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Introduction: Off-season upsurge of respiratory syncytial virus (RSV) infection with changed characteristics and heightened clinical severity during the post-COVID-19 era are raising serious concerns. This study aimed to develop and validate a nomogram for predicting the risk of severe acute lower respiratory tract infection (SALRTI) in children hospitalized for RSV infection during the post-COVID-19 era using machine learning techniques., Methods: A multicenter retrospective study was performed in nine tertiary hospitals in Yunnan, China, enrolling children hospitalized for RSV infection at seven of the nine participating hospitals during January-December 2023 into the development dataset. Thirty-nine variables covering demographic, clinical, and laboratory characteristics were collected. Primary screening and dimension reduction of data were performed using Least Absolute Shrinkage and Selection Operator (LASSO) regression, followed by identification of independent risk factors for RSV-associated SALRTI using Logistic regression, thus finally establishing a predictive nomogram model. Performance of the nomogram was internally evaluated by receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) based on the development dataset. External validation of our model was conducted using same methods based on two independent RSV cohorts comprising pediatric RSV inpatients from another two participating hospitals between January-March 2024., Results: The development dataset included 1102 patients, 239 (21.7%) of whom developed SALRTI; while the external validation dataset included 249 patients (142 in Lincang subset and 107 in Dali subset), 58 (23.3%) of whom were diagnosed as SALRTI. Nine variables, including age, preterm birth, underlying condition, seizures, neutrophil-lymphocyte ratio (NLR), interleukin-6 (IL-6), lactate dehydrogenase (LDH), D-dimer, and co-infection, were eventually confirmed as the independent risk factors of RSV-associated SALRTI. A predictive nomogram was established via integrating these nine predictors. In both internal and external validations, ROC curves indicated that the nomogram had satisfactory discrimination ability, calibration curves demonstrated good agreement between the nomogram-predicted and observed probabilities of outcome, and DCA showed that the nomogram possessed favorable clinical application potential., Conclusion: A novel nomogram combining several common clinical and inflammatory indicators was successfully developed to predict RSV-associated SALRTI. Good performance and clinical effectiveness of this model were confirmed by internal and external validations., 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 © 2024 Liu, Zhang, Liu, Li, Li, Wang, Li, Xiang, Lu, Yuan and Fu.)

Our objective was to investigate the status and influence of myopia among primary school students in Fushun, Liaoning Province, China. We aimed to provide a theoretical and epistemological basis for implementing myopia prevention initiatives. We employed cluster sampling and surveyed 5216 primary school students from grades 1-6 across eight primary schools in Fushun City. Our participants included 2606 males and 2610 females whose average age was 9.25 ( SD = 1.76) years. The rate of myopia among these primary school students was 29.54%, with statistically significant differences among students of different genders and grades. Logistic regression analysis further identified several possible protective factors, including appropriate reading distance, adequate home lighting, regular breaks between classes, conscientious eye exercises, and daily outdoor physical activity. Conversely, the associated risk factors were being female, being in a higher grade level, spending more than 4 hours on homework, occasionally reading while lying down, and having one or both parents with myopia. Overall, our results indicated a high incidence of myopia, highlighting the need for scientifically controlled interventions to manage and mitigate the occurrence and progression of myopia in this population., Competing Interests: Declaration of Conflicting InterestsThe author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study aimed to investigate the species diversity and genetic differentiation of the genome of the main cultivated strains of Ganoderma in China. Population genomics analysis was conducted based on 150 cultivated strains of Ganoderma collected nationwide. The results indicated that the main species currently cultivated in China were Ganoderma sichuanense and Ganoderma lucidum, with a minor proportion of Ganoderma sessile, Ganoderma weberianum, Ganoderma sinense, Ganoderma gibbosum and Ganoderma australe. A total of 336,506 high-quality single nucleotide polymorphism (SNP) loci were obtained through population evolution analysis. The Fst values were calculated using a 5-kb sliding window, which ranged from 0.11 to 0.74. This suggests varying degrees of genetic differentiation between populations and genetic exchange among varieties. On this basis, the genes related to the stipe length, cap color and branch phenotypes of Ganoderma were excavated, and the region with the top 1% ZFst value region was used as a candidate region. A total of 137, 270 and 222 candidate genes were identified in the aforementioned 3 phenotypes, respectively. Gene annotation revealed that genes associated with stipe length were mainly related to cell division and differentiation, including proteins such as Nse4 protein and DIM1 protein. The genes related to Ganoderma red color were mainly related to the metabolism of tryptophan and flavonoids. The genes related to the branch were mainly related to cytokinin synthesis, ABC transporter and cytochrome P450. This study provided 150 valuable genome resequencing data in assessing the diversity and genetic differentiation of Ganoderma and laid a foundation for agronomic trait analysis and the development of new varieties of Ganoderma., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

To assess the strain resources and address production challenges in Ganoderma cultivation. 150 Ganoderma strains were collected from 13 provinces in China. A comparative analysis of agronomic traits and effective components was conducted. Among the 150 strains, key agronomic traits measured were: average stipe diameter (15.92 mm), average stipe length (37.46 mm), average cap horizontal diameter (94.97 mm), average cap vertical diameter (64.21 mm), average cap thickness (15.22 mm), and average fruiting body weight (14.30 g). Based on these agronomic traits, four promising strains, namely, L08, L12, Z21, and Z39, were recommended for further cultivation and breeding. The average crude polysaccharide content ranged from 0.048% to 0.977%, and triterpenoids ranged from 0.804% to 2.010%. In addition, 73 triterpenoid compounds were identified, constituting 47.1% of the total compounds. Using a distance discrimination method, the types, and relative contents of triterpenoid compounds in 150 Ganoderma strains were classified, achieving 98% accuracy in G. lingzhi identification. The 16 triterpenoid components used for G. lingzhi identification included oleanolic acid, ursolic acid, 3β-acetoxyergosta-7,22-dien-5α-ol, ganoderic acid DM, ganoderiol B, ganorderol A, ganoderic acid GS-1, tsugaric acid A, ganoderic acid GS-2, ganoderenic acid D, ganoderic acid Mf, ganoderic acid A, ganoderic acid K, ganoderic acid V, ganoderic acid G, and leucocontextin J. This study provides valuable insights for exploring and utilizing Ganoderma resources and for the development of new varieties.

Background: In the normal life cycle of the parasite (Echinococcus multilocularis) that causes alveolar echinococcosis, domestic and wild carnivores act as definitive hosts, and rodents act as intermediate hosts. The presented study contributes to the research on the distribution and transmission pattern of E. multilocularis in China having identified sheep as an unusual intermediate host taking part in the domestic transmission of alveolar echinococcosis in Gansu Province, China., Methods: From 2020 to 2021, nine whitish different cyst-like were collected from the liver of sheep in Gansu Province for examination. A near complete mitochondrial (mt) genome and selected nuclear genes were amplified from the cyst-like lesion for identification. To confirm the status of the specimen, comparative analysis with reference sequences, phylogenetic analysis, and network analysis were performed., Results: The isolates displayed ≥ 98.87% similarity to E. multilocularis NADH dehydrogenase sub-unit 1 (nad1) (894 bp) reference sequences deposited in GenBank. Furthermore, amplification of the nad4 and nad2 genes also confirmed all nine samples as E. multilocularis with > 99.30% similarity. Additionally, three nuclear genes, pepck (1545 bp), elp-exons VII and VIII (566 bp), and elp-exon IX (256 bp), were successfully amplified and sequenced for one of the isolates with 98.42% similarity, confirming the isolates were correctly identified as E. multilocularis. Network analysis also correctly placed the isolates with other E. multilocularis., Conclusions: As a result of the discovery of E. multilocularis in an unusual intermediate host, which is considered to have the highest zoonotic potential, the result clearly demonstrated the necessity for expanded surveillance in the area., (© 2023. The Author(s).)

The identification of additional Echinococcus granulosus sensu lato (s.l.) complex species/genotypes in recent years raises the possibility that there might be more variation among this species in China than is currently understood. The aim of this study was to explore intra- and inter-species variation and population structure of Echinococcus species isolated from sheep in three areas of Western China. Of the isolates, 317, 322, and 326 were successfully amplified and sequenced for cox1, nad1, and nad5 genes, respectively. BLAST analysis revealed that the majority of the isolates were E. granulosus s.s., and using the cox1, nad1, and nad5 genes, respectively, 17, 14, and 11 isolates corresponded to Elodea canadensis (genotype G6/G7). In the three study areas, G1 genotypes were the most prevalent. There were 233 mutation sites along with 129 parsimony informative sites. A transition/transversion ratio of 7.5, 8, and 3.25, respectively, for cox1, nad1, and nad5 genes was obtained. Every mitochondrial gene had intraspecific variations, which were represented in a star-like network with a major haplotype with observable mutations from other distant and minor haplotypes. The Tajima's D value was significantly negative in all populations, indicating a substantial divergence from neutrality and supporting the demographic expansion of E. granulosus s.s. in the study areas. The phylogeny inferred by the maximum likelihood (ML) method using nucleotide sequences of cox1-nad1-nad5 further confirmed their identity. The nodes assigned to the G1, G3, and G6 clades as well as the reference sequences utilized had maximal posterior probability values (1.00). In conclusion, our study confirms the existence of a significant major haplotype of E. granulosus s.s. where G1 is the predominant genotype causing of CE in both livestock and humans in China., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Research on the spatiotemporal characteristics and influencing factors of environmental emergency incidents in China in recent decades can improve the effectiveness and accuracy of risk supervision of environmental emergency incidents. Based on the data of environmental emergency incidents in 31 provincial regions in China from 1991 to 2018, this study used spatial autocorrelation analysis and a geographically and temporally weighted regression model to analyze the spatial dependence of environmental emergency incidents and the temporal and spatial heterogeneity of influencing factors. The results showed that: ① there was a significant positive spatial correlation between environmental emergency incidents during 1991-1994 and 2001-2014, and the spatial agglomeration was gradually increasing, that is, environmental emergency incidents existed in the provinces of China; clearly, the space depended on the characteristics and was not completely random. ② There was an unbalanced development pattern of environmental emergency incidents in China. The provinces with "L-L" agglomeration were concentrated in the western and northeastern regions, and the number increased and then decreased; by contrast, the ones with "H-H" agglomeration shifted from the east and south to the central and western regions, and the number increased following the decrease. The role of environmental emergency incident in different provincial regions in the spatial agglomeration was different and constantly changing. ③ The effects of various influencing factors on environmental emergency incidentshad obvious temporal and spatial heterogeneity in different periods and different provinces. The impact of the level of economic development on environmental emergency incidents was shown as a "negative-positive-negative" pattern. The impact of industrial structure on environmental emergency incidents was shown as a "negative-positive" pattern. The overall impact of pollution emissions on environmental emergency incident presented a "positive-negative-positive" pattern. Environmental letters and visits had a positive impact on the occurrence of environmental emergency incidents. The negative impact of the legal environment on environmental emergency incidents was gradually weakening. The negative impact of pollution control on environmental emergency incidents at the provincial level has gradually become apparent.

Minks and brown rats are reservoir hosts for many endoparasites including those of the genus Trichinella, a group of parasite nematodes with a worldwide distribution. However, little is known about the prevalence of Trichinella sp. infection in the American mink (Neovison vison) and rats (Rattus norvegicus) in China. Therefore, we aimed to examine the prevalence of Trichinella sp. infection in farmed minks in Weihai city, Shandong province, China and infer the possible route for Trichinella transmission to farmed American minks. In total, 289 muscle samples from minks and 102 carcasses of rats were collected from Weihai City. The appearance of Trichinella sp. was examined using the pooled artificial HCl-pepsin digestion method. The results showed that muscle larvae were detected in 20 of 289 minks (6.92%) and 2 of 102 synanthropic rats (1.96%). The larval density of Trichinella sp. in mink samples ranged from 0.025 to 0.815 larvae per gram (lpg), while the average larval burden in rats was 0.17 lpg. The isolates derived from minks and rats were identified at the species level using multiplex polymerase chain reaction (PCR), which revealed that the size of the two PCR products matched that of T. spiralis at 173 bp. Furthermore, sequence analysis showed 100% identity of the 5S rDNA inter-gene spacer regions of the two isolates to that of T. spiralis. This study presents a novel report of T. spiralis-mediated infection in minks and synanthropic rats in China. We highlight the vulnerability of farmed minks to Trichinella infection through exposure to synanthropic rats, which may raise a public health concern of potential zoonotic risks for domestic animals., (© 2022 Wiley-VCH GmbH.)

Monitoring the regional changes in vegetation coverage and analyzing its driving factors are beneficial to realizing the sustainable development of ecological environment. Based on Landsat 5/8 remote sensing images from 1989 to 2021, vegetation coverage of Helan Mountain in Ningxia was estimated by pixel dichotomy model. In addition, the influence of 10 factors, including environmental factors and human factors, on the spatial-temporal variations of vegetation coverage was quantified by geodetector. The results showed that average vegetation coverage was 35.8% in the study area from 1989 to 2021. On the temporal scale, it showed an increasing trend, with an average increasing rate of 0.043·(10 a) -1 . On the spatial scale, vegetation coverage presented a distribution characteristic of decreasing from southwest to northeast. 58.1% of vegetation coverage in the study area would continue to improve in the future, but 30.7% of vegetation would have the potential risk of degradation. Precipitation was the dominant environmental factor driving the distribution of vegetation. Compared with single factor, the interaction between environmental factors and human factors had a stronger impact on vegetation coverage, while the interaction between precipitation and other factors played a leading role.

For a long time, the epidemic situation of hemorrhagic fever with renal syndrome (HFRS) caused by hantavirus (HV) in Yunnan Province of China has been relatively severe. The molecular epidemiology and host characteristics of HV in Yunnan Province are still not completely clear, and the systematic and long-term investigation of the epidemic area is very limited. In this study, a total of 488 murine-shaped animals were captured in the three regions of Mile City, Mangshi City and Lianghe County in Yunnan Province, and then the type of HV was identified by multiplex real-time RT-PCR and sequenced. The results indicate that 2.46% of the murine-shaped animal specimens were infected with HV. A new subtype of Seoul virus (SEOV) was found in the rare rat species Rattus nitidus in Lianghe County, and the two strains of this new subtype were named YNLH-K40 and YNLH-K53. Through the phylogenetic analysis of this new subtype, it is shown that this new subtype is very similar to the type S5 of SEOV, which is previously described as the main cause for the high incidence of HFRS in Longquan City, Zhejiang Province, China. This new subtype is highly likely to cause human infection and disease. Therefore, in addition to further promoting the improvement of the HV gene database and strengthening the discovery and monitoring of the host animals in Yunnan Province, more attention should be paid to the pathogenic potential of the newly discovered HV type.

Importance: A rapid nutritional transition has caused greater childhood obesity prevalence in many countries, but the repertoire of effective preventive interventions remains limited., Objective: To determine the effectiveness of a novel multifaceted intervention for obesity prevention in primary school children., Design, Setting, and Participants: A cluster randomized clinical trial was conducted during a single school year (from September 11, 2018, to June 30, 2019) across 3 socioeconomically distinct regions in China according to a prespecified trial protocol. Twenty-four schools were randomly allocated (1:1) to the intervention or the control group, with 1392 eligible children aged 8 to 10 years participating. Data from the intent-to-treat population were analyzed from October 1 to December 31, 2019., Interventions: A multifaceted intervention targeted both children (promoting healthy diet and physical activity) and their environment (engaging schools and families to support children's behavioral changes). The intervention was novel in its strengthening of family involvement with the assistance of a smartphone app. The control schools engaged in their usual practices., Main Outcomes and Measures: The primary outcome was the change in body mass index (BMI; calculated as weight in kilograms divided by height in square meters) from baseline to the end of the trial. Secondary outcomes included changes in adiposity outcomes (eg, BMI z score, prevalence of obesity), blood pressure, physical activity and dietary behaviors, obesity-related knowledge, and physical fitness. Generalized linear mixed models were used in the analyses., Results: Among the 1392 participants (mean [SD] age, 9.6 [0.4] years; 717 boys [51.5%]; mean [SD] BMI, 18.6 [3.7]), 1362 (97.8%) with follow-up data were included in the analyses. From baseline to the end of the trial, the mean BMI decreased in the intervention group, whereas it increased in the control group; the mean between-group difference in BMI change was -0.46 (95% CI, -0.67 to -0.25; P < .001), which showed no evidence of difference across different regions, sexes, maternal education levels, and primary caregivers (parents vs nonparents). The prevalence of obesity decreased by 27.0% of the baseline figure (a relative decrease) in the intervention group, compared with 5.6% in the control group. The intervention also improved other adiposity outcomes, dietary, sedentary, and physical activity behaviors, and obesity-related knowledge, but it did not change moderate- to vigorous-intensity physical activity, physical fitness, or blood pressure. No adverse events were observed during the intervention., Conclusions and Relevance: The multifaceted intervention effectively reduced the mean BMI and obesity prevalence in primary school children across socioeconomically distinct regions in China, suggesting its potential for national scaling., Trial Registration: ClinicalTrials.gov Identifier: NCT03665857.

Background: Streptococcus pneumoniae (S. pneumoniae) is a major cause of bacterial meningitis, septicemia and pneumonia in children. Inappropriate choice of antibiotic can have important adverse consequences for both the individual and the community. Here, we focused on penicillin/cefotaxime non-susceptibility of S. pneumoniae and evaluated appropriateness of targeted antibiotic therapy for children with IPD (invasive pneumococcal diseases) in China., Methods: A multicenter retrospective study was conducted in 14 hospitals from 13 provinces in China. Antibiotics prescription, clinical features and resistance patterns of IPD cases from January 2012 to December 2017 were collected. Appropriateness of targeted antibiotics therapy was assessed., Results: 806 IPD cases were collected. The non-susceptibility rates of S. pneumoniae to penicillin and cefotaxime were 40.9% and 20.7% respectively in 492 non-meningitis cases, whereas those were 73.2% and 43.0% respectively in 314 meningitis cases. Carbapenems were used in 21.3% of non-meningitis cases and 42.0% of meningitis cases for targeted therapy. For 390 non-meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were used in 17.9% and 8.7% of cases respectively for targeted therapy. For 179 meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were prescribed in 55.3% and 15.6% of cases respectively. Overall, inappropriate targeted therapies were identified in 361 (44.8%) of 806 IPD cases, including 232 (28.8%) cases with inappropriate use of carbapenems, 169 (21.0%) cases with inappropriate use of vancomycin and 62 (7.7%) cases with inappropriate use of linezolid., Conclusions: Antibiotic regimens for IPD definite therapy were often excessive with extensive prescription of carbapenems, vancomycin or linezolid in China. Antimicrobial stewardship programs should be implemented to improve antimicrobial use., (© 2021. The Author(s).)

In an occasional series of articles, we will be publishing autobiographical sketches from some of those working in the field of genome evolution. The series will feature both the very eminent, but also researchers closer to their start of their career, and those from underrepresented groups. The series will show the unusual paths that academics sometimes take and the obstacles they have overcome. We start this series with one of the most influential researchers in the field of molecular evolution, Wen-Hsiung Li. Wen-Hsiung has contributed enormously to the field and published on a wide diversity of topics, as described in this autobiographical sketch; he also wrote two textbooks, one of them with Dan Graur, which for many years were the bibles of the field. He was awarded the Motoo Kimura prize by the Society of Molecular Biology and Evolution in 2019 in recognition of his contributions to our subject., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.)

Cysticercosis caused by the metacestode larval stage of Taenia hydatigena formerly referred to as Cysticercus tenuicollis is a disease of veterinary importance that constitutes a significant threat to livestock production worldwide, especially in endemic regions due to condemnation of visceral organs and mortality rate of infected young animals. While the genetic diversity among parasites is found to be potentially useful in many areas of research including molecular diagnostics, epidemiology and control, that of T. hydatigena across the globe remains poorly understood. In this study, analysis of the mitochondrial DNA (mtDNA) of adult worms and larval stages of T. hydatigena isolated from dogs, sheep and a wild boar in China showed that the population structure consists of two major haplogroups with very high nucleotide substitutions involving synonymous and non-synonymous changes. Compared with other cestodes such as Echinococcus spp., the genetic variation observed between the haplogroups is sufficient for the assignment of major haplotype or genotype division as both groups showed a total of 166 point-mutation differences between the 12 mitochondrial protein-coding gene sequences. Preliminary analysis of a nuclear protein-coding gene (pepck) did not reveal any peculiar changes between both groups which suggests that these variants may only differ in their mitochondrial makeup.

Introduction: Mindfulness training (MT) has shown preliminary efficacy as a behavioral treatment for smoking cessation. We examined the effect of a brief-MT intervention on smoking cessation for Chinese women in workplaces in Hong Kong, China., Methods: In this pilot randomized controlled trial, 213 daily smokers were recruited from workplaces and computer-randomized into the intervention (n = 114) or control (n = 99) groups. Participants in both groups received a self-help booklet. Participants in the intervention group additionally attended 2 sessions of a brief-MT workshop. The primary outcome was self-reported 7-day point-prevalence abstinence (PPA) at 6 months. Secondary outcomes were biochemically validated abstinence (exhaled CO < 4 ppm and salivary cotinine < 10 ng/mL) and smoking reduction at 6 months. Analyses were done by intention to treat. We conducted a post-trial qualitative evaluation on participants in the intervention group (n = 14). Data were analyzed thematically., Results: At 6-month follow-up, self-reported 7-day PPA were similar between the intervention and control groups (18.4% vs. 21.2%; P = 0.61). Very few participated in biochemical validation (n = 17), and validated abstinence and smoking reduction rates showed no significant difference (5.3% vs. 11.1%, P = 0.12 and 20.2% vs. 20.2%, P = 1.00, respectively). A posteriori analysis showed that brief-MT participants who were psychologically engaged with the intervention had greater 6-month PPA. Qualitative evaluation showed brief-MT reduced stress but its effectiveness was restrained by the insufficient home practice., Conclusions: This pilot trial on a brief-MT intervention for smoking cessation on Chinese women in workplaces showed feasibility, but improving compliance is needed to maximize the efficacy in future fully powered trials., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective: To investigate the clinical characteristics and genetic features of congenital myasthenic syndrome (CMS) related to SLC25A1 gene variant. Methods: The clinical data of two SLC25A1 gene variant related CMS patients treated at the Children's Hospital of Fudan University between January 2015 and June 2019 were analyzed retrospectively. A literature search with "SLC25A1" and "congenital myasthenic syndrome" as key words was conducted at China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, National Center from Biotechnology Information and Pubmed (up to June 2020). The clinical characteristics and genetic features of congenital myasthenic syndrome related to SLC25A1 gene variant were summarized. Results: Two patients were all males, aged 9 years and 2 years respectively and the onset age was in infancy. In addition to typical CMS symptoms (fatigable muscular weakness, including bilateral ptosis, strabismus, masticatory weakness, low voice and limb weakness), the two patients both had developmental delay along with metabolic abnormalities (elevated urinary 2-ketoglutarate (2-KG), elevated lactic acid levels or 2-hydroxyglutaric aciduria). Trio whole-exome sequencing (WES) revealed two novel pathogenic variants of SLC25A1(c.628C>T, p.R210X; c.145G>A, p.V49M) in case 1 and (c.145G>A, p.V49M; microdeletion) in case 2. After literature search, 15 cases in 3 English articles were found, which made up the complete case data of 17 patients (including these 2 cases). Seventeen patients had very early onset with the age of 2 years. Mild intellectual disability was recorded in 9 patients, and mild developmental delay was observed in one patient. 5 SLC25A1 gene variants (three missense, one nonsense and one microdeletion) were identified in these cases. Twelve patients from 6 pedigrees harbored one same variant (c.740G>A, p.R247Q) and two cases had the other variant (c.145G>A, p.V49M). Conclusions: Patients diagnosed with SLC25A1 related CMS have very early onset, and most of them have intellectual disability or developmental delay. Part of patients had metabolic abnormalities. The variants (c.740G>A, p.R247Q and c.145G>A, p.V49M) are recurrent.

Polyunsaturated fatty acids (PUFAs) are essential for mammalian testis development and sperm function. However, PUFAs that are contained in linseed oil are easily oxidized in the diet and biohydrogenated in the rumen. In this study, we investigated the effect of linseed as a source of PUFAs on the antioxidant capacity and testis development in Hu lamb. Seventy-five 3-month-old lambs were randomly assigned to three groups. Within each treatment group, 25 lambs were allocated to five pens (five lambs per pen). The lambs in the control group were fed a control diet without linseed for 42 days from D22 to D63. Group I (BS28) was fed a control diet from D22 to D35 and 8% linseed diet from D36 to D63. Group II (BS42) was fed an 8% linseed diet for 42 days from D22 to D63. After 63-day feeding trial, all lambs except the heaviest and lightest in each pen were humanely slaughtered and investigated. Results revealed that feeding linseed did not affect the body weight, scrotal circumference, and testis weight, whereas feeding linseed for 42 days increased the epididymis weight (37.85 ± 1.61 g vs. 32.09 ± 1.06 g, P < 0.05) compared with the control group. Feeding lambs with linseed for 42 days also significantly upregulated the expression of antioxidative (glutathione peroxidase 4 and copper-zinc superoxide dismutase), steroidogenesis (3β-hydroxysteroid dehydrogenase and steroid acute regulatory protein), and PUFA metabolism-related genes (fatty acid desaturase 2 and elongation of very long-chain fatty acid protein 2) and proliferating cell nuclear antigen mRNA (P < 0.05). It also increased the relative expression of mitochondrial DNA (P < 0.05), total antioxidant capacity (0.230 ± 0.019 mmol/mgprot vs. 0.175 ± 0.011 mmol/mgprot, P < 0.05), and superoxide dismutase (1661.467 ± 147.117 U/mgprot vs. 1158.891 ± 98.850 U/mgprot, P < 0.05) in testicular tissue but decreased the cholesterol concentration (0.331 ± 0.073 mmol/mgprot vs. 0.671 ± 0.092 mmol/mgprot, P < 0.05) compared with the control group. Therefore, feeding lambs with linseed for 42 days stimulated seminiferous tubule development and increased the number of Sertoli cells (20.71 ± 0.89 vs. 17.6 ± 0.73, P < 0.05), epididymal cauda lumina diameter (638.26 ± 22.32 μm vs. 444.41 ± 34.80 μm, P < 0.05), and the number of sperm in the epididymal cauda (68.91 ± 7.06 × 10 8 /g vs. 36.61 ± 7.50 × 10 8 /g). All these results suggested that feeding linseed in the early reproductive development stage of lambs upregulated the expression of antioxidative, steroidogenesis, and PUFA metabolism-related genes; increased the antioxidant capacity in lamb's testis; and contributed to testis development and spermatogenesis., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Previous studies about the reliability and validity of the updated PCL version for the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (PCL-5) have only been evaluated in certain samples of the population, which lacks in the sample of Healthcare Workers. Our study focused on the factor structure, reliability and validity of the PCL-5 among Chinese Healthcare Workers during the Outbreak of Corona Virus Disease 2019., Methods: We conducted an online survey of frontline healthcare workers using the PCL-5 for PTSD. Total of 212 frontline healthcare providers were included in this study., Results: The findings showed that PCL-5 is a reliable instrument in our sample. The total and subscale scores showed good internal consistency. The convergent and discriminant validity of the PCL-5 were also well demonstrated. Our result showed a better fit with the seven-factor hybrid model compared with other models and supported that the PCL-5 Chinese version can be used as a reliable screening tool to conduct psychological screening for Chinese healthcare workers., Limitation: We could not examine other aspects of reliability and validity like test-retest reliability or criterion validity. We didn't use the gold-standard structured interview for PTSD in our study. Besides, most of our samples were young people who had access to the internet. Not all professional levels and seniorities were presented because our sample had a lower mean income and educational level., Conclusion: Our study shows that the Chinese PCL-5 has good validity and reliability in frontline healthcare workers during the outbreak., (Copyright © 2020. Published by Elsevier B.V.)

Background: Cystic or alveolar echinococcosis caused by the larval stages of Echinococcus spp. is a very severe zoonotic helminth infection. Echinococcus shiquicus is a newly discovered species that has only been reported in the Qinghai and Sichuan provinces of the Qinghai-Tibet plateau, China where, to date, it has only been confirmed in Tibetan foxes and wild small mammal populations of the Tibetan plateau. Information on its genetic and evolutionary diversity is scanty. The aim of this study was to investigate the prevalence of E. shiquicus in plateau pikas (Ochotona curzoniae), a known intermediate host, and to determine the genetic variation and phylogenetic relationship of the E. shiquicus population in the Tibet region of China based on mitochondrial DNA., Methods: Echinococcus shiquicus samples were collected from Damxung and Nyêmo counties (located in Tibet Autonomous Region, China). The mitochondrial cox1 and nad1 gene sequences were analyzed, and the genetic diversity and epidemiology of E. shiquicus in the region were discussed based on the results., Results: The prevalence of E. shiquicus in pikas in Damxung and Nyêmo counties was 3.95% (6/152) and 6.98% (9/129), respectively. In combination with previous public sequence data, the haplotype analysis revealed 12 haplotypes (H) characterized by two distinct clusters (I and II), and a sequence distance of 99.1-99.9% from the reference haplotype (H1). The diversity and neutrality indices for the entire E. shiquicus populations were: haplotype diversity (Hd) ± standard deviation (SD) 0.862 ± 0.035; nucleotide diversity (Hd ± SD) 0.0056 ± 0.0003; Tajima's D 0.876 (P > 0.05); and Fu's F 6.000 (P > 0.05)., Conclusions: This was the first analysis of the newly discovered E. shiquicus in plateau pikas in the Tibet Autonomous Region of China. The neutrality indices suggest a deficiency of alleles, indicative of a recent population bottleneck.

Misperception of nutritional status is common and hinders the progress of childhood obesity prevention. This study aimed to examine the effectiveness of a smartphone-assisted intervention to improve student and parental perception of students' nutritional status (underweight, normal weight, overweight, obese). We conducted a parallel-group controlled trial with a non-randomized design in three junior middle schools of Beijing, China in 2019. One school was allocated to the intervention group and two schools to the control group. A total of 573 students (aged 13.1 ± 0.4 years) participated in the trial. The 3-month intervention included three components: health education sessions for students and parents, regular monitoring of students' weight, and the provision of feedback via a smartphone application. Schools in the control group continued their usual practice. Primary outcomes included the student and parental accurate perception of students' nutritional status. The percentage of students' accurate perception of their own nutritional status in the intervention group increased from 49.0% to 59.2% from baseline to three months, whereas it decreased from 64.1% to 58.1% in the control group; the adjusted odds ratio (OR) between the two groups was 1.71 (95% confidence interval (CI): 1.13, 2.59). The intervention did not significantly improve parental perception of students' nutritional status ( p > 0.05). The study findings provided a brief approach for improving perception of nutritional status among middle school students.

Background: Pregnancy presents a teachable moment to engage male smokers whose partners are pregnant in smoking cessation. Evidence on how to approach and help these smokers quit smoking in antenatal settings has remained scarce. This paper presents the rationale and study design of a trial which aims to evaluate the effectiveness of a brief intervention model for promoting smoking cessation in expectant fathers., Methods: BANSAR is a pragmatic randomised controlled trial conducted in antenatal clinic in seven public hospitals in Hong Kong, China. An estimated 1148 fathers who smoke at least one cigarette daily and whose partners are pregnant and non-smoking will be randomised (1:1) to receive brief advice combined with 1-week sample of nicotine replacement therapy (NRT) and active referral to smoking cessation services, or brief advice only (usual care). Outcome will be assessed at 3 and 6 months after treatment initiation. The primary outcome is carbon monoxide-verified (<4 part per million) abstinence at 6 months post-treatment initiation. Secondary outcomes include self-reported 7-day point-prevalence abstinence and 24-week continuous abstinence, use of smoking cessation service and NRT and quit attempt, and smoking reduction, change in nicotine dependence and intention to quit in continuing smokers., Comment: This trial will provide real-world evidence on the effectiveness of a combined brief intervention model for smoking cessation in expectant fathers, an understudied population. The findings may be particularly relevant to low and middle-income countries, where male-to-female smoking ratios and birth rates tend to be higher than higher-income countries., Trial Registration: ClinicalTrials.gov, number NCT03671707., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier Inc. All rights reserved.)

A novel nocardioform strain, CICC 11023 T , was isolated from a tissue biopsy of neck lesions of a patient with primary cutaneous nocardiosis and characterized to establish its taxonomic position. The morphological, biochemical, physiological and chemotaxonomic properties of strain CICC 11023 T were consistent with classification in the genus Nocardia . Whole-cell hydrolysates were rich in meso-diaminopimelic acid, galactose, arabinose and fructose. Mycolic acids were present. The major polar lipids were diphosphatidylglycerol, phosphatidylethanolamine, one unidentified phospholipid and two unidentified lipids, and the predominant menaquinone was cyclo MK-8 (H4, ω-cyclo). The main fatty acids (>5 %) were C 18 : 0 10-methyl (TBSA), C 16 : 0 , summed feature 4 (C 16 : 1 trans 9/C 15 : 0 iso 2OH), C 15 : 0 and C 17 : 0 10-methyl. Phylogenetic analyses based on 16S rRNA gene sequences revealed that the isolate is most closely related (>98 % similarity) to the type strains Nocardia ninae OFN 02.72 T , Nocardia iowensis UI 122540 T and Nocardia alba YIM 30243 T , and phylogenetic analysis of gyrB gene sequences showed similarity (89.1-92.2 %) to Nocardia vulneris NBRC 108936 T , Nocardia brasiliensis IFM 0236 T and Nocardia exalbida IFM 0803 T . DNA-DNA hybridization results for strain CICC 11023 T compared to Nocardia type strains ranged from 20.4 to 35.4 %. The genome of strain CICC 11023 T was 8.78 Mbp with a G+C content of 67.4 mol% overall. The average nucleotide identity (ANI) values between strain CICC 11023 T and N. alba YIM 30243 T were low (OrthoANIu=77.47 %), and the ANI values between strain CICC 11023 T and N. vulneris NBRC 108936 T were low (OrthoANIu=83.75 %). Consequently, strain CICC 11023 T represents a novel Nocardia species on the basis of this polyphasic study, for which the name Nocardia colli sp. nov. is proposed. The type strain is CICC 11023 T (=KCTC 39837 T ).

We investigated the prevalence, awareness, treatment, and control of hypertension in a large opportunistic screening study in China. Our study participants had to be ≥18 years of age and had ideally not taken blood pressure (BP) for ≥1 year. BP was measured three times consecutively in the sitting position with a 1-minute interval, using a validated electronic BP monitor or mercury sphygmomanometer. Trained volunteer investigators administered a questionnaire to collect information on medical history, lifestyle, and use of medications. The 364 000 participants (52.6% women, and mean age 53.4 years) had a mean systolic/diastolic BP of 124.2/76.4 mm Hg. The proportion of hypertension was 24.7%. In all hypertensive subjects (n = 89 925), the awareness, treatment, and control rates of hypertension were 60.1%, 42.5%, and 25.4%, respectively. In multiple stepwise logistic regression analyses, the odds for unawareness vs awareness of hypertension was higher in men and lower with age advancing, current smoking, and the presence of diabetes mellitus, coronary heart disease, and stroke or transient ischemic attack (P < .0001). The odds for uncontrolled vs controlled hypertension was higher with age advancing and current smoking, and lower with the presence of diabetes mellitus and coronary heart disease (P ≤ .03) in 38 207 treated hypertensive patients, and it was also higher with the use of antihypertensive monotherapy (odds ratio 1.13, P = .0003) in 19 523 treated hypertensive patients with specific antihypertensive drugs. Our study identified several factors as barriers to BP control in China, such as male gender, younger age, current smoking, and the under-use of combination therapy., (© 2020 Wiley Periodicals, Inc.)

In China, automated blood pressure monitors have been readily available for home use. Home blood pressure monitoring has been indispensable in the management of hypertension. There is therefore a need to establish guidelines for home blood pressure monitoring on the basis of the 2012 consensus document. In this guidelines document, the committee put forward recommendations on the selection and calibration of blood pressure measuring devices, the frequency (times) and duration (days) of blood pressure measurement, and the diagnostic threshold of home blood pressure., (© 2019 Wiley Periodicals, Inc.)

In December 2019, coronavirus disease-2019 (COVID-19) broke out in Wuhan and other places. Seven versions of the Diagnosis and Treatment Program for Coronavirus Disease-2019 successively issued by the Chinese government have designated traditional Chinese medicine (TCM) as a necessary medical strategy. Based on the changes in TCM diagnosis and treatment strategies in these seven versions of Diagnosis and Treatment Program for Coronavirus Disease-2019 , this paper collected data reported by the Chinese government media; analyzed the understanding of the etiology, pathogenesis, syndrome differentiation, treatment methods, and prescriptions of COVID-19 by TCM and evaluated the clinical efficacy of TCM strategies. COVID-19 is associated with TCM disease of pestilence, and its pathogenesis can be summarized as an "epidemic pathogen invading the body, followed by entering the internal organs and transforming into heat, resulting in pathogen trapping in the interior and healthy qi collapsing, and deficiency of qi and yin". Pathological processes should be emphasized in syndrome differentiation. The manifestations of qi deficiency and yin deficiency are exhibited during the recovery period. TCM strategies represented by Qing Fei Pai Du Tang have shown apparent advantages in improving symptoms, promoting virus clearance, and shortening hospitalization, as well as surprising efficacy of zero patient progressing from mild to severe cases in a TCM cabin hospital. Clinical data illustrate the effectiveness of TCM strategies proposed by the Chinese government. This major epidemic may bring new opportunities for TCM development.

Objective: To summarize the clinical and genetic features of β-propeller protein-associated neurodegeneration (BPAN). Methods: The clinical data of 17 patients with BPAN with WDR45 gene variants were retrospectively collected at Children's Hospital of Fudan University, Peking University First Hospital, Capital Institute of Pediatrics, Shengjing Hospital of China Medical University and Shanghai Children's Hospital from June 2016 to December 2018, and their clinical manifestations, electroencephalogram, neuroimaging and genetics were analyzed. Results: Seventeen cases (13 females, 4 males), aged 1.1-8.8 years, were included. The median age of seizure onset was 14.5 months, from 3 months to 24 months of age, manifested with epileptic spasm in 6 cases and focal seizures in 5 cases. Eight patients had only one seizure type and 8 patients had two or more seizure types. Nine patients had complete remission of seizures. All 16 patients with seizures had developmental delay before the seizure onset, of whom 13 patients had moderate to severe seizures. The brain magnetic resonance imaging (MRI) was abnormal in 13 patients, including cerebral atrophy (10 cases) and thinning of the corpus callosum (9 cases). The brain magnetic susceptibility weighted imaging (SWI) in preschool stage showed prominent T2 hypointense signals in bilateral globus pallidus and brainstem ventral in two cases. Five seizure types (spasm, focal, absence, myodonic and generalized tonic clonic seizures)were found on ictal electroencephalogram(EEG) recordings. Compared to female patients(17(6-24) months of ege), male cases had earlier seizure onset (3, 4, 5, 18 months of age) . All patients had de novo variations in WDR45(6 nonsense, 4 frameshift, 3 missense and 4 splicing variations), with hemizygous variants in 3 males, mosaic variants in a male and heterozygous variants in 13 females, within which 5 variations had not been reported (c.977-1C>T,c.976+1G>C,c.10C>T,c.806del and c.110T>C). Conclusions: The patients with BPAN have profound developmental delay and are vulnerable to seizures. The male patients with BPAN tend to have more severer clinical phenotype than females. Early brain SWI could facilitate the timely diagnosis of this disease.

Microplastic pollution (plastics with particle sizes<5 mm) has become a serious problem. In this study, we sampled the surface water, sediment, and bird excrement from the shore, center of the lake, and active areas for birds in Baisha Lake, which is key habitat for migratory birds in the Poyang Lake wetlands. The microplastics were separated by flotation separation, and then, we analyzed the pollution characteristics of this area. The main results were as follows. ① There were significant differences in the abundance of microplastics in water and sediment at different sampling points in the study area. The average abundance of microplastics in water and sediment were 263.28 per·m -3 and 215.9 per·kg -1 , respectively. The average abundance of microplastics in migratory bird feces was 4.93 per·g -1 . ② There were four kinds of microplastics in the surface water in terms of the different morphologies of particles, namely, pellets, films, fragments, and fibers, among which pellets were the major type. The main colors of microplastics were red, yellow, green, blue, purple, black, and transparent. The rank in terms of the size of microplastics was follows: < 1 mm > 1-2 mm > 2-3 mm > 3-5 mm, and the abundance decreased with the increase of particle size. ③ There were also four kinds of microplastics with different morphologies in the sediment, namely, pellets, films, fragments, and fibers. The main colors of these microplastics were red, yellow, blue, purple, black, and transparent. Microplastic sizes on the shore of the lake and bird habitat were mainly < 1 mm, and 1-2 mm particles were mainly detected in the center of the lake. ④ There were four types of microplastics in the excrement of migratory birds, namely, pellets, films, fragments, and fibers. The colors of these microplastics were red, yellow, green, purple, and transparent, and the particle size was mainly < 1 mm. ⑤ There was no consistency in the types of microplastics in the water body, sediment, and bird droppings. However, the size distribution for water and bird excrement was consistent. The results indicate that Poyang Lake bird habitat is polluted by microplastics, and the birds are inevitably exposed to microplastics. This study warns that microplastics will be an emerging threat to migratory birds.

Peripheral arterial disease is one part of systematic atherosclerosis, becoming a heavy burden of human health. Patients in end stage of peripheral arterial disease manifest critical limb ischemia with severe rest pain and refractory ulcer. Surgical revascularization is the optimal option for patients with critical limb ischemia to avoid major amputation and improve quality of life. However, some of them contraindicate surgical revascularizations owing to coexisting morbidities. Spinal cord stimulation is reported to be effective and minimally invasive in pain relief and limb salvage for patients with limb ischemia. Here, we reported one case with chronic critical limb ischemia and gangrene of foot who underwent spinal cord stimulation, which was, as we knew, the first case in China. He was diagnosed with Burger disease and accompanied with history of stroke, chronic obstructive pulmonary disease and Castleman's disease. It showed totally occlusive lesions of external iliac and femoropopliteal artery and no outflows below the knee in the computed tomography angiography. Given the complexity of lesions and weakness of the patient, spinal cord stimulation was indicated for control of rest pain and limb salvage. As specified, we implanted the temporary neurostimulator as the first step. After 2 weeks from temporary neurostimulator implantation, the patient achieved significant relief in intensity of pain, and acquired 20% improvement of transcutaneous oxygen pressure. The satisfactory results indicated probable effectiveness of spinal cord stimulation, thus we performed the permanent neurostimulator implantation 1 month later. During 2 months of follow-up, the patients stabilized at Fountain III with pain relief with one kind of nonsteroidal anti-inflammatory drug. In our case, we confirmed the significant validity of spinal cord stimulation for pain control and consequent improvement of quality of life in non-reconstructable chronic critical limb ischemia. Furthermore, we reviewed that a number of published studies suggested that spinal cord stimulation be a reasonable option for patients with critical rest pain, especially who contraindicated surgical revascularization. The application of spinal cord stimulation in pain relief for non-reconstructable chronic critical limb ischemia was approved by related guidelines released by European Society of Cardiology and Trans-Atlantic Inter-Society Consensus. Further investigations are required for assessing the long-term outcome in limb salvage.

Throughout the world, busy waterways near large ports witness heavy vessel traffic in recent decades. The waterways are characterized by high risk in terms of loss of life, property, and pollution to environment. To facilitate maritime safety management with satisfactory efficiency and efficacy, the authors propose a framework of safety indexes to evaluate the risk level in busy waterways according to the accident severity, fatality rate and special indicators of maritime transportation. The safety indexes consist of Safety Evaluation Index (SEI) and Safety Warning Index (SWI), and are derived from the proposed risk criteria of Chinese vessel traffic. As a case study, data on vessel traffic accidents reported in the Western Shenzhen Port, South China from 1995 to 2015 are analyzed. The actual risk level of this area during the period is calculated under the framework. The implementation of the safety indexes indicate that the risk criteria and safety indexes are practicable and effective for the vessel traffic management. The methodology based on long-term accident data can significantly support the risk analysis in the macroscopic perspective for busy ports and waterways, such that SWI can act as threshold to trigger actions, while SEI can act as an indicator to measure safety status., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objective: To understand the epidemiological and etiological characteristics of outbreaks on acute gastroenteritis caused by sapovirus (SaV) worldwide. Methods: Literature about the outbreaks on acute gastroenteritis caused by SaV were retrieved from the databases including WanFang, CNKI, PubMed and Web of Science after evaluation. Time, geography, setting and population distributions of outbreaks, transmission mode, SaV genotype and clinical characteristics of the patients were analyzed. Results: A total of 34 papers about SaV were included, involving 146 outbreaks occurred between October 1976 and April 2016. In these papers, 138 outbreaks were reported on the related months. All these outbreaks occurred in northern hemisphere. SaV outbreaks occurred all year around, but mainly in cold season, the incidence was highest in December (25 outbreaks) and lowest in in August (2 outbreaks). Most outbreaks were reported by Japan, followed by Canada, the United States of America and the Netherlands. There were 141 outbreaks for which the occurring settings were reported, child-care settings were most commonly reported setting (48/141, 34.04 % ), followed by long-term care facility (41/141, 29.08 % ) and hospital (16/141, 11.35 % ). Clinical symptoms of 1 704 cases in 31 outbreaks were reported, with the most common symptom was diarrhea (1 331/1 704, 78.12 % ), followed by nausea (829/1 198, 69.20 % ), abdominal pain (840/1 328, 63.25 % ), vomiting (824/1 704, 48.36 % ) and fever (529/1 531, 34.53 % ). Genotypes of SaV were determined for 119 outbreaks. GⅠ(51/119, 42.86 % ) and GⅣ (45/119, 37.82 % ) were predominant. The outbreaks of GⅣ SaV increased suddenly in 2007, and the outbreaks of GⅠ SaV mainly occurred in 2008 and during 2011-2013. Conclusions: SaV outbreaks were reported mainly by developed countries, with most outbreaks occurred in cold season, in child-care settings and long term care facility. GⅠ and GⅣ were the most common genotypes of SaV. Prevention and control of SaV outbreak in China seemed relatively weak, and it is necessary to conduct related training and to strengthen the SaV outbreak surveillance in areas where service is in need.

Purpose: The First Year Inventory (FYI) is a parent-report instrument, and is developed to assess behaviors of 12-month-old infants that could suggest risk for an eventual diagnosis of autism. This study was designed to examine the application of the FYI in the Chinese community., Design and Methods: FYIs were completed at a community health center by 541 families during the child's physical examination at 12 months of age from 2013 to 2015. The weighted risk scores used in this study were based on US norms, and compared the FYI differences between China and the U.S., Results: The total risk scores ranged from 5 to 42 points; the 95th percentile cutoff was 27.00(9.8 points higher than the 95th percentile cutoff in the US), the 98th percentile cutoff was 29.66(7.04 points higher than the 98th percentile cutoff in the US), and the 99th percentile cutoff was 31.83. Higher risk scores were found for boys than girls. Mothers with a junior college education reported significantly higher FYI risk scores than other three groups including high school, college graduates and post-graduates., Conclusions: There were no significant effects of birth parity, investigator, or investigation year on risk scores. Large-scale longitudinal research is encouraged in the future to develop an early detection model of autism in China., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objective: To analyze the spatial distribution of the incidence of tuberculosis (TB) in China from 2012 to 2014 and provide evidence for the prevention and control of TB. Methods: The database of TB in China from 2012 to 2014 was established by using geographical information system, the spatial distribution map was drawn, trend analysis and spatial autocorrelation analysis were conducted to explore the spatial distribution pattern of TB and identify hot areas. Results: The trend surface analysis showed that the incidence of TB decreased gradually from the west to the east in China, and the U type curve could reflect the TB distribution from the south to the north; Global spatial autocorrelation analysis showed the 2012-2014 global Moran's I were 0.366, 0.364 and 0.358 ( P <0.01), suggesting that the incidence of TB had a spatial clustering in China; Local Getis-OrdG (i) spatial autocorrelation analysis by ArcGIS software showed that there was 11 cluster areas, 3 high incidence areas (Xinjiang, Tibet, Qinghai) and 8 low incidence areas (Beijing, Tianjin, Shanghai, Hebei, Inner Mongolia, Shanxi, Shandong, Jiangsu). Conclusion: The incidence of TB had obviously spatial clustering characteristic, the areas at high risk were mainly in the northwestern and plateau area in China.

Sogatella furcifera (Horváth) is a migratory insect that is one of the most important pest species on rice in many Asian countries. Control of S. furcifera (Hemiptera: Delphacidae) primarily depends on the use of chemical insecticides, and with this extensive reliance on pesticides, determining the degree of resistance of S. furcifera populations to the chemicals used for its control is essential. In this study, the resistance level to six conventional insecticides in five populations of S. furcifera from Guizhou Province was monitored yearly using the rice-stem dipping method in 2012-2015 to precisely understand current resistance levels and to estimate trends in the development of insecticide resistance in S. furcifera in Guizhou. Overall, S. furcifera from five regions in Guizhou showed a trend toward decreased susceptibility to isoprocarb (resistance ratio [RR] 0.82-3.59), susceptibility to low resistance against thiamethoxam (RR 0.27-9.69), susceptibility to moderate resistance to imidacloprid (RR 0.71-26.06), and decreased susceptibility to moderate resistance to chlorpyrifos (RR 4.63-19.58). The resistance to pymetrozine (RR 10.48-84.65) was moderate to high, and that to buprofezin (RR 6.36-412.43) was low to very high. In conclusion, the use of buprofezin and pymetrozine to control S. furcifera should be reduced in Guizhou Province, whereas prudent use at a reasonable frequency of chlorpyrifos and imidacloprid can continue. Isoprocarb and thiamethoxam are the best choices for effective management of S. furcifera. Rotations using alternative insecticides with different modes of action are recommended for regions in which resistance is at a moderate level., (© The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America.)

Objectives: To establish reference values for left ventricular (LV) myocardial strains in a cohort of healthy Chinese volunteers with feature tracking cardiac magnetic resonance imaging., Methods: A total of 60 healthy volunteers were recruited, receiving a cardiac magnetic resonance imaging (CMR) examination at 3.0T scanner (Tim Trio, Magnetum, Siemens, Germany). A new feature tracking CMR software (Trufisp-strain, Siemens) was used to analyze left ventricular myocardial strain parameters, including radial, circumferential, longitudinal strain, systolic strain rate, and early diastolic strain rate., Results: The image quality was sufficient to perform strain analysis.The reference values of global strain, global strain rate and segmental strains were obtained. A good inter- and intra-observer agreement was achieved in global strain analysis (except circumferential straininter-observer in apical level), with (37.7±9.6)% for LV global mean radial strain, (-18.4±3.3)% for circumferential strain and (-15.2±2.3%) for longitudinal strain, respectively.Age was positively correlated with global mean radial strain ( r =0.416, P <0.001) and negatively correlated with early diastolic strain rate (circumferential or longitudinal) and circumferential strain( r =-0.436, P <0.001; r =-0.326, P =0.011; r =-0.273, P =0.035, respectively). Women showed higher circumferential and longituinal strain values and lower systolic circumferential strain rate than men. The strain parameters were correlated with left ventricular ejection fraction (LVEF) ( P <0.05)., Conclusions: FT-CMR (Trufisp-strain software) is a fast, convenient and highly reproducible method for analyzing left ventricular myocardial strains, which can sensitively detect gender and age differences. The reference values of LV myocardial strains can support further studies in the future.

Background: Little is known about the clinical benefit of a non-vitamin K antagonist oral anticoagulant compared with warfarin in elderly Chinese patients with atrial fibrillation (AF)., Objective: The purpose of this study was to evaluate the clinical benefit of dabigatran in elderly (age ≥80 years) Chinese patients with nonvalvular AF with regard to the risk of ischemic stroke and intracranial hemorrhage (ICH)., Methods: This was an observational study., Results: We studied 571 Chinese patients (mean age 84.8 ± 4.0 years; 58.1% women) with nonvalvular AF. The primary outcome was hospital admission for ischemic stroke, and the secondary outcome was admission for ICH. The mean CHA2DS2-VASc (congestive heart failure [1 point], hypertension [1 point], age 65-74 years [1 point] and age ≥75 years [2 points], diabetes mellitus [1 point], prior stroke or transient ischemic attack [2 points], vascular disease [1 point], sex category [female] [1 point]) and HAS-BLED (hypertension [1 point], abnormal renal/liver function [1 point], stroke [1 point], bleeding history [1 point] or predisposition [1 point], labile international normalized ratio [1 point], elderly [age >65 years] [1 point], drugs/alcohol concomitantly [1 point]) scores were 4.8 ± 1.6 and 2.4 ± 0.8, respectively. Of 571 patients, 129 (22.6%) were taking dabigatran 110 mg twice daily and the remaining were on warfarin. After a mean follow-up of 2.6 years (a total of 1471 patient-years), ischemic stroke occurred in 83 patients on warfarin (6.9% per year) compared with 4 patients on dabigatran (1.4% per year) (hazard ratio 0.22; 95% confidence interval 0.23-0.67). There were 8 incidences of ICH: 7 in patients on warfarin (0.59% per year) and 1 patient on dabigatran (0.35% per year). Dabigatran was associated with a substantially lower ischemic stroke risk (1.4% per year vs 5.4% per year) and similar ICH risk (0.35% per year vs 0.36% per year) as compared with warfarin with time in therapeutic range (TTR) ≥55%., Conclusion: In elderly Chinese patients with AF, this study suggested that dabigatran achieved superior stroke risk reduction and similar risk of ICH compared with warfarin with TTR ≥55%. Dabigatran may be preferable to warfarin in elderly patients with AF for stroke prevention, particularly in those with poor TTR., (Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

A liquid chromatography with tandem mass spectrometric detection (LC-MS/MS) method was established for the simultaneous determination of the levels of 10 β2-agonists in meat. The samples were extracted using an aqueous acidic solution and cleaned up using a Quick, Easy, Cheap, Effective, Rugged and Safe (QuEChERS) technique utilising a DVB-NVP-SO3Na sorbent synthesised in-house. First, the β2-agonist residues were extracted in an aqueous acidic solution, followed by matrix solid-phase dispersion for clean-up. The linearities of the method were R(2)=0.9925-0.9998, with RSDs of 2.7-15.3% and 73.7-103.5% recoveries. Very low limits of detection (LOD) and quantitation (LOQ) of 0.2-0.9 μg/kg and 0.8-3.2 μg/kg, respectively, were achieved for spiked meat. The values obtained were lower than the maximum residue limits (MRLs) established by the EU and China. These results clearly demonstrate the feasibility of the proposed approach. The evaluated method provided reliable screening, quantification and identification of 10 β2-agonists in meat., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Tetraspanin-18 (TSPAN18) potentially plays a role in the calcium signaling that is associated with dopamine-induced cortical neuron apoptosis and is considered to be an important mechanism in the pathogenesis of schizophrenia (SCZ). Furthermore, a genome-wide association study (GWAS) identified TSPAN18 as a possible susceptibility gene for SCZ. To validate these findings and reveal the effects of different inheritance models, seven single nucleotide polymorphisms (SNPs) of the TSPAN18 gene were analyzed in 443 patients with SCZ and 628 controls of Han Chinese descent via the SNPscan method. Single SNP, genotype, and association analyses with different models (i.e., additive, dominant, and recessive models) were performed, and the published datasets (2062 cases and 2053 controls) were combined with our results to determine the inheritance effects of the SNPs on SCZ. We observed genotypes and allele distributions of TSPAN18 gene did not show any significant associations in the Han Chinese population based on our experimental and meta-analytical results. Our findings indicate that the TSPAN18 gene is unlikely to be a major susceptibility gene for schizophrenia in Han Chinese.

NOTCH4 regulates signaling pathways associated with neuronal maturation, a process involved in the development and patterning of the central nervous system. The NOTCH4 gene has also been identified as a possible susceptibility gene for schizophrenia (SCZ). The objective of this study was to examine the relationship between NOTCH4 polymorphisms and SCZ in the Chinese Han population. The rs2071287 and rs204993 polymorphisms of the NOTCH4 gene were analyzed in 443 patients with SCZ and 628 controls of Han Chinese descent. Single SNP allele-, genotype-, and gender-specific associations were analyzed using different models (i.e., additive, dominant, and recessive models). This association study revealed that the rs204993 polymorphism is significantly associated with susceptibility for SCZ and that the AA genotype of rs204993 is associated with a higher risk for SCZ (P = 0.027; OR = 1.460; 95% CI, 1.043-2.054). Our data are consistent with those obtained in previous studies that suggested that rs204993 is associated with SCZ and that the AA genotype of rs204993 demonstrates a higher risk. Further large-scale association analyses in Han Chinese populations are warranted.

Lake Bosten is the largest inland freshwater lake in China and plays a key role in the local arid-area ecosystem. This study focuses on the dynamics of water salinity of Lake Bosten in the past 55 years (1955-2009) and intends to quantify the associations between the water salinity and the magnitudes of water level, inflow, outflow, total wastewater drainage into the lake, including industrial and residential wastewater. Correlation analysis reveals that the water salinity has strong associations with those six factors (R = -0.810, -0.510, -0.844, 0.903, 0.855, and 0.685, respectively). We predict that water level, inflow and water salinity of Lake Bosten will decline in 2010-2019. This study recommends a reduction in salt input to the Bosten River by reducing industrial wastewater discharge along the river and the development of clean production technology.

Objective: To assess the design and the Mainland China subgroup baseline characteristics of the study to evaluate the efficacy and safety of alogliptin versus placebo in subjects with type 2 diabetes (T2DM) as monotherapy, add-on to metformin or add-on to pioglitazone., Methods: This was a multi-center, randomized, double-blind, placebo-controlled, 16-week study comparing alogliptin (ALO, 25 mg, 1/d) versus placebo (PLA) as monotherapy (A), add-on to metformin (B) or add-on to pioglitazone ± metformin (C). The T2DM subjects with glycosylated hemoglobin A1c(HbA1c) between 7% and 10% and aged between 18 years and 75 years were enrolled and randomized to the alogliptin group and the placebo group in 1: 1 ratio with 16 weeks treatment. All patients were followed up every 4 weeks. The safety endpoints consisted of the incidence of hypoglycemia and other adverse events., Results: A total of 491 patients were enrolled in the Mainland China subgroup of the study (181 in group A, 186 in group B and 124 in group C). In each treatment group, the baseline characteristics including age, gender, body mass index, diabetes duration, HbA1c, fasting plasma glucose, body weight, daily dosage of metformin and daily dosage of pioglitazone were all well balanced., Conclusion: The demographic data, medical history, glycemic profile and treatment regimen at baseline in Mainland China subgroup are well balanced. The result of this study will provide the clinical evidence for the use of alogliptin in Chinese T2DM patients.

A total of 16 Taenia multiceps isolates collected from naturally infected sheep or goats in Gansu Province, China were characterized by sequences of mitochondrial cytochrome c oxidase subunit 1 (cox1) gene. The complete cox1 gene was amplified for individual T. multiceps isolates by PCR, ligated to pMD18T vector, and sequenced. Sequence analysis indicated that out of 16 T. multiceps isolates 10 unique cox1 gene sequences of 1,623 bp were obtained with sequence variation of 0.12-0.68%. The results showed that the cox1 gene sequences were highly conserved among the examined T. multiceps isolates. However, they were quite different from those of the other Taenia species. Phylogenetic analysis based on complete cox1 gene sequences revealed that T. multiceps isolates were composed of 3 genotypes and distinguished from the other Taenia species.

Metal binding to microbial extracellular polymeric substances (EPS) greatly influences the distribution of heavy metals in microbial aggregates, soil and aquatic systems in nature. In this work, the thermodynamic characteristics of the binding between aqueous metals (with copper ion as an example) and EPS of activated sludge were investigated. Isothermal titration calorimetry was employed to estimate the thermodynamic parameters for the binding of Cu²⁺ onto EPS, while three-dimensional excitation-emission matrix (EEM) fluorescence spectroscopy with parallel factor analysis was used for quantifying the complexation of Cu²⁺ with the EPS. The binding mechanisms were further explored by X-ray absorption fine structure (XAFS) and Fourier transform infrared (FTIR) spectroscopy analysis. The results show that the proteins and humic substances in EPS were both strong ligands for Cu²⁺. The binding capacity N, binding constant K, binding enthalpy ΔH were calculated as 5.74 × 10⁻² mmol/g, 2.18 × 10⁵ L/mol, and -11.30 kJ/mol, respectively, implying that such a binding process was exothermic and thermodynamically favorable. The binding process was found to be driven mainly by the entropy change of the reaction. A further investigation shows that Cu²⁺ bound with the oxygen atom in the carboxyl groups in the EPS molecules of activated sludge. This study facilitates a better understanding about the roles of EPS in protecting microbes against heavy metals., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Tea is a popular drink around the world. It is also one of the sources of metal intake. The objectives of this study were to assess chromium (Cr) intake from popular green, oolong, black and Pu-erh tea. In total, 128 Chinese made teas were analysed and concentration differences among four types of tea were explored. Black tea contained highest total Cr, which varied between 0.63 and 17.60 mg/kg. The lowest content was found in the green tea samples, between 0.26 and 1.30 mg/kg. Cr(III) and Cr(VI) in black tea were higher than in other types of tea. Cr(III), Cr(VI) and total Cr concentration in different tea infusions were also analysed. The results suggest that drinking tea is an effective way for Cr intake and the risk of adults and children being chronically intoxicated by tea infusions is low.

Sludge-based activated carbon (SAC) was prepared from paper mill sewage sludge by physical activation with steam for wastewater treatment in this study. The effects of preparation variables, including carbonization temperature, carbonization time, activation temperature and activation time, on iodine number and yield were investigated through orthogonal experiments. The influences of washing by deionized water and acid on the characteristics and adsorption capacities of SAC for phosphate, methylene blue and reactive red 24 were also studied. The results indicated that the optimal preparation conditions were: carbonization temperature of 350 °C, carbonization time of 40 min, activation temperature of 800 °C and activation time of 20 min. The characteristics and adsorption capacities of SAC were obviously different before and after washing, especially by acid. The surface area was improved and adsorption capacities for dyes increased after washing, while adsorption capacity for phosphate decreased. The maximum adsorption capacities provided strong evidence of the potential of SAC as an alternative adsorbent for wastewater treatment.

In 2006, an unusual nosocomial outbreak of anaplasmosis occurred in Anhui Province, China. To follow these emerging tickborne-rickettsioses, a larger survey of Ehrlichia chaffeensis and Anaplasma phagocytophilum seroprevalence among farm worker populations, and the divergence of the partial 16S rRNA gene sequences of A. phagocytophilum among domestic animals, were conducted in Yanqing, Miyun, and Tongzhou Counties in Beijing from March to April, 2009. Blood samples from 562 farmers, 90 goats, 73 cattle, and 2 dogs were collected. IgG antibodies against E. chaffeensis and A. phagocytophilum were assayed by micro-indirect immunofluorescence assay (IFA). Partial fragments of 16S rRNA genes of A. phagocytophilum were amplified from blood DNA from domestic animals and their sequences analyzed. The total E. chaffeensis and A. phagocytophilum seroprevalence among the farm worker population was 16.4% and 14.1%, respectively. For domestic animals, the seropositive rates of A. phagocytophilum for goats, cattle, and dogs, were 2.3%, 0%, and 0%, respectively. The PCR-positive rates for A. phagocytophilum in goats and cattle were 48.9% and 23.9%, respectively. Three dominant genetic groups of Chinese A. phagocytophilum isolates were determined for goats and cattle, and these isolate varieties were broadly identified in China, Japan, and Korea. The prevalence of E. chaffeensis and A. phagocytophilum among farmers and domestic animals in Beijing rural areas was also demonstrated. The diagnoses and differential diagnoses of these emerging infectious diseases should be emphasized in clinics, and further ecological investigation of E. chaffeensis and A. phagocytophilum vectors and hosts is needed.

Background: The development of betel-quid (BQ) processing industry in Hunan has increased the usage of this substance and may produce significant health consequences. However, the update data for the prevalence of BQ chewing and its effect on oral submucous fibrosis (OSF) are limited., Methods: A population-based survey was conducted to investigate the prevalence of BQ chewing and OSF in Hunan. A questionnaire interview and an oral examination were conducted. A multivariate logistic regression model was used to study the effect of socio-demographic characteristics on area-specific behaviors of BQ chewing., Results: A total of 2356 subjects participated in this survey, with a 78.5% of response rate. The lifetime prevalence of BQ chewing was 16.2% (2.9% for ex-chewers and 13.3% for current-chewers). The findings from multivariate logistic regression model showed that a higher prevalence of this habit was among individuals who were males, urban residents, 15-49 years old, educated for 9-12 years, smokers, and drinkers. Male chewers occupied a fairly higher percentage of the combined use of tobacco and/or alcohol (86.1-87.5%) than the non-chewers (50.6-56.7%). The overall prevalence of OSF was 1.0%. Compared with the subjects without OSF (1.7-23.2%), a significantly higher proportion of OSF patients were a current-chewer (62.3% in men and 100.0% in women)., Conclusions: BQ chewing is a vital risk factor for OSF in Hunan. A high prevalence of BQ chewing found among the younger cohort (15-49 years old) is an urgent warning for this oral premalignant disorder., (© 2012 John Wiley & Sons A/S.)

The attribution of individual human papillomavirus (HPV) types to cervical neoplasia, especially intraepithelial lesions, varies ethnogeographically. Population-specific data are required for vaccine cost-effectiveness assessment and type replacement monitoring. HPV was detected from 2,790 Chinese women (444 invasive cervical cancers [ICC], 772 cervical intraepithelial neoplasia [CIN] grade 3, 805 CIN2 and 769 CIN1. The attribution of each HPV type found in multiple-type infections was approximated by the fractional contribution approach. Multiple-type infection was common and correlated inversely with lesion severity (54.7% for CIN1, 48.7% for CIN2, 46.2% for CIN3, 27.5% for ICC). Vaccine-covered high-risk types (HPV16/18) attributed to 59.5% of squamous cell carcinoma, 78.6% of adenocarcinoma, 35.9% of CIN3, 18.4% of CIN2 and 7.4% of CIN1. Distinct features compared to worldwide were a higher attribution of HPV52 and HPV58, and a much lower attribution of HPV45. Inclusion of HPV52 and HPV58 in future vaccines would provide the highest marginal increase in coverage with 11.7% for squamous cell carcinoma, 14.4% for CIN3, 22.6% for CIN2 and 17.7% for CIN1. The attribution of HPV types in southern China is different from elsewhere, which should be considered in prioritizing HPV types for vaccine and screening assay development., (Copyright © 2011 UICC.)

Objective: To investigate the status of Ehrlichia (E.) chaffeensis and Anaplasma (A.) phagocytophilum infection among farming populations and domestic animals in the rural area of Beijing, China., Methods: Blood samples from 562 farmers and 163 blood samples including 90 goats, 71 ox and 2 dogs, were collected. Specificity of IgG antibodies against E. chaffeensis and A. phagocytophilum were tested by micro-indirect immunofluorescent assay (mIFA). 16S rRNA genes of A. phagocytophilum were amplified from the domestic animal blood samples and products were sequenced and analyzed by nested PCR., Results: The positive rates of E. chaffeensis and A. phagocytophilum antibody were 16.5% and 14.0% respectively for farmers. The total positive rates of A. phagocytophilum were 2.3% and 0 for both goats and oxen respectively. No antibody was found for the 2 tested dogs. The PCR positive rates were 48.9% and 23.9% for goats and oxen respectively. Three dominant varieties of A. phagocytophilum were demonstrated in goats and oxen., Conclusion: The prevalence rates of E. chaffeensis and A. phagocytophilum were identified in the rural areas of Beijing.