The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is higher among individuals with inflammatory bowel disease (IBD) than in the general population. Emerging evidence indicates that the development of MASLD in patients with IBD may occur independently of traditional metabolic risk factors, suggesting a unique pathophysiological mechanism distinct from conventional MASLD pathways. Bile acids (BAs), which act as critical signaling molecules in enterohepatic circulation, play an essential role in maintaining gastrointestinal homeostasis through bidirectional gut–liver axis communication. These molecules are increasingly recognized as pivotal regulators in the progression of both MASLD and IBD. While previous studies have characterized the dynamics of BA in blood or fecal samples under both conditions, a comprehensive understanding of their metabolic profiles and the associated interactions within the gut–liver axis is still lacking. This review synthesizes current evidence from studies employing BA metabolomics to investigate IBD and MASLD. By focusing on BA signatures, we summarize conserved alterations between these two conditions and their potential mechanisms of disease progression. Our review advances understanding of BA-mediated pathways in IBD and MASLD, providing a foundation for assessing their roles in contributing to the pathogenesis of MASLD in patients with IBD.

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.

Aim To study the mechanism of adipose mesenchymal stem cell exosomes(ASC-exo)inhibition of fluorescein isothiocyanate(FITC)-induced atopic dermatitis(AD).Methods The mouse age,extrac-tion method,and the concentration of a solution of typeⅠ collagen enzyme and other conditions were compared to study the effects on the morphology and quantity of adipose mesenchymal stem cells(ASCs)after extrac-ted.FITC-induced mouse model in vivo was estab-lished and different doses of ASC-exo were given to measure ear thickness,ear weight and ear scratching times of mice.HE staining was used to observe the pathological changes of ear tissue of mice.The non-toxicity of ASC-exo was detected.IgE,IL-5,IL-13 and other cytokines were detected by ELISA.The gene ex-pressions of TSLP,IL-33,occludin,Claudin-1(CLDN-1)and E-cadherin were detected by RT-qPCR.The protein expression was detected by immunohistochemis-try.Results An efficient method for extracting ASCs was established.Compared with the blank group,mice in the model group showed obvious AD symptoms.Compared with the model group,ASC-exo administra-tion group significantly reduced the number of ear scratches,epidermal thickening,inflammatory cell infil-tration and the secretion of Th2 cytokines IL-5 and IL-13.Meanwhile,ASC-exo administration group signifi-cantly increased the expression of structural proteins CLDN-1 and occludin in epithelial cells and decreased the expression of TSLP and IL-33.Conclusions ASC-exo can significantly improve Th2 skin inflamma-tion in AD mice,and its mechanism may be through in-creasing the expression of tight junction proteins and adhesion link protein in epithelial cells,repairing the skin barrier,and inhibiting the key promoters of allergy TSLP and IL-33.

Aim To study the mechanism of adipose mesenchymal stem cell exosomes(ASC-exo)inhibition of fluorescein isothiocyanate(FITC)-induced atopic dermatitis(AD).Methods The mouse age,extrac-tion method,and the concentration of a solution of typeⅠ collagen enzyme and other conditions were compared to study the effects on the morphology and quantity of adipose mesenchymal stem cells(ASCs)after extrac-ted.FITC-induced mouse model in vivo was estab-lished and different doses of ASC-exo were given to measure ear thickness,ear weight and ear scratching times of mice.HE staining was used to observe the pathological changes of ear tissue of mice.The non-toxicity of ASC-exo was detected.IgE,IL-5,IL-13 and other cytokines were detected by ELISA.The gene ex-pressions of TSLP,IL-33,occludin,Claudin-1(CLDN-1)and E-cadherin were detected by RT-qPCR.The protein expression was detected by immunohistochemis-try.Results An efficient method for extracting ASCs was established.Compared with the blank group,mice in the model group showed obvious AD symptoms.Compared with the model group,ASC-exo administra-tion group significantly reduced the number of ear scratches,epidermal thickening,inflammatory cell infil-tration and the secretion of Th2 cytokines IL-5 and IL-13.Meanwhile,ASC-exo administration group signifi-cantly increased the expression of structural proteins CLDN-1 and occludin in epithelial cells and decreased the expression of TSLP and IL-33.Conclusions ASC-exo can significantly improve Th2 skin inflamma-tion in AD mice,and its mechanism may be through in-creasing the expression of tight junction proteins and adhesion link protein in epithelial cells,repairing the skin barrier,and inhibiting the key promoters of allergy TSLP and IL-33.

Objective To explore the predictive value of intratumor and peritumoral edema radiomics combined with the autoencoder algorithm for human epidermal growth factor receptor(HER-2)status in breast cancer to provide a new idea for preoperative noninvasive prediction of HER-2 status.Methods Totally 145 breast cancer patients from Yancheng Hospital Affiliated to Nanjing University Medical College(Center 1)and 52 ones from Jianhu Hospital Affiliated to Nantong University(Center 2)had their clinical and imaging data collected retrospectively,who were divided into a HER-2 positive group including 87 ones from Center 1 and 30 ones from Center 2 and a HER-2 negative group including 58 ones from Center 1 and 22 ones from Center 2.From December 2018 to October 2024 there were 78 patients with peritumoral edema from Center 1 randomly enrolled into a training set(55 patients)and a validation set(23 patients)in a ratio of 7∶3,and from November 2024 to March 2025 another 26 ones placed into a time validation set.The 52 patients with peritumoral edema from Center 2 were included into an external test set.Firstly,the Mazda software was used to delineate the regions of interest for the largest tumor layer and the peritumoral edema area.Secondly,multivariate analysis of variance(ANOVA),Kruskal-Wallis test,recursive feature elimination(RFE)and Relief algorithm were respectively employed to screen the radiomics features;finally,combined with ten-fold cross validation,the receiver operating characteristic curve was drawn,and the diagnostic efficacy of the models respectively constructed with radiomics parameters and ten types of machine learning algorithms,including auto encoder,support vector machine,linear discriminant analysis,random forest,Logistic regression,Logistic regression via Lasso,adaptive boosting,Gaussian process,native Bayes and decision tree,was evaluated for the HER-2 status in breast cancer.Results The model established by the auto encoder algorithm combined with three feature parameters including intratumor MaxNorm and Variance and peritumoral edema SumAverg behaved the best.The average AUC values of the training and validation sets were 0.808 and 0.735 resepctively,and the AUC values of the time validation and external test sets were 0.746 and 0.732 respectively.Conclusion The model developed with intratumor and peritumoral edema radiomics combined with the auto encoder algorithm can be used for preoperative noninvasive prediction of HER-2 status of breast cancer,which provides references for the preparation of individualized treatment scheme of breast cancer patients.[Chinese Medical Equipment Journal,2025,46(9):9-15]

Objective:To investigate the association of cumulative resting heart rate(cumRHR)exposure with cardi-ovascular disease(CVD)risk and accumulation of cardiovascular risk factors in the elderly.Methods:This prospec-tive study enrolled 336 elderly physical examinees from Cangzhou People's Hospital between March and October 2016.Resting heart rate(RHR)measured by electrocardiogram was collected during three consecutive health check-ups at 2-year intervals to calculate cumRHR.Six common cardiovascular risk factors were recorded,including smoking,alcohol consumption,hypertension,diabetes,hyperuricemia,and dyslipidemia.A three-year follow-up commenced after the third health check-up,with incident CVD(including coronary heart disease and ischemic stroke)as the endpoint event.The association between cumRHR and CVD risk was assessed using a Logistic regres-sion model,with subgroup analysis stratified by gender.Spearman correlation analysis was performed to examine the association of cumRHR with the number of accumulated cardiovascular risk factors.Results:During follow-up,21 participants occurred incident CVD.Compared to participants in the no CVD group,those in CVD group had sig-nificant higher proportions of smoking(47.6％vs.20.3％,P=0.003),hypertension(61.9％vs.35.9％,P=0.017),diabetes(38.1％vs.19.1％,P=0.035),hyperuricemia(38.1％vs.13.0％,P=0.002),dyslipidemia(71.4％vs.41.9％,P=0.008)and cumRHR[(349.90±30.24)bpm*year vs.(290.77±32.43)bpm*year,P＜0.001].After adjusting for confounding factors,multivariate Logistic regression analysis showed that cumRHR was still an independent risk factor of incident CVD(OR 1.05,95％CI 1.03～1.07,P＜0.001).This association remained in subgroup analysis stratified by gender in both males and females(OR 1.05,95％CI 1.03～1.07 and OR 1.06,95％CI 1.03～1.09,respectively,P＜0.001 both).Spearman correlation analysis detected a positive correla-tion between cumRHR and number of accumulated cardiovascular risk factors≥3(r=0.459,P＜0.001).Conclu-sion:Higher cumRHR is associated with an increased risk of CVD,and there is a significant positive correlation be-tween the number of accumulated cardiovascular risk factors and the risk of elevated cumRHR.

Objective To explore the predictive value of intratumor and peritumoral edema radiomics combined with the autoencoder algorithm for human epidermal growth factor receptor(HER-2)status in breast cancer to provide a new idea for preoperative noninvasive prediction of HER-2 status.Methods Totally 145 breast cancer patients from Yancheng Hospital Affiliated to Nanjing University Medical College(Center 1)and 52 ones from Jianhu Hospital Affiliated to Nantong University(Center 2)had their clinical and imaging data collected retrospectively,who were divided into a HER-2 positive group including 87 ones from Center 1 and 30 ones from Center 2 and a HER-2 negative group including 58 ones from Center 1 and 22 ones from Center 2.From December 2018 to October 2024 there were 78 patients with peritumoral edema from Center 1 randomly enrolled into a training set(55 patients)and a validation set(23 patients)in a ratio of 7∶3,and from November 2024 to March 2025 another 26 ones placed into a time validation set.The 52 patients with peritumoral edema from Center 2 were included into an external test set.Firstly,the Mazda software was used to delineate the regions of interest for the largest tumor layer and the peritumoral edema area.Secondly,multivariate analysis of variance(ANOVA),Kruskal-Wallis test,recursive feature elimination(RFE)and Relief algorithm were respectively employed to screen the radiomics features;finally,combined with ten-fold cross validation,the receiver operating characteristic curve was drawn,and the diagnostic efficacy of the models respectively constructed with radiomics parameters and ten types of machine learning algorithms,including auto encoder,support vector machine,linear discriminant analysis,random forest,Logistic regression,Logistic regression via Lasso,adaptive boosting,Gaussian process,native Bayes and decision tree,was evaluated for the HER-2 status in breast cancer.Results The model established by the auto encoder algorithm combined with three feature parameters including intratumor MaxNorm and Variance and peritumoral edema SumAverg behaved the best.The average AUC values of the training and validation sets were 0.808 and 0.735 resepctively,and the AUC values of the time validation and external test sets were 0.746 and 0.732 respectively.Conclusion The model developed with intratumor and peritumoral edema radiomics combined with the auto encoder algorithm can be used for preoperative noninvasive prediction of HER-2 status of breast cancer,which provides references for the preparation of individualized treatment scheme of breast cancer patients.[Chinese Medical Equipment Journal,2025,46(9):9-15]

Objective:To investigate the association of cumulative resting heart rate(cumRHR)exposure with cardi-ovascular disease(CVD)risk and accumulation of cardiovascular risk factors in the elderly.Methods:This prospec-tive study enrolled 336 elderly physical examinees from Cangzhou People's Hospital between March and October 2016.Resting heart rate(RHR)measured by electrocardiogram was collected during three consecutive health check-ups at 2-year intervals to calculate cumRHR.Six common cardiovascular risk factors were recorded,including smoking,alcohol consumption,hypertension,diabetes,hyperuricemia,and dyslipidemia.A three-year follow-up commenced after the third health check-up,with incident CVD(including coronary heart disease and ischemic stroke)as the endpoint event.The association between cumRHR and CVD risk was assessed using a Logistic regres-sion model,with subgroup analysis stratified by gender.Spearman correlation analysis was performed to examine the association of cumRHR with the number of accumulated cardiovascular risk factors.Results:During follow-up,21 participants occurred incident CVD.Compared to participants in the no CVD group,those in CVD group had sig-nificant higher proportions of smoking(47.6％vs.20.3％,P=0.003),hypertension(61.9％vs.35.9％,P=0.017),diabetes(38.1％vs.19.1％,P=0.035),hyperuricemia(38.1％vs.13.0％,P=0.002),dyslipidemia(71.4％vs.41.9％,P=0.008)and cumRHR[(349.90±30.24)bpm*year vs.(290.77±32.43)bpm*year,P＜0.001].After adjusting for confounding factors,multivariate Logistic regression analysis showed that cumRHR was still an independent risk factor of incident CVD(OR 1.05,95％CI 1.03～1.07,P＜0.001).This association remained in subgroup analysis stratified by gender in both males and females(OR 1.05,95％CI 1.03～1.07 and OR 1.06,95％CI 1.03～1.09,respectively,P＜0.001 both).Spearman correlation analysis detected a positive correla-tion between cumRHR and number of accumulated cardiovascular risk factors≥3(r=0.459,P＜0.001).Conclu-sion:Higher cumRHR is associated with an increased risk of CVD,and there is a significant positive correlation be-tween the number of accumulated cardiovascular risk factors and the risk of elevated cumRHR.

Objective:To investigate the association of systemic immune-inflammation index(SII)and serum cysta-tin C(CysC)with the severity of acute pulmonary embolism(APE),and their predictive value for prognosis.Meth-ods:A total of 181 patients who were first diagnosed with APE in Cangzhou People's Hospital between January 2018 and January 2023 were retrospectively selected.The severity of APE was determined according to risk stratification criteria for pulmonary embolism,and the patients were divided into low-risk group(n=67),middle-risk group(n=81)and high-risk group(n=33).General clinical data and venous blood neutrophils,platelet and lymphocyte counts,CysC and other indicators were collected,and SII was calculated according to the formula.The relevant in-dicators were compared among three groups,and their correlation with the severity of APE was analyzed by Spearman correlation analysis.According to the prognosis,all APE patients were divided into favorable outcome group(n=129)and unfavorable outcome group(n=52).The general clinical data were compared and multivariate Cox regression analysis was used to study the influencing factors of unfavorable outcome in APE patients.The re-ceiver operating characteristic curve(ROC)was drawn to evaluate the predictive value of SII,CysC and their com-bination for the prognosis of APE patients.Nomogram model for prognosis was constructed.Results:Compared with patients in low-risk group,those in the middle-risk group and the high-risk group had significantly higher levels of serum creatinine,CysC and uric acid(P＜0.05 or＜0.01).The SII in the high-risk group was significant-ly higher than those of middle-risk group and low-risk group(P＜0.001 all).Spearman correlation analysis showed that serum creatinine,CysC,uric acid and SII were significant positively correlated with the severity of APE(r=0.356,0.358,0.233,0.353,P＜0.01 all).Compared with patients in the favorable outcome group,those in the unfavorable outcome group had significantly higher levels of D-dimer,serum creatinine,CysC,uric acid and SII(P＜0.01 all).There was a statistically significant difference in the severity of APE between the two groups(P=0.001).Multivariate Cox regression analysis showed that CysC,SII,and middle or high risk of disease severity were independent risk factors for unfavorable outcome in APE patients(HR=1.001～14.453,P＜0.05 or＜0.01).ROC curve indicated that the AUC of SII,CysC and their combination in predicting unfavorable outcome of APE patients were 0.815(95％CI 0.749～0.881),0.747(95％CI 0.661～0.832)and 0.878(95％CI,0.821～0.936),respectively.The combined AUC of the two was significantly higher than those of SII and CysC alone(Z=-2.234,-3.500,P＜0.05 or＜0.01).Based on the above independent risk factors,the AUC values of the 1-year and 3-year unfavorable outcome nomogram models were 92.9 and 88.2,respectively.The calibration prediction curve and the ideal curve fitted well.The decision curve showed that the model had a good net benefit.Conclusion:SII and CysC are significant positively correlated with the severity of APE and they are independent risk factors for unfavor-able outcome of APE,and the combination of the two indicators has a good predictive value for the prognosis of APE.The nomogram constructed has good accuracy and practicability.

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.