Objective: To evaluate the risk of donation-related adverse reactions, donation behavior, and contributions to the blood supply among donors aged 56-65 years following extension of the upper age limit for voluntary blood donation, and to provide real-world evidence for optimizing blood donation age policies in China. Methods: A multicenter retrospective cohort was established using blood donation databases from Hainan, Shenzhen, and Jiangxi. A total of 1 180 767 donors contributing 2 020 407 whole-blood and apheresis donations were included. Donations were classified by donor age at each donation into the 18-55-year and 56-65-year groups. Generalized estimating equation (GEE) models were used to compare the risks of overall, local, and systemic donation-related adverse reactions between the two age groups. Restricted cubic spline analysis was used to assess the continuous association between donor age and the risk of overall adverse reactions. Poisson GEE models were used to compare annual donation frequency, and donation participation and contributions to the blood supply among donors aged 56-65 years were evaluated. The study was approved by the Ethics Committee of the Institute of Blood Transfusion, Chinese Academy of Medical Sciences (No.2025012) and registered with the Chinese Clinical Trial Registry (ChiCTR2500114960). Results: A total of 1 960 711 donations were included in the 18-55-year group and 59 696 in the 56-65-year group. The overall donation-related adverse reaction rates were 3.890‰and 0.704‰, respectively. Multivariable GEE analysis showed that, compared with donors aged 18-55 years, those aged 56-65 years had lower risks of overall adverse reactions (adjusted OR=0.294, 95%CI: 0.217-0.398, P<0.001) and systemic adverse reactions (adjusted OR=0.163, 95%CI: 0.101-0.263, P<0.001), whereas no statistically significant difference was observed in the risk of local adverse reactions (adjusted OR=1.337, 95%CI: 0.487-3.670, P=0.573). Donor age was nonlinearly associated with the risk of overall adverse reactions (P overall<0.001, P nonlinear<0.001), with the risk generally decreasing with increasing age between 18 and 65 years. The mean annual donation frequency was higher among donors aged 56-65 years than among those aged 18-55 years (1.63 vs 1.24 donations per year; adjusted IRR=1.34, 95%CI: 1.30-1.39, P<0.001). During the study period, donors aged 56-65 years contributed 2.95% of all donations; their whole-blood donations and whole-blood collection volume accounted for 2.36% and 2.37% of the corresponding totals, respectively. Conclusion: Under current health screening and standardized donor management, donors aged 56-65 years did not show an increased risk of short-term donation-related adverse reactions and demonstrated a higher annual donation frequency, together with a measurable contribution to the blood supply. These findings support appropriately extending the upper age limit for voluntary blood donation under strict health screening to broaden the donor pool and supplement the blood supply.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Objective:To assess the impact of vaporized hydrogen peroxide (VHP) on the terminal decontamination effectiveness following the spillage of infectious materials in a BSL-3 laboratory.Methods:Within BSL-3 laboratories with volumes of 92.5 m 3 and 218 m 3, two types of Geobacillus stearothermophilus spore strips were used as biological indicators. ATCC7953 was affixed to stainless steel strips, while ATCC12980 was applied to paper strips. The strips were soaked in cell culture medium and chicken embryo egg fluid to simulate minor spill models. While strips continuously immersed in cell culture medium or chicken embryo egg fluid served as major spill models. These were compared against untreated biological indicator strips to evaluate the terminal decontamination efficacy of VHP. Results:After the completion of terminal disinfection, in laboratories of different volumes and at various sampling points, the culture result of both types of bacterial strips from the minor spill models and the untreated control strips were all negative. In the major spill models, the positivity rate of the two types of bacterial strips soaked in cell culture medium was 75%, while the positivity rate of the two types of bacterial strips soaked in chicken embryo egg fluid was 100%.Conclusions:In the event of a large spill of infectious materials in a laboratory, to ensure biosafety, it is recommended to first treat the spilled materials before initiating the terminal disinfection process. Additionally, under the same disinfection conditions, the material of the biological indicator strips does not affect the terminal disinfection outcomes.

Objective To evaluate the impact of medical service price adjustment policies on the economic operations of public hospitals.Methods Utilizing operational data from a provincial tertiary hospital in Anhui Province spanning December 2022 to December 2024,an interrupted time series analysis(ITS)was conducted,with the price adjustment policy implemented in December 2023 as the intervention node.This study quantified trends in surgical income,laboratory income,and cost structure changes before and after the policy implementation.Sensitivity analysis was performed to validate the robustness of findings.Results Following the surgical service price adjustment,income surged by 6.125 million(11.72％)in the first month,with adjusted items contributing 42.5％to this increase.The long-term monthly growth rate rose to 78.9 thousand,and the proportion of technical labor income increased from 6.1％to 10.1％.For laboratory services,the price adjustment led to an initial income decline of 10.324 million(P＜0.001).However,through domestic consumable substitution(provincially centralized procure-ment of testing reagents achieved an average price reduction of 53.9％)and process automation(reducing 30％-40％ of repeti-tive labor in testing personnel),the monthly decline narrowed to 195 thousand driving a transition toward technology-driven labo-ratory services.Conclusion The price adjustment policy optimized public hospital revenue structures through dual mechanisms of"technical value compensation"and"separation of technical services from consumables",effectively addressing the issue of"consumable-dependent revenue models".Public hospitals should enhance refined management,establish a technical labor val-ue-oriented pricing system,and coordinate with dynamic policy adjustments to achieve synergistic improvements in economic effi-ciency and healthcare quality.

The Huangdi Neijing proposes the " using bitter herbs to nourish or purge" theory to guide clinical prescription and formulation of herbal remedies based on the physiological characteristics and functions of the five zang viscera, along with the properties and flavors of medicinal herbs. This study explored diabetic kidney disease pathogenesis and treatment based on the " using bitter herbs to nourish or purge" theory. Kidney dryness is a key pathological factor in diabetic kidney disease, and the disharmony of kidney dryness is an essential aspect of its pathogenesis. Strengthening is the primary therapeutic principle, and kidney dryness is a persistent factor throughout the occurrence and progression of diabetic kidney disease. In the early stage, the pathogenesis involves heat-consuming qi and injuring yin, leading to kidney dryness. In the middle stage, the pathogenesis manifests as qi deficiency and blood stasis in the collaterals, resulting in turbidity owing to kidney dryness. In the late stage, the pathogenesis involves yin and yang deficiency, with kidney dryness and disharmony. This study proposes the staging-based treatment based on the " need for firmness" characteristic of the kidney. The aim is to provide new insights for clinical diagnosis and treatment in traditional Chinese medicine by rationally using pungent, bitter, and salty medicinal herbs to nourish and moisturize the kidney. This approach seeks to promote precise syndrome differentiation and personalized treatment for different stages of diabetic kidney disease, thereby enhancing clinical efficacy.

Objective To clarify the metabolic phenotypic changes in the serum and placenta of pre-eclampsia(PE)patients and their potential impact on fetal serum,and to identify and explore potential predic-tive biomarkers related to PE by using non-targeted metabolomics technology,thereby providing a reference for clinical diagnosis and disease monitoring.Methods Based on non-targeted metabolomics using liquid chro-matography-mass spectrometry(LC-MS),metabolomic analyses were performed on serum,placenta and um-bilical cord blood samples from 6 PE patients(PE group)and 6 healthy pregnant women in the late trimester(control group).Differential endogenous metabolites in each sample were screened using multivariate and uni-variate statistical methods.Metabolic pathways involved in the differential metabolites were enriched using MetaboAnalyst software.Additionally,potential biomarkers for predicting PE were identified based on binary logistic regression models.Results Compared with the control group,significant differences in the metabolic profiles of serum,placenta,and fetal serum were observed in the PE group.In the serum of PE patients,major metabolic abnormalities included α-linolenic acid metabolism,taurine metabolism,glycine,serine and threonine metabolism.In the placenta,abnormalities in linoleic acid metabolism,taurine metabolism,α-linolenic acid me-tabolism,and unsaturated fatty acid biosynthesis were detected.In the fetus of PE patients,metabolic abnor-malities were found in glutamine and glutamate metabolism,α-linolenic acid metabolism,and alanine,aspar-tate,and glutamate metabolism,involving polyunsaturated fatty acids and amino acids.The receiver operating characteristic(ROC)curves of differential metabolites were plotted using binary logistic regression models,and 4 serum metabolites with an area under the curve(AUC)＞0.9 were identified,mainly polyunsaturated fatty acid metabolites.The AUC of α-linolenic acid,a common differential metabolite in all three samples,was 0.806,with a sensitivity of 66.67％and specificity of 100.00％,indicating high diagnostic value.Conclusion The serum,placenta,and fetal serum metabolic profiles of PE patients and healthy pregnant women in the late trimester are significantly different and affect the metabolic phenotypes of offspring,providing insights into the pathogenesis of PE.

Objective To determine the acute effects of blood flow restriction(BFR)running warm-up on Achilles tendon morphology and function in basketball players in order to provide a theoretical basis for optimizing warm-up protocols for military personnel and athletes susceptible to Achilles tendon injuries.Methods Twenty-seven male basketball players were subjected and asked to participate in 3 different running warm-up protocols:low-speed running(LSR),high-speed running(HSR),and BFR combined with LSR(BFR-LSR).The acute changes in Achilles tendon morphology,mechanical properties,and functional performance across the 3 testing sessions were analyzed and compared.Results Immediately after training,both HSR warm-up and BFR-LSR warm-up significantly improved Achilles tendon thickness,blood flow,stiffness,and gastrocnemius maximal voluntary isometric contraction(MVIC)when compared with LSR warm-up(P<0.05).No statistical differences were observed in above indicators between the BFR-LSR and HSR warm-ups(P>0.05).24 hours after training,compared with LSR warm-up,HSR warm-up still significantly improved Achilles tendon thickness,blood flow,stiffness,and gastrocnemius MVIC(P<0.05).Although BFR-LSR warm-up did not show statistically significant differences in these parameters compared to LSR warm-up,it still demonstrated positive trends.Immediately and 24 h after training,no obvious difference were found in jump performance among the 3 warm-up protocols(P>0.05),but,both BFR-LSR and HSR warm-ups exhibited superior performance than LSR warm-up.Conclusion Immediately after training,BFR-LSR warm-up demonstrates comparable effects to the HSR warm-up on improving Achilles tendon morphology and performance,as well as enhancing jump performance.However,its sustained and long-term effects require further investigation.

[Objective]To investigate the intervention effect of eriocitrin on intracranial aneurysm(IA)model rats based on stromal cell derived factor-1α(SDF-1α)/C-X-C motif chemokine receptor 4(CXCR4)signaling pathway.[Methods]IA rat model was established by isolating and ligating the left common carotid artery and renal artery,and removing both ovaries.The rats were randomly assigned into IA group(intragastric and intraperitoneal administration of 0.9%sodium chloride solution),eriocitrin low(intragastric 8 mg·kg-1 of eriocitrin),medium(intragastric 16 mg·kg-1 of eriocitrin)and high(intragastric 32 mg·kg-1 of eriocitrin)dose groups,and eriocitrin high dose(intragastric 32 mg·kg-1)+SDF-1α/CXCR4 pathway activator CTCE-0214(intraperitoneal administration of 10 mg·kg-1 CTCE-0214)group,and the other 10 rats only exposed the left common carotid artery,renal artery and ovaries,which were recorded as sham operation(intragastric and intraperitoneal administration of 0.9%sodium chloride solution)group.Each group was intervened once a day for 8 consecutive weeks.Tweenty-four hours after the last administration,enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and nitric oxide(NO)in each group.Elastica van Gieson staining was used to measure the length of aneurysms,the area of the aneurysm lumen and the length of internal elastic layer rupture.Hematoxylin-eosin(HE)staining was applied to detect pathological changes in arterial aneurysm tissue.Real time-polymerase chain reaction(RT-PCR)was applied to detect the mRNA expression of matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF)and MMP-2 in tissues.Western blot was applied to detect the expression of SDF-1α/CXCR4 related proteins in tissues.[Results]Compared with sham operation group,the levels of TNF-α,IL-6;aneurysm length,aneurysm cavity area,internal elastic layer rupture length;MMP-9,VEGF,MMP-2 mRNA expression;SDF-1α and CXCR4 protein expression were prominently higher in IA group,while the level of NO was obviously lower(P<0.05).Compared with IA group,the levels of TNF-α,IL-6;aneurysm length,aneurysm cavity area,internal elastic layer rupture length;MMP-9,VEGF,MMP-2 mRNA expression;SDF-1α and CXCR4 protein expression in eriocitrin low,medium and high dose groups were obviously lower,while the level of NO was prominently higher(P<0.05).Compared with eriocitrin high dose group,the levels of TNF-α,IL-6;aneurysm length,aneurysm cavity area,internal elastic layer rupture length;MMP-9,VEGF,MMP-2 mRNA expression;SDF-1α and CXCR4 protein expression in eriocitrin-high+CTCE-0214 group were prominently higher,while the level of NO was prominently lower(P<0.05).[Conclusion]Eriocitrin alleviates the inflammatory response in IA rats by regulating the SDF-1α/CXCR4 signaling pathway,improves the function of vascular endothelial cells and reduces the risk of aneurysm rupture.

Objective To explore the mediating role of activities of daily living (ADL) in pain and depressive symptoms in the elderly in China. Methods Utilizing the data from 2020 China Health and Retirement Longitudinal Study, 4403 Chinese elderly individuals aged ≥ 60 years old were selected as the research subjects. Depression Scale (CES-D 10) of the Center for Epidemiological Survey and ADL scale were used in the study. The PROCESS4.1 macro was used to test the mediating effect of daily living activities between pain and depressive symptoms, and the Bootstrap method was applied for verification of the mediating variables. Results A total of 2368 cases of depressive symptoms were detected in the elderly in China, with a detection rate of 53.78%. Pain was positively correlated with depressive symptoms (r=0.27, P<0.01), and activities of daily living were negatively correlated with pain and depressive symptoms (r=-0.27, -0.337, P<0.01). The results showed that the total effect value of pain on depressive symptoms was 0.33, the direct effect value was 0.24, and the mediating effect value of daily living activities was 0.09, accounting for 27.27%. Conclusion Pain and activities of daily living are important factors influencing depressive symptoms in the elderly, and activities of daily living play a partial mediating role in the relationship between pain and depressive symptoms in the elderly.