BACKGROUND:Breast cancer is the most commonly diagnosed cancer among women worldwide. This study analyzed and compared breast cancer patterns in China and the Group of 20 (G20) countries and predicted future trends. METHODS:Using data from the Global Burden of Disease 2021 study, the authors examined incidence, mortality, mortality-to-incidence ratio (MIR), age-standardized mortality rate (ASMR), age-standardized incidence rate (ASIR), and average annual percent change. Joinpoint regression was used to identify trend changes. Social demographics index associations were examined. Autoregressive integrated moving average was used to forecast trends to 2040. RESULTS:Between 1990 and 2021, breast cancer incidence in China increased by over 360%, with ASIR rising from 9.42 to 23.65 per 100,000, significantly higher than the G20 average (from 24.85 to 29.45). The most pronounced ASIR increases were observed among men 15-49 years old. Although G20 countries reduced their ASMR from 9.57 to 8.14 per 100,000, China's ASMR increased slightly from 4.71 to 5.04 per 100,000. The MIR declined in both China and G20, especially in females 15-69 years old. Projections suggest continued ASIR growth in China, especially among those 50-69 years old, whereas ASMR is expected to stabilize or decline by 2040. CONCLUSIONS:Breast cancer incidence and mortality are increasing more rapidly in China than in G20 countries, driven by reproductive, lifestyle, and environmental factors. These trends highlight the urgent need for enhanced prevention, targeted screening-particularly for women 50-69 years old-and strengthened international collaboration to mitigate the growing disease burden.

Background: Research in hypothyroidism has expanded significantly in the last decade, resulting in a vast array of studies that pose challenges in comprehensive review and assessment. Bibliometric methodologies serve as quantitative tools to analyze and understand the current research progress and focal areas within this field. Methods: A systematic search was conducted for articles and reviews pertaining to hypothyroidism within the Core Collection database of Web of Science from 2010 to 2024. Utilizing bibliometric software, notably visualization of similarities viewer and CiteSpace, we performed analyses to assess the contributions, co-occurrence relationships among various references, countries/regions, institutions, journals, and keywords associated with hypothyroidism research. Results: This study encompassed 16,274 English-language papers published across 2504 journals, originating from 10,616 institutions in 137 countries/regions. Notably, the quantity of hypothyroidism-related publications has exhibited a consistent upward trajectory over the past decade, underscored by robust international collaboration. The United States emerged as the leading contributor in terms of publication count and demonstrated a high concentration of prolific research institutions. The journal "THYROID" prominently featured as the primary publication source for hypothyroidism research, having disseminated several pivotal treatment guidelines within this domain. Recent research has notably spotlighted specific subsets, such as hypothyroidism during pregnancy. Moreover, recent trends have steered focus towards metabolic ailments associated with hypothyroidism, encompassing diabetes, obesity, and exploring the role of dietary supplements. Conclusion: Leveraging bibliometric tools enables an objective and comprehensive analysis of pertinent data, shedding light on the evolving dynamics within the field of hypothyroidism research.

BACKGROUND:The red blood cell distribution width to albumin ratio (RAR) is a novel comprehensive biomarker of inflammation and nutrition, which has emerged as a reliable prognostic indicator for adverse outcomes and mortality in patients with various diseases. However, the association between RAR and low cognitive performance in older adults remains unclear. This study aims to investigate the relationship between RAR and low cognitive performance among older adults in the United States. METHODS:This study, a retrospective analysis, included 2,765 participants aged 60 years and older from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2014. Low cognitive performance was assessed using word learning subset from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the Digit Symbol Substitution Test (DSST), and the Animal Fluency Test (AFT). Low cognitive performance was defined as scores below the lowest quartile in each cognitive test. The association between RAR and low cognitive performance was evaluated using weighted multivariable logistic regression, restricted cubic splines (RCS), and subgroup analyses. RESULTS:After adjusting for all potential confounders, RAR was independently and linearly positively associated with both low DSST performance and low AFT performance. Specifically, compared to participants in the first quartile of RAR, those in the fourth quartile had adjusted ORs (95% CIs) of 1.81 (1.03, 3.20) for low DSST performance and 1.68 (1.05, 2.67) for low AFT performance. Subgroup analysis did not reveal significant interactions between stratification variables. CONCLUSION:RAR is significantly linearly positively associated with low cognitive performance. Maintaining a lower RAR may be a crucial strategy for mitigating the risk of cognitive decline in the elderly population.

Background The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) serves as a novel composite lipid indicator for atherosclerosis. However, the association between the NHHR and mortality in patients with diabetes or prediabetes remains unclear. Therefore, the present study aimed to examine the correlation between the NHHR and both all-cause and cardiovascular mortality in U.S. adults with diabetes or prediabetes. Methods This study enrolled a total of 12,578 adult participants with diabetes or prediabetes from the National Health and Nutrition Examination Survey in the US (1998–2018). The mortality outcomes were ascertained through linkage with the National Death Index (NDI) records available until December 31, 2019. We employed weighted multivariate Cox proportional hazards models to estimate the associations between the NHHR and both all-cause and cardiovascular mortality. Restricted cubic splines (RCS) were employed to evaluate nonlinear correlations. Moreover, a segmented Cox proportional hazards model was utilized to assess the associations between the NHHR and mortality on both sides of the inflection point. Results During a median follow-up period of 8.08 years, 2403 participants experienced all-cause mortality, with 662 of them specifically succumbing to cardiovascular mortality. The RCS revealed a U-shaped association between the NHHR and all-cause mortality in participants with diabetes or prediabetes, while an L-shaped association was observed for cardiovascular mortality. The analysis of threshold effects revealed that the inflection points for the NHHR and all-cause and cardiovascular mortality were 2.71 and 2.85, respectively. Specifically, when the baseline NHHR was below the inflection points, a negative correlation was observed between the NHHR and both all-cause mortality (HR: 0.80, 95% CI: 0.73–0.88) and cardiovascular mortality (HR: 0.78, 95% CI: 0.67–0.92). Conversely, when the baseline NHHR exceeded the inflection points, a positive correlation was observed between the NHHR and all-cause mortality (HR: 1.07, 95% CI: 1.03–1.11). Conclusions In U.S. adults with diabetes or prediabetes, a U-shaped correlation was observed between the NHHR and all-cause mortality, whereas an L-shaped correlation was identified with cardiovascular mortality. The inflection points for all-cause and cardiovascular mortality were 2.71 and 2.85, respectively.

The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) serves as a novel composite lipid indicator for atherosclerosis. However, the association between NHHR and mortality in patients with diabetes or prediabetes remains unclear. Consequently, the objective of this study was to investigate the relationship between NHHR and both all-cause and cardiovascular mortality in US adults with diabetes or prediabetes. This study included 12,578 adult participants with diabetes or prediabetes from the US National Health and Nutrition Examination Survey (1999–2018). Mortality outcomes were ascertained by linking to the National Death Index (NDI) record up to December 31, 2019. We employed a weighted multivariate Cox proportional hazards model and restricted cubic splines to assess the associations between NHHR and all-cause and cardiovascular mortality. A segmented Cox proportional hazards model was used for evaluating threshold effects. Furthermore, a competing risks analysis was performed to explore the relationship between NHHR and cardiovascular mortality. During a median follow-up period of 8.08 years, 2403 participants encountered all-cause mortality, with 662 of them specifically succumbing to cardiovascular mortality. The restricted cubic splines revealed a U-shaped association between NHHR and all-cause mortality, while an L-shaped association was observed for cardiovascular mortality. The analysis of threshold effects revealed that the inflection points for NHHR and all-cause and cardiovascular mortality were 2.72 and 2.83, respectively. Specifically, when the baseline NHHR was below the inflection points, a negative correlation was observed between NHHR and both all-cause mortality (HR: 0.76, 95

心房颤动是一种常见的快速性心律失常,对病人的生活质量和健康造成巨大影响.张京春主任通过分析宫廷医案,发现心悸与肝脾两脏存在相关性,同时在现代医学机制上存在一定联系.宫廷医学治疗心悸使用调肝健脾的治疗原则,从疏肝、养肝、健脾等方面组方用药,可作为现代临床中治疗心房颤动的一种参考.

Background Depression is an independent factor to predict the hospitalization and mortality in the chronic HF patients. Citalopram is known as an effective drug for depression treatment. Currently, there is no specific recommendation in the HF guidelines for the treatment of psychological comorbidity. In recent years, many studies have shown that the citalopram may be safe in treating of chronic HF with depression. Objective To evaluate the efficacy and safety of the citalopram in the treatment of elderly chronic HF combined with depression. Methods PubMed, EMBASE, Cochrane, Web of Science, CNKI, VIP, CBM, and Wanfang were searched from their inception to May 2022. In the treatment of elderly chronic HF combined with depression, randomized controlled studies of the citalopram were included. Independent screening and extraction of data information were conducted by two researchers, and the quality was assessed by the Cochrane bias risk assessment tool. Review manager 5.4.1 was employed for statistical analysis. Results The results of meta-analysis prove that the citalopram treatment for depressed patients with chronic HF has a benefit for HAMD-24 (MD: −8.51, 95% CI: −10.15 to −6.88) and LVEF (MD: 2.42, 95% CI: 0.51 to 4.33). Moreover, the score of GDS decreases, and NT-proBNP (MD: −537.78, 95% CI: −718.03 to −357.54) is improved. However, the comparison with the control group indicates that there is no good effect on HAMD-17 (MD: −5.14, 95% CI: −11.60 to 1.32), MADRS (MD: −1.57, 95% CI: −3.47 to 0.32) and LVEDD (MD: −1.45, 95% CI: −3.65 to −0.76). No obvious adverse drug reactions were observed. Conclusion Citalopram treatment for depressed patients with chronic HF has a positive effect on LVEF and NT-proBNP. It can alleviate HAMD-24 and GDS, but the relative benefits for LVEDD, HAMD-17 and MADRS still need to be verified. Systematic Review Registration : PROSPERO [CRD42021289917].

宫廷制度在我国持续了两千余年,历代帝王大都热衷于追寻延年益寿之法,以期长久统治.他们在追求长寿的道路上,尝试过多种方法,如服石炼丹、膏方滋补、功法保健等.究竟哪一种方法能真正地延年益寿,让现代的我们也能从中获益呢? 长寿篇 历史洪流验明了"仙丹"的正身 关于丹药的发展,最早可以追溯至战国时期,《韩非子·外储说左上》记载,燕王相信方士有神仙不死的法术,人们开始相信,神仙长生,乃是服食了能令人不死的仙药.

快速性心律失常是临床较为多发和常见的心血管疾病,可发生于任何年龄阶段,且随着年龄的增长患病率也增加.中医理论认为肝、心两脏功能均与情志活动密切相关,对心系疾病从肝论治已在古今医著中多有体现.张京春主任医师在研究清宫原始医药档案及临床治疗中发现从肝论治快速性心律失常可取得较好疗效,故创立调肝益气定悸方,并根据年轻人与老年人生理机能差异,在辨证中各有侧重.在此基础上通过分析肝与心律失常的相关性,探讨不同年龄人群快速性心律失常的诊治规律.

目的:利用网络药理学方法和分子对接探讨调肝益气定悸药对甘松-仙鹤草治疗常见心律失常室性期前收缩(PVCs)的物质基础和作用机制.方法:通过中药系统药理学数据库及分析平台(TCMSP)结合相关文献筛选甘松、仙鹤草的化学成分及其靶点.借助人类基因数据库(GeneCards),在线人类孟德尔遗传数据库(OMIM),DrugBank数据库寻找治疗PVCs的潜在靶点.通过STRING平台进行蛋白质相互作用分析.利用Metascape平台进行基因本体(GO)富集分析与京都基因与基因组百科全书(KEGG)通路富集分析.利用Cytoscape 3.8.0软件,构建甘松-仙鹤草药对化学成分-潜在靶点-信号通路网络.利用AutoDock 4.2.6将主要靶点蛋白与甘松-仙鹤草活性成分进行分子对接.结果:甘松-仙鹤草药对中槲皮素、山柰酚、金合欢素等9种活性成分治疗PVCs的靶点主要涉及肿瘤坏死因子(TNF),丝裂原活化蛋白激酶1(MAPK1),蛋白激酶B1(Akt1)等.其潜在靶点主要富集在癌症通路(pathways in cancer),高级糖基化终末产物/高级糖基化终末产物受体信号通路(AGE/RAGE signaling pathway in diabetic complications)等26条相关信号通路.分子对接结果显示该药对大部分活性成分(92.59％)与主要靶点蛋白TNF,MAPK1,Akt1的结合活性较好.结论:甘松-仙鹤草药对中多种活性成分可通过多靶点、多通路的干预,发挥调节心肌离子通道、抗炎症、抗氧化应激等作用以治疗PVCs,同时还可通过抑制单胺氧化酶活性、抗神经损伤等改善抑郁、焦虑相关症状.为进一步探索其治疗PVCs的物质基础及作用机制提供了研究思路和理论基础.

Objective: To systematically evaluate the clinical efficacy and safety of Tanreqing injection in the treatment of heart failure complicated with pulmonary infection. Methods: The database of CNKI, SinoMed, VIP full text database, Wanfang database, Cochrance Library, Web of Science and PubMed were searched. The retrieval time was from the inception to August 2021. Clinical randomized controlled trial of Tanreqing injection in the treatment of heart failure complicated with pulmonary infection was collected, and two researchers independently screened the document data. Meta-analysis was performed using RevMan 5.4.1 software. Results: A total of 10 documents were included, including 862 cases of heart failure complicated with pulmonary infection, including 431 cases in the test group, and 431 cases in the control group. The Meta analysis showed that compared to the control group, the test group increased clinical efficiency [OR=4.56, 95％ CI(2.79, 7.52), P<0.00001], reduced the value of C-reactive protein [MD =-7.55, 95％ CI (- 11.40, -3.69), P=0.0001], reduced the time required to correct heart failure [OR=-4.04, 95％ CI (-4.59, -3.49), P<0.00001], reduced the number of days of the average hospitalization [MD =-4.78, 95％CI (-6.67, -2.89), P<0.00001], and there were no statistically significant differences in the incidence of adverse reactions. Conclusion: Tanreqing injection, as an auxiliary treatment for heart failure complicated with pulmonary infection, has significantly effective effect on improving efficiency. Tanreqing injection has a certain advantage in reducing C-creative protein values, shortening the time of correcting heart failure, and reducing the number of days of the average hospitalization, and the adverse reactions are smaller. However, the overall quality of the included studies is low, and more high-quality randomized controlled trials are needed to increase the evidence-based basis.

BackgroundThe control of diseases related to atrial fibrillation (AF) may reduce the occurrence of AF, delay progression, and reduce complications, which is beneficial to the prevention and treatment of AF. An increasing number of studies have shown that AF is associated with depression. However, to date, there has not been a bibliometric analysis to examine this field systematically. Our study aimed to visualize the publications to determine the hotspots and frontiers in research on AF and depression and provide guidance and reference for further study.MethodsPublications about AF and depression between 2001 and 2021 were retrieved from the Web of Science Core Collection (WOSCC) database. CiteSpace 5.8. R1, VOSviewer 1.6.16, and Excel 2019 software tools were used to conduct this bibliometric study.ResultsIn total, 159 articles and reviews were analyzed. The number of publications has been increased sharply since 2018. David D. McManus had the largest number of publications. The most prolific country was the USA with 54 publications but the centrality was <0.1. The most prolific institution was Northeastern University. Three clusters were formed based on keywords: The first cluster was composed of atrial fibrillation, depression, anxiety, symptoms, ablation, and quality of life, et al. The second cluster were risk, prevalence, mortality, heart failure, association, et al. While the third cluster included anticoagulation, impact, stroke, management, warfarin, et al. After 2019, stroke and prediction are the keywords with strongest citation bursts.ConclusionResearch on AF and depression is in its infancy. Cooperation and exchanges between countries and institutions must be strengthened in the future. The effect of depression on prevalence and mortality in AF, depression on ablation in AF, and impact of depression on anticoagulation treatment in AF have been the focus of current research. Stroke prevention (including anticoagulant therapy) is the research frontier, which may still be the focus of research in the future.

目的:系统评价痰热清注射液辅助治疗心力衰竭合并肺部感染的临床疗效及安全性.方法:检索中国知网、中国生物医学文献数据库、中文科技期刊全文数据库、万方数据库、Cochrance Library、Web of Science和PubMed数据库,检索时间从建库至2021年8月,收集痰热清注射液治疗心力衰竭合并肺部感染的临床随机对照试验,由2位研究员独立筛选录入文献数据,运用RevMan5.4.1软件进行数据分析.结果:共纳入10篇文献,包含862例心力衰竭合并肺部感染患者,其中试验组有431例,对照组有431例.Meta分析结果显示,试验组与对照组相比,可提高临床总有效率[OR=4.56,95％CI(2.79,7.52),P<0.00001],降低C-型反应性蛋白数值[MD=?7.55,95％CI(?11.40,?3.69),P=0.0001],缩短纠正心衰的时间[OR=?4.04,95％CI(?4.59,?3.49),P<0.00001],减少平均住院的天数[MD=?4.78,95％CI(?6.67,?2.89),P<0.00001],两组不良反应发生率差异无统计学意义(P>0.05).结论:痰热清注射液辅助治疗心力衰竭合并肺部感染,可提高临床总有效率,在降低C-型反应性蛋白数值、缩短纠正心衰的时间、减少平均住院的天数方面具有一定的优势,不良反应较小.但纳入研究数据总体质量偏低,尚需开展更多高质量的随机对照试验以增加循证依据.

目的 系统评价调控肠道菌群的中药口服制剂干预脂代谢紊乱的有效性与安全性.方法 计算机检索PubMed、EMbase、The Cochrane Library、中国知网(CNKI)、万方数据库(WangFang Data)、维普网(VIP)有关调控肠道菌群的中药口服制剂干预脂代谢紊乱的随机对照试验(RCT),检索时限均为各数据库建库至2020年12月,利用RevMan 5.4.1软件对纳入研究结果 进行Meta分析.结果共纳入12项研究,涉及1260例脂代谢紊乱相关疾病病人.Meta分析结果显示:试验组三酰甘油(TG)水平[MD=-0.38,95％CI(-0.49,-0.27),P<0.00001]、总胆固醇(TC)水平[MD=-0.64,95％CI(-0.88,-0.41),P<0.00001]、低密度脂蛋白胆固醇(LDL-C)水平[MD=-0.47,95％CI(-0.65,-0.29),P<0.00001]均明显低于对照组,高密度脂蛋白胆固醇(HDL-C)水平[MD=0.21,95％CI(0.09,0.33),P=0.0005]高于对照组.试验组有20例出现腹泻、腹痛、泌尿系感染等不良反应.结论 现有证据表明,调控肠道菌群的中药口服制剂可改善血脂代谢紊乱相关疾病病人血脂水平,且安全性良好,有望广泛应用于血脂异常病人的一级、二级预防.