Regulation of Myc transcription by an enhancer cluster dedicated to pluripotency and early embryonic expression.

MYC plays various roles in pluripotent stem cells, including the promotion of somatic cell reprogramming to pluripotency, the regulation of cell competition and the control of embryonic diapause. However, how Myc expression is regulated in this context remains unknown. The Myc gene lies within a ~ 3-megabase gene desert with multiple cis-regulatory elements. Here we use genomic rearrangements, transgenesis and targeted mutation to analyse Myc regulation in early mouse embryos and pluripotent stem cells. We identify a topologically-associated region that homes enhancers dedicated to Myc transcriptional regulation in stem cells of the pre-implantation and early post-implantation embryo. Within this region, we identify elements exclusively dedicated to Myc regulation in pluripotent cells, with distinct enhancers that sequentially activate during naive and formative pluripotency. Deletion of pluripotency-specific enhancers dampens embryonic stem cell competitive ability. These results identify a topologically defined enhancer cluster dedicated to early embryonic expression and uncover a modular mechanism for the regulation of Myc expression in different states of pluripotency.

P53 and BCL-2 family proteins PUMA and NOXA define competitive fitness in pluripotent cell competition.

Cell Competition is a process by which neighboring cells compare their fitness. As a result, viable but suboptimal cells are selectively eliminated in the presence of fitter cells. In the early mammalian embryo, epiblast pluripotent cells undergo extensive Cell Competition, which prevents suboptimal cells from contributing to the newly forming organism. While competitive ability is regulated by MYC in the epiblast, the mechanisms that contribute to competitive fitness in this context are largely unknown. Here, we report that P53 and its pro-apoptotic targets PUMA and NOXA regulate apoptosis susceptibility and competitive fitness in pluripotent cells. PUMA is widely expressed specifically in pluripotent cells in vitro and in vivo. We found that P53 regulates MYC levels in pluripotent cells, which connects these two Cell Competition pathways, however, MYC and PUMA/NOXA levels are independently regulated by P53. We propose a model that integrates a bifurcated P53 pathway regulating both MYC and PUMA/NOXA levels and determines competitive fitness.

The prevalence of osteoporosis in China, a community based cohort study of osteoporosis.

Background: Osteoporosis has already been a growing health concern worldwide. The influence of living area, lifestyle, socioeconomic, and medical conditions on the occurrence of osteoporosis in the middle-aged and elderly people in China has not been fully addressed. Methods: The study was a multicenter cross-sectional study on the middle-aged and elderly permanent residents, which gathered information of 22,081 residents from June 2015 to August 2021 in seven representative regions of China. The bone mineral density of lumbar vertebrae and hip were determined using the dual-energy X-ray absorptiometry densitometer instruments. Serum levels of bone metabolism markers were also measured. Information about education, smoking, and chronic diseases were also collected through face-to-face interviews. Age-standardized prevalence and 95% confidence intervals (CIs) of osteopenia and osteoporosis by various criteria were estimated by subgroups and overall based on the data of China 2010 census. The relationships between the osteoporosis or osteopenia and sociodemographic variables or other factors were examined using univariate linear models and multivariable multinomial logit analyses. Results: After screening, 19,848 participants (90%) were enrolled for the final analysis. The age-standardized prevalence of osteoporosis was estimated to be 33.49%(95%CI, 32.80-34.18%) in the middle-aged and elderly Chinese permanent residents, for men and women was 20.73% (95% CI, 19.58-21.87%) and 38.05% (95% CI, 37.22-38.89%), respectively. The serum concentrations of bone metabolic markers, and calcium and phosphorus metabolism were influenced by age, body mass index (BMI), gender, education level, regions, and bone mass status. Women, aged 60 or above, BMI lower than 18.5 kg/m2, low education level including middle school, primary school and no formal education as well as current regular smoking, a history of fracture were all significantly associated with a higher risk of osteoporosis and osteopenia in the middle-aged and elderly people. Conclusions: This study revealed dramatic regional differences in osteoporosis prevalence in China, and female, aged 60 or older, low BMI, low education level, current regular smoking, and a history of fracture were associated with a high risk of osteoporosis. More prevention and treatment resources should be invested into particular population exposed to these risk factors.

Greater habitual resveratrol intakes were associated with lower risk of hip fracture- a 1:1 matched case-control study in Chinese elderly.

The aim of the study was to testify the association of dietary resveratrol (RSV) intakes with hip fracture risk in Chinese elderly. This was a 1:1 age- and gender- matched case-control study. Eligible cases were newly diagnosed patients of hip fracture. Dietary assessment was made by a 79-item validated food frequency questionnaire. Habitual RSV intakes were estimated as the sum of trans- and cis- isomers of resveratrol and piceid according to the available database. Multivariable conditional logistic regression was applied to examine the relationship of dietary RSV and RSV-rich foods with hip fracture risk. A total of 1,070 pairs of hip fracture incident cases and controls were recruited and 1,065 were included for analysis. Compared with the lowest group, total RSV in the highest quartile group had significantly reduced hip fracture risk by 66.3% (OR: 0.337, 0.222 ~ 0.571, ptrend < 0.001). Similar findings were observed for cis- and trans-RSV, cis- and trans-Piceid, as well as RSV-rich foods (grapes, apples and nuts) respectively. Subgroup analysis suggested more evident findings among female and less obese participants. Our findings demonstrated that higher habitual RSV intakes and RSV-rich foods, even in a relatively low amount, were associated with reduced risk of hip fracture in Chinese elderly.

Dietary Acid Load Was Positively Associated with the Risk of Hip Fracture in Elderly Adults.

Previous studies have shown that dietary acid load (DAL) harms bone health, but the evidence is inconsistent and insufficient. This study examined the relationships between DAL and the risk of hip fracture. This case−control study contained 1070 pairs of 1:1 age-, city-, and gender-matched incident cases and controls (mean age, 71 years) recruited in Guangdong, China. Dietary information was collected using a validated 79-item food frequency questionnaire through face-to-face interviews. DAL was estimated based on established algorithms for the potential renal acid load (PRAL) and net endogenous acid production (NEAP). Higher PRAL and NEAP were dose-dependently associated with a higher risk of hip fracture in both the conditional logistic regression model and restricted cubic spline analysis after adjusting for potential covariates. The multivariate-adjusted odds ratios and 95% CI of hip fracture for tertiles 2 and 3 (vs. 1) of DAL were 1.63 (1.18, 2.25) and 1.92 (1.36, 2.71) for PRAL and 1.81 (1.30, 2.53) and 2.55 (1.76, 3.71) for NEAP in all participants (all p-trends < 0.001), respectively. Subgroup analyses showed more pronounced associations in participants with a lower body mass index. Our findings suggested positive associations between the estimated DAL and the risk of hip fractures in the elderly Chinese population.

Early functional rehabilitation compared with traditional immobilization for acute Achilles tendon ruptures : a meta-analysis.

AIMS: The aim of this meta-analysis was to assess the prognosis after early functional rehabilitation or traditional immobilization in patients who underwent operative or nonoperative treatment for rupture of the Achilles tendon. METHODS: PubMed, Embase, Web of Science, and Cochrane Library were searched for randomized controlled trials (RCTs) from their inception to 3 June 2020, using keywords related to rupture of the Achilles tendon and rehabilitation. Data extraction was undertaken by independent reviewers and subgroup analyses were performed based on the form of treatment. Risk ratios (RRs) and weighted mean differences (WMDs) (with 95% confidence intervals (CIs)) were used as summary association measures. RESULTS: We included 19 trials with a total of 1,758 patients. There was no difference between the re-rupture rate (RR 0.84 (95% CI 0.56 to 1.28); p = 0.423), time to return to work (WMD -1.29 (95% CI -2.63 to 0.05); p = 0.060), and sporting activity (WMD -1.50 (95% CI -4.36 to 1.37); p = 0.306) between the early functional rehabilitation and the traditional immobilization treatment strategies. Early rehabilitation up to 12 weeks yielded significantly better Achilles tendon Total Rupture Scores ((ATRS) WMD 5.11 (95% CI 2.10 to 8.12); p < 0.001). Patients who underwent functional rehabilitation had significantly lower limb symmetry index of heel-rise work ((HRW) WMD -4.19 (95% CI -8.20 to 0.17); p = 0.041) at one year. CONCLUSION: Early functional rehabilitation is safe and provides better early function and the same functional outcome in the longer term. Cite this article: Bone Joint J 2021;103-B(6):1021-1030.

Donor-Acceptor Complex Enables Cascade Radical Cyclization of N-Arylacrylamides with Katritzky Salts.

Cascade radical cyclization of N-arylacrylamides is an attractive method to prepare 3,3-disubstituted oxindoles. As the reported methods often require additives and/or photocatalysts, we herein report an additive- and photocatalyst-free deaminative strategy for their synthesis under mild conditions, enabled by photoactivation of an electron donor-acceptor (EDA) complex. DFT studies indicated that the involvement of an explicit xylene solvent molecule can greatly enhance the photoactivity of the EDA complex between N-arylacrylamides and Katritzky salts.

Chinese Medicine Involving Triple Rehabilitation Therapy for Knee Osteoarthritis in 696 Outpatients: A Multi-Center, Randomized Controlled Trial.

OBJECTIVE: To determine the effects of Chinese medicine (CM) involving triple rehabilitation therapy on the progression of knee osteoarthritis (KOA). METHODS: A total of 722 patients recruited from 38 community health service centers located in China from March 2013 to March 2017 were randomly divided into treatment and control groups equally, using a cluster randomization design. Health education combined with CM involving triple rehabilitation therapy for KOA (electro-acupuncture, Chinese medicinal herb fumigating-washing, and traditional exercises) was administered in the treatment group while conventional rehabilitation therapy (physical factor therapy, joint movement training, and muscle strength training) was administered in the control group. Patients with a visual analog scale (VAS) scores ≽4 were treated with dispersible meloxicam tablets (7.5 mg, once daily). The Lequesne index scores, VAS scores, range of motion (ROM), lower limb muscle strength, knee joint circumference, quantitative scores of KOA symptoms, and the short-form 36 item health survey questionnaire (SF-36) scores were measured for each patient at 5 checkpoints (before treatment, at the 2nd week and the 4th week during the 4-week treatment period, at 1 month and 3 months after end of treatment), and adverse reactions were observed also. RESULTS: A total of 696 patients completed the entire process, with 351 in the treatment group and 345 in the control group. At all treatment checkpoints, the treatment group demonstrated better outcomes than the control group with regard to the total Lequesne index scores, effective rate and improvement rate of the total Lequesne index scores, VAS scores, lower limb muscle strength, knee circumference, quantitative scores of KOA symptoms, and SF-36 scores as well (P<0.05 or P<0.01). No adverse reactions were encountered in this study. CONCLUSIONS: CM involving triple rehabilitation therapy can alleviate KOA-related pain and swelling, improve lower limb muscle strength, promote flexion and activity of the knee and improve the quality of life in patients undergoing KOA. It is suitable for patients with early or mid-stage KOA. (Registration No. ChiCTR-TRC-12002538).

Retracted: The Effects of Ludartin on Cell Proliferation, Cell Migration, Cell Cycle Arrest and Apoptosis Are Associated with Upregulation of p21WAF1 in Saos-2 Osteosarcoma Cells In Vitro.

The authors repeated experiments and found that the results shown in figure 2 were not reproducible. Reference: Shuang-li Zhang, Bao-lin Li, Wei Li, Ming Lu, Lin-ying Ni, Hui-li Ma, Qing-gang Meng. The Effects of Ludartin on Cell Proliferation, Cell Migration, Cell Cycle Arrest and Apoptosis Are Associated with Upregulation of p21WAF1 in Saos-2 Osteosarcoma Cells In Vitro. Med Sci Monit 2018; 24: LBR4926-4933. 10.12659/MSM.909193.

Evaluating nitrite content changes in some Chinese home cooking with a newely-developed CDs diazotization spectrophotometry.

The research developed a diazo-coupling carbon-dots (CDs) method for determining nitrite and optimized variables of sodium sulfanilate, CDs synthesis, characteristic wavelength, reaction time and temperature. The method can assay 0.025-2.0 mg/L NO2- and has a detection limit of 9.6 µg/L and 95-105% recovery. Subsequently, it was applied in detecting NO2- changes in some Chinese home cooking, the gotten results indicated that if the sautéed vegetables (cabbage, Chinese cabbage, spinach and lettuce) and stir-fry pork, fried peas and pickled vegetable are stored at 4 °C for 72 h, nitrite contents are far lower than the recommended value, but if stored at room temperature for 24 h, the content in pure vegetables and shredded pork with green pepper will exceed the recommended value. Therefore, the staying fresher for the sautéed vegetables at room temperature is 24 h, if stored in a refrigerator at 4 °C, their staying fresher can be extended to 72 h.

[Research advances on the duration aftereffect].

Recent sensory history plays a critical role in the perception of event duration. For example, repetitive exposure to a particular duration leads to the distortion of subsequent duration perception. This phenomenon, termed duration adaptation, induces a robust repulsive duration aftereffect. In particular, adaptation to relatively long sensory events shortens the perceived duration of a subsequent event, while adaptation to relatively short sensory events lengthens the perception of subsequent event durations. This phenomenon implies the plasticity of duration perception and offers important clues for revealing the cognitive neural mechanism of duration perception. Duration aftereffect has received more and more attention in recent years. In this review, we introduce recent research advances in our understanding of duration aftereffect, especially with regards to its manifestations, origin, and cognitive neural mechanisms. We also propose possible directions for future research. In sum, we posit that studies on the duration aftereffect phenomenon are helpful in understanding general duration perception, and as such, should receive more attention in future.

Novel Cucurbitane Triterpenes from the Tubers of Hemsleya amabilis with Their Cytotoxic Acitivity.

Chemical research of the medicinal plant Hemsleya amabilis (Cucurbitaceae) yielded five new cucurbitane-type triterpenes hemslelis A⁻E (1⁻5) by silica gel column, ODS column, and semi-HPLC techniques. Their structures were determined by spectroscopic analysis and examined alongside existing data from prior studies. Compounds 1⁻5 were evaluated for their cytotoxic activities against three human tumor cell lines, Hela, HCT-8, and HepG-2, with the IC50 ranging from 5.9 to 33.9 µM compared to Cisplatin.

Fluorescence quenching capillary analysis for determining trace-level nitrite in food based on the citric acid/ethylenediamine nanodots/nitrite reaction.

We found that nitrite after protonation can react with amine radical on citric acid/ethylenediamine carbon nanodots (CA/EDA-CDs) to form nitrosamines, and fluorescence quenching of CA/EDA-CDs occurred during this process. Using the reaction mechanism a fluorescence quenching capillary analysis (FQCA) was developed. After optimized reaction conditions, the following results were obtained: the required concentration of CA/EDA-CDs was 12 mg/L, HCl concentration was 32 mmol/L, and the reaction conducted in room temperature for 20 min. Under optimized conditions, FQCA has a linear response in 20-500 µg/L in which RSD was less 4.5% (n = 11), the detection limit was 6.5 µg/L and the recovery was in 95-105%. The measured results were consistent with the national standard method. FQCA has been used for determining nitrite in foods and nature waters. The capillary in FQCA was used as the container for CA/EDA-CDs/NO2- reaction and NO2- determination, and realized trace-level analysis for micro-volume samples (<10 µL/time).

The Effects of Ludartin on Cell Proliferation, Cell Migration, Cell Cycle Arrest and Apoptosis Are Associated with Upregulation of p21WAF1 in Saos-2 Osteosarcoma Cells In Vitro.

BACKGROUND The aim of this study was investigate the effects of the sesquiterpene lactone, ludartin, on cell proliferation, cell migration, apoptosis, and the cell cycle in osteosarcoma cell lines, compared with a normal osteoblast cell line. MATERIAL AND METHODS Osteosarcoma cell lines, MG-63 Saos-2 U-2OS, T1-73 143B, and HOS, and normal hFOB 1.19 osteoblasts, were cultured and treated with increasing doses of ludartin, The MTT colorimetric assay was used to measure cell metabolic activity and viability. Apoptosis was studied by fluorescence-activated cell sorting (FACS) using 4',6-diamidino-2-phenylindole (DAPI) nuclear staining and Annexin-V/propidium iodide (PI) staining. Cell cycle was studied using flow cytometry. Cell migration and invasion were studied using wound healing and Boyden chamber assays. Protein expression was measured by Western blotting. RESULTS Ludartin inhibited cell viability, cell migration, cell proliferation, and increased cell apoptosis, in all osteosarcoma cell lines, with an IC50 dose ranging from 15-30 µM. The greatest effects were on the Saso-2 osteosarcoma cells, with an IC50 of 15 µM. However, ludartin showed minor cytotoxic effects of the normal hFOB 1.19 osteoblasts (IC50 >100 µM). Ludartin exerted its anti-proliferative effects on Saos-2 cells via induction of apoptosis and cell cycle arrest at the G2/M checkpoint, associated with reduced expression of Cdc25c (Ser216), Cdc25c, pCdc2 (Tyr15), and Cdc2 and increased expression of p21WAF1. Ludartin inhibited cell migration and invasion of the Saos-2 cells. CONCLUSIONS The dose-dependent effects of ludartin on cell proliferation, migration, apoptosis, cell cycle arrest at the G2/M checkpoint involved p21WAFI in Saos-2 osteosarcoma cells.

[Draft of soil environmental function regionalization of China]. / 中国土壤环境功能区划方案.

Soil environmental function regionalization is of significance for soil environmental classification management in China. In this paper, we discussed the broad and narrow concept of soil environmental function and its corresponding attributes. Based on the constraint analysis on the soil environmental quality to function, relationship between soil environmental function and quality was illustrated. Compared with different methods and indices of soil environmental function regionalization, we established the index system of soil environmental function regionalization according to the soil environmental suitability and function. The proposed draft of soil environmental function regionalization included four first-class function types, 10 second-class function types, and 75 soil environmental functional areas. According to the differences among those functional areas, we proposed corresponding management countermeasures. The results provided scientific basis for the control and prevention of soil pollution and the control of regional risk in China.

Higher dietary carotenoid intake associated with lower risk of hip fracture in middle-aged and elderly Chinese: A matched case-control study.

BACKGROUND: Mechanism studies have suggested that carotenoids may benefit bone health due to their antioxidant properties, but epidemiological data on their effects on risk of hip fracture are sparse. PURPOSE: To explore the relationships between dietary total and specific carotenoids and the risk of hip fracture in a middle-aged and elderly Chinese population. DESIGN: A case-control study of 1070 patients with hip fractures (diagnosed within 2 weeks) aged 55-80 years and 1070 age- (within 3 years) and gender-matched controls was conducted in Guangdong, China between 2009 and 2015. Information on dietary carotenoid intake was assessed using a 79-item food frequency questionnaire administered in face-to-face interviews, and general information was collected using structured questionnaires. The univariate and multivariate conditional logistic regression models were applied to analyze the associations. MAIN RESULTS: Higher intakes of both total and some specific carotenoids (including ß-carotene, ß-cryptoxanthin and lutein/zeaxanthin) were significantly associated with a lower risk of hip fracture (all p trends <0.01). Compared with the lowest quartile of carotenoids, the multivariate-adjusted odds ratios and 95% confidential intervals of the highest quartile were 0.44 (0.29, 0.68) (total carotenoids), 0.50 (0.29, 0.69) (ß-carotene), 0.55 (0.38, 0.80) (ß-cryptoxanthin) and 0.40 (0.27, 0.59) (lutein/zeaxanthin), respectively. There were no statistically significant associations between α-carotene and lycopene intakes and hip fracture risk after adjustment for various confounding variables. CONCLUSION: These results suggest that the consumption of carotenoids may be protective against hip fracture in middle-aged and elderly Chinese adults.

Effect of extracorporeal shock-wave therapy for treating patients with chronic rotator cuff tendonitis.

BACKGROUND: This study aimed to determine the efficacy and safety of extracorporeal shock-wave therapy (ESWT) for treating patients with chronic rotator cuff tendonitis (CRCT). METHODS: In this study, 84 patients with CRCT were randomly divided into intervention and control groups in a ratio of 1:1. Patients in the intervention group received ESWT, whereas those in the control group received placebo. The primary outcome was measured by Numeric Rating Scale (NRS). The secondary outcomes were measured by the Constant-Murley score (CMS), simple shoulder test (SST) score, and adverse events. RESULTS: Compared with placebo, ESWT showed greater efficacy in shoulder pain relief with regard to NRS score and shoulder function as measured by using CMS and SST score at 4 weeks (P < .05) and 8 weeks (P < .01) after treatment. However, no adverse events occurred in both groups. CONCLUSION: ESWT was efficacious and safe for treating patients with CRCT.

Biosensor of alkaline phosphatase based on non-fluorescent FRET of Eu3+-doped oxide nanoparticles and phosphorylated peptide labeled with cyanine dye.

Dephosphorylation of biomolecules under the catalysis of alkaline phosphatase (ALP) is a critical physiological process. Abnormal levels of ALP activity have been associated with a number of diseases; thus, a simple and sensitive assay of ALP activity is highly demanded. Herein, to simulate biological conditions, we labeled a hydrosoluble phosphorylated heptapeptide Gly-Pro-Gly-Asn-p-Tyr-Gly-Ala (pGA) with aminated heptamethine cyanine dye (Cy) to give a low fluorescent labeled peptide Cy-pGA. The synthesized Cy-pGA and Eu3+-doped oxide Y0.6Eu0.4VO4 nanoparticles (NPs) were employed respectively as acceptor and donor to in situ form a non-fluorescent Fluorescence Resonance Energy Transfer (FRET) Cy-pGA-NP system, with the help of the strong interaction between Eu3+ ions in the NPs and phosphate group in Cy-pGA. The breaking of the FRET system of Cy-pGA-NP was triggered by the removal of phosphate group in Cy-pGA catalyzed by ALP and resulting in the release of fluorescent Y0.6Eu0.4VO4 NPs. Thus, the formed Cy-pGA-NP as a sensitive sensor can very well respond to the activity of ALP by measuring the time-resolved fluorescent intensity at near-infrared 617 nm (λ ex = 320 nm, delay time 400 µs). This sensor can not only accurately measure the activity of ALP (1-5 mU/mL) in the designed solutions, but it can also be applied to detect the activity of ALP in biological samples, such as cell lysate and human serum, without the interference of autofluorescent background of biosamples and screen ALP inhibitor by a simple mix-and-measure manner. Graphical abstract A biosensor of alkaline phosphatase (ALP) based on non-fluorescent FRET of Eu3+-doped oxide Y0.6Eu0.4VO4 nanoparticles and the phosphorylated heptapeptide labeled with cyanine dye (Cy-pGA).

Association Between Diet Inflammatory Index and Osteoporotic Hip Fracture in Elderly Chinese Population.

BACKGROUND: Chronic inflammation provides the substrate for various mechanisms involved in osteoporotic fracture. The Dietary Inflammatory Index (DII) could shed light on the effect of the inflammatory potential of the diet on osteoporotic hip fracture. OBJECTIVE: This study tested the hypothesis that higher DII scores are associated with greater hip fracture risk in an elderly Chinese population. METHODS: A 1:1 age- (±3 years), sex- and region-matched case-control study of 1050 pairs (female/male: 781/269) of elderly (age range = 52-83 years) Chinese was conducted in Guangdong, China (2009-2015). Cases were newly diagnosed (within 2 weeks) hip fracture patients and controls were recruited from either communities (n = 835 controls) or the hospital (n = 215). DII scores were calculated from self-reports using a validated 79-item food frequency questionnaire. Odds ratios (ORs) and their 95% confidence intervals (CIs) of the risk of hip fracture for DII scores were estimated from conditional logistic regression. RESULTS: The multivariable-adjusted ORs (95% CIs) for hip fracture across quartiles of DII scores were 1 (reference), 1.42 (1.01, 1.99), 1.63 (1.16, 2.28), and 2.44 (1.73, 3.45) (P trend <.001). Comparing extreme quartiles, the adjusted ORs (95% CIs) for hip fractures were 2.08 (1.38, 3.12) for female and 4.30 (1.89, 9.80) for male participants, respectively (P interaction = .26). When stratified by the source of controls, a dose-response positive relationship was observed between DII scores and hip fracture risk among community-based controls but not those from the hospital (P interaction = .16). CONCLUSIONS: A proinflammatory diet appears to be positively associated with hip fracture risk.

Effect and safety of sertraline for treat posttraumatic stress disorder: a multicenter randomised controlled study.

OBJECTIVE: Although several previous studies have examined the efficacy of sertraline in the treatment of posttraumatic stress disorder (PTSD), none involved Chinese PTSD patients. This study aimed to evaluate sertraline efficacy and adverse events in Chinese patients with PTSD over 12 weeks. METHODS: In total, 72 PTSD patients were randomly assigned to receive sertraline (135 mg daily) or a placebo for 12 weeks. Impact of Event Scale-Revised subscores constituted the primary outcome, with Clinical Global Impression Scale-Severity scores and adverse events as secondary outcomes. RESULTS: Sixty-five subjects completed the study, and their data were included in the final analysis. Sertraline showed greater efficacy in enhancing Impact of Event Scale-Revised and Clinical Global Impression Scale-Severity scores at 6 and 12 weeks relative to that of the placebo. The most common adverse event was nausea, which occurred in 12 (33.3%) and 8 (22.2%) patients in the sertraline and placebo groups, respectively. No sertraline-related deaths were recorded. CONCLUSIONS: In summary, we demonstrated that 12 weeks of sertraline was efficacious and well-tolerated in Chinese patients with PTSD.