Objective:To investigate the feasibility and effectiveness of 3D ultrasound technique in diagnosing uterine arteriovenous fistula(UAVF),and compare it with two-dimensional color Doppler ultrasound(2D-CDUS).Methods:A total of fifty patients with suspected uterine arteriovenous fistula(UAVF)who received examination in the Department of Ultrasound,Baoding Maternal and Child Health Care Hospital from November 2023 to September 2024 were selected,and they were divided into control group and observation group by the random number table method,with 25 cases in each group.The control group received 2D-CDUS examination,while the observation group received the examination of three-dimensional transvaginal ultrasound(3D-TVS).The results of the ultrasound examinations were recorded,and the diagnostic indicators of the ultrasound examinations were calculated.The result of contrast enhanced ultrasound(CEUS)to conduct comparison and analysis,and the receiver operating characteristic(ROC)curve was adopted to analyze the diagnostic value of the two kinds of diagnostic methods.Results:There were no statistically significant differences in the positive rate and UAVF type after 2D-CDUS,3D-TVS and CEUS examinations between control group and observation group(P>0.05).There were no statistically significant difference in the sensitivity,specificity,accuracy and positive predictive value between the control group with 2D-CDUS examination and the observation group with 3D-TVS examination(P>0.05).The negative predictive value of 3D-TVS was 83.33%,which was higher than that of 2D-CDUS,and the difference was statistically significant(x2=7.481,P<0.05).Conclusion:The 3D-TVS technique shows a favorably negative predictive value in diagnosing UAVF,which can effectively make up for deficiencies of 2D-CDUS.It has the feasibility and effectiveness of clinical diagnosis,and provides a more comprehensive assessment method for early diagnosis for UAVF.

Medical artificial intelligence （AI） is a new type of application formed by the combination of machine learning， computer vision， natural language processing， and other technologies with clinical medical treatment. With the continuous iteration and development of relevant technologies， medical AI has shown great potential in improving the efficiency of diagnosis and treatment， and service quality， but it also increases the possibility of triggering ethical issues. Ethical issues resulting from the clinical application of medical AI were analyzed， including the lack of algorithmic interpretability and transparency of medical AI， leading to information asymmetry and cognitive discrepancies； the concerning status of security and privacy protection of medical data； and the complex and unclear division of responsibilities due to the collaborative participation of multiple subjects in the clinical application of medical AI， resulting in increased difficulty in the identification of medical accidents and clarification of responsibilities. The paper proposed the principles of not harming patients’ interests， physician’s subjectivity， fairness and inclusiveness， and rapid response. It also explored the strategies and implementation paths for responding to the ethical issues of medical AI from multiple perspectives， including standardizing the environment and processes， clarifying responsibility attribution， continuously assessing the impact of data protection， guaranteeing data security， ensuring model transparency and interpretability， carrying out multi-subject collaboration， as well as the principles of being driven by ethical values and adhering to the “human health-centeredness.” It aimed to provide guidance for the healthy development of medical AI， ensuring technological progress while effectively managing and mitigating accompanying ethical risks， thereby promoting the benign development of medical AI technology and better serving the healthcare industry and patients.

Objective:To observe any impact of supplementing conventional rehabilitation training with electrothermal acupuncture on the upper limb motor functioning of hemiplegic stroke survivors.Methods:Thirty-six hemiplegic persons who had recently survived a stroke were divided at random into an electrothermal acupuncture group ( n=18) and a control group ( n=18). Both groups received conventional rehabilitation training, while the electrothermal acupuncture group was additionally provided with daily 30-minute sessions of electrothermal acupuncture, 6 days per week for 3 weeks. Before and after the treatment everyone′s upper limb motor functioning was quantified using the Fugl-Meyer assessment (FMA-UE), and their ability in the activities of daily living (ADL) was assessed using the modified Barthel index (MBI). The Hong Kong version of the functional test for the hemiplegic upper extremity (FTHUE-HK) was also administered. Surface electromyography (sEMG) was employed to compute the co-contraction ratios (CRs) of the agonist to antagonist muscles during elbow flexion and extension. Results:After the treatment, both groups exhibited significant improvements in their average FMA-UE, FTHUE-HK and MBI results, but with significantly greater improvement in the electrothermal acupuncture group. The root mean square values of the wrist flexor and extensor and elbow flexor muscles during flexion showed significant improvement in both groups, with the average values in the electrothermal acupuncture group significantly better than those of the control group. The CR values during elbow extension in the electrothermal acupuncture group demonstrated significant improvement compared to before the treatment.Conclusions:Supplementing conventional rehabilitation measures with electrothermal acupuncture can better increase the strength of the elbow and wrist extensor muscles in the early days after a stroke. It promotes the recruitment of muscle fibers in the extensor muscle group, reduces abnormal coordination patterns in the elbow joint, and improves upper limb motor function, the practicality of hand function, and ability in the activities of daily living.

Objective:To explore the application value of three-dimensional ultrasound(3D-US)combined with two-dimensional trans vaginal sonography(2D-TVS)in diagnosing uterine arteriovenous fistula(UAVF).Methods:A total of 36 patients with suspected UAVF who admitted to Baoding Maternal and Child Health Care Hospital from January 2024 to December 2024 were retrospective selected.All of them underwent 3D-US,2D-TVS and combined examinations of 3D-US and 2D-TVS.The gynecological intravenous contrast-enhanced ultrasound was used as the"gold standard"to compare and analyze the sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of 3D-US,2D-TVS and the combined examination of them.The diagnostic efficacies of the three diagnostic methods were calculated by the four-grid table method and the analysis of the receiver operating characteristic(ROC)curve.The detection rates of 2D-TVS and combined examination of 2D-TVS and 3D-US for UAVF imaging signs were compared.Results:In 36 patients,gold standard confirmed 26 positive cases and 10 negative cases.The sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of 2D-TVS examination were respectively 69.23%,80.00%,72.22%,90.00%and 50.00%.These indicators of 3D-US examinations were respectively 84.62%,90.00%,86.11%,95.65%and 69.23%.These indicators of the combined examination were respectively 92.31%,90.00%,91.67%,96.00%and 81.82%.There were not statistically significant differences in these indicators among the three diagnostic methods(P>0.05).However,the sensitivity,accuracy rate of the combined examination were respectively higher than those of 2D-TVS examination,and the differences were statistically significant(x2=4.457,4.600,P<0.05).The detection rates of the sings included lake-like,multicolored Mosaic and blood flow spectrum of high-speed low-resistance in UAVF images of the combined examination were all higher than those of 2D-TVS examination,and the differences were statistically significant(x2=4.000,4.431,4.600,P<0.05).Conclusion:The combination of 3D-US and 2D-TVS can significantly improve the diagnostic sensitivity,accuracy and detection rate of imaging signs in the diagnosis for UAVF,which has important clinical application value.

Objective:To explore the application value of three-dimensional ultrasound(3D-US)combined with two-dimensional trans vaginal sonography(2D-TVS)in diagnosing uterine arteriovenous fistula(UAVF).Methods:A total of 36 patients with suspected UAVF who admitted to Baoding Maternal and Child Health Care Hospital from January 2024 to December 2024 were retrospective selected.All of them underwent 3D-US,2D-TVS and combined examinations of 3D-US and 2D-TVS.The gynecological intravenous contrast-enhanced ultrasound was used as the"gold standard"to compare and analyze the sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of 3D-US,2D-TVS and the combined examination of them.The diagnostic efficacies of the three diagnostic methods were calculated by the four-grid table method and the analysis of the receiver operating characteristic(ROC)curve.The detection rates of 2D-TVS and combined examination of 2D-TVS and 3D-US for UAVF imaging signs were compared.Results:In 36 patients,gold standard confirmed 26 positive cases and 10 negative cases.The sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of 2D-TVS examination were respectively 69.23%,80.00%,72.22%,90.00%and 50.00%.These indicators of 3D-US examinations were respectively 84.62%,90.00%,86.11%,95.65%and 69.23%.These indicators of the combined examination were respectively 92.31%,90.00%,91.67%,96.00%and 81.82%.There were not statistically significant differences in these indicators among the three diagnostic methods(P>0.05).However,the sensitivity,accuracy rate of the combined examination were respectively higher than those of 2D-TVS examination,and the differences were statistically significant(x2=4.457,4.600,P<0.05).The detection rates of the sings included lake-like,multicolored Mosaic and blood flow spectrum of high-speed low-resistance in UAVF images of the combined examination were all higher than those of 2D-TVS examination,and the differences were statistically significant(x2=4.000,4.431,4.600,P<0.05).Conclusion:The combination of 3D-US and 2D-TVS can significantly improve the diagnostic sensitivity,accuracy and detection rate of imaging signs in the diagnosis for UAVF,which has important clinical application value.

Objective:To observe any impact of supplementing conventional rehabilitation training with electrothermal acupuncture on the upper limb motor functioning of hemiplegic stroke survivors.Methods:Thirty-six hemiplegic persons who had recently survived a stroke were divided at random into an electrothermal acupuncture group ( n=18) and a control group ( n=18). Both groups received conventional rehabilitation training, while the electrothermal acupuncture group was additionally provided with daily 30-minute sessions of electrothermal acupuncture, 6 days per week for 3 weeks. Before and after the treatment everyone′s upper limb motor functioning was quantified using the Fugl-Meyer assessment (FMA-UE), and their ability in the activities of daily living (ADL) was assessed using the modified Barthel index (MBI). The Hong Kong version of the functional test for the hemiplegic upper extremity (FTHUE-HK) was also administered. Surface electromyography (sEMG) was employed to compute the co-contraction ratios (CRs) of the agonist to antagonist muscles during elbow flexion and extension. Results:After the treatment, both groups exhibited significant improvements in their average FMA-UE, FTHUE-HK and MBI results, but with significantly greater improvement in the electrothermal acupuncture group. The root mean square values of the wrist flexor and extensor and elbow flexor muscles during flexion showed significant improvement in both groups, with the average values in the electrothermal acupuncture group significantly better than those of the control group. The CR values during elbow extension in the electrothermal acupuncture group demonstrated significant improvement compared to before the treatment.Conclusions:Supplementing conventional rehabilitation measures with electrothermal acupuncture can better increase the strength of the elbow and wrist extensor muscles in the early days after a stroke. It promotes the recruitment of muscle fibers in the extensor muscle group, reduces abnormal coordination patterns in the elbow joint, and improves upper limb motor function, the practicality of hand function, and ability in the activities of daily living.

Objective:To investigate the feasibility and effectiveness of 3D ultrasound technique in diagnosing uterine arteriovenous fistula(UAVF),and compare it with two-dimensional color Doppler ultrasound(2D-CDUS).Methods:A total of fifty patients with suspected uterine arteriovenous fistula(UAVF)who received examination in the Department of Ultrasound,Baoding Maternal and Child Health Care Hospital from November 2023 to September 2024 were selected,and they were divided into control group and observation group by the random number table method,with 25 cases in each group.The control group received 2D-CDUS examination,while the observation group received the examination of three-dimensional transvaginal ultrasound(3D-TVS).The results of the ultrasound examinations were recorded,and the diagnostic indicators of the ultrasound examinations were calculated.The result of contrast enhanced ultrasound(CEUS)to conduct comparison and analysis,and the receiver operating characteristic(ROC)curve was adopted to analyze the diagnostic value of the two kinds of diagnostic methods.Results:There were no statistically significant differences in the positive rate and UAVF type after 2D-CDUS,3D-TVS and CEUS examinations between control group and observation group(P>0.05).There were no statistically significant difference in the sensitivity,specificity,accuracy and positive predictive value between the control group with 2D-CDUS examination and the observation group with 3D-TVS examination(P>0.05).The negative predictive value of 3D-TVS was 83.33%,which was higher than that of 2D-CDUS,and the difference was statistically significant(x2=7.481,P<0.05).Conclusion:The 3D-TVS technique shows a favorably negative predictive value in diagnosing UAVF,which can effectively make up for deficiencies of 2D-CDUS.It has the feasibility and effectiveness of clinical diagnosis,and provides a more comprehensive assessment method for early diagnosis for UAVF.

BACKGROUND:Bone tissue defects are one of the most common diseases in orthopedics,and the current treatments for this disease are inadequate.The development of tissue engineering brings new hope for bone defect repair:by regulating the release of bioactive substances and the process of vascularization and neurogenesis at the defect site,it can effectively improve the microenvironment of bone tissue and promote osseointegration,which is the most promising research idea for large-size bone defect repair. OBJECTIVE:To explore the research progress of regulating bone microenvironment changes in bone defect repair in recent years from the effects of bioactive substances,vascularization and neurotization on three aspects of bone microenvironment changes,and to provide new ideas and strategies for the treatment of large-size bone defects. METHODS:The search terms"bone tissue engineering,angiogenesis,neurotization,cytokines,bone morphogenetic protein,vascular endothelial growth factor,neuropeptides,bone microenvironment"in Chinese and English were used to search for articles on the influence of changes in the bone microenvironment and their application in bone tissue engineering published from January 1,2001 to December 31,2022 on CNKI,WanFang,Web of Science,Science Direct,and PubMed.Finally,109 articles were included for review. RESULTS AND CONCLUSION:(1)The bone microenvironment is essential for the induction of bone tissue stem cell growth and differentiation,and mainly consists of the extracellular matrix of the bone tissue seeds and the biochemical factors required for intercellular interactions,the local blood circulation network and the surrounding nerve tissue.(2)Bone defect repair is a continuous process divided into multiple phases that overlap and are mediated by multiple cytokines,and the same cytokine can have mutually synergistic or antagonistic effects in one or more healing phases.(3)Neovascular regeneration is key to initiating bone repair,as neovascularisation not only provides essential nutrients,osteoblasts and growth factors for bone repair,but is also a gateway for repair cells to enter the injury zone.(4)In addition to regulating the type,dose and timeliness of vascular-inducing factor release to achieve blood transport reconstruction.The study of differential release delivery systems of multiple factors and the application of gene transfer technology will be the future research direction to solve large bone defects.(5)Neuropeptides can bind to relevant receptors and act on specific signaling pathways to guide vascular growth and influence bone healing,bone regeneration and the balance between osteogenesis and osteolysis through a variety of pathways.(6)In the establishment of neuralized tissue-engineered bone,the role of changes in the bone tissue microenvironment and neuromodulation is bidirectional.Cytokines in the bone matrix can participate in neuronal signaling pathways through the blood-nerve barrier.Neuropeptides secreted by glial cells act on the bone microenvironment,affecting bone healing,bone regeneration and the balance between osteogenesis and osteolysis.(7)There are still many questions regarding the regulation of the bone microenvironment by bioactive substances and the processes of vascularization and neurogenesis,such as the rapid diffusion and degradation of cytokines in the body and their loss of activity,the temporal and spatial distribution of angiogenesis-related growth factors,and the establishment of neurogenesis through the body's feedback regulatory mechanism,which need to be improved by subsequent studies.

Objective:To discuss the inhibitory effect of Schisandrin B on the proliferation of pancreatic cancer Pan02 cells,and to clarify the mechanism.Methods:CCK-8 method was used to detect the proliferation rates of the Pan02 cells after treated with different concentrations(0,0.78,1.56,3.12,6.25,12.50,and 25.00 mg·L-1)of Schisandrin B to select the optimal concentration and treatment time of Schisandrin B.The mouse pancreatic cancer Pan02 cells were divided into control group(0 mg·L-1 Schisandrin B),2.5 mg·L-1 Schisandrin B group,5.0 mg·L-1 Schisandrin B group,and 10.0 mg·L-1 Schisandrin B group.The morpholoy of Pan02 cells invarious groups was observed with light microscope;5-ethynyl-2'-deoxyuridine(EdU)staining assay was used to detect the positive expression rates of the Pan02 cells in various groups;flow cytometry was used to detect the percentages of the Pan02 cells at different cell cycles and the apoptotic rates of the cells in various groups;Western blotting method was used to detect the expression levels of cell cycle and apoptosis-related proteins in the cells in various groups.Results:The CCK-8 method results showed that after treated with Schisandrin B for 48 and 72 h,compared with 0 mg·L-1 Schisandrin B,the proliferation rates of the Pan02 cells after treated with different concentrations of Schisandrin B were decreased(P<0.01),especially at 72 h.0.25,5.0,and 10.0 mg·L-1 Schisandrin B were selected to treat the Pan02 cells,and 72 h was the treatment time.In control group,the Pan02 cells had a spindle shape,with good condition,and grew closely adhered to the wall with normal organelles and cytoplasm,in 2.5 and 5.0 mg·L-1 Schisandrin B groups,the cell volume was decreased,the intercellular adhesion was disappeared,and the cell membrane was intact but more permeable;the cytoplasm shrank and vacuolar structures appeared inside the cells,with some fragmented and floating on the surface of the solution;in 10.0 mg·L-1 Schisandrin B group,the Pan02 cells exhibited notable apoptotic bodies,indicating an apoptotic state.The EdU staining results showed that compared with control group,the rates of EdU positive cells in 2.5,5.0,and 10.0 mg·L-1 Schisandrin B groups were significantly decreased(P<0.01).The flow cytometry results showed that compared with control group,the percentages of the cells at S phase in 2.5,5.0,and 10.0 mg·L-1 Schisandrin B groups were significantly increased(P<0.01),while the percentages of the cells at G2/M phase were significantly decreased(P<0.01),and the percentages of the cells at G0/G1 phase in 5.0 amd 1.0 mg·L-1 Schisandrin groups were decreased(P<0.01);compared with control group,the apoptotic rates of the cells in 2.5,5.0,and 10.0 mg·L-1 Schisandrin B groups were significantly increased(P<0.01).The Western blotting results showed that compared with control group,the expression levels of p27,B-cell lymphoma 2(Bcl-2)associated X protein(Bax),cleaved cysteine aspartic acid protease-3(cleaved Caspase-3),and cleaved poly adenosine diphosphate(ADP)ribose polymerase(cleaved PARP)proteins in the cells in 2.5 mg·L-1 Schisandrin B group were significantly increased(P<0.05 or P<0.01),the expression levels of cyclin A2,cyclin E2,and Bcl-2 proteins in the cells in 5.0 and 10.0 mg·L-1 Schisandrin B groups were significantly decreased(P<0.05 or P<0.01),while the expression levels of p27,Bax,cleaved Caspase-3,and cleaved PARP proteins in the cells in 5.0 and 10.0 mg·L-1 Schisandrin B groups were significantly increased(P<0.01).Conclusion:Schisandrin B has an inhibitory effect on proliferation of the pancreatic cancer Pan02 cells,and its mechanism may be related to the activation of the cysteine aspartic acid protease-3(Caspase-3)pathway to induce the apoptosis and activating p27 protein to induce the arrest of cell cycle at S phase.

Objective To investigate the correlation between somatosensory evoked potentials(SEP)of upper limbs,and sensory and motor functions in stroke patients in different stages. Methods From June,2021 to October,2023,177 stroke patients in Shijiazhuang People's Hospital were diveded into acute stage group(within 14 days,n=25),early recovery group(14 days to one month,n=110)and middle to late recovery group(one to six months,n=42)according to the duration of the disease.General information of the patients was recorded;SEP examination was performed,and N20 lantency and amplitude were recorded.Monofilament touch and two-point discrimination sensation of the patient's hands were tested using the monofila-ment and two-point discrimination tools,respectively;and motor function was assessed with Fugl-Meyer Assess-ment-Upper Extremities(FMA-UE).The correlation between SEP,and the sensory and motor scores in each group was analyzed. Results There was no significant difference in the monofilament tactile and two-point discrimination scores among the three groups(P>0.05).SEP was not correlated with sensory and motor functions in the acute stage group(P>0.05);in the early recovery group,N20 latency was negatively correlated with monofilament tactile sensation(r=-0.267,P=0.005)and positively correlated with two-point discrimination sensation(r=0.220,P=0.021),and N20 amplitude was positively correlated with monofilament tactile sensation(r=0.328,P<0.001)and FMA-UE score(r=0.418,P<0.001),and negatively correlated with two-point discrimination(r=-0.405,P<0.001);in the middle to late recovery group,the N20 latency was negatively correlated with FMA-UE score(r=-0.313,P=0.044),and N20 amplitude was positively correlated with monofilament tactile sensation(r=0.598,P<0.001)and FMA-UE score(r=0.393,P=0.010),and negatively correlated with two-point discrimination(r=-0.591,P<0.001).Multiple linear regression analyses showed that the score of monofilament tactile sensa-tion was negatively correlated with N20 latency(β=-0.510,P=0.046),and the FMA-UE score was positively correlated with N20 amplitude(β=0.313,P=0.026)in the middle to late recovery group;in the early recovery group,the two-point discriminative sensation score was negatively correlated with N20 amplitude(β=-0.270,P=0.039). Conclusion The correlation between SEP and sensory and motor functions becomes more significant with the prolonga-tion of disease.