In the era of deep technologization with the flourishing development of newquality productive forces， China’s medical science and technology innovation has transitioned from “following” to “leading”， and the ethical governance environment of medical science and technology has undergone profound changes. However， the traditional ethical governance system of medical science and technology faces several issues， such as outdated ethical governance concepts， inadequate ethical norms， excessive hidden ethical risks， and numerous loopholes in governance systems， which fail to effectively respond to the diverse and complex ethical risk challenges. To this end， it is essential to promote the transformation of ethical governance thinking in medical science and technology based on the reality of newquality productivity forces and deep technologization， as well as to shift unilateral， extensive， and single governance into comprehensive， precise， and early-warning governance. Additionally， it is necessary to cultivate an ethical governance concept that prioritizes ethics and prevention， establish a diverse and collaborative ethical governance model， set up a prevention mechanism focused on major ethical risks， as well as enhance the systems of ethical communication， review， and feedback in medical science and technology.

ObjectiveTo retrospectively analyze the epidemiological trends of birth defects in perinatal infants in Fengxian District, Shanghai from 2018 to 2022, so as to provide a scientific evidence for the formulation of related prevention and control strategies. MethodsBased on the data from the National Birth Defects Surveillance System, statistical analysis was conducted on the perinatal birth defects from monitored hospitals within the region from 2018 to 2022. ResultsFrom 2018 to 2022, a total of 20 870 perinatal infants delivered in the monitored hospitals in Fengxian District, with 472 cases with birth defects, showing a significant increase in the prevalence of birth defects (PRR=1.49, 95%CI: 1.39‒1.59). The risk of birth defects increased with maternal age, especially for advanced maternal age (PRR=1.58, 95%CI: 1.12‒2.25). Infants born to mothers with gestational diabetes had a higher prevalence of birth defects compared to those without gestational diabetes (PRR=1.99, 95%CI: 1.46‒2.70). Infants with birth defects were more likely to be born prematurely (PRR=2.07, 95%CI:1.56‒2.76). The top three types of birth defects were congenital heart disease (CHD), other anomalies of the external ear, and polydactyly. ConclusionThe prevalence of birth defects in Fengxian District monitored hospitals showed an upward trend from 2018 to 2022. Advanced maternal age and gestational diabetes were identified as risk factors for birth defects. CHD is the leading type of birth defect in Fengxian District over the five-year period. To reduce the prevalence of birth defects, it is crucial to implement comprehensive prevention and treatment measures for CHD.

Objective: To analyze the distribution characteristics of immunoglobulin A (IgA) concentration in Nanning Zhuang blood donors by measuring the concentration of plasma IgA. Methods: Enzyme-linked immunosorbent assay (ELISA) was performed to measure the absorbance of 2 000 plasma samples from Zhuang blood donors. The IgA concentration in samples was calculated using the ELISA Calc regression/fitting technology program. Results: The standard curve demonstrated that ELISA detection of plasma IgA concentration exhibited good precision. The frequency of IgA deficiency was 0/2 000. No statistically significant difference in the distribution of IgA concentration was observed between males and females (P>0.05). The distribution of IgA concentration varied significantly across age groups: younger individuals (18-39 years old) had lower plasma IgA levels (mg/dL) compared to older individuals (40-56 years old): 5-89.99 mg/dL group, 8.80% (176/2 000) vs 17.20% (344/2 000); 90-450 mg/dL group,20.65% (413/2 000) vs 51.20% (1 024/2 000); >450 mg/dL group, 0.45%, (9/2 000) vs 1.70% (34/2 000), P<0.05. No significant difference in IgA concentration was found among different ABO blood types in Zhuang blood donors (P>0.05). Spearman correlation analysis revealed a positive correlation between age and IgA concentration (R =0.114, P<0.05). Conclusion: No individuals with IgA deficiency were screened out among the Zhuang blood donors in Nanning area, and plasma IgA levels progressively increase with age.

ObjectiveTo systematically evaluate the public health governance capacity of 40 cities in Jiangsu, Zhejiang, and Anhui Provinces, providing a scientific evaluation basis for building a "Healthy Yangtze River Delta". MethodsA comprehensive collection of policy documents, public information reports, and research literature related to public health governance capacity in Jiangsu, Zhejiang, and Anhui Provinces was conducted, totaling 6 920 policy documents, 1 720 information reports, and 1 200 literature pieces. Based on the evaluation standards for an appropriate public health system established by the research team, the basic status of public health governance capacity was assessed to identify the strengths and weaknesses of the 40 cities. ResultsIn 2022, the public health governance capacity score for the 40 cities in Jiangsu, Zhejiang, and Anhui Provinces was (562.5±38.0) points. In terms of specific areas, the emergency response field received the highest score of (791.4±49.7) points, while the chronic disease prevention and control field received the lowest score of (368.2±29.6) points. The Jiangsu-Zhejiang-Anhui region has largely achieved the strategic priority of health, gradually improved public health legal regulations, and established a basic organizational framework with a solid foundation for information and data infrastructure. However, challenges still need to be addressed, such as unstable government funding for public health, unclear departmental responsibilities, and barriers to information interoperability. ConclusionThe public health governance capacity of the 40 cities in Jiangsu, Zhejiang, and Anhui Province has been at a moderate level, but disparities have still existed across regions and fields. In the future, while continuing to deepen existing advantages, it is essential to accurately identify the causes of problems, establish a long-term and stable investment mechanism, enhance information connectivity mechanisms, further clarify departmental responsibilities, and promote the achievement of the "Healthy Yangtze River Delta" goal.

Objective:To comprehensively and systematically collect and review domestic and international studies on the practices of continuous bladder irrigation (CBI) following transurethral resection of the prostate (TURP), including the topics, research methods, and evaluation techniques used in these studies, and to provide clinical nursing staff with a reference.Methods:Nine Chinese and English databases were systematically searched, including CNKI, Wanfang, SinoMed, VIP, Embase, Cochrane Library, PubMed, CINAHL, and Web of Science. The search covered all literature up to April 10, 2023. The practices of CBI were extracted and systematically analyzed, and the results were reported in a standardized manner using a scoping review methodology.Results:A total of 23 eligible studies were included, comprising two English articles and 21 Chinese articles. The types of studies included 12 randomized controlled trials and 11 quasi-experimental studies. The interventions were categorized into single and comprehensive measures, including methods such as adjusting the temperature and flow rate of bladder irrigation, selection of indwelling catheters, traditional Chinese medicine-based nursing, perioperative psychological care, and rapid recovery protocols. The evaluation metrics used in the studies were classified into three levels: symptom indicators, process indicators, and management indicators.Conclusions:Research on CBI following TURP has achieved a certain scale, with a variety of intervention methods currently available. However, there is still a lack of high-quality evidence. Future studies should focus on enhancing research design, developing standardized quality assessment tools for bladder irrigation, and improving innovative irrigation devices to enhance clinical nursing quality.

Objective:To investigate the value of early tight junction protein Claudin-5 levels in predicting the severity of acute pancreatitis (AP).Methods:A prospective observational study was conducted, including patients diagnosed with AP and admitted to the Northern Jiangsu People's Hospital from December 1, 2021 to November 30, 2022. Eligible healthy volunteers were randomly selected to serve as healthy controls during the same period. Patients were classified into mild acute pancreatitis (MAP) group, moderate-severe acute pancreatitis (MSAP) group, and severe acute pancreatitis (SAP) group based on the 2012 Atlanta classification criteria. Patients with SAP were then divided into three subgroups of 1, 3, and 7 days based on the duration of hospitalization. Baseline data, such as gender, age, underlying disease, and probable etiology, was collected from all enrolled individuals. The enzyme-linked immunosorbent assay (ELISA) was employed to detect serum Claudin-5 levels in each cohort of enrollees. Data on additional serologic indicators, including hematocrit (HCT), albumin (Alb), serum Ca 2+, C-reactive protein (CRP), and procalcitonin (PCT) levels, were obtained via the in-hospital test query system in each group of patients with AP. The modified Marshall score (mMarshall), modified CT severity index (mCTSI) score, bedside severity index of severity in acute pancreatitis (BISAP) score, and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) were recorded for each group of patients with AP. Differences in the above indicators between groups were analyzed and compared. Spearman's correlation method was employed to examine the relationship between Claudin-5 levels and each influential factor. The receiver operator characteristic curve (ROC curve) was plotted to analyze the predictive value of each influencing factor on SAP. Ridge regression was used to screen for independent risk factors for SAP. Results:A total of 109 patients with AP were enrolled, comprising 66 in the MAP group, 15 in the MSAP group, and 28 in the SAP group. Additionally, 27 healthy volunteers were enrolled as the healthy control group. No statistically significant differences were observed in gender and age among the enrolled groups, and no statistically significant differences were identified among the three groups of patients with AP in terms of underlying disease and etiologic composition. As the disease progressed, serum Claudin-5 levels exhibited a notable increase across all AP patient groups, and they were all significantly higher than those in the healthy control group [ng/L: 888.58 (574.52, 1 141.59), 3 749.02 (2 784.93, 5 789.92), 4 667.81 (3 935.21, 7 315.66) vs. 291.13 (250.19, 314.75), all P < 0.05]. Subgroup analyses showed that as the disease duration prolonged, patients in the SAP group exhibited a notable decline in Claudin-5 levels at 3 days post-admission, compared with those at 1 day post-admission [ng/L: 2 052.59 (1 089.43, 4 006.47) vs. 4 667.81 (3 935.21, 7 315.66), P < 0.05]. Spearman correlation analysis showed that serum Claudin-5 levels in patients with AP were significantly positively correlated with CRP, PCT, HCT, and mMarshall, mCTSI, and BISAP scores ( r values were 0.570, 0.525, 0.323, 0.774, 0.670, 0.652, all P < 0.001), and significantly negatively correlated with Alb ( r = -0.394, P < 0.001). A significant trend was observed in patients with AP, with an increase of HCT levels and a decrease of Alb levels as the disease progressed (both P < 0.05). An improvement of aforementioned phenomena was observed in patients with SAP following treatment, indirectly indicating that serum Claudin-5 level was a positive indicator of vascular leakage. ROC curve analysis showed that serum Claudin-5 levels in patients with AP exhibited the highest accuracy for early prediction of SAP, with the area under the ROC curve (AUC) of 0.948. When serum Claudin-5 levels ≥2 997 ng/L, the sensitivity for early screening for SAP was 100% and the specificity was 88.89%. Multifactorial ridge regression analysis showed that serum Claudin-5 level, PCT and APACHEⅡscore could be used as independent risk factors for early prediction of SAP (all P < 0.05). Conclusion:Serum Claudin-5 levels facilitate early prediction of SAP and are strongly associated with inflammatory response and vascular leakage.

Objective:To explore the intolerable uncertainty level and its related factors in female patients re-ceiving in vitro fertilization and embryo transfer.Methods:A total of 503 female patients receiving in vitro fertiliza-tion and embryo transfer in a tertiary reproductive hospital in Shandong province were selected.Theywere assessed with a self-designed general information questionnaire,the Intolerance of Uncertainty scale-12(IUS-12),Fertility Problem Inventory(FPI,including social concern,sexual concern,relationship concern,need for parenthood,and re-jection of childfree lifestyle),and Hospital Anxiety and Depression Scale(HADS).Results:The score of IUS-12 was 28(13,60).Multiple stepwise regression analysis showed that having children,having anxiety symptoms,the scores of social concern,sexual concern and need for parenthood were positively associated with IUS-12 scores(β=0.11,0.19,0.21,0.13,0.25),and rejection of childfree lifestyle was negatively associated with IUS-12 scores(β=-0.18).Conclusion:It suggests that the unbearable uncertainty of women receiving in vitro fertilization and embryo transfer is related to whether they have children,social concerns,sexual concerns,need for parenthood,and rejection of childfree lifestyle.

Objective:To establish an automated labeling method of 18F-AlF-1, 4, 7-triazocyclohexane-1, 4, 7-triacetic acid- D-Phe1-Tyr3-Thr8-octreotide (NOTATATE) and perform neuroendocrine tumor (NET) imaging. Methods:Based on the GE-FASTLab2 synthesis module, 18F-AlF-NOTATATE was automatically prepared by one-step chelation labeling with aluminum fluoride, and its labeling conditions were optimized. The product quality was analyzed. One patient (male, 47 years old) with lower rectal segment NET and one patient (female, 52 years old) with pancreatic NET underwent 18F-AlF-NOTATATE PET/CT imaging. Results:18F-AlF-NOTATATE was successfully prepared with a total synthesis time of 35 min. The optimized radiochemical yield was (23.8±3.1)% (without decay correction, n=3), the radioactivity was (4.63±0.68) GBq, and the radiochemical purity was >95%. The stability was good, and the product quality met the requirements. 18F-AlF-NOTATATE showed clear imaging in the patient with rectal segment NET, with SUV max of 13.3 and tumor/liver ratio of 3.3. Metastatic lesions in the liver, lymph nodes, and ribs showed high SUV max and tumor/liver ratios. The imaging of the pancreatic NET patient showed an abnormal increase in local radioactive uptake at the uncinate process of the pancreatic head, with SUV max of 5.6 and SUV max of 6.3 and the tumor/liver ratio of 2.3 after 2-hours imaging. Conclusions:Using the GE-FASTLab2 synthesis module, 18F-AlF-NOTATATE can be prepared with high activity. The preparation is simple, the method is stable, and the product has high radiochemical purity. 18F-AlF-NOTATATE exhibits good imaging performance in NET patients, providing valuable information for diagnosis, treatment, and prognosis evaluation.

Objective:To investigate the impacts of magnesium isoglycyrrhetinic acid combined with continuous blood purification on organ function and inflammatory mediator levels in patients with severe acute pancreatitis (SAP) complicated with sepsis.Methods:A total of 124 patients with SAP complicated with sepsis who came to Subei People′s Hospital from March 2020 to February 2023 were grouped into an observation group (62 cases) and a control group (62 cases) according to the treatment method, the control group was treated with continuous blood purification, and the observation group was treated with magnesium isoglycyrrhetate on basis of the control group, the organ function, inflammatory mediator levels, clinical efficacy, and clinical medication safety of two groups were compared.Results:After treatment, the scores of acute physiology and chronic health status assessment (APACHE) Ⅱ and sequential organ failure assessment (SOFA) in both groups were decreased compared to before treatment, and the scores of APACHE Ⅱ and SOFA in the the observation group were lower than those in the control group: (26.43 ± 3.78) scores vs. (35.99 ± 3.87) scores, (9.18 ± 1.52) scores vs. (14.51 ± 1.88) scores, there were statistical differences ( P<0.05). After treatment, the levels of interleukin (IL)-8, tumor necrosis factor-α (TNF-α) and IL-6 in both groups were decreased, and the levels of IL-8, TNF-α and IL-6 in the the observation group were lower than those in the control group: (114.81 ± 23.74) ng/L vs.(268.32 ± 29.14) ng/L, (214.41 ± 25.09) ng/L vs. (311.33 ± 28.11) ng/L, (32.58 ± 4.76) ng/L vs. (46.35 ± 5.76) ng/L, there were statistical differences ( P<0.05). The total clinical effective rate after treatment in the the observation group was higher than that in the control group: 96.77%(60/62) vs. 80.65%(50/62), there was statistical difference ( χ2 = 6.52, P<0.05). The incidence of adverse reactions in the two groups had no statistical difference ( χ2 = 0.08, P>0.05). Conclusions:Magnesium isoglycyrrhetinic acid combined with continuous blood purification can improve organ function and reduce inflammatory mediator levels in SAP patients with sepsis.

Objective To observe the correlations of chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with blood eosinophil(EOS)level.Methods Chest CT data of 162 AECOPD patients with elevated eosinophils were retrospectively analyzed.The patients were divided into low EOS group(n=105)and high EOS group(n=57)according to the absolute counting of blood EOS.The quantitative CT parameters,including the number of whole lung bronchi and the volume of blood vessels,low-attenuation area percentage(LAA％)of whole lung,of left/right lung and each lobe of lung,as well as the luminal diameter(LD),wall thickness(WT),wall area(WA)and WA percentage of total bronchial cross-section(WA％)of grade 3 to 8 bronchi were compared between groups.Spearman correlations were performed to analyze the correlations of quantitative CT parameters with blood EOS level.Results LAA％of the whole lung,of the left/right lung and each lobe of lung,as well as of the upper lobe of right lung LDgrade4,middle lobe of right lung WTgrade5,upper lobe of right lung WAgrade4,middle lobe of right lung WAgrade5 and lower lobe of left lung WAgrade3 in low EOS group were all higher than those in high EOS group(all P＜0.05).Except for the upper lobe of right lung LDgrade4,the above quantitative CT indexes being significant different between groups were all weakly and negatively correlated with blood EOS level(r=-0.335 to-0.164,all P＜0.05).Conclusion Chest CT quantitative parameters of AECOPD patients were correlated with blood EOS level,among which LAA％,a part of WT and WA were all weakly negatively correlated with blood EOS level.