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BackgroundThe COVID-19 epidemic may elevate mental distress and depressive symptoms in various populations in China. ObjectiveThis study investigates the levels of depression and mental distress due to COVID-19, and the associations between cognitive, behavioral, and psychosocial factors, and depression and mental distress due to COVID-19 among university students in China. MethodsA large-scale online cross-sectional study (16 cities in 13 provinces) was conducted among university students from February 1 to 10, 2020, in China; 23,863 valid questionnaires were returned. The Patient Health Questionnaire-9 was used to assess depression. Structural equation modeling was performed to test mediation and suppression effects. ResultsOf the 23,863 participants, 47.1% (n=11,235) reported high or very high levels of one or more types of mental distress due to COVID-19; 39.1% (n=9326) showed mild to severe depression. Mental distress due to COVID-19 was positively associated with depression. All but one factor (perceived infection risks, perceived chance of controlling the epidemic, staying at home, contacted people from Wuhan, and perceived discrimination) were significantly associated with mental distress due to COVID-19 and depression. Mental distress due to COVID-19 partially mediated and suppressed the associations between some of the studied factors and depression (effect size of 6.0%-79.5%). ConclusionsBoth mental distress due to COVID-19 and depression were prevalent among university students in China; the former may have increased the prevalence of the latter. The studied cognitive, behavioral, and psychosocial factors related to COVID-19 may directly or indirectly (via mental distress due to COVID-19) affect depression. Interventions to modify such factors may reduce mental distress and depressive symptoms during the COVID-19 epidemic.

Objective To explore the effects of prophylactic analgesia with esketamine on pain, hemodynamics, and stress response in patients with single-segment thoracolumbar fracture after percutaneous pedicle screw fixation (PPSF). Methods From April 2021 to April 2023, 85 patients with single-segment thoracolumbar fracture undergoing PPSF at The Sixth People's Hospital of Nantong were enrolled as the research objects. All patients underwent PPSF under tracheal intubation and general anesthesia, routine anesthesia induction, maintenance and patient controlled intravenous analgesia. Among all the patients, 42 cases in obeservation group were given intravenous injection of esketamine (10 mg) at 20 min before the end of the surgery, 43 cases in control group did not receive any other treatment. The postoperative pain ［visual analogue scale (VAS)］, hemodynamics ［heart rate (HR), mean arterial pressure (MAP), oxygen saturation (SpO2), respiratory rate］, stress response ［eosinophils (EOS), platelet count (PLT)］ and adverse reactions were compared between the two groups. Results Compared with control group, obeservation group had higher HR and lower MAP immediately after surgery(T1), lower VAS scores at 2 h (T2) and 6 h (T3) after surgery, and lower frequency of analgesic pump compression at 48h after surgery (P＜0.05). There was no significant difference in SpO2, respiratory rate between two groups (P＞0.05). At T1 and T3, EOS was higher, while PLT was lower in observation group than control group (P＜0.05). There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group (9.52% vs4.65%, χ2=0.206, P=0.433). Conclusion Prophylactic analgesia with esketamine is beneficial to relieve short-term pain, stress response and stabilize hemodynamics in patients with single-segment thoracolumbar fracture after PPSF, which has few effects on postoperative cognitive function and good safety.

Objective: This three-wave longitudinal study tested the prospective relationships between college adjustment, self-esteem, and mental health status (ie, subjective well-being, anxiety, and depression). Participants: The study recruited 265 Chinese undergraduate students. Methods: Demographic, college adjustment, self-esteem, and mental health status data were collected. Results: College adjustment and self-esteem were moderate in magnitude and maintained a reasonable stability over time. College adjustment and self-esteem at Year 1 and Year 2, and mental health status at Year 3, were significantly correlated with each other. College adjustment at Year 1 and Year 2, and self-esteem at Year 1 significantly predicted mental health status at Year 3. Conclusions: Interventions to improve self-esteem and college adjustment may benefit long-term mental health outcomes.

Hyperglycemia drives dysfunction of the intestinal barrier. 5-Hydroxytryptaine 4 receptor (5-HT4R) agonists have been considered therapeutics for constipation in clnic. However, the roles of 5-HT4R activation in mucosa should be fully realized. Here, we investigate the effects of 5-HT4R activation on diabetes-induced disruption of the tight junction (TJ) barrier in the colon. Not surprisingly, the TJ barrier in diabetic mice with or without 5-HT4R is tremendously destroyed, as indicated by increased serum fluorescein isothiocyanate (FITC)-dextran and decreased transepithelial electrical resistance (TER). Simultaneously, decreased expressions of TJ proteins are shown in both wild-type (WT) and 5-HT4R knockout (KO) mice with diabetes. Notably, chronic treatment with intraperitoneal injection of a 5-HT4R agonist in WT mice with diabetes repairs the TJ barrier and promotes TJ protein expressions, including occludin, claudin-1 and ZO-1, in the colon, whereas a 5-HT4R agonist does not improve TJ barrier function or TJ protein expressions in 5-HT4R KO mice with diabetes. Furthermore, stimulation of 5-HT4R inhibits diabetes-induced upregulation of myosin light chain kinase (MLCK), Rho-associated coiled coil protein kinase 1 (ROCK1), and phosphorylated myosin light chain (p-MLC), which are key molecules that regulate TJ integrity, in the colonic mucosa of WT mice. However, such action induced by a 5-HT4R agonist is not observed in 5-HT4R KO mice with diabetes. These findings indicate that 5-HT4R activation may restore TJ integrity by inhibiting the expressions of MLCK, ROCK1 and p-MLC, improving epithelial barrier function in diabetes.