ObjectiveTo systematically review and analyze the core ethical challenges accompanying technological convergence in the field of rehabilitation engineering, and to propose a forward-looking and actionable ethical governance framework. MethodsTaking the basic principles of policies and regulations, medical ethics, and scientific and technological ethics as the theoretical foundation, and combining with the application characteristics of rehabilitation engineering technology, this paper systematically sorted out the core issues existing in the ethical review of rehabilitation engineering, and conducted targeted analyses focusing on the key points of ethical governance. ResultsThis paper systematically reviewed the core ethical challenges arising from technological convergence in rehabilitation engineering, encompassing dilemmas of identity and autonomy, inequitable resource allocation and biases, data privacy and security risks, and accountability attribution difficulties in multi-stakeholder collaboration. It further proposed targeted governance recommendations along three dimensions: deepening ethical principles, improving review mechanisms and building capacity among diverse stakeholders. ConclusionRehabilitation engineering, leveraging artificial intelligence and robotics offers novel rehabilitation pathways for individuals with functional impairments, and has substantially improved therapeutic outcomes. Nevertheless, its widespread application is accompanied by ethical challenges, including privacy breaches, difficulties in liability attribution, inequitable service access, and emotional dependency. Governance pathways should be established around the refinement of ethical principles, the formulation of specific regulatory frameworks, and the cultivation of ethical competence among diverse stakeholders. Ethical considerations must be embedded throughout the entire lifecycle of technology research and development, clinical translation and deployment. Through the coordinated advancement of policy, technology and humanistic values, a balance can be struck between technological innovation and the protection of human rights, thereby fostering the beneficent and sustainable development of rehabilitation engineering.

Ubiquitination is a crucial post-translational modification that is extensively involved in the regulation of protein activity,signal transduction,and the maintenance of genomic stability.As an important member of the deubiquitinating enzyme(DUB)family,ubiquitin-specific protease 11(USP11)dynamically regulates the stability and function of key tumor proteins by targeting specific substrates for deubiquitination.This,in turn,influences various biological behaviors of tumor cells,including proliferation,apoptosis,migration,invasion,metastasis,and drug resistance,ultimately exhibiting a dual role in either promoting or inhibiting cancer.This article systematically reviewed the relevant research progress on the role of USP11 in tumorigenesis and development and provided an in-depth analysis of the specific mechanisms by which USP11 participates in cellular biological behav-iors,aiming to offer a theoretical basis for the future development of small-molecule inhibitors targeting USP11,the formulation of combination drug strategies,and the identification of effective biomarkers.

Aim To study the diastolic effect and mechanism of farrerol on isolated pulmonary arteries of C57BL/6J mice.Methods After anesthesia,mouse lung tissue was quickly removed and placed into the 4 ℃ K-H buffer,pulmonary arteries were isolated under the microscope and cut into 2 mm long vascular rings for spare use.(1)The effect of farrerol on the resting tension of isolated mouse pulmonary arteries:in the resting state,the active mouse pul-monary artery rings were treated with different concentrations of farrerol(10-6,3×10-6,10-5,3×10-5 and 10-4 mol/L).(2)Farrerol relaxed mouse pulmonary artery experiment:pulmonary arteries were contracted using phenylephrine(PE,1 μmol/L)or KCl(60 mmol/L),and when the contraction reached the platform,different concentrations of farrerol(10-6,3×10-6,10-5,3×10-5 and 10-4 mol/L)was added.(3)Farrerol inhibited pulmonary artery contraction experi-ment:under conditions with or without the addition of farrerol,pulmonary arteries were contracted using different concen-trations of PE(10-9,3×10-9,10-8,3 × 10-8,10-7,3×10-7 and 10-6 mol/L)or KCl(20,30,40,60,80 and 120 mmol/L),and the pulmonary artery muscle tension was recorded.(4)Calcium free and recalcification experiments:under conditions with or without the addition of farrerol,the changes of isolated mouse pulmonary artery tension were meas-ured in the state of calcium free or recalcification { 2.5 mmol/L[Ca2+]ex }.(5)The relationship between farrerol in-duced relaxation of isolated mouse pulmonary arteries and potassium ion channels:firstly,60 mmol/L KCl solution was used to contract the mouse pulmonary arteries until the platform.Then,3 mmol/L aminopyridine(4-AP),2 mmol/L tet-raethylammonium(TEA),30 μmol/L BaCl2,and 10 μmol/L glibenclamide(Gli)were added and treated for 15 min.Subsequently,the pulmonary arteries were relaxed using a concentration gradient of farrerol.Results Farrerol had no significant effect on the mouse pulmonary arteries in the resting state,but had a concentration-dependent relaxing effect on the mouse pulmonary arteries pre-contracted with PE and KCl.While the pretreatment of 3×10-5 mol/L farrerol could sig-nificantly reduce the maximum contraction of mouse pulmonary arteries induced by PE and KCl(P＜0.01),as well as sig-nificantly reduce the contraction of mouse pulmonary arteries induced by KCl under calcium free or recalcification conditions(P＜0.01).Addition of the voltage-dependent potassium ion channel blocker 4-AP significantly reduced the maximum diastolic rate of mouse pulmonary arteries induced by farrerol(P＜0.01),while addition of the high conductivity calcium activated potassium ion channel blocker TEA,inward rectifying potassium ion channel blocker BaCl2,or ATP sensitive po-tassium ion channel blocker Gli had no significant effect on the vasodilation effect of farrerol(P＞0.05).Conclusion Farrerol has a relaxing effect on isolated mouse pulmonary arteries,and its mechanism may be related to open voltage-de-pendent potassium ion channels.

Aim To study the diastolic effect and mechanism of farrerol on isolated pulmonary arteries of C57BL/6J mice.Methods After anesthesia,mouse lung tissue was quickly removed and placed into the 4 ℃ K-H buffer,pulmonary arteries were isolated under the microscope and cut into 2 mm long vascular rings for spare use.(1)The effect of farrerol on the resting tension of isolated mouse pulmonary arteries:in the resting state,the active mouse pul-monary artery rings were treated with different concentrations of farrerol(10-6,3×10-6,10-5,3×10-5 and 10-4 mol/L).(2)Farrerol relaxed mouse pulmonary artery experiment:pulmonary arteries were contracted using phenylephrine(PE,1 μmol/L)or KCl(60 mmol/L),and when the contraction reached the platform,different concentrations of farrerol(10-6,3×10-6,10-5,3×10-5 and 10-4 mol/L)was added.(3)Farrerol inhibited pulmonary artery contraction experi-ment:under conditions with or without the addition of farrerol,pulmonary arteries were contracted using different concen-trations of PE(10-9,3×10-9,10-8,3 × 10-8,10-7,3×10-7 and 10-6 mol/L)or KCl(20,30,40,60,80 and 120 mmol/L),and the pulmonary artery muscle tension was recorded.(4)Calcium free and recalcification experiments:under conditions with or without the addition of farrerol,the changes of isolated mouse pulmonary artery tension were meas-ured in the state of calcium free or recalcification { 2.5 mmol/L[Ca2+]ex }.(5)The relationship between farrerol in-duced relaxation of isolated mouse pulmonary arteries and potassium ion channels:firstly,60 mmol/L KCl solution was used to contract the mouse pulmonary arteries until the platform.Then,3 mmol/L aminopyridine(4-AP),2 mmol/L tet-raethylammonium(TEA),30 μmol/L BaCl2,and 10 μmol/L glibenclamide(Gli)were added and treated for 15 min.Subsequently,the pulmonary arteries were relaxed using a concentration gradient of farrerol.Results Farrerol had no significant effect on the mouse pulmonary arteries in the resting state,but had a concentration-dependent relaxing effect on the mouse pulmonary arteries pre-contracted with PE and KCl.While the pretreatment of 3×10-5 mol/L farrerol could sig-nificantly reduce the maximum contraction of mouse pulmonary arteries induced by PE and KCl(P＜0.01),as well as sig-nificantly reduce the contraction of mouse pulmonary arteries induced by KCl under calcium free or recalcification conditions(P＜0.01).Addition of the voltage-dependent potassium ion channel blocker 4-AP significantly reduced the maximum diastolic rate of mouse pulmonary arteries induced by farrerol(P＜0.01),while addition of the high conductivity calcium activated potassium ion channel blocker TEA,inward rectifying potassium ion channel blocker BaCl2,or ATP sensitive po-tassium ion channel blocker Gli had no significant effect on the vasodilation effect of farrerol(P＞0.05).Conclusion Farrerol has a relaxing effect on isolated mouse pulmonary arteries,and its mechanism may be related to open voltage-de-pendent potassium ion channels.

Objective:The New Medicine is an emerging field of medicine that integrates traditional medicine with artificial intelligence (AI) and big data. Under the background of New Medicine, this study aims to explore the application of AI in medical higher education, investigate the development status of universities in this field, and propose targeted optimization suggestions, with the purpose of providing a reference for improving medical education quality and cultivating outstanding doctors.Methods:In each of the six administrative divisions of China, a key university and a general university were randomly selected as research objects. Two researchers with teaching experience conducted a search on the official websites of these universities, using "artificial intelligence" as the keyword. They retrieved publicly available information from January 1, 2020 to December 18, 2024, and screened for the content related to medical teaching. The data of these universities were organized and summarized based on five categories: courses, training, teaching platforms, conferences, and lectures.Results:After a series of searches, screenings, and summaries, the researchers identified a total of 58 AI-related projects applied in medical education across the five areas of courses, training, teaching platforms, conferences, and lectures. Of these, 34 projects came from six key universities, and 24 projects were from six general universities. Key universities have demonstrated the advantages in multidisciplinary integration, technology-driven approaches, and international perspectives through systematic curriculum design (e.g., multi-level AI course at Zhejiang University), intelligent teaching assistant tools (e.g., "Brainiac Buddy" at Peking University), and international visiting programs (e.g., AI Summer Visting Program at Zhejiang University). General universities implemented practices such as knowledge graphs, 5G smart platforms, and virtual simulation courses (e.g., "medical image processing" course at Southwest Medical University), achieving multi-level capability enhancement from basic medical education to health management skill education, as well as significant outcomes in "health-centered" and "education model innovation".Conclusions:AI-powered medical education has shown great innovation potential in Chinese universities, with unique development characteristics at different universities.

Objective:The New Medicine is an emerging field of medicine that integrates traditional medicine with artificial intelligence (AI) and big data. Under the background of New Medicine, this study aims to explore the application of AI in medical higher education, investigate the development status of universities in this field, and propose targeted optimization suggestions, with the purpose of providing a reference for improving medical education quality and cultivating outstanding doctors.Methods:In each of the six administrative divisions of China, a key university and a general university were randomly selected as research objects. Two researchers with teaching experience conducted a search on the official websites of these universities, using "artificial intelligence" as the keyword. They retrieved publicly available information from January 1, 2020 to December 18, 2024, and screened for the content related to medical teaching. The data of these universities were organized and summarized based on five categories: courses, training, teaching platforms, conferences, and lectures.Results:After a series of searches, screenings, and summaries, the researchers identified a total of 58 AI-related projects applied in medical education across the five areas of courses, training, teaching platforms, conferences, and lectures. Of these, 34 projects came from six key universities, and 24 projects were from six general universities. Key universities have demonstrated the advantages in multidisciplinary integration, technology-driven approaches, and international perspectives through systematic curriculum design (e.g., multi-level AI course at Zhejiang University), intelligent teaching assistant tools (e.g., "Brainiac Buddy" at Peking University), and international visiting programs (e.g., AI Summer Visting Program at Zhejiang University). General universities implemented practices such as knowledge graphs, 5G smart platforms, and virtual simulation courses (e.g., "medical image processing" course at Southwest Medical University), achieving multi-level capability enhancement from basic medical education to health management skill education, as well as significant outcomes in "health-centered" and "education model innovation".Conclusions:AI-powered medical education has shown great innovation potential in Chinese universities, with unique development characteristics at different universities.

Objective To test the reliability and validity of the Chinese version of the Nine-Item Avoidant/Restrictive Food Intake Disorder Scale (NIAS) in patients with inflammatory bowel disease (IBD). Methods Based on convenience sampling method, 304 patients from the Treatment Center for Inflammatory Bowel Disease of two Grade Ⅲ Level hospitals A in Jiangsu Province were selected as the research objects, and they were investigated by a general information questionnaire, NIAS, and the Satisfaction with Food-Related Life (SWFL). Item analysis (discrimination analysis, correlation coefficient) and reliability analysis of the total scale and subscales (Cronbach's α coefficient) were performed. Exploratory factor analysis, confirmatory factor analysis, criterion-related validity, convergent validity, and discriminant validity were used to test the validity of the scale. Results The Chinese version of NIAS contained 9 items, including 3 subscales of picky eating, appetite and fear; the confirmatory factor analysis indicated a good construct validity in 3-factor model[χ²/df=2.340, root mean square error of approximation (RMSEA)=0.078, standardized root mean square residual (SRMR)=0.046, incremental fit index (IFI)=0.969, comparative fit index (CFI)=0.969, normed fit index (NFI)=0.948, goodness of fit index (GFI)=0.951, the Tucker-Lewis index (TLI)=0.951]; the correlation coefficient between the total score of the Chinese version of NIAS and the SWFL scale was -0.353, indicating a strong correlation; the aggregated validity CR values for each dimension of the scale were 0.821 to 0.855, and the AVE values were 0.606 for appetite, 0.621 for picky eating, and 0.664 for fear. The total Cronbach's α coefficient of the Chinese version of the NIAS scale was 0.82, and the Cronbach's α coefficients for dimensions of picky eating, appetite and fear were 0.87, 0.71 and 0.92 respectively, indicating the Chinese version of the NIAS scale had good internal consistency and stability. Conclusion The Chinese version of the NIAS scale has good reliability and validity, and can be used to evaluate avoidant and restrictive food intake disorder behaviors in IBD patients.

Objective This study aimed to explore the spatial heterogeneity and risk factors for dental caries in 12-year-old children in Shanxi province,China. Methods The data encompassed 3,721 participants from the two most recent oral health surveys conducted across 16 districts in Shanxi Province in 2015 and 2018.Eighteen specific variables were analyzed to examine the interplay between socioeconomic factors,medical resources and environmental conditions.The Geo-detector model was employed to assess the impacts and interactions of these ecological factors. Results Socioeconomic factors(Q=0.30,P<0.05)exhibited a more substantial impact compared to environmental(Q=0.19,P<0.05)and medical resource factors(Q=0.25,P<0.05).Notably,the urban population percentage(UPP)demonstrated the most significant explanatory power for the spatial heterogeneity in caries prevalence,as denoted by its highest q-value(q=0.51,P<0.05).Additionally,the spatial distribution's heterogeneity of caries was significantly affected by SO2 concentration(q=0.39,P<0.05)and water fluoride levels(q=0.27,P<0.05)among environmental factors. Conclusion The prevalence of caries exhibited spatial heterogeneity,escalating from North to South in Shanxi Province,China,influenced by socioeconomic factors,medical resources,and environmental conditions to varying extents.

Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.

Objective To explore the relationship between anxiety sensitivity and psychological stress before parachuting training among parachuting trainees and the mediating role of resilience between them.Methods Anxiety sensitivity index scale(version 3),resilience scale,psychological stress self-evaluation test and self-compiled general information questionnaire were employed for 258 parachuting trainees before training.Pearson correlation analysis was used to analyze the correlations among anxiety sensitivity,resilience and psychological stress.A multiple linear regression analysis was conducted with anxiety sensitivity and resilience as independent variables and psychological stress as dependent variable to explore the relationships among these 3 factors.The mediating effect of resilience on the relationship between anxiety sensitivity and psychological stress was examined using the Hayes Process macro program and bias corrected non-parametric percentile Bootstrap method.Results Before parachuting training,the prevalence of psychological stress among parachuting trainees was 5.0%(13/258).The correlations between anxiety sensitivity,resilience and psychological stress were significant(all P＜0.01).Anxiety sensitivity was positively associated with psychological stress among parachuting trainees(b=0.412,t=7.062,P＜0.01),while resilience was negatively associated with psychological stress(b=-0.187,t=-3.722,P＜0.01).Anxiety sensitivity and resilience were found to explain 31.4%of the total variance.Resilience partially mediated the effect of anxiety sensitivity on psychological stress,accounting for 20.48%of the total effect.Conclusion Parachuting trainees are at a relatively low stress level,with good psychological adaptation.Resilience plays a partial mediating role in the association between anxiety sensitivity and psychological stress.More attention should be paid to parachuting trainees with high anxiety sensitivity,enhancing their resilience,and reducing psychological stress before parachuting training.