Grounded in organizational change-complex systems theory,it investigates the pathways and mechanisms for deep integration of Artificial Intelligence(AI)into clinical management.Addressing structural challenges in current clinical management systems,it propose a dynamic three-phase model"unfreezing-changing-refreezing"driven by AI technologies.By deconstructing systemic contradictions arising from technological penetration e.g.,multi-agent coordination,ethical risks,and responsibility ambiguity,a layered governance framework and dynamic regulatory mechanisms are established.Through synergistic evolution of technology,organization,and institution,an adaptive transition in clinical management paradigms can be achieved,ultimately fostering an AI-augmented healthcare ecosystem that balances efficiency with safety.

Grounded in organizational change-complex systems theory,it investigates the pathways and mechanisms for deep integration of Artificial Intelligence(AI)into clinical management.Addressing structural challenges in current clinical management systems,it propose a dynamic three-phase model"unfreezing-changing-refreezing"driven by AI technologies.By deconstructing systemic contradictions arising from technological penetration e.g.,multi-agent coordination,ethical risks,and responsibility ambiguity,a layered governance framework and dynamic regulatory mechanisms are established.Through synergistic evolution of technology,organization,and institution,an adaptive transition in clinical management paradigms can be achieved,ultimately fostering an AI-augmented healthcare ecosystem that balances efficiency with safety.

Objective To evaluate the effect of clemastine fumarate on Toll-like receptor 4/phosphatidylinositol-3-kinase/serine-threonine kinase (TLR4/PI3K/Akt) signaling pathway during hypoxia-reoxygenation (H/R) in rat cardiomyocytes.Methods H9C2 cells of rats cultured in vitro were seeded in culture wells or dishes at a density of 1×105 cells/ml and divided into 3 groups (n=11 each) by using a random number table method:control group (group C),H/R group and clemastine fumarate group (CF group).Cardiomyocytes were exposed to 5％ CO2-95％ N2in a low-glucose DMEM medium at 37℃ for 4 h followed by 4 h reoxygenation.At 4 h of reoxygenation,the cell viability was detected by CCK-8 assay,the ultrastructure was observed with a transmission electron microscope,the expression of TLR4,PI3K,phosphorylated Akt (p-Akt) and caspase-3 was detected by Western blot,and the expression of TLR4,PI3K and caspase-3 was detected by immunofluorescence.Results Compared with group C,the cell viability was significantly decreased,the expression of TLR4 and caspase-3 was up-regulated,and the expression of PI3K and p-Akt was down-regulated in group H/R (P＜0.05).Compared with group H/R,the cell viability was significantly increased,the expression of TLR4 and caspase-3 was down-regulated,the expression of PI3K and p-Akt was up-regulated (P＜0.05),and the mitochondrial damage was significantly attenuated in group CF.Conclusion The mechanism by which clemastine fumarate alleviates H/R injury to rat cardiomyocytes may be related to inhibiting TLR4 expression and activating PI3K/Akt signaling pathway.

Liver cancer is a common type of malignant tumor in digestive system. At present, computed tomography (CT) plays an important role in the diagnosis and treatment of liver cancer. Segmentation of tumor lesions based on CT is thus critical in clinical diagnosis and treatment. Due to the limitations of manual segmentation, such as inefficiency and subjectivity, the automatic and accurate segmentation based on advanced computational techniques is becoming more and more popular. In this review, we summarize the research progress of automatic segmentation of liver cancer lesions based on CT scans. By comparing and analyzing the results of experiments, this review evaluate various methods objectively, so that researchers in related fields can better understand the current research progress of liver cancer segmentation based on CT scans.

Objective To investigate the association of multi-modality neuroimaging features and cognitive function in mild cognitive impairment (MCI) and Alzheimer's disease (AD).Methods Nine individuals with amnestic MCI (aMCI), fifteen patients with mild probable AD, and eleven age-controlled cognitively normal controls (NC) were recruited.All participants were administered with mini-mental status examination (MMSE) and Cognitive assessment screening instrument (CASI) to assess general cognitive function.Optimized voxel-based morphometry ( VBM ) was used for the analysis with 3-D high resolution anatomical images.Values of fractional anisotropy (FA) and mean apparent diffusivity coefficient (ADC) were measured from different brain regions on diffusion-tensor images ( DTI) .The relationship between structural atrophy and DTI-based measurements in the selected brain regions was examined.Results The scores of MMSE and CASI were correlated with the volumetric changes in such areas as temporal, frontal and parietal lobes, and cingulate gyrus and hippocampal gyrus (P <0.001).The scores of MMSE and CASI were positively correlated with FA values, and negatively with ADC values in the white-matter-affected regions including temporal, frontal, parietal lobes, cingulate gyrus, and parahippocampal gyrus (P < 0.05).Conclusions Cognitive decline was associated with atrophy and white matter microstructural alterations in temporal, frontal, parietal lobes, cingulate gyrus, and parahippocampal gyrus in MCI and AD. Multi-modality imaging technique may be important in elucidating the brain mechanism of cognitive impairment.

Objective To evaluate the microstructural integrity of white matter (WM) in mild cognitive impairment ( MCI ) and Alzheimer disease (AD) using DTI technique, and to explore the relationship between WM abnormalities and cognitive dysfunction. Methods Nine cases of amnestic MCI, 15 cases of mild probable AD and 11 cases of normal controls (NC) with normal-appearing WM (NAWM) were studied using 3. 0 T MR system. Fractional anisotropy (FA) and mean diffusivity (MD) were measured in different WM areas. One-way analysis of variance was used to test the difference among the three groups for DTI indices. Spearman Correlation analysis was applied to reveal the correlation between the DTI indices and the MMSE and CASI scores. Results The FA value in parietal, centrum semiovale, posterior cingulate gyrus, parahippocampus, temporal and frontal WM in MCI was 0. 31 ± 0.03,0. 39 ± 0. 03,0. 62 ± 0. 05,0. 59 ± 0. 05,0. 47 ± 0. 08,0. 32 ± 0. 04, respectely, and MD value was ( 899 ± 30 ) × 10-6,(782±53) × 10-6, (732±45) × 10-6, (806±38) × 10-6, (772 ± 55) × 10-6, (792 ± 35) × 10-6 mm2/s. The FA value of these regions in AD was 0. 28 ± 0. 04, 0. 37 ± 0. 03,0. 55 ± 0. 06,0. 52 ± 0.05,0.40±0. 05,0. 27 ± 0. 04,and MD value was (912±37) × 10-6,(800 ± 67) × 10-6, (762 ± 46) × 10-6, (874±57)×10-6,(822±55)×10-6, (822±39)×10-6 mm2/s. The FA value in NC was 0.36±0.03,0.43±0.05,0.64±0.05, 0.60±0.05, 0.52±0.05,0.33±0.03, and MD value was (866±37)×10-6,(754±54)×10-6,(718±32)×10-6,(810±39)×10-6,(755±48) × 10-6, (785±23)×10-6 mm2/s. Compared with NC, the FA value in parietal WM was significantly decreased in MCI(P<0. 01 ), The significantly reduced FA values in parietal, centrum semiovale, posterior cingulate gyrus, parahippocampus, temporal and frontal WM , as well as significantly elevated MD values were found in AD(P <0. 05). There was significant correlation between these DTI indices and MMSE and CASI scores (P<0.05). Conclusions MR DTI can detect WM abnormalities in AD and MCI. The parietal WM abnormalities and the disconnection of WM circuitry may play an important role in the development of dementia.