Objective: To analyze the characteristics and key risk factors of abnormal blood disposal throughout the 2024-2025 blood collection and supply process based on nationwide multi-site monitoring data, develop a comprehensive prevention and control strategy across the entire chain, reduce preventable blood waste, and ensure clinical blood safety. Methods: According to the Guidelines for Haemovigilance (T/CSBT 001-2026), we extracted 74 cases of abnormal blood disposal events reported by the China Blood Transfusion Association′s Blood Safety Monitoring System from January 1 2024, to December 31 2025, and conducted descriptive statistical analysis on the distribution of events, types of deviations, root causes, and classifications of disposal manifestations. Results: A total of 664 adverse events related to blood collection and supply were reported over two years, with 74 cases involving discarded abnormal blood units, accounting for 11.1% of the total. Among these, blood component preparation (40.5%) and blood collection (37.8%) remained traditional high-risk stages. The proportion of blood waste occurring during storage, distribution, and transportation increased from 7.7% in 2024 to 34.3% in 2025. Deviations from standard operating procedures (SOP) by personnel were the primary cause, accounting for 74.3% of cases. Discarded blood units were categorized into four types: compromised closed blood bag systems (40 cases), mainly due to inadequate heat sealing, physical damage, or dropped bags; blood out of the cold chain (12 cases), primarily resulting from blood being left at work sites; imbalanced proportion of preservation solution (10 cases), mostly caused by blood collection volumes exceeding the standard capacity of blood bags; and other causes (12 cases). Conclusion: Human operational errors are the core cause of abnormal blood waste. The collection and preparation stages have long been at high-risk, and the risks in the storage and transportation stages have been increasing year by year. We should focus on standardizing personnel management, improving specialized operation norms such as heat sealing, transportation, and storage, establishing a full-process intelligent cold chain monitoring and multi-node visual verification mechanism, and systematically reducing the occurrence rate of abnormal blood waste through a closed-loop quality intervention system, thereby improving the utilization efficiency of voluntary blood donation resources.

Objective: To identify the latent classes of acceptance and striving and their associated factors among nursing students, and to examine the mediating role of positive acceptance and striving in the association between self transcendence and subjective well being, so as to provide evidence for targeted interventions to improve subjective well being among nursing students. Methods: From July to October 2025, a convenience sample of 861 nursing students was recruited from five schools in Sichuan and Chongqing, China. Participants were surveyed using the Self transcendence Scale, the Positive Acceptance and Striving Scale, and the General Well being Scale. Latent profile analysis was conducted to identify profiles of positive acceptance and striving. Logistic regression analysis was used to examine associated factors, and relative mediation analysis was performed to assess differences in the mediating effect across latent profiles. Results: Three latent classes of acceptance and striving were identified: the low acceptance-low striving profile (46.34%, n =399), the moderate acceptance-moderate striving profile (40.88%, n =352), and the high acceptance-high striving profile (12.78%, n =110). Multivariable Logistic regression analysis showed that, with the low acceptance-low striving profile as the reference, nursing students with higher self transcendence scores ( OR =151.85) and those who studied nursing because of personal preference ( OR =14.72) or parental expectations ( OR =11.16) were more likely to be classified into the high acceptance-high striving profile (all P <0.05). Male students ( OR =0.19), those perceiving nurses social status as average ( OR =0.35), and those receiving moderate teacher support ( OR =0.23) were less likely to be classified into the high acceptance-high striving profile (all P <0.05). Positive acceptance and striving partially mediated the association between self transcendence and subjective well being, with a total effect of β =0.97 and a mediating effect of β =0.48; the mediating effect accounted for 49.34% of the total effect. Relative mediation analysis showed that the mediating effect was statistically significant only in the low acceptance-low striving profile ( β =0.21), whereas the direct effects were stronger in the moderate acceptance-moderate striving and high acceptance-high striving profiles ( β =0.39, 1.06)(all P <0.05). Conclusions Positive acceptance and striving among nursing students exhibit substantial heterogeneity. Its predictive effect on subjective well being and the underlying mediating mechanism vary across latent profiles. Profile specific interventions should therefore be implemented to improve subjective well being among nursing students.

ObjectiveTo investigate the mechanisms by which the combination of berberine （BBR） and baicalin （BAI） ameliorates type 2 diabetes mellitus （T2DM） due to internal accumulation of dampness-heat from the perspectives of gut microbiota and metabolomics. MethodsAntibiotics were used to induce pseudo-sterile mice. Thirty pseudo-sterile mice were randomized into a normal fecal microbiota transplantation group （n=10） and a T2DM （syndrome of internal accumulation of dampness-heat） fecal microbiota transplantation group （n=20）. The mice were then administrated with suspensions of fecal microbiota from healthy volunteers and a patient with T2DM due to internal accumulation of dampness-heat by gavage， respectively. Each mouse received 200 µL suspension every other day for a total of 15 times to reshape the gut microbiota. The T2DM model mice were then assigned into a model group （n=8） and a BBR-BAI group （n=11）. BBR was administrated at a dose of 200 mg·kg^-1， and BAI was administrated in a ratio of BBR-BAI 10∶1 based on preliminary research findings. The administration lasted for 8 consecutive weeks. Fasting blood glucose （FBG）， glycated hemoglobin （HbA1c）， insulin （INS）， triglycerides （TG）， total cholesterol （CHOL）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， aspartate aminotransferase （AST）， and alanine aminotransferase （ALT） levels were measured to evaluate the effects of the BBR-BAI combination on glucose and lipid metabolism and liver function in T2DM mice. Hematoxylin-eosin staining was employed to observe pathological changes in the colon tissue. The expression of claudin-1， zonula occludens-1 （ZO-1）， and occludin in the colon tissue was determined by Western blot. Real-time quantitative polymerase chain reaction（Real-time PCR） was employed to assess the levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6） in the colon tissue. The fecal microbiota composition and differential metabolites were analyzed by 16S rRNA sequencing and ultra-high performance liquid chromatography-quadrupole-time of flight tandem mass spectrometry （UPLC-Q-TOF-MS）， respectively. ResultsThe BBR-BAI combination lowered the FBG， HbA1c， and INS levels （P<0.05， P<0.01） and alleviated insulin resistance （P<0.01） in T2DM mice. Additionally， BBR-BAI elevated the levels of ZO-1， occludin， and claudin-1 （P<0.05， P<0.01） and down-regulated the expression levels of TNF-α， IL-1β， and IL-6 in the colon （P<0.05， P<0.01）. The results of 16S rRNA sequencing showed that BBR-BAI increased the relative abundance of Ligilactobacillus， Phascolarctobacterium， and Akkermansia （P<0.05）， while significantly decreasing the relative abundance of Alistipes， Odoribacter， and Colidextribacter （P<0.05）. UPLC-Q-TOF-MS identified 28 differential metabolites， which were primarily involved in arachidonic acid metabolism and α-linolenic acid metabolism. ConclusionBBR-BAI can ameliorate T2DM due to internal accumulation of dampness-heat by modulating the relative abundance of various bacterial genera in the gut microbiota and the expression of fecal metabolites.

Objective To explore the clinical value of the platelet count(PLT)to high-density lipoprotein cholesterol(HDL-C)ratio(PHR)in predicting poor prognosis after intravenous thrombolysis in patients with acute cerebral infarction(ACI).Methods A total of 304 patients with ACI who received intravenous thrombolytic therapy in this hospital from January 2021 to December 2023 were selected as the research sub-jects.According to the modified Rankin scale score at 6-month follow-up,the 304 patients with ACI were di-vided into the good prognosis group(n=216)and the poor prognosis group(n=88).Clinical data of all pa-tients were collected.The levels of PLT,HDL-C and PHR were compared between the two groups.The pre-dictive value of PLT,HDL-C and PHR for the prognosis of ACI patients was analyzed by using the receiver operating characteristic(ROC)curve.Binary Logistic stepwise regression analysis was used to explore the in-fluencing factors of prognosis in ACI patients.Results Compared with the good prognosis group,the HDL-C level in the poor prognosis group decreased,while the PLT level and PHR increased(P＜0.05).The results of the ROC curve showed that the area under the curve(AUC)and 95％CI of PLT,HDL-C,and PHR for pre-dicting poor prognosis after intravenous thrombolysis in ACI patients was 0.829(0.784-0.874),0.743(0.693-0.788),and 0.918(0.873-0.968),respectively.The AUC of PHR in predicting poor prognosis af-ter intravenous thrombolysis in ACI patients was higher than that of PLT and HDL-C alone(Z=13.239,10.776,P＜0.001).The proportions of National Institutes of Health Stroke Scale(NIHSS)score ≥8 points at admission,transformation of previous symptomatic hemorrhage,combined hypertension,and combined dia-betes in the poor prognosis group were all higher than those in the good prognosis group(P＜0.05).The re-sults of binary Logistic stepwise regression showed that the NIHSS score at admission(OR=2.565,95％CI:1.292-5.094),the transformation of previous symptomatic hemorrhage(OR=2.073,95％CI:1.179-8.645),and PHR(OR=3.732,95％CI:2.037-6.839)were risk factors for poor prognosis in ACI patients(P＜0.05).Conclusion PHR is expected to become an important reference index for predicting the prognosis of ACI patients after intravenous thrombolysis therapy.PHR,NIHSS score at admission,and the transforma-tion of previous symptomatic hemorrhage are all influencing factors for the prognosis of ACI patients after in-travenous thrombolysis therapy.

Objective:To investigate the correlation between the timing of minimally invasive puncture drainage and the outcome of patients with hypertensive intracerebral hemorrhage (HICH) in the basal ganglia region.Methods:Patients with HICH in the basal ganglia region underwent minimally invasive puncture and drainage at Hanchuan People's Hospital from January 2019 to September 2023 were selected. According to the timing of surgery, the patients were divided into onset to surgery time ≤12-hour group and >12-hour group. According to the modified Rankin Scale score at 90 days after onset, they were divided into a good outcome group (0-2) and a poor outcome group (>2). Multivariate logistic regression analysis was used to evaluate the independent influencing factors of functional outcome. Results:A total of 150 patients were included, with 78 males (52.00%), aged 53.15±4.35 years (range, 40-75 years). Eighty-six patients (57.33%) underwent surgery within 12 hours after onset, while 64 (42.67%) underwent surgery after 12 hours; 97 patients (64.67%) had good outcome, while 53 (35.33%) had poor outcome. Univariate analysis showed that compared with the onset to surgery time ≤12-hour group, the onset to surgery time >12-hour group had a longer time from onset to admission, a larger postoperative hematoma volume, longer hospitalization time, lower postoperative hematoma clearance rate, and a higher proportion of patients with poor outcome and deaths within 90 days (all P<0.05). Compared with the good outcome group, the poor outcome group had a longer time from onset to admission, higher baseline National Institutes of Health Stroke Scale (NIHSS) scores, larger baseline and postoperative hematoma volumes, and a higher proportion of patients with onset to surgery time >12 hours. However, the postoperative hematoma clearance rate, baseline Glasgow Coma Scale (GCS) score, and the proportion of patients with baseline GCS score >8 was lower in the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that the higher baseline NIHSS score (odds ratio [ OR] 1.847, 95% confidence interval [ CI] 1.362-2.503; P=0.001) and the time from onset to surgery >12 hours (compared with ≤12 hours: OR 1.347, 95% CI 1.058-1.715; P=0.016) were the independent risk factors for poor outcome, while higher baseline GCS scores ( OR 0.723, 95% CI 0.558-0.937; P=0.006) and higher postoperative hematoma clearance rates ( OR 0.615, 95% CI 0.462-0.819; P=0.004) were the independent protective factors for good outcome. Conclusion:In patients with HICH in basal ganglia, it is ideal to perform minimally invasive puncture and drainage within 12 h after onset, and the postoperative recovery is relatively better.

Objective To define the conceptual connotation of network dynamic collaboration capacity in medical surge response and construct its theoretical model.Methods A mixed concept analysis method was employed,integrating multidisciplinary literature and collecting empirical evidence through semi-structured expert interviews to extract the concept of network dynamic collaboration capacity in medical surge response.By integrating complex systems,network science,synergetics,and dynamic capability theory,and combining the interview results,the study used the analogy of flood control in hydraulic engineering to develop a"network-dynamic-collaboration"triangular capacity theoretical model.Results It reveals one antecedents(sudden external shocks have led to an abnormal and continuous surge in medical demand),six core attributes(information interconnection accessibility,dynamic resource adaptability,risk perception responsiveness,multi-party collaborative interactivity,service process adaptability elasticity,and learning iterative evolution),and four consequences(mitigation of crowding risk,protection of service continuity,minimization of crisis spillover,and enhancement of system resilience)for the network dynamic collaboration capacity in medical surge response.The theoretical model elucidates the coupling mechanisms among network structural resilience,dynamic regulation processes,and collaborative co-evolution in resisting medical surge.Conclusion The new concept and theoretical model proposed in this study deepen the understanding of medical surge response system mechanisms and offer a theoretical framework and practical guidance for strengthening the full-chain resilience of health emergency systems.

Objective To empirically analyze multiple pathways for enhancing medical surge response capacity and provide useful references for improving the resilience of health systems.Methods A comprehensive theoretical analysis framework for improving medical surge response capacity was constructed based on the 4S theory and collaborative governance theory.68 interview texts on medical surge response capacity conducted in July 2024 were selected as analysis samples.Using fuzzy-set Qualitative Comparative Analysis(fsQCA),7 conditional variables were selected from four dimensions:management system,information system,materials,and personnel to analyze their impact on medical surge response capacity.Results(1)A single conditional variable does not constitute a necessary condition for improving medical surge response capacity;(2)After the combination of conditions,8 specific configuration paths for capacity improvement were identified.Through systematic and comprehensive refinement,they were summarized into three modes of comprehensive configuration capacity improvement paths,namely:rapid response and collaborative operation mode,information empowerment and precise response mode,and resource conditions and resilience construction mode.Conclusion It is necessary to explore and construct systematic,combined,modularized and path-oriented capacity building strategies,refine the operational implementation paths for improving China's medical surge response capacity,target the linkage and configuration modes of different conditional variables,promote the formulation and implementation of modular construction schemes oriented by key capacity,and make efforts from multiple aspects to enhance the resilience of the health system.

Tailored lipid nanoparticles (LNPs)-mediated small interfering RNA (siRNA) nanomedicines show promise in treating liver disease, such as acute liver injury (ALI) and non-alcoholic steatohepatitis (NASH). However, constructing LNPs that address biosafety concerns, ensure efficient delivery, and target specific hepatic subcellular fractions has been challenging. To evade above obstacles, we develop three novel self-degradable "gemini-like" ionizable lipids (SS-MA, SS-DC, SS-MH) by incorporating disulfide bonds and modifying the length of ester bond and tertiary amino head. Our findings reveal that the disulfide-bond-bridged LNPs exhibit reduction-responsive drug release, improving both biosafety and siRNA delivery efficiency. Furthermore, the distance of ester bond and tertiary amino head significantly influences the LNPs' pK _a, thereby affecting endosomal escape, hemolytic efficiency, absorption capacity of ApoE, uptake efficiency of hepatocytes and liver accumulation. We also develop the modified-mannose LNPs (M-LNP) to target liver macrophages specifically. The optimized M-MH_LNP@TNFα exhibits potential in preventing ALI by decreasing tumor necrosis factor α (TNFα) levels in the macrophages, while MH_LNP@DGAT2 could treat NASH by selectively degrading diacylglycerol O-acyltransferase 2 (DGAT2) in the hepatocytes. Our findings provide new insights into developing novel highly effective and low-toxic "gemini-like" ionizable lipids for constructing LNPs, potentially achieving more effective treatment for hepatic diseases.

Premature ovarian insufficiency(POI)is a disease that seriously affects the health and life of women,which is also one of the main causes of female infertility.The incidence of POI is increasing in recent years.The diagnostic criteria of POI are not uniform,and different diagnostic criteria have inconsistent thresholds for various indicators.Strict diagnostic criteria are more conducive to early detection and treatment of POI.At present,complementary and alternative therapies such as traditional Chinese medicine,acupuncture and moxibustion are widely used in the treatment of POI.This article reviewed the recent studies on the complementary and alternative therapy of traditional Chinese medicine in the treatment of POI,and finds that the dialectical treatment of traditional Chinese medicine is based on the perspective of traditional Chinese medicine theory and puts forward corresponding treatment plans for different dialectical types.For example,treatment from the kidney,tonifying kidney filling essence,regulating chongren;Treatment from the liver,soothing the liver,regulating qi,nourishing blood and softening the liver;Treatment from the heart and spleen,nourishing Yangming,tonifying the spleen and nourishing the heart.In terms of acupuncture treatment,regulating menstruation and promoting pregnancy and regulating the conception vessel and toning the governor vessel and toning the kidney are often used to treat POI.In addition,moxibustion regulates body function by stimulating the bladder meridian and conception vessel and governor vessel acupoints.Other methods,such as ear acupoint bean-pressing,acupoint thread-embedding and acupoint injection,have also shown potential in the treatment of POI.This article summarizes the role and characteristics of traditional Chinese medicine in the treatment of POI,in order to provide ideas and basis for clinical treatment of POI.

Objective:To explore the effect of EAERI (E: environment; A: accompany; E: emotion; R: respect; I: information) support strategies in the application of nurse second victims in restoring the passage of a patient safety incident, and to provide support to nurse second victims experiencing a safety incident in restoring the incident and mitigating secondary victimization from the incident.Methods:The method of historical comparison was adopted. A convenience sampling method was used to select nurses who experienced patient safety events in Shanxi Bethune Hospital (Shanxi Academy of Medical Sciences) from January 2023 to February 2024 as the study subjects, which were divided into observation group and control group by the historical control grouping method. The observation group used the EAERI support strategy for patient safety incident reduction, and the control group used the conventional reduction method. The second victims of the nurses in both groups were assessed for their level of harm and support in the patient safety incident using the Second Victim Experience and Support Tool before and after the event reduction, respectively.Results:A total of 124 second victims completed the study. There were 63 cases in the control group, including 13 males and 50 females, with an age of (30.24 ± 4.91) years old. There were 20 males and 41 females in the observation group, with an age of (30.85 ± 5.50) years old. Before the restoration event, there was no significant differences in the total scores of victim experience and support, the degree of injury and the degree of support between the two groups (all P>0.05). The total scores of victim experience and support, the degree of injury and the degree of support were (89.35 ± 10.69), (44.57 ± 6.19), (44.78 ± 9.40) points in the control group, and (64.13 ± 9.36), (33.56 ± 8.84), (30.56 ± 3.17) points in the observation group. The differences were significant between the two groups ( t=14.02, 8.07, 11.29, all P<0.01). Conclusions:The EAERI support strategy is feasible and effective. The implementation of the EAERI support strategy can reduce the degree of injury when the second victim of the nurse restores the safety incident and improve the degree of support.