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There is an increase in decoration and renovation activities in the construction industry, and waste generation rates (WGRs) play a crucial role in guiding the management of demolition waste in decoration and renovation projects (DWDRPs). However, there has been little systematic research on this type of waste. Based on site surveys and a document review of 26 projects, this study offers insights into DWDRP wastes, from their initial generation to their final disposal. The results revealed that the WGRs for DWDRPs ranged from 30.96 kg/m2 to 629.96 kg/m2 and that the key components of DWDRPs included mortar, concrete, timber, tile, and metal; these five types of waste contributed 75.02% of the total waste. Although these findings deviate slightly from those of previous studies, these variations are attributed to diverse waste management practices, awareness levels, and employed construction technologies. Despite its importance, in China, the management of DWDRPs faces challenges, such as limited public awareness, inadequate collection and sorting guidance, and insufficient legislation. To counter these issues, we recommend a set of strategies, including stringent regulations, enhanced supervision, government incentives, improved collection and sorting methods, and the adoption of innovative technologies. This study not only sheds light on the specific challenges in decoration and demolition waste management in rapidly urbanizing areas but also proposes a comprehensive approach for improving waste management practices. [ABSTRACT FROM AUTHOR]

Rhinoplasty is a frequently performed aesthetic surgery with a high procedural volume. Despite the operational ease and safety profile of biocompatible materials such as silicone and inflatable prosthetics, postoperative complications like surgical site infections can lead to significant clinical challenges. These complications necessitate effective therapeutic and reconstructive interventions. This study aims to evaluate the efficacy of different flap transplantation techniques for early treatment of post‐rhinoplasty nasal tissue deficiencies. A retrospective study was conducted from May 2018 to May 2023, involving 38 patients divided into a control group receiving standard anti‐infective treatment and an observation group undergoing early flap grafting procedures. Efficacy was evaluated using objective metrics—namely, nasal appearance, function and flap condition—each assessed through a 10‐point scoring system, and subjective metrics such as patient satisfaction gauged through self‐administered questionnaires. Statistical analyses were performed using SPSS version 27.0. Both groups were statistically comparable in terms of demographics such as age, marital status and educational background. The observation group displayed significantly improved outcomes in terms of nasal aesthetics (mean score 7.92 ± 1.00), nasal function (mean score 8.47 ± 0.51) and flap condition (mean score 7.89 ± 1.12) compared to the control group. Flap transplantation techniques demonstrated superior therapeutic and reconstructive efficacy in the management of nasal tissue deficiencies arising from post‐rhinoplasty surgical infections. These findings contribute to evidence‐based recommendations for optimal clinical practice. [ABSTRACT FROM AUTHOR]

Background: Appropriate medication is very important for pilots with acute stress disorder. Improper medication can not only affect the physical and mental health of the pilots but can also endanger flight safety. Hence, we aimed to quickly and effectively relieve symptoms and restore cognitive function by forming a consensus of Chinese experts on the pharmacological treatment of acute stress disorder in pilots using the Delphi method. Methods: Relevant literature was searched to enumerate the current status of pharmacological treatment of acute stress disorder in pilots, followed by two rounds of expert consultation and discussion according to the listed status of the survey using the Delphi method. A descriptive statistical method was used to analyze the basic information, authority coefficients, concentration of opinions, and survey items of the experts to develop a consensus on the pharmacological treatment of acute stress disorder in pilots. Results: A total of 16 experts in psychiatry, pharmacology, and aerospace medicine from different provinces and cities across China were invited for consultation. The recovery rate of the two rounds of consultation was 100%, and the expert authority coefficients were 0.897 and 0.906, respectively. Kendall's coefficient of concordance of indicators at all levels was 0.564–0.594 (p < 0.01). Based on the number of votes received, alprazolam tablets (16), eszopiclone tablets (15), and lorazepam tablets (14) were recommended for the treatment of excitatory psychomotor symptoms of acute stress disorder; paroxetine tablets (15) and sertraline tablets (15) were available for psychomotor depressive symptoms; olanzapine tablets (15), olanzapine orally disintegrating tablets (14), and quetiapine fumarate tablets (14) were selected for psychotic symptoms. Conclusions: This study formed a consensus on rapid and effective pharmacological treatment for different symptoms of acute stress disorder pilots, which provides a reference for clinical treatment. [ABSTRACT FROM AUTHOR]

Sedimentary mercury (Hg) records from remote areas are significant for revealing historical variations of regional Hg and understanding the influence of regional and global Hg emissions. In this study, sediment cores were retrieved from two subalpine lakes in Shanxi Province in North China and employed to reconstruct atmospheric Hg variations over the last two centuries. The two records show similar anthropogenic Hg fluxes and evolution trends, corresponding with that they were affected mainly by regional atmospheric Hg deposition. Before ~1950, the records show negligible Hg pollution signals. Atmospheric Hg in the region had increased rapidly since the 1950s, lagged more than a half-century compared to the global Hg. This indicates that they were seldom affected by Hg emissions dominated by Europe and North America after the industrial revolution. The Hg increases since the 1950s in the two records corresponded well with rapid industrial developments in and around Shanxi Province after the founding of the China, implying the dominant contribution of domestic Hg emissions. By comparing other Hg records, we find that widespread increases in atmospheric Hg in China likely occurred post ~1950. This study rouses to re-examine historical variations in atmospheric Hg at various settings, which is significant to understanding global Hg cycling in the industrial era. [ABSTRACT FROM AUTHOR]

China's urbanisation process is unique compared to that of other developed economies in that while the rural population is migrating to the cities in large numbers, the area of rural homestead use also continues to increase. This research uses macro data and a threshold model to further analyse this phenomenon of "farmers leaving while rural homestead increasing". Specifically, we focus on the mechanisms of action, development patterns and regional differences in the impact of the rate of rural–urban migration (RRUM) on the rate of increase in the area of rural homesteads (IARH), and discuss the spatial spillover effects of the impact between the two. The results of the research show that: (1) There is an "inverted U-shaped" double threshold effect on the impact of RRUM on IARH. (2) Rural population density and regional urban–rural income disparity are used as threshold variables, respectively, resulting in a sudden change in the relationship between RRUM and IARH. (3) The threshold effect of RRUM on IARH mainly exists in the central and western regions, non-minority nationality areas, non-provincial capital cities and non-resource-based cities. (4) The RRUM can not only directly affect the local IARH, but also indirectly affect the surrounding areas through spatial spillover effects. Our research provides critical insights for policy makers on the reform of the rural homestead system and urbanisation development strategies in different regions. [ABSTRACT FROM AUTHOR]

Background soils are frequently utilized as a surrogate to assess pollution levels and environmental risks of heavy metals in Chinese lakes. However, there remains a lack of understanding regarding the reliability and uncertainty of such assessments. Here, we determined heavy metals (As, Cd, Co, Cr, Cu, Hg, Ni, Pb, and Zn) in sediment cores from five rural lakes in North China to evaluate the reliability and uncertainty of the assessments using background soils by comparing them with assessments based on background sediments. Comparative studies reveal large uncertainties in the assessments using background soils. Among these metals, uncertainties for Hg and Cd are relatively large, whereas those for the other metals are minor. This discrepancy is due to the considerably higher natural variability of Hg and Cd in soils and sediments in comparison to the other metals. Generally, assessments utilizing background soils underestimate pollution levels and risks of Hg but overestimate those of Cd in these lakes. Despite limited human activities around the lakes, they still received a considerable influx of heavy metals via regional atmospheric transport. Assessments of the nine metals indicate moderate to considerable ecological risks in these lakes. The risks are contributed primarily (78–89%) by Hg and Cd. This study underscores the substantial uncertainties in assessing heavy metal pollution and risks using regional background soils and emphasizes the importance of controlling atmospheric emissions of Hg and Cd to mitigate pollution in rural and remote water bodies in China. [ABSTRACT FROM AUTHOR]

To determine whether late percutaneous coronary intervention (PCI) of an infarct-related artery >12 h after ST-segment elevation myocardial infarction onset is beneficial, patients were included from the prospective, nationwide, multicenter China Acute Myocardial Infarction registry. The number of patients who underwent PCI or received drug therapy alone was 4791 and 1149, respectively. Hazard ratio (HR) and associated 95% confidence interval (CI) were calculated. Compared with drug therapy, PCI was associated with lower incidences of 2-year major adverse cardiac and cerebrovascular events (MACCE; 6.43 vs 20.19%; HR,.27; 95% CI,.23-.32; P <.001), all-cause death (4.13 vs 15.74%; HR,.24; 95% CI,.20-.30; P <.001), myocardial infarction (1.73 vs 3.31%; HR,.49; 95% CI,.33-.72; P =.0003), stroke (1.02 vs 2.00%; HR,.47; 95% CI,.28-.77; P =.0026), and revascularization (10.96 vs 27.56%; HR,.32; 95% CI,.26-.39; P <.001). Subgroup analysis consistently indicated that PCI was superior to drug therapy. Moreover, the left ventricular ejection fraction in the PCI group was increased after 2-year follow-up, whereas there was no significant increase in the drug therapy group. In conclusion, late PCI is common in Chinese clinical practice, and it is associated with significant improvements in cardiac function and survival compared with drug therapy alone. [ABSTRACT FROM AUTHOR]

The thrombopoietin mimetic peptide for injection is a second-generation thrombopoietin receptor agonist (TPO-RA) used in the treatment of patients with immune thrombocytopenia. The aim of the present study was to assess the safety, tolerance, pharmacokinetic and pharmacodynamic properties of thrombopoietin mimetic peptide for injection in Chinese healthy volunteers. A randomized, placebo-controlled, double-blind, dose-escalation study was conducted in healthy Chinese subjects aged 18–50 years. Thirty subjects received single subcutaneous injection of 0.3 μg/kg, 1.0 μg/kg, 2.0 μg/kg thrombopoietin mimetic peptide or placebo. Thrombopoietin mimetic peptide was safe and well tolerated at doses of 0.3–2.0 μg/kg. There was no significant change in mean platelet count (PLT) from baseline at the 0.3 μg/kg or placebo groups. The mean PLT of subjects in the 1.0 μg/kg and 2.0 μg/kg groups peaked at day 12 (± 1), began to decline around day 17, and returned to the baseline level at day 28 (± 1). Platelet aggregation rates of the three dose groups showed no significant change before and after administration. Serum concentrations of thrombopoietin mimetic peptide in all subjects were below the quantization limit. This was the first study to demonstrate that subcutaneous injection of thrombopoietin mimetic peptide at doses of 0.3–2.0 μg/kg was safe and well tolerated in Chinese healthy subjects. As a second-generation TPO-RA, thrombopoietin mimetic peptide is effective at improving PLT after single subcutaneous injection at dose of ≥1 μg/kg. P lain l anguage s ummary What is the context? ● Immune thrombocytopenia (ITP) is a rare, serious autoimmune disorder characterized by low platelet count (PLT) without an alternate cause. The treatment goal of ITP is to increase the platelet count to a safe level that can stop active bleeding and reduce the risks of future bleeding. ● Thrombopoietin receptor agonists (TPO-RAs, e.g. eltrombopag, avatrombopag, hetrombopag, and romiplostim) have shown high response rates in stimulating platelet production and reducing the risk of bleeding. TPO-RAs provide ITP patients with well-tolerated, long-term treatment choices. What is new? ● The thrombopoietin mimetic peptide for injection is a new TPO-RAs developed by Shandong Quangang Pharmaceutical Co., Ltd. (China). ● This study showed that thrombopoietin mimetic peptide is effective at improving PLT after a single subcutaneous injection. ● The thrombopoietin mimetic peptide is safe and well-tolerated in Chinese healthy subjects. What is the impact? ● This study provides evidence for the further development potential of the thrombopoietin mimetic peptide. [ABSTRACT FROM AUTHOR]

Objectives: Congenital myasthenic syndrome (CMS) is a clinically and genetically heterogeneous group of inherited disorders characterized by neuromuscular junction defects. Mutations in GFPT1 have been shown to underlie CMS. An increasing number of patients with CMS due to mutations in GFPT1 have been reported. However, a comprehensive review of clinical and genetic analyses of GFPT-related CMS worldwide is lacking, especially, given that the common or hotspotmutations inGFPT1 have not been reported. Here, we described the clinical and genetic findings of three patients with GFPT1 mutations from southwestern China and reviewed the clinical and genetic features of patients with GFPT1-related CMS worldwide. Methods: Clinical, laboratory, electrophysiological, myopathological, and genetic analyses of three patients with GFPT1-related CMS fromsouthwestern China were conducted, and a review of previously published or reported cases about congenital myasthenic syndrome with GFPT1 mutations in the PubMed database was made. Results: The clinical, laboratory, electrophysiological, and myopathological features by muscle biopsy of three patients with GFPT1-related CMS were consistent with those of previously reported patients with GFPT1 mutations. Additionally, an abnormal decrement in high-frequency RNS was found. Two different homozygous missense mutations (c.331C>T, p.R111C; c.44C>T, p.T15M) were detected by whole-exome sequencing (WES) or targeted neuromuscular disorder gene panels. Conclusion: A distinct decremental response to high-frequency RNS was found in three patients with GFPT1-related CMS from southwestern China, which has never been reported thus far. In addition, the location and degree of tubular aggregates (TAs) seemed to be associated with the severity of clinical symptoms and serum creatine kinase levels, further expanding the phenotypic spectrum of GFPT1-related CMS. Lastly, some potential hotspot mutations in GFPT1 have been found in GFPT1-CMS worldwide. [ABSTRACT FROM AUTHOR]

Maximizing the use of solar energy to increase the indoor temperature of greenhouse is of great significance to the green and energy-saving intensive greenhouse production in China. In this study, an active solar heating system (ASHS) was developed and analyzed, consisting of five solar water heaters equipped with vacuum tube solar collectors, one heat storage tank and heating system including booster pump and heating pipes. During the day, the water was heated in the solar collectors and stored in tanks before being placed into circulation in the heating pipes to distribute the heat to the aerial and root zones of plants. To evaluate the performance of ASHS and the feasibility of practical application, climate and plant growth parameters were monitored in two Chinese Solar Greenhouses (CSGs) located in Yangling, China. Results revealed that under the operating condition with the flow rate of 5.4 L/min, the effective heat collection, average heat collection efficiency and energy-saving efficiency of ASHS were 1.9 MJ/(m2•h), 64% and 84%, respectively. The coefficient of performance (COP) was between 4.5 and 6.2, and the payback period was 12.0 years. Furthermore, the results revealed that the ASHS successfully provided 76% of its annual heating needs, heated the CSG for 4 months and maintained the nocturnal temperature above 8 ℃. The actual application effect proved that it increased average indoor air temperature by 2.2 ℃ and substrate temperature by 3.3 ℃ in heated greenhouse. The growth rate of tomato plant height in the heated greenhouse was 0.7427 cm/d, greater than that in the unheated greenhouse (0.6 cm/d). The novel system proposed in this study adopting particular location enables the rise of the ambient and the substrate temperatures with lower energy consumption, improvement of the environmental conditions in CSG, and a more suitable growing environment for plants in the cold season. [ABSTRACT FROM AUTHOR]

Reconstructing climate change over the last millennium is important for understanding natural climate variability and improving global climatic prediction. Precipitation variations from different records in north-central China, especially in the EASM margin area, are controversial. Here, we present a multi-proxy (grain size, pollen, TOC and TOC/TN ratio) record from Kulun-nuur Lake in east-central Inner Mongolia as an archive of moisture variations over the last millennium. Our record reveals that the Kulun-nuur Lake area is characterized by a wet Medieval Warm Period (MWP; 900–1300 AD), a dry Little Ice Age (LIA; 1300–1820 AD) and a relatively wet Current Warm Period (CWP; 1820 AD to present). In addition, within the context of an overall wet climate during the MWP, a short-term relatively dry episode occurred from 1000 to 1070 AD. The climate patterns reconstructed from Kulun-nuur Lake display good consistency with other records and models, suggesting that warm-wet/cold-dry are the main climate patterns in north-central China during the last millennium. These patterns of regional hydrological changes on multi-decadal to centennial scales may be related to solar activity and the Atlantic Multidecadal Oscillation. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to analyze the interest conflicts and strategy evolution process of various stakeholders in the process of homestead withdrawal, to reveal which key factors can balance the interests of all parties. Design/methodology/approach: The authors developed an evolutionary game theoretical framework for homestead withdrawal in Yujiang District, Jiangxi Province, China. The authors compared the dynamic process of strategy change in different situations based on system dynamics. Findings: Compared with indirect external factors, direct economic factors, such as increasing compensation standards or increasing fines, are more likely to encourage peasants to withdraw from their homesteads. The dynamic subsidy strategy can increase the probability of peasants withdrawing from their homestead. Additionally, awarding officials with promotions can effectively encourage local governments during the process. Originality/value: Previous studies have conceptualized farmers' willingness to withdraw from their homestead as a static process, ignoring the underlying dynamism. This paper analyzes the game mechanism among the stakeholders of the homestead withdrawal process from a dynamic perspective, to provide efficient suggestions regarding policymaking for homestead withdrawal. [ABSTRACT FROM AUTHOR]

Background: Patients with diabetes and triple-vessel disease (TVD) are associated with a high risk of events. The choice of treatment strategies remains a subject of discussion. In the real-world, we aim to compare the outcomes of medical therapy (MT), coronary artery bypass grafting (CABG), and percutaneous coronary intervention (PCI) treatment strategies in patients with diabetes and TVD. Methods: A total of 3117 consecutive patients with diabetes and TVD were enrolled. The primary endpoint was all-cause death and the secondary endpoint was major adverse cardiac and cerebrovascular events (MACCE, composite of all-cause death, myocardial infarction, or stroke). Results: During the mean follow-up of 6.3 ± 2.6 years, 573 (18.4%) deaths and 1094 (35.1%) MACCE occurred. Multivariate analysis showed that PCI (hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.32–0.51) and CABG (HR 0.33, 95% CI 0.26–0.44) were associated with a lower risk of death compared with MT, with no difference between the PCI and CABG groups. When MACCE was the endpoint, PCI (HR 0.71, 95% CI 0.60–0.84) and CABG (HR 0.48, 95% CI 0.39–0.57) had a lower risk than MT. CABG was associated with a significantly lower risk of MACCE compared with PCI (HR 0.67, 95% CI 0.55–0.81), which was mainly attributed a lower risk in myocardial infarction, but a higher risk of stroke. Conclusions: In this big real-world data and intermediate-term follow-up study, for patients with diabetes and TVD, PCI and CABG were associated with a lower risk of death and MACCE more than MT. The results suggest the importance of appropriate revascularization for diabetic patients with TVD. However, CABG was not associated with a lower risk of death, but with a lower risk of MACCE, compared with PCI. In the future, we perhaps should strengthen comprehensive treatment in addition to PCI or CABG. [ABSTRACT FROM AUTHOR]

CO2 and N2O are important greenhouse gases that are related to soil mineralization–immobilization turnover and nitrification. To explore the responses of CO2 and N2O emissions to N deposition in forests with different N transformation characteristics, CO2 and N2O fluxes were measured in two NH4NO3 fertilized plots. One plot was in a temperate pine plantation in Heilongjiang Liangshui National Nature Reserve (LS) with slow and minimally coupled mineralization–immobilization turnover and a high nitrification rate. The other plot was in a subtropical bamboo forest in the Fujian Daiyun Mountain National Nature Reserve (DY) in China with rapid and coupled mineralization–immobilization turnover but a low nitrification rate. The results showed that CO2 emissions in the DY with a high mineralization rate were greater than those in the LS. Cumulative CO2 emissions were significantly enhanced by N addition in DY, but in LS, they were not affected. The mean N2O fluxes in the control were 0.010 and 0.008 mg N m−2 hr−1 for LS and DY, respectively. High N addition stimulated N2O emissions in both LS and DY, but the response ratio for N2O flux in LS (8.6) was larger than that in DY (2.9). These results suggested that soils with rapid and coupled mineralization–immobilization turnover are beneficial to CO2 emissions and their positive response to N deposition. A high nitrification rate contributed to high N2O emissions and the sensitive response of N2O emissions to N deposition. [ABSTRACT FROM AUTHOR]

Since December 2019, the outbreak of novel coronavirus disease 2019 became a major epidemic threat in China and later spread worldwide. During the coronavirus disease 2019 outbreak in mainland China, the Chinese Obstetricians and Gynecologists Association distributed guidelines regarding the care of gynecologic patients. These guidelines were developed by the Department of Obstetrics and Gynecology at the Peking Union Medical College Hospital and represent an effort to integrate infection control strategy and promote professionalism in medical practice. The guidelines represent collaboration with experts from 31 provinces and autonomous regions of mainland China over 2 weeks' time. With the implementation of these guidelines, no nosocomial infections of coronavirus disease 2019 have been identified at the Peking Union Medical College Hospital. We think these guidelines might be helpful to departments of obstetrics and gynecology internationally during these unprecedented times. In our guidelines, we describe basic infection precaution principles, an epidemiologic screening tool, prioritization of surgical procedures, and operating room requirements. Using these principles, we then review the management of gynecologic patients during the coronavirus disease 2019 epidemic in the outpatient and operative and nonoperative inpatient settings and in clinical trials. [ABSTRACT FROM AUTHOR]

Background: While the cities in China in which spinal cord injury (SCI) studies have been conducted previously are at the forefront of medical care, northwest China is relatively underdeveloped economically, and the epidemiological characteristics of SCI have rarely been reported in this region. Methods: The SCI epidemiological survey software developed was used to analyze the data of patients treated with SCI from 2014 to 2018. The sociodemographic characteristics of patients, including name, age, sex, and occupation, were recorded. The following medical record data, obtained from physical and radiographic examinations, were included in the study: data on the cause of injury, fracture location, associated injuries, and level of injury. Neurological function was evaluated using the American Spinal Injury Association (ASIA) impairment scale. In addition, the treatment and complications during hospitalization were documented. Results: A total of 3487 patients with SCI with a mean age of 39.5 ± 11.2 years were identified in this study, and the male to female ratio was 2.57:1. The primary cause of SCI was falls (low falls 47.75%, high falls 37.31%), followed by traffic accidents (8.98%), and impact with falling objects (4.39%). Of all patients, 1786 patients (51.22%) had complications and other injuries. According to the ASIA impairment scale, the numbers of grade A, B, C, and D injuries were 747 (21.42%), 688 (19.73%), 618 (17.72%), and 1434 (41.12%), respectively. During the hospitalization period, a total of 1341 patients experienced complications, with a percentage of 38.46%. Among all complications, pulmonary infection was the most common (437, 32.59%), followed by hyponatremia (326, 24.31%), bedsores (219, 16.33%), urinary tract infection (168, 12.53%), deep venous thrombosis (157, 11.71%), and others (34, 2.53%). Notably, among 3487 patients with SCI, only 528 patients (15.14%) received long-term rehabilitation treatment. Conclusion: The incidence of SCI in northwest China was on the rise with higher proportion in males; fall and the MCVs were the primary causes of SCI. The occupations most threatened by SCI are farmers and workers. The investigation and analysis of the epidemiological characteristics of SCI in respiratory complications are important factors leading to death after SCI, especially when the SCI occurs in the cervical spinal cord. Finally, the significance of SCI rehabilitation should be addressed. [ABSTRACT FROM AUTHOR]

Changes in cultivated land in China are related to food security for nearly 1.4 billion people. Administrative ruling has decomposed the goal of cultivated land protection in China and implemented it from top to bottom, so that cultivated land data have nested attributes. Although related research on cultivated land changes has achieved fruitful results, these studies have neglected the scale effect created by the nested structure of cultivated land data, and it is easy for the policy to lose its effect in scaling. A two-layer linear model of the hierarchical linear model is constructed in this paper based on spatial autocorrelation and scale variance analyses to analyse the different spatial scales for cultivated land changes and reveal the interaction mechanism of the driving factors at different spatial scales. The results show the following: (1) The smaller the spatial scale of the study area, the easier the spatial correlation of the cultivated land quantity distribution. (2) An analysis of the driving factors of cultivated land change in Chongqing finds that 33.80% of the differences are from the functional block scale and 66.20% are from the district or county scale. (3) We found that the spatial scale has a certain impact on the effectiveness of the driving factors of cultivated land changes. Large-scale driving factors will change the correlation between small-scale driving factors and cultivated land change. In the future, the problem of scale effects should be considered in the field of cultivated land management, the effects of different driving forces at various scales should be considered and the scientific decomposition of cultivated land protection tasks according to the spatial scale should be carried out to improve the efficiency of the protection of cultivated land. [ABSTRACT FROM AUTHOR]

Background: Data of susceptible gene polymorphisms related to progression of coronary atherosclerosis in patients with three-vessel disease (TVD) is limited in China. This case-control study aimed to analyze the differences of variant carrier frequencies between cases and controls, and to explain the possible genetic effects on the progression of TVD.Methods: A total of 8943 TVD patients were consecutively enrolled. Major adverse cardiac and cerebrovascular events (MACCE) included all-cause death, acute myocardial infarction, repeat revascularization, readmission and stroke. Patients with 1-year MACCE in this cohort were selected as MACCE group. Blood samples from MACCE group and non-CAD control groups were collected, and a deoxyribonucleic acid library was created. A total of 34 tag or hot single nucleotide polymorphisms (SNPs) in six genes including CDKN2B-AS1, ADAMTS7, ABO, ADAMTS13, IL-18, and PECAM1 were analyzed by a SNPscan™ multi-genotyping kit. Carrier frequencies of each SNP were compared between the two groups using dominant, recessive and codominant allele model, respectively. Multivariate logistic regression model was established.Results: Variant allele frequencies of rs10757274, rs1333042, rs1333049, rs4977574, rs9632884, rs1063192 and rs3217986 on CDKN2B-AS1 gene showed significant differences between the two groups in at least one allele model. Variant allele frequency of rs3217986 was not statistically significant after adjusting for the false discovery rate using Benjamini-Hochberg procedure (Q > 0.05). Variant allele frequencies of rs1333049, rs10757274, rs4977574 on CDKN2B-AS1 gene were significantly higher in MACCE group in all dominant, recessive and codominant models. Rs1055432 on ADAMTS13 and rs8176694 on ABO gene showed threshold significance between the two groups. After multivariable adjustment, G mutant homozygous rs9632884 (GG vs. GC + CC) (OR: 0.24; 95% CI: 0.09-0.65; P = 0.005) on CDKN2B-AS1 gene were independent protective factor of MACCE in recessive model.Conclusions: In patients with TVD in China, variant alleles on CDKN2B-AS1 gene may form part of the genetic basis of coronary atherosclerosis progression, promoting or suppressing ischemic events. [ABSTRACT FROM AUTHOR]

Purpose: This investigation aimed to synthesize biochar-supported nanoscale zero-valent iron (BC-nZVI) to immobilize cadmium (Cd) in contaminated sediments of shallow grass-type rivers in typical cold and arid regions in northern China and reduce the bioavailability of Cd. Besides, the influence of multiple factors on the immobilization effect was discussed. In particular, the effects of the addition of humic acid (HA) on the fraction of Cd and enzyme activities were investigated. Materials and methods: In this study, BC-nZVI was synthesized and all materials were characterized by field emission scanning electron microscopy (FESEM), energy dispersive spectrometer (EDS), x-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR). The remediation effect of BC-nZVI on Cd-contaminated sediments was evaluated through sequential extraction experiments. Batch tests such as experiments of iron-to-carbon ratio, dosage, and incubation time were examined; the effect of HA concentration on Cd immobilization was highlighted, and corresponding enzyme activities (catalase, urease, and alkaline phosphatase) were tested for further illustration. Results and discussion: BC-nZVI could immobilize Cd efficiently, with the maximum residual percentage of Cd increasing by 19.57 to 81.98% after 35 days of incubation, at 1:3 iron-to-carbon ratio and 0.05 g dosage. Sequential extraction experiments indicated that most labile fractions of Cd were transformed into stable fraction. When 10 and 20 mg kg−1 HA were added, immobilization was enhanced, and residual fraction increased to 89.43% and 88.70%, respectively. Meanwhile, exclusive of catalase, the activities of urease and alkaline phosphatase were enhanced with increased incubation time. Conclusions: This study proved that BC-nZVI has a significant effect on Cd immobilization. The addition of HA greatly promoted the immobilization of Cd and enzyme activities in sediments. In conclusion, BC-nZVI is an effective substance that can be used to remediate sediments contaminated with heavy metals. [ABSTRACT FROM AUTHOR]

The present study reveals that the Madden–Julian oscillation (MJO)-related temperature anomalies over East Asia have notable differences among positive, neutral, and negative Arctic Oscillation (AO) phases. In MJO phases 2–3, cold anomalies over eastern China occur mainly during positive AO. In MJO phase 7, warm anomalies over eastern China are observed mostly during neutral AO, and in MJO phase 8 warm anomalies appear in positive and neutral AO. Regional mean temperature anomalies over northeastern East Asia tend to be negative during negative AO but positive during positive AO in six of eight MJO phases. In MJO phases 2–3, the AO-related mid- to high-latitude wave train over Eurasia and the MJO convection-triggered poleward wave train work together in contributing to negative height anomalies over eastern China and leading to cold anomalies there. The mid- to high-latitude wave train is stronger when the AO is negative than positive, which is associated with stronger zonal winds. In MJO phases 7–8, the positive AO-related mid- to high-latitude wave train over Eurasia and the MJO-induced poleward wave train cooperate in inducing positive height anomalies and leading to warm anomalies over eastern China. The mid- to high-latitude wave train is the main contributor to negative height anomalies over eastern China when the AO is negative during MJO phases 7–8. Meanwhile, the intensity of the South Asian wave source associated with the MJO convection is subjected to the modulation of southeastward dispersion of wave energy from western Europe during negative AO. [ABSTRACT FROM AUTHOR]

Abstract Objective The predictive value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with stable coronary artery disease (SCAD) in the drug-eluting stent era is not yet clear. We aimed to evaluate the prognostic value of NT-proBNP in SCAD patients after percutaneous coronary intervention (PCI). Methods We examined 4,293 consecutive SCAD patients who underwent PCI between January 2013 and December 2013 in Fuwai Hospital, China. The primary endpoint was all-cause death. NT-proBNP levels were measured before PCI using Elisa kits (Biomedica, Austria). The indication for PCI was based on the degree of coronary stenosis and evidence of ischemia. Results Among 3,187 SCAD patients with NT-proBNP data, after a 2-year follow-up, NT-proBNP levels were predictive for all-cause death in the SCAD population [area under the receiver operating characteristic curve, 0.768; 95% confidence interval (CI), 0.687–0.849; P < 0.001]. At the optimum cutoff point of 732 pg/mL, the sensitivity and specificity of death was 75.0% and 72.3%, respectively. In a multivariable Cox regression model, the death hazard ratio was 6.43 (95% CI , 2.99–13.82; P < 0.001) for patients with NT-proBNP levels ≥ 732 pg/mL, compared with < 732 pg/mL. Conclusion NT-proBNP is a strong predictor of 2-year death with SCAD after PCI in the drug-eluting stent era. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore the presentation and management of hypertension secondary to Takayasu arteritis (TA) in a large cohort, single center in China. We retrospectively analyzed 381 TA patients with hypertension hospitalized in Fuwai hospital between Jan. 2004 and Feb. 2014. Diagnosis of hypertension was according to clinic blood pressure or the central blood pressure measured during angiography. Renal artery stenosis was the most common cause (264, 69.3%), followed by the thoracic descending aorta stenosis (98, 25.7%), abdominal aorta stenosis (78, 20.5%), and severe aortic regurgitation (45, 11.8%). More than two kinds of pathologies were found in 98 (25.7%) patients. The mean age of hypertension onset was 25.0 ± 14.3 years. The mean blood pressure of upper extremity in patients without bilateral subclavian artery stenosis (321, 84.3%) was 176.0 ± 29.4 mmHg/97.2 ± 23.0 mmHg, while in 60 (15.7%) patients with bilateral subclavian artery stenosis, the mean central blood pressure was 192.7 ± 30.8 mmHg/102.4 ± 121.1 mmHg. A total of 305 were followed for 38.4 ± 36.7 months, and the rate of blood pressure control, improvement, and failure was 50.8, 41.0, and 8.2%, respectively. Immunosuppressive therapy (OR 2.402, 95% confidence interval 1.253-4.603, P = 0.008) and the pathogenesis of hypertension (P = 0.010) were associated with prognosis of hypertension. The pathogenesis of hypertension due to TA is very complex and multifactorial. Renal artery stenosis is most frequently observed, followed by stenosis of the thoracic descending aorta, abdominal aorta, and severe aortic regurgitation. Immunosuppressive therapy and identifying the pathogenesis of hypertension is of great importance in patients with TA. [ABSTRACT FROM AUTHOR]

Our aim is to investigate the prevalence and risk factors associated with hypertension among the Chinese Qiang population. From September 2012 to March 2013, a cross-sectional study was conducted in urban and rural communities of the Qiang population using multistage cluster sampling. A total of 2676 people aged above 20 years were enrolled in the analysis. Standardized mercury sphygmomanometer was used to measure the blood pressure twice after a 10-minute seated rest, and the average blood pressure was obtained. The hypertension prevalence among the population aged above 20 years was 13.9%, and age-standardized prevalence was 12.3%. Male and female prevalence of hypertension, as well as the prevalence in urban and rural areas, all increased with age. There were no significant differences between males and females and between urban and rural residents. Among hypertensive patients, 44.2% were aware of their hypertension, 38.0% were undergoing antihypertensive treatment, but only 10.5% achieved blood pressure control. Multivariate logistic regression analysis showed that the risk factors of hypertension included age, low income, overweight and obesity, family history of hypertension. The prevalence of hypertension in Chinese Qiang adults is significantly lower than the national level. Awareness, treatment, and control rates of hypertension were low in the Qiang population. Thus, hypertension-related health knowledge should be more aggressively delivered to improve public awareness and the capacity of community health services should be strengthened. [ABSTRACT FROM AUTHOR]

Aim: To investigate the impact of diabetic status on 2-year clinical outcomes in Chinese patients undergoing contemporary percutaneous coronary intervention (PCI) treatment. Methods and Results: A total of 10 724 consecutive patients underwent PCI at Fu Wai Hospital were prospectively collected. Two-year clinical outcomes were compared between patients with and without diabetes mellitus (DM). Diabetic patients had more baseline clinical risks and more extensive coronary disease. During 2-year follow-up, the rates of all-cause death, myocardial infarction (MI), revascularization, and major adverse cardiac events (MACE) were significantly higher in DM group. After multivariable-adjusted Cox regression analysis, DM was an independent risk factor for MACE but not for the individual components of MACE. After performing propensity score matching, rates of all-cause death, MI, revascularization, stroke, stent thrombosis, and MACE were not significantly different between the 2 groups, and DM was not predictive of MACE and any clinical adverse outcomes. Conclusions: Diabetic patients who underwent PCI had worse prognosis including death and repeat revascularization during 2-year follow-up, but DM was not an independent risk factor for adverse clinical outcomes. [ABSTRACT FROM AUTHOR]

We developed a new risk factor profile for contrast-induced acute kidney injury (CI-AKI) under a new definition in patients who underwent an emergency percutaneous coronary intervention (PCI). Consecutive patients (n = 1061) who underwent an emergency PCI were divided into a derivation group (n = 761) and a validation group (n = 300). The rates of CI-AKI were 23.5% (definition 1: serum creatinine [SCr] increase ≥25% in 72 hours), 4.3% (definition 2: SCr increase ≥44.2 μmol/L in 72 hours), and 7.0% (definition 3: SCr increase ≥44.2 μmol/L in 7 days). Due to the high sensitivity of definition 1 and the high rate of missed cases for late diagnosis of CI-AKI under definition 2, definition 3 was used in the study. The risk factor profile included body surface area <1.6 m2 (P = .030), transient ischemic attack/stroke history (P = .001), white blood cell count >15.00 × 109/L (P = .047), estimated glomerular filtration rate <60 mL/min/1.73 m2 (P = .002) or baseline SCr >133 μmol/L (P = .007), intra-aortic balloon pump application (P = .006), and diuretics administration (P < .001), showing a significant predictive power in the derivation group and validation group. The new risk factor profile of CI-AKI under a new CI-AKI definition in emergency PCI patients is easily applicable with a useful predictive value. [ABSTRACT FROM AUTHOR]

A strong cold event hit eastern China around 24 January 2016 with surface air temperature reaching more than 10°C below the climatological mean in most regions of eastern China south of 40°N. A total of 37 strong cold events similar to the January 2016 event with temperature anomalies over eastern China exceeding −5°C have been identified during the winters from 1979/80 to 2015/16. A comparative analysis of events with surface temperature anomalies of the same intensity but limited to north of 40°N indicates that the southward invasion of cold air to eastern China south of 40°N is related to two factors. One is the latitudinal location of the upper-level wave train, the surface Siberian high, and the midtropospheric East Asian trough over the mid- to high-latitude Eurasian continent. The other is a subtropical upper-level wave train emanating from the midlatitude North Atlantic. The emergence of the subtropical wave train is related to the positive phase of the North Atlantic Oscillation (NAO). When the mid- to high-latitude wave train is located too far northward and the subtropical wave train induces an anomalous midtropospheric high over southern China, the East Asian trough does not extend southwestward and the Siberian high does not expand southeastward. In such a case, the cold air mainly affects northeastern China and northern Japan. [ABSTRACT FROM AUTHOR]

Background: In recent years, most drug-eluting stents (DESs) were domestically produced in China, but how domestic DESs perform compared to imported DESs was still unknown.Methods: A total of 9011 consecutive cases with DESs implantation in a single center throughout 2013 were prospectively collected. Two-year clinical outcomes were evaluated between patients implanted with imported and domestic DESs.Results: During 2-year follow-up, the rates of all-cause death, cardiac death, myocardial infarction, stroke, and stent thrombosis were not significantly different between two groups. However, the rate of revascularization was significantly higher in domestic DES group, shown as higher rates of overall revascularization, target vessel revascularization (TVR), and target lesion revascularization (TLR) (9.7% vs 6.4%, P < 0.001; 5.6% vs 3.2%, P < 0.001; 4.5% vs 2.2%, P < 0.001, respectively). Accordingly, major adverse cardiac events (MACE) rate was significantly higher in domestic DES group (12.1% vs 8.5%, P < 0.001). Multivariable Cox regression analysis indicated that domestic DES was an independent risk factor of MACE (HR [95%CI]: 1.22 [1.05-1.41]), overall revascularization (HR [95%CI]: 1.29 [1.09-1.53]), TVR (HR [95%CI]: 1.54 [1.22-1.94]), and TLR (HR [95%CI]: 1.85 [1.41-2.42]). After propensity score matching, the rates of overall revascularization, TVR, and TLR were still significantly higher in domestic DES group, and domestic DES was still predictive of overall revascularization, TVR, and TLR in multivariate Cox regression analysis.Conclusions: Domestic DESs showed the same safety as imported DESs in this real-world cohort. But, patients implanted with domestic DESs had a higher risk of revascularization than imported DESs. [ABSTRACT FROM AUTHOR]

Long-term trends of atmospheric compositions are significant for assessing the influence of human activities on the atmosphere and protecting the atmospheric environment. In this study, based on heavy metal concentrations and Pb isotope ratios in a well-dated sediment core from a remote alpine lake in central North China, anthropogenic fluxes of As, Cd, Sb, and Pb were reconstructed and heavy metal evolutions in the atmosphere were revealed in the last 200 years. The heavy metals in the atmosphere were generally natural origins before 1980 A.D. Since the 1980s they began to increase gradually, but they increased the most in the 1990s resulting from rapid developments of rough and high energy-consuming industries in North China. After entering the 21st century the industries still developed rapidly, but the atmospheric Pb ceased increase and the As and Sb even decreased in the 2000s due to (1) phasing out of leaded gasoline and (2) implementing stricter industrial emission standards in 2000 A.D. in China. However, in the 2000s the atmospheric heavy metals still kept at a relatively high level and even likely began to increase again in the 2010s. Considering the lake relatively remote and seldom affected by local human activities, the results likely reflect heavy metal evolutions in the regional background atmosphere of central North China at the annual/decadal timescale in the last 200 years. [ABSTRACT FROM AUTHOR]

Liddle syndrome, an autosomal dominant form of monogenic hypertension, has been regarded as a rare disorder, which leads to many Liddle syndrome patients being misdiagnosed and experiencing severe complications at an early age. Little is known about the prevalence of Liddle syndrome. In this study, the authors investigated the prevalence of Liddle syndrome confirmed by genetic testing among young hypertension patients of undetermined causes in China. A total of 330 hypertensive patients aged 14 to 40 years after exclusion of common secondary causes of hypertension were enrolled and serum potassium concentrations were measured. Patients with hypokalemia underwent genetic testing of the 13th exon of genes encoding β and γ subunits of the epithelial sodium channel (ENaC). Diagnosis was established by identification of mutations that destroy the PY motif of ENaC. Five patients were diagnosed with Liddle syndrome (prevalence, 1.52%), as well as 12 of their relatives. These patients with Liddle syndrome presented with an earlier onset of hypertension, a stronger family history of hypertension, and higher blood pressure than those with essential hypertension. All patients had hypokalemia and suppressed plasma renin activity. The results demonstrated that Liddle syndrome is an important etiology of hypertension in this young population. Screening of Liddle syndrome should focus on young hypertension patients, particularly those with early penetrance, hypokalemia, and low renin levels after exclusion of common secondary causes. [ABSTRACT FROM AUTHOR]

Reconstructing the long-term Hg history in major emission countries is important for understanding the global Hg cycle and controlling Hg pollution. In this study, the atmospheric Hg history was reconstructed over the last three centuries based on three lacustrine sediment records from southeastern Inner Mongolia in North China, and its relationship with global and regional Hg emissions was revealed. These records show little Hg pollution in the 18th and 19th centuries. This implies a limited influence of Hg emitted from Europe and North America in this region, which is confirmed by their different Hg trends during the two World Wars and the post-1970s. Atmospheric Hg in the region had increased gradually since the 1900s, primarily contributed by emissions from the former Soviet Union in Lake Dalihu (DLH) and Lake Zhagesitai (ZGST) and from the Beijing-Tianjin-Hebei region in Lake Kulunnao (KLN). In the last century, two decreases in Hg fluxes occurred in the KLN core due to the economic recession in the 1960s–1970s and reduced energy consumption and industrial production in the 1990s. In the DLH and ZGST cores, only one decrease occurred, corresponded with the dissolution of the Soviet Union in the 1990s. Although atmospheric Hg emissions in China had stabilized or even decreased in the last decade, atmospheric Hg continued to increase, particularly in KLN, because of emissions from small cities in the region. This study can help understand Hg sources and control Hg pollution in North China and supplement the understanding of the global Hg cycling. [Display omitted] • Atmospheric Hg in the region has increased since the 1900s. • The increase in Hg in the 20th century was mainly affected by regional Hg emissions. • Sediment records showed different increasing patterns related to various Hg sources. • Hg emissions from small cities in the region dominated the 21st century increase. [ABSTRACT FROM AUTHOR]

Background: Sex plays an important role in the clinical expression and prognosis of various cardiovascular diseases. This study was designed to observe the effects of sex on hypertrophic cardiomyopathy (HCM). Methods and Results: A total of 621 unrelated patients with HCM without heart failure (460 males) were enrolled from 1999 to 2011. Compared to male patients, at baseline female patients were older at diagnosis (49.6±17.2 years vs. 46.7±14.4 years, P = 0.033), and had greater frequency of left ventricular outflow tract obstruction (72/161, 44.7% vs. 149/460, 32.4%, P = 0.005). During the average four year follow-up period (range 2–7 years), survival analysis showed that the incidences of mortality from all causes, cardiovascular death and progression to chronic heart failure were greater in women than in men (P = 0.031, 0.040 and 0.012, respectively). After adjustment for multiple factors that may confound survival and cardiac function, female sex remained an independent risk factor for all-cause mortality, cardiovascular death, and chronic heart failure [hazard ratio (HR) 2.19, 95% confidence interval (CI) 1.21–3.95, P = 0.010; HR 2.19, 95% CI 1.17–4.09, P = 0.014; HR 1.73, 95% CI 1.12–2.69, P = 0.014, respectively] in HCM patients. Subgroup analysis revealed that female sex as a risk factor was identified only in patients younger than 50 years old (P = 0.011, 0.011 and 0.009, respectively), but not for those 50 years or older. Conclusion: Our results suggest that female sex is associated with worse survival and heart failure in HCM patients. Further studies are required to determine whether female hormones modify the clinical expression and prognosis of HCM. [ABSTRACT FROM AUTHOR]

Genggahai Lake, a small, shallow water body on the northeastern Qinghai-Tibetan Plateau, is presently occupied by dense aquatic vegetation. The distribution of macrophytes is strongly associated with water depth. Macrofossils from a 7.82-m sediment core indicate that the dominant taxa in past aquatic plant communities were almost the same as those that dominate the lake today. In combination with sediment geochemical variables TOC, TN, and δC, macrofossil assemblages (aquatic plant remains, stem encrustations, and mollusc shells) were employed to reconstruct lake-level fluctuations over the past 16 ka. The lake formed or refilled at 15.3 cal ka and sustained a low level until 11.4 cal ka. From 11.4 to 6.3 cal ka, a remarkably high level was punctuated by a period of relatively low level between 9.2 and 7.4 cal ka. Stepwise drops in lake level occurred from 6.3 to 5.5 cal ka. Water level was characterized by more frequent fluctuations between 5.5 and 4.1 cal ka. Low level persisted from 4.1 to 2.1 cal ka and from 1.6 to 0.3 cal ka. Short-lived episodes of high water level were centered around 1.8 cal ka and since 0.3 cal ka. The lake-level history of Genggahai Lake appears to be largely consistent with the Asian monsoon records from nearby and distant locations. Our preliminary results suggest that monsoon variability on centennial to millennial timescales was superimposed on the long-term pattern of the Asian monsoon, modulated by orbitally induced summer insolation, and that the Asian monsoon may play an important role in water balance in marginal regions. [ABSTRACT FROM AUTHOR]

Sequential samples of a 7.82-m sediment core from Genggahai Lake in the central Gonghe Basin, controlled with 12 accelerator mass spectrometry (AMS) C dates, have been analysed for total organic carbon (TOC) and total nitrogen (TN) contents, carbon isotope of bulk organic matter ( δC), and carbonate content. Plant macrofossils and stem encrustations, derived mainly from the species of P. pectinatus, M. spicatum and Chara spp., were identified, and they dominated the aquatic plant community of the lake. Alternations of plant macrofossils of Chara spp. and the vascular species reflect the changing productivity of the lake over time. In such a shallow lake, the carbonate content is highly related to photosynthesis of aquatic macrophytes and thus indirectly indicates variations in productivity, consistent with a quantitative estimate of palaeoproductivity. Based on these results, the palaeoproductivity history was reconstructed over the past ca. 16 ka. The lake was formed or recharged at 15.3 cal ka BP, as indicated by aeolian sand deposits at the core base. A marked increase in palaeoproductivity occurred from 15.3 to 11.6 cal ka BP. Between 11.6 and 9.2 cal ka BP, a sharply increased water-level, modulated probably by the enhanced Asian summer monsoon, might have exceeded the optimum water depth for macrophyte vegetation, causing a marked decline in coverage of aquatic macrophytes and low palaeoproductivity. The palaeoproductivity appeared to be high in the early stage of the period from 9.2 to 7.4 cal ka BP, and then decreased at approximately 8.6 cal ka BP. The palaeoproductivity sustained an overall high level between 7.4 and 2.1 cal ka BP, and decreased gradually since 2.1 cal ka BP. Our results suggest that the variability of Genggahai Lake palaeoproductivity may be associated with fluctuations of the lake level controlled by the strength of the Asian summer monsoon, probably indicating changes in the Asian summer monsoon. [ABSTRACT FROM AUTHOR]

The progress of flame retarded polymer nanocomposites and coatings in China over the past decades are described in this review. Emphasis on flammability performance of polymer nanocomposites containing nanofillers, mainly layered inorganic compounds, nanofibers and nanoparticles, combined with conventional flame retardant additives are addressed based on the open literature. Polymeric coatings with improved flame retardancy prepared using a wide variety of additives and UV-curing technology are also introduced. Derived from this research, the combination of multiple methods and technologies including catalyst and nanotechnology, is predicted to have a high probability to enhance char formation and improve the flame retardancy of polymeric materials. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Automatic severity assessment and progression prediction can facilitate admission, triage, and referral of COVID-19 patients. This study aims to explore the potential use of lung lesion features in the management of COVID-19, based on the assumption that lesion features may carry important diagnostic and prognostic information for quantifying infection severity and forecasting disease progression. A novel LesionEncoder framework is proposed to detect lesions in chest CT scans and to encode lesion features for automatic severity assessment and progression prediction. The LesionEncoder framework consists of a U-Net module for detecting lesions and extracting features from individual CT slices, and a recurrent neural network (RNN) module for learning the relationship between feature vectors and collectively classifying the sequence of feature vectors. Chest CT scans of two cohorts of COVID-19 patients from two hospitals in China were used for training and testing the proposed framework. When applied to assessing severity, this framework outperformed baseline methods achieving a sensitivity of 0.818, specificity of 0.952, accuracy of 0.940, and AUC of 0.903. It also outperformed the other tested methods in disease progression prediction with a sensitivity of 0.667, specificity of 0.838, accuracy of 0.829, and AUC of 0.736. The LesionEncoder framework demonstrates a strong potential for clinical application in current COVID-19 management, particularly in automatic severity assessment of COVID-19 patients. This framework also has a potential for other lesion-focused medical image analyses. [ABSTRACT FROM AUTHOR]

: PurposeTo determine the prevalence of hypertrophic cardiomyopathy in China.: MethodsThis epidemiologic investigation was performed in 8080 adults from nine communities across nine provinces in China from October 2001 to February 2002, using a multistage, random sample design. Hypertrophic cardiomyopathy was defined as nondilated ventricular hypertrophy, documented by echocardiography, that was not caused by any known cardiac or systemic disease.: ResultsOf the 4064 men and 4016 women who were screened, 13 (0.16%; 9 men and 4 women) had definite echocardiographic evidence for hypertrophic cardiomyopathy. The age- and sex-adjusted prevalence was about 80 per 100,000 adults.: ConclusionHypertrophic cardiomyopathy is not rare in China. Based on the estimated prevalence, there are at least 1 million cases in China. [Copyright &y& Elsevier]

Transportation has become a key bottleneck which restricts economic development in Western China. However, during the construction of the western railway, the permafrost problem has plagued railway construction on the Qinghai–Tibet Plateau, and has not yet been resolved. Accurately identifying permafrost by geophysical method is the most effective means to solve this problem. However, the mountainous and plateau terrain in Western China impose huge challenges in collecting geophysical data. To address this issue, this paper proposes an airborne transient electromagnetic method to collect geophysical electromagnetic data to identify permafrost in the mountains and plateaus of Western China. Based on Maxwell's equations, the forward model of the airborne electromagnetic was derived, and the finite element method was used to calculate the two-dimensional (2D) space electromagnetic responses of different permafrost geo-electrical models. Furthermore, a coupling function was constructed to estimate the distribution of the resistivity of the permafrost by the least-squares fitting algorithm. Comparison between inversion resistivity distribution and the geo-electrical model showed that the proposed airborne transient electromagnetic method was valid for exploring the permafrost in the mountains and the Qinghai–Tibet Plateau in Western China. [ABSTRACT FROM AUTHOR]

To investigate the different causes of vision loss and school-based treatment regimens at Quanzhou Blind School (QBS), China's largest blind school, in 2008 and 2016. In 2008, 144 students received comprehensive eye examinations along with a complete family and ophthalmic history; in 2016, 125 students were examined. Vision loss was categorized into visual impairment and blindness classifications based on WHO guidelines. The etiologies of impairment and blindness in 2008 were compared to those in 2016 using the Fisher exact test. The prevalence and type of visual aids were also analyzed during this period. The leading cause of visual impairment significantly shifted from corneal scarring in 2008 to retinopathy of prematurity (ROP) in 2016 (P = 0.020). Congenital cataracts remained the leading cause of blindness in 2008 and 2016. In 2016 there was a significant increase in the use of visual aids, with 63.2% of students using them in 2016 compared to 8.3% in 2008 (P = 0.0001). Between 2008 and 2016, the leading cause of visual impairment shifted from corneal scarring to ROP, while congenital cataracts remained the leading cause of blindness. [ABSTRACT FROM AUTHOR]

Background: Compared with visual angiographic assessment, pressure wire-based physiological measurement more accurately identifies flow-limiting lesions in patients with coronary artery disease. Nonetheless, angiography remains the most widely used method to guide percutaneous coronary intervention (PCI). In FAVOR III China, we aimed to establish whether clinical outcomes might be improved by lesion selection for PCI using the quantitative flow ratio (QFR), a novel angiography-based approach to estimate the fractional flow reserve.Methods: FAVOR III China is a multicentre, blinded, randomised, sham-controlled trial done at 26 hospitals in China. Patients aged 18 years or older, with stable or unstable angina pectoris or patients who had a myocardial infarction at least 72 h before screening, who had at least one lesion with a diameter stenosis of 50-90% in a coronary artery with a reference vessel of at least 2·5 mm diameter by visual assessment were eligible. Patients were randomly assigned to a QFR-guided strategy (PCI performed only if QFR ≤0·80) or an angiography-guided strategy (PCI based on standard visual angiographic assessment). Participants and clinical assessors were masked to treatment allocation. The primary endpoint was the 1-year rate of major adverse cardiac events, a composite of death from any cause, myocardial infarction, or ischaemia-driven revascularisation. The primary analysis was done in the intention-to-treat population. The trial was registered with ClinicalTrials.gov (NCT03656848).Findings: Between Dec 25, 2018, and Jan 19, 2020, 3847 patients were enrolled. After exclusion of 22 patients who elected not to undergo PCI or who were withdrawn by their physicians, 3825 participants were included in the intention-to-treat population (1913 in the QFR-guided group and 1912 in the angiography-guided group). The mean age was 62·7 years (SD 10·1), 2699 (70·6%) were men and 1126 (29·4%) were women, 1295 (33·9%) had diabetes, and 2428 (63·5%) presented with an acute coronary syndrome. The 1-year primary endpoint occurred in 110 (Kaplan-Meier estimated rate 5·8%) participants in the QFR-guided group and in 167 (8·8%) participants in the angiography-guided group (difference, -3·0% [95% CI -4·7 to -1·4]; hazard ratio 0·65 [95% CI 0·51 to 0·83]; p=0·0004), driven by fewer myocardial infarctions and ischaemia-driven revascularisations in the QFR-guided group than in the angiography-guided group.Interpretation: In FAVOR III China, among patients undergoing PCI, a QFR-guided strategy of lesion selection improved 1-year clinical outcomes compared with standard angiography guidance.Funding: Beijing Municipal Science and Technology Commission, Chinese Academy of Medical Sciences, and the National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital. [ABSTRACT FROM AUTHOR]

This study reveals that the dominant time scale of intraseasonal snow cover variation over the eastern China is within 30 days by using the latest satellite snow cover data from the moderate resolution imaging spectroradiometer (MODIS)/Terra product. The leading empirical orthogonal function (EOF) mode of 10–30‐day snow cover variation during boreal winter from 2004 to 2018 over the eastern China has two centers: northwest part of the eastern China and north of the Yangtze River. Composite analysis based on 25 snow events identified from normalized leading principal time series (PC1) indicates that the southeastward intrusion of surface anticyclonic anomalies and accompanying low temperature anomalies provide the temperature condition for snow events. Negative Arctic Oscillation induces mid‐latitude wave train and leads to the development of surface anticyclonic anomalies and upper‐level cyclonic anomalies over East Asia. The cyclonic anomalies induce ascending motion and anomalous convergence of water vapor fluxes over the eastern China, which supplies moisture for snowfall. [ABSTRACT FROM AUTHOR]

Present study reveals that winter cold events over eastern China may be induced by Madden-Julian Oscillation (MJO)-associated anomalous convection over the Maritime Continent. We conduct composite analysis separately for identified intraseasonal cold events over eastern China that occur following anomalous convection over the Maritime Continent and the tropical Indian Ocean. For cold events related to anomalous convection over the Maritime Continent, the southward intrusion of cold air into eastern China takes an eastward path in association with eastward location of anomalous Siberian high compared to cold events related to anomalous convection over the tropical Indian Ocean. The Maritime Continent convection related cold events tend to occur with negative Arctic Oscillation (AO), whereas the tropical Indian Ocean convection related cold events tend to be accompanied by weak AO. Anomalous convective heating over the Maritime Continent triggers a poleward Rossby wave train, which, together with an AO-related southward wave train from northern Eurasia, contributes to the deepening of the East Asian trough. The poleward wave energy dispersion is similarly trigged by anomalous convective heating over the tropical Indian Ocean. In both types of cold events, anomalous tropical heating induces a meridional vertical circulation, with large-scale air mass convergence in the upper-mid-troposphere and the descending of air on the northern branch of the vertical cell over Siberia. The upper-level mass convergence and the radiative cooling over Siberia work together for the enhancement and southeastward expansion of the Siberian high and the southward intrusion of cold anomalies to eastern China. [ABSTRACT FROM AUTHOR]

Deferred revascularization of mildly stenotic coronary vessels based exclusively on physiological evaluation is associated with up to 5% residual incidence of future adverse events at 1 year. We aimed to evaluate the incremental value of angiography-derived radial wall strain (RWS) in risk stratification of non–flow-limiting mild coronary narrowings. This is a post hoc analysis of 824 non–flow-limiting vessels in 751 patients from the FAVOR III China (Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous Intervention in Patients With Coronary Artery Disease) trial. Each individual vessel had ≥1 mildly stenotic lesion. The primary outcome was vessel-oriented composite endpoint (VOCE), defined as the composite of vessel-related cardiac death, vessel-related myocardial infarction (nonprocedural), and ischemia-driven target vessel revascularization at 1-year follow-up. During 1-year follow-up, VOCE occurred in 46 of 824 vessels, with a cumulative incidence of 5.6%. Maximum RWS (RWS max) was predictive of 1-year VOCE with an area under the curve of 0.68 (95% CI: 0.58-0.77; P < 0.001). The incidence of VOCE was 14.3% in vessels with RWS max >12% vs 2.9% in those with RWS max ≤12%. In the multivariable Cox regression model, RWS max >12% was a strong independent predictor of 1-year VOCE in deferred non–flow-limiting vessels (adjusted HR: 4.44; 95% CI: 2.43-8.14; P < 0.001). The risk of deferred revascularization based on combined normal RWS max and Murray–law-based quantitative flow ratio (μQFR) was significantly reduced compared with μQFR alone (adjusted HR: 0.52; 95% CI: 0.30-0.90; P = 0.019). Among vessels with preserved coronary flow, angiography-derived RWS analysis has the potential to further discriminate vessels at risk of 1-year VOCE. (Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous Intervention in Patients With Coronary Artery Disease [FAVOR III China Study]; NCT03656848) [Display omitted] [ABSTRACT FROM AUTHOR]

• High platelet reactivity and gastric mucosal injury after aspirin (ASA) treatment compromise clinical efficacy. • Adding Panax notoginseng saponin (PNS) to ASA potentiates platelet inhibition without increased bleeding. • PNS alleviates ASA-related dyspepsia symptoms and mitigates ASA-induced gastric mucosal injury. • These effects are associated with intraplatelet and gastric arachidonic acid metabolism modulation by lipidomic analysis. High platelet reactivity and gastric mucosal injury after aspirin (ASA) treatment are associated with poor compliance and an increased risk of cardiovascular events. Panax notoginseng saponins (PNS) have been widely used for the treatment of coronary heart disease (CHD) in addition to antiplatelet drugs in China; however, the joint effect and possible mechanism of PNS in addition to ASA on platelet activation and gastric injury remain unclear. This study was designed to investigate the combinational effects of PNS with ASA, and to explore the underlying mechanism via arachidonic acid (AA) metabolism pathway using lipidomic analysis. In a randomized, assessor-blinded trial, 42 patients with stable coronary heart disease (SCHD) and chronic gastritis were randomly assigned to receive ASA (n = 21) or PNS + ASA (n = 21) for 2 months. Compared with ASA alone, PNS + ASA further inhibited CD62p expression, GPIIb-IIIa activation and platelet aggregation and led to increased platelet inhibition rate. PNS + ASA suppressed the activity of platelet cyclooxygenase (COX)-1, and decreased the production of TXB 2 , PGD 2 , PGE 2 , 11-HETE, the downstream oxylipids of AA/COX-1 pathway in platelets, compared with ASA alone. The severity of dyspepsia assessment (SODA) results showed that patients in PNS + ASA group exhibited relieved dyspeptic symptoms as compared with those in ASA group, which might be associated with enhanced secretion of gastrin and motilin. In vivo study of myocardial infarction rats demonstrated that PNS attenuated ASA-induced gastric mucosal injury, which was related to markedly boosted gastric level of 6,15-diketo-13,14-dihydro-prostaglandin (PG)F1α, 13,14-dihydro-15-keto-PGE 2 and PGE 2 from AA/PG pathway in response to PNS + ASA compared with ASA alone. In summary, our study demonstrated that the combination of PNS and ASA potentiated the antiplatelet effect of ASA via AA/COX-1/TXB 2 pathway in platelets, and mitigated ASA-related gastric injury via AA/PG pathway in gastric mucosa. [ABSTRACT FROM AUTHOR]

The UN sustainable development goals ask countries to advance sustainable production methods in agriculture. While the need for a transition to sustainable agricultural production is widely felt, there is little insight into local stakeholders' perceptions regarding agroecosystem (dis)services in areas with intensive production methods. The North China Plain is an agricultural production area with intensive production systems and simplified agricultural landscapes. We conducted a survey with 267 farmers in Quzhou county in the North China Plain in 2020 to measure the perceived level of agroecosystem (dis)services supply and the changes therein between 2015 and 2020. We analyzed which explanatory factors were associated with farmers' perceptions. Provisioning services were at a high level, while the regulating and supporting ecosystem services were considered to be in low supply, as evidenced by low scores for the presence of natural enemies and earthworms, and for natural habitats such as hedgerows and windbreaks. Most of the participants did not perceive dis-services from agriculture. Differences in perception between villages with contrasting biophysical and socio-economic conditions highlight the relevance of contextualized policy development for agricultural landscape composition and configuration to manage ecosystem (dis)services. • We surveyed stakeholder perceptions on agricultural ecosystem services. • Data were collected in a county with intensive cropping systems in China. • Farmers perceived a low supply of regulating and supporting services. • Farmers reported unawareness of dis-services. • Farmers' perceptions were associated with village characteristics. [ABSTRACT FROM AUTHOR]

• Long-term environmental changes of Lake Baiyangdian are spatially heterogeneous. • Hydrological process and land use together lead to the spatial heterogeneities. • Major environmental transitions of the wetland occurred in the 1960 s and 1990 s. • Humulus pollen is a key indicator of anthropogenic impacts in populated wetland. Understanding long-term environmental changes and man-land interactions within wetlands is important for their ecological maintenance and restoration. However, there has been little focus on the spatial heterogeneity of environmental variations of wetlands, especially large agricultural wetlands, which hinders the development of targeted management programs for specific areas. We conducted a multi-proxy study of the sediments of a typical agricultural wetland, Lake Baiyangdian in North China, to assess the spatial heterogeneity of environmental changes over the past 70 years. The results reveal that the environmental changes in Lake Baiyangdian were spatially heterogeneous, mainly reflected by the response to hydrological variations before the 1970 s, and by changes in trophic level and land cover transitions since the 1990 s, which are strongly linked to changes in agricultural land use. Pollen and grain-size analyses revealed the large-scale spatial heterogeneity of changes in the sedimentary environment. Areas with greater openness, shallower water depths, and proximity to inflowing rivers were generally more sensitive to hydrological processes and provided regional records of environmental change. In contrast, populated areas far from inflows tended to capture more local changes related to anthropogenic impacts. Intensive agricultural activity has led to a continuous increase in nutrient enrichment and significant land cover transitions in Lake Baiyangdian, mainly the loss of natural wetland. Variations in Humulus pollen were a key indicator of these anthropogenic impacts. Hydrological processes and land use changes were together responsible for the spatial heterogeneity of the environmental variations in Lake Baiyangdian over the last 70 years, indicating the dominant role of human impacts on the spatio-temporal pattern of the evolution of this wetland ecosystem, and the complexity of its environmental management. [ABSTRACT FROM AUTHOR]

Abstract: Independent dust provenance data play an important role in understanding changes in the atmospheric dust loading over geological time. Major elemental compositions and grain-size characteristics of the aeolian deposits (Xiangshan (XS) section) at the southeastern margin of the Tengger Desert in northwestern China demonstrate that the deposits are an intermediate product of the transportation of aeolian materials from the dust source area (deserts) to the dust depositional regions (Chinese Loess Plateau) that were likely formed by dust storm processes. The >40μm and 63–178μm fractions and the ratio of SiO2/TiO2 of the XS section were used as proxies to reconstruct the surface wind regime over the last 20kyr. The results show that the surface winds were much stronger and fluctuate acutely from 19.1 to 11.4kyr. The winds gradually attenuated after the beginning of the Holocene and reached a minimum between 4.0 and 3.5kyrBP. A sharp increase in surface winds occurred after 2.5kyrBP. The surface winds in the Asian dust source area are largely consistent with the changes in winter monsoon strength documented by the Chinese loess deposits. Also, the stronger surface winds from 19.1 to 11.4kyr coincide with the high mineral dust concentration determined from the Greenland ice core, except for the period of Bölling–Allerød (B/A), when the atmospheric dust may have been washed out by enhanced global hydrological cycles although dust was still emitted from source areas. This suggests that the stronger surface winds in dust source areas can enhance the atmospheric dust loadings during the late glacial. The weakening surface wind regime during the Holocene may have greatly contributed to the decrease in dust concentration of the remote dust records. The paleo-environmental changes in the study area since 42.5kyrBP are broadly in agreement with other adjacent records. However, the possible warm and humid spell of 42.5–19.1kyrBP still requires verification. [Copyright &y& Elsevier]