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.

Objectives:To examine the feasibility of using foundation model in computer vision for echocardiographic left ventricular ejection fraction measurement. Methods:Based on the most extensive publicly accessible repository of echocardiographic loops,EchoNet-Dynamic,featuring 10024 recordings from individual patients,a foundation model in computer vision,VideoMAE V2,was fine-tuned,validated,tested using 7460,1288,and 1276 echocardiographic loops,respectively. Results:The mean absolute error between left ventricular ejection fraction measurements of VideoMAE V2 and expert's measurements was 3.94％ (95％CI:3.79％-4.11％).The Pearson's correlation coefficient was 0.91 (95％CI:0.89-0.92).Additionally,VideoMAE V2 demonstrated exceptional accuracy in identifying patients with a left ventricular ejection fraction below 50％,achieving an AUC of 0.96 (95％CI:0.95-0.97). Conclusions:This study validates the feasibility of using foundation model in computer vision for measuring left ventricular ejection fraction in echocardiographic loops and lays the foundation for the development of a generalized multimodal automated interpretation system for echocardiography.

Objective: To investigate the correlations between single nucleotide polymorphisms (SNPs) in the D-loop of mitochondrial DNA (mtDNA) and the disease risk as well as the prognosis of diffuse large B cell lymphoma (DLBCL). Methods: Blood samples from 108 DLBCL patients treated at the Department of Hematology of the Fourth Hospital of Heibei Medical University during July, 1991 and July 2012 were collected for this study; in addition, blood samples from 159 healthy controls during the same period were also collected. DNA was extracted according to the standard protocols for PCR amplification and SNP locus genotype analyses. The risk of D-loop SNPs was investigated by case-control study. Results: The minor alleles of nucleotides 73A/G, 263A/G, 315C/C insert were associated with a decreased risk for DLBCL. The minor allele of the nucleotides 200G/Awas associated with an increased risk for DLBCL. To further evaluate the predictive function of D-loop SNPs in DLBCL patients, five SNP sites were identified by Log-Rank test that with statistically significant prediction value of DLBCL survival in a univariate analysis. In a multivariate analysis, allele 16304 was identified as an independent predictor of DLBCL prognosis. The survival time of DLBCL patients with 16304C was significantly shorter than that of patients with 16304T (RR=0.513, 95% CI=0.266-0.989, P<0.05). Conclusion: The analysis of D-loop SNPs in mtDNA can help identifying the occurrence risks and poor prognosis subtypes of DLBCL.

Objective To evaluate the effect of single-nucleotide polymorphisms at the miRNA binding site rs3660 in the 3'-untranslated region of the KRT81 gene (miR-SNPs) on the cancer risk and clinical prognosis of non-Hodgkin's lymphomas (NHL).Methods The single-nucleo-tide polymorphisms of rs3660 was genotyped with ligation detection reaction method.The association of rs3660 with NHL survival was calculated with log-rank test using Kaplan-Meier method.Multivariate survival analysis was performed using a Cox proportional hazards model.Results The rs3660 genotype distribution difference was not statistically significant between the case and control group (P =0.50).Patients carrying the rs3660 CG/CC genotype exhibited a significantly longer survival time than patients carrying the GG genotype (P =0.012).In addition,rs3660 was associated independently with the survival of NHL patients in multivariate analysis (RR=0.589,95％ CI:0.415-0.832,P =0.004).The association of this miR-SNP with NHL survival was further confirmed in the peripheral T cell lymphoma (PTCL) subtype.Conclusion Our results indicate that KRT81 rs3660 GG type is an independent prognostic marker in NHL.

Objective: To evaluate the relationship between platelet distribution width(PDW) and the extent of coronary artery disease and 2-year outcome in patients received percutaneous coronary artery intervention(PCI) because of stable coronary artery disease(SCAD). Methods: We consecutively enrolled 4 293 patients who received PCI because of SCAD in Fuwai Hospital from Jan 2013 to Dec 2013, patients were followed up for 2 years. Patients were divided into three groups according to tertiles values of PDW as follows: PDW≤11.4%(1 402 patients), 11.4%12.9% (1 450 patients). Major adverse cardiovascular and cerebrovascular events (MACCE) were defined as the occurrence of death, myocardial infarction, target vessel revascularization, intra stent thrombosis and stroke during follow-up. Multivariable logistic regression was used to evaluate the relationship between PDW and the extent of CAD. Multivariable Cox regression was used to evaluate the relationship between PDW and prognosis of SCAD patients. Results: PDW was associated with diabetes mellitus, body mass index, red cell distribution width, mean platelet volume (MPV), platelet counts and glycosylated haemoglobin (P<0.05), but not associated with age, sex, estimated glomerular filtration rate (P>0.05). PDW was not correlated with the extent of CAD(P=0.990), SYNTAX score(P=0.721), no-reflow phenomenon after PCI(P=0.978). Multivariable logistic regression also showed no relationship between PDW and extent of CAD (OR=0.994, 95%CI 0.961-1.029, P=0.73). PDW was found to be an independent risk factor of 2-year cardiac death (HR=1.242, 95%CI 1.031-1.497, P=0.022), but was not an independent risk factor of all-cause death and MACCE. Conclusions PDW is not related with the extent of coronary artery disease. PDW is an independent risk factor of 2-year cardiac death, but is not an independent risk factor of all-cause death and MACCE in this patient cohort.

Objective To evaluate the safety and effects on blood transfusion of modified minimally cardiopulmonary bypass(CPB).Methods From April 2013 to February 2016,1103 elective cardiac surgery cases in National Center for Cardiovascular Diseases China,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College were prospectively enrolled in the study.Patients undergoing modified minimally CPB were assigned to mini-CPB group(n=553),the others undergoing conventional CPB were assigned to conventional group(n=550).In mini-CPB group,oxygenator with integrated arterial filter,modified minimized circuit,mini-cardioplegia and vacuum assisted venous drainage(VAVD)were used.In conventional group,conventional CPB was composed with conventional oxygenator from the same manufactory,conventional circuit and 1:4 blood cardioplegia.Analysis was performed with t test,t'test,Wilcoxon rank-sum test,x2 test,and Fisher exact test.Results No CPB accidents and perioperative stroke were observed.There was no statistical difference in postoperative mechanical ventilation time,length of ICU stay,postoperative complications and mortality between the two groups.The incidence of erythrocyte transfusion(13.7％vs.27.6％,x2=32.458,P=0.000)and the incidence of ultrafilter(11.0％vs.33.7％,x2=76.019,P=0.000)were lower in the mini-CPB group.Postoperative hematocrit(M(QR):32.9(5.7)vs.32.2(5.7),Z=3.403,P=0.001)and 12-hour chest drainage((228±154)ml vs.(260-±197)ml,t'=3.004,P=0.003)of mini-CPB were imporved compared with conventional group.Conclusions Modified minimally CPB is safe.It might reduce erythrocyte transfusion for adult cardiac surgery,warranting widely adoption.

Objective To evaluate the safety and effects on blood transfusion of modified minimally cardiopulmonary bypass(CPB).Methods From April 2013 to February 2016,1103 elective cardiac surgery cases in National Center for Cardiovascular Diseases China,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College were prospectively enrolled in the study.Patients undergoing modified minimally CPB were assigned to mini-CPB group(n=553),the others undergoing conventional CPB were assigned to conventional group(n=550).In mini-CPB group,oxygenator with integrated arterial filter,modified minimized circuit,mini-cardioplegia and vacuum assisted venous drainage(VAVD)were used.In conventional group,conventional CPB was composed with conventional oxygenator from the same manufactory,conventional circuit and 1:4 blood cardioplegia.Analysis was performed with t test,t'test,Wilcoxon rank-sum test,x2 test,and Fisher exact test.Results No CPB accidents and perioperative stroke were observed.There was no statistical difference in postoperative mechanical ventilation time,length of ICU stay,postoperative complications and mortality between the two groups.The incidence of erythrocyte transfusion(13.7％vs.27.6％,x2=32.458,P=0.000)and the incidence of ultrafilter(11.0％vs.33.7％,x2=76.019,P=0.000)were lower in the mini-CPB group.Postoperative hematocrit(M(QR):32.9(5.7)vs.32.2(5.7),Z=3.403,P=0.001)and 12-hour chest drainage((228±154)ml vs.(260-±197)ml,t'=3.004,P=0.003)of mini-CPB were imporved compared with conventional group.Conclusions Modified minimally CPB is safe.It might reduce erythrocyte transfusion for adult cardiac surgery,warranting widely adoption.