The clinical diagnosis of serious mental illnesses (SMI) has long been constrained by the limitations of traditional symptomatic criteria and the absence of objective biological markers. Exosomes, serving as natural nanocarriers capable of crossing the blood-brain barrier, along with the miRNAs they carry, offer novel molecular markers for the precise diagnosis of SMI. This article summarizes recent research advances on exosomes in schizophrenia, schizoaffective disorder, bipolar disorder, and major depressive disorder, exploring the potential mechanisms by which they participate in the regulation of neuroinflammation and synaptic dysfunction through the delivery of miRNA molecules. Although the specific origins and monitoring of exosomes require further investigation, their value in assisting the diagnosis of psychiatric disorders is increasingly being recognized, holding promise for providing more objective references for clinical practice in the future.

With the advancement of transfusion medicine and the widespread use of platelet-related preparations, platelet transfusion has become a critical therapeutic intervention in clinics. To enhance the safety and efficacy of platelet transfusion, platelet blood group typing has been increasingly implemented in clinical practice, accompanied by the emergence of novel testing technologies and methodologies, such as flow cytometric immuno-bead array analysis, microtiter plate-based immobilized recombinant single antigen enzyme-linked immunosorbent assay and third-generation sequencing. Significant progress has been made in platelet blood group detection, including improvements in serological testing methods, integration and optimization of multi-platform detection technologies, and the development of high-throughput molecular genotyping techniques. The advancement in platelet blood group detection technology has significantly enhanced detection precision and clinical applicability, providing an important support for transfusion safety, managing platelet-related diseases, and developing antiplatelet drugs.

Objective:To investigate the relationship between macrophage activation related factors and clini-cal symptoms of schizophrenia(SCZ).Methods:Outpatient or inpatient SCZ patients(n=166)and normal con-trols(n=71)meeting the diagnostic criteria of DSM 4th edition were selected as subjects.The psychopathological symptoms were assessed by the Positive and Negative Syndrome Scale(PANSS),and the concentrations of α-Na-Galases,MAF and IL-18 were determined by enzyme-linked immunosorbent assay(ELISA).The correlation be-tween biological indicators and clinical symptoms was analyzed and the mediation effect was tested.Results:The concentrations of α-NaGalases(P＜0.001)and MAF(P＜0.01)in SCZ group were lower than those in normal control group.In SCZ group,IL-18 was negatively correlated with α-NaGalases concentration(r=-0.24,P＜0.01).α-NaGalases was positively correlated with MAF concentration(r=0.67,P＜0.001),and the total score of PANSS positive symptom scale was positively correlated with IL-18(r=0.21,P＜0.05)and MAF concentration(r=0.22,P＜0.01).The mediating effect of α-NaGalases and MAF was statistically significant,and the relative mediating effect accounted for 25.47％.Conclusion:The increase of IL-18 level may indicate the occurrence of positive symptoms of schizophrenia,and α-NaGalases and MAF may negatively regulate the inflammatory damage effect of IL-18 on SCZ,thereby reducing the positive symptoms.

Objective:To investigate the relationship between macrophage activation related factors and clini-cal symptoms of schizophrenia(SCZ).Methods:Outpatient or inpatient SCZ patients(n=166)and normal con-trols(n=71)meeting the diagnostic criteria of DSM 4th edition were selected as subjects.The psychopathological symptoms were assessed by the Positive and Negative Syndrome Scale(PANSS),and the concentrations of α-Na-Galases,MAF and IL-18 were determined by enzyme-linked immunosorbent assay(ELISA).The correlation be-tween biological indicators and clinical symptoms was analyzed and the mediation effect was tested.Results:The concentrations of α-NaGalases(P＜0.001)and MAF(P＜0.01)in SCZ group were lower than those in normal control group.In SCZ group,IL-18 was negatively correlated with α-NaGalases concentration(r=-0.24,P＜0.01).α-NaGalases was positively correlated with MAF concentration(r=0.67,P＜0.001),and the total score of PANSS positive symptom scale was positively correlated with IL-18(r=0.21,P＜0.05)and MAF concentration(r=0.22,P＜0.01).The mediating effect of α-NaGalases and MAF was statistically significant,and the relative mediating effect accounted for 25.47％.Conclusion:The increase of IL-18 level may indicate the occurrence of positive symptoms of schizophrenia,and α-NaGalases and MAF may negatively regulate the inflammatory damage effect of IL-18 on SCZ,thereby reducing the positive symptoms.

The clinical diagnosis of serious mental illnesses (SMI) has long been constrained by the limitations of traditional symptomatic criteria and the absence of objective biological markers. Exosomes, serving as natural nanocarriers capable of crossing the blood-brain barrier, along with the miRNAs they carry, offer novel molecular markers for the precise diagnosis of SMI. This article summarizes recent research advances on exosomes in schizophrenia, schizoaffective disorder, bipolar disorder, and major depressive disorder, exploring the potential mechanisms by which they participate in the regulation of neuroinflammation and synaptic dysfunction through the delivery of miRNA molecules. Although the specific origins and monitoring of exosomes require further investigation, their value in assisting the diagnosis of psychiatric disorders is increasingly being recognized, holding promise for providing more objective references for clinical practice in the future.

With the advancement of transfusion medicine and the widespread use of platelet-related preparations, platelet transfusion has become a critical therapeutic intervention in clinics. To enhance the safety and efficacy of platelet transfusion, platelet blood group typing has been increasingly implemented in clinical practice, accompanied by the emergence of novel testing technologies and methodologies, such as flow cytometric immuno-bead array analysis, microtiter plate-based immobilized recombinant single antigen enzyme-linked immunosorbent assay and third-generation sequencing. Significant progress has been made in platelet blood group detection, including improvements in serological testing methods, integration and optimization of multi-platform detection technologies, and the development of high-throughput molecular genotyping techniques. The advancement in platelet blood group detection technology has significantly enhanced detection precision and clinical applicability, providing an important support for transfusion safety, managing platelet-related diseases, and developing antiplatelet drugs.

Objective:To investigate the effects of free triiodothyronine/free thyroxine(FT3/FT4) and one carbon metabolites on metabolic syndrome(MetS) in patients with severe mental illness(SMI).Methods:Retrospective case-control study was conducted to select 328 patients with SMI who were hospitalized in Beijing Huilongguan Hospital from January 2022 to August 2023 as the study subjects, including 180 patients with schizophrenia (SZ), 74 patients with bipolar disorder (BD), and 74 patients with major depression (MDD). Another 74 healthy subjects in the same period were selected as the control group. The levels of thyroid hormones and one-carbon metabolites [ folic acid, vitamin B12 (VitB12) and homocysteine (HCY) ] were compared between the two groups. At the same time, clinical data and MetS related information of SMI patients were collected. Partial correlation analysis and Logistic regression analysis were used to study the relationship between FT3/FT4 and one-carbon metabolites and MetS risk factors and insulin resistance in SMI patients, respectively.Results:There were statistically significant differences in gender, age, course of disease, smoking rate, body mass index (BMI), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG)/HDL-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), antipsychotic drug use rate, mood stabilizer use rate, antidepressant drug use rate and hypoglycemic treatment among SZ, BD and MDD groups in SMI patients (all P<0.05).Compared with the control group, FT3/FT4, folic acid and VitB12 in patients with SMI were significantly lower ( Z=-4.315, P<0.001; Z=-8.216, P<0.001; Z=-6.021, P<0.001), HCY increased significantly ( Z=-8.789, P<0.001);Partial correlation analysis showed that FT3/FT4 in patients with SMI was positively correlated with TG( r=0.303, P<0.001), TG/HDL-C( r=0.228, P<0.001), insulin resistance index(HOMA-IR)( r=0.204, P<0.001), triglyceride glucose index(TyG)( r=0.284, P<0.001), triglyceride glucose body mass index(TyG-BMI)( r=0.211, P<0.001) and body mass index(BMI)( r=0.154, P=0.005), and negatively correlated with insulin sensitivity index(QUICKI)( r=-0.205, P<0.001). VitB12 was positively correlated with HDL-C( r=0.144, P=0.009) and QUICKI( r=0.115, P=0.038), and negatively correlated with TyG-BMI ( r=-0.122, P=0.028) and BMI ( r=-0.127, P=0.022). HCY was positively correlated with TyG ( r=0.114, P=0.039) and TyG-BMI ( r=0.188, P=0.001). Multivariate ordinal logistic regression analysis showed that smoking( OR=1.602,95% CI=1.004-2.558), female( OR=1.736,95% CI=1.041-2.895), FT3/FT4( OR=17.811,95% CI=1.596-198.764), HCY ( OR=1.026,95% CI=1.009-1.043) and BD ( OR=2.150,95% CI=1.092-4.232) were the influencing factors of the number of risk factors for MetS in patients with SMI, while VitB12 ( OR=0.997,95% CI=0.995-0.998) was a protective factor; binary Logistic regression analysis showed that patients with SMI with long course of disease( OR=1.024,95% CI=1.008-1.041) and high level of HCY ( OR=1.033,95% CI=1.014-1.052) were more likely to have MetS. Conclusion:Dynamic monitoring of FT3/FT4 and one-carbon metabolites levels is helpful to identify the risk of MetS in patients with SMI and provide reference for prevention and treatment.

Objective:To investigate the levels of β-amyloid 1-42 (Aβ1-42) and total bilirubin (TBIL) in serum of patients with Alzheimer ′s disease (AD) and the relationship between them.Methods:A case-control study was conducted to select 73 patients with AD who were hospitalized in Beijing Huilongguan Hospital from November 2023 to February 2024 as AD group, and 70 healthy controls (HC) were selected as HC group. The basic information of all subjects and the clinical information of AD patients were collected, and the levels of Aβ1-42 and TBIL were detected and compared between the two groups. The effects of Aβ1-42 and TBIL on AD were analyzed by binary logistic regression. Correlation analysis was used to analyze the relationship between TBIL and Aβ1-42 in AD group and HC group. According to the level of Aβ1-42 in AD patients, they were divided into Aβ1-42 elevated group and Aβ1-42 normal group. The differences of clinical data and TBIL levels between the two groups were compared. According to the quartile of TBIL in AD patients, they were divided into Q1 group, Q2 group, Q3 group and Q4 group. The correlation between TBIL and the risk of Aβ1-42 elevation was analyzed by binary logistic regression. The receiver operating characteristic (ROC) curve was drawn to analyze the ability of TBIL level to predict the increase of Aβ1-42 in AD patients.Results:There was no significant difference in gender, marital status, education level, smoking and drinking between AD group and HC group ( P>0.05), while the levels of Aβ1-42 and TBIL and age in AD group were significantly higher than those in HC group [101.10(71.20, 128.60) pg/ml/22.40(10.00, 39.60) pg/ml , Z=-8.714, P<0.001;(11.00±3.22/8.07±3.00) μmol/L , t=5.621, P<0.001;(77.14±8.20/68.30±10.27) years, t=5.672, P<0.001]. For AD patients, the TBIL level in the Aβ1-42 elevated group was lower than that in the Aβ1-42 normal group [(10.05±2.94/11.66±3.28) μmol/L , t=-2.148, P=0.035], while there was no significant difference in other demographic and clinical data between the two groups ( P>0.05). Binary logistic regression analysis showed that higher levels of Aβ1-42 ( OR=1.021, 95% CI：1.010-1.032) and TBIL ( OR=1.505, 95% CI：1.249-1.814), older age ( OR=1.083, 95% CI：1.020-1.150) and female ( OR=4.348, 95% CI：1.253-15.094) were risk factors for AD. Correlation analysis showed that TBIL was negatively correlated with Aβ1-42 in AD patients ( r=-0.322, P=0.006). After adjusting the relevant covariates, binary logistic regression showed that compared with AD patients in Q1 group, the risk of Aβ1-42 elevation in AD patients in Q4 group was lower ( OR=0.052, 95% CI：0.005-0.535, P<0.05), and TBIL was negatively correlated with the risk of Aβ1-42 elevation ( P trend<0.05). ROC curve showed that the area under the curve (AUC) of TBIL in predicting the increase of Aβ1-42 in AD patients was 0.642. Conclusion:The levels of Aβ1-42 and TBIL in AD patients were higher, and the level of TBIL was negatively correlated with the risk of Aβ1-42 elevation.

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.

Objective:To investigate the effects of free triiodothyronine/free thyroxine(FT3/FT4) and one carbon metabolites on metabolic syndrome(MetS) in patients with severe mental illness(SMI).Methods:Retrospective case-control study was conducted to select 328 patients with SMI who were hospitalized in Beijing Huilongguan Hospital from January 2022 to August 2023 as the study subjects, including 180 patients with schizophrenia (SZ), 74 patients with bipolar disorder (BD), and 74 patients with major depression (MDD). Another 74 healthy subjects in the same period were selected as the control group. The levels of thyroid hormones and one-carbon metabolites [ folic acid, vitamin B12 (VitB12) and homocysteine (HCY) ] were compared between the two groups. At the same time, clinical data and MetS related information of SMI patients were collected. Partial correlation analysis and Logistic regression analysis were used to study the relationship between FT3/FT4 and one-carbon metabolites and MetS risk factors and insulin resistance in SMI patients, respectively.Results:There were statistically significant differences in gender, age, course of disease, smoking rate, body mass index (BMI), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG)/HDL-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), antipsychotic drug use rate, mood stabilizer use rate, antidepressant drug use rate and hypoglycemic treatment among SZ, BD and MDD groups in SMI patients (all P<0.05).Compared with the control group, FT3/FT4, folic acid and VitB12 in patients with SMI were significantly lower ( Z=-4.315, P<0.001; Z=-8.216, P<0.001; Z=-6.021, P<0.001), HCY increased significantly ( Z=-8.789, P<0.001);Partial correlation analysis showed that FT3/FT4 in patients with SMI was positively correlated with TG( r=0.303, P<0.001), TG/HDL-C( r=0.228, P<0.001), insulin resistance index(HOMA-IR)( r=0.204, P<0.001), triglyceride glucose index(TyG)( r=0.284, P<0.001), triglyceride glucose body mass index(TyG-BMI)( r=0.211, P<0.001) and body mass index(BMI)( r=0.154, P=0.005), and negatively correlated with insulin sensitivity index(QUICKI)( r=-0.205, P<0.001). VitB12 was positively correlated with HDL-C( r=0.144, P=0.009) and QUICKI( r=0.115, P=0.038), and negatively correlated with TyG-BMI ( r=-0.122, P=0.028) and BMI ( r=-0.127, P=0.022). HCY was positively correlated with TyG ( r=0.114, P=0.039) and TyG-BMI ( r=0.188, P=0.001). Multivariate ordinal logistic regression analysis showed that smoking( OR=1.602,95% CI=1.004-2.558), female( OR=1.736,95% CI=1.041-2.895), FT3/FT4( OR=17.811,95% CI=1.596-198.764), HCY ( OR=1.026,95% CI=1.009-1.043) and BD ( OR=2.150,95% CI=1.092-4.232) were the influencing factors of the number of risk factors for MetS in patients with SMI, while VitB12 ( OR=0.997,95% CI=0.995-0.998) was a protective factor; binary Logistic regression analysis showed that patients with SMI with long course of disease( OR=1.024,95% CI=1.008-1.041) and high level of HCY ( OR=1.033,95% CI=1.014-1.052) were more likely to have MetS. Conclusion:Dynamic monitoring of FT3/FT4 and one-carbon metabolites levels is helpful to identify the risk of MetS in patients with SMI and provide reference for prevention and treatment.