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.

[Objective] To analyze the effects of different factors and red blood cell transfusion thresholds on the efficacy of neonatal red blood cell (RBC) transfusion, in order to provide more references for neonatal transfusions to better achieve rational and effective blood use. [Methods] A retrospective collection of data from 282 neonates who received RBC transfusions at our hospital from 2022 to 2023 was conducted, including birth weight, gestational age, number of blood transfusions, length of hospital stay, assisted ventilation during RBC transfusion, and laboratory test results before and after transfusion. SPSS software was used for statistical analysis to comprehensively analyze the impact of different factors on the efficacy of RBC transfusion in neonates. [Results] The results showed that the gestational age and weight of newborns at birth were negatively correlated with their length of hospital stay and the number of RBC transfusions during hospitalization. Newborns with younger gestational age and lower weight had longer hospital stays and more RBC transfusions during hospitalization. After administering RBCs according to the standard of 15 mL/kg, there was a statistically significant difference in the efficacy of RBC transfusion at different transfusion thresholds. In non-critical situations, RBC transfusions were ineffective when the pre-transfusion hemoglobin (Hb) level was >120 g/L. When the pre-transfusion Hb level was ≤70 g/L, RBC transfusions achieved higher efficacy in both critical and non-critical situations. [Conclusion] In critical situations, the group with pre-transfusion Hb values ≤ 70 g/L has the best RBC transfusion effect, while in non-critical situations, the group with pre-transfusion Hb levels between 81 and 90 g/L has the best RBC transfusion effect. Overall, the efficacy of RBC transfusion in non-critical situations is higher than that in critical situations.

In January 2025， the European Society for Medical Oncology （ESMO） released the ESMO clinical practice guideline interim update on the management of biliary tract cancer as a supplementary update to Biliary tract cancer： ESMO clinical practice guideline for diagnosis， treatment and follow-up published in November 2022. This interim update mainly revises the latest evidence-based medical recommendations in the key fields of molecular diagnostics and clinical management since the release of the original guidelines， and it is not a comprehensive update of the entire document. This article summarizes and makes an excerpt of the new recommendations from this interim update.

Objective To establish a collaborative governance framework model for the construction of National Medical Center and National Regional Medical Centers,offering insights for the expansion of premium medical resources and balanced regional healthcare service distribution.Methods Based on the Latent Dirichlet Allocation model and grounded theory,text semantic analysis and thematic coding were performed using Python and NVivo 12.0 Plus software.Results The collaborative construction of the"Dual Centers"hinges on six core elements:policy safeguards,talent cultivation,discipline advancement,teaching frameworks,research foundations,and information connectivity.These elements interplay synergistically,forming a collabortive governance framework model for"Dual Centers"construction.The model is structured into two dimensions:horizontal and vertical nested collaboration,encompassing three tiers:the support layer,driving layer,and action layer.It is characterized by its theoretical robustness,openness,and hierarchical organization.Conclusion Inter-embedded collaboration offers a viable solution to the governance challenges encountered by governments,output hospitals,and supporting hospitals during the"Dual Centers"construction,enhancing the efficacy of cross-sectoral collaborative governance.

Chronic ulcers on the body surface are non-healing wounds.Establishing a suitable animal model of chronic wounds will provide an important tool for research aimed at preventing and understanding the complexity of chronic wound formation and related pathological mechanisms in the human body.Animal wound models are usually constructed by inducing molecular abnormalities via external injury interventions to induce wound formation.Common modeling method include surgical resection,pressure ischemia,drugs,and radiation treatment.The success of model construction can then be evaluated by various monitoring method,such as natural recovery of the wound without intervention,measurement of wound size observation of physical signs,measurement of body mass,organ index,and infrared imaging.Despite the existence of numerous modeling and evaluating method,however,there is currently a lack of unified standards for animal chronic wound models.Researchers should thus choose appropriate modeling and model-evaluation method based on their actual needs,to obtain the best experimental result.

Objective To establish a collaborative governance framework model for the construction of National Medical Center and National Regional Medical Centers,offering insights for the expansion of premium medical resources and balanced regional healthcare service distribution.Methods Based on the Latent Dirichlet Allocation model and grounded theory,text semantic analysis and thematic coding were performed using Python and NVivo 12.0 Plus software.Results The collaborative construction of the"Dual Centers"hinges on six core elements:policy safeguards,talent cultivation,discipline advancement,teaching frameworks,research foundations,and information connectivity.These elements interplay synergistically,forming a collabortive governance framework model for"Dual Centers"construction.The model is structured into two dimensions:horizontal and vertical nested collaboration,encompassing three tiers:the support layer,driving layer,and action layer.It is characterized by its theoretical robustness,openness,and hierarchical organization.Conclusion Inter-embedded collaboration offers a viable solution to the governance challenges encountered by governments,output hospitals,and supporting hospitals during the"Dual Centers"construction,enhancing the efficacy of cross-sectoral collaborative governance.

Chronic ulcers on the body surface are non-healing wounds.Establishing a suitable animal model of chronic wounds will provide an important tool for research aimed at preventing and understanding the complexity of chronic wound formation and related pathological mechanisms in the human body.Animal wound models are usually constructed by inducing molecular abnormalities via external injury interventions to induce wound formation.Common modeling method include surgical resection,pressure ischemia,drugs,and radiation treatment.The success of model construction can then be evaluated by various monitoring method,such as natural recovery of the wound without intervention,measurement of wound size observation of physical signs,measurement of body mass,organ index,and infrared imaging.Despite the existence of numerous modeling and evaluating method,however,there is currently a lack of unified standards for animal chronic wound models.Researchers should thus choose appropriate modeling and model-evaluation method based on their actual needs,to obtain the best experimental result.

Objective To investigate the molecular typing,virulence,and drug resistance features of bacterial strains in a simultane-ous outbreak of paratyphoid fever A and B,and then provide evidence for the prevention and treatment of the simultaneous transmission of different types of paratyphoid fever.Methods The clinical data of 31 patients confirmed as paratyphoid fever in the Hospital of Xin-jiang Production and Construction Corps from September 2018 to November 2018 were retrospectively analyzed.The isolated strains were performed serotyping and drug sensitivity tests.The molecular typing and the detection of virulence and drug resistance genes were carried out by multiplex PCR,pulsed-field gel electrophoresis(PFGE),and multilocus sequence typing(MLST).Results A total of 32 strains of Salmonella paratyphi were isolated from 31 patients,with 19 strains classified as type A and 13 as type B.The intermedi-ate rates of all strains against ciprofloxacin were 100%.The molecular typing and serotyping results of 11 representative strains were consistent.The PFGE fingerprints of Salmonella paratyphi A and B were also consistent.The MLST of Salmonella paratyphi A was ST85,and that of Salmonella paratyphi B was ST86.All strains carried virulence island SPI1-SPI5 representative genes such as invA,sitC,sseL,sifA,mgtC,siiE,and sopB,and regulatory gene phoP.Salmonella paratyphi A also carried cytolethal distending toxin(CDT)genes with trimeric structure such as cdtB,pltA,and pltB.The virulence plasmid genes such as pefA,prot6E,and spvB were all negative.Conclusion The simultaneous transmission of Salmonella paratyphi A and B has the characteristics of high pathogenicity and poor sensitivity to ciprofloxacin,which should be highly concerned by clinical and laboratory personnel.

Objective:To understand the current status of anemia, iron deficiency, and iron-deficiency anemia among preschool children in China.Methods:A cross-sectional study was conducted with a multi-stage stratified sampling method to select 150 streets or townships from 10 Chinese provinces, autonomous regions, or municipalities (East: Jiangsu, Zhejiang, Shandong, and Hainan; Central: Henan; West: Chongqing, Shaanxi, Guizhou, and Xinjiang; Northeast: Liaoning). From May 2022 to April 2023, a total of 21 470 children, including community-based children aged 0.5 to<3.0 years receiving child health care and kindergarten-based children aged 3.0 to<7.0 years, were surveyed. They were divided into 3 age groups: infants (0.5 to<1.0 year), toddlers (1.0 to<3.0 years), and preschoolers (3.0 to<7.0 years). Basic information such as sex and date of birth of the children was collected, and peripheral blood samples were obtained for routine blood tests and serum ferritin measurement. The prevalence rates of anemia, iron deficiency, and iron-deficiency anemia were analyzed, and the prevalence rate differences were compared among different ages, sex, urban and rural areas, and regions using the chi-square test.Results:A total of 21 460 valid responses were collected, including 10 780 boys (50.2%). The number of infants, toddlers, and preschoolers were 2 645 (12.3%), 6 244 (29.1%), and 12 571 (58.6%), respectively. The hemoglobin level was (126.7±14.8) g/L, and the serum ferritin level was 32.3 (18.5, 50.1) μg/L. The overall rates of anemia, iron deficiency, and iron-deficiency anemia were 10.4% (2 230/21 460), 28.3% (6 070/21 460), and 3.9% (845/21 460), respectively. The prevalence rate of anemia was higher for boys than for girls (10.9% (1 173/10 780) vs. 9.9% (1 057/10 680), χ2=5.58, P=0.018), with statistically significant differences in the rates for infants, toddlers and preschoolers (18.0% (475/2 645), 10.6% (662/6 244), and 8.7% (1 093/12 571), respectively, χ2=201.81, P<0.01), and the rate was significantly higher for children in rural than that in urban area (11.8% (1 516/12 883) vs. 8.3% (714/8 577), χ2=65.54, P<0.01), with statistically significant differences in the rates by region ( χ2=126.60, P<0.01), with the highest rate of 15.8% (343/2 173) for children in Central region, and the lowest rate of 5.3% (108/2 053) in Northeastern region. The prevalence rates of iron deficiency were 33.8% (895/2 645), 32.2% (2 011/6 244), and 25.2% (3 164/12 571) in infants, toddlers, and preschoolers, respectively, and 30.0% (3 229/10 780) in boys vs. 26.6% (2 841/10 680) in girls, 21.7% (1 913/8 821), 40.0% (870/2 173), 27.1% (2 283/8 413), 48.9% (1 004/2 053) in Eastern, Central, Western, and Northeastern regions, respectively, and each between-group showed a significant statistical difference ( χ2=147.71, 29.73, 773.02, all P<0.01). The prevalence rate of iron-deficiency anemia showed a significant statistical difference between urban and rural areas, 2.9% (251/8 577) vs. 4.6% (594/12 883) ( χ2=38.62, P<0.01), while the difference in iron deficiency prevalence was not significant ( χ2=0.51, P=0.476). Conclusions:There has been a notable improvement in iron deficiency and iron-deficiency anemia among preschool children in China, but the situation remains concerning. Particular attention should be paid to the prevention and control of iron deficiency and iron-deficiency anemia, especially among infants and children in the Central, Western, and Northeastern regions of China.

Intrahepatic cholangiocarcinoma （ICC） is a highly malignant biliary tumor， and early-onset ICC （EOICC） refers to ICC with an age of ≤50 years at the time of confirmed diagnosis and often has a higher clinical stage and more significant biological invasiveness. At present， the incidence rate of EOICC is increasing rapidly， but the research on EOICC is still in its early stage. Current evidence has shown that EOICC has significantly different epidemiological， clinical， and molecular characteristics from late-onset ICC. Therefore， the research on the high-risk factors and pathogenesis of EOICC is of great importance for the early identification， diagnosis， and targeted treatment of EOICC. Due to the younger age and better physical condition of EOICC patients， they can tolerate medical interventions with higher risks， and active individualized diagnosis and treatment regimens can be adopted， allowing patients to obtain similar survival and prognosis as those with late-onset ICC. However， due to the significant differences in molecular characteristics between EOICC and ICC， existing targeted drugs may not be suitable for EOICC patients， posing a huge challenge for the systematic treatment of patients with advanced EOICC. The clinical and basic research on EOICC is still lagging behind， and the population characteristics and pathogenic factors of EOICC should be further clarified， in order to promote the establishment of prevention， diagnosis， and treatment standards for the EOICC population.