TP53 R249S Mutations, Exposure to Aflatoxin, and Occurrence of Hepatocellular Carcinoma in a Cohort of Chronic Hepatitis B Virus Carriers from Qidong, China

Hepatocellular carcinoma (HCC) has a high mortality in East Asia and Sub-Saharan Africa, two regions where the main etiologic factors are chronic infections with hepatitis B vir-us and dietary exposure to aflatoxin. A single base substitution at the third nucleotide of codon 249 of TP53 (R249S) is common in HCC in these regions and has been associated with aflatoxin-DNA adducts. To determine whether R249S may be detected in plasma DNA before HCC diagnosis, we conducted a case-control study nested in a cohort of adult chronic hepatitis B virus carriers from Qidong County, People's Republic of China. Of the 234 plasma specimens that yielded adequate DNA, only 2 (0.9%) were positive for R249S by restriction fragment length polymorphisms, and both of them were controls. Of the 249 subjects tested for aflatoxin-albumin adducts, 168 (67%) were positive, with equal distribution between cases and controls. Aflatoxin-albumin adduct levels were low in the study, suggesting an overall low ongoing exposure to aflatoxin in this cohort. The R249S mutation was detected in 11 of 18 (61%) available tumor tissues. To assess whether low levels of mutant DNA were detectable in pre-diagnosis plasma, 14 plasma specimens from these patients were analyzed by short oligonucleotide mass analysis. Nine of them (64%) were found to be positive. Overall, these results suggest that HCC containing R249S can occur in the absence of significant recent exposure to aflatoxins. The use of short oligonucleotide mass analysis in the context of low ongoing aflatoxin exposure may allow the detection of R249S in plasma several months ahead of clinical diagnosis. (Cancer Epidemiol Biomarkers Prev 2009;18(5):1638-43)

Factors influencing the output of rural cataract surgical facilities in China: the SHARP study

Purpose: To identify factors associated prospectively with increased cataract surgical rate (CSR) in rural Chinese hospitals.

Methods: Annual cataract surgical output was obtained at baseline and 24 months later from operating room records at 42 rural, county-level hospitals. Total local CSR (cases/million population/y), and proportion of CSR from hospital and local competitors were calculated from government records. Hospital administrators completed questionnaires providing demographic and professional information, and annual clinic and outreach screening volume. Independent cataract surgeons provided clinical information and videotapes of cases for grading by two masked experts using the Ophthalmology Surgical Competency Assessment Rubric (OSCAR). Uncorrected vision was recorded for 10 consecutive cataract cases at each facility, and 10 randomly-identified patients completed hospital satisfaction questionnaires. Total value of international nongovernmental development organization (INGDO) investment in the previous three years and demographic information on hospital catchment areas were obtained. Main outcome was 2-year percentage change in hospital CSR.

Results: Among the 42 hospitals (median catchment population 530,000, median hospital CSR 643), 78.6% (33/42) were receiving INGDO support. Median change in hospital CSR (interquartile range) was 33.3% (-6.25%, 72.3%). Predictors of greater increase in CSR included higher INGDO investment (P = 0.02, simple model), reducing patient dissatisfaction (P = 0.03, simple model), and more outreach patient screening (P = 0.002, simple and multiple model).

Conclusions: Outreach cataract screening was the strongest predictor of increased surgical output. Government and INGDO investment in screening may be most likely to enhance output of county hospitals, a major goal of China's Blindness Prevention Plan.

The impact of parental migration on health status and health behaviours among left behind adolescent school children in China.

BACKGROUND:

One out of ten of China's population are migrants, moving from rural to urban areas. Many leave their families behind resulting in millions of school children living in their rural home towns without one or both their parents. Little is known about the health status of these left behind children (LBC). This study compares the health status and health-related behaviours of left behind adolescent school children and their counterparts in a rural area in Southern China.

METHODS:

A cross-sectional study was conducted among middle school students in Fuyang Township, Guangdong, China (2007-2008). Information about health behaviours, parental migration and demographic characteristics was collected using a self-administered questionnaire. Overweight/obesity and stunting were defined based on measurements of height and weight. Univariate and multivariate analyses were used to estimate the differences in health outcomes between LBC and non-LBC.

RESULTS:

18.1% of the schoolchildren had one or both parents working away from home. Multivariate analysis showed that male LBC were at higher risk of skipping breakfast, higher levels of physical inactivity, internet addiction, having ever smoked tobacco, suicide ideation, and being overweight. LBC girls were more likely to drink excessive amounts of sweetened beverage, to watch more TV, to have ever smoked or currently smoke tobacco, to have ever drunk alcohol and to binge drinking. They were also more likely to be unhappy, to think of planning suicide and consider leaving home.

CONCLUSIONS:

Our findings suggest that parental migration is a risk factor for unhealthy behaviours amongst adolescent school children in rural China. Further research is required in addition to the consideration of the implications for policies and programmes to protect LBC.

Prevention of Cataract Blindness in Rural China.

China has undergone dramatic economic and social reforms during last 30 years, leading to a notably higher level of living standards and health care access for Chinese citizens. However, China's cataract surgical rate of 780 cases/y per million population trails Asian neighbors with lower income levels such as India and Vietnam. Eye care providers and patients encounter many barriers in gaining access to one another.Hands-on training programs conducted by international nongovernmental organizations and the government have helped to increase the number of qualified cataract surgeons in rural area, but establishing a residency training system that produces ophthalmologists capable of performing independent surgery is the only sustainable way to meet the increasing demand for surgery from an aging population. The New Rural Cooperative Medical System has successfully reduced the financial burden of cataract surgery for the rural population; however, reimbursement for outpatient treatment of leading eye diseases is needed.Community outreach screening combined with education is essential in rural areas' increased demand for surgery. Methods to optimize the yield from such screening must still be devised and proven, however. Improvements in the hospital administration and management structure are also needed to improve the efficiency of China's rural hospitals in delivering high-quality, low-cost cataract surgical services.

When the rising dragon sees fading stars: China's view of the European Union. CEPS Special Report No. 73, 29 November 2012

This CEPS Special Report gives an overview of China’s perceptions of the EU and the protection of Chinese investments in Europe since the outbreak of the European sovereign debt crisis, especially since the more concrete talks in late 2011 on possible financial support from China. Although the top leadership of the communist party of China (CPC) changed in its recent handover, the perceptions described in this paper are likely to remain the same, just as the main tenets of China’s foreign policy are unlikely to change in the near future. The report argues that while the EU’s image has suffered greatly from the sovereign debt crisis and the way it has been handled, there is room to improve China’s view of Europe and for the EU to maintain a relatively strong negotiation position towards China.

An investigation of the existing situation and trends in building energy efficiency management in China

According to the Chinese State Council's "Building Energy Efficiency Management Ordinance", a large-scale investigation of energy efficiency (EE) in buildings in contemporary China has been carried out in 22 provincial capitals and major cities in China. The aim of this project is to provide reliable information for drawing up the "Decision on reinforcing building energy efficiency" by the Ministry of Construction of China. The surveyed organizations include government departments, research institutions, property developers, design institutions, construction companies, construction consultancy services companies, facility management departments, financial institutions and those which relate to the business of building energy efficiency. In addition, representatives of the media and residents were also involved. A detailed analysis of the results of the investigation concerning aspects of the cur-rent situation and trends in building energy consumption, energy efficiency strategy and the implementation of energy efficiency measures has been conducted. The investigation supplies essential information to formulate the market entrance policy for new buildings and the refurbishment policy for existing buildings to encourage the development of energy efficient technology.

Confucius, constructivism and the impact of continuing professional development on teachers of English in China

In this article we explore issues around the sustainability and appropriateness of professional development for secondary teachers of English in China offered by overseas providers from the perspective of teachers who completed courses at the University of Reading between 2003 and 2010. We start by offering an overview of English teaching in China. We then describe the collection and analysis of interviews and focus groups discussions involving former participants, their teaching colleagues and senior management, as well as classroom observation. Evidence is presented for changes in teachers’ philosophies of education directly attributable to participation in the courses; for improved teacher competencies (linguistic, cultural and pedagogical) in the classroom; and for the ways in which returnees are undertaking new roles and responsibilities which exploit their new understandings. Finally, we discuss the implications of these findings for both providers and sponsors of CPD for English language teachers. We conclude that the recognition of English as an essential element in the modernisation of China, together with the growing awareness of the weaknesses of traditional approaches to the teaching of the language, has opened up new spaces for dialogue concerning pedagogy and professional practice. It is clearly important, however, that new approaches to the teaching of English are presented in a way which allows teachers to decide which elements should be incorporated into their teaching and how.

Palaeovegetation in China during the late Quaternary: Biome reconstructions based on a global scheme of plant functional types

Two previous reconstructions of palaeovegetation across the whole of China were performed using a simple classification of plant functional types (PFTs). Now a more explicit, global PFT classification scheme has been developed, and a substantial number of additional pollen records have become available. Here we apply the global scheme of PFTs to a comprehensive set of pollen records available from China to test the applicability of the global scheme of PFTs in China, and to obtain a well-founded reconstruction of changing palaeovegetation patterns. A total of 806 pollen surface samples, 188 mid-Holocene (MH, 6000 14C yr BP) and 50 last glacial maximum (LGM, 18,000 14C yr BP) pollen records were used to reconstruct vegetation patterns in China, based on a new global classification system of PFTs and a standard numerical technique for biome assignment (biomization). The biome reconstruction based on pollen surface samples showed convincing agreement with present potential natural vegetation. Coherent patterns of change in biome distribution between MH, LGM and present are observed. In the MH, cold and cool-temperate evergreen needleleaf forests and mixed forests, temperate deciduous broadleaf forest, and warm-temperate evergreen broadleaf and mixed forest in eastern China were shifted northward by 200–500 km. Cold-deciduous forest in northeastern China was replaced by cold evergreen needleleaf forest while in central northern China, cold-deciduous forest was present at some sites now occupied by temperate grassland and desert. The forest–grassland boundary was 200–300 km west of its present position. Temperate xerophytic shrubland, temperate grassland and desert covered a large area on the Tibetan Plateau, but the area of tundra was reduced. Treeline was 300–500 m higher than present in Tibet. These changes imply generally warmer winters, longer growing seasons and more precipitation during the MH. Westward shifts of the forest–shrubland–grassland and grassland–desert boundaries imply greater moisture availability in the MH, consistent with a stronger summer monsoon. During the LGM, in contrast, cold-deciduous forest, cool-temperate evergreen needleleaf forest, cool mixed forests, warm-temperate evergreen broadleaf and mixed forest in eastern China were displaced to the south by 300–1000 km, while temperate deciduous broadleaf forest, pure warm-temperate evergreen forest, tropical semi-evergreen and evergreen broadleaf forests were restricted or absent from the mainland of southern China, implying colder winters than present. Strong shifts of temperate xerophytic shrubland, temperate grassland and desert to the south and east in northern and western China and on the Tibetan Plateau imply drier conditions than present.

Timing and structure of the 8.2 kyr BP event inferred from delta(18)O records of stalagmites from China, Oman, and Brazil

Oxygen isotope records of stalagmites from China and Oman reveal a weak summer monsoon event, with a double-plunging structure, that started 8.21 +/- 0.02 kyr B. P. An identical but antiphased pattern is also evident in two stalagmite records from eastern Brazil, indicating that the South American Summer Monsoon was intensified during the 8.2 kyr B. P. event. These records demonstrate that the event was of global extent and synchronous within dating errors of <50 years. In comparison with recent model simulations, it is plausible that the 8.2 kyr B. P. event can be tied in changes of the Atlantic Meridional Overturning Circulation triggered by a glacial lake draining event. This, in turn, affected North Atlantic climate and latitudinal position of the Intertropical Convergence Zone, resulting in the observed low-latitude monsoonal precipitation patterns.

An Analysis of Living Conditions in Rural Villages in China. A New Geography of the Country.

Analysts, politicians and international players from all over the world look at China as one of the most powerful countries on the international scenario, and as a country whose economic development can significantly impact on the economies of the rest of the world. However many aspects of this country have still to be investigated. First the still fundamental role played by Chinese rural areas for the general development of the country from a political, economic and social point of view. In particular, the way in which the rural areas have influenced the social stability of the whole country has been widely discussed due to their strict relationship with the urban areas where most people from the countryside emigrate searching for a job and a better life. In recent years many studies have mostly focused on the urbanization phenomenon with little interest in the living conditions in rural areas and in the deep changes which have occurred in some, mainly agricultural provinces. An analysis of the level of infrastructure is one of the main aspects which highlights the principal differences in terms of living conditions between rural and urban areas. In this thesis, I first carried out the analysis through the multivariate statistics approach (Principal Component Analysis and Cluster Analysis) in order to define the new map of rural areas based on the analysis of living conditions. In the second part I elaborated an index (Living Conditions Index) through the Fuzzy Expert/Inference System. Finally I compared this index (LCI) to the results obtained from the cluster analysis drawing geographic maps. The data source is the second national agricultural census of China carried out in 2006. In particular, I analysed the data refer to villages but aggregated at province level.

China Urban Competitiveness in Industrialization: Based on the Panel Data of 25 Cities in China from 1990 to 2009

There is a consensus in China that industrialization, urbanization, globalization and information technology will enhance China's urban competitiveness. We have developed a methodology for the analysis of urban competitiveness that we have applied to China's 25 principal cities during three periods from 1990 through 2009. Our model uses data for 12 variables, to which we apply appropriate statistical techniques. We are able to examine the competitiveness of inland cities and those on the coast, how this has changed during the two decades of the study, the competitiveness of Mega Cities and of administrative centres, and the importance of each variable in explaining urban competitiveness and its development over time. This analysis will be of benefit to Chinese planners as they seek to enhance the competitiveness of China and its major cities in the future.

Huntington's like conditions in China, A review of published Chinese cases

Background: Knowledge about HD in China is lacking in the international literature. We have therefore analyzed the Chinese literature to thoroughly explore the clinical characteristics of Huntington disease in China. Methods: A computer-based online search of China National Knowledge Infrastructure was performed to review case reports concerning HD published between January 1980 and April of 2011, and the clinical characteristics were extracted. Results: A total of 92 studies involving 279 patients (157 males and 122 females) were collected, 82.0% of which were from provinces of North China. Most of the cases (97.8%) had a family history of HD, and paternal inheritance (65.5%) was higher than maternal inheritance (34.5%). Onset age was 35.8 (± 11.8) years, death occurred with 45.6 (± 13.5) years after a course of 11.6 (± 5.6) years. Involuntary movements were the most frequent reported presentation (found in 52.3%, including 64.4% in the entire body, 19.8% in the upper limbs, and 13.7% in the head and face). Psychiatric symptoms at onset were reported in 16.1%, and cognitive impairment in 1.8%. With disease progression, 99.6% of patients had abnormal movements, 67.9% cognitive impairment, and 35.0% suffered psychiatric symptoms. Of the reported patients, only 22 underwent IT15 gene testing with positive results. Conclusion: HD is a well-reported entity in Chinese medical literature, however, only a small number of instances have been proven by molecular diagnosis. Most of the features resemble what is known in other countries. The highly predominant motor presentation, and the higher male prevalence as well as the apparent concentration in Northern China may be due to observational bias. There is therefore a need to prospectively examine cohorts of patients with appropriate comprehensive assessment tools including genetic testing.

CAN CHINA USE ALTERNATIVE ENERGIES INSTEAD OF COAL TO PROVIDE MORE ELECTRICITY BY 2030?

Following the rapid growth of China's economy, energy consumption, especially electricity consumption of China, has made a huge increase in the past 30 years. Since China has been using coal as the major energy source to produce electricity during these years, environmental problems have become more and more serious. The research question for this paper is: "Can China use alternative energies instead of coal to produce more electricity in 2030?" Hydro power, nuclear power, natural gas, wind power and solar power are considered as the possible and most popular alternative energies for the current situation of China. To answer the research question above, there are two things to know: How much is the total electricity consumption in China by 2030? And how much electricity can the alternative energies provide in China by 2030? For a more reliable forecast, an econometric model using the Ordinary Least Squares Method is established on this paper to predict the total electricity consumption by 2030. The predicted electricity coming from alternative energy sources by 2030 in China can be calculated from the existing literature. The research results of this paper are analyzed under a reference scenario and a max tech scenario. In the reference scenario, the combination of the alternative energies can provide 47.71% of the total electricity consumption by 2030. In the max tech scenario, it provides 57.96% of the total electricity consumption by 2030. These results are important not only because they indicate the government's long term goal is reachable, but also implies that the natural environment of China could have an inspiring future.