Cognitive impairment (CI) is highly prevalent among older adults with hypertension and imposes substantial burdens on individuals, families, and healthcare systems. Identifying factors associated with CI is essential for developing targeted prevention strategies, yet evidence from tropical regions of China remains limited.

To examine the prevalence of CI and factors associated with CI among community-dwelling older adults with hypertension in tropical China.

This community-based cross-sectional study included 735 older adults aged ≥60 years with self-reported, physician-diagnosed hypertension recruited from community health centers in Haikou, China, between 2023 and 2025. Cognitive function was assessed using the Chinese Mini-Mental Status with education-adjusted cutoff values. Multivariable logistic regression was performed to identify factors associated with CI. Age- and sex-stratified analyses, interaction analyses, and sensitivity analyses were conducted to evaluate the robustness of the findings.

Among the 735 participants (mean age, 72.3 ± 7.7 years; 57.6% women), 223 (30.3%) had CI. In the fully adjusted model, participants aged ≥80 years had significantly higher odds of CI than those aged 60-69 years (OR = 2.21, 95% CI: 1.34-3.64). Depressive symptoms were also associated with increased odds of CI (OR = 1.87, 95% CI: 1.03-3.39), whereas higher educational attainment, medium monthly income, and higher BMI were associated with lower odds of CI. Stratified analyses suggested potential sex differences in the association between marital status and CI, and formal interaction analysis demonstrated a significant interaction between sex and marital status (P for interaction = 0.015). Sensitivity analyses generally supported the robustness of the primary findings.

CI was common among community-dwelling older adults with hypertension in tropical China. Older age and depressive symptoms were associated with higher odds of CI, whereas higher educational attainment, moderate income, and higher BMI were associated with lower odds. The observed sex differences in the association between marital status and CI highlight the importance of considering social determinants and sex-specific approaches when developing community-based cognitive health strategies for older adults with hypertension.

Pharmacogenomics-guided prescribing uses patient genetic information to individualize drug selection and dosing and has attracted interest as a strategy to improve outcomes and reduce adverse drug events in cardiovascular diseases. Several systematic reviews have examined its cost-effectiveness, but their findings have not been synthesized across drug classes and healthcare settings.

To identify, critically appraise, and synthesize findings from systematic reviews evaluating cost-effectiveness or cost-utility of pharmacogenomics-guided treatment of cardiovascular diseases.

This systematic review of systematic reviews was pre-registered in PROSPERO (CRD420261281565). Five databases were searched from inception, without language restrictions. Eligible studies were systematic reviews that summarized cost-effectiveness evidence on pharmacogenomics-guided cardiovascular drug prescribing. Risk of bias was assessed using ROBIS and methodological quality using AMSTAR 2. Findings were synthesized narratively.

Ten systematic reviews (2010-2024) were included, encompassing 149 unique primary cost-effectiveness studies. The corrected covered area across reviews was 9.47% (moderate overlap). Most evidence was derived from economic modelling studies and substantial heterogeneity was observed across drug-gene pairs, comparators, and healthcare settings. CYP2C19-guided clopidogrel therapy was frequently reported as cost-effective or cost-saving, although results were less favourable when universal ticagrelor served as comparator. Evidence for CYP2C9/VKORC1-guided coumarin anticoagulation was more heterogeneous with cost-effectiveness varying across contexts. Limited evidence suggested that SLCO1B1-guided statin therapy may be cost-effective, although data were sparse. No review reported pooled incremental cost-effectiveness ratios or net monetary benefit. Risk of bias was low in 7 reviews; AMSTAR 2 confidence was high in 4 and low in 5.

Cost-effectiveness of pharmacogenomics-guided cardiovascular treatment seems to vary by drug-gene pair, comparator, healthcare context, and modelling assumptions. Further real-world studies and standardized economic evaluations are needed to clarify broader clinical adoption.

Malondialdehyde (MDA) is a critical biomarker of oxidative stress, playing a significant role in diagnosing and monitoring conditions associated with oxidative damage, including cardiovascular diseases, neurodegenerative disorders, and cancer. This study reports the synthesis and application of a molecularly imprinted polymer (MIP)-based electrochemical sensor for MDA detection using a dual biopolymer chitosan/κ-carrageenan matrix integrated with Fe₃O₄ nanoparticles on a boron-doped diamond (BDD) electrode. Differential pulse voltammetry (DPV) was employed to evaluate analyte recognition, while FTIR, DLS, SEM, EIS, and cyclic voltammetry were used for sensor characterization. Under optimized conditions (75% chitosan, 25% κ-carrageenan, and 10 mg Fe₃O₄ nanoparticles), the sensor exhibited high sensitivity (687.35 μA/μM), a low detection limit (0.005 μM), and a linear detection range of 0.026-0.26 μM. The developed platform also demonstrated good reproducibility, repeatability, and selectivity toward MDA in the presence of common interfering compounds. Analytical performance was further validated in spiked water and artificial serum samples, showing satisfactory recovery values. The proposed sensor outperformed several previously reported MDA sensing platforms, highlighting its potential as a sensitive and reliable tool for oxidative stress biomarker detection and future clinical applications.

Obesity prevalence among females in the United States continues to rise across the lifespan, imposing a substantial burden on individuals and the health care system through an increasing number of preventable, excess weight-attributable disabling diseases and mortality. A clearer understanding of the impact of obesity and treatment interventions on outcomes for reproduction, cardiometabolic risk, musculoskeletal health, and mental health at various life stages is critical to optimizing management strategies for women with obesity.

This narrative clinical review synthesizes published literature and expert perspectives regarding obesity-related risk factors, health outcomes, and treatment considerations related to obesity in women, including the impact of obesity medications across the lifespan.

Adiposity influences reproductive, cardiometabolic, musculoskeletal, and mental health outcomes across the female lifespan. During adolescence, early pubertal onset and metabolic dysfunction are common. In reproductive years, infertility, polyendocrine metabolic ovarian syndrome, and pregnancy complications are prominent. Perimenopause is associated with vasomotor symptoms, sleep disruption, and increased cardiovascular risk. In older age, risks for cancer, functional decline, and frailty increase. Pharmacologic therapies, including incretin-based agents, demonstrate efficacy in weight reduction and cardiometabolic improvement, although life stage-specific safety and outcome data remain limited.

Obesity management in women requires individualized, life stage-specific approaches integrating lifestyle interventions and pharmacotherapy. Additional research is needed to clarify long-term outcomes and optimize treatment strategies across the lifespan.

Cardiovascular diseases (CVDs) remain the leading cause of global morbidity and mortality, encompassing coronary artery disease, hypertension, heart failure, and cerebrovascular disorders. The global burden of CVD continues to rise, driven by complex interactions among endothelial dysfunction, oxidative stress, inflammation, genetic predisposition, and lifestyle-related risk factors. This review aims to provide a comprehensive overview of the epidemiology, pathophysiology, risk factors, and emerging therapeutic approaches for CVD, highlighting recent advances in precision medicine and phytotherapy.

A comprehensive literature search was conducted using PubMed, ScienceDirect, and Google Scholar databases. Keywords included "cardiovascular disease," "Atherosclerosis," "Pathophysiology," "Risk Factors," "Treatment," "Hyperglycemia," and "Hypertension." Approximately 300 publications were initially identified. Following title, abstract, and full-text screening, 156 relevant articles were selected for inclusion. About 85% of the reviewed literature was published between 2020 and 2025, while the remaining 15% originated from 2016 to 2019.

The review demonstrates a substantial increase in the global burden of CVDs, with prevalence nearly doubling between 1990 and 2019 and mortality continuing to rise worldwide. Atherosclerosis emerged as the primary pathological basis of ischemic cardiovascular disorders, driven by endothelial dysfunction, oxidative stress, inflammatory cytokines, and vascular remodeling. Major modifiable risk factors include hypertension, smoking, diabetes, dyslipidemia, obesity, unhealthy diet, alcohol consumption, and physical inactivity, while age, sex, and genetic susceptibility contribute to disease risk. Emerging therapeutic strategies such as PCSK9 inhibitors, dual SGLT1/2 inhibitors, siRNA-based therapies, CRISPR/Cas9 genome editing, and anti-inflammatory biologics show promising clinical outcomes. Additionally, medicinal plants including Astragalus membranaceus, Citrus bergamia, Hibiscus sabdariffa, and Olea europaea exhibit cardioprotective effects.

CVD remains a significant global health challenge requiring multifaceted management strategies. The integration of conventional pharmacotherapy, precision medicine, gene-based interventions, and evidence-based phytotherapeutics offers promising opportunities to improve cardiovascular outcomes and reduce the growing global disease burden.

Pyroptosis is an emerging form of inflammatory programmed cell death primarily mediated by the gasdermin protein family, characterized by cell swelling, membrane pore formation, and the release of pro-inflammatory cytokines such as IL-1β and IL-18. This mode of cell death has garnered significant attention due to its critical involvement in a variety of diseases, including cancer, cardiovascular disorders, autoimmune diseases, and metabolic syndromes, positioning it as a promising therapeutic target. Despite advances, the complexity of pyroptosis regulation and its dual roles in disease pathogenesis present challenges that necessitate comprehensive understanding. This review systematically summarizes the molecular regulatory mechanisms of pyroptosis, encompassing classical and non-classical inflammasome pathways, activation and modulation of gasdermin proteins, and the intricate signaling networks involved. We further highlight the dualistic roles of pyroptosis in tumor development, immune modulation, and chronic inflammatory conditions. Incorporating the latest research progress, we explore emerging therapeutic strategies targeting pyroptosis, including small molecule inhibitors, nanomaterials, stem cell-derived exosomes, and gene regulation technologies, critically evaluating their clinical applicability and limitations. By providing an integrative overview of pyroptosis-related mechanisms and innovative treatment approaches, this article aims to offer a theoretical foundation and future research direction for precision medicine and novel drug development.

The gut microbiota has emerged as a metabolically active endocrine-like organ with a crucial role in coronary artery disease (CAD), yet its contribution to adverse clinical outcomes remains incompletely understood. In this prospective cohort of 319 participants, we integrated metagenomic and metabolomic profiling with longitudinal follow-up over a median of 1.85 years. Fecal microbiota transplantation from patients with CAD transmitted susceptibility to atherosclerosis in antibiotic-treated ApoE ^-/- mice, accompanied by microbiota-induced vascular inflammation mediated through LPS-TLR4 signaling. Gut microbiota-derived aromatic amino acid metabolism was associated with thrombotic risk and major adverse cardiac events (MACE). Machine learning identified gut microbial features that improved prospective prediction of MACE. Together, these findings implicate the gut microbiome in CAD progression and support the development of microbiome-based strategies for cardiovascular risk prediction and prevention.

Heart failure with preserved ejection fraction (HFpEF) is a highly complex clinical syndrome associated with significant morbidity and mortality. Its underlying mechanisms are poorly understood, treatment options are limited, the disease burden on patients is substantial, and clinical outcomes are poor. Previous clinical studies have preliminarily suggested that Shengxian Yixin Granule (SXYX) is an effective herbal formula for the treatment of HFpEF, but it lacks high-quality clinical evidence. This study therefore plans to conduct a randomized controlled trial (RCT) to evaluate the efficacy and safety of SXYX in treating HFpEF, aiming to provide a new therapeutic strategy for this condition.

This study is a multicenter, randomized, double-blind, placebo-controlled clinical trial. It will be conducted at four Chinese medicine hospitals in China. A total of 148 eligible patients with HFpEF will be enrolled and randomly assigned in a 1:1 ratio to the SXYX group or the placebo group. The SXYX group will receive Shengxian Yixin Granule, while the placebo group will receive a matching placebo. Both groups will receive standard Western medical therapy as background treatment. The treatment duration for all groups is 24 weeks. The primary outcome is the change in peak VO₂ (assessed by cardiopulmonary exercise testing) from baseline to 24 weeks. Secondary outcome measures include the change in peak oxygen uptake from baseline to 12 weeks, NT-proBNP, echocardiographic parameters, NYHA functional class, 6-minute walk test distance (6MWT), Traditional Chinese Medicine (TCM) syndrome scale, major symptoms and signs, EQ-5D score, and coagulation function. These outcomes will be used to evaluate the efficacy of SXYX. Routine blood, urine, and stool tests, liver and kidney function tests, electrocardiograms, and adverse events will be used to assess the safety of SXYX. Wearable monitoring devices will be used for out-of-hospital, dynamic, and multidimensional assessment of patients' exercise tolerance, including heart rate, blood oxygen saturation, step count, and walking distance.

This study will evaluate the efficacy and safety of SXYX in treating HFpEF. The findings will provide a scientific basis for the clinical application of SXYX.

https://itmctr.ccebtcm.org.cn, identifier ITMCTR2026000833.

Kawasaki disease is an acute immune vasculitis, and intravenous immunoglobulin (IVIG) therapy was an important treatment method, although a small proportion of children exhibited IVIG resistance. Our study aimed to construct a risk model for Kawasaki disease with IVIG resistance and to validate it across different clinical characteristic subgroups, with the goal of optimizing personalized and precise management to improve patient outcomes.

We first compared various factors between the groups with and without IVIG resistance. Then, we used LASSO analysis to screen for factors that significantly predicted outcomes. The selected factors were used to develop the risk model. We evaluated the model using ROC curves, calibration curves, and decision curve analysis, and conducted internal validation through 5-fold cross-validation. Finally, we performed subgroup analyses based on age, sex, and other factors.

Through univariate analysis, LASSO analysis, and correlation analysis, we identified WBC, PLT, CRP, fever days, PLR, and ALT as key factors in constructing the risk model. The model achieved an area under the curve of 0.816 (95% CI: 0.775-0.857). Additionally, calibration curves, DCA, and 5-fold cross-validation demonstrated that the model had good predictive performance. The model's effectiveness was also satisfactory across various subgroups.

Our study successfully constructed a risk model for Kawasaki disease with IVIG resistance in the Chinese population. The model demonstrated strong predictive ability and was validated across multiple subgroups, showing potential clinical application value.

Guillain -Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy involving multifaceted pathogenic mechanisms. Although humoral immunity is central to GBS pathogenesis, longitudinal changes in peripheral immune circuits across symptomatic disease and clinical recovery remain incompletely understood at single-cell resolution.

We performed longitudinal single-cell RNA sequencing of peripheral blood mononuclear cells collected during the symptomatic GBS and clinical recovery phases from a patient with GBS. Changes in immune cell composition, transcriptional programs, intercellular communication, and gene regulatory networks were examined, with particular attention to plasma cells, monocytes, B cells, and putative double-negative T cells (DNTs).

Plasma cells, monocytes, and putative DNTs exhibited stage-dependent transcriptional remodeling. During the GBS phase, plasma cells exhibited increased secretory and IgG-associated programs, consistent with enhanced antibody-producing activity. Monocytes represented higher relative proportion and showed enrichment of antigen-presentation and inflammatory pathways. Cell -cell communication analysis indicated stronger inferred BAFF and APRIL signaling from monocytes toward B cells and plasma cells during the GBS phase, suggesting a potential monocyte contribution to humoral activation. Regulatory network analysis identified SPI1-associated activity within the inflammatory monocyte program. In parallel, putative DNTs showed comparatively higher inferred outgoing cytokine signaling together with enrichment of ribosome biogenesis and protein synthesis pathways. During recovery, plasma cell secretory signatures were attenuated. B cells upregulated memory- and regulatory-associated genes, inflammatory monocyte programs diminished, and inferred DNT-associated cytokine signaling was lower in the recovery sample, accompanied by receptor-mediated and adhesion-related transcriptional programs.

Collectively, these findings provide a longitudinal single-cell view of peripheral immune remodeling in GBS and highlight a stage-associated monocyte -B-cell regulatory axis and differences in DNT-associated inferred cytokine signaling between the GBS and recovery samples.