Extramammary Paget disease (EMPD) is an intraepidermal adenocarcinoma that predominantly occurs in apocrine gland-rich regions such as the vulva and perianal area. It commonly presents clinically as erythematous and pruritic plaques. The disease is categorized into primary and secondary types: the former often arises from abnormal differentiation of epidermal or adnexal cells, while the latter is frequently associated with underlying malignancies of the gastrointestinal or genitourinary tracts. Differentiation between the two subtypes relies on immunohistochemical markers and endoscopic examinations. This article provides a systematic review of recent advances in the epidemiology, pathogenesis, diagnosis, and treatment of EMPD. Epidemiological studies indicate variations in incidence influenced by geographic region and gender. Research on pathogenesis has revealed potential driver mutations in genes such as ERBB2 and PIK3CA. In terms of diagnosis, the combined use of immunohistochemical markers plays a crucial role in subtype classification and differential diagnosis. Regarding treatment, Mohs micrographic surgery is the preferred option for localized lesions, while photodynamic therapy, imiquimod, and radiotherapy are applicable in selected cases. For metastatic disease, targeted therapies against HER2 and the PIK3CA/AKT pathway offer promising new directions. Comprehensive and individualized treatment strategies are essential for improving patient prognosis.

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 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.

Extramammary Paget disease (EMPD) is an intraepidermal adenocarcinoma that predominantly occurs in apocrine gland-rich regions such as the vulva and perianal area. It commonly presents clinically as erythematous and pruritic plaques. The disease is categorized into primary and secondary types: the former often arises from abnormal differentiation of epidermal or adnexal cells, while the latter is frequently associated with underlying malignancies of the gastrointestinal or genitourinary tracts. Differentiation between the two subtypes relies on immunohistochemical markers and endoscopic examinations. This article provides a systematic review of recent advances in the epidemiology, pathogenesis, diagnosis, and treatment of EMPD. Epidemiological studies indicate variations in incidence influenced by geographic region and gender. Research on pathogenesis has revealed potential driver mutations in genes such as ERBB2 and PIK3CA. In terms of diagnosis, the combined use of immunohistochemical markers plays a crucial role in subtype classification and differential diagnosis. Regarding treatment, Mohs micrographic surgery is the preferred option for localized lesions, while photodynamic therapy, imiquimod, and radiotherapy are applicable in selected cases. For metastatic disease, targeted therapies against HER2 and the PIK3CA/AKT pathway offer promising new directions. Comprehensive and individualized treatment strategies are essential for improving patient prognosis.

Eight new C-diterpenoid alkaloid arabinosides, named aconicarmichosides E-L (-), were isolated from an aqueous extract of the lateral roots of (Fu Zi). Their structures were determined by spectroscopic and chemical methods including 2D NMR experiments and acid hydrolysis. Compounds -, together with the previously reported four neoline 14--arabinosides from the same plant, represent the only examples of glycosidic diterpenoid alkaloids so far. At a dose of 1.0 mg/kg (i.p.), as compared with the black control, compounds , , and - exhibited analgesic effects with >65.6% inhibitions against acetic acid-induced writhing of mice. Structure-activity relationship was also discussed.

In order to find the anti-virus constituents of Alternanthera philoxeroides (Mart.) Griseb, the investigation was carried out. The paper reported the five triterpenoid saponins isolated from n-BuOH fraction: 3-O-beta-D-glucopyranosyl (1-->3)-O-[beta-D-glucopyranosyl-oleanolic acid]-28-O-beta-D-glucuronopyranoside (1), oleanolic acid-3-O-beta-D-glucuronopyranoside (calenduloside E, 2), oleanolic acid-3-O-beta-D-glucopyranosyl-28-Obeta-D-glucopyranosyl ester (chikusetsusaponin-IVa, 3), 3-O-(6'-O-butyl-beta-D-glucuronopyranosyl)-oleanolic acid-28-O-beta-D-glucopyranosyl ester (4) and hederagenin-3-O-beta-D-glucuronopyranoside (HN-sapoins K, 5). 1 is a new compound, saponins 4 and 5 were isolated from the plant for the first time.

Objective To investigate vascular endothelial growth factor(VEGF) and TNF-α levels in the serum of patients with primary hepatocellur carcinoma(HCC),and to evaluate their relevance with the development and metastasis of HCC.Methods VEGF and TNF-α levels in serum were examined by enzyme linked immunosorbent assay(ELISA) technology in 87 patients with HCC and 10 healthy individuals.Results Serum VEGF and TNF-α,levels in HCC patients were significantly higher than that in the contorl group.In addition,HCC patients infected with hepatitis virus(including HBV and HCV) showed a remarkable elevation in serum VEGF and TNF-α levels.The VEGF and TNF-α levels in HCC with metastasis were also higher than those without metastasis.Conclusion The serum VEGF and TNF-α levels in HCC patients might serve as the pivotal biological indices that could reflect HCC progressien and metastasis.