Objective: To evaluate the application value of a digital technology-based multiparameter vital signs monitoring system in perioperative comprehensive full-cycle surveillance. Methods: A comprehensive multidimensional vital signs monitoring system was developed through the integration of medical-grade wireless wearable devices, incorporating patch-type ambulatory electrocardiographic monitor, continuous glucose monitoring sensor, pulse oximeter, wireless digital thermometer, smart wristband, and bioelectrical impedance analyzer. This system facilitates continuous real-time acquisition of multiple physiological parameters including electrocardiogram, blood glucose, oxygen saturation, body temperature, physical activity, and body composition indices. The acquired data were systematically integrated and analyzed through a four-level digital architecture consisting of nurse mobile interfaces, bedside patient terminals, centralized ward monitoring displays, and hospital management information systems. One patient with gastric cancer complicated by diabetes mellitus was selected for full-cycle digital monitoring from preoperative evaluation to hospital discharge. The technical performance of the monitoring system was assessed in terms of data acquisition continuity and timeliness of abnormal event alerts. Results: The monitoring system effectively identified early postoperative abnormalities, such as decreased oxygen saturation and blood glucose fluctuations, providing timely guidance for clinical intervention. The built-in algorithm enabled visualization of perioperative stress levels through heart rate variability indices and continuous glucose monitoring data. The patient demonstrated good compliance with early postoperative mobilization, and the satisfaction score for monitoring management was 4 points based on the Likert 5-point scale. Conclusions: The multiparameter vital signs monitoring system enhanced the precision of perioperative management through continuous and dynamic physiological status assessment. Its modular design aligns with the principles of enhanced recovery after surgery, offering a novel technological solution for intelligent perioperative management.
Humans ; Stomach Neoplasms/physiopathology* ; Vital Signs ; Monitoring, Physiologic/instrumentation* ; Diabetes Mellitus ; Wearable Electronic Devices ; Perioperative Period

Gelsemium elegans (G. elegans) is an extremely poisonous plant that is widely distributed in southern China and southeastern Asia. G. elegans poisoning events occur frequently in southern China, and are therefore an urgent public health problem requiring multidisciplinary action. However, the toxic components and toxicological mechanisms remain unclear. Here, we describe a systematic investigation on the toxic components of G. elegans, resulting in the isolation and identification of 120 alkaloids. Based on acute toxicity screening, the structure-toxicity relationship of Gelsemium alkaloids was proposed for the first time. Moreover, gelsedine- and humantenine-type alkaloids were detected in the clinical blood sample, and were confirmed to be causative in the poisoning. The most toxic compound, gelsenicine (1), had selective inhibitory effects toward ventral respiratory group (VRG) neurons in the medulla, which is the main brain region controlling respiration in the central nervous system. Gelsenicine (1) strongly inhibited the firing of action potentials in VRG neurons through its ability to stimulate GABA_A receptors, the main receptors involved in inhibitory neurotransmission. Application of GABA_A receptor antagonists successively reversed action potential firing in gelsenicine (1)-treated VRG neurons. Importantly, the GABA_A receptor antagonists securinine and flumazenil significantly increased the survival of poisoned animals. Our findings provide insight into the components and mechanisms of G. elegans toxicity, and should assist the development of effective emergency treatments for G. elegans poisoning.

Purpose/Significance To conduct the real world research on the application and impact of artificial intelligence(AI)technology in medical institutions,and to assist in intelligent governance decision-making in the field of medicine and health.Method/Process Taking Peking University Third Hospital as the research scene,the AI medical social experiment is carried out through literature meta-analysis,knowledge graph construction and mixed methodology research.Result/Conclusion Scholars at home and abroad are cautious and optimistic about the application of AI technology in the field of health.The research,development and application of AI technology in domestic public hospitals are very active,but small-scale field studies suggest that AI technology may lead to problems such as misleading decision-making and weakening of human subjectivity while improving the efficiency of diagnosis and treatment.In-telligent governance in the field of health,represented by AI technology,requires a long period and a wide range of sociological observa-tions.It is recommended to build a research base for medical AI technology R&D and supervision based on public hospitals,and continue to pay attention to issues such as human subjectivity,medical ethics and scientific and technological ethics in AI social governance.

Objective:To compare the diagnostic efficacy of 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT, 18F-FDG PET/CT and multi-parameter MRI (mpMRI) in prostate cancer (PCa). Methods:Retrospective analysis was conducted on data from 22 patients ((72.6±6.2) years) with pathologically confirmed PCa in the Affiliated Taizhou People′s Hospital of Nanjing Medical University between April 2021 and September 2022. All patients underwent 18F-PSMA-1007 PET/CT, 18F-FDG PET/CT, and mpMRI examination within 30 d, and the imaging parameters were collected, including PSMA-SUV max, FDG-SUV max, minimum apparent diffusion coefficient (ADC min), mean apparent diffusion coefficient (ADC mean), PSMA-SUV max/ADC min, PSMA-SUV max/ADC mean, FDG-SUV max/ADC min, FDG-SUV max/ADC mean. Patients were divided into groups based on the International Society of Urological Pathology (ISUP) grading (≤3 vs >3) and serum total prostate specific antigen (TPSA; ≤20 μg/L vs >20 μg/L), and differences of imaging parameters between groups were compared (Mann-Whitney U test or independent-sample t test). ROC curves were generated to evaluate the diagnostic ability of each parameter for different levels of PCa. χ2 test and ROC curve analysis were used to compare the detection rate and diagnostic efficiency of three imaging methods for primary focus, lymph node metastasis, and bone metastasis in PCa. Results:Differences were found between ISUP≤3 ( n=6) and >3 ( n=16) groups in PSMA-SUV max/ADC min, PSMA-SUV max/ADC mean, PSMA-SUV max, and ADC min ( z values: from -2.65 to -2.36, t=3.60, P values: 0.002-0.018). But there was no significant difference found between TPSA≤20 μg/L ( n=5) and >20 μg/L ( n=17) groups in all indices ( z values: from -1.76 to -1.45, t values: -1.19 and 1.28, all P>0.05). The optimal cut-off value for PSMA-SUV max/ADC min in differentiating high-grade and low-grade PCa was determined to be 22.628×10 3. In the patient-based analysis, no statistical difference was found in the detection rate of PCa primary tumors among 18F-PSMA-1007 PET/CT, 18F-FDG PET/CT, and mpMRI ( χ2=1.91, P=0.767). However, the detection rates of lymph node and bone metastasis among three imaging methods were significantly different (72.73%(16/22), 59.09%(13/22), 36.36%(8/22) and 81.82%(18/22), 63.64%(14/22), 45.45%(10/22); χ2 values: 6.03, 6.29; P values: 0.049, 0.043). 18F-PSMA-1007 PET/CT resulted in a 36.36%(8/22) increase in N stage and the 40.91%(9/22) increase in M stage compared to mpMRI. Conclusions:PSMA-SUV max/ADC min is a valuable parameter for differentiating high-grade and low-grade PCa. 18F-PSMA-1007 PET/CT demonstrates superior detection rate of PCa lymph node and bone metastasis compared to 18F-FDG PET/CT and mpMRI, and exhibits higher diagnostic efficiency, so it can be recommended for NM staging in patients with PCa.

Objective To explore the clinical features,diagnostic methods,and treatment strategies for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)encephalitis confirmed through cerebrospinal fluid(CSF)analysis.Methods The clinical data of patients diagnosed with SARS-CoV-2 encephalitis through CSF analysis in the Neurology Intensive Care Unit of the First Affiliated Hospital of Nanchang University from March 2022 to March 2023 were collected.Additionally,the relevant literature published in both domestic and international databases was analyzed and synthesized.Results The main neurological manifestations of five cases included decreased consciousness(5/5),psychiatric disorder(2/5),seizures(2/5),quadriplegia(1/5),and headaches(1/5).Two cases had abnormal brain magnetic resonance imaging(MRI)changes,involving the temporal lobe,insular lobe,thalamus,hippocampus,and pons.Additionally,CSF analysis showed mildly elevated protein levels in two cases.Next-generation sequencing(NGS)of the CSF identified SARS-CoV-2 in all five cases(sequence:41-1620),and human herpesvirus 1 in one case(sequence:21).The treatment regimen for all cases included antiviral therapy,three were additionally treated with glucocorticoids and one received immunoglobulin therapy.All cases achieved a favorable outcome(mRS:0-2).Conclusion SARS-CoV-2 has the potential to induce encephalitis/meningitis due to its neurotropic nature.The consideration of this condition is warranted in patients with relevant epidemiological history and symptoms related to the central nervous system.CSF NGS serves as a valuable tool for early diagnosis,while active antiviral therapy and immunotherapy may improve patient outcomes.

Objective To investigate the effect and potential molecular mechanism of PTGS2 on the prognosis of colon cancer patients.Methods The transcriptomic and proteomic data of pan-cancer were collected from TCGA,HPA,UALCAN and other databases,and the expression pattern and prognostic value of PTGS2 were analyzed by combining the clinical data such as staging,histology,survival time and so on.Based on GSEA,the biological functions which were significantly activated in patients with high expression of PTGS2 were iden-tified and the colon cancer cell line SW480 was used as an example for in vitro validation.PTGS2 over-expressing cell strains were constructed,and the effect on cell proliferation was determined by CCK8 method.Different concen-trations of H2O2 were used to form gradient oxidative stress,and the changes in cell antioxidant capacity were detected.The regulatory mechanism was preliminarily verified by Western blot.Results The transcription and expression of PTGS2 were found to be significantly up-regulated in colon cancer patients(P<0.05),and the increased expression of PTGS2 was associated with an increased mortality risk(P<0.05).Data analysis and in vitro experiments showed that over-expression of PTGS2 may promote the proliferation of colon cancer cells by activating the mTOR pathway.The antioxidant effect of cells was regulated by up-regulating oxidative stress regulatory proteins SOD2 and NRF2.Conclusions PTGS2 is a potential risk factor for colon cancer and its over-expression promotes cell proliferation,enhances cell antioxidant effect and is associated with poor progno-sis of colon cancer patients.

Objective:To explore the clinical application pathway of the CT generative adversarial networks (CTGANs) algorithm in mandibular reconstruction surgery, aiming to provide a valuable reference for this procedure.Methods:A clinical exploratory study was conducted, 27 patients who visited the Department of Oral and Maxillofacial Surgery, Xiangya Hospital of Central South University between January 2022 and January 2024 and required mandibular reconstruction were selected. The cohort included 16 males and 11 females, with the age of (46.6±11.5) years; among them, 7 cases involved mandibular defects crossing the midline. The CTGANs generator produced 100 images, and the mean squared error (MSE) was calculated for differences between any two generated images. Preoperative cone-beam CT data from 5 patients were used to construct a labeled test database, divided into groups: normal maxilla, normal mandible, diseased mandible, and noise (each group containing 70 cross-sectional images). The CTGANs discriminator was used to evaluate the loss values for each group, and one-way ANOVA and intergroup comparisons were performed. Using the self-developed KuYe multioutcome-option-network generation system (KMG) software, the three-dimensional (3D) completion area of the mandible under cone-beam CT was defined for the 27 patients. The CTGANs algorithm was applied to obtain a reference model for the mandible. Virtual surgery was then performed, utilizing the fibular segment to reconstruct the mandible and design the surgical expectation model. The second-generation combined bone-cutting and prebent reconstruction plate positioning method was used to design and 3D print surgical guides, which were subsequently applied in mandibular reconstruction surgery for the 27 patients. Postoperative cone-beam CT was used to compare the morphology of the reconstructed mandible with the surgical expectation model and the mandibular reference model to assess the three-dimensional deviation.Results:The MSE for the CTGANs generator was 2 411.9±833.6 (95% CI: 2 388.7-2 435.1). No significant difference in loss values was found between the normal mandible and diseased mandible groups ( P>0.05), while both groups demonstrated significantly lower loss values than the maxilla and noise groups ( P<0.001). All 27 patients successfully obtained mandibular reference models and surgical expectation models. In total, 14 162 negative deviation points and 15 346 positive deviation points were observed when comparing the reconstructed mandible morphology with the surgical expectation model, with mean deviations of -1.32 mm (95% CI:-1.33- -1.31 mm) and 1.90 mm (95% CI: 1.04-1.06 mm), respectively. Conclusions:The CTGANs algorithm is capable of generating diverse mandibular reference models that reflect the natural anatomical characteristics of the mandible and closely match individual patient morphology, thereby facilitating the design of surgical expectation models. This method shows promise for application in patients with mandibular defects crossing the midline.

Objective:To study the operation pattern and valuable experiences of the internationally renowned Proof-of-Concept Center(PoCC), and to improve the construction and management of PoCC in clinical medicine of our country.Methods:The data of basic structure, operation model, and performance in the health field of major PoCCs in the United States and Europe were compiled by literature review, policy combing, and official website search, and analyzed and summarized in combination with the basic national conditions and our practical experience.Results:The fundamental function of a PoCC consists of research and development support, science and technology evaluation, and communication services. The key points of building a PoCC include clear targets of service, widely opened resources, diversified operation patterns, and professional personnel.Conclusions:In China, PoCCs in the clinical medicine field could be built upon public hospitals with the full participation of physicians. Interdisciplinary cooperation, flexible mechanism, and versatile talents in technical management are also essential.

Vascular dementia (VaD) is the second commonest type of dementia which lacks of efficient treatments currently. Neuroinflammation as a prominent pathological feature of VaD, is highly involved in the development of VaD. In order to verify the therapeutic potential of PDE1 inhibitors against VaD, the anti-neuroinflammation, memory and cognitive improvement were evaluated in vitro and in vivo by a potent and selective PDE1 inhibitor 4a. Also, the mechanism of 4a in ameliorating neuroinflammation and VaD was systematically explored. Furthermore, to optimize the drug-like properties of 4a, especially for metabolic stability, 15 derivatives were designed and synthesized. As a result, candidate 5f, with a potent IC₅₀ value of 4.5 nmol/L against PDE1C, high selectivity over PDEs, and remarkable metabolic stability, efficiently ameliorated neuron degeneration, cognition and memory impairment in VaD mice model by suppressing NF-κB transcription regulation and activating cAMP/CREB axis. These results further identified PDE1 inhibition could serve as a new therapeutic strategy for treatment of VaD.

Objective:To explore the development path of improving the intangible assets management, and promoting science and technology transfer of public hospitals.Methods:Analyze and summarize problems and challenges in the identification and disposal of intangible assets related to scientific and technological achievements in the process of technology transfer based on policy research, literature review and practical experience reflection.Results:So far, the identification and measurement norms of intangible assets are not operable enough. Assets evaluation remains controversial and nonstandard.Conclusions:It is recommended to improve the management systems of science and technology transfer and related financial affairs including strengthening the awareness of intangible assets protection, standardizing the management system of intangible assets and optimizing the informatization construction of financial management.