Relevance Carotid atherosclerosis affects more than one billion people, and the use of statins is sometimes limited by adverse effects. Tongxinluo (TXL) capsule, a standardized 12-herb formula, is widely used for cardiovascular conditions. Objectives This study aimed to systematically evaluate the efficacy, safety, and certainty of evidence for TXL added to statins in patients with carotid atherosclerosis, focusing on vascular remodeling and inflammatory modulation. Materials and methods A systematic search was performed across seven major databases for randomized controlled trials (RCTs) published from January 2000 to June 2025. We prespecified inclusion criteria and designated carotid intima-media thickness (IMT) as the primary outcome. Secondary outcomes included lipid profile parameters, Crouse plaque score, inflammatory biomarkers, and adverse events. All eligible articles were included for further analysis. Results Forty-three RCTs involving 4175 participants were included. Compared with statins alone, TXL plus statin therapy significantly decreased IMT (moderate certainty) and lowered Crouse plaque scores (moderate certainty). The combination therapy also improved lipid profiles, by reducing total cholesterol (TC, moderate certainty), triglycerides (TG, moderate certainty), and low-density lipoprotein cholesterol (LDL-C, moderate certainty), alongside an increase in high-density lipoprotein cholesterol (HDL-C, moderate certainty). Furthermore, levels of interleukin-6 (IL-6, low certainty), tumor necrosis factor-alpha (TNF-α, low certainty), high-sensitivity C-reactive protein (hs-CRP, moderate certainty), and homocysteine (Hcy, low certainty) were significantly lowered. No statistically significant differences were observed in adverse event incidence (low certainty). Conclusion TXL combined with statins appears to improve lipid profiles, attenuate atherosclerotic burden, and enhance anti-inflammatory and antioxidant effects, without increasing adverse events. These findings support TXL as a potentially valuable adjunctive therapy for carotid atherosclerosis, which warrants further confirmation from high-quality, large-scale trials.

Background Cavotricuspid isthmus (CTI) ablation performed using thermal ablation or pentaspline pulsed field ablation (PFA) catheters has demonstrated favorable efficacy and safety. Objective To evaluate the safety, effectiveness, and mid-term outcomes of focal PFA for CTI-dependent atrial flutter. Methods We performed a retrospective analysis of consecutive patients who underwent focal PFA for CTI-dependent AFL between August 2025 and December 2025. The primary endpoints were acute procedural success, periprocedural complications, and recurrence of any documented atrial arrhythmia lasting >30 seconds during follow-up. Results A total of 61 patients underwent CTI ablation with focal PFA. The mean age was 60.4 years, and 36.1% were female. Acute bidirectional conduction block was achieved in all patients (100%), with no cases requiring supplemental radiofrequency ablation to complete the linear lesion. Periprocedural complications included transient ST-segment elevation in 2 patients (3.3%), and PR interval prolongation in 2 patients (3.3%). Over a median 113-day follow-up, 58 (95.1%) of patients remained free from any atrial arrhythmias, with an estimated 180-day event-free survival of 91.9%. Sixty patients (98.4%) did not have typical atrial flutter recurrence, with an estimated 180-day event-free rate of 96.9%. Conclusion Focal pulsed field ablation appears to be a feasible and effective approach for treating CTI-dependent atrial flutter with a satisfactory mid-term outcome. The selection of optimized catheter ablation parameters (bipolar, biphasic, voltage 1800 V, pulse width 10 μs) may help to minimize procedural complication risks. However, larger prospective randomized trials with extended follow-up and systematic monitoring are required to confirm its durable efficacy.

Background : Shexiang Baoxin pill (MUSKARDIA) is a well-known traditional Chinese medicine that has demonstrated protective effects in coronary artery disease (CAD). Purpose : To evaluate MUSKARDIA in patients with stable CAD and reduced estimated glomerular filtration rate (eGFR). Study Design : This was a subgroup analysis of the multicenter, double‑blind, placebo‑controlled phase IV randomized clinical trial (MUST, ChiCTR-TRC-12003513). The MUST trial randomly assigned patients with stable CAD to MUSKARDIA or placebo group in a 1:1 ratio. The primary composite efficacy endpoint was the incidence of major adverse cardiovascular events. The secondary composite efficacy endpoint included all‑cause mortality, non‑fatal MI, non‑fatal stroke, hospitalization for unstable angina or heart failure, and coronary revascularization. Methods This subgroup analysis included patients with reduced baseline eGFR (< 90 ml/min/1.73m²). Results : Among the 1354 participants with reduced baseline eGFR, there were numerical advantages with MUSKARDIA in improving the primary (hazard ratio=0.713; 95% CI: 0.379-1.342; P=0.292) and secondary (hazard ratio=0.840; 95% CI: 0.608-1.161; P=0.290) composite efficacy endpoints. Multivariable adjustment confirmed these benefits. The primary composite efficacy endpoint showed a trend toward a protective effect of MUSKARDIA after 12 months. MUSKARDIA significantly improved the secondary composite efficacy endpoint after 14 months. The profiles of adverse events were comparable between groups. There were no clinically meaningful differences in liver and kidney function indicators. Conclusion Long-term MUSKARDIA shows a protective trend against cardiovascular events in patients with stable CAD and reduced eGFR, and may be a consideration for clinical management.

Introduction Tongxinluo (TXL) capsule, composed of 12 Chinese herbal extracts, is indicated for the treatment of coronary heart disease. This study aimed to elucidate the chemical composition of TXL capsules and uncover their potential mechanisms against atherosclerosis through integrated component profiling, network pharmacology, and experimental validation. Methods TXL constituents were systematically characterized using ultra-performance liquid chromatography-mass spectrometry (UPLC-MS). Network pharmacology was employed to predict therapeutic targets, followed by molecular docking. The anti-inflammatory activities of TXL were evaluated by measuring the inhibition of nitric oxide (NO), interleukin (IL)-6, and tumor necrosis factor (TNF)-α production in lipopolysaccharide (LPS)-induced RAW 264.7 cells. The ability of TXL to reduce oxidative stress was assessed by the nuclear factor erythroid 2-related factor 2 (Nrf2) luciferase and intracellular reactive oxygen species (ROS) assays. Finally, the capacity of TXL extract to restore endothelial cell survival and function was evaluated in human endothelial EA.hy926 cells using cell migration and tube formation assays. Key signaling pathways were validated through Western blotting and immunofluorescence as guided by network pharmacology and molecular docking. Results Based on the 97 active ingredients identified in TXL, network pharmacology revealed 340 compound-disease intersection targets enriched in inflammation, oxidative stress, endothelial dysfunction, and lipid-related pathways with strong binding affinities between major TXL components and core atherosclerosis-related targets. TXL dose-dependently reduced LPS-induced NO, IL-6, TNF-α, and ROS levels. In endothelial cells, TXL attenuated H2O2-induced oxidative injury, restored viability, decreased ROS accumulation, and significantly enhanced migration and tube formation. The molecular mechanisms of TXL were associated with suppression of NF-κB p65 nuclear translocation and activation of the Nrf2-HO-1 axis. Discussion TXL restored endothelial survival and function, which were at least partly attributed to modulation of the NF-κB inflammatory pathway and activation of the Nrf2-HO-1 antioxidant axis to suppress inflammation and oxidative stress. These findings underscore TXL’s potential as a promising adjunctive therapy for the treatment of atherosclerosis.

ObjectiveVentilator-associated pneumonia (VAP) frequently results in difficulties with weaning, high mortality rates, and is often caused by drug-resistant pathogens, emphasizing the critical importance of effective treatment. The efficacy and safety of Tanreqing injection (TRQI) in the treatment of VAP patients have been demonstrated, but further validation is required. The objective of this study is to synthesize the findings of clinical research on TRQI for the treatment of VAP, thereby providing clinical evidence for its effectiveness and importance.MethodsA comprehensive search of eight databases was conducted, covering all records up to 30 August 2024. The data were extracted, quality-assessed, and analyzed rigorously. The methodological quality of the included studies was evaluated using the RoB-2 tool. The statistical analyses were conducted using RevMan 5.4 software, with either a fixed-effect or random-effect model employed as appropriate. The evidence quality of the included literature was evaluated using Grade pro 3.6.1 software.ResultsA total of 20 clinical studies, comprising a total of 1,446 patients, were included in the review. The meta-analysis of these studies demonstrated that TRQI significantly improved inflammatory markers (CRP, PCT, WBC) (P < 0.00001) and reduced the duration of antibiotic use (P < 0.00001). Furthermore, the intervention resulted in a shorter duration of ventilator usage (P < 0.0001), an increased initial weaning success rate (P = 0.001), and a reduction in the length of stay in the intensive care unit (ICU) (P < 0.00001). Furthermore, the TRQI demonstrated superior performance compared to the control group in CPIS (Clinical Pulmonary Infection Score) assessments (P < 0.00001). Meanwhile, the quality of evidence for CRP, PCT, Duration of Antibiotic Use, Duration of Ventilator Use, and Length of ICU Stay is Moderate.ConclusionThis study provides further evidence-based support for the clinical application of TRQI in the treatment of VAP. Additionally, it summarizes previous clinical research through a literature quality assessment, offering insights and recommendations for the design and implementation of future research protocols. The findings indicate that TRQI can improve inflammatory markers and pulmonary infection scores in VAP patients, reduce ventilator dependence, and shorten antibiotic use duration. Moreover, it has a low overall incidence of adverse reactions, demonstrating good efficacy and safety as an adjuvant therapy for VAP. However, some of the included clinical studies had limitations such as small sample sizes, lack of sample size calculations. Therefore, future study designs should be more rigorous to enhance the reliability of findings.Systematic Review Registration:https://inplasy.com/inplasy-2025-2-0008/.

ObjectiveTo evaluate the clinical and preclinical effects of Tongxinluo Capsule (TXL) on acute myocardial infarction (AMI) and to summarize reported mechanisms of action, thereby informing clinical decision-making and future research.MethodsA comprehensive computerized search of eight databases and four clinical trial registries was performed from their inception until 1 April 2025. Data extraction, quality assessment and analysis were conducted in strict accordance with predefined protocols. The methodological quality of included studies was evaluated using the RoB-2 and SYRCLE tools. Statistical analyses were carried out using RevMan 5.4 software, employing fixed-effect or random-effects models as appropriate.ResultsThis review included 54 clinical studies (4,353 patients in trail group; 4,296 patients in control group) and 11 animal studies (95 animals in trail group; 94 animals in control group). Meta-analysis of clinical studies indicated that, compared with control groups, TXL was associated with lower all-cause mortality, cardiovascular mortality, and incidence of myocardial reinfarction (P < 0.05). Compared with control groups, TXL was associated with lower incidence of repeated revascularization, heart failure, angina pectoris, and arrhythmias (P < 0.05). Furthermore, TXL demonstrated greater improvement in cardiac function indicators and vascular endothelial function (P < 0.001), alongside significant reductions in blood lipids levels (TC, TG, HDL-C, LDL-C; P < 0.05) and inflammation markers. TXL was associated with fewer adverse reactions (P = 0.01), primarily gastrointestinal in nature. In animal studies, TXL was correlated with lower myocardial infarction area and the no-reflow area (P < 0.001), higher cardiac function indicators (LVEF and LVFS; P < 0.05) and better vascular endothelial function (P < 0.05) compared to control group. Reported biological mechanisms of TXL include inhibition of apoptosis, suppression of inflammation, protection of cardiomyocytes and endothelial cells, promotion of angiogenesis, and synergistic lipid-lowering and plaque-stabilization effects.ConclusionThis study is the first meta-analysis to integrate both clinical and animal research on TXL for AMI. The finding suggests that TXL may be associated with alterations in left ventricular systolic function and clinical prognosis, potentially mediated through mechanisms such as inhibition of apoptosis, protecting endothelial function, reducing of inflammation, preservation of cardiomyocytes, and promotion of angiogenesis. Limitations of the included studies constrain the strength of these conclusions, and further validation through larger, high-quality randomized controlled trials is warranted.

Heart failure (HF) remains a leading cause of cardiovascular morbidity and mortality globally, affecting over 64 million individuals ( 1). Despite advancements in therapeutic strategies, the heterogeneity of HF symptoms complicates risk stratification and personalized management. Bendopnea, defined as dyspnea occurring within 30 s of forward trunk flexion, has emerged as a potential marker of hemodynamic compromise, yet its clinical significance in large multicenter cohorts remains underexplored. This prospective study enrolled 482 hospitalized HF patients from 2 tertiary care centers, stratifying them into bendopnea (n = 208) and non-bendopnea (n = 274) groups. Our results demonstrated that bendopnea was associated with more severe cardiac dysfunction, including lower left ventricular ejection fraction (LVEF: 38.9% ± 7.6% vs. 42.7% ± 8.1%, P < 0.001), larger left ventricular end-diastolic diameter (LVEDD: 63.8 ± 5.9 mm vs. 59.2 ± 5.6 mm, P < 0.001), and higher NT-proBNP levels (median 1,320.5 ng/L vs. 985.2 ng/L, P < 0.001). Over 1.5 years of follow-up, patients with bendopnea exhibited a significantly higher cumulative incidence of adverse events: HF rehospitalization (35.1% vs. 22.3%, P < 0.001), all-cause mortality (19.7% vs. 12.4%, P = 0.003), and arrhythmias requiring intervention (20.7% vs. 11.7%, P = 0.001). Multivariable Cox regression confirmed bendopnea as an independent predictor of adverse outcomes (HR = 1.6, 95% CI 1.3–2.0, P < 0.001). These findings highlight bendopnea as a clinically actionable marker for risk stratification in HF, supporting its integration into routine clinical practice.

Background: Previous studies have indicated that blood lipids can influence skeletal health. However, limited research exists on the impact of serum apolipoprotein B (ApoB) on bone mineral density (BMD); meanwhile, it remains unclear to what extent cardiovascular disease plays in mediating this process. Methods: Therefore, we conducted a cross-sectional analysis involving 2930 participants from the National Health and Nutrition Examination Survey (NHANES) database to explore the relationship between serum ApoB and total body BMD (TB-BMD) and lumbar spine BMD (LS-BMD). We employed a two-step, two-sample Mendelian randomization (MR) analysis using genetic instruments to investigate causality and assess the mediating effects of six cardiovascular diseases. Results: Multivariable linear regression models demonstrated an inverse linear association between serum ApoB and TB-BMD (β = –0.26, 95% confidence interval (CI): –0.41 to –0.12, p < 0.001; p for non-linearity = 0.771) and LS-BMD (β = –0.53, 95% CI: –0.75 to –0.31, p < 0.001; p for non-linearity = 0.164). The primary analysis utilized the multiplicative random effects inverse variance weighted (IVW-MRE) method for the two-sample MR analysis. The results demonstrated a causal relationship between serum ApoB with TB-BMD (β = –0.0424, 95% CI: –0.0746 to –0.0103; p = 0.0096) and LS-BMD (β = –0.0806, 95% CI: –0.1384 to –0.0229; p = 0.0062). The two-step MR analysis indicated heart failure as a mediating factor in the causal relationship between serum ApoB and TB-BMD, with a mediation proportion of 18.69%. Conclusions: The results of this study support that lowering serum ApoB levels could enhance BMD while preventing the occurrence of heart failure might reduce the harm caused by the decrease in BMD due to elevated ApoB levels.

Atrial standstill (AS), a rare and diagnostically challenging cardiac disorder with total absence of atrial electrical and mechanical activity, often presents variably, mimicking atrial fibrillation (AF) in electrocardiogram (ECG). This report details a case of AS initially misdiagnosed as AF. A 65-year-old Chinese female had 5-year intermittent palpitations. Prehospital ECG showed paroxysmal AF, and echocardiogram showed a giant atrium. A single-chamber pacemaker (ventricular pacing, ventricular sensing, inhibited) was implanted 6 months ago due to long ventricular intervals. During this hospitalization, AS was confirmed using electrophysiological examination, altering the treatment approach and prognosis. AS is complex and overlooked. Early recognition and proper management are crucial. Accurate diagnosis via echocardiogram and electrophysiological testing is vital for at-risk patients. This case highlights the need for precise test interpretation and comprehensive evaluation for optimal patient care. AS is an infrequently encountered arrhythmia that eludes clear diagnosis using surface ECG. It is characterized by complete atrial electrical and mechanical inactivity, bradycardia, atrioventricular junction escape rhythm, and absence of P waves. Despite its rarity, patients may present with palpitations, syncope, or stroke, warranting diagnostic attention. Acquired AS can result from myocardial infiltrative diseases like amyloidosis, sarcoidosis, and hemochromatosis, as well as infections (viral myocarditis), autoimmune disorders, and certain medications. Here, we present a case of AS potentially due to long-term AF.

BACKGROUND:Atrial standstill (AS), a rare and diagnostically challenging cardiac disorder with total absence of atrial electrical and mechanical activity, often presents variably, mimicking atrial fibrillation (AF) in electrocardiogram (ECG). This report details a case of AS initially misdiagnosed as AF. CASE PRESENTATION:A 65-year-old Chinese female had 5-year intermittent palpitations. Prehospital ECG showed paroxysmal AF, and echocardiogram showed a giant atrium. A single-chamber pacemaker (ventricular pacing, ventricular sensing, inhibited) was implanted 6 months ago due to long ventricular intervals. During this hospitalization, AS was confirmed using electrophysiological examination, altering the treatment approach and prognosis. CONCLUSIONS:AS is complex and overlooked. Early recognition and proper management are crucial. Accurate diagnosis via echocardiogram and electrophysiological testing is vital for at-risk patients. This case highlights the need for precise test interpretation and comprehensive evaluation for optimal patient care. AS is an infrequently encountered arrhythmia that eludes clear diagnosis using surface ECG. It is characterized by complete atrial electrical and mechanical inactivity, bradycardia, atrioventricular junction escape rhythm, and absence of P waves. Despite its rarity, patients may present with palpitations, syncope, or stroke, warranting diagnostic attention. Acquired AS can result from myocardial infiltrative diseases like amyloidosis, sarcoidosis, and hemochromatosis, as well as infections (viral myocarditis), autoimmune disorders, and certain medications. Here, we present a case of AS potentially due to long-term AF.

OBJECTIVE:To determine whether a bidirectional causal relationship exists between major depressive disorder (MDD) and heart failure (HF).METHODS:Our two-sample bidirectional Mendelian randomization (MR) study consisted of two parts. In the first part, we conducted a forward MR analysis where MDD was considered as the exposure and HF as the outcome. In the second part, a reverse MR analysis was performed, treating HF as the exposure and MDD as the outcome. Summary data on MDD and HF were obtained from the IEU Open GWAS database.RESULTS:Based on the results of the MR-Egger regression intercept test, there was no evidence of horizontal pleiotropy in this study. Furthermore, the IVW results consistently suggested estimates of causal effect values. The findings revealed that individuals with MDD had a 16.9% increased risk of HF compared to those without MDD (OR = 1.169, 95%CI: 1.044-1.308, P = 0.007). However, there was no evidence to support that HF would increase the risk of MDD (OR = 1.012, 95%CI: 0.932-1.099, P = 0.773). Heterogeneity in SNPs of MDD and HF was observed through the heterogeneity test and funnel plot. Additionally, the leave-one-out method did not identify any instances where a single SNP was biased toward or dependent on causation.CONCLUSION:Our study provides evidence supporting a one-way causal relationship between MDD and HF. Specifically, MDD increases the risk of developing HF. However, our findings did not provide any evidence suggesting that HF increases the risk of developing MDD.

Ischemic heart disease (IHD) can trigger responses from the innate immune system, provoke aseptic inflammatory processes, and result in the recruitment and accumulation of neutrophils. Excessive recruitment of neutrophils is a potential driver of persistent cardiac inflammation. Once recruited, neutrophils are capable of secreting a plethora of inflammatory and chemotactic agents that intensify the inflammatory cascade. Additionally, neutrophils may obstruct microvasculature within the inflamed region, further augmenting myocardial injury in the context of IHD. Immune-related molecules mediate the recruitment process of neutrophils, such as immune receptors and ligands, immune active molecules, and immunocytes. Non-immune-related molecular pathways represented by pro-resolving lipid mediators are also involved in the regulation of NR. Finally, we discuss novel regulating strategies, including targeted intervention, agents, and phytochemical strategies. This review describes in as much detail as possible the upstream molecular mechanism and external intervention strategies for regulating NR, which represents a promising therapeutic avenue for IHD.

BackgroundThis research explores the causal association between circulating inflammatory markers and the development of sciatica, a common and debilitating condition. While previous studies have indicated that inflammation may be a factor in sciatica, but a thorough genetic investigation to determine a cause-and-effect relationship has not yet been carried out. Gaining insight into these interactions may uncover novel treatment targets.MethodsWe utilized data from the OpenGWAS database, incorporating a large European cohort of 484,598 individuals, including 4,549 sciatica patients. Our study focused on 91 distinct circulating inflammatory markers. Genetic variations were employed as instrumental variables (IVs) for these markers. The analysis was conducted using inverse variance weighting (IVW) as the primary method, supplemented by weighted median-based estimation. Validation of the findings was conducted by sensitivity studies, utilizing the R software for statistical computations.ResultsThe analysis revealed that 52 out of the 91 inflammatory markers studied showed a significant causal association with the risk of developing sciatica. Key markers like CCL2, monocyte chemotactic protein-4, and protein S100-A12 demonstrated a positive correlation. In addition, there was no heterogeneity or horizontal pleiotropy in these results. Interestingly, a reverse Mendelian randomization analysis also indicated potential causative effects of sciatica on certain inflammatory markers, notably Fms-related tyrosine kinase 3 ligands.DiscussionThe study provides robust evidence linking specific circulating inflammatory markers with the risk of sciatica, highlighting the role of inflammation in its pathogenesis. These findings could inform future research into targeted treatments and enhance our understanding of the biological mechanisms underlying sciatica.

Glucocorticoids (GC) are crucial in the treatment of rheumatoid arthritis (RA), but discontinuing GC effectively in RA patients poses a significant challenge for rheumatologists. In this two-stage, single-center, non-randomized controlled trial, we investigated the benefits of combining Chinese traditional herbal treatment with csDMARDs to aid GC discontinuation in terms of GC tapering, disease control, and safety. A total of 231 participants were enrolled, of which 150 eligible subjects were included in the first phase and allocated to three groups (control group, treatment group 1, and treatment group 2) based on their willingness to take traditional Chinese medicine and syndrome differentiation, in a 1:1:1 ratio. All groups received basic treatment consisting of methotrexate tablets (10 mg, qw), leflunomide (10 mg, qd), and stratified GC bridging therapy and tapering regimen (The intervention regimen was developed based on rigorous adherence to available evidence). Treatment group 1 received basic treatment combined with Juanbi Granule, while treatment group 2 received basic treatment combined with Yupingfeng Guizhi Decoction Granule. Efficacy was evaluated after a 12-week follow-up, with slightly adjustments to the treatment group based on efficacy and change of syndrome, followed by continued observation until 24 weeks to complete the study. The efficacy evaluation and data analysis were conducted in a blinded manner, including group label concealment, data cleaning, confounder and control regimen analysis, and outcome analysis. This project has received ethical approval from the Ethics Committee of Yunnan Provincial Hospital of Traditional Chinese Medicine (YLZ [2022] Ethical Review No. (006)-01) and has been registered with the China Clinical Trials Registry (Registration number: ChiCTR2300067676, Registered 17 January 2023, https://www.chictr.org.cn/showproj.html?proj=184908). This trial was the first to evaluate the clinical efficacy of combining Chinese herbal medicines with standard Western medicines to facilitate the discontinuation of glucocorticoid (GC) therapy in patients with rheumatoid arthritis (RA).

Chronic Obstructive Pulmonary Disease (COPD) significantly impacts individuals’ quality of life (QoL), particularly in regions with high prevalence rates like China, where environmental and lifestyle factors contribute to disease severity. Traditional management focuses on pharmacological treatments, but the potential of adaptive aerobic exercise to enhance QoL and physical health in COPD patients remains underexplored. This study aimed to assess the effectiveness of an adaptive aerobic exercise program tailored to individual patient capabilities and limitations in improving QoL and physical health parameters among COPD patients in China. A quasi-experimental study design was implemented, involving COPD patients from multiple healthcare centers across China. Participants were divided into two groups: the intervention group, which participated in a 12-week adaptive aerobic exercise program, and the control group, which received standard care. Primary outcome measures included QoL changes, assessed by the COPD Assessment Test (CAT) and the St. George’s Respiratory Questionnaire (SGRQ), and physical health improvements, measured by the six-minute walk test (6MWT) and spirometry (FEV1 and FVC). Secondary outcomes focused on exercise adherence, self-reported symptom changes, and healthcare utilization. The intervention group showed significant improvements in QoL, evidenced by reduced CAT scores and improved SGRQ outcomes, particularly in the domains of symptoms and activity level. Physical health also significantly improved, with increased 6MWT distances and enhanced spirometric measures indicating better lung function. High adherence rates (over 80%) and reduced self-reported exacerbations, along with decreased healthcare service needs, were observed in the exercise group. Adaptive aerobic exercise significantly improves the quality of life and physical health of COPD patients in China, demonstrating the value of integrating tailored physical activity interventions into COPD management strategies. The program’s high adherence rates and the observed decrease in healthcare utilization underscore its potential to be a viable, cost-effective addition to standard COPD care.

目的 探究植物雌激素(PE)在心血管领域的研究热点、前沿及未来研究趋势.方法 在Web of Science Core Collection(WoSCC)数据库中检索相关文献,以纯文本的格式导出检索文献的全记录与引用的参考文献,运用CiteSpace V对这些文献的国家、机构、作者、学科领域、共被引文献、关键词、聚类、突发词进行可视化分析.结果 1048篇文献由个74国家(地区)、1329个机构、5207例作者完成.发文量最多的国家和机构分别是美国和中国医学科学院,中国的陈裕明与意大利的Alessandra Bitto为最具生产力的作者.饮食与营养学、药理学、内分泌代谢学与心脏病学为该领域的主要学科.大豆异黄酮、金雀异黄素、绝经后女性、心血管疾病、冠心病、动脉粥样硬化、血压等为高频关键词,NFκB、炎症、凋亡、多酚、胰岛素抵抗等为突现词.结论 PE在心血管领域的研究涉及多国家、多机构、多学科的多位学者,本研究分析得到了目前该领域的研究热点和未来的研究趋势.未来仍需要更多的随机双盲对照试验及系统评价来探索PE对心血管系统的影响.

目的:探索中医药在高脂血症领域 2000年以来的研究情况及趋势,对相关文献进行计量、共现及可视化分析.方法:检索中国知网(CNKI)学术期刊数据库 2000年 1月—2022年 9月中医药治疗高脂血症的相关文献,将纳入文献导入 CiteSpace软件,分析发文量情况,对作者和机构进行共现分析,对关键词进行共现分析、聚类分析和突现分析.结果:2000年以来,中医药在高脂血症领域研究的发文量总体呈上升趋势.中医药在高脂血症领域存在大量分散作者,也存在较为稳定且高产的研究团队,但研究机构较分散.热点关键词形成了 12个聚类.近 5年来,总结类文献关键词突现.结论:医学研究者在高脂血症的中医药防治方面开展了许多相关研究,取得了一定的成果,研究者及其团队之间仍需加强合作,把握方向,进一步研究以获得更多有效对策.

OBJECTIVE:To explore the cardioprotective effects of astragaloside IV (AS-IV) in heart failure (HF).METHODS:PubMed, Excerpta Medica Database (EMBASE), Cochrane Library, Web of Science, Wanfang Database, Chinese Bio-medical Literature and Retrieval System (SinoMed), China Science and Technology Journal Database (VIP), and China National Knowledge Infrastructure (CNKI) were searched from inception to November 1, 2021 for animal experiments to explore AS-IV in treating HF in rats or mice. The left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic dimension (LVESD), left ventricular weight-to-body weight (LVW/BW) and B-type brain natriuretic peptide (BNP) were recorded. The qualities of included studies were assessed by the risk of bias according to the Cochrane handbook. Meta-analysis was performed using Stata 13.0.RESULTS:Twenty-one articles involving 558 animals were considered. Compared with the control group, AS-IV improved cardiac function, specifically by increasing LVEF (mean difference (MD)=6.97, 95% confidence interval (CI)=5.92 to 8.03, P<0.05; fixed effects model) and LVFS (MD=7.01, 95% CI=5.84 to 8.81, P<0.05; fixed effects model), and decreasing LVEDD (MD=-4.24, 95% CI=-4.74 to -3.76, P<0.05; random effects model) and LVESD (MD=-4.18, 95% CI=-5.26 to -3.10, P<0.05; fixed effects model). In addition, the BNP and LVW/BW levels were decreased in the AS-IV treatment group (MD=-9.18, 95% CI=-14.13 to -4.22, P<0.05; random effects model; MD=-1.91, 95% CI=-2.42 to -1.39, P<0.05; random effects model).CONCLUSIONS:AS-IV is a promising therapeutic agent for HF. However, this conclusion needs to be clinically validated in the future.

ObjectiveTo use CiteSpace and VOSviewer visual metrology to analyze the research status, frontier hotspots, and trends in research on atrial myxoma.MethodsThe Web of Science core collection database was used to retrieve relevant literature on atrial myxoma from 2001 to 2022. CiteSpace software was used to analyze keywords with a co-occurrence network, co-polymerization class, and burst terms, and a corresponding visual atlas was drawn for analysis.ResultsA total of 893 valid articles were included. The country with the highest number of articles was the United States (n = 186). The organization with the highest number of articles was the Mayo Clinic (n = 15). The author with the highest number of articles was Yuan SM (n = 12). The highest cited author was Reynen K (n = 312). The highest cited journal was Annals of Thoracic Surgery (n = 1,067). The most frequently cited literature was published in the New England Journal of Medicine in 1995, which was cited 233 times. The keywords co-occurrence, copolymerization analysis, and Burst analysis revealed that the main research focuses were surgical methods, case reports, and genetic and molecular level studies on the pathogenesis of myxoma.ConclusionsThis bibliometric analysis revealed that the main research topics and hotspots in atrial myxoma included surgical methods, case reports, genetic and molecular studies.

Migraine is one of the most prevalent and disabling neurological disease, but the current pharmacotherapies show limited efficacy and often accompanied by adverse effects. Acupuncture is a promising complementary therapy, but further clinical evidence is needed. The influence of acupuncture on migraine is not an immediate effect, and its mechanism remains unclear. This study aims to provide further clinical evidence for the anti-migraine effects of acupuncture and explore the mechanism involved. A randomized controlled trial was performed among 10 normal controls and 38 migraineurs. The migraineurs were divided into blank control, sham acupuncture, and acupuncture groups. Patients were subjected to two courses of treatment, and each treatment lasted for 5 days, with an interval of 1 day between the two courses. The effectiveness of treatment was evaluated using pain questionnaire. The functional magnetic resonance imaging (fMRI) data were analyzed for investigating brain changes induced by treatments. Blood plasma was collected for metabolomics and proteomics studies. Correlation and mediation analyses were performed to investigate the interaction between clinical, fMRI and omics changes. Results showed that acupuncture effectively relieved migraine symptoms in a way different from sham acupuncture in terms of curative effect, affected brain regions, and signaling pathways. The anti-migraine mechanism involves a complex network related to the regulation of the response to hypoxic stress, reversal of brain energy imbalance, and regulation of inflammation. The brain regions of migraineurs affected by acupuncture include the lingual gyrus, default mode network, and cerebellum. The effect of acupuncture on patients' metabolites/proteins may precede that of the brain.