The widespread use of artificial intelligence （AI） in the field of healthcare poses dilemmas in the division of moral responsibility. In the traditional concept of moral responsibility， sufficient control and adequate understanding of actions and their possible consequences are the preconditions for taking moral responsibility， which makes only human beings the subjects of moral responsibility. However， in the use of medical AI， human beings do not have enough control over AI and cannot fully understand the consequences of developing and using AI， leading to a dilemma of moral responsibility in medical AI applications. To resolve the responsibility gap in the human-machine relationships， AI can be regarded as a limited moral subject and bear limited moral responsibility. Meanwhile， a kind of human-machine joint responsibility is envisaged， in which the forward-looking moral responsibility should be borne by human beings， and the retrospective moral responsibility can be jointly borne by humans and machines.

[Purpose]To analyze the survival of lung cancer,liver cancer and stomach cancer in Jiashan County,Zhejiang Province from 2006 to 2020.[Methods]From January 1,2006 to De-cember 31,2020,new cases of lung cancer,liver cancer and stomach cancer were collected in Jiashan County,Zhejiang Province.The 5-year observed survival rate(OSR),relative survival rate(RSR)and age-standardized relative survival rate(ARSR)by sex and age were calculated from 2006-2010,2011-2015 and 2016-2020.The observed and relative survivals were calculated using the lifetime table and Ederer Ⅱ methods,respectively,and age standardized using the Inter-national Cancer Survival Standard.Joinpoint software was utilized to compute the average annual percentage change(AAPC)for analyzing trends in various survival rates from 2006 to 2020.[Re-sults]The 5-year RSR of lung cancer,liver cancer and stomach cancer increased from 8.1％,4.8％and 23.2％(2006-2010)to 36.0％,17.6％and 48.2％(2016-2020),showing an increasing trend(AAPC=14.4％,AAPC=11.4％,AAPC=6.4％,respectively,all P＜0.05).Accordingly,the 5-year RSR of three types of malignant tumors showed an increasing trend in both men and women(all P＜0.05)except liver cancer in women(P＞0.05).The 5-year RSR of three types of malignant tu-mors in the age groups of 0～64 and 65+years old showed a significant increasing trend(all P＜0.05).The increase of lung cancer and liver cancer was greater in the age group of 0～64 years old,and the increase of gastric cancer was greater in the age group of 65+years old.[Conclusion]The 5-year survival rates of the three types of malignant tumors with the highest mortality risk in Jiashan County,Zhejiang Province all increased significantly from 2006 to 2020,indicating that the pre-vention and treatment effect of malignant tumors is significant,but the survival rate of malignant tumors varied significantly among different populations,so targeted intervention should be carried out.

[Purpose]To analyze the survival of colorectal cancer patients in Jiashan County of Zhejiang Province from 1991 to 2020.[Methods]The data of newly reported cases of colorectal cancer were collected in Jiashan County from January 1,1991 to December 31,2020,and pa-tients were followed-up till December 2023.The observed survival rate(OSR)and relative survival rate(RSR)were calculated using the life table and Ederer Ⅱ method with 5-year intervals.Rela-tive survival was adjusted using the International Cancer Survival Standards.The Joinpoint re-gression model was used to calculate the average annual percentage change(AAPC)to analyze the change trend of survival rate.[Results]The 5-year RSR of colorectal cancer increased from 21.7％during 1991 to 1995 to 73.4％during 2016 to 2020,showing an increasing trend(AAPC=4.6％,P＜0.05),for men it increased from 17.7％to 72.7％and for women it increased from 30.0％to 74.3％,with AAPCs of 3.9％and 4.3％,respectively(P＜0.05).The 5-year RSR of colorectal can-cer in all age groups showed an increasing trend(P＜0.05 for all age groups,except for 75+),and the highest increase was found in the age group of 65～74 years old(AAPC=4.9％).[Conclusion]From 1991 to 2020,the 5-year survival rate of colorectal cancer in Jiashan County showed a steady increase,for women and those aged 65～74 years old the increase was more significant.The cancer screening of high-risk groups should be focused on to improve colorectal cancer survival rate.

Objective:To investigate the effects of the novel oral edaravone(EDA)on rats with diabetic encepha-lopathy(DE).Methods:The network pharmacology research methodology was employed to elucidate the mechanism of action of oral EDA in the treatment of diabetes mellitus,identify intersecting targets,and conduct initial validation of these findings in vivo.Thirty male SD rats were randomly assigned to three groups:A normal control(control)group,a diabetic encephalopathy DE(DE)group,and an oral edaravone treatment(DE+EDA)group.Diabetic encephalop-athy was induced in both the DE and DE+EDA groups using the streptozotocin(STZ)method.After successful model-ing,the DE+EDA group received oral administration of EDA,while the other two groups were administered equal doses of saline as controls.Serum samples were examined for lipid release rate,and the protein expression levels of oxidative stress factor 3-nitrotyrosine(3-NT)and apoptotic factor cysteinyl aspartate specific proteinase-3(caspase-3)in brain tissues were detected by Western blot.Brain samples were stained with HE staining to observe the pathological changes.Histopathological changes were observed through hematoxylin-eosin(HE)staining.Results:Network pharmacological analysis yielded 27 core targets,and functional annotation of gene bioprocesses showed that the intersecting targets were mainly enriched in response to oxidative stress and neuronal apoptosis.Serum-related lipid assay showed that the DE+EDA group had significantly improved lipid metabolism disorders compared with the DE group.Additionally,expression levels of 3-NT and caspase-3 were significantly higher in the DE group when compared with controls(P＜0.05);How-ever,both markers exhibited a significant decrease within the DE+EDA treatment cohort as opposed to their counter-parts in the DE group(P＜0.05).HE staining showed that in DE group the cellular arrangement was disordered,the cells were shrunk with intact plasma membrane,and the nuclei were condensed showing karyopyknosis,fragmented and dissolved.Compared with the DE group,the brain tissue in the DE+EDA group was relatively dense and neatly ar-ranged,and the cell karyopyknosis,fragmentation and lysis were significantly improved.Conclusion:Both network pharmacology and in vivo experiments provide preliminary evidence that oral EDA reduces damage in diabetic encepha-lopathy rats.

Objective:To investigate the effects of the novel oral edaravone(EDA)on rats with diabetic encepha-lopathy(DE).Methods:The network pharmacology research methodology was employed to elucidate the mechanism of action of oral EDA in the treatment of diabetes mellitus,identify intersecting targets,and conduct initial validation of these findings in vivo.Thirty male SD rats were randomly assigned to three groups:A normal control(control)group,a diabetic encephalopathy DE(DE)group,and an oral edaravone treatment(DE+EDA)group.Diabetic encephalop-athy was induced in both the DE and DE+EDA groups using the streptozotocin(STZ)method.After successful model-ing,the DE+EDA group received oral administration of EDA,while the other two groups were administered equal doses of saline as controls.Serum samples were examined for lipid release rate,and the protein expression levels of oxidative stress factor 3-nitrotyrosine(3-NT)and apoptotic factor cysteinyl aspartate specific proteinase-3(caspase-3)in brain tissues were detected by Western blot.Brain samples were stained with HE staining to observe the pathological changes.Histopathological changes were observed through hematoxylin-eosin(HE)staining.Results:Network pharmacological analysis yielded 27 core targets,and functional annotation of gene bioprocesses showed that the intersecting targets were mainly enriched in response to oxidative stress and neuronal apoptosis.Serum-related lipid assay showed that the DE+EDA group had significantly improved lipid metabolism disorders compared with the DE group.Additionally,expression levels of 3-NT and caspase-3 were significantly higher in the DE group when compared with controls(P＜0.05);How-ever,both markers exhibited a significant decrease within the DE+EDA treatment cohort as opposed to their counter-parts in the DE group(P＜0.05).HE staining showed that in DE group the cellular arrangement was disordered,the cells were shrunk with intact plasma membrane,and the nuclei were condensed showing karyopyknosis,fragmented and dissolved.Compared with the DE group,the brain tissue in the DE+EDA group was relatively dense and neatly ar-ranged,and the cell karyopyknosis,fragmentation and lysis were significantly improved.Conclusion:Both network pharmacology and in vivo experiments provide preliminary evidence that oral EDA reduces damage in diabetic encepha-lopathy rats.

[Purpose]To analyze the survival of lung cancer,liver cancer and stomach cancer in Jiashan County,Zhejiang Province from 2006 to 2020.[Methods]From January 1,2006 to De-cember 31,2020,new cases of lung cancer,liver cancer and stomach cancer were collected in Jiashan County,Zhejiang Province.The 5-year observed survival rate(OSR),relative survival rate(RSR)and age-standardized relative survival rate(ARSR)by sex and age were calculated from 2006-2010,2011-2015 and 2016-2020.The observed and relative survivals were calculated using the lifetime table and Ederer Ⅱ methods,respectively,and age standardized using the Inter-national Cancer Survival Standard.Joinpoint software was utilized to compute the average annual percentage change(AAPC)for analyzing trends in various survival rates from 2006 to 2020.[Re-sults]The 5-year RSR of lung cancer,liver cancer and stomach cancer increased from 8.1％,4.8％and 23.2％(2006-2010)to 36.0％,17.6％and 48.2％(2016-2020),showing an increasing trend(AAPC=14.4％,AAPC=11.4％,AAPC=6.4％,respectively,all P＜0.05).Accordingly,the 5-year RSR of three types of malignant tumors showed an increasing trend in both men and women(all P＜0.05)except liver cancer in women(P＞0.05).The 5-year RSR of three types of malignant tu-mors in the age groups of 0～64 and 65+years old showed a significant increasing trend(all P＜0.05).The increase of lung cancer and liver cancer was greater in the age group of 0～64 years old,and the increase of gastric cancer was greater in the age group of 65+years old.[Conclusion]The 5-year survival rates of the three types of malignant tumors with the highest mortality risk in Jiashan County,Zhejiang Province all increased significantly from 2006 to 2020,indicating that the pre-vention and treatment effect of malignant tumors is significant,but the survival rate of malignant tumors varied significantly among different populations,so targeted intervention should be carried out.

[Purpose]To analyze the survival of colorectal cancer patients in Jiashan County of Zhejiang Province from 1991 to 2020.[Methods]The data of newly reported cases of colorectal cancer were collected in Jiashan County from January 1,1991 to December 31,2020,and pa-tients were followed-up till December 2023.The observed survival rate(OSR)and relative survival rate(RSR)were calculated using the life table and Ederer Ⅱ method with 5-year intervals.Rela-tive survival was adjusted using the International Cancer Survival Standards.The Joinpoint re-gression model was used to calculate the average annual percentage change(AAPC)to analyze the change trend of survival rate.[Results]The 5-year RSR of colorectal cancer increased from 21.7％during 1991 to 1995 to 73.4％during 2016 to 2020,showing an increasing trend(AAPC=4.6％,P＜0.05),for men it increased from 17.7％to 72.7％and for women it increased from 30.0％to 74.3％,with AAPCs of 3.9％and 4.3％,respectively(P＜0.05).The 5-year RSR of colorectal can-cer in all age groups showed an increasing trend(P＜0.05 for all age groups,except for 75+),and the highest increase was found in the age group of 65～74 years old(AAPC=4.9％).[Conclusion]From 1991 to 2020,the 5-year survival rate of colorectal cancer in Jiashan County showed a steady increase,for women and those aged 65～74 years old the increase was more significant.The cancer screening of high-risk groups should be focused on to improve colorectal cancer survival rate.

Objective To investigate the mechanism behind the protective effects of gastrodin against microglia-mediated inflammatory responses following hypoxic-ischemic brain damage(HIBD)in neonatal mice.Methods Thirty-six 10-day-old C57BL/6J mice were randomized into sham-operated group,HIBD(induced by ligation of the left common carotid artery followed by hypoxia for 40 min)group,and HIBD with gastrodin treatment groups(n=12).In gastrodin treatment group,100 mg/kg gastrodin was injected intraperitoneally 1 h before and at 2 and 12 h after hypoxia.After the treatments,the expressions of CCR5,AKT,p-AKT,and TNF-α and the co-expression of IBA1 and CCR5 in the corpus callosum of the mice were detected with Western blotting and immunofluorescence double staining.In a BV2 microglial cell model of oxygen-glucose deprivation(OGD),the effects of pretreatment with gastrodin and Maraviroc(an CCR5 antagonist)on protein expressions of CCR5,AKT,p-AKT,TNF-α and IL-1β were evaluated using Western blotting and immunofluorescence double staining.Results The neonatal mice with HIBD showed significantly increased expressions of CCR5 and TNF-α with lowered p-AKT expression in the brain tissues,and GAS treatment obviously reversed these changes.HIBD also significantly increased the co-expression of IBA1 and CCR5 in the corpus callosum of the mice,which was obviously lowered by gastrodin treatment.In BV2 cells,OGD significantly increased the expressions of CCR5,TNF-α,and IL-1β and decreased the expression of p-AKT,and these changes were inhibited by treatment with gastrodin,Maraviroc or their combination;the inhibitory effect of the combined treatment did not differ significantly from that of gastrodin or Maraviroc alone.Conclusion Gastrodin can produce neuroprotective effects in neonatal mice with HIBD by inhibiting inflammatory cytokine production and activate AKT phosphorylation via inhibiting CCR5.

Objective To evaluate the status quo of organizational commitment and job burnout of male nurses in Nanjing Municipal hospitals,and to analyze the effect of organizational commitment on job burnout.Methods A total of 349 male nurses working in the hospitals of various districts in Nanjing city from March to August 2022 were selected.The general demographic data questionnaire,Chinese version of nurses'job burnout questionnaire and organizational commitment scale of Chinese workers were used to conduct a ques-tionnaire survey.The Pearson correlation was used to analyze the relationship between organizational commit-ment and job burnout.Results The scores of three dimensions of job burnout in the Chinese version of Maslach job burnout scale were at a high level,which was significantly higher than that in the norm(P＜0.05);the score of various dimensions in the organizational commitment of Chinese workers scale also were in the higher level.The emotional exhaustion and depersonalization of male nurses were negatively correlated with the total scores of emotional commitment,normative commitment,ideal commitment and organizational commitment(P＜0.001),and significantly positively correlated with the opportunity commitment(P＜0.05).The low personal accomplishment sense of male nurses was negatively correlated with emotional com-mitment and opportunity commitment(P＜0.001),and positively correlated with the total scores of norma-tive commitment,ideal commitment and organizational commitment(P＜0.001).Conclusion The job burn-out of male nurses in Nanjing area is at a high level,and the organizational commitment is at a high level.It is necessary to give special attention to male nurses with professional identity and low job satisfaction in order to reduce the occurrence of job burnout.

Objective:To investigate the effect of gastrodin(GAS)on the sex-determining region Y-box2(SOX2)/β-catenin pathway in microglia induced by lipopolysaccharide(LPS).Methods:BV2 microglia was cultured in vitro and divided into the following groups:Control group(Control),LPS group(LPS),LPS+0.17 mmol/L gastrodin treatment group(LPS+GAS-L),LPS+0.34 mmol/L gastrodin treatment group(LPS+GAS-H),SOX2 inhibitor pronethalolgroup(PR),LPS+PR group(LPS+PR),and LPS+PR+GAS group(LPS+PR+GAS).Effect of PR on BV2 microglia viability was detected by CCK-8.The expression of SOX2,β-catenin,mannose receptor(CD206)and tumor necrosis factor-α(TNF-α)was assessed using Western Blot and immunofluorescence double staining.Results:PR did not induce significant BV2 cell death in the 0～40 μmol/L range.After LPS treatment,the expression levels of SOX2,β-catenin,and TNF-α significantly increased in the LPS group,while CD206 decreased(P＜0.05).Following GAS treatment,the expression levels of SOX2,β-catenin,and TNF-α significantly decreased,while CD206 increased(P＜0.05).Compared to the LPS group,the expression levels of β-catenin and TNF-α significantly de-creased in the PR group(P＜0.05),but no significant difference was observed between the LPS+GAS and LPS+PR+GAS group.Conclusion:GAS significantly inhibits LPS-induced microglia activation potentially through the inhibi-tion of the SOX2/β-catenin signaling pathway,and exerts anti-inflammatory effects.