Association between the hemoglobin-to-red cell distribution width ratio and poor sleep quality in US adults.

A HBNP delivery system enhances the pharmacokinetics and efficacy of TIG in K. pneumoniae infections

Tibetan medicine Bawei Chenxiang Wan attenuates chronic mountain sickness by targeting the AKT/FOXO3a/CAT axis to inhibit oxidative stress.

Introduction: Major gastrointestinal bleeding (MGB) is a critical complication of sepsis that is associated with a poor prognosis. We aimed to identify independent predictors of MGB in a large multicenter cohort of septic patients to facilitate clinical risk stratification. Materials and methods: This retrospective study analyzed data collected from four tertiary hospitals in China between 2016 and 2023. Data on patient demographics, comorbidities, infection sources, admission laboratory parameters and treatments were collected. The primary outcome was MGB within 28 d, defined as overt bleeding with a hemoglobin drop >20 g/L or transfusion requirement. Results: Of 10,249 eligible patients, 205 (2.0%) developed MGB. In-hospital mortality was significantly higher in the MGB group compared to the non-MGB group (44.0% vs. 17.0%, p < 0.001). Multivariable analysis identified independent risk factors for MGB: renal dysfunction (aOR 1.61), malignancy or immunosuppression (aOR 1.55), gastrointestinal infection (aOR 1.50), elevated blood urea nitrogen (BUN; aOR 1.03) and older age (aOR 1.01). Conversely, urinary tract infection (aOR 0.29) and higher baseline hemoglobin (HGB) levels (aOR 0.99) were associated with a lower risk. The predictive model achieved an area under the curve (AUC) of 0.702. Conclusions: Although MGB occurred in only 2.0% of septic patients, it was associated with substantially higher mortality. Older age, renal dysfunction, elevated BUN and gastrointestinal sources were key drivers of risk, while urinary tract infection was associated with a lower risk. These findings underscore the importance of early risk stratification and targeted preventive strategies in high-risk patients to mitigate bleeding events and improve survival.

Comparative multitarget vaso-protective effects of brown and black Vigna unguiculata (L.) walp extracts: Evidence of stronger modulation of sickle cell pathophysiology by the brown variety.

Sickle Cell Disease (SCD) and β-thalassemia are hemoglobinopathies characterized by significant morbidity and mortality due to defective hemoglobin production, chronic anemia, and systemic complications. Pharmacological agents such as hydroxyurea and thalidomide have demonstrated efficacy in managing these disorders by modulating fetal hemoglobin (HbF) levels and alleviating disease severity. Hydroxyurea, a well-established therapy, increases HbF production by stimulating gamma-globin synthesis and reducing hemoglobin S (HbS) polymerization. In SCD, it mitigates vaso-occlusive crises, acute chest syndrome, and anemia by stabilizing red blood cells, decreasing neutrophil and platelet counts, and promoting nitric oxide-mediated vasodilation. In β-thalassemia, hydroxyurea improves erythropoiesis, reduces transfusion dependency, and alleviates extramedullary hematopoiesis. Thalidomide, an emerging agent, induces HbF through transcriptional regulation of gamma-globin genes by inhibiting BCL11A and activating erythroid Krüppel-like factor (KLF1). It has shown significant efficacy in increasing HbF levels, particularly in β-thalassemia, where it also improves anemia, reduces ineffective erythropoiesis, and lessens transfusion requirements. Additionally, thalidomide's anti-inflammatory effects, mediated by suppression of pro-inflammatory cytokines like TNF-α, may contribute to its therapeutic benefits in SCD. The synergistic action of hydroxyurea and thalidomide presents a promising approach for optimizing treatment outcomes, as their combined effects on HbF induction and inflammation modulation may enhance clinical benefits. While hydroxyurea remains the cornerstone of SCD therapy, thalidomide offers promise as a complementary or alternative treatment, especially for β-thalassemia patients unresponsive to conventional approaches. This review discusses the molecular mechanisms, clinical benefits, and limitations of hydroxyurea and thalidomide in SCD and β-thalassemia, highlighting their potential for optimizing therapeutic strategies in these hemoglobinopathies.

This study aimed to compare the effects of low-load circuit training (LL-CT) and moderate-load circuit training (ML-CT) on physical performance adaptations, hormonal responses, and hematological parameters in resistance-trained men. Thirty-two resistance-trained males (age 20.31 ± 1.00 y) were randomly assigned to three groups: LL-CT (n = 11), ML-CT (n = 11), or CON (n = 10). Participants in the training groups performed two sessions per week for 8 weeks. Both protocols consisted of four rounds of five exercises in a circuit format with a 30 s work:30 s rest duty cycle and 2-min inter-set rest. Exercise intensity was prescribed as 30% 1RM (LL-CT) or 70% 1RM (ML-CT), where 1RM was determined for four lifts: power clean, back squat, bench press, and deadlift. Loads during each exercise were expressed as a percentage of that exercise's own 1RM. Pre- and post-intervention measures included one-repetition maximum in the back squat and bench press (kg); countermovement jump and squat jump height (cm); 30-m sprint time (s); 505 change-of-direction time (s); peak power (W) and relative peak power (W·kg-1); and maximal oxygen uptake VO2max (mL·kg-1·min-1). Blood samples were collected to analyze resting hormone levels and hematological profiles. Both the LL-CT and ML-CT groups showed significant improvements in 1RM, CMJ, SJ, 30-m sprint, 505 agility, PP, and VO2max (p < 0.05), whereas the CON group only improved in squat 1RM (p < 0.05). No significant differences were observed in RPP across all three groups (p > 0.05). Between-group comparisons revealed that only 1RM showed significant superiority in the training groups compared to CON (p < 0.05), with no significant differences observed in other performance outcomes (p > 0.05). Both LL-CT and ML-CT resulted in significant increases in total testosterone (T) and mean corpuscular hemoglobin concentration (MCHC) (p < 0.05), while only ML-CT showed a significant improvement in hemoglobin (HB). No significant changes were observed in red blood cell (RBC) count, white blood cell (WBC) count, red cell distribution width (RDW), or hematocrit (HCT) across groups. Under comparable hormonal responses and hematological adaptations, LL-CT demonstrated greater mechanical efficiency while achieving physical performance improvements equivalent to those of moderate-load training.

To explore the correlation between the serum uric acid/creatinine ratio(SUA/Cr) and skeletal muscle mass index (SMI) in patients with lumbar spine diseases. A total of 101 inpatients with lumbar spine diseases admitted from September 2023 to September 2024 were selected. The clinical data and laboratory test results of the patients were collected. Dual-energy X-ray absorptiometry(DXA) was used to measure bone mineral density(BMD),SMI,and body mass index (BMI). According to the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS) 2019,the patients were divided into the low SMI group (51 cases) and the normal SMI group (50 cases). Clinical data were compared between the two groups. Spearman correlation analysis was used to study the correlation between SMI and related variables,and multivariate Logistic regression analysis was used to identify the influencing factors of SMI. Univariate analysis of variance showed that there were statistically significant differences between the two groups in BMI,total body bone mineral density (TBMD),hemoglobin(HB),serum uric acid(UA),high-density lipoprotein cholesterol(HDL-C),and SUA/Cr(all P<0.05). Spearman correlation analysis was performed between SMI and the indicators with P<0.05 in the inter-group comparison. The results showed that in both the low SMI group and the normal SMI group,SMI was positively correlated with BMI,total bone mineral density (TBMD),HB,UA,and SUA/Cr (all P<0.05),and negatively correlated with HDL-C. The direction of correlation between SMI and each indicator was consistent in the two groups. Taking the presence of low SMI (low SMI=1,normal SMI=0) as the dependent variable,and the indicators with statistically significant correlation(P<0.05) as independent variables,multivariate Logistic regression analysis was conducted. Although there were differences in baseline characteristics between the two groups,the direction of correlation between SMI and each indicator was consistent in the correlation analysis. Therefore,the total sample size(n=101) was used for the Logistic analysis. The forward regression method was used to evaluate the regression equation,and a regression model with BMI,TBMD,HDL-C,and SUA/Cr as independent variables was obtained. The analysis showed that BMI,TBMD,HDL-C,and SUA/Cr were independent influencing factors of SMI. Low SUA/Cr is a risk factor for low SMI in patients with lumbar spine diseases. For patients with lumbar spine diseases and low SUA/Cr,screening for sarcopenia should be emphasized.

Gestational diabetes mellitus (GDM) is associated with complications such as fetal macrosomia, shoulder dystocia, and prolonged labor, making cesarean section an important delivery option to reduce maternal and neonatal risks. This study aims to identify factors associated with cesarean delivery in women with GDM and to develop a predictive model for clinical risk assessment. This retrospective cross-sectional study included 2,276 GDM patients who were delivered at a tertiary hospital from January 2020 to December 2023. Data on age, BMI, gravidity, abortion history, and family history of diabetes were collected. Patients were grouped by delivery mode. ANOVA/Kruskal-Wallis, chi-square test, Pearson correlation, and stepwise logistic regression were used to identify independent predictors. Two prediction models were developed and evaluated using ROC curves. Among all included GDM patients, 200 (8.79 %) underwent cesarean section. The average age and BMI were 30.8±3.9years and 23.658±4.221, respectively. Cesarean section rates increased with rising BMI (p<0.05). Significant differences among BMI groups were observed in age, number of pregnancies, miscarriage history, family history of diabetes, HbA1c, hemoglobin (HGB), and platelet count (PLT) (all p<0.05). BMI was correlated with adjusted BMI, HbA1c, HGB, and PLT. Logistic regression identified six independent predictors of cesarean section: BMI, adjusted BMI, HGB, PLT, prothrombin time (PT), and D-dimer. Model one showed good predictive ability (AUC=0.792). After optimization, Model two (including BMI grouping, number of miscarriages, and HbA1c) performed better (AUC=0.842). A multi-parameter model demonstrates strong potential for predicting cesarean risk in GDM patients and may assist clinical decision-making.

Purpose Ionizing radiation (IR) can induce long-term alterations in the hematopoietic and immune systems. This study aimed to investigate the potential of luteolin (with known anti-inflammatory and anti-senescence properties), a natural flavonoid, to mitigate radiation-induced hematopoietic and immune system long-term damage in a mouse model. Materials and methods C57BL/6 mice were subjected to single whole-body irradiation (WBI) to establish a model of radiation-induced long-term damage, with five mice per group. WBI was performed using a γ-ray irradiator at a dose rate of 0.88 Gy/min, with a total radiation dose of 6 Gy. Four months post-IR, mice were administered luteolin (0.5 mg/kg/day) via oral gavage for two months. Flow cytometry was employed to analyze peripheral blood counts, bone marrow hematopoietic stem/progenitor cells (HSPCs) populations, and immune cell compositions in the thymus, spleen, and mesenteric lymph nodes (MLNs). Senescence-associated β-galactosidase (SA-β-Gal) staining and immunohistochemical analysis of p16 and p21 proteins were performed to assess aging-related changes in the spleen and thymus. Results WBI significantly reduced white blood cell (WBC) counts and induced myeloid–lymphoid skewing, with increased neutrophils and decreased lymphocytes, while also reducing red blood cell (RBC) counts and hemoglobin (HGB) levels. Luteolin did not alter total WBC counts but partially restored lymphocyte proportions and improved RBC and HGB levels. In bone marrow, WBI disrupted the HSPC compartment, decreasing LSKs and CD34+ LSKs while expanding CD34− LSKs and MEPs; these changes were partially reversed by luteolin. In immune organs, luteolin alleviated radiation-induced senescence in the thymus and spleen, increased B-cell proportions, and reduced macrophage accumulation, with minimal effects on T-cell subsets. Conclusions Luteolin partially mitigates radiation-induced long-term injury by attenuating cellular senescence and modulating hematopoietic and immune system alterations. These results suggest that luteolin may represent a potential adjunctive strategy for alleviating long-term hematopoietic and immune damage following radiation exposure.

ObjectiveThis study aims to investigate the efficacy of enteral nutrition support combined with prone position mechanical ventilation in patients with severe pneumonia.MethodsThis retrospective cohort study included 55 patients with severe pneumonia, who were allocated to a control group (n = 35) receiving conventional mechanical ventilation combined with early enteral nutrition support, and an observation group (n = 20) receiving prone position mechanical ventilation combined with early enteral nutrition support. The intervention lasted for 1 week. Changes in blood gas indicators were compared before and after the intervention. Improvement in nutritional status and inflammatory indicators, including serum prealbumin (PAB), albumin (ALB), haemoglobin (HGB) and C-reactive protein (CRP), and procalcitonin (PCT), were assessed. The incidence of adverse events during the intervention was compared between groups. This study was approved by the Ethics Review Committee of our hospital, and written informed consent was obtained from all participants.ResultsAfter the intervention, both groups showed increased PaO2, SpO2, and PaO2/FiO2 levels and decreased PaCO2 levels, with more pronounced improvement observed in the observation group. Nutritional indicators (PAB, ALB, and HGB) improved in the observation group. CRP and PCT levels were reduced in both groups, with the observation group demonstrating lower levels. The observation group showed a lower incidence of adverse events than the control group (15.00% vs. 42.86%).ConclusionEnteral nutrition support combined with prone position mechanical ventilation reduces the incidence of adverse events, improves respiratory function and nutritional status, and alleviates inflammatory response in patients with severe pneumonia.

Free palatal gingival grafts (FGG) are commonly harvested during mucogingival procedures. The present study investigates age-related local and systemic early secondary wound healing outcomes, following FGG harvest in a rat model. A 4.2 mm diameter defect was created in the palate of 24 younger (2m) and 24 older (6m) Wistar male rats. They were divided according to experimental days 1-4. Values of complete blood count, chemistry analysis, and inflammatory biomarkers were assessed. Specimens were examined histologically. Wound healing was similar between groups, with a significant de-epithelized surface reduction from day 1 to day 2 (p=0.0007) and day 2 to day 3 (p=0.002), without a significant difference between day 3 and day 4 (p=0.4). Histological inflammation scores were consistently higher in younger individuals, suggesting a more pronounced local inflammatory response. Picrosirius red staining revealed more dynamic collagen fiber organization in the younger rats, with significant differences at days 2 (p=0.01), 3 (p=0.03), and 4 (p=0.03). Age-related differences were noted regarding levels of WBC (white blood cells), RBC (red blood cells), HGB (hemoglobin), HCT (hematocrit), MCV (mean corpuscular volume), MCH (mean corpuscular hemoglobin), platelet counts, creatinine, SGPT (serum glutamic pyruvic transaminase), SGOT (serum glutamic-oxaloacetic transaminase), and AlkPhos. Younger rats displayed higher MCV, MCH, platelet counts, and a delayed rise in SGPT, creatinine, and AlkPhos over time, whereas older rats presented constantly higher WBC, RBC, HGB, HCT, and creatinine levels. Serum TNF-α levels were initially higher in the older rats but declined rapidly. In contrast, IL-6 peaked earlier and was higher in the older rats. IL-18 peaked earlier in the older (day 2) compared with the younger rats (day 3). Local and systemic early events following surgery of the palatal mucosa revealed age-related differences. The older rats demonstrated in general a decreased local response vs. an increased systemic response. Free palatal gingival grafts are commonly harvested during mucogingival procedures around teeth and implants. The present study investigated age-related local and systemic early phase outcomes following palatal free gingival harvest with a 4.2 mm diameter punch in a rat model. Younger and older Wistar male rats were included and divided into four experimental groups according to experimental days 1-4. Systemic outcome parameters included complete blood count, chemistry analysis, and immunological parameters. Biopsies were examined for local histological-inflammatory outcome and collagen immunohistochemistry. Wound healing was similar between the older and younger groups. Local inflammation scores were consistently higher in younger rats. Collagen staining revealed more dynamic activity in the younger rats. The older group exhibited higher and more stable serologic levels of WBC, RBC, HGB, HCT, and creatinine. The younger group displayed higher serologic MCV, MCH, platelet counts, and a delayed rise in SGPT, creatinine, and AlkPhos over time. Serum TNF-α levels were initially higher in the older group but declined rapidly, IL-6 peaked higher in the older group and IL-18 peaked earlier in the older group. It can be concluded that local and systemic wound healing early events following surgery of the palatal mucosa reveal age-related differences. The older group demonstrated in general a decreased local response versus an increased systemic response.

Pulmonary hypertension (PH) is a progressive cardiopulmonary disorder with high mortality, necessitating non-invasive methods for early detection and treatment evaluation. In this paper, this study proposes a novel machine learning model for non-invasively identifying the therapeutic effects of Baicalin in PH using routine hematological indicators. The core innovation is an enhanced Bat Algorithm (BA) variant, termed RGBA, which integrates an Elite-based Random Walk Strategy (ERWS) and an Elite Guided Strategy (EGS) to achieve a superior balance between exploration and exploitation. And the RGBA demonstrated significantly improved global search capability in IEEE CEC 2014 benchmark tests, outperforming several state-of-the-art meta-heuristic algorithms. Subsequently, a binary version of RGBA (bRGBA) was developed and combined with a Kernel Extreme Learning Machine (KELM) classifier within a wrapper-based feature selection framework, forming the bRGBA-KELM model. Applied to a dedicated PH dataset from murine models, bRGBA-KELM achieved a prediction accuracy of 97.43% via ten-fold cross-validation, outperforming nine comparable hybrid models. Critically, it identified four key blood biomarkers—Red Blood Cell count (RBC), Hemoglobin (HGB), Mean Corpuscular Volume (MCV), and Hematocrit (HCT)—that are mechanistically linked to PH pathogenesis and modulated by Baicalin treatment. In conclusion, the proposed RGBA offers a robust optimization tool, while the bRGBA-KELM model provides a clinically viable, non-invasive technical reference for early PH prediction and therapeutic assessment.

In this study, we investigated the effects of high temperature on plasma biochemical indicators and hematological parameters in blunt snout bream ( Megalobrama amblycephala ) following high-temperature stress. The fish (17.72 ±0.05 g) were exposed to two temperature conditions: a control group at ambient temperature (25°C, measured temperature 25.25 ± 0.34°C) and a high-temperature treatment group (34°C, measured temperature 33.07 ± 0.26°C). 6 fish were randomly sampled from each group at 0, 3, 6, 12, 24, and 48 hours. The results showed that high temperature significantly affects both plasma and hematological parameters. In the high-temperature group, both alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities initially increased and then decreased with prolonged stress duration. Alkaline phosphatase (ALP) activity reached its lowest point at 48 hours in this group(P &lt; 0.05). Total protein (TP) and albumin (ALB) levels in the high-temperature group decreased significantly after 3 hours (P &lt; 0.05). Glucose (Glu) levels in the high-temperature group increased significantly at 24 hours (P &lt; 0.05). As stress duration increased, white blood cell count (WBC), red blood cell count (RBC), hemoglobin (HGB) levels, and hematocrit (HCT) in the high-temperature group all showed an upward trend. The results indicate that high-temperature stress induces pronounced stress responses, liver dysfunction, and adaptive alterations in blood oxygen-carrying capacity in blunt snout bream.

Two-dimensional Pd-based nanosheets have aroused intense research interests as a promising catalyst for oxygen reduction reaction (ORR); nevertheless the electrocatalytic performance is still far from satisfactory due to the lack of basal plane active sites. Herein, the grain boundary (GB) engineering strategy and doping strategy are adopted to construct GB-rich Mn-doped Pd nanosheets (GB-PdMn NSs) via a one-pot wet chemical approach. Benefiting from the synergistic effect between the localized tensile strain aroused by GBs and electronic structure modification by Mn doping, GB-PdMn NSs exhibit a high mass activity of 2.65 A mg-1 at 0.90 V (vs RHE), which is 12.62 times higher than that of commercial Pt/C in alkaline media, together with a superior stability up to 10 000 potential cycles. In situ Raman spectroscopy investigations certify that GBs enhance the direct adsorption capacity of O2 and facilitate OOH* adsorption-desorption dynamics. Experimental results combined with theoretical calculations indicate that the localized lattice strain near the GBs can trigger the basal plane inert sites in Mn-doped Pd NSs, thereby optimizing the overall potential barrier for the entire ORR pathway. This work provides useful guidance for the synthesis and accurate modulation of Pd-based electrocatalysts with abundant active sites and high intrinsic activity.

Chronic lymphocytic leukemia (CLL) exhibits heterogeneous clinical outcomes influenced by chromosomal aberrations and genetic mutations. NOTCH1 and SF3B1 mutations are critical prognostic markers linked to disease progression and therapy resistance. This study analyzed 60 CLL patients from Hiwa Hospital (Sulaymaniyah, Iraq). Hematological parameters were assessed, and genomic DNA was sequenced for NOTCH1 exon 34 and SF3B1 exons 15–16. In silico pathogenicity was predicted using I-Mutant and PolyPhen-2. Mutations were found in 23.3% of patients (14/60), including the recurrent NOTCH1 c.7541_7542delCT (p.P2514Rfs) (10%) and SF3B1 c.2098A > G (p.K700E) (6.6%). Two novel NOTCH1 variants (PX317668 and PX317669) were also identified. Mutated cases showed advanced Binet stages, elevated LDH, and reduced hemoglobin (HGB) and platelet (PLT) counts. These findings reveal a notable prevalence of NOTCH1 and SF3B1 mutations associated with adverse features, expanding the CLL mutational spectrum and offering valuable prognostic and therapeutic insights.

Acute mountain sickness (AMS) is a major health challenge in high-altitude environments, yet its genetic underpinnings, particularly in the Chinese population, remain poorly characterized. We conducted a genome-wide association study (GWAS) on 156 AMS patients and 313 controls in Chinese population, revealing four novel suggestive single nucleotide polymorphisms (SNPs) (P < 1 × 10- 5). Among these four SNPs, two SNPs (rs1424442 and rs2246690) were successfully replicated in an independent cohort (P < 0.05), which contains 214 AMS patients and 196 controls. We provide functional insights for these two SNPs: the rs1424442-C allele is implicated in AMS susceptibility potentially by upregulating BPGM expression, thereby altering oxygen release and increasing red blood cell count (RBC) along with hemoglobin (HGB) concentration; while the rs2246690-A allele is associated with reduced UHRF2 expression in the prefrontal cortex and cognitive delay, offering a direct genetic link to AMS-related neurological impairment. Integrative analyses further substantiated the involvement of immune and gastrointestinal systems in AMS pathogenesis. Our work not only reports new genetic associations but also proposes specific molecular mechanisms, providing a valuable foundation for understanding AMS and developing future interventions.

Diethyl phthalate (DEP) is a synthetic organic compound widely used as plasticiser in various consumer products and it is known to act as an endocrine disruptor. Indiscriminate disposal of DEP-made products has harmful effects on fish and other aquatic organisms. Hence the present study was conducted to assess the toxic impact of DEP on general physiology of Clarias gariepinus. The fish were treated with different sub lethal concentrations (26.0, 34.5, 43.25, 53.8 and 62.5 µL/L) of DEP after series of range finding and acute studies. The LC50 value of DEP-exposed C. gariepinus was estimated to be 1.803 and 2.181 µL/L respectively of acute and chronic toxicities. Acute and chronic toxicity tests revealed disrupted normal swimming patterns, induced erratic movements, and impaired opercula function which may have implications for ecological functions of C. gariepinus. WBC count of 22.93±0.73 cells/mm³ was obtained in the control group and the treatment groups ranged from 22.97±3.00 to 33.40±1.16 cells/mm³. The P-value for WBC is 0.191, indicating no statistically significant difference between the control and treatment groups. The red blood cell (RBC) count in the control group was 1.50±0.29 million/mm³. The treatment groups varied, with the highest value (1.89±0.23 million/mm³) at 62.5 µL/L diethyl phthalate. The P-value is 0.548, indicating no significant differences in RBC counts between groups. Haemoglobin (HGB) levels in the control group were 4.93±1.13 g/dL. Treatment group values fluctuated, with the highest (6.93±1.36 g/dL) at 26 µL/L. The P-value of 0.639 indicates no significant difference in haemoglobin levels across the groups. The control group showed a haematocrit (HCT) level of 20.13±3.34%. Treatment groups varied, with no clear trend. The P-value is 0.520, suggesting that diethyl phthalate did not significantly affect haematocrit. Varied degrees of histological degradations like gill lamellae hypertrophy, hepatic vacuolation in liver and tubular degeneration in the kidneys were recorded and these anomalies were DEP concentration dependent. This work has revealed that DEP exerts its toxic effects even at sub lethal concentrations and this shows that Conclusively, DEP exerted dose-dependent toxic effects that disrupted normal pphysiological functions. Therefore, indiscriminate usage of DEP in environment should be monitored with strict vigilance.

Background:Inflammatory processes play a central role in rheumatoid arthritis (RA), involving complex interactions among cytokines and blood cell components. Current clinical tools, including the Disease Activity Score (DAS28), and biomarkers such as erythrocyte sedimentation rate and C-reactive protein (CRP), have limitations in monitoring disease activity.Objectives:This study aimed to assess the utility of routine hematological parameters as potential biomarkers for diagnosing RA and evaluating disease activity in drug-naïve patients.Methods:In this single-center retrospective study, 486 RA patients and 301 age- and sex-matched healthy controls were analyzed. Drug-naïve RA patients (not treated with disease-modifying antirheumatic drugs or glucocorticoids) were selected according to the 2010 American College of Rheumatology/European League Against Rheumatism criteria. Hematological parameters (white blood cell count and differential, hemoglobin (HGB), platelet count (PLT), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), red cell distribution width (RDW), and mean platelet volume (MPV)) were obtained and calculated from complete blood counts. Disease activity was assessed using the 28-joint DAS28 with CRP. Diagnostic accuracy and association with disease activity were evaluated using receiver operating characteristic (ROC) analysis, correlation tests, and logistic regression.Results:Compared with controls, RA patients exhibited distinct hematological profiles, with significantly higher NLR, PLR, and RDW, and lower MPV (all p < 0.001). Multivariate logistic regression identified MPV (odds ratio (OR): 1.315, 95% confidence interval (CI): 1.085–1.594, p = 0.005) and age (OR: 0.984, 95% CI: 0.969–0.999, p = 0.038) as independent factors associated with moderate-to-high disease activity. MPV showed significant inverse correlations with DAS28-CRP (r = −0.098, p = 0.031) and CRP (r = −0.148, p = 0.001). ROC analysis demonstrated that NLR had a modest performance (area under the curve (AUC): 0.676) for distinguishing RA patients from controls, and its performance in differentiating disease activity levels was weak (AUC: 0.598).Conclusion:This study suggests that hematological indices, particularly NLR, PLR, and MPV, hold potential as supplementary biomarkers in RA, but not standalone diagnostic tools. MPV emerged as an independent marker associated with higher disease activity, yet its clinical significance requires further validation. These readily available parameters may be integrated as complementary components of a broader diagnostic and monitoring strategy.

g-C3N4-based photocatalysts have attracted considerable research attention for their applicability in green H2O2 production. However, the photocatalytic activity of these catalysts is limited by their low light-absorption efficiency and high carrier recombination rate. This study developed a highly crystalline carbon nitride (CDCN-X) through thermal polymerization using eutectic salt, which promoted the incorporation of cyano groups, created electron-transport "bridges", and guided directional material growth into a nanorod morphology. Enhanced crystallinity effectively minimized internal defects within the material, thus notably suppressing the recombination of photogenerated electron-hole pairs. Cyano groups and Na+/K+ ions were introduced to modulate the electronic band structure of CDCN-X and establish an internal built-in electric field, thus achieving a broader light absorption range and efficient transport channels for photogenerated charge carriers. Additionally, the cyano groups served as active sites, enhancing the adsorption capacity for O2 and promoting the reaction progress. As a result of these modifications, CDCN-550 enabled rapid two-step single electron oxygen reduction, thereby promoting rapid H2O2 generation. Furthermore, a CDCN-550-catalyzed H2O2 yield of 36.69 mmol g-1 h-1 was achieved, representing a 17.39-fold increase compared to conventional carbon nitride (DCN). Overall, the proposed approach is viable for the rational design and modification of carbon nitride materials to achieve excellent photocatalytic performance.