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Purpose: Prenatal exposure to famine has been linked to increased diabetes risk in adulthood. However, one fundamental issue to be addressed is that the reported famine-diabetes relation may be confounded by the age differences between the exposed and non-exposed groups. We aimed to determine the association between prenatal exposure to the Chinese famine of 1959–1962 and risk of diabetes by applying age well-controlled strategies. Methods: Among 20,535 individuals born in 1955–1966 who participated in the China Health and Nutrition Survey from 1997 to 2015, we constructed age-matched exposed vs. non-exposed groups to investigate the role of prenatal exposure to the Chinese famine of 1959–1962 in relation to diabetes. We also built a hierarchical age-period-cohort (HAPC) model to specifically examine the relation of famine to diabetes risk independent of age. Results: Compared to the age-balanced men in the non-exposed group, the exposed men born in 1961 had a 154% increased risk of diabetes [odds ratio (OR) 2.54 (95% CI 1.07–6.03), P = 0.04). In the HAPC analysis, the predicted probabilities of diabetes peaked in the 1961-birth cohort of men [3.4% (95% CI 2.4%–5.0%)], as compared to the average probability of diabetes (reference) of 1.8% for men overall. Neither analytical strategy revealed any strong relation between famine exposure and diabetes risk in women. Conclusion: Among the pre-defined Chinese famine period of 1959–1962, early-life exposure to famine was associated with increased diabetes risk in men but not in women, and these relations were independent of age. [ABSTRACT FROM AUTHOR]

Background: Genetic variants in GARP (also known as LRRC32) have been reported to have significant associations with asthma and eczema in special populations, but little is known about allergic rhinitis. This study purposes to evaluate the association of single nucleotide polymorphisms (SNPs) in GARP with house dust mite (HDM)-sensitized persistent allergic rhinitis (PER) in a population of Han Chinese. Methods: In this hospital-based case–control study, 534 HDM-sensitized PER patients and 451 healthy controls were recruited from East China. In this population, six SNPs in GARP were identified. Serum total and specific IgE levels were measured with ImmunoCAP. Secondary structure and minimum free energy were predicted by RNAfold. Results: rs79525962 was associated with the risk of HDM-sensitized PER (P < 0.05). The individuals with CT+TT genotype demonstrated a higher risk of HDM-sensitized PER than those with CC genotype (adjusted OR = 1.393, 95% CI = 1.019– 1.904). The homozygous genotype CC of rs3781699 rendered a lower risk of HDM-sensitized PER than the wild-type genotype AA (adjusted OR = 0.646, 95% CI = 0.427– 0.976); however, the genotype and allele frequencies of rs3781699 demonstrated no associations with HDM-sensitized PER (P > 0.05). rs79525962 increased the risk of HDM-sensitized PER in the subgroup aged ≥ 16 years (adjusted OR = 1.745, 95% CI = 1.103– 2.760), and this high risk was also found in the females (adjusted OR = 1.708, 95% CI = 1.021– 2.856). The G-C haplotype of rs1320646-rs3781699 rendered a lower risk of HDM-sensitized PER than the common haplotype G-A (adjusted OR = 0.819, 95% CI = 0.676– 0.993). The secondary structure of GARP altered in response to different genotypes of rs79525962 and rs3781699. Conclusion: SNP rs79525962 in the GARP gene marks a risk locus of HDM-sensitized PER in Chinese Hans. [ABSTRACT FROM AUTHOR]

Background: Allergic rhinitis (AR) is a nasal inflammatory disease resulting from a complex interplay between genetic and environmental factors. The association between Toll-like receptor (TLR) signaling pathway and environmental factors in AR pathogenesis remains to be explored. This study aims to assess the genetic association of AR with single nucleotide polymorphisms (SNPs) in TLR signaling pathway, and investigate the roles of gene–gene and gene–environment interactions in AR. Methods: A total of 452 AR patients and 495 healthy controls from eastern China were enrolled in this hospital-based case–control study. We evaluated putatively functional genetic polymorphisms in TLR2, TLR4 and CD14 genes for their association with susceptibility to AR and related clinical phenotypes. Interactions between environmental factors (such as traffic pollution, residence, pet keeping) and polymorphisms with AR were examined using logistic regression. Models were stratified by genotype and interaction terms, and tested for the significance of gene–gene and gene–environment interactions. Results: In the single-locus analysis, two SNPs in CD14, rs2563298 (A/C) and rs2569191 (C/T) were associated with a significantly decreased risk of AR. Compared with the GG genotype, the GT and GT/TT genotypes of TLR2 rs7656411 (G/T) were associated with a significantly increased risk of AR. Gene–gene interactions (eg, TLR2 rs7656411, TLR4 rs1927914, and CD14 rs2563298) was associated with AR. Gene–environment interactions (eg, TLR4 or CD14 polymorphisms and certain environmental exposures) were found in AR cases, but they were not significant after Bonferroni correction. Conclusion: The genetic polymorphisms of TLR2 and CD14 and gene–gene interactions in TLR signaling pathway were associated with susceptibility to AR in this Han Chinese population. However, the present results were limited to support the association between gene–environment interactions and AR. [ABSTRACT FROM AUTHOR]

The purpose of this study was to demonstrate the effectiveness of HIV self-testing (HIVST) on promoting regular HIV testing, which defined as having uptake HIV testing every three to 6 months, among men who have sex with men (MSM) in Guangzhou, China. 491 ever-tested MSM were recruited from a community-based HIV clinic and randomly assigned into either intervention arm that provided text message plus HIVST service (n = 250) or standard of care arm (n = 241) being a text message promoting HIV testing every 3 months. Overall, 73.7% (330/448) of the participants had uptake HIV testing, and 27.7% (124/448) of them reported ever used of an HIV self-test during study period. HIVST significantly increased regularly HIV testing among participants in the intervention arm compared with standard of care arm (77.4% vs 69.5%). HIVST as a supplement to the existing facility-based testing services is promising in promoting regular HIV testing among MSM in China. Trial registration number: ChiCTR1800016811. [ABSTRACT FROM AUTHOR]

Aim: Given the increasing prevalence of hysteromyoma among the Chinese rural women of childbearing age, it is imperative that more attention should be given to researching risk factors that predispose women to this condition so that early preventive measures may be taken. Our study investigates potential risk factors for uterine fibroids such as participants' demographic characteristics (age, ethnicity, education), physiological characteristics (age at menarche, primiparous age), and the occurrence of several different female reproductive diseases (vaginitis, pelvic inflammatory disease). Methods: 2200 rural women of reproductive age were screened from a cross‐sectional study carried out in the northern Anhui province. Data were collected by questionnaire surveys, gynecological and laboratory examinations and were subjected to univariate and multivariate analysis to evaluate the risk factors for uterine fibroids. Results: Of the 2200 women, 440 had uterine fibroids. In general, women with endometriosis, ovarian cysts and early menarche were more likely to suffer from hysteromyoma. Factors including higher parity, late age of first childbirth, and a regular menstrual cycle were associated with the reduced risk of uterine fibroids. Conclusions: Our findings indicate that parameters such as earlier age of menarche, early primiparous age, lower parity and a variety of female reproductive diseases were associated with an increased risk of uterine fibroids. These findings may be used to guide the formulation of effective prevention and intervention protocols to improve the reproductive health of rural women. [ABSTRACT FROM AUTHOR]

The Loess Plateau can be considered as a landslide-prone area in northwest China. The genera consensus about the interaction between landslide deposit and terrace sediments is not well studied; this paper summarised 40 loess landslides in the South Jingyang Platform, Shaanxi Province, China to help understand of this issue. Four of the loess landslides with high mobility have been analysed in detail. Three trenches T1, T2 and T3 dug after the loess landslides LD37, LD11 and LD38 highlighted the landslide-induced changes in geomorphology and internal geometry of geology, respectively. Furthermore, observation of upwards seepage flow on the profile of trench T3 is believed to be the trigger of the high speed, and long runout flowslides in the study area. A newly developed sandbox apparatus is used to reproduce the landslide kinematics due to a mass travelling over an inclined plane. The sandbox experiments show that the sediments are sheared and pushed upwards after the collision with the deposits. The deposits are then wrapped in a space between sediments, which tends to form the 'sandwich' structure. The distal sediments are thrust when the loess deposits' kinetic energy consistently dissipates, developing the accumulated folded strata. These results reveal the deposits' interactions with the sediments in the study area and provide key guideposts regarding prevention and mitigation of loess landslide hazards. [ABSTRACT FROM AUTHOR]

Strata erosion in northwest China has become an engineering concern as a result of overdevelopment of land. This issue is more distinct for loess soil than other soils since it is characterised by metastable microstructure, high porosity, and water sensitivity. This study explores the potential for the use of agricultural waste straw as a recycled reinforcement material to form the enhanced shearing behaviour towards preventing instability of the loess body. The stress-strain relation and the pore pressure behaviour of Lantian loess and reinforced Lantian loess were studied using the conventional triaxial compression (CTC) stress path for three different confining pressures. Comparison with Jingyang loess and Delhi silt of similar relative fraction of silt to clay, sheared under the reduced triaxial compression (RTC) stress path and the reduced triaxial extension (RTE) stress paths, respectively, was conducted, with emphasis on strength uniqueness and critical state behaviour, to shed light on the effect of waste straw inclusions. The results indicate that the stress path in undrained compression and extension tests had a pronounced effect on the stress-strain relation of the studied soils. Insertion of the waste straw in Lantian loess restrained the development of volumetric deformation, producing higher pore pressures than Lantian loess (unreinforced). This study explores an exciting potential for the use of agricultural waste straw to prevent instability of the loess body in hilly-gullied regions of northwest China when subjected to quick surface thick fills. [ABSTRACT FROM AUTHOR]

Salix matsudana, a member of Salicaceae, is an important ornamental tree in China. Because of its capability to tolerate high salt conditions, S. matsudana also plays an important ecological role when grown along Chinese coastal beaches, where the salinity content is high. Here, we aimed to elucidate the mechanism of higher salt tolerance in S. matsudana variety '9901' by identifying the associated genes through RNA sequencing and comparing differential gene expression between the S. matsudana salt-tolerant and salt-sensitive samples treated with 150 mM NaCl. Transcriptomic comparison of the roots of the two samples revealed 2174 and 3159 genes responsive to salt stress in salt-sensitive and salt-tolerant sample, respectively. Real-time polymerase chain reaction analysis of 9 of the responsive genes revealed a strong, positive correlation with RNA sequencing data. The genes were enriched in several pathways, including carbon metabolism pathway, plant-pathogen interaction pathway, and plant hormone signal transduction pathway. Differentially expressed genes (DEGs) encoding transcription factors associated with abiotic stress responses and salt stress response network were identified; their expression levels differed between the two samples in response to salt stress. Hub genes were also revealed by weighted gene co-expression network (WGCNA) analysis. For functional analysis of the DEG encoding sedoheptulose-1,7-bisphosphatase (SBPase), the gene was overexpressed in transgenic Arabidopsis, resulting in increased photosynthetic rates, sucrose and starch accumulation, and enhanced salt tolerance. Further functional characterization of other hub DEGs will reveal the molecular mechanism of salt tolerance in S. matsudana and allow the application of S. matsudana in coastal afforestation. [ABSTRACT FROM AUTHOR]

Purpose: Rupture of an intracranial aneurysm is a life-threatening acute cerebrovascular event. The purpose of this study was to investigate whether aneurysmal subarachnoid haemorrhage (SAH) incidence rate is higher or lower in elderly population than in middle aged population. Materials and methods: Aneurysmal SAH cases were collected retrospectively from the archives of 21 hospitals in Mainland China. All the cases were collected from September 2016 and backward consecutively for a period of time up to 8 years. SAH was initially diagnosed by brain computed tomography (CT). CT angiography (CTA) or digital subtraction angiography (DSA) was followed and SAH was confirmed to be due to cerebral aneurysm rupture. For cases when multiple bleeding occurred, the age of the first SAH was used in this study. The total incidence from all hospitals at each age group were summed together for females and males respectively; then adjusted by the total population number at each age group for females and males which was from the 2010 population census of the People’s Republic of China. Results: In total there were 8,144 cases of intracranial aneurysmal SAH, with 4,861 females and 3,283 males. For females the relative aneurysmal SAH incidence rate started to decrease after around 65 years old, while for males the relative aneurysmal SAH incidence rate started to decrease after around 53 years old. Conclusion: Our data tentatively suggest elderly patients may be at a reduced risk of rupture compared with patients who are younger while have similar other risk factors. [ABSTRACT FROM AUTHOR]

Background. The prevalence, trends, and the role of different HIV testing strategies in late presentation of HIV infection in China were unknown. Methods. Data of newly reported HIV cases in Guangzhou between 2008 and 2013 was analyzed to examine the prevalence, trends, and characteristics of late presentation of HIV infection by three types of HIV testing strategies. Results. Overall, 53.2% (1412/2653) and 27.3% (724/2653) met the criteria of late presentation and presentation with advanced HIV disease. The overall trend of late presentation of HIV infection within the study period was declining. Late presentation was 62.9% in 2008 and dropped to 43.3% in 2013 (P<0.001); presentation with advanced HIV disease was 40.3% in 2008 and dropped to 15.2% in 2013 (P<0.001). Of the three testing strategies, PITC presented higher odds of both late presentation [AOR (95% CI): PITC versus VCT: 1.37 (1.09, 1.73); PITC versus MHT: 3.09 (2.16, 4.42)] and presentation with advanced HIV disease [AOR (95% CI): PITC versus VCT: 1.65 (1.29, 2.11); PITC versus MHT: 13.14 (8.47, 20.39)]. Conclusions. Although the late presentation of HIV infection was declining, it was still high in Guangzhou. The worse situation among PITC cases urges the policy adjustment in medical settings to increase early HIV diagnosis. [ABSTRACT FROM AUTHOR]

HIV-syphilis co-infection is often cited as a major reason behind recent resurgence in syphilis prevalence among men who have sex with men in China. Most published literatures explore factors associated with either HIV or syphilis, but not their co-infection. We analysed data from a cross-sectional survey on men who have sex with men in seven Chinese cities. Snowball sampling was used to recruit participants for the survey. Socio-demographic and behavioural predictors for HIV-syphilis mono/co-infection were examined using ordinal logistic regression. Factor scores were used to summarise (1) HIV-related knowledge and (2) access to HIV preventive services. Prevalence of HIV, syphilis, and their co-infection, among 2936 self-identified men who have sex with men, were 7.7%, 14.3%, and 2.6%, respectively. In the adjusted analysis, the significant positive correlates of poorer diagnoses (co-infection vs mono- and no infection or co- and mono-infection vs no infection) were: 30 to 39 years and ≥40 years age, education up to senior high school, unprotected anal intercourse, recent sexually transmitted infection symptoms, incorrect knowledge about routes of transmission, and access to preventive or counselling/testing services for HIV. For effective control of this dual epidemic, integrated HIV and syphilis surveillance and targeted intervention strategies for Chinese men who have sex with men are needed urgently. [ABSTRACT FROM AUTHOR]

In the past three decades, the fast development of economy and urbanization has caused increasingly severe pollutions of urban water bodies in China. Consequently, eutrophication and deterioration of aquatic ecosystem, which is especially significant for aquatic vegetation, inevitably became a pervasive problem across the Yangtze River Basin. To rehabilitate the degraded urban water bodies, vegetation replanting is an important issue to improve water quality and to rehabilitate ecosystem. As a case study, a representative polluted urban river, Nanfeihe River, in Hefei City, Anhui Province, was chosen to be a rehabilitation target. In October 2009 and May 2010, 13 species of indigenous and prevalent macrophytes, including seven species emergent, one species floating leaved, and five species submersed macrophytes, were planted along the bank slopes and in the river. Through 1.5 years' replanting practice, the water quality and biodiversity of the river had been improved. The concentrations of total nitrogen (TN), total phosphorus (TP), and ammonia nitrogen (NH-N) declined by 46.0, 39.5, and 60.4 %, respectively. The species of macrophytes increased from 14 to 60, and the biodiversity of phytoplankton rose significantly in the river ( p < 0.05). The biomasses of zooplankton and benthos were also improved after the vegetation replanting. The study confirmed that vegetation replanting could alleviate the increasing water pollution and rehabilitate the degraded aquatic ecosystem. The case study would be an example for polluted urban waters restoration in the middle-downstream area of Yangtze River Base. [ABSTRACT FROM AUTHOR]

As an important resource for screening microbial strains capable of conferring stress tolerance in plants, the fungal community associated with the plants grown in stressful environments has received great attention. In this study, high-throughput sequencing was employed to study the rhizosphere fungal community in the reclaimed area (i.e., sites F, H, and T) of the eastern coast of China. Moreover, endophytic fungi from the root of six plant species colonizing the investigated sites were isolated and identified. The differences in soil physicochemical parameters, fungal diversity, and community structure were detected among the sampling sites and between the seasons. Ectomycorrhizal (ECM) fungi (e.g., genera Tuber and Geopora) were dominant at site F, which was characterized by high soil total carbon (SC) and total nitrogen (SN) contents and low soil electrical conductivity (EC) value. Arbuscular mycorrhizal (AM) fungi, including genera Glomus, Rhizophagus, and Entrophospora were dominant at sites H (winter), H (summer), and T (summer), respectively. The positive relationship between the EC value and the abundance of genus Glomus indicated the ability of this AM fungus to protect plants against the salt stress. Endophytic fungi at sites F (Aspergillus and Tetracladium), H (Nigrospora), and T (Nigrospora, Coniochaeta and Zopfiella) were recognized as the biomarkers or keystone taxa, among which only genus Aspergillus was isolated from the plant roots. The aforementioned AM fungi and endophytic fungi could contribute to the promotion of plant growth in the newly reclaimed land. [ABSTRACT FROM AUTHOR]

The nitrogen (N) balance for aquaculture is an important aspect, especially in China, and it is attributed to the eutrophication in many freshwater bodies. In recent years, constructed wetlands (CWs) have been widely used in wastewater treatment and ecosystem restoration. A recirculating aquaculture system (RAS) consisting of CWs and 4 fish ponds was set up in Wuhan, China. Channel catfish (Ictalurus punctatus) fingerlings were fed for satiation daily for 168 days with 2 diets containing 5.49 % and 6.53 % nitrogen, respectively. The objectives of this study were to investigate the N budget in the RAS, and try to find out the feasibility of controlling N accumulation in the fish pond. It is expected that the study can provide a mass balance for the fate of N in the eco-friendly treatment system to avoid eutrophication. The results showed that the removal rates of ammonia (NH+4-N), sum of nitrate & nitrite (NO-X-N), and total nitrogen (TN) by the CWs were 20-55%, 38-84 % and 39-57 %, respectively. Denitrification in the CWs was the main pathway of nitrogen loss (41.67 %). Nitrogen accumulation in pond water and sediment accounted for 3.39 % and 12.65 % of total nitrogen loss, respectively. The nitrogen removal efficiency and budget showed that the CW could be used to control excessive nitrogen accumulation in fish ponds. From the viewpoint of the nitrogen pollution control, the RAS combined with the constructed wetland can be applied to ensure the sustainable development for aquaculture. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether asbestosis is a risk factor for mortality of lung cancer. Methods: A fixed cohort study was established in an asbestos plant in Chongqing, China, and followed up for 30 years from the beginning of 1972. Basic personal information on life state, cause of death, and diagnosis of asbestosis was collected. Multiple logistic regressions were applied to analyze risk factors. Results: During the 30-year follow-up, 584 male workers constituting a total of 14 664 person-years were monitored and data were analyzed. Among them, 203 (34.8%) died and the mortality rate was 13.8 per 1000 person-years, cancer accounting for 37.4%. Excess risks were observed for lung cancer (OR=3.72) and nonmalignant respiratory diseases (OR=2.73) among workers with asbestosis. High-exposure level was another risk factor for lung cancer (OR=3.20). Workers with category II of asbestosis demonstrated a higher OR of both lung cancer and nonmalignant respiratory diseases than those with category I of asbestosis. Conclusion: High asbestos exposure level and asbestosis were the risk factors for death of lung cancer and nonmalignant respiratory diseases. Asbestosis is an independent risk factor for lung cancer among Chinese workers exposed to chrysotile, the risk increases with the increasing profusion of opacities of lung. [Copyright &y& Elsevier]

This paper studies the model risk; the risk of selecting a model for estimating the Value-at-Risk (VaR). By considering four GARCH-type volatility processes exponentially weighted moving average (EWMA), generalized autoregressive conditional heteroskedasticity (GARCH), exponential GARCH (EGARCH), and fractionally integrated GARCH (FIGARCH), we evaluate the performance of the estimated VaRs using statistical tests including the Kupiec's likelihood ratio (LR) test, the Christoffersen's LR test, the CHI (Christoffersen, Hahn, and Inoue) specification test, and the CHI nonnested test. The empirical study based on Shanghai Stock Exchange A Share Index indicates that both EGARCH and FIGARCH models perform much better than the other two in VaR computation and that the two CHI tests are more suitable for analyzing model risk. [ABSTRACT FROM AUTHOR]

Water shortages and the presence of point and diffuse source pollution have caused a serious deterioration in water quality in two tributaries (the Tangxi River and Shiwuli River) of Chaohu Lake, China. To reduce nutrient pollution and suppress harmful algal blooms (HABs), hard engineering and ecological remediation projects were implemented. A post-project investigation from 2013 to 2016 was carried out to evaluate the outcome of the remediation projects by monitoring the seasonal and spatial variations in water quality and the phytoplankton community. In the Tangxi River, the average total phosphorus (TP) concentrations in the four seasons were below 0.5 mg L−1, with the lowest concentration (0.29 ± 0.12 mg L−1) found in autumn. Remediation measures including sediment dredging, riparian buffer zone creation, downstream wetland park construction, and water augmentation using reclaimed water and filtered lake water might combine to promote P source mitigation. Moreover, the percentage of bloom-forming cyanobacteria (i.e., Microcystis , Aphanizomenon , Anabaena , Oscillatoria , Phormidium and Planktothrix) in the phytoplankton assemblage and the biomass of the dominant species indicated successful HAB control. In the Shiwuli River, water quality improvements and phytoplankton responses have been observed since 2015 after the upgrading of a local wastewater treatment plant (WWTP) with effluent that was used for flow augmentation. Nevertheless, there is still room for improvement via increasing the river self-purification ability (e.g., the creation of downstream wetlands and riparian buffer zones) and promoting water augmentation according to the experience gained in the remediation projects of the Tangxi River. • Integrated remediation measures jointly contribute to P mitigation in Tangxi River. • Nutrient mitigation lead to successful manipulation of bloom-forming cyanobacteria. • Combination of hard engineering and ecological remediation projects is recommended. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate a gender-specific association between oral health-related quality of life (OHRQoL) and depressive symptoms in college students, as there are limited relevant studies conducted among youths.Methods: In 2017, a cross-sectional study of 3461 Chinese college students was conducted in Shenyang, China. OHRQoL and depressive symptoms were screened by a 14-item oral health impact profile questionnaire and a Self-rating Depression Scale, respectively. A multivariable logistic regression analysis was performed to examine the association of OHRQoL with depressive symptoms.Results: The number of youths reported to have depressive symptoms was 20.7%. A univariate analysis showed that categories with a OHRQoL score over 6 were more likely to have a higher prevalence of depressive symptoms compared to the category with a score of 0 (male: ORs [95% CI]: 3.10, 2.05-4.68, P < 0.001; female: ORs [95% CI]: 3.11, 2.38-4.05, P < 0.001). Similar results were observed after adjusting for sociodemographic, anthropometric, and lifestyle-related covariates (male: ORs [95% CI]: 3.07, 1.98-4.76, P < 0.001; female: ORs [95% CI]: 2.90, 2.21-3.81, P < 0.001).Conclusions: College students who have higher OHRQoL tend to have a lower prevalence of depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Timely monitoring HIV epidemic among key populations is a formidable challenge. This study aimed to evaluate the agreement between data collected from an enhanced HIV sentinel surveillance (HSS+) and an HIV service, and to discuss whether testing service data can be used for surveillance purposes.Methods: The HSS+ data were collected from HIV sentinel surveillance conducted annually among men who have sex with men (MSM) between 2009 and 2013 in Guangzhou, China. The HIV service data were obtained from the China-Bill & Melinda Gates Foundation Cooperation Program on HIV Prevention and Care (China-Gates HIV Program) in Guangzhou during the same period. The China-Gates HIV Program aimed to increase HIV counseling and testing among MSM. We compared demographic characteristics, condom use, HIV testing history, and the HIV status among individuals in these two datasets. The Armitage-trend test was used to evaluate the HIV epidemic and behaviors of the participants in the two datasets over the study period.Results: Overall, a total of 2224 and 5311 MSM were included in the surveillance and service datasets, respectively. The majority of participants in the two datasets were between 20 and 29 years old, at least attended college, and had never been married. However, socio-demographic characteristics varied slightly between the two datasets. Similar trends were observed for the HIV epidemic in these two datasets. The surveillance dataset indicated that HIV prevalence increased from 3.9% in 2009 to 11.4% in 2013 (P-value for trend < 0.001), while data from the HIV service dataset indicated that MSM HIV prevalence during this same period increased from 6.2 to 8.9% (P-value for trend = 0.025). The rates of condom use were similar between the two datasets and remained consistent throughout the study period.Conclusion: HIV service data can complement existing HIV surveillance systems for MSM in China, though it may underestimate the HIV prevalence (HSS+ data contains people whose status is already know, while service data contains people who were initially negative or people of unknown status). HIV service data can be used for surveillance purposes, when prerequisite variables are collected from a large number people, if the quality assessment is conducted. [ABSTRACT FROM AUTHOR]

Background: With the gradual popularity of relatively novel medial sural artery perforator flap (MSAPF), robust studies are needed to compare the surgical outcomes of MSAPF versus multiple free soft flaps (MFSFs) to verify the advantages and disadvantages of MSAPF., Methods: The authors searched PubMed, Web of Science, EMBASE, Cochrane Library, Chinese BioMedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) until September, 2020, to identify studies that compared surgical outcomes of MSAPF and MFSFs. Two authors followed the PRISMA guidelines, individually extracted the data and performed the quality assessments. Survival rate of flaps, satisfaction degree of patients in recipient and donor site, skin grafting, and morbidity of recipient and donor site were evaluated., Results: A total of 441 cases from 7 studies were included in our analysis. No significant differences were found regarding survival rate of flaps, recipient morbidity, and recipient satisfaction degree between the 2 groups. However, MSAPF group was significantly superior to MFSFs group in terms of skin grafting, morbidity, and satisfaction degree of donor site., Conclusion: Our meta-analysis showed that the MSPAF and MFSFs groups were similar in terms of survival rate of flaps, recipient morbidity, and recipient satisfaction degree. Medial sural artery perforator flap group was superior to MFSFs group in terms of morbidity and satisfaction degree of donor site. The results may prove that MSAPF is gaining popularity for a reason and is a good choice for repairing soft tissue defects., Competing Interests: The authors report no conflicts of interest., (Copyright © 2020 by Mutaz B. Habal, MD.)

Purpose: This study focused on quality of life for patients in northeast China who underwent oral cancer resection directly before flap reconstruction. In addition, this study compared differences among the radial forearm free flap (RFFF), ulnar forearm free flap (UFFF), and anterolateral thigh flap (ALTF) for defect reconstruction., Materials and Methods: To assess patients' quality of life, the University of Washington Quality of Life and 14-item Oral Health Impact Profile (OHIP-14) questionnaires were completed 6 months after reconstruction., Results: The flap size of the ALTF group was much larger than that of the UFFF and RFFF groups. The appearance score of the ALTF group was markedly higher than that of the UFFF and RFFF groups, whereas these groups had a much higher swallowing score than the ALTF group. Furthermore, the ALTF group had much lower social disability OHIP-14 scores than the RFFF group., Conclusions: The results indicate that all 3 reconstruction methods are similar, but that the ALTF has a slight advantage over the UFFF and RFFF., (Copyright © 2019 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Objective: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China., Methods: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary., Results: A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001)., Conclusions: The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.

Background: The free fibula flap has become popular for mandibular reconstruction. The purpose of this study was to propose comprehensive functional assessments of the donor site., Methods: Thirty free fibula flaps for mandible reconstruction were prospectively enrolled in the study. Objective assessments included isokinetic testing of the ankle joint, electromyographic examination of the superficial peroneal nerve (SPN), and preoperative and postoperative foot scans. The Patient and Observer Scar Assessment Scale (POSAS) was used to subjectively assess the donor site., Results: The isokinetic values of the donor side showed a significant decrease 1 year postoperatively. The results of the electromyographic test of the SPN were categorized as 3 types. The plantar center pressure shifted to the heel on the donor side 6 months postoperatively. The aesthetic outcome was satisfactory., Conclusion: The functional parameters of the donor site indeed declined in our assessments. Further refinements in the surgical technique are needed to improve the donor site status. © 2016 Wiley Periodicals, Inc. Head Neck 39: 279-287, 2017., (© 2016 Wiley Periodicals, Inc.)

Sediment anoxia generally results from intense organic enrichment and is a limiting factor in the restoration of vegetation in eutrophic waters. To investigate the effect of sediment anoxia on a typical pollution-tolerant submerged macrophyte species, Hydrilla verticillata, and acclimation mechanisms in the plant, a gradient of sediment anoxia was simulated with additions of sucrose to the sediment, which can stimulate increased concentrations of total nitrogen, NH4(+) and Fe in pore water. H. verticillata growth was significantly affected by highly anoxic conditions, as indicated by reduced total biomass in the 0.5 and 1% sucrose treatments. However, slight anoxia (0.1% sucrose addition) promoted growth, and the shoot biomass was 22.64% higher than in the control. In addition to morphologic alterations, H. verticillata showed physiological acclimations to anoxia, including increased anaerobic respiration and changes in carbon and nitrogen metabolism in roots. The soluble protein and soluble carbohydrate contents in roots of the 1% treatment were both significantly higher compared with those in the control. The increase in alcohol dehydrogenase activity and pyruvate content in the roots suggested that H. verticillata has a well-developed capacity for anaerobic fermentation. This study suggests that highly anoxic sediments inhibit the growth of H. verticillata and the species has a degree of tolerance to anoxic conditions. Further in situ investigations should be conducted on the interactions between sediment conditions and macrophytes to comprehensively evaluate the roles of sediment in the restoration of vegetation in eutrophic waters.

Aims: Androgen-deprivation therapy (ADT) is a main treatment option for patients with prostate cancer (PCa), but its effect on cognition remains unclear. The primary purpose of this cross-sectional case-control study was to evaluate the effects of ADT on cognition in Chinese PCa patients., Methods: Participants included PCa patients who had undergone ADT (ADT group, n = 33) and patients who did not undergo ADT (non-ADT group, n = 32), as well as age- and education-matched healthy controls (HC group, n = 35). All participants were examined using the neuropsychological battery aimed at assessing several cognitive domains including attention, memory and information processing performance., Results: The ADT group obtained significantly worse scores than the non-ADT and HC groups in the following neuropsychological tests: Recognition (P < 0.01), WAIS Digit Span forward (P < 0.05), Trailmaking B (P < 0.01) and Stroop Interference test (P < 0.01). No significant difference was found between the non-ADT and HC groups (P > 0.05)., Conclusions: Chinese PCa patients receiving ADT showed cognitive impairments in several domains including memory, attention and information processing performance., (© 2015 Wiley Publishing Asia Pty Ltd.)

Introduction: Previous studies have reported a possibly increasing HIV prevalence among men who have sex with men (MSM) in China. However there have been limited systematic analyses of existing surveillance data to learn the trend of HIV prevalence and factors driving the trend. The aims of this study were to examine the trend of HIV prevalence among MSM in Guangzhou and to explore the role of unprotected anal intercourse (UAI) in the trend., Methods: Snow-ball sampling was applied in the subject recruitment for the annual serological and behavioral surveys among MSM from 2008 to 2013. Data collected in the behavioral survey include demographic information, HIV related sexual behavior with men and women, access to HIV prevention services, and symptoms of sexually transmitted infections. Chi-square test was used to analyze the trend of HIV prevalence. Multivariate logistic regression was conducted to test the factors associated with HIV infection., Results: HIV prevalence increased significantly from 5.0% in 2008 to 11.4% in 2013 while syphilis prevalence decreased from 17.4% to 3.3% in the same period. UAI rates were high and stable in every single year, ranging from 54.5% to 62.0%. Those who were having UAI (OR = 1.80, 95% confidence interval (CI): 1.26-2.58), being migrants, having more than 10 partners, and infected with syphilis had higher risk for HIV infection., Conclusions: HIV epidemic is expanding in Guangzhou. The persistently high UAI may have played a major role in the increasing trend of HIV prevalence. Targeted prevention program should be conducted among MSM who are migrants, low educational level, syphilis infected, or having multiple partners to encourage HIV test and change UAI behavior. The general high UAI calls for tailored intervention program to promote healthy culture and form a safe sex social norm in the MSM community.

Objective: To analyze the genetic characterization of the complete genome from a human coxsackievirus B3 strain A103/KM/09 isolated in Yunnan province, 2009., Methods: By using RT-PCR, all the eight fragments which containing about 1000 nucleotides and covering full viral genome, were sequenced. By using Mega 5.05,Geneious, RDP 3 and SimPlot 3.5.1 software, sequences were aligned with other enterovirus reference sequences. Phylogenetic and recombination analysis were also carried out., Results: The A103/KM/09 isolate genome showed 7389 nucleotides in length , encoding for 2185 amino acids. In the complete genome, the homology of nucleotide and amino acid among the seven coxsackievirus B3 isolates were 81.0%-88.0% and 95.7%-98.0%, respectively. There appeared 81.0% and 95.7% homology when compared with that of Nancy prototype strain. Results from the Phylogenetic analysis showed that the coxsackievirus B3 formed five distinct clades, I-V. Nucleotide divergence rates between clades were 16.2%-24.3% . The A103/KM/09 strain belonged to clade V. Clade V was further divided into four sub-clades,A-D. The nucleotide divergence between sub-clades was 4.3%-11.4%. Putative recombinant event for A103/ KM/09 was detected., Conclusion: All coxsackievirus B3 isolates could be divided into five clades, with A103/KM/09 strain belonged to Clade V-D. Evolution of coxsackievirus B3 had occurred in China.

The epidemiological features of 298 imported malaria cases during 2008-2012 in Guangzhou were analyzed. Among the cases, 169 (56.7%) were falciparum malaria, 106 (35.6%) were vivax malaria, and 23 (7.7%) were unidentified. The proportion of falciparum malaria cases was raising gradually in the last 5 years. Most of the cases were infected in malaria endemic regions of Africa and South-East Asia. Among them, 160 (53.7%) were business services, 78 (26.2%) were export laborers, 20 (6.7%) were peasants, and 18 (6.0%) were others.

Objective: To analyze the genetic characterization of the complete genome from a human echovirus 6 (Echo6) strain KM57-09 isolated in Yunnan, China, in 2009., Methods: Using the RT-PCR, eight fragments containing about 1000 nucleotides which covered the whole viral genome were sequenced. The sequences were aligned with other reference enterovirus sequences downloaded from the GenBank, using Mega 5.05, RDP 3 and SimPlot 3.5.1 softwares., Results: Similar to the other human enterovirus, KM57-09 isolate genome appeared to have 7419 nucleotides in length, encoding for 2191 amino acids. In the complete genome, the rates of homology on nucleotide and amino acid among the seven Echo6 isolates were 79.3% - 80.2% and 93.3% - 94.4%, respectively as well as 79.3% and 93.6% of the rates of homology when compared with that of D' Amor prototype strain. In different segment of genome. The 2C-3A genome region was most similar to the HN-2-E25 strain, the 5' UTR, VP4, 3D and 3' UTR genome region were most similar to the CoxB5-Henan-2010. In the VP1 gene, the rates of homology on nucleotide and amino acid among the China isolates were 80.0% - 96.0% and 95.8% - 99.0%, respectively, and showed 77.6% - 96.0% and 95.2% - 99.0% of the rates on homology when compared to the other Echo6 reference strains isolated from other countries or areas, respectively., Results: from phylogenetic analysis showed that the Echo6 formed five distinct groups, A-E. The KM57-09 strain belonged to clade E. The nucleotide divergence between clades was 15.6% - 23.3%. The putative recombinant event for KM57-09 was detected with RDP 3, SimPlot 3.5.1 and 3D sequence phylogenetic analysis., Conclusion: All the Echo6 isolates could be divided into five clades, the KM57-09 strain belonged to Clade E. The Echo6 strains isolated in China were contributed to several different chains of transmission.

Objective: To develop a human immune deficiency virus (HIV) infection risk appraisal model suitable for men who has sex with men (MSM) in Guangzhou, and to provide tools for follow-up the outcomes on health education and behavior intervention., Methods: A cros-sectional study was conducted in Guangzhou from 2008 to 2010. Based on the HIV surveillance data, the main risk factors of HIV infection among MSM were screened by means of logistic regression. Degree on relative risk was transformed into risk scores by adopting the statistics models. Individual risk scores, group risk scores and individual infection risk in comparison with usual MSM groups could then be calculated according to the rate of exposure on those risk factors appeared in data from the surveillance programs., Results: Risk factors related to HIV infection among MSM and the quantitative assessment standard (risk scores and risk scores table of population groups) for those factors were set up by multiple logistic regression, including age, location of registered residence, monthly income, major location for finding their sexual partners, HIV testing in the past year, age when having the first sexual intercourse, rate of condom use in the past six months, symptoms related to sexually transmitted diseases (STDs) and syphilis in particular. The average risk score of population was 6.06, with risk scores for HIV positive and negative as 3.10 and 18.08 respectively (P < 0.001). The rates of HIV infection for different score groups were 0.9%, 2.0%, 7.0%, 14.4% and 33.3%, respectively. The sensitivity and specificity on the prediction of scores were 54.4% and 75.4% respectively, with the accuracy rate as 74.2%., Conclusion: HIV infection risk model could be used to quantify and classify the individual's infectious status and related factors among MSM more directly and effectively, so as to help the individuals to identify their high-risk behaviors as well as lifestyles. We felt that it could also serve as an important tool used for personalized HIV health education and behavior intervention programs.

A respondent-driven sampling survey was conducted to investigate HIV related serological and behavioral characteristics of men who have sex with men (MSM) in Guangzhou, China, and to identify associated factors potentially driving the epidemic. Respondent-Driven Sampling Analysis Tool and SPSS were used to generate adjusted estimates and to explore associated factors. Three hundred seventy-nine eligible participants were recruited. The adjusted prevalence of HIV and current syphilis infection are 5.2% and 17.5% respectively. 60.3% have unprotected anal sex in the past 6 months. Unprotected anal sex, having receptive anal sex and current syphilis infection are significant factors associated with HIV infection. The potential for a rapid rise of HIV and syphilis infections among MSM in Guangzhou exists. Targeted interventions with voluntary counseling and testing (VCT) and sexually transmitted infection (STI) services are needed to address the epidemic, with a focus on such subgroups as those of with current syphilis, and non-official Guangzhou residence status.

Objective: To explore the HIV and syphilis infection and AIDS-related behaviors among money boys (MB) in Guangzhou., Methods: A total of 152 subjects were recruited from MB gathering place (clubs, parks, Internet etc.) by a local NGO. Of which, 151 individuals completed the investigation and blood sample collection. An anonymous face to face interview were used to obtain data of AIDS-related behavior, knowledge and attitudes. Venous blood samples were collected for HIV and syphilis antibody test. χ(2) test were used to compare the characteristics of HIV and syphilis infection subjects and P < 0.05 was counted as significant., Results: HIV and current syphilis infection rate were 11.3% (17/151) and 19.9% (30/151), respectively. Among the subjects, 47.0% (71/151) had unprotected anal intercourse (UAI) with commercial male sex partners, 43.7% (66/151) had UAI with non-commercial male sex partners in the past six month. 85.4% (129/151) were aware of AIDS-related knowledge, while 34.4% (52/151) thought they have no risk of HIV infection, 24.5% (37/151) didn't know the prevalence of HIV among MSM in China, and 55.0% (83/151) had no idea of HIV prevalence or thought HIV prevalence was not serious at all among MB. MB who had experienced sex after drunk/used drugs had higher proportion of syphilis infection (33.3% vs 16.5%; χ(2) = 4.26, P = 0.039), and who had ever been experiencing condom broken during sex had much higher syphilis infection rate than those didn't (36.7% vs 15.7%; χ(2) = 6.64, P = 0.010). A multi-Logistics regression analysis showed that subjects had ever been experiencing condom broke during sex in the past six month were associated with syphilis infection (χ(2) = 6.24, P = 0.012; OR = 3.11, 95%CI = 1.28 - 7.57)., Conclusion: Money boys have high prevalence of HIV and syphilis infection. They are lack of perception of HIV risk and active in unsafe sex behavior.

Background: China entered the World Trade Organization (WTO) in 2001 after years of negotiations. As a WTO member, China had to reduce tariffs on imported cigarettes and remove non-tariff barriers to allow foreign cigarettes to be more competitive in the Chinese market. Among foreign tobacco companies, British American Tobacco (BAT) was the most active lobbyist during China's WTO negotiations., Objective: To review and analyse BAT's tactics and activities relating to China's entry into the WTO., Methods: Internal tobacco industry documents were reviewed and are featured here. Industry documents were searched mainly on the website of BAT's Guildford Depository and other documents' websites. 528 documents were evaluated and 142 were determined to be relevant to China's entry into the WTO., Results: BAT was extremely active during the progress of China's entry into the WTO. The company focused its lobbying efforts on two main players in the negotiations: the European Union (EU) and the US. Because of the negative moral and health issues related to tobacco, BAT did not seek public support from officials associated with the WTO negotiations. Instead, BAT lobbyists suggested that officials protect the interests of BAT by presenting the company's needs as similar to those of all European companies. During the negotiation process, BAT officials repeatedly spoke favourably of China's accession into the WTO, with the aim of presenting BAT as a facilitator in this process and of gaining preferential treatment from their Chinese competitor., Conclusions: BAT's activities clearly suggest that tobacco companies place their own interests above public health interests. Today, China struggles with issues of tobacco control that are aggravated by the aggressive practices of transnational tobacco companies, tobacco-tariff reductions and the huge number of smokers. For the tobacco-control movement to progress in China, health advocates must understand how foreign tobacco companies have undermined anti-tobacco activities by taking advantage of trade liberalisation policies. China should attach importance to public health and comprehensive tobacco-control policies and guarantee strong protection measures from national and international tobacco interests supported by international trade agreements.

This study was to explore the relationship among mental ability, occupational stress, and psychological work performance in Chinese workers, and to identify relevant modifiers of mental ability and psychological work performance. Psychological Stress Intensity (PSI), psychological work performance, and mental ability (Mental Function Index, MFI) were determined among 485 Chinese workers (aged 33 to 62 yr, 65% of men) with varied work occupations. Occupational Stress Questionnaire (OSQ) and mental ability with 3 tests (including immediate memory, digit span, and cipher decoding) were used. The relationship between mental ability and psychological work performance was analyzed with multiple linear regression approach. PSI, MFI, or psychological work performance were significantly different among different work types and educational level groups (p<0.01). Multiple linear regression analysis showed that MFI was significantly related to gender, age, educational level, and work type. Higher MFI and lower PSI predicted a better psychological work performance, even after adjusted for gender, age, educational level, and work type. The study suggests that occupational stress and low mental ability are important predictors for poor psychological work performance, which is modified by both gender and educational level.