In the context of the rapid development of 5G technology， the development of artificial intelligence （AI） in traditional Chinese medicine （TCM） faces new opportunities and challenges. Focusing on how to uphold tradition while innovating in the development of AI in TCM， starting from the current development status of AI in Chinese medicine， including the integration of four diagnostic methods， syndrome differentiation and treatment， auxiliary diagnosis and treatment， research and development of Chinese herbal medicine， prevention and treatment of diseases， knowledge inheritance， and other aspects， this paper discussed the support of policies and technical advancements， as well as development opportunities such as increased demand for health. Regarding machine ethics， data ethics， regulatory review， and other aspects， it also proposed some suggestions that the training algorithm should be improved to assist medical work； data ownership should be clarified to ensure data security； and an AI ethics committee should be set up to improve the review system， aiming to maximize the advantages of smart healthcare and accelerate the modernization of TCM for the benefit of patients and the service of human health.

BACKGROUND:Traditional methods of urinary tract reconstruction are limited by donor scarcity,high complication rates,and suboptimal functional recovery.Tissue engineering strategies offer new directions in this field.Since the urinary tract is mainly composed of muscle tissue,the key is to find suitable seed cells and efficiently induce them to differentiate into smooth muscle cells.Comparative studies on the efficacy of different smooth muscle cell induction regimens are still lacking. OBJECTIVE:To isolate,culture,and identify human urine-derived stem cells,and to compare the effects of two different induction protocols. METHODS:Human urine-derived stem cells were isolated from urine samples of 11 healthy adult volunteers by multiple centrifugations.Surface markers were identified by flow cytometry.The multi-directional differentiation potential of human urine-derived stem cells was verified through osteogenic and adipogenic differentiation.Differentiation was induced by transforming growth factor-β1 or transforming growth factor-β1 combined with platelet derived growth factor for 14 days.Immunofluorescence staining and western blot assay were employed to compare the expression differences of smooth muscle-specific proteins(α-SMA and SM22). RESULTS AND CONCLUSION:(1)Urine-derived stem cells were successfully isolated from the eight urine samples of healthy people.These cells exhibit a"rice grain"-like morphology and possess a robust proliferative capacity.(2)Urine-derived stem cells exhibited high expression of mesenchymal stem cell surface markers(CD73,CD90,and CD44)and extremely low expression of hematopoietic stem cell surface markers(CD34 and CD45).These cells did not express CD19,CD105,and HLA-DR.(3)After osteogenic and adipogenic differentiation,the formation of calcium nodules and lipid droplets was observed,with positive staining results from Alizarin Red S and Oil Red O staining.(4)After 14 days of smooth muscle induction culture,immunofluorescence staining revealed that the smooth muscle differentiation rate of urine-derived stem cells treated with a combination of transforming growth factor-β1 and platelet derived growth factor was significantly higher compared to those treated with transforming growth factor-β1 alone(P<0.005).(5)After 14 days of smooth muscle induction culture,western blot assay further demonstrated that the expression levels of α-SMA and SM22 in the transforming growth factor-β1/platelet derived growth factor group were significantly elevated compared to those in the transforming growth factor-β1 only group(P<0.005).These findings confirm that urine-derived stem cells can be non-invasively isolated using multiple rounds of centrifugation.Compared with transforming growth factor-β1 alone,the combination of transforming growth factor-β1 and platelet derived growth factor can improve the efficiency of inducing urine-derived stem cells to differentiate into smooth muscle cells.

Staphylococcus aureus is a Gram-positive bacterium with strong pathogenicity. With the widespread use of antibiotics， its multi-drug resistance has gradually increased. Among them， methicillin-resistant S. aureus （MRSA） is one of the main pathogens of hospital and community infections. Antimicrobial peptides are short-chain peptides with good antibacterial effects and low drug resistance， which have been widely studied in recent years. This study summarizes the mechanism of action of antimicrobial peptides and related study on antimicrobial peptides against MRSA from different sources. It is found that the mechanisms of action of antimicrobial peptides include targeting bacterial cell membranes， bacterial cells， and bacterial cell walls， etc. Besides isolating antimicrobial peptides with anti-MRSA activity from animals， plants， and microorganisms， antimicrobial peptides can also be obtained through synthetic methods. Among them， GHa-derived peptides from animal sources， Ib-AMP4 from plant sources， Ph-SA from microbial sources， the synthetic peptide LLKLLLKLL-NH2， and so on， due to their effective antibacterial activity， rapid bactericidal speed， and low toxicity， are promising candidates for anti-MRSA drugs.

OBJECTIVES: The Charlson comorbidity index reflects overall comorbidity burden and has been applied in cardiovascular medicine. However, its role in predicting in-hospital mortality in patients with acute myocardial infarction (AMI) complicated by ventricular arrhythmias (VA) remains unclear. This study aims to evaluate the predictive value of the Charlson comorbidity index in this setting and to construct a nomogram model for early risk identification and individualized management to improve outcomes. METHODS: Using the open-access critical care database MIMIC-IV (Medical Information Mart for Intensive Care IV), we identified intensive care unit (ICU) patients diagnosed with AMI complicated by VA. Patients were grouped according to in-hospital survival. The predictive performance of the Charlson comorbidity index and other clinical variables for in-hospital mortality was analyzed. Key predictors were selected using the least absolute shrinkage and selection operator (LASSO) regression, followed by multivariable Logistic regression. A nomogram model was constructed based on the regression results. Model performance was assessed using receiver operating characteristic (ROC) curves and calibration plots. RESULTS: A total of 1 492 patients with AMI and VA were included, of whom 340 died and 1 152 survived during hospitalization. Significant differences were observed between survivors and non-survivors in sex distribution, vital signs, comorbidity burden, organ function, and laboratory parameters (all P<0.05). The area under the curve (AUC) of the Charlson comorbidity index for predicting in-hospital mortality was 0.712 (95% CI 0.681 to 0.742), significantly higher than albumin, international normalized ratio (INR), hemoglobin, body temperature, and platelet count (all P<0.001), but comparable to Sequential Organ Failure Assessment (SOFA) score (P>0.05). LASSO regression identified seven key predictors: the Charlson comorbidity index (quartile groups: T1, <6; T2, ≥6-<7; T3, ≥7-<9; T4, ≥9), ventricular fibrillation, age, systolic blood pressure, respiratory rate, body temperature, and SOFA score. Multivariate Logistic regression showed that compared with T1, mortality risk increased significantly in T2 (OR=1.996, 95% CI 1.135 to 3.486, P=0.016), T3 (OR=3.386, 95% CI 2.192 to 5.302, P<0.001), and T4 (OR=5.679, 95% CI 3.711 to 8.842, P<0.001). Age (OR=1.056, P<0.001), respiratory rate (OR=1.069, P<0.001), SOFA score (OR=1.223, P<0.001), and ventricular fibrillation (OR=2.174, P<0.001) were independent risk factors, while systolic blood pressure (OR=0.984, P<0.001) and body temperature (OR=0.648, P<0.001) were protective factors. The nomogram incorporating these predictors achieved an AUC of 0.849 (95% CI 0.826 to 0.871) with high discrimination and good calibration (mean absolute error=0.014). CONCLUSIONS The Charlson comorbidity index is an independent predictor of in-hospital mortality in AMI patients complicated by VA, with performance comparable to the SOFA score. The nomogram model based on the Charlson comorbidity index and additional clinical variables effectively estimates mortality risk and provides a valuable reference for clinical decision-making.
Humans ; Nomograms ; Hospital Mortality ; Myocardial Infarction/complications* ; Male ; Female ; Comorbidity ; Middle Aged ; Aged ; Arrhythmias, Cardiac/complications* ; ROC Curve ; Intensive Care Units

Natural polysaccharides have important physiological effects on immune regulation,and their effects on natural and ac-quired immunity are worthy of further discussion.Natural polysaccharides can regulate the innate immune system by regulating macro-phages,natural killer cells,inflammatory response,physiological barrier,complement system,and oxidation of the body,and they can also regulate the adaptive immune system by regulating humoral immunity and cellular immunity.Therefore,this article reviews the re-search advances in the role of natural polysaccharides in innate immunity and adaptive immunity,in order to provide new ideas for fur-ther research.

Tumor microenvironment(TME)is the cellular environment for tumor development,growth,and metastasis.Adenosine(ADO)is an immunosuppressive metabolic product that is continuously upregulated in TME,with various types and wide distribution of receptors.The complex and dynamic interactions between ADO and tumor cells constantly influence tumor progression.ADO can di-rectly or indirectly promote tumor development and progression by promoting tumor generation and metastasis,mediating the immune escape of tumor,and modulating tumor-infiltrating immune cells.Based on the characteristics of ADOs in TME,this article reviews the latest advances in the dynamic alterations of ADO in TME,in order to provide insights into tumor treatment targeting the ADO pathway.

BackgroundNon-suicidal self-injury （NSSI） behavior among adolescents has become a global public health concern. Anxiety and depression are considered key factors influencing NSSI behavior， while social support may play a protective role in alleviating emotional and behavioral issues. However， existing research has primarily focused on the direct impact of individual factors on NSSI behavior， with insufficient exploration of the combined effects of anxiety， depression and social support. ObjectiveTo investigate the direct effect of anxiety on NSSI， the mediating role of depression and the moderating role of social support in relationship between anxiety and NSSI behavior， thus to provide references for the prevention and intervention of NSSI behavior among adolescents. MethodsIn February 2022， a total of 40 820 students in grades 7 to 12 across 10 middle schools in a district of Chengdu were selected as participants， and they were assessed using Generalized Anxiety Disorder Scale-7 item （GAD-7）， Patient's Health Questionnaire Depression Scale-9 item （PHQ-9）， Social Support Scale for Urban Students （SSSUS） and Adolescent Self-Harm Scale （ASHS）. Pearson correlation analysis was conducted to examine the correlations between scale scores among adolescents with NSSI behaviors. Mediation and moderation analyses were performed using Process 3.5 in SPSS， and the significance was tested with bootstrapping. The interaction was visualized by using simple slope analysis. ResultsAmong 34 534 （84.60%） valid respondents， 542 adolescents （1.57%） reported engaging in NSSI behavior. Significant differences in gender， GAD-7 scores， PHQ-9 scores， and SSSUS scores were observed between NSSI behavior group and non-NSSI group （χ²/t=62.889， 71.120， 94.365， -41.464， P<0.01）.Adolesents with NSSI showed positive correlations between GAD-7 scores and both ASHS and PHQ-9 scores （r=0.158， 0.166， P<0.01）. PHQ-9 scores were positively correlated with ASHS scores （r=0.364， P<0.01）， but negatively correlated with SSSUS scores （r=-0.290， P<0.01）. SSSUS scores were negatively correlated with ASHS scores （r=-0.247， P<0.01）. Depression partially mediated the relationship between anxiety and NSSI behavior， with an effect size of 0.544 （95% CI： 0.162~0.944）， accounting for 35.79% of the total effect. Social support moderated the relationship between depression and NSSI bahavior， with an effect value of -0.082 （95% CI： -0.135~-0.029）. ConclusionAnxiety not only directly influences NSSI bahavior among adolescents， also indirectly exacerbates it through depression， while social support mitigates the impact of depression on NSSI behavior. ［Funded by Youth Project of National Natural Science Foundation of China （number， 82401812）； Project of Health Commission of Sichuan Province （number， 24LCYJPT18）］

Objective:To explore the safety, economic benefits, and clinical application effect of the new practical patent open window central venous catheter combination dressing (Patent No.ZL 202121652858.8).Methods:From October 2022 to October 2023, a randomized controlled trial was conducted. A total of 120 tumor patients in Yunnan Cancer Hospital with indwelling central venous catheters who met the inclusion and exclusion criteria were randomly divided into three groups at a ratio of 1∶1∶1 with random digit table, with 40 patients in each group: control group 1, control group 2, and the experimental group. In control group 1, Smith & Nephew IV 3000 dressing was used, in control group 2, 3M transparent dressing was used; and in the experimental group, the self - developed fenestrated central venous catheter combined dressing by the researchers was used for catheter maintenance. The skin surface bacterial colonization, the occurrence of medical adhesive-related skin injuries, catheter maintenance time, and maintenance costs were compared among the three groups.Results:In control group 1, there were 21 males and 19 females, with an average age of (51.53 ± 12.01) years. In control group 2, there were 22 males and 18 females, with an average age of (54.00 ± 11.03) years. In the experimental group, there were 19 males and 21 females, with an average age of (53.60 ± 9.41) years. During the 72 - hour observation period, 1, 3, and 2 cases of bacterial colonization occurred in control group 1, control group 2, and the experimental group respectively, and there was no significant difference among the three groups ( χ2 = 1.10, P = 0.577). No medical adhesive - related skin injury occurred in the experimental group, and there was a significant difference compared with the 4 cases in control group 2 ( χ2 = 4.21, P = 0.040). The average catheter maintenance time and maintenance cost in the experimental group were (15.20 ± 1.56) minutes and (8.11 ± 1.35) yuan respectively. Compared with (21.05 ± 3.31) minutes and (13.16 ± 1.03) yuan in control group 1, the differences were statistically significant ( t = 5.85, 5.05, both P<0.001). Compared with (21.08 ± 3.00) minutes and (15.17 ± 1.63) yuan in control group 2, the differences were also statistically significant ( t = 5.88, 7.06, both P<0.001). Conclusions:The open-window central venous catheter combination dressing designed in this study can effectively reduce the incidence of medical adhesive-related skin injury, and also has a better role in saving maintenance time and reducing maintenance costs, especially for patients who need repeated dressing changes at the puncture point for treatment with the advantages of, convenience, economy, speed, firm fixation and safety.

Objective:To explore the core dimensions of adolescent anxiety and their relationship with parental rearing styles and perceived social support using network analysis.Methods:A total of 3 712 adolescents were in-vestigated.The Screen for Child Anxiety Related Emotional Disorders,the Short-form Egna Minnenav Barndoms Uppfostran for Chinese,and the Perceived Social Support Scale were used to assess the anxiety levels,parental rea-ring styles,and perceived social support.Network analysis and gender network comparison were conducted using R programming language.Results:The network analysis model showed that generalized anxiety and somatization/pan-ic anticipation had the highest Expected Influence of 1.21 and 1.12,which were the two core dimensions of adoles-cent anxiety levels.The affective warmth in parental rearing styles had a Bridge Expected Influence index of 0.34,making it a bridging node in the network.The network comparison result indicated that there were significant struc-tural gender differences in the adolescent anxiety-parenting style-perceived social support network(P＜0.05),but there was no significant gender difference in global strength(P＞0.05).Conclusion:Interventions targeting adoles-cent anxiety should prioritize generalized anxiety and somatization/panic.Emotional warmth in parenting serves as a bridge connecting adolescent anxiety with perceived levels of social support.

Human immunodeficiency virus(HIV)is the pathogen of acquired immune deficiency syndrome(AIDS).The vi-rus is a highly contagious and highly pathogenic disease caused by the virus attacking the human immune system,which remains a ma-jor global public health problem.Interferon(IFN)is a key cytokine with antiviral and cell-regulatory properties,involved in functions such as cell proliferation,innate and adaptive immune responses.The JAK/STAT signaling pathway is a signal transduction pathway stimulated by cytokines that is involved in many important biological processes such as cell proliferation,differentiation,apoptosis,and immune regulation.With the further in-depth research on AIDS,it has been revealed that IFN and the JAK/STAT pathway play crucial roles in the activation and replication of HIV-1 in target cells.This paper summarizes the structure,signal transduction,and regulatory mechanisms of IFN and the JAK/STAT pathway,and explores the mechanism of IFN-regulated JAK/STAT signaling path-way in HIV-1.It is expected to provide new treatment strategies for the clinical treatment of AIDS.