Fungal keratitis represents a significant cause of blindness, with current therapeutic approaches yielding limited success. The disease's onset and progression are primarily driven by fungal virulence factors and the host's immune response. The innate immune system is the first to respond, with neutrophils playing a pivotal role in the antifungal defense. Although neutrophils are critical for pathogen clearance, their excessive or abnormal activation can lead to tissue damage, exacerbating the disease. Thus, elucidating the mechanisms underlying neutrophil activity in fungal keratitis is crucial for refining treatment strategies. This article aims to systematically review the principal antimicrobial mechanisms employed by neutrophils, including phagocytosis, degranulation, and the formation of neutrophil extracellular traps(NETs). Furthermore, it explores the crosstalk between neutrophils and macrophages, alongside their collective impact and underlying mechanisms in the context of fungal keratitis. Exploration of the mechanisms of fungal keratitis facilitates precise intervention and enhances the efficacy of treatment.

This article briefly introduces the new concept of burnout and the new burnout assessment tool BAT. In the past, the most famous burnout definition was proposed by Maslach and Leiter. The Maslach Burnout Inventory (MBI) developed by Maslach has also been the gold standard for evaluating burnout. With the development of burnout research, the concept of burnout has a certain defect. MBI has also been criticized in conceptual, practical and psychological measurement. It may hinder new research, and urgently needs to improve the concept and evaluation of burnout. Therefore, Schaufeli redefined the concept of burnout, and developed a new burnout assessment tool for groups and individuals based on the new concept of burnout-Burnout Assessment Tool (BAT) . This paper systematically reviews the proposal of the new concept of burnout, the development of the BAT scale and its application at home and abroad, and analyzes the advantages and application prospects of the BAT scale.

Objective:To verify the reliability and validity of the short version of the Chinese version of the new Burnout Assessment Tool (12 items version of Burnout Assessment Tool, BAT-12) .Methods:From October to December 2023, the cluster sampling method was adopted, and the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS) and the BAT-12 scale were used simultaneously. A questionnaire survey was conducted among enterprise employees (4329 people) in Shanghai and Guangdong Province. Exploratory factor analysis and confirmatory factor analysis and other methods were employed to analyze its reliability (internal consistency reliability and combination reliability) and validity (structural validity, convergent validity, discriminative validity and criterion validity) .Results:A total of 4329 questionnaires were retrieved, among which 4086 were valid, with an effective recovery rate of 94.39%. The Cronbach's α coefficient of the Chinese version of the BAT-12 total scale was 0.956, and the combination reliability coefficients of each dimension ranged from 0.914 to 0.952. The scale contained 12 items, and 4 common factors were extracted from exploratory factor analysis, including exhaustion, mental distance, cognitive impairment, and emotional impairment. The cumulative variance contribution rate reached 86.63%. Confirmatory factor analysis showed that both the four-factor correlation model and the second-order model were ideally fitted overall, with the four-factor correlation model having the best data fit (comparative fit index 0.972, Tuker-Lewis fit index 0.962, root mean square error of approximation 0.064, and standardized root mean square residual 0.033). The average variance extracted (AVE) of each dimension of the scale ranged from 0.780 to 0.868, and the square roots of AVE (0.883 to 0.932) were all greater than their Pearson correlation coefficients (0.630 to 0.850). The Pearson correlation coefficient between BAT-12 and MBI-GS was 0.787 ( P<0.001) . Conclusion:The Chinese version of the BAT-12 scale demonstrates strong internal consistency and combination reliability, with excellent reliability. Its four-dimensional structure validity has been validated, with good convergent validity, discriminative validity, and ideal criterion validity, demonstrating excellent validity. The Chinese version of the BAT-12 scale can be used to measure the level of occupational burnout among Chinese employees.

This article briefly introduces the new concept of burnout and the new burnout assessment tool BAT. In the past, the most famous burnout definition was proposed by Maslach and Leiter. The Maslach Burnout Inventory (MBI) developed by Maslach has also been the gold standard for evaluating burnout. With the development of burnout research, the concept of burnout has a certain defect. MBI has also been criticized in conceptual, practical and psychological measurement. It may hinder new research, and urgently needs to improve the concept and evaluation of burnout. Therefore, Schaufeli redefined the concept of burnout, and developed a new burnout assessment tool for groups and individuals based on the new concept of burnout-Burnout Assessment Tool (BAT) . This paper systematically reviews the proposal of the new concept of burnout, the development of the BAT scale and its application at home and abroad, and analyzes the advantages and application prospects of the BAT scale.

Objective:To verify the reliability and validity of the short version of the Chinese version of the new Burnout Assessment Tool (12 items version of Burnout Assessment Tool, BAT-12) .Methods:From October to December 2023, the cluster sampling method was adopted, and the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS) and the BAT-12 scale were used simultaneously. A questionnaire survey was conducted among enterprise employees (4329 people) in Shanghai and Guangdong Province. Exploratory factor analysis and confirmatory factor analysis and other methods were employed to analyze its reliability (internal consistency reliability and combination reliability) and validity (structural validity, convergent validity, discriminative validity and criterion validity) .Results:A total of 4329 questionnaires were retrieved, among which 4086 were valid, with an effective recovery rate of 94.39%. The Cronbach's α coefficient of the Chinese version of the BAT-12 total scale was 0.956, and the combination reliability coefficients of each dimension ranged from 0.914 to 0.952. The scale contained 12 items, and 4 common factors were extracted from exploratory factor analysis, including exhaustion, mental distance, cognitive impairment, and emotional impairment. The cumulative variance contribution rate reached 86.63%. Confirmatory factor analysis showed that both the four-factor correlation model and the second-order model were ideally fitted overall, with the four-factor correlation model having the best data fit (comparative fit index 0.972, Tuker-Lewis fit index 0.962, root mean square error of approximation 0.064, and standardized root mean square residual 0.033). The average variance extracted (AVE) of each dimension of the scale ranged from 0.780 to 0.868, and the square roots of AVE (0.883 to 0.932) were all greater than their Pearson correlation coefficients (0.630 to 0.850). The Pearson correlation coefficient between BAT-12 and MBI-GS was 0.787 ( P<0.001) . Conclusion:The Chinese version of the BAT-12 scale demonstrates strong internal consistency and combination reliability, with excellent reliability. Its four-dimensional structure validity has been validated, with good convergent validity, discriminative validity, and ideal criterion validity, demonstrating excellent validity. The Chinese version of the BAT-12 scale can be used to measure the level of occupational burnout among Chinese employees.

Fungal keratitis is a serious blinding eye disease. The development of fungal infections depends primarily on the interaction of fungal virulence with host immune defense factors. The cornea is considered an immune-privileged organ, and resident macrophages are the main immune cells that respond to the heterogeneity exhibited by the microenvironment with their polarization. In the early stage of infection, macrophages polarize towards M1, which promotes inflammation and facilitates fungal clearance but produces a cellular storm that exacerbates immune damage; in the late stage of infection, macrophages polarize towards M2, which suppresses the inflammatory response and facilitates tissue repair, but may be immunosuppressed or even immune escape to the detriment of pathogen clearance. The balance between pro-inflammatory and anti-inflammatory responses is key to maintaining the functional integrity of the cornea. Current antifungal drug therapy is limited, so it is particularly important to find a therapeutic target for the inflammatory response triggered by the immune response in addition to antifungal therapy. In this review, the functional and phenotypic characterization of macrophage subsets associated with fungal keratitis was reviewed, more in-depth research is needed to explore the specific mechanisms by which macrophage polarization and their impact on fungal keratitis. Targeted regulation of macrophage differentiation based on their phenotype and function could be an effective approach to treat and manage fungal keratitis in the future.

Objective    To retrospectively analyze the surgical treatment of Stanford type A aortic dissection after coronary artery stenting, and to explore the surgical techniques and surgical indications. Methods    Clinical data of 1 246 consecutive patients who underwent operations on Stanford type A aortic dissection from April 2016 to July 2019 in Beijing Anzhen Hospital were retrospectively analyzed. Patients with Stanford type A aortic dissection after coronary artery stenting were enrolled. Results    Finally 19 patients were collected, including 16 males and 3 females with an average age of 54±7 years ranging from 35 to 66 years. There were 11 patients in acute phase, 15 patients with AC (DeBakey Ⅰ) type and 4 patients with AS (DeBakey Ⅱ) type. In AC type, there were 10 patients receiving Sun's surgery and 5 patients partial arch replacement. Meanwhile, coronary artery bypass grafting was performed in 7 patients and mitral valve replacement in 1 patient. Stents were removed from the right coronary artery in 4 patients. In this group, 1 patient died of multiple organ failure in hospital after operation combined with malperfusion of viscera. Eighteen patients recovered after treatment and were discharged from hospital. The patients were followed up for 30 (18-56) months. One patient underwent aortic pseudoaneurysm resection, one thoracic endovascular aortic repair, one emergency percutaneous coronary intervention due to left main artery stent occlusion, and one underwent femoral artery bypass due to iliac artery occlusion. Conclusion    Iatrogenic aortic dissection has a high probability of coronary artery bypass grafting at the same time in patients with Stanford type A aortic dissection after coronary artery stenting. Complicated type A aortic dissection after percutaneous coronary intervention should be treated with surgery aggressively.

Objective To analyze the influence of HIV drug resistance genotypes on the outcomes of antiretroviral treatment in AIDS patients.Methods A total of 499 AIDS patients were included as the research subjects.Drug resistance genotypes were detected and compared with the database.Simultaneously,viral load and the absolute counts of CD4+lymphocyte were measured.The genotypes of drug resistance and effects of clinical treatment were analyzed.Results Among the 499 cases studied,409 samples were successfully amplified and sequenced,and 181 cases occurred drug resistance.The patients with drug resistance were significantly older than those without drug resistance,and their CD4+absolute cell counts were significantly lower.Nucleoside reverse transcriptase inhibitors(NR-TI)and non-nucleoside reverse transcriptase inhibitors(NNRTIs)were more likely to develop high-level drug resistance compared to protease inhibitors(PI).Additionally,drug-resistant patients had higher viral loads.Conclusion The overall incidence of drug resist-ance in AIDS patients in Nanjing area is relatively low,but the proportion of multidrug-resistant and highly resistant patients among those with drug resistance is relatively high.During diagnosis and treatment,clinical indicators should be monitored,and antiretroviral treatment plans should be adjusted in a timely manner with preference given to the antiretroviral drugs with high resistance barriers.

Background Under the backdrop of the national innovation-driven development strategy, the increasing occupational stress and job burnout among employees are noteworthy for their impact on employees' subjective well-being. Objective To clarify the status, distribution characteristics, and the relationship between subjective well-being, occupational stress, and job burnout of employees in research and development (R&D) enterprises, in order to improve their subjective well-being. Methods A total of 3366 employees from R&D departments at 7 enterprises in Minhang District of Shanghai were selected. The well-being level of the research subjects was investigated by using the World Health Organization Well-Being Index (WHO-5) that yielded total scores from 0 to 25, and a higher total score indicated a higher well-being level; the levels of occupational stress and job burnout were investigated by using the Chinese version of the Job Content Questionnaire, and the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS). The scores of WHO-5, JDC, and MBI-GS were incorporated into structural equation modeling (SEM) as numerical variables to analyze their relationship. Results The scores of subjective well-being, occupational stress, and job burnout of employees in the R&D enterprises were 13.30±6.09, 1.12±0.45, and 2.18±1.12, respectively. The positive rates of occupational stress and job burnout were 44.4% and 70.9% respectively, and the positive rate of severe job burnout was 11.7%. There were statistically significant differences in the score of subjective well-being among the participants by gender, age, educational level, marital status, registered residence, working seniority, and jobs (P<0.05); there were statistically significant differences in the positive rate of occupational stress by gender, educational level, marital status, working seniority, and jobs (P<0.05); there were statistically significant differences in the positive rate of job burnout by gender, age, educational level, marital status, registered residence, working seniority, and jobs (P<0.05). There was a negative correlation between subjective well-being and occupational stress (r=−0.1747, P < 0.01), a negative correlation between subjective well-being and job burnout (r=−0.2987, P < 0.01), and a positive correlation between occupational stress and job burnout (r=0.3342, P < 0.01). A structural equation containing partial mediating effect of job burnout on the relationship between occupational stress and subjective well-being was established, and the partial effect accounting for 52.5% of the total effect. Conclusion The job burnout among employees in R&D companies partially mediates the impact of occupational stress on subjective well-being. Reducing the level of job burnout will help alleviate occupational stress and thus improve employees' subjective well-being.

Background/Aims: To evaluate the causal correlation between complement components and non-viral liver diseases and their potential use as druggable targets. Methods: We conducted Mendelian randomization (MR) to assess the causal role of circulating complements in the risk of non-viral liver diseases. A complement-centric protein interaction network was constructed to explore biological functions and identify potential therapeutic options. Results: In the MR analysis, genetically predicted levels of complement C1q C chain (C1QC) were positively associated with the risk of autoimmune hepatitis (odds ratio 1.125, 95% confidence interval 1.018–1.244), while complement factor H-related protein 5 (CFHR5) was positively associated with the risk of primary sclerosing cholangitis (PSC;1.193, 1.048– 1.357). On the other hand, CFHR1 (0.621, 0.497–0.776) and CFHR2 (0.824, 0.703–0.965) were inversely associated with the risk of alcohol-related cirrhosis. There were also significant inverse associations between C8 gamma chain (C8G) and PSC (0.832, 0.707–0.979), as well as the risk of metabolic dysfunction-associated steatotic liver disease (1.167, 1.036–1.314). Additionally, C1S (0.111, 0.018–0.672), C7 (1.631, 1.190–2.236), and CFHR2 (1.279, 1.059–1.546) were significantly associated with the risk of hepatocellular carcinoma. Proteins from the complement regulatory networks and various liver diseaserelated proteins share common biological processes. Furthermore, potential therapeutic drugs for various liver diseases were identified through drug repurposing based on the complement regulatory network. Conclusions Our study suggests that certain complement components, including C1S, C1QC, CFHR1, CFHR2, CFHR5, C7, and C8G, might play a role in non-viral liver diseases and could be potential targets for drug development.