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 investigate the clinical characteristics and treatment of pancreatic pseudocyst after pegaspargase treatment in children. Methods: The clinical data of 6 children with pancreatic pseudocyst after pegaspargase treatment in the Department of Pediatrics in Peking University Third Hospital from July 2018 to February 2021 were analyzed retrospectively. Results: There were 4 males and 2 females, and their age of onset was 9.5 (5.8, 13.0) years. The total number of pegaspargase applications was 2.5 (2.0, 3.5) times. The course from the last dose of pegaspargase to the onset of pancreatitis was 11.0 (9.0, 17.2) days, and 42.5 (35.0, 129.5) days from the onset of pancreatitis to the diagnosis of pancreatic pseudocyst. Abdominal pain was the most prominent manifestation of pancreatitis (6/6). All of the 6 children were asymptomatic when pancreatic pseudocyst was noted, and were treated conservatively at first, but one case later developed intermittent abdominal distension or nausea after eating. All the cases had pancreatic pseudocyst enlargement during the conservative treatment. Three children were treated with endoscopic ultrasound-guided transgastric drainage, and the cyst disappeared from 10 days to 4 months after the operation. The other 3 children received endoscopic retrograde cholangiopancreatography (ERCP)-guided transpapillary drainage, but one of them turned to surgery due to pancreatic duct stricture, and in the rest 2 children the cyst disappeared at 1 and 3 months after operation respectively. Regarding safety issues, 1 child who received ERCP-guided transpapillary drainage had acute postoperative pancreatitis, which were improved after treatment, and the other 5 had no complications. Conclusions: Pancreatic pseudocyst after pegaspargase chemotherapy can be asymptomatic in the early stage, and should be diagnosed with a history of pegaspargase treatment and timely imaging examination. Conservative treatment is the first choice for asymptomatic pseudocyst. When the pseudocyst enlarges, different endoscopic drainage treatments are required according to whether the pseudocyst is connected with the main pancreatic duct.
Female ; Male ; Humans ; Child ; Retrospective Studies ; Asparaginase ; Polyethylene Glycols/adverse effects* ; Pancreatitis

OBJECTIVE: To investigate the clinical effect of arthroscopic assisted TightRope plate, Triple-Endobutton plate and Double Endobutton plate in treating of Rockwood type Ⅲ-Ⅴ acromioclavicular dislocation. METHODS: From January 2014 to January 2018, 128 patients with acromioclavicular dislocation were treated by operation. According to the operation plan, the patients were divided into three groups:Double Endobutton group, Triple-Endobutton group and TightRope group. All patients with acromioclavicular dislocation were operated by the same operation team, and the chief surgeon was the same chief physician. General baseline data such as gender, age, operation time, incision length, intraoperative blood loss, VAS score of pain and Constant-Murley shoulder function score were recorded. RESULTS: The wound healed well and no recent complications occurred. One hundred and eleven patients were followed up for 6 to 12(9.1±3.1) months. There was no significant difference on general data among three groups (P >0.05). Among three groups, the operation time of Triple -Endobutton group was the longest, significantly higher than that of other two groups(<0.05);the operation time of TightRope group was the shortest, significantly lower than that of other two groups (<0.05). At 1 month after operation, VAS score comparison of three groups, TightRope group was significantly lower than other two groups, with statistical difference (<0.05). At 12 months after operation of three groups, the Constant-Murley score of TightRope group was significantly higher than that of two group (<0.05). The incidence of incision infectionin TightRope group was significantly lower than that of other two groups(<0.05); the incidence of reduction loss in Double Endobton group was significantly higher than that of other two groups(<0.05), the incidence of reduction loss in TightRope group was significantly higher than that of Triple endobton group(<0.05);the incidence of joint adhesion in TightRope group was significantly lower than that of other two groups(<0.05). CONCLUSION TightRope plate fixation with arthroscopy is more advantageous than Double Endobutton plate fixation and Triple-Endobutton plate fixation.
Acromioclavicular Joint ; Arthroscopy ; Bone Plates ; Humans ; Joint Dislocations ; Shoulder Dislocation ; Treatment Outcome

【Objective】 To investigate the inhibitory effect of RGD- modified，MRI visualized nanocarrier（RGD- PEG-g-PEI-SPION）targeting for Survivin siRNA（siRNA）delivery to hepatocellular carcinoma（HCC）in nude mice； and to investigate the MRI imaging function of RGD-PEG-g-PEI-SPION in nude mouse liver cancer. 【Methods】Nude mice were subcutaneously injected with Bel- 7402 cells to establish a subcutaneous tumor- bearing model. Tumor growth inhibition test，HE staining，immunohistochemical staining and tumor cell apoptosis test were used to evaluate the therapeutic effect of RGD-PEG-g-PEI-SPION targeted Survivin siRNA on liver cancer in nude mouse ；MRI imaging was used to analyze the targeting imaging function of RGD-PEG-g-PEI-SPION on hepatocellular carcinoma【Results】The subcutaneous tumor- bearing model of nude mice was successfully established，and the tumor volume of subcutaneous graft of RGD-PEG-g-PEI-SPION /siRNA，PEG-g-PEI-SPION/siRNA，RGD-PEG-g-PEI-SPION /siNC，PEG-g-PEI-SPION/ siNC and PBS solution in nude mice after first injection in the tail vein for 25 days was 59±8，156±7，202±7，212±9 and 220±8（mm3），respectively. Tumor histological examination showed that the RGD-PEG-g-PEI-SPION/siRNA group had the widest range of tumor necrosis，the lowest Survivin protein expression，and the number of apoptotic tumor cells significantly increased. Three hours after injection of RGD-PEG-g-PEI-SPION vector and PEG-g-PEI-SPION vector into the tail vein，the standardized MRI signal intensity of subcutaneous transplanted tumor decreased to（51.6±4.3）% and（88.5±3.2）% ，respectively ，compared with that before injection. 【Conclusion】 RGD- PEG- g- PEI- SPION delivers Survivin siRNA to hepatocellular carcinoma，promotes tumor cell apoptosis，inhibits tumor growth，and achieves good anti-tumor effect；RGD-PEG-g-PEI-SPION has a well targeted MRI imaging function in nude mouse liver cancer tissues.

OBJECTIVE: To study on the expression and clinical significance of interleukin 10 receptor 1(IL-10R1)in T lymphocytes in peripheral blood of children with food allergy. METHODS: The food allergy group included 50 cases of children admitted in Department of Pediatrics of Peking University Third Hospital from July 1,2017 to December 31,2017 and were diagnosed with food allergy. A total of 25 cases of healthy children who visited Child Health and Development Center of Peking University Third Hospital in the same period with no food allergy manifestation were selected as a healthy control group. The clinical manifestations of food allergy in different age groups were compared.Flow cytometry was used to examine the expression of IL-10R1 in CD4~+T cells and CD8~+T cells in peripheral blood and the MFI. According to the results of allergen specific Ig E test,the food allergy children were classified as allergen specific Ig E positive group and negative group. The expression of l L-10R1 in the CD4~+T lymphocytes and CD8~+T lymphocytes in peripheral blood and the MFI of the two groups were compared. A severity index of clinical symptoms and signs of food allergy was used to grade illness severity of food allergy children. Then it analyzed the correlation between the expression rates of IL-10R1 in CD4~+T cells and CD8~+T cells in peripheral blood and the scores. RESULTS: The expression rates and MFI of IL-10R1 in CD4~+T cells in peripheral blood of food allergy group were lower compared to the control group. The median expression rates and MFI were 40.23 versus 45.32,12.18 versus 17.69(Z=-2.506,-5.547,P=0.012,0.000,respectively). The expression rates and MFI of IL-10R1 in CD8~+T cells in the peripheral blood of food allergy group were also lower than the control group. The median expression rates and MFI were 34.50 versus 39.46,12.47 versus 17.28(Z=-4.035,-5.226,P=0.000,0.000,respectively). IL-10R1 expression rates and MFI on CD4~+T cells and CD8~+T cells in peripheral blood of allergen specific Ig E positive group were similar to those of the negative group. The expression rates of IL-10R1 on CD4~+T cells and CD8~+T cells in peripheral blood of children with food allergy had no correlation with the symptom and sign scores of food allergy. CONCLUSION: The decrease of the expression of IL-10R1 in CD4~+T cells and CD8~+T cells in peripheral blood may be associated with food allergy of children;the expression of IL-10R1 may be involved in the pathogenesis of food allergy mediated by Ig E and non-Ig E,but it was not associated with the severity of food allergy.

The effect of topical propranolol gel on the levels of plasma renin, angiotensin II (ATII) and vascular endothelial growth factor (VEGF) in superficial infantile hemangiomas (IHs) was investigated. Thirty-three consecutive children with superficial IHs were observed pre-treatment, 1 and 3 months after application of topical propranolol gel for the levels of plasma renin, ATII and VEGF in Department of General Surgery of Dongfang Hospital from February 2013 to February 2014. The plasma results of IHs were compared with those of 30 healthy infants of the same age from out-patient department. The clinical efficiency of topical propranolol gel at 1st, and 3rd month after application was 45%, and 82% respectively. The levels of plasma renin, ATII and VEGF in patients pre-treatment were higher than those in healthy infants (565.86 ± 49.66 vs. 18.19 ± 3.56, 3.20 ± 0.39 vs 0.30 ± 0.03, and 362.16 ± 27.29 vs. 85.63 ± 8.14, P < 0.05). The concentrations of VEGF and renin at 1st and 3rd month after treatment were decreased obviously as compared with those pre-treatment (271.51 ± 18.59 vs. 362.16 ± 27.29, and 405.18 ± 42.52 vs. 565.86 ± 49.66 P < 0.05; 240.80 ± 19.89 vs. 362.16 ± 27.29, and 325.90 ± 35.78 vs. 565.86 ± 49.66, P < 0.05, respectively), but the levels of plasma ATII declined slightly (2.96 ± 0.37 vs. 3.20 ± 0.39, and 2.47 ± 0.27 vs. 3.20 ± 0.39, P > 0.05). It was indicated that the increased renin, ATII and VEGF might play a role in the onset or development of IHs. Propranolol gel may suppress the proliferation of IHs by reducing VEGF.
Administration, Cutaneous ; Adrenergic beta-Antagonists ; therapeutic use ; Angiotensin II ; blood ; Case-Control Studies ; Female ; Gels ; Hemangioma, Capillary ; blood ; blood supply ; drug therapy ; pathology ; Humans ; Infant ; Infant, Newborn ; Male ; Propranolol ; therapeutic use ; Renin ; blood ; Skin Neoplasms ; blood ; blood supply ; drug therapy ; pathology ; Treatment Outcome ; Vascular Endothelial Growth Factor A ; blood

OBJECTIVETo explore the effect of half circle external fixation for the treatment of open tibial fractures.

METHODSFrom March 2005 to March 2011, 94 patients with open tibiofibula fractures were treated by closed manipulative or Kirschner-wire poking reduction with half circle groove external fixation including 63 males and 31 females with an average age of 39 years old ranging from 17 to 65 years old. Among these patients, 5 cases were cross shaped fractures, 19 were oblique form and spiral fractures, 70 cases were comminuted fractures. According to the fracture Gustilo classification, 49 cases were type IIIA, 45 were type IIIB. The incidence of wound infection, fracture healing time were observed. The function was evaluated according to the Johner-Wruhs standard.

RESULTSAll patients were followed up for 14 to 63 months (averaged 29 months). The wound healing time was from 16 to 39 weeks (means 21.4 weeks). No fracture nonunion, osteomyelitis and calf compartment syndrome occurred. The wounds of 81 cases were healed at the first period,deep wound infection occurred in 2 cases. According to the function Johner-Wruhs evaluation criteria:the result was excellent in 52 cases, good in 37 cases, fair in 5 cases.

CONCLUSIONClosed manipulative or Kirschner-wire poking reduction and half circle groove external fixation can reduce the infection rate of open tibiofibula fractures. For open tibiofibula comminuted fractures, after the half circle groove external fixation for 3 to 6 weeks, a middle Kirschner-wire was removed according to fracture end healing situation to make fixation dynamic and promote fracture healing.

Adolescent ; Adult ; Aged ; Bone Wires ; External Fixators ; Female ; Fracture Fixation ; instrumentation ; Fractures, Comminuted ; surgery ; Fractures, Open ; surgery ; Fractures, Ununited ; surgery ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery ; Young Adult

Fragments encoding amino acids 76-130 in the linear conserved region (LCR) of A/Hubei/1/2010 (H5N1) HA2 was fused to hepatitis B core antigen (HBc) to generate a LCR-HBe virus-like particle (VLP). Results showed that the fusion protein of LCR-HBc was highly expressed in this prokaryotic expression system. The purified LCR-HBc particle stimulated high levels of IgG production in mice with a titer of > 1:12 800, and provided 50% cross-protection against lethal challenge by H1N1 viruses.
Amino Acid Sequence ; Animals ; Female ; Hemagglutinin Glycoproteins, Influenza Virus ; immunology ; Influenza A Virus, H5N1 Subtype ; immunology ; Influenza Vaccines ; immunology ; Interferon-gamma ; biosynthesis ; Lung ; pathology ; Mice ; Mice, Inbred BALB C ; Molecular Sequence Data

BACKGROUND: Acute liver failure (ALF) caused by viral and non-viral hepatitis is often accompanied with severe metabolic disorders, the accumulation of toxic substances and continuous release and accumulation of a large number of endogenous toxins and inflammatory mediators. The present study aimed to investigate the effects of various combined non-biological artificial liver treatments for patients with acute liver failure (ALF) complicated by multiple organ dysfunction syndrome (MODS). METHODS: Thirty-one patients with mid- or late-stage liver failure complicated by MODS (score 4) were randomly divided into three treatment groups: plasmapheresis (PE) combined with hemoperfusion (HP) and continuous venovenous hemodiafiltration (CVVHDF), PE+CVVHDF, and HP+CVVHDF, respectively. Heart rate (HR) before and after treatment, mean arterial pressure (MAP), respiratory index (PaO2/FiO2), hepatic function, platelet count, and blood coagulation were determined. RESULTS: Signifi cant improvement was observed in HR, MAP, PaO2/FiO2, total bilirubin (TBIL) and alanine aminotransferase (ALT) levels after treatment (P<0.05). TBIL and ALT decreased more signifi cantly after treatment in the PE+CVVHDF and PE+HP+CVVHDF groups (P<0.01). Prothrombin time (PT) and albumin were signifi cantly improved only in the PE+CVVHDF and PE+HP+CVVHDF groups (P<0.05). TBIL decreased more significantly in the PE+HP+CVVHDF group than in the HP+CVVHDF and PE+CVVHDF groups (P<0.05). The survival rate of the patients was 58.1％ (18/31), viral survival rate 36.4％ (4/11), and non-viral survival rate 70％ (14/20). CONCLUSION: Liver function was relatively improved after treatment, but PE+HP+CVVHDF was more efficient for the removal of toxic metabolites, especially bilirubin. The survival rate was significantly higher in the patients with non-viral liver failure than in those with viral liver failure.

Objective:To explore the effect of half circle external fixation for the treatment of open tibial fractures. Meth-ods: From March 2005 to March 2011,94 patients with open tibiofibula fractures were treated by closed manipulative or Kirschner wire poking reduction with half circle groove external fixation including 63 males and 31 females with an average age of 39 years old ranging from 17 to 65 years old. Among these patients ,5 cases were cross shaped fractures ,19 were oblique form and spiral fractures,70 cases were comminuted fractures. According to the fracture Gustilo classification,49 cases were typeⅢA,45 were typeⅢB. The incidence of wound infection,fracture healing time were observed. The function was evaluated according to the Johner Wruhs standard. Results:All patients were followed up for 14 to 63 months (averaged 29 months). The wound healing time was from 16 to 39 weeks (means 21.4 weeks). No fracture nonunion,osteomyelitis and calf compart-ment syndrome occurred. The wounds of 81 cases were healed at the first period ,deep wound infection occurred in 2 cases. According to the function Johner-Wruhs evaluation criteria:the result was excellent in 52 cases,good in 37 cases,fair in 5 cases. Conclusion:Closed manipulative or Kirschner wire poking reduction and half circle groove external fixation can reduce the infection rate of open tibiofibula fractures. For open tibiofibula comminuted fractures ,after the half circle groove external fixation for 3 to 6 weeks,a middle Kirschner wire was removed according to fracture end healing situation to make fixation dy-namic and promote fracture healing.