The strong shallow earthquake struck shortly before midnight on Monday, sending residents fleeing outside in sub-zero temperatures.
Thousands of houses were reported damaged, and state media said public infrastructure had been damaged "to varying degrees".
The death toll rose yesterday morning as rescuers reached the affected areas. The authorities in Gansu said 113 people had died in the province, with 397 people injured.
Qinghai reported 13 dead, 182 injured, and 20 still missing.
It is the deadliest earthquake in China since the 2010 Yushu quake hit Gansu and Qinghai, which measured 6.9 and killed at least 2,698 people.
State media characterised the rescue effort as a "race against time" because of cold weather sweeping across China. The high-altitude area.
where the quake hit reported temperatures of -14C yesterday morning.
"Based on past rescues, the biggest difficulty of this operation is the local low temperature," said Wang Duo, a team leader from the Gansu Houtian disaster rescue centre, according to China News Weekly.
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