Sepsis is a complex clinical syndrome closely associated with the occurrence of acute organ dysfunction and is often characterized by high mortality. Due to the rapid progression of sepsis, early diagnosis and intervention are crucial. Recent research has focused on exploring the pathological response involved in the process of sepsis. Liver sinusoidal endothelial cells (LSECs) are a special type of endothelial cell and an important component of liver non-parenchymal cells. Unlike general endothelial cells, which mainly provide a barrier function within the body, LSECs also have important functions in the clearance and regulation of the immune response. LSECs are not only vital antigen-presenting cells (APCs) in the immune system but also play a significant role in the development of infectious diseases and tumors through their specific immune regulatory pathways. However, in certain disease states, the functions of LSECs may be impaired, leading to immune imbalance and the development of organ failure. Investigating the immune pathways of LSECs in sepsis may provide new solutions for the prevention and treatment of sepsis and is crucial for maintaining microcirculation and improving patient outcomes.

The monitoring of peripheral circulation, as indicated by the capillary refill time, is a sensitive and accurate method of assessing the microcirculatory status of the body. It is a widely used tool for the evaluation of critically ill patients, the guidance of therapeutic interventions, and the assessment of prognosis. In recent years, there has been a growing emphasis on microcirculation monitoring which has led to an increased focus on capillary refill time. The International Sepsis Guidelines, the American Academy of Pediatrics, the World Health Organization, and the American Heart Association all recommend its inclusion in the evaluation of the system in question. Furthermore, the methodology for its measurement has evolved from a traditional manual approach to semiautomatic and fully automatic techniques. This article presents a comprehensive overview of the current research on the measurement of capillary refill time, with a particular focus on its clinical significance. The aim is to provide a valuable reference for clinicians and researchers and further advance the development and application of microcirculation monitoring technology.

Background: China has implemented policies to strengthen its pharmacist workforce since the 2009 healthcare reform, yet a comprehensive evaluation of their long-term systemic effects is lacking. Objective: To systematically analyze the evolution of China’s pharmacist workforce in healthcare institutions from 2007 to 2023 across four dimensions: quantity, quality, structure, and distribution, providing an empirical foundation for policy optimization. Methods: A retrospective analysis was conducted using longitudinal data from the China Health Statistics Yearbooks. Trends were delineated via descriptive statistics. Equity and spatial evolution were assessed using the Gini coefficient, Theil index decomposition, and spatial autocorrelation analyses (Global Moran’s I and hotspot analysis). Results: From 2007 to 2023, the total number of pharmacists increased from 357,700 to 569,500 (average annual growth: 2.2%). This growth lagged behind physicians (4.6%) and nurses (7.4%),causing the pharmacist-to-physician ratio to decline from 1:5.15 to 1:8.39. The workforce showed trends of feminization (female proportion rose from 59.7% to 70.8%) and aging. While quality improved, 51.1% still held an associate degree or below, and only 6.6% held senior titles. Equity analysis revealed the provincial Gini coefficient improved from 0.145 to 0.093. Theil index decomposition confirmed intra-provincial disparities as the primary inequality driver. Spatial analysis showed a non-significant global Moran’s I by 2023 (0.154, P *>0.05), down from 0.254 ( P <0.01) in 2007. Hotspot analysis confirmed this transition, revealing a contraction of high-confidence clusters and a trend toward balanced distribution. Conclusions: China has made measurable progress in expanding pharmacist workforce size and improving inter-provincial equity since 2007. However, persistent structural challenges remain: relative workforce contraction compared to other health professions, an aging demographic, a shortage of senior talent, and significant intra-provincial inequity. Future policies must prioritize optimizing workforce structure and enhancing clinical service capabilities to catalyze a shift toward patient-centered pharmaceutical care. Highlights: First longitudinal study (2002–2023) tracking China’s institutional pharmacist workforce post-healthcare reform, revealing a critical structural shortage. Pharmacist growth rate (2.2% annually) severely lagged physicians (4.6%) and nurses (7.4%), causing the pharmacist-to-physician ratio to plummet from 1:5.15 to 1:8.39. 69.2% of China’s drug market (prescription drugs) is managed by only 569,500 institutional pharmacists—175,000 fewer than retail pharmacists, exposing a critical workload imbalance. Spatial disparity paradox: Gini coefficient improved to 0.093 (high equity), yet Theil decomposition revealed intra-provincial (urban/rural) gaps as the primary driver of inequality. High-level talent deficit: Despite quality gains, only 6.6% hold senior titles and 6.1% have master’s degrees—a bottleneck for advancing clinical pharmaceutical care.