Medical Research Articles

Clinical guidance for cannabidiol-associated hepatotoxicity: A narrative review.

There is increasing evidence that cannabidiol (CBD) use is associated with clinically significant liver enzyme (LE) elevations and drug-induced liver injury (DILI). The proportion of LE elevations and DILI events reported in the literature meet the Council for International Organizations of Medical Sciences' (CIOMS) classification of a common adverse drug reaction. However, these potential adverse events are unknown to many clinicians and may be overlooked. The increasing use of CBD for both medical and non-medical use necessitates clear direction in the diagnosis and management of CBD-associated hepatotoxicity. To our knowledge, no such clinical guidance currently exists. For people presenting with elevated LEs, CBD use should be screened for and be considered in the differential diagnosis. This narrative review will provide clinicians with guidance in the prevention, detection, and management of CBD-related hepatotoxicity.

Diagnosa Penyakit Kelamin (Vulvodynia) pada Wanita Menggunakan Metode Certainty Factor

Vulvodynia is a chronic pain condition affecting the vulva that significantly impacts women’s quality of life. Accurate and early diagnosis poses a challenge due to the often-overlapping symptoms with other conditions and the lack of definitive diagnostic tests. This paper proposes the use of expert system methods as a diagnostic tool for vulvodynia in women. The expert system, integrating medical knowledge with inference algorithms, is designed to analyze symptoms, medical history, and test results to provide accurate diagnoses and treatment recommendations. The study involves the development and evaluation of a computer-based expert system prototype that uses clinical data and medical decision-making to enhance the accuracy of vulvodynia diagnosis. Preliminary results indicate that the expert system can improve diagnostic rates and reduce the time required for identifying this condition, offering a potentially valuable tool for medical professionals in clinical practice.

Анализ заболеваемости глаукомой населения регионов Черноземья за 2014–2021 годы.

The aim of the study is to analyze the dynamics of glaucoma prevalence and incidence in population of Black Earth regions in 2014–2021. Materials and methods. The dynamics of glaucoma incidence and prevalence was studied by data of medical aid appealability of population of Black Earth regions. Analysis covered the period from 2014 to 2021. The study of morbidity rates was based on data from statistical digests of the Ministry of Health of the Russian Federation and Russian Research Institute of Health. Results. The research findings showed the increase in glaucoma prevalence in 2014–2021 in population of Black Earth regions in general (by 0,5%) and in the Voronezh Region (by 21,7%), the Kursk Region (by 24,9%) and the Tambov Region (by 7,1%). Two Black Earth regions showed the decrease in glaucoma prevalence – the Belgorod Region (by 7,0%) and the Lipetsk Region (by 3,7%). Glaucoma incidence rate during analyzed period is characterized by downward trend in Russia as a whole (by 22,4%), as well as in all the Black Earth regions: the Lipetsk Region by 63,4%, the Tambov Region by 32,6%, the Belgorod Region by 23,4%, the Kursk Region by 20,1%, the Voronezh Region by 1,8%. Conclusions. The increase in glaucoma prevalence and incidence in the population of Russia, the Voronezh Region, the Kursk Region, the Tambov Region indicates the accumulation of a patient population with previously diagnosed glaucoma due to increased expectation of life and decreased detection of new glaucoma cases. The decrease in glaucoma prevalence and incidence in the Belgorod Region and the Lipetsk Region indicates the decreased access of medical services for patients with ophthalmic disease in public medical establishments of these regions.

Investigation on Phenomics of Traditional Chinese Medicine from the Diabetes

AbstractWith thousands of years of application history, traditional Chinese medicine (TCM) has unique advantages in the prevention of various chronic diseases, and in recent years, the development of TCM has presented a situation where opportunities and challenges coexist. Phenomics is an emerging area of life science research, which has numerous similarities to the cognitive perspective of TCM. Thus, how to carry out the interdisciplinary research between TCM and phenomics deserves in-depth discussion. Diabetes is one of the most common chronic non-communicable diseases around the world, and TCM plays an important role in all stages of diabetes treatment, but the molecular mechanisms are difficult to elucidate. Phenomics research can not only reveal the hidden scientific connotations of TCM, but also provide a bridge for the confluence and complementary between TCM and Western medicine. Facing the challenges of the TCM phenomics research, we suggest applying the State-target theory (STT) to overall plan relevant researches, namely, focusing on the disease development, change trends, and core targets of each stage, and to deepen the understanding of TCM disease phenotypes and the therapeutic mechanisms of herbal medicine.

Estimating release of the antibiotic metronidazole into the environment from hospital effluents and assessment of the associated ecological risk: a case study in Isfahan, Iran (2023)

Hospital effluents are important sources for the release of pharmaceuticals into the environment. Metronidazole (MTZ) is one of the most popular antimicrobial agent, widely used in veterinary and human medicine. This study aims to determine the concentrations of MTZ in the effluent of hospitals and to evaluate ecotoxicological risk for aquatic organisms. Grab samples were taken from the effluents of 15 large hospitals in Isfahan City (Iran) and MTZ concentrations were analyzed using HPLC-UV. Average daily MTZ prescriptions for patients in each hospital was also determined. MTZ was detected in effluents of all 15 hospitals in the range of 0.3 to 9.5 µg/L (mean = 4.8 ± 6.4 µg/L). A significant correlation was observed between MTZ concentration in hospital effluent and MTZ prescription as well as the hospital beds. Ecological risk assessment showed MTZ contamination of hospital effluent from 7 of 15 hospitals had median risk (risk quotient of 0.1 to 1) for green algae (Chlorella sp.) while the effluent of all hospitals had minimal risk (risk quotient <0.1) for gram-negative bacteria (Vibrio fischeri) and aquatic crustaceans (Daphnia magna). It is necessary to develop efficient treatment methods for the removal of MTZ from the hospital effluents before discharging them into the municipal wastewater systems.

The relationship of emotional intelligence to burnout and related factors in healthcare profession students

BackgroundHigh prevalence of burnout amongst healthcare profession students results in detrimental effects on academic performance, mental health, and quality of life. Emotional intelligence is a trainable skillset demonstrated to protect against burnout, improve psychological well-being, and decrease anxiety and stress, yet it lacks standardized inclusion in many healthcare profession program curricula. ObjectivesTo explore the utility of emotional intelligence as a tool for burnout mitigation, this study aimed to determine the relationship between emotional intelligence and burnout in an interprofessional sample of healthcare profession students and identify related variables. DesignCross-sectional survey study. SettingsData was collected over 14 weeks in the fall of 2022 via a nationally distributed online survey. Participants147 healthcare profession students from the following professional or doctoral programs: Master of Science in Athletic Training (ATC), Doctor of Physical Therapy (DPT), Master of Science in or Doctor of Occupational Therapy (OT/OTD), Master of Science in Speech-Language Pathology (SLP), Doctor of Medicine (MD), Physician Assistant Studies (PA-S), Bachelor of Science in Nursing (RN), or Nurse Practitioner Studies (NP). MethodsParticipants completed a demographics form (personal/school related variables including prior education and mindfulness habits), the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), Oldenberg Burnout Inventory-Student (OLBI-S), and RU-SATED sleep health scale. ResultsA large negative correlation was noted between emotional intelligence and burnout (r = −0.591, p < .001). Emotional intelligence and age were significant predictors of burnout. Previous emotional intelligence learning and mindfulness practice also demonstrated significant differences in emotional intelligence. ConclusionsThese findings suggest that greater emotional intelligence may have a positive impact on burnout and wellbeing in healthcare profession students. Educational interventions aimed to improve emotional intelligence should be explored for inclusion in healthcare profession educational program curricula.

Examining the influence of team-based learning on medical students' comprehension and attitudes regarding psychedelic therapies.

This study evaluates the impact of a two-hour team-based learning (TBL) curriculum on medical students' knowledge, comprehension, ethical understanding, and attitudes towards psychedelic therapies. Sixty-three pre-surveys and fifty post-surveys assessed students' perceived knowledge and attitudes using Likert scales. Forty-eight matched pre/post-knowledge tests with multiple-choice questions quantified changes in comprehension. The TBL approach featured independent learning, team readiness assessments, and application exercises. Post-curriculum, students demonstrated significantly improved test scores (mean 41.4% increase, p < 0.0001) and more positive attitudes across 16 of 18 items (p ≤ 0.0495). Overall attitude scores increased 23% (p < 0.0001). Qualitative feedback reflected enhanced comfort discussing psychedelics clinically. While some students expressed support for psychedelic-assisted therapy, others cited reservations. This innovative curriculum bridged an important education gap given the increasing relevance of psychedelic medicine. Findings suggest TBL enhances medical student preparedness in this emerging field. Continued curricular development is warranted to ensure proper psychedelic education aligns with patient needs and legislative policies. As psychedelic research progresses, maintaining instructional excellence is crucial for future healthcare professionals.

Survey indicates addressing workplace environment, work-life balance, and flexibility are key to attracting and retaining veterinarians in academia.

Referencing growing concerns over the recruitment and retention of faculty in academic veterinary medicine, the authors hypothesized that among surveyed veterinary residents and early-career faculty, work-life balance and workplace climate and culture are stronger motivators than financial considerations, regardless of demographic factors such as gender, race/ethnicity, and area of specialization. 541 participants were included in data analysis. A mixed methods approach was utilized, incorporating both quantitative data and qualitative, free-text responses to better understand veterinary career choices by contextualizing factors associated with academic medicine. Factors underpinning career-related decision-making were ranked by level of importance as (1) workplace environment/culture, (2) personal well-being/work-life balance, (3) salary and bonuses, (4) geographic location, (5) facilities and resources, (6) benefits, and (7) schedule flexibility. Desires for workload balance, schedule flexibility, support from leadership, and mentorship and collaboration were among the top themes of qualitative responses for both residents and early career faculty respondents. Factors influencing career decision-making for resident and early-career faculty are varied. Workplace environment, work-life balance, and schedule flexibility are areas that academic institutions can address and continue to improve and that are likely to positively impact entry into academia and the desire to stay. This study sought to understand factors related to career decision-making and interest in academic veterinary medicine among residents and early-career faculty. Understanding these factors can support efforts to recruit and retain faculty in academic veterinary medicine.

Opinions on the Medical and Recreational Use and Legalization of Marijuana in Mexico: Results of a National Survey

Introduction. The use of medical marijuana was legalized in Mexico in 2017. In June 2021, the Supreme Court authorized personal marijuana use, as well as its planting, cultivation, harvest, preparation, possession, and transportation for recreational purposes by persons aged 18 and over, decriminalizing its use. Objectives. 1) To determine which variables are associated with favorable opinions regarding medical use, recreational use, and the legalization of marijuana use; and 2) to determine whether there are differences in the variables that best predict support for medicinal and recreational use and legalization of marijuana among marijuana users and non-users. Method. Data are drawn from the 2016 National Survey on Drug, Alcohol, and Tobacco Use, administered to a nationally representative sample of Mexican households. A validated questionnaire was used with questions on demographic characteristics, marijuana use (including the number of times it has been used), respondents’ opinions regarding the legalization of marijuana and recreational use, whether they have been offered marijuana without having to pay for it, perception of risk associated with marijuana use, and excessive alcohol consumption. Results. Being male and having a low perception of the risks of marijuana use are the variables mostly strongly associated with approving medical and recreational use and its legalization, irrespective of whether respondents used it. Other variables associated with approval are age, educational attainment, and income level. Discussion and Conclusion. Legislators and policy makers should consider the full range of public opinion concerning the use and legalization of marijuana and incorporate it into their proposals.

A Review of Studies on the Treatment of Premature Ejaculation with Traditional Chinese Medicine

By combing the literature and analyzing the current status of traditional Chinese medicine (TCM) treatment for premature ejaculation (PE), the strengths and shortcomings of the existing studies were identified. Building upon this assessment, we put forward a prospect for the establishment of TCM-specific strategies for PE, including more targeted and individualized comprehensive diagnosis and treatment approaches for PE, the establishment of a TCM hierarchical management program, and the exploration of the most effective entry points for collaborative treatment of PE using both TCM and Western medicine. Indeed, integrating therapeutical strategies from the two perspectives in a multifaceted and complex symptom such as PE, would enhance the possibility of success, possibly also reducing side effects. Moreover, with the help of well-established and new scientific and technological tools, we can explore the key links and targets in treating PE by TCM. At the same time, the mechanism of TCM treatment for PE could and should be examined in depth to lay the foundation for widespread clinical application. Finally, we suggest conducting multicenter, nationwide standardized clinical studies on treating PE with TCM. These studies should employ high-quality randomized controlled trial designs to obtain robust evidence-based medical data.

“Scapular heat penetration” technique of acupuncture in treatment of scapulohumeral periarthritis: Exploratory research: “穿胛热”针法治疗肩周炎-探索性研究

ObjectiveTo observe the clinical effect of “scapular heat penetration” technique of acupuncture in treatment of scapulohumeral periarthritis. DesignIt was a single-central randomized controlled trial, the participants, outcome assessors and statisticians were blinded. SettingThe trial was undertaken in Department of Acupuncture and Moxibustion, Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, from June 2021 to January 2022. ParticipantsSixty-seven patients with scalpulohumeral periarthritis were participated. InterventionsIn the control group, the routine acupuncture was given, while in the trial group, the “scapular heat penetration” technique of acupuncture was adopted. The intervention was delivered once every two days, 3 treatments a week; and one course included 9 treatments. Before the 1st treatment and after the 9th treatment, the symptoms and physical signs were observed and recorded in each group. OutcomesPrimary outcome: the score of visual analogy scale (VAS) before treatment and after treatment completion. Secondary outcomes: the range of movement (ROM) of shoulder joint, the score of Japanese Orthopaedic Association (JOA) of shoulder joint and the infrared thermal imaging temperature around the shoulder. ResultsA total of 102 cases were collected, 72 cases of them were eligible and 5 cases were withdrawn. Sixty-seven cases were included in analysis. In the within-group comparison, VAS score, ROM and JOA score as well as the shoulder temperature were all ameliorated after 9 treatments in either the trial group or the control group, compared with those before treatment (P < 0.05). In the comparison between two groups, after 9 treatments, VAS score in the trial group was lower than that of the control group (P < 0.05); and the improvements in ROM and shoulder temperature in the trial group were better than those of the control group (P < 0.05). No adverse reactions were found in the two groups. ConclusionBoth the “scapular heat penetration” technique of acupuncture and the conventional acupuncture are effective on scapulohumeral periarthritis. But, regarding the improvements in pain, ROM of shoulder joint, the activity of daily life and shoulder temperature, the “scapular heat penetration” technique of acupuncture is superior to the conventional acupuncture. Registration numberChiCTR1900025505

A Case of Peritoneal Dialysis-associated Encapsulated Peritoneal Sclerosis Treated with a Combination of Chinese and Western Medicine

A Case of Peritoneal Dialysis-associated Encapsulated Peritoneal Sclerosis Treated with a Combination of Chinese and Western Medicine

Diagnosis and Treatment of Membranous Nephropathy in Integrative Medicine

Membranous nephropathy (MN) is a common glomerular disease. The related pathological changes are primarily characterized by the deposition of immune complexes beneath the epithelial cells of the glomerular basement membrane, accompanied by diffuse thickening of the basement membrane. Its etiology and pathogenesis are not fully understood yet; however, they are associated with genetics, infections, tumors, drugs, heavy metals poisoning, environmental pollution, and the loss of immune tolerance. Over 10 target antigens, including the phospholipase A2 receptor (PLA2R) and thrombospondin type 1 domain containing 7A (THSD7A), associated with MN have been identified, each having different clinical implications. Clinical manifestations of MN patients mainly include proteinuria and nephrotic syndrome, with a propensity to form thrombi. Its diagnostic accuracy can be enhanced by combining clinical manifestations, serum antibody testing, and renal biopsy. Proteinuria, estimated glomerular filtration rate (eGFR), and PLA2R antibody levels are vital for the prognostic risk stratification of MN. Low-risk patients primarily undergo non-immunosuppressive treatment (angiotensin-converting enzyme inhibitor [ACEI]/angiotensin II receptor blocker [ARB], sodium-glucose cotransporter 2 inhibitor [SGLT2i], anticoagulants, and traditional Chinese medicine [TCM] treatments), while high-risk patients need to consider using steroids and immunosuppressants, such as cyclophosphamide (CTX), calcineurin inhibitors (CNIs), and anti-cluster of differentiation 20 (anti-CD20) monoclonal antibodies. TCM holds that MN is the imbalance of Fei (lung), Pi (spleen), and Shen (kidney) function, leading to the generation of Neixie such as Shi, Re, Du, and Yu. This disease is difficult to heal because of Shire and Yu. The treatment is based on the use of Jianpi Bushen, simultaneously emphasizing the use of drugs for Qingre Qushi Huoxue. Dialectical use of TCM can obviously improve the clinical response rate and alleviate symptoms such as edema and fatigue by increasing the serum albumin level more rapidly while introducing fewer adverse reactions. Combined with Western medicine, TCM can also reduce toxicity and increase efficiency. This article systematically reviews the etiology, podocyte antigens, clinical manifestations, diagnostic approaches, risk assessment, and integrative medicine therapeutic strategies for MN, aiming to deepen the understanding of MN and guide clinical practice.

Determinants and prediction of hypertension among Chinese middle-aged and elderly adults with diabetes: a machine learning approach

ObjectiveMultimorbidity, particularly diabetes combined with hypertension (DCH), is a significant public health concern. Currently, there is a gap in research utilizing machine learning (ML) algorithms to predict hypertension risk in Chinese middle-aged and elderly diabetic patients, and gender differences in DCH comorbidity patterns remain unclear. We aimed to use ML algorithms to predict DCH and identify its determinants among middle-aged and elderly diabetic patients in China. Study designCross-sectional study. MethodsData were collected on 2,775 adults with diabetes aged ≥45 years from the 2015 China Health and Retirement Longitudinal Study. We employed nine ML algorithms to develop prediction models for DCH. The performance of these models was evaluated using the area under the curve (AUC). Additionally, we conducted variable importance analysis to identify key determinants. ResultsOur results showed that the best prediction models for the overall population, men, and women were extreme gradient boosting (AUC=0.728), light gradient boosting machine (AUC=0.734), and random forest (AUC=0.737), respectively. Age, waist circumference, body mass index, creatinine level, triglycerides, taking Western medicine, high-density lipoprotein cholesterol, blood urea nitrogen, total cholesterol, low-density lipoprotein cholesterol, and sleep disorders were identified as common important predictors by all three populations. ConclusionsML algorithms showed accurate predictive capabilities for DCH. Overall, non-linear ML models outperformed traditional logistic regression for predicting DCH. DCH predictions exhibited variations in predictors and model accuracy by gender. These findings could help identify DCH early and inform the development of personalized intervention strategies.

Alternative therapy for lymphoma with febrile neutropenia using traditional Chinese medicine: A case report

IntroductionFebrile neutropenia is a common complication in patients undergoing chemotherapy for hematologic malignancies and is associated with significant morbidity and mortality. Primary granulocyte colony-stimulating factor (G-CSF) prophylaxis is consistently associated with a notable reduction in the risk of febrile neutropenia. However, the use of G-CSF in patients who are already neutropenic from chemotherapy remains controversial. Studies have shown that 12.9% of cancer patients incorporate traditional Chinese medicine (TCM) to alleviate chemotherapy side effects in Taiwan; thereby providing an alternative management strategy for neutropenic fever in cancer patients. Case presentationThis is an 18-year-old female with newly diagnosed precursor T-lymphoblastic lymphoma. After chemotherapy, the patient developed febrile neutropenia. Despite the use of antibiotics and G-CSF, the febrile neutropenia persisted for two months. Approximately ten days after the initiation of traditional Chinese medicine decoction with the strategy of tonifying the spleen and stomach, clearing yin fire, and uplifting yang, her absolute neutrophil count (ANC) had gradually increased. Additionally, after two weeks of treatment, her fever subsided. The patient continued with chemotherapy and was discharged in stable condition. DiscussionAntibiotic use aligns with the TCM perspective of an “attack” approach. Conversely, our TCM decoction was designed to raise the ANC by tonifying the spleen and stomach, clearing Yin Fire, and uplifting Yang. Li Dongyuan, one of the four great masters of the Jin Yuan Dynasty, created the formula: Bupiwei Shengyang Sanhuo Decoction that is notable in this regard. The herbs in our decoction have shown hematopoietic and myelosuppression-alleviating effect. For many patients who do not respond adequately to G-CSF alone, integrative treatments involving both TCM and Western medicine can offer additional therapeutic benefits by increasing blood cell counts.

Breaking the Silence: Restoring Justice in Academic Medicine.

Breaking the Silence: Restoring Justice in Academic Medicine.

The Resurgence of Exogenous Psychosis: A Phenomenological Examination of Substance-Induced Psychopathology.

The psychopathological manifestations associated with substance use, including induced psychotic experiences, are increasingly relevant but not well-understood within the medical community. Novel psychoactive substances and potentiated old compounds like cannabis and cocaine have emerged as a global concern, especially among adolescents and young adults. Transition rates from substance-induced psychosis (SIP) to persistent psychosis are significant, particularly in cases of cannabis-induced psychosis. Scientific inquiry into induced psychotic phenomena has revealed differences between SIP and primary psychotic disorders, highlighting the risk factors associated with each. The concept of exogenous psychosis, including its toxic variant known as lysergic psychoma, provides valuable insights into the role of external factors in psychosis development. A phenomenological approach characterizes this disruption in perception as a shift in temporal and spatial dimensions, leading to auditory and visual hallucinations. The "twilight state" of consciousness plays a crucial role in the transition from substance use to psychosis, with implications for spatiality, intersubjectivity, and temporality. This complex path to psychosis challenges traditional diagnostic models and underscores the need for a more nuanced understanding of substance-induced psychopathological experiences.

Application of ChatGPT to Support Nutritional Recommendations for Dialysis Patients – A Qualitative and Quantitative Evaluation

ObjectivesThe diversity of food preferences and the need for personalized care can be challenging for renal dietitians. We explored ChatGPT-4 to support nutritional advice given to dialysis patients. DesignIn this simulation study, we tasked ChatGPT-4 with generating a personalized daily meal plan, including nutritional information. SettingThe study used virtual “patients” generated through Monte Carlo simulation. SubjectsData from a randomly selected virtual patient were presented to ChatGPT. InterventionWe provided to ChatGPT patient demographics, food preferences, laboratory data, clinical characteristics, and available budget, to generate a one-day sample menu with recipes and nutritional analyses. The generated content was rated by a renal dietitian and compared with a USDA-approved nutrient analysis software. ChatGPT also analyzed nutrition information of two recipes published online. We also requested a translation of the output into Spanish, Mandarin, Hungarian, German, and Dutch. Main outcome measureThe outcome measures were the accuracy of ChatGPT's nutritional analysis, the quality of recipe and cooking instructions on a five-point Likert scale, and a quantitative nutritional analysis. ResultsChatGPT generated a daily menu with five recipes. The renal dietitian rated the recipes at 3 (3,3) [median (Q1, Q3)], the cooking instructions at 5 (5,5), and the nutritional analysis at 2 (2,2) on the five-point Likert scale. ChatGPT’s nutritional analysis underestimated calories by 36% (95% CI: 44-88%), protein by 28% (25-167%), fat 48% (29-81%), phosphorus 54% (15-102%), potassium 49% (40-68%), and sodium 53% (14-139%). The nutritional analysis of online available recipes differed only by 0 to 35%. The translations were rated as reliable by native speakers (4 on the five-point Likert scale). ConclusionWhile ChatGPT-4 shows promise in providing personalized nutritional guidance for diverse dialysis patients, improvements are necessary. This study highlights the importance of thorough qualitative and quantitative evaluation of AI-generated content, especially regarding medical use cases.

Targeting Therapeutic Windows for Rheumatoid Arthritis Prevention.

Rheumatoid arthritis (RA) is a worldwide public health problem. Interventions to delay or prevent the onset of RA have attracted much attention in recent years, and researchers are now exploring various prevention strategies. At present, there is still no unified consensus for RA prevention, but targeting therapeutic windows and implementing interventions for at-risk individuals are extremely important. Due to the limited number of clinical trials on pharmacologic interventions, further studies are needed to explore and establish optimal intervention regimens and effective measures to prevent progression to RA. In this review, we introduce the RA disease process and risk factors, and present research on the use of both Western and Chinese medicine from clinical perspectives regarding RA prevention. Furthermore, we describe several complete and ongoing clinical studies on the use of Chinese herbal formulae for the prevention of RA.

Efficient skin lesion segmentation with boundary distillation.

Medical image segmentation models are commonly known for their complex structures, which often render them impractical for use on edge computing devices and compromising efficiency in the segmentation process. In light of this, the industry has proposed the adoption of knowledge distillation techniques. Nevertheless, the vast majority of existing knowledge distillation methods are focused on the classification tasks of skin diseases. Specifically, for the segmentation tasks of dermoscopy lesion images, these knowledge distillation methods fail to fully recognize the importance of features in the boundary regions of lesions within medical images, lacking boundary awareness for skin lesions. This paper introduces pioneering medical image knowledge distillation architecture. The aim of this method is to facilitate the efficient transfer of knowledge from existing complex medical image segmentation networks to a more simplified student network. Initially, a masked boundary feature (MBF) distillation module is designed. By applying random masking to the periphery of skin lesions, the MBF distillation module obliges the student network to reproduce the comprehensive features of the teacher network. This process, in turn, augments the representational capabilities of the student network. Building on the MBF distillation module, this paper employs a cascaded combination approach to integrate the MBF distillation module into a multi-head boundary feature (M2BF) distillation module, further strengthening the student network's feature learning ability and enhancing the overall image segmentation performance of the distillation model. This method has been experimentally validated on the public datasets ISIC-2016 and PH2, with results showing significant performance improvements in the student network. Our findings highlight the practical utility of the lightweight network distilled using our approach, particularly in scenarios demanding high operational speed and minimal storage usage. This research offers promising prospects for practical applications in the realm of medical image segmentation.