Platelet-derived exosomes (PLT-Exos) are a subgroup of nanoscale extracellular vesicles released by platelets upon activatin. As key intercellular signaling mediators, they precisely regulate target cells through the delivery of functional molecules, exerting multiple biological effects that promote tissue repair. Accumulating evidence has demonstrated that PLT-Exos significantly facilitate the repair of various tissue injuries by modulating inflammatory responses, stimulating angiogenesis, activating key repair signaling pathways, and mediating stem cell homing. Furthermore, owing to their inherent targeting capacity and low immunogenicity, PLT-Exos have emerged as a promising platform for novel drug delivery carriers in tissue repair. This article systematically reviews the biological characteristics of PLT-Exos, their isolation and identification techniques, the underlying mechanisms of action, and recent advances in clinical application. It also addresses the current challenges in clinical translation, including standardized preparation, subpopulation heterogeneity, scalable production, and clinical implementation, aiming to provide a theoretical reference for both basic research and clinical translation of PLT-Exos in tissue repair.

Objective To explore the mechanism of Shen Hong capsule in preventing and treating acute mountain sickness based on biological information platform and in vitro experiment. Methods Traditional Chinese Medicine Systems Pharmacology （TCMSP） and Traditional Chinese Medicine Information Database （TCMID） were used to obtain the active components and predicted targets of Shen Hong capsule. Therapeutic Target Database （TTD）, Disease Gene Network （DisGeNET） database and GeneCards database were used to search for the targets of acute mountain sickness related diseases, and the potential therapeutic targets were obtained. The protein-protein interaction （PPI） was analyzed by Search Tool for the Retrieval of Interacting Genes/Proteins （STRING）, the Database for Annotation, Visualization, and Integrated Discovery （DAVID） online platform was used to analyse the Gene Ontology （GO） and the Kyoto Encyclopedia of Genes and Genomes （KEGG） signal pathway enrichment. The network information was visualized by Cytoscape software, the key targets in PPI network were obtained according to the topology data, and the binding ability of main active components and key therapeutic targets were analyzed by molecular docking. The validation of the main active components was performed by liquid chromatography-mass spectrometry （LC-MS）. The hypoxia model was created by H9c2 cells, apoptosis was visualized by Hoechst33342 staining, and key target proteins were verified by Western blot. Results 91 active components, 3 main active components and 150 predicted targets were selected from Shen Hong capsule. 515 targets of altitude sickness-related diseases and 37 targets of Shen Hong capsule regulating altitude sickness-related diseases were screened out. 44 related signal pathways, such as HIF-1 signal pathway, PPAR signal pathway, drug metabolism - cytochrome P450, were enriched and analyzed. TNF, IL1B, VEGFA, NOS3, EGFR, ESR1, PPARG, NR3C1, HMOX1 and IFNG were 10 key targets. The molecular docking results showed that the docking conformations between the main active components and the key targets were stable. The three main active components of quercetin, luteolin and kaempferol were identified by LC-MS, and in vitro experiments proved that Shen Hong capsule could relieve acute hypoxia injury by regulating the expression of HIF-1α, PPARG, NOS3, and TNF. Conclusion Shen Hong capsule could regulate the body’s hypoxia response and metabolism through multi-component, multi-target and multi-channel ways, so as to prevent and treat acute mountain sickness. This study provided a direction for further exploring the mechanism of Shen Hong capsule, and also provided a theoretical basis for further development and clinical application.

Objective: To investigate the association between body weight standardized vitamin B intakes and blood pressure among school aged children, so as to provide evidence for developing dietary guidance and intervention strategies of promoting healthy blood pressure in children. Methods: The data were derived from a pediatric health cohort established in both urban and rural areas of Chongqing. A total of 1 368 primary school students in grades one to three were recruited for the baseline survey between October and November 2014 by using a stratified cluster random sampling design. From February to March 2019, 1 283 participants completed the first follow up assessment. Dietary intake and sociodemographic characteristics were assessed using a food frequency questionnaire and a self administered questionnaire. Blood pressure, height, weight, and other anthropometric indicators were measured. Body weight standardized intakes of six B vitamins(B 1, B 2, B 3, B 6, B 9, and B 12 )were categorized into tertiles( T1-T 3). Linear mixed effects models were applied to examine the associations between body weight standardized vitamin B intakes and changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP). In addition, mixed effects Logistic regression models were used to assess the risk of elevated blood pressure. Results: Linear mixed effects model regression analyses showed that, after adjusting for potential confounders including age, sex, and family history of obesity, body weight standardized B vitamin intake was negatively associated with SBP, DBP, and MAP in school aged children ( β =-7.79 to -0.68, all P <0.05). Results from the mixed effects Logistic regression models showed that, compared with the T 1 group, children in the T 3 group had a lower risk of elevated blood pressure for vitamin B 1 ( OR=0.40, 95%CI =0.25-0.64), B 2 ( OR=0.36, 95%CI =0.23-0.58), B 3 ( OR=0.47, 95%CI =0.31-0.72, B 6 ( OR=0.37, 95%CI =0.22-0.60), B 9 ( OR=0.36, 95%CI =0.21-0.60), and B 12 ( OR= 0.56 , 95%CI =0.37-0.86)(all P <0.05). Conclusions Body weight standardized B vitamins were associated with changes in blood pressure levels and the risk of elevated blood pressure among school aged children. Ensuring sufficient dietary intakes of vitamin B may help prevent and control of abnormal blood pressure in children.

Objective:To evaluate the prevalence of hepatitis C virus (HCV) infection among patients attending a comprehensive tertiary hospital in Beijing and to pinpoint the key demographics for anti-HCV screening.Methods:A comprehensive retrospective analysis was undertaken, examining data from 631 424 patients who underwent anti-HCV testing between 2017 and 2023. Testing for anti-HCV was conducted using the Abbott i2000 fully automated chemiluminescent immunoassay analyzer. HCV nucleic acid testing was performed with the Roche Cobas AmpliPrep/Cobas TaqMan 96 fluorescent quantitative PCR system, while HCV genotyping was achieved through sequencing.Results:The positive rate of HCV antibodies demonstrated a gradual decline over the years, decreasing from 1.62% in 2017 to 1.01% in 2023. The overall positive rate stood at 1.36% (8 574/631 424), with a nucleic acid testing rate of 59.24% (5 079/8 574) and a nucleic acid positive rate of 34.28% (1 741/5 079). The majority of anti-HCV positive patients came from the department of hepatology (12.17%), followed by hepatobiliary surgery (3.03%), emergency medicine (1.68%), cardiovascular medicine (1.24%) and ophthalmology clinic (1.23%). Notably, the anti-HCV positive rate was significantly elevated in the ≥40 years old group compared to the <40 years old group, with statistical significance ( χ2=1 892.577, P=0.000). The highest anti-HCV positive rates were observed within the 60-69- and 80-99-years old brackets (both at 1.85%), while the peak HCV RNA positive rate was recorded in the 50-59 years old group (27.08%). Females exhibited a significantly higher positive rate (18.53%) than males (15.75%) ( χ2=8.066, P<0.01). When anti-HCV levels surpassed 9 S/CO, the HCV RNA positive rate was notably high, exceeding 38.97%. Intriguingly, at antibody levels ranging from 15 to 16 S/CO, the HCV RNA positive rate climbed to a maximum of 56.17%. Conclusions:This study has successfully identified the key populations for anti-HCV screening: Patients aged over 40, particularly female patients within the 50-69 age bracket; Patients in hepatology, hepatobiliary surgery, emergency medicine, cardiovascular medicine and ophthalmology departments.

Objective:To understand the related factors of new-type drugs use and high-risk behaviors in online-dating men who have sex with men (MSM) in Shandong Province, and provide evidence for the development of targeted HIV prevention and intervention strategies.Methods:A cross-sectional study was conducted from April to July 2023 in eight sentinel surveillance sites across cities in Shandong, recruiting MSM participants. Each city enrolled a sample of 400 individuals. Face-to-face questionnaire surveys were conducted to collect data on socio-demographic characteristics, drug use and sexual behaviors, risk perception, and online-dating practices of the MSM, and χ2 test was used to compare the differences between online-dating MSM who used new-type drugs and those who didn't use. Logistic regression model was used to analyze the related factors of group sex behavior and the lack of HIV detection before sexual behavior in the online-dating MSM. Statistical analysis was performed by using software SPSS 29.0. Results:A total of 3 235 MSM were surveyed, in whom 2 787 (86.15%) used online-dating platforms to find partners in the past six months. The majority were those who were aged 25-34 years (39.18%, 1 092/2 787), unmarried/divorced/widowed (71.51%, 1 993/2 787), had an education level of college or above (69.36%, 1 933/2 787), and primarily identified as homosexual gays (77.97%, 2 173/2 787), 37.78% (1 053/2 787) believed that they were at low risk for HIV infection and 10.88% (303/2 786) believed that using new-type drugs was less harmful and 57.59% (1 605/2 787) reported new-type drugs use. Multivariate logistic regression analysis indicated that MSM who used new-type drugs had higher risk for group sex in the past six months (a OR=1.31, 95% CI: 1.06-1.63) and sexual activity without pre-HIV testing (a OR=1.57, 95% CI:1.14-2.15) compared with those who didn't use new-type drugs.MSM who believed that the risk of using new-type drugs was general, higher and very high had higher risks for group sex in the past six months (a OR=1.54, 95% CI: 1.09-2.18) and sexual activity withou pre-HIV testing (a OR=2.02, 95% CI:1.34-3.05) compared with those who believed using new-type drugs was less harmful. Conclusions:The use of new-type drugs was relatively common in the online-dating MSM in Shandong, with widespread high-risk behaviors and poor awareness of risks to health. A gap between knowledge awareness and behavior exists. It is necessary to strengthen the health education and promotion of HIV informed dating practices in MSM.

Objective:This study aimed to investigate the association between genetic factors and the risk of developing treatment-resistant depression (TRD), as well as the efficacy of modified electroconvulsive therapy (MECT), with a specific focus on identifying gene polymorphisms that can differentiate TRD from non-TRD.Methods:This case-control study included inpatients with depression in Adult Psychiatry Department, Affective Disorders Department and Geriatrics Department of Guangzhou Medical University Affiliated Brain Hospital from January 2023 to June 2024, as well as healthy individuals undergoing physical examinations in the outpatient department. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was utilized to genotype 16 loci across 10 candidate genes in 107 non-TRD patients, 101 TRD patients and 281 healthy controls. Hardy-Weinberg equilibrium testing, genotype frequency distribution analysis, and genetic association studies were conducted using PLINK software. Univariate binary logistic regression under a dominant model was performed using R software to analyze gene loci associated with non-TRD and TRD.Results:All 16 gene loci in the control group, the TRD group, and the non-TRD group were found to be in Hardy-Weinberg equilibrium ( P>0.05). No significant differences were observed in the genotype distribution of these gene loci across the groups ( P>0.05). Univariate binary logistic regression analysis revealed that individuals with depression carrying the HTR2A-rs7997012 G allele had a significantly lower risk of developing TRD ( OR=0.26, P=0.047). Among the patients receiving MECT, the proportion of G allele carriers who showed improvement at 2, 4, and 6 weeks of treatment was significantly higher compared to those who did not show improvement (96.61% vs. 80.95%, 96.55% vs. 50.00%, 96.59% vs. 46.15%, respectively), with χ2 values of 6.743, 29.295, and 32.300, respectively, and all P values <0.05. Conclusion:The HTR2A-rs7997012 polymorphism may represent a genetic distinction between TRD and non-TRD. Depressed patients with the rs7997012 G allele have a reduced likelihood of developing TRD, moreover, MECT demonstrates superior efficacy in this patient population.

The invasive arterial blood pressure(ABP)monitoring technique is widely utilized in the management of critically ill patients,providing medical professionals with real-time,continuous,and dynamic blood pressure data that plays a crucial role in guiding patient treatment.However,current traditional methods for arterial catheter blood collection and zero setting and measurement technology for ABP and central venous pressure(CVP)present certain issues such as complex operation procedures,inaccurate zero setting,and the inability to simultaneously monitor both ABP and CVP.Additionally,these methods may increase the risk of bloodstream infection and occupational exposure.Therefore,the department of critical care medicine at Tianjin Medical University General Hospital has developed a vascular access convenient blood collection device which has been granted a National Utility Model Patent(patent number:ZL 202322581247.4).This device includes a connecting tube,a specimen collection structure,a blood suction structure,a multifunctional pressure measurement device with laser emission structure,a pressure measurement conversion structure,and an efficient vascular access blood collection device.By optimizing the blood collection procedure and simplifying the manometry process,this design reduces the risk of bloodstream infection for patients and minimizes occupational exposure for medical staff.The device ensures accurate zero point adjustment of pressure measurements while guaranteeing the authenticity and reliability of collected data.Additionally,it supports synchronous monitoring of ABP and CVP,thereby saving medical consumables and reducing workload for healthcare professionals.This simple yet safe and efficient device meets clinical requirements effectively and is highly recommended for widespread use.

To summarize the postoperative nursing experience for a child with Uhl's anomaly undergoing complex heart surgery.Nursing key points include implementing goal-oriented liquid negative balance management to promote the recovery of cardiac function;carrying out pressure load management and closely monitoring the heart rate and rhythm to maintain the stability of the circulatory system;closely monitoring the central venous pressure in the upper chamber and paying attention to the changes of the pulmonary artery pressure in real time;adopting a refined integrated management to avoid an abnormal rise in the pulmonary artery pressure;withdrawing invasive mechanical ventilation as early as possible and carrying out the non-invasive ventilator deconditioning training in an orderly manner;the synergistic management of bleeding and anticoagulation;the adoption of various measures to actively prevent complications;the prevention and control of infections in an all-round and multi-angle manner;the formulation of individualized cardiac rehabilitation training and nutritional intervention programs.The child was transferred from the pediatric intensive care unit back to the pediatric ward on postoperative day 9,transferred back to the pediatric intensive care unit on postoperative day 11 for 13 d for right atrial thrombus,stabilized and transferred back to the pediatric ward,and discharged after 10 d for recovery.The prognosis showed good recovery after 1 month and 3 months.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Objective:To explore the predictive value of baseline serum levels of hepatitis B virus (HBV) RNA for HBeAg seroconversion in chronic hepatitis B (CHB) subjects with advanced fibrosis/compensated cirrhosis undergoing tenofovir disoproxil fumarate (TDF) therapy.Methods:A case-control study was conducted on 141 patients with CHB combined with advanced fibrosis/compensated cirrhosis who were treated with TDF and tested at Peking University People′s Hospital from January 2015 to December 2020. Patients were divided into HBeAg seroconversion (16 cases) group and non-seroconversion (59 cases) group based on whether HBeAg seroconversion occurred at 240 weeks after treatment. The patients were divided into HBeAg positive and negative groups at baseline (75 and 66 cases, repectively) and at 12 weeks treatment (61 and 80 cases, repectively). The baseline serum levels of relevant indicators were analyzed. HBV RNA levels were measured at baseline and at 240 weeks after treatment. The correlation between HBV RNA and HBV DNA was analyzed using Pearson correlation analysis, and the predictive value was evaluated using the receiver operating characteristic (ROC) curve.Results:For the 75 HBeAg-positive patients at baseline, 21.3% (16/75) achieved HBeAg seroconversion. The HBV DNA and HBV RNA in the HBeAg-positive group were significantly higher than that in the HBeAg-negative group (all P<0.001). Compared with the non-seroconversion group, the HBeAg seroconversion group had significantly lower baseline serum levels of HBV RNA ( P<0.05). Pearson correlation analysis showed that serum HBV RNA levels were positively correlated with HBV DNA in both baseline and 12 weeks HBeAg-negative group and HBeAg-positive group, respectively (baseline: r=0.718, 0.794, P<0.001; 12 weeks: r=0.689, 0.750, P<0.001). ROC curve showed that baseline levels of HBV RNA could be used as a predictor of HBeAg seroconversion in CHB patients with advanced fibrosis/compensated cirrhosis treated with TDF. The area under curve was 0.781, the sensitivity was 75.0%, and the specificity was 78.0%. Conclusion:Baseline serum levels of HBV RNA has a predictive value for HBeAg seroconversion in CHB patients with advanced fibrosis/compensated cirrhosis treated with TDF.