M2-Type Macrophages and Cancer-Associated Fibroblasts Combine to Promote Colorectal Cancer Liver Metastases.

Purpose: This research explored the association between CD163-labeled M2-type macrophages and cancer-associated fibroblasts (CAFs) in the tumor microenvironment (TME) of 38 colorectal cancer (CRC) liver metastases. In addition, we investigated the correlation differences between M2-type macrophages and CAFs in the tumor microenvironments of 38 primary colorectal cancer patients with confirmed liver metastases and 946 colorectal cancer patients, as well as possible mechanisms of action between the two cells. Methods: The Immunohistochemistry (IHC) method was applied to detect the expression levels of M2-type macrophages and CAFs in the tissues of 984 cases of CRC and to analyze the correlation between M2-type macrophages and CAFs in colorectal cancer tissues. The IHC method was also applied to detect the expression levels of M2-type macrophages and CAFs in the liver metastases of 38 cases of CRC in the experimental group and to analyze the correlation between the two cells in liver metastases. Results: 1. M2-type macrophages and CAFs expression were significantly higher in 38 primary colorectal cancer patients compared to 946 controls, and the expression of M2-type macrophages was significantly positively correlated with CAFs. 2. In 984 CRC cases, M2-type macrophages and CAFs expression levels were significantly higher in the cancer tissues than in the paired paracancerous tissues. 3. The expression levels of M2-type macrophages and CAFs in primary colorectal cancer were significantly higher in the experimental group than in colorectal cancer tissues without distant metastasis. Conclusion: M2-type macrophages and CAFs are involved in the development of the colorectal cancer tumor microenvironment, and their interaction influences the initiation and progression of liver metastasis in colorectal cancer. It may provide new clinical ideas for early diagnosis of CRC liver metastases and searching for immune targets.

Butylparaben induced zebrafish (Danio rerio) kidney injury by down-regulating the PI3K-AKT pathway.

Butylparaben, a common endocrine disruptor in the environment, is known to be toxic to the reproductive system, heart, and intestines, but its nephrotoxicity has rarely been reported. In order to study the nephrotoxicity and mechanism of butylparaben, we examined the acute and chronic effects on human embryonic kidney cells (HEK293T) and zebrafish. Additionally, we assessed the potential remedial effects of salidroside against butylparaben-induced nephrotoxicity. Our in vitro findings demonstrated oxidative stress and cytotoxicity to HEK293T cells caused by butylparaben. In the zebrafish model, the concentration of butylparaben exposure ranged from 0.5 to 15 µM. An assortment of experimental techniques was employed, including the assessment of kidney tissue morphology using Hematoxylin-Eosin staining, kidney function analysis via fluorescent dextran injection, and gene expression studies related to kidney injury, development, and function. Additionally, butylparaben caused lipid peroxidation in the kidney, thereby damaging glomeruli and renal tubules, which resulted from the downregulation of the PI3K-AKT signaling pathway. Furthermore, salidroside ameliorated butylparaben-induced nephrotoxicity through the PI3K-AKT signaling pathway. This study reveals the seldom-reported kidney toxicity of butylparaben and the protective effect of salidroside against toxicological reactions related to nephrotoxicity. It offers valuable insights into the risks to kidney health posed by environmental toxins.

The early predictive roles of NLR and NE% in in-hospital mortality of septic patients.

Background: This study aimed to retrospectively investigate the early predictive value of inflammation-related parameters in-hospital mortality of septic patients. Methods: We retrospectively recruited 606 patients from Wuhan Union Hospital from January 2009 to October 2022. The inflammation-related parameters including neutrophil-to-lymphocyte ratio (NLR), neutrophil percentage (NE%), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) in survivals and non-survivals on day 1, 2, 3 and 7 after hospitalization were collected and analyzed. Results: NLR and NE% in non-survivals (n = 185) were significantly higher than those in survivals (n = 421). The area under the receiver operating characteristic curve (AUC) of NLR or NE% was 0.880 or 0.852 on day 1, 0.770 or 0.790 on day 2, 0.784 or 0.777 on day 3, and 0.732 or 0.741 on day 7. The optimal cut-off values of NLR or NE% for predicting in-hospital mortality were 10.769 or 87.70% on day 1, 17.544 or 90.69% on day 2, 14.395 or 85.00% on day 3, and 9.105 or 83.93% on day 7. The day 1, 2 and 3 NLR and NE% were significant predictors of in-hospital mortality in the Cox proportional hazards models. Conclusions: NLR ≥10.769 and NE% ≥ 87.70% could be used early biomarkers for predicting in-hospital mortality of septic patients.

Magnesium-L-threonate treats Alzheimer's disease by modulating the microbiota-gut-brain axis.

JOURNAL/nrgr/04.03/01300535-202410000-00029/figure1/v/2024-02-06T055622Z/r/image-tiff Disturbances in the microbiota-gut-brain axis may contribute to the development of Alzheimer's disease. Magnesium-L-threonate has recently been found to have protective effects on learning and memory in aged and Alzheimer's disease model mice. However, the effects of magnesium-L-threonate on the gut microbiota in Alzheimer's disease remain unknown. Previously, we reported that magnesium-L-threonate treatment improved cognition and reduced oxidative stress and inflammation in a double-transgenic line of Alzheimer's disease model mice expressing the amyloid-ß precursor protein and mutant human presenilin 1 (APP/PS1). Here, we performed 16S rRNA amplicon sequencing and liquid chromatography-mass spectrometry to analyze changes in the microbiome and serum metabolome following magnesium-L-threonate exposure in a similar mouse model. Magnesium-L-threonate modulated the abundance of three genera in the gut microbiota, decreasing Allobaculum and increasing Bifidobacterium and Turicibacter. We also found that differential metabolites in the magnesium-L-threonate-regulated serum were enriched in various pathways associated with neurodegenerative diseases. The western blotting detection on intestinal tight junction proteins (zona occludens 1, occludin, and claudin-5) showed that magnesium-L-threonate repaired the intestinal barrier dysfunction of APP/PS1 mice. These findings suggest that magnesium-L-threonate may reduce the clinical manifestations of Alzheimer's disease through the microbiota-gut-brain axis in model mice, providing an experimental basis for the clinical treatment of Alzheimer's disease.

{Mo4}-directed structural evolution of highly reduced molybdenum red clusters for efficient proton conduction.

A series of highly reduced Mo red clusters {Mo28} (1), {Mo30} (2), and {Mo40} (3) are synthesized from the rational assembly of planar {MoV4} building blocks and employed for proton conduction. 3 exhibits the best conductivity of 7.56 × 10-3 S cm-1 under optimal conditions due to the most efficient hydrogen-bonding network.

Full-Endoscopic Foraminoplasty and Lumbar Discectomy for Single-Level Lumbar Disc Herniation.

The Transforaminal Endoscopic Surgical System (TESSYS) technique has gained popularity for the treatment of lumbar disc herniations. Foraminoplasty is the key procedure in TESSYS. However, it requires advanced skills and long-term learning, which hinder its widespread adoption among surgeons. Recently, the introduction of full-endoscopic solutions has made the process more manageable. The main difference from traditional single-portal endoscopic surgery is that full-endoscopic surgery is equipped with a larger working channel, allowing full visualization of foraminoplasty and decreasing reliance on intraoperative fluoroscopy. Recently, published studies have shown that full-endoscopic foraminoplasty and lumbar discectomy (FEFLD) could achieve comparable results to conventional microdiscectomy in terms of pain relief and functional outcomes, while enhancing postoperative recovery. This study describes the technique of FEFLD in detail, including every crucial step, such as patient positioning, puncture trajectory, endoscopic dissection of the superior articular process (SAP), endoscopic foraminoplasty, and more. We hope this will be helpful to beginners who wish to apply this approach.

Automatic diagnosis of depression based on attention mechanism and feature pyramid model.

Currently, most diagnoses of depression are evaluated by medical professionals, with the results of these evaluations influenced by the subjective judgment of physicians. Physiological studies have shown that depressed patients display facial movements, head posture, and gaze direction disorders. To accurately diagnose the degree of depression of patients, this paper proposes a comprehensive framework, Cross-Channel Attentional Depression Detection Network, which can automatically diagnose the degree of depression of patients by inputting information from the facial images of depressed patients. Specifically, the comprehensive framework is composed of three main modules: (1) Face key point detection and cropping for video images based on Multi-Task Convolutional Neural Network. (2) The improved Feature Pyramid Networks model can fuse shallow features and deep features in video images and reduce the loss of miniscule features. (3) A proposed Cross-Channel Attention Convolutional Neural Network can enhance the interaction between tensor channel layers. Compared to other methods for automatic depression identification, a superior method was obtained by conducting extensive experiments on the depression dataset AVEC 2014, where the Root Mean Square Error and the Mean Absolute Error were 8.65 and 6.66, respectively.

Expression and diagnostic value of lncRNA MALAT1 and NLRP3 in lower limb atherosclerosis in diabetes.

OBJECTIVE: This study aimed to examine the diagnostic predictive value of long non-coding RNA (lncRNA) metastasis-associated lung adenocarcinoma transcript 1(MALAT1) and NOD-like receptor protein 3(NLRP3) expression in patients with type 2 diabetes mellitus(T2DM) and lower extremity atherosclerosis disease (LEAD). METHODS: A total of 162 T2DM patients were divided into T2DM with LEAD group (T2DM + LEAD group) and T2DM alone group (T2DM group). The lncRNA MALAT1 and NLRP3 expression levels were measured in peripheral blood, and their correlation was examined. Least absolute shrinkage and selection operator (LASSO) regression model was used to screen for the best predictors of LEAD, and multivariate logistic regression was used to establish a predictive model and construct the nomogram. The effectiveness of the nomogram was assessed using the receiver operating characteristic (ROC) curve, area under the curve (AUC), calibration curve, and decision curve analysis (DCA). RESULTS: The levels of the lncRNA MALAT1 and NLRP3 in the T2DM + LEAD group were significantly greater than those in the T2DM group (P <0.001), and the level of the lncRNA MALAT1 was positively correlated with that of NLRP3 (r = 0.453, P<0.001). The results of the LASSO combined with the logistic regression analysis showed that age, smoking, systolic blood pressure (SBP), NLRP3, and MALAT1 were the influencing factors of T2DM with LEAD(P<0.05). ROC curve analysis comparison: The discriminatory ability of the model (AUC = 0.898), MALAT1 (AUC = 0.804), and NLRP3 (AUC = 0.794) was greater than that of the other indicators, and the predictive value of the model was the greatest. Calibration curve: The nomogram model was consistent in predicting the occurrence of LEAD in patients with T2DM (Cindex = 0.898). Decision curve: The net benefit rates obtained from using the predictive models for clinical intervention decision-making were greater than those obtained from using the individual factors within the model. CONCLUSION: MALAT1 and NLRP3 expression increased significantly in T2DM patients with LEAD, while revealing the correlation between MALAT1 and NLRP3. The lncRNA MALAT1 was found as a potential biomarker for T2DM with LEAD.

High-performance VO2/CNT@PANI with core-shell construction enable printable in-planar symmetric supercapacitors.

As a progressive electronic energy storage device, the flexible supercapacitor holds tremendous promise for powering wearable/portable electronic products. Of various pseudocapacitor materials, vanadium dioxide (VO2) has garnered extensive attention due to its impressive theoretical capacitance. However, the challenges of inferior cycling life and lower energy density to be addressed. Herein, we prepare VO2 nanorods with winding carbon nanotubes (CNT) via a facile solvothermal route, followed by in situ polymerization of polyaniline (PANI) shell. Taking full advantage of the synergistic effect, the VO2/CNT@PANI composite delivers a high specific capacitance of 354.2F/g at 0.5 A/g and a long cycling life of âˆ¼ 88.2 % over 5000 cycles resulting from the enhanced conductivity of CNT and stabilization of PANI shell. By screen printing the formulated inks with outstanding rheological behaviours, we manufacture an in-planar VO2/CNT@PANI symmetric supercapacitor (VO2/CNT@PANI SSC) device featuring an orderly arrangement structure. This device yields a remarkable areal energy density of 99.57 µWh/cm2 at a power density of 387.5 µW/cm2 while retaining approximately âˆ¼ 87.6 % of its initial capacitance after prolonged use. Furthermore, we successfully powered a portable game machine for more than 2 min using two SSCs connected in series with ease. Therefore, this work presents a universal strategy that utilises combination and coating to boost electrochemical performance for flexible high-performance supercapacitors.

Generation, degradation mechanism, and toxicity evaluation of pigmented compounds in Leucosceptrum canum nectar.

Leucosceptrum canum nectar (LCN) emerges as a novel food resource, distinguished by its unique dark brown hue. This study delves into the composition and toxicity assessment of novel pigments within LCN. Through liquid chromatography-tandem mass spectrometry (LC-MS/MS) and chemical synthesis, seventeen 2,5-di-(N-(-)-prolyl)-para-benzoquinone (DPBQ) analogs in LCN were identified. These compounds are synthesized in LCN via the Michael addition reaction, utilizing p-benzoquinone (BQ), derived from phenol metabolism, and amino acids as substrates in an alkaline environment (pH = 8.47 ± 0.06) facilitated by dissolved ammonia and the presence of alkaloids. Analytical techniques, including principal component analysis (PCA), orthogonal partial least squares discrimination analysis (OPLS-DA), and volcano plot analysis, were employed to investigate DPBQ analog degradation within the nectar and honey's unique environments. Toxicity assays revealed that DPBQ analogs exhibited no toxicity, displaying a significant difference in toxicity compared to the precursor compound BQ at concentrations exceeding 25 µM.

Transient Receptor Potential Ankyrin 1-dependent Activation of Extracellular Signal-regulated Kinase 2 in the Cerebral Cortices Contributes to Cortical Spreading Depolarization.

Extracellular signal-regulated kinase (ERK) are serine/threonine-selective proteins and ERK1/2 can be phosphorylated in peripheral and central brain regions after cortical spreading depolarization (CSD) and calcitonin gene-related peptide; However, it remains unclear about whether and how ERK activity modulates CSD that correlates to migraine aura. Here, we determined the role of ERK in regulating CSD and explored the underlying mechanism involving transient receptor potential ankyrin 1 (TRPA1), a stress-sensing cation channel. CSD was recorded using intrinsic optical imaging in mouse brain slices, and electrophysiology in rats. Phosphorylated ERK (pERK1/2) and interleukin-1ß (IL-1ß) protein levels were detected using Western blot or enzyme-linked immunosorbent assay, respectively. IL-1ß mRNA level was detected using qPCR. The results showed that an ERK inhibitor, SCH77298, markedly prolonged CSD latency and reduced propagation rate in mouse brain slices. Corresponding to this, CSD induction increased levels of cytosolic pERK1/2 in ipsilateral cerebral cortices of rats, the elevation of which correlated to the level of IL-1ß mRNA. Mechanistic analysis showed that pre-treatment of an anti-TRPA1 antibody reduced the cytosolic pERK2 level but not pERK1 following CSD in cerebral cortices of rats and this level of pERK2 correlated with that of cerebral cortical IL-1ß protein. Furthermore, an ERK activator, AES16-2M, but not its scrambled control, reversed the prolonged CSD latency by a TRPA1 inhibitor, HC-030031, in mouse brain slices. These data revealed a crucial role of ERK activity in regulating CSD, and elevation of pERK and IL-1ß production induced by CSD is predominantly TRPA1 channel-dependent, thereby contributing to migraine pathogenesis.

Mesoporous carbon spheres with programmable interiors as efficient nanoreactors for H2O2 electrosynthesis.

The nanoreactor holds great promise as it emulates the natural processes of living organisms to facilitate chemical reactions, offering immense potential in catalytic energy conversion owing to its unique structural functionality. Here, we propose the utilization of precisely engineered carbon spheres as building blocks, integrating micromechanics and controllable synthesis to explore their catalytic functionalities in two-electron oxygen reduction reactions. After conducting rigorous experiments and simulations, we present compelling evidence for the enhanced mass transfer and microenvironment modulation effects offered by these mesoporous hollow carbon spheres, particularly when possessing a suitably sized hollow architecture. Impressively, the pivotal achievement lies in the successful screening of a potent, selective, and durable two-electron oxygen reduction reaction catalyst for the direct synthesis of medical-grade hydrogen peroxide disinfectant. Serving as an exemplary demonstration of nanoreactor engineering in catalyst screening, this work highlights the immense potential of various well-designed carbon-based nanoreactors in extensive applications.

The Role of Base in Reaction Performance of Photochemical Synthesis of Thiazoles: An Integrated Theoretical and Experimental Study.

Artificial intelligence (AI)/machine learning (ML) is emerging as pivotal in synthetic chemistry, offering revolutionary potential in retrosynthetic analysis, reaction conditions and reaction prediction. We have combined chemical descriptors, primarily based on Density Functional Theory (DFT) calculations, with various AI/ML tools such as Multi-Layer Perceptron (MLP) and Random Forest (RF), to predict the synthesis of 2-arylbenzothiazole in photoredox reactions. Significantly, our models underscore the critical role of the molecular structure and physicochemical characteristics of the base, especially the total atomic polarizabilities, in the rate-determining steps involving cyclohexyl and phenethyl moieties of the substrate. Moreover, we validated our findings in articles through experimental studies. It showcases the power of AI/ML and quantum chemistry in shaping the future of organic chemistry.

Progress in Microbial Fertilizer Regulation of Crop Growth and Soil Remediation Research.

More food is needed to meet the demand of the global population, which is growing continuously. Chemical fertilizers have been used for a long time to increase crop yields, and may have negative effect on human health and the agricultural environment. In order to make ongoing agricultural development more sustainable, the use of chemical fertilizers will likely have to be reduced. Microbial fertilizer is a kind of nutrient-rich and environmentally friendly biological fertilizer made from plant growth-promoting bacteria (PGPR). Microbial fertilizers can regulate soil nutrient dynamics and promote soil nutrient cycling by improving soil microbial community changes. This process helps restore the soil ecosystem, which in turn promotes nutrient uptake, regulates crop growth, and enhances crop resistance to biotic and abiotic stresses. This paper reviews the classification of microbial fertilizers and their function in regulating crop growth, nitrogen fixation, phosphorus, potassium solubilization, and the production of phytohormones. We also summarize the role of PGPR in helping crops against biotic and abiotic stresses. Finally, we discuss the function and the mechanism of applying microbial fertilizers in soil remediation. This review helps us understand the research progress of microbial fertilizer and provides new perspectives regarding the future development of microbial agent in sustainable agriculture.

Fumarate Hydratase Enhances the Therapeutic Effect of PD-1 Antibody in Colorectal Cancer by Regulating PCSK9.

Despite the notable achievements of programmed death 1 (PD-1) antibodies in treating various cancers, the overall efficacy remains limited in the majority of colorectal cancer (CRC) cases. Metabolism reprogramming of tumors inhibits the tricarboxylic acid (TCA) cycle, leading to down-regulation of fumarate hydratase (FH), which is related to poor prognosis in CRC patients. By establishing a tumor-bearing mouse model of CRC with Fh1 expression deficiency, we confirmed that the therapeutic effect of PD-1 antibodies alone was suboptimal in mice with low Fh1 expression, which was improved by combination with a protein invertase subtilisin/kexin 9 (PCSK9) inhibitor. Mechanistically, FH binds to Ras-related nucleoprotein (RAN), which inhibits the nuclear import of the PCSK9 transcription factor SREBF1/2, thus reducing the expression of PCSK9. This leads to increased clonal expansion of CD8+ T cells while the number of Tregs remains unchanged, and the expression of PD-L1 does not change significantly, thus enhancing the immunotherapy response. On the contrary, the expression of PCSK9 increased in CRC cells with low FH expression, which antagonized the effects of immunotherapy. Overall, CRC patients with low FH expression may benefit from combinatorial therapy with PD-1 antibodies and PCSK9 inhibitors to enhance the curative effect.

Bright luminescence from nontoxic all-inorganic low-dimensional cesium halide.

Due to the superiority of low cost, easy manufacture, and tunable light emission owing to the diversity of compositions and dimensionalities, the metal halides have appeared as a promising class of semiconductors. Nevertheless, the toxicity problem along with inherent instability of Pb-based metal halides greatly limits their large-scale applications. Based on this situation, it is necessary to develop eco-friendly materials, which could simultaneously maintain the excellent optoelectronic properties of lead materials. In this Letter, the one-dimensional Cu + -alloyed Cs2AgI3 has been successfully synthesized. An intense blue emission located at 469 nm with a large Stokes shift was observed. Density functional theory calculation indicated that the Cu+ ions could effectively modulate the density of state population, which was the key factor drastically boosting the photoluminescence quantum yield (PLQY). This kind of highly efficient metal halide may overcome the bottlenecks of toxicity and poor efficiency issues of blue emission and will have a promising prospect in the optoelectronic fields.

Cobalt/Nitrogen Co-Doped Carbon Materials Enhance the Reaction Rate of Sodium-Potassium Alloy Electrodes.

Sodium-potassium (NaK) alloy electrodes are ideal for next-generation dendrite-free alkali metal electrodes due to their dendrite-free nature. However, issues such as slow diffusion kinetics due to the large K+ radius and the loss of active potassium during the reaction severely limit its application. Here a novel cobalt/nitrogen-doped carbon material is designed and it is applied to the construction of a NaK alloy electrode. The experimental and theoretical results indicate that the confining effect of the nitrogen-doped graphitic carbon layer can protect the cobalt nanoparticles from corrosion leaching, while the presence of Co─Nx bonds and cobalt nanoparticles provides more active sites for the reaction, realizing the synergistic effect of adsorption-catalytic modulation, lowering the K+ diffusion energy barrier and promoting charge transfer and ion diffusion. The application of this electrode to a symmetrical battery can achieve more than 1800 stable cycles under a current density of 0.4 mA cm-2 and a charge/discharge specific capacity of 122.64 mAh g-1 under a current of 0.5C in a full battery. This finding provides a new idea to realize a fast, stable, and efficient application of NaK alloy electrodes.

Microfluidization improved hempseed yogurt's physicochemical and storage properties.

BACKGROUND: Plant-based yogurts are suffering from the common problems, such as an unattractive color, stratified texture state and rough taste. Therefore, it is urgent to develop a novel processing method to improve the quality and extend the storage life of hempseed yogurt. In the present study, hempseed yogurt was microfluidized prior to fermentation. The effects of microfluidization on microstructure, particle size, mechanical properties, sensory acceptability, variations in pH and titratable acidity, lactic acid bacteria (LAB) counts, and stability of hempseed yogurt during 20 days of storage were investigated. RESULTS: Microfluidization contributed to the production of hempseed yogurt as a result of the better physicochemical properties compared to normal homogenization. Specifically, microfluidization reduced the particle size of hempseed yogurt with a uniform particle distribution, increased water holding capacity, and improved texture and rheological properties. These advancements resulted in higher sensory scores for the yogurt. Furthermore, during storage, microfluidization effectively inhibited the post-acidification process of hempseed yogurt, and increased LAB counts and storage stability. CONCLUSION: Microfluidization improved the physicochemical properties and storage stability of hempseed yogurt. Our findings support the application of microfluidization in hempseed yogurt and provide a new approach for enhancing the quality of plant-based alternatives that meet consumers' demands for high-quality food products. © 2023 Society of Chemical Industry.

Pulsed light treatment enhances starch hydrolysis and improves starch physicochemical properties of germinated brown rice.

BACKGROUND: Recently, germinated brown rice (GBR) has gained substantial attention as a functional food because of its nutritional attributes. Notably, pulsed light technology (PLT) has emerged as a promising tool for enhancing rice germination and, consequently, has improved the nutritional and functional qualities of GBR-derived products. However, further research is required to comprehensively understand the impact of PLT on GBR physicochemical properties. The present study aimed to investigate the stimulating effects of PLT on starch hydrolysis, starch structure and functional properties of GBR. RESULTS: The PLT substantially boosted α-amylase activity during brown rice germination, leading to a 10.9% reduction in total starch content and a 17.3% increase in reducing sugar content, accompanied by elevated free water levels. Structural analysis indicated no changes in starch crystalline types, whereas gelatinization temperature slightly increased. Pasting properties exhibited a significant drop in peak viscosity. Scanning electron microscopy showed surface erosion of starch granules with microstructural changes. Furthermore, correlation analysis established positive links between α-amylase activity, reducing sugar accumulation, starch structure and functional properties in GBR. CONCLUSION: The present study demonstrates that PLT enhanced the physicochemical properties of GBR starch, significantly improving the stability of GBR products, thereby contributing to expanded applicability of rice starch in the food industry. © 2023 Society of Chemical Industry.

Disease burden of COPD in the Chinese population: a systematic review.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of the main contributors to the global burden of disease. OBJECTIVES: This systematic review aimed to evaluate the disease burden of COPD in the Chinese population and to determine the factors influencing the economic burden of the disease. DESIGN: This is a systematic review study. DATA SOURCES AND METHODS: We searched PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure, WANGFANG Data, and VIP databases for studies regarding the disease burden of COPD in mainland China published before 31 December 2022. The Agency for Healthcare Research and Quality's recommendation rating tool assessed the cross-sectional studies' risk of bias. RESULTS: A total of 45 studies were included. The disability-adjusted life years (DALYs) for COPD have generally decreased in the Chinese population over the past 30 years. The total number of DALYs due to COPD in China decreased from 26.12 million person-years to 19.92 million person-years, with an annual decline rate of 0.9%. Subjects aged 40 years and older make up the majority of those with COPD in the Chinese population, and the condition is more prevalent among males than females, in rural areas than urban places, and in the West than the East. The median direct medical cost of COPD ranges from 150 to 2014 USD per capita per year. Among 23 influencing factors, age, hospitalization days, hospital type, gender, and career were the most significant variables that had an impact on the economic burden of COPD patients. CONCLUSION: The overall burden of COPD in China has been decreasing over the past 30 years. But there is a lack of standardized indicators for the economic burden of COPD patients in China, and it is recommended to establish a unified standard. REGISTRATION: The systematic review protocol was prospectively registered with PROSPERO (No. CRD42023393429).

Disease burden of COPD in the Chinese populationChronic obstructive pulmonary disease (COPD) is one of the main contributors to the global burden of disease. This systematic review aimed to evaluate the disease burden of COPD in the Chinese population and to determine the factors influencing the economic burden of the disease. We searched PubMed, Web of Science, Embase, CNKI, WANGFANG Data, and VIP databases for studies regarding the disease burden of COPD in mainland China published before December 31, 2022. The Agency for Healthcare Research and Quality's (AHRQ) recommendation rating tool assessed the cross-sectional studies' risk of bias. The overall burden of COPD in China has been decreasing over the past 30 years. But there is a lack of standardized indicators for the economic burden of COPD patients in China, and it is recommended to establish a unified standard.