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.

Immobilized enzyme-based enzyme electrode biosensors, characterized by high sensitivity and efficiency, strong specificity, and compact size, demonstrate broad application prospects in life science research, disease diagnosis and monitoring, etc. Immobilization of enzyme is a critical step in determining the performance (stability, sensitivity, and reproducibility) of the biosensors. Random immobilization (physical adsorption, covalent cross-linking, etc.) can easily bring about problems, such as decreased enzyme activity and relatively unstable immobilization. Whereas, directional immobilization utilizing amino acid residue mutation, affinity peptide fusion, or nucleotide-specific binding to restrict the orientation of the enzymes provides new possibilities to solve the problems caused by random immobilization. In this paper, the principles, advantages and disadvantages and the application progress of enzyme electrode biosensors of different directional immobilization strategies for enzyme molecular sensing elements by specific amino acids (lysine, histidine, cysteine, unnatural amino acid) with functional groups introduced based on site-specific mutation, affinity peptides (gold binding peptides, carbon binding peptides, carbohydrate binding domains) fused through genetic engineering, and specific binding between nucleotides and target enzymes (proteins) were reviewed, and the application fields, advantages and limitations of various immobilized enzyme interface characterization techniques were discussed, hoping to provide theoretical and technical guidance for the creation of high-performance enzyme sensing elements and the manufacture of enzyme electrode sensors.

Lymph node metastasis (LNM) is a crucial risk factor influencing an unfavorable prognosis in specific cancers. Fundamental research illuminates our understanding of tumor behavior and identifies valuable therapeutic targets. Nevertheless, the exploration of fundamental theories and the validation of clinical therapies hinge on preclinical experiments. Preclinical models, in this context, serve as the conduit connecting fundamental theories to clinical outcomes. In vivo models established in animals offer a valuable platform for comprehensively observing interactions between tumor cells and organisms. Using various experimental animals, including mice, diverse methods, such as carcinogen-induced tumorigenesis, tumor cell line or human tumor transplantation, genetic engineering, and humanization, have been used effectively to construct numerous models for tumor LNM. Carcinogen-induced models simulate the entire process of tumorigenesis and metastasis. Transplantation models, using human tumor cell lines or patient-derived tumors, offer a research platform closely mirroring the histology and clinical behavior of human tumors. Genetically engineered models have been used to delve into the mechanisms of primary tumorigenesis within an intact microenvironment. Humanized models are used to overcome barriers between human and murine immune systems. Beyond mouse models, various other animal models have unique advantages and limitations, all contributing to exploring LNM. This review summarizes existing in vitro and animal preclinical models, identifies current bottlenecks in preclinical research, and offers an outlook on forthcoming preclinical models.
Animals ; Humans ; Mice ; Lymphatic Metastasis/pathology* ; Disease Models, Animal ; Cell Line, Tumor

Objective:To compare the consistency of lymphoma multigene detection panels based on next-generation sequencing (NGS) with FISH detection of B-cell lymphoma gene rearrangement.Methods:From January 2019 to May 2023, fusion genes detected by lymphoma-related 413 genes that targeted capture sequencing of 489 B-cell lymphoma tissues embedded in paraffin were collected from Henan Cancer Hospital, and the results were compared with simultaneous FISH detection of four break/fusion genes: BCL2, BCL6, MYC, and CCND1. Consistency was defined as both methods yielding positive or negative results for the same sample. The relationship between fusion mutation abundance in NGS and the positivity rate of cells in FISH was also analyzed.Results:Kappa consistency analysis revealed high consistency between NGS and FISH in detecting the four B-cell lymphoma-related gene rearrangement ( P<0.001 for all) ; however, the detection rates of positive individuals differed for the four genes. Compared with FISH, NGS demonstrated a higher detection rate for BCL2 rearrangement, a lower detection rate for BCL6 and MYC rearrangement, and a similar detection rate for CCND1 rearrangement. No correlation was found between fusion mutation abundance in NGS and the positivity rate of cells in FISH. Conclusions:NGS and FISH detection of B-cell lymphoma gene rearrangement demonstrate overall good consistency. NGS is superior to FISH in detecting BCL2 rearrangement, inferior in detecting MYC rearrangement, and comparable in detecting CCND1 rearrangement.

Objective To explore the clinical efficacy of arthroscopy combined with cubital tunnel expansion and plasty in the treatment of patients with elbow osteoarthritis and cubital tunnel syndrome.Methods A total of 101 patients with elbow osteoarthritis and cubital tunnel syndrome who were admitted to the Department of Orthopedics,Cangzhou Hospital of Integrated TCM-WM Hebei from September 2020 to August 2023 were selected as the research subjects.According to different surgical methods,the patients were divided into an observation group(n=51)and a control group(n=50).The surgical method in the observation group was arthroscopy combined with cubital tunnel expansion and plasty,and the surgical method in the control group was conventional cubital tunnel expansion and plasty.The operation time,intraoperative blood loss,length of hospital stay,and complications were observed and recorded for both groups.The mayo elbow performance score(MEPS)was used to assess elbow function,the activities of daily living(ADL)scale was used to evaluate daily living ability,and the visual analogue scale(VAS)was used to assess pain levels preoperatively and at 6 months postoperatively.Elbow range of motion,including pronation,supination,and flexion-extension,was measured using a goniometer.Nerve recovery was evaluated by measuring compound muscle action potential(CMAP)of the abductor digiti minimi,ulnar nerve conduction velocity(NCV),and motor evoked potential latency(MEPLP)using a Keypoint electromyography device.Results The operation time and length of hospital stay in the observation group were significantly shorter than those in the control group,and the intraoperative blood loss and complications were significantly less than those in the control group(P＜0.05).Before operation,there were no statistically significant differences in MEPS scores,ADL scores and VAS scores between the observation group and the control group(P＞0.05);6 months after operation,the MEPS scores and ADL scores of patients in the observation group were signifi-cantly higher than those in the control group,and the VAS scores were significantly lower than those in the control group(P＜0.05).Before operation,there were no statistically significant differences in pronation,supination and flexion-extension between the observation group and the control group(P＞0.05);6 months after operation,the pronation,supination and flexion-extension of patients in the two groups were significantly higher than those before operation(P＜0.05),but there were no statistically significant differences in pronation,supination and flexion-extension between the observation group and the control group(P＞0.05).Before operation,there were no statistically significant differences in CMAP,NCV and MEPLP between the observation group and the control group(P＞0.05);6 months after operation,the CMAP and NCV of patients in the observation group were significantly higher than those in the control group,and the MEPLP ratio was significantly lower than that in the control group(P＜0.05).Conclusion Conventional cubital tunnel expansion and plasty and arthroscopy combined with cubital tunnel expansion and plasty can improve the range of motion of the elbow in patients with elbow osteoar-thritis and cubital tunnel syndrome,but the latter features less damage and faster recovery,is better in improving elbow function and daily living ability,reducing pain,and adjusting electromyographic examination indicators,and has fewer complications.

Objective To analyze the setup errors during proton and heavy ion therapy for head and head neck tumor patients fixed by thermoplastic film combined with styrofoam.Methods Totally 20 patients undergoing proton and heavy ion therapy at some hospital from January to December 2018 were selected retrospectively,of whom 10 ones had head tumors with clinical targets located in the head and the other 10 cases had head and neck tumors with clinical targets distributed in the head and neck.All the 20 patients were fixed with thermoplastic film combined with styrofoam.The head and neck images of the patients acquired after image guidance were aligned with the CT localization-based digitally reconstructed radiograph images,and the setup errors at six-dimensional directions(left-right translation,head-foot translation,forward-backward translation,isocentric rotation,pitch rotation and transverse-roll rotation)were recorded in the first five and the last five times of radiotherapy treatment.The data were processed by using the SPSS 23.0 statistical software and EXCEL.Results There were no significant differences between the head tumor patients in the setup errors at the six directions during the first and last five times of radiotherapy(P＞0.05).The head and neck tumor patients did not have obvious differences in the setup errors at the the directions of left-right translation,forward-backward translation,isocentric rotation and transverse-roll rotation(P＞0.05),while did at the directions of head-foot translation and pitch rotation(P＜0.05).The head and head neck tumor patients with the fixation by thermoplastic film combined with styrofoam had their setup errors at the six directions meet clinical requirements after calibration by the six-dimensional treatment table.Conclusion The fixation mode by thermoplastic film and styrofoam behaves well to enhance the setup repeatability for head tumor patients at the six-dimensional directions,while not so well for head neck tumor patients at the directions of head-foot translation and pitch rotation.Proper measures have to be taken to decrease the setup errors during proton and heavy ion therapy for head and head neck tumor patients.[Chinese Medical Equipment Journal,2024,45(7):56-61]

The call of the times to"promote education informatization towards a new journey"has posed new challenges to edu-cation,and the education industry should be committed to modernizing education through education informatization.In recent years,online teaching has become the norm.In this context,our teaching team introduced short video teaching into teaching innovation to spread Animal Immunology knowledge.Animation and ideological and political elements were integrated into each video,making knowledge points from"abstract"to"concrete",which stimulated students'interest in learning and cultivate the quality of rigorous scholarship and moral cultivation.The short video comment area has become a medium for interaction between teachers and students.The real-time feedback of the data platform provides a reference for the optimization and design of teaching content.The short video teaching practice effectively solves the"pain points"in traditional teaching and makes the obscure animal immunology knowledge more understandable.Students have increased their interest in learning,using fragmented time to actively acquire knowledge,achieving the effect of improving the teaching quality of animal immunology through online teaching resources.

Objective To observe the effects of Wuhu Decoction on autophagy and the expressions of IL-8,IL-23 and muc5ac in lung tissue of asthmatic mice induced by exosomes of bone marrow mesenchymal stem cells infected by RSV(BMSCs-Exo-RSV);To explore its mechanism in the treatment of asthma.Methods Totally 40 male SPF C57 mice were randomly divided into blank group,model group,Wuhu Decoction group and ribavirin group,with 10 mice in each group.The blank group was given PBS nasal drops,and the other groups were given BMSCs-Exo-RSV nasal drops once every other day for 7 times.24 hours after the end of modeling,Wuhu Decoction group was given Wuhu Decoction,and ribavirin group was given ribavirin solution,the blank group and model group were given distilled water,once a day,for consecutive 7 d.The general behavior of mice was observed,the peak expiratory flow(PEF)and forced vital capacity(FVC)were detected,HE and Masson staining were used to observe the inflammatory infiltration and collagen deposition in the lung tissue,RT-qPCR was used to detect the expressions of LC3A/B,beclin-1,p62,IL-8,IL-23 and muc5ac mRNA in lung tissue,Western blot was used to detect the expressions of LC3B,beclin-1 and p62 proteins in lung tissue,immunohistochemstry was used to detect the expression of IL-8,IL-23,muc5ac proteins in lung tissue.Results Compared with the blank group,the body mass of mice in the model group decreased,and showed behavioral changes such as shortness of breath,nodding wheezing,lifting of upper limbs,shrugging,vertical hair,scratching nose,etc.,the PEF and FVC were decreased(P<0.01),inflammatory infiltration and collagen deposition in lung tissue increased,the expressions of LC3A/B,beclin-1,IL-8,IL-23 and muc5ac mRNA in lung tissue increased,the expression of p62 mRNA decreased(P<0.01),while the expression of LC3BⅡ,beclin-1,IL-8,IL-23 and muc5ac proteins and the ratio of LC3BⅡ/Ⅰ increased(P<0.01),while the expression of LC3BⅠand p62 protein decreased(P<0.01).Compared with the model group,the symptoms of Wuhu Decoction group and ribavirin group were improved,the PEF and FVC were increased(P<0.01,P<0.05),the inflammatory infiltration and collagen deposition in lung tissue were reduced,the expression of LC3A/B,beclin-1,IL-8,IL-23 and muc5ac mRNA in lung tissue decreased(P<0.01),the expression of p62 mRNA increased(P<0.01),the expressions of LC3BⅡ,beclin-1,IL-8,IL-23 and muc5ac protein and the ratio of LC3BⅡ/Ⅰ decreased(P<0.05,P<0.01),while the expressions of LC3BⅠ and p62 protein increased(P<0.01).Conclusion BMSCs-Exo-RSV can promote autophagy and the expressions of IL-8,IL-23 and muc5ac in lung tissue of mice to induce asthma changes.Wuhu Decoction has therapeutic effect on asthmatic mice by inhibiting autophagy and reducing the expressions of IL-8,IL-23 and muc5ac.

Objective To investigate the risk factors of hip instability in elderly patients with femoral neck fracture after hemiarthroplasty(HA).Methods The medical records of 133 patients with femoral neck fracture who received HA treatment in the Department of Orthopedics of our hospital from January 2015 to October 2022 were retrospectively collected.According to whether the patients suffered hip dislocation after surgery,the patients were divided into dislocation group(n=35)and non-dislocation group(n=98).Demographic variables such as age,sex and body mass index(BMI)were recorded in the two groups.Complications such as diabetes,hypertension,heart disease and chronic obstructive pulmonary disease(COPD)were recorded.Prosthetic type,surgical approach,soft tissue repair type,blood loss and other surgical phase variables were recorded.Central marginal Angle(CEA),extraneous Angle(ABA),eccentricity,lower limb length difference(LLD),acetabular width,acetabular depth,and femoral head coverage(FCR)were measured on radiographs.Wald method was used to establish Logistic regression model to elucidate the risk factors of dislocation after HA.Results The proportion of COPD in the dislocation group was significantly higher than that in the control group(P＜0.05),and there was no significant difference in baseline characteristics between the two groups(P＞0.05).There was no significant difference between the two groups(P＞0.05).There were no significant differences in CEA,ABA,LLD,acetabular width,eccentricity and FCR between 2 groups(P＞0.05),but the acetabular depth and depto-width ratio in luxation group were significantly lower than those in control group(P＜0.05).Gender,COPD,CEA,acetabular width-to-depth ratio and LLD were independent risk factors for hip instability after HA(P＜0.05).Conclusion In this study,COPD,male,LLD,and small CEA and acetabular broad-to-depth ratio are independent risk factors for hip instability after HA,and therefore HA is not recommended for the treatment of femoral neck fractures in elderly patients with these conditions.