ObjectiveThe biosynthesis of heterophyllin B （HB）， a cyclopeptide from Pseudostellaria heterophylla， is regulated by various abiotic stresses. Elucidating the transcriptional regulatory mechanism underlying HB biosynthesis is of great guiding significance for the directional improvement of P. heterophylla varieties and the enhancement of HB content. MethodsBased on transcriptome data from different tissues of P. heterophylla， transcription factors （TFs） specifically upregulated and highly expressed in the phloem of tuberous roots were screened through a combination of Mfuzz time-series clustering， transcription factor family prediction， and correlation analysis. Quantitative real-time polymerase chain reaction （Real-time PCR） was employed to analyze expression patterns of candidate TFs under abscisic acid （ABA） induction， and the dual-luciferase reporter assay was applied to verify their regulatory effects on HB precursor genes. ResultsContent determination showed that HB accumulated at the highest in the phloem of P. heterophylla tuberous roots （34 μg·g^-1 fresh weight）. Transcriptome analysis identified 15 868 up-regulated differentially expressed genes （DEGs）， among which 4 375 were specifically up-regulated in the phloem. From these， 25 TFs highly expressed in the phloem were screened. Correlation analysis revealed that the expression level of WRKY70 was significantly positively correlated with HB content， the expression of precursor genes prePhHB， and PhPOP1. Additionally， WRKY70 expression was significantly upregulated under ABA induction. Dual-luciferase reporter assay confirmed that WRKY70 specifically activated the transcriptional activity of the prePhHB promoter （Pro-prePhHB）. ConclusionHB is mainly accumulated in the phloem of P. heterophylla tuberous roots. WRKY70 positively regulates HB biosynthesis by directly activating the promoter activity of prePhHB. This study clarifies the key role of WRKY70 in the regulation of HB biosynthesis and provides an important theoretical basis for the in-depth analysis of the molecular regulatory mechanism underlying HB biosynthesis.

Objective: To evaluate the causal effects and population heterogeneity of Guangzhou′s Voluntary Blood Donation Privilege Certificate Policy on blood donation behavior, and to provide empirical evidence for optimizing blood management policies. Methods: Using an interrupted time series (ITS) design, we analyzed 30 quarters of blood collection data from Guangzhou Blood Center (from July 2018 to December 2025). Taking the third quarter of 2021 as the intervention node, we constructed ordinary least squares (OLS) regression models incorporating level and trend effects, and conducted stratified analyses by gender, age group, previous donation frequency, and per-donation volume. Results: The tiered incentive policy demonstrated significant heterogeneous effects. Apheresis donations showed sustained growth, with 2 units of component blood exhibiting a significant trend effect (β=304.58, P<0.001); high-frequency donors (11+ times) demonstrated sustained growth trends in apheresis donations. For whole blood, immediate effects were significant for donors with 1-2 previous donations (β=4 537.55, P<0.001) and 3-10 previous donations (β=2 159.69, P<0.05); high-frequency donors (11-30 times) showed sustained growth trends (P<0.01). Stratified by per-donation volume, 400 mL whole blood demonstrated a significant immediate effect (β=4 391.01, P<0.1), while 200 mL whole blood showed a significant declining trend (β=-893.24, P<0.01). Conclusion: The tiered incentive policy effectively enhanced blood donation participation while maintaining the donors’ altruistic motivations. Young and middle-aged adults primarily drove apheresis donations. The policy demonstrated immediate incentive effects on low-frequency whole blood donors and long-term retention effects on high-frequency donors. Per-donation volume showed an "upward migration" trend, optimizing the blood collection structure. Differentiated outreach, conversion and retention strategies are recommended to further strengthen blood supply security.

BackgroundNon-suicidal self-injury （NSSI） behavior has become a global public health concern affecting the physical and mental health of adolescents. The experiential avoidance model posits that childhood trauma contributes to NSSI behavior through the mediating pathway of emotional dysregulation. However， existing research has predominantly focused on isolated psychological or social factors， with limited attention to their interactive effects of emotional dysregulation and social anxiety， both of which fall within the psychosocial domain. ObjectiveTo examine the relationship between childhood trauma and NSSI among adolescents， and to analyze the mediating role of emotional dysregulation and the moderating role of social anxiety， so as to provide evidence for targeted interventions for NSSI behavior of adolescents. MethodsA total of 282 adolescent inpatients who consecutively admitted to the Department of Psychiatry of Guangdong Provincial People's Hospital from March to December 2025 and met the Diagnostic and Statistical Manual of Mental Disorders，fifth edition（DSM-5）criteria for NSSI were enrolled as study participants. Participants were assessed using the general information questionnaire， the Adolescent Self-Harm Questionnaire， the Childhood Trauma Questionnaire （CTQ）， the Difficulties in Emotion Regulation Scale （DERS）， and the Social Anxiety Scale for Adolescents （SAS-A）. Pearson correlation analysis was used to examine correlations among scale scores. model 4 and model 58 of the Process 4.1 were used to test the mediating effect of emotional dysregulation and the moderating effect of social anxiety， respectively. ResultsCTQ score was positively associated with score of the Adolescent Self-Injury Questionnaire （r=0.279， P<0.01）. Emotional dysregulation significantly partially mediated the relationship between childhood trauma and NSSI behavior， with a mediating effect of 0.112 （95% CI： 0.043–0.208）， accounting for 40.14% of the total effect. Social anxiety moderated the association between childhood trauma and emotional dysregulation，the effect value was 0.102 （95% CI： 0.008–0.196）， as well as the relationship between emotional dysregulation and NSSI behavior， the effect value was 0.130 （95% CI： 0.033–0.226）. ConclusionEmotional dysregulation may mediate the relationship between childhood trauma and NSSI behavior among hospitalized adolescents， while social anxiety moderates both the first and second paths of this mediating process. ［Funded by Guangdong Medical Science and Technology Research Fund Project （number， A2022538）］

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

[Objective]To investigate and explore the characteristics and influencing factors of glucose metabolism in children with β-thalassemia major(β-TM)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).[Methods]The follow-up data of 41 patients with β-TM who underwent HSCT at Hematopoietic Stem Cell Transplantation Department of Children's Medical Center of Sun Yat-sen Memorial Hospital,Sun Yat-sen University were retrospectively analyzed.Their glucose metabolism characteristics were evaluated through laboratory tests and the related influencing factors were analyzed.[Results]In the study,41.46％(17/41)of patients developed abnormal glucose homeostasis after HSCT.Among them,82.35％(14/17)characterized by insulin resistance,but no cases of diabetes mellitus were found.The results of insulin releasing test and oral glucose tolerance test(OGTT)showed that 45.00％(9/20)of patients had abnormal insulin releasing curve and 40.0％(8/20)had delayed serum glucose peak.The average age of HSCT in abnormal glucose homeostasis group was significantly older than that in the normal glucose homeostasis group[(8.8±3.9)years old vs(6.0±3.1)years old,P=0.015].[Conclusions]Patients with β-TM after HSCT may develop abnormal glucose homeostasis,consists largely of insulin resistance.The elder age of HSCT(≥7 years old)is a risk factor for abnormal glucose homeostasis in β-TM patients after HSCT.It is recommended to regularly monitor glucose metabolism indicators in β-TM children after HSCT,especially in elderly transplant recipients.

Objective:To investigate the effect of preoperative continuous fascia iliaca compartment block (FICB) on perioperative opioids dosage and quality of postoperative recovery in elderly patients with frail.Methods:A prospective study method was used. Sixty elderly frail patients underwent selective unilateral femoral head replacement surgery from November 2022 to October 2024 in Sihui People′s Hospital were selected. The patients were divided into control group and FICB group by random digits table method with 30 cases each. The patients in control group did not receive continuous FICB before surgery, and the patients in FICB group received continuous FICB 1 d before surgery. The perioperative use of opioids and analgesic effect, operative time, intraoperative blood loss, postoperative hospital stay, quality of recovery-40 (QoR-40) score at discharge and postoperative complications were compared between the two groups.Results:A total of 57 patients completed the study, with 29 cases in the FICB group and 28 cases in the control group. There were no statistical differences in operative time, intraoperative blood loss and postoperative hospital stay between the two groups ( P>0.05). The sufentanil dosage of patient-controlled analgesia (PCA), perioperative nalbuphine dosage, frequency of perioperative visual analog score (VAS)>4 scores, rate of preoperative rescue analgesia, rate of postoperative rescue analgesia and pressing frequency of PCA in FICB group were significantly lower than those in control group: (94.1 ± 5.4) μg vs. (102.1 ± 6.1) μg, 0 (0, 0) mg vs. 10.0 (0, 20.0) mg, 3.0 (2.0, 5.0) times vs. 5.0 (4.0, 6.0) times, 3.4% (1/29) vs. 32.1% (9/28), 13.8% (4/29) vs. 39.3% (11/28) and 2.0 (1.0, 3.0) times vs. 4.0 (3.0, 5.0) times, and there were statistical differences ( P<0.01 or <0.05). The total QoR-40 score and physical comfort, pain scores in FICB group were significantly higher than those in control group: 156(153, 161) scores vs. 153 (148, 159) scores, 47 (45, 50) scores vs. 45 (43, 47) scores and 30 (29, 31) scores vs. 28 (25, 30) scores, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in emotional state, physical independence and psychological support scores between the two groups ( P>0.05). The incidences of dizziness and nausea vomiting in FICB group were significantly lower than those in control group: 13.8% (4/29) vs. 42.9% (12/28) and 10.3% (3/29) vs. 35.7% (10/28), and there were statistical differences ( P<0.05); there were no statistical difference in the incidences of delirium, pulmonary infection and deep vein thrombosis in the lower extremities between the two groups ( P>0.05). Conclusions:Preoperative continuous FICB can reduce perioperative opioids dosage in elderly patients with frail, and improve early stage postoperative recovery quality.

Objective To investigate the difference of spontaneous hemorrhagic transformation(HT)in enlarged perivascular space(EPVS)of different site and various dilation in patients with acute ischemic stroke.Methods A total of 595 patients admitted to our department acute ischemic stroke from January 2021 to June 2024 were recruited in this study.Brain magnetic resonance ima-ging was conducted in all of them within 72 h after admission,and their EPVS status was collect-ed.According to the results of brain MRI,they were divided into EPVS(384 cases)and non-EPVS(211 cases)groups.Based on EPVS site,the EPVS group was further assigned into basal ganglia(135 cases),centrum semiovale(132 cases),and midbrain(117 cases)subgroups,and based on the severity,the group was also into mild(155 cases)and severe(229 cases)subgroups.Brain CT or MRI examination was re-performed on the 7th to 10th day during hospitalization to investigate the intracranial condition,and then spontaneous HT was evaluated.The incidence of spontaneous HT in the EPVS patients of different sites and severity was analyzed and compared.Results The incidence of spontaneous HT was significantly higher in the EPVS group than the non-EPVS group(27.08％vs 8.53％,P＜0.01),and the incidence of spontaneous HT was also obviously higher in the basal ganglia subgroup than the centrum semiovale subgroup and then the midbrain subgroup(40.00％vs 21.97％vs 17.95％,P＜0.01).What's more,the severe subgroup had nota-bly higher incidence of spontaneous HT than the mild subgroup(33.19％vs 18.06％,P＜0.01).Conclusion There is difference in spontaneous HT among acute ischemic stroke patients with EPVS of different site and severity.EPVS in the basal ganglia and of severe level indicates a high-er risk of spontaneous HT,and the two features can better predict the incidence of spontaneous HT.

Objective To assess the efficacy of combining specialized scenarios with workshop-based teaching in training newly recruited nurses for occupational exposure.Methods This study was conducted with 200 nurses recruited between January 2020 and December 2021 as the control group and 200 nurses from January 2022 to December 2023 as the intervention group.The control group and the intervention group received routine training and workshop-based training,respectively.The efficacy was assessed through theoretical exams,skills assessments,occupational exposure incidence,and training satisfaction,measured u-sing the Simulation Design Scale(SDS).Results The intervention group demonstrated higher scores on theoretical knowledge and operational skills assessments compared to the control group.The occupational exposure were lower in the intervention group.Additionally,the intervention group scored higher on the SDS and reported greater satisfaction with the training(P＜0.05).Conclusion The teaching method integrated with specialized scenarios and workshop-based teaching effectively enhances the theoretical knowledge and operational skills related to occupational exposure among newly recruited nurses.It reduces the inci-dence of occupational exposure,such as needlestick injuries,and improves training outcomes and nurse satisfaction,making it a valuable approach for clinical application.

Objective To assess the efficacy of combining specialized scenarios with workshop-based teaching in training newly recruited nurses for occupational exposure.Methods This study was conducted with 200 nurses recruited between January 2020 and December 2021 as the control group and 200 nurses from January 2022 to December 2023 as the intervention group.The control group and the intervention group received routine training and workshop-based training,respectively.The efficacy was assessed through theoretical exams,skills assessments,occupational exposure incidence,and training satisfaction,measured u-sing the Simulation Design Scale(SDS).Results The intervention group demonstrated higher scores on theoretical knowledge and operational skills assessments compared to the control group.The occupational exposure were lower in the intervention group.Additionally,the intervention group scored higher on the SDS and reported greater satisfaction with the training(P＜0.05).Conclusion The teaching method integrated with specialized scenarios and workshop-based teaching effectively enhances the theoretical knowledge and operational skills related to occupational exposure among newly recruited nurses.It reduces the inci-dence of occupational exposure,such as needlestick injuries,and improves training outcomes and nurse satisfaction,making it a valuable approach for clinical application.

Objective To explore the impact of admission modes on the reperfusion time and short-term prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI).Methods 497 patients who visited the Chest Pain Center of Xiamen Cardiovascular Hospital of Xiamen University from January 2023 to November 2024 and were diagnosed with STEMI were included.All patients received direct percutaneous coronary intervention.According to admission modes,the patients were divided into the self-referral group(122 cases),emergency medical service group(EMS)(51 cases)and transfer PCI group(324 cases).The basic characteristics,reperfusion time,complications between group were compared.Results The age of the patients in this study was(58.64±13.62)years old,and there were 423 male cases(85.11%).Compared with the self-referral group and the EMS group,the time of door-wire in transfer PCI group was shorter[35(29,45)min vs.43(35,53)min vs.43(33,48)min,P＜0.001],but the time of first medical contact-wire was longer[123(80,192)min vs.43(35,52)min vs.57(51,76)min,P＜0.001].Compared with the self-referral group and the transfer PCI group,the time of symptom-to-first medical contact and the time of symptom-to-wire in EMS group were both shorter,which were[55(32,136)min vs.185(116,360)min vs.120(60,236)min,P＜0.001]and[136(101,188)min vs.228(169,413)min vs.282(190,400)min,P＜0.001].The incidence of infections in the transfer PCI group was lower than that in the self-referral group(12.65%vs.22.95%,P＜0.05).Conclusions To comprehensively enhance the treatment effect,it is necessary to prioritize the promotion and continuous optimization of the response process of EMS,simultaneously strengthen the standardized collaboration of referral,and enhance the identification ability of STEMI through public education to reduce the delay of self-referral patients..