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Recently, Chatbot Generative Pre-trained Transformer (ChatGPT) is recognized as a promising clinical decision support system (CDSS) in the medical field owing to its advanced text analysis capabilities and interactive design. However, ChatGPT primarily focuses on learning text semantics rather than learning complex data structures and conducting real-time data analysis, which typically necessitate the development of intelligent CDSS employing specialized machine learning algorithms. Although ChatGPT cannot directly execute specific algorithms, it aids in algorithm design for intelligent CDSS at the textual level. In this study, besides discussing the types of CDSS and their relationship with ChatGPT, we mainly investigate the benefits and drawbacks of employing ChatGPT as an auxiliary design tool for intelligent CDSS. Our findings indicate that by collaborating with human expertise, ChatGPT has the potential to revolutionize the development of robust and effective intelligent CDSS.

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Objectives: Anterior cruciate ligament reconstruction (ACLR) is the most common surgery for anterior cruciate ligament (ACL) injuries, and the relationships between patients' return to sports (RTS) readiness and different physical functions are inconclusive among patients with ACLR. This study aimed to investigate the correlations of strength, proprioception, and tactile sensation to the RTS readiness among patients with ACLR. Methods: Forty-two participants who received ACLR for at least 6 months were enrolled in this study. Their strength, proprioception, and tactile sensation were tested, and their RTS readiness was measured with the Knee Santy Athletic Return to Sports (K-STARTS) test, which consists of a psychological scale [Anterior Cruciate Ligament Return to Sports after Injury scale (ACL-RSI)] and seven functional tests. Partial correlations were used to determine their correlations while controlling for covariates (age, height, weight, and postoperative duration), and factor analysis and multivariable linear regressions were used to determine the degrees of correlation. Results: Knee extension strength was moderately correlated with K-STARTS total, ACL-RSI, and functional scores. Knee flexion strength, knee flexion and extension proprioception, and tactile sensation at the fifth metatarsal were moderately correlated with K-STARTS total and functional scores. Strength has higher levels of correlation with functional scores than proprioception. Conclusion: Rehabilitation to promote muscle strength, proprioception and tactile sensation should be performed among patients with ACLR, muscle strength has the highest priority, followed by proprioception, with tactile sensation making the least contribution.

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OBJECTIVES: The humerus fracture is one of the most commonly occurring fractures. In this research, we attempted to evaluate and compare the extent of malrotation and biomechanical environment after surgical treatment of humeral shaft fractures. METHODS: A finite element (FE) model of the shoulder was built based on Computed Tomography (CT) data of a patient with a humeral shaft fracture. The muscle group around the shoulder joint was simulated by spring elements. The changes of shoulder stresses under rotation were analyzed. The biomechanics of the normal shoulder and postoperative malrotation of the humeral shaft was analyzed and compared. RESULTS: During rotations, the maximum stress was centered in the posterosuperior part of the glenoid for the normal shoulder. The von Mises shear stresses were 4.40 MPa and 4.89 MPa at 40° of internal and external rotations, respectively. For internal rotation deformity, the shear contact forces were 7-9 times higher for the shoulder internally rotated 40° than for the normal one. For external rotation deformity, the shear contact forces were about 3-5 times higher for the shoulder with 40° external rotation than the normal one. CONCLUSION: Postoperative malrotation of humeral shaft fracture induced the changes of the biomechanical environment of the shoulders. The peak degree of malrotation was correlated with increased stresses of shoulders, which could be paid attention to in humeral shaft fracture treatment. We hoped to provide information about the biomechanical environment of humeral malrotation.

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Diabetes mellitus, a worldwide health threat, is considered an independent risk factor for cardiovascular diseases. The overall cardiovascular risk of diabetes is similar to the one having one myocardial infarction (MI) attack although the precise impact of diabetes on MI-induced myocardial anomalies remains elusive. Given that mortality following MI is much greater in diabetic patients compared to nondiabetic patients, this study was designed to examine the effect of melatonin on MI injury-induced myocardial dysfunction in diabetes. Adult mice were made diabetic using high-fat feeding and streptozotocin (100 mg/kg body weight) prior to MI and were treated with melatonin (50 mg/kg/d, p.o.) for 4 weeks prior to assessment of cardiac geometry and function. The MI procedure in diabetes displayed overt changes in cardiac geometry (chamber dilation and interstitial fibrosis) and functional anomalies (reduced fractional shortening and cardiomyocyte contractile capacity) in association with elevated c-Jun N-terminal kinase (JNK) phosphorylation and p53 level. Melatonin treatment markedly attenuated cardiac dysfunction and myocardial fibrosis in post-MI diabetic mice. Furthermore, melatonin decreased JNK phosphorylation, reduced p53 levels, and suppressed apoptosis in hearts from the post-MI diabetic group. In vitro findings revealed that melatonin effectively counteracted high-glucose/high fat-hypoxia-induced cardiomyocyte apoptosis and contractile dysfunction through a JNK-mediated mechanism, the effects of which were impaired by the JNK activator anisomycin. In summary, our study suggests that melatonin protects against myocardial injury in post-MI mice with diabetes, which offers a new therapeutic strategy for the management of MI-induced cardiac injury in diabetes.

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