AI's deep dive into complex pediatric inguinal hernia issues: a challenge to traditional guidelines?

OBJECTIVE: This study utilized ChatGPT, an artificial intelligence program based on large language models, to explore controversial issues in pediatric inguinal hernia surgery and compare its responses with the guidelines of the European Association of Pediatric Surgeons (EUPSA). METHODS: Six contentious issues raised by EUPSA were submitted to ChatGPT 4.0 for analysis, for which two independent responses were generated for each issue. These generated answers were subsequently compared with systematic reviews and guidelines. To ensure content accuracy and reliability, a content analysis was conducted, and expert evaluations were solicited for validation. Content analysis evaluated the consistency or discrepancy between ChatGPT 4.0's responses and the guidelines. An expert scoring method assess the quality, reliability, and applicability of responses. The TF-IDF model tested the stability and consistency of the two responses. RESULTS: The responses generated by ChatGPT 4.0 were mostly consistent with the guidelines. However, some differences and contradictions were noted. The average quality score was 3.33, reliability score was 2.75, and applicability score was 3.46 (out of 5). The average similarity between the two responses was 0.72 (out of 1), Content analysis and expert ratings yielded consistent conclusions, enhancing the credibility of our research. CONCLUSION: ChatGPT can provide valuable responses to clinical questions, but it has limitations and requires further improvement. It is recommended to combine ChatGPT with other reliable data sources to improve clinical practice and decision-making.

[Research advancements of two-dimensional black phosphorus in dentistry].

Two-dimensional black phosphorus (BP) has unique layered structure, excellent photothermal properties, good biocompatibility and high biodegradability. In recent years, it has been found that BP has stable drug loading and light controlled sustained-release drug functions, excellent antibacterial properties and the ability to promote vascular and nerve regeneration in the medicine field, which has a broad application prospect in dentistry. This review elaborates the biological properties of two-dimensional BP and its application progress in dentistry, so as to provide new ideas for the further research and application of two-dimensional BP.

Photoacoustic imaging of cerebral hypoperfusion during acupuncture.

Using acupuncture to treat cerebral hypoperfusion is a hot topic. However, there is a lack of effective tools to clarify the therapeutic effect of acupuncture on cerebral hypoperfusion. Here, we show in a mouse model of cerebral hypoperfusion that photoacoustic tomography (PAT) can noninvasively image cerebral vasculature and track total hemoglobin (HbT) concentration changes in cerebral hypoperfusion with acupuncture stimulation on the YangLingQuan (GB34) point. We measured the changes of HbT concentration and found that the HbT concentration in hypoperfusion regions was clearly lower than that in the control regions when the acupuncture was absent; however, it was significantly increased when the acupuncture was implemented on the GB34 point. We also observed the increase of vessel size and the generation of new vessels in cerebral hypoperfusion during acupuncture. Laser speckle imaging (LSI) was employed to validate some of the PAT findings.

PG27, an extract of Tripterygium wilfordii hook f, induces antigen-specific tolerance in bone marrow transplantation in mice.

PG27, an active fraction purified from an extract of a Chinese herb, Tripterygium wilfordii hook f, was used to prevent graft-versus-host disease (GVHD) in a murine model. Lethally irradiated BALB/c (H-2(d)) recipients of B10.D2 (H-2(d)) donor grafts were given daily intraperitoneal injections of PG27 (40 mg/kg per day) for the first 35 days after transplantation. Control mice were given daily injections of solvent vehicle (Ethanol and Cremophor EL). All the control recipients (15/15) died of GVHD within 90 days, but all the recipients given prophylactic treatment with PG27 (15/15) survived beyond 100 days without any signs of GVHD. Furthermore, the GVHD-free recipients were used as donors, and their bone marrow and spleen cells were transplanted into lethally irradiated normal BALB/c (same party) or lethally irradiated normal C3H (H-2(k), third party) mice. Although 10 of 10 same-party recipients survived more than 100 days without any signs of GVHD, 10 of 10 third-party C3H recipients died of GVHD within 40 days. Further studies of PG27 in the murine BCL1 leukemia/lymphoma model demonstrated that animals treated with PG27 partially retained the graft-versus-leukemia (GVL) effect of the graft without GVHD. These results suggest that treatment with PG27 induces host-specific tolerance and retains the GVL effect of allogeneic marrow grafts. (Blood. 2000;95:705-710)

[The effects of Xuezhikang on neointimal proliferation and C-myc gene expression after angioplasty in rabbits].

OBJECTIVE: To investigate the effects of Xuezhikang (XZhK) on the neointimal proliferation and C-myc gene expression after angioplasty in rabbits. METHODS: Angioplasty for atherosclerotic stenosis of celiac arteries was performed in 30 male white rabbits after being fed with cholesterol-supplemented diet for 8 weeks, which were then randomized to control group, high-cholesterol group and XZhK group. After 4 weeks, the local vessels were collected for morphological observation. C-myc mRNA level was measured with RT-PCR and C-myc protein with immunohistochemical analysis. RESULTS: Morphological observation showed that the neointimal area in the XZhK group were less than the control group (P < 0.05), and that in control group were less than that in the high-cholesterol group (P < 0.05). The levels of C-myc mRNA measured with RT-PCR and the percentage of C-myc protein positive cell by immunohistochemical analysis were lower in the XZhK group than in the control and high-cholesterol group (P < 0.05), The levels in the latter two groups showed no difference (P > 0.05). CONCLUSION: XZhK can inhibit the neointimal proliferation and the expression of C-myc gene after angioplasty in rabbits.

[Non-surgical treatment of small cell lung cancer with chemo-radio-immunotherapy and traditional Chinese medicine].

54 consecutive cases of small cell lung cancer (SCLC) were treated with longterm short-interval combined treatment modalities of chemotherapy, radiotherapy (55-65 GY), immunotherapy, traditional Chinese medicine (leaf of Asiatic Ginseng, root of Astragalus membranaceus Bge, etc) and other adjuvants. Chemotherapy consisted of vincristine, cyclophosphamide, methotrexate and carmustine. A complete response of 59.2%, partial response of 38.9% and an overall response of 98.1% were achieved. According to Kaplan-Meier, the survival rates of SCLC with limited disease for 1, 3, 5 and 10 years were 78.1%, 42.6%, 32.1% and 21.4% respectively; while those with extensive disease for 1, 3, and 5 years 90.5%, 13.4% and 13.4%. According to classification of international TNM staging (1988), the survival rates of stage II SCLC for 1, 3, 5 and 10 years were 92.9%, 61.9%, 53.1% and 31.8% respectively; of stage IIIa for 1, 3 and 5 years 80.0%, 30.0% and 20.0%, and of stage IIIb 83.3%, 20.8% and 15.6%. Our combined modalities raised the survival rates considerably; the improved effect was mainly due to the long-term (especially more than 2 years or 10 courses), short-interval, effective and timely combined treatment with chemotherapy, radiotherapy and adjuvants such as traditional Chinese medicine and immunotherapy. By using the above therapeutic strategy, 10 out of 12 SCLC patients including 4 with extensive disease, who were relatives of our hospital staffs, have gained more than 3-17 years of survival. Therefore small cell lung cancer even with extensive disease was a hopeful curable disease.