In order to solve difficulties in traditional Chinese medicine (TCM) and western medicine integration of information resources, based on the research of distributed technology, this article used Web service technology based on SOA architecture associated TCM and western medicine treatment of the same disease. It finally put forward the integrated model of TCM and western medicine information resources based on distributed technology and in-depth design. It solved the problem of professional TCM or western medicine doctors who cannot use combined TCM and western medicine scheme. It realized the integration, reusability and expansibility of TCM and western medicine information resources. It provided important reference for the development of modern medicine.

Purpose To investigate the gene expression and significance ofβ-catenin, Cyclin D1 and Notch1 in primary breast cancer stem cells ( BCSC) and matched lymph node metastasis stem cells. Methods 30 cases of breast invasive ductal carcinoma and matched metastasis lymph nodes were made into single cell suspensions, then BCSC were separated from them by immunomagnetic sor-ting. β-catenin, Cyclin D1 and Notch1 gene expressions of Wnt, Notch signaling pathway were detected by real time PCR. ResultsThe expression of β-catenin in primary BCSC and matched lymph nodes metastasis stem cells had statistically no differences ( P >0.05), while the expression of Cyclin D1 and Notch1 in matched lymph nodes metastasis stem cells were significantly higher than the expression in primary BCSC (P<0.01, respectively). Conclusion Compared with the primary cancer stem cells, Cyclin D1 and Notch1 activation in metastasis cancer stem cells are in higher level, which leades to a higher capability of invasion and metastasis, which may be a new therapeutic target.

Thyroid cancer has become more prevalent in recent years. Patients urgently need efficient, personalized services based on an accurate assessment. The combination of artificial intelligence (AI) and traditional medical approaches can potentially improve the accuracy of medical decision-making. This review focuses on the use of AI to evaluate and predict the prognosis of thyroid cancer and aims to provide a foundation for the extraction of key information with AI to guide individualized treatment. First, we briefly introduce the concept and development of AI and the significance of precision medicine in the thyroid cancer. Second, the potential applications of AI in diagnosing thyroid cancer and predicting its prognosis are discussed. Furthermore, we analyze the opportunities and challenges of ultrasonic and pathological diagnostic and prognostic evaluation methods based on traditional pathological parameters and the gene mutation pathway model. Finally, we discuss the future research direction of AI in relation to thyroid cancer. Keywords: thyroid cancer, artificial intelligence, precision medicine, diagnosis, prognosis

Objective:To analyze the research status of the external use of medicinal materials and decoction pieces in the 2020 edition of Chinese Pharmacopoeia （volume 1）， so as to provide reference for the clinical external use research of Chinese medicines. Method:The external function， usage， dosage and other information of medicinal materials and decoction pieces in the 2020 edition of Chinese Pharmacopoeia （volume 1） were analyzed and compared. Result:In the 2020 edition of Chinese Pharmacopoeia （volume 1）， there were 165 kinds of Chinese medicines that could be used externally， including 25 kinds of Chinese medicines that clearly recorded their functions for external use， such as Euphorbiae Semen， Euphorbiae Semen Pulveratum， Arisaematis Rhizoma， Arisaematis Rhizoma Preparatum， Crotonis Fructus， Crotonis Semen Pulveratum， Nardostachyos Radix et Rhizoma， Artemisiae Argyi Folium， Alumen， Stemonae Radix， Genkwa Flos， Cera Flava， Mel， Psoraleae Fructus， Gardeniae Fructus， Calomelas， Bruceae Fructus， Drynariae Rhizoma， Euphorbiae Ebracteolatae Radix， Cuscutae Semen， Phytolaccae Radix， Meretricis Concha， Talcum， Talci Pulvis and Propolis. The amount of Chinese medicine for external use recorded in the 2020 edition of Chinese Pharmacopoeia was mostly appropriate for external use， the amount for external use was not clear. The application method for external use focused on beating powder and applying the affected areas， decocting for fumigation and washing， simmering to paste， etc. Clinical external use was used for the treatment of eczema， tinea pedis， chapped skin and other skin diseases. Conclusion:The number of Chinese medicines recorded in the 2020 edition of Chinese Pharmacopoeia for external use is increasing， but the function， dosage and usage of these Chinese medicines for external use still need to be improved.

Objective To investigate the effects of calcitriol intervention on PI3K/AKT signaling pathway and wound healing in rats with diabetic foot ulcer(DFU).Methods Thirty-two male SD rats were divided into normal control(Con)group,DFU group,calcitriol low dose(L)group and calcitriol high dose(H)group.A circular wound of 5 mm in diameter and deep to the fascia was made on the dorsum of the left foot of rats in each group.HE staining was used to evaluate the histopathological changes of the wounds.Immunohistochemical method was selected to compare the distribution of CD34-positive cells and the expression of p-PI3K and p-AKT in traumatic tissues of each group.ELISA was adopted in the detection of serum IL-6,IFN-γ,TNF-α and IL-7.RT-PCR was used to detect the mRNA expression of PI3K and AKT in each group,and western blot was used to detect the protein expression of PI3K,p-PI3K,AKT,p-AKT and VEGF.Results Compared with Con group,the expressions of IL-6,IFN-γ,TNF-α,IL-7,CD34,PI3K mRNA,AKT mRNA,p-AKT protein,p-PI3K protein,p-PI3K/PI3K,p-AKT/AKT increased,while PI3K protein expression decreased in DFU,L and H groups(P<0.05),VEGF and AKT protein expression decreased in DFV and L groups(P<0.05).Compared with DFU group,the expressions of VEGF,AKT and PI3K protein increased(P<0.05),while the expressions of p-PI3K/PI3K,p-AKT/AKT decreased in L and H groups(P<0.05),IL-6 decreased in L group(P<0.05),and CD34 expression increased in H group(P<0.05),while IL-6,IFN-γ,TNF-α and IL-7,PI3K mRNA,AKT mRNA,p-AKT protein and p-PI3K protein expression decreased(P<0.05).Compared with L group,the expressions of CD34,VEGF,AKT and PI3K protein increased(P<0.05),while IL-6,PI3K mRNA,AKT mRNA,p-AKT protein,p-PI3K protein,p-PI3K/PI3K and p-AKT/AKT decreased in H group(P<0.05).Conclusions Calcitriol intervention may reduce the activity of the PI3K/AKT signaling pathway,inhibit inflammation,promote neovascularization,and facilitate wound healing in rats with DFU.

Objective:To investigate the value of the venous-to-arterial CO 2 gap (Δ CO 2 gap) before and after the fluid challenge (FC) in determining the fluid responsivenessin septic shock patients. Methods:A total of 104 septic shock patients admitted to the Medical Intensive Care Unit (MICU) of Peking Union Medical College Hospital were included in the retrospective study. All patients were monitored by Swan Ganz floating catheter during the FC. Hemodynamics and blood gas indices were collected before FC (T0) and immediately (T1), 10 min (T2), 30 min (T3) and 60 min (T4) after FC. Responders were defined as patients with a > 10% increase in cardiac output (CO) after FC. Spearman correlation analysis was used to evaluate the correlation between CO 2 gap and CO. The value of ΔCO2 gap were calculated by the area under the receiver operating characteristic (AUROC) curve in the whole population. Results:Among 104 patients, the effective rates of FC at T1, T2, T3 and T4 were 59% (61/104), 72% (75/104), 73% (76/104), and 77% (80/104), respectively. CO of patients in the reactive group was lower than that in the non-reactive group at T2 [6.0 (4.7, 7.5) vs. 7.2 (6.4, 8.5) L/min, P=0.019], and there was no significant difference in CO 2 gap between the two groups before FC. Spearman correlation analysis showed that CO 2 gap was negatively correlated with CO, and the correlations between CO 2 content gap and CO was -0.34, and -0.33 of CO 2 pressure gap and CO, respectively (both P <0.05). ROC curve analysis showed that the ΔCO 2 gap at T1 could weakly judge the reactivity at T2, T3 and T4, but could not judge the reactivity at T1. The AUROC at T2 was 0.669 of ΔCO 2 content gap and 0.684 of ΔCO 2 pressure gap (both P <0.05). Conclusions:The evaluate time judging the effect of FC should be appropriately extended. The change value of CO 2 gap before and immediately after volume expansion in septic shock patients can judge the fluid responsiveness within 10 min after FC.

In vivo confocal microscopy of the cornea is a non-invasive, rapid, and comprehensive technique for real-time, dynamic observation of all layers of the cornea. Confocal microscopy allows the examination of the morphology and cell density in the different layers of the cornea through direct visualization. With the increasing prevalence of diabetes, ocular complications have become common and have garnered more interest and in-depth research from clinical and scientific communities. This paper provides a comprehensive review of research progress made using in vivo confocal microscopy to observe various layers of cornea tissue in diabetic patients.