BackgroundCardiovascular diseases (CVDs) are the leading global disease burden, with alcohol consumption closely linked to their occurrence. This study analyzes data from the Global Burden of Disease Study 2021 (GBD 2021) to assess the distribution and trends of high alcohol use-related CVD from 1990 to 2021 across global, regional, and national levels.Materials and methodsWe used the data from the GBD 2021 to conduct stratification by region, country, gender, age, SDI, and disease type in terms of the number of deaths, age-standardized mortality rate (ASMR), disability-adjusted life years (DALYs), age-standardized rate of DALYs (ASDR), years lived with disability (YLDs), age-standardized rate of YLDs, years of life lost (YLLs), and age-standardized rate of YLLs to comprehensively assess the burden of high alcohol use-related CVD from 1990 to 2021. All statistical analyses in this study were performed using R statistical software (version 4.1.2).ResultsBetween 1990 and 2021, global deaths, DALYs, YLDs, and YLLs attributable to high alcohol use-related CVD showed notable variation. By 2021, global deaths had doubled compared to 1990, while ASMR, ASDR, age-standardized YLD rate, and YLL rate all declined. Eastern Europe had the highest rates in 2021. Males consistently had higher ASMR, ASDR, YLD, and YLL rates compared to females, with the highest number of deaths occurring in the 70–74 age group, and the 65–69 age group showing the highest DALYs, YLDs, and YLLs. These rates increased with age. Stroke was the most common high alcohol use-related CVD, while ischemic heart disease (IHD) was the least common.ConclusionBetween 1990 and 2021, the overall burden of high alcohol use-related CVD declined globally, though some regions experienced an increase. This highlights the need for continued public health efforts, particularly targeting high-risk regions and populations, to mitigate the impact of alcohol on cardiovascular health.

AIMS:To assess the changing patterns of heart failure (HF) in China from 1990 to 2021, providing evidence for informed healthcare strategies. METHODS AND RESULTS:Data on prevalence, years lived with disability (YLDs), and their corresponding 95% uncertainty intervals (UI) were obtained from the Global Burden of Disease (GBD) Study 2021. The joinpoint regression model, the age-period-cohort model, and the autoregressive integrated moving average (ARIMA) model were utilized for more in-depth analysis. In 2021, 13 099 727 (95% UI, 11 320 895 to 15 376 467) individuals lived with HF and this illness accounted for 1 290 810 (95% UI, 865 894 to 1 775 731) YLDs in China. The burden of HF is more pronounced in males and the elderly, with ischaemic heart disease having become the leading cause since 2002. The age-standardized rates of prevalence and YLDs increased at average annual percentage changes of 0.23% (95% CI, 0.20 to 0.26) and 0.25% (95% CI, 0.23 to 0.27), respectively. The curve of local drift showed a downward trend with age. Both the period and cohort rate ratios have increased significantly over the last 30 years. By 2031, the age-standardized rates of prevalence will decrease to 678.69 (95% CI, 640.75 to 716.63), while the age-standardized rates of YLDs will increase to 69.19 (95% CI, 66.95 to 71.43). CONCLUSION:The burden and risk of HF in China remains a major concern. The implementation of comprehensive strategies should be taken into consideration, including strengthening the primary healthcare system, enhancing public health education, and promoting cardiac rehabilitation.

INTRODUCTION:Uric acid (UA) is considered as a potential risk factor for coronary heart disease (CHD) and other cardiovascular diseases (CVDs). However, the association between hyperuricemia and the risk of CHD and other cardiovascular outcomes has not been fully clarified. This systematic review and dose-response meta-analysis was conducted to comprehensively the association between hyperuricemia and the risk of CHD or other cardiovascular outcomes in the general population. METHODS:We systematically searched Medline, Cochrane Library, Embase, and two clinical trial registration databases from inception to June 30, 2025, without restrictions on language or publication status. Only cohort and case-control studies enrolling participants without CHD, other CVDs, or gout at baseline were included. The primary outcome was the association between hyperuricemia and the risk of CHD, and secondary outcomes were the association between hyperuricemia and the risk of fatal and nonfatal CVDs, included CHD death, CVD, CVD death, and myocardial infarction (MI). Risk of bias was assessed using the Risk Of Bias In Non-randomized Studies-of Exposure (ROBINS-E) tool. All statistical analyses were performed using R 4.4.2. We conducted meta-analyses, heterogeneity assessments, publication bias tests, trim-and-fill analyses, subgroup and sensitivity analyses, meta-regressions, and dose-response meta-analyses. The GRADE recommendation was used to evaluate the quality of evidence. RESULTS:A total of 42 articles representing 39 individual studies and 1,082,880 participants were included. Among these, 2 articles were assess as "very high risk of bias", eight as "high risk of bias", and two as "some concerns". Hyperuricemia was significantly associated with an increased risk of CHD [HR 1.21 (95%CI 1.14-1.28), p < 0.001, I2 = 34.34%], CHD death [1.20 (1.05-1.36), p = 0.005, I2 = 41.28%], CVD death [1.75 (1.12-2.74), p = 0.014, I2 = 49.48%], and MI [1.23 (1.03-1.47), p = 0.025, I2 = 56.96%]. No significant association was observed for overall CVD risk [1.09 (0.94-1.27), p = 0.245, I2 = 0%]. For each unit increase in serum UA, the risk of CHD, CHD death, CVD, CVD death, and MI increased by 16%, 13%, 12%, 11%, and 7%, respectively. No factors with a significant impact on the results were identified through subgroup analyses or meta-regression. Sex may have a potential influence, but the results were not robust. Further dose-response meta-analysis revealed a linear relationship between higher serum UA and CVD risk, and a U-shaped association between serum UA and CVD mortality in men. The quality of evidence was rated as low for CHD and very low for the other cardiovascular outcomes. CONCLUSION:This systematic review and dose-response meta-analysis provides low- to very-low-quality evidence suggesting that hyperuricemia may be associated with an increased risk of CHD and other fatal or nonfatal CVDs. TRIAL REGISTRATION:This study was registered in PROSPERO CRD42024538553.

Background and objective Cardiac rehabilitation (CR) has been demonstrated to improve outcomes in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). However, the optimal CR initiation time and duration remain to be determined. This study aimed to explore the impact of the time factors on the CR outcomes in AMI patients who received PCI by the method of meta-regression analysis. Methods We searched five databases (PubMed, Embase, Cochrane Library, Web of Science and Google scholar) up to October 31, 2023. Meta-regression analysis was utilized to explore the impact of the time factors on the effect sizes. Subgroups with more than 3 studies were used for meta-regression analysis. Results Our analysis included 16 studies and a total of 1810 patients. The meta-regression analysis revealed that the initiation time and duration of CR had no significant impact on the occurrence of arrhythmia, coronary artery restenosis and angina pectoris. The initiation time and duration of CR also had no significant impact on the changes in left ventricular ejection fraction (LVEF, starting time: estimate = 0.160, p = 0.130; intervention time: estimate = 0.017, p = 0.149), left ventricular end-diastolic volume (LVEDV, starting time: estimate = − 0.191, p = 0.732; intervention time: estimate = − 0.033, p = 0.160), left ventricular end-systolic volume (LVESV, starting time: estimate = − 0.301, p = 0.464; intervention time: estimate = 0.015, p = 0.368) and 6-minute walk test (6MWT, starting time: estimate = − 0.108, p = 0.467; intervention time: estimate = 0.019, p = 0.116). Conclusion Implementation of CR following PCI in patients with AMI is beneficial. However, in AMI patients, there is no significant difference in the improvement of CR outcomes based on different CR starting times within 1 month after PCI or different durations of the CR programs. It indicates that it is feasible for patients with AMI to commence CR within 1 month after PCI and continue long-term CR, but the time factors which impact CR are intricate and further clinical research is still needed to determine the optimal initiation time and duration of CR.

Background and aimsCoffee contains many bioactive compounds, and its inconsistent association with subclinical atherosclerosis has been reported in observational studies. In this Mendelian randomization study, we investigated whether genetically predicted coffee consumption is associated with subclinical atherosclerosis, as well as the role of potential mediators.MethodsWe first conducted a two-sample Mendelian randomization analysis to examine the causal effect of coffee and its subtypes on subclinical atherosclerosis inferred from coronary artery calcification (CAC). Next, the significant results were validated using another independent dataset. Two-step Mendelian randomization analyses were utilized to evaluate the causal pathway from coffee to subclinical atherosclerosis through potential mediators, including blood pressure, blood lipids, body mass index, and glycated hemoglobin. Mendelian randomization analyses were performed using the multiplicative random effects inverse-variance weighted method as the main approach, followed by a series of complementary methods and sensitivity analyses.ResultsCoffee, filtered coffee, and instant coffee were associated with the risk of CAC (β = 0.79, 95% CI: 0.12 to 1.47, p = 0.022; β = 0.66, 95% CI: 0.17 to 1.15, p = 0.008; β = 0.66, 95% CI: 0.20 to 1.13, p = 0.005; respectively). While no significant causal relationship was found between decaffeinated coffee and CAC (β = −1.32, 95% CI: −2.67 to 0.04, p = 0.056). The association between coffee and CAC was validated in the replication analysis (β = 0.27, 95% CI: 0.07 to 0.48, p = 0.009). Body mass index mediated 39.98% of the effect of coffee on CAC (95% CI: 9.78 to 70.19%, p = 0.009), and 5.79% of the effect of instant coffee on CAC (95% CI: 0.54 to 11.04%, p = 0.030).ConclusionOur study suggests that coffee other than decaffeinated coffee increases the risk of subclinical atherosclerosis inferred from CAC. Body mass index mediated 39.98 and 5.79% of the causal effects of coffee and instant coffee on CAC, respectively. Coffee should be consumed with caution, especially in individuals with established cardiovascular risk factors, and decaffeinated coffee appears to be a safer choice.

INTRODUCTION:Hyperuricemia, characterized by elevated serum uric acid levels, has garnered significant attention in cardiovascular research due to its potential association with coronary heart disease (CHD). While some studies suggest hyperuricemia as a risk factor of CHD, others present conflicting findings. A systematic review and dose-response meta-analysis is warranted to comprehensively summarize the previous studies and determine the association between hyperuricemia and CHD, thereby supporting clinical practice and future studies in this field. METHODS:In this study, we will comprehensively search Medline, EMBase, Cochrane Central, ICTRP, and ClinicalTrials.gov, from inception to December 31, 2024. Prospective or retrospective cohort studies and case-control studies investigating the association between hyperuricemia and CHD will be included. Two independent reviewers will conduct study selection, data extraction, and risk of bias assessment. The primary outcome will be the pooled relative risk of CHD associated with hyperuricemia by using random-effect model. Dose-response meta-analysis will be performed with linear and non-linear model to explore the the magnitude and direction of the association between serum uric acid levels and CHD risk. Subgroup analyses will be conducted based on uric acid test approaches and corresponding cut-off values and human races. Sensitivity analyses will assess the robustness of the results with leave-one-out method, while publication bias will be evaluated using funnel plots, Egger's test, and Begg's test. We will further use GRADE to evaluate the quality of the evidences provided by our systematic review. EXPECTED RESULTS:From this systematic review and dose-response meta-analysis, we hope out findings will provide reliable conclusion and data support on the association between hyperuricemia and CHD. The transparent and replicable methodologies outlined in this protocol contribute to advancing understanding of hyperuricemia as a potentially modifiable risk factor for CHD, thus supporting evidence-based strategies for cardiovascular disease management. CONCLUSIONS:This protocol describes a rigorous plan to systematically review and analyze the quantitative association between hyperuricemia and CHD risk. In a word, we will help further clinical practice and scientific studies in this field. TRIAL REGISTRATION:This protocol was registered in PROSPERO CRD42024538553.

Background: Heart failure is a leading public health issue in China, with a steadily increasing burden. This study aims to assess the changing patterns of heart failure in China from 1990 to 2021, providing evidence for informed healthcare strategies. Methods: Data on prevalence, years lived with disability (YLDs), and their corresponding 95% uncertainty intervals (UI) were obtained from the Global Burden of Disease (GBD) Study 2021. The joinpoint regression model was used to identify both overall and localized trends of heart failure burden, and the age-period-cohort model served to analyze the contributions of age, period, and birth cohort separately. We further utilized the autoregressive integrated moving average (ARIMA) model to predict future trends of heart failure in the next 10 years. Results: In 2021, 13099727 (95% UI, 11320895 to 15376467) individuals lived with heart failure and this illness accounted for 1290810 (95% UI, 865894 to 1775731) YLDs in China. The burden of heart failure is more pronounced in males and the elderly, and ischemic heart disease has become the leading cause since 2002. The age-standardized rates of prevalence and YLDs increased at average annual percentage changes of 0.23% (95% CI, 0.20 to 0.26) and 0.25% (95% CI, 0.23 to 0.27) respectively. The curve of local drift showed a downward trend with age. Both the period and cohort rate ratios have increased significantly over the last 30 years. By 2031, the age-standardized rates of prevalence will decrease to 678.69 (95% CI, 640.75 to 716.63), while the age-standardized rates of YLDs will increase to 69.19 (95% CI, 66.95 to 71.43). Conclusions: The burden of heart failure in China remains concerning. The implementation of comprehensive strategies should be taken into consideration, including strengthening primary healthcare system, enhancing public awareness, and promoting cardiac rehabilitation. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was supported by the National Key Research and Development Program of China (grant number: 2022YFC3500101). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: For the secondary analysis of the Global Burden of Disease studies, the Institutional Review Board of the University of Washington reviewed and approved a waiver of informed consent (https://www.healthdata.org/research-analysis/gbd). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Datasets analyzed for this study are publicly available at https://vizhub.healthdata.org/gbd-results/.

Background & Objective:Anemia in patients with heart failure (HF) is a growing concern. However, there has no bibliometric analysis in this area up to now. The aim of this study is to explore the status and trends in the field of anemia in HF through the bibliometric analysis, and to provide an outlook on future research.Methods:We retrieved publications from the Web of Science Core Collection database, and the following data analysis and visualization tools were utilized to perform data processing, statistical computing and graphics generation: VOSviewer (v.1.6.18), CiteSpace (v.6.2 R5), Scimago Graphica (v.1.0.36), Biblimatrix and Microsoft Excel.Results:We identified a total of 3490 publications from 2004 to 2023. The publications in the field of anemia in HF are growing steadily. The United States, the United Kingdom, and Italy were the leading countries in this area. Stefan D Anker, as the most influential author, held the most total citations and publications. Harvard University was the most productive institution in this area. The European Journal of Heart Failure had published the most papers. Through the analysis of co-citations, 14 major clusters based on cluster labels were identified. Keyword analysis showed that mortality, outcome, prevalence, and risk were the most frequent keywords, and the potential research hotspots in the future will be intravenous iron and iron deficiency.Conclusion:This study provides a comprehensive analysis of countries, authors, institutions, journals, co-cited references, and keywords in the field of anemia in HF through bibliometric analysis and data visualization. The status, hotspots and future trends in this field offer a reference for in-depth research. Further studies are necessary in the future to broaden the spectrum of research in this field, to evaluate comprehensive approaches to treating anemia in patients with HF, and to find rational targets for the management of anemia.

Background: Guanxinning tablet (GXNT), a Chinese patent medicine, is composed of salvia miltiorrhiza bunge and ligusticum striatum DC, which may play the role of endothelial protection through many pathways. We aimed to explore the molecular mechanisms of GXNT against atherosclerosis (AS) through network pharmacology and molecular docking verification. Methods: The active ingredients and their potential targets of GXNT were obtained in traditional Chinese medicine systems pharmacology database and analysis platform and bioinformatics analysis tool for molecular mechanism of traditional Chinese medicine databases. DrugBank, TTD, DisGeNET, OMIM, and GeneCards databases were used to screen the targets of AS. The intersection targets gene ontology and Kyoto encyclopedia of genes and genomes enrichment analysis were performed in DAVID database. GXNT-AS protein-protein interaction network, ingredient-target network and herb-target-pathway network were constructed by Cytoscape. Finally, we used AutoDock for molecular docking. Results: We screened 65 active ingredients of GXNT and 70 GXNT-AS intersection targets. The key targets of protein-protein interaction network were AKT1, JUN, STAT3, TNF, TP53, IL6, EGFR, MAPK14, RELA, and CASP3. The Kyoto encyclopedia of genes and genomes pathway enrichment analysis showed that pathways in cancer, lipid and atherosclerosis, and PI3K-Akt signaling pathway were the main pathways. The ingredient-target network showed that the key ingredients were luteolin, tanshinone IIA, myricanone, dihydrotanshinlactone, dan-shexinkum d, 2-isopropyl-8-methylphenanthrene-3,4-dione, miltionone I, deoxyneocryptotanshinone, Isotanshinone II and 4-methylenemiltirone. The results of molecular docking showed that tanshinone IIA, dihydrotanshinlactone, dan-shexinkum d, 2-isopropyl-8-methylphenanthrene-3,4-dione, miltionone I, deoxyneocryptotanshinone, Isotanshinone II and 4-methylenemiltirone all had good binding interactions with AKT1, EGFR and MAPK14. Conclusion: The results of network pharmacology and molecular docking showed that the multiple ingredients within GXNT may confer protective effects on the vascular endothelium against AS through multitarget and multichannel mechanisms. AKT1, EGFR and MAPK14 were the core potential targets of GXNT against AS.

中医药在新型冠状病毒肺炎疫情中发挥了巨大作用,数据显示,全国新型冠状病毒肺炎确诊病例中,中医药使用率达91.5%,总有效率达90%以上,能够有效缓解症状、提高治愈率、降低病死率等,中医药的发展迎来了重大的历史机遇.中医临床学生作为中医药事业继承和发扬的主力军,他们对中医药的认知至关重要,此问卷旨在调查新型冠状病毒肺炎疫情后该群体对中医药认知的改变及影响因素.

目的:探讨焦虑和(或)抑郁对经皮冠状动脉介入治疗(PCI)术后病人主要心血管不良事件(MACE)的影响.方法:检索中国知网(CNKI)、万方、维普(VIP)数据库自建库至2020年8月所有焦虑和(或)抑郁对冠心病PCI术后病人MACE影响的相关文献,用RevMan 5.3进行统计分析.结果:纳入12篇文献,均为队列研究,Meta分析结果显示,焦虑抑郁组PCI术后病人MACE发生率高于对照组,差异有统计学意义[OR=2.59,95％CI(1.59,4.21),P=0.0001];抑郁组PCI术后病人MACE发生率高于对照组,差异有统计学意义[OR=2.62,95％CI(2.05,3.34),P<0.00001].结论:现有证据表明,焦虑和(或)抑郁会增加PCI术后病人MACE发生率,但仍需高质量、大样本的研究进一步验证.

目的 基于数据挖掘技术探讨针灸治疗心力衰竭的穴位配伍规律.方法 初步检索获得针灸治疗心力衰竭的文献215篇,根据纳入和排除标准将58篇文献纳入数据库,采用Microsoft Excel 2016、SPSS 23.0及SPSS Modeler 18.0软件进行分析.结果 针灸治疗心力衰竭的腧穴以内关、心俞、血海、神门、足三里为主,位于四肢;属于手厥阴心包经、足太阳膀胱经、任脉;特定穴使用以络穴、背俞穴、八脉交会穴多见;关联分析显示相关性最高的穴位组合:内关-心俞、内关-血海、内关-足三里、内关-神门.高频腧穴聚类分析得到4个聚类群:百会-巨阙-合谷;四神聪-水泉;厥阴俞-膈俞-内关-三阴交-郗门-肾俞-肺俞-心俞-血海-神门-足三里-膻中-中脘;关元-气海-丰隆-神阙-太溪.结论 针灸治疗心力衰竭选穴以手厥阴心包经、手少阴心经及足太阳膀胱经为主,以四肢多见,重视特定穴的使用,尤其是络穴、八脉交会穴、原穴,注重原络配穴法.

ObjectiveTo compare the efficacy and safety of bioresorbable scaffolds (BRS) with drug-eluting stents (DES) in patients with myocardial infarction undergoing percutaneous coronary interventions (PCI).MethodsWe performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing BRS with DES on clinical outcomes with at least 12 months follow-up. Electronic databases of PubMed, CENTRAL, EMBASE, and Web of Science from inception to 1 March 2022 were systematically searched to identify relevant studies. The primary outcome of this study was the device-oriented composite endpoint (DOCE) consisting of cardiac death, target-vessel myocardial infarction, and target lesion revascularization. Secondary outcomes were a composite of major adverse cardiac events (MACE, all-cause death, target-vessel myocardial infarction, or target vessel revascularization) and the patient-oriented composite endpoint (POCE, defined as a composite of all-cause death, myocardial infarction, or revascularization). The safety outcomes were definite/probable device thrombosis and adverse events.ResultsFour randomized clinical trials including 803 participants with a mean age of 60.5 & PLUSMN; 10.8 years were included in this analysis. Patients treated with BRS had a higher risk of the DOCE (RR 1.62, 95% CI: 1.02-2.57, P = 0.04) and MACE (RR 1.77, 95% CI: 1.02-3.08, P = 0.04) compared with patients treated with DES. No significant difference on the POCE (RR 1.33, 95% CI: 0.89-1.98, P = 0.16) and the definite/probable device thrombosis (RR 1.31, 95% CI: 0.46-3.77, P = 0.61) were observed between BRS and DES. No treatment-related serious adverse events were reported.ConclusionBRS was associated with a higher risk of DOCE and MACE compared with DES in patients undergoing PCI for myocardial infarction. Although this seems less effective in preventing DOCE, BRS appears as safe as DES.Systematic review registration[], identifier [CRD 42022321501].

目的 探讨冠心病合并抑郁状态的影响因素及中医证候分布特点.方法 连续入选2020年6月—2021年4月在北京中医药大学东直门医院心血管内科就诊的冠心病患者共200例,符合纳排标准共172例,根据汉密尔顿抑郁量表(HAMD)评分结果分为无抑郁(≤7分)58例、轻度抑郁(8～17分)84例、中度抑郁(18～24分)21例、重度抑郁(≥25分)9例.比较无抑郁和抑郁状态患者性别、年龄、文化程度、就诊方式、病史(吸烟史、饮酒史、心力衰竭、高血压、糖尿病、高血脂症、PCI术后、脑卒中、心房纤颤、肾功能不全).同时根据2017年《双心疾病中西医结合诊治专家共识》的诊断标准探讨冠心病合并抑郁状态的证候特点.结果 单因素分析显示,冠心病合并抑郁状态的影响因素有性别、年龄、就诊方式、吸烟、肾功能不全(P均<0.05).多变量Logistic回归分析结果显示:女性、CCU住院、肾功能不全是冠心病合并抑郁状态的独立影响因素(P均<0.05);114例冠心病合并抑郁状态患者中,心血瘀阻证38例(33.3％),肝气郁结证28例(24.6％),痰火扰心证17例(14.9％),心脾两虚证12例(10.5％),心肾阳虚证10例(8.8％),心肾不交证9例(7.8％).结论 冠心病患者抑郁状态的患病率为66.3％;女性、CCU住院、肾功能不全为冠心病合并抑郁状态的独立影响因素;冠心病合并抑郁状态的证候特点以心血瘀阻证和肝气郁结证为主,其他依次为痰火扰心证、心脾两虚证、心肾阳虚证、心肾不交证.

Background: Obstructive sleep apnea (OSA) is a common disease that can lead to intermittent hypoxia, increased sympathetic overdrive, and excessive oxidative stress, and eventually lead to cardiovascular/cerebrovascular diseases and metabolic disorders. The prevalence of OSA is reported to be higher in people with certain cardiovascular diseases (CVD). Therefore, the relationship between OSA and CVD has been gradually favored by researchers. Material/Methods: Data were downloaded from the Web of Science Core Collection database. Citespace was used to remove duplicated data and construct knowledge visual maps. Results: A total of 7047 publications were obtained. The USA was the largest contributor as well as an important player in the cooperation network between nations. The leading institution was the Mayo Clinic. Our study ultimately identified the top 5 hotspots and 4 research frontiers in this field. Top 5 hotspots were: the specific types of obstructive sleep apnea-related cardiovascular and metabolic co-morbidities, the curative effects of CPAP on these co-morbidities, the specific mechanisms of co-morbidities, the importance of polysomnography on OSA and its co-morbidities with CVD, and the prevalence of OSA and its co-morbidities with CVD in particular populations. The top 4 frontiers were: the relationship between OSA and resistant hypertension, the molecular mechanisms of OSA and its co-morbidities with CVD, specific medications and treatment guidelines for the co-morbidities, and the mainstream research methods in this field. Conclusions: This study provides insight and valuable information for researchers and helps to identify new perspectives concerning potential collaborators and cooperative institutions, hot topics, and research frontiers in this field.

Licorice,also known as Radix Glycyrrhizae,is a natural sweetener and widely used as a drug,and it has been considered to be a healthy natural substance with few side effects. （1,2） Pseudo hyperaldosteronism（PsHA）,which is characterized by hypertension,hypokalemia and alkalosis,should be considered when licorice or its related products are excessively ingested.Moreover,

从血瘀探讨冠心病合并抑郁的病机及治法.冠心病病人常因病程迁延不愈、长期服药、家庭经济压力、社会因素导致紧张、焦虑、抑郁等情志问题.血瘀是冠心病合并抑郁的重要病理基础,治疗应注重活血化瘀,冠心病病人中血瘀与抑郁的发生发展密切相关.目前临床以疏肝解郁治疗为主,但应考虑血瘀的因素.

Objective To compare the efficacy and safety of bioresorbable scaffolds (BRS) with drug-eluting stents (DES) in patients with myocardial infarction undergoing percutaneous coronary interventions (PCI). Methods We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing BRS with DES on clinical outcomes with at least 12 months follow-up. Electronic databases of PubMed, CENTRAL, EMBASE, and Web of Science from inception to 1 March 2022 were systematically searched to identify relevant studies. The primary outcome of this study was the device-oriented composite endpoint (DOCE) consisting of cardiac death, target-vessel myocardial infarction, and target lesion revascularization. Secondary outcomes were a composite of major adverse cardiac events (MACE, all-cause death, target-vessel myocardial infarction, or target vessel revascularization) and the patient-oriented composite endpoint (POCE, defined as a composite of all-cause death, myocardial infarction, or revascularization). The safety outcomes were definite/probable device thrombosis and adverse events. Results Four randomized clinical trials including 803 participants with a mean age of 60.5 ± 10.8 years were included in this analysis. Patients treated with BRS had a higher risk of the DOCE (RR 1.62, 95% CI: 1.02–2.57, P = 0.04) and MACE (RR 1.77, 95% CI: 1.02–3.08, P = 0.04) compared with patients treated with DES. No significant difference on the POCE (RR 1.33, 95% CI: 0.89–1.98, P = 0.16) and the definite/probable device thrombosis (RR 1.31, 95% CI: 0.46–3.77, P = 0.61) were observed between BRS and DES. No treatment-related serious adverse events were reported. Conclusion BRS was associated with a higher risk of DOCE and MACE compared with DES in patients undergoing PCI for myocardial infarction. Although this seems less effective in preventing DOCE, BRS appears as safe as DES. Systematic review registration [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=321501], identifier [CRD 42022321501].

目的 观察参桂胶囊联合西药治疗冠心病慢性心力衰竭阳虚血瘀证临床疗效.方法 将57例冠心病慢性心力衰竭阳虚血瘀证患者按照随机数字表法分为治疗组30例,对照组27例.两组均予规范化药物治疗,治疗组在此基础上联合使用参桂胶囊,每次1.2 g,每日3次,两组均治疗8周;比较治疗前后两组患者纽约心脏协会(New York Heart Association,NYHA)心功能分级、中医证候积分、N端B型脑钠肽前体(NT-proBNP)、超声心动图指标及心肌能量消耗值(MEE),并分析MEE与NT-proBNP相关性.结果 治疗后两组NYHA心功能分级比较,治疗组优于对照组(P＜0.05),治疗组心功能疗效总有效率(70.0％)优于对照组(37.0％)(P＜0.05).与治疗前相比,两组患者治疗后阳虚症状积分、血浆NT-proBNP水平均明显下降(P＜0.05);治疗后治疗组气喘、气短、乏力、畏寒肢冷症状评分及血浆NT-proBNP水平改善优于对照组(P＜0.05).与治疗前相比,两组患者治疗后左室每搏输出量(LVSV)、二尖瓣舒张早期与舒张晚期血流速峰值比值(E/A)、左室射血分数(LVEF)均升高(P＜0.05),治疗组LVSV、E/A、LVEF较对照组升高更明显(P＜0.05).与治疗前相比,治疗组MEE明显降低(P＜0.05),治疗组MEE降低优于对照组(P＜0.05).Pearson相关性分析结果显示,MEE水平与NT-proBNP呈正相关(r=0.320,P=0.015).结论 参桂胶囊联合常规标准化西医治疗能显著改善冠心病慢性心力衰竭阳虚血瘀证患者临床症状、心脏舒张功能,并降低心肌能量消耗水平.