Abstract The prevention and control of myopia in Chinese children and adolescents has become a major public health issue. While maintaining increased outdoor activity as a cornerstone intervention, there is an urgent need to explore new complementary approaches that can be effectively implemented in both indoor and outdoor settings. In recent years, environmental spatial frequency has gained increasing attention as one of the key environmental factors influencing the development and progression of myopia. Both animal studies and human research have confirmed that indoor environments lacking mid to high spatial frequency components, often characterized as "visually impoverished", can promote axial elongation and myopia through mechanisms such as disruption of retinal neural signaling, impaired accommodative function, and altered expression of related molecules. Based on the scientific consensus, it is recommended that "enriching of environmental spatial frequency" should be integrated into the myopia prevention and control framework. Following the principles of schoolled organization, family cooperation, community involvement, and student participation, specific measures are put forward in three areas：optimizing school visual settings, improving home spatial environments, and promoting healthy visual behavior. The aim is to create "visually friendly" indoor environments as an important supplement to outdoor activity, thereby providing a novel perspective and strategy for comprehensively advancing myopia prevention and control among children and adolescents.

Objective: To analyze the causes and distribution characteristics of leukopenia in apheresis platelet donors, and to formulate effective pre-donation intervention measures. Methods: The data of apheresis platelet donors with leukopenia in Dongguan Central Blood Station during the entire year of 2021 were collected. Combined with the results of peripheral blood smear examination, the related factors that may cause leukopenia were analyzed. Results: There were 57 apheresis platelet donors with leukopenia in peripheral blood, with an incidence of 1.53% (57/3 726). The rate of leukopenia showed no significant difference between male and female apheresis platelet donors (χ =0.627, P>0.05), and was not related to the frequency of platelet donation (χ =1.48, P>0.05). However, there were statistically significant differences in the rate of leukopenia across seasons (χ =10.13, P<0.05), highly significant differences among different age groups (χ =22.98, P<0.001), and a significant association with the number of apheresis platelet donations (χ =7.80, P<0.05). Multivariate logistic regression analysis showed that age (36-55 years old), number of donations (≥26 times), and season (first and fourth quarters) were independent risk factors for leukopenia in apheresis platelet donors, while gender had no significant independent effect on leukopenia. Peripheral blood smear examination was performed on all apheresis platelet donors with leukopenia, and primary malignant hematological diseases infiltrated into peripheral blood were excluded. Among them, two cases of peripheral blood smear showed left shift of granulocyte nucleus with increased and thickened granules, whereas the other 55 cases only showed decreased peripheral blood nucleated cell counts without obvious morphological abnormalities. Conclusion: Leukopenia in apheresis platelet donors mainly occurred in young and middle-aged people and those with ≥26 donations, with high incidence in winter and spring, and more common in males. Blood routine examination combined with blood smear examination can facilitate the detection of conditions that are not suitable for blood donation, including hematological malignant diseases and infection-related leukopenia. Strengthening health consultation before blood donation is an important measure to identify blood donors with leukopenia.

Based on the theory of "disease of both blood and water" in Essentials from the Golden Cabinet （《金匮要略》）， and in combination with the dynamic syndrome evolution of heart failure with preserved ejection fraction （HFpEF）， this paper systematically clarifies the pathomechanism of HFpEF， characterized by yang deficiency as the root， blood stasis as the pivotal factor and water retention as the manifestation. Accordingly， the therapeutic principles have been proposed， which are warming yang and banking up original qi to consolidate the root， activating blood and unblocking collaterals to smooth the mechanism， and promoting urination and regulating pivot to remove the branch. On this basis， a compound formula structure of "one monarch， one minister and one assistant" is established， forming an integrated intervention strategy that synergistically combines the three methods of warming yang， activating blood， and promoting urination through combined classical formulas. Zhenwu Decoction （真武汤）， which warms yang and dissolves rheum， is used to consolidate the root and directly target the source of yang deficiency， serving as the monarch； Guizhi Fuling Pills （桂枝茯苓丸）， which activates blood， promotes urination and unblocks the pivot， assists in interrupting the binding of blood stasis and water retention， serving as the minister； Tingli Dazao Xiefei Decoction （葶苈大枣泻肺汤）， which regulates qi， disperses retained fluids， and eliminates the manifestation， alleviates acute water-retention symptoms， serving as the assistant. This compound formula is warming without being drying， diuretic without being drastic， and dispels stasis without consuming blood， thereby achieving the therapeutic effects of warming yang， activating blood， and promoting urination.

As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

Objective To retrospectively analyze the impact of low-dose computed tomography (LDCT) parameter optimization on the diagnostic accuracy for pulmonary nodules and their radiation exposure, and to provide a basis for balancing diagnostic performance and radiation safety. Methods Data from 300 high-risk individuals who underwent pulmonary LDCT screening at Wuhan Hospital of Traditional Chinese Medicine between January 2023 and December 2024 were collected. Participants were divided into an optimized LDCT group (n = 150; 100 kV, 70-90 mA) and a traditional LDCT group (n = 150; 120 kV, 140-160 mA) based on scanning parameters. Baseline characteristics, radiation dose, image quality, and diagnostic accuracy were compared between the two groups. Key factors influencing diagnostic accuracy were analyzed. Results In the optimized group, the volume CT dose index, dose-length product, and effective dose decreased by over 40% (t = 37.492, 35.351, and 35.262, respectively, all P<0.001). Similarly, tube voltage and current decreased significantly (t = 14.582 and 28.653, respectively, both P<0.001), while scan time showed no significant change (t = 0.321, P = 0.760). The overall image quality score of the optimized group was slightly lower than that of the traditional group (4.21 ± 0.43 vs. 4.38 ± 0.39; t = 3.587, P<0.001), but remained within the good-to-excellent range. Both groups demonstrated high diagnostic confidence (4.25 vs. 4.41; t = 3.361, P = 0.001) and high inter-evaluator consistency as indicated by an intraclass correlation coefficient of 0.82. No significant differences were observed between the two groups in sensitivity (94.83% vs. 96.43%; Z = 0.393), specificity (91.30% vs. 90.22%; Z = 0.292), accuracy (92.78% vs. 93.33%; χ² = 0.031), and area under the receiver operating characteristic curve (0.931 vs. 0.938; Z = 0.202) (all P>0.05). Diagnostic performance for<6 mm nodules showed no significant difference (P = 0.778). Multivariable analysis identified nodule size, solid density, lobulated margins, and image quality score as independent predictors of diagnostic accuracy. Conclusion Optimized LDCT can significantly reduce radiation exposure (by over 40%) while maintaining diagnostic accuracy for pulmonary nodules, including small nodules, and good image quality, making it suitable for lung cancer screening in high-risk populations.

[Objective] To explore the clinical significance and application value of establishing a database for red blood cell alloantibody detection. [Methods] Patients who were scheduled for blood transfusion in our hospital from January 1, 2020 to May 1, 2024 were selected as the research subjects. A red blood cell alloantibody detection database was established using Microsoft Office Excel software to register the detection data of patients' alloantibodies and antibodies of undetermined specificity (AUS). A retrospective analysis was conducted on the clinical characteristics, antibody distribution, antibody decay and repeat positivity of the patients in the database. The LISS-IAT method was routinely used for antibody screening and identification. [Results] Among the alloantibodies, the Rh blood group system had the highest detection rate, followed by antibodies of the MNS blood group system and the Lewis blood group system. The predominant antibody in the Rh blood group system was anti-E. In the univariate analysis, the positivity of antibody was significantly associated with the patient's gender, age, blood transfusion history, pregnancy history and type of disease (all P<0.001). In the database, 48 patients experienced antibody decay, accounting for 15.24%(48/315), with an average time span of antibody decay ranging from 22 to 1 324 days. Six cases showed repeat positivity after decay, which were related to blood transfusions. The shortest interval between blood transfusions that led to antibody repeat positivity was 3 days, and the longest interval was 427 days. Among 58 cases with AUS, 3 converted into alloantibodies, among which 2 were anti-E and 1 was anti-Lea. [Conclusion] Establishing a red blood cell alloantibody detection database is an effective way to guide ambiguous cross-matching in clinical practice and is also an effective measure for the management of transfusion risks.

Objective To introduce an innovative technique, the "balance-shaped sternal elevation device" and its application in the subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) for anterior mediastinal masses resection. Methods Patients who underwent single-port thoracoscopic assisted anterior mediastinal tumor resection through the xiphoid process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from May to June 2024 were included, and their clinical data were analyzed. Results A total of 7 patients were included, with 3 males and 4 females, aged 28-72 years. The diameter of the tumor was 1.9-17.0 cm. The operation time was 62-308 min, intraoperative blood loss was 5-100 mL, postoperative chest drainage tube retention time was 0-9 days, pain score on the 7th day after surgery was 0-2 points, and postoperative hospital stay was 3-12 days. All patients underwent successful and complete resection of the masses and thymus, with favorable postoperative recovery. Conclusion The "balance-shaped sternal elevation device" effectively expands the retrosternal space, providing surgeons with satisfactory surgical views and operating space. This technique significantly enhances the efficacy and safety of minimally invasive surgery for anterior mediastinal masses, reduces trauma and postoperative pain, and accelerates patient recovery, demonstrating important clinical significance and application value.

Objective To investigate the effect of triptolide on cerebral ischemia- reperfusion injury （CIRI） and explore its molecular mechanism. Methods One hundred and forty-four Wistar rats were randomly divided into sham operation group, model group, low, medium, high dose of triptolide group and butylphthalide group, with 24 rats in each group. The CIRI rat model was established by blocking the middle cerebral artery for 2 hours. 3 days before modeling, the rats in each group were ip administration once a day. 24 hours after reperfusion, the neurological deficit score was detected, the rate of cerebral infarction was measured by TTC staining, the blood brain barrier （BBB） permeability was detected by EB penetration test. The pathological changes neurons in the ischemic penumbra cortex were observed by HE and TUNEL staining. The content of inflammatory factors in ischemic cerebral cortex were detected by Elisa method. The expression of TLR4/NF-κB pathway related proteins were detected by Western blot. Results Compared with the model group, the neurological deficit score, cerebral infarction rate and EB content in the triptolide middle, high dose groups and the butylphthalide group were significantly decreased （P<0.05）. The pathological changes of cortical neurons in the ischemic penumbra were significantly improved, and the apoptosis rate of neurons was significantly decreased （P<0.05）. The content of TNF-α, IL-1β and the expression of TLR4, p-NF-κB, cleaved caspase-3, Bax were significantly decreased, the expression of Bcl-2 was significantly increased, the ratio of p-NF-κB/NF-κB and Bax/Bcl-2 were significantly decreased （P<0.05）. The regulatory effect of the high dose triptolide group on various detection indexes were better than that of the butylphthalide group （P<0.05）. Conclusion Triptolide could protect the permeability of BBB, improve the neurological deficit and neuropathy in CIRI rats, and reduce the rate of cerebral infarction, its mechanism may be related to the inhibition of TLR4/NF-κB pathway and which mediated inflammatory response and neuronal apoptosis.

Objective To establish a model for accurate prediction of hematoma expansion（HE）following spontaneous intracerebral hemorrhage（sICH）based on CT radiomics and different machine learning algorithms. Methods A retrospective analysis was performed for the patients with sICH who were admitted to Sir Run Run Shaw Hospital and Beijing Electric Power Hospital in 2019-2022，and they were established as the training cohort and the external validation cohort，respectively. Radiomic features of hematomas were extracted from CT images and were combined with related clinical risk factors for HE to establish predictive models using four different machine learning algorithms. The receiver operating characteristic（ROC）curve was used to assess the predictive performance of each model，and the area under the ROC curve（AUC）and corresponding confusion matrix metrics were calculated. Results Compared with the other three models，the support vector machine（SVM）model showed the best predictive performance，achieving an AUC of 0.844 in the training cohort and 0.994 in the external validation cohort. In addition，the SVM model achieved the highest F1 scores（0.891 and 0.989），accuracy rates（83.8% and 98.4%），precision rates（94.5% and 99.9%），and specificities（82.4% and 99.9%）. Conclusion The radiomics model based on SVM provides a noninvasive tool for accurately predicting the risk of HE，which can help clinicians to identify high-risk sICH patients in the early stage and adjust treatment strategies in a timely manner.

This study employs ultra-performance liquid chromatography(UPLC) to analyze the differences in alkaloid content of Commelina communis from various geographical origins, exploring its feasibility as a quality evaluation indicator. A total of 57 batches of C. communis samples from 23 provinces, autonomous regions, and municipalities in China were selected. The MicroPulite HSS T3(2.1 mm×50 mm, 1.8 μm)column was used with a mobile phase of acetonitrile-0.2% phosphoric acid aqueous solution(20∶80), detection wavelength at 254 nm, and a flow rate of 0.3 mL·min~(-1) to measure the content of 1-deoxynojirimycin(DNJ) and deoxymannojirimycin(DMJ). The MicroPulite XP tC_(18)(2.1 mm×100 mm, 1.7 μm)column was employed with a mobile phase of acetonitrile-0.2% phosphoric acid aqueous solution(4∶96), detection wavelength at 254 nm, and a flow rate of 0.4 mL·min~(-1) to measure the content of norharmine(NHM) and harmanme(HM). Chemometric methods were applied to study the relationships and differences among the 57 batches of C. communis. Significant differences in alkaloid content were observed among C. communis from different regions, with the average total content decreasing in the order of North China, Northeast China, Northwest China, East China, Southwest China, Central China, and South China. Cluster analysis(CA) and principal component analysis(PCA) further revealed the quality differences of C. communis from various origins, and partial least squares discriminant analysis(PLS-DA) identified DNJ as a marker compound to distinguish the quality differences between different geographical sources of C. communis. It is recommended that the content limit of DNJ be set at no less than 0.055 9%, providing a reference for the quality evaluation and clinical application of C. communis medicinal materials.
Alkaloids/analysis* ; Drugs, Chinese Herbal/chemistry* ; China ; Chromatography, High Pressure Liquid ; Chemometrics/methods* ; Quality Control