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 interaction between traditional Chinese medicine (TCM) syndromes of histiocytic necrotizing lymphadenitis (HNL) and pathological types of HNL, so as to discover the distribution rule of TCM syndromes for indiction of intervention of HNL. Methods: A total of 166 patients with HNL were included. The baseline data of the patients, clinical feature, the four diagnosis information of TCM and histopathological of cervical lymph node were collected. The syndromes of TCM were judged. The pathological types were confirmed by cervical lymph node biopsy. The Multi-way ANOVA was used to analyze the correlation between traditional Chinese medicine syndromes of HNL and its pathological types. Results: Among the 166 patients, the ratio of different types are as follow: wind-heat and phlegm-toxin syndrome (57.83%, 96/166), heat-toxin exuberance syndrome (34.34%, 57/166), and phlegm and blood stasis syndrome (7.83%, 13/166). The pathological types include proliferative type (57.83%, 96/166), necrotizing type (35.54%, 59/166), and xanthomatous type (6.63%, 11/166). There were significant differences in targeted lymph node diameter, pain scores, body temperature (F value were 3.737, 34.484, 34.805, all Ps<0.05), while the difference of WBC (F=1.194, P>0.05) among three TCM Syndrome types were notsignificant. There were significant differences in pain scores, body temperature (F value were 12.153, 25.931, all Ps<0.05), but not for the targeted lymph node diameter, WBC (F value were 2.249, 0.671, all Ps>0.05) among three pathological types. The corresponding analysis result showed that, on point sets, wind-heat and phlegm-toxin syndrome were correlated with proliferative type, heat-toxin exuberance syndrome correlated with necrotizing type, and phlegm and blood stasis syndrome correlated with xanthomatous type (χ²=235.100, P<0.001). Conclusions There is a close correlation between syndrome types of TCM and pathological types of HNL. The pathological change of wind-heat and phlegm-toxin syndrometends toproliferative type, heat-toxin exuberance syndrome tends to necrotizing type, and phlegm and blood stasis syndrome tends to xanthomatous type.