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Background Identifying reliable prognostic markers is crucial for the effective management of hypertension. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a potential inflammatory marker linked to cardiovascular outcomes. This study aims to investigate the association of NLR with all-cause and cardiovascular mortality among patients with hypertension. Methods This study analyzed data from 3067 hypertensive adults in the National Health and Nutritional Examination Surveys (NHANES) from 2009 to 2014. Mortality details were obtained from the National Death Index (NDI). Restricted cubic spline (RCS) was deployed to visualize the association of the NLR with mortality risk. Weighted Cox proportional hazards models were employed to assess the independent association of NLR with mortality risk. Time-dependent receiver operating characteristic curve (ROC) analysis was conducted to access the predictive ability of NLR for survival. Mediation analysis was used to explore the indirect impact of NLR on mortality mediated through eGFR. Results Over a median 92.0-months follow-up, 538 deaths occurred, including 114 cardiovascular deaths. RCS analysis revealed a positive association between NLR and both all-cause and cardiovascular mortality. Participants were stratified into higher (> 3.5) and lower (≤ 3.5) NLR groups. Weighted Cox proportional hazards models demonstrated that individuals with higher NLR had a significantly increased risk of all-cause (HR 1.96, 95% confidence interval (CI) 1.52–2.52, p  < 0.0001) and cardiovascular mortality (HR 2.33, 95% CI 1.54–3.51, p  < 0.0001). Stratified and interaction analysis confirmed the stability of the core results. Notably, eGFR partially mediated the association between NLR and both all-cause and cardiovascular mortality by a 5.4% and 4.7% proportion, respectively. Additionally, the areas under the curve (AUC) of the 3-, 5- and 10- year survival was 0.68, 0.65 and 0.64 for all-cause mortality and 0.68, 0.70 and 0.69 for cardiovascular mortality, respectively. Conclusion Elevated NLR independently confers an increased risk for both all-cause and cardiovascular mortality in individuals with hypertension.

Identifying dependable prognostic indicators is essential for the efficient management of metabolic dysfunction-associated steatotic liver disease (MASLD). The index of hemoglobin glycation (HGI) has been demonstrated to be closely linked to the onset and advancement of MASLD. Currently, no studies have investigated the relationship between HGI and mortality rates among MASLD patients. This study analyzed data from the National Health and Nutrition Examination Surveys (NHANES) covering 1999 to 2018, involving 8,257 adult patients diagnosed with MASLD. The HGI was determined using a linear regression model that correlated hemoglobin A1c (HbA1c) with fasting plasma glucose (FPG). The study employed Kaplan-Meier survival curves and weighted Cox proportional hazards models to evaluate the independent association between HGI and mortality risk. The study utilized restricted cubic splines (RCS) to visually depict the relationship between HGI and mortality risk. Over a median follow-up duration of 97.0 months, there were 1,352 recorded deaths, among which 386 were attributed to cardiovascular disease (CVD). Participants were classified into two groups based on their HGI values: the high HGI group (≥ 0.4605) and the low HGI group (< 0.4605). The results from the weighted Cox proportional hazards model indicated that individuals in the high HGI group faced a significantly higher risk of all-cause mortality (HR 1.47, 95% CI 1.19–1.82, P <  0.001). However, no significant increase in CVD mortality risk was observed (HR 1.38, 95% CI 0.95–1.99, P =  0.090). The RCS analysis identified a U-shaped association between HGI and both all-cause mortality and CVD mortality, with critical points at -0.0564 and − 0.0573, respectively. Below the critical points, HGI was negatively correlated with all-cause mortality (HR 0.82, 95% CI: 0.72–0.92, P <  0.001) and not significantly associated with CVD mortality (HR 0.78, 95% CI: 0.57–1.07, P =  0.126). Above the critical points, HGI was significantly positively correlated with both all-cause mortality (HR 1.36, 95% CI: 1.20–1.53, P <  0.001) and CVD mortality (HR 1.44, 95% CI: 1.11–1.88, P =  0.007). Further subgroup and interaction analyses corroborated the reliability of these findings. HGI could potentially function as a useful and dependable marker for evaluating all-cause mortality and cardiovascular mortality in MASLD patients.

Aging is a progressive disease affecting around 900 million people worldwide, and in recent years, the mechanism of aging and aging-related diseases has been well studied. Treatments for aging-related diseases have also made progress. For the long-term treatment of aging-related diseases, herbal medicine is particularly suitable for drug discovery. In this review, we discuss cellular and molecular mechanisms of aging and aging-related diseases, including oxidative stress, inflammatory response, autophagy and exosome interactions, mitochondrial injury, and telomerase damage, and summarize commonly used herbals and compounds concerned with the development of aging-related diseases, including Ginkgo biloba, ginseng, Panax notoginseng, Radix astragali, Lycium barbarum, Rhodiola rosea, Angelica sinensis, Ligusticum chuanxiong, resveratrol, curcumin, and flavonoids. We also summarize key randomized controlled trials of herbal medicine for aging-related diseases during the past ten years. Adverse reactions of herbs were also described. It is expected to provide new insights for slowing aging and treating aging-related diseases with herbal medicine.

Aging is a main risk factor for a number of debilitating diseases and contributes to an increase in mortality. Previous studies have shown that Ginkgo biloba extract (EGb) can prevent and treat aging-related diseases, but its pharmacological effects need to be further clarified. This study aimed to propose a network pharmacology-based method to identify the therapeutic pathways of EGb for aging. The active components of EGb and targets of sample chemicals were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) database. Information on aging-related genes was obtained from the Human Ageing Genomic Resources database and JenAge Ageing Factor Database. Subsequently, a network containing the interactions between the putative targets of EGb and known therapeutic targets of aging was established, which was used to investigate the pharmacological mechanisms of EGb for aging. A total of 24 active components, 154 targets of active components of EGb, and 308 targets of aging were obtained. Network construction and pathway enrichment were conducted after data integration. The study found that flavonoids (quercetin, luteolin, and kaempferol) and beta-sitosterol may be the main active components of EGb. The top eight candidate targets, namely, PTGS2, PPARG, DPP4, GSK3B, CCNA2, AR, MAPK14, and ESR1, were selected as the main therapeutic targets of EGb. Pathway enrichment results in various pathways were associated with inhibition of oxidative stress, inhibition of inflammation, amelioration of insulin resistance, and regulation of cellular biological processes. Molecular docking results showed that PPARG had better binding capacity with beta-sitosterol, and PTGS2 had better binding capacity with kaempferol and quercetin. The main components of EGb may act on multiple targets, such as PTGS2, PPARG, DPP4, and GSK3B, to regulate multiple pathways, and play an antiaging role by inhibiting oxidative stress, inhibiting inflammation, and ameliorating insulin resistance.

Background. Several types of drugs have been recommended for the secondary prevention of myocardial infarction (MI). However, these conventional strategies have several limitations, such as low adherence, high cost, and side effects during long time use. Novel approaches to this problem are still needed. This trial aimed to test the effectiveness and safety of Qi-Shen-Yi-Qi Dripping Pills (QSYQ), a multi-ingredient Chinese patent medicine, for the secondary prevention of MI. Methods and Findings. A total of 3505 eligible patients were randomly assigned to QSYQ group (1746 patients) or aspirin group (1759). Patients took their treatments for 12 months. The final follow-up visit took place 6 months after the end of the trial drugs. The 12-month and 18-month estimated incidences of the primary outcome were 2.98% and 3.67%, respectively, in the QSYQ group. The figures were 2.96% and 3.81% in the aspirin group. No significant difference was identified between the groups. Conclusions. This trial did not show significant difference of primary and secondary outcomes between aspirin and QSYQ in patients who have had an MI. Though inconclusive, the result suggests that QSYQ has similar effects to aspirin in the secondary prevention of MI.

Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a class of widely used hypoglycemic agents for the treatment of type 2 diabetes mellitus (T2DM). In addition to lowering blood glucose, SGLT2i protects the heart and kidney, significantly reduces cardiovascular events, and delays the progression of heart failure and chronic kidney disease. However, previous studies have not exhaustively discussed the association between SGLT2i and the risk of developing cardiac arrhythmias. The purpose of this study is to assess the association of SGLT2i with cardiac arrhythmias in patients with T2DM and without T2DM in cardiovascular outcome trials (CVOTs). Methods: We performed a meta-analysis and systematic review of CVOTs that compared SGLT2i with placebo. MEDLINE, Web of Science, The Cochrane Library and Embase were systematically searched from inception to December 2022. We included CVOTs reporting cardiovascular or renal outcomes with a follow-up duration of at least 6 months. Results: A total of 12 CVOTs with 77,470 participants were included in this meta-analysis (42,016 SGLT2i vs 35,454 control), including patients with T2DM, heart failure (HF), or chronic kidney disease (CKD). Follow-up duration ranged from 9 months to 5.65 years. Medications included empagliflozin, canagliflozin, dapagliflozin and ertugliflozin. SGLT2i were associated with a lower risk of tachycardia (risk ratio (RR) 0.86; 95% confidence interval (CI) 0.79–0.95), supraventricular tachycardia (SVT; RR 0.84; 95% CI 0.75–0.94), atrial fibrillation (AF; RR 0.86; 95% CI 0.75–0.97) and atrial flutter (AFL; RR 0.75; 95% CI 0.57–0.99) in patients with T2DM, HF and CKD. SGLT2i could also reduce the risk of cardiac arrest in CKD patients (RR 0.50; 95% CI 0.26–0.95). Besides, SGLT2i therapy was not associated with a lower risk of ventricular arrhythmia and bradycardia. Conclusions: SGLT2i therapy is associated with significantly reduced the risk of tachycardia, SVT, AF, and AFL in patients with T2DM, HF, and CKD. In addition, SGLT2i could also reduce the risk of cardiac arrest in CKD patients. Further researches are needed to fully elucidate the antiarrhythmic mechanism of SGLT2i.

Technological innovation is regarded as an important means to improve carbon efficiency. However, there is no consensus on this view. Meanwhile, few studies have considered how technological innovation affects carbon efficiency. To this end, this study investigates the influencing mechanism and effects of technological innovation on carbon emission efficiency from the perspectives of industrial restructuring and R&D element flow. It establishes the influencing and mechanism model and then deeply studies the impact and paths of technological innovation on carbon emission efficiency, using panel data from 30 provinces in 1999–2020. Results show that (1) technological innovation improves carbon emission efficiency. (2) Regional differences in the impact effects of technological innovation are evident, with a greater contribution to carbon emission efficiency in eastern region. (3) Innovation improves carbon efficiency through two paths: advanced industrial structure and industrial structure rationalization. (4) The moderating effect demonstrates that the technological innovation’s influence is gradually enhanced with the interregional mobility of R&D personnel and capital. Hence, decision-makers should correctly guide the orderly flow of R&D factors and further improve the carbon emission reduction effect by increasing innovation support and helping optimize the industrial structure.

Under the new development paradigm, the digital economy has emerged as a crucial driver of China’s green development. Utilizing a quasi-natural experiment of the “Broadband China” strategy, this paper examines its impact on carbon productivity through a multi-period difference-in-differences model, a moderating effect model, and a spatial panel model. The findings indicate that the policy significantly enhances carbon productivity. As population size increases, the policy impact initially flattens, then rises, and eventually decreases before flattening again. The effect is particularly pronounced in the eastern and central regions, the southern region, and the first batch of demonstration cities. Furthermore, innovation, financial development, and urbanization amplify the policy’s effectiveness in boosting carbon productivity. From a spatial perspective, the digital economy positively influences carbon productivity of both local and neighboring areas. This research provides insights for further advancing Digital China and accelerating “dual carbon” goals.

This paper addresses challenges in the application of existing colters in Chinese ecological tea plantations due to abundant straw roots and insufficient tillage depth. Aligned with the agronomic requirements of hilly eco-tea plantations, our study optimizes the structural advantages of the joint use of rotary tillage blades and double-disc colters to design an efficient trenching device. Our investigation explores the motion characteristics of a double-disc colter during deep trenching operations, in conjunction with rotary tillage blades. Employing discrete element method (DEM) simulations, this paper aims to minimize the working resistance and enhance the tillage depth stability. Single-factor experiments are conducted to determine the impact of key structural parameters on the tillage depth stability and working resistance. The optimal parameters are determined as a relative height of 80 mm to 120 mm, a 280 mm to 320 mm diameter for the double-disc colter, and a 10° to 14° angle between the two discs. The central composite design method is used to optimize the structural parameters of the double-disc colter. The results indicate that when the relative height is 82 mm, the diameter of the double-disc colter is 297 mm, and the angle between the two discs is 14°, the tillage depth stability performance reaches 91.64%. With a working resistance of merely 93.93 N, the trenching device achieves optimal operational performance under these conditions. Field validation testing shows a tillage depth stability coefficient of 92.37% and a working resistance of 104.2 N. These values deviate by 0.73% and 10.93%, respectively, from the simulation results, confirming the reliability of the simulation model. A field validation test further confirms that the operational performance of the colter aligns with the agronomic requirements of ecological tea plantations, offering valuable insights for research on trenching devices in such environments.

Purpose In this paper, boric acid was loaded on the surface of expandable graphite (EG), polyvinyl alcohol (PVA) and silane coupling agent (KH550) served as a bridge. The purpose of this study was to improve the flame retardant properties of semi-rigid polyurethane, meanwhile, the mechanical properties of the foam got ameliorated. Design/methodology/approach PVA was dissolved in hot water. EG was added to this solution. After stirring for 0.5 h at 85°C in ultrasonic agitation, the system was put at room temperature to cool. The silane coupling agent KH550 was added dropwise into the solution system, stirring to fully hydrolyze. Boric acid was added into the system, placing it in an oven at 90°C to dry after filtration. Changing of flame retardant properties and mechanical properties of semi-rigid polyurethane adding modified EG were characterized. Findings The flame retardant performance of the foam with EG has been improved, whereas the tensile strength decreased with an increase in the content of EG. After adding modified EG, compared to semi-rigid polyurethane with EG, flame retardant performance and tensile strength of the foam improved. Research limitations/implications In the study reported here, the surface of EG was modified by boric acid. The modified EG was added into semi-rigid polyurethane foam. The flame retardant performance and tensile strength of the foam after adding modified EG were discussed. Results of this research could benefit in-depth study of the influence of adding modified EG to semi-rigid polyurethane. The study could promote the application of flame-retardant polyurethane foam. Originality/value The flame retardant performance and tensile strength of the semi-rigid polyurethane were improved by adding modified EG. The effects of modified EG on the flame retardant performance and tensile strength of semi-rigid polyurethane were discussed in detail.