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Five new orchid species from southwestern China's Yunnan Province and the Tibetan Autonomous Region, Neottia lihengiae, Neottia chawalongensis, Papilionanthe motuoensis, Gastrochilus lihengiae, and Gastrochilus bernhardtianus, are described and illustrated. To confirm their identities, and to resolve phylogenetic relationships, we sequenced the complete plastomes of these taxa with their congeneric species, adding new plastomes of three Neottia species, two Papilionanthe species and nine Gastrochilus species. Combined with published plastid sequences, our well-resolved phylogeny supported the alliance of N. lihengiae with the the N. grandiflora + N. pinetorum clade. Neottia chawalongensis is now sister to N. alternifolia, while P. motuoensis is closely related to P. subulata + P. teres. Conversely, phylogenetic analyses based on complete plastomes and plastid sequences showed inconsistent relationships among taxa in the genus Gastrochilus, but the two new species, G. lihengiae and G. bernhardtianus were supported by all datasets. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate the association between starchy vegetable consumption and subgroup consumption in the first trimester and the risk of gestational diabetes mellitus (GDM). Methods: A prospective study (n = 1444) was conducted in China. Dietary information was assessed by 24-hour dietary recalls for three days and then we calculated the consumption of total starchy vegetable and its subgroups, including (1) potato and (2) other starchy vegetable (pumpkin, lotus root, yam, taro, water chestnut, pea, and cowpea). GDM was diagnosed according to the results of 75-g two-hour oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. A modified log-binomial regression was used to estimate RRs and 95% CIs of GDM risk. Results: Among the 1444 participants in our study, 520 were diagnosed with GDM. The adjusted RRs (95% CIs) for GDM from the lowest to the highest quartiles of total starchy vegetable consumption were 1.00 (reference), 1.29 (1.06, 1.57), 1.13 (0.93, 1.40), and 1.26 (1.02, 1.56), respectively; p for trend = .032. For potato, the RR of GDM risk was 1.32 for the highest potato intake quartile compared with the lowest quartile (95% CI 1.07–1.64, p for trend = .003). In addition, we did not observe an association between other starchy vegetable intakes and GDM risk. Conclusions: A higher consumption of total starchy vegetables and potatoes in the first trimester is associated with a greater risk of GDM. [ABSTRACT FROM AUTHOR]

Methods: A retrospective study was performed with 128,270 pregnant women who delivered at Ningbo Women & Children's Hospital from January 2010 to December 2020. Univariate and multivariate logistic regression analysis was applied to estimate the risk factors associated with GDM prevalence. Segmented regression analyses of interrupted time series (ITS) were conducted to assess the effect of the universal two-child policy on the trends of GDM. Results: The prevalence of GDM increased remarkably from 4% in 2010 to 21% in 2020. ITS analysis presented that the prevalence of GDM increased by 0.190% (b1) permonth from 2010 to 2016 (P<0.05), and by 0.044% (b1+b3) permonth after the implementation of the universal two-child policy; the rate of elevation of GDM slowed down significantly (b3=-0.146, P=0.004). Advanced maternal age (>30 years), multigravidity, multiparity, multiple gestation and gestational hypertension were significantly associated with GDM. Advanced age remained an independent risk factor for GDM even after cross stratification with gravidity and parity. The proportion of womenwith advancedmaternal age (>30 years) increased by 0.161% per month before the implementation of the universal two-child policy and increased by 5.25% during the policy took effect month, and gradually increased by 0.124% (b1+b3) per month after then. Conclusions: The prevalence of GDM has sharply increased in the past decade. The growth rate of GDM slowed down after the implementation of the universal two-child policy in China, but the rate would maintain at a high plateau. The rise in the proportion of older pregnant women could increase the GDM rate. We recommend having children at a relatively optimal reproductive age when encouraging childbearing. [ABSTRACT FROM AUTHOR]

Vaccinium motuoense (Ericaceae), a new species from Motuo County, Xizang Autonomous Region, China is described and illustrated. This new species belongs to Vaccinium sect. Calcicolus and is morphologically most similar to V. dunalianum, but differs in having yellowish-brown tomentose young branches, petioles and inflorescence rachis, leaf blades with 2-3(-4) pairs of secondary veins, usually all basal and with fine veins impressed adaxially and urceolate to spherical corollas. [ABSTRACT FROM AUTHOR]

Context: Up to 40% of patients with polycystic ovary syndrome (PCOS) have prediabetes; an optimal pharmacotherapy regimen for diabetes prevention in PCOS is yet to be established.Objective: To evaluate clinical efficacy of exenatide (EX), metformin (MET), or combination (COM) for prediabetes in PCOS.Design: Randomized, open-label, parallel-group controlled trial.Setting: Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine.Patients: PCOS with prediabetes (fasting plasma glucose 5.6-6.9 mmol/L and/or 2 hour post glucose 7.8-11.0 mmol/L on oral glucose tolerance test [OGTT]). A total of 150 out of 183 eligible enrollees completed the study.Intervention: EX (10-20μg daily), MET (1500-2000 mg daily), or COM (EX plus MET) for 12 weeks.Main Outcome Measures: Sustained remission rate of prediabetes (primary endpoint, a normal OGTT after 12 weeks of treatment followed by 12 weeks of washout on no drug treatment) along with anthropometric, hormonal, metabolic, and pancreatic β-cell function parameters (secondary endpoints) and potential mechanisms were assessed.Results: Impaired glucose tolerance was found the dominant prediabetes phenotype. Overall sustained prediabetes remission rate was 50.7%. Remission rate of COM group (64%, 32/50) or EX group (56%, 28/50) was significantly higher than that of the MET group (32%, 16/50) (P = .003 and .027, respectively). EX was associated with superior suppression of 2-hour glucose increment in OGTT. A 2-step hyperglycemic clamp study revealed that EX had led to higher postprandial insulin secretion than MET, potentially explaining the higher remission rate.Conclusions: Compared with MET monotherapy, EX or COM achieved higher rate of remission of prediabetes among PCOS patients by improving postprandial insulin secretion. [ABSTRACT FROM AUTHOR]

Bulbophyllum reflexipetalum, a new species from Motuo County, Southeast Xizang, China, is described and illustrated here. This new species belongs to Bulbophyllum sect. Umbellata Bentham & J. D. Hooker, and it is morphologically similar to B. umbellatum Lindley, B. guttulatum (J. D. Hooker) N. P. Balakrishnan and B. salweenensis X.H. Jin, but is distinguished from them by having reflexed petals, base of dorsal sepal with 1 dentate on each side, lip with significantly revolute margin, adaxially with dark brown spots or patches and one longitudinal groove. [ABSTRACT FROM AUTHOR]

Two genera, Callipeltis Steven (Rubiaceae) and Acanthocephalus Kar. & Kir. (Asteraceae), together with five species, Callipeltis cucullaris (L.) DC., Acanthocephalus benthamianus Regel, Galium verticillatum Danthoine ex Lam. (Rubiaceae), Nonea turcomanica Popov (Boraginaceae), and Erysimum croceum Popov (Brassicaceae), are reported as new records to China. [ABSTRACT FROM AUTHOR]

Background: The New Cooperative Medical Scheme (NCMS) for peasantries implemented in 2003 and the Urban Resident Basic Medical Insurance (URBMI) for the urban unemployed implemented in 2007 have many similarities. They both apply the financing mode of individual premiums plus government's subsidies, and the voluntary enrollment. The Chinese government plans to integrate these two systems and build a unified basic medical insurance system for the unemployed in order to achieve the medical equity and increase the general health level. Thus, to analyze the main influencing factors of the enrollment of the urban unemployed and rural residents is very important for improving the system and securing the stability of the system during the transition.Methods: The study uses data from the China Health and Nutrition Survey (CHNS) and adopts logistic regression models to test which factors influence the enrollment of the URBMI and the NCMS under the background of rather high enrollment rate of Chinese basic medical insurances and strong fiscal support of the Chinese government, especially whether health status or age influences enrollment of these two insurances greater.Results: There is indeed some adverse selection in the URBMI and the NCMS. Whether the individual has chronic diseases have significant influence on enrollments of both the urban unemployed and rural residents, while whether the individual got ill in last four weeks just influences enrollments of the urban unemployed. Age influences enrollment greater than health status. The older the insured are, the larger the enrollment rates are.Conclusion: Because of the active support for basic medical insurances of the Chinese government, the enrollment performance of the urban unemployed and rural residents has already changed. When implementing the new policy, the government should pay attention to the willingness to enroll in and the change of enrollment performance of the insured. Therefore, under the policy of voluntary enrollment, every coordinated province and city should enlarge the proportion of young people to insuring group, optimizing the age structure, and the financing proportion of governments and individuals should be measured properly. With the increasing of governments' subsidies, the proportion of individual's premiums should also be increased. [ABSTRACT FROM AUTHOR]

Climate change and human activities have changed a number of characteristics of river flow in the northwest of China. Numerous problems such as water resource shortage, drying up of rivers, water pollution are the direct consequences of these changes. In this paper, we used the example of Yulin city in northwest China to assess the spatio-temporal characteristics and driving forces of annual river flow changes. Our research was based on the long-term time series of hydrological data from 1956 to 2005, to analyse annual flow in four main rivers (Kuye River, Tuwei River, Wuding River and Jialu River). The river flow depends upon the runoff characteristics of the river catchment, therefore we used variation ratio, variation index, unevenness, Runoff-Concentration Degree (RCD) and Runoff-Concentration Period (RCP) to determine the change in runoff characteristics of the four main rivers flows of the Yulin city. We tested the tendency of runoff by the Mann-Kendall non-parameter statistical method to obtain the temporal evolution law. At the same time, Kriging spatial interpolation and GIS were used to derive the spatial evolution law. The dates of climate change (precipitation) and human activities were also used to calculate the driving forces for annual runoff changes of the rivers’ catchments. Through the accumulation curves and multi-recursive techniques, we built the correlation between precipitation and runoff. The driving factors for annual runoff change were then calculated by using the runoff coefficient method. Results showed that the distribution of annual runoff was uneven and had a small accumulation in July and August, especially in Kuye River, and there seemed to be a significant reducing trend in annual runoff. Isolines and the thematic map of Mann-Kendall tests U(R) revealed that the Tuwei River's catchment is the most affected catchment, with annual runoff substantially changed. At the 5% significance level, precipitation did not significantly drop compared with annual runoff. We also found that precipitation is not the only factor responsible for the decreased annual runoff. Therefore we included human activities affect in this case study by using the past 25 years land use, water conservancy and urbanisation data. We discriminated the impacts of climate change and human activities on the surface runoff by multi-recursive analysis method and runoff coefficient method. The results showed that human activities are the direct cause for the changes of river runoff. The results of the study also revealed that the Wuding and Jialu rivers had the most and the least changes in the runoff respectively; this phenomenon should be seriously considered for future water resources planning and management. [ABSTRACT FROM PUBLISHER]

Background: Hepatitis B virus (HBV) is still one of the serious infectious risks for the blood transfusion safety in China. One plausible reason is the emergence of the variants in the major antigenic alpha determinant within the major hydrophilic region (MHR) of hepatitis B surface antigen (HBsAg), which have been assumed to evade the immune surveillance and pose a challenge to the disease diagnosis. It is well documented that some commercial ELISA kits could detect the wild-type but not the mutant viruses. The high prevalence of HBV in China also impaired the application of nucleic acid testing (NAT) in the improvement of blood security. Molecular epidemiological study of HBsAg variations in China is still limited. This study was designed to identify the prevalence of mutations in the HBsAg in voluntary blood donors in Nanjing, China., Methods: A total of 20,326 blood units were enrolled in this study, 39 donors were positive for HBV S gene in the nested-PCR. Mutations in the major hydrophilic region (MHR; aa 99-169) were identified by direct sequencing of S region., Results: Among of 20,326 blood units in the Red Cross Transfusion Center of Nanjing from October 2008 to April 2009, 296 samples (1.46%, 296/20,326) were HBsAg positive in the 2 successive rounds of the ELISA test. In these HBsAg positive units, HBV S gene could be successfully amplified from 39 donors (13.18%, 39/296) in the nested-PCR. Sequence analysis revealed that 32 strains (82.1%, 32/39) belong to genotype B, 7 strains (17.9%, 7/39) to genotype C. Besides well known G145R, widely dispersed variations in the MHR of S region, were observed in 20 samples of all the strains sequenced., Conclusions: HBV/B and HBV/C are dominant in Nanjing, China. The mutations in the MHR of HBsAg associated with disease diagnosis are common.