Objective To explore imaging findings of 10 cases of misdiagnosed IgG4-associated pancreatitis.Methods Ten cases of IgG4-associated pancreatitis misdiagnosed by preoperative CT and/or MRI were retrospectively collected,and intrapancreatic and extra pancreatic manifestations were observed.Results Among 10 cases,diffuse lesions resulted"sausage like"appearance of pancreas were observed in 2 cases,focal lesions were found in 7 cases,including 3 cases in neck,3 cases in head and 1 case in tail of pancreas,while multifocal lesions involved the head,neck and tail of pancreas in 1 case.The lesions mostly presented as slightly low densities and occasional calcifications on non-enhanced CT,slightly low signals on MR T1WI,equal or high signals on T2WI as well as slightly high signals on diffusion weighted imaging,and progressively enhanced after administration of contrast agents.Peripheral halo sign was found in 3 cases,and mild dilatation of main pancreatic duct was observed in 7 cases.Extrapancreatic manifestations mainly included dilatation of bile ducts both inside and outside the liver and involvement of other organs.Conclusion Imaging findings of misdiagnosis IgG4-associated pancreatitis present as focal or diffuse lesions of pancreas with peripheral halo sign and extrapancreatic involvements,which progressively enhanced after administration of contrast agents.

Objective To explore imaging findings of 10 cases of misdiagnosed IgG4-associated pancreatitis.Methods Ten cases of IgG4-associated pancreatitis misdiagnosed by preoperative CT and/or MRI were retrospectively collected,and intrapancreatic and extra pancreatic manifestations were observed.Results Among 10 cases,diffuse lesions resulted"sausage like"appearance of pancreas were observed in 2 cases,focal lesions were found in 7 cases,including 3 cases in neck,3 cases in head and 1 case in tail of pancreas,while multifocal lesions involved the head,neck and tail of pancreas in 1 case.The lesions mostly presented as slightly low densities and occasional calcifications on non-enhanced CT,slightly low signals on MR T1WI,equal or high signals on T2WI as well as slightly high signals on diffusion weighted imaging,and progressively enhanced after administration of contrast agents.Peripheral halo sign was found in 3 cases,and mild dilatation of main pancreatic duct was observed in 7 cases.Extrapancreatic manifestations mainly included dilatation of bile ducts both inside and outside the liver and involvement of other organs.Conclusion Imaging findings of misdiagnosis IgG4-associated pancreatitis present as focal or diffuse lesions of pancreas with peripheral halo sign and extrapancreatic involvements,which progressively enhanced after administration of contrast agents.

Objective:To evaluate the accuracy and reliability of high frequency ultrasound in measuring the penetration depth of hypertrophic scar with ultra-pulse CO 2 fractional laser. Methods:From February 2022 to February 2023, 10 cases of hypertrophic scar tissue underwent surgical resection in the Hunan Provincial People′s Hospital were collected. After irradiating the hypertrophic scar tissue with different energy ultra-pulse CO 2 dot matrix laser, high-frequency ultrasound was used to observe and identify the laser gasification holes and tissue degeneration areas in the scar. The same scar tissue was histopathically sliced and the images of laser vaporized pores and tissue degeneration area were collected after hematoxylin-eosin (HE) staining, and the correlation and consistency of the two results of high-frequency ultrasound and pathological tissue section were compared and analyzed. Results:There was a strong positive correlation between the results of laser channel depth measured by pathological section and the results of laser channel depth measured by high-frequency ultrasound and the depth of tissue degeneration area ( r=0.976, 0.927, all P<0.001). Among them, the results of pathological section and high-frequency ultrasound measured laser channel depth were highly consistent, and could be used interchangeably in clinical work. Conclusions:High-frequency ultrasound can be used to evaluate the change of scar internal condition after ultra-pulsed CO 2 dot matrix laser irradiation, and measure the penetration depth of laser on scar tissue. The measurement results have high accuracy and reliability.

As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

Objective:To evaluate the accuracy and reliability of high frequency ultrasound in measuring the penetration depth of hypertrophic scar with ultra-pulse CO 2 fractional laser. Methods:From February 2022 to February 2023, 10 cases of hypertrophic scar tissue underwent surgical resection in the Hunan Provincial People′s Hospital were collected. After irradiating the hypertrophic scar tissue with different energy ultra-pulse CO 2 dot matrix laser, high-frequency ultrasound was used to observe and identify the laser gasification holes and tissue degeneration areas in the scar. The same scar tissue was histopathically sliced and the images of laser vaporized pores and tissue degeneration area were collected after hematoxylin-eosin (HE) staining, and the correlation and consistency of the two results of high-frequency ultrasound and pathological tissue section were compared and analyzed. Results:There was a strong positive correlation between the results of laser channel depth measured by pathological section and the results of laser channel depth measured by high-frequency ultrasound and the depth of tissue degeneration area ( r=0.976, 0.927, all P<0.001). Among them, the results of pathological section and high-frequency ultrasound measured laser channel depth were highly consistent, and could be used interchangeably in clinical work. Conclusions:High-frequency ultrasound can be used to evaluate the change of scar internal condition after ultra-pulsed CO 2 dot matrix laser irradiation, and measure the penetration depth of laser on scar tissue. The measurement results have high accuracy and reliability.

ObjectiveTo investigate the pharmacodynamic characteristics and explore the molecular mechanism of Honghua oral liquid （HOL） in relieving neuropathic pain （NP）. MethodHealthy male SD rats were randomly assigned into sham group， model group， low-， medium-， high-dose （0.5， 1.0， 2.0 mL·kg^-1·d^-1， respectively） HOL groups， and a positive drug （pregabalin， 25 mg·kg^-1·d^-1） group， with 6 rats in each group. Spinal nerve ligation （SNL） of L5 was conducted in other groups except the sham group. Drug administration was performed 3 days after the SNL surgery for 2 consecutive weeks， and samples were collected after the end of the administration. During the treatment period， the mechanical pain threshold and cold pain threshold were determined to measure the pain-relieving effect of HOL. Transcriptome sequencing was performed on hippocampal tissue samples from the sham， model， and high-dose HOL groups， and differentially expressed genes between the sham group and the model group as well as the model group and HOL high-dose group were obtained. After pathway enrichment analysis， we selected the targets which were closely related to neuroinflammation for validation， and predicted the specific binding sites of the major active components in HOL with the targets through molecular docking. In addition， the serum levels of tumor necrosis factor-α （TNF-α） and interleukin-10 （IL-10） were determined by enzyme-linked immunosorbent assay （ELISA） to evaluate the effect of HOL on neuroinflammation in NP rats. ResultCompared with the sham group， SNL decreased the mechanical pain threshold and cold pain threshold （P<0.05）. Compared with the model group， HOL recovered the mechanical pain threshold and cold pain threshold （P<0.05）. The transcriptome data showed that 376 differentially expressed genes （DEGs） were identified between the model group and the sham group， including 124 upregulated genes and 252 downregulated genes， and 194 DEGs between the model group and the high-dose HOL group， including 33 upregulated genes and 161 downregulated genes. Among them， insulin-like growth factor 1（IGF1）， matrix metallopeptidase-2 （MMP-2）， matrix metallopeptidase-14 （MMP-14）， erb-B2 receptor tyrosine kinase 2 （ERBB2）， and integrin subunit alpha 5 （ITGA5） associated with NP were selected for further validation. The Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） results showed that compared with the sham group， the modeling up-gurelated the mRNA levels of the above five molecules in the hippocampus （P<0.01）. Compared with model group， HOL down-regulated the mRNA levels of these molecules （P<0.01）. The molecular docking results showed that the main active components of safflower， hydroxysafflor yellow A， kaempferol， and quercetin， formed stable hydrogen bonds with the amino acid residues of IGF1， MMP-2， MMP-14， ERBB2， and ITGA5. The enzyme-linked immunosorbent assay（ELISA） results showed that compared with those in the sham group， the serum levels of TNF-α and IL-10 were out of balance in the model rats （P<0.01）. Compared with the model group， HOL lowered the level of the pro-inflammatory cytokine TNF-α （P<0.01） and elevated that of the anti-inflammatory cytokine IL-10 （P<0.05）. ConclusionHOL exerts analgesic effect on SNL rats by inhibiting neuroinflammation.

Objective To investigate the therapeutic effect of free thinning anterolateral thigh flap for reconstruction of soft tissue defects after resection of buccal carcinoma.Methods From January 2012 to April 2015,15 cases with buccal carcinoma received radical resection and immediate reconstruction with free thinning anterolateral thigh flap.The flap size ranged from 8 cm × 6 cm to 12 cm × 8 cm.Results Flap necrosis happened in one case.The other 14 flaps survived completely with good color and texture.The patients were followed up for 6-36 months with good appearance and function.There was no malfunction on donor site.One case(T3N1M0) died 16 months after operation.1 case(T3N1M0) had local recurrence 8 month later.Conclusions The free thinning anterolateral thigh flap has reliable blood supply with minimal morbidity on donor sites.It is a good choice for reconstruction with good cosmetic and functional results.

Objective To investigate the therapeutic effect of free thinning anterolateral thigh flap for reconstruction of soft tissue defects after resection of buccal carcinoma.Methods From January 2012 to April 2015,15 cases with buccal carcinoma received radical resection and immediate reconstruction with free thinning anterolateral thigh flap.The flap size ranged from 8 cm × 6 cm to 12 cm × 8 cm.Results Flap necrosis happened in one case.The other 14 flaps survived completely with good color and texture.The patients were followed up for 6-36 months with good appearance and function.There was no malfunction on donor site.One case(T3N1M0) died 16 months after operation.1 case(T3N1M0) had local recurrence 8 month later.Conclusions The free thinning anterolateral thigh flap has reliable blood supply with minimal morbidity on donor sites.It is a good choice for reconstruction with good cosmetic and functional results.

Objective By investigating the actualities of career development potential of eight-year program medical students, to explore a direction of training mode innovation aiming to improve career development potential. Methods Eight-year program medical graduates, their tutors, and di-rectors of their clinical department in a university hospital were the subjects of the current study. Questionnaire method was applied to evaluate professional competence including clinical skills, re-search capabilities and integrative ability . Anonymous questionnaires were dispensed to eight-year program medical graduates for self-evaluation. Distinct anonymous questionnaires were dispensed to tutors directors for evaluation. Traditional doctoral graduates (professional degree or academic degree) were set as standard for comparison of specific ability of eight-year program medical students. Results 74 out of 85 (87%) questionnaires for Eight-year program medical graduates were available. 53 out of 63 (84%) questionnaires for tutors were available. 21 out of 26 (81%) questionnaires for directors of clinical departments were available. In clinical capabilities, according to 43 percent (32 persons) of the eight-year MD graduates' self-assessment and the evaluation of 94%(50 persons) mentors and 81%(17 people) department directors, eight-year program medical graduates were regarded as lower-skilled clinicians compared with doctoral graduates with professional degree . Eight-year program medical graduates were also considered with worse research capabilities than doctoral graduates with profes-sional degree by themselves (76%, n=56), their tutors (91%, n=48), and their department directors (86%, n=18). Conclusions The survey shows that to some extent, the current eight-year clinical doctoral graduates lack of career development potential, reflecting the current training mode cannot lead to the given training goals. We suggest that both clinical skills and research capabilities should be enhanced to make sure that eight-year program medical graduates deserve the title of academic physicianorphysician scientists.

OBJECTIVETo observe the expression of the C-terminal truncated human apoptosis-inducing factor (AIF) and its biological effect on MCF-7 cells.

METHODSPcDNA3.0-FDT-AIFδ1-480 was transfected into human breast carcinoma MCF-7 cells with lipofectamine. The expression of the truncated AIF gene was detected by Western blotting, and its effects on the biological behaviors of MCF-7 cells and on the expression of cytochrome c (cytC) were evaluated using flow cytometry, MTT assay, colony-forming assay, and mitochondrial membrane potential measurement.

RESULTSPcDNA3.0-FDT-AIFδ1-480 enhanced AIF expression in MCF-7 cells, obviously inhibited the cell proliferation, and significantly reduced the mitochondrial membrane potentials (P<0.05). Transfection of the cells with PcDNA3.0-FDT-AIFδ1-480 promoted the expression of cytC and resulted in significantly increased apoptosis of MCF-7 cells (P<0.05).

CONCLUSIONThe expression of C-terminal truncated human AIF gene can induce apoptosis of human MCF-7 cells by promoting cytC release from mitochondria.

Apoptosis ; Apoptosis Inducing Factor ; genetics ; metabolism ; Breast Neoplasms ; metabolism ; pathology ; Cell Proliferation ; Cytochromes c ; genetics ; metabolism ; Female ; Humans ; MCF-7 Cells ; Membrane Potential, Mitochondrial ; Mitochondria ; metabolism