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.

Objective:To explore the research hotspots and effective promotion paths of post market surveillance and supervise of medical consumables with non-active medical devices.Methods:Data mining methods were used to collect related journal literatures and documents from the websites of China regulatory institutions and the China National Knowledge Infrastructure(CNKI),order sub item data of medical device adverse event reports,extract the MeSH element words of literatures and documents,perform bibliometric analysis and visual display.Results:The number of medical devices adverse event reports in China has been increasing year by year,reaching 694 866 in 2022,in the four statistical years from 2019 to 2022,the number of reports on non-active medical devices and IVD reagents also showed a parallel increasing trend,accounting for about 65.00% of the total number of adverse event reports on medical devices in the year.The bibliometric analysis of journal literature shows that research in this field has received varying degrees of participation from regulatory institutions,universities,medical institutions,and enterprises.Regulatory institutions have contributed 46 articles,accounting for 56.79% of the total number of articles,followed by 28 articles from universities.The co-occurrence analysis shows that hot topic is focused in 5 clusters:quality management,risk management,international experiences discussion and adverse event surveillance and re-evaluation and real-world research.China regulatory institutions attach great importance to post market surveillance and supervise,and have issued more than 20 relevant documents since 2006,focusing on specific topics and gradually deepening around safety and effectiveness.Conclusion:The post market surveillance and supervise of medical devices,especially medical consumables based on non-active medical devices,need to be promoted synchronously in three dimensions:regulatory institutions,medical institutions,and enterprises.Universities,research institutes,and industry organizations should work in coordinating to strengthen the collection,identification,and active surveillance of risk signals based on adverse event surveillance,safety evaluation based on risk management,and conducting real-world research,research and develop risk control and corrective and preventive measures.

Objective:To explore the risk factors of insomnia among employees in the thermal power generation industry and the network relationships between their interactions, and to provide scientific basis for personalized interventions for high-risk groups with insomnia.Methods:In November 2022, 860 employees of a typical thermal power generation enterprise were selected as the research subjects by cluster sampling. On-site occupational health field surveys and questionnaire surveys were used to collect basic information, occupational characteristics, anxiety, depression, stress, occupational stress, and insomnia. The interaction between insomnia and occupational health psychological factors was evaluated by using structural equation model analysis and Bayesian network construction.Results:The detection rates of anxiety, depression and stress were 34.0% (292/860), 32.1% (276/860) and 18.0% (155/860), respectively. The total score of occupational stress was (445.3±49.9) points, and 160 workers (18.6%) were suspected of insomnia, and 578 workers (67.2%) had insomnia. Structural equation model analysis showed that occupational stress had a significant effect on the occurrence of insomnia in thermal power generation workers (standardized load coefficient was 0.644), and occupational health psychology had a low effect on insomnia (standardized load coefficient was 0.065). However, the Bayesian network model further analysis found that anxiety and stress were the two parent nodes of insomnia, with direct causal relationships, the arc strength was-8.607 and -15.665, respectively. The model prediction results showed that the probability of insomnia occurring was predicted to be 0 in the cases of no stress and anxiety, low stress without anxiety, and no stress with low anxiety. When high stress with low anxiety and low stress with high anxiety occurred, the predicted probability of insomnia occurring were 0.38 and 0.47, respectively. When both high stress and high anxiety occurred simultaneously, the predicted probability of insomnia occurring was 0.51.Conclusion:Bayesian network risk assessment can intuitively reveal and predict the insomnia risk of thermal power generation workers and the network interaction relationship between the risks. Anxiety and stress are the direct causal risks of insomnia, and stress is the main risk of individual insomnia of thermal power generation workers. The occurrence of insomnia can be reduced based on scientific intervention of stress conditions.

Objective:To understand the monkeypox knowledge awareness, risk perception and vaccination intention in men who have sex with men (MSM) in five cities in northeast China.Methods:A cross-sectional study was conducted by using electronic questionnaire in MSM selected by convenience sampling in five cities in northeast China (Shenyang, Panjin, Changchun, Harbin and Jiamusi) from June 28 to July 8, 2023 by local centers for disease control and prevention and MSM communities. The sample size was estimated to be 220. Information about their demographics, monkeypox-related knowledge awareness, perceived concern about epidemic risk perception, and monkeypox vaccination intention were collected. Logistic regression model was used to analyze related factors for MSM's monkeypox vaccination intention.Results:In 355 MSM, 63.9% (227/355) had monkeypox vaccination intentions, and 55.5% (197/355) had high awareness of monkeypox related knowledge with a mean knowledge awareness score of 3.7±1.5. MSM with education level of high-school and above (a OR=1.93, 95% CI:1.01-3.69), higher knowledge awareness score (a OR=1.19, 95% CI:1.02-1.40) and higher risk perception of monkeypox infection (a OR=1.82, 95% CI:1.15-2.88), were more willing to receive monkeypox vaccination. The main reasons for willingness to receive monkeypox vaccine were preventing monkeypox (86.3%, 196/227) and worrying about appearance being affected (62.1%, 141/227). The main reasons for unwillingness for the vaccination included concerns about vaccine safety (53.1%, 68/128), clinical progression of AIDS being affected (46.1%, 59/128) and efficacy of antiretroviral therapy being affected (44.5%, 57/128). Conclusions:The levels of knowledge awareness and vaccine intentions still need to be improved among MSM in five cities of northeast China. It is necessary to improve the awareness of monkeypox and intention of monkeypox vaccination, promote protected sex behavior and self-assessment of infection risk, reduce vaccine hesitancy and increase monkeypox vaccination intention in MSM in 5 cities in northeast China.

Objective:To explore the prognostic impact of different intracranial radiotherapy modalities in patients with a limited number (≤10) of brain metastases from small cell lung cancer (SCLC-BM).Methods:The data of 143 cases with SCLC-BM that received intracranial radiotherapy at the First Affiliated Hospital of Bengbu Medical University in 2019-2022 were analyzed. The patients were grouped by radiotherapy modalities: whole brain radiotherapy (WBRT, 58 cases), WBRT combined with simultaneous integrated boost (WBRT+ SIB, 53 cases), and WBRT combined with sequential integrated boost (WBRT+ SEB, 32 cases). The overall survival (OS) and intracranial progression-free survival (IPFS) were calculated using the Kaplan-Meier method, and the Cox proportional hazard model was used for prognostic analysis.Results:In the whole group, the median OS and IPFS were 11.9 and 9.9 months, and the 1-, 2-, and 3-year survival rates were 49.7%, 15.3%, and 2.9%, respectively. The difference in OS among patients in the WBRT+ SIB, WBRT+ SEB, and WBRT groups was not significant (median OS: 13.0 months vs. 12.5 months vs. 11.2 months, P>0.05). The WBRT+ SIB and WBRT+ SEB groups were preferred over the WBRT group in terms of IPFS (median IPFS: 11.7 months vs. 10.4 months vs. 8.1 months, χ2=21.69, P<0.001). For patients with few brain metastases (≤3) analyzed separately, the WBRT+ SIB and WBRT+ SEB groups were preferred over the WBRT group in terms of OS and IPFS (median OS: 14.4 months vs. 13.7 months vs. 11.5 months, χ2=8.72, P=0.013; median IPFS: 12.6 months vs. 10.4 months vs. 8.9 months, χ2=12.37, P=0.002). Evaluation of the central nervous system as well as hematological acute radiological reactions reaching grade 2 and above showed no significant differences among the three groups ( P>0.05). Multivariate analysis showed that subsequent chemotherapy, targeted therapy, and immunotherapy were common independent influencing factors for patients′ OS and IPFS. Body mass index (BMI) level was an independent influencing factor for patients′ OS, and the number of brain metastases, lymph node metastasis, and radiotherapy modality were independent influencing factors for patients′ IPFS. Conclusions:BMI level and subsequent treatment (chemotherapy, targeted therapy, and immunotherapy) are independent influencing factors for patients' prognosis. WBRT+ SIB and WBRT+ SEB modalities are associated with increased IPFS.

Objective:To explore the risk factors of insomnia among employees in the thermal power generation industry and the network relationships between their interactions, and to provide scientific basis for personalized interventions for high-risk groups with insomnia.Methods:In November 2022, 860 employees of a typical thermal power generation enterprise were selected as the research subjects by cluster sampling. On-site occupational health field surveys and questionnaire surveys were used to collect basic information, occupational characteristics, anxiety, depression, stress, occupational stress, and insomnia. The interaction between insomnia and occupational health psychological factors was evaluated by using structural equation model analysis and Bayesian network construction.Results:The detection rates of anxiety, depression and stress were 34.0% (292/860), 32.1% (276/860) and 18.0% (155/860), respectively. The total score of occupational stress was (445.3±49.9) points, and 160 workers (18.6%) were suspected of insomnia, and 578 workers (67.2%) had insomnia. Structural equation model analysis showed that occupational stress had a significant effect on the occurrence of insomnia in thermal power generation workers (standardized load coefficient was 0.644), and occupational health psychology had a low effect on insomnia (standardized load coefficient was 0.065). However, the Bayesian network model further analysis found that anxiety and stress were the two parent nodes of insomnia, with direct causal relationships, the arc strength was-8.607 and -15.665, respectively. The model prediction results showed that the probability of insomnia occurring was predicted to be 0 in the cases of no stress and anxiety, low stress without anxiety, and no stress with low anxiety. When high stress with low anxiety and low stress with high anxiety occurred, the predicted probability of insomnia occurring were 0.38 and 0.47, respectively. When both high stress and high anxiety occurred simultaneously, the predicted probability of insomnia occurring was 0.51.Conclusion:Bayesian network risk assessment can intuitively reveal and predict the insomnia risk of thermal power generation workers and the network interaction relationship between the risks. Anxiety and stress are the direct causal risks of insomnia, and stress is the main risk of individual insomnia of thermal power generation workers. The occurrence of insomnia can be reduced based on scientific intervention of stress conditions.

Purpose/Significance The paper analyzes the application of remote consultation in Henan province and the factors affect-ing service efficiency,optimizes service mode,and provides suggestions for the sound development of telemedicine.Method/Process The volume of remote consultation business,patient and doctor data,and consultation process data carried out through the regional tele-medicine integrated service platform in Henan province in 2022 are collected and sorted out.IBM SPSS 23.0 software is used to analyze the distribution of patients and business development of remote consultation,and factors affecting the efficiency of consultation are ana-lyzed through multiple logistic regression.Result/Conclusion The level of the hospital applying for remote consultation and the consulta-tion department affect the duration of the consultation process.The consultation department,expert titles,and referral suggestions are the main factors affecting the response time of consultation.It is suggested to optimize the service process of remote consultation,enhance the enthusiasm of doctors to participate in consultation,reduce the response time of consultation,and improve the efficiency of consultation.

Objective:To investigate the effect of melatonin on the expression of PD-L1 on the surface of ovarian cancer cells.Methods:Ovarian cancer cell line OVCAR3 was treated with melatonin,then flow cytometry was used to detect the expression level of PD-L1 on the surface of ovarian cancer cells.Western blot was used to detect the expressions of PD-L1 and LC-3 in ovarian cancer cells after different treatments.After adding autophagy inhibitor Autophinib,flow cytometry was used to detect the expression of PD-L1 on the surface of ovarian cancer cells,ovarian cancer cells were treated with melatonin or melatonin combined with autophagy inhibi-tors and co-incubated with human T lymphocyte Jurkat.The proportion of ovarian cancer cell apoptosis was detected by flow cytometry.Results:Melatonin treatment significantly reduced expression of PD-L1 on the surface of ovarian cancer cells,promoted autophagy of ovar-ian cancer cells.Autophagy inhibitors reversed down regulation of PD-L1 treated by melatonin,Jurkat cells killed more melatonin treated ovarian cancer cells,and the killing of ovarian cancer cells by Jurkat cells revised by autophagy inhibitors.Conclusion:Mela-tonin can enhance the killing effect of T cells on ovarian cancer cells.

Purpose/Significance To investigate the operation status of telemedicine facilities in hospitals of different classifications and the evaluation of medical staff on the operation of facilities,so as to provide scientific basis for further promoting the construction of telemedicine and improving the level of telemedicine services.Method/Process Through an online questionnaire survey,the configura-tion and operation of telemedicine terminals in medical institutions are collected nationwide,and the feedback of medical personnel on the convenience of operation of telemedicine system is investigated.By using SPSS 25.0 software,descriptive analysis method is adopted to evaluate the availability of telemedicine facilities,and variance analysis is used to compare the differences in equipment failure frequency,the operation convenience of telemedicine system and facility evaluation in hospitals of different classifications from the perspective of medical institutions and medical personnel.Result/Conclusion The overall failure rate of telemedicine equipment is low,and the use of telemedicine system is relatively convenient,but the hospital information system is relatively poor to meet the needs of telemedicine,and the telemedicine system connections between different hospitals,as well as the telemedicine infrastructure facilities of primary medical in-stitutions need to be further improved.

Objective:To explore the current status and research hotspots of structural equation modeling in nursing from 2012 to 2021.Methods:We searched for literature on the structural equation modeling in nursing based on Web of Science core collection database. CiteSpace and Excel were used to analyze the time, space, and keywords included in 742 articles.Results:From 2012 to 2021, the number of domestic and international publications showed a rapid growth trend with the growth of the year. China was the country with the highest number of publications. The Western University in Canada was the institution with the highest number of publications. The frequency of keywords such as structural equation modeling, quality of life, job satisfaction, health, social support and stress was high. The clustering effect of keywords was significant ( Q=0.72, S=0.87) , and research hotspots mainly included physical and mental health care and nursing work management. Conclusions:The structural equation modeling in nursing is showing a rapid development trend. In the future, numerous studies should be conducted on the construction and validation of nursing structural relationship models to promote the development of nursing.