The rapid development of digital intelligence technologies is providing a powerful boost to the high-quality development of the healthcare system.Considering the current state of our healthcare services and guided by General Secretary Xi Jinping's insights on new quality productive forces and the directives from Third Plenary Session of Communist Party of China's 20th Central Committee,the high-quality development of the healthcare service system should focus on digital intelligence technologies such as cloud computing,big data,privacy computing,blockchain,Internet of Things(IoT),mobile computing,and AI.The key measures should include the optimization of production factors,services,and governance.Emphasis should be placed on enhancing the efficient and intensive development of the development model,ensuring the high-quality and continuous integration of the supply model,and transitioning to scientific and modern management methods.Herein,we analyzed the"factor optimization—service optimization—governance optimization"development mechanism driven by digital intelligence and proposed corresponding implementation pathways,intending to provide references for establishing a high-quality and efficient healthcare service system with Chinese characteristics.

Objective: To explore the value of an oral squamous cell carcinoma (OSCC) diagnostic model constructed by using principal component analysis (PCA) to analyze a database of differentially expressed genes in OSCC and to provide a reference for clinical diagnosis and treatment. Methods: RNA-seq expression data of OSCC and normal control samples were obtained from The Cancer Genome Atlas (TCGA) database, and then, normalized and differentially expressed genes (DEGs) were identified by R software. DEGs were enriched by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis to identify their main biological characteristics. 70% of DEGs expression data in RNA-seq were randomly selected as the training set and 30% were selected as the test set. Then, the PCA method was applied to analyze the training set data and extract the principal components (PCs) related to the diagnosis of OSCC in order to construct a PCA model. Then, the receiver operating characteristic (ROC) curves of PCA models in the training set and the test set were respectively drawn, and the area under curve (AUC) was calculated to evaluate the accuracy of the PCA model in the diagnosis of OSCC. Results: RNA-seq expression data of OSCC and normal control samples obtained from TCGA database included 330 samples and 32 samples, respectively. Using false discovery rate (FDR) <0.001 and |log2 fold change| (|log2FC|) >4 as the thresholds, a total of 159 downregulated and 248 upregulated DEGs were identified, which were mainly enriched in cellular components such as intermediate fiber and melanosomal membrane, pigment and salivation-related biological processes and mainly involved in salivary secretion and tyrosine metabolism pathways (P.adjust<0.05 and Q<0.05). The DEGs were proposed as tumor markers for OSCC, and PCA analysis of the training set showed that the cumulative ratio of variance of PC1, PC2 and PC3: [including submaxillary gland androgen regulated protein 3B (SMR3B), proline rich 27 (PRR27), histatin 3 (HTN3), statherin (STATH), cystatin D (CST5), BPI fold containing family A member 2 (BPIFA2), proline rich protein Hae Ⅲ subfamily 2 (PRH2), keratin 35(KRT35), histatin 1 (HTN1), amylase alpha 1B (AMY1B)] were 0.873, 0.100 and 0.023, respectively, and the total weight of the three was 0.996. The PCA diagnostic model of OSCC was further constructed by combining the eigenvectors of the above three components. The ROC curves of the training set and test set showed that the AUC values of the PCA model were 0.852 and 0.844, respectively, which were higher than those of other single genes. Conclusion The OSCC diagnostic model based on the expression levels of SMR3B, PRR27, HTN3, STATH, CST5, BPIFA2, PRH2, KRT35, HTN1 and AMY1B constructed with the PCA method and DEGs has a high diagnostic advantage. This study provides a theoretical basis for the early genetic diagnosis of OSCC and the application of the PCA model in clinical diagnosis.

Objective:To explore the effect of intermittent oro-esphageal tube feeding (IOE) on functional recovery from severe brain injury complicated by tracheotomy.Methods:A total of 98 patients with severe brain injury and tracheotomy were randomly divided into an observation group and a control group. All received neurotrophic and anti-infection medication, physical therapy, acupuncture and exercise. The observation group was also given intermittent oro-esophageal tube feeding, while the control group was given nasogastric tube feeding for 4 weeks. Before and after the treatment, each patient′s nutritional status, extubation time and extubation rate of the tracheotomy, and Glasgow Coma Scale score was evaluated as well as the incidence of complications.Results:After the 4 weeks the average hemoglobin, albumin and pre-albumin levels of the observation group and its average body mass index were all significantly better than the control group′s averages. It also had a significantly better overall incidence of complications, average extubation rate, average extubation duration and average GCS score.Conclusions:Where feasible, intermittent oro-esphageal tube feeding is superior to nasogastric tube feeding for improving the nutritional status and consciousness level of patients with severe brain injury. It promotes early removal of the tracheotomy cannula, which inhibits complications.

Objective:To explore the clinical application value of group A Streptococcus (GAS) antigen rapid detection method in children suffering from GAS infection.Methods:A total of 44 733 children with suspected GAS infection who were admitted to the Outpatient and Inpatient Departments of Shenzhen Children′s Hospital from January 2015 to December 2019.Throat swab specimens from all children were collected, and BinaxNOW Strep A Test reagent was used for GAS antigen rapid detection.Among them, the throat swabs of 346 children were inoculated with blood culture medium for traditional bacterial culture, and then the GAS antigen rapid detection was tested.The sensitivity and specificity of the two methods were compared, and according to the result of the GAS antigen rapid detection, its age, gender and seasonal trends were analyzed.SPSS 19.0 software was applied for statistical analysis of the data.Results:Among the 346 children tested by both methods, the results of bacterial culture were adopted as the reference method, the sensitivity of the rapid detection method for GAS antigen was 89.41%(152/170 cases), and the specificity was 94.32%(166/176 cases) compared with culture methods.A total of 44 733 cases GAS antigen were tested in children in Shenzhen, of which 10 024 cases were positive, with the positive detection rate of 22.41%.The trend of GAS antigen rapid detection was consistent with the five-year trend, with the high positive rate of 3-8 years, of which 4-6 years of positive rate was the highest.The two seasonal peaks were evident each year, with peaks occurring in April-June, and November and January of next year.The detection rate ratio of male and female was 1.74∶1, and the gender difference was significant ( χ2=27.93, P<0.000 1). GAS antigen rapid detection rate in different clinical departments from high to low in order are as follows: dermatology outpatient (52.34%), emergency clinic (47.74%), internal medicine outpatient (37.36%), infectious disease area (19.71%), five-level disease area (10.27%), internal medicine area (8.63%), surgical areas (7.34%) and neonatal areas (0). Conclusions:GAS antigen rapid detection method and bacterial culture method have high coincidence rate, and high sensitivity and specificity, and can be popularized and applied in the diagnosis of GAS infectious diseases in children.GAS detection rate is higher in outpatient emergency department and dermatology clinics.There are obvious differences from seasonal and population (age and gender) in the positive detection of GAS antigen.No neonates were found.

The clinical manifestations of patients with schizophrenia and patients with depression not only have a certain similarity, but also change with the patient's mood, and thus lead to misdiagnosis in clinical diagnosis. Electroencephalogram (EEG) analysis provides an important reference and objective basis for accurate differentiation and diagnosis between patients with schizophrenia and patients with depression. In order to solve the problem of misdiagnosis between patients with schizophrenia and patients with depression, and to improve the accuracy of the classification and diagnosis of these two diseases, in this study we extracted the resting-state EEG features from 100 patients with depression and 100 patients with schizophrenia, including information entropy, sample entropy and approximate entropy, statistical properties feature and relative power spectral density (rPSD) of each EEG rhythm (δ, θ, α, β). Then feature vectors were formed to classify these two types of patients using the support vector machine (SVM) and the naive Bayes (NB) classifier. Experimental results indicate that: ① The rPSD feature vector performs the best in classification, achieving an average accuracy of 84.2% and a highest accuracy of 86.3%; ② The accuracy of SVM is obviously better than that of NB; ③ For the rPSD of each rhythm, the β rhythm performs the best with the highest accuracy of 76%; ④ Electrodes with large feature weight are mainly concentrated in the frontal lobe and parietal lobe. The results of this study indicate that the rPSD feature vector in conjunction with SVM can effectively distinguish depression and schizophrenia, and can also play an auxiliary role in the relevant clinical diagnosis.
Bayes Theorem ; Depression ; Electroencephalography ; Humans ; Schizophrenia ; Signal Processing, Computer-Assisted ; Support Vector Machine

Objective: To examine the sex difference in the emotional processing of adolescents with elevated callous unemotional (CU) trait. Methods: A total of 770 middle school students completed the inventory of Callous-Unemotional Traits (ICU). According to the prevalence of psychopathy in the general population, the top 5％ and the last 5％ of ICU scores were selected as higher and lower CU trait groups. Finally, 33 students in each group participated in the experiment, including 27 males and 39 females. In the facial expression recognition task, the participants were presented with happy, neutral, sad and fear facial expressions and were asked to identify these four facial expressions. Accuracy and response time were recorded as dependent variables and were analyzed by repeated ANOVA. Results: The accuracy of males was lower than that of females [ (73. 3 ± 22. 1) ％ vs. (81. 6 ± 16. 2) ％, P ＜ 0. 05] and the response time of males was shorter than that of females [ (850 ± 236) ms vs. (939 ± 158) ms, P ＜ 0. 05]. Moreover, when identifying fear emotions, compared to lower CU trait males, the males with higher CU trait had lower accuracy [ (60. 4 ± 24. 6) ％vs. (86. 0 ± 10. 1) ％, P ＜ 0. 01], whereas the difference of the response time between the males with higher and lower CU trait was not significant. While between higher and lower CU trait females, the accuracy and response time were not significantly different. When identifying other emotions, there was no significant difference in the accuracy and response time between higher and lower CU trait groups of both males and females. Conclusion: The higher callous unemotional trait adolescent males may display deficits in processing fear emotions, but adolescent females with higher callous unemotional trait can accurately recognize fear emotion.

Objective: To observe the efficacy and safety of de novo combination of Lamivudine(LAM) and Adefovir Dipivoxil (ADV) therapy counter to Entecavir (ETV) monotherapy in patients with chronic hepatitis B (CHB)- related compensated liver cirrhosis. Methods: Patients with chronic hepatitis B-related compensated cirrhosis who were initially treated with LAM and ADV for more than 1 year were randomly assigned to two groups, one half replaced with ETV monotherapy, and the other half continued LAM and ADV co-therapy. Liver biochemistry, renal biochemistry, estimated glomerular filtration rate, alpha-fetoprotein, HBV serology markers and serum HBV DNA were measured every 3 months. Urine β2-microglobulin was measured every 6 months And retinol binding protein, followed up for 3 years. The mean values of the two groups were compared with t-test, and the rate of comparison was analyzed by x2 test. Results: A total of 580 cases were collected, 290 cases were replaced with ETV monotherapy, the other 290 patients continued to LAM and ADV combination therapy. In the ETV group, the rates of HBV DNA negative conversion at 1 year, 2 years and 3 years were 77.6%, 84.5% and 94.5% respectively, while the HBV DNA negative conversion rates at 1, 2 and 3 years in the LAM and ADV combination groups were 69.3%, 73.4% and 80.3% respectively. Among them, the negative rates of HBV DNA in the second year and the third year were P < 0.05, the difference was statistically significant. The 3-year cumulative gene-resistant rate in the ETV group was 1.4%, while the combined treatment was as high as 8.6%, and the difference was statistically significant in the two groups. The estimated value of serum creatinine and glomerular filtration rate in ETV group was followed by 3 years, and the baseline level was maintained, in the same group, the serum creatinine was higher than baseline, and the estimated value of glomerular filtration rate decreased. The results showed that there were 6.2%, 12.1%, 22.1% and 0, 0.3%, 1%, respectively, in 1, 2 and 3 years for the group of consecutive treatment and the replacement of ETV Group. The estimated glomerular filtration rate decreased by more than 30% compared with the baseline. The difference was statistically significant; the proportion of serum creatinine in the 1 year, 2 years and 3 years of the combined treatment group was 1.7%, 4.5% and 6.6%, compared with the baseline rise of > 50 μmol/l, and the ETV group was replaced in the 1 year, The values of 2 and 3 years were 0,0,0.7%, of which the 2nd and 3rd years were statistically significant; the proportion of microalbuminuria and retinol-binding protein in patients with combined treatment group was also significantly higher than that of Β2-m ETV Group. Conclusion The initial combination of LAM and ADV therapy is inferior in terms of ETV monotherapy. Single therapy with ETV increase the rate of viral response, reduce the incidence of drug resistance, and also reduce the incidence of renal impairment in patients with chronic hepatitis B -related compensated liver cirrhosis.

Objective To explore the effect and action principle of extracorpoporeal shock wave(ESW) combine hyperbaric oxygen(HBO) in bone nonunion treatment .Methods Totally 50 standard New Zealand white rabbits were chosen ,and 48 rabbits were successfully made to models .Then ,they were divided into four groups by using the random number table ,12 in each group . The group A was in ESW combine HBO group ;The group B was in hyperbaric oxygen group ;The group C was in pure ESW group ;The group D was in control group .X‐ray inspected before treatment and after treatment in 4 、8 、12 weeks .The calcium con‐tent was checked ,the osteoblast in bone callus was observed by the optical microscope ,and the data was analyzed by statistics .Re‐sults There was a significant difference in 4 ,8 ,12 weeks between group A and group B ,C ,D in the nonunion gap(P< 0 .05) ,there was significant difference in 4 ,8 ,12 weeks between group A and group B ,C ,D in the generation bone callus(P< 0 .05) .Callus calci‐um content of group A was higher than group C ,the difference was statistical significance(P< 0 .05) ,there was significant differ‐ence in 4 ,8 weeks between group A and group C in callus osteoblast count(P < 0 .05) .Conclusion ESW combine HBO treatment for bone nonunion is better than pure ESW therapy ,simple hyperbaric therapy has no obvious help for the treatment of bone nonun‐ion ,HBO can be used as a good synergy method in the extracorporeal shock wave treatment of bone nonunion .

Objective To investigate the clinical application value of padded molars.Methods Totally 54 cases of malocclusions from Department of Orthodontics of West China Hospital of Stomatology were received occlusal pads by optiband ultra band bongding at the early stage of orthodontic treatment (1th -5thmonth).The lateral cephalometric radiographs before and after treatments were analyzed.The effects on vertical height of molars after using padded molars were observed.Results The padded molars did not affect the vertical height without statistical difference (P ＞ 0.05).Conclusions Temporary using padded molars were feasible in orthodontic treatment.Padded molars may be widely applied in clinical orthodontics.

Objective To investigate the clinical application value of psychological induction in impression taking of deciduous crossbite.Methods Totally 84 children of deciduous crossbite receiving impression taking were divided equally into 2 groups.Children in the control group received impression taking directly,while children in the experimental group received psychological induction before impression taking.A comparative study was carried out according to special cooperative behavior assessment for children.Results The cooperation degree of the experiment group was increased significantly after psychological induction with statistical differences between them(P ＜ 0.05).Conclusions Psychological induction can improve the cooperation degree of children in impression taking.