[Compound Tinglizi Decoction intervenes COPD-associated pulmonary hypertension through regulation of HMGB1-mediated pyroptosis and immune imbalance].

This paper aimed to investigate the effects of high mobility group box 1(HMGB1)-mediated pulmonary artery smooth muscle cell pyroptosis and immune imbalance on chronic obstructive pulmonary disease-associated pulmonary hypertension(COPD-PH) in rats and the intervening mechanism of Compound Tinglizi Decoction. Ninety rats were randomly divided into a normal group, a model group, low-dose, medium-dose, and high-dose Compound Tinglizi Decoction groups, and a simvastatin group. The rat model of COPD-PH was established by fumigation combined with lipopolysaccharide(LPS) intravascular infusion, which lasted 60 days. Rats in the low, medium, and high-dose Compound Tinglizi Decoction groups were given 4.93, 9.87, and 19.74 g·kg~(-1) Compound Tinglizi Decoction by gavage, respectively. Rats in the simvastatin group were given 1.50 mg·kg~(-1) simvastatin by gavage. After 14 days, the lung function, mean pulmonary artery pressure, and arterial blood gas of rats were analyzed. Lung tissues of rats were collected for hematoxylin-eosin(HE) staining to observe the pathological changes. Real-time fluorescent quantitative polymerase chain reaction(qRT-PCR) was used to determine the expression of related mRNA in lung tissues, Western blot(WB) was used to determine the expression of related proteins in lung tissues, and enzyme linked immunosorbent assay(ELISA) was used to determine the levels of inflammatory factors in the lung tissues of rats. The ultrastructure of lung cells was observed by transmission electron microscope. The forced vital capacity(FVC), forced expiratory volume in 0.3 second(FEV_(0.3)), FEV_(0.3)/FVC, peek expiratory flow(PEF), respiratory dynamic compliance(Cdyn), arterial partial pressure of oxygen(PaO_2), and arterial oxygen saturation(SaO_2) were increased, and resistance of expiration(Re), mean pulmonary arterial pressure(mPAP), right ventricular hypertrophy index(RVHI), and arterial partial pressure of carbon dioxide(PaCO_2) were decreased by Compound Tinglizi Decoction in rats with COPD-PH. Compound Tinglizi Decoction inhibited the protein expression of HMGB1, receptor for advanced glycation end products(RAGE), pro caspase-8, cleaved caspase-8, and gasdermin D(GSDMD) in lung tissues of rats with COPD-PH, as well as the mRNA expression of HMGB1, RAGE, and caspase-8. Pulmonary artery smooth muscle cell pyroptosis was inhibited by Compound Tinglizi Decoction. Interferon-γ(IFN-γ) and interleukin-17(IL-17) were reduced, and interleukin-4(IL-4) and interleukin-10(IL-10) were incresead by Compound Tinglizi Decoction in lung tissues of rats with COPD-PH. In addition, the lesion degree of trachea, alveoli, and pulmonary artery in lung tissues of rats with COPD-PH was improved by Compound Tinglizi Decoction. Compound Tinglizi Decoction had dose-dependent effects. The lung function, pulmonary artery pressure, arterial blood gas, inflammation, trachea, alveoli, and pulmonary artery disease have been improved by Compound Tinglizi Decoction, and its mechanism is related to HMGB1-mediated pulmonary artery smooth muscle cell pyroptosis and helper T cell 1(Th1)/helper T cell 2(Th2), helper T cell 17(Th17)/regulatory T cell(Treg) imbalance.

Requirements in structure for chiral recognition of chitosan derivatives.

In order to investigate the influence of a minor variation in structure of N-acyl chitosan derivatives on enantioseparation, chiral selectors (CSs) of chitosan 3,6-bis(phenylcarbamate)-2-(phenylacetamide)s and chitosan 3,6-bis(phenylcarbamate)-2-(cyclohexylacetamide)s were synthesized. The corresponding chiral stationary phases (N-PhAc CSPs and N-cHeAc CSPs) were also prepared, respectively, with the two series of CSs. Enantioseparation results revealed that the N-PhAc CSPs were better than the N-cHeAc ones in enantioseparation. Thus, benzyl group (Bn) at C2 should be more preferable to enantioseparation than cyclohexylmethyl (cyclohexyl-CH2-) at the same position. Because N-PhAc CSPs exhibited higher enantioseparation capability than chitosan 3,6-bis(phenylcarbamate)-2-(benzamide) based CSPs (N-Bz CSPs), the Bn should also be more beneficial to enantioseparation than phenyl group (Ph) at C2 in N-Bz CSPs. In addition, it was found that, the cyclohexyl group at C2 in chitosan 3,6-bis(phenylcarbamate)-2-(cyclohexylformamide) CSPs was better than cyclohexyl-CH2- in N-cHeAc CSPs to enantioseparation. In a word, a minor variation at C2 of chitosan derivatives significantly affected enantioseparation. After the prepared CSPs were stood for six months, their enantioseparation capabilities were changed obviously, and the changes were probably related to nature, position and number of a substituent on Ph connected to carbamates at C3 and C6 of the CSs.

The rate of acute kidney injury (AKI) alert detection by the attending physicians was associated with the prognosis of patients with AKI.

Introduction: Early identification of AKI was always considered to improve patients' prognosis. Some studies found that AKI early warning tools didn't affect patients' prognosis. Therefore, additional studies were necessary to explore the reasons. Methods: This study was a secondary analysis of a multicenter randomized controlled trial that found electronic health record warnings for AKI did not influence patients' prognoses. Univariate, multivariate, subgroup, curve fitting, and threshold effect analysis were used to explore the association between AKI warnings detected by attending physicians and the patient's prognosis. Results: A total of 6,030 AKI patients were included in the study. The patients were classified into two groups based on the rate of AKI alerts detected by attending physicians: the partial group (n = 5,377), and the complete group (n = 653). In comparison to the partial group, the complete group significantly decreased 14-day AKI progression, 14-day dialysis, and 14-day mortality, with adjusted ORs of 0.48 (0.33, 0.70), 0.26 (0.09, 0.77), and 0.53 (0.33, 0.84) respectively, and the complete group significantly improve the discharge to home, with an OR value of 1.50 (1.21, 1.87). When the rate of AKI alerts detected by the attending physicians as a continuity variable, we found that the rate of alerts seen by attending physicians was associated with 14-day mortality and the discharge to home, with adjusted ORs of 1.76 (1.11, 2.81) and 1.42 (1.13, 1.80). The sensitivity analysis, curve-fitting analysis, and threshold effect analysis also showed that the rate of alert seen by the attending physician was correlated with the patient's prognosis. Conclusion: The rate of AKI alert detection by attending physician were related to the patient's prognosis. The higher the rate of AKI alert detection by attending physicians, the better the prognosis of patients with AKI.

Conversion of azidoamylose to ureidoamylose carbamates in one-pot reactions.

In order to covert azidoamylose into ureidoamylose derivatives in a facile way, 6-azido-6-deoxyamylose was reacted with triphenylphosphine, and then with water and a phenyl isocyanate in turn. The obtained product was amylose 2,3-bis(phenylcarbamate)-6-deoxy-6-(phenylurea), which was synthesized through three reactions in a one-pot method. The essential point to ensure the method be successful was that the water should be fed at an appropriate amount. The prepared amylose 2,3-bis(phenylcarbamate)-6-deoxy-6-(phenylurea)s were characterized by FT-IR, 1H NMR and elemental analysis, substantiating the reduction of the azido group and the subsequent derivatization of the resulted amino group and the hydroxyl group in amylose were fully performed. In addition, the amylose 2,3-bis(phenylcarbamate)-6-deoxy-6-(phenylurea)s were coated on macroporous 3-aminopropyl silica gel to afford chiral stationary phases (CSPs) for high-performance liquid chromatography. The enantioseparations of the CSPs were evaluated, and the results indicated that the CSPs possessed chiral recognition ability towards some chiral compounds.

Evidence Based Social Science in China Paper 2: The History and Development of Evidence Based Social Work in China.

OBJECTIVES: To present the history and potential for development of evidence-based (EB) social work in China. STUDY DESIGN AND SETTING: The conception and methodology of EB social work is a potential strategy to support high quality development of social work in China. This article documents and analyzes the progress of EB social work in China. We focus on current research, reasons, challenges, and strategies. RESULTS: EB social work started late in China. The number of EB social work literature and systematic reviews has increased since 2004. The development of EB social work has been uneven nationally with few practitioners and decision makers involved. However, more and more social work researchers received training in evidence-based practice through national workshops and conferences. CONCLUSION: EB social work faced various challenges, but there are now more opportunities for EB social work development in China. Researchers, practitioners, managers and decision makers are encouraged to work together to establish a thorough methodological system and use existing evidence as much as possible when carrying out social work programs and services.

Evidence Based Social Science in China Paper 4 : The quality of social science systematic reviews and meta-analysis published from 2000-2019.

OBJECTIVES: To examine the characteristics, methodological and reporting quality of systematic reviews and meta-analyses in social science journals in China. STUDY DESIGN AND SETTING: The Chinese Social Sciences Citation Index (CSSCI) databases were searched for systematic reviews and meta-analysis published between January 2000 and December 2019. We randomly selected 200 articles from the 401 identified in our search. The Assessing the Methodological Quality of Systematic Reviews (AMSTAR) and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklists were used to assess the methodological and reporting quality, respectively. RESULTS: The 200 articles we selected covered a wide range of research fields in 9 disciplines, most of which belonged to management, education and psychology. The mean AMSTAR score and PRISMA score was 8.99 ± 3.36 points and 14.74 ± 3.96 points, respectively. These findings indicated that the quality of the systematic reviews was below the average level. Meanwhile, year of publication was related to both methodological quality (P = 0.001) and reporting quality (P < 0.01). CONCLUSION: Although many systematic reviews and meta-analysis have been published in top Chinese journals, the methodological and reporting quality is troubling. Thus, the most urgent task is to increase the standard of systematic reviews and meta-analysis of every discipline rather than continuing to publish them in great quantity.

Chiral separation materials based on derivatives of 6-amino-6-deoxyamylose.

In order to develop new type of chiral separation materials, in this study, 6-amino-6-deoxyamylose was used as chiral starting material with which 10 derivatives were synthesized. The amino group in 6-amino-6-deoxyamylose was selectively acylated and then the hydroxyl groups were carbamoylated yielding amylose 6-amido-6-deoxy-2,3-bis(phenylcarbamate)s, which were employed as chiral selectors (CSs) for chiral stationary phases of high-performance liquid chromatography. The resulted 6-amido-6-deoxyamyloses and amylose 6-amido-6-deoxy-2,3-bis(phenylcarbamate)s were characterized by IR, 1 H NMR, and elemental analysis. Enantioseparation evaluations indicated that most of the CSs demonstrated a moderate chiral recognition capability. The 6-nonphenyl (6-nonPh) CS of amylose 6-cyclohexylformamido-6-deoxy-2,3-bis(3,5-dimethylphenylcarbamate) showed the highest enantioselectivity towards the tested chiral analytes; the phenyl-heterogeneous (Ph-hetero) CS of amylose 6-(4-methylbenzamido)-6-deoxy-2,3-bis(3,5-dimethylphenylcarbamate) baseline separated the most chiral analytes; the phenyl-homogeneous (Ph-homo) CS of amylose 6-(3,5-dimethylbenzamido)-6-deoxy-2,3-bis(3,5-dimethylphenylcarbamate) also exhibited a good enantioseparation capability among the developed CSs. Regarding Ph-hetero CSs, the enantioselectivity depended on the combination of the substituent at 6-position and that at 2- and 3-positions; as for Ph-homo CSs, the enantioselectivity was related to the substituent at 2-, 3-, and 6-positions; with respect to 6-nonPh CSs, the retention factor of most analytes on the corresponding CSPs was lower than that on Ph-hetero and Ph-homo CSPs in the same mobile phases, indicating π-π interactions did occur during enantioseparation. Although the substituent at 6-position could not provide π-π interactions, the 6-nonPh CSs demonstrated an equivalent or even higher enantioselectivity compared with the Ph-homo and Ph-hetero CSs.

The interactions between chiral analytes and chitosan-based chiral stationary phases during enantioseparation.

The goal of the present study was to disclose the interactions between chitosan-type chiral selectors (CSs) and chiral analytes during enantioseparation. Hence, six chitosan 3,6-bis(phenylcarbamate)-2-(cyclohexylmethylurea)s were synthesized and characterized. These chitosan derivatives were employed as CSs with which the corresponding coated-type chiral stationary phases (CSPs) were prepared. According to the nature and position of the substituents on the phenyl group, the CSs and CSPs were divided into three sets. The counterparts of the three sets were 3,5-diMe versus 3,5-diCl, 4-Me versus 4-Cl and 3-Me versus 3-Cl. The enantioseparation capability of the CSPs was evaluated with high-performance liquid chromatography. The CSPs demonstrated a good enantioseparation capability to the tested chiral analytes. In enantioselectivity, the CSs with 3,5-diCl and with 4-Me roughly were better than the counterparts with 3,5-diMe and with 4-Cl respectively. The CS with 3-Me enantiomerically recognized more analytes than the one with 3-Cl, but showed lower separation factors in more enantioseparations. The acidity of the amide hydrogen in the phenylcarbamates was investigated with density functional theory calculations and 1H NMR measurements. The trend of the acidity variation with different substituents on the phenyl group was confirmed by the retention factors of acetone on the CSPs. Compared the retention factors of analytes on every set of the counterparts, the formation of hydrogen bond (HB) in enantioseparation could be outlined as follows: when the CSs interacted with chiral analytes without reactive hydrogen but with lone paired electrons, the carbamate N‒Hs in the CSs were HB donors and the analytes were HB acceptors; if the CSs interacted with analytes with a reactive hydrogen, the role of the CSs in HB formation was related to the acidity of the reactive hydrogen; the patterns of HB formation between the CSs and analytes were also impacted by compositions of mobile phases, in addition to the nature, number and position of substituents on the phenyl group. Based on the discussion, chiral recognition mechanism could be understood in more detail. Besides, the strategy to improve enantioseparation capability of a CSP by introducing a substituent onto phenyl group was clarified and further comprehended.

Probing Activity Enhancement of Photothermal Catalyst under Near-Infrared Irradiation.

Exploring highly efficient catalysts with excellent photothermal conversion and further unveiling their catalytic mechanism are of significant importance for photothermal catalysis technologies, but there remain grand challenges to these activities. Herein, we fabricate a nest-like photothermal nanocatalyst with Pd decorated on a N-doped carbon functionalized Bi2S3 nanosphere (Bi2S3@NC@Pd). Given its well-dispersed ultrafine Pd nanoparticles and the excellent photothermal heating ability of support material, the Bi2S3@NC@Pd composite exhibits a superior activity and photothermal conversion property to commercial Pd/C catalyst for hydrogenation of organic dyes upon exposure to near-infrared (NIR) light irradiation. In addition, the photothermal effect (temperature rise) and activity enhancement of the heterogeneous catalysis system are further probed by comparing the reaction rate with and without the NIR light irradiation. Furthermore, the catalytic behaviors of the Bi2S3@NC@Pd catalyst under conventional and photothermal heating are investigated at the same reaction temperature. This work not only improves our fundamental understanding of the catalytic behavior in heterogeneous liquid-solid reaction systems under near-infrared irradiation but also may promote the design of catalysts with photothermally promoted activity.

Preparation of 6-amino-6-deoxy cellulose and its derivatives used as chiral separation materials.

In order to find a facile and practical method to synthesize amino cellulose in bulk with high regional selectivity and high degree of substitution, the reaction conditions to brominate cellulose and to reduce azido group were carefully studied and some interesting phenomena were observed. With the optimized method, 6-amino-6-deoxy cellulose could be easily prepared with very simple separation techniques. The degree of substitution of the amino group amounted to 0.97 which was determined by 1H NMR spectrum of 6-benzamido-6-deoxy cellulose. Moreover, the amino group was evidenced to be at the C6 of glucose unit by 1H-1H COSY NMR and 1H-13C HSQC NMR spectra. In addition, three cellulose 6-acetamido-6-deoxy-2,3-bis(phenylcarbamate)s were prepared from the 6-amino-6-deoxy cellulose prepared with the techniques optimized in the present study. The developed cellulose derivatives were used as chiral selectors with which chiral stationary phases (CSPs) were prepared. The CSPs exhibited enantioseparation power to some chiral compounds.

A Nomogram to Predict the 28-day Mortality of Critically Ill Patients With Acute Kidney Injury and Treated With Continuous Renal Replacement Therapy.

BACKGROUND: Acute kidney injury (AKI) is a severe and common complication in critically ill patients and is associated with increased morbidity and mortality. At present, there is not a tool to predict the prognosis of critically ill patients with AKI and treated with continuous renal replacement therapy (CRRT). METHODS: A retrospective cohort study was to construct a prediction model for the 28-day mortality of patients with AKI and treated with CRRT. From January 2009 to September 2016, A total of 846 cases were included in our study. RESULTS: A total of five variables selected by multi-factor Cox regression analysis were used to constructed three predictive models and adopted bootstrapping for internal validation. Finally, we get five sets of models (three sets of construction models and two sets of internal verification models) with similar predictive value. The stepwise model, which including four variables (CCI score, Alb, Phosphate (24h) and SOFA score), was the simplest model, so we chose it as our final predictive model and constructed a nomogram based on it. The area under the ROC curve (AUC) of the stepwise model and the stepwise bootstrap model (BS stepwise) were respectively 0.78(0.75,0.82) and 0.78 (0.75,0.82). The AUC of the stepwise model and the BS stepwise in patients with sepsis were 0.77 (0.73,0.81) and 0.77 (0.73,0.81). The AUC of the stepwise model and the BS stepwise in patients without sepsis were 0.83 (0.78,0.89) and 0.83 (0.78,0.89). CONCLUSIONS: We developed a four-marker-based prognostic tool that could effectively predict each individual's 28-day mortality for patients with AKI and treated with CRRT.

SOFA score is superior to APACHE-II score in predicting the prognosis of critically ill patients with acute kidney injury undergoing continuous renal replacement therapy.

BACKGROUND: Acute kidney injury (AKI) is the most common cause of organ failure in multiple organ dysfunction syndrome (MODS) and is associated with increased mortality. This study aimed at determining the efficacy of sequential organ failure assessment (SOFA), and acute physiology and chronic health evaluation II (APACHE-II) scoring systems in assessing the prognosis of critically ill patients with AKI undergoing CRRT. METHODS: The predictive value of SOFA and APACHE-II scores for 28- and 90-d mortality in patients with AKI undergoing continuous renal replacement therapy (CRRT) were determined by multivariate analysis, sensitivity analysis, and curve-fitting analysis. RESULTS: A total of 836 cases were included in this study. Multivariate Cox logistic regression analysis showed that SOFA scores were associated with 28- and 90-d mortality in patients with AKI undergoing CRRT. The adjusted HR of SOFA for28-d mortality were 1.18 (1.14, 1.21), 1.24 (1.18, 1.31), and 1.19 (1.13, 1.24) in the three models, respectively, and the adjusted HR of SOFA for 90-d mortality was 1.12 (1.09, 1.16), 1.15 (1.10, 1.19), and 1.15 (1.10, 1.19), respectively. The subgroup analysis showed that the SOFA score was associated with 28-d and 90-d mortality in patients with AKI undergoing CRRT. APACHE-II score was not associated with 28- and 90-d mortality patients with AKI undergoing CRRT. Curve fitting analysis showed that SOFA scores increased had a higher prediction accuracy for 28- and 90-d than APACHE-II. CONCLUSIONS: The SOFA score showed a higher accuracy of mortality prediction in critically ill patients with AKI undergoing CRRT than the APACHE-II score.

A Retrospective Population Study to Develop a Predictive Model of Prediabetes and Incident Type 2 Diabetes Mellitus from a Hospital Database in Japan Between 2004 and 2015.

BACKGROUND Type 2 diabetes mellitus is a global public health problem. Prediabetes may be reversed by weight loss, diet, and lifestyle changes. However, without intervention, between 30-50% of individuals with prediabetes develop type 2 diabetes. This retrospective population study was conducted to develop a predictive model of prediabetes and incident type 2 diabetes mellitus using data from 2004 to 2015 from the DRYAD Japanese hospital database. MATERIAL AND METHODS A retrospective longitudinal population study was conducted using the DRYAD database from Murakami Memorial Hospital, Gifu, Japan, to construct a predictive model for prediabetes and incident type 2 diabetes mellitus in the population. Univariate analysis and multivariate analysis were performed to identify the variables that were associated with prediabetes. These variables were used to construct (75% samples) and verify (25% samples) the predictive model. RESULTS From 2004 to 2015, a total of 11,113 cases were identified. Multivariate logistic regression analysis included the six variables of age, waist circumference, smoking history, the presence of fatty liver, fasting blood glucose (FBG), and glycated hemoglobin (HbA1c) level. Data were used to construct (75% samples) and verify (25% samples) in a predictive model. The area under the receiver operating characteristic (ROC) curve (AUC) of the predictive model was 0.87 (0.85-0.89) in the training cohort and 0.87 (0.86-0.90) in the validation cohort. CONCLUSIONS A prognostic model based on six variables was predictive for incident type 2 diabetes mellitus and prediabetes in a healthy population in Japan.

Comparison in enantioseparation performance of chiral stationary phases prepared from chitosans of different sources and molecular weights.

The aim of the present study was to compare the enantioseparation performance of chiral stationary phases (CSPs) which were derived from chitosans of different sources and molecular weights. Therefore, chitosans of shrimp and crab shells were prepared. The viscosity-average molecular weights of the chitosans both prepared from shrimp and crab shells were 2.8 × 105 and 1.4 × 105. The chitosans were isobutyrylated yielding isopropylcarbonyl chitosans which were then derivatized with 4-methylphenyl isocyanate to provide chitosan 3,6-bis(4-methylphenylcarbamate)-2-(isobutyrylamide)s. The chitosan 3,6-bis(4-methylphenylcarbamate)-2-(isobutyrylamide)s were used as chiral selectors (CSs) with which the corresponding CSPs were prepared. With the same chiral analytes and under the same mobile phase conditions, the enantioseparation capability of the CSPs was evaluated by high-performance liquid chromatography. In two CSs prepared from the same source, the one with higher molecular weight showed better enantioseparation capability; in two CSs prepared with the chitosans of the same molecular weight, the one derived from shrimp shell exhibited better performance. With regard to the two shrimp chitosan CSs, most of chiral analytes interacted more strongly with the one with lower molecular weight, and an opposite trend was found for the two crab chitosan CSs. Based on the results observed in the present study and in previous work, we believe that the influence of molecular weight on CSP enantioseparation performance is related to the substituent introduced in the CS molecule.

Land use alters relationships of grassland productivity with plant and arthropod diversity in Inner Mongolian grassland.

The threats of land-use intensification to biodiversity have motivated considerable research directed toward understanding the relationship between biodiversity and ecosystem functioning (BEF). Functional diversity is deemed a better indicator than species diversity to clarify the BEF relationships. However, most tests of the BEF relationship have been conducted in highly controlled plant communities, with terrestrial animal communities largely unexplored. Additionally, most BEF studies examined the effects of biodiversity on ecosystem functions, with the effects of ecosystem functioning strength on biodiversity hardly considered. Based on a 6-yr grassland experiment in the typical steppe region of Inner Mongolia, we examined the variation of taxonomic diversity (TD) and functional diversity (FD) of both plant and arthropod communities, and their relations with grassland productivity, across three land management types (moderate grazing, mowing, and enclosure). We aimed to clarify the interrelations among plant FD, arthropod FD, grassland productivity, and soil factors. We found the following: (1) Grassland under mowing performed best in terms of sustaining a high TD and FD of plants and arthropods compared to that under grazing and enclosure. (2) The relationships between plant and arthropod diversity and productivity varied with management types. Plant TD and FD were negatively related, whereas arthropod FD was positively related with productivity under enclosure; plant FD, but not arthropod FD, was positively related with productivity under grazing; arthropod FD, but not plant FD, was negatively related with productivity under mowing. (3) Grassland productivity was positively interrelated with plant FD, but not plant TD; and was negatively interrelated with arthropod TD, but not arthropod FD across different management types. The respective positive vs. negative bidirectional relationships of productivity with plant diversity vs. arthropod diversity, were majorly a consequence of divergent grazing/mowing effects on plant vs. arthropod diversity. The results indicate that grazing increases plant diversity, but decreases arthropod diversity, whereas fall mowing provides a management strategy for conservation of both trophic levels. These results also provide new insights into the effects of land-use changes on biodiversity and ecosystem processes, and indicate the importance of incorporating the functional interrelations among different trophic groups in sustainable grassland management.

Post-Traumatic Stress and School Adaptation in Adolescent Survivors Five Years after the 2010 Yushu Earthquake in China.

(1) Background: The devastating Ms 7.1 earthquake struck Yushu city, China, in 2010, leading to serious consequences and damage in the central Tibetan Plateau. This study aimed to assess school adaptation and post-traumatic stress disorder (PTSD) symptoms of adolescent survivors five years after the Yushu earthquake. (2) Methods: A large-scale, school-based mental health survey was conducted 5 years after the earthquake among Tibetan students in the city of Yushu using the Adolescent's School Adaptation Scale (ASAS) and the PTSD Checklist. (3) Results: A total of 1976 questionnaires were collected. A total of 30.7% of Tibetan adolescents had poor school adaptation and 19.5% were estimated as having probable PTSD. Logistic regression showed that females (OR = 0.73, 95% CI: 0.60-0.89), senior students (OR = 0.48, 95% CI: 0.39-0.59), and those who participated in post-disaster reconstruction (OR = 0.68, 95% CI: 0.54-0.85) were less likely to have poor school adaptation, while a positive association was observed among those buried under a collapsed building (OR = 1.47, 95% CI: 1.04-2.09) and those who experienced bereavement (OR = 1.77, 95% CI: 1.27-2.45). Students who had experienced bereavement were also more likely to have PTSD (OR = 1.60, 95% CI: 1.12-2.28). (4) Conclusions: The post-traumatic effects of the Yushu earthquake on Tibetan adolescents were severe and long-lasting. Sustainable long-term mental health services to help adolescents to restructure their mental health are necessary.

Higher body mass index is not a protective risk factor for 28-days mortality in critically ill patients with acute kidney injury undergoing continuous renal replacement therapy.

Background: Acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) is a fatal and common clinical disorder in critically ill patients. Recent studies have shown that the relationship between BMI and the outcome of patients with AKI undergoing CRRT is conflicting. Methods: A retrospective cohort study based on data reuse. Univariate analysis, multi-factor regression analysis and subgroup analyses were used to explore the association of the BMI with the 28-days mortality risk in patients with AKI undergoing CRRT. Results: From January 2009 to September 2016, a total of 1120 cases met the inclusion criteria and were enrolled in this study. The univariate analysis showed that BMI was associated with 28-days mortality of patients with AKI undergoing CRRT, its HR value was 0.98 (0.96, 0.99). The multi-factor regression analysis showed that BMI was not associated with 28-days mortality of patients with AKI undergoing CRRT in the four models, the adjusted HR value of four models were 1.00 (0.96, 1.04), 1.01 (0.97, 1.04), 1.00 (0.96, 1.04) and 1.00 (0.96, 1.04), respectively. The subgroups analyses showed that the BMI was a risk factor of the 28-days mortality in patients with AKI undergoing CRRT when GFR ≥30 mL/min, its HR value was 1.04 (1.01, 1.09). Conclusion: Higher BMI was not a protective risk of 28-day mortality in patients with AKI undergoing CRRT. Especially, when GFR ≥30 mL/min, higher BMI increased the risk of the 28-day mortality rate in patients with AKI undergoing CRRT.

Efficacy of sertraline for post-stroke depression: A systematic review protocol of randomized controlled trial.

BACKGROUND: Depression is a prevalent disorder for patients with stroke. Clinical researches indicate that sertraline is utilized to treat post-stroke depression (PSD) effectively. However, no systematic review has investigated this issue yet presently. Thus, this study aims to systematically assess the efficacy and safety of sertraline for patients with PSD. METHODS: Literature sources will be divided into 2 sections: electronic sources and manual sources. We will search electronic literature sources as follows: EMBASE, MEDICINE, Web of Science, Cochrane Library, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from their inceptions to the February 28, 2019. Manual sources include dissertations, ongoing trials, and conference abstracts. Two reviewers will select the literatures, extract and collect data information, and evaluate the risk of bias independently. Statistical analysis will be carried out by using RevMan 5.3 software. RESULTS: Primary outcome is depression. It can be measured by Hamilton depression scale, Beck Depression Inventory, or any other scales. Secondary outcome are anxiety (as assessed by Hamilton anxiety scale, or other tools) response rate, activities of daily living (as measured by Barthel Index, or other scales), quality of life (as measured by 36-Item Short Form Health Survey), and safety. CONCLUSIONS: The results of this systematic review may summarize the up-to-date evidence on the efficacy and safety of sertraline for patients with PSD. ETHICS AND DISSEMINATION: This systematic review will not need any ethical approval, because it will not analyze any individual patient data. The findings of this study are expected to disseminate at peer-reviewed journals.