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 investigate occupational exposure levels of lead, arsenic and cadmium in the lead smelting plant of Hunan Shui Kou Shan Nonferrous Metals Group Co. Ltd., analyze their effects on health of employees, and compare the applicability of different occupational health risk assessment methods, and to provide a basis for prevention and control of occupational exposure risks in enterprises. Methods According to systematic sampling method, 380 employees with lead, arsenic and cadmium exposure (exposure group) and 100 non-exposure employees (non-exposure group) were selected from 2022 to 2024 for on-site investigation of occupational health [concentration time-weighted average (C_TWA)] and physical examination. The risk was evaluated by qualitative assessment method, the U.S. Environmental Protection Agency (EPA) inhalation risk assessment method, and the Singapore Ministry of Manpower (MOM) semi-quantitative method. The consistency was analyzed by the Kappa test. Results C_TWA values of lead, arsenic, and cadmium in all positions were lower than the occupational exposure limit (OEL). The levels of blood lead, urine arsenic, and urine cadmium, as well as the prevalence of multiple systems in the exposure group were significantly higher than those in the non-exposure group (P<0.05). The proportions of chronic lead, arsenic, and cadmium poisoning were increasing year by year in the exposure group (P<0.05). The qualitative assessment method mainly indicated low and medium risk, while the EPA and MOM methods mainly indicated medium and high risk, with good agreement between the two methods (Kappa=0.676, P<0.05). Conclusion Although the enterprise meets the C_TWA standards, there are still occupational health risks of lead, arsenic, and cadmium. The EPA inhalation risk assessment method is more applicable.

[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.

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.

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.

ObjectiveTo investigate the protective effect of total lignans of Arctii Fructus on the retinal tissue in the rat model of type 2 diabetes mellitus. MethodWistar rats were randomized into normal， model， solvent， Shuangdan Mingmu Capsules （618 mg·kg^-1）， and low-， medium-， and high-dose （100， 200， 400 mg·kg^-1， respectively） total lignans of Arctii Fructus groups， with 16 rats in each group. The rat model was established by streptozotocin （STZ） combined with a high-fat diet and administrated with corresponding drugs by gavage once a day for 14 weeks. At the 14^th week， blood was sampled for the collection of serum from the abdominal aorta after anesthesia， and bilateral eyeballs were collected and frozen. Hematoxylin-eosin （HE） staining was used to observe the histopathological changes of the retinal tissue in rats. The pathological changes of retinal vascular network in rats were observed by retinal vascular tissue digestion and mounting The levels of vascular endothelial growth factor （VEGF）， tumor necrosis factor-α （TNF-α）， and intercellular adhesion molecule-1 （ICAM-1） in the serum were determined by the ELISA kit. ResultCompared with the normal group， the solvent group showed pathological changes in the retinal tissue， reduced retinal ganglion cells （P<0.01）， and retinal thinning （P<0.01）， decreased E/P value in retinal blood vessels （P<0.01）， and elevated serum levels of VEGF， TNF-α， and ICAM-1 （P<0.01）. Compared with the model group， the total lignans of Arctii Fructus increased the retinal ganglion cells （P<0.01）， thickened the retina （P<0.01）， and lowered the serum levels of VEGF， TNF-α， and ICAM-1 （P<0.05， P<0.01）. ConclusionTotal lignans of Arctii Fructus may lower the VEGF， TNF-α， and ICAM-1 levels to protect the retina.

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.