PURPOSE: To investigate the protective effect of sub-hypothermic mechanical perfusion combined with membrane lung oxygenation on ischemic hypoxic injury of yorkshire brain tissue caused by traumatic blood loss. METHODS: This article performed a random controlled trial. Brain tissue of 7 yorkshire was selected and divided into the sub-low temperature anterograde machine perfusion group (n = 4) and the blank control group (n = 3) using the random number table method. A yorkshire model of brain tissue injury induced by traumatic blood loss was established. Firstly, the perfusion temperature and blood oxygen saturation were monitored in real-time during the perfusion process. The number of red blood cells, hemoglobin content, NA⁺, K⁺, and Ca²⁺ ions concentrations and pH of the perfusate were detected. Following perfusion, we specifically examined the parietal lobe to assess its water content. The prefrontal cortex and hippocampus were then dissected for histological evaluation, allowing us to investigate potential regional differences in tissue injury. The blank control group was sampled directly before perfusion. All statistical analyses and graphs were performed using GraphPad Prism 8.0 Student t-test. All tests were two-sided, and p value of less than 0.05 was considered to indicate statistical significance. RESULTS: The contents of red blood cells and hemoglobin during perfusion were maintained at normal levels but more red blood cells were destroyed 3 h after the perfusion. The blood oxygen saturation of the perfusion group was maintained at 95% - 98%. NA⁺ and K⁺ concentrations were normal most of the time during perfusion but increased significantly at about 4 h. The Ca²⁺ concentration remained within the normal range at each period. Glucose levels were slightly higher than the baseline level. The pH of the perfusion solution was slightly lower at the beginning of perfusion, and then gradually increased to the normal level. The water content of brain tissue in the sub-low and docile perfusion group was 78.95% ± 0.39%, which was significantly higher than that in the control group (75.27% ± 0.55%, t = 10.49, p < 0.001), and the difference was statistically significant. Compared with the blank control group, the structure and morphology of pyramidal neurons in the prefrontal cortex and CA1 region of the hippocampal gyrus were similar, and their integrity was better. The structural integrity of granulosa neurons was destroyed and cell edema increased in the perfusion group compared with the blank control group. Immunofluorescence staining for glail fibrillary acidic protein and Iba1, markers of glial cells, revealed well-preserved cell structures in the perfusion group. While there were indications of abnormal cellular activity, the analysis showed no significant difference in axon thickness or integrity compared to the 1-h blank control group. CONCLUSIONS Mild hypothermic machine perfusion can improve ischemia and hypoxia injury of yorkshire brain tissue caused by traumatic blood loss and delay the necrosis and apoptosis of yorkshire brain tissue by continuous oxygen supply, maintaining ion homeostasis and reducing tissue metabolism level.
Animals ; Perfusion/methods* ; Disease Models, Animal ; Brain Injuries/etiology* ; Swine ; Male ; Hypothermia, Induced/methods*

The rapid development of artificial intelligence (AI), especially generative AI (GenAI), has already brought, and will continue to bring, revolutionary changes to our daily production and life, as well as create new opportunities and challenges for diagnostic and therapeutic practices in the medical field. Haihe Hospital of Tianjin University collaborates with the National Supercomputer Center in Tianjin, Tianjin University, and other institutions to carry out research in areas such as smart healthcare, smart services, and smart management. We have conducted research and development of a full-process disease diagnosis and treatment assistance system based on GenAI in the field of smart healthcare. The development of this project is of great significance. The first goal is to upgrade and transform the hospital's information center, organically integrate it with existing information systems, and provide the necessary computing power storage support for intelligent services within the hospital. We have implemented the localized deployment of three models: Tianhe "Tianyuan", WiNGPT, and DeepSeek. The second is to create a digital avatar of the chief physician/chief physician's voice and image by integrating multimodal intelligent interaction technology. With generative intelligence as the core, this solution provides patients with a visual medical interaction solution. The third is to achieve deep adaptation between generative intelligence and the entire process of patient medical treatment. In this project, we have developed assistant tools such as intelligent inquiry, intelligent diagnosis and recognition, intelligent treatment plan generation, and intelligent assisted medical record generation to improve the safety, quality, and efficiency of the diagnosis and treatment process. This study introduces the content of a full-process disease diagnosis and treatment assistance system, aiming to provide references and insights for the digital transformation of the healthcare industry.
Artificial Intelligence ; Humans ; Delivery of Health Care ; Generative Artificial Intelligence

Objective To investigate the diagnostic value Tamm-Horsfall protein(THP)and osteopontin(OPN)in serum and 24-hour urine for urolithiasis.Methods A total of 101 patients with urolithiasis who underwent flexible ureteroscopy lithotripsy at the Urology Department of Civil Aviation General Hospital from April 2020 to March 2023 were included as the stone group,and 50 healthy individuals were enrolled as the control group.The samples of serum and 24-hour urine samples were collected from both the groups,and the levels of THP and OPN were measured using enzyme-linked immunosorbent assay(ELISA).Logistic regression analysis was performed to evaluate the association between each biomarker and urolithiasis,and receiver operating characteristic(ROC)curves were plotted to assess their diagnostic value.Results The stone group showed significantly lower THP levels(20.13[13.12,26.03]mg/d)and OPN levels(51.24[36.72,101.37]μg/d)in 24-hour urine,and THP levels(182.01[160.91,209.20]ng/mL)and OPN lev-els(18.76[15.72,22.48]ng/mL)in serum compared to the control group(all the P＜0.001).Binary Logistic regression analysis re-vealed that THP(OR=0.736,95％CI:0.606-0.895),OPN(OR=0.975,95％CI:0.958-0.993)and citrate(OR=0.067,95％CI:0.012-0.376)in 24-hour urine,and THP(OR=0.946,95％CI:0.908-0.986)and OPN(OR=0.896,95％CI:0.803-0.999)in ser-um were the protective factors for urolithiasis,while calcium level(OR=2.125,95％CI:1.243-3.633)24-hour urine was a risk factor(all the P＜0.05).ROC curve analysis showed that the areas under the curve(AUCROC)for the individual diagnosis of urolithiasis were 0.846,0.809,0.786,0.823,0.748,and 0.755 for the above six biomarkers,respectively.The AUCROC for the combined diagnosis u-sing THP+OPN in serum,THP+OPN in 24-hour urine and all the six biomarkers were 0.882,0.920 and 0.984,respectively,indica-ting better diagnostic performance.Conclusion The combined detection of the THP and OPN levels in serum and 24-hour urine may have good diagnostic value for urolithiasis and serve as potential diagnostic biomarkers.

Purpose::Ischemia and hypoxia are the main factors limiting limb replantation and transplantation. Static cold storage (SCS), a common preservation method for tissues and organs, can only prolong limb ischemia time to 4 - 6 h. The normothermic machine perfusion (NMP) is a promising method for the preservation of tissues and organs, which can extend the preservation time in vitro by providing continuous oxygen and nutrients. This study aimed to evaluate the difference in the efficacy of the 2 limb preservation methods. Methods::The 6 forelimbs from beagle dogs were divided into 2 groups. In the SCS group ( n = 3), the limbs were preserved in a sterile refrigerator at 4 °C for 24 h, and in the NMP group ( n = 3), the perfusate prepared with autologous blood was used for the oxygenated machine perfusion at physiological temperature for 24 h, and the solution was changed every 6 h. The effects of limb storage were evaluated by weight gain, perfusate biochemical analysis, enzyme-linked immunosorbent assay, and histological analysis. All statistical analyses and graphs were performed using GraphPad Prism 9.0 one-way or two-way analysis of variance. The p value of less than 0.05 was considered to indicate statistical significance. Results::In the NMP group, the weight gained percentage was 11.72% ± 4.06%; the hypoxia-inducible factor-1α contents showed no significant changes; the shape of muscle fibers was normal; the gap between muscle fibers slightly increased, showing the intercellular distance of (30.19 ± 2.83) μm; and the vascular α-smooth muscle actin (α-SMA) contents were lower than those in the normal blood vessels. The creatine kinase level in the perfusate of the NMP group increased from the beginning of perfusion, decreased after each perfusate change, and remained stable at the end of perfusion showing a peak level of 4097.6 U/L. The lactate dehydrogenase level of the NMP group increased near the end of perfusion and reached the peak level of 374.4 U/L. In the SCS group, the percentage of weight gain was 0.18% ± 0.10%, and the contents of hypoxia-inducible factor-1α increased gradually and reached the maximum level of (164.85 ± 20.75) pg/mL at the end of the experiment. The muscle fibers lost their normal shape and the gap between muscle fibers increased, showing an intercellular distance of (41.66 ± 5.38) μm. The contents of vascular α-SMA were much lower in the SCS group as compared to normal blood vessels.Conclusions::NMP caused lesser muscle damage and contained more vascular α-SMA as compared to SCS. This study demonstrated that NMP of the amputated limb with perfusate solution based on autologous blood could maintain the physiological activities of the limb for at least 24 h.

To introduce a strategy for a case of severe pneumonia complicated with lung abscess caused by Fusobacterium necrotum.The pathogen was not identified,but the patient was still coughing up feverish bloody sputum after being treated with meropenem,linezolid and ornidazole.The results of detection of pathogen metagenomes in bronchoalveolar lavage fluid by posterior bronchoscopy suggested that the pathogen was Fusobacterium necrophorum,according to the characteristics of bacteria,the dynamic changes of clinical symptoms,liver and kidney function,body temperature and blood picture infection index,combined with the results of bacterial culture/drug sensitivity test,bronchoalveolar lavage fluid NGS and the pharmacokinetic/pharmacodynamic characteristics of antimicrobial agents,to propose an anti-infective regimen that is strategically adjusted to imipenem cilastatin(1.0 g,ivd,q8h)plus ornidazole(0.5 g,ivd,q12h)for the implementation of pharmaceutical care after adoption by physicians.After 21 days,the patient's severe infection and lung abscess was controlled and patient was discharged.In this case,clinical pharmacists study the bacterial characteristics of Fusobacterium necrotum,review a large number of domestic and foreign literature to track the frontier knowledge of antimicrobial agents,and use their own expertise to provide effective pharmaceutical support for the clinical team,to assist clinical team in the diagnosis and treatment of rare infections,to achieve professional value.

Purpose/Significance To explore the feasibility of applying blockchain technology to the current healthcare system of hos-pitals,and to achieve the purpose of protecting patients'privacy to the greatest extent possible at a lower cost.Method/Process 505 questionnaires are randomly distributed and collected from people of different age groups in Beijing,Tianjin,Shanghai and Shenzhen who have a certain degree of understanding of blockchain technology,and the results are analyzed.Result/Conclusion Different age groups are highly concerned about personal privacy and privacy protection,and are willing to accept blockchain as an emerging technology.There is a greater demand and acceptance for the application of blockchain technology in the primary health care systems.

Objective To understand the status of screen exposure in children with epilepsy and analyze the influencing factors for screen exposure time,providing a scientific basis for managing screen exposure in these children. Methods A convenience sampling method was used to select 275 children with epilepsy from outpatient clinics or those undergoing 24-hour electroencephalogram monitoring at two tertiary hospitals in Jinan from March to June 2023. Their parents (fathers or mothers) completed a questionnaire to collect data on screen exposure,parental screen regulation behaviors,and related information about the children and their families. The Wilcoxon rank-sum test or the Kruskal-Wallis H test was used to conduct a univariate analysis of the average screen exposure time of children on school days and weekends,as well as the daily average screen exposure time. A multivariate logistic regression analysis was used to identify the risk factors for children whose screen exposure time exceeded the recommended guidelines (average screen exposure time on school days>1 hour or average on weekends>2 hours). Results The median screen exposure duration on school days was 40 minutes,while on weekends it was 120 minutes. Among the children studied,23.1％ (63/273) had average screen exposure time exceeding 1 hour on school days,and 42.5％ (117/275) had average screen exposure time exceeding 2 hours on weekends. Four children experienced seizures while using screen devices. Multivariate logistic regression analysis indicated that using screen devices shortly before sleep,lower educational levels of parents,caregivers discussing screen content with children,and longer seizure durations in children were risk factors for exceeding recommended guidelines (P<0.05). Conclusions Some children with epilepsy have a screen exposure time exceeding the recommended guidelines. A longer seizure duration,lower parental education levels,and permissive digital parenting are closely associated with children's screen exposure time exceeding the recommended guidelines. Families and children exhibiting these characteristics should be prioritized for attention and health education.

Objective To investigate the protective effects and underlying mechanisms of sodium butyrate on rats exposed to hypoxia and cold conditions.Methods Fifty-eight male SD rats (aged 7～8 weeks,weighing 240～260 g ) were randomly divided into normoxia normothermia saline control (NNC ) group (n=10),normoxia normothermia sodium butyrate(NNB)group(n=10),hypoxia cold saline control (HCC) group (n=19),and hypoxia cold sodium butyrate (HCB)group (n=19).The intragastric dose of sodium butyrate was 200 mg/kg for the NNB and HCB groups,while the NNC and HCC groups were given normal saline of 5 mL/kg.①After continuous intragastric administration for 7 d,the rats in the HCC and HCB groups were placed in a low-pressure hypoxic chamber to simulate an altitude of 5000 m and exposed to a temperature of 8 ℃ for 7 d.Subsequently,blood samples were collected from the abdominal aorta for blood gas analysis,blood routine test,and detection for serum biochemical indicators.ELISA was used to determine serum inflammatory cytokines and endocrine hormones.The rats in the NNC and NNB groups(n=10)were fed outside the chamber and underwent the same tests in 7 d later to evaluate the protective effects of sodium butyrate on the body.②Core body temperature monitoring was conducted to assess the impact of sodium butyrate on the rmoregulation in rats exposed to hypoxia and cold(n=3).③Hypoxia exercise tolerance of the HCC group and HCB group in a hypoxic chamber (11％O2 )was evaluated for their hypoxia resistance (n=6).Results Compared to the NNC group,the rats in the HCC group exhibited significant decreases in arterial oxygen saturation (SaO2 )and arterial oxygen partial pressure (PaO2 ),serum levels of IL-4,estradiol (E2)and cortisol (F),core temperature,and exercise duration (P<0.05),and had notably increased levels of red blood cell (RBC)count,hemoglobin (HGB),hematocrit (HCT),cardiac troponin (CRDAC-T),uric acid (UA),alanine aminotransferase (ALT),total cholesterol (TC),low-density lipoprotein (LDL),IL-6 and granulocyte-macrophage colony-stimulating factor (GM-CSF)(P<0.05).Compared to the HCC group,the rats in the HCB group exhibited significant increases in SaO2,PaO2,IL-4,E2,F,corticotropin releasing hormone (CRH)and adrenocorticotropic hormone (ACTH)(P<0.05),remarkably longer exercise duration under hypoxic exposure (P<0.05 ),but decreases in RBC count,serum levels of HGB,HCT,CRDAC-T,UA,ALT,TC,LDL,IL-6,GM-CSF and free thyroxine (FT4 ),and core temperature (P<0.05).Conclusion Sodium butyrate exhibits protective effects on rats exposed to hypoxia and cold conditions,and it is helpful in their adaptation to these hypoxia and cold environments.

Objective To observe the effect of omeprazole enteric-coated capsules on clinical symptoms and serum inflammatory factor levels in children with chronic gastritis and peptic ulcer.Methods Children with chronic gastritis and peptic ulcer were divided into treatment group and control group by random number table method.The control group was given triple therapy of ranitidine hydrochloride tablets,amoxicillin and clarithromycin,while the treatment group was treated with omeprazole enteric-coated capsules combined with amoxicillin and clarithromycin.Clinical efficacy,symptom relief time,and changes in serum motilin(MOT),gastrin(GAS)and inflammatory factors[interlrukin-6(IL-6)and interlrukin-8(IL-8)]were compared between the two groups.Results There were 48 cases in treatment group and 48 cases in control group.After treatment,the total effective rates in treatment group and control group were 93.74％(45 cases/48 cases)and 85.42％(41 cases/48 cases),with significant difference(P＜0.05).After treatment,the disappearance time of ulcer induced pain in treatment group and control group were(1.51±0.26)and(2.08±0.42)d;the disappearance time of acid regurgitation were(2.29±0.40)and(2.93±0.33)d;the disappearance time of burning sensation were(2.37±0.21)and(2.85±0.54)d;the length of hospital stay were(6.21±1.07)and(6.94±1.25)d;serum MOT levels were(298.48±35.15)and(273.58±31.25)pg·mL-1;serum GAS levels were(167.28±19.46)and(128.32±18.61)ng·L-1;IL-6 levels were(58.67±5.39)and(76.14±6.63)mg·mL-1;IL-8 levels were(50.08±5.16)and(58.68±5.49)mg·mL-1.The above indexes were significantly different between control group and treatment group(all P＜0.05).The total incidence of adverse drug reactions in treatment group and control group were 8.33％and 12.50％,with no statistical significance(P＞0.05).Conclusion Omeprazole enteric-coated capsules in the treatment of children with chronic gastritis and peptic ulcer can effectively alleviate various clinical symptoms and improve clinical efficacy.At the same time,it can lower serum levels of inflammatory factors and improve inflammation,with good effect.

Objective:To quantitatively evaluate left ventricular myocardial work in patients with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD) by pressure strain loop (PSL) technique.Methods:A total of 103 T2DM patients diagnosed at the Heping Hospital Affiliated to Changzhi Medical College from April 2022 to May 2023 were selected. They were divided into three groups based on their fatty liver ultrasound findings: group A (34 cases without NAFLD), group B (37 cases with mild NAFLD), and group C (32 cases with moderate to severe NAFLD). All patients underwent routine echocardiography, which measured the end diastolic left ventricular diameter (LVIDd), end systolic left ventricular diameter (LVIDs), end diastolic interventricular septum (IVSTd), left ventricular posterior wall thickness (LVPWTd), and end systolic left atrial diameter (LAD). The biplane Simpson method was used to measure left ventricular ejection fraction (LVEF), end diastolic left ventricular volume (LVEDV), and end systolic left ventricular volume (LVESV). PSL technology was applied to analyze the overall longitudinal strain (GLS), global work index (GWI), global effective work (GCW), global ineffective work (GWW), and overall work efficiency (GWE) of the left ventricular myocardium. We compared the conventional echocardiography parameters and myocardial work parameters among three groups, and analyzed the correlation between myocardial work parameters and GLS and glycosylated hemoglobin (HbA 1c). Results:The differences in body mass index (BMI), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) between group B and group A were statistically significant (all P<0.05); There was a statistically significant difference in BMI, HbA 1c, and low density lipoprotein cholesterol (LDL-C) between group C and group B (all P<0.001); The differences in BMI, HbA 1c, ALT, AST, triglyceride (TC), high density lipoprotein cholesterol (HDL-C), and LDL-C between group C and group A were statistically significant (all P<0.05). The GWI and GCW in group B were lower than those in group A (all P<0.05), while the absolute GLS, GCW, GWI, and GWE in group C were lower than those in group A, and GWW was higher than those in group A (all P<0.05); The absolute values of GLS, GCW, GWI, and GWE in group C were lower than those in group B ( P<0.05). The correlation analysis results showed that GLS and HbA 1c were negatively correlated with GCW and GWI ( r=-0.571, -0.533, -0.273, -0.223, P<0.05). Conclusions:PSL technology can quantitatively evaluate left ventricular myocardial work in patients with T2DM combined with NAFLD, and can detect early impairment of left ventricular systolic function in patients. It has clinical reference value in evaluating overall and local cardiac function.