Longitudinal changes in mental health among medical students in China during the COVID-19 epidemic: depression, anxiety and stress at 1-year follow -up.

This study aimed to evaluate the influence of COVID-19 on the mental health of Chinese medical students at 1-year of follow-up. From 2 February 2020 to 23 February 2021, we conducted three waves of research online (T1 = during outbreak, T2 = controlling period, T3 = 1 year after outbreak). The survey collected demographic data and several self reporting questionnaires to measure the depressive, anxiety and stress symptoms. A total of 4002 participants complete the whole research phases. The study major, grade level and gender were the main factors related to psychological distress caused by the COVID-19 crisis. Importantly, medical knowledge has a protective effect on medical students' psychological distress during the COVID-19 period.

Detection and genetic characterization of canine kobuvirus from stray dogs in Shanghai, China.

In this study, rectal samples collected from 60 stray dogs in dog shelters were screened for canine kobuvirus and other enteroviruses by quantitative real-time reverse transcription polymerase chain reaction. Canine kobuvirus was detected in 25% (15/60) of the samples. In the 15 positive samples, the coinfection rates of canine distemper virus, canine coronavirus, canine astrovirus, canine norovirus, and canine rotavirus were 26.67%, 20.00%, 73.33%, 0%, and 20.00%, respectively. Phylogenetic analysis based on partial VP1 sequences identified a novel canine kobuvirus that was a recombinant of canine and feline kobuvirus. Bayesian evolutionary analysis revealed that the rate of evolution of the VP1 gene of canine kobuvirus was 1.36 × 10-4 substitutions per site per year (95% highest posterior density interval, 6.28 × 10-7 - 4.30 × 10-4 substitutions per site per year). Finally, the divergence time of VP1 was around 19.44 years ago (95% highest posterior density interval, 12.96-27.57 years).

Depression and Anxiety During the COVID-19 Pandemic: Epidemiology, Mechanism, and Treatment.

The Coronavirus Disease 2019 (COVID-19) pandemic has had an adverse impact on the physical and mental health of the public worldwide. In addition to illness in patients with COVID-19, isolated people and the general population have experienced mental health problems due to social distancing policies, mandatory lockdown, and other psychosocial factors, and the prevalence of depression and anxiety significantly increased during the pandemic. The purpose of this review is to elucidate the epidemiology, contributing factors, and pathogenesis of depression and anxiety. during the pandemic. These findings indicate that physicians and psychiatrists should pay more attention to and identify those with a high risk for mental problems, such as females, younger people, unmarried people, and those with a low educational level. In addition, researchers should focus on identifying the neural and neuroimmune mechanisms involved in depression and anxiety, and assess the intestinal microbiome to identify effective biomarkers. We also provide an overview of various intervention methods, including pharmacological treatment, psychological therapy, and physiotherapy, to provide a reference for different populations to guide the development of optimized intervention methods.

Identification of potential anti-pneumonia pharmacological components of Glycyrrhizae Radix et Rhizoma after the treatment with Gan An He Ji oral liquid.

Glycyrrhizae Radix et Rhizoma, a traditional Chinese medicine also known as Gan Cao (GC), is frequently included in clinical prescriptions for the treatment of pneumonia. However, the pharmacological components of GC for pneumonia treatment are rarely explored. Gan An He Ji oral liquid (GAHJ) has a simple composition and contains GC liquid extracts and paregoric, and has been used clinically for many years. Therefore, GAHJ was selected as a compound preparation for the study of GC in the treatment of pneumonia. We conducted an in vivo study of patients with pneumonia undergoing GAHJ treatments for three days. Using the intelligent mass spectrometry data-processing technologies to analyze the metabolism of GC in vivo, we obtained 168 related components of GC in humans, consisting of 24 prototype components and 144 metabolites, with 135 compounds screened in plasma and 82 in urine. After analysis of the metabolic transformation relationship and relative exposure, six components (liquiritin, liquiritigenin, glycyrrhizin, glycyrrhetinic acid, daidzin, and formononetin) were selected as potential effective components. The experimental results based on two animal pneumonia models and the inflammatory cell model showed that the mixture of these six components was effective in the treatment of pneumonia and lung injury and could effectively downregulate the level of inducible nitric oxide synthase (iNOS). Interestingly, glycyrrhetinic acid exhibited the strongest inhibition on iNOS and the highest exposure in vivo. The following molecular dynamic simulations indicated a strong bond between glycyrrhetinic acid and iNOS. Thus, the current study provides a pharmaceutical basis for GC and reveals the possible corresponding mechanisms in pneumonia treatment.

Exploration of Q-Marker of Rhubarb Based on Intelligent Data Processing Techniques and the AUC Pooled Method.

Rhubarb, as a traditional Chinese medicine, has several positive therapeutic effects, such as purging and attacking accumulation, clearing heat and purging fire, cooling blood, and detoxification. Recently, Rhubarb has been used in prescriptions for the prevention and treatment of COVID-19, with good efficacy. However, the exploration of effective quantitative approach to ensure the consistency of rhubarb's therapeutic efficacy remains a challenge. In this case, this study aims to use non-targeted and targeted data mining technologies for its exploration and has comprehensively identified 72 rhubarb-related components in human plasma for the first time. In details, the area under the time-concentration curve (AUC)-pooled method was used to quickly screen the components with high exposure, and the main components were analyzed using Pearson correlation and other statistical analyses. Interestingly, the prototype component (rhein) with high exposure could be selected out as a Q-marker, which could also reflect the metabolic status changes of rhubarb anthraquinone in human. Furthermore, after comparing the metabolism of different species, mice were selected as model animals to verify the pharmacodynamics of rhein. The in vivo experimental results showed that rhein has a positive therapeutic effect on pneumonia, significantly reducing the concentration of pro-inflammatory factors [interleukin (IL)-6 and IL-1ß] and improving lung disease. In short, based on the perspective of human exposure, this study comprehensively used intelligent data post-processing technologies and the AUC-pooled method to establish that rhein can be chosen as a Q-marker for rhubarb, whose content needs to be monitored individually.

Efficacy and safety of a self-developed home-based enhanced knee flexion exercise program compared with standard supervised physiotherapy to improve mobility and quality of life after total knee arthroplasty: a randomized control study.

BACKGROUND: This randomized controlled study compared standard supervised physiotherapy (SPT) with a self-developed, home-based, enhanced knee flexion exercise program involving a low stool (KFEH) in patients who underwent total knee arthroplasty (TKA). METHODS: Patients were recruited from July 2014 to December 2015 and randomly assigned to one of two groups: KFEH (n = 60) and SPT (n = 59). Outcomes (joint function) were evaluated according to the Knee Society Score (KSS), visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and range of motion (ROM) assessment at selected time points (preoperatively; 1 week; 1, 3, and 6 months; and 1 year after surgery). RESULTS: Pain and functional improvement were observed in both groups. Non-inferiority of KFEH was evident 12 months postoperatively; however, patients in the KFEH group exhibited better ROM at 1 month (P < 0.01). Absolute WOMAC and KSS scores were slightly better in the KFEH group, although the difference was not statistically significant. There was no difference in VAS scores and complication rates between the two groups. Additionally, the home program would save patient time and decrease the economic burden associated with in-hospital SPT. CONCLUSION: Considering rehabilitation and economic efficiency as well as the COVID pandemic, a home-based enhanced knee flexion exercise program for TKA rehabilitation is recommended.

Obesity aggravates COVID-19: A systematic review and meta-analysis.

Obesity and COVID-19 are both worldwide epidemics now. There may be some potential relationships between them, but little is known. This study was done to explore this relationship through literature search, systematic review, and meta-analysis. Pubmed, Embase, WOS, Cochrane, CNKI, Wanfang, and Sinomed databases were searched to collect literature concerning obesity and COVID-19. Systematic review and meta-analysis were conducted after literature screening, quality assessment, and data extraction. A total of 180 articles were initially searched after duplicate removal, and 9 were finally included in our analysis. Results show that severe COVID-19 patients have a higher body mass index than non-severe ones (WMD = 2.67; 95% CI, 1.52-3.82); COVID-19 patients with obesity were more severely affected and have a worse outcome than those without (OR = 2.31; 95% CI, 1.3-4.12). Obesity may aggravate COVID-19.

Obesity aggravates COVID-19: An updated systematic review and meta-analysis.

This review aimed to evaluate the impact of obesity on the onset, exacerbation, and mortality of coronavirus disease 2019 (COVID-19); and compare the effects of different degrees of obesity. PubMed, EMBASE, and Web of Science were searched to find articles published between December 1, 2019, and July 27, 2020. Only observational studies with specific obesity definition were included. Literature screening and data extraction were conducted simultaneously by two researchers. A random-effects model was used to merge the effect quantity. Sensitivity analysis, subgroup analysis, and meta-regression analysis were used to deal with the heterogeneity among studies. Forty-one studies with 219,543 subjects and 115,635 COVID-19 patients were included. Subjects with obesity were more likely to have positive SARS-CoV-2 test results (OR = 1.50; 95% CI: 1.37-1.63, I2 = 69.2%); COVID-19 patients with obesity had a higher incidence of hospitalization (OR = 1.54, 95% CI: 1.33-1.78, I2 = 60.9%); hospitalized COVID-19 patients with obesity had a higher incidence of intensive care unit admission (OR = 1.48, 95% CI: 1.24-1.77, I2 = 67.5%), invasive mechanical ventilation (OR = 1.47, 95% CI: 1.31-1.65, I2 = 18.8%), and in-hospital mortality (OR = 1.14, 95% CI: 1.04-1.26, I2 = 74.4%). A higher degree of obesity also indicated a higher risk of almost all of the above events. The region may be one of the causes of heterogeneity. Obesity could promote the occurrence of the whole course of COVID-19. A higher degree of obesity may predict a higher risk. Further basic and clinical therapeutic research needs to be strengthened.

Identifying potential anti-COVID-19 pharmacological components of traditional Chinese medicine Lianhuaqingwen capsule based on human exposure and ACE2 biochromatography screening.

Lianhuaqingwen (LHQW) capsule, a herb medicine product, has been clinically proved to be effective in coronavirus disease 2019 (COVID-19) pneumonia treatment. However, human exposure to LHQW components and their pharmacological effects remain largely unknown. Hence, this study aimed to determine human exposure to LHQW components and their anti-COVID-19 pharmacological activities. Analysis of LHQW component profiles in human plasma and urine after repeated therapeutic dosing was conducted using a combination of HRMS and an untargeted data-mining approach, leading to detection of 132 LHQW prototype and metabolite components, which were absorbed via the gastrointestinal tract and formed via biotransformation in human, respectively. Together with data from screening by comprehensive 2D angiotensin-converting enzyme 2 (ACE2) biochromatography, 8 components in LHQW that were exposed to human and had potential ACE2 targeting ability were identified for further pharmacodynamic evaluation. Results show that rhein, forsythoside A, forsythoside I, neochlorogenic acid and its isomers exhibited high inhibitory effect on ACE2. For the first time, this study provides chemical and biochemical evidence for exploring molecular mechanisms of therapeutic effects of LHQW capsule for the treatment of COVID-19 patients based on the components exposed to human. It also demonstrates the utility of the human exposure-based approach to identify pharmaceutically active components in Chinese herb medicines.

An Acute Manic Episode During 2019-nCoV Quarantine.

BACKGROUND: The 2019-nCov pandemic is currently a stressor for the general public worldwide. In China, people who have a history of contact with infected or suspected individuals need to quarantine for at least 2 weeks. Many people experienced anxiety, panic and depression in the quarantine period. However, acute manic episode triggered by stressful events is not common and was neglected. CASE PRESENTATION: A 32-year-old woman with direct contact history with her infected colleagues showed elevated mood and increased activity when she was identified negative of nuclear acid amplification test, after experiencing extreme stress in quarantine. She was diagnosed with acute manic episode finally. The social zeitgeber and reward hypersensitivity theoretical models have attempted to use psychobiological perspectives to determine why life stress can trigger a mood episode, including (hypo)mania. Besides, the temporal correlation between her somatic symptoms and psychological stimuli indicated a possibility of functional disturbance under acute stress. CONCLUSION: Quarantine is a major stressful event disrupting social zeitgebers for people who have had contact with infected individuals, especially for vulnerable individuals with a hypersensitive reward system. Stress could act as a trigger in the onset of manic episode, so psychological support should be more targeted at the vulnerable individuals in the initial phase of emergent crisis.