Metabolites produced as intermediaries or end-products of microbial metabolism provide crucial signals for health and diseases, such as metabolic dysfunction-associated steatotic liver disease (MASLD). These metabolites include products of the bacterial metabolism of dietary substrates, modification of host molecules (such as bile acids [BAs], trimethylamine-N-oxide, and short-chain fatty acids), or products directly derived from bacteria. Recent studies have provided new insights into the association between MASLD and the risk of developing chronic kidney disease (CKD). Furthermore, alterations in microbiota composition and metabolite profiles, notably altered BAs, have been described in studies investigating the association between MASLD and the risk of CKD. This narrative review discusses alterations of specific classes of metabolites, BAs, fructose, vitamin D, and microbiota composition that may be implicated in the link between MASLD and CKD.

Metabolites produced as intermediaries or end-products of microbial metabolism provide crucial signals for health and diseases, such as metabolic dysfunction-associated steatotic liver disease (MASLD). These metabolites include products of the bacterial metabolism of dietary substrates, modification of host molecules (such as bile acids [BAs], trimethylamine-N-oxide, and short-chain fatty acids), or products directly derived from bacteria. Recent studies have provided new insights into the association between MASLD and the risk of developing chronic kidney disease (CKD). Furthermore, alterations in microbiota composition and metabolite profiles, notably altered BAs, have been described in studies investigating the association between MASLD and the risk of CKD. This narrative review discusses alterations of specific classes of metabolites, BAs, fructose, vitamin D, and microbiota composition that may be implicated in the link between MASLD and CKD.

Metabolites produced as intermediaries or end-products of microbial metabolism provide crucial signals for health and diseases, such as metabolic dysfunction-associated steatotic liver disease (MASLD). These metabolites include products of the bacterial metabolism of dietary substrates, modification of host molecules (such as bile acids [BAs], trimethylamine-N-oxide, and short-chain fatty acids), or products directly derived from bacteria. Recent studies have provided new insights into the association between MASLD and the risk of developing chronic kidney disease (CKD). Furthermore, alterations in microbiota composition and metabolite profiles, notably altered BAs, have been described in studies investigating the association between MASLD and the risk of CKD. This narrative review discusses alterations of specific classes of metabolites, BAs, fructose, vitamin D, and microbiota composition that may be implicated in the link between MASLD and CKD.

OBJECTIVE To investigate a method for dynamic monitoring of drug consumption （DMDC） based on statistical process control （SPC）， aiming to improve the macro-supervisory capacity in the process of drug utilization. METHODS The lists of key monitoring drug varieties in our hospital were established based on drug cost and relevant national documents. Monthly consumption data of key monitoring drug varieties in the entire hospital， outpatient pharmacy and inpatient pharmacy were taken as monitoring objects，and the DMDC model was established using SPC’s X control chart， moving range control chart， and exponentially weighted moving-average control chart， monitoring from three dimensions： single-month consumption， range variation， and consumption trend. Rosuvastatin， metoprolol and meropenem were taken as examples to demonstrate the monitoring capabilities of the DMDC model. RESULTS Lists of key monitoring drug varieties were established for entire hospital， outpatient pharmacy and inpatient pharmacy， containing 203， 167 and 200 varieties， respectively. After excluding drug varieties that could not be modeled and for which modeling failed， 179， 116 and 172 DMDC models were successfully established for these three drug consumption areas， respectively. During the first four months of 2024， these three groups of model separately warned 54， 32 and 62 drug varieties. The DMDC model successfully monitored the monthly consumption of drugs，such as rosuvastatin throughout the hospital， metoprolol in outpatient pharmacy， and meropenem in inpatient pharmacy. Compared with the previously used floating rate ranking method in our hospital， the application of the DMDC model significantly improved the scope and depth of drug monitoring， with the monitored drug varieties greatly expanded from about 50 to 179， and the monitoring dimensions increased from a single dimension to three. CONCLUSIONS The DMDC model based on SPC is effective and feasible，suitable for monitoring drug varieties with stable monthly consumption.

The incidence of myopia among Chinese adolescents is progressively rising, indicating a distinct trend toward younger age onset.This paper aims to comprehensively review the impact of various visual performance on myopia and its progression, with a specific emphasis on accommodative function, convergence function, and ocular position. A meticulous exploration of accommodation function, encompassing accommodative amplitude, accommodative facility, accommodative response, positive relative accommodation, and negative relative accommodation, has been undertaken to elucidate its contributory role in myopia progression. Concurrently, an exhaustive analysis of convergence function has been conducted including esotropia and exotropia, convergence insufficiency and convergence excess, fusional function vergence, divergence insufficiency, and excess, providing a nuanced understanding of convergence's implications for myopia advancement. Furthermore, the influence of ocular position on myopia progression, along with other factors affecting perceptual ocular position and intermittent exotropia, is discussed. The primary objective of this article is to unveil the multifaceted visual performance influencing myopia and its progression, elucidating the paramount significance of accommodative function, convergence function, and ocular position in this context.

Objective:To examine the burden and trends of acute viral hepatitis in Guangdong Province from 1990 to 2019, and provide reference evidences for hepatitis prevention and control in the province.Methods:Data on acute viral hepatitis (hepatitis A, B, C, and E) in Guangdong from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 database. The incidence, prevalence, mortality, and disability-adjusted life years (DALY) data were analyzed by age and gender, and the estimated annual percentage change (EAPC) was calculated to describe the changing trends in disease burden.Results:From 1999 to 2019, the standardized incidence, prevalence, mortality, and DALY of acute viral hepatitis in Guangdong were higher than the national averages. In 2019, 51.43% (2 245 087/4 365 221) of acute viral hepatitis cases in Guangdong Province were mainly attributed to hepatitis B, and 77.18% (106/138) of deaths were due to acute hepatitis B. In different age groups, except for acute hepatitis B, which was more common in adults, the incidence rates of other types of viral hepatitis such as hepatitis A, B, and E showed an overall decreasing trend with age. The mortality rates of different types of acute viral hepatitis, except for the <5 age group, increased with age. The overall incidence and mortality rates of acute viral hepatitis were higher in men than in women.Conclusions:The overall burden of acute viral hepatitis in Guangdong declined in 2019, but remained higher than the national level. Further efforts are needed to strengthen hepatitis prevention and screening in different population in Guangdong Province, especially in children and the elderly.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To evaluate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of solid intraductal papilloma (sIDP) of breast by comparing with fibronenoma of breast (FA).Methods:The CEUS data of 62 cases of sIDP patients and 94 cases of FA patients that confirmed by pathology in the First Affiliated Hospital of Soochow University from October 2016 to January 2021 were retrospectively analyzed. The patients were divided into sIDP group and FA group according to the pathological results. The enhancement speed, enhancement degree, enhancement uniformity, whether the edge after enhancement was polished, whether the enhancement range was enlarged, whether there was a ring unenhanced area in the inner edge of the lesion and whether the inner edge of the unenhanced area was polished were observed in the two groups. SonoLiver software was used to perform offline analysis of the dynamic process of CEUS in the two groups respectively, the enhancement sequence diagram of the lesions was obtained. The pathological result was taken as the gold standard, univariate analysis was applied, and the parameters with statistical significance between the two groups were included in multivariate Logistic regression analysis to establish a differential diagnosis model. The diagnostic efficiency of sIDP was analyzed by ROC curve and diagnostic model.Results:Compared with the FA group, CEUS in the sIDP group mostly showed fast forward, high enhancement, and the enhancement sequence was mostly centrifugal. After CEUS, the lesion edges in the sIDP group were mostly accompanied by unenhanced areas and the inner edges of the unenhanced areas were not intact, and the differences between the two groups were statistically significant (all P<0.05). Binary Logistic regression showed that age, enhancement degree and enhancement order were independent risk factors for sIDP diagnosis. The ROC curve showed that the area under the ROC curve of age, enhancement degree and enhancement sequence combined for the diagnosis of sIDP was 0.874 (95% CI=0.812-0.922), the accuracy was 76.9%, the sensitivity was 67.7%, the specificity was 83.0%, the positive predictive value was 72.4%, and the negative predictive value was 79.6%. Conclusions:There are significant differences in age, enhancement degree and enhancement sequence between sIDP and FA patients. The three-parameter combination can improve the diagnostic efficiency of sIDP.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-positive bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-positive bacteria from blood cultures in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:A total of 3 163 strains of Gram-positive pathogens were collected from 51 member units，and the top five bacteria were Staphylococcus aureus（ n=1 147，36.3%），coagulase-negative Staphylococci（ n=928，29.3%）， Enterococcus faecalis（ n=369，11.7%）， Enterococcus faecium（ n=296，9.4%）and alpha-hemolyticus Streptococci（ n=192，6.1%）. The detection rates of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）were 26.4%（303/1 147）and 66.7%（619/928），respectively. No glycopeptide and daptomycin-resistant Staphylococci were detected. The sensitivity rates of Staphylococcus aureus to cefpirome，rifampin，compound sulfamethoxazole，linezolid，minocycline and tigecycline were all >95.0%. Enterococcus faecium was more prevalent than Enterococcus faecalis. The resistance rates of Enterococcus faecium to vancomycin and teicoplanin were both 0.5%（2/369），and no vancomycin-resistant Enterococcus faecium was detected. The detection rate of MRSA in southern China was significantly lower than that in other regions（ χ2=14.578， P=0.002），while the detection rate of MRCNS in northern China was significantly higher than that in other regions（ χ2=15.195， P=0.002）. The detection rates of MRSA and MRCNS in provincial hospitals were higher than those in municipal hospitals（ χ2=13.519 and 12.136， P<0.001）. The detection rates of MRSA and MRCNS in economically more advanced regions（per capita GDP≥92 059 Yuan in 2022）were higher than those in economically less advanced regions（per capita GDP<92 059 Yuan）（ χ2=9.969 and 7.606， P=0.002和0.006）. Conclusions:Among the Gram-positive pathogens causing bloodstream infections in China， Staphylococci is the most common while the MRSA incidence decreases continuously with time；the detection rate of Enterococcus faecium exceeds that of Enterococcus faecalis. The overall prevalence of vancomycin-resistant Enterococci is still at a low level. The composition ratio of Gram-positive pathogens and resistant profiles varies slightly across regions of China，with the prevalence of MRSA and MRCNS being more pronounced in provincial hospitals and areas with a per capita GDP≥92 059 yuan.

Objective To explore the distribution and difference of bone thickness in the infrazygomatic crest(IZC)in adolescents at different eruption stages of the maxillary second molar and provide guidance for placement of orthodontic IZC miniscrew.Methods Cone beam CT scans of 110 adolescents with normal occlusion were assessed.According to the eruption stage of the maxillary second molar,the subjects were divided into 3 groups of S1(44 cases),S2(30 cases),and S3(36 cases).The horizontal base plane(HB)in this study was defined as a horizontal axial section with the mesiobuccal cusps of the left maxillary first molar on.Two coronal slices of interest were selected which passing through the apex of mesiobuccal(MB)and distobuccal(DB)roots of the left maxillary first molar respectively.In both of the two coronal slices,the buccal bone thickness was measured at 13(HB13),15(HB15),17(HB17)mm above the HB plane at a gingival inclination of 60°.The measurement differences of bone thickness between MB and DB,and among different heights were evaluated,and the differences among S1,S2,and S3 groups in each simulated paths were compared.Distributions of measurements were reported as colormaps.Results The IZC bone thickness of DB was thicker than MB at HB13 and HB15 in the 3 groups.The higher the insertion height,the smaller the bone thickness(P<0.05).Bone thickness decreased from S1 to S2 to S3 at HB13 and HB15.The maximum bone thickness(5.20 mm)was observed at HB13 in DB,and the minimum bone thicness(1.90 mm)was observed at HB17 in DB.Conclusion The thickest bone in IZC of the three groups located at HB13 in DB of the maxillary first molar,and the bone thickness decreases with the increase of the insertion height.The later the eruption stage of the maxillary second molar,the less bone thickness in the IZC region and the operation difficulty might increase.