1.Interpretation of the role of circadian rhythm health in cardiometabolic health and disease risk: The scientific statement from the American Heart Association
Zixiong NIE ; Honghua YUE ; Weitao LIANG ; Zhong WU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(04):543-549
The circadian system maintains physiological homeostasis by precisely orchestrating 24-hour cycles of metabolic and cardiovascular functions. Circadian disruption has been substantiated as a contributor to cardiometabolic dysfunction, significantly elevating the risk of obesity, type 2 diabetes, hypertension, and cardiovascular diseases, thereby emerging as a crucial target for global chronic disease prevention. In 2025, the American Heart Association (AHA) issued a dedicated scientific statement that systematically reviewed the regulatory mechanisms of circadian rhythms and their intrinsic links to cardiometabolic health. It highlighted the pivotal role of modifiable behavioral factors, including light exposure, sleep-wake patterns, meal timing, and timing of physical activity, and proposed multi-faceted intervention strategies centered on chronotherapy. Considering the distinct circadian characteristics and chronic disease epidemiology in the Chinese population compared to Western counterparts, this article, grounded in the statement's core framework and incorporating evidence from localized Chinese research, provides a systematic interpretation of the biological basis of circadian rhythms, the pathophysiological mechanisms underlying disruption-related diseases, and potential intervention pathways. It particularly discusses the applicability of the statement's conclusions to clinical practice and public health strategies in China, aiming to offer an evidence-based reference for developing a cardiometabolic health support system tailored to the national context.
2.Cohort study on the association of vegetable intake with glucose and lipid metabolism levels among school aged children
Chinese Journal of School Health 2026;47(4):465-469
Objective:
To explore the association between vegetable intake with glucose and lipid metabolism levels among school aged children, so as to provide scientific basis for dietary intervention on children s metabolic health.
Methods:
Based on a natural population cohort in Jiulongpo District and Fengdu County of Chongqing, 2 133 school aged children aged 6-9 years were enrolled in the baseline survey in 2014, and 2 029 children completed the follow up in 2019. Questionnaire surveys were used to collect vegetable intake, general demographic and lifestyle data. Height, weight and waist circumference were measured, and glucose and lipid metabolism indicators such as fasting blood glucose (FBG), triglyceride (TG) and total cholesterol (TC), low densith lipoprotein triglyceride (LDL-C), high densith lipoprotein triglyceride (HDL-C) were detected. Mann-Whitney U test and Kruskal-Wallis H test were used for intergroup comparisons in multivariate analysis, and mixed effects linear regression model was used to analyze the association between vegetable intake and glucose and lipid metabolism.
Results:
The levels of FBG, TG, TC, HDL-C and LDL-C at baseline and follow up were [4.09(3.90,4.48), 0.84(0.60,1.14), 3.49(3.09,3.91), 1.25(1.09,1.46), 1.69 ( 1.39 ,2.02);4.31(4.00,4.64), 0.92(0.71,1.22), 3.49(3.12,3.87), 1.36(1.16,1.57), 1.77(1.51,2.06)] mmol/L, respectively. Among these indicators, FBG, TG, HDL-C and LDL-C all increased significantly ( Z =-12.08, -7.82, -9.82, -5.37, all P < 0.01 ). The detection rate of low HDL-C levels at follow up (13.11%) was significantly lower than that at baseline (18.10%) ( χ 2=19.57, P <0.05). At baseline, there were significant differences in FBG, TC, TG, HDL-C and LDL-C among children with different vegetable intake levels ( H =68.47, 30.16, 11.02, 13.27, 44.70); at followup, only HDL-C showed significant intergroup differences ( H =13.10)(all P <0.05). Mixed effects linear regression model showed that after adjusting for confounding factors, vegetable intake was significantly negatively correlated with blood glucose levels among school aged children ( β=-0.03, 95%CI = -0.05 to -0.01, P <0.01).
Conclusion
Higher vegetable intake can independently reduce the risk of abnormal blood glucose in school aged children, which is of great significance for maintaining glucose metabolic health.
3.Study of risk prediction model of metabolic dysfunction associated steatotic liver disease among children and adolescents
XIANG Fanying, NA Xiaona, AN Xizhou, CHEN Lijing, ZHONG Haiying, LIANG Xiaohua, CHEN Jingyu
Chinese Journal of School Health 2026;47(4):475-479
Objective:
To construct a risk prediction model for pediatric metabolic dysfunction associated steatotic liver disease (MASLD), so as to provide practical tool for the early identification of high risk children.
Methods:
A healthy cohort of children in Southwest China was established from January 2021 to April 2025. A nested case-control study design was used to include 507 cases MASLD group and 507 cases in non MASLD group. Data on physical measurements, blood biochemical parameters, and liver ultrasound indicators were collected. Conditional Logistic regression was used to analyze the relationship between individual variables and MASLD, Lasso regression was applied for multivariable screening, and a high risk prediction model was constructed and presented in the form of a nomogram. Internal validation was performed using 10 repeated ten fold cross validations to assess model discrimination, accuracy, sensitivity, and specificity.
Results:
Logistic regression analysis showed that MASLD was associated with central obesity ( OR=22.11, 95%CI =15.62-31.29), apolipoprotein B ( OR=30.24, 95%CI =12.42-73.63), increased hepatorenal echo ( OR=326.00, 95%CI =183.87-578.01), hepatomegaly ( OR=24.98, 95%CI =16.66-37.46) (all P <0.05). The Lasso regression jointly selected 6 key variables, including hepatorenal echo, central obesity, hepatomegaly, right liver lobe inclination, body mass index, and alanine amino transferase. The results of cross validation showed that the average area under the curve (AUC) was 0.999 5, the average accuracy was 98.74%, and the sensitivity and specificity were 98.21% and 99.22% respectively, indicating a good predictive effect of the model.
Conclusion
The risk prediction model for high risk MASLD among children based on ultrasound and clinical indicators has good prediction effect, which is helpful for the early identification and risk stratification of pediatric MASLD.
4.Association between body weight standardized vitamin B intakes and blood pressure among school aged children
ZHANG Meiling, NA Xiaona, LUO Shunqing, ZHONG Haiying, XIAO Lun, LIANG Xiaohua
Chinese Journal of School Health 2026;47(5):704-709
Objective:
To investigate the association between body weight standardized vitamin B intakes and blood pressure among school aged children, so as to provide evidence for developing dietary guidance and intervention strategies of promoting healthy blood pressure in children.
Methods:
The data were derived from a pediatric health cohort established in both urban and rural areas of Chongqing. A total of 1 368 primary school students in grades one to three were recruited for the baseline survey between October and November 2014 by using a stratified cluster random sampling design. From February to March 2019, 1 283 participants completed the first follow up assessment. Dietary intake and sociodemographic characteristics were assessed using a food frequency questionnaire and a self administered questionnaire. Blood pressure, height, weight, and other anthropometric indicators were measured. Body weight standardized intakes of six B vitamins(B 1, B 2, B 3, B 6, B 9, and B 12 )were categorized into tertiles( T1-T 3). Linear mixed effects models were applied to examine the associations between body weight standardized vitamin B intakes and changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP). In addition, mixed effects Logistic regression models were used to assess the risk of elevated blood pressure.
Results:
Linear mixed effects model regression analyses showed that, after adjusting for potential confounders including age, sex, and family history of obesity, body weight standardized B vitamin intake was negatively associated with SBP, DBP, and MAP in school aged children ( β =-7.79 to -0.68, all P <0.05). Results from the mixed effects Logistic regression models showed that, compared with the T 1 group, children in the T 3 group had a lower risk of elevated blood pressure for vitamin B 1 ( OR=0.40, 95%CI =0.25-0.64), B 2 ( OR=0.36, 95%CI =0.23-0.58), B 3 ( OR=0.47, 95%CI =0.31-0.72, B 6 ( OR=0.37, 95%CI =0.22-0.60), B 9 ( OR=0.36, 95%CI =0.21-0.60), and B 12 ( OR= 0.56 , 95%CI =0.37-0.86)(all P <0.05).
Conclusions
Body weight standardized B vitamins were associated with changes in blood pressure levels and the risk of elevated blood pressure among school aged children. Ensuring sufficient dietary intakes of vitamin B may help prevent and control of abnormal blood pressure in children.
5.Coronary CT Angiography-Derived Fractional Flow Reserve in Asia and the United States: 2025 Status Update
Woo Jin AHN ; Maros FERENCIK ; Ming-Yen NG ; Liang ZHONG ; Mona BHATIA ; Akira KURATA ; Pannipa SUWANNASOM ; Yung-Liang WAN ; Trang Ngoc NGUYEN ; Suyon CHANG ; Sung Mok KIM ; Hwan Seok YONG ; Cherry KIM
Korean Journal of Radiology 2026;27(1):27-33
Coronary CT-derived fractional flow reserve (CT-FFR) is a noninvasive alternative to invasive FFR for assessing the hemodynamic significance of coronary artery stenosis. CT-FFR uses routinely acquired coronary CT angiography (CCTA) with artificial intelligence and computational fluid dynamics to estimate pressure gradients, thereby supporting clinical decisionmaking without procedural risk. Adoption and implementation vary widely across regions. In Asia, South Korea exclusively uses HeartMedi+, which enables rapid analysis, streamlined workflow integration, and high user satisfaction. Japan relies primarily on FFR CT, which has national reimbursement and significantly influences treatment strategies, reducing unnecessary invasive procedures. Hong Kong, Singapore, Taiwan, Thailand, and Vietnam remain in early or exploratory phases due to cost, reimbursement, and infrastructure barriers. In the United States, CT-FFR is guideline-endorsed and reimbursed, where HeartFlow is the most widely used, supported by robust clinical validation and outcome data. Despite regional variability, CTFFR offers a noninvasive solution that enhances patient management, reduces unnecessary invasive testing, and is poised for broader clinical integration as technology and validation advance.
6.Mechanism of Shenfukang capsule in ameliorating renal interstitial fibrosis by regulating cellular crosstalk via the STAT3/YAP pathway
Wei DU ; Yufang YANG ; Yanhong LIAO ; Xiaoqin ZOU ; Zhiwei LIANG ; Xiangqian FENG ; Xiaobin ZHONG
China Pharmacy 2026;37(12):1547-1552
OBJECTIVE To investigate the mechanism by which Shenfukang capsule (SFK) ameliorates renal interstitial fibrosis (RIF) by regulating macrophage-fibroblast crosstalk via the signal transducer and activator of transcription 3 (STAT3)/Yes-associated protein (YAP) pathway. METHODS RAW264.7 macrophages were induced to polarize with transforming growth factor-β 1 (TGF-β 1 ). Subsequently, a non-contact co-culture system of macrophages with renal fibroblasts NRK-49F, as well as a non-contact co-culture system of macrophages with YAP-knockdown renal fibroblasts, were established. Cells were treated with low, medium, and high concentrations (4, 8, 16 μg/mL) of SFK, as well as a STAT3 inhibitor (STAT3-I,1.64 μg/mL) and losartan potassium tablets (positive control, 0.28 μg/mL), for 48 h. After intervention, the protein and mRNA expression levels of CD86, CD163, and STAT3 in macrophages, as well as CD86, F4/80, and STAT3 mRNA, were detected. In co-cultured renal fibroblasts, the protein and mRNA expression levels of α -smooth muscle actin ( α -SMA), Vimentin, collagen type Ⅰ (Col-Ⅰ), matrix metalloproteinase-1 (MMP-1), and YAP were detected. In co-cultured YAP-knockdown renal fibroblasts, the protein and mRNA expression levels of α -SMA, Vimentin, and MMP-1 were also detected. RESULTS Following TGF-β 1 induction, the protein expression levels of CD86, CD163, and STAT3, as well as the mRNA expression levels of CD86, F4/80, and STAT3 in macrophages were significantly increased ( P <0.05). The conditioned medium from polarized macrophages activated renal fibroblasts, as evidenced by significantly increased protein and mRNA expression levels of α -SMA, Vimentin, Col-Ⅰ, and YAP, and significantly decreased protein and mRNA expression levels of MMP-1 in renal fibroblasts ( P <0.05). Treatment with SFK and STAT3-I reversed the changes in the above indicators, with the medium concentration SFK group showing stronge r effects on some indicators than the low and high concentration groups. In the non-contact co-culture experiment of macrophages and YAP-knockdown renal fibroblasts, there were no statistically significant differences in the protein and mRNA expression of α-SMA, Vimentin, and MMP-1 among the groups. CONCLUSIONS SFK can inhibit macrophage-renal fibroblast crosstalk by blocking the STAT3/YAP pathway, thereby delaying the progression of RIF.
7.Analysis of influencing factors affecting the efficacy of Shenfukang capsule in the treatment of chronic kidney disease and construction of prediction model
Li TANG ; Mengyuan QIN ; Yufang YANG ; Xiaoqin ZOU ; Zhiwei LIANG ; Xiaobin ZHONG
China Pharmacy 2026;37(13):1740-1745
OBJECTIVE To explore the influencing factors of Shenfukang capsule in the treatment of chronic kidney disease (CKD) and construct a nomogram prediction model for evaluating its therapeutic efficacy. METHODS CKD patients who were hospitalized from July 2019 to August 2022 in the First Affiliated Hospital of Guangxi Medical University and treated with Shenfukang capsule were selected as study subjects. Clinical data of the patients were collected from the hospital’s electronic medical record system, and they were divided into an effective group and an ineffective group based on treatment outcomes. Lasso-Logistic multivariate regression analysis was used to screen the influencing factors of the efficacy of Shenfukang capsule. Using the effectiveness of Shenfukang capsule treatment as the prediction outcome and the screened influencing factors as predictor variables, a nomogram prediction model was constructed using R software. All patients were randomly divided into a training cohort and a validation cohort. The discriminative ability, calibration, and clinical net benefit of the model were evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis, respectively. RESULTS Lasso-Logistic regression analysis revealed that concurrent diabetes mellitus, decreased levels of blood urea nitrogen, triglycerides, and serum phosphorus, as well as prolonged prothrombin time and elevated apolipoprotein AⅠ levels, were influencing factors for reduced efficacy of Shenfukang capsule in CKD treatment. The evaluation results of the nomogram prediction model showed that the area under curve values were 0.745 and 0.797 in the training and validation cohorts, respectively, which were close and both exceeded 0.70, indicating stable predictive performance. The calibration curves demonstrated good agreement in both datasets, suggesting satisfactory calibration performance. The clinical decision curves were positioned above the two extreme reference lines, indicating high clinical benefit of the model. CONCLUSIONS Diabetes mellitus, blood urea nitrogen, triglycerides, apolipoprotein AⅠ, serum phosphorus, and prothrombin time were factors associated with the efficacy of Shenfukang capsule in CKD patients. The nomogram prediction model established in this study may provide a basis for rational clinical application of Shenfukang capsule and for improving its therapeutic efficacy in CKD.
8.Analysis of influencing factors affecting the efficacy of Shenfukang capsule in the treatment of chronic kidney disease and construction of prediction model
Li TANG ; Mengyuan QIN ; Yufang YANG ; Xiaoqin ZOU ; Zhiwei LIANG ; Xiaobin ZHONG
China Pharmacy 2026;37(13):1740-1745
OBJECTIVE To explore the influencing factors of Shenfukang capsule in the treatment of chronic kidney disease (CKD) and construct a nomogram prediction model for evaluating its therapeutic efficacy. METHODS CKD patients who were hospitalized from July 2019 to August 2022 in the First Affiliated Hospital of Guangxi Medical University and treated with Shenfukang capsule were selected as study subjects. Clinical data of the patients were collected from the hospital’s electronic medical record system, and they were divided into an effective group and an ineffective group based on treatment outcomes. Lasso-Logistic multivariate regression analysis was used to screen the influencing factors of the efficacy of Shenfukang capsule. Using the effectiveness of Shenfukang capsule treatment as the prediction outcome and the screened influencing factors as predictor variables, a nomogram prediction model was constructed using R software. All patients were randomly divided into a training cohort and a validation cohort. The discriminative ability, calibration, and clinical net benefit of the model were evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis, respectively. RESULTS Lasso-Logistic regression analysis revealed that concurrent diabetes mellitus, decreased levels of blood urea nitrogen, triglycerides, and serum phosphorus, as well as prolonged prothrombin time and elevated apolipoprotein AⅠ levels, were influencing factors for reduced efficacy of Shenfukang capsule in CKD treatment. The evaluation results of the nomogram prediction model showed that the area under curve values were 0.745 and 0.797 in the training and validation cohorts, respectively, which were close and both exceeded 0.70, indicating stable predictive performance. The calibration curves demonstrated good agreement in both datasets, suggesting satisfactory calibration performance. The clinical decision curves were positioned above the two extreme reference lines, indicating high clinical benefit of the model. CONCLUSIONS Diabetes mellitus, blood urea nitrogen, triglycerides, apolipoprotein AⅠ, serum phosphorus, and prothrombin time were factors associated with the efficacy of Shenfukang capsule in CKD patients. The nomogram prediction model established in this study may provide a basis for rational clinical application of Shenfukang capsule and for improving its therapeutic efficacy in CKD.
9.From transmission to elimination: progress of schistosomiasis control in Sichuan Province
Jiajia WAN ; Zisong WU ; Lin CHEN ; Nannan WANG ; Yu ZHANG ; Chen PU ; Rongzhi LI ; Xianhong MENG ; Liang XU ; Jingye SHANG ; Ding LU ; Bo ZHONG ; Yang LIU
Chinese Journal of Schistosomiasis Control 2026;38(3):232-239
Sichuan Province is a hilly schistosomiasis-endemic province in China with the highest endemicity and largest coverage. During the period of more than 70 years of integrated control, there are five distinct phases of schistosomiasis control in Sichuan Province, including baseline investigation, Oncomelania hupensis snail control, chemotherapy for both humans and livestock, management of source of Schistosoma japonicum infections, and sustained control and intensified surveillance and early warning, and a package of key interventions are implemented, including environmental modification, snail control with chemical treatment, large-scale chemotherapy for humans and livestock, management of source of S. japonicum infections, intensified integrated control, establishment of an early warning and surveillance system. As a result, schistosomiasis has been eliminated across all 63 disease-endemic counties (cities, districts) in Sichuan Province by June 2025. Government-led multi-sectoral collaborations, science and technology-supported precision control strategies, and a sustainable control model tailored to the ecological and socio-economic conditions in endemic regions are essential to achieving the target of schistosomiasis elimination in Sichuan Province.
10.Study on quality standard of ethnic medicine Diplazium lanceum
Liyuan HU ; Chuhui ZHOU ; Limei LIANG ; Yong CHEN ; Jiajia ZHONG ; Jiangcun WEI
China Pharmacy 2026;37(15):1986-1991
OBJECTIVE To study the quality standard of the ethnic medicine Diplazium lanceum, and to provide reference for its quality control.METHODS The medicinal material of D. lanceum was identified by properties, microscopy, and thin-layer chromatography(TLC), and its moisture, ash, and extract contents were determined. The contents of chlorogenic acid and rutin in 10 batches of D. lanceum were determined by high-performance liquid chromatography . RESULTS The rhizome of D. lanceum is slender and creeping, the leaf is leathery and shriveled, and yellow sporangia are borne on the abaxial surface of the leaf. The transverse section of the leaf shows inclusions, sclerenchyma, phloem cells, etc.; the transverse section of the petiole shows ground tissue, sclerenchyma, endodermis, etc.; the transverse section of the rhizome shows ground tissue, tracheids, vascular bundles, etc.; and the powder shows spiral vessels and brown inclusions. The TLC identification results showed that the chromatogram of the test sample exhibited spots of the same color at the corresponding positions as the chromatogram of the chlorogenic acid reference substance. The content ranges of moisture, total ash, acid-insoluble ash, extract, chlorogenic acid, and rutin in the 10 batches of samples were 10.18%-12.43%, 7.08%-19.12%, 0.95%-10.62%, 14.13%-26.05%, 0.113 1-1.015 9 mg/g, and 0.009 9-0.208 9 mg/g, respectively. CONCLUSIONS In the quality standard of D. lanceum, the moisture content should be ≤12.5%, total ash content should be ≤20.0%, acid-insoluble ash content should be ≤11.0%, extract content should be ≥14.0%, and chlorogenic acid content should be ≥0.11 mg/g. The established method is simple, specific, and reproducible, and can provide a scientific basis for the quality control of D. lanceum.


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