1.Guideline-driven clinical decision support for colonoscopy patients using the hierarchical multi-label deep learning method.
Junling WU ; Jun CHEN ; Hanwen ZHANG ; Zhe LUAN ; Yiming ZHAO ; Mengxuan SUN ; Shufang WANG ; Congyong LI ; Zhizhuang ZHAO ; Wei ZHANG ; Yi CHEN ; Jiaqi ZHANG ; Yansheng LI ; Kejia LIU ; Jinghao NIU ; Gang SUN
Chinese Medical Journal 2025;138(20):2631-2639
BACKGROUND:
Over 20 million colonoscopies are performed in China annually. An automatic clinical decision support system (CDSS) with accurate semantic recognition of colonoscopy reports and guideline-based is helpful to relieve the increasing medical burden and standardize the healthcare. In this study, the CDSS was built under a hierarchical-label interpretable classification framework, trained by a state-of-the-art transformer-based model, and validated in a multi-center style.
METHODS:
We conducted stratified sampling on a previously established dataset containing 302,965 electronic colonoscopy reports with pathology, identified 2041 patients' records representative of overall features, and randomly divided into the training and testing sets (7:3). A total of five main labels and 22 sublabels were applied to annotate each record on a network platform, and the data were trained respectively by three pre-training models on Chinese corpus website, including bidirectional encoder representations from transformers (BERT)-base-Chinese (BC), the BERT-wwm-ext-Chinese (BWEC), and ernie-3.0-base-zh (E3BZ). The performance of trained models was subsequently compared with a randomly initialized model, and the preferred model was selected. Model fine-tuning was applied to further enhance the capacity. The system was validated in five other hospitals with 3177 consecutive colonoscopy cases.
RESULTS:
The E3BZ pre-trained model exhibited the best performance, with a 90.18% accuracy and a 69.14% Macro-F1 score overall. The model achieved 100% accuracy in identifying cancer cases and 99.16% for normal cases. In external validation, the model exhibited favorable consistency and good performance among five hospitals.
CONCLUSIONS
The novel CDSS possesses high-level semantic recognition of colonoscopy reports, provides appropriate recommendations, and holds the potential to be a powerful tool for physicians and patients. The hierarchical multi-label strategy and pre-training method should be amendable to manage more medical text in the future.
Humans
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Colonoscopy/methods*
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Deep Learning
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Decision Support Systems, Clinical
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Female
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Male
2.Molecular mechanisms of lung cancer induced by the insecticide lambda-cyhalothrin.
Yongshun DUAN ; Zifei WANG ; Mengxuan WU ; Shuo WANG ; Xin GUO ; Zhihua NI
Chinese Journal of Biotechnology 2025;41(10):3801-3816
The inappropriate utilisation of the agricultural insecticide lambda-cyhalothrin (LCT) has the potential to result in residues that compromise food safety and human health. Respiratory exposure represents a major route of LCT contact in humans. Nevertheless, its deleterious effects on the respiratory system remain inadequately characterized. It is imperative to elucidate the potential relationship and mechanisms by which lung cancer, a significant malignant neoplasm of the respiratory system, is associated with exposure to LCT. The objective of this study is to utilise bioinformatics methodologies to screen and analyse the key target molecules affected by LCT in the occurrence of lung cancer, and their mechanisms of action. Specifically, network toxicology methods were employed to identify core targets of LCT-induced lung cancer. Subsequently, functional annotation to delineate associated cellular pathways, and finally, molecular docking to simulate binding modes between LCT and shared core targets. Core target screening identified 50 targets for large cell lung cancer, 54 for small cell lung cancer, 29 for lung squamous cell carcinoma, and 28 for lung adenocarcinoma, with EGFR, HSP90AA1, JUN, CCL2, MYC, CXCL8, and HSPA4 shared in all subtypes. Functional annotation revealed that LCT-triggered oncogenic pathways predominantly involved ubiquitination, chemotaxis, and tumor immune signaling. Molecular docking demonstrated spontaneous binding of LCT to core targets mediated by hydrogen bonds and π-cation interactions. These results establish a theoretical framework for evaluating LCT-associated risks of lung cancer and respiratory system damage.
Lung Neoplasms/metabolism*
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Pyrethrins/toxicity*
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Humans
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Insecticides/toxicity*
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Nitriles/toxicity*
;
Molecular Docking Simulation
3.Effects of emotional loss and cognitive loss on suppression control in college students with mobile phone dependent
Yilin WU ; Xizhen FENG ; Mengxuan JI
Chinese Mental Health Journal 2024;38(3):271-276
Objective:To investigate the effect of mobile phone dependence on suppression control under the conditions of emotional loss and cognitive loss in college students.Methods:A total of 553 college students were recruited,and 108 in the mobile phone dependence group and 194 in the non-dependent group were screened with the Mobile Phone Addiction Tendency Scale(MPATS).Ninety-nine of them were selected to participate in experi-ment 1,and the effect of emotional loss on the inhibitory control,and 101 students were selected to participate in ex-periment 2 to investigate the effect of cognitive loss on the inhibitory control.The GO/NOGO paradigm was used to compare the correct rate and response of different mobile phones dependent on college students under different emo-tional and cognitive depletion conditions.Results:In experiment 1,the main effect of emotional loss was statistically significant[F(1,55)=6.16,178.91;Ps<0.05],the inhibition control accuracy rates were lower and reaction tim-es were shorter in the high emotional loss group than in the low emotional loss group.In experiment 2,the main effect of the group was statistically significant[F(1,57)=17.90,19.06;Ps<0.001],the accuracy rates of inhibi-tion control were lower and the inhibition control reaction times were longer in the mobile phone-dependent group than in the non-dependent group.The interaction between groups and cognitive loss types was statistically significant[F(1,57)=7.95,P<0.01],and the inhibition control accuracy rates of the mobile phone-dependent group were lower under high cognitive loss.Conclusion:Emotional loss and cognitive loss could reduce the inhibition and con-trol ability of individuals,and the mobile phone dependence group is more likely to be affected in the case of cogni-tive loss.
4.Construction and Demonstration of Evaluation Index System of Regional Clinical Medical Discipline Construction
Mengxuan CHEN ; Xuechen XIONG ; Ping WU ; Hongyu LI ; Li LUO
Chinese Hospital Management 2024;44(8):37-41
Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.
5.Construction and Demonstration of Evaluation Index System of Regional Clinical Medical Discipline Construction
Mengxuan CHEN ; Xuechen XIONG ; Ping WU ; Hongyu LI ; Li LUO
Chinese Hospital Management 2024;44(8):37-41
Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.
6.Construction and Demonstration of Evaluation Index System of Regional Clinical Medical Discipline Construction
Mengxuan CHEN ; Xuechen XIONG ; Ping WU ; Hongyu LI ; Li LUO
Chinese Hospital Management 2024;44(8):37-41
Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.
7.Construction and Demonstration of Evaluation Index System of Regional Clinical Medical Discipline Construction
Mengxuan CHEN ; Xuechen XIONG ; Ping WU ; Hongyu LI ; Li LUO
Chinese Hospital Management 2024;44(8):37-41
Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.
8.Construction and Demonstration of Evaluation Index System of Regional Clinical Medical Discipline Construction
Mengxuan CHEN ; Xuechen XIONG ; Ping WU ; Hongyu LI ; Li LUO
Chinese Hospital Management 2024;44(8):37-41
Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.
9.Construction and Demonstration of Evaluation Index System of Regional Clinical Medical Discipline Construction
Mengxuan CHEN ; Xuechen XIONG ; Ping WU ; Hongyu LI ; Li LUO
Chinese Hospital Management 2024;44(8):37-41
Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.
10.Construction and Demonstration of Evaluation Index System of Regional Clinical Medical Discipline Construction
Mengxuan CHEN ; Xuechen XIONG ; Ping WU ; Hongyu LI ; Li LUO
Chinese Hospital Management 2024;44(8):37-41
Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.

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