Knowledge domain and emerging trends in diabetic cardiomyopathy: A scientometric review based on CiteSpace analysis.

Objective: To review the literature related to diabetic cardiomyopathy (DCM), and investigate research hotspots and development trends of this field in the relevant studies based on CiteSpace software of text mining and visualization in scientific literature. Methods: The relevant literature from the last 20 years was retrieved from the Web of Science (WoS) Core Collection database. After manual selection, each document record includes title, authors, year, organization, abstract, keywords, citation, descriptors, and identifiers. We imported the downloaded data into CiteSpace V (version 5.8.R2) to draw the knowledge map and conduct cooperative network analysis, cluster analysis, burst keyword analysis, and co-citation analysis. Results: After manual screening, there were 3,547 relevant pieces of literature published in the last 18 years (from 2004 to 2021), including 2,935 articles and reviews, which contained 15,533 references, and the number was increasing year by year. The publications of DCM were dedicated by 778 authors of 512 institutions in 116 countries. The People's Republic of China dominated this field (1,117), followed by the USA (768) and Canada (176). In general, most articles were published with a focus on "oxidative stress," "heart failure," "diabetic cardiomyopathy," "dysfunction," "cardiomyopathy," "expression," "heart," "mechanism," and "insulin resistance." Then, 10 main clusters were generated with a modularity Q of 0.6442 and a weighted mean silhouette of 0.8325 by the log-likelihood ratio (LLR) algorithm, including #0 heart failure, #1 perfused heart, #2 metabolic disease, #3 protective effect, #4 diabetic patient, #5 cardiac fibrosis, #6 vascular complication, #7 mitochondrial dynamics, #8 sarcoplasmic reticulum, and #9 zinc supplementation. The top five references with the strongest citation bursts include "Boudina and Abel", "Jia et al.", "Fang et al.", "Poornima et al.", and "Aneja et al.". Conclusion: The global field of DCM has expanded in the last 20 years. The People's Republic of China contributes the most. However, there is little cooperation among authors and institutions. Overall, this bibliometric study identified the hotspots in DCM research, including "stress state," "energy metabolism," "autophagy," "apoptosis," "inflammation," "fibrosis," "PPAR," etc. Thus, further research focuses on these topics that may be more helpful to identify, prevent DCM and improve prophylaxis strategies to bring benefit to patients in the near future.

[Advances in risk prediction model of disease and syndrome combination and concept of construction of risk prediction model for in-stent restenosis after PCI].

Traditional Chinese medicine(TCM) has its unique understanding of the etiology, pathogenesis, and risk factors of di-seases, and is advantageous in the study of risk prognosis.First recorded in Huangdi's Internal Classic, the TCM theory of treating di-sease before its onset has a long history.Supplemented and improved by the later generations of doctors, the TCM theory of treating di-sease before its onset has been applied to clinical practice and achieved good results.With the development of modern medicine, it has become a new trend to construct the risk prediction model integrating the research results of modern medicine with disease and syndrome combination of TCM characteristics.The construction of risk prediction model of disease and syndrome combination is conducive to early clinical screening and intervention, and provides ideas for the integration of TCM and western medicine.Coronary heart disease(CHD) is one of the common chronic diseases, and percutaneous coronary intervention(PCI) is an important therapeutic approach.In-stent restenosis(ISR) is a common complication after PCI, which seriously affects the outcome and prognosis of patients.Although some patients can be treated with balloon dilatation and endovascular stents, a significant number of patients still refuse secondary stenting intervention.The construction of risk prediction model of disease and syndrome combination for ISR after PCI can provide an effective tool for clinical risk prediction of ISR and indicators with TCM characteristics for early screening and intervention of people at a high risk of ISR, and guide clinical monitoring and intervention, which has certain clinical significance and reference value for the prevention and reduction of ISR.

Protective effect of the effective part of Andrographis paniculata (Burm.f.) Nees on PM2.5-induced lung injury in rats by modulating the NF-κB pathway.

ETHNOPHARMACOLOGICAL RELEVANCE: Andrographis paniculata (Burm.f.) Nees, a traditional Chinese herb, has been widely used in various Asian countries as a treatment for upper respiratory tract infections for centuries. AIM OF THE STUDY: Continuous inhalation of fine particulate matter (PM2.5) may induce various respiratory diseases. This study elucidated the protective effect of the effective part of Andrographis paniculata (Burm.f.) Nees (AEP) against PM2.5-induced lung injury and detailed the underlying mechanism. MATERIALS AND METHODS: Male Wistar rats were orally administered 0.5% sodium carboxymethylcellulose (CMC-Na), andrographolide (AG) (200 mg/kg) and AEP (100 mg/kg, 200 mg/kg and 400 mg/kg) once a day for 28 days. The rats were intratracheally instilled with PM2.5 suspension (8 mg/kg) every other day beginning on the 24th day for a total of 3 times. On the 29th day, bronchoalveolar lavage fluid (BALF) was collected to analyze the levels of lactate dehydrogenase (LDH), acid phosphatase (ACP), alkaline phosphatase (AKP), total proteins (TP), tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6). Hematoxylin & eosin staining was conducted to evaluate the pathological changes in the lung tissues. The protein expression of NF-κB p65 in the lung tissues was analyzed by immunohistochemistry staining. Moreover, the nuclear translocation of NF-κB p65 and the phosphorylation of IκBα were analyzed by western blotting. RESULTS: PM2.5 exposure caused lung toxicity, which was characterized by pathological injury and increased levels of LDH, ACP, AKP and TP in BALF. Meanwhile, PM2.5 exposure induced lung inflammatory response, including infiltration of inflammatory cells and increased levels of inflammatory factors, such as TNF-α and IL-6 in BALF. AEP treatment significantly ameliorated the PM2.5-induced lung toxicity and the inflammatory response in rats. Moreover, AEP significantly inhibited the PM2.5-induced upregulation of NF-κB p65 protein expression, phosphorylation of IκBα and nuclear translocation of NF-κB p65 in lung tissue. Compared to AG, AEP exhibited a better ability to alleviate PM2.5-induced pathological damage and decrease the TP level in the BALF. CONCLUSION: AEP could be used to improve PM2.5-induced lung injury by modulating the NF-κB pathway, and multicomponent therapy with traditional Chinese medicine may be more effective than single-drug therapy.

Mechanism of SQQX Decoction's Protective Effect on SHR: A Serum Metabolomics-Based Analysis.

SangQiQingXuan (SQQX) decoction is a pharmaceutical preparation exerting good therapeutic efficacy on high blood pressure (BP) and has widely been accepted in primarily hypertensive patients as a herbal formula prescribed by Professor Li Huang from China-Japan Friendship Hospital according to her 30-year clinical experience. A previous study showed that SQQX could reduce BP by decreasing levels of many inflammatory factors such as transforming growth factor beta (TGFß) and elevating peroxisome proliferator activated receptor (PPAR) expression. However, a research focusing on SQQX's protection against HTN from a metabolomic perspective has never been done before. This study aimed to figure out the metabolic profiling variations due to oral administration of SQQX in spontaneous hypertensive rat (SHR) models and to find out the optimal dosage of SQQX. SHR in the intervention group orally received SQQX extract of three doses, namely, the low- (5.25 g/kg/d), middle- (10.5 g/kg/d), and high-dosage groups (21 g/kg/d) for 90 days. Rats were sacrificed at the end of the experiment, and their serum was collected for further examination. Serum metabolic profiling variations were analyzed using ultraperformance liquid chromatography coupled with tandem mass spectrometry (UPLC/MS). Results showed that dealing with SQQX remarkably decreased systolic blood pressure (SBP) of SHRs and the high-dosage group was with the best therapeutic effect where a total of 11 metabolites were markedly changed in contrast to the model group. Orthogonal partial least square discriminant analysis (OPLS-DA) score plot showed that the 5 groups of serum samples were divided into 5 categories, and the metabolic trajectory of the high-dosage SQQX group was inclined to move to the control group. Glycochenodeoxycholic acid, nicotinamide-N-oxide, and tryptophan betaine might be biomarkers that specifically marked the protective effects of SQQX against high BP mainly involving in cholesterol metabolism, primary bile acid biosynthesis, bile secretion, and nicotinate and nicotinamide metabolism. To conclude, SQQX has a protective effect on SHR, which may be partially correlated to restoration of perturbed metabolism in serum.

The Effect of Chinese Herbal Medicine Combined With Western Medicine on Vascular Endothelial Function in Patients With Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: Vascular endothelium plays a fundamental role in regulating endothelial dysfunction, resulting in structural changes that may lead to adverse outcomes of hypertension. The aim of this study was to systematically evaluate the effect of a combination of Chinese herbal medicine (CHM) and Western medicine on vascular endothelial function in patients with hypertension. METHODS: We systematically searched the literature for studies published in Chinese and English in PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China Knowledge Resource Integrated Database, Wanfang Data, and China Science and Technology Journal Database. Databases were searched using terms concerning or describing CHM, hypertension, vascular endothelium, and randomized controlled trials. RevMan 5.3.0 was used for data analysis. If the included studies were sufficiently homogeneous, quantitative synthesis was performed; if studies with different sample sizes and blind methods were used, subgroup analyses were performed. GRADEpro was selected to grade the current evidence to reduce bias in our findings. RESULTS: In this review, 30 studies with 3,235 patients were enrolled. A relatively high selection and a performance bias were noted by risk of bias assessments. Meta-analysis showed that the combination of CHM and conventional Western medicine was more efficient than conventional Western medicine alone in lowering blood pressure (risk ratio, 1.21; 95% CI, 1.16 to 1.26) and increasing nitric oxide (95% CI, 1.24 to 2.08; P < 0.00001), endothelin-1 (95% CI, -1.71 to -1.14; P < 0.00001), and flow-mediated dilation (95% CI, 0.98 to 1.31; P <0.00001). No significant difference was observed between the combination of CHM and conventional Western medicine and conventional Western medicine alone for major cardiovascular and cerebrovascular events. CHM qualified for the treatment of hypertension. The GRADEpro presented with low quality of evidence for the available data. CONCLUSION: CHM combined with conventional Western medicine may be effective in lowering blood pressure and improving vascular endothelial function in patients with hypertension. To further confirm this, more well-designed studies with large sample sizes, strict randomization, and clear descriptions about detection and reporting processes are warranted.