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Objective: This study aims to explore the multiple mediating roles of illness acceptance and symptom severity between health locus of control and symptom distress in acute leukemia patients., Methods: From June 2022 to March 2023, a convenience sampling method was used to recruit 208 acute leukemia patients in the inpatient center of a hospital in Hebei. The Chinese versions of Multidimensional Health Locus of Control Scale, Illness Acceptance Scale, and Anderson Symptom Assessment Scale was used in the cross-sectional study., Results: All participants reported the presence of symptom distress. Symptom distress was significantly correlated with chance health locus of control, illness acceptance, and symptom severity (P＜0.05). Illness acceptance alone played a mediating role in the relationship between chance health locus of control and symptom distress in acute leukemia patients (β=0.087, 95%CI 0.030-0.167). The indirect role of chance health locus of control on symptom distress through symptom severity alone was also statistically significant (β=0.131, 95%CI 0.008-0.252). Furthermore, the multiple mediating role of chance health locus of control and symptom distress through illness acceptance and symptom severity combined was verified (β=0.027, 95%CI 0.001-0.089). The alternative model is also valid, indicating bidirectional relationships between symptom severity, illness acceptance, and chance health locus of control, collectively influencing symptom distress., Conclusion: There is a positive relationship between chance health locus of control and symptom distress; additionally, increasing social psychological interventions for illness acceptance and strengthening the management of core symptoms will help alleviate the impact of health chance locus of control on symptom distress in acute leukemia patients. Longitudinal studies are needed to confirm the causal relationships among the variables explored within the model., Impact on Nursing Practice: It is recommended that healthcare professionals pay attention to the assessment of health locus of control in patients, identify patients with health chance locus of control in a timely manner, take measures to enhance their disease acceptance, and strengthen the management of core symptoms, thereby reducing their level of symptom distress., 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 © 2024 Elsevier Ltd. All rights reserved.)

China announced the development of its first 5 national parks in 2021, the primary objective of which is to conserve the natural state and integrity of natural ecosystems. As such, ecosystem services and biodiversity levels are crucial assessment factors for the parks. For Giant Panda National Park (GPNP), we evaluated ecological sensitivity based on water and soil erosion and rocky desertification; ecosystem services based on headwater conservation, soil and water conservation, and biodiversity conservation; and presence of giant panda (Ailuropoda melanoleuca) and sympatric species (e.g., takin [Budorcas taxicolor], Asiatic black bear [Ursus thibetanus]) habitat suitability derived from niche modeling to identify the ecosystem status and assess ecological problems within the park. From our results, we proposed ecologically critical areas to target to meet the park's goals. The suitable habitat for pandas and sympatric species encompassed 62.98% of the park and occurred mainly in the Minshan Mountains. One quarter of the total area (25.67%) contained areas important for ecosystem services. Ecologically sensitive and extremely sensitive areas covered 88.78% of the park and were distributed mainly in Qionglaishan and Minshan Mountains. This coverage indicated that there was much habitat for pandas and sympatric species but that the ecosystems in GPNP are vulnerable. Therefore, ecologically critical areas encompassed all suitable habitats for all the species examined and areas important and extremely important to ecosystem service provision,ecologically sensitive and extremely sensitive areas, encompassed 15.17% of panda habitat, accounted for 16.37% of the GPNP area, and were distributed mainly in the Minshan Mountains. Our results indicated where conservation efforts should be focused in the park and that by identifying ecologically critical areas managers can provide targeted protection for wildlife habitat and ecosystems and effectively and efficiently protect the composite ecosystem. Additionally, our methods can be used to inform development of new national parks., (© 2023 Society for Conservation Biology.)

The use of umbrella species to promote biodiversity conservation is practiced worldwide. The giant panda (Ailuropoda melanoleuca) an iconic species for world wildlife conservation, that inhabits regions with significant biodiversity. Given that the functions at wildlife of different trophic levels and in different body size groups are different within the ecosystem, it is unknown whether those groups of wildlife co-occurring with giant pandas are each likewise protected. To examine the umbrella effect of giant pandas on sympatric species, we used an extensive dataset of wildlife from more than 78% of giant panda habitats. We analysed the changes in distribution for four wildlife categories (large carnivores, large herbivores, medium carnivores and medium herbivores) using a generalized linear mixed model, and the underlying driving factors using binomial logistic regression models. Changes in forests in giant panda habitats were evaluated using Fragstats. The results have shown that the counts of herbivores and medium carnivores increased significantly during the decade. However, those of large carnivores significantly declined. Forest cover and nature reserves showed significant and positive effects on wildlife in 2001 and 2011, while the human population had significant and negative impacts on the herbivores and carnivores. Our results have also suggested that there has been a slight alleviation in forest fragmentation in areas unaffected by earthquakes. We concluded that the umbrella strategy of using the giant panda as an umbrella species achieved partial success by promoting the recovery of herbivores and medium carnivores. Meanwhile, this has indicated that the strategy was not sufficient for large carnivores, and therefore not enough for local ecosystems, given the critical role of large carnivores. We have suggested integrating habitat patches, controlling human disturbance, and preparing for potential human-wildlife conflict management in the Giant Panda National Park to restore large carnivore populations and maintain ecosystem functioning., 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 Elsevier Ltd. All rights reserved.)

Background: In this study, we conducted this population-based study to evaluate the genetic diversity and clustering rate of Mycobacterium tuberculosis (MTB) strains using the whole-genome sequencing (WGS), to better understand its transmission in Ordos., Methods: All patients with culture-positive TB notified in Ordos from January 2021 to December 2022 were recruited. WGS was performed to analyze single-nucleotide polymorphism (SNP) and to identify genotypic drug susceptibilities of MTB isolates., Results: Overall, a total of 186 patients were included in the present study, of whom 35 (18.8%) had no symptoms suggestive of active TB. Lineage 2 was the predominant MTB sublineage, accounting for 186 of isolates tested. When the pairwise SNP difference ≤ 12 was used as the cutoff for WGS-based clusters, we identified 17 genotypic clusters, and 38 isolates belonged to these 17 clusters, resulting in a clustering rate of 20.4%. The Beijing genotype was an independent factor associating with genomic-clustering (adjusted OR 4.219, 95% CI 0.962-18.502). The overall sensitivity on WGS-based resistance prediction was 85.7% for rifampicin, 73.1% for isoniazid, 60.0% for Ethambutol, 72.7% for streptomycin, and 72.7% for fluoroquinolones., Conclusion: To conclude, the present study demonstrates the extensive recent transmission of Beijing genotype strains in the community of Ordos. The failure to provide a comprehensive pattern of transmission indicated the missed diagnosis of active TB within the community. A substantial proportion of subclinical TB cases are recognized in the bacteria-positive cases, emphasizing that we must interrupt transmission by finding people with active TB before they infect others., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Lymph node metastasis is one of the most common ways of tumour metastasis. The presence or absence of lymph node involvement influences the cancer's stage, therapy, and prognosis. The integration of artificial intelligence systems in the histopathological diagnosis of lymph nodes after surgery is urgent., Methods: Here, we propose a pan-origin lymph node cancer metastasis detection system. The system is trained by over 700 whole-slide images (WSIs) and is composed of two deep learning models to locate the lymph nodes and detect cancers., Results: It achieved an area under the receiver operating characteristic curve (AUC) of 0.958, with a 95.2% sensitivity and 72.2% specificity, on 1,402 WSIs from 49 organs at the National Cancer Center, China. Moreover, we demonstrated that the system could perform robustly with 1,051 WSIs from 52 organs from another medical centre, with an AUC of 0.925., Conclusion: Our research represents a step forward in a pan-origin lymph node metastasis detection system, providing accurate pathological guidance by reducing the probability of missed diagnosis in routine clinical practice., (© 2024 S. Karger AG, Basel.)

PPCPs (pharmaceuticals and personal care products) are widely found in the environment and can be a risk to human and ecosystem health. In this study, spatiotemporal distribution, critical risk source identification and potential risks of 14 PPCPs found in water collected from sampling points in Luoma Lake and its inflowing rivers in two seasons in 2019 and 2020 were investigated. The PPCPs concentrations ranged from 27.64 ng·L -1 to 613.08 ng·L -1 in December 2019, and from 16.67 ng·L -1 to 3287.41 ng·L -1 in April 2020. Ketoprofen (KPF) dominated the PPCPs with mean concentrations of 125.85 ng·L -1 and 640.26 ng·L -1 , respectively. Analysis of sources showed that the pollution in Luoma Lake mostly originated from sewage treatment plant effluents, inflowing rivers and domestic wastewater. Among them, the inflowing rivers contributed the most (82.95%) to the concentration of total PPCPs. The results of ecological risk assessment showed that there was a moderate risk (0.1 < RQs < 1) from carbamazepine (CBZ) in December 2019 and a high risk (RQs > 1) from naproxen (NPX) in April 2020. The results of human risk assessment found that NPX posed a high risk to infant health, and we found that NPX was associated with 83 diseases according to Comparative Toxicogenomics Database. NPX was identified as a substance requiring major attention. The results provide an understanding of the concentrations and ecological risks of PPCPs in Luoma Lake. We believe the data will support environmental departments to develop management strategies and prevent PPCPs pollution., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Antibiotics have attracted widespread attention around the world because they are ubiquitous in the environment and can lead to antibiotic-resistant microbes developing and pose ecotoxicological risks. In this study, we determined the spatiotemporal distributions of 39 antibiotics in 19 drinking water sources in Jiangsu area of the lower Yangtze River and attempted to identify the sources of the antibiotics and to prioritize the antibiotics. The total antibiotic concentrations in spring and fall were 234.56-6515.99 and 151.12-2562.59 ng/L, respectively. In spring, the total antibiotic concentration gradually increased from upstream to downstream. In fall, the antibiotic concentration did not markedly vary upstream to downstream (total concentrations 151.12-432.17 ng/L) excluding site S9 and S10. Analysis using a positive matrix factorization (PMF) model indicated that the antibiotics had four main sources. Pharmaceutical wastewater was the main source, contributing 34.1% and 41.2% of total antibiotics in spring and fall, respectively, and domestic wastewater was the second most important source, contributing 24.4% and 43% of total antibiotics in spring and fall, respectively. Pharmaceutical wastewater was the main source from midstream to downstream, but the other sources made different contributions in different areas because of the various ranges of human activities. An ecological risk assessment was performed. Stronger risks were posed by antibiotics in spring than fall, and fluoroquinolone antibiotics posed the strongest risks. Optimized risk quotients indicated that norfloxacin was a high-risk contaminant. An assessment of the risk of resistance development indicated that norfloxacin, ciprofloxacin, and enrofloxacin posed moderate to high risks of resistance development and should be prioritized for risk management. The results of this study are important reference data for identifying key sources of antibiotics and developing strategies to manage antibiotic contamination in similar areas., Competing Interests: Declaration of competing interest The authors declared that they have no conflicts of interest to this work. We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Aims: Urbanization plays an important role in individuals' health. However, it is difficult to isolate healthy migrant effect between urbanization and health. This study examined the effects of urbanization on depressive symptoms and its possible pathways among Chinese middle-aged and older adults independent of the influence of health-selective migration., Methods: Using the baseline survey of the China Health and Retirement Longitudinal Study, this study compared the depressive symptoms among three groups (urbanized rural residents, rural non-migrants and urban non-migrants). The 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) short form was used to measure depressive symptoms. Logistic regression models and Structural Equation Model (SEM) were applied to examine the association between urbanization and depressive symptoms and the corresponding potential mechanisms., Results: Our final sample contained 11,156 respondents with an average age of 58.91 (SD = 9.48), with 5,142 males (46.09%) and 6,014 females (53.91%). Compared with urbanized rural residents, rural residents were more likely to have depressive symptoms (OR = 1.19, 95% CI = 1.07, 1.32), and urban residents were associated with a decreased risk of depressive symptoms (OR = 0.81, 95% CI: 0.70, 0.94). A large proportion of the association between urbanization and depressive symptoms were mainly mediated by social participation, income and living conditions., Conclusions: Planned urbanization had an independent impact on decreased depressive symptoms. Improvements in social participation, income and living conditions are the main drivers behind this relationship. Additionally, urbanization compensates for the negative impact of depressive symptoms from disadvantaged early life conditions, but it cannot eliminate the gap between urbanized rural people and urban non-migrants., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Hong, Xiong, Li, Ning, Qi, Yang, Liu and Luo.)

Urban rivers dynamically interfered by anthropogenic activities are considered as a vital reservoir of antibiotic resistance genes (ARGs). Here, a total of 198 ARGs and 12 mobile genetic elements (MGEs) were profiled in water and sediment from the Chaobai river, Beijing. The total abundances of ARGs (1.01 × 10 6 -4.58 × 10 8 copies/L in water and 2.92 × 10 6 -3.34 × 10 9 copies/g in sediment), which were dominated by beta-lactamase genes, exhibited significant seasonal variations (p < 0.05). Significant linear correlations between the total abundances of ARGs and MGEs were observed in both water and sediment (p < 0.01). Variance partitioning analysis disclosed that environmental variables (i.e., water temperature (WT), dissolved oxygen (DO), nutrients, metals, etc.) and antibiotics were the main contributors to the variations of ARGs and MGEs, and explained 55-80 % and 27-67 % of the total variations in ARGs and MGEs, respectively. The partial least-squares path model revealed the ARG abundances in water and sediment were affected by environmental variables and antibiotics both directly and indirectly but by MGEs directly. Moreover, random forest algorithm explored that WT, Ni, DO, Co, and polyether and macrolide antibiotics were the main drivers (>10 %) of ARGs dissemination in water, whereas the transposase genes of Tp614, tnpA, and IS613 were the main drivers of ARGs dissemination in both water and sediment. This study provides a comprehensive understanding of the driving factors for the ARGs dissemination in an urban river, which is of great significance for risk management of antibiotic resistome., 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 © 2022 Elsevier B.V. All rights reserved.)

With rapid economic development, the protection of the ecological environment has become very important. The modernization of rural ecological governance is the basis and prerequisite for the sustainable economic and social development of vast rural areas of China in the current era. It is urgent to analyze the influencing factors and to improve China's rural ecological environment governance efficiency for Rural Revitalization in the new era, and to promote the modernization of the national environmental governance system and governance capacity. This paper empirically examines the influencing factors on rural ecological environment governance efficiency in the whole country, and in the eastern, central and western regions separately, at the provincial level, using the Tobit regression model. The results show that, at the national scale, the level of rural economic development, the size of village committees and rural public participation all have positive roles in promoting the efficiency of rural ecological environment governance. Rural population agglomeration, financial support for agriculture. And environmental protection social organizations have negative roles, hindering the efficiency of rural ecological environment governance. From the perspective of the eastern, central, and western regions, the factors affecting the efficiency of rural ecological environment governance are different due to regional differences. According to the results of empirical analysis, it is proposed that the key issue in improving the efficiency of rural ecological environment governance in China is to promote differentiated regional coordinated governance mechanisms.

The occurrence of antibiotics in drinking water resources, like reservoirs, is of considerable concern due to their potential risks to ecosystem, human health, and antimicrobial resistance development. Here, we quantified 83 antibiotics in water and sediments of wet and dry seasons from the Miyun reservoir and its inflow rivers in Beijing, China. Twenty-four antibiotics were detected in water with concentrations of ND-11.6 ng/L and 19 antibiotics were observed in sediments with concentrations of ND-6.50 ng/g. Sulfonamides (SAs) were the dominated antibiotics in water in two seasons. SAs and quinolones (QNs) in wet season and macrolides (MLs) and QNs in dry season predominated in sediments. The reservoir and inflow rivers showed significant differences in antibiotic concentrations and compositions in water and sediments. As an important input source of reservoir, the river water showed significantly higher total antibiotic concentrations than those in the reservoir. In contrast, the reservoir sediments are the sink of antibiotics, and had higher total antibiotic concentrations compared with rivers. A prioritization approach based on the overall risk scores and detection frequencies of antibiotics was developed, and 3 (sulfaguanidine, anhydroerythromycin, and sulfamethoxazole) and 5 (doxycycline, sulfadiazine, clarithromycin, roxithromycin, and flumequine) antibiotics with high and moderate priority, respectively, were screened. The study provides a comprehensive insight of antibiotics in the Miyun Reservoir and its inflow rivers, and is significant for future monitoring and pollution mitigation of antibiotics., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Sheepgrass is a perennial native grass species in China, and it can tolerate high levels of salt stress with an aggressive and vigorous rhizome system. Many salt-stress-responsive genes have been identified in sheepgrass. In this study, we report the cloning and characterization of a novel salt-induced gene, LcSAIN3 ( Leymus chinensis &nbsp;salt-induced 3), from sheepgrass. Expression analysis confirmed that LcSAIN3 was induced by PEG, ABA, and salt treatments, and the expression of LcSAIN3 was significantly increased in salt-tolerant germplasms under salt treatment. Subcellular localization analysis indicated that the GFP-LcSAIN3 protein was mainly localized in the chloroplasts. The heterologous expression of LcSAIN3 in Arabidopsis increased the seed germination rate of transgenic plants under salt, ABA, and mannitol treatments. The seedling survival rate, plant height, and fresh weight of the transgenic plants were higher than those of WT plants under salt stress. The overexpression of LcSAIN3 caused a relatively high accumulation of free proline, enhanced SOD activity, and led to the upregulation of several stress-responsive genes such as AtRD26 , AtRD29B , AtSOS1, and AtP5CS1 . These results suggest that LcSAIN3 could be a potential target for molecular breeding to improve plants' salt tolerance.

Background: Body height is a marker of childhood health and cumulative net nutrition during growth periods. However, sex-specific associations between body height and cognitive impairment are not well known in northern rural China., Methods: We assessed sex differences in the association between body height and cognitive impairment in a low-income elderly population in rural China. A population-based cross-sectional study was conducted from April 2014 to August 2014 to collect basic information from elderly residents aged 60 years and older in rural areas of Tianjin, China. Body height and Mini Mental State Examination (MMSE) scores were measured, and the relationships between these variables were assessed., Results: A total of 1081 residents with a mean age of 67.7 years were enrolled in this study. After adjusting for age, educational attainment, smoking status, drinking status, and the presence of hypertension, diabetes, and hypercholesterolemia, higher body height was found to be associated with a decreased prevalence of cognitive impairment in elderly men. Each 1-dm increase in height was associated with a 37% decrease in the prevalence of cognitive impairment. However, there was no significant association between body height and cognitive impairment among elderly women., Conclusion: In conclusion, shorter body height was related to cognitive impairment independently of age, educational attainment, lifestyle factors, and health-related comorbid factors among low-income elderly men in rural China. Accordingly, shorter elderly men may be targeted for effective dementia prevention in rural China., (© 2021. The Author(s).)

Background: The intraoperative 15° left-tilt position during cesarean delivery has more recently been questioned regarding its effect on fetal acid-base balance and is a frequent source of complaints by surgeons. We hypothesized that a 30° left-tilt position during surgical preparation could improve the acid-base balance of the fetus compared with the 15° left-tilt or supine position during surgical preparation., Methods: Women undergoing elective cesarean delivery under combined spinal epidural anesthesia were randomized to a supine position, 15° left-lateral tilt position or 30° left-lateral tilt position; the position was changed to supine before the incision. Anesthetic management was standardized and included fluid loading with 10 mL/kg of normal saline followed by colloid loading. Hypotension (systolic blood pressure [SBP] reduction >20% baseline value or SBP <90 mm Hg) was treated with boluses of phenylephrine or ephedrine according to maternal heart rate. The primary outcome was umbilical arterial blood pH and the secondary outcomes included maternal SBP within 15 minutes after induction of anesthesia, the amount of vasoactive drug administered before end of the surgery, and the incidence of hypotension during cesarean delivery., Results: Seventy-five patients were included. After testing by analysis of variance, there was no significant difference in the umbilical arterial pH among the 3 groups (supine group: 7.31 ± 0.03 vs 15° group: 7.30 ± 0.04 vs 30° group: 7.31 ± 0.02, P = .28). The 30° group required significantly less phenylephrine (P = .007) and ephedrine (P = .005) before the end of surgery than the supine group; however, the only benefit observed in the 15° group was that the mean SBP at 3 minutes after spinal injection was significantly improved compared with the supine group., Conclusions: Compared with the supine position, the 30° left-tilt position during surgical preparation did not significantly improve the fetal acid-base status, but it significantly reduced the use of phenylephrine and ephedrine and reduced the incidence of hypotension; however, these benefits were not observed in the 15° left-tilt group., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 International Anesthesia Research Society.)

The Korean pine and broad-leaved mixed forests are the most typical and complete ecosystem among the global boreal forests, with extremely important ecological functions. However, few studies on the changes of soil ammonia oxidizers and potential nitrification after clear-cutting of forests are reported. In this study, in contrast to primary Korean pine forests, nitrate (NO 3 - ) was significantly higher in secondary broad-leaved forests, while ammonium (NH 4 + ) was on the contrary. The abundance of ammonia-oxidizing bacteria (AOB) was greatly higher in secondary broad-leaved forests, while levels of ammonia-oxidizing archaea (AOA) were not significantly different between them. The significant differences of community structure of AOA and AOB were observed in different forest types and soil layers. Compared with AOA, community compositions of AOB was more sensitive to forest type. The dominant groups of AOA were Nitrososphaera and Nitrosotalea, and the dominant group of AOB was Nitrosospira, of which Nitrosospira cluster 2 and 4 were functional groups with highly activity. Soil potential nitrification rate (PNR) was higher in secondary broad-leaved forests. Furthermore, PNR and AOB abundance had a significant positive correlation, but no significant correlation with AOA abundance. These results provide insights into the soil nitrogen balance and effects on forest restoration after clear-cutting.

Aims: Abnormal glucose regulation, which can present as diabetes and prediabetes, has become one of the most common chronic conditions. However, sex differences in the prevalence of and factors associated with abnormal glucose regulation remain unclear. Thus, we aimed to explore sex differences in the prevalence of and factors associated with abnormal glucose regulation in low-income adults in China aged ≥50 years with normal fasting plasma glucose levels., Materials and Methods: A total of 2,175 individuals aged ≥50 years with normal fasting plasma glucose levels were recruited into this study. After an overnight fast of at least 10 h, individuals underwent an oral glucose tolerance test. Fasting and 2-h plasma glucose levels were measured to determine the state of glucose regulation., Results: Women were more likely than men to have isolated-impaired glucose tolerance (i-IGT) overall (24.7% vs 20.8%; P= 0.034), among individuals aged <65 years (21.7% vs 15.9%; P= 0.012). Among men, independent risk factors for i-IGT were an age of ≥65 years, hypertension, and high serum uric acid (SUA) and triglyceride levels; independent risk factors for diabetes mellitus (DM) were an age of ≥75 years and alcohol consumption. Among women, independent risk factors for i-IGT were central obesity and high levels of high-sensitivity C-reactive protein and SUA; independent risk factors for DM were low education and an elevated white blood cell count., Conclusions: Our findings suggest that conventional cardiovascular disease risk factors (i.e., age, hypertension, and dyslipidemia) associated with high risk of developing DM in men, but poor life style (i.e., obesity) and low education attainment in women. It is necessary for delay or stopping the development of DM among low-income adults in China to implement the personalized scheme of prevention DM between men and women, especially highlight control the risk factors in young and middle aged women., 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. The reviewer XY declared a shared affiliation with the authors, to the handling editor, at time of review., (Copyright © 2021 Zhang, Liu, Shao, Yang, Qi, Wang, Lin, Liu, Tu, Wang, Ning and Cui.)

Pyrus xerophila has strong resistance to drought, cold, salt, and rust. It is one of the main rootstock types of pear in Northwest China, with high production value. However, its habitat is seriously damaged. The prediction of the geographical distribution of P. xerophila under different climate scenarios will provide important scientific basis for rational development and utilization of resources and the protection of diversity. Based on MaxEnt model and ArcGIS spatial analysis, the potential spatial distribution pattern of P. xerophila in the current and future (2050, 2070) was constructed using comprehensive and accurate distribution records and high-resolution environmental data, and the relative importance of environmental factors was evaluated. The results showed that the suitable habitat area of P. xerophila was 3.32×10 5 km 2 , mainly located in eastern Qinghai, southern Gansu, southern Ningxia, central Shaanxi, southern Shanxi and western Henan. Mean UV-B of the month with lowest UV-B and altitude were identified as the critical factors shaping habitat availability for P. xerophila. Overall, with global warming, the potential habitat for P. xerophila might decrease in 2050 and 2070 under different CO 2 climate scenarios. Real-time monitoring of P. xerophila populations should be enhanced.

This paper examined the extent and risk factors of child subjective wellbeing and psychological health empirically using China Family Panel Studies data set. Child subjective wellbeing was measured in this paper using six indicators including the frequency in feelings of depression, nervousness, restlessness, hopelessness, helplessness, and meaninglessness. Risk factors of child subjective wellbeing have also been examined in particular to the domains of household multidimensional material deprivation, parenting practices, and children's personal health conditions. The results of this paper implied that providing adequate nutrition and ensuring children's access to basic water and sanitation facilities were important strategies for promoting children's psychological health and wellbeing. Also important factor for child wellbeing is parenting styles and practices, that is, how parents interact with children in daily lives and how they behave as parents., (© 2020 Wiley Periodicals LLC.)

Objective: To explore the relationship between couples' prepregnancy body mass index (BMI) and time to pregnancy (TTP) among those with no prior gravidity., Design: Retrospective cohort study., Setting: Local maternal/child health care or family-planning service institutions., Patient(s): A total of 2,301,782 eligible couples participating in the National Free Preconception Check-up Projects from January 1, 2015 to December 31, 2017., Intervention(s): None., Main Outcome Measure(s): Time to pregnancy., Result(s): Underweight, overweight, or obese status in women and underweight status in men were associated with couples' prolonged TTP. The optimal BMI levels were 20.61-23.06 kg/m 2 and 22.69-27.74 kg/m 2 for women and men, respectively. Compared with couples in whom both partners had a normal BMI, the pregnancy rates were reduced by 10% (fecundability odds ratio [FOR] 0.90; 95% confidence interval [CI], 0.88-0.92) and 19% (FOR 0.81; 95% CI, 0.78-0.84) for couples in whom both partners were underweight or obese, respectively. The combination of women with a normal BMI and overweight men had the greatest fertility (FOR 1.03; 95% CI, 1.02-1.03), and the combination of obese women and underweight men had the lowest fertility (FOR 0.70; 95% CI, 0.65-0.76)., Conclusion(s): Abnormal prepregnancy BMIs in either women or men were associated with prolonged TTP among couples with no prior gravidity. Scientific management of couples' prepregnancy BMI could improve their fertility., (Copyright © 2020 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Parasitic infections are among the important causes of death of giant pandas (Ailuropoda melanoleuca) that hamper their survival in the wild. There are about 35 species of parasites which have been identified in giant pandas, but no information is currently available regarding the infection of Babesia in giant pandas. Babesia spp. are common intraerythrocytic parasite in wildlife, transmitted by ixodid ticks, which cause babesiosis. Clinical signs of babesiosis include fever, hemolysis, anemia, jaundice and death., Methods: A species of Babesia was detected in the blood of a giant panda based on morphology and PCR amplification of the 18S rRNA gene. The phylogenetic relationship of Babesia sp. infecting giant panda was assessed by gene sequence alignment and phylogenetic analysis., Results: Our analysis revealed that the Babesia isolate detected was most similar to an unidentified species of Babesia identified in black bears (Ursus thibetanus japonicus) from Japan (Babesia sp. Iwate, AB586027.1) with a 99.56% sequence similarity, followed by Babesia sp. EBB (AB566229.1, 99.50%) and Babesia sp. Akita (AB566229.1, 99.07%)., Conclusions: To our knowledge, this is the first report of Babesia detected in the giant panda. The results indicate that this Babesia sp. may be a novel species, currently named Babesia sp. strain EBP01.

Utilizing the Chinese Family Panel Studies (CFPS) dataset and the structural equation model, this paper examines the direct and indirect influences of family income on children's emotional wellbeing as a function of parents' life satisfaction and parents' emotional wellbeing. Firstly, the empirical analysis of this paper shows that family income exerts a positive influence on children's emotional wellbeing outcomes, including depressed, hopeless, helpless, and meaningless feelings. Secondly, the findings show that family income is significantly associated with parents' emotional wellbeing, through which children's wellbeing is affected. The intergenerational emotional transmission mechanism is validated. The ability to control personal emotions is an important skill, related not only to personal health but also to children's health and wellbeing. Furthermore, parents' life satisfaction serves as the mediator between family income and parents' emotional wellbeing. If parents are more satisfied with their own lives, they are less likely to experience emotional problems. Policy implications are discussed in the end., Competing Interests: Both of the authors declare no conflict of interest.

Background: In 2013, Jinan KingMed Diagnostics (JKD) first established a systematic cervical cytology training and quality control (QC) program in Shandong Province, China. We compared the efficacy of high-risk human papillomavirus (HR-HPV) detection, cytology, and their combination in routine clinical practice after the implementation of the training and QC program to identify the optimal first-line screening method in this region., Methods: The data of patients histologically diagnosed with cervical intraepithelial neoplasia (CIN) 1, CIN2/3, and invasive cervical cancer (ICC) between January 2014 and December 2017 were retrieved from the JKD database. Cytology and/or HR-HPV testing results within 3 months preceding the CIN1 diagnoses and 6 months preceding the CIN2/3 and ICC diagnoses were analyzed., Results: Prior screening data were available for 1829 CIN1 patients, 2309 CIN2/3 patients, and 680 ICC patients. Cytology alone and HR-HPV testing alone had similar rates of positive results for CIN2/3 (97.2% [854/879] vs. 95.4% [864/906], P = 0.105) and ICC detection (89.1% [205/230] vs. 92.7% [204/220], P = 0.185). Compared with either method alone, co-testing slightly increased the screening sensitivity for CIN2/3 (99.8% [523/524], all P < 0.001) and ICC (99.6% [229/230], all P < 0.001) detection. In the CIN1 group, cervical cytology alone (92.9% [520/560]) was more sensitive than HR-HPV testing alone (79.9% [570/713], P < 0.001), and co-testing (95.3% [530/556]) did not significantly improve the screening sensitivity (P = 0.105)., Conclusions: After the implementation of a systematic training and QC program, both cytology and HR-HPV testing may be adopted for primary cervical cancer screening in Shandong Province.

Objective: To investigate the effect of corticosteroid on hospital mortality, hospital length of stay, and time of viral clearance in patients with severe and critical COVID-19., Patients and Methods: Patients with severe and critical COVID-19 who had been discharged or expired were enrolled in this study. Patients were divided into corticosteroid group and non-corticosteroid group according to the systemic corticosteroid use or not. Clinical data were collected, and hospital mortality, hospital length of stay, time of viral clearance, time of mechanical ventilation, and duration from illness onset to symptom resolution were compared between the two groups., Results: A total of 72 inpatients who were diagnosed with severe and critical COVID-19 were enrolled, in which 47 patients were divided into corticosteroid group and 25 were involved as the non-corticosteroid group. Baseline characteristics were generally similar between the two groups. Four (5.6%) patients died during hospitalization, and 68 (94.4%) were discharged. Among survivors, the mean duration time from admission to discharge was 19.5d (SD 7.05 d). The mean time of viral clearance among survivors was 17.5d (SD 7.67 d), with a maximum of 37 d, and a minimum of 5 d. Hospital mortality (4.3% vs. 8.0%), length of hospital stay (18.7d vs. 21.0d), and time of viral clearance (16.1d vs. 19.4d) had no significant difference between two groups (p>0.05). The duration of symptoms suffering was shorter in the corticosteroid group than non-corticosteroid group, with statistically significant difference (p<0.05)., Conclusions: Corticosteroid therapy in patients with severe COVID-19 cannot reduce the hospital mortality, and is not associated with delayed viral clearance, but it could relieve the inflammatory storm and improve clinical symptoms in brief. Patients with severe COVID-19 could benefit from low-dose corticosteroid treatment.

Objective: Chinese pediatricians are working on the front line to fight COVID-19. They have published a great amount of first-hand clinical data. Collecting their data and forming a large sample for analysis is more conducive to the recognition, prevention and treatment of coronavirus disease 2019 in children. The epidemic prevention and control experience of Chinese pediatricians should be shared with the world., Methods: By searching Chinese and English literature, the data of 406 children with COVID-19 in China were analyzed., Results: It was found that the clustered incidence of children's families is a dynamic transmission feature; the incidence is low; asymptomatic infections and mild cases account for 44.8%, with only 7 cases of critical illness; laboratory examination of lymphocyte counts is not reduced, as it is for adults; chest CT findings are less severe than those for adults. These presentations are the clinical features of COVID-19 in children. Only 55 of the 406 cases were tested by anal swab for virus nucleic acid, 45 of which were positive, accounting for 81.8% of stool samples., Conclusion: There are more children than adults with asymptomatic infections, milder conditions, faster recovery, and a better prognosis. Some concealed morbidity characteristics also bring difficulties to the early identification, prevention and control of COVID-19. COVID-19 screening is needed in the pediatric fever clinic, and respiratory and digestive tract nucleic acid tests should be performed. Efforts should be made to prevent children from becoming a hidden source of transmission in kindergartens, schools or families. Furthermore, China's experience in treating COVID-19 in children has led to faster recovery of sick children., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest, (Copyright © 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.)

Objectives : China has already entered the aging society, and its aging population is the largest worldwide. Accordingly, several aging-related conditions including hyperuricemia are becoming a public health concern owing to their increasing prevalence in rural areas. However, the sex-specific differences in the risk factors for hyperuricemia among the middle-aged and elderly in rural North China are unclear. Thus, this study aimed to evaluate sex-specific differences in the prevalence of and risk factors for hyperuricemia in low-income adults in rural North China. Methods : This population-based cross-sectional study recruited participants aged ≥50 years from the Tianjin Brain Study between April and August 2019. After excluding those who had cancer, severe psychiatric disturbances, hepatic failure, and serious renal disease (i.e., an estimated glomerular filtration rate (eGFR) of <30 mL/min/1.73 m 2 ), 3119 (1392 men and 1727 women) eligible participants were included. Basic information and blood samples were collected, and data were analyzed using logistic regression models. Results : Hyperuricemia was prevalent in 14.4% (men, 14.2%; women, 14.5%)of the participants, and the prevalence significantly increased with increasing age in both sexes (male, P = 0.034; female, P < 0.001). In multivariate analysis, obesity, metabolic syndrome, and high levels of total cholesterol, 2 h plasma glucose, and blood urea nitrogen were risk factors for hyperuricemia in both men and women. Physical activity was a risk factor in men, while a high white blood cell count was a risk factor in women. A high eGFR was a protective factor in both sexes. Conclusions : Hyperuricemia was highly prevalent in low-income adults in Tianjin, with men and women showing differences in risk profiles and comorbidities. Early management of hyperuricemia according to sex-specific risk factors should be considered in primary care to reduce the prevalence and burden of hyperuricemia in rural China.

Solar distillation is emerging as a robust and energy-effective tool for water purification and freshwater production. However, many water sources contain harmful volatile organic compounds (VOCs), which can evaporate through the photothermal evaporators and be collected together with distilled water, or even be enriched in the distilled water. In view of the penetration of volatile organic compounds, herein, we rationally demonstrate a dual-scale porous, photothermal/photocatalytic, flexible membrane for intercepting volatile organic compounds during solar distillation, which is based on a mesoporous oxygen-vacancy-rich TiO 2- x nanofibrous membrane (m-TiO 2- x NFM). The dual-scale porous structure was constructed by micrometer-sized interconnected tortuous pores formed by the accumulation of m-TiO 2- NFM is employed to purify practical river water in an evaporation prototype under real solar irradiation, complex volatile natural organic contaminants can be effectively intercepted and the produced distilled water meets the drinking water standards of China. This development will promote the application prospects of solar distillation. x nanofibers and nanometer-sized pores in the m-TiO 2- x individual nanofibers. Consequently, the membrane can sustainably in situ intercept VOCs by providing more photocatalytic reactive sites for collision (mainly by mesopores) and longer tortuous channels for prolonging VOC retention (mainly by micrometer-sized pores); thus, it results in less than 5% of phenol residual in distilled water. As a proof of concept, when the m-TiO 2- x NFM is employed to purify practical river water in an evaporation prototype under real solar irradiation, complex volatile natural organic contaminants can be effectively intercepted and the produced distilled water meets the drinking water standards of China. This development will promote the application prospects of solar distillation.

Background: Coronary artery disease (CAD) and atrial fibrillation (AF) frequently coexist in clinical practice, making it challenging for the treating physician to choose anticoagulation and antiplatelet therapies. The aim of this study was to investigate antithrombotic strategies and assess related adverse outcomes in stable coronary artery disease (SCAD) and acute coronary syndrome (ACS) patients with AF when the CHA 2 DS 2 -VASc score was ≥2., Methods: We performed a retrospective study and collected data from a computer-based patient record management system in Zhengzhou University People's Hospital in China. In total, 2978 patients with a hospital discharge diagnosis of CAD and concomitant AF who met the inclusion criteria were enrolled from January 1, 2012 to December 31, 2016, and data from 2050 patients were finally analysed. The χ 2 test was used to compare the incidences of clinical endpoints between the SCAD+AF group and the ACS + AF group. Multivariable Cox regression analysis was performed to identify independent predictive factors of adverse outcomes in both groups., Results: Oral anticoagulant (OAC) monotherapy was the most common antithrombotic therapy in SCAD+AF patients (49.55%), while double antiplatelet therapy (DAPT) was the most common treatment in ACS + AF patients (54.19%) at discharge. OAC monotherapy significantly increased and the use of single antiplatelet therapy (SAPT) decreased during follow-up (34 ± 13 months) when compared to their use at discharge in the SCAD+AF group (all p < 0.001). In the ACS + AF group, the proportion of patients using DAPT decreased notably, while the proportions of patients using SAPT and dual therapy (DT) combining OAC with SAPT increased significantly during follow-up (all p < 0.001) compared to the proportions at discharge. According to multivariable Cox regression analysis, age, hypertension and prior stroke were independent risk factors for ischaemic stroke in the SCAD+AF group and ACS + AF group (all p < 0.05). OAC was an independent protective factor for ischaemic stroke in both groups (all p < 0.05). Previous bleeding independently increased the risk of haemorrhage in both groups (all p < 0.01)., Conclusions: In this study, the proportion of anticoagulant-antiplatelet combined therapy was low in ACS + AF patients with high stroke risk. In clinical practice, the awareness of anticoagulation needs to be strengthened regarding patients with CAD and AF.

Objective: Since December 2019, a novel coronavirus disease 2019 (COVID-19) broke out in Wuhan, China, which has rapidly spread from China to at least 200 countries abroad. COVID-19 was issued a global outbreak and pandemic by the World Health Organization with more than 3 million confirmed cases by May 31, 2020. So far more than ten thousand severe and critically ill patients and hospital-related infection with COVID-19 have been reported with more than four thousand deaths in China. There is a great challenge for intensive care units (ICUs) in hospitals., Patients and Methods: The comment mainly focused on admission and discharge criteria, therapy protocol, prevention and control strategies for ICU during COVID-19 outbreak. The emergency strategy for ICU will be helpful for prevention and control of COVID-19 and treatment of critically ill patients with COVID-19., Conclusions: Progress in the management of ICU is crucial for a decrease in the mortality of critically ill patients with COVID-19 with the clinical evidence and experience updated.

Giant pandas (Ailuropoda melanoleuca) were historically hunted using dogs and are currently threatened by free-roaming dogs and their associated diseases. To better understand the spatial magnitude of this threat, we used a GIS approach to investigate edge effects of dogs on giant panda habitat. We first examined two nature reserves with contrasting free-roaming dog populations: Liziping, with many dogs (~0.44/km 2 ), and Daxiangling, with few dogs (~0.14/km 2 ). Spatial analysis indicated that giant pandas at Liziping (but not Daxiangling) showed a shift in habitat use away from populated areas consistent with a risk response to the foray distance of free-roaming dogs (10.9 km path-distance). Most giant panda locations (86%) from the 2014 census in Liziping were clustered around remote "dog-free zones." Expanding this analysis across the entire giant panda range revealed that 40% of panda habitat is within the foray distance of dogs. Our assessment will inform dog control programs including monitoring, education, veterinary care, and other measures. We recommend that reserves designated for the release of translocated pandas receive priority consideration for dog control efforts. Only by understanding and managing complex interactions between humans, domestic animals, and wild animals can we sustain natural systems in a world increasingly dominated by humans.

The assessment and control of losses of nitrogen (N) and phosphorus (P) from paddy fields is critical to improve the quality of water and atmosphere on earth. A field experiment was conducted to investigate the effect of three N managements (local common N fertilization practice, urea mixed with controlled-release N fertilizer, and optimized and reduced N fertilizer, designated CN, U + CRF and ON, respectively) on N and P losses through runoff and leaching from a paddy field, and yield of rice under shallow-irrigation and deep-sluice (SIDS) and continuous flooding irrigation (FI) in the Jianhan Plain of China in 2016. The results showed that, compared with FI, SIDS significantly reduced the frequency of irrigation and amount of irrigation water, resulting in an increase of 16.2% in rainfall use efficiency, and therefore, a reduction in the amount of surface runoff and water that had leached. This was responsible for the decreased total N (TN) and total P (TP) losses through runoff leaching under SIDS. The U + CRF and ON treatments resulted in a significant reduction in losses of TN through runoff and leaching and the loss of TP through leaching compared to CN. SIDS resulted in comparable or greater soil TN and TP contents in the 0-40 cm soil depths after rice harvest; N and P accumulation at the jointing, filling and maturity stages; and yield of grain compared to FI. Moreover, the U + CRF and ON improved or maintained accumulation of N and P and yield of rice compared to CN. Compared with FI coupled with CN, SIDS coupled with the U + CRF or ON treatments significantly reduced losses of N and P from paddy fields and enhanced or maintained the accumulation of N and P and yield of rice grains. In conclusion, SIDS coupled with the new N management could be an effective approach to reduce losses of N and P from paddy fields and would be a positive improvement for high yield of middle-season rice grains in the Jianhan Plain of central China and other regions with similar environments.

Abstract: Heavy metal pollution threatens the health and life of animals and humans through the food chain. This study was performed to survey the heavy metal contamination in feedstuffs and feeds in Hubei Province, People's Republic of China, from 2012 to 2016. Samples were analyzed for cadmium (306 samples), mercury (117 samples), chromium (149 samples), and arsenic (4,358 samples) using atomic absorption spectrometry or atomic fluorescence spectrometry. The incidence rates of cadmium, mercury, chromium, and arsenic contamination of feedstuffs and feeds were high, and feeds were most often contaminated with chromium, followed by arsenic, cadmium, and mercury. The concentrations of heavy metals in samples positive for cadmium, mercury, chromium, and arsenic ranged from 0.001 to 1.200, 0.002 to 6.540, 0.060 to 8737.000, and 0.070 to 33.000 mg/kg, respectively. The mineral and additive samples had higher concentrations of heavy metals. The present study findings highlight the importance of monitoring heavy metals in feedstuffs and feeds and implementing feed management and bioremediation strategies to reduce heavy metal exposure., (Copyright ©, International Association for Food Protection.)

China is the origin and evolutionary centre of Oriental pears. Pyrus betuleafolia is a wild species native to China and distributed in the northern region, and it is widely used as rootstock. Here, we report the de novo assembly of the genome of P. betuleafolia-Shanxi Duli using an integrated strategy that combines PacBio sequencing, BioNano mapping and chromosome conformation capture (Hi-C) sequencing. The genome assembly size was 532.7 Mb, with a contig N50 of 1.57 Mb. A total of 59 552 protein-coding genes and 247.4 Mb of repetitive sequences were annotated for this genome. The expansion genes in P. betuleafolia were significantly enriched in secondary metabolism, which may account for the organism's considerable environmental adaptability. An alignment analysis of orthologous genes showed that fruit size, sugar metabolism and transport, and photosynthetic efficiency were positively selected in Oriental pear during domestication. A total of 573 nucleotide-binding site (NBS)-type resistance gene analogues (RGAs) were identified in the P. betuleafolia genome, 150 of which are TIR-NBS-LRR (TNL)-type genes, which represented the greatest number of TNL-type genes among the published Rosaceae genomes and explained the strong disease resistance of this wild species. The study of flavour metabolism-related genes showed that the anthocyanidin reductase (ANR) metabolic pathway affected the astringency of pear fruit and that sorbitol transporter (SOT) transmembrane transport may be the main factor affecting the accumulation of soluble organic matter. This high-quality P. betuleafolia genome provides a valuable resource for the utilization of wild pear in fundamental pear studies and breeding., (© 2019 The Authors. Plant Biotechnology Journal published by Society for Experimental Biology and The Association of Applied Biologists and John Wiley & Sons Ltd.)

Aims/introduction: The worldwide prevalence of diabetes mellitus has been increasing over the past decades, particularly in developing countries. Because of the lack of information regarding changes in diabetes mellitus prevalence, awareness, treatment and control in rural China, we assessed these trends - overall and in the context of related health conditions - to explore the impact of these primary health issues on these rates in a poorly educated, rural population., Materials and Methods: Diabetes mellitus prevalence, awareness, treatment and control rates were compared between two surveys carried out in 1992 and 2011. The residents of three villages, aged 35-64 years, were recruited for this study., Results: In 1992, 1,091 individuals were interviewed and, in 2011, 2,338 individuals were interviewed. Between the two surveys, the overall diabetes mellitus prevalence in the study population was lower in 1992 than that in 2011 (P < 0.001); among men, the prevalence was 5.2-fold higher in 2011 than in 1992 (10.5 vs 1.7%) and nearly 4.3-fold higher (11.2 vs 2.1%) among women. Men aged 35-44 years, with >6 years of education, stage I hypertension and being overweight, had a higher prevalence of diabetes mellitus in 2011 than in 1992. Similarly, for the same time periods, there was also a higher diabetes mellitus prevalence among women aged 55-64 years, with 1-6 years of education, stage III hypertension and who were overweight. However, there were no significant changes in diabetes mellitus awareness, treatment or control in this population., Conclusions: These results suggest that particular efforts must be made to enhance diabetes mellitus prevention, control and public awareness in rural communities in China., (© 2019 The Authors Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)

Human activities have altered the environmental nitrogen (N) and phosphorus (P) supply from both aspects of overall supply level and relative supply ratio. However, the effects of the two aspects on plant community composition are still not clear. In this study, a field manipulation experiment combining 3 overall nutrient supply levels (Low, Medium and High) and 3 N:P supply ratios (5,1, 15:1 and 45:1) was conducted in a supratidal wetland in the Yellow River Delta from 2015 to 2018. The effects of the two aspects on soil properties, performance of dominant species and plant community diversity were examined. The results showed that the N:P supply ratio and overall supply level both affected the concentration of soil inorganic N and available P, and N:P ratio significantly, while only overall supply level exerted a significant effect on the importance value of the dominant species, species richness and Shannon diversity. There were big gaps in the N and P supply amounts among the treatments that having same overall supply level with different supply ratio, but the plant composition displayed no significant difference among these treatments, which suggested that P may be also very important in affecting plant community composition in the study area. The species richness and the Shannon diversity were negatively correlated with the importance value of Suaeda glauca. With the rise of overall supply level, S. glauca became increasingly dominant and suppressed other species. Compared with the control treatment, the species richness and the Shannon diversity declined significantly only at high supply level (minimum N supply amount of 26.01 g m -2  yr -1 ), indicated that the supratidal wetland had high resilience to nutrient enrichment. Our results revealed that the N:P supply ratio has little influence on plant composition, compared with overall supply, in relative short-term in the supratidal wetland., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Autosomal recessive polycystic kidney disease (ARPKD) is a hereditary fibrocystic disease that primarily involves the kidneys and hepatobiliary tract. The polycystic kidney and hepatic disease 1 (PKHD1) gene is the only gene implicated in ARPKD. The present study aimed to identify PKHD1 mutations causing ARPKD in a Chinese family. A couple that underwent prenatal genetic diagnosis for ARPKD and their families were recruited for the present study. Genomic DNA was collected from the amniotic fluid of the fetus (proband) and from peripheral blood of all other available family members. Targeted exome sequencing was performed on the couple and the proband, followed by direct Sanger sequencing on other family members and normal controls to confirm candidate pathogenic variants. Two novel compound heterozygous mutations in the PKHD1 gene were identified as causative in the proband, including maternally inherited c.2876C>T (p.Ser959Phe) and paternally inherited c.5772C>A (p.Phe1924Leu). Each mutation was found to co‑segregate with the ARPKD phenotype in the family. Other family members either carried one of the two mutations or lacked both mutations, while the mutations were not found in 576 ethnically matched normal controls. Therefore, two novel compound heterozygous PKHD1 mutations were implicated in causing ARPKD in a Han Chinese family. The results expand the mutation spectrum of PKHD1 that leads to ARPKD, which may improve genetic counseling and prenatal diagnosis for families with ARPKD.

Background: Cardiovascular disease including ST elevation myocardial infarction (STEMI) is increasing and the leading cause of death in China. There has been limited data available to characterize STEMI management and outcomes in rural areas of China. The Henan STEMI Registry is a regional STEMI project with the objectives to timely obtain real-world knowledge about STEMI patients in secondary and tertiary hospitals and to provide a platform for care quality improvement efforts in predominantly rural central China., Methods: The Henan STEMI Registry is a multicentre, prospective and observational study for STEMI patients. The registry includes 66 participating hospitals (50 secondary hospitals; 16 tertiary hospitals) that cover 15 prefectures and one city direct-controlled by the province in Henan province. Patients were consecutively enrolled with a primary diagnosis of STEMI within 30 days of symptom onset. Clinical treatments, outcomes and cost are collected by local investigators and captured electronically, with a standardized set of variables and standard definitions, and rigorous data quality control. Post-discharge patient follow-up to 1 year is planned. As of August 2018, the Henan STEMI Registry has enrolled 5479 patients of STEMI., Discussion: The Henan STEMI Registry represents the largest Chinese regional platform for clinical research and care quality improvement for STEMI. The board inclusion of secondary hospitals in Henan province will allow for the exploration of STEMI in predominantly rural central China., Trial Registration: [NCT02641262] [29 December, 2015].

Background: High-risk human papillomavirus (HR-HPV) testing is more sensitive than cytology for the detection of cervical cancer and its precursors. However, limited and inconsistent data are available about the efficacy of the combination of these two methods for screening cervical adenocarcinoma. This multicenter retrospective study investigated the screening results of a cohort of Chinese patients who were subsequently diagnosed with invasive cervical adenocarcinoma, with the goal of identifying the optimal cervical adenocarcinoma screening method., Methods: We retrospectively retrieved and analyzed the data from patients with histologically confirmed primary invasive cervical adenocarcinoma from eight local pathology laboratories operated by KingMed Diagnostics, the largest independent operator of pathology laboratories in China, over a 2-year period. Only patients who underwent cytology and/or HR-HPV testing within 6 months before the adenocarcinoma diagnosis were included. HR-HPV DNA was detected using one of two HPV test kits: the Hybrid Capture 2 (HC2) assay (Qiagen, Hilden, Germany) and an HPV genotyping panel (Yaneng Bio, Shenzhen, China)., Results: Of the 311 patients, 136 underwent cytology alone, 106 underwent HR-HPV testing alone, and 69 underwent cytology and HR-HPV co-testing. The sensitivities of cytology alone (64.0, 95% confidence interval [CI]: 55.9-72.0) and HR-HPV testing alone (66.0, 95% CI: 57.0-75.1) were similar (P = 0.738). The sensitivity of cytology and HR-HPV co-testing (87.0, 95% CI: 79.0-94.9) was significantly higher than that of either cytology (P = 0.001) or HR-HPV testing alone (P = 0.002)., Conclusions: Both cytology alone and HR-HPV testing alone showed poor screening efficiency, whereas the combination of the two clearly increased the efficiency of primary cervical adenocarcinoma screening. Thus, cytology and HR-HPV co-testing might be the most efficient cervical adenocarcinoma screening method.

Background: The association of abnormal blood pressure levels (including hypertension and prehypertension) with reduced fecundability among young childbearing-age couples is not yet elucidated completely., Objective: The purpose of this study was to investigate the association between abnormal preconception blood pressure level and time to pregnancy among couples who are attempting to conceive their first pregnancy., Study Design: A total of 2,234,350 eligible couples (with no previous gravidity and whose female partners were 20-49 years old) participated in the National Free Preconception Check-up Projects from January 1, 2015, to December 31, 2016. Each couples' preconception blood pressure levels were measured, and time to pregnancy was recorded. Cox models for discrete survival time were used to estimate fecundability odds ratios and their corresponding 95% confidence intervals after adjustment for age, ethnicity, educational level, occupation, household registration, region, tobacco exposure, alcohol intake, body mass index, duration of marriage of the couples, and fasting plasma glucose levels of the female partner., Results: Compared with normotensive women, those women with hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg) had a 21% lower pregnancy rate (fecundability odds ratio, 0.79; 95% confidence interval, 0.78-0.81). A similar finding was found among men (fecundability odds ratio, 0.89; 95% confidence interval, 0.88-0.90). Prehypertension (systolic blood pressure between 120 and 139 mm Hg, and/or a diastolic blood pressure between 80 and 89 mm Hg) in both male and female partners was associated slightly with reduced fecundability odds ratios. Compared with couples in which both partners were normotensive, the pregnancy rate was reduced by 27% (fecundability odds ratio, 0.73; 95% confidence interval, 0.69-0.77) among couples in which both partners had hypertension., Conclusion: Abnormal preconception blood pressure levels were associated with prolonged time to pregnancy among couples who were attempting to conceive their first pregnancy; the mechanism is worth further investigation., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Dissolved Organic Carbon (DOC) is a key organic compound in wet precipitation, but few data are available in China marginal seas. To probe the concentration, deposition flux, seasonality, source and potential ecological environmental effects of precipitation DOC, in this study, one-year precipitation samples were collected at Jiaozhou Bay (JZB), a typical anthropogenic-influenced semi-enclosed bay in the western Yellow Sea for the first time from June 2015 to May 2016. The concentrations of DOC in precipitation were highly variable with a volume-weighted mean (VWM) concentration of 3.63 mg C L -1 , which was mostly higher than those in other areas. DOC concentrations were lower in wet season than that in dry season due to the dilution from more amount of rainfall. The wet deposition flux of DOC was calculated to be 3.15 g C m -2  yr -1 with 68.7% of which occurred in wet season mainly owing to the promoting of more rainfall amount. Besides, local emissions together with the long-range transport of pollutants were other factors controlling precipitation DOC. Fossil fuel combustion particularly coal burning was considered to be the leading source of precipitation DOC based on correlation analysis with some generally accepted indicators. Wet deposition dominates the external input of DOC at JZB by comparison with riverine input with a percentage of 54%. Heavy storm may exert enrichment effect on DOC levels in the surface water of JZB, and then promote the secondary productivity. This study emphasizes that wet deposition is an important process that should be seriously considered in the models of global/regional carbon biogeochemical cycling., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Study Question: What is the relationship between pre-pregnancy maternal glucose levels and fecundability in Chinese couples?, Summary Answer: Elevated pre-pregnancy maternal glucose levels were associated with fecundability, as reflected by prolonged time to pregnancy (TTP) among the couples with no prior gravidity., Study Design, Size, Duration: Based on the National Free Pre-conception Check-up Projects supported by the Chinese government, 2 226 048 eligible couples attempting first pregnancy and participating in the project from 2015 to 2016 were included. They were followed-up for 1 year or until they reported pregnancy., Participants/materials, Settings, Methods: The Kaplan-Meier method was used to estimate the cumulative pregnancy rate in each menstrual cycle, and the discrete-time analogue of the Cox models was used to estimate the fecundability odds ratios (FORs) and 95% CIs by different pre-pregnancy maternal glucose levels (impaired fasting glucose (IFG) or diabetes as compared to normal)., Main Results and the Role of Chance: The cumulative pregnancy rate for 12 cycles of the normal fasting plasma glucose (FPG) level group was 42.29%, significantly higher than that of the IFG (35.52%) and diabetes groups (31.52%). After adjusting for confounding factors, the FORs were 0.82 (95% CI: 0.81-0.83) and 0.74 (95% CI: 0.72-0.76) for the IFG and diabetes groups, respectively, as compared to the normal group. The association between pre-pregnancy maternal FPG levels and the FORs was non-linear, and the optimal FPG level for greatest fecundability (shortest TTP) was 3.90-4.89 mmol/L., Limitations, Reasons for Caution: The findings from this register-based cohort study require cautious interpretation given that information bias would be inevitable for single FPG measurements and for TTP calculations that were based on telephone follow-up information. Additionally, because couples who achieved pregnancy during their first menstrual cycle in the study were excluded, the pregnancy rates reported were low and possibly biased., Wider Implications of the Findings: The current report suggests that elevated pre-pregnancy maternal glucose levels were associated with prolonged TTP. Early evaluation and preventive treatment for female partners with IFG or diabetes in a pre-pregnancy examination are necessary., Study Funding/competing Interest(s): Funding was provided by the National Key Research and Development Program of China (grants No. 2016YFC1000300 and 2016YFC1000307), the National Natural Science Foundation of China (grant No. 81872634), the CAMS Innovation Fund for Medical Sciences (grant No. 2018-I2M-1-004), the National Human Genetic Resources Sharing Service Platform (grant No. 2005DKA21300) and the National Population and Reproductive Health Science Data Center (grant No. 2005DKA32408), People's Republic of China. The authors have no conflicts of interest to declare., Trial Registration Number: N/A., (© The Author(s) 2019. Published by Oxford University Press.)

Objective: To understand the dietary intake quantity and quality of high school students in Shanghai education., Methods: From 2015 to 2016, Shanghai center for Disease Control and Prevention, divided the school into three levels(urban area, suburban area and rural area) according to the economic level and population composition of the street where the school was located. The probability-proportional-to-size sampling technique was used to select 19 high schools, from which 9 boys and 9 girls from same class were randomly recruited for each grade. A total of 1026 students were recruited. The survey included general situation questionnaire and dietary inquiry. Participants were required to complete the standardized questionnaire form through face-to-face interviews with trained interviewers. Chinese Dietary Guidelines(2016) was used to evaluate dietary quantity while China healthy diet index(CHDI) was used to evaluate dietary quality., Results: The medians of intake of grain, vegetables, fruits, meat/livestock, fish/shrimp, eggs, milk and milk products, bean and bean products, cooking oil, cooking salt were 313. 8, 189. 7, 66. 3, 179. 2, 34. 7, 48. 9, 133. 3, 33. 3, 27. 1 and 6. 0 g/d within high school students, respectively. In both boys and girls, the medians of intake of vegetables, fruits, fish/shrimp, dairy products were lower than reference standard and meat/livestock was higher(P<0. 05). The intake differences among different area's high school students upon grain, vegetables, fruits, poultry/livestock, fish/shrimp, dairy products, beans/nuts, cooking oil, cooking salt were statistically significant(P<0. 05). The CHDI median total score of high school students was 68. 5 in Shanghai. 75. 2% of the CHDI total scores were between 60 and 80. The vegetable score, dark vegetable score, fruit score and total CHDI score in boys were significantly lower than those in girls(P<0. 05). The urban area CHDI score was significantly higher than suburban's and countryside's(P<0. 05)., Conclusion: Both dietary structure and dietary quality are inappropriate and unfit within high school students in Shanghai, the urban area's condition is better than another two. We suggest to increase intake of vegetables, fruits, fish/shrimp, dairy products while decrease poultry/livestock's consumption.

The Qinghai-Tibetan Plateau (QTP), the source and upper reaches of many Asian rivers, are crisscrossed by rivers and dotted with lakes. Schizothoracinae fishes, species native to the QTP, are distributed widely through these rivers and lakes. Over the past decades, ecological protection has become increasingly intense. The rapid acquisition of the genetic information and accurate gene sequence database are assumed to play an important role in the conservation of species diversity and biodiversity. In this study, 153 COI sequences (648bp in length) covering 13 species in 8 genera of Schizothoracinae fishes in Qinghai Province were used to determine whether barcode could identify Schizothoracinae species accurately. The average Kimura two parameter (K2P) genetic distances within and among species were 0.35% and 8.83%, respectively. The maximum K2P distance within species was observed in Gymnocypris eckloni (1.36%) while minimum K2P distance among species was observed between Chuanchia labiosa and Schizopygopsis pylzovi (0.23%). Overlaps existed in K2P distance intra- and inter- species based on both the genes. Eleven groups with 9 single-species groups and 2 multi-species groups were identified through Automatic Barcode Gap Discovery System, which were consistent with the overlaps of K2P distance. 96.7% as the accurate ratio for COI barcode was calculated and high solution was observed in the phylogenetic trees based on COI gene and Cyt b gene. Except for the similar results based on two genes above, COI barcode was more economical than Cyt b gene. The SOM model successfully predicted characteristic-diagnostic sites at species level: 36 characteristic-diagnostic sites from eight species, in which 12 from Gmnodiptychus pachycgeilus , 2 from Platypharodon extremus , 7 from Ptychobarbus kaznakovi , 2 from Schizopygopsis anteroventris , 2 from Schizopygopsis malacanthus , 3 from Schizopygopsis malacanthus chengi , 3 from Schizothorax dolichonema and 5 from Schizothorax lantsangensis . Our results show that Schizothoracinae fishes can be identified validly by using COI DNA barcode. Thirty-six characteristic-diagnostic sites were proposed to be applied into works of species identification for the Schizothoracinae fishes in Qinghai Province.

The relationship between females with low glucose-6-phosphate dehydrogenase activity level (LG6PD) and HBV infection is unclear. We conducted a cross sectional study of 124 406 reproductive-age Chinese females who participated in the National Free Pre-conception Check-up Projects to investigate the risk of HBV infection among females with LG6PD and its effect on liver enzyme. Based on HBV serological test results, the participants were divided into the susceptible, immunized, and HBV infected groups. The multivariable-adjusted odds ratios (ORs) for HBV infection in LG6PD participants were 1.71 (95% confidence interval (CI): 1.45-2.01) and 1.41 (95% CI: 1.23-1.62), respectively with the susceptible and immunized participants as references, compared to those without LG6PD. Participants with HBV infection only and combined with HBV infection and LG6PD had 184% and 249% significantly higher risks of elevated alanine transaminase (ALT) (susceptible participants as reference). If the immunized participants were used as reference, significant higher odds of elevated ALT occurred (3.48 (95% CI: 3.18-3.80), 4.28 (95% CI: 2.92-6.28)). Thus, reproductive-age females with LG6PD had a higher prevalence of HBV infection, and LG6PD might exacerbate ALT elevation in HBV infected females. Our findings underscore the need to explore collaborative management approaches for these two diseases among reproductive-age females for maternal and child health.

Few studies have focused on the mountain ranges scale effects of roads on wildlife. This lack of data could lead to an underestimation of the negative impact of roads on animal populations. We analyzed a dataset that included 74.4% of the giant panda population and covered 78.7% of the global giant panda habitat to estimate road-effect zones for major roads, and to investigate how these major roads influenced the distribution of giant pandas on a mountain range spatial scale. We found that the density of giant panda signs was significantly decreased by proximity to major roads. The effect zone reached 5,000 m from national roads and 1,500 m from provincial roads. Structural equation model analysis revealed that the strongest negative impact of major roads on giant pandas was via the reduction of nearby forest cover. The results should provide a better understanding of the impact of anthropogenic infrastructure and regional economic development on wildlife, thus providing a basis for conservation policy decisions. We suggest that the environmental impact assessment of proposed roadways or further researches on road ecological effects should expand to a larger scale and consider the possible habitat degradation caused by road access.

Background: Data regarding human papillomavirus (HPV) prevalence and genotype distribution are limited in Shandong Province, China. Therefore, we investigated the recent HPV prevalence and genotype distribution among females in Shandong and aimed to provide comprehensive data to guide HPV-based cervical cancer screening and HPV vaccination for this population of Chinese women., Methods: HPV testing results of 94,489 females were retrospectively reviewed and extracted from the database of Jinan KingMed Diagnostics, the largest independent pathology laboratory in Shandong Province, China. HPV was detected by a HPV genotyping panel from January 2011 to June 2017. The overall prevalence, age-specific prevalence, and genotype distribution were analyzed., Results: A total of 26,839 cases (28.4%) were HPV-positive, with 4.3% positive for low- or undetermined-risk HPV (lr-/urHPV)-only, 18.1% positive for high-risk HPV (hrHPV)-only, and 6.1% positive for mixed lr-/urHPV and hrHPV infections. Single HPV infections accounted for 62.8%, while the rest were multiple HPV infections of two or more genotypes. HPV16 (5.8%), HPV52 (5.1%), HPV58 (3.5%), HPV51 (2.6%), and HPV56 (2.3%) were the five most common hrHPV genotypes; while HPV81 (2.8%), HPV53 (2.8%), and HPV6 (2.3%) were the three most common lr-/urHPV genotypes. HPV18 (1.7%) was only the ninth most common hrHPV genotype. HPV16 but not HPV52 was more common in single infections than in multiple infections. The distribution of both mixed lr-/urHPV and hrHPV as well as overall HPV infections demonstrated a bimodal pattern across age groups, of which the first peak appeared in the younger group and the second peak was found in older women. A similar age-specific distribution was observed in multiple infections of three or more subtypes as well. Moreover, the proportion of mixed lr-/urHPV and hrHPV infection significantly increased, while those of lr-/urHPV-only and hrHPV-only infections declined as the number of co-infections increased during the study period., Conclusion: This large daily clinical practice report shows that HPV prevalence and genotype distribution are different in this population, who had limited cervical cancer screening service, compared to those in developed countries. Therefore, different strategies should be developed for HPV-based cervical cancer screening and vaccine-based HPV prevention in Shandong Province., Competing Interests: Jinan KingMed Diagnostics does not alter our adherence to PLOS ONE policies on sharing data and materials.

To resovle the problems of in-situ conservation and resource utilization of Pyrus caller-yana, maximum entropy model (MaxEnt) and geographic information system (GIS) were used to predict the global ecological suitable region of P. calleryana in different climate scenarios based on 236 distribution data and 19 ecological factors. The results showed that the ecological suitable regions of P. calleryana were mainly concentrated in North America, Asia and other regions, with a total area of 1.6×10 7 km 2 . In China, the regions with high ecological suitability were Hunan, Hubei, Anhui, Jiangxi, Jiangsu, Zhejiang and Fujian provinces. The main factors affecting the geographical distribution of P. calleryana were mean annual temperature and mean annual precipitation, followed by the seasonality of temperature. The model simulations indicated that P. calleryana would have different suitable habitat areas and marginally suitable habitat areas in different climate scenarios. In terms of the spatial distribution of the potential habitat area, both the distributional range and the center of distribution of suitable and marginally suitable habitat area would shift from east to west. The suitable habitat area in North America and marginally suitable habitat areas in Europe would increase rapidly.

Ecosystem services (the benefits to humans from ecosystems) are estimated globally at $125 trillion/year [1, 2]. Similar assessments at national and regional scales show how these services support our lives [3]. All valuations recognize the role of biodiversity, which continues to decrease around the world in maintaining these services [4, 5]. The giant panda epitomizes the flagship species [6]. Its unrivalled public appeal translates into support for conservation funding and policy, including a tax on foreign visitors to support its conservation [7]. The Chinese government has established a panda reserve system, which today numbers 67 reserves [8, 9]. The biodiversity of these reserves is among the highest in the temperate world [10], covering many of China's endemic species [11]. The panda is thus also an umbrella species [12]-protecting panda habitat also protects other species. Despite the benefits derived from pandas, some journalists have suggested that it would be best to let the panda go extinct. With the recent downlisting of the panda from Endangered to Vulnerable, it is clear that society's investment has started to pay off in terms of panda population recovery [13, 14]. Here, we estimate the value of ecosystem services of the panda and its reserves at between US$2.6 and US$6.9 billion/year in 2010. Protecting the panda as an umbrella species and the habitat that supports it yields roughly 10-27 times the cost of maintaining the current reserves, potentially further motivating expansion of the reserves and other investments in natural capital in China., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

To compare and analyze the effect and the safety of the paclitaxel-eluting stents and paclitaxel-eluting balloon in the treatment for in-stent rest enosis. 120 cases, who had been undergone percutaneous coronary intervention (PCI) in the Department of Cardiology of Henan Provincial People's Hospital from January 2012 to January 2014 were selected. All the patients were randomly treated with paclitaxel-eluting balloon or paclitaxel-eluting stents. The former were divided into different groups that named group A and the later group B. All the selected patients signed the informed consent on interventional therapy and be given anti-platelet drugs before operating. At the same time, they had routine examination, like chest X-ray, ultrasound, biochemical detection, Myocardial injury markers. (1) The two groups had no significant difference in the general information (P>0.05); (2) The success rate in the two groups reached 100% and (3) All the patients were visited in the 9th, 12th and 24th month to see if any of them was dead. The reexamination results in the 9th month showed that both drug-eluting balloon and drug-eluting stents were safe and effective in treating coronary artery in-stent restenosis. In addition, drug-eluting balloon was more effective than drug-eluting stents to prevent from the in-stent restenosis.