The American Heart Association (AHA) and the American College of Cardiology (ACC), in collaboration with multiple professional organizations, jointly released the "Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults" in August 2025. Based on the latest evidence-based medical findings from February 2015 to January 2025, the guideline proposes an individualized treatment strategy grounded in total cardiovascular disease risk stratification, incorporates the novel PREVENT risk assessment model, lowers the medication initiation threshold and control targets for high-risk populations, and provides specific management recommendations for special populations. This article provides an interpretation of these updates and conducts a comparative analysis with the current status of hypertension prevention and treatment in China as well as Chinese guidelines, aiming to offer reference for hypertension control practices in China.

The American Heart Association (AHA) officially released the "2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association" on January 27, 2025. This report systematically compiles the latest statistics on major cardiovascular diseases worldwide, while simultaneously integrating relevant outcome indicators, including quality of care, procedures, and economic costs, and updating the global prevalence patterns and evolving trends of diverse risk factors impacting cardiovascular health, providing essential guidance for the prevention, diagnosis, and treatment of cardiovascular diseases. Synthesizing insights from this pivotal report and other relevant studies, this article highlights key findings concerning the global prevalence and mortality of heart diseases, associated risk factors, and emerging diagnostic and therapeutic technologies.

The advancement of artificial intelligence and big data has accelerated the exploration of decentralized clinical trials （DCTs）， and their future complementary relationship with traditional clinical trial models represents an inevitable trend. Given the greater complexity of preliminary research and protocol design in oncology drug clinical trials， the implementation of “decentralization” requires all stakeholders to clarify the responsibilities and authorities， enhance communication and collaboration， conduct comprehensive training， and progressively promote the integration and sharing of medical resources， thereby facilitating the establishment of a new quality and risk management framework. Concurrently， institutional review board should focus on reviewing and evaluating the scientificity， feasibility， and research risk controllability of DCT project protocol designs. It should also prioritize the implementation of informed consent norms， the management of safety event reporting and continuing review， and the protection of participants’ personal information and privacy. By adopting corresponding ethical review procedures， it emphasizes improving the risk identification and addressing capabilities of institutional review board members regarding the review projects， guiding researchers to adhere to DCT regulations. This aims to genuinely implement the “value-oriented， patient-centered” philosophy， thereby promoting the standardized and efficient conduct of DCTs.

Precancerous lesions of gastric cancer （PLGC） are a group of pathological changes caused by abnormalities in the structure， morphology， and differentiation of gastric mucosal epithelial cells. Since the early symptoms are hidden and non-specific， PLGC is not easy to be diagnosed and it has often developed into intermediate or advanced gastric cancer once being diagnosed and missed the best time for treatment. Accordingly， the incidence of this disease is increasing year by year， which lifts a heavy burden on the patients. The pathogenesis of PLGC is complex， involving inflammatory microenvironment， bile reflux， glycolysis， autophagy， and apoptosis. Currently， PLGC is mainly treated with anti-inflammatory and endoscopic therapies， which are difficult to curb the development of PLGC. Therefore， seeking a safe and effective therapy is an important topic of modern research. Traditional Chinese medicine （TCM）， characterized by treatment based on syndrome differentiation and a holistic view， exerts effects via multiple pathways， mechanisms， and targets. Recent studies have confirmed that TCM can regulate the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR）， Wnt/β-catenin， Sonic Hedgehog， nuclear factor-κB （NF-κB）， Janus kinase/signal transducer and activator of transcription （JAK/STAT）， hypoxia-inducible factor-1α （HIF-1α）， neurogenic locus notch homolog protein （Notch）， nuclear factor E₂-related factor 2 （Nrf2） and other signaling pathways. By targeting these pathways， TCM can inhibit aerobic glycolysis， reduce oxidative stress， repair the inflammatory microenvironment， regulate cellular autophagy， and promote vascular normalization， thereby delaying or reversing PLGC. However， few researchers have systematically summarized the TCM regulation of PLGC-associated pathways. By reviewing the relevant articles at home and abroad， this paper summarized the roles of the above signaling pathways in the development of PLGC and the research progress in the regulation of signaling pathways by TCM in the treatment of PLGC， with a view to providing a new theoretical basis for the clinical research on PLGC and the drug development for this disease.

ObjectiveTo establish a quality evaluation method for Zhuye Shigao granules（Zhuye Shigaotang） based on fingerprint and determination of index components， and to investigate the therapeutic effect of Zhuye Shigao granules on mice with cold-dampness pestilence attacking lung syndrome. MethodsThe fingerprint of Zhuye Shigao granules was established by high performance liquid chromatography（HPLC）， and the methods for determination of total calcium， orientin， isoorientin， ginsenosides Rg₁， Re and Rb₁ and other 2 index components were established. Fifty ICR mice were randomly divided into the blank group， model group， Zhuye Shigao granules low， medium and high dose groups（9.3， 18.6， 37.2 g·kg^-1·d^-1）， with 10 mice in each group. In addition to the blank group， the model mice with cold-dampness pestilence attacking lung syndrome was prepared by nasal drip of lipopolysaccharide combined with cold-dampness environment. Each administration group was given the corresponding liquid by gavage according to the dose， while the blank group and model group were given the same volume of normal saline by gavage. Then， the body temperature and organ index of mice in each group were measured， hematoxylin-eosin（HE） staining was used to investigate the lung tissue injury of mice in each group， and enzyme-linked immunosorbent assay（ELISA） was used to detect the changes of tumor necrosis factor-α（TNF-α）， interleukin（IL）-lβ， IL-6， IL-10 levels in serum and lung tissue， as well as immunoglobulin（Ig）A and IgM levels in serum. ResultsThe fingerprint similarity of 10 batches of Zhuye Shigao granules was>0.950， and 20 common peaks were calibrated. Seven of them were identified， including peak 11（isoorientin）， peak 12（orientin）， peak 14（apioside liquiritin）， peak 15（liquiritin）， peak 17（apioside isoliquiritin）， peak 19（isoliquiritin） and peak 20（liquiritigenin）. The results of quantitative analysis showed that the content range of each index component in 10 batches of Zhuye Shigao granules was as follows：Total calcium of 9.978-11.294 mg·g^-1， isoorientin of 0.033-0.041 mg·g^-1， orientin of 0.046-0.055 mg·g^-1， ginsenoside Rg₁+ginsenoside Re of 0.748-0.762 mg·g^-1， ginsenoside Rb₁ of 0.151-0.197 mg·g^-1， liquiritin of 1.106-1.366 mg·g^-1， glycyrrhizic acid of 0.904-1.182 mg·g^-1_. Compared with the blank group， the body temperature of mice in the model group was significantly increased， the organ indexes of liver， lung and spleen were significantly decreased， the organ index of thymus was significantly increased， HE staining of lung tissue showed infiltration of inflammatory cells， a small amount of serous exudation was observed in the alveoli， and lung tissue was damaged. After the intervention of Zhuye Shigao granules， the pathological changes were improved compared with the model group. The expression levels of IL-1β， IL-6 and TNF-α were significantly increased， the expression level of IL-10 was significantly decreased in serum and lung tissue. The levels of IgA and IgM in serum were significantly decreased（P<0.01）. Compared with the model group， the body temperature， the organ indexes and immune factor levels in serum and lung tissue of mice in the Zhuye Shigao granules medium and high dose groups were significantly reduced（P<0.05， P<0.01）. ConclusionIn this study， the quality evaluation of Zhuye Shigao granules was carried out based on fingerprint combined with determination of index components， and the fingerprint of four herbs（Lophatheri Herba， Ophiopogonis Radix， Pinelliae Rhizoma and Glycyrrhizae Radix et Rhizoma） in this formula and the determination of 8 index components were established. The therapeutic effect of Zhuye Shigao granules on mice with cold-dampness pestilence attacking lung syndrome may be related to inhibiting inflammatory response and mediating immune regulation.

Objective To establish the judgment basis of ventilation pipe status by 0 daPa wideband acoustic immittance(WAI-0 daPa),and to assist doctors to determine the status of ventilation tube and determine the timing of extubation.Methods A total of 43 children with 62 ears aged 3-6 years old were tested by 0 daPa broadband acoustic reactance test.The normal middle ear function group were ten children with 20 ears.Children with secreto-ry otitis media more than 12 months after tympanic tube catheterization were divided into 11 cases 19 ears of clear ventilation tube group,and 23 ears in 22 cases of ventilation tube blockage group.A total of 107 frequencies of WAI-0 daPa were obtained.The Kruskal-Wallis H and Nemenyi were used to analyze the influence of ventilation tube status on WAI-0 daPa.Results The WAI-0 daPa at 226-667 Hz was significantly higher in the clear ventila-tion tubegroupthan in the normal middle ear group.The WAI-0 daPa at 226-500 Hz was significantly lower in the blocked ventilation tube group than in the clear ventilation tube group.The WAI-0 daPa at 2 000-3 364 Hz and 6 727 Hz in the normal middle ear function group were significantly higher than those in the blocked ventilation tube group.The WAI-0 daPa in low frequencies was less than 20％,the possibility of blackage of eardrum tube was greater.Conclusion The absorptivity in low frequency region of WAI-0 daPa can be used to determine the status of tympanic catheter ventilation tube and assist doctors to determine the timing of extubation.

Objective To investigate the feasibility of estimating the real-ear-to-coupler difference(RECD)in children with head circumference,so as to further optimize the personalized and accurate matching scheme of hearing aid fitting for children.Methods A total of 106 children(197 ears)were enrolled in this study.Head circumference was measured using a soft ruler and RECD was measured using OmetroricsAuricalTM.SPSS software was used to analyze the correlation between the head circumference,month age and RECD values at each frequency of children.Results ① The head circumference of boys was slightly larger than that of girls,but there was no significant differ-ence between them(P＞0.05).② Unitary linear correlation analysis showed that RECD values at 750-6 000 Hz were negatively correlated with the head circumference,and a regression equation was established between RECD values at 1 000-6 000 Hz and the head circumference.③ RECD values calculated by regression formula based on the head circumference showed no significant difference between 1 000-3 000 Hz and 6 000 Hz and children's actu-al RECD values.Conclusion The individual RECD values of 0-6 years old children were correlated with the head circumference,and with the increase of the head circumference,RECD values at middle and high frequencies de-creased gradually.For children whose physical developments were not consistent with biological age,the RECD data at middle and high frequencies could be estimated based on the head circumference.

Objective:To understand the incidence rate of herpes zoster (HZ) and postherpetic neuralgia (PHN) in Beijing, and analyze the incidence trend of HZ and PHN from 2015 to 2022.Methods:Cases of HZ and PHN from 2015 to 2022 were retrieved from the Hospital Information Systems (HIS) of all primary and above hospitals/clinics in three districts representing the urban, inner suburban, and outer suburban areas of Beijing. After duplication screening, the first visit cases were screened, and the incidence characteristics were described. The incidence rate of HZ and PHN in each year by sex and age group and the age-standardized incidence rate were calculated. The annual percentage increase (APC) of incidence rate was calculated using the Joint regression model, and the change trend was analyzed.Results:The age-standardized incidence rate of HZ in Beijing from 2015 to 2022 ranged from 7.44‰ to 10.05‰, with an average annual incidence rate of 8.95 ‰, significantly increasing with age ( P<0.001). The Joinpoint regression model showed that the overall age-standardized incidence of HZ remained relatively stable, with no significant difference (APC=2.28%, t=1.56, P=0.170). However, the incidence rate among the 0-19-year-old group exhibited a trend of decrease (APC=-10.70%, t=-6.29, P<0.001). For PHN, the age-standardized incidence in Beijing ranged from 0.77‰ to 2.67‰, with an average annual incidence rate of 1.59‰ and a proportion of 9.48% to 26.86% among HZ cases. Both the incidence of PHN and its proportion among HZ cases increased with age ( P<0.001). The age-standardized incidence of PHN increased annually (APC=18.56%, t=9.02, P<0.001). Conclusion:The incidence rate of HZ and PHN in Beijing continues to be at a high level, and PHN shows an increasing trend over time.

Objective To establish the judgment basis of ventilation pipe status by 0 daPa wideband acoustic immittance(WAI-0 daPa),and to assist doctors to determine the status of ventilation tube and determine the timing of extubation.Methods A total of 43 children with 62 ears aged 3-6 years old were tested by 0 daPa broadband acoustic reactance test.The normal middle ear function group were ten children with 20 ears.Children with secreto-ry otitis media more than 12 months after tympanic tube catheterization were divided into 11 cases 19 ears of clear ventilation tube group,and 23 ears in 22 cases of ventilation tube blockage group.A total of 107 frequencies of WAI-0 daPa were obtained.The Kruskal-Wallis H and Nemenyi were used to analyze the influence of ventilation tube status on WAI-0 daPa.Results The WAI-0 daPa at 226-667 Hz was significantly higher in the clear ventila-tion tubegroupthan in the normal middle ear group.The WAI-0 daPa at 226-500 Hz was significantly lower in the blocked ventilation tube group than in the clear ventilation tube group.The WAI-0 daPa at 2 000-3 364 Hz and 6 727 Hz in the normal middle ear function group were significantly higher than those in the blocked ventilation tube group.The WAI-0 daPa in low frequencies was less than 20％,the possibility of blackage of eardrum tube was greater.Conclusion The absorptivity in low frequency region of WAI-0 daPa can be used to determine the status of tympanic catheter ventilation tube and assist doctors to determine the timing of extubation.

Objective To investigate the feasibility of estimating the real-ear-to-coupler difference(RECD)in children with head circumference,so as to further optimize the personalized and accurate matching scheme of hearing aid fitting for children.Methods A total of 106 children(197 ears)were enrolled in this study.Head circumference was measured using a soft ruler and RECD was measured using OmetroricsAuricalTM.SPSS software was used to analyze the correlation between the head circumference,month age and RECD values at each frequency of children.Results ① The head circumference of boys was slightly larger than that of girls,but there was no significant differ-ence between them(P＞0.05).② Unitary linear correlation analysis showed that RECD values at 750-6 000 Hz were negatively correlated with the head circumference,and a regression equation was established between RECD values at 1 000-6 000 Hz and the head circumference.③ RECD values calculated by regression formula based on the head circumference showed no significant difference between 1 000-3 000 Hz and 6 000 Hz and children's actu-al RECD values.Conclusion The individual RECD values of 0-6 years old children were correlated with the head circumference,and with the increase of the head circumference,RECD values at middle and high frequencies de-creased gradually.For children whose physical developments were not consistent with biological age,the RECD data at middle and high frequencies could be estimated based on the head circumference.