“By successfully integrating artificial intelligence(AI)into research workflows,researchers could substantially increase scientific productivity”[1].In biofabrication,AI is dr iving a paradigm shift from empiricism ...“By successfully integrating artificial intelligence(AI)into research workflows,researchers could substantially increase scientific productivity”[1].In biofabrication,AI is dr iving a paradigm shift from empiricism toward intelligen t,data centric manufacturing[2].By integrating computation,automation,and biology,AI gives rise to self-evolving,adaptive systems that learn from data,predict complex behaviors,and autonomously optimize fabrication outcomes.Such systems translate experimental insights into patient-specific and clinically relevant solutions,bridging laboratory research and regenerative therapies[3].This emerging frontier is rapidly advancing from concept to application.This Special Column highlights how AI-driven advanc es in materials,design,and manufacturing are reshaping biof abrication for regenerative medicine and clinical translation.展开更多
Iron deficiency anemia affects approximately 1.62 billion people worldwide,yet traditional iron supplements present bioavailability limitations and gastrointestinal side effects.This randomized,double-blind clinical t...Iron deficiency anemia affects approximately 1.62 billion people worldwide,yet traditional iron supplements present bioavailability limitations and gastrointestinal side effects.This randomized,double-blind clinical trial investigated a novel Auricularia auricula polysaccharide-iron complex(AAPIC)compared with heme iron and ferrous glycinate in 180 iron-deficient adults receiving 30 mg elemental iron daily for 12 weeks.AAPIC achieved comparable hemoglobin improvements(from 98.3±8.7 to 126.5±9.2 g/L)to heme iron(from 97.8±9.1 to 128.3±8.6 g/L)and was significantly superior to ferrous glycinate(from 98.6±8.9 to 119.7±10.3 g/L;p<0.001).Iron absorption efficiency showed AAPIC at 23.7±4.2%,heme iron at 25.1±3.8%,and ferrous glycinate at 18.4±5.1%.Toxicological assessments revealed no hepatotoxicity,nephrotoxicity,or mutagenicity.Gastrointestinal adverse events occurred in 8.3%of AAPIC recipients versus 15.0%with ferrous glycinate and 10.0%with heme iron.The polysaccharide component facilitates iron transport through enhanced intestinal uptake mechanisms.AAPIC represents a promising,well-tolerated alternative with clinical efficacy comparable to established iron formulations.展开更多
While conventional FISH and IHC methods struggle to decode complex tissue heterogeneity and comprehensive molecular diagnosis due to low-throughput spatial information,spatial omics technologies enable high-throughput...While conventional FISH and IHC methods struggle to decode complex tissue heterogeneity and comprehensive molecular diagnosis due to low-throughput spatial information,spatial omics technologies enable high-throughput molecular mapping across tissue microenvironments.These technologies are emerging as transformative tools in molecular diagnostics and medical research.By integrating histopathological morphology with spatial multi-omics profiling(genome,transcriptome,epigenome,and proteome),spatial omics technologies open an avenue for understanding disease progression,therapeutic resistance mechanisms,and precise diagnosis.It particularly enhances tumor microenvironment analysis by mapping immune cell distributions and functional states,which may greatly facilitate tumor molecular subtyping,prognostic assessment,and prediction of the radiotherapy and chemotherapy efficacy.Despite the substantial advancements in spatial omics,the translation of spatial omics into clinical applications remains challenging due to robustness,efficacy,clinical validation,and cost constraints.In this review,we summarize the current progress and prospects of spatial omics technologies,particularly in medical research and diagnostic applications.展开更多
Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was ...Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was conducted with 190 clinical nurses recruited from an oncology hospital in Central Vietnam.The self-administered Evidence-Based Practice Questionnaire(EBPQ)was employed to assess the nurses'knowledge/skills,attitudes,and implementation of EBP.Data analysis utilized descriptive statistics,the Mann-Whitney test,the Kruskal-Wallis test,and Spearman's rho correlation.Results:The mean total score for EBP implementation among the nurses was 29.52(SD=7.14)out of 42 scores.The most frequently undertaken activity was sharing evidence with colleagues,whereas finding relevant evidence was the least performed.The level of EBP implementation significantly varied based on the nurses'role types and their participation in related courses(P<0.05).Moreover,a strong positive correlation was observed between EBP implementation and both knowledge/skills(r=0.703,P<0.001)and attitudes toward EBP(r=0.536,P<0.001).Conclusions:The implementation of EBP by oncology nurses is generally moderate and is significantly positively correlated with their knowledge/skills and attitudes toward EBP.These findings underscore the importance of enhancing educational programs and facilitating suppor tive institutional policies to fur ther encourage the adoption of EBP among nurses.展开更多
Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate...Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate diagnosis difficult in routine clinical practice.Misdiagnosis may lead to inappropriate treatment strategies,increased psychological and physical burdens,reduced quality of life,and impaired social functioning.Genetic overlap may partially explain the clinical similarities between MDD and BD-Ⅱ,and biomarkers along with neuroimaging techniques are receiving increasing attention as tools to aid in diagnosis.For example,electroencephalography has been shown to effectively distinguish between unipolar depression and bipolar depression;serum levels of glycogen synthase kinase-3 have also been investigated as a potential tool for differentiating between the two disorders.A comprehensive assessment integrating clinical characteristics,genetic basis research,and multimodal evaluations using neuroimaging and biomarkers through a multidisciplinary approach will help enhance clinicians'ability to distinguish between MDD and BD-Ⅱ.By improving diagnostic accuracy,more personalized and effective treatment strategies can be developed,ultimately improving patients'health outcomes and quality of life.展开更多
The interleukin-17 family is the key group of cytokines and displays a broad spectrum of biological functions,including regulating the inflammatory cascade in various autoimmune and inflammatory diseases,such as multi...The interleukin-17 family is the key group of cytokines and displays a broad spectrum of biological functions,including regulating the inflammatory cascade in various autoimmune and inflammatory diseases,such as multiple sclerosis,neuromyelitis optica spectrum disorder,myasthenia gravis,Guillain–Barre syndrome,acute disseminated encephalomyelitis,diabetes,inflammatory skin diseases,joint inflammation,and cancer.Although the function of the interleukin-17 family has attracted increasing research attention over many years,the expression,function,and regulation mechanisms of different interleukin-17 members are complicated and still only partially understood.Currently,the interleukin-17A pathway is considered a critical therapeutic target for numerous immune and chronic inflammatory diseases,with several monoclonal antibodies against interleukin-17A having been successfully used in clinical practice.Whether other interleukin-17 members have the potential to be targeted in other diseases is still debated.This review first summarizes the recent advancements in understanding the physicochemical properties,physiological functions,cellular origins,and downstream signaling pathways of different members and corresponding receptors of the interleukin-17 family.Subsequently,the function of interleukin-17 in various immune diseases is discussed,and the important role of interleukin-17 in the pathological process of immune diseases is demonstrated from multiple perspectives.Then,the current status of targeted interleukin-17 therapy is summarized,and the effectiveness and safety of targeted interleukin-17 therapy are analyzed.Finally,the clinical application prospects of targeting the interleukin-17 pathway are discussed.展开更多
[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to t...[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to two tertiary hospitals in Jingzhou City between March and August 2024 were collected.Patients were randomly divided into three groups:<3-year-old,3—17-year-old,and≥18-year-old.A retrospective analysis was performed on their clinical features(including laboratory findings,disease course,and imaging characteristics)and epidemiological characteristics.[Results]In the<3-year-old group,28 cases(36.4%)were unvaccinated and 22 cases(28.6%)had received only one dose of the pertussis vaccine.In the 3—17-year-old group,91 cases(94.8%)had received four doses.Vaccination history was unknown for the≥18-year-old adult group.The<3-year-old group exhibited significantly higher incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the 3—17-year-old and≥18-year-old groups.Post-tussive vomiting was less frequent in the<3-year-old group than in the 3—17-year-old group but more frequent than in the≥18-year-old group;these differences were statistically significant(P<0.05).The≥18-year-old group had significantly lower incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the<3-year-old and 3—17-year-old groups(P<0.05).The proportion of cases with pneumonia and increased lung markings was higher in the<3-year-old group than in the 3—17-year-old group but lower than in the≥18-year-old group,showing statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was lower in the<3-year-old group than in both the 3—17-year-old and≥18-year-old groups,and these differences were also statistically significant(P<0.05).The proportion of pneumonia cases in the 3—17-year-old group was lower than in both the<3-year-old and≥18-year-old groups.The proportion of cases with increased lung markings was lower than in the<3-year-old group but higher than in the≥18-year-old group;these differences were statistically significant(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci in the 3—17-year-old group was higher than in the<3-year-old group but lower than in the≥18-year-old group,with statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was higher in the≥18-year-old group than in both the<3-year-old and 3—17-year-old groups,and these differences were also statistically significant(P<0.05).[Conclusions]Analysis of the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City contributes to enhancing the prevention and control of pertussis within the city.展开更多
Ganmai Dazao Decoction,originating from“Jin Gui Yao Lue”(Synopsis of the Golden Chamber),is a classical prescription for treating visceral agitation.Composed of three medicinal and edible substances-licorice(Gancao)...Ganmai Dazao Decoction,originating from“Jin Gui Yao Lue”(Synopsis of the Golden Chamber),is a classical prescription for treating visceral agitation.Composed of three medicinal and edible substances-licorice(Gancao),wheat(Xiaomai),and jujube(Dazao),it functions to nourish the heart and calm the mind,harmonize the middle burner and regulate Qi,and alleviate urgency and restlessness.As its clinical application has expanded from traditional emotional disorders to neurological,endocrine,and various psychosomatic diseases,establishing a scientifically precise quality control system and deeply elucidating its pharmacodynamic material basis and mechanism of action have become critical tasks.Modern analytical methods,typified by chromatography,spectroscopy,and their hyphenated techniques,with their high sensitivity,high resolution,and powerful substance characterization capabilities,have become the core driving force for standardizing the quality control and modernizing the clinical application research of this formula.This paper systematically reviews the progress of the aforementioned analytical techniques and chemometrics in interpreting the chemical composition,establishing fingerprint profiles,controlling process quality,and researching the pharmacodynamic material basis of Ganmai Dazao Decoction.Furthermore,it discusses integrated approaches combining analytical techniques with pharmacology and clinical medicine to reveal mechanisms of action and explore therapeutic biomarkers.Finally,it provides an outlook on future directions and challenges,including technological integration and innovation,standardization of whole-process quality control systems,and evidence-based research aimed at internationalization.展开更多
Grifola frondosa(Maitake)is traditionally valued for its health benefits,with polysaccharides being key bioactive components.This paper investigates a specific subfraction,Fraction D(GFP-D),evaluating its clinical eff...Grifola frondosa(Maitake)is traditionally valued for its health benefits,with polysaccharides being key bioactive components.This paper investigates a specific subfraction,Fraction D(GFP-D),evaluating its clinical effects and mechanisms in immune enhancement,adjunctive anti-tumor activity,and regulation of glucose/lipid metabolism.Three clinical trials were conducted.In an immune study,120 healthy volunteers(CD4+T cell count 500–1000 cells/μL)received 150 mg/day GFP-D for 8 weeks,resulting in significant increases in CD4+T cells(from 632±95 to 812±108 cells/μL,28.5%increase,within the physiological activation range),CD4+/CD8+ratio,NK cell activity,IL-2,and IFN-γ(all P<0.001 vs.placebo).An anti-tumor study with 80 advanced cancer patients(stratified by age,tumor stage,and histotype)showed that adding 1000 mg/day GFP-D to chemotherapy improved objective response rate(52.5%vs.30.0%,P=0.036,95%CI:1.02–3.87),one-year progression-free survival(55.8%vs.33.3%,P=0.022),and preserved immune parameters versus chemotherapy alone.A metabolic study in 90 type 2 diabetes patients found that 400 mg/day GFP-D for 12 weeks significantly lowered fasting glucose,HbA1c,total cholesterol,triglycerides,and LDL-C,while raising HDL-C(from 1.0±0.2 to 1.2±0.2 mmol/L,20%increase,supported by increased AMPK phosphorylation).Mechanistically,immune enhancement involves macrophage/dendritic cell activation via Dectin-1/TLR4 receptors(confirmed by increased receptor expression and downstream signaling molecules),promoting cytokine-driven T/NK cell responses.Anti-tumor effects stem from immunomodulation,direct induction of cancer cell apoptosis(via mitochondrial/caspase pathways,verified by increased Bax/Bcl-2 ratio and caspase-3 activation),and angiogenesis inhibition by downregulating VEGF.Metabolic benefits are linked to AMPK pathway activation in liver/muscle(confirmed by increased p-AMPK/AMPK ratio),enhancing glucose uptake and inhibiting gluconeogenesis/lipogenesis,alongside modulation of gut microbiota(increased Bifidobacterium and Lactobacillus abundance).All trials reported no severe adverse events related to GFP-D;liver/kidney function parameters(ALT,AST,creatinine,urea nitrogen)remained within normal ranges throughout the intervention.Collectively,GFP-D emerges as a multi-functional bioactive agent with substantial therapeutic potential.展开更多
BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges f...BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges from nonoperative methods to surgical interventions such as intramedullary K-wires,which promote faster rehabilitation and improved elbow mobility.AIM To evaluate the outcomes of managing humeral shaft fractures using closed reduction and internal fixation with flexible intramedullary K-wires.METHODS This was a retrospective cohort study analyzing the medical records of patients with humeral shaft fractures managed with flexible intramedullary K-wires at King Abdulaziz Medical City,using non-random sampling and descriptive analysis for outcome evaluation.RESULTS This study assessed the clinical outcomes of 20 patients treated for humeral shaft fractures with intramedullary K-wires.Patients were predominantly male(n=16,80%),had an average age of 39.2 years,and a mean body mass index of 29.5 kg/m^(2).The fractures most frequently occurred in the middle third of the humerus(n=14,70%),with oblique fractures being the most common type(n=7,35%).All surgeries used general anesthesia and a posterior approach,with no intraoperative complications reported.Postoperatively,all patients achieved clinical and radiological union(n=20,100%),and the majority(n=13,65%)reached an elbow range of motion from 0 to 150 degrees.CONCLUSION These results suggest that intramedullary K-wire fixation may be an effective option for treating humeral shaft fractures,with favorable outcomes in range of motion recovery,fracture union,and a low rate of intraoperative complications.展开更多
AIM:To investigate the clinical features and prognosis of patients with orbital inflammatory myofibroblastic tumor(IMT).METHODS:This retrospective study collected clinical data from 22 patients diagnosed with orbital ...AIM:To investigate the clinical features and prognosis of patients with orbital inflammatory myofibroblastic tumor(IMT).METHODS:This retrospective study collected clinical data from 22 patients diagnosed with orbital IMT based on histopathological examination.The patients were followed up to assess their prognosis.Clinical data from patients,including age,gender,course of disease,past medical history,primary symptoms,ophthalmologic examination findings,general condition,as well as imaging,laboratory,histopathological,and immunohistochemical results from digital records were collected.Orbital magnetic resonance imaging(MRI)and(or)computed tomography(CT)scans were performed to assess bone destruction of the mass,invasion of surrounding tissues,and any inflammatory changes in periorbital areas.RESULTS:The mean age of patients with orbital IMT was 28.24±3.30y,with a male-to-female ratio of 1.2:1.Main clinical manifestations were proptosis,blurred vision,palpable mass,and pain.Bone destruction and surrounding tissue invasion occurred in 72.73%and 54.55%of cases,respectively.Inflammatory changes in the periorbital site were observed in 77.27%of the patients.Hematoxylin and eosin staining showed proliferation of fibroblasts and myofibroblasts,accompanied by infiltration of lymphocytes and plasma cells.Immunohistochemical staining revealed that smooth muscle actin(SMA)and vimentin were positive in 100%of cases,while anaplastic lymphoma kinase(ALK)showed positivity in 47.37%.The recurrence rate of orbital IMT was 27.27%,and sarcomatous degeneration could occur.There were no significant correlations between recurrence and factors such as age,gender,laterality,duration of the disease,periorbital tissue invasion,bone destruction,periorbital inflammation,tumor size,fever,leukocytosis,or treatment(P>0.05).However,lymphadenopathy and a Ki-67 index of 10%or higher may be risk factors for recurrence(P=0.046;P=0.023).CONCLUSION:Orbital IMT is a locally invasive disease that may recur or lead to sarcomatoid degeneration,primarily affecting young and middle-aged patients.The presence of lymphadenopathy and a Ki-67 index of 10%or higher may signify a poor prognosis.展开更多
Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal ...Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.展开更多
Alzheimer’s disease(AD)is a complex,progressive neurodegenerative disorder and the leading cause of dementia worldwide.It is characterized by the accumulation of extracellular amyloid-beta(Aβ)plaques and intracellul...Alzheimer’s disease(AD)is a complex,progressive neurodegenerative disorder and the leading cause of dementia worldwide.It is characterized by the accumulation of extracellular amyloid-beta(Aβ)plaques and intracellular tau neurofibrillary tangles,leading to synaptic dysfunction,neuronal loss,and cognitive decline.These pathological changes can begin decades before clinical symptoms emerge,highlighting the critical need for early,accessible,and accurate diagnostic tools.展开更多
Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of U...Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of UC remain elusive. Currenttherapeutic approaches, including anti-inflammatory, immunosuppressiveand immunomodulating agents, are often limited in efficacy and frequently associatedwith adverse drug reactions. Therefore, there is an urgent need to developsafer and more effective treatment strategies to address the limitations of existingtherapies. Scutellaria baicalensis Georgi (HQ), a traditional Chinese medicinal herb,has been employed in the treatment of UC for over 2000 years. Recent studieshave demonstrated that HQ contains multiple active components capable oftreating UC through anti-inflammation, immune modulation, intestinal barrierprotection, antioxidant activity, and regulation of the gut microbiota. This paperreviews recent studies on the mechanism of action and clinical trials of HQ intreating UC based on relevant literature, with the aim of providing valuable insightsinto future treatment approaches.展开更多
Due to the special anatomical location,complex functions,and significant impact on patients’appearance and psychology,the treatment of oral and maxillofacial tumors has always been a key and difficult issue in the fi...Due to the special anatomical location,complex functions,and significant impact on patients’appearance and psychology,the treatment of oral and maxillofacial tumors has always been a key and difficult issue in the field of head and neck surgery.With the rapid development of surgical technology,microsurgical reconstruction technology,perioperative management,and multidisciplinary treatment models,surgical treatment has occupied a core position in the comprehensive treatment system of oral and maxillofacial tumors.Based on this,this paper conducts research on the clinical outcomes of surgical treatment for patients with oral and maxillofacial tumors,expounds the optimization strategies of surgical treatment,and analyzes the clinical effects of the optimized surgical treatment,aiming to provide a reference for the clinical treatment of oral and maxillofacial tumors.展开更多
Objective To develop a clinical decision and prescription generation system(CDPGS)specifically for diarrhea in traditional Chinese medicine(TCM),utilizing a specialized large language model(LLM),Qwen-TCM-Dia,to standa...Objective To develop a clinical decision and prescription generation system(CDPGS)specifically for diarrhea in traditional Chinese medicine(TCM),utilizing a specialized large language model(LLM),Qwen-TCM-Dia,to standardize diagnostic processes and prescription generation.Methods Two primary datasets were constructed:an evaluation benchmark and a fine-tuning dataset consisting of fundamental diarrhea knowledge,medical records,and chain-ofthought(CoT)reasoning datasets.After an initial evaluation of 16 open-source LLMs across inference time,accuracy,and output quality,Qwen2.5 was selected as the base model due to its superior overall performance.We then employed a two-stage low-rank adaptation(LoRA)fine-tuning strategy,integrating continued pre-training on domain-specific knowledge with instruction fine-tuning using CoT-enriched medical records.This approach was designed to embed the clinical logic(symptoms→pathogenesis→therapeutic principles→prescriptions)into the model’s reasoning capabilities.The resulting fine-tuned model,specialized for TCM diarrhea,was designated as Qwen-TCM-Dia.Model performance was evaluated for disease diagnosis and syndrome type differentiation using accuracy,precision,recall,and F1-score.Furthermore,the quality of the generated prescriptions was compared with that of established open-source TCM LLMs.Results Qwen-TCM-Dia achieved peak performance compared to both the base Qwen2.5 model and five other open-source TCM LLMs.It achieved 97.05%accuracy and 91.48%F1-score in disease diagnosis,and 74.54%accuracy and 74.21%F1-score in syndrome type differentiation.Compared with existing open-source TCM LLMs(BianCang,HuangDi,LingDan,TCMLLM-PR,and ZhongJing),Qwen-TCM-Dia exhibited higher fidelity in reconstructing the“symptoms→pathogenesis→therapeutic principles→prescriptions”logic chain.It provided complete prescriptions,whereas other models often omitted dosages or generated mismatched prescriptions.Conclusion By integrating continued pre-training,CoT reasoning,and a two-stage fine-tuning strategy,this study establishes a CDPGS for diarrhea in TCM.The results demonstrate the synergistic effect of strengthening domain representation through pre-training and activating logical reasoning via CoT.This research not only provides critical technical support for the standardized diagnosis and treatment of diarrhea but also offers a scalable paradigm for the digital inheritance of expert TCM experience and the intelligent transformation of TCM.展开更多
Whole Slide Imaging (WSI) technology, as a revolutionary digital technology in the field of pathology, is gradually changing the traditional clinical pathological diagnosis model. By converting traditional glass patho...Whole Slide Imaging (WSI) technology, as a revolutionary digital technology in the field of pathology, is gradually changing the traditional clinical pathological diagnosis model. By converting traditional glass pathological sections into complete digital images through high-resolution scanning, it provides a new method for pathological diagnosis. Based on this, this paper studies the application of WSI technology in clinical pathological diagnosis, elaborates on its application value, analyzes the current application status, and proposes corresponding application countermeasures, aiming to provide reference for the standardized and popularized development of this technology in clinical pathological diagnosis.展开更多
Alzheimer’s disease-associated transcriptomic landscapes have been defined in brain tissue.However,changes in blood RNA and their clinical relevance remain poorly understood.In this study,we developed an RNA profile ...Alzheimer’s disease-associated transcriptomic landscapes have been defined in brain tissue.However,changes in blood RNA and their clinical relevance remain poorly understood.In this study,we developed an RNA profile based on 1468 blood samples from both human and mouse studies,which include bulk RNA sequencing(RNA-seq),microRNA-seq,and single-cell RNA-seq data.We developed a comprehensive analysis pipeline that conducted over 11 million comparisons and correlations to identify more than 20,000 blood features.With these findings,we established a blood RNA database related to Alzheimer’s disease,RNAs in Blood of AD(RBAD,http://www.bioinform.cn/RBAD/).Using RBAD,we initially validated well-established Alzheimer’s disease-related pathways,including olfactory transduction.We then observed a decrease in both the proportion and functionality of erythroid cells,likely attributed to their elevated CD45 levels and interactions with GZMK^(+)CD8^(+)T cells.Furthermore,we identified 449 blood RNAs linked to patients’overall survival,along with two mRNAs(H4C3 and CTU1)associated with cognitive decline.In summary,RBAD is the first web-based analysis platform dedicated to investigating blood RNA changes in Alzheimer’s disease,and provides valuable insights into potential peripheral biomarkers and pathogenic mechanisms related to Alzheimer’s disease.展开更多
The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published s...The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published separate guidelines for NSCLC and small cell lung cancer(SCLC)for the first time to improve clinical usability.展开更多
Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and...Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and treatment efficiencies,presenting new clinical challenges.Therefore,a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique.This expert consensus discusses case selection and grading of treatment difficulty,principle of clear aligner therapy,clinical procedures and potential complications,which are crucial to the clinical success of clear aligner treatment.展开更多
文摘“By successfully integrating artificial intelligence(AI)into research workflows,researchers could substantially increase scientific productivity”[1].In biofabrication,AI is dr iving a paradigm shift from empiricism toward intelligen t,data centric manufacturing[2].By integrating computation,automation,and biology,AI gives rise to self-evolving,adaptive systems that learn from data,predict complex behaviors,and autonomously optimize fabrication outcomes.Such systems translate experimental insights into patient-specific and clinically relevant solutions,bridging laboratory research and regenerative therapies[3].This emerging frontier is rapidly advancing from concept to application.This Special Column highlights how AI-driven advanc es in materials,design,and manufacturing are reshaping biof abrication for regenerative medicine and clinical translation.
文摘Iron deficiency anemia affects approximately 1.62 billion people worldwide,yet traditional iron supplements present bioavailability limitations and gastrointestinal side effects.This randomized,double-blind clinical trial investigated a novel Auricularia auricula polysaccharide-iron complex(AAPIC)compared with heme iron and ferrous glycinate in 180 iron-deficient adults receiving 30 mg elemental iron daily for 12 weeks.AAPIC achieved comparable hemoglobin improvements(from 98.3±8.7 to 126.5±9.2 g/L)to heme iron(from 97.8±9.1 to 128.3±8.6 g/L)and was significantly superior to ferrous glycinate(from 98.6±8.9 to 119.7±10.3 g/L;p<0.001).Iron absorption efficiency showed AAPIC at 23.7±4.2%,heme iron at 25.1±3.8%,and ferrous glycinate at 18.4±5.1%.Toxicological assessments revealed no hepatotoxicity,nephrotoxicity,or mutagenicity.Gastrointestinal adverse events occurred in 8.3%of AAPIC recipients versus 15.0%with ferrous glycinate and 10.0%with heme iron.The polysaccharide component facilitates iron transport through enhanced intestinal uptake mechanisms.AAPIC represents a promising,well-tolerated alternative with clinical efficacy comparable to established iron formulations.
基金supported by the National Natural Science Foundation of China(32171022,32221005,and 32401246).
文摘While conventional FISH and IHC methods struggle to decode complex tissue heterogeneity and comprehensive molecular diagnosis due to low-throughput spatial information,spatial omics technologies enable high-throughput molecular mapping across tissue microenvironments.These technologies are emerging as transformative tools in molecular diagnostics and medical research.By integrating histopathological morphology with spatial multi-omics profiling(genome,transcriptome,epigenome,and proteome),spatial omics technologies open an avenue for understanding disease progression,therapeutic resistance mechanisms,and precise diagnosis.It particularly enhances tumor microenvironment analysis by mapping immune cell distributions and functional states,which may greatly facilitate tumor molecular subtyping,prognostic assessment,and prediction of the radiotherapy and chemotherapy efficacy.Despite the substantial advancements in spatial omics,the translation of spatial omics into clinical applications remains challenging due to robustness,efficacy,clinical validation,and cost constraints.In this review,we summarize the current progress and prospects of spatial omics technologies,particularly in medical research and diagnostic applications.
文摘Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was conducted with 190 clinical nurses recruited from an oncology hospital in Central Vietnam.The self-administered Evidence-Based Practice Questionnaire(EBPQ)was employed to assess the nurses'knowledge/skills,attitudes,and implementation of EBP.Data analysis utilized descriptive statistics,the Mann-Whitney test,the Kruskal-Wallis test,and Spearman's rho correlation.Results:The mean total score for EBP implementation among the nurses was 29.52(SD=7.14)out of 42 scores.The most frequently undertaken activity was sharing evidence with colleagues,whereas finding relevant evidence was the least performed.The level of EBP implementation significantly varied based on the nurses'role types and their participation in related courses(P<0.05).Moreover,a strong positive correlation was observed between EBP implementation and both knowledge/skills(r=0.703,P<0.001)and attitudes toward EBP(r=0.536,P<0.001).Conclusions:The implementation of EBP by oncology nurses is generally moderate and is significantly positively correlated with their knowledge/skills and attitudes toward EBP.These findings underscore the importance of enhancing educational programs and facilitating suppor tive institutional policies to fur ther encourage the adoption of EBP among nurses.
文摘Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate diagnosis difficult in routine clinical practice.Misdiagnosis may lead to inappropriate treatment strategies,increased psychological and physical burdens,reduced quality of life,and impaired social functioning.Genetic overlap may partially explain the clinical similarities between MDD and BD-Ⅱ,and biomarkers along with neuroimaging techniques are receiving increasing attention as tools to aid in diagnosis.For example,electroencephalography has been shown to effectively distinguish between unipolar depression and bipolar depression;serum levels of glycogen synthase kinase-3 have also been investigated as a potential tool for differentiating between the two disorders.A comprehensive assessment integrating clinical characteristics,genetic basis research,and multimodal evaluations using neuroimaging and biomarkers through a multidisciplinary approach will help enhance clinicians'ability to distinguish between MDD and BD-Ⅱ.By improving diagnostic accuracy,more personalized and effective treatment strategies can be developed,ultimately improving patients'health outcomes and quality of life.
基金supported by the National Natural Science Foundational of China(Key Program),No.U24A20692(to CJZ)the National Natural Science Foundational of China,Nos.82101414(to MLJ),82371355(to CJZ)+4 种基金the National Natural Science Foundational of China for Excellent Young Scholars,No.82022019(to CJZ)Sichuan Special Fund for Distinguished Young Scholars,No.24NSFJQ0052(to CJZ)The Innovation and Entrepreneurial Team of Sichuan Tianfu Emei Program,No.CZ2024018(to CJZ)Funding for Distinguished Young Scholars of Sichuan Provincial People’s Hospital,No.30420230005(to CJZ)Funding for Distinguished Young Scholars of University of Electronic Science and Technology of China,No.A1098531023601381(to CJZ)。
文摘The interleukin-17 family is the key group of cytokines and displays a broad spectrum of biological functions,including regulating the inflammatory cascade in various autoimmune and inflammatory diseases,such as multiple sclerosis,neuromyelitis optica spectrum disorder,myasthenia gravis,Guillain–Barre syndrome,acute disseminated encephalomyelitis,diabetes,inflammatory skin diseases,joint inflammation,and cancer.Although the function of the interleukin-17 family has attracted increasing research attention over many years,the expression,function,and regulation mechanisms of different interleukin-17 members are complicated and still only partially understood.Currently,the interleukin-17A pathway is considered a critical therapeutic target for numerous immune and chronic inflammatory diseases,with several monoclonal antibodies against interleukin-17A having been successfully used in clinical practice.Whether other interleukin-17 members have the potential to be targeted in other diseases is still debated.This review first summarizes the recent advancements in understanding the physicochemical properties,physiological functions,cellular origins,and downstream signaling pathways of different members and corresponding receptors of the interleukin-17 family.Subsequently,the function of interleukin-17 in various immune diseases is discussed,and the important role of interleukin-17 in the pathological process of immune diseases is demonstrated from multiple perspectives.Then,the current status of targeted interleukin-17 therapy is summarized,and the effectiveness and safety of targeted interleukin-17 therapy are analyzed.Finally,the clinical application prospects of targeting the interleukin-17 pathway are discussed.
文摘[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to two tertiary hospitals in Jingzhou City between March and August 2024 were collected.Patients were randomly divided into three groups:<3-year-old,3—17-year-old,and≥18-year-old.A retrospective analysis was performed on their clinical features(including laboratory findings,disease course,and imaging characteristics)and epidemiological characteristics.[Results]In the<3-year-old group,28 cases(36.4%)were unvaccinated and 22 cases(28.6%)had received only one dose of the pertussis vaccine.In the 3—17-year-old group,91 cases(94.8%)had received four doses.Vaccination history was unknown for the≥18-year-old adult group.The<3-year-old group exhibited significantly higher incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the 3—17-year-old and≥18-year-old groups.Post-tussive vomiting was less frequent in the<3-year-old group than in the 3—17-year-old group but more frequent than in the≥18-year-old group;these differences were statistically significant(P<0.05).The≥18-year-old group had significantly lower incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the<3-year-old and 3—17-year-old groups(P<0.05).The proportion of cases with pneumonia and increased lung markings was higher in the<3-year-old group than in the 3—17-year-old group but lower than in the≥18-year-old group,showing statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was lower in the<3-year-old group than in both the 3—17-year-old and≥18-year-old groups,and these differences were also statistically significant(P<0.05).The proportion of pneumonia cases in the 3—17-year-old group was lower than in both the<3-year-old and≥18-year-old groups.The proportion of cases with increased lung markings was lower than in the<3-year-old group but higher than in the≥18-year-old group;these differences were statistically significant(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci in the 3—17-year-old group was higher than in the<3-year-old group but lower than in the≥18-year-old group,with statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was higher in the≥18-year-old group than in both the<3-year-old and 3—17-year-old groups,and these differences were also statistically significant(P<0.05).[Conclusions]Analysis of the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City contributes to enhancing the prevention and control of pertussis within the city.
文摘Ganmai Dazao Decoction,originating from“Jin Gui Yao Lue”(Synopsis of the Golden Chamber),is a classical prescription for treating visceral agitation.Composed of three medicinal and edible substances-licorice(Gancao),wheat(Xiaomai),and jujube(Dazao),it functions to nourish the heart and calm the mind,harmonize the middle burner and regulate Qi,and alleviate urgency and restlessness.As its clinical application has expanded from traditional emotional disorders to neurological,endocrine,and various psychosomatic diseases,establishing a scientifically precise quality control system and deeply elucidating its pharmacodynamic material basis and mechanism of action have become critical tasks.Modern analytical methods,typified by chromatography,spectroscopy,and their hyphenated techniques,with their high sensitivity,high resolution,and powerful substance characterization capabilities,have become the core driving force for standardizing the quality control and modernizing the clinical application research of this formula.This paper systematically reviews the progress of the aforementioned analytical techniques and chemometrics in interpreting the chemical composition,establishing fingerprint profiles,controlling process quality,and researching the pharmacodynamic material basis of Ganmai Dazao Decoction.Furthermore,it discusses integrated approaches combining analytical techniques with pharmacology and clinical medicine to reveal mechanisms of action and explore therapeutic biomarkers.Finally,it provides an outlook on future directions and challenges,including technological integration and innovation,standardization of whole-process quality control systems,and evidence-based research aimed at internationalization.
文摘Grifola frondosa(Maitake)is traditionally valued for its health benefits,with polysaccharides being key bioactive components.This paper investigates a specific subfraction,Fraction D(GFP-D),evaluating its clinical effects and mechanisms in immune enhancement,adjunctive anti-tumor activity,and regulation of glucose/lipid metabolism.Three clinical trials were conducted.In an immune study,120 healthy volunteers(CD4+T cell count 500–1000 cells/μL)received 150 mg/day GFP-D for 8 weeks,resulting in significant increases in CD4+T cells(from 632±95 to 812±108 cells/μL,28.5%increase,within the physiological activation range),CD4+/CD8+ratio,NK cell activity,IL-2,and IFN-γ(all P<0.001 vs.placebo).An anti-tumor study with 80 advanced cancer patients(stratified by age,tumor stage,and histotype)showed that adding 1000 mg/day GFP-D to chemotherapy improved objective response rate(52.5%vs.30.0%,P=0.036,95%CI:1.02–3.87),one-year progression-free survival(55.8%vs.33.3%,P=0.022),and preserved immune parameters versus chemotherapy alone.A metabolic study in 90 type 2 diabetes patients found that 400 mg/day GFP-D for 12 weeks significantly lowered fasting glucose,HbA1c,total cholesterol,triglycerides,and LDL-C,while raising HDL-C(from 1.0±0.2 to 1.2±0.2 mmol/L,20%increase,supported by increased AMPK phosphorylation).Mechanistically,immune enhancement involves macrophage/dendritic cell activation via Dectin-1/TLR4 receptors(confirmed by increased receptor expression and downstream signaling molecules),promoting cytokine-driven T/NK cell responses.Anti-tumor effects stem from immunomodulation,direct induction of cancer cell apoptosis(via mitochondrial/caspase pathways,verified by increased Bax/Bcl-2 ratio and caspase-3 activation),and angiogenesis inhibition by downregulating VEGF.Metabolic benefits are linked to AMPK pathway activation in liver/muscle(confirmed by increased p-AMPK/AMPK ratio),enhancing glucose uptake and inhibiting gluconeogenesis/lipogenesis,alongside modulation of gut microbiota(increased Bifidobacterium and Lactobacillus abundance).All trials reported no severe adverse events related to GFP-D;liver/kidney function parameters(ALT,AST,creatinine,urea nitrogen)remained within normal ranges throughout the intervention.Collectively,GFP-D emerges as a multi-functional bioactive agent with substantial therapeutic potential.
基金approved by King Abdullah International Medical Research Center Ethics Committee(approval No.0000074524).
文摘BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges from nonoperative methods to surgical interventions such as intramedullary K-wires,which promote faster rehabilitation and improved elbow mobility.AIM To evaluate the outcomes of managing humeral shaft fractures using closed reduction and internal fixation with flexible intramedullary K-wires.METHODS This was a retrospective cohort study analyzing the medical records of patients with humeral shaft fractures managed with flexible intramedullary K-wires at King Abdulaziz Medical City,using non-random sampling and descriptive analysis for outcome evaluation.RESULTS This study assessed the clinical outcomes of 20 patients treated for humeral shaft fractures with intramedullary K-wires.Patients were predominantly male(n=16,80%),had an average age of 39.2 years,and a mean body mass index of 29.5 kg/m^(2).The fractures most frequently occurred in the middle third of the humerus(n=14,70%),with oblique fractures being the most common type(n=7,35%).All surgeries used general anesthesia and a posterior approach,with no intraoperative complications reported.Postoperatively,all patients achieved clinical and radiological union(n=20,100%),and the majority(n=13,65%)reached an elbow range of motion from 0 to 150 degrees.CONCLUSION These results suggest that intramedullary K-wire fixation may be an effective option for treating humeral shaft fractures,with favorable outcomes in range of motion recovery,fracture union,and a low rate of intraoperative complications.
基金Supported by the National Key R&D Program of China(No.2023YFC2410203)Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support(No.ZLRK202503).
文摘AIM:To investigate the clinical features and prognosis of patients with orbital inflammatory myofibroblastic tumor(IMT).METHODS:This retrospective study collected clinical data from 22 patients diagnosed with orbital IMT based on histopathological examination.The patients were followed up to assess their prognosis.Clinical data from patients,including age,gender,course of disease,past medical history,primary symptoms,ophthalmologic examination findings,general condition,as well as imaging,laboratory,histopathological,and immunohistochemical results from digital records were collected.Orbital magnetic resonance imaging(MRI)and(or)computed tomography(CT)scans were performed to assess bone destruction of the mass,invasion of surrounding tissues,and any inflammatory changes in periorbital areas.RESULTS:The mean age of patients with orbital IMT was 28.24±3.30y,with a male-to-female ratio of 1.2:1.Main clinical manifestations were proptosis,blurred vision,palpable mass,and pain.Bone destruction and surrounding tissue invasion occurred in 72.73%and 54.55%of cases,respectively.Inflammatory changes in the periorbital site were observed in 77.27%of the patients.Hematoxylin and eosin staining showed proliferation of fibroblasts and myofibroblasts,accompanied by infiltration of lymphocytes and plasma cells.Immunohistochemical staining revealed that smooth muscle actin(SMA)and vimentin were positive in 100%of cases,while anaplastic lymphoma kinase(ALK)showed positivity in 47.37%.The recurrence rate of orbital IMT was 27.27%,and sarcomatous degeneration could occur.There were no significant correlations between recurrence and factors such as age,gender,laterality,duration of the disease,periorbital tissue invasion,bone destruction,periorbital inflammation,tumor size,fever,leukocytosis,or treatment(P>0.05).However,lymphadenopathy and a Ki-67 index of 10%or higher may be risk factors for recurrence(P=0.046;P=0.023).CONCLUSION:Orbital IMT is a locally invasive disease that may recur or lead to sarcomatoid degeneration,primarily affecting young and middle-aged patients.The presence of lymphadenopathy and a Ki-67 index of 10%or higher may signify a poor prognosis.
基金supported by the Innovative Team Project of Ordinary Universities in Guangdong Province(No.2022KCXTD016).
文摘Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.
文摘Alzheimer’s disease(AD)is a complex,progressive neurodegenerative disorder and the leading cause of dementia worldwide.It is characterized by the accumulation of extracellular amyloid-beta(Aβ)plaques and intracellular tau neurofibrillary tangles,leading to synaptic dysfunction,neuronal loss,and cognitive decline.These pathological changes can begin decades before clinical symptoms emerge,highlighting the critical need for early,accessible,and accurate diagnostic tools.
基金Supported by National Natural Science Foundation of China,No.82374200Construction of Traditional Chinese Medicine Inheritance and Innovation Development Demonstration Pilot Projects in Pudong New Area-High-Level Research-Oriented Traditional Chinese Medicine Hospital Construction,No.YC-2023-0901.
文摘Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of UC remain elusive. Currenttherapeutic approaches, including anti-inflammatory, immunosuppressiveand immunomodulating agents, are often limited in efficacy and frequently associatedwith adverse drug reactions. Therefore, there is an urgent need to developsafer and more effective treatment strategies to address the limitations of existingtherapies. Scutellaria baicalensis Georgi (HQ), a traditional Chinese medicinal herb,has been employed in the treatment of UC for over 2000 years. Recent studieshave demonstrated that HQ contains multiple active components capable oftreating UC through anti-inflammation, immune modulation, intestinal barrierprotection, antioxidant activity, and regulation of the gut microbiota. This paperreviews recent studies on the mechanism of action and clinical trials of HQ intreating UC based on relevant literature, with the aim of providing valuable insightsinto future treatment approaches.
文摘Due to the special anatomical location,complex functions,and significant impact on patients’appearance and psychology,the treatment of oral and maxillofacial tumors has always been a key and difficult issue in the field of head and neck surgery.With the rapid development of surgical technology,microsurgical reconstruction technology,perioperative management,and multidisciplinary treatment models,surgical treatment has occupied a core position in the comprehensive treatment system of oral and maxillofacial tumors.Based on this,this paper conducts research on the clinical outcomes of surgical treatment for patients with oral and maxillofacial tumors,expounds the optimization strategies of surgical treatment,and analyzes the clinical effects of the optimized surgical treatment,aiming to provide a reference for the clinical treatment of oral and maxillofacial tumors.
基金National Key Research and Development Program of China(2024YFC3505400)Capital Clinical Project of Beijing Municipal Science&Technology Commission(Z221100007422092)Capital’s Funds for Health Improvement and Research(2024-1-2231).
文摘Objective To develop a clinical decision and prescription generation system(CDPGS)specifically for diarrhea in traditional Chinese medicine(TCM),utilizing a specialized large language model(LLM),Qwen-TCM-Dia,to standardize diagnostic processes and prescription generation.Methods Two primary datasets were constructed:an evaluation benchmark and a fine-tuning dataset consisting of fundamental diarrhea knowledge,medical records,and chain-ofthought(CoT)reasoning datasets.After an initial evaluation of 16 open-source LLMs across inference time,accuracy,and output quality,Qwen2.5 was selected as the base model due to its superior overall performance.We then employed a two-stage low-rank adaptation(LoRA)fine-tuning strategy,integrating continued pre-training on domain-specific knowledge with instruction fine-tuning using CoT-enriched medical records.This approach was designed to embed the clinical logic(symptoms→pathogenesis→therapeutic principles→prescriptions)into the model’s reasoning capabilities.The resulting fine-tuned model,specialized for TCM diarrhea,was designated as Qwen-TCM-Dia.Model performance was evaluated for disease diagnosis and syndrome type differentiation using accuracy,precision,recall,and F1-score.Furthermore,the quality of the generated prescriptions was compared with that of established open-source TCM LLMs.Results Qwen-TCM-Dia achieved peak performance compared to both the base Qwen2.5 model and five other open-source TCM LLMs.It achieved 97.05%accuracy and 91.48%F1-score in disease diagnosis,and 74.54%accuracy and 74.21%F1-score in syndrome type differentiation.Compared with existing open-source TCM LLMs(BianCang,HuangDi,LingDan,TCMLLM-PR,and ZhongJing),Qwen-TCM-Dia exhibited higher fidelity in reconstructing the“symptoms→pathogenesis→therapeutic principles→prescriptions”logic chain.It provided complete prescriptions,whereas other models often omitted dosages or generated mismatched prescriptions.Conclusion By integrating continued pre-training,CoT reasoning,and a two-stage fine-tuning strategy,this study establishes a CDPGS for diarrhea in TCM.The results demonstrate the synergistic effect of strengthening domain representation through pre-training and activating logical reasoning via CoT.This research not only provides critical technical support for the standardized diagnosis and treatment of diarrhea but also offers a scalable paradigm for the digital inheritance of expert TCM experience and the intelligent transformation of TCM.
文摘Whole Slide Imaging (WSI) technology, as a revolutionary digital technology in the field of pathology, is gradually changing the traditional clinical pathological diagnosis model. By converting traditional glass pathological sections into complete digital images through high-resolution scanning, it provides a new method for pathological diagnosis. Based on this, this paper studies the application of WSI technology in clinical pathological diagnosis, elaborates on its application value, analyzes the current application status, and proposes corresponding application countermeasures, aiming to provide reference for the standardized and popularized development of this technology in clinical pathological diagnosis.
基金supported by Research and Innovation Foundation of Wuhan Asia General Hospital,No.2022KYCX1-B10(to FH)the Natural ScienceFoundation of Hubei Province,No.2023AFB550(to FH)+2 种基金the National Natural Science Foundation of China,Nos.32400554(to FH),82371444(to YZ)theGuiding Project of the Scientific Research Program of the Department of Education of Hubei Province,No.B2021016(to FH)the Natural Science Foundationof Hubei Province,No.2024AFB853(to QW).
文摘Alzheimer’s disease-associated transcriptomic landscapes have been defined in brain tissue.However,changes in blood RNA and their clinical relevance remain poorly understood.In this study,we developed an RNA profile based on 1468 blood samples from both human and mouse studies,which include bulk RNA sequencing(RNA-seq),microRNA-seq,and single-cell RNA-seq data.We developed a comprehensive analysis pipeline that conducted over 11 million comparisons and correlations to identify more than 20,000 blood features.With these findings,we established a blood RNA database related to Alzheimer’s disease,RNAs in Blood of AD(RBAD,http://www.bioinform.cn/RBAD/).Using RBAD,we initially validated well-established Alzheimer’s disease-related pathways,including olfactory transduction.We then observed a decrease in both the proportion and functionality of erythroid cells,likely attributed to their elevated CD45 levels and interactions with GZMK^(+)CD8^(+)T cells.Furthermore,we identified 449 blood RNAs linked to patients’overall survival,along with two mRNAs(H4C3 and CTU1)associated with cognitive decline.In summary,RBAD is the first web-based analysis platform dedicated to investigating blood RNA changes in Alzheimer’s disease,and provides valuable insights into potential peripheral biomarkers and pathogenic mechanisms related to Alzheimer’s disease.
文摘The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published separate guidelines for NSCLC and small cell lung cancer(SCLC)for the first time to improve clinical usability.
文摘Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and treatment efficiencies,presenting new clinical challenges.Therefore,a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique.This expert consensus discusses case selection and grading of treatment difficulty,principle of clear aligner therapy,clinical procedures and potential complications,which are crucial to the clinical success of clear aligner treatment.
