Objective: To investigate the impact of disposable plastic food container usage on the executive function among primary school students, so as to provide the evidence for the formulation of relevant health policies. Methods: From November 2023 to May 2024, a convenience sampling method was employed to select 1 118 grade 1-3 students from three primary schools in a central district of Chongqing. A self developed questionnaire was used to collect demographic characteristics and data on disposable plastic food container usage. Executive function of primary school students was assessed using the Childhood Executive Functioning Inventory (CHEXI). Multivariate linear regression analysis was conducted to explore the associations between disposable plastic food container usage and heating with executive function among primary school students. Results: Median scores for working memory, inhibition and total executive function among primary school students were 32 (26, 39), 33 (28, 38), and 66 (54, 75), respectively. Multivariate linear regression analysis showed that among girls, higher frequencies of eating meals from plastic lunchboxes were associated with higher CHEXI working memory scores ( β =1.29), inhibition scores ( β =1.57), and total executive function scores ( β =2.85) ( P <0.05). Compared to girls who did not use plastic cups or drank bottled water, those who used plastic cups for drinking or drank bottled water had higher scores in working memory ( β =2.63), inhibition ( β =2.10), and total executive function ( β =4.73); compared to girls who did not eat canned food from metal cans, those who ate such food had higher scores in working memory ( β =3.62), inhibition ( β =1.89), and total executive function ( β =5.50) ( P <0.05).Among boys, higher frequencies of eating meals from plastic lunchboxes were associated with higher inhibition scores ( β =1.13) ( P <0.05). Compared to girls who ate with a plastic lunch box and did not heat it when they ate,girls who more frequent heating plastic lunchboxes with food inside had higher working memory scores ( β = 5.39), inhibition scores ( β =4.29), and total executive function scores ( β = 9.68) ( P <0.05). Conclusions The use of disposable plastic food containers may adversely affect executive function of primary school students, with a more pronounced effect observed in girls. Strengthened regulation of disposable plastic products and health education are urgently needed.

Mitochondrial dysfunction in chondrocytes is a key pathogenic factor in osteoarthritis (OA), but directly modulating mitochondria in vivo remains a significant challenge. This study is the first to verify a correlation between mitochondrial dysfunction and the downregulation of the FOXO3 gene in the cartilage of OA patients, highlighting the potential for regulating mitophagy via FOXO3 gene modulation to alleviate OA. Consequently, we developed a chondrocyte-targeting CRISPR/Cas9-based FOXO3 gene-editing tool (FoxO3) and integrated it within a nanoengineered 'truck' (NETT, FoxO3-NETT). This was further encapsulated in injectable hydrogel microspheres (FoxO3-NETT@SMs) to harness the antioxidant properties of sodium alginate and the enhanced lubrication of hybrid exosomes. Collectively, these FoxO3-NETT@SMs successfully activate mitophagy and rebalance mitochondrial function in OA chondrocytes through the Foxo3 gene-modulated PINK1/Parkin pathway. As a result, FoxO3-NETT@SMs stimulate chondrocytes proliferation, migration, and ECM production in vitro, and effectively alleviate OA progression in vivo, demonstrating significant potential for clinical applications.

Over the past few decades, tumor immunotherapy has revolutionized the landscape of cancer clinical treatment. There is a flourishing development of combination strategies to improve the anti-tumor efficacy of mono-immunotherapy. However, instead of a straightforward combination of multiple therapeutics, it is more preferable to pursue a synergistic effect by designing rational combinations as well as administration strategies, which are based on a comprehensive understanding of the physiological and pathological features. In this case, the timing and spatial distribution of the combination drugs become essential factors in achieving improved therapeutic outcomes. Therefore, the concept of Sequential Drug Delivery System (SDDS) is proposed to define the spatiotemporally programmed drug delivery/release through triggers of internal conditions and/or external interventions, thus complying with the dynamic disease evolution and the human immunity. This review summarizes the recent advancements in biomaterial-based SDDSs used for spatiotemporally-tuned combination tumor immunotherapy. Furthermore, the rationales behind various engineering strategies are discussed. Finally, an overview of potential synergistic mechanisms as well as their prospects for combination immunotherapy is presented.

As a severe clinical manifestation of nonalcoholic fatty liver disease， nonalcoholic steatohepatitis （NASH） is characterized by lipid deposition and inflammatory damage in the liver. At present， clinical medications for NASH are still in the exploratory phase， and it is urgent to make progress. Recent studies have shown that the pathogenesis of NASH is associated with circadian rhythm disorders in the liver， with the specific manifestation of dysregulated expression of liver clock genes such as BMAL1， which increases hepatic lipogenesis， reduces fatty acid oxidation， and activates pro-inflammatory factors. Therefore， improving circadian rhythm of the liver and regulating the expression of liver clock genes are feasible strategies for the prevention and treatment of NASH. Currently， some medications for NASH via activating the proteins encoded by clock genes have been applied in animal experiments， for example， the REVERB full-agonist SR9009 can inhibit the development of liver inflammation， which confirms the possibility of NASH treatment by targeting the proteins encoded by clock genes. This article summarizes the role of hepatic clock genes in regulating lipid metabolism and the development and progression of inflammation in the liver and elaborates on the recent advances in medications targeting clock genes and the proteins encoded by clock genes， in order to provide new targets for the treatment of NASH.

ObjectiveTo explore the research status and trends of cohort studies on traditional Chinese medicine （TCM） efficacy evaluation from 2017 to 2022 and provide ideas and references for research in this field. MethodsSix databases including Pubmed， Web of Science， Embase， Scopus， Cochrane Library and CNKI were searched from January 1st， 2017 to December 31st， 2022. The total number of annual publications， journals， highly cited literatures， and keywords were quantitatively and visually analyzed by Bibliometrix. ResultsA total of 328 articles were included， which were published in 141 journals. The number of articles published in this field showed an overall upward trend， and retrospective cohort studies （282 papers， 85.98%） accounted for the largest proportion. A total of 151 cohort studies （46.04%） were conducted based on the database and showed an overall upward trend. The subjects were mainly patients with tumors （77 papers， 23.48%）， and cardiovascular and cerebrovascular diseases （64 papers， 19.51%）. The top 3 highly cited literatures mainly explore the association between TCM and survival outcome and quality of life in patients with malignant tumors. Fourteen and twenty-five high-frequency keywords were included in Chinese and English literature respectively， which formed 3 clusters such as research methods， statistical analysis and diseases. ConclusionIt was the current status to focus on retrospective cohort studies and focus on patients with tumors or cardiovascular and cerebrovascular diseases. Using observational database to conduct cohort studies of TCM efficacy evaluation could be the future research direction.

Objective:To analyze the epidemiological characteristics and economic burden of palmoplantar pustulosis (PPP) in China.Methods:A population-based retrospective study was conducted using the data from China′s Urban Basic Medical Insurance data from January 1, 2012, to December 31, 2016. International Classification of Diseases code and diagnoses in Chinese for PPP were used to identify cases and estimate the prevalence, incidence, and cost. Subgroup analyses were performed according to age and sex, and sensitivity analyses were conducted to evaluate the robustness of the results. Age-adjusted prevalence rates were calculated based on the 2010 national census data.Results:The crude prevalence and incidence rate of PPP in 2016 were 2.730/100 000 (95% CI: 2.218/100 000-3.242/100 000) and 1.556/100 000 (95% CI: 1.154/100 000-1.958/100 000), and the prevalence rate of females (2.910/100 000) was higher than that of males (2.490/100 000, χ2=97.48, P=0.001). The incidence rate of females (1.745/100 000) was also higher than that of males (1.418/100 000, χ2=85.02, P=0.001). The age peak of incidence and prevalence of patients with PPP was in the 30-39-year age group and a small peak existed in the 0-3-year age group among people under 20 years old. From 2012 to 2016, the average number of visits was (2.44±0.04) per patient, and the total per-capita cost per year was (982.40±39.19) yuan. Conclusion:In 2016, the prevalence and incidence rate of PPP in China were higher in females than in males, and the highest age peak was in the 30-39-year age group.

Objective:To analyze the epidemiological characteristics and economic burden of palmoplantar pustulosis (PPP) in China.Methods:A population-based retrospective study was conducted using the data from China′s Urban Basic Medical Insurance data from January 1, 2012, to December 31, 2016. International Classification of Diseases code and diagnoses in Chinese for PPP were used to identify cases and estimate the prevalence, incidence, and cost. Subgroup analyses were performed according to age and sex, and sensitivity analyses were conducted to evaluate the robustness of the results. Age-adjusted prevalence rates were calculated based on the 2010 national census data.Results:The crude prevalence and incidence rate of PPP in 2016 were 2.730/100 000 (95% CI: 2.218/100 000-3.242/100 000) and 1.556/100 000 (95% CI: 1.154/100 000-1.958/100 000), and the prevalence rate of females (2.910/100 000) was higher than that of males (2.490/100 000, χ2=97.48, P=0.001). The incidence rate of females (1.745/100 000) was also higher than that of males (1.418/100 000, χ2=85.02, P=0.001). The age peak of incidence and prevalence of patients with PPP was in the 30-39-year age group and a small peak existed in the 0-3-year age group among people under 20 years old. From 2012 to 2016, the average number of visits was (2.44±0.04) per patient, and the total per-capita cost per year was (982.40±39.19) yuan. Conclusion:In 2016, the prevalence and incidence rate of PPP in China were higher in females than in males, and the highest age peak was in the 30-39-year age group.

Objective:To explore the effects of the core symptoms of attention deficit hyperactivity disorder (ADHD) and behavior problems on the sleep of children with ADHD and their correlation.Methods:In this cross-sectional study, a total of 289 children aged 6-12 years with ADHD who visited the Outpatient Department of the Center for Cognition and Sleep at the People′s Hospital of Guangxi Zhuang Autonomous Region from June 2021 to December 2022 were selected.The Swanson, Nolan and Pelham Rating Scale Ⅳ was used to assess ADHD core symptoms (attention deficit and hyperactivity-impulsivity), the Conners Parent Symptom Questionnaire was used to assess behavior problems (conduct, learning, psychosomatic symptoms, and anxiety), and the Sleep Disturbance Scale for Children (SDSC) was used to assess sleep.Multivariate Logistic regression, multivariate linear regression, and path analysis were performed for statistical analysis of the data.Results:Multivariate Logistic regression analysis showed that after controlling age, gender, verbal intelligence quotient and performance intelligence quotient, attention deficit ( P=0.008, OR=2.60, 95% CI: 1.28-5.28), psychosomatic symptoms ( P=0.027, OR=6.77, 95% CI: 1.24-36.93) and anxiety ( P=0.013, OR=3.96, 95% CI: 1.43-11.67) increased the risk of sleep disturbances in children with ADHD (SDSC score >39 points).Path analysis showed that attention deficit ( β=0.244, P=0.001), psychosomatic symptoms ( β=0.114, P=0.046) and anxiety ( β=0.216, P<0.001) directly affected the SDSC score.Hyperactivity-impulsivity indirectly affected the SDSC score through psychosomatic symptoms ( β=0.142, P=0.039), and attention deficit indirectly affected the SDSC score through anxiety ( β=0.321, P<0.001). Conclusions:The severer the core symptoms of ADHD and behavior problems are, the higher the degree of sleep disturbances in children with ADHD is.Psychosomatic symptoms and anxiety are directly associated with the sleep disturbances of ADHD children.Attention deficit has direct or anxiety-mediated indirect impact on the sleep of ADHD children.Hyperactivity-impulsivity indirectly affects the sleep of children with ADHD through psychosomatic symptoms.

This paper briefly introduces the definition, classification and significance of effect modification in epidemiological studies, summarizes the difference between effect modifier and confounders, and analyze the influence as well as the role of effect modification in epidemiological studies and Meta-analysis. In this paper, the possible scenarios of effect modification and related analysis strategy in Meta-analysis are indicated by graphics, aiming to arouse researchers' attention to effect modification. This paper also demonstrates how to identify and deal with effect modification in Meta-analysis through a study case of "Efficacy of sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes", and shows the analysis process and interpretation of results of subgroup analysis and Meta-regression methods respectively. The advantages and disadvantages of these two methods are summarized to provide reference for the method selection of future research.

This paper briefly introduces the characteristics, research significance, and global reporting status of effect modification in network Meta-analysis, demonstrates the heterogeneity caused by effect modification in network Meta-analysis, and emphasizes the importance of exploring effect modification in network Meta-analysis. This paper also summarizes the normalized description and analysis strategies of effect modification in network Meta-analysis. Finally, by the case of "comparison of efficacy of three new hypoglycemic drugs in reducing body weight in type 2 diabetes patients", this paper demonstrates the realization of subgroup analysis and network Meta-regression in exploring effect modification, summarizes the advantages and disadvantages of the two methods, to provide references for future researchers.