To investigate the therapeutic effects of ginsenoside Rb1 on non-alcoholic steatohepatitis (NASH) and its mechanisms through modulating gut microbiota and repairing intestinal barriers in liver inflammation and metabolic disorders.

A model NASH mouse was established by high-fat, high-cholesterol diet (HFHCD) feeding. After modeling, the NASH mice were treated with Rb1 via intraperitoneal injection. An in vitro NASH model was induced with oleic acid+cholesterol in HepG2 cells. Serum biochemistry, histopathological observation (HE, Oil Red O, Masson, Sirius Red staining), and Western blotting (inflammatory and tight junction proteins) were performed. Gut microbiota was analyzed with 16S rRNA gene sequencing. The correlations between key microbiota and metabolic phenotypes were analyzed using Spearman correlation analysis and SHapley Additive exPlanations (SHAP) analysis.

Rb1 significantly reduced serum levels of total cholesterol (TC), triglyceride (TG), alanine transaminase (ALT), aspartate aminotransferase (AST) and low-density lipid-cholesterol (LDL-C) in the NASH mice (P<0.05), decreased lipid accumulation and fibrosis in liver tissues, inhibited TNF-α and IL-1β expression, and increased zonula occludens-1（ZO-1) and Occludin levels (P<0.05). It also boosted beneficial bacteria like Lactobacillus and Bifidobacterium, reduced harmful bacteria such as Desulfovibrio, and enhanced gut microbiota diversity (P<0.05). Correlation analysis showed that beneficial bacteria enriched by Rb1 were positively correlated with the improvements of metabolic indicators and negatively with inflammatory factors and liver injury markers (P<0.05). The machine learning model identified ALT as the key predictor for NASH.

Rb1 can inhibit inflammatory response and improve lipid metabolism by modulating gut microbiota and repairing the intestinal barrier, and thus significantly alleviate NASH progression.

To compare the characteristics of tongue coating flora in healthy people, patients with chronic hepatitis B (CHB) and patients with CHB complicated with non-alcoholic fatty liver disease (NAFLD), and to explore the characteristics of tongue coating flora in patients with CHB complicated with NAFLD and its comorbidity mechanism.

From January 2024 to December 2024, 42 with CHB complicated with NAFLD patients with CHB complicated with NAFLD(CHB complicated with NAFLD group) and 34 patients with simple CHB (simple CHB group) were subjected in our department, and 28 healthy individuals were selected and served as control group. Baseline clinical data were collected from all the participants, and intergroup differences were analyzed. After tongue coating samples were harvested for 16S ribosomal RNA (16S rRNA) sequencing using the PacBio Sequel sequencing platform. After sequence quality control, denoising, and amplicon sequence variant (ASV) clustering, the microbial composition, α diversity, and β diversity were analyzed in the 3 sample groups. Linear discriminant analysis effect size (LEfSe) was used to screen for intergroup differential marker species, by linear discriminant analysis (LDA) score >2 and P<0.05, and Kyoto encyclopedia of genes and genomes (KEGG) and MetaCyc functional prediction analyses were also performed.

Significant differences were observed among the 3 groups in terms of age, gender, body mass index (BMI), alanine aminotransferase (ALT), fasting plasma glucose (FPG) and free fatty acids (FFA) (P<0.05). There were totally 48 236 ASVs obtained, with CHB complicated with NAFLD group having the highest number of unique ASVs. Compared to the healthy control group, the CHB complicated with NAFLD group exhibited an increasing trend in species richness, community heterogeneity, and distribution uniformity of the tongue coating microbiota. At the phylum level, the proportions of Firmicutes (32%) and Proteobacteria (26%) were increased, while the proportion of Bacteroidota (27%) was decreased in the CHB complicated with NAFLD group than the healthy control group. In comparison to the CHB-only group, the proportion of Bacteroidota was increased. At the genus level, the proportions of Veillonella (18%) and Neisseria (18%) were increased, while that of Prevotella_7 (15%) was decreased in the CHB complicated with NAFLD group than the healthy control group, and that of Neisseria and Prevotella_7 was increased in the CHB complicated with NAFLD group when compared with the CHB-only group. LEfSe analysis revealed that Actinobacteriota, Neisseria_elongata, and Streptococcus_oralis were potential marker species in the CHB complicated with NAFLD group. Both KEGG and MetaCyc functional prediction analyses indicated that the differentially expressed functions of the tongue coating microbiota among the 3 groups were primarily enriched in pathways such as cofactor and vitamin metabolism, carbohydrate metabolism, and lipid metabolism.

CHB complicated with NAFLD patients exhibit characteristic changes in their tongue coating microbiota. The flora of tongue coating may affect the glucose and lipid metabolism of CHB patients through the "Oral-gut-liver axis", and promote the process and progress of NAFLD.

To systematically assess the disease burden of ischemic stroke (IS) attributable to high fasting plasma glucose (HFPG) among Chinese adults aged 25 years and older from 1990 to 2021 based on 2021 Global Burden of Disease (GBD) data, and to analyze population disparities and project trends for 2022 to 2035, providing evidence for prevention and control strategies.

Data were extracted from the GBD 2021 database, including age-standardized mortality rate (ASMR), disability-adjusted life years per million (ASDR), and population subgroup data for HFPG-related IS in China from 1990 to 2021. Joinpoint regression model was used to analyze temporal trends, and Bayesian age-period-cohort (BAPC) model was employed to predict future burden changes.

Overall, both the ASMR and ASDR for HFPG-related IS showed a declining trend from 1990 to 2021 among individuals aged 25 and older in China. However, in 2021, the ASMR (19.76 per 100 000) and ASDR (354.37 per 100 000 person-years) remained significantly higher than the global levels (ASMR=14.69 per 100 000; ASDR=266.36 per 100 000 person-years). The disease burden was higher in males than in females, with an increasing trend among those aged 25 to 44 years and a non-significant decline among those aged 80 years and older. Projections indicated that China’s ASMR and ASDR will be in a continuous decline from 2022 to 2035, with a projected rate of decrease exceeding the global average, though absolute levels will still remain higher than the global average.

Although the overall burden of HFPG-related is among Chinese individuals aged ≥25 years has decreased, the prevention and control situation remains severe. Countermeasures　It is recommended to enhance blood glucose screening for high-risk populations and standardized primary care management. Precise intervention strategies should be formulated for males, the elderly, and other young high-risk groups. Additionally, it is essential to improve the continuum of stroke treatment, rehabilitation services, and medical insurance coverage, while establishing a monitoring, evaluation, and early warning system to curb the burden of hyperglycemia-related ischemic stroke.

To investigate the association between Framingham steatosis index (FSI) and the risk of gallstone disease in order to evaluate its potential as a risk marker and simple screening tool.

A cross-sectional study was conducted on 5 705 adults subjected from the 2017-2020 cycle of the US National Health and Nutrition Examination Survey (NHANES). A complex sampling-weighted multivariable logistic regression model was employed to assess the association between FSI (treated as both a continuous variable and in quartiles) and gallstone risk. Restricted cubic spline (RCS) and threshold effect analyses were utilized to explore nonlinear relationships. Interaction and subgroup analyses were performed to examine potential effect modifiers, and multiple sensitivity analyses were applied to verify the robustness of the findings.

The fully adjusted logistic regression model showed a significant positive association between FSI and gallstone risk (OR=1.31, 95%CI: 1.20 to 1.44, P<0.001). Compared with the low FSI quartile, the high quartile had a significantly increased risk (OR=3.67, 95%CI: 2.21 to 6.09, P<0.001). Restricted cubic spline analysis suggested a nonlinear relationship between FSI and gallstone disease (P for nonlinear=0.031), with an inflection point at -0.27. Sensitivity analyses confirmed the robustness of the positive association.

Elevated FSI levels are significantly positively correlated with the risk of gallstone disease, suggesting its potential as a convenient metabolic composite indicator in community and clinical settings for the rapid identification of high-risk individuals.　Countermeasures　It is recommended that public health authorities should consider taking FSI into screening program for adult gallstone risk. Following prospective validation in Chinese populations, its threshold value could be utilized for rapid community-based risk stratification (high-vs low-risk), thereby optimizing the allocation of screening resources. Furthermore, comprehensive guidelines targeting body weight, blood lipids, blood pressure, and blood glucose should be developed and promoted. Strengthening public education and enhancing surveillance should be conducted to achieve the ultimate goals of early warning, precise intervention, and reduction of disease burden for high-risk populations.

To analyze the epidemiological trends and disease burden in chronic hepatitis B (including cirrhosis) from 1990 to 2021 globally and in China based on Global Burden of Disease Database (GBD) 2021 study, assess development-related inequality patterns and demographic drivers, and project China’s future burden and risk-factor contributions.

A secondary analysis was conducted on GBD 2021 data for 1990—2021 to extract the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized disability-adjusted life-year rate (ASDR) globally (204 countries/territories) and in China, each with 95% uncertainty interval (UI). Joinpoint regression was used to estimate the average annual percent change (AAPC) with 95% confidence interval (CI). Combining sociodemographic index (SDI)-related inequality metrics, frontier analysis, and Das Gupta symmetric decomposition, differences in disease burden were quantified, and the relative contributions of population growth, population aging, and changes in age-specific rates to changes in absolute burden were also analyzed. Autoregressive integrated moving average (ARIMA) models were fitted to China’s annual series for 1990—2021 to forecast trends for 2022—2035. Within the GBD comparative risk assessment framework, the attributable burden from alcohol consumption and drug use were quantified.

Global ASIR, ASPR and ASDR in chronic hepatitis B were declined overall from 1990 to 2021 (all AAPCs, P<0.05). However, under the combined effects of population growth and aging, absolute numbers of cases and disability-adjusted life years (DALYs) did not decrease in parallel with age-standardized rates. The burden was concentrated primarily in low-middle SDI countries/territories in Asia and sub-Saharan Africa. In China, all 3 age-standardized indicators were decreased by more than 50% when compared with the values in 1990, and the burden was declined markedly in children; Nonetheless, middle-aged and old men remained the main high-burden group, with total cases and DALYs staying at relatively high levels. Decomposition analyses indicated that declines in age-specific rates (epidemiologic change) were the primary driver of reductions in China’s absolute burden, whereas changes in global DALYs were more readily offset or driven by population growth and aging. ARIMA projections suggested that, under continuation of historical control intensity, China’s ASIR and ASDR will decline slowly through 2035, while ASPR will remain comparatively high. Comparative risk assessment showed that alcohol consumption and drug use were important modifiable contributors to DALYs related to chronic hepatitis B (including cirrhosis) globally and in China; alcohol-attributable ASDR in China was higher than the global average.

From 1990 to 2021, the age-standardized burden of chronic hepatitis B (including cirrhosis) declined globally and in China, yet substantial absolute-burden pressure persists worldwide due to population growth and aging and is unevenly distributed. Despite major progress in China in vaccination, prevention of mother-to-child transmission, and antiviral therapy, strengthened management of prevalent infections and prevention of complications remain critical to further reduce residual burden. Countermeasures　In line with the 2030 goal of eliminating viral hepatitis as a public health threat of World Health Organization, we recommend sustaining high coverage of timely birth-dose and full-course hepatitis B vaccination and strengthening prevention of mother-to-child transmission (PMTCT); prioritizing middle-aged and old men and high-risk areas to improve coverage of screening, follow-up, and treatment; integrating alcohol reduction and services for substance use disorders into hepatitis B care; and directing testing and treatment resources toward low-middle SDI settings and other resource-limited areas to narrow burden disparities.

To investigates the association between the variability of remnant cholesterol (RC) during long-term follow-up and cardiac conduction block (CCB) based on the Kailuan cohort.

A retrospective study was conducted on the research cohort in the Kailuan study population who consecutively participated in the physical examinations of 2006, 2008, and 2010. Based on the inclusion and exclusion criteria, 39 299 subjects were ultimately enrolled in the study. The variability of RC during the follow-up period was calculated, with the variability assessed through standard deviation (SD), average real variability (ARV), coefficient of variation (CV), and variability independent of the mean (VIM). The participants were divided into 4 groups based on the interquartile range of RC variability, and followed up every 2 years. The endpoints were defined as the occurrence of CCB, death, or the termination of follow-up (December 31, 2019). Kaplan-Meier test and Log-Rank test were carried out respectively calculate and compare the cumulative incidence rate of endpoint events across groups. Cox proportional hazards model and restricted cubic spline (RCS) analysis were performed to analyze the association between the variability of RC and CCB and its subtypes.

After an average follow-up of 7.43 years in 39 299 participants, 916 patients developed CCB. After adjusting for confounding factors, using CCB as the outcome event, and were dividing the participants into groups based on the RC-SD quartiles, the hazard ratios (HR) for CCB occurrence were 1.344 in the Q1 group (95% CI: 1.110~1.626, P=0.002), 1.068 (95% CI: 0.878 to 1.299, P=0.509) in the Q3 group and 1.311 (95% CI: 1.089~1.579, P=0.004) in the Q4 group, when compared to the group of lowest incidence density (the Q2 group). Similar results were obtained for the quartiles of RC-ARV, RC-CV, and RC-VIN grouping. RCS analysis revealed a U-shaped association between RC-SD and CCB (P_overall<0.05, P_nonlinearity<0.05). Sensitivity and stratified analyses further validated this finding.

There exists a U-shaped association between the variability of RC and the risk of CCB. This finding provides a new direction for preventing the occurrence of CCB. Countermeasures　China’s blood lipid management strategy should undergo a paradigm shift from pursuing “low-level stability” toward integrating “long-term stability of biomarker levels” This entails systematically incorporating the new concept of “maintaining physiological fluctuations of blood lipids within an optimal range” into the national prevention and treatment plans for cardiovascular and cerebrovascular diseases, primary public health service programs, and the public health education system. Such a transition will propel chronic disease management into a more precise and scientific new stage.

To investigate the risk factors and causal relationships of coronary heart disease (CHD) by utilizing clinical data and genetic variation data, and construct an interpretable risk prediction model for the disease.

A retrospective cohort analysis was conducted on the clinical data and genetic variation data collected from the Kaggle platform and the IEU OpenGWAS Project database, respectively. SMOTEENN mixed sampling was used to balance the data. Logistic regression models and two-sample Mendelian randomization (MR) were combined to screen risk factors and analyze their causal effects. Then risk prediction models were further constructed using random forest (RF), eXtreme gradient boosting (XGBoost), and artificial neural networks (ANN), and feature importance was assessed with the SHAP algorithm.

Logistic regression analysis showed that gender, age, education level, smoking, hypertension, total cholesterol (TC), systolic blood pressure (SBP), and blood glucose were significantly associated with CHD (P<0.05), while body mass index (BMI), diastolic blood pressure (DBP), history of stroke, and diabetes had no such association. Two-sample MR analysis indicated that BMI (OR=1.014, 95%CI: 1.011 to 1.017, P=1.720×10^-22), age (OR=1.015, 95%CI: 1.012 to 1.019, P=3.455×10^-18), number of cigarettes smoked per smoker per day (OR=1.007, 95%CI: 1.002 to 1.011, P=0.005), hypertension (OR=1.057, 95%CI: 1.046 to 1.067, P=5.870×10^-28) were positively associated with CHD; Education level (OR=0.970, 95%CI: 0.960 to 0.979, P=1.231×10^-9) and high-density lipoprotein (OR=0.990, 95%CI: 0.986 to 0.993, P=0.002) were negatively associated with CHD. In the machine learning models, the SMOTEENN-RF performed best, with an accuracy rate of 0.887 and an AUC value of 0.962. SHAP analysis indicated that age, gender, hypertension, SBP, and cigarettes smoked per day contributed most to the model.

Key risk factors such as age, hypertension, and blood lipid levels are significantly correlated with CHD. A high-performing SMOTEENN-RF prediction model is successfully constructed, providing reliable methodological support and practical tool for CHD risk early warning and precision prevention and treatment.

To explore the transition patterns of latent classes of depressive symptoms among postgraduate students and their influencing factors.

A prospective cohort study was conducted. Two waves of survey were carried out on 5 577 postgraduate students from an university in Hubei Province and another one in Anhui Province in October 2021 (T1) and October 2022 (T2). Self-Rating Depression Scale and College Students Mental Health Screening Scale were applied respectively to measure the severities of depressive symptoms and developmental distress. The optimal classification model was determined through the fitting indicators of the latent class model, mainly including indicators such as Entropy value, Lo-Mendell-Rubin (LMR), and Bootstrapped Likelihood Ratio Test (BLRT). Latent transition analysis was used to obtain the transition probabilities of latent class changes at different time points, and multivariate logistic regression analysis was employed to identify the factors influencing the latent class transition of depressive symptoms in the postgraduate students.

① The depressive symptoms could be classified into 3 categories among the postgraduate students (T1: Entropy=0.85, LMRP<0.05, BLRTP<0.001; T2: Entropy=0.88, LMRP<0.001, BLRT P<0.001), that is, a non-depressive symptom group (66.0% vs 64.3%), a mild depressive symptom group (25.6% vs 26.9%), and a moderate depressive symptom group (8.4% vs 8.8%). ② The probabilities of each latent class remaining in the original group at time point T2 were 84.1%, 56.9%, and 26.6%, respectively. The probability of transition from moderate to mild depressive symptom group was 41.3%, and the probability from mild to non-depressive symptom group was 29.3%.③ Adaptation challenges(OR=1.08, 95%CI: 1.02 to 1.16, P<0.05) and employment stress (OR=1.05, 95CI: 1.01 to 1.10, P<0.05) were promoting factors for the transition from non-depressive to mild depressive symptom group. Romantic troubles (OR=0.86, 95%CI: 0.76 to 0.99, P<0.05) was an obstructive factor for the transition from moderate to non-depressive symptom group.

There are 3 latent categories of depressive symptoms among postgraduate students. an obstructive factor for the transition from moderate to non-depressive symptom group.Adaptation challenges, employment stress and romantic troubles are important factors for the development of depressive symptoms.