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Shukun Chai, Chuan Wang, Yi Liu, Jingrong Xia, Xiaolin Wang, Jinying Shi Department of Respiratory Medicine, Shijiazhuang People’s Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of ChinaCorrespondence: Jinying Shi, Department of Respiratory Medicine, Shijiazhuang People’s Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China, Email 15176988001@163.comPurpose: Lower Respiratory Tract Infection (LRTI) is a leading cause of morbidity and mortality worldwide. In this study, the distribution patterns of causative pathogens in LRTI were evaluated within a city-level hospital by combining conventional microbiological tests (CMT) with metagenomic next-generation sequencing (mNGS).Patients and Methods: This retrospective cohort study involved 160 patients suspected of having LRTI in a single center. Specimens, including bronchoalveolar lavage fluid (BALF), blood, tissue, sputum, and pus were utilized to identify pathogens. The seasonal prevalence of pathogens and co-pathogens involved in multiple infections was analyzed.Results: A total of 137 patients with 156 samples were included in this study. Pseudomonas aeruginosa, Corynebacterium striatum, Klebsiella pneumoniae, Candida, and human herpesvirus were the top prevalent pathogens. We observed seasonal dynamic variation in the top prevalent bacteria (Pseudomonas aeruginosa and Klebsiella pneumoniae) and herpesvirus (Epstein-Barr virus and Human herpesvirus-7). The majority of patients had single bacterial infections, followed by instances of bacterial-viral co-infections, as well as mixed infections involving bacteria, fungi, and viruses. Notably, the spectrum of co-infecting pathogens was broader among the elderly population, and positive Spearman correlations were observed among these co-infecting pathogens.Conclusion: Co-infections were prevalent among patients with LRTI, and the pathogens displayed distinct seasonal distribution patterns. The findings underscored the significance of comprehending pathogen distribution and epidemic patterns, which can serve as a basis for early etiological identification.Keywords: metagenomic next-generation sequencing, low respiratory tract infection, co-pathogens, seasonal prevalence

Runqi Cheng,1 Tiansheng Wang,1 Yuankun Cai,1 Songshan Chai,1 Lei Shen,1 Dongyuan Xu,1 Jingyi Yang,1 Chuqiao Yue,1 Jianzhang Pu,2 Nanxiang Xiong1 1Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, People’s Republic of China; 2Department of Neurosurgery, Beijing Shunyi District Hospital, Shunyi Teaching Hospital of Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Nanxiang Xiong, Email mozhuoxiong@163.comObjective: To predict the volume and shape of the balloon before PBC by reconstructing the Meckel’s cave (MC) and establishing a volumetric measurement model, supporting preoperative preparation and intraoperative decisions.Methods: The clinical data of 31 patients with good therapeutic effects who underwent PBC are retrospectively collected, including preoperative MRI, the volume of contrast agent injected into the balloon, and intraoperative lateral X-ray images. The MC on the affected side of the 31 patients is reconstructed based on MRI using 3D Slicer, while the volume of the MC is calculated to compare with the volume of contrast agent. The width (W) and length (L) of the model of the MC in lateral view are measured and used to classify the shape of the MC based on W/L. The consistency between the W/L of the model of the MC and the W/L of the intraoperative balloon is evaluated.Results: For volume, the mean value of the models of the MC (V1) in 31 patients is 399.77± 155.13 mm³, while the mean value of the contrast agent injected during PBC (V2) is 539.03± 111.93 mm³. The formula obtained by linear regression is V2= 392.1 + 0.3676×V1. Based on the value of W/L, the shape of the MC is classified into thin “pear” in 5 patients (16.13%), standard “pear” in 22 patients (70.97%), and square “pear” in 4 patients (12.90%). There is no significant difference in W/L between the models of the MC and the intraoperative balloons in 31 patients (P=0.221).Conclusion: In 31 patients with good efficacy, it is verified that the prediction of the MC before PBC by 3D Slicer is consistent with the actual situation of the intraoperative balloon. This method can provide certain basis for preoperative preparation and intraoperative judgment.Keywords: trigeminal neuralgia, percutaneous balloon compression, Meckel’s cave, 3D Slicer, reconstruction

Yufang Liu, Sanbao Chai, Xiaomei Zhang Department of Endocrinology, Peking University International Hospital, Beijing, 102206, People’s Republic of ChinaCorrespondence: Xiaomei Zhang, Email z.x.mei@163.comObjective: To investigate the association between adipose distribution and hepatic steatosis in American adults and to assess whether this association varies among different blood glucose states.Methods: Data from the American National Health and Nutrition Examination Survey (NHANES) 2017– 2018 were analyzed. The subjects were divided into three groups: diabetes, prediabetes and normal glucose tolerance (NGT). Hepatic steatosis was quantified by median controlled attenuation parameter (CAP), which was measured by ultrasound transient elastography. Total abdominal fat volume, visceral adipose tissue (VAT) volume, total percent fat, trunk percent fat, android percent fat and android to gynoid ratio (AGR) was measured by dual-energy X-ray absorptiometry (DXA).Results: Data pertaining to 2986 participants (1581 with hepatic steatosis) were included in the analysis. In the NGT group, the proportion of S0 (< 5% of the hepatocytes with fatty infiltration) was 58.9%, and 25.2% for S3 (≥ 66% of the hepatocytes with fatty infiltration). In contrast, the proportion of S0 was 11.1%, while S3 accounts for as high as 68.7% in the diabetes group. In the NGT group, all parameters of fat distribution revealed a positive relation with the occurrence of hepatic steatosis (p< 0.05) except total percent fat (p=0.872) after adjusting for confounding factors. In the prediabetes group, VAT volume, trunk percent fat, android percent fat and AGR had significant influence on hepatic steatosis (p< 0.05). As for diabetes, only AGR remained significantly correlated with hepatic steatosis (p=0.004).Conclusion: For NGT individuals, high level of total abdominal fat volume, VAT volume, trunk percent fat, android percent fat and AGR all can be used to predict hepatic steatosis. For diabetes, only AGR can predict hepatic steatosis among the surveyed parameters of adipose distribution.Keywords: adipose distribution, hepatic steatosis, diabetes

Xin Ma &ast;, Jie Yang &ast;, Xiaolu Wang &ast;, Xiang Wang &ast;, Shuhong Chai Department of Clinical Laboratory, Urumqi Friendship Hospital, Urumqi, Xinjiang Uygur Autonomous Region, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Shuhong Chai, Department of Clinical Laboratory, Urumqi Friendship Hospital, No. 558 Shengli Road, Tianshan District, Urumqi, Xinjiang Uygur Autonomous Region, 830049, People’s Republic of China, Tel +86-18997994493, Email 18997994493@126.comPurpose: Systemic inflammatory response index (SIRI) was an independent predictor of the prognosis of many diseases. Inflammatory prognostic index (IPI) was a new inflammatory prognostic marker with certain clinical significance. We aimed to explore the association between SIRI, IPI and early stage severity of stroke as well as 3-month outcome of AIS patients.Patients and Methods: A total of 63 AIS patients who treated with alteplase were selected. The patients were divided into mild group and moderate to severe group according to the National Institutes of Health Stroke Scale (NIHSS) scores. According to the modified Rankin scale (mRS) score, patients were divided into the good prognosis group and the poor prognosis group. Spearman correlation statistically analyzed the correlation between SIRI, IPI and NIHSS score. Univariate and multivariate logistic regression analyzed the risk factors of 3-month prognosis. ROC curve was adopted to predict the effect of SIRI and IPI levels on poor prognosis in AIS patients.Results: Spearman analysis showed that there was positively correlated with NIHSS score and IPI in mild AIS group (r=0.541, P< 0.05). Compared with the mild group, SIRI and IPI in the moderate to severe group was significantly higher (P< 0.05). The SIRI and IPI in the poor prognosis group were significantly higher than those in the good prognosis group (P< 0.05). Univariate and multivariate logistic regression analysis showed that SIRI and IPI were independent prognostic factors for the 3-month prognosis of AIS patients (P< 0.05). The ROC curve showed that the areas under the 3-month prognosis curve predicted by SIRI and IPI were 0.685, 0.774 respectively.Conclusion: IPI is correlated with stroke severity at admission. SIRI and IPI are independent predictors of short-term prognosis in AIS patients. SIRI and IPI can be a novel the good short-term prognostic biomarker for AIS patients treated with intravenous thrombolysis.Keywords: acute ischemic stroke, systemic inflammatory response index, inflammatory prognosis index, short term prognosis

Xiuhua Jiang,1,&ast; Shiqi Chai,1,&ast; Yan Huang,2,&ast; Zuxiong Huang,3,&ast; Wenting Tan,4,&ast; Yanhang Gao,5,&ast; Xiaobo Lu,6,&ast; Zhongji Meng,7,&ast; Huayou Zhou,8 Wenbing Kong,8 Xiaoting Tang,1 Yujun Tang,1 Tingting Qi,1 Chengjin Liao,2 Qiaorong Gan,3 Xiaomei Xiang,4 Yanan Zhang,5 Shuai Wang,6 Yuanyuan Chen,7 Jinjun Chen1,9 1Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China; 2Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 3Department of Hepatology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 4Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China; 5Department of Hepatology, the First Hospital of Jilin University, Changchun, People’s Republic of China; 6Infectious Disease Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic of China; 7Department of Infectious Diseases, Hubei Clinical Research Center for Precise Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China; 8Department of Blood Transfusion, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China; 9Hepatology Unit, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jinjun Chen, Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Dadao Bei, Guangzhou, 510515, People’s Republic of China, Email chjj@smu.edu.cnBackground: Acute-on-chronic liver failure (ACLF) has high short-term mortality and lacks sufficient medical therapy. Available algorithms are unable to precisely predict short-term outcomes or safely stratify patients with ACLF as emergent liver transplantation candidates. Therefore, a personalized prognostic tool is urgently needed.Purpose: Platelet function and its clinical significance in ACLF patients with chronic hepatitis B virus (HBV) infection have not been investigated. This study aimed to assess changes in platelet function using thromboelastography (TEG) and platelet mapping (TEG-PM) in HBV-related ACLF patients.Methods: Chronic liver disease patients with acute decompensation or acute hepatic injury were recruited. The derivation cohort enrolled HBV-related patients at Nanfang Hospital. HBV-related and non-HBV-related patients were both enrolled in internal and external validation cohorts at seven university hospitals. TEG and TEG-PM were performed at baseline in the derivation cohort and baseline, day 7, and day 14 in the validation cohorts. The primary outcome was all-cause 28-day mortality. Status check and new-onset complications were recorded during the 3-month follow-up, but status check will extend to 5 years.Conclusion and Future Plans: In this study, 586 participants were enrolled, including 100 in derivation cohort, 133 in internal validation cohort, and 353 in external validation cohort. Biomaterials, including plasma, serum, urine, and some explanted liver tissues, were collected from these patients. A 3-month follow-up with survival status was completed. The baseline characteristics indicated that 51% of the patients had adenosine diphosphate (ADP)-hyporesponsive circulating platelets. The prognostic potential of platelet function will be explored in the derivation cohort (HBV-related ACLF patients) and further substantiated in the validation cohorts (HBV-related and non-HBV-related ACLF patients). Biosamples are currently used to explore the underlying mechanisms related to ADP-hyporesponsive platelets. The ongoing proteomic and metabolic analyses will provide new insights into the pathogenesis of extrahepatic organ failures in ACLF patients.Keywords: acute-on-chronic liver failure, coagulopathy failure, platelet function, thromboelastography, prognosis, study design

Mengjie Hu,1,&ast; Songling Chai,2,&ast; Wenyi Lei,1 Kexin Liao,1 Rongxin Zhang1 1Department of Dermatology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, People’s Republic of China; 2Department of Oral and Maxillofacial Surgery, Stomatology College of Dalian Medical University, Dalian, Liaoning, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Rongxin ZhangDepartment of Dermatology, The Second Hospital of Dalian Medical University, No. 467 Zhongshan Road, Dalian, 116027, Liaoning, People’s Republic of ChinaTel +8617709873080Fax +86-411-84672130Email zrx_1980@126.comAbstract: Cutaneous cryptococcosis, an infectious disease resulting from Cryptococcus neoformans, primarily affects immunodeficient individuals. Here, we report a case of mediastinal small cell carcinoma (MSCC) complicated with multiple skin and soft tissue infections mimicking erysipelas and cellulitis. Antibiotics for bacteria were ineffective and a culture of pus from the infected areas revealed Cryptococcus neoformans in this patient. The absence of any evidence indicative of systemic cryptococcal infection leads to a final diagnosis of primary cutaneous cryptococcosis (PCC). Following two weeks of fluconazole at 400 mg/day and 200 mg/day for the subsequent three months, combined with incision, irrigation and drainage, the wound gradually healed. An analysis and discussion of the clinical features of this patient are presented. This case alerts clinicians as to the possibility of Cryptococcus neoformans in patients with advanced malignant tumors complicated with multiple skin and soft tissue infections. While a timely diagnosis and treatment of PCC in this patient resulted in a favorable outcome, the patient succumbed to the malignant tumor at six months post-discharge.Keywords: mediastinal small cell carcinoma, primary cutaneous cryptococcosis, Cryptococcus neoformans, immunodeficiency, therapy

Yihao Wang,1 Fangcheng Zhang,1 Nanxiang Xiong,2 Hao Xu,3 Songshan Chai,1 Haofei Wang,1 Jiajing Wang,1 Hongyang Zhao,1 Xiaobing Jiang,1 Peng Fu,1 Wei Xiang1 1Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People’s Republic of China; 2Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, 430071, People’s Republic of China; 3Department of Neurosurgery, General Hospital of the Yangtze River Shipping, Wuhan, 430022, People’s Republic of ChinaCorrespondence: Peng Fu; Wei XiangDepartment of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People’s Republic of ChinaTel +86 15902706600; +86 13667291375Fax +86 27 85350819Email pfu@hust.edu.cn; xiangwei20@hotmail.comAbstract: The blood-brain barrier (BBB) is an essential structure of the central nervous system (CNS), and its existence makes the local internal environment of the CNS a relatively independent structure distinct from other internal environments of the human body to ensure normal physiological and high stability of activities of the CNS. Changes in BBB structure and function are fundamental to the pathophysiology of many diseases. The occurrence and development of glioma are often accompanied by a series of changes in the structure and function of the internal environment, the most significant of which is remodelling of the BBB. The remodelling of the BBB usually leads to changes in the permeability of local microvessels, which provide certain favourable conditions for the occurrence and development of glioma. Meanwhile, the newly generated abnormal blood vessels and the remaining intact regions of the BBB also hinder the effects of drug treatments. Changes in permeability and structural function often lead to the creation of abnormally functioning vascular regions, which pose further treatment challenges. At present, therapeutic methods for glioma have not achieved satisfactory effects in clinical practice, and emerging therapeutic methods have not yet been widely used in clinical practice. In this review, we summarize the knowledge of remodelling of the BBB in the glioma environment, the type of changes that occur, and current BBB treatment methods and prospects for the treatment of glioma.Keywords: blood-brain barrier, glioma, blood-brain barrier-associated therapy, remodelling, structural and functional changes

Runtang Meng,1,2,* Yong Yu,2,3,* Shouxia Chai,4,* Xiangyu Luo,5 Boxiong Gong,6 Bing Liu,2,3 Ying Hu,1,7 Yi Luo,8 Chuanhua Yu1,71Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan 430071, People’s Republic of China; 2Centre of Health Administration and Development Studies, Hubei University of Medicine, Shiyan 442000, People’s Republic of China; 3School of Public Health and Management, Hubei University of Medicine, Shiyan 442000, People’s Republic of China; 4School of Nursing, Hubei University of Medicine, Shiyan 442000, People’s Republic of China; 5Department of Cardiothoracic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, People’s Republic of China; 6Department of Oncology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, People’s Republic of China; 7Global Health Institute, Wuhan University, Wuhan 430072, People’s Republic of China; 8School of Nursing, Ningbo College of Health Sciences, Ningbo 315100, People’s Republic of ChinaCorrespondence: Chuanhua YuDepartment of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan 430071, People’s Republic of ChinaTel +86 276 875 9299Email yuchua@whu.edu.cn*These authors contributed equally to this workBackground: Self-compassion has been regarded as a key psychological construct and a protective factor of mental health status. The focus of the present study was to adapt the Self-Compassion Scale (SCS) into Chinese, assess the validity and reliability of the measure and test measurement invariance (MI) across nursing students and medical workers.Methods: The current study assessed the psychometric properties and invariance of the SCS-Short Form (SCS-SF) in two samples of 2676 from nursing students and medical workers. For construct validity, confirmatory and exploratory factor analyses (CFAs and EFAs) were conducted. Using Perceived Stress Questionnaire , Short Form-8 Health Survey (SF-8) and Goldberg Anxiety and Depression Scale, we evaluated concurrent validity and convergent/divergent validity. For reliability, internal consistency and test–retest analysis were employed. Multi-group analyses were conducted to examine MI of the different SCS-models across populations.Results: CFA showed that the proposed six-factor second‐order model could not be replicated and the six-factor first‐order model was a reasonable to mediocre fitting model in both samples. EFA supported a three-factor structure which consisted of one positive and two negative factors. CFA confirmed that the hypothesized three-factor structure with 10 items ultimately was considered as the optimal model on the fitted results. The SCS-SF‐10 (10 items form) also demonstrated acceptable internal consistency and test–retest reliability, as well as strong concurrent validity with measures of stress perception, health status, anxious and depressive symptoms. Convergent/divergent validity was not satisfactory. Multi-group CFAs provided support for the validity of the established models.Conclusion: The Chinese version of the SCS-SF‐10 has sound psychometric properties and can be applied to efficiently assess self-compassion in Chinese-speaking populations. The current study contributes to the identification and measurement of self-compassion after adversities.Keywords: medical workers, nursing students, self-compassion, Chinese, measurement invariance, psychometric assessment

Song Chai,1,* Shifeng Kan,1,* Ran Sun,1 Ruijuan Zhou,1 Yi Sun,2 Wenhua Chen,1 Bo Yu1,3 1Department of Rehabilitation, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai 200080, China; 2Department of Rehabilitation, Shanghai Sunshine Rehabilitation Center, Yangzhi Affiliated Rehabilitation Hospital of Tongji University, Shanghai 201209, China; 3Department of Rehabilitation Therapy, School of International Medical Technology, Shanghai Sanda University, Shanghai 201209, China *These authors contributed equally to this work Background: Integration of several types of therapeutic agents into one nanoplatform to enhance treatment efficacy is being more widely used for cancer therapy. Methods: Herein, a biocompatible polydopamine (PDA)-coated MoSe2-wrapped doxorubicin (DOX)-loaded hollow mesoporous silica nanoparticles (HMSNs) nanoplatform (PM@HMSNs-DOX) was fabricated for dual-sensitive drug release and chemo-photothermal therapy for enhancing the therapeutic effects on breast cancer. The HMSNs were obtained by a “structural difference-based selective etching” strategy and served as the drug carrier, exhibiting a high DOX loading capacity of 427 mg/g HMSNs-NH2, and then wrapped with PDA-coated MoSe2 layer to form PM@HMSNs-DOX. Various techniques proved the successful fabrication of the nanocomposites. Results: The formed PM@HMSNs-DOX nanocomposites exhibited good biocompatibility, good stability, and super-additive photothermal conversion efficiency due to the cooperation of MoSe2 and PDA. Simultaneously, the pH/near-infrared-responsive drug release profile was observed, which could enhance the synergistic therapeutic anticancer effect. The antitumor effects of PM@HMSNs-DOX were evaluated both in vitro and in vivo, demonstrating that the synergistic therapeutic efficacy was significantly superior to any monotherapy. Also, in vivo pharmacokinetics studies showed that PM@HMSNs-DOX had a much longer circulation time than free DOX. In addition, in vitro and in vivo toxicity studies certified that PM@HMSNs are suitable as biocompatible agents. Conclusion: Our nanoplatform loaded with DOX displays pH/near-infrared-induced chemotherapy and excellent photothermal therapy, which hold great potential for cancer treatment. Keywords: hollow mesoporous silica nanoparticles, MoSe2, polydopamine, chemo-photothermal therapy

Peiyang Ding,1,2 Teng Zhang,2,3 Yafei Li,1,2 Man Teng,2 Yaning Sun,2 Xiao Liu,2,4 Shujun Chai,2 Enmin Zhou,1 Qianyue Jin,2,5 Gaiping Zhang1,2,4,5 1College of Veterinary Medicine, Northwest A&F University, Yangling, 2Henan Provincial Key Laboratory of Animal Immunology, Henan Academy of Agricultural Sciences, 3College of Life Sciences, Henan Agricultural University, 4College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 5Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, People’s Republic of China Abstract: Recent advancements in biotechnology have enabled the rapid identification and subsequent expression of pathogenic microbial major antigens that induce protective immune responses. However, subunit vaccines have not been successfully commercialized mainly due to the lack of sufficient levels of neutralizing antibodies (NAs). High levels of NA rely on the efficient recognition and cross-linking of multiple neutralizing epitopes with B-cell receptors (BCRs). Nanoparticles are able to display coupled antigenic arrays at high density and provide multiple binding molecular scenarios with BCRs. The high-resolution antigenic structure makes it possible to accurately display stable neutralizing epitopes. Therefore, the development of a nanovaccine that orientationally displays neutralizing epitopes is a feasible strategy. To address this hypothesis, the capsid (Cap) protein of porcine circovirus type 2 as model antigen was conjugated to gold nanoparticles (AuNPs) through direct reaction of the mercapto group of the unique cysteines with AuNPs, rendering Cap-AuNPs to have neutralizing epitopes on outer surface and an immunodominant epitope buried within the inner surface. In vitro studies showed that AuNPs promoted the phagocytosis of Cap protein and NA levels were significantly improved, meanwhile antibody levels against the immunodominant epitope was significantly reduced. In mouse studies, Cap-AuNP-immunized mice displayed a high production of interleukin (IL)-4, IL-10, and interferon-γ, suggesting that Cap-AuNPs can effectively activate CD4+ and CD8+ T cells and balance Th1 and Th2 cellular responses. This study presents a new vaccine design strategy based on antigen structure, where nanoparticles are coupled to antigens in well-ordered arrays and orientationally display neutralizing epitopes to enhance NA levels. Keywords: gold nanoparticles, porcine circovirus type 2, neutralizing antibody, epitopes, structure, orientationally display

In recent years, there has been a significant surge in the prevalence of myopia at younger ages in China. Numerous studies have investigated methods for preventing and controlling myopia, including orthokeratology, low-concentration atropine eye drops, light therapy, posterior scleral reinforcement, and traditional Chinese medicine. These approaches can modulate choroidal thickness, blood flow, and target various molecular mechanisms. Orthokeratology and low-concentration atropine demonstrate a thickening effect on the choroid and regulate choroidal blood flow; the use of multi-point defocus control lenses also shows promise in thickening the choroid; the influence of light and light feeding therapy on myopia prevention and control is also reflected in the choroidal thickness and blood flow; and the traditional Chinese medicine has shown good prospect in influencing the microstructure of the choroid for myopia prevention and control. However, the long-term effects of various prevention and control measures on the choroid still need to be explored with a large sample size. This article provides an overview of various methods used to regulate the choroid and prevent myopia. The mechanisms by which these interventions act on the choroid are described to provide new insights and identity novel clinical strategies for myopia management.

BackgroundThe mental health problems of employees in administrative organs and public institutions are highly valued. However， there is a lack of understanding regarding the mental health status of employees in provincial and municipal administrative organs and public institutions in Qinghai region.ObjectiveTo analyze the anxiety and depression of employees in provincial and municipal administrative organs and public institutions in Qinghai region， so as to provide references for promoting their mental health and intervening in psychological problems.MethodsFrom October 23 to 28， 2022， a total of 3 096 employees in provincial and municipal administrative organs and public institutions in Qinghai region were enrolled using stratified cluster sampling technique， and were assessed using Self-rating Anxiety Scale （SAS） and Self-rating Depression Scale （SDS）.ResultsA total of 1797 （58.04%） employees in municipal and above administrative organs and public institutions in Qinghai region completed a valid questionnaire survey. Depressive symptoms were noted in 579 （32.22%）. SDS scores yielded statistical difference among the selected employees of different ethnicities， types of job positions and educational levels （F=9.074， 101.488， 4.477， P