Objective:To analyze the management and treatment of patients with psychosis in china in 2020 and compare with those in the past five years to provide a reference for making policy and service delivery.Methods:Descriptive analysis was used to analyze the system usage and registration, management, and treatment situation of the patients with psychosis, using the data obtained from 'National Information System for Psychosis′ in China, with date traced from 1st August 2011 to 31st December 2020.Results:By the end of 2020, the information system was adopted by 100% of districts/counties. 6 430 587 patients were registered, with a registered rate of 0.46% (6 430 587/1 396 537 459). In 2020, 6 116 599 patients were provided with follow-up services by primary healthcare staff, with a management rate of 95.12% (6 116 599/6 430 587). 5 724 019 patients were followed up regularly, with the regular management rate of 89.01% (5 724 019/6 430 587). Moreover, the medication-taking rate was 87.83% (5 648 162/6 430 587), and the regular medication- taking rate was 68.84% (4 426 498/6 430 587). 5 277 746 patients were stable, and the stable condition rate was 96.40% (5 277 746/5 474 881). Compared with 2019, 200 430 more patients were registered in 2020. The management rate, regular management rate, medication-taking rate, regular medication-taking rate, and stable condition rate were increased by 0.88%, 2.50%, 3.75%, 11.39%, and 1.15%, respectively. The regular medication-taking rate among patients registered in the western region was significantly lower than that in the eastern and central areas ( F=6.317, P=0.005). According to the diagnosis, the duration of the untreated period of patients registered in 2020 with schizophrenia, bipolar disorder, delusional disorder, schizoaffective disorder, psychotic disorder with epilepsy, mental retardation with psychotic symptoms were 2.69, 3.28, 1.68, 1.92, 4.70, and 9.89 years respectively, which were shorter than patients registered in 2019. Conclusion:The number of registered patients was sustainably growing. The untreated periods of newly registered patients were considerably shorter. The services and treatment situations improved in 2020. Appropriate policies should be developed to address the weaknesses of local mental health services in the western region to improve treatment rates.

Objectives:To analyze the allocation of mental health resources in Chinese mainland and the change of these resources during the 13 th Five-year Mental Health Plan period. This analysis will serve as evidence for developing future national mental health prevention and control policies. Methods:The National Mental Health Program Office created one questionnaire to survey available mental health facilities by the end of 2020. Descriptive methods were used to analyze the mental health facilities, psychiatric beds, and mental health professionals from type, sponsor, administrative level, regions, and sub-specialities.Results:By the end of 2020, 5 936 facilities were providing mental health services in Chinese mainland. 798 191 psychiatric beds (5.65 beds/10 000 persons), 50 124 psychiatrists (3.55/100 000 persons), and 139 642 registered nurses (9.89/100 000 persons) were located in these facilities. Of all these 5 936 mental health facilities, 649 (1.09%) had geriatric psychiatric wards, 312 (0.53%) had child psychiatric wards, and 1 548 (26.08%) had rehabilitation departments. 350 counties (12.31%) had no mental health facilities and 883 counties (31.05%) had no psychiatric beds in Chinese mainland, mainly in the mid-western regions. The numbers of psychiatric beds, psychiatrists, and registered nurses per unit land area in the western region were about 4 times lower than those in the middle region and 7-11 times lower than those in the eastern region.Conclusions:The mental health resources in Chinese mainland increased significantly from 2015 to 2020, but there are still the problems of uneven geographical allocation of resources and lagged sub-specialities development. While formulating the construction and development plan for mental health prevention and control system in the future, we should further develop the mental health resources at the county level, and vigorously support to establish of mental health sub-specialities for the elderly and children, as well as mental health rehabilitation, particularly in the mid-western regions.

Objective:To analyze the management and treatment of patients with psychosis in china in 2020 and compare with those in the past five years to provide a reference for making policy and service delivery.Methods:Descriptive analysis was used to analyze the system usage and registration, management, and treatment situation of the patients with psychosis, using the data obtained from 'National Information System for Psychosis′ in China, with date traced from 1st August 2011 to 31st December 2020.Results:By the end of 2020, the information system was adopted by 100% of districts/counties. 6 430 587 patients were registered, with a registered rate of 0.46% (6 430 587/1 396 537 459). In 2020, 6 116 599 patients were provided with follow-up services by primary healthcare staff, with a management rate of 95.12% (6 116 599/6 430 587). 5 724 019 patients were followed up regularly, with the regular management rate of 89.01% (5 724 019/6 430 587). Moreover, the medication-taking rate was 87.83% (5 648 162/6 430 587), and the regular medication- taking rate was 68.84% (4 426 498/6 430 587). 5 277 746 patients were stable, and the stable condition rate was 96.40% (5 277 746/5 474 881). Compared with 2019, 200 430 more patients were registered in 2020. The management rate, regular management rate, medication-taking rate, regular medication-taking rate, and stable condition rate were increased by 0.88%, 2.50%, 3.75%, 11.39%, and 1.15%, respectively. The regular medication-taking rate among patients registered in the western region was significantly lower than that in the eastern and central areas ( F=6.317, P=0.005). According to the diagnosis, the duration of the untreated period of patients registered in 2020 with schizophrenia, bipolar disorder, delusional disorder, schizoaffective disorder, psychotic disorder with epilepsy, mental retardation with psychotic symptoms were 2.69, 3.28, 1.68, 1.92, 4.70, and 9.89 years respectively, which were shorter than patients registered in 2019. Conclusion:The number of registered patients was sustainably growing. The untreated periods of newly registered patients were considerably shorter. The services and treatment situations improved in 2020. Appropriate policies should be developed to address the weaknesses of local mental health services in the western region to improve treatment rates.

Objectives:To analyze the allocation of mental health resources in Chinese mainland and the change of these resources during the 13 th Five-year Mental Health Plan period. This analysis will serve as evidence for developing future national mental health prevention and control policies. Methods:The National Mental Health Program Office created one questionnaire to survey available mental health facilities by the end of 2020. Descriptive methods were used to analyze the mental health facilities, psychiatric beds, and mental health professionals from type, sponsor, administrative level, regions, and sub-specialities.Results:By the end of 2020, 5 936 facilities were providing mental health services in Chinese mainland. 798 191 psychiatric beds (5.65 beds/10 000 persons), 50 124 psychiatrists (3.55/100 000 persons), and 139 642 registered nurses (9.89/100 000 persons) were located in these facilities. Of all these 5 936 mental health facilities, 649 (1.09%) had geriatric psychiatric wards, 312 (0.53%) had child psychiatric wards, and 1 548 (26.08%) had rehabilitation departments. 350 counties (12.31%) had no mental health facilities and 883 counties (31.05%) had no psychiatric beds in Chinese mainland, mainly in the mid-western regions. The numbers of psychiatric beds, psychiatrists, and registered nurses per unit land area in the western region were about 4 times lower than those in the middle region and 7-11 times lower than those in the eastern region.Conclusions:The mental health resources in Chinese mainland increased significantly from 2015 to 2020, but there are still the problems of uneven geographical allocation of resources and lagged sub-specialities development. While formulating the construction and development plan for mental health prevention and control system in the future, we should further develop the mental health resources at the county level, and vigorously support to establish of mental health sub-specialities for the elderly and children, as well as mental health rehabilitation, particularly in the mid-western regions.

Objective To purify the anti-T cell immunoglobulin mucin ( TIM)-3 monoclonal antibody 4E8 and examine its biological function in vitro. Methods The mouse monoclonal antibody against human TIM-3, clone 4E8, was obtained by standard protocol for monoclonal antibody purification. The cell lines expressing human TIM-3 molecule were obtained by cell transfection technique. We ex-amined the ability of 4E8 binding to human TIM-3 by flow cytometry. The ability of 4E8 blocking the binding of fusion protein TIM-3 Ig-huFc with phosphatidylserine( PtdSer) , the apoptotic cell surface TIM-3 ligand, was also analyzed by flow cytometry. Mixed lympho-cyte reaction ( MLR) and ELISA assays were used to determine the effect of TIM-3 monoclonal antibody ( 4E8) on IFN-γsecretion in CD4+ T cells. Results 4E8 specifically bound to human TIM-3 but could not block the binding of TIM-3 to Ptdser. Compared with the negative control (IFN-γ secretion: 958.3±153.2), 4E8 enhanced the ability of CD4+ T cells to secrete IFN-γ in MLR (4E8 of 10μg/mL group:IFN-γ secretion 2563±150.3 and 4E8 of 3.33 μg/mL group:IFN-γ secretion 1981±211.5) with statistically signifi-cant difference ( P<0.05) . In addition, the combined application of 4E8 with the anti-programmed death-1 ( PD-1) monoclonal anti-body nivolumab showed synergistic effects for increasing IFN-γ secretion in MLR assay ( 4E8 of 10 μg/mL group: IFN-γ secretion 3049±80.5 and 4E8 of 0.33μg/mL group:IFN-γsecretion 1957±321.3) as compared with 4E8 alone (10μg /mL group:IFN-γse-cretion 2563±150.3 and 0.33 μg/mL group:IFN-γ secretion 844±76.2) with statistically significant difference (P<0.05). Conclu-sion We successfully obtained a 4E8 clone of monoclonal antibody to human TIM-3 which may enhance the capacity of IFN-γsecre-tion from CD4+ T cells. The effect of enhancing IFN-γ secretion of CD4+T cells by TIM-3 monoclonal antibody was independent from blocking the binding of TIM-3 with Ptdser.