The present study examined the ability of the body roundness index (BRI) to predict the incidence of diabetes and prediabetes among adults in the USA. The study enrolled 11,980 adults aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES). Logistic regression served as the primary method for analyzing the relevant link between BRI and the incidence of diabetes and prediabetes, including univariate analysis, multivariate regression analysis, smooth curve fitting analysis, and subgroup analysis. What’s more, receiver operating characteristic (ROC) analysis was applied to confirm the predictive values of BRI for diabetes and prediabetes. Each unit higher than BRI was associated with a 17% increased risk of diabetes and prediabetes after covariate adjustments (OR: 1.17, 95% CI: 1.07–1.27). Those with BRI in the high scores (Q4) possessed an increased likelihood of having diabetes and prediabetes than individuals in the reference group (OR: 1.83, 95% CI: 1.29–2.58). A smooth curve fitting analysis revealed a non-linear trend. The results across all population subgroups were uniform to those of the total population. The ROC curve indicated that the BRI was the best predictor of diabetes and prediabetes among other anthropometric indices. Diabetes and prediabetes occurrence rates and BRI have a positive and non-linear relationship in American adults. The BRI indices could function as predictive markers for diabetes and prediabetes.

Acute lung injury (ALI) is a severe respiratory disease accompanied by diffuse inflammatory responses induced by various clinical causes. Many fresh medicinal plants have shown better efficacy than their dried forms in preventing and treating diseases like inflammation. As a classical Chinese herb, platycodon grandiflorum (PG) has been demonstrated effective in treating pneumonia, but most of previous studies focused on the efficacy of processed or dried PG formats, while the specific benefits of its fresh form are still underexplored. Exosome-like nanoparticles derived from medicinal plants are expected to point out an important direction for exploring the material basis and mechanism of this fresh herbal medicine. The fresh form of PG could effectively improve ALI induced by lipopolysaccharide (LPS), relieve lung histopathological injury and weight loss, and reduce levels of inflammatory factors in mice, exhibiting better efficacy than dried PG in the treatment of ALI. Further extraction and purification of PG exosome-like nanoparticles (PGLNs) demonstrated that PGLNs had good biocompatibility, with characteristics consistent with general exosome-like nanoparticles. Besides, proteomic analysis indicated that PGLNs were rich in a variety of proteins. Animal experiments showed that PGLNs improved the pathological changes in LPS-induced lung tissues, inhibited the expression of inflammatory factors and promoted the expression of anti-inflammatory factors, and exerted a regulatory effect on the polarization of lung macrophages. Cell experiments further confirmed that PGLNs could be effectively taken up by RAW264.7 cells and repolarize M1 macrophages into M2 type, therefore reducing the secretion of harmful cytokines. Moreover, non-targeted metabolomics analysis reveals that PGLNs reduce inflammation and control macrophage polarization in a manner closely linked to pathways including glycolysis and lipid metabolism, highlighting a potential mechanism by which PGLNs protect the lungs from inflammatory damage like ALI. Fresh PG has better anti-inflammatory and repair effects than its dried form. As one of the most effective active substances in fresh PG, PGLNs may regulate macrophage inflammation and polarization by regulating metabolic pathways including lipid metabolism and glycolysis, so as to reduce inflammation and repair lung injury.

Medicinal plant-derived exosome-like nanovesicles is a kind of vesicles with a diameter of 30– 300 nm extracted from medicinal plants, which can regulate the microenvironment of various systems, diseases and cells through multiple drug delivery routes, so as to achieve the purpose of alleviating and treating diseases. In this paper, the extraction and identification methods of nanovesicles derived from medicinal plants were summarized. Then, according to the systematic classification of diseases, the effects and mechanisms of the treatment of diseases and the regulation of the microenvironment by the nanovesicles derived from medicinal plants were summarized and analyzed. This paper finds Medicinal plant-derived exosome-like nanovesicles, as plant-derived nanoscale vesicles, can act more efficiently on various microenvironments of the body such as inflammation, tumors, immunity and the intestine through various administration methods such as oral administration and intravenous injection according to the characteristics of the disease, achieving the effect of treating diseases and alleviating symptoms. Medicinal plant-derived exosome-like nanovesicles have initiated a new model of transboundary communication regulation involving plants in the human microenvironment, using their own advantages to regulate the human microenvironment. Meanwhile, it can also be used as a drug carrier to achieve a dual communication regulation effect. It provides ideas for the follow-up research and clinical use of nanovesicles derived from medicinal plants.

Objective: To investigate the effect of multiple eHealth-delivered lifestyle interventions on obesity-related anthropometric outcomes in children and adolescents.Methods: The Medline (via PubMed), Embase, Cochrane Library, Web of Science, CBM, VIP, CNKI, and Wanfang electronic databases were systematically searched from their inception to March 18, 2022, for randomized controlled trials (RCTs). Meta-analyses were performed to investigate the effect of multiple eHealth-delivered lifestyle interventions on obesity-related anthropometric outcomes (body mass index [BMI], BMI Z-score, waist circumference, body weight, and body fat%). Two independent investigators reviewed the studies for accuracy and completeness. All included studies were evaluated using the Cochrane Risk-of-Bias (ROB) Tool.Results: Forty trials comprising 6,403 patients were selected for the meta-analysis. The eligible trials were published from 2006 to 2022. Compared with the control group, the eHealth-intervention group was more effective in reducing BMI (weighted mean difference [WMD] = −0.32, 95% confidence interval [CI]: −0.50 to −0.13, I² = 85.9%), BMI Z-score (WMD = −0.08, 95% CI: −0.14 to −0.03, I² = 89.1%), waist circumference (WMD = −0.87, 95% CI: −1.70 to −0.04, I² = 43.3%), body weight (WMD = −0.96, 95% CI: −1.55 to −0.37, I² = 0.0%), and body fat% (WMD = −0.59, 95% CI: −1.08 to −0.10, I² = 0.0%). The subgroup analysis showed that parental or school involvement (WMD = −0.66, 95% CI: −0.98 to −0.34), eHealth-intervention duration of >12 weeks (WMD = −0.67, 95% CI: −0.96 to −0.38), and mobile-based interventions (WMD = −0.78, 95% CI: −1.13 to −0.43) had a significantly greater intervention effect size on BMI.Conclusions: This review recommends that multiple eHealth-delivered lifestyle strategies may be useful for preventing or treating overweight and obesity among children and adolescents. However, our results should be cautiously interpreted due to certain limitations in our study.