Background: Tanshinone IIA, derived from Radix Salviae Miltiorrhizae (Salvia miltiorrhiza Bunge), constitutes a significant component of this traditional Chinese medicine. Numerous studies have reported positive outcomes regarding its influence on cardiac function. However, a comprehensive comprehension of the intricate mechanisms responsible for its cardioprotective effects is still lacking.Methods: A rat model of heart failure (HF) induced by acute myocardial infarction (AMI) was established via ligation of the left anterior descending coronary artery. Rats received oral administration of tanshinone IIA (1.5 mg/kg) and captopril (10 mg/kg) for 8 weeks. Cardiac function was assessed through various evaluations. Histological changes in myocardial tissue were observed using staining techniques, including Hematoxylin and Eosin (HE), Masson, and transmission electron microscopy. Tunel staining was used to detect cell apoptosis. Serum levels of NT-pro-BNP, IL-1β, and IL-18 were quantified using enzyme-linked immunosorbent assay (ELISA). Expression levels of TLR4, NF-κB p65, and pyroptosis-related proteins were determined via western blotting (WB). H9C2 cardiomyocytes underwent hypoxia-reoxygenation (H/R) to simulate ischemia-reperfusion (I/R) injury, and cell viability and apoptosis were assessed post treatment with different tanshinone IIA concentrations (0.05 μg/ml, 0.1 μg/ml). ELISA measured IL-1β, IL-18, and LDH expression in the cell supernatant, while WB analysis evaluated TLR4, NF-κB p65, and pyroptosis-related protein levels. NF-κB p65 protein nuclear translocation was observed using laser confocal microscopy.Results: Tanshinone IIA treatment exhibited enhanced cardiac function, mitigated histological cardiac tissue damage, lowered serum levels of NT-pro-BNP, IL-1β, and IL-18, and suppressed myocardial cell apoptosis. Moreover, tanshinone IIA downregulated the expression of TLR4, NF-κB p65, IL-1β, pro-IL-1β, NLRP3, Caspase-1, and GSDMD-N pyroptosis-related proteins in myocardial tissue. Additionally, it bolstered H/R H9C2 cardiomyocyte viability, curbed cardiomyocyte apoptosis, and reduced the levels of TLR4, NF-κB p65, IL-1β, pro-IL-1β, NLRP3, Caspase-1, and GSDMD-N pyroptosis-related proteins in H/R H9C2 cells. Furthermore, it hindered NF-κB p65 protein nuclear translocation.Conclusion: These findings indicate that tanshinone IIA enhances cardiac function and alleviates myocardial injury in HF rats following AMI. Moreover, tanshinone IIA demonstrates potential suppression of cardiomyocyte pyroptosis. These effects likely arise from the inhibition of the TLR4/NF-κB p65 signaling pathway, presenting a promising therapeutic target.

To explore the associations of central obesity indicators including waist circumference (WC), waist-to-height ratio (WHtR), and weight-adjusted waist index (WWI) with the impairment of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) among middle-aged and elderly population in China. This prospective study used baseline data from 2011 and follow-up data, involving 6440 and 9646 participants, respectively. Binary logistic regression analysis was used to assess the relationships. Restricted cubic spline (RCS) curve was also used to analyze the correlation trends. Stratified analyses were performed to identify potential differences. Receiver operating characteristic curves were plotted to evaluate the predictive value of each indicator. WC (OR = 1.01, 95% CI:1.01–1.02), WHtR (OR = 1.21, 95% CI = 1.09–1.33), and WWI (OR = 1.10, 95% CI:1.02–1.19) were significantly associated with BADL impairment. Only WWI (OR = 1.16, 95%CI:1.09–1.23) was associated with IADL impairment. WC, WHtR and WWI were linearly associated with BADL impairment while WWI was linearly associated with IADL impairment. The risk association between WWI and BADL was stronger in drinking individuals and males. In the participants with a BMI less than 24 kg/m² and who had received a high school education or above, the increase in WWI was accompanied by a more significant risk of IADL impairment. The predictive ability of WWI is higher than that of WC and WHtR, with AUC values of 0.597 and 0.615. WWI, as a comprehensive indicator of central obesity, may be useful in comprehensively identifying the risk of early daily living activity impairment among middle-aged and elderly population.

As the global population ages, the burden of drug use disorders (DUDs) among the elderly is rising. It is imperative to conduct a quantitative analysis of the disease burden affecting this vulnerable population. Utilize the Global Burden of Disease Study 2021 database to obtain incidence rates and disability-adjusted life years (DALYs) for opioids, cocaine, amphetamines, and cannabis among the elderly (aged 60–89) across 204 countries and 5 SDI regions from 1990 to 2021. Employ Joinpoint regression analysis to calculate the average annual percentage change (AAPC) of age-standardized incidence rates (ASIR) and age-standardized DALYs rates (ASDR). Use the Das Gupta method to decompose and analyze the impacts of changes in age structure, population growth, and epidemiology on DALYs during this period. Finally, apply the Nordpred model to predict DALYs for global and high-burden regions from 2022 to 2035. Of the four DUDs, opioids have the highest disease burden. Joinpoint analysis indicates that from 1990 to 2021, the ASIR and ASDR remained stable. Cocaine use disorder ASIR remained stable, but ASDR increased with an AAPC of 0.94 (95% CI 0.77–1.11). The burden of amphetamine and cannabis use disorders generally stabilized. Geographic heterogeneity was evident at regional and national levels, with ASDR for all four DUDs increasing in high-SDI areas while remaining stable or declining in other SDI areas. High-income North America, represented by the United States, shows a higher burden of disease. Decomposition analysis shows that population growth is the main factor affecting the change in the burden of DUDs in most regions, and high-income North America is mainly affected by epidemiological changes. According to the Predictive models, the DALYs of DUDs in the global elderly population is still on the rise, especially in the man group in North America. The burden of DUDs among the elderly varies across countries, regions, SDI levels, and genders, underscoring the need for targeted public health policy adjustments and strategic allocation of medical resources to mitigate this burden.

Objective: To investigate and compare the associations of body mass index (BMI), waist circumference (WC), a body shape index (ABSI), weight-adjusted waist index (WWI), and waist-to-height ratio (WHtR) with activities of daily living (ADL) impairment among the middle-aged and elderly population in China.Methods: In this study, 8,700 participants from 2011 were included in the cross-section analysis. The prospective study used baseline data from 2011 and follow-up data from 2013, 2015, 2018, and 2020, with a total of 5,945 participants included. Binary logistic regression models were employed in the cross-sectional study to calculate odds ratio (OR) with corresponding 95% confidence interval (95% CI). In the prospective study, Cox proportional hazards regression models were utilized to estimate hazard ratio (HR) with 95% CI. Restricted cubic spline curve was used to identify trends, with subgroup analysis performed. Diagnostic performance was quantified through receiver operating characteristic curve analysis, with area under the curve values computed.Results: In the cross-sectional study, BMI (OR = 0.98, 95% CI: 0.97–1.00) was significantly negatively associated with ADL impairment risk, while ABSI (OR = 1.25, 95% CI: 1.14–1.37), WWI (OR = 1.16, 95% CI: 1.09–1.24) were positively associated with ADL impairment. However, there was no significant association between WC, WHtR and ADL impairment. In the prospective study, WC, WHtR and BMI showed no significant association with ADL impairment, while ABSI (HR = 1.07, 95% CI: 1.01–1.14) and WWI (HR = 1.05, 95% CI: 1.01–1.10) remained positively associated with ADL impairment. Positive linear correlations were observed among ABSI, WWI, and ADL impairment and there was no difference among subgroup variables. The predictive ability of WWI was slightly higher than ABSI, with an AUC value of 0.598.Conclusion: ABSI and WWI were significantly associated with the risk of ADL impairment among the middle-aged and elderly population in China. ABSI and WWI had the potential to serve as superior obesity indicators for identifying individuals at higher risk for ADL impairment.