该文旨在比较DeepSeek-V3.1与ChatGPT-5在结直肠癌肝转移(CRLM)多学科团队(MDT)决策中的应用表现,评估其与MDT专家意见的一致性,为大语言模型(LLMs)的临床实践提供循证依据与优化方向。该文基于真实世界数据与最新指南,设计了6例涵盖不...该文旨在比较DeepSeek-V3.1与ChatGPT-5在结直肠癌肝转移(CRLM)多学科团队(MDT)决策中的应用表现,评估其与MDT专家意见的一致性,为大语言模型(LLMs)的临床实践提供循证依据与优化方向。该文基于真实世界数据与最新指南,设计了6例涵盖不同肿瘤负荷、基因突变谱和体能状态的虚拟CRLM病例,通过结构化的提示策略,在DeepSeek-V3.1与ChatGPT-5模型中分别生成MDT治疗建议。由4名MDT专家采用7维度5级李克特量表对模型输出进行独立评审。并通过统计学分析对两款模型在各个病例、各项维度和各个学科的表现分别进行比较。2款大语言模型在所有病例中的综合得分均≥4.0分(满分5分),表明其在复杂的MDT决策场景下具备可接受的临床效能。在跨维度分析中,两者在清晰度、个体化程度、抗幻觉能力和伦理安全4项上得分较高,而在准确性、全面性和前沿性方面仍有一定提升空间。DeepSeek-V3.1在整体表现(4.27±0.77 vs 4.08±0.86)、前沿性(3.90±0.65 vs 3.24±0.72)与伦理安全(4.87±0.34 vs 4.58±0.65)方面显著优于ChatGPT-5(P<0.05);在放疗领域亦明显领先(4.55±0.67 vs 3.38±0.91,P<0.01)。ChatGPT-5则在胃肠外科领域表现优于DeepSeek-V3.1(4.48±0.67 vs 4.17±0.85,P=0.02)。DeepSeek-V3.1与ChatGPT-5均表现出为CRLM-MDT决策提供可靠建议的良好能力。其中,Deep Seek-V3.1在前沿知识整合、伦理安全性及放射肿瘤学领域展现出显著优势,而Chat GPT-5则在胃肠外科方面表现更优,二者形成优势互补。该文证实了大型语言模型作为“MDT协作者”的可行性,为缩小地域间诊疗水平差距、提升临床决策效率提供了一项便捷可靠的技术方案。展开更多
Plasticity of cerebellar Purkinje cells(PC)is influenced by progeste rone via the classical progeste rone receptors PR-A and PR-B by stimulating dendritogenesis,spinogenesis,and synaptogenesis in these cells.Dissociat...Plasticity of cerebellar Purkinje cells(PC)is influenced by progeste rone via the classical progeste rone receptors PR-A and PR-B by stimulating dendritogenesis,spinogenesis,and synaptogenesis in these cells.Dissociated PC cultures were used to analyze progeste rone effects at a molecular level on the voltage-gated T-type-Ca^(2+)-channels Ca_(v)3.1,Ca_(v)3.2,and Ca_(v)3.3 as they helped determine neuronal plasticity by regulating Ca^(2+)-influx in neuronal cells.The results showed direct effects of progesterone on the mRNA expression of T-type-Ca^(2+)-channels,as well as on the protein kinases A and C being involved in downstream signaling pathways that play an important role in neuronal plasticity.For the mRNA expression studies of T-type-Ca^(2+)-channels and protein kinases of the signaling cascade,laser microdissection and purified PC cultures of diffe rent maturation stages were used.Immunohistochemical staining was also performed to characte rize the localization of T-type-Ca^(2+)-channels in PC.Expe rimental progesterone treatment was performed on the purified PC culture for 24 and 48 hours.Our results show that progesterone increases the expression of Ca_(v)3.1 and Ca_(v)3.3 and associated protein kinases A and Cin PC at the mRNA level within 48 hours after treatment at latest.These effects extend the current knowledge of the function of progesterone in the central nervous system and provide an explanatory approach for its influence on neuronal plasticity.展开更多
Nineteen diterpenoids, including saldigitin A(1) bearing an unprecedented 10-methylated 6/7/6 carbon ring system, two new icetexanes(2, 3), and two new nor-abietanes(5, 6) were characterized from the roots of Salvia d...Nineteen diterpenoids, including saldigitin A(1) bearing an unprecedented 10-methylated 6/7/6 carbon ring system, two new icetexanes(2, 3), and two new nor-abietanes(5, 6) were characterized from the roots of Salvia digitaloides. Their structures were elucidated by the analysis of the spectroscopic data,X-ray crystallography, and TDDFT calculations of ECD spectra. The novel architecture of 1 should be biogenetically derived through the cleavage and re-cyclization of the B/C rings from the normal abietane skeleton. Biologically, 1–5 exhibited noticeable inhibitions on Ca_(v)3.1 low voltage-gated Ca2+channel(LVGCC), with IC50values in the range of 3.43–11.70 μmol/L. They are the first example of diterpenoids with 6/7/6 carbon rings system as Ca_(v)3.1 antagonists.展开更多
文摘该文旨在比较DeepSeek-V3.1与ChatGPT-5在结直肠癌肝转移(CRLM)多学科团队(MDT)决策中的应用表现,评估其与MDT专家意见的一致性,为大语言模型(LLMs)的临床实践提供循证依据与优化方向。该文基于真实世界数据与最新指南,设计了6例涵盖不同肿瘤负荷、基因突变谱和体能状态的虚拟CRLM病例,通过结构化的提示策略,在DeepSeek-V3.1与ChatGPT-5模型中分别生成MDT治疗建议。由4名MDT专家采用7维度5级李克特量表对模型输出进行独立评审。并通过统计学分析对两款模型在各个病例、各项维度和各个学科的表现分别进行比较。2款大语言模型在所有病例中的综合得分均≥4.0分(满分5分),表明其在复杂的MDT决策场景下具备可接受的临床效能。在跨维度分析中,两者在清晰度、个体化程度、抗幻觉能力和伦理安全4项上得分较高,而在准确性、全面性和前沿性方面仍有一定提升空间。DeepSeek-V3.1在整体表现(4.27±0.77 vs 4.08±0.86)、前沿性(3.90±0.65 vs 3.24±0.72)与伦理安全(4.87±0.34 vs 4.58±0.65)方面显著优于ChatGPT-5(P<0.05);在放疗领域亦明显领先(4.55±0.67 vs 3.38±0.91,P<0.01)。ChatGPT-5则在胃肠外科领域表现优于DeepSeek-V3.1(4.48±0.67 vs 4.17±0.85,P=0.02)。DeepSeek-V3.1与ChatGPT-5均表现出为CRLM-MDT决策提供可靠建议的良好能力。其中,Deep Seek-V3.1在前沿知识整合、伦理安全性及放射肿瘤学领域展现出显著优势,而Chat GPT-5则在胃肠外科方面表现更优,二者形成优势互补。该文证实了大型语言模型作为“MDT协作者”的可行性,为缩小地域间诊疗水平差距、提升临床决策效率提供了一项便捷可靠的技术方案。
文摘Plasticity of cerebellar Purkinje cells(PC)is influenced by progeste rone via the classical progeste rone receptors PR-A and PR-B by stimulating dendritogenesis,spinogenesis,and synaptogenesis in these cells.Dissociated PC cultures were used to analyze progeste rone effects at a molecular level on the voltage-gated T-type-Ca^(2+)-channels Ca_(v)3.1,Ca_(v)3.2,and Ca_(v)3.3 as they helped determine neuronal plasticity by regulating Ca^(2+)-influx in neuronal cells.The results showed direct effects of progesterone on the mRNA expression of T-type-Ca^(2+)-channels,as well as on the protein kinases A and C being involved in downstream signaling pathways that play an important role in neuronal plasticity.For the mRNA expression studies of T-type-Ca^(2+)-channels and protein kinases of the signaling cascade,laser microdissection and purified PC cultures of diffe rent maturation stages were used.Immunohistochemical staining was also performed to characte rize the localization of T-type-Ca^(2+)-channels in PC.Expe rimental progesterone treatment was performed on the purified PC culture for 24 and 48 hours.Our results show that progesterone increases the expression of Ca_(v)3.1 and Ca_(v)3.3 and associated protein kinases A and Cin PC at the mRNA level within 48 hours after treatment at latest.These effects extend the current knowledge of the function of progesterone in the central nervous system and provide an explanatory approach for its influence on neuronal plasticity.
基金financially supported by the National Natural Science Foundation of China (Nos. 32070392 and 32070393)the Second Tibetan Plateau Scientific Expedition and Research(STEP) Program (Nos. 2019QZKK0502-0303 and 2019QZKK0502-0304)+2 种基金Natural Science Foundation of Yunnan Province (Nos.202001AS070040 and 202101AV070010)Yunnan Young&Elite Talents Project (No. YNWR-QNBJ-2020-277)CAS “Light of West China” Program (2021)。
文摘Nineteen diterpenoids, including saldigitin A(1) bearing an unprecedented 10-methylated 6/7/6 carbon ring system, two new icetexanes(2, 3), and two new nor-abietanes(5, 6) were characterized from the roots of Salvia digitaloides. Their structures were elucidated by the analysis of the spectroscopic data,X-ray crystallography, and TDDFT calculations of ECD spectra. The novel architecture of 1 should be biogenetically derived through the cleavage and re-cyclization of the B/C rings from the normal abietane skeleton. Biologically, 1–5 exhibited noticeable inhibitions on Ca_(v)3.1 low voltage-gated Ca2+channel(LVGCC), with IC50values in the range of 3.43–11.70 μmol/L. They are the first example of diterpenoids with 6/7/6 carbon rings system as Ca_(v)3.1 antagonists.
