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

PURPOSE: To judge the injury mode and injury severity of the real human body through the measured values of anthropomorphic test devices (ATD) injury indices, the mapping relationship of lumbar injury between ATD and human body model (HBM) was explored. METHODS: Through the ATD model and HBM simulation, the mapping relationship of lumbar injury between the 2 subjects was explored. The sled environment consisted of a semi-rigid seat with an adjustable seatback angle and a 3-point seat belt system with a seatback-mounted D-ring. Three seatback recline states of 25°, 45°, and 65° were designed, and the seat pan angle was maintained at 15°. A 23 g, 47 km/h pulse was used. The validity of the finite element model of the sled was verified by the comparison of ATD simulation and test results. ATD model was the test device for human occupant restraint for autonomous vehicles (THOR-AV) dummy model and HBM was the total human model for safety (THUMS) v6.1. The posture of the 2 models was adjusted to adapt to the 3 seat states. The lumbar response of THOR-AV and the mechanical and biomechanical data on L1 - L5 vertebrae of THUMS were output, and the response relationship between THOR-AV and THUMS was descriptive statistically analyzed. RESULTS: Both THOR-AV and THUMS were submarined in the 65° seatback angle case. With the change of seatback angle, the lumbar spine axial compression force (F_z) of THOR-AV and THUMS changed in the similar trend. The maximum F_z ratio of THOR-AV to THUMS at 25° and 45° seatback angle cases were 1.6 and 1.7. The flexion moment (M_y) and the time when the maximum M_y occurred in the 2 subjects were very different. In particular, the form of moment experienced by the L1 - L5 vertebrae of THUMS also changed. The changing trend of M_y measured by THOR-AV over time can reflect the changing trend of maximum stress of L1 and L2 of THUMS. CONCLUSION The F_z of ATD and HBM presents a certain proportional relationship, and there is a mapping relationship between the 2 subjects on F_z. The mapping function can be further clarified by applying more pulses and adopting more seatback angles. It is difficult to map M_y directly because they are very different in ATD and HBM. The M_y of ATD and stress of HBM lumbar showed a similar change trend over time, and there may be a hidden mapping relationship.
Humans ; Lumbar Vertebrae/injuries* ; Finite Element Analysis ; Biomechanical Phenomena ; Manikins ; Spinal Injuries/physiopathology*

Testicular histology based on testicular biopsy is an important factor for determining appropriate testicular sperm extraction surgery and predicting sperm retrieval outcomes in patients with azoospermia. Therefore, we developed a deep learning (DL) model to establish the associations between testicular grayscale ultrasound images and testicular histology. We retrospectively included two-dimensional testicular grayscale ultrasound from patients with azoospermia (353 men with 4357 images between July 2017 and December 2021 in The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China) to develop a DL model. We obtained testicular histology during conventional testicular sperm extraction. Our DL model was trained based on ultrasound images or fusion data (ultrasound images fused with the corresponding testicular volume) to distinguish spermatozoa presence in pathology (SPP) and spermatozoa absence in pathology (SAP) and to classify maturation arrest (MA) and Sertoli cell-only syndrome (SCOS) in patients with SAP. Areas under the receiver operating characteristic curve (AUCs), accuracy, sensitivity, and specificity were used to analyze model performance. DL based on images achieved an AUC of 0.922 (95% confidence interval [CI]: 0.908-0.935), a sensitivity of 80.9%, a specificity of 84.6%, and an accuracy of 83.5% in predicting SPP (including normal spermatogenesis and hypospermatogenesis) and SAP (including MA and SCOS). In the identification of SCOS and MA, DL on fusion data yielded better diagnostic performance with an AUC of 0.979 (95% CI: 0.969-0.989), a sensitivity of 89.7%, a specificity of 97.1%, and an accuracy of 92.1%. Our study provides a noninvasive method to predict testicular histology for patients with azoospermia, which would avoid unnecessary testicular biopsy.
Humans ; Male ; Azoospermia/diagnostic imaging* ; Deep Learning ; Testis/pathology* ; Retrospective Studies ; Adult ; Ultrasonography/methods* ; Sperm Retrieval ; Sertoli Cell-Only Syndrome/diagnostic imaging*

OBJECTIVES: To identify risk factors for recurrent plastic bronchitis (PB) among children with Mycoplasma pneumoniae pneumonia (MPP). METHODS: The clinical data of children with MPP complicated by PB who underwent bronchoscopy at Gansu Province Maternity and Child Health Hospital between July 2023 and January 2025 were retrospectively analyzed. Patients were grouped into a single-episode PB group and a recurrent PB group according to the number of PB episodes. Multivariable logistic regression was used to identify risk factors for recurrent PB. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of individual and combined predictors. RESULTS: A total of 264 children were included; 188 (71.2%) had a single episode of PB and 76 (28.8%) had recurrent PB. Multivariable logistic regression analysis showed that decreased serum albumin, atelectasis, and fever persisting beyond 72 hours after the initial bronchoscopy were significantly associated with recurrent PB (all P<0.05). The combination of these predictors yielded a sensitivity of 82.9%, specificity of 61.7%, and an area under the ROC curve of 0.777 (95%CI: 0.714-0.839), outperforming any single predictor (P<0.05). CONCLUSIONS In children with MPP complicated by PB, decreased serum albumin, the presence of atelectasis, and fever persisting beyond 72 hours after the initial bronchoscopy are associated with an increased risk of PB recurrence. In such cases, early repeat or multiple bronchoscopic interventions should be considered.
Humans ; Pneumonia, Mycoplasma/complications* ; Male ; Female ; Risk Factors ; Recurrence ; Child, Preschool ; Bronchitis/etiology* ; Child ; Retrospective Studies ; Logistic Models ; Infant ; ROC Curve ; Adolescent

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

Patients suffering from nerve injury often experience exacerbated pain responses and complain of memory deficits. The dorsal hippocampus (dHPC), a well-defined region responsible for learning and memory, displays maladaptive plasticity upon injury, which is assumed to underlie pain hypersensitivity and cognitive deficits. However, much attention has thus far been paid to intracellular mechanisms of plasticity rather than extracellular alterations that might trigger and facilitate intracellular changes. Emerging evidence has shown that nerve injury alters the microarchitecture of the extracellular matrix (ECM) and decreases ECM rigidity in the dHPC. Despite this, it remains elusive which element of the ECM in the dHPC is affected and how it contributes to neuropathic pain and comorbid cognitive deficits. Laminin, a key element of the ECM, consists of α-, β-, and γ-chains and has been implicated in several pathophysiological processes. Here, we showed that peripheral nerve injury downregulates laminin β1 (LAMB1) in the dHPC. Silencing of hippocampal LAMB1 exacerbates pain sensitivity and induces cognitive dysfunction. Further mechanistic analysis revealed that loss of hippocampal LAMB1 causes dysregulated Src/NR2A signaling cascades via interaction with integrin β1, leading to decreased Ca²⁺ levels in pyramidal neurons, which in turn orchestrates structural and functional plasticity and eventually results in exaggerated pain responses and cognitive deficits. In this study, we shed new light on the functional capability of hippocampal ECM LAMB1 in the modulation of neuropathic pain and comorbid cognitive deficits, and reveal a mechanism that conveys extracellular alterations to intracellular plasticity. Moreover, we identified hippocampal LAMB1/integrin β1 signaling as a potential therapeutic target for the treatment of neuropathic pain and related memory loss.
Animals ; Laminin/genetics* ; Hippocampus/metabolism* ; Neuralgia/metabolism* ; Cognitive Dysfunction/etiology* ; Male ; Peripheral Nerve Injuries/metabolism* ; Extracellular Matrix/metabolism* ; Integrin beta1/metabolism* ; Pyramidal Cells/metabolism* ; Signal Transduction

This study aimed to comprehensively examine the association of gallstones, cholecystectomy, and cancer risk. Multivariable logistic regressions were performed to estimate the observational associations of gallstones and cholecystectomy with cancer risk, using data from a nationwide cohort involving 239 799 participants. General and gender-specific two-sample Mendelian randomization (MR) analysis was further conducted to assess the causalities of the observed associations. Observationally, a history of gallstones without cholecystectomy was associated with a high risk of stomach cancer (adjusted odds ratio (aOR)=2.54, 95% confidence interval (CI) 1.50-4.28), liver and bile duct cancer (aOR=2.46, 95% CI 1.17-5.16), kidney cancer (aOR=2.04, 95% CI 1.05-3.94), and bladder cancer (aOR=2.23, 95% CI 1.01-5.13) in the general population, as well as cervical cancer (aOR=1.69, 95% CI 1.12-2.56) in women. Moreover, cholecystectomy was associated with high odds of stomach cancer (aOR=2.41, 95% CI 1.29-4.49), colorectal cancer (aOR=1.83, 95% CI 1.18-2.85), and cancer of liver and bile duct (aOR=2.58, 95% CI 1.11-6.02). MR analysis only supported the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer. This study added evidence to the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer, highlighting the importance of cancer screening in individuals with gallstones.
Humans ; Mendelian Randomization Analysis ; Gallstones/complications* ; Female ; Male ; Cholecystectomy/statistics & numerical data* ; Middle Aged ; Risk Factors ; Aged ; Adult ; Neoplasms/etiology* ; Stomach Neoplasms/epidemiology*

Objective:To investigate the factors influencing left atrial fibrosis in patients with atrial fibrillation(AF)and the association of Periostin protein,serum transforming growth factor-β2(TGF-β2)with left atrial fibrosis.Methods:We enrolled 100 AF patients admitted to Gansu Provincial People's Hospital between March 2021 and March 2023.They were divided into control group(＜10％,n=53)and fibrosis group(≥10％,n=47)according to their left atrial low voltage region.Univariate and multivariate Logistic regression were used to analyze the influ-encing factors of left atrial fibrosis in AF patients and construct a nomogram model.The diagnostic value of related factors and their combined detection for left atrial fibrosis in AF patients were analyzed by receiver operating char-acteristic curve(ROC).Spearman correlation analysis was used to analyze the association of Periostin protein,TGF-β2 with left atrial fibrosis in AF patients.Results:Compared to patients in the control group,those in the fibrosis group had significant higher left atrial diameter(LAD)[(37.08±3.19)mm vs.(33.45±2.45)mm],levels of ser-um uric acid(SUA)[(313.75±49.06)μmol/L vs.(279.88±38.15)μmol/L],Periostin protein[(83.27±3.98)ng/L vs.(75.21±3.04)ng/L],TGF-β2[(4346.84±321.34)ng/L vs.(4186.02±306.91)ng/L],and signifi-cant lower left atrial ejection fraction(LVEF)[(62.28±5.00)％vs.(67.24±3.07)％](P＜0.05 or＜0.01).Multivariate Logistic regression analysis showed that LAD(OR=1.663,95％CI 1.238～3.887,P=0.001),SUA(OR=1.586,95％CI 1.164～2.892,P＜0.001),Periostin protein(OR=1.997,95％CI 1.513～4.585,P=0.001),TGF-β2(OR=2.013,95％CI 1.543～5.864,P＜0.001)were independent risk factors for left atrial fi-brosis in AF patients,while LVEF was an independent protective factor(OR=0.524,95％CI 0.141～0.920,P=0.002).The nomogram model for left atrial fibrosis in AF patients:logit(P)=4.631+0.445 × LVEF+0.546 × LAD+0.575 × SUA+0.530 × Periostin protein+0.347 × TGF-β2.ROC curve showed that the area under the curve(AUC)of combined detection(0.893,95％CI 0.842～0.932)was significantly higher than SUA(AUC=0.637,95％CI 0.566～0.704),LVEF(AUC=0.701,95％CI 0.632～0.763),LAD(AUC=0.649,95％CI 0.579～0.715),Periostin protein(AUC=0.676,95％CI 0.606～0.740),TGF-β2(AUC=0.641,95％CI 0.570～0.707)alone(Z=5.265,6.399,6.379,6.040,6.483,P＜0.001 all).Spearman correlation analysis showed that Perios-tin protein and TGF-β2 were significantly positive correlated with left atrial fibrosis in AF patients(r=0.536,0.578,P＜0.001 all).Conclusion:Periostin protein and TGF-β2 were independent risk factors for left atrial fi-brosis in AF patients and were significantly positive correlated with it,a combination of above-mentioned indexes,cardiac function indexes and uric acid had good diagnostic value for left atrial fibrosis.

Hospital pharmacy research is significant in enhancing the level of rational drug use,improving the quality of pharmacy services,and promoting the improvement of drug treatment effects.To guarantee the standardization of hospital pharmacy research,the compilation team of"Hospital Pharmacy Research Standards"adheres to the principles of scientificity,universality,guidance,and operability,combs through the key management contents from three aspects,namely,relevant national policy docu-ments,relevant domestic and international standards and norms,and literature analysis,combines with the actual working condition of hospital pharmacy research,and formulates the standards after several rounds of opinion collection and expert argumentation.This paper analyzes the key contents of the standard,including basic requirements,research process management,and research re-sults management,to provide guidance and reference for hospital pharmacy researchers to understand the standard in-depth and further improve the standardization of hospital pharmacy research.

Objective To investigate the profile of common oral diseases in the Inner Mongolia region and the im-pact on local residents,and to obtain a clear picture of technology availability for local oral physicians and their needs for oral medical training.This will provide an important basis for optimizing the content of continuing educa-tion program and the direction of counterpart assistance in order to improve the technical level of local oral physi-cians and the practicality of oral medical teaching.Methods The study selected oral physicians from the Inner Mongolia region as subjects and designed a questionnaire to explore the current status of oral diseases and the training needs of oral physicians in this area.The chi-square test or Fisher's exact probability method was used for statistical testing.Results Data collected from the survey questionnaires of 181 oral physicians in the Inner Mongolia region indicated that 56.83%of physicians were engaged in routine oral medicine,reaching 56.83%.Dental caries and peri-odontitis were the most common oral diseases in the region(70.37%and 65.74%respec-tively).The most common impacts of these diseases on patients were pain and discomfort.In terms of clinical skills,diagnostic imaging skills,oral examination skills and root canal therapy were the most important as the ob-jective of training there were 70.17%of respondents expressed expectation to get the learning and training opportu-nity for new technologies and methods.Conclusions Continuing education programs and specific targeted assistance projects should focus on strengthening basic professional training for dental practitioners in Inner Mongolia and the promotion of capacity building in the field of healthcare and promotion of oral health in the region.