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.

ObjectiveTo investigate the protective effect and mechanism of Wendan Ningxin granules （WNG） on susceptibility to atrial fibrillation （AF） in mice with inflammatory injury. Methods100 C57BL/6 mice were divided into a blank control group， a model group， a low-dose WNG group （2.34 g·kg^-1·d^-1）， a high-dose WNG group （4.68 g·kg^-1·d^-1）， and an amiodarone positive control group （0.091 g·kg^-1·d^-1）， with 20 mice in each group. Except for the blank control group， mice in other groups received intraperitoneal injections of lipopolysaccharide （LPS） to establish an inflammatory injury model. Treatment groups received continuous intragastric administration of their respective interventions for four weeks. During the fourth week， the treatment groups received LPS injections concurrently with their treatments. The blank control and model groups received distilled water （10 mL·kg^-1·d^-1） by gavage， with a gavage volume of 10 mL·kg^-1 for all groups， once daily. Hematoxylin-eosin （HE） staining and Sirius red staining were used to observe atrial tissue morphology and fibrosis degree. Immunohistochemistry was used to assess the expression of α-smooth muscle actin （α-SMA） in mouse atrial tissue. Electrophysiological detection was performed using a multi-channel electrophysiology mapping system to measure AF inducibility， AF duration， and atrial effective refractory period （AERP）. High-resolution optical mapping was used to measure action potential duration （APD） dispersion， conduction heterogeneity index， and calcium transient （CaT） dispersion. Real-time quantitative polymerase chain reaction （Real-time PCR） was used to detect mRNA expression of proteins related to diastolic calcium leakage in mouse atria： Ca²⁺/calmodulin-dependent protein kinase Ⅱ（CaMKⅡ）， ryanodine receptor 2（RyR2）， sarco/endoplasmic reticulum Ca²⁺-ATPase （SERCA）， and sodium-calcium exchanger （NCX）. Western blot analysis was performed to detect the expression of CaMKII， RyR2， SERCA， and NCX proteins in myocardial tissue from each group. Enzyme-linked immunosorbent assay （ELISA） was used to measure serum levels of inflammatory factors interleukin-1β （IL-1β） and tumor necrosis factor-α （TNF-α）. ResultsPathological staining results showed that compared with the blank control group， the model group exhibited disrupted atrial tissue structure， inflammatory cell infiltration， atrial fibrosis， and diffuse infiltration of numerous brown α-SMA positive cells in the atrial interstitium （P<0.01）. AF could be induced by electrical stimulation with a longer duration. AERP was shortened， while APD dispersion， conduction heterogeneity index， and CaT dispersion were increased （P<0.01）. The expression of proteins associated with diastolic calcium leakage， including CaMKⅡ， RyR2， and NCX1， showed elevated mRNA and protein levels， whereas SERCA2a mRNA and protein expression decreased （P<0.05）. Serum levels of inflammatory factors IL-1β and TNF-α were elevated （P<0.01）. Compared with the model group， intervention with WNG alleviated cardiac structural damage， reduced inflammatory cell infiltration， improved atrial fibrosis， and reduced the diffuse infiltration of α-SMA positive cells （P<0.01）. AF inducibility and AF duration upon electrical stimulation were significantly reduced （P<0.05）， AERP was prolonged （P<0.05）， mRNA and protein expression of CaMKⅡ， RyR2， and NCX1-proteins associated with diastolic calcium leakage-were reduced， whilst mRNA and protein expression of SERCA2a increased （P<0.05）， and serum levels of IL-1β and TNF-α were decreased （P<0.01）. ConclusionBoth low‑ and high‑dose WNG can effectively reduce susceptibility to inflammation-related AF. The mechanism by which WNG reduce AF susceptibility may be related to regulating proteins involved in sarcoplasmic reticulum diastolic calcium leak， thereby improving cardiac electrical remodeling， and alleviating inflammation-induced myocardial fibrosis， thus improving cardiac structural remodeling.

ObjectiveTo investigate the therapeutic effects of modified Baoyuantang combined with Linggui Zhugantang on post-myocardial infarction heart failure in rats and its influence on NOD-like receptor pyrin domain-containing protein 3 （NLRP3）/gasdermin D （GSDMD）-mediated pyroptosis. MethodsSixty male SD rats were randomized into sham， model， low-， medium-， and high-dose （2.52， 5.04， 10.08 g·kg^-1， respectively） modified Baoyuantang combined with Linggui Zhugantang， and sacubitril/valsartan sodium （0.021 g·kg^-1） groups， with 10 rats in each group. Except the sham group， the other groups underwent left anterior descending coronary artery ligation for the modeling of myocardial infarction. The treatment groups were administrated with corresponding drugs by gavage， and the sham and model groups received an equal volume of normal saline. Administration began on the first day after successful modeling， once daily， for 4 weeks. Echocardiography was used to measure left ventricular ejection fraction （LVEF）， left ventricular fractional shortening （LVFS）， left ventricular end-diastolic and end-systolic diameters （LVIDd and LVIDs）， left ventricular posterior wall thicknesses at end-diastole and end-systole （LVPWd， LVPWs）， and left ventricular volumes at end-diastole and end-systole （LV Vold and LV Vols）. Cardiac mass index and heart weight-to-tibia length ratio were calculated. Hematoxylin-eosin （HE） staining and Sirius Red staining were performed to observe myocardial morphology and collagen deposition. Immunohistochemistry was employed to detect the expression of type I collagen （Collagen Ⅰ）， NLRP3， GSDMD， and interleukin-1β （IL-1β）. Transmission electron microscopy was used to observe the mitochondrial ultrastructure. Tetramethylrhodamine methyl ester （TMRM） staining was conducted to assess mitochondrial membrane potential （MMP） in cardiomyocytes. Real-time PCR was used to quantify the mRNA levels of NLRP3， cysteinyl aspartate-specific proteinase-1 （Caspase-1）， IL-1β， GSDMD， and interleukin-18 （IL-18） in the myocardial tissue. Western blotting was employed to determine the protein levels of NLRP3， Caspase-1， GSDMD， IL-1β， IL-18， nuclear factor kappa-B （NF-κB） p50， and NF-κB p65 in the myocardial tissue. Enzyme-linked immunosorbent assay （ELISA） was adopted to measure the serum levels of tumor necrosis factor-α （TNF-α）， IL-1β， and IL-6. ResultsCompared with the sham group， the model group showed increased LVIDd， LVIDs， LV Vold， LV Vols， cardiac mass index， and heart weight-to-tibia length ratio （P<0.05）， decreased LVPWs， LVEF， LVFS， and MMP （P<0.05）， evident myocardial inflammation， fibrosis， and mitochondrial damage， upregulated expression of NLRP3， Caspase-1， GSDMD， IL-1β， IL-18， NF-κB p50， and NF-κB p65， and elevated serum levels of TNF-α， IL-1β， and IL-6 （P<0.05）. Compared with the model group， modified Baoyuantang combined with Linggui Zhugantang reduced the LVIDd， LVIDs， LV Vols， cardiac mass index， and heart weight-to-tibia length ratio （P<0.05）， increased the LVPWs， LVEF， LVFS， and MMP （P<0.05）， alleviated myocardial inflammation and fibrosis， improved the mitochondrial structure and function， downregulated the expression of NLRP3， Caspase-1， GSDMD， IL-1β， IL-18， NF-κB p50， and NF-κB p65 （P<0.05）， and reduced the serum levels of TNF-α， IL-1β， and IL-6 （P<0.05）. ConclusionModified Baoyuantang combined with Linggui Zhugantang can ameliorate post-myocardial infarction ventricular remodeling and improve the cardiac function by reducing mitochondrial damage and inhibiting NLRP3/GSDMD-mediated pyroptosis.

ObjectiveMaxing Shigan Tang， as a traditional prescription for treating pneumonia， has a remarkable clinical effect. This study aims to systematically investigate the molecular mechanisms of Maxing Shigan Tang in treating pneumonia by integrating its structural and transcriptomic data at the target level. MethodsNP-TCMtarget， a developed systematic network pharmacological model focusing on drug targets， was used to mine the effect targets of Maxing Shigan Tang for treating pneumonia based on the transcriptome data. The structural targets of chemical components in Maxing Shigan Tang were predicted based on the structural information. The intersection of effect targets and structural targets was taken as the direct targets of Maxing Shigan Tang for treating pneumonia， and the remaining effect targets except direct targets were taken as indirect targets. Finally， functional enrichment analysis was performed on these targets to explore the molecular mechanism of Maxing Shigan Tang in treating pneumonia. ResultsA total of 1 604 effect targets and 816 structural targets of Maxing Shigan Tang for treating pneumonia were identified. Maxing Shigan Tang exerted its therapeutic effects through 164 direct targets and 1 440 indirect targets. The functional analysis of 1 604 effect targets predicted 19 significantly enriched pathways. Comprehensive analysis of these pathways showed that these targets were mainly linked to immune and inflammatory responses， such as cytokine-cytokine receptor interaction， necrosis factor （NF）-κB signaling pathway， and helper T cell 17 differentiation. ConclusionFocusing on the hierarchical feature of drug targets and the structural and transcriptomic data， this study systematically reveals the path of herbal component-direct target-indirect target-biological effects of Maxing Shigan Tang in treating pneumonia.

Objective To characterize the clinical features of the group of gout patients to facilitate earlier identifi-cation,and optimize the diagnosis and treatment of the condition.Methods The retrospective study analyzed 24 gout patients with shoulder joint(s)involved and consulted by physicians of Peking Union Medical College Hospital from March 2021 to April 2025,while 70 outpatient gout patients matched by clinical course duration and sex were enrolled as control group.Clinical data including medical history,laboratory tests,therapeutic interventions.Prog-nosis was systematically collected to delineate the distinctive clinical manifestations of the patients.Results All 24 gout patients with shoulder joints involved were male,aged(43.16±13.13)years and had an average BMI of 27.70±4.63.The duration of gout was 8(5,12)years while of those patients had an early onset before 30 years old.The maximal serum uric acid concentration was(754.15±175.79)μmol/L.It was shown by case review that 16.67％of the patients were asymptomatic,and 79.17％suffered from shoulder pain.A quarter of the patients developed subcutaneous tophi.All the patients affected(P＜0.05).The affected joints ascended from lower extremities to the upper averagely took 4.72±2.80 years and had heavier burden of hyperuricemia(P＜0.05),while no significant difference was found in renal function and inflammation level.Conclusions Gout patients with shoulder joints involvement are older and have atypical manifestation.The diagnosis needs support of imaging or ar-throcentesis.

ObjectiveMaxing Shigan Tang， as a traditional prescription for treating pneumonia， has a remarkable clinical effect. This study aims to systematically investigate the molecular mechanisms of Maxing Shigan Tang in treating pneumonia by integrating its structural and transcriptomic data at the target level. MethodsNP-TCMtarget， a developed systematic network pharmacological model focusing on drug targets， was used to mine the effect targets of Maxing Shigan Tang for treating pneumonia based on the transcriptome data. The structural targets of chemical components in Maxing Shigan Tang were predicted based on the structural information. The intersection of effect targets and structural targets was taken as the direct targets of Maxing Shigan Tang for treating pneumonia， and the remaining effect targets except direct targets were taken as indirect targets. Finally， functional enrichment analysis was performed on these targets to explore the molecular mechanism of Maxing Shigan Tang in treating pneumonia. ResultsA total of 1 604 effect targets and 816 structural targets of Maxing Shigan Tang for treating pneumonia were identified. Maxing Shigan Tang exerted its therapeutic effects through 164 direct targets and 1 440 indirect targets. The functional analysis of 1 604 effect targets predicted 19 significantly enriched pathways. Comprehensive analysis of these pathways showed that these targets were mainly linked to immune and inflammatory responses， such as cytokine-cytokine receptor interaction， necrosis factor （NF）-κB signaling pathway， and helper T cell 17 differentiation. ConclusionFocusing on the hierarchical feature of drug targets and the structural and transcriptomic data， this study systematically reveals the path of herbal component-direct target-indirect target-biological effects of Maxing Shigan Tang in treating pneumonia.

Objective:To analyze the application value of evaluation model for dimension of safe management in standardized management for medical equipment in department of orthopedics.Methods:The management objectives were refined from the aspects of management objects,goal refinement,problem analysis,index screening,and evaluation feedback in the safe management for medical equipment in department of orthopedics,and an evaluation model for dimension of safe management was constructed to conduct whole-process management for medical equipment in department of orthopedics.A total of 73 clinically medical equipment that were used in department of orthopedics of Beijing Chao-yang Hospital,Capital Medical University from January 2022 to December 2023 were selected.In them,36 equipment during January to December 2022 were managed by adopting conventional management model,and 37 equipment during January to December 2023 were managed by adopting the evaluation model for dimension of safe management(model management mode).The clinical service quality,incidence of risk,and scores of quality management capability for equipment between the two management modes were compared.Results:The mean values of consistency rate of the requirement for average configuration,compliance rate of performance parameter,stability rate of quality detection,and qualification rate of cleaning and disinfection of the equipment of adopting the model management mode were respectively(91.69±4.36)%,(92.36±3.54)%,(91.80±3.54)%and(92.36±4.20)%,all of which were higher than those of adopting the conventional management mode,with statistically significant differences(t=15.003,14.545,11.529,11.921,P<0.05).The failure rate,defect rate of components,unqualified rate of cleaning and disinfection,and improper rate of managing equipment of the 37 equipment of adopting the model management mode were respectively 5.41%,5.41%,2.70%and 8.11%,all of which were lower than those of adopting the conventional management model,with statistically significant differences(x2=9.182,10.538,11.696,9.667,P<0.05).The scores of resource allocation,technical support,and information foundation for equipment of adopting the model management mode were all higher than those of adopting the conventional management mode,with statistically significant differences(t=11.494,10.089,13.831,P<0.05).Conclusion:The application of evaluation model for dimension of safe management for medical equipment in department of orthopedics can improve the operational quality of equipment,and reduce safety hazards and failure rates of equipment,and enhance use efficiency of equipment.

Mitophagy is a selective degradation process of damaged mitochondria in response to mitochondrial toxicity,which plays a crucial role in regulating mitochondrial quality and quantity.Abnormal mitophagy can cause or exacerbate mitochondrial dysfunction,which is closely associated with the pathogenesis of numerous diseases.Given that cochlear hair cells are highly sensitive to energy metabolism,proper regulation of mitophagy is essential for maintaining auditory function.Mitochondrial damage resulting from mitophagy dysfunction involves diverse pathophysiological mechanisms underlying sensorineural hearing loss.This review summarizes the latest progress on mitophagy and its role in the pathogenesis of sensorineural hearing loss,aiming to enhance our understanding of the involvement of mitophagy in auditory function and provide a theoretical basis for future research on targeted therapy for mitochondria.

Acute urinary retention(AUR)occurs frequently among astronauts on orbit.The current treatment is complex and easy to damage the urethra,which seriously affects the life and work of astronauts.In contrast,acupuncture,a traditional Chinese remedy,has shown promising results in managing urinary retention.However,the specific acupoints that could potentially prevent AUR remain uncertain due to the unique physiological conditions experienced by individuals in space compared to those on Earth.To address this gap,our research delved into the mechanisms of AUR and acupuncture within both traditional Chinese medicine and modern medical practices.We conducted a thorough literature review from Pubmed,Web of Science,CNKI,Wanfang database,VIP database and Chinese Medical Code database.A hierarchical evidence-scoring approach was utilized to analyze the included literatures,thus devised acupuncture protocols for the treatment of AUR.The outcomes of our study aim to establish a foundation for the application of acupuncture in managing AUR.

Under the influence of long-term space flights and the confined space environment,it is very easy to induce space depression syndrome,mainly manifested as decreased emotional stability,sleep disorders,mental fatigue,etc.,which seriously affect the living conditions and working abilities of astronauts.The current treatment methods mainly focus on psychological support and drug intervention.Acupuncture has a good effect in treating depression.Therefore,starting from the TCM pathogenesis and modern medical pathogenesis of aerospace depression syndrome,we conducted literature retrieval from databases such as the Chinese Medical Classic,China National Knowledge Infrastructure(CNKI),Wanfang,VIP,PubMed,and Web of science.For the included literature,we adopted the stratified evidence scoring method and combined the TCM mechanism and modern medical mechanism of the effect of acupuncture.A prescription for acupuncture points was constructed to provide a basis for selecting acupuncture points for the prevention of aerospace depression syndrome through acupuncture.