Objective: To investigate the prevalence and influencing factors of depressive symptoms among grassroots healthcare workers in Zhejiang Province, so as to provide insights into improving their mental health. Methods: Grassroots healthcare workers of community health service centers and township health centers were sampled from one county (city, district) in each of 11 cities in Zhejiang Province using a convenience sampling method from December 2022 to January 2023. Participants' gender, age, educational level and average daily sleep duration in the past week were collected through questionnaires, and depression symptoms was investigated according to Self-rating Depression Scale. Factors affecting the depressive symptoms were identified using a multivariable logistic regression model. Results: A total of 1 946 questionnaires were distributed, and 1 945 valid questionnaires were recovered, with an effective response rate of 99.95%. There were 444 boys, accounting for 22.83%, and 1 501 girls, accounting for 77.17%. The median age was was 36 (interquartile range, 44) years. There were 786 healthcare workers detected with depressive symptoms, with a prevalence rate of 40.41%, and the prevalence rates of mild, moderate and severe depressive symptoms were 26.94%, 10.49% and 2.98%, respectively. Multivariable logistic regression analysis identified age (50 years and older, OR=0.572, 95%CI: 0.386-0.846), annual income (100 000 to 149 999 Yuan, OR=0.780, 95%CI: 0.635-0.958; 150 000 to 199 999 Yuan, OR=0.463, 95%CI: 0.282-0.760; 200 000 Yuan and above, OR=0.303, 95%CI: 0.098-0.937), vocation (nurse, OR=1.593, 95%CI: 1.252-2.027) and sleep duration (less than 7 hours, OR=2.164, 95%CI: 1.768-2.648) as factors affecting depressive symptoms among grassroots healthcare workers in Zhejiang Province. Conclusions The prevalence of depressive symptoms among grassroots healthcare workers in Zhejiang Province is 40.41%. Age, annual income, job and sleep duration may affect the development of depressive symptoms among grassroots healthcare workers.

Objective: To explore the imaging presentation of ¹⁸F-FDG PET-CT and clinical characteristics of the patients with lymphoblastic lymphoma (LBL). Methods: The clinical and imaging data of 18 patients with newly diagnosed LBL in the First Affiliated Hospital with Nanjing Medical University from July 2009 to June 2017 were retrospectively analyzed. The sensitivity, specificity and accuracy of ¹⁸F-FDG PET-CT to diagnose bone marrow involvement (BMI) was calculated respectively. Results: There were 18 LBL patients, including 12 male and 6 female with median age of 24.5 (14-51) years old. Eleven patients were T-LBL, and 7 patients were B-LBL. All lesions were presented with high ¹⁸F-FDG uptake on ¹⁸F-FDG PET-CT imaging, with a median SUV_max of 14.3 (10.6, 16.8). The most frequent lymph node involvement site was mediastinal lymph nodes, and 7 T-LBL cases had jugular node involvement. The most frequent extranodal involvement site was bone marrow, with multifocal FDG accumulation in bone marrow on ¹⁸F-FDG PET-CT imaging in 8 cases. The median SUV_max of node and extranodal involvement were 15.0 (9.0, 18.2), 12.3 (8.4, 15.3), and there was no significant difference (Z=-0.867, P= 0.386). The median SUV_max of T-LBL and B-LBL patients was 14.1 (9.2, 15.9), 14.5 (12.1, 19.5) respectively, and there was no significant difference (Z=-0.679, P= 0.497). According to clinical features, ¹⁸F-FDG PET-CT and bone marrow biopsy (BMB), 12 patients were diagnosed as BMI. If multifocal FDG accumulation and diffuse hypermetabolism of FDG in bone marrow were considered as the diagnosis criteria, the sensitivity, specificity and accuracy of PET-CT was 91.7% (11/12), 66.7% (4/6), 83.3% (15/18), respectively. The parameters in BMB were 50.0% (6/12), 100.0% (6/6), 66.7% (12/18), respectively. Conclusions LBL mostly occurs in young men and its clinical manifestations include lymphadenectasis and invasion of bone marrow. ¹⁸F-FDG PET-CT has certain characteristics which are helpful to diagnose and staging.

Objective: To investigate the impact of temperature changes between neighboring days (TCN) on the mortality risk of respiratory diseases, so as to provide the evidence for the study of deaths from respiratory diseases caused by climate change. Methods: The monitoring data of deaths from respiratory diseases in Zibo City from 2015 to 2019 were collected from Shandong Provincial Management Information System for Chronic Diseases and Cause of Death Surveillance. The meteorological and air pollutant data of the same period were collected from China Meteorological Data Website and ChinaHighAirPollutants dataset. The effect of TCN on the risk of deaths from respiratory diseases was examined using a generalized additive model combined with a distributed lag non-linear model, and subgroup analyses for gender and age were conducted. The disease burden attributed to TCN at different intervals was assessed by calculating attributable fraction. Results: Totally 11 767 deaths from respiratory diseases were reported in Zibo City from 2015 to 2019, including 6 648 males (56.50%) and 5 119 females (43.50%). There were 1 307 deaths aged <65 years (11.11%), and 10 460 deaths aged 65 years and older (88.89%). A monotonically increasing exposure-response relationship was observed between TCN and deaths from respiratory diseases in the general population, females, and the population aged 65 years and older. The 95th percentile of TCN (P95, 3.84 ℃) reached the peak at a cumulative lagged of day 11 (RR=2.063, 95%CI: 1.261-3.376). The results of subgroup analyses showed greater impacts on females and the population aged 65 years and older, with cumulative lagged effects peaking at day 12 (RR=3.119, 95%CI: 1.476-6.589) and day 11 (RR=2.107, 95%CI: 1.260-3.523). The results of attributional risk analysis showed that next-day warming might increase the attributable risk of deaths from respiratory diseases, and next-day cooling might decrease the attributable risk. Conclusion Next-day warming may increase the mortality risk of respiratory diseases, and has greater impacts on females and the population aged 65 years and older.

OBJECTIVETo evaluate the adaptation of different lithium disilicate glass-ceramic crown and whether different fabrication processes affect the adaptation of crowns.

METHODSThirty epoxy dies crowns were divided into 3 groups. They were cemented to domestic lithium disilicate glass-ceramic crowns in Group A, to IPS e.max CAD crowns in Group B and to IPS e.max Press crowns in Group C respectively. All crowns were cut by cutting machine. A confocal laser scanning microscope was used to measure the gap between crown tissue surface and die.

RESULTSThere were significant differences in the three groups of measurement points(P<0.05). Within the groups, specimens in group A showed in the lowest marginal fit([46.8±9.1] μm). Those in group B showed the lowest shoulder suitability([59.3±7.9] μm), axial plane([50.5±3.6] μm) and occlusal surface([87.6±11.6 μm]. Those in group C demonstrated the lowest axial plane angle[(84.4±10.1) μm]. In addition to the axial plane angle, the CAD/CAM system exhibited good accuracy of fit.

CONCLUSIONSThe three groups of lithium disilicate glass-ceramic crowns appeared to have clinically acceptable fit.

Ceramics ; Computer-Aided Design ; Crowns ; Dental Marginal Adaptation ; Dental Porcelain ; Dental Prosthesis Design ; methods ; Humans ; Microscopy, Confocal ; Surface Properties