In the era of big data,artificial intelligence(AI)technology has developed rapidly,with medical field being one of its most deeply penetrated application domains.Leveraging the advantages of big data and AI requires the sharing and integration of medical data,yet balancing privacy protection and data sharing poses significant challenges.This paper analyzes the focus issues of patient privacy and data security in medical AI from a global perspective across 6 dimensions:challenges in data sovereignty and cross-border flow compliance,technical vulnerabilities in de-anonymization and re-identification risks,failure of informed consent mechanisms and dynamic authorization needs,regulatory gaps in algorithmic"black boxes"and data misuse,technological dependency and supply chain security risks,and the dilemma of balancing privacy protection with public health interests.Corresponding solutions and strategies are also proposed.

Central nervous system vasculitis (CNSV) is a type of inflammatory disease involving the blood vessels of the brain, spinal cord and meninges, and its clinical diagnosis is quite challenging. The sensitivity and specificity of traditional imaging examinations are very low, while high-resolution vessel wall imaging (HRVWI) can clearly show vascular wall and perivascular lesions. CNSV on HRVWI may manifested as concentric thickening and enhancement of the vascular wall, and perivascular enhancement with or without vascular stenosis. HRVWI has high value in the diagnosis and differential diagnosis of CNSV and related diseases. This article reviews the HRVWI characteristics of CNSV and the differential diagnosis of related diseases.

Background During urbanization, the passenger load on urban public transport systems continues to increase, exposing bus drivers to a high risk of musculoskeletal disorders (MSDs). This occupational health issue may also potentially compromise public transport safety. Objective To investigate the prevalence of MSDs among bus drivers in a first-tier city and to explore associated influencing factors. Methods A self-administered questionnaire survey was conducted from December 2024 to March 2025 among 1300 bus drivers in a bus company. Data were collected on general demographic information, occupational activities, and MSDs indicators. A total of 1268 valid questionnaires were returned, yielding a response rate of 97.5%. Descriptive statistics were used to analyze the distribution characteristics of MSDs. Pearson χ² tests were employed to examine the association between MSDs prevalence and individual/occupational characteristics. Logistic regression was performed to identify the influencing factors of MSDs. Results The survey revealed that the prevalence of MSDs among the bus drivers was 28.5%, with the highest prevalence in the 41–50 years age group (30.5%). The conditions primarily affected the cervical spine (60.5%) and lumbar spine (61.9%), with some cases involving multiple sites. The logistic regression model indicated that the following factors were associated with a higher risk of MSDs: frequent smoking (OR=1.477), poor or moderate self-reported health status (OR=4.422), 11–20 years of service (OR=1.749), daily cumulative driving time ≥361 min (OR=1.616), frequent whole-body fatigue during driving (OR=2.077), occasional whole-body fatigue during driving (OR=1.873), feeling tense during driving (OR=1.518), fatigue after work (OR=2.485), work-related stress (OR=1.882), and prolonged smartphone use with head-down posture (OR=1.671). Conversely, occasional exercise (OR=0.713)/frequent exercise (OR=0.569), driving intervals ≥21 min per round (OR=0.645), and perceiving the driving seat comfortable (OR=0.429) were associated with a lower risk of MSDs. Conclusion Physical exercise, smoking, years of service, daily cumulative driving time, driving intervals per round, prolonged smartphone use with head-down posture, self-reported health status, and psychological factors such as work-related stress are influencing factors for MSDs among bus drivers. Drivers should increase physical exercise and change unhealthy living habits. Employers should optimize working conditions, arrange reasonable driving schedules, and foster a positive work environment to reduce MSDs prevalence.

Objective:To explore the risk factors of deaths caused by influenza-associated encephalopathy (IAE) in children.Methods:A case control study was conducted.The clinical data (including baseline fata, organ function indices, inflammatory factors, imaging data, treatment, and outcomes) of IAE children hospitalized in the pediatric intensive care unit (PICU) of Shanghai Children′s Hospital, School of Medicine, Shanghai Jiao Tong University from January 2020 to December 2023 were retrospectively analyzed.The children were divided into a survival group and a death group.The Logistic regression and receiver operating characteristic (ROC) curve were used to analyze the risk factors of death in IAE children.Results:A total of 46 cases were included, with an onset age of 74.8(46.0, 92.5) months.The main cause of IAE was influenza A virus infection, which was detected in 45 cases(97.8%), and 32 cases (69.6%) of them had H3N2.One child (2.2%) was infected by influenza B virus.Eight children died, showing a mortality of 17.4%.There was significant difference in Glasgow Coma Scale between the survival and death groups when they were admitted into the PICU [10 (9, 11) points vs.3 (3, 5) points] ( Z=-4.510, P<0.05).All patients in the death group had multiple organ dysfunction syndrome, respiratory failure and circulatory system failure.Serum procalcitonin (PCT)[15.7 (3.3, 37.4) μg/L], interleukin-6 (IL-6)[1 039.1 (319.3, 2 884.3) ng/L], and cerebrospinal fluid protein(CSFP)[13 050.0 (5 865.0, 21 100.0) mg/L] in the death group compared with those in the survival group [0.2 (0.1, 0.8) μg/L, 15.5 (7.9, 44.8) ng/L, 227.0 (190.0, 332.0) mg/L]were highly increased ( Z=-3.364, -4.088, -3.757, all P<0.001).Logistic regression analysis showed that PCT ( OR=0.660, P<0.05), IL-6 ( OR=1.014, P<0.05) and CSFP ( OR=1.001, P<0.05) were risk factors of death in IAE.The areas under the ROC curve for these three factors were 0.88 (95% CI: 0.77-0.97), 0.96 (95% CI: 0.86-1.00) and 0.93 (95% CI: 0.76-1.00), respectively.When a cutoff value of 2.50 μg/L, 269.67 ng/L and 5 240.00 mg/L was taken, PCT achieved a sensitivity of 0.875 and a specificity of 0.816, IL-6 achieved a sensitivity of 0.875 and specificity of 0.974, and CSFP achieved a sensitivity of 0.875 and specificity of 0.974, respectively. Conclusions:High levels of serum PCT, IL-6 and CSFP at PICU admission are risk factors of poor prognosis in children with IAE.

Objective To investigate the expression level of centromere protein(CENP)Ⅰin lung adenocarcinoma cells,to study the effects of CENPⅠon the proliferation,invasion,migration,apoptosis,and epithelial-mesenchymal transition(EMT)of lung adenocarci-noma cells,and to explore the possible mechanisms related to its occurrence.Methods The expression of CENPⅠmRNA and protein in four types of lung adenocarcinoma cells and normal alveolar epithelial cells were detected by quantitative real-time polymerase chain reaction(RT-qPCR)and Western blotting.The expression of CENPⅠin H1650 cells was knocked down by the siRNA technique,The transfection efficiency was detected by RT-qPCR and Western blotting.The effects of knock-down CENPⅠon proliferation,cell cycle,apoptosis,invasion and migration of H1650 cells were detected by the cell counting kit-8 assay,the transwell assay,and flow cytometry.Western blotting was used to detect the expression of E-cadherin,N-cadherin,vimentin,Ki-67,cyclin D1,Bcl-2,PI3K,AKT,mTOR,p-PI3K,p-AKT,and p-mTOR.Results After the knock-down of CENPⅠ,the proliferative ability of the H1650 cells significantly decreased,the number of apoptotic cells significantly decreased,and the cell invasion and migration abilities significantly decreased(P<0.01).E-cadherin expression was upregulated and N-cadherin,vimentin,Ki-67,cyclin D1,Bcl-2,p-PI3K,p-AKT,and p-mTOR expres-sion were down-regulated in the CENTI group compared with the control group(P<0.05).The expression of p-PI3K,p-AKT,and p-mTOR in the si-CENPⅠ+IGF-1 group was upregulated compared to that in the si-CENPⅠgroup(P<0.05).Conclusion High expression of CENPⅠin lung adenocarcinoma cells promotes the proliferation,invasion,and migration of lung adenocarcinoma H1650 cells and EMT inhibits apoptosis,which may be related to the activation of the PI3K/AKT/mTOR signaling pathway.

AIM:To investigate the mechanism of reduced tear secretion in depression-related dry eye rats based on 5-HT/TRPV4/AQP5.METHODS:Healthy SD male rats were established with chronic unpredictable mild stress(CUMS)method to establish a depression-induced dry eye model(n=8), and the control group was blank rats(n=8). The ELISA method was used to compare the 5-hydroxytryptamine(5-HT)in serum and hippocampal tissue of the two groups, and the HE sections of lacrimal gland and AQP5 immunohistochemistry were observed. Western blot and RT-PCR were used to detect the expression of 5-HT3R, TRPV4 and AQP5 in the lacrimal gland tissue of the two groups of rats.RESULTS:The tear secretion in the depression-induced group was significantly reduced(P=0.001), the serum and hippocampal 5-HT levels were significantly reduced(all P<0.05), the expression of AQP5 antibody in the lacrimal gland immunohistochemistry was significantly lower than that in the control group(P<0.001), the expression of 5-HT3R, TRPV4 and AQP5 in the lacrimal gland was significantly reduced(all P<0.05), and no obvious inflammatory cells were found in the lacrimal gland tissue sections.CONCLUSION:Depression-related dry eye may occur through a non-inflammatory 5-HT/TRPV4/AQP5 mechanism.

AIM:To investigate the mechanism of reduced tear secretion in depression-related dry eye rats based on 5-HT/TRPV4/AQP5.METHODS:Healthy SD male rats were established with chronic unpredictable mild stress(CUMS)method to establish a depression-induced dry eye model(n=8), and the control group was blank rats(n=8). The ELISA method was used to compare the 5-hydroxytryptamine(5-HT)in serum and hippocampal tissue of the two groups, and the HE sections of lacrimal gland and AQP5 immunohistochemistry were observed. Western blot and RT-PCR were used to detect the expression of 5-HT3R, TRPV4 and AQP5 in the lacrimal gland tissue of the two groups of rats.RESULTS:The tear secretion in the depression-induced group was significantly reduced(P=0.001), the serum and hippocampal 5-HT levels were significantly reduced(all P<0.05), the expression of AQP5 antibody in the lacrimal gland immunohistochemistry was significantly lower than that in the control group(P<0.001), the expression of 5-HT3R, TRPV4 and AQP5 in the lacrimal gland was significantly reduced(all P<0.05), and no obvious inflammatory cells were found in the lacrimal gland tissue sections.CONCLUSION:Depression-related dry eye may occur through a non-inflammatory 5-HT/TRPV4/AQP5 mechanism.