Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacte...Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacterales have been increasingly reported in children,with higher rates in Asian and Middle Eastern settings than in high-income countries[1,2].展开更多
Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by...Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by climbing antibiotic resistance and intolerable side-effects of standard triple or quadruple therapies.In recent years,fecal microbiota transplantation(FMT),a strategy that reconstructs the gut ecosystem by introducing a healthy donor microbiome,has emerged as a novel adjunct or alternative.By competitively excluding H.pylori,reinforcing mucosal barrier integrity,modulating host immunity and secreting bacteriocins,FMT can raise eradication rates,relieve dyspeptic symptoms and lower recurrence.This review synthesizes up-to-date pre-clinical,pilot and controlled clinical data,dissects underlying mechanisms,compares delivery routes,donor screening protocols and safety profiles,and discusses regulatory,ethical and standardization hurdles that must be overcome before large-scale clinical application.展开更多
Natural product(NPT)derived from traditional Chinese medicine has a rich history as an integral part of Chinese healthcare for thousands of years.Recently,the application of NPT in sonodynamic antibacterial therapy(SD...Natural product(NPT)derived from traditional Chinese medicine has a rich history as an integral part of Chinese healthcare for thousands of years.Recently,the application of NPT in sonodynamic antibacterial therapy(SDAT)has emerged as a promising area of research.This perspective summarizes the recent NPT-based sonosensitizers in SDAT.Currently,common NPT-based sonosensitizers include curcumin,chlorophyll derivatives,hypericin,and berberine.Compared with other sonosensitizers,natural sources of NPT-based sonosensitizers with reactive oxide species production performance under ultrasound conditions,low biotoxicity,and other additional biological activity make them have application prospects in bacterial removal.Finally,the potential benefits and challenges of NPT-based nanosonosensitizers were also discussed.展开更多
BACKGROUND Due to the increasing rate of thyroid nodules diagnosis,and the desire to avoid the unsightly cervical scar,remote thyroidectomies were invented and are increasingly performed.Transoral endoscopic thyroidec...BACKGROUND Due to the increasing rate of thyroid nodules diagnosis,and the desire to avoid the unsightly cervical scar,remote thyroidectomies were invented and are increasingly performed.Transoral endoscopic thyroidectomy vestibular approach and trans-areolar approaches(TAA)are the two most commonly used remote approaches.No previous meta-analysis has compared postoperative infections and swallowing difficulties among the two procedures.AIM To compared the same among patients undergoing lobectomy for unilateral thyroid carcinoma/benign thyroid nodule.METHODS We searched PubMed MEDLINE,Google Scholar,and Cochrane Library from the date of the first published article up to August 2025.The term used were transoral thyroidectomy vestibular approach,trans areolar thyroidectomy,scarless thyroidectomy,remote thyroidectomy,infections,postoperative,inflammation,dysphagia,and swallowing difficulties.We identified 130 studies,of them,30 full texts were screened and only six studies were included in the final meta-analysis.RESULTS Postoperative infections were not different between the two approaches,odd ratio=1.33,95%confidence interval:0.50-3.53,theχ2 was 1.92 and the P-value for overall effect of 0.57.Similarly,transient swallowing difficulty was not different between the two forms of surgery,with odd ratio=0.91,95%confidence interval:0.35-2.40;theχ2 was 1.32,and the P-value for overall effect of 0.85.CONCLUSION No significant statistical differences were evident between trans-oral endoscopic Mirghani H.Infections and swallowing difficulty in scarless thyroidectomy WJCC https://www.wjgnet.com 2 January 6,2026 Volume 14 Issue 1 thyroidectomy vestibular approach and trans-areolar approach regarding postoperative infection and transient swallowing difficulties.Further longer randomized trials are needed.展开更多
Recent increases in infectious diseases affecting the central nervous system have raised concerns about their role in neuroinflammation and neurodegeneration.Viral pathogens or their products can invade the central ne...Recent increases in infectious diseases affecting the central nervous system have raised concerns about their role in neuroinflammation and neurodegeneration.Viral pathogens or their products can invade the central nervous system and cause damage,leading to meningitis,encephalitis,meningoencephalitis,myelitis,or post-infectious demyelinating diseases.Although neuroinflammation initially has a protective function,chronic inflammation can contribute to the development of neurodegenerative diseases.Mechanisms such as protein aggregation and cellular disturbances are implicated with specific viruses such as herpes simplex virus type 1 and Epstein-Barr virus being associated with Alzheimer's disease and multiple sclerosis,respectively.Extracellular nucleotides,particularly adenosine triphosphate and its metabolites are released from activated,infected,and dying cells,acting as alarmins mediating neuroinflammation and neurodegeneration.When viruses infect central nervous system cells,adenosine triphosphate is released as an alarmin,triggering inflammatory responses.This process is mediated by purinergic receptors,divided into two families:P1,which responds to adenosine,and P2,activated by adenosine triphosphate and other nucleotides.This review highlights how specific viruses,such as human immunodeficiency virus type 1,Theiler's murine encephalomyelitis virus,herpes simplex virus type 1,Epstein-Barr virus,dengue virus,Zika virus,and severe acute respiratory syndrome coronavirus 2,can initiate inflammatory responses through the release of extracellular nucleotides,particularly adenosine triphosphate,which act as critical mediators in the progression of neuroinflammation and neurodegenerative disorders.A better understanding of purinergic signaling pathways in these diseases may suggest new potential therapeutic strategies for targeting neuroinflammation to mitigate the long-term consequences of viral infections in the central nervous system.展开更多
Mucormycosis is an invasive fungal infection with an acute onset,rapid progression,and high mortality rate.Since its incidence is lower than that of common fungal infections such as Aspergillus,Candida,and Cryptococcu...Mucormycosis is an invasive fungal infection with an acute onset,rapid progression,and high mortality rate.Since its incidence is lower than that of common fungal infections such as Aspergillus,Candida,and Cryptococcus,it is often overlooked in clinical practice.[1]However,in recent years,the incidence of mucormycosis has increased worldwide,potentially correlating with the growing population of diabetic patients.展开更多
Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative ...Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative potential of comprehensive perioperative disinfection and isolation protocols in gastrointestinal surgery,demonstrating a 55%reduction in postoperative infection rates and attenuation of systemic inflammation.Their findings underscore the critical role of multidisciplinary strategies—such as preoperative povidone-iodine decolonization,intraoperative laminar airflow systems,and strict postoperative wound care—in mitigating infection risk and preserving organ function.However,the study revealed persistent gaps in protocol standardization and compliance monitoring,particularly in resource-limited settings.Although these measures reduce reliance on antibiotics and align with global antimicrobial resistance containment efforts,challenges such as the high cost of technology and issues with contextual adaptability warrant urgent attention.This study conclusively demonstrated that structured perioperative disinfection protocols significantly transform surgical outcomes by creating comprehensive infection barriers that extend beyond traditional antibiotic prophylaxis.Future priorities include prospective multicenter trials to validate efficacy,cost-benefit analyses for equitable implementation,and integration of artificial intelligence-driven innovations to optimize infection prevention.This study redefines infection control as a cornerstone of surgical quality,urging collaborative action to bridge the gap between clinical evidence and real-world practice.展开更多
BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological ...BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological care on emotional states,nosocomial infection rates,and quality of life in critically ill patients.METHODS A total of 202 critically ill patients admitted to Beijing Ditan Hospital(December 2023 to May 2024)were randomly assigned to control(Ctrl,n=101)or observation groups(Obs,n=101).The Ctrl group received 222-nm UV disinfection and routine care,while the Obs group received 222-nm UV disinfection with empathetic psychological care.Emotional states[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)],hospital infection rates,quality of life(36-Item Short Form Health Survey),and patient satisfaction were evaluated.RESULTS At baseline,there were no significant differences in SAS and SDS scores between the groups(P>0.05).Following care,both groups demonstrated reductions in SAS and SDS scores,with the Obs group exhibiting a significantly greater reduction(P<0.05).The Obs group also experienced a significantly lower overall hospital infection rate(P<0.05).Similarly,while baseline 36-Item Short Form Health Survey scores did not differ significantly between the groups(P>0.05),post-care scores improved in both groups,with a greater improvement observed in the Obs group(P<0.05).Additionally,the Obs group reported higher patient satisfaction ratings(P<0.05).CONCLUSION The combination of 222-nm UV disinfection and empathetic psychological care improves emotional states,reduces hospital infection rates,enhances the quality of life,and increases patient satisfaction among critically ill patients.展开更多
BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a ...BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.展开更多
This study focuses on the detection of infection sources in dynamic networks,which is very important for network analysis,cybersecurity,and public health.We aim to improve source detection in complex networks using da...This study focuses on the detection of infection sources in dynamic networks,which is very important for network analysis,cybersecurity,and public health.We aim to improve source detection in complex networks using data,computational advances,and machine learning to improve epidemic response and public health protection.We explore dynamic network analysis and recent algorithms for infection source detection,emphasizing data integration and machine learning.Our approach involves reviewing existing research,identifying gaps,and proposing dynamic network-based infectious disease source detection strategies.Our study highlights evolving infection source detection methods and underscores the potential of machine learning and artificial intelligence.We acknowledge ongoing challenges due to network complexity and outline promising research directions.Detecting infection sources in dynamic networks is vital.This study emphasizes the need for improved techniques and technology integration to address complexities effectively.Advancements will empower us to identify and mitigate epidemics,reducing their societal and public health impacts.展开更多
Background Acupuncture and its related therapies,as an important part of traditional Chinese medicine,have been widely accepted by the public and healthcare professionals all over the world.According to previous revie...Background Acupuncture and its related therapies,as an important part of traditional Chinese medicine,have been widely accepted by the public and healthcare professionals all over the world.According to previous reviews,the department of acupuncture is a potential place where nosocomial infection might occur.Objectives To investigate the common pathogens and possible risk factors for nosocomial infection,figure out the measures and strategies for control and prevention,and provide general reporting guideline for future cases.Methods A systematic literature search of 6 libraries(EMBASE,CINAHL,PubMed,VIP,CNKI,SinoMed)was carried out on nosocomial infection(NIs)after acupuncture and its related therapies(e.g.,moxibustion,cupping,massage,dry needling)published from January 1,2012 to August 31,2023.Studies providing primary data were included;reviews,comments,and non-primary data studies were excluded to prevent duplicate case analysis.Data on bibliographic details,study characteristics,and clinical information were extracted.Results were synthesized through tabulation and categorized by therapy type,country income level,symptoms/diagnoses,pathogens,risk factors,treatments,and outcomes.Conclusion Nosocomial infections after acupuncture and its related therapies are possible but preventable.Prevention measures can be carried out in terms of the risk factors listed above.Future case reports are suggested to provide specific details of infection,including the setting,qualification,treatment,disinfection,and causal evidence.展开更多
Background:In view of the ever-increasing representation of Staphylococcus spp.strains resistant to various antibiotics,the development of in vivo models for evaluation of novel antimicrobials is of utmost importance....Background:In view of the ever-increasing representation of Staphylococcus spp.strains resistant to various antibiotics,the development of in vivo models for evaluation of novel antimicrobials is of utmost importance.Methods:In this article,we describe the development of a fully immunocompetent porcine model of extensive skin and soft tissue damage suitable for testing topical anti-microbial agents that matches the real clinical situation.The model was developed in three consecutive stages with protocols for each stage amended based on the results of the previous one.Results:In the final model,10 excisions of the skin and underlying soft tissue were created in each pig under general anesthesia,with additional incisions to the fascia performed at the base of the defects and immediately inoculated with Staphylococcus aureus suspension.One pig was not inoculated and used as the negative control.Subsequently,the bandages were changed on Days 4,8,11,and 15.At these time points,a filter paper imprint technique(FPIT)was made from each wound for semi-quantitative microbiological evaluation.Tissue samples from the base of the wound together with the adjacent intact tissue of three randomly selected defects of each pig were taken for microbiological,histopathological,and molecular-biological examination.The infection with the inoculated S.aureus strains was sufficient during the whole experiment as confirmed by both FPIT and from tissue samples.The dynamics of the inflammatory markers and clinical signs of infection are also described.Conclusions:A successfully developed porcine model is suitable for in vivo testing of novel short-acting topical antimicrobial agents.展开更多
Osteomyelitis remains a global challenge in the field of orthopedics.Even after standard debridement and antibiotic-assisted treatment,the long-term recurrence rate remains at 20%-30%.Given the dynamic changes in immu...Osteomyelitis remains a global challenge in the field of orthopedics.Even after standard debridement and antibiotic-assisted treatment,the long-term recurrence rate remains at 20%-30%.Given the dynamic changes in immune responses and defense mechanisms during bone infection,as well as the complex“race for the surface”involving bacterial adhesion and host cells(macrophages and tissue cells)on implant surfaces,biomaterials with immunomodulatory functions have attracted considerable attention.Macrophages,as crucial components of the immune system,participate in the inflammatory regulation and tissue remodeling of bone infections through highly plastic polarization mechanisms after bacterial invasion.The different microenvironmental characteristics and therapeutic needs at different stages of bone infection highlight the promising applications of biomaterials capable of macrophage polarization remodeling and sequential regulation.In this review,we provide a detailed discussion of the complex immune regulatory patterns in the bone infection microenvironment and the critical functions of macrophage polarization.We then explore how implant surface properties influence bacterial adhesion and macrophage function,highlighting the importance of achieving precise and dynamic regulation of macrophage polarization based on the Race for the Surface theory.Furthermore,we focus on recent advances,potential challenges,and opportunities in biomaterial-mediated macrophage polarization remodeling and sequential modulation strategies across different stages of osteomyelitis,aiming to offer insights that may accelerate the clinical translation of novel biomaterial-based macrophage immunotherapies.展开更多
Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria...Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria.Viral-bacterial co-infections,which have become increasingly common and a global concern,can lead to substantial complications,causing higher morbidity and adverse prognosis[2].Previous studies have reported low positive detection rates of targeted pathogens related to acute respiratory infections,owing to the limited number of detected pathogens and variations in the sensitivity of diagnostic methods[3-4].Low positive detection rates may impede our understanding of respiratory pathogen characteristics and hamper the development of precise treatment and prevention strategies.展开更多
BACKGROUND The application of perioperative disinfection and isolation measures to patients undergoing gastrointestinal surgery with postoperative infection can provide a data reference for reducing the postoperative ...BACKGROUND The application of perioperative disinfection and isolation measures to patients undergoing gastrointestinal surgery with postoperative infection can provide a data reference for reducing the postoperative infection rate,improving post-operative biochemical markers,and enhancing postoperative recovery outcomes.AIM To explore the effectiveness of perioperative disinfection and isolation measures in controlling postoperative infection following gastrointestinal surgery.It also sought to compare infection rates and biochemical markers between the obser-vation and control groups and evaluate the impact of disinfection and isolation measures on reducing postoperative complications.METHODS A retrospective analysis was conducted.Ninety-six patients who underwent gastrointestinal surgery between January 2022 and December 2023 were selected and divided into an observation group and a control group,with 48 cases in each.The observation group received disinfection and isolation measures during the perioperative period,whereas the control group received standard nursing care.The incidence of infection,white blood cell count,C-reactive protein levels,hemoglobin levels,and liver function markers(alanine aminotransferase,aspartate aminotransferase,creatinine,and blood urea nitrogen)were monitored postoperatively in both groups.RESULTS The postoperative infection rate in the observation group was significantly lower than that in the control group(P<0.05).White blood cell and C-reactive protein levels decreased significantly after surgery in the observation group and were significantly lower than those in the control group(P<0.05).Alanine aminotransferase,aspartate aminotransferase,creatinine,and blood urea nitrogen levels in the observation group were lower than those in the control group on postoperative days 1 and 3,showing a significant difference(P<0.05).CONCLUSION Perioperative disinfection and isolation measures effectively reduce postoperative infection rates in gastrointestinal surgery patients and improve biochemical markers,thereby enhancing recovery outcomes.This study provides a valuable basis for postoperative infection control and has significant clinical applications.展开更多
This editorial critically evaluated the recent study by Wang et al,which systematically investigated the efficacy of perioperative disinfection and isolation measures(including preoperative povidone-iodine disinfectio...This editorial critically evaluated the recent study by Wang et al,which systematically investigated the efficacy of perioperative disinfection and isolation measures(including preoperative povidone-iodine disinfection,intraoperative sterile barrier techniques,and postoperative intensive care)in reducing infection rates.The study further incorporated the surgical site infection risk prediction model(constructed via the least absolute shrinkage and selection operator al-gorithm,integrating patients'baseline characteristics,surgical indicators,and regional antibiotic-resistant bacterial data),and proposed a dynamic prevention and control system termed“disinfection protocols-predictive models–real-time monitoring”.The article highlighted that preoperative risk stratification,intraoperative personalized antibiotic selection,and postoperative multidimensional monitoring(encompassing inflammatory biomarkers,imaging,and microbiological testing)enabled the precise identification of high-risk patients and optimized intervention thresholds.Future research is deemed necessary to validate the synergistic effects of disinfection protocols and predictive models through large-scale multicenter studies,combined with advanced intraoperative rapid microbial detection technologies.This approach aims to establish standardized infection control protocols tailored for precision medicine and regional adaptability.Future research should prioritize validating the synergistic effects of disinfection protocols and predictive models via multi-center studies,while incorporating advanced rapid intraoperative microbial detection technologies to develop standardized infection prevention and control procedures.Such efforts will enhance the implementation of precise and regionally adaptive infection control strategies.展开更多
As the core department in medical institutions responsible for cleaning,disinfecting,sterilizing,and supplying reusable medical devices,instruments,and items,the quality of work in the disinfection supply center direc...As the core department in medical institutions responsible for cleaning,disinfecting,sterilizing,and supplying reusable medical devices,instruments,and items,the quality of work in the disinfection supply center directly impacts medical safety and infection control effectiveness.Professional protective training for personnel is crucial to ensure operational quality in this department.Systematic training enhances staff awareness of occupational exposure risks,standardizes protective measures in procedures,reduces cross-infection risks caused by improper operations,and ultimately lowers infection transmission risks.This paper analyzes the core content,implementation approaches,and practical role of professional protective training for disinfection supply center personnel in infection control.It aims to clarify the significant value of such training,providing references for medical institutions to optimize disinfection center management and strengthen infection control systems,thereby contributing to improved overall medical safety standards.展开更多
In-utero exposure to Zika virus(ZIKV)could lead to miscarriage,preterm birth and congenital Zika syndrome.This study aimed at estimating the burden of ZIKV and Dengue virus(DENV)infections among pregnant women in Boju...In-utero exposure to Zika virus(ZIKV)could lead to miscarriage,preterm birth and congenital Zika syndrome.This study aimed at estimating the burden of ZIKV and Dengue virus(DENV)infections among pregnant women in Bojude,Nigeria.A total of 200 blood samples were collected from pregnant women between February and April 2022.Using the updated CDC guidelines for the diagnosis of ZIKV infections,including ELISA and microneutralization test(MNT),we found that 16.5%of participants were positive for ZIKV IgM,10%were positive for IgG,and 23%had nAb in their serum.Among the 46 ZIKV nAb-positive women,52.2%and 10.9%were recent and previous ZIKV infections,respectively,while 6.5%had previous DENV infections.Although no recent DENV infection was detected,recent and previous ZIKV/DENV co-infections were 13.0%and 17.4%,respectively.Two participants had recent secondary ZIKV infections,while 39.1%had prolonged lifelong immunity.Recent ZIKV infection rates were significantly higher among sexually active females aged 20–29 years than other age groups,with the highest risk observed in the first trimester of pregnancy.In addition,the grand-multiparous women are at higher risk of ZIKV infections than other categories.Monotypic recent,secondary and past ZIKV infections,as well as DENV and ZIKV co-infections,were detected in both the asymptomatic and symptomatic pregnant women.These findings highlight that ZIKV infection is prevalent among pregnant women in Nigeria and underscore the associated risk factors,providing evidence-based information on the burden of ZIKV infections in DENV-endemic region.展开更多
AIM To report the results of the International Nosocomial Infection Control Consortium(INICC)study conducted in Quito,Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI)prospective surveillance st...AIM To report the results of the International Nosocomial Infection Control Consortium(INICC)study conducted in Quito,Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI)prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units(ICUs)from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network(CDC/NHSN)definitions and INICC methods.RESULTS We followed 776 ICU patients for 4818 bed-days.The central line-associated bloodstream infection(CLABSI)rate was 6.5 per 1000 central line(CL)-days,the ventilator-associated pneumonia(VAP)rate was 44.3 per 1000 mechanical ventilator(MV)-days,and the catheterassociated urinary tract infection(CAUTI)rate was 5.7 per 1000 urinary catheter(UC)-days.CLABSI and CAUTI rates in our ICUs were similar to INICC rates[4.9(CLABSI)and 5.3(CAUTI)]and higher than NHSN rates[0.8(CLABSI)and 1.3(CAUTI)]-although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios.By contrast,despite the VAP rate was higher than INICC(16.5)and NHSN's rates(1.1),MV DUR was lower in our ICUs.Resistance of A.baumannii to imipenem and meropenem was 75.0%,and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%,all them higher than CDC/NHSN rates.Excess length of stay was 7.4 d for patients with CLABSI,4.8 for patients with VAP and 9.2 for patients CAUTI.Excess crude mortality in ICUs was 30.9%for CLABSI,14.5%for VAP and 17.6%for CAUTI.CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates.展开更多
BACKGROUND Patients with hepatitis B virus(HBV)infection require chronic and personalized care to improve outcomes.Large language models(LLMs)can potentially provide medical information for patients.AIM To examine the...BACKGROUND Patients with hepatitis B virus(HBV)infection require chronic and personalized care to improve outcomes.Large language models(LLMs)can potentially provide medical information for patients.AIM To examine the performance of three LLMs,ChatGPT-3.5,ChatGPT-4.0,and Google Gemini,in answering HBV-related questions.METHODS LLMs’responses to HBV-related questions were independently graded by two medical professionals using a four-point accuracy scale,and disagreements were resolved by a third reviewer.Each question was run three times using three LLMs.Readability was assessed via the Gunning Fog index and Flesch-Kincaid grade level.RESULTS Overall,all three LLM chatbots achieved high average accuracy scores for subjective questions(ChatGPT-3.5:3.50;ChatGPT-4.0:3.69;Google Gemini:3.53,out of a maximum score of 4).With respect to objective questions,ChatGPT-4.0 achieved an 80.8%accuracy rate,compared with 62.9%for ChatGPT-3.5 and 73.1%for Google Gemini.Across the six domains,ChatGPT-4.0 performed better in terms of diagnosis,whereas Google Gemini demonstrated excellent clinical manifestations.Notably,in the readability analysis,the mean Gunning Fog index and Flesch-Kincaid grade level scores of the three LLM chatbots were significantly higher than the standard level eight,far exceeding the reading level of the normal population.CONCLUSION Our results highlight the potential of LLMs,especially ChatGPT-4.0,for delivering responses to HBV-related questions.LLMs may be an adjunctive informational tool for patients and physicians to improve outcomes.Nevertheless,current LLMs should not replace personalized treatment recommendations from physicians in the management of HBV infection.展开更多
文摘Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacterales have been increasingly reported in children,with higher rates in Asian and Middle Eastern settings than in high-income countries[1,2].
基金the 2026 Health Commission Fund of Guizhou Province,China.the freestatistics suite for its technical support.
文摘Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by climbing antibiotic resistance and intolerable side-effects of standard triple or quadruple therapies.In recent years,fecal microbiota transplantation(FMT),a strategy that reconstructs the gut ecosystem by introducing a healthy donor microbiome,has emerged as a novel adjunct or alternative.By competitively excluding H.pylori,reinforcing mucosal barrier integrity,modulating host immunity and secreting bacteriocins,FMT can raise eradication rates,relieve dyspeptic symptoms and lower recurrence.This review synthesizes up-to-date pre-clinical,pilot and controlled clinical data,dissects underlying mechanisms,compares delivery routes,donor screening protocols and safety profiles,and discusses regulatory,ethical and standardization hurdles that must be overcome before large-scale clinical application.
基金supported by the Innovation and Entrepreneurship Training Program for College Students(X2025102911746,X2025102910483).
文摘Natural product(NPT)derived from traditional Chinese medicine has a rich history as an integral part of Chinese healthcare for thousands of years.Recently,the application of NPT in sonodynamic antibacterial therapy(SDAT)has emerged as a promising area of research.This perspective summarizes the recent NPT-based sonosensitizers in SDAT.Currently,common NPT-based sonosensitizers include curcumin,chlorophyll derivatives,hypericin,and berberine.Compared with other sonosensitizers,natural sources of NPT-based sonosensitizers with reactive oxide species production performance under ultrasound conditions,low biotoxicity,and other additional biological activity make them have application prospects in bacterial removal.Finally,the potential benefits and challenges of NPT-based nanosonosensitizers were also discussed.
文摘BACKGROUND Due to the increasing rate of thyroid nodules diagnosis,and the desire to avoid the unsightly cervical scar,remote thyroidectomies were invented and are increasingly performed.Transoral endoscopic thyroidectomy vestibular approach and trans-areolar approaches(TAA)are the two most commonly used remote approaches.No previous meta-analysis has compared postoperative infections and swallowing difficulties among the two procedures.AIM To compared the same among patients undergoing lobectomy for unilateral thyroid carcinoma/benign thyroid nodule.METHODS We searched PubMed MEDLINE,Google Scholar,and Cochrane Library from the date of the first published article up to August 2025.The term used were transoral thyroidectomy vestibular approach,trans areolar thyroidectomy,scarless thyroidectomy,remote thyroidectomy,infections,postoperative,inflammation,dysphagia,and swallowing difficulties.We identified 130 studies,of them,30 full texts were screened and only six studies were included in the final meta-analysis.RESULTS Postoperative infections were not different between the two approaches,odd ratio=1.33,95%confidence interval:0.50-3.53,theχ2 was 1.92 and the P-value for overall effect of 0.57.Similarly,transient swallowing difficulty was not different between the two forms of surgery,with odd ratio=0.91,95%confidence interval:0.35-2.40;theχ2 was 1.32,and the P-value for overall effect of 0.85.CONCLUSION No significant statistical differences were evident between trans-oral endoscopic Mirghani H.Infections and swallowing difficulty in scarless thyroidectomy WJCC https://www.wjgnet.com 2 January 6,2026 Volume 14 Issue 1 thyroidectomy vestibular approach and trans-areolar approach regarding postoperative infection and transient swallowing difficulties.Further longer randomized trials are needed.
基金supported by funds from the Conselho Nacional de Desenvolvimento Cientifico e Tecnologico do Brasil(CNPq)(312286/2023-6,307201/2023-6,and Instituto Nacional Saude Cerebral INSC,No.406020/2022-1)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior(CAPES)Fundacao de Amparo a Pesquisa do Estado do Rio de Janeiro-FAPERJ(E-26/010.002260/2019,E-26/010.001652/2019,E-26/010.101036/2018,E-26/202.774/2018,E-26/210.240/2020,E-26/211.138/2021,26/210.823/2021,E-26/211.325/2021,E-26/210.779/2021,E-26/201.086/2022,E-26/210.312/2022,E-26/203.262/2023,E-26/200.195/2023)(to LEBS)。
文摘Recent increases in infectious diseases affecting the central nervous system have raised concerns about their role in neuroinflammation and neurodegeneration.Viral pathogens or their products can invade the central nervous system and cause damage,leading to meningitis,encephalitis,meningoencephalitis,myelitis,or post-infectious demyelinating diseases.Although neuroinflammation initially has a protective function,chronic inflammation can contribute to the development of neurodegenerative diseases.Mechanisms such as protein aggregation and cellular disturbances are implicated with specific viruses such as herpes simplex virus type 1 and Epstein-Barr virus being associated with Alzheimer's disease and multiple sclerosis,respectively.Extracellular nucleotides,particularly adenosine triphosphate and its metabolites are released from activated,infected,and dying cells,acting as alarmins mediating neuroinflammation and neurodegeneration.When viruses infect central nervous system cells,adenosine triphosphate is released as an alarmin,triggering inflammatory responses.This process is mediated by purinergic receptors,divided into two families:P1,which responds to adenosine,and P2,activated by adenosine triphosphate and other nucleotides.This review highlights how specific viruses,such as human immunodeficiency virus type 1,Theiler's murine encephalomyelitis virus,herpes simplex virus type 1,Epstein-Barr virus,dengue virus,Zika virus,and severe acute respiratory syndrome coronavirus 2,can initiate inflammatory responses through the release of extracellular nucleotides,particularly adenosine triphosphate,which act as critical mediators in the progression of neuroinflammation and neurodegenerative disorders.A better understanding of purinergic signaling pathways in these diseases may suggest new potential therapeutic strategies for targeting neuroinflammation to mitigate the long-term consequences of viral infections in the central nervous system.
基金supported by the National Natural Science Foundation(82372206)the Project of Jiangsu Provincial Health Commission(H2023107)the Project of Basic and Clinical Research on Cardiac Arrest in the Emergency and Critical Care Department of the Second Affiliated Hospital of Soochow University(XKTJ-XK202408-2).
文摘Mucormycosis is an invasive fungal infection with an acute onset,rapid progression,and high mortality rate.Since its incidence is lower than that of common fungal infections such as Aspergillus,Candida,and Cryptococcus,it is often overlooked in clinical practice.[1]However,in recent years,the incidence of mucormycosis has increased worldwide,potentially correlating with the growing population of diabetic patients.
文摘Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative potential of comprehensive perioperative disinfection and isolation protocols in gastrointestinal surgery,demonstrating a 55%reduction in postoperative infection rates and attenuation of systemic inflammation.Their findings underscore the critical role of multidisciplinary strategies—such as preoperative povidone-iodine decolonization,intraoperative laminar airflow systems,and strict postoperative wound care—in mitigating infection risk and preserving organ function.However,the study revealed persistent gaps in protocol standardization and compliance monitoring,particularly in resource-limited settings.Although these measures reduce reliance on antibiotics and align with global antimicrobial resistance containment efforts,challenges such as the high cost of technology and issues with contextual adaptability warrant urgent attention.This study conclusively demonstrated that structured perioperative disinfection protocols significantly transform surgical outcomes by creating comprehensive infection barriers that extend beyond traditional antibiotic prophylaxis.Future priorities include prospective multicenter trials to validate efficacy,cost-benefit analyses for equitable implementation,and integration of artificial intelligence-driven innovations to optimize infection prevention.This study redefines infection control as a cornerstone of surgical quality,urging collaborative action to bridge the gap between clinical evidence and real-world practice.
基金Supported by Beijing Ditan Hospital Affiliated to Capital Medical University“Sailing Plan”,No.DTQH-202405.
文摘BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological care on emotional states,nosocomial infection rates,and quality of life in critically ill patients.METHODS A total of 202 critically ill patients admitted to Beijing Ditan Hospital(December 2023 to May 2024)were randomly assigned to control(Ctrl,n=101)or observation groups(Obs,n=101).The Ctrl group received 222-nm UV disinfection and routine care,while the Obs group received 222-nm UV disinfection with empathetic psychological care.Emotional states[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)],hospital infection rates,quality of life(36-Item Short Form Health Survey),and patient satisfaction were evaluated.RESULTS At baseline,there were no significant differences in SAS and SDS scores between the groups(P>0.05).Following care,both groups demonstrated reductions in SAS and SDS scores,with the Obs group exhibiting a significantly greater reduction(P<0.05).The Obs group also experienced a significantly lower overall hospital infection rate(P<0.05).Similarly,while baseline 36-Item Short Form Health Survey scores did not differ significantly between the groups(P>0.05),post-care scores improved in both groups,with a greater improvement observed in the Obs group(P<0.05).Additionally,the Obs group reported higher patient satisfaction ratings(P<0.05).CONCLUSION The combination of 222-nm UV disinfection and empathetic psychological care improves emotional states,reduces hospital infection rates,enhances the quality of life,and increases patient satisfaction among critically ill patients.
基金Supported by Natural Science Foundation of Shandong Province,No.ZR2023MH331.
文摘BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.
文摘This study focuses on the detection of infection sources in dynamic networks,which is very important for network analysis,cybersecurity,and public health.We aim to improve source detection in complex networks using data,computational advances,and machine learning to improve epidemic response and public health protection.We explore dynamic network analysis and recent algorithms for infection source detection,emphasizing data integration and machine learning.Our approach involves reviewing existing research,identifying gaps,and proposing dynamic network-based infectious disease source detection strategies.Our study highlights evolving infection source detection methods and underscores the potential of machine learning and artificial intelligence.We acknowledge ongoing challenges due to network complexity and outline promising research directions.Detecting infection sources in dynamic networks is vital.This study emphasizes the need for improved techniques and technology integration to address complexities effectively.Advancements will empower us to identify and mitigate epidemics,reducing their societal and public health impacts.
基金Supported by grants from Shanghai Municipal Health Commission for the Inheritance and Innovation of Traditional Chinese Medicine:ZY (2021-2023)-0204。
文摘Background Acupuncture and its related therapies,as an important part of traditional Chinese medicine,have been widely accepted by the public and healthcare professionals all over the world.According to previous reviews,the department of acupuncture is a potential place where nosocomial infection might occur.Objectives To investigate the common pathogens and possible risk factors for nosocomial infection,figure out the measures and strategies for control and prevention,and provide general reporting guideline for future cases.Methods A systematic literature search of 6 libraries(EMBASE,CINAHL,PubMed,VIP,CNKI,SinoMed)was carried out on nosocomial infection(NIs)after acupuncture and its related therapies(e.g.,moxibustion,cupping,massage,dry needling)published from January 1,2012 to August 31,2023.Studies providing primary data were included;reviews,comments,and non-primary data studies were excluded to prevent duplicate case analysis.Data on bibliographic details,study characteristics,and clinical information were extracted.Results were synthesized through tabulation and categorized by therapy type,country income level,symptoms/diagnoses,pathogens,risk factors,treatments,and outcomes.Conclusion Nosocomial infections after acupuncture and its related therapies are possible but preventable.Prevention measures can be carried out in terms of the risk factors listed above.Future case reports are suggested to provide specific details of infection,including the setting,qualification,treatment,disinfection,and causal evidence.
基金Supported by the Ministry of Health of the Czech Republic,Grant/Award Number:NU22-05-00475 and NV19-05-00214。
文摘Background:In view of the ever-increasing representation of Staphylococcus spp.strains resistant to various antibiotics,the development of in vivo models for evaluation of novel antimicrobials is of utmost importance.Methods:In this article,we describe the development of a fully immunocompetent porcine model of extensive skin and soft tissue damage suitable for testing topical anti-microbial agents that matches the real clinical situation.The model was developed in three consecutive stages with protocols for each stage amended based on the results of the previous one.Results:In the final model,10 excisions of the skin and underlying soft tissue were created in each pig under general anesthesia,with additional incisions to the fascia performed at the base of the defects and immediately inoculated with Staphylococcus aureus suspension.One pig was not inoculated and used as the negative control.Subsequently,the bandages were changed on Days 4,8,11,and 15.At these time points,a filter paper imprint technique(FPIT)was made from each wound for semi-quantitative microbiological evaluation.Tissue samples from the base of the wound together with the adjacent intact tissue of three randomly selected defects of each pig were taken for microbiological,histopathological,and molecular-biological examination.The infection with the inoculated S.aureus strains was sufficient during the whole experiment as confirmed by both FPIT and from tissue samples.The dynamics of the inflammatory markers and clinical signs of infection are also described.Conclusions:A successfully developed porcine model is suitable for in vivo testing of novel short-acting topical antimicrobial agents.
基金supported by National Natural Science Foundation of China(Grant No.82072392)Yunnan Orthopedics and Sports Rehabilitation Clinical Medicine Research Center(Grant No.202102AA310068)+2 种基金Yunnan Clinical Medical Center for Traumatology and Orthopedics(Grant No.ZX20191001)Basic research project of Science and Technology Department of Yunnan Province(Grant No.202301AC070621)Scientific Research Fund Project Department of Education of Yunnan Province(Grant No.2024Y251)。
文摘Osteomyelitis remains a global challenge in the field of orthopedics.Even after standard debridement and antibiotic-assisted treatment,the long-term recurrence rate remains at 20%-30%.Given the dynamic changes in immune responses and defense mechanisms during bone infection,as well as the complex“race for the surface”involving bacterial adhesion and host cells(macrophages and tissue cells)on implant surfaces,biomaterials with immunomodulatory functions have attracted considerable attention.Macrophages,as crucial components of the immune system,participate in the inflammatory regulation and tissue remodeling of bone infections through highly plastic polarization mechanisms after bacterial invasion.The different microenvironmental characteristics and therapeutic needs at different stages of bone infection highlight the promising applications of biomaterials capable of macrophage polarization remodeling and sequential regulation.In this review,we provide a detailed discussion of the complex immune regulatory patterns in the bone infection microenvironment and the critical functions of macrophage polarization.We then explore how implant surface properties influence bacterial adhesion and macrophage function,highlighting the importance of achieving precise and dynamic regulation of macrophage polarization based on the Race for the Surface theory.Furthermore,we focus on recent advances,potential challenges,and opportunities in biomaterial-mediated macrophage polarization remodeling and sequential modulation strategies across different stages of osteomyelitis,aiming to offer insights that may accelerate the clinical translation of novel biomaterial-based macrophage immunotherapies.
基金supported by the Beijing Science and Technology Planning Project of the Beijing Science and Technology Commission(Z241100009024047)the High-Level Public Health Technical Talent Training Plan(lingjunrencai-01-02).
文摘Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria.Viral-bacterial co-infections,which have become increasingly common and a global concern,can lead to substantial complications,causing higher morbidity and adverse prognosis[2].Previous studies have reported low positive detection rates of targeted pathogens related to acute respiratory infections,owing to the limited number of detected pathogens and variations in the sensitivity of diagnostic methods[3-4].Low positive detection rates may impede our understanding of respiratory pathogen characteristics and hamper the development of precise treatment and prevention strategies.
文摘BACKGROUND The application of perioperative disinfection and isolation measures to patients undergoing gastrointestinal surgery with postoperative infection can provide a data reference for reducing the postoperative infection rate,improving post-operative biochemical markers,and enhancing postoperative recovery outcomes.AIM To explore the effectiveness of perioperative disinfection and isolation measures in controlling postoperative infection following gastrointestinal surgery.It also sought to compare infection rates and biochemical markers between the obser-vation and control groups and evaluate the impact of disinfection and isolation measures on reducing postoperative complications.METHODS A retrospective analysis was conducted.Ninety-six patients who underwent gastrointestinal surgery between January 2022 and December 2023 were selected and divided into an observation group and a control group,with 48 cases in each.The observation group received disinfection and isolation measures during the perioperative period,whereas the control group received standard nursing care.The incidence of infection,white blood cell count,C-reactive protein levels,hemoglobin levels,and liver function markers(alanine aminotransferase,aspartate aminotransferase,creatinine,and blood urea nitrogen)were monitored postoperatively in both groups.RESULTS The postoperative infection rate in the observation group was significantly lower than that in the control group(P<0.05).White blood cell and C-reactive protein levels decreased significantly after surgery in the observation group and were significantly lower than those in the control group(P<0.05).Alanine aminotransferase,aspartate aminotransferase,creatinine,and blood urea nitrogen levels in the observation group were lower than those in the control group on postoperative days 1 and 3,showing a significant difference(P<0.05).CONCLUSION Perioperative disinfection and isolation measures effectively reduce postoperative infection rates in gastrointestinal surgery patients and improve biochemical markers,thereby enhancing recovery outcomes.This study provides a valuable basis for postoperative infection control and has significant clinical applications.
文摘This editorial critically evaluated the recent study by Wang et al,which systematically investigated the efficacy of perioperative disinfection and isolation measures(including preoperative povidone-iodine disinfection,intraoperative sterile barrier techniques,and postoperative intensive care)in reducing infection rates.The study further incorporated the surgical site infection risk prediction model(constructed via the least absolute shrinkage and selection operator al-gorithm,integrating patients'baseline characteristics,surgical indicators,and regional antibiotic-resistant bacterial data),and proposed a dynamic prevention and control system termed“disinfection protocols-predictive models–real-time monitoring”.The article highlighted that preoperative risk stratification,intraoperative personalized antibiotic selection,and postoperative multidimensional monitoring(encompassing inflammatory biomarkers,imaging,and microbiological testing)enabled the precise identification of high-risk patients and optimized intervention thresholds.Future research is deemed necessary to validate the synergistic effects of disinfection protocols and predictive models through large-scale multicenter studies,combined with advanced intraoperative rapid microbial detection technologies.This approach aims to establish standardized infection control protocols tailored for precision medicine and regional adaptability.Future research should prioritize validating the synergistic effects of disinfection protocols and predictive models via multi-center studies,while incorporating advanced rapid intraoperative microbial detection technologies to develop standardized infection prevention and control procedures.Such efforts will enhance the implementation of precise and regionally adaptive infection control strategies.
文摘As the core department in medical institutions responsible for cleaning,disinfecting,sterilizing,and supplying reusable medical devices,instruments,and items,the quality of work in the disinfection supply center directly impacts medical safety and infection control effectiveness.Professional protective training for personnel is crucial to ensure operational quality in this department.Systematic training enhances staff awareness of occupational exposure risks,standardizes protective measures in procedures,reduces cross-infection risks caused by improper operations,and ultimately lowers infection transmission risks.This paper analyzes the core content,implementation approaches,and practical role of professional protective training for disinfection supply center personnel in infection control.It aims to clarify the significant value of such training,providing references for medical institutions to optimize disinfection center management and strengthen infection control systems,thereby contributing to improved overall medical safety standards.
文摘In-utero exposure to Zika virus(ZIKV)could lead to miscarriage,preterm birth and congenital Zika syndrome.This study aimed at estimating the burden of ZIKV and Dengue virus(DENV)infections among pregnant women in Bojude,Nigeria.A total of 200 blood samples were collected from pregnant women between February and April 2022.Using the updated CDC guidelines for the diagnosis of ZIKV infections,including ELISA and microneutralization test(MNT),we found that 16.5%of participants were positive for ZIKV IgM,10%were positive for IgG,and 23%had nAb in their serum.Among the 46 ZIKV nAb-positive women,52.2%and 10.9%were recent and previous ZIKV infections,respectively,while 6.5%had previous DENV infections.Although no recent DENV infection was detected,recent and previous ZIKV/DENV co-infections were 13.0%and 17.4%,respectively.Two participants had recent secondary ZIKV infections,while 39.1%had prolonged lifelong immunity.Recent ZIKV infection rates were significantly higher among sexually active females aged 20–29 years than other age groups,with the highest risk observed in the first trimester of pregnancy.In addition,the grand-multiparous women are at higher risk of ZIKV infections than other categories.Monotypic recent,secondary and past ZIKV infections,as well as DENV and ZIKV co-infections,were detected in both the asymptomatic and symptomatic pregnant women.These findings highlight that ZIKV infection is prevalent among pregnant women in Nigeria and underscore the associated risk factors,providing evidence-based information on the burden of ZIKV infections in DENV-endemic region.
文摘AIM To report the results of the International Nosocomial Infection Control Consortium(INICC)study conducted in Quito,Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI)prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units(ICUs)from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network(CDC/NHSN)definitions and INICC methods.RESULTS We followed 776 ICU patients for 4818 bed-days.The central line-associated bloodstream infection(CLABSI)rate was 6.5 per 1000 central line(CL)-days,the ventilator-associated pneumonia(VAP)rate was 44.3 per 1000 mechanical ventilator(MV)-days,and the catheterassociated urinary tract infection(CAUTI)rate was 5.7 per 1000 urinary catheter(UC)-days.CLABSI and CAUTI rates in our ICUs were similar to INICC rates[4.9(CLABSI)and 5.3(CAUTI)]and higher than NHSN rates[0.8(CLABSI)and 1.3(CAUTI)]-although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios.By contrast,despite the VAP rate was higher than INICC(16.5)and NHSN's rates(1.1),MV DUR was lower in our ICUs.Resistance of A.baumannii to imipenem and meropenem was 75.0%,and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%,all them higher than CDC/NHSN rates.Excess length of stay was 7.4 d for patients with CLABSI,4.8 for patients with VAP and 9.2 for patients CAUTI.Excess crude mortality in ICUs was 30.9%for CLABSI,14.5%for VAP and 17.6%for CAUTI.CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates.
基金Supported by National Natural Science Foundation of China,No.82260133the Key Laboratory Project of Digestive Diseases in Jiangxi Province,No.2024SSY06101Jiangxi Clinical Research Center for Gastroenterology,No.20223BCG74011.
文摘BACKGROUND Patients with hepatitis B virus(HBV)infection require chronic and personalized care to improve outcomes.Large language models(LLMs)can potentially provide medical information for patients.AIM To examine the performance of three LLMs,ChatGPT-3.5,ChatGPT-4.0,and Google Gemini,in answering HBV-related questions.METHODS LLMs’responses to HBV-related questions were independently graded by two medical professionals using a four-point accuracy scale,and disagreements were resolved by a third reviewer.Each question was run three times using three LLMs.Readability was assessed via the Gunning Fog index and Flesch-Kincaid grade level.RESULTS Overall,all three LLM chatbots achieved high average accuracy scores for subjective questions(ChatGPT-3.5:3.50;ChatGPT-4.0:3.69;Google Gemini:3.53,out of a maximum score of 4).With respect to objective questions,ChatGPT-4.0 achieved an 80.8%accuracy rate,compared with 62.9%for ChatGPT-3.5 and 73.1%for Google Gemini.Across the six domains,ChatGPT-4.0 performed better in terms of diagnosis,whereas Google Gemini demonstrated excellent clinical manifestations.Notably,in the readability analysis,the mean Gunning Fog index and Flesch-Kincaid grade level scores of the three LLM chatbots were significantly higher than the standard level eight,far exceeding the reading level of the normal population.CONCLUSION Our results highlight the potential of LLMs,especially ChatGPT-4.0,for delivering responses to HBV-related questions.LLMs may be an adjunctive informational tool for patients and physicians to improve outcomes.Nevertheless,current LLMs should not replace personalized treatment recommendations from physicians in the management of HBV infection.
