ObjectiveThis paper aims to investigate the material basis of the anti-inflammatory efficacy and mechanism of action of Bushen Tongdu prescription （BSTDP）. MethodsThe chemical components of BSTDP and its blood-absorbed components in vivo were systematically identified by using ultra-performance liquid chromatography-linear ion trap-electrostatic field orbitrap high-resolution mass spectrometry （UPLC-LIT-Orbitrap-MS）. Network pharmacology was employed to screen blood-absorbed bioactive components and potential targets of this formula. A protein-protein interaction （PPI） network of core targets was constructed to conduct enrichment analysis. Molecular docking was further utilized to verify the binding affinity between key components and targets. The inflammatory model was established and verified in vivo by using a transgenic zebrafish Tg （mpx： GFP）. At three days post-fertilization （3 dpf）， larvae of zebrafish were randomly assigned to blank group， model group， positive drug dexamethasone acetate group （75 μmol·L^-1）， and BSTDP groups with low， medium， and high doses （500， 1 000， and 2 000 mg·L^-1）. The distribution and quantity of neutrophils in the yolk sac region were observed under a fluorescence microscope. The mRNA expression levels of key genes in the toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/nuclear factor kappa-B （NF-κB） signaling pathway and inflammatory factors including interleukin （IL）-1β， IL-6， and tumor necrosis factor-α （TNF-α） were detected by Real-time quantitative polymerase chain reaction （Real-time PCR）. ResultsA total of 120 chemical components were identified in BSTDP， among which 26 original components were confirmed by using serum pharmacochemical methods. A total of 227 common targets linking rheumatoid arthritis （RA） and the blood-absorbed components were screened by network pharmacology. It is suggested that pseudobrucine， vomicine， sinapine， rehmannioside， cinnamyl alcohol glycoside， and methylephedrine exert anti-inflammatory effects by acting on core targets including protein kinase B1 （Akt1）， signal transducer and activator of transcription 3 （STAT3）， tumor necrosis factor （TNF）， TLR4， mitogen-activated protein kinase 14 （MAPK14）， and phosphatidylinositol-4，5-bisphosphate 3-kinase catalytic subunit α （PIK3CA）， thereby modulating multiple signaling pathways such as TLR4 and NF-κB. In vivo verification in zebrafish demonstrates that the maximum tolerable concentration of Bushen Tongdu Formula is 2 000 mg·L^-1. Compared to those in the blank group， zebrafish in the model group showed a significantly higher number of neutrophils in the yolk sac region （P<0.01） and rising mRNA levels of TLR4， MyD88， NF-κB， TNF-α， IL-6， and IL-1β （P<0.01）. Compared to that in the model group， the number of neutrophils was significantly reduced in BSTDP groups with medium and high doses， as well as the dexamethasone acetate group （P<0.05， P<0.01）. There was no statistically significant difference in the low dose group. The mRNA expression levels of TLR4， MyD88， NF-κB， TNF-α， IL-6， and IL-1β were significantly down-regulated （P<0.05， P<0.01）. ConclusionThis paper identifies the material basis of the efficacy of BSTDP， demonstrating that the formula can exert an anti-inflammatory effect through the TLR4/MyD88/NF-κB signaling pathway. The results provide scientific experimental evidence for its further clinical application.

AIM: To investigate the differences in morphological structure and retinal blood perfusion between the affected eye and the contralateral healthy eye using optical coherence tomography angiography(OCTA)in patients with idiopathic macular epiretinal membrane(IMEM)before and after surgery, and to evaluate the association of these parameters with functional and anatomical outcomes to inform prognostic assessment. METHODS:A prospective study was conducted at Zhejiang Provincial People's Hospital between January 2023 and December 2024. Consecutive patients diagnosed with unilateral IMEM were enrolled; the fellow eye served as an internal control. All participants underwent standardized ophthalmic evaluations, including optical coherence tomography(OCT), OCTA, and color fundus photography. Key quantitative parameters assessed included best-corrected visual acuity(BCVA), central macular thickness(CMT), foveal avascular zone(FAZ)area, vessel density in the inner capillary plexus(ICP), superficial capillary plexus(SCP), deep capillary plexus(DCP), and choroidal capillary perfusion area(CCPA). Measurements were obtained preoperatively and at 1 and 3 mo postoperatively. Correlation analyses were performed between the above parameters and postoperative BCVA and CMT.RESULTS: This study enrolled 30 patients(60 eyes)diagnosed with IMEM, comprising 14 males and 16 females, with a mean age of 65.4±10.8 y.At baseline, IMEM-affected eyes demonstrated significantly reduced BCVA, DCP density, and FAZ area, alongside significantly increased CMT and CCPA, compared with contralateral controls. Following vitrectomy with membrane peeling, CMT decreased significantly at both 1 and 3 mo(both P<0.05)postoperatively; DCP density and BCVA showed significant improvement(both P<0.05). No significant change in FAZ area was observed postoperatively(P>0.05). At 3 mo postoperatively, BCVA of the affected eye was negatively correlated with CMT(r=-0.549, P=0.022). At 1 mo postoperatively, CMT was negatively correlated with preoperative DCP and FAZ, positively correlated with preoperative CMT, and positively correlated with ICP and SCP at 1 mo postoperatively, and negatively correlated with FAZ at 1 mo postoperatively(all P<0.05). Furthermore, CMT at 3 mo postoperatively was negatively correlated with preoperative DCP(r=-0.498,P=0.042).CONCLUSION:In patients with IMEM, the affected eyes exhibit significantly reduced DCP density and FAZ area, alongside increased CMT and CCPA. Following vitrectomy with membrane peeling, CMT decreased progressively, DCP density demonstrated partial restoration, and vision improved gradually. Preoperatively, smaller CMT larger DCP, and FAZ were associated with more favorable surgical outcomes; postoperatively, smaller ICP and SCP densities—combined with a larger FAZ—also correlated with better functional recovery.

ObjectiveThis paper aims to investigate the material basis of the anti-inflammatory efficacy and mechanism of action of Bushen Tongdu prescription （BSTDP）. MethodsThe chemical components of BSTDP and its blood-absorbed components in vivo were systematically identified by using ultra-performance liquid chromatography-linear ion trap-electrostatic field orbitrap high-resolution mass spectrometry （UPLC-LIT-Orbitrap-MS）. Network pharmacology was employed to screen blood-absorbed bioactive components and potential targets of this formula. A protein-protein interaction （PPI） network of core targets was constructed to conduct enrichment analysis. Molecular docking was further utilized to verify the binding affinity between key components and targets. The inflammatory model was established and verified in vivo by using a transgenic zebrafish Tg （mpx： GFP）. At three days post-fertilization （3 dpf）， larvae of zebrafish were randomly assigned to blank group， model group， positive drug dexamethasone acetate group （75 μmol·L^-1）， and BSTDP groups with low， medium， and high doses （500， 1 000， and 2 000 mg·L^-1）. The distribution and quantity of neutrophils in the yolk sac region were observed under a fluorescence microscope. The mRNA expression levels of key genes in the toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/nuclear factor kappa-B （NF-κB） signaling pathway and inflammatory factors including interleukin （IL）-1β， IL-6， and tumor necrosis factor-α （TNF-α） were detected by Real-time quantitative polymerase chain reaction （Real-time PCR）. ResultsA total of 120 chemical components were identified in BSTDP， among which 26 original components were confirmed by using serum pharmacochemical methods. A total of 227 common targets linking rheumatoid arthritis （RA） and the blood-absorbed components were screened by network pharmacology. It is suggested that pseudobrucine， vomicine， sinapine， rehmannioside， cinnamyl alcohol glycoside， and methylephedrine exert anti-inflammatory effects by acting on core targets including protein kinase B1 （Akt1）， signal transducer and activator of transcription 3 （STAT3）， tumor necrosis factor （TNF）， TLR4， mitogen-activated protein kinase 14 （MAPK14）， and phosphatidylinositol-4，5-bisphosphate 3-kinase catalytic subunit α （PIK3CA）， thereby modulating multiple signaling pathways such as TLR4 and NF-κB. In vivo verification in zebrafish demonstrates that the maximum tolerable concentration of Bushen Tongdu Formula is 2 000 mg·L^-1. Compared to those in the blank group， zebrafish in the model group showed a significantly higher number of neutrophils in the yolk sac region （P<0.01） and rising mRNA levels of TLR4， MyD88， NF-κB， TNF-α， IL-6， and IL-1β （P<0.01）. Compared to that in the model group， the number of neutrophils was significantly reduced in BSTDP groups with medium and high doses， as well as the dexamethasone acetate group （P<0.05， P<0.01）. There was no statistically significant difference in the low dose group. The mRNA expression levels of TLR4， MyD88， NF-κB， TNF-α， IL-6， and IL-1β were significantly down-regulated （P<0.05， P<0.01）. ConclusionThis paper identifies the material basis of the efficacy of BSTDP， demonstrating that the formula can exert an anti-inflammatory effect through the TLR4/MyD88/NF-κB signaling pathway. The results provide scientific experimental evidence for its further clinical application.

OBJECTIVE To investigate a dynamic monitoring of drug consumption （DMDC） model based on the seasonal Mann-Kendall trend test， aiming to provide scientific evidence for the efficient and macroscopic monitoring of drug use. METHODS A monitoring list of key outpatient drugs was established based on the top 20% of drugs ranked by sales volume in the outpatient pharmacy in October 2024. A DMDC model based on the Mann-Kendall trend test was constructed using the monthly usage data of key outpatient drugs from November 2021 to October 2024， aiming to eliminate the impact of seasonal fluctuations and analyze the temporal trends in drug consumption. Taking mucolytic expectorants， triazole derivatives for dermatophytosis， and single-agent hydroxymethylglutaryl coenzyme A （HMG-CoA） reductase inhibitors as examples， the monitoring effectiveness of the DMDC model was demonstrated， and its performance was compared with that achieved by the traditional sequential growth rate ranking method. RESULTS A total of 215 drug varieties were included in the monitoring list， and DMDC models were successfully established for all of them. Among these， 119 showed a significant increasing trend （P＜0.05， S′＞0）. The model successfully monitored the monthly consumption of mucolytic expectorants， triazole derivatives for dermatophytosis， and single- agent HMG-CoA reductase inhibitors. The precision and recall rates of the DMDC model for identifying abnormal drug use were 60.7% and 85.0%， respectively， both significantly higher than those of the sequential growth rate ranking method （8.3% and 15.0%， respectively） （χ2＝20.114， P＜0.001； χ2＝19.600， P＜0.001）. CONCLUSIONS DMDC model based on the seasonal Mann-Kendall trend test can effectively identify long-term trends in drug consumption， eliminate seasonal interference， enhance monitoring accuracy and management efficiency， and is suitable for the dynamic monitoring of drug consumption.

Objective: To investigate the influencing factors of snoring among people with high risk of atherosclerotic cardiovascular disease (ASCVD), so as to provide evidence for improving sleep respiratory health and preventing and controlling cardiovascular disease risks. Methods: From May to July 2021, a multi-stage cluster random sampling method was used to select individuals aged 35 to 70 years at high risk of ASCVD in Shaoxing City, Zhejiang Province, as the study subjects. Data on demographic information, disease history, lifestyle, and anthropometric and biochemical indicators (including height, weight, waist circumference, and blood biochemical parameters) were collected through questionnaire surveys, physical examinations, and laboratory tests. Snoring was assessed using the Berlin Questionnaire. Factors affecting snoring were analyzed using a multivariable logistic regression model. Results: A total of 1 695 individuals were surveyed, including 940 males (55.46%) and 755 females (44.54%), with a mean age of (62.56±6.08) years. Snoring was reported in 383 individuals, accounting for 22.60%. Multivariable logistic regression analysis revealed that males(OR=1.410, 95%CI: 1.102-1.803), with a history of hypertension (OR=1.714, 95%CI: 1.220-2.406), who were overweight (OR=1.608, 95%CI:1.189-2.163) or obese (OR=1.603, 95%CI: 1.056-2.434), and with increased waist circumference (OR=1.020, 95%CI: 1.001-1.039) had a higher likelihood of snoring among the ASCVD high-risk people. Conclusion The prevalence of snoring among people with high risk of ASCVD was 22.60%, primarily influenced by gender, history of hypertension, body mass index, and waist circumference.

Objective: To investigate the influencing factors for sarcopenia among the elderly, so as to provide the evidence for developing prevention and control strategies for sarcopenia among the elderly. Methods: From April 2023 to October 2025, a multi-stage stratified cluster sampling method was used to select elderly individuals aged ≥60 years in Shaoxing City, Zhejiang Province as survey participants. Demographic information, lifestyle behaviors, and indicators including height, weight, and waist circumference were collected through questionnaire surveys and physical examinations, and body mass index (BMI) was calculated. Appendicular skeletal muscle mass was measured using bioelectrical impedance analysis, and the appendicular skeletal muscle mass index was calculated. Muscle strength and physical function were assessed using handgrip strength test and 6-meter gait speed test. Sarcopenia was diagnosed according to the 2019 Asian Working Group for Sarcopenia Consensus on Diagnosis and Treatment. Factors affecting sarcopenia among the elderly were analyzed using a multivariable logistic regression model. Results: A total of 4 095 elderly individuals were surveyed, with a mean age of (71.17±6.89) years. There were 1 773 males (43.30%) and 2 322 females (56.70%). Sarcopenia was detected in 539 cases, with a prevalence of 13.16% (95%CI: 12.13%-14.20%). Multivariable logistic regression analysis showed that elderly individuals aged ≥70 years (70-<80 years, OR=2.709, 95%CI: 2.069-3.547; 80-<90 years, OR=10.574, 95%CI: 7.615-14.681; ≥90 years, OR=16.729, 95%CI: 6.681-41.887), those with underweight (OR=5.239, 95%CI: 3.394-8.807), and those who did not consume meat and poultry daily (OR=7.739, 95%CI: 5.871-10.202) had a higher risk of sarcopenia. Conversely, the elderly with overweight or obesity (OR=0.071, 95%CI: 0.050-0.100) had a lower risk of sarcopenia. Conclusions The risk of sarcopenia among the elderly was associated with age, BMI, and meat and poultry intake. For the elderly with advanced age or low BMI, optimizing dietary patterns and promoting appropriate physical activity are recommended.

Objective: To investigate the detection rates of overweight and obesity among employed workers in Shaoxing City, Zhejiang Province, so as to provide a basis for formulating weight management intervention strategies for occupational population. Methods: Physical examination data of employed workers aged 18-59 years in 2024, including demographic information, height and weight were collected through the health management platform of the physical examination information systems of 20 designated physical examination hospitals in Shaoxing City. Overweight and obesity were determined according to the Criteria of Weight for Adults, and the detection rates of overweight and obesity were calculated and standardized using the data from the Sixth National Population Census in 2010. The gender- and age-specific detection rates of overweight and obesity among employed workers were analyzed. Results: A total of 201 066 employed workers were included, with a mean age of (40.90±11.60) years. There were 107 682 males (53.56%) and 93 384 females (46.44%). A total of 64 224 cases of overweight were detected, with a detection rate of 31.94% and a standardized detection rate of 30.19%. A total of 22 727 cases of obesity were detected, with a detection rate of 11.30% and a standardized detection rate of 11.47%. The standardized detection rates of overweight and obesity were higher in males than in females (38.46% vs. 20.21%, 6.13% vs. 5.80%). The detection rate of overweight increased with age (P<0.05), with the higher rate observed in the group aged 55-59 years (38.27%). The detection rates of overweight among both males and females increased with age (both P<0.05). The detection rate of obesity first increased and then decreased with age, with the higher rates in the groups aged 30-<35 years (12.37%) and 35-<40 years (12.33%). The detection rate of obesity among males first increased and then decreased with age, with the higher rates observed in the groups aged 30-<35 years (17.96%) and 35-<40 years (17.99%). The detection rate of obesity among females first decreased and then increased with age, with the higher rates observed in the group aged 55-59 years (7.77%). Conclusions The detection rates of overweight and obesity were higher in male employed workers than those in female in Shaoxing City. The detection rate of overweight increased with age, while the detection rate of obesity showed an inverted U-shaped trend. Males aged 30-<40 years and females aged 55-59 years should be prioritized for obesity prevention and control.

Objective: To investigate the current status and influencing factors of falls among the elderly in Shaoxing City, Zhejiang Province, so as to provide evidence for developing fall prevention and intervention strategies for the elderly. Methods: From April 2023 to October 2025, residents aged ≥60 years in Shaoxing City were selected as study participants using multi-stage stratified random cluster sampling. Data on demographic characteristics, lifestyle behaviors, chronic diseases, body mass index (BMI), and falls in the past 1 year were collected through questionnaires and physical examinations.The Chinese version of the Frail Scale and the EuroQoL five-dimensions three-levels questionnaire were used to assess frailty status and health related quality of life, respectively. The incidence of falls among the elderly was analyse. A multivariable logistic regression model was used to analyze the influencing factors of falls. Results: A total of 4 095 participants were surveyed. The mean age of participants was (71.17±6.89) years. There were 1 773 males (43.30%) and 2 322 females (56.70%). Falls were identified in 465 participants, with an incidence of 11.36%. Multivariable logistic regression analysis showed that unmarried/divorced/widowed (OR=1.263, 95%CI: 1.003-1.590), daily sedentary time ≥6 hours (OR=1.349, 95%CI: 1.050-1.733), pre-frailty (OR=2.316, 95%CI: 1.872-2.864) and frailty (OR=4.268, 95%CI: 2.577-7.068) had a higher risk of falls; junior high school or above education level (junior high school, OR=0.669, 95%CI: 0.484-0.926; high school and above, OR=0.413, 95%CI: 0.189-0.901), annual household income of 20 000-<100 000 yuan (20 000-<50 000 yuan, OR=0.699, 95%CI: 0.535-0.911; 50 000-<100 000 yuan, OR=0.669, 95%CI: 0.476-0.940), and higher health related quality of life (OR=0.076, 95%CI: 0.036-0.160) had a lower risk of falls. Conclusions The incidence of falls among the elderly in Shaoxing City was 11.36%. Falls were possibly associated with marital status, educational level, annual household income, daily sedentary time, frailty status and health related quality of life.

Objective: To construct a prediction model for depressive symptoms among overweight and obese adults based on machine-learning algorithms. Methods: Residents aged ≥18 years with body mass index ≥24.0 kg/m2 were recruited from three autonomous counties (districts) in Qinghai Province using the convenience sampling method from July 2024 to August 2025. Data on age, gender and the number of common chronic diseases were collected through questionnaire surveys. The Pittsburgh Sleep Quality Index, International Physical Activity Questionnaire and Patient Health Questionnaire-9 were used to assess sleep disorders, physical activity level and depressive symptoms, respectively. The participants were randomly divided into a training set and a validation set at a ratio of 7∶3. LASSO regression, Boruta algorithm and random forest model were applied to screen predictive factors. Five prediction models including random forest, logistic regression, decision tree, extreme gradient boosting and support vector machine were established. The prediction performance of the models was compared using the area under the receiver operating characteristic curve (AUC), Brier score, and decision curve analysis. SHAP values were adopted to evaluate the contribution of each variable to the model. Results: A total of 1 065 overweight and obese adults were investigated, with a median age of 55.00 (interquartile range, 15.00) years. There were 498 males (46.76%) and 567 females (53.24%). Depressive symptoms were detected in 448 overweight and obese adults, with a detection rate of 42.07%. Annual household income, ethnicity, number of common chronic diseases, sleep disorders and physical activity level were identified as predictive factors for depressive symptoms among overweight and obese adults. Among the five established prediction models, the random forest model showed relatively optimal predictive performance. In the training set, the AUC value, accuracy, sensitivity, specificity, F1-score and Brier score were 0.839, 0.769, 0.682, 0.833, 0.713 and 0.168, respectively; the corresponding values in the validation set were 0.725, 0.646, 0.560, 0.708, 0.570 and 0.208, respectively. The maximum clinical net benefit of 0.277 was obtained at a threshold probability of 25%. Variable importance ranking indicated that sleep disorders contributed the most to the random forest model. Conclusion The random forest model constructed in this study has good discrimination and clinical utility for predicting the risk of depressive symptoms among overweight and obese adults.

The cost economics of early-stage lung cancer treatments is a key focus in the field of lung cancer. The primary treatment modalities for early-stage lung cancer include radiotherapy and thoracic surgery, each offering distinct advantages in therapeutic outcomes and costs. To better understand the cost-effectiveness of radiotherapy versus thoracic surgery for early-stage lung cancer, this paper reviews the progress of recent research on economic evaluations of these two treatment approaches.