Sepsis was redefined in 2016 by the updated Sepsis 3.0 criteria as a life-threatening organ dysfunction caused by dysregulated immune response to infection. This revision introduced the sequential organ failure assessment (SOFA) score as one of the key diagnostic criteria, making the diagnosis of sepsis more precise and clinically applicable. Despite significant advancements in the diagnosis and treatment of sepsis, its high incidence, mortality rate, and healthcare costs remain major global public health challenges. The core pathogenesis of sepsis involves severe dysregulation of the host immune response, which further leads to tissue damage and multiple organ dysfunction. Therefore, in-depth research into the immune response mechanisms of sepsis is crucial for optimizing clinical treatment strategies. This article systematically summarizes the characteristics of pathogenic microorganisms in sepsis, its pathogenesis, immune features at various stages, and the challenges faced in clinical treatment. It also explores the potential value of precision medicine in the clinical diagnosis and treatment of sepsis, aiming to provide references for addressing key issues in multidrug resistance and immune mechanism research in sepsis.

Sepsis was redefined in 2016 by the updated Sepsis 3.0 criteria as a life-threatening organ dysfunction caused by dysregulated immune response to infection. This revision introduced the sequential organ failure assessment (SOFA) score as one of the key diagnostic criteria, making the diagnosis of sepsis more precise and clinically applicable. Despite significant advancements in the diagnosis and treatment of sepsis, its high incidence, mortality rate, and healthcare costs remain major global public health challenges. The core pathogenesis of sepsis involves severe dysregulation of the host immune response, which further leads to tissue damage and multiple organ dysfunction. Therefore, in-depth research into the immune response mechanisms of sepsis is crucial for optimizing clinical treatment strategies. This article systematically summarizes the characteristics of pathogenic microorganisms in sepsis, its pathogenesis, immune features at various stages, and the challenges faced in clinical treatment. It also explores the potential value of precision medicine in the clinical diagnosis and treatment of sepsis, aiming to provide references for addressing key issues in multidrug resistance and immune mechanism research in sepsis.

Tooth decay is prevalent, and secondary caries causes restoration failures, both of which are related to demineralization. There is an urgent need to develop new therapeutic materials with remineralization functions. This article represents the first review on the cutting edge research of poly(amido amine) (PAMAM) in combination with nanoparticles of amorphous calcium phosphate (NACP). PAMAM was excellent nucleation template, and could absorb calcium (Ca) and phosphate (P) ions via its functional groups to activate remineralization. NACP composite and adhesive showed acid-neutralization and Ca and P ion release capabilities. PAMAM+NACP together showed synergistic effects and produced triple benefits: excellent nucleation templates, superior acid-neutralization, and ions release. Therefore, the PAMAM+NACP strategy possessed much greater remineralization capacity than using PAMAM or NACP alone. PAMAM+NACP achieved dentin remineralization even in an acidic solution without any initial Ca and P ions. Besides, the long-term remineralization capability of PAMAM+NACP was established. After prolonged fluid challenge, the immersed PAMAM with the recharged NACP still induced effective dentin mineral regeneration. Furthermore, the hardness of pre-demineralized dentin was increased back to that of healthy dentin, indicating a complete remineralization. Therefore, the novel PAMAM+NACP approach is promising to provide long-term therapeutic effects including tooth remineralization, hardness increase, and caries-inhibition capabilities.
Amines ; pharmacology ; Calcium ; Calcium Phosphates ; chemistry ; pharmacology ; Dentin ; chemistry ; Humans ; Nanocomposites ; chemistry ; Nanoparticles ; Tooth Remineralization ; methods

Objective To explore the abilities and personal qualities that medical undergraduates need for their future clinical work, and develop their competency model. Methods The self-made ques-tionnaire survey on medical undergraduates' competencies was conducted among the 1326 medical under-graduates in a medical university by using the cluster sampling method, and the 1099 effective question-naires were collected with effective rates of 82.88%. The exploratory factor analysis was used to analyze the internal structure of competency item and to build the competency model. The rating method was used to calculate the weight of each competency item. Results The overall Cronbach's alpha coefficient of the competency questionnaire was 0.965, and the coefficient of each dimension was above 0.832. The KMO statistic value was 0.970, and the probability associated with Bartlett test statistic was P=0.000, showing that the questionnaire has high reliability and validity. The competency model of medical undergraduates covers six aspects, namely, craftsmanship, personal qualities, professional learning, interpersonal communication, psychological adaptation and the pursuit of excellence, which contain 49 factors. The cumulative variance contribution rate was 54.729%. The weights of these six aspects in the model were 0.204 4, 0.202 1, 0.175 3, 0.158 8, 0.137 6 and 0.121 8 respectively. Conclusion The competency model of undergraduate medi-cal students has a certain scientific and practical value, which can provide new evaluation methods and ideas for medical education objectives, quality assurance, teaching evaluation, medical personnel selection and training.