With the continuous development of artificial intelligence (AI) language models, their preliminary application in the medical field has demonstrated tremendous potential. AI language models hold significant promise for development and application in nursing clinical decision support systems, showcasing distinct advantages while facing various challenges. This review aims to explore the prospects, advantages, and challenges of integrating AI language models into nursing clinical decision support systems against the backdrop of advancing informatization and intelligent healthcare. It provides insights and references for future applications of AI language models in nursing clinical decision-making.

With the continuous development of artificial intelligence (AI) language models, their preliminary application in the medical field has demonstrated tremendous potential. AI language models hold significant promise for development and application in nursing clinical decision support systems, showcasing distinct advantages while facing various challenges. This review aims to explore the prospects, advantages, and challenges of integrating AI language models into nursing clinical decision support systems against the backdrop of advancing informatization and intelligent healthcare. It provides insights and references for future applications of AI language models in nursing clinical decision-making.

Objective:To investigate the effectiveness, safety, and advantages of modified radical neck dissection by gasless unilateral axillary approach (GUA-MRND) in the surgical management of selected patients with papillary thyroid cancer.Methods:We retrospectively analyzed patients with papillary thyroid cancer who underwent GUA-MRND (endoscopic group, n=16) versus unilateral open modified radical neck dissection (MRND) (open group, n=32) during the period from Jan. 2019 to Jun. 2021, including the differences in surgical efficiency, complication rate, and incisional satisfaction.Results:Compared MRND with GUA-MRND, the patients were younger ( P<0.05) , operative time and postoperative drainage anterior ( P<0.01) were slightly inferior in the latter, but it had obvious advantages in cervical swallowing discomfort and incision satisfaction evaluation ( P<0.05) . There was no significant difference in the incidence of temporary recurrent laryngeal nerve injury, intraoperative and postoperative bleeding, hematoma, infection, lymphatic or chylous leakage and supraclavicular numbness after surgery ( P>0.05) . The number of dissected lymph nodes in area II in the GUA-MRND was lower ( P<0.05) , but it was significantly higher ( P<0.01) in area III. And the average regional cleaning efficiency in the GUA-MRND was level Ⅲ (35.5%) , level Ⅵ (28.59%) , level Ⅳ (23.21%) , level Ⅱ (7.18%) and level Ⅴ (7.12%) , suggested that GUA-MRND had higher efficacy for level III, level Ⅵ and Level IV. Conclusion:GUA-MRND is safe, effective, and has high cosmetic satisfaction in the treatment of selected patients with lateral cervical lymph node metastases from papillary thyroid cancer.

Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.

To provide anatomy information for harvesting the posterior tibial artery cutaneous branches-chain flaps. Methods The research was performed from January, 2017 to January, 2018. Anatomic ob-servation on 10 legs from fresh human cadaver were performed. The location of cutaneous branches of the posterior tibial artery was observed and its diameter and length was measured. Five legs were prepared to investigate the cuta-neous branches of posterior tibial artery.The anastomosis of cutaneous branches of posterior tibial artery was observed by PVA-bismuth oxide perfusion for molybdenum target X-ray arteriography in 5 perfused legs. The cutaneous branches with diameter over 0.2 mm in 10 legs of latex perfusion microdissection were included in the statistical analysis.The data were clustered and analyzed to find the location of distant and near cutaneous branches, which was called the gathering point of cutaneous branch vascular plexus. Secondly, the measured data of distal and near seg-ments containing cutaneous branches were compared by t-test.Then the distribution of cutaneous branches of posteri-or tibial artery on the tibiofibular side was compared by Chi-square test.It was considered to be significant if P value was under 0.05. Results ①There were 4.3 cutaneous branches raised from the posterior tibial artery.There was no significant difference on the tibial and ribula side distribution of the cutaneous branches from the posterior tibial artery (P＞0.05).②The distal cutaneous branch clusters was located at about 1/5 of the distal leg and there were 3.6 cutaneous branches raised from the posterior tibial artery. While the proximal clusters was located at 1/3 of the proximal leg and there were 0.7 cutaneous branches raised from the posterior tibial artery.There were no significant differences in the di-ameters (P=0.28) and pedicle length (P=0.14) between distal and proximal cutaneous branches. ③There were the large cutaneous perforators (≥1.0) mm from the posterior tibial artery at (6.37±1.22) cm proximal to the medial malleolus.The diameter and pedicle length of the distal perforators were (1.11±0.09) mm and (6.53±1.51) mm respectively.④The vas-cular chains parallel to the posterior tibial artery were formed via anastomosis of the adjacent cutaneous perforators. Conclusion The cutaneous expenditure of posterior tibial artery is constant, with a certain pedicle length and diameter. There are 2 relatively dense vascular plexus of cutaneous branches. The proximal and distal vascular flaps can be de-signed with these 2 vascular dense points as rotation points.

Objective To evaluate the infection status and genotype distribution of high risk human papillomavirus (HPV) in Chongqing women with different healthy status of cervix .Methods A retrospective analysis including 3 118 cases from June 2013 to March 2014 were performed ,945 of which were carried out multiplex real time PCR ,and data of cervix healthy status and HPV positive cases were subjected to chi‐square test .Results The general positive percentage of high risk HPV was 27 .49% ,16 .35%in healthy check‐up group ,and 24 .42% in cervicitis group and 39 .87% in cervical neoplasia lesion ,there was a significant difference of HPV positive ratio between these three groups(P< 0 .05) ;and HPV positive ratio was higher in older women without significant difference .In Chongqing region ,the three most common HPV types were HPV52 (21 .97% ) ,HPV16 (20 .00% ) and HPV58 (14 .75% ) .However ,the three most common HPV types in various groups are different :HPV52 (26 .20% ) ,HPV58 (14 .3% ) and HPV51 (10 .70% ) in health check‐up group ; HPV52 (21 .10% ) ,HPV58 (20 .00% ) and HPV16 (18 .90% ) in cervicitis group while HPV16 (29 .00% ) ,HPV52 (19 .80% ) and HPV58 (11 .50% ) in cervical neoplasia lesion group .The multiple infec‐tion rate of HPV was 5 .86% ,as the cervix status gets worse ,HPV concurrent infection increases ,and concurrent HPV types vary :mostly with HPV 52 in healthy check‐up group while with HPV 16 in cervical neoplasia lesion group .Conclusion The prevalence and genotype distribution of HPV in Chongqing women with different healthy status of cervix are significant difference.

Objective To investigate the application of PKH26 fluorescent labeling on nucleus pulposus cells isolat-ed from bovine coccyx disc, and to provide nucleus pulposus tissue engineering with traceable nucleus pulposus cells by PKH26 fluorescence labelling. Methods Nucleus pulposus primary cells were isolated from the nucleus pulposus tissue de-tached from bovine coccyx disc by enzymatic digestion, and observed under the inverted microscope. Safranin O, toluidine blue and type Ⅱ collagen immunocytochemistry methods used to stain for passage one generation cells. Nucleus pulposus cells were labeled with PKH26 fluorescence in accordance with the instructions. The cell activity, fluorescence intensity at d0, d14 and d28 of culture, characteristics of proliferation and the expression of gene in labeled cells were assessed. Re-sults Isolated nucleus pulposus cells amounted to (1.56 ± 0.35) × 106/g. Under the inverted microscope, primary cells ad-hered at the 4 th day of culture, grew in groups, and covered the bottom of culture flask at the 13 th day. Both primary cells and the P1 generation cells were chondrocyte-like morphology. The staining of safranin O, toluidine blue and typeⅡcolla-gen immunocytochemistry for P1 generation of nucleus pulposus cells showed positive results. The cell activity before and af-ter PKH26 labeling showed more than 95%, and the fluorescence intensity at d0, d14 and d28 performed a decreasing trend, but still showed detect strong fluorescence at d28. There were no significant differences in proliferation and the expression of gene (collagen typeⅠandⅡ, aggrecan) before and after cell labeling (P>0.05). Conclusion As the seed cells of tissue en-gineering, nucleus pulposus cells isolated from bovine coccyx can reach a satisfactory number and maintain cartilage-like phenotype, and no changes shown in the biological characteristics after labeling. PKH26 labeled nucleus pulposus cells are suitable for the traceable cells in vivo study.

AIM: To observe the activity and distribution of astrocytes and glial fibrillary acid protein(GFAP) after middle cerebral artery occlusion (MCAO). METHODS: The rat MCAO model was made by two-kidney, tow clip renovascular hypertensive rat stroke prone(RHRSP). Rats were killed and brain samples were collected at the end of 1,3,6 and 9 weeks after MCAO, respectively. The ultrastructure of astrocytes was determined at broder of infarct (A area); distant of infarct (B area) and opposite of hemisphere (C area) by electron microscope. The number and optical density of GFAP-positive cells were also observed. RESULTS: The astrocyte proliferation distributed in the whole brain after MCAO. The highest numbers of GFAP-positive cells were observed at A area, then B area. The lowest numbers of GFAP positive cells were found in C area. The time course of GFAP-positive cell change was that the highest number was observed at 1 week after MCAO, then decreased by time from 3, 6 weeks to 9 weeks. The optical density of GFAP-positive cells showed the same patterns. CONCLUSION: The correlation between astrocyte proliferation and tissue damage after MCAO can be estimated by GFAP expression. The astrocyte proliferation plays an important role in healing process after MCAO.