Objective To evaluate the independent and combined associations of nighttime sleep duration and midday napping duration with all-cause mortality and premature death in Chinese older adults and to examine potential sex-specific differences. Methods This longitudinal cohort study analyzed 11,054 adults aged ≥60 years from the China Health and Retirement Longitudinal Study 2018–2020. Sleep is a key factor in the health of older adults, but prior research has focused on nighttime sleep in Western populations, with limited attention to the culturally common practice of midday napping in China and no systematic analysis of sex differences. Nighttime sleep and daily midday napping durations were collected using standardized questionnaires. Two-year all-cause mortality and premature death were tracked as the primary outcomes. Cox regression, restricted cubic spline analysis, and multiple sensitivity analyses were performed. The proportional hazards assumption was verified using Schoenfeld residuals (all p > 0.05). Results After adjustment for covariates (age, sex, education level, marital status, smoking, alcohol consumption, and number of chronic diseases), daily napping ≥60 min was independently associated with a higher risk of all-cause mortality (overall hazard ratio = 1.289, p = 0.013; males: hazard ratio = 1.298, p = 0.049). The “long sleep + long nap” pattern (>8 h nighttime sleep + ≥60 min nap) was associated with the highest risk of all-cause mortality (hazard ratio = 3.048, p < 0.001). Males with 8–10 h of nighttime sleep had an elevated risk of all-cause mortality (hazard ratio = 3.095, p = 0.001), whereas females with 4–6 h of nighttime sleep had a lower risk of premature death (hazard ratio = 0.522, p = 0.039). Restricted cubic spline analysis confirmed a nonlinear U-shaped association between nighttime sleep duration and all-cause mortality. Conclusions In Chinese older adults, prolonged daily napping (≥60 min) was associated with a higher risk of mortality after adjustment for covariates. Sex-specific differences were observed, although the formal interaction test did not reach statistical significance (p = 0.112). Nighttime sleep of 6–8 h and avoiding daily napping ≥60 min may be associated with a lower risk of mortality; however, as this was an observational study, causal inference cannot be established.

Background:With the accelerating trend of population aging, increasing attention has been paid to the health status and quality of life among older adults. However, the underlying mechanisms linking pain and life satisfaction remain not fully elucidated. This research intended to explore the mediating role of sleep quality in the association between pain and life satisfaction. Methods:The present research enrolled 9481 participants aged 60 and above from wave 2020 of the China Health and Retirement Longitudinal Study (CHARLS). We employed linear regression and bootstrap methods to examine the mediating role of sleep quality in the association between pain and life satisfaction. Results:Following adjustment for confounding variables, pain was negatively associated with life satisfaction (β = -0.097, P < 0.001) and was associated with poorer sleep quality (r = -0.27, P < 0.001). The mediating effect of sleep quality accounted for 26.5% of the total effect of pain on life satisfaction, and the size of the mediating effect was a×b =-0.0077 (95% CI: -0.0089, -0.0064). Conclusion:Among Chinese older adults, pain was associated with lower life satisfaction both directly and indirectly through its association with poorer sleep quality. This finding suggests that in addressing the health challenges of an aging society, it is essential to focus not only on the management of pain itself but also on improving sleep quality among older adults, thereby potentially enhancing their overall life satisfaction.

[This corrects the article DOI: 10.3389/fnut.2023.1285494.].

BackgroundChanges in the gut microbiota are closely related to insomnia, but the causal relationship between them is not yet clear.ObjectiveTo clarify the relationship between the gut microbiota and insomnia and provide genetic evidence for them, we conducted a two-sample Mendelian randomization study.MethodsWe used a Mendelian randomized two-way validation method to discuss the causal relationship. First, we downloaded the data of 462,341 participants relating to insomnia, and the data of 18,340 participants relating to the gut microbiota from a genome-wide association study (GWAS). Then, we used two regression models, inverse-variance weighted (IVW) and MR-Egger regression, to evaluate the relationship between exposure factors and outcomes. Finally, we took a reverse MR analysis to assess the possibility of reverse causality.ResultsThe combined results show 19 gut microbiotas to have a causal relationship with insomnia (odds ratio (OR): 1.03; 95% confidence interval (CI): 1.01, 1.05; p=0.000 for class. Negativicutes; OR: 1.03; 95% CI: 1.01, 1.05; p=0.000 for order.Selenomonadales; OR: 1.01; 95% CI: 1.00, 1.02; p=0.003 for genus.RikenellaceaeRC9gutgroup). The results were consistent with sensitivity analyses for these bacterial traits. In reverse MR analysis, we found no statistical difference between insomnia and these gut microbiotas.ConclusionThis study can provide a new direction for the causal relationship between the gut microbiota (class.Negativicutes, order.Selenomonadales, genus.Lactococcus) and insomnia and the treatment or prevention strategies of insomnia.

AimTobacco smoke exposure and vitamin D (VD) status were both associated with insomnia. However, the combined effect of smoking and VD on insomnia has not been discussed. This study aimed to explore the role of VD in the association between tobacco smoke exposure and insomnia.MethodsData on adults were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2005–2008 for this cross-sectional study. Weighted univariate and multivariate logistic regression analyses were used to explore the associations between serum cotinine, serum VD, and insomnia. A surface diagram was drawn to reflect the effect of VD on the association between serum cotinine and insomnia. In addition, the potential regulating effect of VD in subgroups of smoking status was also performed. The evaluation index was odds ratios (ORs) with 95% confidence intervals (CIs).ResultsAmong the eligible participants, 1,766 had insomnia. After adjusting for covariates, we found that elevated serum cotinine levels were associated with higher odds of insomnia [OR = 1.55, 95% CI: (1.22, 1.97)]. However, the relationship between serum VD level and insomnia was not significant (P = 0.553). Higher serum cotinine levels were also associated with higher odds of insomnia [OR = 1.52, 95% CI: (1.17, 1.98)] when serum VD level was <75 nmol/L; however, this relationship became non-significant when serum VD concentration was elevated (P = 0.088). Additionally, the potential regulating effect of VD was also found in adults who were not smoking.ConclusionVD may play a potential regulative role in the association between tobacco smoke exposure and insomnia. Further studies are needed to clarify the causal relationships between VD, tobacco smoke exposure, and insomnia.

Sepsis is a systemic inflammatory response syndrome caused by bacteria and other pathogenic microorganisms. Every year, approximately 31.5 million patients are diagnosed with sepsis, and approximately 5.3 million patients succumb to the disease. In this study, we identified biomarkers for diagnosing sepsis analyzed the relationships between genes and Immune cells that were differentially expressed in specimens from patients with sepsis compared to normal controls. Finally, We verified its effectiveness through animal experiments. Specifically, we analyzed datasets from four microarrays(GSE11755、GSE12624、GSE28750、GSE48080) that included 106 blood specimens from patients with sepsis and 69 normal human blood samples. SVM-RFE analysis and LASSO regression model were carried out to screen possible markers. The composition of 22 immune cell components in patients with sepsis were also determined using CIBERSORT. The expression level of the biomarkers in Sepsis was examined by the use of qRT-PCR and Western Blot (WB). We identified 50 differentially expressed genes between the cohorts, including 2 significantly upregulated and 48 significantly downregulated genes, and KEGG pathway analysis identified Salmonella infection, human T cell leukemia virus 1 infection, Epstein−Barr virus infection, hepatitis B, lysosome and other pathways that were significantly enriched in blood from patients with sepsis. Ultimately, we identified COMMD9, CSF3R, and NUB1 as genes that could potentially be used as biomarkers to predict sepsis, which we confirmed by ROC analysis. Further, we identified a correlation between the expression of these three genes and immune infiltrate composition. Immune cell infiltration analysis revealed that COMMD9 was correlated with T cells regulatory (Tregs), T cells follicular helper, T cells CD8, et al. CSF3R was correlated with T cells regulatory (Tregs), T cells follicular helper, T cells CD8, et al. NUB1 was correlated with T cells regulatory (Tregs), T cells gamma delta, T cells follicular helper, et al. Taken together, our findings identify potential new diagnostic markers for sepsis that shed light on novel mechanisms of disease pathogenesis and, therefore, may offer opportunities for therapeutic intervention.

BackgroundThe negative effects of insomnia on adolescents’ development, academic performance, and quality of life place a burden on families, schools, and society. As one of the most important research directions for insomnia, adolescent insomnia has significant research value, social value, and practical significance. Unfortunately, there is no bibliometric analysis in this field of study. This study aims to analyze published articles using bibliometrics, summarize the current research progress and hot topics in this field systematically and exhaustively, and predict the future direction and trend of research.MethodsFor this study, the Web of Science Core Collection (WoSCC) database was searched between 2002 and 2022 for publications related to adolescent insomnia. The R–bibliometrix, VOSViewer, and CiteSpace software were utilized for bibliometric analysis.ResultsThis investigation included 2468 publications from 3102 institutions in 87 countries, led by China and the United States. This field of research has entered a period of rapid development since 2017. The journal with the most publications on adolescent insomnia is Sleep, which is also the most co–cited journal. American Journal of Psychology has the highest impact factor among the top 10 journals. These papers were written by 10605 authors; notably, Liu Xianchen emerged as the author with the highest frequency of publications, while Mary A. Carskadon was the most frequently co–cited author. Mental health and comorbid diseases were the main research directions in this field. “Depression,” “anxiety,” “mental health,” “COVID–19,” “stress,” “quality of life,” “heart rate variability,” and “attention–deficit hyperactivity disorder” were hot spots and trends in this field at the current moment.ConclusionThe research on adolescent insomnia has social value, research value, and research potential; its development is accelerating, and an increasing number of researchers are focusing on it. This study summarized and analyzed the development process, hot spots, and trends of adolescent insomnia research using bibliometric analysis, which identified the current hot topics in this field and predicted the development trend for the future.

IntroductionInsomnia is the most common form of sleep deprivation (SD) observed in clinics. Although there are differences between insomnia and SD, they have similar symptoms and the same animal model. Currently, there is a lack of microarray data on insomnia. Therefore, for now, we are going to apply the SD data to insomnia. Although many studies have explained the possible mechanisms associated with insomnia, no previous studies have considered the key genes associated with insomnia or the relationship between insomnia and immune cells. In this study, we analyzed the relationship between key genes and immune cells by identifying biomarkers for the diagnosis of insomnia. Next, we verified the efficacy of these biomarkers experimentally.MethodsFirst, we downloaded four microarrays (GSE11755, GSE12624, GSE28750, and GSE48080) from the Gene Expression Omnibus (GEO) database, which included data from 239 normal human blood samples and 365 blood specimens from patients with SD. Then, we analyzed two groups of differentially expressed genes (DEGs) and used Support Vector Machine Recursive Feature Elimination (SVM-RFE) analysis and the Least Absolute Shrinkage and Selection Operator (LASSO) regression model to investigate these key genes. Next, we used CIBERSORT to investigate the composition of 22 immune cell components of key genes in SD patients. Finally, the expression levels of key biomarkers in sleep-deprived patients were examined by quantitative real-time polymerase chain reaction (qRT-PCR).ResultsA total of 50 DEGs were identified: six genes were significantly upregulated, and 44 genes were significantly downregulated. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that Salmonella infection, NOD-like receptor (NLR) signaling pathway, Kaposi sarcoma-associated herpesvirus infection, and Th17 cell differentiation were significant. Based on machine learning, we identified C2CD2L, SPINT2, APOL3, PKNOX1, and A2M as key genes for SD; these were confirmed by receiver operating characteristic (ROC) analysis. Immune cell infiltration analysis showed that C2CD2L, SPINT2, APOL3, PKNOX1, and A2M were related in different degrees to regulatory T cells (Tregs), follicular T helper cells, CD8 cells, and other immune cells. The qRT-PCR experiments confirmed that the expression levels of C2CD2L concurred with the results derived from machine learning, but PKNOX1 and APOL3 did not.DiscussionIn summary, we identified a key gene (C2CD2L) that may facilitate the development of biomarkers for insomnia.

结合临床实践经验,从新冠病毒毒株的变异、中医对疫病的认识、中医的临床救治进行整理和思考,提出"浊毒犯络"的防疫思路,防治结合,分型论治,截断病势,以化浊解毒贯穿于治疗的始终.

Fructus gardeniae (FG) is a traditional Chinese medicine and health food for thousands of years of application throughout Chinese history and is still widely used in clinical Chinese medicine. FG has a beneficial impact on anxiety, depression, insomnia, and psychiatric disorders; however, its mechanism of action requires further investigation. This study aimed to investigate the effects and mechanisms of FG on sleep deprivation (SD)-induced anxiety-like behavior in rats. A model of SD-induced anxiety-like behavior in rats was established by intraperitoneal injection of p-chlorophenylalanine (PCPA). This was accompanied by neuroinflammation and metabolic abnormalities in the hippocampus and disturbance of intestinal microbiota. However reduced SD-induced anxiety-like behavior and decreased levels of pro-inflammatory cytokines including TNF-α and IL-1β were observed in the hippocampus of rats after 7 days of FG intervention. In addition, metabolomic analysis demonstrated that FG was able to modulate levels of phosphatidylserine 18, Phosphatidylinositol 18, sn-glycero-3-phosphocholine, deoxyguanylic acid, xylose, betaine and other metabolites in the hippocampus. The main metabolic pathways of hippocampal metabolites after FG intervention involve carbon metabolism, glycolysis/gluconeogenesis, pentose phosphate, and glycerophospholipid metabolism. 16S rRNA sequencing illustrated that FG ameliorated the dysbiosis of gut microbiota in anxious rats, mainly increased the abundance of Muribaculaceae and Lactobacillus, and decreased the abundance of Lachnospiraceae_NK4A136_group. In addition, the correlation analysis demonstrated that there was a close relationship between hippocampal metabolites and intestinal microbiota. In conclusion, FG improved the anxiety behavior and inhibited of neuroinflammation in sleep-deprived rats, and the mechanism may be related to the FG regulation of hippocampal metabolites and intestinal microflora composition.

Sepsis is a common acute and critical disease, which is a systemic inflammatory response syndrome. More and more evidence shows that chromium regulators (CRs) are involved in the progress of inflammation and sepsis. The purpose of this study was to explore the role of CRS in sepsis patients and provide prognostic value CRs were obtained from previous top level studies. We downloaded four microarrays（GSE11755、GSE12624、GSE28750、GSE48080）from Gene Expression Omnibus (GEO). CRs related genes were extracted for differential analysis, and GO, KEGG, DO analysis was conducted for different CRs. We conduct PPI analysis on different CRs and screen hub genes. We use the ssGSEA algorithm to obtain the relevant immune cells and immune function infiltration matrix, and draw the relevant heat map for correlation analysis and difference analysis between immune cells and immune function. We analyzed the correlation between hub genes, immune cells and immune functions, and screened out the most relevant hub genes (IHGs). Finally, IHGs are used to build models, and nomograms, ROC curves, and calibration charts are drawn to predict IHGs related drugs and related miRNAs and genes, and RT-PCR is used to verify related genes. We obtained 69 normal blood samples and 106 sepsis patients' blood samples, and extracted relevant CRS genes. GO analysis shows that CRS gene involves histone modification, peptidyl−lysine modification、chromatin remodeling, etc. KEGG analysis involves cell cycle, Viral carcinogenesis and Hepatocellular carcinoma signal pathways. We identified 10 hub genes, including TP53, EZH2, RNF2, and mapped relevant maps. 10 drugs such as PHA may be useful for the treatment of Sepsis. MiRNAs such as hsa-miR-4281, hsa-miR-4715-5p, hsa-miR-409-5p and TP53, CHD3, CBX4 genes are associated with this disease. RT-PCR results showed that the expression levels of TP53 and CHD3 were significantly reduced, and the expression levels of CBX4 were significantly increased Our study provides new insights into the role of CRS in sepsis, and provides reliable biomarkers to determine the prognosis of sepsis patients.

Review question / Objective: This study is intended to evaluate the efficacy of various doses of xuebijing injections for sepsis treatment.Condition being studied: Sepsis is characterized by high incidence rate, high mortality, and difficulty in curing.About 14000 people worldwide die of sepsis and its complications every day, which seriously affects the quality of human life and poses a great threat to human health.Xuebijing has obvious anti-inflammatory and promoting blood circulation and removing blood stasis effects.At present, it has been widely used in the treatment of critical diseases and sepsis in China.This study aimed to systematically review the effectiveness of xuebijing in the treatment of sepsis.

脓毒症是宿主对感染反应失调而引起的危及生命的器官功能障碍,是急诊科常见的急危重症之一,患者机体内白细胞介素-33/生长刺激表达基因2蛋白(IL-33/ST2)通路与炎症相关.无论从中医角度还是西医角度,都应及早应用大黄类药物.现主要从IL-33/ST2通路与脓毒症胃肠功能障碍关系的方向探讨其作用机制,并从中西医不同角度分析大黄类药物的应用.

OBJECTIVE:To evaluate the clinical efficacy and safety of combination of traditional Chinese and Western medicine in the treatment of coronavirus disease 2019 (COVID-19) by Meta analysis.METHODS:The clinical randomized controlled trials (RCT) and cohort studies on the treatment of COVID-19 with combination of Chinese traditional and Western medicine published on CNKI, Wanfang database, VIP database and PubMed were searched by computer from January 2020 to June 2020. Patients in the simple Western medicine treatment group were treated with routine treatment of Western medicine, and the patients in integrated traditional Chinese and Western medicine treatment group were treated with traditional Chinese medicine on the basis of routine treatment of Western medicine. The main outcome was the total effective rate of treatment. The secondary outcome were the antipyretic rate, chest CT recovery rate, lymphocyte count (LYM), C-reactive protein (CRP) level and safety. The Cochrane manual and the Newcastle Ottawa Scale (NOS) were used to evaluate the quality of the literature; the RevMan5.3 software was used to analyze the articles that meets the quality standards, and a funnel chart was drawn to evaluate the total effective publication bias.RESULTS:Thirteen articles were analyzed, including 1 039 COVID-19 patients, 559 in integrated traditional Chinese and Western medicine treatment group and 480 in simple Western medicine treatment group. The results of Meta- analysis showed that compared with the simple Western medicine treatment group, the combination of routine treatment of Western medicine and traditional Chinese medicine Qingfei Paidu decoction, Lianhua Qingwen granule, Shufeng jiedu capsule, Xuebijing injection or Reyanning mixture could significantly improve the total effective rate, antipyretic rate and chest CT recovery rate [total effective rate: odds ratio (OR) = 2.95, 95% confidence interval (95%CI) was 2.10-4.14, P < 0.000 01; antipyretic rate: OR =3.01, 95%CI was 1.64-5.53, P = 0.000 4; chest CT recovery rate: OR = 2.53, 95%CI was 1.83-3.51, P = 0.000 1], increase LYM levels [mean difference (MD) = 0.26, 95%CI was 0.02-0.50, P = 0.03], and reduce of CRP content (MD = -17.68, 95%CI was -33.14 to -2.22, P = 0.02). Based on the funnel chart analysis of 12 articles with total efficiency, the result showed that the funnel chart distribution was not completely symmetrical, indicating that there might be publication bias.CONCLUSIONS:On the basis of routine treatment with Western medicine, combined with traditional Chinese medicine can significantly improve the total effective rate of COVID-19 and improve the laboratory results and clinical symptoms of patients. Compared with the routine treatment of Western medicine alone, the combination of traditional Chinese and Western medicine has better clinical efficacy and safety.

目的 观察丹红注射液联合针刺对急性呼吸窘迫综合征患者呼吸功能、血气指标以及炎症因子的影响.方法 将2019年3月—2020年10月河北省中医院重症医学科收治的72例急性呼吸窘迫综合征患者按照随机数字表法分为对照组和观察组各36例.对照组给予重症医学科常规治疗,观察组在此基础上给予丹红注射液静点和针刺治疗,2组均治疗2周.比较2组患者机械通气时间、ICU治疗时间,观察2组治疗前后APACHEⅡ评分、序贯性器官功能衰竭评分(SOFA评分),动脉血pH值、氧分压[p(O2)]、二氧化碳分压[p(CO2)]、血氧饱和度[Sa(O2)],白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、降钙素原(PCT)水平的变化,统计2组疗效及不良反应发生情况.结果 观察组患者机械通气时间、ICU治疗时间明显短于对照组(P均<0.05);2组患者治疗后APACHEⅡ评分、SOFA评分、p(CO2)及IL-6、TNF-α、CRP、PCT水平均明显低于治疗前,且观察组上述指标均明显低于对照组,差异均有统计学意义(P均<0.05);治疗后2组患者pH值、p(O2)、Sa(O2)均明显高于治疗前,且观察组上述指标均明显高于对照组,差异均有统计学意义(P均<0.05).治疗后,观察组总有效率为80.6％(29/36),对照组总有效率为61.1％(22/36),观察组总有效率明显高于对照组(P<0.05).治疗后2组患者无明显严重不良反应发生.结论 丹红注射液联合针刺疗法治疗急性呼吸窘迫综合征临床疗效显著,能明显改善患者呼吸情况和血气分析指标,并减轻炎症反应.

目的 观察麻杏饮治疗慢性阻塞性肺疾病急性加重期(AECOPD)呼吸肌疲劳的疗效及对肺功能、血气分析指标、炎症因子的影响.方法 将60例AECOPD呼吸肌疲劳患者按照随机数字表法分为2组,对照组30例予西医常规治疗,治疗组30例在对照组治疗基础上加麻杏饮治疗,2组均治疗2周.比较2组疗效;观察2组治疗前后肺功能指标、血气分析指标、炎症因子及中医证候评分变化;观察2组不良反应发生情况.结果 治疗组总有效率86.7％(26/30),对照组总有效率63.3％(19/30),治疗组疗效优于对照组(P<0.05).2组治疗后用力肺活量(FVC)、第1 s用力呼气容积占预计值百分比(FEV1％pred)、FEV1/FVC、每分钟最大通气量(MVV)及呼吸肌功能指标最大吸气压(MIP)与本组治疗前比较均升高(P<0.05),且治疗组较对照组升高更明显(P<0.05).2组治疗后pH值、氧分压[p(O2)]、血氧饱和度(SaO2)均较本组治疗前升高(P<0.05),二氧化碳分压[p(CO2)]较本组治疗前降低(P<0.05),且治疗组治疗后pH值、p(O2)、SaO2均高于对照组(P<0.05),p(CO2)低于对照组(P<0.05).2组治疗后肿瘤坏死因子 α(TNF-α)、白细胞介素6(IL-6)、血清C反应蛋白(CRP)、降钙素原(PCT)水平均较本组治疗前降低(P<0.05),且治疗组较对照组降低更明显(P<0.05).2组治疗后中医证候咳嗽咯痰、喘息、动则喘甚、气短气急、神疲乏力、食少纳呆评分均较本组治疗前降低(P<0.05),且治疗组较对照组降低更明显(P<0.05).2组患者均未出现严重不良反应.结论 麻杏饮治疗AECOPD呼吸肌疲劳,能有效改善患者肺功能和血气分析指标,改善临床症状,且安全性高,其机制可能与改善呼吸道炎症因子水平有关.

OBJECTIVE:To analyze the research status, research hotspots and frontier trends of traditional Chinese medicine (TCM) in the treatment of influenza in the past 20 years through the knowledge graph, so as to provide reference basis for further research.METHODS:The related literatures of TCM in the treatment of influenza were collected in China National Knowledge Infrastructure (CNKI) from 2000 to 2019. The relevant graphs of authors, research institutions and key words were drawn by CiteSpace 5.6, the distribution and cooperation of main research forces in this field were analyzed, and the research frontiers and hot spot information in this field were discussed.RESULTS:A total of 3 048 related literatures were obtained, involving 949 authors and 242 research institutions. The analysis of the number of articles showed that the volume of articles related to the treatment of influenza with TCM fluctuated greatly in the past 20 years, which was obviously affected by the sudden hot spots around 2010, but showed an overall upward trend, with an average annual volume of about 152 articles. The analysis of the author's cooperation map showed that a total of 77 core authors had published more than 5 articles, accounting for only 8.1% of all authors, and 5 authors had published more than 30 articles. Five major teams had been formed with Gu Ligang, Liu Qingquan, Lu Fangguo, Cui Xiaolan and Zhang Fengxue as the core. The analysis of the cooperation map of research institutions showed that the cooperation among institutions was not good, and only the scientific research institutes in Beijing and Guangzhou had formed a closely related cooperation network. The keyword co-occurrence map showed that 8 keywords appeared more than 100 times, especially ultra-high-frequency keywords, influenza virus ranked first (n = 518). There were 14 key nodes, such as influenza virus, TCM treatment, viral pneumonia and so on, which supported the current research field of TCM in the treatment of influenza. Fourteen clusters were formed to classify the current research hotspots, including the nomenclature of influenza, virus type, TCM treatment, western medicine knowledge, etc., and the map showed that the clustering was reasonable and the structure was significant. Timeline graph showed that parainfluenza virus, virus disease, pharmacodynamics, heat-clearing and detoxifying drugs, bacteriostasis and experimental research had all been studied for more than 8 years, revealing the research hotspots and trends of TCM in the treatment of influenza.CONCLUSIONS:The overall research related to the treatment of influenza with TCM is relatively perfect. In the future, the close cooperation among authors and institutions should be strengthened. The molecular mechanism research, clinical and animal trials of TCM should be further studied, so as to improve the research system of TCM treatment of influenza.

新型冠状病毒肺炎(COVID-19)患者一旦出现急性心脏事件,往往预后较差,病死率明显增加.通过分析COVID-19并发应激性心肌病的病理机制,中医对应激性心肌病的病因病机认识以及防治的相关论述,进一步完善中医药对COVID-19并发应激性心肌病在临床救治方面的认识,为后续COVID-19的治疗提供参考,减少死亡率.

Background :At present, there is a lot of research in the field of septic shock and hypotension, but there is no comprehensive analysis of the current situation, hot spots and frontiers in this field，and many researchers don't know where to start..Therefore，in this study, the research status, research hotspots and frontier trends of septic shock hypotension in the past 30 years were analyzed by knowledge graph, so as to provide a reference basis for further research. Methods : We collected the literature related to hypotension in septic shock in Web Of Science (WOS) from 1991 to 2020, and made a bibliometric analysis of the literature. At the same time, we Use Excel2019 and Adobe Illustrator CC2018 software to analyze the annual volume of articles and draw bar charts and VOSviewer software to draw the relevant maps of countries, authors and institutions to explore the cooperative relationship in this field and CiteSpace software to draw keyword co-occurrence map, cluster timeline map and emergence map of keywords, and analyze the frontiers and hotspots in this field. Results : A total of 1419 articles were obtained, of which the country with the largest number of articles was the United States, and the centrality was the highest. Professor Bellomo Rinaldo in Australia has published the largest number of articles, up to 29 articles, which plays an important role in this field. In the organization cooperation graph, Univ sao Paulo cooperates closely with other agencies and publishes a large number of articles. There are high-frequency keywords such as sepsis, septic shock and hypotensio, 11 clusters such as relative adrenal insufficiency, nitric oxide and thromboxane, and high-prominence keywords of endotoxin and tumor necrosis factor. Conclusion : In the past 30 years, the volume of articles in the field of hypotension in septic shock showed a steady upward trend. Institutions in North America, Australia and Europe have made outstanding contributions to this field, but the degree of inter-country and inter-agency cooperation is worrying. Three major author cooperation groups have been formed, with close ties within the group. In the future, international exchanges and cooperation can be strengthened and the degree of cooperation in this field can be improved. Drugs for the treatment of hypotension, molecular mechanisms including endotoxin and tumor necrosis factor, and physiological and pathological mechanisms of hypotension are the research hotspots and frontiers in recent years.

2019 Novel coronavirus (2019-nCoV) infection caused a pandemic in the world. From the reported cases in the literatures, the level of D-dimer in patients with coronavirus disease 2019 (COVID-19) is positively correlated with the severity of illness, which needs the attention of clinical workers. According to Western medicine, the increase of D-dimer is related to the hyperactivity of fibrinolytic system and the shortening of prothrombin time (PT), resulting in excessive production and degradation of plasma fibrin and hypercoagulable state of blood, while traditional Chinese medicine (TCM) believes that the above syndromes belong to the pathogenesis of "blood stasis" according to TCM theories. Over the years, TCM has a significant effect on promoting blood circulation, removing blood stasis and improving microcirculation. This article reviews the mechanism, clinical significance, understanding of TCM and common methods of promoting blood circulation and removing blood stasis caused by 2019-nCoV, in order to provide ideas for the prevention and treatment of impaired blood coagulation in patients with COVID-19.