Patterns of mental health problems before and after easing COVID-19 restrictions: Evidence from a 105248-subject survey in general population in China.

BACKGROUND: The COVID-19 pandemic has alarming implications for individual and population level mental health. Although the future of COVID-19 is unknown at present, more countries or regions start to ease restrictions. The findings from this study have provided the empirical evidence of prevalence and patterns of mental disorders in Chinese general population before and after easing most COVID-19 restrictions, and information of the factors associated with these patterns. METHODS: A cross-sectional population-based online survey was carried out from February to March 2020 in the general population across all provinces in China. The 12-item General Health Questionnaire (GHQ-12) was incorporated in the survey. Latent class analyses were performed to investigate the patterns of mental disorders and multinomial logistic regressions were used to examine how individual and regional risk factors can predict mental disorder patterns. RESULTS: Four distinctive patterns of mental health were revealed in the general population. After the ease of most COVID-19 restrictions, the prevalence of high risk of mental disorders decreased from 25.8% to 20.9% and prevalence of being high risk of unhappiness and loss of confidence decreased from 10.1% to 8.1%. However, the prevalence of stressed, social dysfunction and unhappy were consistently high before and after easing restrictions. Several regional factors, such as case mortality rate and healthcare resources, were associated with mental health status. Of note, healthcare workers were less likely to have mental disorders, compared to other professionals and students. CONCLUSIONS: The dynamic management of mental health and psychosocial well-being is as important as that of physical health both before and after the ease of COVID-19 restrictions. Our findings may help in mental health interventions in other countries and regions while easing COVID-19 restrictions.

[Vitamin D3 regulates mononuclear phagocyte polarization induced by serum from patients with ankylosing spondylitis].

OBJECTIVE: To investigate the effect of vitamin D3 on polarization of monocyte macrophages induced by serum from patients with ankylosing spondylitis (AS). METHODS: Twenty AS naïve patients and 20 healthy controls from Wenzhou People's Hospital during January 2016 and December 2017 were enrolled. The macrophages were differentiated from THP1 cells induced by phorbol 12-myristate 13-acetate (PMA), and then co-cultured with the serum from healthy subjects (control group) or AS patients. Vitamin D3 was added in the medium mixed with serum from AS patients. Flow cytometry was used to analyze the ratio of CD68 and CD206 positive cells, and RT-PCR was performed to detect the mRNA expression of inducible nitric oxide synthase(iNOS) and arginase-1(Arg-1). RESULTS: THP1 cells could be polarized into mononuclear-macrophages with the induction of PMA. The proportion of CD206 positive cells in AS-serum group was lower than that in the control group (t=9.434, P<0.05), while the proportion of CD68 positive cells was higher than that in the control group (t=43.920, P<0.05). The proportion of CD206 positive cells in vitamin D3 group was higher than that in AS-serum group (t=8.895, P<0.05), while the proportion of CD68 positive cells was lower than that in AS-serum group (t=9.089, P<0.05). mRNA expression of Arg-1 in AS-serum group was lower than that in the control group (t=8.899, P<0.05), while mRNA expression of iNOS was higher than that in the control group (t=3.656, P<0.05). mRNA expression of Arg-1 in vitamin D3 group was higher than that in AS-serum group (t=6.219, P<0.05), while mRNA expression of iNOS was lower than that in AS-serum group (t=5.876, P<0.05). CONCLUSIONS: Vitamin D3 can regulate the polarization of mononuclear macrophages for immunoregulation in patients with AS.