Under the background of rapid development of artificial intelligence(AI),this paper systematically proposes AI-based education(AIBE).It empowers the teaching process,learning process,research process,and teaching management with AI,and constructs an AI-based educational paradigm,including AI-based teaching(AIBT),AI-based learning(AIBL),AI-based re-search(AIBR),and AI-based management(AIBM).Taking the AI course of immunology teaching as an example,this paper deeply analyzes the practices and explorations of implementing AIBT,AIBL,AIBR and AIBM based on the AI course,so as to accelerate the promotion of the transformation of the fourth generation of medical education.

Objective:To investigate the prognostic value of deep learning-based automated quantification of tumor-stroma ratio (TSR) in patients undergoing neoadjuvant therapy (NAT) for breast cancer.Methods:Specimens were collected from 209 breast cancer patients who received NAT at Renmin Hospital of Wuhan University from October 2019 to June 2023. TSR levels in pre-NAT biopsy specimens were automatically computed using a deep learning algorithm and categorized into low stroma (TSR≤30%), intermediate stroma (TSR 30% to ≤60%), and high stroma (TSR>60%) groups. Residual cancer burden (RCB) grading of post-NAT surgical specimens was determined to compare the relationship between TSR expression levels and RCB grades. The correlation of TSR with NAT efficacy was analyzed, and the association between TSR expression and patient prognosis was further investigated.Results:There were 85 cases with low stroma (TSR≤30%), 93 cases with intermediate stroma (TSR 30% to ≤60%), and 31 cases with high stroma (TSR>60%). Different TSR expression levels showed significant differences between various RCB grades ( P<0.05). Logistic univariate and multivariate analyses showed that TSR was a risk factor for obtaining a complete pathological remission from neoadjuvant therapy for breast cancer when it was used as a continuous variable ( P<0.05); COX regression and survival analyses showed that the lower the percentage of tumorigenic mesenchyme was, the better the prognosis of the patient was ( P<0.05). Conclusions:The deep learning-based model enables automatic and accurate quantification of TSR. A lower pre-treatment tumoral stroma is associated with a lower RCB score and a higher rate of pathologic complete response, indicating that TSR can predict the efficacy of neoadjuvant therapy in breast cancer and thus holds prognostic significance. Therefore, TSR may serve as a biomarker for predicting therapeutic outcomes in breast cancer neoadjuvant therapy.

Experimental teaching is an important component of the course Medical Immunology,which requires the use of experimental animals and the execution of experimental animals by medical students.By applying the carbon dioxide euthanasia system,it can effectively reduce the pain of experimental animals,ensure their welfare,and meet ethical requirements.It can also improve the efficiency of experimental teaching in Medical Immunology,reduce environmental pollution,and promote medical students to estab-lish scientific values and worldviews that pay attention to experimental animals and respect life,which is conducive to becoming future medical service talents.In the experimental teaching of Medical Immunology,the appropriate application of carbon dioxide euthanasia system combined with effective ideological and political construction of the curriculum can further implement the Party's educational policy of cultivating morality and talents,and lay a good foundation for cultivating medical talents with comprehensive knowledge,high skills and excellent quality.

Patients with advanced pregnancy complicated by acute ST-segment elevation myocardial infarction are relatively rare both domestically and internationally,and there are currently no relevant guidelines to guide clinical treatment.In this case,a 39-year-old pregnant woman was admitted to the hospital with sudden chest pain,and the electrocardiogram showed extensive anterior ST-segment elevation myocardial infarction.Coronary angiography showed subtotal subtotal occlusion of the proximal left anterior descending artery.Reperfusion and revascularization were given,and the blood flow grade of the trial of thrombolytic in myocardial infarction was restored.Complete intravascular ultrasonography to determine the cause of occlusion due to spontaneous hematoma of the left anterior descending artery.After the operation,a reasonable antiplatelet and anticoagulant treatment regimen was selected according to the coronary artery lesion,and the pregnancy was terminated at the appropriate time,and 1 live male baby was successfully delivered.Maternal and fetal health was followed up after 1、3 and 6 months.Through the experience and summary of the treatment process,combined with the literature,the pathogenesis of this disease is discussed,and the strategy of revascularization,the selection of antithrombotic drugs and the timing of pregnancy termination are discussed in depth for clinical reference.

Objective:To investigate the prognostic value of deep learning-based automated quantification of tumor-stroma ratio (TSR) in patients undergoing neoadjuvant therapy (NAT) for breast cancer.Methods:Specimens were collected from 209 breast cancer patients who received NAT at Renmin Hospital of Wuhan University from October 2019 to June 2023. TSR levels in pre-NAT biopsy specimens were automatically computed using a deep learning algorithm and categorized into low stroma (TSR≤30%), intermediate stroma (TSR 30% to ≤60%), and high stroma (TSR>60%) groups. Residual cancer burden (RCB) grading of post-NAT surgical specimens was determined to compare the relationship between TSR expression levels and RCB grades. The correlation of TSR with NAT efficacy was analyzed, and the association between TSR expression and patient prognosis was further investigated.Results:There were 85 cases with low stroma (TSR≤30%), 93 cases with intermediate stroma (TSR 30% to ≤60%), and 31 cases with high stroma (TSR>60%). Different TSR expression levels showed significant differences between various RCB grades ( P<0.05). Logistic univariate and multivariate analyses showed that TSR was a risk factor for obtaining a complete pathological remission from neoadjuvant therapy for breast cancer when it was used as a continuous variable ( P<0.05); COX regression and survival analyses showed that the lower the percentage of tumorigenic mesenchyme was, the better the prognosis of the patient was ( P<0.05). Conclusions:The deep learning-based model enables automatic and accurate quantification of TSR. A lower pre-treatment tumoral stroma is associated with a lower RCB score and a higher rate of pathologic complete response, indicating that TSR can predict the efficacy of neoadjuvant therapy in breast cancer and thus holds prognostic significance. Therefore, TSR may serve as a biomarker for predicting therapeutic outcomes in breast cancer neoadjuvant therapy.

Objective:To investigate the feasibility of varicocele ligation with mobile phone microscope.Methods:The high-performance mobile phone and mobile phone stand were combined to act as a mobile phone microscope.And the varicocele ligation was performed under the mobile phone microscope.Results:All five patients successfully underwent varicocelectomy under the guidance of a mobile phone microscope.The average operation time was(112.8±52.2)with ranged from 74.0 to 195.0 minutes.Three pa-tients completed the follow-up after the operation with the proportion of improved sperm quality reaching 100.0％(3/3).Conclusion:High-performance mobile phone microscope can be used for varicocele ligation.

Neurosyphilis is a group of clinical syndromes caused by treponema pallidum invading the central nervous system and causing varying degrees of damage to the brain parenchyma, brain (spinal) membrane or spinal cord. Cerebral syphilitic gumma is the rarest form of neurosyphilis, and its clinical manifestations lack specificity, which is easily confused with other intracranial space occupying lesions on imaging. In this article, a patient with cognitive dysfunction, intracranial hypertension, and imaging findings similar to multicentric glioma was diagnosed as cerebral syphilitic gumma by serology, cerebrospinal fluid test and brain histopathology. The symptoms basically disappeared after treatment with standard penicillin. This report aims to raise awareness of cerebral syphilitic gumma in order to reduce missed diagnosis and misdiagnosis.

Objective To explore whether creatine therapy regulates neuronal ferroptosis by inhibiting the activation of STAT1 signaling pathway associated with suppressor of cytokine signaling 1(SOCS1)in Alzheimer's disease.Methods Immunohistochemical staining and counting of positive results using paraffin sections of human brain frontal lobes were employed to determine the trend of changes in the target proteins.Further validation was performed by immunofluorescence and Western blotting.STAT1 phosphorylation was inhibited by creatine injection using eleven FAD4T mice and by cerebellar medullary pool puncture,and the expression of target proteins was examined by immunohistochemistry and immunofluorescence after postmortem sampling.Results Compared with the age controls,interferon-γ(IFN-γ),an activating cytokine of the STAT1 signaling pathway,and SOCS1,a negative regulator of STAT1 activation,were both significantly up-regulated,STAT1 phosphorylation was enhanced,and the ferroptosis markers ferritin light chain(FTL)and cystine/glutamate transporter(xCT)increased markedly in the cortex of AD human brains;Creatine treatment of FAD4T mice resulted in a reduction of both IFN-γ and SOCS1,and a significant decrease in the ferroptosis markers FTL and xCT(SLC7A11).Conclusion Creatine ameliorates neuronal ferroptosis in AD model mice by reducing neuronal STAT1-SOCS1 signalling activation.

OBJECTIVE: The relationship between fish consumption and stroke is inconsistent, and it is uncertain whether this association varies across predicted stroke risks. METHODS: A cohort study comprising 95,800 participants from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project was conducted. A standardized questionnaire was used to collect data on fish consumption. Participants were stratified into low- and moderate-to-high-risk categories based on their 10-year stroke risk prediction scores. Hazard ratios ( HRs) and 95% confidence intervals ( CIs) were estimated using Cox proportional hazard models and additive interaction by relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI). RESULTS: During 703,869 person-years of follow-up, 2,773 incident stroke events were identified. Higher fish consumption was associated with a lower risk of stroke, particularly among moderate-to-high-risk individuals ( HR = 0.53, 95% CI: 0.47-0.60) than among low-risk individuals ( HR = 0.64, 95% CI: 0.49-0.85). A significant additive interaction between fish consumption and predicted stroke risk was observed (RERI = 4.08, 95% CI: 2.80-5.36; SI = 1.64, 95% CI: 1.42-1.89; AP = 0.36, 95% CI: 0.28-0.43). CONCLUSION Higher fish consumption was associated with a lower risk of stroke, and this beneficial association was more pronounced in individuals with moderate-to-high stroke risk.
Humans ; China/epidemiology* ; Male ; Female ; Stroke/etiology* ; Middle Aged ; Prospective Studies ; Incidence ; Aged ; Animals ; Fishes ; Risk Factors ; Diet ; Seafood ; Adult ; Cohort Studies

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.