Infertility has become one of the most common chronic diseases among reproductive- aged individuals, and male factors account for about 50 %. Zinc is a trace element that is essential for sperm quality and male reproductive system. Although several current studies with small sample sizes have investigated this relationship, the conclusions have been still controversial. Here, using a large population sample involved 25,915 participants from Changzhou Maternity and Child Health Care Hospital, we revealed an inverted "U"-shaped trend between seminal plasma zinc concentrations and sperm motility PR/PR + NP (PR, progressive motility; NP, non-progressive motility). The results showed that the highest values of sperm PR/PR + NP observed in the group with intermediate concentrations of zinc (Group 2, 0.25-2.11 mmol/L). The mean values were 43.17 ± 19.03 % and 56.64 ± 20.28 %, respectively. And the lowest values came out in the highest zinc levels group (Group 4, > 3.04 mmol/L). In vitro cell experiments also showed that zinc caused dose-dependent cytotoxicity for GC-2 cells at a threshold value. Furthermore, RNA-seq analysis demonstrated that high concentrations of zinc exerted toxic effects on GC-2 cells through immune injury. Taken together, our findings suggested that moderate amounts of zinc are crucial for human reproduction and excessive concentrations may have adverse effects on male fertility.

To evaluate the current views on doctor–patient relationship (DPR) between citizens and medical staff in post-Corona Virus Disease 2019 (COVID-19) period and predict the possible factors of DPR, we distributed questionnaires by a online questionnaire platform--Questionnaire Star (https://www.wjx.cn) to evaluate DPR in post-COVID-19 period. Overall, 312 questionnaires for citizens and 421 questionnaires for medical staff were completed. Citizens felt that service attitude and communication with medical staff, and registering process have been improved. And their trust in doctors has increased by 86.8%. Majority of citizens (66.0%) preferred the tertiary hospitals. If doctor–patient contradictions occurred, 62.9% citizens preferred internal negotiation (with the doctor involved, 44.6%; with hospital management department, 18.3%). There was significant difference of views on the causes of medical violence incidents and the reasons for doctor–patient conflicts in the future between citizens and medical staff. The DPR score of medical staff was lower than citizens at each stage, and even showed a downward tendency in post-COVID-19 period. Furthermore, 20.4% medical staff believed that harmonious DPR would not be maintained, which was distinct from that of the citizens. Combating the COVID-19 provided an important opportunity to improve the DPR. However, unbalanced allocation of high-quality medical resources, gap between the actual treatment efficacy and patient’s expectation, fairness and efficiency issues, financial conflicts, and medical information symmetry were still the influencing factors of DPR.

In order to understand the research status of the relationship between health communication and doctor-patient relationship, and to explore a new path of the impact of health communication on doctor-patient relationship, this paper adopted qualitative methods to quantize the literature over the past 10 years in the Web of Science database and carried out Co-Authorship Analysis, Co-Citation Analysis and Co-Occurrence Analysis based on CiteSpace. In addition, according to the results of bibliometric research, self-designed questionnaires were used to verify the result. A convenience sampling survey was conducted through the online “Questionnaire Star” platform (https://www.wjx.cn) on May 8, 2022, and a total of 254 questionnaires were collected. Interviewees were asked to use social software to acquire health knowledge. Participants come from 21 provinces, 4 municipalities, and 4 autonomous regions across the country, which is geographically representative. The results show that uncertainty of social media information and the particularity of the epidemic make the research on health communication and doctor-patient relationship in social media become a new hot spot. Social media health information quality (source credibility and content trust perception), information asymmetry perception, doctor-patient communication, doctor-patient consistency, doctor-patient trust, doctor-patient relationship may be the key variables for constructing theoretical models.

To explore how college students’ academic engagement has changed in the outbreak of coronavirus disease 2019 (COVID-19) (hereinafter referred to as “in the outbreak”), this research will encompass more than just looking into the relationship among anxiety, benefit finding (BF) and academic engagement, but also involve evaluating how anxiety moderates the positive impact of BF on academic engagement. Among college students, this study comprised an online-based cross-sectional survey in cities where COVID-19 broke out. Convenience sampling method was used. The survey took place between November 10 and November 19, 2021, during which all the cities surveyed were in the outbreak. With language revision, scales include Student Version of the Utrecht Work Engagement Scale (UWES-S), recompiled Benefit Finding Scale (BFS) and 7-item Generalized Anxiety Disorder Scale (GAD-7), as methods for gauging the academic engagement, BF and anxiety experienced by college students, respectively. Academic engagement in the outbreak is higher than that before the outbreak stage of COVID-19 (hereinafter referred to as “before the outbreak”) (Z = −18.201, P < 0.001). Between anxiety and BF, a negative correlation can be observed in the outbreak (P = 0.001), whereas BF and anxiety have an adverse correlation with academic engagement (P < 0.001). The positive effect of BF on academic engagement will be debilitated by anxiety. Further analysis shows that college students who are close to medium-and high-risk areas, worried about the infection, unvaccinated and concerned about the epidemic, are more likely to be anxious (P < 0.001). Those with confidence in government's ability to prevent and control the epidemic, as well as increased trust in medical workers, have a higher BF (P < 0.001). While COVID-19 could still exert adverse effects on psychology of college students, but it can also stimulate college students to perceive the meaning of life. In the outbreak, an increase in academic engagement seems to be a manifestation of growth in adversity. Compared with short-term negative emotional intervention, life meaning and gratitude in education may stimulate their potential ability for a longer time.

Objective This study aims to explore the difference and relationship between anxiety, benefit finding (BF), and academic engagement in the outbreak and stable stages of COVID-19, as well as the effects of anxiety and BF on academic engagement. Methods This repeated cross-sectional pilot study involved online surveys of college students in cities in the outbreak stage from November 10 to 19, 2021, and in the stable stage from December 1 to 19, 2021. The questionnaire collected demographic information and included the Generalized Anxiety Disorder Scale, Benefit Finding Scale, and Student Version of the Utrecht Work Engagement Scale. A convenience sampling method was employed, yielding 3602 valid responses from the first survey and 1262 from the second. Propensity score matching was employed to control for confounding variables. SPSS was used for data analysis, while AMOS was employed for validate the relationships among anxiety, BF, and academic engagement. Results After matching 1262 pairs, the data results of age, gender, educational backgrounds, majors, and distance from medium-and high-risk areas were the same among students in the outbreak and stable stages of COVID-19 (p > .05). The ages of college students were 20.69 ± 1.70 and 21.12 ± 1.42 in two periods of COVID-19. The proportion of males and females were 51.8% and 48.2%, respectively. There were statistically significant differences in academic engagement, BF, and anxiety between two periods (t = -2.655, p = .008; t = 8.408, p < .001; t = 24.222, p < .001). Anxiety was negatively correlated with academic engagement, while BF was positively correlated with it in two periods. Compared with the stable stage of COVID-19, the influence of BF on academic engagement weakened, while the influence of anxiety on academic engagement was strengthened in the outbreak stage, which was validated through structural equation modeling using AMOS. Conclusion With the control of the COVID-19, college students have shown increased academic engagement, alongside reduced BF and anxiety. Enhancing students' BF and alleviating their anxiety can further promote academic engagement. In the outbreak stage, interventions aimed at reducing anxiety may be more critical. Simultaneously, sustained efforts to effectively enhance and maintain BF are essential to further promote academic engagement.