Objective To assess the situation and influencing factors of occupational burnout among the staff at the Center for Disease Control and Prevention (CDC) in Sichuan Province. Methods A total of 1 038 CDC staff members in Sichuan Province were selected as the study subjects using the stratified random sampling method. Occupational burnout of the staff was assessed using the Maslach Burnout Inventory General Survey via an online questionnaire. Results The detection rate of occupational burnout was 42.3% (439/1 038). Binary logistic regression analysis result showed that, after controlling for confounding factors such as education level and alcohol consumption, CDC staffs aged at 20-<31, 31-<41, and 41-<51 years were at higher risk of occupational burnout compared with those ≥51 years (all P<0.05). CDC staffs with 5-<10 or ≥10 years of service had higher occupational burnout risk compared with those with <5 years (both P<0.05). CDC staffs with poor or fair health status, irregular diet, and poor sleep quality had higher risk of occupational burnout compared with those healthy, have regular diet, and good sleep quality (all P<0.05). The risk of occupational burnout increased with higher overtime frequency (all P<0.05). Conclusion Occupational burnout among CDC staffs in Sichuan Province is relatively high. Age, years of service, health status, diet, sleep quality, and overtime frequency are key influencing factors.

Objective:To investigate the brain functional connectivity and network of patients with bipolar depression (BD) during emotion recognition, and to assess the correlation of brain functional indicators with clinical data.Methods:From August 2023 to September 2024, a total of 34 BD patients and 35 healthy controls were recruited for the study. The 17-item Hamilton depression scale(HAMD-17) and the Hamilton anxiety scale (HAMA) were used to assess the depression and anxiety symptoms of BD patients. While all the participants performed the emotion recognition task, a functional near-infrared spectroscopy (fNIRS) with 52 channels was utilized to collect their oxyhemoglobin concentrations in dorsolateral prefrontal cortex (DLPFC), medial prefrontal cortex (mPFC), and temporal lobe (TL). Brain functional indicators, including brain functional connectivity(BFC) and brain functional network (BFN) parameters, were extracted using fNIRS analysis algorithms. SPSS 26.0 software was used to perform t-test, Wilcoxon rank sum test, chi-square test, Pearson correlation and multiple linear regression analysis. Results:The emotion recognition accuracy of BD patients ((69.40±18.32) %) was lower than that of healthy controls ((76.94±6.09)%)( t=-2.13, P=0.036), and the average spending time ((4.00±1.78) s) of BD patients was longer than that of healthy controls ((2.69±1.27) s) ( t=-2.81, P=0.007). The BFC values of right DLPFC-right mPFC, right DLPFC-left TL, right DLPFC-left mPFC, right TL-right mPFC, right TL-left TL, right TL-left mPFC, right mPFC-left DLPFC, and right mPFC-left mPFC, the clustering coefficient, and small-world coefficient of BD patients were lower than those of healthy controls (all P<0.05).The characteristic path length of BD patients was higher than that of healthy controls ( t=1.27, P<0.05). For BD patients, the total score of HAMD-17 were significantly and negatively correlated with the clustering coefficient, small-world coefficients, and BFC values of right DLPFC-left mPFC and right mPFC-left DLPFC ( r=-0.45--0.27, all P<0.05).The total score of HAMA was significantly and positively correlated with the BFC value of right DLPFC-left mPFC ( r=0.30, P<0.05). The results of multiple linear regression analysis showed that the clustering coefficient ( β=-0.12, t=-0.69, P=0.009), small-world coefficients ( β=-0.22, t=-1.05, P=0.013), and BFC values of right DLPFC-left mPFC ( β=-0.47, t=-2.29, P=0.030) and right mPFC-left DLPFC( β=-0.20, t=-0.90, P=0.010) were influencing factors of depressive symptoms in BD patients. The BFC value of right DLPFC -left mPFC ( β=0.37, t=2.36, P=0.026) was influencing factor for anxiety symptoms in BD patients. Conclusions:There are abnormalities in some BFC values and BFN parameters in the DLPFC, mPFC, and TL brain regions during the emotional recognition task, which are related to the clinical symptoms. The abnormalities may be associated with the emotional recognition deficits in BD patients. These findings may provide theoretical guidance for the development of clinical intervention strategies for BD patients.

Objective To investigate the effects of eicosanoic acid(C20DC)on the proliferation and migration of human retinal endothelial cells(HRECs)and its mechanism.Methods The optimal working concentration of C20DC in human retinal pigment epithelium 19(ARPE-19)cells and HRECs was determined as 30 mg·L-1 and 25 mg·L-1,respec-tively.HRECs were divided into the C20DC treatment group(HRECs treated with C20DC)and the control group[HRECs treated with dimethyl sulfoxide(DMSO)].The effects of C20DC on the migration and proliferation of HRECs were detec-ted by cell proliferation and migration experiments.The molecular docking method was used to simulate the binding ability of C20DC to peroxisome proliferator-activated receptor δ(PPARδ).ARPE-19 cells were divided into the C20DC+ARPE-19 group(ARPE-19 cells treated with C20DC)and the DMSO+ARPE-19 group(ARPE-19 cells treated with DMSO).The ex-pression levels of PPARδ and angiopoietin-like protein 4(ANGPTL4)in ARPE-19 cells and ANGPTL4 protein in HRECs were detected using Western blot.The ANGPTL4 protein expression levels in ARPE-19 cells and HRECs were quantitatively analyzed using enzyme-linked immunosorbent assay(ELISA).Results Compared with the control group,the prolifera-tion and migration of cells in the C20DC treatment group significantly increased(both P＜0.05),and C20DC could stably bind to PPAR8(binding energy:-7.20 kcal·mol-1).Western blot showed that the expression level of ANGPTL4 protein in the C20DC+ARPE-19 group was higher than that in the DMSO+ARPE-19 group,and the difference was statistically sig-nificant(P＜0.05);there was no statistically significant difference in the expression level of PPARδ receptor protein be-tween the two groups(P＞0.05).The expression level of ANGPTL4 protein in the C20DC treatment group was higher than that in the control group,and the difference was statistically significant(P＜0.05).ELISA quantitative analysis showed that the expression level of ANGPTL4 in the C20DC+ARPE-19 group was higher than that in the DMSO+ARPE-19 group(P＜0.001);the expression level of ANGPTL4 in the C20DC treatment group was higher than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion C20DC can promote the expression of ANGPTL4 pro-tein by binding to PPARδ and thus increase the proliferation and migration of retinal related cells(HRECs and ARPE-19 cells).Its mechanism may be related to the increased angiogenesis in retinopathy of prematurity.

Objective To investigate the efficacy and safety of intravenous thrombolysis with low-dose and standard-dose recombinant tissue plasminogen activator(rt-PA)in the elderly patients(aged over 80 years)with acute ischemic stroke(AIS).Methods A total of 201 elderly patients with AIS treated at Tianjin Fourth Central Hospital from February 2019 to February 2023 were prospectively included and randomly assigned to the rt-PA low-dose group(n=93,0.6 mg/kg)and rt-PA standard-dose group(n=108,0.9 mg/kg).The incidence of intra-cranial hemorrhage,symptomatic intracranial hemorrhage,fatal intracranial hemorrhage,neurologic deterioration within 7 days and mortality within 90 days were observed to evaluate the safety.The neurologic improvement rate and good prognosis rate at 90 days were used to evaluate the effectiveness.A stratified analysis of 90-day outcomes was performed based on stroke severity and age.Results The incidence of intracranial hemorrhage,symptomatic intracranial hemorrhage and fatal intracranial hemorrhage within 7 days in rt-PA low-dose group was lower than that in rt-PA standard-dose group(P＜0.05).There were no statistically significant differences between the two groups concerning the residual safety index and the effectiveness index.The 90-day good prognosis rate of moderate stroke sub-group and of≥90 years of age sub-group in rt-PA low-dose group were both higher than that of rt-PA standard-dose group(P＜0.05).Conclusions For AIS patients with moderate stroke and aged over 90 years,intravenous thrombolytic therapy with rt-PA 0.6 mg/kg is recommended.

Objective This study aimed to use platinum resistance-related(PRR)genes to classify ovarian cancer(OV)patients and establish a prognostic risk model,in order to provide reference for individualized clinical treatment and related mechanism research of OV patients.Methods The univariate Cox regression was used to screen PRR genes with prognostic value,unsupervised consensus clustering was used for subtyping,and the prognostic differences were compared between subtypes.LASSO regression analy-sis was used to further screen prognosis related PRR genes and construct platinum resistance related gene scores(PRR-GS),com-bined with clinical information,constructed a prognostic risk model for OV patients,and validated it.Results Univariate Cox regres-sion analysis identified 68 platinum resistance related genes that were associated with patient prognosis.Unsupervised consensus clus-tering identified 2 subtypes of OV,with C1 group patients having a better prognosis.Twelve genes were used to construct prognostic markers for PRR genes score,and the area under the ROC curves at 1,3,and 5 years were all above 0.700.Age,stage,and PRR-GS were independent factors affecting prognosis in multivariate Cox regression analysis.The model's C-index was 0.719,and the areas under the ROC curves for 1-year,3-year,and 5-year overall survival rates were 0.774,0.758,and 0.768,respectively.The calibra-tion curve and decision curve analysis showed that the model had good predictive performance.Conclusion Two subtypes of OV pa-tients were identified,each with differences in immune microenvironment,prognosis,and other aspects.The platinum resistance gene prognostic score is an independent risk factor,and when combined with clinical variables,it can effectively predict patient survival out-comes.

Objective:To construct the risk control operation and maintenance management system of TiRobot Recon navigation system of Tianji orthopedic robot(hereinafter referred to as the risk control operation and maintenance management system)and to analyze the application effect,so as to provide theoretical guidance and reference for improving the clinical service effect and quality of Tianji orthopedic robot.Methods:By reviewing the literature and summarizing clinical practice experience,the risk critical control points of the TiRobot Recon navigation system were clarified,and the risk control operation and maintenance management system was constructed based on this.The management effect of TiRobot Recon navigation system before the implementation of system(January 2022 to December 2022)and after the implementation(January 2023 to December 2023)was compared.Results:After the implementation of the risk control operation and maintenance system,the average daily use time,expected target compliance rate,system risk event reporting accuracy,risk early warning timeliness and risk event data standardization of TiRobot Recon navigation system were higher than before the implementation,and the system failure standby time and failure rate were lower than those before the implementation,and the difference was statistically significant(t=6.956,9.656,5.415,4.678,3.711,3.354,5.229,P<0.05).After the implementation of the risk control operation and maintenance system of sub-line control,the scores of daily maintenance,pre-use inspection,post-use cleaning,system operation,fault response,emergency treatment and other operation proficiency scores of the TiRobot Recon navigation system were higher than those before the implementation,and the difference was statistically significant(t=4.225,2.399,2.385,2.597,2.421,3.560,P<0.05).Conclusion:The use of risk control operation and maintenance platform can improve the use effect of TiRobot Recon navigation system,strengthen the operation proficiency of personnel,with obvious advantages in clinical application and promotion value.

Acute ischemic stroke (AIS) is a kind of central nervous system disease that seriously threatens human health and life. Current treatment for AIS is mainly reperfusion. However, the time-sensitive of reperfusion limits its clinical application, and a considerable part of patients within the time window cannot achieve the expected effect after reperfusion; related complications of reperfusion have not been completely solved. So far, some clinical trials have confirmed that neuroprotectants are useful supplements and adjuncts to reperfusion. This paper reviews the recent advance in neuroprotectants combined with reperfusion in AIS to provide references for AIS treatment.

ObjectiveTo investigate the acute effects of compound air pollution on children’s respiratory function. MethodsUsing panel group study design， 223 students in five classes of grade 4 from two primary schools （a， b） in Xuhui and Hongkou districts of Shanghai were randomly selected to measure pulmonary function and exhaled nitric oxide （FeNO）. The first three tests were carried out from May to June in 2020， and the fourth test was carried out from September to December in 2021. At the same time， the daily and hourly mean values of PM_2.5， PM₁₀， SO₂， NO₂， O₃ and CO was collected from the nearby air quality monitoring points of the two schools during the same period ， as well as meteorological monitoring data （temperature， humidity， wind speed and atmospheric pressure）. The linear mixed effect model was used to analyze the effects of air pollution on pulmonary function and respiratory inflammation in the summer. ResultsThe results of single pollutant model showed that PM_2.5， PM_10， SO₂ and NO₂ were positively correlated with FeNO， and the effect was reflected in lag0， lag1 and lag3 （P<0.05）. PM_2.5， PM₁₀ and NO₂ were negatively correlated with the changes of lung function FEF_25%， FEF_50%， FEF_75%， FeF_25%-75%， PEF， FVC， FEV1 and FEV1/FVC， and the effect was reflected in lag0 to lag3 days （P<0.05）. The results of the dual pollutant model showed that the concentration changes of SO₂ and NO₂ were significantly correlated with the decrease of FEV1 when combined with O₃ or PM_2.5 （P<0.01）， and the concentration changes of PM_2.5 was significantly correlated with the increase of FeNO when O₃， SO₂ and NO₂ were combined respectively （P<0.01）. The effects of the dual pollutant model were greater than the effect of PM_2.5 single pollutant model. ConclusionThe health effects of different air pollutants on children’s respiratory tract function indexes in summer are different. The combined effects of two pollutants on the lung function of children increased to different degrees. Although air pollution is light in summer， it still has an impact on children’s respiratory tract function index and inflammation index， and the combined effect of dual pollutants is more significant than that of single pollutant.

Objective:To explore the effects of hyperoxic environments on renal metabolites to understand the potential mechanisms that contribute to pathologic retinal vascular neovascularization and renal injury through metabolomic studies in a mouse model of oxygen-induced retinopathy (OIR) model.Methods:Sixteen C57/B6J mice pups born to day 7 (P7) were randomly and equally divided into an OIR model group and a normal control group using a randomized numerical table of mother mice.Mice were reared standardly from birth until day 7 (P7), then mice and their mother mice in the OIR group were placed in a hyperoxic (75±2)% chamber until day 12 (P12) and then reared normally.Mice in the normal control group were reared normally throughout.Mice in two groups were killed by carbon dioxide euthanasia on postnatal day 17 (P17). The mice retinal wholemount from the two groups were made and stained with isolectin B4 (IB4) to observe the morphology of retinal vessels, central non-perfusion area and pathological neovascularization.The kidney tissue of P17 mice was analyzed by liquid chromatograph mass spectrometer.After anticoagulant treatment, the whole blood of mice was centrifuged and precipitated, and the obtained plasma without cellular components was analyzed by targeted metabonomics.Mass spectral information was interpreted using metabolomics data processing software Progenesis QI v2.3.Overall differences in metabolic profiles were distinguished by unsupervised principal component analysis and orthogonal partial least squares analysis (OPLS-DA). The fold change and P values of metabolites were compared between the two groups.The variable importance of projection value>1 and P value<0.05 was used to screen out differential metabolites.Metabolic pathway enrichment analysis of differential metabolites was performed based on the KEGG database.The feeding and use of animals were strictly in accordance with the requirements of the Ethics Committee of Jinan University, and the research protocol was reviewed and approved by the Ethics Committee of Jinan University (No.20200401-54). Results:The IB4 staining of retinal wholemounts showed that the retinal blood vessels were evenly distributed in the P17 mice from control group.The peripheral retinal vessels were tortuous and disordered with a large non-perfusion area in central region in P17 mice from OIR group, and a large number of neovascularization clusters were formed at the junction of the nonperfusion area and the vascular area of the retina, showing strong fluorescent staining.The relative area of retinal nonperfusion area in OIR group was (25.16±3.50)%, which was significantly larger than (0.63±0.30)% in normal control group ( t=12.07, P<0.001). The OPLS-DA parameter R2X cum (0.578), interpretation rate R2Y cum (0.978) and prediction rate Q2 cum (0.857) values were all greater than 0.5, indicating that the OPLS-DA model had a good predictive ability.A total of 26 main differential metabolites were found, among which 17 were up-regulated and 9 were down-regulated, including glycerophospholipids (PC 20∶4(5Z, 8Z, 11Z, 14Z)/0∶0, PC 22∶6(4Z, 7Z, 10Z, 13Z, 16Z, 19Z)/0∶0, PC 14∶1(9Z)/20∶2(11Z, 14Z), PE P-18∶0/20∶4(6E, 8Z, 11Z, 14Z)(5OH[S]), amino acid metabolites (arginine, ornithine, pipecolic acid, and hydroxylysine), purines (guanine, hypoxanthine, hydroxypurinol), and fatty acids (methyl 15-palmitate, 2, 6, 8, 12-tetramethyl-2, 4-tridecadien-1-ol), and so on.Differential metabolites were mainly enriched in ABC transporters (L-arginine, taurine, inositol, adenosine, N-acetyl-D-glucosamine, L-glutamine), aminoacyl-tRNA biosynthesis (L-isoleucine, L-proline, L-arginine, L-histidine, L-glutamine), arginine biosynthesis (L-arginine, L-ornithine, L-glutamine) metabolic pathways.The plasma targeted metabonomics showed that the differential amino acid metabolites were mainly enriched in metabolic pathways such as aminoacyl-tRNA biosynthesis, arginine biosynthesis and metabolism, and ABC transporters. Conclusions:ABC transporter, aminoacyl-tRNA biosynthesis, and arginine biosynthesis metabolic pathways in OIR mice may participate in the pathological changes of renal injury and neovascularization in retinopathy of prematurity.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.