OBJECTIVES: Accurate identification of risk factors for precocious puberty is essential for clinical diagnosis and management, yet the performance of natural language processing methods applied to unstructured electronic medical record (EMR) data remains to be fully evaluated. This study aims to assess the performance of a prompt engineering method for extracting individual risk factors of precocious puberty from EMRs. METHODS: Based on the capacity and role-insight-statement-personality-experiment (CRISPE) prompt framework, both simple and optimized prompts were designed to guide the large language model GLM-4-9B in extracting 10 types of risk factors for precocious puberty from 653 EMRs. Accuracy, precision, recall, and F1-score were used as evaluation metrics for the information extraction task. RESULTS: Under simple and optimized prompt conditions, the overall accuracy, precision, recall, and F1-score of the model were 84.18%, 98.09%, 81.99%, and 89.32% versus 97.15%, 98.31%, 98.16%, and 98.23%, respectively. The optimized prompts achieved more stable performance across age (<9 years vs ≥9 years) and visit-time (<2023 vs ≥2023) subgroups compared with simple prompts. The accuracy range for extracting each risk factor was 60.03%-97.24%, while with optimized prompts, the range improved to 92.19%-99.85%. The largest performance improvement occurred for "beverage intake" (60.03% vs 92.19%), and the smallest for "maternal age of menarche" (97.24% vs 99.23%). In comparing distributions among simple prompts, optimized prompts, and ground truth, statistically significant differences were observed for snack intake, beverage intake, soy milk intake, honey intake, supplement use, tonic use, sleep quality, and sleeping with the light on (all P<0.001), while exercise (P=0.966) and maternal menarche age (P=0.952) showed no significant differences. CONCLUSIONS Compared with simple prompts, optimized prompts substantially improved the extraction performance of individual risk factors for precocious puberty from EMRs, underscoring the critical role of prompt engineering in enhancing large language model performance.
Humans ; Puberty, Precocious/epidemiology* ; Risk Factors ; Electronic Health Records ; Female ; Child ; Natural Language Processing

Objective To observe the effects of Yiqi Huoxue Tuodu Prescription on Keap1Nrf2/HO-1 signaling pathway in rats with chronic nonbacterial prostatitis(CNP);To explore its mechanism for the treatment of CNP.Methods CNP rat model was prepared using castration combined with estrogen induction method.Totally 48 SD rats were divided into blank group,model group,celecoxib group and Yiqi Huoxue Tuodu Prescription group according to the random number table method,with 12 rats in each group.In the celecoxib group,celecoxib suspension was instilled 0.035 g/kg,and in the Yiqi Huoxue Tuodu Prescription group,Yiqi Huoxue Tuodu Prescription water decoction was instilled 8.64 g/kg,and the blank group and the model group were instilled with equal volume of normal saline for 28 days.Mechanical pain threshold in rats was measured using Von Frey fiber optic pain gauge,HE staining was used to observe pathological changes in prostate tissue and pathological scoring,the content of reactive oxygen species(ROS)in prostate tissue were detected by chemical fluorescence method and the glutathione peroxidase(GSH-Px)activity and malondialdehyde(MDA)content in prostate tissue were detected by colorimetric method,Western blot was used to detect the expressions of Kelch like ECH related protein 1(Keap1),nuclear factor E2 related factor 2(Nrf2),and heme oxygenase-1(HO-1)protein in prostate tissue.Results Compared with the blank group,rats in the model group had significantly lower mechanical pain threshold and significantly decreased prostate index(P<0.01);the size of the glandular cavity in prostate tissue varied,with the disappearance of secretions in the cavity,interstitial looseness and edema,a large amount of fibrous tissue hyperplasia and inflammatory cell infiltration,and a significant increase in pathological scores(P<0.01);the contents of ROS and MDA in prostate tissue significantly increased,the activity of GSH-Px significantly decreased(P<0.01),the expression of Keap1 and Nrf2 proteins significantly decreased,and the expression of HO-1 protein significantly increased(P<0.01,P<0.05).Compared with the model group,the mechanical pain threshold of the rats in the Yiqi Huoxue Tuodu Prescription group was significantly higher(P<0.01);there was mild damage to prostate tissue,with a small amount of fibrous hyperplasia and inflammatory cell infiltration,and a significant decrease in pathological scores(P<0.01,P<0.05);the contents of ROS and MDA in prostate tissue significantly decreased,and the GSH-Px activity significantly increased(P<0.01),the Keap1 and Nrf2 protein expressions significantly increased and HO-1 protein expression significantly decreased in prostate tissue(P<0.01,P<0.05).Conclusion Yiqi Huoxue Tuodu Prescription can effectively improve the histopathological morphology and increase the pain threshold of the prostate gland in CNP rats,and its mechanism of action may be related to the regulation of Keap1/Nrf2/HO-1 signaling pathway and reduction of oxidative stress damage in prostate tissue of rats.

Objective To systematically evaluate the efficacy and safety of mesenchymal stem cells(MSC)in the treatment of acute-on-chronic liver failure(ACLF).Methods This study was conducted according to PRISMA guidelines,with the PROSPERO registration number of CRD42024517851.PubMed,Embase,Wanfang Data,VIP,CNKI,CBM,and the Cochrane Library were searched for randomized controlled trials(RCT)and cohort studies on MSC in the treatment of ACLF published up to November 1,2023,and the articles were screened according to inclusion and exclusion criteria.After data extraction and quality assessment,RevMan 5.3 software was used to perform the Meta-analysis.Results A total of 11 articles involving 803 subjects were included in this meta-analysis.The results showed that for the patients with ACLF,MSC could improve 8-week survival rate(odds ratio[OR]=2.71,95%confidence interval[CI]:1.58-4.67,P=0.000 3),12-week survival rate(OR=2.24,95%CI:1.36-3.69,P=0.001),24-week survival rate(OR=2.09,95%CI:1.37-3.17,P=0.000 6),and 48-week survival rate(OR=2.09,95%CI:1.29-3.40,P=0.003)and reduce 12-week Model for End-Stage Liver Disease(MELD)score(mean difference[MD]=-3.27,95%CI:-6.07 to-0.48,P=0.02)and 24-week MELD score(MD=-2.24,95%CI:-3.16 to-1.33,P<0.000 01);it could also reduce the level of total bilirubin after 4 weeks of treatment(MD=-36.86,95%CI:-48.72 to-25.01,P<0.000 01)and increase 4-week albumin level(MD=2.11,95%CI:0.62-3.61,P=0.006)and 24-week albumin level(MD=3.54,95%CI:2.06-5.02,P<0.000 01).Adverse events were evaluated in 6 studies,with no serious adverse events.Conclusion MSC have a good safety in treatment and can improve the survival rate of patients and enhance liver function to some extent,and therefore,it holds promise for clinical application.

In the context of the high-quality development of public hospitals,it focuses on the task of improving the level of comprehensive budget management,with the difficulties and challenges in budget management in a certain hospital,it explores the path of building a smart financial system to serve comprehensive budget management.The practical application of the system has shown that information technology has effectively improved the budget management level of medical use.At a deeper level,case studies on the construction of the intelligent financial system demonstrate the importance of information technology in assisting hospitals with comprehensive budget management,elucidating the significance of information technology in improving the hospital budget management level and promoting high-quality development.

In the context of the high-quality development of public hospitals,it focuses on the task of improving the level of comprehensive budget management,with the difficulties and challenges in budget management in a certain hospital,it explores the path of building a smart financial system to serve comprehensive budget management.The practical application of the system has shown that information technology has effectively improved the budget management level of medical use.At a deeper level,case studies on the construction of the intelligent financial system demonstrate the importance of information technology in assisting hospitals with comprehensive budget management,elucidating the significance of information technology in improving the hospital budget management level and promoting high-quality development.

In the context of the high-quality development of public hospitals,it focuses on the task of improving the level of comprehensive budget management,with the difficulties and challenges in budget management in a certain hospital,it explores the path of building a smart financial system to serve comprehensive budget management.The practical application of the system has shown that information technology has effectively improved the budget management level of medical use.At a deeper level,case studies on the construction of the intelligent financial system demonstrate the importance of information technology in assisting hospitals with comprehensive budget management,elucidating the significance of information technology in improving the hospital budget management level and promoting high-quality development.

In the context of the high-quality development of public hospitals,it focuses on the task of improving the level of comprehensive budget management,with the difficulties and challenges in budget management in a certain hospital,it explores the path of building a smart financial system to serve comprehensive budget management.The practical application of the system has shown that information technology has effectively improved the budget management level of medical use.At a deeper level,case studies on the construction of the intelligent financial system demonstrate the importance of information technology in assisting hospitals with comprehensive budget management,elucidating the significance of information technology in improving the hospital budget management level and promoting high-quality development.

In the context of the high-quality development of public hospitals,it focuses on the task of improving the level of comprehensive budget management,with the difficulties and challenges in budget management in a certain hospital,it explores the path of building a smart financial system to serve comprehensive budget management.The practical application of the system has shown that information technology has effectively improved the budget management level of medical use.At a deeper level,case studies on the construction of the intelligent financial system demonstrate the importance of information technology in assisting hospitals with comprehensive budget management,elucidating the significance of information technology in improving the hospital budget management level and promoting high-quality development.

In the context of the high-quality development of public hospitals,it focuses on the task of improving the level of comprehensive budget management,with the difficulties and challenges in budget management in a certain hospital,it explores the path of building a smart financial system to serve comprehensive budget management.The practical application of the system has shown that information technology has effectively improved the budget management level of medical use.At a deeper level,case studies on the construction of the intelligent financial system demonstrate the importance of information technology in assisting hospitals with comprehensive budget management,elucidating the significance of information technology in improving the hospital budget management level and promoting high-quality development.

In the context of the high-quality development of public hospitals,it focuses on the task of improving the level of comprehensive budget management,with the difficulties and challenges in budget management in a certain hospital,it explores the path of building a smart financial system to serve comprehensive budget management.The practical application of the system has shown that information technology has effectively improved the budget management level of medical use.At a deeper level,case studies on the construction of the intelligent financial system demonstrate the importance of information technology in assisting hospitals with comprehensive budget management,elucidating the significance of information technology in improving the hospital budget management level and promoting high-quality development.