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*

OBJECTIVE: To compare the posterior cruciate ligament(PCL) index with six different measurement methods, and analyze and verify its clinical diagnostic value in anterior cruciate ligament (ACL) injury. METHODS: The Magnetic resonance imaging (MRI) data of 225 knee joints in our hospital from May 2018 to March 2022 were retrospectively analyzed, aged from 18 to 60 years old, with a median of 32 years old. On the sagittal MRI images of 114 patients with ACL injury and 111 patients with intact ACL, Measure the straight-line distance (A) between the femoral attachment point and the tibial attachment point of the PCL on the MRI sagittal image and the maximum vertical distance (B) between the straight line and the arcuate mark point of the PCL on the sagittal image, calculate the PCL index and evaluate the diagnostic value of the PCL index for ACL injury. RESULTS: The PCL index of the ACL normal group and the ACL injury group were statistically described. There was no significant difference in PCL index 1, 2, 3 and 6 between the two groups(P>0.05). The difference of PCL index 4 and 5 between the two groups was statistically significant (P<0.001). This study only found that the PCL index 2, 6 in the ACL normal group had a negative correlation with the patient's age (correlation coefficient=-0.213, -0.819;P<0.05), and the PCL index 5 in the ACL injury group was significantly correlated with the patient's body mass index(BMI)had a negative correlation (correlation coefficient=-0.277, P<0.05). CONCLUSION The change of PCL index is helpful for the diagnosis of ACL injury, PCL index 4 and 5 can be used as effective reference indexes for diagnosing ACL injury in clinic.
Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Posterior Cruciate Ligament/diagnostic imaging* ; Anterior Cruciate Ligament Injuries/diagnostic imaging* ; Anterior Cruciate Ligament ; Retrospective Studies ; Knee Joint ; Magnetic Resonance Imaging/methods*

The global pandemic of coronavirus disease 2019 (COVID-19) has brought great challenges to the traditional medical model. During the outbreak of COVID-19 in Shanghai, China, from March to May, 2022, there was a significant increase in the number of pediatric cases due to high transmissibility, immune escape, and vaccine breakthrough capacity of Omicron variants. The designated hospitals for children with COVID-19 served as a connecting link between children's specialized hospitals and mobile cabin hospitals. From April 7 to June 2, 2022, a total of 871 children with COVID-19 were admitted to Renji Hospital, Shanghai Jiao Tong University School of Medicine (South Branch), a designated hospital for children with COVID-19. Among these patients, 568 (65.2%) were children under 3 years old, 870 (99.9%) were mild or moderate, and 1 was severe. This article reports the experience in the management of pediatric cases in this designated hospital, which included the following aspects: establishing an optimal case-admission process; strengthening multidisciplinary standardized diagnosis and treatment; optimizing the management, warning, and rescue system for severe COVID-19; implementing family-centered nursing care; formulating an individualized traditional Chinese medicine treatment regimen; optimizing the discharge process and strengthening bed turnover; implementing strict whole-process control to reduce the risk of nosocomial infection; constructing a structured medical record system and using information platforms to adapt to the work mode of large-volume cases; conducting scientific research and sharing the experience in diagnosis and treatment.
COVID-19 ; Child ; Child, Preschool ; China ; Hospitals, Pediatric ; Humans ; SARS-CoV-2

Antibodies, Viral ; blood ; Betacoronavirus ; Coronavirus ; immunology ; Coronavirus Infections ; immunology ; Humans ; Immunoglobulin G ; blood ; Pandemics ; Pneumonia, Viral ; immunology

BackgroundWallerian degeneration (WD) of bilateral middle cerebellar peduncles (MCPs) can occur following pontine infarction, but its characteristics have not yet been clarified because of the low incidence. Thus, the present study discussed the clinical and radiological features to improve the awareness of this disease.

MethodsClinical and radiological information from consecutive individuals diagnosed with WD of bilateral MCPs following pontine infarction in three hospitals over the past 4 years between October 2012 and October 2016 were retrospectively investigated and compared with a control group (patients with pontine infarction had no secondary WD).

Results:This study involved 30 patients with WD of MCPs, with a detection rate of only 4.9%. The primary infarctions (χ =24.791, P = 0.001, vs. control group) were located in the paramedian pons in 21 cases (70.0%), and ventrolateral pons in nine cases (30.0%). WD of the MCPs was detected 8-24 weeks after pons infarction using conventional magnetic resonance imaging (MRI); all secondary WDs were asymptomatic and detected incidentally. All WD lesions exhibited bilateral, symmetrical, and boundary blurring on MRI. The signal features were hypointense on T1-weighted imaging, hyperintense on T2-weighted imaging and fluid-attenuated inversion recovery, and slightly hyperintense or isointense on diffusion-weighted imaging and apparent diffusion coefficient maps. Secondary brainstem atrophy was found in six (20.0%) cases. A Modified Rankin Scale score 0-2 was found in 10 (33.3%) cases and score >2 in 20 (66.7%) cases at 90 days after discharge, and the short-term prognosis was worse than that in control group (χ =12.814, P = 0.001).

ConclusionsDespite the rarity of bilateral and symmetrical lesions of MCPs, secondary WD should be highly suspected if these lesions occur within 6 months after pontine infarction, particularly paramedian pons. Conventional MRI appears to be a relatively sensitive method for detecting WD of MCPs, which might affect the short-term prognosis.

Adult ; Aged ; Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Models, Biological ; Prognosis ; Retrospective Studies ; Wallerian Degeneration ; diagnostic imaging

BACKGROUNDThe prevalence of hepatitis B virus (HBV) infection is high among individuals infected with human immunodeficiency virus (HIV) in China. Both HIV and HBV can be treated with tenofovir disoproxil fumarate (TDF) and lamivudine (3TC), so we evaluated the safety and efficacy of combination antiretroviral therapy (ART) that included TDF, 3TC, and efavirenz (EFV) among ART-naive individuals who were co-infected with HIV and HBV.

METHODSOne hundred HIV/HBV co-infected ARV-naive individuals were started on the regimen of TDF, 3TC, and EFV, and the levels of plasma HBV DNA, HIV RNA, and biochemical evaluation related to the function of liver and kidney were analyzed.

RESULTSConcerning efficacy, this study found that by week 48, the vast majority co-infected participants receiving this ART regimen had undetectable HBV DNA levels (71%) and/or HIV RNA levels (90%). Concerning safety, this study found that the median estimated glomerular filtration rate of participants decreased from baseline (109 ml·min-1·1.73 m-2) to week 12 (104 ml·min-1·1.73 m-2) but was almost back to baseline at week 48 (111 ml·min-1·1.73 m-2).

CONCLUSIONThis combination ART regimen is safe and effective for patients with HIV/HBV co-infection.

TRIAL REGISTRATIONClinicalTrials.gov, NCT01751555; https://clinicaltrials.gov/ct2/show/NCT01751555.

Adult ; Alanine Transaminase ; metabolism ; Anti-HIV Agents ; therapeutic use ; Aspartate Aminotransferases ; metabolism ; Benzoxazines ; therapeutic use ; CD4-Positive T-Lymphocytes ; metabolism ; Coinfection ; drug therapy ; Female ; HIV Infections ; drug therapy ; Hepatitis B virus ; drug effects ; pathogenicity ; Humans ; Lamivudine ; therapeutic use ; Male ; Tenofovir ; therapeutic use

Retroperitoneal hemangiopericytoma is a kind of uncommon tumor. We report a case of 41-year-old man who was diagnosed retroperitoneal tumor without significant symptoms by abdominal ultrasonography. Abdominal CT and MRI scans show a 6 cm × 5 cm solid tumor delineated clearly from adjacent organs. Excision of the tumor was performed and the histopathological examination confirmed the diagnosis of hemangiopericytoma.
Adult ; Hemangiopericytoma ; diagnosis ; Humans ; Male ; Retroperitoneal Neoplasms ; diagnosis

OBJECTIVETo investigate the mortality of HIV infected clients from methadone maintenance treatment (MMT) clinics in Yili Kazakh autonomous prefecture as well as the factors associated with mortality of HIV infected clients.

METHODSA retrospective cohort study was performed. Data of 860 cases were collected from National Methadone Maintenance Treatment database, National AIDS/HIV database and antiretroviral therapy (ART) treatment database for adults. Information collected included demographic information of HIV infected clients, methadone daily treatment information, CD4 testing information, ART treatment information and death information. Recruiting began from August, 2005 through May, 2011. Cox proportional regression was used to identify factors associated with mortality. The proportional hazard assumption was assessed using Schoenfeld's residuals test. Missing values were imputed using the multiple linear regression method. R software (version 2.13.0) was used to perform data analysis.

RESULTSA total of 860 HIV positive MMT clients were analyzed. The methadone dose for study subjects was (38.2 ± 20.7) mg/d. 27.8% (239/860) of study subjects participated in ART treatment, 38.7% (333/860) had never tested for CD4 count. The age for study subjects was (32.9 ± 6.4) years old. Among all these subjects, 67.3% (579/860) were married. During the observation period, 151 deaths were observed in 2192.9 person years. The average observation time was 2.6 year for each subject. The all-cause mortality rate was 68.9‰. Cox proportion model showed that ART treatment (HR = 0.53, 95%CI: 0.32 - 0.88), baseline CD4 count at 200 - 350 cells/µl (HR = 0.35, 95%CI: 0.20 - 0.60), baseline CD4 count more than 350 cells/µl (HR = 0.16, 95%CI: 0.09 - 0.29), and marriage (HR = 0.55, 95%CI: 0.37 - 0.82) were associated with less mortality compared with control group. Age (more than 45 years old) (HR = 5.20, 95%CI: 2.60 - 10.20) and sharing needles (HR = 1.40, 95%CI: 1.02 - 2.00) were risk factors associated with death.

CONCLUSIONHigh mortality rate was observed among HIV infected clients. Methadone clinic should provide ART treatment or ART referral services.

Acquired Immunodeficiency Syndrome ; drug therapy ; mortality ; Adolescent ; Adult ; Anti-HIV Agents ; therapeutic use ; China ; Female ; HIV Infections ; drug therapy ; mortality ; Humans ; Male ; Methadone ; therapeutic use ; Middle Aged ; Retrospective Studies ; Survival Rate ; Young Adult

A water-soluble compound, sodium formononetin-3'-sulfonate with good lipid-lowering and liver-protection activities was synthesized. It was synthesized by sulfonation reaction, and its structure was characterized by IR, NMR and elemental analyses. The solubility of sodium formononetin-3'-sulfonate in water and n-octanol/water partition coefficient were determined by UV spectrophotometry. The lipid-lowering and liver-protection activities of sodium formononetin-3'-sulfonate were tested by using rat's high fat model induce by feeding with high fat food. The results showed that sodium formononetin-3'-sulfonate not only had favorable water, solubility but also had good lipid-lowering and liver-protection activities.
Adipose Tissue ; drug effects ; Alanine Transaminase ; metabolism ; Animals ; Aspartate Aminotransferases ; metabolism ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Hypolipidemic Agents ; chemical synthesis ; chemistry ; pharmacology ; Isoflavones ; chemical synthesis ; chemistry ; pharmacology ; Lipids ; blood ; Liver ; enzymology ; pathology ; Male ; Molecular Structure ; Protective Agents ; chemical synthesis ; chemistry ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Solubility ; Triglycerides ; blood