Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is the primary cause of mortality in sepsis, with its core pathophysiological mechanism being severe ischemia and hypoxia in critical units—composed of microcirculation and the mitochondria of functional cells—resulting from disruptions in blood flow and oxygen flow following a dysregulated host response. Due to the systemically convergent yet clinically heterogeneous nature of the host response, current understanding and management strategies for hemodynamics remain inconsistent, often leading to inadequate resuscitation or overtreatment. To improve the quality of care, based on a systematic review of the "blood flow-oxygen flow" theory, an expert panel emphasizes reevaluating septic shock from an integrated perspective of blood flow and oxygen flow, and has formulated the Expert Consensus on Blood Flow and Oxygen Delivery Phenotyping and Clinical Management of Septic Shock (2025). The consensus proposes that clinical typing of blood flow-oxygen flow should comprehensively consider cardiac function, vascular tone, oxygen flow utilization status in critical units, and disease trajectory, while optimizing subtype identification by integrating host response phenotypes and artificial intelligence technologies. It advocates establishing a continuous assessment system through multi-site oxygen flow monitoring for organ perfusion, peripheral perfusion monitoring, and critical care ultrasound. Under the framework of the "critical care triangle", the consensus promotes the implementation of individualized, bundled management strategies, providing guidance for multiple management points to restore blood flow-oxygen flow matching, reduce the risk of organ failure, and decrease patient mortality.

Objective:To analyze the incidence and risk factors of malignant tumors among HIV-infected patients in Taizhou, Zhejiang Province.Methods:The data were collected from the China Information System for Disease Control and Prevention and the Taizhou Chronic Disease Information Management System. A retrospective cohort study design was used. The subjects were HIV-infected patients who had their household registration in Taizhou from 2005 to 2023 and participated in the follow-up. The observation period was until December 31, 2024. The standardized incidence ratios (SIR) of malignant tumors among HIV-infected patients were analyzed. Cox proportional hazards regression model was used to analyze the influencing factors of malignant tumor incidence.Results:A total of 3 593 HIV-infected patients were included, of whom 292 had malignant tumors. The proportions of AIDS-defining malignancies and non-AIDS-defining malignancies were 12.33% (36/292) and 87.67% (256/292), respectively. The proportion of malignant tumors before and after AIDS confirmation was 43.49% (127/292) and 56.51% (165/292), respectively. 3 466 HIV-infected patients were included in the follow-up cohort, with a total follow-up of 24 968.59 person-years. The incidence rate of malignant tumors in patients with HIV infection was 658.46 per 100 000 (SIR=1.89, 95% CI: 1.61-2.20). The SIR of malignant tumors showed an upward trend with the increase of time. The results of Cox proportional hazards regression model analysis showed that HIV-infected patients in the age groups of 45-59 and ≥60 years (a HR=2.58, 95% CI: 1.26-5.28; a HR=5.00, 95% CI: 2.38-10.51) were more likely to develop malignant tumors. HIV-infected patients with an educational level of senior high school or above (a HR=0.52, 95% CI: 0.29-0.95) and those in the first CD4 +T lymphocyte/CD8 +T lymphocyte count ratio ≥0.5 (a HR=0.52, 95% CI: 0.28-0.97) were less likely to develop malignant tumors. Conclusions:From 2005 to 2023, the incidence of malignant tumors among HIV-infected people in Taizhou was higher than that of the general population, and most of them were non-AIDS-defining malignancies. It is necessary to strengthen the early screening and diagnosis of malignant tumors among HIV-infected patients.

This article explores the construction and practice of the"Party Building+Health Science Popularization"model,using the"Yixian Health Science Popularization Guangdong Tour"campaign conducted by Sun Yat-sen Memorial Hospital as a case study.The initiative has achieved remarkable results.Additionally,it summarizes innovative measures,as well as uni-versal and exemplary experiences,providing new insights and pathway recommendations for public hospitals to develop the"Party Building+Health Science Popularization"model.

Objective:To explore a systematic training for quick identification for diagnosis and treatment of the causes of reversible cardiac arrest,which was assisted by bedside ultrasound simulator combined with memory mnemonic,so as to improve the treatment skill of physicians for the causes of disease,and enhance the success rate of cardiopulmonary resuscitation.Methods:Thirty clinical resident doctors who were rotating in the emergency intensive care unit(ICU)of Xuanwu Hospital,Capital Medical University,from May 2023 to May 2024 were selected.The bedside ultrasound simulator combined with memory mnemonic was used to simulate training,which can improve the ability of resident doctors in quickly determining the cause of reversible cardiac arrest.The self-made questionnaire was used to investigate the baseline situation of resident doctors before they were trained,and the teaching effectiveness after they received training.After training,the grasping states of resident doctors for the cause of reversible cardiac arrest were detected through 10 kinds of clinical cases included pulmonary embolism,myocardial infarction,aortic dissection,pericardial tamponade,ventricular fibrillation,electrolyte disturbance,hypovolemic shock,tension pneumothorax,poisoning and hypothermia.Results:The duration of quick retelling of resident doctors for the causes of reversible cardiac arrest was(15.07±3.68)s after training,which was lower than(47.27±10.25)s before training,and the difference was significant(t=14.763,P<0.05).The awareness rate of them for the causes of reversible cardiac arrest was 100%after training,which was significantly higher than 3.33%before training,and the difference was significant(x2=56.129,P<0.05).The identification of resident doctor for ultrasonic image was zero basis before training,and the identification rate was 0%.All of resident doctors can achieve 100%identification for routine ultrasound,cardiac arrest,pericardial tamponade and ventricular fibrillation within the simulator after training,and the correct recognition rates of them for pulmonary embolism,tension pneumothorax,acute myocardial infarction and aortic dissection were respectively 86.67%,63.33%,70%and 66.67%.After training,the duration of correct recognition of resident doctors for pulmonary embolism,tension pneumothorax and acute myocardial infarction were respectively(58.77±19.61)s,(69.05±10.47)s and(75.52±10.51)s,all of which were less than the duration of incorrect recognition,and the differences were statistically significant(t=2.153,2.781,2.124,P<0.05).Conclusion:Ultrasound combined with memory mnemonic can help resident doctors to quickly establish the clinical thinking clue about hypoxia,hypovolemia,hypo/hyperkalemia,hypo/hyperthermia,hypo/hyperglycemia,tamponade cardiac,thrombosis pulmonary,thrombosis coronary,toxins,tension pneumothorax(5H5T)for the cause of reversible cardiac arrest,which will contribute to strengthen and improve the practical ability of clinician in quick judgement for reversible etiology.

Angiopoietin-like proteins(ANGPTLs)are a family of proteins that are structurally similar to angio-poietin.So far,eight ANGPTLs have been discovered,namely ANGPTL1 to ANGPTL8.They are not only angiogenic fac-tors,but also play a pivotal role in various pathophysiological processes such as glucose and lipid metabolism,redox regu-lation,chronic inflammation and cancer,and having a close connection with the occurrence and development of metabolic diseases.This review focuses on the mechanism of action of ANGPTLs in metabolic associated fatty liver disease,in order to make a contribution to the prevention and treatment of MAFLD and concurrent diseases.

This article explores the construction and practice of the"Party Building+Health Science Popularization"model,using the"Yixian Health Science Popularization Guangdong Tour"campaign conducted by Sun Yat-sen Memorial Hospital as a case study.The initiative has achieved remarkable results.Additionally,it summarizes innovative measures,as well as uni-versal and exemplary experiences,providing new insights and pathway recommendations for public hospitals to develop the"Party Building+Health Science Popularization"model.

Angiopoietin-like proteins(ANGPTLs)are a family of proteins that are structurally similar to angio-poietin.So far,eight ANGPTLs have been discovered,namely ANGPTL1 to ANGPTL8.They are not only angiogenic fac-tors,but also play a pivotal role in various pathophysiological processes such as glucose and lipid metabolism,redox regu-lation,chronic inflammation and cancer,and having a close connection with the occurrence and development of metabolic diseases.This review focuses on the mechanism of action of ANGPTLs in metabolic associated fatty liver disease,in order to make a contribution to the prevention and treatment of MAFLD and concurrent diseases.

Medication literacy directly impacts the safety of drug therapy and clinical outcomes.Patients with low medication literacy demonstrate poorer medication adherence,higher medication risks,and inferior disease control outcomes.Chronic disease patients face significant medication safety hazards due to multimorbidity and polypharmacy.Accurately assessing medication literacy can quantify individual medication capabilities and promote safe medication management.This paper reviews the structure,methods,applicable population,current applications,advantages,and limitations of medication literacy assessment tools for chronic disease patients,both domestically and internationally.The aim is to provide references for developing and applying medication literacy assessment tools for patients in China,offering a basis for scientifically evaluating medication literacy levels and formulating medication safety intervention strategies.

Objective:To explore a systematic training for quick identification for diagnosis and treatment of the causes of reversible cardiac arrest,which was assisted by bedside ultrasound simulator combined with memory mnemonic,so as to improve the treatment skill of physicians for the causes of disease,and enhance the success rate of cardiopulmonary resuscitation.Methods:Thirty clinical resident doctors who were rotating in the emergency intensive care unit(ICU)of Xuanwu Hospital,Capital Medical University,from May 2023 to May 2024 were selected.The bedside ultrasound simulator combined with memory mnemonic was used to simulate training,which can improve the ability of resident doctors in quickly determining the cause of reversible cardiac arrest.The self-made questionnaire was used to investigate the baseline situation of resident doctors before they were trained,and the teaching effectiveness after they received training.After training,the grasping states of resident doctors for the cause of reversible cardiac arrest were detected through 10 kinds of clinical cases included pulmonary embolism,myocardial infarction,aortic dissection,pericardial tamponade,ventricular fibrillation,electrolyte disturbance,hypovolemic shock,tension pneumothorax,poisoning and hypothermia.Results:The duration of quick retelling of resident doctors for the causes of reversible cardiac arrest was(15.07±3.68)s after training,which was lower than(47.27±10.25)s before training,and the difference was significant(t=14.763,P<0.05).The awareness rate of them for the causes of reversible cardiac arrest was 100%after training,which was significantly higher than 3.33%before training,and the difference was significant(x2=56.129,P<0.05).The identification of resident doctor for ultrasonic image was zero basis before training,and the identification rate was 0%.All of resident doctors can achieve 100%identification for routine ultrasound,cardiac arrest,pericardial tamponade and ventricular fibrillation within the simulator after training,and the correct recognition rates of them for pulmonary embolism,tension pneumothorax,acute myocardial infarction and aortic dissection were respectively 86.67%,63.33%,70%and 66.67%.After training,the duration of correct recognition of resident doctors for pulmonary embolism,tension pneumothorax and acute myocardial infarction were respectively(58.77±19.61)s,(69.05±10.47)s and(75.52±10.51)s,all of which were less than the duration of incorrect recognition,and the differences were statistically significant(t=2.153,2.781,2.124,P<0.05).Conclusion:Ultrasound combined with memory mnemonic can help resident doctors to quickly establish the clinical thinking clue about hypoxia,hypovolemia,hypo/hyperkalemia,hypo/hyperthermia,hypo/hyperglycemia,tamponade cardiac,thrombosis pulmonary,thrombosis coronary,toxins,tension pneumothorax(5H5T)for the cause of reversible cardiac arrest,which will contribute to strengthen and improve the practical ability of clinician in quick judgement for reversible etiology.