COVID-19 Vaccine Hesitancy Among Medicare Beneficiaries with and Without Cancer History: A US Population-based Study.

Understanding COVID-19 vaccine hesitancy among Medicare beneficiaries is critical for increasing COVID-19 vaccine uptake in the US. This study aimed to estimate and compare the vaccine hesitancy rate among community-dwelling Medicare beneficiaries with and without cancer history, also to investigate factors associated with vaccine hesitancy during the first four months after COVID-19 vaccine became available. We used population-based, cross-sectional data on 3,034 community-living Medicare beneficiaries from the Medicare Current Beneficiary Survey COVID-19 Winter 2021 Supplement. Sample weights were applied to account for the complex survey design with results generalizable to 16.4 million Medicare beneficiaries. Weighted multivariable logistic regression model was conducted to investigate the association between cancer history and vaccine hesitancy adjusting for covariates. A total of 39.6% were hesitant about getting COVID-19 vaccine. Those with cancer history were significantly less likely to be hesitant to get vaccinated than those without cancer history (adjusted odds ratio = 0.80, 95% confidence interval: 0.64, 0.99, p = .050). The most common reason for being hesitant to get COVID-19 vaccine was that the vaccine could have side effects or was viewed as not safe (19.2%), followed by not trusting what government says about vaccine (11.4%). Those with cancer history were more likely to report ongoing health conditions, lack of recommendation from a doctor, and doctor recommending against COVID-19 vaccination as reasons for not getting the vaccine compared to participants without cancer history. Increasing the confidence and knowledge about vaccine benefits among high-risk and more hesitant individuals are urgently needed to increase the vaccine uptake.

[Identifying Depressive Disorder With Sleep Electroencephalogram Data: A Study Based on Deep Learning].

Objective: To explore the effectiveness of using deep learning network combined Vision Transformer (ViT) and Transformer to identify patients with depressive disorder on the basis of their sleep electroencephalogram (EEG) signals. Methods: The sleep EEG signals of 28 patients with depressive disorder and 37 normal controls were preprocessed. Then, the signals were converted into image format and the feature information on frequency domain and spatial domain was retained. After that, the images were transmitted to the ViT-Transformer coding network for deep learning of the EEG signal characteristics of the rapid eye movement (REM) sleep and non-rapid eye movement (NREM) sleep in patients with depressive disorder and those in normal controls, respectively, and to identify patients with depressive disorder. Results: Based on the ViT-Transformer network, after examining different EEG frequencies, we found that the combination of delta, theta, and beta waves produced better results in identifying depressive disorder. Among the different EEG frequencies, EEG signal features of delta-theta-beta combination waves in REM sleep achieved 92.8% accuracy and 93.8% precision for identifying depression, with the recall rate of patients with depression being 84.7%, and the F0.5 value being 0.917±0.074. When using the delta-theta-beta combination EEG signal features in NREM sleep to identify depressive disorder, the accuracy was 91.7%, the precision was 90.8%, the recall rate was 85.2%, and the F0.5 value was 0.914±0.062. In addition, through visualization of the sleep EEG of different sleep stages for the whole night, it was found that classification errors usually occurred during transition to a different sleep stage. Conclusion: Using the deep learning ViT-Transformer network, we found that the EEG signal features in REM sleep based on delta-theta-beta combination waves showed better effect in identifying depressive disorder.

Single-Crystal Transformation Engineering the Spin Change of Metal-Organic Frameworks via Cluster Deconstruction.

Spin crossover (SCO) materials with new architectures will expand and enrich the research in the SCO field. Here, we report two metal-organic frameworks (MOFs) containing tetradentate organic ligands and hexatopic linkers [Ag8 X8 (CN)6 ]6- (X=Br and I), which represents the first SCO MOF with clusters as building blocks. The silver halide cluster can be further removed after reacting with lithium tetracyanoquinodimethan (LiTCNQ). Such post-synthetic modification (PSM) is realized via single-crystal to single-crystal (SCSC) transformation from urk to nbo topology. Accordingly, the spin state and fluorescence properties are greatly modified by cluster deconstruction. Therefore, these achievements will provide new ideas for the design of new SCO systems and the development of PSM methods.

Redox-Programmable Spin-Crossover Behaviors in a Cationic Framework.

Metal-organic frameworks (MOFs) provide versatile platforms to construct multi-responsive materials. Herein, by introducing the neutral tetradentate ligand and the linear dicyanoaurate(I) anion, we reported a rare cationic MOF [FeII(TPB){AuI(CN)2}]I·4H2O·4DMF (TPB = 1,2,4,5-tetra(pyridin-4-yl)benzene) with hysteretic spin-crossover (SCO) behavior near room temperature. This hybrid framework with an open metal site (AuI) exhibits redox-programmable capability toward dihalogen molecules. By means of post-synthetic modification, all the linear [AuI(CN)2]- linkers can be oxidized to square planar [AuIII(CN)2X2]- units, which results in the hysteretic SCO behaviors switching from one-step to two-step for Br2 and three-step for I2. More importantly, the stepwise SCO behaviors can go back to one-step via the reduction by l-ascorbic acid (AA). Periodic DFT calculations using various SCAN-type exchange-correlation functionals have been employed to rationalize the experimental data. Hence, these results demonstrate for the first time that switchable one-/two-/three-stepped SCO dynamics can be manipulated by chemical redox reactions, which opens a new perspective for multi-responsive molecular switches.

Single-Crystal to Single-Crystal Transformation of a Spin-Crossover Hybrid Perovskite via Thermal-Induced Cyanide Linkage Isomerization.

Linkage isomers involving changes in the bonding mode of ambidentate ligands have potential applications in data storage, molecular machines, and motors. However, the observation of the cyanide-linkage-isomerism-induced spin change (CLIISC) effect characterized by single-crystal X-ray diffraction remains a considerable challenge. Meanwhile, the high-spin and low-spin states can be reversibly switched in spin-crossover (SCO) compounds, which provide the potential for applications to data storage, switches, and sensors. Here, a new perovskite-type SCO framework (PPN)[Fe{Ag(CN)2}3] (PPN+ = bis(trisphenylphosphine)iminium cation) is synthesized, which displays the unprecedented aging and temperature dependences of hysteretic multistep SCO behaviors near room temperature. Moreover, the thermal-induced cyanide linkage isomerization from FeII-N≡C-AgI to FeII-C≡N-AgI is revealed by single-crystal X-ray diffraction, Raman, and Mössbauer spectra, which is associated with a transition from the mixed spin state to the low-spin state and a dramatic volume shrinkage. Considering the wide use of cyanogen in magnetic systems, the association of CLIISC and SCO opens a new dimension to modulate the spin state and realize a colossal negative thermal expansion.

Relationships among the Dosage of Erythropoiesis-Stimulating Agents, Erythropoietin Resistance Index, and Mortality in Maintenance Hemodialysis Patients.

BACKGROUND: Erythropoiesis-stimulating agents (ESAs) constitute an important treatment option for anemia in hemodialysis (HD) patients. We investigated the relationships among the dosage of ESA, erythropoietin resistance index (ERI) scores, and mortality in Chinese MHD patients. METHODS: This multicenter observational retrospective study included MHD patients from 16 blood purification centers (n = 824) who underwent HD in 2011-2015 and were followed up until December 31, 2016. We collected demographic variables, HD parameters, laboratory values, and ESA dosages. Patients were grouped into quartiles according to ESA dosage to study the effect of ESA dosage on all-cause mortality. The ERI was calculated as follows: ESA (IU/week)/weight (kg)/hemoglobin levels (g/dL). We also compared outcomes among the patients stratified into quartiles according to ERI scores. We used the Cox proportional hazards model to measure the relationships between the ESA dosage, ERI scores, and all-cause mortality. Using propensity score matching, we compared mortality between groups according to ERI scores, classified as either > or ≤12.80. RESULTS: In total, 824 patients were enrolled in the study; 200 (24.3%) all-cause deaths occurred within the observation period. Kaplan-Meier analyses showed that patients administered high dosages of ESAs had significantly worse survival than those administered low dosages of ESAs. A multivariate Cox regression identified that high dosages of ESAs could significantly predict mortality (ESA dosage >10,000.0 IU/week, HR = 1.59, 95% confidence intervals (CIs) (1.04, 2.42), and p = 0.031). Our analysis also indicated a significant increase in the risk of mortality in patients with high ERI scores. Propensity score matching-analyses confirmed that ERI > 12.80 could significantly predict mortality (HR = 1.56, 95% CI [1.11, 2.18], and p = 0.010). CONCLUSIONS: Our data suggested that ESA dosages >10,000.0 IU/week in the first 3 months constitute an independent predictor of all-cause mortality among Chinese MHD patients. A higher degree of resistance to ESA was related to a higher risk of all-cause mortality.

An mHealth Intervention to Improve Medication Adherence and Health Outcomes Among Patients With Coronary Heart Disease: Randomized Controlled Trial.

BACKGROUND: The treatment of many chronic illnesses involves long-term pharmaceutical therapy, but it is an ongoing challenge to find effective ways to improve medication adherence to promote good health outcomes. Cardioprotective medications can prevent the enlargement of harmful clots, cardiovascular symptoms, and poor therapeutic outcomes, such as uncontrolled high blood pressure and hyperlipidemia, for patients with coronary heart disease. Poor adherence to cardioprotective medications, however, has been reported as a global health concern among patients with coronary heart disease, and it is particularly a concern in China. OBJECTIVE: This study aimed to evaluate the efficacy of a mobile health (mHealth) intervention using 2 mobile apps to improve medication adherence and health outcomes. METHODS: A randomized, placebo-controlled, 2-arm parallel study was conducted in a major university-affiliated medical center located in Chengdu, China. Participants were recruited by flyers and health care provider referrals. Each participant was observed for 90 days, including a 60-day period of mHealth intervention and a 30-day period of nonintervention follow-up. The study coordinator used WeChat and Message Express to send educational materials and reminders to take medication, respectively. Participants used WeChat to receive both the educational materials and reminders. Participants in the control group only received educational materials. This study received ethics approval from the Duke Health Institutional Review Board (Pro00073395) on May 5, 2018, and was approved by West China Hospital (20170331180037). Recruitment began on May 20, 2018. The pilot phase of this study was registered on June 8, 2016, and the current, larger-scale study was retrospectively registered on January 11, 2021 (ClinicalTrials.gov). RESULTS: We recruited 230 patients with coronary heart disease. Of these patients, 196 completed the baseline survey and received the intervention. The majority of participants were married (181/196, 92.4%), male (157/196, 80.1%), and lived in urban China (161/196, 82.1%). Participants' average age was 61 years, and half were retired (103/191, 53.9%). More than half the participants (121/196, 61.7%) were prescribed at least 5 medications. The mean decrease in medication nonadherence score was statistically significant at both 60 days (t179=2.04, P=.04) and 90 days (t155=3.48, P<.001). Systolic blood pressure and diastolic blood pressure decreased in the experimental group but increased in the control group. The mean decrease in diastolic blood pressure was statistically significant at both 60 days (t160=2.07, P=.04) and 90 days (t164=2.21, P=.03). The mean decrease in systolic blood pressure was significantly different in the groups at 90 days (t165=3.12, P=.002). CONCLUSIONS: The proposed mHealth intervention can improve medication adherence and health outcomes, including systolic blood pressure and diastolic blood pressure. TRIAL REGISTRATION: ClinicalTrials.gov NCT02793830; https://clinicaltrials.gov/ct2/show/NCT02793830 and ClinicalTrials.gov NCT04703439; https://clinicaltrials.gov/ct2/show/NCT04703439.

Psychometric properties and latent profile analysis of the Nursing Brand Image Scale: a methodological study in the Chinese context.

AIMS: To translate the U.S. version of the Nursing Brand Image Scale to Chinese (NBIS-C) and evaluate its psychometric properties when administered to a national sample of Chinese nurses, and identify nursing brand image profiles in Chinese nurses. DESIGN: A cross-sectional study was conducted to validate the NBIS-C among nurses in China. METHODS: The psychometric properties of the NBIS-C were tested in accordance with the COSMIN checklist. The reliability, validity, and responsiveness of the 42-item NBIS-C were examined in a national sample of 759 nurses recruited from 29 Chinese provinces. Latent Profile Analyses (LPA) were conducted to reveal nurses' perceptions of the brand image of nursing. RESULTS: Results of this study demonstrated acceptable validity (content validity, structural validity, and construct validity), reliability (internal consistency and test-retest reliability), adequate responsiveness, and no floor/ceiling effect of the NBIS-C. LPA yielded five subgroups: Integrated, Traditional, Subordinate, Creative and Leader. CONCLUSION: The psychometric properties of the NBIS-C are suitable for assessing the image of nursing among Chinese nurses. Future studies with a larger, more diverse sample are recommended. Although the role of nurses in China has evolved, nurses in general have failed to communicate a consistent, positive, and accurate brand image for the nursing profession.

The effect of group-based Otago exercise program on fear of falling and physical function among older adults living in nursing homes: A pilot trial.

This pilot trial explored the feasibility of group-based Otago exercise program (OEP) and its impact on fear of falling (FOF) and physical function among Chinese older adults living in nursing homes. The intervention group received group-based OEP for 12 weeks, while the control group received routine care. The modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE), timed Up and Go test (TUG), four-stage Balance test (FSBT), and 30 seconds sit-to-stand test (30s-SST) were used. After twelve weeks, we found that the intervention group had better outcomes than the control group in mSAFFE, TUG, FSBT and 30s-SST (p<0.05). Also, we compared the pretest-posttest results within the two groups, respectively. We found that, within the intervention group, the outcomes of mSAFFE, TUG, FSBT, and 30s-SST become significantly better after twelve weeks, but within the control group, the outcomes of TUG, FSBT, and 30s-SST become significantly worse. Our findings demonstrated that a group-based OEP was feasible and acceptability among Chinese older adults living in nursing homes and the group-based OEP could improve FOF and physical function among those older adults.

Response to the COVID-19 Outbreak in Urban Settings in China.

The COVID-19 outbreak in China was devastating and spread throughout the country before being contained. Stringent physical distancing recommendations and shelter-in-place were first introduced in the hardest-hit provinces, and by March, these recommendations were uniform throughout the country. In the presence of an evolving and deadly pandemic, we sought to investigate the impact of this pandemic on individual well-being and prevention practices among Chinese urban residents. From March 2-11, 2020, 4607 individuals were recruited from 11 provinces with varying numbers of COVID-19 cases using the social networking app WeChat to complete a brief, anonymous, online survey. The analytical sample was restricted to 2551 urban residents. Standardized scales measured generalized anxiety disorder (GAD), the primary outcome. Multiple logistic regression was conducted to identify correlates of GAD alongside assessment of community practices in response to the COVID-19 pandemic. We found that during the COVID-19 pandemic, the recommended public health practices significantly (p < 0.001) increased, including wearing facial mask, practicing physical distancing, handwashing, decreased public spitting, and going outside in urban communities. Overall, 40.3% of participants met screening criteria for GAD and 49.3%, 62.6%, and 55.4% reported that their work, social life, and family life were interrupted by anxious feelings, respectively. Independent correlates of having anxiety symptoms included being a healthcare provider (aOR = 1.58, p < 0.01), living in regions with a higher density of COVID-19 cases (aOR = 2.13, p < 0.01), having completed college (aOR = 1.38, p = 0.03), meeting screening criteria for depression (aOR = 6.03, p < 0.01), and poorer perceived health status (aOR = 1.54, p < 0.01). COVID-19 had a profound impact on the health of urban dwellers throughout China. Not only did they markedly increase their self- and community-protective behaviors, but they also experienced high levels of anxiety associated with a heightened vulnerability like depression, having poor perceived health, and the potential of increased exposure to COVID-19 such as living closer to the epicenter of the pandemic.

Does non-invasive blood pressure measurement increase the complications and decrease indwelling time of peripheral intravenous catheters: A cohort study.

AIMS AND OBJECTIVES: To explore the efficacy of non-invasive blood pressure monitors on reducing clinical complications of peripheral intravenous catheters in renal transplant recipients. BACKGROUND: A peripheral intravenous catheter is a regular route of medication administration, but the incidence of complications such as infiltration, occlusion and phlebitis perpetuates in the clinical setting. DESIGN: This was a cohort study. METHODS: Patients were placed naturally into observation group or control group according to whether or not the two procedures (non-invasive blood pressure monitoring and peripheral intravenous catheters indwelling) were on the same arm. Univariate test and Cox regression model were used to estimate relative risk factors. The STROBE checklist was used to guide the submission. RESULTS: We identified 177 kidney recipient patients during the perioperative period with 440 peripheral intravenous catheters. There were incidences of 112 (25.5%) phlebitis, 137 (31.1%) occlusion and 150 (31.8%) infiltration. There was no significant difference between incidence of phlebitis, occlusion and infiltration between the observation group and the control group (p > .05). The observation group peripheral intravenous catheters indwelling time was 97.03 ± 6.76 hr, while it was 89.22 ± 9.55 hr for the control group. However, this difference was not significant between the two groups (p > .05). Cox risk regression showed that only a high BMI was a risk factor for peripheral intravenous catheters indwelling time. CONCLUSION: Non-invasive blood pressure monitoring did not increase complications or shorten PIVCs indwelling time among renal transplant recipients. BMI represented an independent risk factor for the peripheral intravenous catheters indwelling time. RELEVANCE TO CLINICAL PRACTICE: It is not a prohibition to take non-invasive blood pressure measurement when having a peripheral intravenous catheter, especially in some special circumstances in the clinical practice or when good prevention procedures are implemented.

The effect of the group-based Otago exercise program on frailty among nursing home older adults with cognitive impairment.

This study investigated the effect of the group-based Otago exercise program (OEP) on frailty and physical function in older adults with cognitive impairment. We recruited eighteen older adults with cognitive impairment from a nursing-home to perform the OEP three times a week, for a period of three months in a nursing home. The intervention was feasible with attending an average of 21 out of 36 sessions. The frailty score decreased significantly (p<0.05). Physical function including Time Up and Go test (TUG), 30 seconds Sit-To-Stand Test (30 s-SST) and Four-Stage Balance Test was significantly positive after intervention (all p<0.001). The group-based OEP is a potentially effective strategy for reversing frailty and improving physical function among older adults with cognitive impairment.

Guest-Driven Light-Induced Spin Change in an Azobenzene Loaded Metal-Organic Framework.

Stimuli-responsive materials that can be reversibly switched by light are of immense interest. Among them, photo-responsive spin crossover (SCO) complexes have great promises to combine the photoactive inputs with multifaceted outputs into switchable materials and devices. However, the reversible control the spin-state change by photochromic guests is still challenging. Herein, we report an unprecedented guest-driven light-induced spin change (GD-LISC) in a Hofmann-type metal-organic framework (MOF), [Fe(bpn){Ag(CN)2 }2 ]⋅azobenzene. (1, bpn=1,4-bis(4-pyridyl)naphthalene). The reversible trans-cis photoisomerization of azobenzene guest upon UV/Vis irradiation in the solid-state results in the remarkable magnetic changes in a wide temperature range of 10-180 K. This finding not only establishes a new switching mechanism for SCO complexes, but also paves the way toward the development of new generation of photo-responsive magnetic materials.

Working together to learn new oral hygiene techniques: Pilot of a carepartner-assisted intervention for persons with cognitive impairment.

We pilot tested a carepartner-assisted intervention to improve oral hygiene in persons with cognitive impairment (participants) and help carepartners become leaders who can adapt approaches that foster participants' ability to develop new skills for oral hygiene care. Following the intervention, we conducted interviews with participants and carepartners to understand their challenges in working together to learn new oral hygiene skills. Participants reported challenges such as frustration using the electric toothbrush correctly, lack of desire to change, uncertainty about correctness of technique, and difficulty sustaining two minutes of toothbrushing. Carepartners reported challenges such as learning a new way of toothbrushing, learning new communication techniques, switching from instructing to working together, learning to balance leading with being too bossy, and being mindful of word choices. Findings suggested that despite challenges, participants were able to learn adaptive strategies to support new oral hygiene behaviors with support of the carepartner as the adaptive leader.

Two-Step Spin-Crossover with Three Inequivalent FeII Sites in a Two-Dimensional Hofmann-Type Coordination Polymer.

An unprecedented two-step spin-crossover behavior with the sequence of γHS =1↔γHS =3/4↔γHS =1/4 was observed in two-dimensional Hofmann type coordination polymer [Fe(isoq)2 {Ag(CN)2 }2 ] (isoq=isoquinoline), which resulted from three crystallographically inequivalent FeII sites with distinct transition temperatures.

The Determination and Correlation of Various Virulence Genes, ESBL, Serum Bactericidal Effect and Biofilm Formation of Clinical Isolated Classical Klebsiella pneumoniae and Hypervirulent Klebsiella pneumoniae from Respiratory Tract Infected Patients.

Klebsiella pneumoniae strains that are commonly recognized by clinicians and microbiologists are termed as classical K. pneumoniae (cKP). A strain with capsule-associated mucopolysaccharide web is known as hypervirulent K. pneumoniae (hvKP) as it enhances the serum resistant and biofilm production. Aim is to determine and correlate various virulence genes, ESBL, serum bactericidal effect and biofilm formation of clinical isolated cKP and hvKP from respiratory tract infected patients. A total of 96 K. pneumoniae strains were isolated from sputum of respiratory tract infected patients. The isolates were performed string test, AST, ESBL virulence gene, serum bactericidal and biofilm assays. Out of 96 isolates, 39 isolates (40.6%) were identified with hypervirulent phenotypes. The number of cKP exhibiting resistance to the tested antimicrobials and ESBLs were significantly higher than that of the hvKP strains. The virulence genes of K. pneumoniae such as K1, K2, rmpA, uge, kfu and aerobactin were strongly associated with hvKP than cKP. However, no significant difference was found in FIM-1 and MrKD3 genes. ESBL producing cKP and hvKP were significantly associated with strong biofilm formation (both P < 0.05) and highly associated with bactericidal effect of serum (both P < 0.05) than cKP strains. However, neither biofilm formation nor bactericidal effect of serum was found with significant difference in between ESBL producing cKP and ESBL producing hvKP strains (both P > 0.05). Although the hvKP possess more virulence gene, but they didn't show any significant difference between biofilm formation and bactericidal effect of serum compared with ESBL producing cKP strains.

Guest-Switchable Multi-Step Spin Transitions in an Amine-Functionalized Metal-Organic Framework.

Materials with hysteretic multi-step spin-crossover (SCO) have potential application in high-order data storage. Here, an unprecedented hysteretic four-step SCO behavior with the sequence of LS↔HS0.25 LS0.75 ↔HS0.5 LS0.5 ↔ HS0.75 LS0.25 ↔HS is found in a three-dimensional (3D) Hofmann-type metal-organic framework (MOF), which is evidenced by magnetic, differential scanning calorimetry, and crystal data. Further experiments involving guest exchange leads to the first reversible modulation of four-, two-, and one-stepped SCO behaviors, which provides a new strategy for developing multi-step SCO materials.

Symmetry-Supported Magnetic Blocking at 20 K in Pentagonal Bipyramidal Dy(III) Single-Ion Magnets.

Single-molecule magnets (SMMs) that can be trapped in one of the bistable magnetic states separated by an energy barrier are among the most promising candidates for high-density information storage, quantum processing, and spintronics. To date, a considerable series of achievements have been made. However, the presence of fast quantum tunnelling of magnetization (QTM) in most SMMs, especially in single-ion magnets (SIMs), provides a rapid relaxation route and often sets up a limit for the relaxation time. Here, we pursue the pentagonal bipyramidal symmetry to suppress the QTM and present pentagonal bipyramidal Dy(III) SIMs [Dy(Cy3PO)2(H2O)5]Cl3·(Cy3PO)·H2O·EtOH (1) and [Dy(Cy3PO)2(H2O)5]Br3·2(Cy3PO)·2H2O·2EtOH (2), (Cy3PO = tricyclohexyl phosphine oxide). Magnetic characterizations reveal their fascinating SMM properties with high energy barriers as 472(7) K for 1 and 543(2) K for 2, along with a record magnetic hysteresis temperature up to 20 K for 2. These results, combined with the ab initio calculations, offer an illuminating insight into the vast possibility and potential of what the symmetry rules can achieve in molecular magnetism.

Spin-Crossover Phenomenon in a Pentanuclear Iron(II) Cluster Helicate.

The first spin-crossover cluster helicate [{Fe(II)(µ-bpt)3}2Fe(II)3(µ3-O)][Fe(II)2(µ-Cl)(µ-bpt)(NCS)4(H2O)]·2H2O·C2H5OH [Hbpt = 3,5-bis(pyridin-2-yl)-1,2,4-triazole] was reported, in which one spin-crossover unit and one low-spin triple-stranded [Fe(II)(bpt)3](-) unit wrapped a rare planar [Fe(II)3(µ3-O)](4+) core to form a bis(triple-helical) cation with trigonal-bipyramidal topology. The origin of different magnetic behaviors of two [Fe(II)(bpt)3](-) units could be ascribed to their different intermolecular interactions.

A Clinical Multicenter Randomized Controlled Study on JianpiQinghua Decoction in Treating Stage 3 Chronic Kidney Disease with A Syndrome Type of Dampness-heat due to Spleen Deficiency.

Objective To evaluate the clinical effectiveness of JianpiQinghua decoction in treating stage 3 chronic kidney disease (CKD3) with syndrome type of dampness-heat due to spleen deficiency. Methods A multicenter, randomized, controlled, prospective, double-blind, and double-simulation study was undertaken. A total of 270 CKD3 patients with syndrome type of dampness-heat due to spleen deficiency from the outpatient departments of six general hospitals were randomly divided into telmisartan+analog traditional Chinese medicine (TA) group, traditional Chinese medicine+analog telmisartan (TCMA) group, and telmisartan+traditional Chinese medicine (TTCM) group, in which the corresponding treatment was applied in addition to basic treatment. Six months later, changes in the traditional Chinese medicine (TCM) clinical symptom scores and renal functions before and after treatment were compared among these three groups. Results Of these 270 CKD3 patients who had been enrolled in this study, 30 cases lost to follow-up. The baseline data were comparable among these three groups. After treatment, the TCM clinical symptom scores of both syndrome of spleen-qi deficiency and dampness-heat in TA group were significantly higher than those in TCMA group and TTCM group (P<0.001). With the treatment time prolonged, the TCM clinical symptom scores showed similar descending trends in TCMA group and TTCM group but were different from that in TA group. After treatment, abnormal creatinine rate decreased (P=0.003), and these three treatments and their interactions with each visit had no effect on serum urea nitrogen value (P=0.270, P=0.520); with prolonged treatment, the estimated glomerular filtration rates in three groups tended to be relatively stable after the first rise. The liver function and abnormal serum potassium rate were not statistically significant before and after treatment (P>0.05). Conclusions JianpiQinghua decoction can improve clinical symptoms of TCM in CKD3 patients with syndrome type of dampness-heat due to spleen deficiency and thus improve the quality of life and prognosis. The clinical efficacy of JianpiQinghua decoction alone or combined with telmisartan is superior to telmisartan monotherapy.