Objective To develop a multiplex PCR assay for simultaneous detection of four intestinal parasites, including Giardia duodenalis, Cryptosporidium parvum, Enterocytozoon bieneusi and Moniezia, and to preliminarily evaluate its detection efficiency. Methods Four pairs of specific primers were designed based on the conserved sequences of the corresponding genes of G. duodenalis (GenBank accession number: XM_001710026.2), C. parvum (GenBank accession number: XM_626998.1), E. bieneusi (GenBank accession number: KJ719492.1) and Moniezia (GenBank accession number: OM296991.1) retrieved from the GenBank database, and a multiplex PCR assay for simultaneous detection of G. duodenalis, C. parvum, E. bieneusi and Moniezia was developed and optimized. A total of 116 fresh goat stool samples were collected from four goat farms in Zhanjiang City, Guangdong Province during the period from October to December 2022, including 96 samples used for evaluating the detection efficacy of the multiplex PCR assay, and 20 samples as baseline controls for sample testing. Genomic DNA extracted from 96 goat stool samples was tested using the single-target PCR assay and the developed multiplex PCR assay, and the sensitivity, specificity, positive predictive value, and negative predictive value of the multiplex PCR assay were evaluated for detection of G. duodenalis, C. parvum, E. bieneusi and Moniezia DNA in goat stool samples with the single-target PCR assay as the gold standard. Results The multiplex PCR assay developed in this study allowed simultaneous amplification of specific gene fragments of G. duodenalis, C. parvum, E. bieneusi and Moniezia, with 1 400, 755, 314 bp and 585 bp in sizes, respectively, and the detection limit was 10² and higher copies of parasite DNA clones, while the multiplex PCR assay was negative for gene amplification of Schistosoma japonicum, Fasciola hepatica, Echinococcus granulosus, Blastocystis hominis and Homalogaster paloniae. Single-target PCR assay and the developed multiplex PCR assay were employed to test DNA samples extracted from 96 goat stool samples, and single-target PCR assay tested positive in 40 goat stool samples (41.67%), including 39 positive samples tested with the multiplex PCR assay, with a mean coincidence rate of 97.50% (39/40). The multiplex PCR assay tested positive for G. duodenalis DNA in 26 goat stool samples (27.10%), C. parvum DNA in 22 samples (22.90%), E. bieneusi DNA in 24 samples (25.00%), and Moniezia in 9 samples (9.40%), which was consistent with the detection using the single-target PCR assay. The sensitivity, negative predictive value, and positive predictive value of the multiplex PCR assay were 96.15%, 95.83%, 100.00% and 100.00%, 98.90%, 98.92%, 100.00% and 100.00%, 100.00%, 100.00%, 100.00% and 100.00% for detection of G. duodenalis, C. parvum, E. bieneusi and Moniezia DNA in goat stool samples, respectively, if the single-target PCR assay served as the gold standard. Conclusion A highly sensitive and specific multiplex PCR assay has been developed for simultaneous detection of G. duodenalis, C. parvum, E. bieneusi and Moniezia in goats, which is suitable for rapid, large-scale screening of intestinal parasites in sheep stool samples.

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.