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.

Recently,the theoretical system and practical path for the deep integration of digitalization and traditional industrialization have gradually matured.Medical innovation and digital technology are progressing,and the deep integration of intensive care medicine and intelligence is surpassing the traditional informatization and ushering in new development opportunities.Technologies such as 5G,big data,artificial intelligence,and digital twins can help to understand more complex critical care issues,improve the diagnoses and prediction of diseases and symptoms,develop more accurate treatment strategies,and even transform the service model of critical care medicine.This paper summarizes the application and challenge of digital technology in the practical scenarios of critical care medicine,so as to further consolidate infrastructure,enrich application scenarios,accelerate implementation,improve effectiveness,and strengthen the safety and compliance with the regulations.

Objective The aim of this study was to reveal the association characteristics between cancer and depression u-sing the data from community-based multi-morbidity study in rural China(COMMON),and provide a scientific basis for early pre-vention and intervention of depression in cancer patients.Methods We collected questionnaire responses,physical examination re-cords,health insurance data,and electronic medical records from both cancer and non-cancer participants.Using propensity score matching at a 1∶4 ratio,we balanced baseline characteristics between the cancer and control groups.We then compared the preva-lence of depression between these groups,as well as across subgroups stratified by age,sex,income,and other factors.The association between cancer and depression risk was assessed using univariate and multivariate logistic regression.Finally,we conducted sensitivity analyses by restricting the regression models to participants with mild-to-severe depression.Results After matching the baseline characteristics,a total of 206 cancer patients and 824 controls were included in the study,and all baseline characteristics between the two groups.Among all individuals,women,participants under 60 years old and those from low-income families(10,000-34,999 Yuan per year),the cancer group had a higher prevalence of depression than the non-cancer group(P<0.05),no difference was found in other subgroup(P>0.05).The results of multivariate logistic regression analysis showed that cancer was an independent risk factor for depression,and the risk of depression in cancer patients was 2.38 times that of participants without cancer(95%CI:1.44-3.89,P<0.001).The analysis results of different gender,age,and family income subgroups showed that the effect of cancer on the risk of de-pression was different among subgroups(P<0.05).Conclusions Cancer is an independent risk factor for depression.Therefore,the assessment and intervention of mental health should be paid attention during the treatment of cancer patients.It is of great significance to screen for depression in cancer patients and intervene in them to improve the life quality of patients.In addition,paying attention to high-risk groups can help to implement targeted prevention and intervention and improve their mental health.

Objective The aim of this study was to reveal the association characteristics between cancer and depression u-sing the data from community-based multi-morbidity study in rural China(COMMON),and provide a scientific basis for early pre-vention and intervention of depression in cancer patients.Methods We collected questionnaire responses,physical examination re-cords,health insurance data,and electronic medical records from both cancer and non-cancer participants.Using propensity score matching at a 1∶4 ratio,we balanced baseline characteristics between the cancer and control groups.We then compared the preva-lence of depression between these groups,as well as across subgroups stratified by age,sex,income,and other factors.The association between cancer and depression risk was assessed using univariate and multivariate logistic regression.Finally,we conducted sensitivity analyses by restricting the regression models to participants with mild-to-severe depression.Results After matching the baseline characteristics,a total of 206 cancer patients and 824 controls were included in the study,and all baseline characteristics between the two groups.Among all individuals,women,participants under 60 years old and those from low-income families(10,000-34,999 Yuan per year),the cancer group had a higher prevalence of depression than the non-cancer group(P<0.05),no difference was found in other subgroup(P>0.05).The results of multivariate logistic regression analysis showed that cancer was an independent risk factor for depression,and the risk of depression in cancer patients was 2.38 times that of participants without cancer(95%CI:1.44-3.89,P<0.001).The analysis results of different gender,age,and family income subgroups showed that the effect of cancer on the risk of de-pression was different among subgroups(P<0.05).Conclusions Cancer is an independent risk factor for depression.Therefore,the assessment and intervention of mental health should be paid attention during the treatment of cancer patients.It is of great significance to screen for depression in cancer patients and intervene in them to improve the life quality of patients.In addition,paying attention to high-risk groups can help to implement targeted prevention and intervention and improve their mental health.

Objective:To observe the clinical and pathological features of choroidal malignant melanoma (CM).Methods:A retrospective case study. From 2011 to 2021, paraffin specimens from 15 eyes of 15 CM patients diagnosed by pathological examination in the Department of Pathology, the Second Affiliated Hospital of Soochow University were included in the study. The age, gender, clinical manifestations, treatment plan and pathological examination results of patients were collected retrospectively through the hospital information system. The clinical characteristics, immunohistochemical staining and molecular pathological characteristics were analyzed.Results:Among the 15 cases, 8 males and 7 females. The average age was 61. All patients were monocular paroxysm. There were 8 cases of decreased vision, blurred vision and dark shadow in front of the eyes; 1 case had red eye, lacrimation and purulent secretion; 2 cases had visual loss and no light perception; 4 cases had retinal detachment. The average diameter of the tumors was 1.4 cm. The general appearance of the tumor was hemispherical, "mushroom-shaped" or flat diffuse. Most of the tumor cells were arranged in solid, flaky and cross clusters, and some of them were arranged in false "chrysanthemum form" around the blood vessels with necrosis. In 15 eyes, spindle-cell type, epithelioid type and mixed cell type were 6, 2 and 7 eyes, respectively. The cytoplasm was partly double stained or eosinophilic, partly clear, and partly rich in pigment. The cells had poor adhesion, marked atypia, rough chromatin, frequent mitotic figures, and prominent nucleoli. Immunohistochemical staining was positive for HMB45, SOX10, S100 and Melan-A in 15 patients, but negative for epithelial markers AE1/3, lymphatic markers LCA, neuroendocrine markers CgA and Syn. Genetic testing results showed that none of the patients found C-KIT, BRAF, NRAS gene mutations. Fifteen patients were followed up for 8-96 months, of which 12 survived and 3 died after recurrence and/or metastasis.Conclusion:CM has no specific clinical clinical manifestations, and he diagnosis depends on histological morphology and immunohistochemical staining.

The Singapore Health Services cluster (SingHealth) radiology film archives are a valuable repository of local radiological cases dating back to the 1950s. Some of the cases in the archives are of historical medical interest, i.e. cerebral angiography in the workup of patients with hemiplegia. Other cases are of historical social interest, being conditions seen during earlier stages of Singapore's development, i.e. bound feet. The archives form a unique portal into the development of local radiology as well as the national development of Singapore. A selection from the archives is published in commemoration of the International Day of Radiology in 2020, as well as the 200th anniversary of the Singapore General Hospital in 2021. This pictorial essay comprises gastroenterology, musculoskeletal and obstetrics and gynaecology cases from the archives.

Objective:To investigate the effect of fibrinogenase combined with aspirin on blood viscosity and clinical efficacy in patients with acute cerebral infarction.Methods:Senventy patients with mild to moderate acute cerebral infarction from October 2016 to June 2020 were collected from the Third People′s Hospital of Dalian. Patients were divided into control group and treatment group according to the random number table method, with 35 cases in each group. The control group was given oral aspirin plus an intravenous drip of normal saline equal to the treatment group, while the treatment group was given aspirin plus fibrinogenase by intravenous drip. Both groups were given symptomatic treatment such as management of blood glucose, blood pressure, arteriosclerosis plaque stabilization and improvement of circulation for 10 d. Blood viscosity and neurological deficit score were measured before and after treatment.Results:Compared with baseline values, WBV showed a slight decrease in all shear rates in the control group after treatment compared with that before treatment, but the difference was not statistically significant ( P>0.05). In the treatment group, all shear rates decreased compared with that before treatment ( P<0.05), and the effect of WBV was significant compared with that of the control group ( P<0.05). The improvement of neurological function in the treatment group was better than that in the control group. The significant efficiency and the total effective rate in the treatment group were significantly higher than those in the control group: 34.3% (12/35) vs. 25.7% (9/35), 88.6% (31/35) vs.71.4% (25/35). Conclusions:Fibrinogenase combined with aspirin in the treatment of acute cerebral infarction patients can safely and effectively reduce blood viscosity and improve clinical symptoms.

The Singapore Health Services cluster (SingHealth) radiology film archives are a valuable repository of local radiological cases dating back to the 1950s. Some of the cases in the archives are of historical medical interest, i.e. cerebral angiography in the workup of patients with hemiplegia. Other cases are of historical social interest, being conditions seen during earlier stages of Singapore's development, i.e. bound feet. The archives form a unique portal into the development of local radiology as well as the national development of Singapore. A selection from the archives is published in 2020 in commemoration of the 20th anniversary of the formation of SingHealth, the 55th National Day of Singapore, and the 125th anniversary of the International Day of Radiology. This pictorial essay comprises cardiovascular, respiratory and neurological cases from the archives.

Lycophytes and seed plants constitute the typical vascular plants. Lycophytes have been thought to have no paleo-polyploidization although the event is known to be critical for the fast expansion of seed plants. Here, genomic analyses including the homologous gene dot plot analysis detected multiple paleo-polyploidization events, with one occurring approximately 13-15 million years ago (MYA) and another about 125-142 MYA, during the evolution of the genome of Selaginella moellendorffii, a model lycophyte. In addition, comparative analysis of reconstructed ancestral genomes of lycophytes and angiosperms suggested that lycophytes were affected by more paleo-polyploidization events than seed plants. Results from the present genomic analyses indicate that paleo-polyploidization has contributed to the successful establishment of both lineages-lycophytes and seed plants-of vascular plants.
Evolution, Molecular ; Genome, Plant ; Genomics ; Phylogeny ; Polyploidy ; Selaginellaceae/genetics*

OBJECTIVETo explore the impact of plasma homocysteinemia(Hcy) on contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients.

METHODSConsecutive 684 ACS patients undergoing first PCI in our department between January 2013 and December 2014 were prospectively enrolled.Patients were divided into 2 groups according to the pre-procedural plasma Hcy level: high-Hcy group (Hcy≥10 μmol/L, n=404) and control group (Hcy<10 μmol/L, n=280). The CIN was defined as serum creatinine ≥ 44.2 μmol/L or 25% increase compared to baseline within 48-72 h after PCI.The baseline clinical data and the ratio of CIN were compared between the 2 groups.Multivariate logistic regression analysis was used to define the independent risk factors for CIN.

RESULTSCIN occurred in 133(19.4%) out of 684 enrolled patients, and the incidence of CIN was significantly higher in high Hcy group than in the control group (22.0%(89/404)vs. 15.7%(44/280), P=0.040). After adjusting the confounding factors, including age, acute myocardial infarction, co-morbidities(hypertension, diabetes mellitus, and old myocardial infarction), laboratory examination (level of cystatin C and uric acid), glomerular filtration rate, left ventricular ejection fraction, angiographic and procedural characteristics (3 diseased vessels, multiple stent implantation), treatment at admission (spironolactone, digoxin), multivariate logistic regression analysis showed that high Hcy was independently associated with the development of CIN (OR=1.70, 95%CI 1.60-2.64, P=0.021).

CONCLUSIONElevated Hcy prior PCI is an independent risk factor of CIN in ACS patients undergoing first PCI.

Acute Coronary Syndrome ; Diabetes Mellitus ; Glomerular Filtration Rate ; Humans ; Hyperhomocysteinemia ; Incidence ; Kidney Diseases ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Risk Factors ; Ventricular Function, Left