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.

As a vital resource, blood directly impacts the life and health of patients and the continuity of medical care. Given that it can only be obtained through voluntary donations from blood donors, its supply is susceptible to shortages due to various external factors. As the first article in a series introducing the " National Plan for NHS Blood and Transplant and Hospitals to Address Blood Shortage in the United Kingdom", this paper provides a detailed overview of the UK’s emergency management system, with a particular focus on its health emergency management framework. Regarding the UK’s emergency management system, this article elaborates on the regulatory and standards framework and institutional mechanisms for emergency management, non-statutory guidance documents offering preparation and implementation advice, the local resilience forums (LRFs) system enabling cross-departmental and multi-agency emergency coordination and collaboration, the UK government’s capacity-building efforts, as well as emergency response entities and command-and-control mechanisms. Supplementing the preceding review, the article further details the legal basis of the UK’s health emergency system and the core standards framework of national health service (NHS) emergency preparedness, resilience, and response (EPRR), with specific reference to relevant documents.

As the second installment in our series introducing the UK Blood Shortage Response Plan, this article outlines the UK's blood emergency management framework, including: Business Continuity Management (BCM) for healthcare institutions; Structure of emergency command coordination and participating organizations in the UK; Key components of blood emergency management guidelines. Simultaneously, by detailing the National Blood Transfusion Committee's component agencies, institutional responsibilities, operational requirements and operational remit, it provides deeper insights into the development and functioning of the UK's blood emergency management system, thereby delivering comprehensive foundational knowledge for understanding the implementation of the Blood Shortage Response Plan.

As the second installment in our series introducing the UK Blood Shortage Response Plan, this article outlines the UK's blood emergency management framework, including: Business Continuity Management (BCM) for healthcare institutions; Structure of emergency command coordination and participating organizations in the UK; Key components of blood emergency management guidelines. Simultaneously, by detailing the National Blood Transfusion Committee's component agencies, institutional responsibilities, operational requirements and operational remit, it provides deeper insights into the development and functioning of the UK's blood emergency management system, thereby delivering comprehensive foundational knowledge for understanding the implementation of the Blood Shortage Response Plan.

Objective: To analyze the epidemiological characteristics and changing trends of non suicidal self injury (NSSI) behaviors among middle school students in Jiading District of Shanghai, from 2015 to 2023, so as to provide a basis for the development of NSSI prevention and control measures among students. Methods: Using a stratified cluster random sampling method, a total of five times for Shanghai Adolescent Health Risk Behavior Surveys were conducted for every two years in Jiading District of Shanghai from 2015 to 2023. A total of 5 231 middle school students from junior high schools and senior high schools were selected for questionnaire surveys. Intergroup comparisons were performed using the x 2 test or the χ 2 trend test, and the JointPoint 5.0 software was used to analyze the changing trends, with the annual percent change (APC) used for evaluation. A binary Logistic regression model was employed to analyze the related factors of NSSI behavior among middle school students. Results: In 2023, the reported NSSI rate among middle school students in Jiading District was 14.2%. The rate was significantly higher among junior high school students (17.1%) than that among senior high school students (11.1%), and higher among females (19.2%) than that among males (10.0%) ( χ 2=10.04, 23.21, both P <0.01). From 2015 to 2023, the overall reported NSSI rate showed an increasing trend, rising from 8.6% in 2015 to 14.2% in 2023 ( χ 2 trend =22.25), with an APC of 6.64% ( t =3.49), and the APC for girls was 9.79 % ( t =3.20) (all P <0.05). Among students reporting NSSI, the proportion experiencing ≥6 episodes increased from 10.8% in 2015 to 19.2% in 2023 ( χ 2 trend =6.57, P <0.05). Multivariate Logistic regression analysis indicated that girls, junior high school students, those with insomnia, depressive emotion and drinkers had higher risks of NSSI, compared to boys, senior high school students, those without insomnia, non depressive emotion students and non drinkers ( OR =1.71, 1.96, 3.44, 4.76, 1.77, all P < 0.05 ). Conclusions The reported rate of NSSI among middle school students in Jiading District of Shanghai, increased annually from 2015 to 2023, and the proportion of repeated NSSI also showed an upward trend. Early intervention measures targeting middle school students, especially junior high school students and females, should be implemented to prevent and control its occurrence and development.

As the third part of a series introducing the "national plan for NHS blood and transplant and hospitals to address blood shortage in the UK", this article details the development and full content of the plan to address red cell shortages. It primarily outlines an action framework and specific measures to be taken under the four defined red cell supply levels. The article places particular emphasis on the formulation and implementation of the Emergency Blood Management Arrangements (EBMA), transfusion indications, the impact and monitoring of blood shortages, and the work involved in the recovery phase of blood supply. Furthermore, by referencing appendix content, it presents the above information graphically in charts and tables.

As the fourth installment in the series introducing the "national plan for NHS blood and transplant and hospitals to address blood shortage in the UK" details the development process and full content of the "Guidance for transfusion triage and blood allocation in massively bleeding patients during a severe national blood shortage". It primarily covers: defining "massive haemorrhage," outlining the activation and implementation procedures for Emergency Blood Management Arrangements, and introducing the emergency decision-making framework for blood allocation in patients anticipated to require massive transfusion. It also elaborates on the transfusion triage process and the methods for re-evaluating triaged patients, supported by examples cited from the appendices. Notably, it proposes ethical principles for the triage of transfusion patients, offering reference principles for China in formulating relevant policies and corresponding measures. As the final article in the series on the “Overview of national plan for NHS blood and transplant and hospitals to address blood shortage in the United Kingdom ", this piece summarizes the entire collection. It concludes that unified national planning, close cross-institutional collaboration, deep involvement of specialist committees, and evidence-based clinical practice are indispensable pillars for building a blood emergency management system capable of withstanding various shocks and consistently safeguarding patient lives. For China, which is committed to refining its own blood emergency management system, the UK's experience offers profound insights and lessons for reference, particularly in areas such as system architecture, legal framework development, the operation of specialist committees, and standardized processes.

Objective To investigate the clinical efficacy and mechanism of the Compound Huzhang Prescription in the treatment of dampness-heat accumulation type metabolic-associated fatty liver disease(MAFLD).Methods Eighty MAFLD patients were randomly divided into the treatment group(treated with Compound Huzhang Prescription)and the control group(treated with polyene phosphatidylcholine capsules),with 40 cases in each group.After 3 months of treatment,liver function indicators(ALT,AST,γ-GGT),fast-ing blood glucose(FBG),lipid profiles(TC,TG,HDL-C,LDL-C),hepatic steatosis index(HSI),fibroblast growth factor 21(FGF21),β-Klotho(KBL),homeostasis model assessment of insulin resistance(HOMA-IR)index,and liver fat content measured by MRI were compared between pre-and post-treatment.The efficacy of traditional Chinese medicine(TCM)syndrome was evaluated based on TCM syndrome scores,and the total effective rates of the two groups were compared.Results Two cases dropped out from the treatment group and one from the control group,leaving 38 cases in the treatment group and 39 cases in the control group.The levels of liver function indicators decreased significantly in both groups after treatment compared with those before treatment(P＜0.05).After treatment,TG in the treatment group showed significant decrease com-pared with both pre-treatment level and the control group(P＜0.05).In the control group,there were no significant differences in HSI,FGF21,KBL,HOMA-IR index,or liver fat content before and after treatment(P＞0.05).However,in the treatment group,HSI,FGF21,HOMA-IR,and liver fat content significantly de-creased,while KBL significantly increased after treatment(P＜0.05).Post-treatment,all these indicators in the treatment group showed significant improvement when compared to the control group(P＜0.05).The to-tal effective rate of TCM syndrome efficacy was 81.6%in the treatment group and 46.2%in the control group,with a statistically significant difference between the two groups(P＜0.05).Conclusion The Com-pound Huzhang Prescription is effective in treating MAFLD,and its mechanism is related to alleviating FGF21 resistance.

Objective To study the effective fraction and mechanism of Lycium barbarum leaves on improving learning and memory ability of subacute aging mice induced by D-galactose injection.Methods The model of subacute aging mice was developed by injection of D-galactose subcutaneously,and different extracts of Lycium barbarum leaves were prepared.The effects of the extracts of Lycium barbarum leaves on the learning and memory ability of model mice were evaluated by Y maze experiment and new object recognition experiment.The pathomorphological changes of hippocampus in mice were observed by hematoxylin-eosin and Nissl staining.The levels of brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),glial cell line-derived neurotrophic factor(GDNF),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interferon-γ(IFN-γ)and interleukin-10(IL-10)in hippocampus of mice were detected by enzyme-linked immunosorbent assay.The activities of superoxide dismutase(SOD)and the contents of glutathione(GSH)and malondialdehyde(MDA)in hippocampus of mice were detected by related assay kits.Detection of apoptosis in the hippocampal region of mouse brain tissue using the TUNEL method.Western blotting analysis was used to detect the expressions of antioxidant proteins Nrf2,HO-1 and apoptotic proteins Caspase-3,Caspase-9 in hippocampus of mice.Results The water extraction part and 80%alcohol precipitation supernatant part of Lycium barbarum leaves significantly improved the learning and memory ability of model mice,improved the pathological damage of hippocampus in mice,increased the number of Nissl bodies in hippocampus of mice,and promoted the expression of neurotrophic factors BDNF,NGF and GDNF,and promoted the expression of neurotrophic factors BDNF,NGF and GDNF.Pro-inflammatory factors TNF-α,IL-1β and IFN-γ expression declines while anti-inflammatory factor IL-10 expression rises.The activity of SOD and the expression of GSH were increased,and the expression of MDA was decreased.Increase the expression of Nrf2 and HO-1 antioxidant proteins;reduce the expression of Caspase-3 and Caspase-9 apoptosis pathway proteins.Inhibition of apoptosis in the hippocampal region of mouse brain tissue using a model.Conclusion The water extracts and 80%alcohol precipitation supernatant extracts of Lycium barbarum leaves are the effective fractions of Lycium barbarum leaves to improve the learning and memory ability of D-galactose-induced subacute aging mice,and its mechanism might be related to the inhibition of neuronal apoptosis caused by oxidative stress and inflammation.