Medical artificial intelligence （AI） is a new type of application formed by the combination of machine learning， computer vision， natural language processing， and other technologies with clinical medical treatment. With the continuous iteration and development of relevant technologies， medical AI has shown great potential in improving the efficiency of diagnosis and treatment， and service quality， but it also increases the possibility of triggering ethical issues. Ethical issues resulting from the clinical application of medical AI were analyzed， including the lack of algorithmic interpretability and transparency of medical AI， leading to information asymmetry and cognitive discrepancies； the concerning status of security and privacy protection of medical data； and the complex and unclear division of responsibilities due to the collaborative participation of multiple subjects in the clinical application of medical AI， resulting in increased difficulty in the identification of medical accidents and clarification of responsibilities. The paper proposed the principles of not harming patients’ interests， physician’s subjectivity， fairness and inclusiveness， and rapid response. It also explored the strategies and implementation paths for responding to the ethical issues of medical AI from multiple perspectives， including standardizing the environment and processes， clarifying responsibility attribution， continuously assessing the impact of data protection， guaranteeing data security， ensuring model transparency and interpretability， carrying out multi-subject collaboration， as well as the principles of being driven by ethical values and adhering to the “human health-centeredness.” It aimed to provide guidance for the healthy development of medical AI， ensuring technological progress while effectively managing and mitigating accompanying ethical risks， thereby promoting the benign development of medical AI technology and better serving the healthcare industry and patients.

In order to integrate clinical data, image data, and omics data scattered across different systems, and effectively support clinical research based on real-world data, a hospital has integrated Hadoop big data processing technology with distributed parallel database technology to build a data storage and calculation system that integrates lakes and warehouses. Through the integration of 15 medical information system data, data governance based on patient master indexes, and the design and development of an application platform that covered 8 major functions and integrated general scientific research and specialized disease applications, the hospital has built an integrated scientific research big data platform, which included 3.3 billion pieces of data from 20.26 million patients and 98.57 million visits, and has built 3 specialized disease databases. From January to August 2024, it has supported data extraction and analysis for 35 research projects, reducing traditional code-based data retrieval time from 5-45 workdays to several hours or even minutes, significantly enhancing the efficiency of clinical research.

In order to integrate clinical data, image data, and omics data scattered across different systems, and effectively support clinical research based on real-world data, a hospital has integrated Hadoop big data processing technology with distributed parallel database technology to build a data storage and calculation system that integrates lakes and warehouses. Through the integration of 15 medical information system data, data governance based on patient master indexes, and the design and development of an application platform that covered 8 major functions and integrated general scientific research and specialized disease applications, the hospital has built an integrated scientific research big data platform, which included 3.3 billion pieces of data from 20.26 million patients and 98.57 million visits, and has built 3 specialized disease databases. From January to August 2024, it has supported data extraction and analysis for 35 research projects, reducing traditional code-based data retrieval time from 5-45 workdays to several hours or even minutes, significantly enhancing the efficiency of clinical research.

Purpose/Significance To analyze the satisfaction,service effectiveness and willingness to participate in telemedicine services from the perspective of medical staff,and to identify the existing problems.Method/Process The research group conducts an e-lectronic questionnaire survey for medical institutions across the country,and collects a total of 1 524 valid questionnaires.Based on questionnaire survey data,logistic regression models are constructed to analyze the key factors that affect the evaluation and attitude of medical staff.Result/Conclusion The overall satisfaction and service effectiveness of medical staff to telemedicine services are at a high level,and their willingness to participate is strong.It is necessary to improve the telemedicine service system and promote the experience of medical staff by strengthening infrastructure construction,optimizing service process,and perfecting incentive mechanisms.

Objective:To evaluate the risk factors for prognosis of primary intussusception treated by enema reduction in children.Methods:A retrospective analysis of 519 patients with primary intussusception in Anhui Provincial Children′s Hospital from January 2017 to December 2020 was performed. Among the 519 patients, there were 346 males and 173 females. The median age was 15 months, with a range of 3 to 69 months, some basic information was collected. Patients were divided into bad prognosis group ( n=71) and good prognosis group ( n=448) according to prognosis.Propensity score matching (PSM) was conducted to reduce confounding bias between the groups. Conditional logistic regression were used to analysis the risk factors of primary intussusception treated by enema reduction. Results:There were 71 cases of poor prognosis among 519 primary intussusception patients, incidence was 13.7%.Before PSM, there was significant difference in 6 covariates, including gender, age, duration of symptoms, bloody stool, diarrhoea and fever between two group ( P<0.05). There was no significant difference in abdominal pain and vomit between two group ( P>0.05). With propensity score matching, 69 pairs of patients were sucessfully matched. After PSM, distribution of the above covariates reached equilibrium between two groups ( P>0.05). There were statistically significant differences in enema reduction, mass location, seroperitoneum, lactic acid and overweight/obese between the two groups ( P<0.05). Conditional logistic regression analysis confirmed that enema reduction( OR=3.478, 95% CI: 1.150-10.517, P=0.027), mass location ( OR=6.596, 95% CI: 1.669-26.056, P=0.007), lactic acid( OR=1.012, 95% CI: 1.003-1.021, P=0.010), overweight/obese ( OR=6.085, 95% CI: 1.650-22.436, P=0.007) were independent factors for predicting prognosis of primary intussusception treated by enema reduction. Conclusions:AER, mass located left hemicolon, elevated lactic acid and overweight/obese were independent risk factors for poor prognosis of primary intussusception treated by enema reduction.

Objective: To observe influence of enalapril maleate and folic acid tablet (EFA) on blood pressure and blood glucose levels in patients with H-type hypertension (HTH) complicated diabetes mellitus (DM).Methods: According to random number table, a total of 300 HTH + DM patients were equally divided into enalapril group, amlodipine group and EFA group.Levels of blood pressure, plasma homocysteine (Hcy), carotid intima-media thickness (CIMT), fasting plasma glucose (FPG), 2h postprandial glucose (2hPG), fasting insulin (FINS), 2h postprandial insulin (2hPINS) were measured and compared among three groups before, and one, 12 and 24 months after treatment.All patients were followed up for two years, incidence rates of cardiovascular and cerebrovascular events were compared among three groups.Results: Compared with enalapril group and amlodipine group on 24 months after treatment, there were significant reductions in levels of SBP[(134.65±7.25) mmHg, (136.00±8.62) mmHg vs.(128.62±5.00) mmHg], DBP[(84.79±4.26) mmHg, (88.47±7.25) mmHg vs.(74.29±5.06) mmHg], plasma Hcy[(11.18±5.21)μmol/L , (30.29±5.62)μmol/L vs.(9.72±2.47)μmol/L], CIMT[(1.30±0.19) mm, (1.46±0.37) mm vs.(0.95±0.38) mm], 2hPG[(12.50±1.70)mmol/L, (12.90±1.90)mmol/L vs.(9.50±1.00)mmol/L]and 2hPINS[(71.38±17.63)μU/ml, (78.42±21.49)μU/ml vs.(61.28±18.14)μU/ml], P<0.05 or <0.01.After two-year follow-up, compared with enalapril group and amlodipine group on 24 months after treatment, there was significant reductions in incidence rates of cerebrovascular events (11%, 23% vs.0) and cardiovascular events (2%, 11% vs.0) in EFA group, P<0.01 all.Conclusion: EFA tablets can significantly reduce blood pressure, blood glucose and Hcy level and effectively delay atherosclerosis progression in HTH+DM patients,its safety is good, which is worth extending.

Objective To evaluate the diagnostic value of magnetic resonance enterography(MRE)and ectopic gastric mucosa imaging(EGMI)in children with lower gastrointestinal hemorrhage.Methods The clinical data including gender,age,amount of bleeding and preoperative minimum hemoglobin(Hb)levels of 54 children with lower gastrointestinal hemorrhage were collected,who received surgical exploration in Department of Pediatric Surgery,Anhui Provincial Children's Hospital between February 2014 and April 2016.Children were divided into lesion group and non-lesion group according to the findings of surgical exploration.Lesion group were defined as children with Meckel's diverticulum(MD)or duplication of the small intestine by surgery and postoperative pathological findings.A total of 36 cases,25 cases of boys,11 cases of girls,aged(2.86±1.59)years old.Non-lesion group were defined as children,who underwent operation with negative result or with lesions but not MD or duplication of the small intestine.A total of 18 cases,14 cases of boys,4 cases of girls,aged(3.87±1.62)years old.MRE and EGMI were performed when the children stopped bleeding,before the inspection,should fasting for 4-6 h.SPSS 13.0 software was used for statistical processing.The evaluation of EGMI,MRE and the both in diagnosing MD or duplication of the small intestine were conducted by receiver operating characteristic curve(ROC).According to the principles of biggest gain best diagnostic value by Youden index,and the degree of sensitivity and specificity was calculated at this time,P<0.05 for the difference was statistically significant.Results There was no significant differences statistically in gender between 2 groups(x2=0.415,P>0.05).There were statistically significant differences in age,amount of bleeding and preoperative minimum hemoglobin levels(t=2.179,2.027,2.222,all P<0.05).There were statistically significant differences in classification comparison by EGMI and MRE between 2 groups(x2=15.226,29.121,all P<0.01).The optimal cut-off value of EGMI and MRE in the diagnosis of enteric malformation was more than level 3,and the suspected positive and being positive value was assigned as positive results.According to the cut-off value above,EGMI,MRE and EGMI plus MRE in series and in parallel in the diagnosis of enteric malformation,the areas under curves(AUC)were 0.809,0.917,0.750 and 0.847,respectively.The sensitivity was 61.1％,75.0％,55.6％and 80.6％,respectively.The specificity was 90.4％,94.4％,94.4％and 88.9％,respectively.The Youden's indexes were 0.515,0.694,0.500 and 0.695,respectively.The optimal cut-off value of age and preoperative minimum hemoglobin levels in the diagnosis of enteric malformation were 2.92 years and 80 g/L,respectively.The AUC was 0.761 and 0.672.The Youden's indexes were 0.515 and 0.333.There was no significant differences statistically in AUC compared with age,MRE and EGMI(all P<0.05).Conclusions The high diagnostic value in children with lower gastrointestinal hemorrhage is found by using MRE and EGMI.Then,MRE as a separate diagnosis method is also worthy of clinical application.

Purpose To characterize normal growth of the fetal fourth ventricle in the second trimester of pregnancy by standardized ultrasonography.Materials and Methods 516 cases of pregnant women with single fetus aged 18-27 weeks and 6 days were examined by conventional ultrasound.At the standard section of the fourth ventricle,the transverse dimension,anteroposterior dimension,circumference and area of the fourth ventricle were measured.Results The display rate of the fourth ventricles of fetuses aged 18-27 weeks and 6 days was up to 100％.There were no significant differences in the values of the fourth ventricles between fetuses with different gender (P＞0.05).The values of the fourth ventricle,including transverse dimension,anteroposterior dimension,circumference and area,increased linearly with the increase of gestational age,and there were positive correlations (r=0.374,0.378,0.387,0.379,P＜0.05).Conclusion The normal size of the fourth ventricle can be obtained by standardized measurement,which can be used as a reference for the clinical evaluation of the size of the fourth ventricle.

Objective To evaluate methods of OP mesh spreading in preperitoneal tension-free repair of inguinal hernia via open anterior approach.Methods The clinical data of 1 528 cases underwent preperitoneal tension-free repair of inguinal hernia via open anterior approach from March 2012 to April 2015 was analyzed retrospectively.The methods of mesh crimp spreading, pectineal ligament suture fixation, pubic tubercle suture fixation and auxiliary support were used.Results The mesh crimp spreading method was used in 1 021 cases, pectineal ligament suture fixation method was used in 64 cases, pubic tubercle suture fixation method was used in 48 cases, auxiliary support method was used in 395 cases.Meshes were all well spreaded.Conclusions The four methods of mesh spreading are effective, simple, convenient and easy to use in preperitoneal tension-free repair of inguinal hernia via open anterior approach.

Occupational therapy is an important part of rehabilitation medicine. There is movement, feel, swallowing, speech, vision,cognitive, psychological and social relations dysfunction in stroke patients. Occupational therapy play an important part in the whole processof intervention for stroke patients, and help them improve their quality of life.