From the patient’s perspective， taking the control right of artificial intelligence （AI） in the analysis of pregnant and postpartum women’s health data as the entry point， this paper constructed a patient-centered governance framework for AI medical data control. It defined the different stages and scenarios of applications related to the health data analysis of pregnant and postpartum women， conducted a comparative analysis that combines existing ethical issues concerning AI data control in the medical field， and discussed autonomy issues in health management scenarios from three dimensions， namely， voluntariness， purposiveness， and steadfastness. Based on these discussions， this paper highlighted the reflection on autonomy under the behavioral research paradigm. Starting from the basic actions such as provision， deletion， analysis， triggering， presentation， revision， and response， it regarded technical behaviors as a form of instrumental communication and emphasized ensuring patients’ ample opportunities to participate in interactive links such as “information provision and adoption” “analysis and judgment” “presentation and summarization，” and “feedback and revision.” This will lay a foundation for expanding the existing discussion on medical AI autonomy to the ethical category of information usage.

Antibody-drug conjugates (ADC) are one of the most popular types of anti-tumor drugs nowadays. Monomethyl auristatin E (MMAE), as a tubulin binder, is the most common applied payload in ADC and is also the main component that causes peripheral neuropathy (PN). By describing the clinical characteristics of 3 cases with MMAE ADC associated severe PN complications and analyzing reported references, this article summarizes that the occurrence of MMAE ADC associated PN is correlated with therapeutic cycles and duration of ADC, MMAE ADC associated PN is different from traditional chemotherapy-induced PN in the clinical presentation. Patients with MMAE ADC associated PN may present with a length-dependent involvement of peripheral motor and sensory nerves, and generally their weakness and deep sensory deficiency symptoms are more serious compared with traditional chemotherapy-induced PN. Two of the 3 patients achieved a relatively rapid recovery after treated with plasma exchange or immunoglobulin intravenous infusions.

Objective To investigate the application value of clinical-radiomics nomogram in predicting the expression of liver kinase B1(LKB1)in non-small cell lung cancer(NSCLC)before surgery.Methods A total of 140 NSCLC patients were randomized into training group(n=106)and validation group(n=34)according to the ratio of 7∶3.The training group was used as the study cohort to screen the clinically independent predictors and radiomics characteristics related to LKB1 expression,and the clinical model,radiomics model and clinical-radiomics nomogram model were constructed,respectively.The predictive performance of the three models was analyzed using the receiver operating characteristic(ROC)curve in the training group,and validated in the validation group.The calibration curve was used to assess the consistency between the predicted results of nomogram model and the actual observations,and the decision curve was used to evaluate the clinical benefit of the nomogram model.Results The clinical model consisted of pathological type and hilal/mediastinal lymphadenopathy,the radiomics model consisted of Radiomics score(Radscore),and the nomogram model consisted of Radscore,pathological type and hilal/mediastinal lymphadenopathy.In the training group,the area under the curve(AUC)of the nomogram model,radiomics model and clinical model was 0.884,0.843 and 0.788,respectively.In the validation group,the AUC of the three models were 0.976,0.851,and 0.912,respectively.The calibration curve analysis showed good consis-tency between the predicted results of nomogram model and the actual observations,and the decision curve showed that the model had good clinical benefit.Conclusion Radiomics combined with clinical risk factors can effectively predict the expression of LKB1 in NSCLC patients before surgery,so as to contribute to the formulation of therapeutic strategies in clinical practice.

Objective To investigate the application value of clinical-radiomics nomogram in predicting the expression of liver kinase B1(LKB1)in non-small cell lung cancer(NSCLC)before surgery.Methods A total of 140 NSCLC patients were randomized into training group(n=106)and validation group(n=34)according to the ratio of 7∶3.The training group was used as the study cohort to screen the clinically independent predictors and radiomics characteristics related to LKB1 expression,and the clinical model,radiomics model and clinical-radiomics nomogram model were constructed,respectively.The predictive performance of the three models was analyzed using the receiver operating characteristic(ROC)curve in the training group,and validated in the validation group.The calibration curve was used to assess the consistency between the predicted results of nomogram model and the actual observations,and the decision curve was used to evaluate the clinical benefit of the nomogram model.Results The clinical model consisted of pathological type and hilal/mediastinal lymphadenopathy,the radiomics model consisted of Radiomics score(Radscore),and the nomogram model consisted of Radscore,pathological type and hilal/mediastinal lymphadenopathy.In the training group,the area under the curve(AUC)of the nomogram model,radiomics model and clinical model was 0.884,0.843 and 0.788,respectively.In the validation group,the AUC of the three models were 0.976,0.851,and 0.912,respectively.The calibration curve analysis showed good consis-tency between the predicted results of nomogram model and the actual observations,and the decision curve showed that the model had good clinical benefit.Conclusion Radiomics combined with clinical risk factors can effectively predict the expression of LKB1 in NSCLC patients before surgery,so as to contribute to the formulation of therapeutic strategies in clinical practice.

Antibody-drug conjugates (ADC) are one of the most popular types of anti-tumor drugs nowadays. Monomethyl auristatin E (MMAE), as a tubulin binder, is the most common applied payload in ADC and is also the main component that causes peripheral neuropathy (PN). By describing the clinical characteristics of 3 cases with MMAE ADC associated severe PN complications and analyzing reported references, this article summarizes that the occurrence of MMAE ADC associated PN is correlated with therapeutic cycles and duration of ADC, MMAE ADC associated PN is different from traditional chemotherapy-induced PN in the clinical presentation. Patients with MMAE ADC associated PN may present with a length-dependent involvement of peripheral motor and sensory nerves, and generally their weakness and deep sensory deficiency symptoms are more serious compared with traditional chemotherapy-induced PN. Two of the 3 patients achieved a relatively rapid recovery after treated with plasma exchange or immunoglobulin intravenous infusions.

Objective:To investigate the value of preoperative C-reactive protein to albumin ratio (CAR) in predicting microvascular invasion (MVI) and early postoperative recurrence of hepatocellular carcinoma(HCC).Methods:A retrospective cross-sectional study was conducted to analyze the clinical data of 190 patients with hepatocellular carcinoma who underwent radical resection in the First Affiliated Hospital of Anhui University of Science and Technology and the First Affiliated Hospital of Anhui Medical University from January 2020 to April 2022. The patients were divided into MVI group ( n=57) and non-MVI group ( n=133) according to whether there was microvascular invasion in postoperative pathology. The systemic inflammatory response index (SIRI), systemic immunoinflammatory index(SII), fibrinogen to albumin ratio (FAR) and CAR were calculated. 190 patients were followed up for 2 years after surgery. 86 patients had a recurrence, of whom 45 were in the MVI group and 41 were in the non-MVI group. SIRI, SII, FAR and CAR of the two groups were observed. And the value of SIRI, SII, FAR and CAR in predicting MVI and early postoperative recurrence was determined by receiver operating characteristic(ROC) curve. Univariate and multifactorial analysis of MVI risk factors in HCC. Quantitative data data consistent with normal distribution were represented by ( ± s), and independent sample t test was used for comparison between groups. Quantitative data that did not conform to normal distribution were represented by quartile M( Q1, Q3), and comparison between groups was performed by Mann-Whitney U test. Qualitative data were compared using chi-square test. Multivariate Logistic regression analysis was used for multivariate analysis. Results:There were 86 patients with early recurrence after operation, the recurrence rate was 45.26%. Among them, 45 cases (78.95%) recurred in MVI group and 41 cases (30.83%) in non-MVI group. There were 9 deaths (15.79%) in MVI group and 5 deaths (3.76%) in non-MVI group. There were differences in recurrence and death between MVI group and non-MVI group ( P<0.05). CAR was better than SIRI, SII and FAR in predicting MVI of hepatocellular carcinoma ( P<0.05). The area under ROC curve (AUC), sensitivity and specificity of CAR were 0.651, 70.20% and 60.20%, respectively, and the best predictive value was 0.01. CAR was an independent risk factor for MVI ( OR=1.068, 95% CI: 0.819-1.393, P<0.05). CAR was better than SIRI, SII and FAR in predicting early postoperative recurrence ( P<0.05). AUC, sensitivity and specificity of CAR were 0.641, 55.40% and 73.80%, and the predicted value was 0.01. Conclusion:Preoperative CAR is a risk factor for MVI in HCC, which can predict the occurrence of MVI and early recurrence after operation.

Aspergillosis ; Humans ; Mucor ; Mucormycosis/drug therapy*

Objective: To learn the epidemiological characteristics of coronavirus disease 2019（COVID-19）in Huzhou,so as to provide reference for prevention and control of COVID-19. Methods: All the confirmed cases of COVID-19 in Huzhou,diagnosed according to the COVID-19 Diagnosis and Treatment Plan（Sixth Version Trial）and reported from January 25 to February 7,2020,were recruited. The process of diagnosis and treatment,clinical manifestation,exposure history and close contacts were collected to analyze the epidemiological characteristics. Results: On January 25,the first confirmed cases of COVID-19 in Huzhou was reported. By February 7,totally 10 confirmed cases were reported and no asymptomatic infection was found. They were all imported,including three Wuhan residents,two with a trip to Wuhan,three with a trip to Suizhou,one with a trip to Hangzhou and one with a trip to Thailand（two Wuhan passengers on the same flight）. The ratio of male to female cases was 1∶1. The median age was 32 years old. Seven cases were found when they went to a doctor by themselves,and three cases were found during the quarantine. The main clinical manifestations were fever,dry cough and fatigue. The median time from onset to diagnosis was 3 days. By March 3,all the cases were discharged,with median course of 24 days. There were 312 close contacts,and all of them were released after 14 days of quarantine. Conclusions To prevent imported cases from outside and stop spread inside taken by Huzhou government was proved to be effective. All the COVID-19 cases in Huzhou were imported,mostly from Wuhan. No local cases were reported.

Objective To analyze the genetic characteristics of norovirus (NoV) outbreaks in Huzhou city in 2018.Methods Totally 73 stool samples were collected from NoV outbreaks and tested by real-time RT-PCR.The polymerase and capsid protein regions were amplified from the norovirus nucleic acid positive samples in each cluster epidemic.The amplified products were further analyzed by gene sequencing and genotyping.Results A total of 57 specimens from 8 outbreaks were positive for GII type NoV nucleic acid and 5 samples were positive for both genogroup Ⅰ and genogroup [I.The alignment of polymerase and capsid protein nucleic acid sequences showed that 5 cases were GII.P16/GII.2 type,1 case was GII.P17/ GII.17 type,1 case was GII.P12/GII.3 type,and 1 case was mixed infection with GI.P4/GI.5 type and GII.P17/GII.17 type.Conclusions NoV is the main pathogen causing the epidemic of acute gastroenteritis and diarrhea in Huzhou city.The virus was mainly GII type,with multiple genotypes and recombinant strains.