At the beginning of the century, the emergence of systems biology and physiome have opened doors of the integrative life sciences. Until then, the reductionism approach was mainstream in the life science. And a few years later, the development of deep learning algorithm has accelerated the advancement of data analysis technology by machine learnings in a wide range of fields. In recent years, application of systems biology and machine learnings to medical science has begun. To lead the development of this new medical science, the AI systems medicine research and training center（AISMEC）was established in April 2018 at the graduate school of medicine and Yamaguchi University hospital. In this article, we briefly summarize the backgrounds of systems biology and machine learnings. Also, we introduce the activities of AISMEC and outline the situation of applications of these new technologies to medical science in recent years.

【Background and Aim】Older patients often exhibit delirium upon awakening after sedated endoscopy. This pilot study aimed to observe arousal levels using the Bispectral Index System（BIS）and clarify the appropriate timing for nursing intervention.【Methods】Participants consisted of four patients aged 65 and over（mean age 74.3）．Arousal level variability was measured using a BIS monitor. BIS data were obtained for 15 successive minutes the day prior to the procedure as baseline and for 240 successive minutes after sedated endoscopy.【Results】None of the participants exhibited delirium. BIS values started to decrease soon after sedation and increased around 120 min after patients completed the endoscopy and were transferred back to their room. During the endoscopy, the average BIS value changed within the moderate sedation depth recommended by the Japan Gastroenterological Endoscopy Society.【Conclusion】Our results suggest some possibility that delirium could appear in older patients around 120 min after endoscopy, although no delirium had been observed in participants included herein. Thus, BIS values could perhaps be used as ancillary data for controlling moderate sedation depth during endoscopy and performing timely nursing intervention.

The aneurysmectomy with posterior approach may be the most radical surgery to treat popliteal artery aneurysm（PAA）．However, major problems of this operation are choice and harvest of the autologous conduit in the prone position. A 73-year-old man presented to the orthopedic clinic with a posterior knee pain, numbness of the calf and intermittent claudication of the left leg. He was referred to our department due to the mass of the popliteal fossa and the reduction in ankle / brachial pressure index（0.62）．Contrast-enhanced CT and MRI revealed a thrombosed PAA with a diameter of 4cm. To improve of ischemic and nerve compression symptoms, we performed aneurysmectomy with posterior approach and arterial reconstruction using the basilic vein. Preoperatively, we confirmed that the diameter and length of the left basilic vein fitted the target artery using sonography and it was able be harvested in a prone position. We reported a case of PAA who underwent aneurysmectomy and arterial reconstruction using the basilic vein graft without changing position from prone to supine during operation.