In the context of the rapid development of 5G technology， the development of artificial intelligence （AI） in traditional Chinese medicine （TCM） faces new opportunities and challenges. Focusing on how to uphold tradition while innovating in the development of AI in TCM， starting from the current development status of AI in Chinese medicine， including the integration of four diagnostic methods， syndrome differentiation and treatment， auxiliary diagnosis and treatment， research and development of Chinese herbal medicine， prevention and treatment of diseases， knowledge inheritance， and other aspects， this paper discussed the support of policies and technical advancements， as well as development opportunities such as increased demand for health. Regarding machine ethics， data ethics， regulatory review， and other aspects， it also proposed some suggestions that the training algorithm should be improved to assist medical work； data ownership should be clarified to ensure data security； and an AI ethics committee should be set up to improve the review system， aiming to maximize the advantages of smart healthcare and accelerate the modernization of TCM for the benefit of patients and the service of human health.

ObjectiveTo investigate the ability of the modified albumin-bilirubin （mALBI） grade in predicting the prognosis of patients with Child-Pugh A unresectable hepatocellular carcinoma （uHCC） after transcatheter arterial chemoembolization （TACE） combined with immunotherapy and anti-angiogenic drugs （hereafter referred to as targeted immunotherapy）. MethodsA retrospective analysis was performed for the data of 76 patients with Child-Pugh A uHCC who met the inclusion criteria and underwent TACE combined with targeted immunotherapy in The First Affiliated Hospital of Soochow University from January 2020 to January 2023， and according to the mALBI grade， they were divided into mALBI 1/2a group with 38 patients and mALBI 2b group with 38 patients. The primary endpoint was overall survival （OS）， and the secondary endpoints were progression-free survival （PFS）， objective response rate （ORR）， and disease control rate （DCR）. Evaluation criteria included complete remission， partial remission， stable disease， and progressive disease. The independent-samples t test was used for comparison of normally distributed continuous data between groups， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between groups； the chi-square test was used for comparison of categorical variables between two groups. The Kaplan-Meier method was used to plot survival curves， and the Log-rank test was used for comparison of median OS （mOS） and median PFS （mPFS） between groups. The univariate and multivariate Cox proportional hazards models were used to analyze the influencing factors for prognosis. ResultsThere were significant differences in albumin and tumor burden between the two groups （both P<0.05）. The 76 patients had an mOS of 25.2 months （95% confidence interval ［CI］： 18.4 — 32.0）， an mPFS of 9.4 months （95%CI： 7.1 — 11.7）， an ORR of 63.2%， and a DCR of 82.9%. The mOS was 30.1 months （95%CI： 19.8 — 40.4） in the mALBI 1/2a group and 19.5 months （95%CI： 7.1 — 31.9） in the mALBI 2b group， and there was a significant difference in mOS between the two groups （χ²=4.490， P=0.034）. The mALBI 1/2a group had an mPFS of 10.2 months （95%CI： 8.4 — 12.0）， an ORR of 71.1%， and a DCR of 86.8%， while the mALBI 2b group had an mPFS of 7.6 months （95%CI： 4.6 — 10.6）， an ORR of 55.3%， and a DCR of 78.9%； there were no significant differences in mPFS， ORR， and DCR between the two groups （all P>0.05）. ECOG status， tumor burden， mALBI grade， portal vein invasion， and extrahepatic metastasis were independent risk factors for mOS in patients undergoing TACE combined with targeted immunotherapy （all P<0.05）. There were no treatment-related deaths. ConclusionThe mALBI grade has a good value in predicting the survival of patients with Child-Pugh A uHCC undergoing TACE combined with targeted immunotherapy.

ObjectiveTo evaluate the efficacy and safety of first-line transcatheter arterial chemoembolization （TACE） combined with targeted therapy and immunotherapy in the treatment of patients with stage Ⅱb/Ⅲa hepatocellular carcinoma （HCC） based on China Liver Cancer Staging （CNLC）. MethodsA total of 198 patients who received first-line TACE combined with targeted therapy and immunotherapy or received TACE alone from January 2015 to December 2022 in the First Affiliated Hospital of Soochow University were enrolled in this study， and after propensity score matching， there were 50 patients in combination group and 50 patients in TACE group. The Kaplan-Meier method was used to calculate median overall survival （mOS） and median progression-free survival （mPFS）. Modified Response Evaluation Criteria in Solid Tumors was used to evaluate objective response rate （ORR） and disease control rate （DCR）， and Common Terminology Criteria for Adverse Events v5.0 was used to evaluate adverse events. The chi-square test was used for comparison of categorical data between two groups； the t-test was used for comparison of normally distributed continuous data between two groups， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups. The Kaplan-Meier method was used to estimate survival time and calculate 95% confidence interval （CI）， and the Log-rank test was used for comparison of mOS and mPFS between two groups. ResultsThe combination group had an mOS of 30.1 months （95%CI： 21.9‍ ‍—‍ ‍38.3）， and the TACE group had an mOS of 14.5 months （95%CI： 11.0 ‍—‍‍ ‍18.0）， with a significant difference between the two groups （χ²=17.8， P<0.001）； the combination group had an mPFS of 10.3 months （95%CI： 8.8‍ ‍—‍ ‍11.8）， and the TACE group had an mPFS of 7.1 months （95%CI： 5.8‍ — ‍8.4）， with a significant difference between the two groups （χ²=10.4， P<0.001）. There were significant differences between the combination group and the TACE group in ORR （84% vs 58%， P<0.05） and DCR （94% vs 80%， P<0.05）. There was no significant difference between the combination group and the TACE group in the incidence rate of adverse events （24% vs 16%， P=0.317）， and no adverse event-related deaths were observed in either group. ConclusionCompared with TACE alone， TACE combined with targeted therapy and immunotherapy has a better efficacy in the treatment of patients with CNLC stage Ⅱb/Ⅲa HCC， without increasing the incidence rate of severe adverse events.

Objective To construct a model for predicting the benign and malignant risk of the patients with gastric diseases using con-ventional laboratory indicators such as tumor markers,blood routine,and coagulation indicators,and validate its predictive value.Methods The medical records of patients with gastric diseases who visited the First Affiliated Hospital of Guangzhou Medical Univer-sity from January 2018 to January 2023 were analyzed retrospectively.According to the pathological results,the patients were divided into the gastric cancer(GC)group(n=134)and chronic non-atrophic gastritis(CNAG)group(n=298).Their routine test data such as serum and whole blood tests were collected.The statistical analysis was conducted using the R 4.2.3 software,and a model for pre-dicting the risk of GC was constructed and validated.Results A model for predicting the risk of GC was constructed successfully using the Logistic regression analysis,which included D-dimer,carcinoembryonic antigen(CEA),carbohydrate antigen 72-4(CA72-4)and hemoglobin(Hb).A visual nomogram was plotted as the final prediction model.The areas under the receiver operating characteristic(ROC)curve(AUCROC)of the model in the training and testing sets were 0.809(95%CI:0.754-0.864)and 0.808(95%CI:0.724-0.892),respectively.The sensitivity and specificity of the model were 58.5%and 93.3%,respectively,indicating that it had good pre-dictive ability.Conclusion The model for predicting the malignant risk of patients with gastric diseases constructed using routine tes-ting indicators has good accuracy and can effectively predict the risk of gastric disease transforming into gastric cancer.It helps to find early gastric cancer patients in clinical practice and take targeted prevention and intervention measures.

Objective:To discuss the anti-inflammatory and antioxidant effect of mesalazine(MSZ)in the RAW264.7 cell model,and to elucidate its therapeutic effect on periodontitis in the rats.Methods:The proliferation rates of RAW264.7 cells stimulated by different concentrations(0,62.5,125.0,250.0,500.0,1 000.0,and 2 000.0 mg·L-1)of MSZ were detected by CCK-8 method to determine the optimal concentration of MSZ for cell treatment.Porphyromonas gingivalis lipopolysaccharide(P.g-LPS)and MSZ were used to treat the RAW264.7 cells,and the cells were divided into control group,P.g-LPS group,and MSZ+P.g-LPS group.The levels of reactive oxygen species(ROS)in the cells in various groups were detected by the DCFH-DA fluorescent probe assay;the malondialdehyde(MDA)levels,glutathione(GSH)levels and superoxide dismutase(SOD)activities in the cells in various groups were detected by ELISA method;the expression levels of inflammatory factors interleukin-8(IL-8)and interleukin-1β(IL-1β)mRNA in the cells in various groups were detected by real-time fluorescence quantitative PCR(RT-qPCR)method.The periodontitis rat model was established by the ligation method combined with the injection of P.g bacterial fluid.A total of 18 rats were randomly divided into control group(without treatment),model group(making period ontits model),and drug administration group(making periodontits model and given MSZ),and there were 6 rats in each group.Micro-CT was used to assess the alveolar bone destruction of the rats in various groups;HE staining was used to observe the morphology of periodontal tissue of the rats in various groups.Results:Compared with control group,the proliferation rate of the cells in 500.0 mg·L-1 MSZ group was significantly increased(P＜0.01),so 500.0 mg·L-1 MSZ was subsequently selected to treat the cells.Compared with control group,the levels of ROS and MDA in the cells in P.g-LPS group were significantly increased(P＜0.01),and the level of GSH and activity of SOD were significantly decreased(P＜0.01),and the expression levels of IL-1β and IL-8 mRNA were significantly increased(P＜0.01);compared with P.g-LPS group,the levels of ROS and MDA in the cells in MSZ+P.g-LPS group were significantly decreased(P＜0.01),the level of GSH and activity of SOD were significantly increased(P＜0.01),and the expression levels of IL-1β and IL-8 mRNA were significantly decreased(P＜0.01).The micro-CT assay results showed that compared with control group,the distance from the cemento-enamel junction to alveolar bone crest(CEJ-ABC)of the rats in model group was significantly increased(P＜0.01),and the bone volume fraction(BV/TV)was significantly decreaced(P＜0.05);compared with model group;the CEJ-ABC of the rats in drug administration group was decreased(P＜0.01),and the BV/TV was increased(P＜0.05).The HE staining results showed that the inflammatory cell infiltration in periodontal tissue of the rats in drug administration group was reduced,and epithelial attachment was restored.Conclusion:MSZ effectively inhibits the production of pro-inflammatory factors and peroxides in the P.g-LPS-induced RAW264.7 cells,improves the cellular anti-inflammatory and antioxidant capacity,inhibits the alveolar bone resorption,and alleviates the inflammation of periodontal tissues in the periodontitis rats.

OBJECTIVE: A prospective randomized controlled study was conducted to investigate the early postoperative analgesic effectiveness of using liposomal bupivacaine (LB) for local infiltration anesthesia (LIA) in unicompartmental knee arthroplasty (UKA). METHODS: Between January 2024 and July 2024, a total of 80 patients with knee osteoarthritis (KOA) who met the selection criteria were enrolled in the study. Patients were randomly assigned to either the LB group or the "cocktail" group in a 1∶1 ratio using a random number table, with 40 patients in each group. Baseline characteristics, including gender, age, body mass index, operated side, Kellgren-Lawrence grade, and preoperative American Society of Anesthesiologists (ASA) classification, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and knee joint range of motion, showed no significant difference between the two groups ( P>0.05). Both groups received LIA and comprehensive pain management. The surgical duration, incision length, pain-related indicators [resting and activity visual analogue scale (VAS) scores, total dosage of oral morphine, WOMAC scores], knee joint range of motion, first ambulation time after operation, length of hospital stay, and postoperative adverse events. RESULTS: There was no significant difference between the two groups in surgical duration, incision length, first ambulation time after operation, length of hospital stay, total dosage of oral morphine, and pre-discharge satisfaction with surgery and WOMAC scores ( P>0.05). At 4, 12, and 24 hours after operation, the resting and activity VAS scores in the "cocktail" group were lower than those in the LB group; at 60 and 72 hours postoperatively, the resting VAS scores in the LB group were lower than those in the "cocktail" group, with the activity VAS scores also being lower at 60 hours; all showing significant differences ( P<0.05). There was no significant difference in the above indicators between the two groups at other time points ( P>0.05). On the second postoperative day, the sleep scores of the LB group were significantly higher than those of the "cocktail" group ( P<0.05), while there was no significant difference in sleep scores on the day of surgery and the first postoperative day ( P>0.05). Additionally, the incidence of complications showed no significant difference between the two groups ( P>0.05). CONCLUSION The use of LB for LIA in UKA can provide prolonged postoperative pain relief; however, it does not demonstrate a significant advantage over the "cocktail" method in terms of short-term analgesic effects or reducing opioid consumption and early functional recovery after UKA. Nevertheless, LB may help reduce postoperative sleep disturbances, making it a recommended option for UKA patients with cardiovascular diseases and insomnia or other mental health issues.
Aged ; Female ; Humans ; Male ; Middle Aged ; Anesthesia, Local/methods* ; Anesthetics, Local/administration & dosage* ; Arthroplasty, Replacement, Knee/methods* ; Bupivacaine/administration & dosage* ; Liposomes ; Osteoarthritis, Knee/surgery* ; Pain Measurement ; Pain, Postoperative/prevention & control* ; Prospective Studies ; Treatment Outcome

Objective:To explore the application value of the new gastric cancer screening scoring system for risk populations in the island of Fujian province.Methods:From April to June 2019, gastric cancer screening was performed on the population of Nanri Island, Putian City, Fujian Province, and epidemiological data of all subjects were prospectively collected. Participants underwent gastroscopy based on gastric cancer risk stratification of the new scoring system. Suspected positive cases further received magnifying endoscopy and biopsy. Additional endoscopic procedures and other surgical treatments were conducted. The detection rates of gastric cancer and precancerous lesions in each group of gastric cancer risk stratification were compared, and the Chi-square test was used for statistical analysis.Results:A total of 1 423 subjects were included, and 19 cases (1.34%) of gastric cancer were detected. The detection rates of gastric cancer were 0.88% (9/1 025) in the low-risk group, 1.76% (6/341) in the medium-risk group, and 7.02% (4/57) in the high-risk group. Paired comparison between the low-risk group and the high-risk group showed significant difference ( χ2=12.364, P=0.003). There was no significant difference between the low-risk group and medium-risk group, or between the medium-risk group and high-risk group ( P>0.05). Among all participants, 87 (6.11%) cases of gastric precancerous lesions were identified. The detection rates of precancerous lesions in the low-risk, medium-risk, and high-risk groups were 6.24% (64/1 025), 5.87% (20/341), and 5.26% (3/57) respectively, with no significant difference among the three groups ( P>0.05) .Conclusion:During gastric cancer screening, the novel gastric cancer screening scoring system helps to stratify gastric cancer risk for population in the islands of Fujian province, serving as a foundation for subsequent detailed endoscopy.

Equipment for maritime joint search and rescue (SAR) is the hardware basis for joint SAR operations at sea, and its level of development is a decisive factor of the joint SAR capability. This paper introduced the maritime SAR equipment systems in the US, UK, and other major maritime powers, and analyzed the present situation and the existing problems of China’s maritime joint SAR equipment system. The paper also put forward suggestions for the future construction of China’s system, namely, developing new SAR equipment, enhancing the SAR capability in the middle and high seas under complex meteorological conditions, which could be of some reference value to the construction of China’s SAR equipment system.

Major maritime countries regard the joint maritime search and rescue (SAR) system as a complex systematic project and have been building it in that way. This paper analyzed region-based joint maritime SAR systems at home and abroad, pointed out existing problems in China’s current maritime SAR system, and put forward five suggestions for building a joint air-sea SAR system based on maritime region division in China, namely, optimizing division of maritime SAR region, straightening out chain of SAR command and coordination, strengthening professional SAR forces, enhancing air-sea SAR trainings, and perfecting laws and regulations for maritime SAR.

In light of the practical difficulties in setting up a training environment for the search and rescue (SAR) of man overboard, the paper constructed a simulation platform for the SAR training based on refined modeling and high-precision virtual simulation technology. Then, the paper illustrated the details of the platform, namely, responsibility of each post, technical design, functions, and key technologies, which, therefore, provided technical support for scientifically and rationally carrying out SAR trainings at sea.