Sepsis-associated myocardial injury (SICM) is one of the most common and severe complications of sepsis. The present study aimed to analyze research trends, collaborative networks, and knowledge dissemination in SICM over the past decade using bibliometric methods, thereby providing a reference for future research directions.

Relevant literature published between 2015 and 2025 was retrieved from the Web of Science Core Collection (WOSCC) database. A bibliometric cross-sectional analysis was performed using software tools, including VOSviewer and CiteSpace, with corresponding evaluation metrics extracted or calculated. Publications were categorized by country, institution, author, journal, highly cited papers, and keywords; these variables were compared with respect to publication output and academic impact, followed by bibliometric and visual analyses.

Over the past decade (2015-2025), remarkable advances have been achieved in sepsis research related to SICM. A total of 2927 papers were included in this study. China, the United States, and England constituted the primary sources of publications in this field; among the top 20 contributing institutions, 15 were from China, 4 from the United States, and one from Australia, with Yang Yang identified as the core contributing author. Shock ranked first in the number of publications, while Critical Care topped the list in terms of citation frequency. The most frequently used keywords were sepsis, mortality, and septic shock. Analysis of keyword bursts revealed that precision regulation based on molecular mechanisms and the exploration of intervention targets represent the current research hotspots.

Research on sepsis-associated SICM is flourishing. The present study clarifies the research hotspots in this field, provides a comprehensive overview of relevant research trends, and offers a reference for potential collaborations and future research directions.

This study aimed to investigate the potential mechanisms of Zhigancao Decoction (ZGCT) in insomnia-arrhythmia comorbidity using a target-centered network pharmacology and molecular docking approach. In addition, a refined candidate bioactive compound library was constructed. Active components of ZGCT were retrieved from TCMSP and HERB databases, and target prediction was performed using SwissTargetPrediction. Disease-related targets for insomnia and arrhythmia were obtained from GeneCards, followed by identification of intersection targets. A protein-protein interaction (PPI) network was constructed using STRING, and hub genes were identified via topological analysis and Maximal Clique Centrality (MCC) in Cytoscape. Functional enrichment analysis was performed using Metascape, and molecular docking was used to evaluate ligand-target interactions. A total of 84 active compounds and 193 associated targets were identified for ZGCT. Intersection analysis yielded 41 common targets. PPI network analysis identified 10 hub targets, including AKT1, PPARG, and MMP9. Based on a target-centered reverse screening strategy, 22 candidate bioactive compounds were identified, and molecular docking showed computationally favorable binding energies between key compounds and core targets. These compounds are associated with neuroendocrine, inflammatory, and cardiovascular signaling pathways. ZGCT is predicted to exert therapeutic effects on insomnia-arrhythmia comorbidity through a systems-level multi-target regulatory network involving neuroendocrine modulation, renin-angiotensin system-related pathways, and cardiovascular remodeling. The proposed target-centered reverse screening strategy provides a refined and interpretable framework for constructing a disease-specific bioactive compound library, offering potential directions for further experimental validation and drug development.

Physical functional limitations and sleep disturbances frequently co-occur in older adults, yet their joint mortality risks and the potential nonlinear dynamics of systemic inflammation remain unclear. This study investigated the joint associations of health behavior profiles (physical function and sleep) and the systemic immune-inflammation index (SII) with mortality, focusing on exploring nonlinear relationships. Data were obtained from 4548 individuals who participated in the National Health and Nutrition Examination Survey (2011-2014). Survey-weighted Cox proportional hazards models and restricted cubic splines with change-point diagnostics were used to characterize exposure-response relationships. Compared with healthy controls, participants with physical functional limitations exhibited >2-fold increases in the risks of all-cause mortality (hazard ratio: 2.44) and cardiovascular mortality (hazard ratio: 2.46). Concurrent sleep disturbances conferred minimal additional risk. The association of SII value with mortality was nonlinear. Risk remained stable at lower SII values but increased sharply beyond identified model-based turning points (SII ≈ 447-644 for all-cause mortality; SII ≈ 332-643 for cardiovascular mortality). Physical functional limitations are robustly associated with mortality, overshadowing the contribution of sleep disturbances. The identified model-based turning points reflect an inflection in mortality risk, suggesting a potential threshold effect in systemic inflammation. Specifically, the findings highlight a unique susceptibility of the cardiovascular system to low-level inflammation. Given the observational nature of this study, these turning points are exploratory and warrant external validation.

Sarcopenia, characterized by a decline in muscle mass and function, is increasingly recognized as a significant comorbidity in chronic diseases, including rheumatoid arthritis (RA). However, its relevance to all-cause mortality in RA patients remains to be explored. Here, we examine the correlation between sarcopenia and all-cause mortality in RA patients using the NHANES database. Data were obtained from 910 RA patients identified through self-reported data in the nationwide NHANES (1999-2018). Sarcopenia was defined by an appendicular skeletal muscle mass index adjusted for body mass index (ASM/BMI). Cox regression models were utilized to measure the connection between sarcopenia and all-cause mortality, adjusted for demographic, clinical, and lifestyle factors. Moreover, subgroup and sensitivity analyses were also performed. Sarcopenia was independently linked to a higher risk of all-cause mortality (HR = 1.610, 95% CI: 1.192-2.176, P = .002) after adjusting for potential confounders. Subgroup analysis showed significant associations in individuals aged <60 years, males, and those with comorbid conditions such as hypertension, diabetes, and cardiovascular disease. Additionally, sensitivity analysis confirmed the robustness of the findings. Sarcopenia was associated with a higher mortality risk in patients with RA, suggesting that its early identification and management may improve survival outcomes.

Acute decompensated heart failure (ADHF) exhibits a heterogeneous diuretic response. Chloride-bicarbonate imbalances may reduce loop diuretic efficiency. The effect of admission bicarbonate levels on diuretic resistance in unselected ADHF patients remains unclear. We aimed to evaluate whether higher admission bicarbonate identifies patients at risk of early diuretic dose escalation and less effective early decongestion.

Our study was planned as a retrospective, single-centre, consecutive ADHF cohort. This study included 1000 hospitalised patients with ADHF (mean age 69 years, ± 11.2 years, 42.7% female) who underwent arterial blood sampling and pH ranging from 7.35 to 7.45. Patients were divided into three groups according to their admission bicarbonate value (< 22 mmol/L-group 1, 22-28 mmol/L-group 2, > 28 mmol/L-group 3). The primary endpoint was early diuretic escalation within 48 hours (dose doubling and/or thiazide add-on or infusion switch). Secondary endpoints included diuretic efficiency, 24/48-hour net fluid balance, 48-hour weight change, early spot urine sodium, and safety/utilisation metrics. Multivariable models adjusted for prespecified clinical and laboratory covariates and baseline diuretic regimen.

Higher admission bicarbonate (particularly > 28 mmol/L) was independently associated with greater odds of early escalation and with less effective decongestion. Patients with higher bicarbonate demonstrated lower diuretic efficiency, smaller 24-48 hour net fluid losses, attenuated early weight reduction, and lower early urine sodium. Companion markers (lower chloride, higher pH and pCO₂) paralleled these findings, consistent with an alkalosis phenotype.

Admission bicarbonate is a simple, physiologically coherent marker of early decongestion dynamics in ADHF. Embedding this chemistry-based flag within urine-sodium-guided protocols may enable earlier, objective intensification of pharmacologic therapy and more efficient decongestion. Prospective trials should test bicarbonate-informed pathways against usual care on clinical outcomes.

Heart valve disease is a significant cause of morbidity and mortality, and aortic valve replacement (AVR) is a common treatment option. Recently, sutureless biological valves have gained increasing use. This study aimed to evaluate the concordance between preoperative computed tomography-derived annulus measurements and valve sizes implanted during surgery rather than the direct clinical impact of imaging on prosthesis selection.

A total of 40 patients with aortic valve stenosis who underwent elective open-heart surgery and preoperative multislice computed tomography between February 20 and May 20, 2024, were included and were randomly allocated into two groups: sutureless biological valve (n = 20) and mechanical valve (n = 20). Data were obtained from patient records and the hospital's data system and analysed statistically.

A total of 40 patients were included in the study: 20 received sutureless, rapidly implantable biological valves, and 20 underwent mechanical AVR. The mean age of the cohort was 61.5 ± 9.1 years, with 45% females and 55% males. Compared with the sutureless group, the mechanical valve group had significantly longer cross-clamp (73.5 vs. 53.0 minutes, p < 0.001) and cardiopulmonary bypass times (102 vs. 92 minutes, p = 0.011), as well as smaller sinotubular junction diameters (30.2 vs. 32.3 mm, p = 0.025). In contrast, the sutureless group demonstrated a significantly greater optimal effective orifice area index (1.58 vs. 0.77, p < 0.001).

Preoperative computed tomography is a reliable tool for planning AVR. Sutureless biological valves provide shorter cross-clamp and bypass times and favourable haemodynamic performance, whereas mechanical valves are more often associated with smaller valve sizes and longer procedures. Early postoperative outcomes were comparable between groups.

Prolonged warm ischemia time (WIT) increases susceptibility to ischemia-reperfusion injury in liver grafts. Viability assessment during normothermic machine perfusion (NMP) mainly targets hepatocyte and cholangiocyte function, whereas the contribution of liver sinusoidal endothelial cells (LSECs) is less explored. We evaluated whether clearance of hyaluronan (HA) and N-terminal propeptide of procollagen type III (PIIINP) reflects LSEC clearance function and predicts inflammatory activation during NMP.

In a porcine model with 45 min of WIT, livers were randomized to either immediate NMP for 12 h (n = 7), or 4 h of static cold storage followed by 8 h of NMP (SCS-NMP, n = 7). Perfusate HA and PIIINP were quantified as markers of LSEC function. Interstitial cytokines and metabolic profiles were assessed with microdialysis.

Immediate NMP resulted in significantly lower HA and PIIINP concentrations after 4 and 12 h, accompanied by increased expression of their clearance receptors, stabilin-1 and stabilin-2. Moreover, impaired HA clearance was associated with elevated levels of interleukin (IL)-1α, IL-1β, IL-6, and interferon-γ, whereas PIIINP correlated positively with granulocyte-macrophage colony-stimulating factor. Histology confirmed preserved sinusoidal structure with continuous Wheat Germ Agglutinin lectin labeling. The SCS-NMP group exhibited greater lactate/pyruvate ratios and glycerol levels, indicating greater metabolic stress and cellular injury.

Immediate NMP after prolonged WIT preserves LSEC clearance, modulates inflammatory cytokine release, and enhances metabolic recovery compared with SCS-NMP. These findings highlight the overlooked role of LSECs during ex situ perfusion of ischemic grafts. This may have implications for graft assessment under conditions of prolonged warm ischemia.

Psilocybin-assisted interventions are moving from efficacy trials toward psychiatric implementation. Cardiovascular interpretation is central to this transition because trial participants are generally medically selected, receive standardized pharmaceutical-grade doses, and are monitored more intensively than many patients encountered in routine care. This review translates the cardiovascular evidence into a risk-stratified psychiatric decision framework.

We conducted a structured narrative review of clinical trials, systematic reviews, meta-analyses, cardiovascular pharmacology, drug-interaction studies, product-standardization literature, and implementation guidance. Searches were updated through July 10, 2026. Evidence was selected purposively to address acute hemodynamics, corrected QT interval (QTc), 5-hydroxytryptamine receptor-mediated effects, valvular biology, repeated exposure, naturally derived product variability, and practical screening and monitoring.

In supervised studies, pooled estimates indicate mean increases of approximately 19.0 mmHg in systolic blood pressure and 8.7 mmHg in diastolic blood pressure. The largest and most consistent group differences occur about 60-90 min after dosing and generally resolve within 4-6 h; heart-rate effects are smaller and less consistent. Serious acute cardiovascular events remain uncommon in selected participants. Risk interpretation changes with cardiovascular comorbidity, interacting medications, repeated exposure, and non-standardized mushroom products, whose active-alkaloid content can vary by more than an order of magnitude. Mean QTc effects at standard exposure are small. A 5-HT2B-mediated valvular concern remains biologically plausible under chronic exposure, but assay results and exposure-margin estimates are heterogeneous and clinical valvular injury has not been established.

Current evidence supports monitored, intermittent administration of standardized psilocybin in carefully selected populations, not general cardiovascular reassurance across all products, exposure patterns, or psychiatric settings. Product identity, medication review, risk-stratified cardiovascular assessment, session monitoring, and explicit escalation pathways should be integrated into treatment planning.

Geniposidic acid (GPA) is a bioactive iridoid glycoside mainly found in many traditional medicinal plants, including Eucommia ulmoides and Gardenia jasminoides. These plants are also commonly used in traditional diets and herbal teas throughout East Asia, particularly in China and Japan, where they are used to maintain well-being and protect the respiratory, cardiovascular, and renal systems. Despite the growing number of individual studies that highlight GPA's therapeutic potential, to date, there has been a lack of a systematic, critical synthesis of current knowledge. The aim of this review is to summarize the available information regarding the natural sources, methods of extraction, chemical structure, and biological and therapeutic actions of GPA. Data were obtained from PubMed, Scopus, and Web of Science, as well as reports published up to 2025. Evidence shows that GPA exerts manifold biological activities. The pharmacological actions in various disease models, including inflammatory, metabolic syndromes, neurodegenerative, cardiovascular, renal, and hepatic diseases and their mechanisms of action were discussed. The protective actions of GPA are associated with modulation of multiple cellular signaling pathways, including NF-κB, NRF2/HO-1, PI3K/AKT, FXR, and TGF-β signaling, as well as inhibition of NLRP3 inflammasome activation. However, direct molecular target validation has only been demonstrated for selected pathways, particularly FXR and NLRP3, whereas most mechanistic evidence remains based on downstream signaling observations. Although preclinical studies in cells and animals demonstrate that GPA is effective, poor bioavailability remains one major limiting factor. Furthermore, comprehensive pharmacokinetic, toxicological, safety profiling, and well-designed clinical studies are required to support the clinical translation of GPA. This review identifies knowledge gaps and outlines further research directions necessary for the development of GPA as a potential therapeutic agent.

Cardiovascular involvement is a leading cause of morbidity and mortality in autoimmune rheumatic diseases (ARDs), arising through diverse mechanisms such as microvascular dysfunction, inflammation, fibrosis, in addition to traditional cardiovascular risk factors. Cardiac troponin (cTn), a sensitive and specific marker of myocardial injury, is increasingly investigated for its diagnostic and prognostic value. However, interpretation in ARDs is complex, as cTn elevations may reflect primary cardiac involvement, comorbidities or analytical interferences. This review explores the value of cTn as a biomarker of cardiac involvement in several ARDs, such as systemic sclerosis, rheumatoid arthritis, systemic lupus erythematosus, vasculitides, and idiopathic inflammatory myopathies. Articles in the PubMed database (1969-november 2025) were selected using each ARD in combination with "troponin," "cardiovascular," "myocardial involvement," "cardiac involvement," and "biomarker", as keywords. High sensitivity cTn assays can identify both overt and subclinical myocardial injury, predict major adverse cardiovascular events, and correlate with imaging findings, such as myocardial fibrosis and inflammation. Also, cTn increase can result from renal impairment, infections, anemia, or pulmonary hypertension, which frequently complicate ARDs. Further challenges arise from analytical pitfalls, including heterophilic antibodies, rheumatoid factor interference, and macrocomplexes, which may generate false results in ARDs patients. Despite growing evidence, significant knowledge gaps persist regarding the differential value of cTn isoforms, optimal thresholds in ARDs populations, and their role in guiding treatment strategies. Overall, hs-cTn represents a promising, accessible tool to refine diagnosis, risk stratification, and monitoring in ARDs, provided results are interpreted carefully in the clinical and laboratory context.