Objective: To systematically analyze the current status and influencing factors of platelet supply in medical institutions across China, and to explore the problems and future development directions of the existing supply models. Methods: From February 25 to March 5, 2025, a web-based questionnaire survey was performed. A self-designed questionnaire was distributed to staff in the blood transfusion departments of medical institutions nationwide in China. Data on the current status and influencing factors of platelet supply were collected and analyzed. Results: A total of 2 268 responses were collected in this survey, with 1 366 valid questionnaires finally included, covering 33 provinces, autonomous regions, and municipalities directly under the central government across China. The survey revealed that platelet supply in Chinese medical institutions exhibited a pattern of "sufficient in the eastern region, stable in the central region, and scarce in the western region": adequate in East China; generally favorable in South China except Guangxi; centered on Beijing and Tianjin in North China; basically met but with insufficient reserves in Central China; subject to seasonal fluctuations in Northeast China; only meeting the baseline supply in Yunnan, Guizhou, and Sichuan in Southwest China; and notably short in Qinghai, Ningxia, and Xinjiang in Northwest China. Family donor mobilization was required in 81.2% (1 109/1 366) of institutions, whereas this proportion was only 12.7% (173/1 366) among institutions with sufficient supply. Tertiary hospitals constituted the main users, among which tertiary Class A hospitals had the highest sufficiency rate, and secondary Class B hospitals showed the most pronounced shortage. A total of 84% (1 147/1 366) of institutions lacked a professional management team; only 19% (266/1 366) had an inventory warning system, of which 88% (234/266) considered it effective. Platelet reservation required 3 days in 33% (458/1 366) of institutions. The mandatory transfusion rate was 30.55% (29/118) when the reservation lead time exceeded 3 days, representing an increase of 5.98% compared with 24.57% (55/180) in the same-day reservation group. For optimization, most institutions called for improved blood donation services, strengthened education and incentives, establishment of regional coordination and policy collaboration, and supplementary suggestions focused on technologies for extending platelet shelf life. Conclusion: Regional imbalance in platelet supply across China is prominent, with supply shortages in some provinces, reliance on family donor mobilization in most institutions, weak grassroots support capacity, imperfect management systems, and supply timeliness constraining clinical practice. Systematic improvements are needed in optimizing blood donation services, strengthening regional coordination, improving relevant policies, and developing platelet preservation technologies, so as to enhance the level of supply security and patient safety.

Objective: To explore the correlation between parent-child separation experience and non suicidal self injury (NSSI) behavior among junior and senior high school students, so as to provide a reference for the prevention and improvement of NSSI behavior among junior and senior high school students. Methods: Using a stratified cluster random sampling method, 3 114 junior and senior high school students aged 11-19 years were recruited from Chenzhou and Jishou cities in Hunan Province between November 2024 and September 2025. A self designed questionnaire and the Functional Self injury Behavior Assessment Scale were used to collect information on parental labor migration and adolescents NSSI behavior status. Binary Logistic regression model was used to analyse the association between parent-child separation experiences and NSSI behavior among junior and senior high school students, with further stratified analysis by gender. Results: The prevalence rate of NSSI behavior among junior and senior high school students was 9.9%, and the overall incidence of parent-child separation was 48.9%, comprising 17.1% separated from their father only, 5.5% separated from their mother only, and 26.3% separated from both parents. After adjusting for variables such as age, gender, and ethnicity, the results of binary Logistic regression analyses indicated that adolescents with parent-child separation experiences had a higher risk of NSSI behavior ( OR =1.31, 95% CI =1.01-1.69, P <0.05). Compared with those without parent-child separation experiences, adolescents who were separated from their mother only ( OR =1.68, 95% CI =1.03-2.74) or from both parents ( OR =1.41, 95% CI =1.04-1.92) showed significantly increased risks of NSSI behavior (both P <0.05). Conclusions Parent-child separation experiences are associated with an increased risk of NSSI behavior among junior and senior high school students. Strengthened attention should be paid to left behind senior high school students to reduce the occurrence of NSSI in adolescents.

Objective: To systematically investigate the current status of platelet clinical application in Chinese medical institutions based on a nationwide large-sample survey, to analyze the key issues in rational utilization and transfusion efficacy management, and to provide empirical evidence for the construction of a standardized and refined platelet management system. Methods: A selfdesigned online questionnaires was distributed to transfusion department personnel across China to collect and analyze the current clinical application status of platelets. Results: A total of 2 268 questionnaires were collected in this survey, among which 1 375 valid responses were obtained from medical institutions across 33 provinces, autonomous regions, and municipalities directly under the Central Government (including Hong Kong, Macao and Taiwan). The survey revealed an uneven distribution of clinical platelet consumption; 67.05% of facilities used fewer than 500 platelet u-nits annually, and highvolume demand concentrated in a small number of largescale hospitals. Platelet consumption showed a weak correlation with hospital grade and hospital bed number. The disease spectrum for platelet transfusion was highly concentrated. Hematological diseases constituted the leading indication (reported by 1 022 institutions), followed by traumarelated surgeries and solid tumors. In terms of management practice, 70.3% of participating institutions routinely performed posttransfusion efficacy evaluation. Nevertheless, this practice was limited by inadequate evaluation depth (only 58.3% kept detailed records) and institutional deficiency (12.9% had no relevant evaluation systems), mainly due to insufficient awareness and lack of unified criteria. Although 70.0% of hospitals had established adversereaction management workflows and 91.8% achieved highcoverage adverseevent reporting, prominent drawbacks remained, including nonstandardized implementation (standard practice was adopted merely in 41.9% of centers), unsystematic outcome analysis (regular analysis performed in only 26.4% of institutions), and broken feedback loops (56.3% failed to send feedback to blood collection and supply institutions). More than 90% of hospitals selfrated their rational plateletuse rate above 75%. The primary contributors to inappropriate platelet transfusion included biased assessment of clinical indications and excessive prophylactic transfusion triggered by timerelated imbalance between blood supply and clinical demand. Platelet supply status had no statistically significant correlation with routine posttransfusion assessment and selfevaluated rational use levels. Furthermore, plateletrelated management was confronted with a paradox coexisting of supply shortage and bloodproduct waste. While platelet preparation quality was generally reliable, expiration was the top cause of platelet discard (24.80%). Insufficient and untimely supply (79.3%) and short shelflife (46.0%) were recognized as core systematic challenges. Conclusion: China's current platelet management system features extensive institutional coverage paired with insufficient closedloop effectiveness. First, platelet consumption is highly concentrated, yet supply shortage and expiredproduct discard coexist, reflecting insufficient capacity for dynamic inventory allocation and wholeprocess administration. Second, clinicians generally hold positive selfevaluations for rational platelet application, whereas their clinical decisions are substantially constrained by conflicts between supply and demand, bringing about situational compromises under resource limitations. Third, despite established frameworks for efficacy evaluation and adverseevent management, widespread problems such as irregular documentation, unsystematic data analysis and interrupted crosshospital feedback hinder the transition from formal rules to practical management benefits. Comprehensive strategies should be adopted for future improvement. Clinically, standardized training on transfusion indications and unified criteria for posttransfusion assessment should be popularized. Administratively, intelligent inventory systems ought to be constructed to balance supplydemand matching, and closedloop management covering adverseevent analysis and feedback to bloodsupply agencies should be enforced. At the systematic level, advances in technologies for prolonged platelet storage are urgently required to build a resilient and highefficiency plateletguarantee system.

Objective: To evaluate the operational efficiency of a single-center platelet genotype database in HLA genotype-matched platelet search and applcation, and to compare the efficiency among different matching strategies, hospitals, and between first-time versus repeat application modes. Methods: Data on platelet genotype-based matching applications from December 1, 2025, to May 31, 2026, at our center were collected. Four time intervals were defined according to the workflow: the time from clinical hospital application to blood center receipt confirmation (Δt ); the time from blood center confirmation to completion of platelet gene database search (Δt ); the time from completion of database searching to availability of compatible platelet products (Δt ); and the time from clinical hospital application to availability of compatible platelet products (Δt ). Applications were classified as first-time or repeat based on application history, and as speed-priority matching strategy or classical matching strategy based on matching approach, with efficiency differences compared across the groups. Results: A total of 1 051 valid matching applications were included. The median values of Δt , Δt , Δt , and Δt were 6.2 h, 0.1 h, 0.2 h, and 11.5 h, respectively. Overall, 55.9% of genotype-based matches resulted in compatible platelets being available on the same day. The median Δt of the speed-priority strategy was significantly shorter than that of the classical strategy (5.2 h vs 39.6 h, P<0.001). Median Δt differed significantly among hospitals (P<0.001), with the shortest being 4.4 h. The median Δt for repeat applications was 6.9 h, significantly shorter than that for first-time applications (27.7 h, P<0.001). Conclusion: The platelet gene database demonstrates sufficient efficiency in HLA genotype-matched platelet searching and application to meet clinical demands. Optimizing matching strategies and hospital application workflows may shorten the time for obtaining compatible platelets.

Objective To investigate the epidemiological status and molecular characteristics of diarrheagenic Escherichia coli(DEC)infection in Xiangshan County,providing a basis for its infection surveillance and outbreak control.Methods The real-time fluores-cence quantitative PCR(qRT-PCR)was used to detect virulence genes in isolated E.coli strains.The identified DEC strains were per-formed whole genome sequencing(WGS).The sequencing data were utilized for bacterial resistance gene analysis,multilocus sequence typing(MLST),and core genome multilocus sequence typing(cgMLST).Results A total of 29 DEC strains were isolated,with a detection rate of 9.8%.Enteroaggregative E.coli(EAEC)and enterotoxigenic E.coli(ETEC)were the main strains,accounting for 51.7%and 31.1%,respectively,while enteropathogenic E.coli(EPEC)had a relatively low proportion(17.2%).Drug resistance gene analysis showed that these strains were generally resistant to multiple antibiotics such as fluoroquinolones and carbapenems.MLST typing identified 19 sequence types(STs),including one novel ST type(STcpEC1).Among them,ST117,ST2178,ST31,and ST48 were dominant types.ETEC strains were mainly concentrated in the clonal complex CC-10,while the molecular typing of EAEC and EPEC strains was more dispersed.cgMLST analysis further confirmed the genetic characteristics of different DEC strains.Conclusion DEC infections in Xiangshan County are mainly caused by EAEC,ETEC,and EPEC.These strains have abundant resistance genes.Among them,the molecular typing of EAEC and EPEC is relatively dispersed,while ETEC is concentrated in the clonal complex CC-10.

Objective To investigate the characteristics and correlation between peak oxygen uptake(VO?peak)and heart rate recov-ery(HRR)during cardiopulmonary exercise test(CPET)in patients with coronary borderline lesions.Methods From January,2022 to January,2024,183 patients with coronary borderline lesions in Beijing Bo'ai Hospital were divided into low cardiorespiratory fitness(LCF)group(n=61),moderate cardiorespiratory fitness(MCF)group(n=62)and high cardiorespiratory fitness(HCF)group(n=60)based on VO?peak.Their characteristics and CPET parameters including VO?peak,exercise-phase heart rate(HR1,HR2,HR3),and post-exercise heart rate recovery(HRR1,HRR2,HRR3)were analyzed.Results After adjusting for age and body mass index,analysis of covariance showed that the peak heart rate,HR1,HR2 and HR3 were the lowest in LCF group(F>5.388,P<0.01).Repeated-measures analysis of variance showed that the inter-and intra-group effects were significant in HRR(F>14.561,P<0.001).Partial correlation analy-sis showed that VO?peak positively correlated with HRR1(r=0.404,P<0.001),HRR2(r=0.379,P<0.001)and HRR3(r=0.425,P<0.001).Conclusion In patients with coronary artery borderline lesions,VO?peak demonstrated a significant inverse correlation with HRR,the lower the VO?peak,the more delays of HRR.

Objective To explore application of intermittent oral to esophageal tube feeding(IOE)supported by continuity of care in stroke patients with swallowing disorders.Methods A total of 100 stroke patients with swallowing disorders admitted to the Second Affiliated Hospital of Wenzhou Medical University from January to September 2023 were selected as subjects,and they were divide into control group(n=50)and observation group(n=50)by using random number table method.Control group received nutritional support through a nasogastric tube,while observation group received IOE.Swallowing function of patients before and after intervention,nutritional indicators,item short from health survey(SF-36)scores,and incidence of complications were compared between two groups.Results After the intervention,the swallowing function of observation group improved compared to control group(P＜0.05).Nutritional indicators of both groups increased,and observation group was higher than control group(P＜0.05).The scores of each item on the SF-36 in observation group were higher than those in control group(P＜0.05).The incidence of complications in observation group was reduced compared to control group(P＜0.05).Conclusion Implementing IOE with continuity of care support can improve swallowing function of stroke patients with swallowing disorders,reduce occurrence of complications.

Objective:To compare the efficacy of the detection kit based on MicroDrop microdroplet digital PCR platform that can identify mycoplasma pneumonia and common drug-resistance mutation,and throughout targeted next-generation sequencing(tNGS)in detecting common drug-resistance mutations of mycoplasma pneumonia.Methods:A total of 300 samples of clinical respiratory tract of pneumonia inpatients at Guangdong Provincial People's Hospital between 2023 and 2024 were collected.Both the detection kit for drug-resistance mutation of mycoplasma pneumoniae and the tNGS method were employed to detect drug-resistance mutation genes.For samples with inconsistent results,Sanger sequencing was used for verification.Results:For the 300 samples,the detection rates of positive mycoplasma pneumonia of the detection kit for drug-resistance mutation of mycoplasma pneumoniae and the tNGS method were respectively 87.00%and 78.67%,with a Kappa value of 0.711,indicating a relatively high level of agreement between the two methods.Among 25 samples with inconsistent results,Sanger sequencing was employed for validation.The results revealed that for samples with low-frequency gene mutations,the reagent kit maintained reliable detection capability,whereas tNGS exhibited missed detections.Thus,the reagent kit demonstrates superior performance in detecting low-frequency mutation samples.Conclusion:The detection rate of low-frequency mutation samples by the digital PCR-based mycoplasma pneumoniae drug-resistance mutation detection kit is higher than that of the tNGS method.This approach helps enhance the accuracy of detection results,providing a rapid and precise means of detecting drug-resistance genes for clinical diagnosis and treatment.

Objective:To investigate the clinical characteristics and prognostic significance of germline mutations in patients with myelodysplastic neoplasms (MDS) .Methods:Clinical data from 407 patients with MDS [male, 252; female, 155; median age, 64 (range, 19-85) years] diagnosed at the First Affiliated Hospital of Zhejiang University School of Medicine were retrospectively analyzed. The clinical features and prognostic effects of germline mutations were evaluated.Results:The prevalence of germline mutations in patients with MDS was 5.9% (24/407), peaking at 20.0% in the group aged 21-30 years. The spectrum of germline mutations comprised DDX41 (9 cases, 2.2%), TP53 (3 cases, 0.7%), and single cases of RUNX1, TET2, MPL, CBL, ATRX, CEBPA, ETV6, IDH1, KDM5C, SBDS, GNAS, and CTC1. Patients with germline mutations exhibited significantly lower peripheral WBC counts than those without (1.87×10 9/L vs 2.50×10 9/L, P=0.018), but showed comparable median overall survival (21.3 months vs 21.1 months, P=0.97). Patients with DDX41 germline mutations, compared with those with other germline mutations, had a significantly older median age (65 vs 54 years, P=0.010), lower WBC counts (1.51×10 9/L vs 2.31×10 9/L, P=0.040), increased mean corpuscular volume (111.80 fl vs 97.25 fl, P=0.003), and a higher prevalence of normal karyotypes (100.0% vs 53.3%, P=0.022). The most frequently co-occurring somatic mutations in DDX41 germline mutation carriers were ASXL1, TET2, and RUNX1. Conclusion:In this study, the detection rate of germline mutations in MDS patients was 5.9% (24/407), peaking at 20% in the group aged 21-30 years. DDX41 and TP53 were the most prevalent germline mutations. DDX41 mutation carriers displayed distinct clinical characteristics; however, germline mutations overall showed no significant prognostic effect.

Objective:To construct and validate the risk prediction model of osteoporosis (OP) in the middle-aged and elderly healthy physical examination population.Methods:In this cross-sectional study, 18 030 middle-aged and elderly people with bone mineral density tested in Health Management Center of Guangxi Zhuang Autonomous Region Hospital from January 2020 to December 2022 were selected. The general data, physical examination index and biochemical blood index were collected. The subjects were divided into training set (12 621 cases) and validation set (5 409 cases) in a ratio of 7∶3 with the simple random sampling method. The variables were screened with minimum LASSO regression and logistic regression and the corresponding nomogram prediction model for the risk of osteoporosis in the middle-aged and elderly health examination population was established. The performance of the nomogram model was evaluated with the area under the receiver operating characteristic curve (ROC AUC), specificity, sensitivity, calibration curve (CAL), and decision curve (DCA).Results:The results of LASSO regression and multivariate logistic regression in training set showed that gender, age, body mass index, hip circumference, waist circumference, systolic blood pressure, total cholesterol, glutamyl transpeptidase and albumin/globulin ratio were the independent best predictors of OP risk in the middle-aged and elderly health examination population (all P<0.05). The ROC AUC-value of the training set was 0.895 (95% CI: 0.886-0.904), with a sensitivity of 87.25% and a specificity of 85.01%. The ROC AUC value of the validation set was 0.892 (95% CI: 0.886-0.898), with a sensitivity of 83.74% and a specificity of 82.46%. The CAL showed a C-index value of 0.790 in the training set and a C-index value of 0.784 in validation set. The CALs all showed deviation correction and obvious curves similar to the ideal line. DCA showed that when the OP risk threshold probability of the training set was 45%-93%, and the OP risk threshold probability of the validation set was 45%-92%, the nomogram model had better efficacy in predicting OP risk in the middle-aged and elderly physical examination population, and the two results were still relatively consistent. Both CAL and DCA showed good performance. Conclusion:This study establishes a practical prediction model for osteoporosis risk in the middle-aged and elderly population, it can provide an early warning for the timely detection of OP risk for the middle-aged and elderly people.