The application of artificial intelligence(AI)in medical diagnosis and treatment is becoming increasingly widespread,providing doctors and patients with more high-quality,efficient and personalized medical services.However,it also raised a series of ethical issues such as data security,algorithm transparency,responsibility definition,fairness and justice,doctor-patient relationships,and other aspects.Based on the combing of existing research results,this paper analyzed the research status of medical ethics in the application of AI in diagnosis and treatment,as well as expected that future medical ethics research can further explore the ethical issues of AI technology in medical treatment in greater depth,thus ensuring the rational application of AI in the medical field and maximizing the protection of patients'rights and interests.

Objective:To observe any effect of dynamic motor instability training on the balance and postural control of stroke survivors.Methods:Forty stroke survivors with poor balance were randomly divided into a control group and an observation group, each of 20. In addition to routine rehabilitation, the observation group was given 20 minutes of dynamic motor instability training, 5 days a week for 8 weeks, while the control group underwent routine rehabilitation for the same length of time. Before and after the intervention, surface electromyogram of the rectus femoris, biceps femoris, and erector spinae were recorded during perturbation. Activation time and the intensity of the anticipatory and complementary postural adjustments (APAs and CPAs) were also observed. Balance and lower limb motor functioning were assessed using the Berg balance scale (BBS), the Fugl-Meyer lower extremity assessment (FMA-LE), and GaitWatch analysis.Results:After the treatment the average activation time of the rectus femoris, biceps femoris in the affected side and those of the biceps femoris [(-84.31±5.74)s] and erector spinae in the intact side in APAs were all significantly shorter in the observation group than in the control group, while the average activation intensity of the rectus femoris and erector spinae was significantly greater. There was no significant difference in the activation intensity of each muscle group in CPAs after the treatment. After the intervention the average BBS score, FMA-LE score, stride length and walking speed of the observation group all were significantly better than the control group′s averages.Conclusions:Supplementing traditional rehabilitation training with dynamic motor instability training can further improve the posture control of stroke survivors and promote recovery of their balance and walking ability.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

The chemical complexity of traditional Chinese medicines (TCMs) makes the active and functional annotation of natural compounds challenging. Herein, we developed the TCMs-Compounds Functional Annotation platform (TCMs-CFA) for large-scale predicting active compounds with potential mechanisms from TCM complex system, without isolating and activity testing every single compound one by one. The platform was established based on the integration of TCMs knowledge base, chemome profiling, and high-content imaging. It mainly included: (1) selection of herbal drugs of target based on TCMs knowledge base; (2) chemome profiling of TCMs extract library by LC‒MS; (3) cytological profiling of TCMs extract library by high-content cell-based imaging; (4) active compounds discovery by combining each mass signal and multi-parametric cell phenotypes; (5) construction of functional annotation map for predicting the potential mechanisms of lead compounds. In this stud TCMs with myocardial protection were applied as a case study, and validated for the feasibility and utility of the platform. Seven frequently used herbal drugs (Ginseng, etc.) were screened from 100,000 TCMs formulas for myocardial protection and subsequently prepared as a library of 700 extracts. By using TCMs-CFA platform, 81 lead compounds, including 10 novel bioactive ones, were quickly identified by correlating 8089 mass signals with 170,100 cytological parameters from an extract library. The TCMs-CFA platform described a new evidence-led tool for the rapid discovery process by data mining strategies, which is valuable for novel lead compounds from TCMs. All computations are done through Python and are publicly available on GitHub.

Objective:To explore the development history, research hotspots and future trends of curriculum ideological and political education in nursing.Methods:Articles related to nursing curriculum ideological and political education from January 2017 to December 2021 were retrieved from the three databases of China National Knowledge Infrastructure, VIP and WanFang Data. ItgInsight was used to analyze the trend of publication, high-volume journals, author association network, institutional cooperation, research hotspot clustering and its development trend.Results:In the past five years, a total of 333 nursing curriculum ideological and political education articles were published in China, and the number of published papers increased year by year. The main journals were educational journals, with the most vocational education journals. According to the research direction, the scholars were divided into five groups of "Nursing Basic Curriculum Ideological and Political Education" "Comprehensive Training of Nursing Post Competencies" "Morality Establishment and People Cultivation" "Socialist Core Values", and "Teaching Ability Design". There was little academic cooperation among the institutions. A total of 84.68% (282/333) of the articles received funding, and the overall funding ratio was high. Relevant research mainly focused on three aspects, namely, teaching content and teaching methods, entry point of ideological and political elements, and teaching management of curriculum ideological and political education. From 2017 to 2021, "values" continued to be a research hotspot.Conclusions:Although the number of nursing curriculum ideological and political education has increased, it has not yet formed a stable and high-yield author group. In addition, the quality of research needs to be improved, the level of funded projects is low, the academic cooperation among institutions needs to be strengthened, and research hotspots are updated quickly, but the sustainability of research still needs to be improved.

Objective To explore the effect of robot-assisted gait training on pelvis kinematics and the walking function of hemiplegic stroke survivors.Methods Thirty stroke survivors with hemiplegia were randomly divided into a treatment group and a control group,each of 15.Both groups were given routine clinical medication and rehabilitation training,while the treatment group was additionally provided with 20 minutes of robot-assisted gait training a day,6 d/wk for 8 weeks.Before and after the treatment,all of the patients' pelvis kinematics were assessed using 10 m walking speed (MWS),the timed up and go test (TUGT) and functional ambulation categorization (FAC).Results Before the treatment there were no significant differences between the two group in any of the measurements.After the treatment,significant improvement was observed in both groups in the vertical displacement and rotation and tilt angles of the pelvis while walking,with significantly more improvement in the treatment group than in the control group.There was also significant improvement in the average walking speed,TUGT time and FAC score of both groups,with significantly more improvement in the treatment group.Conclusion Robot-assisted gait training can significantly improve the pelvis control and walking ability of hemiplegic stroke survivors.

Objective To explore the effect of robot assistance on the gait kinematics of hemiplegic persons after a stroke.Methods Forty hemiplegic stroke patients were randomly divided into an experimental group and a control group,each of 20.Both groups were given routine neurological medication and rehabilitation training,while the experimental group was additionally provided with 20 minutes of robot-assisted gait training daily,six times a week,for 8 weeks.Before and after the intervention,both groups' motor function,balance,step length and pace were evaluated,as well as their pelvic rotation angles,side inclination,vertical displacement and lateral displacement.The Fugl-Meyer assessment for the lower extremities (FMA-LE) was used along with the Berg balance scale (BBS),the gait analysis system of Biodex Gait Trainer-2 equipment.Results After the treatment,the average FMA-LE score,BBS score,pace and step length of the experimental group were all significantly better than the before the treatment and significantly better than the control group's averages after the treatment.The improvements observed in the pelvic rotation angle,side inclination,vertical displacement and lateral displacement were all significant.Conclusion Robot assistance can usefully supplement routine rehabilitation training after stroke.It can improve control of the pelvis,enhance walking and balance and generally improve the motor function of the lower extremities.

Objective: To analyze the clinical features of inpatients infected with influenza A virus, and then to provide evidence for the diagnosis, treatment and prevention of influenza A in primary hospital. Methods: The clinical data of inpatients with influenza A in one district hospital from Dec 2016 to Mar 2017 were collected to analyze retrospectively. Results: A total of 21 665 patients were admitted to hospital from Dec 2016 to Mar 2017. Among them 647 flu-like cases accepted influenza A nucleic acid detection, and 203 cases were positive, the positive rate was 31.4%. The median age of influenza A positive patients was 64.25 years, and 20.2% were 0 to 4 years, 49.26% were 65 years of age or older. 58.13% patients had at least one underlying medical condition. Fever, Cough and Sputum were the most symptoms of patients infected with influenza A. Compared with the patients under 60 years old, non-fever symptoms were more common in those 60 years or older, the difference was statistically significant (χ²=15.43, P<0.001). Laboratory examination indicated that lymphocytopenia were detected in 54.27% of patients, and increased level of C-reactive protein and procalcitonin (PCT) in 74.83% and 11.76% of patients respectively. Moreover, 75.58% of patients had high erythrocyte sedimentation rate (ESR), 8 patients (97.3%) had findings consistent with pneumonia. 78.33% of patients received anti-viral treatment with oseltamivir, the rate of antibiotic utilization was as high as 85.22%. The median of hospitalization expense of patients infected with influenza A was 4 280 (interquartile range 2 792-9 565) yuan, and the cost of inpatients who had combined underlying diseases were higher than that in inpatients who had no coexisting medical conditions, the difference was statistically significant (Z=7.106, P<0.01). No death occurred in this study. Conclusions Children and old people were at high risk for influenza A infection. Fever, cough and lymphocytopenia were the common clinical features of patients infected with influenza A. It is especially noteworthy for the patients who were 60 years of age or older with flu-like symptoms but without fever, or the patients who had one or more underlying medical conditions, and such patients should receive influenza virus nucleic acid tests as early as possible.

Objective To explore the improvement of cognitive impairment in patients with mild and moderate vascular cognitive impairment( VCI) treated with cerebralcare granule ( CG) and basic treat-ment.Methods From October in 2014 to December in 2016 year,143 cases of VCI patients were admitted from six hospitals in some areas of Hebei Province as the research objects,and divided into CG treatment group (experimental group,n=98) and conventional treatment group (control group,n=66).Three months and six months after treatment,the score of mental state examination ( MMSE) ,the Montreal cognitive assess-ment scale ( MoCA) and the daily living capacity scale( ADL) of the two groups were compared after 3 and 6 moths of treatment.Results ①The total score of MMSE in the experimental group was higher than that of the control group for six months after treatment, and the difference was statistically significant ( ( 23. 76 ± 4.02) vs (21.52±5.13),P<0.05).②Six months after treatment,the total score of MoCA ((21.06±4.66) vs (18.32±5.20)) and visual spatial/executive function((3.05±1.37) vs (2.42±1.66)),calculation force ((2.24±0.84) vs (1.83±1.05)) and orientation ability((5.20±1.12) vs (4.06±1.35)) scores in the ex-perimental group were significantly higher than those in the control group (P<0.05) .③Six months after treat-ment,the ADL score in the experimental group was lower than that before treatment,and the difference was statistically significant((24.96±8.74) vs (29.20±11.55),P<0.05);while there was no significant difference in the ADL score between the experimental group and the control group after 6 months (P>0.05).Conclusion CG can improve cognitive function in mild to moderate VCI patients,mainly in visual space/execution func-tion,calculation ability and orientation ability,and with the extension of treatment time,the curative effect is more obvious.

Objective To investigate the safety of training using a lower-limb rehabilitation robot and its effectiveness in terms of stroke survivors' cardiopulmonary function.Methods Thirty-two hemiplegic stroke survivors were randomly divided into a robot group and a control group,each of 16.Both groups received conventional rehabilitation medication and training,120 min/d,5 d/week for 8 weeks.The robot group was additionally trained with a Flexbot robotic gait training apparatus for 30 min/d,5 d/week for the same 8 weeks.The subjects' maximum oxygen consumption (VO2max),heart rate,blood pressure,ventilation (VE) and rate of perceived exertion (RPE) were quantified before and after the training.Results After the 8 weeks there was no significant difference in average heart rate,blood pressure,VE or RPE between the two groups.The average VO2max of the robot group was,however,significantly higher than that of the control group.Conclusion Robotic gait training is safe and can improve the cardiopulmonary function of stroke survivors.