Adenocarcinoma ; metabolism ; pathology ; Adenocarcinoma, Follicular ; metabolism ; pathology ; surgery ; Bronchial Neoplasms ; metabolism ; secondary ; surgery ; Carcinoid Tumor ; metabolism ; pathology ; DNA-Binding Proteins ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Thyroglobulin ; metabolism ; Thyroid Neoplasms ; metabolism ; pathology ; surgery ; Transcription Factors

The application of face recognition technology is gradually expanding to the medical field. It has been initially used in the medical diagnosis of endocrine diseases and genetic syndrome. This technology is expected to be used for the screening of genetic syndrome and endocrine diseases, shortening the delay period of disease diagnosis and helping the staging of endocrine diseases. However, this technology also has some moral risks, such as the risk of personal information security disclosure, the challenge to the future of mankind and the division of moral responsibility. This paper reflected on the dilemma of moral responsibility in the application of face recognition and medical diagnosis, and explored the two basic problems of "who is the subject of moral responsibility" and "the specific division of moral responsibility of different moral subjects" in face recognition and medical diagnosis. Finally, some suggestions on the moral responsibility in face recognition and medical diagnosis are put forward. The first is to determine the role of face recognition and medical diagnosis as an auxiliary category, and doctors are still the main medical subject; the second is to build the responsibility ethics mechanism and laws and regulations, the establishment of the responsibility system of face recognition and medical diagnosis is inseparable from the joint action of law and ethics.

Objective To evaluate the imaging findings of thoracic Castleman's disease (CD)to improve the diagnostic accuracy. Methods The imaging findings of 14 cases of thoracic CD confirmed by pathology were analyzed retrospectively.Plain and dynamic contrast-enhanced CT scans were performed in all patients before surgery.Results Among the 14 cases,10 cases were hyaline vascular type (HVT)and other 4 cases were plasma cell type (PCT).HVT-CD showed well-define,homogeneous soft-tissue lesion with different sizes of lymph nodes around the lesions in 2 cases,mottled calcification in 2 cases and coarse calcification in 1 case.Dynamic enhanced CT showed HVT-CD had obvious enhancement in arterial phase,and sustained enhancement in venous phase and delayed phase.PCT-CD all showed enlarged lymph nodes in the mediastinum and bilateral axillary,associated with interstitial pneumonia,pulmonary nodules,ground glass opacity and pleural effusion,with marked and sustained enhancement 1 case.Conclusion Thoracic HVT-CD presents equal density on CT plain scan,and obvious and durative enhanement on multiphase contrast-enhanced CT,which can be accompanied by lymphnodes around the lesions and intratumoral calcification.With the above imaging findings,we should consider the possibility of HVT-CD.CT features of PCT-CD are non-specific,a comprehensive evaluation of the clinical data should be combined,but the obviously enhanced PCT-CD can be diagnosed.

Objective:To explore the psychological experience and demand of parents of children with delayed recovery after congenital heart disease surgery.Methods:This study adopted phenomenological research methods from qualitative research. Using the purposive sampling method, parents of postoperative delayed recovery children with congenital heart disease who met the inclusion criteria were selected as the research objects from October to November 2019 at Fuwai Hospital, Chinese Academy of Medical Sciences. Semi-structured interviews were conducted with the parents of the children, and the data were analyzed by Colaizzi 7-step analysis method.Results:Finally, 13 parents of children with delayed recovery after congenital heart disease surgery were included. According to the interview results, four themes were extracted, which were negative psychological experience of parents of children with delayed recovery, positive psychological experience and expectation change of parents, heavy economic burden of parents and diversified needs of parents.Conclusions:During the delayed recovery period, psychological experience of parents is complex and their needs are diverse. The nursing staff should identify and pay attention to the causes of the negative psychological experience of the parents of the children, timely channel their negative emotions and strengthen the positive psychological experience in many aspects. They can assist parents to seek social help to reduce physical and mental pressure and meet the diverse needs of parents by providing high-quality nursing services and multi-channel information support.

Under the diagnosis-related groups(DRG) prospective payment system, innovative health technologies with high costs and risks may be limited to some extent. How to balance the increase of health care cost and the development of innovative health technology is a difficult problem to be solved in the current reform. By studying the relatively mature payment systems of innovative health technologies in the world, the authors found that countries generally adopted additional payment or compensation to encourage the development of new technologies. But at the same time, a relatively perfect health technology assessment and payment management mechanism had been established to ensure the standardized operation of payment plan. These international advanced experience and practice could provide references for China′s innovative health technology payment strategy under the DRG payment system. It is suggested to establish a scientific and reasonable assessment mechanism of innovative health technology, create a special access channel for innovative health technology with limited short-term evidence, and gradually form a long-term incentive mechanism of innovative health technology in DRG payment system.

Objective:To investigate the importance and clinical significance of breast reconstruction’s procedure classification and coding.Methods:By retrieving the medical record information system, the breast reconstruction cases with a diagnosis code (ICD-10) of C50 or Z85.3 and a procedure code (ICD-9-CM-3) of 85.33, 85.35, 85.53, 85.54, 85.55, 85.7, 85.95, or 85.96 were collected from Wuhan Union Hospital from Jan. 2016 to Dec. 2019. The reconstruction techniques and timing of the cases were counted according to the clinical procedure names in the operation notes and to the ICD codes verified by the content from operation notes and progress notes, respectively. The results were compared and analyzed by chi-square test with P<0.05 indicating statistically significant difference. Results:A total of 108 cases were included in the study. The difference between clinical procedure names and ICD codes regarding the reconstruction techniques is statistically significant ( P<0.05) with 51 clinical procedure naming ambiguities (47.2%) i. e., the names do not precisely indicate the reconstruction techniques. Similarly, the difference between clinical procedure names and ICD codes regarding the reconstruction timing is statistically significant ( P<0.05) with 29 clinical procedure name errors (26.9%). i. e., the reconstruction timing in the name does not correspond to its counterpart in reality. Conclusions:The clinical procedure names cannot accurately tell the reconstruction techniques or the timing of the procedure, affecting the correctness of the procedure coding and the diagnosis-related groups (DRGs) result. We suggest the reconstruction surgeons to learn some procedure classification and coding knowledge in a timely manner in order to enhance the correctness of the procedure names and coding and to get adapt to the medical insurance payment reform based on CHS-DRG.

Objective:To investigate the importance and clinical significance of breast reconstruction’s procedure classification and coding.Methods:By retrieving the medical record information system, the breast reconstruction cases with a diagnosis code (ICD-10) of C50 or Z85.3 and a procedure code (ICD-9-CM-3) of 85.33, 85.35, 85.53, 85.54, 85.55, 85.7, 85.95, or 85.96 were collected from Wuhan Union Hospital from Jan. 2016 to Dec. 2019. The reconstruction techniques and timing of the cases were counted according to the clinical procedure names in the operation notes and to the ICD codes verified by the content from operation notes and progress notes, respectively. The results were compared and analyzed by chi-square test with P<0.05 indicating statistically significant difference. Results:A total of 108 cases were included in the study. The difference between clinical procedure names and ICD codes regarding the reconstruction techniques is statistically significant ( P<0.05) with 51 clinical procedure naming ambiguities (47.2%) i. e., the names do not precisely indicate the reconstruction techniques. Similarly, the difference between clinical procedure names and ICD codes regarding the reconstruction timing is statistically significant ( P<0.05) with 29 clinical procedure name errors (26.9%). i. e., the reconstruction timing in the name does not correspond to its counterpart in reality. Conclusions:The clinical procedure names cannot accurately tell the reconstruction techniques or the timing of the procedure, affecting the correctness of the procedure coding and the diagnosis-related groups (DRGs) result. We suggest the reconstruction surgeons to learn some procedure classification and coding knowledge in a timely manner in order to enhance the correctness of the procedure names and coding and to get adapt to the medical insurance payment reform based on CHS-DRG.

Objective:To understand the monkeypox knowledge awareness, risk perception and vaccination intention in men who have sex with men (MSM) in five cities in northeast China.Methods:A cross-sectional study was conducted by using electronic questionnaire in MSM selected by convenience sampling in five cities in northeast China (Shenyang, Panjin, Changchun, Harbin and Jiamusi) from June 28 to July 8, 2023 by local centers for disease control and prevention and MSM communities. The sample size was estimated to be 220. Information about their demographics, monkeypox-related knowledge awareness, perceived concern about epidemic risk perception, and monkeypox vaccination intention were collected. Logistic regression model was used to analyze related factors for MSM's monkeypox vaccination intention.Results:In 355 MSM, 63.9% (227/355) had monkeypox vaccination intentions, and 55.5% (197/355) had high awareness of monkeypox related knowledge with a mean knowledge awareness score of 3.7±1.5. MSM with education level of high-school and above (a OR=1.93, 95% CI:1.01-3.69), higher knowledge awareness score (a OR=1.19, 95% CI:1.02-1.40) and higher risk perception of monkeypox infection (a OR=1.82, 95% CI:1.15-2.88), were more willing to receive monkeypox vaccination. The main reasons for willingness to receive monkeypox vaccine were preventing monkeypox (86.3%, 196/227) and worrying about appearance being affected (62.1%, 141/227). The main reasons for unwillingness for the vaccination included concerns about vaccine safety (53.1%, 68/128), clinical progression of AIDS being affected (46.1%, 59/128) and efficacy of antiretroviral therapy being affected (44.5%, 57/128). Conclusions:The levels of knowledge awareness and vaccine intentions still need to be improved among MSM in five cities of northeast China. It is necessary to improve the awareness of monkeypox and intention of monkeypox vaccination, promote protected sex behavior and self-assessment of infection risk, reduce vaccine hesitancy and increase monkeypox vaccination intention in MSM in 5 cities in northeast China.

This article highlighted the invaluable expertise of Academician TONG Xiaolin in managing severe cases of COVID-19， thereby providing ideas for the treatment of severe and critically ill patients with SARS-CoV-2 infection by integrating traditional Chinese and western medicine. It is believed that COVID-19 belongs to the “cold dampness epidemic” in traditional Chinese medicine， which is caused by pathogenic qi of cold and dampness. The course of the disease can be divided into four stages： constraint， block， collapse， and deficiency， and the severe cases are mainly in the block and collapse stages. The pathogenesis at the block stage is described as epidemic toxins blocking the lung， which should be treated by diffusing the lung and unblocking the bowels， resolving phlegm and unblocking collaterals. The primary formula used is Zilong Xuanbai Chengqi Decoction （子龙宣白承气汤） with modifications based on individual condition. The pathogenesis at the collapse stage is described as internal block and external collapse， which should be treated by restoring yang to save from collapse， boosting qi to relieve collapse， diffusing the lung and unblocking the bowels， resolving phlegm and unblocking collaterals， usually with the formula Poge Zilong Xuanbai Chengqi Decoction （破格子龙宣白承气汤） with modifications.

Objective: To explore the relationship between monocyte-to-lymphocyte ratio (MLR) in peripheral blood of patients with pulmonary sarcomatoid carcinoma (PSC) and their clinicopathological features and prognosis, and to investigate its clinical significance. Methods: A retrospective analysis was carried out to analyze the complete case data of 80 patients with PSC from October 2010 to April 2017 in Tianjin Cancer Hospital (monocyte and lymphocyte counts of peripheral blood, clinicopathological features, and survival follow-up). The receiver operating curve (ROC) was used to determine the best cut-off value of MLR for the prediction of overall survival time (OS). The patients were divided into high MLR group and low MLR group. Kaplan-Meier method was used to calculate OS and draw survival curves. The Log-Rank test was used to compare the difference in OS between the two groups. The variables with statistical significance in univariate analysis were included into the COX risk regression model to verify and calculate thehazard ratio (HR)and 95% confidence interval (95%CI). Results: The absolute median values of monocytes and lymphocytes were 0.63×109/L and 1.84×109/L, respectively. The best cut-off value of MLR is 0.44. Univariate analysis shows that MLR≥0.44 (P<0.01), no radical surgery (P<0.01), clinical stage Ⅲ+Ⅳ (P<0.01), tumor maximal diameter > 3 cm (P<0.01), and LDH>247 U /L (P<0.01) are the poor prognostic factors affecting overall survival. Multivariate analysis shows that MLR≥0.44（HR=3.554; 95%CI=1.671-6.125; P<0.01), and clinical stage Ⅲ+Ⅳ（HR=3.275; 95%CI=2.047-9.399; P<0.01) are the independent risk factors for the overall survival of PSC, and radical surgery is an independent protective factor affecting the overall survival of PSC（HR=0.360; 95%CI=0.195-0.848; P<0.01). Conclusion: High MLR is an independent risk factor for poor prognosis in patients with PSC.