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.

AIM: To explore the application effect of eyelid margin incision combined with floating bridge technique in the treatment of ptosis patients, and to analyze its effects on the margin reflex distance 1(MRD1)and the aesthetic effect of the eyes. METHODS:Prospective study. This study enrolled patients with blepharoptosis treated at the Department of Ophthalmology of the hospital between January 2023 and July 2025, who were assigned to either an observation group or a control group. The patients in the control group received levator aponeurosis shortening surgery through conventional double-eyelid incision, while the patients in the observation group underwent levator aponeurosis shortening surgery using the eyelid margin incision combined with floating bridge technique. Subsequently, the surgical-related indicators,the correction effect of ptosis, the aesthetic effect, the ocular function indicators, the postoperative complication occurrence rate, and recurrence rate were compared and analyzed between two groups.RESULTS:A total of 100 patients(100 eyes)with blepharoptosis were enrolled in this study, with 50 patients(50 eyes)in the observation group and 50 patients(50 eyes)in the control group. The observation group had a mean age of 27.33±5.32 y, including 20 males and 30 females. The control group had a mean age of 27.64±4.66 y, including 24 males and 26 females. Compared with the control group, the operative time of the observation group was longer, the postoperative swelling resolution time and natural recovery time were shorter,and the correction rate was higher(P<0.05). Three months after the surgery, the VSS score and POSAS score of the observation group were lower than those of the control group, while the scores for eyelid curvature, symmetry of eyelid height, and the PFH, MRD1, palpebral fissure size, and upper eyelid levator muscle strength were all higher than those of the control group(all P<0.05). However, there was no significant difference in postoperative complication occurrence rate and recurrence rate between two groups(all P>0.05).CONCLUSION:The combined use of eyelid margin incision and floating bridge technique for treating ptosis results in slightly longer operation time, but it can shorten the postoperative recovery period, effectively ameliorate the MRD1 and ocular function of patients, and enhance the correction effect and aesthetic quality of the eyes. In addition, it has a low incidence of complications and guaranteed safety.

Objective To explore the characteristics of coagulation and immune function and their clinical significance in children with severe adenovirus pneumonia(SAP).Methods A total of 122 children with SAP and 120 children with non-severe adenovirus pneumonia(NSAP)were enrolled and assigned to severe group and non-severe group.The severe group was further subdivided into good prognosis subgroup(n=105)and poor prognosis subgroup(n=17)according to prognosis.Addition-ally,120 healthy children undergoing physical examination during the same period were included as control group.Coagulation function indicators,including prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),and thrombin time(TT)were measured.Levels of immunoglobulin A(IgA),immunoglobulin G(IgG),and immunoglobulin M(IgM)were determined using the nephelometric immunoassay.Multivariate Cox regression analysis was conducted to explore the influencing factors of poor prognosis.Results Compared with the control group,children in both the non-severe and severe groups exhibited increased levels of white blood cells(WBC),neutrophils(N),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),interleukin-6(IL-6),procalci-tonin(PCT),FIB,and IgG,as well as decreased levels of B lymphocytes,natural killer(NK)cells,PT,APTT,IgA,and IgM(P＜0.05).Compared with the non-severe group,children in the severe group showed increased levels of WBC,N,CRP,ESR,IL-6,PCT,FIB,and IgG,as well as decreased levels of B lymphocytes,NK cells,PT,APTT,IgA,and IgM(P＜0.05).Compared with the good prognosis subgroup,the poor prognosis subgroup exhibited increased levels of CRP,IL-6,PCT,and IgG,as well as decreased levels of APTT,IgM,and IgA(P＜0.05).The results of multivariate Cox regression analysis showed that PCT,APTT,and IgM were influencing factors of poor prognosis in children with SAP(P＜0.05).Conclusion Children with SAP have decreased levels of PT,APTT,IgA,and IgM,as well as increased levels of FIB and IgG.Coagulation and im-mune function indicators are correlated with the prognosis of SAP.

OBJECTIVE: To explore and quantify the association of hot night exposure during the sperm development period (0-90 lag days) with semen quality. METHODS: A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014-2020 were recruited in this multicenter study. Two indices (i.e., hot night excess [HNE] and hot night duration [HND]) were used to estimate the heat intensity and duration during nighttime. Linear mixed models were used to examine the association between hot nights and semen quality parameters. RESULTS: The exposure-response relationship revealed that HNE and HND during 0-90 days before semen collection had a significantly inverse association with sperm motility. Specifically, a 1 °C increase in HNE was associated with decreased sperm progressive motility of 0.0090 (95% confidence interval [ CI]: -0.0147, -0.0033) and decreased total motility of 0.0094 (95% CI: -0.0160, -0.0029). HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021 (95% CI: -0.0040, -0.0003) and 0.0023 (95% CI: -0.0043, -0.0002), respectively. Consistent results were observed at different temperature thresholds on hot nights. CONCLUSION Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.
Humans ; Male ; Semen Analysis ; Adult ; Sperm Motility ; Hot Temperature/adverse effects* ; China ; Middle Aged ; Spermatozoa/physiology* ; Young Adult

The oropouche virus (OROV) poses a threat to pregnant women and fetuses, potentially causing fetal neurological defects and even stillbirth, which has caused global attention. OROV is an arthropod-borne virus belonging to the Orthobunyavirus genus in the Bunyavirales order, primarily transmitted by arthropods and causing oropouche fever. This article reviews the etiological characteristics, epidemiological distribution, clinical symptoms, detection methods, and prevention strategies of OROV. OROV is prevalent in Central and South America, with a sharp increase in cases reported in Brazil in 2024. The virus's symptoms resemble those of several other arthropod-borne viral diseases, which can lead to misdiagnosis. Currently, there are no specific drugs or vaccines available, and treatment is mainly supportive. Culicoides paraensis and Culex quinquefasciatus are among the significant vectors of OROV. Furthermore, the article analyzes the distribution of Culex quinquefasciatus in China, highlights the risk of imported cases, proposes targeted prevention and control strategies, and underscores the significance of international cooperation in disease prevention and control.

Objective To predict the potential suitable areas of Cyperus rotundus L.in China;To provide a theoretical basis for the protection of wild resources of Cyperus rotundus L.and its artificial cultivation.Methods The data of 732 sample points were collected,combined with the data of 36 environmental factors,and the feature combination and regularization multiplier parameters were optimized using R 3.6.3.The MaxEnt model and geographic information system software ArcGIS 10.4.1 were used to analyze the distribution of the main environmental factors affecting the distribution of the suitability and the distribution of the suitable areas of Cyperus rotundus L.Results The main environmental factors that significantly affected the distribution of the suitability of Cyperus rotundus L.were minimum temperature of coldest month,precipitation of driest month,mean temperature of wettest quarter,mean temperature of warmest quarter,and precipitation of warmest quarter.The highly suitable areas of Cyperus rotundus L.are mainly located in Hainan,Guangdong,Guangxi,western and southern Taiwan,southern Yunnan,southern Tibet,east-central Hubei,eastern Hunan,northern Anhui,and central Jiangxi.Conclusion The results of this study can provide references for the sustainable development of wild resources,artificial cultivation optimization,planting site selection and management.

In the context of the new medical reform,the formation mechanism of drug prices is one of the important is-sues of this round of medical reform.Drug prices involve the interests of drug companies,hospitals,patients,and other parties,so it is particularly important to establish a reasonable mechanism for the formation of drug prices to safeguard the interests of all parties.This paper first analyzes the characteristics of drugs and the drug market,and then discusses the actual situation and challenges faced by the formation mechanism of drug prices.On this basis,it proposes basic principles for drug pricing and opti-mization recommendations for the formation mechanism of drug prices in the context of the new medical reform.This can provide a reference for the country to formulate relevant drug price policies and promote the rational development of drug prices.

ObjectiveTo investigate the prevalence of cardiovascular diseases and their influencing factors in community-based schizophrenia patients in Shanghai, and to provide a scientific basis for the early identification and prevention of cardiovascular disease in this population. MethodsBased on the Shanghai community cohort with severe mental disorders in 2022, a total of 3 954 community-based schizophrenia patients were identified and included in this study through a stratified cluster sampling method. Basic information and relevant clinical data (including metabolic index data) were collected through questionnaire survey, physical examination and laboratory testing. Univariate analyses were performed using the chi-square tests, and multivariate logistic regression analyses were employed to identify influencing factors of comorbid cardiovascular diseases. ResultsA total of 3 954 community-based schizophrenia patients were included, of which a total of 1 237 (31.28%) patients had comorbid cardiovascular diseases. Multivariate logistic regression analyses showed that age 60 years old or above (OR=5.524, 95%CI: 3.716‒8.214), smoking behavior (OR=1.328, 95%CI: 1.042‒1.692), overweight (OR=1.900, 95%CI: 1.046‒3.451) or obesity (OR=2.678, 95%CI: 1.439‒4.985), elevated blood pressure (OR=1.546, 95%CI: 1.294‒1.846), abnormal fasting blood glucose (OR=1.552, 95%CI: 1.322‒1.823) and high-density lipoprotein cholesterol abnormalities (OR=1.283, 95%CI: 1.025‒1.606) were positively associated with the risk of comorbid cardiovascular diseases in patients with schizophrenia, while educational attainment of college/bachelor’s degree or above (OR=0.640, 95%CI: 0.450‒0.910) and being unmarried (OR=0.552, 95%CI: 0.457‒0.667) were negatively associated with the risk of cardiovascular diseases comorbidity. ConclusionAdvanced age, unhealthy behaviors and lifestyles, as well as abnormalities in blood pressure, blood glucose, and blood lipids, could all increase the risk of comorbid cardiovascular diseases in community schizophrenia patients. It is suggested to strengthen the monitoring and management of these risk factors in this population in the future, so as to achieve early detection, early diagnosis and early intervention of cardiovascular diseases.

Objective:To investigate the role and mechanism of protein arginine methyltransferase 7(PRMT7)in muscle inflamma-tion,oxidative stress,and fibrosis in Duchenne muscular dystrophy mice.Methods:In this study,C57BL/6 wild-type mice were used as the control group,mdx mice as the model group of Duchenne muscular dystrophy,and mdx mice injected with AAV9-PRMT7 by the caudal vein as the experimental group.The levels of inflammatory factors were measured by an enzyme-linked immunosorbent assay.Oxidative stress-related indicators were measured using commercial kits.Masson staining was performed to assess the fibrosis degree of the gastrocnemius.The expression of PRMT7,peroxisome proliferator-activated receptor gamma coactivator-1 alpha(PGC-1α),and nuclear factor erythroid 2-related factor 2(Nrf2)was analyzed by a Western blot assay.The arginine methylation level of PGC-1α was determined by an immunoprecipitation assay.Results:PRMT7 expression was significantly reduced in the gastrocnemius of mdx mice(0.67±0.03,F=70.764,P=0.001).The up-regulation of PRMT7 resulted in significant decreases in the levels of inflammatory factors(interleukin-1β:167.87±13.25,F=407.751,P<0.001;tumor ne-crosis factor-α:1071.54±46.63,F=55.996,P=0.048)and signifi-cant improvements in the oxidative stress and fibrosis status in the gastrocnemius of mdx mice(reactive oxygen species:1.16±0.03,F=86.820,P=0.008;malondialdehyde:66.11±3.84,F=228.175,P=0.001;glutathione/oxidized glutathione:2.53±0.06,F=499.962,P<0.001;fibrosis area:10.33±0.47,F=604.272,P=0.002),an in-crease in the arginine methylation level of PGC-1α,and significant increases in protein levels of PGC-1α and Nrf2(PGC-1α:1.94±0.11,F=31.565,P=0.038;Nrf2:1.53±0.12,F=140.761,P<0.001).Conclusion:Increasing PRMT7 expression attenuates the inflam-mation,oxidative stress,and pathological state of fibrosis in the gastrocnemius of mdx mice.Thses effects may be achieved through the PGC-1α/Nrf2 pathway.