ObjectiveTo develop a full-process data platform of renal rehabilitation, diagnosis and quality control information. MethodsA hierarchical architectural design was proposed, adhering to clinical pathway models and standardized data protocols. The platform comprehensively covered assessment, intervention, follow-up and quality control for maintenance hemodialysis (MHD) patients. By integrating multidisciplinary resources and standardizing rehabilitation workflows, it delivered standardized and intelligent rehabilitation services. ResultsThe platform achieved standardized and intelligent management of rehabilitation services, effectively improved the physiological function, psychological state and quality of life convenience for MHD patients, while significantly reduced the economic and care burden on patients' families and society. ConclusionThe rehabilitation service model based on a full-process data platform may provide scientific and systematic support for MHD patients.

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 explore the effect and mechanism of USP7 on immune and inflammatory response of EV71 infection.Methods:THP-1 cells were induced to differentiate into t-Mφ cells by PMA,cells were treated by targeted USP7 inhibitor P22077,and divided into DMSO control group and P22077 experimental group,and infected with EV71.ELISA was used to detect supernatant concentration of IL-6,CCL3,TNF-α of cells separately.RT-qPCR was used to detect RNA expression of EV71-VP1,plaque test was used to detect virus titer in cell supernatant.Western blot was used to detect expressions and phosphorylation of molecules related to innate immune signaling pathway.Full-length plasmid Myc-USP7 and Flag-MDA5 were constructed and transfected into HEK293T cells,and Co-IP was used to detect external interaction between USP7 and MDA5 with Myc antibody and Flag antibody,respectively.Infected t-Mφ cells with EV71,and Co-IP detection of their interaction by USP7 and MDA5 antibodies,respectively.t-Mφ cells of DMSO control group and P22077 experimental group were infected with EV71,CHX test was used to detect expression of MDA5 and downstream related molecules.Transfected Flag-MDA5,Myc-USP7,HA-Ub or HA-K48 plasmids,Co-IP detection of ubiquitination and ubiquitination types of MDA5 regulated by USP7 with Flag antibody.Co-IP detection of MDA5 ubiquitination types regulated by USP7 in t-Mφ cells by using MDA5 antibodies.Results:After infected with EV71 and inhibited of USP7,mRNA and protein expres-sions of IL-6,CCL3 and TNF-α were decreased(P<0.05),while EV71 replication(P<0.05),and titer increased;expression of MDA5,and activation of p-IKKα/β,p-IκBα and p-p65 in innate immunity signal pathway decreased.Interaction between USP7 and MDA5 could inhibit MDA5 degradation by inhibiting K48 ubiquitination of MDA5.Conclusion:USP7 stabilizes MDA5 expression by inhibiting K48 ubiquitination of MDA5,thereby positively regulating EV71 infection immunity and inflammatory response.

Objective To analyze the efficacy and safety of different doses of esketamine for laparoscopic high hernia sac ligation in school-age children.Methods The school-age children who underwent laparoscopic high ligation of hernia sac were divided into small-dose group and conventional-dose group according to cohort method.The conventional-dose group was given intravenous 0.75 mg·kg-1 esketamine hydrochloride injection to prepare for induction;the small-dose group was given intravenous 0.50 mg·kg-esketamine hydrochloride injection to prepare for induction,and the two groups were given the same anesthesia induction,anesthesia maintenance and postoperative analgesia.The recovery time,laryngeal mask removal time,anesthesia recovery room residence time,children face,legs,activity,cry,consolability behavioral tool(FLACC)score of the children in the two groups were observed,the hemodynamic indexes were recorded at the time of entry(T1),before anesthesia induction(T2),immediately after laryngeal mask placement(T3),and the safety was evaluated.Results A total of 39 cases and 43 cases children were included in the conventional-dose group and the small-dose group,respectively.After treatment,the recovery time of conventional-dose group and small-dose group were(26.36±3.91)and(23.21±3.55)min;the time of removing laryngeal mask were(13.02±2.15)and(12.24±2.30)min;the retention time of postanesthesia care unit(PACU)were(37.23±5.64)and(32.11±5.36)min;the scores of FLACC were(2.08±0.45)and(2.16±0.51)points,respectively.At T1,T2 and T3,the heart rate(HR)of the conventional-dose group were(99.23±15.78),(102.19±17.20)and(118.30±14.96)beat·min-1;that of the small-dose group were(99.93±16.27),(103.28±16.75)and(120.19±15.39)beat·min-1,respectively.The mean arterial pressure(MAP)of the conventional-dose group were(84.56±7.22),(85.92±6.96)and(89.89±7.02)mmHg;that of the small-dose group were(84.88±6.87),(86.16±6.45)and(91.12±7.31)mmHg,respectively.There were statistically significant differences in the recovery time and PACU retention time between the small-dose group and the conventional-dose group(all P＜0.05).The adverse drug reactions in the two groups mainly included nausea and vomiting,increased secretions and transient hypertension.The incidence of total adverse drug reactions in the conventional-dose group and the small-dose group were 10.26％and 4.65％,respectively,with no statistical significance(P＞0.05).Conclusion Small-dose esketamine hydrochloride injection can effectively maintain hemodynamic stability in the preoperative intravenous administration of school-age children undergoing laparoscopic high ligation of hernia sac,and the effect of reducing postoperative pain and inhibiting agitation during the recovery period is comparable to that of conventional-dose,with good safety.

Informal caregivers play an important role in chronic disease management, and their level of caregiver activation directly affects the quality of care and health outcomes of patients with chronic diseases. This article summarizes the concept, assessment tools, current status, influencing factors, and interventions of caregiver activation among informal caregivers of patients with chronic diseases, aiming to provide a reference for research on caregiver activation.

Objective:To investigate the effect of physical activity on mortality risk in patients with chronic obstructive pulmonary disease (COPD) in Sichuan Province.Methods:Based on baseline data from 2004 to 2008 from the China Kadoorie Biobank project site in Pengzhou City, Sichuan Province, a total of 8 501 COPD patients aged 30-79 years were enrolled and followed up for a long period to determine mortality outcomes. Quartiles were used to group physical activity levels. The Cox proportional hazards regression model was used to analyze the effect of physical activity level on mortality outcomes.Results:As of December 31, 2017, the cumulative follow-up of the participants totaled 85 600.58 person-years (mean follow-up duration: 10.07 years). During this period, a total of 2 000 deaths were recorded, yielding a cumulative mortality rate of 23.53%. Among these deaths, 665 were attributed to COPD, corresponding to a cumulative mortality rate of 7.82%; and 1 116 were attributed to cardiovascular and cerebrovascular disease (CVD), corresponding to a cumulative mortality rate of 13.13%. The Cox proportional hazards regression model analysis revealed that, after adjusting for confounding factors, total physical activity was associated with a reduced risk of mortality from COPD, CVD, and all causes in patients with COPD. Compared with the low-level group of total physical activity, the medium-high-level group had the lowest risk of COPD mortality, with an HR of 0.39 (95% CI: 0.30-0.49). The high-level group had the lowest risk of CVD death and all-cause death, with HRs of 0.46 (95% CI: 0.37-0.56) and 0.55 (95% CI: 0.48-0.64), respectively. The lowest risk of COPD death and CVD death was found in the medium-high level of work-based physical activity group, with HRs of 0.36 (95% CI: 0.28-0.46) and 0.43 (95% CI: 0.36-0.51), respectively; the risk of all-cause mortality was lowest in the medium-high and high-level groups, with HRs values of 0.53 (95% CI: 0.46-0.61) and 0.53 (95% CI: 0.45-0.61). The risk of COPD death was lowest in the high-level transportation physical activity group, with an HR of 0.66 (95% CI: 0.53-0.83), and the risk of CVD and all-cause death was lowest in the medium-high level group, with HRs of 0.63 (95% CI: 0.53-0.76) and 0.73 (95% CI: 0.64-0.84), respectively. The risk of COPD death and CVD death was the lowest in the high-level domestic physical activity group, with HRs of 0.66 (95% CI: 0.49-0.89) and 0.76 (95% CI: 0.61-0.95), respectively, and the risk of all-cause death was the lowest in the medium-high level group, with an HR of 0.82 (95% CI: 0.72-0.94). There is no statistical association between leisure physical activity and the risk of death from three types of diseases. Conclusions:Total physical activity, including work-based, transportation-based, and domestic physical activity, reduced the risk of COPD, CVD, and all-cause mortality in patients with COPD in Sichuan Province. The magnitude of mortality risk was influenced by the type and level of physical activity.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

To investigate the molecular mechanisms underlying the mechanosensitive ion channel PI-EZO2 in osteoarthritis(OA),we developed a lentiviral vector for endogenous PIEZO2 overexpression and established a stable PIEZO2-high-expressing immortalized human primary chondrocyte line.By map-ping the open reading frame of the PIEZO2 locus and designing sequence-specific sgRNA,we employed the CRISPR/Cas9 synergistic activation mediator(SAM)system to precisely integrate transcriptional ac-tivation elements into the PIEZO2 promoter region.Lentiviral-mediated targeted genomic integration en-sured endogenous PIEZO2 overexpression,confirmed by mCherry fluorescence tracing coupled with flow cytometric sorting,which revealed membrane-specific localization of PIEZO2 protein(localization effi-ciency:78.49％).Quantitative PCR demonstrated a 17-fold upregulation of PIEZO2 mRNA,while Western blotting validated enhanced membrane-localized protein expression.Strikingly,PIEZO2-overex-pressing chondrocytes exhibited hallmark OA metabolic phenotypes compared to wild-type controls:typeⅡ collagen mRNA expression decreased to 50％of baseline levels,whereas matrix metalloproteinase 13(MMP13)mRNA surged by 20-fold.These alterations recapitulated the pathological matrix metabolic phenotype observed in biomechanical OA models induced by cyclic mechanical stress(10％strain,0.5 Hz,8 h/day for 2 consecutive days).Collectively,we successfully generated a human chondrocyte model with stable PIEZO2 overexpression,which faithfully mirrors mechanotransduction-driven OA progression.This engineered cellular system provides a robust platform for dissecting PIEZO2-mediated mechanosig-naling networks and advancing targeted therapeutic discovery.

Objective To analyze the global literature related to functional cure of hepatitis B from 2019 to 2023 by using bibliometric analysis methods,so as to help researchers understand the research hotspots and trends in this field.Methods The literature related to the topic of functional cure of hepatitis B included in the Science Citation Index Expanded(SCI-Expanded)of the Web of Science Core Collection from 2019 to 2023 was searched.By using VOSviewer and CiteSpace visual analysis tools,analyses were conducted from the perspectives of publication trends,international research cooperation networks,and keyword emergence,and were elaborated with the specific contents of the related literature to elucidate research hotspots and trends.Results A total of 600 eligible papers in this field were included.Keyword co-occurrence and thematic clustering suggested that the main research directions of functional cure were:serum biomarkers for prediction and monitoring of functional cure,functional cure and immunity,nucleoside analog discontinuation,interferon therapy,and long-term prognosis of functional cure.The research contents of the ESI highly cited original research papers were similar to the clustering of the above,but showed more attention on the novel agents for functional cure.The content of the keyword emergence map showed that hotspots of interest changed from virologic mechanisms and serum markers,to nucleoside analog discontinuation and interferon therapy,and finally to immunologic mechanisms and new drug.Conclusion The research hotspots and trends of functional cure of hepatitis B were focused on virological mechanism,serum markers,immunological mechanism,nucleoside analog discontinuation,interferon therapy,and long-term prognosis after cure.