Objective : To analyze the mediating effect of psychological resilience between occupational stress and job burnout of medical staff, so as to provide the reference for improving job burnout of medical staff. Methods: The front-line medical staff from four tertiary general hospitals in a joint logistics support center were selected as the research objects from April to June 2022 using the convenience sampling method. The data on gender, age, professional title, and working years were collected by a questionnaire survey. Occupational stress, psychological resilience, and job burnout were evaluated using the Job Stressors Scale, the Connor-Davidson Resilience Scale, and the Maslach Burnout Inventory, respectively. The mediating effect of psychological resilience between occupational stress and job burnout was analyzed using the Process procedure, and the significance of the mediating effect was analyzed using the Bootstrap method. Results: A total of 383 people were investigated, among whom 370 were females (96.61%), and 13 were males (3.39%), with a mean age of (28.97±6.56) years. The scores of occupational stress, psychological resilience, and job burnout were (347.17±157.98), (87.18±13.17), and (56.07±17.09) points, respectively. The results of mediating effect analysis showed that occupational stress could directly positively affect job burnout with a direct effect value of 0.061 (95%CI: 0.004-0.119), and it could also indirectly positively affect job burnout through psychological resilience with a mediating effect value of 0.035 (95%CI: 0.002-0.122), and the mediating effect accounted for 57.38% of the total effect. Conclusions Occupational stress can directly or indirectly affect job burnout through psychological resilience. It is suggested to strengthen the mental health training of medical staff to improve psychological resilience and reduce job burnout.

OBJECTIVE To compare the anti-hepatitis mechanisms of Abrus pulchellus subsp. cantoniensis （Hance） Verdc. （AC） and Abrus pulchellus subsp. mollis（Hance） Verdc. （AM）. METHODS SD rats were randomly divided into blank group， AC- treated group， and AM-treated group， with each group consisting of 10 rats. The rats’ orbital venous blood was collected at 5， 15， 30 minutes， and 1， 1.5， 2， 4， 6， 8， 12 hours after gavage administration of 24 g/kg of the corresponding drug （calculated by crude drug） or water， respectively. Ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry technology was utilized to identify the prototype components present in the serum. The network pharmacology method was adopted to predict the anti-hepatitis active components， key targets， and signaling pathways of AC and AM. Additionally， molecular docking technology was utilized to verify the binding activity of the core active components with key targets. RESULTS A total of 35 prototype components migrating to the blood of AC and AM were identified in the serum of administered rats， among which 24 were common components. The active components in AC， such as acetylanguidine， physcion， soyasaponin A3 and soyasaponin Ⅰ， as well as those in AM， including vicenin 3， acetylanguidine，soyasaponin Ⅰ and schaftoside， all acted on key targets such as steroid receptor coactivator， phosphatidylinositol-4，5-bisphosphate 3-kinase catalytic subunit alpha， epidermal growth factor receptor （EGFR）， and protein kinase B1（Akt1）. These components modulated pathways in cancer， EGFR tyrosine kinase inhibitor resistance， and the phosphoinositide 3-kinase （PI3K） -Akt pathway， thereby exerting anti-hepatitis effects. Furthermore， the binding energies between these active components and their key targets were all less than －5 kJ/mol. CONCLUSIONS There are differences in the active components of AC and AM against hepatitis， but their mechanisms of action are similar. Both may exert their anti-hepatitis effects through pathways in cancer， EGFR tyrosine kinase inhibitor resistance， and the PI3K-Akt pathway.

Objective: To analyze the association of sedentary types with symptom of depressive and anxiety among college freshmen, so as to provide a reference for improving the mental health of college students. Methods: From October to November 2022, all college freshmen at three colleges and universities in Anhui Province were selected by a cluster sampling method. The Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Youth Leisure-Time Sedentary Behavior Questionnaire (YLSBQ) were used for the investigation. A binary Logistic regression analysis was conducted to investigate the relationship of different types of sedentary behavior with anxiety and depressive symptom. Results: The detection rates of anxiety and depressive symptom among college freshmen were 32.8% and 49.9%, respectively. The results of the binary Logistic regression model analysis showed that after controlling for gender, family location, parental education level, self rated family economic status and number of intimate partners, high level overall, video based, and social based sedentary time were associated with an increased risk of anxiety ( OR =1.26, 1.56, 1.27) and depressive symptom ( OR =1.42, 1.94, 1.29) among college freshmen; the association between moderate level sedentary time and depressive symptom was statistically significant ( OR =0.83) (all P <0.05). The overall trends of the association between sedentary behavior with symptom of anxiety and depressive were similar in both boys and girls. Conclusions Sedentary behavior is associated with an increased risk of anxiety and depressive symptom in college students. Reducing video based and social based sedentary behaviors is beneficial for mental health promotion in college students.

Objective To evaluate postoperative recovery and health-related quality of life in patients undergoing robotic,laparoscopic,or open total hysterectomy.Methods A total of 152 patients who underwent total hysterectomy at the Department of Obstetrics and Gynecology of The Second Affiliated Hospital of Naval Medical University from May 2022 to May 2024 were enrolled and assigned to robot-assisted laparoscopic surgery group(robotic surgery group,44 cases),traditional laparoscopic surgery group(laparoscopic surgery group,62 cases),or open surgery group(46 cases)based on the surgical approach.General information,perioperative indexes,and discomfort symptoms 1 month after discharge were collected.Health-related quality of life was evaluated using 36-item short-form health survey(SF-36)at 1-month postoperative follow-up.Results There were no significant differences in age,body mass index,education level,work status,or diagnosis of benign or malignant diseases(all P＞0.05).The postoperative hospital stay,time of first ambulation,time of first oral intake,and 24-h pain score in the robotic surgery group were significantly lower than those in the laparoscopic and open surgery groups(all P＜0.01).The incidence of urinary system and digestive system discomfort within 1 month after discharge was significantly lower in the robotic surgery group than in the laparoscopic and open surgery groups,and the incidence of lower abdominal pain was significantly lower in the robotic surgery group than in the open surgery group(all P＜0.01).The scores of SF-36 in each dimension were significantly higher in the robotic surgery group than those in the laparoscopic and open surgery groups 1 month after discharge(all P＜0.01).Conclusion Compared with those undergoing traditional laparoscopic or open total hysterectomy,patients who underwent robot-assisted laparoscopic total hysterectomy demonstrate faster postoperative recovery and better health-related quality of life.

The Janus kinase/signal transducers and activators of transcription (JAK-STAT) control natural killer (NK) cells development and cytotoxic functions, however, whether long non-coding RNAs (lncRNAs) are involved in this pathway remains unknown. We found that miR155HG was elevated in activated NK cells and promoted their proliferation and effector functions in both NK92 and induced-pluripotent stem cells (iPSCs)-derived NK (iPSC-NK) cells, without reliance on its derived miR-155 and micropeptide P155. Mechanistically, miR155HG bound to miR-6756 and relieved its repression of JAK3 expression, thereby promoting the JAK-STAT pathway and enhancing NK cell proliferation and function. Further investigations disclosed that upon cytokine stimulation, STAT3 directly interacts with miR155HG promoter and induces miR155HG transcription. Collectively, we identify a miR155HG-mediated positive feedback loop of the JAK-STAT signaling. Our study will also provide a power target regarding miR155HG for improving NK cell generation and effector function in the field of NK cell adoptive transfer therapy against cancer, especially iPSC-derived NK cells.

Ursodeoxycholic acid (UDCA) is a naturally occurring, low-toxicity, and hydrophilic bile acid (BA) in the human body that is converted by intestinal flora using primary BA. Solute carrier family 7 member 11 (SLC7A11) functions to uptake extracellular cystine in exchange for glutamate, and is highly expressed in a variety of human cancers. Retroperitoneal liposarcoma (RLPS) refers to liposarcoma originating from the retroperitoneal area. Lipidomics analysis revealed that UDCA was one of the most significantly downregulated metabolites in sera of RLPS patients compared with healthy subjects. The augmentation of UDCA concentration (≥25 μg/mL) demonstrated a suppressive effect on the proliferation of liposarcoma cells. [¹⁵N₂]-cystine and [¹³C₅]-glutamine isotope tracing revealed that UDCA impairs cystine uptake and glutathione (GSH) synthesis. Mechanistically, UDCA binds to the cystine transporter SLC7A11 to inhibit cystine uptake and impair GSH de novo synthesis, leading to reactive oxygen species (ROS) accumulation and mitochondrial oxidative damage. Furthermore, UDCA can promote the anti-cancer effects of ferroptosis inducers (Erastin, RSL3), the murine double minute 2 (MDM2) inhibitors (Nutlin 3a, RG7112), cyclin dependent kinase 4 (CDK4) inhibitor (Abemaciclib), and glutaminase inhibitor (CB839). Together, UDCA functions as a cystine exchange factor that binds to SLC7A11 for antitumor activity, and SLC7A11 is not only a new transporter for BA but also a clinically applicable target for UDCA. More importantly, in combination with other antitumor chemotherapy or physiotherapy treatments, UDCA may provide effective and promising treatment strategies for RLPS or other types of tumors in a ROS-dependent manner.

Objective This study aims to introduce and explore the application of the medical service price online audit system,which enables pre-positioning,informatization,intelligence,and refinement of price management,ensuring the safety of medical insurance funds and protecting the legitimate rights and interests of patients.Methods Taking a tertiary hospital in Guangdong Province as an example,the application practice of the medical institution's online audit system for price management is thoroughly introduced.Results Through the real-time monitoring of charge data by the online audit system,full-process man-agement is carried out,including pre-warning,mid-intervention,and post-analysis of medical billing behavior,in order to stand-ardize clinical diagnosis and treatment practices.Conclusion By utilizing information technology and continuously improving in-telligent audit rules,the standardization of hospital charge management can be promoted,internal control construction can be strengthened,and the hospital's refinement development can be facilitated.

Objective:To investigate the effect of atosiban on hemodynamic parameters of uterine arteries and clinical effect evaluation in patients with previous implantation failure undergoing frozen-thawed embryo transfer.Methods:A retrospective cohort study was conducted to analyze 298 cycles of FET in the Department of Reproductive Medicine of the Second Affiliated Hospital of Zhengzhou University from January 2021 to June 2023. Patients were categorized into atosiban group ( n=149) and control group ( n=149) according to whether administered atosiban or not. The related indicators and clinical outcomes were compared between the two groups. Hemodynamic parameters of the uterine arteries, including bilateral uterine artery peak systolic velocity/diastolic velocity (S/D), pulsatility index (PI), resistance index (RI), and serum levels of prostaglandin F2α (PGF2α) and oxytocin were compared before and after atosiban treatment. Univariate and multivariate logistic regression analysis were applied to assess the effect of atosiban on pregnancy outcomes. The effect of atosiban on live birth rate was analyzed by age stratification. Results:The implantation rate [51.92% (135/260)], the clinical pregnancy rate [67.11% (100/149)] and the live birth rate [59.06% (88/149)] in atosiban group were significantly higher than those in control group [41.13% (102/248), P=0.015; 51.01% (76/149), P=0.005; 40.27% (60/149), P=0.001]; and the early miscarriage rate [9.00% (9/100)] was lower than that of control group [19.74% (15/76), P=0.040]. Multivariate logistic regression analysis showed that atosiban was an independent influencing factor of live birth rate ( OR=2.236, 95% CI: 1.371-3.646, P=0.001). The post-treatment right uterine artery blood flow S/D [4.61 (4.00, 5.36)], PI [1.81 (1.58, 2.05)], RI [0.79 (0.75, 0.82)], and left uterine artery blood flow S/D [4.62 (3.83, 5.61)], PI (1.84±0.38), RI [0.79 (0.74, 0.82)] were all lower than those before treatment [right S/D 4.93 (4.06, 6.04), P<0.001; PI 1.93 (1.60, 2.17), P=0.001; RI 0.80 (0.76, 0.83), P<0.001; left S/D 5.05 (4.20, 6.32), P<0.001; PI 1.95±0.43, P<0.001; RI 0.81 (0.76, 0.84), P<0.001]. Besides, the levels of PGF2α [97.01 (85.15, 109.93) ng/L] and oxytocin [41.18 (37.16, 46.78) ng/L] after treatment in atosiban group were significantly lower than those before treatment [119.71 (108.85, 129.99) ng/L, P<0.001; 51.87 (46.44, 55.54) ng/L, P<0.001). Moreover, the endometrial peristalsis waves in atosiban group were significantly less after treatment [1.00 (0.00, 2.00) times/min] than before treatment [2.00 (1.00, 3.00) times/min], and the difference was statistically significant ( P<0.001). Conclusion:Atosiban can improve uterine artery blood flow and reduce endometrial peristalsis waves in women with previous implantation failure, which increases endometrial blood perfusion. Additionally, it can also reduce the levels of PGF2α and oxytocin, and optimize the pregnancy outcome of the frozen-thawed embryo transfer.

Objective:To investigate the therapeutic effects and underlying mechanisms of intrauterine perfusion of umbilical cord blood mononuclear cells (UCB-MNCs) on thin endometrium.Methods:SPF-grade Kunming mice aged 6-8 weeks were selected. A mouse model of thin endometrium was established by infusing 95% ethanol into the uterine cavity for a duration of 5 min. Using a completely randomized grouping method, 40 female mice with regular estrous cycles were randomly divided into four groups: untreated group (no intervention, n=10), sham-operated group (operation without modeling, n=10), experimental group (intrauterine infusion of UCB-MNCs during estrus after one estrous cycle post-modeling, n=10) and negative control group (intrauterine infusion of saline during estrus after one estrous cycle post-modeling, n=10). Following the administration of UCB-MNCs or physiological saline, all groups' uterine tissues were collected two estrous cycles later during their respective estrus phases. Hematoxylin-eosin staining was used to assess endometrial morphology, measure thickness, and count glands. Western blotting and reverse transcription real-time quantitative polymerase chain reaction were utilized to measure the relative protein and mRNA expression levels of leukemia inhibitory factor (LIF), vascular endothelial growth factor (VEGF), integrin (ITG) α V, ITG β 3 and proliferating cell nuclear antigen (PCNA) in the endometrium across different groups for intergroup comparisons. Results:The endometrial thickness and the number of glands in the untreated group [(507.32±85.66) μm, 18.67±6.66] showed no statistically significant differences compared with those in the sham-operated group [(502.78±73.26) μm, 19.33±7.73, all P>0.05]. The experimental group showed significantly increased endometrial thickness [(347.71±82.24) μm vs. (118.85±29.19) μm, P<0.001] and gland number (15.00±2.65 vs. 2.00±2.00, P=0.030) compared with the negative control group. There was no statistically significant difference in the relative protein and mRNA expression levels of LIF, VEGF, ITG α v, ITG β 3, and PCNA in the endometrium between the untreated group and the sham-operated group (all P>0.05). The relative protein and mRNA expression levels of endometrial LIF, VEGF, ITG α V, ITG β 3 and PCNA of the experimental group were all significantly higher than those in the negative control group (all P<0.05). Conclusion:Intrauterine perfusion with UCB-MNCs may promote endometrial regeneration and repair, as well as improve endometrial receptivity, through the upregulation of the expression levels of PCNA, LIF, VEGF, and ITG α V, ITGβ 3.

Objective:To conduct a latent profile analysis of general self-efficacy among postpartum nurses with two children and explore the influencing factors of different profiles.Methods:A stratified sampling approach was used to recruit 298 clinical nurses with two children who had resumed work from 12 public healthcare facilities in Mianyang during May and December 2023. Data were collected using a demographic questionnaire, Work-Family Conflict Scale, Nursing Stress Scale, Family Stress Scale, and General Self-Efficacy Scale. Latent profile analysis was performed via Mplus 8.3. Pearson correlation and logistic regression analyses were used to examine associations between self-efficacy, work-family conflict, nursing stress, family stress, and profile membership.Results:Data collection yielded 298 questionnaires, with 281 valid responses (94.3% response rate). Three latent profiles of general self-efficacy were identified: low efficacy group (43.8%), moderate efficacy group (42.7%), and high efficacy group (13.5%). Work position, hospital level, time since return to work, nursing stress, and family stress were significant predictors of profile membership ( P< 0.05) . Conclusions:General self-efficacy among nurses with two children post-childbirth is heterogeneous. Nursing administrators should deliver tailored interventions based on latent profile characteristics and develop individualized self-efficacy enhancement programs from both individual and organizational perspectives to improve adaptability and competency during post-return work transition.