Background The global prevalence of obesity is on the rise and is closely associated with various chronic non-communicable diseases such as cardiovascular diseases and diabetes. There is a relative lack of long-term dynamic studies on compound obesity among occupational populations. Objective To explore the changing trends of compound obesity among different occupational groups aged 18–59 years in nine provinces (autonomous regions, municipalities) of China from 1993 to 2018, and to provide a scientific basis for formulating targeted weight management strategies for occupational populations. Methods A total of 34519 employed adults aged 18–59 years from nine waves of the China Health and Nutrition Survey in1993, 1997, 2000, 2004, 2006, 2009, 2011, 2015, and 2018 were included. Obesity types were determined according to the Chinese Adult Weight Management Guidelines. The Joinpoint regression model was used to calculate the average annual percentage change (AAPC) and annual percentage change (APC) of compound obesity rates. Results From 1993 to 2018, the age-standardized compound obesity rate among the occupational population aged 18–59 years showed an upward trend (AAPC=6.24%, 95%CI: 5.09%, 7.41%, P<0.05). The AAPCs (95%CI) for age-standardized compound obesity rates among agricultural workers, blue-collar workers, other occupational groups, service workers, and white-collar workers were 9.55% (7.51%, 11.64%), 6.18% (4.70%, 7.69%), 5.53% (2.27%, 8.90%), 4.07% (2.40%, 5.77%), and 3.89% (2.16%, 5.65%), respectively, with statistically significant differences (P<0.05). Among males, the AAPCs (95%CI) for age-standardized compound obesity rates among agricultural workers, blue-collar workers, other occupational groups, service workers, and white-collar workers were 11.52% (7.71%, 15.47%), 7.28% (6.18%, 8.40%), 5.92% (2.28%, 9.69%), 5.56% (2.11%, 9.12%), and 4.22% (2.33%, 6.15%), respectively, with statistically significant differences (P<0.05). Among females, the AAPCs (95%CI) for age-standardized compound obesity rates among agricultural workers, blue-collar workers, and white-collar workers were 7.45% (6.22%, 8.69%), 3.72% (0.84%, 6.67%), and 2.41% (0.17%, 4.70%), respectively, with statistically significant differences (P<0.05). A turning point was observed in the compound obesity rate among female white-collar workers in 2006, with an APC (95%CI) of 9.69% (5.24%, 14.33%) from 2006 to 2008, showing a statistically significant difference (P<0.05), while no significant trend was found from 1993 to 2006 (P>0.05). No significant trends were observed in the age-standardized compound obesity rates among females in other occupational groups and service workers (P>0.05). Conclusion The compound obesity rate among China's occupational population is increasing rapidly, with the growth rate among agricultural workers being particularly prominent. In 2018, male white-collar workers and female agricultural workers exhibit relatively high compound obesity rates, warranting focused attention. Although the overall growth rate among service workers is slower, the expanding workforce in this sector indicates that obesity remains a serious issue. Targeted occupational health and weight management interventions are needed in the future.

Background With rising obesity rates and earlier hypertension onset among occupational populations, there is an urgent need to elucidate the long-term cardiovascular impacts of dynamic body weight patterns. Current evidence lacks trajectory modeling studies examining occupation-specific prevention strategies. Objective To investigate the association between long-term body mass index (BMI) trajectories and incident hypertension risk in Chinese working adults, and to examine occupation-specific heterogeneity in this relationship. Methods A dynamic sub-cohort of 4 413 occupational participants was constructed from ten survey waves (1991–2018) of the China Health and Nutrition Survey (CHNS). Eligible individuals had valid key BMI records at three or more independent follow-ups before the outcome event; the individual baseline was set as the year of their first participation in the survey. Group-based trajectory modeling (GBTM) was used to identify BMI change patterns. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence interval (CI) for hypertension incidence across trajectory groups, with stratified analysis by occupational categories. Results Among 4413 occupational participants, 1441 incident hypertension cases were reported during the follow-up window. Three long-term BMI trajectories were identified: low-stable, moderate-slowly rising, and high-rising. In Model 3 with all selected confounders adjusted, compared with the low-stable group, the moderate-slowly rising group showed a significantly higher risk of incident hypertension (HR=1.28, 95%CI: 1.12, 1.45; P < 0.001), as did the high-increasing group (HR=1.80, 95%CI: 1.45, 2.23; P < 0.001). The stratified analyses revealed occupational differences in the association. Among agricultural workers, the moderate-slowly rising group (HR=1.35, 95%CI: 1.15, 1.57) and the high-rising group (HR=2.00, 95%CI: 1.50, 2.66) both exhibited significantly increased risks of hypertension (P<0.001). Conversely, among white-collar workers, an increased risk of hypertension was observed only in the high-rising group (HR=1.97, 95%CI: 1.23, 3.17; P<0.05). Conclusion Rapid BMI escalation constitutes a significant risk factor for incident hypertension in occupational populations. Targeted long-term weight monitoring and tailored interventions are recommended for high-risk occupations.

Objective:To analyze the efficacy of enzyme replacement therapy and anti-drug antibody production in children with Fabry disease.Methods:The clinical data of 7 children with Fabry disease treated with enzyme replacement therapy for more than 1 year at Children′s Hospital of Zhejiang University School of Medicine from July 2021 to June 2024 were retrospectively analyzed. The basic information and the changes of related clinical indicators before and after treatment were collected. Paired sample t test was used to compare renal function, left heart mass index, pain score and other related indexes before and after treatment. The anti-drug antibodies were detected by enzyme-linked immunosorbent assay. Results:A total of 6 boys and 1 girl were included. The age of diagnosis was (12.2±1.8) years. After 1 year of enzyme replacement therapy, the abnormal substrate globotriaosylsphingosine and brief pain inventory scores of all children were significantly lower than those before treatment ((16±11) vs. (63±42) μg/L, 22±19 vs. 45±29, t=3.88, 3.43, both P<0.05). There were no significant differences in glomerular filtration rate, urinary microalbumin to creatinine and left heart mass index before and after treatment ((124±35) vs. (136±26) ml/(min·1.73 m 2), (9.3±8.3) vs. (3.8±2.5) mg/g, (38±9) vs. (33±6) g/m 2.7, t=1.33, 1.74, 1.19, all P>0.05). Patients 4, 5 and 6 developed anti-drug antibodies at 1 month, 4 months and 1 month after medication, respectively. Patient 4 had persistently high anti-drug antibody titers (absorbance 3.65-3.73) accompanied by urticaria, elevated globotriaosylsphingosine and worsening clinical symptoms. Conclusions:The enzyme replacement therapy can effectively improve the clinical symptoms and reduce the level of globotriaosylsphingosine in children with Fabry disease. The anti-drug antibody is common in patients after long-term enzyme replacement therapy and may diminish the efficacy, which needs dynamic monitoring.

Objective:By analyzing the relationship between the efficiency of traditional Chinese medicine services and the efficiency of comprehensive medical services in county-level traditional Chinese medicine hospitals in Shandong,it explores the path of coordinated development between traditional Chinese medicine and western medicine in traditional Chinese medicine hospitals,providing references for the high-quality development of county-level traditional Chinese medicine hospitals.Methods:The efficiency of traditional Chinese medicine services and comprehensive medical services in county-level traditional Chinese medicine hospitals in Shandong Province from 2019 to 2022 was analyzed by Data Envelopment Analysis(DEA),and the correlation was analyzed by Spearman correlation coefficient.Results:The efficiency of traditional Chinese medicine services in county-level traditional Chinese medicine hospitals in Shandong Province is lower than that of comprehensive medical services,and the scale return coefficient of traditional Chinese medicine category indicators is better than that of comprehensive category indicators.There is a positive correlation between the efficiency of traditional Chinese medicine services and the efficiency of comprehensive medical services.Conclusion:Traditional Chinese medicine hospitals should appropriately expand their investment in traditional Chinese medicine resources.Adhere to the hospital management model of traditional Chinese medicine services as the main focus,and build a coordinated development path between traditional Chinese and western medicine from both the supply and demand sides.

Objective:To explore the combination of high risk screening and family screening for potential patients with Fabry disease in adult hemodialysis population, and to improve the diagnostic efficiency of the disease.Methods:It was a cross-sectional investigation study. High-risk screening for Fabry disease was performed on adult hemodialysis patients with end-stage kidney disease who were admitted to Yongkang First People's Hospital of Zhejiang Province between November 2022 and February 2023. Dry blood paper α-galactosidase A (α-Gal A) detection assay was performed in males, or glycosphingolipids (Lyso-GL-3) detection assay was performed in females. GLA genetic assay was performed for further diagnosis after abnormal screening results. Family screening was carried out on the family members of the confirmed Fabry disease patients, and α-Gal A activity and Lyso-GL-3 of peripheral blood were measured. Additionally, urine routine, blood biochemistry, eye examination, hearing test, cranial magnetic resonance imaging, and electrocardiogram were performed to assess organ damage. Results:Among 244 hemodialysis patients, 139 (56.97%) were males and 105 (43.03%) were females. The age ranged from 25 to 81 years (with median age of 61 years). One female patient with Fabry disease was identified GLA IVS4+919G>A mutation, resulting in a total prevalence of 0.41%. Pedigree screening was conducted on 41 family members of the patient, leading to the confirmation of 12 patients (including the proband), including 3 males and 9 females. Among them, 9 patients were abnormal in enzyme examination, 10 patients were abnormal in substrate, and 11 patients were abnormal in gene sequencing. None of the 12 patients exhibited limb pain, hypohidrosis, angiokeratoma, corneal opacity, and hearing impairment. Eight patients had heart abnormalities. Nine patients had abnormal urine routine (albuminuria or hematuria) and one patient had abnormal renal function. Four patients had abnormal cranial magnetic resonance imaging findings. Conclusions:One GLA IVS4+919G>A mutation family is successfully identified through the combination of high-risk screening and family screening in adult hemodialysis patients, with a total of 12 cases of Fabry disease. The combination of high-risk screening and family screening proves to be effective in detecting potential patients with Fabry disease, and improve the screening efficiency of Fabry disease.

The seco-prezizaane-type sesquiterpenes (SPS), as a special class of sesquiterpenes with a highly oxidative five-ring cage structure and seven consecutive chiral centers, are isolated from the genus Illicium, which have a variety of biological activities, including neurotoxicity and neurotrophic effects, etc. This review summarizes the chemical constituents and pharmacological effects of SPS, and discusses the potential trend and scope of future research.

Objective To compare the impact of continuous profound neuromuscular blockade versus con-ventional neuromuscular blockade on postoperative shoulder pain in patients undergoing robot-assisted laparoscopic surgery during steep Trendelenburg position.Methods This study was a single-center,randomized,double-blind clinical trial.The inclusion criteria encompassed individuals aged between 18 and 80 years,with an American Society of Anesthesiologists status of Ⅰ or Ⅱ,and a body mass index ranging from 18 kg/m2 to 30 kg/m2.A total of one hundred patients were randomly assigned to either the deep neuromuscular blockade group(D group)or the conventional neuromuscular blockade group(C group),with equal distribution of fifty cases in each group.Rocuronium dosage was titrated to achieve post-tetanic count values of 1～2 and train-of-four stimulation levels of 1～2 during surgery for D and C groups respectively.At the end of surgery,sugammadex was administered for reversal of neuromuscular blockade.The primary endpoint assessed the incidence of postoperative shoulder pain within three days after surgery.Secondary endpoints included Leiden score evaluation during intraoperative period,number of additional neuromus-cular blockers required by the surgeon,recovery time for muscle relaxation postoperatively,nausea and vomiting scores during recovery phase,visual analog scale(VAS)scores in Post-Anesthesia Care Unit(PACU)as well as within three days after surgery,incidence rate for postoperative pulmonary complications,length of hospital stay duration and patient satisfaction score.Results The incidence of postoperative shoulder pain was significantly lower in group D compared to group C(D group 32%vs.C group 56%;P<0.05).However,there were no significant differences in postoperative shoulder pain VAS scores between the two groups(P>0.05).No significant differences were observed between the groups in terms of Leiden score,surgeon's requirement for additional neuromuscular blockers,nausea and vomiting in PACU,and VAS score(P>0.05).Group D exhibited better early postoperative activity pain scores than group C(P<0.05).There were no significant differences in VAS scores between the groups at other time points(P>0.05).Furthermore,there were no significant differences in the incidence of postoperative pulmonary complications,length of stay,and satisfaction scores between the two groups.Conclusion The imple-mentation of continuous deep neuromuscular blockade in patients undergoing robot-assisted laparoscopic surgery with steep Trendelenburg position can effectively mitigate the occurrence of postoperative shoulder pain.

Objective:By analyzing the relationship between the efficiency of traditional Chinese medicine services and the efficiency of comprehensive medical services in county-level traditional Chinese medicine hospitals in Shandong,it explores the path of coordinated development between traditional Chinese medicine and western medicine in traditional Chinese medicine hospitals,providing references for the high-quality development of county-level traditional Chinese medicine hospitals.Methods:The efficiency of traditional Chinese medicine services and comprehensive medical services in county-level traditional Chinese medicine hospitals in Shandong Province from 2019 to 2022 was analyzed by Data Envelopment Analysis(DEA),and the correlation was analyzed by Spearman correlation coefficient.Results:The efficiency of traditional Chinese medicine services in county-level traditional Chinese medicine hospitals in Shandong Province is lower than that of comprehensive medical services,and the scale return coefficient of traditional Chinese medicine category indicators is better than that of comprehensive category indicators.There is a positive correlation between the efficiency of traditional Chinese medicine services and the efficiency of comprehensive medical services.Conclusion:Traditional Chinese medicine hospitals should appropriately expand their investment in traditional Chinese medicine resources.Adhere to the hospital management model of traditional Chinese medicine services as the main focus,and build a coordinated development path between traditional Chinese and western medicine from both the supply and demand sides.

Objective:By analyzing the relationship between the efficiency of traditional Chinese medicine services and the efficiency of comprehensive medical services in county-level traditional Chinese medicine hospitals in Shandong,it explores the path of coordinated development between traditional Chinese medicine and western medicine in traditional Chinese medicine hospitals,providing references for the high-quality development of county-level traditional Chinese medicine hospitals.Methods:The efficiency of traditional Chinese medicine services and comprehensive medical services in county-level traditional Chinese medicine hospitals in Shandong Province from 2019 to 2022 was analyzed by Data Envelopment Analysis(DEA),and the correlation was analyzed by Spearman correlation coefficient.Results:The efficiency of traditional Chinese medicine services in county-level traditional Chinese medicine hospitals in Shandong Province is lower than that of comprehensive medical services,and the scale return coefficient of traditional Chinese medicine category indicators is better than that of comprehensive category indicators.There is a positive correlation between the efficiency of traditional Chinese medicine services and the efficiency of comprehensive medical services.Conclusion:Traditional Chinese medicine hospitals should appropriately expand their investment in traditional Chinese medicine resources.Adhere to the hospital management model of traditional Chinese medicine services as the main focus,and build a coordinated development path between traditional Chinese and western medicine from both the supply and demand sides.

Objective:By analyzing the relationship between the efficiency of traditional Chinese medicine services and the efficiency of comprehensive medical services in county-level traditional Chinese medicine hospitals in Shandong,it explores the path of coordinated development between traditional Chinese medicine and western medicine in traditional Chinese medicine hospitals,providing references for the high-quality development of county-level traditional Chinese medicine hospitals.Methods:The efficiency of traditional Chinese medicine services and comprehensive medical services in county-level traditional Chinese medicine hospitals in Shandong Province from 2019 to 2022 was analyzed by Data Envelopment Analysis(DEA),and the correlation was analyzed by Spearman correlation coefficient.Results:The efficiency of traditional Chinese medicine services in county-level traditional Chinese medicine hospitals in Shandong Province is lower than that of comprehensive medical services,and the scale return coefficient of traditional Chinese medicine category indicators is better than that of comprehensive category indicators.There is a positive correlation between the efficiency of traditional Chinese medicine services and the efficiency of comprehensive medical services.Conclusion:Traditional Chinese medicine hospitals should appropriately expand their investment in traditional Chinese medicine resources.Adhere to the hospital management model of traditional Chinese medicine services as the main focus,and build a coordinated development path between traditional Chinese and western medicine from both the supply and demand sides.