Artificial intelligence (AI) is among the forefront science in recent years. The rapid development of intelligent medicine based on AI, a new concept in the medical field, has resulted in a large impact on traditional medicine. AI poses a great opportunity and also many challenges for clinical physicians. Recently, researches in the development and application of AI are increasingly published in the field of endocrinology, such as the diagnosis and prediction of diabetes and its complications, the optimizing treatment and blood glucose management, the development of artificial pancreas, the diagnosis and treatment of obesity, the prognosis of bariatric surgery, osteoporosis and fracture prediction, bone age analysis, non-invasive assessment of liver steatosis and fibrosis, diagnosis of acromegaly, pathological diagnosis of thyroid and pituitary tumors. Nevertheless, the clinical applications of AI for medicine are still at an initial stage. With the rapid development of AI, we are expecting that it will play a pivotal role in the field of endocrinology and metabolism in the future. This is a new era for medical community to embrace new technology. Only with the properly dealing with the innovation of AI, a win-win result could be achieved.

Objective To investigate the image quality,radiation dose and iodine intake of CT pulmonary angiography (CTPA) in patients using low tube voltage (100 kVp) combination of different noise indexes (NI) and low concentration contrast agent.Methods A total of 80 patients with suspected pulmonary embolism (PE) and other pulmonary diseases who had undergone CTPA were divided into four groups (A,B,C and D),with 20 patients in each group.Group A underwent 120 kVp CT scan protocol in combination with NI=25 and 370 mg iodine/ml contrast agent,while groups B,C and D underwent 100 kVp CT scan protocol in combination with NI=30,35,40,and 320 mg iodine/ml contrast agent,respectively.All images were restructured using 60％ adaptive statistical iterative algorithm 2.0.Objective image quality evaluation included CT values of pulmonary artery,noise values of pulmonary artery,signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).Subjective image evaluation used a 5-point scoring method and was conducted by two independent radiologists.The CT dose index of volume (CTDIvol),dose-length product (DLP) and iodine intake was recorded,and the mean value was calculated.The DLP was converted to the effective dose (ED).Analysis of Variance or Kruskal-Wallis test was used to evaluate the differences among the four groups in terms of image quality,radiation dose and iodine intake.Results There was a significant difference in CT values of pulmonary artery among the groups A,B,C and D (P＜0.05),and the CT values of pulmonary artery of group A was the lowest.There was no significant differences in noises of pulmonary artery,SNR,CNR and subjective indexes scores among the groups A,B,C and D (P＞0.05).There was a significant difference in iodine intake among the groups A,B,C and D,iodine intake of the group A was the highest,iodine intake of the group D was the lowest.The iodine intake of groups B,C and D decreased by 12.4％ (42/340),13.2％ (45/340) and 15.0％ (51/340) relative to group A,respectively.There was a significant difference in radiation dose among the groups A,B,C and D,The CTDIvol,DLP and ED of group D decreased by 45.3％ (3.9/8.6),48.6％ (120/247) and 48.3％ (2.02/4.18) relative to group A,respectively (P＜0.01).Conclusion Low tube voltage combination with high NI value and low concentration contrast agent can more effectively reduce the radiation dose and iodine intake for CTPA while maintaining diagnostic image quality.

Objective To explore the effect of ginseng co?enzyme Q10 suncream on the skin damage caused by ul?traviolet ( UV) radiation in mice. Methods 36 mice were randomly assigned to four groups. The mice were shaved on the back and the left untreated side was taken as control group, or was treated with UV as model group. Before treated with UV, the mice were painted with suncream containing ginseng co?enzyme Q10 , or octyl methoxycinnamate as positive con?trols. The mice were treated for 8 weeks. At the end of the experiment, blood samples of all mice were collected from the eyes, then subjected to cell counting or biochemical measurements, and skin samples were cut for pathological examina?tion. Results Compared with the control group, there was a significant increase in white blood cell counts ( P<0?05 ) and MDA content ( P<0?05 ) , and declined serum levels of SOD ( P <0?05 ) and GSH?Px ( P <0?05 ) in the model group, and the skin was rough and wrinkled with stratum corneum exfoliation. Compared with the model group, the mice of ginseng co?enzyme Q10 suncream group had significantly lower white blood cell count ( P<0?05 ) and MDA content ( P<0?05), and increased serum levels of T?SOD(P<0?05) and red blood cell counts (P<0?05). The skin had no rough? ness and wrinkles and without stratum corneum exfoliation. Compared with the model group, the positive control group showed significantly decreased white blood cell count (P<0?05) and MDA content (P<0?05), and increased serum lev?els of GSH?Px(P<0?05). The skin had no roughness and wrinkles and no stratum corneum exfoliation. However, there was no significant difference between the ginseng co?enzyme Q10 suncream group and positive control group. Conclusions Ginseng co?enzyme Q10 suncream shows satisfactory preventive effects on the UV radiation?induced skin damage in mice, similar to the preventive effects of the octyl methoxycinnamate?containing sunsream.

Objective To compare the image quality and radiation dose of CTA of the kidney in patients using routine CT and the spectral imaging combination of different scanning protocols with the adaptive statistical iterative reconstruction 2.0 algorithm (ASIR 2.0). Methods A total of 90 patients who had undergone a CTA of the kidney were divided into three groups (A, B and C), with 30 patients in each group. Group A underwent a routine CT examination, and the scan parameters are:120 kVp, 30 to 650 mA, rotation time 0.5 s/r, scan FOV 50 cm × 50 cm;while groups B and C underwent spectral imaging protocol 1 and 2, the scan parameters of spectral imaging protocol 1 and 2 are:rapid dual kVp (80-140 kVp) switching in 0.25 ms, 375 mA and 360 mA, rotation time 0.7 s/r and 0.6 s/r, scan FOV 36 cm × 36 cm and 32 cm × 32 cm, respectively. All images were reconstructured using ASIR 2.0. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of all images were calculated when the kidney CTA was completed. Each subjective image evaluation used a 5-point scoring method and was conducted by two independent radiologists. The CT dose index (CTDIvol) and dose-length product (DLP) were recorded, and the mean value was calculated. The DLP was converted to the effective dose (ED). All data were compared with Kruskal-Wallis test and one-way ANOVA. Results The energy level of 49 to 56 keV was found to provide the best CNR for displaying CTA of the kidney. There were significant differences in CT values, noise, SNR, CNR and subjective score between groups B, C and A (P<0.05), and there was no significant differences in CT values, noise, SNR, CNR and subjective score between groups B and C (P>0.05). There were significant differences in ED among groups A, B and C (P<0.05), and the ED of groups A, B and C were (8.2±1.2), (5.2± 0.9) and (4.4 ± 0.7) mSv, respectively. Conclusion Spectral imaging with different scanning protocols can more effectively reduce the radiation dose than the routine CT scan mode for a kidney CTA while still maintaining diagnostic image quality, and protocol 2 of spectral imaging in our study is recommended.

BACKGROUND:Cuscuta chinensis is a mature seed of Cuscutachinensis Lam., can warm kidney. Previous studies demonstrated that kidney compound composed of Cuscuta chinensis could apparently inhibit bone loss and improve bone density.
OBJECTIVE:To explore the influence of flavonoids from Cuscuta chinensis on bone mineral density of femur, 1,25(OH)2D3 levels of serum and kidney, the expression of smal intestine CaBp-D9K mRNA in model rats with ovariectomized osteoporosis.
METHODS:A total of 72 Sprague-Dawley female rats were equal y and randomly divided into six groups (n=12):sham surgery group, model group, vitamin D3 group and low-, moderate-and high-dose flavonoids groups. The sham surgery group only received sham operation and the other five groups were ovariectomized respectively. One week after ovariectomy, the rats were given flavonoids from low-, moderate-and high-dose Cuscuta chinensis and vitamin D3 (2 mg/kg) by intragastric administration for 3 consecutive months. Blood was obtained from the abdominal aorta. Serum was isolated. The kidney was obtained. Enzyme linked immunosorbent assay was used to determine 1,25(OH)2D3 contents of renal and serum. Rats were sacrificed at the end of experiment. The thighbone was taken out to determine bone mineral density. The second lumbar vertebra was taken out to measure the expression of lumbar vertebra and renal vitamin D receptor mRNA using real-time fluorescent reverse transcription-polymerase chain reaction. The smal intestine was taken out to measure the expression of smal intestine CaBp-D9K mRNA using real-time fluorescent reverse transcription-polymerase chain reaction.
RESULTS AND CONCLUSION:Compared with the sham operation group, bone mineral density of femur, and 1,25(OH)2D3 levels of serum and kidney and the expression of lumbar vertebra vitamin D receptor mRNA significantly decreased in model group, and the expression of smal intestine CaBp-D9K mRNA significantly decreased in model group. Compared with the model group, bone mineral density of femur, and 1,25(OH)2D3 levels of serum and kidney, and the expression of the second lumbar vertebra vitamin D receptor mRNA, and the expression of smal intestine CaBp-D9K mRNA were increased in moderate-and high-dose flavonoids groups and vitamin D3 group. Results indicated that flavonoids from Cuscuta chinensis could significantly raise bone mineral density of femur, and 1,25(OH)2D3 levels of serum and kidney and the expression of lumbar vertebra vitamin D receptor mRNA and the expression of smal intestine CaBp-D9K mRNA, accelerate intestinal calcium absorption and osteoblast activity, and reinforce quality of the bone.

Objective To study the training methods of equipments for the national medical rescue team,for the purpose of enhanced equipment operation ability of team members and enhanced overall capacity for emergency rescue.Methods Using such methods as investigation and discussion,procedures development,examination standards development,and training and examination.These methods are designed to improve the equipment training methods for the national medical rescue team.Results Following the training,get-ready time of the whole team is cut back from 200 minutes to 90 minutes,and the roll-up time from 170 minutes to 80 minutes.Number of equipments mastered by the whole team has risen from 147 pcs/sets(47.2 ％) to 290 pcs/sets(94.5 ％),while average number of equipments mastered per person has risen from 98 pcs/sets(31.9％) to 185 pcs/sets(60.3％).Conclusion The Equipment Operation Procedures List and Equipment Training and Examination Standards should be made in consideration of the development needs of a national medical rescue team and disaster rescue experiences.In addition,such trainings and examinations as those by means of whole team,groups,and group-section crossing can improve the emergency rescue capabilities of the national medical rescue team.

Objective To explore the value of coronary flow reserve(CFR) evaluating myocardial ischemia measured by adenosine triphosphate (ATP) stress transthoracic Doppler echocardiography (TTDE),and the feasibility of CFR to predict coronary stenosis.Methods Fifty-four patients suffering chest pain with known or suspected coronary artery disease were performed ATP stress TTDE to measure resting and maximum expansion coronary blood flow velocity and calculate CFR.all patients were performed by coronary angiography (CAG) and single-photon emission computed tomography (SPECT) myocardial perfusion imaging.Results ① To evaluate myocardial ischemia,there was not statistical significant difference between non-invasive CFR and SPECT myocardial perfusion imaging(P ＞0.05).CFR≤2.0 was the best cutoff value for evaluating myocardial ischemia which yielded a sensitivity of 93.3 ％ and specificity of 89.7％.②Coronary artery stenosis was negatively correlated with CFR (P ＜0.001).ROC curve analysis demonstrated that CFR≤ 1.60 yielded a sensitivity of 92.3％ and specificity of 73.3％ to predict coronary stenosis significantly.Conclusions CFR measured by ATP stress TTDE can evaluate myocardial ischemia of coronary artery disease and predict LAD significant stenosis before CAG.Using CFR and CAG has important clinical value for choosing treatment of stable coronary artery disease.

Objective To study if IRF1 could regulate the polarization by IRF 1 and M1 status and affect M1 media-ted antitumor function .Methods U937 derived M1 macrophage ( U937-M1 ) model was established .The cells were devided into 4 groups:the PMA pretreated unpolarized macrophage (M0), the PMA, IFN-γand LPS induced M1 macrophage (M1), the siRNA of IRF1 knocked down M1 macrophage (siIRF1) and the negative control siR-NA treated M1 macrophage (siC).Furthermore, the expression of CD86 and CD206 was detected by flow cytome-try, the M1/M2 associated markers (IL-12p35,IL-12p40,IL-23p19,IL-6,TNF-α/IL-10) and IFNB1 were ana-lyzed by qPCR,the expression of IL-12p70 and IL-10 was examined by ELISA, the expression of IRF1 and IRF5 was detected by Western blot , the proliferration and apoptosis of HCC were analyzed by CCK 8 and flow cytometry , respectively.Results Compared with the U937-M1, the IRF1 knocked down group showed impaired CD 86 expres-sion, but enhanced CD206 expreesion ( P<0.05 ); the expression of M1 related cytokines including IL-12p35, IL-12p40,IL-23p19,IL-6,TNF-αand IFNB1 was decreased, but M2 related cytokine IL-10 level was increased (P<0.01);the expression of IFN-β, IL-12p70 and IRF5 was impaired, but IL-10 was enhanced (P<0.05).In IRF1 knocked down U937-M1, the CCK8 analysis indicated that the M1 mediated anti-proliferation effects on hepatoma carcinoma cell were turned to pro-proliferation ( P<0.05);the flow cytometry showed that the M 1 mediated pro-ap-optosis effects were reversed to anti-apoptosis ( P<0.01 ) .Interestingly , IRF5 and IFN-βwere decreased at both mRNA and protein levels in IRF1 knocked down U937-M1 compared with the U937-M1 (P<0.01).Conclusions IRF1 may partly modulate IRF5 and IFN-β, and further regulate M1 polarization and its antitumor effects .

Objective To observed the influence of preoperative enteral nutrition(EN) on postoperative nutritional status,immune function and complications in elderly patients with colorectal cancer complicating nutritional risk.Methods The NRS2002 nutritional risk screening criteria was used to select 70 elderly patients with colorectal cancer complicating nutritional risk,including 36 cases in the EN group and 34 cases in the control group.The EN support was given in the ENN group on preoperative 3 d.The levels of plasma total protein,prealbumin,albumin,transferrin,total lymphocyte count,plasma D-lactate(D-LAC) and plasma diamine oxidase (DAO) were detected on postoperative 1,3,5 7 d.The intraoperative intestinal cleanliness and postoperative complications were observed.Results The levels of plasma total protein,prealbumin,albumin,transferrin and total lymphocyte count in the EN group were significantly higher than those in the control group and the levels of D-LAC and DAO,and the incidence rates of abdominal infection and wound infection were significantly lower than those in the control group,the differences were statistically significant(P＜0.05).There was no statistically significant differences in the incidence rates of intestinal cleanliness and anastomotic leakage between the two groups (P＞0.05).Conclusion Preoperative EN support therapy in the patients with colorectal cancer complicating nutritional risk can significantly improve clinical prognosis.

OBJECTIVEEndothelial oxidative stress plays an important role in the pathogenesis of cardiovascular disease. Salidroside, a phenylpropanoid glycoside isolated from Rhodiola rosea L, could exert potent antioxidant properties. In this study, we investigated the protective effects, and related mechanism of salidroside against high glucose (33 mmol/L)-induced cell damage in human umbilical vein endothelial cells (HUVECs).

METHODSHUVECs were cultured in normal glucose (5.5 mmol/L), high glucose (33 mmol/L), high salidroside (10 µg/ml+33 mmol/L glucose), moderate salidroside (4 µg/ml+33 mmol/L glucose), low salidroside (1 µg/ml+33 mmol/L glucose) and very low salidroside (0.1 µg/ml+33 mmol/L glucose) for 48 h. Cell viability, the level of malondialdehyde (MDA) , reactive oxygen species (ROS) , nitric oxide (NO) , [Ca(2)+]i, calmodulin (CaM) , calmodulin-dependent kinase (CaMK) IIδ, endothelial nitric oxide synthase (eNOS) , active caspase-3 protein expression and eNOS ser 1177 phosphorylation of HUVECs post various treatments were measured. The cell viability was assessed with MTT assay, and the level of ROS, and [Ca(2)+]i was analyzed using flow cytometry. Nitric oxide and MDA was detected by Nitric Oxide Assay Kit and MDA Assay Kit. Western blot was performed to detect the protein expressions of eNOS, active caspase-3 and eNOS ser 1177 phosphorylation.

RESULTSComparing to the normal glucose group, high glucose treatment increased the cell damage, the level of NO and [Ca(2)+]i (P < 0.05) , downregulated CAMKIIδ, eNOS expression and eNOS ser 1177 phosphorylation (P < 0.05), elevated the concentration of MDA and ROS (P < 0.05) in HUVECs. Salidroside treatment significantly attenuated high glucose-induce cell damage on cultured HUVECs in a dose-dependent manner. Comparing to the high glucose group, 10 µg/ml Salidroside significantly increased cell viability (P < 0.05) , inhibited high glucose-induced release of MDA , generation of ROS, active caspase 3 protein expression (P < 0.05) , upregulated the release of nitric oxide and [Ca(2)+]i by HUVECs (P < 0.05) , enhanced CaM, CAMKIIδ, eNOS expression and eNOS ser 1177 phosphorylation in HUVECs (P < 0.05) .

CONCLUSIONSThese findings suggeste that salidroside could attenuate high glucose induced apoptosis in HUVEC, partly through activating the Ca(2)+/CaM/CAMKIIδ/eNOS pathway.

Apoptosis ; drug effects ; Calcium ; metabolism ; Calcium-Calmodulin-Dependent Protein Kinase Type 2 ; metabolism ; Calmodulin ; metabolism ; Cell Survival ; drug effects ; Cells, Cultured ; Glucose ; toxicity ; Glucosides ; pharmacology ; Human Umbilical Vein Endothelial Cells ; drug effects ; metabolism ; pathology ; Humans ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Phenols ; pharmacology ; Phosphatidylinositol 3-Kinases ; metabolism ; Signal Transduction