Cardiovascular and cerebrovascular diseases have a high global incidence and are major causes of disability and mortality. This review integrates perspectives from both TCM and modern medicine. Based on the TCM theory of "heart-brain homology", it comprehensively analyzes the effects of cardiovascular risk factors and cerebral lesions on the heart-brain axis. A three-dimensional regulatory axis is proposed, encompassing metabolic reprogramming, inflammatory-oxidative cascade reactions, and epigenetic regulation mediated by ten-eleven translocation methylcytosine dioxygenases(TET enzymes). Furthermore, the protective effects of multi-target therapeutic agents, including statins, sodium-glucose cotransporter 2(SGLT2) inhibitors, and TCM preparations such as Tongxinluo Capsules and Naoxintong Capsules, on the cardiovascular and nervous systems are discussed. Future directions include artificial intelligence(AI)-assisted drug discovery and novel drug delivery platforms(e.g., functional hydrogels and nanocarriers), which offer promising strategies for heart-brain targeted therapy.

This study aimed to explore the prescription patterns of TCM in the treatment of cerebral small vessel disease(CSVD) based on latent structure model combined with association rules and provide a reference for clinical diagnosis and treatment based on syndrome differentiation. Multiple databases including PubMed, EMbase, Cochrane Library, CNKI, Wanfang, VIP, SinoMed, ITMCTR, and ChiCTR were searched from their inception to November 17, 2025. Literature related to TCM prescriptions for CSVD was selected, and a database of TCM prescriptions was established using Microsoft Excel 2019. Lantern 5.0 and Rstudio were used to conduct latent structure analysis and association rule analysis on high-frequency TCMs with a frequency >4.00% to explore the prescription patterns of TCM in the treatment of CSVD. A total of 126 TCM prescriptions involving 164 TCMs and 1 313 total frequencies were included. High-frequency TCMs included Chuanxiong Rhizoma, Pheretima, Astragali Radix, Acori Tatarinowii Rhizoma, and Salviae Miltiorrhizae Radix et Rhizoma, with the main efficacy shown by tonic TCMs and blood-activating and stasis-resolving TCMs. Latent structure analysis identified 12 latent variables, 24 latent classes, 6 comprehensive clustering models, and 17 core prescriptions. Based on the prescriptions, the common syndromes of CSVD were speculated to be Qi deficiency with blood stasis, liver-kidney Yin deficiency, intermingled phlegm and stasis, and wind-phlegm obstructing the collaterals. Association rule analysis identified 39 strong association rules, with Astragali Radix→Chuanxiong Rhizoma having the highest support and Paeoniae Radix Rubra + Persicae Semen→Chuanxiong Rhizoma having the highest confidence. CSVD is a syndrome characterized by deficiency in nature and excess in superficiality, with Qi deficiency and essence depletion as the fundamental aspects, and turbid phlegm and blood stasis as the manifestations. The treatment principles should focus on tonifying Qi, activating blood, and nourishing the liver and kidney, as well as resolving phlegm, dispelling stasis, subsiding wind, unblocking the collaterals, pacifying liver, and subduing Yang.

Ischemic stroke(IS) is a globally prevalent neurological emergency, with its core pathology featuring oxidative stress-driven cascade injury induced by ischemia-reperfusion(I/R). This pathology involves the synergistic amplification of reactive oxygen species(ROS) burst, inflammation activation, and multiple types of cellular damage. Existing therapeutic approaches struggle to achieve simultaneous blocking of multiple targets. TCM, centering on the holistic concept and syndrome differentiation and treatment, exerts therapeutic effects via multiple components and pathways, which are highly compatible with the complex pathological network of IS. Accordingly, TCM has evolved into a key strategy for IS intervention. This article systematically summarizes the initiating and amplifying mechanisms of oxidative stress in the IS pathological cascade, and focuses on reviewing the multi-target intervention systems of TCM. The active components of single herbs precisely target key nodes of the cascade through mechanisms such as antioxidation, anti-inflammation, inhibition of abnormal cell death, protection of the blood-brain barrier(BBB), and metabolic microenvironment regulation. Classic TCM formulae achieve holistic blocking of the cascade loop by virtue of cross-system regulation, multi-link coverage, and clinical scenario adaptability. Novel intelligent drug delivery systems effectively address intracerebral delivery challenges and significantly enhance intervention efficacy. Meanwhile, this article highlights the current core research gaps: inadequate elaboration on the molecular mechanisms underlying the multicomponent synergistic intervention of TCM, insufficient standardization of clinical studies, and delayed translation of drug delivery systems into clinical applications. In the future, it is necessary to rely on interdisciplinary technologies such as systems biology and nanomedicine to deeply decipher the synergistic intervention mechanisms of TCM, and improve the basic-clinical medical translation system. In summary, TCM, through a synergistic blocking model supported by multicomponent empowerment, multi-targeting, and multistage intervention, offers a unique and feasible solution for breaking through the bottlenecks in the clinical treatment for IS and is expected to become a core intervention method for the integrated traditional Chinese and western medicine treatment of IS.

To compare the outcomes of self-expandable (S-EXP) and balloon-expandable (B-EXP) bridging stents used with the E-nside off-the-shelf inner-branch endograft for thoracoabdominal and complex abdominal aortic aneurysm repair within the ItaliaN Branched Registry of E-nside EnDograft (INBREED) registry.

All patients enrolled in the INBREED registry between January 2021 and December 2024 were analyzed. Clinical, anatomical, and procedural data were collected for all target vessels (TVs). The most frequently used self-expandable (S-EXP) and balloon-expandable (B-EXP) bridging stents were identified and compared. The primary endpoint was target vessel instability (TVI), defined as a composite of occlusion, significant stenosis, type Ic/IIIb/IIIc endoleak, kinking, disconnection, rupture, or target vessel-related mortality. Secondary endpoints included technical success and reintervention rates.

A total of 581 target vessels (TVs) from 148 patients were analyzed: 423 (72.8%) were bridged with B-EXP and 158 (27.2%) with S-EXP stents. Overall technical success was 99.5%. During a mean follow-up of 22.1 ± 12.3 months, TVI occurred in 40/581 vessels (6.9%), with a lower incidence in the S-EXP group (3.2%) compared to the B-EXP group (8.3%; p = .03). However, this association did not remain statistically significant at multivariable analysis, which identified only renal target vessels (OR 1.87; 95% CI, 1.05-3.82; p = .045) and pre-existing target vessel stenosis (OR 1.93; 95% CI, 1.13-4.11; p = .047) as independent predictors of TVI.

Inner-branch endovascular repair with the E-nside endograft achieved high technical success and favorable mid-term outcomes. A lower crude rate of target vessel instability was observed with self-expandable stents; however, this association did not remain significant after multivariable adjustment. Renal target vessels and pre-existing stenosis were identified as the main predictors of instability.

Cardiovascular diseases (CVD) are a leading cause of global mortality and disability, with insulin resistance and inflammation indicated by high-sensitivity C-reactive protein (hs-CRP) as key risk factors.

Data from 9,190 participants in a nationwide health and retirement longitudinal study were analyzed. Participants with missing data or a history of stroke or heart disease at baseline were excluded. Baseline TyG-BMI and hs-CRP were measured. CVD events (based on self-reported physician diagnoses) were assessed using standardized surveys. Cox proportional hazards models were applied to evaluate the association of combined TyG-BMI and hs-CRP levels with incident CVD, adjusting for covariates. The reference group comprised participants with TyG-BMI below the median and hs-CRP <1 mg/L.

The presence of elevated TyG-BMI and hs-CRP levels was significantly associated with an increased risk of CVD, with an adjusted hazard ratio (aHR) of 1.215 (95% CI 1.085-1.362). The risk was particularly pronounced in the age group of 45 to 59 years, with an aHR of 1.325 (95% CI 1.131-1.552) for cardiovascular diseases and 1.687 (95% CI 1.143-2.490) for stroke in the 60 to 69 years age group. The study also indicated a nonlinear correlation between TyG-BMI and incident CVD, and a linear correlation for hs-CRP.

The combined elevation of baseline TyG-BMI and hs-CRP is associated with higher incident CVD risk in an aging Chinese population, particularly in middle-aged and older adults. These findings suggest that integrating both markers into clinical risk assessment may help refine cardiovascular risk stratification, pending further validation in independent cohorts.

Electrocardiogram analysis is vital for cardiovascular diagnosis, yet traditional methods struggle with inter-patient variability and complex multi label correlations. Existing Large Language Model integrations often freeze internal parameters, which limits adaptation to idiosyncratic signal patterns across diverse subjects.&#xD;Approach. To overcome these challenges, this study proposes a framework that integrates Large Language Models fine-tuned via Low Rank Adaptation with a multi-label dynamic graph convolutional network. The application of Low Rank Adaptation allows the model to encode specific signal features and mitigate inter-patient variability while retaining essential clinical semantic knowledge. Furthermore, the dynamic graph convolutional module is designed to capture the complex correlations between diverse cardiac diseases, thereby enhancing the modeling of multi-label dependencies. The final inference strategy leverages refined semantic embeddings to achieve accurate classification of diagnostic categories without requiring extensive labeled training data for every new patient population.&#xD;Main results. Experimental results on the PTB-XL dataset yield F1-scores of 0.781 for the five class task and 0.370 for the twenty class task, representing improvements of 12.4% and 12.9% respectively compared to state of the art methods. Evaluation on the CPSC2018 dataset further confirms robust cross-dataset generalization with an F1-score of 0.606, which corresponds to an 18.8% relative improvement over existing approaches.&#xD;Significance. By effectively resolving inter patient variability and modeling disease correlations, the proposed framework provides a scalable and accurate solution for diagnosing cardiac conditions in complex clinical environments where annotated data is limited.&#xD;&#xD.

The bromodomain and extra-terminal (BET) protein family are key epigenetic regulators. Their aberrant expression causes widespread gene dysregulation, which disrupts normal cellular functions and is strongly implicated in diverse human pathologies, including inflammation, cancer, cardiovascular diseases, and central nervous system disorders. Currently, several BET inhibitors have entered clinical trials. However, most are pan-BET inhibitors, whose lack of selectivity is associated with adverse effects such as dose-limiting toxicities and thrombocytopenia. Therefore, the development of highly selective inhibitors targeting individual bromodomains (BD1 or BD2) within the BET family has become a key focus in the field. This review outlines the structure and function of BET proteins and summarizes recent advances in the discovery of domain-selective BET inhibitors. It aims to deepen the mechanistic understanding of BET proteins and lay the groundwork for the rational design of next-generation, high-selectivity therapeutics.

Redox-responsive nanomedicine has emerged as a promising approach for site-selective drug delivery by leveraging pathological redox imbalances. Nevertheless, the majority of systems predominantly depend on glutathione (GSH) as a universal trigger, an assumption that frequently fails to account for the complexity and heterogeneity of endogenous redox biology across various diseases. This review critically evaluates redox-responsive nanomedicine beyond GSH, emphasizing emerging endogenous redox triggers such as reactive oxygen species (ROS), thioredoxin systems, NADPH-dependent pathways, hypoxia, and disease-specific oxidative signatures. We discuss advancements in redox-responsive chemistries, logic-gated and multi-trigger nanocarrier designs, and disease-adapted delivery strategies across oncology, inflammatory, metabolic, cardiovascular, and neurodegenerative disorders. Importantly, we analyze translational bottlenecks responsible for bench-to-bedside attrition and propose design principles to enhance biological relevance, safety, and clinical success. By integrating redox biology with nanocarrier engineering, this review outlines a roadmap toward precision redox-responsive drug delivery.

To characterize prevalence, patterns, and clinical correlates of cardiac involvement in a cohort of patients with Behçet's syndrome (BS) undergoing clinically-driven cardiological assessment.

This retrospective study included adult patients with BS, followed at a tertiary referral center (Florence, Italy), who underwent clinically-driven cardiological evaluation. Clinical, demographic, and therapeutic characteristics were compared in patients with and without evidence of cardiac involvement. Timing, type of cardiac involvement, disease activity, cardiovascular risk factors, and treatments were analyzed.

Among 312 patients with BS, 90 underwent cardiological assessment and 49 had confirmed cardiac involvement. Arrhythmias were the most frequent manifestation (n = 15), followed by pericarditis (n = 12) and ischemic heart disease (n = 8). Cardiac involvement occurred a median of 6.1 (2.5-8.7) years after BS diagnosis, although in a proportion of patients they preceded or coincided with diagnosis. Most patients had active systemic disease at the time of the cardiac involvement (93.9%), and were receiving immunosuppressant treatment (84%). Over 80% had at least one traditional cardiovascular risk factor, yet <40% were receiving cardiovascular primary prevention therapy before the first event. Male patients more frequently experienced ischemic manifestations, while arrhythmias were more common in females. No cardiac-related deaths were observed.

Cardiac involvement in BS is more common than traditionally reported when actively investigated. Cardiac involvement frequently occurs during active disease and in patients with a high burden of cardiovascular risk factors but suboptimal preventive therapy. These findings support the need for integrated cardio-rheumatologic management in BS.

ANCA-associated vasculitides (AAV) are rare diseases characterized by small-vessel necrotizing vasculitis, multiorgan involvement and positivity for antineutrophil cytoplasmic antibodies (ANCA). The main phenotypes are granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA), representing distinct yet partially overlapping entities in terms of pathogenesis, clinical expression and therapeutic management. Patients with AAV face a substantial cardiovascular (CV) and thrombotic risk, with higher rates of myocardial infarction, ischaemic stroke and venous thromboembolism than the general population. The excess CV burden reflects a complex, time-dependent interplay between disease-related inflammation, traditional cardiovascular risk factors and treatment-related toxicity, with inflammatory activity emerging as a key driver of early CV events. Across the disease course, this evolving risk profile requires multidisciplinary management to limit CV damage accrual and related mortality. This review integrates evidence on pathogenesis, clinical manifestations and management of CV disease in AAV, highlighting its time-dependent trajectory and key unmet needs.