Objective: To explore the association between nap duration with anxiety and depressive symptoms among junior high school students, in order to provide evidence for mental health interventions for adolescents. Methods: From May to June 2022, a combination of convenience sampling and cluster sampling was used to select 2 491 students from 2 junior high schools in Haizhu District, Guangzhou City for questionnaire survey and physical examination. The questionnaire collected nap duration, night time sleep duration, bedtime, physical activity, and sedentary behavior. Anxiety and depressive symptoms were assessed using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Log-binomial regression model was used to analyze the association of nap duration with anxiety and depressive symptoms, as well as comorbidity among junior high school students, and a restricted cubic spline (RCS) Log-binomial regression model was employed to analyze the non linear relationship after adjusting for covariates. Results: The detection rates of anxiety symptoms, depressive symptoms and comorbidity among junior high school students were 13.29%,14.65%,9.19%. After adjusting for covariates such as age, gender and nighttime sleep duration, compared with a school day nap duration of <30 min/d, a nap duration of 30-<60 min/d was associated with a reduced risk of anxiety symptoms ( APR =0.68, 95% CI =0.49-0.98) and comorbidity ( APR =0.56, 95% CI =0.39-0.87)(both P < 0.05 ). Compared with no napping on weekends, a nap duration of 30-<60 min/d was associated with a reduced risk of anxiety symptoms ( APR =0.62, 95% CI =0.41-0.88), depressive symptoms ( APR =0.52, 95% CI =0.34-0.75) and comorbidity ( APR = 0.52 , 95% CI =0.30-0.83)(all P <0.05). RCS curves showed a nonlinear relationship between weekend nap duration and the prevalence of anxiety, depressive symptoms and comorbidity among junior high school students(all P non linear <0.05); weekend nap duration of <120 min was associated with a lower risk of anxiety and depressive symptoms, and weekend nap duration of >180 min was associated with an increased risk. Conclusions Appropriate nap duration can help reduce the risk of anxiety, depressive symptoms, and the comorbidity among junior high school students. Adolescents should be guided to reasonably arrange nap duration for promoting physical and mental health.

Objective: To map the research landscape of artificial intelligence (AI)-assisted tongue diagnosis through bibliometric analysis and to quantify its diagnostic accuracy and clinical interpretability through a diagnostic test accuracy (DTA) meta-analysis. Methods: For the bibliometric analysis, the Web of Science Core Collection (WoSCC) was queried for English-language articles and reviews on AI-assisted tongue diagnosis published between January 1, 2014 and December 31, 2025, and analysed using Bibliometrix, VOSviewer, and CiteSpace, with major output dimensions including annual publication output and disciplinary distribution, journal and citation characteristics, country/region and institutional collaboration, author networks, keyword co-occurrence, and keyword burst detection. For the DTA meta-analysis, four databases [Scopus, PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI)] were searched in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy (PRISMA-DTA) guidelines. A bivariate random-effects model hierarchical summary receiver operating characteristic (HSROC) was used to pool sensitivity and specificity, with subgroup analyses by disease category, AI model architecture, and sample-size strata. Methodological quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2) tool, and publication bias was evaluated by Deeks’ funnel plot asymmetry test. Results: A total of 198 publications met the bibliometric eligibility criteria. Annual output increased 24.5-fold (from 2 in 2014 to 49 in 2025), with the period 2022 – 2025 alone accounting for 65.2% of all publications. China contributed approximately 83.5% of all institutional affiliations, with Shanghai University of Traditional Chinese Medicine and Jiatuo Xu being the most productive institution and author, respectively. Keyword analysis identified four thematic clusters (AI and deep-learning architectures, image processing and segmentation, traditional Chinese medicine (TCM)-specific applications, and disease-specific applications) and a temporal evolution from traditional machine learning to deep learning and transformer-based, explainable, and multimodal AI architectures. Sixteen DTA meta-analysis studies (14 755 participants) covering metabolic and hepatic disorders, oncological and oral lesions, cardiovascular risk, diabetes, and other clinical applications were included in the DTA meta-analysis. The pooled sensitivity was 90.3% [95% confidence interval (CI): 86.7% – 93.1%] and the pooled specificity was 93.0% (95% CI: 90.6% – 94.7%); the area under the summary receiver operating characteristic (SROC) curve (AUC) was 0.961. Heterogeneity was substantial (I2 = 95.8% for sensitivity; I2 = 92.1% for specificity). Subgroup performance was broadly consistent across disease categories, AI architectures, and sample-size strata, and Deeks’ test indicated no significant publication bias (P = 0.258). Conclusion AI-assisted tongue diagnosis has progressed rapidly and shows pooled diagnostic performance comparable to established screening modalities, supporting its potential as a complementary and easily accessible decision-support tool.

ObjectiveTo investigate the role and mechanism of action of paeoniflorin （PF） in protecting HepG2 cells induced by palmitic acid （PA）. MethodsHepG2 cells were stimulated with PA at a concentration of 250 μmol/L to establish a NAFLD model. Compound C at a concentration of 10 μmol/L was used as an inhibitor， and PF at a concentration of 25 μmol/L was used for intervention. The experiment was divided into normal group （CON group） treated with complete culture medium， model group （MOD group） treated with PA， PF treatment group （MOD+PF group） treated with PA and PF， model+inhibitor group （MOD+COM group） treated with PA and Compound C， and model+inhibitor+PF group （MOD+COM+PF group） treated with PA， Compound C， and PF. Kits were used to measure lipid deposition indicators， liver function parameters， oxidative stress indicators， and inflammation indicators； oil red O staining was used to observe lipid deposition； Western Blot was used to measure the protein expression levels of AMPK， SIRT1， PGC-1α， mTOR， Beclin-1， LC3， and P62 in cells. The one-way analysis of variance was used for comparison of quantitative data between groups， while the Tukey’s test was used for comparison between two groups. ResultsCompared with the MOD group， PF improved the levels of TC and TG （P<0.05）， reduced the levels of ALT， AST， CRP， TNF-α， IL-1β， and IL-6 （P<0.05）， increased the activity of SOD and CAT and the level of GSH， and reduced the level of MDA in cells （all P<0.05）. Oil red O staining showed that PF alleviated lipid deposition in cells. Western blot results showed that compared with the MOD group， PF increased the protein expression levels of p-AMPK， SIRT1， PGC-1α， LC3Ⅱ/LC3Ⅰ， and Beclin-1 and reduced the protein expression levels of p-mTOR and P62 （all P<0.05）. ConclusionPF can inhibit PA-induced oxidative stress and inflammatory response in HepG2 cells， improve lipid deposition， and promote autophagy via the AMPK/SIRT1/PGC-1α/mTOR signaling pathway.

Objectives:This study aims to investigate the incidence,characteristics and clinical outcomes of vagal response(VR)during pulmonary vein isolation(PVI).Methods:A total of 702 patients with nonvalvular atrial fibrillation(AF)who received the first PVI radiofrequency ablation in Central China Fuwai Hospital from January 2022 to December 2023 were consecutively enrolled.PVI was initiated from right superior pulmonary vein(RSPV),followed by other pulmonary veins(PVs).The VR was defined as atrioventricular block(AVB),asystole or a 50%increase in the RR interval.Results:Among 702 patients with AF,380 patients(54.1%)were paroxysmal AF and 322 patients(45.9%)were persistent AF.77 patients(11.0%)developed 81 VR episodes,which were more common in paroxysmal group than in persistent AF group(19.5%vs.0.9%,P<0.001).VR manifestations included 51 sinus arrest(63.0%),26 sinus bradycardia(32.1%),and 4 atrioventricular block(AVB,4.9%).Most VR episodes were observed in the left superior ganglionated plexi(67[82.7%]).Paroxysmal AF(OR=18.667,95%CI:6.638-52.491,P<0.001),body mass index(BMI)≥28.0 kg/m2(OR=2.361,95%CI:1.376-4.051,P=0.002)and left ventricular ejection fraction(LVEF)≥62.0%(OR=1.964,95%CI:1.119-3.447,P=0.019)were independent risk factors of VR.During a mean of(13.0±7.1)months follow up,among paroxysmal AF patients,6 patients(8.1%)with VR and 33 patients(10.8%)without VR experienced AF recurrence(P=0.496).Kaplan-Meier curves estimated that the AF-free survival rate was similar between VR group and non-VR group among paroxysmal AF patients(log-rank P=0.735).Conclusions:The most common sites of VR when initiating PVI from right RSPV occur in left superior ganglionated plexi.Paroxysmal AF,BMI≥28.0 kg/m2 and LVEF≥62.0%are independent risk factors of VR.VR does not affect AF-free survival.

Objective To investigate the value of peripheral blood circRNA9226 combined with tumor markers for the diagnosis of lung adenocarcinoma.Methods A total of 30 patients with lung adenocarcinoma who were admitted to the Affiliated Lihuili Hospital of Ningbo University from December 2022 to January 2023 were selected as case group.Additionally,twenty healthy individuals who underwent physical examinations during the same period were selected as control group.The expression levels of circRNA9226,carcinoembryonic antigen(CEA),carbohydrate antigen(CA)199,and albumin(Alb)were compared between two groups.The diagnostic efficacy of circRNA9226 and CEA for lung adenocarcinoma was evaluated by receiver operating characteristic(ROC)curve,and the correlation between circRNA9226 and other indicators was analyzed.Results The peripheral blood circRNA9226 expression levels in case group was higher than that in control group(P＜0.05).The sensitivity of circRNA9226 and CEA for diagnosing lung adenocarcinoma was 83.3％and 46.7％,respectively,with specificity of 90.0％and 100.0％.Area under the curve(AUC)was 0.897 and 0.776,respectively.When both tests were combined,the sensitivity was 93.3％,accuracy was 92.0％,and AUC was 0.918,showing a significant improvement in both sensitivity and accuracy compared to single tests.The correlation analysis results showed that circRNA9226 was positively correlated with CEA concentration(r=0.371,P＜0.05)and negatively correlated with Alb concentration(r=-0.548,P＜0.05).Conclusion Peripheral blood circRNA9226 has advantages in distinguishing lung adenocarcinoma from healthy controls,and combined with CEA can further improve the diagnostic efficacy.

Objectives:This study aims to investigate the incidence,characteristics and clinical outcomes of vagal response(VR)during pulmonary vein isolation(PVI).Methods:A total of 702 patients with nonvalvular atrial fibrillation(AF)who received the first PVI radiofrequency ablation in Central China Fuwai Hospital from January 2022 to December 2023 were consecutively enrolled.PVI was initiated from right superior pulmonary vein(RSPV),followed by other pulmonary veins(PVs).The VR was defined as atrioventricular block(AVB),asystole or a 50%increase in the RR interval.Results:Among 702 patients with AF,380 patients(54.1%)were paroxysmal AF and 322 patients(45.9%)were persistent AF.77 patients(11.0%)developed 81 VR episodes,which were more common in paroxysmal group than in persistent AF group(19.5%vs.0.9%,P<0.001).VR manifestations included 51 sinus arrest(63.0%),26 sinus bradycardia(32.1%),and 4 atrioventricular block(AVB,4.9%).Most VR episodes were observed in the left superior ganglionated plexi(67[82.7%]).Paroxysmal AF(OR=18.667,95%CI:6.638-52.491,P<0.001),body mass index(BMI)≥28.0 kg/m2(OR=2.361,95%CI:1.376-4.051,P=0.002)and left ventricular ejection fraction(LVEF)≥62.0%(OR=1.964,95%CI:1.119-3.447,P=0.019)were independent risk factors of VR.During a mean of(13.0±7.1)months follow up,among paroxysmal AF patients,6 patients(8.1%)with VR and 33 patients(10.8%)without VR experienced AF recurrence(P=0.496).Kaplan-Meier curves estimated that the AF-free survival rate was similar between VR group and non-VR group among paroxysmal AF patients(log-rank P=0.735).Conclusions:The most common sites of VR when initiating PVI from right RSPV occur in left superior ganglionated plexi.Paroxysmal AF,BMI≥28.0 kg/m2 and LVEF≥62.0%are independent risk factors of VR.VR does not affect AF-free survival.

Objective To investigate the value of peripheral blood circRNA9226 combined with tumor markers for the diagnosis of lung adenocarcinoma.Methods A total of 30 patients with lung adenocarcinoma who were admitted to the Affiliated Lihuili Hospital of Ningbo University from December 2022 to January 2023 were selected as case group.Additionally,twenty healthy individuals who underwent physical examinations during the same period were selected as control group.The expression levels of circRNA9226,carcinoembryonic antigen(CEA),carbohydrate antigen(CA)199,and albumin(Alb)were compared between two groups.The diagnostic efficacy of circRNA9226 and CEA for lung adenocarcinoma was evaluated by receiver operating characteristic(ROC)curve,and the correlation between circRNA9226 and other indicators was analyzed.Results The peripheral blood circRNA9226 expression levels in case group was higher than that in control group(P＜0.05).The sensitivity of circRNA9226 and CEA for diagnosing lung adenocarcinoma was 83.3％and 46.7％,respectively,with specificity of 90.0％and 100.0％.Area under the curve(AUC)was 0.897 and 0.776,respectively.When both tests were combined,the sensitivity was 93.3％,accuracy was 92.0％,and AUC was 0.918,showing a significant improvement in both sensitivity and accuracy compared to single tests.The correlation analysis results showed that circRNA9226 was positively correlated with CEA concentration(r=0.371,P＜0.05)and negatively correlated with Alb concentration(r=-0.548,P＜0.05).Conclusion Peripheral blood circRNA9226 has advantages in distinguishing lung adenocarcinoma from healthy controls,and combined with CEA can further improve the diagnostic efficacy.

Objective:To analyze the distribution and genomic characteristics of SARS-CoV-2 variants isolated from imported cases of COVID-19 in Sichuan Province from December 2022 to January 2023.Methods:This study selected 108 nasal and throat swab samples with fluorescence threshold (Ct)≤32 that were collected from imported COVID-19 cases in Sichuan Province from December 2022 to January 2023. Targeted amplification and Illumina NextSeq? 2000 system were used for whole-genome sequencing. Nextclade and Pangolin online platforms were used to determine the virus genotypes and analyze the mutation loci. A phylogenetic tree was constructed using maximum likelihood.Results:A total of 55 SARS-CoV-2 whole genome sequences with coverage of >95% were obtained, and all of the strains were Omicron variants. Compared with the sequence of reference strain Wuhan-Hu-1, the median number of nucleotide mutation sites of 21L, 22B, 22D, 22E, and 22F genotypes were 93, 75, 92, 78, and 92, and the median number of amino acid mutation sites were 68, 53, 68, 69, and 65, respectively. From December 2022 to January 2023, the predominant circulating SARS-CoV-2 variants from imported cases in Sichuan Province were BA.5.2 (10.91%, 6/55), XBB.1.1 (9.10%, 5/55), BF.7.14 (7.23%, 4/55), and BQ.1.1 (7.23%, 4/55).Conclusions:The distribution of SARS-CoV-2 variants can reflect the global epidemic trend to a certain extent. However, it is different from the distribution of local circulating variants in the Chinese mainland. The XXB variants with transmission advantages can be detected in large numbers of inbound travelers before becoming the predominant circulating strains in the Chinese mainland.

Digital intraoral scanning is a hot topic in the field of oral digital technology.In recent years,digital intra-oral scanning has gradually become the mainstream technology in orthodontics,prosthodontics,and implant dentistry.The precision of digital intraoral scanning and the accuracy and stitching of data collection are the keys to the success of the impression.However,the operators are less familiar with the intraoral scanning characteristics,imaging process-ing,operator scanning method,oral tissue specificity of the scanned object,and restoration design.Thus far,no unified standard and consensus on digital intraoral scanning technology has been achieved at home or abroad.To deal with the problems encountered in oral scanning and improve the quality of digital scanning,we collected common expert opin-ions and sought to expound the causes of scanning errors and countermeasures by summarizing the existing evidence.We also describe the scanning strategies under different oral impression requirements.The expert consensus is that due to various factors affecting the accuracy of digital intraoral scanning and the reproducibility of scanned images,adopting the correct scanning trajectory can shorten clinical operation time and improve scanning accuracy.The scanning trajec-tories mainly include the E-shaped,segmented,and S-shaped methods.When performing fixed denture restoration,it is recommended to first scan the abutment and adjacent teeth.When performing fixed denture restoration,it is recommend-ed to scan the abutment and adjacent teeth first.Then the cavity in the abutment area is excavated.Lastly,the cavity gap was scanned after completing the abutment preparation.This method not only meets clinical needs but also achieves the most reliable accuracy.When performing full denture restoration in edentulous jaws,setting markers on the mucosal tissue at the bottom of the alveolar ridge,simultaneously capturing images of the vestibular area,using different types of scanning paths such as Z-shaped,S-shaped,buccal-palatal and palatal-buccal pathways,segmented scanning of dental arches,and other strategies can reduce scanning errors and improve image stitching and overlap.For implant restora-tion,when a single crown restoration is supported by implants and a small span upper structure restoration,it is recom-mended to first pre-scan the required dental arch.Then the cavity in the abutment area is excavated.Lastly,scanning the cavity gap after installing the implant scanning rod.When repairing a bone level implant crown,an improved indi-rect scanning method can be used.The scanning process includes three steps:First,the temporary restoration,adjacent teeth,and gingival tissue in the mouth are scanned;second,the entire dental arch is scanned after installing a standard scanning rod on the implant;and third,the temporary restoration outside the mouth is scanned to obtain the three-di-mensional shape of the gingival contour of the implant neck,thereby increasing the stability of soft tissue scanning around the implant and improving scanning restoration.For dental implant fixed bridge repair with missing teeth,the mobility of the mucosa increases the difficulty of scanning,making it difficult for scanners to distinguish scanning rods of the same shape and size,which can easily cause image stacking errors.Higher accuracy of digital implant impres-sions can be achieved by changing the geometric shape of the scanning rods to change the optical curvature radius.The consensus confirms that as the range of scanned dental arches and the number of data concatenations increases,the scanning accuracy decreases accordingly,especially when performing full mouth implant restoration impressions.The difficulty of image stitching processing can easily be increased by the presence of unstable and uneven mucosal mor-phology inside the mouth and the lack of relatively obvious and fixed reference objects,which results in insufficient ac-curacy.When designing restorations of this type,it is advisable to carefully choose digital intraoral scanning methods to obtain model data.It is not recommended to use digital impressions when there are more than five missing teeth.

Ulna impingement syndrome is the main cause of wrist ulnar pain.It is caused by repeated impingement between the ulnar bone,triangular fibrocartilage complex,lunate bone and triangular bone,resulting in long-term overload of the ulnar side of wrist,affecting local blood supply and joint lubrication fluid nutrition disorders,and finally causing a series of pathological changes and clinical symptoms of joint degenerative diseases.The main clinical manifestations are pain on the ulnar side of the wrist,which gradually aggravated with repeated strong grasping activities,forearm pronation or ulnar deviation of the wrist.At present,the diagnosis of ulna impingement syndrome mainly depends on the symptoms,physical examination,imaging examination and wrist arthroscopy.Conservative treatment can be selected for ulnar impaction syndrome,but the effect is often poor.Therefore,surgery is still the main treatment.The surgical methods mainly include ulna shortening osteotomy,Wafer,Darrach and Sauvé-Kapandji,and the former two are the most commonly used.This article reviews the progress of diagnosis and treatment of ulna impingement syndrome.