Modified Respiratory Rate Oxygenation Index: An Early Warning Index for the Need of Intubation in COVID-19 Patients with High-Flow Nasal Cannula Therapy.

BACKGROUND: High-flow nasal cannula oxygen therapy (HFNC) is recommended for patients with COVID-19. However, the increasing use of HFNC brings a risk of delayed intubation. The optimal timing of switching from HFNC to invasive mechanical ventilation (IMV) remains unclear. An effective predictor is needed to assist in deciding on the timing of intubation. Respiratory rate and oxygenation (ROX) index, defined as (SpO2/FiO2) / respiratory rate, has already shown good diagnostic accuracy. Modified ROX (mROX) index, defined as (PaO2 /FiO2) / respiratory rate, might be better than the ROX index in predicting HFNC failure. OBJECTIVE: The aim was to evaluate the predictive value of mROX for HFNC failure in patients with COVID-19. METHODS: Severe or critical patients with COVID-19 treated with HFNC were enrolled in two clinical centers. Laboratory indicators, respiratory parameters, and mROX index at 0 h and 2 h after initial HFNC were collected. Based on the need for IMV after HFNC initiation, the patients were divided into an HFNC failure group and an HFNC success group. The predictive value of mROX index for IMV was evaluated by the area under the receiver operating characteristic curve (AUROC) and logistic regression analysis. We performed Kaplan-Meier survival analysis using the log-rank test. RESULTS: Sixty patients with COVID-19 (mean ± SD age, 62.8 ± 14.1 years; 42 patients were male) receiving HFNC were evaluated, including 18 critical and 42 severe cases. A total of 33 patients had hypertension; 14 had diabetes; 17 had chronic cardiac disease; 11 had chronic lung disease; 13 had chronic kidney disease; and 17 had a history of stroke. The AUROC of mROX index at 2 h was superior to that of other respiratory parameters to predict the need for IMV (0.959; p < 0.001). At the mROX index cutoff point of 4.45, predicting HFNC failure reached the optimal threshold, with specificity of 94% and sensitivity of 92%. Logistic regression analysis showed that 2-h mROX index < 4.45 was a protective factor for IMV (odd radio 0.18; 95% CI 0.05-0.64; p = 0.008). In the HFNC failure group, the median time from HFNC to IMV was 22.5 h. The 28-day mortality of the late intubation patients (≥ 22.5 h) was higher than that of the early intubation patients (< 22.5 h) (53.8% vs. 8.3%; p = 0.023). CONCLUSIONS: mROX at 2 h is a good early warning index of the need for IMV in patients with COVID-19 after HFNC initiation. Early intubation may lead to better survival in patients with 2-h mROX index < 4.45.

A cross-sectional survey on the lung ultrasound training and practice of respiratory therapists in mainland China.

PURPOSE: This national study aimed to investigate the lung ultrasound (LUS) training and practice of respiratory therapists (RTs) in mainland China. METHODS: A cross-sectional multicenter survey was conducted from May 22, 2021 to August 12, 2021, through online platforms. This survey included RTs in mainland China. The survey was divided into four sections: (1) demographic characteristics and basic information; (2) basic information about LUS training and practice; (3) LUS practice details; and (4) Other ultrasound training and practice. RESULTS: A total of 514 responses were received, and 494 valid responses were included in the analysis. 81.2% (401/494) participants' highest degree of education was a bachelor's degree, and 43.1% (213/494) participants were at level II in terms of job ranking. 99.2%(490/494) participants agreed that the RTs needed to learn lung ultrasound, but only 12.3% (61/494) participants had received a LUS training course. Further, 66.2% (327/494) experienced participants responded to Sect. 3. Most of RTs used LUS when the patient had hypoxia (265/327, 81%) or dyspnea (260/317, 79.5%); they also used it during spontaneous breathing trial(SBT) (191/327, 58.4%) or in prone position (177/327, 54.1%). The A-line (302/327, 92.4%), B-line (299/327, 91.4%), lung slide (263/327, 80.4%), and bat sign (259/327, 79.2%) were well known as LUS signs. Also, 30.6% (100/327) participants did not use the LUS protocol in their clinical practice, and only 25.4%(83/327) participants said they had used LUS scores. Moreover, 55.7% (182/327) participants frequently changed the respiratory therapy strategy according to LUS results. CONCLUSIONS: We should improve the number and workplace of RTs in mainland China in the future. We should also standardize the application of LUS practice and training for RTs in mainland China and establish corresponding certification pathways.

Characteristics and topic trends on electrical impedance tomography hardware publications.

Objective: Electrical impedance tomography (EIT) is a technique to measure electrical properties of tissue. With the progress of modern integrated circuits and microchips, EIT instrumentation becomes an active research area to improve all aspects of device performance. Plenty of studies on EIT hardware have been presented in prestigious journals. This study explores publications on EIT hardware to identify the developing hotspots and trends. Method: Publications covering EIT hardware on the Web of Science Core Collection (WoSCC) database from 1989 to 2021 were collected for bibliometric analysis. CiteSpace and VOS viewer were used to study the characteristics of the publications. Main results: A total of 592 publications were analyzed, showing that the number of annual publications steadily increased. China, England, and South Korea were the most prolific countries on EIT hardware publications with productive native institutions and authors. Research topics spread out in "bio-electrical impedance imaging", "hardware optimization", "algorithms" and "clinical applications" (e.g., tissue, lung, brain, and oncology). Hardware research in "pulmonary" and "hemodynamic" applications focused on monitoring and were represented by silhouette recognition and dynamic imaging while research in "tumor and tissue" and "brain" applications focused on diagnosis and were represented by optimization of precision. Electrode development was a research focus through the years. Imaging precision and bioavailability of hardware optimization may be the future trend. Conclusion: Overall, system performance, particularly in the areas of system bandwidth and precision in applications may be the future directions of hardware research.

Prediction of high-flow nasal cannula outcomes at the early phase using the modified respiratory rate oxygenation index.

BACKGROUND: This study was designed to explore the early predictive value of the respiratory rate oxygenation (ROX) index modified by PaO2 (mROX) in high-flow nasal cannula (HFNC) therapy in patients with acute hypoxemia respiratory failure (AHRF). METHOD: Seventy-five patients with AHRF treated with HFNC were retrospectively reviewed. Respiratory parameters at baseline and 2 h after HFNC initiation were analyzed. The predictive value of the ROX (ratio of pulse oximetry/FIO2 to respiratory rate) and mROX (ratio of arterial oxygen /FIO2 to respiratory rate) indices with two variations by adding heart rate to each index (ROX-HR and mROX-HR) was evaluated. RESULTS: HFNC therapy failed in 24 patients, who had significantly higher intensive care unit (ICU) mortality and longer ICU stay. Both the ROX and mROX indices at 2 h after HFNC initiation can predict the risk of intubation after HFNC. Two hours after HFNC initiation, the mROX index had a higher area under the receiver operating characteristic curve (AUROC) for predicting HFNC success than the ROX index. Besides, baseline mROX index of greater than 7.1 showed a specificity of 100% for HFNC success. CONCLUSION: The mROX index may be a suitable predictor of HFNC therapy outcomes at the early phase in patients with AHRF.

Marine heatwave events near Weizhou Island, Beibu Gulf in 2020 and their possible relations to coral bleaching.

Marine heatwaves (MHWs) are events of anomalously high sea surface temperatures lasting for five days or more and have recently been linked to widespread environmental stress on marine organisms, though there are few studies in the Beibu Gulf. This study characterizes MHWs near Weizhou Island (21°00'-21°10' N, 109°00'-109°15' E) using a recently developed detection algorithm on a high-resolution satellite sea surface temperature (SST) product and considers their potential influence on coral bleaching events. Reanalysis data are used to investigate atmospheric factors in MHWs occurrences. Results showed that among a total of 112 MHWs having occurred from 1983 to 2020, eight discrete MHWs occurring throughout 2020 in Weizhou Island. Interestingly, although not the most intense in 2020, the June 3rd-August 2nd event lasted for an enormous 61 days with mean and maximum intensities of 2.68 °C and 1.73 °C above climatology, respectively. The reasons for the occurrence and severity of MHWs in 2020 the intensification of Northwest Pacific subtropical high and its extension leading to increased shortwave radiation reaching the sea surface during the summer, reduced typhoon activity in July, weakened wind fields north of 20.5°N, and an enhancement in sea level anomalies. These act in concert to prevent heat transport away from the Beibu Gulf and thus, more intense MHWs. A massive coral bleaching event occurred in 2020 and is highly likely to be linked to MHWs activity.

The 2020 Summer Floods and 2020/21 Winter Extreme Cold Surges in China and the 2020 Typhoon Season in the Western North Pacific.

China experienced significant flooding in the summer of 2020 and multiple extreme cold surges during the winter of 2020/21. Additionally, the 2020 typhoon season had below average activity with especially quiet activity during the first half of the season in the western North Pacific (WNP). Sea surface temperature changes in the Pacific, Indian, and Atlantic Oceans all contributed to the heavy rainfall in China, but the Atlantic and Indian Oceans seem to have played dominant roles. Enhancement and movement of the Siberian High caused a wavier pattern in the jet stream that allowed cold polar air to reach southward, inducing cold surges in China. Large vertical wind shear and low humidity in the WNP were responsible for fewer typhoons in the first half of the typhoon season. Although it is known that global warming can increase the frequency of extreme weather and climate events, its influences on individual events still need to be quantified. Additionally, the extreme cold surge during 16-18 February 2021 in the United States shares similar mechanisms with the winter 2020/21 extreme cold surges in China.

Present Situation and Research Progress of Kidney Function Recoverability Evaluation of Acute Kidney Injury Patient.

Acute kidney injury (AKI) is a critical illness in clinic. The guideline recommendation of kidney disease for improving global outcomes regards urine volume and creatinine as standards to evaluate kidney functions. However, urine volume and creatinine have a certain delay for kidney function evaluation, and these would be interfered by many factors. Whether the renal function of AKI patients can recover is very important, which affects the quality of life of patients. Therefore, the present study reviews the application situation and research progress of the recoverability evaluation of AKI patient kidney function from three aspects: conventional indexes, biomarkers, and imaging methods of kidney function.

Quantitative estimation of sea surface temperature increases resulting from the thermal discharge of coastal power plants in China.

The operation of coastal nuclear power plants and thermal power plants (CNATPPs) can cause regional sea surface temperature (SST) increases. To assess their effects on coastal ecosystems, the scope and extent of their impacts must be understood. We aimed to quantitatively assess the SST increases caused by thermal discharge under climate warming by comparing SSTs between control and test groups and among different offshore buffer zones based on daily MODIS SST data from 2002 to 2017. The results showed that (1) a good correlation occurred between the CNATPP installed capacity and SST increase in the 0-2 km offshore waters; (2) the SST increase caused by thermal discharge was the largest in summer and the smallest in winter; and (3) the effect of thermal discharge occurred within 2 km offshore when the installed capacity exceeded 2000 MW and extended to 5 km when it reaches more than 4000 MW.

Emerging Trends and Hot Spots of Electrical Impedance Tomography Applications in Clinical Lung Monitoring.

OBJECTIVE: This study explores the emerging trends and hot topics concerning applications on electrical impedance tomography (EIT) in clinical lung monitoring. METHODS: Publications on EIT applications in clinical lung monitoring in 2001-2021 were extracted from the Web of Science Core Collection (WoSCC). The search strategy was "electrical impedance tomography" and "lung." CiteSpace, a VOS viewer was used to study the citation characteristics, cooperation, and keyword co-occurrence. Moreover, co-cited reference clustering, structural variation analysis (SVA), and future research trends were presented. RESULTS: Six hundred and thirty-six publications were included for the final analysis. The global annual publications on clinical lung monitoring gradually increased in the last two decades. Germany contributes 32.2% of total global publications. University Medical Center Schleswig-Holstein (84 publications, cited frequency 2,205), Physiological Measurement (105 publications, cited frequency 2,056), and Inéz Frerichs (116 articles, cited frequency 3,609) were the institution, journal, and author with the largest number of article citations in the research field. "Electrical impedance tomography" (occurrences, 304), "mechanical ventilation" (occurrences, 99), and "acute respiratory distress syndrome" (occurrences, 67) were the top most three frequent keywords, "noninvasive monitoring" (Avg, pub, year: 2008.17), and "extracorporeal membrane oxygenation" (Avg, pub, year: 2019.60) were the earliest and latest keywords. The keywords "electrical impedance tomography" (strength 7.88) and co-cited reference "Frerichs I, 2017, THORAX" (strength 47.45) had the highest burst value. "Driving pressure," "respiratory failure," and "titration" are the three keywords still maintaining a high brush value until now. The largest and smallest cluster of the co-cited references are "obstructive lung diseases" (#0, size: 97) and "lung perfusion" (#20, size: 5). Co-cited reference "Frerichs I, 2017, THORAX" (modularity change rate: 98.49) has the highest structural variability. Categories with most and least interdisciplinary crossing are "ENGINEERING" and "CRITICAL CARE MEDICINE." CONCLUSIONS: EIT is a valuable technology for clinical lung monitoring, gradually converting from imaging techniques to the clinic. Research hot spots may continue monitoring techniques, the ventilation distribution of acute respiratory distress syndrome (ARDS), and respiratory therapy strategies. More diversified lung function monitoring studies, such as lung perfusion and interdisciplinary crossing, are potentially emerging research trends.

TRIM31 promotes apoptosis via TAK1-mediated activation of NF-κB signaling in sepsis-induced myocardial dysfunction.

Sepsis is a major condition caused by an overwhelming inflammatory response to an infection. Sepsis-induced myocardial dysfunction (SIMD) is a common complication in septic patients and a major predictor of morbidity and mortality. Here, we investigated the role of tripartite motif 31 (TRIM31) protein in sepsis progression in vitro and in vivo. Quantitative real-time PCR and western blot were used to detect the expression levels of relative genes and proteins. Cell proliferation and apoptosis were evaluated to determine cell viability. H&E and IHC staining were performed to examine morphological and pathological changes in mice. ELISA assay was used to detect inflammatory factors. TRIM31 was upregulated in septic patients compared with normal people. TRIM31 depletion reduced LPS-induced apoptosis whereas TRIM31 overexpression-elevated LPS-induced apoptosis. Furthermore, TRIM31 interacted with and ubiquitinated transforming growth factor-ß-activated kinase-1 (TAK1), resulting in TAK1 activation and subsequent induction of NF-κB signaling. Of note, Trim31 depletion or blockade by PDTC treatment inhibited LPS-induced apoptosis in vivo. In conclusion, TRIM31 played an important role in SIMD by activating TAK1-mediated NF-κB signaling pathway.

[A successfully treated case of colchicine poisoning with lethal dose].

At present, there is no specific antidote for colchicine intoxication, and 0.8 mg/kg is its lethal dose. The prognosis of colchicine intoxication patients is closely related to the dosage, but the individual difference is very great. A 38-year-old man with colchicine poisoning was admitted to the Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, who had ingested 80 mg colchicine tablets (1.19 mg/kg) orally for 4 hours. He was immediately put on gastric lavage, enema, and catharsis. Continuous blood purification was performed for 34 hours and 22 minutes, with a combination of hemoperfusion (HP) and continuous veno-venous hemofiltration dialysis (CVVHDF). He also received a large dose of the glucocorticoid with 80 mg of methylprednisolone injected intravenously every 8 hours and organ function support. The patient was hospitalized for 2 weeks and discharged with improvement. The successful treatment of this case was reported for reference.

MiR-215-5p inhibits the inflammation injury in septic H9c2 by regulating ILF3 and LRRFIP1.

MicroRNAs (miRNAs) are small non-coding RNAs (ncRNAs) playing crucial roles in sepsis-induced diseases, including myocardial inflammation. Nevertheless, the expression pattern and role of miR-215-5p in myocardial inflammation are still un-investigated up to now. The purpose of our study is to further inquire the effect of miR-215-5p on lipopolysaccharide (LPS)-activated inflammation injury in H9c2 cells and the possibly associated mechanisms. First of all, LPS-induced H9c2 cells models were constructed and affirmed via detection of pro-inflammatory factors, the viability and apoptosis. MiR-215-5p was overtly down-regulated in LPS-treated H9c2 cells and miR-215-5p overexpression could suppress the inflammation injury. LRRFIP1 was proved to be the target gene of miR-215-5p and meanwhile, miR-215-5p also targeted ILF3 that experimented to bind to and stabilize LRRFIP1. Final rescue assays confirmed that the overexpression of LRRFIP1 or ILF3 rescued the repressive effect of miR-215-5p up-regulation on the inflammation injury in septic H9c2. Totally, miR-215-5p exerted protective function in the inflammation injury in septic H9c2 via targeting ILF3 and LRRFIP1, suggesting an additional treatment method for sepsis-activated myocardial inflammation.

Occurrence of polycyclic aromatic hydrocarbons (PAHs) in coral reef fish from the South China Sea.

Little data are available on the bioaccumulation of polycyclic aromatic hydrocarbons (PAHs) in coral reef fish from the South China Sea (SCS). In this study, we collected 21 coral reef fish species from the Xisha and Nansha Islands in the SCS to investigate the occurrence of 16 US-EPA PAHs. The total PAH concentrations (ΣPAH) in the collected fish ranged from 12.79 to 409.28 ng/g dry weight (dw, Xisha Islands) and from 32.71 to 139.09 ng/g dw (Nansha Islands), respectively. The ΣPAH concentration of Scarus niger collected from the Xisha Islands (237.13 ng/g dw) was about twofold higher than that of Scarus niger collected from the Nansha Islands (139.09 ng/g dw). The dominant compounds were found to be 2-ring and 3-ring PAHs. Based on qualitative and quantitative analyses, the main PAH sources were found to be coal and biomass combustion (50.43%), petroleum sources (25.86%), and vehicular emissions (16.10%).

Preliminary study of the source apportionment and diversity of microplastics: Taking floating microplastics in the South China Sea as an example.

At present, the study of microplastic sources is in a relatively preliminary stage due to the complexity of microplastic features in the environment. Based on a literature review, we developed a source-specific classification system for the quantitative analysis of microplastic sources. The classification system includes ten types of microplastics based on morphology and composition and can identify their main sources and the associated probabilities. To reflect the complexity of types and sources in the regional combination of microplastics, we first propose a microplastic diversity index (D1-D'(MP)). We use the South China Sea as an example to carry out quantitative source analysis and calculate the diversity index. Eight types of microplastics were found, mainly consisting of maritime coatings (type "Gran_coat") (33.0%) and synthetic fibers (type "Fib_thin") (29.6%). We also found that the diversity increased with offshore distance. In addition, we partitioned surface microplastics globally according to a two-dimensional microplastic abundance-diversity index. We believe that these indicators can effectively reflect pollution status and ultimately lead to different types of control measures. In the future, additional indicators for the characterization of microplastics must be included in the classification system to establish a one-to-one source analysis system for microplastic characteristics and source apportionment. In general, our study may provide new insights into the establishment of more accurate and quantitative source apportionment techniques and effective pollution control.

Microplastics in a wind farm area: A case study at the Rudong Offshore Wind Farm, Yellow Sea, China.

Despite the rapid construction of offshore wind farms, the available information regarding the risks of this type of development in terms of emerging pollutants, particularly microplastics, is scarce. In this study, we quantified the level of microplastic pollution at an offshore wind farm in the Yellow Sea, China, in 2016. The abundance of microplastics was 0.330 ±â€¯0.278 items/m3 in the surface water and 2.58 ±â€¯1.14 items/g (dry) in the sediment. To the best of our knowledge, the level of microplastic pollution in our study area was slightly higher than that in coastal areas around the world. The microplastics detected in the surface waters and sediments were mainly fibrous (75.3% and 68.7%, respectively) and consisted of some granules and films. The microplastics in the samples might originate from garments or ropes via wastewater discharge. The abundance of plastic in the water and sediment samples collected from the wind farm area was lower than that in the samples collected from outside the wind farm area. The anthropogenic hydrodynamic effect was the main factor affecting the local distribution of microplastics. The presence of a wind farm could increase the bed shear stress during ebb tide, disturbing the bed sediment, facilitating its initiation and transport, and ultimately increasing the ease of washing away the microplastics adhered to the sediment. This study will serve as a reference for further studies of the distribution and migration of microplastics in coastal zones subjected to similar marine utilization.

miR-25 inhibits sepsis-induced cardiomyocyte apoptosis by targetting PTEN.

To investigate the regulatory mechanism of miR-25 in sepsis-induced cardiomyocyte apoptosis. Rats models of sepsis were established by cecal ligation and puncture (CLP). Lipopolysaccharide (LPS)-induced cardiomyocyte was used as an in vitro model of sepsis. The expressions of miR-25, tensin homolog deleted on chromosome 10 (PTEN), Toll-like receptors 4 (TLR4), and p-p65 were analyzed by quantitative real-time PCR (qRT-PCR) and Western blot, respectively. The levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected by ELISA. Cell apoptosis was detected by terminal deoxynucleotidyl transferase-mediated d-UTP nick end labeling (TUNEL) assay. The relationship between miR-25 and PTEN was measured by luciferase reporter assays. MiR-25 expression in serum of CLP rats and LPS-induced cardiomyocyte was decreased, while the contents of TNF-α and IL-6 were increased. Moreover, the expressions of PTEN, TLR4, and p-p65 in LPS-induced cardiomyocyte were significantly increased. Overexpression of miR-25 increased the survival rate of rats, inhibited LPS-increased cardiomyocyte apoptosis, reversed the increased expression of PTEN, TLR4, p-p65, TNF-α, and IL-6 induced by LPS. The luciferase assay demonstrated that PTEN was a target of miR-25. Additionally, pcDNA-PTEN reversed the inhibitory effect of miR-25 mimic on cardiomyocyte apoptosis, while TAK-242 (TLR-4 inhibitor) countered this effect. miR-25 reduced LPS-induced cardiomyocyte apoptosis by down-regulating PTEN/TLR4/NF-κB axis.

Effect of dexmedetomidine on rats with convulsive status epilepticus and association with activation of cholinergic anti-inflammatory pathway.

Convulsive status epilepticus (CSE) is a neurological disease with contraction and extension of limbs, leading to damage of hippocampus and cognition. This study aimed to explore the effects of dexmedetomidine (DEX) on the cognitive function and neuroinflammation in CSE rats. All rats were divided into control group, CSE group and DEX group. Morris water maze test was used to measure cognitive function. Acute hippocampal slices were made to detect long-term potentiation (LTP). Immunohistochemistry was used to determine the expression of α7-nicotinic acetylcholine receptor (α7-nAChR) and interleukin-1ß (IL-1ß). Enzyme-linked immunosorbent assay (ELISA) was used to measure serum levels of IL-1ß, tumor necrosis factor-α (TNF-α), S-100ß and brain-derived neurotrophic factor (BDNF). Our results showed that DEX improved the memory damage caused by CSE. DEX reduced seizure severity and increased the amplitudes and sustainable time of LTP, and also inhibited the hippocampal expression of α7-nAChR and IL-1ß in CSE rats. DEX treatment decreased serum IL-1ß, TNF-α and S-100ß levels and increased BDNF levels. The effects of DEX on seizure severity and LTP could be simulated by nicotine or attenuated by concurrent α-bungarotoxin (α-BGT) treatment. In conclusions, DEX significantly improved spatial cognitive dysfunction, reduced seizure severity and increased LTP in CSE rats. Improvements by DEX were closely related to enhancement of cholinergic anti-inflammatory pathway.

[Progress in antimicrobial substances of endophytes].

Isolation and characterization of metabolites produced by endophytes are significant ways to search for novel natural active substances, proving that the endophytes are the unique resources of newer and more effective compounds. Many new compounds with antimicrobial activity from different endophytes have been isolated so far. These new compounds provide alternatives to fight against multi-drug resistance of microorganisms. This review outlined the major achievements and latest developments of endophytes, including the diversity of endophytes and antimicrobial activity of endophytes, as well as its development in China.

Assessing natural and anthropogenic influences on water discharge and sediment load in the Yangtze River, China.

The water discharge and sediment load of rivers are changing substantially under the impacts of climate change and human activities, becoming a hot issue in hydro-environmental research. In this study, the water discharge and sediment load in the mainstream and seven tributaries of the Yangtze River were investigated by using long-term hydro-meteorological data from 1953 to 2013. The non-parametric Mann-Kendall test and double mass curve (DMC) were used to detect trends and abrupt change-points in water discharge and sediment load and to quantify the effects of climate change and human activities on water discharge and sediment load. The results are as follows: (1) the water discharge showed a non-significant decreasing trend at most stations except Hukou station. Among these, water discharge at Dongting Lake and the Min River basin shows a significant decreasing trend with average rates of -13.93×108m3/year and -1.8×108m3/year (P<0.05), respectively. However, the sediment load exhibited a significant decreasing trend in all tributaries of the Yangtze River. (2) No significant abrupt change-points were detected in the time series of water discharge for all hydrological stations. In contrast, significant abrupt change-points were detected in sediment load, most of these changes appeared in the late 1980s. (3) The water discharge was mainly influenced by precipitation in the Yangtze River basin, whereas sediment load was mainly affected by climate change and human activities; the relative contribution ratios of human activities were above 70% for the Yangtze River. (4) The decrease of sediment load has directly impacted the lower Yangtze River and the delta region. These results will provide a reference for better resource management in the Yangtze River Basin.