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.

ObjectiveTo evaluate a novel nomogram based on contrast-enhanced MRI radiomics combined with clinical variables for the preoperative prediction of perineural invasion （PNI） in intrahepatic cholangiocarcinoma （ICC）. MethodsThe clinical data of 59 ICC patients were retrospectively collected. According to postoperative pathology reports， the patients were divided into the non-PNI group （n = 33） and the PNI group （n = 26）. Regions of interest （ROI） were delineated from five MRI sequences. Radiomics features were then extracted and filtered to select those with the strongest discriminative power for PNI identification. These selected features were used to construct a radiomics model， which subsequently generated a quantitative radiomics score （radiomics score， Radscore）. Univariate analysis was applied to identify clinical variables associated with PNI， and the glm function was subsequently used to construct clinical and combined models. Finally， the models were evaluated using receiver operating characteristic （ROC） curves， calibration curves， and decision curve analysis （DCA）. The combined model was then visualized as a nomogram. ResultsThe clinical model included age， carbohydrate antigen 19-9 （CA19-9）， red blood cell distribution width， and albumin， whereas the Radscore included five radiomic features. The areas under the ROC curves （AUCs） for the clinical and radiomics models were 0.717 （95%CI： 0.586-0.848） and 0.896 （95%CI： 0.820-0.973）， respectively， whereas the combined model further improved its AUC to 0.917 （95% CI：0.848-0.987）. The calibration curves and DCA showed that the nomogram was well calibrated and provided the greatest net clinical benefit. ConclusionThe novel nomogram may serve as a basis for preoperative prediction of PNI status， thereby assisting clinical decision-making and guiding personalized treatment.

Objective To explore the efficacy and safety of blue laser vaporization in the treatment of large-volume (＞80 mL) benign prostatic hyperplasia (BPH). Methods A retrospective analysis was conducted on the clinical data of 149 BPH patients with prostate volume＞80 mL who underwent blue laser vaporization at our hospital during Aug. 2023 and Aug. 2025. The 1-month postoperative maximum urinary flow rate (Qmax) and international prostate symptom score (IPSS), operation time, postoperative hemoglobin drop, bladder irrigation volume, catheter indwelling time, and incidence of postoperative complications were recorded and analyzed. Results All operations were successfully completed, without conversion to other approaches. The operation time was (41.47±11.05) minutes, postoperative hemoglobin drop (2.78±1.19) g/L, bladder irrigation volume (9.97±1.49) bags, and catheter indwelling time (3.30±1.85) days. One month after surgery, the Qmax was significantly higher than the preoperative value [(20.19±3.39) mL/s vs. (2.39±2.17) mL/s], while the IPSS was significantly lower [(4.46±0.87) vs. (27.69±2.06)], with statistically significant differences (P＜0.001). Postoperative complications included 1 case of incontinence (0.67%), 2 cases of urethral stricture/bladder neck contracture (1.34%), and 1 case of secondary bleeding (0.67%), all of which improved with symptomatic treatment. Conclusion Blue laser vaporization is effective for treating large-volume BPH, with advantages such as minimal bleeding risk, short operation time, fast recovery and safety.

Pancreatic ductal adenocarcinoma （PDAC） is highly malignant and often has an extremely poor prognosis， and early postoperative liver metastasis is one of the key influencing factors for prognosis. With reference to the clinical and experimental studies in recent years， this article reviews the clinical risk factors for early liver metastasis after PDAC and systematically elaborates on major molecular events underlying early postoperative liver metastasis from various aspects of construction of the pre-metastatic niche in the liver driven by tumor-derived exosomes， the pro-metastatic microenvironment maintained by metastasis-associated macrophages and neutrophil extracellular traps， the invasive phenotype and liver-tropic migration of tumor cells， intrahepatic immunometabolic adaptation， and fibrotic remodeling， in order to provide a theoretical basis for perioperative risk stratification and the development of intervention strategies.

Objective To analyze the urban drinking water quality and its influencing factors in Anhui Province from 2014 to 2022, and to provide a scientific basis for water quality improvement and protection. Methods The data were collected, saved and monitored according to the Standard Test Method for Drinking Water (GB/T5750-2006) and evaluated according to the Hygienic Standard for Drinking Water (GB 5749-2006). Results A total of 20 941 samples were collected, and the overall qualified rate was 84.26%. The qualified rate of urban drinking water increased from 76.9% in 2014 to 93.3% in 2022, and the qualified rate of water quality was on the rise (χ²=544.43, P＜0.01). From 2014 to 2022, the qualified rate of water quality in dry season was higher than that in wet season (χ²=35.98, P<0.001), the qualified rate of surface water was higher than that of ground water (χ²=4440.8, P<0.001), and the qualified rate of peripheral tap water was higher than that of factory water (χ²=145.1, P<0.001). Among all kinds of disinfection methods, chlorination disinfection had the highest qualified rate (χ²=1483.8, P<0.001). The qualified rate of water quality increased with the increase of the scale of water plant. Among the inspected indicators, the main unqualified indicators were chlorine dioxide (7.72%), fluoride (7.41%), free residual chlorine (3.90%), and total bacterial count (2.13%). Conclusion The passing rate of urban drinking water quality in Anhui Province is on an upward trend, and the quality of urban drinking water has improved. However, it is still important to pay attention to the problem of excessive microorganism and fluoride in water, and the quality of drinking water varies from place to place.

Radon, the only naturally occurring radioactive noble gas, is among the most common radioactive nuclides to which humans are exposed. Radon can induce various biological effects in the human body and is a risk factor for lung cancer. Circular RNAs (circRNAs) are stable, tissue-specific, and abundantly expressed in body fluids. circRNAs can regulate gene expression and play an important role in the development of cancer. In this paper, we summarized the changes in the expression and function of circRNAs, highlighting the potential mechanisms of circRNAs in radon exposure-induced cancers. Our results provided theoretical support for the use of circRNAs as a biomarker of radon exposure-induced radiation damage, and offer a theoretical basis for the early diagnosis, treatment, and prevention of radon exposure-induced diseases.

Objective To investigate the knee disorders and risk factors in electromechanical soldiers of a warship,so as to provide a basis for prevention and treatment measures.Methods The knee disorders and treatment data of 200 electromechanical soldiers(study group)and 200 soldiers from other departments(control group)were colected by questionnaire survey and medical records.Results The incidence of knee diseases was 37.5%(75 cases)in the study group,which was significantly higher than that in the control group(16.0%,32 cases,P＜0.05).Traumatic and degenerative diseases were the main types of knee disorders.Age and body mass index were the influencing factors of knee disorders in electromechanical soldiers.Conclusion There is a high incidence of knee disorders in electromechanical soldiers,which is related to a variety of factors.Appropriate prevention and treatment measures are of great significance to reduce the incidence of knee disorders,promote rapid recovery,and reduce non-combat casualty.

Objective To investigate the predictive value of serum circular RNA(circRNA)CDYL and circRNA ACAP2 expression levels for major adverse cardiovascular events(MACE)in pa-tients with acute myocardial infarction(AMI).Methods A total of 98 AMI patients were enrolled into the observation group,and divided into MACE group(n=45)and no-MACE group(n=53)based on whether they experienced MACE.Another 98 healthy individuals who underwent physical ex-amination during the same period were selected as the control group.The expression levels of serum cir-cRNA CDYL and circRNA ACAP2 were compared among groups.Multivariate logistic regression analysis was used to identify factors influencing the occurrence of MACE in AMI patients.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the predictive value of serum circRNA CDYL and circRNA ACAP2 levels for MACE in AMI patients.Results The serum circRNA CDYL level in the observation group was significantly lower than that in the control group,while the circRNA ACAP2 level was significantly higher(P＜0.05).The circRNA CDYL level in the MACE group was significantly lower,and the circRNA ACAP2 level was significantly higher than that in the no-MACE group(P＜0.05).Heart rate and circRNA ACAP2 were identified as independent risk factors for MACE in AMI patients,whereas circRNA CDYL served as independent protective factor(P＜0.05).The area under the ROC curve(AUC)for predicting MACE in AMI patients using se-rum circRNA CDYL,circRNA ACAP2 and their combination were 0.814,0.821 and 0.921,re-spectively.The sensitivity and specificity of combined prediction using serum circRNA CDYL and circRNA ACAP2 were 91.11％and 79.25％,respectively.The combined prediction efficacy of serum circRNA CDYL and circRNA ACAP2 was superior to their individual prediction(Zcombined-circRNA CDYL=1.975,Zcombined-circRNAACAP2=2.064,P=0.048,0.039).Conclusion Serum circRNA CDYL lev-el is down-regulated and circRNA ACAP2 level is up-regulated in AMI patients,and circRNA ACAP2 is an independent risk factor for MACE,while circRNA CDYL is a independent protective factor.The combined value of circRNA CDYL and circRNA ACAP2 in predicting the occurrence of MACE is higher.

Objective:The aim of this study was to investigate whether the Model for end-stage liver disease-excluding international normalised ratio ( MELD-XI) score whether it can predict the prognosis of patients on veno-arterial extracorporeal membrane oxygenation support.Methods:This study was a retrospective cohort study, which retrospectively included clinical data data of patients using ECMO from January 2015 to December 2023 in Fuwai Huazhong Cardiovascular Disease Hospital. Inclusion criteria: 1. clinical patients using VA-ECMO, excluding VAV-ECMO and VV-ECMO; 2. available laboratory values of blood creatinine and total bilirubin within the first 24 hours of on-boarding; 3. complete basic information of the patients; and 4. age greater than 18 years. Exclusion criteria: 1. patients whose family members abandoned the treatment due to economic reasons; 2. on-boarding time less than 24 hours; 3. patients with incomplete clinical information or patients who did not have a detailed record of general information on VA-ECMO. Using X-tile software, they were divided into MELD-XI score ≤13.9 and MELD-XI score >13.9 groups, and variables with P < 0.05 were included in the binary logistic regression model after using univariate analysis. Results:: Univariate analysis of 940 patients revealed that the MELD-XI score ≤13.9 group compared with the MELD-XI score >13.9 group had a significant difference in the success of machine withdrawal ( χ2=31.812, P<0.001), death while the machine was in operation ( χ2=52.453, P<0.001), death after machine withdrawal ( χ2=4.210, P=0.040), cerebral thrombotic complications ( χ2=4.319, P=0.038), lower extremity thrombotic complications ( χ2=8.789, P=0.003), and CRRT use ( χ2=15.648, P<0.001), length of boarding (Z=-17.786, P<0.001), length of hospital stay (Z=-17.503, P<0.001), and length of ICU stay ( Z=-18.790, P<0.001) were significantly different. Multifactorial binary logistic regression showed that successful machine withdrawal ( OR=2.078, 95% CI:1.158-3.731, P=0.014), death while the machine was running ( OR=0.271, 95% CI:0.144-0.512, P<0.001), CRRT use ( OR=3.227, 95% CI:1.659-6.474, P=0.001), length of hospital stay ( OR=1.138, 95% CI:1.107-1.171, P<0.001), length of boarding ( OR=1.035, 95% CI:1.027-1.043, P<0.001), ICU stay ( OR=1.365, 95% CI:1.278-1.458, P < 0.001) are independent influencing factor for VA-ECMO support patients. Kaplan-Meier curve analysis showed that both in-hospital mortality ( HR=2.167, 95% CI:1.508-3.114, P<0.001) and withdrawal success ( HR=5.353, 95% CI:4.023-7.121, P<0.001) were significantly lower in the MELD-XI score ≤13.9 group than in the MELD-XI score >13.9 group. Conclusions:The MELD-XI score can predict the prognosis of VA-ECMO-supported patients and help clinician doctors to make complex clinical decisions.

Objective To assess the level of research integrity awareness among clinical nursing personnel in Yunnan Province,analyze the influencing factors,and identify related risks.Methods From June 2025 to July 2025,a research integrity awareness questionnaire was conducted on 697 clinical nursing personnel from a university-affiliated tumor hospital and children's hospital using the Questionnaire Star platform.The survey content included basic information,research integrity awareness status,research integrity construction awareness,and the causes of research misconduct.Data were analyzed using SPSS 27.0.Results The research integrity awareness score of clinical nursing personnel was(47.49±11.06),with an overall awareness rate of 51.48%.Univariate analysis showed statistically significant differences in awareness scores based on nursing categories(t=-2.45),marital status(F=5.557),age(F=2.735),work experience(F=4.775),highest education level(F=13.11),whether serving as a master's supervisor(t=2.693),participation in research projects(t=4.95),whether they had published papers as the first author or corresponding author(t=5.11),and attendance of research integrity training(t=12.48)(P<0.05).Multivariate linear regression analysis indicated that marital status,highest education level,and participation in research integrity training were significant factors influencing clinical nursing personnel's research integrity awareness(P<0.05).The main reason for research misconduct was lack of research integrity awareness The(76.47%),and 92.37%of clinical nursing personnel believed further strengthening of research integrity construction was necessary.Conclusion The research integrity awareness level of clinical nursing personnel needs improvement.Hospitals should enhance research integrity training,improve research integrity management systems,and optimize scientific talent evaluation mechanisms.