Chen Shigong is a renowned traditional Chinese medical surgeon in the Ming Dynasty， and his medical ethical thought is an important part of ancient Chinese medical ethical thought. The “five precepts of physicians” and the “ten essentials for physicians” in his book Orthodox Manual of External Diseases are regarded as the third monument in the history of the development of traditional Chinese medical ethics. Chen Shigong’s medical ethical thought was mainly influenced by the Song and Ming philosophies， forming the worldview of “unity of heaven and humanity” and a philosophy of life of “unity of knowledge and action.” He also advocated the values of benevolence among physicians and indifference to fame and fortune， the doctor-patient view of treating patients equally and preserving privacy， the medical view of respecting peers and spreading medical skills， and the diagnosis and treatment view of fulfilling duties and treating patients based on syndrome differentiation. Chen Shigong’s medical ethical thought advocated that medical ethics and skills should be given equal importance， which has a strong vitality and important reference value in strengthening medical ethical education， improving doctor-patient relationships， and cultivating the spirit of “benevolence” among physicians.

ObjectiveTo examine the public cognition， preferences， and values regarding organ allocation， thereby enhancing the public trust in China’s organ allocation system and providing a theoretical basis for human organ allocation in China. MethodsBy drawing on foreign questionnaires and finalizing the questionnaire after two rounds of expert discussion and evaluation， a nationwide online survey was conducted to investigate the Chinese public’s cognition， attitudes， and preferences towards organ allocation. ResultsNearly half of the respondents reported that they had only heard of （45.44%） or had never heard of （46.90%） the Organ Procurement Organizations （OPOs）. Most respondents expressed limited understanding of China’s organ allocation policy （68.42%） or specific procedures （67.89%）. Only 9.65% of respondents expressed strong support for the current organ allocation policy， while 75.76% indicated that national allocation policies would influence their willingness or decision to donate organs. The public showed stronger endorsement of the principles of “prioritizing the sickest，” “first-come， first-served，” and “prioritizing those with better prognosis” for organ allocation. There were statistically significant differences in the public cognition， attitudes， and preferences for organ allocation by gender， age， education level， and occupation （all P<0.05）. ConclusionThe Chinese public’s cognition regarding organ allocation is generally low， and their willingness to donate organs is not high. The public attitude towards organ allocation policy remains unclear and is still in a “wait-and-see” state； the public prefers an ethical distribution model that balances fairness and efficiency. Increasing the public understanding of organ allocation procedures and incorporating public opinion into national organ allocation guidelines could play a significant role in enhancing public willingness to donate organs.

Objective:To implement visual analysis on inflammatory bowel disease and sleep to explore research hotspots and development trends.Methods:Literature related to inflammatory bowel disease and sleep was obtained from the Web of Science core collection database. The search period was from January 2003 to October 2023. CiteSpace 5.6.R5 was used for visual analysis.Results:A total of 311 articles on inflammatory bowel disease and sleep were included, and the overall publication volume showed an upward trend. The countries and institutions with the highest publications were the United States and Harvard University. The journal and author with the highest publication volume were Inflammatory Bowel Diseases and Ali Keshavarzian. The research hotspots on inflammatory bowel disease and sleep focused on quality of life, psychological state (depression, anxiety, and stress), fatigue, and risk. Conclusions:The overall trend of inflammatory bowel disease and sleep is developing. Quality of life, psychological state (depression, anxiety, and stress), fatigue, and risk are hotspots on inflammatory bowel disease and sleep.

Objective To review the literatures about ability in management of perioperative frailty in the elderly cancer patients and to provide references for clinical development of perioperative frailty management.Methods The methodological framework proposed by Arskey and O'Malley was used to retrieve studies on perioperative management of frailty in elderly cancer patients through the databases of CNKI,Wanfang Data,Chinese Biomedical Literature,PubMed,CINAHL,Embase,Cochrane and Scopus,from inception of the databases to May 2023.The included literatures were summarised and analysed by two independent researchers.Results A total of 23 studies were included,with 14 randomised controlled trials,6 reviews,1 expert consensus and 2 quasi-experimental studies.Perioperative frailty management abstracted from the retrieved literatures included preoperative frailty management,early postoperative frailty management,continuous frailty management after discharge,and hospice care management.Conclusions Perioperative fateful management of elderly cancer patients is diversified,including management of perioperative frailty,early postoperative frailty,continuous frailty after discharge and hospice care.The results of this study provide references in perioperative frailty management of elderly cancer patients.

Rosuvastatin(RVS)is an excellent drug with anti-inflammatory and lipid-lowering properties in the aca-demic and medical fields.However,this drug faces a series of challenges when used to treat atherosclerosis caused by hyperhomocysteinemia(HHcy),including high oral dosage,poor targeting,and long-term toxic side effects.In this study,we applied nanotechnology to construct a biomimetic nano-delivery system,macrophage membrane(M?m)-coated RVS-loaded Prussian blue(PB)nanoparticles(MPR NPs),for improving the bioavailability and targeting capacity of RVS,specifically to the plaque lesions associated with HHcy-induced atherosclerosis.In vitro assays demonstrated that MPR NPs effectively inhibited the Toll-like receptor 4(TLR4)/hypoxia-inducible factor-1α(HIF-1α)/nucleotide-binding and oligomerization domain(NOD)-like receptor thermal protein domain associated protein 3(NLRP3)signaling pathways,reducing pyroptosis and inflammatory response in macrophages.Additionally,MPR NPs reversed the abnormal distribution of adenosine triphosphate(ATP)-binding cassette transporter A1(ABCA1)/ATP binding cassette transporter G1(ABCA1)/ATP binding cassette transporter G1(ABCG1)caused by HIF-1α,promoting cholesterol efflux and reducing lipid deposition.In vivo studies using apolipoprotein E knockout(ApoE-/-)mice confirmed the strong efficacy of MPR NPs in treating atherosclerosis with favorable bio-security,and the mechanism behind this efficacy is believed to involve the regulation of serum metabolism and the remodeling of gut microbes.These findings suggest that the synthesis of MPR NPs provides a promising nanosystem for the targeted therapy of HHcy-induced atherosclerosis.

Objective: The aim of this study was to determine the poly (ADP-ribose) polymerase inhibitors (PARPis) response and outcome of ovarian cancer (OC) patients with BRCA1/2 germline mutation and a history of breast cancer (BC). Methods: Thirty-nine OC patients with BRCA1/2 germline mutation and a history of BC were included. The clinicopathological characteristics, PARPis response and prognosis were analyzed. Results: The median interval from BC to OC diagnosis was 115.3 months (range=6.4–310.1).A total of 38 patients (38/39, 97.4%) received platinum-based chemotherapy after surgical removal. The majority of these patients were reported to be platinum sensitive (92.1%, 35/38).21 patients (53.8%) received PARPis treatment with 16 patients (76.2%) for maintenance treatment and 5 patients (5/21, 23.8%) for salvage treatment. The median duration for PARPis maintenance and salvage treatment was 14.9 months (range=2.0–56.9) and 8.2 months (range=5.2–20.7), respectively. In the entire cohort, 5-year progression-free survival (PFS) and overall survival (OS) rate was 33.1% and 78.9%, respectively. Patients with BRCA1 mutation had a non-significantly worse 5-year PFS (28.6% vs. 45.8%, p=0.346) and 5-year OS (76.9% vs.83.3%, p=0.426) than those with BRCA2 mutation. In patients with stage III–IV (n=31), first line PARPis maintenance treatment associated with a non-significantly better PFS (median PFS: NR vs. 22.4 months; 5-year PFS: 64.3% vs. 21.9%, p=0.096). Conclusion The current study shows that these patients may have a good response to platinum-based chemotherapy and a favorable survival. And these patients can benefit from PARPis treatment and will likely be suitable candidates for PARPis.

Objective To evaluate early outcomes of transthoracic pulmonary valve implantation for the treatment of moderate and severe pulmonary regurgitation by using homemade self-expanding valve (SalusTM). Methods Patients with severe pulmonary regurgitation who underwent transthoracic pulmonary valve implantation in Guangdong Provincial People’s Hospital from September 2, 2021 to November 25, 2022 were prospectively enrolled. The early postoperative complications and improvement of valve and heart function were summarized and analyzed. Results A total of 25 patients were enrolled, including 16 males and 9 females, with an average age of 24.5±1.5 years and an average weight of 57.0±3.0 kg. The mean systolic diameters of the bifurcation near the main pulmonary artery, the stenosis of the middle segment of the aorta and near the valve of the right ventricular outflow tract of the patients were 31.8±7.4 mm, 30.6±5.9 mm and 38.4±8.0 mm, respectively. All patients were successfully implanted with valves, and there were no serious complications such as death, coronary compression, stent fracture, valve displacement and infective endocarditis in the early postoperative period. The indexed left atrial longitudinal diameter, indexed right atrial longitudinal diameter, and indexed right ventricular outflow tract anteroposterior diameter decreased significantly after the operation. The degree of tricuspid and pulmonary valve regurgitation and the indexed regurgitation area decreased significantly. The above differences were statistically significant (P<0.05). Conclusion The early outcomes of transthoracic pulmonary valve implantation with homemade self-expanding pulmonary valve (SalusTM) in the treatment of severe pulmonary regurgitation is relatively good, and the long-term outcomes need to be verified by the long-term follow-up studies with large samples.

In order to further standardize the diagnosis and treatment of long-term systemic complications in kidney transplant recipients,Branch of Organ Transplantation of Chinese Medical Association initiated the formulation of"Clinical Diagnosis and Treatment Guidelines for Long-term Systemic Complications in Kidney Transplant Recipients in China".Experts on organ transplantation were organized to summarize and integrate the latest progress in this field based on existing clinical guidelines,systematic evaluations,case studies,expert consensus.The guideline was formed after multiple rounds of discussion and reaching a consensus which included complications of hematological system,central nervous system,cardiovascular system,ocular,cutaneous and osteoporosis disorders.The full text focuses on 27 clinical problems and forms 40 recommendations,mainly involving the risk factors,classification,diagnosis,treatment and prevention of various complications.This guideline graded the quality of evidence and the strength of recommendation for each clinical issue using 2009 Oxford Centre for Evidence-Based Medicine(OCEBM)Grading and Strength of Recommendation criteria,so as to provide reference for the diagnosis and treatment of late complications,comprehensively improve the management capacity of clinicians to benefit kidney transplant recipients.

The diagnosis and treatment of digestive system complications of kidney transplant recipients is related to the long-term survival and quality of life of patients,which needs great attention.In order to further standardize its diagnosis and treatment,Branch of Organ Transplantation of Chinese Medical Association initiated the formulation of"Clinical Diagnosis and Treatment Guidelines for Digestive System Complications in Kidney Transplant Recipients in China",and organized experts in organ transplantation and related disciplines to summarize the new progress in diagnosis and treatment of digestive system complications of kidney transplant recipients at home and abroad in recent years based on existing clinical research,systematic evaluation,case study,expert consensus and existing guidelines,and reached a consensus after many discussions.This paper focuses on 11 clinical problems,forming 16 recommendations,and grading the evidence quality and recommendation strength of each clinical problem by the evidence grading and recommendation strength standard of Oxford University Evidence-based Medicine Center in 2009,in order to provide reference for the diagnosis and treatment of digestive system complications of kidney transplant recipients,comprehensively improve the management ability of digestive system complications of clinicians in an all-round way and benefit transplant recipients.

The STAR tool was used to evaluate and analyze the science, transparency, and applicability of Chinese pathology guidelines and consensus published in medical journals in 2022. There were a total of 18 pathology guidelines and consensuses published in 2022, including 1 guideline and 17 consensuses. The results showed that the guideline score was 21.83 points, lower than the overall guideline average (43.4 points). Consensus ratings scored an average of 27.87 points, on par with the overall consensus level (28.3 points). Areas that scored above the overall level were "conflict of interest" and "working groups", while areas that scored below the overall level were "proposals", "funding", "evidence", "consensus approaches" and "accessibility". To sum up, the formulation of pathology guidelines and consensuses in 2022 is not standardized, and the evidence retrieval process, evidence evaluation methods and grading criteria for recommendations on clinical issues are not provided in the formulation process; the process and method for reaching consensus are not provided, the plan is lacking, and registration is not carried out. It is therefore suggested that guidelines/consensus makers in the field of pathology should attach importance to evidence-based medical evidence, strictly follow guideline formulation methods and processes, further improve the scientific, applicable and transparent guidelines/consensuses in the field, and better provide support for clinicians and patients.