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Aims. The aim of this study is to assess the relationship between rivaroxaban plasma concentration quantified by the gold standard and anticoagulant activities measured by routine coagulation assays in Chinese atrial fibrillation (AF) patients. Whether the normal results of these tests were reliable to rule out clinically relevant rivaroxaban levels at various thresholds was also explored. The effect of clinical drug-drug interactions (DDIs) on the exposure and anticoagulant effect of rivaroxaban were further evaluated. Methods. 116 patients receiving rivaroxaban for the management of nonvalvular AF were recruited. Rivaroxaban concentrations and coagulation tests were measured by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) and a blood coagulation analyzer, respectively. Results. The correlation of trough concentration (Ctrough) and prothrombin time (PT) or international normalized ratio (INR) was moderate with Spearman's correlation coefficient of 0.495 and 0.506, respectively. A normal PT/INR was unable to rule out Ctrough levels of >30 ng/mL and >50 ng/mL, but the negative predictive value reached 100% to exclude Ctrough of >100 ng/mL. Ctrough showed a small correlation with activated partial thromboplastin time (aPTT) (Spearman's correlation coefficient: 0.241) and no correlation with thrombin time (TT) (Spearman's correlation coefficient: 0.074). Neither aPTT nor TT accurately predicted Ctrough at any concentration. Peak concentration (Cpeak) did not correlate with any coagulation parameters. The presence of digoxin and febuxostat significantly increased rivaroxaban Ctrough by 2.18 fold and prolonged PT and INR by 44.16% and 43.60%, respectively. Conclusions. Normal routine coagulation assays were insufficient to monitor therapy with rivaroxaban. Poor correlations between rivaroxaban concentration and routine coagulation assays were observed in Chinese AF patients. The use of digoxin/febuxostat alone had no effect on rivaroxaban concentrations; however, combined strong breast cancer resistance protein inhibitor (febuxostat) and P-glycoprotein probe (digoxin) in patients with renal impairment is likely to cause clinically significant DDI with rivaroxaban. More studies are needed to establish routine therapeutic drug monitoring of rivaroxaban in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: We systematically retrospected and analyzed the general characteristics of ophthalmic drug clinical trials (CTs) registered in China from January 2014 to December 2021. Methods: Data were retrieved from the Drug Trial Registration and Information Publication Platform and then standardized and statistically classified using bibliometric analysis. Results: We identified 201 drug CTs for eye diseases, including 24 international multicenter trials. The number of drug CTs for eye diseases has considerably increased since 2017 in parallel with new policies to encourage innovation in drugs and medical devices in China. The drug types consist of biologicals (48.26%), chemicals (45.77%), and traditional Chinese medicine/natural medicines (5.97%). The main indications were age-related macular degeneration (AMD; n = 47, 23.38%), macular edema (n = 32, 15.92%), and diabetic retinopathy (n = 19, 9.45%). The trials included those in phase I (n = 67, 33.33%), phase II (n = 33, 16.42%), and phase III (n = 72, 35.82%). The phase I trials comprised 24 innovative drug treatments for AMD and 6 novel drug treatments for neuromyelitis optica spectrum disorders, with 39 biologicals and 27 chemicals. The trials mostly followed a randomized (84.08%) or masked (67.16%) design, with 90.37% of the latter being double-masked trials. Conclusion: Research and development of ophthalmic drugs have substantially increased in recent years and are influenced by regulatory policies. Among these drugs, biologicals for AMD are the most prevalent, followed by biologicals for macular edema. Randomized double-masked research designs are often used and represent high-quality evidence. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the distribution of ocular biometric parameters and its association to refraction in university students in central China. Methods: Ocular biometric parameters including axial length (AL), central corneal thickness (CCT), keratometry power (K), anterior chamber depth (AQD) and lens thickness (LT) were measured by an optical biometry in a cohort of university students. Corneal radius of curvature (CR), lens position (LP), lens power (PBennett), vitreous chamber depth (VCD) and AL to corneal radius ratio (AL/CR) were calculated. Cycloplegic refraction was measured using an autorefractor. Results: A total of 7650 undergraduate students participated in this study, with a mean age of 20.0 ± 1.4 years. The following ocular biometric parameters were measured: AL (24.78 ± 1.21 mm), CCT (539.83 ± 33.03 μm), AQD (3.23 ± 0.25 mm), LT (3.47 ± 0.18 mm), CR (7.79 ± 0.27 mm), LP (4.97 ± 0.23 mm), VCD (17.55 ± 1.15 mm), PBennett (25.00 ± 1.07 dioptres) and AL/CR (3.18 ± 0.15). Male subjects were found to have longer AL, thicker CCT, flatter CR, thinner lens, deeper AQD and VCD than female ones. Myopic subjects were found to have longer AL, thinner CCT, steeper CR, thinner and posterior lens, deeper AQD and VCD, lower PBennett and larger AL/CR than emmetropes and hyperopes. Spherical equivalent (SE) showed a negative correlation with AL/CR (r = −0.914), AL (r = −0.755) and VCD (r = −0.751). Conclusions: This study provided a range of reference values for the main ocular biometric parameters in young adults and reported their distributions based on gender and refractive status. Our study indicates that SE has a strong correlation with AL/CR ratio, AL and VCD. [ABSTRACT FROM AUTHOR]

Motivation The coronavirus disease 2019 (COVID-19) caused by a new type of coronavirus has been emerging from China and led to thousands of death globally since December 2019. Despite many groups have engaged in studying the newly emerged virus and searching for the treatment of COVID-19, the understanding of the COVID-19 target–ligand interactions represents a key challenge. Herein, we introduce COVID-19 Docking Server, a web server that predicts the binding modes between COVID-19 targets and the ligands including small molecules, peptides and antibodies. Results Structures of proteins involved in the virus life cycle were collected or constructed based on the homologs of coronavirus, and prepared ready for docking. The meta-platform provides a free and interactive tool for the prediction of COVID-19 target–ligand interactions and following drug discovery for COVID-19. Availability and implementation http://ncov.schanglab.org.cn. Supplementary information Supplementary data are available at Bioinformatics online. [ABSTRACT FROM AUTHOR]

Summary Background China is the world's largest consumer of tobacco and has a large smoking-related chronic disease burden. In this nationwide study, we aimed to evaluate smoking prevalence and its implication on chronic diseases in the Chinese population. Methods We collected data from serial cross-sectional National Health Service Surveys done in China in 2003, 2008, and 2013. These surveys cover all 31 provinces, autonomous regions, and municipalities in mainland China, and use multistage stratified cluster sampling. We divided mainland China into east, central, and west regions and then sampled counties from each region stratified by urban and rural areas. All respondents aged 15 years or older in the selected households were eligible. We analysed the variation in smoking prevalence from 2003 to 2013, further identified risk factors for smoking, and assessed the association between smoking and chronic diseases by using multiple logistic regression. Findings The number of individuals interviewed and involved in the study was 153 450 in 2003, 145 223 in 2008, and 229 676 in 2013. The standardised smoking prevalence in China was consistently high, with a proportion of current smokers of 26·0% (95% CI 25·8–26·2) in 2003, 24·9% (24·8–25·1) in 2008, and 25·2% (25·1–25·4) in 2013 (p value for trend 0·5062). For men, prevalence was 48·4% (48·1–48·7) in 2003, 47·0% (46·6–47·4) in 2008, and 47·2% (46·9–47·5) in 2013. For women, prevalence was 3·1% (3·0–3·2) in 2003, 2·3% (2·2–2·5) in 2008, and 2·7% (2·6–2·8) in 2013. Smoking prevalence varied in different regions, and we identified four major patterns. While a consistently high proportion of Chinese men smoked, the standardised smoking prevalence in women younger than 40 years increased from 1·0% in 2003 to 1·6% in 2013. Moreover, the smoking prevalence among adolescent smokers aged 15–24 years increased from 8·3% in 2003 to 12·5% in 2013. Alcohol consumption was closely linked to smoking in adolescents (odds ratio 7·5, 95% CI 6·9–8·1). Risk factors for adolescent smoking were having older family members who smoke (1·9, 1·8–1·9) and low level education (1·3, 1·2–1·4). Increased risks of chronic diseases were related to smoking (1·1, 1·0–1·1), with higher risks related to early smoking initiation (1·1, 1·0–1·1) and long-term smoking (1·2, 1·2–1·3). Interpretation The implementation of tobacco control policies in China since the signing of the WHO Framework Convention on Tobacco Control in 2003 has not been effective in reducing smoking prevalence. Smoking prevalence among adolescents of both genders has increased substantially and there has been a steady increase among young women. More practical and effective policies targeting adolescents and women are urgently needed. Action is needed to prevent the large and growing smoking-related chronic disease burden further increasing as China's population ages. Funding National Health Commission of the People's Republic of China. [ABSTRACT FROM AUTHOR]

Abstract: This study empirically investigated the structure and function of maladaptive cognitions related to Pathological Internet Use (PIU) among Chinese adolescents. To explore the structure of maladaptive cognitions, this study validated a Chinese Adolescents’ Maladaptive Cognitions Scale (CAMCS) with two samples of adolescents (n1=293 and n2=609). The results of the exploratory factor analysis and confirmatory factor analysis revealed that CAMCS included three distinct factors, namely, “social comfort,” “distraction,” and “self-realization.” To examine the function of maladaptive cognitions, this study tested an updated cognitive-behavioral model in the third sample of 1059 adolescents. The results of structural equation model analyses verified both the direct effect of maladaptive cognitions on PIU and their mediating role in the relationships between distal factors (social anxiety and stressful life events) and PIU among Chinese adolescents. Theoretical and practical implications of these findings were discussed. [Copyright &y& Elsevier]

The article describes the development of clinical data groups for Electronic Medical Records (EMR) in China. Topics covered include the adoption of the Health Level 7 Clinical Document Architecture Release 2 Model in categorizing information in the medical sheets, the use of the data groups as guidelines for building EMR Systems and the combination of international standards with Chinese national regulations and standards.

The article discusses the highlights of the Eighth International Conference on Plant Biology Frontiers held in Fujian, China on September 23 to 27, 2010. The event featured keynote speeches, plenary talks and poster presentations. It tackled various issues concerning plant cell and signaling biology including the systems biology of cell polarization in yeast, the dynamics of the cytoskeleton and protein trafficking.

Investigation indicates that the subsidence pattern in the lower Yangtze Delta area is related to groundwater extraction. Suzhou-Wuxi-Changzhou region (“Su-Xi-Chang”) belongs to the hinterland of the lower Yangtze Delta that has a total area of 12,000 km2. From 1979 to 2000, long-term pumping of groundwater at Su-Xi-Chang has caused a rapid decline in groundwater table, resulting in large-scale land subsidence. In this paper, establishment of a GPS-based monitoring system for land subsidence using 30 years of data, is presented. The data were obtained through monitoring of 184 wells. Also analyzed herein is the relationship between the observed lowering of the groundwater table and subsidence. Monitoring data indicate that the depression cone of groundwater table and the occurrence of subsidence are basically identical in time and space. The generation of both features is attributed to excessive extraction of ground water in the region. Finally, countermeasures against subsidence are proposed. [ABSTRACT FROM AUTHOR]

Background: China accounts for more than 30% of the world's suicides and displays a unique pattern of suicide rates. Prior research had established the link between macrosocial changes and suicide. Comprehensive surveillance system of suicide in this rapidly developing country is much needed. This paper examined the trends of national-, region-, gender-, and age-specific suicide rates, and male to female ratios in suicide in China for the period of 1991-2000, which was a time that rapid economic and social changes took place.Methods: A regression model was used to detect any variations in national-, region-, gender-, and age-specific suicide rates and gender ratios reported by the most recent mortality statistics from China's Ministry of Health.Results: National, urban, and rural suicide rates for both men and women decreased significantly for the period of 1991-2000; age-specific suicide rates, however, showed that there were different patterns of changes in suicide rates in rural and urban areas. Although elderly suicide rates showed the most significant decrease in urban areas, younger women showed the largest decrease in rural areas; male to female gender ratio in suicide increased significantly in the urban areas, but no significant change was found in rural areas.Conclusions: Possible explanations that may account for the downward trends in suicide rates and increase in male to female gender ratio in urban area were provided. Longer historical studies are needed to reveal the relationship between macrosocial changes and the pattern of suicide. [ABSTRACT FROM AUTHOR]

Abstract: Objective: For the purpose of establishing electronic health record (EHR), business-oriented health data distributed in different systems should be integrated to focus on individuals. This study is aimed at collecting health data items that are now nationally available in various health information systems, and harmonizing them by modeling and defining the data elements. Methods: This study followed a bottom-up strategy in data standard development. Health data items were identified and collected by referring to national health service regulations, consulting domain experts and performing field investigations. Data items were classified and modeled based on recognized domain knowledge, information standards and specifications developed by standard development organizations (SDOs) of other countries. Data elements were extracted from data items and defined according to ISO/IEC 11179 –Metadata registries (MDR) and confirmed needs. Results: 1588 data items were collected from 33 recording forms that have been used nationally in health services, and were classified with a conceptual data model that was composed of 7 super classes (healthcare clients, healthcare providers, birth registry, health event/act, healthcare process, death, and others) and 15 classes (person''s identification, person''s socio-demographic characteristics, address, communication, provider-organization, provider-individual, birth, health event/act, observation, procedure, drug and material administration, recommendation, evaluation, expenditure, death, others). By normalizing the concepts and representations of data items, data elements were derived and defined as the attributes of classes in the data model. Data items were specified as instances of corresponding data elements. Conclusions: A large number of health data have been collected nationwide but person''s life-long health record is incomplete and inconsistent now. To integrate such massive quantity of health data from various sources, a conceptual data model was established to organize data items, avoiding conflicts and duplications in between. For data consistency, data elements should be extracted from the data items and defined as attributes of classes in the data model by choosing essential metadata attributes. Treating data items as instances of well defined data elements might make data in different contexts manageable and agreeable. To be semantically unambiguous, further study should be performed to deal with the standardization of detailed medical information, and perfect the approach of data harmonization. [Copyright &y& Elsevier]

Railway design is complex and closely linked to environmental concerns. To solve this problem, a two-stage method considering three categories of environmental factors (topography, ecology and geology) is proposed and demonstrated by being applied to a real-world case in China. The first stage focuses on environmental impact assessment. An elevation accessibility map is generated by determining railway spatially-reachable ranges. Then, the three categories of environmental factors are divided into 12 sub-factors and their spatial relations with railways are analyzed using a GIS. After that, an environmental suitability map is produced by combining the influences of these sub-factors with a multi-criteria analytical hierarchy process. The second stage focuses on automated railway design. The study area is first narrowed based on the two maps to determine feasible search spaces. Then, a distance transform algorithm is customized to search for railway alignments. During the search, a multi-criteria tournament decision method is integrated to optimize alignment solutions. Lastly, the application results of our two-stage method are analyzed. The outcomes reveal that the two environment-related maps provide effective descriptions of the study area. Through comparisons between the computer-generated railway and the best alternative produced by experienced designers, improvements of our method are also discussed. • A two-stage method is proposed for solving multi-criteria railway design problems. • The first stage generates an elevation accessibility map of railway spatially-reachable ranges. • A railway suitability map is produced with GIS and AHP on the influences of 12 environmental factors. • The second stage incorporates a MTD into a LCP algorithm to solve the MCDM problem. • The two-stage method shows significant improvements over traditional methods in a complex actual case. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, the social distancing has significantly affected the healthy lifestyle behaviors of residents. China ended social distancing on January 8, 2023, and the healthy lifestyle behaviors of residents after this time are unclear. The goal of this study was to evaluate the differences in healthy lifestyle behaviors between Chinese urban and rural residency after the termination of social distancing., Methods: From February 1, 2023, to February 8, 2023, a cross-sectional survey which include participants (≥ 18 years old) was carried out in four regions of mainland China (Changzhou in the eastern region, Zhengzhou in the central region, Xining in the western region, and Mudanjiang in the northeastern region). A healthy lifestyle behaviors scale containing 11 items was designed to calculate the healthy lifestyle behaviors scores among urban and rural residents. The healthy lifestyle behaviors scores ranged from 11 to 51. Multivariate linear regression was used to analyze the influencing factors of healthy lifestyle behaviors scores among urban and rural residents. Propensity Score Matching was used to assess the net differences in healthy lifestyle behaviors scores between urban and rural residents., Results: A total of 5780 residents (53.04% females) were included in the study, including 3302(57.13%) urban residents. The average healthy lifestyle behavior score was 38.33(95%CI: 38.18 to 38.49). Healthy lifestyle behaviors score among males was lower than that among females in both urban (β = -1.98, 95%CI: -3.05 to -2.10) and rural residents (β = -2.57, 95%CI: -2.37 to -1.60). Higher education was associated with higher healthy lifestyle behaviors scores in both urban and rural residents. PSM analysis indicated that urban residents still had higher healthy lifestyle behaviors scores (38.72, 95% CI: 38.46 to 38.99) than rural residents (37.85, 95%CI: 37.57 to 38.13), with a net difference of 0.87 points., Conclusions: After the termination of social distancing, the overall healthy lifestyle behaviors of Chinese residents were found to be at a medium level. Urban residents have a better healthy lifestyle behavior compared to their rural counterparts. It is essential to prioritize efforts towards enhancing the healthy lifestyle behaviors of rural residents., Competing Interests: Declarations. Ethics approval and consent to participate: The studies involving human participants were reviewed and approved by the Life Science Ethics Review Committee of Zhengzhou University (Record No: 2021–12-21–05). We have obtained consent to publish from all participants (or legal parent or guardian for children). Consent for publication: We have obtained consent to publish from all participants (or legal parent or guardian for children). Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

This study aimed to evaluate how the duration of travel affects the behavior of urban and rural residents regarding free COVID-19 vaccination, and provide scientific evidence for promoting free vaccination and building an immune barrier to cope with future epidemics. From August 3, 2022 to February,18,2023, A follow-up survey was conducted in urban and rural adults in four cities in China to collect information on socio-demographic factors, vaccination status and travel time for vaccination. Propensity score matching (PSM) analysis was deployed to measure the net difference of the enhanced vaccination rate between urban and rural residents in different traffic time distribution. A total of 5780 samples were included in the study. The vaccination rate of the booster dose of COVID-19 vaccine among rural residents was higher than that of urban residents with a significant P-value (69.36% VS 64.49%, p  < .001). The traffic time had a significant negative impact on the COVID-19 booster vaccination behavior of urban and rural residents. There was a significant interaction between the travel time to the vaccination point and the level of trust in doctors. Travel time had a negative impact on the free vaccination behavior of both urban and rural residents. The government should optimize and expand the number of vaccination sites and enhance residents' trust in the medical system. This is crucial for promoting free vaccination and effective epidemic management in the future.

Background: Sarcopenia and multimorbidity are common in older adults, and most of the available clinical studies have focused on the relationship between specialist disorders and sarcopenia, whereas fewer studies have been conducted on the relationship between sarcopenia and multimorbidity. We therefore wished to explore the relationship between the two., Methods: The study subjects were older patients (aged ≥ 65 years) who were hospitalized at the Department of Geriatrics of the First Affiliated Hospital of Chongqing Medical University between March 2016 and September 2021. Their medical records were collected. Based on the diagnostic criteria of the Asian Sarcopenia Working Group in 2019, the relationship between sarcopenia and multimorbidity was elucidated., Results: 1.A total of 651 older patients aged 65 years and above with 2 or more chronic diseases were investigated in this study, 46.4% were suffering from sarcopenia. 2. Analysis of the relationship between the number of chronic diseases and sarcopenia yielded that the risk of sarcopenia with 4-5 chronic diseases was 1.80 times higher than the risk of 2-3 chronic diseases (OR 1.80, 95%CI 0.29-2.50), and the risk of sarcopenia with ≥ 6 chronic diseases was 5.11 times higher than the risk of 2-3 chronic diseases (OR 5.11, 95% CI 2.97-9.08), which remained statistically significant, after adjusting for relevant factors. 3. The Charlson comorbidity index was associated with skeletal muscle mass index, handgrip strength, and 6-meter walking speed, with scores reaching 5 and above suggesting the possibility of sarcopenia. 4. After adjusting for some covariates among 14 common chronic diseases in older adults, diabetes (OR 3.20, 95% CI 2.01-5.09), cerebrovascular diseases (OR 2.07, 95% CI 1.33-3.22), bone and joint diseases (OR 2.04, 95% CI 1.32-3.14), and malignant tumors (OR 2.65, 95% CI 1.17-6.55) were among those that still a risk factor for the development of sarcopenia., Conclusion: In the hospitalized older adults, the more chronic diseases they have, the higher the prevalence of sarcopenia. When the CCI is 5, attention needs to be paid to the occurrence of sarcopenia in hospitalized older adults., (© 2024. The Author(s).)

Background: Achieving universal health coverage (UHC) is one crucial target of the Sustainable Development Goals. However, consistent trends data for UHC evaluation in China are still scarce. The aim of our study was to provide a comprehensive assessment of UHC in China., Methods: In this serial cross-sectional study, we collected nationally representative data from the latest four rounds (2003, 2008, 2013, and 2018) of the National Health Service Surveys, with the aim of evaluating UHC in China. These surveys used multistage stratified cluster sampling covering all 31 provinces, autonomous regions, and municipalities in mainland China. Within each household, all members aged 15 years and older were interviewed. For children and adolescents aged younger than 15 years, their adult family members answered the questions for them. We constructed a UHC index following the WHO-recommended framework that included service coverage (nine prevention indicators and five treatment indicators) and financial protection (three indicators) dimensions. Bayesian regression models were done to investigate the trends in and projections of UHC index and indicators, with average annual percentage change (AAPC) and probabilities of achieving the 2030 WHO targets. Based on trends and projections, we counted population equivalents with UHC coverage. To examine the potential efficiency of financial investment, we quantified UHC performance based on government health expenditure (GHE) per capita. Finally, we explored the association between each UHC indicator and macroeconomic and health systems characteristics by using multiple regression., Findings: We sampled 57 023 households from 95 counties between September and October, 2003; 56 456 households from 94 counties between June and July, 2008; 93 613 households from 156 counties between August and October, 2013; and 94 076 households from 156 counties in September, 2018. A total of 901 182 individuals were involved in this study (193 689 in 2003, 177 501 in 2008, 273 688 in 2013, and 256 304 in 2018). Although the overall UHC increased from 44·0% (95% CI 43·0-44·9) in 2003 to 79·8% (79·2-80·3) in 2018 and is predicted to meet the 80% global target by 2030, the progress towards UHC has steadily slowed down nationally. Based on current projections, an estimated 105·8 (95% CI 27·3-189·1) million population equivalents would still not have UHC coverage in 2030. The treatment index showed a large increase over time from 2003 to 2018 (AAPC 4·9%, 2·9-7·2), with minimal disparities and all subgroups will achieve the target in the treatment domain by 2030 (possibilities higher than 90%). However, the prevention index presented poor performance with a small increase over time from 2003 to 2018 (AAPC 1·4%, 0·3-2·5) and sizable disparities across regions, urban-rural areas, and income (all p<0·0001). To achieve at least 80% UHC coverage, provinces would need to reach at least ¥445 in GHE per capita per year under maximum efficiency. However, large gaps between the observed and frontier UHC index, especially in several western provinces, indicated inefficiency. Furthermore, we found that primary health-care institutions were closely and positively related to UHC indicators especially in the prevention domain., Interpretation: Although considerable achievements have been made, the progress towards UHC is not keeping pace with the rapid society development in China. Considering an increased burden in non-communicable diseases and an ageing population, prioritising the efficacy of financial investment and optimising resource allocation by strengthening primary health care are necessary to achieve UHC in China., Funding: National Natural Science Foundation of China and National Health Commission of the People's Republic of China., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Myopia has become a major public health issue with an increasing prevalence. There are still individuals who experience similar environmental risk factors and, yet, remain non-myopic. Thus, there might be genetic factors protecting people from myopia. Considering the opposite ocular characteristics of primary angle closure glaucoma (PACG) to myopia and possible common pathway between them, we propose that certain risk genes for PACG might act as a protective factor for myopia. In this study, 2,678 young adults were genotyped for 37 targeted single nucleotide polymorphisms. Compared with emmetropia, rs1401999 (allele C: OR=0.795, P=0.03; genotype in dominant model: OR=0.759, P=0.02) and rs1258267 (allele A: OR=0.824, P=0.03; genotype in dominant model: OR=0.603, P=0.01) were associated with low to moderate myopia and high myopia, respectively. Genotype under recessive model of rs11024102 was correlated with myopia (OR=1.456, P=0.01), low to moderate myopia (OR=1.443, P=0.02) and high myopia (OR=1.453, P=0.02). However, these associations did not survive Bonferroni correction. Moreover, rs1401999, rs1258267, and rs11024102 showed associations with certain ocular biometric parameters in different groups. Our study suggests that ABCC5, CHAT and PLEKHA7 might be associated with refractive errors by contributing to the regulation of ocular biometry, in terms of uncorrected results and their biological functions., (© 2022. Science China Press and Springer-Verlag GmbH Germany, part of Springer Nature.)

Previous research has identified exposure to interparental conflict (IPC) in childhood as a risk factor for young adults' depression. However, there is still a lack of understanding of the underlying mediating mechanisms of this association. Driven by the spillover hypothesis, the present study investigated whether maternal antipathy and neglect, and in turn unmet psychological needs, mediated the relation between IPC and early adulthood depression in a sample of 347 undergraduate students (M = 23.27 years; SD = 0.86; 57.05% women) in China. The participants completed self-report measures of IPC, maternal care, satisfaction of basic psychological needs, and depression. Structural equation modeling revealed that: (a) IPC was positively associated with early adulthood depression; (b) this association was sequentially mediated by inadequate maternal care (i.e., antipathy and neglect) and by unsatisfied psychological needs. These findings suggest that efforts to prevent depression should focus on reducing not only IPC, but also inadequate maternal care and unmet psychological needs.

Background: To assess the impact of study-at-home during the COVID-19 pandemic on myopia development in Chinese schoolchildren. Methods: This historical cohort involved two groups with a total of 154 children. The exposed group was formed from 77 children aged 8 to 10 years who studied at home in the 7-month period during the COVID-19 pandemic (follow-up period: January - August 2020) and did not study at home in the 7-month period before the COVID-19 outbreak (baseline period: July 2019 - January 2020). Seventy-seven children who did not undergo study-at-home (baseline period: 7 months in 2015, follow-up period: 7 months in 2016) were included in the control group. Cycloplegic refraction, axial length and uncorrected visual acuity were measured 3 times. The questionnaire mainly focused on collecting visual habits. Results: Myopia progression was similar between the two groups in the baseline period. However, in the follow-up period the exposed group had a greater change in refraction toward myopia (-0.83 ± 0.56 D) than the control group (-0.28 ± 0.54 D; p < 0.001). In addition, the exposed group exhibited a significantly greater change in refraction toward myopia in the follow-up period (-0.83 ± 0.56 D) than in the baseline period (-0.33 ± 0.46 D; p < 0.001). Difference-in-difference analysis indicated that study-at-home accelerated the change in refraction toward myopia ( t = -0.567; p < 0.001). Conclusions: During the COVID-19 pandemic study-at-home accelerated the change of refraction toward myopia in children., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ma, Wei, Li, Yang, Cao, Hu, Peng, Yan, Fu, Grzybowski, Jin and Wang.)

Objective: To analyze the rates of blindness with the demographics and clinical characteristics of patients with primary angle-closure disease (PACD) to provide a comprehensive epidemiologic reference in China., Methods: A retrospective analysis was conducted in the Chinese Glaucoma Study Consortium database, which is a national multicenter glaucoma research alliance of 111 hospitals participating between December 21, 2015 and September 9, 2018. The diagnosis of PACD was made by qualified physicians through examination. Comparison of sex, age, family history, subtypes of PACD, and blindness were analyzed., Results: A total of 5762 glaucoma patients were included, of which 4588 (79.6%) had PACD. Of PACD patients, 72.1% were female with the sex ratio (F/M) of 2.6, and the average age of patients was 63.8±9.3 years with the majority between 60 and 70 years. Additionally, 30% of these patients had low vision in one eye, 8.8% had low vision in both eyes, 1.7% had blindness in one eye, and 0.3% had blindness in both eyes. There were statistical differences with regards to age between male and female patients with PACD, with male patients being older on average. Primary angle-closure glaucoma was more commonly diagnosed in males (60%) compared to females (35.9%), whereas acute primary angle closure (APAC) was more commonly diagnosed in females (54.3%) compared to males (37.7%). The visual acuity in APAC patients was lower and the rate of low vision and blindness was higher than other subtypes., Conclusion: PACD was the major type of glaucoma in Chinese hospitals. There were more female patients with PACD, mostly between 60 and 70 years old, with higher rates of APAC in women. APAC resulted in the worst visual outcomes of all PACD subtypes., (Copyright © 2021 Canadian Ophthalmological Society. All rights reserved.)

Purpose: To determine myopia progression in children during the COVID-19 and the related factors associated with myopia., Methods: All subjects underwent three-timepoint ocular examinations that were measured in July 2019, January, and August 2020. We compared the changes in uncorrected visual acuity (UCVA), mydriatic spherical equivalent (SE), and axial length (AL) between two periods (before and during COVID-19). A questionnaire was performed to investigate risk factors for myopia., Results: Compared with before the COVID-19, the mean (S.D.) myopia progression during the COVID-19 was significantly higher in right eyes (- 0.93 (0.65) vs. - 0.33 (0.47) D; p < 0.001). However, the differences in UCVA changes and the axial elongation between two periods were clinically insignificant. Through logistic regressive analysis, we found the difference of the SE changes was associated with the baseline AL (P = 0.028; 95% confidence interval [CI], 1.058, 2.632), online education (P = 0.02; 95% CI, 1.587, 8.665), and time of digital screen (p < 0.005; 95% CI, 1.587, 4.450)., Conclusions: Children were at higher risk of myopia progression during COVID-19, which was associated with the baseline AL, the longtime online learning, and digital screen reading., (© 2021. The Author(s).)

Precis: Chinese Glaucoma Study Consortium (CGSC) as the first nationwide glaucoma registry in China, we describe its design, rationale, the geographic distribution of the hospitals, and baseline patient characteristics., Aim: As a leading cause of blindness in China, glaucoma affects 2% to 4% of adults over the age of 40 and will become increasingly prevalent as the population ages. At the national level, there are few reports on the current medical practice for glaucoma patients. CGSC will be considered as the first nationwide glaucoma registry in China. Here we describe its design, rationale, the geographic distribution of the hospitals, and baseline patient characteristics., Methods: From December 21, 2015 to September 9, 2018, CGSC recruited patients with the diagnoses of primary angle-closure suspect, primary angle-closure, primary angle-closure glaucoma, acute primary angle closure, primary open-angle glaucoma (POAG), pigmentary glaucoma (PG), and pseudoexfoliative glaucoma (PXG) from 111 hospitals covering 67 cities from 22 provinces, 4 municipalities, and 5 autonomous regions in mainland China. Clinical data were collected using an Electronic Data Capture System designed by Tongren hospital and Gauss informed Ltd. Blood samples were collected from every patient for further genetic analysis., Results: Medical records of 10,892 patients were collected, of which 5762 patients have complete information. The average age of those with complete information (n=5762) was 62.05±11.26 years old, and 35.25% were males. Primary angle-closure disease, including primary angle-closure suspect/primary angle-closure/primary angle-closure glaucoma/acute primary angle closure, was predominant (4588, 79.63%), and the distribution for others is as follows: POAG (1116, 19.37%), PXG (41, 0.71%) and PG (17, 0.30%). A total of 16,684 blood samples were collected, of which 9917 (82.68%) were primary angle-closure disease, 1987 (16.57%) were POAG, 69 (0.58%) were PXG, 22 (0.18%) were PG, and 4689 were normal controls., Conclusions: The CGSC is the first national-level glaucoma registry study in China. Clinical data and blood samples will provide the opportunity to study the epidemiology of glaucoma in Chinese hospitals, to evaluate the level of medical diagnosis and treatment of glaucoma in China, and to identify the susceptibility loci for glaucoma.

Purpose: To investigate the prevalence and associations of visual impairment and spectacle use in university students in central China., Design: Cross-sectional study., Methods: This study included students aged 16-26 years in China. Study subjects from 2 universities underwent distance visual acuity (VA) assessment in both eyes with a logarithm of the minimum angle of resolution chart and their refractions were measured by cycloplegic autorefraction. Blindness was defined as presenting VA less than three-sixtieth in the better eye (World Health Organization definition), and visual impairment was defined as presenting VA less than six-twelfths., Results: Overall, 9710 undergraduates were enumerated, 7704 (79.3%) subjects were included in this study. The prevalence of uncorrected VA less than six-twelfths and less than three-sixtieth in the better eye were 69.9% and 0.9%, respectively. Only 77.0% (4148/5388) of subjects with uncorrected VA in the better eye of less than six-twelfths wore glasses. For presenting VA, the prevalence of mild (VA <6/12 to 6/18), moderate (VA <6/18 to 6/60), and severe (VA <6/60 to 3/60) visual impairment was 6.3%, 11.2%, and 0.7%, respectively. Overall, 71.7% (4300/6001) of students with myopia (spherical equivalent ≤-0.5 diopters) wore spectacles. In multiple logistic regression analysis, visual impairment was associated with female sex (P < .001) and lower year level of education (P = .006) when presenting with VA., Conclusions: This study has documented a relatively high prevalence of visual impairment and relatively low spectacle coverage in Chinese university students. Given the potential impact of visual impairment, target education and accessible refraction services are highly important to solve the problem., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: The major infectious diseases of hepatitis B has constituted an acute public health challenge in China. An effective and affordable HBV control model is urgently needed. A national project of Community-based Collaborative Innovation HBV (CCI-HBV) demonstration areas has optimized the existing community healthcare resources and obtained initial results in HBV control., Methods: Based on the existing community healthcare network, CCI-HBV project combined the community health management and health contract signing service for long-staying residents in hepatitis B screening. Moreover, HBV field research strategy was popularized in CCI-HBV areas. After screening, patients with seropositive results were enrolled in corresponding cohorts and received treatment at an early stage. And the uninfected people received medical supports including health education through new media, behavior intervention and HBV vaccinations. In this process, a cloud-based National Information Platform (NIP) was established to collect and store residents' epidemiological data. In addition, a special quality control team was set up for CCI project., Results: After two rounds of screening, HBsAg positive rate dropped from 5.05% (with 5,173,003 people screened) to 4.57% (with 3,819,675 people screened), while the rate of new HBV infections was 0.28 per 100 person-years in the fixed cohorts of 2,584,322 people. The quality control team completed PPS sampling simultaneously and established the serum sample database with 2,800,000 serum samples for unified testing., Conclusions: CCI-HBV project has established a large-scale field research to conduct whole-population screening and intervention. We analyzed the HBsAg prevalence and new infection rate of HBV in the fixed population for the epidemic trend and intervention effect. The purpose of CCI-HBV project is to establish and evaluate a practical model of grid management and field strategy, to realize the new goal to control hepatitis B in China. To provide policymakers with a feasible model, our results are directly applicable., Trial Registration: The project was funded by the Major Projects of Science Research for the 11th and 12th five-year plans of China, entitled "The prevention and control of AIDS, viral hepatitis and other major infectious diseases", Grant Nos. 2009ZX10004901, 2011ZX10004901, 2013ZX10004904, 2014ZX10004007 and 2014ZX10004008.

Purpose: To assess the prevalence of refractive errors and associated factors in university students in urban areas of Anyang, Central China., Methods: This is a cross-sectional university-based study of 16- to 26-year-old students in China. Subjects from two universities were invited to undergo a comprehensive eye examination. Cycloplegic refraction was acquired by autorefractor with two drops of 1% cyclopentolate. The prevalence of myopia, high myopia, hyperopia, astigmatism, and anisometropia was calculated. Only data from right eyes were included in analysis., Results: A total of 7732 eligible subjects were included, with an average age of 20.2 ± 1.4 years. Overall, the mean spherical equivalent (SE) was -2.92 ± 2.48 diopters (D). The prevalence of myopia (SE ≤ -0.50 D), emmetropia, and hyperopia (SE ≥ +0.50 D) was 83.2%, 9.5%, and 7.3%, respectively. Female sex (OR = 1.542; P < 0.001) and science and engineering students (OR = 1.219; P = 0.004) were more likely to be myopic. The prevalence of high myopia, defined using SE ≤ -5.0 D, ≤ -6.0 D, and ≤ -10.0 D, respectively, occurred in 20.2%, 11.1 %, and 0.5%. High myopia (SE ≤ -6.0 D) was statistically associated with female sex (OR = 1.202; P = 0.029) and younger age (OR = 0.896; P = 0.001). The prevalence of astigmatism (cylinder of ≤ -0.75 D) was 28.8%. Astigmatism was associated with male sex (OR = 0.824; P = 0.001) and younger age (OR = 0.925; P = 0.001)., Conclusions: A prevalence of 83.2% for myopia and 11.1% for high myopia (SE ≤ -6.0 D) was found in central Chinese university students. In the future, this generation of university students may encounter long-term, vision-threatening effects, especially pathologic myopia.

Background: National vital registration systems are the principal source of cause specific mortality statistics, and require periodic validation to guide use of their outputs for health policy and programme purposes, and epidemiological research. We report results from a validation of cause of death statistics from health facilities in urban China., Methods: 2917 deaths from health facilities located in six cities in China constituted the study sample. A reference diagnosis of the underlying cause was derived for each death, based on expert review of available medical records, and compared with that filed at registration. Sensitivity, specificity and positive predictive value were computed for specific causes/cause categories according to the International Classification of Diseases (ICD), including analyses based on quality of evidence scores for each cause. Patterns of misclassification by the registration system were studied for individual causes of death., Results: The registration system had good sensitivity in diagnosing cerebrovascular disease and several site specific cancers (lung, liver, stomach, colorectal, breast and pancreas). Sensitivity was average (50-75%) for some major causes of adult death in China, namely ischaemic heart disease (IHD), chronic obstructive lung disease (COPD), diabetes, and liver and kidney diseases, with compensatory misclassification patterns observed between several of them. Sensitivity was particularly low for hypertensive disease., Conclusions: Although diagnostic misclassification is not uncommon in urban death registration data, they appear to balance each other at the population level. Compensating misclassification errors suggest that caution is required when drawing conclusions about particular chronic causes of adult death in China. Investment is required to improve the quality of cause attribution for health facility deaths, and to assess the validity of cause attribution for home deaths. Periodic assessments of the quality of cause of death statistics will enhance their usability for health policy and epidemiological research.