Prostate cancer (PCa) ranks as the second most prevalent malignancy among men worldwide. Early diagnosis, personalized treatment, and prognosis prediction of PCa play a crucial role in improving patients' survival rates. The advancement of artificial intelligence (AI), particularly the utilization of deep learning (DL) algorithms, has brought about substantial progress in assisting the diagnosis, treatment, and prognosis prediction of PCa. The introduction of the foundation model has revolutionized the application of AI in medical treatment and facilitated its integration into clinical practice. This review emphasizes the clinical application of AI in PCa by discussing recent advancements from both pathological and imaging perspectives. Furthermore, it explores the current challenges faced by AI in clinical applications while also considering future developments, aiming to provide a valuable point of reference for the integration of AI and clinical applications.
Humans ; Prostatic Neoplasms/diagnosis* ; Male ; Artificial Intelligence ; Deep Learning ; Prognosis

OBJECTIVE: To compare the short-term clinical outcomes and radiographic results of robotic-assisted total knee arthroplasty (RATKA) using the ROSA robot with those of traditional total knee arthroplasty (TKA). METHODS: A retrospective analysis was conducted on 55 patients who underwent unilateral TKA due to end-stage knee osteoarthritis(KOA), defined as Kellgren-Lawrence grade Ⅲ or Ⅳ, between June 2024 and December 2024. The patients were divided into two groups based on the surgical approach:the RATKA group and the conventional TKA group. The RATKA group included 25 patients, consisting of 6 males and 19 females, aged from 46 to 84 years old with a mean of ( 65.20±1.93 ) years old. Among them, 11 cases involved the left knee and 14 cases involved the right knee. The traditional TKA group included 30 patients, consisting of 5 males and 25 females, aged from 57 to 85 years old with an average of (68.73±1.36) years old. Among them, 13 cases involved the left knee and 17 cases involved the right knee. Operation time, total perioperative blood loss, and postoperative complications were compared between the two groups. Radiographic evaluation included preoperative and postoperative hip-knee-ankle (HKA) angle, and postoperative lateral tibial component angle (LTC), frontal femoral component angle (FFC), sagittal lateral femoral component angle(LFC), and frontal tibial component (FTC), for the assessment of lower extremity mechanical axis and prosthesis position. The American Knee Society score(KSS), visual analogue scale(VAS) for pain, and range of motion (ROM) of the knee joint preoperatively and postoperatively were compared between the two groups to evaluate the short-term clinical efficacy. RESULTS: All surgeries in both groups were successfully completed without intraoperative vascular or nerve injury. Primary wound healing (GradeⅠ) was achieved in all cases, and no infection occurred during follow-up. A total of 55 patients completed the follow-up, with a follow-up duration ranging from 3 to 6 months with a mean of (4.0±1.1) months. The average operation time was (106.56±9.70) minutes in the RATKA group and (90.10±10.97) minutes in the traditional TKA group, with a statistically significant difference between the two groups (P<0.05). However, there was no statistically significant difference in the total perioperative blood loss between the two groups(P>0.05). Postoperative X-ray examinations showed that the prosthesis was well-positioned in all patients of both groups, with no signs of prosthesis loosening or dislocation. On the 1st day postoperatively, the HKA and FFC angle in the RATKA group were (179.25±2.50)° and (89.24±1.58)°, while those in the traditional TKA group were (177.68±2.73)° and (88.25±1.91)°, both showing statistically significant differences(P<0.05). In contrast, there were no statistically significant differences in the FTC, LTC, or LFC angles between the two groups(P>0.05). At 1 month and 3 months postoperatively, the ROM values were (110.68±4.92)° and (117.28±4.91)° in the RATKA group, and (106.25±6.89)° and (113.43±7.91)° in the traditional TKA group, both showing statistically significant difference(P<0.05). Nevertheless, there were no statistically significant differences in the VAS (both at rest and during movement) or KSS between the two groups at 1 month and 3 months postoperatively(P>0.05). Compared with the preoperative data, both groups showed significant improvements in the HKA angle, VAS(at rest and during movement), knee ROM, and KSS (both clinical and functional scores) postoperatively, with statistically significant differences(P<0.05). CONCLUSION Compared to traditional TKA, ROSA robotic system-assisted TKA in patients with severe knee osteoarthritis achieved superior accuracy in prosthesis positioning and lower limb mechanical axis restoration, showing satisfactory clinical outcomes. Although short-term outcomes are favorable, long-term clinical efficacy requires further investigation.
Humans ; Male ; Female ; Arthroplasty, Replacement, Knee/methods* ; Aged ; Middle Aged ; Aged, 80 and over ; Robotic Surgical Procedures/methods* ; Retrospective Studies ; Osteoarthritis, Knee/surgery* ; Treatment Outcome ; Knee Joint/physiopathology*

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Objective:To investigate the enrollment scale and distribution of Master's Degree in Pediatrics programs in China, and to provide a reference for promoting pediatric education and disciplinary development.Methods:Data on colleges and universities authorized to award Master's Degree in Pediatrics in 2023 were collected, sorted, and analyzed for the number, structure, distribution, and enrollment scale and direction of these institutions using descriptive statistics.Results:Among the 117 clinical medicine academic master's degree programs in China, 72 enroll pediatric academic master's degree candidates, with an enrollment of 260 students. Among the 120 master's degree programs in clinical medicine, 104 enroll professional master's degree candidates, enrolling 1 195 students. Enrollment is mainly concentrated in East China, "non-double first-class" colleges and universities, medical colleges and universities with subject level B, and enrollment is carried out in the direction of secondary disciplines.Conclusions:The number of colleges and universities authorized to award Master's Degree in Pediatrics was small, and the distribution of these colleges and universities was unbalanced. The enrollment scale was small and the orientation of Professional Master's Degree was not reasonable. Some colleges and universities were authorized to award Master's Degree in Pediatrics, but did not enroll any students. It is suggested to increase the number of colleges and universities authorized to award Master's Degree in Pediatrics and strengthen the staffing of pediatric departments. The aim is to expand the enrollment scale of candidates for Master's Degree in Pediatrics, improving the differential training of candidates for Academic Master's Degree and Professional Master's Degree, and attach importance to the construction of pediatrics.

Objective To analyze the risk factors of gastrointestinal bleeding in patients with type A aortic dissection(TAAD)after Sun's operation.Methods The clinical data of 87 patients who underwent TAAD Sun's operation in our hospital from March 2021 to June 2022 were retrospectively analyzed.They were divided into the bleeding group and the non-bleeding group according to whether there was gastrointestinal bleeding after operation.The clinical data of patients in the two groups was compared and analyzed.The binary Logistic regression analysis was used to analyze the risk factors of gastrointestinal bleeding.The clinical predictor of postoperative gastrointestinal bleeding was analyzed by receiver operating characteristic(ROC)curve.Results In this study,there were 40 cases of postoperative gastrointestinal bleeding(the bleeding group)and 47 cases of non-bleeding(the non-bleeding group).Compared with the non-bleeding group,the bleeding group had a shorter onset time,a higher proportion of patients with hypertension history,a higher preoperative creatinine abnormality rate,more intraoperative blood loss,longer postoperative mechanical ventilation time,higher postoperative infection rate,and higher poor prognosis rate,with statistically significant differences(P<0.05).There was no statistically significant difference in the gender,age,gastrointestinal diseases history,smoking history,preoperative platelets,preoperative international normalized ratio(INR),preoperative alanine aminotransferase(ALT),preoperative aspartate aminotransferase(AST),preoperative γ-glutamyl transpeptidase(GGT),preoperative dissection involving abdominal aorta,operation time,intraoperative cardiopulmonary bypass time,intraoperative circulatory arrest time,intraoperative aortic occlusion time or intraoperative blood transfusion rate.Logistic regression analysis showed that hypertension history(OR=2.468,95%CI:0.862 to 7.067,P=0.037),preoperative creatinine>105 μmol/L(OR=3.970,95%CI:1.352 to 11.659,P=0.011),long postoperative mechanical ventilation time(OR=1.015,95%CI:0.094 to 1.018,P=0.041)and postoperative infection(OR=3.435,95%CI:0.991 to 11.900,P=0.012)were the independent risk factors for postoperative gastrointestinal bleeding in TAAD patients.ROC curve showed that the postoperative mechanical ventilation time exceeding 64 hours were the clinical predictor of postoperative gastrointestinal bleeding in TAAD patients.Conclusion The prognosis of TAAD patients with postoperative gastrointestinal bleeding after Sun's operation is poor.Hypertension history,preoperative acute renal insufficiency,long postoperative mechanical ventilation time and postoperative infection are closely related to postoperative gastrointestinal bleeding in TAAD patients after operation,which should be paid more attention to,and corresponding evaluation,early identification and early intervention should be made to improve the prognosis of patients.

Objective:To analyze the correlation between serum antibody titers of anti-contactin associated protein-like 2 (CASPR2) antibody and clinical features and prognosis in encephalitis.Methods:A retrospective analysis was conducted on the clinical data of 31 patients diagnosed with anti-CASPR2 antibody encephalitis at the First Affiliated Hospital of Zhengzhou University from January 2018 to April 2024. Patients were divided into low titer group (≤1∶32) and high titer group (>1∶32) based on serum anti-CASPR2 antibody titers, and their clinical characteristics, auxiliary examination results, and prognosis were compared between the two groups.Results:Among the 31 patients with anti CASPR2 antibody encephalitis (male∶female=1∶1.4), there were 16 cases in the low titer group and 15 cases in the high titer group; The age of patients in the high titer group was (33.9±17.9)years, which was lower than that of patients in the low titer group [(52.9±17.9)years], and the difference was statistically significant ( P=0.006). The proportion of patients with prodromal infection in the high titer group (6/15) was higher than that in the low titer group (1/16, P=0.037). There was no statistically significant difference in the cerebrospinal fluid related test results, imaging examination of intracranial abnormal lesions, abnormal electroencephalogram, serum abnormal tumor markers, and serum abnormal rheumatic immune indicators between the two groups of patients (all P>0.05). During hospitalization, one patient in the high titer group died; During the follow-up period, one patient died and three patients relapsed, all of whom were in the high titer group. During follow-up, the mRS scores of 6 patients ranged from 3 to 5 points (indicating functional impairment), with 4 cases in the high titer group and 2 cases in the low titer group. The proportion of patients with poor prognosis in the high titer group (9/15) was higher than that in the low titer group (2/16), and the difference was statistically significant ( P=0.021). Conclusions:Patients with high serum anti-CASPR2 antibody titers and encephalitis have a lower age of onset and are prone to pre infection triggers. High antibody titers may be associated with a higher risk of disease recurrence and poor prognosis for patients.

Objective:Peritoneal free cancer cells can negatively impact disease progression and patient outcomes in gastric cancer.This study aimed to investigate the feasibility of using golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging(GRASP DCE-MRI)to predict the presence of peritoneal free cancer cells in gastric cancer patients.Methods:All enrolled patients were consecutively divided into analysis and validation groups.Preoperative magnetic resonance imaging(MRI)scans and perfusion were performed in patients with gastric cancer undergoing surgery,and peritoneal lavage specimens were collected for examination.Based on the peritoneal lavage cytology(PLC)results,patients were divided into negative and positive lavage fluid groups.The data collected included clinical and MR information.A nomogram prediction model was constructed to predict the positive rate of peritoneal lavage fluid,and the validity of the model was verified based on data from the verification group.Results:There was no statistical difference between the proportion of PLC-positive cases predicted by GRASP DCE-MR and the actual PLC test.MR tumor stage,tumor thickness,and perfusion parameter Tofts-Ketty model volume transfer constant(Ktrans)were independent predictors of positive peritoneal lavage fluid.The nomogram model featured a concordance index(C-index)of 0.785 and 0.742 for the modeling and validation groups,respectively.Conclusions:GRASP DCE-MR could effectively predict peritoneal free cancer cells in gastric cancer patients.The nomogram model constructed using these predictors may help clinicians to better predict the risk of peritoneal free cancer cells being present in gastric cancer patients.

Objective This paper aims to investigate the application of intraoral scanning and cone beam computed tomography(CBCT)registration implant robot in dental implant surgery.Methods The data of 40 cases with dental de-fect of robot-assisted implantation from November 2023 to May 2024 were retrospectively analyzed.Before the opera-tion,the intraoral scan data and CBCT data of the posi-tioning markers were automatically fused with the initial CBCT images,and the registration error was calculated.The average registration error of positioning markers was determined during the operation,and the implantation ac-curacy was analyzed after the operation.Results The intraoral scan data and CBCT data of 40 patients with dental defect wearing positioning markers were successfully registered with the initial CBCT image,and the registration errors were(0.157±0.026)mm and(0.154±0.033)mm,respectively.Statistical analysis showed no statistical significance between them.The registration errors of the marker was(0.037 3±0.003 6)mm.A total of 55 implants were performed,and the total deviations of the implant point and the apical point were(0.78±0.41)and(0.89±0.28)mm,respectively.The transverse deviations of the implant point and the apical point were(0.44±0.36)and(0.58±0.25)mm,respectively.The depth deviations of the implant point and the apical point were(0.51±0.32)and(0.54±0.36)mm,respectively.The devia-tion of the implant angle was 1.24°±0.67°.Conclusion The fusion technology based on intraoral scanning and CBCT registration can meet the accuracy requirements of preoperative registration of oral implant robots.The technology in-creases the choice of registration methods before robot-assisted dental implant surgery and reduces the multiple radiation exposuresof the patient.

Objective To compare the early effects on pelvic floor function of three modes of labor:natural delivery,cesarean section and forceps-assisted delivery.Methods Fifty-eight cases of women who underwent transperineal three-dimensional pelvic floor ultrasonography at 6 weeks postpartum at Obstetrics and Gynecology Hospital,Fudan University from Jan 2019 to Jan 2020 were collected and divided into three groups:the natural birth group(n=22),cesarean section group(n=9),and forceps group(n=27).General data such as age,parity,birth order,neonatal weight,and pelvic floor ultrasonography findings were collected.Results The differences in age,gestational week at delivery,newborn weight and number of pregnancies among the three groups were not statistically significant.In pelvic floor ultrasonography,it was found that in the resting state,the cervix had a smaller vertical distance from the inferior border of the pubic symphysis and a smaller posterior vesicourethral angle in the forceps group compared with the cesarean section group.In the forceps group,the angle of urethral inclination was greater,and the area of the anorectal hiatus was smaller in the resting state compared with the natural birth group and cesarean section group.In the Valsalva state,the vertical distance of the bladder neck and the cervix from the lower edge of the pubic symphysis were smaller in the forceps group compared with the natural birth group and cesarean section group.In the transition from resting to Valsalva state,the angle of rotation of the urethra was greater in the natural birth group and the forceps group than in the cesarean section group.Cervical mobility and recto-pubic abdominal mobility were greater in the forceps group compared to the natural birth group and the cesarean section group.All these differences were statistically significant(P<0.05).Conclusion In the early stage of labor,forceps-assisted delivery had a greater effect on the displacement of pelvic floor organs than natural labour and cesarean section.

Objective:To investigate the etiological characteristics of hand, foot and mouth disease (HFMD) and the VP1 gene evolution of coxsackievirus A6 (CVA6) in Qingdao from 2020 to 2022.Methods:Total enterovirus (EV), enterovirus 71 (EV71), coxsackievirus A16 (CVA16), CVA6 and coxsackievirus A10 (CVA10) were detected by fluorescent RT-PCR in throat swab samples from HFMD patients in Qingdao from 2020 to 2022. The full-length sequence amplification of VP1 gene and gene sequence determination of CVA6 isolates were performed, and the phylogenetic and molecular characteristics were analyzed by MEGA-X software.Results:The overall positive rate of enteroviruses in 1 645 samples collected during 2020-2021 was 80.73%(1 328/1 645). The proportions of EV71, CVA16, CVA6, CVA10 and other enteroviruses were 0.08%(1/1 328), 19.65%(261/1 328), 68.15%(905/1 328), 0.98%(13/1 328) and 11.14%(148/1 328), respectively. Children under 5 years old accounted for 75.68% (1 245/1 645) of all cases and 100% (2/2) of severe cases. A phylogenetic tree was constructed based on the VP1 region sequences of 45 CVA6 strains showing all strains belonging to the D3a subtype. There were 10 non-synonymous mutations of amino acids in the VP1 protein by gene evolution analysis.Conclusions:CVA6 D3a subtype is the main epidemic strain causing HFMD in Qingdao from 2020 to 2022, especially in children under 5 years old.