Objective: To systematically analyze the current status and influencing factors of platelet supply in medical institutions across China, and to explore the problems and future development directions of the existing supply models. Methods: From February 25 to March 5, 2025, a web-based questionnaire survey was performed. A self-designed questionnaire was distributed to staff in the blood transfusion departments of medical institutions nationwide in China. Data on the current status and influencing factors of platelet supply were collected and analyzed. Results: A total of 2 268 responses were collected in this survey, with 1 366 valid questionnaires finally included, covering 33 provinces, autonomous regions, and municipalities directly under the central government across China. The survey revealed that platelet supply in Chinese medical institutions exhibited a pattern of "sufficient in the eastern region, stable in the central region, and scarce in the western region": adequate in East China; generally favorable in South China except Guangxi; centered on Beijing and Tianjin in North China; basically met but with insufficient reserves in Central China; subject to seasonal fluctuations in Northeast China; only meeting the baseline supply in Yunnan, Guizhou, and Sichuan in Southwest China; and notably short in Qinghai, Ningxia, and Xinjiang in Northwest China. Family donor mobilization was required in 81.2% (1 109/1 366) of institutions, whereas this proportion was only 12.7% (173/1 366) among institutions with sufficient supply. Tertiary hospitals constituted the main users, among which tertiary Class A hospitals had the highest sufficiency rate, and secondary Class B hospitals showed the most pronounced shortage. A total of 84% (1 147/1 366) of institutions lacked a professional management team; only 19% (266/1 366) had an inventory warning system, of which 88% (234/266) considered it effective. Platelet reservation required 3 days in 33% (458/1 366) of institutions. The mandatory transfusion rate was 30.55% (29/118) when the reservation lead time exceeded 3 days, representing an increase of 5.98% compared with 24.57% (55/180) in the same-day reservation group. For optimization, most institutions called for improved blood donation services, strengthened education and incentives, establishment of regional coordination and policy collaboration, and supplementary suggestions focused on technologies for extending platelet shelf life. Conclusion: Regional imbalance in platelet supply across China is prominent, with supply shortages in some provinces, reliance on family donor mobilization in most institutions, weak grassroots support capacity, imperfect management systems, and supply timeliness constraining clinical practice. Systematic improvements are needed in optimizing blood donation services, strengthening regional coordination, improving relevant policies, and developing platelet preservation technologies, so as to enhance the level of supply security and patient safety.

Objective: To develop a prediction model for mild cognitive impairment (MCI) risk among the elderly, so as to provide a tool for MCI early screening. Methods : From July 2022 to September 2024, a multi-stage stratified random cluster sampling method was used to recruit permanent residents aged ≥65 years from the Xinjiang Uygur Autonomous Region as study participants. Data on sociodemographic characteristics, nutritional status, body composition indices, bone mineral density, and handgrip strength were collected through questionnaires and physical examinations. Sarcopenia was defined based on appendicular skeletal muscle index and handgrip strength. MCI was assessed using the Mini-Mental State Examination, with adjustments for educational level. Participants were randomly divided into a training set and a validation set in a 7∶3 ratio. LASSO regression and multivariable logistic regression models were employed to screen for predictors and construct an MCI risk prediction model. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve and decision curve analysis (DCA). Results: A total of 1 641 participants were surveyed, including 755 males (46.01%) and 886 females (53.99%). The majority of participants were aged 65-<75 years, comprising 1 154 individuals (70.32%). MCI was detected in 517 participants, corresponding to a detection rate of 31.51%. Resultsfrom LASSO regression and multivariate logistic regression analysis showed that residence (rural, OR = 2.323, 95% CI: 1.682-3.210), age (75-<85 years, OR = 1.405, 95% CI: 1.019-1.937; ≥85 years, OR = 3.655, 95% CI: 1.696-7.875), educational level (primary school, OR = 0.341, 95% CI: 0.247-0.472; junior high school, OR = 0.255, 95% CI: 0.160-0.408; high school, OR = 0.286, 95% CI: 0.154-0.531; bachelor's degree or above, OR = 0.120, 95% CI: 0.041-0.351), history of alcohol consumption (yes, OR = 3.216, 95% CI: 2.164-4.779), risk of malnutrition (yes, OR = 1.464, 95% CI: 1.064-2.014), sarcopenia (yes, OR = 3.197, 95% CI: 2.332-4.385), and waist-to-hip ratio (abnormal, OR = 1.540, 95% CI: 1.159-2.048) were identified as predictive factors for MCI among the elderly. In the training set, the area under the ROC curve, sensitivity, and specificity were 0.788, 0.719, and 0.712, respectively. In the validation set, the corresponding values were 0.784, 0.913, and 0.542, respectively. DCA demonstrated that the model provided a higher clinical net benefit for predicting MCI risk when the risk threshold probability ranged from 0.124 to 0.764. Conclusion The prediction model developed in this study demonstrates good discriminative ability and clinical utility, indicating its substantial value for predicting the MCI risk among the elderly.

ObjectiveTo observe the clinical efficacy and safety of Huatan Quyu formula in treating cerebral small vessel disease （CSVD） with phlegm and blood stasis blocking collateral pattern via randomized controlled trial， and explore its mechanism of improving CSVD by regulating glymphatic system （GS） circulation. MethodsSixty-eight CSVD patients with phlegm and blood stasis blocking collateral pattern in the Department of Encephalopathy， Affiliated Hospital of Shaanxi University of Chinese Medicine from April to December 2024 were selected and randomly divided into an experimental group （34 cases） and a control group， with 34 cases in each group. Both groups received basic Western medicine treatment， while the experimental group additionally received Huatan Quyu formula. After a course of 12 weeks， the following parameters were compared between the two groups before and after treatment. Clinical outcomes were assessed using the Tinetti performance-oriented mobility assessment （POMA）， Montreal Cognitive Assessment （MoCA）， Scales for Outcomes in Parkinson's Disease-Autonomic （SCOPA-AUT）， and traditional Chinese medicine （TCM） syndrome scores of phlegm and blood stasis blocking collateral pattern. Perivascular space （PVS） in the frontal lobe/basal ganglia and cerebrospinal fluid （CSF） flow parameters in the cerebral aqueduct were evaluated by 3.0T brain MRI， cerebrospinal fluid flow imaging， and phase-contrast magnetic resonance imaging （PC-MRI）. Then， safety indicators were monitored， and SPSS 25.0 was used for statistical analysis. ResultsSixty-four patients completed the study （32 in each group）. ①Baseline data： No statistically significant difference was found between the two group. ②Efficacy indicators： After treatment， the experimental group exhibited significantly improved total POMA， SCOPA-AUT， and TCM syndrome scores （P<0.01）， outperforming the control group （P<0.05）. No significant change was observed in MoCA scores between the two groups. ③Imaging indicators： The experimental group showed a reduced PVS area alongside significantly increased CSF flow parameters （including downward flow during the systolic period， and upward flow during the diastolic period） （P<0.01）， which were superior to the control group （P<0.01）. ④Safety： The laboratory indicators were normal in both groups， with no drug-related adverse reactions. ConclusionFor CSVD patients with phlegm and blood stasis blocking collateral pattern， Huatan Quyu formula can safely and effectively improve motor function， autonomic nerve function， and TCM syndromes， with potential mechanisms related to pulsatile CSF flow enhancement and GS circulation efficiency improvement.

AIM To observe the effects of Yiqi Jiedu Tongluo Formula(YQJDTL)on renal microvascular endothelial function and prevention of renal injury in a rat model of type 2 diabetes mellitus(T2DM).METHODS The SD rats were randomly divided into a normal group and a model group.The model group was administered with high-fat diet combined with a single intraperitoneal injection of STZ to establish the T2DM model.The successfully modeled rats were randomly divided into the model group,the canagliflozin group(9 mg/kg),and the low-dose and high-dose YQJDTL groups(4.77,9.45 g/kg).The corresponding doses of the drug were administered by gavage for a total of 12 weeks,during which the rats underwent observation of their general condition and blood glucose changes.After the end of administration,the rats had their levels of renal index,24-hour UP,serum SCr,BUN,TC,TG,HDL-C,LDL-C,ET-1 and NOS measured;their changes in renal microvasculature and the degree of renal fibrosis observed using HE staining,Masson staining,PAS staining,and PASM staining;their ultrastructure of the glomeruli observed using transmission electron microscopy;their renal protein expressions of TGF-β,SMAD2,SMAD3,Col-1,VEGFA and PKC detected by immunohistochemical staining and Western blot;and their renal mRNA expressions of VEGFA,TGF-β,SMAD2 determined by RT-qPCR.RESULTS Compared with the model group,the high-dose YQJDTL group showed decreased levels of renal index,blood glucose,TG,TC,HDL,24 h UP,BUN,SCr and ET-1(P＜0.05,P＜0.01);increased LDL and NOS levels(P＜0.05,P＜0.01);reduced renal inflammatory infiltration and fibrosis degree,inhibited fusion of foot processes and thickening of basement membrane;decreased renal protein expressions of TGF-β,SMAD2,SMAD3,VEGFA,PKC and Col-1(P＜0.05,P＜0.01);and decreased mRNA expressions of VEGFA,TGF-β and SMAD2(P＜0.01).CONCLUSION In the rat models of T2DM,YQJDTL can reduce their levels of blood glucose and lipids by improving the renal indices levels and the renal microvascular endothelial functions to alleviate renal fibrosis and microangiopathy as well,and the mechanism may be associated with the down-regulated expressions of TGF-β/SMAD and VEGF pathway-related proteins.

Objective:To develop the Motivation for Bedtime Procrastination Questionnaire for College Students(CS-MBPQ)and evaluate its validity and reliability.Methods:Based on literature analysis,interviews with severe bedtime procrastinators,and open-ended surveys with college students,the initial questionnaire was formed.A total of 389 college students were recruited to conduct item analysis and exploratory factor analysis.Additionally,691 college students were selected for confirmatory factor analysis,criterion validity testing,and internal consistency reliability analysis,and 132 of them were retested two weeks later.The subscale of behav-ioral intention from the Theory of Planned Behavior Questionnaire(TPBQ),Bedtime Procrastination Scale(BPS),and a self-made question for the frequency of bedtime procrastination were used as criterion tools.Results:The CS-MBPQ consists of 10 items,encompassing three factors:emotional need,external influence,and behavioral attitude,explaining 63.31％of the variance.Confirmatory factor analysis indicated that the three-factor structure model of CS-MBPQ fitted well(x2/df=4.90,RMSEA=0.07,CFI=0.96,TLI=0.94).The CS-MBPQ total scores and scores for each factor were positively associated with the score of intentions to sleep on time,BPS scores,and bed-time procrastination frequency(ICC=0.14-0.53,Ps＜0.05).The internal consistency reliabilities for CS-MBPQ and the three factors were 0.87,0.89,0.74,and 0.66,respectively,and the test-retest reliabilities(ICC)were 0.74,0.66,0.69,and 0.58,respectively.Conclusion:The Motivation for Bedtime Procrastination Questionnaire for College Students(CS-MBPQ)demonstrates good validity and reliability,which could be used as a tool to evaluate motivations for bedtime procrastination among Chinese college students.

Objective:To explore the impact of adverse childhood experiences on psychosomatic symptoms and job burnout in the nursing population.Methods:Utilizing a multistage stratified cluster random sampling meth-od,1 661 nurses were selected.Through a 1∶2 propensity score matching approach,demographic and work-related characteristics were balanced between the positive and negative groups of adverse childhood experiences.Finally,880 cases were successfully matched(positive group:300 cases,negative group:580 cases).Linear regression was employed to explore the relationship between nurses'adverse childhood experiences and psychosomatic symptoms(anxiety,depression,physical symptoms),as well as job burnout.The average treatment effect among the treated(ATT)was calculated.Results:Linear regression results revealed a significant positive association between adverse childhood experiences and scores for anxiety symptoms,depression symptoms,physical symptoms,and job burnout(B=1.68,2.67,2.89,5.90;ATT=1.64,2.58,2.82,5.96,Ps＜0.001).However,there was no statistically signif-icant association with scores for a sense of inadequacy in individual achievements(P＞0.05).Conclusion:Nurses who have experienced childhood adverse experiences may exhibit more severe psychosomatic symptoms and job burnout compared to those who have not experienced such adversities during childhood.

Objective:To evaluate the association between erectile dysfunction(ED)and myocardial infarction(MI)using two sample Mendelian randomization.Methods:A Mendelian randomization study was conducted using comprehensive data on ED and MI from extensive genome-wide association data.Using inverse variance weighted analysis for causal relationships,and correct for confounding factors using multivariate Mendelian randomization,the potential mediating effects were evaluated as well.Based on Gene-card data,the genes related to ED and MI were identified.Molecular docking was used to reveal spontaneously bound drug molecules.Results.Our study found that exposure to ED was a risk factor for MI(OR:1.001 0,95％CI:1.000 2-1.001 8,P=0.017 7),which also held true in the validation dataset(OR:1.028 5,95％CI:1.005 0-1.052 6,P=0.017 2).No statistically significant heterogeneity or horizontal pleiotropy was found.The results of reverse Mendelian randomization analysis showed any reverse causal re-lationship between ED and MI.In multivariate Mendelian randomization analysis,after excluding confounding factors(excluding tri-glycerides and high-density lipoprotein),the P-value remained less than 0.05,and the OR ranged from 1.000 1 to 1.000 7,indica-ting that ED was still a risk factor for MI.In the mediation analysis,it was found that the current mediation ratio of smoking to MI was 13.06％.In summary-data-based mendelian randomization analysis,it was found that the gene PTPN11 was a common target gene for MI and ED(OR=0.990,P＜0.001).Subsequent molecular docking with sildenafil,clopidogrel,and dapoxetine could spontaneous-ly bind to the PTPN11 gene receptor.Conclusion:There is a causal relationship between ED and MI,with smoking as a potential mediating factor,and the gene PTPN11 being a co-target gene.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective To investigate the mechanism of Achyranthoside Ⅰ inhibits pyroptosis in chondrocytes through the nuclear factor-κB(NF-κB)/NOD receptor protein structure domain related proteins 3(NLRP3)/cystine containing aspartate specific proteins-1(caspase-1)signaling pathway.Methods Primary mouse chondrocytes were divided into blank group(phosphate buffered solution with the same volume),model group[10 ng·mL-1 interleukin-1β(IL-1 β)],control group(10 ng·mL-1 IL-1β+20 μmol·L-1 celecoxib)and experimental group(10 ng·mL-1 IL-1β+3 μg·mL-1 Achyranthoside Ⅰ).After 24 hours of intervention,the cell proliferation was measured by cell counting kit 8,the levels of superoxide dismutase(SOD),malondialdehyde(MDA),IL-1 and IL-6 were detected by enzyme-linked immunosorbent assay,the protein expression levels of NF-κB p65,NLRP3 and caspase-1 were detected by Western Blot.Results The apoptosis rates in experimental,control,model and blank groups were(13.34±0.61)％,(15.64±1.01)％,(21.81±1.10)％and 0;the SOD levels were(147.03±16.49),(130.09±7.33),(122.03±10.71)and(164.40±22.74)nU·mL-1;the MDA levels were(6.43±0.71),(7.63±1.01),(8.89±1.84)and(5.69±0.81)nmol·L-1;the IL-1 levels were(338.69±40.95),(361.78±32.15),(391.44±30.59)and(289.23±25.19)pg·mL-1;the IL-6 levels were(89.96±8.81),(101.10±11.59),(120.39±14.71)and(60.29±6.03)pg·mL-1;the relative expression levels of NF-κB p65 were 0.68±0.05,0.97±0.05,1.26±0.05 and 0.57±0.05;the relative expression levels of NLRP3 were 0.71±0.08,1.02±0.10,1.50±0.06 and 0.31±0.05;the relative expression levels of caspase-1 were 0.70±0.07,1.29±0.08,1.66±0.07 and 0.51±0.07,respectively.Compared with the model group,the differences of above indexes were statistically significant in the experimental group(all P＜0.05).Conclusion Achyranthoside Ⅰ can improve the oxidative stress status induced by IL-1 β in chondrocytes,reduce the expression of proteins related to the NF-κB signaling pathway,and thereby decrease the occurrence of caspase-1 dependent pyroptosis,providing a protective effect on chondrocytes.

Objective This study investigated feasible cases and their significance in promoting the"generalized"development of inspection through digital-intelligent equipment.Methods A qualitative research approach was used,involving interviews conducted between February 2025 and March 2025 with experts in traditional Chinese medicine diagnostics,clinical research methodology,medical engineering integration,and related disciplines,using both online and offline methods.In accordance with the Consolidated Criteria for Reporting Qualitative Research,feasible cases involving the specific application of digital equipment in various parts of observation were collected through item enrichment.The significance of extending observation capabilities via these cases was analyzed,along with the overall implications of integrating digital technologies with traditional inspection method.Results Interviews were completed with 11 experts from domestic universities and research institutes in the fields of traditional Chinese medicine diagnosis,medical engineering integration,and related disciplines.A total of 78 feasible cases of digital-intelligent inspection were identified,along with 69 insights regarding the significance of enhancing the inspection capabilities.These insights were synthesized into two dimensions and 23 holistic meanings.The first dimension is to expand the scope of inspection,including obtaining internal environmental characteristics,observing external environmental characteristics,expanding thermodynamic characteristic data,and crossing time and space.The second dimension is to improve the quality of observation and diagnosis information collection and analysis,including 19 specific meanings,such as standardized collection environment,objective quantification,and refined observation.Conclusion Digital-intelligent equipment plays a significant role in expanding the scope of inspection content and achieving high-quality acquisition and analysis of extensive inspection information.These advancements extend and enrich the capabilities of traditional inspection method in traditional Chinese medicine.