As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

As a ligand-dependent transcription factor,retinoid-associated orphan receptor γt(RORyt)that controls T helper(Th)17 cell differentiation and interleukin(IL)-17 expression plays a critical role in the pro-gression of several inflammatory and autoimmune conditions.An emerging novel approach to the therapy of these diseases thus involves controlling the transcriptional capacity of RORyt to decrease Th17 cell development and IL-17 production.Several RORyt inhibitors including both antagonists and inverse agonists have been discovered to regulate the transcriptional activity of RORyt by binding to orthosteric-or allosteric-binding sites in the ligand-binding domain.Some of small-molecule inhibitors have entered clinical evaluations.Therefore,in current review,the role of RORyt in Th17 regulation and Th17-related inflammatory and autoimmune diseases was highlighted.Notably,the recently developed RORyt inhibitors were summarized,with an emphasis on their optimization from lead compounds,ef-ficacy,toxicity,mechanisms of action,and clinical trials.The limitations of current development in this area were also discussed to facilitate future research.

Objective:To investigate the clinical characteristics of elderly patients with coronavirus disease 2019(COVID-19), in order to provide scientific evidence for the diagnosis and treatment of COVID-19 in elderly patients.Methods:Clinical data of 102 patients with COVID-19 admitted to the B11 East Ward of the Zhongfaxincheng campus and the E1-3 ward of the Guanggu Campus of Tongji Hospital affiliated to Huazhong University of Science and Technology in Wuhan from 1 February 2020 to 28 February 2020 were retrospectively collected and analyzed.Patients were categorized into 2 groups: the elderly group(≥60 years old)and the young and middle-aged group(<60 years old). Differences in epidemiological features, demographics, clinical symptoms, laboratory results and imaging findings between the two groups were retrospectively analyzed.Results:Among 102 patients with COVID-19, 58 were in the elderly group(≥60 years old), with a median age of 67.0(63.8, 71.0)years old, and 44 in the young and middle-aged group(<60 years old), with a median age of 47.5(38.0, 51.8)years old.There was no significant difference in gender ratio between the two groups( χ2=0.033, P=0.855). Of 102 patients, 42.0%(21/50)had close contact with an infected person, 14.0%(7/50)were from infection clusters, and 18.0%(9/50)had suspected hospital-acquired infections.Fever and cough remained the most common symptoms, but gastrointestinal symptoms such as nausea, poor appetite, diarrhea and muscle cramps were also warning signs.Fatigue and cough were the most common presenting symptoms in elderly male patients.Bilateral patchy infiltrates(57.9%, 22/38)and ground-glass opacities(42.1%, 16/38)were the main imaging features and 42.1%(16/38)patients had multiple areas of the lungs involved.Over 50% patients had increased levels of blood glucose, D-dimer, fibrinogen, C-reactive protein, procalcitonin, multiple cytokines and neutrophil-to-lymphocyte ratio, as well as decreased levels of albumin, hemoglobin, hematocrit, lymphocytes and serum calcium.Compared with the young and middle-aged group, the elderly group had higher rates of abnormality in levels of D-dimer and serum calcium( χ2=7.067 and 4.166, P=0.008 and 0.041). Conclusions:Fever and cough are the most common symptoms in elderly patients with COVID-19.Elderly patients with COVID-19 have multiple abnormalities in clinical laboratory test results, which show a certain level of specificity compared with young and middle-aged patients.

Aim To investigate the role and potential mechanism of transcriptional co-activator p300 in atrial fibrosis caused by high hydrostatic pressure. Methods The left atrial appendage tissues of humans in three groups of sinus rhythm, atrial fibrillation (AF), hypertension and AF were collected. The expressions of p300 protein and TGF-β/Smad3 signaling pathway and fibrotic factors as type I/III collagen Alphal chain (Col-lAl/Col-3Al), matrix metalloproteinase 2/9 (MMP-2/9) were tested by Western blot. Mouse atrial appendage fibroblasts were cultured under hydrostatic pressures of 0, 20 and 40 mmHg. The fibroblasts cultured under 40 mmHg pressure were treated with curcumin and p300 interference RNA. Western blot was used to test changes in the expression of p300 and the above fibrosis indicators. CCK-8 method was used to test changes of cell proliferation. Results The expressions of p300 and TGF-β/Smad3 signaling pathway proteins and fibrotic factors in AF group and hypertension combined with AF group were significantly higher than those in sinus rhythm group (P < 0. 05). 40 mmHg high hydrostatic pressure stimulation in vitro could increase the expression of p300 and fibrotic factors in fibroblasts (P < 0. 0 5) and enhance the proliferation ability (P < 0. 05). Both curcumin and p300 interfering RNA could reverse the increased expression of p300 and fibrotic factors (P < 0. 05) and decrease cell proliferation (P < 0. 05) induced by hydrostatic pressure. Conclusions High hydrostatic pressure can induce atrial fibrosis, which involves the participation of p300 in this process by regulating the TGF-β/Smad3 signaling pathway.

OBJECTIVE: To investigate the incidence rate of infectious diseases during hospitalization in late preterm infants in Beijing, China, as well as the risk factors for infectious diseases and the effect of breastfeeding on the development of infectious diseases. METHODS: Related data were collected from the late preterm infants who were hospitalized in the neonatal wards of 25 hospitals in Beijing, China, from October 23, 2015 to October 30, 2017. According to the feeding pattern, they were divided into a breastfeeding group and a formula feeding group. The two groups were compared in terms of general status and incidence rate of infectious diseases. A multivariate logistic regression analysis was used to investigate the risk factors for infectious diseases. RESULTS: A total of 1 576 late preterm infants were enrolled, with 153 infants in the breastfeeding group and 1 423 in the formula feeding group. Of all infants, 484 (30.71%) experienced infectious diseases. The breastfeeding group had a significantly lower incidence rate of infectious diseases than the formula feeding group (22.88% vs 31.55%, CONCLUSIONS Breastfeeding can significantly reduce the incidence of infectious diseases and is a protective factor against infectious diseases in late preterm infants. Breastfeeding should therefore be actively promoted for late preterm infants during hospitalization.
Beijing/epidemiology* ; Breast Feeding ; China/epidemiology* ; Communicable Diseases/epidemiology* ; Female ; Hospitalization ; Hospitals ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Male ; Pregnancy

OBJECTIVETo investigate the effects of Lactobacillus rhamnosus GG (LGG) for inhibiting E.coli K1 (E44) adhesion and invasion of an intestinal epithelial cell model with Muc2 gene knockdown established using CRISPR-Cas9 system.

METHODSTwo 20-25 bp sgRNAs targeting Muc2 were chemically synthesized to construct CRISPR expression vectors for transfection in wild-type human colonic cancer cell line Ht29. The efficiency of Muc2 knockdown was determined using Western blotting. After assessment of the viability and proliferation of the transfected cells with MTT assay, we evaluated the effects of the probiotics against E44 adhesion and invasion of the cells through a competitive exclusion assay.

RESULTSTransfection of the cells with Lenticrisprv2 plasmid vectors resulted in a cell line with stable Muc2 knockdown by 81%. The inhibitory effects of probiotics against E44 adhesion and invasion of the transfected cells were markedly attenuated, and the relative adhesion and invasion rates of E44 were 72.23% (P<0.05) and 81.49% (P<0.05), respectively.

CONCLUSIONMuc2 knockdown causes attenuation of the inhibitory effects of probiotics against E44 adhesion and invasion of the intestinal epithelial cells, suggesting that up-regulation of Muc2 may serve as an important mechanism for the probiotics to reinforce the intestinal barrier and antagonize the pathogenic bacteria, which sheds light on a new strategy for prevention and treatment of bacterial intestinal infections.

Bacterial Adhesion ; CRISPR-Cas Systems ; Epithelial Cells ; cytology ; microbiology ; Escherichia coli ; pathogenicity ; Gene Knockdown Techniques ; HT29 Cells ; Humans ; Intestines ; cytology ; Lactobacillus rhamnosus ; Mucin-2 ; genetics ; Probiotics ; Transfection ; Up-Regulation

OBJECTIVETo retrospectively analyze the causes of death in elderly patients with hypertension in a hospital-based population from 1993 to 2012.

METHODSDuring the study period of over 19 years, a total of 2866 cases of death in 25238 hospitalized hypertensive patients with the age of 60 years or older were documented. Age, gender, complications, cause of death and other relevant variables were collected. All patients were divided into different subgroups according to gender, age or hypertension stage and risk stratification. The mortality of elderly hypertensive patients was analyzed using chi-square test.

RESULTS(1) Target organ damage (TOD) associated with hypertension was present in a substantial proportion of elderly patients. The complications related to death were heart disease (45.15%), stroke (34.37%), renal failure (11.88%), infective disease (4.58%), and cancer (4.06%). (2) Mortality in male elderly hypertension was higher than in women (53.31% vs 46.69%). The percentage of deaths from heart disease and stroke were higher in men than those in women (heart disease: 46.73% vs 43.35%; stroke: 37.04% vs 31.32%). (3) Age-specific constituent ratio of cause of death showed that deaths from stroke were significantly lower in very old patients (> or = 90 years) than in patients with 60-79 years of age (P < 0.01). In addition, deaths from heart disease, renal failure and infection disease were significantly lower in patients with more than 90 years than other patients. Deaths from cancer were highest in patients with 70-79 years of age (P < 0.01). (4) When compared with patients at stage 1 and 2 hypertension, subjects at stage 3 were more likely to die from stroke (P < 0.01) and renal failure (P < 0.05), while less likely to die from heart disease and cancer (P < 0.01). Patients in high and very high risk stratification of hypertension, compared with subjects in low and medium risk were likely to die from renal failure (P < 0.01) whereas less likely to die from heart disease (P < 0.05) and stroke (P < 0.01).

CONCLUSIONPrevalence of complication and TOD is high in elderly hypertensive inpatients, especially in deaths. The male patients and 60- 79-year-old patients have a higher percentage of causes of death. The stage and risk stratification of hypertension are associated with constituent ratios of the causes of death.

Aged ; Cause of Death ; Female ; Humans ; Hypertension ; mortality ; Incidence ; Inpatients ; Male ; Middle Aged ; Renal Insufficiency ; mortality ; Retrospective Studies ; Risk Factors ; Stroke ; mortality

OBJECTIVETo compare the clinical efficacies of endovascular aortic repair(EVAR)and open surgical repair(OSR)for ruptured abdominal aortic aneurysm(rAAA).

METHODSThe clinical data of 28 rAAA patients undergoing emergent treatment between February 2002 and February 2013 in PUMC Hospital were retrospectively reviewed. Among them 13 cases were treated by EVAR and 15 cases by OSR.

RESULTSBefore the surgery,the general conditions,comorbidities,and hemodynamics were not significantly different between these two groups(all P>0.05),although the EVAR group had significantly higher mean age than OSR group(P=0.041). In the perioperative period,the EVAR group showed significantly lower 30-day mortality(P=0.044),less blood loss(P=0.005),less blood transfusion(P=0.003),less infusion quantity(P=0.000),shorter length of procedure(P=0.001),and shorter hospital stay(P=0.020). Also,the EVAR group had no severe perioperative complications and showed superior 1-year follow up survival(P<0.05).

CONCLUSIONSEVAR is an effective treatment for rAAA and can improve the clinical outcomes. EVAR may be adopted as the first-line treatment for rAAA,especially for the aged.

Aortic Aneurysm, Abdominal ; surgery ; Aortic Rupture ; surgery ; Humans ; Length of Stay ; Retrospective Studies ; Treatment Outcome ; Vascular Surgical Procedures ; methods

OBJECTIVETo investigate the effect of Chinese medicine (CM) and Western medicine (WM) on quality of life (QOL) after conservative surgery for endometriosis.

METHODSA total of 320 patients with endometriosis were randomized into two groups by using random block design, CM group (160 cases, activating blood circulation and removing blood stasis treatment based on syndrome differentiation) and WM group (160 cases, gonadotropin-releasing hormone agonist or gestrinone treatment) after conservative surgery. Treatment was given for 3-6 months (according to the revised American Fertility Society scoring system stage), and the World Health Organization QOL-BREF (WHOQOL-BREF) was applied to patients before and after treatment to assess QOL.

RESULTSThere were 136 cases in the CM group and 141 cases in the WM group completing therapy. In the CM group, the use of the WHOQOL-BREF showed that the physical, psychological and environmental scores posttreatment were significantly higher than those at pre-treatment (P < 0.05), and for 12 items (pain and discomfort, energy and fatigue, sleep and rest, mobility, activities of daily living, work capacity, negative feelings, health and social care: accessibility and quality, participation in and opportunities for recreation/leisure activities, appetite, QOL score, overall health status and QOL), the difference in scores was significant (P < 0.05). In the WM group, 4 items (pain and discomfort, opportunities for acquiring new information and skills, QOL score, overall health status and QOL) had significantly different scores post-treatment compared with those at pre-treatment (P < 0.05). Before treatment, the QOL in the two groups of patients showed no significant difference (P > 0.05). After treatment, the scores for physical health in the CM group were significantly higher than those of the WM group (P < 0.05) and the scores of 4 items (mobility, activities of daily living, sexual activity, QOL score) in the CM group were significantly higher than those in the WM group (P < 0.05).

CONCLUSIONSCM and WM treatment could improve the QOL of patients with endometriosis after conservative surgery. CM treatment is more effective than WM.

Adolescent ; Adult ; China ; Drugs, Chinese Herbal ; therapeutic use ; Endometriosis ; diagnosis ; surgery ; Female ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; antagonists & inhibitors ; therapeutic use ; Humans ; Middle Aged ; Pain Measurement ; Pain, Postoperative ; drug therapy ; physiopathology ; Patient Satisfaction ; statistics & numerical data ; Postoperative Care ; methods ; Prospective Studies ; Quality of Life ; Reference Values ; Risk Assessment ; Treatment Outcome ; Young Adult

OBJECTIVETo analyze the correlation between mitral regurgitation grading and left ventricular ejection fraction in elderly patients (>60 years of age) in a 2-year follow-up.

METHODSA total of 455 patients with the diagnosis of at least mild mitral regurgitation by echocardiography were divided into ischemic mitral regurgitation (IMR) group and non-ischemic regurgitation (NIMR) group. The patients were followed up with echocardiography every 6 months and the data were analyzed at the end of 24 months.

RESULTSMitral regurgitation grade was inversely correlated with left ventricular ejection fraction (LVEF). Patients with moderate and severe IMR had a lower LVEF than those with NIMR (P<0.05). After adjustment for age, sex, body mass index, high blood pressure, diabetes, atrial fibrillation and cardiomyopathy, the mean LVEF at 2 years was lowered by 2.7% (1.4%-4.1%), 2.7% (1.3%-4.0%), and 5.2% (3.5%-6.9%) in mild, moderate and severe IMR patients, respectively (P<0.04), and by 3.2% (1.6%-4.8%), and 3.0% (1.4%-4.5%), and 1.7%(-0.5%-3.9%) in mild, moderate and severe NIMR patients (P=0.30).

CONCLUSIONThe mean LVEF in IMR patients is significantly lowered compared to that in NIMR patients. The grade of mitral regurgitation is inversely correlated with the regurgitation area in IMR patients. Stratified management might help improve LVEF in severe IMR patients.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Mitral Valve Insufficiency ; Stroke Volume ; Ventricular Dysfunction, Left ; physiopathology