Clinical significance of platelet mononuclear cell aggregates in patients with sepsis and acute respiratory distress syndrome

BACKGROUND The diagnosis of sepsis combined with acute respiratory distress syndrome(ARDS)has increased owing to the enhanced awareness among medical profes-sionals and the continuous development of modern medical technologies,while early diagnosis of ARDS still lacks specific biomarkers.One of the main patho-genic mechanisms of sepsis-associated ARDS involves the actions of various pathological injuries and inflammatory factors,such as platelet and white blood cells activation,leading to an increase of surface adhesion molecules.These adhesion molecules further form platelet-white blood cell aggregates,including platelet-mononuclear cell aggregates(PMAs).PMAs has been identified as one of the markers of platelet activation,here we hypothesize that PMAs might play a potential biomarker for the early diagnosis of this complication.METHODS We selected 72 hospitalized patients diagnosed with sepsis as the study population between March 2019 and March 2022.Among them,30 patients with sepsis and ARDS formed the study group,while 42 sepsis patients without ARDS comprised the control group.After diagnosis,venous blood samples were imme-diately collected from all patients.Flow cytometry was employed to analyze the expression of PMAs,platelet neutrophil aggregates(PNAs),and platelet aggregates(PLyAs)in the serum.Additionally,the Acute Physiology and Chronic Health Evaluation(APACHE)II score was calculated for each patient,and receiver operating characteristic curves were generated to assess diagnostic value.RESULTS The study found that the levels of PNAs and PLyAs in the serum of the study group were higher than those in the control group,but the difference was not statistically significant(P>0.05).However,the expression of PMAs in the serum of the study group was significantly upregulated(P<0.05)and positively correlated with the APACHE II score(r=0.671,P<0.05).When using PMAs as a diagnostic indicator,the area under the curve value was 0.957,indicating a high diagnostic value(P<0.05).Furthermore,the optimal cutoff value was 8.418%,with a diagnostic sensitivity of 0.819 and specificity of 0.947.CONCLUSION In summary,the serum levels of PMAs significantly increase in patients with sepsis and ARDS.Therefore,serum PMAs have the potential to become a new biomarker for clinically diagnosing sepsis complicated by ARDS.

Dissolvable polymeric microneedles loaded with aspirin for antiplatelet aggregation

To reduce mucosal damage in the gastrointestinal tract caused by aspirin,we developed a dissolvable polymeric microneedle(MN)patch loaded with aspirin.Biodegradable polymers provide mechanical strength to the MNs.The MN tips punctured the cuticle of the skin and dissolved when in contact with the subcutaneous tissue.The aspirin in the MN patch is delivered continuously through an array of micropores created by the punctures,providing a stable plasma concentration of aspirin.The factors affecting the stability of aspirin during MNs fabrication were comprehensively analyzed,and the hydrolysis rate of aspirin in the MNs was less than 2%.Compared to oral administration,MN administration not only had a smoother plasma concentration curve but also resulted in a lower effective dose of antiplatelet aggregation.Aspirin-loaded MNs were mildly irritating to the skin,causing only slight erythema on the skin and recovery within 24 h.In summary,aspirin-loaded MNs provide a new method to reduce gastrointestinal adverse effects in patients requiring aspirin regularly.

Chemokine platelet factor 4 accelerates peripheral nerve regeneration by regulating Schwann cell activation and axon elongation

Schwann cells in peripheral nerves react to traumatic nerve injury by attempting to grow and regenerate.Howeve r,it is unclear what factors play a role in this process.In this study,we searched a GEO database and found that expression of platelet factor 4 was markedly up-regulated after sciatic nerve injury.Platelet factor is an important molecule in cell apoptosis,diffe rentiation,survival,and proliferation.Further,polymerase chain reaction and immunohistochemical staining confirmed the change in platelet factor 4 in the sciatic nerve at different time points after injury.Enzyme-linked immunosorbent assay confirmed that platelet factor 4 was secreted by Schwann cells.We also found that silencing platelet factor 4 decreased the proliferation and migration of primary cultured Schwann cells,while exogenously applied platelet factor 4 stimulated Schwann cell prolife ration and migration and neuronal axon growth.Furthermore,knocking out platelet factor 4 inhibited the prolife ration of Schwann cells in injured rat sciatic nerve.These findings suggest that Schwann cell-secreted platelet factor 4 may facilitate peripheral nerve repair and regeneration by regulating Schwann cell activation and axon growth.Thus,platelet factor 4 may be a potential therapeutic target for traumatic peripheral nerve injury.

Impacts of Aggregation Methods and Trophospecies Number on the Structure and Function of Marine Food Webs

Aggregation of species with similar ecological properties is one of the effective methods to simplify food web researches.However,species aggregation will affect not only the complexity of modeling process but also the accuracy of models’outputs.Selection of aggregation methods and the number of trophospecies are the keys to study the simplification of food web.In this study,three aggregation methods,including taxonomic aggregation(TA),structural equivalence aggregation(SEA),and self-organizing maps(SOM),were analyzed and compared with the linear inverse model–Markov Chain Monte Carlo(LIM-MCMC)model.Impacts of aggregation methods and trophospecies number on food webs were evaluated based on the robustness and unitless of ecological net-work indices.Results showed that aggregation method of SEA performed better than the other two methods in estimating food web structure and function indices.The effects of aggregation methods were driven by the differences in species aggregation principles,which will alter food web structure and function through the redistribution of energy flow.According to the results of mean absolute percentage error(MAPE)which can be applied to evaluate the accuracy of the model,we found that MAPE in food web indices will increase with the reducing trophospecies number,and MAPE in food web function indices were smaller and more stable than those in food web structure indices.Therefore,trade-off between simplifying food webs and reflecting the status of ecosystem should be con-sidered in food web studies.These findings highlight the importance of aggregation methods and trophospecies number in the analy-sis of food web simplification.This study provided a framework to explore the extent to which food web models are affected by dif-ferent species aggregation,and will provide scientific basis for the construction of food webs.

Small molecules to target tau amyloid aggregation

Protein aggregation has been linked with many neurodegenerative diseases,such as Alzheimer’s disease(AD)or Parkinson’s disease.AD belongs to a group of heterogeneous and incurable neurodegenerative disorders collectively known as tauopathies.They comprise frontotemporal dementia,Pick’s disease,or corticobasal degeneration,among others.The symptomatology varies with the specific tau protein variant involved and the affected brain region or cell type.However,they share a common neuropathological hallmark-the formation of proteinaceous deposits named neurofibrillary tangles.Neurofibrillary tangles,primarily composed of aggregated tau(Zhang et al.,2022),disrupt normal neuronal functions,leading to cell death and cognitive decline.

A novel approach to Parkinson's disease treatment with a potentially dual-acting therapeutic agent that targetsα-synuclein aggregation and neuron death

Parkinson's disease(PD),a prevalent neurodegenerative disorder,is chara cterized by the loss of dopaminergic neurons and the aggregation ofα-synuclein protein into Lewy bodies.While the current standards of therapy have been successful in providing some symptom relief,they fail to address the underlying pathophysiology of PD and as a result,they have no effect on disease progression.

Kelp Fucoidans Facilitate Vascular Recanalization via Inhibiting Excessive Activation of Platelet in Deep Venous Thrombosis Model of Mouse

This study was carried out explore the mechanism underlying the inhibition of platelet activation by kelp fucoidans in deep venous thrombosis(DVT)mouse.In the control and sham mice,the walls of deep vein were regular and smooth with intact intima,myometrium and adventitia.The blood vessel was wrapped with the tissue and there was no thrombosis in the lumen.In the DVT model,the wall was uneven with thicken intima,myometrium and adventitia.After treated with fucoidans LF1 and LF2,the thrombus was dissolved and the blood vessel was recanalized.Compared with the control group,the ROS content,ET-1 and VWF content and the expression of PKC-βand NF-κB in the model were significantly higher(P<0.05);these levels were significantly reduced following treatments with LF2 and LF1.Compared with H_(2)O_(2)treated-HUVECs,combined LF1 and LF2 treatment resulted in significant decrease in the expression of PKC-β,NF-κB,VWF and TM protein(P<0.05).It is clear that LF1 and LF2 reduces DVT-induced ET-1,VWF and TM expressions and production of ROS,thus inhibiting the activation of PKC-β/NF-κB signal pathway and the activation of coagulation system and ultimately reducing the formation of venous thrombus.

Case of Refractory Thrombocytopenia in Pregnancy Associated with May-Heglin Anomaly after Repeated Platelet Transfusions

May-Heglin Anomaly is an autosomal dominant disorder characterized by macrothrombocytopenia with a platelet function that is usually preserved. Platelets play an essential role in hemostasis. During pregnancy, a woman is susceptible to complications, including postpartum hemorrhage. Monitoring patients’ hemostatic functions and observing the patient’s clinical picture to maintain patient safety is paramount, while avoiding unnecessary therapeutic measures. This case report presents a rare instance of May-Heglin Anomaly (MHA) in a 35-year-old pregnant patient, with refractory thrombocytopenia despite receiving multiple platelet transfusions. Initially referred to as gravida 5 para 4 with severe thrombocytopenia at 28 weeks gestation, throughout her pregnancy, she was closely monitored and received over 40 units of platelets, which failed to increase her platelet count significantly. She delivered a healthy baby via vaginal delivery at 38 weeks, with her platelet count still critically low. This report highlights the challenges of managing MHA in pregnancy, the inefficacy of standard thrombocytopenia treatments such as platelet transfusion in MHA patients, and the importance of tailored management strategies to ensure maternal and fetal safety.

Aggregation-regulated bioreduction process of graphene oxide by Shewanella bacteria

The bioreduction of graphene oxide(GO)using environmentally functional bacteria such as Shewanella represents a green approach to produce reduced graphene oxide(rGO).This process differs from the chemical reduction that involves instantaneous molecular reactions.In bioreduction,the contact of bacterial cells and GO is considered the rate-limiting step.To reveal how the bacteria-GO integration regulates rGO production,the comparative experiments of GO and three Shewanella strains were carried out.Fourier-transform infrared spectroscopy,X-ray photoelectron spectroscopy,Raman spectroscopy,and atomic force microscopy were used to characterize the reduction degree and the aggregation degree.The results showed that a spontaneous aggregation of GO and Shewanella into the condensed entity occurred within 36 h.A positive linear correlation was established,linking three indexes of the aggregation potential,the bacterial reduction ability,and the reduction degree(ID/IG)comprehensively.

Aspirin suppresses hepatocellular carcinoma progression by inhibiting platelet activity

BACKGROUND Hepatocellular carcinoma(HCC)is the most common malignant liver disease in the world.Platelets(PLTs)are known to play a key role in the maintenance of liver homeostasis and the pathophysiological processes of a variety of liver diseases.Aspirin is the most classic antiplatelet agent.However,the molecular mechanism of platelet action and whether aspirin can affect HCC progression by inhibiting platelet activity need further study.AIM To explore the impact of the antiplatelet effect of aspirin on the development of HCC.METHODS Platelet-rich plasma,platelet plasma,pure platelet,and platelet lysate were prepared,and a coculture model of PLTs and HCC cells was established.CCK-8 analysis,apoptosis analysis,Transwell analysis,and real-time polymerase chain reaction(RT-PCR)were used to analyze the effects of PLTs on the growth,metastasis,and inflammatory microenvironment of HCC.RT-PCR and Western blot were used to detect the effects of platelet activation on tumor-related signaling pathways.Aspirin was used to block the activation and aggregation of PLTs both in vitro and in vivo,and the effect of PLTs on the progression of HCC RESULTS PLTs significantly promoted the growth,invasion,epithelial-mesenchymal transition,and formation of an inflammatory microenvironment in HCC cells.Activated PLTs promoted HCC progression by activating the mitogenactivated protein kinase/protein kinase B/signal transducer and activator of transcription three(MAPK/AKT/STAT3)signaling axis.Additionally,aspirin inhibited HCC progression in vitro and in vivo by inhibiting platelet activation.CONCLUSION PLTs play an important role in the pathogenesis of HCC,and aspirin can affect HCC progression by inhibiting platelet activity.These results suggest that antiplatelet therapy has promising application prospects in the treatment and combined treatment of HCC.

Straw return increases crop production by improving soil organic carbon sequestration and soil aggregation in a long-term wheat-cotton cropping system

Straw return is a promising strategy for managing soil organic carbon(SOC)and improving yield stability.However,the optimal straw return strategy for sustainable crop production in the wheat(Triticum aestivum L.)-cotton(Gossypium hirsutum L.)cropping system remains uncertain.The objective of this study was to quantify the long-term(10 years)impact of carbon(C)input on SOC sequestration,soil aggregation and crop yields in a wheat-cotton cropping system in the Yangtze River Valley,China.Five treatments were arranged with a single-factor randomized design as follows:no straw return(Control),return of wheat straw only(Wt),return of cotton straw only(Ct),return of 50%wheat and 50%cotton straw(Wh-Ch)and return of 100%wheat and 100%cotton straw(Wt-Ct).In comparison to the Control,the SOC content increased by 8.4 to 20.2%under straw return.A significant linear positive correlation between SOC sequestration and C input(1.42-7.19 Mg ha^(−1)yr^(−1))(P<0.05)was detected.The percentages of aggregates of sizes>2 and 1-2 mm at the 0-20 cm soil depth were also significantly elevated under straw return,with the greatest increase of the aggregate stability in the Wt-Ct treatment(28.1%).The average wheat yields increased by 12.4-36.0%and cotton yields increased by 29.4-73.7%,and significantly linear positive correlations were also detected between C input and the yields of wheat and cotton.The average sustainable yield index(SYI)reached a maximum value of 0.69 when the C input was 7.08 Mg ha^(−1)yr^(−1),which was close to the maximum value(SYI of 0.69,C input of 7.19 Mg ha^(−1)yr^(-1))in the Wt-Ct treatment.Overall,the return of both wheat and cotton straw was the best strategy for improving SOC sequestration,soil aggregation,yields and their sustainability in the wheat-cotton rotation system.

Inverse relationship between platelet Akt activity and hippocampal atrophy:A pilot case-control study in patients with diabetes mellitus

BACKGROUND Akt plays diverse roles in humans.It is involved in the pathogenesis of type 2 diabetes mellitus(T2DM),which is caused by insulin resistance.Akt also plays a vital role in human platelet activation.Furthermore,the hippocampus is closely associated with memory and learning,and a decrease in hippocampal volume is reportedly associated with an insulin-resistant phenotype in T2DM patients without dementia.AIM To investigate the relationship between Akt phosphorylation in unstimulated platelets and the hippocampal volume in T2DM patients.METHODS Platelet-rich plasma(PRP)was prepared from the venous blood of patients with T2DM or age-matched controls.The pellet lysate of the centrifuged PRP was subjected to western blotting to analyse the phosphorylation of Akt,p38 mitogen-activated protein(MAP)kinase and glyceraldehyde 3-phosphate dehydrogenase(GAPDH).Phosphorylation levels were quantified by densitometric analysis.Hippocampal volume was analysed using a voxel-based specific regional analysis system for Alzheimer’s disease on magnetic resonance imaging,which proposes the Z-score as a parameter that reflects hippocampal volume.RESULTS The levels of phosphorylated Akt corrected with phosphorylated p38 MAP kinase were inversely correlated with the Z-scores in the T2DM subjects,whereas the levels of phosphorylated Akt corrected with GAPDH were not.However,this relationship was not observed in the control patients.CONCLUSION These results suggest that an inverse relationship may exist between platelet Akt activation and hippocampal atrophy in T2DM patients.Our findings provide insight into the molecular mechanisms underlying T2DM hippocampal atrophy.

Online identification and extraction method of regional large-scale adjustable load-aggregation characteristics

This article introduces the concept of load aggregation,which involves a comprehensive analysis of loads to acquire their external characteristics for the purpose of modeling and analyzing power systems.The online identification method is a computer-involved approach for data collection,processing,and system identification,commonly used for adaptive control and prediction.This paper proposes a method for dynamically aggregating large-scale adjustable loads to support high proportions of new energy integration,aiming to study the aggregation characteristics of regional large-scale adjustable loads using online identification techniques and feature extraction methods.The experiment selected 300 central air conditioners as the research subject and analyzed their regulation characteristics,economic efficiency,and comfort.The experimental results show that as the adjustment time of the air conditioner increases from 5 minutes to 35 minutes,the stable adjustment quantity during the adjustment period decreases from 28.46 to 3.57,indicating that air conditioning loads can be controlled over a long period and have better adjustment effects in the short term.Overall,the experimental results of this paper demonstrate that analyzing the aggregation characteristics of regional large-scale adjustable loads using online identification techniques and feature extraction algorithms is effective.

Differentially Private Support Vector Machines with Knowledge Aggregation

With the widespread data collection and processing,privacy-preserving machine learning has become increasingly important in addressing privacy risks related to individuals.Support vector machine(SVM)is one of the most elementary learning models of machine learning.Privacy issues surrounding SVM classifier training have attracted increasing attention.In this paper,we investigate Differential Privacy-compliant Federated Machine Learning with Dimensionality Reduction,called FedDPDR-DPML,which greatly improves data utility while providing strong privacy guarantees.Considering in distributed learning scenarios,multiple participants usually hold unbalanced or small amounts of data.Therefore,FedDPDR-DPML enables multiple participants to collaboratively learn a global model based on weighted model averaging and knowledge aggregation and then the server distributes the global model to each participant to improve local data utility.Aiming at high-dimensional data,we adopt differential privacy in both the principal component analysis(PCA)-based dimensionality reduction phase and SVM classifiers training phase,which improves model accuracy while achieving strict differential privacy protection.Besides,we train Differential privacy(DP)-compliant SVM classifiers by adding noise to the objective function itself,thus leading to better data utility.Extensive experiments on three high-dimensional datasets demonstrate that FedDPDR-DPML can achieve high accuracy while ensuring strong privacy protection.

A non-probabilistic reliability topology optimization method based on aggregation function and matrix multiplication considering buckling response constraints

A non-probabilistic reliability topology optimization method is proposed based on the aggregation function and matrix multiplication.The expression of the geometric stiffness matrix is derived,the finite element linear buckling analysis is conducted,and the sensitivity solution of the linear buckling factor is achieved.For a specific problem in linear buckling topology optimization,a Heaviside projection function based on the exponential smooth growth is developed to eliminate the gray cells.The aggregation function method is used to consider the high-order eigenvalues,so as to obtain continuous sensitivity information and refined structural design.With cyclic matrix programming,a fast topology optimization method that can be used to efficiently obtain the unit assembly and sensitivity solution is conducted.To maximize the buckling load,under the constraint of the given buckling load,two types of topological optimization columns are constructed.The variable density method is used to achieve the topology optimization solution along with the moving asymptote optimization algorithm.The vertex method and the matching point method are used to carry out an uncertainty propagation analysis,and the non-probability reliability topology optimization method considering buckling responses is developed based on the transformation of non-probability reliability indices based on the characteristic distance.Finally,the differences in the structural topology optimization under different reliability degrees are illustrated by examples.

Red cell distribution width/platelet ratio estimates the 3-year risk of decompensation in Metabolic Dysfunction-Associated Steatotic Liver Disease-induced cirrhosis

BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.

Salivary C-reactive protein and mean platelet volume as possible diagnostic markers for late-onset neonatal pneumonia

BACKGROUND Neonatal sepsis,a formidable threat to newborns,is a leading cause of neonatal mortality,with late-onset sepsis manifesting after 72 hours post-birth being particularly concerning.Pneumonia,a prevalent sepsis presentation,poses a significant risk,especially during the neonatal phase when lung defenses are compromised.Accurate diagnosis of pneumonia is imperative for timely and effective interventions.Saliva,a minimally invasive diagnostic medium,holds great promise for evaluating infections,especially in infants.AIM To investigate the potential of serum C-reactive protein(CRP),salivary CRP(sCRP),and mean platelet volume(MPV)as diagnostic markers for late-onset neonatal pneumonia(LONP).METHODS Eighty full-term neonates were systematically examined,considering anthropometric measurements,clinical manifestations,radiology findings,and essential biomarkers,including serum CRP,sCRP,and MPV.RESULTS The study reveals noteworthy distinctions in serum CRP levels,MPV,and the serum CRP/MPV ratio between neonates with LONP and healthy controls.MPV exhibited a robust discriminatory ability[area under the curve(AUC)=0.87]with high sensitivity and specificity at a cutoff value of>8.8.Correlations between serum CRP,sCRP,and MPV were also identified.Notably,sCRP demonstrated excellent predictive value for serum CRP levels(AUC=0.89),underscoring its potential as a diagnostic tool.CONCLUSION This study underscores the diagnostic promise of salivary and serum biomarkers,specifically MPV and CRP,in identifying and predicting LONP among neonates.These findings advocate for further research to validate their clinical utility in larger neonatal cohorts.

Studies on the Basic Principles for the Processing of Rhizoma Cibotii Part Ⅰ Influence of Rhizoma Cibotii and Its Processed Samples on Thrombin Induced Rabbit Platelet Aggregation

比较研究了狗脊及其不同炮制品对凝血酶诱导的兔血小板聚集作用的影响 ,各炮制品均有抑制血小板聚集作用 ,抗血小板聚集作用砂烫品 >盐制品 >酒蒸品 >单蒸品 >

Effects of Berbamine on PAF Production in Human Neutrophils and on Platelet Aggregation

本实验研究了双苄基异喹啉类生物碱小檗胺（Ｂｅｒｂａｍｉｎｅ）对人中性粒细胞血小板激活因子（ＰＡＦ）的产生及ＰＡＦ引起的兔血小板聚集的影响，并与钙通道阻断剂维拉帕米进行比较。结果表明，小檗胺（５０μｍｏｌ／Ｌ，１００μｍｏｌ／Ｌ）和维拉帕米（１０μｍｏｌ／Ｌ，１００μｍｏｌ／Ｌ）预处理的人粒细胞，用Ａ－２３１８７攻击后，ＰＡＦ的产生明显降低。小檗胺和维拉帕米也能抑制ＰＡＦ（７０ｐｍｏｌ／Ｌ）引起的血小板聚集，其抑制作用呈剂量依赖性。本实验结果提示，小檗胺和维拉帕米对ＰＡＦ生成及血小板聚集的抑制作用可能与阻断钙离子内流有关。

Platelets in hemostasis and thrombosis:Novel mechanisms of fibrinogen-independent platelet aggregation and fibronectin-mediated protein wave of hemostasis

Platelets are small anucleate cells generated from megakaryocytes in the bone marrow. Although platelet genera- tion, maturation, and clearance are still not fully understood, significant progress has been made in the last 1-2 dec- ades. In blood circulation, platelets can quickly adhere and aggregate at sites of vascular injury, forming the platelet plug （i.e. the first wave of hemostasis）. Activated platelets can also provide negatively charged phosphatidylserine- rich membrane surface that enhances cell-based thrombin generation, which facilitates blood coagulation （i.e. the second wave of hemostasis）. Platelets therefore play central roles in hemostasis. However, the same process of hemostasis may also cause thrombosis and vessel occlusion, which are the most common mechanisms leading to heart attack and stroke following ruptured atherosclerotic lesions. In this review, we will introduce the classical mechanisms and newly discovered pathways of platelets in hemostasis and thrombosis, including fibrinogen-inde- pendent platelet aggregation and thrombosis, and the plasma fibronectin-mediated ＂protein wave＂ of hemostasis that precedes the classical first wave of hemostasis. Furthermore, we briefly discuss the roles of platelets in inflam- marion and atherosclerosis and the potential strategies to control atherothrombosis.