Objective: To explore the intervention effects of different exercise modalities on executive function in school aged children, providing references for formulating exercise prescriptions to promote school aged children executive function. Methods: A systematic literature search was conducted using PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP and CBM to identify studies on the effects of exercises on executive function in school aged children. The search period spanned from the database inception to August 2025. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias of the included studies. Network Meta analysis was performed using Stata 16.0. Results: A total of 51 studies involving 5 710 school aged children and seven modalities of exercises(control group,small ball sports,large ball sports,aerobic exercise,combined exercise,sport game,gymnastic and dance sports) were finally included. Network Meta analysis showed that, in terms of inhibitory control development of school aged children, small ball sports ( SMD =-0.98,95% CI =-1.32 to -0.64 ), large ball sports ( SMD =-0.64,95% CI =-0.91 to -0.36), and mixed sports ( SMD =-0.26,95% CI =-0.50 to -0.02]) were more effective than the control group; in terms of working memory, largeball sports ( SMD =-1.26,95% CI =-1.88 to -0.65) and small ball sports ( SMD =-0.91,95% CI =-1.64 to -0.19) were superior to the control group; in terms of improving cognitive flexibility, large ball sports ( SMD =-1.02,95% CI =-1.28 to -0.76), gymnastics and dance sports ( SMD =-0.80,95% CI =-1.21 to -0.40), and small ball sports ( SMD =-0.75,95% CI =-1.15 to -0.36) were more effective than the control group (all P <0.05). Surface under cumulative ranking curve(SUCRA) showed that small ball sports had the highest value (SUCRA=98.9%) in improving inhibitory control, while large ball sports achieved the highest score(SUCRA=92.6%) in enhancing working memory, and large ball sports also had the highest value(SUCRA=94.7%) in promoting cognitive flexibility. Conclusions For developing inhibitory control in school aged children, small ball sports are recommended as a priority. For enhancing working memory and cognitive flexibility, large ball sports are recommended.

BACKGROUND: Chronic liver disease (CLD), mainly non-alcoholic fatty liver disease (NAFLD), is a significant public health concern worldwide. This study aims to quantify the burden of NAFLD in CLD globally and within China, using data from the Global Burden of Disease (GBD) Study 2021, providing crucial insights for global and local health policies. METHODS: The study used comprehensive data from the GBD study 2021. It included estimates of prevalence, incidence, mortality, and disability-adjusted life years (DALYs). Age-standardized rates and average annual percent change (AAPC) from 2011 to 2021 were reported. A meticulous decomposition analysis was conducted. RESULTS: In 2021, there were 1582.5 million prevalent cases, 47.6 million incident cases, 1.4 million deaths, and 44.4 million DALYs attributable to CLD, globally. Among these, NAFLD has emerged as the predominant cause, accounting for 78.0% of all prevalent CLD cases (1234.7 million) and 87.2% of incident cases (41.5 million). Correspondingly, NAFLD had the highest age-standardized prevalence (15,017.5 per 100,000 population) and incidence (876.5 per 100,000 population) rates among CLDs. In addition, China's CLD age-standardized prevalence rate was 21,659.5 per 100,000 population, and the age-standardized incidence rate was 752.6 per 100,000 population, higher than the global average. From 2011 to 2021, the global prevalence rate of CLD increased slowly (AAPC = 0.17), consistent with the trend in China (AAPC = 0.23). Furthermore, the prevalence rate of NAFLD rose significantly in China (AAPC = 1.30) compared with the global average (AAPC = 0.91). Decomposition analysis also showed the worldwide increase in deaths and DALYs for NAFLD, which were primarily attributable to population growth and aging. CONCLUSIONS The burden of CLD and NAFLD remains substantial globally and within China in terms of high prevalence and incidence. As such, this underscores the need for targeted prevention and treatment strategies. These findings emphasize the importance of continued surveillance and research to mitigate the growing impact of liver diseases on global and Chinese health systems.
Humans ; Non-alcoholic Fatty Liver Disease/mortality* ; Global Burden of Disease ; China/epidemiology* ; Prevalence ; Male ; Disability-Adjusted Life Years ; Female ; Incidence ; Middle Aged ; Chronic Disease ; Adult ; Quality-Adjusted Life Years ; Liver Diseases/epidemiology* ; Aged

ObjectiveTo evaluate the methodological quality and reporting quality of published guidelines/consensuses on traditional Chinese medicine （TCM）/integrated traditional Chinese and Western medicine diagnosis and treatment of nonalcoholic fatty liver disease （NAFLD）， and to provide a basis for formulating guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD in the future. MethodsDatabases including PubMed， Embase， Web of Science， CNKI， Wanfang Data， and CBM and the websites of China Association of Chinese Medicine and China Association of Integrative Medicine were searched for related articles published up to September 1， 2024. Two clinical researchers independently assessed the methodological quality and reporting quality of the guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD by using Appraisal of Guidelines for Research and Evaluation Ⅱ （AGREE Ⅱ） and Reporting Items for Practice Guidelines in Healthcare （RIGHT）. ResultsA total of nine guidelines/consensuses were included after literature screening， with four guidelines and five expert consensuses. The scores of different domains assessed by AGREE Ⅱ for the nine guidelines/consensuses were as follows： scope and purpose （47.1%）， stakeholder involvement （41.0%）， rigor of development （21.6%）， clarity of presentation （40.2%）， applicability （19.0%）， and editorial independence （19.6%）. The recommendation level of the articles was B level （recommended after revision） for four articles and C level （not recommended） for five articles. The RIGHT assessment showed high reporting rates for “Basic Information” and “Background”， while other areas needed to be improved. Currently， there was no international standard for the guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD， and the quality of these guidelines/consensuses needed to be enhanced to ensure comprehensiveness and credibility. ConclusionThere is still potential for improving the quality of guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD， and AGREE Ⅱ and RIGHT checklists should be strictly followed to ensure the fairness， scientific rigor， and transparency of these guidelines/consensuses.

Objective:To clarify the current status of mechanical ventilation management in critically ill patients and identify prognostic risk factors in Xinjiang Uygur Autonomous Region, thereby providing evidence for targeted training programs and quality improvement initiatives.Methods:A cohort study was conducted across multiple ICUs in Xinjiang Uygur Autonomous Region from January 31 to February 1, 2024. Patients receiving mechanical ventilation during the study period were enrolled, with clinical outcomes followed up until February 28, 2024. Statistical analyses included demographic characteristics, therapeutic interventions, laboratory parameters, and medication regimens.Results:A total of 77 ICUs and 727 patients were screened in the study, and 253 (34.80%) patients who received mechanical ventilation were ultimately included. Among these patients, 177 patients (69.96%) were treated in tertiary hospitals, and 76 patients (30.04%) in secondary hospitals. Significant differences were observed between tertiary and secondary hospitals regarding ventilator mode selection and mechanical ventilation parameter settings (all P<0.05). No significant differences were found in the 28-day mortality rate between tertiary hospitals and secondary hospitals (33.9% vs. 43.4%, P=0.194). Compared with patients in the survival group, death group patients were older and had more severe disease severity. Multivariate Cox regression analysis demonstrated that body temperature ( HR=1.573, 95% CI: 1.173-2.110, P=0.003), white blood cell count ( HR=1.048, 95% CI: 1.012-1.084, P=0.008), pH ( HR=0.019, 95% CI: 0.001-0.349, P=0.007), age > 65 years ( HR=1.817, 95% CI: 1.086-3.041, P=0.023), and fraction of inspired oxygen ≥ 60% ( HR=2.072, 95% CI: 1.143-3.757, P=0.016) were independent influencing factors for 28-day mortality in mechanically ventilated patients. Conclusions:Mechanically ventilated patients are a major component of the ICU population in Xinjiang Uygur Autonomous Region, with the characteristics of high risk of death. The clinical practice of mechanical ventilation in this region is heterogeneous. In the future, it is urgent to strengthen the improvement of medical quality and related training to improve the success rate of patients with mechanical ventilation.

Purpose To explore the clinicopathologic features,pathogenesis and differential diagnosis of Malaco-plakia.Methods The clinical features,imaging manifestations,cytopathologic features,histopathologic features,im-munohistochemistry,special staining and molecular pathological manifestations of 17 patients with Malacoplakia were analysed and the relevant literature was reviewed.Results Seventeen patients with Malacoplakia were mostly female,of which 13 lesions were located in the bladder,1 in the prostate,1 in the colon,1 in the right external auditory canal,and 1 in the retroperitoneum.Cytologic morphology varied depending on the site of the lesion,with phagocytes and MG-like microsomal analogues seen in renal puncture cytology,and small numbers of squamous epithelial cells and uroepi-thelial cells(NHGUC)seen in urinary cytology specimens.Histologic morphology showed a large number of foamy his-tiocytes and small numbers of neutrophils and eosinophils against a background of chronic inflammation dominated by lymphocytes and plasma cells;the cytoplasm of the histiocytes was eosinophilic and granular,with blue calcified vesi-cles scattered throughout,some of which were in the form of target-ring or concentric-circle-like structures,which are known as Michaelis-Gutmann bodies(MG bodies).Special stains showed PAS and iron staining(+);immunohisto-chemistry showed diffuse histiocyte CD68(+),CD163(+),CK(AE1/AE3)(-);molecular pathology showed TB-DNA(-).Conclusion Malacoplakia is a chronic granulomatous disease that can be cured.Imaging often shows occupancy,which is easily misdiagnosed as a tumour clinically,and confirming the diagnosis mainly relies on patholog-ical diagnosis,differential diagnosis includes xanthogranulomatous cystitis,xanthogranulomatous pyelonephritis,colon cancer,granulosa cell tumour and Langerhans histiocytosis.

Objective:To analyze the incidence trend of lip and oral cancer in China from 1990 to 2021.Methods:The incidence data of lip and oral cancer in China from 1990 to 2021 were obtained through the Global Health Data Exchange (GHDx) database, including incidence rates by gender and age-standardized incidence rates. Joinpoint regression was used to analyze the trend of lip and oral cancer incidence rate. Age-period-cohort (APC) model was adopted to estimate the effects of Age, Period and Cohort on the incidence of lip and oral cancer in China.Results:The crude and age-standardized incidence rates of lip and oral cancer in China from 1990 to 2021 showed an increasing trend, and the crude incidence rates of the whole population, male and female in the year 2021 increased by 216.8%, 266.7% and 130.4%, respectively, compared with 1990. The age effect, period effect and birth cohort effect of the incidence risk of lip and oral cancer in China were statistically significant (all P<0.05). People of older the age and the more recent the birth cohort, the higher the incidence risk. Conclusions:The incidence of lip and oral cancer is on the rise in China from 1990 to 2021. Age, period and birth cohort are all the factors affecting the incidence of lip and oral cancer.

Objective:To analyze the incidence trend of lip and oral cancer in China from 1990 to 2021.Methods:The incidence data of lip and oral cancer in China from 1990 to 2021 were obtained through the Global Health Data Exchange (GHDx) database, including incidence rates by gender and age-standardized incidence rates. Joinpoint regression was used to analyze the trend of lip and oral cancer incidence rate. Age-period-cohort (APC) model was adopted to estimate the effects of Age, Period and Cohort on the incidence of lip and oral cancer in China.Results:The crude and age-standardized incidence rates of lip and oral cancer in China from 1990 to 2021 showed an increasing trend, and the crude incidence rates of the whole population, male and female in the year 2021 increased by 216.8%, 266.7% and 130.4%, respectively, compared with 1990. The age effect, period effect and birth cohort effect of the incidence risk of lip and oral cancer in China were statistically significant (all P<0.05). People of older the age and the more recent the birth cohort, the higher the incidence risk. Conclusions:The incidence of lip and oral cancer is on the rise in China from 1990 to 2021. Age, period and birth cohort are all the factors affecting the incidence of lip and oral cancer.

Purpose To explore the clinicopathologic features,pathogenesis and differential diagnosis of Malaco-plakia.Methods The clinical features,imaging manifestations,cytopathologic features,histopathologic features,im-munohistochemistry,special staining and molecular pathological manifestations of 17 patients with Malacoplakia were analysed and the relevant literature was reviewed.Results Seventeen patients with Malacoplakia were mostly female,of which 13 lesions were located in the bladder,1 in the prostate,1 in the colon,1 in the right external auditory canal,and 1 in the retroperitoneum.Cytologic morphology varied depending on the site of the lesion,with phagocytes and MG-like microsomal analogues seen in renal puncture cytology,and small numbers of squamous epithelial cells and uroepi-thelial cells(NHGUC)seen in urinary cytology specimens.Histologic morphology showed a large number of foamy his-tiocytes and small numbers of neutrophils and eosinophils against a background of chronic inflammation dominated by lymphocytes and plasma cells;the cytoplasm of the histiocytes was eosinophilic and granular,with blue calcified vesi-cles scattered throughout,some of which were in the form of target-ring or concentric-circle-like structures,which are known as Michaelis-Gutmann bodies(MG bodies).Special stains showed PAS and iron staining(+);immunohisto-chemistry showed diffuse histiocyte CD68(+),CD163(+),CK(AE1/AE3)(-);molecular pathology showed TB-DNA(-).Conclusion Malacoplakia is a chronic granulomatous disease that can be cured.Imaging often shows occupancy,which is easily misdiagnosed as a tumour clinically,and confirming the diagnosis mainly relies on patholog-ical diagnosis,differential diagnosis includes xanthogranulomatous cystitis,xanthogranulomatous pyelonephritis,colon cancer,granulosa cell tumour and Langerhans histiocytosis.

ObjectiveTo assess the quality of randomized controlled trials （RCTs） of compound traditional Chinese medicine （TCM） prescriptions in the treatment of nonalcoholic steatohepatitis （NASH）， and to provide recommendations for standardizing the design and reporting of RCTs in this field. MethodsDatabases such as PubMed， Web of Science， Embase， the Cochrane Library， CNKI， VIP， and Wanfang Data were searched for RCTs of compound TCM prescriptions in the treatment of NASH published from January 1， 2018 to December 31， 2023， and the articles were screened and assessed based on the Cochrane risk-of-bias assessment tool （RoB 2）， the unified standard for clinical trial reporting （CONSORT 2010）， and CONSORT-CHM Formulas 2017 for compound TCM prescriptions. ResultsA total of 45 articles were finally included， and most of these studies were rated as high-risk bias by RoB 2.0. The analysis based on the CONSORT control checklist showed a relatively low reporting rate for most of the key items regarding the quality of RCT studies. ConclusionA relatively large risk of bias is observed in the clinical studies on compound TCM prescriptions in the treatment of NASH published in the past six years， which may lead to the poor quality of reporting and evidence. It is suggested that the top-level design of clinical studies should be taken seriously in addition to investigating the advantages of TCM， so as to improve the quality of clinical studies.

OBJECTIVE To investigate the effect and mechanism of Panax notoginseng saponins （PNS） on wound healing after anal fistula surgery in rats by regulating the hypoxia-inducible factor-1α （HIF-1α）/vascular endothelial growth factor （VEGF）/ vascular endothelial growth factor receptor-2 （VEGFR2） signaling pathway. METHODS SD rats were selected to establish a postoperative rat model of anal fistula by infecting wound with Escherichia coli. The model rats were randomly grouped into model group， PNS low-dose and high-dose groups （15， 30 mg/cm2）， high-dose of PNS+2-methoxyestradiol （2ME2） group （PNS 30 mg/cm2+HIF-1α inhibitor 2ME2 4 mg/kg）， with 10 rats in each group. Another 10 normal rats were selected for back hair removal treatment as the control group. Each drug group was injected with the corresponding drug solution intramuscularly or （and） intraperitoneally， once a day， for 3 weeks. After the last administration， the wound healing rate （excluding the control group）， microvascular density （MVD）， the expression of collagen Ⅰ and fibronectin （FN） in the wound tissue were detected in each group； the levels of angiogenic factors [VEGF， E-mail：842710813@qq.com angiopoietin-Ⅰ （Ang-Ⅰ）， Ang-Ⅱ] in serum， the levels of inflammatory factors [interleukin-6 （IL-6） and IL-2] in serum binggui7183@163.com and wound tissue as well as the expressions of the related proteins of HIF-1α/VEGF/VEGFR2 signaling pathway in the wound tissue of rats were also detected in each group. RESULTS The MVD， the expression of collagen Ⅰ and FN in the wound tissue， and the levels of IL-6 and IL-2 in serum and wound tissue of rats increased significantly in the model group， compared to the control group （P＜0.05）， while the serum levels of VEGF， Ang- Ⅰ and Ang-Ⅱ decreased significantly （P＜0.05）. The wound healing rate， the MVD in wound tissue， the serum levels of VEGF， Ang-Ⅰ and Ang-Ⅱ， the expressions of collagen Ⅰ and FN in the wound tissue， and protein expressions of HIF-1α， VEGF and VEGFR2 in the PNS low-dose and high-dose groups increased significantly， compared to the model group （P＜0.05）， while the levels of IL-6 and IL-2 in serum and wound tissue decreased significantly （P＜0.05）； the high-dose PNS had a stronger effect （P＜ 0.05）. 2ME2 could weaken the effect of PNS on above indicators of rats after anal fistula surgery （P＜0.05）. CONCLUSIONS PNS can promote the production of angiogenic factors and inhibit the production of pro-inflammatory factors， thereby promoting wound healing in rats after anal fistula surgery. The above effects are related to the activation of HIF-1α/VEGF/VEGFR2 signaling pathway.