The background of revising GB 19083-2023 Protective face mask for medical use was introduced.GB 19083-2023 was compared with GB 19083-2010 Technical requirements for protective face mask for medical use.The revision points were described in detail involving in dead space,total leakage rate,respiratory resistance,resistance to synthetic blood penetration,microbial indicators,biocompatibility and etc,and the convergence between GB 19083-2023 and international mainstream standards was analyzed.References were provided for the understanding of the standard for the production enterprises and consumers.[Chinese Medical Equipment Journal,2025,46(1):73-77]

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

OBJECTIVE To investigate the mechanisms of adrenal dysfunction among adult offspring rats caused by prenatal ethanol exposure(PEE)aggravated by high-fat diet(HFD)and unpredictable chronic stress(UCS).METHODS Pregnant rats were randomly divided into the control group(saline,ig,once)and PEE group(4 g·kg-1,ig,once)from gestational day(GD)11 until delivery.At postnatal week 4(PW4),offspring rats from the control group and PEE group were randomly assigned to three sub-groups:the normal diet(ND)group,HFD group,and HFD-UCS group(n=20 per subgroup,at an equal male-to-female ratio).The rats in each group were given a corresponding diet until PW24.The HFD-UCS group received HFD until PW24,with additional UCS treatment initiated at PW21 and continued for 3 weeks.Serum adrenocorticotropic hormone(ACTH)levels were measured by radioimmunoassay,and corticosterone(CORT)levels were quantified via enzyme-linked immunosorbent assay(ELISA).Adrenal mRNA expressions of steroidogenic factor 1(Sf1),steroidogenic acute regulatory protein(Star),cyto-chrome P450 cholesterol side chain cleavage(P450scc),3β-hydroxysteroid dehydrogenase(3β-Hsd),steroid 21-hydroxylase(P450c21),steroid 11β-hydroxylase(P450c11),11β-hydroxysteroid dehydrogenase type 1(11β-Hsd1),11β-Hsd 2,mineralocorticoid receptor(Mr),glucocorticoid receptor(Gr),insulin-like growth factor 1(Igf1),IGF1 receptor(Igf1r),and serine/threonine kinase 1(Akt1)were determined using real-time quantitative PCR.Protein expressions of Akt1 and phosphorylated Akt1(p-Akt1)were analyzed via immunohistochemistry.RESULTS In male offspring,HFD/PEE significantly reduced serum ACTH and CORT levels,downregulated Star,P450scc,3β-Hsd and P450c11 mRNA,decreased 11β-Hsd1 mRNA expressions and 11β-Hsd1/11β-Hsd2 ratio,but increased Igf1,Igf1r mRNA,and p-Akt1 protein.Conversely,HFD-UCS/PEE elevated ACTH,CORT,P450scc,3β-Hsd and P450c11 mRNA,increased 11β-Hsd1 and 11β-Hsd1/11β-Hsd2 ratio while suppressing Igf1 mRNA,and p-Akt1 protein.In females,HFD/PEE decreased ACTH but upregulated Igf1,Akt1 mRNA,and p-Akt1 protein.HFD-UCS/PEE increased ACTH,CORT,Sf1,Star,P450scc and P450c11 mRNA,and 11β-Hsd1/11β-Hsd2 ratio,but reduced lgf1 and Igf1r mRNA.CONCLUSION HFD/UCS can aggravate PEE-induced adrenal dysfunction in adult offspring.The adrenal"GC-IGF1 axis"is an endocrine negative feedback one,and its decompensation may increase the susceptibility of a wide range of GC-related adult chronic diseases,such as diabetes.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

The background of revising GB 19083-2023 Protective face mask for medical use was introduced.GB 19083-2023 was compared with GB 19083-2010 Technical requirements for protective face mask for medical use.The revision points were described in detail involving in dead space,total leakage rate,respiratory resistance,resistance to synthetic blood penetration,microbial indicators,biocompatibility and etc,and the convergence between GB 19083-2023 and international mainstream standards was analyzed.References were provided for the understanding of the standard for the production enterprises and consumers.[Chinese Medical Equipment Journal,2025,46(1):73-77]

OBJECTIVE To investigate the mechanisms of adrenal dysfunction among adult offspring rats caused by prenatal ethanol exposure(PEE)aggravated by high-fat diet(HFD)and unpredictable chronic stress(UCS).METHODS Pregnant rats were randomly divided into the control group(saline,ig,once)and PEE group(4 g·kg-1,ig,once)from gestational day(GD)11 until delivery.At postnatal week 4(PW4),offspring rats from the control group and PEE group were randomly assigned to three sub-groups:the normal diet(ND)group,HFD group,and HFD-UCS group(n=20 per subgroup,at an equal male-to-female ratio).The rats in each group were given a corresponding diet until PW24.The HFD-UCS group received HFD until PW24,with additional UCS treatment initiated at PW21 and continued for 3 weeks.Serum adrenocorticotropic hormone(ACTH)levels were measured by radioimmunoassay,and corticosterone(CORT)levels were quantified via enzyme-linked immunosorbent assay(ELISA).Adrenal mRNA expressions of steroidogenic factor 1(Sf1),steroidogenic acute regulatory protein(Star),cyto-chrome P450 cholesterol side chain cleavage(P450scc),3β-hydroxysteroid dehydrogenase(3β-Hsd),steroid 21-hydroxylase(P450c21),steroid 11β-hydroxylase(P450c11),11β-hydroxysteroid dehydrogenase type 1(11β-Hsd1),11β-Hsd 2,mineralocorticoid receptor(Mr),glucocorticoid receptor(Gr),insulin-like growth factor 1(Igf1),IGF1 receptor(Igf1r),and serine/threonine kinase 1(Akt1)were determined using real-time quantitative PCR.Protein expressions of Akt1 and phosphorylated Akt1(p-Akt1)were analyzed via immunohistochemistry.RESULTS In male offspring,HFD/PEE significantly reduced serum ACTH and CORT levels,downregulated Star,P450scc,3β-Hsd and P450c11 mRNA,decreased 11β-Hsd1 mRNA expressions and 11β-Hsd1/11β-Hsd2 ratio,but increased Igf1,Igf1r mRNA,and p-Akt1 protein.Conversely,HFD-UCS/PEE elevated ACTH,CORT,P450scc,3β-Hsd and P450c11 mRNA,increased 11β-Hsd1 and 11β-Hsd1/11β-Hsd2 ratio while suppressing Igf1 mRNA,and p-Akt1 protein.In females,HFD/PEE decreased ACTH but upregulated Igf1,Akt1 mRNA,and p-Akt1 protein.HFD-UCS/PEE increased ACTH,CORT,Sf1,Star,P450scc and P450c11 mRNA,and 11β-Hsd1/11β-Hsd2 ratio,but reduced lgf1 and Igf1r mRNA.CONCLUSION HFD/UCS can aggravate PEE-induced adrenal dysfunction in adult offspring.The adrenal"GC-IGF1 axis"is an endocrine negative feedback one,and its decompensation may increase the susceptibility of a wide range of GC-related adult chronic diseases,such as diabetes.

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 study the magnetic resonance imaging (MRI) and clinical manifestations of intraspinal echinococcosis.Methods:The general conditions, MRI and clinical manifestations of 23 patients with intraspinal echinococcosis diagnosed by pathology at the First Affiliated Hospital of Xinjiang Medical University from September 2011 to May 2023 were retrospectively analyzed.Results:There were 10 males and 13 females of the 23 patients with intraspinal echinococcosis. The age of the patients was (44.1 ± 13.9) years old, with a median age of 41 years old and a range of 25 to 72 years old. Eleven patients (47.8%) had a history of echinococcosis in the spine or other parts of the body. Among the 23 patients with intraspinal echinococcosis, 12 cases (52.2%) involved thoracic segment, 6 cases (26.1%) involved lumbar segment, 1 case (4.3%) involved sacral segment, 1 case (4.3%) involved thoracolumbar segment, 2 cases (8.7%) involved lumbosacral segment, and 1 case (4.3%) involved cervical and lumbar segment. There were 2 cases (8.7%) involving the intramedullary, 9 cases (39.1%) involving the extramedullary subdural, and 12 cases (52.2%) involving the extramedullary epidural. At the same time, 18 cases (78.3%) involved adjacent vertebral bodies, accessories or surrounding soft tissues. Intramedullary cystic echinococcosis was characterized by multiple nodules at the lower end of the spinal cord and the cauda equina nerve on MRI, with equal or low signal on T1WI, slightly high signals on T2WI and short time of inversion recovery (STIR), accompanied by small vesicles with high signal on T2WI. Intramedullary alveolar echinococcosis was characterized by nodular T1WI signals, slightly lower signals on T2WI and STIR, and circular enhancement on enhanced scan. Extramedullary subdural echinococcosis was mostly manifested as oval small vesicles with low signal on T1WI and high signal on T2WI, with a grape string-like appearance, and the capsular wall with low signal on T2WI could be seen at the edge. Extramedullary epidural echinococcosis was manifested as slightly low signal on T1WI, high signals on T2WI and STIR, accompanied by single or multiple small vesicles with high signal on T2WI, and compression of the dural sac. The clinical manifestations were chest and back, lumbosacral pain in 21 cases (91.3%), and lower limb dysfunction in 6 cases (26.1%).Conclusions:Intraspinal echinococcosis is relatively rare compared with other sites. When MRI features are clear, typical clinical manifestations are present, or there is a history of echinococcosis in other sites, intraspinal echinococcosis should be considered.