Objective To construct large medical model named by "Huaxi HongYi"and explore its application effectiveness in assisting medical record generation. Methods By the way of a full-chain medical large model construction paradigm of "data annotation - model training - scenario incubation", through strategies such as multimodal data fusion, domain adaptation training, and localization of hardware adaptation, "Huaxi HongYi" with 72 billion parameters was constructed. Combined with technologies such as speech recognition, knowledge graphs, and reinforcement learning, an application system for assisting in the generation of medical records was developed. Results Taking the assisted generation of discharge records as an example, in the pilot department, after using the application system, the average completion times of writing a medical records shortened (21 min vs. 5 min) with efficiency increased by 3.2 time, the accuracy rate of the model output reached 92.4%. Conclusion It is feasible for medical institutions to build independently controllable medical large models and incubate various applications based on these models, providing a reference pathway for artificial intelligence development in similar institutions.

Pulpitis is a common infective oral disease in clinical situations. The regulatory mechanisms of immune defense in pulpitis are still being investigated. Osteomodulin (OMD) is a small leucine-rich proteoglycan family member distributed in bones and teeth. It is a bioactive protein that promotes osteogenesis and suppresses the apoptosis of human dental pulp stem cells (hDPSCs). In this study, the role of OMD in pulpitis and the OMD-induced regulatory mechanism were investigated. The OMD expression in normal and inflamed human pulp tissues was detected via immunofluorescence staining. Intriguingly, the OMD expression decreased in the inflammatory infiltration area of pulpitis specimens. The cellular experiments demonstrated that recombined human OMD could resist the detrimental effects of lipopolysaccharide (LPS)-induced inflammation. A conditional Omd knockout mouse model with pulpal inflammation was established. LPS-induced inflammatory impairment significantly increased in conditional Omd knockout mice, whereas OMD administration exhibited a protective effect against pulpitis. Mechanistically, the transcriptome alterations of OMD overexpression showed significant enrichment in the nuclear factor-κB (NF-κB) signaling pathway. Interleukin-1 receptor 1 (IL1R1), a vital membrane receptor activating the NF-κB pathway, was significantly downregulated in OMD-overexpressing hDPSCs. Additionally, the interaction between OMD and IL1R1 was verified using co-immunoprecipitation and molecular docking. In vivo, excessive pulpal inflammation in Omd-deficient mice was rescued using an IL1R antagonist. Overall, OMD played a protective role in the inflammatory response via the IL1R1/NF-κB signaling pathway. OMD may optimize the immunomodulatory functions of hDPSCs and can be used for regenerative endodontics.
Pulpitis/metabolism* ; NF-kappa B/metabolism* ; Animals ; Signal Transduction ; Humans ; Mice ; Mice, Knockout ; Dental Pulp/metabolism* ; Disease Models, Animal ; Lipopolysaccharides

Objective:To analyze the curative effect of the modified sinus tarsi small incision and minimally invasive internal fixation in the treatment of Sander Ⅱand Ⅲ calcaneal fractures and its influence on inflammatory factors and immune function.Methods:From February 2018 to February 2020, 116 patients with Sander Ⅱand Ⅲ calcaneal fractures admitted to the First People′s Hospital of Linping District, Hangzhou City were prospectively selected and randomly divided into the control group and the observation group according to the digital table method. There were 58 cases in each group, the control group was treated with traditional lateral L-shaped incision internal fixation, and the observation group was treated with modified tarsal sinus small incision internal fixation and minimally invasive treatment. The clinical indicators, incision healing, postoperative complications, Bohler angle, Gissane angle, interleukin(IL)-1β, IL-6 , IL-22 and immunoglobulin (IgA, IgG, IgM) before and after surgery were compared between the two groups. The function of the hind foot and ankle were evaluated by American Foot and Ankle Society Ankle and Hindfoot Function Score (AOFAS) before and 6 months after surgery.Results:The operation time, intraoperative blood loss, hospital stay and fracture healing time in the observation group were lower than those in the control group: (61.08 ± 15.17) min vs. (85.82 ± 13.50) min, (27.51 ± 2.64) ml vs. (82.53 ± 3.81) ml, (7.14 ± 1.18) d vs. (10.76 ± 1.50) d, (46.44 ± 8.16) d vs.(52.28 ± 10.40) d, there were statistical differences ( P<0.05). The Bohler angle in the observation group at 3 months after the operation was greater than that in the control group: (26.46 ± 3.64)° vs. (24.55 ± 3.86)°; and Gissane angle was smaller than that in the control group: (113.73 ± 6.56)° vs. (117.09 ± 7.16)°, there were statistical differences ( P<0.05). The grade A healing rate in the observation group was higher than that in the control group: 89.66%(52/58) vs. 32.76%(19/58), χ2 = 39.54, P<0.05. The incidence of complications in the observation group was lower than that in the control group: 3.45%(2/58) vs. 20.69%(12/58), χ2 = 8.12, P<0.05. The levels of IL-1β, IL-6 and IL-22 in the observation group at 3 months after operation were lower than those in the control group, the levels of IgA, IgG and IgM in the observation group at 3 months after operation were higher than those in the control group, there were statistical differences ( P<0.05). Conclusions:The modified tarsal sinus small incision internal fixation and minimally invasive surgery have better curative effect in the treatment of Sander Ⅱ and Ⅲ calcaneal fractures. The function of the hind foot and ankle is restored.

Animals ; Cell Nucleus ; enzymology ; Drosophila Proteins ; genetics ; metabolism ; Drosophila melanogaster ; Extracellular Signal-Regulated MAP Kinases ; genetics ; metabolism ; Long-Term Potentiation ; physiology ; MAP Kinase Signaling System ; physiology ; Memory Consolidation ; physiology ; Neurons ; cytology ; enzymology