Objective To construct large medical model named by "Huaxi HongYi"and explore its application effectiveness in assisting medical record generation. Methods By the way of a full-chain medical large model construction paradigm of "data annotation - model training - scenario incubation", through strategies such as multimodal data fusion, domain adaptation training, and localization of hardware adaptation, "Huaxi HongYi" with 72 billion parameters was constructed. Combined with technologies such as speech recognition, knowledge graphs, and reinforcement learning, an application system for assisting in the generation of medical records was developed. Results Taking the assisted generation of discharge records as an example, in the pilot department, after using the application system, the average completion times of writing a medical records shortened (21 min vs. 5 min) with efficiency increased by 3.2 time, the accuracy rate of the model output reached 92.4%. Conclusion It is feasible for medical institutions to build independently controllable medical large models and incubate various applications based on these models, providing a reference pathway for artificial intelligence development in similar institutions.

Objective:To observe the effects of problem-based learning (PBL) and case-based learning (CBL) combined with self-media platform in clinical probation teaching of gastroenterology.Methods:From July 2019 to June 2020, 60 students in the Department of Gastroenterology of the Army Characteristic Medical Center of PLA were assigned to the traditional teaching group (control group, n=30) and the PBL and CBL combined with the self-media platform teaching group (experimental group, n=30). After the teaching, theoretical examination, practical assessment, and questionnaires were used to evaluate the effects of the two teaching methods. SPSS 23.0 was used to perform the t-test. Results:The comprehensive scores of students in the experimental group, including theoretical examination score (86.60±1.17) and practical assessment score (86.40±0.83), were significantly higher than those in the control group [(81.70±0.98), (82.00±1.18), P<0.001]. The questionnaire survey showed that the experimental group was superior to the traditional teaching group in terms of self-study and data access ability, students' self-confidence, and satisfaction with teaching ( P<0.001). Conclusion:PBL and CBL combined with self-media platform uses actual medical records to guide students to discuss, analyze, and summarize clinical issues. Combined with flexible learning on the self-media platform, this method breaks through the limitations of traditional teaching models and improves teaching quality and learning satisfaction. Therefore, this method can be promoted in clinical probation teaching of gastroenterology.

Pancreatitis is one of the most common inflammatory diseases of the pancreas caused by autodigestion induced by excessive premature protease activation. However, recognition of novel pathophysiological mechanisms remains a still challenge. Both genetic and environmental factors contribute to the pathogenesis of pancreatitis, and the gut microbiota is a potential source of an environmental effect. In recent years, several new frontiers in gut microbiota and genetic risk assessment research have emerged and improved the understanding of the disease. These investigations showed that the disease progression of pancreatitis could be regulated by the gut microbiome, either through a translocation influence or in a host immune response manner. Meanwhile, the onset of the disease is also associated with the heritage of a pathogenic mutation, and the disease progression could be modified by genetic risk factors. In this review, we focused on the recent advances in the role of gut microbiota in the pathogenesis of pancreatitis, and the genetic susceptibility in pancreatitis.

Objective:To evaluate the biosafety of medical injectable carboxymethyl glycosaminoglycan gel.Methods:Ames test, chromosome aberration test in vitro and gene mutation test in vitro were used to detect the genotoxicity of the medical carboxymethyl glycosaminoglycan gel. The gel saline extract (50 ml/kg) was injected slowly through the marginal vein of the ear into Japanese big-eared rabbits. The body temperature was measured and the temperature rise was calculated. The gel saline extract (50 ml/kg) and normal saline (control) were injected intraperitoneally and intravenously into the Kunming mice, respectively. The toxicity response in mice was observed after injection, and bodyweight change was valued. The gel saline extract, normal saline and distilled water were added into the rabbit anti-clotting, to detect the rate of hemolysis.Results:Under active and inactive conditions, the number of spontaneous revertants of the 4 strains of gel saline extract group and gel DMSO extract group did not reach 2 times of that of the corresponding negative control group. The rate of chromosome aberration of the three dose groups were 0. There was no significant increase in the large colony mutation frequency, small colony mutation frequency and total mutation frequency in three dose groups (all P>0.05). After injection of gel saline extract for 24, 48 and 72 h, no toxic reaction was found in each group of mice. With the extension of time after injection, the body weight of mice in the sample group and the control group increased, but the difference was not statistically significant ( P>0.05). After injection of gel saline extract, the temperature rise of 3 Japanese big-eared rabbits were 0.0, 0.3 and 0.2 ℃ respectively. The results of hemolysis test showed that the hemolysis rate of the polycarboxymethyl glucosamine gel was 0.1%. Conclusions:No genetic toxicity changes were found in carboxymethyl glycosaminoglycan to induce gene mutation or chromosome damage in bacteria and cells, and no pyrogenicity, acute systemic toxicity and hemolysis were observed. These results indicate that thecarboxymethyl glycosaminoglycan gel has good biosafety.

ObjectiveTo analyze the articles on endoscopic retrograde cholangiopancreatography (ERCP), an important method for minimally invasive treatment of biliary and pancreatic diseases, published worldwide, and to investigate the status, hotspots, and development trends in this field. MethodsThe web of science core collection database in Web of Science platform was selected to search by the subject words “TS = (Cholangiopancreatography, Endoscopic Retrograde)”, for the articles published from January 1, 2015 to December 31, 2019, and the literature type was selected as “article”. CiteSpace 5.6.R2 (64-bit) was used to analyze the authors, key words, institutions, countries (regions), and references and plot visualized maps. ResultsA total of 1535 articles on ERCP were included. The analysis showed that Hiroyuki Isayama had the highest number of published articles, followed by Yousuke Nakai and Takeshi Ogura, and University of Tokyo had the highest number of published articles, followed by Shanghai Jiao Tong University and University of Ulsan College of Medicine. Moreover, the US, Japan, and China were the top three countries from the aspect of the number of published articles in the recent 5 years, and ERCP, complication, and risk factor were the key words with the highest frequency in the recent 5 years. The most frequently cited articles mainly focused on the complications of ERCP and related consensus or guidelines. ConclusionThe main research hotspots and trends in the field of ERCP are related factors and clinical prevention of ERCP-related complications.

BACKGROUND: The injectable carboxymethyl glycosaminoglycan anti-adhesion gel prepared in the previous study combines the advantages of anti-adhesion membrane and anti-adhesion liquid. It can form soft gel in situ in a relatively short time, which is not affected by body position, bear the pressure of surrounding tissues and can be used without compression. OBJECTIVE: To evaluate the biocompatibility of medical injectable carboxymethyl glycosaminoglycan anti-adhesion gel. METHODS: Logarithmic growing L929 cells were used as test cells, and the cytotoxicity of injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract was detected by MTT method. The intradermal stimulation test of injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract was carried out in Japanese big ear rabbits. Guinea pigs were used as experimental animals to carry out intradermal induction and local induced delayed hypersensitivity test of injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract. Wistar rats were used as experimental animals to carry out the subchronic toxicity test of injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract. RESULTS AND CONCLUSION: The cytotoxicity of injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract was grade 1, meeting the standard requirements. Injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract had no potential intradermal stimulation and no potential skin sensitization. In the subchronic toxicity test, the rats were subjected to the tail vein injection of injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract for 28 continuous days, and there was no obvious subchronic systemic toxicity in body mass, hematology, coagulation function, blood biochemistry and visceral pathology. These results indicate that the injectable carboxymethyl glycosaminoglycan anti-adhesion gel has good biosafety.

Objective To summarize the application experiences and curative efficacies of single lung transplantation assisted by extracorporeal circulation with coated lung ,centrifugal pump and coated pipe .Methods Retrospective analysis was conducted for clinical data of 6 adult patients with respiratory insufficiency undergoing single lung transplantation .The changes of hemodynamics and oxygenation before and after adjuvant treatment were observed ,the effects of adjuvant evaluated and the experiences of application summarized .Results The hemodynamic parameters post-assistance significantly improved as compared with that pre-assistance and pulmonary arterial pressure dropped from (56 ± 15 ) to (45 ± 13 ) mmHg with statistically significant differences . Arterial blood gas parameters significantly improved .PO2 spiked from (47 ± 12) to (68 ± 9) mmHg and PCO2 declined from (65 ± 14) to (55 ± 12)mmHg .And there were statistically significant differences .All patients were discharged successfully .Conclusions The simple extracorporeal membrane oxygenation system of coated lung , centrifugal pump and coated pipe during routine extracorporeal circulation may guarantee the operative safety of single lung transplantation and provide a new therapeutic option .

Objective: To study the effects of hedysarum polybotys saccharides (HPS) and selenizated hedysarum polybotys saccharides (SE-HPS) on the oral squamous cancer cell line SCC25. Methods: Different concentrations (0, 10, 25, 50, 100, 200, 400 μg/ml) of HPS and SE-HPS were added to SCC25 cells in the logarithmic growth stage. Cell proliferation was detected by the CCK-8 method, apoptosis was detected by flow cytometry, and apoptosis-related indexes were observed by RT-qPCR and Western blotting. Results : The concentrations of HPS and SE-HPS inhibited the proliferation of SCC25 cells. The inhibitory effect of 50 μg/mL HPS and SE-HPS on the proliferation of SCC25 cells was the strongest and was time-dependent. The inhibition effect significantly increased within 48 h, and the effect was achieved after 48 h. At the plateau stage, SE-HPS inhibited the proliferation of SCC25 cells more strongly than HPS (P < 0.05). The results of flow cytometry showed that 50 μg/mL HPS and SE-HPS acted on SCC25 cells for 48 h, and the apoptotic rates were 25.8% and 30.8% respectively. Compared with the control group (0 μg/mL HPS and SE-HPS), the difference was statistically significant (P < 0.05). RT-qPCR and Western blotting showed that 50 μg/mL HPS and SE-HPS acted on SCC25 cells for 48 h, and the mRNA and protein expression levels of the apoptosis gene Fas/FasL were upregulated. The difference was statistically significant (P < 0.05). Conclusion Both HPS and SE-HPS can inhibit the proliferation of SCC25 oral cancer cells, but SE-HPS is superior to HPS and can induce apoptosis through the Fas/Fasl pathway.

In recent years, gene engineering is developing rapidly and many recombinant proteins have been expressed. The use of plant bioreactor to express specific pharmaceutical proteins provides a new way for the prevention and treatment of some important diseases in human beings. Nowadays, chloroplast genetic transformation and expression system has become a research hotspot in plant bioreactor. Higher plant chloroplasts have unique advantages in the expression of recombinant proteins due to their special structures and inherited characteristics: such as high expression, site-specific integration, and the maternal inheritance characteristics of exogenous genes. The maternal inheritance of chloroplast is helpful for biological safety of transgene escaping by pollens. Many important pharmaceutical proteins have been successfully expressed in plant chloroplasts. As a chloroplast transformation model of higher plants, tobacco has made significant progress in the expression of pharmaceutical proteins, such as vaccine antigens, antibodies, and other important recombinant proteins. Chloroplast genetic transformation in higher plants also provides new techniques and methods for the study of chloroplast gene expression and regulation mechanisms. In order to provide a new idea for the development of chloroplast expression platform and the expression of important pharmaceutical proteins, this review outlined the progress of chloroplast genetic transformation system in higher plants, including the chloroplast transformation principle, vector construction, expression of recombinant proteins and important pharmaceutical proteins, and the effects of recombinant proteins expression on plant metabolism and traits.

Objective To study the effects of drug-containing serum of Ficus Hirta on oxidative damage of spleen lymphocyte due to aging in aged mice; To discuss its mechanism of action.Methods Forty aged mice were randomly divided into control group and high-, medium- and low-dose Ficus Hirta groups. Control group was given 0.9% sodium chloride solution for gavage, while high-, medium- and low-dose Ficus Hirta groups were given 6.6, 4.4, and 2.2 g/kg aqueous extract of Ficus Hirta for gavage. The spleen index was observed for optimum dose in aged mice. The optimum time and dilution of drug-containing serum of Ficus Hirta were confirmed by MTT method in lymphocyte proliferation test. The positive rate of senescent cells, the activity of T-SOD and the contents of MDA and ROS were determined in cellular antioxidant experiment after treated by optimal drug-containing serum for 48 h. Results Compared with the control group, the spleen index was significantly improved in high-, medium- and low-dose Ficus Hirta groups (P<0.05,P<0.01). 20% drug-containing serum of Ficus Hirta cultivated for 48 h had the best effects on lymphocyte proliferation in aged mice. 20% drug-containing serum of Ficus Hirta could significantly decrease the positive rate of senescent cells (P<0.01), improve T-SOD activity and decrease the contents of MDA and ROS (P<0.05,P<0.01).Conclusion The drug-containing serum of Ficus Hirta can improve the proliferative activity of spleen lymphocyte in aged mice and the mechanism of action may be involved in decreasing the positive rate of senescent cells and increasing antioxidant ability of lymphocyte.