Abstract The accelerating population aging and the rejuvenation trend of chronic diseases in China have continuously aggravated the chronic disease burden, making chronic disease prevention and control increasingly essential. General practitioners are the core workforce for chronic disease prevention and control, and their training quality directly determines the performance of grassroots healthcare services. Digital intelligence, built on digital infrastructure, enables standardized data collection, analysis, and product transformation adapted to clinical scenarios. Leveraging artificial intelligence, big data, and machine learning, it mines high-value clinical and public health key information to support evidence-based medical decision-making and optimize the diagnosis, treatment, and management processes for chronic diseases. On the basis of the characteristics of chronic disease prevention and control talents in grassroots healthcare institutions and the background of digital intelligence development in the new era, this study systematically retrieves and reviews domestic and foreign research on the profile, training paths and digital intelligence-enabled teaching progress of grassroots medical talents engaged in chronic disease prevention and control. Focusing on the core challenges existing in current teaching and training for such talents, and combining practical experience in grassroots medical education, this study proposes a digital intelligence empowerment-oriented strategy to effectively align the supply of training resources with the actual demands of grassroots settings, so as to construct a context-adapted systematic training mechanism and optimized development path for chronic disease prevention and control talents in grassroots healthcare institutions.

Angiogenesis within atherosclerotic plaques is a critical determinant of plaque stability.The biome-chanical microenvironment,consisting of fluid shear force,plaque structural stress,and matrix stiffness,serves as signifi-cant factors in mediating plaque angiogenesis.Endothelial cells respond to mechanical signals and participate in plaques neovascularization through force chemical signal transduction mechanisms.This review provides an overview of the mecha-nisms by which mechanical factors regulate angiogenesis within plaques and offers a novel therapeutic approach for the pre-vention and treatment of atherosclerosis.

Objective:To investigate the correlation between endoscopic ultrasonography (EUS) and enhanced computed tomography (CT) image features and pathological risk of gastric stromal tumors (GSTs).Methods:Data of primary GSTs patients treated at Renmin Hospital of Wuhan University from January 2018 to November 2022, confirmed by endoscopy or surgical pathology and immunohistochemistry were retrospectively reviewed. A total of 286 cases (288 lesions) underwent EUS before surgery, of which 70 cases (71 lesions) had complete preoperative enhanced CT examination data. Patients who underwent EUS were divided into relatively benign group (including very low-risk and low-risk, 245 cases of 247 lesions) and relatively malignant group (including intermediate-risk and high-risk, 41 cases of 41 lesions) based on the pathological risk of GSTs. Patients who underwent enhanced CT examination were also divided into relatively benign group (38 cases of 39 lesions) and relatively malignant group (32 cases of 32 lesions) based on the pathological risk of GSTs. Univariate analysis and multivariate logistic regression analysis were used to explore the independent risk factors associated with the malignant potential of GSTs based on EUS and enhanced CT imaging features.Results:(1) Univariate analysis showed that there were significant differences among groups in terms of ulceration presence on lesion surface, long diameter, boundary regularity, internal echo uniformity and cystic change under EUS ( P<0.05). Logistic regression analysis showed that ulcers on the lesion surface ( P=0.010, OR=4.519, 95% CI:1.432-14.257) and lesion long diameter ( P<0.001, OR=2.398, 95% CI:1.688-3.406) under EUS were independent risk factors for GSTs relative to malignancy. The result of receiver operator characteristic (ROC) curve analysis of GSTs long diameter predicting pathological risk relative to malignancy under EUS showed the area under curve (AUC) was 0.891 (95% CI: 0.839-0.943), the maximum Youden index was 0.667, and the corresponding long diameter of lesion was 1.55 cm. In this case, the sensitivity and specificity of predicting the pathological risk of GSTs were 90.2% and 76.5%, respectively. (2) Univariate analysis showed that there were significant differences in lesion long diameter, shape (round or quasi-round/irregular), boundary clarity, enhancement pattern, and necrosis under enhanced CT among groups ( P<0.05). Logistic regression analysis showed that lesion long diameter under enhanced CT ( P=0.010, OR=2.533, 95% CI:1.245-5.154) was an independent risk factor for GSTs relative to malignancy. The ROC curve analysis of GSTs long diameter predicting pathological risk relative to malignancy under enhanced CT showed that AUC was 0.824 (95% CI: 0.724-0.924), the maximum Youden index was 0.560, and the corresponding long diameter of the lesion was 3.65 cm. The sensitivity and specificity of predicting the pathological risk of GSTs were 68.8% and 87.2%, respectively. Conclusion:The long diameter of GSTs under EUS and enhanced CT exhibits a significant association with the pathological risk of GSTs, which can be used to predict the relative malignancy of GSTs (medium to high risk).

Objective To observe the value of CT angiography(CTA)for classifying type of peripheral arteriovenous fistula(AVF)in children.Methods Totally 22 children with peripheral AVF were retrospectively enrolled,the type of AVF was classified with preoperative CTA,and therapeutic planning was developed.Taken digital subtraction angiography(DSA)findings during interventional therapy as gold standards,the efficacy of CTA for classifying type of AVF was analyzed.Results Among 22 cases,DSA detected 3 cases of type Ⅰ,13 cases of type Ⅱa and 6 cases of typeⅡb peripheral AVF,while 3 cases of type Ⅰ,14 cases of type Ⅱa and 5 cases of type Ⅱb peripheral AVF were classified based on CTA.CTA misdiagnosed 1 case of type Ⅱa as type Ⅱb,and 2 cases of type Ⅱb as type Ⅱa peripheral AVF,its accuracy of CTA for classifying type Ⅰ,Ⅱa and Ⅱb peripheral AVF was 100%(3/3),92.31%(12/13)and 66.67%(4/6),respectively.Among 22 cases,13 cases underwent interventional closure,2 cases underwent interventional therapy combined with surgery,while 3 cases did not receive relevant treatment due to drainage vein occlusion.One month after treatments,the symptoms of 19 cases who underwent treatment improved significantly,and no signs of AVF was found with re-examination of ultrasound nor CTA.Conclusion CTA was helpful to classifying type of peripheral AV in children,which could provide references for interventional therapy.

AIM:To identify surrogate clinical bio-markers for profiling the eosinophilic status of an individual patient over induced sputum analysis.METHODS:We conducted a cross-sectional study on 100 asthmatic patients whose induced sputum was successfully collected.Subjects were further classified into either EA or NEA based on whether the percentage of sputum eosinophil count(SEC％)was≥3％.Demographic and clinical data were col-lected,including basic information,routine blood tests,lung function tests,bronchodilator reversibili-ty tests,fractional exhaled nitric oxide(FeNO),the Asthma Control Test(ACT)and the Asthma Control Questionnaire(ACQ).All variables significantly asso-ciated with EA were candidates for multivariate lo-gistic regression analysis.A scoring system present-ed as a nomogram for the prediction of EA was de-veloped.RESULTS:In the univariate analysis,com-pared with NEA subjects,those with EA were of older age and had worse asthma control and lung function in addition to higher values of blood eosin-ophils,serum IgE and FeNO.Multivariable logistic regression analysis revealed that age,FeNOx serum IgE and blood eosinophil count(BEC)were identi-fied as independent risk factors for eosinophilic asthma,which were all included in the nomogram.CONCLUSION:A combination assessment including age,FeNOx serum IgE and BEC could be applicable to clinicians in identifying eosinophilic asthma and is easier,faster,more inexpensive and more readily available than the induced sputum test.

Objective To observe the value of CT angiography(CTA)for classifying type of peripheral arteriovenous fistula(AVF)in children.Methods Totally 22 children with peripheral AVF were retrospectively enrolled,the type of AVF was classified with preoperative CTA,and therapeutic planning was developed.Taken digital subtraction angiography(DSA)findings during interventional therapy as gold standards,the efficacy of CTA for classifying type of AVF was analyzed.Results Among 22 cases,DSA detected 3 cases of type Ⅰ,13 cases of type Ⅱa and 6 cases of typeⅡb peripheral AVF,while 3 cases of type Ⅰ,14 cases of type Ⅱa and 5 cases of type Ⅱb peripheral AVF were classified based on CTA.CTA misdiagnosed 1 case of type Ⅱa as type Ⅱb,and 2 cases of type Ⅱb as type Ⅱa peripheral AVF,its accuracy of CTA for classifying type Ⅰ,Ⅱa and Ⅱb peripheral AVF was 100%(3/3),92.31%(12/13)and 66.67%(4/6),respectively.Among 22 cases,13 cases underwent interventional closure,2 cases underwent interventional therapy combined with surgery,while 3 cases did not receive relevant treatment due to drainage vein occlusion.One month after treatments,the symptoms of 19 cases who underwent treatment improved significantly,and no signs of AVF was found with re-examination of ultrasound nor CTA.Conclusion CTA was helpful to classifying type of peripheral AV in children,which could provide references for interventional therapy.

Objective:To investigate the correlation between endoscopic ultrasonography (EUS) and enhanced computed tomography (CT) image features and pathological risk of gastric stromal tumors (GSTs).Methods:Data of primary GSTs patients treated at Renmin Hospital of Wuhan University from January 2018 to November 2022, confirmed by endoscopy or surgical pathology and immunohistochemistry were retrospectively reviewed. A total of 286 cases (288 lesions) underwent EUS before surgery, of which 70 cases (71 lesions) had complete preoperative enhanced CT examination data. Patients who underwent EUS were divided into relatively benign group (including very low-risk and low-risk, 245 cases of 247 lesions) and relatively malignant group (including intermediate-risk and high-risk, 41 cases of 41 lesions) based on the pathological risk of GSTs. Patients who underwent enhanced CT examination were also divided into relatively benign group (38 cases of 39 lesions) and relatively malignant group (32 cases of 32 lesions) based on the pathological risk of GSTs. Univariate analysis and multivariate logistic regression analysis were used to explore the independent risk factors associated with the malignant potential of GSTs based on EUS and enhanced CT imaging features.Results:(1) Univariate analysis showed that there were significant differences among groups in terms of ulceration presence on lesion surface, long diameter, boundary regularity, internal echo uniformity and cystic change under EUS ( P<0.05). Logistic regression analysis showed that ulcers on the lesion surface ( P=0.010, OR=4.519, 95% CI:1.432-14.257) and lesion long diameter ( P<0.001, OR=2.398, 95% CI:1.688-3.406) under EUS were independent risk factors for GSTs relative to malignancy. The result of receiver operator characteristic (ROC) curve analysis of GSTs long diameter predicting pathological risk relative to malignancy under EUS showed the area under curve (AUC) was 0.891 (95% CI: 0.839-0.943), the maximum Youden index was 0.667, and the corresponding long diameter of lesion was 1.55 cm. In this case, the sensitivity and specificity of predicting the pathological risk of GSTs were 90.2% and 76.5%, respectively. (2) Univariate analysis showed that there were significant differences in lesion long diameter, shape (round or quasi-round/irregular), boundary clarity, enhancement pattern, and necrosis under enhanced CT among groups ( P<0.05). Logistic regression analysis showed that lesion long diameter under enhanced CT ( P=0.010, OR=2.533, 95% CI:1.245-5.154) was an independent risk factor for GSTs relative to malignancy. The ROC curve analysis of GSTs long diameter predicting pathological risk relative to malignancy under enhanced CT showed that AUC was 0.824 (95% CI: 0.724-0.924), the maximum Youden index was 0.560, and the corresponding long diameter of the lesion was 3.65 cm. The sensitivity and specificity of predicting the pathological risk of GSTs were 68.8% and 87.2%, respectively. Conclusion:The long diameter of GSTs under EUS and enhanced CT exhibits a significant association with the pathological risk of GSTs, which can be used to predict the relative malignancy of GSTs (medium to high risk).

Angiogenesis within atherosclerotic plaques is a critical determinant of plaque stability.The biome-chanical microenvironment,consisting of fluid shear force,plaque structural stress,and matrix stiffness,serves as signifi-cant factors in mediating plaque angiogenesis.Endothelial cells respond to mechanical signals and participate in plaques neovascularization through force chemical signal transduction mechanisms.This review provides an overview of the mecha-nisms by which mechanical factors regulate angiogenesis within plaques and offers a novel therapeutic approach for the pre-vention and treatment of atherosclerosis.

AIM:To identify surrogate clinical bio-markers for profiling the eosinophilic status of an individual patient over induced sputum analysis.METHODS:We conducted a cross-sectional study on 100 asthmatic patients whose induced sputum was successfully collected.Subjects were further classified into either EA or NEA based on whether the percentage of sputum eosinophil count(SEC％)was≥3％.Demographic and clinical data were col-lected,including basic information,routine blood tests,lung function tests,bronchodilator reversibili-ty tests,fractional exhaled nitric oxide(FeNO),the Asthma Control Test(ACT)and the Asthma Control Questionnaire(ACQ).All variables significantly asso-ciated with EA were candidates for multivariate lo-gistic regression analysis.A scoring system present-ed as a nomogram for the prediction of EA was de-veloped.RESULTS:In the univariate analysis,com-pared with NEA subjects,those with EA were of older age and had worse asthma control and lung function in addition to higher values of blood eosin-ophils,serum IgE and FeNO.Multivariable logistic regression analysis revealed that age,FeNOx serum IgE and blood eosinophil count(BEC)were identi-fied as independent risk factors for eosinophilic asthma,which were all included in the nomogram.CONCLUSION:A combination assessment including age,FeNOx serum IgE and BEC could be applicable to clinicians in identifying eosinophilic asthma and is easier,faster,more inexpensive and more readily available than the induced sputum test.

Objective:To examine the structural network changes in participants with amnestic mild cognitive impairment(aMCI)and investigate the correlation between these changes and the onset of Alzheimer's disease(AD).Methods:In this prospective study, a total of 100 individuals with amnestic mild cognitive impairment(aMCI)were enrolled as the research group.Additionally, 25 healthy individuals who were matched in terms of age and sex were enrolled as healthy controls.Upon enrollment, all participants underwent MRI scans, neuropsychological assessments, and clinical evaluations.The participants were then followed every 6 months for a period of 36 months or until they withdrew from the study.Based on the outcome of the follow-up(whether Alzheimer's disease occurred), the aMCI participants were divided into two groups: stable aMCI group and progressive aMCI group.The Chinese version of the Brief Mental State Examination(MMSE), the Montreal Cognitive Assessment(MoCA), the Clinical Dementia Rating Scale(CDR), and the Auditory Word Learning Test(AVLT)were utilized to evaluate the overall mental and cognitive status of the subjects.Pearson correlation analysis was employed to investigate the relationship between structural network changes and cognitive decline.Logistic regression was performed to analyze the predictive ability of structural network changes in determining the onset of AD.Results:Compared to the stable aMCI group, the progressive aMCI group exhibited lower levels of global efficiency( P=0.002), local efficiency( P=0.007), feeder connections( P=0.003), local connections( P=0.008), and right precuneus nodal efficiency( P=0.010).Correlation analysis revealed that global efficiency( r=0.604, P=0.002), feeder connections( r=0.513, P=0.012), and right precuneus nodal efficiency( r=0.504, P=0.014)were correlated with AVLT-delay scores(baseline)in the progressive aMCI group.A logistic regression model demonstrated that global efficiency, feeder connections, and right precuneus nodal efficiency could significantly predict the onset of AD(all P<0.05, AUCunited=0.797, 95% CI: 0.684-0.884, sensitivity=73.91, 95% CI: 51.6-89.8, specificity=76.60, 95% CI: 62.0-87.7). Conclusions:Among participants with aMCI, individuals who exhibit lower global efficiency, feeder connections, or right precuneus nodal efficiency are at a higher risk of developing AD.These indicators are anticipated to serve as new targets for clinical intervention.