Objective: To investigate the factors associated with HLA antibody formation in patients undergoing platelet transfusion and to evaluate the intervention effect of leukocyte depletion technology. Methods: The study enrolled 2 518 patients who received platelet transfusions from March 1, 2021 to March 31, 2025. HLA antibodies were detected using a solid-phase agglutination method. The effects of gender, age, the number of platelet transfusions, and leukocyte depletion on the formation of HLA antibodies were analyzed. Results: Gender, age, and the number of platelet transfusions were identified as independent risk factors for HLA antibody formation. Female patients exhibited a 1.64-fold higher risk compared to males (OR 1.64, 95% CI 1.31-2.07). Compared with patients under 18 years of age, those aged 18-60 and over 60 showed a 35% and 40% reduction in antibody formation risk, respectively (OR 0.65, 95% CI 0.50-0.86; OR 0.60, 95% CI 0.44-0.83). Compared with patients who received single platelet transfusion, those with 2 and ≥3 transfusions were associated with a 2.02-fold and 14.50-fold increased risk, respectively (OR 2.02, 95% CI 1.49-2.74; OR 14.50, 95% CI 11.16-18.84). The HLA antibody positivity rate was significantly higher in the non-leukocyte-depleted group (20.76%) than in the leukocyte-depleted group (14.31%) (χ =12.27, P<0.01). However, after multivariate adjustment, absence of leukocyte depletion was not an independent predictor of HLA antibody formation. Interaction analysis between the number of transfusions and leukocyte depletion revealed that: 1) Among patients receiving 2 transfusions, no significant difference in antibody formation risk was observed between the group with 1 non-leukocyte-depleted transfusion and the fully depleted group (P>0.05), whereas the group with 2 non-leukocyte-depleted transfusions had a 1.64-fold higher risk (OR 1.64, 95% CI 1.19-2.28); 2) Among patients receiving ≥3 transfusions, the groups with 1, 2, and 3 non-leukocyte-depleted transfusion exhibited 25.45-, 10.59-, and 11.45-fold higher risks, respectively (OR 25.45, 95% CI 10.73-60.36; OR 10.59, 95% CI 5.07-22.14; OR 11.45, 95% CI 8.76-14.96), compared with the fully depleted group. In patients who received 1 platelet transfusion, compared with patients who received platelets filtered by the hospital blood bank, the risk of HLA antibody formation was reduced by 65% (OR 0.35, 95% CI 0.18-0.69) in patients who received platelets filtered by the blood station. There was no statistically significant difference in the risk of antibody formation between the group that received platelets filtered twice by the hospital blood bank and the group that received platelets filtered once (P>0.05). Conclusion: Female, younger age (under 18), and increased number of platelet transfusions are significant risk factors for HLA antibody formation. Leukocyte depletion effectively reduces the incidence of HLA antibody positivity. For female patients with a history of pregnancy and pediatric patients under 18 years of age, and patients receiving ≥3 platelet transfusions, leukocyte-depleted apheresis platelets from the blood station should be the preferred choice.

Diabetic retinopathy(DR)remains the leading cause of vision loss in patients with diabetes. Current anti-vascular endothelial growth factor(VEGF)therapies are limited by inadequate response in some patients and the necessity for repeated intravitreal injections, underscoring the urgent need for novel therapeutic targets. Angiopoietin-like protein 4(ANGPTL4), a multifunctional secreted protein, has emerged as a critical regulator in the pathogenesis and progression of DR, positioning it as a promising interventional target. This review systematically elaborates the biological characteristics of ANGPTL4, with a focus on its expression dynamics, molecular mechanisms, and regulatory networks rolesin the development of DR. Furthermore, the prospects of ANGPTL4-targeted therapeutic strategies are discussed, aiming to offer new insights and directions for understanding DR pathogenesis, advancing multi-target drug development, and improving clinical management.

Objective To investigate the influencing factors of stroke patients with hypertension and their compliance with antihypertensive drugs, and to provide targeted intervention measures for stroke prevention in hypertensive patients.  Methods Using the method of multi-stage cluster sampling, a total of 59,434 permanent residents aged 40 and above were selected from 48 monitoring sites in 9 cities of Hebei Province from December 2019 to December 2020. Unconditional logistic regression analysis was used to explore the influencing factors of stroke complicated with hypertension and the compliance of patients with antihypertensive drugs.  Results Among the 59 434 subjects, the prevalence rate of stroke was 4.33% and the prevalence rate of stroke complicated with hypertension was 82.47%. The results of univariate analysis showed that the proportion of women, rural areas, dyslipidemia, diabetes, obesity, and people with family history of stroke was higher in stroke patients with hypertension, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that rural areas, dyslipidemia, diabetes, obesity, and family history of stroke significantly increased the risk of stroke, and the OR (95%CI) values were 1.29 (1.03-1.62), 1.39 (1.12-1.72), 1.58 (1.25-1.99), 1.61 (1.22-2.12) and 1.60 (1.26-2.04), respectively. Among stroke patients with hypertension, 92.71% of patients took antihypertensive drugs. It was found that women's compliance with antihypertensive drugs was good, with an OR (95%CI) value of 1.46 (1.01-2.09).  Conclusion The prevalence rate of stroke complicated with hypertension is high in people aged 40 and above in Hebei Province. Hypertensive people should lower blood lipids, control blood glucose, and lose weight as soon as possible to prevent the occurrence of stroke.

Objective: To investigate the association between brain and muscle Arnt like protein 1( BMAL 1) gene and ambulatory blood pressure (ABP) parameters in college students, and to explore the influence of the interaction between the gene and weight status on the ABP levels, so as to provide reference for early prevention of chronic cardiovascular diseases related to hypertension. Methods: During September 2022 to June 2024, a total of 510 college students were recruited from a university in Changsha, China for on site questionnaire investigation, physical examination, ABP monitoring and genotyping testing. Multiple linear regression method was used to explore the association between the BMAL 1 gene and ABP indicators. An interaction term was included in the general linear model of multiple linear regression to analyze the interactive effects of BMAL 1 gene polymorphisms and weight status on ABP levels. Results: The prevalence of abnormal 24 hour blood pressure, abnormal daytime blood pressure, and abnormal nighttime blood pressure were 3.3%, 3.1%, and 3.9%, respectively. Multiple linear regression analysis showed that the BMAL 1/rs7950226 polymorphism was positively correlated with the 24 hour diastolic blood pressure(DBP) and the daytime DBP level after adjusting for gender, age, and body mass index( β =0.87,0.99, both P <0.05). Also, interaction between BMAL 1/ rs 11022775 and weight status on the nighttime DBP level ( P interaction =0.03) was found. The CC genotype carriers had significantly higher nighttime DBP level ( β =3.52, P <0.05) among overweight/obesity college students, but no differences in nocturnal DBP levels were observed between CC genotype carriers and TT+CT genotype carriers among college students with normal body weight( P > 0.05). Conclusions The rs 7950226 polymorphism is associated with 24 hours DBP and daytime DBP levels. Significant interaction between rs 11022775 with weight status on the nighttime DBP level is found among college students.

Keratoconus(KC)is a blinding eye disease caused by a variety of factors, with its pathogenesis still not well understood. In recent years, it has been discovered that sex hormones and prolactin-induced protein(PIP)have a profound impact on the cornea, with more noticeable changes when there are abnormalities in their body content. It has been found that various sex hormone receptors are distributed in the cornea. Based on this, this article reviews a multitude of studies on how sex hormones and PIP affect the cornea, along with relevant clinical research. It has been observed that sex hormones and PIP also play a role in KC patients and influence the occurrence and progression of KC. Additionally, it has been noted that pregnant and lactating women may be more susceptible to KC. Sex hormones and PIP have the potential to become new diagnostic and therapeutic targets. This article not only provides new insights but also offers important references for clinical practice.

Keratoconus(KC)is a blinding eye disease caused by a variety of factors, with its pathogenesis still not well understood. In recent years, it has been discovered that sex hormones and prolactin-induced protein(PIP)have a profound impact on the cornea, with more noticeable changes when there are abnormalities in their body content. It has been found that various sex hormone receptors are distributed in the cornea. Based on this, this article reviews a multitude of studies on how sex hormones and PIP affect the cornea, along with relevant clinical research. It has been observed that sex hormones and PIP also play a role in KC patients and influence the occurrence and progression of KC. Additionally, it has been noted that pregnant and lactating women may be more susceptible to KC. Sex hormones and PIP have the potential to become new diagnostic and therapeutic targets. This article not only provides new insights but also offers important references for clinical practice.

Intracranial atherosclerotic stenosis (ICAS) is a common cause of ischemic stroke. The evaluation of its structure and function is of great significance for formulating clinical intervention strategies. The indications for endovascular treatment of ICAS lesions in the past were mainly based on the degree of luminal stenosis showed by cerebral angiography, which had certain limitations. The translesional pressure ratio (PR), as an important indicator for functional assessment after arterial stenosis, has gradually received attention in the evaluation of ICAS lesions in recent years. This article reviews the evaluation methods and clinical significance of PR in ICAS lesions.

Objective:To investigate changes in behavior and hippocampal and prefrontal cortical myelin basic protein(MBP) in model mice with post-traumatic stress disorder(PTSD).Methods:Thirty-two clean-grade male C57BL/6J mice were randomly divided into control group, PTSD 3 d group, PTSD 7 d group and PTSD 14 d group based on matching body mass, with 8 mice in each group. The mice in PTSD 3 d, 7 d and 14 d groups were decapitated at 3 d, 7 d, and 14 d after modeling.The PTSD mouse model was established through conditioned foot shock and single prolonged stress. Anxious- and depressive-like behaviors of mice were assessed by the open field test(OFT). The mouse step-through passive avoidance experiment was used for electric shock training and learning and memory retention. Myelin morphology alterations in the hippocampus and prefrontal cortex of the mouse were examined via myelin staining.The expression levels of MBP were quantified using Western blot and immunohistochemical staining techniques. All experimental data were analyzed and visualized using GraphPad Prism 8.0.2 and SPSS 25.0, the multi groups comparison of behavioral and molecular indicator data was conducted by one-way ANOVA, and the correlation between MBP relative protein expression level and behavioral indicators was analyzed by Pearson correlation analysis.Results:(1) Behavioral results: in OFT, there were significant differences in total distance, average speed, time of stationary and times of entering the central area among all groups( F=16.72, 16.74, 7.37, 5.93, all P<0.05).The total distance and the average speed time of PTSD 3 d, 7 d, 14 d group were all lower than those in control group(all P<0.05).In the mouse step-through passive avoidance experiment, significant differences were observed across all groups in terms of total distance traveled, average speed, dark box entries, and activity time( F=52.78, 55.47, 9.07, 24.88, all P<0.05).All the indexes of PTSD 3 d group and PTSD 7 d group were all higher than those in control group and PTSD 14 d group(all P<0.05).(2)Myelin staining revealed statistically significant differences in the myelin staining areas of the hippocampal CA1 region and the prefrontal cortex across all groups( F=6.67, 5.77, all P<0.05). The stained myelin area in the CA1 region of the hippocampus in the PTSD 3 d group((123.30±11.62)μm 2)was significantly lower compared to the control group((153.00±2.61)μm 2)( P<0.05). The stained myelin area in the prefrontal cortex of the PTSD 3 d group((119.50±9.26)μm 2)was significantly lower compared to that in the control group((154.80±12.40)μm 2)( P<0.05). (3) Western blot results demonstrated significant variations in the expression levels of myelin basic protein (MBP) within the hippocampus and prefrontal cortex across all experimental groups ( F=10.15, 5.28, all P<0.05). The expression levels of MBP in the hippocampal tissue of the PTSD 3 d group (0.89±0.07), PTSD 7 d group (0.90±0.14), and PTSD 14 d group (0.85±0.13) were significantly lower compared to those in the control group(1.17±0.02)(all P<0.05). The expression levels of MBP protein in the prefrontal cortex of the PTSD 3 d group(0.73±0.16) and PTSD 7 d group (0.70±0.12)were significantly lower compared to those in the control group (0.94±0.04)(all P<0.05). (4) Immunohistochemical staining revealed significant variations in the number of MBP-positive cells within the hippocampal CA1 region and the prefrontal cortex across all groups ( F=39.32, 21.81, both P<0.05). The quantity of MBP-positive cells in the hippocampal tissue of mice in the PTSD 3 d group((187.10±1.12)/mm 2)and PTSD 7 d group((193.10±2.18) /mm 2)was significantly reduced compared to the control group((204.80±3.25)/mm 2)(all P<0.05). The quantity of MBP-positive cells in the prefrontal cortex of the PTSD 7 d group((183.90±1.71)/mm 2) was significantly reduced compared to the control group((191.60±1.04) /mm 2)( P<0.05). Conclusion:The PTSD model mice showed anxious- and depression-like behavior, impaired learning and memory ability, and myelin damage in the hippocampus and prefrontal cortex.

Percutaneous coronary intervention(PCI),as one of the primary approaches for revascularization,still faces complications such as restenosis,myocardial ischemia-reperfusion injury and no-reflow/slow-flow phenomena,with no currently effective interventions ensuring long-term efficacy.Based on Li Dongyuan's theory that"fire and original qi cannot coexist",this article inherited Academician Chen Keji's academic perspective on"toxin-stasis pathogenesis"and the hemodynamic characteristics of coronary arteries to propose a"four-stage pathological progression"in post-PCI patients,namely spleen-stomach impairment-original qi deficiency-endogenous yin-fire-toxin-stasis accumulation.It emphasized that the heart vessels rely on qi and blood for nourishment and patency for function,elucidated the therapeutic rationale of Danggui Buxue Decoction,and presented the self-formulated Yixin Hemai Prescription,modified through syndrome differentiation,and performed simultaneous reinforcement and dredging,in order to provide diagnosis and treatment ideas for coronary heart disease after PCI treated with TCM.

Ligusticum sinense cv.Fuxiong derived from"Xiongqiong",and in the Song Dynasty's Tai Ping Hui Min He Ji Ju Fang,it was already distinguished from Chuanxiong Rhizoma in usage.Doctors in the Ming Dynasty further clarified the differences in efficacy between the two.However,with the widespread circulation of Chuanxiong Rhizoma,Ligusticum sinense cv.Fuxiong gradually became marginalized,serving as a substitute,and is now only cultivated and used in small quantities within Jiangxi Province.This article reviewed the prescriptions and the ancient Chinese medical books that have records of Ligusticum sinense cv.Fuxiong,analyzed its specific applications alongside Chuanxiong Rhizoma in prescriptions and case studies to elucidate their differences in efficacy:Ligusticum sinense cv.Fuxiong is pungent and has strong dispersing power and is good at unblocking meridians and promoting qi circulation,which is suitable for excessive syndromes;Chuanxiong Rhizoma is good at promoting blood circulation and relieving pain,and is good at regulating and nourishing,which is suitable for patients with deficiency syndromes,aiming to provide insights and recommendations for the further development and rational clinical medication of Ligusticum sinense cv.Fuxiong.