Background With China's socio-economic development, the dietary structure of Chinese residents has gradually shifted from a traditional Eastern pattern characterized by high carbohydrate intake to a relatively high-fat Western dietary model, alongside a growing burden of chronic diseases. However, dietary changes may vary across different occupational groups. Objective To analyze the long-term trends in dietary energy and three major macronutrient intake among various occupational groups aged 18-59 years in nine provinces of China from 1989 to 2018, providing a scientific basis for developing occupation-specific dietary intervention strategies. Methods Based on 11 waves of data (1989–2018) from the China Health and Nutrition Survey (CHNS), 57458 employed individuals aged 18-59 years were selected as observation subjects after applying inclusion and exclusion criteria. Joinpoint regression was used to analyze temporal trends by calculating the annual percentage change (APC) and average annual percentage change (AAPC) with 95% confidence intervals. The analysis covered the energy supply ratio from the three major macronutrients and the proportion of the participants within the acceptable macronutrient distribution ranges (AMDR) for the total occupational population and specific occupational group. Results From 1989 to 2018, the dietary structure of the occupational population in the nine provinces gradually Westernized. The carbohydrate energy supply ratio showed a decreasing trend (AAPC=−0.77%, 95%CI: −1.00%, −0.55%, P<0.05), while the fat energy supply ratio increased (AAPC=1.42%, 95%CI: 1.07%, 1.77%, P<0.05). The protein energy supply ratio remained largely unchanged (AAPC=−0.19%, 95%CI: −0.08%, 0.46%, P>0.05), and the total energy intake declined (AAPC=−0.62%, 95%CI: −0.94%, −0.30%, P<0.05). Among the occupational groups studied, white-collar workers were the first to show characteristics of dietary Westernization. Using the AMDR as the criterion, their average fat energy supply ratio first exceeded the AMDR upper limit (30%) in 1993, and their average carbohydrate energy supply ratio first fell below the AMDR lower limit (50%) in 2006, both time points being earlier than other occupational groups. Agricultural workers lagged in this transition (their average fat energy supply ratio first reached ≥30% in 2011), but their rate of increase in the fat energy supply ratio was the fastest among all occupational groups (AAPC=1.59%, 95%CI: 0.90%, 2.30%, P<0.05; P for trend comparison between groups<0.05). The other three occupational groups (blue-collar workers, service workers, and others) generally fell between these two extremes. Taking the fat energy supply ratio as an example, their AAPCs of increase were 1.02% (95%CI: 0.73%, 1.32%, P<0.05) for blue-collar workers, 0.85% (95%CI: 0.61%, 1.09%, P<0.05) for service workers, and 0.88% (95%CI: 0.58%, 1.17%, P<0.05) for others. Conclusion From 1989 to 2018, the macronutrient structure of the occupational population aged 18-59 years in nine China provinces is gradually Westernized. The energy supply ratios of carbohydrates and proteins primarily face issues of potential inadequacy, while the fat energy supply ratio is excessively high. Furthermore, the patterns of change vary among different occupational groups. It is recommended to propose personalized dietary advice tailored to specific occupations.

Objective To investigate the diagnostic value of plasma heparin-binding protein(HBP)in the bloodstream infection of tumor patients.Methods The tumor patients treated at Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from Janu-ary 2023 to December 2023 were selected and further divided into the following three groups:124 patients with positive blood cultures(bloodstream infection group),95 with negative blood cultures but positive cultures from other body fluids(culture-positive group),and 100 with negative bacterial cultures(culture-negative group).The levels of HBP,procalcitonin(PCT),C-reactive protein(CRP),interleukin 6(IL-6),white blood cell(WBC),and neutrophil(NE)in the three groups were detected.The level differences of each indicator among three groups were compared.The differences in the expression levels of HBP in the bloodstream infection group with different pathogens such as Gram-negative bacteria,Gram-positive bacteria,and fungi were also compared.The Logistic regression analysis was used to evaluate the predictive efficacy of each indicator for the risk of bloodstream infection.The receiver operating char-acteristics(ROC)curve was used to assess the diagnostic value of each indicator alone and in combination for the bloodstream infection of tumor patients.Results The expression level of HBP in the bloodstream infection group(32.14[14.01,110.40]ng/mL)was sig-nificantly higher than that in the culture-positive group(23.00[5.90,54.87]ng/mL,t=5.39,P＜0.05),and both of them were sig-nificantly higher than that in the culture-negative group(6.80[5.90,16.05]ng/mL,Z=47.248,P＜0.05).HBP had a certain clini-cal predictive value for the occurrence of bloodstream infection in tumor patients(OR=1.017,95％CI:1.008～1.027,P＜0.001).In addition,the levels of HBP in the Gram-negative bacterial infection group(78.04[21.60,157.20]ng/mL)were significantly higher than that in the Gram-positive bacterial infection group(51.00[18.45,106.50]ng/mL,t=2.01,P＜0.05),and both of them were significantly higher than that in the fungal infection group(5.90[5.90,14.17]ng/mL,Z=3.40,P＜0.05).The area under the ROC curve(AUCROC),sensitivity,and specificity of HBP for the diagnosis of bloodstream infection in tumor patients were 0.717,67.37％,and 67.26％,respectively,which were superior to those of PCT(0.700,77.17％,and 52.14％),CRP(0.667,63.16％,and 62.39％),and IL-6(0.629,60.47％,and 60.47％).The AUCROC,sensitivity,and specificity of the combination of HBP,CRP,PCT,and IL-6 were 0.739,70.24％,and 68.42％,respectively,which were better than those of each indicator alone.Conclusion The detection of HBP has high clinical application value in the diagnosis of bloodstream infections of tumor patients and may serve as a potential biomarker for the bloodstream infection of tumor patients.

Objective To investigate the occurrence of liver function abnormalities in patients with follicular lymphoma(FL)treated with the G-CDOP regimen in the real world.Methods Using the hospital information system,a retrospective collection of clinical data was conducted on inpatients diagnosed with FL and treated with at least four courses of the G-CDOP regimen in the Department of Hematology,the First Affiliated Hospital of Soochow University from September 2021 to August 2023.The analysis focused on the incidence,severity,and types of liver function abnormalities,as well as the timing of these occurrences in relation to medication use and other relevant clinical characteristics.Results The study encompassed a total of 55 patients with FL,out of which 30 patients encountered liver function abnormalities during the G-CDOP regimen treatment,yielding an incidence rate of 54.5%.There were 23 cases(41.8%)of grade 1,3 cases(5.5%)of grade 2,and 4 cases(7.3%)of grade 3 liver function abnormalities.Among them,12 cases(21.8%)were hepatocellular injury type,while the cholestasis type was observed in 4 cases(7.3%),and the mixed type was found in 14 cases(25.5%).Liver function abnormalities appeared in 21 patients(38.2%)during the first cycle of the G-CDOP regimen treatment,5 patients(9.1%)in the second cycle,and 1 patient(1.8%),2 patients(3.6%),and 1 patient(1.8%)in the third,fourth,and fifth cycles.Conclusion The G-CDOP regimen has the potential to impact liver function indicators in FL patients,but most are mild and reversible.However,there are also cases of severe liver injury that need to attract clinical attention.

Objective To investigate the diagnostic value of plasma heparin-binding protein(HBP)in the bloodstream infection of tumor patients.Methods The tumor patients treated at Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from Janu-ary 2023 to December 2023 were selected and further divided into the following three groups:124 patients with positive blood cultures(bloodstream infection group),95 with negative blood cultures but positive cultures from other body fluids(culture-positive group),and 100 with negative bacterial cultures(culture-negative group).The levels of HBP,procalcitonin(PCT),C-reactive protein(CRP),interleukin 6(IL-6),white blood cell(WBC),and neutrophil(NE)in the three groups were detected.The level differences of each indicator among three groups were compared.The differences in the expression levels of HBP in the bloodstream infection group with different pathogens such as Gram-negative bacteria,Gram-positive bacteria,and fungi were also compared.The Logistic regression analysis was used to evaluate the predictive efficacy of each indicator for the risk of bloodstream infection.The receiver operating char-acteristics(ROC)curve was used to assess the diagnostic value of each indicator alone and in combination for the bloodstream infection of tumor patients.Results The expression level of HBP in the bloodstream infection group(32.14[14.01,110.40]ng/mL)was sig-nificantly higher than that in the culture-positive group(23.00[5.90,54.87]ng/mL,t=5.39,P＜0.05),and both of them were sig-nificantly higher than that in the culture-negative group(6.80[5.90,16.05]ng/mL,Z=47.248,P＜0.05).HBP had a certain clini-cal predictive value for the occurrence of bloodstream infection in tumor patients(OR=1.017,95％CI:1.008～1.027,P＜0.001).In addition,the levels of HBP in the Gram-negative bacterial infection group(78.04[21.60,157.20]ng/mL)were significantly higher than that in the Gram-positive bacterial infection group(51.00[18.45,106.50]ng/mL,t=2.01,P＜0.05),and both of them were significantly higher than that in the fungal infection group(5.90[5.90,14.17]ng/mL,Z=3.40,P＜0.05).The area under the ROC curve(AUCROC),sensitivity,and specificity of HBP for the diagnosis of bloodstream infection in tumor patients were 0.717,67.37％,and 67.26％,respectively,which were superior to those of PCT(0.700,77.17％,and 52.14％),CRP(0.667,63.16％,and 62.39％),and IL-6(0.629,60.47％,and 60.47％).The AUCROC,sensitivity,and specificity of the combination of HBP,CRP,PCT,and IL-6 were 0.739,70.24％,and 68.42％,respectively,which were better than those of each indicator alone.Conclusion The detection of HBP has high clinical application value in the diagnosis of bloodstream infections of tumor patients and may serve as a potential biomarker for the bloodstream infection of tumor patients.

Objective To investigate the occurrence of liver function abnormalities in patients with follicular lymphoma(FL)treated with the G-CDOP regimen in the real world.Methods Using the hospital information system,a retrospective collection of clinical data was conducted on inpatients diagnosed with FL and treated with at least four courses of the G-CDOP regimen in the Department of Hematology,the First Affiliated Hospital of Soochow University from September 2021 to August 2023.The analysis focused on the incidence,severity,and types of liver function abnormalities,as well as the timing of these occurrences in relation to medication use and other relevant clinical characteristics.Results The study encompassed a total of 55 patients with FL,out of which 30 patients encountered liver function abnormalities during the G-CDOP regimen treatment,yielding an incidence rate of 54.5%.There were 23 cases(41.8%)of grade 1,3 cases(5.5%)of grade 2,and 4 cases(7.3%)of grade 3 liver function abnormalities.Among them,12 cases(21.8%)were hepatocellular injury type,while the cholestasis type was observed in 4 cases(7.3%),and the mixed type was found in 14 cases(25.5%).Liver function abnormalities appeared in 21 patients(38.2%)during the first cycle of the G-CDOP regimen treatment,5 patients(9.1%)in the second cycle,and 1 patient(1.8%),2 patients(3.6%),and 1 patient(1.8%)in the third,fourth,and fifth cycles.Conclusion The G-CDOP regimen has the potential to impact liver function indicators in FL patients,but most are mild and reversible.However,there are also cases of severe liver injury that need to attract clinical attention.

Objective To investigate the coagulation abnormalities and molecular genetic characteristics of a family with asymptomatic inherited fibrinogen disorders(IFD).Methods The clinical data of a family with IFD,including 5 individuals from two generations,were collected.Their peripheral blood coagulation indicators were detected.The coding sequences of FGA,FGB and FGG genes were amplified by PCR and Sanger sequencing was used to identify the candidate variants,which were further validated in the family mem-bers.The bioinformatic software was used to analyze the pathogenicity and conservation of the missense mutation and its effect on the spatial structure and function of the protein.Results The IFD patients had significantly low fibrinogen antigen(Fg:Ag)concentration and fibrinogen coagulation(Fg:C)activity concentration as well as prolonged thrombin time(TT),while coagulation indicators of the unaffected relatives were normal.The results of Sanger sequencing showed that all IFD patients carried a heterozygous missense variant of c.1001A>C(p.Asn334Thr)in the FGG gene.The bioinformatic analysis suggested that Asn334Thr was a pathogenic variant,while homology analysis indicated that the Asn334 locus was highly conserved in evolution.The analysis of protein spatial structure showed that the Asn334Thr mutation altered hydrogen bonds between amino acids.Conclusion The heterozygous missense variant c.1001A>C(p.Asn334Thr)in the FGG gene may be the pathogenic cause of the proband.The finding enriches the spectrum of FGG gene mutations and provides experimental evidence for the genetic counseling of affected families.

Objective:To investigate the association between blood selenium levels and sex hormones in Chinese men aged 18-79 years.Methods:Data were derived from the China National Human Biomonitoring survey conducted in 2017-2018, with a final sample size of 5 414 men. General demographic characteristics, behavioral habits, and dietary frequency were collected through questionnaires and physical examinations. Fasting blood samples were collected to measure blood lead, serum testosterone, and estradiol levels. Complex sampling linear regression models were used to analyze the associations between blood selenium levels and testosterone, estradiol, and the testosterone/estradiol ratio, adjusting for confounding factors including age, education level, marital status, smoking status, alcohol consumption, seafood intake, soy product intake, protein supplement intake, BMI, and diabetes status.Results:The mean age of the 5 414 participants was (46.85±27.91) years; 4 774 (91.65%) were of Han ethnicity and 4 505 (86.68%) were married. The median ( Q1, Q3) blood selenium concentration in men was 97.80 (80.64, 116.99) μg/L. After adjusting for confounding factors, the complex sampling linear regression model revealed negative associations between blood selenium levels and both testosterone levels and the testosterone/estradiol ratio, with a significant linear trend ( Ptrend<0.05). Compared with the Q1 group, the β (95% CI) values for testosterone in the Q2, Q3, and Q4 groups were -0.02 (-0.06 to 0.02), -0.03 (-0.08 to 0.01), and -0.06 (-0.09 to -0.02), respectively. Similarly, the β (95% CI) values for the testosterone/estradiol ratio in the Q2, Q3, and Q4 groups were -0.01 (-0.03 to 0.02), -0.01 (-0.04 to 0.04), and -0.03 (-0.06 to -0.01), respectively. Subgroup analysis indicated stronger associations between blood selenium levels and testosterone/estradiol levels in non-smoking and obese men (BMI≥28 kg/m2). Conclusion:Blood selenium levels are negatively associated with testosterone levels and the testosterone/estradiol ratio in Chinese adult males.

Objective:To construct an index system for the systematic evalaution of response capabiity for public health risk in mass gathgering and improvemet of preparedness and level of public health risk response.Methods:Based on the theory of health emergency management and the public health practice to support domestic and international mass events, the theoretical framework was constructed. Authoritative experts in relevant fields were invited to conduct multiple rounds of expert consultation for the construction of an evaluation index system, with Delphi method.Results:In this study, 12 authoritative experts in relevant professional fields were selected to participate in the survey, with an expert response rate of 100.0% and an average authority coefficient of 0.89. The final Kendall's W coefficient was 0.408 for the second-level indicators, and 0.416 for the third-level indicators (all P<0.001). Finally, an evaluation index system consisting of 4 first-level indicators (surveillance, risk assessment, laboratory support and response), 15 second-level indicators, and 75 third-level indicators was constructed. Conclusion:The evaluation index system constructed in this study can provide a reference for evaluation of the response capability for the public health risk in mass gathering.

Objective:To investigate the clinical characteristics and prognosis of acute pancreatitis (AP) with different etiologies.Methods:The retrospective cohort study was conducted. The clinical data of 702 patients with AP who were admitted to Xuanwu Hospital of Capital Medical University from January 2018 to December 2022 were collected. There were 451 males and 251 females,aged (52±17)years. Observation indicators: (1) clinical characteristics of AP patients with different etiologies; (2) complications and prognosis of AP patients with different etiologies; (3) complications and prognosis of moderately severe and severe AP patients with different etiologies. Comparison of measurement data with normal distribution among multiple groups was conducted using the one-way analysis of variance. Comparison of measurement data with skewed distribution among multiple groups was conducted using the Kruskal-Wallis H test. Comparison of count data among multiple groups was conducted using the chi-square test. Results:(1) Clinical characteris-tics of AP patients with different etiologies. Of the 702 AP patients, 434 cases were biliary AP, 199 cases were hypertriglyceridemic-induced AP,29 cases were alcoholic AP, and 40 cases were idiopathic AP. There were significant differences in gender,age,body mass index,combined cardiovascular disease,combined diabetes,combined nephrosis,disease severity and modified computed tomography severity index among AP patients with different etiologies ( χ2=24.61, F=48.65, 12.24, χ2=13.67, 12.90, 14.12, 15.56, H=17.62, P<0.05). (2) Complications and prognosis of AP patients with different etiologies. There was no significant difference in infectious pancreatic necrosis,duration of intensive care unit stay,total duration of hospital stay, and death of patients during hospitalization among AP patients with different etiologies ( P>0.05). (3) Complications and prognosis of moderately severe and severe AP patients with different etiologies. Of the 395 patients with moderately severe and severe AP, 217 cases were biliary AP, 128 cases were hypertriglyceridemic-induced AP, 19 cases were alcoholic AP, and 31 cases were idiopathic AP. There were significant differences in renal injury, multiple organ dysfunction syndrome and walled-off necrosis among moderately severe and severe AP patients with different etiologies ( χ2=12.62, 8.25, 14.33, P<0.05), and there was no significant difference in infectious pancreatic necrosis, lung injury, circulation system injury, duration of intensive care unit stay, total duration of hospital stay, or death of patients during hospitalization among moderately severe and severe AP patients with different etiologies ( P>0.05). Conclusions:The clinical charac-teristics vary among AP patients with different etiologies. The risk of complications varies among moderately severe and severe AP patients with different etiologies.