An 18-year-old boy in central China knelt and kowtowed to his adoptive mother after completing the gaokao, thanking her for years of devotion that helped fund his medical treatment.

From June 7 to 9, more than 12.9 million candidates sat China’s fiercely competitive national college entrance examination, or gaokao. Among them was Lele, from Xiangyang in Hubei province.

Outside the exam venue, his adoptive mother, Ye Huanzhi, waited in a red qipao dress, holding sunflowers and his favourite drink.

Their bond began on a rainy night in April 2008, when Ye found a newborn boy wrapped in blankets on her way home. His ears were visibly malformed, and his umbilical cord had not fully fallen off.

Though of modest means, Ye took him in, named him Lele, and raised him as her own.

Lele was later diagnosed with congenital microtia, a condition that left him with only one-third of normal hearing, according to the mainland media outlet Jimu News.

Doctors said surgery could cost up to 300,000 yuan (US$44,000), a prohibitive sum for Ye, who worked as a taxi driver.