Re-emergence of severe acute diarrhea syndrome coronavirus (SADS-CoV) in Henan, central China, 2023

Severe acute diarrhea syndrome coronavirus (SADS-CoV) was first detected in Guangdong province of China in 2017. And yet from May 2021 to Jun 2023, there were no SADS-CoV outbreaks. In this study, we reported the recent outbreak of SADS-CoV in China on Jun 2023. Phylogenetic analysis showed the novel strain was derived from the ongoing transmission and evolution of SADS-CoV in China, rather than a separate cross-species transmission from bats. Also, the novel strain was found to participate in a recombant event as a minor parent and a missing base in the genome was discovered indicating an novel evolutionary pathway. Through virulence assays in piglets, we further determined that novel strain (SADS-CoV/HNNY/2023) was a highly virulent SADS-CoV strain with typical clinical symptoms: acute diarrhea, vomiting, rapid weight loss. Therefore, the re-emergence of SADS-CoV strains should be brought to people's attention.

Epidemiological and etiological characteristics of 1266 patients with severe acute respiratory infection in central China, 2018-2020: a retrospective survey

BACKGROUND

Severe acute respiratory infection (SARI), a significant global health concern, imposes a substantial disease burden. In China, there is inadequate data concerning the monitoring of respiratory pathogens, particularly bacteria, among patients with SARI. Therefore, this study aims to delineate the demographic, epidemiological, and aetiological characteristics of hospitalised SARI patients in Central China between 2018 and 2020.

METHODS

Eligible patients with SARI admitted to the First Affiliated Hospital of Zhengzhou University between 1 January 2018 and 31 December 2020 were included in this retrospective study. Within the first 24 h of admission, respiratory (including sputum, nasal/throat swabs, bronchoalveolar lavage fluid, thoracocentesis fluid, etc.), urine, and peripheral blood specimens were collected for viral and bacterial testing. A multiplex real-time polymerase chain reaction (PCR) diagnostic approach was used to identify human influenza virus, respiratory syncytial virus, parainfluenza virus, adenovirus, human bocavirus, human coronavirus, human metapneumovirus, and rhinovirus. Bacterial cultures of respiratory specimens were performed with a particular focus on pathogenic microorganisms, including S. pneumoniae, S. aureus, K. pneumoniae, P. aeruginosa, Strep A, H. influenzae, A. baumannii, and E. coli. In cases where bacterial culture results were negative, nucleic acid extraction was performed for PCR to assay for the above-mentioned eight bacteria, as well as L. pneumophila and M. pneumoniae. Additionally, urine specimens were exclusively used to detect Legionella antigens. Furthermore, epidemiological, demographic, and clinical data were obtained from electronic medical records.

RESULTS

The study encompassed 1266 patients, with a mean age of 54 years, among whom 61.6% (780/1266) were males, 61.4% (778/1266) were farmers, and 88.8% (1124/1266) sought medical treatment in 2020. Moreover, 80.3% (1017/1266) were housed in general wards. The most common respiratory symptoms included fever (86.8%, 1122/1266) and cough (77.8%, 986/1266). Chest imaging anomalies were detected in 62.6% (792/1266) of cases, and 58.1% (736/1266) exhibited at least one respiratory pathogen, with 28.5% (361/1266) having multiple infections. Additionally, 95.7% (1212/1266) of the patients were from Henan Province, with the highest proportion (38.3%, 486/1266) falling in the 61-80 years age bracket, predominantly (79.8%, 1010/1266) seeking medical aid in summer and autumn. Bacterial detection rate (39.0%, 495/1266) was higher than viral detection rate (36.9%, 468/1266), with the primary pathogens being influenza virus (13.8%, 175/1266), K. pneumoniae (10.0%, 127/1266), S. pneumoniae (10.0%, 127/1266), adenovirus (8.2%, 105/1266), P. aeruginosa (8.2%, 105/1266), M. pneumoniae (7.8%, 100/1266), and respiratory syncytial virus (7.7%, 98/1266). During spring and winter, there was a significant prevalence of influenza virus and human coronavirus, contrasting with the dominance of parainfluenza viruses in summer and autumn. Respiratory syncytial virus and rhinovirus exhibited higher prevalence across spring, summer, and winter. P. aeruginosa, K. pneumoniae, and M. pneumoniae were identified at similar rates throughout all seasons without distinct spikes in prevalence. However, S. pneumoniae showed a distinctive pattern with a prevalence that doubled during summer and winter. Moreover, the positive detection rates of various other viruses and bacteria were lower, displaying a comparatively erratic prevalence trend. Among patients admitted to the intensive care unit, the predominant nosocomial bacteria were K. pneumoniae (17.2%, 43/249), A. baumannii (13.6%, 34/249), and P. aeruginosa (12.4%, 31/249). Conversely, in patients from general wards, predominant pathogens included influenza virus (14.8%, 151/1017), S. pneumoniae (10.4%, 106/1017), and adenovirus (9.3%, 95/1017). Additionally, paediatric patients exhibited significantly higher positive detection rates for influenza virus (23.9%, 11/46) and M. pneumoniae (32.6%, 15/46) compared to adults and the elderly. Furthermore, adenovirus (10.0%, 67/669) and rhinovirus (6.4%, 43/669) were the primary pathogens in adults, while K. pneumoniae (11.8%, 65/551) and A. baumannii (7.1%, 39/551) prevailed among the elderly, indicating significant differences among the three age groups.

DISCUSSION

In Central China, among patients with SARI, the prevailing viruses included influenza virus, adenovirus, and respiratory syncytial virus. Among bacteria, K. pneumoniae, S. pneumoniae, P. aeruginosa, and M. pneumoniae were frequently identified, with multiple infections being very common. Additionally, there were substantial variations in the pathogen spectrum compositions concerning wards and age groups among patients. Consequently, this study holds promise in offering insights to the government for developing strategies aimed at preventing and managing respiratory infectious diseases effectively.

Recent-year variations in O3 pollution with high-temperature suppression over central China

By analyzing environmental and meteorological monitoring data over recent years of 2015-2022, the Twain-Hu Basin (THB) in central China was identified as a regional O3 pollution center over China with the highest increasing trend at 1.10 %⸱yr-1 in interannual variations of O3 concentrations with deteriorating O3 pollution over recent years. We explored the spatiotemporal variations in O3 pollution in the THB with ozone suppression (OS) under high air temperature over metropolitan, small urban, and mountainous areas. The bipolarized interannual trends in interannual O3 variations in urban and mountainous areas over central China were characterized with the increasing and decreasing 90th percentiles of the daily maximum 8-h (MDA8-90) O3 concentrations respectively in polluted urban areas and clean mountainous areas over recent eight years. The changes of the near-surface O3 concentrations with air temperature exhibited the inflection points of OS from increasing to decreasing O3 at air temperature of 30.5 °C in mountainous areas, 32.5 °C in small urban areas, and 34.5 °C in metropolitan areas, and the intensity of OS was estimated in the ranking with mountainous areas (-2.30 μg⸱m-3⸱°C-1) > small urban areas (-1.96 μg⸱m-3⸱°C-1) > metropolitan areas (-1.54 μg⸱m-3⸱°C-1), indicating that the OS was more significant over the lower-O3 mountainous areas. This study has implications for understanding O3 pollution variations with the meteorological drivers.

Reduction potential of ammonia emissions and impact on PM2.5 in a megacity of central China

Ammonia control has attracted attention due to the possibility for fine particles (PM2.5) mitigation. Based on past decade ammonia emissions assessments and future predictions, this study seasonally evaluated the ammonia emissions reduction potential in 2025 and 2030 in Wuhan, a Central China megacity, according to the short-term and long-term predictable policies. Furthermore, combined with the reduction potential, PM2.5 components observation and thermodynamic model, the effectiveness of implementing ammonia emission control to reduce PM2.5 by 2025 and 2030 was explored seasonally. Results indicated that the total ammonia emissions are expected to decrease by 19.6-33.9% in 2025 and 2030 under positive reduction scenarios, or increase by 8.9-11.7% in the absence of any intervention. Livestock holds the largest potential for reducing ammonia emissions accounting for 46.4-52.5% of the total. Improvement of human excrement management in rural regions also contributes a 35-37% potential. Despite the implementation of exhaust requirements, ammonia emissions from vehicles in 2030 are expected to continue to increase by 55.3% and 23.5% under the regular (S1) and enhanced (S2) reduction strategy scenarios, respectively. Seasonally, the most potential source of ammonia reduction in spring, summer and fall remains livestock. While in winter, non-agricultural sources dominate the reduction potential. Further results indicated that by ammonia control is expected to decrease PM2.5 concentration up to 5% (less than 1 μg m-3) in 2025-2030. Despite the better effectiveness in winter, ammonia control won't be an effective way to reduce PM2.5 in Central China in future, from the management policies and areal ammonia-rich conditions.

Intensification of compound temperature extremes by rapid urbanization under static and dynamic Urban-rural division: A comparative case study in Hunan Province, Central-South China

Climate extremes, notably compound extremes, pose significant risks to human society and environmental systems. These extremes, heightened by urbanization-a hallmark of modern socioeconomic progression-inflict persistent, intense thermal conditions. The comprehension of urbanization's impact on compound temperature extremes, particularly in Central-South China, a region with rapid urbanization and a subtropical climate, remains limited. In addition, most existing studies relied on static urban-rural division, and few used dynamic division, with no research yet juxtaposing findings from both methods. Against this backdrop, this study provided an unprecedented assessment of urbanization's impact on both individual and compound temperature extremes in Central South China, focusing on Hunan Province during long-time period of 1960-2022 under both static and dynamic urban-rural divisions. In both urban and rural stations, a pronounced warming trend was evident across individual and compound temperature extremes. Besides, a tendency of independent day/night extremes shifting towards extremes spanning both was observed. Notably, the escalation of heat compound extreme temperature indices (ETIs) outpaces that of cold ones, with a larger urban-rural discrepancy under dynamic classifications. Urbanization intensifies temperature extremes, particularly affecting the reduction of independent cold days (30.97 %-33.94 %) and the increase in compound hot events (23.91 %-24.87 %). Interestingly, urbanization's impact is more substantial on independent daytime extremes than on independent nighttime ones. Urbanization's influence on ETIs was consistently observed under both static and dynamic classifications, with the latter revealing a more pronounced contribution (1 %-3 %), and the contribution to compound ETIs is 6 %-8 % higher than to individual ETIs. These findings emphasize the importance of considering urbanization's multifaceted impacts on climate strategies and underscore the need for adaptive infrastructure and sustainable practices to mitigate escalating climate risks.

A New Species of the Genus Gekko (Squamata: Sauria: Gekkonidae) from the Dabie Mountains, China

This study describes a novel species of Gekko (Squamata: Gekkonidae) based on its distinct morphological features and molecular evidence, which was identified in the Dabie Mountains on the border of Anhui and Henan provinces of Central China. Gekko kaiyaisp. nov. could be distinguished from its congeners owing to its morphological characteristics, such as being a medium body sized gecko species (snout-vent length, 56.98-64.99 mm, n = 4, females; 50.03-61.56 mm, n = 11, males); nostrils scale in contact with rostral scale; tubercles on the dorsal and limb, while the upper forelimb is smooth with no tubercles; 22-33 interorbital scales between the anterior corners of the eyes; 157-209 ventral scales between mental and cloacal slit; 90-121 midbody scale rows; 30-43 ventral scale rows; 7-9 sub-digital lamellae on first fingers, 8-13 fourth fingers, 7-9 first toes, and 7-11 fourth toes; free of webbing in the fingers and toes; 9-12 pre-cloacal pores in males, which are absent in females; post-cloacal unilateral tubercles 1 (few 2); and a dorsum that is greyish white to dark brown, with 6-7 brown markings between the nape and sacrum. The phylogenetic tree based on the mitochondrial DNA sequences (16S, CYTB, and COI) indicated that Gekko kaiyaisp. nov. form an independent clade with strong support (100/1) and are a sister group to G. hokouensis. At the inter-species level, the genetic distances were all large, further confirming that an independent species had been identified. The discovery of this species implies that there are now 87 identified species in the genus Gekko, 22 of which can be found within China.

Spatiotemporal characteristic analysis of PM2.5 in central China and modeling of driving factors based on MGWR: a case study of Henan Province

Since the start of the twenty-first century, China's economy has grown at a high or moderate rate, and air pollution has become increasingly severe. The study was conducted using data from remote sensing observations between 1998 and 2019, employing the standard deviation ellipse model and spatial autocorrelation analysis, to explore the spatiotemporal distribution characteristics of PM2.5 in Henan Province. Additionally, a multiscale geographically weighted regression model (MGWR) was applied to explore the impact of 12 driving factors (e.g., mean surface temperature and CO2 emissions) on PM2.5 concentration. The research revealed that (1) Over a period of 22 years, the yearly mean PM2.5 concentrations in Henan Province demonstrated a trend resembling the shape of the letter "M", and the general trend observed in Henan Province demonstrated that the spatial center of gravity of PM2.5 concentrations shifted toward the north. (2) Distinct spatial clustering patterns of PM2.5 were observed in Henan Province, with the northern region showing a primary concentration of spatial hot spots, while the western and southern areas were predominantly characterized as cold spots. (3) MGWR is more effective than GWR in unveiling the spatial heterogeneity of influencing factors at various scales, thereby making it a more appropriate approach for investigating the driving mechanisms behind PM2.5 concentration. (4) The results acquired from the MGWR model indicate that there are varying degrees of spatial heterogeneity in the effects of various factors on PM2.5 concentration. To summarize the above conclusions, the management of the atmospheric environment in Henan Province still has a long way to go, and the formulation of relevant policies should be adapted to local conditions, taking into account the spatial scale effect of the impact of different influencing factors on PM2.5.

Distribution and antimicrobial resistance analysis of gram-negative bacilli isolated from a tertiary hospital in Central China: a 10-year retrospective study from 2012 to 2021

Background

Gram-negative bacilli are one of the most common causes of various infections in clinical. The emergence and global spread of multi-drug resistant gram-negative bacilli has become a major challenge in the global public health field.

Methods

A total of 51,189 non-repetitive strains of gram-negative bacilli were isolated in clinical settings. The antimicrobial susceptibility testing was conducted by using the automated VITEK 2 compact system and the matched AST susceptibility test card, complemented by the disk diffusion method. The antimicrobial susceptibility results were interpreted by CLSI. Rates of MDR and XDR in Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa were investigated. Used the chi-square test to determine whether the antimicrobial resistance rates of four major gram-negative bacilli isolated from ICU and non-ICU department have statistical differences.

Results

Escherichia coli (31.4%), Klebsiella spp. (21.2%), Acinetobacter spp. (13.8%), and P. aeruginosa (11.0%) were the most frequently isolated gram-negative bacilli. Escherichia coli was the top one organism isolated from urinary tract (68.4%), bloodstream (39.9%), body fluid (33.2%), wound and pus (37%), except for respiratory tract (8.8%). Whereas Acinetobacter baumannii and K. pneumoniae were the major isolated organisms from respiratory tract. Acinetobacter baumannii showed high resistance to fluoroquinolones, β-lactam/β-lactamase inhibitor combinations class, ceftazidime, cefepime, imipenem, and meropenem, the resistance rates reached more than 70%. Ceftazidime showed a lower resistance rate to E. coli than ceftriaxone. For E. coli, fluoroquinolones showed a high resistance rate (ciprofloxacin 61.36% and levofloxacin 53.97%), whereas amikacin, carbapenems exhibited a lower resistance rate fluctuating at 2%. Acinetobacter baumannii and K. pneumoniae showed rapid increases in carbapenem resistance whereas E. coli had the lowest resistance rate and remain stable at 2%. Acinetobacter baumannii exhibited the highest rate of MDR and XDR, reaching 60-80 and 45-55%, respectively. Compared to non-ICU departments, the resistance rates of four major gram-negative bacilli in the ICU department were much higher and the differences were statistically significant (p < 0.05).

Conclusion

Amikacin, carbapenems, and piperacillin/tazobactam exhibited relatively high sensitivity, whereas fluoroquinolones showed high resistance rate whether they can be the first-line antimicrobials for empirical treatment of UTI should take more consideration. The gram-negative bacilli in ICU were more resistance than that in non-ICU. These findings are helpful for clinicians using antimicrobials reasonably.

Ecological footprint model of heavy metal pollution in water environment based on the potential ecological risk index

Social heavy metal pollution poses a significant threat to aquatic ecosystems. Heavy metals are easily adsorbed by sediments and have cumulative effects on aquatic organisms, which is different with the hypothesis of the conventional ecological footprint model that the pollutants are independently degraded by water bodies. To solve this problem, an ecological footprint for heavy metal pollution (EFHM) is constructed based on the potential ecological risk index (PERI). EFHM is defined as the sediment area to control the cumulative ecological risk of heavy metals within the allowable limit. And then, EFHM uses ecological footprint index (EFI) and ecological footprint contribution rate (EFCR) to quantify the hazard of social heavy metal load and recognize the key risk factor. EFHM is applied for assessing the heavy metal pollution of Central China. The results show that (i) the EFHM model can effectively evaluate the cumulative ecological hazards of heavy metals in sediment. (ii) The EFHM values of Central China in 2015 and 2020 are 20,764.56 and 17,358.59 km2, respectively. (iii) Compared with 2015, the EFI values of Hunan Province and Jiangxi Province in 2020 decrease from 1.53 to 0.87 to 1.23 and 0.39, respectively, both of which are improved by one grade. The EFI values of Hubei Province increases from 0.42 to 1.34, which is deteriorated by one grade. (iv) In 2020, both of the key risk factors of Hunan Province and Hubei Province are Hg, and the crucial hazard source of Jiangxi Province is Cd. (v) The mine pollution control in Central China should be further consolidated, and the wastewater treatment of electronics and machinery industries should be strengthened.

Fear of COVID-19 among cancer patients in Henan Province, Central China: causes, results, and coping factors

Objectives

Cancer patients exhibit fear of COVID-19, which could lead to serious consequences. However, minimal information is available about the effect of the COVID-19 pandemic on the mental health of cancer patients. Therefore, this study aims to examine the fear level of COVID-19 among cancer patients in Henan Province, Central China and to identify its causes, results, and coping factors.

Methods

An online survey was conducted among 1,067 cancer patients. The participants reported their individual fear level of COVID-19, risk of COVID-19 infection, risk of death from COVID-19, COVID-19 vaccination concerns, influence level of COVID-19 pandemic on their disease treatment, loneliness due to COVID-19, economic burden from COVID-19, quality of life, safety behavior, information regarding COVID-19 vaccination, psychological guidance, physical activities, and demographic characteristics. Chi-square and cumulative logistic regression were used to determine the predictors of COVID-19 fear level.

Results

This study indicates that cancer patients report moderate fear level of COVID-19 in Central China (66.9%). The six cause factors (risk of COVID-19 infection, risk of death from COVID-19, COVID-19 vaccination concerns, influence level of COVID-19 pandemic on disease treatment, loneliness due to COVID-19, and economic burden from COVID-19) were positively associated with COVID-19 fear level. Three coping factors (information regarding COVID-19 vaccination, psychological guidance, and physical activities) were negatively associated with COVID-19 fear level. COVID-19 fear level was negatively associated with quality of life and positively associated with safety behavior.

Conclusion

Our results suggest that governments should improve access to personalized vaccine counseling and psychological guidance by undertaking the responsibility of patients' attending physicians and increasing publicity. Physical activities should be included in the treatment program to help cancer patients better recover their physical and mental health.

VOC species controlling O3 formation in ambient air and their sources in Kaifeng, China

The concentration of ozone has been in a rising crescendo in the last decade while the fine particles (PM_2.5) is gradually decreasing but still at a high level in central China. Volatile organic compounds (VOCs) are the vital precursors of ozone and PM_2.5. A total of 101 VOC species were measured in four seasons at five sites from 2019 to 2021 in Kaifeng. VOC sources and geographic origin of sources were identified by the positive matrix factorization (PMF) model and the hybrid single-particle Lagrangian integrated trajectory transport model. The source-specific OH loss rates (L_OH) and ozone formation potential (OFP) were calculated to estimate the effects of each VOC source. The average mixing ratios of total VOCs (TVOC) were 43.15 parts per billion (ppb), of which the alkanes, alkenes, aromatics, halocarbons, and oxygenated VOCs respectively accounted for 49%, 12%, 11%, 14%, and 14%. Although the mixing ratios of alkenes were comparatively low, they played a dominant role in the L_OH and OFP, especially ethene (0.55 s^-1, 7%; 27.11 μg/m³, 10%) and 1,3-butadiene (0.74 s^-1, 10%; 12.52 μg/m³, 5%). The vehicle-related source which emitted considerable alkenes ranked as the foremost contributing factor (21%). Biomass burning was probably influenced by other cities in the western and southern Henan and other provinces, Shandong and Hebei.

Veronicahongii (Plantaginaceae), a new species from Central China

A new species Veronicahongii, from western Hubei Province, Central China is described and illustrated. The species is morphologically similar to V.henryi Yamazaki, but mainly differs in the glabrous plant, except pedicels, broadly ovate leaf blades, glandular-pubescent pedicels, obovate calyx lobes, smaller corolla, broadly ovate capsule and much smaller seeds.

Young Adults' Perception of Forests Using Landscape-Image-Sketching Technique: A Case Study of Changsha, Central China

The forest-landscape image is the bridge for communication between human beings and the forest. The aim of this paper is to construct the landscape-image conceptual model from the personal perception of the forest, with what people are looking at and how they are viewing themselves as a part of the forest. This research constructed a forest-landscape image by young adults by utilizing the landscape-image-sketching technique and selecting 140 young adults who had lived in Changsha, Central China for ten years, using convenience sampling, during April and May 2018. The results demonstrated that the forest was considered as the people's life world, as rural scenery around the respondents' homes, instead of the perception of the objective forest, an important habitat for animals and a limited resource supplier for human living. In fact, the natural values of the forest, such as the ecological and aesthetic values, received more attention than the social ones of the forest, including the life, production, and cultural values. Finally, it is important to raise the public's awareness of the objective entity of the forest and to guide the variety of experiences for the respondents in the forest.

Astragalusbashanensis (Leguminosae), a new species from Central China

A new species Astragalusbashanensis, from western Hubei Province, Central China is described and illustrated. The new species is morphologically similar to Astragalussinicus and A.wulingensis, but differs from both by its spreading pubescent indumentum on stems and petioles, longer petioles, white bracts, whitish or yellow corolla, longer claw of the keel-petal, hairy pods and smaller seeds.

Fractionation analysis and risk assessment of potential toxic elements in reservoir sediments in central China

The pollution of potential toxic elements (PTEs) in the environment is a persistent issue and draws public attention constantly. However, there is no study comprehensively assessing the PTE pollution of water supply reservoirs in central China. This study determined the total contents and fractions of seven PTEs in 10 water supply reservoirs of central China, and evaluated PTE pollution risks by adopting various models. The results indicated that PTE pollution in water supply reservoirs was lower comparing that in estuary or river sediments, and Mn (manganese) was the predominant PTE in central China reservoirs. Fractionation analysis revealed that for B1 fraction (exchangeable/acid-soluble fraction) of Mn, Zn (zinc) and B2 fraction (reducible fraction) of Pb (lead) was high, while the effective state portion of Cr (chromium) was small. The monomial potential ecological risk indices and Igeo values were low among most samples, indicating overall modest PTE pollution. However, the results of the individual contamination factor (ICF) suggested that Pb might lead to potential health risks to human beings.

Gray water footprint evaluation of arsenic in Central China: from the perspective of health risk theory

Central China is one of the areas with the most serious arsenic (As) pollution in the world. However, the local controlling standards of arsenic are not unique, and its toxicities to humans have gender differences, which brings challenges to gray water footprint (GWF) evaluation. The GWF model is improved on the basis of health risk theory to address the abovementioned problems. According to the gender differences in health parameters, the assessment is further divided into male and female GWFs (i.e., GWF (As-M) and GWF (As-F), respectively). The results show that (1) the average annual GWF (As-M) and GWF (As-F) values in Central China from 2011 to 2015 are 97.27 and 105.11 billion m³, respectively. Hunan Province accounts for about 77% of the total GWF (As-M) and GWF (As-F) in Central China (2). The carcinogenic hazard of arsenic load in Hunan Province is the most serious among the three provinces in central China. The water pollution levels of arsenic for male and female in Hunan Province are 0.917 and 0.843 in 2011, both of which belong to the "high" grade. The carcinogenic hazards of arsenic loads in Hubei Province and Jiangxi Province are the second and third highest in Central China (3). For the females, the average daily dose to arsenic is about 1.03 times larger than the male's, and the female carcinogenic risk of arsenic is higher than that of males. Therefore, women are the main protection group of arsenic pollution in Central China (4). The decrease in the GWF (As-M) and GWF (As-F) risk factors in Central China is primarily caused by the closure of Shimen realgar mine in Hunan Province. The leaching of historical slag is a key source to be controlled to further improve water safety of Central China.

Comparison of atmospheric polycyclic aromatic hydrocarbons (PAHs) over six years at a CAWNET background site in central China: Changes of seasonal variations and potential sources

Total suspended particles (TSP) and gaseous samples were collected by using a high-volume sampler from March 2012 to March 2013 and January 2018 to January 2019 at a background site (Jinsha, JSH) in central China to study the chemical characteristics, seasonal variations, and potential sources of polycyclic aromatic hydrocarbons (PAHs). The average concentrations of ∑₁₅PAHs were 24.55 ± 9.19 ng m^-3 in 2012/2013 and 20.98 ± 9.77 ng m^-3 in 2018/2019. Low-ring PAHs were more concentrated in gas phase while high-ring PAHs were prone into particle phase. The concentrations of PAHs in the two sampling years were high in winter but low in summer and autumn. The relationships between the gas concentrations of PAHs and temperature indicated that most PAHs were influenced by long-range atmospheric transport (LRAT) in 2012/2013 and in 2018/2019, excluding anthracene (Ant) and pyrene (Pyr) were partially affected by air-surface re-volatilization in 2012/2013. The source of atmospheric PAHs at JSH was similar in 2012/2013 and 2018/2019,which was mainly due to the LRAT of PAHs emitted from biomass/fossil fuel combustion in the northern area of JSH. From 2012/2013 to 2018/2019, there was no significant difference between the concentrations of PAHs in spring and winter, whereas the concentrations of PAHs decreased from 2012/2013 to 2018/2019 in summer. In all, the control of PAHs at the source region was partially effective from 2012/2013 to 2018/2019.

Infection in Pet Birds in Henan Province, Central China

Blastocystis spp. are common intestinal parasites found in humans and many kinds of animals. Blastocystis spp. infection is associated with a variety of symptoms, including diarrhea, abdominal pain, and chronic urticaria, among which asymptomatic infection is the most common. Among the 11 potentially zoonotic subtypes of Blastocystis spp., 9 subtypes have been reported in bird species. The purpose of this study was to detect the infection rate and gene subtype distribution of Blastocystis spp. in pet birds in Henan Province, Central China, to provide a foundation for preventing and controlling Blastocystis spp. in pet birds. Fecal DNA was extracted from 382 fresh fecal samples of pet birds collected from five areas in Henan Province, Central China. Twenty-three species of pet birds from four orders, from local pet trading markets, parks, and individuals, were sampled. All DNA samples were investigated by PCR, and positive samples were sequenced to analyze the gene subtypes based on the small ribosomal subunit (SSU rRNA) gene. Blastocystis spp. was detected in 0.8% of the samples. Further DNA sequencing and phylogenetic analyses resulted in the identification of two known zoonotic subtypes, ST1 (n = 2) and ST7 (n = 1). As far as we know, this is the first time that ST1 subtype has been reported in Chinese birds. It is found that pet birds may be the hosts of zoonotic Blastocystis spp. subtypes, and the role of birds in transmitting Blastocystis spp. to humans needs to be further studied.

Cerasus from Central China

A new species, Prunuswangii Q.L.Gan, Z.Y.Li & S.Z.Xu from western Hubei, Central China is described and illustrated. It is morphologically similar to P.clarofolia Schneid. and P.pseudocerasus Lindl., but differs in larger height, nearly erect branches, densely and horizontally arranged lenticels, straight lateral veins of leaves, persistent brownish bracts, reflexed and entire calyx lobes, 2-lobed petals with narrowly triangular sinus, earlier flowering and broadly ellipsoid fruits. Furthermore, P.wangii blooms in late February and the colour of flower changes with time, which makes it possible to be a new breeding material for ornamental cherry with early spring blooms.

Antibiotic resistomes in water supply reservoirs sediments of central China: main biotic drivers and distribution pattern

Water supply reservoirs form one of the critical drinking water resources. Their water quality directly affects human health. However, reservoir sediments have not received adequate attention in antibiotic resistance genes (ARGs) dissemination, though they reflect long-term ARGs contamination of water supply reservoirs. Moreover, the physicochemical parameters in water supply reservoir sediments are generally better than those in the other media. Thus, the main ARGs biotic drivers of the media would demonstrate their unique characteristics. In this study, sediment samples were collected from 10 water supply reservoirs in central China, and the antibiotic resistomes were determined with the metagenomic method. As revealed from the results, 174 ARGs (18 ARG types) were detected in the reservoir sediment. Besides, multidrug-, sulfonamide-, and vancomycin-ARGs were the dominant ARGs in the sediment samples. The macrolide-resistant Microcystis was prevalent (100% detection frequency with 0.35% average percentage) in reservoir sediments and posed potential risks to human health. Furthermore, the results of the Mantel test and VPA demonstrated that mobile genetic elements (MGEs) were the more essential biotic drivers in ARG contents of reservoir sediments rather than the bacteria community.

Associations of long-term exposure to ambient air pollutants with metabolic syndrome: The Wuhan Chronic Disease Cohort Study (WCDCS)

BACKGROUND

Evidence on the associations between long-term exposure to ambient air pollutants (including particle with aerodynamic diameter ≤10 μm (PM₁₀), particle with aerodynamic diameter ≤2.5 μm (PM_2.5), ozone (O₃), nitrogen dioxide (NO₂), and sulfur dioxide (SO₂)) and prevalence of metabolic syndrome (MetS) remains inconclusive. This study aimed to determine the associations based on a case-control study nested in the Wuhan Chronic Disease Cohort study (WCDCS), a population-based study with baseline survey in 2019.

METHODS

A total of 10,253 residents living in Wuhan were recruited. The 3-year average concentrations of main pollutants (PM₁₀, PM_2.5, O₃, NO₂, and SO₂) at residences prior to the survey date were estimated to evaluate the long-term exposures. The generalized linear mixed models were used to investigate the changes in MetS prevalence by an IQR increases in each air pollutant exposure concentrations. Interaction effects between air pollutants and demographic, lifestyle, and dietary factors on MetS were evaluated by including an interactive item in the main model.

RESULTS

The prevalence of MetS in Wuhan was 9.8%, and the 3-year exposure concentrations of PM₁₀, PM_2.5, O₃, NO₂, and SO₂ were 84.1 μg/m³, 50.5 μg/m³, 55.7 μg/m³, 46.0 μg/m³, and 9.4 μg/m³, respectively. Higher PM₁₀, PM_2.5 and O₃ exposure concentrations were associated with an elevated MetS prevalence (e.g. an IQR increase in PM_2.5, OR = 1.193, 95% confidence intervals (95%CIs): 1.028, 1.385; for O₃, OR = 1.074, 95%CIs: 1.025, 1.124), whereas NO₂, and SO₂ were negatively or insignificant correlated with odds of Mets (e.g. an IQR increase in NO₂, OR = 0.865, 95%CIs: 0.795, 0.941). Males, smokers, alcohol drinkers and individuals who intake fruits occasionally exposure to PM₁₀ and PM_2.5 were found had a higher risk of developing MetS.

CONCLUSIONS

Long-term exposure to higher concentrations of ambient air pollutants may elevate the prevalence of MetS in populations in Central China. Susceptible individuals especially those with unhealthy lifestyles had a higher risk for MetS.

Eco-efficiency assessment of industrial parks in Central China: a slack-based data envelopment analysis

Industrial parks have made important contributions to China's economic development, but they have caused serious pollution to the environment. With the promotion of China's sustainable development, improving the eco-efficiency of industrial parks has gradually become the focus of attention. In this study, a slack-based data envelopment analysis (SBM-DEA) model, which included three input indicators and six output indicators, was applied to assess the eco-efficiencies of 18 industrial parks in Central China. The ecological development level of different industrial parks in Central China was uneven, and their efficiency scores ranged from 0.06 to 1. Next, the most sensitive input and output variables are identified by sensitivity analysis, and it is concluded that land and water consumption will have a significant impact on the evaluation results of the model. Then, the influencing factors of eco-efficiency are discussed, and it was found that a reasonable energy structure and industrial structure, as well as high industrial added value, would increase the eco-efficiency of industrial parks. Finally, based on the findings, policy recommendations for improving the eco-efficiency of industrial parks are put forward, including fulfilling government responsibilities, adjusting energy and industrial structures, and improving the high-quality development of the parks.

Benefits of refined NH3 emission controls on PM2.5 mitigation in Central China

Atmospheric ammonia (NH₃) is one of the most crucial precursors of secondary inorganic aerosols. However, its emission control is still weakness over China. NH₃ emission inventories of 2015 with and without considering a set of refined emission reduction strategies covering seven major NH₃ emission sources were constructed in Central China. GEOS-Chem model simulations were conducted to quantify the benefits of NH₃ emission reduction on PM_2.5 mitigation in four typical months (January, April, July and October). The results showed that these control strategies could reduce approximately 47.0% (152 Gg) of the total NH₃ emissions in Hubei Province, with the agricultural (livestock and fertilizer application) source being reduced the most (133 Gg). NH₃ had a significant nonlinear relationship with sulfate, nitrate, ammonium and PM_2.5. NH₃ emission reduction exerted less effect on sulfate mitigations (the annual average sensitivity was 4.5%), but it obviously alleviated nitrate, ammonium and thus PM_2.5, with the annual average sensitivities of 81.9%, 34.8% and 22.0%, respectively. The average provincial concentrations of PM_2.5 were alleviated by 11.2% in January, 10.6% in October, 10.2% in April and 9.3% in July through NH₃ emission reduction by 47.0%. The reduction benefits were more pronounced in high NH₃ emission areas, such as Yichang, with the PM_2.5 reduction of 14.4% in January. This research could provide scientific support for formulating NH₃ emission reduction policies to further mitigate PM_2.5 pollution.

Assessment of summertime O3 formation and the O3-NOX-VOC sensitivity in Zhengzhou, China using an observation-based model

Zhengzhou, the provincial capital of Henan province in Central China and a major hub of the country's transportation network, has been suffering from severe summertime ozone (O₃) pollution. Simultaneous field measurements of O₃ and its precursors, including NO_x, CO, HONO, and 106 volatile organic compounds (VOCs), were conducted at an urban site (the municipal environmental monitoring station, MEM) in Zhengzhou in July 2019. The Community Multiscale Air Quality (CMAQ) model, which incorporates the Master Chemical Mechanism (MCMv3.3.1), was modified to work as a 0-D observation-based photochemical box model to assess the sources and sinks of HO_x radicals and O₃, and the OH reactivity (K_OH) and ozone formation potential (OFP) of major VOC groups. In addition, the O₃-NO_x-VOC sensitivity was evaluated using the relative incremental reactivity (RIR) and O₃ formation isopleth techniques. The OH radicals were mainly generated from the propagation reaction of HO₂ + NO (91-95%). The daily average mixing ratios of OH and HO₂ radicals were significantly higher during high O₃ days, reaching as high as 4.8 × 10⁶ and 7.7 × 10⁸ molecules cm^-3, respectively. Photochemical O₃ formation was mostly due to the conversion of NO to NO₂ by HO₂ radicals (52-54%), while the NO₂ + OH reaction was the main contributor to O₃ destruction (70- 76%). Alkenes and aromatics were the main anthropogenic VOC contributors to K_OH and OFP. Contributions of biogenic VOCs became much more important on high O₃ days, correlating with the increase in temperature and solar radiation. RIR analysis showed that the O₃ formation was under the VOC-limited on low O₃ days but was in the transition regime during the O₃ pollution buildup and persisting days. These results are generally consistent with those based on the O₃ formation isopleth. This paper provides important corroborative scientific evidence urgently needed by local governments to formulate O₃ pollution control strategies.

Prevalence and molecular subtyping of Blastocystis in domestic pigeons in Henan Province, Central China

Blastocystis is an anaerobic intestinal protozoan parasite found in humans and many kinds of animals that mainly causes diarrhea, abdominal pain and other clinical symptoms. At present, research on the prevalence and subtype diversity of Blastocystis in domestic pigeons is very limited. The purpose of this study was to detect the infection rate and gene subtype distribution of Blastocystis in domestic pigeons in Henan Province, Central China, to provide a foundation for preventing and controlling Blastocystis in domestic pigeons. Fecal DNA was extracted from 504 fresh fecal samples of pigeons collected from 4 areas in Henan Province, Central China. All DNA samples were investigated by polymerase chain reaction (PCR), and positive samples were sequenced to analyze the gene subtypes based on small ribosomal subunit (SSU rRNA) gene. The overall infection rate of Blastocystis in pigeons in Henan Province was 7.7% (39/504). Four subtypes (STs) of Blastocystis were identified including ST1 (2/39, 5.1%), ST3 (16/39, 41.0%), ST4 (1/39, 2.6%) and ST7 (20/39, 51.3%), all of which belonged to zoonotic subtypes, and ST7 was the dominant gene subtype. The results show that Blastocystis infection is common in domestic pigeons in Henan Province, Central China, and the pathogen were zoonotic subtypes. Particular attention should be given to reducing the risk of transmission of Blastocystis from domestic pigeons to humans.

Knockdown Resistance (kdr) Mutations I1532T and F1534S Were Identified in Aedes albopictus Field Populations in Zhejiang Province, Central China

Aedes albopictus is the only vector that can transmit the dengue virus in Zhejiang Province, central China, and it can develop insecticide resistance due to long-term exposure to pyrethroids. The presence of knockdown resistance (kdr) mutations is one of the mechanisms responsible for pyrethroid resistance, and has been reported in some Ae. albopictus populations in southern China. However, little is known about the DNA diversity of the voltage-gated sodium channel (VGSC) gene in Ae. albopictus populations in central China. Four Ae. albopictus field populations were collected, in Yiwu (YW), Quzhou (QZ), Wenzhou (WZ), and Jiaxing (JX) from Zhejiang Province, central China. The susceptibility of Ae. albopictus adults to three pyrethroids (beta-cypermethrin, deltamethrin, and permethrin) was tested using the WHO tube assay, and Kdr mutations were identified via PCR and sequencing. The relationship between kdr mutations and pyrethroid phenotypes was also analyzed. Of the four populations, none was sensitive to any pyrethroid tested, and the YW population showed the strongest pyrethroid resistance. Non-synonymous kdr mutations were detected in codons 1532 and 1534, domain III. At codon 1534, one mutant allele, TCC(S), was detected in the four populations with a frequency of 42.08%, while at codon 1532, one mutant allele, ACC(T), was detected in the JX and QZ populations, with frequencies of 4.22 and 3.03%, respectively. The F1534S mutant allele was positively correlated with both beta-cypermethrin and deltamethrin resistance phenotypes (OR > 1, P < 0.05), whereas the I1532T mutant allele was possibly negatively correlated with beta-cypermethrin, deltamethrin, and permethrin resistance phenotypes (OR < 1, P > 0.05). In conclusion, resistance and resistance mutations regarding to three pyrethroids are already present in the Ae. Albopictus populations from Zhejiang, central China, which prompts the need to use non-insecticide-based methods of insect control.

Comparison of Immediate and Sequential Withdrawal of a Systemic Glucocorticoid in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Multicenter, Randomized, Double-Blind, Parallel-Controlled, Open-Label Study

Patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) were treated with immediate or sequential withdrawal after 5 days of systemic glucocorticoids. The effects of the two withdrawal methods on the prognosis of patients were compared at 30, 90, 180, and 360 days after discharge. A multicenter, randomized, double-blind, parallel-controlled, open-label study was conducted in the respiratory department of tertiary hospitals in Central China. Patients met inclusion criteria for AECOPD and needed to use systemic glucocorticoids. They were randomly assigned to immediate and sequential withdrawal groups at a 1:1 ratio. The study was completed in August 2020 and is registered at the China Clinical Trials Registry (Chictr.org) (ChiCTR1800018894). According to general data and clinical characteristics, there were no statistically significant differences between the 329 patients in the immediate withdrawal group and the 310 patients in the sequential withdrawal group (P > 0.05). At the 30, 90, 180, and 360-days follow-up, the acute exacerbation frequency, rehospitalization rate, mortality, and intensive care unit (ICU) treatment rate were not significantly different between the immediate withdrawal group and sequential withdrawal group (P > 0.05). The modified Medical Research Council (mMRC) and COPD assessment test (CAT) scores were also not significantly different between the two groups. At the 180- and 360-day follow-up, forced expiratory volume in 1 s (FEV1%) and peak expiratory flow (PEF) were not significantly different between the two groups (P > 0.05). The time from discharge to first acute exacerbation was significantly lower in the immediate withdrawal group (46.12 days) than in sequential withdrawal group (49.02 days) (P < 0.05). The time of stay in the hospital for the first time after discharge was not significantly different between the two groups (P > 0.05). Adverse events were not significantly different between the immediate withdrawal group and sequential withdrawal group (P < 0.05). Subgroup analysis was performed according to age, degree of disease, and relevant indicators. At the 30-day follow-up, the acute exacerbation frequency of patients with advanced age, high global strategy for chronic obstructive lung disease (GOLD), and high fractional exhaled nitric oxide was significantly higher in the immediate withdrawal group than in the sequential withdrawal group (P < 0.05). In addition, according to receiver operating characteristic (ROC) curve analysis, the frequency of acute exacerbations at the 30-day follow-up was significantly higher in patients with age > 63.5 years or GOLD > 3 in the immediate withdrawal group than in the sequential withdrawal group, suggesting that the short-term efficacy was poor.

Assessment of Elemental Components in Atmospheric Particulate Matter from a Typical Mining City, Central China: Size Distribution, Source Characterization and Health Risk

Atmospheric particulate matters in nine size fractions were sampled at Huangshi city, Hubei province. Elemental concentrations occurred unimodal size distribution for Zn, Pb and Ni, dimodal distribution for Ca, S, Fe and Ti, and trimodal distribution for Cl, K, Mn, Cu and Cr. Enrichment factor and principal component analysis identified the main sources from crustal material, biomass burning, waste incineration, vehicular and industrial emission. As for the non-carcinogenic health risk through inhalation, there were certain potential risks for Mn and Sb for children, and Pb for children and adults in PM_2.5. It showed certain potential risks for Mn, Sb and Pb for children and adults in PM₁₀. As for the carcinogenic health risk through inhalation, Cr in PM_2.5 and Ni, Co and Cr in PM₁₀ indicated unacceptable risk for children and adults. Meanwhile, Co and Ni in PM_2.5 represented acceptable risk for children.

From Plasmodium vivax outbreak to elimination: lessons learnt from a retrospective analysis of data from Guantang

BACKGROUND

Malaria was once a serious public health problem in China, with Plasmodium vivax the major species responsible for more than 90% of local transmission. Following significant integrated malaria control and elimination programmes, malaria burden declined, and since 2017 China has not recorded any indigenous case. To understand the historical malaria transmission patterns and epidemic characteristics in China and insights useful to guide P. vivax malaria control and elimination elsewhere, a retrospective study was carried out.

METHODS

Historical data from a pilot study conducted in Guantang, Luyi in central China from 1971-1995, were digitized. The data included monthly numbers of reported cases, febrile cases, parasite carriage rates, the neonatal infection rate, and entomological data regarding Anopheles sinensis.

RESULTS

Following 25 years of continuous integrated malaria control activities, malaria incidence in Guantang decreased from 4,333 cases per 10,000 in 1970 before integrated implementation to 0.23 cases per 10,000 in 1991, and no cases in 1992-1995. Some fluctuations in incidence were observed between 1977 and 1981. During the period parasite rates, antibody levels and the neonatal infection rate also decreased. The pattern of seasonality confirmed that P. vivax in Henan Province was primarily of the long incubation type (temperate) during non-transmission period. The findings retrospectively provide a scientific basis for the implementation of mass campaigns of liver stage hypnozoite clearance. Entomological studies indicated that An. sinensis was the only vector, and it preferred bovine to human hosts, predominantly biting and resting outdoors. Mosquito densities declined between 1971 and 1984.

CONCLUSION

The integrated malaria control approach in Guantang effectively controlled malaria and achieved elimination. Analysis of the effectiveness of the programme can provide guidance to other regions or countries with similar ecological settings aiming to move from malaria control to elimination. There is a potential challenge in the maintenance of non-transmission status owing to imported cases and the long dormancy of liver stage hypnozoites.

Seasonal characterization of aerosol composition and sources in a polluted city in Central China

We characterized the aerosol composition and sources of particulate matter (PM) in Sanmenxia, a polluted city located in the Fen-Wei Plain region of Central China. The PM_2.5 concentration decreased by 18% from 72 μg m^-3 in 2014 to 59 μg m^-3 in 2019. All chemical species presented pronounced seasonal variations, with their highest concentrations in winter due to enhanced emissions and the frequent stagnant meteorological conditions. Nitrate was the major fraction of PM_2.5 during all seasons (35-41%) except summer (25%), while sulfate was a dominant species in summer (29%) compared to other seasons (16-18%) from July 2018 to June 2019. The detailed analysis of a wintertime severe haze episode that lasted for approximately half a month demonstrated that secondary aerosols, including secondary organic aerosol, sulfate, nitrate, and ammonium, contributed 89% to non-refractory PM₁ (NR-PM₁), indicating the remarkable role of secondary aerosol formation in air pollution in Sanmenxia. Positive matrix factorization analysis further showed considerably enhanced low-volatility oxygenated organic aerosol (OA) and hydrocarbon-like OA during severe haze episodes, while significant contributions in semi-volatile oxygenated OA and coal combustion OA during clean periods. Severe pollution events in the city were generally associated with air masses from the southwest, and we also found that aerosol species, especially secondary aerosol species, showed distinct forenoon increases that were caused by the subsidence of air pollutants aloft. Our results highlight that future air quality improvement would benefit substantially from a more efficient control of gaseous precursors, particularly the NO_x emissions from industry and vehicle emissions.

Phthalate esters contamination in vegetable-soil system of facility greenhouses in Jingmen, central China and the assessment of health risk

Residual levels of six priority phthalate esters (PAEs) compounds in top soils and vegetables of 40 selected greenhouses in two typical facility vegetable greenhouse production areas of Jingmen (Hubei, central China) were determined. Total concentrations of six target PAEs (Σ6PAEs) in 72 vegetable and 40 soil samples ranged from 862 ± 209 to 4260 ± 385 µg kg^-1 (dry weight, DW), and from 1122 ± 156 to 4134 ± 272 µg kg^-1 (DW), respectively. Di-n-butyl phthalate and di-(2-ethylhexyl) phthalate (DEHP) are the two most frequently and massively detected in all samples. The highest Σ6PAEs appeared in leaf samples of Tuanlin, vegetable fruits of Zhongxiang and soils of Tuanlin. No carcinogenic risk was posed based on the results of health risk assessment, but non-carcinogenic risk of DEHP to children less than 6 years old in Tuanlin (all 24 sampling sites) and Zhongxiang (4/16 sampling sites) and people older than 6 years old in Tuanlin (19/24 sampling sites) were achieved from hazard quotient values. The contamination risk problem of PAEs in Tuanlin deserves greatest concern in Jingmen. Combined with the results of our former study, the health risks of target pollutants were clarified and the lack of survey data on PAE concentrations in facility vegetable greenhouses of central China was filled in. Due to high residuals and significant non-carcinogenic risk values, DEHP should be nominated as priority PAEs in China. Our study suggested better regulation for PAEs control in intensively managed greenhouses and references for revision of Chinese environmental standards.

Effects of climate warming and nitrogen deposition on subtropical montane ponds (central China) over the last two centuries: Evidence from subfossil chironomids

Many remote montane ecosystems are experiencing biogeochemical changes driven by warming climate and atmospheric pollution. Compared with circumpolar and temperate lakes, the responses of subtropical montane lakes to these external stressors have been less investigated. Here we present sedimentary multi-proxies records (i.e. chironomids, elements and stable isotope of carbon and nitrogen) in ²¹⁰Pb-dated cores from two montane ponds (central China). Before the 1900s, low biomass and the dominance of opportunistic species (e.g. Chironomus anthracinus-type) in both ponds might be in response to cold and harsh condition. Thereafter, chironomid communities in both ponds experienced pronounced shifts. Nutrient-tolerant/warm-adapted species (e.g. Chironomus sp., Polypedilum nubeculosum-type and Endochironomus impar-type) proliferated and biomass increased synchronously after the 1900s, suggestive of favorable condition for chironomid growth. Redundancy analyses revealed that changes in chironomid communities in both ponds were significantly correlated with rising temperature and δ¹⁵N depletion. Prolonged growing season and nitrogen subsidy would increase primary productivity, and hence enhancing food availability for chironomids. Catchment-mediated indirect effects of warming and nitrogen deposition, such as hydrological changes and terrestrial organic matter inputs, would impose further influences on chironomid communities. Taken together, the combined effects of climate warming and nitrogen deposition have caused significant shifts in primary consumers of these montane ponds, and imposed cascading effects on structure and function of subtropical montane aquatic ecosystems.

Effects of long-term straw retention on soil microorganisms under a rice-wheat cropping system

The objective of this study was to investigate how straw-incorporating practices affect bacterial communities and carbon source utilization capacity under a rice-wheat rotational farming practice in central China. To clarify the effect of long-term straw incorporation in microbial abundance and carbon metabolism, a long-term field experiment was initiated in May 2005 (rice-planting season). Soil bacterial communities were revealed by high-throughput sequencing technology. After ten cycles of annual rice-wheat rotation (2005-2015), 2 M (straw incorporation) and 2 M + NPK (high straw incorporation + chemical fertilizer) treatments had significantly more bacterial phyla compared with CK (non-fertilization) and NPK (chemical fertilizer) treatments. Taxonomic analysis revealed that 2 M and NPK + 2 M treatments had a significantly greater abundance of microbial communities, especially the Gemmatimonadetes, Acidobacteria, Firmicutes, and Actinobacteria. In the NPK versus 2 M, 2 M treatment had a significantly greater abundance of Rozellomycota (P < 0.05). In the NPK + 2 M versus NPK, NPK + 2 M treatment also had significantly greater abundance of Ascomycota (P < 0.05). Principal component analysis (PCA) analysis showed that 2 M treatment was separate from other treatments. Using biolog-ECO method, the metabolic diversity and functional characteristics of microbial communities were used to indicate the ability of microorganisms to utilize carbon source. The carbon utilization ability of soil microorganisms in 2 M + NPK treatment was significantly higher than that of CK treatment (P < 0.05). The utilization ability of carboxylic acids, polymers, and other mixtures of carbon sources in 2 M treatment was higher than those of other treatments. These findings suggest that long-term straw incorporation affects the abundance and carbon utilization ability of soil microorganisms within 0-20 cm soil depths, among which, Gemmatimonadetes, Firmicutes, and Actinobacteria may play crucial roles in bacterial communities and carbon source utilization capacity.

Toxocara infection: seroprevalence and associated risk factors among primary school children in central China

Toxocariasis is a zoonotic disease that poses a threat to public health worldwide. In the present study, we investigated the seroprevalence of Toxocara infection among primary school children in Henan province, central China, which was previously unknown. Sera from 2451 primary school children were collected from September 2015 to October 2018, and evaluated for anti-Toxocara antibodies by enzyme-linked immunosorbent assay (ELISA). The overall seroprevalence of Toxocara infection was 5.14% (126/2451). The main risk factors related to Toxocara infection identified in this study were the age of children, residence area of children, contact with cats or dogs, and exposure to soil. Hand washing before eating was considered to be a protective factor. These findings demonstrate that Toxocara infection is relatively common among primary school children in Henan province.

Seroprevalence and risk factors of Toxoplasma gondii infection in primary school children in Henan province, central China

Toxoplasma gondii is an obligate intracellular protozoan parasite with global distribution. However, data on T. gondii infection among children in primary school in Henan province, central China were lacking. In this study, 2451 serum samples of primary school children in this province were collected from September 2015 to October 2018 and evaluated for T. gondii antibodies using an enzyme-linked immunosorbent assay (ELISA). The overall seroprevalence was 9.51% (233/2451), of which 7.59% (186/2451) showed IgG positivity, 0.73% (18/2451) IgM and 1.18% (29/2451) both. The main risk factors related to T. gondii infections were the age of children, residence area, contact with cats, and exposure to soil. Moreover, hand washing before eating was considered a protective factor. Seroprevalence of T. gondii infection among the study population was common, emphasizing the need to prevent and control this infection. This is the first report of T. gondii seroprevalence in primary school children in Henan province, central China.

Application of a universal soil extractant for determining the available NPK: A case study of crop planting zones in central China

Being important parameters of crop growth the precise measurements of available nitrogen (N), phosphorus (P) and potassium (K) on site not only help the farmer to control his budget but also helps to keep the environmental pollution under control. Currently, the existing extractant cannot be applied to rapidly determine the concentrations of available NPK by soil chemical analysis methods, simultaneously. In the present paper, a universal extraction reagent consisting of 0.45 M NaHCO₃ and 0.374 M Na₂SO₄ buffered at pH 8.5 in association with a portable multi-channel photoelectric system has been proposed. The present method provides the most useful indication for the rapid determination of available NPK concentrations in neutral and calcareous soil in field. A large number of soil samples were collected from crop planting zones in Henan province of central China for evaluating the effectiveness of this universal extractant. A portable multi-channel photoelectric system associated with this universal soil extractant was exclusively designed to provide reliable and reproducible available NPK concentrations in soil extracts. The experimental results showed that available NPK concentrations determined by this method are highly correlated with the laboratory-based methods. A '3414' fertilizer scheme was applied to optimize the fertilizer recommendation for achieving the high targeted yield. The recommendation fertilizer system worked with a high correlation coefficient and fertilizer utilization rate has been established by this '3414' fertilizer scheme. With advantage of portability, accuracy and low cost, the proposed method can help to cut down the economic burden of the farmer and also it helps to optimize the utilization of the fertilizers by limiting its excessive usage and hence control the environmental pollution.

Distribution characteristics and noncarcinogenic risk assessment of culturable airborne bacteria and fungi during winter in Xinxiang, China

Bioaerosols are an important component of particulate matter in the atmosphere and are harmful to human health. In this study, the concentration, size distribution, and factors influencing culturable airborne bacteria and fungi in the atmosphere were investigated using a six-stage impactor device in the city of Xinxiang, China, during the winter season. The results revealed that the concentration of culturable airborne bacteria and fungi varied significantly during the sampling period: 4595 ± 3410 and 6358 ± 5032 CFU/m³, respectively. The particle sizes of the bioaerosols were mainly within stage V (1.1-2.1 μm), and fine particulate matter accounted for 45.9% ± 18.9% of airborne bacteria and 52.0% ± 18.5% of airborne fungi, respectively. With the deterioration of air quality, the concentration of airborne fungi gradually increased, and that of airborne bacteria increased when the air quality index was lower than 200 and decreased when it was higher than 200. With respect to the diurnal variation pattern of bioaerosol concentration, the highest and lowest concentrations were registered at night and noon, respectively, probably because of changes in ultraviolet radiation intensity. Bioaerosol concentration positively correlated with humidity, concentration of PM_2.5, PM₁₀, SO₂, and NO₂ and negatively correlated with O₃ concentration. The risk of exposure of humans to the airborne bacteria was primarily associated with the respiratory inhalation pathway, and the risk of skin exposure was negligible. These results should improve our understanding of the threat of bioaerosols to public health.

Stable H-O Isotopic Composition and Water Quality Assessment of Surface Water and Groundwater: A Case Study in the Dabie Mountains, Central China

In order to understand the water cycle and assess the water quality for irrigation purposes in the Upper Pi River Basin (UPRB), which is the northern slope of the Dabie Mountains, 68 surface water and groundwater samples were collected and analyzed for H-O isotopes and hydrochemistry during the high-flow season in 2017 and 2018. The results show that ranges of hydrogen and oxygen isotopic composition (δ²H: −68.8‰ to −40.8‰, δ¹⁸O: −10.05‰ to −5.05‰) are controlled by the medium latitude and high altitude of the UPRB. Among different types of water, the δ²H and δ¹⁸O values can be ordered as follows: reservoir water < spring water ≈ river water < pond water. The water of the upstream medium and small reservoir is enriched with lighter isotopes that is likely related to more exchange with rainwater and less residence time; however, large reservoirs are similar to the upstream river and spring in terms of the H-O isotopic composition. Hydro-chemical facies are dominated by the Ca-HCO₃ type in the UPRB, which reflects fresh recharged water from rainfall, and few samples are of the Ca-Cl type that is caused by intensive evaporation. The water quality for irrigation purposes was also evaluated. According to the Wilcox diagram, United States Salinity Laboratory (USSL) diagram, magnesium hazard, and Kelly’s ratio, all water samples have been considered suitable for irrigation water.

Antimicrobial resistance trends in bloodstream infections at a large teaching hospital in China: a 20-year surveillance study (1998-2017)

Background

Bacterial bloodstream infections (BSIs) cause high morbidity and mortality worldwide in humans, but the pathogenic spectrum varies from region to region. Long-term monitoring of the pathogenic spectrum and changes in bacterial antibiotic resistance is hugely important for effective clinical therapy and infection control. This study examined the data for BSIs in Tongji Hospital, one of the largest teaching hospitals in China, in an attempt to gain better understanding of bacterial antibiotic resistance in China, focusing on central China.

Methods

Data from Tongji Hospital for a 20-year period (1998–2017) were used for a retrospective analysis to understand the pathogenic spectrum of BSIs and the changes occurring in antimicrobial resistance in central China. The disk diffusion and E test methods were used for antimicrobial susceptibility testing according to Clinical & Laboratory Standards Institute methodologies, and the data were analyzed by WHONET 5.6 software.

Results

The isolated pathogens mainly came from hospitalized patients not treated in intensive care units (ICUs), and accounted for 81.5% of the total (9130/11200). The most common Gram-negative and Gram-positive bacterial BSI-causing pathogens were Escherichia coli and Staphylococcus aureus, respectively. The detection rate for methicillin-resistant S. aureus (MRSA) in the hospitalized non-ICU patients increased from 8.4% in 1998–2002 to 63% in 2013–2017, while the detection rate for carbapenem-resistant (CR) Klebsiella pneumoniae was below 5% in 1998–2012 but increased to 34.9% in 2013–2017. In contrast, worryingly, the detection rate for CR K. pneumoniae in ICU patients increased from 0% in 2013 to 75% in 2016. E. coli displayed the highest sensitivity rates to imipenem, meropenem and amikacin, all of which were > 90%, followed by cefoxitin at > 80%, and cefoperazone/sulbactam at > 70%. K. pneumoniae isolates were most sensitive to imipenem, meropenem and amikacin antibiotics, with sensitivity rates exceeding 60%. S. aureus isolates were most sensitive to vancomycin, teicoplanin and trimethoprim/sulfamethoxazole, with sensitivity rates exceeding 90%.

Conclusions

BSIs caused by CR K. pneumoniae clearly posed a severe challenge to infection control and treatment of ICU and non-ICU patients in this retrospective study, while MRSA was an issue for non-ICU patients.

Assessment of Air Pollution Aggravation during Straw Burning in Hubei, Central China

Crop straw burning frequently occurs in Central China, where agriculture is highly productive. We carried out a two-month observation on straw burning in Hubei Province from September 1 to October 31, 2015 to track the variations of air pollutants and comprehensively quantify their influence on regional air quality. Results showed that the concentration of suspended particles (particles smaller than 2.5 or 10 µm, i.e., PM_2.5/PM₁₀) and gas pollutants including ozone (O₃), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), and carbon monoxide (CO) was significantly enhanced with the increasing number of fire spots. The average daily concentrations of PM₁₀, PM_2.5 and O₃ during the intensive burning period (from October 12 to 25) exceeded the daily limits published by the World Health Organization (WHO) by 101.8, 72.7 and 59.1 μg/m³, respectively. In the hourly distribution of pollutant concentration, PM_10, PM_2.5, O₃, SO₂, NO₂ and CO were 63.49%, 46.29%, 65.56%, 64.40%, 48.57% and 13.49% higher during burning periods than during non-burning periods. Statistical results based on the air quality index (AQI) indicated that biomass burning was the key factor for the deterioration of local air quality, with a contribution ratio exceeding 41%. Additionally, the pollutants were more spatially homogeneous during the burning period than during the non-burning period. Straw burning not only worsened the local air quality but also raised the pollution level of surrounding regions due to the transport of air mass.

Source tagging modeling study of heavy haze episodes under complex regional transport processes over Wuhan megacity, Central China

Wuhan as a megacity of Central China was suffering from severe particulate matter pollution according to previous observation studies, however, the mechanism behind the pollution formation especially the impact of regional chemical transport is still unclear. This study, carried out on the Nested Air Quality Prediction Modeling System (NAQPMS) coupled with an on-line source-tagging module, explores different roles regional transport had in two strong haze episodes over Wuhan in October 2014 and quantitatively assesses the contributions from local and regional sources to PM_2.5 concentration. Validation of predictions based on observations shows modeling system good skills in reproducing key meteorological and chemical features. The first short-time haze episode occurred on 12 October under strong northerly winds, with a hourly PM_2.5 peak of 180 μg m^-3, and was found to be caused primarily by the long-range transport from the northern regions, which contributed 60.6% of the episode's PM_2.5 concentration (versus a total of 32.7% from sources in and near Wuhan). The second episode lasted from the 15-20 October under stable regional large-scale synoptic conditions and weak winds, and had an hourly PM_2.5 peak of 231.0 μg m^-3. In this episode, both the long-distance transport from far regions and short-range transport from the Wuhan-cluster were the primary causes of the haze episode and account for 24.8% and 29.2% of the PM_2.5 concentration respectively. Therefore, regional transport acts as a crucial driver of haze pollution over Wuhan through not only long-range transfer of pollutants, but also short-range aerosol movement under specific meteorological conditions. The present findings highlight the important role of regional transport in urban haze formation and indicate that the joint control of multi city-clusters are needed to reduce the particulate pollution level in Wuhan.

Occurrence and air-soil exchange of organochlorine pesticides and polychlorinated biphenyls at a CAWNET background site in central China: Implications for influencing factors and fate

Ambient air and soil samples were collected between March 2012 and March 2013 at Jinsha, a regional background site in central China, to measure the concentrations of organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs). The average concentrations of total OCPs and total PCBs were 191 ± 107 and 39.4 ± 27.1 pg/m³ in air (gaseous and particulate phase) and 0.585 ± 0.437 and 0.083 ± 0.039 ng/g in soil, respectively. The higher concentrations of p,p'-dichlorodiphenyltrichloroethane (p,p'-DDT) and p,p'-DDT/p,p'-DDE ratios in the soil indicated recent p,p'-DDT input to the soil. A strong positive temperature dependence and average fugacity fraction value > 0.5 were observed for p,p'-DDT, suggesting that volatilization of residual DDT in the soil was the main influencing factor on atmospheric p,p'-DDT. Highly average fugacity fractions (>0.7) of trans-chlordane (TC) and cis-chlordane (CC) and high TC/CC ratios both in the soil and atmosphere suggested fresh inputs. Higher gaseous concentrations of hexachlorobenzene (HCB) were observed in winter and negative temperature dependence was directly attributed to the surrounding ongoing source (e.g. fuel consuming activities), especially in winter. Overall, most targeted OCPs and PCBs were influenced by long-range transport, and fugacity fraction values indicated highly volatile compounds (e.g. α-hexachlorocyclohexane (α-HCH) and lower chlorinated PCBs) were volatilized and low volatility compounds (e.g. p,p'-DDE and higher chlorinated PCBs) were deposited at the air-soil interface. Knowing the source and sink of OCPs and PCBs can help to control their pollution in this area and provide a reference for other studies.

Prehypertension and its optimal indicator among adults in Hubei Province, Central China, 2013-2015

BACKGROUND

Hypertension accounts for 7% of the annual global disease burden, despite great efforts to counter this trend. Thus, interventions targeted at prehypertension might lead to a breakthrough for hypertension prevention. This study focused on the prevalence of prehypertension among adults in Central China and the best indicator of prehypertension, which would provide the basis for future interventions.

METHODS

This cross-sectional study was conducted using multistage stratified random sampling in seven counties in Hubei Province. Data from 30,634 survey respondents were analyzed using logistic regression and receiver operating characteristic (ROC) curve statistical tests, for the prevalence of prehypertension and the predictive ability of body mass index (BMI), waist-to-height ratio (WHtR), and waist circumference (WC) for prehypertension.

RESULTS

The prevalence of prehypertension in adults was 42.2%. The following factors contributed to the risk of prehypertension: male sex, elder age, divorce/separation, drinking, heavy labor intensity, and high BMI (p < 0.05). Being a farmer and exercise exhibited positive associations with prehypertension (p < 0.05). Compared with BMI and WHtR, WC had a higher predictive value for prehypertension (area under ROC curve, AUC = 0.630, 95% confidence interval: 0.623-0.637, p < 0.0001), especially for men. The optimal cutoffs of WC for prehypertension were 79.95 cm in men and 76.85 cm in women.

CONCLUSIONS

The prehypertension rate in adults was high in Central China. Significant factors related to hypertension were identified. More interventions targeting individuals with WC above the cutoff level are needed for timely awareness of prehypertension and early prevention of hypertension.

Molecular epidemiology of porcine reproductive and respiratory syndrome virus in Central China since 2014: The prevalence of NADC30-like PRRSVs

Porcine reproductive and respiratory syndrome (PRRS), characterized by respiratory disorders in piglets and reproductive failure in sows, is still the great threat of swine industry. Recently, Emergence of the novel NADC30-like PRRS viruses (PRRSVs) has caused widespread outbreaks of PRRS. To investigate the epidemic characteristics of PRRSVs in Central China since 2014, 6372 clinical serum samples were tested by ELISA, 250 tissue samples were tested by RT-PCR, and among these, 30 ORF5 and 17 Nsp2 genes sequences were analyzed. Phylogenetic tree based on ORF5 revealed that, 17 isolates were clustered into subgroup 1, represented by the NADC30. And for the Nsp2, The strains which had a discontinuous 131-amino-acid deletion in Nsp2, called NADC30-like strains, were clustered into subgroup 2. Our data suggested that the NADC30-like PRRSV strains spread quickly and are now circulating and prevalent in Central China as well as the classical HP-PRRSV strains. In addition, amino acid variation analysis of GP5 revealed that the amino acid sequences of NADC30-like PRRSV strains underwent rapid evolution and contained extensive amino acid substitutions in important motifs, such as potential neutralization epitope and the N-glycosylation sites. In summary, our data would provide a large amount of detailed information on molecular variation and genetic diversity of PRRSV in central China.

A neglected risk for sparganosis: eating live tadpoles in central China

A 29-year-old farmer from central China was sent into the Emergency Department of the Affiliated Hospital of Zhengzhou University. He had a 15-day history of persistent high fever, abdominal distention and pain. The patient was clinically diagnosed as appendicitis and peritonitis, and treated with antibiotics in a local hospital, did not improve. On exploratory laparotomy, the appendicular perforation and peritonitis were seen; appendicectomy were performed, and antibiotics were given. However, high fever and abdominal pain still persisted; intestinal adhesion and obstruction, ascites appeared. He was given the “critically ill notice”. He had eosinophilia (12.95%) and the history of eating live frog tadpoles for treating his cutaneous pruritus 3 days before onset of the disease. Serum anti-sparganum antibodies assayed by ELISA were positive. This patient has hospitalized for one and half months and spend more than US$ 12 000. This patient was primarily diagnosed as visceral sparganosis, and cured with praziquantel.

Sparganosis is one neglected but important parasitic zoonosis of poverty. Human infections were mainly acquired by eating raw or uncooked meat of frogs and snakes infected with plerocercoids, using frog or snake flesh as poultices, or drinking raw water contaminated with infected copepods. However, sparganosis caused by ingestion of live tadpoles are emerging in central China. Our surveys showed that 11.93% of tadpoles in Henan province are infected with plerocercoids. Eating live tadpoles is a high risk for sparganum infection. The comprehensive public health education should be carried out for people in endemic areas and the bad habit of eating live tadpoles must be discouraged.

Evaluation of biometry and corneal astigmatism in cataract surgery patients from Central China

Background

To evaluate the distribution of biometric parameters and corneal astigmatism using the IOLMaster device before phacoemulsification in cataract patients in Central China.

Methods

Consecutive cataract patients were recruited at the Central Hospital of Wuhan between January 2015 and June 2016. Ocular axial length (AL), keratometry values, anterior chamber depth (ACD) and horizontal corneal diameter (white to white [WTW]) of each cataract-affected eye were measured with the IOLMaster device.

Results

The study evaluated 3209 eyes of 2821 cataract patients. The mean AL, ACD, and WTW were 24.38 ± 2.47 mm, 3.15 ± 0.48 mm, and 11.63 ± 0.43 mm, respectively. Corneal astigmatism of 0.51–1.00 diopters (D) was the most common range of values (34.96%). A total of 10.56% patients exhibited a corneal astigmatism greater than 2.0 D. The flat and steep keratometry values gradually increased with age. The mean ACD and WTW showed increasing trends as the AL increased (P < 0.001). When the AL was shorter than 26.0 mm, the keratometry decreased as AL increased. The against-the-rule (ATR) astigmatism proportion increased with age and the with-the-rule (WTR) astigmatism proportion decreased with age.

Conclusions

The profile of ocular biometric data and corneal astigmatism may help ophthalmologists improve their surgical procedures and make an appropriate IOL choice to gain a high quality of postoperative vision.

February-May temperature reconstruction based on tree-ring widths of Abies fargesii from the Shennongjia area in central China

February-May temperature strongly affects ecological processes and socio-economics in central China, yet its long-term variability has not been thoroughly assessed due to the shortness of instrumental records. In order to improve the understanding of the regularities of temperature variability in central China, in this study, we present a new tree-ring chronology from the Shengnongjia Mountains in central China which provides a valuable 245-year record of temperature variability. The reconstructed temperature correlated strongly with February-May mean temperature records of the Fangxian meteorological station from AD 1958 to AD 2011, and the derived reconstruction explained 44.5 % of the instrumental temperature variation during this period. The study shows that this region experienced three warm periods and two cool periods, i.e., the major warm periods occurred in AD 1783-1806, AD 1879-1909, and AD 1975 to the present, whereas the cool intervals occurred in AD 1807-1878 and AD 1910-1974. This reconstruction could aid in the evaluation of regional climate variability in subtropical China.

Clinical and laboratory features, and quality of life assessment in wheat dependent exercise-induced anaphylaxis patients from central China

Wheat dependent exercise-induced anaphylaxis (WDEIA) is a rare but potentially severe food allergy caused by the combination of wheat ingestion and physical exercise. The impact of WDEIA on quality of life (QOL) is unclear. This study characterized the clinical and laboratory features and investigated the QOL in WDEIA patients from Central China. Twenty-eight WDEIA patients were analyzed, and QOL was measured by validated Chinese version Food Allergy Quality of Life Questionnaire-Adult Form (FAQLQ-AF) and Food Allergy Independent Measure (FAIM) after obtaining the diagnosis. The results showed that half of the patients were females. The median onset age was 37 years old. The symptoms occurred within 1 h after wheat ingestion (26/28). Symptoms of anaphylaxis included cutaneous (26/28), respiratory (11/28), gastro-intestinal (5/28) and cardiovascular manifestations (27/28). Skin prick tests were positive to salt soluble (89.3%) and salt insoluble wheat allergen extracts (100%). Positive rate to wheat, gluten and omega-5 gliadin specific IgE was 64.3%, 92.9% and 92.9% respectively. Specific IgE to omega-5 gliadin with a cut-off value 0.83 KU/L offered highly efficient diagnostic criterion for WDEIA (sensitivity: 89.3%; and specificity: 88.9%). The mean scores of FAQLQ-AF and FAIM were 4.70 and 4.98 respectively and level of anti-omega-5 gliadin IgE had positive correlations with FAQLQ scores. Thereby, WDEIA is commonly found in mid-age adults. In most cases, multi-organs especially skin and cardiovascular systems are involved. Salt insoluble wheat allergen skin test and serum specific IgE to gluten and omega-5 gliadin help to diagnose WDEIA. QOL in WDEIA patients is severely impaired.

Analysis of 4931 renal biopsy data in central China from 1994 to 2014

The purpose of this study is to investigate the changing spectrum and clinicopathologic correlation of biopsy-proven renal diseases in central China. We retrospectively analyzed data of 4931 patients who underwent renal biopsy in ten hospitals between September 1994 and December 2014. Among them, 81.55% were primary glomerular diseases (GD), and 13.02% were secondary GD. IgA nephropathy (IgAN) was the most common primary GD (43.45%), followed by focal glomerulonephritis (16.79%), mesangial proliferative glomerulonephritis (MsPGN, 14.35%), and membranous nephropathy (MN, 13.28%). IgAN was leading primary GD in patients under 60 years old, while MN was the leading one over 60 years old. The most frequent secondary GD was lupus nephritis (LN) (47.35%). The prevalence of IgAN, MN and minimal change disease was found to increase significantly (p < 0.001, p < 0.001, and p < 0.01, respectively), while that of MsPGN, membranoproliferative glomerulonephritis and LN decreased significantly (p < 0.001, p < 0.001, and p < 0.05, respectively). The main indication for renal biopsy was proteinuria and hematuria (49.03%), followed by nephrotic syndrome (NS, 20.36%). IgAN was the most common cause in patients with proteinuria and hematuria, chronic-progressive kidney injury, hematuria and acute kidney injury; and MN was the leading cause of NS. Primary GD remained the predominant renal disease in central China. IgAN and LN were the most prevalent histopathologic lesions of primary and secondary GD, respectively. The spectrum of biopsy-proven renal disease had a great change in the past two decades. Proteinuria and hematuria was the main indication for renal biopsy.