The promulgation of the Technical Specifications for Clinical Use of Blood (2025 Edition) signifies that China's clinical blood transfusion management has transitioned from mere technical operations to a new stage centered on patient blood management (PBM). Through an in-depth comparison of the new and old specifications, this paper analyzes the core transformations regarding conceptual reconstruction, legal alignment, technological upgrades, and closed-loop management. The new specifications establish PBM principles, reinforce legal safeguards for informed consent and emergency treatment, and construct a comprehensive, refined quality control system by specifying compatibility testing standards and introducing a post-transfusion evaluation system. Medical institutions should seize this opportunity to update management protocols and information systems, deepen multidisciplinary collaboration, and drive the profound transformation of clinical blood use from focusing solely on safety assurance to placing equal emphasis on science and value.

As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

OBJECTIVE To formulate Guidelines for the standardized implementation of pharmacist-managed clinics （ 2026 edition ） in response to the challenges faced by such clinics in China， including uneven development， large discrepancies in service specifications， insufficient patient awareness， and limited medical insurance coverage. METHODS Led by the Pharmaceutical Affairs Professional Committee of the Chinese Hospital Association， the Evidence-based Pharmacy Professional Committee of the Chinese Pharmaceutical Association， and the Hospital Pharmacy Professional Committee of the Cross-strait Medical and Health Exchange Association， a total of 19 domestic hospital pharmacy experts were organized. Through a systematic review of national policies and literature research， current practical experience was summarized. Consensus on the contents of the guidelines was reached after in-depth discussions. RESULTS &CONCLUSIONS The guidelines covered five sections： definition and connotation of pharmacist-managed clinics， establishment requirements， implementation and management， post competency， and practical research. Firstly， the definition and connotation included three operational forms of pharmacist-managed clinics （independent mode， physician-pharmacist joint mode， and online pharmacist-managed clinic mode） and classified service modes （specialty-specific， drug-specific， and disease-specific pharmacist-managed clinics）. The establishment requirements were further refined， covering system construction （pharmaceutical service management system， quality control and assessment mechanism）， personnel qualifications （professional credentials， continuing education and professional training， etc）， service recipients， as well as service venues and facilities. Subsequently， the implementation and management of pharmacist-managed clinics were proposed， involving service procedures， intervention measures， documentation and records， patient education and follow-up， humanistic care， as well as risk management and quality control. Finally， post competency encompassed the competency requirements for pharmacists providing services in pharmacist-managed clinics， as well as the suggestions on teaching methods； practical research encouraged the conduct of high-quality pharmaceutical practice in the setting of pharmacist-managed clinics. The guidelines provide valuable guidance for the standardized implementation of pharmacist-managed clinics in China in terms of establishment， management， teaching， and research， fill the guideline gap in this field， and can promote the high-quality development of pharmacist-managed clinics.

ObjectiveTo assess the cost-effectiveness of human immunodeficiency virus (HIV) prevention and control strategies across different high-risk populations, investment levels, and allocation proportions in an area, thereby providing a reference for optimizing resource allocation in acquired immunodeficiency syndrome (AIDS) prevention and control. MethodsDemographic, epidemiological, and clinical progression data of the target population in an area from 2018 to 2024 were collected, along with the input costs and intervention coverage of HIV-related projects. The Optima HIV model was utilized to perform fitting and prediction, whereby the allocation of resources to optimized target populations and program interventions was modeled under varying future investment scenarios to predict the impacts on the reduction of new HIV infections and HIV-related deaths. ResultsUnder the scenario of maintaining the current level of intervention input for HIV key populations, new HIV infections and related deaths in the region were predicted to be controlled at a low level by 2030. In terms of intervention input for HIV key populations, it is suggested that appropriately increasing the intervention input for key HIV populations will further reduce new HIV infections and HIV-related deaths in the region. However, when the total input increases to 1.75 times the baseline level, the marginal effect of input will be saturated. Regarding structural adjustments in investment and considering both the current total investment scenario and 1.75 times the total investment scenario, it is predicted that further reductions in regional HIV new infections and HIV-related deaths can be achieved, provided that the intervention input for key populations (including men who have sex with men, MSM) is increased, while concurrently intensifying the proportion of intervention measures such as condom promotion to form optimized intervention portfolios. ConclusionIn the field of HIV/ AIDS prevention and control, sustained commitment to intervention investment, with a strategic focus on interventions for key populations and intensified implementation of critical intervention measures, will effectively improve the epidemiological impacts of HIV/AIDS prevention and control efforts.

Intelligent prescription recommendation has become an important research direction in traditional Chinese medicine (TCM), offering new opportunities to support clinical decision-making and promote the modernization of TCM practice. With the rapid development of artificial intelligence (AI), a variety of computational approaches have been proposed to learn prescription patterns from clinical data and generate personalized treatment recommendations. However, despite increasing research activity, systematic and comprehensive reviews of AI-driven methods for TCM prescription recommendation remain limited. In this study, we present a comprehensive review of computational approaches for herbal prescription recommendation (HPR) in TCM. Existing methods are systematically categorized into several major paradigms, including traditional machine learning methods, topic model methods, sequential generative methods, deep learning and graph-based methods, and large language model–based frameworks. In addition to summarizing methodological developments, we also review commonly used public datasets and evaluation metrics in this field. Furthermore, representative models with publicly available implementations are experimentally evaluated on multiple benchmark datasets to provide a comparative analysis of their performance on the HPR task. Finally, we discuss the key challenges that hinder the practical deployment of intelligent prescription recommendation systems, including data heterogeneity, limited interpretability, and insufficient integration of TCM domain knowledge. Future research directions are outlined to facilitate the development of more reliable, interpretable, and clinically applicable AI-assisted HPR systems for TCM.

Objective To identify renal function and other readily accessible indicators influencing the prognosis of renal cell carcinoma (RCC) patients after nephrectomy, and to construct a prognostic prediction model based on them. Methods The clinical and pathological data of 624 RCC patients undergoing radical or partial nephrectomy in the First Hospital of Shanxi Medical University during Jan. 2013 and Dec. 2021 were retrospectively analyzed. The independent prognostic factors affecting postoperative overall survival (OS) were identified with LASSO algorithm combined with Cox regression analysis. Based on these factors, a nomogram was constructed to predict the 1-, 3-, and 5-year survival rates. The performance of the model was evaluated using the concordance index (C-index), time-dependent receiver operating characteristic (ROC) curves and the area under the curve (AUC), calibration plots, and decision curve analysis (DCA). Finally, the cutoff value of the nomogram was calculated to stratify patients into risk groups. Kaplan-Meier survival analysis with log-rank testing was performed to compare outcomes between the risk groups. Results Nine independent prognostic factors were identified, including age, smoking history, diabetes mellitus history, maximum tumor diameter, tumor subtype, N stage, Fuhrman grade, preoperative serum creatinine and cystatin C (P＜0.05). The nomogram achieved a C-index of 0.891, with time-dependent AUC of 0.920, 0.903, and 0.867 for 1-, 3-, and 5-year OS, respectively. Calibration curves showed excellent agreement with actual observations, and DCA demonstrated significant clinical net benefits across a wide threshold probability range. Using a cutoff score of 110.4, Kaplan-Meier analysis revealed statistically significant survival differences between risk groups (P＜0.001). Conclusion The proposed nomogram, incorporating renal function and other readily accessible clinical indicators, exhibits strong predictive accuracy for postoperative survival in RCC patients and may serve as a practical tool for individualized clinical decision-making.

Objective To compare the therapeutic efficacy and identify differences between haploidentical hematopoietic stem cell transplantation combined with mesenchymal stem cells (Haplo-MSC) and umbilical cord blood hematopoietic stem cell transplantation combined with mesenchymal stem cells (UCB-MSC) in mice with bone marrow acute radiation syndrome (ARS). Methods Eight-to ten-week-old CB6F1 mice were exposed to 8 Gy of ⁶⁰Co γ-ray irradiation to establish a bone marrow-type ARS model.The mice were then randomly assigned to three groups: the Haplo-MSC group (haploidentical hematopoietic stem cells combined with MSCs), the UCB-MSC group (umbilical cord blood stem cells combined with MSCs), and a saline control group. The survival rate, peripheral blood cell counts, pathological changes in target organs, colony formation of bone marrow cells, and graft-versus-host disease (GVHD) were observed. Results All mice in the saline control group died within 14 days, with a median survival time of 8.9 days. The 30 day survival rate was 65% in the Haplo-MSC group and 60% in the UCB-MSC group. The Log-rank test showed no significant difference in survival time between the two transplantation groups (P=0.561). At 28 days post-transplantation, no significant differences were observed in WBC, PLT, RBC, or Hb counts between the two groups (P=0.151, 0.733, 0.856, and 0.300, respectively). Pathological changes in bone marrow cells showed that bone marrow failure occurred later in the UCB-MSC group than in the Haplo-MSC group. In contrast, the Haplo-MSC group exhibited faster hematopoietic stem cell engraftment. Furthermore, the numbers of CFU-E, CFU-GM, and CFU-GEMM differed significantly between the two groups (P<0.05). Conclusion Both the Haplo-MSC and UCB-MSC regimens promoted hematopoietic engraftment and reconstitution in mice with lethal-dose radiation-induced bone marrow ARS. However, the onset of bone marrow failure was delayed in mice treated with the UCB-MSC regimen. In contrast, mice treated with the Haplo-MSC regimen showed faster engraftment.

Objective: To summarize strategies for improving childhood hypertension, so as to provide evidencebased recommendations for poliymaking and practice childhood hypertension management in China. Methods: From March to April 2024, child health stakeholders from five districts in Hangzhou were selected using a combination of stratified and convenience sampling methods. Data were analyzed using a groundedtheory approach. During the indepth interview phase, six policymakers were interviewed. Focus group discussions were conducted with school administrators, healthcare providers, and parents, comprising a total of 62 participants. Results: Through threelevel coding, 116 initial categories were identified(e.g., "trend of younger age" "difficulty in behavior change"), 35 main categories (e.g., "higher incidence compared to the past" "caused by comprehensive influencing factors"), and 12 core categories (e.g., "epidemic status" "influencing factors"). Finally, the cognitive status, problem analysis, and management strategies of children hypertension were constructed. Conclusion Effective prevention and control of childhood hypertension requires coordinated efforts among governments, schools, families, and society to establish a comprehensive management system, with dynamic monitoring and evaluation to optimize policy implementation.

Objective: To examine the association between the left behind status and health risk behaviors (HRB) among adolescents, so as to provide empirical evidence for identifying high risk groups and developing intervention measures for HRB. Methods: From October to November 2023, by using a combination of convenient sampling and cluster sampling,14 964 adolescents from 6 schools in a county level city in Hubei Province (3 junior high schools and 3 senior high schools) and 7 schools in a county level city in Hunan Province (all junior high schools) were selected as the research subjects. The adolescents were divided into non-left-behind, father absent, mother absent, and both parents absent groups based on their left behind status. A self designed adolescent HRB questionnaire was utilized to investigate the prevalence of 12 types of HRBs and their co-existence among the subjects. Multifactorial Logistic regression and unordered multinomial Logistic regression analyses were used to explore the association between the left behind status of adolescents and the occurrence of individual HRBs as well as the co-existence of multiple HRBs. Results: After controlling for gender, age, only child, and subjective socioeconomic status, the results of the multiple factor Logistic regression analysis showed that having father in absence for working was positively associated with screen use long time on school days ( OR= 1.15, 95%CI =1.05-1.26) and rest days ( OR=1.16, 95%CI =1.06-1.26); having mother in absence for working was significantly associated with increased risks of smoking ( OR=1.68, 95%CI =1.22-2.32), spending long time on screen during school days ( OR= 1.19, 95%CI =1.00-1.41)and rest days ( OR=1.36, 95%CI =1.16-1.59), skipping breakfast ( OR=1.20, 95%CI =1.03-1.39), skipping dinner ( OR=1.20, 95%CI =1.01-1.43), not eating fruit ( OR=1.34, 95%CI =1.12-1.61), and consuming sugar sweetened beverages ( OR=1.30, 95%CI =1.09-1.55); having both parents in absence for working was positively associated with screen use on rest days ( OR=1.51, 95%CI =1.38-1.65), skipping dinner ( OR=1.15, 95%CI =1.04-1.27), not eating fruit ( OR=1.80, 95%CI =1.62-1.99),and non suicidal self injury ( OR=1.16, 95%CI =1.04-1.29), and negatively associated with fast food consumption ( OR=0.72, 95%CI =0.65-0.79)(all P <0.05).The results of unordered multiclass Logistic regression analysis showed that mother absence for working was associated with an increased risk of moderate and high co-occurrence of HRBs ( OR= 1.25, 95%CI=1.06-1.47; OR=1.67, 95%CI =1.30-2.13), both parents absence for working was also positively correlated with a high cooccurrence risk of HRBs ( OR=1.29, 95%CI =1.11-1.50) (all P <0.05). Conclusion Father absence for working is only related to adolescents screen time, while adolescents with mother absence or both parents absent for working are priority groups for HRB prevention.

Soil cadmium pollution can adversely affect the cultivation of the ornamental plant, Coleus scutellarioides. Upon cadmium contamination of the soil, the growth of C. scutellarioides is impeded, and it may even succumb to the toxic accumulation of cadmium. In this study, we investigated the effects of arbuscular mycorrhizal fungi (AMF) on the adaptation of C. scutellarioides to cadmium stress, by measuring the physiological metabolism and the degree of root damage of C. scutellarioides, with Aspergillus oryzae as the test fungi. The results indicated that cadmium stress increased the activity of superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT), and the content of malondialdehyde (MDA) and proline (Pro) within the cells of C. scutellarioides, but inhibited mycorrhizal infestation rate, root vigour and growth rate to a great degree. With the same cadmium concentration, the inoculation of AMF significantly improved the physiological indexes of C. scutellarioides. The maximum decrease of MDA content was 42.16%, and the content of secondary metabolites rosemarinic acid and anthocyanosides could be increased by up to 27.43% and 25.72%, respectively. Meanwhile, the increase of root vigour was as high as 35.35%, and the DNA damage of the root system was obviously repaired. In conclusion, the inoculation of AMF can promote the accumulation of secondary metabolites, alleviate root damage, and enhance the tolerance to cadmium stress in C. scutellarioides.
Cadmium/toxicity* ; Mycorrhizae/physiology* ; Plant Roots/drug effects* ; Soil Pollutants/toxicity* ; Stress, Physiological ; Superoxide Dismutase/metabolism*