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 From the perspective of China’s healthcare system， to evaluate the cost-effectiveness of amivantamab combined with chemotherapy versus chemotherapy alone for patients with EGFR-mutated advanced non-small cell lung cancer （NSCLC） who experience disease progression during or after treatment with osimertinib monotherapy. METHODS The Markov model was established according to MARIPOSA-2 clinical trial. The simulation time limit was 10 years and the cycle period lasted for 21 days. The incremental cost-effectiveness ratio（ICER） of amivantamab combined with chemotherapy versus chemotherapy alone for the treatment of EGFR-mutated advanced NSCLC was calculated， and then compared with the willingness-to-pay（WTP） threshold set in this study[3 times the per capita gross domestic product（GDP） of China in 2023， which was 268 200 yuan per quality-adjusted life year（QALY）]， in order to assess its cost-effectiveness. Single-factor sensitivity analysis and probability sensitivity analysis were performed to evaluate the stability of the model； scenario analysis was carried out to determine the potential price of amivantamab at which the regimen became cost-effective. RESULTS Compared with chemotherapy alone， the cost of amivantamab combined with chemotherapy was higher （1 248 411.60 yuan vs. 89 023.39 yuan）， but at the same time， there were also more benefits of survival （0.756 QALY vs. 0.584 QALY）， ICER was 6 757 285.38 yuan/QALY. ICER was most affected by the utility of progression-free survival and the price of amivantamab. The price of amivantamab decreased to 310.3 yuan per 350 mg， and the combination therapy became cost-effective， compared with chemotherapy alone. CONCLUSIONS From the perspective of Chinese health system， when the WTP threshold is set at three times the per capita GDP of the Chinese population in 2023， amivantamab combined with chemotherapy is not cost-effective for EGFR-mutated advanced NSCLC； the patients’ affordability can be improved when the price of amivantamab experiences a significant decrease.

OBJECTIVE To systematically evaluate the efficacy and safety of Insulin degludec and liraglutide injection （IDegLira） and Insulin glargine and lixisenatide injection（iGlarLixi） in the treatment of type 2 diabetes mellitus（T2DM）， and provide an evidence-based basis for the clinical treatment of T2DM. METHODS Computerized searches of PubMed， Embase， the Cochrane Library， CNKI， Wanfang data and VIP were conducted with a time frame from the inception to August 2024. Randomized controlled trials（RCTs） were rigorously screened according to inclusion and exclusion criteria， from which information was extracted and included studies were evaluated for risk of bias. Network meta-analysis was performed using Stata 14.0 software. RESULTS A total of 15 RCTs， including 9 513 patients， were included， involving four treatment regimens： IDegLira， iGlarLixi， insulin degludec（IDeg）， and insulin glargine（iGlar）. The differences between IDegLira and iGlarLixi were not statistically significant（P＞0.05） for the outcome indexes of glycosylated hemoglobin（HbA1c）， fasting blood glucose， body weight， and the incidence of adverse events（P＞0.05）； for the outcome index of the incidence of hypoglycemic events， IDegLira was significantly superior to iGlarLixi [OR＝0.41，95%CI（0.18，0.91），P＜0.05]. Surface under the cumulative ranking curve（SUCRA） results showed that iGlarLixi（84.5%）＞IDegLira（81.7%） in lowering HbA1c； IDegLira（71.3%）＞iGlarLixi（20.0%） in lowering fasting blood glucose； IDegLira（90.7%）＞iGlarLixi（61.8%） in lowering body weight； IDegLira（95.5%）＞iGlarLixi（9.7%） in reducing the incidence of hypoglycemic events； and IDegLira（27.1%）＞iGlarLixi（14.5%） in reducing the incidence of adverse events. CONCLUSIONS iGlarLixi has better therapeutic efficacy in reducing HbA1c； IDegLira has better therapeutic efficacy in reducing fasting blood glucose and body weight. IDegLira has the lowest risk of hypoglycemia.

OBJECTIVE To evaluate the long-term cost-effectiveness of insulin degludec and insulin aspart （IDegAsp） in patients with type 2 diabetes mellitus （T2DM） in China. METHODS A cost-effectiveness analysis was conducted from the perspective of the Chinese healthcare system， using the CORE diabetes model to simulate long-term （20-year） health and economic outcomes. Baseline cohort characteristics and treatment effect data were derived from the CREATE study. The prices of glucose- lowering drugs were obtained from medical insurance payment standards and the average winning bid prices in the follow-up round of the specialized centralized procurement for insulin， while the daily dosages were derived from the CREATE study. The costs of complications and utility values were obtained from published literature， with a discount rate of 5%. One-way sensitivity analysis， scenario analysis， and probabilistic sensitivity analysis were performed to verify the robustness of the results. RESULTS Patients switching from previous once-daily basal insulin regimens to IDegAsp therapy gained an incremental 0.190 quality-adjusted life year （QALY） with direct medical cost savings of 42 163.58 yuan. For those switching from premixed insulin therapies， IDegAsp treatment provided 0.130 incremental QALY and reduced direct healthcare costs by 41 129.11 yuan. The outcome was significantly influenced by the discount rate and the cost of complications. Probabilistic sensitivity analysis and scenario analysis confirmed the robustness of these findings. CONCLUSIONS Switching from previous daily basal insulin or premixed insulin regimens to IDegAsp in Chinese patients with T2DM can improve patients’ long-term health outcomes and achieve cost savings， making it a more cost-effective treatment option.

Objective To analyze the disease burden of cervical cancer in major Asian countries and globally from 1990 to 2019,which help to provide reference for the prevention and control of cervical cancer.Methods We utilized data from the(Global Burden of Disease,GBD)2019 database,and our analysis incorporated key measures such as incidence,deaths and(Disability-Adjusted Life Years,DALY)to quantitatively assess the global impact of cervical cancer.We employed the(Estimated Annual Percent Change,EAPC)to analyze the time trends in the disease burden.Results From 1990 to 2019,the global standardized incidence rate of cervical cancer decreased from 7.64/100,000 to 6.81/100,000,while the standardized death rate decreased from 4.46/100,000 to 3.40/100,000.The standardized DALYrate also decreased from 139.98/100,000 to 107.20/100,000.The annual average reductions were 0.39%,0.96%,and 0.94%,respectively(EAPC<0,P<0.05).Among major Asian countries,China's standardized incidence rate increased from 4.20/100,000 to 5.53/100,000,with an average annual growth of 1.63%(EAPC>0,P>0.05).The number of cervical cancer deaths in China increased from 26,400 to 53,400,representing a relative increase of 1.02 times.While the standardized mortality rate and standardized DALY rate for cervical cancer decreased globally and in major Asian countries,China did not exhibit a declining trend.Relevant analysis revealed no significant correlation between incidence rate and(Socio-Demographic Index,SDI)(ρ=-0.13,P=0.11).However,mortality rate showed a negative correlation with SDI(ρ=-0.74,P<0.001),and DALY also exhibited a negative correlation with SDI(ρ=-0.77,P<0.001).Conclusion The standardized incidence and death rates of cervical cancer in China have been increasing year by year,and the disease burden is on the rise.It is imperative to proactively implement scientifically effective prevention and control measures to reduce the burden of cervical cancer.

Objective:To investigate the treatment methods of peripheral T-cell lymphoma (PTCL).Methods:The clinical data of 251 newly treated PTCL patients in the First Hospital of Jilin University from August 2011 to October 2021 were retrospectively analyzed, from which 168 patients were intercepted from February 2015 (the first targeted drug of PTCL, chidamide, was launched in China) to October 2021, among which 20 patients received chemotherapy combined with brentuximab vedotin (BV, BV group), 37 patients received chemotherapy combined with chidamide (chidamide group), and 111 patients received non-targeted therapy (non-targeted therapy group); all patients received ≥2 courses of treatment. Ten patients received autologous peripheral blood hematopoietic stem cell transplantation, with non-transplanted patients in the same period as controls. The clinical efficacy and prognosis of patients with different treatment methods were analyzed. Kaplan-Meier method was used for survival analysis and log-rank test was performed.Results:Of all 251 patients with PTCL, 26.7% (67/251) received targeted therapy in combination with chemotherapy. In the chidamide group, the efficacy could be evaluated in 36 cases, with an overall response rate (ORR) of 91.7% (33/36); in the non-targeted therapy group, the efficacy could be evaluated in 88 cases, with an ORR of 71.6% (63/88); in the BV group, 20 cases were evaluable, with an ORR of 75.0% (15/20). The difference in ORR between the non-targeted therapy group and the chidamide group was statistically significant ( χ2 = 5.89, P = 0.015), and the difference in ORR between the non-targeted therapy group and the BV group was not statistically significant ( χ2 = 0.09, P = 0.759). The 1-year progression-free survival (PFS) rates were 79.9%, 88.2% and 64.2%, and the 1-year overall survival (OS) rates were 85.7%, 89.7% and 70.1% in the chidamide, BV and non-targeted therapy groups, respectively; the PFS and OS in the chidamide and BV groups were better than those in the non-targeted therapy group (all P < 0.05), and the adverse effects were mostly tolerable. Among patients treated with chemotherapy combined with BV, the ORR of patients with CD30 expression rate <60% and ≥60% were 54.5% (6/11) and 100.0% (9/9), and the difference was statistically significant ( P = 0.038). In the 10 hematopoietic stem cell transplanted patients and 50 non-transplanted patients, 1-year PFS rates were 87.5% and 59.5%, 1-year OS rates were 90.0% and 67.1%, and the differences were not statistically significant (both P > 0.05). Conclusions:Chemotherapy-based combination therapy is the main treatment methods for PTCL, and chemotherapy combined with chidamide or BV targeted therapy and hematopoietic stem cell transplantation can improve the long-term survival of PTCL patients.

Objective:To investigate the efficacy, safety and recurrence rate of oral atenolol in the treatment of infantile hemangioma, so as to provide evidence-based medicine basis and reference for clinic.Methods:Search on the following public databases from January 1, 2008 to June 13, 2022: Web of Science, PubMed, Cochrane Library, Embase, U. S. National Library of Medicine Clinical Trials Registry Platform; China National Knowledge Infrastructure(CNKI), Chinese Biomedical Literature Service System(SinoMed), Chinese Science and Technology Journal Database and Wanfang Data. According to inclusion and exclusion criteria, studies on oral atenolol for the treatment of infantile hemangioma were selected. The outcome indicators were efficiency (complete response rate), incidence of adverse effects and recurrence rate. The single-arm meta-analysis was performed using R software version 4.1.2. Egger’s test was employed and funnel plots were drawn to assess publication bias in the literature.Results:A total of 14 studies were included, comprising 5 randomized controlled trials, 5 single-arm studies, 3 non-randomized controlled trials, and 1 case-control study. The oral administration of atenolol for the treatment of infantile hemangiomas resulted in an efficacy rate (complete remission rate) of 62% (95% CI 52%~71%). The incidence rate of adverse reactions related to the digestive system was 18% (95% CI 7%~30%), while that related to β2 receptor blockade was 4% (95% CI 2%~6%), central nervous system-related adverse reactions occurred at a rate of 10% (95% CI 5%~16%), the recurrence rate was 5% (95% CI 2%~9%). Egger’s test indicated that there was no significant publication bias in the efficacy rate, central nervous system-related adverse reaction rate, and gastrointestinal-related adverse reaction rate of oral atenolol treatment for infantile hemangiomas ( P>0.05). The sensitivity analysis for the efficacy rate, adverse reaction rate, and recurrence rate of oral atenolol treatment for infantile hemangiomas suggested that the result were stable and reliable. Conclusion:Oral administration of atenolol for the treatment of infantile hemangiomas demonstrates significant efficacy, fewer adverse reactions, and a low recurrence rate, making it a promising candidate as a reasonable alternative to oral propranolol for treating infantile hemangiomas.

Objective:To investigate the efficacy, safety and recurrence rate of oral atenolol in the treatment of infantile hemangioma, so as to provide evidence-based medicine basis and reference for clinic.Methods:Search on the following public databases from January 1, 2008 to June 13, 2022: Web of Science, PubMed, Cochrane Library, Embase, U. S. National Library of Medicine Clinical Trials Registry Platform; China National Knowledge Infrastructure(CNKI), Chinese Biomedical Literature Service System(SinoMed), Chinese Science and Technology Journal Database and Wanfang Data. According to inclusion and exclusion criteria, studies on oral atenolol for the treatment of infantile hemangioma were selected. The outcome indicators were efficiency (complete response rate), incidence of adverse effects and recurrence rate. The single-arm meta-analysis was performed using R software version 4.1.2. Egger’s test was employed and funnel plots were drawn to assess publication bias in the literature.Results:A total of 14 studies were included, comprising 5 randomized controlled trials, 5 single-arm studies, 3 non-randomized controlled trials, and 1 case-control study. The oral administration of atenolol for the treatment of infantile hemangiomas resulted in an efficacy rate (complete remission rate) of 62% (95% CI 52%~71%). The incidence rate of adverse reactions related to the digestive system was 18% (95% CI 7%~30%), while that related to β2 receptor blockade was 4% (95% CI 2%~6%), central nervous system-related adverse reactions occurred at a rate of 10% (95% CI 5%~16%), the recurrence rate was 5% (95% CI 2%~9%). Egger’s test indicated that there was no significant publication bias in the efficacy rate, central nervous system-related adverse reaction rate, and gastrointestinal-related adverse reaction rate of oral atenolol treatment for infantile hemangiomas ( P>0.05). The sensitivity analysis for the efficacy rate, adverse reaction rate, and recurrence rate of oral atenolol treatment for infantile hemangiomas suggested that the result were stable and reliable. Conclusion:Oral administration of atenolol for the treatment of infantile hemangiomas demonstrates significant efficacy, fewer adverse reactions, and a low recurrence rate, making it a promising candidate as a reasonable alternative to oral propranolol for treating infantile hemangiomas.

Objective:To investigate the effect and mechanism of miR-195 regulating FOXK1 gene and PI3K/Akt pathway on stomach adenocarcinoma proliferation, invasion and migration ability.Methods:Public database samples were employed to analyze the expression differences and prognostic significance of miR-195 in stomach adenocarcinoma. After overexpression of mir-195-5p in two cell lines, MGC803 and AGS, altered cell proliferation, invasion, and migration abilities were detected by Alamar Blue, Wound healing, and Transwell assays. The potential target genes and binding sites of miR-195 were predicted by the starBase. Western blot was used to detect the expression levels of foxk1 and phosphorylation sites in the PI3K/Akt pathway of target genes after overexpression of mir-195-5p. A Dual-luciferase reporter assay was used to verify the relationship between mir-195-5p and foxk1. Statistical analyses were performed with IBM SPSS 22 software and R 4.0.3.Results:Our results showed a significant over-expression of miR-195 in the tumor tissues, compared with the paired normal tissues ( P<0.001) , which could inhibit the proliferation and invasion of stomach carcinoma cells and significantly correlated with survival ( P=0.011) . Moreover, our study indicated that miR-195 depressed the expression of FOXK1 and significantly reduced the activation of the PI3K/Akt pathway, which had a negative effect on the proliferation and invasion of stomach carcinoma cells. The phosphorylated Akt (s473 site) expression in the PI3K/Akt pathway was significantly decreased after overexpression of miR-195. Conclusion:Overall, our studies clarify the important function of the miR-195 in the diagnosis and therapy of patients with stomach carcinoma and reveal the FOXK1 and PI3K/Akt pathway regulation by the miR-195, which are of important clinical significance in the differential diagnosis.

Eukaryotes inhibit the translation of mRNA under stress conditions and form particles-stress granules (stress granules). At present, stress granules have been proved to be related to the occurrence and development of a variety of diseases, including tumors. The production of stress granules is promoted by microenvironment such as hypoxia and hyperactive oxygen in tumor cells, while stress granules-related proteins such as G3BP1, RACK1, YB-1 and mammalian target of rapamycin (mTOR) can promote the occurrence and metastasis of tumors, but the mechanism is not yet clear. In addition, studies have linked the formation of stress granules to the survival of tumor cells during chemotherapy, and believe that stress granules play a role in the treatment of tumors by different anti-tumor drugs. This review introduces the biological characteristics of stress granules and their relationship with tumors.