BackgroundThe history of traditional Chinese medicine is extensive and well-documented. Various traditional Chinese medicine injections (TCMIs) with heat-clearing and detoxifying properties, developed from classical ancient prescriptions, have been widely used in the treatment of viral pneumonia. To evaluate the efficacy and safety of various heat-clearing and detoxifying TCMIs for the treatment of viral pneumonia through a network meta-analysis.MethodsWe searched eight databases to identify randomized controlled trials (RCTs) that examined heat-clearing and detoxifying TCMIs combined with conventional medicine (CM) for the treatment of viral pneumonia, published until 12 December 2025. We used R software for the Bayesian network meta-analysis.ResultsOur study included 83 RCTs with a total sample size of 8,678 participants, representing seven different types of heat-clearing and detoxifying TCMIs: Reduning Injection (RDN), Xiyanping Injection (XYP), Yanhuning Injection (YHN), Tanreqing Injection (TRQ), Xuebijing Injection (XBJ), Shuanghuanglian Injection (SHL), and Qingkailing Injection (QKL). RDN + CM was the most effective treatment for shortening cough disappearance and hospitalization time, reducing interleukin-6 level, and increasing the cluster of differentiation 4/cluster of differentiation 8 ratio. Additionally, RDN + CM also showed a significant reduction in adverse events compared to CM. QKL + CM demonstrated the best results in improving the total clinical efficacy rate, shortening antipyretic time, and decreasing the duration of lung rales. Meanwhile, YHN + CM proved most effective at alleviating asthma, while also reducing levels of tumor necrosis factor alpha and high-sensitivity C-reactive protein.ConclusionPatients with viral pneumonia benefit significantly from the use of heat-clearing and detoxifying TCMIs along with CM. Based on patient outcomes, RDN shows considerable promise and may be the preferred choice of TCMIs for the treatment of viral pneumonia.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024610013.

Menkes disease is a rare X-linked recessive multisystem copper metabolism disorder first reported in 1962.Recent studies have shown that its incidence and mortality rates may be underestimated due to miscarriages and early deaths.The clinical manifestations of Menkes disease are closely related to copper metabolism disorder，mainly characterized by neurodegeneration and vascular and connective tissue abnormalities.These symptoms stem from copper transport disorders and abnormal activity of copper-dependent enzymes caused by copper metabolism disorder.By integrating clinical symptoms and mechanism analysis，this paper reveals the core role of copper metabolism disorder in the multisystem damage of Menkes disease，providing a theoretical basis for early diagnosis and intervention.

Objective:To observe the efficacy and safety of Shengqing Jiangzhuo (raising the clear and lowering the turbid) acupuncture method for sepsis-associated gastrointestinal dysfunction, and to preliminarily explore its mechanism. Methods:Ninety-six patients with sepsis-associated gastrointestinal dysfunction were randomly divided into an observation group (48 cases, 1 case dropped out) and a control group (48 cases, 5 cases dropped out). The observation group was treated with Shengqing Jiangzhuo acupuncture method on the basis of conventional western medical treatment, with acupoints including bilateral Zusanli (ST36), Neiguan (PC6), and Taichong (LR3), once daily for 7 days. The control group was treated with sham acupuncture on the basis of conventional western medical treatment, with corresponding non-acupoints, once daily for 7 days. Acute gastrointestinal injury ultrasonography score (AGIUS) was assessed before treatment and after 1, 3, and 7 days of treatment. Gastric residual volume (GRV) and incidence of feeding intolerance on days 1, 3, and 7 after initiation of enteral nutrition, daily caloric intake on days 1 and 3, and time required to reach target caloric intake were recorded.Peripheral blood inflammatory indexes [interleukin (IL)-10, IL-6, tumor necrosis factor-α (TNF-α), IL-17A, systemic immune- inflammation index (SII), white blood cell count (WBC), and procalcitonin (PCT)] and sequential organ failure assessment (SOFA) score were measured before and after treatment. The 28-day mortality and adverse events were recorded. Results:After 1 day of treatment, AGIUS in the observation group was lower than that before treatment (P<0.001). After 3 and 7 days of treatment, AGIUS in both groups were lower than those before treatment and after 1 day of treatment (P<0.001). After 7 days of treatment, AGIUS in the observation group was lower than that after 3 days of treatment (P<0.001). After 1, 3, and 7 days of treatment, AGIUS in the observation group were lower than those in the control group (P<0.001). On days 3 and 7 after initiation of enteral nutrition, GRV in both groups was lower than that on day 1 (P<0.001),and GRV on day 7 was lower than that on day 3 (P<0.001); GRV in the observation group at all time points was lower than that in the control group (P<0.001). On days 1 and 3 after initiation of enteral nutrition, the incidence of feeding intolerance in the observation group was lower than that in the control group (P<0.001, P<0.01), and daily caloric intake was higher than that in the control group (P<0.05, P<0.01). The time required to reach target caloric intake in the observation group was shorter than that in the control group (P<0.05). After treatment, SOFA scores in both groups were lower than those before treatment (P<0.001), and SOFA score in the observation group was lower than that in the control group (P<0.001). There was no statistically significant difference in 28-day mortality between the two groups (P>0.05).After treatment, the levels of IL-6, TNF-α, IL-17A, SII, WBC, and PCT in the observation group were lower than those before treatment (P<0.05), and IL-10 level was higher than that before treatment (P<0.05); in the control group, IL-6 and WBC levels were lower than those before treatment (P<0.05), and IL-10 level was higher than that before treatment(P<0.05). After treatment, except for IL-10, other inflammatory indexes in the observation group were lower than those in the control group (P<0.01, P<0.05). No adverse events related to acupuncture treatment or operation occurred in either group. Conclusion:Shengqing Jiangzhuo acupuncture method can improve gastrointestinal function in patients with sepsis-associated gastrointestinal dysfunction, reduce the risk of early feeding intolerance. Its mechanism may be related to alleviating inflammatory response.

Background:Alzheimer's disease (AD) poses a significant public health challenge to China's aging population. Patients and their families increasingly turn to short-video platforms such as Douyin and Bilibili for information. However, there is currently a lack of systematic analysis regarding the quality and reliability of advertising content on these platforms, creating a critical gap in understanding this emerging information ecosystem. Aim:Systematically evaluate the quality and reliability of videos on Douyin and Bilibili, analyzing the relationship between content themes, upload sources, and user engagement metrics. Methods:Using "Alzheimer's disease" as the keyword, we retrieved the top 100 videos from multiple platforms. Videos were categorized by uploader type and content. Two qualified researchers assessed their reliability and quality using the JAMA, the modified DISCERN instrument (mDISCERN), and Global Quality Score (GQS) scale. Data analysis employed nonparametric statistical methods. Apply relevance and logistic regression analysis to discuss factors that may influence video quality. Results:This study analyzed a total of 171 videos. Results indicate that compared to Douyin, videos on the Bilibili platform scored higher across multiple quality evaluation metrics (GQS: 2.0(1.0-2.0) vs 1.0(1.0-2.0); mDISCERN: 2.0(2.0-2.0) vs. 2.0(2.0-2.0); JAMA: 2.0(1.0-2.0) vs. 1.0 (1.0-2.0); p < 0.001). This disparity may be attributed to Bilibili's longer video format, which allows for more in-depth content, and its user base that tends to favor detailed, knowledge-oriented media. Regarding uploader identity, videos posted by professionals (e.g. physicians) demonstrated superior quality compared to nonprofessional sources (e.g. patients). However, patient-uploaded videos exhibited stronger engagement metrics (e.g. likes, comments). Content-wise, videos focusing on disease prevention and treatment consistently achieved the highest overall quality (all comparisons p < 0.05). Correlation analysis indicated that while interaction metrics showed strong internal correlations, they did not significantly correlate with JAMA, mDISCERN, or GQS scores. Ordered logistic regression analysis indicates that uploader identity, content classification, and presentation format are the three key factors influencing video quality. Conclusion:This study reveals a pronounced "quality-dissemination paradox" in AD content across mainstream short-video platforms: While scientifically rigorous content published by medical professionals receives high quality ratings, it significantly underperforms in user engagement metrics compared to nonprofessional content centered on patient narratives and lived experiences. This highlights a severe disconnect between scientific rigor and public participation within algorithmic dissemination ecosystems. To address this, platforms should optimize algorithms to enhance the visibility of authoritative content, encourage collaboration between professional and nonprofessional creators to boost content appeal, and strengthen health media literacy education for the public-particularly older adults-to improve their ability to discern information.

This review highlights the crucial role of pericytes in sepsis-induced vascular barrier dysfunction and proposes pericytes as a potential therapeutic target. Research shows that the loss of pericytes is closely associated with increased microvascular permeability, abnormal microcirculation, and multi-organ dysfunction in sepsis. Interventions such as activation of the Ang/Tie2 pathway, VEGF inhibition, PDGF-B signaling modulation, and MSC-derived exosomes may effectively restore microvascular stability and alleviate organ damage related to sepsis. The article further explores the integration of cutting-edge technologies such as single-cell genomics and proteomics to precisely identify pericyte function and therapeutic targets, providing new directions and innovative strategies for sepsis treatment. Background Pericytes are mural cells embedded in the vascular basement membrane and form an integral part of the microvascular structure. Through close interactions with endothelial cells, they participate in vascular remodeling, maintenance of barrier integrity, regulation of capillary blood flow, and protection of the central nervous system. Relevant studies have increasingly emphasized the role of pericytes in sepsis-associated microcirculatory dysfunction, suggesting new directions for therapeutic intervention. This review outlines the biological features of pericytes and their contribution to sepsis-related vascular pathology, with particular attention to mechanisms by which pericytes mediate organ injury. By highlighting key signaling pathways and processes involved in pericyte-driven vascular barrier disruption, we suggest that targeting pericytes may offer a potential strategy for the treatment of sepsis.

Background The complete cell count (CBC) is a fundamental diagnostic tool in clinical practice and is essential for screening and managing diseases such as anemia, infections, and malignant blood disorders. In China, a rapidly aging population and a growing burden of chronic diseases have increased the demand for accessible health knowledge resources. Short videos have now become a popular channel for medical information dissemination. Therefore, this study aimed to assess the overall quality and credibility of videos about CBC in China. Objective The aim of this study was to assess the information quality of CBC-related videos on short video sharing platforms in China. Methods We searched for short videos that popularize the main knowledge of CBC posted on three short video platforms in China that are currently accessed with a large amount of information: Douyin, Bilibili, and Rednote. A total of 242 relevant videos were retrieved, and we collected, processed, and analyzed the authors and basic information of all videos. The quality and reliability of their contents were assessed by using the Global Quality Score scale, the Modified DISCERN Medical Video Quality Evaluation Tool. Subsequently, short video platforms as well as video publishers were analyzed and compared descriptively as a whole. Potential correlations between general video information and video quality and reliability were analyzed by Spearman's correlation coefficient. Results The quality of online videos provided by short video platforms showed a moderate level of quality (just 49.5% met the high-quality level criterion), and the completeness of their content, as well as their reliability was average (only 28.9% of videos met the reliability criterion). Further results on group comparisons showed that videos from healthcare professionals were better than those from non-healthcare professionals in terms of content comprehensiveness, reliability, and quality. Additionally, we observed a positive correlation between the production length of the video and video quality; however, there was no significant correlation between video likes and comments, etc., and video quality. Conclusion The results of this study suggest that the overall quality and reliability of short videos about CBC-related content in current short video platforms are still significantly deficient. It is recommended that viewers should treat this content with caution. Among them, videos posted from medical personnel are more instructive. Nevertheless, video-based popularization of medical knowledge still holds promise. The overall quality and reliability of medical information shared on short video platforms can be improved by implementing appropriate strategies.

Membranous nephropathy (MN) and IgA nephropathy (IgAN) pose challenges in clinical treatment with existing therapies primarily focusing on symptom relief and often yielding unsatisfactory outcomes. The search for novel drug targets remains crucial to address the shortcomings in managing both kidney diseases. Utilizing GWAS data for MN (ncase = 2150, ncontrol = 5829) and IgAN (ncase = 15587, ncontrol = 462197), instrumental variables for plasma proteins were derived from recent GWAS. Sensitivity analysis involved bidirectional Mendelian randomization analysis, MR Steiger, Bayesian co-localization, and Phenotype scanning. The SMR analysis using eQTL data from the eQTLGen Consortium was conducted to assess the availability of selected protein targets. The PPI network was constructed to reveal potential associations with existing drug treatment targets. The study, subjected to the stringent Bonferroni correction, revealed significant associations: four proteins with MN and three proteins with IgAN. In plasma protein cis-pQTL data from two cohorts, an increase in one standard deviation in PLA2R1 (OR = 2.01, 95

ObjectiveThe objective of this study was to investigate the impact of electro-acupuncture (EA) on sepsis-related intestinal injury and its relationship with macrophage polarization.MethodsA sepsis model was established using cecal ligation and puncture (CLP) to assess the effectiveness of EA. The extent of pathological injury was evaluated using Chiu’s score, the expression of ZO-1 and Ocludin, and the impact on macrophage polarization was examined through flow cytometry and immunofluorescence staining. The expression of spermidine, one type of polyamine, and ornithine decarboxylase (ODC) was measured using ELISA and PCR. Once the efficacy was determined, a polyamine depletion model was created, and the role of polyamines was reassessed by evaluating efficacy and observing macrophage polarization.ResultsEA treatment reduced the Chiu’s score and increased the expression of ZO-1 and Ocludin in the intestinal tissue of septic mice. It inhibited the secretion of IL-1β and TNF-α, promoted the polarization of M2-type macrophages, increased the secretion of IL-10, and upregulated the expression of Arg-1, spermidine, and ODC. However, after depleting polyamines, the beneficial effects of EA on alleviating intestinal tissue damage and modulating macrophage polarization disappeared.ConclusionThe mechanism underlying the alleviation of intestinal injury associated with CLP-induced sepsis by EA involves with the promotion of M2-type macrophage polarization mediated by spermidine expression.

Background: Cardiogenic shock (CS) is the primary cause of death in patients suffering acute myocardial infarction. As an emerging and efficacious therapeutic approach, Chinese herbal injections (CHIs) are gaining significant popularity in China. However, the optimal CHIs for treating CS remain uncertain.Method: We searched eight databases from inception to 30 September 2023. Subsequently, we conducted the Bayesian network meta-analysis (NMA). Interventions were ranked based on the surface under the cumulative ranking curve (SUCRA) probability values. To compare the effects of CHIs on two distinct outcomes, a clustering analysis was performed. Furthermore, the quality of the studies was assessed.Results: For the study, we included 43 RCTs, encompassing 2,707 participants. The study evaluated six herbal injections, namely, Shenfu injection (SF), Shengmai injection (SM), Shenmai injection (Sm), Danshen injection (DS), Huangqi injection (HQ), and Xinmailong injection (XML). The analysis findings suggested that Sm (MD = −1.05, 95% CI: −2.10, −0.09) and SF (MD = −0.81, 95% CI: −1.40, −0.25) showed better efficacy compared to Western medicine (WM) alone in reducing in-hospital mortality. The SUCRA values revealed that Sm + WM ranked first in terms of in-hospital mortality, cardiac index (CI), and hourly urine output but second in improving left ventricular ejection fraction (LVEF) and mean arterial pressure (MAP). SF + WM, however, had the greatest impact on raising the clinical effective rate. In MAP, SM + WM came out on top. Moreover, in terms of safety, only 14 studies (31.8%), including five types of CHIs: SF, Sm, SM, HQ, and XML, observed adverse drug reactions.Conclusion: To summarize, this analysis discovered that, in terms of patients suffering from CS, CHIs + WM yielded significantly greater advantages than WM alone. Based on in-hospital mortality and the remaining outcomes, Sm performed excellently among all the involved CHIs.Systematic Review Registration: https://www.Crd.york.ac.uk/prospero/, identifier: CRD42022347053.

Background Observational studies show that patients with chronic obstructive pulmonary disease (COPD) tend to be sedentary during leisure time. Physical activity (PA) may reduce the risk of COPD, but the causal relationship is unclear. We used a Mendelian randomisation (MR) method to elucidate the association of leisure sedentary behaviours (LSB) and PA with lung function and COPD.Methods Data on LSB (n=422 218), PA (n=608 595), COPD (n=299 929) and lung function (n=79 055) were obtained from the large-scale genome-wide association study. Causal inference used inverse variance-weighted, MR-Egger and weighted median. Sensitivity analysis was performed to assess heterogeneity and pleiotropy, and radial MR was used to distinguish outliers. The primary outcome was analysed by multifactorial MR adjusted for daily smoking.Results The inverse variance weighted analysis indicated that increased moderate-to-vigorous PA (MVPA) is associated with higher levels of forced vital capacity (FVC) (beta=0.27, 95% CI 0.12 to 0.42; p=3.51×10–4). For each increment of 2.8 hours in television watching, the odds of COPD were 2.25 times greater (OR=2.25; 95% CI 1.84 to 2.75; p=2.38×10–15). For early-onset COPD, the odds were 2.11 times greater (OR=2.11; 95% CI 1.56 to 2.85; p=1.06×10–6), and for late-onset COPD, the odds were 2.16 times greater (OR=2.16; 95% CI 1.64 to 2.84; p=3.12×10–8). Similarly, the odds of hospitalisation for COPD were 2.02 times greater with increased television watching (OR=2.02; 95% CI 1.59 to 2.55; p=4.68×10–9). Television watching was associated with lower FVC (beta=−0.19, 95% CI −0.28 to −0.10; p=1.54×10–5) and forced expiratory volume in the 1 s (FEV1) (beta=−0.16, 95% CI −0.25 to −0.08; p=1.21×10–4) levels. The results remained significant after adjustment for smoking.Conclusions Our study suggests a potential association with LSB, particularly television watching, is associated with higher odds of COPD and lower indices of lung function as measured continuously, including FEV1 and FVC. Conversely, an increase in MVPA is associated with higher indices of lung function, particularly reflected in increased FVC levels.

Federated learning (FL) has emerged as a significant method for developing machine learning models across multiple devices without centralized data collection. Candidemia, a critical but rare disease in ICUs, poses challenges in early detection and treatment. The goal of this study is to develop a privacy-preserving federated learning framework for predicting candidemia in ICU patients. This approach aims to enhance the accuracy of antifungal drug prescriptions and patient outcomes. This study involved the creation of four predictive FL models for candidemia using data from ICU patients across three hospitals in China. The models were designed to prioritize patient privacy while aggregating learnings across different sites. A unique ensemble feature selection strategy was implemented, combining the strengths of XGBoost’s feature importance and statistical test p values. This strategy aimed to optimize the selection of relevant features for accurate predictions. The federated learning models demonstrated significant improvements over locally trained models, with a 9% increase in the area under the curve (AUC) and a 24% rise in true positive ratio (TPR). Notably, the FL models excelled in the combined TPR + TNR metric, which is critical for feature selection in candidemia prediction. The ensemble feature selection method proved more efficient than previous approaches, achieving comparable performance. The study successfully developed a set of federated learning models that significantly enhance the prediction of candidemia in ICU patients. By leveraging a novel feature selection method and maintaining patient privacy, the models provide a robust framework for improved clinical decision-making in the treatment of candidemia.

ObjectiveThis study aimed to investigate the relationship between the dose and efficacy of acupuncture in treating limb dysfunction during acute stroke.MethodsStudies were searched from seven databases, including PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Wanfang Data (WF), VIP information database (VIP), and China Biology Medicine Database (CBM). All databases were searched until August 1, 2023 from inception. The risk of bias was assessed using Cochrane Collaboration’s risk of bias tool (RoB2). Meta-analyses were performed using RevMan V.5.4 and Stata 12.0 statistical software. We used Fugl-Meyer Assessment (FMA) to measure recovery of limb dysfunction, NIH Stroke Scale (NIHSS) to measure neurological deficits, and Barthel index, Modified Barthel Index (MBI), and Activities of Daily Living (ADL) to measure activities of daily living. The primary outcome measure is FMA. After examining and integrating the raw data, we performed a meta-analysis using a 3-step process. First, we investigated the dose-related effects of acupuncture at varying doses and determined the optimal dosage for maximum therapeutic benefits. Second, we determined the difference between post-intervention and baseline scores on the outcomes of interest to determine minimal clinically important differences (MCID) to provide evidence for clinical treatment. Third, by combining the results of step 1 and step 2, we made the recommendations employing the Grades of Recommendations, Assessment, Development and Evaluations (GRADE) tool.ResultsTwenty-six studies containing 1947 participants were included, among which 61.5% of RCTs had a low risk of bias. Through the three-step analysis, the effect in improving limb dysfunction of acute stroke varied across different acupuncture dosages. Regarding the frequency of acupuncture, the results demonstrated a significant improvement in the low (every other day) and moderate-frequency (once a day) groups (low frequency: MD: 9.02, 95%CI: 5.40–12.64, p < 0.00001; moderate frequency: MD: 10.11, 95%CI: 5.05–15.18, p < 0.00001, heterogeneity (p = 0.87), I2 = 0%). For the acupuncture retention time, the results showed no significant difference between the short and medium retention groups (short retention time: MD: 0.05, 95% CI: −0.21–0.31, p = 0.71; medium retention time: MD: −1.16, 95% CI: −2.80–0.48, p = 0.17, heterogeneity (p < 0.00001), I2 = 99%). For the course of acupuncture, the results showed a significant improvement in the short course treatment (less than 2 weeks) group (MD: 14.87, 95% CI: 12.18–17.56, p < 0.00001, heterogeneity (p = 0.45), I2 = 0%).ConclusionOur study demonstrated the effectiveness of different acupuncture dose in improving limb dysfunction. The pooled data suggested that the optimal intervention dose for acupuncture interval time was low (every other day) and moderate frequency (once a day), the optimal intervention dose for needle course time was short course treatment (less than 2 weeks). But we did not find the optimal intervention dose for needle retention time. Future studies of higher quality are needed to confirm this.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, CRD42023447202.

BACKGROUND:Recent studies have highlighted a connection between gut microbiota and hypertension, yet the precise nature of this relationship remains unclear. OBJECTIVE:This research aims to analyze the causal link between gut microbiota and hypertension, along with associated complications, utilizing two-sample bidirectional Mendelian randomization (MR). MATERIALS AND METHODS:Summary data from genome-wide association studies (GWAS) meta-analyses, including gut microbiota GWAS data from 24 cohorts, and the latest GWAS data for hypertension-related conditions were acquired. Employing various MR methods, including Inverse-variance weighted (IVW), MR-Egger, Weighted Median, Simple Mode, and Weighted Mode, we investigated the association between gut microbiota and hypertension-related conditions. Sensitivity analyses were conducted for result stability, and reverse MR analysis assessed the potential for reverse causality. RESULTS:The Mendelian randomization analysis involving 199 microbial taxa and four phenotypes identified 46 microbial taxa with potential causal links to hypertension and its complications. Following Bonferroni correction, genus.Victivallis showed a robust causal relationship with hypertension (OR = 1.08, 95% CI = 1.04-1.12, P = 9.82e-5). This suggests an 8% increased risk of hypertension with each unit rise in genus.Victivallis abundance. CONCLUSION:In conclusion, this study establishes a causal connection between gut microbiota and hypertension, along with common associated complications. The findings unveil potential targets and evidence for future hypertension and complication treatment through gut microbiota interventions, offering a novel avenue for therapeutic exploration.

Background: Rotavirus enteritis (RVE) accounts for 37% of all death in children ( < 5 years) with diarrhea. Chinese herbal injections (CHIs) have drawn more attention from practitioners because of the valid effects for RVE. However, the most beneficial one has not yet been determined.Methods: Eight databases were searched from their inception up to September 3rd, 2022. The primary outcome was clinical effective rate and the secondary outcomes were time for disappearance of diarrhea, time of defervescence, time for disappearance of vomiting, and adverse drug reactions or adverse drug events. OpenBUGS 3.2.3 and STATA 14.0 software were employed to carry out the NMA. Results: 58 randomized controlled trials (RCTs) with 6436 child patients were included in this Bayesian NMA. Four CHIs were investigated including Yanhuning injection (YHN), Xiyanping injection (XYP), Re-duning injection (RDN), and Zedoary Turmeric Oil injection (ZTO). The results showed that YHN [OR = 6.16, 95% CI (4.39, 8.77)] had a superior effect in improving clinical effective rate compared to Ribavirin based on Western medicine (WM). According to SUCRA values, YHN (84.1%) ranked highest. As for the sec-ondary outcomes, XYP was the better intervention in shortening the time for disappearance of diarrhea. Regarding time for defervescence, RDN had obvious advantages and also performed well in time for dis-appearance of vomiting.Conclusion: CHIs combined with WM could be beneficial than Ribavirin in improving clinical effective rate, and YHN was the optimum treatment. From the comprehensive evaluations of both the clinical effective rate and other outcomes, YHN also indicated a favorable therapeutic effect in RVE. Study registration: PROSPERO, CRD42022357149.(c) 2023 Korea Institute of Oriental Medicine. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )

Abstract BACKGROUND A large number of observational studies have now shown that a decrease in the estimated glomerular filtration rate (eGFR) is associated with an increased risk of cardiovascular disease. However, there are no uniform conclusions regarding the potential relationship between the estimated glomerular filtration rate and cardiovascular disease. We will explore the causal relationship between estimated glomerular filtration rate and cardiovascular disease for the first time using a two-sample Mendelian randomization analysis. METHODS We first identified genetic tools for estimating glomerular filtration rate from a genome-wide association study (GWAS). We performed a two-sample analysis of different cardiovascular outcome events using MR analysis with inverse variance weighting, weighted median, MR- PRESSO, MR- Egger, and leave-one-out methods. RESULTS The findings showed weak evidence of a potential causal relationship between reduced estimated glomerular filtration rate and heart failure (HF), with IVW results suggesting critical statistical significance (OR = 1.009,95%CI = 1.003–1.015, p = 0.003). In estimating glomerular filtration rate and coronary artery disease (CAD) (OR = 1.006,95%CI = 0.998–1.013, p = 0.14), estimated glomerular filtration rate and cardiovascular disease (CVD) (OR = 1.003,95%CI = 0.995–1.011, p = 0.45), estimating glomerular filtration rate and stroke (OR = 1.000, 95%CI = 0.9998–1.0001, p = 0.95) and estimated glomerular filtration rate and atrial fibrillation (AF) (OR = 1.004, 95% CI = 0.9952–1.0126, p = 0.38) the results of the IVW trial did not suggest a potential causal relationship between eGFR and cardiovascular outcome events. CONCLUSION Multiple large MR analyses we performed found a weak causal association between estimated glomerular filtration rate and the risk of heart failure, but we did not find a significant causal association of estimated glomerular filtration rate for other cardiovascular outcome events (stroke, CVD, atrial fibrillation, coronary artery disease).

BackgroundThe relationship between gut microbiota and the occurrence of cholecystitis remains unclear. Existing research lacks a clear understanding of how circulating vitamin levels modulate this relationship. Therefore, our study aims to investigate whether circulating vitamin levels mediate the causal relationship between gut microbiota and cholecystitis using a two-step bidirectional Mendelian randomization approach.MethodsIn this study, we initially employed Linkage Disequilibrium Score Regression (LDSC) analysis to assess the genetic correlation of five circulating vitamin level genome-wide association study (GWAS) summary datasets, thereby avoiding potential sample overlap. Subsequently, we conducted a two-step analysis to investigate the causal effects between gut microbiota and cholecystitis. In the second step, we explored the causal relationship between circulating vitamin levels and cholecystitis and identified the mediating role of vitamin D. The primary method used for causal analysis was the inverse variance-weighted approach. We performed additional sensitivity analyses to ensure result robustness, including the cML-MA method and reverse Mendelian randomization (MR) analysis.ResultsAn increment of one standard deviation in RuminococcaceaeUCG003 was associated with a 25% increased risk of cholecystitis (OR = 1.25, 95%CI = 1.01–1.54, p = 0.04), along with a 3% decrease in 25-hydroxyvitamin D levels (OR = 0.97, 95%CI = 0.944–0.998, p = 0.04). However, following the rigorous Bonferroni correction, every one standard deviation decrease in circulating vitamin D levels was associated with a 33% increased risk of cholecystitis (OR = 0.67, 95%CI = 0.49–0.90, p = 0.008, Padjust = 0.04). Thus, the potential link between gut microbiota and cholecystitis risk might be mediated by circulating vitamin D levels (proportion mediated = 5.5%). Sensitivity analyses provided no evidence of pleiotropy.ConclusionOur study results suggest that an elevated abundance of specific gut microbiota is associated with an increased susceptibility to cholecystitis, with the causal relationship being mediated by circulating vitamin D levels. Further large-scale randomized controlled trials are necessary to validate the causal effects of gut microbiota on cholecystitis risk. This study provides novel insights into cholecystitis prevention through the regulation of gut microbiota.

Introduction: Exploring the potential efficacy of a drug is a valid approach for drug development with shorter development times and lower costs. Recently, several computational drug repositioning methods have been introduced to learn multi-features for potential association prediction. However, fully leveraging the vast amount of information in the scientific literature to enhance drug-disease association prediction is a great challenge.Methods: We constructed a drug-disease association prediction method called Literature Based Multi-Feature Fusion (LBMFF), which effectively integrated known drugs, diseases, side effects and target associations from public databases as well as literature semantic features. Specifically, a pre-training and fine-tuning BERT model was introduced to extract literature semantic information for similarity assessment. Then, we revealed drug and disease embeddings from the constructed fusion similarity matrix by a graph convolutional network with an attention mechanism.Results: LBMFF achieved superior performance in drug-disease association prediction with an AUC value of 0.8818 and an AUPR value of 0.5916.Discussion: LBMFF achieved relative improvements of 31.67% and 16.09%, respectively, over the second-best results, compared to single feature methods and seven existing state-of-the-art prediction methods on the same test datasets. Meanwhile, case studies have verified that LBMFF can discover new associations to accelerate drug development. The proposed benchmark dataset and source code are available at: https://github.com/kang-hongyu/LBMFF.

卒中相关性肺炎是脑卒中的常见并发症,也是脑卒中患者致残率和致死率升高的重要危险因素.中医药治疗可以增加卒中相关性肺炎患者的临床疗效,缩短治疗时间,降低治疗费用,且安全性高.但卒中相关性肺炎的中医辨证仍然缺乏具有可操作性的统一判定标准,因此,本文通过对近年来卒中相关性肺炎中医辨证分型相关文献分析和归纳总结,旨在对临床使用中医药治疗卒中相关性肺炎和提高卒中相关性肺炎的临床疗效提供参考依据.

Background: Sepsis has high mortality and is responsible for significant healthcare costs. Chinese herbal injections (CHIs) have been widely used in China as a novel and promising treatment option for sepsis. Therefore, this study assessed and ranked the effectiveness of CHIs to provide more sights for the selection of sepsis treatment.Method: Eight databases were searched from their inception up to September 1, 2021. The methodological quality of included study was evaluated by the Revised Cochrane risk-of-bias tool for randomized trials. Then Bayesian network meta-analysis was performed by OpenBUGS 3.2.3 and STATA 14.0 software. The surface under the cumulative ranking curve (SUCRA) probability values were applied to rank the examined treatments. Publication bias was reflected by a funnel plot.Results: A total of 50 eligible randomized controlled trials involving 3,394 participants were identified for this analysis. Five CHIs including Shenfu injection, Shenmai injection, Shengmai injection, Shenqifuzheng injection, and Huangqi injection were included. The results of the NMA and sensitivity analysis showed that Shenqifuzheng (MD = −4.48, 95% CI = −5.59 to −3.24), Shenmai (MD = −3.38, 95% CI = −4.38 to −2.39), Shenfu (MD = −2.38, 95% CI = −3.03 to −1.70) and Shengmai (MD = −1.90, 95% CI = −3.47 to −0.31) combined with Western medicine (WM) had a superior effect in improving the APACHE II score. Based on SUCRA values, Shenqifuzheng injection (95.65%) ranked highest in the APACHE II score, followed by Shenmai (74%), Shenfu (47.1%), Shengmai (35.3%) and Huangqi injection (33.2%). Among the secondary outcomes, Shenmai injection was the most favorable intervention in reducing PCT and CRP levels, and Shenqifuzheng injection was the second favorable intervention in reducing CRP level. Shenfu injection combined with WM was more effective than the other treatments in decreasing the serum IL-6 and TNF-α levels and lowering the 28-days mortality. Regarding the improvement of immune function, Shenqifuzheng injections had obvious advantages.Conclusion: In conclusion, Shenqifuzheng injection was the optimum treatment regimen to improve APACHE II score, reduce CRP level, and regulate immune function. Shenfu injection was superior in reducing the expression of inflammatory factors and decreasing 28-days mortality. Nevertheless, more multicenter, diverse, and direct comparisons randomized controlled trials are needed to further confirm the results.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=254531, identifier CRD42021254531.

Background Severe pneumonia (SP) has a high mortality and is responsible for significant healthcare cost. Chinese herbal injections (CHIs) have been widely used in China as a novel and promising treatment option for SP. Therefore, this study will assess and rank the effectiveness of CHIs to provide more sights for the selection of SP treatment. Method Seven databases will be searched, including PubMed, the Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, and the Chinese Scientific Journal Database (VIP) from their inception up to October, 2021. The literatures screening, data extraction and the quality assessment of included studies will be conducted independently by two reviewers. Then Bayesian network meta-analysis (NMA) will be performed by WinBUGS 14.0 and STATA 14.0 software. Surface under the cumulative ranking curve (SUCRA) probability values will be applied to rank the examined treatments. The risk of bias of each included study will be evaluated using the Revised Cochrane risk-of-bias tool for randomized trials (ROB 2). Publication bias will be reflected by a funnel plot. Results The results of this NMA will be disseminated through a peer-reviewed journal publication. Conclusion Our study findings maybe reveal which CHI or CHIs will be better in the treatment of SP and provide more therapy strategies for clinical practitioners and patients. PROSPERO registration number CRD42021244587. Strengths and limitations of this study Bayesian network meta-analysis (NMA) can integrate direct evidence with indirect evidence of severe pneumonia treated by Chinese herbal injections to generate a clinically useful ranking of these regimens. This NMA will address Chinese herbal injections for SP and its findings may help to provide more sights for selection of SP treatment. Evidence drawn from an NMA is limited and should be interpreted with caution. We only included studies in Chinese and English languages, which may increase the publication bias.