Chronic heart failure （CHF） is an end-stage cardiac syndrome driven by multiple factors. Its pathological process involves interactions of multiple pathways such as energy metabolism dysfunction， neuroendocrine dysregulation， and myocardial fibrosis. Although current clinical medicine can alleviate symptoms through single-target approaches， significant limitations in reversing cardiac remodeling and disease progression remain. Puerarin， a major bioactive isoflavone constituent derived from Pueraria lobata， exhibits multidimensional pharmacological effects， such as vasodilatory effects， regulation of neuroendocrine balance， enhancement of metabolic homeostasis， and suppression of myocardial apoptosis. This review systematically integrated puerarin's multi-target regulatory network， elucidating its mechanisms such as improving energy metabolism by AMP-activated protein kinase/mechanistic target of rapamycin （AMPK/mTOR） pathway， inhibiting fibrosis mediated by transforming growth factor-β （TGF-β）/Smad signals， and attenuating oxidative-inflammatory cascades by regulating nuclear factor erythroid 2 （E₂）-related factor 2/nuclear transcription factor-κB（Nrf2/NF-κB） axis. Clinical research data was used to validate its efficacy in improving the left ventricular ejection function and reducing the therapeutic potential of cardiovascular events' risks. The study proposed that puerarin's "systemic regulation" characteristic breaks through the limitations of traditional single-target drugs and prospected its clinical translation pathway based on metabolomics and nano-delivery technology， offering an integrative perspective from molecular mechanisms to precise therapy for the research on modernization of traditional Chinese medicine.

Chronic heart failure （CHF） is an end-stage cardiac syndrome driven by multiple factors. Its pathological process involves interactions of multiple pathways such as energy metabolism dysfunction， neuroendocrine dysregulation， and myocardial fibrosis. Although current clinical medicine can alleviate symptoms through single-target approaches， significant limitations in reversing cardiac remodeling and disease progression remain. Puerarin， a major bioactive isoflavone constituent derived from Pueraria lobata， exhibits multidimensional pharmacological effects， such as vasodilatory effects， regulation of neuroendocrine balance， enhancement of metabolic homeostasis， and suppression of myocardial apoptosis. This review systematically integrated puerarin's multi-target regulatory network， elucidating its mechanisms such as improving energy metabolism by AMP-activated protein kinase/mechanistic target of rapamycin （AMPK/mTOR） pathway， inhibiting fibrosis mediated by transforming growth factor-β （TGF-β）/Smad signals， and attenuating oxidative-inflammatory cascades by regulating nuclear factor erythroid 2 （E₂）-related factor 2/nuclear transcription factor-κB（Nrf2/NF-κB） axis. Clinical research data was used to validate its efficacy in improving the left ventricular ejection function and reducing the therapeutic potential of cardiovascular events' risks. The study proposed that puerarin's "systemic regulation" characteristic breaks through the limitations of traditional single-target drugs and prospected its clinical translation pathway based on metabolomics and nano-delivery technology， offering an integrative perspective from molecular mechanisms to precise therapy for the research on modernization of traditional Chinese medicine.

Background The prevalence of chronic diseases among the Chinese occupational population is rising steadily, with hypertension and diabetes becoming important health concerns. Occupational health examinations (OHE) provide stable population coverage, standardized protocols, and fixed follow-up intervals, offering a robust data foundation for risk assessment. However, most existing hypertension prediction studies rely on cross-sectional data and mainly focus on clinic onset, failing to capture the dynamic progression and cumulation of individual risk. Objective To construct a machine learning-based risk prediction model for blood pressure abnormality in occupational populations, providing a reference for health risk stratification and targeted health interventions. Methods Longitudinal data from 2020 to 2023 were extracted from the occupational health examination database of an institution in Shanghai. After excluding individuals with hypertension in any of the first three years, 3710 workers who participated 4 consecutive years of OHE were included. Six categories of blood pressure-related indicators from 2020 to 2022 were selected, including basic information, lifestyles, occupational exposures, cardiovascular indicators, routine blood tests, and biochemical markers, comprising 30 variables in total. For feature engineering, continuous variables were processed to reflect three-year dynamic characteristics: level (mean), variability (variance), and temporal trend (slope). Categorical variables were incorporated using 2022 values. Least absolute shrinkage and selection operator regression was applied to identify variables for inclusion in the machine learning models. Five models (decision tree, logistic regression, random forest, support vector machine, and XGBoost) were employed to predict blood pressure abnormality risk in 2023. And then sensitive analysis was conducted. The optimal model was selected based on the area under the curve (AUC) of receiver operating characteristic. Feature importance and SHAP analyses were applied to interpret the final model. Results Feature engineering transformed 17 continuous variables into 51 secondary variables, combined with 13 baseline variables, resulted in 24 variables screened out by LASSO regression. The logistic regression model achieved the best performance. Feature importance analysis indicated that the dynamic trajectory of blood pressure played a central role in the model, complemented by other biochemical and lifestyle indicators. SHAP analysis further showed that the model’s ability to not only identify risks of high-normal blood pressure and hypertension but also quantify the specific contribution of individual examination indicators to predicted risk, supporting risk-stratified population management in occupational health management. Conclusion Based on an existing occupational health examination database and routinely collected data, this study has developed a risk prediction model for blood pressure abnormalities in occupational populations. By incorporating dynamic change characteristics from longitudinal examinations, the study demonstrates the feasibility of using routine health data for early risk identification and stratified management. However, its applicability is limited by the availability of repeated examination data and the focus on specific occupational groups, requiring further validation across broader populations and diverse clinic scenarios.

ObjectiveTo measure the distance from the surface of Fengfu （GV 16） to the deep important bony structures in children aged 4 to 8 years based on CT three-dimensional reconstruction technology， thereby providing imaging reference data for clinical acupuncture safe operations in terms of different age groups and needle insertion angles. MethodsCervical CT image data were collected from healthy children aged 4 to 8 years with five age groups （4-， 5-， 6-， 7-， 8-year-old groups）， 20 cases in each group. The images were imported into Mimics 21.0 software for three-dimensional reconstruction. The straight-line distances from the skin model surface of the Fengfu （GV 16） to the first underlying bony barrier （such as the lower edge of the occipital bone， the posterior arch of the atlas vertebra） were measured at intervals of 5° on both the transverse section （0° ± 35°） and the sagittal section （40° upward to 40° downward on the diagonal）. The correlation between the measured distance， age， and angle was analyzed. ResultsIn the transverse and sagittal sections， the measured distance from the skin surface to the underlying bone of Fengfu （GV 16） at each angle increased with age. In the transverse section， the increase was relatively small within the 0° to 20° angle range， whereas a more pronounced increase was observed when the angle exceeded 20°； at measurement angles of 30° to 35°， the distance of the skin surface to the bone at Fengfu （GV 16） in the 7- and 8-year-old groups was significantly greater than that in the 4-year-old group （P＜0.05）. In the sagittal section， the measured distance from the skin surface to the bone at Fengfu （GV 16） was shortest and changed greatly at oblique upward angles of 15° to 40° within each age group， and increased markedly at near-vertical angles of 0° to 10°； it was longest at oblique downward angles of -40° to -5° and showed relatively gradual changes. ConclusionThis study obtained the imaging distance data from Fengfu （GV 16） to the surrounding bony structures in children aged 4 to 8 years through three-dimensional modeling， finding that this distance has clear age and angle dependence， which can provide quantitative evidence for developing individualized and precise safe acupuncture schemes at Fengfu （GV 16） in pediatric clinical practice.

ObjectiveTo measure the distance from the surface of Fengfu （GV 16） to the deep important bony structures in children aged 4 to 8 years based on CT three-dimensional reconstruction technology， thereby providing imaging reference data for clinical acupuncture safe operations in terms of different age groups and needle insertion angles. MethodsCervical CT image data were collected from healthy children aged 4 to 8 years with five age groups （4-， 5-， 6-， 7-， 8-year-old groups）， 20 cases in each group. The images were imported into Mimics 21.0 software for three-dimensional reconstruction. The straight-line distances from the skin model surface of the Fengfu （GV 16） to the first underlying bony barrier （such as the lower edge of the occipital bone， the posterior arch of the atlas vertebra） were measured at intervals of 5° on both the transverse section （0° ± 35°） and the sagittal section （40° upward to 40° downward on the diagonal）. The correlation between the measured distance， age， and angle was analyzed. ResultsIn the transverse and sagittal sections， the measured distance from the skin surface to the underlying bone of Fengfu （GV 16） at each angle increased with age. In the transverse section， the increase was relatively small within the 0° to 20° angle range， whereas a more pronounced increase was observed when the angle exceeded 20°； at measurement angles of 30° to 35°， the distance of the skin surface to the bone at Fengfu （GV 16） in the 7- and 8-year-old groups was significantly greater than that in the 4-year-old group （P＜0.05）. In the sagittal section， the measured distance from the skin surface to the bone at Fengfu （GV 16） was shortest and changed greatly at oblique upward angles of 15° to 40° within each age group， and increased markedly at near-vertical angles of 0° to 10°； it was longest at oblique downward angles of -40° to -5° and showed relatively gradual changes. ConclusionThis study obtained the imaging distance data from Fengfu （GV 16） to the surrounding bony structures in children aged 4 to 8 years through three-dimensional modeling， finding that this distance has clear age and angle dependence， which can provide quantitative evidence for developing individualized and precise safe acupuncture schemes at Fengfu （GV 16） in pediatric clinical practice.

Background Long-term occupational health surveillance facilitates the identification of chronic health risks arising from occupational hazard exposures. However, under low-level exposure conditions in chemical enterprises, traditional workplace-centered risk assessment models are insufficient to fully explain the observed health effects among workers, highlighting the need for individual-focused health management strategies that focus on the worker. Objective To characterize long-term health trends among workers in a chemical enterprise and examine the limitations of workplace hazard monitoring and health surveillance under low-level multiple exposure scenarios, thereby providing a scientific basis for more comprehensive worker health protection measures. Methods We analyzed 972 occupational health examination records collected over a 15-year period (2010–2024) from a chemical enterprise, integrating these with enterprise hazard monitoring reports and workshop air monitoring of volatile organic compounds (VOCs). The annual counts and prevalences of abnormalities in liver function tests, metabolic syndrome-related indicators, and liver imaging were summarized. Temporal trends were evaluated using the Cochran-Armitage trend test. Time-related changes in abnormal health indicators among active workers were evaluated by generalized linear mixed-effects models (GLMMs), adjusting for age and sex. Individual longitudinal profiles were described for nine workers with continuous 15-year records. In addition, paired comparisons of health outcomes were conducted for 81 workers with both pre-employment and periodic examinations. Results Workplace hazard monitoring indicated that airborne concentrations of major occupational contaminants including VOCs, acids and bases, dust, and physical factors were below national occupational exposure limits. However, 62 VOC species—including chlorobenzene, chloromethane, and cyclohexane—were detected in workshop air, suggesting complex mixed organic solvent exposure. From 2010 to 2015, occupational health examination records were primarily based on physicians’ qualitative assessment, yielding generally low abnormality detection rates. During 2016–2024, data collection was complete, and the prevalences of abnormalities in liver function, metabolic syndrome-related indicators, and liver imaging among active workers remained relatively high. Trend analysis indicated that only the abnormality rates of total bilirubin (TBIL) and hypertension showed statistically significant temporal trends; other indicators exhibited no significant linear changes despite high prevalences. After adjusting for age and sex, the GLMMs showed that the abnormality rates of aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), TBIL, and hypertension decreased over time, whereas those of total cholesterol, triglycerides, and fatty liver increased. In a subgroup of 9 workers with continuous 15-year follow-up data, the cumulative number of abnormal health indicators increased in several individuals after 2016. Among the 81 workers with both pre-employment and periodic records, abnormalities in total cholesterol, triglycerides, body mass index, and fatty liver were significantly more prevalent after employment over time, whereas changes in liver function enzymes were not statistically significant. Conclusion With increasing age, workers exhibit a gradual deterioration in liver function and metabolic-related health indicators, reaching abnormality rates comparable to those reported in the general population. These findings suggest that both workplace-related and non-occupational factors jointly contribute to the observed health changes. Consequently, occupational health management should shift towards an "individual-centered" approach. Enhancing workers' health literacy, strengthening workplace health promotion, and extending occupational health services beyond the workplace are essential to comprehensively protect workers' health.

Objective To analyze the coverage of chronic disease-related indicators and the distribution of positive detection rates in occupational medical examinations (OME). Methods A total of 872 862 currently employed workers who underwent OME from 2015 to 2023 were selected as the study participants using a convenience sampling method. According to the year of OME, the study period was divided into three periods: 2015-2017, 2018-2020, and 2021-2023. The examination rates and positive detection rates of five chronic disease-related indicators, including obesity, high blood pressure, hyperglycemia, dyslipidemia, and hyperuricemia, were analyzed. Results Regarding the routine medical examination indicators in OME, the examination rates for systolic and diastolic blood pressure were both 97.4%, while those for body height and weight were both 6.8%. Among the mandatory or optional examination items for specific occupational groups in OMEs, the examination rates of fasting blood glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were 35.2%, 18.5%, 18.5%, 7.8%, and 7.9%, respectively. Regarding items not included in OMEs, the examination rates of glycated hemoglobin and uric acid were 0.2% and 19.2%, respectively. The examination rates for systolic and diastolic blood pressure consistently exceeded 95.0%, the examination rates for fasting blood glucose, triglycerides, and uric acid ranged from 32.9% to 37.0%, 16.8% to 21.4%, and 16.9% to 24.1%, respectively, while the rates for body height and weight remained below 10.0% across these three periods. Among workers who completed corresponding OME items, dyslipidemia and hyperuricemia showed relatively higher positive detection rates, with rates of 23.2% and 23.0%, respectively. The positive detection rates of obesity, high blood pressure, and hyperglycemia were relatively lower, at 9.6%, 3.5%, and 1.4%, respectively. Across the three periods, the positive detection rates of dyslipidemia, hyperuricemia, obesity, high blood pressure, and hyperglycemia ranged from 18.0% to 33.7%, 7.0% to 28.5%, 7.8% to 10.9%, 3.3% to 3.9%, and 1.4% to 1.5%, respectively, all showing increasing trends with advancing OME periods (all P<0.01). Conclusion Current OME practices show a mismatch between the coverage of chronic disease-related indicators and the actual health risks among occupational worker populations. Although blood pressure monitoring is well implemented, basic physical indicators (body height and body weight) and key metabolic indicators (blood glucose, blood lipids, and uric acid) are insufficiently covered, limiting comprehensive assessment of occupational health risks. Optimization of monitoring strategies is urgently needed to improve data completeness.

ObjectiveTo explore the effects of mechanical pressure regulation on the migration and bone-promoting ability of suture dural cells （S-DCs） and non-suture dural cells （NS-DCs）. MethodsDural cells （S-DCs）， non-cranial suture dural cells （NS-DCs） and cranial suture mesenchymal stem cells （CS-MSCs） of 5-day-old SD rats were isolated and cultured. Four experimental conditions， namely S-DCs-Normal， S-DCs-Stress， NS-DCs-Normal and NS-DCs-Stress， were set according to the source of the cells and whether mechanical pressure （1.07 kPa， 24 hours） was applied. The migration ability of dural cells was detected by cell scratch test. Four experimental condition culture media were collected and co-cultured with CS-MSCs for osteogenic induction. Calcium salt deposition was detected by alizarin red staining， and the expression of osteogenesis-related proteins was detected by Western blot. ResultsCompared with the Normal group， the migration abilities of both S-DCs and NS-DCs decreased after Stress treatment （P<0.05）. Compared with S-DCs， NS-DCs has a weaker migration ability under the same processing conditions （P<0.05）. The conditioned medium experiment showed that Stress treatment reduced the osteogenic ability of CS-MSCs （P<0.05）， and the osteogenic effect of the conditioned medium derived from NS-DCs was weaker than that of S-DCs （P<0.05）. The Western blot results were consistent with the trend of alizarin red staining. Both Stress treatment and NS-DCs sources could down-regulate the expression of osteogenesis-related proteins （P<0.05）. ConclusionMechanical stress can significantly inhibit the migration of dural cells and the osteogenic differentiation process of CS-MSCs mediated by it. The mechanical tolerance and osteogenic regulation ability of S-DCs are significantly better than those of NS-DCs.

As a primary approach to safeguarding workers' occupational health in China, the work-related injury insurance still has insufficient preventive measures for occupational groups. By reviewing the preventive measures embedded in Germany’s statutory accident insurance (Gesetzliche Unfallversicherung) and Japan’s workers’ accident compensation insurance, this study summarized their best practices and then proposed the following policy directions based on China’s specific context: strengthening the prevention-oriented institutional framework, increasing financial investment in occupational injury prevention, improving the incentive mechanisms of floating premium rate, and promoting data integration and intelligent applications in occupational health management. These measures are expected to shift China’s work-related injury insurance system from a compensation-oriented model to one that emphasizes comprehensive prevention and health promotion, thereby providing useful insights for better safeguarding the health of Chinese workers.

Flap transplantation is a critical surgical strategy for the reconstruction of tissue defects caused by trauma, tumor resection, and congenital malformations, and its survival rate directly determines surgical efficacy and patient prognosis. Following transplantation, flaps inevitably undergo ischemia-reperfusion (I/R) injury, during which oxidative stress, inflammatory responses, and metabolic disturbances are intricately intertwined, ultimately leading to cellular injury and tissue necrosis. Recent studies have demonstrated that multiple forms of programmed cell death—including apoptosis, pyroptosis, ferroptosis, necroptosis, and PANoptosis—play central roles in flap I/R injury. The extensive crosstalk and molecular interactions among these pathways form a highly complex cell death network. Specifically, apoptosis is mediated by the imbalance of Bcl-2 family proteins and the activation of cysteine-dependent aspartate-specific protease (caspase) cascades; pyroptosis is driven by the NLRP3-caspase-1-GSDMD axis, resulting in membrane pore formation and the release of pro-inflammatory cytokines; ferroptosis is characterized by iron-dependent lipid peroxidation and dysfunction of glutathione peroxidase 4 (GPX4); necroptosis is triggered by the receptor-interacting serine/threonine-protein kinase 1 (RIPK1)-RIPK3-MLKL signaling complex, leading to membrane rupture; and PANoptosis represents an integrated form of inflammatory cell death that coordinates multiple death pathways. Importantly, these forms of programmed cell death are not independent but are interconnected through extensive signaling crosstalk. Key regulatory molecules, including caspase-8, reactive oxygen species (ROS), nuclear factor-κB (NF-κB), and nuclear factor erythroid 2-related factor 2 (Nrf2), collectively modulate the dynamic balance among these pathways. Therefore, the multidimensional interplay and spatiotemporal dynamics of programmed cell death constitute a fundamental pathological basis of flap I/R injury. This review systematically summarizes the latest advances in the mechanisms and interactions of various programmed cell death pathways in flap I/R injury, aiming to elucidate the underlying regulatory network. These insights may provide novel theoretical foundations for optimizing flap protection strategies, improving flap survival, and promoting tissue repair.