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Reconstruction of hydrological fluctuations in arid regions has proven challenging due to a lack of reliable chronologic constraints on sparse geological archives. The aim of this study was to establish an independent record of hydrologic changes in the hyper-arid Tarim Basin (TB; northwest China) with high spatiotemporal resolution. We present comprehensive radiocarbon and tree-ring data sets of subfossilized plant remains in the TB compiled from geomorphological investigations of the paleochannels of the Tarim River (TR), the longest endorheic river in China, crossing the world's second-largest shifting sand desert. Results show that the late medieval configuration of the TR basin was characterized by enhanced hydrological connectivity, as indicated by the formation of significant riparian forests in the desert regions at ca. 1170 CE. A distinct low-flow interval (ca. 1500-1650 CE) is identified for the first time, refining the period of a wetter-than-present TB. The present-day organization of streams in the lower TR was proto-formed after the dry period, possibly led by episodic flood-induced diversion. Our study describes the centennial-scale dynamics in the TR flow over the past millennium, offering a robust long-term context for hydrological assessment in the extensive drylands of the Asian interior. [ABSTRACT FROM AUTHOR]

Background: Although rarely indicated, antibiotics are commonly used for acute diarrhoea in China. We conducted a randomised, double blind exploratory clinical trial of loperamide, berberine and turmeric for treatment of acute diarrhoea. Methods: Adults with acute uncomplicated diarrhoea aged 18 to 70 were randomised to 4 groups: (A) loperamide; (B) loperamide and berberine; (C) loperamide and turmeric; (D) loperamide, berberine and turmeric. All participants were given rescue ciprofloxacin for use after 48 h if symptoms worsened or were unimproved. Primary endpoints were feasibility and ciprofloxacin use during the 2-week follow-up period. Semi-structured interviews were conducted following recruitment and were analysed thematically. Recruiting doctors, delivery pharmacists and research assistants were blinded to treatment allocation. Results: Only 21.5% (278/1295) of patients screened were deemed eligible, and 49% (136/278) of these consented and were entered into the final analysis. Most participants had mild symptoms, because most patients with moderate or severe symptoms wanted to be given antibiotics. Follow-up was good (94% at 2 weeks). Only three participants used rescue antibiotics compared to 67% of acute diarrhoea patients in the hospital during the recruitment period. The median symptom duration was 14 h in group B (interquartile range (IQR) 10-22), 16 h in group D (IQR 10-22), 18 h in group A (IQR 10-33) and 20 h in group C (IQR 16-54). Re-consultation rates were low. There were no serious treatment-related adverse events. Most interviewed participants said that although they had believed antibiotics to be effective for diarrhoea, they were surprised by their quick recovery without antibiotics in this trial. Conclusion: Although recruitment was challenging because of widespread expectations for antibiotics, patients with mild diarrhoea accepted trying an alternative. The three nutraceuticals therapy require further evaluation in a fully powered, randomised controlled trial among a broader sample. Trial registration: ChiCTR-IPR-17014107 [ABSTRACT FROM AUTHOR]