition have shown controversial results, pointing to the system-specific effect of N addition. Here we conducted an N addition experiment in a temperate natural forest in northeastern China to test how potential changes in N deposition alter soil N2O emission and its sources from nitrification and denitrification. Soil N2O emission was measured using closed chamber method and a separate incubation experiment using acetylene inhibition method was carried out to determine denitrification fluxes and the contribution of nitrification and denitrification to N2O emissions between Jul. and Oct. 2012. An NH4NO3 addition of 50 kg N/ha/yr significantly increased N2O and N2 emissions, but their “pulse emission” induced by N addition only lasted for two weeks. Mean nitrification-derived N2O to denitrification-derived N2O ratio was 0.56 in control plots, indicating higher contribution of denitrification to N2O emissions in the study area, and this ratio was not influenced by N addition. The N2O to (N2+N2O) ratio was 0.41–0.55 in control plots and was reduced by N addition at one sampling time point. Based on this short term experiment, we propose that N2O and denitrification rate might increase with increasing N deposition at least by the same fold in the future, which would deteriorate global warming problems. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes is often accompanied by altered cardiometabolic risk profiles, including abdominal obesity, hypertension, and dyslipidaemia. The association of altered cardiometabolic risk profiles with chronic complications of diabetes is not well investigated. Methods: We recruited 2954 type 2 diabetes patients with a body mass index ≥25 kg/m2 who visited the diabetes clinics of 62 hospitals in 21 cities in Guangdong province of China from August 2011 to March 2012. Demographic characteristics, personal and family medical histories, and data on chronic complications of diabetes were collected. Clinical examinations and laboratory assessment were conducted. Results: Abdominal obesity was found in 91.6% of the study population, elevated blood pressure in 78.3%; elevated serum triacylglycerols in 57.8%, and reduced serum HDL-C in 55.9%. Among the cardiometabolic risk factors, elevated blood pressure was significantly associated with almost all the chronic complications of diabetes. After adjusting for age, gender, duration of diabetes, and HbA1c, elevated blood pressure was significantly associated with diabetic retinopathy (OR 1.63, 95% CI: 1.22–2.19), diabetic nephropathy (OR 3.16, 95% CI: 2.25–4.46), cardiovascular disease (OR 2.71, 95% CI: 1.70–4.32), and stroke (OR 1.90, 95% CI: 1.15–3.12). Abdominal adiposity was significantly associated with diabetic nephropathy (OR 1.39, 95% CI: 1.11–1.74). Elevated triacylglycerols was significantly associated with diabetic retinopathy (OR 1.29, 95% CI: 1.05–1.58) and diabetic nephropathy (OR 1.30, 95% CI: 1.05–1.58). Reduced HDL-C was significantly associated with stroke (OR 1.41, 95% CI: 1.05–1.88). Conclusions: Altered cardiometabolic risk profiles, and elevated blood pressure in particular, were significantly associated with chronic complications in overweight and obese patients with type 2 diabetes. Future studies on the prevention of chronic complications of diabetes might make lowering blood pressure a primary target. [ABSTRACT FROM AUTHOR]

Despite many recent advances in genotype characterization of Enterocytozoon bieneusi worldwide and the exploration of the extent of cross-species transmission of microsporidiosis between humans and animals, the epidemiology of this neglected disease in China is poorly understood. In this study, a very high prevalence (60.3%; 94/156) of E. bieneusi infections in farmed pigs in Jilin province was detected by PCR of the ribosomal internal transcribed spacer (ITS). DNA sequence analysis of 88 E. bieneusi–positive specimens identified 12 distinct genotypes (11 known: CHN7, CS-1, CS-4, CS-6, EbpA, EbpB, EbpC, EbpD, EBITS3, G, and Henan-I; one novel: CS-9). Frequent appearance of mixed genotype infections was seen in the study animals. Weaned (74.6%; 53/71) or pre-weaned (68.8%; 22/32) pigs have infection rates significantly higher than growing pigs (35.8%; 19/53) (p<0.01). Likewise, E. bieneusi was detected in 2 of 45 sheep fecal specimens (4.4%) in Heilongjiang province, belonging to the known genotype BEB6. Genotypes EbpA, EbpC, EbpD, and Henan-I examined herein have been documented in the cases of human infections and BEB6, EbpA, EbpC, and EbpD in wastewater in central China. Infections of EbpA and EbpC in humans were also reported in other areas of the world. The other known genotypes (CHN7, CS-1, CS-4, CS-6, EBITS3, EbpB, and G) and the new genotype CS-9 were genetically clustered into a group of existing E. bieneusi genotypes with zoonotic potential. Thus, pigs could be a potential source of human E. bieneusi infections in China. [ABSTRACT FROM AUTHOR]

Background: China has made remarkable progress in schistosomiasis control over the past decades. Transmission control has replaced morbidity control as the country moves towards the goal of elimination and the current challenge is to find a sensitive measure capable of gauging transmission risk in low-prevalence areas. The study aims to develop a Schistosomiasis Early Warning Index (SEWI) and demonstrate its use in Jiangsu Province along the lower Yangtze River. Methodology/Principal Findings: The Delphi approach, a structured communication technique, was used to develop the SEWI. Two rounds of interviews with 30 public health experts specialized in schistosomiasis control were conducted using 40 indicators that reflected different aspects of schistosomiasis transmission and control. The necessity, feasibility, and sensitivity of each indicator were assessed and the weight value of each indicator determined based on these experts' judgment. The system included 3 first-order indicators, 7 second-order indicators, and 30 third-order indicators. The 3 first-order indicators were endemic status, control measures, social and environmental factors, with the weight values 0.366, 0.343 and 0.291, respectively. For the 7 second-order indicators, the highest weight value was for control measures for snails (0.175) and the lowest for transmission route (0.110). We estimated and mapped the SEWI for endemic areas at the county scale in Jiangsu Province finding that the majority of the endemic areas were characterized as medium transmission risk (SEWI risk values between 0.3 and 0.6), while areas where transmission interruption had been officially declared showed SEWI values <0.30. A few isolated areas (e.g. endemic islands in the Yangtze River) produced SEWI values >0.60. These estimates are largely in agreement with the endemicity levels based on recent epidemiological surveys. Conclusions/Significance: The SEWI should be useful for estimation of schistosomiasis transmission surveillance, particularly with reference to the elimination of the disease in China. [ABSTRACT FROM AUTHOR]

Different geographical origins and species of Paris obtained from southwestern China were discriminated by near infrared (NIR) spectroscopy and high performance liquid chromatography (HPLC) combined with multivariate analysis. The NIR parameter settings were scanning (64 times), resolution (4 cm−1), scanning range (10000 cm−1∼4000 cm−1) and parallel collection (3 times). NIR spectrum was optimized by TQ 8.6 software, and the ranges 7455∼6852 cm−1 and 5973∼4007 cm−1 were selected according to the spectrum standard deviation. The contents of polyphyllin I, polyphyllin II, polyphyllin VI, and polyphyllin VII and total steroid saponins were detected by HPLC. The contents of chemical components data matrix and spectrum data matrix were integrated and analyzed by partial least squares discriminant analysis (PLS-DA). From the PLS-DA model of NIR spectrum, Paris samples were separated into three groups according to the different geographical origins. The R2X and Q2Y described accumulative contribution rates were 99.50% and 94.03% of the total variance, respectively. The PLS-DA model according to 12 species of Paris described 99.62% of the variation in X and predicted 95.23% in Y. The results of the contents of chemical components described differences among collections quantitatively. A multivariate statistical model of PLS-DA showed geographical origins of Paris had a much greater influence on Paris compared with species. NIR and HPLC combined with multivariate analysis could discriminate different geographical origins and different species. The quality of Paris showed regional dependence. [ABSTRACT FROM AUTHOR]

Background: Epidemics of HFMD are elevated every year globally, especially in mainland China. The disease now presents as an increasing threat to public health worldwide. Methods: Five hundred and seventy-one EV71-infected HFMD patients in Beijing You'an Hospital were grouped by disease severity: Mild (no severe complication) (n = 221), and Severe group (complicated with brainstem encephalitis (BE), and/or pulmonary edema (PE) (n = 350)). Clinical and laboratory findings and levels of 7 serum cytokines were analyzed. Results: Univariate analysis showed that (RR)>26/min (p<0.001), age<4 yo (p = 0.001), GLU>8.3 mmol/L (p = 0.008), CL<98 mmol/L (p = 0.026), and WBC>1.2×109/L (p = 0.040) were associated with severe cases. Results of multivariate analysis indicated five independent risk factors (RR>26/min (p<0.001), Age<4 yo (p<0.001), GLU>8.3 mmol/L (p = 0.011), LYM>40% (p = 0.010), and ALT>40 U/L (p = 0.045)). In addition to single-factor analysis, we further analyzed the use of different combinations of risk factors. “GLU>8.3 and CL<98 and RR>26” (confidence ration (CR) = 100%) is the top indicator, followed by “ALT>40 and LYM>40% and RR>26 and Age<4 yo” (CR = 92.9%). Serum levels of IL-2, IL-4, IL-10, IFNγ, GM-CSF, and TNFα were higher in severe cases than in mild cases. A new evaluation scoring system by scoring each risk factor 1 and independent risk factor 2 was developed for early identification of severe HFMD cases. Conclusions: Five independent risk factors, along with indicative combinations of risk factors, for severe cases were identified, and a scoring system was created to facilitate the use of indicators for early medical intervention. [ABSTRACT FROM AUTHOR]

Background: Human Enterovirus 71 and Coxsackie A16 have caused many outbreaks in the last decade in mainland China, resulting in thousands of fatal cases. Seroepidemiology which provides important information to document population immunity is rare in China. Methodology/Principal Findings: A cross sectional study of Enterovirus 71 (EV71) and Coxsackie A16 (CA16) seroprevalence was carried out in Guangdong, China, pre- and post- the 2010 hand, foot and mouth disease (HFMD) epidemic period. The levels of EV71 and CA16 specific antibodies were evaluated by a microneutralization test and the geometric mean titer (GMT) was calculated and compared. Our results indicated frequent infection by EV71 and CA16 in Guangdong before the 2010 epidemic. Only EV71 neutralizing antibody but not CA16 seroprevalence was significantly increased after the 2010 HFMD epidemic. Children less than 3 years old especially those aged 2 years showed the lowest positive rates for EV71 and CA16 NA before epidemic and the most significantly increased EV71 seroprevalence after epidemic. CA16 GMT values declined after the 2010 epidemic. Conclusions: These results indicate EV71 was the major pathogen of HFMD in Guangdong during the 2010 epidemic. The infection occurs largely in children less than 3 years, who should have first priority to receive an EV71 vaccine. [ABSTRACT FROM AUTHOR]

Background: Yellow horn (Xanthoceras sorbifolia Bunge) is an oil-rich seed shrub that grows well in cold, barren environments and has great potential for biodiesel production in China. However, the limited genetic data means that little information about the key genes involved in oil biosynthesis is available, which limits further improvement of this species. In this study, we describe sequencing and de novo transcriptome assembly to produce the first comprehensive and integrated genomic resource for yellow horn and identify the pathways and key genes related to oil accumulation. In addition, potential molecular markers were identified and compiled. Methodology/Principal Findings: Total RNA was isolated from 30 plants from two regions, including buds, leaves, flowers and seeds. Equal quantities of RNA from these tissues were pooled to construct a cDNA library for 454 pyrosequencing. A total of 1,147,624 high-quality reads with total and average lengths of 530.6 Mb and 462 bp, respectively, were generated. These reads were assembled into 51,867 unigenes, corresponding to a total of 36.1 Mb with a mean length, N50 and median of 696, 928 and 570 bp, respectively. Of the unigenes, 17,541 (33.82%) were unmatched in any public protein databases. We identified 281 unigenes that may be involved in de novo fatty acid (FA) and triacylglycerol (TAG) biosynthesis and metabolism. Furthermore, 6,707 SSRs, 16,925 SNPs and 6,201 InDels with high-confidence were also identified in this study. Conclusions: This transcriptome represents a new functional genomics resource and a foundation for further studies on the metabolic engineering of yellow horn to increase oil content and modify oil composition. The potential molecular markers identified in this study provide a basis for polymorphism analysis of Xanthoceras, and even Sapindaceae; they will also accelerate the process of breeding new varieties with better agronomic characteristics. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the correlation of total lymphocyte count (TLC) and CD4 cell count and the suitability of TLC as a surrogate marker for CD4 cell count of HIV-infected patients in China. Methods: Usefulness of TLC as a surrogate marker for a CD4 cell count <350 cells/mm3 for HIV-positive patients in China was evaluated by 977 pairs of TLC and CD4 cell count from 977 outpatients. The result was then validated by a literature review which was conducted on 9 relevant articles. Further investigation using the 977 pairs of TLC and CD4 cell count data was done to determine a TLC threshold for predicting a CD4 cell count <500 cells/mm3. Correlation and receiver operating characteristic (ROC) analysis were performed for both CD4 cell counts, and the sensitivity and specificity were computed. Results: Good correlation was noted between TLC and CD4 count (r = 0.60, 95% CI, 0.56–0.64). TLC obtained a relatively high diagnostic performance (area under ROC curve, 0.80) for predicting a CD4 cell count <350 cells/mm3, with a sensitivity of 0.65 (95% CI, 0.61–0.68) and a specificity of 0.80 (95% CI, 0.75–0.85) at the TLC threshold of 1570 cells/mm3. The literature review suggested that for a CD4 cell count <350 cells/mm3, the optimal TLC threshold was 1500 cells/mm3, which was similar to the figure presented in this observational study. As for predicting a CD4 cell count <500 cells/mm3, TLC obtained a high diagnostic performance (area under ROC curve, 0.82) as well with a sensitivity of 0.70 (95% CI, 0.67–0.73) and a specificity of 0.80 (95% CI, 0.73–0.87). Conclusions: When considering the antiretroviral therapy for HIV-infected Chinese individuals, total lymphocyte count can be considered as an inexpensive and easily available surrogate marker for predicting two clinically important thresholds of CD4 count of 350 cells/mm3 and 500 cells/mm3. [ABSTRACT FROM AUTHOR]

New Delhi metallo-β-lactamase-1 (NDM-1), an acquired class B carbapenemase, is a significant clinical threat due to its extended hydrolysis of β-lactams including carbapenems. In this study, we identified the first confirmed clinical isolate of Escherichia coli BJ01 harboring blaNDM-1 in China. The isolate is highly resistant to all tested antimicrobials except polymyxin. blaNDM-1, blaCTX-M-57, and blaTEM-1 were identified in the isolate. blaNDM-1 was transferable to E. coli EC600 and DH5α in both plasmid conjugation experiments and plasmid transformation tests. BJ01 was identified as a new sequence type, ST224, by multilocus sequence typing. Analysis of genetic environment shows complex transposon-like structures surrounding the blaNDM-1 gene. Genetic analysis revealed that the region flanking blaNDM-1 was very similar to previously identified NDM-positive Acinetobacter spp. isolated in China. The findings of this study raise attention to the emergence and spread of NDM-1-carrying Enterobacteriaceae in China. [ABSTRACT FROM AUTHOR]

Plant samples of Cardamine hupingshanesis (Brassicaceae), Ligulariafischeri (Ledeb.) turcz (Steraceae) and their underlying top sediments were collected from selenium (Se) mine drainage areas in Enshi, China. Concentrations of total Se were measured using Hydride Generation-Atomic Fluorescence Spectrometry (HG-AFS) and Se speciation were determined using liquid chromatography/UV irradiation-hydride generation-atomic fluorescence spectrometry (LC-UV-HG-AFS). The results showed that C. hupingshanesis could accumulate Se to 239±201 mg/kg DW in roots, 316±184 mg/kg DW in stems, and 380±323 mg/kg DW in leaves, which identifies it as Se secondary accumulator. Particularly, it could accumulate Se up to 1965±271 mg/kg DW in leaves, 1787±167 mg/kg DW in stem and 4414±3446 mg/kg DW in roots, living near Se mine tailing. Moreover, over 70% of the total Se accumulated in C. hupingshanesis were in the form of selenocystine (SeCys2), increasing with increased total Se concentration in plant, in contrast to selenomethionine (SeMet) in non-accumulators (eg. Arabidopsis) and secondary accumulators (eg. Brassica juncea), and selenomethylcysteine (SeMeCys) in hyperaccumulators (eg. Stanleya pinnata). There is no convincing explanation on SeCys2 accumulation in C. hupingshanesis based on current Se metabolism theory in higher plants, and further study will be needed. [ABSTRACT FROM AUTHOR]

Background: Current knowledge about incident dementia is mainly derived from studies undertaken in the West, showing that dementia is related to older age, low socio-economic status, lack of social network, depression and cardiovascular disease risk factors. We know little about incidence and predictors of dementia in China, where the prevalence is increasing and the patterns of risk factors are different. Methods: Using a standard interview method, we examined 1526 non-demented people aged $65 years who had at least minimal educational level in China in a 7.5-year follow up. Incident dementia was diagnosed by GMS-AGECAT algorithms and psychiatrists. Results: Age-standardised incidence of dementia was 14.7 per 1000 person-years (95%CI 11.3-18.2 per 1000 person-years). The increased risk was significantly associated with age, female gender (adjusted odds ratio 2.48, 95%CI 1.20-5.13), low educational levels, smoking, angina (2.58, 1.01-6.59) and living with fewer family members. Among participants with low educational level, the increased risk was associated with higher income, and with the highest and lowest occupational classes; adjusted odds ratio 2.74 (95%CI 1.12-6.70) for officers/teachers, 3.11 (1.61-6.01) for manual labourers/peasants. Conclusions: Our findings of high incidence of dementia and increased risk among people having low education levels but high income suggest a more potential epidemic and burden of dementia populations in China. Maintaining social network and activities and reducing cardiovascular factors in late life could be integrated into current multi-faceted preventive strategies for curbing the epidemic of dementia. [ABSTRACT FROM AUTHOR]

Objective: To investigate the associations of Insulin-like growth factor-II (IGF2) gene, Insulin-like growth factor-II receptor (IGF2R) gene and Insulin-like growth factor-II binding protein 2 (IGF2BP2) gene polymorphisms with the susceptibility to gestational diabetes mellitus (GDM) in Chinese population., Methods: A total of 1703 pregnant women (835 GDM and 868 Non-GDM) were recruited in this case-control study. All participants underwent prenatal 75 g oral glucose tolerance test (OGTT) examinations during 24-28 gestational weeks at the Maternal and Child Health Hospital of Hubei Province from January 15, 2018 to March 31, 2019. Genotyping of candidate SNPs (IGF2 rs680, IGF2R rs416572, IGF2BP2 rs4402960, rs1470579, rs1374910, rs11705701, rs6777038, rs16860234, rs7651090) was performed on Sequenom MassARRAY platform. Logistic regression analysis was conducted to investigate the associations between candidate SNPs and risk of GDM. In addition, multifactor dimensionality reduction (MDR) method was applied to explore the effects of gene-gene interactions on GDM risk., Results: There were significant distribution differences between GDM group and non-GDM group in age, pre-pregnancy BMI, education level and family history of diabetes (P < 0.05). After adjusted for age, pre-pregnancy BMI, education level and family history of diabetes, there were no significant associations of the candidate SNPs polymorphisms and GDM risk (P > 0.05). Furthermore, there were no gene-gene interactions on the GDM risk among the candidate SNPs (P > 0.05). However, the fasting blood glucose (FBG) levels of rs6777038 CT carriers were significantly lower than TT carriers (4.69±0.69 vs. 5.03±1.57 mmol/L, P < 0.01), and the OGTT-2h levels of rs6777038 CC and CT genotype carriers were significantly lower than TT genotype carriers (8.10±1.91 and 8.08±1.87 vs. 8.99±2.90 mmol/L, P < 0.01)., Conclusions: IGF2 rs680, IGF2R rs416572, IGF2BP2 rs4402960, rs1470579, rs11705701, rs6777038, rs16860234, rs7651090 polymorphisms were not significantly associated with GDM risk in Wuhan, China. Further lager multicenter researches are needed to confirm these results., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Echinolaelaps fukienensis is the dominant mite species parasitic on the body surface of the genus Niviventer. The mitochondrial genome (mitogenome) has its own independent genetic material and genetic system, and is now widely used in population genetics, genealogical biogeography, phylogeny and molecular evolution studies. Species diversity of the superfamily Dermanyssoidea is very rich, but its mitogenomes AT content is high, and it is difficult to amplify the complete mitogenome by routine PCR. To date, we have only obtained the mitogenomes of 6 species, scarcity on sequence data has greatly impeded the studies in the superfamily Dermanyssoidea., Methods: Echinolaelaps fukienensis were collected in 2019 from the body surface of Niviventer confucianus (Rodentia, Muridae) in Yunnan Province. The E. fukienensis mitogenome was determined and analyzed for the first time using the Illumina Novoseq 6000 platform. Phylogenetic analyses of the superfamily Dermanyssoidea were conducted based on the entire mitogenome sequences., Results: The E. fukienensis mitogenome was 14,402 bp, which is known the smallest genome of the superfamily Dermanyssoidea, encoding a total of 37 genes, including 13 PCGs, 22 tRNAs, 2 rRNAs and 1 control region. Most protein-coding genes use ATN as the start codon and TAN as the stop codon. AT and GC skew of atp8 genes in E. fukienensis were both 0. The average length of 22 tRNA genes of E. fukienensis was 64 bp, and secondary structures of tRNAs showed base mismatches and missing D-arms in many places. Compared with gene arrangement pattern of the hypothetical ancestor of arthropods, the E. fukienensis mitogenome shows a novel arrangement pattern. Phylogenetic tree supported the monophyly of the superfamily Dermanyssoidea. Echinolaelaps fukienensis being the least genetic distant (0.2762) and most closely related to Varroa destructor., Conclusions: This study analyzed comprehensive the structure and evolution of the E. fukienensis mitogenome for the first time, enriches molecular data of the genus Echinolaelaps, which will contribute to further understand phylogeny and rearrangement patterns of the superfamily Dermanyssoidea., Competing Interests: The authors declare that they have no conflict of interest., (Copyright: © 2023 He et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The construction of refuge spaces in rapidly urbanizing historic cities is a challenging task owing to their complex urban form, unique urban fabric, and historic preservation requirements. Refuge green space (RGS) is a green space that can serve as an emergency shelter in cities, providing a flexible means to increase the emergency shelter capacity for rapidly urbanized historic cities. After major earthquakes, spatial accessibility to GRSs is a critical planning strategy for disaster prevention and emergency response in historic cities. To match the RGS planning with the emergency service demand, we must examine the spatial disparity in access to existing RGSs. In this study, the urban area of Nanjing was selected as the target region to analyze the spatial disparity in access to RGSs using the Gaussian two-step floating catchment area method at four evacuation times (10, 20, 30, and 60 min). The results showed that the spatial accessibility exhibited clustering characteristics, where high-accessibility spaces were mainly distributed in the northern and southern regions of Nanjing. The increase in the evacuation time improved accessibility to RGSs, but the existing RGSs still could not sufficiently satisfy the emergency shelter needs of citizens. Based on the bivariate local Moran's I analysis of the RGS accessibility and population density, the spatial mismatch regions were dominant in the center of the urban area. These findings not only are expected to assist emergency planners by improving their strategic plans for emergency shelter investment in Nanjing and their ability to respond to catastrophic earthquakes, but also provide a strong reference for the construction of a safe environment in other rapidly developing historic cities that face earthquake threats., Competing Interests: The authors have declared that no competing interests exist.

Understanding the temporal and spatial distribution characteristics of the cultural heritage of the Yellow River Basin can effectively improve the scientific understanding of the historical changes, environmental evolution, and cultural and economic development of the Yellow River Basin and thus provide a scientific and reasonable decision-making basis for the protection and development of its cultural heritage. The research object of this paper are the national cultural relic protection units. These are examined using the GIS spatial analysis method to explore the spatial and temporal distribution characteristics and spatial structure of 2,102 national material cultural heritage sites in the Yellow River basin. The results show that the spatial distribution of cultural heritage has a significant spatial agglomeration effect. The whole basin is concentrated in stable high- and low-value areas, and the difference between the high- and low-value areas is clear. Some aspects of the spatial structure heterogeneity are strong, showing a low value dispersion distribution trend. In different periods, the distribution direction and scope of cultural heritage have low ranges of rotation, a clear direction, and a high degree of centripetal distribution. The spatial and temporal distribution of cultural heritage is the result of the combined action of natural geographical environment such as climate change, topography, river hydrology, and human environment such as administrative institutional changes, ideological evolution, and social and economic development., Competing Interests: The authors have declared that no competing interests exist.

Objective: To evaluate the microbial loading in aerosols produced after air-puff by non-contact tonometer (NCT) as well as the effect of alcohol disinfection on the inhibition of microbes and thus to provide suggestions for the prevention and control of COVID-19 in ophthalmic departments of hospitals or clinics during the great pandemics., Methods: A cross-sectional study was carried out in this study. A NIDEK NCT was used for intraocular pressure (IOP) measurement for patients who visited Department of Ophthalmology in Qilu Hospital of Shandong University during March 18-25 2020. After ultra-violate (UV) light disinfection, the room air was sampled for 5 minutes. Before and after alcohol disinfection, the air samples and nozzle surface samples were respectively collected by plate exposure method and sterile moist cotton swab technique after predetermined times of NCT air-puff. Microbial colony counts were calculated after incubation for 48 hours. Finally, mass spectrometry was performed for the accurate identification of microbial species., Results: Increased microbial colonies were detected from air samples close to NCT nozzle after air-puff compared with air samples at a distance of 1 meter from the nozzle (p = 0.001). Interestingly, none microbes were detected on the surface of NCT nozzle. Importantly, after 75% alcohol disinfection less microbes were detected in the air beside the nozzle (p = 0.003). Microbial species identification showed more than ten strains of microbes, all of which were non-pathogenic., Conclusion: Aerosols containing microbes were produced by NCT air-puff in the ophthalmic consultation room, which may be a possible virus transmission route in the department of ophthalmology during the COVID-19 pandemic. Alcohol disinfection for the nozzle and the surrounding air was efficient at decreasing the microbes contained in the aerosols and theoretically this prevention measure could also inhibit the virus. This will give guidance for the prevention of virus transmission and protection of hospital staff and patients., Competing Interests: The authors have declared that no competing interests exist.

Anthrax is an endemic disease in China. Cases are reported every year, especially in the northwestern areas. In August 2016, an outbreak of 21 cutaneous anthrax cases was reported in Min County, Gansu Province, China. In this study, the general characteristics of the anthrax outbreak are described. Two molecular typing methods, canonical single-nucleotide polymorphism (canSNP) and multiple-locus variable-number tandem repeat analysis with 15 markers (MLVA15), were used to investigate the possible source of transmission and to identify the genetic relationship among the strains/samples isolated in this outbreak as well as previous isolates. In this outbreak, all patients were infected through contact with diseased livestock or contaminated animal products. Livestock had been introduced into the local area shortly before the outbreak from Gannan Prefecture (in Gansu Province), Sichuan and Qinghai Provinces. In the molecular typing analysis, there were two canSNP subgroups found in Gansu, A.Br.001/002 and A.Br.Ames, and five MLVA15 genotypes were observed. The strains collected from the anthrax outbreak in Min County in 2016 belonged to the A.Br.001/002 canSNP subgroup and the MLVA15-28 and MLVA15-30 genotype. Strains previously isolated from Sichuan, Inner Mongolia and Maqu County (in Gannan Prefecture, Gansu Province) were clustered with these outbreak-related strains/samples according to the MLVA15-30 genotype. The MLVA15-28 genotype was found in strains isolated from Gansu and Xinjiang in previous studies. Combining the epidemiological investigation and molecular typing results, we conclude that the patients in this outbreak were infected by a local pathogen present in the adjoining area of Gansu, Sichuan and Qinghai Provinces., Competing Interests: The authors have declared that no competing interests exist.

The third plague pandemic originated from Yunnan Province, China in the middle of the 19th century. The last human plague epidemic in Yunnan occurred from 1986-2005. On June 6, 2016, a case of human plague was reported in the Xishuangbanna Prefecture, Yunnan. The patient suffered from primary septicemic plague after exposure to a dead house rat (Rattus flavipectus), which has been identified as the main plague reservoir in the local epizootic area. Moreover, a retrospective investigation identified another bubonic plague case in this area. Based on these data, human plague reemerged after a silent period of ten years. In this study, three molecular typing methods, including a clustered regularly interspaced short palindromic repeats (CRISPR) analysis, different region analysis (DFR), and multiple-locus variable number of tandem repeats analysis (MLVA), were used to illustrate the molecular characteristics of Yersinia pestis (Y. pestis) strains isolated in Yunnan. The DFR profiles of the strains isolated in Yunnan in 2016 were the same as the strains that had previously been isolated in this Rattus flavipectus plague focus. The c3 spacer present in the previously isolated strains was absent in the spacer arrays of the Ypc CRISPR loci of the strains isolated in 2016. The MLVA analysis using MLVA (14+12) showed that the strains isolated from the human plague case and host animal plague infection in 2016 in Yunnan displayed different molecular patterns than the strains that had previously been isolated from Yunnan and adjacent provinces., Competing Interests: The authors have declared that no competing interests exist.

Alport syndrome (AS) is a clinically and genetically heterogeneous, progressive nephropathy caused by mutations in COL4A3, COL4A4, and COL4A5, which encode type IV collagen. The large sizes of these genes and the absence of mutation hot spots have complicated mutational analysis by routine polymerase chain reaction (PCR)-based approaches. Here, in order to design a rapid and effective method for the genetic diagnosis of AS, we developed a strategy by utilizing targeted capture associated with next-generation sequencing (NGS) to analyze COL4A3, COL4A4, and COL4A5 simultaneously in 20 AS patients. All the coding exons and flanking sequences of COL4A3, COL4A4, and COL4A5 from the probands were captured followed by HiSeq 2500 sequencing. Candidate mutations were validated by classic Sanger sequencing and quantitative (q)PCR. Sixteen patients (16/20, 75%) showed X-linked inheritance, and four patients (4/20, 20%) showed autosomal recessive inheritance. None of the individuals had autosomal-dominant AS. Fifteen novel mutations, 6 known mutations, and 2 novel fragment deletions were detected by targeted capture and NGS. Of these novel mutations, 12, 3, and 2 mutations were detected in COL4A5, COL4A4, and COL4A3, respectively. A comparison of the clinical manifestations caused by different types of mutations in COL4A5 suggested that nonsense mutations and glycine substitution by an acidic amino acid are more severe than the other missense mutations. Pathogenic mutations were detected in 20 patients. These novel mutations can expand the genotypic spectrum of AS. Our results demonstrated that targeted capture and NGS technology are effective in the genetic diagnosis of AS.

Enterocytozoon bieneusi has been increasingly reported in non-human primates (NHPs) in recent years, and this has garnered attention. However, reports of E. bieneusi infections in NHPs are limited worldwide. To appreciate the genetic diversity and assess the zoonotic potential during the transmission of human microsporidiosis, we examined a total of 369 fecal samples from NHPs and performed PCR amplification of the ITS gene of E. bieneusi. An infection rate of 12.5% (46/369) was detected in NHPs, with three known genotypes (D, PigEBITS7, and SC02) and a novel genotype (SCM01) characterized. Phylogenetic analysis indicated that all four genotypes in our study were classified as zoonotic group 1. Multilocus genotyping of positive E. bieneusi strains revealed that 36, 37, 30, and 29 specimens were successfully amplified and sequenced to generate 16, six, four, and five types of MS1, MS3, MS4, and MS7 loci, respectively. Twenty-four specimens were successfully amplified and sequenced at all four loci, forming 13 multilocus genotypes (MLGs). The occurrence of zoonotic genotypes suggests that zoonotic transmission of E. bieneusi between humans and NHPs has probably occurred and NHPs could be a source of human microspordiosis.

24-h urinary sodium excretion is the gold standard for evaluating dietary sodium intake, but it is often not feasible in large epidemiological studies due to high participant burden and cost. Three methods--Kawasaki, INTERSALT, and Tanaka--have been proposed to estimate 24-h urinary sodium excretion from a spot urine sample, but these methods have not been validated in the general Chinese population. This aim of this study was to assess the validity of three methods for estimating 24-h urinary sodium excretion using spot urine samples against measured 24-h urinary sodium excretion in a Chinese sample population. Data are from a substudy of the Prospective Urban Rural Epidemiology (PURE) study that enrolled 120 participants aged 35 to 70 years and collected their morning fasting urine and 24-h urine specimens. Bias calculations (estimated values minus measured values) and Bland-Altman plots were used to assess the validity of the three estimation methods. 116 participants were included in the final analysis. Mean bias for the Kawasaki method was -740 mg/day (95% CI: -1219, 262 mg/day), and was the lowest among the three methods. Mean bias for the Tanaka method was -2305 mg/day (95% CI: -2735, 1875 mg/day). Mean bias for the INTERSALT method was -2797 mg/day (95% CI: -3245, 2349 mg/day), and was the highest of the three methods. Bland-Altman plots indicated that all three methods underestimated 24-h urinary sodium excretion. The Kawasaki, INTERSALT and Tanaka methods for estimation of 24-h urinary sodium excretion using spot urines all underestimated true 24-h urinary sodium excretion in this sample of Chinese adults. Among the three methods, the Kawasaki method was least biased, but was still relatively inaccurate. A more accurate method is needed to estimate the 24-h urinary sodium excretion from spot urine for assessment of dietary sodium intake in China.

A bacterial isolate (SCU-B244T) was obtained in China from crickets (Teleogryllus occipitalis) living in cropland deserted for approximately 10 years. The isolated bacteria were Gram-negative, facultatively anaerobic, oxidase-negative rods. A preliminary analysis of the 16S rRNA gene sequence indicated that the strain belongs to either the genus Erwinia or Pantoea. Analysis of multilocus sequence typing based on concatenated partial atpD, gyrB and infB gene sequences and physiological and biochemical characteristics indicated that the strain belonged to the genus Erwinia, as member of a new species as it was distinct from other known Erwinia species. Further analysis of the 16S rRNA gene showed SCU-B244T to have 94.71% identity to the closest species of that genus, Erwinia oleae (DSM 23398T), which is below the threshold of 97% used to discriminate bacterial species. DNA-DNA hybridization results (5.78±2.52%) between SCU-B244T and Erwinia oleae (DSM 23398T) confirmed that SCU-B244T and Erwinia oleae (DSM 23398T) represent different species combined with average nucleotide identity values which range from 72.42% to 74.41. The DNA G+C content of SCU-B244T was 55.32 mol%, which also differs from that of Erwinia oleae (54.7 to 54.9 mol%). The polyphasic taxonomic approach used here confirmed that the strain belongs to the Erwinia group and represents a novel species. The name Erwinia teleogrylli sp. nov. is proposed for this novel taxon, for which the type strain is SCU-B244T (= CGMCC 1.12772T = DSM 28222T = KCTC 42022T).

To explore a scientific boundary of WHtR to evaluate central obesity and CVD risk factors in a Chinese adult population. The data are from the Prospective Urban Rural Epidemiology (PURE) China study that was conducted from 2005-2007. The final study sample consisted of 43 841 participants (18 019 men and 25 822 women) aged 35-70 years. According to the group of CVD risk factors proposed by Joint National Committee 7 version and the clustering of risk factors, some diagnosis parameters, such as sensitivity, specificity and receiver operating characteristic (ROC) curve least distance were calculated for hypertension, diabetes, high serum triglyceride (TG), high serum low density lipoprotein cholesterol (LDL-C), low serum high density lipoprotein cholesterol (HDL-C) and clustering of risk factors (number≥2) to evaluate the efficacy at each value of the WHtR cut-off point. The upper boundary value for severity was fixed on the point where the specificity was above 90%. The lower boundary value, which indicated above underweight, was determined by the percentile distribution of WHtR, specifically the 5th percentile (P5) for both males and females population. Then, based on convenience and practical use, the optimal boundary values of WHtR for underweight and obvious central obesity were determined. For the whole study population, the optimal WHtR cut-off point for the CVD risk factor cluster was 0.50. The cut-off points for severe central obesity were 0.57 in the whole population. The upper boundary values of WHtR to detect the risk factor cluster with specificity above 90% were 0.55 and 0.58 for men and women, respectively. Additionally, the cut-off points of WHtR for each of four cardiovascular risk factors with specificity above 90% in males ranged from 0.55 to 0.56, whereas in females, it ranged from 0.57 to 0.58. The P5 of WHtR, which represents the lower boundary values of WHtR that indicates above underweight, was 0.40 in the whole population. WHtR 0.50 was an optimal cut-off point for evaluating CVD risks in Chinese adults of both genders. The optimal boundaries of WHtR were 0.40 and 0.57, indicating low body weight and severe risk for CVD, respectively, in Chinese adults.

Fertilization via nutrient deposition and agricultural inputs is one of the most important factors driving decreases in plant diversity. However, we still do not fully understand which processes (niche process or neutral process) are more important in leading to decreases in plant diversity caused by fertilization. A hypothesis-based approach was used to test the relative importance of niche versus neutral processes along a fertilization gradient in an alpine meadow community on the eastern Tibetan plateau, China. Niche overlap values were calculated for species biomass, and the null model was used to generate the values of niche overlap expected at random. A linear regression modeling was used to evaluate the relationship between functional traits (specific leaf area, leaf dry matter content, and leaf total nitrogen concentration) and species relative abundance. Our results demonstrated that observed niche overlap for species biomass was significantly higher than expected at lower fertilization gradients. Moreover, we also found a significantly negative correlation between species relative abundance and specific leaf area and leaf dry matter content, but a significantly positive correlation between relative abundance and leaf nitrogen concentration at lower fertilization gradients. However, these relationships were not significant at higher fertilization gradients. We concluded that community assembly is dynamic progression along the environmental gradients, and niche and neutral processes may together determine species diversity loss in response to fertilization.

Background: Transradial approach (TRA) outweighed transfemoral approach (TFA) in acute coronary syndrome patients because the former has better short-term outcomes in high-volume percutaneous coronary intervention (PCI) centers. Our study was one of the limited studies specifically in comparing the short- and medium-term effects of TRA and those of TFA in patients undergoing elective PCIs., Methods: A total of 21,242 patients who underwent elective PCI with stent implantation were included. Using propensity score methodology, 1,634 patient pairs were matched. Major clinical outcomes and PCI-related complications between TRA and TFA were compared., Results: In the propensity score-matched patients, the rates of in-hospital net adverse clinical events, which included death, myocardial infarction (MI), target vessel revascularization (TVR), stroke, and major bleeding, were much lower with TRA than with TFA (1.8% vs. 3.9%, P < 0.001). This difference was mainly due to the lower rate of major bleeding (0.6% vs. 1.8%, P < 0.001) and the decreased rate of MI (1.1% vs. 1.9%, P = 0.060). PCI-related dissection and thrombosis were similar between the TRA and TFA groups (both P > 0.05). Meanwhile, one-year incidence rates of major adverse cardiovascular events, which included death, MI, and TVR, were also similar (4.1% vs. 4.9%, P = 0.272) in TRA and TFA. Multivariable regression analyses showed that TRA was an independent predictor of the low rate of in-hospital net adverse clinical events (odds ratio, 0.53; 95% confidence interval, 0.40 to 0.71), but not of major adverse cardiovascular events at one-year follow-up (hazard ratio, 1.01; 95% confidence interval, 0.96 to 1.06)., Conclusions: In patients undergoing elective PCI, TRA patients had lower rates of in-hospital net adverse clinical outcomes compared with TFA patients. TRA might be recommended as a routine approach in high-volume PCI hospitals for elective PCIs.

Mutations of glucocerebrosidase (GBA) confer susceptibility to Parkinson's disease in several ethnical populations, with a high incidence especially in the Ashkenazi Jewish population. Although there are several studies that have investigated a similar association in a Chinese population, small sample sizes and few positive outcomes have made it difficult to obtain conclusive results from these individual studies. Therefore, the present study used a meta-analysis approach, pooling the appropriate data from published studies to investigate the association of GBA mutations and Parkinson's disease in a Chinese population. Nine studies containing 6536 Chinese subjects (3438 cases and 3098 healthy controls) and examining the GBA mutations of L444P, N370S and several other mutations were included. Review Manager 5.2 software was applied to analyze the pooled odds ratios (ORs) and 95% confidence intervals (CIs). The results showed a significant association of Parkinson's disease risk with overall GBA mutations (OR = 6.34, 95% CI = 3.77-10.68, p<0.00001), and with the subgroup of L444P mutation (OR = 11.68, 95% CI = 5.23-26.06, p<0.00001). No such association was observed for the subgroup with N370S mutation or other mutations, in part because of the small sample size or rare events. Thus, for the rare occurrence of GBA mutations, studies with larger sample size are necessary to minimize the sampling error and to obtain convincing results.

Residue management in cropping systems is believed to improve soil quality. However, the effects of residue management on methane (CH4) and nitrous oxide (N2O) emissions from paddy field in Southern China have not been well researched. The emissions of CH4 and N2O were investigated in double cropping rice (Oryza sativa L.) systems with straw returning of different winter cover crops by using the static chamber-gas chromatography technique. A randomized block experiment with three replications was established in 2004 in Hunan Province, China, including rice-rice-ryegrass (Lolium multiflorum L.) (Ry-R-R), rice-rice-Chinese milk vetch (Astragalus sinicus L.) (Mv-R-R) and rice-rice with winter fallow (Fa-R-R). The results showed that straw returning of winter crops significantly increased the CH4 emission during both rice growing seasons when compared with Fa-R-R. Ry-R-R plots had the largest CH4 emissions during the early rice growing season with 14.235 and 15.906 g m(-2) in 2012 and 2013, respectively, when Ry-R-R plots had the largest CH4 emission during the later rice growing season with 35.673 and 38.606 g m(-2) in 2012 and 2013, respectively. The Ry-R-R and Mv-R-R also had larger N2O emissions than Fa-R-R in both rice seasons. When compared to Fa-R-R, total N2O emissions in the early rice growing season were increased by 0.05 g m(-2) in Ry-R-R and 0.063 g m(-2) in Mv-R-R in 2012, and by 0.058 g m(-2) in Ry-R-R and 0.068 g m(-2) in Mv-R-R in 2013, respectively. Similar result were obtained in the late rice growing season, and the total N2O emissions were increased by 0.104 g m(-2) in Ry-R-R and 0.073 g m(-2) in Mv-R-R in 2012, and by 0.108 g m(-2) in Ry-R-R and 0.076 g m(-2) in Mv-R-R in 2013, respectively. The global warming potentials (GWPs) from paddy fields were ranked as Ry-R-R>Mv-R-R>Fa-R-R. As a result, straw returning of winter cover crops has significant effects on increase of CH4 and N2O emission from paddy field in double cropping rice system.

This study investigated diarrheic broiler and layer chickens (<50 days; n=14) and pigs of three age groups (preweaned <30 days, weaned ≈30 to 60 days, and growing >60 days; n=64) for E. bieneusi genotypes in northeast China and evaluated the potential roles of chickens and pigs in zoonotic transmission of microsporidiosis. Two 45-day-old layer chickens in city Jixi, Heilongjiang province and one 23-day-old broiler chicken in city Songyuan, Jilin province were identified to harbor a human-pathogenic E. bieneusi genotype Henan-IV and a new genotype named CC-1, respectively, by nested PCR and sequence analysis of the ribosomal internal transcribed spacer (ITS). Eleven of 64 (17.2%) duodenal mucosal specimens from pigs in city Tianjin, city Tongliao of Inner Mongolia, cities Jilin and Songyuan of Jilin province, and cities Daqing, Harbin, and Suihua of Heilongjiang province, were positive for E. bieneusi, with the infection rates of weaned pigs (35%, 7/20) significantly higher than preweaned ones (3.6%, 1/28; P<0.05). Nucleotide sequences of the ITS were obtained from 6 pig specimens, belonging to 3 known genotypes CHN7, EbpC, and Henan-IV. That the previous reports have described the occurrence of genotypes EbpC and Henan-IV in humans and EbpC in wastewater in central China and the clustering of genotypes CC-1 and CHN7 into a major phylogenetic group of E. bieneusi genotypes with zoonotic potential indicated that chickens and pigs could be potential sources of human micorsporidiosis. To our knowledge, this is the first report describing the existence of zoonotic E. bieneusi genotypes in diarrheic chickens.

Cronobacter spp. (Enterobacter sakazakii) is an important pathogen contaminating powdered infant formula (PIF). To describe the genotypic diversity of Cronobacter isolated in China, we identified the isolates using fusA allele sequencing, and subtyped all of the isolates using pulsed-field gel electrophoresis (PFGE), multi-locus sequence typing (MLST), and multiple-locus variable-number tandem-repeat analysis (MLVA). A total of 105 isolates were identified, which included C. sakazakii (58 isolates), C. malonaticus (30 isolates), C. dublinensis (11 isolates), C. turicensis (5 isolates), and C. muytjensii (1 isolate). These isolates were showed to have 85 PFGE-patterns, 71 sequence types (STs), and 55 MLVA-patterns. Comparisons among the three molecular subtyping methods revealed that the PFGE method was the most distinguishable tool in identifying clusters of Cronobacter spp. through DNA fingerprinting, and MLST method came second. However, ESTR-1, ESTR-2, ESTR-3, and ESTR-4 were not effective loci for subtyping Cronobacter spp. such that the MLVA method requires further improvement.

Background: Cytotoxic T lymphocyte-associated antigen-4 (CTLA4), a critical negative regulator of the T-cell response, has been considered a candidate for many autoimmune diseases. Evidence from Caucasians supported a genetic predisposition of CTLA4 to myasthenia gravis (MG), but the contribution in East Asians has not been established., Objectives: To investigate the role of CTLA4 variants in the susceptibility to MG and the contribution to subtypes of MG., Methods: Six autoimmune disease-related risk alleles of CTLA4 (rs1863800, rs733618, rs4553808, rs5742909, rs231775, and rs3087243) were investigated for MG in northern Chinese. 168 patients with MG (mean age 37.1±20.5 years, 64 men and 104 women) and 233 healthy controls (mean age 53.3±8.7 years, 96 men and 137 women) were screened, and the contribution of CTLA4 to the general risk of MG and each subgroup was explored., Results: rs1863800*C, rs733618*C, and rs231775*G were significantly associated with the whole cohort of patients with MG after permutation correction for multiple-testing adjustment (P = 0.027, 0.001, and 0.032, respectively). A risk haplotype (CCACG) [odds ratio (OR) = 1.535, range = 1.150-2.059, P = 0.004)] was also identified. The stratified subtype analysis indicated that the positive contribution was possibly derived from early onset MG (EOMG), seropositive MG (SPMG), female patients, and MG without thymoma. No association was observed in juvenile MG/LOMG, and MG coupled with thymoma., Conclusion: A predisposing effect of rs1863800*C, rs733618*C, and rs231775*G of CTLA4 gene to general risk of MG in Chinese was demonstrated for the first time, which was likely derived from EOMG, SPMG, MG without thymoma and the female patients.