Assessment of infant gonadal dose irradiated from urine-contaminated diapers during diuretic renal scintigraphy.

OBJECTIVE: To estimate the gonadal doses irradiated from urine- contaminated diapers during diuretic renal scintigraphy. METHODS: Images of 31 patients (18 males and 13 females) with urine-contaminated diapers during 99m Tc-MAG3 renal scintigraphy were analyzed. The count rate of the diapers was converted into a time-activity curve based on the calibrated factor of the gamma camera system. The cumulative activity was determined from the area under the curve. By incorporating dose per unit cumulative activity pre-calculated from Monte Carlo simulation with 0-year phantom, the gonadal dose irradiated from diaper was calculated. To assess the degree of this additionally introduced dose from diapers, the calculated gonadal dose was compared to the internal gonadal dose from injected radiotracer activity. RESULTS: The cumulative activities irradiated from urine-contaminated diapers were 1.12 E04 ±â€…1.29E04 MBq.s in male infants, which was nearly half of the 1.94 E04 ±â€…1.80E04 MBq.s ( P  = 0.15) in female infants. However, the absorbed doses for testes in male infants were 7.37E-01 ±â€…8.50E-01 mGy, which was approximately 10 times the 6.38E-02 ±â€…5.94E-02 mGy for ovaries in female infants ( P  < 0.01). The diaper-introduced dose for testes and ovaries was 91.7% and 3.9% of the gonadal doses from the injected activity in patients with normal renal function, and 99.0% and 4.3% of those in patients with abnormal renal function. CONCLUSION: Urine-contaminated diapers introduced additional radiation doses to infant patients during 99m Tc-MAG3 renal scintigraphy. The gonadal doses were of significance in male infants who had nearly double the absorbed dose for the testes.

[Source Apportionment and Potential Ecological Risk Assessment of Soil Heavy Metals in Typical Industrial and Mining Towns in North China].

To understand the status of heavy metals in soils of typical industrial and mining towns and quantitatively analyze the potential sources, the contents of seven heavy metals (Cd, As, Pb, Cr, Cu, Ni, and Zn) in 150 surface soils in Xuanhua District, Zhangjiakou City, Hebei Province were collected and examined. The geoaccumulation index and potential ecological risk index methods were used to evaluate the heavy metal pollution status and potential ecological risk. Principal component analysis (PCA) and the positive matrix factorization (PMF) model were used to comprehensively analyze the pollution sources of seven heavy metals, and geostatistics was used to identify the high contribution areas of potential sources. The results revealed that:① the average values of heavy metals in the study area ranged from 0.23-103.34 mg·kg-1, among which the average contents of Cd, Pb, Cu, and Zn were higher than the soil background value of Hebei Province. ② The results of the geoaccumulation and potential ecological risk indices demonstrated that the degree of pollution of the seven heavy metals was in the following order:Cd>Pb>Cu>Zn>Ni>As>Cr, the content of Cd in 16% sites was above a moderate pollution level, and the potential ecological risk of heavy metals in more than 95% sites was at a light risk level. ③ The main sources of accumulation of the seven heavy metals in the study area were combined sources of industry and traffic, natural sources, and agricultural sources, with their contribution rates of 33.1%, 48.7%, and 18.2%, respectively. Among them, Cd, Pb, Cu, and Zn were primarily affected by the combined sources of industry and transportation; Cr, Ni, and As were mainly affected by natural sources, whereas Cd and some As were affected by agricultural sources. The organic combination of PCA, PMF model, and geostatistical methods confirmed the results of each analysis, which increased the reliability of the analytical results of heavy metal sources.

Levels, distribution, childhood exposure assessment, and influencing factors of polybrominated diphenyl ethers (PBDEs) in household dust from nine cities in China.

Household dust is an important source of premature exposure to polybrominated diphenyl ethers (PBDEs), especially for children. In this onsite study, 246 dust samples were collected from 224 households in nine Chinese cities during 2018-2019. Questionnaires were administered to explore the association between household-related information and PBDEs in household dust. The median concentration of Σ12PBDEs in household dust from 9 cities was 138 ng/g (94-227 ng/g), with the arithmetic mean of 240 ± 401 ng/g. Among the nine cities, the highest median concentration of Σ12PBDEs in household dust was found in Mianyang (295.57 ng/g), while the lowest was found in Wuxi (23.15 ng/g). BDE-71 was the most dominant congener, ranging from 42.08 % to 98.15 % of the 12 PBDE congeners among 9 cities. Three potential sources for the indoor environment were Penta-BDE, Octa-BDE commercial products, and photolytic bromine from Deca-BDEs based on the largest contribution (81.24 %). Under the moderate exposure scenario, the exposure levels through ingestion and dermal absorption for children were 7.30 × 10-1 ng/kg BW/day and 3.26 × 10-2 ng/kg BW/day, respectively. Temperature, CO2, years of residence, income, family size, household size, use of computers, heating, use of insecticide, and use of humidifiers were influential factors for PBDE concentrations in household dust. Based on the evidence of the correlation between PBDEs and these household parameters, it can be applied to reduce PBDE concentrations in household dust, which is a basis for controlling PBDEs pollution in Chinese households and protecting population health.

URA3 as a Selectable Marker for Disruption and Functional Assessment of PacC Gene in the Entomopathogenic Fungus Isaria javanica.

An effective selection marker is necessary for genetic engineering and functional genomics research in the post-genomic era. Isaria javanica is an important entomopathogenic fungus with a broad host range and prospective biocontrol potentials. Given that no antibiotic marker is available currently in this fungus, developing an effective selection marker is necessary. In this study, by applying overlap PCR and split-marker deletion strategy, combining PEG-mediated protoplasm transformation method, the uridine auxotrophy gene (ura3) in the I. javanica genome was knocked out. Then, using this transformation system, the pH response transcription factor gene (IjpacC) was disrupted successfully. Loss of IjpacC gene results in an obvious decrease in conidial production, but little impact on mycelial growth. The virulence of the ΔIjpacC mutant on caterpillars is similar to that of the wild-type strain. RT-qPCR detection shows that expression level of an acidic-expressed S53 gene (IF1G_06234) in ΔIjpacC mutant is more significantly upregulated than in the wild-type strain during the fungal infection on caterpillars. Our results indicate that a markerless transformation system based upon complementation of uridine auxotrophy is successfully developed in I. javanica, which is useful for exploring gene function and for genetic engineering to enhance biological control potential of the fungus.

FISHERMAN: A Serious Game for Executive Function Assessment of Older Adults.

Executive functions (EFs) are essential for daily living activities but decline with age. Convenient assessment and timely intervention have particular significance for older adults. However, the traditional laboratory tasks of EFs are typically monotonous and inconvenient. The current study aimed to develop an interesting and convenient supplementary tool to assess EFs for older adults. According to the theory of EFs, we developed a serious game, FISHERMAN, to assess EFs. The game includes three subgames, Cautious Fisherman, Agile Fisherman, and Wise Fisherman, targeting core components of inhibition, shifting, and working memory, respectively. The current study aims to verify the reliability and validity of the game. One hundred and eight healthy older adults participated in this study and were tested through the FISHERMAN game and a battery of cognitive tests. The results show that the FISHERMAN game has high internal consistency reliability and good construct validity as well as criterion-related validity, suggesting that the game design is valid and can be used in EFs assessment for older adults. Future studies are warranted to establish the norm of the FISHERMAN game in older adults and investigate whether the FISHERMAN game can be generalized to other populations.

Development and Validation of a Risk Assessment Tool for Gaming Disorder in China: The Gaming Hazard Assessment Scale.

Despite the growing research interest in gaming disorder, risk screening tools developed specifically for the Chinese population are still lacking. This study aimed to construct a screening tool to evaluate the risk of gaming disorder (GD) development, by assessing the severity of GD symptoms among Chinese gamers, based on clinical expert interviews, structured interviews with GD patients, a background literature review, and IGD/GD criteria proposed by the DSM-5 and ICD-11. It introduced the Gaming Hazard Assessment Scale-a multidimensional GD risk screening tool-and evaluated the dimension structure, reliability, and validity of the scale among 959 Chinese gamers. A three-level structure, consisting of 18 items scored from 0 to 54, ultimately indicated satisfactory reliability, good validity, and acceptable model fit. The scale will help large-scale initial screening and early identification of patients with a high risk of GD. Further evaluation of the Gaming Hazard Assessment Scale in clinical settings is highly recommended.

Characteristics, distribution, and children exposure assessment of 13 metals in household dust in China: A big data pilot study.

To explore the pollution characteristics of metals in household dust in China and their exposure to children, this study searched peer-reviewed papers published during 1980-2020 and analyzed 30 eligible papers screened under the per-decided strategy. We evaluated the sample-weighted concentration (SWC) of each metal, explored the sources of metals, and presented the quantitative description of spatial-temporary characteristics and children exposure to 13 metals with multi-route under a general living scenario. The results showed the concentrations of 13 metals with a range of 0.89-29 090.19 mg/kg. The SWC of Cd in household dust from rural areas was 3.29 times of that from urban areas, while the SWC of Ni from urban areas was 3.71 times of that from rural areas. The results showed that four principal components were extracted, and the cumulative contribution rate reached 79.127%. The exposure dose of 13 metals to children aged 2-3 years was presented with the highest by ingestion. Metals such as Fe, Zn, and Mn posed inevitable health risk to children with high exposure. Countermeasures should be carried out to minimize the children exposure to metals in household dust urgently, such as the establishment of environmental health standard for household dust.

Prevalence and Management of Severe Hand, Foot, and Mouth Disease in Xiangyang, China, From 2008 to 2013.

Therapeutic strategies for severe hand, foot, and mouth disease (HFMD) are currently either inconsequent or deficient in evidence. We retrospectively surveyed HFMD outbreaks in Xiangyang from June 2008 to December 2013. HFMD is staged from I to V according to clinical severity. Severe HFMD is defined as a case involving the central nervous system (CNS). We analyzed risk factors for fatality of severe cases and compared the efficiency and outcome of some therapies by binary logistic regression. The overall HFMD cases included 637 (1.26%) severe cases and 38 fatalities (0.075%). Analyses indicate that age (<3 years), enterovirus 71 (+), autonomic nervous system dysregulation, pulmonary edema/hemorrhage, C-reactive protein (CRP) (>40 mg/L), and cardiac troponin I (>0.04 ng/ml) are risk factors for fatality (all P < 0.05). Intravenous immunoglobulin (IVIG) and mechanical ventilation applied only in early stage IV significantly improved HFMD progression (both P < 0.05) with odds ratios of 0.24 (95% CI: 0.10-0.57) and 0.01 (95% CI: 0.00-0.10), respectively. Neither methylprednisolone nor milrinone administered in any stage made any significant difference on mortality (all P > 0.05). Precise recognition of the severe HFMD cases in early stage IV and prompt IVIG and mechanical ventilation application may reduce mortality. Mechanical ventilation training programs and dispatch of specialists to hospitals where there is no chance of transferring critical cases to the severe HFMD designated hospitals are two key measures to reduce fatality.

Prevalence and Management of Severe Hand, Foot, and Mouth Disease in Xiangyang, China from 2008-2013.

Therapeutic strategies for severe hand, foot, and mouth disease (HFMD) are currently either inconsequent or deficient in evidence. We retrospectively surveyed HFMD outbreaks in Xiangyang from June 2008 to December 2013. HFMD is staged form I to V according to clinical severity and the case with central nervous system involvement is defined as a severe one. We analyzed risk factors for fatality of severe cases and compared the efficiency and outcome of some therapies by binary logistic regression. The overall HFMD cases included 637 (1.26%) severe cases, 38 fatalities (0.75‰). Analysis indicates that age (<3 y), enterovirus 71 (+), autonomic nervous system dysregulation, pulmonary edema/hemorrhage, CRP (>40 mg/L) and cardiac troponin I (>0.04 ng/mL) are risk factors for fatality (all P < 0.05). Intravenous immunoglobulin (IVIG) and mechanical ventilation applied only in early stage IV significantly improved HFMD progression (both P < 0.05) with odds ratios of 0.24 (95% CI: 0.10-0.57) and 0.01 (95% CI: 0.00-0.10), respectively. Neither methylprednisolone nor milrinone administered in any stage made any significant difference on mortality (all P > 0.05). Precise recognition of the severe HFMD cases in early stage IV and prompt IVIG and mechanical ventilation application may decrease mortality. Mechanical ventilation training programs and dispatching specialists to county-level or district hospitals when there is no chance of transfer critical HFMD cases to a superior hospital are two key successful administrative initiatives. This article is protected by copyright. All rights reserved.

Prevalence of frailty in China: Protocol for systematic review and meta-analysis.

INTRODUCTION: China is facing more and more enormous challenges including aging, the increase of social security costs and health care cost, decrease of labors, and how to keep elders' capacity to function well and live independently. Healthy aging has become an extremely challenging issue. Frailty, a geriatric syndrome resulted from the declines of multiple physiological systems, characterized by malnutrition, exercise intolerance, dependence, longer bed rest, lower gaits peed, weakness, weight loss, anorexia, hip fracture, risk of falling, delirium, dementia, and keep indoors, has become one of the biggest challenges in facilitating healthy aging. Because the research of frailty just had started in recent years in China, the evidence regarding the prevalence of frailty among the Chinese population is scarce and just limited in certain area. METHOD: We will systematically search 7 electronic database including PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of science, MEDLINE, CNKI (Chinese National Knowledge Infrastructure), and CBM (Chinese Biological Medical Database) to identify studies that provide or potential available of data regarding to prevalence of frailty. Risk of bias of individual study will be assessed using 8-iterm critical appraisal criteria for prevalence or incidence studies. Data will be analyzed using STATA V.12.0 software. CONCLUSIONS: Our systematic review and meta-analysis will firstly pool the results from available studies to provide a comprehensive evidence for the prevalence of frailty. The results of this study will be submitted to a peer-reviewed journal for publication.

A novel estimator of between-study variance in random-effects models.

BACKGROUND: With the rapid development of high-throughput sequencing technologies, many datasets on the same biological subject are generated. A meta-analysis is an approach that combines results from different studies on the same topic. The random-effects model in a meta-analysis enables the modeling of differences between studies by incorporating the between-study variance. RESULTS: This paper proposes a moments estimator of the between-study variance that represents the across-study variation. A new random-effects method (DSLD2), which involves two-step estimation starting with the DSL estimate and the [Formula: see text] in the second step, is presented. The DSLD2 method is compared with 6 other meta-analysis methods based on effect sizes across 8 aspects under three hypothesis settings. The results show that DSLD2 is a suitable method for identifying differentially expressed genes under the first hypothesis. The DSLD2 method is also applied to Alzheimer's microarray datasets. The differentially expressed genes detected by the DSLD2 method are significantly enriched in neurological diseases. CONCLUSIONS: The results from both simulationes and an application show that DSLD2 is a suitable method for detecting differentially expressed genes under the first hypothesis.

The prevalence of colistin resistance in Escherichia coli and Klebsiella pneumoniae isolated from food animals in China: coexistence of mcr-1 and blaNDM with low fitness cost.

Increasing colistin resistance is a global concern because colistin is used as a last resort for the treatment of carbapenem-resistant Enterobacteriaceae infections. The plasmid-mediated colistin resistance gene, mcr-1 was found in distinct bacterial species isolated from humans, animals, and the environment. In this study, farms in four different agricultural provinces in China were investigated to determine the occurrence of the antimicrobial resistance and related genes. A total of 373 Escherichia coli and 54 Klebsiella pneumoniae were isolated from 510 non-duplicated samples. Of the E. coli and K. pneumoniae isolates, 72.7% and 66.7%, respectively, were susceptible to colistin. Isolates resistant to colistin comprised 46.6% of the samples isolated from Shandong, and 17.8% and 16.4% of the samples from Jilin and Henan, respectively. Twenty-six carbapenem-resistant E. coli isolates were resistant to colistin, in which both mcr-1 and blaNDM were present. Specifically, the co-existence was found in isolates from animals and sewage. Most of the resistance genes were located on plasmids and were 40-244 kilobases. Growth curves of transconjugants carrying mcr-1, blaNDM-1, blaNDM-4, blaNDM-5, and blaNDM-9 showed a low fitness cost compared with the recipient. In conclusion, mcr-1 was widespread in E. coli and K. pneumoniae isolated from farms in China. Co-existence of mcr-1 and blaNDM-9 was identified in different sequence types of E. coli with low fitness cost from various origins, indicating an urgent need to take measures for decreasing dissemination.

Differentiation of functional endothelial cells from human induced pluripotent stem cells: A novel, highly efficient and cost effective method.

Endothelial cells derived from human induced pluripotent stem cells (hiPSC- EC) are of significant value for research on human vascular development, in vitro disease models and drug screening. Here we report an alternative, highly efficient and cost-effective simple three step method (mesoderm induction, endothelial cell differentiation and endothelial cell expansion) to differentiate hiPSC directly into endothelial cells. We demonstrate that efficiency of described method to derive CD31+ and VE-Cadherin+ double positive cells is higher than 80% in 12 days. Most notably we established that hiPSC-EC differentiation efficacy depends on optimization of both mesoderm differentiation and endothelial cell differentiation steps.

Rapid baculovirus titration assay based on viable cell side scatter (SSC).

The baculovirus expression system is one of the most powerful tools for the production of recombinant proteins on both laboratory and industrial scales. Multiplicity of infection (MOI) is the crucial parameter for efficient protein expression. To obtain an optimal MOI, it is important to determine titer of virus stock before protein production. Herein, we established a label-free, simple and rapid method for virus titration based on viable cell side scatter (SSC). Generally, the SSC of cells infected with a series of virus dilutions was measured by a flow cytometer at 48 h post-infection, and the probability of infected cells at a given dilution was estimated. For each well with the infection probabilities between 0.20 and 0.80, the range of dilutions was chosen, and virus titer was determined with a statistical method. Log-scale comparison of the results between the SSC based method and a standard plaque assay showed a good correlation (R(2)=0.9853), suggesting the fine accuracy of this proposed method.

Methods of assessment of tophus and bone erosions in gout using dual-energy CT: reproducibility analysis.

This study aims to evaluate the intraobserver and interobserver reproducibility of the tophus urate volume, erosion volume, and the erosion score measurements in patients with gout by using dual-energy CT (DECT) scans comparing their bone erosion volumes against bone erosion scores and also to determine a valid measure of joint destruction in chronic gout. Sixty-six subjects underwent DECT scans of the hands or feet. Two independent observers measured the tophus urate volumes and bone erosion volumes using automated volume assessment software and the erosion scores based on the rheumatoid arthritis magnetic resonance imaging score (RAMRIS). The intraobserver and interobserver reproducibility were analyzed by intraclass correlation coefficient (ICC) and limits of agreements analysis. The relationship between erosion volumes and erosion scores was analyzed. The intraobserver and interobserver ICC for tophus urate volume measurements (n = 636) were 1.000 (95 % confidence interval (95 % CI) 1.000 to 1.000) and 1.000 (95 % CI 1.000 to 1.000), 0.999 (0.999, 0.999) and 0.999 (0.999, 0.999) for bone erosion volumes (n = 350), 0.937 (0.928, 0.946) and 0.899 (0.883, 0.912) for erosion scores (n = 350). Strong positive correlations were demonstrated between individual erosion volumes and scores (r s = 0.914, p < 0.001) as well as total erosion volume and score per patient (r = 0.838-0.867, p < 0.001). This study demonstrated a high reproducibility of tophus urate volumes, erosion volumes, and erosion score measurements using DECT. Erosion volumes show to be a more direct and accurate method to evaluate bone erosion compared with erosion score, strongly supporting it as a superior and standard measure of structural joint damage in gout.

Value of dynamic ³¹P magnetic resonance spectroscopy technique in in vivo assessment of the skeletal muscle mitochondrial function in type 2 diabetes.

BACKGROUND: Phosphorous magnetic resonance spectroscopy ((31)P-MRS) has been successfully applied to study intracellular membrane compounds and high-energy phosphate metabolism. This study aimed to evaluate the capability of dynamic (31)P-MRS for assessing energy metabolism and mitochondrial function in skeletal muscle from type 2 diabetic patients. METHODS: Dynamic (31)P-MRS was performed on 22 patients with type 2 diabetes and 26 healthy volunteers. Spectra were acquired from quadriceps muscle while subjects were in a state of rest, at exercise and during recovery. The peak areas of inorganic phosphate (Pi), phosphocreatine (PCr), and adenosine triphosphate (ATP) were measured. The concentration of adenosine diphosphate (ADP) and the intracellular pH value were calculated from the biochemistry reaction equilibrium. The time constant and recovery rates of Pi, PCr, and ADP were analyzed using exponential curve fitting. RESULTS: As compared to healthy controls, type 2 diabetes patients had significantly lower skeletal muscle concentrations of Pi, PCr and ß-ATP, and higher levels of ADP and Pi/PCr. During exercise, diabetics experienced a significant Pi peak increase and PCr peak decrease, and once the exercise was completed both Pi and PCr peaks returned to resting levels. Quantitatively, the mean recovery rates of Pi and PCr in diabetes patients were (10.74 ± 1.26) mmol/s and (4.74 ± 2.36) mmol/s, respectively, which was significantly higher than in controls. CONCLUSIONS: Non-invasive quantitative (31)P-MRS is able to detect energy metabolism inefficiency and mitochondrial function impairment in skeletal muscle of type 2 diabetics.

Evaluating ecological and economic benefits of a low-carbon industrial park based on millennium ecosystem assessment framework.

The Millennium Ecosystem Assessment (MA) framework was modified with a special focus on ecosystem service values. A case study of a typical low-carbon industrial park in Beijing was conducted to assess the ecological and economic benefits. The total economic value of this industrial park per year is estimated to be 1.37 × 10(8) RMB yuan, where the accommodating and social cultural services are the largest two contributors. Due to the construction of small grasslands or green roofs, considerable environmental regulation services are also provided by the park. However, compared with an ecoindustrial park, carbon mitigation is the most prominent service for the low-carbon industrial park. It can be concluded that low-carbon industrial park construction is an efficacious way to achieve coordinated development of society, economy, and environment, and a promising approach to achieving energy saving and carbon reduction.

Accurate assessment of antibiotic susceptibility and screening resistant strains of a bacterial population by linear gradient plate.

The dynamics of a bacterial population exposed to the minimum inhibitory concentration (MIC) of an antibiotic is an important issue in pharmacological research. Therefore, a novel antibiotic susceptibility test is urgently needed that can both precisely determine the MIC and accurately select antibiotic-resistant strains from clinical bacterial populations. For this purpose, we developed a method based on Fick's laws of diffusion using agar plates containing a linear gradient of antibiotic. The gradient plate contained two layers. The bottom layer consisted of 15 mL agar containing the appropriate concentration of enrofloxacin and allowed to harden in the form of a wedge with the plate slanted such that the entire bottom was just covered. The upper layer consisted of 15 mL plain nutrient agar added with the plate held in the horizontal position. After allowing vertical diffusion of the drug from the bottom agar layer for 12 h, the enrofloxacin concentration was diluted in proportion to the ratio of the agar layer thicknesses. The uniform linear concentration gradient was verified by measuring the enrofloxacin concentration on the agar surface. When heavy bacterial suspensions were spread on the agar surface and incubated for more than 12 h, only resistant cells were able to form colonies beyond the boundary of confluent growth of susceptible cells. In this way, the true MIC of enrofloxacin was determined. The MICs obtained using this linear gradient plate were consistent with those obtained using conventional antibiotic susceptibility tests. Discrete colonies were then spread onto a gradient plate with higher antibiotic concentrations; the boundary line increased significantly, and gene mutations conferring resistance were identified. This new method enables the rapid identification of resistant strains in the bacterial population. Use of the linear gradient plate can easily identify the precise MIC and reveal the dynamic differentiation of bacteria near the MIC. This method allows the study of genetic and physiological characteristics of individual strains, and may be useful for early warning of antibiotic resistance that may occur after use of certain antimicrobial agents, and guide clinical treatment.

Automatic bone age assessment based on intelligent algorithms and comparison with TW3 method.

PURPOSE: New algorithms are proposed to improve the validity, accuracy and practicality of automatic bone age assessment (ABAA). MATERIALS AND METHODS: The concept of object-based region of interest (ROI) was proposed. Thirteen RUS (including radius, ulna and short finger bones) ROIs and seven carpal ROIs were appointed respectively according to Tanner-Whitehouse (TW3) method. Five features including size, morphologic features and fusional/adjacent stage of each ROI were extracted based on particle swarm optimization (PSO) and input into ANN classifiers. ANNs were built upon feed-forward multilayer networks and trained with back-propagation algorithm rules to process RUS and carpal features respectively. About 1046 digital left hand-wrist radiographs were randomly utilized half for training ANNs and the rest for ABAA after manual reading by TW3 method. RESULTS: BA comparison between observers indicated that the S.D. of RUS BA was larger than that of carpal BA (S.D.=4.40, 2.42 respectively), but interestingly, both CVs were 4.0, and both concordance rates were very high (95.5% and 94.2%), and both differences between observers were not significant (both P>0.05). We found by comparison between results of ABAA and manual readings that RUS BA had larger S.D.s than carpal BA between two methods, but the CVs were very similar in the case of carpal BA<9 years and RUS BA>or=9 years (CV=3.0, 3.1 respectively), apart from a comparatively larger CV for RUS BA<9 years (CV=3.5). Both parts of ABAA system, RUS and carpal, had very high concordance rates (97%, 93.8% and 96.5%) and no significant difference compared with manual method (all P>0.05). CONCLUSIONS: PSO method made image segmentation and feature extraction more valid and accurate, and the ANN models were sophisticated in processing image information. ABAA system based on intelligent algorithms had been successfully applied to all cases from 0 to 18 years of bone age.