Hongxuan Tong

Digital literacy is increasingly recognized as a key determinant of health, yet the mechanisms linking it to self-rated health in transitional economies like China remain underexplored. This study examines how digital literacy influences self-rated health, directly and indirectly through mental health, while exploring heterogeneity across age and gender groups. Using data from the 2023 Chinese General Social Survey (n=8,039 adults aged 18 and above), we constructed a multidimensional digital literacy index via entropy weighting and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), integrating dimensions of digital access, usage, and entertainment. Structural equation modeling (SEM) and multi-group analyses were employed to test relationships, controlling for gender, age, and education. Model fit was assessed using RMSEA, CFI, and other indices; robustness was verified through alternative specifications, sensitivity checks, and outlier trimming. Digital literacy had a significant positive effect on self-rated health (β=0.115, p<0.001), comprising a direct effect (β=0.076, p<0.001) and an indirect effect via mental health (β=0.039, p<0.001; mediation proportion=33.9%). Multi-group SEM revealed heterogeneity: effects were strongest in young and middle-aged females (β=0.141–0.143, p60, p<0.01). Mental health mediated more strongly in older groups (β=0.500, p<0.001). The model explained 38.5% of variance in self-rated health. Digital literacy positively influences self-rated health by enhancing resource access and mental well-being, with pronounced benefits for younger and female populations. Policymakers should prioritize age-appropriate digital literacy initiatives with psychological support to reduce disparities, aligning with China’s “Healthy China 2030” and “Digital China” strategies.

Background: Ischemic stroke (IS), the leading stroke subtype (∼87%), arises from vascular occlusions, triggering brain necrosis through ischemia-reperfusion injury. Ferroptosis, an iron-driven cell death via Fe²⁺-mediated lipid peroxidation, is implicated in IS pathology. This study demonstrates that enoyl-coA hydrolase 1 (ECH1) may serve as a peripheral biomarker and therapeutic target for IS based on ferroptosis signaling.Methods: We integrated transcriptome data from the GEO database with preprocessing and normalization. Hub genes were screened using differential expression analysis and machine learning algorithms. Subsequently, genes were further filtered by mendelian randomization and also validated using transient middle cerebral artery occlusion (tMCAO) model.Results: Ferroptosis-related genes in the IS group showed higher expression compared with the healthy control group. Using differential expression analysis and machine learning algorithms, 12 potential hub genes were successfully screened. Mendelian randomization analysis further confirmed the causal association between ECH1 and stroke. In the tMCAO mouse model, ECH1 mRNA levels were down-regulated, consistent with the results of the clinical samples.Conclusion: In this study, taking ferroptosis as an entry point, ECH1 may serve as a potential peripheral blood biomarker and therapeutic target for IS through multidimensional validation, providing a basis for the development of relevant precision diagnostic strategies.

Recent advances in bladder cancer immunotherapy have shown promise, particularly in addressing limitations of the current gold standard, Bacillus Calmette-Guérin (BCG). Novel combinations, such as sasanlimab (a PD-1 monoclonal antibody) with BCG, have improved event-free survival in high-risk non-muscle-invasive bladder cancer (NMIBC). Intravesical anti-PD-1/PD-L1 agents like pembrolizumab and nadofaragene firadenovec have demonstrated efficacy and safety in BCG-unresponsive NMIBC, leading to regulatory approval. Additionally, BCG combined with immunostimulatory protein complexes (e.g., N-803) achieved high complete response rates while preserving quality of life. For muscle-invasive bladder cancer (MIBC) patients ineligible for cisplatin, neoadjuvant immunotherapy trials are exploring anti-PD-1/PD-L1 monotherapy or combinations with anti-CTLA-4 antibodies. The Pandore trial highlights the role of mucosal immunity in predicting response to systemic immune checkpoint inhibitors. Promising results have also been observed with intravesical oncolytic immunotherapy combined with systemic anti-PD-1 therapy in cisplatin-ineligible MIBC. These advancements underscore the potential of intravesical and systemic immunotherapies to improve bladder cancer outcomes and warrant further investigation.

Background: This study aimed to assess the prevalence and identify risk factors associated with depression among coronary heart disease (CHD) patients at different stages in China. Methods: Conducted as a hospital-based, cross-sectional study across 48 hospitals in 23 provinces, the research spanned from October 2016 to April 2018. A total of 9044 patients were initially recruited, with 8353 deemed eligible for participation. Depression was assessed using the nine-item Patient Health Questionnaire-9 (PHQ-9) Scale. Univariate analysis identified predictors of postoperative depression, and binary logistic regression analysis was employed to ascertain risk factors associated with depressive symptoms. The predictive model was constructed using the “rms” package in R software, demonstrating robust predictive capabilities according to the ROC curve. Results: In general, both the degree and overall score based on the PHQ-9 revealed a trend: as the severity of the disease increased, so did the severity of patient depression. Univariate analysis indicated statistical differences concerning general situations and lifestyles. The binary logistic regression model highlighted the proximity of depression to risk factors such as gender, nationality, marital status, education, drinking, BMI, sleep disturbance, and disease status. Utilizing these findings, a predictive nomogram for depression was developed. The model exhibited excellent predictive ability, with an AUC of 0.768 (95% CI = 0.757– 0.780). Conclusion: This study systematically investigated the prevalence of depression among coronary heart disease patients at various stages. As coronary heart disease advanced, the level of depression intensified. The nomogram developed in this study proves valuable in predicting the incidence of depression in coronary heart disease patients.

Musculoskeletal pain imposes a significant burden due to its high prevalence and complex pathophysiology. This perspective paper examines the current knowledge regarding the underlying mechanisms of musculoskeletal pain conditions and explores the therapeutic potential of acupotomy. Preliminary evidence suggests that acupotomy holds promise in effectively alleviating pain, improving functional outcomes, and facilitating myofascial tissue healing in individuals with musculoskeletal pain. However, further studies are warranted to elucidate the precise mechanisms through which acupotomy modulates fascia and trigger points, thus influencing pain processing. The targeted and precise nature of acupotomy in addressing specific trigger points and promoting tissue healing offers a promising approach for managing musculoskeletal pain. Nevertheless, additional research is imperative to comprehensively understand its mechanisms of action and optimize treatment protocols. This perspective paper critically contributes valuable insights into the contemporary understanding of musculoskeletal pain and underscores the potential of acupotomy as a valuable treatment modality.

Non-alcoholic fatty liver disease (NAFLD) has emerged as a global public health concern, affecting over one-quarter of the global population. It is closely associated with the prevalence of obesity and metabolic syndrome. Current treatment options for NAFLD are limited and often have side effects. Traditional Chinese medicine (TCM) offers a promising alternative with its holistic approach and use of multi-component herbal formulations. A recent study explored the potential of the TCM formula, "Fanlian Huazhuo Formula (FLHZF)", to alleviate high-fat diet-induced NAFLD by regulating autophagy and lipid synthesis signaling pathways. TCM has shown advantages in the prevention and treatment of NAFLD due to its efficacy and minimal side effects. However, the complex multicomponent and multitarget characteristics of formulas such as FLHZF present challenges in research. Future studies should focus on utilizing modern techniques to deepen our understanding of the mechanisms of action and active ingredients of Chinese herbal medicines, thereby promoting their modernization.

Background: Western dietary patterns are well-established risk factors for coronary heart disease (CHD); however, the potential role of Traditional Chinese Medicine (TCM) dietary theory in exacerbating specific TCM syndromes among CHD patients remains a significant knowledge gap. To address this gap, our study aimed to investigate the relationship between dietary patterns, encompassing diet tastes and eating habits, and the occurrence of Heart-Related Blood Vessel Syndromes (HRBVS) in Chinese patients with CHD. Methods: Data from 4428 patients with CHD were collected, including 2,973 stable angina pectoris (SAP) cases, 614 acute coronary syndrome (ACS) cases, and 841 heart failure (HF) cases. The Coronary Heart Disease HRBVS Scale and the Patient Self-Assessment of Dietary Habits Scale were used. Logistic regression analysis and a backward stepwise regression strategy were employed to identify dietary factors affecting HRBVS. Results: Individuals with a preference for salty, greasy, and spicy foods and those with irregular eating habits were more likely to experience HRBVS. Good dietary habits and regular meal timing were associated with a lower incidence of HRBVS. In the multivariate regression analysis, individuals who preferred spicy, greasy, and cold foods and those who kipped or had no breakfast had a higher risk of HRBVS. Conversely, individuals with good dietary habits had a lower risk of HRBVS. Conclusion: HRBVS in patients with coronary heart disease is closely related to dietary habits. Positive dietary interventions may play a significant role in improving HRBVS and enhancing prognosis. Identifying and intervening in these dietary factors may improve the overall prognosis in patients with coronary heart disease. Trial Registration: ClinicalTrials.gov (NCT02967718).