The pile-up took place in Boshan district of Shadong province's Zibo city around 8:23 am when a truck collided with two buses, a car and a motorcycle on a village road, state-run news agency Xinhua quoted the district government as saying.
Four persons on a bus, one in the car and another in the truck died, an initial report said.
Two of the 20 injured were said to be in critical condition.
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