The application of artificial intelligence (AI) in medicine has attracted extensive attention. AI-assisted endoscopic diagnosis is the hot spot of research. The operation of digestive endoscopy is completed by endoscopists in clinical settings, and the diagnosis is completed by endoscopists' eyes along with pathological biopsy findings. It is essentially a process of continuously accumulating experience and gradually perfecting. AI-assisted endoscopic diagnosis is expected to improve the detection rate of digestive tract lesions and reduce missed diagnosis effectively. This article reviewed the role and progress in research on application of AI in endoscopic diagnosis of digestive system diseases.

ObjectiveTo investigate the status of health literacy of child rearing among caregivers of 0‒3 year-old children and analyze its determinants in Minhang District， Shanghai to provide scientific evidence for further promoting health literacy of caregivers. MethodsThe caregivers of 0‒3 year-old children were randomly selected and investigated using a questionnaire of health literacy in 13 community health care centers of Minhang District from March 2020 to April 2021. ResultsA total of 2819 valid questionnaires were collected. The total score of health literacy of child rearing for caregivers were 159.2±23.1 （full score being 200.0）. The score of physical health literacy and mental health literacy were 80.0±10.2 and 79.1±15.1， respectively （full score being 100.0）. The proportions of health literacy in the caregivers were： scarce 3.1%， insufficient 7.6%， good 47.2%， and excellent 42.1%. The multivariate ordinal Logistic regression model showed the following were independent determinants： always （OR=5.90） or often （OR=3.55） choosing information from professional approach like hospital to guide children rearing，mother （OR=4.98） or father （OR=3.95） being caregivers， easy access to children rearing information （OR=4.50）， mother education degree being master and above （OR=3.10） or junior college， undergraduate （OR=2.14）， father education degree being junior college， undergraduate （OR=1.59） or master and above （OR=1.53）， single child （OR=1.37）， household registration being Shanghai （OR=1.37）. All caregivers with the above factors showed more superior health literacy. ConclusionThe level of health literacy of child rearing among caregivers of 0‒3 year-old children in Minhang District has a good level of health literacy. Targeted health education should be strengthened for caregivers of children in the future.

ObjectiveTo explore the effect of interaction of hypertension and abdominal obesity on morbidity of diabetes and to provide the scientific bases for preventing diabetes. MethodsA total of 11 914 people who took the physical examination in 2019 were examined with cluster sampling method for the interaction analysis. The data was collected by physical measurements and laboratory tests. SPSS 16.0 and interaction models were used for data analysis. ResultsIn the subjects there were 75.19% with abdominal obesity， 47.99% with hypertension， 16.26% with diabetes， and 39.42% had abdominal obesity plus hypertension. Multivariate logistic regression analysis showed， after adjusting gender and age， the abdominal obesity（OR=1.29， 95%CI：1.14‒1.46） and hypertension （OR=2.93， 95%CI： 2.63‒3.26） were related to high risk of diabetes. There was no multiplicative interaction effect between abdominal obesity and hypertension （OR=0.98，95%CI： 0.76‒1.27）. The additive interaction was significant between abdominal obesity and hypertension with RERI=0.53（95%CI：0.09‒0.98）， AP=0.14（95%CI：0.02‒0.26）， and SI=1.24（95%CI：1.01‒1.52）. ConclusionThere is a synergistic effect on morbidity of diabetes between abdominal obesity and hypertension. The improvement of weight and control of blood pressure could prevent significantly the diabetes.

ObjectiveTo explore the cumulative incidence of diabetes mellitus and its influencing factors among the diabetes mellitus high-risk groups in Minhang District of Shanghai, and to provide a basis for the development of community-based diabetes mellitus early prevention and treatment strategies in Shanghai. MethodsThe data of this study were collected from the screening project of diabetes mellitus high-risk groups in Minhang District of Shanghai, which was carried out from 2016‒2017. A total of 12 278 people were screened, of which 10 442 were at high risk based on the results of blood glucose diagnosis except those with diabetes. People diagnosed with abnormal fasting blood glucose, impaired fasting blood glucose and abnormal glucose tolerance were classified into the abnormal blood glucose group, and those with normal fasting blood glucose were classified into the normal blood glucose group. In 2023, the cumulative incidence of diabetes mellitus in the 2 groups was followed up, furthermore, the influencing factors of diabetes mellitus were analyzed. ResultsA total of 8 774 cases within the high-risk groups were followed up in 2023, of which 808 cases progressed to diabetes. Of the 8 774 cases, the cumulative incidence of diabetes mellitus in the abnormal blood glucose group (n=2 163) was 16.37% (354/2 163), and that in the normal blood glucose group (n=6 611) was 6.87% (454/6 611), and the difference in cumulative incidence of diabetes mellitus between the 2 groups was statistically significant (χ²=175.88, P<0.001). A history of impaired glucose regulation (OR=2.828, 95%CI: 2.177‒3.675), family history of type 2 diabetes (OR=1.294, 95%CI: 1.047‒1.600), hypertension (OR=1.268, 95%CI: 1.083‒1.485), dyslipidemia (OR=1.205, 95%CI: 1.003‒1.448), overweight/obesity (OR=1.526, 95%CI: 1.300‒1.792) were positively correlated with the cumulative incidence of type 2 diabetes, while female gender (OR=0.785, 95%CI: 0.675‒0.914) and sedentary lifestyle (OR=0.506, 95%CI: 0.374‒0.685) were negatively correlated with the cumulative incidence of type 2 diabetes. ConclusionBlood glucose monitoring should be strengthened in diabetes mellitus high-risk groups with an impaired glucose regulation history, a family history of type 2 diabetes, hypertension, and dyslipidemia, so as to achieve early detection of diabetes. Timely intervention measures should be taken for high-risk population with unhealthy lifestyle or overweight/obesity.

ObjectiveTo investigate the incidence of hypertension and its influencing factors in community-dwellers at risk for high blood pressure in Minhang District of Shanghai， and to provide scientific evidence for the community management. MethodsA retrospective cohort study was conducted using the electronic health records of community-dwellers at risk for high blood pressure in Minhang District， Shanghai from January 1， 2011 to December 31， 2017. The study end-point was the occurrence of hypertension，and the followup was finished in December 2021. A total of 17 265 community-dwellers at risk for high blood pressure were enrolled in our study. Log-rank test and Cox regression analysis were used to determine the influencing factors. ResultsAfter 6.04 years of follow-up， the hypertension incidence among community-dwellers at risk for high blood pressure in Minhang District of Shanghai was 25.5%. Family history of hypertension （HR=1.250， 95%CI： 1.168‒1.338）， family history of stroke （HR=1.295， 95%CI： 1.080‒1.553）， history of diabetes （HR=1.203， 95%CI： 1.076‒1.345）， daily smoking （HR=1.187， 95%CI： 1.087‒1.296）， overweight （HR=1.393， 95%CI：1.308‒1.484）， obesity（HR=1.903， 95%CI： 1.719‒2.106）， high values of normal blood pressure （HR=1.275， 95%CI： 1.195‒1.359） and advanced age （HR=1.033， 95%CI： 1.030‒1.036） were all risk factors. Emaciation （HR=0.649， 95%CI： 0.500‒0.840） was a protective factors. ConclusionBlood pressure monitoring should be strengthened for people elderly， with family history of hypertension， family history of stroke， diabetes or high values of normal blood pressure， so as to diagnose hypertension early. Timely intervention measures should be taken for community-dwellers with unhealthy lifestyles such as smoking， overweight and obesity.

ObjectiveTo identify and analyze the possible influencing factors of obesity among public primary school students in Minhang District， Shanghai. MethodsBasic data， collected through questionnaire stars， was imported with merged physical examination data into Excel to form a database. Data were collected by questionnaire and analyzed by SPSS 22.00. Independent sample t-test was used for the data with normal distribution. Nonparametric test was used for the data with non-normal distribution. χ² test was used for the quantitative data. Logistic regression was used for univariate and multivariate analysis. ResultsAccording to the national physical health standards for students （revised in 2014） ， the prevalence rate of obesity among primary school students in Minhang district was 29.63% . The prevalence of overweight and obesity was 32.1% in boys and 26.9% in girls. The trend of overweight and obesity in different grades was similar among different genders .A single factor analysis showed that， being the only child （χ²=9.300， P<0.01） ， father obesity（χ²=106.417， P<0.001） or mother obesity（χ²=118.534， P<0.001） ， mother's overweight during pregnancy （χ²=159.731， P<0.001） ， caregiver's role as grandparents （χ²=38.736， P<0.001） ， low education level （χ²=111.309， P<0.001） had effects on overweight and obesity of children while the differences had statistical significance. Pupil's bad eating habit （χ²=18.905，P<0.001） and preference （χ²=22.901， P<0.001） ， insufficient sleep time （χ²=61.685， P<0.001） ， long-time using of electronic products （χ²=37.182， P<0.001） and low-time of exercise （χ²=15.328， P<0.001） also affected the obesity of primary school students. Among the five factors of family， diet， psychology， static state and dynamic state， the influencing factors of obesity in primary school students from grade one to grade four were being the only child， obese father and/or mother， overweight mother during pregnancy， caregivers without higher education. In terms of diet， it was mainly based on eating habits before bedtime， as well as partial and picky eating habits. In terms of psychology， the main psychological source was the pressure of learning in school. There was a clear relationship between the pace of learning and not keeping up. Static analysis revealed a correlation with lack of sleep. After assigning values based on eye hygiene recommendations for the use of electronic products， it was found that there was no direct correlation between obesity in primary school students and the duration of electronic product use. Dynamic analysis showed that not taking part in school physical exercise was related to obesity. ConclusionThe obesity of primary school students is influenced by family， diet， psychology， static and dynamic factors. The intervention of obesity in primary school needs the joint efforts of school， society， family， self-cognition and so on.

Objective:To retrospectively characterize the perinatal birth defects in the latest 5 years in Minhang District of Shanghai， and provide the evidence to improve the preventive strategies. Methods:The data of perinatal birth defects was retrieved from “Shanghai information reporting system for children with birth defects and disabilities” ，which was recorded by five sentinel hospitals in Minhang District from January 2014 to December 2018. Average proportion of perinatal birth defects in the recent 5 years， annual variation， comparison with municipal data in the same period， difference between registered population and migrant population， difference between male and female， and common birth defects were determined. Results:The average proportion of perinatal birth defects in the recent 5 years was determined to be 6.24‰， which increased from 5.32‰ in 2014 to 7.90‰ in 2018. It was lower than the municipal proportion in Shanghai with an average of 11.02 ‰ （from 9.7 ‰ in 2014 to 14.00 ‰ in 2018）. The proportion was higher in resident population （9.15‰） than that in migrant population （5.57‰）. In addition， the proportion was higher in male infants （6.81‰） than that in female infants （5.59‰）. The first two common defects were congenital heart disease and polydactyly， while cleft lip and cleft lip with palate showed a decreasing trend. Conclusion:In the recent 5 years， the proportion of birth defect increases， which is consistent with the whole city. There remain challenges in the maternal and children healthcare.