In order to effectively prevent and control the occurrence of catheter-associated urinary tract infection and ensure the safety of both patients and medical personnel,the National Health Commission of the People's Re-public of China officially released the recommended health industry standard"Standard for prevention and control of catheter-associated urinary tract infection"(WS/T862-2025)in Aug.2025.This paper provides an interpreta-tion of the standard,covering its drafting background,basis and content,to assist relevant medical personnel in healthcare institutions in enhancing their understanding and recognition of the standard,and to further promote its implementation and enforcement.

Here reports a rare case of severe pneumonia with pulmonary abscess and empyema caused by Trophe-ryma whipplei(TW)infection.TW infection was confirmed by clinical manifestations as well as polymerase chain reaction(PCR)of bronchoalveolar lavage fluid(BALF)and pleural effusion.After treatment with meropenem(fo-llowed by sequential ceftriaxone)combined with compound sulfamethoxazole,the patient improved and was dis-charged from hospital.Combined with literature review,this study explores the clinical manifestations,laboratory examinations,and treatment scheme of TW infection,aiming to improve the awareness and vigilance of clinicians on TW infection,conduct targeted anti-infection therapy as early as possible,and reduce the mortality of patients.

Objective:To investigate the trends of pathogen distribution and drug resistance in elderly patients with stroke-associated pneumonia(SAP)in China,providing references for clinical antibiotic selection and application.Methods:A meta-analysis was conducted to comprehensively evaluate changes in resistance rates of major pathogens isolated from elderly SAP patients to key clinical antibiotics over the past 10 years.The trends of antimicrobial resistance were analyzed.Results:A total of 12 qualified articles were screened out,involving 1 202 cases of pulmonary infections and 1 315 pathogenic isolates.Gram-negative bacilli accounted for 951 strains(72.32%),Gram-positive cocci for 278 strains(21.14%),and fungi for 86 strains(6.54%).The top five pathogens were Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter Baumannii,Staphylococcus aureus and Escherichia coli.The resistance rates to various antibiotics showed minor fluctuations across years.Conclusions:Gram-negative bacilli dominate pulmonary infections in elderly stroke patients,with a high proportion of multidrug-resistant strains.Strengthened pathogen surveillance and rational antibiotic use are critical in clinical practice.

Objective:To evaluate the functional outcomes and postoperative complications associated with modified Toupet-like (mToupet-like) anastomosis following proximal gastrectomy for patients with gastric tumors.Methods:After proximal gastrectomy, barbed sutures (2-3 stitches) in the seromuscular layer were used to secure the anterior wall of the stomach at a distance of 1-2 cm from the closure line and the posterior wall of the esophagus at a distance of 5.0 cm from the closure line. The remnant stomach was then positioned posterior to the esophagus on the greater curvature side. Esophagogastric anterior wall anastomosis (manual or circular stapling) was performed at the greater curvature of the remnant stomach, 3 cm distal to the gastroesophageal fixation point. A Toupet-like folding procedure was conducted by folding the reconstructed gastric fundus and wall anteriorly from behind the esophagus and embedding the esophagus within a 270° wrap at the site of stomach-esophagus fixation.Results:Twelve patients with gastric tumors underwent proximal partial gastrectomy with mToupet-like anastomosis in the Department of Gastric Surgery at Zhejiang Cancer Hospital from January to March 2024. Among them, 10 diagnosed as upper gastric adenocarcinoma, and 2 diagnosed as gastric gastrointestinal stromal tumors. The cohort included nine male patients and three female patients, aged 46 to 77 years old, with a body mass index (BMI) ranging from 19.7 to 27.3 kg/m2. The maximum tumor diameter was less than 4 cm, and the predicted residual gastric volume exceeded one-half. Laparoscopic surgery was performed in 11 patients, while only 1 patient underwent open surgery. The mean duration of mToupet-like anastomosis was 48.3±8.7 minutes with an estimated intraoperative blood loss was 53.0±11.2 ml. All the 12 patients successfully achieved R0 resection. Among these patietns, the median postoperative hospital stay was 8.5 (7.0, 11.0) days, and the average hospitalization cost was 5.0±0.2 ten thousand yuan. No Clavien-Dindo grade II or higher complications were observed during the perioperative period. Patients were followed up for 6 to 8 months after operation, and no cases of reflux esophagitis were detected by gastroscopy, and no patient required long-term oral proton pump inhibitors.Conclusions:mToupet-like anastomosis for digestive tract reconstruction after proximal gastrectomy is a safe and feasible technique, demonstrating favorable preliminary efficacy.

Objective:To investigate the trends of pathogen distribution and drug resistance in elderly patients with stroke-associated pneumonia(SAP)in China,providing references for clinical antibiotic selection and application.Methods:A meta-analysis was conducted to comprehensively evaluate changes in resistance rates of major pathogens isolated from elderly SAP patients to key clinical antibiotics over the past 10 years.The trends of antimicrobial resistance were analyzed.Results:A total of 12 qualified articles were screened out,involving 1 202 cases of pulmonary infections and 1 315 pathogenic isolates.Gram-negative bacilli accounted for 951 strains(72.32%),Gram-positive cocci for 278 strains(21.14%),and fungi for 86 strains(6.54%).The top five pathogens were Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter Baumannii,Staphylococcus aureus and Escherichia coli.The resistance rates to various antibiotics showed minor fluctuations across years.Conclusions:Gram-negative bacilli dominate pulmonary infections in elderly stroke patients,with a high proportion of multidrug-resistant strains.Strengthened pathogen surveillance and rational antibiotic use are critical in clinical practice.

Objective:To explore the advantages of robotic-arm assisted total hip arthroplasty (rTHA) in acetabular component positioning and lower limb length assessment in patients with severe pelvic coronal tilt.Methods:A retrospective analysis was conducted on the data of 122 patients with unilateral end-stage hip disease and coronal pelvic tilt angle >3° who underwent total hip arthroplasty (THA) at the First Medical Center of PLA General Hospital from June 2022 to December 2023. Among them, 44 patients underwent rTHA, and 78 underwent manual THA (mTHA). The rTHA group included 18 males and 26 females, with an average age of 60.5±9.3 years; the mTHA group included 41 males and 37 females, with an average age of 58.5±8.4 years. Compare the differences in the anteversion angle, abduction angle, pelvic tilt angle, leg length discrepancy (LLD) of the acetabular prosthesis, and the proportions of patients with LLD>0.5 cm and >1 cm between the two groups of patients after surgery. Calculate the proportion of outlier rates of acetabular abduction angle (<30° or >45°), and proportions within Callanan's safe zone. The early efficacy of the hip joint was evaluated by using the modified Harris score and joint range of motion.Results:All patients were followed up for 6 to 12 months, with an average of 8 months. All the surgical incisions of the patients achieved primary healing. Postoperative comparisons showed no statistically significant differences in acetabular abduction angle (39.5°±3.3° vs. 38.4°±7.3°) or anteversion angle (20.7°±1.6° vs. 19.7°±1.6°) between rTHA and mTHA groups ( P>0.05). However, pelvic tilt angle [2.5° (1.1°, 3.6°) vs. 3.5° (2.3°, 5.9°)] showed a statistically significant difference ( U=4.371, P=0.008). The rTHA group exhibited smaller absolute LLD [0.2 (0.1, 0.4) cm vs. 0.5 (0.2, 0.5) cm] and lower proportions of LLD >0.5 cm [14% (6/44) vs. 49% (38/78)] and >1 cm [2% (1/44) vs. 18% (14/78)], with statistical significance ( P<0.05). The rTHA group had a lower outlier rate for acetabular abduction angle (<30°or >45°) compared to the mTHA group [2% (1/44) vs. 33% (26/78)], with statistical significance (χ 2=10.388, P<0.001). Taking the Callanan safety zone as the standard, the proportion of acetabular cups within the safe zone was significantly higher in the rTHA group (98%, 43/44) compared to the mTHA group (67%, 52/78), with a statistically significant difference (χ 2=13.998, P<0.001). The modified Harris score and hip joint range of motion in the mTHA group increased from 47.6±6.6 points and 83° (73°, 88°) before the operation to 83.5±11.2 points and 118° (110°, 122°) at the last follow-up, respectively. The rTHA group increased from 46.5±9.2 points and 79° (71°, 90°) before the operation to 85.0±12.5 points and 124° (116°, 130°) at the last follow-up. The differences in the modified Harris score and hip joint range of motion between the two groups before the operation and at the last follow-up were statistically significant ( P<0.05). However, there was no statistically significant difference between the groups at the last follow-up ( P>0.05). No THA-related complications occurred during follow-up period. Conclusion:For patients with end-stage hip joint diseases with coronal tilt exceeding 3°, robotic-assisted technology significantly improves the accuracy of acetabular component placement during THA and offers better control of postoperative LLD.

Here reports a rare case of severe pneumonia with pulmonary abscess and empyema caused by Trophe-ryma whipplei(TW)infection.TW infection was confirmed by clinical manifestations as well as polymerase chain reaction(PCR)of bronchoalveolar lavage fluid(BALF)and pleural effusion.After treatment with meropenem(fo-llowed by sequential ceftriaxone)combined with compound sulfamethoxazole,the patient improved and was dis-charged from hospital.Combined with literature review,this study explores the clinical manifestations,laboratory examinations,and treatment scheme of TW infection,aiming to improve the awareness and vigilance of clinicians on TW infection,conduct targeted anti-infection therapy as early as possible,and reduce the mortality of patients.

With the great improvement in the prognosis and survival of breast cancer patients, coupled with the widespread use of cardiotoxic drugs, the cardiotoxicity caused by radiation-induced heart disease (RIHD) partially offsets the overall survival benefits of breast cancer patients. Heart damage occurs in many structures, such as left and right coronary arteries, the cardiac conduction system, the pericardium, and heart valves. RIHD has a long incubation period, most of which occur more than 10 years after radiotherapy, and the clinical manifestations become prominent with the extension of time. Advanced modern radiotherapy concepts such as respiratory gating, image-guided radiotherapy, conformal intensity-modulated radiotherapy, and intensity-modulated proton therapy can effectively reduce the radiation dose of breast cancer radiotherapy-related heart and left anterior descending coronary artery. The study of precise radiotherapy protection technology for the heart and large vessels is expected to reduce non-tumor-related death and achieve long-term survival in patients with breast cancer. The important direction in the future is to study the mechanism of RIHD, to find the best cardiac dose reference point, and to define the ideal dose-response relations. Combined with hematological markers, auxiliary examination parameters and cardiovascular risk factors, a predictive model will be established to estimate the probability of radiation-related cardiotoxicity in patients with breast cancer. As the radiation-related cardiotoxicity of breast cancer has become increasingly prominent, the purpose of this article is to summarize the related studies of RIHD in order to improve the long-term survival rate and quality of life of these sufferers.

In the context of comprehensively advancing the Healthy China initiative,the high-quality development of public hospitals must be guided by the core principle of"people's health".It provides a systematic analysis of the historical evolution of developmental paradigms in Chinese public hospitals.By integrating the current policy requirements for their high-quality development,it proposes key pathways including the innovation of development concepts,the reconstruction of hospital connotations,the extension of service management,the optimization of the system structure,and the empowerment of digital and intelligent technologies.Through empirical case studies that demonstrate the viability of these pathways,it aims to provide theoretical support and practical reference for the high-quality development of public hospitals centered on people's health.

Objective:To investigate the application value of gastric suspension method in supra-pancreatic lymph node dissection of laparoscopic radical gastrectomy of gastric cancer.Method:The retrospective cohort study was conducted. The clinicopathological data of 84 patients who under-went laparoscopic radical gastrectomy of gastric cancer at Zhejiang Cancer Hospital from August 2023 to July 2024 were collected. There were 61 males and 23 females, aged (64±11)years. Of the 84 patients, 42 patients undergoing supra-pancreatic lymph node dissection during laparoscopic radical gastrectomy of gastric cancer with traditional method for surgical field exposure were divided into the control group, and 42 patients undergoing supra-pancreatic lymph node dissection during laparoscopic radical gastrectomy of gastric cancer with gastric suspension method for surgical field exposure were divided into the suspension group. Observation indicators: (1) surgical conditions; (2) postoperative conditions. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test. Results:(1) Surgical condi-tions. The time for supra-pancreatic lymph node dissection of the control group was (78±14)minutes. Number of grasping operations was 116±34, number of bleeding sites caused by grasping operations was 7.8±2.7, and operation time was (3.9±0.8)hours. The above indicators of the suspension group were (59±12)minutes, 68±19, 2.1±1.5, and (3.3±0.7)hours, respectively. There were significant diffe-rences in the above indicators between the two groups ( t=5.42, 8.10, 8.31, 3.14, P<0.05). (2) Post-operative conditions. The tumor diameter was 2.5(2.0,3.5)cm for patients of the control group, versus 3.0(2.4, 4.4)cm for patients of the suspension group, showing a significant difference between the two groups ( Z=-1.98, P<0.05). Conclusion:Compared with the traditional non-suspension method, the gastric suspension method in laparoscopic radical gastrectomy of gastric cancer for supra-pancreatic lymph node dissection is associated with shorter operation time and less trauma.