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Abstract Background Childhood maltreatment (CM) is closely linked to internet addiction (IA), especially in adolescents with Major Depressive Disorder (MDD). Previous studies have shown that adolescents who experience CM are more likely to develop IA and other psychological problems. This study aims to explore the complex relationship between CM and IA through network analysis, particularly identifying the core symptoms and bridge symptoms to better understand the development of IA in these adolescents. Methods A cross-sectional study was conducted in seven hospitals in Anhui Province, China, involving 332 adolescents diagnosed with MDD using DSM-5 criteria. The Childhood Trauma Questionnaire - Short Form (CTQ-SF) and the Internet Addiction Test (IAT) were used to assess CM and IA symptoms, respectively. Gender-based network analysis was also performed. Results Network analysis constructed a CM-IA network and identified core and bridge symptoms. “Depress/moody/nervous being offline”, “Request an extension for longer time”, “Sleep loss due to late-night logins”, and “emotional abuse” emerged as central symptoms within the CM-IA network. Additionally, “emotional abuse”, “sexual abuse”, and “complaints about online time” were identified as key bridge symptoms linking CM and IA. These symptoms demonstrated significant connectivity, underscoring their critical role in linking CM and IA. Conclusion The findings highlight the complex relationship between CM and IA in adolescents with MDD. Specific symptoms, such as emotional abuse and online-related symptoms, play important roles in understanding and intervening in adolescent IA. Future interventions should target these core and bridge symptoms for more effective prevention and treatment.

Abstract Burnout, depression, anxiety, and stress negatively impact the well-being and retention of healthcare professionals. The interplay of these symptoms is understudied. Utilizing network analysis, this study examined the interrelationships among these symptom clusters in clinical therapists in China. An anonymous survey was conducted among clinical therapists from 41 tertiary psychiatric hospitals in China. Burnout was assessed using the Maslach Burnout Inventory-Human Service Survey (MBI-HSS), while symptoms of depression, anxiety, and stress were assessed via the Depression, Anxiety, and Stress Scale-21 (DASS-21). Analyses were performed to identify central symptoms and bridge symptoms of this network. A total of 419 participants were included in this survey. The prevalence rate for burnout, depression, anxiety, and stress was 19.8%, 22.2%, 17.9%, and 8.6%, respectively. Network analysis indicated that stress symptoms had the highest expected influence values, closely followed by emotional exhaustion from MBI-HSS. Notably, emotional exhaustion emerged as the strongest bridge of expected influence. The stability of the expected influence and bridge expected influence was robust, with coefficients at 0.75. The study’s findings underscore the importance of recognizing the central symptoms and bridge symptoms, which could lead to more effective early detection and intervention for burnout, depression, anxiety, and stress among clinical therapists.

BackgroundThe COVID-19 pandemic significantly increased the levels of burnout and symptoms of depression, anxiety, and stress among healthcare professionals. However, research on the interrelations between burnout and psychological symptoms is scarce, particularly among psychiatrists. This study addresses this gap in a national sample.MethodData was collected via an online survey conducted in Mainland China from January to March 2021 with a sample size of 3,783 participants. Psychological symptoms were assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21), and physician burnout was assessed using the Maslach Burnout Inventory-Human Service Survey (MBIHSS). Network analysis was used to examine the interconnection between physician burnout and psychological symptoms, with further analysis conducted on multiple levels, including individual symptoms in central positions or acting as bridges between clusters, and identifying core symptom combinations with significant correlations.ResultsStress emerged as the highest Expected Influence (EI) index, with emotional exhaustion in the burnout cluster being the singular bridge symptom. Furthermore, depressive symptoms such as hopelessness and anhedonia showed a strong and the most straightforward association with emotional exhaustion, while stress-related overreaction was closely associated with depersonalization.ConclusionNetwork analysis between burnout and psychological symptoms identified critical symptoms like stress and emotional exhaustion in Chinese psychiatrists. Close monitoring of these symptoms may be crucial for mitigating the risk of common psychological disturbances and preventing their exacerbation in this population.

Introduction Healthcare workers are integral to public smoking cessation; however, their own smoking behavior can create a significant obstacle to intervening in patients' cessation efforts. Conversely, their success in quitting can enhance their ability to support patients. Research on smoking behavior, particularly smoking cessation among Chinese psychiatric professionals is limited. This study addresses this gap by examining the factors associated with smoking cessation in this population, providing insights for targeted tobacco control policies. Methods A cross-sectional survey was conducted, targeting psychiatric professionals including psychiatrists and psychiatric nurses, in 41 tertiary psychiatric hospitals in China. From January to March 2021, a WeChat-based questionnaire was distributed to collect demographic, occupational, and health-behaviors (including smoking) data. Statistical analyses, including the chi-squared test and adjusted binary logistic regression analysis, were conducted to identify the factors associated with smoking cessation. Results Among the 12762 psychiatric professionals who participated in the survey, 11104 (87.0%) were non-smokers, 1196 (9.4%) were current smokers, and 462 (3.6%) were ex-smokers. Several factors were found to be associated with smoking cessation. Women had a higher prevalence of ex-smokers than men (AOR=1.88; 95% CI: 1.332–2.666, p

Abstract Background The mental health workforce sustainability in China suffers high rates of attrition and the intention to leave. Among current professionals, the intention to choose the same career is an interesting way to gauge their job satisfaction and other factors, and it may affect the career choices of younger generations. We aimed to survey the intention of psychiatrists and psychiatry residents to choose the same career if they could start over and to identify associated factors. Methods We conducted an anonymous survey of psychiatrists in 41 tertiary psychiatric hospitals in China. We collected demographic data, work-related information, the sense of professional identity, job satisfaction, and burnout (Maslach Burnout Inventory), and we specifically asked each participant whether they would choose to be a psychiatrist again if they could. Results Among 3,783 psychiatrists we surveyed, one-quarter responded that they would not choose to be a psychiatrist again if they had a choice, with less than half (47.2%) saying they would. Those who would not choose psychiatry again were more likely to have a negative (relative to positive) professional identity (OR = 7.47, P＜0.001, 95%CI: 4.587–12.164); experience job burnout (OR = 2.945, P＜0.001, 95%CI: 2.356–3.681); be dissatisfied with their job (OR = 2.739, P＜0.001, 95%CI: 2.102–3.569) and excessive regulation (OR = 1.819, P＜0.001, 95%CI: 1.487–2.226); have a heavy workload (OR = 1.749, P＜0.001, 95%CI: 1.423–2.149) or a lower income (OR = 1.748, P＜0.001, 95%CI: 1.415–2.161); be married (relative to single) (OR = 1.604, P = 0.004, 95%CI: 1.165–2.208); be dissatisfied with strained doctor-patient relationship (OR = 1.333, P = 0.005, 95%CI: 1.089–1.632); have more night shifts per month (OR = 1.055, P = 0.021, 95%CI: 1.008–1.104) or work longer hours per week (OR = 1.016, P = 0.001, 95%CI: 1.006–1.025). Conclusion Among psychiatrists in tertiary hospitals in China, those with a heavier workload, poor sense of professional identity, job dissatisfaction, and burnout were less likely to choose psychiatry again. Policymakers and hospital administrators need to take effective measures to improve psychiatrists’ sense of professional identity and increase their intention to stay.

Introduction: Zearalenone-14-glucoside (Z14G) is a modified mycotoxin that widely contaminates food across the world. Our preliminary experiment showed that Z14G degrades to zearalenone (ZEN) in the intestine exerting toxicity. Notably, oral administration of Z14G in rats induces intestinal nodular lymphatic hyperplasia. Objectives: To investigate the mechanism of Z14G intestinal toxicity and how it differs from ZEN toxicity. We conducted a precise toxicology study on the intestine of rats exposed to Z14G and ZEN using multi-omics technology. Methods: Rats were exposed to ZEN (5 mg/kg), Z14G-L (5 mg/kg), Z14G-H (10 mg/kg), and pseudo germ free (PGF)-Z14G-H (10 mg/kg) for 14 days. Histopathological studies were performed on intestines from each group and compared. Metagenomic, metabolomic, and proteomic analyses were performed on rat feces, serum, and intestines, respectively. Results: Histopathological studies showed that Z14G exposure resulted in dysplasia of gut-associated lymphoid tissue (GALT) compared to ZEN exposure. The elimination of gut microbes in the PGF-Z14G-H group alleviated or eliminated Z14G-induced intestinal toxicity and GALT dysplasia. Metagenomic analysis revealed that Z14G exposure significantly promoted the proliferation of Bifidobacterium and Bacteroides compared to ZEN. Metabolomic analysis showed that Z14G exposure significantly reduced bile acid, while proteomic analysis found that Z14G exposure significantly reduced the expression of C-type lectins compared to ZEN. Conclusions: Our experimental results and previous research suggest that Z14G is hydrolyzed to ZEN by Bifidobacterium and Bacteroides promoting their co-trophic proliferation. This leads to inactivation of lectins by hyperproliferative Bacteroides when ZEN caused intestinal involvement, resulting in abnormal lymphocyte homing and ultimately GALT dysplasia. It is noteworthy that Z14G is a promising model drug to establish rat models of intestinal nodular lymphatic hyperplasia (INLH), which is of great significance for studying the pathogenesis, drug screening and clinical application of INLH.

Introduction: Epimedium L., the largest herbaceous genus of Berberidaceae, is one of the most taxonomically difficult representatives. The classification and phylogenetic relationships within Epimedium are controversial and unresolved. Objectives: For the first time, we systematically studied the phylogeny and evolution of Epimedium based on plastid genome (plastome) data for better understanding this enigmatic genus. Methods: We explored the molecular phylogeny, assessed the infrageneric classification, estimated the divergence times, and inferred the ancestral states for flower traits of Epimedium based on 45 plastomes from 32 species. Results: The Epimedium plastome length ranged from 156,635 bp to 159,956 bp. Four types of plastome organization with different inverted repeat boundary changes were identified. Phylogenetic analysis revealed a strong support for the sister relationship of sect. Macroceras and sect. Diphyllon but did not provide a distinct route for petal evolution in sect. Diphyllon. Disharmony between phylogenetic relationships and traditional classification of sect. Diphyllon was observed. Results from divergence time analysis showed that Epimedium diverged in the early Pleistocene (~2.11 Ma, 95% HPD = 1.88–2.35 Ma). Ancestral character state reconstructions indicated transitions from long spur (large-flowered group) to other petal types (small-flowered group) in Epimedium. Conclusion: These findings provide new insights into the relationships among Epimedium species and pave the way for better elucidation of the classification and evolution of this genus.

In this work, a green analytical method was established for the simultaneous extraction and detection of 20 analytes–10 neonicotinoid insecticides and their 10 major toxic metabolites in edible herbs. QuEChERS and LC-MS/MS were used to analyze the 20 analytes in five edible herbs. The residues of the 20 neonicotinoid insecticides and their metabolites in 109 herbal samples were detected, of which 90 samples were positive, and the residue of total neonicotinoid insecticides ranged from 0.26 to 139.28 μg/kg. Acetamiprid (77.06 %, ≤85.95 μg/kg), imidacloprid (67.89 %, ≤32.49 μg/kg) and their metabolites (N-desmethyl-acetamiprid (44.04 %, ≤18.42 μg/kg) and desnitro imidacloprid (48.62 %, ≤16.55 μg/kg) were most frequently detected in herbs. Significant positive correlations were found between imidacloprid/acetamiprid and their metabolites in Lycii fructus and Citri reticulatae pericarpium. Therefore, more attention may be given to the neonicotinoid insecticide residues in edible herbs in the future.

Abstract Background Previous studies suggest that transient receptor potential (TRP) channels and neurogenic inflammation may be involved in idiopathic pulmonary fibrosis (IPF)-related high cough sensitivity, although the details of mechanism are largely unknown. Here, we aimed to further explore the potential mechanism involved in IPF-related high cough sensitivity to capsaicin challenge in a guinea pig model of pulmonary fibrosis induced by bleomycin. Methods Western blotting and real-time quantitative polymerase chain reaction (RT-qPCR) were employed to measure the expression of TRP channel subfamily A, member 1 (TRPA1) and TRP vanilloid 1 (TRPV1), which may be involved in the cough reflex pathway. Immunohistochemical analysis and RT-qPCR were used to detect the expression of neuropeptides substance P (SP), Neurokinin-1 receptor (NK1R), and calcitonin gene-related peptide (CGRP) in lung tissues. Concentrations of nerve growth factor (NGF), SP, neurokinin A (NKA), neurokinin B (NKB), and brain-derived neurotrophic factor (BDNF) in lung tissue homogenates were measured by ELISA. Results Cough sensitivity to capsaicin was significantly higher in the model group than that of the sham group. RT-qPCR and immunohistochemical analysis showed that the expression of TRPA1 and TRPV1 in the jugular ganglion and nodal ganglion, and SP, NK1R, and CGRP in lung tissue was significantly higher in the model group than the control group. In addition, expression of TRP and neurogenic factors was positively correlated with cough sensitivity of the experimental animals. Conclusion Up-regulated expression of TRPA1 and TRPV1 in the cough reflex pathway and neurogenic inflammation might contribute to the IPF-related high cough sensitivity in guinea pig model.

Crataegi Fructus, a medicinal and edible herb in China, has been considered a popular dietary supplement globally. It is used for the treatment of dyspepsia and chronic heart failure according to the Chinese Pharmacopoeia (2020). However, fungal contamination in Crataegi Fructus affects its quality and safety, thus preventing its global promotion. In this study, we comprehensively studied the fungal community in processed products of Crataegi Fructus by high-throughput sequencing. A total of 21 Crataegi Fructus samples were collected from five provinces in China, and the samples were divided into five groups based on collection areas, as well as into three groups based on processing methods. We then targeted the internal transcribed spacer 2 sequence through the Illumina Miseq PE300 platform to investigate fungal composition and diversity. Results showed that all 21 samples were detected with fungal contamination, and Ascomycota was dominant at the phylum level. In the groups based on collection areas, Dothideomycetes, Pleosporaceae, and Alternaria were dominant at the class, family, and genus levels, respectively. In the groups based on processing methods, Dothideomycetes, Aspergillaceae, and Alternaria were the most abundant at the class, family, and genus levels, respectively. Differences in fungal communities between various groups were also observed. Furthermore, a total of 115 species were identified, among which seven were potential toxigenic, namely, Trichothecium roseum, Alternaria tenuissima, Aspergillus carbonarius, Penicillium brevicompactum, Aspergillus fumigatus, Rhizopus microspores, and Pichia fermentans. In conclusion, this study reveals great fungal richness and diversity of Crataegi Fructus, providing references for the prevention and control of fungal contamination of Crataegi Fructus in practical production.

Tumorigenesis is a complex multifactorial and multistep process in which tumors can utilize a diverse repertoire of immunosuppressive mechanisms to evade host immune attacks. The degradation of tryptophan into immunosuppressive kynurenine is considered an important immunosuppressive mechanism in the tumor microenvironment. There are three enzymes, namely, tryptophan 2,3-dioxygenase (TDO), indoleamine 2,3-dioxygenase 1 (IDO1), and indoleamine 2,3-dioxygenase 2 (IDO2), involved in the metabolism of tryptophan. IDO1 has a wider distribution and higher activity in catalyzing tryptophan than the other two; therefore, it has been studied most extensively. IDO1 is a cytosolic monomeric, heme-containing enzyme, which is now considered an authentic immune regulator and represents one of the promising drug targets for tumor immunotherapy. Collectively, this review highlights the regulation of IDO1 gene expression and the ambivalent mechanisms of IDO1 on the antitumoral immune response. Further, new therapeutic targets via the regulation of IDO1 are discussed. A comprehensive analysis of the expression and biological function of IDO1 can help us to understand the therapeutic strategies of the inhibitors targeting IDO1 in malignant tumors.

Relevant studies have demonstrated that urban green spaces composed of various types of plants are able to alleviate the morbidity and mortality of respiratory diseases, by reducing air pollution levels. In order to explore the relationship between the spatial pattern of urban green spaces and air pollutant concentrations, this study takes 37 garden cities with subtropical monsoon climate in China as the research object and selects the urban air quality monitoring data and land use type data in 2019 to analyze the relationship between the spatial pattern and the air pollutant concentration through the landscape metrics model and spatial regression model. Moreover, the threshold effect of the impact of green space on air pollutant concentrations is estimated, as well. The results showed that the spatial pattern of urban green space was significantly correlated with the concentrations of PM2.5 (PM with aerodynamic diameters of 2.5 mmor less), NO2 (Nitrogen Dioxide), and SO2 (Sulfur dioxide) pollutants in the air, while the concentrations of PM10 (PM with aerodynamic diameters of 10 mmor less) pollutants were not significantly affected by the green space pattern. Among them, the patch shape index (LSI), patch density (PD) and patch proportion in landscape area (PLAND) of forest land can affect the concentration of PM2.5, NO2, and SO2, respectively. The PLAND, PD, and LSI of grassland and farmland can also have an additional impact on the concentration of SO2 pollutants. The study also found that there was a significant threshold effect within the impact mechanism of urban green space landscape pattern indicators (LSI, PD, PLAND) on the concentrations of PM2.5, NO2, and SO2 air pollutants. The results of this study not only clarified the impact mechanism of the spatial pattern of urban green space on air pollutant concentrations but also provided quantitative reference and scientific basis for the optimization and updating of urban green space to promote public health.

Morindae Officinalis Radix (MOR) and Alpiniae Oxyphyllae Fructus (AOF) have been widely used as dietary supplements and traditional herbal medicines for centuries. Fungal and mycotoxin contamination in MOR and AOF has been reported recently. In this study, fungi in MOR and AOF are first investigated using DNA metabarcoding, and the differences in fungal microbiome between moldy and non−moldy samples are analyzed. The results show that Ascomycota is the most prevailing fungus at the phylum level in MOR and AOF with relative abundances of 49.53–94.32% and 14.81–81.85%, respectively. Penicillium (1.86–76.14%), Cladosporium (1.82–56.65%), and Trichoderma (0.12–19.71%) are the dominant genera in MOR. Penicillium (0.27–56.06%), Papiliotrema (0.04–51.71%), and Cladosporium (3.08–44.41%) are the dominant genera in AOF. Two potential toxigenic fungi were detected, namely, Trichoderma atroviride and Fusarium equiseti. Moreover, the differences in fungal communities between moldy and non−moldy samples were monitored. In conclusion, DNA metabarcoding can be used to assess the fungal microbiome in edible medicinal herbs, thereby providing a basis for ensuring food safety and drug efficacy.

Platycladi Semen, which is derived from the dried ripe seed of Platycladus orientalis, has been used for the treatment of insomnia and constipation in China for 2000 years. However, it is susceptible to fungal and aflatoxin contamination under proper humidity and temperature during storage. Although aflatoxin contamination in Platycladi Semen has been reported preliminarily, few studies have been conducted on fungal infection and aflatoxin contamination simultaneously. Thus, this work aims to provide an in-depth understanding of fungal contamination in Platycladi Semen, and information on aflatoxin contamination. We focused on a comparison of the difference in fungal diversity between aflatoxin-contaminated and aflatoxin-free Platycladi Semen samples. First, aflatoxin levels in 11 Platycladi Semen samples, which were collected from local herbal markets in Shandong, Anhui, and Hebei provinces throughout China, were determined by IAC-HPLC-FLD, and positive confirmation of detected samples was performed by LC-MS/MS. The samples were divided into two groups, based on production or non-production of aflatoxin. We then used the Illumina MiSeq PE250 platform, and targeted the internal transcribed spacer two sequences to analyze the diversity and composition of the fungal microbiome, as well as to assess the presence of potential mycotoxin-producing fungi. Results showed that five samples were contaminated with aflatoxins, one of which exceeded the legal limits of Chinese Pharmacopeia Commission (2015). At the phylum level, the Ascomycota was the most dominant in all tested samples, with a relative abundance of 83.04–99.46%. Aspergillus (27.88–97.28%), Xerochrysium (0–28.49%), and Xeromyces (0–22.24%) were the three predominant genera. Furthermore, differences in fungal composition between the aflatoxin-contaminated and aflatoxin-free groups, as well as between different provinces were observed. A total of 74 species were identified, and four potential mycotoxin-producing fungi were detected in all samples, namely Aspergillus flavus, Aspergillus fumigatus, Fusarium poae, and Penicillium steckii. In conclusion, we report the great diversity of fungi associated with Platycladi Semen, highlight the risk to consumers of ingesting potent aflatoxin, and provide a reference for the safe application and quality improvement of Platycladi Semen.

Ziziphi Spinosae Semen (ZSS) has been widely used in traditional Chinese medicine system for decades. Under proper humidity and temperature, ZSS is easily contaminated by fungi and mycotoxins during harvest, storage, and transport, thereby posing a considerable threat to consumer health. In this study, we first used the Illumina MiSeq PE250 platform and targeted the internal transcribed spacer 2 sequences to investigate the presence of fungi in moldy and normal ZSS samples collected from five producing areas in China. Results showed that all 14 samples tested were contaminated by fungi. Ascomycota was the dominant fungus at the phylum level, accounting for 64.36⁻99.74% of the fungal reads. At the genus level, Aspergillus, Candida, and Wallemia were the most predominant genera, with the relative abundances of 13.52⁻87.87%, 0.42⁻64.56%, and 0.06⁻34.31%, respectively. Meanwhile, 70 fungal taxa were identified at the species level. Among these taxa, three potential mycotoxin-producing fungi, namely, Aspergillus flavus, A. fumigatus, and Penicillium citrinum that account for 0.30⁻36.29%, 0.04⁻7.37%, and 0.01⁻0.80% of the fungal reads, respectively, were detected in all ZSS samples. Moreover, significant differences in fungal communities were observed in the moldy and normal ZSS samples. In conclusion, our results indicated that amplicon sequencing is feasible for the detection and analysis of the fungal community in the ZSS samples. This study used a new approach to survey the fungal contamination in herbal materials. This new approach can provide early warning for mycotoxin contamination in herbal materials, thereby ensuring drug efficacy and safety.