The rapid development of artificial intelligence (AI), especially generative AI (GenAI), has already brought, and will continue to bring, revolutionary changes to our daily production and life, as well as create new opportunities and challenges for diagnostic and therapeutic practices in the medical field. Haihe Hospital of Tianjin University collaborates with the National Supercomputer Center in Tianjin, Tianjin University, and other institutions to carry out research in areas such as smart healthcare, smart services, and smart management. We have conducted research and development of a full-process disease diagnosis and treatment assistance system based on GenAI in the field of smart healthcare. The development of this project is of great significance. The first goal is to upgrade and transform the hospital's information center, organically integrate it with existing information systems, and provide the necessary computing power storage support for intelligent services within the hospital. We have implemented the localized deployment of three models: Tianhe "Tianyuan", WiNGPT, and DeepSeek. The second is to create a digital avatar of the chief physician/chief physician's voice and image by integrating multimodal intelligent interaction technology. With generative intelligence as the core, this solution provides patients with a visual medical interaction solution. The third is to achieve deep adaptation between generative intelligence and the entire process of patient medical treatment. In this project, we have developed assistant tools such as intelligent inquiry, intelligent diagnosis and recognition, intelligent treatment plan generation, and intelligent assisted medical record generation to improve the safety, quality, and efficiency of the diagnosis and treatment process. This study introduces the content of a full-process disease diagnosis and treatment assistance system, aiming to provide references and insights for the digital transformation of the healthcare industry.
Artificial Intelligence ; Humans ; Delivery of Health Care ; Generative Artificial Intelligence

Objective: To systematically evaluate the efficacy and safety of CT-guided percutaneous lung puncture biopsy versus ultrasound-guided percutaneous lung puncture biopsy. Methods: Relevant domestic and foreign related databases such as PubMed, Web of Science, Cochrane Library, OVID, China Biology Medicine, VIP, Wanfang and CNKI databases were searched, the randomized controlled trial about the applications of CT-guided and ultrasound-guided percutaneous lung puncture biopsy were collected. After extracting the relevant data, a Meta-analysis was performed using RevMan 5.2 and Stata softwares. Results: Ten studies met the inclusion criteria, with a total sample size of 1 158 cases, of which 635 were CT-guided puncture biopsy and 523 were ultrasound-guided puncture biopsy. Meta-analysis showed that the difference of the success rate between the CT-guided group and the ultrasound-guided group was not statistically significant [97.48% (619/635) vs. 96.56% (505/523), RR= 1.01, 95% CI 0.99-1.03, P= 0.360]; the puncture diagnosis rate in the CT-guided group was lower than in the ultrasound-guided group, and the difference was statistically significant [92.44% (619/635) vs. 96.56% (505/523), RR= 0.97, 95% CI 0.94-0.99, P= 0.007]. The total incidence of complications after puncture in the CT-guided group was higher than that in the ultrasound-guided group, and the difference was statistically significant [14.49% (92/635) vs. 9.56% (50/523), RR= 1.56, 95% CI 1.11-2.19, P= 0.010]; the incidence of pneumothorax after puncture in the CT-guided group was higher than that in the ultrasound-guided group, and the difference was statistically significant [11.50%(73/635) vs. 6.31% (33/523), RR= 1.77, 95% CI 1.17-2.68, P= 0.007]; the difference of the incidence of bleeding after puncture between the CT-guided group and the ultrasound-guided group was not statistically significant [2.99% (19/635) vs. 3.25% (17/523), RR= 1.08, 95% CI 0.59-1.98, P= 0.800]. Conclusions Both CT-guided and ultrasound-guided percutaneous lung puncture biopsy have good clinical diagnostic value. However, for the intrapulmonary masses shown by ultrasound, the ultrasound-guided lung puncture biopsy has a shorter operation time, lower cost, and higher safety.

Objective To investigate the CT and MRI finding of extrapleural solitary fibrous tumor (ESFT) to improve the preoperative diagnostic ability of such tumors. Methods The clinical data and CT/MRI finding of 11 ESFT patients confirmed by pathology from January 2007 to June 2018 in Jiaxing Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine University were retrospectively analyzed. CT scan was performed in 9 cases and MRI scan in 4 cases. Results Of the 11 patients with ESFT, 6 cases occurred in the abdominal cavity, 3 cases in the cavitas pelvis and 2 cases in the ocular region. All the tumors were solitary, and the maximum diameter of the lesion was (8.3 ± 4.2) cm. The boundary of the tumor was clear in 7 cases, and the boundary was not clear in 4 cases. The tumor form was circular or fusiform in 6 cases and lobulated in 5 cases (some tumors had notch sign). CT scanning presented isodensity or inhomogeneous low density, including 4 cases of cystic degeneration accompanied by inner grid separation, and 3 cases of patchy calcification. The enhanced scanning mass showed 6 cases of geographic enhancement and 7 cases of earthworm drilling soil. MRI T1WI showed slightly lower signal intensity; T2WI fat-suppression sequences showed slightly higher mixed signal intensity in 2 cases and an iso-to high mixed signal intensity in 2 cases; and DWI showed uneven high signal intensity in 3 cases. The solid part of the enhanced scanning showed'fast enhancement and slow washout'. Conclusions ESFT is usually manifested as isolated mass, and its CT and MRI finding has certain characteristics, especially in the diagnosis and differential diagnosis of the disease, such as geographic enhancement and earthworm drilling soil signs.

Radiotherapy can improve the local control rate of the tumors by destructing the tumor cells within the radiation field, can reduce the distant spread by activating the body 's anti-tumor immune response through various mechanisms, and also can exert systemic anti-tumor effect synergistically assisted by immunotherapy. As a new combination therapy, a large number of studies have found that local radiotherapy combined with different immunotherapy can benefit the survival of cancer patients. The optimal efficacy is closely related to the appropriate radiotherapy dose, segmentation model and combined timing. This paper discusses the effects of radiotherapy on the immune system, the related basic and clinical researches of radiotherapy and immunotherapy, and the better way to make the combination effectively.

Objective To assess the effectiveness of uterine arterial embolization for the treatment of hysteromyomas and to discuss the factors related to the clinical results.Methods Super-selective uterine arterial embolization was performed in forty-five patients with hysteromyomas.Of 45 patients,multiple hysteromyomas were seen in 36 and solitary lesion in 9.The lesion was located at the myometrium in 41 cases,among them coexisted endometrioma was found in 5 cases and coexisted submucosal myoma in 2.The lesion was located submucous layer in the remaining 4 cases.The diagnosis was confirmed by imaging study and gynecological examination.After the operation,ultrasonography and laboratory tests were carried out in all patients to observe the tumor size.hormone levels and hemoglobin concentration.Results A total of 91 uterine arteries were found in 45 patients.including double left uterine arteries in one case.Successful catheterization was obtained in 87 arteries(95.6%).All forty-five patients were followed up for 6-36 months.Six months after the procedure the mean reduction of the tumor size was 69.3%.and the lesion completely disappeared in two cases.In the anemic patients the hemoglobin concentration returned to normal level.The main side-effects included low fever and pain at lower abdomen.Conclusion Uterine arterial embolization is a safe and effective treatment for hysteromyomas.

Objective　To explore the expression and significance of p21WAF1 and p53 in HCC. Methods　Immunohistochemical method (IHC) was used to localize and semi-quantitate the proteins of p21WAF1 and p53 and to observe the relationship between the expression of p21WAF1 and the different histopathologic characters in 38 patients of HCC and their peri-cancer tissue as well as 5 normal liver tissue. Results　Of all 38 cases, both p21WAF1 and p53 expression were significantly higher in tumor than that in corresponding non-tumors liver tissue; 14 (36.8 %) of 38 cases showed p21WAF1 positive staining, 28 cases (73.7 %) were p53 positive, p21WAF1＋/p53＋ or p21WAF1-/p53－ were observed in 18, while 20 cases showed p53＋/p21WAF1－ or p53－/p21WAF1＋. p21WAF1＋ was seen in 1 of 38 (2.6 %) corresponding non-cancerous tissue and 2 of 5 normal liver tissue. p53 protein was not detected neither in the non-tumorous tissue nor in normal liver. No significant association was found between the expressions of p21WAF1 and p53(P＞0.05) in HCC. Their was no significant correlation between p21WAF1 or p53 expression and the different histopathologic characters of tumor (differentiating grades, intrahepatic metastasis and/or cancerous thrombi within portal veins). Conclusion　Both p21WAF1 and p53 proteins are over expressed in HCC than that in corresponding non-tumorous liver tissue, but there is no relationship between them. Both p53-independent and p53-dependent mechanism may play a role in regulating p21WAF1 expression in HCC. p21WAF1 immunostaining cannot be used to assess the status of p53 in any given cell or tissue.

Purpose:To investigate the effects of tumor suppressor gene p53 on the activity of telomerase/hTERT in human HCC-9204 cell line.Methods:Lipofection-mediated gene transfection method was used to transfect wild-type p53(wt-p53) gene into HCC 9204 cell which expresses telomerse /hTERT and carries mutant-type p53 gene. The expression of p53 was confirmed by Western blot. Both the telomerase activity and hTERT mRNA expression were detected by PCR-ELISA,TRAP-silver staining,in-situ hybridization and RT-PCR methods. The apoptotic appearance was examined by FCM.Results:Higher telomerase activity and hTERT mRNA level were detected in HCC-9204,and they were markedly inhibited after transfection with wt-p53. Meanwhile,decreasing level of bcl-2 protein and appearance of apoptosis were also shown in the transfected cells.Conclusions:Over expression of the exogenous wt-p53 gene does suppress both telomrease activity and hTERT mRNA expression in HCC cell line. There is a p53-dependent regulatory pathway for activation and expression of telomerase/hTERT in HCC.

mutant (UCN 7 17) of producing high yield Kojic acid was screened fr om Aspergillus flavus after treated with UV three times, ? ray of 60 Co one time and NTG four times, underoptimal conditions, the Kojic aci d production level reached up to 6 3% after 7 days, compared with original stains 0 926% The experiments showed that compound mutation using various mutagenic agents ca n alter the original stains sensitivity to mutagenic agents, increase mutation frequency and raise Kojic acid yield