OBJECTIVE To evaluate the efficacy and safety of rituximab （RTX） in the treatment of primary Sjögren syndrome （pSS）. METHODS Randomized controlled trials （RCTs） on the effects of RTX （trial group） versus placebo （control group） in the treatment of pSS were searched from the Cochran Library， PubMed， Embase， Medline， Web of Science， VIP， CNKI， Wanfang， and other databases during the inception to February 2024. After literature screening and quality evaluation， meta-analysis was performed by using RevMan 5.3 software. RESULTS Seven RCTs were finally included， involving a total of 518 patients. Results of meta-analysis showed that European League Against Rheumatism Sjögren syndrome disease activity index （ESSDAI） score [MD＝－1.17， 95%CI（－1.52， －0.82）， P＜0.000 01] and oral dryness visual analogue scale （VAS） score [MD＝－3.97， 95%CI （－5.08， －2.86）， P＜0.000 01] in the trial group were significantly lower than the control group； unstimulated salivary flow rate [SMD＝0.64， 95%CI（0.41， 0.87）， P＜0.000 01] and Schirmer score [MD＝0.19， 95%CI（0.18， 0.20）， P＜0.000 01] were significantly higher than the control group. There was no statistical significance in response rate [RD＝0.10， 95%CI（－0.04， 0.23）， P＝0.16]， fatigue VAS score [MD＝－12.50， 95%CI（－35.14， 10.15）， P＝0.28]， European League Against Rheumatism Sjögren syndrome patient reported index （ESSPRI） score [MD＝0.33， 95%CI（－0.53， 1.18）， P＝0.46]， Short-form 36 health survey physical component summary （SF36-PCS） score [MD＝0.90， 95%CI（－2.97， 4.78）， P＝0.65]， SF-36 mental component summary （SF36-MCS） score [MD＝0.11， 95%CI（－0.41， 0.63）， P＝0.68]， total salivary gland ultrasound score [SMD＝－1.91， 95%CI（－4.01， 0.19）， P＝0.07] or the incidence of adverse drug reactions [OR＝1.15，95%CI（0.62，2.13），P＝0.66] between 2 groups. CONCLUSIONS RTX has advantages in the improvement of ESSDAI score， unstimulated salivary flow rate， Schirmer score and oral dryness VAS score in pSS patients， and has a good safety profile. However， it did not exhibit significant improvement in fatigue VAS score， ESSPRI score， SF36-PCS score， SF36-MCS score or response rates.

Objective: To assess the awareness and associated factors of wild mushroom poisoning among students in Guizhou Province, so as to provide a scientific foundation for wild mushroom poisoning prevention and control among students. Methods: By a multi stage stratified cluster random sampling method, 1 162 students from Guizhou Province were selected in May 2024. The questionnaire survey was administered to evaluate knowledge regarding wild mushroom poisoning. Data were analyzed employing the χ 2 test and Logistic regression model. Results: Among the nine questions assessing awareness of wild mushroom poisoning, only three had the awareness rate exceeding 70%. Binary Logistic regression analysis revealed that students who "actively learn about the prevention of wild mushroom poisoning" ( OR=0.48, 95%CI =0.26-0.92) and "spread knowledge about wild mushroom poisoning to others" ( OR=0.47, 95%CI =0.33-0.69) scored higher on the wild mushroom poisoning knowledge questions ( P <0.05). Conversely, students with a habit of consuming wild mushrooms ( OR=1.52, 95%CI =1.15-2.02) scored lower ( P < 0.05 ). 42.3% of the students suggested that scientific dissemination and publicity about wild mushrooms should be intensified. Conclusions The awareness rate of wild mushroom poisoning knowledge among students in Guizhou Province requires further attention. Comprehensive knowledge should be disseminated systematically through various channels to further improve students awareness of the prevention and control of wild mushroom poisoning.

The NOD-like receptor protein 3 (NLRP3) inflammasome is essential in innate immune-mediated inflammation, with its overactivation implicated in various autoinflammatory, metabolic, and neurodegenerative diseases. Pharmacological inhibition of NLRP3 offers a promising treatment strategy for inflammatory conditions, although no medications targeting the NLRP3 inflammasome are currently available. This study demonstrates that clioquinol (CQ), a clinical drug with chelating properties, effectively inhibits NLRP3 activation, resulting in reduced cytokine secretion and cell pyroptosis in both human and mouse macrophages, with a half maximal inhibitory concentration (IC₅₀) of 0.478 μM. Additionally, CQ mitigates experimental acute peritonitis, gouty arthritis, sepsis, and colitis by lowering serum levels of interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α). Mechanistically, CQ covalently binds to Arginine 335 (R335) in the NACHT domain, inhibiting NLRP3 inflammasome assembly and blocking the interaction between NLRP3 and its component protein. Collectively, this study identifies CQ as an effective natural NLRP3 inhibitor and a potential therapeutic agent for NLRP3-driven diseases.

Objective:To discuss the optimal doping concentration of vanadium(V)and silicon(Si)co-doped TiO? coating(V-Si TiO?)formed on titanium surface by electrochemical treatment,to evaluate its antibacterial effect under visible light irradiation,and to clarify its visible light response mechanism.Methods:The medical pure titanium sheets were subjected to micro-arc oxidation followed by high-temperature calcination,and V-Si TiO2 coatings with different doping concentrations were prepared by adjusting the ratio of V to Si in the electrolyte.The experiment was divided into 1V:10Si(V5Si50)group,2V:10Si(V10Si50)group,and 3V:10Si(V15Si50)group;control group was set up(contains only bacterial culture medium).The optimal doping concentration was screened based on comprehensive evaluation of surface morphology,ion release,photocatalytic ability,and biocompatibility;cell counting kit-8(CCK-8)method was used to detect the proliferation activities and the survival rates of the cells in various group.Subsequently,the optimized coating was characterized and compared by scanning electron microscope(SEM),atomic force microscopy(AFM),digital eddy current coating thickness gauge,X-ray diffraction(XRD),X-ray photoelectron spectroscope(XPS),and ultraviolet-visible absorption spectroscopy(UV-vis).The experiment was divided into PT group(blank control),PEO group(no element doping),V10 group(V doping),Si50 group(Si doping),and V10Si50 group(2V:10Si).The ability of the coating materials to degrade methylene blue(MB)and generation of reactive oxygen species(ROS)under visible light were detected.For antibacterial experiments,Staphylococcus aureus(S.aureus)and Escherichia coli(E.coli)were used.The colony counts on plates in various groups were recorded after visible light irradiation for 2 h and dark treatment for 2 h,respectively.The ROS levels were detected using 2',7'-dichlorofluorescein diacetate(DCFH-DA)ROS probe.ROS scavenging experiment was performed using the optimal doping concentration V10Si50 group,and the two kinds of bacteria were divided into blank control group,N-acetylcysteine(NAC)group,V10Si50 group,and NAC+V10Si50 group.The colony counts on plates in various groups were recorded after visible light irradiation for 2 h.Results:The V concentration of 0.01 mol·L?1 and Si concentration of 0.05 mol·L?1 in the electrolyte solution were the optimal doping concentrations for the V-Si TiO? coating.The SEM observation results showed that compared with V5Si50 group and V15Si50 group,the surface pore size of the coating material in V10Si50 group was significantly decreased(P<0.05),and the coating thickness was significantly increased(P<0.05);its crystal structure was mainly anatase type,and the MB degradation rate of the coating material in V10Si50 group after 9 h of visible light catalysis was significantly increased(P<0.05).Compared with control group,the cell proliferation activity and cell survival rate in V10Si50 group were significantly increased at 1,2,and 4 d of cell culture(P<0.05);at 2 and 4 d of cell culture,the cell proliferation activity and cell survival rate in V5Si50 group and V15Si50 group were significantly decreased(P<0.05).Compared with PT,PEO,and Si50 groups,the colony counts of two kinds of the bacteria in V10 group and V10Si50 group after visible light irradiation for 2 h were significantly decreased(P<0.05).Compared with PT group and PEO group,the ROS levels in two kinds of the bacteria in V10Si50 group after 2 h of irradiation were significantly increased(P<0.05).Compared with V10Si50 group,the colony counts of two kinds of the bacteria in NAC+V10Si50 group were significantly increased(P<0.05).Conclusion:A reasonably loaded V-Si TiO? coating material(V10Si50)was screened out,which maintained good biological activity and significantly enhanced the antibacterial effect under visible light irradiation.

Objective To investigate the status quo of health management behaviors in elderly patients with type 2 diabetes mellitus(T2DM)complicating chronic complications and the influencing factors based on health ecology theory.Methods The convenience sampling method was used to select elderly patients with T2DM complicating chronic complications in the Shanghai City from January to July 2022 as the respondents.Based on the health ecology theory,the five aspects of personality traits,psychological and behavioral traits,family and community interpersonal networks,living and working conditions and policy environment were in-vestigated.The Pearson correlation coefficient was used to analyze the correlation of various variables.The hi-erarchical linear regression was used to analyze the influencing factors of health management behaviors in eld-erly patients with T2DM complicating chronic complications.Results A total of 272 questionnaires were dis-tributed and 264 valid questionnaires were recovered,with an effective recovery rate of 97.06％(264/272).There were statistically significant differences in DSMB-Oscores among the patients with different chronic complications number,sleep quality,per capita monthly household income and medical payment methods(P＜0.05).The DSMB-Oscore in elderly patients with T2DM complicating chronic complications was positively correlated with HLSCP,DES,PACIC and CIRS scores(P＜0.05),and negatively correlated with the PAID-5 score(P＜0.05).Conclusion The health management behaviors of elderly patients with T2DM complicating chronic complications is jointly affected and acted by many factors,and it is necessary to identify and manage the related influencing factors from different aspects and different levels.

Objective:Based on the accounting results of total health expenditure in different regions since the 18th National Congress of the Communist Party of China,to analyze the regional disparity and evolution trend of health financing level and financing structure in 2012-2022,so as to provide references for subsequent adjustment and improvement.Methods:Range,standard deviation and coefficient of variation were used to analyze the degree of absolute and relative differences of total regional health expenditure in China and the changing characteristics of regional total health expenditure differences since the New Era(2012-2022).Results:Since 2012,the total health expenditure in various regions has been increasing continuously,and the average annual growth rate of total health expenditure is higher than that of the economy in this region.The relative difference of the proportion of total health expenditure to GDP in 31 provinces has converged in the fluctuation,but the absolute difference is still very large;the relative gap and absolute gap of per capita total health expenditure are expanding;the absolute difference in the proportion of out-of-pocket payments to total health expenditure has narrowed,while the relative difference has gradually narrowed.Conclusion:There are obvious differences in the growth rate of total health expenditure in different regions,so it is suggested that"appropriate growth"and"accurate control of health expenditure"should be carried out in parallel;the regional disparity of health investment in China has not improved,especially the regional disparity of per capita investment level continues to increase,so narrowing the regional disparity is a long-term task.The gap of regional financing structure has converged,but the gap is still large.

Objective:Based on the accounting results of total health expenditure in different regions since the 18th National Congress of the Communist Party of China,to analyze the regional disparity and evolution trend of health financing level and financing structure in 2012-2022,so as to provide references for subsequent adjustment and improvement.Methods:Range,standard deviation and coefficient of variation were used to analyze the degree of absolute and relative differences of total regional health expenditure in China and the changing characteristics of regional total health expenditure differences since the New Era(2012-2022).Results:Since 2012,the total health expenditure in various regions has been increasing continuously,and the average annual growth rate of total health expenditure is higher than that of the economy in this region.The relative difference of the proportion of total health expenditure to GDP in 31 provinces has converged in the fluctuation,but the absolute difference is still very large;the relative gap and absolute gap of per capita total health expenditure are expanding;the absolute difference in the proportion of out-of-pocket payments to total health expenditure has narrowed,while the relative difference has gradually narrowed.Conclusion:There are obvious differences in the growth rate of total health expenditure in different regions,so it is suggested that"appropriate growth"and"accurate control of health expenditure"should be carried out in parallel;the regional disparity of health investment in China has not improved,especially the regional disparity of per capita investment level continues to increase,so narrowing the regional disparity is a long-term task.The gap of regional financing structure has converged,but the gap is still large.

Objective:Based on the accounting results of total health expenditure in different regions since the 18th National Congress of the Communist Party of China,to analyze the regional disparity and evolution trend of health financing level and financing structure in 2012-2022,so as to provide references for subsequent adjustment and improvement.Methods:Range,standard deviation and coefficient of variation were used to analyze the degree of absolute and relative differences of total regional health expenditure in China and the changing characteristics of regional total health expenditure differences since the New Era(2012-2022).Results:Since 2012,the total health expenditure in various regions has been increasing continuously,and the average annual growth rate of total health expenditure is higher than that of the economy in this region.The relative difference of the proportion of total health expenditure to GDP in 31 provinces has converged in the fluctuation,but the absolute difference is still very large;the relative gap and absolute gap of per capita total health expenditure are expanding;the absolute difference in the proportion of out-of-pocket payments to total health expenditure has narrowed,while the relative difference has gradually narrowed.Conclusion:There are obvious differences in the growth rate of total health expenditure in different regions,so it is suggested that"appropriate growth"and"accurate control of health expenditure"should be carried out in parallel;the regional disparity of health investment in China has not improved,especially the regional disparity of per capita investment level continues to increase,so narrowing the regional disparity is a long-term task.The gap of regional financing structure has converged,but the gap is still large.

Objective:Based on the accounting results of total health expenditure in different regions since the 18th National Congress of the Communist Party of China,to analyze the regional disparity and evolution trend of health financing level and financing structure in 2012-2022,so as to provide references for subsequent adjustment and improvement.Methods:Range,standard deviation and coefficient of variation were used to analyze the degree of absolute and relative differences of total regional health expenditure in China and the changing characteristics of regional total health expenditure differences since the New Era(2012-2022).Results:Since 2012,the total health expenditure in various regions has been increasing continuously,and the average annual growth rate of total health expenditure is higher than that of the economy in this region.The relative difference of the proportion of total health expenditure to GDP in 31 provinces has converged in the fluctuation,but the absolute difference is still very large;the relative gap and absolute gap of per capita total health expenditure are expanding;the absolute difference in the proportion of out-of-pocket payments to total health expenditure has narrowed,while the relative difference has gradually narrowed.Conclusion:There are obvious differences in the growth rate of total health expenditure in different regions,so it is suggested that"appropriate growth"and"accurate control of health expenditure"should be carried out in parallel;the regional disparity of health investment in China has not improved,especially the regional disparity of per capita investment level continues to increase,so narrowing the regional disparity is a long-term task.The gap of regional financing structure has converged,but the gap is still large.

Objective:Based on the accounting results of total health expenditure in different regions since the 18th National Congress of the Communist Party of China,to analyze the regional disparity and evolution trend of health financing level and financing structure in 2012-2022,so as to provide references for subsequent adjustment and improvement.Methods:Range,standard deviation and coefficient of variation were used to analyze the degree of absolute and relative differences of total regional health expenditure in China and the changing characteristics of regional total health expenditure differences since the New Era(2012-2022).Results:Since 2012,the total health expenditure in various regions has been increasing continuously,and the average annual growth rate of total health expenditure is higher than that of the economy in this region.The relative difference of the proportion of total health expenditure to GDP in 31 provinces has converged in the fluctuation,but the absolute difference is still very large;the relative gap and absolute gap of per capita total health expenditure are expanding;the absolute difference in the proportion of out-of-pocket payments to total health expenditure has narrowed,while the relative difference has gradually narrowed.Conclusion:There are obvious differences in the growth rate of total health expenditure in different regions,so it is suggested that"appropriate growth"and"accurate control of health expenditure"should be carried out in parallel;the regional disparity of health investment in China has not improved,especially the regional disparity of per capita investment level continues to increase,so narrowing the regional disparity is a long-term task.The gap of regional financing structure has converged,but the gap is still large.