A systematic review involving 11,187 participants evaluating the impact of COVID-19 on anxiety and depression in pregnant women.

BACKGROUND: COVID-19 has started to spread within China since the end of December 2019. As a special population, the pregnant and delivery women maybe influenced both in physical and psychological aspects. The meta-analysis was conducted about mental health in pregnant and delivery women. METHODS: We searched both MEDLINE, EMBASE, Cochrane Library in English and CBM, CNKI, WANFANG and CSSCI in Chinese to find literature from December 2019 to 31 July 2020 related to COVID-19 and mental health in patient with pregnancy and delivery, among which results such as comments, letters, reviews and case reports were excluded. The prevalence of anxiety and depression in the population was synthesized and discussed. RESULTS: A total of 11,187 subjects were included in 15 studies. Random effect model is used to account for the data by Revman 5.2. The results showed that the prevalence of depression was 30% (95% CI: 0.23-0.37), the prevalence of anxiety was 34% (95% CI: 0.26-0.43) and prevalence of both anxiety and depression was 18% (95% CI: 0.09-0.29). The prevalence of anxiety (OR = 2.15, 95% CI: 1.39-3.31, Z = 3.47, p=.0005), depression (OR = 1.95, 95% CI: 1.07-3.56, Z = 2.19, p=.03) were higher than that of controls. Significant heterogeneity was detected across studies regarding these prevalence estimates. Subgroup analysis was taken according to assessment tools, and sensitivity analysis was done to explore the sources of heterogeneity. CONCLUSIONS: The higher prevalence of depression, anxiety, both depression and anxiety in women with pregnancy and delivery during COVID-19 pandemic although the significant heterogeneity detected in studies. We must interpret the results with caution and also put attention to this result. As the epidemic is ongoing, it is vital to set up a comprehensive crisis prevention system.

Childhood infection and subsequent risk of psychotic disorders in adults: A systematic review and meta-analysis.

OBJECTIVE: The effects of childhood infection exposure on the risk of subsequent psychosis are unclear and no overview is available. We conducted a meta-analysis to assess the link between childhood infection and the risk of psychosis in later life. METHODS: We performed systematic searches of the PubMed and Embase databases to identify relevant articles published up to March 1, 2020. Random-effects models were used to pool the odds ratios [OR] of childhood infection and later psychosis. RESULTS: Thirteen observational studies (seven on hospital exposure to infection and six on central nervous system (CNS) infection) were included in the meta-analysis. Hospital contact with any infection during childhood was associated with an increased risk of psychosis (OR, 1.27; 95 % confidence interval (CI), 1.13-1.44; p < 0.001; I2 = 84 %) or schizophrenia (OR, 1.44; 95 % CI, 1.19-1.73; p < 0.001; I2 = 54.2 %) later in life. In further analysis, the association also existed for children exposed to CNS infection (OR, 1.68; 95 % CI, 1.08-2.62; p = 0.021; I2 = 68.7 %). However, the risk was modulated by the timing and frequency of infection. CONCLUSIONS: Our results suggest an increased risk of psychosis later in life with infection exposure in childhood. However, non-causal explanations for the association cannot be ruled out.

Mental Health During the Covid-19 Outbreak in China: a Meta-Analysis.

BACKGROUND: Covid-19 has started to spread within China since the end of December 2019. Despite government's immediate actions and strict control, more and more people were infected every day. As such a contagious virus can spread easily and rapidly between people, the whole country was put into lockdown and people were forced into isolation. In order to understand the impact of Covid-19 on mental health well-being, Chinese researchers have conducted several studies. However, no consistent results were obtained. Therefore, a meta-analysis was conducted. METHODS: We searched Embase, PubMed, and Web of Science databases to find literature from December 2019 to April 2020 related to Covid-19 and mental health, among which results such as comments, letters, reviews and case reports were excluded. The incidence of anxiety and depression in the population was synthesized and discussed. RESULTS: A total of 27,475 subjects were included in 12 studies. Random effect model is used to account for the data. The results showed that the incidence of anxiety was 25% (95% CI: 0.19-0.32), and the incidence of depression was 28% (95% CI: 0.17-0.38). Significant heterogeneity was detected across studies regarding these incidence estimates. Subgroup analysis included the study population and assessment tools, and sensitivity analysis was done to explore the sources of heterogeneity. CONCLUSIONS: Owing to the significant heterogeneity detected in studies regarding this pooled prevalence of anxiety and depression, we must interpret the results with caution. As the epidemic is ongoing, it is vital to set up a comprehensive crisis prevention system, which integrating epidemiological monitoring, screening and psychological crisis prevention and interventions.

Optimized integration of fluoxetine and 7, 8-dihydroxyflavone as an efficient therapy for reversing depressive-like behavior in mice during the perimenopausal period.

Fluoxetine (FLX) has been considered as an effective anti-depressant drug. Besides, previous studies reported reasonable anti-depressant effects for 7, 8-dihydroxyflavone (7, 8 DHF). However, the combination of FLX and 7, 8 DHF in a well-established depression model has not been explored. In this study, we demonstrate that the 7, 8 DHF can improve the anti-depressant efficacy of FLX in a chronic unpredictable mild stress (CUMS)-induced depression during the perimenopausal period. The corresponding mechanism of FLX+7, 8 DHF therapy and the effect of ANA-12 are also investigated. Moreover, the influences of 7, 8 DHF (5 mg/kg/day), FLX (18 mg/kg/day), and ANA-12 (0.5 mg/kg/day) on a depressive-like behavior are displayed. Inflammatory, autophagic and apoptotic changes of hippocampus and cortex are examined by using western blot, immunofluorescence, and Real-Time Quantitative reverse transcription-polymerase chain reaction (RT-qPCR) techniques. The protein levels of phosphatidylinositol 3 kinase (PI3K)/ protein kinase B (Akt)/mechanistic target of rapamycin (mTOR)/phosphorylated extracellular signal-regulated kinase1/2 (p-ErK 1/2)/brain-derived neurotrophic factor (BDNF)/tropomyosin-related kinase B (TrkB) of hippocampus and cortex are assessed by western blot. The combined FLX and 7, 8 DHF treatment can significantly improve depressive-like behavior in sucrose preference and forced swimming tests accompanied by a noticeable upregulation of autophagy, neuronal nuclei (NeuN), ionized calcium-binding adaptor molecule 1 (Iba1) expressions, and PI3K/Akt/ mTOR/ p-ErK 1/2 signaling pathways. Besides, an obvious increase of the brain-derived neurotrophic factor (BDNF) and TrkB levels are observed with down-regulated inflammation and apoptosis. These findings suggest that the integrated FLX and 7, 8 DHF holds a potential as an efficient treatment to ameliorate depressive-like behavior in perimenopausal patients.

Gracilibacillus eburneus sp.nov., a moderately halophilic bacterium isolated from Xinjiang province, China.

A novel Gram-staining positive, moderately halophilic, endospore-forming, motile, rod-shaped and strictly aerobic strain, designated YIM 93565T, was isolated from a salt lake in Xinjiang province of China and subjected to a polyphasic taxonomic study. Strain YIM 93565T grew in the range of pH 6.0-9.0 (optimum pH 7.0), 10-45 °C (optimum 35-40 °C) and at salinities of 2-24% (w/v) NaCl (optimum 7-10%). Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain YIM 93565T clustered with members of the genera Gracilibacillus and form a clade with Gracilibacillus bigeumensis KCTC 13130T (95.6% similarity) and Gracilibacillus halophilus DSM 17856T (94.9%), which was well separated from others. The DNA G + C content of this novel strain was 36.8 mol%. The major fatty acids were anteiso-C15:0, iso-C15:0, C16:0 and anteiso-C17:0 and its polar lipids consisted of diphosphatidylglycerol, phosphatidylglycerol, one unidentified glycolipid and two unidentified phospholipids. The predominant menaquinone was MK-7. The cell-wall peptidoglycan was based on meso-diaminopimelic acid. Based on the results of phylogenetic, physiological and chemotaxonomic comparative analyses, the isolate is assigned to a novel species of the genus Gracilibacillus, for which the name Gracilibacillus eburneus sp. nov. is proposed, with the type strain YIM 93565T (= DSM 23710T = CCTCC AB 2013249T).

An exploratory cross-sectional study on the impact of education on perception of stigma by Chinese patients with schizophrenia.

BACKGROUND: Stigma is a major issue across various society and cultures, and few studies focus on the perception of stigma by Chinese patients with schizophrenia. In the current cross-sectional study, we sought to assess the extent of internalized stigma among outpatients with schizophrenia in China and to investigate whether education level correlated with the experience of stigma. METHODS: Outpatients with schizophrenia were evaluated using the brief psychosis rating scale (BPRS), the positive and negative syndrome scale (PANSS), the clinical global impression-severity of illness (CGI-SI) scale and the Stigma Scale for Mental Illness (SSMI 2C). Patients were categorized into the high education and low education group according to their educational levels. RESULTS: One hundred thirty-three subjects were included in the study. Their mean course of illness was 4.32 ± 6.14 years (range, 1 month to 15 years). Their mean BPRS score was 19.87 ± 5.46, their mean PANSS score was 44.11 ± 13.1, and their mean CGI-SI score was 2.22 ± 0.81. In addition, the mean SSMI 2C score of the high education group (7.15 ± 0.98) was markedly higher than that of the low education group (5.75 ± 0.79, P < 0.05). The mean domain I score of the high education group (2.30 ± 0.76) was comparable to that of the low education group (2.07 ± 0.78, P > 0.05). The mean domain II score of the high education group (2.42 ± 0.96) was markedly higher than that of the low education group (2.01 ± 0.79, P < 0.05). Moreover, the mean domain III score of the high education group (2.43 ± 0.79) was significantly higher than that of the low education group (1.67 ± 0.77, P < 0.05). CONCLUSIONS: Education level impacts on the perception of stigma by patients with schizophrenia and more psycho-education should be done to improve patients' knowledge about schizophrenia.

Case Report of Cushing's Syndrome with an Acute Psychotic Presentation.

A 36-year-old Chinese woman was brought to the emergency department of a general hospital with a 3-day history of mania, persecutory delusions, and suicidal ideation; she also had a 6-month history of disrupted sleep, hypervigilance, and somatic symptoms. Her physical exam on admission to the psychosomatic ward identified a moon-shaped face, exophthalmos, and purple striae on her legs, so acute psychiatric symptoms secondary to Cushing's syndrome was suspected. Elevated plasma cortisol and adrenocorticotropic hormone (ACTH) and identification of a mass on her left adrenal gland on the computed tomography (CT) scan of her abdomen confirmed the diagnosis. Low dose quetiapine (75-125 mg/d) and alprazolam (0.4 mg/qn) were prescribed to control the psychotic symptoms and improve her sleep. After surgical removal of a benign ACTH-independent adrenal tumor, her cortisol and ACTH levels returned to normal and her psychiatric symptoms gradually diminished over a one-month period, at which point she was discharged. Low-dose quetiapine was continued for 2 months after discharge and then discontinued; by this time her psychiatric symptoms had completely disappeared. In this case the patient had pathognomonic symptoms of CS, so it was relatively easy to make the diagnosis; but acute psychotic symptoms in CS can be life-threatening and may not be associated with the typical physical symptoms of CS (if there is only modest hypercortisolemia), so psychiatric clinicians should always consider CS among the possible differential diagnoses for unexplained acute psychosis.

Jonesia luteola sp. nov., a bacterium isolated from Xinjiang Province, China.

A Gram-positive, facultative anaerobe microorganism, designated YIM 93067(T), was isolated from a salt lake in Xinjiang Province of China and subjected to a polyphasic taxonomic study. Strain YIM 93067(T) grew at 5-40 °C, 0-8.0 % (w/v) NaCl and pH 7.0-9.0. Phylogenetic analyses based on 16S rRNA gene sequences revealed that the organism belongs to the genus Jonesia and exhibited a sequence similarity of 98.8 % to the closely related type strain Jonesia quinghaiensis DSM 15701(T). The predominant menaquinone was MK-9 and the major fatty acids were anteiso-C15:0 and C16:0. The polar lipids consisted of diphosphatidylglycerol, glycolipid, phosphatidylglycerol, phosphatidylinositol, phosphatidylinositol mannoside and one unidentified phospholipid. The G+C content of the genomic DNA was 57.4 mol%. Based on the results of phylogenetic, physiological and chemotaxonomic comparative analyses, the isolate is assigned to a novel species of the genus Jonesia, for which the name Jonesia luteola sp. nov. is proposed, with the type strain YIM 93067(T) (=DSM 21367(T) = CCTCC AB 2014350(T)).

Skermanella rubra sp. nov., a bacterium isolated from the desert of Xinjiang, China.

A Gram-negative, pink-coloured, rod-shaped, motile bacterium, designated YIM 93097(T), was isolated from the desert soil collected from Xinjiang province of China. Strain YIM 93097(T) was found to grow at 20-45 °C (optimum 28-37 °C), pH 5.0-7.0 (optimum pH 7.0) and 0-8 % (w/v) NaCl (optimum 1 %, w/v). Based on 16S rRNA gene sequence similarity studies, it belongs to the genus Skermanella. The 16S rRNA gene sequence similarity was identified to be 98.7 % to Skermanella xinjiangensis CCTCC AB 207153(T) while the DNA-DNA hybridization value was found to be only 48.1 %. The predominant isoprenoid quinone was determined to be Q-10. The major fatty acids were identified to be C16:0, C18:1 ω7c and summed feature 4 (consisting of C17:1 anteiso B/iso I). The major polar lipids were identified as phosphatidylcholine, phosphatidylglycerol, phosphatidylethanolamine, diphosphatidylglycerol, two unidentified phospholipids and one unidentified aminolipid. The DNA G+C content was found to be 67.2 mol %. The analysis of the genotypic and phenotypic data indicated that strain YIM 93097(T) belongs to a novel species of the genus Skermanella, for which the name Skermanella rubra sp. nov. is proposed. The type strain is YIM 93097(T) (=DSM 21389(T)=CCTCC AB 2015161(T)).

Glycyrrhizic acid inhibits apoptosis and fibrosis in carbon-tetrachloride-induced rat liver injury.

AIM: To investigate anti-apoptotic effects of glycyrrhizic acid (GA) against fibrosis in carbon tetrachloride (CCl4)-induced liver injury and its contributing factors. METHODS: Liver fibrosis was induced by administration of CCl4 for 8 wk. Pathological changes in the liver of rats were examined by hematoxylin-eosin staining. Collagen fibers were detected by Sirius red staining. Hepatocyte apoptosis was determined by TUNEL assay and the expression levels of cleaved caspase-3, Bax, α-SMA, connective tissue growth factor (CTGF), matrix metalloproteinase (MMP) 2 and MMP9 proteins were evaluated by western blot analysis, and α-SMA mRNA, collagen type I and III mRNA were estimated by real-time PCR. RESULTS: Treatment with GA significantly improved the pathological changes in the liver and markedly decreased the positive area of Sirius red compared with rats in the CCl4-treated group. TUNEL assay showed that GA significantly reduced the number of TUNEL-positive cells compared with the CCl4-treated group. The expression levels of cleaved caspase-3, Bax, α-SMA, CTGF, MMP2 and MMP9 proteins, and α-SMA mRNA, collagen type I and III mRNA were also significantly reduced by GA compared with the CCl4-treated group (P < 0.05). CONCLUSION: GA treatment can ameliorate CCl4-induced liver fibrosis by inhibiting hepatocyte apoptosis and hepatic stellate cell activation.

A systematic review of Chinese randomized clinical trials of SSRI treatment of depression.

BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) have become the most frequently used antidepressants in China in recent decades. This systematic review and meta-analysis examined the efficacy and tolerability of SSRIs in Chinese studies and the quality of Chinese randomized controlled trials. METHODS: Major Western and Chinese electronic databases were searched for double-blind, parallel group randomised controlled trials (RCTs) comparing SSRIs (fluoxetine, citalopram, escitalopram, fluvoxamine, paroxetine, or sertraline) with other antidepressants such as SSRI, Selective Noradrenaline Reuptake Inhibitor (SNRI), tricyclic antidepressant (TCA), Traditional Chinese Medicine (TCM) and/or placebo. Response, remission, and dropout rates due to side effects were defined as primary outcomes. Mean total Hamilton Rating Scale of Depression (HAMD) scores at endpoint, overall dropout rates and total Treatment Emergent Symptom Scale (TESS) scores were defined as secondary outcomes. Data were combined with random effects models. Risk of bias was assessed by the Cochrane evaluation tool. Quality of reports was assessed by the fulfilment of Consolidated Standards of Reporting Trial (CONSORT) items. RESULTS: A total of 71 studies were included. Only one study was listed in both Chinese and Western databases. SSRIs were found to be more effective than TCAs. No significant differences were observed regarding dropout rates due to side effects. Using the Cochrane risk of bias tool, adequate methods of sequence generation were described in 16 (23%) studies. All authors failed to report trial registration. Informed consent, sources of funding, email address, protocol, and limitations were also not mentioned in most studies. However, reporting quality improved steadily between 1996 and 2013. CONCLUSIONS: In light of the low trial quality, the findings of a significant advantage of SSRI over TCA in terms of response rate and remission rate should be replicated by large high-quality Chinese studies.

A cross-sectional study on perception of stigma by Chinese schizophrenia patients.

OBJECTIVE: In this cross-sectional study, we sought to assess the extent of internalized stigma among inpatients and outpatients with schizophrenia in the People's Republic of China and to investigate whether education level correlated with the experience of stigma. METHODS: Schizophrenia patients were evaluated using the Brief Psychiatric Rating Scale (BPRS), the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impressions-Severity of Illness (CGI-S) scale and the Stigma Scale for Mental Illness (SSMI-C). Patients were categorized into high education and low education groups, according to their educational levels. RESULTS: One hundred thirty-three subjects were included in the study. Their mean course of illness was 4.32±6.14 years (range: 1 month to 15 years). Their mean BPRS score was 19.87±5.46, their mean PANSS score was 44.11±13.1, and their mean CGI-S score was 2.22±0.81. In addition, their mean SSMI-C score was 6.49±0.9. The mean SSMI-C score of patients who have received high school education or above was 7.15±0.98, which was markedly higher than that of patients who have received middle school education or below, which was 5.75±0.79 (P<0.05). Before the study most patients (92.5%, 123/133) took atypical drugs. CONCLUSION: Education level impacts on the perception of stigma by schizophrenia patients, and more psychoeducation should be undertaken to improve patients' knowledge about schizophrenia.

Aquisalimonas halophila sp. nov., a moderately halophilic bacterium isolated from a hypersaline mine.

A Gram-negative, moderately halophilic, strictly aerobic strain, designated YIM 95345(T), was isolated from a soil sample of a hypersaline mine in Yunnan province, PR China, and subjected to a polyphasic taxonomic study. Strain YIM 95345(T) grew at 15-45 °C (optimum 30-35 °C), 3.0-23.0% (w/v) NaCl (optimum 10.0-11.0%, w/v) and pH 6.0-9.0 (optimum pH 7.0-8.0). Phylogenetic analyses based on 16S rRNA gene sequences revealed that the organism belongs to the genus Aquisalimonas and exhibited sequence similarity of 96.6% to the sole type strain Aquisalimonas asiatica CG12(T). The predominant isoprenoid quinone was Q-8 and the major fatty acids were C16 : 0, C19 : 0 cyclo ω8c and C18 : 1ω7c. The polar lipids consisted of diphosphatidylglycerol, phosphatidylcholine, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylinositol, three aminolipids and three unidentified phospholipids. The G+C content of the genomic DNA was 59.4 mol%. Based on the results of our comparative phylogenetic, chemotaxonomic and physiological analyses, the new isolate is assigned to a novel species of the genus Aquisalimonas, for which the name Aquisalimonas halophila sp. nov. is proposed, with the type strain YIM 95345(T) ( = DSM 25902(T) = CCTCC AB 2012043(T)).