Hepatocellular carcinoma （HCC） is a malignant tumor with relatively high incidence and mortality rates worldwide， and its therapeutic resistance and recurrence mechanism are closely associated with liver cancer stem cells （LCSC）. This article systematically introduces the biological characteristics of LCSC and their key role in the progression of HCC， reviews the functional characteristics of the specific surface markers （such as EpCAM and CD133） and related signaling pathways （such as Wnt/β-catenin， TGF-β， and STAT3）， elaborates on the interaction between LCSC and tumor microenvironment， and summarizes the latest clinical treatment strategies targeting LCSC and the countermeasure for existing resistance mechanisms. The article points out that LCSC promote tumor development and progression through metabolic reprogramming and immune microenvironment remodeling， and it is proposed to establish a standardized detection system for LCSC specific markers and promote a triple synergistic therapeutic paradigm combining targeted therapy， immune regulation， and traditional chemotherapy， in order to provide new ideas for the clinical intervention of HCC.

Liver cirrhosis is the final stage of the progression of various chronic liver diseases， often accompanied by serious complications and high mortality rates. Recent studies have shown that the interaction between gut microbiota and bile acid metabolism （the gut microbiota-bile acid axis） is closely associated with liver cirrhosis. This article systematically reviews the mechanism of action of the gut microbiota-bile acid axis in the progression of liver cirrhosis， elaborates on the pathological features of liver cirrhosis and its harm to the body， and summarizes the association of the gut microbiota-bile acid axis with the development and progression of liver cirrhosis. It also analyzes the key regulatory role of this axis in the progression of liver cirrhosis and explores its potential application value as a therapeutic target for liver cirrhosis， in order to provide a theoretical basis for exploring more effective clinical intervention methods.

This paper provides a systematic review of the policies, regulations, and management requirements in the development and use of in vitro diagnostic reagents by healthcare institutions, along with their current implementation status both domestically and internationally, and includes a case analysis of the pilot program at Peking Union Medical College Hospital (PUMCH). The Medical Affairs Department of PUMCH, serving as the leading and operational management unit, established a multi-department collaborative governance structure and developed a full-lifecycle management model encompassing project selection, manufacturing approach determination, regulatory submission and approval, batch production, and clinical implementation. Under this management model, the hospital successfully completed five projects within just one year, achieving the highest number of project filings nationwide. Economic benefit evaluation of the first approved reagent, which is urgently required by clinical practice and named allergen-specific immunoglobulin E detection assay for Fraxinus pennsylvanica pollen, demonstrates that the project realized controllable risk and predictable commercial value, and proves that proactive implementation of systematic management model and project systematic construction is the key to successfully advancing laboratory-developed test programs. The experiences provide both theoretical insights and practical guidance for peer medical institutions seeking to develop and implement self-developed in vitro diagnostic reagents.

Autism Spectrum Disorder (ASD) is marked by early-onset neurodevelopmental anomalies, yet the temporal dynamics of genetic contributions to these processes remain insufficiently understood. This study aimed to elucidate the role of the Shank3 gene, known to be associated with monogenic causes of autism, in early developmental processes to inform the timing and mechanisms for potential interventions for ASD. Utilizing the Shank3B knockout (KO) mouse model, we examined Shank3 expression and its impact on neuronal maturation through Golgi staining for dendritic morphology and electrophysiological recordings to measure synaptic function in the anterior cingulate cortex (ACC) across different postnatal stages. Our longitudinal analysis revealed that, while Shank3B KO mice displayed normal neuronal morphology at one week postnatal, significant impairments in dendritic growth and synaptic activity emerged by two to three weeks. These findings highlight the critical developmental window during which Shank3 is essential for neuronal and synaptic maturation in the ACC.
Animals ; Nerve Tissue Proteins/metabolism* ; Mice, Knockout ; Dendrites/metabolism* ; Mice ; Synapses/metabolism* ; Gyrus Cinguli/metabolism* ; Male ; Mice, Inbred C57BL ; Autism Spectrum Disorder/genetics* ; Microfilament Proteins

Objective To investigate the current status of construction and monitoring of healthcare-associated in-fection(HAI)system in maternal and child health care institutions in Guangxi Zhuang Autonomous Region,and provide reference for improving the quality of HAI management.Methods After discussed by members of expert group of HAI Prevention and Control Professional Committee of Guangxi Maternal and Child Health Care Associa-tion,the"Questionnaire on the construction and monitoring of HAI system in maternal and child health care institu-tions in Guangxi Zhuang Autonomous Region"was designed.The questionnaires were distributed to all maternal and child health care institutions in the region via"Questionnaire Star",and a WeChat group was established to ad-dress any questions in questionnaires.Results A total of 104 maternal and child health care institutions were in-cluded in the study,including 6 primary,74 secondary,and 24 tertiary level institutions.All maternal and child health care institutions have established HAI management departments,95.19％(n=99)of institutions held HAI management committee meeting at least once every six months.Among 201 HAI management professionals,most were female(90.55％),with nursing specialty(72.64％),with a bachelor's degree(66.17％),and aged 31-50 years old(73.13％).Only 30.77％of the maternal and child health care institutions had HAI monitoring system.Seventy institutions(67.30％)have carried out the special action of improving the pathogen detection rate before antimicrobial therapy for hospitalized patients,out of which 55(78.57％)were led by the HAI management depart-ment.Ninety-seven(92.27％)maternal and child health care institutions conducted surgery-related monitoring,with 50.96％of institutions relying on manual monitoring;only 30.77％of institutions have carried out the special action of"Strengthening perioperative infection prevention and control to ensure surgical quality and safety".Conclusion HAI management system in maternal and child health care institutions in Guangxi has been basically es-tablished and can carry out monitoring work,but personnel compostion is limited and talent reserve is insufficient.The information construction of HAI monitoring is underdeveloped,with a lagged implement of special action.Ad-ministrative support is needed to enhance infection prevention and control at the grassroots level.All levels of ma-ternal and child health care institutions should communicate and exchange work experience.Hospitals should in-crease their support for the construction of HAI information technology,improve level of HAI monitoring as well as prevention and control capabilities.

As one of the most common and severe complications of diabetic mellitus,diabetic foot ulcers(DFUs)can result in severe tissue damage and dysfunction.Macrophage polarization is an important immune reactions,and the balance of macrophage polarization has remarkable impact on the occurrence,persistence and outcomes of inflammatory reactions.The imbalance of macrophage polarization may aggravate the inflammatory reactions of the diabetic mellitus patients,which therefore exacerbate the symptoms of the DFUs patients and bring more diffi-culties to the treatment.The adjustment of macrophage polarization may facilitate the improvement of symptoms and treatment.The influencing factors for the macrophage polarization and some of potential treatment measures for DFUs targeting the adjustment of macrophage polarization were reviewed in the article.

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Bacterial infection is a major threat to global public health, and can cause serious diseases such as bacterial skin infection and foodborne diseases. It is essential to develop a new method to rapidly diagnose clinical multiple bacterial infections and monitor food microbial contamination in production sites in real-time. In this work, we developed a 4-mercaptophenylboronic acid gold nanoparticles (4-MPBA-AuNPs)-functionalized hydrogel microneedle (MPBA-H-MN) for bacteria detection in skin interstitial fluid. MPBA-H-MN could conveniently capture and enrich a variety of bacteria within 5 min. Surface enhanced Raman spectroscopy (SERS) detection was then performed and combined with machine learning technology to distinguish and identify a variety of bacteria. Overall, the capture efficiency of this method exceeded 50%. In the concentration range of 1 × 10⁷ to 1 × 10¹⁰ colony-forming units/mL (CFU/mL), the corresponding SERS intensity showed a certain linear relationship with the bacterial concentration. Using random forest (RF)-based machine learning, bacteria were effectively distinguished with an accuracy of 97.87%. In addition, the harmless disposal of used MNs by photothermal ablation was convenient, environmentally friendly, and inexpensive. This technique provided a potential method for rapid and real-time diagnosis of multiple clinical bacterial infections and for monitoring microbial contamination of food in production sites.

Objective To analyze the causes and intervention measure efficacy of an outbreak of neonatal Pseudo-monas aeruginosa(P.aeruginosa)infection in a medical institution.Methods The epidemiological investigation was conducted on 5 neonates who had P.aeruginosa infection in the neonatal intensive care unit(NICU)of this medical institution from May 26 to June 10,2024.Specimens were taken from potentially contaminated environ-ments to infer the cause of P.aeruginosa transmission in the NICU,infection control measures were also taken,and the efficacy of the control measures was continuously monitored.Results Among the 5 infected neonates,3 had lower respiratory tract infection and 2 had lower respiratory tract combined with bloodstream infection.Seven strains of P.aeruginosa were detected with a consistent antimicrobial resistance spectrum.Infected neonates were in the same ward and had spatial and temporal clustering.Through environmental hygiene monitoring,P.aerugi-nosa with consistent antimicrobial resistance spectrum of neonatal infection was isolated from the NICU handwashing sink and water-related environment(suction connection pipe,bedside isolation gowns).Infection was controlled af-ter improving sink disinfection methods and enhancing contact isolation measures,and no further P.aeruginosa was detected in the environment.Conclusion The outbreak of neonatal HAI in the NICU is inferred to be caused by contamination of ward handwashing sink by P.aeruginosa,then further contaminated the suction connection tube,thereby leading to the transmission of neonatal infection through suction procedures.Healthcare-associated infection surveillance and control professionals need to fully understand the characteristics of outbreak pathogens and take tar-geted measures to curb the transmission of neonatal infection.

Bacterial infection is a major threat to global public health,and can cause serious diseases such as bacterial skin infection and foodborne diseases.It is essential to develop a new method to rapidly di-agnose clinical multiple bacterial infections and monitor food microbial contamination in production sites in real-time.In this work,we developed a 4-mercaptophenylboronic acid gold nanoparticles(4-MPBA-AuNPs)-functionalized hydrogel microneedle(MPBA-H-MN)for bacteria detection in skin inter-stitial fluid.MPBA-H-MN could conveniently capture and enrich a variety of bacteria within 5 min.Surface enhanced Raman spectroscopy(SERS)detection was then performed and combined with ma-chine learning technology to distinguish and identify a variety of bacteria.Overall,the capture efficiency of this method exceeded 50％.In the concentration range of 1 × 10 7 to 1 × 10 10 colony-forming units/mL(CFU/mL),the corresponding SERS intensity showed a certain linear relationship with the bacterial concentration.Using random forest(RF)-based machine learning,bacteria were effectively distinguished with an accuracy of 97.87％.In addition,the harmless disposal of used MNs by photothermal ablation was convenient,environmentally friendly,and inexpensive.This technique provided a potential method for rapid and real-time diagnosis of multiple clinical bacterial infections and for monitoring microbial contamination of food in production sites.