Transfusion safety monitoring and learning provide a mechanism for identifying transfusion risks, enabling medical institutions to implement intervention measures, to reduce transfusion risks, and ultimately to improve patient safety. Recently, in response to ongoing challenges in transfusion safety, the UK Serious Hazards of Transfusion (SHOT) integrated and transformed the recommendations scattered in previous annual reports, and released the Standards for Transfusion Safety. This document specifies standards and requirements/criterion in eight key areas, including transfusion safety, transfusion information technology and equipment, supporting staff to work safely, staff education and training, safety culture, patients as safety partners, haemovigilance and risk management, and governance. The issue and implementation of the Standards marks a significant transformation in the UK's blood transfusion safety governance strategy. Understanding the content and background of the Standards will be beneficial for contemplating and exploring the future direction of China's blood transfusion safety governance strategy.

As the second part of this series, this article summarizes and synthesizes the key aspects of UK Serious Hazards of Transfusion (SHOT), SHOT’s continuous promotion of learning from excellent daily transfusion events over the past six years. This summary is based on an introduction to the holistic approach to improving patient safety—proactively learning from both failures and successes. The covered topics include an overview, definitions, case studies, implementation methods, safety culture, psychological safety in the workplace, civility in work, the use of neutral language, leading and lagging indicators, and compassionate governance. It is hoped that this article will assist domestic colleagues in understanding and studying the strategic significance of the transformation of transfusion safety governance in the UK, and inspire reflection on the strategic development direction of transfusion safety governance in China.

Whole blood, containing all blood components in physiological proportions, is a preferred resuscitative fluid for patients with severe hemorrhage. The preparation, supply, and clinical use of whole blood are more convenient, safe, and effective, offering the advantages of reduced blood utilization and associated costs. In recent years, an increasing number of countries and regions have initiated whole blood transfusion programs. The newly issued "Medical Treatment Specifications for Trauma Patients in Emergencies (2025 Edition)" by China's National Health Commission designates whole blood as the preferred choice for early trauma transfusion. Establishing a priority supply mechanism for whole blood has become a critical task for blood services in China. This paper introduces the recommendations of the European Blood Alliance practical guidance on implementation of a whole blood programme within a blood service, hoping to provide insights and assistance in establishing a priority supply mechanism for whole blood in China.

Yttrium-90 microsphere selective internal radiation therapy (SIRT), also known as transarterial radioembolization, has become one of the pivotal treatments for liver cancer, particularly for selected advantageous patient groups. This review summarizes the characteristics of different patients with liver cancer that could obtain maximum benefit from SIRT and discusses key factors affecting efficacy and safety, including tumor characteristics, liver function, patient performance status, and treatment intent. In evaluating appropriate candidates, mapping serves as a crucial simulation procedure to assess tumor vascular anatomy, predict lung shunting, and guide catheter positioning and dose planning. This procedure substantially enhances therapeutic precision while minimizing the risk of nontarget radiation-related adverse events, such as radiation-induced pneumonitis and gastrointestinal toxicity. Several studies have suggested that SIRT is not only suitable for patients with early or limited hepatocellular carcinoma but can also be used as a bridging therapy for liver transplantation and conversion therapy for unresectable liver cancers. In combination with systemic treatments, SIRT has demonstrated survival benefits in patients with unresectable liver cancer. This review also highlights the importance of further optimizing patient screening through personalized dosimetry and mapping to ensure the precision and safety of treatment. A thorough review of relevant literature and clinical practice offers clinicians comprehensive suggestions on patient screening and clarifies the promise of SIRT in the liver cancer population.

This article reviews the history and current status of the development of quality management good practice for blood establishments worldwide, covering its standardization, systematization, formalization, and global harmonization and collaboration. It introduces three international harmonization guidelines for quality management in blood establishments, namely, the WHO Good practices for blood establishments, the EU Good practice guidelines for blood establishments, and the PIC/S Good practices guide for blood establishments and hospital blood banks, with the aim of contributing to the reflection and exploration of directions for revising quality management standards for blood establishments in China.

The recently updated best practice guidelines for hospital blood inventory management by the UK Blood Stocks Management Scheme comprehensively address best practices for managing blood component inventory in hospital transfusion laboratories. These include training and responsibility of laboratory staff, appropriate stock levels and ordering patterns, promoting best practice, patient blood management, movement of stock, satellite fridges and remote issue, useful data tools, KPIs and benchmarking, effective collaboration, blood management planning and conservation, and managing stocks during an IT downtime. This article introduces the main content of the guidelines, aiming to provide insights and support for the development, implementation, and continuous improvement of blood inventory management standards in Chinese hospitals.

The incidence and mortality of hepatocellular carcinoma (HCC) in China are among the highest in the world, imposing a heavy social burden. Liver resection and liver transplantation are the primary radical treatments for HCC, although most patients are no longer able to meet the surgical requirements at initial diagnosis. Yttrium-90 microsphere selective internal radiation therapy (⁹⁰Y-SIRT) has the advantages of shrinking tumors, enlarging residual liver, regressing portal vein tumor thrombus and improving the quality of life, which can be used for conversion, downstaging and bridging therapy for HCC before surgical treatment, enabling patients regain the chance of radical treatment and reducing the postoperative recurrence rate. This review focuses on the clinical application and progress of ⁹⁰Y-SIRT in this field.

Objective To investigate the prevalence and risk factors of work-related musculoskeletal disorders (WMSDs) among construction workers. Methods A total of 5 783 workers were selected as participants from 12 construction companies in Guangdong Province, Guangxi Zhuang Autonomous Region and Zhejiang Province using a convenient sampling method. The revised Musculoskeletal Disorders Questionnaire was used to investigate the prevalence and influencing factors of WMSDs. Results The prevalence of WMSDs was 27.4% among the construction workers. The prevalence of WMSDs in shoulder, neck, waist/lower back and hand/wrist was 10.6%, 9.5%, 9.5% and 9.4% respectively, which was higher than that in other body parts. Bianry logistic regression analysis showed that the risk of WMSDs in construction workers with junior high school education and below was higher than that of high school/ college and above (P<0.05). The risk of WMSDs was higher in drinkers than that in non-drinkers (P<0.01). The worse the health status of construction workers, the higher the risk of WMSDs (P<0.01). The risk of WMSDs in those who exercised once or twice a month was lower than that in those who did not exercise (P<0.05). The risk of WMSDs was higher in construction workers with longer working hours in uncomfortable postures and greater back bending amplitude at work (all P<0.01). The risk of WMSDs in construction workers with hands holding above the shoulder was higher than that with hands below the shoulder (P<0.05). Construction workers who repeated the same work daily, involved in high-temperature work, often worked overtime, had insufficient rest time, and had a shortage of department personnel had a relatively high risk of WMSDs (all P<0.01). Conclusion The prevalence of WMSDs among the construction workers was relatively high, and the most common WMSDs occurred in shoulder, neck, waist/lower back and hand/wrist. Individual characteristic, work type, work posture and work organization are the influencing factors of WMSDs. Comprehensive measures, especially ergonomic measures based on personal and occupational characteristics should be taken to reduce the risk of WMSDs among construction workers.

Room temperature stored platelets are associated with a higher risk of sepsis and related fatality. The risk of bacterial contamination of platelets is a leading risk of infection from blood transfusion. U.S. Food and Drug Administration recently issued a guidance on bacterial risk control strategies for blood collection establishments and transfusion services to enhance the safety and availability of platelets for transfusion. The prevention and control strategies in the guidance would be informative and instructive for further development of risk control strategies of platelet bacterial contamination in China.

BACKGROUND: The FAVOR (Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous Intervention in Patients with Coronary Artery Disease) III China trial demonstrated that percutaneous coronary intervention (PCI) lesion selection using quantitative flow ratio (QFR) measurement, a novel angiography-based approach for estimating fractional flow reserve, improved two-year clinical outcomes compared with standard angiography guidance. This study aimed to assess the cost-effectiveness of QFR-guided PCI from the perspective of the current Chinese healthcare system. METHODS: This study is a pre-specified analysis of the FAVOR III China trial, which included 3825 patients randomized between December 25, 2018, and January 19, 2020, from 26 centers in China. Patients with stable or unstable angina pectoris or those ≥72 hours post-myocardial infarction who had at least one lesion with a diameter stenosis between 50% and 90% in a coronary artery with a ≥2.5 mm reference vessel diameter by visual assessment were randomized to a QFR-guided strategy or an angiography-guided strategy with 1:1 ratio. During the two-year follow-up, data were collected on clinical outcomes, quality-adjusted life-years (QALYs), estimated costs of index procedure hospitalization, outpatient cardiovascular medication use, and rehospitalization due to major adverse cardiac and cerebrovascular events (MACCE). The primary analysis calculated the incremental cost-effectiveness ratio (ICER) as the cost per MACCE avoided. An ICER of ¥10,000/MACCE event avoided was considered economically attractive in China. RESULTS: At two years, the QFR-guided group demonstrated a reduced rate of MACCE compared to the angiography-guided group (10.8% vs . 14.7%, P <0.01). Total two-year costs were similar between the groups (¥50,803 ± 21,121 vs . ¥50,685 ± 23,495, P = 0.87). The ICER for the QFR-guided strategy was ¥3055 per MACCE avoided, and the probability of QFR being economically attractive was 64% at a willingness-to-pay threshold of ¥10,000/MACCE avoided. Sensitivity analysis showed that QFR-guided PCI would become cost-saving if the cost of QFR were below ¥3682 (current cost: ¥3800). Cost-utility analysis yielded an ICER of ¥56,163 per QALY gained, with a 53% probability of being cost-effective at a willingness-to-pay threshold of ¥85,000 per QALY gained. CONCLUSION: In patients undergoing PCI, a QFR-guided strategy appears economically attractive compared to angiographic guidance from the perspective of the Chinese healthcare system. TRIAL REGISTRATION ClinicalTrials.gov , NCT03656848.
Humans ; Cost-Benefit Analysis ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Angiography/methods* ; Middle Aged ; Aged ; Coronary Artery Disease/surgery* ; Quality-Adjusted Life Years ; Fractional Flow Reserve, Myocardial/physiology*