The application of artificial intelligence （AI） in the medical field has significantly improved medical efficiency， yet it has also posed numerous ethical challenges. From the perspective of traditional Confucianism， this paper explored ethical challenges faced in the application of medical AI and the responses of Confucianism， elaborating on the importance of Confucianism in achieving value alignment. This paper analyzed the ethical dilemmas faced by medical AI in practical applications from four aspects， including the doctor-patient trust crisis， patient safety issues， fairness and conflict of interest， and challenges of responsibility attribution. It also explored the application of Confucianism in the ethical governance of medical AI， focusing on the analysis of how “benevolence，”“righteousness，” and role ethics deal with issues such as doctor-patient trust， patient safety， fairness， market profit-seeking， and responsibility allocation. By emphasizing the guiding role of ethical principles in technological development through the principle of “governing technology with ethics，” the achievement of the value alignment goal in medical AI can be promoted. Confucianism provides an important ethical foundation for the value alignment of medical AI. Its core concepts run through the deep integration of technology and ethics， offering unique cultural wisdom and practical solutions for AI governance on a global scale.

OBJECTIVES: To analyze sex and age distribution of global disease burden of calcific aortic valve disease (CAVD) from 1990 to 2021. METHODS: CAVD data during 1990-2021 were obtained from the IHME website for Global Burden of Disease (GBD). The prevalence, mortality, years lived with disability (YLDs), and disability-adjusted life years (DALYs) were analyzed by gender and age groups. Joinpoint regression was used to calculate annual percentage change (APC) and average annual percentage change (AAPC). RESULTS: In 2021, there were 13.32 million CAVD patients and 142 000 deaths caused by CAVD globally. Age-standardized prevalence was higher in males (193.2/10⁵) than that in females (128.9/10⁵). Patients in 65-<85 age group accounted for 64.0% of total cases, while those ≥85 years old accounted for 16.1%. From 1990 to 2021, prevalence increased in both sexes with an AAPC of 0.72% for males and 0.57% for females, respectively. Prevalence grew fastest from 2000 to 2010, slowed thereafter, and declined from 2015 to 2021. In <65 years old, the mortality of males was 2.4 times higher than that of females, while in ≥85 years old, mortality of females (117.3/10⁵) exceeded that of males (99.1/10⁵). YLD rates increased with age, and were higher in males for all age groups. DALY rates decreased overall but increased in ≥85 years old, with a greater increase in females. CONCLUSIONS There are significant gender and age disparities in global disease burden of CAVD, with the elderly, especially super-elderly females deserving particular attention. It is recommended to develop personalized intervention strategies for these populations.
Humans ; Male ; Female ; Aged ; Calcinosis/mortality* ; Prevalence ; Global Burden of Disease ; Aged, 80 and over ; Middle Aged ; Aortic Valve/pathology* ; Aortic Valve Stenosis/epidemiology* ; Age Distribution ; Adult ; Disability-Adjusted Life Years ; Sex Distribution ; Global Health ; Aortic Valve Disease/epidemiology* ; Sex Factors

OBJECTIVE: To assess the practical and health economical values of non-invasive prenatal test (NIPT) in Changsha Municipal Public Welfare Program. METHODS: A retrospective analysis was carried out on 149 165 women undergoing NIPT test from April 9, 2018 to December 31, 2019. For pregnant women with high risks, invasive prenatal diagnosis and follow-up of pregnancy outcome were conducted. The cost-benefit of NIPT for Down syndrome was analyzed. RESULTS: NIPT was carried out for 149 165 pregnant women and succeeded in 148 749 cases (99.72%), for which outcome were available in 148 538 (99.86%). 90% of pregnant women from the region accepted the screening with NIPT. 415 (0.27%) were diagnosed as high risk. Among these, 381 (91.81%) accepted amniocentesis, which led to the diagnosis of 212 cases of trisomy 21 (PPV=85.14%), 41 cases with trisomy 18 (PPV=48.81%) and 10 cases with trisomy 13 (PPV=20.83%). The sensitivity and specificity of NIPT for trisomy 21, trisomy 18 and trisomy 13 were (97.70%, 99.98%), (97.62%, 9.97%) and (100%, 99.97%), respectively. In addition, 213 and 30 cases were diagnosed with sex chromosomal aneuploidies (PPV=46.2%) and other autosomal anomalies (PPV=16.57%), respectively. For Down syndrome screening, the cost and benefit of the project was 120.79 million yuan and 1,056.95 million yuan, respectively. The cost-benefit ratio was 1: 8.75, and safety index was 0.0035. CONCLUSION NIPT is a highly accurate screening test for trisomy 21, which was followed by trisomy 18 and sex chromosomal aneuploidies, while it was less accurate for other autosomal aneuploidies. The application of NIPT screening has a high health economical value.
Aneuploidy ; Cost-Benefit Analysis ; Female ; Humans ; Noninvasive Prenatal Testing ; Pregnancy ; Retrospective Studies ; Trisomy 18 Syndrome/genetics*

Objective To investigate the compliance of follow-up and the associated factors of diabetic retinopathy screening among diabetes patients in Muping District,Yantai City.Methods 438 diabetes patients who received free diabetic retinopathy (DR) screening in Traditional Chinese Medicine Hospital of Muping District of Yantai City from April 2012 to June 2013 were enrolled in the cross-sectional study.The re-examination rate at five years later,as well as the possible associated factors,including age,gender,height,weight,education level,occupation,past medical history,smoking and drinking habits,diabetes process,diabetes medication history,severity of DR,glycosylated hemoglobin (HbA1 c),renal functionand blood lipid were analyzed and evaluated.Results Among 438 patients,159 returned for check up five years later,with a follow-up rate of 36.3％.Further analysis revealed that follow-up rate was related to occupation types (P =0.003) and HbAlc level (P =0.006).Other factors did not show statistical significance (P ＞ 0.05).Conclusions The compliance of DR screening visits is related to occupational type and blood glucose control.It is suggested that in the screening of DR in China,we should pay attention to the propaganda and education of diabetic patients to control blood glucose,and focus on some occupational diabetes people,such as housework workers and farmers.

Three-electrode testing method was used to investigate the effect of temperature on electrode impedance, and the pH shifts in saline solution resulting from the electrical stimulation were also determined. Experiments in PBS (phosphate buffered solution) solution showed that the electrode impedance was almost invariable at the human body temperature range (35 degrees C-40 degrees C). And the experiments in unbuffered saline solution showed that pH shifts decreased from 0.03 to 0.005 when the frequency of biphasic charged-balanced pulses increased from 1 Hz to 100 Hz. Even stimulated by monophasic pulses (frequency is 15 Hz, amplitude is 50 microA), the stimulus-induced pH shift of electrode only varies 0.15 (anodic pulse current increased 0.15 and cathodic pulse current decreased 0.15).
Electrochemistry ; Eye, Artificial ; Materials Testing ; Microelectrodes ; Prostheses and Implants

The paper proposed a new method to design and fabricate a flexible neural microelectrode arrays (MEA) for retinal prosthesis, the ion-beam technology was introduced to decrease the width of conductive wires and the distances between wires, a high density MEA (120 microelectrodes with a matrix of 10 x 12) was fabricated on a single layer of polymer from this. The MEA was proved to possess a fine electrochemical property. In vitro test, the average impedance of MEA on 1 kHz was 16 k omega +/- 2 k omega and the average phase difference was -85 degrees +/-30 degrees.
Micro-Electrical-Mechanical Systems ; Microelectrodes ; Prosthesis Design ; Visual Prosthesis

The paper proposed a new method to design and fabricate a flexible neural microelectrode arrays(MEA) for retinal prosthesis, the Ion-Beam technology was intruduced to decrease the width of conductive wires and the distances between wires, a high density MEA(120 microelectrodes with a matrix of 10×12) was fabricated on a single layer of polymer from this. The MEA was proved to possess a fine electrochemical property. In vitro test, the average impedance of MEA on 1 kHz was 16 kΩ±2 kΩand the average phase difference was-85o±3o.

This paper proposed a new design on multi-layer flexible microelectrode arrays (MEA) of epiretinal prosthesis, as well as a set of automatic testing system to evaluate and analyze the MEA. Experiment results showed that the MEA was satisfying on both flexibility and impedance and the multi-layer design didn't introduce significant differences.
Microarray Analysis ; Microelectrodes ; Prostheses and Implants ; Prosthesis Design ; Prosthesis Implantation ; instrumentation ; Retina

This review paper presents the current research progress, challenges and future development on microelectrode array of retinal prosthesis, including epi-retinal and sub-retinal implants.
Microelectrodes ; Prosthesis Design ; Visual Prosthesis

AIM: To explore the therapeutic effects of flunarizine combined with aspirin in the treatment of migrainous cerebral infaction. METHODS: 38 cases of patients diagnosed as migrainous cerebral infaction were respectively given flunarizine 10 mg combined with aspirin 100 mg every night for a month. The observed indices included the dysfunction scores of nervous system, the total classes of living ability, and the accumulating rate of platelet and viscosity of plasma before and after the treatment. RESULTS: Before the treatment the dysfunction scores of nervous system and the living ability of the patients were 13.51 ? 4.78 and 3.45 ? 1.13 , and after the treatment the values were 4.34 ? 1.85 and 1.79 ? 0.72 respectively (P