1.Prediction and verification of the mechanism of Chaiqi yigan granules improving hepatocellular carcinoma
Guiping MA ; Yuanjie ZHANG ; Yichi ZHOU ; Jinzhen LYU ; Conghui WANG ; Fenping LU ; Bowen LIU ; Yun RAN ; Shiping HU
China Pharmacy 2026;37(5):620-625
OBJECTIVE To predict and validate the mechanisms of Chaiqi yigan granules (CQYG) improving hepatocellular carcinoma (HCC). METHODS The signaling pathways of CQYG intervention in HCC were predicted using network pharmacology. A mice model of transplanted hepatocellular carcinoma was established by injecting H22 hepatoma cells into the axilla. Successfully modeled mice were randomly divided into model group (normal saline), sorafenib group (positive control, 50 mg/kg), and CQYG low-, medium- and high-dose groups (24.83, 49.66, 99.32 g/kg), with 10 mice in each group. Mice in each group were administered the corresponding drug solution or normal saline intragastrically, once a day, for 14 consecutive days. After last administration, pathological morphological changes in the tumor tissues of mice were observed in each group. Immunohistochemical staining was performed to detect the expression of the nuclear proliferation antigen Ki-67 in tumor tissues of mice. Western blot assay was used to measure the expression of proteins related to epithelial-mesenchymal transition (EMT) [N-cadherin, E-cadherin, Vimentin, matrix metalloproteinase 7 (MMP7)] and the mitogen-activated protein kinase (MAPK) signaling pathway [p38 MAPK, phosphorylated p38 MAPK, c-Jun N-terminal kinase (JNK), phosphorylated JNK, extracellular regulated protein kinase 1/2 (ERK1/2), phosphorylated ERK1/2] in tumor tissue of mice. RESULTS Network pharmacology analysis revealed that metabolic pathways, pathways in cancer, and the MAPK signaling pathway were key signaling pathways through which CQYG exert their anti-hepatocellular carcinoma effects. In animal experiments, the tumor tissues of mice in the model group exhibited dense tumor cells and vigorous growth. Compared with model group, CQYG high-dose group showed a decreased density of tumor cells in the tumor tissues of mice. Moreover, the expression levels of Ki-67, N-cadherin, MMP7 and Vimentin proteins, along with the phosphorylation levels of ERK1/2 and JNK proteins, were all significantly reduced ( P <0.05). The expression level of E-cadherin protein was significantly increased ( P <0.05), the phosphorylation level of p38 MAPK protein was increased, the difference was not statistically significant ( P >0.05). CONCLUSIONS CQYG can inhibit EMT by regulating the MAPK signaling pathway, thereby suppressing tumor cell invasion and metastasis and ultimately exerting a therapeutic effect in improving HCC.
2.Management of prevention and treatment of chronic diseases after kidney transplantation
Organ Transplantation 2026;17(2):192-197
Kidney transplantation is the most ideal treatment method for end-stage renal disease, significantly improving the survival rate and quality of life of patients. However, as the postoperative survival period gradually lengthens, chronic diseases have become the main obstacle affecting the long-term outcome of kidney transplantation. These chronic diseases have a high incidence, involve multiple organs and significantly impact prognosis. The core driving factors are mainly related to long-term immunosuppressive therapy. This article systematically discusses the occurrence mechanisms, prevention and treatment strategies, and classification management of common chronic diseases after kidney transplantation (mainly including chronic graft dysfunction, cardiovascular diseases, infections, malignant tumors, bone metabolism disorders, etc.). At the same time, it explores future development directions such as precision medicine, new immune modulators and remote management, emphasizing a comprehensive management model centered on "multidisciplinary collaboration + individualized treatment + continuous monitoring" to achieve long-term, systematic, and dynamic prevention and treatment of chronic diseases for kidney transplant recipients.
3.Comorbidity Mechanism Between Ulcerative Colitis and Atrial Fibrillation Based on "Gut Microbiota-gut-heart" Axis
Meiyu FENG ; Wenjing ZHANG ; Yihang DU ; Xuanye DING ; Yuanhui HU ; Haitai YUAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):276-281
The gut microbiota is regarded as the "eighth organ" of the human body and plays a critical regulatory role in the occurrence and progression of various diseases. Ulcerative colitis (UC) is a chronic inflammatory bowel disease with a complex etiology and a tendency toward recurrent episodes. In recent years, studies have shown that gut microbiota dysbiosis plays a key role in its pathological processes. Meanwhile, an increasing number of studies have demonstrated that imbalances in the gut microbiota and abnormalities in its metabolites are closely associated with the development of atrial fibrillation (AF). Although UC and AF belong to diseases of the digestive system and cardiovascular system, respectively, both exhibit systemic inflammatory characteristics and are often accompanied by gut microbiota dysregulation and abnormal metabolic products. However, systematic investigations into the mechanisms by which gut microbiota-derived metabolites act in these two diseases remain limited. Based on this, the present study adopts literature review and theoretical analysis methods, taking the "gut microbiota-gut-heart" axis as the entry point, to systematically summarize the signaling networks of three key classes of metabolites, i.e., short-chain fatty acids (SCFAs), bile acids (BAs), and trimethylamine N-oxide (TMAO), in the comorbidity mechanism of UC and AF. The findings indicate that these metabolites may activate key inflammatory pathways, such as NF-κB and NLRP3, thereby synergistically mediating intestinal barrier dysfunction and systemic inflammation and constructing a potential comorbidity network. On this basis, potential intervention strategies for the treatment of UC-AF comorbidity, including probiotic intervention and fecal microbiota transplantation, are further discussed. This study aims to provide new theoretical evidence and research perspectives for prevention and treatment strategies of cross-system diseases.
4.Qinlian Hongqutang Improves NASH by Promoting Macrophage Polarization Through TLR4 and STAT6 Signaling Pathways
Yong ZHANG ; Yong HU ; Yunliang HE ; Yang YANG ; Donghui CHEN ; Sijie DANG ; Jia HE ; Yaqi LUO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):10-20
ObjectiveTo investigate the therapeutic effects and mechanisms of Qinlian Hongqutang (QLHQT) on nonalcoholic steatohepatitis (NASH). MethodsC57BL/6J mice were randomly divided into normal and modeling groups. The NASH model was established by feeding a high-fat diet for 12 weeks. After successful modeling, mice were randomly assigned to the model group, low-, medium-, and high-dose QLHQT groups (0.51, 1.02, and 2.04 g·kg-1), and a positive control metformin group, with six mice in each group. The mice were treated for 8 weeks. Body weight was recorded before and after treatment. Serum levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C), as well as hepatic TC, TG, and LDL-C contents, were determined by biochemical assays. Hematoxylin-eosin (HE) staining and oil red O staining were used to evaluate liver histopathology and lipid deposition, respectively. Flow cytometry, enzyme-linked immunosorbent assay (ELISA), and Real-time polymerase chain reaction (Real-time PCR) were used to assess hepatic macrophage expression and related markers. Western blot and immunofluorescence were used to investigate the potential mechanisms of QLHQT in regulating macrophage polarization. ResultsCompared with the normal group, body weight and serum and hepatic levels of TC, TG, and LDL-C were significantly increased in the model group (P<0.01). Liver histopathology showed unevenly distributed round lipid droplets in the hepatocyte cytoplasm, accompanied by inflammatory cell aggregation. Flow cytometry showed that the proportion of CD86-positive cells was significantly increased, whereas the proportion of CD206-positive cells was markedly decreased (P<0.05). Hepatic inducible nitric oxide synthase (iNOS) levels and tumor necrosis factor-α (TNF-α) mRNA expression were significantly increased, while hepatic IL-10 levels and IL-4 mRNA expression were significantly decreased (P<0.01). The protein expression levels of Toll-like receptor 4 (TLR4), tumor necrosis factor receptor-associated factor 6 (TRAF6), and myeloid differentiation factor 88 (MyD88) in the liver were significantly increased (P<0.01). Compared with the model group, body weight was reduced in the high-, medium-, and low-dose QLHQT groups and in the metformin group. Serum and hepatic TC, TG, and LDL-C levels were significantly decreased (P<0.01). Liver histopathology showed alleviated hepatic lipid deposition, with markedly reduced lipid droplets and inflammation. Immunofluorescence and flow cytometry showed that the proportions of CD86-positive cells were significantly decreased, whereas the proportions of CD206-positive cells were significantly increased in the high-, medium-, and low-dose QLHQT groups (P<0.05). Hepatic iNOS levels and TNF-α mRNA expression were significantly decreased (P<0.01), whereas hepatic IL-10 levels and IL-4 mRNA expression were significantly increased (P<0.01). The hepatic protein expression levels of TLR4, TRAF6, and MyD88 were significantly decreased, while signal transducer and activator of transcription 6 (STAT6) phosphorylation was significantly increased (P<0.05, P<0.01). There was no statistically significant difference in total STAT6 protein expression. ConclusionQLHQT effectively ameliorates hepatic inflammation in NASH mice, and the mechanism may involve STAT6- and TLR4-mediated signaling pathways driving polarization of M1 macrophages toward the M2 phenotype.
5.Mechanisms of Mahuang Lianqiao Chixiaodoutang in Improving Obesity-type Polycystic Ovary Syndrome in Rats Based on PI3K/Akt Signaling Pathway
Shiwei HU ; Biran ZHU ; Jinrong ZHANG ; Luyao RUAN ; Ji KUANG ; Jianghuan HUA ; Zhe LIU ; Yanyue YAO ; Ji WANG ; Min ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):21-31
ObjectiveTo investigate the mechanisms by which Mahuang Lianqiao Chixiaodoutang (MLC) improves obesity-type polycystic ovary syndrome (PCOS) through the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. MethodsThirty-six female Sprague-Dawley (SD) rats were randomly divided into a blank control group (Con) and an obesity-type PCOS model preparation group. The model was induced by gavage with letrozole (1 mg·kg-1) combined with a high-fat diet (HFD). After model establishment, the obesity-type PCOS model preparation group was further divided into the model group (Mod, normal saline), metformin group (Met, 0.3 g·kg-1), low-dose MLC group (MLC-L, 4.3 g·kg-1), medium-dose MLC group (MLC-M, 8.6 g·kg-1), and high-dose MLC group (MLC-H, 17.2 g·kg-1). Active components of MLC and targets of obesity-type PCOS were screened from databases, a protein-protein interaction (PPI) network was constructed, and gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed. The gut microbiota structure was analyzed based on 16S rRNA sequencing and correlated with network pharmacology pathways. Body weight and estrous cycle were dynamically monitored. Ovarian morphology was observed by hematoxylin-eosin (HE) staining. Cell apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). Enzyme-linked immunosorbent assay (ELISA) was used to detect levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH), testosterone (T), and estradiol (E2). Western blot was used to detect the protein expression levels of phosphorylated PI3K/PI3K (p-PI3K/PI3K), phosphorylated Akt/Akt (p-Akt/Akt), B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X protein (Bax). ResultsNetwork pharmacology screening identified 124 active components of MLC and 408 overlapping targets between the herbal formula and the disease. Core targets such as Akt1 and Bcl-2 were revealed. As indicated by 16S rRNA sequencing, the abundances of Lachnospiraceae, Lachnoclostridium, and Dorea were increased in the MLC groups (P<0.05), while the abundance of Veillonella was decreased (P<0.05). KEGG correlation analysis integrating network pharmacology and gut microbiota data showed significant enrichment of the PI3K/Akt signaling pathway. Animal experiments showed that, compared with the Mod group, body weight decreased to normal levels in the Met, MLC-M, and MLC-H groups. The estrous cycle became regular. The number of corpora lutea increased and cystic follicles decreased. Serum levels of T, FSH, and LH/FSH were reduced (P<0.05, P<0.01), while the E2 level was increased (P<0.01). Ovarian cell apoptosis was reduced (P<0.01), and the protein expression levels of p-PI3K/PI3K, p-Akt/Akt, and Bcl-2 in ovarian tissue were significantly increased, whereas Bax protein expression was significantly decreased (P<0.05, P<0.01). ConclusionMLC can regulate gut microbiota structure, effectively improve ovarian pathology in rats with obesity-type PCOS, and inhibit ovarian granulosa cell apoptosis. The mechanism may be associated with upregulation of the PI3K/Akt signaling pathway.
6.Treatment of Colorectal Cancer with Traditional Chinese Medicine Based on Hippo Signaling Pathway: A Review
Shuo ZENG ; Suqin HU ; Yang HU ; Lei LUO ; Mingyan LI ; Qinsheng ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):297-305
Colorectal cancer, a leading malignant gastrointestinal tumor globally in terms of incidence and mortality, has seen a consistent annual rise in newly diagnosed cases. While conventional therapies like radiotherapy, chemotherapy, and surgery are available, problems such as lack of early diagnosis, poor prognosis, and drug resistance remain significant burdens for patients. Given the complex and diverse pathogenesis of colorectal cancer, there is an urgent clinical need for safe, effective, reliable, and multi-targeted therapeutic strategies. The Hippo signaling pathway, closely linked to mechanisms like tumorigenesis, cancer cell invasion, migration, and drug resistance, extensively participates in the occurrence and development of colorectal cancer, so targeting the signaling pathway for cancer prevention and treatment has become a crucial research direction in recent years. Traditional Chinese medicine (TCM) offers multi-faceted, multi-pathway, and multi-target advantages and becomes an important therapy for colorectal cancer by enhancing patients' immunity, improving the life quality, and prolonging survival. Studies show that the active components of TCM, including flavonoids, terpenoids, phenols, alkaloids, quinones, lignans, and saponins, as well as TCM compounds such as modified Sijunzi decoction, Jiedu Sangen decoction, Jianpi Jiedu compound, and Quyu Jiedu decoction, exhibit significant targeting effects on the Hippo signaling pathway. These TCMs can exert an anti-colorectal cancer effect through various mechanisms, such as inducing cancer cell autophagy and apoptosis, inhibiting epithelial-mesenchymal transition, reversing drug resistance of the tumor, and blocking the cancer cell cycle. This paper reviewed and analyzed Chinese and international research on the action mechanisms of TCM in regulating the Hippo signaling pathway for the prevention and treatment of colorectal cancer with a comprehensive overview presentation, aiming to provide new references and ideas for the clinical application of TCM and the development of new pharmacological agents in the prevention and treatment of colorectal cancer.
7.Qinlian Hongqutang Improves NASH by Promoting Macrophage Polarization Through TLR4 and STAT6 Signaling Pathways
Yong ZHANG ; Yong HU ; Yunliang HE ; Yang YANG ; Donghui CHEN ; Sijie DANG ; Jia HE ; Yaqi LUO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):10-20
ObjectiveTo investigate the therapeutic effects and mechanisms of Qinlian Hongqutang (QLHQT) on nonalcoholic steatohepatitis (NASH). MethodsC57BL/6J mice were randomly divided into normal and modeling groups. The NASH model was established by feeding a high-fat diet for 12 weeks. After successful modeling, mice were randomly assigned to the model group, low-, medium-, and high-dose QLHQT groups (0.51, 1.02, and 2.04 g·kg-1), and a positive control metformin group, with six mice in each group. The mice were treated for 8 weeks. Body weight was recorded before and after treatment. Serum levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C), as well as hepatic TC, TG, and LDL-C contents, were determined by biochemical assays. Hematoxylin-eosin (HE) staining and oil red O staining were used to evaluate liver histopathology and lipid deposition, respectively. Flow cytometry, enzyme-linked immunosorbent assay (ELISA), and Real-time polymerase chain reaction (Real-time PCR) were used to assess hepatic macrophage expression and related markers. Western blot and immunofluorescence were used to investigate the potential mechanisms of QLHQT in regulating macrophage polarization. ResultsCompared with the normal group, body weight and serum and hepatic levels of TC, TG, and LDL-C were significantly increased in the model group (P<0.01). Liver histopathology showed unevenly distributed round lipid droplets in the hepatocyte cytoplasm, accompanied by inflammatory cell aggregation. Flow cytometry showed that the proportion of CD86-positive cells was significantly increased, whereas the proportion of CD206-positive cells was markedly decreased (P<0.05). Hepatic inducible nitric oxide synthase (iNOS) levels and tumor necrosis factor-α (TNF-α) mRNA expression were significantly increased, while hepatic IL-10 levels and IL-4 mRNA expression were significantly decreased (P<0.01). The protein expression levels of Toll-like receptor 4 (TLR4), tumor necrosis factor receptor-associated factor 6 (TRAF6), and myeloid differentiation factor 88 (MyD88) in the liver were significantly increased (P<0.01). Compared with the model group, body weight was reduced in the high-, medium-, and low-dose QLHQT groups and in the metformin group. Serum and hepatic TC, TG, and LDL-C levels were significantly decreased (P<0.01). Liver histopathology showed alleviated hepatic lipid deposition, with markedly reduced lipid droplets and inflammation. Immunofluorescence and flow cytometry showed that the proportions of CD86-positive cells were significantly decreased, whereas the proportions of CD206-positive cells were significantly increased in the high-, medium-, and low-dose QLHQT groups (P<0.05). Hepatic iNOS levels and TNF-α mRNA expression were significantly decreased (P<0.01), whereas hepatic IL-10 levels and IL-4 mRNA expression were significantly increased (P<0.01). The hepatic protein expression levels of TLR4, TRAF6, and MyD88 were significantly decreased, while signal transducer and activator of transcription 6 (STAT6) phosphorylation was significantly increased (P<0.05, P<0.01). There was no statistically significant difference in total STAT6 protein expression. ConclusionQLHQT effectively ameliorates hepatic inflammation in NASH mice, and the mechanism may involve STAT6- and TLR4-mediated signaling pathways driving polarization of M1 macrophages toward the M2 phenotype.
8.Mechanisms of Mahuang Lianqiao Chixiaodoutang in Improving Obesity-type Polycystic Ovary Syndrome in Rats Based on PI3K/Akt Signaling Pathway
Shiwei HU ; Biran ZHU ; Jinrong ZHANG ; Luyao RUAN ; Ji KUANG ; Jianghuan HUA ; Zhe LIU ; Yanyue YAO ; Ji WANG ; Min ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):21-31
ObjectiveTo investigate the mechanisms by which Mahuang Lianqiao Chixiaodoutang (MLC) improves obesity-type polycystic ovary syndrome (PCOS) through the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. MethodsThirty-six female Sprague-Dawley (SD) rats were randomly divided into a blank control group (Con) and an obesity-type PCOS model preparation group. The model was induced by gavage with letrozole (1 mg·kg-1) combined with a high-fat diet (HFD). After model establishment, the obesity-type PCOS model preparation group was further divided into the model group (Mod, normal saline), metformin group (Met, 0.3 g·kg-1), low-dose MLC group (MLC-L, 4.3 g·kg-1), medium-dose MLC group (MLC-M, 8.6 g·kg-1), and high-dose MLC group (MLC-H, 17.2 g·kg-1). Active components of MLC and targets of obesity-type PCOS were screened from databases, a protein-protein interaction (PPI) network was constructed, and gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed. The gut microbiota structure was analyzed based on 16S rRNA sequencing and correlated with network pharmacology pathways. Body weight and estrous cycle were dynamically monitored. Ovarian morphology was observed by hematoxylin-eosin (HE) staining. Cell apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). Enzyme-linked immunosorbent assay (ELISA) was used to detect levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH), testosterone (T), and estradiol (E2). Western blot was used to detect the protein expression levels of phosphorylated PI3K/PI3K (p-PI3K/PI3K), phosphorylated Akt/Akt (p-Akt/Akt), B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X protein (Bax). ResultsNetwork pharmacology screening identified 124 active components of MLC and 408 overlapping targets between the herbal formula and the disease. Core targets such as Akt1 and Bcl-2 were revealed. As indicated by 16S rRNA sequencing, the abundances of Lachnospiraceae, Lachnoclostridium, and Dorea were increased in the MLC groups (P<0.05), while the abundance of Veillonella was decreased (P<0.05). KEGG correlation analysis integrating network pharmacology and gut microbiota data showed significant enrichment of the PI3K/Akt signaling pathway. Animal experiments showed that, compared with the Mod group, body weight decreased to normal levels in the Met, MLC-M, and MLC-H groups. The estrous cycle became regular. The number of corpora lutea increased and cystic follicles decreased. Serum levels of T, FSH, and LH/FSH were reduced (P<0.05, P<0.01), while the E2 level was increased (P<0.01). Ovarian cell apoptosis was reduced (P<0.01), and the protein expression levels of p-PI3K/PI3K, p-Akt/Akt, and Bcl-2 in ovarian tissue were significantly increased, whereas Bax protein expression was significantly decreased (P<0.05, P<0.01). ConclusionMLC can regulate gut microbiota structure, effectively improve ovarian pathology in rats with obesity-type PCOS, and inhibit ovarian granulosa cell apoptosis. The mechanism may be associated with upregulation of the PI3K/Akt signaling pathway.
9.Treatment of Colorectal Cancer with Traditional Chinese Medicine Based on Hippo Signaling Pathway: A Review
Shuo ZENG ; Suqin HU ; Yang HU ; Lei LUO ; Mingyan LI ; Qinsheng ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):297-305
Colorectal cancer, a leading malignant gastrointestinal tumor globally in terms of incidence and mortality, has seen a consistent annual rise in newly diagnosed cases. While conventional therapies like radiotherapy, chemotherapy, and surgery are available, problems such as lack of early diagnosis, poor prognosis, and drug resistance remain significant burdens for patients. Given the complex and diverse pathogenesis of colorectal cancer, there is an urgent clinical need for safe, effective, reliable, and multi-targeted therapeutic strategies. The Hippo signaling pathway, closely linked to mechanisms like tumorigenesis, cancer cell invasion, migration, and drug resistance, extensively participates in the occurrence and development of colorectal cancer, so targeting the signaling pathway for cancer prevention and treatment has become a crucial research direction in recent years. Traditional Chinese medicine (TCM) offers multi-faceted, multi-pathway, and multi-target advantages and becomes an important therapy for colorectal cancer by enhancing patients' immunity, improving the life quality, and prolonging survival. Studies show that the active components of TCM, including flavonoids, terpenoids, phenols, alkaloids, quinones, lignans, and saponins, as well as TCM compounds such as modified Sijunzi decoction, Jiedu Sangen decoction, Jianpi Jiedu compound, and Quyu Jiedu decoction, exhibit significant targeting effects on the Hippo signaling pathway. These TCMs can exert an anti-colorectal cancer effect through various mechanisms, such as inducing cancer cell autophagy and apoptosis, inhibiting epithelial-mesenchymal transition, reversing drug resistance of the tumor, and blocking the cancer cell cycle. This paper reviewed and analyzed Chinese and international research on the action mechanisms of TCM in regulating the Hippo signaling pathway for the prevention and treatment of colorectal cancer with a comprehensive overview presentation, aiming to provide new references and ideas for the clinical application of TCM and the development of new pharmacological agents in the prevention and treatment of colorectal cancer.
10.Disease burden and changing trend in tracheal, bronchus, and lung cancer attributable to air pollution globally and in China and the United States from 1990 to 2021
Shoucai HU ; Chenglong YANG ; Lingling ZHANG ; Fu LI ; Yanan ZHANG ; Bin LIU ; Qingxin LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(01):97-104
Objective To systematically analyze the spatiotemporal distribution characteristics and epidemiological trends of tracheal, bronchus, and lung cancer (TBL) disease burden attributed to air pollution globally and in China and the United States from 1990 to 2021, and to assess the patterns of disease burden changes from 2022 to 2031 based on predictive models, providing a scientific basis for formulating targeted TBL prevention and control strategies. Methods Based on the Global Burden of Disease (GBD) 2021 database, we analyzed the disease burden data of TBL attributed to air pollution globally and in China and the United States from 1990 to 2021. R Studio 4.3.2 software was used to analyze the corresponding trends and the Bayesian age-period-cohort (BAPC) prediction model was used to predict the status of the disease burden of TBL attributed to air pollution in the world and in China and the United States from 2022 to 2031. Results In 2021, China had the highest number of deaths and disability-adjusted life years attributed to air pollution (211 400 patients and 4.8947 million person-years), followed by the United States (6 000 patients and 124 300 person-years). The age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years rate (ASDR) of TBL due to air pollution in the world and in China and the United States showed a decreasing trend. From 1990 to 2021, the ASMR and ASDR of TBL in China due to air pollution were much higher than those in the United States and the global average. In terms of gender, from 1990 to 2021, the disease burden of male patients with TBL attributed to air pollution was much higher than that of female patients. The BAPC prediction model showed that from 2022 to 2031, the ASMR and ASDR of TBL attributed to air pollution showed an upward trend globally, while they showed a downward trend in China and the United States. Conclusion Over the past 30 years, the air pollution-related TBL disease burden in the world and in China and the United States has continued to decline, but China's disease burden is still significantly higher than the global average. The disease burden in men far exceeds that in women, with men and the population aged ≥50 years being high-risk groups. In the future, the global disease trend may reverse and rise, while China and the United States are expected to continuously decline. However, precise prevention and control for high-risk groups remains a key challenge.

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