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To explore the mediating effect of sleep duration on the relationship between qi stagnation constitution and anxiety/depression in junior high school students. Methods From March 20 to March 31, 2020, a total of 10, 325 students from 6 junior high schools in Henan, Liaoning, Shaanxi, Shandong, and Fujian provinces were sampled by cluster sampling. Firstly, the general conditions ( age, gender, grade, hometown, whether they are an only child) and sleep duration were collected, and their qi stagnation constitution, depression and anxiety status were evaluated by using the Qi Stagnation Subscale in the "' TCM Constitution Classification and Judgment Scale", the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder ( GAD-7). Secondly, Spearman correlation analysis was used to explore the correlation between qi stagnation constitution, sleep duration, and anxiety/ depression. Then, linear regression analysis and mediating effect test were used to explore the relationship between qi stagnation constitution and anxiety/depression in junior high school students, and the mediating effect of sleep duration was analyzed, and the results were verified. Results (i) The detection rate of anxiety in non-only children was higher than that of only children (X1 = 11. 198, P = 0. 001) ； The detection rate of anxiety (f = 106. 967, P<0. 001) or depression (f = 84. 692, P<0. 001) was higher among senior students than those in lower grades, while those of girls with anxiety = 100.441, P<0.001) or depression (太2 = 71.418, P <0.001) were higher than those of boys. The detection rates of anxiety (太2 = 1 092. 298, P<0. 001) and depression (X1 = 866. 740, P<0. 001) in qi stagnation constitution students were higher than those of non-qi stagnation constitution students, and the detection rates of anxiety (χ2 = 1 076. 716, P<0. 001) and depression (太2 = 1 099. 725, P<0. 001) in students whose sleep duration less than 8 h were higher than those of whose sleep duration more than 8 h, and the shorter the sleep duration, the higher the detection rate. (ii) Qi stagnation constitution positively predicted anxiety/depression (β = 0.679, P<0.001;β = 0.718, P<0.001), and sleep duration had a negative predictive effect on anxiety/depression (β = -0.403, P<0. 001 ；β = -0. 439, P<0.001). ( iii) Sleep duration played a partial mediating role in the relationship between qi stagnation constitution and anxiety/depression in junior high school students, and the mediating effect accounted for 13. 40% and 13. 79% of the total effect, respectively. Conclusion Although qi stagnation constitution mainly affects anxiety/depression through direct effect, it can still be partially indirectly realized through the mediating variable of sleep duration, that is, the shorter the sleep duration, the higher the risk of anxiety/depression in junior high school students. Therefore, the mental health problems of junior high school students can be prevented and improved by regulating qi stagnation constitution and ensuring adequate sleep duration. [ABSTRACT FROM AUTHOR]

Objective: To clarify the structural and functional characteristics of the gut microbiota in individuals with qi stagnation constitution (QSC) and identify the potential biomarkers related to QSC. Methods: This cross-sectional study involved individuals with QSC and balanced constitution (BC) confirmed by TCM clinicians. The clinical features were recorded, and fecal samples were collected for 16S rDNA sequencing. The structure of the fecal-associated microbiome (FAM) was described by the alpha-diversity indexes, beta-distances, and relative abundances of dominant taxa. The differences in FAM distribution were analyzed by the Wilcoxon rank-sum test, MetagenomeSeq, and LEfSe analysis. The 16S rDNA gene sequences were assigned to the KEGG dataset to predict the functional information of bacterial metabolic pathways by using PICRUSt. Differences in functional pathways between groups were assessed with the Wilcoxon rank-sum test. The ROC curve based on specific operational taxonomic units (OTUs) was constructed, and the AUC was calculated. Results: Twenty-two individuals with BC and 8 with QSC were recruited. Significant differences between the two groups were found in body mass index, health status, and low-density lipoprotein, etc. There was no significant difference in the alpha-diversity index. PCoA showed no evident clustering of bacterial communities according to constitutions. Bacteroidaceae, Lachnospiraceae, Ruminococcaceae, and Prevotellaceae were the four common bacteria with high abundances. Notably, MetagenomeSeq, LEfSe analysis, and the Wilcoxon rank-sum test identified significantly different distributions of 66, 42, and 36 OTUs, respectively. Predictive function analysis showed that 13 metabolic pathways were significantly differentially distributed, including those related to fatty acid synthesis. Five specific OTUs were selected as potential biomarkers of a QSC, and the AUC was 0.94. Conclusion: Individuals with QSC have unique FAM structure and related functional characteristics. Five specific OTUs were identified to serve as potentially effective biomarkers related to QSC.