Objective To evaluate the recognition capability of AI-enabled Cellsee CS-BM1 automatic cell morphology analyzer for pe-ripheral blood smears and its roles in assisting manual classification,and explore the application value of AI system in the diagnosis network of tiered primary medical units.Methods The blood samples which triggered the re-examination rules were collected from six primary medical units,including the Laboratory Department of Shanghai Jiahui International Hospital,and so on,from March to No-vember 2023.The smears of peripheral blood were prepared and AI analyzer was used for pre-classification to evaluate its recognition performance in identifying the samples with abnormal WBC and RBC.The sensitivity,specificity,and accuracy of WBC classification by six junior and intermediate technicians,both with and without AI assistance,were analyzed.Additionally,the roles of the AI system in tiered diagnosis of primary medical units were also evaluated.Results The sensitivity,specificity,and accuracy of AI system in recognizing malignant primitive cells were 92.86％,95.16％,and 95.10％,respectively.The sensitivities of AI system in recognizing immature granulocytes,reactive lymphocytes,and nucleated RBCs were all greater than 90％.The sensitivity of AI system in identif-ying abnormal morphology of RBCs reached 99.59％,along with rapid quantitative analysis for various anomalous types of RBCs.In AI-assisted mode,the sensitivity of recognition for all cell types was improved to varying degrees by junior and intermediate technicians,and the sensitivity for recognizing malignant primitive cells,reactive lymphocytes,and immature granulocytes increased to 58.24％,53.39％,and 62.37％for junior technicians,and to 92.06％,83.24％,and 83.12％for intermediate technicians,respectively.The improvements for junior technicians were particularly significant,with increases of 12.46％,10.61％,and 3.71％for each cell type,respectively.Both groups achieved higher specificity and accuracy.Through AI pre-classification and manual review,a variety of pe-ripheral blood cell-related diseases were accurately diagnosed in the tiered healthcare practice of primary medical units,including 339 cases(11.13％)of red blood cell diseases,5 cases(0.16％)of platelet diseases,2 343 cases(76.90％)of infection-related disea-ses,and 28 cases(0.92％)of malignant hematological diseases.In addition,332 cases(10.90％)which lacked an obvious related cause or required further examinations were identified as well.Conclusion AI pre-classification has demonstrated strong cell recogni-tion capabilities and may assist technicians in improving the sensitivity,specificity,and accuracy of blood cell classification.AI could en-hance the disease-screening capabilities in the tiered diagnosis network of primary medical units,presenting a broad application prospect.

Objective To evaluate the recognition capability of AI-enabled Cellsee CS-BM1 automatic cell morphology analyzer for pe-ripheral blood smears and its roles in assisting manual classification,and explore the application value of AI system in the diagnosis network of tiered primary medical units.Methods The blood samples which triggered the re-examination rules were collected from six primary medical units,including the Laboratory Department of Shanghai Jiahui International Hospital,and so on,from March to No-vember 2023.The smears of peripheral blood were prepared and AI analyzer was used for pre-classification to evaluate its recognition performance in identifying the samples with abnormal WBC and RBC.The sensitivity,specificity,and accuracy of WBC classification by six junior and intermediate technicians,both with and without AI assistance,were analyzed.Additionally,the roles of the AI system in tiered diagnosis of primary medical units were also evaluated.Results The sensitivity,specificity,and accuracy of AI system in recognizing malignant primitive cells were 92.86％,95.16％,and 95.10％,respectively.The sensitivities of AI system in recognizing immature granulocytes,reactive lymphocytes,and nucleated RBCs were all greater than 90％.The sensitivity of AI system in identif-ying abnormal morphology of RBCs reached 99.59％,along with rapid quantitative analysis for various anomalous types of RBCs.In AI-assisted mode,the sensitivity of recognition for all cell types was improved to varying degrees by junior and intermediate technicians,and the sensitivity for recognizing malignant primitive cells,reactive lymphocytes,and immature granulocytes increased to 58.24％,53.39％,and 62.37％for junior technicians,and to 92.06％,83.24％,and 83.12％for intermediate technicians,respectively.The improvements for junior technicians were particularly significant,with increases of 12.46％,10.61％,and 3.71％for each cell type,respectively.Both groups achieved higher specificity and accuracy.Through AI pre-classification and manual review,a variety of pe-ripheral blood cell-related diseases were accurately diagnosed in the tiered healthcare practice of primary medical units,including 339 cases(11.13％)of red blood cell diseases,5 cases(0.16％)of platelet diseases,2 343 cases(76.90％)of infection-related disea-ses,and 28 cases(0.92％)of malignant hematological diseases.In addition,332 cases(10.90％)which lacked an obvious related cause or required further examinations were identified as well.Conclusion AI pre-classification has demonstrated strong cell recogni-tion capabilities and may assist technicians in improving the sensitivity,specificity,and accuracy of blood cell classification.AI could en-hance the disease-screening capabilities in the tiered diagnosis network of primary medical units,presenting a broad application prospect.

OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
Bronchopulmonary Dysplasia/epidemiology* ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Pregnancy ; Respiratory Distress Syndrome, Newborn/epidemiology* ; Retrospective Studies ; Treatment Outcome

Objective:To compare the adverse reactions of oxycodone hydrochloride prolonged-release tablets and fentanyl transdermal system in the treatment of moderate and severe cancer pain.Methods:The medical records of patients with moderate to severe cancer pain who used oxycodone hydrochloride prolonged-release tablets (oxycodone group) or fentanyl transdermal systems (fentanyl group) for more than 1 week during hospitalization in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2018 to December 2019 were collected. The occurrence of adverse reactions after analgesic treatments were retrospectively analyzed.Results:A total of 698 patients were enrolled in the analysis, including 535 in the oxycodone group and 163 in the fentanyl group. The incidence of adverse reactions in the oxycodone group was significantly higher than that in the fentanyl group [72.5% (388/535) vs. 51.5% (84/163), χ2=25.139, P<0.001]. The common adverse reactions (with incidence ≥5%) in the oxycodone group were constipation, nausea/vomiting, xerostomia, drowsiness, and dizziness, while those in the fentanyl group were constipation, nausea/vomiting, and dizziness. The incidence of constipation in the oxycodone group was significantly higher than that in the fentanyl group [60.9% (326/535) vs. 40.5% (66/163), χ2=21.209, P<0.001]. The differences in the incidence of other adverse reactions in the 2 groups were not statistically significant (all P>0.05). All adverse reactions were grade 1 or 2, which were improved after symptomatic treatments. No adverse reactions of grade 3 or more severe occurred. Conclusions:Both oxycodone hydrochloride prolonged-release tablets and fentanyl transdermal system are safe during the treatment for moderate to severe cancer pain, with mild adverse reactions, which can be relieved by symptomatic treatments. Oxycodone hydrochloride prolonged-release tablets are more likely to cause constipation than fentanyl transdermal system.

Objective:To compare the adverse reactions of oxycodone hydrochloride prolonged-release tablets and fentanyl transdermal system in the treatment of moderate and severe cancer pain.Methods:The medical records of patients with moderate to severe cancer pain who used oxycodone hydrochloride prolonged-release tablets (oxycodone group) or fentanyl transdermal systems (fentanyl group) for more than 1 week during hospitalization in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2018 to December 2019 were collected. The occurrence of adverse reactions after analgesic treatments were retrospectively analyzed.Results:A total of 698 patients were enrolled in the analysis, including 535 in the oxycodone group and 163 in the fentanyl group. The incidence of adverse reactions in the oxycodone group was significantly higher than that in the fentanyl group [72.5% (388/535) vs. 51.5% (84/163), χ2=25.139, P<0.001]. The common adverse reactions (with incidence ≥5%) in the oxycodone group were constipation, nausea/vomiting, xerostomia, drowsiness, and dizziness, while those in the fentanyl group were constipation, nausea/vomiting, and dizziness. The incidence of constipation in the oxycodone group was significantly higher than that in the fentanyl group [60.9% (326/535) vs. 40.5% (66/163), χ2=21.209, P<0.001]. The differences in the incidence of other adverse reactions in the 2 groups were not statistically significant (all P>0.05). All adverse reactions were grade 1 or 2, which were improved after symptomatic treatments. No adverse reactions of grade 3 or more severe occurred. Conclusions:Both oxycodone hydrochloride prolonged-release tablets and fentanyl transdermal system are safe during the treatment for moderate to severe cancer pain, with mild adverse reactions, which can be relieved by symptomatic treatments. Oxycodone hydrochloride prolonged-release tablets are more likely to cause constipation than fentanyl transdermal system.

OBJECTIVESTo study the progression of cirrhosis in patients with HIV/HCV coinfection.

METHODSThe patients were divided into two groups, HIV/HCV coinfection group (n = 140) and simple HCV infection group (n = 33). A retrospective study was designed to compare the development of cirrhosis in a 15-year period between the two groups.

RESULTSThe development of cirrhosis in the HIV/HCV coinfection group was higher than that in the simple HCV infection group (16.4% vs. 3.0%, P=0.045). Counts of CD4+ T and CD8+ T in the HIV/HCV group were 200.0+/-134.1 cells/microl and 880.6+/-444.2 cells/microl, respectively. The counts of CD4+ T and CD8+ T in the group of simple HCV infection were 752.3+/-251.7 cells/microl and 529.0+/-170.7 cells/microl, respectively. There were significant differences between the two groups regarding the counts of CD4+ T and CD8+ T. Comparing the cases of HCV RNA (+) and anti-HCV (+) with the cases of HCV RNA (+) and anti-HCV (-), we found that the ratio was 89 to 15 in the group of HIV/HCV coinfection, and 25 to 0 in the group of simple HCV infection. The difference between the two groups was statistically significant (P = 0.043).

CONCLUSIONHIV/HCV coinfection can accelerate the progression of cirrhosis, which may be due to the effect of HIV on cellular immunity and humoral immunity.

Adult ; CD4-CD8 Ratio ; China ; epidemiology ; Female ; HIV Infections ; complications ; immunology ; HIV-1 ; Hepatitis C ; complications ; immunology ; Humans ; Liver Cirrhosis ; complications ; epidemiology ; Male ; Middle Aged ; Retrospective Studies