Objective To investigate the impact of large language models on medical record coding,providing insights for the medical record management industry and professionals to better understand,familiarize with,and utilize large language models.Methods The study compared the time consumption,completion rate,and accuracy rate of coding 93 rare diseases u-sing ICD-10 codes between manual search and multiple large language models,elucidating the influence of large language models on medical record coding.Results In terms of coding time consumption,Model A and Model B required the least time,comple-ting all coding in 8 minutes,which is 90 times faster than manual search.Regarding completion rate,all models except Model C(91.4％)achieved 100％.In terms of accuracy rate,Model A was the highest(87.1％),surpassing manual search coding(84.9％).Model B and Model C had similar accuracy rates,47.3％and 43.5％respectively,while Model D had the lowest(0％).Conclusion There is a significant difference in coding accuracy among different large language models,but the accura-cy of Model A has already surpassed that of manual search coding.This demonstrates the powerful capabilities and potential of large language models in medical record coding.In the future,AI based on large language models may replace much of the manu-al work in disease coding.

Objective Guided by"Medical Record Management Quality Control Indicators(2021 Edition)"(hereafter regarded as Medical Record Quality Indicators),this study aims to evaluate the quality of inpatient hospice medical records at a tertiary hospital in Guangzhou.Methods A total of 1,071 inpatient hospice medical records from the year 2023 in a tertiary gen-eral hospital in Guangzhou were selected for evaluation.The evaluation focused on three aspects:documentation compliance of documentation of critical examinations(including CT/MRI,pathology,and pathogen examinations),the compliance rate of treat-ment behavior records(encompassing antibiotic usage,chemotherapy or radiotherapy or targeted or immunotherapy for malignant tumors,and surgical records),and the incidence of unreasonable duplication within medical record.Results The compliance rate for major examination records ranged from 47.7％to 100.0％,with the lowest compliance rate(47.7％)observed in docu-mentation of pathogen culture analysis.Treatment behavior documentation compliance varied from 49.1％to 100.0％,with the lowest compliance rate of 49.1％observed in the recording of antibiotic usage.Rates of inappropriate duplication ranged from 1.0％to duplication(63.1％),with the highest rate of 63.1％occurring when initial progress notes replicated admission histo-ries without synthesis(63.1％).Conclusion The Medical Record Management Quality Control Indicators serves as an effective tool for evaluating the dimensions of medical record quality and offers a systematic framework for enhancing documentation integri-ty within hospitals.

Objective To investigate the impact of large language models on medical record coding,providing insights for the medical record management industry and professionals to better understand,familiarize with,and utilize large language models.Methods The study compared the time consumption,completion rate,and accuracy rate of coding 93 rare diseases u-sing ICD-10 codes between manual search and multiple large language models,elucidating the influence of large language models on medical record coding.Results In terms of coding time consumption,Model A and Model B required the least time,comple-ting all coding in 8 minutes,which is 90 times faster than manual search.Regarding completion rate,all models except Model C(91.4％)achieved 100％.In terms of accuracy rate,Model A was the highest(87.1％),surpassing manual search coding(84.9％).Model B and Model C had similar accuracy rates,47.3％and 43.5％respectively,while Model D had the lowest(0％).Conclusion There is a significant difference in coding accuracy among different large language models,but the accura-cy of Model A has already surpassed that of manual search coding.This demonstrates the powerful capabilities and potential of large language models in medical record coding.In the future,AI based on large language models may replace much of the manu-al work in disease coding.

Objective Guided by"Medical Record Management Quality Control Indicators(2021 Edition)"(hereafter regarded as Medical Record Quality Indicators),this study aims to evaluate the quality of inpatient hospice medical records at a tertiary hospital in Guangzhou.Methods A total of 1,071 inpatient hospice medical records from the year 2023 in a tertiary gen-eral hospital in Guangzhou were selected for evaluation.The evaluation focused on three aspects:documentation compliance of documentation of critical examinations(including CT/MRI,pathology,and pathogen examinations),the compliance rate of treat-ment behavior records(encompassing antibiotic usage,chemotherapy or radiotherapy or targeted or immunotherapy for malignant tumors,and surgical records),and the incidence of unreasonable duplication within medical record.Results The compliance rate for major examination records ranged from 47.7％to 100.0％,with the lowest compliance rate(47.7％)observed in docu-mentation of pathogen culture analysis.Treatment behavior documentation compliance varied from 49.1％to 100.0％,with the lowest compliance rate of 49.1％observed in the recording of antibiotic usage.Rates of inappropriate duplication ranged from 1.0％to duplication(63.1％),with the highest rate of 63.1％occurring when initial progress notes replicated admission histo-ries without synthesis(63.1％).Conclusion The Medical Record Management Quality Control Indicators serves as an effective tool for evaluating the dimensions of medical record quality and offers a systematic framework for enhancing documentation integri-ty within hospitals.

Objective:To establish a method for detecting the binding affinity of peptides to HLA-B*1301 by HLA molecular reconstitution after weak acid treatment,and its practicality was evaluated.Methods:C1R cells overexpressing HLA-B*1301 were treated with citrate buffer of different pH for different time.After neutralization of pH,cells were resuspended in culture medium con-taining β2m and brefeldin A.Cells were incubated at 37℃with peptide(peptide group)or without peptide(blank control),after addition of anti-HLA antibody,the cells were detected by flow cytometry.Ratio of fluorescence intensity between peptide group and blank control group was used as an index to measure the level of HLA molecular remodeling,and then represented the interactions between peptide and HLA-B*1301 molecule.Results:HLA-polypeptide complex was denatalized and dissociated after being treated with pH3.0 buffer for 1 min,and only HLA heavy chain molecules were retained on the cell surface.The addition of peptides with binding force could significantly improve the level of HLA molecular remodeling,and the binding force of peptides with HLA-B*1301 could be evaluated by this method.Conclusion:HLA molecular reconstitution assay is a simple and reliable method to detect the binding of peptides to HLA-B*1301,which can also provide reference for the study of other low frequency HLA molecular antigen pre-sentation patterns.

Objective: To understand the allocation of health staff and clinics in primary and secondary schools in Guangdong Province, so as to provide a reference for school health construction. Methods: In December 2020, a total of 17 205 primary and secondary schools in 21 cities in Guangdong Province were investigated by combining document verification and on site surveys. The allocation of health staff and clinics in different cities and types of schools was analyzed using SPSS 25.0 software. Results: The proportion of schools in Guangdong Province that met the national standard for school health staff ratio was 37.7%. Among different types of schools, the lowest ratio was found in nine year schools (33.1%), while the highest was in twelve year schools (61.3%). Among the 17 205 schools in the province, 12.6% had clinics with an area of >40 m 2, and 6.9% with occupational licenses for medical institutions. The proportion of full time health staff was 39.1%. Among all school health staffs, the proportions of permanent staff, temporary staff, and appointed staff were 47.5%, 29.0% and 23.6%, respectively. The rate of school health staff with professional qualifications was 44.9%, while 48.3% had graduated from medical related majors, and 20.9% held a bachelor s degree or higher as their first degree. There were differences among various types of schools, with primary schools having the lowest health staff configuration and professional level (24.0% and 35.7%, respectively). Conclusions There are still issues of insufficient staff and low professional level in health staff and establishment of clinics in primary and secondary schools in Guangdong Province, and the allocation is uneven across different types of schools. The allocation of clinics in the province is still in urgent need of improvement.

Objective To investigate the effect of venlafaxine on learning and memory ability in rats with vascular dementia(VD).Methods Totally 90 Wistar rats were divided into sham-operation group,model group and treatment group (n=30 for each).The VD rat model was established by modified pulsinellis 4-vessel occlusion (4 VO).Rats in the sham-operation group and model group were administered with gastric perfusion of distilled water.Rats in the treatment group were administrated with gastric perfusion of Venlafaxine at 15 mg/kg per day for 4 weeks from the 2nd day after the modeling.The one-way avoidance test was performed to study the learning-memory ability of each group.The contents of norepinephrine,5-hydroxytryptamine and BDNF in the hippocampus and cortex of rats were observed.Results Model group demonstrated a decrease in the percentage of one-way avoidance test (50.3±6.2 vs.92.3±5.6,P＜0.01) as compared with sham-operation group,and this value was increased in treatment group (62 2±4.6).Compared with the sham-operation group,the contents of NE and 5-HT in the hippocampus [(226±34) pg/g and (340±40) pg/g],and cortex [(601±66) pg/g and (657±43) pg/g] in rat brains of model group were decreased (P＜0.01),while increased in treatment group [(264±45) pg/g and (379±42)pg/g,(665±68) pg/g and (798±51)pg/g,P＜0.05].The OD value of BDNF in the hippocampus (0.495±0.041) and cortex (0.488±0.042) were increased (P＜0.05) in model group,and in treatment group,BDNF levels were more higher (0.579±0.044 and 0.578±0.06/4,P＜0.05).Conclusions The content of brain monoamine neurotransmitters are decreased in rats with VD,while venlafaxine can improve the learning memory ability in model rats through increasing the levels of 5-HT,NE and BDNF in hippocampus and cortex.

Objective To explore the possible molecular mechanism of Ginsenoside Rg1 preventing against 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)-induced substantia nigra neurons apoptosis in Parkinson disease(PD) mouse model. Methods C57BL mice were administrated(sc) with MPTP to produce PD mouse model.Different doses of Rg1(5.0,10.0,20.0*!mg/kg) were given(ip) prior 3*!d to MPTP in the pretreatment groups.Nissl staining,tyrosinehydroxythase(TH) immunostatining,cleaved caspase-3 immunostatining and TUNEL staining were used to observe the changes of nigra neurons,meanwhile,Western blot was used to detect the phosphorylated protein of JNK and c-Jun in substantia nigra. Results Pretreatment with Rg1 could prevent the loss of Nissl staining neurons and TH-positive neurons,inhibit JNK and c-Jun phosphorylation in SN,decrease the percent of cleaved caspase-3 and TUNEL-positive cell.Conclusion Rg1 can attenuate MPTP-induced apoptosis in substantia nigra neurons through blocking JNK signaling cascade.

AIM: To study the possible molecular mechanism of beta-amyloid peptide_ 1-40 -induced apoptosis in rat cortical neurons. METHODS: 40 mg/L beta-amyloid peptide_ 1-40 (A?_ 1-40 ) was used to induce apoptosis in cultured rat cortical neurons. The level of CDK4, phosphorylated pRB were detected by flow cytometry and immunoblotting; RT-PCR was used to examine the mRNA expression of E2F1 while fluorescent spectrofluorometer was used to measure caspase-3 activity. All of the above study was designed to observe whether the level of CDK4, phosphorylated pRB and E2F1 mRNA expression could be affected by A?_ 1-40 . RESULTS: (1)The level of CDK4, phosphorylated pRB increased markedly 2-4 hours after treatment with A?_ 1-40 , and caspase-3 activity elevated remarkably 12-24 hours after treatment with A?_ 1-40 ; (2) E2F1 mRNA expression was upregulated 3 hours after incubation with A?_ 1-40 . CONCLUSION: A?_ 1-40 may induce apoptosis in rat cortical neurons in a manner dependent on CDK4-pRB-E2F1 pathway.

AIM: To explore the possible signal transduction pathway of 1-methyl-4-phenylpyridinium(MPP +)-induced apoptosis. METHODS: The apoptosis of SHSY5Y cells induced by MPP + was observed by acridine orange-ethidium bromide(AO-EB) staining. Western blot was used to detect the activity of JNK in SHSY5Y cells, and the antisense oligo- neucleutide of JNK were used as inhibitor of JNK. RESULTS: MPP + induced apoptosis in SHSY5Y cells. During the apoptotic process, JNK activity increased. MPP +-induced apoptosis in SHSY5Y cells was obviously inhibited by pretreatment with NAC or by transfection with antisense oligonucleotide of JNK into SHSY5Y cells. Simultaneously, decrease in JNK activity and percentage of positive cleaved caspase-3 cells in these groups were also observed. CONCLUSION: The possible signal transduction pathway of MPP +-induced apoptosis in SHSY5Y cells might be attributed to the production of ROS ,activation of JNK and then activation of caspase 3.