Objective: To investigate the status and associated factors of sports supplement usage among grade 9 students, so as to provide a scientific basis for targeted supervision and health education regarding sports supplement usage among junior high school students. Methods: From June to September 2025, a stratified cluster random sampling method was used to select 2 261 grade 9 students from 10 provinces (autonomous regions, municipalities) in China. A questionnaire survey was conducted on their sports supplement usage and related factors. The Chi square test was used to compare the usage rates of sports supplements among different groups of students, and binary Logistic regression analysis was employed to investigate the related factors of sports supplement usage among grade 9 students. Results: Totally 59.7% of the grade 9 students used sports supplements. The usage rate (62.5%) was higher among boys than girls (56.3%), higher among students from rural areas and towns/counties (66.5%, 66.2%) than those from urban districts (52.9%), higher among boarding students (65.2%) than non resident students (54.3%), higher among students whose parents occupations were businessmen and workers (fathers: 65.0%, 63.7%; mothers: 63.6%, 61.1%) than those whose parents were farmers and civil servants (fathers: 57.5%, 54.1%; mothers: 58.8%, 55.7%), higher among students with a monthly family income of 5 000- 10 000 yuan (66.3%) than those in other income groups, and higher among students in the high score zone for the entrance physical examination to senior high school (67.7%) than those in the medium and low score zones ( 56.3% , 56.5%) ( χ 2=8.99, 42.21, 27.98, 20.55, 8.20, 22.74, 24.70, respectively, all P <0.05). Binary Logistic regression analysis showed that boys ( OR =1.26), those from rural areas ( OR =1.59), boarding students ( OR =1.36), those with a monthly family income of 5 000- 10 000 yuan ( OR =1.41), and those in the high score zone for entrance physical examination to senior high school ( OR =1.34) were more likely to use sports supplements during the entrance physical examination to senior high school; the probability of sports supplement usage was lower among students whose fathers were civil servants ( OR =0.74) (all P <0.05). Conclusions The usage of sports supplements is relatively common among grade 9 students. Intervention measures should be targeted at specific populations to reduce the risk of misuse.

Objective: To explore the relationship between non suicidal self injury (NSSI) behavior and serum lipid levels as well as thyroid function among college students with depression. Methods: A total of 169 college students with depression in the psychiatry departments of tertiary hospitals (grade 3A and 3B) in Ningbo from December 2023 to April 2025 were selected. The Adolescent Self injury Scale (ASIS) was used to assess the presence of NSSI, and participants were accordingly divided into a NSSI group ( n =51) and a non NSSI group ( n =118). General demographic data (including gender, age, and family situation) were collected from both groups. Blood tests were performed to measure lipid profiles [triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C)] and thyroid hormones [triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH)]. Multivariate Logistic regression was employed to analyze risk factors for NSSI, and receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of serum lipid and thyroid hormone levels for NSSI occurrence in college students with depression. Results: The levels of TC, LDL-C, and TSH in the NSSI group were (4.02±0.73) mmol/L, (2.32±0.36) mmol/L, and (6.57±1.95) mU/L , which were significantly higher than those in the non NSSI group [(3.41±0.56) mmol/L, (2.00±0.27) mmol/L, and ( 4.48± 1.09) mU/L, respectively] ( t =5.32, 5.60, 7.20, all P <0.05). Logistic regression analysis revealed that college students from single parent/reconstituted families, those who had experienced school bullying, and those with higher levels of TC, LDL-C, and TSH had a significantly increased risk of engaging in NSSI ( OR =5.22, 6.12, 5.90, 83.64, 3.64, all P <0.05). ROC curve analysis demonstrated that the combined detection of TC, LDL-C, and TSH had high diagnostic efficacy for predicting NSSI in college students with depression, with a sensitivity of 86.3% and a specificity of 94.9%. Conclusions NSSI behavior in college students with depression is associated with serum lipid levels and thyroid function. These biomarkers may serve as useful reference indicators for assessing the conditions of these patients.

Background Prolonged vibration exposure can lead to vascular endothelial cell dysfunction and cellular injury. However, research on the association between vibration and ferroptosis in vascular endothelial cells remains insufficient. Objective To explore whether occupational vibration exposure is associated with alterations in serum markers related to ferroptosis in patients with hand-arm vibration disease (HAVD), and to further investigate, through in vitro cell experiments, whether vibration exposure may induce ferroptosis in vascular endothelial cells. Methods ①A judgmental sampling method was employed to select 50 workers with HAVD (the HAVD group), 50 vibration-exposed workers without HAVD (the vibration exposure group), and 50 non–hand-transmitted vibration-exposed workers (the control group). Serum iron levels, malondialdehyde (MDA) content, and superoxide dismutase (SOD) levels were measured using serum iron assay kits, MDA detection kits, and SOD detection kits, respectively. One-way analysis of variance and binary logistic regression analysis were performed to examine the relationships between these indicators and HAVD. ②Human umbilical vein endothelial cells (HUVEC) were divided into a vibration group and a control group. The vibration group was subjected to vibration at 120 Hz with an acceleration of 6.5 m·s⁻² and further subdivided into four subgroups: 1 d 2 h, 1 d 4 h, 2 d 2 h, and 2 d 4 h. The control group was treated identically except for vibration exposure. Cellular iron (Fe²⁺) content and reduced glutathione (GSH) levels in HUVEC were measured using ferrous iron colorimetric assay kits and GSH colorimetric assay kits, respectively, to assess the effects of different vibration exposure schedules. Real-time quantitative polymerase chain reaction (RT-qPCR) was performed to detect the mRNA expression levels of ferroptosis-related genes, including acyl-CoA synthetase long-chain family member 4 (ACSL4), tumor suppressor protein P53 (P53), ferritin heavy chain 1 (FTH1), and glutathione peroxidase 4 (GPX4). Western blot analysis was conducted to determine the protein expression levels of ferroptosis-related markers in HUVEC. Results ①Compared with the control group, the patients in the HAVD group showed increased serum iron and MDA levels, along with decreased SOD levels (P<0.05). The logistic regression analysis indicated that elevated serum iron levels were significantly associated with an increased risk of HAVD (OR=4.034; 95%CI: 2.063, 7.887), and elevated MDA levels were also associated with an increased risk of HAVD (OR=1.523; 95%CI: 1.026, 1.936). ②Compared with the control group, increased intracellular Fe²⁺ content and decreased GSH content were observed in HUVECs in the 1 d 4 h and 2 d 4 h vibration subgroups (P<0.05). The RT-qPCR results showed that, compared with the control group, vibration exposures of 1 d 4 h and 2 d 4 h significantly upregulated the expression of ACSL4 and P53 (P<0.05), whereas the mRNA expression levels of GPX4 and FTH1 were downregulated in all vibration-exposed endothelial cells (P<0.05). The Western blot results revealed that, compared with the control group, the vibration exposure schedules of 1 d 2 h and 1 d 4 h significantly upregulated the protein expression levels of ACSL4 and P53 (P<0.05), while the vibration exposure schedules of 1 d 4 h, 2 d 2 h, and 2 d 4 h significantly downregulated the protein expression levels of FTH1 and GPX4 (P<0.05). Conclusion Occupational vibration exposure is associated with alterations in iron metabolism and oxidative stress status in workers with HAVD. The in vitro experiments further demonstrates that vibration stimulation induces intracellular iron accumulation and reduces antioxidant capacity in vascular endothelial cells, accompanied by dysregulated expression of ferroptosis-related molecules. These findings suggest that ferroptosis may play a role in vibration-induced vascular injury and the pathogenesis of HAVD.

Health economics evidence plays an important role in linking clinical value evidence with health resource allocation decisions in the development of clinical practice guidelines. It can not only effectively balance clinical effectiveness and economic feasibility but also avoid forming "idealized" recommendations that are detached from the affordability of the healthcare system or the burden-bearing capacity of patients. To promote guideline developers to use health economics evidence more standardizedly and fully, this paper conducts an in-depth analysis of the current application status, existing challenges, access channels, and application processes of health economics evidence in current guidelines, and on this basis, puts forward considerations and suggestions for strengthening and standardizing the application of health economics evidence in China's clinical practice guidelines.

Objective: To report the hematological phenotypic characteristics and molecular variant features of a rare abnormal hemoglobin Hb K-Woolwich compound with Southeast Asian α-thalassemia in a Chinese family pedigree, aiming to summarize the laboratory screening patterns and the value for clinical genetic counseling, and to supplement the baseline data of this rare variant in the Chinese population. Methods: A three-generation pedigree involving three carriers was enrolled in this study. The proband's medical history and general clinical data of the family were retrospectively analyzed. Phenotypic analysis and molecular genotypic confirmation were performed using complete blood count parameters, capillary hemoglobin electrophoresis, H100Plus high-performance liquid chromatography (HPLC), and gene sequencing, followed by Sanger sequencing. Results: All three individuals in this pedigree were identified as heterozygous carriers of the HBB:c. 397A>C mutation (Hb K-Woolwich) in the β-globin gene, combined with the αα/--SEA Southeast Asian type α-thalassemia genotype. Hematological findings revealed compensatory elevation of red blood cell count, decreased mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH), while hemoglobin (Hb) levels remained within the normal range with no overt anemic phenotype. Both capillary electrophoresis and HPLC detected characteristic abnormal variant peaks, with good concordance between the two screening methods. Conclusion: Hb K-Woolwich compound with αα/--SEA thalassemia presents with distinctive hematological phenotypes, characterized by prominent microcytic and hypochromic changes without anemia, which may be easily overlooked in routine thalassemia screening programs. This is the first report of this compound genotype in China, providing valuable reference for laboratory identification, prenatal screening, and family genetic counseling of rare hemoglobin variants.

ObjectiveTo explore the mechanisms of Salviae Miltiorrhizae Radix et Rhizoma in treating metabolic hypertension induced by a high-sugar and high-fat diet in rats based on network pharmacology， proteomics， and animal experiments. MethodsThirty male SD rats were randomized into the control， model， positive drug （tetrandrine， Tet， 50 mg·kg^-1·d^-1）， low-dose Salviae Miltiorrhizae Radix et Rhizoma （DS-L， 45×10⁴ mg·kg^-1·d^-1）， and high-dose Salviae Miltiorrhizae Radix et Rhizoma （DS-H， 90×10⁴ mg·kg^-1·d^-1） groups. Except for the control group， each group was fed a high-fat and high-sugar diet for 8 weeks for the modeling of metabolic hypertension. Following successful modeling， drug interventions were conducted through gavage for 4 weeks. Blood pressure and lipid indicators were monitored， and cardiac function was assessed via echocardiography. Samples from the thoracic aorta and cardiac tissue were collected for histopathological examination. Network pharmacology analysis identified key active components， potential targets， and mechanisms of Salviae Miltiorrhizae Radix et Rhizoma in treating hypertension. Proteomics technology was employed to analyze the differential proteins and major pathway targets to synergistically elucidate the antihypertensive mechanism of Salviae Miltiorrhizae Radix et Rhizoma. Ca²⁺ concentrations in the thoracic aorta and cardiac tissue were measured. The protein levels of transient receptor potential cation channel （TRPC）3， TRPC6， NADPH oxidase （NOX）2， and NOX4 were quantified via Western blotting. The levels of oxidative stress markers and inflammatory factors， including superoxide dismutase （SOD）， malondialdehyde （MDA）， tumor necrosis factor-α （TNF-α）， and interleukin-1β （IL-1β）， were determined by enzyme-linked immunosorbent assay （ELISA）. Molecular docking analysis was performed for the main components of Salviae Miltiorrhizae Radix et Rhizoma with TRPC3， TRPC6， NOX2， and NOX4. ResultsThe experimental results indicated that compared with the control group， the model group exhibited abnormally elevated blood pressure and increased lipid levels （P<0.01）. Compared with the model group， the DS-L group exhibited reduced systolic blood pressure （SBP）， diastolic blood pressure （DBP）， and mean arterial pressure （MAP） （P<0.05）， decreased serum levels of triglycerides （TG）， total cholesterol （TC）， and low-density lipoprotein cholesterol （LDL-C） （P<0.05）， and increased level of high-density lipoprotein cholesterol （HDL-C） （P<0.01）. The DS-H and Tet groups showed more significant effects （P<0.01）. Moreover， the interventions attenuated vascular wall thickening， myocardial cell injury， and collagen and lipid deposition. Network pharmacology and proteomics prediction results indicated that the core targets of Salviae Miltiorrhizae Radix et Rhizoma in treating hypertension were TRPC3， TRPC6， NOX2， and NOX4， and the core pathways included calcium signaling， cyclic guanosine monophosphate （cGMP）/cGMP-dependent protein kinase （PKG） signaling， and atherosclerosis-related pathways. The molecular mechanism experiment results indicated that compared with the control group， the model group exhibited significantly elevated tissue Ca²⁺ concentrations， exacerbated oxidative stress and inflammatory responses， and upregulated protein levels of TRPC3， TRPC6， NOX2， and NOX4 in the thoracic aorta and myocardial tissue （P<0.01）. Compared with the model group， DS-L reduced the free Ca²⁺ concentration， lowered the levels of IL-1β， TNF-α， SOD， and MDA （P<0.05）， and downregulated the protein levels of TRPC3， TRPC6， NOX2， and NOX4 in the thoracic aorta and myocardial tissue （P<0.05）. DS-H and Tet exhibited more significant effects （P<0.01）. Meanwhile， the main components of Salviae Miltiorrhizae Radix et Rhizoma had strong binding affinity with the core targets of hypertension. ConclusionSalviae Miltiorrhizae Radix et Rhizoma may ameliorate oxidative stress and mitigate inflammatory responses by regulating the TRPC3/6/NOX2/4 signaling pathway， thereby alleviating abnormal blood pressure abnormality and myocardial injury in hypertensive rats.

ObjectiveTo establish three standardized rehabilitation unit models covering acute, critical and comprehensive recovery stages for traumatic brain injury (TBI) that fit the whole-course characteristics, clarify their multidisciplinary collaborative framework, standardized procedures, and information management system, and verify the clinical effectiveness of this staged rehabilitation unit on long-term functional prognosis and in-hospital complications of TBI patients. MethodsThis study was conducted at two stages: model construction and efficacy verification. At the first stage, TBI rehabilitation units for acute, critical and recovery stages were established in the Department of Neurosurgery, Intensive Care Unit and Department of Rehabilitation Medicine, respectively, with unified multidisciplinary team configuration, standardized assessment and treatment protocols, collaborative workflows, and a dedicated information management system. At the second stage, 324 TBI patients admitted to the newly built rehabilitation units from July, 2023 to July, 2025 were enrolled as the observation group, and 167 TBI patients receiving traditional management from January, 2018 to December, 2022 were retrospectively selected as the control group. The primary outcomes were 1-year post-injury Glasgow Outcome Scale (GOS) and Disability Rating Scale (DRS) scores. Secondary outcomes included the incidence of in-hospital complications and the mean indwelling time of tracheal intubation, gastric tube and urinary catheter. ResultsThe 1-year GOS score was significantly higher (t = -7.836, P < 0.001), and the DRS score was significantly lower (t = -6.742, P < 0.001) in the observation group than in the control group. The overall incidence of complications was significantly lower in the observation group than in the control group (χ² = 18.762, P < 0.001). The incidences of pulmonary infection, urinary tract infection, pressure ulcer, lower extremity venous thrombosis and joint contracture deformity were all significantly reduced (χ² > 4.328, P < 0.05). The indwelling time of tracheal intubation, gastric tube and urinary catheter was significantly shorter in the observation group than in the control group (t > 10.276, P < 0.001). ConclusionThe acute-critical-comprehensive three-stage standardized TBI rehabilitation unit could significantly improve the long-term functional outcomes of TBI patients, reduce the incidence of complications, and shorten the indwelling time of invasive tubes through multidisciplinary collaboration, whole-course standardized management and information-based quality control. This model conforms to the pathological and functional laws of TBI, realizes seamless whole-course connection from acute treatment to recovery rehabilitation, and has good clinical feasibility and promotion value. It can provide evidence-based evidence and practical reference for the homogenized and standardized development of TBI rehabilitation in China.

ObjectiveTo analyze the epidemiological and etiological characteristics of hand-foot-and-mouth disease (HFMD) in Jinjiang District of Chengdu City from 2014 to 2024, and to provide a reference basis for HFMD prevention and control. MethodsA retrospective study was conducted to collect confirmed and clinically diagnosed cases of HFMD in Jinjiang District from January 1, 2014 to December 31, 2024. Descriptive epidemiological methods were used to analyze the distribution of cases by person, time, and place. Joinpoint regression models were applied to examine trends for incidence and severe case rates, while seasonal patterns were analyzed using the seasonal index method. Chi-square tests were used for comparing rates, Mann-Whitney U tests were applied for comparing two groups with skewed distributions, and Kruskal-Wallis H rank-sum tests were used for multiple groups with skewed distributions. Pathogen characteristics were primarily analyzed using descriptive statistics. ResultsA total of 15 561 HFMD cases were reported from 2014 to 2024. The annual crude incidence rate ranged from 51.32/100 000 to 502.50/100 000, the age-standardized incidence rate ranged from 55.56/100 000 to 721.07/100 000, peaking in 2018, and the overall epidemic intensity generally showed an alternating-year pattern of intensification. A total of 85 severe cases were reported, showing a declining trend in the severe case rate (APC=AAPC=-37.57%, 95%CI∶ -51.49%‒21.33%， P<0.01). Severe cases were most common in the 1‑year‑old age group (43.53%), with a median age of 1.88 years. Recurrent infections accounted for 1 245 cases (8.00%), with 96.73% of these being reinfections. The median age at first infection for recurrent cases was 1.98 years, significantly lower than that of single-infection cases (2.69 years, P<0.001), and the median interval between consecutive infections was 1.19 years. The disease exhibited a bimodal seasonal pattern, with epidemic peaks occurring from May to July and from October to December, however, summer peaks extending into autumn were observed in 2018 and 2023. There were statistically significant differences in age distribution across different years (H=467.51, P<0.001), with the median age increasing from 2.25 years in 2018 to 4.18 years in 2024, and the interquartile range widening from 1.84 to 3.78 years. Since its initial detection in 2017, CVA6 has been identified annually, showing a peak proportion of 87.50% in 2023 and a second peak of 68.18% in 2018. CVA10 was detected during 2021‒2023, peaking at 18.75% in 2021 and decreasing to 14.29% in 2022. Male incidence rates were consistently higher than female rates each year (P<0.05). The proportion of males in the reinfection group was significantly higher than that in the single-infection group (χ²=9.951, P=0.002). Pathogen analyses showed that CVA16 was detected annually, EV71 detection declined fluctuantly and was not detected after 2022. CVA6 was first detected in 2017 and rapidly increased in prevalence, reaching 87.50% in 2023 and becoming the dominant strain. Among severe cases, EV71 accounted for the highest proportion (52.63%), while CVA16 was most common in non-severe cases (41.60%). There was a statistically significant difference in pathogen composition between severe and non-severe cases (χ²=10.402,P=0.011). ConclusionThe epidemiological profile of HFMD undergoes continuous changes over time. It is necessary to strengthen routine surveillance, with particular attention to changes in the pathogen spectrum and age distribution, so as to provide evidence for precise prevention and control measures and the adjustment of vaccination strategies.

Objective To investigate the risk factors for airway obstruction after cervical spine surgery and to construct and validate a predictive risk model.Methods A retrospective analysis of data from 250 patients who underwent cervical spinesurgery was performed.Patients were divided into modeling set(n=175)and validation set(n=75)in a ratio of 7 to 3.Patients in the modeling set were categorized into respiratory distress group and normal breathing group based on whether they ex-perienced postoperative airway obstruction.General patient data were collected.Multivariate Logistic regression analysis was used to identify independent influencing factors for postoperative airway ob-struction.Based on the identified factors,a risk prediction model was constructed.The R software was utilized to draw a nomogram and calibration curve for the risk prediction model.Receiver operat-ing characteristic(ROC)curves were employed to assess the predictive value of the risk prediction model.The goodness-of-fit was evaluated using the Hosmer-Lemeshow test.Results Among the pa-tients in the modeling set,28 cases developed postoperative airway obstruction,with an incidence rate of 16.00％(28/175).Univariate analysis results indicated that there were statistically significant differences in age,operation time,postoperative edema,surgical segments,preoperative tracheal shifting exercise and the number of involved surgical segments between the respiratory distress group and the normal breathing group(P＜0.05).Age,preoperative tracheal shifting exercise,postopera-tive edema and operation time were identified as independent influencing factors for postoperative airway obstruction(P＜0.05).Internal validation showed that the area under the ROC curve of this model was 0.888,with sensitivity of 75.1％ and specificity of 92.1％.Hosmer-Lemeshow test showed that the prediction model had good fit and high prediction value(x2=3.435,P=0.904).The area under the external validation ROC curve was 0.735,with sensitivity of 83.3％ and specificity of 65.1％.Conclusion Age,preoperative tracheal shifting exercise,postoperative edema and opera-tion time are independent influencing factors for patients with airway obstruction after cervical spine surgery.The risk prediction model constructed based on these factors has good predictive perform-ance and clinical application value.

Objective To explore the effects and mechanism of finasteride on epithelial mesenchymal transition in bladder urothelial carcinoma.Methods T24 human bladder cancer cells were treated with different concentrations of finasteride(0.1%,0.5%,and 1%)for 24 hours,with untreated T24 cells as the control group.Some cells were subjected to hypoxic conditions(1%O2)to mimic a low-oxygen microenvironment.Cell proliferation was assessed by immunofluorescence staining for Ki-67.Apoptosis rates were evaluated using Annexin V-FITC/PI double staining followed by flow cytometry,and cell migration was analyzed via scratch wound assays.Western blot was used to detect the expression of EMT-related proteins such as HIF-1α,E-cadherin,N-cadherin,and Vimentin.To further validate the role of the HIF-1α pathway in finasteride's anti-tumor effects,a HIF-1α overexpression lentiviral vector(MOP-1)was constructed and transfected into T24 cells.For animal experiment,T24 tumor-bearing nude mice were randomly divided into four groups:control,MOP-1,1%finasteride,and 1%finasteride+MOP-1(n=4 per group).After 4 weeks of continuous oral administration,tumor growth,metastasis,and perihepatic lymph node changes were recorded,and histological analysis was performed using H&E staining.Results Finasteride affects the proliferation,apoptosis,and epithelial-to-mesenchymal transition of T24 cells in a concentration-dependent manner.Compared to the control group,finasteride-treated T24 cells showed a reduced number of cells in the growth phase,decreased migration,increased expression of epithelial markers,and decreased expression of mesenchymal markers(P<0.05).In T24 cells exposed to hypoxic conditions,the expression of HIF-1α pathway markers was significantly increased(P<0.05),while 1%finasteride treatment inhibited the HIF-1α pathway(P<0.05).The HIF-1α pathway expression level in the 1%finasteride and HIF-1α overexpression plasmid group was lower than that in the control group(P<0.05).Additionally,the tumor mass-to-body weight ratios were lower,with the number of bladder cancer metastases to the liver decreased(P<0.05).Conclusion Finasteride can effectively block the growth of bladder cancer and the transition of epithelial cells into mesenchymal cells by inhibiting HIF-1α/Snail expression.