Objective To systematically analyze the characteristics of the disease burden of hypertensive heart disease (HHD) in the elderly (≥60 years) globally and in China from 1990 to 2021, and to predict its future trends from 2022 to 2040, with the aim of providing data support for optimizing comprehensive prevention and control strategies for HHD. Methods Based on the Global Burden of Disease (GBD) 2021 database, the number of prevalent cases and disability-adjusted life years (DALYs) of HHD in the elderly were extracted for the world, China, and five regions categorized by sociodemographic index (SDI). Joinpoint regression was used to analyze the temporal trends of age-standardized prevalence rate and age-standardized DALYs rate of HHD in the elderly. A three-factor decomposition method was applied to evaluate the relative contributions of aging, population growth, and epidemiological changes to the variations in the elderly HHD burden. Additionally, a Bayesian age-period-cohort model was used to predict the elderly HHD burden from 2022 to 2040. Results In 2021, the number of prevalent elderly HHD cases reached 10 283 000 globally and 3 412 400 in China, representing increases of 179.20% and 159.20% respectively, compared with 1990. The DALYs of elderly HHD were 18 812 700 person-years globally and 4 731 400 person-years in China, rising by 76.08% and 29.45% respectively from 1990. Meanwhile, the growth rates of the number of prevalent cases and DALYs of elderly HHD varied across different SDI regions. From 1990 to 2021, the age-standardized prevalence rate of elderly HHD in China, as well as the age-standardized DALYs rate of elderly HHD both globally and in China, showed significant downward trends (all average annual percentage changes<0, all P<0.001). In 2021, the 70-74 years age group accounted for the highest proportion of prevalent cases and DALYs of elderly HHD, both globally and in China. Decomposition analysis revealed that population growth was the dominant factor driving the increase in the elderly HHD burden across all regions. The prediction model results indicated that the number of prevalent cases and DALYs of elderly HHD would continue to rise globally and in China from 2022 to 2040, with the growth rate of the elderly HHD burden in China between 2021 and 2040 expected to exceed the global average. Conclusion Over the past 32 years, although the age-standardized disease rates of elderly HHD have mainly shown a downward trend globally and in China, the absolute number of the disease burden has increased substantially. The projection model indicates a continued upward trajectory, with the growth rate in China higher than the global average. Therefore, there is an urgent need to implement precise prevention and control strategies to effectively mitigate the disease burden of elderly HHD.

Objective: To explore the effect of different obesity indicators in predicting cardiovascular and cerebrovascular diseases (CVD) risk among patients with type 2 diabetes mellitus (T2DM), so as to provide the evidence for the early identification of CVD risk among T2DM patients. Methods: The patients with T2DM under community management in Qingpu District, Shanghai Municipality were selected as the study subjects in January 2025. Basic information such as gender, age, and blood glucose control status were collected through the Shanghai Chronic Disease Information Management System, while history of CVD were obtained from residents' electronic health records and the Shanghai Disease Control Information Platform. Obesity was assessed using body mass index (BMI), waist circumference (WC), BMI combined with WC, waist-to-height ratio (WHtR), and triglyceride (TG) combined with WC indicators. The association between obesity and CVD was analyzed using multivariable logistic regression models. The predictive effect of each obesity indicators for CVD was evaluated using the area under the receiver operating characteristic curve (AUC). Results: A total of 4 367 patients with T2DM were included, including 2 121 males (48.57%) and 2 246 females (51.43%). The average age was (68.71±8.05) years. The prevalence of CVD was 44.49%. Multivariable logistic regression analysis showed that after adjusting for age, education level, history of hypertension, duration of T2DM, use of glucose-lowering medications, renal function, and blood glucose control status, obese T2DM patients had a 389.4% increased risk of CVD compared to those with normal BMI; centrally obese T2DM patients had a 100.4% increased risk compared to those with normal WC; T2DM patients with isolated general obesity and compound obesity had 161.0% and 241.1% increased risks of CVD, respectively, compared to those with normal BMI and WC; centrally obese T2DM patients had a 100.4% increased risk compared to those with normal WHtR; T2DM patients with normal TG-high WC and high TG-high WC phenotypes had 83.1% and 68.8% increased risks of CVD, respectively, compared to those with normal TG and normal WC (all P<0.05). BMI had the highest AUC, at 0.714, with sensitivity and specificity of 0.675 and 0.642, respectively. This was followed by BMI combined with WC, which had an AUC of 0.707, with sensitivity and specificity of 0.635 and 0.679, respectively. Conclusions Obesity defined by BMI, WC, BMI combined with WC, WHtR, and TG combined with WC increases the risk of CVD among patients with T2DM. BMI and BMI combined with WC have better predictive effect in predicting CVD risk among patients with T2DM, and can be used as the primary obesity indicators for CVD risk screening.

Objective:To analyze the risk factors for herpes zoster complicated by kidney dysfunction and construct a prediction model.Methods:A retrospective analysis was conducted on the clinical data of 150 patients with herpes zoster who were admitted to Hangzhou Third People's Hospital from January 2022 to December 2023. The patients were divided into two groups based on the presence of kidney dysfunction: kidney dysfunction group ( n = 30, with kidney dysfunction) and control group ( n = 120, without kidney dysfunction). The risk factors for herpes zoster complicated by kidney dysfunction were analyzed. The logistic prediction model was constructed. The effectiveness of this prediction model in predicting herpes zoster complicated by kidney dysfunction was assessed using the receiver operating characteristic curve. Results:The differences in gender, body mass index, comorbidities (hypertension and hyperlipidemia), and sites of onset between the two patient groups were not statistically significant (all P > 0.05). The average age of the kidney dysfunction group was (67.74 ± 6.71) years, which was significantly older than that in the control group [(62.32 ± 5.58) years, t = 4.56, P < 0.001]. In the kidney dysfunction group, the proportions of patients with comorbid diabetes, severe pain, large lesion area, high-dose antiviral medication use, and hemoglobin levels < 120 g/L were 46.67% (14/30), 63.33% (19/30), 56.67% (17/30), 46.67% (14/30), and 40.00% (12/30), respectively. These values were all significantly greater than those in the control group [14.17% (17/120), 34.17% (41/120), 31.67% (36/120), 19.17% (23/120), and 10.00% (12/120), χ2 = 15.46, 2.60, 2.10, 9.76, 16.07, P < 0.001, 0.002, 0.035, 0.002, < 0.001). Logistic regression analysis revealed that older age ( OR = 3.023), comorbid diabetes ( OR = 4.315), severe pain ( OR = 3.623), large lesion area ( OR = 3.481), high-dose antiviral medication use ( OR = 4.030), and hemoglobin levels < 120 g/L ( OR = 0.151) were all significant risk factors for herpes zoster complicated by kidney dysfunction (all P < 0.05). Based on these risk factors, the following logistic prediction model was developed: Logit( P) = -8.753 + 1.106 × age + 1.462 × diabetes + 1.287 × pain severity + 1.247 × lesion area + 1.394 × high-dose antiviral medication use + (-1.889) × hemoglobin. The receiver operating characteristic curve analysis indicated that the area under the curve for predicting herpes zoster complicated by kidney dysfunction was 0.904 (95% CI: 0.859-0.937), with a sensitivity of 84.62% and a specificity of 89.04%. Conclusions:The risk factors for herpes zoster complicated by kidney dysfunction include older age, comorbid diabetes, severe pain, large lesion area, high-dose antiviral medication use, and hemoglobin levels < 120 g/L. Based on these factors, the construction of a logistic prediction model can provide a reliable basis for clinical prediction of the occurrence of kidney dysfunction.

The working principle of Bausch&Lomb BL11110 phacoemulsification system was described.Three cases of typical faults of the phacoemulsification system were introduced,and the causes were analyzed,then the maintenance measures were given accordingly.References were provided for diagnosing and eliminating the faults of the phacoemulsification system.[Chinese Medical Equipment Journal,2025,46(4):118-120]

Pyroptosis is an identified programmed cell death that has been highly linked to endoplasmic reticulum (ER) dynamics. However, the crucial proteins for modulating dynamic ER membrane curvature change that trigger pyroptosis are currently not well understood. In this study, a biotin-labeled chemical probe of potent pyroptosis inducer α-mangostin (α-MG) was synthesized. Through protein microarray analysis, reticulon-4 (RTN4/Nogo), a crucial regulator of ER membrane curvature, was identified as a target of α-MG. We observed that chemically induced proteasome degradation of RTN4 by α-MG through recruiting E3 ligase UBR5 significantly enhances the pyroptosis phenotype in cancer cells. Interestingly, the downregulation of RTN4 expression significantly facilitated a dynamic remodeling of ER membrane curvature through a transition from tubules to sheets, consequently leading to rapid fusion of the ER with the cell plasma membrane. In particular, the ER-to-plasma membrane fusion process is supported by the observed translocation of several crucial ER markers to the "bubble" structures of pyroptotic cells. Furthermore, α-MG-induced RTN4 knockdown leads to pyruvate kinase M2 (PKM2)-dependent conventional caspase-3/gasdermin E (GSDME) cleavages for pyroptosis progression. In vivo, we observed that chemical or genetic RTN4 knockdown significantly inhibited cancer cells growth, which further exhibited an antitumor immune response with anti-programmed death-1 (anti-PD-1). In translational research, RTN4 high expression was closely correlated with the tumor metastasis and death of patients. Taken together, RTN4 plays a fundamental role in inducing pyroptosis through the modulation of ER membrane curvature remodeling, thus representing a prospective druggable target for anticancer immunotherapy.
Pyroptosis/immunology* ; Humans ; Endoplasmic Reticulum/immunology* ; Animals ; Nogo Proteins/antagonists & inhibitors* ; Mice ; Cell Line, Tumor ; Xanthones/pharmacology* ; Neoplasms/pathology* ; Mice, Nude

Melanoma is characterized by high malignancy, ranking the third among skin malignancies, and is associated with lack of specific treatment options and poor prognosis. Therefore, the development of effective therapies for melanoma is imperative. A critical challenge in addressing subcutaneous disease lies in overcoming the skin barrier. In this study, we engineered a microneedle (MN) system that integrates chemotherapy, photothermal therapy (PTT), and targeted therapy to enhance anti-tumor efficacy while effectively penetrating the skin barrier. In vitro studies have demonstrated that the MN drug delivery system (DDS) can effectively penetrate the stratum corneum of the skin, deliver therapeutics to subcutaneous tumor sites, and establish a drug reservoir at these locations to exert anti-tumor effects. Cellular experiments indicated that the engineered PTT chemotherapy-targeted MNs can be internalized by tumor cells, exhibiting enhanced cytotoxicity against them. In vivo pharmacological investigations revealed that the combination of PTT and chemotherapy delivered via this MN DDS produced synergistic anti-tumor effects, achieving a tumor inhibition rate of up to 98.15%. This in situ DDS minimizes involvement with other organs, significantly reducing chemotherapy-related side effects. In summary, the PTT chemotherapy-targeted MNs developed in this study demonstrate promising application potential by enhancing anti-tumor efficacy while minimizing adverse effects.

Ischemic bowel disease(IBD)is a prevalent intestinal vascular disease that poses a serious threat to patients' lives and health.Tthe key pathological process of ischemic bowel disease is intestinal ischemia-reperfusion(II/R)injury.If not diagnosed and treated in a timely manner,it can lead to life-threatening conditions such as peritonitis,intestinal gangrene perforation,and multiple organ dysfunction.Current treatments primarily focus on symptomatic and surgical interventions,lacking targeted pharmacological therapies.A substantial body of research has found that traditional Chinese medicine(TCM)exhibits a protective effect against II/R injury.This review systematically elaborated on the mechanisms by which various TCM bioactive components,including Astragaloside IV,Ginsenosides,Salvianolic acids,and Tetramethylpyrazine,as well as compound formulations such as Shenqi injection,Taoren Chengqi decoction,and Sini decoction ameliorate II/R injury.These findings provide novel research perspectives for developing TCM-based therapeutics for IBD.

Over 40%of critically ill patients will develop coagulopathy.Once critically ill patients are complicated with coagulopathy,the incidence of bleeding and mortality can increase by more than 4 times.Early identification of coagulopathy and accurate evaluation of coagulation function are essential for correcting coagulopathy as soon as possible.Therefore,Chinese Society of Thrombosis,Hemostasis and Critical Care,Chinese Medicine Education Association,together with Chinese People's Liberation Army Professional Committee of Critical Care Medicine updated the"Chinese expert consensus on standardized assessment of severe coagulopathy(2025 Edition)"on the basis of the"Consensus of Chinese experts on standardized evaluation of coagulation dysfunction in severe patients"formulated in 2022.This consensus includes four parts:classification and typing,etiology and mechanism,assessment methods,and diagnostic criteria of severe coagulopathy,with a total of 14 recommendations,aiming to provide corresponding guidance for clinical practice.

Aim To investigate the effect of adenovirus(ADV)-mediated Profurin(PF)expression on the plaque stability of ApoE-/-mice.Methods ApoE-/-mice were fed with high-fat diet for 8 weeks,and then treated with ADV-mediated PF intervention,followed by high-fat diet for 4 weeks.Aortic roots were isolated for atherosclerotic plaque area analysis and immunohistochemical analysis.Plasma phospholipid transfer protein(PLTP)activity was detec-ted by fluorescence donor essay,plasma total cholesterol(TC)and triglyceride(TG)were measured by enzyme assay kits,and fast protein liquid chromatography was used for lipoprotein profile analysis.Results Compared with the con-trol group,the plasma TC and TG levels,PLTP activity and circulating tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in ADV-PF group were significantly decreased(P＜0.01).In the ADV-PF group,there was no significant change in atherosclerotic lesions on the inner surface of the full-length aorta,but the plaque area and lipid area in the aortic root were reduced(P＜0.01),the content of macrophages was significantly decreased(P＜0.01),and the smooth muscle cells and collagen area were not significantly different.The content of matrix metalloproteinase-9 in plaque was signifi-cantly decreased(P＜0.05).Conclusion Overexpression of PF can alleviate atherosclerosis and reduce the levels of circulating inflammatory factors to a certain extent,and effectively improve the plaque stability of ApoE-/-mice.

Lung cancer poses a serious threat to global public health security.Chemotherapy,as the main strategy for cancer treatment,faces challenges such as high toxicity and drug resistance.Anticancer peptides have the potential of being developed into new anticancer drugs due to their advantages of broad-spectrum anticancer activity,rapid action,and difficulty in generating drug resistance,but they also face shortcomings such as weak activity and strong toxic side effects.The weakly acidic microenvironment of tumors(pH 6.5-6.8)provides a good idea for the design of anticancer peptides of high-efficiency and low-toxicity.Previously,we designed the acid-sensitive antibacterial peptide pHly-1 using the wolf spider(Lycosa singoriensis)toxin Lycosin-Ⅰ as a template.In this study,we found that pHly-1 also had acid-sensitive anticancer activity.Further alanine scanning analysis of pHly-1 was carried out,and we ob-tained a mutant pHTP-2 with better acid sensitivity,whose IC50(half maximal inhibitory concentration)against A549 cells was 15.68 μmol/L at pH 6.6 and was greater than 100 μmol/L at pH 7.4.At pH 6.6,pHTP-2 could act on various lung cancer cell lines and induce the death of A549 cells by rapid ly-sis;at pH 7.4,500 μmol/L pHTP-2 had weak toxicity to red blood cells(the hemolysis rate was ap-proximately 38％)and primary myocardial cells(the inhibition rate was 49.7％,with P＜0.05).Analy-sis of its charge,particle size,morphology,and secondary structure showed that at pH 6.6,the histidine in the sequence of pHTP-2 was protonated,increasing the positive charge(P＜0.01),decreasing the hy-drated particle size(P＜0.05)and forming an α-helical structure to induce membrane lysis of A549 cells.At pH 7.4,it was deprotonated,the positive charge decreases,a β-sheet structure was formed and self-aggregation occurred,limiting its effect on the A549 cell membrane and showing weak activity.In summary,pHTP-2 could respond to the weakly acidic microenvironment of tumors to exert selective cyto-toxic activity,effectively overcoming the shortcomings of anticancer peptides such as low efficiency and high toxicity.Our findings suggest that it is a high-quality lead molecule for anticancer drugs.