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Background: Prenatal mental health is a neglected public health issue that places pregnant women at a higher risk for mental disorders. The purpose of this study was to investigate the influencing factors of prenatal mental disorders and provide a scientific basis to guide and promote the mental health of pregnant women., Methods: The study sample comprised 973 women in their first pregnancy, who were in their second trimester and third trimester, who underwent obstetric outpatient checkups at the Maternal and Child Health Hospital in Huai'an, who were recruited in the survey that was conducted from July to December 2017. The Chinese mental health scale (CMHS) was used to assess the mental health of pregnant women. The present study uses the chi-square test to compare the rates of class with different demographic variables, a latent class analysis to identify psychological symptoms, and multiple logistic regression analysis to examine whether the demographics predicted class membership., Results: The chi-square test results showed that participants who reported feeling different in the perinatal period (χ 2 = 6.35, P = 0.04), having marital satisfaction (χ 2 = 15.8, P < 0.001), with an in-law relationship (χ 2 = 29.43, P < 0.001), with a friend relationship (χ 2 = 24.81, P < 0.001), with basic diseases (χ 2 = 8.04, P = 0.02), and taking birth control pills (χ 2 = 8.97, P = 0.01) have different probabilities of being classified. Three latent classes were identified: the high symptoms group (6.89%), the moderate symptoms group (20.56%), and the low symptoms group (72.56%). Pregnant women in the third trimester [odds ratio (OR) = 1.83, 95% confidence interval (CI): 1.04-3.25, P = 0.04], with a poor in-law relationship (OR = 2.82, 95% CI:1.45-5.51, P = 0.002), with a bad friend relationship (OR = 3.17, 95% CI: 1.31-7.71, P = 0.01), and who had basic diseases (OR = 1.70, 95% CI: 1.00-2.90, P = 0.04) tended to be classified under the high symptoms group than under the low symptoms group. Pregnant women with a bad friend relationship (OR = 2.15, 95% CI: 1.08-4.28, P = 0.03) and taking birth control pills (OR = 1.51, 95% CI: 1.08-2.11, P = 0.02) were more likely to be placed under the moderate symptoms group than under the low symptoms group., Conclusions: A pregnant woman's mental health status factors include feeling different in the perinatal period, those with marital satisfaction, those with an in-law relationship, those with a friend relationship, those with basic diseases, and those taking birth control pills. To ensure a smooth progress of pregnancy and promote the physical and mental health of pregnant women, psychological screening and psychological intervention measures should be strengthened., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Pei, Chen, Zhang, He, Wang, Tang, Hou, Zhu, Zhang and Wang.)

Objectives: Little was known regarding the current age of onset patterns of stroke. This study aimed to examine the prevalence of stroke and explore the age of onset patterns of stroke in Jiangsu Province, China., Materials and Methods: Participants were recruited from April 2012 to April 2013 in Jiangsu Province, China. Survival analysis models were used to evaluate the hazards of stroke by a single year of age. Kaplan-Meier analysis and the log-rank test were used to explore the disparities of the age of onset patterns of stroke., Results: This population-based study was conducted among 39,887 participants aged ≥ 18 years in Jiangsu Province, China. Of the 740 (1.9%) events of stroke, 13.2% suffered from hemorrhagic stroke (HS) and 86.8% suffered from ischemic stroke (IS). The prevalence of HS and IS were 0.3% and 1.7%, respectively. The estimated mean age of onset of stroke was 71.98 (95% CI: 71.97-71.99) years by the survival model. Up to age of 45 years, the estimated hazards of stroke onset were at a relatively low level. From the age of 45 years, the increases in hazards accelerated and peaked at age 75 years. Urban, smoking, and drinking males had a higher risk of stroke than their counterparts (P < 0.05). However, no such difference was found among females., Conclusions: The findings emphasize the importance of implementing stroke prevention interventions in Jiangsu Province, China, especially for urban, smoking, and drinking males. It is of great significance to strengthen comprehensive management of health-related behaviors, including smoking cessation and moderate consumption of alcohol to have sustained beneficial effects on stroke risk. Chenlu He and Qian Chen contributed equally to this work., (© 2022. Fondazione Società Italiana di Neurologia.)

Background: Depression of pregnant women has been a growing concern in recent years, and previous research has found that family relationships are strongly associated with depression. From a network perspective, family relationships and depression can be conceptualized as the result of interactions between individual symptoms. This research approach can elucidate the structure and mechanisms of the relationship between individual symptoms within the two groups., Methods: A total of 990 participants were recruited from the obstetrics outpatient clinic of Maternal and Child Health Hospital in Huai'an through a randomized whole-group sampling. Respondents' depressive symptoms and family relationships were self-reported using questionnaire, and the structure of the family relationship-depressive symptoms network and related centrality indicators were examined for this sample., Results: The results of the network analysis suggested that the most influential symptoms in the network of family relationship-depressive symptoms were worry, feeling worthless, equal status with husband and couple relationship. And equal status with husband was the most prominent bridging symptoms in this study. The whole network was robust in both stability and accuracy tests., Limitations: Information was obtained from subjects' self-reports, which may be subject to information bias. As a cross-sectional study, no causal link between family relationships and depressive symptoms can be established., Conclusion: Worry, feeling worthless, equal status with husband and couple relationship are central symptoms of the family relationship-depressive symptoms network structure in pregnant women. Timely and systematic multilevel interventions targeting the central symptoms may be effective in alleviating the onset of depressive symptoms in women during this period., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wang, Pei, Tang, Chen, He, Zhang, Hou, Zhang and Wang.)

Objective: This study aimed to examine the impact of different dietary patterns on stroke outcomes among type 2 diabetes mellitus (T2DM) patients in China., Design: Participants were enrolled by a stratified random cluster sampling method in the study. After collecting dietary data using a quantified food frequency questionnaire, latent class analysis was used to identify dietary patterns, and propensity score matching was used to reduce confounding effects between different dietary patterns. Binary logistic regression and conditional logistic regression were used to analyze the relationship between dietary patterns and stroke in patients with T2DM., Setting: A cross-sectional survey available from December 2013 to January 2014., Participants: A total of 13731 Chinese residents aged 18 years or over., Results: Two dietary patterns were identified: 61.2% of T2DM patients were categorized in the High-fat dietary pattern while 38.8% of patients were characterized by the Balanced dietary pattern. Compared to the High-fat dietary pattern, the Balanced dietary pattern was associated with reduced stroke risk (OR=0.63, 95%CI: 0.52-0.76, P<0.001) after adjusting for confounding factors. The protective effect of the balanced model did not differ significantly (interaction P>0.05)., Conclusion: This study provides sufficient evidence to support the dietary intervention strategies to prevent stroke effectively. Maintaining a Balanced dietary pattern, especially with moderate consumption of foods rich in quality protein and fresh vegetables in T2DM patients, might decrease the risk of stroke in China.

Objective: This study aimed to examine the prevalence of stroke and associated factors of stroke in patients with type 2 diabetes(T2DM) in China., Methods: Participants were 18,013 T2DM patients recruited with stratified random cluster sampling method from December 2013 to January 2014 in China. Propensity score matching was used to eliminate confounding effects between groups and logistic regression analysis was used to examine factors associated with stroke among T2DM patients., Results: Overall, the prevalence of stroke in the subjects with T2DM was 9.5%. After nearest neighbor matching, smoking (OR = 1.60, 95%CI: 1.26-2.03), hypertension (OR = 2.96, 95%CI: 2.55-3.43), dyslipidemia (OR = 2.00, 95%CI: 1.71-2.33), family history of stroke (OR = 2.02, 95%CI: 1.61-2.54), obesity (OR = 1.21, 95%CI: 1.01-1.45) and sleep duration < 6 h/day (OR = 1.44, 95%CI: 1.20-1.73) or > 8 h/day (OR = 1.22, 95%CI: 1.05-1.42) were positively associated with stroke, whereas drinking 1-3 days/week (OR = 0.64, 95%CI: 0.45-0.90) or daily (OR = 0.45, 95%CI: 0.33-0.60), effective exercise (OR = 0.65, 95%CI: 0.57-0.73) and underweight (OR = 0.30, 95%CI: 0.13-0.71) were negatively related to stroke. Besides, the risk of stroke increased substantially with accumulation of above seven modified risk factors. The odds ratio values of stroke in patients having ≥ 5 of the above seven risk factors was 14.39 (95% CI: 8.87-23.26)., Conclusions: The prevalence of stroke was high among T2DM in China. It is of great significance to strengthen comprehensive management of health-related behaviors including smoking cessation, moderate alcohol consumption, effective exercise, 6-8 h of sleep duration, keeping normal weight and the prevention of hypertension and dyslipidemia to have sustained beneficial effects on improvements of stroke risk factors., (© 2021. Springer-Verlag Italia S.r.l., part of Springer Nature.)

Objectives: Diabetes and smoking are known independent risk factors for stroke; however, their interaction concerning stroke is less clear. We aimed to explore such interaction and its influence on stroke in Chinese adults., Design: Cross-sectional study., Setting: Community-based investigation in Xuzhou, China., Participants: A total of 39 887 Chinese adults who fulfilled the inclusion criteria were included., Methods: Participants were selected using a multistage stratified cluster method, and completed self-reported questionnaires on stroke and smoking. Type 2 diabetes mellitus (DM2) was assessed by fasting blood glucose or use of antidiabetic medication. Interaction, relative excess risk owing to interaction (RERI), attributable proportion (AP) and synergy index (S) were evaluated using a logistic regression model., Results: After adjustment for age, sex, marital status, educational level, occupation, physical activity, body mass index, hypertension, family history of stroke, alcohol use and blood lipids, the relationships between DM2 and stroke, and between smoking and stroke, were still significant: ORs were 2.75 (95% CI 2.03 to 3.73) and 1.70 (95% CI 1.38 to 2.10), respectively. In subjects with DM2 who smoked, the RERI, AP and S values (and 95% CIs) were 1.80 (1.24 to 3.83), 0.52 (0.37 to 0.73) and 1.50 (1.18 to 1.84), respectively., Conclusions: The results suggest there are additive interactions between DM2 and smoking and that these affect stroke in Chinese adults., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Previous studies have demonstrated that lycopene possesses anti-inflammatory properties in the central nervous system. However, the potential role and the molecular mechanisms of lycopene in lipopolysaccharide (LPS)-challenge inflammation and depression-like behaviors has not been clearly investigated. The present study aimed to assess the effects and the potential mechanisms of lycopene on LPS-induced depression-like behaviors. Lycopene was orally administered (60mg/kg) every day for seven days followed by intraperitoneal LPS injection (1mg/kg). The Forced swim test and tail suspension test were used to detect changes in the depression-like behaviors. ELISA was used to measure the expression of interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) in the plasma. Immunoblotting was performed to measure the expression of interleukin-1β (IL-1β) and heme oxygenase-1 (HO-1) in the hippocampus. The results showed that pretreatment with lycopene could ameliorate depression-like behaviors. Moreover, lycopene relieved neuronal cell injury in hippocampal CA1 regions. Furthermore, lycopene decreased LPS-induced expression of IL-1β and HO-1 in the hippocampus together with decreasing level of IL-6 and TNF-α in the plasma. Taken together, these results suggest that lycopene can attenuate LPS-induced inflammation and depression-like behaviors, which may be involved in regulating HO-1 in the hippocampus., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Accumulating evidence reveals that lipopolysaccharide (LPS) can induce neuroinflammation, ultimately leading to cognitive deficits. Mangiferin, a natural glucoxilxanthone, is known to possess various biological activities. The present study aimed to investigate the effects of mangiferin on LPS-induced cognitive deficits and explore the underlying mechanisms. Brain injury was induced in mice via intraperitoneal LPS injection (1mg/kg) for five consecutive days. Mangiferin was orally pretreatmented (50mg/kg) for seven days and then treatmented (50mg/kg) for five days after LPS injection. The Morris water maze was used to detect changes in cognitive function. Immunohistochemical and immunoblotting were respectively performed to measure the expression of interleukin-6 (IL-6) and heme oxygenase-1 (HO-1) in the hippocampus. The results showed that mangiferin can ameliorate cognitive deficits. Moreover, mangiferin decreased LPS-induced IL-6 production and increase HO-1 in the hippocampus. Taken together, these results suggest that mangiferin attenuates LPS-induced cognitive deficits, which may be potentially linked to modulating HO-1 in the hippocampus., (Copyright © 2015. Published by Elsevier B.V.)