Platelet activation plays a crucial role in the pathogenesis of cardiovascular and cerebrovascular diseases and the safety of platelet transfusion. Blood-activating and stasis-resolving Chinese herbs, known for improving blood circulation and eliminating blood stasis, can be classified into four categories: blood-activating and pain-relieving herbs, blood-activating and menstruation-regulating herbs, blood-activating and wound-healing herbs, and blood-breaking and mass-eliminating herbs. Modern research has revealed that these herbs exert antiplatelet activation effects through multiple molecular mechanisms. Key mechanisms include regulating the arachidonic acid metabolic pathway, inhibiting platelet membrane receptor function, influencing intracellular signal transduction, and modulating platelet-vascular endothelial interactions. Compared with conventional antiplatelet drugs, blood-activating and stasis-resolving Chinese herbs offer the advantage of multi-pathway synergistic effects and demonstrate potential value in prolonging platelet storage. This article systematically elaborates on the active monomers and mechanisms of these four categories of Chinese herbs in inhibiting platelet activation, summarizing their multi-target and multi-pathway characteristics, aiming to provide a theoretical basis for the clinical application of these herbs in suppressing platelet activation.

Objective:To investigate the association between estimated glomerular filtration rate (eGFR) and the onset and progression of type 2 diabetic retinopathy (DR).Methods:Observational studies on the relationship between eGFR and the progression of DR were searched in the databases of PubMed, Web of Science, Foreign Medical Literature Retrieval Service (FMRS), China National Knowledge Infrastructure and Wanfang data. The search period was from the inception of the databases to January 20, 2024. Meta-analysis of the association between eGFR and the onset and progression of DR with the research data was conducted by using Review Manager 5.3 and Stata 15.0, the weighted mean difference (WMD) and 95% confidence interval (CI) were calculated. Sensitivity analysis and Egger′s test were performed to assess the result stability and publication bias.Results:A total of 30 studies involving 119 142 patients with type 2 diabetes were included in the analysis. The eGFR in the DR group was significantly lower than that in the non-DR group (WMD=8.11, 95% CI: 5.97-10.25, P<0.001). Subgroup analysis by DR type revealed that patients with diabetic macular edema (WMD=7.61, 95% CI: 3.82-11.40) and proliferative DR (WMD=17.40, 95% CI: 10.13-24.66) had significantly lower eGFR when compared to that in non-DR group (both P<0.001). The subgroup analysis results according to different DR diagnostic criteria showed that both the 2003 International DR Grading Standard Group (WMD=8.55, 95% CI: 5.29-11.81) and the 2002 International Clinical DR Severity Grading Standard Group (WMD=10.70, 95% CI: 7.99-13.41) indicated the statistically significant differences in eGFR in relation to the occurrence and progression of DR. Conclusion:The decrease of eGFR is closely related to the occurrence and progression of DR.

Objective:To investigate the adjunctive diagnostic value of retinal imaging structural parameters combined with apolipoprotein E (ApoE) gene polymorphisms for Alzheimer′s disease (AD).Methods:It was a case-control study, 71 confirmed AD patients who attended the Department of Neurology in Sichuan Provincial People′s Hospital from May 2023 to June 2024 and 156 healthy medical checkups who participated in medical checkups in the Health Management Center were continuously with convenience sampling method; the subjects were included as the AD case group and healthy control group, respectively. Optical coherence tomography (OCT) was used to measure the structural parameters of retinal imaging such as the thickness of the retinal nerve fiber layer (RNFL) and the retinal nerve fiber layer-inner plexiform layer (RNFL-IPL) in the study subjects. Information on demographic characteristics and disease history of the study participants were collected through a questionnaire, and venous blood was collected to test for ApoE gene polymorphisms. The retinal imaging structural parameters, ApoE gene polymorphisms and other related indicators were included in a multifactorial logistic regression model to analyze the main factors affecting the risk of AD. Based on the results of the multifactorial analysis, the receiver operating characteristic (ROC) curves were plotted and the areas under the curve (AUC) were calculated to evaluate the efficacy of different models in the adjunctive diagnosis of AD.Results:Of the 227 study subjects included in the analysis, 153 were females and 74 were males; there were 71 cases in the AD case group with a mean age of (66.73±8.83) years, and there were 156 subjects in the healthy control group with an average age of (61.95±8.21) years. Educational attainment of elementary school and below ( OR=4.683, 95% CI: 2.133-10.282), living visual acuity<0.5 ( OR=2.716, 95% CI: 1.12-6.583), and carrying ≥1 ApoE ε4 genes ( OR=5.331, 95% CI: 2.309-11.891) were positively correlated with the risk of AD. RNFL thickening ( OR=0.923, 95% CI: 0.854-0.998) was negatively associated with the risk of AD (all P<0.05). The AD risk assessment model (Model 4), which included fundus imaging features and ApoE gene polymorphisms, had the highest predictive efficacy (AUC=0.857, P<0.001). Conclusion:Retinal imaging structural parameters differ significantly between AD patients and healthy examinees, and a risk assessment model combining retinal imaging structural parameters and ApoE gene polymorphisms has high predictive value and is expected to serve as an auxiliary diagnostic tool for AD.

Objective:To investigate the association between estimated glomerular filtration rate (eGFR) and the onset and progression of type 2 diabetic retinopathy (DR).Methods:Observational studies on the relationship between eGFR and the progression of DR were searched in the databases of PubMed, Web of Science, Foreign Medical Literature Retrieval Service (FMRS), China National Knowledge Infrastructure and Wanfang data. The search period was from the inception of the databases to January 20, 2024. Meta-analysis of the association between eGFR and the onset and progression of DR with the research data was conducted by using Review Manager 5.3 and Stata 15.0, the weighted mean difference (WMD) and 95% confidence interval (CI) were calculated. Sensitivity analysis and Egger′s test were performed to assess the result stability and publication bias.Results:A total of 30 studies involving 119 142 patients with type 2 diabetes were included in the analysis. The eGFR in the DR group was significantly lower than that in the non-DR group (WMD=8.11, 95% CI: 5.97-10.25, P<0.001). Subgroup analysis by DR type revealed that patients with diabetic macular edema (WMD=7.61, 95% CI: 3.82-11.40) and proliferative DR (WMD=17.40, 95% CI: 10.13-24.66) had significantly lower eGFR when compared to that in non-DR group (both P<0.001). The subgroup analysis results according to different DR diagnostic criteria showed that both the 2003 International DR Grading Standard Group (WMD=8.55, 95% CI: 5.29-11.81) and the 2002 International Clinical DR Severity Grading Standard Group (WMD=10.70, 95% CI: 7.99-13.41) indicated the statistically significant differences in eGFR in relation to the occurrence and progression of DR. Conclusion:The decrease of eGFR is closely related to the occurrence and progression of DR.

Objective:To investigate the adjunctive diagnostic value of retinal imaging structural parameters combined with apolipoprotein E (ApoE) gene polymorphisms for Alzheimer′s disease (AD).Methods:It was a case-control study, 71 confirmed AD patients who attended the Department of Neurology in Sichuan Provincial People′s Hospital from May 2023 to June 2024 and 156 healthy medical checkups who participated in medical checkups in the Health Management Center were continuously with convenience sampling method; the subjects were included as the AD case group and healthy control group, respectively. Optical coherence tomography (OCT) was used to measure the structural parameters of retinal imaging such as the thickness of the retinal nerve fiber layer (RNFL) and the retinal nerve fiber layer-inner plexiform layer (RNFL-IPL) in the study subjects. Information on demographic characteristics and disease history of the study participants were collected through a questionnaire, and venous blood was collected to test for ApoE gene polymorphisms. The retinal imaging structural parameters, ApoE gene polymorphisms and other related indicators were included in a multifactorial logistic regression model to analyze the main factors affecting the risk of AD. Based on the results of the multifactorial analysis, the receiver operating characteristic (ROC) curves were plotted and the areas under the curve (AUC) were calculated to evaluate the efficacy of different models in the adjunctive diagnosis of AD.Results:Of the 227 study subjects included in the analysis, 153 were females and 74 were males; there were 71 cases in the AD case group with a mean age of (66.73±8.83) years, and there were 156 subjects in the healthy control group with an average age of (61.95±8.21) years. Educational attainment of elementary school and below ( OR=4.683, 95% CI: 2.133-10.282), living visual acuity<0.5 ( OR=2.716, 95% CI: 1.12-6.583), and carrying ≥1 ApoE ε4 genes ( OR=5.331, 95% CI: 2.309-11.891) were positively correlated with the risk of AD. RNFL thickening ( OR=0.923, 95% CI: 0.854-0.998) was negatively associated with the risk of AD (all P<0.05). The AD risk assessment model (Model 4), which included fundus imaging features and ApoE gene polymorphisms, had the highest predictive efficacy (AUC=0.857, P<0.001). Conclusion:Retinal imaging structural parameters differ significantly between AD patients and healthy examinees, and a risk assessment model combining retinal imaging structural parameters and ApoE gene polymorphisms has high predictive value and is expected to serve as an auxiliary diagnostic tool for AD.

Objective To investigate the clinical diagnostic value of plasma serine protease inhibitor Ka-zal-type 4(SPINK4)expression in colorectal adenocarcinoma(CRC)and progressive adenoma(AA).Methods A total of 62 patients with CRC(CRC group)and 15 patients with AA(AA group)diagnosed by colonoscopy and pathological examination in this hospital from June 2020 to December 2021 were selected,and 22 healthy people undergoing physical examination during the same period were selected as the HC group.The expression of SPINK4 in plasma was detected by ELISA,and the expression of CEA in plasma was detected by electrochemiluminescence,and the correlation was analyzed.The diagnostic efficiency was analyzed by re-ceiver operating characteristic(ROC)curve,and the expression of p53 in CRC tissues was detected by immu-nohistochemistry.Results The expression of plasma SPINK4 in the CRC group and AA group was lower than that in the HC group(Z=3.72,-0.41,P＜0.05),and the expression of CEA in the CRC group was higher than that in the HC group(Z=-3.63,P＜0.05).The area under the curve(AUC),accuracy,sensi-tivity and specificity of SPINK4 combined with CEA in the diagnosis of CRC and AA were higher than those of SPINK4 and CEA alone.The positive rate of mutant type p53 in SPINK4 low expression group and CEA high ex-pression group was significantly increased in CRC patients(72.55％,75.00％,P＜0.05).Conclusion The expression of plasma SPINK4 is decreased in CRC and AA,and the combined detection of SPINK4 and CEA has a good di-agnostic efficiency in CRC and AA.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Carotid atherosclerosis (CAS) is closely associated with the decline of cognitive function in the elderly, which can lead to persistent or progressive cognitive function and neurological dysfunction. Vascular cognitive impairment (VCI) is considered to be an intervenable disease. Studies have shown that CAS is one of the main causes of VCI. Further study on the relationship between CAS and VCI will help to better prevention and treatment of VCI.

ObjectiveTo analyze the feasibility， reliability and validity of the disability assessment for dementia scale for the elderly. MethodsA total of 290 dementia patients from 17 survey sites in 13 districts and counties of Chengdu were enrolled by convenient sampling method， and they were assessed using demographic data inventory， Mini-Mental State Examination （MMSE）， Neuropsychiatric Inventory （NPI）， Physical Self-Maintenance Scale （PSMS） and disability assessment for dementia scale for the elderly. Cronbach's α coefficient， Spearman-Brown coefficient， Guttman split-half coefficient and test-retest reliability were used to evaluate the internal consistency of above scales. Criterion-related validity of the scale was analyzed based on MMSE， NPI and PSMS. ResultsA total of 276 patients （95.17%） completed valid questionnaires. The intraclass correlation coefficient of the total score and each dimension were between 0.828~0.976， the Spearman-Brown coefficient were between 0.790~0.917， the Guttman split-half coefficient were between 0.812~0.857， and the Cronbach’s α coefficient were between 0.737~0.886. The cognitive function dimension score was positively correlated with the MMSE score （r=0.948， P<0.01）， the mental behavior symptom dimension score was positively correlated with the NPI score （r=0.893， P<0.01）， and the daily living ability dimension score was positively correlated with the PSMS score （r=0.997， P<0.01）. The dimensions scores were positively correlated with the total score of the scale （r=0.634~0.841， P<0.05）. ConclusionDisability of dementia assessment scale has good feasibility， reliability and validity， which is a reliable tool to assess senile dementia and disability.

Estrogen is an important hormone secreted by the female reproductive system. Its main function is associated with reproduction, growth and development. Studies have shown that estrogen has biological functions such as regulating vasoconstriction, antioxidant stress, anti-inflammatory and neuroprotection, and also affects brain structure and network. Studies have shown that estrogen is closely associated with the occurrence and development of white matter hyperintensities (WMHs). This article reviews the relationship between estrogen and menopausal hormone replacement therapy and WMHs, and their possible pathophysiological mechanisms.