OBJECTIVE To analyze trends in the burden of disease associated with falls from 1990 to 2023， identify risk factors for falls， and provide a reference for the development of measures to reduce the burden of disease associated with falls and the formulation of public health policies. METHODS Based on the data of 2023 from the Global Burden of Disease （GBD） database， the changes in fall-related prevalence， mortality， disability-adjusted life years （DALYs） and incidence in China and globally from 1990 to 2023 were analyzed， and the stratified analyses by gender， age and socio-demographic index （SDI） were conducted. The risk factors related to falls in 2023 were systematically analyzed， and the impact of multimorbidity and polypharmacy on the occurrence of falls by combining relevant literature evidence was explored. RESULTS & CONCLUSIONS Globally， the percentage changes in age-standardized rates of fall-related prevalence， mortality， DALYs and incidence from 1990 to 2023 were －2.4% （95%UI： －4.8% to －0.3%）， －7.8% （95%UI： －20.5% to 10.9%）， －10.6% （95%UI： －16.5% to －4.3%）， and －4.6% （95%UI： －8.1% to －0.8%）， respectively. However， in some regions， the percentage changes in age-standardized rates for these indicators were greater than 0 （e.g.， prevalence， mortality and DALYs in Australasia， and incidence in Andean Latin America）. In China， the percentage changes in age-standardized rates of fall-related mortality and DALYs from 1990 to 2023 were －18.3% （95%UI： －56.7% to 32.3%） and 1.9% （95%UI： －10.1% to 12.4%）， while the percentage changes in age-standardized rates of prevalence and incidence were 25.9% （95%UI： 20.2% to 32.0%） and 35.7% （95%UI： 28.5% to 44.1%）， respectively. Globally， in regions with high and medium-to-high SDI levels， the percentage changes in age-standardized rates of fall-related prevalence and incidence showed an upward trend， while DALYs showed a downward trend； however， the trend in mortality was unclear. In regions with a middle SDI level， the percentage changes in age-standardized rates of fall-related prevalence and incidence both showed an upward trend， while the trends in mortality and DALYs were unclear. In regions with low-to-medium SDI level， the percentage changes in age-standardized rate of fall-related prevalence， DALYs and incidence all showed a downward trend， while the trend in mortality was unclear； in regions with low SDI level， the trends for all above indicators were unclear. Correlation analyses of the burden of fall-related diseases in China and globally indicated that the risk of fall-related diseases was higher among younger and middle-to-older adult male populations， while women were concentrated in older age groups. Meanwhile， as the SDI levels increase， the percentage change in age-standardized rate of DALYs for fall-related diseases showed a clear upward trend， and this trend was more pronounced in high-SDI regions. Tobacco use， alcohol consumption， low bone density， and occupational risks were risk factors for falls， with low bone density and occupational risks contributing significantly （exceeding 20% in some regions）； multimorbidity and polypharmacy could also significantly increase the risk of falls. It is recommended that clinical settings establish a list of fall-risk increasing drugs and a warning system， improve medication reviews， strengthen medication education and adherence management， foster multidisciplinary collaboration， and develop medication strategies for specific patient populations to reduce the incidence of falls and alleviate the burden of disease.

Objective:To explore the influencing factors of body image in young breast cancer patients after mastectomy from the perspective of self-objectification.Methods:A total of 359 female breast cancer patients who underwent mastectomy at Taizhou Hospital of Zhejiang Province between January 2022 and May 2024 were selected using convenience sampling. Data were collected using a general information questionnaire, the Body Image Self-Rating Questionnaire for Breast Cancer patients (BISQ-BC) , the Body Surveillance Subscale (TBSS) , the Physical Appearance Comparison Scale (PACS) , and the Social Appearance Anxiety Scale (SAAS) .Results:A total of 359 questionnaires were distributed, and 338 valid questionnaires were collected, with an effective response rate of 94.15%. The BISQ-BC score among the 338 participants was (110.88±7.03) , the TBSS score was (39.78±4.58) , the Physical Appearance Comparison Scale score was (14.58±2.52) , and the SAAS score was (65.10±10.66) . Mediation analysis revealed a significant chained mediating effect of physical appearance comparison and social appearance anxiety between body surveillance and body image. The total indirect effect accounted for 44.48% of the total effect. The direct effect of body surveillance on body image was 0.367, accounting for 55.52% of the total effect.Conclusions:The body image status of young breast cancer patients after mastectomy is unsatisfactory. Patients' body surveillance not only directly affects their body image, but also indirectly influences it through physical appearance comparison and social appearance anxiety.

Objective:To explore the influencing factors of body image in young breast cancer patients after mastectomy from the perspective of self-objectification.Methods:A total of 359 female breast cancer patients who underwent mastectomy at Taizhou Hospital of Zhejiang Province between January 2022 and May 2024 were selected using convenience sampling. Data were collected using a general information questionnaire, the Body Image Self-Rating Questionnaire for Breast Cancer patients (BISQ-BC) , the Body Surveillance Subscale (TBSS) , the Physical Appearance Comparison Scale (PACS) , and the Social Appearance Anxiety Scale (SAAS) .Results:A total of 359 questionnaires were distributed, and 338 valid questionnaires were collected, with an effective response rate of 94.15%. The BISQ-BC score among the 338 participants was (110.88±7.03) , the TBSS score was (39.78±4.58) , the Physical Appearance Comparison Scale score was (14.58±2.52) , and the SAAS score was (65.10±10.66) . Mediation analysis revealed a significant chained mediating effect of physical appearance comparison and social appearance anxiety between body surveillance and body image. The total indirect effect accounted for 44.48% of the total effect. The direct effect of body surveillance on body image was 0.367, accounting for 55.52% of the total effect.Conclusions:The body image status of young breast cancer patients after mastectomy is unsatisfactory. Patients' body surveillance not only directly affects their body image, but also indirectly influences it through physical appearance comparison and social appearance anxiety.

OBJECTIVE To evaluate the efficacy， safety and cost-effectiveness of generic drugs and original drugs of voriconazole. METHODS The information of patients who used voriconazole generic drugs selected in National Centralized Drug Procurement （generic drug group） or non-selected original drugs （original drug group） in the treatment of fungal infection was collected from the our hospital. The propensity score matching was carried out to eliminate bias. The comprehensive efficacy was evaluated according to clinical efficacy， image findings and microbiological test， and stratified analysis of different populations was conducted based on fungal species， underlying diseases， etc.， the efficacy of different stratifications was evaluated. Evaluation of safety was performed by using the incidence of adverse reactions. The total cost， defined daily doses （DDDs） and defined daily dose cost （DDDc） were used to evaluate the cost-effectiveness. RESULTS A total of 436 patients were included， and there were 190 patients in each group after matching. In terms of efficacy， the effective rates of voriconazole generic drugs and original drugs were 62.63% and 59.47% （P＝0.528）； in terms of safety， the incidence of adverse reactions caused by generic drugs and original drugs of voriconazole was 13.68% and 7.89%， respectively（P＝0.069）. In terms of cost-effectiveness， the average total cost of generic drugs was 4 636.26 yuan， and that of original drugs was 8 613.20 yuan （P＜0.001）. After the implementation of National Centralized Drug Procurement， replacement rate of generic drugs increased to 87.30%， and DDDc decreased by 59.08%. CONCLUSIONS The efficacy and safety of voriconazole generic drugs are similar to those of original drugs in the treatment of fungal infection， and it is more cost-effective in terms of treatment cost.