Objective To conduct hazard vulnerability analysis(HVA)in a blood bank,aimed to identify high-risk e-vents and optimize emergency management measures.Methods The risk event evaluation index system was established by referring to the Kaiser model and the situation of Guangzhou Blood Center,and risk events were ranked by risk matrix and Borda count.Results The top five events with the highest risk values identified by Kaiser model were information system e-mergencies(39.61％),extreme weather(38.03％),major public sentiment(37.86％),public health events(37.37％)and policy changes(37.24％).The results of risk matrix and Borda count revealed 1 extremely high-risk indicator as information system emergency,5 high-risk indicators with the highest risk being major public sentiment,11 medium-risk indicators with the highest risk being major medical disputes and 1 low-risk indicator as external fires.Conclusion Conducting HVA in combination with the actual situation of blood banks can effectively identify high-risk events and provide theoretical basis for improving emergency management measures.

Objective:To construct an evaluation the index system of entrustable professional activities for resident training doctors in psychiatric department,and to provide reference for formulating training strategies and assessment standards.Entrustable professional activities refers to the ability of trainees to perform and complete spe-cific clinical tasks independently after they have been trusted.Methods:Through documental analysis and semi-structured interviews,the item database of entrustable professional activities for psychiatric resident training physi-cians was established.Delphi consultation was conducted among 63 experts in the field of psychiatry from 7 national resident training bases and 3 medical colleges in China.Indicators were comprehensively screened and sorted out,and indicators at all levels and their weights were determined by the analytic hierarchy process.Results:A hierarchi-cal evaluation index system of entrustable professional activities for psychiatric resident training doctors was con-structed,including 4 first-level indicators,17 second-level indicators and 68 third-level indicators.The weights of the first-level,second-level and third-level indicators were determined.Conclusion:The evaluation index system of en-trustable professional activities is comprehensive and systematic,which is suitable for clinical work and convenient for practical application.It could provide quantitative standards for the assessment of psychiatric residents and pro-mote the improvement of training quality.

【Objective】 To explore the effectiveness of using donor plasma reinfusion to flush the leukoreduction system (LRS) chamber during the final reinfusion phase with the Trima Accel automated blood collection system in preventing the reduction of CD4+ and CD8+ T lymphocytes. 【Methods】 A longitudinal and cross-sectional study was designed. CD4+ count<200 cells/μL and CD8+ count<125 cells/μL were considered as the criteria for deficiency. Eighteen first-time platelet donors were followed up. The lymphocyte count was measured at 0, 3-6 and 7-14 times of blood donation in the last 300 days. 170 healthy blood donors who have not donated blood were selected as the control group. According to the cut-off point(October 2021), 88 blood donors who mainly used automatic blood collection system to donate platelet apheresis in the last 365 days(median blood donation times ≥17.5)were divided into three groups(A, B and C)and blood samples were obtained. The time for Groups A, B and C started donating platelet apheresis were as follows: Group A: before October 2019, Group B: from October 2019 to September 2021, Group C: after October 2021. Blood samples were analyzed to obtain blood counts including CD4 + and CD8 + T lymphocytes. Blood samples were analyzed to obtain blood cell counts including CD4+ and CD8+ T lymphocytes. Through a comparative analysis, this study aimed to determine if there are any statistical differences in the detection indices between the follow-up groups with varying frequencies of blood donation, the control group, and groups A, B, and C. This approach was employed to infer the efficacy of donor plasma reinfusion in flushing the leukoreduction system (LRS) chamber for preventing the decline of CD4+ and CD8+ T lymphocytes. 【Results】 Eighteen first-time blood donors who were converted to regular platelet apheresis donors did not show a decrease of CD4 + and CD8 + T lymphocytes in the 5 th and 11 th blood donation (median number of blood donation), and there was no significant difference between the above indexes and those in the 0 th blood donation. Among the previous frequent blood donors, the CD4+ and CD8+ T lymphocyte counts in Group B and Group C are both higher than the standard value, showing no statistical difference from the control group. Among regular blood donors, the CD4+ and CD8+ T lymphocyte counts in groups B and C were higher than the criteria values, and had no statistical difference compared to the control group.The CD4+ T lymphocyte count in Group A was normal, with only one donor in Group A having a CD8+ T lymphocyte count below 125 cells/μL. This donor has donated 281 times of platelet apheresis, and the group he belongs to has started blood donation 2-21 years(median of 5 years) before the adjustment of reinfusion mode. The CD4+ and CD8+ T lymphocyte counts in Group A showed significant differences compared to the control group, with median counts (Group A/Control Group) of 359/521 and 257/372, respectively, P<0.001. In Group A, 0%(0/35) had a CD4+ count below 200 cells/μL, and 2.85%(1/35) of donors had a CD8+ count below 125 cells/μL, which was far lower than the proportion of CD4+ and CD8+ T cell deficiency found in regular apheresis donors by John M. Gansner and Mahboubeh Rahmani. The study showed that the adjustment of the plasma reinfusion mode did not further reduce the T lymphocyte counts in blood donors, but instead further restored the T lymphocyte counts in regular blood donors. This indicated that after the adjustment of plasma reinfusion mode, blood donors might not have lost CD4+ and CD8+ T lymphocytes during blood donation, or only lost a small amount, and can recover even if they donate platelet apheresis frequently. 【Conclusion】 Trima Accel automated blood collection system has a good effect on preventing CD4 + and CD8 + T lymphocytes from being reduced by flushing the LRS chamber with donor plasma.

Objective:To explore the effect of a nursing model based on Watson humanistic care theory in patients with end-stage heart failure (ESHF) .Methods:From January 2017 to January 2020, convenience sampling was used to select ESHF patients who underwent treatment in the Chengbei District of Hangzhou First People's Hospital as the study subject. Patients were randomly divided into an observation group ( n=135) and a control group ( n=123). The control group received routine nursing model, while the observation group received nursing model based on Watson humanistic care theory. The intervention effect was evaluated using the Self-Care of Heart Failure Index (SCHFI), Heart Failure Knowledge Test (HFKT), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) . Results:After intervention, the HFKT and SCHFI scores of the observation group were higher than those of the control group, and the SAS and SDS scores were lower than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The nursing model based on Watson humanistic care theory can improve the knowledge and self-care ability of ESHF patients, and relieve their anxiety and depression.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective     To explore the association between the preoperative systemic immune-inflammation index (SII) and prognosis in non-small cell lung cancer (NSCLC) patients. Methods     A comprehensive literature survey was performed on PubMed, Web of Science, EMbase, The Cochrane Library, Wanfang, and CNKI databases to search the related studies from inception to December 2021. The hazard ratio (HR) and 95% confidence interval (CI) were combined to evaluate the correlation of the preoperative SII with overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) in NSCLC patients. Results     A total of 11 studies involving 9 180 patients were eventually included. The combined analysis showed that high SII levels were significantly associated with worse OS (HR=1.61, 95%CI 1.36-1.90, P<0.001), DFS (HR=1.50, 95%CI 1.34-1.68, P<0.001), and RFS (HR=1.17, 95%CI 1.04-1.33, P<0.001). Subgroup analyses also further verified the above results. Conclusion     Preoperative SII is a powerful prognostic biomarker for predicting outcome in patients with operable NSCLC and contribute to prognosis evaluation and treatment strategy formulation. However, more well-designed and prospective studies are warranted to verify our findings.

Objective To develop a transitional home nursing program and evaluate its effectiveness in guidance on the elderly patients after surgery of hip fractures.Methods A literature review on transitional home nursing was conducted and then Delphi method was employed to generate a transitional home nursing program and had it applied to the elderly patients after hip fracture surgery.After that,a total of 104 elderly patients with hip fractures admitted to Yancheng First People's Hospital from March 2022 to January 2023 were enrolled as study subjects.According to the order of admission,52 patients admitted between March and August 2022 were assigned to a control group,while the rest of 52 patients admitted between September 2022 and January 2023 were assigned to an trial group.Patients in the control group received routine transitional nursing,and those in the trial group received instructions based on the developed transitional home nursing program.Patient recovery and the quality of life of the two groups were compared at the time of discharge and at 3 months after discharge.The patients'compliance at 3 months after discharge was analysed.Results After 2 rounds of consultations with 12 experts,the questionnaire retrieval rates reached 100.00%and 91.67%,with Kendall's W coefficients of 0.800 and 0.832,respectively(both P<0.05).The home nursing program consisted of methods for the online instructions and postoperative follow-up.The contents of instructions covered diet and nutrition guidance,rehabilitation exercise,home environment,health education,psychological care and prevention of complication.The scores of rehabilitation,functional exercises,medication compliance and quality of life in the trial group were all significantly higher than those in the control group(all P<0.001).Conclusions The transitional home nursing program developed for elderly patients after hip fracture surgery in this study is scientific and practical.It can provide a basis for the hospital-home transitional nursing.

Objective:To investigate the efficacy of gonadotropin releasing hormone agonist (GnRH-a) combined with a levonorgestrel-releasing intrauterine system (Mirena) in patients with adenomyosis and its effects on ovarian function, carbohydrate antigen (CA) 125, CA153 and carcino-embryonic antigen (CEA) expression.Methods:Seventy-eight patients with adenomyosis who received treatment from September 2017 to September 2020 in Shaoxing People's Hospital were included in this study. They were randomly divided into treatment and control groups ( n = 39/group). Patients in the control group were treated with a levonorgestrel-releasing intrauterine system. Patients in the treatment group were treated with GnRH-a, once per month in the first 3 months based on treatment with a levonorgestrel-releasing intrauterine system. After 6 months of treatment, changes in dysmenorrheal relief, menstrual volume, uterine volume, endometrial thickness, ovarian function, CA125, CA153 and CEA levels relative to before treatment were compared. Results:Visual analog scale score and pictorial blood assessment chart score in the treatment group were (1.36 ± 0.28) points and (38.98 ± 5.42) points, which were significantly lower than those in the control group [(1.78 ± 0.31) points, (63.42 ± 6.75) points, t = 6.27, 17.63, both P < 0.05). Uterine volume and endometrial thickness in the treatment group were (209.74 ± 15.65) cm 3 and (7.37 ± 0.57) mm, respectively, which were significantly lower than those in the control group [(278.39 ± 20.90) cm 3, (8.63 ± 0.86) mm, t = 16.45, 7.62, P < 0.05]. There were no significant differences in serum levels of luteinizing hormone, follicle stimulating hormone and estradiol between the two groups (all P > 0.05). Serum CA125, CA153 and CEA levels in the treatment group were (26.87 ± 7.21) U/L, (23.12 ± 7.38) U/mL and (5.45 ± 0.96) μg/L, respectively, which were significantly lower than those in the control group [(49.93 ± 8.97) U/L, (38.94 ± 6.21) U/mL, (8.23 ± 1.35) μg/L, t = 12.51,10.24,10.48, P < 0.05]. Conclusion:GnRH-a combined with a levonorgestrel-releasing intrauterine system (Mirena) can markedly relieve dysmenorrhea, reduce menstrual volume, uterine volume, and endometrial thickness, has no obvious effects on ovarian function, and greatly reduce the levels of CA125, CA153 and CEA. Therefore, the combined method is a safe and effective non-surgical treatment method of adenomyosis.

【Objective】 To apply the spatial distribution analysis based on ArcGIS software, which has been applied widely in other fields, so as to analyze the intended locations for whole blood donation. 【Methods】 After a random stratified sampling was conducted among blood donors in the 17 donation sites during August 1st, 2021- July 30th, 2022, their intended blood donation locations were collected by an e-questionnaire. Addresses of donors′ intended donation locations were derived for GCJ-02 coordinates form and transformed by pandas module of Python to WGS84 coordinates, which further loaded to ArcGIS Arcmap module using Grouping Analysis for 17 median centers. The addresses of 17 blood donation sites in Guangzhou Blood Center were transformed to WGS84 coordinates and loaded to ArcGIS Arcmap module using the same methods for 3 ring buffer analysis. The criterion for judging whether the two were " matched" was whether the intended blood donation sites were covered by or adjacent to the 3 ring buffer zone of the existing blood donation sites. 【Results】 Of the 17 potential sites obtained from the spatial distribution analysis of 40 523 valid addresses of donors, 8 sites were covered or adjacent to the buffer of the existing donation sites, while the other 9 sites were far away from the existing donation sites. 【Conclusion】 By analyzing the spatial distribution of donors′ intended donation addresses, we can find out the service needs of donors for donating blood conveniently, which can provide basis for further blood donation service optimization.

【Objective】 To obtain HTLV prevalence data among blood donors in mainland China through meta-analyze, and provide reference for relevant policies. 【Methods】 The literature concerning HTLV prevalence among blood donors in mainland China before April 15, 2021 in CNKI, Wanfang and Pubmed was searched. According to the inclusion criteria and exclusion criteria, relative literature within recent 10 years was screened and then analyzed by meta-analysis using R3.3. 【Results】 A total of 69 articles were included, covering 22 provincial administrative regions, with a total sample size of 7 435 501 cases. 535 cases were HTLV positive, of which 491 centred on three coastal provinces as Fujian, Guangdong and Zhejiang, and 44 scattered in 11 other provincial administrative regions. The pooled prevalence of HTLV in blood donors in Fujian, Guangdong and Zhejiang provinces were 3.25/10 000(95%CI 1.91/10 000~4.58/10 000), 0.13/10 000(95%CI 0.09/10 000~0.17/10 000) and 0.33/10 000(95%CI 0.06/10 000~0.61/10 000), respectively. Subgroup analysis showed that the pooled prevalence of HTLV in Fujian blood donors decreased since December 2015. 【Conclusion】 Blood donors in mainland China present low HTLV prevalence, mainly distributed in three coastal provinces as Fujian, Guangdong and Zhejiang. The sample size tested increased greatly since HTLV screening for blood donors was popularized nationwide in blood stations in December 2015, the infection rate of HTLV in Fujian, however, did not increase as expected.