This comprehensive review systematically explores the multifaceted applications, inherent challenges, and promising future directions of artificial intelligence (AI) within the medical domain. It meticulously examines AI's specific contributions to basic medical research, disease prevention, intelligent diagnosis, treatment, rehabilitation, nursing, and health management. Furthermore, the review delves into AI's innovative practices and pivotal roles in clinical trials, hospital administration, medical education, as well as the realms of medical ethics and policy formulation. Notably, the review identifies several key challenges confronting AI in healthcare, encompassing issues such as inadequate algorithm transparency, data privacy concerns, absent regulatory standards, and incomplete risk assessment frameworks. Looking ahead, the future trajectory of AI in healthcare encompasses enhancing algorithm interpretability, propelling generative AI applications, establishing robust data-sharing mechanisms, refining regulatory policies and standards, nurturing interdisciplinary talent, fostering collaboration among industry, academia, and medical institutions, and advancing inclusive, personalized precision medicine. Emphasizing the synergy between AI and emerging technologies like 5G, big data, and cloud computing, this review anticipates a new era of intelligent collaboration and inclusive sharing in healthcare. Through a multidimensional analysis, it presents a holistic overview of AI's medical applications and development prospects, catering to researchers, practitioners, and policymakers in the healthcare sector. Ultimately, this review aims to catalyze the deep integration and innovative deployment of AI technology in healthcare, thereby driving the sustainable advancement of smart healthcare.

As the volume of medical research using large language models (LLM) surges, the need for standardized and transparent reporting standards becomes increasingly critical. In January 2025, Nature Medicine published statement titled by TRIPOD-LLM reporting guideline for studies using large language models. This represents the first comprehensive reporting framework specifically tailored for studies that develop prediction models based on LLM. It comprises a checklist with 19 main items (encompassing 50 sub-items), a flowchart, and an abstract checklist (containing 12 items). This article provides an interpretation of TRIPOD-LLM’s development methods, primary content, scope, and the specific details of its items. The goal is to help researchers, clinicians, editors, and healthcare decision-makers to deeply understand and correctly apply TRIPOD-LLM, thereby improving the quality and transparency of LLM medical research reporting and promoting the standardized and ethical integration of LLM into healthcare.

BackgroundThe issue of depression among adolescents is becoming increasingly serious， seriously endangering their healthy development. The issue of sleep disturbances in adolescents with depressive disorder is gradually receiving attention， but there is currently a lack of research on the relationship between sleep quality and suicide risk in this patient population. ObjectiveTo explore the relationship between suicide risk and sleep quality in adolescents with depressive disorders， and analyze the influencing factors of suicide risk， so as to provide references for clinical intervention. MethodsA total of 101 adolescents patients who met the diagnostic criteria for depressive disorder in the International Classification of Diseases， 10th edition （ICD-10） and were hospitalized at Hefei Fourth People's Hospital from June 2020 to February 2023 were selected. The patients were evaluated using the Nurses' Global Assessment of Suicide Risk （NGASR） and Pittsburgh Sleep Quality Index （PSQI）. According to the NGASR score， patients were divided into severe suicide risk group （n=35） and non-severe suicide risk group （n=66）. Pearson correlation analysis was used to examine the correlation between sleep quality and suicide risk in adolescents with depression. Multiple Logistic regression was used to analyze the influencing factors of severe suicide risk in adolescent patients with depression. ResultsStatistically significant differences were found between the two groups in terms of academic pressure， peer relationship and family relationship （t=3.942， 4.378， 6.748， P<0.05）. Moreover， there was a statistically significant difference in PSQI score between two groups （t=7.398， P<0.05）. There was also a statistically significant difference in sleep quality between the two groups （χ²=4.986， P<0.05）. Pearson correlation analysis showed a positive correlation between total PSQI score and NGASR score （r=0.698， P<0.05）. Severe depression （OR=1.628， 95% CI： 1.079~2.457）， high academic pressure （OR=1.118， 95% CI： 1.018~1.228） and poor sleep quality （OR=1.158， 95% CI： 1.033~1.297） were identified as risk factors of severe suicide risk， while good relationships with classmates （OR=0.908， 95% CI： 0.826~0.998） and family （OR=0.904， 95% CI： 0.823~0.993） were protective factors. ConclusionSleep quality in adolescents with depression is negatively correlated with suicide risk and poor sleep quality may be a risk factor for severe suicide risk.

Objective In order to reasonably reduce QY group and improve the accuracy of DRG,we analyzed the data of QY(ambiguity)group in the Diagnosis Related Groups in urology department of a three A and tertiary hospital.Methods Medical insurance settlement statements of urology department of a hospital in the DRG sub-platform of a municipal medical insur-ance bureau were collected from April 1,2022 to November 30,2022,extracting QY cases.The medical records of QY cases were extracted from the digital medical record browser of a hospital.Senior quality control physicians were organized to check medical records,disease classification and medical insurance settlement statements of QY group cases,analyzing the cases.Excel 2010 was used for statistical analysis of the data.Results ① 2 810 copies of medical insurance settlement statements were obtained,of which 43 cases were in the QY groups,accounting for 1.53％.②The cases mainly distributed in urinary system tumors(27.91％),neurogenic bladder(18.60％),prostatic hyperplasia(16.28％),ureteral diseases(11.62％),and ure-thral diseases(11.62％).(3)The total hospitalization cost of patients in QY groups was 731 684.1 yuan,and the average hospi-talization cost was 17 015.91 yuan.The total payment amount of DRG was 419 807.24 yuan,and the average payment amount was 9 762.96 yuan.④The causes of QY groups were as follows:There were 14 cases of DRG grouping rule defect,accounting for 32.56％;There were 29 cases of hospital management defects,accounting for 67.44％.Among the hospital management de-fects,13 cases(30.23％)of the medical insurance settlement statements were defective;There were 8 cases(18.60％)of er-rors in doctors'major diagnoses and major surgical operations.There were 8 cases(18.60％)of coding errors in major diagno-ses and major surgical operations.Conclusion To reasonable reduction QY group,it is necessary to optimize DRG grouping rules and strengthen hospital internal management.Only by paying attention to improve the connotation quality of medical re-cords,accurately classify disease and surgical name,strengthen the management and review of medical insurance settlement state-ments,and establish a long-term mechanism for DRG data quality control,we can further improve the accuracy of DRG and ac-tively promote the reform of medical insurance payment.

The umbrella trial has received increasing attention in the design of clinical trials for oncology drugs in recent years. This trial design categorizes a single disease into multiple sub-types based on predictive biomarkers or other predictive factors, and simultaneously evaluates the efficacy of multiple targeted therapies. When compared with the traditional drug development model of phase Ⅰ, phaseⅡ, and phase Ⅲ randomized controlled trials, umbrella trials are a more scientifically rigorous trial design that can speed up drug evaluation to address the conflict between numerous untested drugs and diseases with a lack of effective treatment options. This article will focus on the concept, main characteristics, eligibility criteria, design and statistical considerations, ethical considerations, and future directions of umbrella trials, with the aim of providing methodological guidance for the design of clinical trials for oncology drugs.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

【Objective】 To explore the clinical characteristics and risk factors of renal function deterioration in children with renal dysplasia and chronic kidney disease (CKD), so as to provide a basis for the diagnosis, treatment, and management. 【Methods】 The clinical data of children with renal dysplasia complicated with CKD treated in the Children’s Hospital of Chongqing Medical University during 2012 and 2022 were retrospectively analyzed, including the gender, age of diagnosis, growth index, concomitant malformation and complications. According to the diagnostic criteria and staging standard of KDIGO2020 guidelines, patients with disease deteriorated to CKD stage 4-5 were enrolled into the regression group. Factors affecting the deterioration of renal function were determined with Cox regression analysis. 【Results】 A total of 122 children were involved, including 66 (54.1%) with CKD stag 4-5. There were more boys than girls. Bilateral and unilateral renal dysplasia occurred in 88 (72.13%) and 34 (27.87%) cases, respectively, and 64 (52.46%) cases were complicated with other urinary diseases. There were significant differences in weight, height and body mass index (BMI) among patients with CKD stage 1-5 (P<0.01). The age of onset of CKD <10 years, BMI lower than the 3rd percentile of the same sex and age, bilateral renal dysplasia, and one or more complications of congenital renal and urinary tract abnormalities (CAKUT) were the risk factors of deterioration of renal function (P<0.05). 【Conclusion】 Renal dysplasia complicated with CKD are more common in boys, with high incidence of bilateral renal dysplasia. Bilateral renal dysplasia, age of onset of CKD <10 years, BMI lower than 3% and complications are important influencing factors of renal dysplasia in children with CKD.

OBJECTIVE To evaluate the effectiveness， safety， economy， innovation， suitability and accessibility of recombinant Mycobacterium tuberculosis fusion protein （EC）， and to provide evidence for selecting skin detection methods for tuberculosis infection diagnosis and auxiliary diagnosis of tuberculosis. METHODS The effectiveness and safety of EC compared with purified protein derivative of tuberculin （TB-PPD） were analyzed by the method of systematic review. Cost minimization analysis， cost-effectiveness analysis and cost-utility analysis were used to evaluate the short-term economy of EC compared with TB-PPD， and cost-utility analysis was used to evaluate the long-term economy. The evaluation dimensions of innovation， suitability and accessibility were determined by systematic review and improved Delphi expert consultation， and the comprehensive score of EC and TB-PPD in each dimension were calculated by the weight of each indicator. RESULTS The scores of effectiveness， safety， economy， innovation and suitability of EC were all higher than those of TB-PPD. The affordability scores of the two drugs were consistent， while the availability score of EC was lower than those of TB-PPD. After considering dimensions and index weight， the scores of effectiveness， safety， economy， innovation， suitability， accessibility and the comprehensive score of EC were all higher than those of TB-PPD. CONCLUSIONS Compared with TB-PPD， EC performs better in all dimensions of effectiveness， safety， economy， innovation， suitability and accessibility. However， it is worth noting that EC should further improve its availability in the dimension of accessibility.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.

The synchronous abnormal discharge of neurons leads to epileptic seizures.However, in addition to neurons, microglia, as the main immune cells in the brain, plays an important role in the development and maintenance of neural circuits.Microglia is involved in early epileptic seizures, which can be mediated by increasing inflammatory cytokines and chemokines.Microglia can regulate the abnormal neurogenesis after epileptic seizures, promote the death of neurons after seizures, and cause neurodegeneration.Moreover, it can also affect synaptic pruning after seizures, eliminate synapses by phagocytosis or stripping, destroy the balance between synaptic excitation and inhibition, and aggravate seizures.Microglia plays an important role in the development of epilepsy.However, whether microglia participates in the occurrence of epilepsy still needs to be further studied.