BACKGROUND:Cervical spondylosis is a chronic degenerative disease that has become one of the most common and frequent diseases threatening human health.At present,the initial diagnosis of the cervical spine and its surrounding structures mainly relies on the interpretation of medical images by radiologists,which not only requires a high level of technical requirements for operators,but also has the disadvantages of strong subjectivity,high labor intensity,and low efficiency.With the rapid development of artificial intelligence technology,its powerful data processing and image recognition capabilities have shown broad application prospects in the medical field.Deep learning has also made certain progress in the research of spinal diseases.OBJECTIVE:To summarize the current status and research progress in the application of artificial intelligence technology in cervical spine imaging images in recent years,evaluating the performance of artificial intelligence models as well as future trends and challenges to be overcome.METHODS:The first author searched the relevant articles in WanFang,CNKI,and PubMed in June 2024.The Chinese search terms were"artificial intelligence,deep learning,cervical spine."English serach terms were"artificial intelligence,Al,cervical vertebrae,cervical."Finally,101 articles were included and analyzed.RESULTS AND CONCLUSION:(1)Artificial intelligence technology can realize automatic segmentation of cervical vertebrae and measurement of curvature change by segmentation,classification,landmarks recognition of medical image parts,detect cervical vertebral fracture,nerve root,and spinal cord type cervical spondylosis,identify cervical spine ossification of posterior longitudinal ligament,and predict post-surgery related risk factors and cervical vertebra maturation classification.(2)Although artificial intelligence technology has shown great potential in the field of cervical spine research,it is still in the early stages of exploration and rapid development,with unlimited room for development and innovation.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

BACKGROUND:Cervical spondylosis is a chronic degenerative disease that has become one of the most common and frequent diseases threatening human health.At present,the initial diagnosis of the cervical spine and its surrounding structures mainly relies on the interpretation of medical images by radiologists,which not only requires a high level of technical requirements for operators,but also has the disadvantages of strong subjectivity,high labor intensity,and low efficiency.With the rapid development of artificial intelligence technology,its powerful data processing and image recognition capabilities have shown broad application prospects in the medical field.Deep learning has also made certain progress in the research of spinal diseases.OBJECTIVE:To summarize the current status and research progress in the application of artificial intelligence technology in cervical spine imaging images in recent years,evaluating the performance of artificial intelligence models as well as future trends and challenges to be overcome.METHODS:The first author searched the relevant articles in WanFang,CNKI,and PubMed in June 2024.The Chinese search terms were"artificial intelligence,deep learning,cervical spine."English serach terms were"artificial intelligence,Al,cervical vertebrae,cervical."Finally,101 articles were included and analyzed.RESULTS AND CONCLUSION:(1)Artificial intelligence technology can realize automatic segmentation of cervical vertebrae and measurement of curvature change by segmentation,classification,landmarks recognition of medical image parts,detect cervical vertebral fracture,nerve root,and spinal cord type cervical spondylosis,identify cervical spine ossification of posterior longitudinal ligament,and predict post-surgery related risk factors and cervical vertebra maturation classification.(2)Although artificial intelligence technology has shown great potential in the field of cervical spine research,it is still in the early stages of exploration and rapid development,with unlimited room for development and innovation.

Rare diseases still lack effective treatments, and the development of drugs for rare diseases (known as orphan drugs) is an urgent medical problem. As natural active ingredients in living organisms, some biomacromolecule drugs have good biocompatibility, low immunogenicity, and high targeting. They have become one of the most promising fields in drug research and development in the 21st century. However, there are still many obstacles in terms of in vivo delivery. In view of the unique advantages of nanocarriers prepared from polymers, lipids, organic biomimetic and inorganic materials in drug delivery, researchers are committed to building an efficient delivery system with versatility and synergy to solve the bottleneck issues in treating rare diseases with biomacromolecule drugs. Therefore, this article reviews the research progress of nanocarrier delivering proteins, peptides and nucleic acids in the field of rare disease treatment in the past ten years, which provides ideas for researches on biomacromolecule drug nanosystems in the field of treatment of rare diseases.

ObjectiveTo compare the nocturnal erectile function between SRPE patients and normal people. MethodsFrom July 1st， 2019 to December 15th， 2022， a clinical comparative study was conducted on 29 SRPE patients （experimental group） and 58 volunteers （control group） who visited our urology department. The Rigiscan System was used to monitor sleep monitoring time， the number of nocturnal erections and the rigidity， duration and circumference growth of the penis when the erection reached 60%～79% and 80%～100%， respectively. The patients and volunteers were asked to make written records when they woke up， and then the total number of awakenings and the number of awakenings when the penis erection reached 60% and 80% were compared between the two groups. ResultsAge was eliminated by matching. There was no statistically significant difference in sleep monitoring time， rigidity， circumference growth and duration of the penis when the erection reached 60%～79% and 80%～100%. between the two groups. In terms of sleep， there was a statistically significant difference in the total number of awakenings between the two groups［3（2 ~ 4）vs 0（0 ~ 0），P<0.01］ .And the same was true for the number of awakenings when the penis erection exceeded 60%～79% ［1（0 ~ 1）vs 0（0 ~ 0），P<0.01］and 80%～100% ［2（1 ~ 3）vs 0（0 ~ 0），P<0.01］. ConclusionRigiscan monitoring showed that there was no difference between SRPE patients and normal male in nocturnal penile erection function. Painful awakening usually occurs when the penis erection reaches 60%～79% or 80%～100%， which reveals that SRPE may be caused by abnormal sensation of nocturnal erections or pain sensitivity in some of these patients.

Objective: To compare the detection rate of advanced neoplasia and the number of people needing endoscopy in colorectal cancer screening giving at different starting age in population at high risk. Methods: Based on the screening project of early diagnosis and treatment of colorectal cancer in Jiashan county, Zhejiang province, two rounds of colorectal cancer screening were conducted between January 2007 and December 2020. After excluding participants who were not at high risk or had incomplete information, 27 130 participants and 31 205 participants were finally enrolled in round one and in round two, respectively. The spline analysis based on the generalized additive model was used to describe the trend of detection rate of advanced neoplasia with age. The detection rate and number of people needing endoscopy for the groups with starting age at 50, 45 and 40 years were calculated, and the differences in the detection rate were tested by χ² goodness of fit test. Results: A total of 21 077 (77.69%) participants in round one and 25 249 (80.91%) participants in round two received endoscopy, in whom 1 097 (detection rate=52.05‰) and 1 151 (detection rate=45.59‰) had advanced neoplasia (cancers and advanced adenomas), respectively. The detection rate increased significantly with age, and the detection rate in round one were significantly higher than that in round two (P<0.05). The overall detection rates of advanced neoplasia for the groups with starting age at 50, 45 and 40 years were 61.11‰, 56.14‰ and 52.05‰ in round one, and 49.10‰, 46.75‰ and 45.59‰ in round two, respectively. The rates were significantly higher for the group with starting age at 50 years than that with starting age at 40 years in both round one and round two (P<0.05). The numbers of people needing endoscopy of advanced neoplasia for the groups with starting age at 50, 45 and 40 years were 17, 18, and 20 in round one, and 21, 22 and 22 in round two. Conclusions: The detection rate of advanced neoplasia increased with age. Starting screening at lower age might contribute to decreased detection rate and increased number of people needing endoscopy. However, the difference was limited.
Adult ; Colorectal Neoplasms/epidemiology* ; Early Detection of Cancer ; Humans ; Mass Screening ; Middle Aged ; Occult Blood

Objective:To study the protective effect of Ficus pandurata extract on acute alcoholic liver injury based on pyroptosis mechanism.Method:The 56 male C57BL/6 mice were randomly divided into normal control group， model control group， positive control group（60 mg·kg^-1）， fresh medicine water extract group（48 g·kg^-1）， dry drug water extract group（48 g·kg^-1），dry drug 50% alcohol extract group（48 g·kg^-1） and dry drug 95% alcohol extract group （48 g·kg^-1）， 8 mice in each group.Positive control and different solvent extract groups of Ficus tenuifolia were intragastrically administrated for 18 days，once a day，while normal group and model group were given the same volume of pure water intragastrically. After 15 days of continuous gavage， mice received 50％ ethanol（12 mL·kg^-1）intragastrically for 3 days to induce acute alcoholic liver injury model except for the normal control group. At 14 h after the last treatment，serum and liver samples were obtained，the serum content of alanine aminotransferase （ALT） and aspartate transaminase（AST） were determined， the histopathologic changes of the hepatic tissues were observed by hematoxylin ecosin（HE） staining.The content of malondialdehyde (MDA) in liver was determined by thiobarbituric acid (TBA) and the content of lactate dehydrogenase (LDH) was determined by microplate method. Western blot and TUNEL assay kit was used to detect the cell pyroptosis rate.Result:Compared with normal group， ALT， AST， MDA and LDH levels in the model group were significantly increased， liver index was significantly increased，TUNEL staining positive， inflammatory factors and pyroptosis related protein expressions were significantly increased （P<0.05）. Compared with model control group， the ALT，AST ，MDA and LDH of the drug intervention group decreased significantly （P<0.05）. The liver index decreased in different degrees， and the expression of inflammatory factors and pyroptosis related protein in the water extract treatment group decreased significantly （P<0.05）.Conclusion:The root extract of Ficus pandurata Hance has protective effect on acute alcoholic liver injury， and the mechanism of water extract might relate to inhibiting hepatocyte pyroptosis.