With the rapid advancement of artificial intelligence technology, chatbots have shown great potential in the healthcare sector. From personalized health advice to chronic disease management and psychological support, chatbots have demonstrated significant advantages in improving the efficiency and quality of healthcare services. As the scope of their applications expands, the relationship between technological complexity and practical application scenarios has become increasingly intertwined, necessitating a more comprehensive evaluation of both aspects. This paper, from the perspective of he althcare applications, systematically reviews the technological pathways and development of chatbots in the medical field, providing an in-depth analysis of their performance across various medical scenarios. It thoroughly examines the advantages and limitations of chatbots, aiming to offer theoretical support for future research and propose feasible recommendations for the broader adoption of chatbot technologies in healthcare.

Objective: To explore perceived social support levels of vocational school students and associated factors, so as to provide a basis for the fine tuned construction of social support networks for vocational school students. Methods: Adopting a combination of multi stage cluster sampling and convenience sampling method, a sample of 11 767 vocational school students in Shanghai City and Jiangsu Province were selected to conduct two surveys (November 2021 and November 2022) by using a self administered electronic questionnaire regarding personal, family, school information and the Child and Adolescent Social Support Scale (CASSS). Correlates were analyzed by generalized linear estimating equations (GEE). Results: The total perceived social support scores in percentage at baseline and follow up survey were (66.13±20.46) and (67.65±21.18). The results of GEE showed that in terms of personal characteristics, girls had higher emotional support and evaluative support scores than boys ( B=0.60, 0.68, P < 0.05 ); extraversion, non-smoking, non-drinking, exercising ≥1 time per week, and better quality of sleep were positively correlated with the total score and the different types scores of precieved social support, and time spent on the Internet >2 h/d was negatively correlated with the total score and the different types scores of precieved social support ( B=1.03-4.49, -4.04--0.58, P < 0.05 ). In terms of family characteristics, parents not in marriage and living with (external) grandparents were negatively correlated with the total score and different types scores of percieved social support, while family characteristics such as satisfaction with family income (average, satisfactory, very satisfactory) and parents education level of junior high school and above were positively correlated with the total score and the different types scores of precieved social support ( B=-1.34--0.37, 0.57-2.37, P <0.05). In terms of school characteristics, without experience of bullying in school and the number of same sex or opposite sex friends >1 were positively correlated with the total score and different types scores of perceptual social support, and without serving as an officer of a student organization was negatively correlated with the total score and the different types scores of precieved social support ( B= 1.21- 5.04, -2.00--0.76, P <0.05). Conclusions The levels of overall and different types of precieved social support among vocational school students need to be improved. According to individual, family, and school related factors of precieved social support can help to target the improvement of students precieved social support level.

Objective: To develop an assessment tool for risky road behavior tendencies among middle school students in western China, as well as to determine the relevant indices and their weights, so as to provide the reference for road safety prevention and control for middle school students in western China. Methods: A Delphi study was employed to construct the assessment tool for risky road behavior tendencies among middle school students in western China. In August 2023, eighteen experts in related fields such as traffic safety, education, and healthcare were invited to achieve Delphi consensus. The final indices were initially selected based on the consulting results,followed by the determination of their individual and combined weights using the analytic hierarchy process. Results: The finalized assessment tool comprised 3 primary indicators, 13 secondary indicators, and 100 tertiary indicators. The positivity coefficient of experts was 100%, accompanied by the authority coefficient 0.90. The mean importance scores for the three primary indicators varied from 4.67 to 4.78, while those for the 13 secondary indicators ranged from 4.22 to 4.89. The Kendall coefficient W was statistically significant at 0.32 ( χ 2=96.83, P <0.05). The weights assigned to the three primary indicators were:ability (0.329 4), opportunity (0.337 3), and motivation (0.333 3). The secondary indicators with the top three highest combined weights were social influence (0.027 4), knowledge (0.027 3), and skills (0.026 7). Conclusions The assessment tool for risky road behavior tendencies among middle school students in western China demonstrates high expert consensus, with balanced weighting of primary and secondary indicators. Expanded use of the assessment tool would provide the data support for intervention work.

Objective:To investigate the dynamic trend of platelet（PLT）count and mean platelet volume（MPV）in children with severe community-acquired pneumonia（SCAP）in PICU and their correlation with prognosis.Methods:A retrospective study was conducted in 215 SCAP children who were admitted to the PICU of Beijing Children's Hospital Affiliated to Capital Medical University from January 2016 to December 2019.According to the disease outcome，the patients were divided into improvement group ( n=184) and unrecovered group ( n=31).The changes of PLT count and MPV at admission，on the 2nd，3rd，and 7th days of hospitalization and before discharge were observed，and the relationship between changes in PLT parameters and poor prognosis was analyzed. Meanwhile，the correlation between thrombocytopenia on admission and on the 7th day of hospitalization and prognosis was further explored. Results:The PLT count of improvement group at admission，on the 2nd，3rd，and 7th days of hospitalization and at discharge[(328±159, 329±137, 362±159, 439±168, 510±171)×10 9/L] were significantly higher than those of unrecovered group [(210±142, 207±152, 267±143, 260±162, 343±159)×10 9/L]（ P＜0.05）.Although the MPV of improvement group [(10.9±1.9)fL] on admission was significantly lower than that of the unrecovered group[(12.7±2.5) fL]（ P＜0.05），there was no significant difference in MPV between two groups on the 2nd，3rd，7th days of hospitalization and discharge（ P＞0.05）.In addition，compared with the admission，children in improvement group had significantly higher PLT count on the 7th day of hospitalization and before discharge（ P＜0.05），but there was no significant change in unrecovered group（ P＞0.05）.Compared with SCAP patients with thrombocytopenia at admission (PLT＜100×10 9/L)( n=22),those with thrombocytopenia on 7th day of hospitalization had a significant higher rate of non recovery( P＜0.05). Conclusion:The occurrence of thrombocytopenia on admission and after 7 days of hospitalization in children with SCAP is associated with poor prognosis.No significant increase or decrease in PLT count after 7 days of hospitalization is often indicative of poor prognosis.Dynamic monitoring of PLT parameter changes may help to better judge the prognosis of severe pneumonia.

Objective: To understand the current situation of school based sexuality education, attitudes and evaluations of teachers and students toward sexuality education, so as to provide evidence for promoting the development of school based sexuality education. Methods: From September to October 2021, 2 140 valid data from students in basic education and 2 146 from kindergarten and primary and secondary school teachers were collected by online questionnaire. The data were described and statistically analyzed, and the influencing factors of teachers willingness to teach sexuality education courses were explored by logistic regression analysis. Results: About 52.06% of the students had not received sexuality education in school, and 47.53% of the teachers did not carry out sexuality education in the school. Sexuality education in schools mainly focuses on reproductive health and physical development. About 48.93% of the teachers thought that the implementation of sexuality education in schools was not good, and the proportion of high school students who thought sexuality education in schools were "very bad" (32.87%) or "not very good" ( 21.23 %) was the highest. The teachers who undertook sexuality education were mainly mental health teachers (55.51% reported by teachers, 43.96% reported by students). About 71.02% of teachers believe that the best way to carry out sexuality education classes was to set up sexuality education curriculum. Students and teachers reported the need for sexuality education, and more than 50% of primary school students and high school students thought that sexuality education were "very needed" and "somewhat needed". About 51.77 % of teachers considered sexuality education "very urgent". All increased recognition of sexuality education, confidence in answering sex questions, external support for sexuality education, and acceptance of sexuality education training increased the likelihood of teachers teaching sexuality education ( OR =1.02, 1.95, 1.03, 3.53, P <0.05). Conclusion The current situation of school based sexuality education is not optimistic, the gap between sexuality education and students needs is wide, and the abilities of sexuality education teachers are insufficient.

Objective: To establish the Professional Standards for Sexuality Education Teachers in Kindergarten in China, so as to provide a basis for strengthening the construction of the sexuality education teacher team in kindergartens and promoting the smooth implementation of sexuality education in kindergartens. Methods: According to the Professional Standards for Kindergarten Teachers (Trial), combined with the existing research and practice results in the field of sexuality education at home and abroad and the development status of kindergarten sexuality education in China, the indicators and specific contents of Professional Standards for Sexuality Education Teachers in Kindergarten in China were selected. In September 2021, two rounds of Delphi expert consultation method were adopted to collect suggestions on professional standards from 34 experts in the field of sexuality education in China, and modifications were made according to the importance scores assessed by experts and specific suggestions until expert opinions converged. Then, the analytic hierarchy process (AHP) was used to assign weights to each indicator at each level, based on the relative importance between each two indicators at the same level as assessed by experts. Results: The Professional Standards for Sexuality Education Teachers in Kindergarten in China were initially established, including 3 primary indexes (professional concept, professional ability and professional knowledge), 7 secondary indexes and 27 tertiary indexes. The recovery rate of the two rounds of consultation documents was 100%, indicating that the experts were highly motivated. The authority coefficient of 2 rounds of expert consultation were both greater than 0.70, proving that the consultation results were reliable. The index weights of the three dimensions of professional concept, professional knowledge and professional ability were 0.44, 0.32 and 0.25, respectively. Conclusion The content of the Professional Standards for Sexuality Education Teachers in Kindergarten in China is complete, and the minimum qualified standard for kindergarten teachers engaged in sexuality education is determined.

Objective To investigate the clinical features,diagnosis and treatment of congenital epulis,to provide a reference for clinical diagnosis and treatment.Methods Two cases of congenital epulis in the mandible and maxilla of a newborn were reported,and the boundary and size of the tumor were determined by ultrasonography and MRI.The tu-mor was resected under general anesthesia.The previous literature on congenital epulis was reviewed and analyzed.Results Patient 1(male)had a hard mass of approximately 20 mm×15 mm×10 mm in the right mandible immedi-ately after birth.MRI was performed,and the mass was removed.In Patient 2(female),a mass approximately 24 mm×23 mm×20 mm in the oral cavity of the anterior maxillary region was shown on ultrasound at 29 gestational weeks,and the mass grew rapidly in the last trimester.The mass was removed after birth.Postoperative pathological examination re-vealed congenital epulis.The results of the literature review showed that the incidence of congenital epulis is greater in females than in males,and it mainly occurs in the maxillary incisor area.Congenital epulis does not invade bone and does not affect tooth development.When a mass affects a child's breathing or swallowing,it must be surgically removed in a timely manner.Recent studies have shown that there is no evidence of recurrence after surgical resection.The histo-logical origin and etiology of the disease are not clear.Clinically,it is often necessary to distinguish between teratomas and congenital epulis.Regarding the clinical manifestations,teratomas and congenital epulis are similar in appearance,and the main distinguishing point lies in pathological manifestations.Under the microscope,teratomas are observed as mature or immature tissue from various embryonic layers,while congenital epulis involves tightly arranged,homoge-neous,polygonal to microspindle-shaped,medium to large cell compositions of nest-like and ribbon-like cells.Conclu-sion Congenital epulis is a rare oral tumor in neonates.The diagnosis should be based on the location,age,clinical manifestations,and imaging findings.The final diagnosis depends on pathological examination.When congenital epulis tumors affect children's breathing and eating,they should be surgically removed as soon as possible,and there is al-most no recurrence after surgery.

Objective:To investigate the impact of donor human leukocyte antigen (HLA) -Bw4 expression on natural killer (NK) cell reconstitution and transplant outcomes in recipients undergoing haploidentical hematopoietic stem cell transplantation (HSCT) from maternal or related donors without ex vivo T-cell depletion.Methods:This study prospectively enrolled 32 patients who received T-replete haploidentical HSCT from maternal or collateral donors (cohort 1) to evaluate the facilitating effect of donor HLA-Bw4 expression on NK cell reconstitution. Furthermore, a retrospective analysis was conducted on 278 patients who underwent T-replete haploidentical HSCT from maternal or collateral donors (cohort 2) to analyze the impact of donor HLA-Bw4 expression on HSCT outcomes. Thus, a comparison was made between the effects of donor HLA-Bw4 expression on HSCT outcomes in patients receiving or not receiving post-transplant cyclophosphamide (PT-Cy) conditioning.Results:Donors expressing HLA-Bw4 alleles facilitated NK cell reconstitution and functional recovery, which remained unaffected by PT-Cy. Donors with HLA-Bw4 expression were associated with reduced transplant-related mortality (TRM), particularly mortality related to infections. The use of PT-Cy did not impact the ability of donor HLA-Bw4 to decrease TRM.Conclusion:In haploidentical HSCT from maternal or related donors without ex vivo T-cell depletion, the presence of donor HLA-Bw4 expression promotes rapid NK cell reconstitution and functional recovery and is significantly associated with lower TRM, especially infection-related mortality. These findings underscore the clinical significance of donor HLA-Bw4 expression in patients who underwent HSCT. Hence, the consideration of donor HLA-Bw4 in recipient selection and HSCT strategies holds important clinical implications.

The ninth edition of TNM staging for lung cancer has been announced at the 2023 World Lung Cancer Congress and implemented from January 1, 2024. The focus of the ninth TNM staging change is dividing N2 into N2a and N2b, as well as M1c into M1c1 and M1c2. Although the T staging has not changed, it has played an important role in verifying the eighth edition of the T staging. The subdivision of stage N2 has led some patients with ⅢA of the eighth edition to experience ascending or descending stages, which will more accurately help to assess the condition and prognosis of patients with mediastinal lymph node metastasis, as well as the design of related clinical studies. Modifying the M1c staging will help define oligometastasis and explore new treatment models in the future. The ninth edition of the TNM staging system provides a more detailed division of different tumor loads, but there is no clear explanation for the staging of lung cancer after neoadjuvant therapy. Further data analysis is needed, and it is expected to be answered in the tenth edition of TNM staging.

The ninth edition of TNM staging for lung cancer has been announced at the 2023 World Lung Cancer Congress and implemented from January 1, 2024. The focus of the ninth TNM staging change is dividing N2 into N2a and N2b, as well as M1c into M1c1 and M1c2. Although the T staging has not changed, it has played an important role in verifying the eighth edition of the T staging. The subdivision of stage N2 has led some patients with ⅢA of the eighth edition to experience ascending or descending stages, which will more accurately help to assess the condition and prognosis of patients with mediastinal lymph node metastasis, as well as the design of related clinical studies. Modifying the M1c staging will help define oligometastasis and explore new treatment models in the future. The ninth edition of the TNM staging system provides a more detailed division of different tumor loads, but there is no clear explanation for the staging of lung cancer after neoadjuvant therapy. Further data analysis is needed, and it is expected to be answered in the tenth edition of TNM staging.