OBJECTIVE To comprehensively evaluate the 16 commonly used kinds of enteral nutrition preparations in Hebei province， aiming to provide a reference for the selection of drugs in medical institutions and clinical drug decision-making. METHODS Based on the Quick Guide for Drug Evaluation and Selection in Chinese Medical Institutions （the Second Edition）， evaluation evidence was collected， and the included drugs were scored and evaluated from four dimensions of pharmaceutical characteristics， clinical characteristics， economy and other attributes. RESULTS & CONCLUSIONS The scores for Enteral nutritional emulsion （TPF-T）， Enteral nutritional emulsion （TPF-D）， Enteral nutritional emulsion （TPF）， Enteral nutritional emulsion （TPF-HE）， Enteral nutritional emulsion （TP）， Enteral nutritional emulsion （SP）， Enteral nutritional suspension （TPF） （1.5 kcal/mL， 1 kcal＝4.184 kJ）， Enteral nutritional suspension （TPF） （1.0 kcal/mL）， Intact protein enteral nutrition （powder）， Enteral nutritional suspension （TPF-DM）， Enteral nutritional suspension （TPF-MCT）， Enteral nutritional suspension （SP）， Short- peptide enteral nutrition， Enteral nutritional powder （TP）， Enteral nutritional suspension （TPF-D） and Enteral nutritional suspension （TPF-FOS） were 82.9， 84.1， 84.1， 86.1， 78.4， 79.1， 82.6， 82.3， 82.4， 80.2， 83.0， 82.4， 82.1， 85.7， 76.0， 82.4 points， respectively. All medications scored above 70 points. In practice， appropriate drugs can be selected according to clinical requirements and patient needs.

Organ donation by minors has long been a highly controversial topic in both legal and ethical discussions worldwide. In the United States, case law has established a case-by-case review mechanism, allowing limited room for the practice of living organ donation by minors under specific conditions. Germany, with a strong emphasis on the protection of personal dignity, adopts a more cautious stance. In China, the law clearly stipulates that living organ donors must possess full civil capacity. However, some scholars argue that under strict conditions and with adequate safeguards, minors should be allowed to donate organs in emergency medical situations. Given the limited domestic experience in this area, China should develop a protective pathway that balances scientific validity, legal compliance, and humanistic concern, in line with its national conditions, legal traditions and cultural background, all under the guidance of the principle of caution. Based on a review of China’s current organ donation system, this article examines legislative philosophies, procedural designs and ethical review mechanisms in the U.S. and Germany. From a comparative law perspective, it extracts institutional elements that could serve as references, with the aim of improving China’s legal framework for organ donation by minors.

ObjectiveTo optimize the extraction method for polysaccharides from turnip（Brassica rapa）， and analyze and evaluate the primary structure of the isolated and purified turnip polysaccharide fraction（BP-1） and its hypoglycemic effects in diabetic zebrafish. MethodsTaking polysaccharide yield as the evaluation index， a semi-bionic extraction method was employed. Single-factor experiments and Box-Behnken response surface methodology were used to investigate three factors of solid-to-liquid ratio， extraction time and extraction temperature， in order to optimize the extraction process. BP-1 was isolated and purified using the Sevage method and DEAE-52 cellulose column chromatography. Structural characterization of the turnip polysaccharides was performed using ultraviolet-visible spectrophotometry（UV）， gas chromatography-mass spectrometry（GC-MS）， Congo red assay， and Fourier-transform infrared spectroscopy（FT-IR） to determine purity， monosaccharide composition， triple-helix structure， and functional groups. The microstructure of the polysaccharides was observed using scanning electron microscopy（SEM） and atomic force microscopy（AFM）. Zebrafish were divided into the blank group（adding E3 medium）， and BP-1-1， BP-1-10， BP-1-50， BP-1-200， BP-1-1 000 groups（adding BP-1 solutions at concentrations of 1， 10， 50， 200， 1 000 mg·L^-1， respectively）， and zebrafish embryos were subjected to a 96-hour exposure experiment. The maximum tolerated concentration of BP-1 in zebrafish was determined by evaluating its effects on phenotype， survival rate， malformation rate， and heart rate. Experimental animals were randomly divided into the blank group， model group， BP-1-10 group（10 mg·L^-1）， BP-1-50 group（50 mg·L^-1）， and BP-1-200 group（200 mg·L^-1）. The blank group was cultured in E3 medium， the model and treatment groups were induced to establish a diabetic model in 4 day-post-fertilization（dpf） zebrafish embryos using 10 g·L^-1 of glucose combined with 500 µmol·L^-1 of alloxan. The treatment groups received corresponding doses of BP-1 solution， while the blank and model groups received an equal volume of saline. Glucose and insulin（INS） levels were measured using enzyme-linked immunosorbent assay（ELISA） kits， the effects on the liver were observed by hematoxylin-eosin（HE） histopathological sections. The mRNA expression levels of glucagon（Glucagon）， insulin（Insa）， and phosphoenolpyruvate carboxykinase 1（PCK1） were detected with real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）. ResultsThe optimized extraction conditions were determined as follows：solid-to-liquid ratio of 1∶40（g·mL^-1）， extraction time of 66 min， and extraction temperature of 79 ℃. Under these conditions， the yield of turnip polysaccharides was （10.34±0.96）%. UV analysis indicated that BP-1 contained no proteins or nucleic acids， GC-MS analysis revealed that BP-1 consisted of six monosaccharides（arabinose， rhamnose， ribose， mannose， galactose and glucose）. Congo red assay indicated that the molecular conformation did not exhibit a triple-helix structure， FT-IR analysis showed the presence of α-glycosidic bonds and uronic acids， SEM analysis revealed an irregular flaky structure with a flat and smooth surface， AFM analysis suggested that the aggregated structure might be formed by the entanglement of molecular chains and intramolecular hydrogen bonding. The maximum tolerated concentration of BP-1 in zebrafish over 96 h was determined to be 200 mg·L^-1. Pharmacodynamic results showed that， compared with the blank group， the model group exhibited significantly increased glucose levels and significantly decreased INS levels（P<0.01）. Compared with the model group， the BP-1-50 group significantly reduced glucose levels and increased INS levels（P<0.05）. Histopathological examination of liver tissue revealed that various doses of BP-1 had a certain reparative effect on damaged liver tissue. The liver tissue structure in the BP-1-200 group was nearly normal， with hepatocytes appearing plump. Real-time PCR results showed that， compared with the blank group， the model group exhibited significantly upregulated mRNA expressions of Glucagon and PCK1， and significantly downregulated mRNA expression of Insa（P<0.01）. Compared with the model group， the BP-1-50 and BP-1-200 groups showed significantly downregulated mRNA expressions of Glucagon and PCK1， and significantly upregulated mRNA expression of Insa（P<0.01）. ConclusionThe semi-bionic extraction method for turnip polysaccharides yields a high extraction rate， is simple to operate， has low costs， making it suitable for large-scale industrial production. BP-1 consists of six monosaccharides， contains α-glycosidic bonds and uronic acids， exhibits hypoglycemic activity， and provides a certain protective effect on the liver of alloxan-induced diabetic model zebrafish.

ObjectiveTo optimize the extraction method for polysaccharides from turnip（Brassica rapa）， and analyze and evaluate the primary structure of the isolated and purified turnip polysaccharide fraction（BP-1） and its hypoglycemic effects in diabetic zebrafish. MethodsTaking polysaccharide yield as the evaluation index， a semi-bionic extraction method was employed. Single-factor experiments and Box-Behnken response surface methodology were used to investigate three factors of solid-to-liquid ratio， extraction time and extraction temperature， in order to optimize the extraction process. BP-1 was isolated and purified using the Sevage method and DEAE-52 cellulose column chromatography. Structural characterization of the turnip polysaccharides was performed using ultraviolet-visible spectrophotometry（UV）， gas chromatography-mass spectrometry（GC-MS）， Congo red assay， and Fourier-transform infrared spectroscopy（FT-IR） to determine purity， monosaccharide composition， triple-helix structure， and functional groups. The microstructure of the polysaccharides was observed using scanning electron microscopy（SEM） and atomic force microscopy（AFM）. Zebrafish were divided into the blank group（adding E3 medium）， and BP-1-1， BP-1-10， BP-1-50， BP-1-200， BP-1-1 000 groups（adding BP-1 solutions at concentrations of 1， 10， 50， 200， 1 000 mg·L^-1， respectively）， and zebrafish embryos were subjected to a 96-hour exposure experiment. The maximum tolerated concentration of BP-1 in zebrafish was determined by evaluating its effects on phenotype， survival rate， malformation rate， and heart rate. Experimental animals were randomly divided into the blank group， model group， BP-1-10 group（10 mg·L^-1）， BP-1-50 group（50 mg·L^-1）， and BP-1-200 group（200 mg·L^-1）. The blank group was cultured in E3 medium， the model and treatment groups were induced to establish a diabetic model in 4 day-post-fertilization（dpf） zebrafish embryos using 10 g·L^-1 of glucose combined with 500 µmol·L^-1 of alloxan. The treatment groups received corresponding doses of BP-1 solution， while the blank and model groups received an equal volume of saline. Glucose and insulin（INS） levels were measured using enzyme-linked immunosorbent assay（ELISA） kits， the effects on the liver were observed by hematoxylin-eosin（HE） histopathological sections. The mRNA expression levels of glucagon（Glucagon）， insulin（Insa）， and phosphoenolpyruvate carboxykinase 1（PCK1） were detected with real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）. ResultsThe optimized extraction conditions were determined as follows：solid-to-liquid ratio of 1∶40（g·mL^-1）， extraction time of 66 min， and extraction temperature of 79 ℃. Under these conditions， the yield of turnip polysaccharides was （10.34±0.96）%. UV analysis indicated that BP-1 contained no proteins or nucleic acids， GC-MS analysis revealed that BP-1 consisted of six monosaccharides（arabinose， rhamnose， ribose， mannose， galactose and glucose）. Congo red assay indicated that the molecular conformation did not exhibit a triple-helix structure， FT-IR analysis showed the presence of α-glycosidic bonds and uronic acids， SEM analysis revealed an irregular flaky structure with a flat and smooth surface， AFM analysis suggested that the aggregated structure might be formed by the entanglement of molecular chains and intramolecular hydrogen bonding. The maximum tolerated concentration of BP-1 in zebrafish over 96 h was determined to be 200 mg·L^-1. Pharmacodynamic results showed that， compared with the blank group， the model group exhibited significantly increased glucose levels and significantly decreased INS levels（P<0.01）. Compared with the model group， the BP-1-50 group significantly reduced glucose levels and increased INS levels（P<0.05）. Histopathological examination of liver tissue revealed that various doses of BP-1 had a certain reparative effect on damaged liver tissue. The liver tissue structure in the BP-1-200 group was nearly normal， with hepatocytes appearing plump. Real-time PCR results showed that， compared with the blank group， the model group exhibited significantly upregulated mRNA expressions of Glucagon and PCK1， and significantly downregulated mRNA expression of Insa（P<0.01）. Compared with the model group， the BP-1-50 and BP-1-200 groups showed significantly downregulated mRNA expressions of Glucagon and PCK1， and significantly upregulated mRNA expression of Insa（P<0.01）. ConclusionThe semi-bionic extraction method for turnip polysaccharides yields a high extraction rate， is simple to operate， has low costs， making it suitable for large-scale industrial production. BP-1 consists of six monosaccharides， contains α-glycosidic bonds and uronic acids， exhibits hypoglycemic activity， and provides a certain protective effect on the liver of alloxan-induced diabetic model zebrafish.

Background As one of the primary operational methods in the power grid industry, the insulated glove working method imposes significant physical demands due to the constraints of insulating equipment and specific required postures, resulting in substantial occupational health hazards among workers in this sector, which have garnered widespread social attention. Objective To investigate the prevalence and influencing factors of work-related musculoskeletal disorders (WMSDs) in the neck, shoulder, and lumbar regions among workers wearing insulated gloves, and to provide targeted measures to reduce occupational hazards. Methods Using stratified cluster sampling, 1079 frontline workers were randomly selected from power supply enterprises across 3 provinces in China. The revised Chinese version of the Musculoskeletal Disorders Questionnaire was used to investigate the 1-year prevalence of WMSDs in the neck, shoulder, and lumbar regions among workers wearing insulated gloves, and to collect factors associated with multi-site WMSDs (defined as involvement of ≥2 sites among the neck, shoulder, and lumbar). Results The 1-year prevalence of WMSDs in the neck, shoulder, and lumbar regions was 39.9%, 30.0%, and 25.3%, respectively, with a multi-site WMSDs prevalence of 32.0%. Multiple logistic regression analysis showed that, compared to workers with technical secondary school education or senior high school education and below, workers with junior college education or bachelor’s degrees and above had a higher risk of multi-site WMSDs (OR=2.12, 95%CI: 1.47, 3.06). Compared to workers with <10 years of work experience, those with 10-<20 years of work experience had a higher risk of multi-site WMSDs (OR=1.96, 95%CI: 1.45, 2.67). Working in uncomfortable postures "sometimes" (OR=1.64, 95%CI: 1.14, 2.36), "frequently" (OR=2.75, 95%CI: 1.76, 4.29), and "very frequently" (OR=3.55, 95%CI: 2.04, 6.19) were significantly associated with an increased risk of multi-site WMSDs compared to never working in such postures. Frequent repetitive movements of the low back (OR=2.05, 95%CI: 1.48, 2.84) increased the risk of multi-site WMSDs, while sufficient rest time decreased the risk (OR=0.45, 95%CI: 0.34, 0.61). Conclusion The prevalences of single-site and multi-site WMSDs in the neck, shoulder, lumbar regions are relatively high among workers wearing insulated gloves. Factors associated with multi-site WMSDs include 10-<20 years of work experience, junior college education or bachelor’s degrees and above, uncomfortable working postures, frequent repetitive low-back movements, and lack of sufficient rest time.

Background As one of the primary operational methods in the power grid industry, the insulated glove working method imposes significant physical demands due to the constraints of insulating equipment and specific required postures, resulting in substantial occupational health hazards among workers in this sector, which have garnered widespread social attention. Objective To investigate the prevalence and influencing factors of work-related musculoskeletal disorders (WMSDs) in the neck, shoulder, and lumbar regions among workers wearing insulated gloves, and to provide targeted measures to reduce occupational hazards. Methods Using stratified cluster sampling, 1079 frontline workers were randomly selected from power supply enterprises across 3 provinces in China. The revised Chinese version of the Musculoskeletal Disorders Questionnaire was used to investigate the 1-year prevalence of WMSDs in the neck, shoulder, and lumbar regions among workers wearing insulated gloves, and to collect factors associated with multi-site WMSDs (defined as involvement of ≥2 sites among the neck, shoulder, and lumbar). Results The 1-year prevalence of WMSDs in the neck, shoulder, and lumbar regions was 39.9%, 30.0%, and 25.3%, respectively, with a multi-site WMSDs prevalence of 32.0%. Multiple logistic regression analysis showed that, compared to workers with technical secondary school education or senior high school education and below, workers with junior college education or bachelor’s degrees and above had a higher risk of multi-site WMSDs (OR=2.12, 95%CI: 1.47, 3.06). Compared to workers with <10 years of work experience, those with 10-<20 years of work experience had a higher risk of multi-site WMSDs (OR=1.96, 95%CI: 1.45, 2.67). Working in uncomfortable postures "sometimes" (OR=1.64, 95%CI: 1.14, 2.36), "frequently" (OR=2.75, 95%CI: 1.76, 4.29), and "very frequently" (OR=3.55, 95%CI: 2.04, 6.19) were significantly associated with an increased risk of multi-site WMSDs compared to never working in such postures. Frequent repetitive movements of the low back (OR=2.05, 95%CI: 1.48, 2.84) increased the risk of multi-site WMSDs, while sufficient rest time decreased the risk (OR=0.45, 95%CI: 0.34, 0.61). Conclusion The prevalences of single-site and multi-site WMSDs in the neck, shoulder, lumbar regions are relatively high among workers wearing insulated gloves. Factors associated with multi-site WMSDs include 10-<20 years of work experience, junior college education or bachelor’s degrees and above, uncomfortable working postures, frequent repetitive low-back movements, and lack of sufficient rest time.

Background A large number of power supply workers are involved in live working and are exposed to multiple risk factors for long periods of time during outdoor work, which in turn causes occupational health problems. Objective To identify potential ergonomic factors related to work-related musculoskeletal disorders (WMSDs) and estimate the ergonomic risk of electricians. Methods A total of 31 workers were randomly selected from a training base under a power supply enterprise in Guangxi, and their operation processes were recorded by video. Using the Rapid Upper Limb Assessment (RULA) method, the workers were scored by the posture of their arms, neck, and torso during operation, and the final scores were summarized to assess their risk level. Two independent samples t-tests were used to compare the differences in RULA scores. Results A total of 31 videos for mounting/dismounting insulation mask and 29 videos for breaking/connecting contact terminal were collected. The RULA score for mounting/dismounting insulation mask was 6.6 ± 0.7 (left side) and 7.0 ± 0.2 (right side), most of the workers had a score of 7 (71.0% on the left side and 96.8% on the right side), and the upper limb and overall scores on the right side were higher than those on the left side (P < 0.05). The RULA score for breaking/connecting contact terminal was 6.9 ± 0.4 (both right and left sides), most of workers had a score of 7 (89.7% on the left side and 93.1% on the right side), and the difference of the overall scores between the right and left side for this operation were not statistically significant (P > 0.05). The ergonomic risk levels for both operations were level 3 or higher. Conclusion Mounting/dismounting insulation mask and breaking/connecting contact terminal are typical upper limb operations, and have a high level of ergonomics risk, requiring effective preventive and protective measures.

Background The positive rate of work-related musculoskeletal disorders (WMSDs) among coal mine workers remains high, which seriously affects the quality of life of the workers. Objective To estimate the prevalence of WMSDs among coal miners in Shanxi Province and analyze their influencing factors. Methods From May to December 2023, 2315 coal miners from a coal mine enterprise inShanxi Province were selected by convenience sampling, and the self-administered Basic Situation Survey Scale, Musculoskeletal Disorders Questionnaire, Effort-Reward Imbalance Questionnaire, and Pittsburgh Sleep Quality Scale were used to evaluate general demographic characteristics, work organization characteristics, living habits, sleep quality, occupational stress, and occurrence of WMSDs symptoms and the corresponding absences (sickness absence) in past 1 year. The positive rate and absenteeism rate of WMSDs were caculated, and Pearson's chi-square test was used for identify influencing factors of WMSDs, and finally a binary logistic regression method was used to further studying the factors. Results A total of 2577 questionnaires were distributed in this survey, and 2315 valid questionnaires were recovered, with an effective recovery rate of 89.9%. The positive rate of WMSDs symptoms was 48.7% (1127/2315), the absenteeism rate due to WMSDs was 22.6% (523/2315), and the waist (17.5%), neck (11.7%), and knee (9.0%) were the most common areas presenting WMSDs symptoms. The results of logistic regression showed that compared with ≤10 years of service, the risk of WMSDs was higher for those with > 20 years of service (OR=2.167, 95%CI: 1.419, 3.311). Compared with the daily working time of ≤8 h, the risk of WMSDs was higher for those >8 h daily working time (OR=1.463, 95%CI: 1.211, 1.767). A higher risk of WMSDs was reported in workers with moderate labor intensity (OR=1.247, 95%CI: 1.009, 1.542) or heavy labor intensity (OR=1.570, 95%CI: 1.215, 2.027) than those with light labor intensity. The higher the education level (OR _{high school and technical secondary school}=1.866, 95%CI: 1.435, 2.425; OR _{junior college/bachelor degree or above}=1.953, 95%CI: 1.445, 2.639), the higher the risk of WMSDs. The risk of WMSDs was higher in workers reporting smoking (OR=1.225, 95%CI: 1.021, 1.470) or alcohol consumption (OR=1.345, 95%CI: 1.122, 1.612). The risk of WMSDs in coal miners with high occupational stress (OR=1.229, 95%CI:1.030, 1.466) or those with sleep disorders (OR=3.616, 95%CI:2.824, 4.629) was higher than that in workers with low occupational stress or no sleep disorders respectively. Conclusion The positive rate of WMSDs among coal mine personnel in Shanxi Province is high, and education level, length of service, daily working hours, smoking, alcohol consumption, labor intensity, sleep disorders, and occupational stress are influencing factors for WMSDs.

Background In recent years, the detection rate of thyroid nodules in China's occupational population has shown an upward trend. The prevalence of this disease needs to be taken seriously and targeted measures should be taken to address its influencing factors. Objective To analyze the detection and influencing factors of thyroid nodules among adult male workers in coal mining enterprises in Shanxi Province, and provide a theoretical basis for the prevention of thyroid nodules. Methods A total of 5195 adult male workers from coal mining enterprises who ordered physical examination provided by the Xishan Coal Electricity (Group) Corporation Occupational Disease Prevention and Control Institute in Taiyuan City, Shanxi Province from May 2023 to December 2023 were selected as research subjects. A questionnaire survey, physical examination, ultrasound examination, and biological sample collection and testing were conducted. Thyroid nodules were diagnosed based on ultrasound results, classified and evaluated according to the Chinese-Thyroid Imaging Reporting and Data System (C-TIRADS), and the crude detection rate and standardized detection rate of thyroid nodules in adult male coal mine workers in Shanxi Province wereestimated. Occupational history and occupational exposure information were retrieved from their annual occupational health examination reports provided by the employer. Logistic regression modeling was used to analyze the influencing factors of thyroid nodule. Results A total of 1688 cases of thyroid nodules were detected, with a crude detection rate of 32.49% and an age-standardized detection rate of 31.17%. The cases (constitution ratio) of thyroid nodules by category in the detected cases was as follows: 358 cases (21.21%) were classified as category 2, 1261 cases (74.70%) as category 3, 67 cases (3.97%) as category 4a, and 2 cases (0.12%) as category 4b. The results of logistic regression showed that the duration of exposure to occupational hazards for 11-20 years, 21-30 years, ≥31 years, average monthly working>26 days, and shift work were positively correlated with the detection of thyroid nodules (P<0.05), and the associated ORs (95%CIs) were 1.29 (1.01, 1.65), 1.55 (1.20, 1.99), 1.68 (1.26, 2.55), 1.19 (1.00, 1.40), and 1.15 (1.02, 1.29), respectively. Conclusion The duration of exposure to occupational hazards, average monthly working days, and shift work are influencing factors of thyroid nodules. Intervention measures should be developed based on these influencing factors to prevent the occurrence of thyroid nodules.

Objective To assess the effectiveness of the Regulations on Medical Dispute Prevention and Resolution(hereafter referred to as the Regulations)and to provide evidence-based recommendations for enhancing the legal governance sys-tem of medical dispute management.Methods A cross-sectional study was conducted involving physicians,nurses,techni-cians,clinical department directors,and head nurses.The investigation was conducted through literature review,questionnaire surveys,and expert interviews.Factor analysis and chi-square tests were employed for statistical analysis.Results Significant differences(P＜0.01)were observed among healthcare practitioners in Guangxi concerning their understanding of the Regula-tions,preferences for dispute resolution methods,implementation of informed consent,and risk intervention practices.However,no significant differences emerged in medical quality and safety evaluations or recommendations for surgical accident insurance.Conclusion This study suggests it is a need to refine the legal framework for medical dispute prevention and resolution.It is rec-ommended to strengthen medical personnel's compliance with informed consent obligations and deepen their understanding of rel-evant laws and regulations.Efforts should be intensified to promote third-party mediation mechanisms such as the Medical Dispute Mediation Committee(MedMC)and medical accident insurance coverage.Additionally,pre-dispute risk assessments should be enhanced,and a risk early intervention model integrating artificial intelligence,healthcare practices,and legal regulations should be established.