BACKGROUND:Apigenin is a bioactive flavonoid and widely found in herbs, fruits, and vegetables. Accumulated evidences have demonstrated the protective potential of apigenin on cardiovascular diseases, but its role in atherosclerosis remains unclear. Here, we aim to investigate the therapeutic effects of apigenin on atherosclerosis in vivo and explore the potential mechanism. METHODS:ApoE-/- mice were fed a high-fat diet (HFD) and supplemented with apigenin (20 mg/kg or 40 mg/kg) by gavage for 12 weeks. Oil Red O, hematoxylin and eosin staining (H&E), and Elastin Van Gieson (EVG) staining were performed to assess atherosclerotic plaque in ApoE-/- mice. Commercial kits were used to measure the serum lipids, inflammatory cytokines and oxidants. Immunohistochemistry staining, immunofluorescent staining and Western blot were performed to assess PPARγ, LXRα, ABCA1, and ABCG1 expression. RESULTS:Apigenin obviously reduced lesion areas in both en-face aortas and aortic root in HFD fed ApoE-/- mice. Apigenin also effectively ameliorated dyslipidemia, reduced inflammatory cytokines and oxidant levels in vivo. Immunofluorescent results showed that apigenin remarkably reduced macrophage foam cells in atherosclerotic plaque. Double immunofluorescent staining demonstrated high expression of ABCA1 and ABCG1. Moreover, apigenin also increased PPARγ and LXRα expression in atherosclerotic plaque. CONCLUSIONS:Apigenin alleviated atherosclerosis development by inhibiting macrophage foam cell formation via PPARγ-LXRα-ABCA1/ABCG1 pathway.

ObjectiveThis study aimed to investigate the long-term effects of chronic sleep deprivation (CSD) on the bone mineral density (BMD), bone microarchitecture, biomechanical properties and body weight of middle-aged and older male C57BL/6 mice.MethodsTwenty-one 8-month-old mice were randomly assigned to a CSD group (n = 9) or a control group (n = 12). The CSD group was subjected to sleep deprivation using an automated sleep deprivation apparatus for 3 months. Trabecular bone microarchitecture at the distal femur was evaluated by microcomputed tomography. Femoral biomechanical properties were assessed using a three-point bending test, and body weight was monitored weekly throughout the experiment.ResultsThree months of CSD significantly reduced BMD, bone volume (BV) and trabecular thickness (Tb.Th) compared with those of the control group (all P < 0.05). Trabecular separation (Tb.Sp) and bone surface (BS) were also significantly decreased (P < 0.05). No significant differences were observed in trabecular number (Tb.N), bone volume fraction (BV/TV) or other microarchitectural parameters. Three-point bending test showed no statistically significant differences in any biomechanical indices, including maximum load, bending stiffness and elastic modulus (all P > 0.05), between the two groups. Body weight monitoring revealed that the CSD group had significantly lower body weight at the early stage of the experiment (week 1) and at week 8 compared with the controls (P < 0.05). No significant differences were observed at most other time points, showing a fluctuating pattern with baseline differences.ConclusionThree months of CSD led to decreased BMD and trabecular thinning in middle-aged and older male mice. No significant deterioration of overall bone biomechanical properties was observed, suggesting the presence of compensatory mechanisms in bone. The effect of sleep deprivation on body weight was intermittent rather than sustained. These findings provide experimental evidence for a comprehensive understanding of the relationship between sleep duration and skeletal health.

Throughout pregnancy, the immune microenvironment undergoes dynamic changes in patients with concomitant autoimmune diseases (AIDs). These alterations not only affect disease activity and clinical manifestations, but also play a pivotal role in sustaining maternal-fetal immune tolerance and pregnancy outcomes. Extensive preclinical studies have elucidated the mechanisms of immune regulation in normal pregnancy, whereas the dynamic immune changes in pregnancies complicated by AIDs remain poorly understood. Recent studies have revealed significant variations in immune responses to pregnancy among individuals with AIDs, which may contribute to distinct patterns of AIDs flares during this period. Despite substantial progress in immunology and reproductive medicine, comprehensive reviews addressing the dynamic changes in the immune microenvironment during pregnancy in the context of AIDs are lacking. In this review, we summarize existing knowledge and incorporate recent multidisciplinary findings, focusing on the dynamic changes in systemic immune adaptation and maternal-fetal immune interactions in the context of AIDs during pregnancy. We emphasize the clinical significance of these immune dynamics for optimizing management and therapeutic strategies. Additionally, we propose new perspectives and provide recommendations to guide future research and the development of personalized treatment approaches.

Myocardial ischemia‑reperfusion injury (I/R) is a major contributor to adverse outcomes in ischemic heart disease. Mitochondrial dysfunction plays a central role in I/R, and modulating mitophagy has shown potential in attenuating such injury. Nevertheless, whether puerarin influences mitophagy during I/R remains poorly understood. An in vivo I/R (30 min/24 h) model was established in C57BL/6 mice after 7 day puerarin pretreatment. In vitro, a hypoxia‑reoxygenation H/R (8 h/4 h) model was constructed using H9c2 cardiomyocytes. Cardiac function was assessed by echocardiography, infarct size was determined via Evans Blue‑TTC staining, mitophagy was visualized by transmission electron microscopy, and expression of mitophagy‑related proteins was evaluated by western blot. Puerarin significantly reduced I/R‑induced damage in both models. It attenuated mitochondrial depolarization and reactive oxygen species generation, increased mitophagic activity, and upregulated the mitophagy receptor FUNDC1. Puerarin alleviates myocardial ischemia‑reperfusion injury by enhancing FUNDC1‑mediated mitophagy, particularly during early reperfusion. These results reveal a key mechanism underlying the cardioprotective effect of puerarin and support its further development as a therapeutic agent for I/R.

The tumor immune niche (TIN) is a dynamic, spatially organized compartment that orchestrates immunotherapy response and resistance. Despite the clinical success of immune checkpoint inhibitors and CAR-T therapies, the TIN’s inherent immunosuppressive properties and adaptive plasticity drive significant therapeutic resistance. This review systematically decodes the spatiotemporal remodeling of the TIN-encompassing aberrant vasculature, dense extracellular matrix barriers, and metabolic competition-during various immunotherapeutic interventions. We highlight core biological processes driving this transformation, including the spatiotemporal coupling of vascular normalization with T-cell infiltration, metabolic functional switching, and myeloid cell phenotypic plasticity. Furthermore, we synthesize clinical evidence identifying molecular and spatial hallmarks of responsive versus resistant niches. Finally, we discuss how emerging single-cell spatiotemporal omics and physio-mimetic organoid models can deconstruct niche heterogeneity to inform personalized, precision combinatorial strategies for durable tumor control.

This study aims to examine the health characteristics of female sex workers (FSWs) in entertainment venues and to investigate the relationship between these characteristics and sleep quality. This study employed a cross-sectional design and was conducted from January to April 2024 in Wuhan, China. Participants were FSWs recruited through snowball sampling from entertainment venues, including hotels, restaurants, nightclubs, karaoke bars and dance halls. Data were collected via structured questionnaires covering sociodemographic information, work experience, psychological stress, health status, sleep quality and circadian rhythms. Latent profile analysis (LPA) was employed to identify health characteristic profiles among FSWs, and multivariate logistic regression was used to examine the associations between these profiles and sleep quality. Among the 1,036 FSWs surveyed, 45.1

Effective therapeutic targets for immune-mediated liver injury remain insufficient, necessitating the urgent development of novel therapeutic agents. Baricitinib is a selective Janus kinase (JAK) 1/2 inhibitor that shows promise in autoimmune diseases such as rheumatoid arthritis. However, its efficacy in immune-mediated liver injury has not been fully elucidated. In this study, we found that JAK2 inhibitors fedratinib and baricitinib significantly mitigated liver damage, as evidenced by reduced serum transaminase levels, diminished histopathological injury, and suppressed inflammatory responses in concanavalin A (ConA)-induced liver injury, a classic animal model of immune-mediated liver injury. Mechanistic studies revealed that baricitinib's protective effects were mediated through JAK2 inhibition in macrophages. Myeloid-specific JAK2 knockout mice exhibited blunted activation of macrophages and CD4+ T cells, conferring resistance to immune-mediated liver injury induction. In vitro, macrophages isolated from baricitinib-treated or JAK2-deficient mice displayed less mature and activated phenotypes as evidenced by lower expressions of major histocompatibility complex class II (MHC-II), inflammatory marker Ly6C, inflammatory cytokine production, and higher phagocytic capacity, which subsequently resulted in lower levels of CD4+ T cell activation. These findings collectively underscore baricitinib's therapeutic potential in modulating immune responses and restoring hepatic homeostasis in immune-mediated liver injury, positioning it as a promising therapeutic candidate for this challenging condition. Further clinical validation is warranted to translate these preclinical insights into patient care.

Prolonged sedentary time and poor mental health are both associated with poorer sleep quality in adolescents, but how they interact to influence sleep quality is unclear. This study examined the interaction between daily sedentary time and mental health on adolescents’ sleep quality and assessed the moderating role of mental health. This cross-sectional study recruited 10,623 adolescents from 13 schools in Shiyan City, China, from October 2023 to January 2024. Data on demographics (age, sex), daily sedentary time, sleep quality, mental health, and other related factors (e.g., father’s smoking status, mode of commuting to school) were collected via self-report questionnaires. Blood pressure was measured using standard protocols. Mental health was assessed with the validated Kessler Psychological Distress Scale, and sleep quality was assessed with the validated Pittsburgh Sleep Quality Index. Multivariate logistic regression was used to examine the associations of daily sedentary time and mental health with sleep quality, as well as the additive and multiplicative interactions between daily sedentary time and mental health on sleep quality. Subsequently, the moderation of the daily sedentary time–sleep quality relationship by mental health was assessed. The prevalence of poor sleep quality was 40.14

The detection rate of psychological distress is notably high amongst adolescents with elevated blood pressure (BP). Thus, identifying its influencing factors is crucial to the development of precise intervention strategies. However, current research specifically targeting this population is limited. This study aimed to analyse the influencing factors of psychological distress in adolescents with elevated BP and construct a prediction model based on machine learning. A cross-sectional survey was conducted using convenience sampling, encompassing 2333 students with elevated BP. Data on demographic characteristics, lifestyle behaviours, sleep quality and psychological distress were collected through questionnaires and anthropometric measurements. Assessment tools included a self-designed demographic and lifestyle behaviour questionnaire, the Pittsburgh Sleep Quality Index and the Kessler Psychological Distress Scale. Anthropometric measurements involved height, weight, neck circumference, chest circumference, waist circumference, hip circumference and BP values. Variables were screened using Least Absolute Shrinkage and Selection Operator regression, and the dataset was balanced using a hybrid oversampling and undersampling method. Eight machine learning algorithms, including artificial neural network, random forest, adaptive boosting, gradient boosting machine, eXtreme gradient boosting (XGBoost), support vector machine, logistic regression and k-nearest neighbours, were employed to develop prediction models and assess variable importance for psychological distress. Model performance was evaluated using area under the receiver operating characteristic curve (AUC), Accuracy, Precision and F1 Score. All eight machine learning models demonstrated good predictive capability for the risk of psychological distress in adolescents with elevated BP. Amongst them, the XGBoost model showed the best performance, achieving an AUC of 0.942, Accuracy of 0.871, Precision of 0.863 and F1 Score of 0.871 on the training set, and an AUC of 0.769 on the test set, indicating excellent predictive performance. Variable importance analysis revealed that key predictors of psychological distress included parent–child relationship, gender, personality, frequency of consuming breakfast, sleep quality, frequency of consuming vegetables, passive smoking, frequency of consuming fried food, frequency of consuming coffee and dietary preferences. Sleep quality received the highest importance score. The XGBoost model exhibits high accuracy and stability in predicting psychological distress amongst adolescents with elevated BP, making it the preferred predictive tool. Sleep quality emerged as the most crucial predictor and should thus be prioritised as an independent indicator, providing a scientific basis for mental health interventions in this population.

Osteoporosis in men is associated with substantial morbidity and mortality, yet simple tools for preliminary risk assessment remain limited. The aim of this study is to examine the associations and potential utility of composite obesity- and metabolism-related indices for osteoporosis risk assessment in adult men. This cross-sectional study included 702 men aged ≥ 30 years who underwent routine health examinations and dual-energy X-ray absorptiometry-based bone mineral density assessment at a tertiary hospital in China, between July and December 2025. Nine composite obesity- and metabolism-related indices, including triglyceride-glucose body mass index (TyG-BMI), triglyceride-glucose-waist circumference index (TyG-WC), abdominal volume index (AVI), body roundness index (BRI), body adiposity index (BAI), relative fat mass (RFM), waist-to-height ratio (WHtR), fatty liver index (FLI), and Chinese visceral adiposity index (CVAI), were calculated. Multivariate logistic regression, restricted cubic spline (RCS), receiver operating characteristic (ROC) and machine learning analysis were performed to evaluate associations, nonlinear relationships, and predictive performance. The area under the ROC curve (AUC) was used to assess discriminatory ability, and Shapley additive explanations analysis was used to assess variable importance. The prevalence of osteoporosis was 9.7

This study aims to assess the relationship between various obesity indicators and elevated blood pressure (BP) among Chinese adolescents, identifying which indicators can predict the risk of elevated BP. From October 2023 to January 2024, a questionnaire survey and medical examination were conducted on 10,609 adolescents aged 12–17 years in Shiyan City, China, using convenience sampling. Conventional besity indicators were measured including body mass index (BMI), ponderal index (PI), waist circumference (WC), waist-to-hip ratio (WHR), conicity index (CI). Additionally, novel obesity indicators such as waist-to-height ratio (WHtR), body shape index (ABSI), body roundness index (BRI), abdominal volume index (AVI), a new hip index (HI), and body adiposity index (BAI), were also calculated. To assess the effectiveness of these obesity indicators in predicting elevated BP, receiver operating characteristic (ROC) curves were used. Multivariate logistic regression was employed to examine the relationship between these obesity indicators and the risk of elevated BP. The overall detection rate of elevated BP among adolescents was 22

Hypertrophic cardiomyopathy (HCM) is the most prevalent inherited cardiomyopathy transmitted in an autosomal dominant manner to offspring. It is characterized by unexplained asymmetrical hypertrophy primarily affecting the left ventricle and interventricular septum while potentially causing obstruction within the left ventricular outflow tract (LVOT). The clinical manifestations of HCM are diverse, ranging from asymptomatic to severe heart failure (HF) and sudden cardiac death. Most patients present with obvious symptoms of left ventricular outflow tract obstruction (LVOTO). The diagnosis of HCM mainly depends on echocardiography and other imaging examinations. In recent years, myosin inhibitors have undergone clinical trials and gene therapy, which is expected to become a new treatment for HCM, has been studied. This article summarizes recent clinical updates on the epidemiology, pathogenesis, diagnostic methods, treatment principles, and complication prevention and treatment of HCM, to provide new ideas for follow-up research.

Antibody-Drug Conjugates (ADCs) have achieved significant success in cancer therapy by combining the targeting specificity of monoclonal antibodies with cytotoxic payloads. However, the concomitant issue of drug resistance has become increasingly prominent, with primary mechanisms including alterations in target antigen expression, impaired drug transport, and inhibition of cell death pathways. ADCs have also shown emerging therapeutic potential in the treatment of autoimmune diseases; for instance, ABBV-3373 has achieved initial success in this area, yet it also faces unique challenges such as the safety of long-term administration, immunogenicity, and heterogeneity of target cells. Addressing these challenges requires multidimensional innovations, including optimizing molecular design, exploring combination therapy strategies, and introducing artificial intelligence (AI)-assisted development. These efforts aim to transition ADCs from the traditional "targeted killing" paradigm to intelligent and personalized precision delivery systems, thereby offering more therapeutic options for patients with cancer and autoimmune diseases.

Atherosclerotic cardiovascular disease (ASCVD) pathogenesis is fundamentally driven by dyslipidemia, characterized by lipid metabolism disorders that facilitate cholesterol deposition within damaged vascular endothelia. This process culminates in atherosclerotic plaque formation and coronary stenosis, ultimately inducing myocardial ischemia. While low-density lipoprotein cholesterol (LDL-C) remains the principal lipid determinant of ASCVD progression, emerging evidence indicates persistent residual cardiovascular risk despite optimal statin-mediated LDL-C control. This review aims to systematically evaluate the contributory role of non-traditional lipid biomarkers in ASCVD pathophysiology and clinical outcomes. Through comprehensive analysis of current research, we examine the biological properties and atherogenic mechanisms of non-conventional lipid particles, epidemiological evidence linking these biomarkers with residual cardiovascular risk, and therapeutic implications of targeting alternative lipid pathways. Particular emphasis is placed on elucidating the pathophysiological interplay between triglyceride-rich lipoproteins, lipoprotein(a), and oxidized phospholipids with vascular inflammation and plaque instability. Furthermore, we critically appraise recent clinical trial data regarding novel lipid-modifying agents and propose future research directions to address current knowledge gaps in residual risk management. This synthesis underscores the necessity of expanding therapeutic strategies beyond LDL-C reduction to achieve comprehensive cardiovascular risk mitigation.

Obesity and insufficient sleep have been linked to increased rheumatoid arthritis risk, but evidence on their combined effects remains limited. This study examined the joint association of body mass index (BMI), nap duration, and nighttime sleep duration with rheumatoid arthritis prevalence among middle-aged and older Chinese adults. Data from 10,127 individuals aged 45 years and older, obtained from the 2015 China Health and Retirement Longitudinal Survey (CHARLS), were included in this analysis. Multivariate logistic regression was performed. The risk of arthritis was the highest in the group with BMI values ≥ 28 kg/m2/nap duration of 1–30 min (odds ratio (OR) = 2.199, P = 0.007) compared with those with 18.5 kg/m2 ≤ BMI ≤ 23.9 kg/m2/0 ≤ nap duration ≤ 30 min. The risk of arthritis was the highest in the group with BMI kg/m2≥ 28/0–6 h of nighttime sleep duration (OR = 1.478, P = 0.003) compared with those with normal BMI/6–8 h of nighttime sleep duration. Coexisting obesity and insufficient nighttime sleep or absence of daytime nap significantly increase the risk of rheumatoid arthritis. Based on these findings, individuals may benefit from maintaining a healthy body weight through balanced diet and regular physical activity, and ensuring adequate nighttime sleep, as part of strategies to potentially reduce rheumatoid arthritis risk in middle-aged and older adults.

BackgroundThere is limited data on the association between TyG-BMI and NAFLD in patients with Type 2 Diabetes Mellitus (T2DM). The magnitude of risk prediction and predictive efficacy of TyG-BMI for T2DM with NAFLD remains unclear.ObjectiveTo examine the association of TyG-BMI with NAFLD in T2DM patients and assess the effectiveness of screening using the TyG-BMI index.MethodsWe conducted a retrospective analysis of clinical data from 602 T2DM patients at an enterprise health lodge from September 2021 to November 2022. Patients were categorized into two groups: T2DM alone (n=250) and T2DM with NAFLD (n=352). The Mann-Whitney U test was used for comparing non-normally distributed continuous data between groups, while the Chi-square test was used for categorical data. Logistic regression analysis was performed to evaluate the effect of BMI, TyG index, and TyG-BMI index on NAFLD. The ROC curve was used to assess the predictive efficacy of the TyG-BMI index for NAFLD in T2DM patients.ResultsBMI predicted the development of NAFLD in T2DM patients with an area under the receiver operating characteristic (ROC) curve of 0.792 (95% CI 0.757-0.828), and the optimal cutoff value was 25.22, with 72.2% sensitivity and 71.6% specificity; The area under the receiver operating characteristic (ROC) curve of the TyG index to predict the development of NAFLD in patients with T2DM was 0.755 (95% CI 0.716-0.794), and the optimal cutoff value was 8. 945, with a sensitivity of 80.1% and a specificity of 59.2%; The area under the receiver operating characteristic (ROC) curve of TyG-BMI index to predict the development of NAFLD in T2DM patients was 0.852, (95% CI 0.822-0.882), and the optimal cutoff value was 227.385, with a sensitivity and specificity of 80.1% and 59.2%, respectively.ConclusionsThe TyG-BMI index is a significant predictor of comorbid NAFLD in T2DM patients and provides better screening performance than BMI alone. The TyG-BMI index shows promise as an early screening tool for NAFLD in T2DM patients.

The atherogenic index of plasma (AIP) is a recent biomarker linked to atherosclerosis that has been validated as a novel indicator for myocardial infarction (MI). However, the relationship between AIP and the severity of coronary artery disease (CAD) in MI patients is still ambiguous, particularly among individuals with different glucose metabolic conditions. A total of 741 participants who were immediately assessed with coronary angiography upon admission and diagnosed with acute MI were recruited. The severity of CAD was assessed based on the number of narrowed vessels. AIP tertiles were used to divide the patients into three groups (T1: AIP < 0.030; T2: 0.030 ≤ AIP ≤ 0.316; T3: AIP > 0.316). The American Diabetes Association’s guidelines define three types of glucose metabolic state: diabetes mellitus (DM), prediabetes (Pre-DM), and normal glucose regulation (NGR). Logistic regression analysis was utilized to confirm an association between AIP and CAD severity in MI patients. ROC curves were employed to evaluate the diagnostic utility of AIP for CAD severity in MI patients. In MI patients, a statistically significant correlation was found between AIP and the severity of CAD, with logistic regression analysis revealing a strong association (OR: 2.055; 95% CI: 1.189–3.550; P = 0.009). Following adjustments for risk factors in the logistic regression model, AIP remained an independent predictor of multi-vessel CAD (OR: 2.902;95% CI: 1.555–5.521 ; P < 0.001). Moreover, compared with the T1 group, the odds ratios for multi-vessel CAD in the T2 and T3 groups were 2.039 (95% CI: 1.321–3.175; P = 0.001) and 2.087 (95% CI: 1.317–3.340; P = 0.001), respectively. The area under the curve for predicting CAD severity with AIP was 0.568 (95% CI: 0.520–0.616; p = 0.006). In addition, a significant association was observed between AIP and an increased risk of multi-vessel CAD in the Pre-DM group. In MI patients, AIP is closely associated with the risk of multi-vessel CAD and the prediction of the severity of CAD. In Pre-DM patients, AIP is clearly associated with the severity of CAD, whereas this association is absent in the NGR and DM groups.

Hypertension, a globally prevalent condition, is closely associated with T cell-mediated inflammatory responses. Studies have shown that T cells, by secreting pro-inflammatory cytokines such as interferon-gamma (IFN-γ), Interleukin-17 (IL-17), and Tumor necrosis factor-alpha (TNF-α), directly lead to vascular dysfunction and elevated blood pressure. The activation of Th1 and Th17 cell subsets, along with the dysfunction of regulatory T cells (Tregs), is a critical mechanism in the onset and progression of hypertension. This review explores the role of T cells in the pathophysiology of hypertension and discusses potential therapeutic strategies targeting T cell regulation, such as immunotherapy and gene-editing technologies. These emerging treatments hold promise for providing personalized therapeutic options for hypertensive patients, reducing inflammatory complications, and improving treatment outcomes.

OBJECTIVE:This study aims to examine the prevalence of elevated blood pressure (BP) among adolescents aged 13-17 years in Shiyan city, Hubei province, China. Additionally, it analyses the distribution characteristics and potential factors influencing elevated BP, providing a scientific foundation for the prevention and management of hypertension in adolescents. DESIGN:Cross-sectional study. SETTING:A total of 11 schools in central China. PARTICIPANTS:From October 2023 to January 2024, a cross-sectional study involving 8534 students aged 13-17 years from 11 schools in central China was conducted. Convenience sampling was used to select participants, and data were collected through questionnaires and medical physical examinations. PRIMARY OUTCOME MEASURES:This study used physiological measurement to assess BP levels, while questionnaire surveys and anthropometric measurements were employed to identify associated factors. RESULTS:The overall detection rate of elevated BP was 22.7% (20.2% for boys and 25.6% for girls). Increased body mass index (BMI) (OR: 1.026, 95% CI: 1.003 to 1.048), neck circumference (OR: 1.099, 95% CI: 1.073 to 1.126) and chest circumference (OR: 1.015, 95% CI: 1.007 to 1.023) were associated with an increased risk of elevated BP. Conversely, longer screen time was linked to a lower risk of elevated BP (OR: 0.961, 95% CI: 0.942 to 0.98). Girls (OR: 1.592, 95% CI: 1.419 to 1.787) were at higher risk than boys. Additionally, not consuming meat or poultry (OR: 2.029, 95% CI: 1.171 to 3.514) was identified as a risk factor for elevated BP. CONCLUSION:The distribution of elevated BP among adolescents exhibited population heterogeneity. Elevated BP was found to be associated with higher BMI, neck circumference and chest circumference, as well as the absence of meat consumption. Additionally, targeted attention to girls is essential for preventing elevated BP.

BACKGROUND:Poor sleep quality is common among Chinese medical students. Identifying its predictors is essential for implementing individualized interventions. However, clinical prediction models targeting sleep quality in this population remain scarce. This study aimed to develop and validate a nomogram to predict poor sleep quality among Chinese medical students. METHODS:A cross-sectional study was used to collect data among Chinese medical students at the Hubei University of Medicine. A total of 2893 medical students were randomly divided into training (70%) and validation (30%) groups. Multivariable Firth logistic regression analysis was performed to examine factors associated with sleep quality. Thereafter, these factors were used to develop a nomogram for predicting sleep quality. The predictive performance was evaluated by receiver operating characteristic curve (ROC) analysis, calibration curve analysis, and decision curve analysis (DCA). RESULTS:A total of 70.4% of medical students in the study reported poor sleep quality. The predictors of sleep quality included grade, gender, self-assessment of interpersonal relationships, and self-assessment of health status. The scores of the nomogram ranged from 0 to 189, and the corresponding risk ranged from 0.50 to 0.95. The calibration curve showed that the nomogram had good classification performance. The area under the curve (AUC) of the ROC for the training group is 0.676, and that for the validation group is 0.702. The DCA demonstrated that the model also had good net benefits. CONCLUSIONS:The nomogram prediction model has sufficient accuracies, good predictive capabilities, and good net benefits. The model can also provide a reference for predicting the sleep quality of medical students.