The rapid development of artificial intelligence (AI), especially generative AI (GenAI), has already brought, and will continue to bring, revolutionary changes to our daily production and life, as well as create new opportunities and challenges for diagnostic and therapeutic practices in the medical field. Haihe Hospital of Tianjin University collaborates with the National Supercomputer Center in Tianjin, Tianjin University, and other institutions to carry out research in areas such as smart healthcare, smart services, and smart management. We have conducted research and development of a full-process disease diagnosis and treatment assistance system based on GenAI in the field of smart healthcare. The development of this project is of great significance. The first goal is to upgrade and transform the hospital's information center, organically integrate it with existing information systems, and provide the necessary computing power storage support for intelligent services within the hospital. We have implemented the localized deployment of three models: Tianhe "Tianyuan", WiNGPT, and DeepSeek. The second is to create a digital avatar of the chief physician/chief physician's voice and image by integrating multimodal intelligent interaction technology. With generative intelligence as the core, this solution provides patients with a visual medical interaction solution. The third is to achieve deep adaptation between generative intelligence and the entire process of patient medical treatment. In this project, we have developed assistant tools such as intelligent inquiry, intelligent diagnosis and recognition, intelligent treatment plan generation, and intelligent assisted medical record generation to improve the safety, quality, and efficiency of the diagnosis and treatment process. This study introduces the content of a full-process disease diagnosis and treatment assistance system, aiming to provide references and insights for the digital transformation of the healthcare industry.
Artificial Intelligence ; Humans ; Delivery of Health Care ; Generative Artificial Intelligence

Objective:To investigate the efficacy of the nomogram model based on multiparametric MRI combined with clinical features for differential diagnosis of benign and malignant breast imaging reporting and data system (BI-RADS) 4 lesions.Methods:This study was a cross-sectional study. Clinical and imaging data of 56 patients (66 lesions) with pathologically confirmed BI-RADS 4 breast lesions from January 2020 to June 2022 at Second Affiliated Hospital of Shantou University Medical College were retrospectively analyzed. The patients were all females aged 42 (17, 71) years old. All patients underwent the breast MRI, including T 1WI, T 2WI, diffusion-weighted imaging, diffusion kurtosis imaging (DKI), and dynamic-enhanced MRI (DCE-MRI), and the patient clinical characteristics, imaging characteristics as well as relevant MRI quantitative parameters were recorded. Comparisons of the indicators of benign and malignant BI-RADS 4 lesions were performed by sample t-test , Mann-Whitney U, or χ 2 test. The least absolute shrinkage and selection operator regression was utilized to further select indicators with statistically significant differences in univariate analyses, and finally, nomogram models were constructed and reclassified all the lesions. Results:Of the 66 lesions in 56 patients, 24 lesions were found in 24 malignant patients and 42 lesions in 32 benign patients. The differences in age, body mass index, and menopausal status between benign and malignant patients were statistically significant (all P<0.05); the differences in tumor longest diameter, type of lesion enhancement, time-single intensity curve type, mean diffusivity and mean kurtosis (MK) between benign and malignant lesions were statistically significant (all P<0.05). After feature selection, MK ( OR=27.952, 95% CI 1.301-600.348, P=0.033), age ( OR=1.140, 95%CI 1.040-1.249, P=0.005), and the type of lesion enhancement ( OR=0.045, 95%CI 0.006-0.316, P=0.005) were the independent influences in predicting BI-RADS 4 malignant lesions. Using this to construct a nomogram model, its area under the curve for predicting BI-RADS 4 malignant lesions was 0.946, and the accuracy of reclassifying 66 BI-RADS 4 lesions as benign versus malignant was 86.36% (57/66). Conclusion:The nomogram model constructed with MK from DKI parameters, the type of lesion enhancement from DCE-MRI, and age is valuable in diagnosing the benign and malignant nature of BI-RADS 4 lesions.

OBJECTIVETo investigate the clinical efficacy of excision of necrotic and infected tissues combined with induced membrane and external fixator technique to treat chronic osteomyelitis in tibia after fracture operation.

METHODSFrom June 2011 to June 2014, a total of 13 patients with tibia osteomyelitis were treated with excision of necrotic and infected tissues and external fixator technique in the first stage. There were 8 males and 5 females, ranging in age from 16 to 67 years old with an average of (37.3±14.3) years old. Within 6 to 8 weeks the induced membrane was formed and the induced membrane technique was applied to promote new bone forming in the second stage.

RESULTSThirteen patients had no reinfection and achieved complete bone healing after 24 to 52 months follow-up. All the patients had satisfactory function.

CONCLUSIONSExcision of necrotic and infected tissues combined with induced membrane and external fixator technique to treat chronic osteomyelitis in tibia after fracture operation can provide satisfactory results.

Objective To investigate the feasibility and applicability of free airbags,free fixed totally extraperitoneal laparoscopic inguinal hernia repair (TEP) treatment of inguinal hernia.Methods In Baotou Medical College,Department of General Surgery,the First Affiliated Hospital,the 40 cases of patients confirmed with inguinal hernia surgery were choosed from Jan.2010 to Dec.2012 as the observed object,depending on the surgical methods.Divided the cases into the TEP group and the open surgery group to observe statistics including postoperative pain,extent of gastrointestinal function recovery time,the time of bedside movement,the number of days of hospitalization,the incidence of postoperative complications,hospital fees indicators.Results The operation time of TEP group was about 20 minutes longer than the open group and the difference was statistically significant (P ＜ 0.05).Compared with the open group,TEP group' s postoperative pain was milder,postoperative feeding time,the time of bedside movement and postoperative exhaust time were earlier,hospital stays were shoter,incidence of postoperative complications was lower,the differences were statistically significant (P ＜ 0.05).The difference was not statistically significant in hospital costs(P ＞ 0.05).Conclusion TEP inguinal hernia greater advantages compared with traditional open surgery,may be appropriate to carry out in my area.

Objective To investigate the laparoscopic treatment of ki-67 inguinal hernia in children compared with traditional surgical superiority.Methods Sixty cases of pediatric hernia clinical data were retrospectively analyzed,divided into two groups,one group was treated with traditional surgical (n =30),and another using laparoscopic surgery(n =30).Compare the difference of surgical results,postoperative recovery,and postoperative complications.Results Laparoscopic surgery over traditional surgery in operative time,blood loss,postoperative pain,postoperative ambulation time,gastrointestinal recovery time,hospital stay time comparison,P ＜ 0.05,there is a significant difference; postoperative pain,scar,postoperative complications,recurrence rate,etc.Compare,P ＜ 0.05,there are significant differences.Conclusions Laparoscopic surgery over traditional surgery in shorter operative time,less bleeding,postoperative pain,postoperative ambulation earlier,gastrointestinal recovery time is short,shorter hospital stay,wound scar subtle,fewer complications,recurrence rate low,so the treatnent of pediatric inguinal hernia laparoscopic surgery has the advantages of minimally invasive.

Objective To investigate the distribution of androgen receptor (AR) gene CAGrepeats in the Chinese Han nationality and its application in genetic diagnosis for Kennedy's disease (KD). MethodsRT-PCR,denaturing polyacrylamide gel electrophoresis (DPAGE) and gene sequencing were conducted for AR gene CAG repetition among 100 healthy controls and 28 patients diagnosed as motorneuron diseases,and the number of the repetition was counted. Results The healthy controls had a range of 15-31 times of CAG repetition,with an average of (23 ± 3) times.Among patients with motoneuron disease,3 cases with CAG repetition for more than 40 times (namely,46,47 and 47 times) were diagnosed as KD.The main clinical manifestations included slow progress of limb weakness,primarily in the proximal lower limbs,fatigue accompanied by myalgia,muscle jumping,muscle atrophy,elevated serum creatine kinase (CK) levels,neurogenic damage revealed by electromyogram (EMG) and androgen insensitivity.Conclusions The incidence of KDmay be underestimated in the Chinese population.Performing genetic diagnosis in patients with motor neuron disease for AR gene can improve clinical diagnosis and avoid misdiagnosis.

Objective Explore the feasibility of the laparoscopy, choledocho-fiberacopy, duodenoscopy for the extrahepatic bile duct stone patients and the scope of application. Methods Sixty-four patients with extract common bile duct stones received the multiple endoscopies. Results Satisfactory outcome was ob-tained, no conversion, residual stones, and other complications were observed. Conclusion With profi-ciency in endoscopic and laparoscopic techniques, and a good grasp of the indications for various methods, minimally invasive treatment for extrahepatic bile duct stones is safe and feasible.

Objective To assess the outcomes of the laparocopic cholecystectomy for complicated gall-stone and to sum up the skills and experiences of the operation. Methods We retrospectively analyzed the clinical data of laparoscopic treatment for the complicated gallstone of 256 patients within three years. Re-sults All patients were cured and discharged, without convention to open surgery and operateive death. Conclusion As long as master the operative indications and the skills to managing complicated problems, LC can be used for the treatment of complicated gallstone.

OBJECTIVETo prospective examine the relationship between smoking, quitting and mortality in older Chinese men by in Xi'an, China.

METHODSThe design was a cohort analytic study. One thousand two hundred and sixty-eight retired male military veterans aged 60 or older were examined in 1987. At baseline, there were 388 never-smokers, 461 former smokers and 419 current smokers. Main outcome measure was all-cause and tobacco-associated mortality.

RESULTSThrough 1999, 299 had died, 943 were alive and 26 lost. The mean follow-up time was 11 years and total person-year of follow-up was 14 163. After adjusting for age, blood pressure, body mass index, total cholesterol, triglycerides, alcohol intake, exercise and existing diseases, using Cox proportional hazard regression model, the relative risks (95% confidence intervals) for ever-smoking, deaths resulting from all causes, chronic obstructive pulmonary disease (COPD), lung cancer and coronary heart disease (CHD) were 1.34 (1.02 - 1.76), 3.23 (0.95 - 10.91), 2.31 (0.95 - 5.61) and 1.60 (0.81 - 3.19) respectively. The risks increased significantly with increasing amount and duration of smoking. Compared with current smokers, former smokers had lower risks of total mortality (excess risk reduction of 56%) and from CHD death (93%), but had higher risks for COPD death (excess risk increased 174%).

CONCLUSIONSSmoking is a major cause of death in older Chinese men and quitting can save lives. These results showing that higher risks of COPD death in former smokers with or without existing diagnosed COPD at baseline than those in current smokers could be explained by either the "healthy smoker effect" or the "ill quitter effect" or both. Early recognition of the significance of COPD symptoms followed by prompt quitting should be emphasized as strategies in the control of the growing tobacco epidemic.

Aged ; China ; Cohort Studies ; Coronary Disease ; etiology ; mortality ; Humans ; Lung Neoplasms ; etiology ; mortality ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; etiology ; mortality ; Risk Factors ; Smoking ; adverse effects ; mortality ; Smoking Cessation ; Survival Rate ; Veterans