International Health Sciences Journal (online)
eISSN: 3051-6501 The International Health Sciences Journal (online) is developed in cooperation with the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, and was launched in 2025. Being a high quality double-blind refereed Journal, the Journal provides an international forum for discussion of current trends and dissemination of knowledge to support evidence-based clinical practice around the World. SCOPE The Journal accepts articles on Clinical Research in all hospital-based Medical Specialties within the main types of research, including: Treatment Research: Focuses on describing medical treatments, including therapeutic or surgical intervention. Screening Research: Investigates and discusses methods for detecting diseases or conditions early. Diagnostic Research: Seeks to describe, discuss and improve diagnostic tests or tools. Genetic Studies: Examines genetic factors related to disease. The favored types of applied research methods include: Observational Studies; Randomized Controlled Trials (RCTs); Cohort Studies; Case-Control Studies; Case-Reports; Authors are expected to follow the applicable international Guidelines for Clinical research reporting, including: Consort for randomized controlled trials STROBE for observational studies CARE for case reports ARRIVE for pre-clinical animal studies See the link for more information on other Guidelines as defined by the Equator Network: https://www.equator-network.org/reporting-guidelines/ Publishing model: Online (Hybrid Journal) eISSN: 3051-6501 Acceptance Rate (2025): n.a. - Rejection Rate (2025): n.a. Average Days for First Decision in 2025: 10 Days Average Days for Publication Online in 2025: 40 days Publishing Fees (NOT APPLIED DURING 2025 and 2026): Open Access (OA) APC: not defined (this is Optional as the Journal is a Hybrid Journal); Authors are not obliged to Publish in OA (please contact the Editorial Office for details). Most articles published in the Journal are Open Access (optional) and should be freely available for worldwide access. The Journal does NOT charge publishing fees during 2025 and 2026. However, this policy may change in the Future, namely, from the third year of the Journal’s activity. Please contact the Editorial Office for further details: editor@qianfoshan.internationalhealthcarereview.com The Journal is very supportive of professionals and first-time-authors as well as undergraduate and post-graduate MEDICAL students aiming to publish their academic work and reach an international audience. We support our published authors to promote their articles after publishing. We may suggest your article for social media promotion and produce authors' interviews to be disseminated through Podcast or video formats to share your work through global online partners and associated platforms. The Journal is a scientific promoting partner of several annual scientific events. Check our news and subscribe to our newsletters. You can join our international Managing Editor's Linkedin community, with over 23,000 followers, where we welcome our authors and promote their work: https://www.linkedin.com/in/international-healthcare-by-paulo-moreira/ J. Paulo Moreira, PhD | LinkedIn The Journal is CITED-by - CrossRef: All articles will be Archived in: https://clockss.org Since its inception in February 2025 the Journal follows and adopts the principles of the Declaration on Research Assessment (DORA), which is a world-wide initiative designed to improve the ways in which the outputs of scholarly research are evaluated. We’re supporting responsible research assessment practices by rolling out a broader range of journal and article metrics publicly available, and helping authors gain deeper insights into the impact of their work. The Journal is a Signatory of DORA DORA is the International Declaration and Guidance for Transparent and truthful assessment of Research Impact. It aims to combat the many falsified Impact Factor information disseminated by a large number of journals, including many published by the leading global publishers. You can check the DORA (the San Francisco Declaration on Research Assessment) here: https://sfdora.org/read/ The Managing Editor is a member of: The Journal has the support of SAGE Publishing for its Editorial Development and Future Indexation procedures.
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Airway Remodeling and Inflammation in Asthma
Asthma, a chronic inflammatory disorder of the airways, involves a complex interplay between airway inflammation and airway remodeling. While both processes are well-documented, a more nuanced understanding of how they interconnect offers valuable insights for potential novel treatments. Unlike the more traditional perspectives that view inflammation as the primary driver of remodeling, recent studies suggest that airway remodeling can occur independently of inflammation and may itself be an initiator of immune responses. This paradigm shift prompts a reconsideration of how these processes interact and what this means for the treatment of asthma. Asthma is generally characterized by wheezing, chest tightness, and coughing, which result from airflow obstruction and bronchial hyperresponsiveness. It has long been recognized that inflammation is at the core of these symptoms. Various immune cells, including eosinophils, T-helper 2 (Th2) lymphocytes, and innate immune cells, release pro-inflammatory mediators, which damage the airway epithelium and perpetuate inflammation. This leads to airway hyperresponsiveness and contributes to the remodeling process, which involves permanent structural changes in the airways. Interestingly, recent evidence suggests that airway remodeling is not merely a consequence of inflammation but may occur concurrently or even before significant inflammatory changes are detectable. Airway remodeling refers to changes such as epithelial cell damage, subepithelial fibrosis, smooth muscle hypertrophy and hyperplasia, and increased vascularity. These structural alterations contribute to the chronicity and severity of asthma, affecting lung function in a way that often resists conventional anti-inflammatory treatment. One unique perspective is the role of epithelial-mesenchymal transition (EMT) in asthma. EMT, a process by which epithelial cells lose their differentiated characteristics and gain mesenchymal properties, has been increasingly recognized in chronic airway diseases, including asthma. In the asthmatic airway, chronic epithelial injury due to repeated exposure to allergens and pollutants may lead to EMT, which contributes to fibrosis and airway remodeling. EMT can be both a driver and a consequence of inflammation, highlighting a bidirectional relationship. Epithelial cells undergoing EMT can release chemokines and cytokines that recruit immune cells, thereby perpetuating inflammation and exacerbating airway remodeling. This mutual reinforcement suggests that therapies targeting EMT could have a dual effect in mitigating both remodeling and inflammation. Another emerging concept in airway remodeling is the role of airway smooth muscle (ASM) beyond its traditional function as an effector of bronchoconstriction. ASM cells, which undergo hypertrophy and hyperplasia in asthma, are increasingly recognized as active contributors to the inflammatory milieu. ASM cells can produce cytokines, chemokines, and growth factors that interact with immune cells and exacerbate inflammation. Thus, the ASM is not merely a passive responder to inflammation but plays an active role in the chronic inflammatory environment. Targeting ASM signaling pathways that are involved in both contraction and the release of pro-inflammatory mediators may offer a novel approach to asthma management. Fibrosis, characterized by the accumulation of extracellular matrix (ECM) proteins such as collagen beneath the epithelial basement membrane, is a hallmark of airway remodeling in asthma. Traditionally, subepithelial fibrosis was viewed as a downstream consequence of chronic inflammation, primarily driven by cytokines such as transforming growth factor-β (TGF-β). However, more recent findings indicate that fibrosis can develop independently of classic eosinophilic inflammation, suggesting that remodeling may be regulated by non-inflammatory pathways as well. For instance, mechanical forces generated by bronchoconstriction could activate fibrotic pathways in ASM and fibroblasts, leading to ECM deposition. This perspective challenges the conventional reliance on anti-inflammatory treatment alone and underscores the need for antifibrotic therapies. Angiogenesis, or the formation of new blood vessels, also plays a significant role in airway remodeling. Increased vascularity within the airway wall leads to edema and further narrowing of the airway lumen, exacerbating airflow limitation. Vascular endothelial growth factor (VEGF) is a critical mediator of angiogenesis, and its levels are elevated in asthma. Interestingly, studies have demonstrated that anti-inflammatory treatments, such as corticosteroids, do not always effectively reduce VEGF levels, suggesting that angiogenesis may be regulated by pathways independent of those targeted by standard anti-inflammatory drugs. Therefore, anti-angiogenic agents may have potential as adjunctive therapies in asthma to address this aspect of remodeling. The bidirectional relationship between airway inflammation and remodeling suggests that these processes cannot be considered independently. For example, remodeling changes such as ASM hypertrophy can contribute to enhanced airway hyperresponsiveness, leading to increased release of pro-inflammatory mediators from ASM cells. Additionally, epithelial damage, a key component of remodeling, results in the release of "alarmins" such as IL-25, IL-33, and thymic stromal lymphopoietin (TSLP), which activate dendritic cells and innate lymphoid cells, perpetuating type 2 inflammation. This creates a self-reinforcing loop that makes asthma a persistent and difficult-to-control condition. Given the interconnected nature of inflammation and remodeling, combination therapies that target both processes simultaneously may be more effective for long-term asthma control. For instance, biologics targeting Th2 cytokines, such as IL-4, IL-5, and IL-13, have shown promise in reducing both inflammation and remodeling in asthma patients. However, their efficacy in reversing established remodeling remains uncertain. Bronchial thermoplasty, a non-pharmacologic intervention that uses thermal energy to reduce ASM mass, offers another approach to targeting airway remodeling directly. Although bronchial thermoplasty has shown benefits in reducing asthma exacerbations and improving quality of life, it is not universally effective, and its mechanism of action is still being elucidated. The interplay between airway remodeling and inflammation in asthma challenges the traditional view that inflammation is solely responsible for disease progression. The recognition that remodeling can occur independently of inflammation and may itself be a driver of immune responses suggests that targeting structural changes in the airway is crucial for effective asthma management. Therapeutic approaches that address both inflammation and remodeling—including targeting EMT, ASM, fibrosis, and angiogenesis—offer the potential for more comprehensive asthma control and improved outcomes for patients with severe or treatment-resistant disease. Future research should focus on elucidating the molecular mechanisms that link inflammation and remodeling and identifying biomarkers that can predict which patients are most likely to benefit from specific interventions. A deeper understanding of the interdependent relationship between these processes may pave the way for personalized treatment strategies that can effectively break the cycle of inflammation and remodeling, ultimately leading to better management of asthma.
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Current status and prospect in atrial fibrillation
Atrial fibrillation (AF) is the most common tachyarrhythmia and significantly increases the risk of death, stroke, heart failure, cognitive impairment, and dementia. The prevalence of AF increases with age and is 5.4% and 4.9% in men and women over 75 years of age. Electrocardiograms are used as the gold standard in the diagnosis of AF, however it is not always readily available. Wearable devices have greatly improved the diagnosis of AF by providing continuous, non-invasive heart rhythm monitoring. The management of AF is a "CARE" model, including the comorbidities and risk factor management, avoiding stroke and thromboembolism, reducing symptoms by rate and rhythm control, evaluation and dynamic reassessment (Gelder et al.,2024). Mechanism study of AF Current understanding shows that atrial fibrosis, atrial electrical remodeling, autonomic nervous system (ANS) imbalance, epicardial adipose tissue, chronic inflammation and other factors have important effects on the pathogenesis of AF, but the exact mechanism of AF is still not completely clear, and is still the focus of research at this stage. Complications and risk factors management A variety of risk factors can increase the susceptibility to AF and promote the occurrence and maintenance of AF. Patients with AF should be evaluated for cardiovascular risk factors and comorbidities, including obesity, inappropriate exercise, alcohol consumption, smoking, diabetes, hypertension, and obstructive sleep apnea syndrome. Therefore, AF patients should carry out weight control, reasonable exercise, reduce alcohol consumption, quit smoking and other lifestyle improvements, and strictly control blood pressure. In diabetic patients with AF, SGLT-2i reduces the risk of new AF and recurrence after ablation. In addition to the above risk factors, new risk factors will also increase the risk of new onset and recurrence of AF, including hyperhomocysteinemia, hyperuricemia, hypoalbuminemia, etc. It is also important to seek new intervention methods for the prevention and treatment of AF (Yang& Chung, 2023). Stroke prevention The harm of AF is mainly related to the increased risk of thromboembolism and heart failure, and the incidence of stroke and systemic embolism is 5 times that of the general population, so anticoagulation therapy is particularly important. In terms of anticoagulant treatment, the oral anticoagulant drugs used include warfarin and direct oral anticoagulants (DOACs). Currently, there are 4 kinds of DOACs in the world, including dabigatrun, rivaroxaban, apoxaban and edoxaban. Currently in the research phase, Factor XIa inhibitors are theoretically capable of reducing the bleeding risks associated with anticoagulant therapy, potentially significantly enhancing the safety, and the corresponding clinical random trials will provide new powerful evidence (Piccinil et al.,2024). In clinical trials compared with warfarin, DOAC was no worse than or better than warfarin in preventing ischemic stroke and systemic embolization, and the risk of intracranial hemorrhage was significantly reduced. In some patients who cannot use anticoagulants due to contraindications, percutaneous left atrial appendage closure (LAAC) may be an alternative or complementary treatment. However, this strategy requires a period of anti-platelet or anticoagulant therapy after procedure and also carries the risk of bleeding in the brain. In view of intraoperative risks, postoperative device-related thrombosis and residual leakage, the main guidelines currently recommend LAAC for patients with contraindicated anticoagulation therapy. Large-scale clinical studies comparing LAAC and DOAC are still underway, and new research results are expected to guide clinical practice (Mills et al., 2024; Waranugraha et al., 2024). Rhythm and rate control Safe and effective rhythm control is an ideal strategy for AF treatment. At present, antiarrhythmic drugs (AADs) and catheter ablation are the main methods of rhythm control. Compared with AADs, catheter ablation significantly reduces the risk of AF recurrence and cardiovascular hospitalization. In particular, as a first-line treatment for paroxysmal AF, catheter ablation has shown considerable advantages. In terms of ablation strategies, pulmonary veins are the most common source of ectopic electrical activity to trigger AF, and achieving pulmonary vein electrical isolation (PVI) should be the basis for catheter ablation of AF. For persistent AF, the success rate of PVI alone is lower. Currently, different centers combined additional ablation strategies based on PVI, including linear ablation, matrix modification (complex disruptive potential ablation), rotor ablation, posterior wall isolation, ablation of external pulmonary vein triggering focus, and left atrial appendage isolation, etc. However, the effectiveness of these ablation strategies remained controversial. Marshall intravenous anhydrous alcohol ablation can improve the mitral isthmus block rate and significantly improve the success rate of ablation of persistent AF. In terms of energy sources for ablation, radiofrequency ablation and cryoballoon ablation had similar safety and efficacy in studies with PVI as the end point of ablation. Pulsed electric field ablation can selectively act on cardiomyocytes in theory, but has little effect on adjacent tissues such as blood vessels, nerves and esophagus. A number of clinical studies have shown that it has good safety and efficacy. However, the potential adverse effects of pulsed electric field ablation, such as the risk of intraoperative anesthesia, coronary artery spasm, asymptomatic brain injury, and tracheal injury, need to be further evaluated and understood (Natale et al.,2024). For patients with long-standing persistent and permanent AF, when the potential benefits of maintaining sinus rhythm are outweighed by the risks or it becomes impossible to maintain sinus rhythm, a rate control approach should be pursued to alleviate patient symptoms. For patients who cannot control ventricular rate with drugs, atrioventricular node ablation combined with cardiac resynchronization therapy or physiological pacing is a reasonable choice (Su et al., 2020). Dynamic assessment Regular review is very important for the prognosis of patients with AF, including regular ECG, blood tests, cardiac imaging, holter ECG, and other necessary imaging tests. This includes the assessment of existing and new risk factors and comorbidities, the re-stratification of stroke and thromboembolism risk, the examination of AF symptoms before and after treatment, the assessment and management of modifiable risk factors, and the development of treatment strategies through assessment at each stage. Conclusion AF is a major medical problem and its complex pathophysiological mechanism has become an important factor that puzzles the treatment. The integration of wearable devices, next-generation novel anticoagulants, catheter ablation strategies and new technologies of energy with interventional treatments such as LAAC has the potential to change the management strategy of AF. Research efforts should continue to unravel the mysteries surrounding AF and improve patient outcomes.
The culprit of chronic complications of diabetes-from glucose to insulin resistance
The prevalence of diabetes and its complications has been increasing exponentially worldwide, especially in China with approximately one-quarter of the global diabetes population. And constitute a major public health problem (Diabetes in China part 1, 2024). As hyperglycemia is the distinguishing feature of diabetes, and also supposed to be the most important risk factor for long-term complications in diabetes by evidence from clinical trials and longitudinal population-based studies (Buse JB et al., 2020), controversy over the target level of glucose control in diabetes lasted more than a decade. The two earliest trials in type 2 diabetes, the United Kingdom Prospective Diabetes Study (UKPDS) in 1970 and the University Group Diabetes Program (UGDP) study in 1998 did not reveal a reduction of cardiovascular endpoints through improved metabolic control(C L Meinertet al., 1970; UK Prospective Diabetes Study (UKPDS) Group,1998). Therefore, the effect of improved glucose control on coronary complications in this population remains questionable. After 2006, three randomized control trials (ACCORD, ADVANCE, Veterans Affairs Diabetes), assessed the impact on cardiovascular events of intensive glucose-lowering therapy (Gerstein HCet al., 2008; Goff DC Jr et al., 2007; Patel A et al., 2008; Robins et al., 2007). None of these studies was able to demonstrate a significant reduction of cardiovascular outcomes in the intensive group (with a HbA1c target of less than 6.0%) as compared to the standard group (with a HbA1c target of 7.0% to 7.9%). Unexpectedly, the ACCORD study was terminated early because of a higher mortality in the intensively group. In contrast, in ACCORD, the study with the most ambitious goal (HbA1c < 6%), the overall and cardiovascular mortality was greater in the intensive group. Meanwhile, in the ADVANCE trial, the mortality and the incidence of cardiovascular events were not statistically different between the two treatment groups. Notably, Veterans Affairs Diabetes study showed that the effect of better glucose control on cardiovascular complications disappeared with duration of the disease and that the risk of cardiovascular events increased in patients with severe hypoglycemic events (Robins et al., 2007). The hypoglycemic risk was finally increased in the intensive group, which may contribute to reduce the positive impact of better glucose control on cardiovascular complications. Therefore, Prof. BYRON J. HOOGWERF, an investigator in the ACCORD trial, once asked” Is glucose a culprit, or does it just run in bad company?”. Glycemic profiles could not fully explain the presence/absence and severity of chronic complications of diabetes. Diabetes shared a common feature of chronic hyperglycemia that results from defects of insulin secretion, insulin action, or both. As early as in the prediabetes, insulin levels began to increase leading to chronic hyperinsulinemia, hyperglycemia-induced β-cell failure, and eventually to type 2 diabetes (Kahn SE, 2003). As the sole hypoglycemic hormone in the body, insulin is an important anabolic hormone and a pivotal regulator of to transform nutrient from production to storage when our body faced nutrient scarcity. In adipose tissue or skeletal muscle and other key storage and consumption sites, insulin can promote carbohydrate uptake. As a result, carbohydrates and proteins are stored as lipids. However, in modern society, western diet, stress, and sedentary lifestyles disrupt the balance and might cause insulin resistance and the subsequent various metabolic abnormalities in proteins, lipids, and carbohydrates (Lee SH et al., 2022). Hyperinsulinemia is considered as the pathogenic driver of many modern diseases, including cardiovascular disease and even cancer (Chiefari E et al., 2021). Many studies indicated that insulin resistance contributes to cardiovascular disease (CVD) risk in patients with diabetes. In patients with diabetes, insulin resistance is associated with a cluster of cardiometabolic risk factors that contribute to the increased risk of cardiovascular disease (Antonino& Ralph A, 2019). The presence of insulin resistance was traditionally regarded as a pathogenic character of type 2 diabetes, however, evidence from clinical practice and public studies indicated it might be common in type 1 diabetes, both in youth and adults. Results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study revealed that 36% of patients with type 1 diabetes showed evidence of insulin resistance.[13-14] In type 1 diabetes, insulin resistance has been reported as an additional risk factor for CVD and all-cause mortality (Sun R et al., 2024).And in routine clinical practice, we constantly encounter patients with type 1 diabetes or even the specific types of diabetes exhibiting severe insulin resistance. For example, the most common type of monogenic diabetes is maturity-onset diabetes of the young (MODY). In one of our MODY 3 patients, which should be characterized as young-onset hyperglycemia, evidence of residual pancreatic function, and lack of beta cell autoimmunity or insulin resistance. Insulin resistance was obvious and the glucose levels were difficult to maintain normal. In conclusion, the treatment of diabetes should be focused on the therapeutic strategies for insulin resistance, which include lifestyle modifications and weight loss. Moreover, the insulin-sensitizing antidiabetic drugs, such as thiazolidinediones, has been shown to reduce cardiovascular events and retard the atherosclerotic process in high-risk patients with diabetes (Antonino& Ralph, 2019). Although glucagon-like peptide-1 (GLP-1) stimulates insulin secretion by β-cells to improve hyperglycemia, they might reduce insulin resistance by weight loss. And the newly launched dual GIP/GLP-1 receptor co-agonist, for example, Tirzepatide, has already been found to improve insulin sensitivity and insulin secretory responses (Nauck & D'Alessio, 2022). Although we have known about diabetes for hundreds of years, we still need more efforts to explore the treatment and prevention of this sweet burden.
Clinical research must follow a set of principles that fall into internationally recognized ethical research guidelines. Amongst the most relevant aspects, it is accepted that the Social and clinical value of all published research should be clear, as well as its Scientific validity, a transparent subject and topic selection free from conflicts of interest. Other international guiding principles include independent reviews, informed consent when required and respect for all potentially enrolled individuals. Additionally, it is also recognized internationally that a favorable risk-benefit ratio of the published research should be demonstrated and its social and clinical value should also be argued. All studies are designed to answer a specific research question, or the problem tackled by the published article. The answer should be important enough to justify the effort of publishing. In other words, answers to the research question should contribute to promote a better scientific understanding of disease processes, diagnosis or therapeutic or other type of clinical intervention. Hence, the challenge of avoiding bias in clinical research has been identified as a rather challenging ethical issue which an ongoing current international debate. This new journal will provide us with an excellent platform. It will bring together the wisdom of the field on a global scale, facilitating a meeting of the minds and helping us to overcome the current challenges. By publishing the in International Health Sciences Journal, your research results will gain wider international exposure and attract the attention of global peers, thus further promoting the development of your research. At the same time, the rigorous peer-review mechanism will ensure that each article will be strictly controlled in terms of academic quality, which will help you to continuously improve your research methodology and research level. I would like to appeal to all readers to actively contribute to this journal. Whether you are an experienced scholar or a newcomer to the field, this journal will be ideal for you to share your wisdom and exchange experiences. Here, your voice will be heard by your peers around the world, and your research will contribute to the advancement of the entire health sciences field. Let's work together to bring vitality and creativity to the International Health Sciences Journal!
The Key Role of Nutritional Interventions in the Prevention and Control of Chronic Diseases
With the advancement of economic development and changes in lifestyle, chronic diseases have become a significant global health threat and economic burden. According to the World Health Organization (WHO) (WHO, 2023), approximately 41 million people die each year from chronic diseases, accounting for 74% of all global deaths. Cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes together account for more than 80% of chronic disease-related mortality. Numerous studies show that 86% of cardiovascular diseases, 73% of diabetes-related deaths, and 70% of cancer-related deaths could be prevented or controlled through effective interventions. However, traditional medical approaches primarily focus on disease treatment and have not fundamentally addressed the rising health and economic burden posed by the increasing prevalence of chronic diseases. In recent years, mounting evidence has highlighted the critical role of dietary and nutritional interventions in both the prevention and management of chronic diseases. This paper aims to review the latest advances in nutritional interventions for chronic disease management, particularly focusing on salt reduction, sugar reduction, and dietary pattern interventions, and to propose new insights for integrating nutritional strategies into chronic disease management. Dietary factors are key contributors to the development and progression of chronic diseases, with salt intake, sugar consumption, and dietary patterns being major areas of current research. Studies have shown that high salt intake significantly increases the risk of hypertension and cardiovascular diseases, particularly among middle-aged and older populations. Currently, global salt consumption far exceeds the recommended levels outlined in health guidelines, which poses a severe threat to public health. Salt reduction interventions have yielded significant success in controlling hypertension and cardiovascular diseases in several countries and regions. For example, the UK has reduced the average salt intake of adults by lowering the salt content in processed foods; the US, Finland, and Australia have implemented health education, food industry standard reforms, and promoted low-sodium alternatives, all contributing to decreased salt intake and improved cardiovascular health outcomes. In contrast, high-salt diets are prevalent in China due to different dietary habits compared to Western countries, leading to persistently high rates of hypertension and cardiovascular diseases. In response, the Chinese government has made positive strides through public health education, reducing salt usage in the food industry, and promoting low-sodium salts, particularly in areas such as Shandong Province, effectively reducing salt intake and blood pressure levels (Xu et al., 2011). Research has also shown (Huang et al., 2023) that dietary sugar intake is a significant risk factor for endocrine and metabolic diseases, cardiovascular diseases, and cancer, especially cardiovascular metabolic diseases. Meta-analysis results suggest that reducing the intake of free or added sugars to below 25g per day (approximately 6 teaspoons) can mitigate adverse health effects. To reduce sugar consumption, the UK implemented the "Soft Drinks Industry Levy" in 2018, which effectively reduced the consumption of sugary beverages and successfully lowered obesity rates among children and adolescents. Similarly, countries such as Mexico, France, and Singapore have also used measures such as sugary drink taxes and health education to successfully reduce obesity rates and decrease the incidence of cardiovascular and metabolic diseases In addition to targeting individual nutrients, dietary patterns have gained attention as a comprehensive intervention strategy. Research has shown that dietary patterns such as the Mediterranean diet and plant-based diets can effectively reduce the incidence and progression of various chronic diseases, including cardiovascular diseases, cancer, and diabetes. These dietary patterns emphasize a balanced approach to food, increasing the intake of plant-based foods and healthy fats, thereby promoting overall nutritional balance. A study published in The Lancet (Springmann Met al., 2018 ) proposed that sustainable dietary patterns should be developed based on the economic conditions and environmental factors specific to different regions, with the goal of achieving both improved health outcomes and reduced environmental impact. In conclusion, nutritional interventions play a crucial role in the prevention and management of chronic diseases. Whether through salt reduction, sugar reduction, or adopting healthy dietary patterns, these measures can significantly reduce the risk of chronic disease development. However, single interventions are often limited in their effectiveness. Therefore, it is essential to advocate for a multi-faceted approach to chronic disease management, including policy guidance, community support, health education, as well as physical activity promotion, smoking cessation, and alcohol moderation. Such a comprehensive strategy is necessary to effectively control chronic diseases and to drive global health improvements to new heights. International Health Sciences Journal is an international academic journal dedicated to advancing innovative research and knowledge sharing in the global health field. We call upon more colleagues to actively contribute and engage in discussions on effective measures for the prevention and control of major chronic diseases, with the aim of improving global health outcomes.
The present situation, breakthrough and challenge in the development of thoracic surgery
The incidence and mortality of lung cancer and esophageal cancer in China are among the top in the world. Most patients have reached the middle and late stage when diagnosed. The five-year survival rate of lung cancer is only 16%, and that of esophageal cancer is less than 20%. Obviously, early diagnosis and treatment is the key to improve the survival rate of patients, and the healthy development of thoracic surgery plays an important role in improving the quality of life of patients with chest tumors. At present, the field of thoracic surgery is being strongly driven forward by ten key directions. "Surgical robot digital medical" integrates top technology, high-precision robotic arm and intelligent imaging system, making surgical operation accurate and micro, opening up a new situation for the treatment of complex diseases; "Lung Transplant Surgery Practice" to overcome the problems of lung source acquisition, surgical anastomosis, anti-rejection, for patients with end-stage lung disease to continue life. "Accelerated rehabilitation surgical process management" runs through the whole perioperative period, fine-adjusting fasting and drinking, precise analgesia, and encouraging early activities of patients to shorten hospital stay and improve medical experience. "Fine control of Medical quality" strictly controls all aspects of medical treatment, standardizes the diagnosis and treatment process with high standards, supervises medical behavior, and ensures that patients receive homogeneous, efficient and safe services; "Multidisciplinary collaborative diagnosis and treatment" breaks the disciplinary barriers, integrates the wisdom of internal medicine, surgery, imaging, pathology and other professionals, and tailors the best comprehensive treatment plan for difficult and complicated diseases; "Perioperative health management model construction" covers the whole surgical cycle, accurate preoperative assessment, careful care during the operation, and continuous follow-up after the operation to help patients smoothly through the surgical period. "Tumor comprehensive treatment strategy" gets rid of the shackles of single therapy, organically combines surgery, chemotherapy, radiotherapy, targeting, immunity and other therapeutic means, and develops a personalized anti-cancer path according to tumor characteristics and individual differences of patients. "Minimally invasive surgical operation technology" with the aid of small incisions and endoscopy can reduce the pain of patients while accurately removing lesions and accelerating recovery. The "Young Doctor Training System" cultivates reserve talents with both morality and talent through systematic training, tutor teaching and practical exercise. "Cutting-edge Medical Technology integration Application" advocates cross-field technology integration, such as bioprinting and tissue repair, artificial intelligence assisted diagnosis, etc., to promote medical innovation. However, the road to thoracic surgery has been rocky. On the one hand, the busy clinical work makes the data collection more quantity than quality, the database repeated entry, low efficiency, incomplete data and poor sharing, and the national unified database that meets international standards is still lacking, which restricts the healthy development of the discipline. On the other hand, the problem of domestic scholars' papers emphasizing quantity over quality still exists, and some lack of innovation, difficult to solve clinical practical problems, low citation rate, and difficult to transform basic research. Moreover, the domestic guidelines do not consider the local characteristics, and the self-developed guidelines lack channels and mechanisms for promotion. In addition, there are still problems such as uneven distribution of medical resources, large gap between urban and rural areas, low urban-rural integration of multidisciplinary diagnosis and treatment mode, and limited comprehensive diagnosis and treatment level. Despite the difficulties, thoracic surgery has made many achievements with the help of modern technology. Looking forward to the future, practitioners need to work together to tap the potential of data, improve the level of scientific research, improve and promote clinical guidelines, narrow the gap between urban and rural medical care, promote thoracic surgery to a new height, inject great strength for "Healthy China 2030", and provide patients with better medical services
Deep brain Stimulation (DBS) : A leap from history to the future
Deep Brain Stimulation (DBS), as a revolutionary method of neuroregulation, has shown remarkable efficacy in the treatment of movement disorders such as Parkinson's disease and dystonia. In recent years, with the continuous advancement of technology and the expansion of research fields, DBS is gradually becoming a key tool in the exploration of complex neurological and psychiatric disorders. This paper briefly reviews the history, current research hotspots and future challenges of DBS, and sincerely invites academic colleagues to actively participate in the exploration and submission of this field. History: From creation to prosperity The origins of DBS technology can be traced back to functional neurosurgery in the 20th century. Early advances in functional localization technology enabled neurosurgeons to accurately locate intracranial structures and perform lesion excision with stereotactic devices, but these operations were often associated with irreversible nerve damage and significant side effects. In the 1950s, high-frequency electrical stimulation was first shown to be effective in inhibiting abnormal nerve signaling, thereby relieving symptoms of tremors and dyskinesia. In the 1980s, a research team in Grenoble, France, pioneered the application of high-frequency stimulation to the subthalamic nucleus to treat Parkinson's disease, and achieved a therapeutic effect comparable to, but more adjustable and reversible than, focal resection surgery (Limousin et al., 1995). This milestone has been hailed as "another miracle in the treatment of Parkinson's disease after levodopa." Since then, DBS technology has been gradually promoted and expanded to other movement disorders and mental illness treatment areas. Current research focus: the dual progress of technology and mechanism In recent years, the development of DBS technology has entered a new stage of interdisciplinary and innovation-driven development. The following three directions are the main research hotspots at present: (1) Exploration of new targets: In addition to the traditional subthalamic nucleus and medial pallidal nucleus, researchers are actively exploring potential new targets such as the amygdala, hypothalamus and mesencephalic limbic system. These regions may play a key role in mood regulation, memory improvement, and the treatment of anxiety disorders. For example, amygdala DBS for patients with depression has shown initial efficacy, opening up new avenues for psychiatric treatment (Davidson B et al., 2020). (2) Closed-loop stimulation technology: Traditional DBS adopts continuous open-loop stimulation mode, while closed-loop stimulation technology promotes DBS to develop in a more personalized and accurate treatment direction through real-time monitoring of nerve electrophysiological signals and dynamic adjustment of stimulation parameters. In patients with Parkinson's disease, closed-loop stimulation using β-band (13-35 Hz) abnormal neural oscillatory activity as a feedback design has been shown to be effective in improving motor symptoms and reducing side effects (Neumann WJ et al., 2023). (3) Mechanism of action: Current studies on the mechanism of DBS mainly focus on the oscillation of neural networks and the regulation of synaptic plasticity. For example, DBS can reduce abnormal neural oscillations in the β-band of Parkinson's patients, and affect cognitive function by inducing changes in synaptic plasticity such as long-term enhancement or long-term inhibition (Gao Y et al., 2024). Challenges and opportunities Despite the great success of DBS technology in the treatment of movement disorders, there are still many challenges to its application in other areas: (1) Specific stimulation targets: Different patients have significantly different responses to DBS targets. How to identify the optimal target location according to the pathological characteristics and needs of patients through advanced imaging technology such as ultra-high field intensity (7T) magnetic resonance, combined with image reconstruction technology, is the focus of future research. (2) Long-term efficacy and safety: The short-term efficacy of DBS has been proven, but its long-term efficacy is still controversial. Some patients experience reduced efficacy for several years after treatment, which may be related to disease progression or tolerance at the site of irritation. Device-related complications, such as electrode displacement and infection, also require further improvement. (3) Mechanism of DBS in complex diseases: For psychiatric diseases and cognitive disorders, the mechanism of DBS is still in the stage of exploration due to the complexity of the disease mechanism itself. Paying attention to the mechanism of DBS at micro, mesoscopic and macro scales is helpful to form a comprehensive analysis of the mechanism of DBS. Outlook and appeal The development of DBS technology provides an important opportunity for the deep cross-integration of neuroscience and clinical medicine. In the future, the deep integration and continuous innovation of closed-loop stimulation technology, neuroimage navigation and artificial intelligence will promote DBS treatment to a higher level of personalization and precision. As a multi-disciplinary frontier technology, the development process of DBS needs the joint efforts of researchers in various fields. The founding of the International Health Sciences Journal has established an important platform for academic exchanges in the field of neuroregulation. We sincerely invite academic colleagues to contribute actively, share research results, and promote the development of the field.
Key challenges and future prospects of microwave ablation in the treatment of small pulmonary nodules and early lung cancer
Driven by the rapid development of minimally invasive surgical techniques, the treatment of small lung nodules and early lung cancer has ushered in epoch-making changes. In particular, Microwave ablation (MWA) technology, as a potential treatment for the treatment of small lung nodules and early lung cancer, received high attention in the industry. MWA, with its unique advantages of minimally invasive, rapid recovery and low complication rate, is gradually subverting the traditional nodule/early lung cancer treatment model. However, although MWA has achieved remarkable results in the clinical treatment process, it still faces some key challenges. The purpose of this article is to explore these key challenges in depth and to look into the future development of microwave ablation in the treatment of pulmonary nodules/early lung cancer. Microwave ablation is a minimally invasive treatment that uses microwave energy to generate heat, effectively destroy tumor cells while maximizing the preservation of surrounding healthy lung tissue. Its significant effectiveness and safety have been widely recognized in the industry, providing an alternative for lung nodules and early lung cancer patients who are not suitable for surgery and cannot tolerate surgery. However, there are still several challenges in clinical practice: Precise location and puncture of pulmonary nodules and lung cancer. It is a challenge to accurately identify and puncture small lung nodules and early lung cancer, especially the aerated organs in the bidirectional movement of exhalation and inhalation in the lung at this moment, and the difficulty of accurate positioning and puncture is much higher than that of other organs. Our team first proposed the concept of "tumor ablation area". Firstly, the concept of multi-dimensional properties of "tumor lesion area (GTR)" and "post-ablation target area (PTZ)" in ablation was proposed, which laid a theoretical foundation for accurate ablation and complete ablation. The technical indexes such as puncture point marking, puncture diameter, target skin distance, tumor lesion area and ablation parameters were quantified. With the wide application and promotion of clinical assisted robot technology, intelligent surgical navigation robot + MWA will become a safe, reliable and extremely minimally invasive solution in the future, which can conduct real-time interactive navigation throughout the operation, short operation time, accurate positioning and puncture, effectively reduce the number of needle insertion, and reduce the risk of pneumothorax and bleeding. Real-time thermal field monitoring and control. Ensuring that heat is evenly distributed during ablation, while avoiding thermal damage to surrounding healthy tissue, is a major challenge in our clinical treatment. Real-time thermal monitoring systems and improved algorithms for controlling ablation areas are essential to prevent complications and optimize treatment outcomes. Our team took the lead in proposing the concept of "tumor ablation zone", first proposed the concept of multi-dimensional properties of "tumor lesion area (GTR)" and "post-ablation target area (PTZ)" for ablation, which laid a theoretical foundation for accurate ablation and complete ablation. At the same time, we created a "three-dimensional visualization planning system" and carried out multi-mode thermal field simulation to simulate the entire ablation process. In the future, the development of a monitoring system that can monitor the temperature and range of the ablation site in real time will greatly promote the accuracy of ablation technology and achieve a higher level of precision ablation therapy. Reduce complications. Although MWA is considered efficient and safe, there are potential risks, including pneumothorax, hemorrhage, pleural effusion and thermal damage to the surrounding structure. Our team developed a new coaxial double-slit rigid water-cooled 19G ablation antenna to reduce the occurrence of complications, and the incidence of pneumothorax, hemorrhage and pleural effusion decreased by 29.0%, 28.9% and 9.9%, respectively. Future development of smaller, more accurate antennas and advanced thermal monitoring systems will be critical to reducing complications and improving patient safety. Reduce in situ recurrence and enhance the distant effect. The integration of multidisciplinary treatment plans requires collaborative research efforts by multidisciplinary teams of oncologists, pathologists, radiologists and surgeons. The use of MWA in combination with chemotherapy, radiotherapy or immunotherapy can effectively reduce the rate of recurrence in situ while enhancing the distant effect. Going forward, we intend to conduct large-scale randomized clinical trials to verify the safety and efficacy of these regiments. Further standardize the technical system. In order to promote the further standardization of the technical system, our team has played a leading role in the successful development and release of 7 domestic and foreign industry guidelines, consensus and norms. These include the world's first "Clinical practice guidelines on image guided thermal ablation of primary and metastatic lung tumors (2022 edition). Looking ahead, our team will continue to focus on deepening research to ensure that the technology system is more complete to meet clinical needs and promote the improvement of medical quality. On the historic occasion of the founding of the International Health Sciences Journal, we offer our best wishes and congratulations. We call on scholars and experts to give full play to the unique role of the International Health Sciences Journal as an academic exchange platform, and actively contribute to disseminate their valuable research results to all parts of the world. We believe that this will bring great benefits to researchers and clinicians, while also strongly promoting technological progress and innovation in the field of minimally invasive therapy. Let us work together to contribute to the prosperity and development of this sector.