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In the context of brain science research strategy in China, transcranial magnetic stimulation, as an input brain-computer interface technology, is able to improve the pathology of patients with mental disorders in a noninvasive way. However, new risks arising from the new technology have been ignored by the legislation, and there is a risk of privacy leaks of the neurological data presented by the patient's brain. The legal issues of physicians neglecting to inform patients of the risks of personality changes and the off-lable use of transcranial magnetic stimulation devices need to be explored. The legal issues of physicians neglecting to inform patients of the risks of personality changes and off-label use of transcranial magnetic stimulator devices need to be urgently explored. Multidisciplinary literature in the fields of trade-off between the right to health and privacy protection, principle of informed consent, data and application of off-label use for devices was searched and analyzed by using literature review and case analysis methods, to summarize the key points of the adjudication documents on off-label use for transcranial magnetic stimulation devices. It was found that the legal interpretations and value balances between the right to health and protection of privacy, physician's right of diagnosis and treatment and patient's right of informed consent, as well as the accessibility and safety of the devices, should be clarified and the adequate notification of new risks in the application of new technologies should be improved; it should be clarified that physicians and medical institutions should respect the privacy of the patients and the obligation to protect the security of neurological data, expand the scope of risk notification, clarify the risks of personality, prohibit the off-label use of the devices and establish a mechanism for risk analysis and dynamic monitoring of adverse reactions.

Background: Obstructive jaundice (OJ) is insensitive to radiation and chemotherapy, and a pathologic diagnosis is difficult to make clinically. Percutaneous transhepatic cholangiobiopsy (PTCB) is simple to perform and minimally invasive, and clinical practice has shown it to be an accurate and reliable new method for bile duct histopathologic diagnosis. Purpose: To investigate the value of PTCB for pathologic diagnosis of causes of OJ. Material and Methods: From April 2001 to December 2011, PTCB was performed in 826 consecutive patients. Data on pathologic diagnosis, true positive rate, and complications were analyzed retrospectively. Patients with negative pathologic findings were diagnosed using clinical, imaging, laboratory, and prognostic data. The feasibility and safety of PTCB for OJ were evaluated and true positive rates for biliary carcinoma and non-biliary carcinoma compared. Results: PTCB was successful in all cases. Of 740 patients clinically diagnosed with malignant biliary stricture and 86 with benign biliary stricture, 727 received a positive pathologic diagnosis; in 99, the pathologic findings were considered false negative. The true positive rate for PTCB was 88.01% overall, differing significantly for biliary and non-biliary carcinoma (χ2 = 12.87, P < 0.05). Malignancy accounted for 89.59% of OJ cases; well, moderately, and poorly differentiated carcinoma represented 57.88%, 19.97%, and 22.15%. Biliary adenocarcinoma was the predominant malignant pathologic type (96.41%). Transient bilemia, bile leakage, and temporary hemobilia occurred in 47, 11, and 28 cases, respectively, with no serious complications. Conclusion: PTCB is safe, feasible, and simple, with a high true positive rate for definitive diagnosis of OJ causes. Well differentiated adenocarcinoma was the predominant pathologic type. [ABSTRACT FROM AUTHOR]

Keratin pearls (KP) is an important indicator of the degree of tumor cell differentiation of esophageal squamous cell carcinomas (ESCC). However, the independent prognostic value of KP in ESCC patients remains unclear. The hematoxylin-eosin (H&E) stained tissue microarrays (TMAs) or whole slides of the patients were prepared to identify the existence of KP. Kaplan-Meier (KM) survival analysis as well as univariate and multivariate Cox regression analyses were used to evaluate the prognostic value of KP. A nomogram based on KP and other clinicopathologic characteristics was constructed. The C-index, calibration curve, Receiver Operating Characteristic (ROC) curve, and Decision Curve Analysis (DCA) were used to evaluate the nomogram. The results indicated KP is a protective factor against lymph node metastasis and is closely associated with the differentiation degree in ESCC patients. KM survival analysis showed that the overall survival (OS) of patients with KP was significantly better than for patients without KP. In addition, multivariate Cox regression analysis revealed that KP was an independent predictor of OS. Furthermore, ROC curve demonstrated that KP combined with differentiation degree could more accurately predict the 5-year survival rate than differentiation degree alone. Importantly, the nomogram showed good discrimination and calibration abilities in both training and validation groups, which could more accurately predict the 3-, 5-, and 10-year survival rates of ESCC patients and adds to the predictive value of TNM stage alone. In conclusion, KP is an independent predictor of prognosis in patients with ESCC and provides incremental prognostic value to degree of differentiation., Competing Interests: None., (AJTR Copyright © 2022.)

In this paper we study an SLIR epidemic model with nonmonotonic incidence rate, which describes the psychological effect of certain serious diseases on the community when the number of infectives is getting larger. By carrying out a global analysis of the model and studying the stability of the disease-free equilibrium and the endemic equilibrium, we show that either the number of infective individuals tends to zero or the disease persists as time evolves. For the stochastic model, we prove the existence, uniqueness and positivity of the solution of the model. Then, we investigate the stability of the model and we prove that the infective tends asymptotically to zero exponentially almost surely as R 0 < 1. We also proved that the SLIR model has the ergodic property as the fluctuation is small, where the positive solution converges weakly to the unique stationary distribution.