Transfusion technicians constitute a core workforce in safeguarding blood safety, and the quality of their standardized training directly affects the operational efficiency of the blood services. At present, training programs for transfusion technicians across China have been developed in a diversified manner. Positive progress has been achieved in integrated theoretical and practical training, on-the-job faculty development, and regional collaborative training models. However, persistent challenges remain, including fragmented training providers, inconsistent training standards, limited coverage, and a disconnect between training and workforce utilization. Based on a review of current standardized training practice, this article systematically analyzes the structural challenges confronting current standardized training, and further proposes a framework for building a comprehensive training system, covering the definition and core components of standardized training, targeted improvement strategies and key assessment indicators. The study aims to facilitate the transformation of training for blood transfusion technicians in blood services from a project-based approach to an institutionalized model, and from fragmented implementation to a systematic framework.

Objective: To develop and compare multiple machine learning models for identifying high-risk college students exhibiting phubbing behavior and to determine key predictive factors, so as to provide evidence for precise screening and early intervention strategies. Methods: In December 2025, 1 828 undergraduate students, selected from three universities in Wuhan by using convenience sampling method, were surveyed via online qustionnaire for sociodemographic characteristics, phubbing behavior, family cohesion index, mature happiness, fear of negative evaluation, multidimensional state boredom, and psychological vulnerability. Four machine learning algorithms, including multilayer perceptron (MLP), extreme gradient booting (XGBoost), K-nearest neighbors (KNN), and gradient boosting decision tree (GBDT), were applied. The dataset was randomly split into a training set and a test set at a ratio of 7∶3. Model performance was evaluated using accuracy, recall, F1-score, and area under the receiver operating characteristic curve (AUC). The best performing model was further interpreted using shapley additive explanation (SHAP) analysis to assess feature importance. Results: In the training set,955 participants were classified as having low level phubbing behavior, and 325 participants were classified as having high level phubbing behavior. Significant differences were observed in psychological vulnerability, multidimensional state boredom, family cohesion index, and mature happiness between groups ( Z =-10.29, -11.72, -8.17, -7.83, all P <0.05). Significant differences were also found in the detection rate of high level phubbing behavior according to family residence, family status, left behind experience,interpersonal relationships,exercise frequency,physical flexibility,and sleep status ( χ 2=12.22, 38.93, 16.90, 44.64, 58.17, 82.14, 37.89, all P <0.05). Among the four machine learning models (MLP, KNN, GBDT, XGBoost),all showed good discrimination ability, with XGBoost performing best (accuracy 79%, recall 71%, F1-score=0.70, AUC=0.78), while GBDT achieved the highest precision (78%). Feature importance analysis showed that multidimensional state boredom was the most important predictor of phubbing behavior, followed by psychological vulnerability, family cohesion, mature happiness, and fear of negative evaluation. SHAP analysis indicated that multidimensional state boredom, psychological vulnerability, and fear of negative evaluation had positive risk effects, while family cohesion and hedonic well being had protective effects for high risk of phubbing behavior. Conclusions Multidimensional state boredom is the core predictor of phubbing behavior among college students. The XGBoost model demonstrates good predictive performance and can provide a reference for identifying high risk individuals and implementing targeted interventions.

OBJECTIVE: Coptis chinensis (Huanglian in Chinese, HL) is commonly utilized in clinical settings to counteract dyslipidemia in patients with hot syndrome. Its lipid-reducing efficacy has been consistently demonstrated in high-fat diet (HFD)-induced hyperlipidemic animal models. However, whether HL's efficacy differs in HFD-fed animals with hot or cold syndromes remains unclear. This study aims to discern the variations in the anti-hyperlipidemic effects of HL in HFD-fed mice with hot or cold syndromes. METHODS: HFD-induced C57BL/6 mice were subjected to cold or hot syndrome via two weeks of ice water (0 °C) and levothyroxine sodium (240 µg/kg) treatment, respectively. Then, an aqueous extract of HL was administered to the mice via oral gavage over the following four-week period. Lipid levels in the serum and liver were gauged to determine the lipid-reducing effects of HL. Furthermore, gut microbiota composition was elucidated using full-length 16S rRNA gene sequencing. RESULTS: HL notably reduced lipid levels in HFD-induced hyperlipidemic mice. Its efficacy was amplified in hyperlipidemic mice with a hot syndrome but was markedly reduced in those with a cold syndrome. HL treatment led to a decline in alpha-diversity (characterized by ACE, Chao1, Shannon and Simpson index) of the gut microbiota in both sets of mice but affected specific microbial populations based on the syndrome. Specifically, while HL led to a notable increase in Eubacterium, Robinsoniella, and Lachnoclostridium genera, along with the enhancement of Clostridium innocuum and Bacteroides thetaiotaomicron species across all conditions, it syndrome-dependently stimulated Romboutsia ilealis and Parabaceroides_sp_HGS0025 species in mice with hot syndrome. CONCLUSION HL shows stronger lipid-lowering effect on hyperlipidemic mice with hot syndrome, which is in accordance with its traditional usage in clinic. The therapeutic outcomes of HL are intrinsically tied, at least in part, to its modulatory effects on the gut microbiota, offering fresh insights into the foundational principles of traditional Chinese medicine.

ObjectiveTo investigate the status of tooth loss in people aged 50 and above, so as to understand their oral health status and provide scientific evidences for promoting oral health of middle-aged and elderly people. MethodsA total of 400 patients who visited the department of stomatology at Sijing Hospital in Songjiang District of Shanghai were performed oral health examinations and their information was collected according to the national epidemiological survey standards for oral health. ResultsThere were statistically significant differences in tooth loss among people aged 50 and above with different ages, educational levels, occupations, types of medical insurance and chronic diseases (P<0.05), but gender and monthly income had no statistically significant correlations with tooth loss (P>0.05). Among lifestyle factors, smoking, alcohol consumption and tea drinking had no statistically significant impacts on the number of remaining teeth (P>0.05), but toothbrushing frequency, flossing frequency, toothpick use frequency, toothbrush replacement frequency, and tooth loosening were statistically associated with the number of remaining teeth (P<0.05). Multiple linear regression analyses indicated that a total of 7 related factors including age, educational level, occupation, medical payment type, chronic disease, tooth loosening and toothpick use frequency were significantly associated with the number level of remaining teeth in individuals aged 50 and above. ConclusionAge, chronic disease, and tooth loosening were influencing factors affecting the number of teeth left in people aged 50 and above. It is recommended to strengthen oral health education and improve healthcare awareness to reduce the risk of tooth loss in people aged 50 and above.

ObjectiveTo investigate the high-risk detection rate and aggregation of cardiovascular diseases（CVD） in 8 districts of Shanghai and influencing factors， and to provide scientific references for prevention and control of CVD. MethodsBased on the Cardiovascular Disease Screening and Management Program in Shanghai from 2016 to 2021， 104 685 participants aged 35 to 75 in 8 districts of Shanghai were selected for analysis. χ² test and multivariate logistic regression were used for statistical analysis of the influencing factors of CVD and aggregation of CVD. ResultsThe proportion of high-risk CVD individuals in the population was 19.17%， including the high-risk individuals with hypertension （8.65%）， dyslipidemia （6.33%）， CVD history （5.58%）， and WHO assessed risk ≥20% types （2.69%）， respectively. Old age， overweight and obesity， central obesity， smoking， drinking， farmers， unmarried， and low family income were the risk factors of CVD， while high education level was the protective factor. In the participants， 16 323 people （81.34%） were classified as CVD high-risk groups； The number of aggregation of 1， 2 and ≥3 high risk types of CVD were 16 323（81.34%）， 3 236（16.13%）， 509（2.54%）， respectively. Old age， low education level， low annual family income， farmers， unmarried， smoking， drinking， overweight， obesity and central obesity were associated with the risk of aggregation of high risk types of CVD， and the correlation strength increased with the increase of aggregation types. ConclusionThe prevention and control of CVD in Shanghai should focus on the hypertension， elderly， overweight， obesity， central obesity， smoking， drinking， low educated， low family income， farmers and unmarried people， and targeted intervention measures should be taken to reduce the risk of CVD among residents.

ObjectiveTo investigate the prevalence of dental caries among preschool children in Chongming District， Shanghai， and to analyze the related factors influencing dental caries in preschool children in Chongming District， in order to provide references and suggestions for the prevention of dental caries in preschool children in Chongming District. MethodsFrom January to April 2022， 939 preschool children from 5 kindergartens in Chongming District of Shanghai were selected as the research objects through random cluster sampling. The dental caries prevalence rate and related risk factors of dental caries in preschool children were studied through oral examinations and questionnaire surveys. ResultsThe prevalence rate of dental caries among the 939 preschool children was 45.69%. The prevalence of dental caries in preschool children was not related to gender but increased with age （P<0.001）. Risk factors for dental caries in children included consuming desserts between meals or before bedtime （OR=3.049， P<0.001）， consuming sugared milk （OR=2.389， P=0.027）， presence of dental caries in caregivers （OR=1.888， P<0.001）， age （OR=1.758， P<0.001）， regular consumption of certain beverages by children （OR=1.250， P=0.029）， and the frequency of snack consumption （OR=1.191， P=0.034）. ConclusionTo reduce the incidence of dental caries in preschool children， it is recommended that caregivers undergo oral health examinations and dental caries treatment to reduce the transmission of cariogenic bacteria. Additionally， reducing the frequency of children’s consumption of snacks， sugary drinks， and dairy products， and avoiding unhealthy eating habits such as consuming desserts before bedtime are advised. It is also important to educate children on proper toothbrushing methods to ensure the effectiveness of toothbrushing and to encourage them to develop good oral hygiene habits.

Objective To investigate the clinical significance and level changes of uric acid(UA)/albumin(ALB)ratio(UAR)in patients with chronic kidney disease(CKD)complicated with coronary heart disease(CHD).Methods A total of 175 patients with CKD were divided into the simple CKD group(control group,n=94)and the CKD complicated with CHD group(experimental group,n=81).The differences of blood routine,blood lipid,renal function and UAR were compared between the two groups.The influencing factors of CKD complicated with CHD were analyzed by binary Logistic regression.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of each index for CKD complicated with CHD.Results There were no significant differences in white blood cell count(WBC),monocytes(Mon),total cholesterol(TC),total triglyceride(TG),high-density lipoprotein(HDL-C)and low-density lipoprotein(LDL-C)between the two groups.The levels of neutrophils(Neu),red cell distribution width variation coefficient(RDW-CV),blood urea nitrogen(BUN),creatinine(Cr),UA and UAR levels were higher in the experimental group than those in the control group(R＜0.05).The levels of lymphocyte(Lym),red blood cell count(RBC),mean corpuscular hemoglobin concentration(MCHC),platelet(PLT),estimated glomerular filtration rate(eGFR)and albumin(Alb)were lower in the experimental group than those in the control group(R＜0.05).Logistic regression analysis showed that lower levels of RBC and MCHC,and higher levels of UAR were independent risk factors for CKD complicated with CHD.ROC curve showed that the area under the UAR curve was the largest in RBC,MCHC and UAR detection,which was 0.912(95%CI:0.870-0.953),the sensitivity was 90.10%,the specificity was 77.70%,the Yoden index was 0.678 and the cutoff value was 10.935.The AUC of combined detection of RBC,MCHC and UAR was 0.987(95%CI:0.974-0.999),the sensitivity was 93.80%and the specificity was 97.90%.Conclusion The increased serum UAR level in patients with CKD is a predictor of CHD.The combined detection of UAR,RBC and MCHC has higher prediction efficiency.

The mild-natured and bitter-flavored traditional Chinese medicines (MB-TCMs) are an important class of TCMs that have been widely used in clinical practice and recognized as safe long-term treatments for chronic diseases. However, as an important class of TCMs, the panorama of pharmacological effects and the mechanisms of MB-TCMs have not been systemically reviewed. Compelling studies have shown that gut microbiota can mediate the therapeutic activity of TCMs and help to elucidate the core principles of TCM medicinal theory. In this systematic review, we found that MB-TCMs commonly participated in the modulation of metabolic syndrome, intestinal inflammation, nervous system disease and cardiovascular system disease in association with promoting the growth of beneficial bacteria Bacteroides, Akkermansia, Lactobacillus, Bifidobacterium, Roseburia as well as inhibiting the proliferation of harmful bacteria Helicobacter, Enterococcus, Desulfovibrio and Escherichia-Shigella. These alterations, correspondingly, enhance the generation of protective metabolites, mainly including short-chain fatty acids (SCFAs), bile acid (BAs), 5-hydroxytryptamine (5-HT), indole and gamma-aminobutyric acid (GABA), and inhibit the generation of harmful metabolites, such as proinflammatory factors trimethylamine oxide (TAMO) and lipopolysaccharide (LPS), to further exert multiplicative effects for the maintenance of human health through several different signaling pathways. Altogether, this present review has attempted to comprehensively summarize the relationship between MB-TCMs and gut microbiota by establishing the TCMs-gut microbiota-metabolite-signaling pathway-diseases axis, which may provide new insight into the study of TCM medicinal theories and their clinical applications.

ObjectiveTo investigate the status, characteristics of population distribution and trends of chronic obstructive pulmonary disease (COPD) deaths among the registered residents in Chongming District, Shanghai from 2002 to 2022, and to provide a scientific basis for precise prevention and control of COPD. MethodsCOPD death data were obtained from the Shanghai Chongming District Death Surveillance System, and indicators such as crude mortality rate, standardized mortality rate, mortality rate by age group, and probability of premature death were calculated for the registered residents with COPD. Joinpoint 5.0.2 software was adopted to analyze the annual percent change (APC) and average annual percent change (AAPC), followed by an analysis of trend changes. ResultsFrom 2002 to 2022, the average annual crude mortality rate and average annual standardized mortality rate of COPD among the residents of Chongming District were 73.49/100 000 and 34.00/100 000, respectively, and both were higher in males than those in females. The crude mortality rate of COPD among the residents aged ≤69 years in Chongming District was 6.78/100 000, followed by 218.28/100 000 in the age group of ≥70 years and 1 042.77/100 000 in the age group of ≥80 years, respectively. The standardized mortality rates for the whole population (AAPC=-9.75%), males (AAPC=-9.06%) , and females (AAPC=-12.25%) all showed a downward trend (all P<0.001). In addition, there was a decreasing trend in the crude mortality rates for the residents aged ≤69 years (AAPC=-7.51%), aged ≥70 years (AAPC=-9.89%), and aged ≥80 years (AAPC=-8.85%) (all P<0.001). Furthermore, the probability of premature death of COPD decreased from 1.45% in 2002 to 0.08% in 2022. ConclusionThe mortality rate and probability of early premature death of COPD among the registered residents in Chongming District, Shanghai from 2002 to 2022 show a downward trend, and the mortality rate of declining in males is slower than that in females. The elderly with advanced age account for the highest number of deaths. Therefore, targeted intervention measures should be taken for key groups to reduce the mortality rate of COPD.

Objective To investigate the effect of resveratrol on endoplasmic reticulum stress and apoptosis in thyroid follicular cells induced by high iodine. Methods The thyroid follicular cell line Nthy-ori 3-1 was cultured in vitro and divided into four groups based on different culture methods: normal culture group (Normal group), high iodine group (HI group), resveratrol group (RES group), and high iodine combined with resveratrol group (HI+RES group). Cell proliferation activity was detected by CCK-8 assay, cell apoptosis was detected by TUNEL assay, and the BIP, CHOP, IRE1 mRNA expressions were detected by real-time quantitative polymerase chain reaction (PCR). Western blot was used to detect the protein expressions of BIP, CHOP, and IRE1. Results Compared with the Normal group, the proliferation activity of cells in the HI group decreased after 72 hours of culture, the proportion of apoptotic cells increased, the proportion of TUNEL staining positive cells increased, and the relative expressions of BIP, CHOP, IRE1 mRNA, as well as BIP and CHOP proteins were significantly elevated (P < 0.001 or P < 0.05). Compared with the HI group, the proliferation activity of cells in the HI+RES group increased after 72 hours of culture, the proportion of apoptotic cells decreased, the proportion of TUNEL staining positive cells decreased, and the relative expressions of BIP, CHOP mRNA, as well as BIP and CHOP proteins, were significantly reduced(P < 0.001 or P < 0.01). Conclusion Resveratrol exerts a protective effect on thyroid follicular cells induced by high iodine, significantly inhibiting endoplasmic reticulum stress and apoptosis caused by excessive iodine intake.