OBJECTIVE: It provides reference for accurate and efficient supervision of medical artificial intelligence industry. METHODS: By summarizing the main responsibility dilemma of medical artificial intelligence diagnosis products, sorting out relevant researches at home and abroad, the primary responsibility system of medical artificial intelligence diagnosis products is constructed. RESULTS: A medical artificial intelligence diagnosis products primary responsibility system with the marketing authorization holder as the "first responsible person" is established, and three safeguard measures are proposed, namely, algorithm transparency and interpretability, classification supervision mode and social co-governance supervision mode. CONCLUSIONS The medical artificial intelligence diagnosis products primary responsibility system is helpful to implement the primary responsibility, to build "responsible and beneficial" artificial intelligence, and to realize "self-discipline", "good governance" and "in good order".
Artificial Intelligence ; China ; Humans

Objective: To observe the clinical effects of free latissimus dorsi myocutaneous flap combined with artificial dermis and split-thickness skin graft in the treatment of degloving injury in lower limbs. Methods: A retrospective observational study was conducted. From December 2017 to December 2020, 8 patients with large skin and soft tissue defect caused by degloving injury in lower extremity were admitted to Ningbo No.6 Hospital, including 5 males and 3 females, aged from 39 to 75 years, with wound area of 25 cm×12 cm-61 cm×34 cm. The free latissimus dorsi myocutaneous flap with latissimus dorsi muscle in the width of 12-15 cm and flap area of 20 cm×8 cm-32 cm×8 cm was used to repair the skin and soft tissue defect of bone/tendon exposure site or functional area. The other defect was repaired with bilayer artificial dermis, and the flap donor site was sutured directly. After the artificial dermis was completely vascularized, the split-thickness skin graft from thigh was excised and extended at a ratio of 1∶2 to 1∶4 and then transplanted to repair the residual wound, and the donor site of skin graft was treated by dressing change. The survival of latissimus dorsi myocutaneous flap, artificial dermis, and split-thickness skin graft after operation was observed, the interval time between artificial dermis transplantation and split-thickness skin graft transplantation was recorded, and the healing of donor site was observed. The appearance and function of operative area were followed up. At the last outpatient follow-up, the sensory recovery of flap was evaluated by British Medical Research Council evaluation criteria, the flap function was evaluated by the comprehensive evaluation standard of flap in Operative Hand Surgery, the scar of lower limb skin graft area and thigh skin donor area was evaluated by Vancouver scar scale, and the patient's satisfaction with the curative effects was asked. Results: The latissimus dorsi myocutaneous flap survived in 6 patients, while the distal tip of latissimus dorsi myocutaneous flap was partially necrotic in 2 patient and was repaired by skin grafting after resection at split-thickness skin grafting. The artificial dermis survived in all 8 patients after transplantation. The split-thickness skin graft survived in 7 patients, while partial necrosis of the split-thickness skin graft occurred in one patient and was repaired by skin grafting again. The interval time between artificial dermis transplantation and split-thickness skin graft transplantation was 15-26 (20±5) d. The donor site of latissimus dorsi myocutaneous flap healed with linear scar after operation, and the thigh skin graft donor site healed with scar after operation. The patients were followed up for 6-18 (12.5±2.3) months. The color and elasticity of the flap were similar to those of the surrounding skin tissue, and the lower limb joint activity returned to normal. There was no increase in linear scar at the back donor site or obvious hypertrophic scar at the thigh donor site. At the last outpatient follow-up, the sensation of the flap recovered to grade S₂ or S₃; 3 cases were excellent, 4 cases were good, and 1 case was fair in flap function; the Vancouver scar scale score of lower limb skin graft area was 4-7 (5.2±0.9), and the Vancouver scar scale score of thigh skin donor area was 1-5 (3.4±0.8). The patients were fairly satisfied with the curative effects. Conclusions: In repairing the large skin and soft tissue defect from degloving injury in lower extremity, to cover the exposed bone/tendon or functional area with latissimus dorsi myocutaneous flap and the residual wound with artificial dermis and extended split-thickness skin graft is accompanied by harvest of small autologous flap and skin graft, good recovery effect of functional area after surgery, and good quality of healing in skin grafted area.
Cicatrix/surgery* ; Degloving Injuries/surgery* ; Dermis/surgery* ; Female ; Humans ; Lower Extremity/surgery* ; Male ; Mammaplasty ; Myocutaneous Flap ; Reconstructive Surgical Procedures ; Skin Transplantation ; Soft Tissue Injuries/surgery* ; Superficial Back Muscles/surgery* ; Treatment Outcome

Objective To investigate the prevalence and influencing factors of soil-transmitted nematode infections in Ningbo City from 2016 to 2021, so as to provide insights into the development of targeted control measures against soil-transmitted nematodiasis. Methods Permanent residents at ages of 3 years and older were sampled in Ningbo City using a multi-stage sampling method each year during the period from 2016 to 2021. Soil-transmitted nematode eggs were detected in stool samples using a modified Kato-Katz thick smear method (two slides for each stool sample), and Enterobius vermicularis eggs were additionally identified among children at ages of 3 to 12 years using the adhesive cellophane-tape perianal swab method. The time- and regions-specific prevalence of soil-transmitted nematode infections was calculated, and the factors affecting hookworm infections were identified using a multivariate logistic regression model. Results A total of 11 573 person-times were detected for soil-transmitted nematode infections in Ningbo City from 2016 to 2021, and 296 egg-positives were detected, with a mean prevalence rate of 2.56% [95% confidential interval (CI): (2.28%, 2.87%)]. Hookworm was the predominant species of soil-transmitted nematode among egg-positives in Ningbo City (98.31%, 291/296), and there was a significant difference in the prevalence of hook-worm infections among years (χ² = 190.27, P < 0.01). The highest prevalence of hook-worm infections was observed in Ninghai County (4.06%), and there was a region-specific prevalence rate of hookworm infection in Ningbo City (χ² = 148.43, P < 0.01). Multivariate logistic regression analysis showed that elderly residents at ages of over 60 years [odds ratio (OR)= 1.94, 95% CI: (1.07, 3.54), P < 0.05], males [OR = 2.19, 95% CI: (1.72, 2.80), P < 0.01], farmers [OR = 6.94, 95% CI: (3.37, 14.29), P < 0.01] and residents with a low education level [illiteracy or semi-illiterate: OR = 3.82, 95% CI: (1.56, 9.35), P < 0.05; primary school: OR = 2.70, 95% CI: (1.11, 6.59), P < 0.05] were at a higher risk for hookworm infections. Conclusions The overall prevalence of soil-transmitted nematode infections was low among residents in Ningbo City from 2016 to 2021. The surveillance and health education for human hookworm disease remain to be reinforced among male farmers with a low education level at ages of over 60 years in Ninghai County.

The molecular mechanism of diffuse large B cell lymphoma (DLBCL) has not been fully elucidated, and epigenetics plays an important role in its development. MicroRNAs (miRNAs) are important parts of epigenetics, which are involved in the occurrence and development of DLBCL. Relevant studies have found that miRNAs can not only be used as molecular diagnostic markers of DLBCL, but also be used to judge the prognosis and treatment effect of DLBCL.

Under the background of technological assistance to prepare for the Beijing Winter Olympics in China, the biomechanical research highlights and the latest achievements related to competitive performance of alpine skiers in recent years were systematically analyzed in this paper, so as to determine biomechanical factors affecting competitive performance of alpine skiers, including aerodynamic drag, frictional forces, ground reaction force (GRF), energy dissipation, turn radius, trajectory of the skis and/or center of mass (COM). In addition, biomechanical differences in turn techniques, multiple turns connections and abilities of individuals were also considered as important factors affecting the alpine skiing performance. In the case of slalom and giant slalom events, the earlier initiation of turns, longer path length and trajectory, earlier and smoother application of GRF, and carbene technique carving to reduce the ski-snow friction and thereby dissipate energy should be used to improve sports performance. During speed skiing, minimizing the exposed frontal area and positioning the arms close to the body can reduce the energy loss caused by aerodynamic drag, thereby improving sports performance. Top-level alpine skiers will always perform well on different courses, terrains and snow conditions during the race. Excellent alpine ski performance from a biomechanical perspective includes the efficient use of potential energy, minimizing ski-snow friction and aerodynamic drag, choosing optimal trajectory and maintaining high-speed skiing. Individual tactics and techniques should be valued in training and competition. For better results, the same performance on multiple sections and on different terrains is more important than excellence in individual sections and specific conditions.

Hepatitis B ; prevention & control ; Hepatitis B Vaccines ; administration & dosage ; Humans ; Infant

Objective: To explore the feasibility and applicability of a novel cavernosum-free surgical technique for concealed penis of children. Methods: From June 2017 to August 2017, 38 boys with concealed penis were treated using our new cavernosum-free surgical technique. The median age was 8.5 years(4-13 years). The technique consisted of 3 steps: Step 1, making a horizon incision and expose the glans; Step 2, suturing skin of penis to the corresponding side of inguinal ligament medial crus at 2 and 10 o′clock without fixing of cavernosum.Step 3, pruning the foreskin and suturing together. No catheter was placed after surgery. Results: All the patients were able to urinate 2 to 6 hours after operation. The numeric rating scales score of postoperative pain was 1-3. Wound dressing was removed 5 to 7 days post-operatively. All of the parents had good cosmetic appearance, penis stretched naturally without deflection. The length of penis increased more than 3.0 cm on average after operation.Edema was observed in 3 cases, but disappeared in 5-7 days.No serious complications such as bleeding or winding occurs. Conclusions The novel cavernosum-free surgical technique is easy to perform. It provides a safe and effective technique for concealed penis of children.

OBJECTIVE: To evaluate the clinical and radiological results of patients with thoracic and lumbar fracture and dislocation treated by posterior transforaminal decompression and interbody fusion. METHODS: From June 2010 to June 2017, posterior transforaminal decompression, interbody fusion combined with pedicle screw fixation were performed in 21 patients with thoracic and lumbar fracture and dislocation. Their clinical and radiological data were collected and retrospectively analyzed, including 15 males and 6 females, aged from 25 to 58 years with an average of 45 years old. According to the criterion of American Spinal Injury(ASIA), preoperative neurological function was graded A in 3 cases, B in 7 cases, C in 6 cases, D in 4 cases and E in 1 case. Operative time and intraoperative blood loss and correlative complications were recorded. And VAS score, ODI and Cobb angle were evaluated before and after surgery. The improvement of neurological function was also analyzed at the final follow-up. Intervertebral bony fusion was observed during the follow-up by CT three-dimensional reconstruction. RESULTS: The operative time was 150 to 240 min with an average of (192±47) min. The intraoperative blood loss was 380 to 750 ml with an average of(603±120) ml. Dura sac tearing and cerebral fluid leakage occurred in 3 cases and were repaired during operation; superficial wound infection occurred in 1 case, and got healing after dressing change. The postoperative follow-up duration was 24 to 45 months with an average of(37.0±9.5) months. VAS score was improved from preoperative 8.9±0.4 to immediately postoperative 4.2±1.3(<0.05). At the final follow-up, VAS score decreased further to 3.6±0.8. ODI was decreased from preoperative (95.30±3.52)% to (32.51±6.30)% at the final follow-up (<0.05). Cobb angle was corrected from preoperative (21.2±8.8)° to immediately postoperative(2.3±3.1)° (<0.05). At the final follow-up, Cobb angle was (3.2±2.5)°, showing no significant difference with immediately postoperative value. The neurological function was grade A in 3 cases, B in 3 cases, C in 5 cases, D in 6 cases and E in 4 cases at the final follow-up. All the patients got solid intervertebral bone fusion in 8 to 13 months after operation, with an average fusion time of (10.3±2.5) months. CONCLUSIONS For the patients with thoracic and lumbar fracture and dislocation mainly involving intervertebral disc and endplate plane, posterior transforaminal decompression and interbody fusion not only is less invasive, but also can effectively reconstruct spinal three column and obtain good biomechanical stability. And, it is beneficial for the good recovery of neurological function.
Adult ; Decompression, Surgical ; Female ; Humans ; Lumbar Vertebrae ; Male ; Middle Aged ; Pedicle Screws ; Retrospective Studies ; Spinal Fusion ; Treatment Outcome

Objective: To determine the situation of myopia among primary and junior high school students from 2019 to 2021 in Yinzhou District, Ningbo City, Zhejiang Province. Methods: Cross-sectional study. Department of Ophthalmology, The Affiliated People's Hospital of Ningbo University, carried out a cross-sectional study by reviewing the results of five times visual acuity screens among primary and junior high school students from 2019 to 2021 in Yinzhou District, Ningbo City, Zhejiang Province. The myopia rate, High myopia rate and spherical equivalent refraction were calculated according to the uncorrected distance visual acuity and non-cycloplegic subjective refraction. Chi-square test and analysis of variance were used to analysis the difference of myopia among term, sex and eye. Results: The visual acuity screen had been completed five times from 2019 to 2021 in Yinzhou District, with a total of 458 654 people, of which 454 812 people met the inclusion criteria. The myopia rate of each screen is 56.6%(50 443/89 122),52.5%(48 463/92 311),63.7%(57 968/91 002),53.2%(48 351/90 886),64.4%(58 920/91 491). The rate of Myopia increased gradually with promoting to high grade, and it was obviously in low grade,up to 17.6%. Conclusion: The myopia rate of primary and junior high school students was raising volatility from 2019 to 2021 in Yinzhou District, Ningbo City, Zhejiang Province.
Humans ; Cross-Sectional Studies ; Myopia ; Refraction, Ocular ; Visual Acuity ; Students ; Prevalence

OBJECTIVETo explore the ideal screw entry point and optimal trajectory for anterior C1 lateral mass screw internal fixation, and provide an anatomical basis for the technique of anterior C1 lateral mass screw placement.

METHODSA radiographic analysis of the anatomy of the C1 lateral mass using Computed tomography, CT scan was performed in cervical spine of 56 healthy Chinese adults (28 males, 28 females; mean age, 36.5 years; age range, 18-55 years), by using the Mimics software to reconstruct the 3-D morphology of C1 lateral mass and measuring the inside, middle and outside effective height of the C1 lateral mass in front and back. Measuring the C1 lateral mass safe width with different extraversion angles range from 0° to 30° with a uniform interval of 5°, to find out the ideal extraversion angle. Measuring the range of sagittal angle, to find out the ideal sagittal angle.

RESULTSThe inside (H1), middle (H3) and outside (H5) effective height of the C1 lateral mass in front is 6.67 mm, 12.09 mm, and 17.51 mm, the inside (H2), middle (H4) and outside(H6) effective height of the C1 lateral mass in back is 8.17 mm, 13.20 mm, and 18.22 mm. When the extraversion angle choose 0°, 5°, 10°, 15°, 20°, 25°, 30°, and δ, the relative results of safe width (SW) of lateral mass were 4.73 mm, 5.36 mm, 5.90 mm, 6.33 mm, 6.44 mm, 5.70 mm, 4.38 mm, 6.95 mm averagely. The mean distance along the atlas anterior surface between the anterior tubercle and the screw entry point was 12.80 mm, the mean distance from the inferior border of the lateral mass to the screw entry point was 6.87 mm. The range of sagittal angle is 24.22° (-17.74°∼6.48°) .

CONCLUSIONSThe ideal extraversion angle was 21.14°. The mean distance along the atlas anterior surface between the anterior tubercle and the screw entry point was 12.80 mm. The mean distance from the inferior border of the lateral mass to the screw entry point was 6.87 mm. The ideal sagittal angle is -5.63°. These measurements may facilitate anterior C1 lateral mass screw fixation decreasing the risk of injury to the spinal cord, vertebral artery, and internal carotid artery theoretically. Delineating the individual anatomy in each case with CT scan before surgery is recommended.

Adolescent ; Adult ; Bone Screws ; Carotid Artery, Internal ; diagnostic imaging ; Cervical Atlas ; Cervical Vertebrae ; diagnostic imaging ; surgery ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Tomography, X-Ray Computed ; Vertebral Artery ; diagnostic imaging ; Young Adult