The rapid development of artificial intelligence in the field of healthcare has greatly improved diagnosis accuracy, disease prediction, personalized treatment and healthcare resource management. However, with the widespread application of medical artificial intelligence, challenges has emerged in the aspects of medical data, model development and evaluation, and societal considerations. Therefore, this study aims to explore challenges in the application of artificial intelligence in healthcare and suggest a series of feasible solutions to improve medical professional and researchers' understanding of medical artificial intelligence and enhance the quality of healthcare in clinical practice

Objective: To explore the most economically feasible cervical cancer screening strategies in urban China. Methods: A series of Markov models were constructed to evaluate health and economic outcomes of different screening strategies. There were 24 screening strategies including four screening methods: liquid-based cytology (LBC), human papillomavirus (HPV) DNA genotyping, HPV DNA genotyping with LBC triage (HPV DNA+ LBC), HPV DNA genotyping and LBC co-testing (HPV DNA-LBC), along with three intervals (every 1, 3 or 5 years) and two starting age for screening (30 or 35 years old) were compared. Models parameters were obtained from a cervical cancer screening study in urban China and literature reviews. Results: The cumulative incidence and mortality risk of cervical cancer declined over 69% and 82% respectively for each screening strategy as compared with the no screening scenario. LBC every five years starting from 35 years old strategy cost the least (RMB 690 per capita) and could save life years compared with no screening. The cost effectiveness ratios of 24 strategies ranged from -10 903 to 117 992 RMB per life year saved. All strategies were cost-effective compared to no screening. In the incremental cost-effectiveness analysis, LBC every 5 years starting from 30 strategy, HPV DNA genotyping every 3 years starting from 30 strategy, LBC every 3 years starting from 30 strategy and LBC every year starting from 30 strategy were dominant strategies. Conclusions Screening can effectively prevent cervical cancer. In urban Chinese areas with insufficient socioeconomic resources, LBC every 5 years from 35 years old strategy is recommended. In relatively more affluent areas, LBC every 5 years from 30 years old strategy, LBC every 3 years from 30 years old strategy, HPV DNA genotyping every 3 years from 30 years old strategy, and LBC every year from 30 years old strategy are recommended successively.

Objective: To study the mRNA expressions of various CD97 isoforms in colorectal carcinoma tissues and their clinical significances. Methods: A total of 50 colon cancer patients in the First Affiliated Hospital of Wenzhou Medical University from December 2013 to May 2014 and human colon cancer cell lines SW480 and SW620 were enrolled. The real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the mRNA expressions of CD97 human epidermal growth factor (EGF) (1, 2, 5), CD97EGF (1, 2, 3, 5) and CD97EGF (1, 2, 3, 4, 5) in colon cancer tissues, adjacent tissues, normal colon tissues, SW480 cells and SW620 cells. The relationship between the mRNA expression of CD97EGF (1, 2, 5) and the clinicopathological factors was analyzed. Results: Compared with those low expressions in adjacent tissues and normal tissues, the mRNA expressions of CD97 isoforms CD97EGF (1, 2, 5), CD97EGF (1, 2, 3, 5) and CD97EGF (1, 2, 3, 4, 5) in cancer tissues were highest, and the differences were statistically significant (0.71±0.20 vs. 0.40±0.09 vs. 0.35±0.07, F = 107.642, P < 0.01; 0.45±0.11 vs. 0.26±0.05 vs. 0.27±0.06, F = 94.231, P < 0.01; 0.41±0.10 vs. 0.21±0.05 vs. 0.19±0.03, F = 165.672, P < 0.01). In addition, the mRNA expression of CD97EGF (1, 2, 5) in colon cancer patients was associated with tumor infiltration depth (T₁-T₂ and T₃-T₄), clinical stages (Ⅰ-Ⅱ and Ⅲ-Ⅳ), and the differences were statistically significant (t = -2.582, P = 0.013; t = -5.062, P < 0.01). The mRNA expression of CD97EGF (1, 2, 5) in SW620 cells was higher than that in SW480 cells. Conclusions CD97 isoforms are highly expressed in colon cancer tissues, and CD97EGF (1, 2, 5) may play an important role in the development and invasion of colon cancer. The CD97 isoforms may be new markers in the treatment of colon cancer.

Objective: To evaluate 3D imaging technology in the preoperative evaluation of breast conserving surgery. Methods: A ret-rospective analysis was conducted using clinical data from 38 patients who underwent breast conserving surgery that was assisted by 3D imaging technology in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from April 2017 to January 2019. All 38 patients underwent 3.0-T breast magnetic resonance imaging (MRI) examination before surgery, and 3D reconstruction of virtu-al images was constructed through 3D modeling of medical digital imaging and communication (DICOM) data. The predicted resected tissue volume was compared with the volume of the actual resected specimen, and the surgical margin and postoperative aesthetics of the breast conserving surgery were evaluated. Results: The reconstructed 3D model clearly displayed the anatomical structures of the breast, tumor, gland, and blood vessels, and their relationship in 3D spaces. The goodness of fit of the 3D model to the practical sit-uation was 97.4% (37/38). In terms of the resection tissue volume, there was no significant difference between the predicted results (PRTV) and actual results (ARTV) [(61.7 ± 20.1) mL vs. (65.1 ± 20.7) mL, P>0.05]. There was a strong positive correlation between ARTV and PRTV (P<0.01). One patient underwent supplementary secondary surgery, resulting in an incidence of 2.6% (1/38). The postopera-tive satisfaction for breast conserving surgery was 100% (38/38). Conclusions: 3D imaging technology clearly displays the anatomical relationship between breast tumor and surrounding tissues, and correctly assesses breast volume, guiding surgical resection.

Objective: To account the direct cost of uterine cervix carcinoma treatment in China and to explore the related factors which influence the direct financial burden of the disease. Methods: Data was collected through the medical record system and telephone interviews in 14 county-level hospitals and 9 provincial and municipal hospitals from 14 provinces/municipalities enrolled in the Chinese National Health Industry Research Project in 2015. The direct financial burden of uterine cervix carcinoma treatment consisted of the direct medical cost and the direct non-medical cost of treatment in different pathological cervical cancer stages and precancerous lesions. Multiple liner regression method was used to analyze the factors affecting the costs. Results: The age of the 3 246 patients was (46.40±10.43) years, including 2 423 patients from provincial and municipal hospitals and 823 patients from county-level hospitals. The direct financial burden for one patient of pathological uterine cervix carcinoma stage or precancerous lesion ranged from 10 156.3 yuan to 75 716.4 yuan in provincial and municipal hospitals, and for patients from county-level hospitals, the cost was between 4 927.9 yuan and 47 524.8 yuan per person. There was a wide gap between the direct financial burden of patients in different disease stages. The direct financial burden of patients with precancerous lesions ranged from 4 927.9 yuan per person to 11 243.0 yuan per person, as for patients of pathological uterine cervix carcinoma stages, the direct financial burden was between 29 274.6 yuan and 75 716.4 yuan per person. The factors which influence direct financial burden would include: the levels of the hospital, pathological period, medicare reimbursement, days of treatment, and the methods of treatment (P<0.001). Conclusion The direct financial burden of diseases in patients with pathological uterine cervix carcinoma stage or precancerous lesion differed in different levels of hospital and pathological periods. In addition, medicare reimbursement, days of treatment, and the methods of treatment all had impact on it.

Through a brief overview of the origin and development of artificial intelligence, the research progress of artificial intelligence in digestive endoscopy, ophthalmoscopy and electronic colposcopy was summarized, and the importance of its application was clarified. This article induced the main problems and suggestions of artificial intelligence in the development of medical endoscopes, and prospected the future application of artificial intelligence in medical endoscopy diagnosis.

To observe a PPAR-alpha agonist effect of N-oleoylethanolamine (OEA) on CB2 (cannabinoid receptor 2), an anti-inflammatory receptor in vascular endothelial cell, healthy HUVECs and TNF-alpha induced HUVECs were used to establish a human vascular endothelial cell inflammatory model. Different doses of OEA (10, 50 and 100 micromol x L(-1)) had been given to HUVECs, cultured at 37 degrees C for 7 h and then collected the total protein and total mRNA. CB2 protein expression was detected by Western blotting and CB2 mRNA expression was assayed by real-time PCR. As the results shown, OEA (10 and 50 micromol x L(-1)) could induce the CB2 protein and mRNA expression, but not 100 micromol x L(-1). To detect if anti-inflammation effect of OEA is partly through CB2, CB2 inhibitor AM630 was used to inhibit HUVEC CB2 expression, then the VCAM-1 expression induced by TNF-alpha was detected, or THP-1 adhere to TNF-alpha induced HUVECs was examined. OEA (50 micromol x L(-1)) could inhibit TNF-alpha induced VCAM-1 expression and THP-1 adhere to HUVECs, these effects could be partly inhibited by a CB2 inhibitor AM630. The anti-inflammation effect of OEA is induced by PPAR-alpha and CB2, suggesting that CB2 signaling could be a target for anti-atherosclerosis, OEA have wide effect in anti-inflammation, it may have better therapeutic potential in anti-inflammation in HUVECs, thus achieving anti-atherosclerosis effect.

BACKGROUND: Various artifacts are found to be appeared in the nuclear magnetic resonance; the frequently appearing ones are the motion artifacts, plait artifacts, metallic artifacts, partial volume effect artifacts, chemical shift artifacts, phase artifacts, zipper artifacts and so on. However, there is still has no report on the controlling and revising method of the zipper artifacts which is produced in the spin-echo sequence imaging process. OBJECTIVE: Based on the discussion of the mechanism of the production of zipper artifact in the spin-echo sequence imaging process, a new impulse sequence is worked out to avoid the zipper artifact. METHODS: Standard SE sequence was complied to obtain the standard image, and compiling the artifact sequence to obtain the linear disturbance image and zipper artifact image, compiling the modified sequence to obtain the modified zipper artifact image. RESULTS AND CONCLUSION: Usually, the linear disturbance image could obtained in the instantaneous gradient of 5 degree with the echo sequence of 120 degree, and the zipper artifact will be obtained in the instantaneous gradient of 90 degree with the echo sequence of 120 degree. Modified sequence instantaneous gradient of 90 degree with the echo sequence of 120 degree can completely eliminate zipper artifact. The interesting result obtained in this paper is that the zipper artifact can be totally avoided with this new impulse sequence.

Objective to investigate the therapeutic efficacy of multiple-point injection with absolute alcohol and pinyangmycin under digital fluoroscopic guidance for superficial venous malformations. Methods By using a disposal venous transfusion needle the superficial venous malformation was punctured and then contrast media lohexol was injected in to visualize the tumor body,which was followed by the injection of ethanol and pinyangmycin when the needle was confirmed in the correct position. The procedure was successfully performed in 31 patients. The clinical results were observed and analyzed. Results After one treatment complete cure was achieved in 21 cases and marked effect was obtained in 8 cases,with a total effectiveness of 93.5%. Conclusion Multiple-point injection with ethanol and pinyangmycin under digital fluoroscopic guidance is an effective and safe technique for the treatment of superficial venous malformations,especially for the lesions that are deeply located and ill-defined.

BACKGROUD: According to the record of Compendium of Herbology of herbs epimedium, Berberidaceae barrenwort genus, herbs epimedium has the effects of supplementing essence qi, consolidating bones and tendons, tonifying bruise of loin and strengthening cardiac ability, etc. In recent years, its clinicalapplications and pharmacological effects have been reported more frequently.OBJECTIVE: To investigate the effects of herba epimedium extract on spontaneous activity and sleep function of mice under the intervention of suprathreshold and subthreshold dose of pentobarbital sodium with the method of jiggle-cage transducer.SETTING: Department of Mathematics and Physics, Laboratory of Analysis, Department of Pharmacology, Gannan Medical College.MATERIALS: A total of 110 healthy adult Kunming male mice of clean grade, with a body mass between 18 g and 22 g.METHODS: The experiment was conducted in Laboratory of Scientific Research Institute of Gannan Medical College from August to September 2004. ① The mice (n=30) were injected intraperitoneally with 1 000 g/L herbs epimediu extract(0.01 mL/g) and put into hanging cage 15 minutes later, after a 3-minute stabilization period, waveforms of spontaneous activity within 15 s after the administration of drug were recorded. ②The mice (n=40) were intraperitoneally injected with 1000 g/L herba epimediu extract(0.01 mL/g), 15 minutes later, injected intraperitone ally with 0.02 mL/g suprathreshold dose of pentobarbital sodium (2.5 g/L), and then observe the disappearance time of righting reflex of the mouse. ③ The mice (n=40) were injected intraperitoneally with 1 000 g/L herba epimediu extract(0.01 mL/g), 15 minutes later,intraperitoneally injected with 0.01mL/g subthreshold dose of pentobarbital sodium (0.25%),and then observe the disappearance time of righting reflex of the mouse.MAIN OUTCOME MEASURES: Frequency of spontaneous activity of the mice; sleeping time of the mouse with suprathreshold and subthreshold dose of pentobarbital sodium.RESULTS: All the 110 mice entered result analysis. ① Herba epimedium extract (0.1 mL/10 g) could significantly inhibit the spontaneous activity of the mice, and the frequencies of large waves and moderate waves decreased obviously (7.4±6.5, 47.1±18.7; t=3.265, P ＜ 0.01). ② Herbs epimedium extract (0.01mL/10g) could shorten the time for falling asleep and prolong the sleeping time of the mouse with suprathreshold dose of pentobarbital sodium, and there was significant difference as compared with the control group [(3.9±2.8), (219.7±87.2); (5.8±2.9), (113.0±77.4) minutes; t=2.452, 2.501, P ＜ 0.05]. ③ Herba epimedium extract (0.01 mL/10 g)could significantly prolong the time for falling asleep and the sleeping time of the mouse with subthreshold dose of pentobarbital sodium, and there was significant difference as compared with the control group [(6.6±5.2),(60.3±71.7); 0, 0 minute; t=3.275, P ＜ 0.01]. Herba epimedium extract and pentobarbital sodium had synergistic effect of central inhibition.CONCLUSION: Herba epimedium extract has the effect of significant central inhibition, which could inhibit the spontaneous activity of mice ,remarkably shorten the time for falling asleep,and obviously prolong the sleeping time of the mouse with suprathreshold dose of pentobarbital sodium, prolong the time for falling asleep of the mouse with subthreshold dose of pentobarbital sodium and increase the amount of animals falling asleep.