1.Primary biliary cholangitis comorbid with other connective tissue diseases: Thoughts and challenges
Siyan CAI ; Yi WEI ; Xu WANG ; Li WANG ; Fengchun ZHANG
Journal of Clinical Hepatology 2025;41(5):817-822
Primary biliary cholangitis (PBC) is a chronic progressive autoimmune liver disease that is often comorbid with other connective tissue diseases (CTDs), and such comorbidity can significantly alter the natural course or clinical phenotype of PBC or CTDs, limiting available therapeutic drugs and complicating clinical decision-making. Due to the involvement of the interdisciplinary subjects of hepatology, rheumatology, and clinical immunology and a paucity of large-scale cohort data and in-depth basic research, there is a limited understanding of such comorbidity in clinical practice, which increases the complexity of clinical diagnosis and treatment. This article summarizes the comorbidity of PBC with common CTDs such as Sjögren’s syndrome, systemic sclerosis, systemic lupus erythematosus, and idiopathic inflammatory myopathies, and analyzes related immune mechanisms, clinical manifestations, diagnostic challenges, treatment strategies, and prognosis. It is expected to establish PBC-CTD comorbidity cohorts through future multidisciplinary collaborations, focus on genetic background, immune mechanisms, and multi-omics approaches, elucidate pathogenesis and novel therapeutic targets, and improve the prognosis of patients by optimizing treatment strategies through precision medicine and artificial intelligence.
2.Study of characteristics of faculty of high-level public health schools in China based on internet information
Huiwen DENG ; Shengfeng WANG ; Yajun XU ; Huakang TU ; Xueyan JING ; Hongmei WANG ; Xifeng WU ; Ying LI ; Siyan ZHAN
Chinese Journal of Epidemiology 2025;46(3):476-483
Objective:To understand the characteristics of faculty in high-level public health schools in China, and analyze the differences in age, area and school level.Methods:Based on the internet information, the faculty information of 18 high-level public health schools was collected for a descriptive analysis on faculty characteristics.Results:There were 1 642 faculty members in the schools of public health in China, in whom 51.8% were women, 92.8% had doctorate, 32.4% had postdoctoral experience and 56.8% were former students staying to teach. The average age of the faculty members was (45.6±9.8) years. Meanwhile the top three study subjects were epidemiology and health statistics (31.0%), occupational health and environmental sanitation (16.5%), and health toxicology (16.3%). In the faculty members aged >40 years, 90.2% had doctorate, 62.6% were former students staying to teach, and 24.7% had no educational background of public health. The proportions of faculty members aged ≤40 years in the three groups mentioned above were 98.2%, 45.8% and 39.1% respectively. In terms of study subject, big data study were mainly conducted in the schools with top subject ranking and the schools in developed areas.Conclusions:The public health faculty was characterized by cross education background and high capability. The study subjects and sub-disciplines varied with schools and areas.
3.Progress in method development and application of distributed learning for estimation of epidemiological effect
Junting YANG ; Xin GAO ; Xiaoxuan WANG ; Mengdi ZHANG ; Xin CHEN ; Yulin WANG ; Zhike LIU ; Siyan ZHAN
Chinese Journal of Epidemiology 2025;46(5):895-906
Objective:To systematically review the progress in the method development and application of distributed learning in the estimation of epidemiological effect and provide methodological reference for multi-center studies.Methods:We conducted a literature retrieval for English papers published up to December 31, 2023 by using keywords of "health/medical big data" and "distributed/federated learning". After consulting experts, we set criteria of paper inclusion and exclusion and created a framework for data extraction. We collected information about basic study details, including method, application, and evaluation. Two researchers independently screened the papers and extracted information. We used EndNote 20 for the management of literatures and EpiData for the management of data.Results:A total of 3 444 papers were collected, and 29 papers were included in the final analysis. Most of the papers (25, 86.2%) were published in or after 2019, and the papers were mainly from the United States (21/29, 72.4%). For the estimation of epidemiological effects, 22 distributed learning methods had been developed, including methods for logistic regression (8), Cox regression (8), Poisson regression (2), and generalized linear mixed model (GLMM) (4), as well as three platforms for distributed analysis (VLP, Vantage6, AusCAT). The 29 papers described 45 applications, with 20 (44.4%) focusing on the establishment of prediction model and 25 (55.6%) on association analysis. Importantly, except for GLMM, current distributed learning methods can estimate effects with little bias in 1-3 rounds of communication. These methods show less bias compared with meta-analysis, especially in the address of data heterogeneity and rare outcomes. However, less studies examined how differences in data structure and sparse data affect results, an area that requires further research.Conclusion:While distributed learning shows promise in epidemiological effect estimation, it is still in early development, requiring further research on data heterogeneity handling and communication efficiency improvement.
4.Analysis of the current application of the Consolidated Framework for Implementation Research in the field of public health
Xinping WANG ; Yunxiao WU ; Wangnan CAO ; Xiaolin WEI ; Siyan ZHAN ; Feng SUN
Chinese Journal of Epidemiology 2025;46(8):1446-1450
Evidence-based public health, as the forefront of modern public health practice, has increasingly important in public health field. However, a significant gap remains between the available evidence and its practical application. Effectively disseminating and implementing evidence-based public health practice in real-world settings has become a key challenge in contemporary public health research. In this context, Implementation Science has emerged as a vital discipline. This paper explores the critical role of Implementation Science in public health, reviews the origins and core components of the Consolidated Framework for Implementation Research (CFIR), and analyzes the current application of CFIR in public health through bibliometric methods. Additionally, it discusses specific examples to further elucidate the steps involved in using the CFIR and its application contexts. The findings indicate that since 2015, research on CFIR in public health has progressively increased, showing a continuous upward trend. CFIR applications mainly address context-specific facilitators, health decision-making, barrier and facilitator identification, and community-based participatory evaluation, predominantly employing qualitative and mixed-methods research. This paper not only reviews and analyzes the current use of CFIR in public health but also provides a detailed discussion on its application. The goal is to offer valuable insights for the development of Implementation Science research within China's public health sector.
5.Current approaches and challenges in addressing class imbalance in medical prediction models
Xianglong MENG ; Yutong WANG ; Xin ZHANG ; Siyan ZHAN ; Shengfeng WANG
Chinese Journal of Epidemiology 2025;46(9):1632-1639
With the rise of personalized medicine and the rapid development of big data technology, medical prediction models have become increasingly important in disease diagnosis, prognosis assessment, and risk stratification. However, class imbalance is a common problem in medical data, which can result in models being overly trained toward the majority class rather than the minority class, influencing the detection power and clinical application value. This paper systematically summarizes traditional methods in addressing class imbalance, including data pre-processing and algorithm level strategies, and introduces the applications of new technologies such as generative adversarial networks and transfer learning and suggests key considerations and potential research focus for addressing class imbalance to provide reference for researchers to select appropriate strategies.
6.Artificial intelligence in epidemiology: a decade-long bibliometric analysis
Conghui WANG ; Ziming YANG ; Wei SHI ; Chengwei XI ; Shucheng SI ; Liuliu WU ; Jian DU ; Shengfeng WANG ; Siyan ZHAN
Chinese Journal of Epidemiology 2025;46(9):1650-1659
Objective:To describe the hotspots and application trends of artificial intelligence (AI) in epidemiology in the past decade and analyze its advantages and challenges.Methods:The literatures with AI and epidemiology related keywords were systematically retrieved from Web of Science and China National Knowledge Infrastructure from 2014 to 2024. CiteSpace was used for bibliometric analysis of publication volume, keyword co-occurrence, clustering, emergence and cited literature co-occurrence analysis.Results:A total of 5 389 English papers and 1 659 Chinese papers were included, showing an increasing publication trend. High-frequency Chinese keywords included prediction, influencing factor, and machine learning, while English keywords frequently used were machine learning, prediction, and artificial intelligence. The Chinese keywords formed 14 clusters such as epidemiological characteristic, dietary pattern, and elderly individual, and the English keywords formed 21 clusters including prediction model, risk factor, and adult. In international studies, health policy, COVID-19, and digital health were the emerging frontier keywords. Eleven core papers were selected, covering key areas like traffic accident risk assessment, public health big data application, and deep learning in medical diagnosis.Conclusions:This study systematically summarized the research hotspots and development trends of AI applications in epidemiology over the past decade by using bibliometric methods, which indicated that current AI-based epidemiological studies are still in the exploratory phase, with the coexisting of both advantages and challenges. Continued attention should be paid to the future development of this field.
7.Primary biliary cholangitis comorbid with other connective tissue diseases:Thoughts and challenges
Siyan CAI ; Yi WEI ; Xu WANG ; Li WANG ; Fengchun ZHANG
Journal of Clinical Hepatology 2025;42(5):817-822
Primary biliary cholangitis(PBC)is a chronic progressive autoimmune liver disease that is often comorbid with other connective tissue diseases(CTDs),and such comorbidity can significantly alter the natural course or clinical phenotype of PBC or CTDs,limiting available therapeutic drugs and complicating clinical decision-making.Due to the involvement of the interdisciplinary subjects of hepatology,rheumatology,and clinical immunology and a paucity of large-scale cohort data and in-depth basic research,there is a limited understanding of such comorbidity in clinical practice,which increases the complexity of clinical diagnosis and treatment.This article summarizes the comorbidity of PBC with common CTDs such as Sj?gren's syndrome,systemic sclerosis,systemic lupus erythematosus,and idiopathic inflammatory myopathies,and analyzes related immune mechanisms,clinical manifestations,diagnostic challenges,treatment strategies,and prognosis.It is expected to establish PBC-CTD comorbidity cohorts through future multidisciplinary collaborations,focus on genetic background,immune mechanisms,and multi-omics approaches,elucidate pathogenesis and novel therapeutic targets,and improve the prognosis of patients by optimizing treatment strategies through precision medicine and artificial intelligence.
8.Nanoengineered cargo with targeted in vivo Foxo3 gene editing modulated mitophagy of chondrocytes to alleviate osteoarthritis.
Manyu CHEN ; Yuan LIU ; Quanying LIU ; Siyan DENG ; Yuhan LIU ; Jiehao CHEN ; Yaojia ZHOU ; Xiaolin CUI ; Jie LIANG ; Xingdong ZHANG ; Yujiang FAN ; Qiguang WANG ; Bin SHEN
Acta Pharmaceutica Sinica B 2025;15(1):571-591
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.
9.Guide on Methodological Standards in Pharmacoepidemiology in China(2nd edition)and their series interpretation(5):classic study designs and derivative approaches
Yiying ZHANG ; Shiwenqian YIN ; Shuhan MENG ; Shanjie WANG ; Siyan ZHAN ; Feng SUN
Chinese Journal of Pharmacoepidemiology 2025;34(5):485-493
Pharmacoepidemiology is an interdisciplinary field that applies epidemiological methods to study drug use,effectiveness,and associated risk in populations.Standardizing research methods in this field is crucial for ensuring research quality and promote the development of the discipline.Based on the Guide on Methodological Standards in Pharmacoepidemiology in China(2nd edition),this article interprets the relevant contents about classic research types and their derivative designs.It aims to clarify the types of study methodological designs in pharmacoepidemiology,systematically describe the characteristics and applications classical derivative designs,and compare these with research design frameworks outlined in international pharmacoepidemiological guidelines.Compared to the first edition,the second edition of the guideline has updated and detailed the types of research,updating the research design to original research(interventional research and non-interventional research),secondary research(systematic review,Meta-analysis,economic analysis,etc.),and tertiary research(umbrella review,etc.).Additionally,a variety of derivative designs have been added,including target trial emulation,nested case-control and case-cohort studies,case-crossover designs,self-controlled case series and self-controlled risk interval designs,case-population studies,interrupted time-series analysis,and case-coverage(ecological)designs for vaccine surveillance.This article strengthens the operability of the theoretical guidance of pharmacoepidemiological research methods in practice and provides a reference for conducting high-quality pharmacoepidemiological research.
10.Relationship between the use of disposable plastic food containers and executive function among primary school students in a district of Chongqing
WANG Wenhe, WU Dan, LIU Shudan, YE Siyan, CUI Chengpeng, LIU Qin
Chinese Journal of School Health 2025;46(6):811-815
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.


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