Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is the primary cause of mortality in sepsis, with its core pathophysiological mechanism being severe ischemia and hypoxia in critical units—composed of microcirculation and the mitochondria of functional cells—resulting from disruptions in blood flow and oxygen flow following a dysregulated host response. Due to the systemically convergent yet clinically heterogeneous nature of the host response, current understanding and management strategies for hemodynamics remain inconsistent, often leading to inadequate resuscitation or overtreatment. To improve the quality of care, based on a systematic review of the "blood flow-oxygen flow" theory, an expert panel emphasizes reevaluating septic shock from an integrated perspective of blood flow and oxygen flow, and has formulated the Expert Consensus on Blood Flow and Oxygen Delivery Phenotyping and Clinical Management of Septic Shock (2025). The consensus proposes that clinical typing of blood flow-oxygen flow should comprehensively consider cardiac function, vascular tone, oxygen flow utilization status in critical units, and disease trajectory, while optimizing subtype identification by integrating host response phenotypes and artificial intelligence technologies. It advocates establishing a continuous assessment system through multi-site oxygen flow monitoring for organ perfusion, peripheral perfusion monitoring, and critical care ultrasound. Under the framework of the "critical care triangle", the consensus promotes the implementation of individualized, bundled management strategies, providing guidance for multiple management points to restore blood flow-oxygen flow matching, reduce the risk of organ failure, and decrease patient mortality.

ObjectiveTo investigate the inhibitory effect of gingerol， an active component of ginger， on Staphylococcus aureus （S. aureus） infection， and to preliminarily explore its mechanism related to extracellular vesicles （EVs）. MethodsS.aureus infection models were established in human umbilical vein endothelial cell （HUVECs）， Vero E6 cells， and C57BL/6 mice. Experimental groups included control， infection， and gingerol-treated groups. Bacterial load and VE-cadherin protein expression were detected using immunofluorescence and Western blot. EVs were isolated by size exclusion chromatography and characterized by transmission electron microscopy and nanoparticle tracking analysis. miRNA sequencing was performed on EVs. ResultsGingerol treatment significantly reduced the bacterial load in both in vitro and in vivo infection models and upregulated VE-cadherin expression. miRNA sequencing of EVs revealed that S. aureus infection upregulated the expression of hsa-miR-320c， while gingerol treatment reversed this abnormal expression. Bioinformatic analysis further predicted that the target genes of hsa-miR-320c were significantly enriched in cell junction-related pathways. ConclusionGingerol exhibits clear antibacterial and host-protective effects， by regulating hsa-miR-320c in EVs to maintain endothelial barrier integrity.

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.

OBJECTIVE To investigate and analyze the current situation and problems of the advanced personnel en-gaging in the hospital-acquired infection control during their training period and explore the existing countermeas-ures and future development.METHODS The literatures regarding to the advanced study in China were retrieved from databases,the subjects of the literatures covered infection control-related advanced study practice,discipline construction,position competence,talent cultivation,scientific research innovation,professional title evaluation,laws,regulations and development plans.From Aug.2024 to Nov.2024,a questionnaire survey and face-to-face interviews were conducted among 36 advanced study personnel from 9 provinces of China who engaged in hos-pital-acquired infection control in the First Medical Center of Chinese PLA General Hospital.Eventually,36 ques-tionnaires were retrieved,all of which were valid with a questionnaire recovery rate of 100.00％.RESULTS Among the 36 advanced study personnel of hospital-acquired infection control,58.33％were medium-grade professional ti-tle;preventive medicine(41.67％),clinical medicine(25.00％)and nursing(16.67％)ranked the top 3 majors.The personnel engaged in the infection control for more than 6 years,and the duration of the advanced study was generally 3 or 6 months.In reality,the personnel faced the choices in terms of the purposes of further education,learning approaches and learning contents.The advanced study personnel also encountered the problems of challenges from promotion,improvement of position competency,integration with clinical training,supervision and practice,as well as physiological,psychological and family pressure.CONCLUSION Aiming at the problems that the advanced study personnel are generally concerned about,such as how to scientifically and effectively carry out hospital-acquired infection control advanced study and preset and solve the problems that may encounter,it is necessary to formulate targeted training programmes so as to provide bases and enlightenment for establishment of a long-term mechanism for advanced study of infection control in China.

Scholarly articles published in the Web of Science database from January 1,2004 to November 10,2024 in the field of medical device utilization management were collected.CiteSpace-based bibliometric analysis of the included literature was performed in terms of the year of publication,region of publication,highly cited literature and highly cited journals and keywords.The Internet of Things(IoT),cloud computing and wearable devices were identified as the current research hotspots in the field of medical device utilization management.References were provided for further research related to medical device utilization management.[Chinese Medical Equipment Journal,2025,46(7):63-67]

Objective:To investigate the role and molecular mechanisms of signal transducer and activator of tran-scription 3(STAT3)in the paraventricular nucleus(PVN)of the hypothalamus in regulating body weight and energy metabolism in mice.Methods:AAV2/9-hSyn-Cre-EGFP virus was stereotactically injected into the PVN of STAT3Flox/Flox mice to conditionally knock out(CKO)STAT3 in the PVN.STAT3 expression was verified via immunoflu-orescence staining and Western blot.Body weight and temperature were monitored,glucose tolerance was assessed using glucose tolerance tests in mice,and morphological changes in the liver,interscapular brown adipose tissue(IBAT),in-guinal white adipose tissue(IWAT),and quadriceps muscle were evaluated via hematoxylin-eosin(HE)staining.RT-qPCR was used to measure mRNA levels of platelet-derived growth factor receptor α(PDGFRα),peroxisome prolifera-tor-activated receptor γ(PPARγ),hormone-sensitive lipase(HSL),and adipose triglyceride lipase(ATGL)in these tissues.Results:STAT3 protein expression in the PVN of CKO mice was significantly reduced,and the number of STAT3-positive neurons was also decreased.Compared to wild-type(WT)mice,CKO mice exhibited increased body weight,impaired thermogenesis in IBAT,and reduced glucose tolerance.HE staining revealed lipid droplet accumula-tion in hepatocytes of the liver,enlarged adipocytes with hypertrophic lipid droplets and leukocyte infiltration in adipose tissues,and intermuscular fat deposition in the quadriceps muscle.RT-qPCR analysis showed decreased mRNA levels of PDGFRα,HSL,and ATGL in the liver;upregulated PPARγ mRNA but downregulated HSL and ATGL mRNA in IBAT and IWAT;and reduced PPARγ and HSL mRNA levels in the quadriceps muscle of CKO mice.Conclusion:The STAT3 signaling pathway in the PVN is critical for maintaining systemic energy balance and serves as a key node in met-abolic regulation.

OBJECTIVE To investigate and analyze the current situation and problems of the advanced personnel en-gaging in the hospital-acquired infection control during their training period and explore the existing countermeas-ures and future development.METHODS The literatures regarding to the advanced study in China were retrieved from databases,the subjects of the literatures covered infection control-related advanced study practice,discipline construction,position competence,talent cultivation,scientific research innovation,professional title evaluation,laws,regulations and development plans.From Aug.2024 to Nov.2024,a questionnaire survey and face-to-face interviews were conducted among 36 advanced study personnel from 9 provinces of China who engaged in hos-pital-acquired infection control in the First Medical Center of Chinese PLA General Hospital.Eventually,36 ques-tionnaires were retrieved,all of which were valid with a questionnaire recovery rate of 100.00％.RESULTS Among the 36 advanced study personnel of hospital-acquired infection control,58.33％were medium-grade professional ti-tle;preventive medicine(41.67％),clinical medicine(25.00％)and nursing(16.67％)ranked the top 3 majors.The personnel engaged in the infection control for more than 6 years,and the duration of the advanced study was generally 3 or 6 months.In reality,the personnel faced the choices in terms of the purposes of further education,learning approaches and learning contents.The advanced study personnel also encountered the problems of challenges from promotion,improvement of position competency,integration with clinical training,supervision and practice,as well as physiological,psychological and family pressure.CONCLUSION Aiming at the problems that the advanced study personnel are generally concerned about,such as how to scientifically and effectively carry out hospital-acquired infection control advanced study and preset and solve the problems that may encounter,it is necessary to formulate targeted training programmes so as to provide bases and enlightenment for establishment of a long-term mechanism for advanced study of infection control in China.

Objective:To investigate the role and molecular mechanisms of signal transducer and activator of tran-scription 3(STAT3)in the paraventricular nucleus(PVN)of the hypothalamus in regulating body weight and energy metabolism in mice.Methods:AAV2/9-hSyn-Cre-EGFP virus was stereotactically injected into the PVN of STAT3Flox/Flox mice to conditionally knock out(CKO)STAT3 in the PVN.STAT3 expression was verified via immunoflu-orescence staining and Western blot.Body weight and temperature were monitored,glucose tolerance was assessed using glucose tolerance tests in mice,and morphological changes in the liver,interscapular brown adipose tissue(IBAT),in-guinal white adipose tissue(IWAT),and quadriceps muscle were evaluated via hematoxylin-eosin(HE)staining.RT-qPCR was used to measure mRNA levels of platelet-derived growth factor receptor α(PDGFRα),peroxisome prolifera-tor-activated receptor γ(PPARγ),hormone-sensitive lipase(HSL),and adipose triglyceride lipase(ATGL)in these tissues.Results:STAT3 protein expression in the PVN of CKO mice was significantly reduced,and the number of STAT3-positive neurons was also decreased.Compared to wild-type(WT)mice,CKO mice exhibited increased body weight,impaired thermogenesis in IBAT,and reduced glucose tolerance.HE staining revealed lipid droplet accumula-tion in hepatocytes of the liver,enlarged adipocytes with hypertrophic lipid droplets and leukocyte infiltration in adipose tissues,and intermuscular fat deposition in the quadriceps muscle.RT-qPCR analysis showed decreased mRNA levels of PDGFRα,HSL,and ATGL in the liver;upregulated PPARγ mRNA but downregulated HSL and ATGL mRNA in IBAT and IWAT;and reduced PPARγ and HSL mRNA levels in the quadriceps muscle of CKO mice.Conclusion:The STAT3 signaling pathway in the PVN is critical for maintaining systemic energy balance and serves as a key node in met-abolic regulation.

Scholarly articles published in the Web of Science database from January 1,2004 to November 10,2024 in the field of medical device utilization management were collected.CiteSpace-based bibliometric analysis of the included literature was performed in terms of the year of publication,region of publication,highly cited literature and highly cited journals and keywords.The Internet of Things(IoT),cloud computing and wearable devices were identified as the current research hotspots in the field of medical device utilization management.References were provided for further research related to medical device utilization management.[Chinese Medical Equipment Journal,2025,46(7):63-67]

Objective:To investigate the effect of protein tyrosine phosphatase D(PTPRD)demethylation on the proliferation,migration,and chemoresistance of gastric cancer(GC)cells through the phosphatidyl inositol 3 kinase/protein kinase B/mammalian target of rapamycin(PI3K/Akt/mTOR)pathway.Methods:The gastric cancer MKN-74 and MKN-45 cells,as well as human gastric mucosal epithelial GES-1 cells,GES-1 were cultured in vitro and PTPRD expression was detected.MKN-45 cells and their drug-resistant variant MKN-45/5-FU cells were routinely cultured and transfected with various vectors:PTPRD empty vector(NC group,NC/5-FU group),PTPRD overexpressing adenovirus(PTPRD group,PTPRD/5-FU group),shRNA empty vector(sh-NC group,sh-NC/5-FU group),shRNA PTPRD lentivirus(sh-PTPRD group,sh-PTPRD/5-FU group),and PTPRD overexpressing adenovirus+10 μmol/L 740Y-P treatment(PTPRD+740Y-P group,PTPRD+740Y-P/5-FU group).MTT assay and wound healing assay were used to assess cell proliferation and migration.Cell autophagy levels were assessed using autophagy assay,and the expression of epithelial-mesenchymal transition(EMT)and PI3K/Akt/mTOR pathway related proteins was detected using western blot(WB).MKN-45 cells were treated with 0,2.5,5,10,20 and 40 μmol/L 5-aza solutions,and the PTPRD mRNA expression and cell proliferation in MKN-45 cells were detected using qPCR and MTT assays.Results:PTPRD mRNA and protein were significantly downregulated in gastric cancer cells(P<0.05).Compared with the MKN-45 group,the numbers of autophagosomes and autophagosomes,as well as the protein expression of PTPRD,E-cadherin,and BAX significantly increased in the PTPRD group(all P<0.05),while cell proliferation,migration rate,and protein expression of p-PI3K,vimentin,p-Akt,and p-mTOR decreased significantly(all P<0.05);However,in the sh-PTPRD group,cell proliferation activity,migration rate,and protein expression of p-PI3K,vimentin,p-Akt,and p-mTOR increased notably,while the quantity of autophagosomes,autophagosomes,and protein expression of PTPRD,E-cadherin,and BAX decreased(all P<0.05).Compared with the PTPRD group,the PTPRD+740Y-P group showed an increase in cell proliferation activity,migration rate,protein expression of p-PI3K,vimentin,p-Akt,and p-mTOR(all P<0.05),and a decrease in number of autophagosomes,autophagosomes,and protein expression of PTPRD,E-cadherin,and BAX(all P<0.05).With the increase of 5-aza concentration,the mRNA expression of PTPRD in MKN-45 cells increased(P<0.05),while the cell proliferation activity decreased(P<0.05).Compared with the MKN-45/5-FU group,the cell migration rate and proliferation activity decreased in PTPRD/5-FU group,while the sh-PTPRD/5-FU group showed an increase in cell migration rate and proliferation activity(all P<0.05).Compared with the PTPRD/5-FU group,the PTPRD+740Y-P/5-FU group showed an increase in cell migration rate and proliferation activity(all P<0.05).Conclusion:PTPRD is downregulated in GC cells,and its demethylation may inhibit proliferation and migration of GC cells and enhance chemosensitivity by suppressing the PI3K/Akt/mTOR pathway.