Objective To construct large medical model named by "Huaxi HongYi"and explore its application effectiveness in assisting medical record generation. Methods By the way of a full-chain medical large model construction paradigm of "data annotation - model training - scenario incubation", through strategies such as multimodal data fusion, domain adaptation training, and localization of hardware adaptation, "Huaxi HongYi" with 72 billion parameters was constructed. Combined with technologies such as speech recognition, knowledge graphs, and reinforcement learning, an application system for assisting in the generation of medical records was developed. Results Taking the assisted generation of discharge records as an example, in the pilot department, after using the application system, the average completion times of writing a medical records shortened (21 min vs. 5 min) with efficiency increased by 3.2 time, the accuracy rate of the model output reached 92.4%. Conclusion It is feasible for medical institutions to build independently controllable medical large models and incubate various applications based on these models, providing a reference pathway for artificial intelligence development in similar institutions.

Aim To explore the mechanism and mate-rial basis of Shenkang injection(SKI)in the treatment of renal fibrosis(RF)by bioinformatics and in vitro experiments.Methods The differentially expressed genes of RF were screened by GEO database.With the help of CMAP database,based on the similarity princi-ple of gene expression profile,the drugs that regulated RF were repositioned,and then the components of SKI potential treatment RF were screened by molecular fin-gerprint similarity analysis.At the same time,the core targets and pathways of SKI regulating RF were predic-ted based on network pharmacology.Finally,it was verified by molecular docking and cell experiments.Results Based on the GEO database,two RF-related data sets were screened,and CMAP was relocated to three common RF therapeutic drugs(saracatinib,da-satinib,pp-2).Molecular fingerprint similarity analysis showed that RF therapeutic drugs had high structural similarity with five SKI components such as salvianolic acid B and hydroxysafflor yellow A.Molecular docking results showed that salvianolic acid B,hydroxysafflor yellow A and other components had good binding abili-ty with MMP1 and MMP13,which were the core targets of SKI-regulated potential treatment of RF.Network pharmacology analysis suggested that the core targets of SKI were mainly enriched in signaling pathways such as Relaxin and AGE-RAGE.Cell experiments showed that SKI could significantly reduce the mRNA expres-sion levels of AGER,NFKB1,COL1A1,SERPINE1,VEGFC in AGE-RAGE signaling pathway and MMP1 and MMP13 in Relaxin signaling pathway in RF model cells,and significantly increase the mRNA expression level of RXFP1.Conclusions SKI can play a role in the treatment of RF by regulating Relaxin and AGE-RAGE signaling pathways,and its material basis may be salvianolic acid B,hydroxysafflor yellow A and other components.

Objective To compare the efficacies of retrograde tibial nailing(RTN)versus minimally invasive percutaneous plate osteosynthesis(MIPPO)in the treatment of distal tibial fractures.Methods A retrospective analysis was conducted on the clinical data of 55 patients with distal tibial fractures who underwent surgery in our hospital.Patients were divided into two groups based on the different surgical methods,patients in the RTN group(n=25)were treated with RTN,and patients in the MIPPO group(n=30)were treated with MIPPO.The surgical parameters(operation time,intraoperative blood loss,intraoperative fluoroscopy times,and success rate of closed reduction),fracture healing time,ankle dorsiflexion range of motion and American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot scores 6 months after operation and at the last follow-up,and the incidence of complications during perioperative period and follow-up were compared between the two groups.Results The operation time,intraoperative blood loss,and intraoperative fluoroscopy times in the RTN group were significantly shorter/less than those in the MIPPO group(P＜0.05).The ankle dorsiflexion range of motion and AOFAS ankle-hindfoot score 6 months after operation in the RTN group were significantly greater/higher than those in the MIPPO group(P＜0.05).There was no statistically significant difference in the fracture healing time,or ankle dorsiflexion range of motion and AOFAS ankle-hindfoot score at the last follow-up between the two groups(P＞0.05).The success rate of closed reduction in the RTN group was 72.00％,which was lower than that of 96.67％in the MIPPO group(P＜0.05).The incidence of soft tissue-related complications in the RTN group was signifi-cantly lower than that in the MIPPO group(P＜0.05),while there was no statistically significant difference in the overall incidence of complica-tions between the two groups(P＞0.05).Conclusion RTN is an effective minimally invasive surgical technique for the treatment of distal tibial fractures,characterized by minimal trauma,low incidence of soft tissue complications,and fast recovery of joint function compared with MIPPO.

Calcified lesions increase the difficulty of interventional therapy for coronary heart disease,and increase the risk of perioperative and long-term complications.Pretreatment of calcified lesions is very important.Coronary lithotripsy(IVL)is used more and more in calcified lesions,and many clinical trials have proved its effectiveness and safety.Stent underexpansion is an important risk factor for stent thrombosis and restenosis,which increases the incidence of complications.At present,there is no effective coping strategy or clear consensus or guidelines for the treatment of stent underexpansion caused by calcified lesions.There are few reports about the treatment of stent under expansion by IVL,and most of them are case reports and small sample studies.In this paper,two cases of stent under expansion were reported.After stent implantation,stent under expansion was found,and IVL was used to treat the cases,which achieved good results.This paper reports 2 cases of stent under expansion to explore the efficacy and safety of IVL in the treatment of such lesions.

Objective To explore root cause of poor prognosis after successful endovascular treatment(EVT)in patients with acute ischemic stroke with large vascular occlusion(AIS-LVO)of anterior circulation.Methods Patients with AIS-LOV of anterior circulation who received successful EVT(postoperative modified thrombolysis incerebral infarction[mTICI]grade≥2b)were retrospectively and continuously collected in the Department of Neurology of Bozhou People's Hospital from January 2022 to March 2024.The baseline and clinical data of the patients were collected,including gender,age,vascular risk factors(hypertension,diabetes,coronary heart disease,hyperlipidemia,valvular heart disease,atrial fibrillation,smoking,and alcohol consumption),prior stroke or transient ischemic attack,baseline blood pressure,baseline National Institutes of Health Stroke scale(NIHSS)score,laboratory test indicators(pre-operative C-reactive protein and D-dimer,post-operative fasting blood glucose,lipid levels,homocysteine,etc).Meanwhile,the data of perioperative indicators was collected,including the time from onset to admission,the time from admission to puncture,the time from puncture to revascularization,the time from onset to puncture,the time from onset to revascularization,remedial measures(balloon dilation,stent placement,arterial thrombolysis)during the surgery or not,using tirofiban or not,postoperative complications(stroke-related pneumonia,stress ulcers,deep vein thrombosis,acute heart failure or renal failure,etc)or not.The patient's medical history and imaging data were collected,and these indicators were defined and collected,including Alberta stroke program early CT score(ASPECTS),location of occlusion(C1 segment of the internal carotid artery,C2 segment to C7 segment of the internal carotid artery,M1 segment of the middle cerebral artery),and the trial of org 10172 in acute stroke treatment(TOAST)classification and a postoperative transformation of cerebral infarction after ischemic stroke and symptomatic intracranial hemorrhage or not.According to the modified Rankin scale(mRS)score at 90 d after surgery,all patients were divided into poor prognosis group(mRS score≥ 3)and good prognosis group(mRS score≤2).The baseline and clinical data of two groups were compared using univariate analysis.Variables with P＜0.1 in the univariate analysis were selected as independent variables,and the poor prognosis was used as the dependent variable.Further,multivariate Logistic regression analysis was performed to identify the influencing factors of poor prognosis after EVT.Results Finally,a total of 192 patients with AIS-LVO of anterior circulation who received successful revascularization were included in this study.There were 101 male patients and 91 female patients.The poor prognosis group had 102 cases and the good prognosis group had 90 cases.Univariate analysis showed that the poor prognosis group had statistically significant differences with the good prognosis group in terms of age(Z=-3.088,P=0.002)and age distribution(x2=13.457,P=0.001),fasting blood glucose(Z=-3.347,P=0.001),baseline NIHSS score(Z=-4.469,P＜0.01),location of occlusion(x2=10.488,P=0.005),transformation of hemorrhage after ischemic stroke(x2=16.943,P＜0.01),and symptomatic intracranial hemorrhage(X2=25.449,P＜0.01),and the baseline ASPECTS of the poor prognosis group was significantly lower than that of the good prognosis group(Z=-4.547,P＜0.01).There were no significant differences in other baseline and clinical data(all P＞0.05).Further multivariate Logistic regression analysis showed that age＞80 years(OR,3.224,95％CI 1.033-10.058,P=0.044),baseline NIHSS score(OR,1.102,95％CI 1.013-1.199,P=0.023),baseline ASPECTS(OR,0.375,95％CI 0.212-0.665,P=0.001),and symptomatic intracranial hemorrhage(OR,7.127,95％CI 1.296-39.203,P=0.024)were independent influencing factors of poor prognosis.Conclusion The independent factors of 90 d poor prognosis after successful EVT in patients with AIS-LVO of anterior circulation are age＞80 years,baseline NIHSS score,baseline ASPECTS,and symptomatic intracranial hemorrhage.

This study analyzed the clinical characteristics of Chlamydia psittaci(C.psittaci)pneumonia to improve clinical understanding of the disease,and its diagnosis and treatment.A retrospective analysis was conducted on clinical data from 65 patients diagnosed with C.psittaci pneumonia admitted to the First Affiliated Hospital of Nanchang University between De-cember 2019 and September 2022.The patients'basic data,clinical manifestations,laboratory examination,chest CT findings,treatment,and prognosis were analyzed.The average age of the 65 patients was 58 years,and the incidence was high-est in autumn and winter.The main manifestations included fever,cough,and fatigue.Compared with non-severe cases,severe cases showed more significantly lower lymphocytes,platelets,and albumin,but significantly higher procalcitonin,alanine transaminase,aspartate transaminase,lactate dehydrogenase,serum creatinine,blood urea nitrogen,and D-dimer.The chest CT findings showed primarily ground glass shadow changes.The extent of lung lesions in severe cases was greater than that in non-severe cases,and all patients required respiratory support.Tetracycline and quinolone antibiotic treatments were effective.The results suggested that C.psittaci pneumonia occurs primarily in the autumn and winter,and manifests mainly as high fe-ver,cough,and elevation of multiple inflammatory markers.Most of the pulmonary imaging findings showed ground glass shadows.The organ damage was more obvious in more severe cases.After active and effective treatment,the prognosis of the disease is favorable.

In recent years,the application of long non-coding RNAs(lncRNAs)in the treatment of dis-eases has been widely concerned.LncRNAs have been proved to play a crucial role in tumor therapy.They usually act as oncogene or suppressor genes to regulate the occurrence and development of tumors.Previously,our group discovered a new lncRNA 606938 that can be used as a target in colorectal cancer through transcriptome analysis.However,its molecular mechanism in colorectal cancer is still unclear.In this study,RT-qPCR test shows that lncRNA 606938 is low expressed in colorectal cancer cell lines com-pared with normal colon epithelial cells.The clonogenicity was decreased by 97％and 54.5％in lncRNA 606938 overexpressed DLD-1 and SW620 cells,respectively.The results of flow cytometry assay showed that overexpression of lncRNA 606938 caused cell cycle arrest at G1 phase(They were prolonged by 50.5％and 63.9％,respectively)and promoted apoptosis of colorectal cancer cells,which was increased by 1.9％and 3.3％,respectively.Western blot results showed that overexpression of lncRNA 606938 down-regulated the expression of related oncogenes(β-catenin,c-Myc,cyclin D1,cyclin D2,cyclin D3,CDK 4,CDK 6)in colorectal cancer cells,and the expression of tumor suppressor genes(TRIM33,caspase 2,and actived caspase 3)was up-regulated.The above results were reversed after knockdown of lncRNA 606938.Mechanistically,it has been confirmed through RNA pulldown assay,RIP assay,and Rescue assay that lncRNA 606938 can target and promote TRIM33 expression,thereby promoting the degradation of β-catenin and blocking the expression of β-catenin and its downstream oncogenes such as c-Myc and cycline D1 to inhibit the progression of colorectal cancer.This study elucidates the molecular mechanism by which the lncRNA 606938 targets TRIM33/β-catenin signaling pathway,inhibits the pro-liferation and promotes the apoptosis of colorectal cancer cells.This study reveals the potential of lncRNA 606938 as a tumor suppressor gene,providing new target and strategies for the clinical treatment of color-ectal cancer.

The SYBR Green Ⅰ real-time fluorescence quantitative PCR detection method was used to determine the prevalence of Japanese encephalitis virus(JEV)in mosquito vectors and cattle se-rum samples in Xinjiang.The E gene fragment of the JEV strain was amplified by PCR,cloned into a pEASY-Blunt vector,produced as a recombinant plasmid,and its sensitivity,specificity and re-producibility were verified.Between 2021 and 2022,serum samples were taken in the regions of Hami,Altay,Ili,Aksu,and Kashi in order to monitor the prevalence of JEV in livestock in Xin-jiang.The positive rate was discovered and evaluated using the established detection method.The established detection method showed a good linear relationship,and the detection interval was 4.03X102-4.03×109 copies/pL.The correlation coefficient was 0.995,the slope was-3.431,and the extreme value of the lower limit of sensitivity was 4.03 × 102 copies/pL.This method has no specific amplification for Zika virus(ZIKV)and Dengue virus(DENV).The intra group coefficient of variation of reproducibility was 0.53％-1.27％,and the inter group coefficient of variation was 0.48％-1.43％.Using this method to detect serum samples from livestock in Xinjiang from 2021 to 2022,the total positive rate was 3.28％,with positive detection rates in horses,cows,and sheep being 2.35％,6.77％,and 3.74％respectively,the virus was identified as Type Ⅰ JEV.A SYBR Green Ⅰ real-time PCR method for the detection of genotype 1 JEV was established.JEV was de-tected in the serum of horses,cattle and sheep in Xinjiang,with a total positive rate of 3.11％.

Objective:To analyze the characteristics and prognosis of patients with mucormycosis after chemotherapy for acute leukemia,and to strengthen understanding of the disease.Methods:7 cases of acute leukemia(AL)patients diagnosed with mucormycosis by metagenomic next generation sequencing(mNGS)after chemotherapy at the First Affiliated Hospital of Bengbu Medical College from October 2021 to June 2022 were collected,and their clinical data,including clinical characteristics,diagnosis,treatment,and prognosis,were retrospectively analyzed.Results:Among the 7 patients with AL complicated with mucormycosis,there were 3 males and 4 females,with a median age of 52(20-59)years.There were 6 cases of acute myeloid leukemia(AML)and 1 case of acute lymphocytic leukemia(ALL).Extrapulmonary involvement in 4 cases,including 1 case suspected of central nervous system involvement.The median time for the occurrence of mucor infection was 16(6-69)days after chemotherapy and 19(14-154)days after agranulocytosis.The main clinical manifestations of mucormycosis were fever(7/7),cough(3/7),chest pain(3/7)and dyspnea(1/7).The most common chest CT imaging findings were nodules,patchy or mass consolidation(6/7).All patients were treated with posaconazole or voriconazole prophylaxis during neutropenia phase.5 patients died within 8 months,and the median time from diagnosis to death was 1 month.Conclusion:Although prophylactic antifungal therapy is adopted,patients with acute leukemia still have a risk of mucor infection during the neutropenia phase.Fever is the main manifestation in the early stage of mucor infection.The use of intravenous antifungal drugs alone is ineffective and there is a high mortality rate in acute leukemia patients with mucormycosis.

Objective:To investigate the etiology,diagnosis and treatment of 45,X/46,XY mixed gonadal dysgenesis and the patients'clinical characteristics of conception,pregnancy and delivery,with purpose of improving the treatment and pregnancy manage-ment of the patients.Methods:We retrospectively analyzed the clinical data on a pregnant patient with45,X/46,XY mixed gonadal dysgenesis.Results:Based on the findings of hypoplasia of secondary sexual characteristics,streak gonads,chromosome karyotype incompatibility with social sex,and chromosome aberration in the gonadal tissue,the patient was diagnosed with 45,X/46,XY mixed gonadal dysgenesis,received oocyte donation and intracytoplasmic sperm injection-embryo transfer(ICSI-ET),and achieved a live birth.Conclusion:Female patients with 45,X/46,XY mixed gonadal dysgenesis are infertile,but can achieve pregnancy through o-ocyte donation.However,the incidence rates of pregnancy complications and abnormal delivery are higher in these patients than in nor-mal females.The perinatal outcomes can be improved by efficient treatment and pregnancy management of the patients.