Diabetic nephropathy is one of the most common complications of diabetic microangiopathy, which significantly reduces the quality of life of diabetic patients and is the main cause of end-stage renal failure. As one of the main drugs in the treatment of diabetes mellitus, metformin plays a vital role in the treatment of diabetic nephropathy. In recent years, studies have found that metformin can not only lower blood sugar through a variety of mechanisms, but also prevent diabetic kidney disease from developing into end-stage renal failure. Several studies have found that metformin has clinical efficacy in the treatment of diabetic nephropathy, and drug safety in patients should be evaluated by glomerular filtration rate. This review summarizes the results of the clinical effects and mechanism of metformin in the treatment of diabetic nephropathy, aiming to better understand the therapeutic effect of metformin on diabetic nephropathy, and provide reference for the treatment of diabetic nephropathy.
Recent studies have identified a trend toward cognitive decline and even progression to dementia in patients with metabolic syndrome (MetS), and Alzheimer's disease (AD) is the most important subtype of dementia. In reviewing the correlation between cognitive impairment due to MetS and development of AD in previous studies, this paper highlights the growing body of data that supports MetS as a whole as well as its components of hypertension and hyperglycemia as risk factors for AD, whereas insulin resistance, neurologic chronic inflammation, and adipokine disorders play important roles in the pathogenesis. Since there are now no viable treatment alternatives available to stop or reverse the degenerative progression of AD, it is expected to provide scientific evidence for a comprehensive strategy for early prevention and treatment of AD by targeting relatively curable MetS for intervention.
Coronary microvascular dysfunction (CMD) and metabolic syndrome (MetS) have attracted much attention recently due to the adverse effects on cardiovascular system. CMD is a potential factor leading to myocardial ischemia, which is closely related to the occurrence, progression and poor prognosis of cardiovascular diseases. MetS is a group of metabolic diseases caused by a combination of genetic and environmental factors. There is an association between CMD and MetS, understanding the complex interactions between the two diseases is essential for developing effective prevention and treatment strategies. This article aims to review the development of MetS and CMD, and the relationship of the components of MetS with CMD, as well as the diagnosis, treatment and future research directions of these diseases.
Multimorbidity have become a major character in the course of chronic diseases that brings a challenge for public health development in China. The development of multimorbidity research in China is in an early stage with fewer literature, and there is a lack of systematic and comprehensive literature analysis.
To conduct a bibliometric and visual analysis of research hotspots and evolutionary trends in the field of multimorbidity in China, grasp the research frontiers and development directions in the field, thereby providing a reference for future research directions.
CNKI (Chinese data source) and WOS (foreign data source) were searched for the literature in the field of multimorbidity researches published by Chinese researchers from 2002 to 2022. CiteSpace software was used to analyze the spatial and temporal distribution of multimorbidity and explore the research hotspots and evolutionary trends in the field of multimorbidity by plotting the collaboration network map of institutions and co-occurrence map of keywords for researches in the field of multimorbidity published by Chinese researchers.
The number of published literatures in the field of multimorbidity showed an increasing trend from 2002 to 2022. The top 5 Chinese keywords were "comorbidity (342 times) " "older adults (161 times) " "depression (155 times) " "chronic diseases (106 times) " "diabetes (94 times) " ; and the top 5 English keywords were "prevalence (126 times) " "older adults (92 times) " "multimorbidity (91 times) " "health (75 times) " "disease (71 times) " . There were 4 development stages in the research development history of multimorbidity: the initial stage of research, the researchers focused on the comorbidity characteristics but did not define it in a uniform way; the second stage of research, the researchers focused on comorbidity and chronic disease in older adults, discovered the high prevalence of multimorbidity in the elderly population; the third stage of research, the domestic researches on multimorbidity developed rapidly, involving influencing factors, comorbidity patterns, polypharmacy, quality of life and debilitation; the fourth stage of research, the definition of multimorbidity is becoming clearer, showing a trend of research diversification.
Researches in the field of multimorbidity is becoming increasingly diversified. Researchers should focus on the prevention and treatment of complex multimorbidity, and construct health management strategies and community intervention programs for multimorbidity population in China.
With the acceleration of population aging, multiple chronic diseases have become common in the elderly, and the research on multiple chronic diseases in the elderly is also increasing. However, few studies have been conducted to analyze its progress and hotspots.
To analyze the hotspots of multiple chronic diseases in the elderly at home and abroad, revealing the hotspots in frontiers research, so as to provide a reference for related researchers to track cutting-edge information.
The literatures related to multiple chronic diseases in the elderly were retrieved from Web of Science, Scopus, CNKI, Wanfang Data, VIP, PubMed, Chinese Medical Association Journal Full-text database, and APA-PsycINFO database of the American Psychological Association with the retrieval time of 2010-2021, based on text mining technology and bibliometrics method, etc. CiteSpace 6.1.3, PASW 18, BICOMB 2.04 and other software were used to analyze and visualize the trends in number of papers published, sources, authors, institutions, keywords and other aspects of literature publication. Strategic coordinate maps were drawn to analyze research hotspots in the field.
Finally, 9 392 literatures related to multiple chronic diseases in the elderly were involved, including 5 776 literatures in foreign language and 3 616 literatures in Chinese. The numbers of literatures related to multiple chronic diseases in the elderly both in foreign language and Chinese have increased exponentially in the past decade, with the annual growth rate of 13.27% in Chinese literature and 15.84% in foreign literature, suggesting the development stage of multiple chronic diseases in the elderly. Five mainstream research hotspots have been identified in both Chinese and foreign literatures. There are more literatures related to multiple chronic disease such as chronic obstructive pulmonary disease, diabetes mellitus, hypertension, and respiratory diseases. The foreign literatures have focused more on the psychiatric comorbidity, followed by somatic comorbidities such as diabetes mellitus, hypertension, and heart failure.
The analysis results shows that the field of multiple chronic diseases in the elderly is in a rapid development stage. Analysis of foreign literature shows that psychiatric comorbidity is a relatively hot topic but not mature enough, research results related to multiple chronic diseases in the elderly are abundant and diversified, but the research depth is in sufficient. Domestic literature analysis shows that chronic obstructive pulmonary disease combined with respiratory diseases in the elderly is at the core of the field, and there is a lack of studies related to psychiatric comorbidity such as depression and mutiple chronic diseases such as health situation, nursing and health care, which may become the main direction of research development in the future.
Multidrug-resistant organisms (MDROs) may increase the risk of nosocomial infection and impose great economic burden on patients' families and society. So it is of great significance to analyze the status, especially hotspots of research on MDROs for further research.
To analyze the research hotspots of MDROs in China from 2000 to 2020.
CiteSpace and bibliometric methods were used to conduct a visualization analysis of studies related to MDROs included in CNKI database of China in recent 20 years, involving the regularity of growth, high-frequency keywords, evolution of research hotspots and so on.
In all, 3 808 studies were included. The number of these studies published during 2000—2020 demonstrated an upward trend in general, and could be divided into five stages: low output (2000—2004) , slow growth (2005—2009) , rapid growth (2010—2015) , relatively stable growth (2016—2018) and further development (2019—2020) . A total of 221 nodes and 302 edges were found by keywords co-occurrence network analysis. And besides MDROs and multidrug resistance, the central value of other 10 of the top 20 most frequently used keywords was equal or over 0.10, including nosocomial infection, multiple drug-resistant bacterial infections, Pseudomonas aeruginosa, ICU, Escherichia coli, drug resistance, antibiotics, Klebsiella pneumoniae, drug sensitivity test, and intensive care unit. The keywords were clustered into 15 clusters by cluster analysis, mainly included the following four themes: multiple resistant strains, multidrug-resistant bacteria infection and prognosis, diseases leading to multiple drug-resistant bacteria infections, generation mechanism and prevention and control of MDROs. The highly cited burst-related words mainly were drug resistant strains, drug resistance, antibacterial agents, and integron from 2000 to 2013, but there were no burst-related words after 2013.
The number of studies about MDROs in China demonstrated an overall upward trend from 2000 to 2020, with nosocomial infection, antibacterial agents, key drug-resistant strains and integron as the research hotspots, but few of them were about surveillance of drug resistance.
