BackgroundThe association between ages and psychological impact of natural disasters has not been well characterized. A population-based study was conducted 15 months after the 2008 Sichuan earthquake to assess whether elderly survivors were more likely to develop posttraumatic stress disorder (PTSD) and general psychiatric morbidity.MethodsA population-based survey of 327 survivors (152 elders, 175 younger adults) was conducted in severely affected areas by the earthquake, using a multi-stage systematic sampling design.ResultsCompared with the younger adult survivors, the elderly were more likely to have symptoms of PTSD (22.5% vs. 8.0%, p = 0.001) and general psychiatric morbidity (42.0% vs. 25.4%, p = 0.003). Risk factors, such as being elderly, having been in serious danger, having lost family members, and having felt guilt concerning one's death or injury were significantly associated with developing PTSD; being elderly, having family members or friends seriously injured, and having felt guilt concerning one's death or injury were significantly associated with developing general psychiatric morbidity. Utilization of mental health services is strongly associated with the decreased risk for developing both of the symptoms.ConclusionCompared with the younger adults, the elderly survivors were more likely to develop PTSD and general psychiatric morbidity. More mental health services should be distributed to the elderly and groups at particular risk, to ensure their smooth mental health reconstruction after the earthquake.

Left-behind children are at significant risk for loneliness. More specific investigations targeted towards the psychological well-being of these children are needed to identify the underlying preventable risk factors.

More than one in five child survivors were identified as having PTSD or depression; HRQoL of these identified children were deeply compromised. Utilization of mental health services may significantly reduce the risk of developing PTSD symptoms.

C-reactive protein (CRP) 3 is a major human acute phase reactant composed of five identical subunits (1, 2). Accumulating evidence demonstrates that the actions of CRP depend on conformation and localization (3-5). CRP is primarily produced by the liver and circulates in the blood as a pentamer but is induced to dissociate into subunits (monomeric CRP, mCRP) upon interaction with the microenvironment at inflammatory loci (6 -18). mCRP exhibits markedly enhanced activities and recognizes an expanded list of binding partners. Following reduction of the intra-subunit disulfide bond, mCRP can be further activated (19). The degradation of mCRP, on the other hand, would generate bioactive fragments showing anti-inflammatory actions (20 -23). The differential contributions of these CRP conformations at distinct locations may therefore account for the intense controversies regarding the function of CRP in animal models and in clinical studies (3-5). mCRP appears to be the major conformation of CRP that regulates local inflammation (3-5), yet how it acts remains incompletely understood. In particular, though the markedly enhanced binding capability of mCRP underlies its actions, little is known through which sites mCRP recognizes diverse ligands. Consequently, no means is available to specifically modulate the actions of mCRP, which is necessary for clarifying the exact contributions of different CRP conformations in vitro and in vivo. The current study was designed to identify the recognition site of mCRP for ligand binding. The results unexpectedly demonstrated cholesterol binding sequence (CBS) as a versatile motif that mediates the interactions of mCRP with different types of ligands, including two newly identified herein. We further showed that synthetic CBS peptide was able to inhibit the proinflammatory actions of mCRP both in vitro and in vivo. Hence, optimized CBS peptide may be developed as a potential inhibitor of mCRP. Experimental ProceduresReagents-Human native CRP (purity Ͼ 99%) purified from ascites was purchased from the BindingSite (Birmingham, UK; catalogue number: BP300.X). mCRP and acylated Cys-mutated mCRP was prepared as described (19,24). Proteins were dialyzed to remove NaN 3 , and passed through Detoxi-Gel Columns (Thermo Fisher Scientific, Rockford, IL; catalogue number: 20344) to remove endotoxin when necessary. CRP peptides (purity Ͼ 98%) were synthesized by Science Peptide Biological Technology (Shanghai, China). Lyophilized peptides were reconstituted aseptically with DMSO at 40 mg/ml and stored at Ϫ20°C in aliquots or kept at 4°C for a maximum of 1 week.

BackgroundThe study was implemented to examine the relationship between traumatic experiences and longitudinal development of mental health for children and adolescents who survived the 2008 Sichuan earthquake.MethodsUsing the method of multistage systematic sampling, 596 children aged between 8 and 16 years were randomly selected from severely affected areas of the earthquake. These children were interviewed with standardized instruments of posttraumatic stress disorder (PTSD) and depression at the 15th month after the earthquake, and re-interviewed at the 36th month.ResultsFrom the initial to the follow-up assessments, there were no significant changes in both PTSD and depression scores. In addition, no significant change was found on the overall prevalence rates of the symptoms: from 12.4% to 10.7% for PTSD, from 13.9% to 13.5% for depression, and from 4.2% to 4.7% for their co-occurrence. The study also indicated that the earthquake might have a delayed impact on the psychosocial functioning of children and adolescents who were not directly affected by the disaster.ConclusionsFor child and adolescent survivors of the earthquake, symptoms of PTSD and depression seemed to persist over time. The finding that children reduced their use of mental health services raised great concerns over how to fulfill the unmet psychological needs of these children. More mental health interventions should be allocated to children who had elevated risk for developing persistent course of the symptoms.

Left-behind children report poorer HRQOL than non-left-behind children due to psychosocial dysfunction. An assessment of such problems is essential to estimate the need of rural children, for the identification of those at particular risk for lower quality of life, and for planning and implementation of appropriate health interventions.

C-reactive protein (CRP) is an established marker of rheumatoid arthritis (RA) but with ill-defined actions in the pathogenesis. Here, we show that CRP regulates the differentiation of osteoclasts, a central mediator of joint inflammation and bone erosion in RA, in a conformation- and receptor activator of NF-κB ligand (RANKL)-dependent manner. CRP in the native conformation is ineffective, whereas the monomeric conformation (mCRP) actively modulates osteoclast differentiation through NF-κB and phospholipase C signaling. Moreover, mCRP can bind RANKL, the major driver of osteoclast differentiation, and abrogate its activities. The binding and inhibition of RANKL are mediated by the cholesterol binding sequence (CBS) of mCRP. Corroborating the in vitro results, CRP knockout exacerbates LPS-induced bone resorption in mice. These results suggest that mCRP may be protective in joint inflammation by inhibiting pathological osteoclast differentiation and that the CBS peptide could be exploited as a potential RANKL inhibitor.

After the Wenchuan earthquake, a large number of studies have focused on postearthquake psychological disorders among survivors; however, most of these studies were conducted within a relatively short period. This study was conducted to examine the symptoms of posttraumatic stress disorder (PTSD) and general psychiatric morbidity among adult survivors 3 years after the Wenchuan earthquake, China. Through a multistage systematic sampling approach, a cross-sectional survey of 360 participants, 18 years or older, was conducted. The prevalence of PTSD and general psychiatric morbidity was 10.3% and 20.6%, respectively. Multivariate analysis revealed significant predictors for PTSD, including female gender and having felt guilt concerning someone's death or injury. Significant predictors for general psychiatric morbidity included unmarried status and having been in serious danger. These results suggest that mental health services should be continuously available to earthquake survivors.