Zhen Ye

Background: Rapid urbanization in China, while boosting socioeconomic development, has triggered “radical urbanization” characterized by land expansion outpacing population growth and economic activity. This spatial mismatch manifests as high building vacancy rates and underutilized infrastructure. Although urbanization is linked to mental health outcomes, evidence on radical urbanization’s impact on depression—especially among middle-aged and elderly populations—remains scarce. Methods: This cross-sectional study utilized 2011 baseline data from the China Health and Retirement Longitudinal Study (CHARLS), including 11,126 participants aged ≥45 years. Depressive symptoms were assessed using the CES-D scale (score ≥10 = clinically significant). The radical urbanization index was calculated as the log ratio of city-level built-up area (from China City Statistical Yearbook) to aggregated nighttime light DN values (using thresholds: eastern China ≥34, western China ≥25). Multivariable logistic regression (three adjusted models) and restricted cubic splines evaluated associations. Subgroup analyses and machine learning models (AUC comparison) further validated findings. Results: (1) Radical urbanization index was significantly higher in the depressive symptoms (DS) group vs. non-depressive symptoms (NDS) group (−4.74 vs. −4.96, *p* < 0.001). (2) Each 1-unit increase in the index elevated depression risk by 26% (OR=1.26, 95% CI:1.14–1.38; fully adjusted Model 3). (3) A dose-response relationship emerged: Q4 (highest index) had 1.68 × higher depression risk than Q1 (lowest) (*p*-trend<0.001). (4) Stronger associations occurred in central/western China (e.g., Hunan, Sichuan), low-education groups (OR=1.31), and rural residents (OR=1.30). (5) Adding the index to prediction models improved test-set AUC from 0.649 to 0.663. Conclusion: Radical urbanization—reflecting inefficient land-use and economic-population mismatch—is independently associated with depression among Chinese middle-aged and elderly adults. Findings underscore the need to reorient urbanization policies from “land expansion” to “human-centered” development to mitigate mental health burdens.

Objective: To compare and rank the effects of different mind–body exercise interventions on psychological and physical outcomes in individuals with type 2 diabetes mellitus using a network meta-analysis. Methods: This study systematically searched PubMed, Embase, Web of Science, and the Cochrane Library, and conducted a frequentist network meta-analysis using Stata with SUCRA-based ranking; risk of bias was assessed using RoB 2.0, certainty of evidence evaluated with CINeMA, and robustness examined through sensitivity analyses and publication bias assessment using funnel plots. Results: This study provides preliminary, outcome-specific evidence based on 13 randomized controlled trials involving over 500 individuals with type 2 diabetes mellitus. Network meta-analysis suggested that Pilates significantly improved balance ability (SMD = 1.52, 95% CI 0.77–2.28) and walking ability (SMD = 1.20, 95% CI 0.28–2.12) compared with control. Walking Meditation showed a favorable effect on aerobic capacity (SMD = 1.40, 95% CI 0.44–2.37), while yoga improved muscle strength (SMD = 0.79, 95% CI 0.26–1.33). Mindfulness-based interventions were associated with reduced anxiety (SMD = 1.05, 95% CI 0.46–1.63). Sensitivity analyses indicated that physical function outcomes were generally robust, whereas psychological outcomes were sensitive to influential studies. The certainty of evidence was predominantly very low according to CINeMA assessment. Conclusion: This network meta-analysis provides preliminary, outcome-specific evidence that mind–body exercise may improve physical function in type 2 diabetes, while effects on psychological outcomes remain uncertain and warrant further high-quality research. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/ , identifier CRD420251133289.

Purpose This study aimed to compare transarterial radioembolization (TARE) and transarterial chemoembolization (TACE) as locoregional therapies (LRT) for HCC patients awaiting liver transplantation (LT). Materials and Methods We conducted a systematic review with meta-analysis by searching PubMed, Embase, Web of Science, and Cochrane Library databases from inception until October 22, 2025. Twelve studies involving 10,661 patients were included. Studies comparing TARE and TACE for downstaging or bridging to LT in HCC patients were included. The primary outcome was downstaging rate. The protocol for this review was registered with PROSPERO under ID: CRD420251183741. Results The analysis demonstrated no significant differences between TARE and TACE in key outcomes such as downstaging rate (OR 0.96; 95% CI 0.60–1.54; P = 0.88), transplantation rate (OR 0.89; 95% CI 0.66–1.21; P = 0.47), and recurrence rate (OR 1.26; 95% CI 0.69–2.28; P = 0.45). However, TARE was associated with fewer LRT sessions (MD -0.66; 95% CI -1.01 to -0.31; P = 0.0002), lower incidence of grade 3/4 bilirubin toxicities (OR 0.32; 95% CI 0.11–0.91; P = 0.03), and higher rates of complete tumor necrosis (OR 2.16; 95% CI 1.14–4.09; P = 0.02). Although no significant differences were observed in 1-year, 2-year, and 3-year overall survival (all p > 0.05), the pooled odds ratios consistently favored TARE (all OR > 1). Additionally, recurrence-free survival was significantly superior with TARE (OR 2.39; 95% CI 1.11–5.16; P = 0.03). Conclusions While TARE and TACE demonstrate comparable efficacy in downstaging or bridging patients to LT, TARE may offer practical clinical advantages due to its enhanced oncologic efficacy, fewer treatment sessions, and a more favorable safety profile. Graphical Abstract

Background Currently, there is no clear consensus on whether medical treatment or endoscopic treatment should be used for peptic ulcer bleeding patients with adherent clot. The aim of this study is to investigate the hemostatic effects of medical treatment, single endoscopic treatment, and combination endoscopic treatment for peptic ulcer bleeding (PUB) patients with adherent clot. Methods We retrospectively analyzed PUB patients with adherent clot who underwent endoscopic examination or treatment in our center from March 2014 to January 2023 and received intravenous administration of proton pump inhibitors. Patients were divided into medical treatment (MT) group, single endoscopic treatment (ST) group, and combined endoscopic treatment (CT) group. Subsequently, inverse probability of treatment weighting (IPTW) was performed to calculate the rebleeding rate. Results A total of 605 eligible patients were included in this study. After IPTW, the rebleeding rate in the MT group on days 3, 7, 14, and 30 were 13.3 (7.3), 14.2 (7.8), 14.5 (7.9), and 14.5 (7.9), respectively; the rebleeding rates in the ST group were 17.4 (5.1), 20.8 (6.1), 20.8 (6.1), and 20.8 (6.1), respectively; the rebleeding rates in the CT group were 0.4 (0.9), 1.7 (3.3), 2.3 (4.5), and 2.3 (4.5), respectively. Although the rebleeding rate in the medical treatment group was higher, there was no significant difference among the three groups on days 3, 7, 14, and 30 (P = 0.132, 0.442, 0.552, and 0.552). Conclusions Medical therapy has similar hemostatic efficacy with endoscopic treatment for PUB patients with adherent clot (FIIb ulcers). However, for patients with more risk factors and access to well-equipped endoscopy centers, endoscopic treatment may be considered. The choice of treatment approach should be based on the individual conditions of the patient, as well as other factors such as medical resources available.