ObjectiveHeadspace solid-phase microextraction-gas chromatography-mass spectrometry（HS-SPME-GC-MS） and GC-triple quadrupole MS（GC-QqQ-MS） in combination with non-targeted and targeted metabolomics were employed to systematically analyze the chemical composition differences of Xihuangwan prepared with natural musk and artificial musk， and establish an identification system for them. MethodsThe volatile components of 9 batches of Xihuangwan samples from 8 manufacturers were analyzed by HS-SPME-GC-MS non-targeted metabolomics， and identified by comparing their MS data with the National Institute of Standards and Technology（NIST） spectral library. Orthogonal partial least squares-discriminant analysis（OPLS-DA） was used to identify differential volatile components of Xihuangwan prepared with natural musk and artificial musk. Additionally， GC-QqQ-MS targeted metabolomics was applied to quantify the levels of α-pinene， β-elemene， muscone， dehydroepiandrosterone， bornyl acetate， and octyl acetate in 27 batches of samples from 9 manufacturers. Cluster analysis， principal component analysis（PCA）， and partial least squares-discriminant analysis（PLS-DA） were conducted to further explore the differences in volatile components between Xihuangwan samples prepared with natural musk and artificial musk. ResultsNon-targeted metabolomics identified 291 volatile compounds in Xihuangwan， including alkanes， esters， alkanes， alcohols， ketones， naphthalenes and others. OPLS-DA analysis revealed distinct separation between Xihuangwan samples containing artificial musk（A1， C1， D1， E1， F1， G1， I1） and those containing natural musk（H1， H3）. A total of 30 differential metabolites were identified. The relative contents of these 30 differential metabolites were visualized using a radar chart， revealing significant differences in the levels of octanol， borneol acetate and muscone. Cluster analysis and PCA results from targeted metabolomics indicated that Xihuangwan could be classified into two distinct groups：one composed of natural musk（H1， H3） and the other of artificial musk， sample H2. PLS-DA identified muscone， octyl acetate， and dehydroepiandrosterone as key differential volatile components. Although no significant difference was observed in the content of octyl acetate between the two groups， statistically significant differences were found for muscone and dehydroepiandrosterone（P<0.05）. ConclusionMuscone and dehydroepiandrosterone can be used for the differentiation of Xihuangwan samples containing natural musk from those containing artificial musk. This study systematically and comprehensively analyzed the differences in the types and contents of major volatile components in Xihuangwan prepared with natural musk and artificial musk， providing a scientific basis for quality evaluation and control of Xihuangwan.

ObjectiveHeadspace solid-phase microextraction-gas chromatography-mass spectrometry（HS-SPME-GC-MS） and GC-triple quadrupole MS（GC-QqQ-MS） in combination with non-targeted and targeted metabolomics were employed to systematically analyze the chemical composition differences of Xihuangwan prepared with natural musk and artificial musk， and establish an identification system for them. MethodsThe volatile components of 9 batches of Xihuangwan samples from 8 manufacturers were analyzed by HS-SPME-GC-MS non-targeted metabolomics， and identified by comparing their MS data with the National Institute of Standards and Technology（NIST） spectral library. Orthogonal partial least squares-discriminant analysis（OPLS-DA） was used to identify differential volatile components of Xihuangwan prepared with natural musk and artificial musk. Additionally， GC-QqQ-MS targeted metabolomics was applied to quantify the levels of α-pinene， β-elemene， muscone， dehydroepiandrosterone， bornyl acetate， and octyl acetate in 27 batches of samples from 9 manufacturers. Cluster analysis， principal component analysis（PCA）， and partial least squares-discriminant analysis（PLS-DA） were conducted to further explore the differences in volatile components between Xihuangwan samples prepared with natural musk and artificial musk. ResultsNon-targeted metabolomics identified 291 volatile compounds in Xihuangwan， including alkanes， esters， alkanes， alcohols， ketones， naphthalenes and others. OPLS-DA analysis revealed distinct separation between Xihuangwan samples containing artificial musk（A1， C1， D1， E1， F1， G1， I1） and those containing natural musk（H1， H3）. A total of 30 differential metabolites were identified. The relative contents of these 30 differential metabolites were visualized using a radar chart， revealing significant differences in the levels of octanol， borneol acetate and muscone. Cluster analysis and PCA results from targeted metabolomics indicated that Xihuangwan could be classified into two distinct groups：one composed of natural musk（H1， H3） and the other of artificial musk， sample H2. PLS-DA identified muscone， octyl acetate， and dehydroepiandrosterone as key differential volatile components. Although no significant difference was observed in the content of octyl acetate between the two groups， statistically significant differences were found for muscone and dehydroepiandrosterone（P<0.05）. ConclusionMuscone and dehydroepiandrosterone can be used for the differentiation of Xihuangwan samples containing natural musk from those containing artificial musk. This study systematically and comprehensively analyzed the differences in the types and contents of major volatile components in Xihuangwan prepared with natural musk and artificial musk， providing a scientific basis for quality evaluation and control of Xihuangwan.

Work-related musculoskeletal disorders (WMSDs) represent a significant occupational health challenge among healthcare professionals globally, posing substantial threats to physical and mental well-being as well as work sustainability. Adopting preventive behaviors—including ergonomic postural adjustments, optimized work-rest scheduling, proper use of protective and assistive equipment, and regular physical activity—is essential for mitigating the risk of WMSDs. Guided by the social ecological model, the review synthesized current evidence on the determinants of WMSDs preventive behaviors across four levels: intrapersonal characteristics, work environment conditions, interpersonal support, and policy/institutional factors. The findings suggest that higher educational attainment, favorable health-related behavioral patterns, optimized ergonomic work environments, adoption of supportive collaborative systems, strong organizational support, as well as policy safeguards facilitate preventive behavior adoption. Conversely, limited prevention-related knowledge, low risk perception, insufficient physical activity, excessive workload, lack of appropriate protective equipment, inadequate ergonomic training, a prevailing culture of presenteeism, and inadequate policy implementation constitute significant barriers. Multi-dimensional intervention strategies targeting these determinants are warranted to enhance preventive behaviors, reduce the risk of WMSDs, and strengthen occupational health protection for healthcare professionals.

Objective To analyze the disease burden and trends of bladder cancer in China and globally from 1992 to 2021.  Methods Using the GBD 2021 database, the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) rates of bladder cancer in China and globally from 1992–2021 were analyzed. Average annual percentage change (AAPC) was calculated using Joinpoint regression. Subgroup analyses by sex and age were conducted, and a Bayesian age-period-cohort (BAPC) model was used to predict trends in age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for the next 15 years.  Results In 2021, China reported 106 000 new cases (ASIR: 5.14/100 000), 571 000 prevalent cases (age-standardized prevalence rate, ASPR: 26.61/100 000), 43 000 deaths (ASMR: 2.34/100 000), and a DALY rate of 45.31/100 000. From 1992–2021, China showed upward trends in ASIR and ASPR but declines in ASMR and DALYs, while global ASIR, ASMR, and DALYs decreased overall with slow ASPR growth. The peak cases in China and globally were both concentrated in the 65-79 age group, with a significantly higher burden on males than females. In China, smoking-related ASMR and ASDR exceeded global averages and rose, whereas high glucose-related indexes were lower and declined. Projections for 2021–2036 indicated that the global incidence and mortality rates would be rising, but ASIR/ASPR would be declining, while in China, the incidence rate would continue to rise, and the mortality rate will stabilize, with a significant increase in ASIR and a gradual decrease in ASPR.  Conclusion From 1992 to 2021, the incidence of bladder cancer in China has shown a continuous upward trend and is projected to persist in the future, with significant gender and age differences. Particular attention should be given to elderly males aged 85-89. The disease burden of bladder cancer attributable to smoking continues to rise, highlighting the urgent need to strengthen tobacco control policies.

Objective: To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer. Materials and Methods: A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs. Results: All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027). Conclusion The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.

ObjectiveThis study aims to analyze the pharmacodynamic material basis and multi-target mechanism of action of Banxia Baizhu Tianmatang combined with Danggui Shaoyaosan in the treatment of Meniere's disease（MD）. MethodsUltra-performance liquid chromatography-high resolution mass spectrometry （UPLC-HRMS） （mobile phase： gradient elution with 0.1% formic acid aqueous solution-acetonitrile. Mass spectrometry scanning range： m/z 90-1 300） was used to identify the chemical components of the compound recipe and components absorbed into blood. The core mechanism was predicted by combining network pharmacology （target screening via SwissTargetPrediction and GeneCards databases， and construction of protein-protein interaction （PPI） network by STRING） and molecular docking （evaluated by Autodock， with binding energy ≤ -5.0 kcal·mol^-1）. For animal experiment validation， 36 Sprague Dawley （SD） rats were divided into a blank group， a model group （postauricular injection of lipopolysaccharide （LPS） at 1 mg·kg^-1）， low/medium/high-dose Chinese medicine groups （5.94， 11.88， and 23.76 g·kg^-1·d^-1， respectively）， and Western medicine group （betahistine at 0.1 mg·kg^-1·d^-1）. After eight weeks of intervention， the gene and protein expressions in cochlear tissue were detected. Results①A total of 2 831 chemical components and 173 components absorbed into blood were identified， with terpenoids showing the highest absorption rate into blood（10.28%）. ②60 common drug-disease targets were screened， with core targets including tumor necrosis factor-α（TNF-α），interleukin-6（IL-6）， Toll-like receptor 4（TLR4）， angiotensin-converting enzyme（ACE）， and endothelial nitric oxide synthase 3（NOS3）.These targets were enriched in the nuclear factor-κB（NF-κB） signaling pathway and renin-angiotensin system（P<0.05）. Molecular docking showed that the active component YC-1 had a strong binding ability to TNF（binding energy-9.66 kcal·mol^-1）. ③In animal experiments， the high-dose Chinese medicine group significantly down-regulated the expression of pro-inflammatory factors TNF mRNA（P<0.01）and up-regulated vascular regulatory factors NOS3 protein（P<0.01）， and alleviated cochlear pathological damage［hematoxylin eosin （HE） score： from 4 to 2］. ConclusionThis compound recipe synergistically regulates the TNF/NF-κB inflammatory pathway and ACE/NOS3 vascular homeostasis pathway through flavonoids， triterpenoids， and other components， thereby inhibiting endolymphatic hydrops and cochlear damage. It provides a scientific basis for the theory of "simultaneous treatment of phlegm and blood stasis" in traditional Chinese medicine.

Objective To investigate the internalized weight bias and weight control beliefs regarding the current status,influencing factors,and impacts on eating behaviors of women losing weight. Methods A convenient sampling method was used to select the females who underwent physical examination in the Peking Union Medical College Hospital from August to December 2023.The general information questionnaire,Weight Bias Internalization Scale,Weight Control Belief Questionnaire,and Chinese version of Three-Factor Eating Questionnaire were utilized for investigation.Latent class analysis was conducted to explore the potential categories based on the characteristics of internalized weight bias and weight control beliefs.Univariate analysis and multiple-factor linear regression analysis were performed to explore influencing factors of potential categories and their effects on eating behaviors. Results A total of 518 subjects were included in this study.The internalized weight bias and weight control beliefs could be classified into three potential categories: low weight bias tolerance type(53.7%),medium weight bias persistence type(29.5%),and high weight bias overcritical type(16.8%).Logistic regression analysis showed that body mass index,unmarriage,and divorce were the influencing factors of the high weight bias overcritical type.The scores of non-control eating and emotional eating in medium weight bias persistence type and high weight bias overcritical type were higher than those in low weight bias tolerance type(all P<0.001). Conclusions The attitudes of Chinese women towards body weight can be categorized into low weight bias tolerance type,medium weight bias persistence type,and high weight bias overcritical type.The high weight bias overcritical type is characterized by high weight bias and high personal responsibility attribution,and it is closely associated with negative eating behaviors.A high body mass index,unmarriage,and divorce are high-risk factors for developing the high weight bias overcritical type.
Humans ; Female ; Feeding Behavior/psychology* ; Surveys and Questionnaires ; Adult ; Body Mass Index ; Weight Loss ; Body Weight ; Body Image ; Middle Aged ; Weight Prejudice

Objective:To investigate the predictive value of changes in body mass index (BMI) and blood glucose indicators in early pregnancy for gestational diabetes mellitus (GDM).Methods:A total of 126 pregnant women with GDM who were admitted to the Department of Obstetrics at Jiaxing Maternity and Child Health Care Hospital from January 2022 to December 2023 were retrospectively analyzed and included in the GDM group. Additionally, 140 healthy pregnant women were included in the non-GDM group. Changes in BMI and levels of blood glucose indicators [fasting blood glucose (FBG), 1-hour postprandial blood glucose, 2-hour postprandial blood glucose (2hPG), and glycated hemoglobin during early pregnancy were compared between the two groups. Influential factors for GDM were analyzed using a multivariate logistic regression model. The predictive value of changes in BMI and blood glucose indicators during early pregnancy for GDM was assessed using receiver operating characteristic curves.Results:The BMI at 10 [(24.60 ± 0.82) kg/m2] and 14 weeks of pregnancy [(23.50 ± 0.85) kg/m2] in the GDM group was significantly higher compared with the non-GDM group (both P < 0.05). The levels of FBG [(5.98 ± 0.36) mmol/L], 1-hour postprandial blood glucose [(10.95 ± 0.83) mmol/L], and 2hPG [(8.60 ± 0.82) mmol/L] in the GDM group were also significantly higher than those in the non-GDM group ( t = 12.25, 23.90, 5.98, all P < 0.001). The levels of total cholesterol [(6.35 ± 1.10) mmol/L] and triglycerides [(3.23 ± 0.60) mmol/L] in the GDM group were significantly higher compared with the non-GDM group ( t = 6.45, 7.45, both P < 0.001). The number of cesarean sections ( n = 69 cases) and the incidence of adverse delivery outcomes [26.98% (34/126)] in the GDM group were significantly higher than those in the non-GDM group ( χ2 = 16.72, 12.71, both P < 0.001). Multivariate logistic regression analysis indicated that BMI at 10 weeks of pregnancy, BMI at 14 weeks of pregnancy, FBG, and 2hPG were independent risk factors for GDM ( OR = 1.292, 6.514, 2.601, 1.784, all P < 0.05). According to Receiver Operating Characteristic curve analysis, the area under the curve (AUC) (95% CI) for BMI at 10 and 14 weeks of pregnancy were 0.717 (0.630-0.795) and 0.719 (0.631-0.796), respectively. The AUC (95% CI) for FBG and 2hPG levels were 0.731 (0.635-0.813) and 0.802 (0.712-0.873), respectively. The AUC (95% CI) for the combined evaluation of these indicators was 0.911 (0.839-0.958), indicating that the combined evaluation had a higher predictive value for GDM than the use of a single indicator ( P < 0.05). Conclusions:The changes in BMI and blood glucose indicators during early pregnancy are closely related to the occurrence of GDM. The combination of these measurements has a high predictive value for GDM and is of significant importance for its prevention.

Objective To explore the clinical application effects of Chen's pancreatojejunostomy in laparoscopic pancreaticoduodenectomy.Methods Clinical data of 176 patients who underwent laparoscopic pancreaticoduodenectomy in Xiangyang Central Hospital from January 2019 to December 2024 were retrospectively analyzed.According to the methods of intraoperative pancreatojejunostomy,the patients were divided into two groups,the research group(102 cases)using Chen's pancreatojejunostomy,and the control group(74 cases)using duct-to-mucosa pancreatojejunostomy.The two groups were compared on clinical indicators,including operation time,pancreatojejunostomy time,intraoperative blood loss,incidence of postoperative complications,length of hospital stay,and 30-day postoperative mortality rate.Results All 176 patients successfully underwent laparoscopic pancreaticoduodenectomy.There were no statistically significant differences between the two groups in intraoperative blood loss,biochemical leakage,abdominal bleeding,upper gastrointestinal bleeding,delayed gastric emptying,bile leakage,abdominal infection,and 30-day postoperative mortality rate(P＞0.05).The pancreatojejunostomy time[(22.33±5.95)min]and operation time[(334.60±66.42)min]in the study group were significantly shorter than those in the control group[(30.70±5.50)min]and[(414.46±60.96)min],with statistically significant differences(P＜0.05).Two groups of patients did not develop grade C pancreatic fistula.The incidence of grade B pancreatic fistula in the study group(5.88％)was significantly lower compared to the control group(16.22％),and this difference was statistically significant(P＜0.05).Additionally,The postoperative hospital stay of the study group patients[(17.10±6.89)days]was significantly shorter than in the control group[(20.88±8.40)days],with a statistically significant difference(P＜0.05).Conclusion Chen's pancreatojejunostomy is a feasible,safe,and effective procedure in laparoscopic pancreaticoduodenectomy,which can shorten the pancreatojejunostomy time,reduce the incidence of postoperative pancreatic fistula,and decrease the length of hospital stay.

Objective To investigate the clinical efficacy of wrapping the hepatic artery with the hepatogastric ligament for preventing bleeding of the hepatic artery and its branches following pancreaticoduodenectomy(PD).Methods 194 patients who underwent PD in Xiangyang Central Hospital from January 2017 to November 2024 were enrolled and categorized into two groups based on whether the hepatic artery was enwrapped with the hepatogastric ligament during the operation.The wrapped group consisted of 95 cases where the hepatic artery was wrapped,while the non-wrapped group had 99 cases without such wrapping.Intraoperative parameters(intraoperative blood loss and operative time)and postoperative complications(pancreatic fistula,abdominal cavity infection,biliary fistula,delayed gastric emptying,postoperative bleeding,and bleeding of the hepatic artery and its branches)were compared between the two cohorts.Univariate and multivariate Logistic regression analyses were conducted to identify the independent risk factors for postoperative bleeding.Results PD was accomplished successfully in both groups.There was no remarkable difference in intraoperative indices like blood loss and operative time between the two groups(P＞0.05).Similarly,no significant disparities were noted in postoperative complications such as pancreatic fistula,abdominal infection,biliary fistula,and delayed gastric emptying(P＞0.05).Nevertheless,the incidence of postoperative bleeding in the wrapped group was lower than that in the non-wrapped group(3.16％vs.12.12％,P=0.019),and the incidence of bleeding of the hepatic artery and its branches after surgery was also significantly decreased in the wrapped group(0 vs.10.10％,P=0.004).Logistic regression analysis revealed that the operation time(OR=1.013,P=0.011),pancreatic fistula(OR=9.006,P=0.006)and celiac infection(OR=7.930,P=0.014)are independent risk factors of postoperative bleeding,Hepatogastric ligament encapsulation of hepatic artery was an independent protective factor for postoperative hemorrhage of PD(OR=0.084,P=0.006).Conclusion Wrapping the hepatic artery with the hepatogastric ligament reduces PD postoperative bleeding,especially that of the hepatic artery and its branches,without adding other complications.