This article provides a systematic interpretation and review of the Society of Critical Care Medicine 2024 Guidelines on Adult ICU Design. Developed based on the Grading of Recommendations Assessment, Development and Evaluation methodology, the guideline address five core themes: ICU layout, room design, infection control, infrastructure, and staff spaces, and put forward 17 evidence-based recommendations, including 5 good practice statements. This article briefly introduces the guideline development methods and evidence characteristics, and focuses on summarizing key recommendations, including high-visibility layouts, single-bed ward settings, natural lighting and noise reduction strategies, integrated infection prevention and control design, remote monitoring, and flexible capacity expansion capabilities. Furthermore, it delves into the applicability and localized implementation pathways within China's healthcare environment, analyzing limitations in terms of evidence quality, specialty applicability, and cost-effectiveness. Furthermore, by integrating the Chinese Guidelines for the Construction and Development of Critical Care Medicine (2025 Edition) and current domestic practices, the article proposes tiered and phased implementation recommendations. This article aims to provide domestic healthcare institutions with a scientific reference that balances international cutting-edge concepts with China's real-world conditions for the construction and renovation of ICUs, thereby promoting the development of intensive care environments centered on patient safety, healthcare worker well-being, and infection control.

ObjectiveTo observe the mechanism of Guihuang formula in regulating the activation of NOD-like receptor protein 3 （NLRP3） inflammasome and inhibiting pyroptosis in the treatment of type Ⅲ prostatitis. Methods（1） In an animal experiment， 50 Sprague Dawley （SD） rats were randomly divided into a blank group， a model group， and low-dose， medium-dose， and high-dose groups of Guihuang formula， with 10 rats in each group. Except for the blank group， the type Ⅲ prostatitis rat model was prepared for the other four groups.After the modeling was successful， the blank group and the model group were given normal saline intragastrically， and the low-dose， medium-dose， and high-dose groups of Guihuang formula were given intragastrically with Guihuang formula （4.9， 9.8， 19.6 g·kg^-1）. After 30 days of intragastrical administration， samples were taken for detection. Inflammatory cell infiltration in prostate tissue was observed by hematoxylin-eosin （HE） staining， and serum IL-1β and IL-18 levels were measured by enzyme-linked immunosorbent assay （ELISA）. Serum malondialdehyde （MDA）， superoxide dismutase （SOD）， and glutathione peroxidase （GSH-Px） levels were determined by biochemistry. NLRP3 expression in prostate tissue was assessed by immunohistochemistry， and the expression of NLRP3， cysteine-aspartic acid protease-1 （Caspase-1）， and gasdermin D （GSDMD） in prostate tissue was measured by Western blot. （2） In a cell experiment， human normal prostate epithelial cells （RWPE-1 cells） were divided into a blank group， a model group， a Guihuang formula group， and an NLRP3 inhibitor group （MCC950 group）. Except for the blank group， the other three groups were stimulated by 100 μg·L^-1 lipopolysaccharide （LPS） for 4 h and 5 mol·L^-1 adenosine triphosphate （ATP） for 30 min to prepare the pyroptosis model. After successful modeling， blank serum was given to the blank group and the model group. 6.25 μg·mL^-1 Guihuang formula drug-containing serum was added to the Guihuang formula group， and MCC950 was added to the MCC950 group on the basis of the model group. Propidium iodide （PI） uptake and Caspase-1 expression were detected by flow cytometry， and lactate dehydrogenase （LDH） level in the cell supernatant was measured by biochemistry. Interleukin （IL）-1β and IL-18 levels of the cell supernatant were determined by ELISA， and the expression of NLRP3， Caspase-1， and GSDMD was detected in Western blot. Results（1） For the animal experiment， compared with the blank group， the model group showed significant infiltration of inflammatory cells in prostate tissue， while the low-dose， medium-dose， and high-dose groups of Guihuang formula showed reduced infiltration of acinar inflammatory cells， reduced degree of glandular epithelial degeneration and interstitial edema， and significantly reduced degree of damage. Compared with those in the blank group， the levels of IL-1β and IL-18 in the serum of the model group were significantly increased （P<0.01）. Compared with the model group， the low-dose， medium-dose， and high-dose groups of Guihuang formula showed a significant decrease in serum IL-1β and IL-18 levels （P<0.01）. Compared with that in the blank group， the serum MDA level in the model group significantly increased （P<0.01）. Compared with that in the model group， the MDA level in the low-dose， medium-dose， and high-dose groups of Guihuang formula was significantly reduced （P<0.01）. Compared with those in the blank group， the levels of SOD and GSH-Px in the serum of the model group significantly decreased （P<0.05）. Compared with the model group， the low-dose， medium-dose， and high-dose groups of Guihuang formula showed a significantly increase in SOD （P<0.01）. Compared with the model group， the low-dose， medium-dose， and high-dose groups of Guihuang formula showed a significantly increase in GSH-Px （P<0.05）. Immunohistochemistry showed that compared with the blank group， the model group had high expression of NLRP3 molecule in prostate tissue. The expression of NLRP3 in the low-dose， medium-dose， and high-dose groups of Guihuang formula was significantly lower than that in the model group. Compared with those in the blank group， the expression levels of NLRP3， Caspase-1， and GSDMD proteins in the prostate tissue of the model group were significantly increased （P<0.01）. Compared with those in the model group， the expression levels of NLRP3， Caspase-1， and GSDMD proteins in the low-dose， medium-dose， and high-dose groups of Guihuang formula were significantly inhibited （P<0.01）. （2） For the cell experiment， compared with that in the blank group， the PI uptake rate of RWPE-1 cells in the model group significantly increased （P<0.01）. Compared with that in the model group， the PI uptake rate of the Guihuang formula group and the inhibitor group significantly decreased （P<0.01）. Compared with that in the blank group， the expression of Caspase-1 in the model group was significantly higher （P<0.01）. Compared with that in the model group， the Caspase-1 in the Guihuang formula group and the inhibitor group significantly decreased （P<0.01）. Compared with the blank group， the model group showed an increase in LDH release （P<0.01）. Compared with the model group， the Guihuang formula group and the inhibitor group showed a significantly decrease in LDH release （P<0.01）. Compared with those in the blank group， the levels of IL-1β and IL-18 in the supernatant of the model group were significantly increased （P<0.01）. Compared with the model group， the Guihuang formula group and the inhibitor group showed a significantly decrease in the levels of IL-1β and IL-18 （P<0.01）. Compared with those in the blank group， the expression levels of NLRP3， Caspase-1， and GSDMD proteins significantly increased in the model group （P<0.01）. Compared with those in the model group， the protein expression levels of NLRP3， Caspase-1， and GSDMD were significantly reduced in the Guihuang formula group and inhibitor group （P<0.01）. ConclusionGuihuang formula can inhibit the activation of Caspase-1， prevent GSDMD cleavation and lysis， and inhibit cell pyrodeath in the treatment of type Ⅲ prostatitis by inhibiting the activation of NLRP3 inflammasome.

The left maxilla of a patient was resected because of tumor,and the defect was reconstruted with fibular transplantation.The autonomous dental implant robot technology was used to achieve precise implantation of multiple implants and immediate denture restoration within the limited left maxilla.The surgery was minimally invasive and efficient,and significantly reducing patient post-operative discomfort.The final restoration was completed 6 months after surgery.

Mannheimia varigena(M.varigena)is a significant pathogen causing bovine respiratory disease.Transferrin binding protein B(TbpB)is a lipoprotein directly exposed to the outer mem-brane of the cell,which is not only involved in the bacterial iron metabolism pathway,but also an important virulence factor.This study aims to lay the groundwork for developing novel subunit vaccines by conducting site-directed mutagenesis on M.varigena TbpB binding-related residues and evaluating their immunogenicity.Based on whole-genome sequencing of a bovine M.varigena i-solate,its iron uptake pathway was predicted.Key amino acid residues of M.varigena TbpB that play a role for binding to bovine transferrin(bTf)was identified by bioinformatics.We constructed two M.varigena TbpB mutants(Y205A and Y258A)and assessed their bTf binding activity and immunogenicity through dot blot assays and mouse immunization studies.Dot blot assays result showed that the Y258A mutation caused TbpB to lose its ability to bind to bTf.Mouse immuniza-tion studies showed that,compared to wild-type TbpB,the mutants of TbpB induced higher levels of specific antibodies.In challenge experiments,mice immunized with mutant TbpB exhibited high-er survival rates.These results demonstrate that site-directed mutagenesis can enhance the immu-nogenicity of TbpB.This study provides a novel approach for developing new subunit vaccines a-gainst M.varigena.

Objective:To generate a chronic lymphocytic leukemia (CLL) mouse model with intact immune competence and short latency by adoptively transferring (AT) splenocytes from immunoglobulin heavy-chain enhancer-driven T-cell leukemia/lymphoma 1 (Eμ-TCL1) transgenic donors into wild-type (WT) recipients.Methods:Specific pathogen-free C57BL/6J WT mice and H11-Eμ-VH-TCL1-β-globin-PolyA knock-in mice were utilized. The H11-Eμ-VH-TCL1-β-globin-PolyA knock-in mice were generated using CRISPR/Cas9 technology, and their genotypes were confirmed by PCR. Experimental animals were randomly divided into an adoptive transfer (AT) group and a WT control group ( n=10 per group). Mice in the AT group received an intraperitoneal injection of splenocytes from H11-Eμ-VH-TCL1-β-globin-PolyA knock-in mice. The weight and general condition of the mice were monitored. Mice were euthanized by cervical dislocation at 9 weeks post-transplantation. The CLL model was validated using key indicators, including pathological manifestations, changes in peripheral blood leukocyte counts, and immunophenotype. Results:AT group mice exhibited significantly increased spleen weight [ (0.92±0.16) g vs (0.06±0.01) g in WT group, P<0.05] and liver weight [ (2.11±0.56) g vs (1.42±0.13) g in WT group, P=0.006], indicative of marked splenomegaly and hepatomegaly. The peripheral blood leukocyte count was significantly higher in the AT group [ (124.33±8.74) ×10 9/L] compared to the WT group [ (5.55±1.67) ×10 9/L] ( P=0.002). Similarly, the percentage of peripheral blood B lymphocytes was markedly increased in the AT group versus the WT group [ (69.13±6.88) % vs (39.78±5.94) %, P<0.05]. Histopathological examination revealed CLL manifestations in the spleen, lymph nodes, and bone marrow of AT group mice, with significant lymphocytic infiltration observed in the liver, lung, and kidney tissues. Flow cytometry analysis showed that the percentages of CD19 +CD5 + B lymphocytes among total lymphocytes in peripheral blood, bone marrow, and spleen of the AT group were (61.37±9.92) %, (28.61± 7.08) %, and (86.03±5.78) %, respectively. These were significantly higher (all P<0.05) than in the WT group [ (4.51±1.32) %, (5.58±1.46) %, and (14.33±3.20) %]. Furthermore, these CLL-like cells in the AT group were positive for CD43 and CD200, but showed lower expression of CD20, CD22, and CD79b compared to WT B cells. Conclusion:Adoptive transfer of splenocytes from Eμ-TCL1 transgenic mice successfully established a CLL mouse model with a relatively short latency period. This model represents a valuable preclinical tool for investigating CLL and related pathologies.

Objective:To develop an ultrasound multi-view fusion recognition model and evaluate its clinical value in diagnosing fetal conotruncal defects (CTD).Methods:This prospective study collected cardiac ultrasound images from fetuses at 20-32 weeks of gestation undergoing prenatal ultrasound at Dongguan Maternal and Child Health Hospital between September 2022 and May 2024. The case group comprised fetuses diagnosed with CTD, while controls with normal cardiac structures were collected at a 1∶2 ratio. Both groups were divided into modeling training and validation sets at a 3∶1 ratio. One optimal standard image each from the four-chamber view, left ventricular outflow tract view, right ventricular outflow tract view, and three vessels and trachea view was included per fetus. A deep learning-based multi-view fusion recognition model was developed to differentiate normal conotruncal anatomy from CTD. Model performance was validated against post-abortion pathology or postnatal echocardiography results. SAS software was used for statistical analysis to calculate the sensitivity and specificity of three fusion models (based on positivity in any two, three, or four views, and were designated as Fusion Model 1, Fusion Model 2, and Fusion Model 3, respectively), with the optimal model determined by the maximum Youden index. Senior, intermediate, and junior prenatal sonologists independently diagnosed cases in the validation set under blinding conditions. Their diagnostic results were compared with those of the optimal model. Paired Chi-square test (Cochran's Q test) was employed to compare the differences between the diagnostic accuracy rates of sonologists at different experience levels and the sensitivity of the optimal model, thereby analyzing the auxiliary diagnostic value of the multi-view fusion recognition model. Results:The study included 88 CTD cases, excluding six cases (non-CTD diagnosed by post-abortion pathology or postnatal echocardiography or poor image quality), divided into 60 training and 22 validation cases (12 tetralogy of Fallot, four double outlet right ventricle, three transposition of great arteries, three persistent truncus arteriosus). The control group included 176 cases, excluding 15 cases (other cardiac abnormalities confirmed postnatally or poor image quality after re-evaluation), divided into 120 training and 41 validation cases. The sensitivities of Fusion Model 1, Fusion Model 2, and Fusion Mudel 3 were 0.86, 0.64, and 0.27, while their specificities were 0.76, 0.95, and 1.00, respectively. Fusion Model 1 demonstrated the highest Youden index (0.62) and was selected as optimal. Its diagnostic sensitivity showed no significant difference from senior sonologists [86% vs. 91% (20/22), Bonferroni-corrected P>0.999], but was significantly higher than intermediate [55% (12/22), Bonferroni-corrected P=0.049] and junior sonologists [32% (7/22), Bonferroni-corrected P=0.003]. Conclusion:The deep learning multi-view fusion model achieved diagnostic performance comparable to senior sonologists, demonstrating potential value in assisting CTD diagnosis, training less experienced sonologists, and supporting research and education.

The incidence of chronic venous disease(CVD)is significantly higher in the elderly population compared to non-elderly individuals,with more severe disease manifestations.Additionally,elderly CVD patients often have comorbid conditions such as cardiovascular diseases,making the evaluation process more complex and increasing treatment difficulty.Currently,there are no established recommendations in China for the diagnosis and treatment of CVD in individuals aged 60 and above.Against this backdrop,the Peripheral Vascular Disease Management Branch of the Chinese Geriatric Society has developed the Chinese Expert Consensus on the Diagnosis and Treatment of Chronic Venous Disease in the Elderly based on domestic and international guidelines,relevant evidence-based medical research,and the physiological and clinical characteristics of the elderly population in China.This consensus aims to provide an important reference for improving the diagnosis and treatment of CVD in elderly patients in China.

Objective To understand the current status of radiation diagnosis and treatment resources and their use in Taiyuan City, China, and provide data support for optimizing resource allocation and standardizing diagnosis and treatment. Methods A census-based approach was implemented using a standardized questionnaire to collect basic information on radiation diagnosis and treatment institutions in Taiyuan City. The number and use frequency of radiation diagnosis and treatment resources were calculated based on the resident population of Taiyuan City at the end of 2023. Results There were a total of 562 radiation diagnosis and treatment institutions in Taiyuan City, with 3970 workers and 1354 pieces of equipment. The numbers of radiation diagnosis and treatment institutions, workers, and equipment per 1 000 000 population were 103, 728, and 248, respectively. There were significant differences in radiation diagnosis and treatment resources among different districts and counties. There were 526 (93.59%) radiation diagnosis and treatment institutions and 25 (96.15%) tertiary hospitals in the six urban districts. All institutions offering nuclear medicine diagnosis and treatment and radiotherapy were located in the urban districts. There were substantial disparities among hospitals of different levels. The average numbers of radiation workers and equipment were in the order of tertiary hospitals (99.42, 17.15) > secondary hospitals (13.31, 4.62) > primary and unrated hospitals (1.43, 1.38). The frequency of radiation diagnosis and treatment in tertiary hospitals was 112 149 per hospital, which is 5 times that of secondary hospitals and 44 times that of primary and unrated hospitals. The use frequency of radiation diagnosis and treatment was 975.79 per 1000 population. The use frequency was 941.12 per 1000 population for X-ray diagnosis, 21.68 per 1000 population for interventional radiology, 8.70 per 1000 population for nuclear medicine diagnosis, 2.33 per 1000 population for nuclear medicine treatment, and 1.95 per 1000 population for radiotherapy. Conclusion There are abundant radiation diagnosis and treatment resources in Taiyuan City. The use frequency of radiation diagnosis and treatment has reached the level of Class II medical and health care regions, and there remains considerable room for growth and improvement. At present, the distribution of radiation diagnosis and treatment resources and services is unbalanced among different districts and counties as well as among institutions of different levels, mainly concentrated in urban districts and tertiary hospitals. The health administrative department needs to make overall plans and allocate resources scientifically.

Objective To compare the clinical efficacy between arthroscopic posteromedial dual-portal valvotomy combined with cyst wall resection and open surgery in the treatment of popliteal cysts.Methods A total of 64 patients with popliteal cysts who were treated in the Kunshan Second People's Hospital from May 2018 to May 2023 were enrolled and randomly assigned to two groups.The combined group(n=32)underwent arthroscopic posteromedial dual-portal valvotomy combined with cyst wall resection,and the traditional group(n=32)underwent open surgery.Surgery-related parameters,pain,inflammatory levels,knee joint function,quality of life,postoperative complications and recurrence rate were compared between the two groups.Results The combined group had less intraoperative blood loss and shorter incision length,operation time,and hospital stay than the traditional group(P＜0.05).The Rauschning-Lindgren grade was improved at 6 months after surgery in both groups(P＜0.05),but there was no significant difference in the Rauschning-Lindgren grade at 6 months after surgery between the two groups(P＞0.05).VAS scores at 6,24 and 48 h postoperatively,lower limb alignment angles,and the levels of interleukin(IL)-6,tumor necrosis factor-α,IL-8,and C reactive protein in the combined group were lower than those in the traditional group(P＜0.05).The range of motion of the knee,Lysholm knee scores,and QOL scores in all dimensions in the combined group were higher than those in the traditional group(P＜0.05).The incidence of postoperative complications in the combined group was lower than that in the traditional group(P＜0.05).Conclusion Arthroscopic posteromedial dual-portal valvotomy combined with cyst wall resection is superior to open surgery in the treatment of popliteal cysts,with less intraoperative blood loss,shorter operation time and hospital stay,lower pain levels,better knee joint function and higher quality of life.

Agriculture, the strategic cornerstone of national long-term stability, is undergoing a fundamental shift from resource-dependent to technology-driven, driven by global food security and ecological conservation needs. Traditional agriculture can no longer sustain the growing food demand. Scientific and technological advancements are fundamental guarantees for ensuring food supply security and are the primary driver for future agricultural development. This special issue compiles the latest research advancements from diverse experts, covering fields such as microbe-driven green agriculture, pesticide technology innovation, intelligent agricultural machinery, smart manufacturing, and molecular design breeding fundamentals. It aims to inspire researchers to explore cutting-edge directions in future agriculture, promote interdisciplinary collaboration and technological integration, and thereby drive innovative breakthroughs and industrial transformation in agricultural modernization.
Agriculture/methods* ; Crops, Agricultural/genetics* ; Food Supply ; Biotechnology ; Pesticides