Objective To systematically analyze the disease burden, long-term trends, and age-sex distribution of major valvular heart disease (VHD) subtypes—rheumatic heart disease (RHD), non-rheumatic valvular disease (NRVD), and non-rheumatic calcific aortic valve disease (CAVD)—in global, Chinese, and US populations from 1990 to 2021, providing evidence for public health strategies and clinical resource allocation. Methods Based on publicly available data from the Global Burden of Disease (GBD) Study 2021, we extracted incidence, mortality, and disability-adjusted life years (DALYs) for VHD from 1990 to 2021. Age-standardized rates (ASRs) were calculated using the GBD 2021 global standard population, and the estimated annual percentage change (EAPC) with its 95% uncertainty interval (UI) was computed for the period. Data from the Agency for Healthcare Research and Quality (AHRQ), the European Society of Cardiology (ESC)/Eurostat surveys, and Chinese national registries were used for trend triangulation and contextual background. Results From 1990 to 2021, the ASR and disease burden of RHD significantly decreased globally and in China (EAPC for DALYs in China: −4.8%, 95%UI: −5.0% to −4.6%). In contrast, the burden of NRVD and CAVD steadily increased in aging populations like those in China and the US, with a higher burden observed in older adults and males. In 2021, the incidence of NRVD and CAVD peaked in individuals aged ≥65 years, with rates being significantly higher in men than in women. RHD burden was concentrated in low socio-demographic index (SDI) regions, whereas NRVD/CAVD burden was strongly associated with high-SDI regions. Conclusion The global VHD epidemiological landscape is transitioning from an RHD-dominant to an NRVD/CAVD-dominant pattern. China faces a dual challenge of a residual RHD burden and a rapidly growing burden of degenerative valvular diseases. Developing tailored screening, prevention, and treatment strategies for different disease subtypes and populations is crucial.

Objective To analyze the global pattern, long-term trends, and regional and population heterogeneity in the burden of 375 diseases and injuries and 88 risk factors from 1990 to 2023 using data from the Global Burden of Disease Study 2023 (GBD 2023). Methods Publicly available GBD 2023 estimates were extracted for incidence, deaths, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs), and age-standardized rates at the global level and by socio-demographic index (SDI), GBD region, age group, and sex. Descriptive analysis, ranking comparison, stratified analysis, and trend analysis were performed, and 95% uncertainty interval was used to assess the stability of estimates. Results In 2023, non-communicable diseases were the leading contributor to global DALYs, accounting for 64.39% of DALYs across the three major disease and injury groups (communicable, maternal, neonatal, and nutritional diseases, non-communicable diseases, and injuries), and also had the highest age-standardized DALYs rate. From 1990 to 2023, age-standardized DALYs rates declined for three major disease and injury groups, with estimated annual percentage changes of −2.69%, −0.78%, and −1.47%, respectively. Cardiovascular diseases ranked first by both DALYs and deaths in 2023, whereas respiratory infections and tuberculosis ranked first by incidence. Non-communicable diseases were the leading cause of disease burden across all SDI strata. As the SDI level declined, the burden of communicable, maternal, neonatal, and nutritional diseases, as well as injuries, increased markedly. Behavioral and metabolic risks remained the main contributors to attributable deaths and DALYs. Conclusion From 1990 to 2023, the global burden of disease continues to shift toward non-communicable diseases; however, some regions still face a double burden of infectious, maternal and child, injury-related, and chronic diseases. Integrating deaths, DALYs, YLLs, YLDs, and risk-attributable burden helps identify priority areas for prevention and resource allocation across regions and populations.

A rapid and accurate method for textile fiber identification was developed for quality control and consumer protection.This method utilized electric soldering iron burning-mesh collision enhanced microtube plasma ionization mass spectrometry(ESIB-MC-μTP-MS)to acquire textile fiber MS data and used a random forest(RF)prediction model to identify fiber composition based on these MS data.The MC-μTP device involved in the method was a homemade low-temperature plasma ionization device constructed using cost-effective and readily available components.The system was applicable for direct analysis of small amount of textile samples without any complex sample pretreatment processes.Characteristic thermal decomposition products of different fibers were generated via soldering iron burning(350℃)in ambient atmosphere,and were subsequently analyzed by a mass spectrometer,with each analysis completed within 5 s.Raw MS data underwent noise reduction,normalization,and global binning steps to form a dataset,and its intrinsic class separability was evaluated using principal component analysis(PCA)combined with k-means clustering.Then,the RF model was trained based on the dimensionality-reduced textile fiber dataset.After grid search optimization,this model demonstrated robust performance with a 0.9762 out-of-bag score,a 0.9683 cross-validation accuracy(5-fold),and a 0.9636 test accuracy,supported by precision,recall,and F1-scores exceeding 0.889 for all fiber classes.The method was applied to analysis of 30 luxury apparel samples from eight brands,among which 20 samples achieved 100%prediction confidence,aligning with labeled compositions.The identification result of two low-confidence samples was further confirmed using attenuated total reflection Fourier transform infrared spectroscopy(ATR-FT-IR).The method has been proven to be simple,portable and with minimal sample requirements for on-site customs inspections,providing a viable tool in the fight against counterfeit products,therefore supporting regulatory enforcement and consumer trust in the textile goods market.

Due to the poor ionization efficiency and the weak mass spectrometry(MS)intensity of weakly polar substances,direct analysis using the traditional electrospray ionization mass spectrometry(ESI-MS)is a big challenge.In this study,a novel rapid on-site detection method of four prohibited sex hormones in cosmetics was proposed using online derivatization strategy coupled with a miniature mass spectrometer.The target substances in the samples were extracted by a custom-made polyaniline/multi-walled carbon nanotube solid-phase microextraction(SPME)probe.The stirring speed was 200 r/min,the extraction temperature was 40℃,and the extraction time was 2 min.A pulled dual-channel θ borosilicate glass capillary emitter was used as the nano-ESI ion source.The SPME probe was inserted into the channel containing methanol in theθborosilicate glass capillary.When the spray voltage was applied,the four sex hormones were desorbed and formed spray microdroplets,which then collided with the hydroxylamine microdroplets generated from the other channel.The microdroplets of reaction product entered into the miniature mass spectrometer for direct analysis.The limits of detection(LOD)and limits of quantification(LOQ)for the four sex hormones were 10-20 ng/mL and 20-50 ng/mL,respectively.The recoveries were from 84.6%to 107.8%with the relative standard deviations(RSD)from 4.1%to 11.6%.Compared to detection without derivatization,the MS signals of the four target substances were increased by 3 to 15 times.This method was simple,rapid,highly efficient and sensitive,and suitable for on-site rapid analysis of weakly polar sex hormones in cosmetics.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective To screen the core genes related to colon cancer in order to provide a new research direction for molecular di-agnosis,targeted therapy and prognosis evaluation of colon cancer.Methods Colon cancer differentially expressed genes(DEGs)were screened out from the gene expression database(GEO),and functional annotation and pathway enrichment analysis of DEGs were per-formed by gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)analysis in Metascape database.The network of protein interactions(PPI)was built utilizing the String database and Cytoscape software to identify the core genes.Survival analysis of se-lected core genes was performed using Kaplan-Meier plotter database,and expression level of core genes was verified using GEPIA2database.Metascape data was used to conduct KEGG pathway enrichment analysis on the selected core genes,and the signal pathway of core gene enrichment was identified.COL1A1 in the core gene was selected for immunohistochemical verification.Results A total of 468 DEGs were identified,including 162 UDEGs and 306 DDEGs.In the two datasets,there were 194 overlapping genes,of which 54 were up-regulated and 140 were down-regulated.With the help of CytoHubba plugin,the top 10gene nodes in the score were selected and identified as the possible core genes of colon cancer(COL1A1,MMP3,COL1A2,COL11A1,THBS2,BGN,MMP1,COL10A1,SPP1,INHBA).The prognosis and expression levels of these 10genes were analyzed,and the expression levels of the 10 core genes were different in colon cancer tissues and normal colon tissues.All of the 10 core genes were correlated with colon cancer prognosis except MMP1,among which MMP3 was positively correlated and the other 8genes were negatively correlated.KEGG analysis showed that core genes were mainly concentrated in three signaling pathways:cytoskeleton,extracellular matrix(ECM)receptor interaction and pro-tein digestion and absorption in muscle cells.Immunohistochemistry analysis revealed a marked increase in the expression level of COL1A1 within the tumor tissue compared to that in paracancer tissue.Conclusion The core genes COL1A1,MMP3,COL1A2,COL11A1,THBS2,BGN,MMP1,COL10A1,SPP1 and INHBA selected by bioinformation analysis may be involved in the occurrence and development of colon cancer,and may be related to the prognosis of patients with colon cancer.It is anticipated that it will serve as a clinically significant biomarker and a therapeutic target for colon cancer.

Objectives:To compare the differences in three rat intervertebral disc degeneration(IDD)models constructed by needle injections of ethanol into the nucleus pulposus,annulus fibrosus,and endplate,respectively.Methods:45 6-week-old Sprague-Dawley rats were randomly divided into three groups using a random number table method,with 15 rats in each group.Three different needle injection of ethanol methods including nucleus pulposus injection(nucleus pulposus injection group),annulus fibrosus injection(annulus fibrosus injection group),and endplate injection(endplate injection group)were used to construct IDD models at the Co6/7 intervertebral disc in rats.At 1,2,3,and 4 weeks post-modeling,3 rats from each group were randomly selected using a random number table for X-ray examination to measure and calculate the disc height index(DHI)of the Co6/7 in rats.Subsequently,rats were euthanized under excessive anesthesia,and the Co6/7 intervertebral disc along with adjacent vertebral bodies were harvested for hematoxylin-eosin(HE)staining to observe degeneration,and the degeneration degree was histologically scored.Results:One rat in each of the nucleus pulposus injection group and annulus fibrosus injection group died unexpectedly due to anesthesia;In the endplate injection group,two rats died due to postoperative infection.At 1,2,3,and 4 weeks after modeling,3 rats were selected from each group of the remaining rats,and a total of 36 rats were included in the result analysis.The remaining rats were sacrificed by excessive anesthesia.One week after modeling,the Co6/7 DHI in each group was lower than that before modeling(Nucleus pulposus injection group:0.117±0.002 vs 0.134±0.005;Annulus fibrosus injection group:0.126±0.005 vs 0.133±0.005;Endplate injection group:0.127±0.002 vs 0.130±0.007,all P＜0.05),which gradually decreased over time.After modeling in each group,the annulus fibrosus broke,the arrangement of fibers gradually became disordered,the matrix and cells of the nucleus pulposus were gradually lost or even completely disappeared,the intervertebral discs gradually collapsed,and the intervertebral spaces gradually narrowed.The degeneration rate and degree of the nucleus pulposus injection group were faster and higher than those of the other two groups.Four weeks after modeling,the DHI of the nucleus pulposus injection group was 0.090±0.008,which was lower than that of the annulus fibrosus injection group(0.106±0.007,P＜0.05)and endplate injection group(0.109±0.000,P＜0.05);The histological score of the nucleus pulposus injection group was 10.00±0.82,which was higher than that of the annulus fibrosus injection group(9.00±1.41,P＜0.05)and endplate injection group(8.75±0.96,P＜0.05).Conclusions:The three needle injection of ethanol methods have their own unique characteristics for constructing IDD models.Nucleus pulposus injection induces the fastest and most severe degeneration,endplate injection leads to slower degeneration but is more in line with natural degeneration processes,and annulus fibrosus injection falls between the other two methods in terms of degeneration characteristics.

Background and Aims:Valeric acid activates the nuclear factor E2-related factor 2(Nrf2)pathway.Recent studies have demonstrated its potent antitumor activity in breast and oral cancers.However,its role in gastric cancer treatment remains unclear.This study aimed to investigate the effects of valeric acid on inflammatory responses and survival in a gastric cancer xenograft model in nude mice and to explore the potential underlying mechanisms to provide new insights for gastric cancer therapy.Methods:A xenograft model was established by subcutaneous injection of human gastric cancer MKN-45 cells into 80 Balb/c nude mice,which were then equally randomized into four groups:control and low-,medium-,and high-dose valeric acid groups(10,20,and 40 mg/kg,respectively).The mice received daily intraperitoneal injections of either saline or valeric acid for 30 days.Tumor growth was monitored during the treatment period.Twelve hours after the final administration,five mice from each group were sacrificed by cervical dislocation;blood was collected via eyeball removal,and tumors were excised and weighed.Histopathological changes in the tumors were observed by HE staining.Serum levels of macrophage inflammatory protein-2(MIP-2),interleukin-10(IL-10),and tumor necrosis factor α(TNF-α)were measured by ELISA.mRNA and protein expression levels of Nrf2 and its downstream molecules,quinone oxidoreductase-1(NQO-1)and heme oxygenase-1(HO-1),were assessed in tumor tissues using qRT-PCR and Western blot.The remaining 15 mice per group were monitored for survival analysis.Results:Compared with the control group,all valeric acid-treated groups showed a significant reduction in tumor volumes at all observation time points and final tumor weight(all P＜0.05),with a dose-dependent trend.HE staining revealed densely arranged tumor cells with high cell density in the control group,while various degrees of tumor necrosis and reduced cell density were observed in valeric acid-treated groups,most pronounced in the high-dose group.ELISA results showed that serum levels of MIP-2 and TNF-α were significantly decreased,while IL-10 levels were significantly increased in valeric acid-treated groups compared to controls(all P＜0.05),exhibiting dose dependence.qRT-PCR and Western blot analyses demonstrated that the mRNA and protein expression levels of Nrf2,HO-1,and NQO-1 in tumors were significantly elevated in the valeric acid groups compared with the control group(all P＜0.05),also showing dose dependence.Survival analysis indicated that the median survival times were 47 d(control),68 d(low dose),81 d(medium dose),and 90 d(high dose),with all valeric acid groups having significantly prolonged survival compared to the control group(all P＜0.05).Conclusion:Valeric acid effectively inhibits the growth of gastric cancer xenografts,attenuates systemic inflammatory responses,and prolongs the survival of nude mice,possibly through activation of the Nrf2 pathway and modulation of the tumor microenvironment.

Oropharyngeal squamous cell carcinoma(OPSCC)is a malignant tumor originating from the squamous epithelium of the oro-pharyngeal mucosa,accounting for more than 90％of oropharyngeal malignancies.In recent years,human papillomavirus(HPV)infec-tion has become one of the primary etiological factors of oropharyngeal squamous carcinoma.The incidence of HPV-associated oropharyn-geal squamous carcinoma has been rising annually,with a noticeable trend toward younger populations,posing a significant threat to hu-man health.Due to the distinct biological behavior and clinical characteristics of HPV-associated oropharyngeal squamous carcinoma com-pared to its non-HPV-related counterpart,the diagnostic and treatment strategies for oropharyngeal squamous carcinoma have undergone substantial changes.Prevention and screening for oropharyngeal squamous carcinoma are of critical importance.The diagnostic and treat-ment process involves multi-disciplinary collaboration,including oral and maxillofacial surgery,otolaryngology,head and neck surgery,oncology,radiology and pathology.Based on evidence from clinical practice,a comprehensive,integrated diagnostic and therapeutic ap-proach has been established,centered around the concept of"prevention,screening,diagnosis,treatment,and rehabilitation",covering the entire patient lifecycle and providing a valuable reference for clinical practice.

Oral squamous cell carcinoma(OSCC)is a malignant lesion originating from the oral mucosal squamous epithelium,account-ing for over 80％of oral and maxillofacial malignancies.Key etiological factors include tobacco,alcohol abuse,and betel quid chewing.In China,its incidence has shown an overall upward trend,posing a significant threat to public health.OSCC exhibits high local invasive-ness,making early diagnosis critical for improving prognosis.Its clinical management requires close multidisciplinary collaboration among oral and maxillofacial surgery,head and neck surgery,radiation oncology,medical oncology,reconstructive surgery,radiology,patholo-gy,and nutritional support teams.Given the increasing disease burden of OSCC and rapid development of multidisciplinary collaborative models,an expert panel has formulated this integrated management consensus based on evidence-based medicine and extensive deliber-ation.Centered on the'Prevention-Screening-Diagnosis-Treatment-Rehabilitation'framework,the consensus provides comprehensive guidance for the entire disease course of OSCC patients,aiming to standardize clinical practice.