The construction of smart hospital is an important part of modern hospital management system,and it is also the key way to build the new system of high-quality hospital development.In terms of building smart hospitals,multi-campus hos-pitals face more difficulties and challenges than single campus hospitals,such as the lack of top-level design,the difficulty of in-tegrated management,the uneven development of hospitals and the widespread phenomenon of information islands.This study summarizes and analyzes the difficulties encountered in the construction and application of smart hospitals in multi-hospital areas.Guided by problems,it puts forward countermeasures and suggestions for the construction of refined and high-quality smart hospi-tals in multi-campus hospitals,including strengthening overall and forward-looking awareness,integrating management according to hospital conditions,characteristic development under demand guidance,establishing a data integration center for smart hospi-tals,scientific planning of talent reserve and discipline layout,etc.

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.

Cardiac toxicity of anthracycline greatly limit its clinical use,to explore the rule of anthracycline cardiotoxicity and prevention and control strategies of Chinese and western medicine,this paper through the literature search mechanism and drugs is summarized,the mechanism can be divided into oxidative stress,inflammatory reaction,myocardial cell autophagy and DNA damage four categories,the prevention and treatment of western medicine to dc prosamine,ACEI,ARB is given priority to,Chinese medicine can be divided into single medicine,by prescription and proprietary Chinese medicine.On this basis,the combination drug is discussed to prevent cardiotoxicity,and the theoretical basis and research status of the combined application of western medicine,traditional Chinese medicine and Chinese and western medicine are introduced.The results show that it has good feasibility and safety,and can provide reference for the clinical treatment strategy of anthracycline chemotherapy drugs.

Objective To investigate sex-related differences in left ventricular systolic dysfunction in heart failure with preserved ejection fraction(HFpEF)and type 2 diabetes mellitus(T2DM).Methods A total of 228 HFpEF patients who were treated in the Department of Endocrinology and Cardiology of the Second Hospital of Shijiazhuang from January 2019 to June 2023 were enrolled.They were divided into HFpEF group[women(n=61),men(n=73)]and HFpEF+T2DM group[women(n=49),men(n=73)]according to whether they had T2DM.Conventional echocardiography and left ventricular global longitudinal strain(GLS)data were measured.Sex-related differences of left ventricular structure and function were compared between the two groups.Multivariable linear regression analysis was performed for the determinants of impaired left ventricular GLS for HFpEF with T2DM patients and HFpEF patients of both sexes.Results LVMI was lower in women than in men in HFpEF group(P<0.05).The left ventricular remodeling rate of women was higher in HFpEF+T2DM group than that of men and women in HFpEF group,and the GLS of women was lower than that of men and women in HFpEF group(P<0.05).The E/E'was higher in women than in men in HFpEF and HFpEF+T2DM groups(P<0.05).Multivariable linear regression analysis showed that age,women,HbA1c and LVMI were the determinants of GLS impairement in HFpEF patients with T2DM.Age,T2DM,NT-proBNP and LVMI were the determinants of GLS impairement in HFpEF women patients,where as age,BMI,CHD,NT-proBNP and LVMI were the determinants of GLS impairement in HFpEF men patients.Conclusions There are sex-related differences in left ventricular systolic dyfunction in HFpEF with T2DM patients.With T2DM exerting a greater adverse effect onleft ventricular systolic dyfunction in women with HFpEF than men.

Objective This paper aims to construct a scientific and standardized index system for evaluating the applica-tion effect of Diagnosis-Intervention Packet(DIP)in medical institutions.It seeks to determine the weights of indicators at all lev-els to provide a basis for evaluating the effectiveness of DIP used in various regions as well as a reference for improving DIP poli-cy.Methods This paper used literature analysis to develop an indicator pool preliminarily.The Delphi method was used to con-duct a questionnaire survey with 22 experts to establish the index system.It also used the Analytic Hierarchy Process(AHP)to determine the weight of each index.Results A total of two rounds of expert consultation questionnaires were conducted.The questionnaire exhibited high expert positive coefficients by 91.00％and 100.00％and higher authority coefficients of both 0.91 for two rounds.The coordination coefficients of the two rounds of expert consultation met the standard,and the expert opinions reached a consistence.Additionally,the questionnaire established comprised three primary indicators(efficiency of medical in-surance fund,medical service management,patient benefit,and satisfaction),9 secondary indicators,and 38 tertiary indicators.The AHP was used to determine the weight of indicators at all levels.Among the primary indicators,patient benefit and satisfac-tion had the highest weight(0.446 9).Among the secondary indicators,patients'medical cost burden had the highest weight(0.287 6).Among the tertiary indicators,the inpatient satisfaction had the highest weight(0.1592).The Cronbach's α coeffi-cients of the two rounds were＞0.7.Conclusion This paper utilized Delphi method and AHP to establish the evaluation system for assessing the implementation effectiveness of DIP.The approach is highly scientific and authoritative.It can be used to evalu-ate the application effect of DIP and provide an effective tool for medical insurance and hospital managers at all levels to assess DIP payment policies.

Background::Cardiovascular disease (CVD) has emerged as the leading cause of death from prostate cancer (PCa) in recent decades, bringing a great disease burden worldwide. Men with preexisting CVD have an increased risk for major adverse cardiovascular events when treated with androgen deprivation therapy (ADT). The present study aimed to explore the prevalence and risk evaluation of CVD among people with newly diagnosed PCa in China.Methods::Clinical data of newly diagnosed PCa patients were retrospectively collected from 34 centers in China from 2010 to 2022 through convenience sampling. CVD was defined as myocardial infarction, arrhythmia, heart failure, stroke, ischemic heart disease, and others. CVD risk was estimated by calculating Framingham risk scores (FRS). Patients were accordingly divided into low-, medium-, and high-risk groups. χ2 or Fisher’s exact test was used for comparison of categorical variables. Results::A total of 4253 patients were enrolled in the present study. A total of 27.0% (1147/4253) of patients had comorbid PCa and CVD, and 7.2% (307/4253) had two or more CVDs. The enrolled population was distributed in six regions of China, and approximately 71.0% (3019/4253) of patients lived in urban areas. With imaging and pathological evaluation, most PCa patients were diagnosed at an advanced stage, with 20.5% (871/4253) locally progressing and 20.5% (871/4253) showing metastasis. Most of them initiated prostatectomy (46.6%, 1983/4253) or regimens involving ADT therapy (45.7%, 1944/4253) for prostate cancer. In the present PCa cohort, 43.1% (1832/4253) of patients had hypertension, and half of them had poorly controlled blood pressure. With FRS stratification, as expected, a higher risk of CVD was related to aging and metabolic disturbance. However, we also found that patients with treatment involving ADT presented an originally higher risk of CVD than those without ADT. This was in accordance with clinical practice, i.e., aged patients or patients at advanced oncological stages were inclined to accept systematic integrative therapy instead of surgery. Among patients who underwent medical castration, only 4.0% (45/1118) received gonadotropin releasing hormone antagonists, in stark contrast to the grim situation of CVD prevalence and risk.Conclusions::PCa patients in China are diagnosed at an advanced stage. A heavy CVD burden was present at the initiation of treatment. Patients who accepted ADT-related therapy showed an original higher risk of CVD, but the awareness of cardiovascular protection was far from sufficient.

Background There is a lack of research evidence on the association between sugar-sweetened beverage (SSB) consumption and gestational diabetes mellitus (GDM) in China. Objective To explore the association between frequency of SSB consumption before pregnancy and risk of GDM in pregnant women in Shaanxi Province, and to provide a scientific basis for targeted interventions to control maternal blood glucose. Methods The recruitment to the China Birth Cohort study started in October 2020. Pregnant women at 6-16 weeks who had their first prenatal examination at five hospitals in Shaanxi Province were recruited. A maternal health questionnaire was used to collect basic information about pregnant women. A semi-quantitative food frequency questionnaire was used to collect the consumption of carbonated beverages, fruit and vegetable juice beverages, coffee beverages, and milk tea beverages in one year before pregnancy, which were summed to obtain the SSB consumption. Pregnant women were divided into three groups according to SSB consumption, namely <1 serving·week⁻¹, 1-4 servings·week⁻¹, and ≥5 servings·week⁻¹. GDM was confirmed by oral glucose tolerance test (OGTT) between 24-28 weeks of gestation. A binary logistic regression model was applied to explore the association between SSB consumption and risk of GDM. Multiple linear regression was applied to investigate the associations between SSB consumption (per 1-serving·d⁻¹ increase) and OGTT fasting plasma glucose, 1-hour glucose, and 2-hour glucose. Results A total of 3811 pregnant women were finally enrolled in this study, of which 752 developed GDM, with an incidence rate of 19.7%. The incidence rates of GDM in pregnant women with SSB consumption frequency of <1 serving·week⁻¹, 1-4 servings·week⁻¹, and ≥5 servings·week⁻¹ were 18.0%, 21.1%, and 26.8%, respectively. After adjusting for maternal age, pre-pregnancy body mass index (BMI), education, number of children born, family history of diabetes, smoking, alcohol consumption, physical activity level, and total energy intake, the risk of GDM increased by 26% (OR=1.26, 95%CI: 1.05, 1.50) in the 1-4 servings·week⁻¹ group and by 76% (OR=1.76, 95%CI: 1.31, 2.38) in the ≥5 servings·week⁻¹ group compared to the <1 serving·week⁻¹ SSB consumption group, respectively. Further stratified analysis revealed no interaction effect (P_interaction>0.05) between SSB consumption and maternal age, pre-pregnancy BMI, or first labor or not. For each additional SSB consumption per day, the risk of GDM increased by 94% (OR=1.94, 95%CI: 1.37, 2.75); and the maternal OGTT 1-hour glucose and 2-hour glucose increased by 0.33 mmol·L⁻¹ and 0.18 mmol·L⁻¹, respectively (P<0.05), and no significant increase in fasting plasma glucose was found (P>0.05). Conclusion Higher SSB consumption before pregnancy increases the risk of GDM in pregnant women.

OBJECTIVE To establish comprehensive quality evaluation method based on multi-index components combined with multivariate statistical analysis， and to comprehensively evaluate the quality of Periploca forrestii. METHODS Taking 11 batches of P. forrestii medicinal materials from different areas in Guizhou as samples， the contents of neochlorogenic acid， cryptochlorogenic acid， chlorogenic acid， procyanidin A2， isochlorogenic acid A and isochlorogenic acid C were determined by HPLC. Clustering heat map analysis， grey correlation analysis（GRA） and technique for order preference by similarity to ideal solution（TOPSIS） were used to evaluate the quality of P. forrestii. RESULTS The results of methodological investigation of content determination were in accordance with the relevant regulations， and the linear relationship and accuracy of each component were good in their respective sampling range. The contents of chlorogenic acid， cryptochlorogenic acid， neochlorogenic acid， procyanidin A2， isochlorogenic acid A and isochlorogenic acid C in 11 batches of samples were 3.650-7.302， 0.888-2.575， 1.371- 2.386， 0.947-1.469， 0.084-0.169 and 0.725-1.067 mg/g， respectively. The content of each component was significantly different， with the highest content of chlorogenic acid and the lowest content of isochlorogenic acid A. The comprehensive results of cluster heat map， GRA and TOPSIS analysis showed that the comprehensive quality of S5 and S10 was relatively good. CONCLUSIONS The established method is accurate， stable and simple. Combined with multivariate statistical analysis method， it can be used for quality evaluation of P. forrestii. The quality of samples from Jiuzhou Town and Caiguan Town of Xixiu District in Anshun City of Guizhou Province are relatively good among 11 different origin samples.

Objective:To investigate the effects of different doses of oxiracetam (ORC) on the neurological impairment and oxidative stress ability of lead(Pb)-exposed rats.Methods:Total 32 male SD rats with SPF grade were randomly divided into control group, the lead-exposed group, low-dose ORC intervention group and high-dose ORC intervention group according to the random number table method, with 8 rats in each group.The neurobehavioral indexes of rats were measured by gait score, tail flicking test, hindlimb support test and Morris water maze test.The lead content in hippocampal tissue was detected by spectrophotometry.The cell morphology of hippocampal tissue was observed by HE staining.Superoxide dismutase (superoxide dismutase, SOD) level in hippocampal tissues was detected by xanthine oxidase, and the level of malondialdehyde (MDA) in the hippocampus tissue was detected by the thiobarbiturate, and the level of glutathione peroxidase (GPx) in the hippocampus tissue was detected by chemical colorimetric.SPSS 24.0 software was used for statistical analysis, one-way ANOVA was used for multiple group comparisons and LSD- t test was used for further pairwise comparisons. Results:(1)After 8 weeks of lead exposure, there was no significant difference in body weight among the 4 groups( F=0.869, P=0.469). (2)Results of neurobehavioral indicators: there were statistically significant differences in gait scores, tail flick time, hind limb deployment distance, escape latency, and number of crossing platforms among the four groups of rats ( F=7.854, 13.630, 8.484, 23.485, 45.457, all P<0.05). The gait score, tail flick time, hind limb deployment distance, and escape latency of the lead-exposed group rats were higher than those of the control group (all P<0.05), while the number of crossing platforms was lower than that of the control group ( P<0.05). The gait score, tail flick time, hind limb deployment distance, and escape latency of the high-dose ORC intervention group were lower than those of the lead exposed group (all P<0.05), and the number of crossing platforms was higher than that of the lead exposed group ( P<0.05). (3)Lead content in hippocampal tissue: there was a statistically significant difference in lead content in the hippocampus of the four groups( F=309.013, P<0.001). The lead contents of lead exposed group ((1.21±0.10)μg/g), low-dose ORC intervention group ((1.03±0.10)μg/g) and high-dose ORC intervention group ((1.02±0.06)μg/g) were higher than that of the control group((0.02±0.00) μg/g) (all P<0.05), while the lead content in the low-dose ORC intervention group and high-dose ORC intervention group were both lower than that of the lead exposed group (both P<0.05). (4) HE staining showed that compared with the control group, the hippocampal tissue cells in the lead exposed group were arranged disordered, the tissue was loose, and the number of cells was reduced.Compared with the lead exposed group, the hippocampal histiocytes were closely arranged and regular, and the nuclei were fuller.(5)Oxidative stress levels in hippocampal tissue: there were significant differences in MDA, GPx content and SOD activity of hippocampal tissues in the four groups( F=69.879, 56.757, 11.644, all P<0.001). The levels of SOD ((2.03±0.18)U/mg, (3.42±0.26)U/mg), GPx((67.29±7.94)nmol/mg, (89.50±7.94)nmol/mg) in the hippocampus tissue of the lead exposed group were lower than those of the control group (all P<0.05), while the content of MDA was higher than that of the control group((43.73±3.74) nmol/mg, (16.42±1.60) nmol/mg)( P<0.05). The levels of SOD ((3.32±0.12) U/mg) and GPx ((84.11±6.26) nmol/mg) in the high-dose ORC intervention group were higher than those in the lead exposed group (both P<0.05), while the levels of MDA ((21.05±2.56) nmol/mg) was lower than that in the lead exposed group ( P<0.05). Conclusion:ORC can alleviate neurological damage in rats caused by lead exposure, which may be related to the up-regulation of antioxidant capacity of hippocampal tissues, thereby improving pathological damage.

In 2016, a national one million general population cohort project was set up in China for the first time in "Precision Medicine Research" Key Project, National Key Research and Development Program of China, which consists of general population cohorts in seven areas in China. As one of the seven major areas in China, northeastern China has unique climate and specific dietary patterns, and population aging is serious in this area. And the burden of chronic and non-communicable diseases ranks tops in China. Therefore, it is of great significance to establish a large general population cohort in northeastern China to explore the area specific exposure factors related to pathogenesis and prognosis of chronic and non-communicable diseases, develop new prevention strategies to reduce the burden of the diseases and improve the population health in northeastern China. In July 2018, the general population cohort study in northeastern China was launched, the study includes questionnaire survey, health examination and blood, urine and stool sample collection and detection in recruited participants. By now, the cohort has covered all age groups, and the baseline data of 115 414 persons have been collected. This paper summarizes the design and practice of the general population cohort study in northeastern China to provide reference for related research in China.