Background Job burnout and depressive symptoms are prevalent among occupational populations, with a close relationship between them. Sleep quality, as a potential mediating factor, significantly affects the mental health of workers. Objective To explore the relationship between job burnout, sleep quality, and depressive symptoms, and determine whether sleep quality mediates the relationship between job burnout and depressive symptoms. Methods From April 25 to May 1, 2024, this study employed cluster sampling to conduct a questionnaire survey among individuals engaged in various occupations across five cities in the Ningxia Hui Autonomous Region. The questionnaires included socio-demographic information, as well as the Chinese Maslach Burnout Inventory (CMBI), the Pittsburgh Sleep Quality Index (PSQI), and the Patient Health Questionnaire-9 (PHQ-9) for assessing burnout, sleep quality, and depressive symptoms, respectively. Out of the 4106 questionnaires distributed, a total of 3837 questionnaires were valid, and the valid recovery rate was 93.45%. The distribution among demographic variables in burnout, sleep quality and depressive symptoms were statistically analyzed. A binary logistic regression model was used for multifactor correlation analysis; Pearson correlation was used to test the correlation between burnout, sleep quality, and depressed mood. Modelling and mediated effect path mapping were performed using Amos 24.0 software. Results The postive rate of occupational burnout in the workers was 97.49% (3741/3837), the positive rate of poor sleep quality was 66.77% (2526/3837), and the positive rate of depressive symptoms was 75.68% (2904/3837). There were statistically significant differences in depressive symptoms by ages, shift types, working years, marital status, smoking habits, drinking habits, and exercising frequency (P < 0.05). The logistic model indicated that working years, drinking habits, job burnout, and overall sleep quality were significant factors influencing the occurrence of depressive symptoms (P < 0.05). The correlation analysis revealed positive correlations between depressive symptom scores and job burnout scores (r=0.045, P < 0.01), between depressive symptom scores and sleep quality scores (r=0.480, P < 0.01), and between job burnout scores and sleep quality scores (r=0.054, P < 0.01). Furthermore, the indirect effect of job burnout on depressive symptoms through sleep quality was 0.100 (95%CI: 0.204, 0.252; P < 0.01). Conclusion Job burnout and sleep quality are significant factors associated with the occurrence of depressive symptoms among occupational populations, and sleep quality plays a partial mediating role in depressive symptoms associated with job burnout. This finding may provide a scientific basis for developing intervention strategies to control depressive symptoms among workers.

Mitochondria are the main site of energy metabolism within cells,generating a substantial amount of ATP to supply energy to the human body.Research has shown that alterations in mitochondrial structure and function exist in individuals with schizophrenia,suggesting their potential impact on the onset of psychiatric disorders and clinical treatment efficacy.Therefore,understanding the research progress on the genetic mechanisms,pathological processes,image manifestations of schizophrenia and mitochondrial quality control,and summarizing the relevant evidence of mitochondrial-related targets as potential therapeutic targets for schizophrenia,can provide references for further research.

After years of development,the advantages of computer-assisted orthognathic surgery have been widely recognized.However,the clinical application of this technology is challenging.Each step may generate errors from data acquisition,computer-assisted diagnosis,and computer-assisted surgical design,causing errors to be transferred from the virtual surgical plan to the operation.The accumulation and amplification of errors will affect the final surgical ef-fect.Currently,digital devices,such as intraoral scanners,are being explored for error control,utilizing automation methods and algorithms,and implementing personalized bone positioning methods.Moreover,there are still many prob-lems that have not been fully resolved,such as precise simulation of postoperative soft tissue,functional assessment of mandibular movement,and absorbable internal fixation materials.Fully understanding computer-assisted orthognathic surgery's limitations could provide direction for optimizing existing methods while helping clinicians avoid risks and maximize its advantages to achieve the best outcome.Many emerging and cutting-edge technologies,such as personal-ized titanium plates,artificial intelligence,and surgical robots,will further promote the development of this discipline.We can expect future optimization of digital orthognathic surgical technology by innovations in automation,intelligence,and personalization.

Schizophrenia is a common chronic mental disorder.Cognitive dysfunction is one of its core symptoms,which severely affects the social functioning of patients.Currently,antipsychotic medication treatments have poor efficacy in improving cognitive functions.Recent studies have found that metformin can improve cognitive dysfunction in patients with schizophrenia.However,the mechanism of action remains unclear.This review summarizes the therapeutic effects of metformin on cognitive dysfunction in schizophrenia patients such as improving insulin resistance,repairing neuronal damage,regulating neuroimmunity,and combating oxidative stress,thereby providing new insights for the treatment of cognitive dysfunction in schizophrenia.

Antipsychotic medications are commonly used to treat schizophrenia,but they can have negative effects on lipid metabolism,leading to an increased risk of cardiovascular diseases,reduced life expectancy,and difficulties with treatment adherence.The specific mechanisms by which antipsychotics disrupt lipid metabolism are not well understood.Sterol regulatory element-binding proteins(SREBPs)are important transcriptional factors that regulate lipid metabolism.Proprotein convertase subtilisin/kexin type 9(PCSK9),a gene regulated by SREBPs,plays a critical role in controlling levels of low-density lipoprotein cholesterol(LDL-C)and has become a focus of research on lipid-lowering drugs.Recent studies have shown that antipsychotic drugs can affect lipid metabolism through the SREBP/PCSK9 pathway.A deep understanding of the mechanism for this pathway in antipsychotic drug-related metabolic abnormalities will promote the prevention of lipid metabolism disorders in patients with schizophrenia and the development and application of new drugs.

Objective:To investigate the association between plasma uric acid and hypertension and the gender difference in community-dwelling middle-aged and elderly population.Methods:A community-based cross-sectional study was conducted in Beijing Tongzhou Yongshun Community Health Service Center from June to December 2021, among residents aged 45 years or older selected by cluster sampling method. According to plasma uric acid (UA) level in quartiles, the subjects were divided into 4 groups; and stratified by gender, the subjects were further divided into subgroups. Multivariate logistic regression model was used to analyze the related factors of hypertension, and restricted cubic spline fitting logistic regression model was used to analyze the nonlinear association between uric acid and hypertension and the cut-off values of uric acid.Results:A total of 6 229 residents with the age of (63.2±7.3) years were enrolled in the study. In 1 874 male participants (30.1%), 946 participants (50.5%) had hypertension, and the uric acid level was 359 (309, 418)μmol/L; in 4 355 female participants (69.9%), 2 003 participants (46.0%) had hypertension, and the uric acid level was 306 (261, 359)μmol/L. Multivariate logistic regression analysis showed that after adjusting for factors that were statistically significant in univariate analyses or potentially clinically relevant (including age, body mass index, diabetes mellitus, coronary heart disease, cerebrovascular disease, albumin, estimated glomerular filtration rate, and cholesterol), uric acid was independently associated with hypertension ( P<0.001), for total participants the risk of hypertension in Q4 group was 1.33 times of that in Q1 group ( OR=1.33,95% CI 1.13-1.56, P=0.001); while for females the risk of hypertension in Q4 group was 1.38 times of that in Q1 group ( OR=1.38,95% CI 1.13-1.68, P=0.002), but no significant association was observed for males ( P>0.05). The results of restricted cubic spline fitting logistic regression analysis showed that there was a linear association between uric acid level and hypertension in the total population and males, and the risk of hypertension increased with uric acid level ( P<0.001 for the total population, P=0.016 for male). However, there was a non-linear association in females. When uric acid>307 μmol/L in females, the risk of hypertension increased significantly as the level of uric acid increased ( P<0.001). Conclusions:Uric acid level was independently associated with hypertension in the community-dwelling middle-aged and elderly population, and there was a gender difference in the correlation. The association was nonlinear in females and the cut-off value of uric acid in females was 307 μmol/L.

Objective:To explore the relationship between the triglyceride glucose (TyG) index and impairment of renal function in community-dwelling middle-aged and elderly population.Methods:A total of 4 988 residents aged ≥45 years undergoing health check-up in Yongshun Health Service Center from January 2016 to December 2021 were enrolled and followed up. According to the quartile of the baseline TyG index, all subjects were divided into Q1, Q2, Q3 and Q4 groups. The medical history, physical examination and laboratory test results were documented. Participants were followed up through regular health check-up until March 31, 2023. The outcomes were rapid decline of estimated glomerular filtration rate (eGFR) (a loss in eGFR>3 ml·min -1·1.73 m -2 per year) and the new-onset of chronic kidney disease (CKD) during the follow-up period. Linear regression model, multivariate logistic regression model, restricted cubic spline fitting logistic regression model and ROC curve analysis were used to analyze the association between the TyG index and the impairment of renal function. Results:Among 4 988 residents, 1 396 (28.0%) were males and the age was (59.76±6.28) years. There were 1 247 participants in Q1, Q2, Q3 and Q4 groups, respectively. After 56 months of follow-up, the incidence of rapid eGFR decline and new-onset CKD was 21.9% (1 294/4 988) and 4.0% (200/4 988), respectively. Multivariate logistic regression model analysis showed that TyG index was correlated positively with rapid eGFR decline and new-onset of CKD ( OR=1.34, 95%CI: 1.17-1.52, P<0.001, and OR=1.57, 95%CI:1.19-2.06, P=0.001). Taking group Q1 as a reference, higher levels of TyG index ( Q2, Q3 and Q4 groups) was an independent risk factor for rapid eGFR decline ( P<0.05), which has a dose-response relationship (for trend P=0.002). Compared with the lowest quartile, the adjusted OR of new-onset CKD in the highest quartile was 1.85 ( 95%CI:1.13-3.03, P=0.014). The results of restricted cubic spline fitting logistic regression analysis showed a linear association between TyG index and both outcomes (both P>0.05). The area under ROC curve ( AUC) of the TyG index for predicting the two adverse outcomes were 0.536 ( 95%CI: 0.516-0.556, P<0.001) and 0.588 ( 95%CI:0.548-0.627, P<0.001), respectively. Conclusion:The elevated levels of TyG index may be used as an independent predictor of rapid eGFR decline and new-onset CKD.

Background Pregnancy-related anxiety has a negative impact on the physical and mental health of pregnant women and the normal growth and development of the fetus. Establishing prediction models for pregnancy-related anxiety to screen associated predictive factors may provide important opportunities for prenatal intervention. Objective To establish a prediction model of pregnancy-related anxiety risk of pregnant women. Methods From January to July 2021, a questionnaire survey on pregnancy-related anxiety and predictors was conducted among pregnant women having routine prenatal check-ups provided by an obstetrics clinic of a tertiary grade A hospital in Ningxia. The socio-demographic characteristics of the subjects were collected, and the pregnant women were evaluated by the Life Event Scale (LES), Perceived Social Support Scale (PSSS), Family APGAR Index (APGAR), and Pregnancy-related Anxiety Questionnaire (PAQ). R 4.2.0 software was used to fit all selected variables by least absolute shrinkage and selection operator (LASSO) regression to identify predictors of pregnancy-related anxiety in the second and third trimesters. On the basis of logistic regression analysis, prediction models of pregnancy-related anxiety in the second and third trimesters were constructed, and the model nomogram and receiver operating characteristic curve (ROC) were drawn. The prediction effect of the model was evaluated by area under the curve (AUC). A calibration chart was drawn to evaluate the calibration of the model. Results A total of 1500 questionnaires were distributed, and 1448 valid questionnaires were recovered, with an effective rate of 96.53%. Among the 1448 pregnant women, the overall positive rate of pregnancy-related anxiety was 28.80% (417/1448), and the positive rates in the second and third trimesters were 29.21% (276/935) and 27.49% (141/513), respectively. The predictors entering the the second trimester model were age of marriage, family care, social support, family expectations for the fetus, physical condition during pregnancy, and whether experiencing life stressful events during pregnancy. The predictors entering the the third trimester model were pregnancy intention, physical discomfort, and whether experiencing life stress during pregnancy. A risk prediction model of pregnancy-related anxiety for the second trimester was established: risk of pregnancy-related anxiety=−0.07× marriage age +0.12× family care −0.03× social support −0.65× family expectation of fetal sex +0.42× physical condition during pregnancy +0.47× whether experiencing life stressful events during pregnancy. A risk prediction model of pregnancy-related anxiety for the third trimester was established: risk of pregnancy-related anxiety=−5.69+0.82× pregnancy intention +1.06× physical discomfort +0.94× whether experiencing life stressful events during pregnancy. The ROC curves of the two models were drawn. The AUC of the second trimester model was 0.71, and the AUC of related validation model was 0.68. The AUC of the third trimester model was 0.72, and the AUC of related validation model was 0.66. Conclusion The risk prediction models of pregnancy-related anxiety constructed based on LASSO regression and logistic regression have good prediction ability, and they suggest that pregnant women in the second trimester with short marriage age, high family care, low social support, family expectations for fetal sex, average physical condition, and experiencing life stress during pregnancy, and pregnant women in the third trimester with spontaneous pregnant intention, unintended pregnancy, physical discomfort, and experiencing life stress during pregnancy are high-risk groups for pregnancy-related anxiety.

Objective:To investigate the application effect of WeChat group combined with case-based learning (CBL) in probation teaching of vascular surgery.Methods:A total of 128 intern doctors of the seven-year medical program in vascular surgery were selected and divided into experimental group (WeChat group combined with CBL teaching) and control group (CBL teaching alone), and a unified assessment method was used to evaluate the mastery degree of professional theories and clinical knowledge and assess the teaching effect of these two teaching modes in vascular surgery. SPSS 22.0 was used to perform the t-test. Results:Compared with the control group, the experimental group had significantly higher scores of theoretical examination [(86.36±7.42) vs. (84.71±6.72)] and clinical examination [(88.44±7.62) vs. (86.22±6.41)], as well as significantly higher degrees of satisfaction with learning interest, classroom climate, self-learning ability, clinical thinking ability, and teamwork spirit.Conclusion:The teaching mode of WeChat group combined with CBL can improve the effect of the probation teaching of vascular surgery and the self-learning and clinical thinking abilities of intern doctors.

Objective:To investigate the prognosis and risk factors for children diagnosed with all types of subaortic stenosis(SAS) who developed recurrent left ventricular outflow tract obstruction after surgical treatment.Methods:The study retrospectively included patients aged 0-18 years old who underwent open heart SAS surgery at Fuwai Hospital from 2016-2019. Children with hypertrophic obstructive cardiomyopathy were excluded. Detailed operative notes, medical records and ultrasound information, and follow-ups were extracted. Recurrent SAS was defined as left ventricular outflow tract gradient 30 mmHg(1 mmHg=0.133 kPa) 1 month after SAS surgical treatment.Results:A total of 137 children were included in this study. The medium age of children at the time of SAS surgery was 4.6 years old(3 months-17.8 years old). After a median follow-up of 4.36 years(3.2-5.7 years), a total of 30 patients developed recurrent LVOTO, with a recurrence rate of 21.9%, and 7(5.1%) underwent a second surgery. Compared to the non-recurrent group, children in the recurrent group were younger at the time of surgery( P=0.0443), had a smaller body surface area( P=0.0485), and a longer length of stay( P=0.0380). In Cox analysis, when only considering preoperative variables, the independent risk factor for LVOTO recurrence were a peak left ventricular outflow tract gradient higher than 50 mmHg( HR=5.25, P=0.001), a BSA less than 0.9( HR=2.5, P=0.023), and a length of SAS 5 mm( HR=2.29, P=0.050). When both preoperative and intraoperative variables were considered, preoperative peak left ventricular outflow tract gradient 50 mmHg( HR=4.91, P=0.002) and peeling from the aortic valve( HR=3.23, P=0.010) were independent risk factors for postoperative recurrence. Conclusion:Recurrent LVOTO after SAS surgical repair is common, and regular postoperative follow-up is crucial to evaluate whether a secondary intervention is required. Regular postoperative follow-up is needed for children at high risk.