Clinical Assessment of Magnetic Resonance Spectroscopy and Diffusion-Weighted Imaging in Diffuse Glioma: Insights Into Histological Grading and IDH Classification.

PURPOSE: To assess the diagnostic utility of clinical magnetic resonance spectroscopy (MRS) and diffusion-weighted imaging (DWI) in distinguishing between histological grading and isocitrate dehydrogenase (IDH) classification in adult diffuse gliomas. METHODS: A retrospective analysis was conducted on 247 patients diagnosed with adult diffuse glioma. Experienced radiologists evaluated DWI and MRS images. The Kruskal-Wallis test examined differences in DWI and MRS-related parameters across histological grades, while the Mann-Whitney U test assessed molecular classification. Receiver Operating Characteristic (ROC) curves evaluated parameter effectiveness. Survival curves, stratified by histological grade and IDH classification, were constructed using the Kaplan-Meier test. RESULTS: The cohort comprised 141 males and 106 females, with ages ranging from 19 to 85 years. The Kruskal-Wallis test revealed significant differences in ADC mean, Cho/NAA, and Cho/Cr concerning glioma histological grade (P < .01). Subsequent application of Dunn's test showed significant differences in ADC mean among each histological grade (P < .01). Notably, Cho/NAA exhibited a marked distinction between grade 2 and grade 3/4 gliomas (P < .01). The Mann-Whitney U test indicated that only ADC mean showed statistical significance for IDH molecular classification (P < .01). ROC curves were constructed to demonstrate the effectiveness of the specified parameters. Survival curves were also delineated to portray survival outcomes categorized by histological grade and IDH classification. Conclusions: Clinical MRS demonstrates efficacy in glioma histological grading but faces challenges in IDH classification. Clinical DWI's ADC mean parameter shows significant distinctions in both histological grade and IDH classification.

Application of improved GalNAc conjugation in development of cost-effective siRNA therapies targeting cardiovascular diseases.

N-Acetylgalactosamine (GalNAc)-conjugated small interfering RNA (siRNA) therapies have received approval for treating both orphan and prevalent diseases. To improve in vivo efficacy and streamline the chemical synthesis process for efficient and cost-effective manufacturing, we conducted this study to identify better designs of GalNAc-siRNA conjugates for therapeutic development. Here, we present data on redesigned GalNAc-based ligands conjugated with siRNAs against angiopoietin-like 3 (ANGPTL3) and lipoprotein (a) (Lp(a)), two target molecules with the potential to address large unmet medical needs in atherosclerotic cardiovascular diseases. By attaching a novel pyran-derived scaffold to serial monovalent GalNAc units before solid-phase oligonucleotide synthesis, we achieved increased GalNAc-siRNA production efficiency with fewer synthesis steps compared to the standard triantennary GalNAc construct L96. The improved GalNAc-siRNA conjugates demonstrated equivalent or superior in vivo efficacy compared to triantennary GalNAc-conjugated siRNAs.

A gender specific risk assessment of coronary heart disease based on physical examination data.

Large-scale screening for the risk of coronary heart disease (CHD) is crucial for its prevention and management. Physical examination data has the advantages of wide coverage, large capacity, and easy collection. Therefore, here we report a gender-specific cascading system for risk assessment of CHD based on physical examination data. The dataset consists of 39,538 CHD patients and 640,465 healthy individuals from the Luzhou Health Commission in Sichuan, China. Fifty physical examination characteristics were considered, and after feature screening, ten risk factors were identified. To facilitate large-scale CHD risk screening, a CHD risk model was developed using a fully connected network (FCN). For males, the model achieves AUCs of 0.8671 and 0.8659, respectively on the independent test set and the external validation set. For females, the AUCs of the model are 0.8991 and 0.9006, respectively on the independent test set and the external validation set. Furthermore, to enhance the convenience and flexibility of the model in clinical and real-life scenarios, we established a CHD risk scorecard base on logistic regression (LR). The results show that, for both males and females, the AUCs of the scorecard on the independent test set and the external verification set are only slightly lower (<0.05) than those of the corresponding prediction model, indicating that the scorecard construction does not result in a significant loss of information. To promote CHD personal lifestyle management, an online CHD risk assessment system has been established, which can be freely accessed at http://lin-group.cn/server/CHD/index.html .

Endoscopic grading of gastric atrophy and histological gastritis staging on risk assessment for early gastric cancer: A case-control study.

OBJECTIVES: To assess the predictive value of endoscopic grading of gastric atrophy using Kimura-Takemoto classification, histological grading systems of operative link on gastritis assessment (OLGA) and operative link on gastric intestinal metaplasia (OLGIM) on risk stratification for early gastric cancer (EGC) and other potential risk factors of EGC. METHODS: A single-center, case-control study was retrospectively conducted including 68 patients with EGC treated with endoscopic submucosal dissection and 68 age- and sex-matched control subjects. Kimura-Takemoto classification, OLGA and OLGIM systems, and other potential risk factors were evaluated between the two groups. RESULTS: Of the 68 EGC lesions, 22 (32.4%) were well differentiated, 38 (55.9%) were moderately differentiated, and 8 (11.8%) were poorly differentiated, respectively. Multivariate analysis revealed O-type Kimura-Takemoto classification (adjusted odds ratio [AOR] 3.282, 95% confidence interval [CI] 1.106-9.744, P = 0.032) and OLGIM stage III/IV (AOR 17.939, 95% CI 1.874-171.722, P = 0.012) were significantly related to a higher risk of EGC. Especially, O-type Kimura-Takemoto classification within 6-12 months before EGC diagnosis (AOR 4.780, 95% CI 1.650-13.845, P = 0.004) was independently associated with EGC risk. Areas under the receiver operating characteristic curve of the three systems for EGC were comparable. CONCLUSIONS: Endoscopic Kimura-Takemoto classification and histological OLGIM stage III/IV are independent risk factors for EGC, which may reduce the need for biopsies in risk stratification of EGC. Further multicenter prospective studies of large sizes are needed.

Association of public health insurance with cancer-specific mortality risk among patients with nasopharyngeal carcinoma: a prospective cohort study in China.

Objective: Health insurance programs are effective in preventing financial hardship in patients with cancer. However, not much is known about how health insurance policies, especially in Southwest China with a high incidence of nasopharyngeal carcinoma (NPC), influence patients' prognosis. Here, we investigated the association of NPC-specific mortality with health insurance types and self-paying rate, and the joint effect of insurance types and self-paying rate. Materials and methods: This prospective cohort study was conducted at a regional medical center for cancer in Southwest China and included 1,635 patients with pathologically confirmed NPC from 2017 to 2019. All patients were followed up until May 31, 2022. We determine the cumulative hazard ratio of all-cause and NPC-specific mortality in the groups of various insurance kinds and the self-paying rate using Cox proportional hazard. Results: During a median follow-up period of 3.7 years, 249 deaths were recorded, of which 195 deaths were due to NPC. Higher self-paying rate were associated with a 46.6% reduced risk of NPC-specific mortality compared to patients with insufficient self-paying rate (HR: 0.534, 95% CI: 0.339-0.839, p = 0.007). For patients covered by Urban and Rural Residents Basic Medical Insurance (URRMBI), and for patients covered by Urban Employee Basic Medical Insurance, each 10% increase in the self-paying rate reduced the probability of NPC-specific death by 28.3 and 25%, respectively (UEBMI). Conclusion: Results of this study showed that, despite China's medical security administration improved health insurance coverage, NPC patients need to afford the high out-of-pocket medical costs in order to prolong their survival time.

Ultrafast and Cost-Effective Fabrication of High-Performance Carbon-Based Flexible Thermoelectric Hybrid Films and Their Devices.

Due to their cost-effectiveness and industry-scale feasibility, carbon-based composites have been considered to be promising thermoelectric materials for low-grade power generation. However, current fabrications for carbon-based composites are time-consuming, and their thermoelectric properties are still low. Herein, we develop an ultrafast and cost-effective hot-pressing method to fabricate a novel carbon-based hybrid film, which consists of ionic liquid/phenolic resin/carbon fiber/expanded graphite. This method only costs no more than 15 min. We found that the expanded graphite as the major component enables high flexibility and the introduction of phenolic resin and carbon fiber enhances the shear resistance and toughness of the film, while the ion-induced carrier migration contributes to a high power factor of 38.7 µW m-1 K-2 at 500 K in the carbon-based hybrid film. After the comparison based on the ratios between the power factor with fabrication time and cost among the current conventional carbon-based thermoelectric composites, our hybrid films show the best cost-effective property. Besides, a flexible thermoelectric device, assembled by the as-designed hybrid films, shows a maximum output power density of 79.3 nW cm-2 at a temperature difference of 20 K. This work paves a new way to fabricate cost-effective and high-performance carbon-based thermoelectric hybrids with promising application potential.

Research on the Measurement of the Coordinated Relationship between Industrialization and Urbanization in the Inland Areas of Large Countries: A Case Study of Sichuan Province.

Industrialization and urbanization are critical paths to modernization for a country or region. The coordination of industrialization and urbanization fosters the development of a regional economy. In academic circles, this is usually measured by the IU ratio (ratio of labor industrialization rate to urbanization rate) and the NU ratio (ratio of non-agricultural employment rate to urbanization rate). However, these methods are inapplicable to large countries' inland areas. The traditional methods failed to explain the real situation and produced contradictory results. The IU ratio shows that industrialization lags behind urbanization, while the NU ratio shows that industrialization is ahead of urbanization. According to studies conducted in the Sichuan Province of China, through comparison with Jiangsu Province, it is found that the non-agricultural employment growth is not dependent on the development of local industrialization, and rural-urban migration is not entirely dependent on the evolution of the non-agricultural employment rate. Other factors that promote urbanization, such as the country's capital policies and funds for migrant labor force transfer, should also be considered. This research attempts to improve the traditional methods for measuring the degree of urbanization and industrialization synergy in inland areas. The new empirical approach can effectively identify the critical characteristics of urbanization in inland provinces, such as the development of non-agricultural employment with external assistance and urban migrants "unrelated to employment opportunities". Based on these key characteristics, it can provide the basis for local urbanization policy formulation.

A Facile Strategy to Obtain Low-Cost and High-Performance Gold-Based Catalysts from Artificial Electronic Waste by [Zr48 Ni6 ] Nano-Cages in MOFs for CO2 Electroreduction to CO.

Expensive gold-based catalysts are frequently used for electrochemical CO2 reduction into CO. A feasible approach to obtain low-cost Au-based catalysts is needed. Herein, a novel framework 1 assembled from [Zr48 Ni6 ] nano-cages is prepared. It exhibits a high BET surface area of 1569 m2 g-1 and high solvents/pH stability. 1 can not only selectively extract AuCl4 - from artificial electronic waste, but can then be transformed into low-cost catalyst Au nanoparticle@1-x (Au NPs@1-x, x=1, 2, 3, 4) with tuneable Au NPs sizes. The CO2 RR investigations revealed that the Au NPs@1-3 displayed an excellent FECO of 95.2 % with a current density of 102.9 mA cm-2 at -1.1 V, and such high catalytic activity can be maintained for at least 15 h without obvious decrease because the confinement effect of [Zr48 Ni6 ] nano-cages prevents Au NPs agglomeration. This work offers a facile strategy to obtain low-cost and high-performance Au-based catalysts for various reactions activated by Au.

Dynamic Impact of Technology and Finance on Green Technology Innovation Efficiency: Empirical Evidence from China's Provinces.

In the new stage of global economic development, we hope to achieve both economic development and environmental improvement through green technology innovation. How to effectively obtain the support of technology and finance to green technology innovation is an issue worth studying. This paper constructed an improved super-SBM-DEA efficiency measurement model and combined it with the window analysis method to measure the green technology innovation efficiency (GTIE) of Chinese provinces from 2006 to 2018. Then, based on the PVAR model, the impulse response function and Monte Carlo simulation were used to study the dynamic impact of various variables of technology and finance on GTIE. Finally, the variance decomposition was used to explore the contribution degree of each variable of technology and finance to improving GTIE. The results revealed the following: (1) the average value of China's provincial GTIE from 2006 to 2018 was 0.42, which is relatively low and shows a trend of volatility and rising. (2) From the impulse response results, it could be seen that various variables of technology and finance have always had a positive impact on GTIE. However, there are differences in the influence degree, shock effect, and dynamic transmission mechanism. (3) The results of the variance decomposition showed that government financial technology investment had the highest contribution to the improvement of GTIE, followed by bank technology credit, then by enterprise independent R&D investment, and finally venture capital. This paper offered a reference to developing countries with regard to improving their GTIE and studying the role of technology and finance.

Multidimensional assessment and cluster analysis for OSA phenotyping.

STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is a heterogeneous disease with varying phenotype. A cluster analysis based on multidimensional disease characteristics, including symptoms, anthropometry, polysomnography, and craniofacial morphology, in combination with auto-continuous positive airway pressure titration response and comorbidity profiles, was conducted within a well-characterized cohort of patients with OSA, with the aim to refine the current phenotypic expressions of OSA with clinical implications. METHODS: Two hundred ninety-one patients with a new diagnosis of moderate to severe OSA referred for auto-continuous positive airway pressure titration to the sleep center were included for analysis. In-laboratory polysomnography and craniofacial computed tomography scanning were performed, followed by an auto-continuous positive airway pressure titration. The symptom of excessive daytime sleepiness was assessed using the Epworth Sleepiness Scale. RESULTS: Three patient phenotypes-normal weight, nonsleepy, moderate OSA; obese, nonsleepy, severe OSA; and obese, sleepy, very severe OSA with craniofacial limitation-were identified. Among the polysomnography parameters, only percentage of N3 time of total sleep time (N3%) and mean pulse oxygen saturation were found to be associated with the Epworth Sleepiness Scale score, and they only explained a small fraction of the variation (R2 = .136). Neck circumference and craniofacial limitation were associated with the more severe phenotype, which had a higher prevalence of hypertension and metabolic syndrome, greater diurnal blood gas abnormalities, and worse positive airway pressure titration response. CONCLUSIONS: Three OSA phenotypes were identified according to multiple aspects of clinical features in patients with moderate to severe OSA, who differed in their prevalence of hypertension, metabolic syndrome, diurnal blood gas parameters, and continuous positive airway pressure titration response. Self-reported excessive daytime sleepiness was not related with the severity of sleep breathing disturbance, and craniofacial limitation was associated with the more severe phenotype. These findings highlight the necessity of integrating multiple disease characteristics into phenotyping to achieve a better understanding of the clinical features of OSA. CITATION: Zhang XL, Zhang L, Li YM, et al. Multidimensional assessment and cluster analysis for OSA phenotyping. J Clin Sleep Med. 2022;18(7):1779-1788.

Testing environmental Kuznets curve hypothesis: considering the impact of Sino-US trade on three main industries in China.

To achieve carbon neutrality and carbon reduction goals, China needs to consider industrial structure and trade. This study aims to test the validity of environmental Kuznets curve (EKC) hypothesis at the industry level in China and study the different impact of Sino-US trade in intermediate goods and trade in final goods on China's environment. To do so, we used the annual data of China's 25 sectors in 1990-2015 and classified 25 sectors into three main industries. Based on the Stochastic Impacts by Regression on Population, Affluence and Technology framework, we investigated the validity of EKC hypothesis and the driving factors of greenhouse gas (GHG) emissions. The results show that (1) EKC hypothesis is verified for the country and the tertiary industry. (2) Compared with the primary industry and the secondary industry, the economic growth of the tertiary industry brings less GHG emissions. (3) Intermediate goods exported to all sectors in the USA will increase GHG emissions in the country and the three main industries, but final goods exported to consumers in the USA will reduce GHG emissions except the tertiary industry. From our results, the EKC hypothesis is a suitable model for environmental policy in tertiary industry, but it does not apply to the primary industry and the secondary industry. Environmental policy in the primary industry and the secondary industry needs to focus on reducing energy intensity. In the case of exports to the USA, intermediate goods pollute the environment, while final improve the environment. Thus, China needs to increase controls on exports of intermediate goods with low added value and high pollution and gradually shift to the production of environmentally friendly final goods.

Fast assessment of left ventricular systolic function in obstructive sleep apnea patients with automated function imaging: Comparison with mitral annular plane systolic excursion.

BACKGROUND: Early detection of left ventricular (LV) subclinical dysfunction is clinically relevant before developing irreversible impairment in obstructive sleep apnea (OSA) patients. Mitral annulus plane systolic excursion (MAPSE) is a fast tool for OSA due to high prevalent obesity; another quick but more comprehensive tool is LV global longitudinal stain (GLS) based on automated function imaging (AFI). We therefore aimed to compare the feasibility and reproducibility of AFI to MAPSE in OSA patients, as a good model in whom obesity is common. METHODS: A comprehensive echocardiographic examination was done in 186 consecutive patients having polysomnography for suspected OSA. MAPSE was measured by using M-mode to calculate excursion of mitral annulus. GLS was derived by offline analysis of three long-axis views that semi-automatically detects LV endocardial boundary, which is adjusted manually as necessary with AFI measurement. Variability of AFI and MAPSE were compared among the different subgroups. RESULTS: Despite a relatively high obesity rate (42.9%), the feasibility of AFI was 94% (175/186) and that of 100% in MAPSE. AFI showed excellent correlation (r = .882) superior to MAPSE (r = .819) between the Expert and Beginner. Intra- and inter- observer variability of AFI and MAPSE in Bland-Altman analysis were 5.5% and 6.5%; 6.2% and 8.8%, respectively. In repeated measurements, AFI showed higher intra-class correlation (ICC = .95) than MAPSE (ICC = .87) (p < 0.05). Furthermore, analysis showed that AFI was feasible even in more obese patients (BMI≥28 kg/m2 ). CONCLUSIONS: Even in obese patients with OSA, AFI-GLS is feasible and more reliable for less expert operators than MAPSE in detecting LV longitudinal dysfunction.

The implications of childcare on grandparents' health self-management in a Chinese elderly population.

Grandparents caring for grandchildren has become a common experience in China. However, the health implications of grandparenting, especially for health self-management, remain unclear. A cross-sectional study was conducted to investigate the effects of grandparenting on health self-management in older adults in China. Information on socioeconomic characteristics, grandparenting, and health self-management was collected through interviewer-administered questionnaires. Age less than 50, male gender, higher education level, being a local resident, having a chronic illness, and supporting themselves financially were all factors that were significantly positively associated with health self-management (P < .05) in grandparents. Grandparenting characteristics, including caring for grandchildren at night, a caregiving burden of more than 50%, poorly behaved grandchildren, caring for grandchildren more than 6 hours per day, and caring for grandchildren less than 1 year in age were significantly negatively associated with health self-management in grandparents (P < .05). Multiple regression analyses indicated that grandparent age, receiving financial support from children, being a local resident, education level, grandchild behavior and age, and being an urban resident were all statistically significant factors associated with health self-management in grandparents involved in grandparenting. Taken together, these results suggested that financial condition and caregiving burden might be the major factors affecting health self-management in grandparents involved in grandparenting.

Factors affecting self-perceived participation and autonomy among patients with burns: A follow-up study.

OBJECTIVE: This study aimed to evaluate self-perceived participation and autonomy in patients with burns in Fujian, China, and to identify key factors influencing these parameters. METHODS: We investigated 212 patients admitted to the burns unit 1 and 3months after discharge using the Impact on Participation and Autonomy (IPA), Acceptance of Disability Scale-Revised, Herth Hope Index, Modified Barthel Index Rating Scale, Visual Analogue Scale, and a self-designed demographic data and disease condition questionnaires. Influencing factors were identified using multivariable linear regression. RESULTS: The general IPA questionnaire scores were 2.13±0.74 and 2.03±0.72 at 1 and 3months post-discharge, respectively. Acceptance of disability, hope, and social participation were significantly correlated (P<0.01). Financial situation, pain level, activities of daily living, acceptance of disability, and hope were major factors affecting self-perceived participation and autonomy 3months post-discharge, accounting for a variance of 77.5%. CONCLUSION: Medium-to-low levels of self-perceived participation and autonomy were observed 1 and 3months post-discharge. Clinicians should adopt specific measures to help patients (including those from poor economic backgrounds) successfully reintegrate into their families/societies. These include alleviating their pain, encouraging participation in daily activities while accepting their disabilities, and offering hope.

Biodistribution and toxicity assessment of intratumorally injected arginine-glycine-aspartic acid peptide conjugated to CdSe/ZnS quantum dots in mice bearing pancreatic neoplasm.

Quantum dots (QDs) conjugated with arginine-glycine-aspartic acid (RGD) peptides (which are integrin antagonists) are novel nanomaterials with the unique optical property of high molar extinction coefficient, and they have potential utility as photosensitizers in photodynamic therapy (PDT). Our group previously demonstrated significant benefits of using PDT with QD-RGD on pancreatic tumor cells. This study aimed to evaluate the biodistribution and toxicity of QD-RGD in mice prior to in vivo application. Mice with pancreatic neoplasms were intratumorally injected with varying doses of QD-RGD, and the biodistribution 0-24 h post injection was compared to that in control mice (intravenously injected with unconjugated QD). Various tissue samples were collected for toxicity analyses, which included inductively coupled plasma mass spectrometry (ICP-MS) to assess Cd2+ concentrations and hematoxylin-eosin staining for histopathological examination. Fluorescent imaging revealed relatively sufficient radiant efficiency in mice under specific conditions. The ICP-MS and HE data showed no significant signs of necrosis due to Cd2+ release by QDs. The mice survived well and had no apparent weakness or weight loss during the 4 weeks post injection. These findings provide novel insights into the biodistribution of QD-RGD and encourage profound in vivo studies regardless of safety concerns. These findings alleviate safety concerns and provide novel insights into the biodistribution of QD-RGD, offering a solid foundation for comprehensive in vivo studies.

Impact of Visceral Obesity and Sarcopenia on Short-Term Outcomes After Colorectal Cancer Surgery.

BACKGROUND: With the increased prevalence of obesity and sarcopenia, those patients with both visceral obesity and sarcopenia were at higher risk of adverse outcomes. AIM: The aim of this study was to ascertain the combined impact of visceral obesity and sarcopenia on short-term outcomes in patients undergoing colorectal cancer surgery. METHODS: We conducted a prospective study from July 2014 to February 2017. Patients' demographic, clinical characteristics, physical performance, and postoperative short-term outcomes were collected. Patients were classified into four groups according to the presence of sarcopenia or visceral obesity. Clinical variables were compared. Univariate and multivariate analyses evaluating the risk factors for postoperative complications were performed. RESULTS: A total of 376 patients were included; 50.8 and 24.5% of the patients were identified as having "visceral obesity" and "sarcopenia," respectively. Patients with sarcopenia and visceral obesity had the highest incidence of total, surgical, and medical complications. Patients with sarcopenia or/and visceral obesity all had longer hospital stays and higher hospitalization costs. Age ≥ 65 years, visceral obesity, and sarcopenia were independent risk factors for total complications. Rectal cancer and visceral obesity were independent risk factors for surgical complications. Age ≥ 65 years and sarcopenia were independent risk factors for medical complications. Laparoscopy-assisted operation was a protective factor for total and medical complications. CONCLUSION: Patients with both visceral obesity and sarcopenia had a higher complication rate after colorectal cancer surgery. Age ≥ 65 years, visceral obesity, and sarcopenia were independent risk factors for total complications. Laparoscopy-assisted operation was a protective factor.

China's Efforts on Management, Surveillance, and Research of Noncommunicable Diseases: NCD Scorecard Project.

BACKGROUND: The incidence of noncommunicable diseases (NCDs) is rising dramatically throughout the world. Aspects of researches concerned with the improvement and development of prevention and control of NCDs have been conducted. Furthermore, the influence of most determinants of the major NCDs has showed that a broad and deep response involving stakeholders in different sectors is required in the prevention and control of NCDs. OBJECTIVE: China has experienced an increase in NCDs in a short period compared with many countries. To address the burden of NCDs in China, it is important to learn about the progress that has been made in prevention and control of NCDs in China and worldwide, informed by opinions of stakeholders in different areas. METHODS: In 2014, GRAND South developed the NCD Scorecard instrument to evaluate progress of NCD prevention and control in 23 countries through a 2-round Delphi process. The scorecard included 51 indicators in 4 domains: governance, surveillance and research, prevention and risk factors, and health system response. Stakeholders were then selected in the areas of government, nongovernmental organizations, private sectors, and academia to join the NCD Scorecard survey. Indicators of progress were scored by stakeholders from 0 (no activity), 1 (present but not adequate), and 2 (adequate) to 3 (highly adequate) and then the percentage of progress in each domain was calculated, representing the current situation in each country. FINDINGS: There were 14 indicators in the domains of governance and surveillance and research. Of 429 stakeholders worldwide, 41 in China participated in the survey. China scored in the top 5 out of all participating countries in those 2 domains, scoring 67% in governance and 64% in surveillance and research. Indicators on which China scored particularly well included having a well-resourced unit or department responsible for NCDs, having a strong national system for recording the cause of all deaths, and having a system of NCD surveillance. Areas where China had the greatest need for improvement included increasing taxes on tobacco and addressing the needs of the population older than age 70 dying from major NCDs. CONCLUSION: In China the burden of disease of NCDs and disabilities remains serious, although China has put significant efforts into its governance and surveillance and research. To improve, further action is needed on reducing tobacco consumption, increasing investment in the national health budget, and increasing the focus on system construction.

[Assessment on Minnesota Living with Heart Failure Questionnaire in the Principle of Chinese Civilization and Traditional Medicine Characteristics].

Objective To assess Minnesota living with heart failure questionnaire in the principle of Chinese civilization and Traditional Medicine characteristics (C-MLHF). Methods A survey was con- ducted in 124 heart failure ( HF) patients using C-MLHF and Minnesota living with heart failure question- naire (MLHF). Reliability, validity, feasibility, and the correlation of New York Heart Association (NYHA) classification was compared between the two questionnaires. Results The recovery of C-MLHF was 95. 2% (118/124) ,the effective rate was 97. 5% (115/118), Cronbach's α was 0. 896, and the validity ranged 0. 505 -0. 875. The correlation with MLHF was 0. 946 (P <0. 01) , the correlation with NYHA classi- fication was 0. 524 (P <0. 05). The recovery of MLHF was 95. 2% (118/124) , the effective rate was 88. 1%(104/118) , Cronbach's a was 0. 889, and the validity ranged 0. 487 -0. 787. The correlation with NYHA classification was 0. 468 (P <0. 05). Conclusions The C-MLHF had better feasibility, reliability, validity, and relativity between feasibility/reliability and NYHA classification, as compared with MLHF. In conclusion C-MLHF was more suitable for assessing quality of life for Chinese HF patients.