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

Amino acids are essential nutrients for the survival of all cells in the body,and their metabolic processes are closely associ-ated with tumor development and progression.The metabolic changes of the essential amino acid tryptophan have a significance impact on tumor microenvironment.Tryptophan is mainly metabolized to kynurenine(KYN)by indoleamine 2,3-dioxygenase and tryptophan 2,3-dioxygenase,and the accumulation of KYN and the deficiency of tryptophan cause alterations in the immune status in tumor micro-environment,which in turn affects tumor development and progression.Based on the current studies on tryptophan,this article system-atically discusses the influence of abnormal tryptophan metabolism on tumors and the interventions targeting this pathway,in order to provide a reference for subsequent tumor therapy.

Tumor microenvironment(TME)is the cellular environment for tumor development,growth,and metastasis.Adenosine(ADO)is an immunosuppressive metabolic product that is continuously upregulated in TME,with various types and wide distribution of receptors.The complex and dynamic interactions between ADO and tumor cells constantly influence tumor progression.ADO can di-rectly or indirectly promote tumor development and progression by promoting tumor generation and metastasis,mediating the immune escape of tumor,and modulating tumor-infiltrating immune cells.Based on the characteristics of ADOs in TME,this article reviews the latest advances in the dynamic alterations of ADO in TME,in order to provide insights into tumor treatment targeting the ADO pathway.

Cholesterol,as an important component of cell membranes,plays a multifaceted role in mediating tumor immunomodulation and drug intervention.In case of cholesterol metabolic imbalance,the accumulation of cholesterol metabolic intermediates,the changes in concentrations,and the regulation of related signaling pathways can affect tumor immunity by promoting inflammation and inhibiting immune cell function.Preclinical and clinical studies have shown that controlling cholesterol metabolism can inhibit tumor growth,re-shape body immune regulation,and enhance antitumor immunity.A deep understanding of the association between immune cells and cholesterol metabolic pathways in the tumor microenvironment can help to develop novel drugs targeting cholesterol metabolism.This article reviews the multifaceted role of cholesterol and its derived metabolites in the tumor microenvironment by regulating various types of immune cells such as myeloid-derived suppressor cells,tumor-associated macrophages,dendritic cells,and T-lymphocytes,as well as the characteristics of tumor immunomodulation mediated by cholesterol metabolism and the advances in pharmaceutical re-search on improving the immune function of the body by intervening against cholesterol,in order to further provide new ideas and a thera-peutic basis for cholesterol modulation and intervention in tumor im-munotherapy.

Objective To analyze the content and psychometric properties of measurement tools for children's gross motor function and activity. Methods Six measurement tools for children's gross motor function and activity were selected,including Gross Motor Function Measure(GMFM),Bruininks-Oseretsky Test of Motor Proficiency-Second Edition(BOT-2),Peabody Developmental Motor Scales-Second Edition(PDMS-2),Movement Assessment Battery for Children-Second Edition(MABC-2),Test of Gross Motor Development-Third Edition(TGMD-3)and Functional Movement Screen(FMS).International Classification of Functioning,Disability,and Health(ICF)linking rules,categories and coding were used to analyze the content of measurement dimensions and items of these six tools,and their psychometric properties were explored. Results For the body function,the content of these six tools primarily addressed neuromusculoskeletal and movement-re-lated functions(b7),such as mobility of joint functions(b710),stability of joint functions(b715),muscle power functions(b730),motor reflexes functions(b750),control of voluntary movement functions(b760),supportive functions of arm or leg(b7603)and gait patterns functions(b770).For the activities and participation,the content primarily addressed mobility(d4),such as changing and maintaining body positions(d410,d415),transferring oneself(d420),walking(d450),running(d4552),and jumping(d4553).GMFM was good in inter-rater and test-retest reliability;BOT-2 was good in inter-rater reliability,test-retest reliability and internal consistency;PDMS-2 was good in inter-rater and test-retest reliability;MABC-2 was good in test-retest reliability and internal consis-tency with an excellent model fit;TGMD-3 was good in internal consistency and test-retest reliability;and FMS was good in internal consistency and test-retest reliability. Conclusion The six tools for motor and activity function measurement primarily concern neuro-musculoskeletal and movement-related functions(b7)for ICF body function,and mobility(d4)for activities and participation.PDMS-2 is suggested for a comprehensive evaluation of children's motor functions and activities;TGMD-3 and GMFM for gross motor functions;and BOT-2,MABC-2 and FMS for motor development,coordination and functional movement patterns.BOT-2,PDMS-2,MABC-2 and TGMD-3 are norm-referenced measures,whereas GMFM and FMS are criterion-referenced.Norm-referenced tools,due to their established norms tailored for various ob-jectives,boast superior psychometric properties and wider applications.All the six tools exhibit good to excellent reliability,and internal consistency coefficients ranging from moderate to excellent.Their validity also spans from moderate to excellent.

Objective To analyze the potential categories of foot care knowledge-attitude-practice(KAP)of diabetic high-risk foot patients,and analyze the influencing factors of different potential categories classification prediction,so as to provide references for clinical nursing.Methods By convenience sampling,a questionnaire survey was conducted from July to December 2023,employing a general information questionnaire and a diabetes foot care KAP evaluation scale on patients at high risk of diabetic foot in a tertiary hospital in Guangzhou.Latent profile analysis was used to identify the potential classifications of foot care KAP status among these patients.The iterative dichotomiser 3 algorithm of decision tree in machine learning was used to make classification prediction of foot nursing KAP status of patients,using multivariate logistic regression to analyse its influencing factors.Results There are 3 potential profiles of foot care KAP in high-risk diabetic foot patients,including"high knowledge-medium attitude-medium behavior"type(29.00％),"low knowledge-low attitude-low behavior"type(56.00％)and"medium knowledge-high attitude-high practice"type(15.00％).Decision tree model showed that residence,education level,receiving education about diabetic foot and stage of diabetic high-risk foot were decision-making factors for different potential categories of foot care KAP.The results of the Logistic analysis showed that literacy level,per capita monthly household income,and whether received diabetes-related follow-up were influential factors in different potential profiles of foot care KAP.Conclusion The level of foot care KAP of patients at high risk of diabetic foot needs to be improved,and shows population heterogeneity.Medical staff should intervene and support diabetic foot patients at high risk according to different potential profile and influencing factors to improve their KAP level.

ObjectiveTo systematically analyze the content and health benefits of structured physical activity programs for children with autism spectrum disorders (ASD). MethodsPublished literature related to structured physical activity for children with ASD and its health benefits were searched in Wanfang database, CNKI, Embase, EBSCO and PubMed from January, 2013 to July, 2023. A systematic review was conducted using the PRISMA guidelines. ResultsSeven literatures were finally included, from China, USA, Germany, Italy and Turkey. The publication dates concentrated after 2019. The study designs were all randomised controlled trials with 193 children with ASD, aged three to 14 years. Structured physical activity intervention sites included community sports halls, special education schools, rehabilitation wards of children's hospitals, and rehabilitation centers for children with disabilities. The intervention attributes were generally treatment, rehabilitation and health promotion. The content of physical activity mainly included motor skill-based activities (e.g., running, jumping, kicking, hitting, throwing), traditional yoga activities (e.g., breathing, mimicking postures and relaxation, as well as appropriate socialization activities such as encouragement of greeting/farewell songs, touch/contact games and expressive games), and a combination of multiple types of exercises integrated with school-based curricula such as aerobic exercises (walking), endurance exercises (jumping) and neuromuscular exercises (throwing paper airplanes), mindfulness for emotions and body, and judo. The frequency of the intervention ranged from 40 to 90 minutes, one to four times a week; the intensity ranged from mild to vigorous; and the duration ranged from eight to 40 weeks. The physical and behavioral health benefits were reflected in three aspects. In terms of body composition, it could reduce fat and body mass, increase muscle strength, and improve cardiorespiratory function. In terms of function, it could improve children's language and communication function, cognitive and executive function, and motor function. In terms of physical activity-related health behaviors, it could enhance children's motivation to exercise, reduce sedentary behavior, increase social and interactive behavior, improve emotional regulation, and reduce the risk of problematic behaviors. ConclusionThe physical and behavioral health benefits of structured physical activity for children with ASD can be reflected in the areas of body composition, function, and physical activity-related health behaviors.

Objective To establish an improved type Ⅱ cardio-renal syndrome rat model and evaluate it.Methods Twenty male SD rats were randomly divided into sham and model groups with 7 rats in the sham group and 13 rats in the model group.The model group received the method of squeezing the heart under a small animal anesthesia machine to permanently ligate the left anterior descending branch of the coronary artery to cause myocardial infarction.One week later,unilateral nephrectomy(right nephrectomy)was performed.The rats underwent cardiac echocardiography,pathological staining,and blood and urine tests at 6 weeks to verify model establishment.Results Compared with the sham group,the cardiac function assessed by echocardiography and the endogenous creatinine clearance rate in the model group rats were significantly decreased(P<0.01),and the levels of brain natriuretic peptide,blood creatinine,urea nitrogen,and 24 h urine protein in the model group were significantly increased(P<0.01).HE staining revealed a disordered myocardial arrangement,glomerular atrophy,and inflammatory cell infiltration in model group rats.Picric acid-Sirius red staining showed a significant increase in myocardial collagen fibers,an irregular arrangement of renal tubules,and a large amount of collagen deposition in model group rats.The positive staining area ratio was also significantly increased(P<0.01).Conclusions This improved modeling method provided a typeⅡcardio-renal syndrome rat model with s simple operation,minimal surgical trauma,and low mortality rate.This model simulates the early onset of cardiac and renal function damage and pathological changes in type Ⅱ CRS,laying the foundation for systematic and in-depth research on the pathogenesis and pathological mechanism of type Ⅱ cardio-renal syndrome.

AIM: To observe the clinical efficacy of Fuzheng Xiaoliu Granules in the treatment of stage II primary liver cancer and to explore its mechanism of action from the perspective of metabolomics. METHODS: Sixty patients with stage II primary liver cancer who achieved complete remission (CR) after comprehensive interventional therapy were randomly divided into treatment group and placebo group, with 30 patients in each group. They were treated for one year and observed for one year. The one-year recurrence rate, traditional chinese medicine (TCM) syndrome score, alpha-fetoprotein and child-pugh grade were compared between the two groups. The serum metabolites of the two groups before and after treatment were screened by ultra-high liquid chromatography-mass spectrometry technology, and the metabolic pathways and related biological pathways were analyzed. RESULTS: The one-year recurrence rate of the treatment group was significantly lower than that of the placebo group, and the overall improvement rate of TCM syndrome score was significantly better than that of the placebo group (P<0.05). There was no statistical significance in the comparison of alpha-fetoprotein and child-pugh grade between the two groups after treatment (P>0.05). Metabolomics results showed that there were 39 and 33 different metabolites in the treatment group before and after treatment and in the two groups after treatment, respectively. After enrichment analysis and topological analysis of the different metabolites, it was found that Fuzheng Xiaoliu Granules could affect amino acid metabolism, fatty acid metabolism and purine metabolism and other metabolic pathways. Before and after treatment in the treatment group and after treatment in the two groups, there were the same differential metabolites and metabolic pathways in the two comparison results. The same differential metabolites with FOLD CHANGE>1 include Stearic acid, Hypoxanthine, Kynurenic acid, Arachidonic acid, and N-Arachidonoyl Dopamine. The same metabolic pathways with Impact>0.1 include Arachidonic acid metabolism and Histidine metabolism. CONCLUSION: Fuzheng xiaoliu granules can effectively reduce the recurrence rate of stage II liver cancer patients after comprehensive intervention and improve the TCM syndrome. It may inhibit the activation of PI3K/Akt and ERK signaling pathways by regulating the content of metabolites involved in metabolic pathways such as amino acids and fatty acids, thereby delaying tumor recurrence.

Ticks belong to arthropods and and the second largest vector of pathogens. Ticks can spread a variety of pathogens and cause diseases, threatening human health and livestock production. Although tick-borne diseases can be found almost in all regions in China, they are mainly distributed in Xinjiang, Inner Mongolia, Heilongjiang and other border areas. Tick-borne diseases in Xinjiang are rising year by year with a serious situations recently, and there are specific features in the distribution and characteristics of pathogens. This article reviews the etiology, epidemic status and clinical manifestations of major tick-borne infectious diseases in Xinjiang.