BACKGROUND:In recent years,deep learning technologies have been increasingly applied in the field of oral medicine,enhancing the efficiency and accuracy of oral imaging analysis and promoting the rapid development of intelligent oral medicine. OBJECTIVE:To elaborate the current research status,advantages,and limitations of deep learning based on oral imaging in the diagnosis and treatment decision-making of oral diseases,as well as future prospects,exploring new directions for the transformation of oral medicine under the backdrop of deep learning technology. METHODS:PubMed was searched for literature related to deep learning in oral medical imaging published from January 2017 to January 2024 with the search terms"deep learning,artificial intelligence,stomatology,oral medical imaging."According to the inclusion criteria,80 papers were finally included for review. RESULTS AND CONCLUSION:(1)Classic deep learning models include artificial neural networks,convolutional neural networks,recurrent neural networks,and generative adversarial networks.Scholars have used these models in competitive or cooperative forms to achieve more efficient interpretation of oral medical images.(2)In the field of oral medicine,the diagnosis of diseases and the formulation of treatment plans largely depend on the interpretation of medical imaging data.Deep learning technology,with its strong image processing capabilities,aids in the diagnosis of diseases such as dental caries,periapical periodontitis,vertical root fractures,periodontal disease,and jaw cysts,as well as preoperative assessments for procedures such as third molar extraction and cervical lymph node dissection,helping clinicians improve the accuracy and efficiency of decision-making.(3)Although deep learning is promising as an important auxiliary tool for the diagnosis and treatment of oral diseases,it still has certain limitations in model technology,safety ethics,and legal regulation.Future research should focus on demonstrating the scalability,robustness,and clinical practicality of deep learning,and finding the best way to integrate automated deep learning decision support systems into routine clinical workflows.

Sepsis is a life-threatening organ dysfunction caused by the host's uncontrolled response to infection, and is one of the main causes of death in critically ill patients. Sepsis-associated acute kidney injury (SA-AKI) is associated with the poor prognosis of sepsis patients, and its pathogenesis is complex and still unclear to this day.Mitochondrial dynamics is crucial for maintaining the normal morphology, quantity, number and function of mitochondria, which is a new research hotspot in recent years. Mitochondrial dynamics disorder is involved in the occurrence and development of SA-AKI by regulating renal tubular dysfunction, which is expected to become new therapeutic targets. Deeply exploring the role of mitochondrial dynamic disorders in the pathogenesis of SA-AKI will help to find more effective treatment methods, thereby improving the success rate of rescue in SA-AKI patients.

Objective This study aims to explore the psychological experiences of patients with Stanford Type A aortic dissection during different stages of their hospital stay.Methods Using purposive sampling,10 patients treated for Stanford Type A aortic dissection from May to August 2022 at a tertiary A general hospital in Guangdong Province were selected as study subjects.Semi-structured interviews were conducted,and the data were analyzed using interpretative phenomenological analysis to extract themes.Results 3 primary themes and 14 sub-themes were identified.1.During the diagnosis phase,patients experienced increased uncertainty,with a strong need for information and emotional support.This included fear of the emergency environment,enhanced sense of the unknown,a desire for attention from medical staff,and hope to have surgery soon.2.During the treatment phase,patients had cognitive bias and low treatment compliance,including fear of monitor alarms,rejection of medical devices and tubes,a sense of lost dignity during treatment,feelings of helplessness due to physical restrictions,and despair over prolonged ICU stays.3.In the recovery phase,patients anticipated and were worried about significant life changes,including a shift in mindset to actively face future life,feelings of guilt towards family members,concerns about artificial blood vessel implants,anxiety about social participation,and worries about disease self-management and prognosis.Conclusion The psychological experiences and needs of patients with Stanford Type A aortic dissection vary during different stages of their hospital stay.During the diagnosis phase,medical staff should strengthen information and emotional support;during the treatment phase,they should enhance communication and psychological counseling;and during the recovery phase,medical staff should improve patients'disease self-management skills,enhance their level of social support,and guide the awakening of positive psychological experiences.

Objective:To evaluate the effectiveness of oral-nasal oxygen supply mouth guard in painless gastroscopy for snoring patients.Methods:The snoring patients who underwent painless gastroscopy at two Endoscopy Centers of Shanghai East Hospital, Tongji University in July 2022 were randomly divided into the observation group (using oral-nasal oxygen supply mouth guard) and the control group (using ordinary nasal oxygen tube and mouth guard). Parameters such as the wearing time and the removal time of the mouth guard, lowest pulse oxygen saturation (SpO 2), incidence of hypoxemia, and the satisfaction of medical staff were compared between the two groups. Results:The wearing time of mouth guard was 11.63±0.84 seconds and the removal time was 5.33±0.76 seconds in the observation group ( n=40), which were lower than those in the control group ( n=47) (14.91±1.21 seconds, t=-14.463, P<0.001; 10.38±0.80 seconds, t=-30.095, P<0.001). The wearing satisfaction score was 9.80±0.61, the lowest SpO 2 was (96.70±3.42)%, the removal satisfaction score was 9.75±0.67, and the anesthesiologists' satisfaction score was 9.20±1.42 in the observation group, which were higher than those in the control group [7.70±0.93, t=12.209, P<0.001; (94.06±3.72)%, t=3.417, P=0.001; 7.96±0.98, t=9.803, P<0.001; 8.13±1.35, t=3.615, P=0.001] with significant difference. There was no significant difference in the incidence of hypoxemia [10.00% (4/40) VS 14.89% (7/47), χ2=0.130, P=0.718] and endoscopic physician satisfaction score (9.30±0.97 VS 9.02±1.31, t=1.112, P=0.269) between the two groups. Conclusion:The oral-nasal oxygen supply mouth guard is easy to wear and remove, effectively reducing SpO 2 fluctuations during painless gastroscopy for snoring patients. It can enhance medical staff satisfaction with high clinical value.

Objective To investigate the frequency of therapy-oriented oral radiation in Nanping, China and its distribution, and to provide a basis for the rational application of therapy-oriented oral radiation and the effective allocation of resources in Nanping. Methods A questionnaire was designed to investigate the frequency of therapy-oriented oral radiation in all oral radiation diagnosis and treatment institutions in Nanping. Results In 2021, there were 54 oral radiation diagnosis and treatment institutions and 79 oral radiation machines in Nanping. The total frequency of therapy-oriented oral radiation was 61593 visits and the radiation frequency was 19.54 visits per thousand patients. The average annual frequency of medical institutions at all levels was 721.87 to 3713.25 visits per institution; the male-to-female composition ratio of frequency of therapy-oriented oral radiation in December 2021 was 50.5%:49.5%. The proportion of radiation frequency of different devices was as follows: 38.7% (intraoral dental film), 46.5% (oral panorama), 10.3% (oral computed tomography [CT]), and 4.5% (cranial photography). The proportion of radiation frequency in patients of different ages was as follows: 17.1% (0−15 years), 48.2% (15−40 years), and 34.7% (over 40 years). The frequency of therapy-oriented oral radiation grew by 77.43%, 35.18%, and 8.16% every two years from 2015 to 2021, respectively. Conclusion The frequency level of therapy-oriented oral radiation in Nanping is at the level of Class II health care. The distribution of therapy-oriented oral radiation is highly unbalanced and is related to the level of economic development. Private healthcare institutions are growing rapidly, and public healthcare institutions of grade two and above occupy the main healthcare resources. The oral panorama accounts for the most, cranial photography accounts for the least, and oral CT is the fastest-growing portion. Therapy-oriented oral radiation is predominantly performed in the young and middle-aged populations, regardless of sex. Except for intraoral dental films, the general trend is upward.

Ductal carcinoma in situ of the breast (DCIS) most commonly manifests as asymptomatic calcifications at mammography. The most common manifestation of MRI is nonmass enhancement. The ultrasound mainly presents as a hypoechoic irregular hypervascular mass without posterior features. Core-needle biopsy is a commonly used method for preoperative diagnosis of DCIS. Due to differences in needle type and sample size, there is a certain degree of pathological upgrading of the lesion. In recent years, there has been controversy over the diagnosis and treatment of DCIS. With the development of breast disease diagnostic technology, advances in digital breast tomography, artificial intelligence, and radiomics are expected to help DCIS management and address issues such as overdiagnosis.

[Objective]To investigate the difference of ultrasound characteristics between pure mucinous carcinoma(PMC)and fibroadenoma(FA)of the breast.[Methods]Ultrasound data of 50 continuous patients with breast PMC from January 2012 to January 2021 and 100 continuous patients with breast FA from June 2018 to January 2019 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were retrospectively reviewed.The ultrasound characteristics of the two groups were evaluated according to the 2013 BI-RADS Ultrasound Atlas,and the differences in age,maximum diameter and ultrasound characteristics between the two groups were compared.[Results]The median age of PMC patients was 47 years and that of FA patients was 33 years.The age of PMC patients was higher than that of the FA group,and the differ-ence between the two groups of patients was statistically significant(P<0.001).The median maximum diameter of PMC pa-tients was 2.4 cm,which was greater than that of the FA group(1.8 cm),and the difference was statistically significant(P=0.001).Of the PMC,70%(35/50)were irregular,82%(41/50)were parallel to the skin,92%(46/50)had no circum-scribed margin,72%(36/50)were hypoechoic,and 68%(34/50)had enhanced posterior echo.Of the FA,69%(69/100)were oval or round,98%(98/100)were parallel to the skin,54%(54/100)had circumscribed margin,98%(98/100)were hypoechoic,and 75%(75/100)had no posterior features.The differences in the above ultrasound characteris-tics between the PMC and FA groups were statistically significant(P<0.001,P=0.001,P<0.001,P<0.001,P<0.001).There was no significant difference between calcifications and blood flow.[Conclusions]Compared with the FA group,pa-tients with PMC are older and the diameter of the lesions are larger.On ultrasound,the morphology and margin of most breast PMC still show the growth characteristics of invasive cancer.Meanwhile,the posterior echo of PMC is enhanced,which is a unique manifestation.

This paper summarized professor WANG Shouchuan's experience in differentiating and treating children epistaxis from the perspective of "four excess and three deficiency". It is believed that the pathogenesis of children epistaxis is concluded as "four excess and three deficiency"， of which the four excess syndromes are exuberant heat in the lung channel， intense stomach fire， heart fire hyperactivity， and liver fire flaming upward， while the three deficiency syndromes include qi， yin and yang deficiency. Seven methods for treating children epistaxis are summarized. For exuberant heat in the lung channel syndrome， it is recommended to clear lung and direct qi downward， using self-made Xiebai Zhiniu Decoction （泻白止衄汤）. For intense stomach fire syndrome， the method of clearing stomach and draining fire can be used with self-made Qingwei Zhiniu Decoction （清胃止衄汤）. In terms of heart fire hyperactivity syndrome， it is better to clear heart and drain fire， using self-made Daochi Zhiniu Decoction （导赤止衄汤）. For liver fire flaming upward syndrome， it is advised to clear liver and drain fire， using self-made Yimu Zhiniu Decoction （抑木止衄汤）. In terms of qi deficiency syndrome， the method of fortifying spleen and boosting qi and containing blood should be used with self-made Futu Zhiniu Decoction （扶土止衄汤）. If there is yin deficiency syndrome， it is advised to supplement kidney， enrich yin and clear heat， using self-made Zishui Zhiniu Decoction （滋水止衄汤）. If there is yang deficiency syndrome， the method of boosting qi， warming yang and nourishing blood can be used， using self-made Wenpi Zhiniu Decoction （温脾止衄汤）.

Objective To analyse the characteristics of spatial distribution of bed resources and bed utilization efficiency of various types of medical and health institutions in Guangxi Province in 2018-2022,and to provide a reference basis for the allocation and management of bed resources of various types of medical and health institutions.Methods Spatial autocorrelation was used to analyse the status of bed allocation in various types of medical and health institutions,and the bed efficiency index and bed utilisation model were used to evaluate the efficiency of bed utilisation.Results Bed resources per 1 000 population vary considerably across types of healthcare organisations and regions.There is no spatial correlation in the overall distribution of bed resources per 1 000 population,but there are different types of aggregation,and there will be little change in the type of aggregation and the place of aggregation from 2018 to 2022.In terms of utilisation efficiency,the bed efficiency index of maternity and child healthcare hospitals is the highest,the bed efficiency index of specialist disease prevention and treatment hospitals(institutes and stations)is the lowest,general hospitals and maternity and child healthcare hospitals are operating at high efficiency,and all other healthcare institutions are operating at low efficiency;the utilisation of bed resources in various types of healthcare institutions exists in the form of efficiency-type,turn-around-type,bed-pressure-type,and unused-type hospitals at the same time.Conclusion There is an imbalance in the allocation of bed resources in various types of medical and health institutions,with large differences in the operational and utilisation efficiencies of beds;the allocation of bed resources should be continuously optimised.

Objective To analyse the characteristics of spatial distribution of bed resources and bed utilization efficiency of various types of medical and health institutions in Guangxi Province in 2018-2022,and to provide a reference basis for the allocation and management of bed resources of various types of medical and health institutions.Methods Spatial autocorrelation was used to analyse the status of bed allocation in various types of medical and health institutions,and the bed efficiency index and bed utilisation model were used to evaluate the efficiency of bed utilisation.Results Bed resources per 1 000 population vary considerably across types of healthcare organisations and regions.There is no spatial correlation in the overall distribution of bed resources per 1 000 population,but there are different types of aggregation,and there will be little change in the type of aggregation and the place of aggregation from 2018 to 2022.In terms of utilisation efficiency,the bed efficiency index of maternity and child healthcare hospitals is the highest,the bed efficiency index of specialist disease prevention and treatment hospitals(institutes and stations)is the lowest,general hospitals and maternity and child healthcare hospitals are operating at high efficiency,and all other healthcare institutions are operating at low efficiency;the utilisation of bed resources in various types of healthcare institutions exists in the form of efficiency-type,turn-around-type,bed-pressure-type,and unused-type hospitals at the same time.Conclusion There is an imbalance in the allocation of bed resources in various types of medical and health institutions,with large differences in the operational and utilisation efficiencies of beds;the allocation of bed resources should be continuously optimised.