Purpose: COVID-19 pandemic has created a serious psychological impact worldwide since it has been declared. This study aims to investigate the level of psychological impacts of COVID-19 pandemic on Turkish population and to determine related factors. Methods: The study was carried out by using an online questionnaire using the virtual snowball sampling method. The sociodemographic data were collected on the following subjects: Participants’ experience on any signs of infection within the last month, the history of COVID-19 contact-treatment-quarantine, level of compliance with precautionary measures, the sources of information and level of knowledge about the pandemic process and their belief levels on the knowledge they acquire. Besides, questions that take place in the depression, anxiety, stress scale (DASS-21), and impact of events scale (IESR) were asked. Results: Of the 3549 participants, anxiety was found in 15.8%, depression in 22.6%, stress in 12.9%, and psychological trauma in 20.29%. Female gender, young age, higher education level, being single, high monthly income, presence of psychiatric illness, a high number of people living together, having any signs of infection, and contact history with COVID-19 infected person or contaminated object are identified as risk factors that may increase psychological impact. Compliance with the rules was found to reduce the risk of psychological response. Conclusions: During the pandemic, reducing the spread of the virus and knowing the risk factors in protecting the mental health of individuals will be guided in determining the measures to be followed and the policies to be followed.

Using a qualitative approach, we explored the protective roles of joint and nuclear families in shaping the life outcomes of children during COVID-19. Sixteen full-time mothers of children aged 9-12 years (8 each from joint and nuclear families) were interviewed and thematic analysis revealed five major themes viz., negative impacts, differences in positive engagement, emotional protective roles, promotion of positive health habits and activity management. Findings suggest that joint families carry more resources to positively engage their children in creativity, studies, exercise and entertainment as compared to nuclear families. Contrary to nuclear families, joint families gave emphasis to resolve emotional grievances, promote positive emotional engagement and support emotionally. The joint and nuclear families also differed in attending food habits, health grievances and physical exercise of children. The joint families played more positive roles in managing play behaviours, sleep habits, television watching and other activities of children compared to nuclear families. Keywords: children; COVID-19; joint family; life outcomes; nuclear family; thematic analysis.

The present study concerns the Stokes flow of a micropolar fluid through a porous cylinder which axis is perpendicular to the plane of flow. Stream functions, velocities, fluid pressures and stresses are evaluated for corresponding fluid flow regions. Streamlines for various values of different parameters are plotted and discussed. Also, the fluid velocity vector and microrotation vector for inside and outside the cylinder are plotted for the different values of the viscosity coefficients and discussed for boundary conditions with continuity of couple stress / continuity of tangential stress. A comparative study of the streamlines, velocity components, microrotation components is presented for two types of the boundary value problems.

We study the dynamics of a two-level crossing model with a cubic modification of the linear Landau-Zener tunneling, and express the non-adiabatic transition amplitudes in terms of the bi-confluent Heun functions which are generalizations of the confluent hypergeometric functions. We find a closed-form series expression of the transition probability at the long time limit, and derive tractable approximate formulas to the state populations by use of simple functions in a large part of the parameter space. The analytical approximations are validated by comparison with numerical results.

TITLE PAGETitle: Interesting changeover from short VA to long VA tachycardia with single atrial premature depolarisation: What is the mechanism?Short title: Concomitant AVNRT and atrial tachycardia: Killing two birds with one stone.

We thank Medina et al. for their interest in our recent work on QTc prolongation associated with treatment of COVID-19 patients with hydroxychloroquine and azithromycin. As they appropriately point out in their letter, genetic variation is likely a significant determinant of QT prolongation in the population at large and in COVID-19 patients specifically. While drugs causing acquired long QT syndrome and torsades de pointes are generally blockers of IKr, repolarization results from the aggregate of multiple inward and outward currents. Patients with sub-clinical defects in any of these ion channels can have normal or only slightly prolonged baseline QT intervals, but may possess decreased repolarization reserve leading to an exaggerated response to IKr blockade (1).  In our study, a baseline QTc of > 460 ms was associated with excessive QTc prolongation, and this likely represents a group of patients with sub-clinical cardiac ion channel mutations (so called “first hit”) (2). We also agree that many patients with latent mutations demonstrate a normal baseline QT, which gets prolonged with the addition of a drug or a change in the clinical condition “second hit” (3). The patients in our study who exhibited QTc prolongation were generally acutely ill, and displayed “multiple hits” that led to QTc prolongation and it is certainly plausible that many may have had sub-clinical cardiac ion mutations. We therefore wholeheartedly agree that pharmacogenetics should be considered in studies of drug-induced QT prolongation, however this information is rarely available to include for acutely ill patients. And while it makes sense to obtain genetic profiles prior to administration of QT-prolonging medications, that can only be performed in the elective outpatient setting, while taking into consideration medical, ethical and social issues related to asymptomatic genetic screening (e.g. cost, reimbursement, informed consent, etc…). There is significant interest in building genomic databases, and when this becomes a reality for the population at large we believe that genetic information should certainly be included in studies of QT prolongation.Roden DM Long QT syndrome: reduced repolarization reserve and the genetic link. J Intern Med. 2006 Jan; 259(1):59-69.Napolitano C, Schwartz PJ, Brown AM, et al. Evidence for a cardiac ion channel mutation underlying drug-induced QT prolongation and life-threatening arrhythmias. J Cardiovasc Electrophysiol. 2000;11:691–6Sauer AJ and Newton-Cheh C. Clinical and genetic determinants of torsade de pointes risk. Circulation. 2012;125:1684-94.

Surgery for placenta accreta spectrum overlying the cesarean scar is challenging for excessive blood loss. Elective cesarean hysterectomy without disrupting the placenta was the generally accepted approach, however, with high maternal morbidity, loss of fertility and psychological trauma. Innovative approaches are being investigated for uterine preservation. A step-by-step surgical technique was developed in our group and has been used to preserve the uterus in all severe cases with placenta increta/percreta overlying the cesarean scar. The procedure details and the surgical outcomes are provided.

In this paper, we give a new higher dimensional Hermite-Hadamard inequality for a function $f:\prod\limits_{i=1}^n[a_i,b_i]\subset\mathbb{R}^n\rightarrow\mathbb{R}$ which is semiconvex of rate $(k_1,k_2,…,k_n)$ on the co-ordinates. This generalizes some existing results on Hermite-Hadamard inequalities of S.S. Dragomir. In addition, we explain the Hermite-Hadamard inequality from the point of view of optimal mass transportation with cost function $c(x,y):=f(y-x)+\sum_{i=1}^n\frac{k_i}{2}\big|x_i-y_i\big|^2$, where $f(\cdot):\prod\limits_{i=1}^n[a_i,b_i]\rightarrow[0,\infty)$ is semiconvex of rate $(k_1,k_2,…,k_n)$ on the co-ordinates and $x=(x_1,x_2,…,x_n)$, $y=(y_1,y_2,…,y_n)\in\prod\limits_{i=1}^n[a_i,b_i]$. Furthermore, by using the higher dimensional Hermite-Hadamard inequality, we compare the transport cost in different transport models on the sphere $\mathbb{S}^2$.

Plant-herbivore-pollinator interactions are of ecological relevance for most angiosperms. However little is known on how plants evolve in response – and in particular how these tripartite interactions influence phenotypic selection on traits that link pollination and herbivory. We here conducted a common garden experiment with woodland strawberry (Fragaria vesca L.) to quantify pollinator- and herbivore-mediated selection on nine traits related to plant defence and attraction. Our results showed that pollinators imposed stronger selection than herbivores on both direct and indirect (i.e., tritrophic-related) defence traits – whereas conflicting selection was imposed on inflorescence density. However, in all cases, selection imposed by one agent was context-dependant on the other, suggesting that dynamic patterns of selection are likely a prevalent feature of these interactions. Our findings highlight the significance of plant-herbivore-pollinator interactions as potential drivers of evolutionary change, and reveal that pollinators may play a generally underappreciated role as selective agents on plant defence.

Introduction. Use of implantable endocardial electronic devices is widely increasing due to pro-longed life span of the community. Several studies evaluated the effect of right ventricular (RV) leads on tricuspid valve by three-dimensional transthoracic echocardiography (3D-TTE); howev-er, this affect has not yet been assessed by post-procedural fluoroscopy. Hence, the purpose of the current study was to evaluate the effect of RV lead placement on tricuspid valve, utilizing fluoroscopy in combination with 3D-TEE. Methods. We prospectively enrolled 59 patients who underwent clinically indicated pacemaker or implantable cardioverter defibrillator (ICD) implantation. Vena contracta (VC) and tricuspid regurgitation (TR) severity were measured using two-dimensional transthoracic echocardiography (2D-TTE) at baseline. Follow up 3D-TTE was performed six months after device implantation to assess TR severity and RV lead location. Results. TR VC was increased after the lead placement, compared to the baseline study (VC: 3.86 ± 2.32 vs 3.18 ± 2.39; p = 0.005). The mean changes in VC levels were 1.14 ± 0.67 mm (Range: -0.4-2.5 mm) after inserting the lead. Among all investigated parameters, VC changes were predicted based on lead placement position only in 3D-TTE (p<0.001) while the other var-iables including fluoroscopy parameters were not predictive. Conclusion. The RV Lead location examined by 3D-TTE seems to be a valuable parameter to predict the changes in the severity of the tricuspid regurgitation. Fluoroscopy findings did not improve the predictive performance ,at least in short term follow up.

Objectives:To identify the best parameter(pubis-cervix measurement, pubis-uterine fundus measurement or pubis-Douglas cul-de-sac measurement) on transperineal ultrasound, based on the difference between measurements taken at rest and with the Valsalva maneuver, for differential diagnosis presurgical between uterine prolapse (UP) and cervical elongation(CE) without UP. Design:Observational prospective cohort study. Setting:Valme University Hospital, Seville, Spain. Sample:60 consecutively recruited patients who underwent corrective surgery of the middle compartment (UP or CE without UP). Methods:A transperineal ultrasound was performed, and the descent of the pelvic organ was measured in relation to the posteroinferior margin of the pubis in the midsagittal plane, referencing the uterine fundus, Douglas cul-de-sac and the cervix. Main outcome measures:Difference between measurements taken at rest and with the Valsalva for the uterine fundus, Douglas cul-de-sac and the cervix maneuver. Results:Receiver-operating characteristic(ROC) curves were constructed for the three evaluated measures, based on the difference between rest and Valsalva, for the diagnosis of UP. For the pubis-cervix distance, an area under the curve(AUC) of 0.59 was obtained; for the pubis-uterine fundus distance, the AUC was 0.81; and for the pubis-Douglas cul-de-sac distance, the AUC was 0.69. Based on the best AUC(the difference in the pubis-uterine fundus distance at rest and with the Valsalva maneuver), a cut-off point of 15 mm was established for the diagnosis of UP (sensitivity:75%; specificity:95%; positive predictive value:86% and negative predictive value:89%). Conclusions:A difference ≥15 mm in the pubis-uterine fundus distance at rest and with the Valsalva maneuver is useful to differentiate UP from CE without UP by ultrasound.

Rationale, aims, and objectives; During the influenza season, most patients suspected of having influenza undergo rapid influenza diagnostic tests (RIDTs) in Japan despite their low sensitivity. However, the physician’s actual rationale for prescribing antivirals, besides the results of RIDTs, remains poorly understood. Our study sought to identify the role of clinical information and physicians’ experience in the initiation of anti-influenza agents. Method; We retrospectively reviewed 380 patients who underwent RIDTs at the emergency department of our hospital from September 2018 to May 2019. Data regarding sex, age, etc., which could affect the decision of prescribing antivirals, were extracted from medical records. We performed logistic regression analysis to analyze the concurrent effect of potentially relevant clinical factors, results of RIDTs, and the physician’s status on antiviral prescription. Results; Multivariable analysis revealed that a positive RIDT had the largest effect on antiviral prescription, followed by physician status, high regional influenza activity, and patients’ presentation within 12 hours of symptom onset. Patient’s age, comorbidities, and presentation after 48 hours of symptom onset were not associated with antiviral treatment. Physicians with more years of experience were significantly more likely to prescribe antivirals for patients with low risk of complications. Conclusions; Our findings revealed the physicians’ rationale for initiating antiviral treatment and the discrepancy with guideline indications of antivirals, which is patient’s age and comorbidities. Physicians, especially those with more than 3 years of experience, frequently prescribed antivirals for patients with low risk of complications; thus, educational interventions against this population could be useful to improve this situation.

Objective: To determine the association of sleep duration and screen time with anxiety among pregnant women under COVID-19 pandemic scenario. Design: Cross-sectional study. Population: A total of 1794 pregnant women cover the whole pregnant period. Methods: We conducted one large-scale, multicenter cross-sectional study which recruited 1794 pregnant women across China. The demographic factor, lifestyle, and mental health of participants were submitted online in self-reported manner by the pregnant women during 6 February to 8 May, 2020. We further investigated the association of sleep duration and screen time with the risk of anxiety by multivariable logistic regression analysis and linear regression analysis after adjusting the potential confounders. Moreover, stratification analysis was subsequently conducted for controlling potential confounders. Main outcome measures: the dependent and interactive effect of sleep duration and screen time with anxiety among pregnant women. Results: Our data revealed that 35% of pregnant women suffered from anxiety during the COVID-19 pandemic. Sleep duration was dose-dependently associated with lower risk of anxiety among pregnant women (OR 0.418: 95%CI 0.276-0.630), while screen time exhibited conversed effect (OR 2.017: 95%CI 1.008-4.399). Notably, sleep duration(>7h/day) together with screen time(3-6h/day) diminished the risk of anxiety (OR 0.708: 95%CI 0.503-0.997). Conclusion: Taken together, sleep duration and screen time were independently and jointly associated with anxiety. Therefore, promoting more active lifestyle and maintaining higher sleep quality could protect mental health of pregnant women, especially under public health emergency. Funding: This work was funded by National Key R&D Program of China (2018YFC1004300, 2018YFC1004304).

Epileptic seizures can be difficult to distinguish from other etiologies that cause cerebral hypoxia, especially cardiac diseases. Long QT syndrome (LQTS), especially LQTS type 2 (LQT2), frequently masquerades as seizures because of the transient hypoxia caused by ventricular arrhythmia. Early and correct diagnosis of LQTS effectively prevents inappropriate treatment with anti-epileptic drugs (AEDs) and sudden death. We report a case of congenital LQT2 with potassium voltage-gated channel subfamily H member 2 gene (KCNH2) mutation misdiagnosed as refractory epilepsy and treated with various AEDs for 22 years. The possibility of cardiac arrhythmia was suspected after the electrocardiograph (ECG) monitor in emergency room showed paroxysmal ventricular tachycardia during attacks. Atypical seizure like attacks with prodromal uncomfortable chest sensation and palpitation, triggered by auditory stimulation, and typical ventricular tachycardia monitored by ECG raised suspicion for LQT2, which was confirmed by exome sequencing. Although the patient rejected implantation of an implantable cardioverter defibrillator, β-blocker was given and the syncope only attacked 1-2 per year when there was an incentive. Our case illustrates how long LQTS can masquerade convincingly as epilepsy and be treated wrongly with AEDs, putting the patient at high risk of sudden death. Careful ECG evaluation is recommend for both patients with first seizure and those with refractory epilepsy.

TitleOn Metabolism: Ensuring Our Health Care System Remains “Ready-to-Hand”

Objective: To identify the current situation and further research direction of clinical pathway management in China. Methods: The published time, research institutions, key words of the literatures obtained from China National Knowledge Infrastructure (CNKI), VIP and Wanfang databases were analyzed by using Citespace software. Results: The clinical pathway research in China has been carried out for 20 years, with delivering about447.3 articles per year. The number of articles reached its peak in 2012, and then decreased year by year. The research field focuses on nursing clinical pathway, health education and clinical pathway teaching, and the research institutions are scattered and lack of inter-agency cooperation. Conclusions: At present, the clinical pathway research in China is insufficient incorporation with medical quality control and performance evaluation, the adjustment of medical service expenses, the reform of payment mode, and the information construction of medical institutions. Practice Implications: How to combine clinical pathway effectively with medical quality control, with DRGs performance evaluation, with medical insurance payment reform, with information construction and with hierarchical diagnosis and treatment, is worthy of deep exploration.

Purpose：Cisplatin-induced nephrotoxicity (CIN) is still the most serious side effect limiting the use of cisplatin. It affects up to 20% of patients. So, there are many precautions to avoid it. The purpose of this study was to conduct a systematic review and meta-analysis to evaluate and determine different hydration options that could provide protection against cisplatin-induced nephrotoxicity. Methods：A computerized literature search of PubMed, Embase, and Cochrane databases was performed. Trials were eligible if they enrolled patients receiving cisplatin and participants to receive different hydration options to prevent nephrotoxicity. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for combinations of studies. Results：Within 1111 eligible studies, 31 articles fulfilling the selection criteria were included in the review. A meta-analysis could only be performed on the 9 retrospective studies concerning magnesium supplementation, and showed nephroprotective effect of CIN (OR0.21, [0.59–0.29]). Conclusion：Although up to now, there is no one method of prevention that shows its indisputable efficacy, our results highlight the potential protective effect of magnesium supplementation on CIN.

Objective: To evaluate the effect of maternal sleep duration (MSD) on low birth weight infants (LBW), small for gestational age infants (SGA), and macrosomia. Design: Prospective cohort study Setting: The Japan Environment and Children’s Study (JECS) Population: Participants enrolled in JECS, with singleton pregnancies after 22 weeks, who gave birth between 2011 and 2014. Methods: Participants were categorized into five groups according to MSD during pregnancy: G1 (MSD <6.0 h), G2 (6.0–7.9 h), G3 (8.0–8.9 h), G4 (9.0–9.9 h), and G5 (10.0–12.0 h). Main outcome measures: The effect of MSD on the risk of LBW (<2,500 g and <1,500 g), SGA, and macrosomia (>4,000 g) with G2 as the reference, while adjusting for gestational excessive body weight gain (BWG). Analysis was also performed after stratification by gestational BWG. Results: We analyzed 82,171 participants. The adjusted odds ratios (aORs) of LBW <2,500 g in G4 and G5 and of SGA in G4 were 0.90 (95% confidence interval [CI], 0.83-0.99), 0.86 (95% CI, 0.76-0.99), and 0.91 (95% CI, 0.82-0.99), respectively, before adjusting for excessive gestational BWG. No significant association was observed between MSD and these outcomes after adjusting for excessive gestational BWG. Among women with appropriate gestational BWG, the aORs of LBW <2,500 g and SGA in G4 were 0.88 (95% CI, 0.80-0.97) and 0.87 (95% CI, 0.78-0.97), respectively. Conclusion: This study revealed that 9.0–9.9 h of MSD significantly decreased LBW <2,500 g and SGA in pregnant women with appropriate gestational BWG, relative to 6.0–7.9 h of MSD.

Echocardiography is the most widely used diagnostic tool for detecting the cardiac functional changes. Pregnancy is a dynamic process that affects cardiovascular system. Recent studies showed that increased parity may cause irreversible changes in cardiovascular system. In this study, we aimed to evaluate echocardiographic changes on women, especially grand multiparous (up to 9 parities) and great grand multiparous (more than 10 parities) women after all their pregnancies finished. This is a cross-sectional study and contains 195 women patients. Women with one delivery history was defined as primiparous (PP), 2 to 5 deliveries were defined as multiparous (MP), 5 to 9 deliveries were defined as grand multiparous (GMP) and more than 9 deliveries were defined as great grand multiparous (GGMP). The mean age was 50.6±16.3 and mean parity was 6.5±4.2. Spearman correlation analysis showed that diastolic dysfunction has positive correlations with parity, age, hypertension, and diabetes mellitus. ROC analysis showed that the best cut-off value of the parity number for predicting left ventricular diastolic dysfunction was 6.5, with 66.3% sensitivity and 66.7% specificity. In present study, we showed that diastolic dysfunction statistically increases as the number of pregnancies increases. Additionally, cut of value of parity for diastolic dysfunction was 6.5 which is higher than other studies.

The Heinitang hot spring is located in the western Yunnan of China and lies in the Tibet-Yunnan geothermal zone and the Tengchong Block. The hot water is of HCO3-Ca•Na type and the F concentration is relatively high (ranging from 3.8 to 5 mg/L). Fossil travertine mounds and cones and new travertine are found at the spring vents. Hydrochemical analyses indicate that the primary factor affecting the deposition of travertine is the concentration of ion pair CaCO30 in the Heinitang hot springs. The Heinitang hot spring shows a positive correlation between the concentration of CaCO30 and the saturation index with respect to aragonite, calcite and dolomite. They are not linearly related, but have an exponential relationship. When the aragonite, calcite and dolomite are in the state of dissolved equilibrium, the corresponding concentrations of CaCO30 are 0.01 mmol/L, 0.008 mmol/L and 0.012 mmol/L, respectively, indicating that the precipitation of travertine can occur when the concentration of CaCO30 is higher than 0.008 mmol/L. In addition, the concentrations of CaCO30 in the Heinitang hot springs decrease gradually with the deposition of travertine. The precipitation of travertine cannot occur when the concentration of CaCO30 decreases to lower than 0.008 mmol/L.

Objective To explore the Chinese reproductive-aged individual’s awareness, wishes, and possible misconceptions of ECS as well as factors affecting their decision-making. Design Anonymous, electronic questionnaire conducted in 5 months. Setting Women’s Hospital of Nanjing Medical University, Jiangsu, China. Population Chinese reproductive-aged individuals with a partner (aged 18-45 years). Methods Chi-square test and multivariate logistic regression to check the potential association between factors with intention of ECS. Main outcome measures Willingness to take ECS testing at own expenses. Results Only 35.0% were aware of ECS, while 93.1% of participants had the intention of ECS at their expenses, and 96.5% of participants had misconceptions of ECS and genetic diseases. Meanwhile, 53.6% would pay less than 1,000 CNY (approximately 145 US Dollars) for the test. Participants whose first reaction was of interests, who had prior awareness of the test, or who perceived the benefits were more likely to intend to use ECS (p<0.001). Participants with bachelor’s or above degrees or with the household income more than 150,000 CNY (approximately 21,700 US Dollars) were more likely to pay 1,000 CNY and greater (p<0.05). Conclusions The Chinese reproductive population had an overall positive attitude towards ECS, with some misconceptions on ECS and genetic disorders. Thus, population-based implementation of ECS is clinically feasible in China, but pre- and post-test education and genetic counselling are required to raise their awareness and to reduce misconceptions. Keywords expanded carrier screening, attitudes, preconception, misconceptions, questionnaire.

Antimicrobial peptides (AMPs) are the arsenals of the innate host defense system exhibiting the ancient evolutionarily conserved characteristics that is present in practically all forms of life. Recent years have witnessed emergence of antibiotic resistant bacteria compounded with a slow discovery rate for new antibiotics that has necessitated scientific efforts to search for alternatives to antibiotics. Research on the identification of AMPs has generated very encouraging evidences that they curb infectious pathologies and are also useful as novel biologics to function as immunotherapeutic agents. Being innate, they exhibit least toxicity to the host and exert wide spectrum of biological activity including low resistance among microbes, and increased wound healing actions. Notably, in veterinary science, the constant practice of massive doses of antibiotics with inappropriate withdrawal programs led to the high risk of livestock-associated antimicrobial resistance. Therefore, the world faces tremendous pressure for designing and devising strategies to mitigate the use of antibiotics in animals and keep it safe for the posterity. In this review, we illustrate the diversity of farm animals specific AMPs, their biochemical foundations, mode of action and prospective application in clinics. Subsequently, we present the data for their systematic classification by the major and minor groups, antipathogenic action, and allied bioactivities in the host. Finally, we address the limitations to their clinical implementation and envision areas for further advancement.

Seasonal freeze-thawing affects soil water migration and distribution, especially in semi-arid degraded agricultural areas, with important impacts on crop production, and wind erosion. We assessed the distribution and migration of soil water in degraded agricultural areas during freeze-thawing and the effect on plant growth and wind erosion. Soil water content (SWC) and soil temperature (ST) dynamic characteristics at a depth of 0-2 m in the semi-arid agro-pastoral northern China are discussed, using data from November 2018 to May 2019. Changes in water potential energy and pore pressure gradient caused soil water migration to the upper layer, which led to a slight decrease in SWC at each layer before ST dropped to the freezing point. The vertical migration distance of soil water exceeded 70 cm, and the SWC above a depth of 100 cm increased significantly during thawing; the water was mainly obtained from the soil layer below a depth of 120 cm. The initial SWC is the main factor affecting the freeze-thawing process. Our results can partly explain the occurrence of wind erosion in spring and provide a scientific basis for predicting soil water status and developing irrigation and erosion control strategies.

Reforestation and check dam construction have been progressively implemented on the Loess Plateau for several decades. However, it is still unclear how the two major sediment control strategies affect soil erosion and sediment yield in a large watershed. A combination of field investigation and model simulation was employed to quantitatively identify the impacts of the two measures on soil erosion and sediment yield in the Kuye River watershed. Significant land use changes, with the conversion of arable land and bare land to vegetation cover and construction land, occurred in the study watershed from 1987 to 2016. In addition, 306 key dams were built in the watershed, with a total storage capacity of 316.64 Mm3, according to the statistical data of 2011. Hot spot analysis showed that the high-risk regions for soil erosion and sediment yield were mainly concentrated on the periphery of Shenmu County and the outlet of the watershed. The simulation results showed that the land use changes from 1987 to 2016 remarkably reduced sediment yield by 51.14% without considering the action of check dams. In the 1987 scenario, the sediment yield was reduced by 50.44% when considering the action of check dams compared with the yield that was estimated without consideration of check dams. Under the combined effect of the two factors, the sediment yield decreased by 73.91% in 2016. More attention should be paid to check dams, and corresponding measures should be taken to protect them, especially in the flood period.