Epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China:a hospital-based retrospective study

Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimotor recovery,increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.

Cost analysis of radical resection of malignant breast tumors under the China Healthcare Security Diagnosis Related Groups payment system

BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hospitalization costs and structure,and explored the impact of China Healthcare Security Diagnosis Related Groups(CHS-DRG)management on patient costs.It aimed to provide medical institutions with ways to reduce costs,optimize cost structures,reduce patient burden,and improve service efficiency.AIM To study the CHS-DRG payment system’s impact on breast cancer surgery costs.METHODS Using the CHS-DRG(version 1.1)grouping criteria,4073 patients,who underwent the radical resection of breast malignant tumors from January to December 2023,were included in the JA29 group;1028 patients were part of the CHS-DRG payment system,unlike the rest.Through an independent sample t-test,the length of hospital stay as well as total hospitalization,medicine and consumables,medical,nursing,medical technology,and management expenses were compared.Pearson’s correlation coefficient was used to test the cost correlation.RESULTS In terms of hospitalization expenses,patients in the CHS-DRG payment group had lower medical,nursing,and management expenses than those in the diagnosis-related group(DRG)non-payment group.For patients in the DRG payment group,the factors affecting the total hospitalization cost,in descending order of relevance,were medicine and consumable costs,consumable costs,medicine costs,medical costs,medical technology costs,management costs,nursing costs,and length of hospital stay.For patients in the DRG nonpayment group,the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses,consumable expenses,medical technology expenses,the cost of medicines,medical expenses,nursing expenses,length of hospital stay,and management expenses.CONCLUSION The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs,medical consumable costs,and the length of hospital stay while ensuring medical safety.

Surgical treatment of liver cancer and pancreatic cancer under the China Healthcare Security Diagnosis Related Groups payment system

BACKGROUND Data from the World Health Organization’s International Agency for Research on Cancer reported that China had the highest prevalence of cancer and cancer deaths in 2022.Liver and pancreatic cancers accounted for the highest number of new cases.Real-world data(RWD)is now widely preferred to traditional clinical trials in various fields of medicine and healthcare,as the traditional research approach often involves highly selected populations and interventions and controls that are strictly regulated.Additionally,research results from the RWD match global reality better than those from traditional clinical trials.AIM To analyze the cost disparity between surgical treatments for liver and pancreatic cancer under various factors.METHODS This study analyzed RWD 1137 cases within the HB1 group(patients who underwent pancreatectomy,hepatectomy,and/or shunt surgery)in 2023.It distinguished different expenditure categories,including medical,nursing,technical,management,drug,and consumable costs.Additionally,it assessed the contribution of each expenditure category to total hospital costs and performed cross-group comparisons using the non-parametric Kruskal–Wallis test.This study used the Steel–Dwass test for post-hoc multiple comparisons and the Spearman correlation coefficient to examine the relationships between variables.RESULTS The study found that in HB11 and HB13,the total hospitalization costs were significantly higher for pancreaticoduodenectomy than for pancreatectomy and hepatectomy.Although no significant difference was observed in the length of hospital stay between patients who underwent pancreaticoduodenectomy and pancreatectomy,both were significantly longer than those who underwent liver resection.In HB15,no significant difference was observed in the total cost of hospitalization between pancreaticoduodenectomy and pancreatectomy;however,both were significantly higher than those in hepatectomy.Additionally,the length of hospital stay was significantly longer for patients who underwent pancreaticoduodenectomy than for those who underwent pancreatectomy or liver resection.CONCLUSION China Healthcare Security Diagnosis Related Groups payment system positively impacts liver and pancreatic cancer surgeries by improving medical quality and controlling costs.Further research could refine this grouping system and ensure continuous effectiveness and sustainability.

The Islamic Studies in China:Research in the Field of History

A history of the Islamic studies in China,not only includes studies on world Islam,it also includes research on Islam and Muslims in China.Before the Reform and Opening Up,China did not achieve much in this field,since then,the research field of Islam and Muslim in China has been expanding and the results have been published,forming a new trend.In this field,scholars such as Jin Yijiu,Li Xinghua,Qin Huibin,Zhou Guoli,Sha Qiuzhen,Zhou Xiefan,Wu Yungui,and Yang Huaizhong have made the most outstanding achievements.Especially in the collation of reference books and historical materials,in the past 20 years,The Encyclopedia of the history of Islam,The Chinese Encyclopedia of Islam have emerged,and the Chinese and World Encyclopedia of Islamic Law and other important historical books have been published.This paper focuses on the field of historical research and divided into academic research history at home and abroad,which is discussed from several fields such as general history,special history,national history,and regional history.

Burden of Cirrhosis and Other Chronic Liver Diseases Caused by Specific Etiologies in China, 1990-2016:Findings from the Global Burden of Disease Study 2016

Objective To estimate the burden of cirrhosis and other chronic liver diseases caused by specific etiologies in China.Methods Data from the Global Burden of Disease Study 2016(GBD 2016)were used.We evaluated the burden by analyzing age-sex-province-specific prevalence,mortality,and disability-adjusted lifeyears(DALYs)of 33 provinces in China.Results From 1990 to 2016,prevalence cases in thousands increased by 73.7%from 6833.3(95%UI:6498.0–7180.6)to 11869.6(95%UI:11274.6–12504.7).Age-standardized mortality and DALY rates per100,000 decreased by 51.2%and 53.3%,respectively.Male and elderly people(aged≥60 years)preponderance were found for prevalence,mortality,and DALYs.The number of prevalence cases,deaths,and DALYs due to hepatitis C virus(HCV)increased by 86.6%,8.7%,and 0.9%,respectively.Also,age-standardized prevalence rates decreased in 31 provinces,but increased in Yunnan and Shandong.The Socio-demographic Index(SDI)values were negatively correlated with age-standardized mortality and DALY rates by provinces in 2016;the correlation coefficients were-0.817 and-0.828,respectively.Conclusion Cirrhosis and other chronic liver diseases remain a huge health burden in China,with the increase of population and the aging of population.Hepatitis B virus(HBV)remains the leading cause of the health burden in China.

Observational Study on the Onset of the South China Sea Southwest Monsoon

Based on the long-term marine ship observation data, records of meteorological stations and High-Reflective Cloud(HRC) data by satellite remote sensing , this paper has studied the circulation patterns and variability in elements during onset and the established periods of the South China Sea(SCS) southwest(SW) monsoon. The averaged date of the onset SW monsoon in the SCS occurs in the middle of May climatologically. The corresponding date for the northern part is little earlier (May 12) and those for the southern parts are little later (May 20). The interannual range of the onset dates is about one month. Following the onset of the SW monsoon, the cloud amount and the precipitation increase while the convection activities enhance over the SCS. But there is a strong spatial heterogeneity within the domain. After onset of the SW monsoon the strong convective area moves northwards, while the SCS rain band moves to the center and north. Sea surface temperature(SST) increases rapidly before the onset and the leading time is about one month. The increment of SST supplies heat and vapor for the onset. From April to May the surface heat fluxes display obvious changes, e.g., latent heat exchange and evaporation enhancement. It is one of the reasons why the SW monsoon bursts firstly in the SCS.

Diagnostic Study of Apparent Heat Sources and Moisture Sinks in the South China Sea and its Adjacent Areas during the Onset of 1998 SCS Monsoon

The apparent heat sources (?Q1 ?) and moisture sinks (?Q2 ?) are calculated based on the reanalyzed data of the South China Sea Monsoon Experiment (SCSMEX) from May 1 to August 31, 1998. It is found that the formation and distribution of the atmospheric heat sources are important for the monsoon onset. The earlier onset of the SCS monsoon is the result of enduring atmospheric heating in the Indo–China Peninsula and South China areas. The atmospheric heating firstly appears in the Indo–China Peninsula area and the sensible heat is the major one. The 30–50 day periodic oscillation of atmospheric heat sources between the SCS area and the western Pacific warm pool has a reverse phase distribution before the middle of July and the low frequency oscillation of heat sources in SCS area has an obvious longitudinal propagation. The 30–50 day low frequency oscillation has vital modificatory effects on the summer monsoon evolution during 1998. Key words Apparent heat sources - Apparent moisture sinks - The South China Sea monsoon - Diagnostic Study Sponsored by the National Key Project of Fundamental Research “ SCSMEX” and the Research Fund for the Doctoral Program of Higher Education: “ Study of the Air-sea Interaction in the SCS Monsoon Region”.

Prevalence and correlates of meeting the muscle-strengthening exercise recommendations among Chinese children and adolescents:Results from 2019 Physical Activity and Fitness in China—The Youth Study

Purpose This study aimed to describe the national prevalence of Chinese children and adolescents who met the World Health Organization muscle-strengthening exercise(MSE)recommendations and identify correlates of meeting the MSE recommendations.Methods Cross-sectional data from the 2019 Physical Activity and Fitness in China—The Youth Study,a nationally representative sample of Chinese children and adolescents(n=80,413;mean age=13.7 years;53.9%girls)and their parents,were analyzed.Children and adolescents who reported engaging≥3 days(up to 7 days)of MSE per week were classified as meeting the MSE recommendations.MSE,demographics,lifestyle behaviors(sport participation,moderate-to-vigorous physical activity,screen time,and sleep duration),exercise intention,peer and parental support,and parental MSE participation were assessed through self-reports.Logistic regression models were used to determine the correlates of meeting the MSE recommendations.The analyses were completed in 2020.Results Overall,39.3%of children and adolescents met the MSE recommendations.Girls,10th-12th graders,minorities,those from lower income households and those from families with lower parental education were less likely to meet the MSE recommendations.Children and adolescents who were proficient in≥2 sports were more likely to meet the MSE recommendations(adjusted odds ratio(aOR)=1.44,95%confidence interval(95%CI):1.26-1.65),as were those with more moderate-to-vigorous physical activity(aOR=1.57,95%CI:1.53-1.61).Additionally,children and adolescents with high exercise intention(aOR=1.60,95%CI:1.51-1.69),those whose parents met the adult MSE recommendations(aOR=1.46,95%CI:1.40-1.52),and those who received high peer(aOR=1.27,95%CI:1.20-1.34)and parental support(aOR=1.07,95%CI:1.04-1.12)were more likely to meet the MSE recommendations.Conclusion Less than two-fifths of Chinese children and adolescents met the World Health Organization MSE recommendations.The correlates identified in our study can help inform the development of school and community based strategies and policies to enhance participation in MSE and improve muscular fitness of all Chinese children and adolescents.

A Monitoring Study of the 1998 Rainstorm along the Yangtze River of China by Using TIPEX Data

By using data from the Secondary Tibetan Plateau Science Experiment (TIPEX) in 1998, including enhanced soundings, surface observations, data from captive balloons, remote sensing, and Doppler radar (China and Japan cooperative study of GAME/ Tibet), a monitoring study on the generation and moving track of the cumulus convective systems over the Tibetan Plateau is made, and the relationship between the evolution of cloud systems over the Tibetan Plateau and 1998 flooding in China is studied. The results are as follows. 1) Analyzing the image animation and Hovmoller diagram of satellite TBB data shows that the rainstorms for the Yangtze River in the last ten days of July 1998 can be tracked regionally to the Tibetan Plateau. 2) For the period of cloud clusters passing through the Amdo station (18–19 July), monitoring observations by Doppler radar is made. The monitoring of radar echoes shows that the developing, eastward motion, and strengthening of the echoes can be frequently observed in the middle of the Tibetan Plateau. An integrated analysis and tracking of the generation, disappearance, development, and eastward motion of these convective systems by using multiple instruments is very valuable for diagnosing and predicting the influence of the plateau systems on the downstream weather situation. 3) The integrated analysis of space-time cross sections of the enhanced upper air and surface observations from TIPEX during the intensified observation period shows that the frequent development of convective clouds over the Tibetan Plateau is related with the quasi-stationary convergence of surface winds. The dynamic convergence of surface winds, the vertical shear in the upper air, and transportation of water vapor due to increasing humidity over the Tibetan Plateau played an important role in the developing and strengthening of rainstorms over the Yangtze River in 1998. 4) Meso-sale filtration analysis of the vertical distribution of water vapor over the Tibetan Plateau indicates that alternating changes of high and low water vapor distribution over the Tibetan Plateau reveals clearly that the sub-synoptic scale waves exist, whose lifetime is on the order of the hours. The revelation of the eastward motion of mesoscale waves from the Tibetan Plateau indicates that the plateau systems obviously influenced the rainstorms over the Yangtze River valley in 1998.

A comparative study of the main factors controlling geohazards induced by 10 strong earthquakes in Western China since the Wenchuan earthquake in 2008

Determining the main controlling factors of earthquake-triggered geohazards is a prerequisite for studying earthquake geohazards and post-disaster emergency response.By studying these factors,the geomorphic and geological factors controlling the nature,condition,and distribution of earthquake-induced geohazards can be analyzed.Such insights facilitate earthquake disaster prediction and emergency response planning.The authors combined field investigations and spatial data analysis to examine geohazards induced by seismic events,examining ten earthquakes including the Wenchuan,Yushu,Lushan events,to elucidate the main control factors of seismic geohazard.The authors observed that seismic geohazard occurrence is usually affected by many factors,among which active nature of the seismogenic fault,seismic peak ground acceleration(PGA),topographic slope and geomorphic height differences,and distance from the fault zone and river system are the most important.Compared with strike-slip earthquakes,thrust earthquakes induce more high-altitude and high-speed remote landslides,which can cause great harm.Slopes of 0°–40°are prone to secondary seismic geohazards,which are mainly concentrated 0–6 km from the river system.Secondary geohazards are not only related to seismogenic fault but also influenced by the associated faults in the earthquake area.The maximum seismic PGA and secondary seismic geohazard number are positively correlated,and the horizontal and vertical ground motions play leading and promoting roles in secondary geohazard formation,respectively.Through the research,the spatial distribution of seismic geohazards is predicted,providing a basis for the formulation of emergency response plans following disasters.

A Multilayer Study of pCO2 in the Surface Waters of the Yellow and South China Seas in Spring and the Sea-Air Carbon Dioxide Flux

A multilayer study of pCO2 for the Yellow and South China Seas in the surface waters was conducted based on data from four cruises sponsored by the China SOLAS Project in 2005 and 2006,including data for the surface microlayer(SML) ,subsurface layer(SSL) and surface layer(SL) . The carbon fluxes across the air-sea interface were calculated. The results showed that the pCO2 values in the surface waters of the study area decreased in the following order:pCO2 SML> pCO2 SSL> pCO2 SL. The highest values were found in March for all SML,SSL and SL,followed by those in April,and the lowest were in May. The pCO2 values had a significant positive correlation with temperature or salinity. While there was no relationship between pCO2 and longitude,there was a significant negative correlation between it and latitude,i.e.,'high latitude low pCO2'. By using four calculation models,the carbon dioxide fluxes(FC O2) in spring in the Yellow and South China Seas,which were found to act as a 'sink' of atmospheric CO2,were preliminarily estimated on the basis of the pCO2 data in the SML to be -7.00×106 t C and -22.35×106 t C,respectively. It is suggested that the FC O2calculated on the basis of pCO2 data in the SML is more reliable than that calculated on the basis of those in the SL.

Real-world 10-year retrospective study of the guidelines for diagnosis and treatment of primary liver cancer in China

BACKGROUND Hepatocellular carcinoma(HCC) is a common malignant tumor worldwide. Many regions across the world have issued various HCC diagnosis and treatment protocols to improve the diagnosis and targeted treatment of patients with HCC. However, real-world studies analysing the practice, application value, and existing problems of the China Liver Cancer(CNLC) staging system are scarce.AIM To analyze the current situation and problems associated with the Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China.METHODS We collected the medical records of all patients with HCC admitted to the First Affiliated Hospital of Zhengzhou University from January 1, 2011 to December 31, 2019, and recorded the hospitalization information of those patients until December 31, 2020. All information on the diagnosis and treatment of the target patients was recorded, and their demographic and sociological characteristics, CNLC stages, screening situations, and treatment methods and effects were analyzed. The survival status of the patients was obtained from follow-up data.RESULTS This study included the medical records of 3022 patients with HCC. Among these cases, 304 patients were screened before HCC diagnosis;their early-stage diagnosis rate was 69.08%, which was significantly higher than that of patients with HCC who were diagnosed without screening and early detection(33.74%). Herein, patients with no clinical outcome at discharge were followed up, and the survival information of 1128 patients was obtained. A Cox model was used to analyse independent risk factors affecting overall survival, which were revealed as age > 50 years, no screening, alpha-fetoprotein > 400 ng/mL, Child–Pugh grade B, and middle and late CNLC stages. Based on the Cox model survival analysis, in our study, patients with HCC identified via screening had significant advantages in overall and tumorfree survival after hepatectomy.CONCLUSION Early diagnosis and treatment can be achieved by screening groups at high risk for HCC based on the guidelines;however, real-world compliance is poor.

The study of the Kuroshio in the East China Sea and the currents east of the Ryukyu Islands

In this study, the inverse method is used to compute the Kuroshio in the East China Sea and southeast of Kyushu and the currents east of the Ryukyu Islands, on the basis of hydrographic data obtained during September-October, 1987 by R/V Chofu Maru. The results show that: (1)A part of the Taiwan Warm Current has a tendency to converge to the shelf break; (2) the Kuroshio flows across the section C3 (PN) with a reduced current width, and the velocity of the Kuroshio at the section C3 increases and its maximum current speed is about 158 cm/s, and its volume transport here is about 26×106m3/s; (3) the Kuroshio has two current cores at the sections C3 (PN) and B2 (at the Tokara Strait); (4) the currents east of the Ryukyu Islands are found to flow northward over the Ryukyu Trench during September-October, 1987. The velocities of the currents are not strong throughout the depths. At the section C2 east of the Ryukyu Islands, the maximum current speed is at the 699 m levei and its magnitude is 25 cm/s, and its volume transport is about 21×06 m3/s; (5) the volume transports of the Kuroshio through the sections B2 (at the Tokara Strait) and C6 (southeast of Kyushu) are 23. 33, 67. 31×106 m3/s, respectively; (6) there are two meso-scale anticyclonic warm eddies between 135° E and the area east of the Ryukyu Islands, and their characters and hydrographic structure are discussed.

The Openness Degree Study of the Jiaoshiba Shale Gas, Sichuan Basin, China–Potential Factor Responsible for Reversed Isotope Series

Objective Reversed alkane δ;C and δ;H values in many prolific shale plays all over the world have aroused much attention in the study of the formation mechanism of reversed isotope series in alkanes in the past few years（Zou Caineng et al., 2016）. Although many researchers have put forward different hypotheses, the mechanism has not been well understood yet. The openness degree of oil and gas system

Is the Mortality Trend of Ischemic Heart Disease by the GBD2013 Study in China Real?

To determine the reason for the different mortality trends of ischemic heart disease （IHD） for China between Global Burden of Disease （GBD） 2010 and GBD2013, and to improve garbage code （GC） redistribution. All data were obtained from the disease surveillance points system, and two proportions for assigning chronic pulmonary heart disease （PHD） as GC to IHD were from GBD2010 and GBD2013,

Study of radioactive status in the Zhujiang Estuary and adjacent sea area in South China Sea (SCS)

Through the investigation on radioactive activities of water, sediment and some marine organismsin the Zhujiang Estuary, adjacent sea area and the distributary mouths of the Zhujiang River, activities of total α. radioactivity, total β radioactivity, artificial radioactive 90Srand 157Cs, and factors inflencing the distribution and the content of U in seawater are studied.The mainly radioactive pollution substances and their sources in the sea area are studied by γ spectra obtained from sediment in the sea area. The results show that the main radioactivity substances are natural radioactivity U,Th series and 40K. which were produced by the modern industry and transported into the sea through the main current of the Zhujiang River.

A study of the chemical composition and transport of marine aerosols over the ocean near China

In this paper the authors cite the aerosol samples collected with a KA-200 Anderson cascade Impactor and a KB-120 sampler during the first cruise of the Kuroshio investigation operated by the People's Republic of China and Japan cooperative program, from July 23 to August 21, 1987. The concentration size distributions and composition of marine aerosols over the Kuroshio area are analyzed. Neutron activation analysis is used to determine the elemental composition of the aerosols. The authors also discuss some characteristics of marine aerosols relating to long-range transport of crustal and anthropogenic elements from the continent to the remote ocean. Analytical results indicate that elements Al, Fe, Sc and Sb over this area are obviously influenced by the continent of Asia, and the size distributions are changed after long-range transport. The concentration of large particles increase. The concentrations of the elements C1 and Na are closely related to ocean conditions; the source of the elements Cl and Na is mainly the ocean. Besides coal combustion, the ocean is also a very important source for the element Se. The amount of Se is related to the distribution of marine life.

A Case-control Study of Environmental Risk Factors for Nonsyndromic Cleft of the Lip and/or Palate in Xuzhou,China

In this study, we sought to determine the association between environmental factors and nonsyndromic cleft of the lip and/or palate （NSCLP） to understand the etiology of the disease. A total of 200 NSCLP cases and 327 controls were recruited at the Maternal and Child Health Hospital of Xuzhou City. We conducted face-to-face interviews with the mothers of both cases and controls. The factors increasing the risk of NSCLP were a positive family history [odds ratio （OR）=56.74], pesticide exposure （OR=8.90）, and indoor decoration pollution （OR= 4.32）. On the other hand, the factors decreasing the risk of NSCLP were a high education level （OR=0.22） and supplementation of folic acid （OR=0.23） and multivitamins （OR=0.16）. Positive family history, pesticide exposure, and indoor decoration pollution are associated with the risk of NSCLP. In contrast, high education level and folic acid and multivitamin supplementation are protective factors against NSCLP.

GEOCHEMICAL STUDY OF THE CORE S01 IN THE SOUTH CHINA SEA

Si, Ti, Al, Fe, Mn, Ca, Mg, K, Na, P and Sr, Ba, Rb, Ga, V, Zr, Cr, Ni, Co, Cu, Zn, Pb,Nb, Y, Th, La in the core S01 were analyzed and the pattems of their enrichment are discussed.Enrichment of Na, Fe, Mn, Ba, Cu elements in the core indicates volcanic material are an importantsoarce of the sediments in the area. The enrichment frequently varying with the deposition processshows bottom volcanism is frequent in the area and that the studied area is a margin basin with distinctoceanic characteristics. The abnormal enrichment of Mn at the layers(0-15 cm and 665-670 cm) of the core could beclosely related to and so, indicate, the wide deposition hiatus that have occurred in the West PacificOcean and adjacent margin seas since Late Pleistocene.

Understanding the Unique Characteristics of Suicide in China: National Psychological Autopsy Study

Objective To compare the characteristics of suicides in the four main demographic groups： urban males, urban females, rural males and rural females in order to help clarify the demographic pattern of suicides in China. Methods A detailed psychological autopsy survey instrument was independently administered to 895 suicide victims in family members and close associates from 23 geographically representative locations from around the country. Results Pesticide ingestion accounted for 58% （519） of all suicides and 61% （3181519） of deaths were due to unsuccessful medical resuscitation. A substantial proportion （37%） of suicide victims did not have a mental illness. Among the 563 victims with mental illness, only 13% （76/563） received psychiatric treatment. Compared to other demographic groups, young rural females who died from suicide had the highest rate of pesticide ingestion （79%）, the lowest prevalence of mental illness （39%）, and the highest acute stress from precipitating life events just prior to the suicide. Contusion Many suicides in China are impulsive acts of deliberate self-harm following acute interpersonal crises. Prevention of suicides in China must focus on improving awareness of psychological problems, improving mental health services, providing alternative social support networks for managing acute interpersonal conflicts, limiting access to pesticides, and improving the resuscitation skills of primary care providers.