In the period of digital transformation of the medical service model， maintaining algorithm justice for medical artificial intelligence possesses multiple value implications. However， practical dilemmas exist at different stages of achieving this value goal. At the initial stage of diagnosis and treatment decision-making， there is a risk of imbalance in patients’ rights and interests， such as weakened effectiveness of patients’ right to informed consent， as well as low synergy between rights and interests protection and technological innovation. In the process of diagnosis and treatment decision-making， the algorithmic model is constrained by the technological bottleneck in the underlying application， deviating from the legal track of technological neutrality. After the diagnosis and treatment decision-making is generated， it triggers a crisis in the remedy of patients’ rights and interests and breeds the phenomenon of an ambiguous definition of subject qualification and attribution principle. In this regard， it is essential to establish a preemptive safeguard system focusing on the protection of patients’ rights and interests， set technological fairness standards， and shape review norms of technological neutrality. The aim is to ensure the equalization of remedy channels for patients’ rights and interests， promote the fairness in the proportion of responsibilities among multiple subjects， and thereby safeguard the digital justice in the field of intelligent diagnosis and treatments.

Prostate cancer is one of the most common male urological malignancies,in which bone metastasis of desmo-plasia-resistant prostate cancer is an important stage in the progression of the disease,which seriously affects the quality of life and survival of patients.With the development of nuclide therapy technology in recent years,223-Ra,as a new type of alpha-targeted therapy,has shown good efficacy in the treatment of desmoplasia-resistant prostate cancer bone metastasis.The purpose of this pa-per is to review the characteristics,mechanism of action,treatment,and the main research results of its treatment of desmoplasia-resistant prostate cancer bone metastasis,and provide a comprehensive review of the clinical application of 223-Ra in the treatment of desmoplasia-resistant prostate cancer bone metastasis for the clinical application of 223-Ra in prostate cancer bone metastasis.

Abstract Inhibitor of DNA binding 1(ID1) is a crucial regulator of cell differentiation and plays a significant role in maintaining normal hematopoietic differentiation and development. Due to the lack of DNA-binding motif, ID1 functions as a dominant-negative inhibitor of basic helix-loop-helix factors to antagonize their abilities to bind to DNA and transcriptionally regulate target genes. Abnormal expression of ID1 is strongly associated with various hematologic disorders, including myeloid and lymphoblastic leukemia, multiple myeloma and myeloproliferative neoplasms. ID1 acts as a potential oncogene by participating in multiple signaling pathways that promote the malignant proliferation, invasion and therapy resistance in leukemic cells. Significant strides have yielded promising antileukemic effects of ID1 inhibitors, both alone and in combination with targeted therapies against oncogenic signaling pathways. Here, we review the relationship between ID1 expression and the initiation and progression of blood disorders, and summarize the clinical significance of ID1 as a novel therapeutic target and potential prognostic biomarker for hematologic malignancies.

Prostate cancer is one of the most common male urological malignancies,in which bone metastasis of desmo-plasia-resistant prostate cancer is an important stage in the progression of the disease,which seriously affects the quality of life and survival of patients.With the development of nuclide therapy technology in recent years,223-Ra,as a new type of alpha-targeted therapy,has shown good efficacy in the treatment of desmoplasia-resistant prostate cancer bone metastasis.The purpose of this pa-per is to review the characteristics,mechanism of action,treatment,and the main research results of its treatment of desmoplasia-resistant prostate cancer bone metastasis,and provide a comprehensive review of the clinical application of 223-Ra in the treatment of desmoplasia-resistant prostate cancer bone metastasis for the clinical application of 223-Ra in prostate cancer bone metastasis.

Objective To observe the ultrasound biomicroscopy(UBM)findings of lacrimal canaliculitis.Methods Totally 35 patients with single eye lacrimal canaliculitis who underwent surgical treatment were retrospectively enrolled,including 3 cases of simple superior lacrimal tubule abnormalities,19 cases of simple inferior lacrimal tubule abnormalities and 13 cases with both superior and inferior lacrimal tubules.UBM data and postoperative laboratory examination results were comparatively analyzed.Results The detection rate of UBM for lacrimal canaliculitis was 100％.Abnormal coenobium-like structures in lacrimal tubule were characterized by elliptical or irregular low echo,with unclear boundaries and uneven internal echo,some with punctate high echoes,while polyps presented as oval or strip-shaped high echo with clear boundaries and uniform internal echoes in UBM.UBM findings of tumor like hyperplasia were similar to abnormal coenobium-like structures but with relatively uniform internal echoes.Sulfur particles extracted from lacrimal tubule revealed no fungi in 35 cases by postoperation pathology,while actinomycete was observed in 24 cases,with UBM finding of abnormal coenobium-like structures and punctate high echoes.Conclusion UBM findings of lacrimal canaliculitis had certain characteristics.Coenobium-like structures and punctate high echoes in lacrimal tubule could be observed after infection of actinomycete.

Objective To observe the ultrasound biomicroscopy(UBM)findings of lacrimal canaliculitis.Methods Totally 35 patients with single eye lacrimal canaliculitis who underwent surgical treatment were retrospectively enrolled,including 3 cases of simple superior lacrimal tubule abnormalities,19 cases of simple inferior lacrimal tubule abnormalities and 13 cases with both superior and inferior lacrimal tubules.UBM data and postoperative laboratory examination results were comparatively analyzed.Results The detection rate of UBM for lacrimal canaliculitis was 100％.Abnormal coenobium-like structures in lacrimal tubule were characterized by elliptical or irregular low echo,with unclear boundaries and uneven internal echo,some with punctate high echoes,while polyps presented as oval or strip-shaped high echo with clear boundaries and uniform internal echoes in UBM.UBM findings of tumor like hyperplasia were similar to abnormal coenobium-like structures but with relatively uniform internal echoes.Sulfur particles extracted from lacrimal tubule revealed no fungi in 35 cases by postoperation pathology,while actinomycete was observed in 24 cases,with UBM finding of abnormal coenobium-like structures and punctate high echoes.Conclusion UBM findings of lacrimal canaliculitis had certain characteristics.Coenobium-like structures and punctate high echoes in lacrimal tubule could be observed after infection of actinomycete.

The incidence of breast cancer is on the rise annually, and chemotherapy is potentially effective in prolonging the lifespan of young breast cancer patients which also irreversibly harm the ovaries. Recently, increasingly more studies have focused on the role of gonadotropin-releasing hormone agonist (GnRH-a) for protecting ovarian function in patients undergoing chemotherapy with disputable findings. This review addresses four perspectives including the impact of chemotherapy on ovarian function, the introduction of GnRH-a and the possible mechanism of protecting ovarian function, the advances of clinical research on the ovarian protection by GnRH-a in chemotherapy for patients with breast cancer and other related issues, with the aim of providing thoughts for clinical diagnosis and associated research.

Overweight and obesity are getting more commonplace worldwide and increasingly developing serious health and social issues. Weight loss intervention is regarded as an effective way to improve the fertility outcomes of overweight or obese women of childbearing age who have a substantial impact on their ability to conceive as well as an elevated risk of various perinatal complications. The effectiveness of weight loss therapies in improving fertility outcomes in overweight or obese infertile women is still being investigated. This article aims to investigate the impact of weight loss therapies on overweight or obese women from multiple perspectives, including the effects of weight loss intervention on fertility, assisted reproductive outcomes, and perinatal outcomes to provide more ideas and references for the clinical practice of weight loss interventions.

Objective To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January,2015 and January,2022 using a convenience sampling method.The patients were divided into a derivation cohort(201 cases)and a validation cohort(101 cases).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients,based on which a risk prediction model was established in the form of a nomogram.The receiver operator characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the discrimination ability,calibration and clinical validity of this model.Results The in-hospital mortality risk prediction model was established based the risk factors including hypertension(OR=3.694,95%CI:1.582-8.621),continuous renal replacement therapy(OR=9.661,95%CI:4.103-22.745),elevated Na2+ level(OR=1.048,95%CI:1.003-1.095)and increased hemoglobin level(OR=0.987,95%CI:0.977-0.998).In the derivation cohort,the area under the ROC curve(AUC)of this model was 0.829(95%CI:0.770-0.889),greater than those of the 4 single factors(all AUC<0.800),APACHE Ⅱ Score(AUC=0.777,95%CI:0.714-0.840)and the SOFA Score(AUC=0.721,95%CI:0.647-0.796).The results of internal validation showed that the AUC of the model was 0.774(95%CI:0.679-0.869),and the goodness of fit test showed a good fitting of this model(χ2=4.629,P>0.05).Conclusion The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation,calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system,and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.

The connotation of theory of"toxin"in TCM is rich,and"toxin"is closely related to the occurrence and development of chronic liver disease.Treatment from"toxin"is an important treatment for chronic liver disease.In this article,by summarizing the ancient and modern literature to explain the theory of"toxin",and combined with clinical experience,it concluded that"toxin"has the pathogenic characteristics of strong bias,lingering nature,complex and changeable in chronic liver disease.The authors put forward the view that"toxin leads to disease occurrence and accelerates disease progression",and explored the idea of treating chronic liver disease from"toxin",including tracing the source of toxins,clarifying the nature of toxins,identifying changes of toxins,strengthening the body and eliminating toxins,in order to provide ideas for the clinical treatment of chronic liver disease.