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As a child god from Chinese legends, the figure of Nezha has a strong appeal to children, and his story has been adapted to various media. This article examines Nezha's image in three animated films, exploring how this figure has been altered to represent Chinese children and youth and symbolize their subjectivity. From a revolutionary hero to a socialized child and a rebellious adolescent, Nezha's transformations demonstrate how an iconic figure has been reimagined to reflect shifting socio-political contexts in the Chinese socialist and post-socialist eras.

Pegmolesatide, a synthetic, polyethylene-glycolylated, peptide-based erythropoiesis-stimulating agent (ESA), has been recently approved in China. Pegmolesatide is derived from the structure of endogenous erythropoietin (EPO), a natural product in mammals. This study compared the in vitro effects and selectivity of pegmolesatide to those of recombinant EPO and carbamylated EPO (CEPO) through computer-aided analyses and biological tests. The findings indicate that pegmolesatide exhibited the same stimulating effect on erythropoiesis as EPO with fewer side effects than EPO and CEPO. [ABSTRACT FROM AUTHOR]

This study aims to analyze the prevalence trend of esophageal cancer in Japan and China to provide suggestions for the prevention and treatment of esophageal cancer. The results showed that the incidence rate for the years 2010–2018 significantly decreased with an APC of 5.66%, and the mortality rate from 2010 to 2015 had an APC of −5.87% in China. However, the incidence rate of Japanese women showed an upward trend, with an APC of 4.09% from 2010 to 2019. The mortality rate of esophageal cancer in Japan showed a downward trend, with an APC of −2.96% from 2010 to 2021. From 2010 to 2018, Chinese esophageal squamous cell carcinoma accounted for the highest proportion, accounting for 85.96%, with the largest distribution in the middle, accounting for 47.25%. Patients are mostly diagnosed at stage III, and the relative survival rate from 2012 to 2015 was 30.3%. Japan also has the highest proportion of squamous cell carcinoma, and the lesions are also mostly located in the middle segment. While Japanese esophageal cancer patients are mostly diagnosed at stage I, and the relative survival rate was 41.5% in Japan from 2009 to 2011. The results of this article indicate that the current prevalence of esophageal cancer in China and Japan is generally declining, and the quality of life of patients is gradually improving, but effective screening and prevention strategies are still needed to reduce the burden of this disease. [ABSTRACT FROM AUTHOR]

Background: Epidemiological research and systematic meta-analyses indicate a higher risk of B-cell lymphomas in patients with chronic hepatitis C virus (HCV) compared to non-infected individuals. However, the genetic links between HCV and these lymphomas remain under-researched. Methods: Mendelian randomization analysis was employed to explore the association between chronic hepatitis C (CHC) and B-cell lymphomas as well as chronic lymphocytic leukemia (CLL). Approximate Bayes Factor (ABF) localization analysis was conducted to find shared genetic variants that might connect CHC with B-cell lymphomas and chronic lymphocytic leukemia (CLL). Furthermore, The Variant Effect Predictor (VEP) was utilized to annotate the functional effects of the identified genetic variants. Results: Mendelian randomization revealed a significant association between CHC and increased diffuse large B cell lymphoma (DLBCL) risk (OR: 1.34; 95% CI: 1.01–1.78; P = 0.0397). Subsequent colocalization analysis pinpointed two noteworthy variants, rs17208853 (chr6:32408583) and rs482759 (chr6:32227240) between these two traits. The annotation of these variants through the VEP revealed their respective associations with the butyrophilin-like protein 2 (BTNL2) and notch receptor 4 (NOTCH4) genes, along with the long non-coding RNA (lncRNA) TSBP1-AS1. Conclusion: This research provides a refined genetic understanding of the CHC-DLBCL connection, opening avenues for targeted therapeutic research and intervention. [ABSTRACT FROM AUTHOR]

The performance of two thermoluminescent dosimetry systems (RGD-3D and RE2000) manufactured in China and Finland was compared. Both of these dosimetry systems demonstrated satisfactory results as their performance met the requirements of the standard. The two dosimetry systems showed similar performance in the energy response. The RGD-3D dosimetry system performed better in nonlinear response, minimum detectable level and blind sample tests, whereas the RE2000 dosimetry system showed better stability. [ABSTRACT FROM AUTHOR]

Background: To report the microbiological isolates, aetiology, complications, antibiotic susceptibilities, and clinical remission of dacryocystitis and canaliculitis in a prominent tertiary ophthalmic teaching and referral hospital located in northern China and to offer appropriate recommendations for preventing and formulating drug treatment strategies. Methods: This prospective study recruited a total of 477 participants who had been diagnosed with either dacryocystitis or canaliculitis. The cohort comprised 307 patients with chronic dacryocystitis, 111 patients with acute dacryocystitis, and 59 patients with canaliculitis. Purulent discharge from the lacrimal duct was collected using a sterile swab and immediately subjected to microbial culture. Antimicrobial susceptibility testing was conducted following established protocols. All participants were scheduled for follow-up visits within 14 days after receiving antibiotic therapy. Results: The present findings indicated that women exhibited a higher susceptibility to the condition, as evidenced by the occurrence of 367 cases in comparison to 110 cases among men. Among the 477 patients, definitive causes were established in 59 individuals, accounting for 12.4% of the patients. Additionally, ocular complications were reported by 132 patients, representing 27.7% of the total. Monocular involvement was observed in the majority of cases, with 402 out of 477 patients (84.3%) affected, while binocular involvement was present in 75 patients (15.7%). In total, 506 microbiological strains were recovered from 552 eyes, with Staphylococcus epidermidis (16.4%) being the most prevalent microorganism. Other predominant isolates included Corynebacterium macginleyi (9.1%), Staphylococcus aureus (5.1%), Streptococcus pneumoniae (4.9%), Haemophilus (4.4%), Propionibacterium acnes (3.5%), and Eikenella corrodens (3.1%). Among the 12 isolated fungi, Candida parapsilosis accounted for 66.7%. The susceptibility to antimicrobial agents tested in gram-negative bacilli (79.5%) was observed to be higher than that of anaerobic bacteria (76.7%) and gram-positive cocci (55.4%). With pharmacological therapy, the remission rate of acute dacryocystitis (72.7%) was found to be higher than that of canaliculitis (53.3%) and chronic dacryocystitis (42.3%). Conclusions: This study highlights the microbial spectrum of dacryocystitis and canaliculitis, particularly C.macginleyi, E.corrodens and C.parapsilosis, which are also more frequently isolated. Vancomycin and imipenem may be more effective treatment options. Most cases have an unknown aetiology, and essential preventive measures involve postoperative cleansing of the lacrimal passage following eye and nasal surgeries, as well as the proactive management of rhinitis. [ABSTRACT FROM AUTHOR]

Drawing on the notions of transmedia storytelling and engagement, this study investigates how practitioners engage with the process of producing and consuming boys' love (BL) audio dramas, the trans-directional communication and interaction between producers and consumers in the transmedia BL subcultural space, and the implications of their engagement for counterculture. We contribute to the growing field of BL studies by providing insights into how practitioners can stimulate these cultural productions as a part of gender–sexuality-related counterculture in the new media space of audio dramas. We argue that the engagement of BL audio drama producers and consumers ('prosumers') features the sense of countering the predominant heteronormativity in China by producing explicit homosexual romance, actively expanding the story elements transmedially, and bringing queer members into the BL audio drama community. In this way, built by both producers and consumers together, the BL audio drama community is no longer a female-only area, but becomes a more inclusive 'third' space constituted by people with diverse sexual identities and orientations. Given its knowledge, perspectives, and experiences, the BL audio drama community, as a countercultural group, has a certain potential to bridge the divide between the female-led BL subculture and the larger queer community. [ABSTRACT FROM AUTHOR]

Background: Radiation pneumonitis (RP) is one of the common side effects after adjuvant radiotherapy in breast cancer. Irradiation dose to normal lung was related to RP. We aimed to propose an organ features based on deep learning (DL) model and to evaluate the correlation between normal lung dose and organ features. Methods: Patients with pathology-confirmed invasive breast cancer treated with adjuvant radiotherapy following breast-conserving surgery in four centers were included. From 2019 to 2020, a total of 230 patients from four nationwide centers in China were screened, of whom 208 were enrolled for DL modeling, and 22 patients from another three centers formed the external testing cohort. The subset of the internal testing cohort (n = 42) formed the internal correlation testing cohort for correlation analysis. The outline of the ipsilateral breast was marked with a lead wire before the scanning. Then, a DL model based on the High-Resolution Net was developed to detect the lead wire marker in each slice of the CT images automatically, and an in-house model was applied to segment the ipsilateral lung region. The mean and standard deviation of the distance error, the average precision, and average recall were used to measure the performance of the lead wire marker detection model. Based on these DL model results, we proposed an organ feature, and the Pearson correlation coefficient was calculated between the proposed organ feature and ipsilateral lung volume receiving 20 Gray (Gy) or more (V20). Results: For the lead wire marker detection model, the mean and standard deviation of the distance error, AP (5 mm) and AR (5 mm) reached 3.415 ± 4.529, 0.860, 0.883, and 4.189 ± 8.390, 0.848, 0.830 in the internal testing cohort and external testing cohort, respectively. The proposed organ feature calculated from the detected marker correlated with ipsilateral lung V20 (Pearson correlation coefficient, 0.542 with p < 0.001 in the internal correlation testing cohort and 0.554 with p = 0.008 in the external testing cohort). Conclusions: The proposed artificial Intelligence-based CT organ feature was correlated with normal lung dose in adjuvant radiotherapy following breast-conserving surgery in patients with invasive breast cancer. Trial registration: NCT05609058 (08/11/2022). [ABSTRACT FROM AUTHOR]

Common ragweed is an invasive alien species causing severe allergies in urban residents. Understanding its urban invasion pathways is crucial for effective control. However, knowledge is limited, with most studies focusing on agricultural and natural areas, and occurrence record-based studies exhibiting uncertainties. We address this gap through a study in East China cities, combining population genetics and occurrence records. Leaf samples from 37 urban common ragweed populations across 15 cities are collected. Genomic and chloroplast DNA extraction facilitate analysis of spatial genetic patterns and gene flows. Additionally, international grain trade data is examined to trace invasion sources. Results indicate spatial genetic patterns impacted by multiple introductions over time. We infer the modern grain trade between the United States and China as the primary invasion pathway. Also, cities act as transportation hubs and ports of grain importation might disperse common ragweed to urban areas. Invasive species control should account for cities as potential landing and spread hubs of common ragweed. Examination of the spatial genetic pattern of common ragweed plants in urban areas in East China cities and the influence of grain trade between China and the U.S suggestions multiple invasion events. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine which method, individual information-centered (IIC) or group information-centered (GIC), is more efficient in recovering missing physical activity (PA) data. Method: A total of 2,758 Chinese children and youth aged 9 to 17 years old (1,438 boys and 1,320 girls) wore ActiGraph GT3X/GT3X+ accelerometers for 7 consecutive days. Those with no missing data ("n" = 900) were used to form a nonmissing sample, which, based on a semisimulation approach, was used to create a missing data set to evaluate a set of recovery methods, including 2 IIC and 22 GIC methods. Root mean square difference (RMSD), mean signed difference, and paired "t" test were used to determine the effectiveness of the recovery methods. Results: The smallest RMSD values, which represent the most accurate recovery, were found with: (a) GIC-Expectation--maximization (GIC-EM) regardless of gender and by age (113,957.64); (b) GIC-EM regardless of gender and age (114,367.88); (c) GIC-EM regardless of age and by gender (114,697.06); (d) GIC-EM by gender and age (116,178.34); and (e) IIC averaging of remaining days (125,851.23). Conclusion: To recover 7-day PA accelerometer-determined activity missing data, we recommend using the GIC-EM and IIC approaches.

Ovarian age assessment is an important indicator to evaluate the ovarian reserve function and reproductive potential of women. At present, the application of ovarian age prediction model in China needs further improvement and optimization to make it more suitable for the actual situation of women in China. In this study, we collected subjects and their data in three ways: firstly, we collected clinical data from a number of women go to local hospital, including healthy women and women with DOR or PCOS; secondly, we obtained data by recruited healthy women through CRO companies for a fee; thirdly, we collected data from a number of healthy women using WeChat applet. Using the data collected by CRO company and WeChat applet, we applied the generalized linear model to optimize the ovarian age prediction model. The optimized formula is: OvAge = exp (3.5254–0.0001*PRL-0.0231*AMH), where P = 0.8195 for PRL and P = 0.0003 for AMH. Applying the formula to the hospital population data set for testing, it showed that the predicted ovarian age in the healthy women was comparable to their actual age, with a root mean squared error (RMSE) = 5.6324. The prediction accuracy was high. These data suggest that our modification of the ovarian age prediction model is feasible and that the formula is currently a more appropriate model for ovarian age assessment in healthy Chinese women. This study explored a new way to collect clinical data, namely, an online ovarian age calculator developed based on a WeChat applet, which can collect data from a large number of subjects in a short period of time and is more economical, efficient, and convenient. In addition, this study introduced real data to optimize the model, which could provide insights for model localization and improvement. [ABSTRACT FROM AUTHOR]

Hydrochemical research and identification of nitrate contamination are of great significant for the endorheic basin, and the Northern Huangqihai Basin (a typical endorheic basin) was comprehensively researched. The results showed that the main hydrochemical facies were HCO3–Mg·Ca and HCO3–Ca·Mg. Spatial variation coefficients of most indices were greater than 60%, which was probably caused by human activities. The hydrochemical evolution was mainly affected by rock weathering and also by cation exchange. The D–18O relationship of groundwater was δD = 5.93δ18O − 19.18, and the d–excess range was −1.60–+6.01‰, indicating that groundwater was mainly derived from precipitation and that contaminants were very likely to enter groundwater along with precipitation infiltration. The NO3(N) contents in groundwater exceeded the standard. Hydrochemical analyses indicated that precipitation, industrial activities and synthetic NO3 were unlikely to be the main sources of nitrate contamination in the study area. No obvious denitrification occurred in the transformation process of nitrate. The δ15N(NO3) values ranged from +0.29‰ to +14.39‰, and the δ18O(NO3) values ranged from −6.47‰ to +1.24‰. Based on the δ15N(NO3) – δ18O(NO3) dual isotope technique and hydrochemical methods, manure, sewage and NH4 fertilizers were identified to be the main sources of nitrate contamination. This study highlights the effectiveness of the integration of hydrochemical and isotopic data for nitrate source identification, and is significant for fully understanding groundwater hydrochemistry in endorheic basins and scientifically managing and protecting groundwater. [ABSTRACT FROM AUTHOR]

The heat storage and release performance of cascade phase change units are investigated numerically for users in Inner Mongolia's severe cold region. Three schemes of phase change material combinations are thoroughly tested. We obtained a better material combination scheme S3 (palmitic acid + polyethylene glycol), which has higher heat storage capacity per unit mass, higher average heat flux, and better unit synchronisation performance, so that it is more suitable for solar heating and cascade heat storage units in cold regions of Inner Mongolia. This study takes into account the irradiation variation of typical days during the winter heating season. The results show that the palmitic acid and polyethylene glycol combination scheme has the highest total heat storage per unit mass. This scheme also performs well in the synchronisation of two-stage storage units. When compared to the other two schemes, the average heat flux is increased by 25.5% for the first stage unit and 16.8% for the second stage unit. [ABSTRACT FROM AUTHOR]

In recent years, in order to improve the quality of living, China has carried out a series of urban renewal projects, such as adding elevators to old communities. Taking Hangzhou as an example, this paper studies the decision to install elevators in old residential buildings. This study used cold spots and hot spots, local autocorrelation and fishnetting analysis to show the spatial and temporal patterns of lift retrofitting in old communities. Finally, the spatial lag model is used to test whether there is a spatial spillover effect in the behavior of residents installing elevators. The research shows that: (1) Hot spots areas for retrofitting lifts are clustered in the central urban areas of Hangzhou, such as the intersection of Shangcheng District, Xiacheng District, Jianggan District, Gongshu District and Xihu District (scenic area); (2) The trend of retrofitting areas spreading from the center to the periphery; (3) In different communities, the number of elevators added in neighboring communities has a positive effect on the decision of adding elevators in other local communities. Therefore, the neighborhood effect cannot be ignored in the topic of community renovation, in which residents spontaneously participate. [ABSTRACT FROM AUTHOR]

Esophageal cancer (EC) threatens many lives in China, especially in areas with high incidences of EC. Our previous studies proved that zinc deficiency (ZD) promotes the cell cycle, thus promoting the progression of EC in areas with a high incidence of EC. Artesunate could inhibit the cell cycle, thereby inhibiting the progression of EC. In this study, we first demonstrated the mechanism by which artesunate inhibits EC in vitro and then demonstrated that artesunate could reverse the ZD-promoted progression of EC before EC occurred in vivo. The results showed that artesunate could inhibit the cell cycle, metastasis, and glycolysis of EC cells. Artesunate could target HK1, promote HK1 degradation, and reduce the levels of HIF-1α and PKM2 expression, which are key glycolysis enzymes. The in vivo results showed that ZD could increase the expression of HK1 and increase the incidence of EC. Artesunate reduced the incidence of EC and decreased the level of HK1 expression before EC occurred. Artesunate has an anti-EC effect by inhibiting aerobic glycolysis and has the potential to be a drug that prevents EC in areas with a high risk of EC. [ABSTRACT FROM AUTHOR]

Background: Hepatocellular carcinoma (HCC) is the most common type of liver cancer and causes many cancer-related deaths worldwide; in China, it is the second most prevalent cause of cancer deaths. Most patients are diagnosed clinically with advanced stage disease. Summary: For more than a decade, sorafenib, a small-molecular-weight tyrosine kinase inhibitor (SMW-TKI) was the only molecular targeted drug available with a survival benefit for the treatment of advanced HCC. With the development of novel TKIs and immune checkpoint inhibitors for advanced HCC, the management of patients has been greatly improved. However, though angiogenic-based targeted therapy remains the backbone for the systemic treatment of HCC, to date, no Chinese guidelines for novel molecular targeted therapies to treat advanced HCC have been established. Our interdisciplinary panel on the treatment of advanced HCC comprising hepatologists, hepatobiliary surgeons, oncologists, radiologists, pathologists, orthopedic surgeons, traditional Chinese medicine physicians, and interventional radiologists has reviewed the literature in order to develop updated treatment regimens. Key Messages: Panel consensus statements for the appropriate use of new molecular -targeted drugs including doses, combination therapies, adverse reaction management as well as efficacy evaluation, and predictions for treatment of advanced HCC with evidence levels based on published data are presented, thereby providing an overview of molecular targeted therapies for healthcare professionals. [ABSTRACT FROM AUTHOR]

Rectal cancer is one of the most common malignant tumors. In China, rectal cancer has been the third most frequently diagnosed cancer and the fifth leading cause of cancer death, with changes of residents' lifestyle factors and diets. The best treatment for rectal cancer depends on many factors. Multidisciplinary Treatment has become the basis for improving the therapeutic effect, in which radiology is increasingly necessary for treating patients with rectal cancer. For patients who have extensive, fixed, bulky tumors or obvious nodal disease, radiotherapy and chemotherapy combined with surgery has emerged as the standard of care. For patients with metastatic disease, the reasonable combination of local and systemic therapy might be an alternative. Improvements in imaging, pathological diagnosis and radiation techniques provide a solid foundation for promoting the level of clinical practice in rectal cancer. High‐quality magnetic resonance imaging distinguishing risk stratification, molecular markers predicting therapeutic effect and prognosis, magnetic resonance imaging in delineating target volumes drawn, intensity‐modulated radiation therapy, and image‐guides radiation therapy for precision treatment delivery are all being widely applied in multiple centers. Furthermore, as the role of targeted therapy and immune therapy has become increasingly prominent, the attempt of combined radiotherapy is also ongoing. In view of the characteristics and current situation of diagnosis and treatment of rectal cancer in China, the guidelines will present the basis and reference for combined treatment and standardized treatments. Meanwhile, there may be continuous new advances in clinical practice, and that will be a new basis to update the guidelines, directly benefiting all rectal cancer patients and facilitating discipline developments. [ABSTRACT FROM AUTHOR]

Research Summary: Previous studies on initial public offerings (IPOs) in mature stock markets have documented that high‐reputation underwriters primarily work with high‐quality firms and vice versa—that is, they are paired through a quality‐matching mechanism. We propose that in a nascent stock market, a pricing mechanism may also play a role, through which pricing (the underwriting fee) sets the pairing. We examine these two mechanisms in the context of China's ChiNext stock exchange, which was launched in 2009 and experienced dramatic regulatory improvements in 2012–2013. With data on IPOs in 2009–2017, we find evidence to support the pricing mechanism's effect before the regulatory improvements and the quality‐matching mechanism's effect after the improvements. We contribute to the literature by developing an evolutionary view on the pairing mechanisms between important capital market participants. Managerial Summary: In a mature stock market, underwriter reputation signals the underlying quality of initial public offering (IPO) firms to external investors because high‐reputation underwriters primarily work with high‐quality IPO firms and vice versa. We find that in a nascent stock market before the market experiences regulatory improvements, underwriters and IPO firms are paired through a pricing mechanism. That is, underwriters with higher reputation charge higher underwriting fees, and IPO firms with lower quality pay higher fees. Since the pricing mechanism rather than the quality‐matching mechanism sets the pairing, underwriter reputation does not have a signaling effect. Instead, we find that higher underwriting fees signal lower quality of IPO firms. Our findings shed important insights on how market participants are paired in other nascent markets, nascent technology fields and industries. [ABSTRACT FROM AUTHOR]

With the gradual improvement of the quality of life, taste, and ecological and environmental awareness of urban residents in China, the environmental landscape of residential areas has gradually become a hot spot. At present, the level of the residential environmental landscape has become a necessary means for real estate developers to publicize products and improve economic benefits. Although many residential areas have invested a high cost in constructing environmental landscapes, there are always some deficiencies and defects in the design and implementation of environmental landscapes in residential areas due to various reasons. Therefore, to ameliorate the low efficiency and high cost of manual processing of landscape images, a Fully Convolutional Network (FCN) model based on the traditional Convolutional Neural Network (CNN) is designed for semantic segmentation of landscape images to deal with the excessive amount of landscape elements in landscape image processing. The deconvolution method is utilized to realize pixel-level semantic segmentation. Besides, the image preprocessing method enhances the data to prevent overfitting from commonly occurring in FCN. Moreover, the model two-stage training method ameliorates long training time and complex convergence in deep learning. Finally, three upsampling network structures, i.e., FCN-32s, FCN-16s, and FCN-8s, are selected for a comparative experiment to determine the most suitable network. The experimental results demonstrate that the FCN-8s upsampling network structure is the most prominent; it attains a pixel accuracy of more than 90%, an average accuracy of 88%, and an average Image Understanding of 75%. The three values are the highest among the three upsampling structures, indicating that the FCN-8s can realize accurate landscape image processing. Besides, the recognition accuracy of FCN for landscape elements reaches 90%, 25% higher than that of CNN. This method is effective and accurate in classifying landscape elements, improves the classification accuracy intelligently, and significantly reduces the cost of landscape element classification, which is feasible. [ABSTRACT FROM AUTHOR]

BACKGROUND: Evidence concerning the effects of greenness on childhood visual impairment is scarce. OBJECTIVES: We aimed to assess whether greenness surrounding schools was associated with visual impairment prevalence and visual acuity levels in Chinese schoolchildren and whether the associations might be explained by reduced air pollution. METHODS: In September 2013, we recruited 61,995 children and adolescents 6–18 years of age from 94 schools in seven provinces/municipalities in China. Greenness exposure was assessed using the normalized difference vegetation index (NDVI) and the soil-adjusted vegetation index (SAVI) from July to August 2013. Visual impairment was defined as at least one visual acuity level (dimensionless) lower than 4.9 (Snellen 5/6 equivalent). Three-year annual averages of particulate matter (PM) with an aerodynamic diameter of =1 lm (PM1) and nitrogen dioxide (NO2) at each school were assessed using machine learning methods. We used generalized linear mixed models to estimate the associations between greenness and prevalent visual impairment and visual acuity levels and used mediation analyses to explore the potential mediating role of air pollution. RESULTS: In the adjusted model, an interquartile range increase in NDVI500m was associated with lower odds of prevalent visual impairment [odds ratio (OR)=0.95; 95% confidence interval (CI): 0.93, 0.97]. The same increase in NDVI500m was also associated with 0.012 (95% CI: 0.008, 0.015) and 0.011 (95% CI: 0.007, 0.015) increases in visual acuity levels for left- and right-eye, respectively. Our results also suggested that PM1 and NO2 significantly mediated the association between NDVI500m and visual impairment. Similar effect estimates were observed for SAVI500m, and our estimates were generally robust in several sensitivity analyses. DISCUSSION: These findings suggest higher greenness surrounding schools might reduce the risk of visual impairment, possibly owing in part to lower PM1 and NO2 in vegetated areas. Further longitudinal studies with more precise greenness assessment are warranted to confirm these findings. https://doi.org/10.1289/EHP8429 [ABSTRACT FROM AUTHOR]

The phase 3 NCT00793962 trial demonstrated that postmastectomy hypofractionated radiation therapy (HFRT) was noninferior to conventional fractionated radiation therapy (CFRT) in patients with high-risk breast cancer. This study assessed the cost-effectiveness of postmastectomy HFRT vs CFRT based on the NCT00793962 trial. A Markov model was adopted to synthesize the medical costs and health benefits of patients with high-risk breast cancer based on data from the NCT00793962 trial. Main outcomes were discounted lifetime costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). We employed a time-dependent horizon from Chinese, French and USA payer perspectives. Model robustness was evaluated with one-way and probabilistic sensitivity analyses. Patients receiving CFRT versus HFRT gained an incremental 0.0163 QALYs, 0.0118 QALYs and 0.0028 QALYs; meanwhile an incremental cost of $2351.92, $4978.34 and $8812.70 from Chinese, French and USA payer perspectives, respectively. Thus CFRT versus HFRT yielded an ICER of $144,281.47, $420,636.10 and $3,187,955.76 per QALY from Chinese, French and USA payer perspectives, respectively. HFRT could maintain a trend of >50% probabilities of cost-effectiveness below a willingness-to-pay (WTP) of $178,882.00 in China, while HFRT was dominant relative to CFRT, regardless of the WTP values in France and the USA. Sensitivity analyses indicated that the ICERs were most sensitive to the parameters of overall survival after radiotherapy. Postmastectomy HFRT could be used as a cost-effective substitute for CFRT in patients with high-risk breast cancer and should be considered in appropriately selected patients. • HFRT is a cost-effective substitute for CFRT for women with high-risk breast cancer. • The incremental cost-effectiveness ratio varied in a time-dependent manner and increased with the time horizon. • Overall survival were the most influential parameter on the incremental cost-effectiveness ratio. [ABSTRACT FROM AUTHOR]

Background: Evidence of the association between common chronic diseases and depression is sparse.Methods: Totally 7819 participants aged 45+ without depression at baseline were followed-up (2011-2015) to detect incident depression. Chronic diseases and depression were defined by self-reported diagnosis and the Center for Epidemiological Studies Depression Scale (CES-D10), respectively. Cox proportional hazards model was used to explore the association between chronic diseases and depression adjusting for age, gender, education, marital/living conditions, area, smoking, drinking, economic status, BMI and health insurance.Results: During an average of 3.42 years follow-up, 2271 participants developed depression (85 per 1000 person-year). Chronic diseases were related to significantly higher risk of depression (HR = 1.38). A higher risk of depression was also associated with specific diseases: stomach/other digestive diseases (HR = 1.19), diabetes (HR = 1.22), arthritis/rheumatism (HR = 1.30), and kidney diseases (HR = 1.34) (P < 0.05). The risk of depression increased with increasing in the number of chronic diseases (1: HR = 1.27, 2: HR = 1.49, and 3+: HR = 1.51, P-trend < 0.001). No significant difference was observed across age, gender, education, and area.Limitations: Chronic diseases and depression were based on self-reported diagnosis and measurement scale, respectively, which could lead to information bias. Some unmeasured confounders might have biased the results.Conclusions: The occurrence of depression in people aged 45+ is associated with number of chronic diseases in a dose-response fashion. These results may provide guidance on preventing depression and improving the quality of life in middle and late adulthood. [ABSTRACT FROM AUTHOR]

The number of confirmed COVID-19 cases has increased drastically; however, information regarding the impact of this disease on the occurrence of arrhythmias is scarce. The aim of this study was to determine the impact of COVID-19 on arrhythmia occurrence. This prospective study included patients with COVID-19 treated at the Leishenshan Temporary Hospital of Wuhan City, China, from February 24 to April 5, 2020. Demographic, comorbidity, and arrhythmias data were collected from patients with COVID-19 (n = 84) and compared with control data from patients with bacterial pneumonia (n = 84) infection. Furthermore, comparisons were made between patients with severe and nonsevere COVID-19 and between older and younger patients. Compared with patients with bacterial pneumonia, those with COVID-19 had higher total, mean, and minimum heart rates (all P < 0.01). Patients with severe COVID-19 (severe and critical type diseases) developed more atrial arrhythmias compared with those with nonsevere symptoms. Plasma creatine kinase isoenzyme (CKMB) levels (P = 0.01) were higher in the severe group than in the nonsevere group, and there were more deaths in the severe group than in the nonsevere group (6 (15%) vs. 3 (2.30%); P = 0.05). Premature atrial contractions (PAC) and nonsustained atrial tachycardia (NSAT) were significantly positively correlated with plasma CKMB levels but not with high-sensitive cardiac troponin I or myoglobin levels. Our data demonstrate that COVID-19 patients have higher total, mean, and minimum heart rates compared with those with bacterial pneumonia. Patients with severe or critical disease had more frequent atrial arrhythmias (including PAC and AF) and higher CKMB levels and mortality than those with nonsevere symptoms. [ABSTRACT FROM AUTHOR]

Background. Mutations in insulin receptor genes can cause severe insulin resistance syndrome. Compared with Rabson-Mendenhall Syndrome and Donohue's Syndrome, type A insulin resistance syndrome is generally not serious. The main manifestations in woman with type A insulin resistance syndrome are hyperinsulinemia, insulin resistance, acanthosis nigricans, hyperandrogenism, and polycystic ovary. Case Presentation. A 13-year-old girl (Han nationality) visited the hospital due to hairiness and acanthosis nigricans. Further examination revealed severe hyperinsulinemia, insulin resistance, elevated blood glucose, hyperandrogenism, and polycystic ovary. Analysis of the insulin receptor gene by sequencing showed the presence of a nucleotide change in intron 7 (c. 1610+1G > A). The mutation was a splicing mutation, which can obviously affect the mRNA splicing of the insulin receptor and cause its function loss. The patient was finally diagnosed with type A insulin resistance syndrome. After 2 months of metformin treatment, the patient had spontaneous menstrual cramps and significantly improved acanthosis nigricans and sex hormones. Conclusion. We report for the first time a new splicing mutation on the insulin receptor gene at the 7th intron (c.1610+1G > A), which leads to type A insulin resistance syndrome. In clinically suspected patients with polycystic ovary syndrome, if there are extremely high blood levels of insulin in the blood, genetic testing should be performed to detect insulin receptor gene mutation of type A insulin resistance syndrome. [ABSTRACT FROM AUTHOR]

Background: There is an increasing application of moderately hypofractionated radiotherapy for prostate cancer. We presented our outcomes and treatment-related toxicities with moderately hypofractionated (67.5 Gy in 25 fractions) radiotherapy for a group of advanced prostate cancer patients from China.Methods: From November 2006 to December 2018, 246 consecutive patients with prostate cancer confined to the pelvis were treated with moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions). 97.6% of the patients received a different duration of androgen deprivation therapy. Failure-free survival (FFS), prostate cancer-specific survival (PCSS), overall survival (OS), and cumulative grade ≥ 2 late toxicity were evaluated using the Kaplan-Meier actuarial method. Prognostic factors for FFS, PCSS, and OS were analyzed.Results: The median follow-up time was 74 months (range: 6-150 months). For all patients, the 5- and 10-year FFS rates were 80.0% (95% CI: 74.7-85.7%) and 63.5% (95% CI 55.4-72.8%). The failure rates for the intermediate, high-risk, locally advanced, and N1 groups were 6.1%, 13.0%, 18.4%, and 35.7%, respectively (P = 0.003). Overall, 5- and 10-year PCSS rates were 95.7% (95% CI 93.0-98.5%) and 88.2% (95% CI 82.8-93.8%). Prostate cancer-specific mortality rates for the high-risk, locally advanced, and N1 groups were 4.0%, 8.2%, and 23.8%, respectively (P < 0.001). Overall, 5- and 10-year actuarial OS rates were 92.4% (95% CI 88.8-96.1%) and 72.7% (95% CI 64.8-81.5%). High level prostate-specific antigen and positive N stage were significantly associated with worse FFS (P < 0.05). Advanced T stage and positive N stage emerged as worse predictors of PCSS (P < 0.05). Advanced age, T stage, and positive N stage were the only factors that were significantly associated with worse OS (P < 0.05). The 5-year cumulative incidence rate of grade ≥ 2 late GU and GI toxicity was 17.8% (95% CI 12.5-22.7%) and 23.4% (95% CI 17.7-28.7%), respectively.Conclusions: Moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions) for this predominantly high-risk, locally advanced, or N1 in Chinese patients demonstrates encouraging long-term outcomes and acceptable toxicity. This fractionation schedule deserves further evaluation in similar populations. [ABSTRACT FROM AUTHOR]

Objective: Whether lipoprotein(a) (Lp(a)) is a predictor for recurrent cardiovascular events (RCVEs) in patients with coronary artery disease (CAD) has not been established. This study, hence, aimed to examine the potential impact of Lp(a) on RCVEs in a real-world, large cohort of patients with the first cardiovascular event (CVE).Methods: In this multicentre, prospective study, 7562 patients with angiography-diagnosed CAD who had experienced a first CVE were consecutively enrolled. Lp(a) concentrations of all subjects were measured at admission and the participants were categorised according to Lp(a) tertiles. All patients were followed-up for the occurrence of RCVEs including cardiovascular death, non-fatal myocardial infarction and stroke.Results: During a mean follow-up of 61.45±19.57 months, 680 (9.0%) RCVEs occurred. The results showed that events group had significantly higher Lp(a) levels than non-events group (20.58 vs 14.95 mg/dL, p<0.001). Kaplan-Meier analysis indicated that Lp(a) tertile 2 (p=0.001) and tertile 3 (p<0.001) groups had significantly lower cumulative event-free survival rates compared with tertile 1 group. Moreover, multivariate Cox regression analysis further revealed that Lp(a) was independently associated with RCVEs risk (HR: 2.01, 95% CI: 1.44 to 2.80, p<0.001). Moreover, adding Lp(a) to the SMART risk score model led to a slight but significant improvement in C-statistic (∆C-statistic: 0.018 (95% CI: 0.011 to 0.034), p=0.002), net reclassification (6.8%, 95% CI: 0.5% to 10.9%, p=0.040) and integrated discrimination (0.3%, 95% CI: 0.1% to 0.7%, p<0.001).Conclusions: Circulating Lp(a) concentration was indeed a useful predictor for the risk of RCVEs in real-world treated patients with CAD, providing additional information concerning the future clinical application of Lp(a). [ABSTRACT FROM AUTHOR]

Background: The role of postmastectomy radiotherapy (PMRT) in women with pT1-T2N1 breast cancer is controversial. The authors developed a nomogram that was predictive for overall survival (OS) and identified patients who derived no benefit from PMRT.Methods: The authors retrospectively evaluated 4869 patients with pT1-T2N1 breast cancer who were treated with mastectomy between 2000 and 2014 in 11 Chinese hospitals. Rates of locoregional recurrence and distant metastasis were calculated using competing risk analysis, and disease-free survival and OS rates were calculated using the Kaplan-Meier method. Based on the risk factors identified from Cox regression analysis in 3298 unirradiated patients, a nomogram predicting OS was developed. The benefit of PMRT was evaluated in different risk groups stratified by the nomogram model.Results: After a median follow-up of 65.9 months, the 5-year OS, disease-free survival, locoregional recurrence, and distant metastasis rates were 93.3%, 84.3%, 5.2%, and 8.3%, respectively. A total of 1571 patients (32.3%) underwent PMRT. On multivariable analyses, PMRT was found to increase OS significantly (hazard ratio, 0.61; P = .002). An OS prediction nomogram evaluated the effect of age; tumor location; tumor size; positive lymph node ratio; estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status; and treatment with trastuzumab. Based on nomogram scores, the entire patient cohort was classified into 3 risk groups. PMRT significantly improved the OS of patients in the intermediate-risk (P < .001) and high-risk groups (P = .004), but not in the low-risk group (P = .728).Conclusions: The authors developed a nomogram that is predictive of OS among women with pT1-T2N1 breast cancer after mastectomy. This nomogram may help to select a subgroup of patients with a good prognosis who will not benefit from PMRT. [ABSTRACT FROM AUTHOR]

Background: Lung cancer is the leading cause of morbidity and mortality worldwide. Small cell lung cancer (SCLC) has been determined to be the most lethal lung malignancy. Few studies have previously analyzed the epidemiological characteristics of SCLC in China. This study analyzed the epidemiological characteristics of SCLC aiming to provide a reference for the prevention of SCLC in Hebei Province. Methods: The epidemiological characteristics of SCLC using lung cancer data based on population and hospital cancer registries in Hebei Province between 2008 and 2017 were analyzed. Results: The proportion of both population‐ and hospital‐based SCLC cases displayed a significant increasing trend. Moreover, the proportion of males was higher than that for female based on population‐ and hospital‐based cases. The proportion of hospital‐based SCLC cases in counties was higher than that in cities, whereas there were no significant regional differences between cities and counties based on population. The proportion of both population‐ and hospital‐based SCLC cases decreased consistently with increasing age. There was a difference between population‐ and hospital‐based distribution of subcategories of SCLC. Conclusions: Significant increases in the proportion of both population‐ and hospital‐based SCLC cases over recent years, particularly in males and in patients aged over 55 years, were observed. Research on the pathogenesis of SCLC in these patients and prevention is urgently required. [ABSTRACT FROM AUTHOR]

Terrestrial biogeochemical silicon (Si) and carbon (C) cycles couple through various processes, such as silicate weathering and the dynamics resulting from different phytolith assemblages. For example, small amounts of organic C (typically ranging from 0.2 to 5.8%) can be occluded during phytolith formation. Phytoliths play an important role in coupled Si and C cycles. In this study, we analyzed variations in C sequestration and the seasonal dynamics of phytoliths formed in different vegetation types in order to clarify the processes and characteristics of phytolith-occluded-carbon (PhytOC) cycles. Firstly, we measured the variation range of phytolith content in the litter and soil of different vegetation types at 11.87–151.90 and 1.81–14.72 g kg−1, respectively, while we measured the corresponding variation range of PhytOC content at 3.58–24.13 and 0.04–0.65 g kg−1, respectively. We also found that seasonal changes in phytolith and PhytOC content were significant (P < 0.01), both exhibiting a significant decreasing trend from litter to soil and from the surface soil to 0–60 cm of soil layers. Secondly, we measured the variation range of PhytOC storage in the litter and soil (0–60 cm) of different vegetation types at 1.26–6.89 and 28.24–75.2 t, respectively. Finally, our study determined the contribution of PhytOC storage in soil (0.42%) compared with conventionally recognized soil C sequestration storage (0.64%). The phytolith C pool is an important component of the forest ecosystem C pool, which plays a critical role in mitigating global warming. [ABSTRACT FROM AUTHOR]

To understand variation in spiritual intelligence with a culture, this paper develops a Spiritual Intelligence Scale in China context using a three-stage sorting process based on interviews and a survey (N = 50) in Study 1. In Study 2, the preliminary study validated the scale using rigorous methods, and a three-factor model of Chinese Spiritual Intelligence (N = 605) is obtained. The results indicate that spiritual intelligence in China is composed of the Identification of Meaning, the Connection of Meaning and the Realization of Meaning. Certainly, there are similarities and differences between this study and Western research. Although the internal consistency reliability was good for Identification and Connection, further improvement for Realization is still required. The three-factor model was better than the alternative models. This research supplements research on spiritual intelligence in different cultures and contributes to research on the Chinese spiritual world. [ABSTRACT FROM AUTHOR]

Objectives: To identify human-to-human transmission of H7N9 avian influenza virus, we investigated a hospital cluster combined with family cluster in this study.Methods: We obtained and analyzed clinical, epidemiological and virological data from the three patients. RT-PCR, viral culture and sequencing were conducted for determination of causative pathogen.Results: The index case presented developed pneumonia with fever after exposure to chicken in a poultry farm. Case A presented pneumonia with high fever on day 3 after she shared a hospital room with the index case. Case B, the father of the index case, presented pneumonia with high fever on day 15 after he took care of the index case. H7N9 virus circulated in the local farm to which the index case was exposed. Full genomic sequence of virus showed 99.8-100% identity shared between the index case and case A or case B. Compared to the earliest virus of Anhui, a total of 29 amino acid variation sites were observed in the 8 segments.Conclusions: A hospital cluster combined with family cluster of H7N9 avian influenza infection was identified. Air transmission resulted in the hospital cluster possibly. A poultry farm was the initially infectious source of the cluster. [ABSTRACT FROM AUTHOR]

Abstract Providing, integrating and improving efficient public service in the construction of 'smart cities' in metropolitan areas have been showed to be difficult to achieve. In this article, we propose a strategy for developing service-dominant platforms with the advancement of ICT and more internet enterprises initiatives. We use the concept of SDP (service dominant platform) as a key contributor in a smart city's construction to explain how value can be co-created during the formation and evolution of the platform. Drawing on case materials from a Business-oriented platform named WeChat in Guangzhou and a government-oriented one in Shanghai, an analytic framework on platform and service innovation-relevant theories are built around the dynamic cyclical value co-creation, and three elements are identified in this process defined as value proposition, value in exchange and value in use, which consist of ten sub-elements on different SDPs along four dimensions, namely openness, services innovation, governance and resource. The study makes three contributions. First, it provides new evidence that pursuing smart city construction is not a mere technological architecture but a value co-creation oriented strategy. While facing persistent problems, China's paths exhibit significant and rapidly improving readiness for it. Second, the study provides new insights into, by positively bridging the linkage between platform governance and service innovation and proposing the service dominant platform (SDP) as a clear sustainable strategy. Finally, the study proposes two different resources-based models for guiding smart city initiatives in developing countries. By providing theoretical concepts to support public service innovation, identifying some implications for smart city developed in emerging countries, and suggesting some operational approaches to co-creating value against the local context, this paper has made a meaningful theoretical and practical significance about smart city. Highlights • Service dominant logic is introduced into smart city service research, SDP and its preliminary framework are proposed. • SDL literature is extended from value co-creation by identifying three mechanisms. • A service-dominant platform enabling smart city development in emerging countries. • There are two specific solutions for different cities to establish SDP with different resource bases and initiators. • A key role that private enterprises can play in partnership with governments in the developing world, like WeChat. • Governments in emerging countries can also encourage entrepreneurs to provide public services. [ABSTRACT FROM AUTHOR]

Introduction: To investigate the effect of dose maintenance, reduction, or discontinuation of the etanercept biosimilar Yisaipu (YSP) on early axial spondyloarthritis (axSpA) patients in remission with YSP 50 mg once weekly (QW).Material and Methods: Patients were enrolled in three groups: full dose (YSP50), half dose (YSP25), and discontinuation (YSP0). Patients were assessed by the same rheumatologist every 8 weeks for 48 weeks. The primary endpoint was the proportion of non-failure patients in each group. If a flare occurred during the study period, the patient resumed YSP 50 mg QW or was switched to another tumor necrosis factor inhibitor.Results: A total of 144 patients were included and each group included 48 patients. The proportion of non-failure patients was significantly greater in the YSP50 group than in the YSP0 group at 48 weeks (91.7% vs. 72.9%, p = 0.032). The difference in the other two comparisons was not statistically significant (YSP50 vs. YSP25 group, p = 0.522; YSP25 vs. YSP0 group, p = 0.132). The median time to flare did not differ significantly between the three groups (p > 0.05). Most patients who flared regained remission rapidly after resuming YSP 50 mg QW or starting adalimumab 40 mg every other week.Conclusions: For patients with early axSpA in remission on YSP for more than 12 weeks, continuation of YSP at full dose was superior to discontinuation of YSP, but not superior to halving the dose. [ABSTRACT FROM AUTHOR]

Background: Artemisia pollen allergy is a major cause of asthma in Northern China. Possible associations between IgE responses to Artemisia allergen components and clinical phenotypes have not yet been evaluated. This study was to establish sensitization patterns of four Artemisia allergens and possible associations with demographic characteristics and clinical phenotypes in three areas of China. Methods: Two hundred and forty patients allergic to Artemisia pollen were examined, 178 from Shanxi and 30 from Shandong Provinces in Northern China, and 32 from Yunnan Province in Southwestern China. Allergic asthma, rhinitis, conjunctivitis, and eczema symptoms were diagnosed. All patients' sera were tested by ImmunoCAP with mugwort pollen extract and the natural components nArt v 1, nArt ar 2, nArt v 3, and nArt an 7. Results: The frequency of sensitization and the IgE levels of the four components in Artemisia allergic patients from Southwestern China were significantly lower than in those from the North. Art v 1 and Art an 7 were the most frequently recognized allergens (84% and 87%, respectively), followed by Art v 3 (66%) and Art ar 2 (48%). Patients from Northern China were more likely to have allergic asthma (50%) than patients from Southwestern China (3%), and being sensitized to more than two allergens increased the risk of allergic asthma, in which co‐sensitization to three major allergens Art v 1, Art v 3, and Art an 7 is prominent. Conclusions: Component‐resolved diagnosis of Chinese Artemisia pollen‐allergic patients helps assess the potential risk of mugwort‐associated allergic asthma. Component‐resolved diagnosis of Chinese Artemisia pollen allergic patients helps assess the potential risk of mugwort‐associated allergic asthma. Sensitization to more than two Artemisia pollen allergens resulted in higher risk of allergic asthma, in which co‐sensitization to Art v 1, Art v 3 and Art an 7 allergens is prominent. [ABSTRACT FROM AUTHOR]

Zhundong coal as a high quality steam coal has not been widely utilized due to severe fouling and slagging problems during combustion. It is crucial to reveal the slagging and fouling mechanisms in a boiler burning Zhundong coal. In this paper, the properties of ash deposits collected from various heat transfer surfaces in a 330 MW boiler were characterized by ICP-OES, SEM−EDX, and XRD. These results were also verified by an experiment burning Zhundong coal in a drop-tube furnace and thermodynamic calculation by the software FactSage. The results indicated the ash deposited on different heat transfer surfaces in 330 MW boiler burning Zhundong coal could be classified into silicates and sulfates based on their elemental and mineral analysis. Further, the ash deposited on the division panel superheater is obviously divided into three layers. In the first layer, wollastonite and sodium silicate are the main minerals with the contents of quartz and feldspar being relatively small. The types of mineral in the second layer are the same with the first layer, but their contents are different from the first layer. Meanwhile, the amount of crystalline phase in the third layer is lower than that of the first and second layer. In addition, the temperature of the flue gas or the tube played an important role in the mechanism of ash deposition. Thermodynamics calculation also shows CaSO 4 can be formed at all temperatures and there only exists CaSiO 3 formed in the range 900–1200 °C. The ash deposits along the flue gas flow attributes to sulfates, silicates and sulfates, respectively. The result of the thermodynamic calculation is in accordance with the experiment results obtained in the drop-tube furnace. [ABSTRACT FROM AUTHOR]

Esophageal cancer (EC) is a common malignant tumor of the gastrointestinal tract with a high incidence in China. Zinc (Zn) deficiency is a key risk factor for the occurrence and development of EC and affects progression by regulating micro RNA (miRNA, miR) expression. In addition, the dysregulation of mi RNAs is accompanied by the dysregulation of their target genes in EC. In this paper, we review the potential molecular mechanisms between Zn deficiency and EC with the aim of providing new strategies and methods for early diagnosis, targeted therapy, and prognostic evaluation. [ABSTRACT FROM AUTHOR]

We collected street dust from Huainan, a typical coal-mining city in China, to investigate the contamination features and health risks of heavy metals. Concentrations of Co, Cr, Cu, Pb, As, and Sb were generally low to moderate, while pollution levels of Cd and Hg were moderate to high. Concentrations of Cd and Hg were associated with considerable health risks at 64.3% and 58.6% of sites, respectively. In particular, about a fifth of samples had associated high risks as a result of Hg contamination levels. Relative to other urban areas, the street dust from the mining area had no more severe metal pollution, which might be partly attributed to the deposition of coal dust onto street dusts. A source assessment indicated that metals in dust form Huainan were mainly derived from vehicular-related activities, industrial emissions, weathering of coal dust and natural soils, and coal combustion. Although the health risk levels from exposure to individual metals in dusts were low, the non-carcinogenic risks from multiple metals to local children exceeded the acceptable level (1.0), suggesting that the overall risk from exposure to multiple metals in dust is concerning. [ABSTRACT FROM AUTHOR]

Background: The incidence of young coronary heart disease (CHD, ≤45 years) in China is increasing. Secondary prevention to counter this trend is an important contemporary public health issure.Methods: A total of 5288 patients (≤45 years) diagnosed with CHD and hospitalized at the Chinese PLA General Hospital and Anzhen Hospital, both in Beijing, were enrolled after satisfying the inclusion criteria.Results: Young CHD patients increased in number from 2010 to 2014, especially men. Among the studied patients, there was no significant change over those years in blood pressure, but heart rate increased significantly (P < 0.05) and body mass index showed a rising trend (P > 0.05). The incidence of hypertension increased from 40.7 to 47.5%, diabetes from 20.3 to 26.1%, and hyperlipidemia from 27.3 to 35.7% (P < 0.05). However, the incidences of smoking and drinking both trended downward (P < 0.05). The levels of total cholesterol and triglycerides also showed a downward trend (P < 0.05), as did levels of low-density lipoprotein, but not to the point of statistical significance (P > 0.05). Mortality during hospitalization decreased significantly from 2010 to 2014 (P < 0.05), but there was no significant improvement in the incidences of cardiac death and major adverse cardiovascular events (MACE) after 1-year follow-up (P > 0.05).Conclusions: Over the 5 years studied, the overall incidence of cardiac death and MACE for young CHD patients (≤45 years) has shown little improvement. Secondary prevention of young CHD, and its risk factors, as well as appropriate courses of medical treatment must be further elucidated. [ABSTRACT FROM AUTHOR]

Purpose: The aim of our study was to estimate the female breast cancer burden and mortality trends in Hebei Province, China.Methods: Eight population-based cancer registries in Hebei Province submitted cancer data to the Hebei Provincial cancer Registry Centre. All data were reviewed for quality and compiled for cancer statistics in 2011. The pooled data were stratified by area (urban/rural) and age group (0-4, 5-9, …, 80+ years). Incidence and mortality rates were calculated and expressed per 100,000 persons. Proportions and ranks for breast cancer were calculated. Mortality data from 1973 to 1975, 1990 to 1992, and 2004 to 2005 were extracted from the national death surveys. Mortality and incidence data from Cixian and Shexian were obtained from population-based cancer registries in each county.Results: The estimated numbers of newly diagnosed breast cancer cases and deaths from 2010 to 2011 were 26,028 and 5472, respectively. The CIR was 36.6/100,000. The ASIRW was 27.7/100,000, ranking the highest among all female cancers. The CMR was 7.7/100,000, and the ASMRW was 6.0/100,000, ranking fifth in female mortality. The ASMRW displayed an increasing trend in Hebei Province from 1973-1975 to 2010-2011, with a 53.7 % increase. In Cixian, the incidence rate increased with an annual percentage change (APC) of 7.7 %, and the mortality rate increased with an APC of 3.8 % from 1988 to 2011. Similar trends were observed for the incidence and mortality rates in Shexian, with APCs of 20.1 % and 11.0 %, respectively, from 2000 to 2011.Conclusion: Hebei Province experienced a heavy burden of breast cancer. The mortality rates increased during the past 40 years and the incidence and mortality trends may continue to increase in the next few years. [ABSTRACT FROM AUTHOR]

Hexabromocyclododecane (HBCD) and tetrabromobisphenol A (TBBPA) are two kinds of brominated flame retardants and widely present in the environment and biota. The levels, spatial distributions and mass inventories of HBCD and TBBPA were investigated in sediments and paddy soils from the Liaohe River Basin in northeast China. The concentrations of ΣHBCD and TBBPA were in the range of not detected (nd) to 4.02 ng/g dry weight (dw) and 0.03 to 4.06 ng/g dw, respectively. γ-HBCD was dominated in sediments, while the abundance of α-HBCD was relatively high in paddy soils. The spatial distributions of HBCD and TBBPA in surface sediments and paddy soils indicated that the local point-input was their major source. The significant correlation between total organic carbon (TOC) contents and the HBCD levels suggested that TOC content also exerted an influence on the distribution of HBCD in sediments. Meanwhile, it was found that the irrigation with river water was not the major transportation pathway of HBCD and TBBPA in paddy soils. Based on the study, it was estimated that there were about 1.67 tons HBCD and 2.20 tons TBBPA deposited into sediments of the Liaohe River system every year. The total mass inventories of HBCD and TBBPA in sediments were far higher than that in paddy soils. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity has become a public health concern in many countries. In Southern China, the prevalence of childhood obesity increased from 6.2 to 7.5 % between 2007 and 2011. This study aimed to report the current prevalence of overweight and obesity, analyzed the early life and behavioral determinants of obesity, and investigated the weight-loss practices among Chinese children in Guangzhou.Methods: Three thousand seven hundred sixty-six primary school students aged 7-12 years were recruited in Guangzhou, China in 2013. Questionnaires were used to assess (1) early life factors: birth weight, delivery mode, gestational age and feeding patterns; (2) behavioral factors: dietary intake, eating speed, sedentary time, physical activities and sleep duration; and (3) weight-loss practices: improving diet, increasing exercise, taking weight-loss drugs and undergoing a diet. The criteria of Working Group of Obesity in China were applied to classify overweight and obesity based on measured weight and height. Multivariable logistic regression analyses were performed to examine the determinants of overweight/obesity and adoption of weight-loss practices.Results: The prevalence of childhood overweight and obesity were 11.2 and 10.0 %, respectively. High birth weight (≥4.0 kg versus 2.5 ~ 4.0 kg, odd ratio [OR]: 2.34; 95 % confidence interval [CI]: 1.53-3.58), sugar-sweetened beverages (SSBs) intake (OR: 1.39; 95 % CI: 1.05-1.85), vegetable intake (OR: 1.12; 95 % CI: 1.01-1.24), and doing homework (OR: 1.24; 95 % CI: 1.08-1.43) were positively associated with obesity. Eating speed faster than peers was positively associated with obesity and yielded the highest OR (versus "as fast as peers", OR: 3.18; 95 % CI: 2.28-4.44). Approximately 57, 81 and 87 % of normal-weight, overweight and obese children, respectively, reported weight-loss practices. Self-perception of weight status presented as the strongest determinant for weight-loss practices.Conclusions: The prevalence of overweight and obesity were high in Chinese children in Guangzhou, and both were higher than previous level in 2011. Further research should address the unhealthy dietary (e.g. SSBs intake, fast eating speed) and sedentary behaviors (e.g. doing homework) of these children. Moreover, an accurate perception of body weight can help promote the adoption of weight-loss practices in overweight and obese children. [ABSTRACT FROM AUTHOR]

Background: Evidence linking caries in primary dentition and children's anthropometric measures is contradictory. We aimed to evaluate the prevalence of primary dental caries and its relationship with body mass index (BMI) among 7-9 years old school children in urban Guangzhou, China.Methods: This cross-sectional study enrolled 32,461 pupils (14,778 girls and 17,683 boys) aged 7-9 years from 65 elementary schools in Guangzhou. Dental caries was detected according to criteria recommended by the World Health Organization (WHO). The total mean decayed, missing or filled teeth (dmft) of primary dentition were assessed. Weight and height were measured and BMI was calculated. Children were classified into underweight, normal weight, overweight and obesity groups by BMI based on Chinese criteria. Z-score of BMI-for-age (BAZ) was calculated by WHO standardized procedure. Multivariable odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using logistic regression. Restricted cubic spline regression was applied to evaluate the shape of the relationship between BAZ and primary dental caries.Results: The prevalence of primary dental caries was 30.7 % in total sample. Regarding dmft values, the mean ± standard deviation (SD) in the combined sample were 1.03 ± 2.05 in boys and 0.93 ± 1.92 in girls. Both indices decreased by age. Compared with normal BMI group, children in overweight and obesity groups have 27 % (OR = 0.73, 95 % CI: 0.66-0.81, P < 0.0001) and 34 % (OR = 0.66, 95 % CI: 0.59-0.74, P < 0.0001) lower odds for the presence of primary dental caries after adjustment for age and gender, respectively. Although in general, increased BAZ was associated with decreased risk of dental caries, full-range BAZ was associated with dental caries in an A-shaped manner with a zenith at around -1.4.Conclusion: Higher BMI was associated with lower odds of caries; overweight and obese children were more likely to be primary dental caries free among 7-9 years in Guangzhou, China. [ABSTRACT FROM AUTHOR]

Objective To explore the risk factors for atopic dermatitis (AD) and disclose the relationship between immune inflammatory factors (Immunoglobulin E (IgE), interleukin (IL)-4, IL-18) and the prevalence of AD in a Chinese population. Methods To evaluate the risk factors for infant AD, a total of 921 mother-newborn pairs were recruited through a questionnaire survey conducted during 2009–2011. Venous blood was collected from the mothers during birth hospitalization and umbilical cord blood was collected during delivery. Thirty-five infants with AD paired with their mothers served as the patient group. Thirty-five non-AD pairs were selected randomly and were used as the control group. Enzyme-linked immunosorbent assay (ELISA) was performed to detect the levels of IgE, IL-4, and IL-18. The relationship between the prevalence of AD and the levels of IgE, IL-4, and IL-18 was analyzed. The risk factors for allergy were assessed in IgE positive cases. Results Family income, parental history of atopy, age of menarche, performing housing renovation before pregnancy, instance of a virus infection during pregnancy, and calcium supplementation during pregnancy were potential factors determining the incidence rate of infant AD. Compared with the control group, the AD patient group showed higher levels of IgE and IL-4 in both the maternal serum and umbilical cord blood ( P < 0.01). In the cases with AD, IL-8 was increased only in the maternal serum ( P < 0.01). In addition, the allergens dust mite, mugwort pollen, and mycete spores were risk factors for the incidence of IgE-positive AD. Conclusion IgE and IL-4 levels in the maternal serum and umbilical cord blood as well as IL-18 level in the maternal serum are related to the occurrence of childhood AD. Potential factors for infant AD include family income, parental history of atopy, age of menarche, housing renovation before pregnancy, virus infection, and calcium supplementation during pregnancy. [ABSTRACT FROM AUTHOR]

Background In 2011, Hebei Province, located in North China with a population of 71 794 239, accounted for approximately 6% of the national population. It is well known as a heavily air polluted area. This study reports the lung cancer burden and mortality trend in Hebei Province from 1973 to 2011. Methods Eight cancer registries in Hebei Province submitted data to the Hebei Provincial Cancer Registry Center. Pooled data were stratified by area (urban/rural), gender, and age group. The proportions, cumulative incidence/mortality rates, and median age at death of lung cancer were calculated. Lung cancer mortality data of 1973-1975, 1990-1992, and 2004-2005 were extracted from national death surveys. Data of lung cancer from Cixian and Shexian were obtained from population-based cancer registries in each county. Results The estimated numbers of newly diagnosed lung cancer cases and deaths in 2011 in Hebei Province were 32 623 and 27 612, respectively. The crude incidence rate of lung cancer was 45.44/100 000. The age-standardized incidence rate by world standard population was 39.01/100 000, ranking second among all cancers. The lung cancer mortality rate was 38.46/100 000, ranking first among all cancer deaths, with a significantly increasing trend in Hebei Province from 1973-1975 to 2010-2011, with an increased rate of 189.15%. Conclusion Hebei Province suffers a heavy disease burden of lung cancer and an obvious increasing trend has been observed over the past 40 years. Preventive and control strategies should be encouraged . [ABSTRACT FROM AUTHOR]

The occurrence and spatial distribution of polychlorinated naphthalenes (PCNs) were investigated in sediments, upland and paddy soils from the Liaohe River Basin. Concentrations of ΣPCNs were in the range of 0.33–12.49 ng g −1 dry weight (dw) in sediments and 0.61–6.60 ng g −1 dw in soils, respectively. Tri-CNs and tetra-CNs were the dominating homologues. An increasing trend of PCNs contamination was found in sediments with the rivers flowing through industrial areas and cities. Soils collected near cities exhibited higher abundance of PCNs than that of rural areas. The distribution of PCNs was related to the local industrial activities, rather than total organic carbon. Positive matrix factorization (PMF) was used for the source apportionment of PCNs in sediments and paddy soils. The result of PMF indicated that PCNs in sediments and paddy soils were mainly from the industrial processes, with additional contributions from the historical use of Halowax 1014 and atmospheric deposition. [ABSTRACT FROM AUTHOR]