OBJECTIVE To compare the efficacy and safety of evolocumab and probucol in patients with ultra-high-risk atherosclerotic cardiovascular disease （ASCVD） following percutaneous coronary intervention （PCI）. METHODS A retrospective analysis was conducted on 156 ultra-high-risk ASCVD patients who underwent PCI in our institution between January 1， 2023 and December 31， 2024. According to the lipid-lowering regimen， the patients were categorized into evolocumab group （ n ＝86） and probucol group （ n ＝70）. Changes in lipid parameters [total cholesterol （TC）， low-density lipoprot ein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， triglycerides， lipoprotein （a）， and lipid goal achievement rate ] ， inflammatory markers [interleukin-6 （IL-6） and C-reactive protein （CRP） ] ， and cardiac function indices （left ventricular ejection fraction， left ventricular end-systolic diameter， left ventricular end-diastolic diameter， and N-terminal pro-B-type natriuretic peptide） were compared between two groups at baseline and after 6 months of treatment. The incidence of adverse clinical events during treatment， including acute myocardial infarction， in-stent restenosis， acute heart failure， cerebral hemorrhage， and stroke， was also evaluated. RESULTS No statistically significant differences were observed between the two groups at baseline （ P ＞0.05）. After 6 months of treatment， both groups demonstrated significant improvements in lipid profiles （except HDL-C） and inflammatory markers compared to those at baseline （ P ＜0.05）. The evolocumab group exhibited greater reductions in TC， LDL-C， IL-6， and CRP， along with a higher lipid target achievement rate， compared with the probucol group （ P ＜0.05）. There were no statistically significant differences in the cardiac function-related indicators before and after treatment between the two groups， nor in the incidence of adverse events during the treatment （ P ＞0.05）. CONCLUSIONS For ultra-high-risk ASCVD patients after PCI， both of the above treatment options are associated with improvements in blood lipid and inflammatory response， with good safety during short-term follow-up. Evolocumab shows superior efficacy in TC， LDL-C and inflammatory markers reduction and lipid target achievement， compared to probucol.

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.

Objective: To explore the relationship between snack consumption and depressive symptoms in first year junior high school students with different left behind experiences in Yunnan Province, so as to provide a basis for improving depressive symptoms among first year junior high school students with different left behind experiences. Methods: From October to December 2022,a cluster random sampling method was used to select 8 500 first year junior high school students from 11 ethnic minority areas (Fugong County, Longling County, Longyang District, Luchun County, Mojiang County, Nanjian County, Qiaojia County, Shuangjiang County, Tengchong City, Yuanmou County, Zhenyuan County) in Yunnan Province for a questionnaire survey. The Chinese version of Depression Anxiety Stress Scale-21 was applied to assess depressive symptoms in first year junior high school students, and snack consumption was collected by employing food frequency questionnaire. The generalized linear model was used to analyze the association between first year junior high school students snack consumption and depressive symptoms, and the analysis was stratified according to left behind experience. Results: The detection rates of depressive symptoms among firstyear junior high school students with and without left behind experience were 36.25% and 26.91%, respectively. After controlling for confounding variables, the generalized linear model analysis showed that sweet snacks ( β=0.16, 95%CI =0.07-0.25), fast food ( β=0.14, 95%CI =0.04-0.23) and carbonated drinks ( β=0.09, 95%CI =0.01-0.17) of first year junior high school students with left behind experience (all P <0.05). Compared with those without such behavior, the risk of depressive symptoms was higher in consumption of fast food ( β=0.13, 95%CI =0.07-0.18) and carbonated drinks ( β=0.10, 95%CI =0.06-0.15)among first year junior high school students without left behind experience (both P <0.05). Conclusion Snack consumption among first year junior high school students in Yunnan may increase the risk of developing depressive symptoms, while first year junior high school students with left behind experience may have a greater risk of developing depressive symptoms.

Hepatic fibrosis is a complex dynamic process caused by multiple chronic pathogenic factors， characterized by excessive accumulation of liver extracellular matrix and abnormal liver structure and function. If anti-fibrotic treatment is not performed in time， it can progress to liver cirrhosis and even liver cancer. Hepatic fibrosis has a complex pathogenesis， and previous studies mainly focused on the activation of hepatic stellate cells. Recent studies have shown that myeloid cells have the potential of multi-directional differentiation and can also participate in the development and progression of hepatic fibrosis. This article systematically reviews the role and regulatory mechanism of myeloid cells in hepatic fibrosis， in order to provide a reference for clinical diagnosis and targeted therapy.

Objective: To validate the performance of the Procleix UltrioPlex E assay (Grifols, Spain) on the Procleix Panther automated nucleic acid detection platform, which employs the TMA method to simultaneously detect HIV-1/HIV-2/HCV/HBV/HEV viruses, and to evaluate its value for screening transfusion-associated infectious diseases. Methods: In accordance with the requirements of ISO15189"Application of the Guidelines for the Accreditation of Quality and Capabilities of Medical Laboratories in the Field of Molecular Diagnostics (CNAS-CL02-A009: 2018)", "Guidelines for Performance Validation of Molecular Diagnostic Testing Procedures (CNAS-GL039: 2019)", and the "Technical Operating Procedures for Blood Banks (2019 Edition)", this study validated the reagent's performance in terms of analytical sensitivity validation, performance consistency validation, interference resistance, and cross-contamination resistance. Results: Probit analysis revealed that the 95% detection limits (95% confidence interval) for HBV, HCV, HIV, and HEV were 2.0 IU/mL, 1.5 IU/mL, 18.0 IU/mL and 3.7 IU/mL, respectively, which were consistent with the minimum detection limits stated in the kit's package insert and were comparable to the Procleix Ultrio Elite kit. Both kits were used to test the performance validation serum plate simultaneously, yielding results consistent with the serum plate (Kappa=1), indicating stable performance. Detection of medium-and low-concentration lipemia and weakly positive hemolysis samples demonstrated good interference resistance. Cross-contamination performance validation showed that the kit exhibited excellent cross-contamination resistance. Conclusion: The Procleix UltrioPlex E nucleic acid detection kit enables combined detection of HIV-1, HIV-2, HCV, HBV, and HEV, allowing single-test screening for multiple viruses in donor blood. The kit's analytical performance is stable and meets basic laboratory requirements, making it suitable for screening transfusion-associated infectious diseases in blood banks.

Objective:To investigate the differences in clinical characteristics and antibiotic resistance of neonatal sepsis（NS）caused by different Gram-staining pathogens.Methods:A retrospective study was conducted on confirmed NS cases admitted to the Neonatal Ward of the Pediatric Department at The First Affiliated Hospital of Dali University，from June 1，2014，to May 31，2024.Patients were divided into Gram-positive and Gram-negative groups based on blood or cerebrospinal fluid（CSF）culture results.Clinical characteristics，pathogen distribution，and antibiotic resistance were compared between the two groups.Results:A total of 98 cases were included，with 81 in the Gram-positive group and 17 in the Gram-negative group.Multivariate logistic regression analysis revealed that NS cases with a high neutrophil percentage（ OR=0.933，95% CI：0.899-0.969）or hemorrhagic symptoms/signs（ OR=0.059，95% CI：0.008-0.458）were less likely to have Gram-positive pathogens detected in blood or CSF cultures（ P<0.05）.Common Gram-positive pathogens included Staphylococcus epidermidis with 35 strains（33.65%）and Staphylococcus hominis with 22 strains（21.15%）.The predominant Gram-negative pathogen was Escherichia coli with 14 strains（13.46%）.Gram-positive pathogens exhibited high resistance to oxacillin（91.30%），erythromycin（90.91%），and penicillin G（90.00%），but low resistance to tigecycline（0），linezolid（0），and vancomycin（0）.Gram-negative pathogens showed high resistance to ampicillin（92.31%），cefazolin（90.00%），and ampicillin/sulbactam（75.00%），but low resistance to amikacin（6.25%），latamoxef（0），and ertapenem（0）.The incidence of concurrent purulent meningitis was lower in the Gram-positive group than in the Gram-negative group（9.88% vs.47.06%， χ2=11.628， P<0.05），and there was significant difference. Conclusion:NS cases with high neutrophil percentages or hemorrhagic symptoms/signs are less likely to be caused by Gram-positive pathogens.Staphylococcus epidermidis and Staphylococcus hominis are common Gram-positive pathogens，while Escherichia coli is the predominant Gram-negative pathogen in NS.Both Gram-positive and Gram-negative pathogens exhibit resistance to specific antibiotics.NS caused by Gram-positive pathogens is less likely to be complicated by purulent meningitis compared to those caused by Gram-negative pathogens.

Objective To investigate the predictive value of combined detection of serum myelin basic pro-tein(MBP),creatine kinase isoenzyme(CKBB)and 8-hydroxydeoxyguanosine(8-OHDG)in the prognosis of neonatal hypoxic-ischemic encephalopathy(HIE).Methods A total of 150 neonates with neonatal HIE in the hospital from January 2020 to December 2023 were selected as the observation group,and 60 healthy neonates were selected as the control group.The levels of serum MBP,CKBB,and 8-OHDG were compared between two groups,the correlation between serum MBP,CKBB,and 8-OHDG levels and the severity of the disease was analyzed,clinical data and serum MBP,CKBB,and 8-OHDG levels of neonates with different prognosis were compared,and the influencing factors of neonatal HIE prognosis and the predictive value of MBP,CKBB,and 8-OHDG in the prognosis of neonatal HIE were analyzed.Results The serum levels of MBP,CKBB and 8-OHDG in mild,moderate and severe neonates in observation group were higher than those in control group(P<0.05).Serum levels of MBP,CKBB and 8-OHDG in observation group were positively correlated with the severity of the disease(P<0.05).The Apgar score 1 min after birth in the neonates with poor prognosis was lower than that in the neonates with good prognosis(P<0.05),and the severity of the disease,serum MBP,CKBB and 8-OHDG levels were higher than those in the neonates with good prognosis(P<0.05).Mul-tivariate Logistic regression analysis showed that Apgar score 1 min after birth,serum MBP,CKBB and 8-OHDG were independent influencing factors for the prognosis of neonates with HIE(P<0.05).The area un-der the curve of combined detection of serum MBP,CKBB and 8-OHDG for predicting the prognosis of neo-nates with HIE was 0.941,which was significantly higher than those predicted by each index alone(P<0.05).Conclusion Serum MBP,CKBB and 8-OHDG levels are related to the prognosis of neonates with HIE and the severity of brain injury,and the combination of the three could provide reference for the prognosis e-valuation of neonates with HIE.

Objective To explore the effect of evening primrose oil(EPO)on aortic endothelial damage in rats with polycystic ovary syndrome(PCOS),using network pharmacology and in vivo experiments.Methods The potential targets of EPO for improving aortic endothelial injury in PCOS rats were predicted by network pharmacology,and the selected core targets and renin-angiotensin signaling(RAS)pathway were verified by experiments.Fifty-eight female SD rats were divided randomly into a blank group(n=10)and a modeling group(n=48).Rats in the blank group were fed a normal diet and rats in the modeling group received a high-fat diet for 8 weeks.The PCOS model was prepared at week 6 by administration of letrozole(1 mg/(kg·d))for 21 days.Blood was taken from the tail vein after modeling and serum was collected to detect hormone levels.The model rats were then divided randomly into four groups and treated with the corresponding drugs for 6 weeks.Blood,blood vessels,and ovaries were then collected.Tissue morphology was examined by hematoxylin and eosin staining and serum levels of luteinizing hormone(LH),testosterone(T),follicle-stimulating hormone(FSH),endothelin(ET-1),and tumor necrosis factor(TNF-α)were detected by enzyme-linked immunosorbent assay(ELISA).Serum levels of nitric oxide(NO)were determined by spectrophotometry.Protein expression levels of core targets and RAS pathway-related factors were assessed by western blotting and immunohistochemistry.Results Twenty-five intersection targets of EPO and PCOS were identified by network pharmacological analysis.Kyoto encyclopedia of genes and genomes analysis showed that EPO improved vascular injury in PCOS rats via multiple pathways,including RAS.Serum levels of ET-1,FSH,LH,and T measured by ELISA were significantly decreased after EPO treatment,compared with the model group(P＜0.01).EPO significantly decreased the expression levels of Ang Ⅰ,VEGF-B,AT2R,ET-1,and TNF-α proteins in the aorta(P＜0.01)and significantly increased expression levels of Ang Ⅱ,CD31,and endothelial NO synthase proteins(P＜0.01).Conclusions EPO may ameliorate vascular endothelial injury in PCOS model rats by inhibiting the RAS signaling pathway and by overactivation of the ACE/Ang Ⅱ/AT1 axis.

Objective:To explore the clinical characteristics, treatment and prognosis of hard metal lung disease (HMLD), and to provide a theoretical reference basis for the prevention, control and intervention of HMLD in China.Methods:In April 2024, literatures related to HMLD and giant cell interstitial pneumonia (GIP) published before March 31, 2024 were retrieved in China National Knowledge Infrastructure (CNKI), Wanfang, VIP database, Embase and PubMed. The search terms in Chinese and English included hard metal lung disease, cobalt, tungsten carbide, giant cell interstitial pneumonia, hard metal, etc. Literature was screened and data were extracted. A systematic review was conducted to analyze the clinical characteristics, imaging, pulmonary function, pathological features, treatment and prognosis of HMLD.Results:A total of 55 literatures were included, including 1 cohort study, 4 cross-sectional studies, 4 case series reports and 46 case reports, involving a total of 227 patients with HMLD and GIP. There were 174 male cases, 51 female cases, and 2 cases whose gender was not mentioned. The age was (43.9±13.4) years old, and the dust exposure time was 7 (4, 13) years. The chest images of the patients showed ground glass shadow, micro-nodule shadow, grid shadow, honeycomb shadow, consolidation shadow, etc. Pulmonary function test showed restrictive ventilation dysfunction with gas exchange disorder. The pathological manifestations of lung tissue were typical GIP, but there were also hypersensitivity pneumonitis, common interstitial pneumonia, diffuse alveolar damage, non-specific interstitial pneumonia, and even honeycomb lung. Clinical diagnosis and treatment evaluation were performed by combining the occupational exposure history of hard metal dust or cobalt-containing dust, clinical manifestations, imaging, lung function and histopathology. Treatment involved cessation of exposure, with glucocorticoids alleviating symptoms and improving imaging and pulmonary function.Conclusion:HMLD can be caused by hard metal dust exposure. The clinical symptoms of HMLD are not specific, and the pathology shows typical GIP or other pulmonary interstitial changes. The treatment involves cessation of exposure and administration of glucocorticoids, and the overall prognosis is good.

Objective:To explore the trajectory and influencing factors of dietary adherence at different periods in patients with newly diagnosed type 2 diabetes mellitus (T2DM), so as to provide a reference for dietary management at different periods in patients with newly diagnosed T2DM.Methods:Convenience sampling was used to select 180 patients with newly diagnosed T2DM who attended Diabetes Clinics in three ClassⅢ Grade A hospitals in Henan Province from May 2021 to May 2023 for the study. Patients were surveyed on the day of diagnosis (T1) and at 3 months (T2), 6 months (T3), and 12 months (T4) after diagnosis using General Information Questionnaire, Decisional Balance Scale for Diabetes Diet, Diabetes Distress Scale, Family APGAR Index, and Influence Factors of Dietary Behavior Compliance Scale for Patients with T2DM (T2DM-CFIDBS), respectively. Pearson correlation was used to test the correlation between dietary adherence, diabetes diet decisional balance, diabetes distress, and family care in patients with newly diagnosed T2DM. Multiple linear regression was used to analyze the factors influencing dietary adherence at each time point in patients with newly diagnosed T2DM. A total of 180 questionnaires were distributed, and 162 valid questionnaires were recovered, with a valid recovery rate of 90.00% (162/180) .Results:CFIDBS scores of patients with newly diagnosed T2DM at the four time points were (69.14±9.97), (61.98±8.82), (60.09±8.97), and (63.29±9.98), respectively. Body mass index and diabetes distress had an impact on patients' dietary adherence at T1, T2, T3, and T4 ( P<0.05). Perceptual deficits had an impact on dietary adherence at T1, T2, and T3 ( P<0.05). Family care had an impact on dietary adherence at T1 and T2 ( P<0.05). Perceived benefit had an impact on dietary adherence only at the T3 ( P<0.05). Education level and work status only had an impact on dietary adherence at the T4 ( P<0.05). All of these differences were statistically significant. Conclusions:Dietary adherence in patients with newly diagnosed T2DM shows a trend of decreasing and then increasing over time, and there are differences in the influencing factors at different times. Healthcare professionals should pay attention to the trajectory and influencing factors of dietary adherence in patients with newly diagnosed T2DM, and develop targeted interventions to improve patients' dietary adherence and diabetes prognosis.