Objective To systematically review and quantify the content and structure of the non-accompanied wards policy texts at the provincial level in China from the perspective of policy tools,providing references and insights for optimizing and implementing future policies.Methods Using the policy analysis tools as framework,it applies content ana lysis to construct a two-dimensional analytical framework with the X-dimension and Y-dimension.A total of 19 policy texts related to non-accompanied ward issued by provincial governments in China from January 2000 to August 2024 were coded and analyzed.Results A total of 141 entries were coded.In the X-dimension,supply-oriented,demand-oriented,and environment-oriented policy tools accounted for 21.28%,19.86%,and 58.86%,respectively,indicating a greater reliance on environmental-oriented policy tools;In the Y-dimension,policies from the"12th Five-Year Plan"(16.31%),"13th Five-Year Plan"(14.89%),and"14th Five-Year Plan"(68.80%)phases were analyzed.The number of policies in the"14th Five-Year Plan"phase was the highest among the three periods.Conclusion The policy framework for non-accompanied wards in China is still in its initial exploration phase and has room for improvement.It is recommended that future policies optimize the use of policy tools,strengthen coordination among them,and support the development of non-accompanied wards.

Objective: To study the impact of disaggregation on the quality of in vitro aggregated apheresis platelets. Methods: The apheresis platelets collected from Guangzhou Blood Center served as the study samples. The in vitro aggregated apheresis platelets after successful disaggregation were designated as the experimental group (referred to as the aggregation group), and apheresis platelets without in vitro aggregation during collection served as the control group. The product volume, platelet content, residual white blood cells, red blood cell contamination, pH value, CD62p expression rate, platelet morphology score and thromboelastography of both groups were respectively detected. Results: The routine quality control indicators such as product volume, platelet content, residual white blood cells, red blood cell contamination, and pH value of both groups all met the quality requirements. There were statistically significant differences in pH value (7.180 vs 7.071) between the two groups (P<0.05). There was no significant difference in product volume, platelet content, residual white blood cells, and red blood cell contamination between the two groups (P>0.05). The CD62p expression rate of the aggregation group was higher than that of the control group (42.386% vs 17.310%, P<0.05), while the cell morphology score of the aggregation group was lower than that of the control group (132.066 vs 141.166, P<0.05). No statistically significant differences were found in thromboelastography parameters (R-CK, K-CK, α angle, MA-CK, CI-CK) between the two groups (P>0.05). Conclusion: After the disaggregation of in vitro-aggregated apheresis platelets, the quality indicators met the national quality requirements. Although the expression rate of CD62p increased and the cell morphology score decreased, there were no statistically significant differences in the thromboelastography parameters between the two groups. This indicates that although some platelet activation occurred, it did not affect the hemostatic function of the platelets.

In terms of the complexity of the"left"and"right"concepts,these directional terms not only indicate spatial orientation but also embody hierarchical order,official titles,systemic imbalances,and temporal sequences.This study explains the medical theory of"liver is born on the left and lung is hidden on the right,"and reveals its implications for ascending and descending of qi movement pathways,sequential patterns,non-equilibrium states,and the centrality of the middle,thus linking the connotation of this theory and its application.In view of this,the theory of"liver is born on the left and lung is hidden on the right"can be used in the clinical diagnosis and treatment of qi-blood-body fluid and emotional diseases,and guides disease prevention and treatment,as well as enhances the subjective initiative of health maintenance and longevity.This study not only deepens the modern interpretation of the classical theory but also provides novel perspectives for its application in disease prevention and treatment.

In terms of the complexity of the"left"and"right"concepts,these directional terms not only indicate spatial orientation but also embody hierarchical order,official titles,systemic imbalances,and temporal sequences.This study explains the medical theory of"liver is born on the left and lung is hidden on the right,"and reveals its implications for ascending and descending of qi movement pathways,sequential patterns,non-equilibrium states,and the centrality of the middle,thus linking the connotation of this theory and its application.In view of this,the theory of"liver is born on the left and lung is hidden on the right"can be used in the clinical diagnosis and treatment of qi-blood-body fluid and emotional diseases,and guides disease prevention and treatment,as well as enhances the subjective initiative of health maintenance and longevity.This study not only deepens the modern interpretation of the classical theory but also provides novel perspectives for its application in disease prevention and treatment.

Objective To systematically review and quantify the content and structure of the non-accompanied wards policy texts at the provincial level in China from the perspective of policy tools,providing references and insights for optimizing and implementing future policies.Methods Using the policy analysis tools as framework,it applies content ana lysis to construct a two-dimensional analytical framework with the X-dimension and Y-dimension.A total of 19 policy texts related to non-accompanied ward issued by provincial governments in China from January 2000 to August 2024 were coded and analyzed.Results A total of 141 entries were coded.In the X-dimension,supply-oriented,demand-oriented,and environment-oriented policy tools accounted for 21.28%,19.86%,and 58.86%,respectively,indicating a greater reliance on environmental-oriented policy tools;In the Y-dimension,policies from the"12th Five-Year Plan"(16.31%),"13th Five-Year Plan"(14.89%),and"14th Five-Year Plan"(68.80%)phases were analyzed.The number of policies in the"14th Five-Year Plan"phase was the highest among the three periods.Conclusion The policy framework for non-accompanied wards in China is still in its initial exploration phase and has room for improvement.It is recommended that future policies optimize the use of policy tools,strengthen coordination among them,and support the development of non-accompanied wards.

Objective Female fertility gradually decreases with the increase in women's age.The underlying reasons include the decline in the quantity and quality of oocytes.Oocyte aging is an important manifestation of the decline in oocyte quality,including in vivo oocyte aging before ovulation and in vitro oocyte aging after ovulation.Currently,few studies have been done to examine oocyte aging,and the relevant molecular mechanisms are not fully understood.Therefore,we used zebrafish as a model to investigate oocyte aging.Three different age ranges of female zebrafish were selected to mate with male zebrafish of the best breeding age.In this way,we studied the effects of maternal age-related oocyte aging on fertility and investigated the potential molecular mechanisms behind maternal age-related fertility decline.Methods Eight female zebrafish aged between 158 and 195 d were randomly selected for the 6-month age group(180±12)d,8 female zebrafish aged between 330 and 395 d were randomly selected for the 12-month age group(360±22)d,and 8 female zebrafish aged between 502 and 583 d were randomly selected for the 18-month age group(540±26)d.Male zebrafish of(180±29)d were randomly selected from zebrafish aged between 158 and 195 d and mated with female zebrafish in each group.Each mating experiment included 1 female zebrafish and 1 male zebrafish.Zebrafish embryos produced by the mating experiments were collected and counted.The embryos at 4 hours post-fertilization were observed under the microscope,the total number of embryos and the number of unfertilized embryos were counted,and the fertilization rate was calculated accordingly.The numbers of malformed embryos and dead embryos were counted 24 hours after fertilization,and the rates of embryo malformation and mortality were calculated accordingly.The primary outcome measure was the embryo fertilization rate,and the secondary outcome measures were the number of embryos per spawn(the total number of embryos laid within 1.5 hours after the beginning of mating and reproduction of the zebrafish),embryo mortality,and embryo malformation rate.The outcome measures of each group were compared.The blastocyst embryos of female zebrafish from each group born after mating with male zebrafish in their best breeding period were collected for transcriptomics analysis.Fresh oocytes of female zebrafish in each group were collected for transcriptomics analysis to explore the potential molecular mechanisms of maternal age-related fertility decline.Results Compared with that of the 6-month group(94.9%±3.6% ),the embryo fertilization rate of the 12-month group(92.3%±4.2% )showed no significant difference,but that of the 18-month group(86.8%±5.5% )decreased significantly(P<0.01).In addition,the fertilization rate in the 18-month group was significantly lower than that in the 12-month group(P<0.05).Compared with that of the 6-month group,the embryo mortality of the female zebrafish in the 12-month group and that in the 18-month group were significantly higher than that in the 6-month group(P<0.000 1,P<0.001).There was no significant difference in the number of embryos per spawn or in the embryo malformation rate among the three groups.The results of the transcriptomics analysis of blastocyst embryos showed that some genes,including dusp5,bdnf,ppip5k2,dgkg,aldh3a2a,acsl1a,hal,mao,etc,were differentially expressed in the 12-month group or the 18-month group compared with their expression levels in the 6-month group.According to the KEGG enrichment analysis,these differentially expressed genes(DEGs)were significantly enriched in the MAPK signaling pathway,the phosphatidylinositol signaling system,and the fatty acid degradation and histidine metabolism pathway(P<0.05).The analysis of the expression trends of the genes expressed differentially among the three groups(the 6-month group,the 12-month group,and the 18-month group in turn)showed that the gene expression trends of fancc,fancg,fancb,and telo2,which were involved in Fanconi anemia pathway,were statistically significant(P<0.05).In the results of oocyte transcriptomics analysis,the genes that were differentially expressed in the 12-month group or the 18-month group compared with the 6-month group were mainly enriched in cell adhesion molecules and the protein digestion and absorption pathway(P<0.05).The results of the trends of gene expression in the zebrafish oocytes of the three groups(the 6-month group,the 12-month group,and the 18-month group in turn)showed that three kinds of gene expression trends of declining fertility with growing maternal age had significant differences(P<0.05).Further analysis of the three significantly differential expression trends showed 51 DEGs related to mitochondria and 5 DEGs related to telomere maintenance and DNA repair,including tomm40,mpc2,nbn,tti1,etc.Conclusion With the increase in the maternal age of the zebrafish,the embryo fertilization rate decreased significantly and the embryo mortality increased significantly.In addition,with the increase in the maternal age of the zebrafish,the expression of mitochondria and telomere-related genes,such as tomm40,mpc2,nbn,and tti1,in female zebrafish oocytes decreased gradually.Maternal age may be a factor contributing to the decrease in oocyte fertilization ability and the increase in early embryo mortality.Maternal age-related oocyte aging affects the fertility and embryo development of the offspring.

【Objective】 To explore the effectiveness of using donor plasma reinfusion to flush the leukoreduction system (LRS) chamber during the final reinfusion phase with the Trima Accel automated blood collection system in preventing the reduction of CD4+ and CD8+ T lymphocytes. 【Methods】 A longitudinal and cross-sectional study was designed. CD4+ count<200 cells/μL and CD8+ count<125 cells/μL were considered as the criteria for deficiency. Eighteen first-time platelet donors were followed up. The lymphocyte count was measured at 0, 3-6 and 7-14 times of blood donation in the last 300 days. 170 healthy blood donors who have not donated blood were selected as the control group. According to the cut-off point(October 2021), 88 blood donors who mainly used automatic blood collection system to donate platelet apheresis in the last 365 days(median blood donation times ≥17.5)were divided into three groups(A, B and C)and blood samples were obtained. The time for Groups A, B and C started donating platelet apheresis were as follows: Group A: before October 2019, Group B: from October 2019 to September 2021, Group C: after October 2021. Blood samples were analyzed to obtain blood counts including CD4 + and CD8 + T lymphocytes. Blood samples were analyzed to obtain blood cell counts including CD4+ and CD8+ T lymphocytes. Through a comparative analysis, this study aimed to determine if there are any statistical differences in the detection indices between the follow-up groups with varying frequencies of blood donation, the control group, and groups A, B, and C. This approach was employed to infer the efficacy of donor plasma reinfusion in flushing the leukoreduction system (LRS) chamber for preventing the decline of CD4+ and CD8+ T lymphocytes. 【Results】 Eighteen first-time blood donors who were converted to regular platelet apheresis donors did not show a decrease of CD4 + and CD8 + T lymphocytes in the 5 th and 11 th blood donation (median number of blood donation), and there was no significant difference between the above indexes and those in the 0 th blood donation. Among the previous frequent blood donors, the CD4+ and CD8+ T lymphocyte counts in Group B and Group C are both higher than the standard value, showing no statistical difference from the control group. Among regular blood donors, the CD4+ and CD8+ T lymphocyte counts in groups B and C were higher than the criteria values, and had no statistical difference compared to the control group.The CD4+ T lymphocyte count in Group A was normal, with only one donor in Group A having a CD8+ T lymphocyte count below 125 cells/μL. This donor has donated 281 times of platelet apheresis, and the group he belongs to has started blood donation 2-21 years(median of 5 years) before the adjustment of reinfusion mode. The CD4+ and CD8+ T lymphocyte counts in Group A showed significant differences compared to the control group, with median counts (Group A/Control Group) of 359/521 and 257/372, respectively, P<0.001. In Group A, 0%(0/35) had a CD4+ count below 200 cells/μL, and 2.85%(1/35) of donors had a CD8+ count below 125 cells/μL, which was far lower than the proportion of CD4+ and CD8+ T cell deficiency found in regular apheresis donors by John M. Gansner and Mahboubeh Rahmani. The study showed that the adjustment of the plasma reinfusion mode did not further reduce the T lymphocyte counts in blood donors, but instead further restored the T lymphocyte counts in regular blood donors. This indicated that after the adjustment of plasma reinfusion mode, blood donors might not have lost CD4+ and CD8+ T lymphocytes during blood donation, or only lost a small amount, and can recover even if they donate platelet apheresis frequently. 【Conclusion】 Trima Accel automated blood collection system has a good effect on preventing CD4 + and CD8 + T lymphocytes from being reduced by flushing the LRS chamber with donor plasma.

Objective To conduct hazard vulnerability analysis(HVA)in a blood bank,aimed to identify high-risk e-vents and optimize emergency management measures.Methods The risk event evaluation index system was established by referring to the Kaiser model and the situation of Guangzhou Blood Center,and risk events were ranked by risk matrix and Borda count.Results The top five events with the highest risk values identified by Kaiser model were information system e-mergencies(39.61％),extreme weather(38.03％),major public sentiment(37.86％),public health events(37.37％)and policy changes(37.24％).The results of risk matrix and Borda count revealed 1 extremely high-risk indicator as information system emergency,5 high-risk indicators with the highest risk being major public sentiment,11 medium-risk indicators with the highest risk being major medical disputes and 1 low-risk indicator as external fires.Conclusion Conducting HVA in combination with the actual situation of blood banks can effectively identify high-risk events and provide theoretical basis for improving emergency management measures.

Objective:To construct an evaluation the index system of entrustable professional activities for resident training doctors in psychiatric department,and to provide reference for formulating training strategies and assessment standards.Entrustable professional activities refers to the ability of trainees to perform and complete spe-cific clinical tasks independently after they have been trusted.Methods:Through documental analysis and semi-structured interviews,the item database of entrustable professional activities for psychiatric resident training physi-cians was established.Delphi consultation was conducted among 63 experts in the field of psychiatry from 7 national resident training bases and 3 medical colleges in China.Indicators were comprehensively screened and sorted out,and indicators at all levels and their weights were determined by the analytic hierarchy process.Results:A hierarchi-cal evaluation index system of entrustable professional activities for psychiatric resident training doctors was con-structed,including 4 first-level indicators,17 second-level indicators and 68 third-level indicators.The weights of the first-level,second-level and third-level indicators were determined.Conclusion:The evaluation index system of en-trustable professional activities is comprehensive and systematic,which is suitable for clinical work and convenient for practical application.It could provide quantitative standards for the assessment of psychiatric residents and pro-mote the improvement of training quality.

Objective:To explore the effect of a nursing model based on Watson humanistic care theory in patients with end-stage heart failure (ESHF) .Methods:From January 2017 to January 2020, convenience sampling was used to select ESHF patients who underwent treatment in the Chengbei District of Hangzhou First People's Hospital as the study subject. Patients were randomly divided into an observation group ( n=135) and a control group ( n=123). The control group received routine nursing model, while the observation group received nursing model based on Watson humanistic care theory. The intervention effect was evaluated using the Self-Care of Heart Failure Index (SCHFI), Heart Failure Knowledge Test (HFKT), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) . Results:After intervention, the HFKT and SCHFI scores of the observation group were higher than those of the control group, and the SAS and SDS scores were lower than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The nursing model based on Watson humanistic care theory can improve the knowledge and self-care ability of ESHF patients, and relieve their anxiety and depression.