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The governance of China under Xi Jinping functions mainly through leading groups. Using the case of water governance, this article examines the interaction between these groups at three levels: the top-level design group, the riverine macroregion groups and the implementation groups. This governance model is designed to avoid nomenklatura failure, restrict fiscal federalism and reduce the agency problem between the centre and local leaders. For the purpose of water governance, China has been divided into five blocs based on river basins, which we call riverine macroregions. Using this approach, the Chinese Communist Party is combining water governance with regional development and enhancing local governments' collective implementation of central policy. [ABSTRACT FROM AUTHOR]

N-nitrosodimethylamine (NDMA) is an environmental and food contaminant, but limited data to concern whether NDMA has adverse effects on the brain. This study first determined the concentration of NDMA in foods from aquaculture markets in Shenzhen, then analyzed the effects on C57BL/6 mice and further evaluated on the urine samples of elderly Chinese residents with normal cognition (NC, n = 144), cognitive decline (CD, n = 116) and mild cognitive impairment (MCI, n = 123). The excessive rate of NDMA in foods was 3.32% (27/813), with a exceeding range of 4.78-131.00 µg/kg. Behavioral tests showed that 60 days treatment of mice with 3 mg/kg NDMA reduced cognitive performance. Cognitive impairment in human was significantly associated with sex, educational levels, length of residence in Shenzhen, household registration, passive smoking, rice, fresh vegetables, bacon products. NDMA was detected in 55.4% (212/383) of urine samples, with a median concentration of 0.23 µg/L (1.20 × 107-157.39 µg/L). The median concentration for NC, CD and MCI were 0.32, 0.27, and 0 µg/L, respectively. The urinary NDMA concentration had a strong negative correlation with cognitive impairment (Kendall's Tau-b = -0.89, P = 0.024). The median estimated daily intake (EDI) of NDMA was determined to be 6.63 ng/kg-bw/day. Taken together, there appears to be an association between NDMA and human and murine cognition, which provides a new clue to Alzheimer's disease (AD). [ABSTRACT FROM AUTHOR]

Background: Early detection, diagnosis, and treatment of children with CHD has been the focus of research attention. Hainan is the southernmost underdeveloped province in China, where the technology of screening, diagnosis, and treatment for children with CHD has not been fully developed. Objectives: This study aimed to introduce and promote an appropriate technology system for screening, diagnosis, and evaluation of neonatal CHD. Methods: Two indicators, namely cardiac auscultation plus pulse oximetry (POX), were used by screening staff to screen live newborns within six to 72 hours afterbirth at all screening institutions in Hainan province from January 1, 2019, to December 31,2021. Diagnosis procedure for the screened-positive newborns was performed in 31 certified medical institutions, and evaluation procedure for the newborns confirmed with CHD was performed in six certified medical institutions. Data about screening, diagnosis, evaluation, and treatment were obtained, uploaded, and managed online through a neonatal CHD screening information management net. Results: A total of 321447 live births were included in the CHD screening project, and an overall screening rate of 97.59% (321447/329387) was determined. According to our results, 8032 cases were screened-positive. A total of 1099 cases of CHD were confirmed, suggesting a CHD prevalence of 3.419 per 1000 live births. Atrial septal defect (ASD) was the most common CHD lesion, with a prevalence of 1.313 per 1000 live births. The sensitivity of cardiac auscultation, POX, and two indicators' combination (i.e., cardiac auscultation plus POX) for CHD detection were 69.15%, 33.49%, and 91.90%, respectively; and the specificity of them were 98.36%, 99.43%, and 97.81%, respectively. The ratio of both positive in two indicators among the children with major (serious and critical) CHD at the initial screening was significantly higher than that of single positive in any indicator (χ² = 59.455, P < 0.001). All children with CHD were evaluated, out of who 154 children with major CHD were treated promptly. Only 15 cases of children with major CHD died, and the standardized mortality of children aged 0-1 years with CHD was 4.67/100,000. Conclusions: It was concluded that the combination of two indicators (i.e., cardiac auscultation plus POX) for CHD screening was reliable as well as non-invasive, simple, and easy to operate so that it was conducive for promotion. It was also found that introducing and promoting an appropriate technology for screening, diagnosis, and evaluation of neonatal CHD were extremely significant since they may have contributed to the timely diagnosing and treating children with CHD, especially those with major CHD. [ABSTRACT FROM AUTHOR]

In this study we identified leader mindfulness as a characteristic relevant to facilitating employee voice behavior, and examined leader-member exchange (LMX) as amediator of this relationship. Via a field study of supervisor-subordinate dyads (197 subordinates and 62 supervisors) in a large retailing company in East China, we revealed a partial mediation model in which leader mindfulness was positively related to employee voice behavior both directly and indirectly through LMX. Our findings suggest that attention should be paid to mindfulness in organizations, and leaders should aim to develop highquality LMX relationships with their subordinates. [ABSTRACT FROM AUTHOR]

Studying the genetic diversity and population structure of natural forest populations is essential for evaluating their ability to survive under future environmental changes and establishing conservation strategies. Pinus koraiensis is a conifer species with high ecological and economic value in Northeast China. However, its natural forests have been greatly reduced in recent years, mostly due to over exploitation and over utilization. Here, we evaluated the genetic diversity and population structure of seven populations of P. koraiensis located throughout its native distribution. A total of 204 samples were genotyped with nine polymorphic nuclear SSR (simple sequence repeat) markers. The results showed high genetic diversity in all populations, with an average expected heterozygosity of 0.610, and the northern-most populations (Dailin (DL) and Fenglin (FL)) showed slightly higher diversity than the other five populations. The level of genetic differentiation among populations was very low (FST = 0.020). Analysis of molecular variance (AMOVA) showed that only 2.35% of the genetic variation existed among populations. Moreover, STRUCTURE analysis clearly separated the seven populations into two clusters. Populations DL and FL from the Xiaoxinganling Mountains comprised cluster I, while cluster II included the five populations from the Changbai Mountains and adjacent highlands. Our research on the genetic diversity and population structure of P. koraiensis in natural forests of China can provide a basis for the implementation of programs for the conservation and utilization of P. koraiensis genetic resources in the future. [ABSTRACT FROM AUTHOR]

How are bureaucrats controlled by their superiors in the Chinese political system? "Leading small groups" (领导小组) are among the most important mechanisms for integrating the interests and opinions of various government and Party departments so that superiors can ensure that their policies are implemented. This article analyzes the roles of the three main actors in the leading small groups: group leaders, the heads of the lead departments, and the office directors. We discuss how these individuals operate through formal institutional approaches and informal political channels. Group politics of this kind is moving China's decision-making process toward "integrated fragmentation." We conclude that compared with previous Chinese regimes, Xi Jinping is making greater use of leading small groups to promote further reforms and to practice individualized centralization. [ABSTRACT FROM AUTHOR]

The identification of recent HIV-1 infection is clinically important for the effective treatment and prevention of transmission. However, the window period for seroconversion with respect to various HIV-1 antibodies is not well characterized. In addition, the routine HIV testing algorithms are not particularly appropriate for the identification of recent HIV-1 infection. In this study, we enrolled individuals who showed seroconversion from negative Western blot (WB) or indeterminate WB results and analyzed the window periods for appearance of HIV-1 antibodies. A total of 10,934 individuals with suspected HIV infection were tested by Wuhan CDC between 2012 and 2017; of these, 40 individuals with initial negative WB and 102 individuals with initial indeterminate WB who showed positive WB results within 100 days were included in the analysis. The mean time for seroconversion was 43.90 (95% confidence interval [CI]: 37.30–50.50) days and 42.15 (95% CI: 37.99–46.30) days, respectively. The time duration for p31 seroconversion among people with negative WB and indeterminate WB was 58.11 (95% CI, 44.30–71.92) days and 51.91 (95% CI, 44.55–59.28) days, respectively, both of which were significantly longer (p = 0.0169) than those in people without p31 seroconversion. A similar difference was observed with respect to p66 seroconversion, with a window time of 53.53 (95% CI, 43.54–63.52) days and 47.87 (95% CI, 43.16–52.57) days among people with negative WB and indeterminate WB, respectively. These data suggest that HIV-1 antibody p66, like p31, may serve as a potential serological marker for distinguishing Fiebig stage V and stage VI at day 70 post-infection. [ABSTRACT FROM AUTHOR]

Background: Chickenpox is a common contagious disease that remains an important public health issue worldwide. Over 90% of unvaccinated individuals become infected, but infection occurs at different ages in different parts of the world. Many people have been infected by 20 to 30 years of age in China, and adults and pregnant women who become infected often develop severe infection. Furthermore, a mortality rate of 2-3 per 100,000 infected persons has been reported. In this study, we explore the temperature-dependent transition of patterns of reported chickenpox cases in two large subtropical climate cities, Wuhan and Hong Kong, China, to aid in the prediction of epidemics and preparation for the effects of climatic changes on epidemiology of chickenpox in China.Methods: We used a time series analysis comprising a spectral analysis based on the maximum entropy method in the frequency domain and the nonlinear least squares method in the time domain. Specifically, the following time series data were analyzed: data of reported chickenpox cases and meteorological data, including the mean temperature, relative humidity and total rainfall in Wuhan and Hong Kong from January 2008 to June 2015.Results: The time series data of chickenpox for both Wuhan and Hong Kong have two peaks per year, one in winter and another in spring, indicating a bimodal cycle. To investigate the source of the bimodal cycle of the chickenpox data, we defined the contribution ratio of the 1-year cycle, Q 1, and the 6-month cycle, Q 2, as the contribution of the amplitude of a 1-year cycle and a 6-month cycle, respectively, to the entire amplitude of the time-series data. The Q 1 values of Wuhan and Hong Kong were positively correlated with the annual mean temperature and rainfall of each city. Conversely, the Q 2 values of Wuhan and Hong Kong were negatively correlated with the annual mean temperature and rainfall of Wuhan and Hong Kong.Conclusion: Our results showed that the mean temperature and rainfall have a significant influence on the incidence of chickenpox, and might be important predictors of chickenpox incidence in Wuhan and Hong Kong. [ABSTRACT FROM AUTHOR]

Background: Ku80 is a DNA repair protein which involves in cell apoptosis and chemoresistance. However, it is unclear whether Ku80 correlates with the efficiency of neoadjuvant chemotherapy in human lung adenocarcinoma, and modulates cisplatin/pemetrexed-induced lung cancer cell apoptosis in vitro.Methods: We recruited 110 patients with stage IIIA lung adenocarcinoma, who received 2 cycles of neoadjuvant chemotherapy, and their lungs were reevaluated by CT scan. Immunohistochemistry and qRT-PCR was performed to detect the expression level of Ku80. A549 cells were transfected by lentiviral vector containing shRNA and full length cDNA to knockdown or upregulate Ku80 gene expression. CCK8 assay, flow cytometry and Western blot were employed to determine the viability and apoptosis of A549 cells treated with cisplatin combined with pemetrexed.Results: Ku80 expression was detected in 76 patients (69%). There were 38 patients who responded to chemotherapy, where Ku80 was positively expressed in 7 cases (18.4%). Immunohistochemical score of Ku80 protein in the response group (2.079 ± 1.617) to chemotherapy was lower than that in the nonresponse group (5.597 ± 2.114, P < 0.05). Tissue samples from the nonresponse group exhibited higher Ku80 mRNA levels compared to the response group. Ku80 knockdown by shRNA augmented cisplatin/pemetrexed-induced decline in viability, whereas Ku80 overexpression attenuated viability reduction induced by these drugs compared to control A549 cells. Both flow cytometry and Western blot analysis displayed that the apoptotic rate of Ku80 shRNA-transfected A549 cells was significantly increased compared to control cells treated with cisplatin/pemetrexed, which was lowered by Ku80 overexpression.Conclusion: Ku80 could predict the probability of resistance to neoadjuvant chemotherapy in lung adenocarcinoma, and reduced cisplatin and pemetrexed-induced apoptosis in A549 cells. [ABSTRACT FROM AUTHOR]

Background and aims To decrease infectious disease transmission, China is expanding methadone maintenance treatment (MMT). This study evaluated the prevalence of hepatitis C virus (HCV) infection at MMT entry, seroconversion rates after admission and potential risk factors for HCV seroconversion during MMT in Wuhan, China. Design Cross-sectional survey of all patients entering MMT and prospective follow-up of patients HCV seronegative at admission. Setting All MMT clinics in Wuhan, China. Participants A total of 12 755 opiate-dependent individuals entering MMT between May 2006 and June 2011; 1200 participants HCV seronegative at admission were followed. Measurements Serological tests for HCV and self-report data on risk behaviors at MMT admission; urine toxicology results and repeated assessments of serological status and risk behaviors during treatment on patients HCV seronegative at admission. Findings HCV seroprevalence at admission was 72.1% [95% confidence interval (CI) = 71.3-72.9%] and 555/1200 (46.3%, 95% CI = 43.5-49.1%) patients seroconverted to HCV during MMT. The mean time to HCV seroconversion was 3 (95% CI = 2.84-3.07) years with a cumulative seroconversion rate of 34.5 (95% CI = 31.5-36.9) per 100 person-years. Significant predictors of HCV conversion included injection drug use in the past 30 days [relative hazard (RH) 2.0, 95% CI: 1.6 - 2.4, P=0.002] and the rate of opiate-positive urine tests during MMT (RH 2.0, 95% CI = 1.3-3.1, P<0.001). Conclusions Methadone maintenance treatment patients in Wuhan, China show a high prevalence of hepatitis C virus at admission (72.1%) and a high rate of seroconversion during treatment (46.3%). Seroconversion is associated with continuing injection drug use. [ABSTRACT FROM AUTHOR]

Media consumption increases trust in high-profile institutions such as the central government and the Communist Party and decreases trust in low-profile institutions-local governments, the civil service, courts, and police. [ABSTRACT FROM AUTHOR]

Background: Methadone maintenance treatment (MMT) reduces the harms of opioid use disorder and is being rapidly scaled-up in China. This study evaluated the real-world implementation of MMT system in Wuhan, China.Methods: Data extracted from electronic medical records collected in 2010 on 8811 patients were used to compute for each patient indices of the prescribed and consumed daily methadone doses, an adherence index, dose adjustments following missed doses, the rates of opiate positive urine tests, self-reported drug use, injection drug use (IDU), and the duration of MMT exposure.Findings: The modal daily doses prescribed were 60 mg and above for 68.5% of patients. Adherence was variable: 51% of patients attended less than 60% and 26% attended 80-100% of their treatment days; and patients with long MMT exposure had significantly higher adherence rates than patients with short MMT exposure. The differences between doses dispensed immediately before and after the interruption in dosing days ranged from 0 to 7 mg, independently of the length of the interruption or the prescribed dosing level. The overall rate of opiate positive tests was 20%; 45% of patients had at least one opiate positive test; 29% reported past month drug use and 53% of them reported past month IDU. Adherence and MMT exposure duration correlated significantly with the proportion of opiate negative urine tests (r=0.355, p<0.001; r=0.351, p<0.001, respectively). Treatment for males and females was comparable.Conclusions: Provision of safe methadone dosing after absences and improving daily attendance are identified as priority improvement areas. [ABSTRACT FROM AUTHOR]

Abstract: Since the majority of heroin abusers use injection as the primary route of admission, heroin abuse contributes significantly to the transmission of hepatitis C virus (HCV). We determined HCV infection and its genotype distribution among injection heroin users in Wuhan, the largest city in the central China. Eight hundred seventy-eight (84%) out of 1046 serum specimens from the injection drug users were positive for HCV antibody. Out of randomly selected 122 specimens positive for HCV antibody, seventy-eight (64%) had detectable HCV RNA with genotype 6a as the predominant strain (50%), followed by 3b (32.2%), 1a (8.1%), 1b (6.5%), and 3a (3.2%). HCV RNA levels in male heroin users were significantly higher (P =0.013) than those in the female subjects. Although there was no significant difference in HCV RNA levels among the specimens positive for HCV 6a and 1a/1b, the samples with 6a or 1a/1b contained higher levels of HCV RNA than the specimens positive for HCV 3b (P =0.019, P =0.012, respectively). These findings indicate that there is a high prevalence of HCV infection with genotypes 6a and 3b as predominated strains among injection heroin users in Wuhan, China. [Copyright &y& Elsevier]

We investigated the responses of leaf and individual traits, growth, and fluorescence characteristics of seedlings of two dominant species of broad-leaved Korean pine forest in Changbai Mountain, i.e ., Pinus koraiensis and Quercus mongolica , to five spectrum-attenuation treatments. Results showed that the architecture and growth of P. koraiensis and Q. mongolica seedlings were mainly regulated by ultraviolet B (UV-B) radiation and blue light. The attenuation of blue light significantly decreased leaf area ratio and relative growth rate of two species. The attenuation of UV-B radiation significantly increased leaf area ratio and relative growth rate of P. koraiensis seedlings by 41.8% and 47.7%, respectively, and significantly decreased plant height, total leaf area, and biomass accumulation of Q. mongolica seedlings. Furthermore, the attenuation of UV-B radiation significantly decreased the fluorescence regulation ability of two tree seedlings, with lower magnitude of P. koraiensis than Q. mongolica . The non-regulatory quantum yield ( Φ NO ) of P. koraiensis increased by 31.6%, and the Φ NPQ / Φ NO ratio, an indicator for photosynthetic fluorescence regulation ability, decreased by 37.5%. These results suggested that those two species might have evolved adaptation strategies to changes in canopy spectral compositions of their respective habitats. Q. mongolica seedlings tended to improve light capture ability through rapid morphological responses, while P. koraiensis seedlings preferred to increase carbon assimilation efficiency by adjusting fluorescence characteristics.

Carrying out the accounting of ecological system gross ecosystem product (GEP) is a necessary measure to promote the construction of ecological civilization system and an important measure for the integration of ecological benefits into the economic and social development evaluation system. Taking Fuzhou City as the object, we constructed an ecosystem value accounting system with the characteristics of "mountain, sea, and city" to calculate the GEP of Fuzhou City in 2015 and 2018, and compared them from the perspective of temporal and spatial changes. The results showed that the GEP of Fuzhou in 2015 and 2018 was 920.592 and 1047.242 billion yuan, respectively. The per capita GEP in 2015 and 2018 was 130200 and 143900 yuan, the supply service value of ecological products was 94.181 and 110.261 billion yuan, the value of ecological regulation was 636.42 and 598.851 billion yuan, and the service value of ecological culture was 189.991 and 338.13 billion yuan, respectively. Compared with that in 2015, the GEP of Fuzhou City in 2018 increased by 126.65 billion yuan, with an increase of 13.8%, which was mainly due to the increases in ecological product supply service and cultural service. The value of ecological regulation services decreased by 37.569 billion yuan, with a reduction of 5.9%, which was mainly due to the decreases in climate regulation, water flow regulation and water purification services. Fuzhou City took the lead in exploring the establishment of accounting system with the characteristics of "mountain, sea, and city", which could provide a "Fuzhou model" for the accounting work of other cities in Fujian Province and other regions in China, and promote the establishment of a long-term mechanism for realizing the value of ecological products.

The extensive pollution of antibiotics and antibiotic resistance genes (ARGs) in drinking water has aroused worldwide concern. Successive monitoring of these pollutants has noteworthy significance for drinking water safety. Accordingly, this study conducted successive monitoring of antibiotics and ARGs from 2015 to 2017 in a drinking water source in East China. The total antibiotic concentration ranged from 19.68 ng/L to 497.00 ng/L, and decreased slightly from 2015 to 2017. Eighteen out of forty-one ARG subtypes showing resistance to six antibiotic classes and one class I integrase gene intI1, were detected in the drinking water source at concentrations ranging from 6.5 × 10 4 copies/mL to 1.6 × 10 6 copies/mL. Importantly, the total ARG concentration increased on an annual basis from 2015 to 2017 with an average annual increment of 0.25 orders of magnitude, which was mainly attributed to the increase in specific ARG subtypes, such as sul1, sul2, sul3, tetA, qnrB, and ermB. Most ARGs was positively correlated with the intI1 genes (r = 0.47-0.55, P < 0.01). Furthermore, the variation of antibiotics and ARGs appeared to be related to the water indices, particularly of the values of COD, BOD 5, NO 2 -N (P < 0.05). This study provides basic data on antibiotic and ARG pollution in the studied drinking water source. Importantly, the findings expound that although the residual antibiotics in this drinking water source decreased slightly from 2015 to 2017, while its biological effect, the antibiotic resistance, increased annually, which give a warning of the antibiotic resistance pollution in the drinking water source., Competing Interests: Declaration of competing interest All authors declare no conflict of interest., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Wuhan was the epicentre of the COVID-19 outbreak in China. We aimed to determine the seroprevalence and kinetics of anti-SARS-CoV-2 antibodies at population level in Wuhan to inform the development of vaccination strategies., Methods: In this longitudinal cross-sectional study, we used a multistage, population-stratified, cluster random sampling method to systematically select 100 communities from the 13 districts of Wuhan. Households were systematically selected from each community and all family members were invited to community health-care centres to participate. Eligible individuals were those who had lived in Wuhan for at least 14 days since Dec 1, 2019. All eligible participants who consented to participate completed a standardised electronic questionnaire of demographic and clinical questions and self-reported any symptoms associated with COVID-19 or previous diagnosis of COVID-19. A venous blood sample was taken for immunological testing on April 14-15, 2020. Blood samples were tested for the presence of pan-immunoglobulins, IgM, IgA, and IgG antibodies against SARS-CoV-2 nucleocapsid protein and neutralising antibodies were assessed. We did two successive follow-ups between June 11 and June 13, and between Oct 9 and Dec 5, 2020, at which blood samples were taken., Findings: Of 4600 households randomly selected, 3599 families (78·2%) with 9702 individuals attended the baseline visit. 9542 individuals from 3556 families had sufficient samples for analyses. 532 (5·6%) of 9542 participants were positive for pan-immunoglobulins against SARS-CoV-2, with a baseline adjusted seroprevalence of 6·92% (95% CI 6·41-7·43) in the population. 437 (82·1%) of 532 participants who were positive for pan-immunoglobulins were asymptomatic. 69 (13·0%) of 532 individuals were positive for IgM antibodies, 84 (15·8%) were positive for IgA antibodies, 532 (100%) were positive for IgG antibodies, and 212 (39·8%) were positive for neutralising antibodies at baseline. The proportion of individuals who were positive for pan-immunoglobulins who had neutralising antibodies in April remained stable for the two follow-up visits (162 [44·6%] of 363 in June, 2020, and 187 [41·2%] of 454 in October-December, 2020). On the basis of data from 335 individuals who attended all three follow-up visits and who were positive for pan-immunoglobulins, neutralising antibody levels did not significantly decrease over the study period (median 1/5·6 [IQR 1/2·0 to 1/14·0] at baseline vs 1/5·6 [1/4·0 to 1/11·2] at first follow-up [p=1·0] and 1/6·3 [1/2·0 to 1/12·6] at second follow-up [p=0·29]). However, neutralising antibody titres were lower in asymptomatic individuals than in confirmed cases and symptomatic individuals. Although titres of IgG decreased over time, the proportion of individuals who had IgG antibodies did not decrease substantially (from 30 [100%] of 30 at baseline to 26 [89·7%] of 29 at second follow-up among confirmed cases, 65 [100%] of 65 at baseline to 58 [92·1%] of 63 at second follow-up among symptomatic individuals, and 437 [100%] of 437 at baseline to 329 [90·9%] of 362 at second follow-up among asymptomatic individuals)., Interpretation: 6·92% of a cross-sectional sample of the population of Wuhan developed antibodies against SARS-CoV-2, with 39·8% of this population seroconverting to have neutralising antibodies. Our durability data on humoral responses indicate that mass vaccination is needed to effect herd protection to prevent the resurgence of the epidemic., Funding: Chinese Academy of Medical Sciences & Peking Union Medical College, National Natural Science Foundation, and Chinese Ministry of Science and Technology., Translation: For the Chinese translation of the abstract see Supplementary Materials section., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The number, intensity and order of emergence of HIV-1 specific antibodies in serum or plasma were associated with the stage of HIV-1 infection. In this study, we retrospectively analyzed the HIV-1 confirmatory results tested by western blot (WB) or recombination immunoblot assay (RIBA) in Wuhan, 2012-2018, to access the profiles of HIV-1 specific antibodies. A total of 14432 HIV-suspected serum or plasma samples collected from local hospitals and other HIV screening laboratories were further screened by two 4th generation enzyme-linked immunosorbent assay (ELISA) kits in our laboratory, of which 11068 specimens (76.69%) had at least one positive ELISA result and thereby were finally confirmed with WB or RIBA. RIBA had identified 652 (81.09%) positive and 13 (1.62%) indeterminate cases from July 1, 2014 to January 7, 2015, while WB had identified 8358 (81.43%) positive and 643 (6.26%) indeterminate cases in the other times during 2012-2018. The indeterminate rate of WB was significant higher than that of RIBA (p<0.001). Although the number of HIV-1 infected subjects increased significantly from 2012 (n = 911) to 2018 (n = 1578), the positive rate of HIV-1 antibodies decreased markedly from 70.08% in 2012 to 58.79% in 2018 (p<0.001). The most commonly observed antibody profile was gp160+gp120+p66+(p55+)p51+gp41+p31+p24+p17+ (4131, 49.43%) for WB-MP and gp160+gp120+gp41+p31+p24+p17+ (382, 58.59%) for RIBA-WANTAI, and the absence of reactivity to three possible serologic markers for recent HIV-1 infection, p31, p66, and p51, increased significantly from 2012 to 2018, with the overall rate of 17.03%, 9.40%, and 15.15%, respectively. The suspected acute HIV-1 infection was also observed to be increased in recent years, with an overall rate of 1.00%. Our results indicated the detection rate had decreased for HIV-1 infection, but increased for suspected recent and acute HIV-1 infection during 2012-2018, reflecting the efforts of intervention among high risk population., Competing Interests: The authors have declared that no competing interests exist.

Selective cutting changes tree species composition and stand structure, modifies tree competition intensity in the stand, with consequences on tree growth and population dynamics. Key tree species play a crucial role in maintaining community structure and ecosystem function. To clarify the competitive characteristics of three key species (Pinus koraiensis, Tilia amurensis, and Fraxinus mandshurica, which accounted for about 70% of growing stock) of typical forest types in broadleaved-Korean pine mixed forest, Hegyi competition index was used in four permanent 1-hm 2 plots, i.e. virgin forest (VF), low-intensity cutting forest (LCF), moderate-intensity cutting forest (MCF) and high-intensity cutting forest (HCF). Compared with VF, the stand density and mean DBH of big trees (DBH≥20 cm) significantly decreased in MCF and HCF, but the stand density of young trees (2 cm≤DBH<10 cm) increased, but no significant changes of stand or DBH in LCF. In all the four forest types, individual competition index (CI) of the three species decreased with increasing DBH. There was a power function relation between CI and DBH. CI curve turned to be gentle at DBH reaching 20 cm, and this rule was not affected by selective cutting. In VF, LCF and HCF, most of competition pressure of young trees of all key species derived from other tree species in secondary canopy or understory, but the competition pressure of small trees (10 cm≤DBH<20 cm) and big trees of P. koraiensis originated mainly from intra-species and other species in secondary canopy or understory. The competition stress of F. mandshurica was mainly affected by P. koraiensis and other species in secondary canopy or understory. T. amurensis was mainly affected by intra-species and P. koraiensis. Betula platyphylla contributed most of the competition stress (over 50%) to all three key species in HCF. Our results suggested that removing the trees which are in secondary canopy or understory but suppress the three key trees species intensively would be beneficial to the regeneration and growth of key species before tree DBH exceeds 20 cm. We proposed to regulate the density of key tree species in overstory to cultivate large diameter timber according to the competition among the key trees species. Once tree DBH exceeds 20 cm, tree growth would not be affected by competition. This study had guiding significance for the cultivation of key tree species and rapid recovery of natural forests after selective cutting.

Non-structural carbohydrates (NSC, including soluble sugars and starch) are key meta-bolites in tree, the storage characteristics of which in tree organs have received extensive attention. It is still unclear how NSC are allocated in the tissues (phloem and xylem) that have different function. In this study, we analyzed the concentration and allocation of NSC in the roots, and in phloem and xylem of the trunk in three dominant species of broadleaved Korean pine forest in the Changbai Mountain, Pinus koraiensis, Fraxinus mandschurica, and Tilia amurensis. The results showed that there was a significant difference in the concentration of NSC between the phloem and xylem. The soluble sugar dominated in the phloem, while starch dominated in the xylem. The concentration of NSC in trunk outside (divided by annual rings, 0-20 years), intermediate (20-40 years) and inner (>40 years) of different tree species was significantly different, but with no difference in the roots. The total soluble sugar concentration in the phloem of P. koraiensis and F. mandschurica was significantly higher than that of T. amurensis, while the difference in xylem was not significant. The results indicated that NSC allocation in the phloem and xylem of the tree had clear tissue differentiation, which might be related to the succession stage of the tree species or the functional evolution of the tissue. These findings would improve our understanding of the carbon storage characteristics and allocation mechanism in temperate trees.

Competition is the main factor affecting the growth, morphology and death of trees in fore-sts. The analysis of individual competition can reflect the characteristics of interaction among individuals and their interaction ranges, which is important for reducing individual competition and promoting tree growth. To understand the effects of competition on tree growth in broad-leaved Korean pine forest, based on Hegyi single-tree competition index and neighborhood analysis method, we explored the neighborhood radius of competition for five key tree species, i.e. Pinus koraiensis, Tilia amurensis, Fraxinus mandshurica, Quercus mongolica and Ulmus japonica (80% of basal area at breast height in total), and analyzed the effects of competition on the growth and death of the key tree species. The results showed that the neighborhood radius of single-tree competition of four tree species, P. koraiensis, T. amurensis, F. mandshurica and Q. mongolica was 11 m, while that of U. pumila was 13 m. The single-tree competition intensity for all five key tree species was negatively correlated with the logarithm of its growth increment, and positively correlated with the size of individual trees. The relative importance of competition intensity on tree growth decreased with tree growth. Neighborhood competition significantly increased tree mortality. Our results revealed the effects of neighborhood competition on the growth and survival of the key tree species at different developmental stages in broad-leaved Korean pine forests in Changbai Mountain. The results are instructive to the adjustment of competitive environment and the improvement of productivity of key tree species in broad-leaved Korean pine forests.

Changbai Mountain is located in the eastern mountain forest region of Northeast China, with broad-leaved Korean pine forest (BKF) as the climax vegetation type. The region is rich in species diversity and serves as an important carrier for precious wood production and forest belts in Northeast China. In the recent 120 years, the vast primary forests in Changbai Mountains have almost disappeared, and have been replaced by secondary forests, over-cut forests, and plantations. Since the founding of the People's Republic of China, the theory and technology of forest management for BKF in Northeast China have gradually improved along with the researches and understanding on the structure and function of BKF, the disputes of Korean pine regeneration characteristics, and the debate about clear cutting and selective cutting. However, the problem of insufficient Korean pine regeneration still exists, and forest management is very extensive. We tried to untangle the management technology trail and research history of BKF in the past 70 years, and to analyze the current forest types and the formation process of the management regulations, with the aim to provide reference for the sustainable management and quality improvement of natural forests in the region.

Changbai Mountain is one of the hotspots for tree ring research in Northeast China, with a large number of related research results having been published. To clarify the advance of tree ring research in Changbai Mountain and understand the responses of tree radial growth to climate factors, we reviewed the related literature and analyzed the differences among them based on tree species identity, elevation, and detrended methods. The radial growth of trees in Changbai Mountain was generally affected by temperature and precipitation, with greater influence of temperature. The relationship between tree radial growth and climate variables varied across both species and altitudes. Most studies reported that the radial growth of conifers were mainly affected by temperature in early growing season (April-May) and growing season precipitation (June-August). The radial growth of broadleaved trees were mainly affected by the temperature in previous and current growing season, the precipitation in dormancy season (November-March), and the precipitation in the current growing season. The previous September precipitation had significant effects on the radial growth of conifers and broadleaved trees. However, many studies had reported different or even opposite results. Most of the differences in the results of the studies appeared at low and medium altitudes, indicating that the altitudinal location of sampling points had impacts on the results. In addition, the detrended method was also the main cause for the variation of results across different studies. Comparatively, the linear or negative exponential detrended method might increase the effective significance of precipitation, especially the effect of precipitation on tree growth during dormancy period, and also strengthen the effective significance of the temperature at the end of the growing season. This study showed the habitat and the detrended method used in chronology were the main reasons for the difference of results among the studies. Therefore, for tree ring research in Changbai Mountain, the number of sampling sites should be increased and the detrended method should be carefully selected.

Exploring the ecological vulnerability of nature reserve and its surrounding area is essential to the maintenance of regional ecological security and sustainability of human development, especially under the stress of global change and human activities. Based on the integration of "sensitivity-resilience-pressure" conceptual model and spatial principal component analysis (SPCA), we analyzed the ecological vulnerability of Changbai Mountain National Nature Reserve and its surrounding 30 km buffer in 2005 and 2015. The main driving factors were further analyzed. The results showed that the ecological vulnerability of Changbai Mountain Nature Reserve was mainly potential, slight, and light levels in 2005 and 2015, indicating the ecological vulnerability inside and outside the reserve was in a good condition. For the whole region, the ecological vulnerability showed a slight downward trend from 2005 to 2015. The degradation area inside and outside the reserve were 254 and 967 km 2 , respectively, with the contribution rate to the increase of overall vulnerability being 30.8% and 69.2%, respectively. The changes in ecological vulnerability inside the reserve were mainly related to the changes in net primary production (NPP), vegetation coverage, and the nearest distance to the road, whereas it was mainly related to the changes in NPP, vegetation coverage and gross domestic product (GDP) density outside the reserve.

To clarify the responses of radial growth of different tree species to climate change and its stability, we explored the relationships between radial growth and climate factors of larch (Larix olgensis) and spruce (Picea jezoensis var. komarovii) distributed at high altitude (1600-1750 m) on the northern slope of Changbai Mountain, using the chronological method. The results showed that the growth of larch was significantly positively correlated with the maximum temperature in June and negatively correlated with the precipitation in June. The radial growth of spruce was significantly positively correlated with the maximum temperature in May. Results from redundancy analysis showed that larch growth was mainly affected by summer temperature, while spruce growth was significantly restricted by spring temperature. During 1959-2014, the relationship between larch growth and summer temperature was relatively stable. For spruce, the correlation between radial growth and spring temperatures had gradually weakened since 1986, mainly due to the growth slowdown because of decreased maximum air temperature. Our results provide theoretical references for predicting the growth response of conifers at Changbai Mountain region in the context of climate change.

Nitrogen deposition and climate warming-drying are the main environmental changes in Northeast China. How they affect forest ecosystems has always been studied in ecological research. In this study, we explored the effects of water stress and nitrogen (N) addition on the short-term (in 55 weeks) growth of seedlings of Pinus koraiensis and Fraxinus mandshurica, two key species in broad-leaved and P. koraiensis mixed forests in temperate zone of Northeast China. Results showed that the responses of seedling growth of P. koraiensis and F. mandshurica to nitrogen addition and water stress were significantly different. P. koraiensis was more sensitive to water stress. In the early stage (in 10 weeks) of water stress, leaf biomass of P. koraiensis significantly decreased while the root biomass increased. Nitrogen addition significantly reduced the root and total biomass of P. koraiensis under water stress. F. mandshurica was more sensitive to N addition. Nitrogen addition rapidly increased the stem, root and total biomass of F. mandshurica. Only sustained water stress could significantly affect the stem, root and total biomass of F. mandshurica. Under continuous water stress and N addition, the biomass contribution of leaves and roots to whole seedling, and the ratio of aboveground to underground biomass of both species tended to be constant, indicating strong self-regulation ability of both species. The results suggested that when drought occurred in the future, P. koraiensis would adopt a "positive" adjustment strategy, while F. mandshurica would adopt a "passive" response. The survival rate and adaptability of P. koraiensis would be higher than F. mandshurica. F. mandshurica would benefit more from N deposition than P. koraiensis. Our results are helpful for predicting the changes of community structure in temperate forest in Northeast China.

The alpine tundra ecosystem, with low soil inorganic nitrogen (N) availability, has a weak buffer against nitrogen and is susceptible to exogenous N enrichment. Here, with a laboratory incubation experiment, we investigated the response of soil carbon and nitrogen mineralization to N deposition with soil samples from the tundra zone on the northern slope of the Changbai Mountain. We set three N levels, control (CK, 0 kg·hm -2 ), low N (N 1 , 25 kg·hm -2 ), and high N (N 2 , 50 kg·hm -2 ), with N being added as NH 4 NO 3 . The results showed that N addition had no significant effect on soil C mineralization rate, but significantly affected the accumulation of soil C minera-lization. The N 2 treatment inhibited soil C mineralization. After the 40 d incubation, soil inorganic N content increased with increasing N addition. After the 80 d incubation, soil inorganic N content in the N 2 and N 1 was similar and significantly higher than that of CK. Those results indicated that N addition promoted soil N mineralization. The soil microbial biomass C and N in the N 1 was higher than that in the N 2 and CK, indicating that low N input had stronger effects on soil microbial activity. Increasing N deposition might accelerate C and N turnover in the tundra soils and enhance the soil inorganic N content. While it could provide more N for plants, it may increase the risk of N loss.

Background: Oral pre-exposure prophylaxis (PrEP) is recommended as an additional prevention choice for men who have sex with men (MSM) at substantial risk of HIV. The aim of this study was to evaluate the extent, and reasons, for MSM's willingness to use oral PrEP in Wuhan and Shanghai, China., Methods: Between May and December 2015, a cross-sectional survey was conducted among 487 MSM recruited through snowball sampling in physical locations frequented by MSM and through social media applications. Exploratory factor analysis was used to group reasons for being willing or not willing to use PrEP. Chi-square tests were used to explore bivariate associations between groupings of reasons for being willing or unwilling to use PrEP, and key sociodemographic and sexual-behavioral characteristics of MSM., Results: Overall, 71.3% of respondents were willing to use PrEP. The most commonly reported reasons for being willing to use PrEP were preventing HIV infection (91.6%), taking responsibility for own sexual health (72.6%) and protecting family members from harm (59.4%). The main reasons for being unwilling to use PrEP were being worried about side effects (72.9%), the necessity of taking PrEP for long periods of time (54.3%) and cost (40.4%). Individual characteristics that influenced the type of reasons given for being willing or unwilling to use PrEP included being married to a woman, having a regular sex partner, rates of condom use with regular and casual sex partners, and the number of casual sex partners., Conclusion: The introduction of PrEP in China could benefit from promotion campaigns that emphasize its role in preventing HIV infection, in taking responsibility for own sexual health, and in protecting family members from potential harm. To reduce uptake barriers, it will be essential to provide accurate information to potential PrEP users about the mild and short-term nature of side effects, and the possibility of taking PrEP only during particular periods of life when the risk of HIV exposure might be highest., Competing Interests: The authors have declared that no competing interests exist.

The methadone maintenance treatment (MMT) has been initiated in Wuhan, China since early 2006. To understand the social-demographic, behavioral, and infectious diseases characteristics of drug users enrolled in their first-ever-MMT between 2006 and 2015, a retrospective observational study was implemented to also provide evidence for health policy-decisions to reduce harm and control disease. Pearson chi-square tests and t-tests were used to assess significant differences between two 5-year periods, 2006-2010 and 2011-2015. We observed increases in the mean age (38.65 vs. 42.43 years, P < 0.001), mean age of initial opioid drug use (28.18 vs. 31.07 years, P < 0.001), employment (11.9% vs. 30.7%, P < 0.001), married/co-habiting (42.4% vs. 47.8%, P < 0.001), and declines in higher education level (93.6% vs. 84.8%, P < 0.001), injection (82.3% vs. 75.1%, P < 0.001), syringe sharing (27.7% vs. 9.9%, P < 0.001), HCV infection rates (72.9% vs. 70.5%, P = 0.017). The number of drug users enrolling each year reduced following a continuous rapid growth in the first 3 years. The findings imply for adjusting in treatment services and allocation of resources to respond to emerging trends. In addition, the data will also be helpful for identifying needs and getting a baseline insight of the social-demographic and behavioral characteristics of the opioid abusers in the area.

Objective: To explore and evaluate the model of antiretroviral treatment that oriented to the medical needs of people living with HIV/AIDS (HIV/AIDS), based on the local prevalence of HIV/AIDS., Methods: A total of 268 HIV/AIDS were selected the CDC of 13 administrative district in Wuhan from 2012 to 2013 and 275 HIV/AIDS were selected in the hospitals of 13 administrative district in Wuhan from 2013 to 2014. The antiretroviral effect of the two groups was compared and the related factors were analyzed., Results: An antiretroviral treatment network that oriented to the medical needs of HIV/AIDS was developed. Data showed that the adherence of patients was better than that when the treatment was carried out at the CDC offices and the status of immuno-recovery on HIV/AIDS was more effective than the hospital-based treatment (P<0.05). Data from multivariable logistic regression analysis showed that different patterns did play different roles on the effects of treatment., Conclusions: The mode of antiretroviral treatment that oriented to the medical needs of HIV/AIDS could effectively improve the adherence and outcomes of treatment. We believe this model could also be adopted elsewhere.

Background: Conducted in Wuhan China, this study examined follow-up and health markers in HIV patients receiving care in two treatment settings. Participants, all men who have sex with men, were followed for 18-24 months., Method: Patients in a "one-stop" service (ACC; N = 89) vs those in standard care clinics (CDC; N = 243) were compared on HIV treatment and retention in care outcomes., Results: Among patients with CD4 cell count ≦350 cells/µL, the proportion receiving cART did not differ across clinic groups. The ACC was favored across five other indicators: proportion receiving tests for CD4 cell count at the six-month interval (98.2% vs. 79.4%, 95% CI 13.3-24.3, p = 0.000), proportion with HIV suppression for patients receiving cART for 6 months (86.5% vs. 57.1%, 95% CI 14.1-44.7, p = 0.000), proportion with CD4 cell recovery for patients receiving cART for 12 months (55.8% vs. 22.2%, 95% CI 18.5-48.6, p = 0.000), median time from HIV confirmation to first test for CD4 cell count (7 days, 95% CI 4-8 vs. 10 days, 95% CI 9-12, log-rank p = 0.000) and median time from first CD4 cell count ≦350 cells/µL to cART initiation (26 days, 95% CI 16-37 vs. 41.5 days, 95% CI 35-46, log-rank p = 0.031). Clinic groups did not differ on any biomedical indicator at baseline, and no baseline biomedical or demographic variables remained significant in the multivariate analysis. Nonetheless, post-hoc analyses suggest the possibility of self-selection bias., Conclusions: Study findings lend preliminary support to a one-stop patient-centered care model that may be useful across various HIV care settings.

In China, the rate of human immunodeficiency virus (HIV) testing is increasing among men who have sex with men. The purpose of the present study was to describe HIV-related biomarkers and selected demographic variables of persons with newly diagnosed HIV/AIDS, among men who have sex with men in particular, in Wuhan China. Demographic indicators, and CD4+ T cell counts and HIV-1 viral load were collected from individuals newly identified as HIV-1 antibody positive during 2011. Of 176 enrolled patients, 132 (75.0%) were men who have sex with men. This group was significantly younger and had higher CD4+ T cell counts than patients who were likely infected through heterosexual contact. Most men who have sex with men (56.6%) were discovered by initiative investigation. Among heterosexual patients CD4+ T cell counts and HIV-1 viral load were significantly correlated; among the group of men who have sex with men, no such association was found., (Copyright © 2013 Wiley Periodicals, Inc.)

Objective: To study the prevalence of hepatitis C virus (HCV) infection and characteristics on molecular biology related to HCV among patients who were enrolled in a Methadone maintenance clinic in Wuhan., Methods: Serum samples from 332 injection drug users (IDUs) were obtained and anti-HCV IgG was detected by enzyme linked immunosorbrent assay(ELISA), together with 86 anti-HCV positive specimens genotyped. A reverse transcriptase-polymerase chain reaction (RT-nPCR) assay using conserved primers deduced from the core-envelopel (C-E1) region of the HCV genome was employed to amplify a 474 bp fragment. Phylogenetic analysis of the C-E1 sequences was conducted by direct sequencing of the RT-nPCR products and alignment with determined by nucleotide sequencing followed by composition of a phylogenetic tree., Results: There were 313 cases (94.3%) appeared positive anti-HCV IgG in the 332 patients from a Methadone maintenance clinic in Wuhan. It was demonstrated that there were four different subtypes of HCV in that clinic in Wuhan, including 6a--71 cases (82.5%), 3b--7 cases (8.2%), 1a--5 cases (5.8%) and 1b--3 cases (3.5%)., Conclusion: Infection of 6a genotype HCV was predominant in patients from the Methadone maintenance clinic in Wuhan, followed by HCV 3b, 1a and 1b.