Objective:To explore the correlation between high cholinergic pathway signaling and cognitive function in patients with Parkinson disease(PD) accompanied with sleep disorder.Methods:PD patients admitted from 2017 to 2022 were divided into PD with sleep disorder group (PD-SD group) ( n=56) and PD without sleep disorder group (PD-NSD group) ( n=41) according to the Parkinson's disease sleep scale (PDSS) score. All participants underwent magnetic resonance imaging examination.All patients were evaluated by the PDSS, Hoehn-Yahr (H-Y), Montreal cognitive assessment scale (MoCA), and cholinergic pathways hyper intensities scale (CHIPS). The difference of cognitive function between the two groups and the correlation between CHIPS and cognitive function were analyzed.Independent sample t-test, Spearman correlation analysis, and binary Logistic regression analysis were performed on the data by SPSS 26.0 statistical software. Results:(1)The MoCA score of the PD-SD group (22.00 (5.00)) was lower than that of the PD-NSD group (26.00 (5.00)) ( Z=-3.830, P<0.05). The total and all aspects scores of CHIPS in PD-SD group were higher than those in PD-NSD group(the total score of the low external capsule: 12.00(8.00), 0(8.00), the total score of the high external capsule: 12.00(2.00), 6.00(9.00), the total score of the radial crown: 8.00(0), 4.00(4.00), the total score of the centrum semiovale: 3.00(4.00), 0(2.00), the total score of the right side: 16.00(9.00), 5.00(10.00), the total score of the left side: 17.00(6.00), 7.00(9.00), the total score of CHIPS: 32.00(14.00), 14.00(20.00))( Z=-5.081, -5.873, -4.933, -3.211, -5.562, -6.232, -5.995, all P<0.05). (2)The correlation analysis between the score of CHIPS and cognitive function in the PD-SD group showed that, the total score of the low external capsule ( r=-0.286), the total score of the centrum semiovale ( r=-0.307), the total score of the right side ( r=-0.376), the total score of the left side ( r=-0.284) and the total score of CHIPS ( r=-0.349) were negatively correlated with MoCA(all P<0.05). (3)Binary Logistic regression analysis showed that white matter lesions in centrum semiovale, low inner capsule, right and left leukodystrophy were not influence factors for cognitive impairment (all P>0.05). Conclusion:PD patients with sleep disorders have lower cognitive function scores, higher CHIPS scores, and significant changes in white matter lesions compared to those without sleep disorders. In PD patients with sleep disorders, the higher the CHIPS score, the lower the cognitive function score, and the more significant the rate of cognitive impairment occurrence and development.

Objective To understand the research status,hotspots and trends of Wuzhuyu Decoction;To provide reference for relevant research.Methods The literature related to Wuzhuyu Decoction was retrieved from CNKI,VIP,Wanfang Data and CBM databases from the establishment to February 28,2023.NoteExpress 3.6 was used to merge and deduplicate,and the author,organization and keywords were mapped and interpreted by CiteSpace 6.1.R6 software.Results A total of 822 articles were included,and the number of publications showed a wave upward trend;the top journals were New Chinese Medicine,Henan Traditional Chinese Medicine and Sichuan Traditional Chinese Medicine;the main research institutions were Beijing University of Chinese Medicine,China Academy of Chinese Medical Sciences and Shandong University of Traditional Chinese Medicine;a total of 566 authors were involved,and the authors with more publications included Wang Zhimin(12),Gong Muxin(9)and Bi Kaishun(5);high-frequency keywords included"headache","Shang Han Lun","TCM therapy"and so on.Conclusion Wuzhuyu Decoction is effective in treating chronic gastritis,hypertension and other primary diseases,which is a research hotspot in this field.It is a research trend in this field to explore its active components by high performance liquid chromatography and explain its action mechanism and target at the molecular level.

Objective To understand the research status,hotspots and trends of animal medicinal materials;To provide reference for future research.Methods The literature related to animal medicinal materials was retrieved from CNKI,VIP,Wanfang Data and CBM from January 1,2000 to April 30,2023.NoteExpress 3.6 was used to merge and deduplicate,and the author,institution and keywords were mapped and interpreted by CiteSpace 6.1.R6 software.Results A total of 1 169 articles were included,and the overall publication quantity in this field showed a stable fluctuation trend;the top journals were Lishizhen Medicine and Materia Medica Research,China Journal of Chinese Materia Medica and Modern Chinese Medicine;the main research institutions were China Academy of Chinese Medical Sciences,Changchun University of Chinese Medicine and Chinese Academy of Medical Sciences;a total of 676 authors were involved,and the authors with more publications included Zhang Hui(22),Liu Rui(15),Lin Zhe and Ma Shuangcheng(14);high-frequency keywords included"identification","TCM resources","clinical application"and so on.Conclusion Resource survey of animal medicinal materials,standardized breeding of medicinal animals,development of alternatives to rare medicinal animal resources,and construction of quality standard system for animal medicinal materials are the research hotspots in this field.The basic research of pharmacodynamic substances of animal medicinal materials based on the integrated analysis strategies of proteomics,peptideomics and transcriptomics,and the revelation of the signaling pathways and targets of animal medicinal materials from the molecular biology level are the research trends in this field.

OBJECTIVE To evaluate the cost-effectiveness of trastuzumab deruxtecan（T-DXd） versus trastuzumab emtansine （T-DM1） in the second-line treatment of HER2-positive metastatic breast cancer， and to provide a basis for the selection of clinical medication regimen and medical and health decisions. METHODS Based on the clinical trial DESTINY-Breast03， a partitioned survival model was constructed， with a cycle of 3 weeks as the simulation of patients’ lifetime. The incremental cost-effectiveness ratio （ICER） was calculated by using quality-adjusted life years （QALY） as output indicators， and sensitivity analysis was used to verify the robustness of the basic analysis results； the cost-effectiveness of the second-line treatment for HER2-positive metastatic breast cancer was compared between T-DXd and T-DM1. RESULTS Under the premise of taking 3 times China’s per capita gross domestic product （GDP） in 2022 as the willingness-to-pay threshold （257 094 yuan/QALY）， the T-DXd group also needed to pay more cost compared with T-DM1 group while obtaining incremental utility （0.69 QALYs）， and the ICER value was 1 850 478.40 yuan/QALY. The results of univariate sensitivity analysis showed that progression-free survival state utility value， T-DXd price， cost discount rate were factors that had a great influence on ICER value， but these parameters could not flip the basic analysis results within a reasonable range. In the probability sensitivity analysis， when the threshold of willingness-to-pay rose to 1 500 400 yuan/QALY， the probability of economic activity was 50% in the T-DXd regimen. The results of the scenario analysis also verified the robustness of the original research results. CONCLUSIONS Under the premise of 3 times China’s per capita GDP as the WTP threshold， compared with T-DM1， T-DXd is not cost-effective in the second-line treatment of HER2-positive metastatic breast cancer.

Objective:To analyze the development status, research hotspots and development trend of Tianma Gouteng Decoction.Methods:Research literature on Tianma Gouteng Decoction in the medical field from January 1, 2002 to December 31, 2022 was retrieved from CNKI, WanFang, VIP, and SinoMed. The NoteExpress 3.7.0 software was used to merge and remove the duplicates. CiteSpace 6.1.R6 software was used to visually analyze the information such as the publication trend, authors, institutions and keywords of the included literature, and to display the cooperation network of authors and institutions, as well as the co-occurrence, clustering and burst map of keywords.Results:Totally 2 137 articles were finally included, with an overall increasing trend of annual publication. The distribution of journals was mainly in TCM, among which the Journal of Practical Traditional Chinese Internal Medicine had the most publications. Xian Shaoxiang (First Affiliated Hospital of Guangzhou University of Chinese Medicine) was the author with the most publications (17 articles). The institution with the most publications was Tianjin University of Traditional Chinese Medicine (23 articles), and the cooperation between research institutions was mainly in Chinese medicine colleges and their affiliated hospitals. The results of keyword analysis showed that the high-frequency keywords were hypertension, vertigo, hyperactivity of liver yang, clinical efficacy, migraine, etc. The keywords formed 10 clusters. The keywords with a long time span were syndrome differentiation and treatment, hypertension, experience of famous doctors, and clinical observation. In recent years, the emergent keywords were adverse reactions, blood pressure levels, vertigo, addition and subtraction treatment, and medication laws. Conclusions:The current research field of Tianma Gouteng Decoction is in a rising stage of development, and it is still necessary to strengthen academic exchanges and cooperation across regions and teams. Relevant research mainly focuses on the clinical application of cardiovascular and cerebrovascular diseases. The commonly used treatment is comprehensive therapy of TCM, focusing on blood pressure changes, adverse reactions and so on. The application of Tianma Gouteng Decoction in the treatment of vertigo, the study of adverse drug reactions and the discussion of medication rules have gradually become research hotspots.

Objective:To understand the current status, hotspots and trends of hospice care education for nursing staff at home and abroad, so as to provide the reference for follow-up research.Methods:Literatures related to hospice care education for nursing staff were retrieved from China National Knowledge Infrastructure and Web of Science database from January 1, 2000 to October 8, 2023. EndNote21 was used for bibliometric analysis. CiteSpace6.2.R2 software was used to draw and interpret the knowledge map of keywords.Results:A total of 445 and 3 637 articles were included in China National Knowledge Infrastructure and Web of Science database. The number of publications was on the rise. A total of 11 clusters and 12 emerging keywords were obtained from China National Knowledge Infrastructure database. A total of 11 clusters and 25 emerging keywords were obtained from Web of Science database.Conclusions:The construction of standardized and homogeneous curriculum system and feedback evaluation system of hospice care education has been a research hotspot at home and abroad in recent years. For nurses with multi-level education, the use of multidisciplinary, multi-center, in-depth intervention research and evidence-based research to explore the hospice care education model in line with China′s national conditions is the development trend in the future.

Objective To understand the current status and development trend of the research on Prunellae Spica;To provide reference for the subsequent research.Methods The research literature related to Prunellae Spica was searched in China Knowledge Resources Database(CNKI),Chinese Science and Technology Journal Database(VIP),Chinese Academic Journal Database(Wanfang Data),and Chinese Biomedical Literature Database(CBM)from January 1,2002 to March 23,2023.After merging and removing duplicates using NoteExpress 3.7.0.9258 software,CiteSpace 6.2.R1 software was used to visualize and analyze authors,institutions and keywords.Results Totally 3 136 articles were included,and the annual number of publications showed a fluctuating upward trend.Shaanxi Journal of Traditional Chinese Medicine had the most publications(93).The core authors included Lin Limei(34),Guo Qiaosheng(27),and Zhang Mingzhi(20),and core research institutions included Shandong University of Traditional Chinese Medicine(37),Tianjin University of Traditional Chinese Medicine(30),and Nanjing University of Chinese Medicine(28),with less cooperation among authors and institutions.The analysis of keywords showed that the research on the treatment of diseases were mainly"hypertension","breast cancer","hyperplasia of mammary glands","vertigo","insomnia".The chemical composition studies were mainly on"rosmarinic acid"and"ursolic acid".The type of literature was mainly"experience of famous doctors"and"clinical observation".Conclusion The research field of Prunellae Spica is in the rising stage of development,and the research content mainly focuses on clinical application and chemical composition research,etc.Summarizing the law of medication,exploring its mechanism of action and action target through data mining and molecular docking technology are the research trends.

Objective To understand the research hotspots and trend of Scrophulariae Radix from 2000 to 2023;To provide reference for related research.Methods The relevant literature of Scrophulariae Radix were retrieved from CNKI,VIP,Wanfang Data and CBM from January 1,2000 to June 1,2023.NoteExpress 3.7.0.9296 software was used to manage files and weight,and CiteSpace 6.2.R4 software was used for visualization analysis of authors,institutions and keywords.Results A total of 2 240 articles were included,and the annual number of publications showed a dynamic upward trend.The source journals with more publications included Shaanxi Journal of Traditional Chinese Medicine,Journal of Traditional Chinese Medicine,Shizhen Journal of Traditional Chinese Medicine Research and so on.The core authors were Zhang Ning,Liu Shumin,Liu Bin,etc;the main research institutions included Beijing University of Chinese Medicine,Nanjing University of Chinese Medicine,Guangzhou University of Chinese Medicine,etc.;high-frequency keywords were"harpagoside","quality standard","clinical observation"and so on.Conclusion The research of Scrophulariae Radix mainly focuses on chemical composition,disease treatment and compatibility application.It is a research trend in recent years to explore the medication law and mechanism of Scrophulariae Radix by using data mining,network pharmacology and molecular docking.

Objective To analyze the research hotspots and trend of Raphani Semen from 2000 to 2023;To provide reference and direction for the follow-up research.Methods The literature related to Raphani Semen was retrieved from CNKI,VIP,Wanfang Data and CBM from January 1,2000 to July 20,2023.NoteExpress 3.7 software was used to organize the bibliothems,and CiteSpace 6.2.R2 software was used to visualize the authors,research institutions and keywords.Results After screening,a total of 1 023 articles were included,and the annual publication volume showed a trend of first fluctuating and then slowly decreasing.The source journals were 421,and the journal with the most articles was Shaanxi Journal of Traditional Chinese Medicine(75 articles).It involved 682 authors,the core authors included Zhou Honglei,Lü Wenhai,Zhu Liqiao,etc.Core research institutions included Shandong University of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,etc.High-frequency keywords included"constipation","data mining","clinical observation"and so on.Conclusion The current research hotspots in Raphani Semen are disease treatment,chemical composition,compatibility of prescriptions,related prescriptions and so on.The key research trend in this field is to summarize the clinical medication law by data mining technology and the treatment of spleen and stomach diseases.

Objective:To investigate the clinical characteristics of patients with rheumatic diseases and abnormal liver function, as well as determine the proportion and severity of liver function abnormalities.Methods:Cross-sectional study. Data were collected from patients registered in the Chinese Rheumatism Date Center from 2011 to 2021. The rheumatic diseases analyzed in this study were rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjogren syndrome (SS), ankylosing spondylitis (AS), and gout. Patient data, including demographic characteristics [ such as age, sex, body mass index,(BMI), and smoking history], liver function test results [including alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase(ALP), and total bilirubin], and use of anti-rheumatic immune drugs and liver-protective drugs, were collected and compared between groups with normal and abnormal liver functions. In addition, the proportions of abnormal liver function were compared between sex and age groups.Results:A total of 116 308 patients were included in this study, including 49 659 with RA, 17 597 with SLE, 9 039 with SS, 11 321 with AS, and 28 692 with gout. The lowest proportion of liver function abnormalities was observed in patients with RA[11.02% (5 470/49 659)], followed by those with SS[17.97% (1 624/9 039)] and AS [18.22% (2 063/11 321) ], whereas patients with SLE [21.14% (3 720/17 597) ] and gout [28.73% (8 242/28 692)] exhibited the highest proportion of these abnormalities. Elevated ALT, mostly classified as grade 1, was the most commonly noted liver function abnormality, whereas elevated ALP was the least common. Some patients who took liver-protective drugs had normal liver function, with the lowest percentage observed in patients with gout [7.45% (36/483) ] and ranging from 21.7% to 30.34% in patients with RA, SLE, SS, and AS. The proportion of liver function abnormalities was higher in males than in females for all disease types [RA: 13.8%(1 368/9 906) vs. 10.3%(4 102/39 753); SLE: 33.6% (479/1 424) vs. 20.0% (3 241/16 173); SS: 25.4%(111/437) vs. 17.6%(1 513/8 602); AS: 20.1%(1 629/8 119) vs. 13.6% (434/3 202); and gout: 29.3% (8 033/27 394) vs. 16.1% (209/1 298)]. In RA, SLE, and AS, the proportions of liver function abnormalities were similar across all age groups. In SS, the proportion of liver function abnormalities increased with age [<40 years: 14.9%(294/1 979); 40-59 years: 18.1%(858/4 741); ≥60 years: 20.4%(472/2 319)], whereas a reversal of this trend was observed in gout [<40 years: 34.9%(4 294/12 320); 40-59 years: 25.5%(2 905/11 398);≥60 years: 21.0%(1 042/4 971)].Conclusions:The proportions of combined liver function abnormalities in patients with rheumatologic diseases were high, and the utilization rates of liver-protective drugs were low. It is necessary to pay more attention to monitoring patients′ liver function, timely administer liver-protective drugs, and optimize liver-protective regimens during the treatment of rheumatic diseases.