Objective To observe the clinical efficacy of Yiqi Yangyin Jiangtang Prescription(mainly composed of Astragali Radix,Rehmanniae Radix,Imperatae Rhizoma,Ophiopogonis Radix,and Puerariae Lobatae Radix)combined with acupoint injection in the treatment of newly-diagnosed type 2 diabetes mellitus(T2DM).Methods One hundred patients with newly-diagnosed T2DM of qi-yin deficiency complicated with blood stasis type were randomly divided into a treatment group and a control group,with 50 patients in each group.The control group was given oral use of Metformin Hydrochloride Tablets,and the treatment group was given the granules of Yiqi Yangyin Jiangtang Prescription orally combined with acupoint injection at unilateral points of Zusanli(ST36),Shenshu(BL23)and Qihai(CV6)on the basis of treatment for the control group.The course of treatment lasted for 4 weeks.Before and after the treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),and serum levels of inflammatory factors of interleukin 6(IL-6),C-reactive protein(CRP),tumor necrosis factor α(TNF-α),as well as the hemorheology indicators of whole blood low-shear viscosity and whole blood high-shear viscosity.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)During the trial,5 cases fell off from the treatment group and 4 cases fell off from the control group,and a total of 91 patients were eventually included in the efficacy statistics,of which 45 cases were in the treatment group and 46 cases were in the control group.(2)After 4 weeks of treatment,the total effective rate of the treatment group was 93.33%(42/45),and that of the control group was 71.74%(33/46).The intergroup comparison(tested by chi-square test)showed that the therapeutic effect of the treatment group was significantly superior to that of the control group(P＜0.01).(3)After treatment,the scores of TCM symptoms of dry mouth and throat,frequent nocturia,shortness of breath and fatigue,hot flushes and night sweating as well as the total TCM syndrome scores in the two groups were significantly lower than those before the treatment(P＜0.05),and the reduction of the scores in the treatment group was significantly superior to that of the control group(P＜0.01).(4)After treatment,the levels of blood glucose and lipid indicators of FPG,2hPG,HbA1c,TC and TG of patients in the two groups were decreased compared with those before treatment(P＜0.05),and the decrease in the treatment group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(5)After treatment,the serum levels of inflammatory factors of IL-6,CRP,and TNF-α in the two groups were all lower than those before treatment(P＜0.01),and the reduction in the treatment group was significantly superior to that in the control group(P＜0.01).(6)After treatment,the levels of hemorheology indicators such as whole blood low-shear viscosity and high-shear viscosity in the two groups were all lower than those before treatment(P＜0.05),and the reduction in the treatment group was significantly superior to that in the control group(P＜0.05).(7)The incidence of adverse reactions in the treatment group was 8.89%(4/45),which was significantly lower than that of the control group(21.74%,10/46),and the difference was statistically significant(P＜0.01).Conclusion Yiqi Yangyin Jiangtang Prescription combined with acupoint injection exerts certain effect in treating patients with newly-diagnosed T2DM of qi-yin deficiency complicated with blood stasis syndrome type.The combined therapy can effectively alleviate the early clinical manifestations,decrease the levels of blood glucose,blood lipids,and inflammatory factors,and improve the hematological indicators and the quality of life of the patients.

Objective To investigate the infection status and changing trend of hepatitis C virus(HCV)infection in hospitalized patients in medical institutions,and provide reference for formulating HCV infection prevention and control strategies.Methods HCV infection surveillance results from cross-sectional survey data reported to China Healthcare-associated Infection(HAI)Surveillance System in 2020 were summarized and analyzed,HCV positive was serum anti-HCV positive or HCV RNA positive,survey result was compared with the survey results from 2003.Results In 2020,1 071 368 inpatients in 1 573 hospitals were surveyed,738 535 of whom underwent HCV test,4 014 patients were infected with HCV,with a detection rate of 68.93％and a HCV positive rate of 0.54％.The positive rate of HCV in male and female patients were 0.60％and 0.48％,respectively,with a statistically sig-nificant difference(x2=47.18,P＜0.001).The HCV positive rate in the 50-＜60 age group was the highest(0.76％),followed by the 40-＜50 age group(0.71％).Difference among all age groups was statistically signifi-cant(x2=696.74,P＜0.001).In 2003,91 113 inpatients were surveyed.35 145 of whom underwent HCV test,resulting in a detection rate of 38.57％;775 patients were infected with HCV,with a positive rate of 2.21％.In 2020,HCV positive rates in hospitals of different scales were 0.46％-0.63％,with the highest in hospital with bed numbers ranging 600-899.Patients'HCV positive rates in hospitals of different scales was statistically signifi-cant(X2=35.34,P＜0.001).In 2020,12 provinces/municipalities had over 10 000 patients underwent HCV-rela-ted test,and HCV positive rates ranged 0.19％-0.81％,with the highest rate from Hainan Province.HCV posi-tive rates in different departments were 0.06％-0.82％,with the lowest positive rate in the department of pedia-trics and the highest in the department of internal medicine.In 2003 and 2020,HCV positive rates in the depart-ment of infectious diseases were the highest,being 7.95％and 3.48％,respectively.Followed by departments of orthopedics(7.72％),gastroenterology(3.77％),nephrology(3.57％)and general intensive care unit(ICU,3.10％)in 2003,as well as departments of gastroenterology(1.35％),nephrology(1.18％),endocrinology(0.91％),and general intensive care unit(ICU,0.79％)in 2020.Conclusion Compared with 2003,HCV positive rate decreased significantly in 2020.HCV infected patients were mainly from the department of infectious diseases,followed by departments of gastroenterology,nephrology and general ICU.HCV infection positive rate varies with gender,age,and region.

Objective To explore the predictive value of CT radiomics and morphological features for the prognosis and survival in non-small cell lung cancer(NSCLC)patients.Methods The clinic data of 300 NSCLC patients(300 lesions)were downloaded from the Cancer Imaging Archive,with 210 randomly selected as the training set and 90 as the test set.According to the prognosis and survival,the patients were divided into two groups with survival period≤3 and＞3 years.3D Slicer software was used to delineate the regions of interest layer by layer in CT images,and the radiomics features were extracted from each region of interest.Both t-test and least absolute shrinkage and selection operator were utilized for radiomics feature screening.Three types of prediction models,namely radiomics model,morphological model and combined model,were constructed with Logistic regression,whose performances were evaluated using the receiver operating characteristic(ROC)curve.Results The differences in radiomics labels and mediastinal lymph node metastasis between the training set and the test set were statistically significant.For radiomics model,morphological model and combined model,the area under the ROC curve was 0.784(95%CI:0.722-0.847),0.734(95%CI:0.664-0.804)and 0.748(95%CI:0.680-0.815)in the training set,and 0.737(95%CI:0.630-0.844),0.665(95%CI:0.554-0.777)and 0.687(95%CI:0.578-0.797)in the test set,which demonstrated that radiomics model had the best diagnostic performance.Conclusion The CT radiomics model can effectively predict the prognosis and survival in NSCLC patients.

Objective To investigate the mechanism of the interaction between Wnt/β-catenin signaling and the epithelial mesenchymal transition(EMT)pathway in mediating sunitinib-resistance in renal cancer cells.Methods The sunitinib-resistant kidney cancer cell lines were constructed by stepwise increase in drug concentrations method with sunitinib,and were divided into resistance group,lv-NC group and lv-Twist group,and human kidney cancer cell lines were selected as normal group.The normal and drug-resistant groups were treated with conventional culture;the lv-NC group was treated with 40 μL of lv-NC lentivirus supernatant containing 2.25 × 108 TU·mL-1 for 72 h,and the lv-Twist group was treated with 50 μL of Twist lentivirus supernatant containing 1.64 × 108 TU·mL-1 for 72 h.The apoptosis ability was detected by flow cytometry;the cell migration ability was detected by cell scratch assay;the cell invasion ability was detected by Transwell assay;and the protein expression levels of Wnt1,β-catenin and Twist were detected by Western blotting assay.Results The apoptosis rates of control,resistant,lv-NC and lv-Twist groups were(17.60±0.59)％,(8.61±0.34)％,(8.60±0.40)％and(3.10±0.34)％;the migration rates were(14.10±0.12)％,(27.64±0.41)％,(14.24±0.45)％and(32.74±2.53)％;the number of invading cells was 27.33±1.15,53.33±1.53,46.00±2.65 and 99.33±2.52;the relative expression levels of Wnt1 protein were 0.10±0.01,0.96±0.06,0.39±0.03 and 3.09±0.31;the relative expression levels of β-catenin protein were 0.39±0.01,1.48±0.16,0.81±0.05 and 1.24±0.14;the relative expression levels of Twist protein were 0.10±0.02,0.91±0.04,0.39±0.03 and 3.09±0.31,respectively.The differences of above indexes were statistically significant between the resistant group and the normal group,and between the lv-Twist group and the lv-NC group(all P＜0.05).Conclusion Twist(EMT related protein)mediates sunitinib resistance in renal cell carcinoma by interacting with Wnt/β-catenin signaling pathway.

Objective To evaluate the clinical efficacy of navel application of Jianpi Hewei Adhesive Plaster combined with oral use of modified Sini Hewei Anshen Decoction in treating diabetic gastroparesis(DGP)accompanied by anxiety of liver-stomach disharmony type in type 2 diabetes patients.Methods One hundred patients with DGP accompanied by anxiety of liver-stomach disharmony type were randomly divided into a treatment group and a control group,with 50 patients in each group.The control group was given oral use of Mosapride Citrate Tablets orally,and the treatment group was given navel application of Jianpi Hewei Adhesive Plaster combined with oral use of modified Sini Hewei Anshen Decoction.The course of treatment for the two groups covered 4 weeks.The two groups were observed in the changes of the traditional Chinese medicine(TCM)syndrome scores,Gastroparesis Cardinal Symptom Index(GCSI)scores,Hamilton Anxiety Scale(HAMA)scores,gastric emptying time,and levels of fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPG),glycated hemoglobin(HbA1c),plasma motilin(MOT),gastrin(GAS),and serum tumor necrosis factor alpha(TNF-α)and interleukin 6(IL-6)before and after the treatment.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)During the trial,4 patients in the treatment group and 3 patients in the control group fell off,and eventually a total of 93 patients were included for the efficacy statistics,including 46 patients in the treatment group and 47 patients in the control group.(2)After 4 weeks of treatment,the total effective rate of the treatment group was 95.65%(44/46)and that of the control group was 76.60%(36/47).The intergroup comparison(tested by chi-square test)showed that the therapeutic effect of the treatment group was significantly superior to that of the control group(P＜0.01).(3)After treatment,the TCM syndrome scores(including epigastric and abdominal congestion,depression or irritability,and poor appetite)and GCSI scores in the two groups were decreased compared with those before treatment(P＜0.05)and the gastric emptying time was shortened compared with that before treatment(P＜0.05),and the effect of the treatment group on decreasing TCM syndrome scores and GCSI scores and on shortening the gastric emptying time were significantly superior to that of the control group(P＜0.01).(4)After treatment,the plasma MOT and GAS levels of the two groups were increased compared with those before treatment(P＜0.05),and the increase in the treatment group was significantly superior to that in the control group(P＜0.01).(5)After treatment,the levels of glucose metabolism indicators of FBG,2hPG,and HbA1c in the two groups were decreased compared with those before treatment(P＜0.05),but the differences of all glucose metabolism indicators between the two groups after treatment were not statistically significant(P＞0.05).(6)After treatment,the serum TNF-α and IL-6 levels in the two groups were decreased compared with those before treatment(P＜0.05),and the decrease in the treatment group was significantly superior to that in the control group(P＜0.05).(7)After treatment,the total HAMA scores and the scores of mental anxiety factor and somatic anxiety factor of HAMA in the two groups were decreased compared with those before treatment(P＜0.05),and the effect on lowering the scores in the treatment group was significantly superior to that in the control group(P＜0.05).(8)During the treatment period,no significant adverse reactions occurred in the two groups of patients,which has high safety.Conclusion Navel application of Jianpi Hewei Adhesive Plaster combined with oral use of modified Sini Hewei Anshen Decoction exerts certain efficacy in treating DGP accompanied by anxiety of liver-stomach disharmony type.The therapy is effective on relieving clinical symptoms,enhancing gastric motility,inhibiting inflammatory response,and improving anxiety emotion and the quality of life of the patients.

Objective:To observe the rehabilitation effect of balance training relying on tilted table on diaphragmatic function of patients with prolonged disorder of consciousness (pDoC).Methods:A prospective study was performed. Thirty patients with pDoC were enrolled from Department of Hyperbaric Oxygen Medicine and Rehabilitation, General Hospital of Southern Theater Command of PLA from May to December 2023. The pateints were divided into study group ( n=15) and control group ( n=15) according to different rehabilitation. Patients from the control group received conventional rehabilitation, while those in the study group received passive balance training relying on tilted table in addition to conventional rehabilitation. Diaphragmatic ultrasound examination was performed before treatment, and 4 and 8 weeks after treatment to measure diaphragm excursion (DE), diaphragm thickening inspiration (DTei), diaphragm thickening expiration (DTee) and diaphragm thickening fraction (DTF) so as to assess the diaphragmatic functions of patients with pDoC. Results:During treatment, 2 patients dropped out from the study group resulting from the willing of the family members, ultimately including 13 and 15 patients in the study and control groups, respectively. (1) Between-group comparison: no significant difference in DE, DTei, DTee or DTF was noted between the study group and control group 4 weeks after treatment ( P>0.05). However, 8 weeks after treatment, the study group had statistically increased DE, DTei and DTF compared with the control group ([1.65±0.32] cm vs. [1.21±0.22] cm; [2.07±0.26] cm vs. [1.83±0.26] cm; and [24.39±3.19]% vs. [18.93±2.50]%). (2) Within-group comparison: both group had significantly increased DE 4 and 8 weeks after treatment compared with those before treatment ( P<0.05); in the study group, DE 8 weeks after treatment was significantly increased compared with that 4 weeks after treatment ( P<0.05). No significant difference in DTei, DTee or DTF was noted in both groups between 4 weeks after treatment and before treatment ( P>0.05). In the study group, DTei, DTee and DTF 8 weeks after treatment were significantly higher than those before treatment and 4 weeks after treatment ( P<0.05). Conclusion:Balance training relying on tilted table is feasible and effective in improving diaphragmatic function in patients with pDoC, and the effect is positively correlated with treatment time within a certain time.

Objective:To investigate whether silencing information regulator 1 (SIRT1) activation can relieve paclitaxel-induced neuropathic pain by inhibiting mitochondrial damage in dorsal root ganglion neurons.Methods:Forty-eight healthy male SD rats were randomly divided into solvent control group, paclitaxel group, paclitaxel+SIRT1 inhibitor group and paclitaxel+SIRT1 agonist group ( n=12). Neuropathic pain model in the later 3 groups was prepared by intraperitoneal injection of paclitaxel at 8 mg/kg on the 1 st, 4 th and 7 th d of experiment, respectively; rats in the paclitaxel+SIRT1 inhibitor group and paclitaxel+SIRT1 agonist group were respectively injected with SIRT1 inhibitor EX527 or agonist SRT1720 30 min before the first injection of paclitaxel. In addition, neuropathic pain model was established in 12 rats (model group) by the same method and SIRT1 expression in the dorsal root ganglion tissues was detected by Western blotting 1 d before experiment and on the 3 rd, 7 th and 14 th d of experiment, respectively. Von-Frey filament was used to detect the 50% paw withdrawal mechanical threshold (PWMT), and thermal radiation thermal pain detector was used to evaluate the paw withdraw thermal latency (PWTL) 1 d before experiment and on the 3 rd, 7 th and 14 th d of experiment. On the 7 th d of experiment, 6 rats in each group were sacrificed with excessive anesthesia after PWMT and PWTL detection; L 4-L 6 dorsal root ganglion tissues were rapidly isolated and primary neurons were cultured; Western blotting was used to detect SIRT1 expression in the dorsal root ganglion tissues, JC-1 mitochondrial membrane potential detection kit was used to detect mitochondrial membrane potential (ratio of orange-red fluorescence to green fluorescence), hydrogen peroxide (H 2O 2) detection kit was used to detect H 2O 2 concentration, and mitochondrial superoxide detection kit and mitochondrial green fluorescence probe kit were used to detect mitochondrial superoxide expression. Results:In the model group, SIRT1 expression in the dorsal root ganglion tissues one d before experiment was significantly decreased compared with that on the 3 rd, 7 th and 14 th d of the experiment ( P<0.05). On 3 rd, 7 th and 14 th d of experiment, compared with the solvent control group, the paclitaxel group had significantly decreased 50% PWMT ([6.37±2.27] g, [5.47±2.42] g and [5.34±1.74] g), and PWTL ([9.38±1.27] s, [9.70±1.97] s and [9.12±1.21] s, P<0.05); compared with the paclitaxel group, the paclitaxel+SIRT1 agonist group had significantly increased 50% PWMT ([13.86±3.72] g, [11.87±3.10] g and [12.39±2.94] g) and PWTL ([14.25±2.63] s, [13.29±2.94] s and [14.43±3.91] s), and the paclitaxel+SIRT1 inhibitor group had significantly decreased 50% PWMT [(2.20±1.43] g, [2.43±1.44] g and [2.21±1.56] g) and PWTL ([4.47±1.66] s, [3.65±1.80] s and [3.14±1.59] s, P<0.05). On the 7 th d of experiment, the paclitaxel group had significantly decreased SIRT1 protein expression (53.95±7.37) and ratio of orange-red fluorescence to green fluorescence (48.74±14.57), and significantly increased H 2O 2 concentration ([4.86±0.69] μmol/L) and mitochondrial superoxide expression (180.17±12.08) in the dorsal root ganglion tissues compared with the solvent control group ( P<0.05); compared with the paclitaxel group, the paclitaxel+SIRT1 agonist group had significantly increased SIRT1 expression (97.51±10.09) and ratio of orange-red fluorescence to green fluorescence (83.52±8.60) and decreased H 2O 2 concentration ([2.30±0.39] μmol/L) and mitochondrial superoxide expression (90.17±18.84) in the dorsal root ganglion tissues ( P<0.05); compared with the paclitaxel group, the paclitaxel+SIRT1 inhibitor group had significantly decreased SIRT1 expression (30.80±6.31) and ratio of orange-red fluorescence to green fluorescence (24.60±6.19) and increased H 2O 2 concentration ([10.67±1.85] μmol/L) and mitochondrial superoxide expression (294.52±26.94) in the dorsal root ganglion tissues ( P<0.05). Conclusion:SIRT1 activation can alleviate paclitaxel-induced neuropathic pain by inhibiting mitochondrial damage in dorsal root ganglion neurons.

Objective The evaluation of lymph node properties before lung cancer surgery has a great impact with the choice of surgical methods.Although there are various examination methods,many methods have invasive or accuracy problems.In order to improve the accuracy of diagnosis,we mainly discuss the value of wide-body spectral CT in the differential diagnosis of mediastinal metastatic lymph nodes,non-metastatic lymph nodes in lung cancer patients and reactive hyperplastic lymph nodes.Methods The clinical and imaging data of 64 patients with lung cancer and 28 patients with pulmonary inflammatory lesions were retrospectively analyzed.All patients underwent plain scan and enhanced dual-phase spectral CT scan.The size,density,three-phase IC,NIC,and λHU of lymph nodes in metastatic,non-metastatic and inflammatory reactive hyperplasia groups were measured on 70 keV single-energy images and iodine-based images,respectively.The single-factor variance and Kruskal-Wallis H rank sum test were used to analyze and compare the differences.Results The short diameter of metastatic lymph nodes was larger than that of non-metastatic lymph nodes and reactive hyperplastic lymph nodes(P<0.001).The plain scan density of reactive hyperplastic lymph nodes was higher than that of metastatic lymph nodes(P<0.001),but there was no significant difference between non-metastatic lymph nodes(P=0.325).The CT values of reactive hyperplastic lymph nodes in arterial phase and venous phase were higher than those of metastatic and non-metastatic lymph nodes(P<0.05).Except for NIC in arterial phase,IC,NIC and λHU in plain scan,IC and λHU in arterial phase,IC,NIC and λHU in venous phase of reactive hyperplastic lymph nodes and metastatic lymph nodes were statistically significant(all P<0.05).There was no significant difference in IC,NIC and λHU between reactive hyperplastic lymph nodes and non-metastatic lymph nodes in plain scan,arterial phase and venous phase(all P>0.05).Conclusion The quantitative and spectral curve slope of iodine in mediastinal metastatic lymph nodes of lung cancer were basically lower than those in reactive hyperplastic lymph nodes.The quantitative parameters of spectral CT had certain diagnostic efficacy in differentiating metastatic lymph nodes and reactive hyperplastic lymph nodes,while the spectral parameters of non-metastatic lymph nodes and reactive hyperplastic lymph nodes were not statistically significant.

Objective To develop deep learning-based auxiliary diagnostic models for diverse pulmonary diffuse cystic diseases,and subsequently evaluate their classification performance to identify the optimal model for clinical diagnosis.Methods A total of 288 patients diagnosed with idiopathic pulmonary fibrosis(IPF),pulmonary lymphangioleiomyomatosis(PLAM),and pulmonary Langerhans cell histiocytosis(PLCH)were prospectively enrolled from the First Affiliated Hospital of Guangzhou Medical University between January 2010 and October 2022,comprising 76 cases of IPF,179 cases of PLAM,and 33 cases of PLCH.A total of 877 CT cases were collected,comprising 232 cases of IPF,557 cases of PLAM,and 88 cases of pulmonary PLCH.Based on the cutoff date of December 31,2019,the CT scans were divided into two datasets:dataset A consisted of 500 CT scans including 185 IPF cases,265 PLAM cases,and 50 PLCH cases;while dataset B comprised 377 CT scans with a distribution of 47 IPFcases,292 PLAMcases,and 38 PLCH cases.The Dataset A was randomly partitioned into training set,validation set,and test set in a ratio of 7∶1∶2.Subsequently,six distinct deep learning neural networks were employed for training after preprocessing and data augmentation.Receiver operating characteristic curves were generated to assess the model performance using metrics such as area under the curve(AUC),accuracy,sensitivity,specificity,and F1 score in order to identify the optimal model.Furthermore,a test set B comprising 30 randomly selected cases from dataset B for each disease type was utilized to evaluate the trained optimal model by employing the same aforementioned metrics.Results In test A,six well-established diagnostic models demonstrated superior classification performance for IPF and LAM,with an AUC greater than 0.9.For LCH,EfficientNet exhibited low classification efficiency with an AUC between 0.6 and 0.7,while Vgg11 showed an AUC between 0.8 and 0.9;the other four models displayed excellent classification efficiency with an AUC greater than 0.9.Except for Inception V3,the remaining five diagnostic models performed poorly in identifying and classifying LCH lesions.Considering multiple indicators,the InceptionV3 model showcased optimal comprehensive performance among the six models,achieving high evaluation parameters such as overall accuracy(94.90%),precision(93.49%),recall(90.84%),and specificity(96.91%).TestB was conducted using the trained InceptionV3 model resulting in an accuracy of 81%,precision of 82%,recall of 81%,and specificity of 90%.Conclusions Six recognition and classification models,developed using deep learning technology in conjunction with pulmonary CT images,demonstrate effective discrimination between LAM,LCH,and IPF.Notably,the model constructed utilizing the InceptionV3 neural network exhibits superior efficiency in accurately recognizing and classifying IPF and LAM.

Objective:To systematically evaluate the correlation between chronic non-occupational arsenic exposure and hypertension.Methods:A literature search was conducted through Web of Science, Pubmed, Embase, Cochrane Library, WanFang Data, China National Knowledge Infrastructure (CNKI), VIP Chinese Journal Service Platform (VIP) Database and China Biomedical Literature Database to comprehensively collect epidemiological literature related to chronic non-occupational arsenic exposure and hypertension published domestically and internationally for inclusion in the study, with a time limit from database establishment to January 1, 2023. Meta-analysis of dichotomous variables was conducted using Stata MP15 software, with odds ratio ( OR) value [95%confidence interval( CI)] as the effect evaluation indicator. A random-effects model or a fixed-effects model was selected for comprehensive quantitative analysis according to the heterogeneity results; the sources of heterogeneity were identified through subgroup analysis; a funnel plot was used for qualitative analysis of publication bias and the results were further assessed by Egger test. Stata 15.0 software was then used to analyze the dose-response relationship between chronic non-occupational arsenic exposure and hypertension using restricted cubic spline function and generalized least squares estimation (GLST) method. Results:Twenty-nine articles ( n = 127 258) were finally included, including 24 English articles and 5 Chinese articles. Through Meta-analysis, the combined OR value (95% CI) for hypertension was 1.07 (1.04 - 1.09), with a statistically significant difference ( P < 0.05). The combined OR values (95% CI) for urinary arsenic, drinking water arsenic, and hair arsenic in subgroup analysis were 1.10 (1.04 - 1.17), 1.13 (1.07 - 1.20), and 2.55 (1.55 - 4.20), respectively. The combined OR values (95% CI) for cross-sectional studies, case-control studies and cohort studies were 1.11 (1.06 - 1.16), 1.13 (1.04 - 1.23) and 1.04 (1.00 - 1.07), respectively. For every unit (μg/L) increase in arsenic exposure in drinking water, the risk of hypertension increased by 0.13% [ OR value (95% CI): 1.001 269 (1.000 104 - 1.002 434), P < 0.05]. Conclusions:There is a correlation between chronic non-occupational arsenic exposure and adult hypertension, with urinary arsenic, drinking water arsenic and hair arsenic as possible exposure markers. There is a non-linear dose-response relationship between chronic non-occupational arsenic exposure and adult hypertension.