Objective To analyze the changing trend and influencing factors of the disease burden of older adults with metabolic dysfunction-associated steatotic liver disease(MASLD)globally and in China from 1990 to 2021,and to predict its future trend.Methods Data on the prevalence and disability-adjusted life years(DALYs)of MASLD among individuals aged 60 years and older from the Global Burden of Disease(GBD)2021 database were extracted for a global context,China,and five socio-demographic index(SDI)regions.Joinpoint regression analysis was employed to calculate the average annual percent change(AAPC)in the age-standardized prevalence(ASPR)and DALY rates(ASDR)from 1990 to 2021,and the subgroup analyses were conducted by age and gender.A three-factor decomposition model was used to quantify the relative impacts of aging,population growth,and epidemiological change on the changes in disease burden,while a Bayesian age-period-cohort model was applied to predict the trend in disease burden of older adults with MASLD from 2022 to 2035.Results The number of MASLD patients in the global and Chinese elderly populations was 366,398,400 cases and 98,916,800 cases in 2021,respectively,representing an increase of 176.40%and 230.71%compared to 1990.The number of DALYs was 1,834,700 person-years and 234,100 person-years,showing increases of 139.52%and 127.06%,respectively.During the period from 1990 to 2021,ASPR[AAPC=0.67%,95%CI(0.62%,0.72%)]and ASDR[AAPC=0.20%,95%CI(0.06%,0.34%)]of MASLD in the global elderly population exhibited a significant upward trend.ASPR[AAPC=0.65%,95%CI(0.55%,0.75%)]of MASLD in the elderly population in China showed a significantly upward trend,while ASDR[AAPC=-0.49%,95%CI(-0.92%,-0.06%)]showed a significantly downward trend.Subgroup analyses by gender indicated that in both 1990 and 2021,the number of prevalence and DALYs in the elderly female populations were higher than those in the corresponding male populations globally and in China.Additionally,while the ASDR of MASLD among the elderly in high-middle and low SDI regions regions showed significant downward trends from 1990 to 2021,the number of patients and DALYs across the five SDI regions increased in 2021 compared to 1990.The 60～64 age group accounted for the highest proportion of case numbers and DALYs among the global elderly population with MASLD in 2021,whereas the 65～69 age group ranked the first in China.Decomposition analysis revealed that population growth was the primary influencing factor for the increase in disease burden of MASLD across all areas,contributing the most(122.09%)to the increase in DALYs in China.The prediction model indicated that by 2035,the number of cases and DALYs in the global elderly population would increase by 65.80%and 43.11%,respectively,compared to 2021,while in China,the increases would be 104.95%and 24.78%,respectively.Conclusion The disease burden of MASLD in the elderly populations globally and in China remains substantial and is expected to continue increasing in the future.It is recommended to promote healthy lifestyle practices while actively adopting a multidisciplinary management approach for elderly MASLD patients and enhancing the research and development of effective drugs to alleviate the burden associated with this disease.

Objective To analyze the disease burden of hypertension in the elderly population from 1990 to 2021 and to predict future trends in China and globally,thereby providing insights for public health de-cision-making regarding older adults with hypertension in China.Methods Data on hypertension-related deaths and disability adjusted life years(DALYs)for individuals aged ≥60 years was extracted from the Global Burden of Disease(GBD)2021 database for the world,China,and five sociodemographic index(SDI)re-gions.Age-standardized mortality and DALYs rates for hypertension in the elderly population were calculated,and Joinpoint regression was used to assess trend changes of disease burden,with results reported as average annual percentage change(AAPC).Additionally,subgroup analyses were conducted based on age and sex.The relative impact of aging,population growth,and epidemiological changes on disease burden was analyzed using a three-factor decomposition method.Future projections for the disease burden from 2022 to 2040 were per-formed using a Bayesian model.Results From 1990 to 2021,both age-standardized mortality and DALYs rates for hypertension in the elderly population demonstrated a significant downward trend globally and in China(both AAPC values were negative,all P＜0.001).However,in 2021,the number of deaths attributed to hy-pertension among the elderly increased by 68.37％globally and by 157.85％in China compared to 1990,while DALYs rose by 61.74％globally and 125.98％in China.Notably,except for the high SDI region,the other four SDI regions witnessed significant increases in deaths and DALYs due to hypertension in 2021 compared to 1990.Furthermore,the burden of hypertension was generally higher among elderly males than females in China.In 2021,the highest number of DALYs due to hypertension was observed in the 70-74 years group,while deaths were predominantly concentrated in the 80-84 years group.Decomposition analysis indicated that popu-lation growth was the primary factor contributing to the increases in deaths and DALYs due to hypertension among the elderly globally and in China.Predictive analysis suggested that the disease burden of hypertension among the elderly in China,encompassing overall,male,and female populations,is expected to continue rising from 2022 to 2040.Conclusions Although age-standardized mortality and DALYs rates for hypertension among the elderly in China have shown a downward trend over the past three decades,the absolute burden re-mains substantial.There is an urgent need for the formulation and implementation of more effective public health policies and clinical interventions to address this critical public health challenge.

Background and Aims: Liver cancer is a digestive system malignancy that poses a significant public health challenge globally. This study aimed to analyze and compare the epidemiological trends of liver cancer attributed to hepatitis B (LCHB) and alcohol use (LCAL) over the past 32 years. Methods: Data on mortality and disability-adjusted life years for LCHB and LCAL in China, globally, and across five sociodemographic index regions were obtained from the Global Burden of Disease 2021 database and comprehensively analyzed. Results: In 2021, the global and Chinese death counts and disability-adjusted life years attributed to LCHB and LCAL showed substantial increases compared to 1990. China had the highest number of deaths from LCHB and LCAL among 204 countries and regions. Gender and age disparities were notable, with males and those aged 40-75 years bearing a higher burden than females and other age groups. Global age-period-cohort analysis revealed an escalating risk of death from LCHB with age, alongside a lower risk in younger cohorts and more recent periods. The mortality risk for LCAL also increased with age but exhibited distinct cohort and period effects compared to LCHB. Decomposition analysis indicated that shifts in the global burden of LCHB and LCAL were influenced by population growth, with population aging playing a crucial role in China. Conclusions: A significant burden of LCHB and LCAL persists, highlighting the need for tailored prevention, screening, and control strategies to mitigate their incidence, as well as the identification of advanced therapeutics to reduce mortality.

ObjectiveTo analyze the methodological and reporting quality of systematic reviews of prediction models published in Chinese journals, with the aim of providing reference for enhancing the overall quality of Chinese systematic reviews of prediction models.MethodsWe searched the CNKI, WanFang Data, CBM, and VIP databases for Chinese systematic reviews of prediction models from inception to July 20, 2023. After two independent reviewers screened literature and extracted data, the AMSTAR(A Measurement Tool to Assess Systematic Reviews) and PRISMA 2020(Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020) tools were used to assess the methodological and reporting quality of the included reviews.ResultsA total of 55 systematic reviews published between 2015 and 2023 were included, 12 of which were meta-analysis. The reviews covered various topics, mainly including cardiovascular diseases, stroke, and diabetes. The identified systematic reviews exhibited obvious deficiencies: items 1, 4, 5, 6, and 10 of AMSTAR showed poor methodological quality, and items 7, 10a, 12, 13a-f, 14, 15, 16a-b, 17, 20b-d, 21, 22, 23d, 24a-c, 25 and 26 of PRISMA 2020 needed improvement in reporting quality. Furthermore, a moderate positive correlation (r=0.58, P < 0.001) was observed between the methodological and reporting quality. Multiple linear regression analysis revealed that a greater number of pages, more recent publications, and funding support were associated with higher methodological quality (P < 0.05). Similarly, a greater number of pages, more recent publications, qualitative systematic reviews, and funding support were associated with higher reporting quality, but the number of authors showed a negative association (P < 0.05).ConclusionThe methodological and reporting quality of existing systematic reviews of prediction models published in Chinese journals is relatively poor and demands improvement.

A dramatic shift in the global food system is occurring with the rapid growth of ultra-processed foods (UPFs) consumption, which poses potentially serious health risks. Systematic review (SR) method has been used to summarise the association between UPF consumption and multiple health outcomes; however, a suboptimal-quality SR may mislead the decision-making in clinical practices and health policies. Therefore, a methodological review was conducted to identify the areas that can be improved regarding the risk of bias and reporting quality of relevant SRs. Systematic searches to collect SRs with meta-analyses of UPFs were performed using four databases from their inception to April 14, 2023. The risk of bias and reporting quality were evaluated using ROBIS and PRISMA 2020, respectively. The key characteristics of the included SRs were summarised descriptively. Excel 2019 and R 4.2.3 were used to analyse the data and draw graphs. Finally, 16 relevant SRs written in English and published between 2020 and 2023 in 12 academic journals were included. Only one SR was rated as low risk of bias, and the others were rated as higher risk of bias mainly because the risk of bias in the original studies was not explicitly addressed when synthesising the evidence. The reporting was required to be advanced significantly, involving amendments of registration and protocol, data and analytic code statement, and lists of excluded studies with justifications. The reviews’ results could improve the quality, strengthen future relevant SRs’ robustness, and further underpin the evidence base for supporting clinical decisions and health policies.

'Target trial emulation' (TTE), as a new framework in real-world research, has been formally established in recent years. It can be used to guide the evaluation of the effectiveness and safety of medical interventions based on real-world data for observational causal inference. The core idea of this framework is to follow the principles of randomized controlled trial (RCT), emulate a corresponding RCT using real-world data, and then draw conclusions about the causal relationship between interventions and outcomes. The main implementation tips of TTE can be summarized as '3-7-2': 3 implementation steps including formulating the causal question, designing the emulation plan, and emulating the target study; 7 design elements including eligibility criteria, treatment strategies, intervention allocation, follow-up period, outcome, causal contrast of interest, and analysis plan; and control of 2 critical biases including immortal time bias and prevalent user bias. In this article, we present an overview of the development, current status, implementation steps, classic examples, advantages and limitations of TTE, and its application prospects in traditional Chinese medicine (TCM). It is hoped that this article can assist researchers in TCM to utilize this method for real-world research and contribute to the construction of a clinical evaluation system with distinctive features of TCM.

Objective: Acupuncture overviews are increasing rapidly; however, their reporting quality is yet unclear. We aimed to investigate the reporting quality of relevant overviews according to the preferred reporting items for overviews of reviews (PRIOR) statement. Methods: We systematically searched PubMed from inception to August 16, 2022 for overviews on acupuncture therapies. Reporting quality of included overviews was evaluated using the PRIOR statement, and the results were cross-checked. Multiple linear regression analysis was used to assess the predictors of the reporting completeness. GraphPad 9.4 was utilized to generate an evidence map, Excel 2019 was used to extract and manage data, and R 4.2.3 was used for data analysis. Results: A total of 49 overviews published from 2006 to 2022 were included, of which China ranked first with 38 overviews. The most frequently searched database was PubMed/ Medline (n = 48, 98%), and commonly used methodological quality assessment tool was AMSTAR-2 (n = 14, 29%). The overarching themes centered on acupuncture for obstetrics, gynecology, reproductive diseases, as well as depression, anxiety, and insomnia. Reporting quality needs to be improved involving the definition of systematic reviews (SRs), overlap of primary studies and SRs, methods for managing discrepant data across SRs, risk of bias in primary studies, heterogeneity, and sensitivity analysis of synthesized results, reporting bias assessment, and registration and protocol. Moreover, publication in recent years and receiving funding support were significantly associated with higher overall reporting quality score (P < 0.05). Conclusion: Based on the PRIOR statement, this methodological study indicates that the reporting quality of the included acupuncture overviews is poor. In the future, authors of overviews are encouraged to use the PRIOR statement for standardized reporting. Furthermore, it is recommended that journal editors mandate the inclusion of this statement in authors’ reports and require a complete PRIOR checklist.

Background Non-alcoholic fatty liver disease (NAFLD) is a major global health problem due to its great disease and economic burdens. Tea is a popular beverage consumed by billions of peopleglobally owing to its health benefits. However, the evidence regarding the association between tea intake and NAFLD risk is inconsistent. Objective To examine the genetically predicted causal association between tea intake and NAFLD risk using the two-sample Mendelian randomization (MR) method. Methods Single‐nucleotide polymorphisms (SNPs) strongly associated with tea intake were obtained from a large dataset (N = 447,485) in the United Kingdom Biobank, and summary‐level genetic data for NAFLD (2,275 cases and 375,002 controls) were collected from the FinnGen consortium. The two-sample MR method was used to investigate the causal association between tea intake and NAFLD risk. The random‐effects inverse‐variance weighted (IVW) was used as the primary approach for estimating the causal effect, and MR Egger, weighted median, simple mode, and weighted mode were used to verify the robustness of the primary results. Results Twenty-four valid SNPs were selected as the instrumental variables for tea intake. The IVW results indicated that tea intake was not causally associated with NAFLD risk (Odds ratio: 1.48; 95% confidence interval: 0.64, 3.43; p = 0.364); moreover, the results from other methods were consistent with this finding. A leave-one-out analysis further demonstrated the robustness of our results. No evidence of heterogeneity, outliers, or horizontal pleiotropy was found. Conclusion Our results do not support tea intake being causally associated with a decreased risk of NAFLD.

BACKGROUND Several systematic reviews (SRs) have investigated the association between ultra -processed foods (UPFs) and the risk of hypertension in various populations. However, the quality of the evidence remains unclear. This umbrella review was thus conducted to fill this gap. METHODS We searched for SRs with and without meta -analyses comparing high UPF versus low UPF consumption on the risk of hypertension in the Cochrane Library, Embase, PubMed, and Web of Science from inception to August 2022. This study was registered in PROSPERO (No. CRD42022352934). The A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR -2) tool and the Preferred Reporting Item for Systematic Review and Meta -analysis 2009 (PRISMA 2009) statement were used to evaluate the methodological and reporting quality of the included SRs. Stata 15/SE was used to reanalyse the data using the random -effects model, and the risk of bias of observational studies from included SRs was reassessed using the Newcastle -Ottawa Scale (NOS) tool. The certainty of the evidence body was assessed using the GRADE recommendation. RESULTS Seven SRs were included in the umbrella review. Among them, nine observational studies (5 cross-sectional and 4 cohort studies), whose available data were resynthesised using meta -analysis. The methodological and reporting quality of the included SRs were relatively poor. The meta -analysis results revealed suggestive evidence of an association between high UPF consumption and the incidence of hypertension (odds ratio: 1.23, 95% con fidence interval: 1.11 to 1.37, p < 0.001, 95% prediction interval: 0.92 to 1.64, critically low certainty) compared to low UPF consumption. CONCLUSION High UPF consumption is associated with an increased risk of hypertension. However, well-conducted SRs, including high -quality prospective cohort studies, are needed to further verify these findings.

Consumption of ultra-processed foods (UPFs) is associated with various adverse health outcomes, which significantly influence the global disease burden. This umbrella review aimed to fill the knowledge gap and guide public health practices by summarizing the association between UPFs and multiple health outcomes. A total of four databases were systematically searched from inception to December 2022, and 14 eligible systematic reviews (SRs) with meta-analyses (MAs) were identified. The SRs were published in 10 journals from 2020 to 2023, with 54,147-5,750,133 participants and 5-61 studies. The overall corrected covered area (CCA) was corresponded to a slight overlap. The results showed that an increased UPFs consumption is associated with multiple health outcomes (e.g., obesity, diabetes, hypertension, mortality). Only two SRs were "Moderate" regarding the overall methodological quality, while the other twelve were "Low" or "Critically low". Therefore, well-conducted SRs with high-quality prospective cohorts with a particular focus on special populations are needed to verify these findings further.

Recently, several meta-analyses (MAs) have focused on the health effects of resveratrol. However, the methodological and reporting quality of these MAs has not yet been fully evaluated so far. Therefore, the present study evaluated the quality of these MAs through a methodological systematic review. Systematic searches were conducted in PubMed, Embase, Web of Science, and Cochrane Library from inception until May 20, 2022, and PubMed was used to update the search until September 6, 2023. The methodological and reporting quality of the selected MAs was evaluated using AMSTAR-2 and PRISMA 2009. Fifty-one MAs published during 2013-2023 were included. In each review, the number of primary studies ranged from 3 to 37, and the number of participants ranged from 50 to 2114. Among the first-listed primary outcomes, only 23 (45.10%) were "positive." As for the methodological quality, most MAs (44, 86.27%) on resveratrol were rated critically low. Inadequate reporting of the included MAs mainly involved items 2 ("Structured summary"), 5 ("Protocol and registration"), 8 ("Search"), 9 ("Study selection"), 10 ("Data collection process"), 12 ("Risk of bias in individual studies"), and 24 ("Summary of evidence") based on the PRISMA 2009. Additionally, journal's impact factor, number of authors, and funding support were positively associated with the overall methodological quality but were not statistically significant (p > 0.05). Future MAs on resveratrol require better design, implementation, and reporting by following the Cochrane Handbook, AMSTAR-2, and PRISMA.

目的:利用科学计量学方法分析药物警戒领域中的高被引研究论文,旨在为国内药物警戒研究和实践活动提供参考.方法:计算机检索Web of Science数据库核心合集以搜集被引次数最高的 100 篇药物警戒论文.来源限制为SCIE和SS-CI,论文类型限制为"Article"或者"Review",语言限制为英语,检索时限为建库至 2022 年 4 月 7 日.利用VOSviewer 1.6.17和CiteSpace 6.1.R1 进行统计分析并绘制相关知识图谱.结果:纳入的百篇高被引药物警戒论文均发表于 1992-2019 年,单篇研究的中位被引次数为 155 次,最高次数为 977 次,最低为 110 次.美、英等发达国家发表的论文数量最多,且它们之间具有密切的合作关系,发文最多的研究机构为斯坦福大学,发文最多的作者为Edwards IR(乌普萨拉监测中心),刊载论文最多的期刊为《Drug Safety》(13 篇,13%).药物警戒高被引论文关注的内容主要包括药品不良反应的信息来源、具体药物或人群的不良反应、不良反应信号检测方法以及具体的不良反应等方面的内容.结论:欧美等发达国家在药物警戒领域处于领先水平且彼此合作密切,药品不良反应的相关内容是药物警戒领域的主要研究热点,上述发现可为我国的药物警戒研究与实践活动提供一定参考.

Context: Berberine is a potential drug that can effectively treat cardiovascular diseases, including premature ventricular contractions (PVCs).Objective: This study was conducted to assess the efficacy and safety of berberine for PVCs.Methods: The literature was searched using PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang, and Chinese Biomedical Literature Database (CBM) for randomized controlled trials (RCTs) from inception to October 1, 2022. The risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to assess the quality of evidence.Results: Ten RCTs with 896 participants were included in the meta-analysis. The results showed that compared to antiarrhythmic drugs (AD), berberine (BE) combined with AD had a higher effective rate (RR = 1.26; 95% CI:1.12, 1.42; p = 0.0001) with no significant incidence of adverse reactions (RR = 0.93; 95% CI:0.33, 2.57; p = 0.88), and BE alone had no significant difference in effective rate (RR = 0.91; 95% CI:0.77, 1.07; p = 0.23), and a lower incidence of adverse reactions (RR = 0.38; 95% CI:0.15, 0.97; p = 0.04) and recurrence rate (RR = 0.40; 95% CI:0.18, 0.88; p = 0.02).Conclusions: The results suggest that BE is an effective and safe adjunctive method for PVCs. In addition, BE is recommended for patients with PVCs who had severe adverse reactions after administrating AD as an alternative therapy.

NutriGrade证据质量分级系统针对营养学研究证据所基于的随机对照试验(randomized controlled trial,RCT)和队列研究分别建立了不同的证据质量分级方法.应用于随机对照试验的NutriGrade证据质量分级部分包括7个评价条目:①偏倚风险、研究质量和研究局限性(3分);②精确性(1分);③异质性(1分);④直接性(1分);⑤发表偏倚(1分);⑥资助偏倚(1分);⑦研究设计(2分).依据评分标准分别对评价条目计分,最终将各条目的评分结果汇总转化为:高质量证据(8-10分)、中等质量证据(＜8分)、低质量证据(＜6分)和极低质量证据(＜4分)四个证据质量等级.本文系统解读该部分NutriGrade的评价条目及评分标准,应用实例加以分析,以期为国内研究者理解和应用此工具提供参考.

Introduction The COVID-19 pandemic posed a detrimental impact on the conduct of non-COVID-19 related clinical trials, raising concerns about the completeness of these studies and waste of resources. While several measures and strategies have been suggested to address these issues, a thorough and timely summarisation is still lacking. Therefore, our aim is to conduct a scoping review to summarise the negative effects of COVID-19 on non-COVID-19 clinical trials, outline the effective measures for mitigating these impacts, and provide insights for future pandemics.Methods and analysis This scoping review will be conducted in line with the Joanna Briggs Institute’s scoping review methodological framework, and the results will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Relevant articles will be searched in PubMed, Embase and the Cochrane Library from 1 December 2019 to 1 July 2023. We will also screen the reference lists of the included studies manually to identify more potentially relevant articles. Articles focusing on the adverse impacts of COVID-19 on non-COVID-19 clinical trials and effective measures for mitigating them will be included. Two investigators will perform study selection and data extraction independently. A narrative summary as well as a descriptive analysis of the basic characteristics and key results of the included studies will be performed.Ethics and dissemination Ethical approval is not required, as this scoping review will be completed based only on published literature. The findings of this scoping review will be disseminated through a peer-reviewed publication and/or conference presentations.

BackgroundRandomized controlled trials (RCTs) are the gold standard for evaluating the efficacy and safety of medical interventions. Phytotherapy, which plays a critical role in the prevention and treatment of many clinical conditions, is also evaluated by RCTs. In recent years, the transparency, methodology, and generalizability of RCTs, as well as disparities in gender and geographical location among researchers, have attracted much attention from the scientific community. However, these aspects of RCTs in phytotherapy interventions have not been fully evaluated. Therefore, a methodological project (i.e., SMART-PT, tranSparency and Methodological chAracteristics of Randomized controlled Trials of PhytoTherapy interventions) was designed to overcome these knowledge gaps and provide key references for relevant future RCTs.MethodsThe SMART-PT project consists of five studies that will be conducted using RCTs derived from two high-impact phytotherapy journals, Phytomedicine and Phytotherapy Research. RCTs published in Phytomedicine and Phytotherapy Research were searched using the PubMed database from inception to February 13, 2023. Study selection was performed by two independent researchers, and data extraction and quality assessment will also be conducted independently by two researchers. First, we will investigate the reporting completeness, data-sharing level, and presence of spin among the included RCTs (Study 1). Second, we will evaluate the risk of bias in the included RCTs and the statistical fragility of primarily binary outcomes, and the likelihood ratio will be used to reinterpret statistically nonsignificant primary outcomes (Study 2). Third, we will evaluate the reporting completeness of phytotherapy interventions in the included RCTs as well as the trustworthiness of the RCTs (Study 3). Fourth, we will investigate the reporting of sociodemographic features and representation of participants in the included RCTs (Study 4). Finally, we will investigate the reporting completeness of the abstracts, the representation of gender, and geographical region of the listed authors among the included RCTs (Study 5). R 4.2.3, Stata 17/SE, and Excel 2019 will be used to analyze the data and create graphics.Results and DiscussionOne-hundred and fifty-two double-arm, parallel-group, superiority RCTs were included in the SMART-PT project. The results of the five meta-research studies will be submitted for publication in peer-reviewed journals.

Review question / Objective: To identify the clinical and preclinical meta-analyses of berberine, summarize the health effects of berberine, and relevant mechanisms.Condition being studied: The health effects of berberine and relevant mechanisms.Information sources: PubMed, Embase, Web of Science, Cochrane Library, and CNKI will be searched to identify relevant meta-analyses from inception to September 12th, 2022.The reference lists of included meta-analyses also will be checked manually to identify potential eligible articles.PubMed and CNKI will be used to update the previous metaanalyses.