Objective:To explore the application effectiveness of the large language model DeepSeek in the cultivation of clinical thinking skills for medical laboratory technology students.Methods:A non-randomized controlled study was conducted. In the 2024-2025 academic year, two classes of second-year medical laboratory technology students from Hubei University of Chinese Medicine were selected and divided into a DeepSeek-assisted teaching group (Class A, n=53) and a traditional teaching control group (Class B, n=53), totaling 106 students. Both groups followed a 20-week problem-based learning (PBL) framework with identical teaching content, instructors, and class hours. Class A utilized DeepSeek via the"Learning Pass AI"platform for case diagnosis reasoning, prompt construction training, test plan formulation, and result analysis, while Class B received traditional PBL instruction. Paired t-tests were used to compare pre-and post-teaching scores in clinical thinking skills, AI interaction literacy, and prompt construction in Class A. Independent samples t-tests and chi-square ( χ2) tests were used to evaluate differences in case reasoning scores, etiology analysis accuracy, and teaching satisfaction between groups. Structured questionnaires supplemented the evaluation of model-assisted teaching processes. Results:The comparison of pre-and post-teaching scores in Class A showed that post-teaching scores significantly improved in clinical thinking skills[(4.02±0.45) points vs. (3.09±0.50) points, t=2.23)] and AI interaction literacy [(4.62±0.41) points vs. (3.27±0.54) points, t=2.18]. Compared to Class B, Class A demonstrated superior performance in case reasoning scores [(81.1±3.8) points vs.(74.3±4.2) points, t=8.97], etiology analysis accuracy [94.3% (50/53) vs. 81.1% (43/53), χ2=4.29], and teaching satisfaction [(95.6±3.2)points vs. (82.6±4.8) points, t=11.86] ( P<0.05). The results of questionnaires indicated that during model application, the prompt construction improved in logic [(2.85±0.58) points to (4.25±0.50) points, t=14.23, P<0.01] and innovation [(2.60±0.53) points to (4.05±0.46) points, t=11.57, P<0.05], but question clarity (77.4%, 41/53) and medical terminology accuracy (43.4%, 23/53) remained primary shortcomings. Conclusion:Integrating large language models into AI-teacher collaborative learning pathways can effectively promote students′ autonomous inquiry and clinical reasoning skills, thereby enhancing medical laboratory technology students′ clinical thinking skills.

Objective:To explore the application effectiveness of the large language model DeepSeek in the cultivation of clinical thinking skills for medical laboratory technology students.Methods:A non-randomized controlled study was conducted. In the 2024-2025 academic year, two classes of second-year medical laboratory technology students from Hubei University of Chinese Medicine were selected and divided into a DeepSeek-assisted teaching group (Class A, n=53) and a traditional teaching control group (Class B, n=53), totaling 106 students. Both groups followed a 20-week problem-based learning (PBL) framework with identical teaching content, instructors, and class hours. Class A utilized DeepSeek via the"Learning Pass AI"platform for case diagnosis reasoning, prompt construction training, test plan formulation, and result analysis, while Class B received traditional PBL instruction. Paired t-tests were used to compare pre-and post-teaching scores in clinical thinking skills, AI interaction literacy, and prompt construction in Class A. Independent samples t-tests and chi-square ( χ2) tests were used to evaluate differences in case reasoning scores, etiology analysis accuracy, and teaching satisfaction between groups. Structured questionnaires supplemented the evaluation of model-assisted teaching processes. Results:The comparison of pre-and post-teaching scores in Class A showed that post-teaching scores significantly improved in clinical thinking skills[(4.02±0.45) points vs. (3.09±0.50) points, t=2.23)] and AI interaction literacy [(4.62±0.41) points vs. (3.27±0.54) points, t=2.18]. Compared to Class B, Class A demonstrated superior performance in case reasoning scores [(81.1±3.8) points vs.(74.3±4.2) points, t=8.97], etiology analysis accuracy [94.3% (50/53) vs. 81.1% (43/53), χ2=4.29], and teaching satisfaction [(95.6±3.2)points vs. (82.6±4.8) points, t=11.86] ( P<0.05). The results of questionnaires indicated that during model application, the prompt construction improved in logic [(2.85±0.58) points to (4.25±0.50) points, t=14.23, P<0.01] and innovation [(2.60±0.53) points to (4.05±0.46) points, t=11.57, P<0.05], but question clarity (77.4%, 41/53) and medical terminology accuracy (43.4%, 23/53) remained primary shortcomings. Conclusion:Integrating large language models into AI-teacher collaborative learning pathways can effectively promote students′ autonomous inquiry and clinical reasoning skills, thereby enhancing medical laboratory technology students′ clinical thinking skills.

[摘 要] 目的：探究驱动蛋白-13家族2C（KIF2C）对肝细胞癌（HCC）细胞增殖、侵袭和迁移以及人脐静脉内皮细胞（HUVEC）血管生成的影响，为HCC治疗提供潜在靶点。方法：用数据库数据分析KIF2C mRNA和蛋白在HCC组织中的表达及其与血管生成相关因子（VEGFR2和HIF-1α）表达的相关性，常规培养人正常肝细胞QSG-7701、HUVEC和HCC细胞Huh-7、Hep3B2.1-7，用Lipofectamine 3000转染试剂将sh-NC和sh-KIF2C转染至Huh-7、Hep3B2.1-7细胞，qPCR检测各组QSG-7701、Huh-7和Hep3B2.1-7细胞中KIF2C mRNA的表达，WB法检测各组细胞中KIF2C蛋白的表达，细胞克隆形成实验检测敲低KIF2C对Hep3B2.1-7和Huh-7细胞克隆形成的影响，小管生成实验检测敲低KIF2C表达的Huh-7和Hep3B2.1-7细胞的条件培养液对HUVEC血管生成能力的影响。结果：数据库分析结果显示，KIF2C mRNA和蛋白在HCC组织中均呈高表达（均P<0.01），用qPCR和WB法检测人HCC中KIF2C mRNA和蛋白的表达水平，结果显示其mRNA和蛋白在各HCC细胞中也呈高表达（均P<0.01），与数据库数据分析结果相符。数据库数据分析还显示，KIF2C与HCC组织中VEGFR2、HIF-1α的表达水平呈正相关（P<0.05或P<0.01）。成功构建了稳定低表达KIF2C的Huh-7和Hep3B2.1-7细胞（均P<0.01），敲低KIF2C表达均可明显抑制Huh-7和Hep3B2.1-7细胞的增殖能力（均P<0.01）、侵袭和迁移能力（均P<0.01），敲低KIF2C表达的HCC细胞条件培养液均可显著抑制体外HUVEC的血管生成能力（P<0.05或P<0.01）。结论：KIF2C可促进Huh-7和Hep3B2.1-7细胞增殖、侵袭和迁移以及HUVEC血管生成的能力，提示KIF2C可能是治疗HCC的潜在靶点。

Objective:To construct and validate prognostic nomograms predicting overall survival (OS) and cancer-specific survival (CSS) of patients with late-stage hepatocellular carcinoma (HCC).Methods:A retrospective cohort study was used in this report. Screened 2382 late-stage HCC patients obtained from Surveillance, Epidemiology, and End Results (SEER) database (2010—2015), were randomly classified into the training cohort and the internal validation cohort by using the function in R software according to the ratio of 1∶1. Chi-square test was applied to verify the comparability of data between two groups. The external validation cohort ( n=62) were collected from the Affiliated Zhangjiagang Hospital of Soochow University. Based on univariate and multivariate COX regression analyses in the training cohort, this study constructed nomograms for 6- and 12- month OS and CSS. Concordance index (C-index), calibration plots, the receiver operating characteristic (ROC) curves and Kaplan-Meier survival curves were applied to measure the performance of nomograms in the training cohort and to validate nomograms in two validation cohorts. The clinical utility was measured by decision curve analysis (DCA). Results:Two nomograms were constructed. The identified risk factors included sex, Edmondson-Steiner grade, T stage, N stage, M stage, tumor size, bone metastasis, Alpha-fetoprotein (AFP), surgery of primary site, radiation and chemotherapy. The C-index for OS in the training and two validation cohorts was 0.729(95% CI: 0.711-0.747), 0.721(95% CI: 0.705-0.737) and 0.860(95 CI: 0.831-0.889), respectively. The C-index for CSS in the training and two validation cohorts was 0.732(95% CI: 0.714-0.750), 0.725(95% CI: 0.707-0.743) and 0.862(95% CI: 0.829-0.895), respectively. Afterwards, for nomograms in the training and two validation cohorts, C-index and calibration plots expressed great predictive accuracy and concordance. ROC curves and Kaplan-Meier survival curves demonstrated good prognostic ability. Furthermore, nomograms performed superior to other models. DCA showed substantial clinical utility. Conclusion:This study has developed and validated nomograms predicting 6- and 12- month OS and CSS of patients with late-stage HCC, which may be useful to develop the individualized treatment.

Objective:To investigate the incidence, prevalence and disease characteristics of Crohn′s disease (CD) in Zhangjiagang city.Methods:A cross-sectional study was conducted. During the period of January 1st to December 31st, 2017, through a voluntary consultation and the medical records retrieval of 5 hospitals in Zhangjiagang city (the First People′s Hospital of Zhangjiagang, Zhangjiagang Hospital of Traditional Chinese Medicine, Zhangjiagang Aoyang Hospital, Zhangjiagang Jinfeng People′s Hospital and Zhangjiagang Leyu Hospital) , the patients who were the registered residents of Zhangjiagang city and diagnosed as CD were collected and included in the study. The general clinical data and epidemiological data were collected by the questionnaire. The age-standardized prevalence and incidence of CD in Zhangjiagang city in 2017 was calculated. The clinical characteristics were described. The single factor analysis and multivariate Logistic regression analysis were performed to identify the independent influencing factors for delayed diagnosis.Results:A total of 123 CD patients were included and 14 patients were newly diagnosed in 2017. The age-standardized prevalence of CD was 12.08 per 100 000 persons in this city in 2017 and the age-standardized incidence was 1.54 per 100 000 persons. There were 73 male patients and 50 female patients, the ratio of male to female was 1.46∶1. The age at diagnosis was 39 (27, 51) years old. The peak ages of diagnosis were 20 to 29 years old and 40 to 49 years old and there were 27 (21.95%) and 25 (20.33%) patients in the two ages respectively. The duration was 45 (24, 82) months. The disease involved the terminal ileum in 72 patients (58.5%) including 2 (1.6%) in the upper gastrointestinal tract simultaneously, the colon in 28 (22.8%) and the ileocolon in 23 (18.7%) . The non-stricturing non-penetrating type of disease was observed in 71 patients (57.7%) , stricturing type in 42 patients (34.1%) , penetrating type in 10 patients (8.1%) . Twenty-three patients (18.7%) had simultaneous perianal disease. 5-aminosalicylic acid was used in 96 patients (78.0%) and nutritional support therapy was used in 64 patients (52.0%) . Delayed diagnosis occurred in 63 patients (51.2%) , the delayed diagnosis time was 8 (2, 36) months. Multivariate analysis showed that simultaneous perianal disease ( OR = 4.081, 95% CI: 1.159-14.367, P = 0.029) was the independent risk factor of delayed diagnosis, and urban resident ( OR = 0.169, 95% CI: 0.073-0.393, P<0.001) was the independent protection factor. Conclusions:The prevalence and incidence of CD in Zhangjiagang city are relatively high. There are more male CD patients and the distribution of age at diagnosis is bimodal. The terminal ileum is the most common site and non-stricturing non-penetrating type is most common in the city. 5-aminosalicylic acid and nutritional support therapy are the most common treatments. Over a half of the patients present delayed diagnosis. The patients with simultaneous perianal disease have higher risk of delayed diagnosis, while the urban patients have lower risk of delayed diagnosis.

Objective:To retrospectively analyze the blood leukocytes (WBC), lymphocytes (LYM), lymphocyte% (LYM%), and serum total immunoglobulin (IGA, IGG, IGM) and complement (C3, C4) index levels to explore its predictive value for the outcome of COVID-19 severe pneumonia.Methods:Eighty-five COVID-19 patients with severe pneumonia diagnosed in our hospital were randomly selected and were divided into good outcome group (50 cases) and poor outcome group (35 cases). WBC, LYM, LYM%, IGA, IGG, IGM, and C3, C4 level data, and analyze the differences between the two groups, the correlation of each indicator, and ROC curves of single and joint detection to explore relationship between indicators and outcomes, and the predictive efficacy of indicators on outcomes.Results:Differences in WBC, LYM, LYM%, IGG, and IGA levels were significant between the two groups ( P=0.000, 0.015, 0.000, 0.000, 0.001), among them with significant differences, LYM and LYM% were significantly positively correlated ( r=0.669, P=0.000), while WBC and LYM% levels were significantly negatively correlated ( r=-0.600, P=0.000), WBC and IGA levels were significantly positively correlated ( r=0.283, P=0.009) and IGG and IGA levels were also significantly positively correlated ( r=0.0.442, P=0.000); After logistic regression analysis, WBC, LYM, LYM%, IGG, and IGA are all important influencing factors ( P=0.001, 0.022, 0.000, 0.000, 0.003); but only the levels of WBC, IGG, and LYM% are Independent risk factors ( P=0.034, 0.004, 0.001), the ROC curve of the single detection and joint detection of their predicted outcome performance, respectively, and the max AUC (AUC=0.890, P=0.000) at the time of joint testing of WBC, LYM% and IGG, index YI=0.657, it has the greatest predictive power for adverse outcomes, with a sensitivity of 77.10% and a specificity of 88.00%. IGM, C3, C4, IGG/IGM, and C3/C4 levels were not significantly different( P=0.066, 0.204, 0.076, 0.310, 0.156). Conclusions:The levels of WBC, LYM, LYM%, IGG, and IGA in the early admission of COVID-19 infected patients with severe pneumonia have important predictive value for the outcome of them. WBC, LYM% and IGG levels are independent risks and joint detection of the three indexes have the best predictive performance.

Objective:To investigate the incidence, prevalence and disease characteristics of Crohn′s disease (CD) in Zhangjiagang city.Methods:A cross-sectional study was conducted. During the period of January 1st to December 31st, 2017, through a voluntary consultation and the medical records retrieval of 5 hospitals in Zhangjiagang city (the First People′s Hospital of Zhangjiagang, Zhangjiagang Hospital of Traditional Chinese Medicine, Zhangjiagang Aoyang Hospital, Zhangjiagang Jinfeng People′s Hospital and Zhangjiagang Leyu Hospital) , the patients who were the registered residents of Zhangjiagang city and diagnosed as CD were collected and included in the study. The general clinical data and epidemiological data were collected by the questionnaire. The age-standardized prevalence and incidence of CD in Zhangjiagang city in 2017 was calculated. The clinical characteristics were described. The single factor analysis and multivariate Logistic regression analysis were performed to identify the independent influencing factors for delayed diagnosis.Results:A total of 123 CD patients were included and 14 patients were newly diagnosed in 2017. The age-standardized prevalence of CD was 12.08 per 100 000 persons in this city in 2017 and the age-standardized incidence was 1.54 per 100 000 persons. There were 73 male patients and 50 female patients, the ratio of male to female was 1.46∶1. The age at diagnosis was 39 (27, 51) years old. The peak ages of diagnosis were 20 to 29 years old and 40 to 49 years old and there were 27 (21.95%) and 25 (20.33%) patients in the two ages respectively. The duration was 45 (24, 82) months. The disease involved the terminal ileum in 72 patients (58.5%) including 2 (1.6%) in the upper gastrointestinal tract simultaneously, the colon in 28 (22.8%) and the ileocolon in 23 (18.7%) . The non-stricturing non-penetrating type of disease was observed in 71 patients (57.7%) , stricturing type in 42 patients (34.1%) , penetrating type in 10 patients (8.1%) . Twenty-three patients (18.7%) had simultaneous perianal disease. 5-aminosalicylic acid was used in 96 patients (78.0%) and nutritional support therapy was used in 64 patients (52.0%) . Delayed diagnosis occurred in 63 patients (51.2%) , the delayed diagnosis time was 8 (2, 36) months. Multivariate analysis showed that simultaneous perianal disease ( OR = 4.081, 95% CI: 1.159-14.367, P = 0.029) was the independent risk factor of delayed diagnosis, and urban resident ( OR = 0.169, 95% CI: 0.073-0.393, P<0.001) was the independent protection factor. Conclusions:The prevalence and incidence of CD in Zhangjiagang city are relatively high. There are more male CD patients and the distribution of age at diagnosis is bimodal. The terminal ileum is the most common site and non-stricturing non-penetrating type is most common in the city. 5-aminosalicylic acid and nutritional support therapy are the most common treatments. Over a half of the patients present delayed diagnosis. The patients with simultaneous perianal disease have higher risk of delayed diagnosis, while the urban patients have lower risk of delayed diagnosis.

English for medical laboratory is an instrumental course,which aims to develop students'competency in reading English literature,writing English scientific papers and conducting international academic exchanges in English.With the continuous expansion and deepening of international exchange and cooperation in laboratory medicine and the demands for training international talents in higher education in China,higher requirements have been put forward for the teaching quality of this course.According to the post competency requirements for professionals of medical laboratory,this paper mainly discusses the teaching mode of English for medical laboratory from the aspectsof educational concept,teaching material construction,teaching mode,assessment mechanism and teachers,hoping to play an active role in the teaching reform of English for medical laboratory at the undergraduate level.

OBJECTIVE: To determine the incidence of surgical site infection (SSI) after abdominal surgery and to further evaluate the related risk factors of SSI in China. METHODS: The multicenter cross-sectional study collected clinical data of all adult patients who underwent abdominal surgery from May 1, 2018 to May 31, 2018 in 30 domestic hospitals, including basic information, perioperative parameters, and incisional microbial culture results. The primary outcome was the incidence of SSI within postoperative 30 days. SSI was classified into superficial incision infection, deep incision infection, and organ/gap infection according to the US Centers for Disease Control and Prevention (CDC) criteria. The secondary outcome variables were ICU stay, postoperative hospital stay, total hospital stay, 30-day mortality and treatment costs. Multivariate logistic regression was used to analyze the risk factors of SSI. RESULTS: A total of 1666 patients were enrolled in the study, including 263 cases of East War Zone Hospital of PLA, 140 cases of Affiliated Hospital of Qingdao University, 108 cases of The First Affiliated Hospital of Nanchang University, 87 cases of Central War Zone Hospital of PLA, 77 cases of West China Hospital, 74 cases of Guangdong General Hospital, 71 cases of Chenzhou First People's Hospital, 71 cases of Zigong First People's Hospital, 64 cases of Zhangjiagang First People's Hospital, 56 cases of Nanyang City Central Hospital, 56 cases of Lanzhou General Hospital of Lanzhou Military Command, 56 cases of Shandong Provincial Hospital, 52 cases of Shangqiu First People's Hospital, 52 cases of People's Hospital of Xinjiang Uygur Autonomous Region, 48 cases of The Second Xiangya Hospital of Central South University, 48 cases of Chinese PLA General Hospital, 44 cases of Affiliated Hospital of Xuzhou Medical University, 38 cases of Hunan Province People's Hospital, 36 cases of Dongguan Kanghua Hospital, 30 cases of Shaoxing Central Hospital, 30 cases of Northern Jiangsu People's Hospital, 29 vases of The First Affiliated Hospital of Zhengzhou University, 27 cases of General Hospital of Tianjin Medical University, 22 cases of Zigong Fourth People's Hospital, 21 cases of The Second Hospital of University of South China, 18 cases of Tongji Hospital, 15 cases of Nanchong Central Hospital, 12 cases of The 901th Hospital of PLA, 11 cases of Hunan Cancer Hospital, 10 cases of Lanzhou University Second Hospital. There were 1019 males and 647 females with mean age of (56.5±15.3) years old. SSI occurred in 80 patients (4.8%) after operation, including 39 cases of superficial incision infection, 16 cases of deep incision infection, and 25 cases of organ/interstitial infection. Escherichia coli was the main pathogen of SSI, and the positive rate was 32.5% (26/80). Compared with patients without SSI, those with SSI had significantly higher ICU occupancy rate [38.8%(31/80) vs. 13.9%(220/1586), P<0.001], postoperative hospital stay (median 17 days vs. 7 days, P<0.001) and total hospital stay (median 22 days vs. 13 days, P<0.001), and significantly higher cost of treatment (median 75 000 yuan vs. 44 000 yuan, P<0.001). Multivariate analysis showed that male rise(OR=2.110, 95%CI:1.175-3.791, P=0.012), preoperative blood glucose level rise(OR=1.100, 95%CI: 1.012-1.197, P=0.026), operative time (OR=1.006, 95%CI:1.003-1.009, P<0.001) and surgical incision grade (clean-contaminated incision:OR=10.207, 95%CI:1.369-76.120, P=0.023; contaminated incision: OR=10.617, 95%CI:1.298-86.865, P=0.028; infection incision: OR=20.173, 95%CI:1.768-230.121, P=0.016) were risk factors for SSI; and laparoscopic surgery (OR=0.348, 95%CI:0.192-0.631, P=0.001) and mechanical bowel preparation(OR=0.441,95%CI:0.221-0.879, P=0.020) were protective factors for SSI. CONCLUSIONS The incidence of postoperative SSI in patients with abdominal surgery in China is 4.8%. SSI can significantly increase the medical burden of patients. Preoperative control of blood glucose and mechanical bowel preparation are important measures to prevent SSI.
Abdomen ; surgery ; Adult ; Aged ; China ; Cross-Sectional Studies ; Female ; General Surgery ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; prevention & control ; Preoperative Period ; Retrospective Studies ; Risk Factors ; Surgical Wound Infection ; prevention & control