As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

Objective The histological grade of breast cancer is closely related with the treatment and prognosis of the malignancy, and radiomics plays a valuable role in the identification of its grade. This article aimed to investigate the values of the conventional parameters of breast MRI and breast MRI-based imaging features in the histological grading of breast invasive ductal carcinoma (IDC).Methods This retrospective study included 71 cases of breast cancer treated in our hospital from June 2015 to June 2016. We obtained the traditional quantitative parameters of MRI, including the apparent diffusion coefficient (ADC) and initial enhancement rate (IER), performed manual segmentation of the ADC and DCE maps, extracted the radiomic features and analyzed the differences in the radiomic signatures between low- and high-grade IDC. Using logistic regression analysis, we assessed the values of ADC and IER and the radiomic signatures of the ADC and DCE images in differentiating low-grade from high-grade IDC.Results The values of ADC, B_sum_variance, L_SRE and R_RP were significantly lower (P<0.05) while those of B_uniform, B_GLN, L_energy, R_homogeneity 2 and R_IDN remarkably higher in the high-grade than in the low-grade IDC patients (P<0.05), but no statistically significant difference was observed in the IER value between the two groups (P>0.05). In differentiating high-grade from low-grade IDC, the ADC image-based radiomic signature model achieved a significantly higher AUC (0.858 [0.774-0.924]) than the ADC (0.709 [0.588-0.830]) and DCE model (0.691 [0.565-0.818]), and the former also manifested markedly higher accuracy, specificity, and rates of positive and negative prediction than the latter two.Conclusion ADC- and MRI-based radiomic features play a valuable role in differentiating high-grade from low-grade IDC, particularly the former, which could provide even more clinical information, while IER is of little value in this aspect.

OBJECTIVETo evaluate the diagnostic value of mammography, computed tomography (CT), and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for axillary lymph node staging in breast cancer patients.

METHODSFrom February, 2014 to October, 2015, 109 women with breast cancer received examinations with preoperative mamography, CT, and DCE-MRI. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the 3 modalities were evaluated using histopathologic assessments as the gold standard.

RESULTSIn total, 39.4% (43/109) of the patients had axillary lymph node metastasis. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of mamography for determining lymph node metastasis were 14.0%, 84.8%, 56.9%, 37.5% and 60.0%, respectively; those of CT were 93.0%, 57.6%, 71.6%,58.8% and 92.7%, and those of DCE-MRI were 95.3%, 65.2%, 77.1%, 64.1% and 95.6%, respectively. Compared with the histopathologic result, the Kappa coefficients of mamography, CT, and DCE-MRI were -0.13, 0.459 and 0.558, respectively. The specificity of mamography was significantly higher (P<0.05), but its sensitivity, accuracy, positive predictive value, and negative predictive value were significantly lower than those of CT and DCE-MRI (P<0.05). Compared with CT, DCE-MRI had significantly higher sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for diagnosis of lymph node metastasis (P<0.05).

CONCLUSIONDCE-MRI has a greater diagnostic power than CT and mammography, and CT has a greater diagnostic power than mammography for axillary lymph node metastasis in breast cancer patients. Mamography alone should be used cautiously for the diagnosis of lymph node metastasis.

Axilla ; Breast Neoplasms ; pathology ; Female ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; diagnosis ; Magnetic Resonance Imaging ; Mammography ; Predictive Value of Tests ; Sensitivity and Specificity ; Tomography, X-Ray Computed

Derris eriocarpa, a traditional Chinese medicine belonging to the family of Leguminosae, is widely distributed mainly over Yunnan, Guangxi and Guizhou of China. Modern pharmacological researches on this herb showed that it had extensive bioactivities, such as promoting urination, removing dampness and cough and reducing inspissated mucus and other biological activities. The extensive studies on the chemical constituents of this plant have resulted in the isolation of triterpenoids, steroids, fatty acid and others, but the flavone compounds haven't reported before. In our further research on the ethyl acetate of this plant, nine flavone compounds were obtained by column chromatography on silica gel, Sephadex LH-20, semi-prep HPLC, polyamide column chromatography and recrystallization for separation and purification. The structures were determined on the basis of extensive spectroscopic analysis, including MS, NMR experiments and comparison with spectroscopic data in the literature, respectively, as diosmetin (1), 3, 3'-di-O-methylquercetin (2), afromosin (3), 6, 3'-dihydroxy-7, 4'-dimethoxyisoflavone (4), odoratin (5), 7, 3'-dihydroxy-8, 4'-dimethoxyisoflavone (6), 6, 4'-dihydroxy-7, 3'-dimethoxyisoflavone (7), 5, 7, 4'-trihydroxy-3, 3', 5'-trimethoxyflavone (8), and alpinumisoflavone (9). All these compounds were isolated from Derris eriocarpa How for the first time. And the in vitro assays showed that compound 2 possessed moderate inhibitory activity against human cancer cells K562 and HEL.
Derris ; chemistry ; Flavonoids ; chemistry ; isolation & purification ; pharmacology ; Humans ; K562 Cells

Objective To investigate the efficacy, safety and tolerance of bosentan, a dual endothelin receptor antagonist, in Chinese patients with idiopathic pulmonary arterial hypertension (IPAH).Methods Totally 79 IPAH patients (hemodynamic criteria confirmed by right heart catheterization) were included in this open-label, prospective multicenter study. Patients received 62. 5 mg of bosentan twice daily for the first 4 weeks, and then up-titrated to 125 mg twice daily for another 12 weeks. The primary end point was the change in exercise capacity showed by six-minute walk distance (6MWD) from baseline to 16 weeks. Secondary end points included the change in World Health Organization (WHO) functional class,Borg dyspnoea scale and systolic pulmonary artery pressure measured by echocardiography. Results The 6MWD increased from (343. 7 ± 93.7) meters at baseline to (397.5 ± 104. 4) meters after 16 weeks ( P ＜0. 01 ), WHO functional class and Borg dyspnoea scale were also significantly improved after 16 weeks therapy compared to baseline levels (all P ＜0. 01 ). Furthermore, the systolic pulmonary artery pressure was significantly decreased from (97.8±25.2) mm Hg (1 mm Hg=0. 133 kPa) to (92.8 ±29.5) mm Hg (P ＜0. 05) after 16 weeks bosentan treatment. There was no patient withdrawal from this study for safety consideration. Conclusion Bosentan therapy is well tolerated and can improve the exercise capacity and WHO functional class in Chinese IPAH patients.

The objective of this study was to elevate the tumorigenic rate of animal model with thymic lymphoma induced by N-methyl-N-nitrosourea (MNU) and to reduce the mortality of this mouse model. The injection regimen and experimental cycle were improved on the basis of previous experiments. The male and female C57BL/6 mice were injected by the intraperitoneal route with MNU solution at different dosages in the first week and the 4th week respectively. Following injection of MNU, the general features of the mice were observed. All mice were sacrificed for autopsy before the 24th experimental week. Complete gross examination was performed for detection of tumor masses. The pathologic and immunohistochemical methods were used to identify the origin and subtype classification of the neoplasm. The results showed that at the 25th week the incidence of thymic lymphoma in mice injected with MNU was 83.3% (55/66), the mortality was 7.6%. In conclusion, improving the program and changing the experimental cycle can increase the tumorigenic rate in the mouse model induced by MNU from 67.5% to 83.3% and reduce the mortality from 10% to 7.6%.
Animals ; Female ; Lymphoma ; chemically induced ; Male ; Methylnitrosourea ; adverse effects ; Mice ; Mice, Inbred C57BL ; Neoplasms, Experimental ; chemically induced ; Thymus Neoplasms ; chemically induced

Adenoviridae ; genetics ; Animals ; Carcinoma, Hepatocellular ; pathology ; Doxorubicin ; pharmacology ; Genetic Therapy ; Interleukins ; genetics ; Liver Neoplasms ; pathology ; Male ; Mice ; Mice, Inbred BALB C ; Neoplasm Transplantation ; pathology