Objective:To investigate the incidence, risk factors, and bile acid profile characteristics of Crohn's disease (CD) patients complicated by gallstones.Methods:A retrospective observational study was conducted. Clinical data of CD patients admitted to Zhongda Hospital of Southeast University from January 2020 to December 2023 were collected. Patients were divided into the gallstone group and the non-gallstone group according to the presence of gallstones. Univariate analysis and Logistic multivariate analysis were perfomed to identify the risk factors of CD patients complicated by gallstones. Sixty-eight CD patients in remission were selected, and serum levels of 15 bile acids were compared between patients with and without gallstones.Results:A total of 296 CD patients were enrolled, including 211 males and 85 females, with a mean age of 37.8 ± 14.8 years, disease duration of 2.0 (1.0, 6.0) years, Crohn's disease activity index of 265.3 ± 121.2, and body mass index of 22.4±2.2 kg/m 2. Among them, 44 patients (14.9%) had gallstones and were assigned to the gallstone group, while the remaining 252 patients (85.1%) were assigned to the non-gallstone group. Univariate analysis and multivariate Logistic regression analysis showed that location was an independent risk factor for CD patients complicated by gallstones. Patients with ileocolonic CD have a 3.92-fold higher risk of developing gallstones than those with colonic CD ( OR=3.92, 95% CI: 1.13-13.61, P = 0.031). Analysis of bile acid profiles in 68 CD patients in remission revealed that, compared to those without gallstones ( n = 50), patients with gallstones ( n = 18) had lower levels of ursodeoxycholic acid and an higher ratio of secondary conjugated bile acid/secondary free bile acid, the differences were significant (both P < 0.05) . Conclusions:CD patients have a high incidence of gallstones, which may be associated with abnormal bile acid metabolism. The ileocolonic CD patients are more prone to developing gallstones.

Implementation Science is an interdisciplinary field dedicated to systematically studying how to effectively translate evidence-based research findings into practical application and implementation. In the health-related context, it focuses on enhancing the efficiency and quality of healthcare services, thereby facilitating the transition from scientific evidence to real-world practice. This article elaborates on Theories, Models, and Frameworks (TMF) within health-related Implementation Science, clarifying their basic concepts and classifications, and discussing their roles in guiding implementation processes. Furthermore, it reviews and prospects current research from three aspects: the constituent elements of TMF, their practical applications, and future directions. Five representative frameworks are emphasized, including the Consolidated Framework for Implementation Research (CFIR), the Practical Robust Implementation and Sustainability Model (PRISM), the Exploration, Preparation, Implementation, Sustainment (EPIS)framework, the Behavior Change Wheel (BCW), and the Normalization Process Theory (NPT). Additionally, resources such as the Dissemination & Implementation Models Webtool and the T-CaST tool are introduced to assist researchers in selecting appropriate TMFs based on project-specific needs.

Objective:To investigate the incidence, risk factors, and bile acid profile characteristics of Crohn's disease (CD) patients complicated by gallstones.Methods:A retrospective observational study was conducted. Clinical data of CD patients admitted to Zhongda Hospital of Southeast University from January 2020 to December 2023 were collected. Patients were divided into the gallstone group and the non-gallstone group according to the presence of gallstones. Univariate analysis and Logistic multivariate analysis were perfomed to identify the risk factors of CD patients complicated by gallstones. Sixty-eight CD patients in remission were selected, and serum levels of 15 bile acids were compared between patients with and without gallstones.Results:A total of 296 CD patients were enrolled, including 211 males and 85 females, with a mean age of 37.8 ± 14.8 years, disease duration of 2.0 (1.0, 6.0) years, Crohn's disease activity index of 265.3 ± 121.2, and body mass index of 22.4±2.2 kg/m 2. Among them, 44 patients (14.9%) had gallstones and were assigned to the gallstone group, while the remaining 252 patients (85.1%) were assigned to the non-gallstone group. Univariate analysis and multivariate Logistic regression analysis showed that location was an independent risk factor for CD patients complicated by gallstones. Patients with ileocolonic CD have a 3.92-fold higher risk of developing gallstones than those with colonic CD ( OR=3.92, 95% CI: 1.13-13.61, P = 0.031). Analysis of bile acid profiles in 68 CD patients in remission revealed that, compared to those without gallstones ( n = 50), patients with gallstones ( n = 18) had lower levels of ursodeoxycholic acid and an higher ratio of secondary conjugated bile acid/secondary free bile acid, the differences were significant (both P < 0.05) . Conclusions:CD patients have a high incidence of gallstones, which may be associated with abnormal bile acid metabolism. The ileocolonic CD patients are more prone to developing gallstones.

Objective:The incidence of infections in patients with malignant hematologic diseases is extremely high and significantly affects their prognosis.Identifying early and precise biomarkers for infection is crucial for guiding the treatment of infections in these patients.Previous studies have shown that procalcitonin(PCT)can serve as an early diagnostic marker for bloodstream infections in patients with malignant hematologic diseases.This study aims to compare serum PCT levels in these patients with different pathogens,disease types,infection sites,and severity levels. Methods:Clinical data and laboratory results of infected patients with malignant hematologic diseases treated at the Department of Hematology,the Third Xiangya Hospital of Central South University from January 2018 to August 2023 were collected.General patient information was retrospectively analyzed.Serum PCT levels were compared among patients with different pathogens,types of malignant hematologic diseases,infection sites,and infection severity;Receiver operator characteristic(ROC)curves were used to determine the cut-off values and diagnostic value of serum PCT levels in diagnosing bloodstream infections versus local infections and severe infections versus non-severe infections.Mortality rates after 4-7 days of anti-infective treatment were compared among groups with rising,falling,and unchanged PCT levels. Results:A total of 526 patients with malignant hematologic diseases were included.The main pathogens were Gram-negative bacteria(272 cases,51.7%),followed by Gram-positive bacteria(120 cases,22.8%),fungi(65 cases,12.4%),viruses(23 cases,4.4%),and mixed pathogens(46 cases,8.7%).The main types of malignant hematologic diseases were acute myeloid leukemia(216 cases,41.1%),acute lymphoblastic leukemia(107 cases,20.3%),and lymphoma(93 cases,17.7%).Granulocyte deficiency was present in 68.3%(359 cases)of the patients during infection,with severe infection in 24.1%(127 cases).Significant differences in serum PCT levels were found among patients with different types of pathogens(P<0.001),with the highest levels in Gram-negative bacterial infections.Significant differences in serum PCT levels were also found among patients with different types of malignant hematologic diseases(P<0.05),with the highest levels in lymphoma patients.Serum PCT levels were significantly higher in systemic infections and severe infections compared to local infections and non-severe infections(both P<0.001).ROC curve analysis showed that the cut-off values for diagnosing bloodstream infections and severe infections were 0.22 and 0.28 ng/mL,with areas under the curve of 0.670 and 0.673,respectively.After 4-7 days of anti-infective treatment,the mortality rates of the PCT declining,PCT unchanged,and PCT rising groups were 11.9%,21.2%,and 35.7%,respectively,and pairwise comparisons were statistically significant(all P<0.05). Conclusion:PCT can be used as an auxiliary indicator for early identification of different pathogens,infection sites,and severity levels in patients with malignant hematologic diseases combined with infections.Dynamic monitoring of PCT levels after empirical antibiotic treatment provides important guidance for assessing patient's prognosis.

Purpose To evaluate the effect of PCSK9 gene knockout on myocardial function in obese mice via ultrasound strain technology,and to discuss the related mechanisms.Materials and Methods Twenty six-week-old wild-type C57BL/6 male mice were selected and randomly divided into a normal group(n=10)and an obese group(n=10).Additionally,ten six-week-old PCSK9-/-C57BL/6 male mice were selected as the PCSK9-/-group.Mice in the obese group and PCSK9-/-group were fed with high-fat feed to create models,while those in the normal group were fed with regular feed.After 12 weeks,mice that were successfully modeled were selected from the obese group and PCSK9-/-group.Then,the three groups of mice were subjected to cardiac ultrasound,transmission electron microscopy and immunofluorescence staining to observe relevant indicators.Results The interventricular septal end-diastolic thickness of mice in obese group,normal group,and PCSK9-/-group were(0.98±0.13)mm,(0.77±0.07)mm,(0.78±0.13)mm,respectively,with statistically significant difference(F=5.10,P=0.02).The obese group was thicker than the normal group(t=2.73,P＜0.05),while the PCSK9-/-group was thinner than the obese group(t=-2.92,P＜0.05).There were statistically significant differences in global longitudinal strain and global circumferential strain of the left ventricle among the three groups(F=7.44,15.40,P＜0.05),with the obese group showing a decrease in global longitudinal strain and global circumferential strain compared to the normal group(t=3.79,5.50,P＜0.05).The PCSK9-/-group showed an increase in global longitudinal strain and global circumferential strain compared to the obese group(t=-2.53,-3.37,P＜0.05).Electron microscopy and immunofluorescence results showed that the myocardial ultrastructure of the obese group was damaged,and the expression of NLRP3 and Caspase-1 were higher than that of the normal group(t=12.53,-4.73,P＜0.05),the myocardial ultrastructure damage in the PCSK9-/-group was significantly improved,the expression of NLRP3 and Caspase-1 were lower than that in the obese group(t=-6.23,2.05,P＜0.05).Conclusion Ultrasound strain can more sensitively detect changes in myocardial function in obese mice with PCSK9 gene knockout compared with conventional cardiac ultrasound parameters.Knockout of the PCSK9 gene may improve myocardial function in obese mice by inhibiting the expression of NLRP3 and Caspase-1.

OBJECTIVES: Bloodstream infections in emergency patients have a high incidence, severe disease progression, and rapid deterioration. Early administration of appropriate antimicrobial agents is crucial for improving patient outcomes. This study aims to investigate the incidence, pathogen distribution, and antimicrobial resistance patterns of bloodstream infections in emergency patients, providing a reference for rational antibiotic use in clinical practice. METHODS: Medical records of patients diagnosed with bloodstream infections in the emergency department of a hospital in Hunan Province between January 2018 and October 2022 were retrospectively collected. Clinical characteristics of bloodstream infection patients were analyzed, and the distribution trends and antimicrobial susceptibility of clinical isolates were examined. RESULTS: During the study period, 2 215 blood culture samples were submitted from the emergency department, with a positivity rate of 13.27%. After excluding eight cases with missing data or suspected contamination, 286 patients with bloodstream infections were included, with community-acquired infections accounting for the majority (85.66%). The most common primary infection site was the urinary tract (24.48%), followed by respiratory tract infections (20.28%) and biliary and intra-abdominal infections (17.13%). The 30-day mortality rate of bloodstream infections was 16.08%. A total of 286 pathogens were isolated, including 181 (63.29%) Gram-negative bacteria, primarily Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa; 101 (35.31%) Gram-positive bacteria, mainly Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pneumoniae; and only 4 (1.40%) fungal isolates. Antimicrobial susceptibility testing showed that the key Enterobacteriaceae strains exhibited resistance rates of 2.4% to carbapenems, 16.3% to piperacillin sodium and tazobactam sodium, and 15.3% to ceftazidime, with no detected resistance to tigecycline or polymyxins. The main non-fermentative bacteria showed resistance rates of 29.6% to piperacillin sodium and tazobactam sodium, 13.3% to cefoperazone sodium and sulbactam sodium, and 27.1% to quinolones. Among Gram-negative bacteria, multidrug-resistant strains accounted for 40.9% (74/181), with carbapenem-resistant Escherichia coli and Klebsiella pneumoniae detected in 5.4% (5/92) and 13.6% (6/44) of cases, respectively. No carbapenem-resistant Pseudomonas aeruginosa was identified. Among Gram-positive bacteria, resistance rates to penicillin G, rifampicin, and cefoxitin were 74.7%, 4.2%, and 50%, respectively, with only 3 cases of resistant to glycopeptide antibiotics. CONCLUSIONS Bloodstream infections in emergency patients are predominantly community-acquired, with Gram-negative bacteria being the most common pathogens. The isolated pathogens exhibited relatively low resistance rates to commonly used clinical antibiotics.
Retrospective Studies ; Emergency Service, Hospital/statistics & numerical data* ; Drug Resistance, Bacterial ; Anti-Bacterial Agents/therapeutic use* ; Incidence ; Microbial Sensitivity Tests/statistics & numerical data* ; Bacteremia/microbiology* ; Community-Acquired Infections/microbiology* ; Gram-Negative Bacteria/isolation & purification* ; Blood Culture/statistics & numerical data* ; Humans ; Male ; Female ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; China/epidemiology*

Skin injuries always disturb people's normal life, even seriously damage the body health. Thus, it is very necessary to use medical dressings to protect and treat skin wounds. Compared with traditional dressings, novel biological dressings develop more rapidly and their application scope is gradually expanding. Collagen is a natural biological material that can promote wound healing and it also has unique functional advantages in care and treatment. At present, collagen-based medical dressings has become one of the preferred choices to assist wound healing. The authors summarize the source, functional advantages and product classification of collagen-based dressings, and introduce the characteristics and applications of various collagen-based dressings, to provides a reference for further research of the collagen-based wound dressings.