OBJECTIVE: To review the application and research progress of artificial intelligence (AI) technology in trauma treatment. METHODS: The recent research literature on the application of AI and related technologies in trauma treatment was reviewed and summarized in terms of prehospital assistance, in-hospital emergency care, and post-traumatic stress disorder risk regression prediction, meanwhile, the development trend of AI technology in trauma treatment were outlooked. RESULTS: The AI technology can rapidly analyze and manage large amount of clinical data to help doctors identify patients' situation of trauma and predict the risk of possible complications more accurately. The application of AI technology in surgical assistance and robotic operations can achieve precise surgical plan and treatment, reduce surgical risks, and shorten the operation time, so as to improve the efficiency and long-term effectiveness of the trauma treatment. CONCLUSION There is a promising future for the application of AI technology in the trauma treatment. However, it is still in the stage of exploration and development, and there are many difficulties of historical data bias, application condition limitations, as well as ethical and moral issues need to be solved.
Humans ; Artificial Intelligence ; Operative Time ; Robotic Surgical Procedures ; Technology

Gestational diabetes mellitus (GDM) is common during pregnancy, with the prevalence reaching as high as 31.0% in some European regions (McIntyre et al., 2019). Dysfunction of the glucose metabolism in pregnancy can influence fetal growth via alteration of the intrauterine environment, resulting in an increased risk of abnormal offspring birth weight (McIntyre et al., 2019). Infants with abnormal birth weight will be faced with increased risks of neonatal complications in the perinatal period and chronic non-communicable diseases in childhood and adulthood (Mitanchez et al., 2015; McIntyre et al., 2019). Therefore, accurate estimation of birth weight for neonates from women with GDM is crucial for more sensible perinatal decision-making and improvement of perinatal outcomes. Timely antenatal intervention, with reference to accurately estimated fetal weight, may also decrease the risks of adverse long-term diseases.
Adult ; Birth Weight ; Diabetes, Gestational ; Female ; Fetal Development ; Humans ; Infant ; Infant, Newborn ; Neural Networks, Computer ; Pregnancy

Objective:To evaluate the clinical value of high-definition intelligent endoscopy (iSCAN) combined with stroboscopy in identifying vocal cord leukoplakia.Methods:Seventy-nine patients with vocal cord leukoplakia who underwent CO 2 laser laryngeal microsurgery and diagnosed by histopathology were recruited between October 2020 to August 2021. The morphological features, microvascular morphology and mucosal waves were observed by stroboscope; SPSS 20.0 software was used for statistical analysis. Results:There were 79 patients with a total of 119 lesions (56 on left and 63 on right).Pathological examination showed that 51 sides of the vocal cords were malignant lesions (severe dysplasia, carcinoma in situ and invasive carcinoma), and 68 sides were benign lesions.Under stroboscopy, 69 sides of mucosal wave were normal or slightly decreased, and 50 sides were severely decreased or disappeared.The decrease degree of mucosal wave was positively correlated with malignant lesions ( ρ=0.687, P<0.001).Under iSCAN endoscopy, there was a positive correlation between the morphological changes of microvessels at the lesion site (vertical) and the malignant lesion ( ρ=0.687, P<0.001).Univariate analysis showed that lesion size, thickness, uneven color, granular elevation, peripheral erythema and asymmetry were positively correlated with malignant lesions ( ρ=0.530, 0.401, 0.538, 0.315, 0.497, 0.281, P<0.05).Logistic regression analysis showed that the risk of pathological malignancy with large lesions was 5.437 times higher than those of small lesions, the vertical vascular changes under iSCAN were 8.711 times higher than that of normal vascular morphology, and the severe reduction or disappearance of mucosal waves was 9.12 times higher than that of normal or mild reduction of mucosal waves. Conclusion:ISCAN can be combined with staphyloscopy to comprehensively observe and evaluate the changes of vocal cord morphology, submucosal microvessels and mucosal wave of vocal cord in patients with vocal cord leukoplosis, thus improving the ability to distinguish benign and malignant lesions.

Objective:To explore the relationship between mobile phone addiction and perceived stress, negative emotion, social support and psychological capital in college students, especially to clarify the internal mechanism of these variables.Methods:A total of 836 college students were investigated with mobile phone addiction index scale, positive psychological capital questionnaire, stress perception scale, positive and negative emotion scale and perceived social support scale.SPSS 22.0 software was used for correlation analysis and SPSS-PROCESS was used to analyze the mediating effect and moderating effect.Results:(1)The scores of psychological capital and perceived stress were(123.38±17.96)and(38.76±6.39)respectively, and the scores of negative emotion, social support and mobile phone addiction were(22.46±6.45), (63.36±12.40)and(39.31±10.01)respectively.Psychological capital was negatively correlated with perceived stress, negative emotion and mobile phone addiction( r=-0.66, -0.37, -0.28, all P<0.01).Perceived stress was positively correlated with negative emotion and mobile phone addiction( r=0.50, 0.38, both P<0.01).Social support was positively correlated with psychological capital( r=0.50, P<0.01), while negatively correlated with perceived stress, negative emotion and mobile phone addiction( r=-0.41, -0.30, -0.12, all P<0.01).(2)Psychological capital influenced mobile phone addiction by the mediating effect of perceived stress( β=-0.20, SE=0.03, 95% CI: -0.27--0.13).In addition, psychological capital influenced mobile phone addiction through the chain mediating effect of perceived stress and negative emotion( β=-0.04, SE=0.01, 95% CI: -0.06--0.01).Moreover, the mediating effect of psychological capital on stress perception was moderated by social support. Conclusion:Perceived stress and negative emotion are important mediations between psychological capital and mobile phone addiction.Social support can moderate the effect of psychological capital on perceived stress.

Objective:To study the predictive value of systemic immune-inflammation index (SII), alpha-fetoprotein (AFP) and tumor diameter on microvascular invasion (MVI) in patients with resectable hepatocellular carcinoma (HCC), with an aim to establish a preoperative prediction model.Methods:The clinical data of 283 patients who underwent hepatectomy at the First Affiliated Hospital of Nanchang University from September 2017 to September 2020 were retrospectively analyzed. In the 283 patients with HCC who were included into this study, 249 were males and 34 were females, aged (53.7±11.0) years. Using postoperative pathology findings, these patients were divided into two groups: the MVI negative group ( n=140) and the MVI positive group ( n=143). Correlation between MVI and related indicators was analyzed using logistic regression analysis. The prediction model of MVI was then established by selecting independent risk factors. Univariate and multivariate analysis of recurrence-free survival (RFS) were performed using the Cox proportional hazards regression model. Results:Multivariate logistic regression analysis showed that AFP>400 ng/ml ( OR=2.304, 95% CI: 1.329-3.995, P=0.003), SII>376.30×10 9/L ( OR=2.249, 95% CI: 1.299-3.894, P=0.004) and tumor diameter>5 cm ( OR=2.728, 95% CI: 1.587-4.687, P<0.001) were independent risk factors for MVI. The Cox proportional hazards regression model showed that AFP ( HR=1.663, 95% CI: 1.063-2.602, P=0.026) and SII ( HR=1.851, 95% CI: 1.173-2.920, P=0.008) were independent risk factors for RFS in HCC patients. The sensitivity and specificity of the model based on SII, AFP and tumor diameter were 59.4% and 75.7%, respectively. Conclusions:SII, AFP and tumor diameter were closely related to occurrence of MVI in patients with HCC. AFP and SII were independent prognostic factors of RFS. This prediction model has certain predictive values for occurrence of MVI and prognosis of HCC patients.

Objective:To explore the diagnosis and treatment of pure red cell aplastic anemia (PRCA) caused by parvovirus B19 (HPV-B19)infection after liver transplantation (LT).Methods:Three adult PRCA patients caused by parvovirus B19 infection after LT were reviewed retrospectively.The relevant literatures were collected to sort out the detection methods and treatment of parvovirus B19 infection after LT.Results:All three patients received liver transplantation due to end-stage liver disease with massive intraoperative blood transfusion and smooth postoperative recovery.Severe anemia occurred at 1-2 Months after discharge.Hemorrhagic anemia was excluded after re-admission and PRCA was diagnosed by bone marrow aspiration and next generation sequencing (NGS). After tapering the intensity of immunosuppressive therapy, intravenous immunoglobulin (IVIG) was administered for 7-10 days and hemoglobin soon normalized.A review of 15 recent literatures on HPV-B19 infection after LT revealed that the diagnosis and treatment of parvovirus B19 infection after LT gradually were became same.Conclusions:HPV-B19 infection causes PRCA after LT in adults.Diagnosing with NGS, intravenous injection of immunoglobulin and modification of immunosuppressant regimen may achieve excellent therapeutic efficacies.

ABSTRACT OBJECTIVE：To study the effects of the extract of Xiongmatang on 5-HT and CGRP in brain tissue of rats with liver-yang hyperactivity and blood stagnation migraine. METHODS：Fifty male spontaneously hypertension （SHR） rats were randomly divided into model control group，Zhengtian pill positive control group （1.6 g/kg），the extract of Xiongmatang low-dose，medium-dose and high-dose groups（4.5，9.0，18.0 g/kg，by crude drug），with 10 rats in each group. Another 10 normal rats were taken as normal control group. Administration group was given relevant medicine intragastrically，once a day，for consecutive 28 d. Normal control group and model control group were given equal volume normal saline intragastrically. After last administration，except for normal control group，other groups were used to stimulate trigeminal ganglia（10 min）to establish liver-yang hyperactivity and blood stagnation migraine model，and maintained the administration once more after making the model. 30 min later，general behavior and tongue quality of rats were observed，and the blood pressure was measured；the contents of 5-HT and CGRP in cerebral tissue of rats were determined by ELISA. The protein expression of CGRP in cerebral tissue of rats were determined by Western blot method. RESULTS： Compared with the normal control group， the rats in the model control group had behavioral symptoms，such as the color of conjunctiva deepened and reddened， excessive hairdressing，head flicking，and most of the rats had purple tongue；the systolic pressure and the content and protein expression of CGRP were all increased obviously（P＜0.05 or P＜0.01）， while the content of 5-HT in cerebral tissue was decreased obviously（P＜0.01）. Compared with model control group，general behavior and tongue quality of rats were improved significantly in administration groups. Systolic pressure，the content and the protein expression of CGRP in cerebral tissue of rats were decreased significantly in Zhengtian pill positive control group and the extract of Xiongmatang high-dose group （P＜0.05），while the content of 5-HT in cerebral tissue of rats were increased significantly in Zhengtian pill positive control group，the extract of Xiongmatang medium-dose and high-dose groups（P＜0.05）.CONCLUSIONS：The extract of Xiongmatang has obvious protective effect on liver-yang hyperactivity and blood stagnation migraine model rats，the mechanism of which may be associated with reducing the content of CGRP in cerebral tissue and raising the content of 5-HT in cerebral tissue

Objective To investigate the differences in stress distribution at the bone-implant interface of dental implants with different length-diameter ratios, so as to provide references for the design of novel dental implants. Methods The three-dimensional finite element model of mandible was established using Geomagic studio, SolidWorks and ANSYS Workbench software. The mandibular molars were applied with different vertical or oblique forces, to compare and analyze stress distributions on dental implants and the surrounding bone tissues. Results Under the same length-diameter ratio, the maximum peak equivalent stress of implant under oblique loading was significantly higher than that under vertical loading. The Von Mises stresses of implants in Group A and Group B occurred in the neck under oblique and vertical loading. Under oblique loading, the implant stress variation in Group A and Group B was 144.74-374.67 MPa and 161.52-475.38 MPa, respectively. Under vertical loading, the implant stress variation in Group A and Group B was 101.28-187.40 MPa and 110.08-210.32 MPa, respectively. The maximum Von Mises stress of Group A was significantly smaller than that of Group B. Conclusions Dentists should focus on a length-diameter ratio of 2.67 to select the standard implants, and the jawbone quality of patients should be taken into full account.

Objective To explore the value of endoscopic retrograde cholangiopancreatography (ERCP) in patients with choledocholithiasis after Billroth Ⅱ gastrointestinal anastomosis.Methods A retrospective cohort study was conducted to retrospective review the data of 189 patients with choledocholithiasis treated by ERCP from December 2015 to November 2017 in Department of Hepatobiliary Surgery,Second Hospital of Hebei Medical University.According to the history of Billroth Ⅱ gastrointestinal anastomosis,the patients who have not undergone digestive surgery were divided into the normal group(n =167) and patients who have undergone digestive surgery were divided into reconstruction group (n =22).The operation time,the success rate of stone extraction,complications,the hospitalization time,total hospitalization expenses were compared between the two groups.Measurement data with normal distribution were represented as (Mean ± SD) and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range).Comparisons of count data were analyzed using the x2 test or Fisher exact probability.Results The operation time of the normal group was (40.18 ± 11.80) min,and the success rate of ERCP was 97.60％ (163/167),the operation time of reconstruction group was(61.81 ± 13.21) min,and the success rate of ERCP was 81.82％ (18/22),There were significant differences between the two groups (t =0.105,x2 =10.400,P ＜ 0.05).The complications,the hospitalization time and the total hospitalization expense of the normal group were 16.17％ (27/167),(3.47 ± 1.55) d,(20 620.69 ± 3 117.88) yuan,the reconstruction group were 18.18％ (4/22),(4.18 ± 2.08) d,(22 426.41 ±5 916.30) yuan,with no statistically significant difference (x2 =0.000,t =4.204),t =10.828,P ＞ 0.05).Conclusions ERCP is safe and feasible for patients with choledocholithiasis after Billroth Ⅱ gastrointestinal anastomosis.It also has a high success rate of stone removal and small trauma,which is worthy of promotion.

Objective: To analyze the genetic characteristics of Coxsackievirus A4 isolated from Taian, 2017-2018. Methods: Sixty throat swab samples of the children who visited Taian Maternal and Child Health Hospital during the year 2017-2018 and were diagnosed as hand, foot and mouth disease, were collected and aseptically inoculated. Fluorescent quantitative PCR analysis was performed using the universal primer for enteroviruses. The high-throughput sequencing was applied to the enterovirus-positive samples, and the full-length genome sequences of the viruses were obtained. Phylogenetic analysis was performed using Mega5.05 and RaxML respectively, and sequence homology and amino acid mutation sites were also analyzed using Mega5.05. Results: Four whole genome sequences of CV-A4 isolated from infants aged 17-19 months old were obtained. Phylogenetic analysis of the full length CV-A4 genomes showed that apart from MG550920/AA/Henan/2016, the remaining CV-A4 strains from China (97.2%), including the four strains from Taian, fell within Group 3. The VP1 genes could be classified into four genotypes and 98.5% of the Chinese strains belonged to genotype D, and the four strains from Taian belonged to D2. It was notable that the Taian isolate A1/Taian is closely related to two strains C179 and C062 from Australia both in the complete genome and the VP1 gene, as well as one strain YT184R isolated from Yantai in 2016 by us. Compared with the prototype CV-A4 strain High Point, 18 amino acid mutations were found in the P1 region. Conclusions Both phylogenetic trees estimated using the complete genome and the VP1 gene sequences revealed that the four CV-A4 isolates from Taian fell within the same clade with the majority of CV-A4 strains circulating in China. Compared with the prototype CV-A4 strain, several amino acid variations have occurred in the P1 region, which warrants further investigation.