This paper aims to discuss the application value and progress of artificial intelligence (AI) in the diagnosis and treatment of gastrointestinal tumors and teaching practice of gastrointestinal oncology. Through a comprehensive analysis of the current clinical research status and literature, this paper summarizes the application practice and exploratory thinking of AI and deep learning technologies in gastrointestinal oncology. In diagnosis, AI technologies have improved the early detection and diagnosis efficiency for gastrointestinal tumors by optimizing medical image analysis, especially in the recognition of liver metastases. Applications of AI in pathological diagnosis include automatic recognition of tumor cells and tissue structure, as well as improving diagnostic sensitivity and specificity through feature extraction and pattern recognition. In treatment, the application scenarios of AI include rapid diagnosis, accurate staging, personalized treatment plan formulation, drug development, and surgical assistance. In surgical assistance, AI technology improves the safety and effectiveness of surgery through preoperative evaluation, surgical navigation, and postoperative evaluation. In teaching, AI technology facilitates knowledge acquisition and clinical skill enhancement of medical students by providing a multidisciplinary learning platform, simulating clinical environment and case details, and establishing a remote learning platform. The application of AI technology in teaching also includes deep learning and assessment feedback, providing personalized teaching and real-time assessment for students. This paper discusses the application prospects for AI technology in the teaching practice of gastrointestinal oncology. Although AI technology shows great potential in the diagnosis and treatment of gastrointestinal tumors and teaching gastrointestinal oncology, it also has limitations and needs to be combined with traditional teaching methods to achieve the best teaching results.

The advanced platelet-rich fibrin(A-PRF)and concentrated growth factor(CGF)are platelet concentrates(PCs)obtained through the collection of venous blood from the patient and using different centrifugation procedures.Both are rich in growth factors,and the internal fibrin structure within them serves as a natural three-dimensional scaffold for the release of growth factors.They possess characteristics such as low cost,high safety and superior regenerative potential.Currently,they have gained wide-spread attention in the field of regeneration and repair of soft and hard tissues in oral implantation.This review provides the progress of A-PRF and CGF research,focusing on their preparation methods,application methods,potential regeneration mechanisms and a comparison of components and scaffold structures promoting alveolar bone defect repair between A-PRF and CGF.

Objective:To explore glucose and lipid metabolism in obese children and its correlation with precocious puberty.Methods:A total of 65 obese children (obese group) and 65 children with normal body weight (control group) who underwent physical examination at the Beijing Luhe Hospital Affiliated to Capital Medical University from March 2021 to March 2023 were retrospectively selected. Glucose and lipid metabolism indexes of the two groups were detected, and precocious puberty was evaluated according to Tanner staging criteria. Spearman test was used to analyze the correlation between glucose and lipid metabolism indexes and precocious puberty. Logistic regression analysis was used to screen the risk factors of precocious puberty in obese children.Results:The levels of fasting blood glucose (FPG), 2-hour postprandial blood glucose(2 h PG), glycosylated hemoglobin (HbA 1c), fasting insulin (FINS), insulin resistance index (HOMA-IR), triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and uric acid (UA) in the obese group were higher than those in the control group: 5.90(5.50, 6.50) mmol/L vs. 4.90(4.40, 5.30) mmol/L, (8.46 ± 1.38) mmol/L vs. (7.39 ± 0.87) mmol/L, 5.90(5.10, 6.70)% vs. 5.30(4.50, 5.70)%, (10.67 ± 2.46) mU/L vs. (5.14 ± 1.22) mU/L, 2.10(1.90, 2.30) vs. 1.10(1.00, 1.30), (141.95 ± 34.92) mmol/L vs. (95.21 ± 12.40) mmol/L, (153.82 ± 25.44) mmol/L vs. (143.59 ± 18.47) mmol/L, 80.50(72.10, 94.50) mmol/L vs. 65.10(59.30, 69.80) mmol/L, 293.20(271.80, 330.70) μmol/L vs. 250.90(210.80, 286.90) μmol/L; while the level of high-density lipoprotein cholesterol (HDL-C) was lower than that in the control group: 53.70(50.10, 58.00) mmol/L vs. 59.30(56.70, 62.60) mmol/L, there were statistical differences ( P<0.05). The incidence of precocious puberty in boys and girls in the obesity group was higher than those in the control group: 23.68%(9/65) vs. 0; 37.04%(10/65) vs. 7.41%(2/65), there were statistical differences ( P<0.05). The results of the Spearman test showed that the Tanner scores of testis and pubic hair in boys and breast and pubic hair in girls in the obesity group were positively correlated with FPG, 2 h PG, HbA 1c, FINS, HOMA-IR, TG, TC, LDL-C and UA ( P<0.05), and there was a negative correlation with HDL-C ( P<0.05). The results of multivariate Logistic regression analysis showed that increased levels of FPG, HbA 1c, FINS, HOMA-IR, TG, TC and UA were risk factors for precocious puberty in obese children ( OR>1, P<0.05). Conclusions:Obesity is associated with precocious puberty and the disorder of glucose and lipid metabolism is related to precocious puberty.

BACKGROUND:Leukoplakia is a common adverse reaction to traditional orthodontic treatment.There are still some controversies about the difference between light-transmitting clear and fixed aligners in the periodontal health status,incidence of leukoplakia,saliva and related bacteria in patients undergoing orthodontic treatment.OBJECTIVE:To compare the effects of clear and fixed aligners on the smooth surface of orthodontic teeth using Universal Visual Scoring System.METHODS:A total of 80 patients admitted to Department of Orthodontics,Second Hospital of Hebei Medical University from January 2018 to December 2022 were selected and randomly divided into a control group(n=40)and an observation group(n=40)using a random number table method.The control group received orthodontic treatment with fixed aligners,and the observation group received orthodontic treatment with clear aligners.Before treatment and after 6,12,and 24 months of treatment,the labial or buccal sides of teeth 13,33,16,and 36 were selected for each patient as the research subjects,and the visual scoring system was used to evaluate the white spot lesions.RESULTS AND CONCLUSION:(1)Before treatment and after 6,12,and 24 months of treatment,there was no significant difference in the color of tooth white spots and the severity of caries between the two groups of patients(P＞0.05).(2)For tooth 13,after 12 months of treatment,the color grade and caries severity of white spots were both higher than before treatment(P＜0.05).For tooth 33,the color grade and caries severity after 12 months of treatment were both higher than before treatment(P＜0.05).The severity of caries after 12 months of treatment was higher than that after 6 months of treatment(P＜0.05).For tooth 16,the color grade of white spots and the severity of caries after 12 months of treatment were both higher than those after 6 months of treatment(P＜0.05).(3)Multi-level ordered multi-classification Logistic regression model analysis showed that the color and severity of white spots on different teeth had little correlation with the type of appliance and were greatly affected by the correction time factor.Among them,the color change and severity of the initial white spots on teeth 33 and 13 were statistically significant at 12 and 24 months of treatment.(4)It is not possible to conclude that there is a difference in the effect of fixed and clear aligners on the white spot lesions of smooth surfaces of the teeth,but an increase in the risk of dental caries with the increase in the duration of treatment can be detected.

Objective To understand phenotype conversion in patients with first-episode depression over a 7-year period,to explore the longitudinal disease characteristics and functional outcomes of transitions and non-transitions,and to further analyse the relevant factors affecting transitions.Methods A total of 346 patients with Hamilton depression scale-17(HAMD-17)score≥18,aged 18-60 years and a single episode of major depressive disorder were included in the study.They were follow-up for 7 years to assess their natural history including demographic data,disease characteristics,whether transitions to manic occurred,treatment status.At the end of the 7-year follow-up,treatment emergent symptom scale(TESS),medication adherence rating scale(MARS),and global assessment function(GAF)were used to evaluate adverse reactions,compliance to medication,and patient's overall functional level.Patients were divided into two groups based on the occurrence of mania or hypomania episodes during the 7-year period:the conversion group(those who developed episodes)and the non-conversion group(those who did not).Results A total of 138 patients were followed up for 7 years,including 54 patients(39.1%)in the conversion group and 84 patients(60.9%)in the non-conversion group.When the first episode was enrolled at baseline,the age of first episode was earlier in the conversion group than in the non-conversion group[(27.63±9.63)years vs.(41.20±11.92)years],and there were differences in marital status(unmarried 40.7%vs.7.1%,first marriage 53.7%vs.85.7%,remarriage 3.7%vs.2.4%,separated/divorced 0.0%vs.2.4%,widowed 1.9%vs.2.4%).The proportion of patients with precipitating factors was lower in the conversion group(29.6%vs.48.8%)and shorter duration of untreated psychosis(DUP)[60(15,90)d vs.90(30,180)d].The treatment method in the conversion group had lower only used antidepressant drugs(61.1%vs.81.0%)and more antidepressant combined with mood stabilizers(31.5%vs.16.7%)(all P<0.05).In the 7 years,total number of episodes in the conversion group was more than in the non-conversion group(4.33±1.21 vs.2.70±1.25,P<0.05).By the end of 7 years,the GAF score was lower in conversion group than in the non-conversion group(66.57±8.22 vs.69.21±7.20,P<0.05).Dichotomous unconditional logistic regression analyses revealed that age at first episode(OR=1.109,95%CI:1.058-1.161,P<0.001),DUP(d)(OR=1.005,95%CI:1.001-1.009,P=0.017),was an independent influencing factor on conversion over a 7-year period in patients with first-episode depressive disorders.Conclusion The rate of conversion over 7 years in patients with first-episode depressive disorder is 39.1%in the present cohort and converted patients had relatively earlier age of onset,more pre-onset without inducement,shorter DUP(d),more recurrence,higher the rate of combined treatment and worse overall functional outcome.

Objective:To explore the effect of non-invasive intervention on preventing maternal breast tenderness, and to provide references for clinicians to select the optimal non-invasive intervention for the prevention of maternal breast tenderness.Methods:Literature focused on the effect of different non-invasive interventions to prevent maternal breast tenderness by randomized controlled trials design was searched in the databases, including China National Knowledge Infrastructure, VIP, Wanfang, SinoMed, PubMed, Web of Science, Embase and Cochrane Library, from inception to April 8, 2024. Two researchers independently screened the literature, extracted the data and evaluated the quality of the literature. Stata 16.0 was used to conduct a network Meta-analysis.Results:A total of 21 studies involving 2 298 women, covering 5 non-invasive interventions (low-frequency pulse electrotherapy, breast massage combined with low-frequency pulse electrotherapy, breast massage and acupoint massage, breast massage and acupoint massage combined with ear point pressure bean, breast massage and acupoint massage combined with external application of Chinese medicine). The network meta-analysis results showed that, compared with routine care, five non-invasive interventions had statistically significant differences in reducing the incidence of maternal breast tenderness ( OR values ranging from 0.20 to 0.39, all P<0.05). Breast massage combined with low-frequency pulse electrotherapy ranked first in terms of effectiveness on preventing of breast tenderness. Conclusions:All five non-invasive interventions are effective on preventing maternal breast tenderness, with breast massage combined with low-frequency pulse electrotherapy being the most effective.

Objective:To analyze the current situation and influencing factors of information need for cardiac rehabilitation of urban and rural patients with coronary heart disease, and explore the inequality of information need for cardiac rehabilitation among urban and rural patients with coronary heart disease and its influencing factors, so as to provide a scientific reference for formulating targeted cardiac rehabilitation programs.Methods:From June to July 2024, hospitalized patients with coronary heart disease from a Class A tertiary hospital in Suzhou City were selected by convenience sampling as the study subjects. A General Information Questionnaire, Information Need in Cardiac Rehabilitation Hospital Anxiety and Depression Scale, Health Literacy Management Scale, and Coronary Artery Disease Self-Management Scale were used to conduct a questionnaire survey. Multiple linear regression was used to analyze the influencing factors of the cardiac rehabilitation information needs and the oaxaca-blinder model was used to analyze the causes of unequal information needs in urban and rural patients.Results:A total of 254 hospitalized patients with coronary heart disease who met the inclusion and exclusion criteria were surveyed, included 127 males and 127 females, 182 of them were aged 60 years or older. The total cardiac rehabilitation information needs score of rural and urban patients with coronary heart disease were 168.00 (115.50, 255.00) and 213.00 (132.00, 255.00), respectively, the difference was significant ( U = 5 389.50, P<0.05). Multiple regression analysis showed that health literacy ( β = 0.871, P<0.05) was the influencing factor of cardiac rehabilitation information needs of rural coronary heart disease patients, and depression ( β = 0.719, P<0.05) and living status ( β = -0.186, P<0.05) was the influencing factor of cardiac rehabilitation information needs of urban coronary heart disease patients. Average monthly household income per capita (C = 14.50%) and health literacy (C = 88.30%) were the main causes of the difference in cardiac rehabilitation information needs between urban and rural patients with coronary heart disease. Conclusions:The information demand for cardiac rehabilitation of patients with coronary heart disease in rural area is lower than that in urban areas in Suzhou, mainly due to health literacy and monthly income. It is recommended to narrow the urban-rural gap by improving rural health literacy, optimizing medical insurance policies, and promoting a multi-level rehabilitation service network.

Objective:To evaluate the therapeutic efficacy of an upper limb rehabilitation robot on the recovery of elbow function recovery following arthroscopic elbow joint release.Methods:Seventy-two patients who underwent arthroscopic elbow joint release at Shanghai Sixth People’s Hospital from December 2022 to December 2023 were recruited. All patients were randomly assigned to either the conventional group (n=36; 16 males, 20 females; age 34.39±9.04 years, range 24-56; fractures: 4 intercondylar humerus, 18 olecranon, 8 radial head, 6 other) which received conventional rehabilitation postoperatively, or the robot-assisted group (n=36; 18 males, 18 females; age 33.78±9.98 years, range 20-59; fractures distribution identical to the conventional group) receiving conventional rehabilitation combined with robot-assisted upper limb rehabilitation therapy. The active range of motion (ROM) of elbow joint, Mayo elbow performance score (MEPS), visual analogue scale (VAS) of elbow joint were recorded preoperatively and at 4 weeks and 3 months postoperatively. The surface electromyography were analyzed at 3 months postoperatively.Results:All patients completed the 3-month rehabilitation program. At 4 weeks postoperatively, the conventional group exhibited a mean active ROM of 106.78°±9.91°, MEPS of 67.78±7.68, VAS of 2.11±0.74; the robot-assisted group showed active ROM of 113.72°±7.06°, MEPS of 73.33±9.28, VAS of 21.89±0.46. By 3 months postoperatively, the conventional group achieved a mean active ROM of 118.11°±6.75°, MEPS of 85.00±8.66, VAS of 0.67±0.67; robot-assisted achieved a mean active ROM of 127.61°±6.61°, MEPS of 91.11±6.57, VAS of 0.39±0.49. Both groups exhibited significant improvements in active ROM and MEPS, and significant reductions in VAS scores at 4 weeks and 3 months postoperatively compared with preoperatively values ( P<0.05). The robot-assisted group demonstrated significantly higher active ROM and MEPS at both 4 weeks and 3 months postoperatively, and a significantly lower VAS score at 3 months postoperatively, compared with the conventional group ( P<0.05). Surface electromyography at 3 months revealed significantly higher biceps brachii root mean square and significantly lower co-contraction index in the robot-assisted group compared to the conventional group ( P<0.05). No adverse symptoms were reported in the treated elbows of either group during the operation and follow-up period. Conclusion:The integration of upper limb rehabilitation robot-assisted therapy and conventional rehabilitation program significantly enhances the recovery of elbow range of motion and functional outcomes at 3 months following arthroscopic elbow joint release.

Objective To investigate the correlation between hemoglobin A1c(HbA1c)levels and excessive daytime sleepiness(EDS)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 132 T2DM patients and 40 healthy people(NC group)who were treated in the outpatient department of Nanjing Meishan Hospital from December 2020 to December 2022 were selected.General clinical data of the subjects were collected,and their Epworth sleepiness scale(ESS)scores,Pittsburgh sleep quality index(PSQI),and apnea-hypopnea index(AHI)were measured.Based on ESS scores,T2DM patients were divided into simple T2DM group(ESS score<9,n=99)and EDS group(ESS score≥9,n=33)according to ESS score.The baseline data were compared for each group.Spearman correlation analysis and multivariate logistic regression model were used to evaluate the correlation between HbA1c levels and EDS.The receiver operating characteristic(ROC)curve was used to calculate the area under the curve(AUC)to evaluate the predictive value of HbA1c levels for EDS.Results HbA1c,fasting plasma glucose,AHI index and PSQI score in EDS group were higher than those in T2DM and NC group(P<0.05).Spearman correlation analysis showed that ESS score was positively correlated with HbA1c in T2DM patients(P<0.05).Multivariate logistic regression analysis revealed that elevated HbA1c levels emerged as a significant and independent risk factor for the onset of EDS.The ROC curve indicated that the AUC of HbA1c for predicting EDS was 0.736.Conclusions There is an independent positive correlation between HbA1c levels and EDS in T2DM patients,which provides clues for early identification and treatment of EDS in clinical practice.

Objective To quantitatively measure the density of hydroxyapatite(HAP)(water)within lumbar vertebral bodies using the gemstone spectral imaging(GSI)material decomposition technique and to compare and analyze the clinical significance of density variations of HAP(water)in different regions of L1-L3 vertebral bodies.Methods A total of 242 patients who underwent lumbar quantitative computed tomography(QCT)scans via utilizing the GSI technique were selected.Following the scans,the HAP(water)density values in four regions(anterosuperior,posterosuperior,anteroinferior,and posteroinferior)of each L1-L3 vertebral bodies were quantitatively measured using the material decomposition technique.Based on the QCT results,all cases were divided into three groups of normal bone mineral density,osteopenia,and osteoporosis.The distributions of HAP(water)density values in the four regions within each vertebral body were compared and analyzed among the groups.Results In all three groups of patients,the highest HAP(water)density values in the L1-L3 vertebral bodies were all located in the posteroinferior region,followed by the posterosuperior region.In the normal bone mineral density group,the lowest HAP(water)density values was found in the anterosuperior region of the L1 vertebral body.In the osteopenia and osteoporosis groups,the lowest HAP(water)density values was found in the anteroinferior region of the L1-L3 vertebral bodies.Conclusion Significant differences in HAP(water)density are present across different regions within lumbar vertebral bodies,which may be related to the development of vertebral osteoporosis and the location of fractures.