With the rapid development of artificial intelligence （AI） technology， the ethical governance of AI has gained increasing attention. The Recommendation on the Ethics of Artificial Intelligence was issued by the United Nations Educational， Scientific and Cultural Organization in 2021， which clarified several principles for the ethical governance of AI. In the field of rehabilitation medicine， the research and application of AI technology have significantly improved patients’ quality of life and survival. However， due to the specificity of the service population in rehabilitation medicine， which is mostly for the sick， injured， disabled， and elderly， a series of complex ethical issues have also arisen. This paper analyzed in detail the ethical issues and challenges encountered in the research and application of AI technology in the field of rehabilitation medicine from various aspects， such as informed consent， security of privacy and data， patients’ physical and mental rehabilitation， compliance regulation， protection of specific groups， and promotion of equity. According to the principles of the Recommendation on the Ethics of Artificial Intelligence and others， response strategies were proposed， including multi-party collaboration and interdisciplinary cooperation， improving and refining relevant laws and regulations， strengthening ethical education across society， establishing accountability mechanisms， increasing investment， promoting equity， and other measures， to promote the healthy development of research and application of AI technology in the field of rehabilitation， as well as benefit humanity.

To investigate the clinical features and peripheral blood immune cell subsets ofelderly (≥60 years old) onset rheumatoid arthritis (EORA) patients.

OBJECTIVE: To observe the effect of heat-sensitive moxibustion at "Feishu" (BL13) on immunoinflammatory response in rats with allergic rhinitis (AR) based on phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway, so as to explore its underlying mechanism. METHODS: Thirty-two male SD rats were randomly divided into a blank group (6 rats) and a modeling group (26 rats). In the modeling group, AR model was prepared using systemic and local attack sensitization method with ovalbumin. The successfully-modeled rats were randomized into a model group (6 rats), a medication group (6 rats) and a moxibustion group (14 rats). In the moxibustion group, the suspending moxibustion was operated at bilateral "Feishu" (BL13), 40 min each time, once daily, for 21 consecutive days; during which, the temperature of the body and tail was recorded. During intervention, if the temperature of the body and tail increased by >1 ℃, the heat-sensitive reaction at the point was determined in the rats of the moxibustion group, and these rats were collected in a heat-sensitive moxibustion group (8 rats involved and 6 rats of them were randomly collected to ensure the sample-size consistency); and those without heat-sensitive moxibustion reaction were assigned to a traditional moxibustion group (6 rats). In the medication group, fluticasone propionate nasal spray was applied, 8 μL on each side, once daily and for 21 days. The behavioral score for AR symptoms after modeling and intervention, and the content of serum immunoglobulin E (IgE) after modeling were observed. After intervention, the histological morphology of the nasal mucosa was observed using HE staining, the positive expression of thymic stromal lymphopoietin (TSLP) in the nasal mucosa was detected using immunohistochemistry, the levels of IgE, interleukin (IL)-4, IL-5, IL-13 and interferon-γ (IFN-γ) were detected by ELISA, and the protein expression of the member 4 of tumor necrosis factor receptor superfamily (OX40), phosphorylated protein kinase B (p-AKT), phosphorylated phosphatidylinositol 3-kinase (p-PI3K) in nasal mucosa was detected by Western blotting. RESULTS: After modeling, the behavioral score of AR symptoms and serum IgE level in the modeling group were higher than those of the blank group (P<0.01), suggesting the success of AR modeling. After intervention, compared with the blank group, the behavioral score of AR symptoms was increased (P<0.01)；the nasal mucosa structure was disordered, the inflammatory infiltration was severe; the positive expression of TSLP in the nasal mucosa increased (P<0.01), the levels of serum IgE, IL-4, IL-5, and IL-13 elevated (P<0.01), and the level of IFN-γ decreased (P<0.01); and the protein expression of OX40, p-AKT, and p-PI3K in the nasal mucosa increased (P<0.05) in the model group. Compared with the model group, the behavioral score of AR symptoms was reduced (P<0.01); the nasal mucosa structure, inflammatory infiltration, and vascular dilation were ameliorated to varying degrees; the positive expression of TSLP in the nasal mucosa decreased (P<0.01); the content of serum IgE, IL-4, IL-5, and IL-13 decreased (P<0.05), and that of IFN-γ increased (P<0.05) in the medication, traditional moxibustion, and heat-sensitive moxibustion groups. Compared with the model group, the protein expression of p-AKT was reduced in the medication and traditional moxibustion groups (P<0.05), the protein expression of OX40, p-AKT, and p-PI3K in the nasal mucosa decreased in the heat-sensitive moxibustion group (P<0.05). When compared with the medication group, the positive expression of TSLP in the nasal mucosa was reduced (P<0.05) in the heat-sensitive moxibustion group. In comparison with the traditional moxibustion group, the content of serum IL-13 was reduced and the content of IFN-γ elevated in the heat-sensitive moxibustion and the medication groups (P<0.05), the protein expression of p-PI3K reduced in the medication group (P<0.05), and the positive expression of TSLP and the protein expression of OX40 and p-PI3K in the nasal mucosa were reduced in the heat-sensitive moxibustion group (P<0.05). CONCLUSION Heat-sensitive moxibustion at "Feishu" (BL13) can alleviate the symptoms of AR rats, ameliorate the inflammatory infiltration and telangiectasia of nasal mucosa, and inhibit immunoinflammatory response, which may be obtained by regulating PI3K/AKT signal pathway.
Animals ; Moxibustion ; Male ; Rats ; Signal Transduction ; Rats, Sprague-Dawley ; Rhinitis, Allergic/genetics* ; Proto-Oncogene Proteins c-akt/immunology* ; Acupuncture Points ; Humans ; Phosphatidylinositol 3-Kinases/immunology* ; Phosphatidylinositol 3-Kinase/immunology*

Liver transplantation (LT) has become a standard treatment for end-stage liver diseases, and graft injury is intricately associated with poor prognosis. Granzyme B (GZMB) plays a vital role in natural killer (NK) cell biology, but whether NK-derived GZMB affects graft injury remains elusive. Through the analysis of single-cell RNA-sequencing data obtained from human LT grafts and the isolation of lymphocytes from mouse livers following ischemia-reperfusion injury (IRI), we demonstrated that 2NK cells with high expression of GZMB are enriched in patients and mice. Both systemically and liver-targeted depletion of NK cells led to a notable reduction in GZMB⁺ cell infiltration, subsequently resulting in diminished graft injury. Notably, the reconstitution of Il2rg ^-/- Rag2 ^-/- mice with purified Gzmb-KO NK cells demonstrated superior outcomes compared to those with wild-type NK cells. Crucially, global knockout of GZMB and pharmacological inhibition exhibited remarkable improvements in liver function in both mouse IRI and rat LT models. Moreover, a phosphorylated derivative of FDA-approved vidarabine was identified as an effective inhibitor of mouse GZMB activity by molecular dynamics, which could provide a potential avenue for therapeutic intervention. Therefore, targeting NK cell-derived GZMB during the LT process suggests potential therapeutic strategies to improve post-transplant outcomes.

Vascular damage plays a significant role in the onset and progression of Alzheimer's disease (AD). However, the precise molecular mechanisms underlying the induction of neuronal injury by vascular damage remain unclear. The present study aimed to examine the impact of fibrinogen (Fg) on tau pathology. The results showed that Fg deposits in the brains of tau P301S transgenic mice interact with tau, enhancing the cytotoxicity of pathological tau aggregates and promoting tau phosphorylation and aggregation. Notably, Fg-modified tau fibrils caused enhanced neuronal apoptosis and synaptic damage compared to unmodified fibrils. Furthermore, intrahippocampal injection of Fg-modified tau fibrils worsened the tau pathology, neuroinflammation, synaptic damage, neuronal apoptosis, and cognitive dysfunction in tau P301S mice compared to controls. The present study provides compelling evidence linking Fg and tau, thereby connecting cerebrovascular damage to tau pathology in AD. Consequently, inhibiting Fg-mediated tau pathology could potentially impede the progression of AD.
Animals ; tau Proteins/metabolism* ; Alzheimer Disease/metabolism* ; Fibrinogen/metabolism* ; Mice, Transgenic ; Mice ; Disease Models, Animal ; Memory Disorders/metabolism* ; Male ; Mice, Inbred C57BL ; Brain/metabolism* ; Hippocampus/metabolism* ; Protein Aggregation, Pathological/metabolism* ; Apoptosis ; Phosphorylation

Humans ; Aged ; Lung Diseases ; Pneumonia/drug therapy* ; Adrenal Cortex Hormones/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Administration, Inhalation ; Community-Acquired Infections/drug therapy*

Abstract Prevention and control of myopia requires comprehensive measures. Based on the system established earlier, the system is revised and upgraded. The original system emphasizes comprehensive measures and proposes to focus on both the symptoms and root causes. These measures are summarized into six aspects, three address the root cause measures including health education, glasses optics and visual environment, and three address symptoms measures including eye exercises, physical therapy and drugs. The paper is comprehensively supplemented and analyzes the primary and the secondary, and promotes physical therapy from treating the symptoms to treat both the symptoms and the root causes. These improvement measures will help promote the prevention and control of myopia in children and adolescents.

Objective:To analyze categories and influencing factors of fall risk perception of elderly inpatients with chronic heart failure (CHF) based on latent profile analysis for providing references on improving their levels of fall risk perception.Methods:During December 2022 and July 2023, the elderly inpatients with CHF were selected as survey subjects through convenience sampling from department of geriatrics of Nanjing Drum Tower Hospital, and they were taken a cross-sectional investigation using a general information questionnaire, Hospital Anxiety Depression Scale, Multidimensional Chronic Disease Self-management Effectiveness Scale, Nurse-patient Trust Scale and Fall Risk Perception Questionnaire for Patients.Their categories of fall risk perception were analyzed by latent profile analysis.The influence factors of their different categories of fall risk perception were analyzed by unordered multi-class Logistic regression analysis.Results:There were 279 patients in final investigation, which contained 148 males and 131 females, and their age were during 60 to 78 (68.58 ± 6.37) years old. The score of fall risk perception of elderly inpatients with CHF was (42.12 ± 13.74).Among the fall risk perception categories of elderly CHF patients, the percentage of patients low risk perception group was 12.55% (35/279), percentage of patents from physical risk perception group was 17.20%(48/279), percentage of patents from environmental risk perception group was 56.99% (159/279) and percentage of patents from high risk perception group was 13.26% (37/279).Compared to high-risk perception group, unordered multi-class logistic regression analysis showed that male, no fall experience, self-management effectivenessand level of patient′s trust on nursewere significant influencing factors of fall risk perception of low risk perception group ( OR values were 0.023-55.980, all P<0.05); no having other chronic diseases, less than 5 years long course of disease, 5 to 10 years long course of disease, self-management effectiveness and level of trusting nurse were significant influencing factors of fall risk perception of physical risk resulting in perception group ( OR values were 0.027-1.711, all P<0.05); less than 7 days long hospital stay, 7 to 14 days long hospital stay, abnormal vision, self-management effectiveness and level of patient′s trust on nurse were significant influencing factors of fall risk perception of environmental risk resulting in perception group ( OR values were 0.907-6.482, all P<0.05). Conclusions:The level of fall risk perception of elderly inpatients with CHF was low and could be divided into low risk perception group, physical risk perception group, environmental risk perception group and high risk perception group. Their fall risk perception was influenced by gender, fall experience, having chronic diseases, course of disease, hospital stay, abnormal vision, self-management effectiveness, and level of patient′s trust on nurse.Clinical medical staff should provide personalized health education to different categories of fall risk perception of elderly inpatients with CHF, in order to improve their level of fall risk perception.

Objective The objective of this study was to explore the key genes regulating the metastasis of breast cancer,de-termine the effects of DLX2 on proliferation,migration,invasion,and apoptosis of breast cancer cells,and explore the role and mecha-nism of DLX2 in regulating the characteristics of breast cancer stem cells.Methods A DLX2 gene knockdown breast cancer MCF7 cell line was constructed.The cell viability was detected in breast cancer cells by CCK-8 assay,apoptosis was detected in breast canc-er cells by flow cytometry,cell migration and invasive abilities were detected by Transwell assay,the expression of SOX4 protein was detected by immunofluorescence(IF)in breast cancer cells and xenografts,the expression of CD44 and ALDH1 protein was detected in breast cancer cells and xenografts by Western blot,apoptosis was detected in xenografts by TUNEL assay,and the malignancy degree of tumor tissues was assessed by HE staining.Results After knocking down DLX2,the cell viability decreased(P＜0.001),apoptosis increased(P＜0.001),and cell migration and invasion abilities decreased in breast cancer cells(P＜0.05).The results of IF showed that the expression of SOX4 was inhibited.The results of Western blot showed a decrease in the expression of CD44 and ALDH1 pro-teins in breast cancer cells,which are cellular stemness markers(P＜0.05).In the Balb/c nude mouse breast cancer transplantation tumor model,the volume of xenografts in the sh-DLX2 group was significantly smaller than that in the model group(P＜0.001),the xenografts grew slowly,and the volume and weight of xenografts were also lower than those of the model group(P＜0.05).Apoptosis in the sh-DLX2 group was higher than that in the model group,and the expression of SOX4,CD44 and ALDH1 was consistent with the cellular level,all of which were inhibited(P＜0.05).Conclusion DLX2 inhibits proliferation,migration and invasion of breast cancer cells,promotes apoptosis of breast cancer cells,and regulates the characteristics of breast cancer stem cells through SOX4.

Approximately 8%to 15%of patients with metastatic colorectal cancer(mCRC)harbor BRAF mutation,and the V600E mutation is the most common form of BRAF mutation.The prognosis of patients with metastatic colorectal cancer harboring BRAF V600E mutation is poor.Initial standard chemotherapy is often ineffective,necessitating an intensive follow-up treatment,which usually provides limited effic-acy.Consequently,the disease becomes notably difficult to treat and progresses rapidly,resulting in a decreased overall patient survival rate.This review details the research advancements in treatment of BRAF V600E-mutant metastatic colorectal cancer.