Objective To compare the performance of 7 Chinese-developed GenAI models (DeepSeek, Wenxin Yiyan, Tongyi, Doubao, Kimi, Hunyuan, and iFLYTEK Spark) in responding to common diseases of the pediatric genitourinary system and to explore their potential applications.Methods A total of 80 questions covering basic disease information, diagnosis, treatment, and prognosis related to “hypospadias, hydronephrosis, and cryptorchidism” were developed as prompts.The models were tested under 3 modes:“quick thinking, ”“deep thinking, ” and “deep thinking + internet access.” The results were evaluated in a blinded review by two pediatric urologists.The responses were graded into 4 levels—A, B, C, and D—based on accuracy, completeness, and relevance.The proportions of responses rated as A and A+B were statistically analyzed and compared across the different models/modes.Results The “deep thinking” mode of DeepSeek demonstrated the best performance, with 88% of responses rated as A and 96% rated as A+B.DeepSeek (deep thinking + internet access), Doubao (quick thinking), Hunyuan (deep thinking), and Doubao (deep thinking + internet access) followed closely, also showing excellent response capabilities.Among the top 5 models/modes, significant differences were observed in the proportion of Alevel responses (P＜0.05), while differences in the proportion of A+B-level responses were not statistically significant (P＞0.05).Conclusion Certain Chinese-developed GenAI models, represented by DeepSeek (deep thinking), demonstrate significant application potential.However, they still cannot consistently provide recommendations rated at the A+B level (recommended grade or higher) with 100% accuracy.In clinical practice, both doctors and patients should view GenAI as an auxiliary tool for education and information acquisition rather than as a final decision-making authority.All information must be reviewed and confirmed by professional physicians.

Objective Chronic atrophic gastritis(CAG)is often accompanied by intestinal flora disorder and intestinal symptoms,forming the phenomenon of"stomach disease involving intestine".This study explored the dynamic correlation between intestinal symptoms and qi-stagnation degree in patients with CAG qi-stagnation syndrome and analyzed the characteristics of gut microbiota from the perspective of"spleen-stomach system serving as the pivotal hub of qi movement"in TCM.Methods According to the syndrome element differentiation method,410 patients with CAG were divided into four groups:non-qi-stagnation group,mild qi-stagnation group,moderate qi-stagnation group and severe qi-stagnation group.Correlation analysis and 16S intestinal flora sequencing technology were used to analyze the correlation and differential flora between the degree of CAG qi-stagnation and intestinal symptoms.Results Patients with CAG qi-stagnation syndrome were often accompanied by intestinal symptoms such as frequent flatulence,poor defecation and alternating loose-constipated stools.The frequency of cases was significantly positively correlated with the degree of qi-stagnation"non-mild-moderate-severe"(P<0.05).There was a difference in the abundance of gut microbiota between the four groups of CAG qi-stagnation none,mild,moderate and severe.The relative abundance of Streptococcus,Subdoligranulum,Eubacterium_coprostanoligenes_group and Haemophilus was positively correlated with the degree of qi-stagnation.The relative abundance of Ruminococcus_torques_group and Butyricicoccus showed a negative correlation,and Haemophilus was statistically significant among the four groups(P<0.05).Conclusion This study can provide clinical evidence and micro-mechanism for the connotation of"gastrointestinal co-morbidities"and"different diseases with the same syndrome",which may open up new ideas for clinical diagnosis and treatment.

Objective Chronic atrophic gastritis(CAG)is often accompanied by intestinal flora disorder and intestinal symptoms,forming the phenomenon of"stomach disease involving intestine".This study explored the dynamic correlation between intestinal symptoms and qi-stagnation degree in patients with CAG qi-stagnation syndrome and analyzed the characteristics of gut microbiota from the perspective of"spleen-stomach system serving as the pivotal hub of qi movement"in TCM.Methods According to the syndrome element differentiation method,410 patients with CAG were divided into four groups:non-qi-stagnation group,mild qi-stagnation group,moderate qi-stagnation group and severe qi-stagnation group.Correlation analysis and 16S intestinal flora sequencing technology were used to analyze the correlation and differential flora between the degree of CAG qi-stagnation and intestinal symptoms.Results Patients with CAG qi-stagnation syndrome were often accompanied by intestinal symptoms such as frequent flatulence,poor defecation and alternating loose-constipated stools.The frequency of cases was significantly positively correlated with the degree of qi-stagnation"non-mild-moderate-severe"(P<0.05).There was a difference in the abundance of gut microbiota between the four groups of CAG qi-stagnation none,mild,moderate and severe.The relative abundance of Streptococcus,Subdoligranulum,Eubacterium_coprostanoligenes_group and Haemophilus was positively correlated with the degree of qi-stagnation.The relative abundance of Ruminococcus_torques_group and Butyricicoccus showed a negative correlation,and Haemophilus was statistically significant among the four groups(P<0.05).Conclusion This study can provide clinical evidence and micro-mechanism for the connotation of"gastrointestinal co-morbidities"and"different diseases with the same syndrome",which may open up new ideas for clinical diagnosis and treatment.

Objective:Exploring the effect of radiofrequency ablation treatment to restore sinus rhythm on the improvement of functional mitral regurgitation (FMR) and cardiac structure in patients with atrial fibrillation combined with moderate or severe FMR, compared with drug therapy alone.Methods:This retrospective cohort study consecutively enrolled patients diagnosed with persistent atrial fibrillation and moderate or severe FMR who were admitted to the Third Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2021. Forty-eight patients who were treated with radiofrequency ablation and maintained sinus rhythm were enrolled in the ablation group, and 63 patients who were treated with medication alone during the same period were in the medicine group. Patients in the ablation group and medicine group were matched in a 1∶1 ratio using a propensity score, and 41 patients were finally included in each of the 2 groups. All patients reexamined echocardiography after 3-month of treatment. The proportion of patients with FMR improvement and the differences in changes of cardiac structural and functional parameters were compared between groups.Results:After propensity score matching, the ablation group was aged (69.3±7.1) years with 21 males (51.2%) and the medicine group was aged (71.3±9.4) years with 21 males (51.2%). The echocardiography after 3-month of treatment showed the rate of FMR improvement was significantly higher in the ablation group than in the medicine group (19 (46.3%) vs. 33 (80.5%), P<0.001), and patients in the ablation group showed a significant decrease in FMR extent (Δmitral regurgitation area: (-1.30±2.64) cm 2 vs. (-3.55±2.50) cm 2, P<0.001), left atrial size (Δleft atrial diameter: (-0.17±3.78) mm vs. (-2.46±4.01) mm, P=0.009) and E/e′ (ΔE/e′:-2.54±7.34 vs.-6.34±7.08, P=0.021) compared with the medicine group. There was also a significant decrease in left ventricular size (Δleft ventricular end diastolic diameter: (-3.12±6.62) mm vs. (-0.73±3.62) mm, P=0.046) and significant increase in left ventricular ejection fraction (Δleft ventricular ejection fraction: (2.73±9.69) % vs. (-0.93±5.41) %, P=0.038) in ablation group. Conclusion:Performing radiofrequency ablation to restore sinus rhythm can effectively reduce the severity of mitral regurgitation and improve left atrial and left ventricular remodeling and cardiac function in patients with atrial fibrillation and FMR.

To enhance patients′ medical experience, a major Grade-A tertiary hospital has chosen its cardio-cerebrovascular disease branch with excellent specialty and prominent aging problems for innovative outpatient service systems. It created a comprehensive outpatient nursing post that integrated multiple departments of outpatient services, providing outpatient nursing services and related medical services such as outpatient office, medical insurance, and finance. By breaking the limitations of professional services, adjusting the outpatient service space, establishing standardized personnel training, assessment, and incentive mechanisms, and establishing an effective quality management system, the patients could complete all medical services without leaving the consultation area. The processing time for comprehensive patient services has been shortened from around 10 min to 1~5 min. In 2023, the complaint rate of the outpatients in the cardio-cerebrovascular disease branch was 0.89 times per 10 000 people, lower than the average of 1.37 times per 10 000 people in the entire hospital. The average satisfaction score of the outpatients from the branch was 93.9 points, higher than the 89.6 points of the entire hospital, achieving satisfactory results.

To enhance patients′ medical experience, a major Grade-A tertiary hospital has chosen its cardio-cerebrovascular disease branch with excellent specialty and prominent aging problems for innovative outpatient service systems. It created a comprehensive outpatient nursing post that integrated multiple departments of outpatient services, providing outpatient nursing services and related medical services such as outpatient office, medical insurance, and finance. By breaking the limitations of professional services, adjusting the outpatient service space, establishing standardized personnel training, assessment, and incentive mechanisms, and establishing an effective quality management system, the patients could complete all medical services without leaving the consultation area. The processing time for comprehensive patient services has been shortened from around 10 min to 1~5 min. In 2023, the complaint rate of the outpatients in the cardio-cerebrovascular disease branch was 0.89 times per 10 000 people, lower than the average of 1.37 times per 10 000 people in the entire hospital. The average satisfaction score of the outpatients from the branch was 93.9 points, higher than the 89.6 points of the entire hospital, achieving satisfactory results.

Objective:To investigate the effects of gestational diabetes mellitus (GDM) on neonatal metabolites.Methods:This retrospective cohort study recruited 580 singleton newborns who were born to women with GDM from January 2018 to December 2018 in Foshan Maternal and Child Health Care Hospital as the GDM group. Another 580 counterparts born to non-GDM singleton mothers with matching age were selected as the non-GDM group with an allocation ratio of 1 to 1. Neonatal genetic metabolic disease screening was performed within 3-7 days after birth. Two independent sample t-test, and multiple linear regression model were used for statistical analysis. Results:There were significant differences in seven amino acids and 10 fatty acids levels between the GDM and non-GDM group. The serum levels of six amino acids and eight fatty acids were increased in the GDM group, while the levels of piperamide [(140.79±32.60) vs (150.26±35.46) μmol/L, t=－4.733, P<0.001], palmitoyl carnitine [(2.59±0.81) vs (2.73±0.82) μmol/L, t=－2.940, P=0.003], and carbamate [(0.066±0.022) vs (0.069±0.022) μmol/L, t=－1.937, P=0.042] were decreased compared with the non-GDM group. After adjusting for maternal gravidity, parity, neonatal birth weight, and gender, multivariate linear regression analysis showed that GDM was positively correlated with three amino acids levels, which were cysteine ( ?=0.012), homocysteine ( ?=0.263) and leucine ( ?=4.225); and was negatively correlated with glycine ( ?=－6.271) and piperamide level ( ?=－9.885). With regard to the fatty acids, GDM was positively correlated with the neonatal propionyl carnitine ( ?=0.214), butyryl carnitine ( ?=0.014), 3-hydroxybutyryl carnitine ( ?=0.006), isovaleryl carnitine ( ?=0.009), 3-hydroxyisovaleryl carnitine ( ?=0.024), hexadecanoyl carnitine ( ?=0.001), decadienoyl carnitine ( ?=0.045), octadecadienyl carnitine level ( ?=0.128), but was negatively correlated with palmitoyl carnitine ( ?=－0.119), and carbamate ( ?=－0.002) (all P<0.05). Conclusions:Correlations between maternal GDM and the levels of amino acids and fatty acids in neonates was noted in this study, suggesting that maternal GDM may affect the metabolism of amino acids and fatty acids in offspring at early stage of life.

Objective:To investigate the epidemiological characteristics and transmission chain of COVID-19 in two families, and to provide scientific evidence for effective prevention and control measures.Methods:Field epidemiological investigation was conducted for the COVID-19 cases occurred in two families and the close contacts in a county of Baotou city in Inner Mongolia Autonomous Region. Descriptive statistical analysis on epidemiological data was conducted.Results:The infection source of the COVID-19 cases in the two families was a man who had living history in Wuhan. After his return, his parents were infected by him. A few days later, the members of a neighbor family were found to be infected, and relatives of this family were also infected after dining together repeatedly. Finally, ten confirmed cases and three suspected cases of COVID-19 were detected in the two families.Conclusions:Human-to-human transmission of COVID-19 can occur not only in a family but also in neighborhoods. The cases in two families had close relationship, indicating the necessity to strengthen the health education about COVID-19 prevention and control and the management of groups at high risk to reduce the incidence of COVID-19 in families and neighborhoods.

Objective To make clear the arsenic distribution in drinking water sources in Hubei Province, make provincial distribution map of high-arsenic water and provide scientific basis for formulating refined measures to prevent and control arsenic poisoning of drinking water type in Hubei Province. Methods In 103 counties of Hubei Province, residents were sampled according to different water supplies (centralized water supply, small centralized water supply in rural areas and decentralized water supply). One water sample was collected from source water and tap water in centralized water supply system and at least 3 samples were collected from decentralized water supply system in a village. Water iodine content was tested using atomic fluorescence spectrometry and a distribution map of high-arsenic water at county level was drawn using ArcGIS 10.2. Results Totally 38 292 water samples were collected. The water-arsenic-concentration median was less than 1.00 μg/L. The high-arsenic water detection rate in urban centralized water supply was 3.7%(80/2 176);which were all 0.1%(4/4 304,30/31 812) in small centralized water supply in rural areas and decentralized water supply. The high-arsenic water sources from centralized water supplies were distributed centrally in the south, the central and the east of Hubei Province and those from dispersed water supplies were distributed dispersedly in the south, the central and the east of Hubei Province.Conclusions There are still some dispersed water supplies with very high arsenic concentration in Hubei Province, which should be included to change the water area as soon as possible. Moreover, high arsenic water samples are found from centralized water supplies, which means the water treatment process should be upgraded or water resources should be changed.

Objective To make clear the fluorine content distribution in drinking water of residents in Hubei Province,draw a provincial distribution map of high-fluorine water and provide scientific basis for formulating refined prevention and control measures of drinking water type fluorosis in Hubei Province.Methods In 116 counties of Hubei Province,including development zones,scenic zones and farmlands,drinking water of residents was sampled according to different water supplies (centralized water supply,small centralized water supply in rual areas and decentralized water supply) from 2013 to 2015.For a centralized water supply,one sample was collected from the source water and the tap water each and at least 3 samples were collected for decentralized water supply in a village.Selective electrode method was used to detect the water fluorine content and ArcGIS 10.2 was used to draw distribution map of high-fluorine water at county level.Results A total of 38 284 water samples were collected,the median of fluorine content was 0.21 mg/L.The highest detective rate of all types of water supply with high fluorine content was pressure water well (64/100,64.0％) and high-fluorine water sample was not found in the reservoir.The high-fluorine water sources from centralized water supplies were distributed dispersedly in the north-west and the east of Hubei Province and those from decentralized water supplies were distributed dispersedly in the middle-north and the east of Hubei Province.Conclusions Fluorine concentration in drinking water is generally low.However,there are still some high-fluorine water supplies which should be reported to Hubei Provincial Water Resources Department as soon as possible.Moreover,there is a phenomenon of fluorine rebounce in the water reduction project,and managements of those projects should be strengthened.