With the adjustment of China's fertility policies, the proportion of advanced maternal age pregnancies has increased, making early identification of critical conditions in this population essential for successful treatment. This article systematically reviews the development of obstetric early warning management systems and advances in machine learning-based artificial intelligence for risk assessment in high-risk pregnant women. As artificial intelligence technology continues to evolve, future developments will include intelligent electronic medical record systems for high-risk pregnant women, generate clinical decision support solutions for early warning management, and establish coordinated critical care systems for severely ill pregnant women.

With the adjustment of China's fertility policies, the proportion of advanced maternal age pregnancies has increased, making early identification of critical conditions in this population essential for successful treatment. This article systematically reviews the development of obstetric early warning management systems and advances in machine learning-based artificial intelligence for risk assessment in high-risk pregnant women. As artificial intelligence technology continues to evolve, future developments will include intelligent electronic medical record systems for high-risk pregnant women, generate clinical decision support solutions for early warning management, and establish coordinated critical care systems for severely ill pregnant women.

Objective To evaluate the diagnostic efficacy of Kwak and ACR( 2017 ) thyroid imaging reporting and data systems ( T I‐RADS ) for thyroid nodules . Methods Cases of thyroid nodule who underwent surgery from January 2015 to M arch 2018 in 15 hospitals in Sichuan province were collected and the ultrasonographic features of thyroid nodules were retrospectively analyzed by trained senior ultrasound physicians using Kwak and ACR T I‐RADS classification methods . Totally ,12 712 thyroid nodules were observed ,7 023 thyroid nodules in 7 023 cases with complete ultrasound and surgical and pathological data were eventually enrolled in the study . T hyroid nodules with solid ,hypoechoic or very hypoechoic ,tall/wide ratio ≥ 1 , margin ill‐defined and microcalcification were classified as malignant signs of ultrasound . M alignant percentage was calculated and diagnostic tests were performed . Results ① T here was a statistical difference between the benign and malignant nodules in the two types of T I‐RADS classification ( P＜0 .01) . ② T he area under ROC curve of Kwak and ACR in the diagnosis of malignant nodules were 0 .89 and 0 .84 ,respectively . T he Youden index of Kwak and ACR were 0 .66 and 0 .57 ,respectively . ③Taking Kwak T I4B and ACR T R4 as critical points for malignancy ,the sensitivity ,specificity ,positive predictive value and negative predictive value of Kwak T I 4B were 75 .0% ,90 .9% ,83 .2% ,and 85 .9% , respectively . T he accuracy of Kwak T I4B was 84 .9% ; T he sensitivity ,specificity ,positive predictive value and negative predictive value of ACR T R4 were 88 .2% ,68 .9% ,62 .9% ,and 90 .8% ,respectively . T he accuracy of ACR T R4 was 76 .2% . T he Kappa value of Kwak TI4B and ACR T R4 was 0 .52 . T he χ2 value of Kwak T I4B and ACR T R4 was 2 174 .6 ( P ＜ 0 .01 ) . Conclusions T he diagnostic values of two T I‐RADS classification methods for thyroid malignant nodules are high . T he overall efficiency of Kwak T I‐RADS classification method is better than that of ACR TI‐RADS classification method .

Objective To explore the clinical manifestations and epidemiological profiles of hospitalized infants with Bordetella pertussis infection and to improve the knowledge for its early diagnosis and treatment.Methods Using a retrospective analysis method,the data of 142 hospitalized infants with Bordetella pertussis infection in Shenzhen Children's Hospital from 2011 to 2013 were collected,which was confirmed by a real-time polymerase chain reaction(PCR) of nasopharyngeal secretion.The SPSS 16.0 software was used for statistical analysis.Results Of the 142hospitalized infants with Bordetella pertussis infection,the ratio of male to female was 2.1∶ 1.0 (96/41 cases).Ninetythree (65.5％) cases were aged less than 3 months old,26 cases (18.3％) were 3-6 months old and 23 cases (16.2％) were 6-36 months old.One hundred and twenty-six (88.7％) patients were unvaccinated or incompletely vaccinated.The most common clinical manifestation was paroxysmal cough which accounts for 104/142 (73.2％) cases,and 6 cases of which had roaring(4.2％).Peripheral blood WBC level of 83 cases increased,and 75 (90.4％) cases were lymphocytosis.The positive rate of X-ray was 60.6％.Eighty-one cases were complicated with bacteria,respiratory virus or mycoplasma pneumonia infection.There were significant differences in symptom of fever and infection of respiratory tract pathogen among 3 groups.The symptom of fever in the group aged less than 3 months old group was significantly lower than the other 2 groups (x2 =11.45,P ＜ 0.01 ;x2 =34.56,P ＜ 0.01),and 6-36 months old group was significantly higher than the other 2 groups(x2 =7.590,P ＜ 0.01 ;x2 =6.928,P ＜ 0.01).Conclusions Bordetella pertussis is an important pathogen for the infants with persistent cough,especially in unvaccinated or incompletely vaccinated infants,but the clinical manifestation and signs of pertussis are atypical,which may lead to a misdiagnosis and delay proper treatment.As a rapid and sensitive method of detecting Bordetella pertussis,PCR may be used for early diagnosis.

Objective To investigate the change and clinical value of serum cystain C(CysC)level in the patients with HBeAg-negative chronic hepatitis B(CHB).Methods 212 cases of CHB in our hospital were selected and divided into the HBeAg-negative group and the HBeAg-positive group according to the HBeAg status.105 healthy individuals at the same time were enrolled as the control group.The levels of serum CysC,ALT,AST,Cr,BUN and HBV DNA in 3 groups were detected and compared.The corre-lations between serum CysC with AST,AST,Cr,Bun,HBV DNA were analyzed by the Pearson correlation analysis.Results The mean CysC level in the HBeAg-negative group was (1 .40±0.36)mg/L,which was higher than (0.93±0.12)mg/L in the control group and (0.96±0.18)mg/L in the HBeAg-positive group,the differences between them was statistically significant(P <0.05). The CysC was significantly positively correlated with serum Cr level in the HBeAg-negative group(r=0.840,P <0.01).Conclusion The CysC level might be used as an effective index for monitoring the early kidney injury in the patients with HBeAg-negative CHB,which has important significance in the prevention and treatment of HBeAg-negative CHB.