The crucial role of lateral root angle in enhancing drought resilience in cotton.

Introduction: Plant responses to drought stress are influenced by various factors, including the lateral root angle (LRA), stomatal regulation, canopy temperature, transpiration rate and yield. However, there is a lack of research that quantifies their interactions, especially among different cotton varieties. Methods: This experiment included two water treatments: well-watered (75 ± 5% soil relative water content) and drought stress (50 ± 5% soil relative water content) starting from the three-leaf growth stage. Results: The results revealed that different LRA varieties show genetic variation under drought stress. Among them, varieties with smaller root angles show greater drought tolerance. Varieties with smaller LRAs had significantly increased stomatal opening by 15% to 43%, transpiration rate by 61.24% and 62.00%, aboveground biomass by 54% to 64%, and increased seed cotton yield by 76% to 79%, and decreased canopy temperature by 9% to 12% under drought stress compared to the larger LRAs. Varieties with smaller LRAs had less yield loss under drought stress, which may be due to enhanced access to deeper soil water, compensating for heightened stomatal opening and elevated transpiration rates. The increase in transpiration rate promotes heat dissipation from leaves, thereby reducing leaf temperature and protecting leaves from damage. Discussion: Demonstrating the advantages conferred by the development of a smaller LRA under drought stress conditions holds value in enhancing cotton's resilience and promoting its sustainable adaptation to abiotic stressors.

Construction of a postoperative infection outbreak investigation form: A tool for early detection and control measures.

BACKGROUND: To develop an investigation form for postoperative infection outbreak (PIO), and to identify sources of the outbreak in the early stage. METHODS: After an exhaustive literature review, we used the Delphi method to determine the indicators and relative risk scores of the assessment tools through 2 rounds of specialist consultation and overall consideration of the opinions and suggestions of 20 specialists. RESULTS: A total of 203 studies of PIO were eligible for inclusion. The mean authority coefficient (Cr) was 0.87. Kendall's W coefficient of the specialist consultation was 0.704 after 2 rounds of consultation (P < .005), suggesting that the specialists had similar opinions. Based on 4 primary items and 19 secondary items of the source of PIO, and tripartite distribution characteristics of infected patients, we constructed the PIO investigation form. CONCLUSIONS: The PIO investigation form can be used in the investigation of the early-stage cluster of cases, it's a prerequisite for taking effective control measures, avoiding PIO occurrence. However, the effect of the investigation form needs to be further evaluated.

Screening and evaluation of drought resistance traits of winter wheat in the North China Plain.

Background: Drought-resistant varieties are an important way to address the conflict between wheat's high water demand and the scarcity of water resources in the North China Plain (NCP). Drought stress impacts many morphological and physiological indicators in winter wheat. To increase the effectiveness of breeding drought-tolerant varieties, choosing indices that can accurately indicate a variety's drought resistance is advantageous. Results: From 2019 to 2021, 16 representative winter wheat cultivars were cultivated in the field, and 24 traits, including morphological, photosynthetic, physiological, canopy, and yield component traits, were measured to evaluate the drought tolerance of the cultivars. Principal component analysis (PCA) was used to transform 24 conventional traits into 7 independent, comprehensive indices, and 10 drought tolerance indicators were screened out by regression analysis. The 10 drought tolerance indicators were plant height (PH), spike number (SN), spikelet per spike(SP), canopy temperature (CT), leaf water content (LWC), photosynthetic rate (A), intercellular CO2 concentration (Ci), peroxidase activity (POD), malondialdehyde content (MDA), and abscisic acid (ABA). In addition, through membership function and cluster analysis, 16 wheat varieties were divided into 3 categories: drought-resistant, drought weak sensitive, and drought-sensitive. Conclusion: JM418, HM19,SM22, H4399, HG35, and GY2018 exhibited excellent drought tolerance and,therefore, can be used as ideal references to study the drought tolerance mechanism in wheat and breeding drought-tolerant wheat cultivars.

Features of gastric cancer by anatomic subsite in northern China: A multi-center Health Science Report database study.

BACKGROUND: The features of gastric cancer based on the anatomic site remain unknown in northern China patients. AIM: To analyze gastric cancer features and associated trends based on the anatomical site in northern China patients. METHODS: This cross-sectional study used incident gastric cancer case data from 10 Peking University-affiliated hospitals (2014 to 2018). The clinical and prevailing local features were analyzed. RESULTS: A total of 10709 patients were enrolled, including antral (42.97%), cardia (34.30%), and stomach body (18.41%) gastric cancer cases. Cancer in the cardia had the highest male:female ratio, proportion of elderly patients, and patients with complications, including hypertension, diabetes, cerebrovascular, and coronary diseases (P < 0.001). gastric cancer involving the antrum showed the lowest proportion of patients from rural areas and accounted for the highest hospitalization rate and cost (each P < 0.001). The proportion of patients with cancer involving the cardia increased with an increase in the number of gastroesophageal reflux disease cases during the same period (P < 0.001). Multivariate analysis revealed that tumor location in the cardia increased the risk of in-hospital mortality (P = 0.046). Anatomical subsite was not linked to postoperative complications. CONCLUSION: The features of gastric cancer based on the anatomical site differ between northern China and other regions, both globally and within the country. Social factors may account for these differences and should affect policy-making and clinical practice.

Single irrigation at the four-leaf stage in the spring optimizes winter wheat water consumption characteristics and water use efficiency.

Water scarcity is a key constraint to crop production in North China Plain (NCP), which produces the majority of the country's winter wheat (Triticum aestivum L.). The objective of this three-year field study was to see whether and when irrigation one-time in spring improved grain productivity and water use efficiency. Four sets of irrigation were established at the 3-leaf visible stage (L3) and the L4, L5, and L6 stages. When irrigation time was postponed, the spike number, 1000-grain weight, and water consumption increased progressively, whereas grain yield, grain number, dry matter, harvest, and WUE grew, then dropped, and peaked at L4. The increased grain number can be attributed to the L4's higher daily water consumption and water consumption percentage throughout the jointing-anthesis stages compared to the L3, L5, and L6. The cumulative (37 days), whereas it was longer in L3, L5, and L6(40, 42, and 43 days, respectively). Furthermore, flag leaf senescence was postponed in L4 with a higher post-anthesis leaf area index, photosynthetic rate, chlorophyll content, higher superoxide dismutase activity, and lower malondialdehyde concentration. As a result, single irrigation at the 4-leaf visible stage optimized water deficit and consumption before and after anthesis, resulting in higher yield and WUE in the NCP.

A Cross-Sectional Study of Breast Cancer Surgery and the Cost Based on Data From 77 Chinese 3A Hospitals in 2015.

Purposes: We aimed to clarify the real-world status of breast cancer surgery and the cost in China. Methods: This cross-sectional survey relied on data obtained from the hospitalization summary reports (HSRs) in 77 top-ranked (grade 3A) hospitals in China to analyze breast cancer patients who underwent surgery between January 2015 and December 2015. The surgery and cost were mainly evaluated. Results: Overall, 31,900 breast cancer patients underwent surgeries in 77 hospitals. The mean age in our study was 51.5 years (SD, 11.7 years). The primary types of surgical procedures were mastectomy (n = 24,629, 77.2%) and breast-conserving surgery (6,210, 19.5%). The rate of mastectomy was the highest at age band 50-65 years (n = 10,861, 82.1%) and in non-first-tier cities (n = 7,651, 88.4%) as well as in Northeast China (n = 3,107, 93.2%). The rate of breast-conserving surgery was less than 10% in non-first-tier cities (9.8%), Southwest China (6.1%), and Northeast China (5.8%). The median cost was $3,352.4 (interquartile range (IQR), $2,492.6-4,588.0). Mastectomy cost was significantly higher than breast-conserving surgery cost in both different city tiers and regional distribution except Northeast China (p < 0.001). Conclusions: This study demonstrated that the main breast cancer surgery in Chinese 3A hospitals was mastectomy and that the cost varied both across and within geographic regions and city tiers. This information helps describe the real-world status of breast surgery and the cost in China.

Rehydration Compensation of Winter Wheat Is Mediated by Hormone Metabolism and De-Peroxidative Activities Under Field Conditions.

Water deficit and rehydration frequently occur during wheat cultivation. Previous investigations focused on the water deficit and many drought-responsive genes have been identified in winter wheat. However, the hormone-related metabolic responses and de-peroxidative activities associated with rehydration are largely unknown. In this study, leaves of two winter wheat cultivars, "Hengguan35" (HG, drought-tolerant cultivar) and "Shinong086" (SN, drought-sensitive cultivar), were used to investigate water deficit and the post-rehydration process. Rehydration significantly promoted wheat growth and postponed spike development. Quantifications of antioxidant enzymes, osmotic stress-related substances, and phytohormones revealed that rehydration alleviated the peroxidation and osmotic stress caused by water deficit in both cultivars. The wheat cultivar HG showed a better rehydration-compensation phenotype than SN. Phytohormones, including abscisic acid, gibberellin (GA), jasmonic acid (JA), and salicylic acid (SA), were detected using high-performance liquid chromatography and shown to be responsible for the rehydration process. A transcriptome analysis showed that differentially expressed genes related to rehydration were enriched in hormone metabolism- and de-peroxidative stress-related pathways. Suppression of genes associated with abscisic acid signaling transduction were much stronger in HG than in SN upon rehydration treatment. HG also kept a more balanced expression of genes involved in reactive oxygen species pathway than SN. In conclusion, we clarified the hormonal changes and transcriptional profiles of drought-resistant and -sensitive winter wheat cultivars in response to drought and rehydration, and we provided insights into the molecular processes involved in rehydration compensation.

Features of colorectal cancer in China stratified by anatomic sites: A hospital-based study conducted in university-affiliated hospitals from 2014 to 2018.

OBJECTIVE: The clinical and biological characteristics of colorectal cancer have been found to differ depending on the anatomic site of the cancer. However, for Chinese patients, there is limited information on the proportion of cases at each site and the related features. In this study, we explored the location, distribution and other features of colorectal cancers at each anatomic site in Chinese patients. METHODS: We conducted a hospital-based study using hospitalization summary reports from 10 Peking University-affiliated hospitals from 2014 to 2018; the reports covered a total of 2,097,347 hospitalizations. Incident cases were chosen as the study population, and their epidemiological features were further analyzed. RESULTS: A total of 20,739 colorectal cancer patients were identified. Rectum was the most common location (48.3%) of the cancer, whereas the proportions of patients with distal and proximal colon cancer were 24.5% and 18.6%, respectively. Patients with rectal cancer were predominantly male and were the youngest for all anatomical sites (each P<0.001). The highest proportion of emergency admissions, the longest hospital stays and the highest hospitalization costs were found in patients with proximal colon cancer (each P<0.001). The proximal colon cancer subgroup included the highest proportions of patients with medical histories of cholecystectomy, cholecystolithiasis and/or gallbladder polyps and appendectomy (P=0.009, P<0.001 and P<0.001, respectively). The distal colon cancer subgroup included the highest proportions of patients with medical histories of diabetes and hypertension (P<0.001, respectively). CONCLUSIONS: The patterns of colorectal cancer observed in this study differ from those reported for Western patients and show a significantly higher proportion of patients with rectal cancer. Different epidemiological features were also found based on anatomic sites. Further studies based on tumor location should be conducted to facilitate more accurate screening and treatment.

Acute kidney injury in solitary kidney patients after partial nephrectomy: incidence, risk factors and prediction.

BACKGROUND: To analyze the incidence and risk factors of acute kidney injury (AKI) after partial nephrectomy (PN) in patients with solitary kidney, and to build AKI prediction models using logistic regression and machine learning (ML) approaches. METHODS: Clinical data of 87 solitary kidney patients with renal mass who received PN from January 2003 to March 2019 were collected. The diagnosis of AKI was based on KDIGO criteria. Logistic regression analysis and ML method were used to build prediction models. RESULTS: AKI developed in 52 (59.8%) patients. The logistic regression model had three variables: ischemia time (P=0.003), surgery time (P=0.001) and preoperative fasted blood glucose level (FBG) (P=0.049). The area under curve (AUC) was 0.826, with the specificity and sensitivity of optimal threshold value 82.9% and 69.2%. The ML model had the following variables: ischemia time, surgery time, age, FBG, mean arterial pressure (MAP), colloid, crystalloid, etc. XGBoost model has the best prediction performance. The AUC was 0.749, lower than that of the logistic regression model with no statistical difference (P=0.258), with the specificity and sensitivity 62.9% and 84.6%, respectively. CONCLUSIONS: The incidence of AKI after PN in patients with a solitary kidney was relatively high, it was associated with longer ischemia time, surgery time and higher FBG level, etc. The performance of ML model had no significant difference with logistic regression model. Prospective studies with larger sample sizes are awaited to test and verify our research findings.

Association between ambient air pollution and hospital admission for epilepsy in Eastern China.

BACKGROUND: We aimed to study the short-term association between air pollutants and hospitalization for epilepsy in 47 hospitals from 10 cities in eastern China. METHOD: We identified hospital epilepsy admissions in 2014 and 2015. A conditional Poisson regression model was used to examine the association between air pollutants and hospital admission, with temperature and relative humidity adjusted using the natural spline (ns) function. Pollutants included sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and particulate matter (PM). The association was stratified by sex, age, and geographic region in single-pollutant and two-pollutant models. RESULTS: An interquartile (IQR) increase of NO2 and CO on the concurrent day is correlated with an increased admission of 2.0% (0.5%, 3.6%) and 1.1% (0.1%, 2.1%), respectively. The association is stronger in children (≤18 years) and in northern China, but did not vary with sex. A positive association was also observed on the previous day for CO [1.5%, 95% confidence interval (CI): 0.3%, 2.6%], NO2 (2.5%, 95% CI: 0.6%, 4.3%), and PM2.5 (1.32%, 95% CI: 0.16%, 2.48%). Moving average concentration of 7 days for all pollutants was associated with decreased admission (CO: -1.29%, NO2: -0.4.69%, SO2:-2.12%, PM2.5:-0.98%, PM10:-1.70%). CONCLUSION: Exposures to NO2 and CO on concurrent days, and PM2.5 on the previous day, are associated with increased epilepsy hospitalization, whereas cumulative exposure appeared protective.

Comparing the Economic Burden of Type 2 Diabetes Mellitus Patients with and without Medical Insurance: A Cross-Sectional Study in China.

BACKGROUND The burden of diabetes has become a worldwide public health issue. Previous studies focused on the composition and influencing factors of hospitalization costs for insured patients. The aim of this study was to compare the economic burden of diabetic patients with and without medical insurance (MI) in China, from the aspects of types of medical costs and diabetic comorbidities. MATERIAL AND METHODS We identified 124 701 patients with type 2 diabetes mellitus in 2015 from electronic Hospitalization Summary Reports. The information on demographics, comorbidities, and hospitalization costs were extracted and evaluated. Differences between groups were analyzed by Mann-Whitney U test. RESULTS The mean age of patients was 58.0±13.4 years. Hypertensive diseases (63.5%), ischemic heart diseases (21.3%), and chronic kidney disease (17.5%) were the most common comorbidities. The median hospitalization costs for diabetic patients with and without MI were 9485.0 RMB and 9104.0 RMB, respectively. The insured patients' median out-of-pocket (OOP) cost was 1601.3 RMB, and they incurred more costs for laboratory tests, imaging examinations, and medical services, and less costs for prescribed drugs (p<0.05). Insured patients had higher costs when associated with hypertensive diseases, cerebrovascular diseases, and ischemic heart diseases (p<0.05). CONCLUSIONS Diabetic patients with MI have higher hospitalization costs than those without MI, but uninsured patients carry a heavier OOP burden. The MI system in China needs further improvement to reduce the economic burden of diabetes.

Present and changing trends in surgical modalities and neoadjuvant chemotherapy administration for female breast cancer in Beijing, China: A 10-year (2006-2015) retrospective hospitalization summary report-based study.

BACKGROUND: This study was conducted to describe present and changing trends in surgical modalities and neoadjuvant chemotherapy (NACT) in female breast cancer patients in China from 2006 to 2015. METHODS: Data of 44 299 female breast cancer patients from 15 tertiary hospitals in Beijing were extracted from hospitalization summary reports. Surgeries were categorized into five modalities: breast-conserving surgery (BCS), simple mastectomy (SM), modified radical mastectomy (MRM), radical mastectomy (RM), and extensive radical mastectomy (ERM). RESULTS: In total, 38 471 (86.84%) breast cancer patients underwent surgery: 22.64% BCS, 8.22% SM, 63.97% MRM, 4.24% RM, and 0.93% ERM. Older patients (> 60) underwent surgery more frequently than younger patients (< 60). The proportion of patients who underwent BCS was highest in the age ≥ 80 (39.24%) and < 40 (28.69%) subgroups and in patients with papillary carcinoma (35.48%), and lowest in the age 60- subgroup (18.17%) and in patients with Paget's disease (19.05%). SM was most frequently performed in patients with Paget's disease (29.00%), and MRM for ductal (64.99%), and lobular (63.78%) carcinomas. During the study period, the proportion of patients who underwent MRM dropped by 29.04%, SM and BCS increased from 15.78% and 30.83%, respectively, and NACT increased in all subgroups, particularly in patients with lymph node involvement (26.72%). CONCLUSIONS: Surgical modalities varied significantly by age and histologic group. The use of BCS and SM increased dramatically, while MRM declined significantly. The proportion of patients treated with NACT has increased significantly, especially in patients with lymph node involvement.

Hospitalization costs and complications in hospitalized patients with type 2 diabetes mellitus in Beijing, China.

BACKGROUND: The aim of the present study was to investigate hospitalization costs, diabetes complications, and their relationships using a large dataset in Beijing, China. METHODS: Data for 2006-10 from the 38 top-ranked (Grade 3 A) hospitals in Beijing, obtained from electronic Hospitalization Summary Reports (HSRs), were analyzed for hospitalization costs and diabetic complications. Patient demographics, types of costs, and length of hospital stay (LOS) were also evaluated. RESULTS: During the period evaluated, 62 523 patients with diabetes were hospitalized, of which 41 875 (67.0 %) had diabetes-associated complications. The median cost of hospitalization for diabetic patients was 7996.11 RMB. Prescribed drugs and laboratory tests were two major contributors to hospitalization costs, accounting for 36.2 % and 22.4 %, respectively. Hospitalization costs were significantly associated with LOS, number of complications, age, year of admission, admission status, sex, and medical insurance (P < 0.001). Both hospitalization costs and LOS increased substantially with an increase in the number of complications (P < 0.001). The highest hospitalization costs were seen in those diabetic patients with foot complications. CONCLUSION: Diabetic complications have a significant effect on increases in hospitalization costs and LOS in patients with type 2 diabetes mellitus.

Changing trends of hospitalisation of liver cirrhosis in Beijing, China.

OBJECTIVE: To examine if the hospitalisation trends of liver cirrhosis are changing with the changes of risk factors of the disease in China. DESIGN: Secondary analysis of hospitalisation records in the 31 top-ranking hospitals in Beijing. RESULTS: Between 2006 and 2010, hospitalisation from viral hepatitis cirrhosis (VHC) decreased by 10% (95% CI=5-14%, p<0.001), but non-viral hepatitis cirrhosis (NVHC) and alcoholic cirrhosis (AC) increased by 35% (26-46%, p<0.001) and 33% (19%- 47%, p<0.001), respectively. The age patterns of hospitalisation varied with different types of liver cirrhosis. The hospitalisation risks for patients with VHC and AC were significantly high in the age groups 40-49 and 50-59 years, but risks for those with NHVC were high in all age groups of 40 years or above. Overall male-to-female hospitalisation ratios for VHC, NVHC and AC were 2.71, 1.14 and 59.9, respectively. The sex ratio became smaller with time from 2006 to 2010 in hospitalised patients with VHC, but it substantially increased in those with NVHC during the same period. CONCLUSIONS: Hospitalisation rates for liver cirrhosis in Beijing are changing with time. The changes of viral hepatitis infection and alcohol consumption in the general population may cause these changes.

Association between winter season and risk of death from cardiovascular diseases: a study in more than half a million inpatients in Beijing, China.

BACKGROUND: Seasonal associations of cardiovascular mortality have been noted in most populations of European origin years ago, but are not well evaluated in Asian populations recently. METHODS: Utilizing the electronic Hospitalization Summary Reports (HSRs) from 32 top-ranked hospitals in Beijing, China, we evaluated the association between winter season and the risk of cardiovascular death among hospitalized individuals. General additive models and logistic regression models were adjusted for confounding factors. RESULTS: Older patients who were admitted to the hospital in the winter months (January, February, November and December) had a death risk that was increased by approximately 30% to 50% (P < 0.01) over those who were admitted in May. However, younger patients did not seem to experience the same seasonal variations in death risk. The excess winter deaths among older patients were associated with ischemic heart disease (RR = 1.22; 95% CI 1.13 to 1.31), pulmonary heart disease (RR = 1.42; 95% CI 1.10 to 1.83), cardiac arrhythmias (RR = 1.67; 95% CI 1.36 to 2.05), heart failure (RR = 1.30; 95% CI 1.09 to 1.54), ischemic stroke (RR = 1.30; 95% CI 1.17 to 1.43), and other cerebrovascular diseases (RR = 1.78; 95% CI 1.40 to 2.25). The risks of mortality were higher in winter months than in the month of May, regardless of the presence or absence of respiratory disease. CONCLUSIONS: Winter season was associated with a substantially increased risk of cardiovascular death among older Chinese cardiovascular inpatients.

Cardiovascular disease and hip fracture among older inpatients in Beijing, China.

OBJECTIVES: To examine the associations between cardiovascular disease (CVD) and hip fracture and to determine if these associations are attributable to hypertensive disease. METHODS: Data were obtained from 2006-2010 hospitalization summary reports of 31 tertiary hospitals in Beijing, China. This study included 864,408 inpatients aged ≥55 years. Occurrence rate of hip fracture was based on the first-listed ICD-10 codes (S72.0, S72.1, and S72.2) and of CVD as comorbidities were based on the second- to the eighth-listed ICD-10 codes (I00-I99). RESULTS: The occurrence rate of hip fracture is 53% higher among older inpatients with a diagnosis of CVD than those without (RR = 1.53, 95% CI 1.47-1.60). Those with hip fracture were more likely to have hypertensive or cerebrovascular disease, with the risk ranging from 1.34 to 1.70. Compared with those without hip fracture, the occurrence rate of overall CVDs increased by 80%, 83%, and 16% among hip fracture patients aged 55-64, 65-79, and ≥80 years. In addition, hypertensive disease did not modify the association between cerebrovascular disease and hip fracture. CONCLUSION: CVD was positively associated with hip fracture, and the associations observed in this sample of Chinese inpatients were similar to those reported from cohort studies conducted in the European populations.

Control costs, enhance quality, and increase revenue in three top general public hospitals in Beijing, China.

BACKGROUND: With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. METHODS: We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS), cost per day (CPD), inpatient mortality rate (IMR), and length of stay (LOS), using a generalized additive model. FINDINGS: There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (P<0.001), from CNY 1,531 in 2006 to CNY 2,169 in 2010. The increasing CPD seemed synchronous with the steady rising of the national annual income per capita. Surgical cost was the main contributor to the temporal change of CPD, while medicine and examination costs tended to be stable over time. From 2006 and 2010, IMR decreased by 36%, while LOS reduced by 25%. Increasing hospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. INTERPRETATIONS: These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role. However, purely market-oriented health-care reform could also misguide future healthcare reform.