The development of organ transplantation has brought new hope to many patients with organ failure and their families， but it has also raised numerous ethical issues. How to balance the rights and interests between organ donors and recipients， as well as ensure the fairness and transparency of the transplantation process has become an urgent problem to be solved. Based on the latest Regulations on Organ Donation and Transplantation and the Working Rules of the Ethics Committee for Human Organ Transplantation， the current difficulties and challenges in organ transplantation ethics were deeply analyzed. Taking the ethical review practice of Shenzhen Third People’s Hospital as an example， this paper explored issues such as full informed consent of both donors and recipients， risk assessment of marginal donors， and the review of relationships between donors and recipients. It also explored and constructed a set of complete ethical review models for organ transplantation through refined management. This model improved the efficiency and quality of ethical review as well as enriched the related knowledge system. It is expected that the implementation of this model can provide a reference for promoting effective ethical review nationwide， advancing the improvement and development of ethical review work in organ transplantation. Meanwhile， more medical ethics experts and practitioners are called upon to focus on and engage in the research and practice of ethical review in organ transplantation， jointly promoting progress in this field.

Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.

Objective:To investigate the efficacy of anatomical resection (AR) in the early stages of treating solitary hepatocellular carcinoma (HCC) combined with liver cirrhosis with a diameter of ≤5 cm in comparison to different surgical methods of preferential hepatic parenchymal preservation (non-anatomical liver resection, NAR).Methods:The clinical data of 1 390 cases with solitary HCC combined with liver cirrhosis at an early stage who underwent liver resection at Mengchao Hepatobiliary Hospital of Fujian Medical University and six other medical centers from September 2013 to May 2019 were retrospectively analyzed. Patients were divided into the AR group (486 cases) and the NAR group (904 cases) and the wide surgical margin (WSM) group (745 cases) and the narrow surgical margin (NSM) group (645 cases) according to whether they received AR and the width of the surgical margin (1 cm). The basic information of the patients, preoperative evaluation index data, and postoperative follow-up (follow-up every 3 months) were collected. The Kaplan-Meier method was used to plot the survival curve.The log-rank test was used to compare the difference in survival between the two groups. The Cox proportional hazards regression model was used to analyze the factors affecting the prognosis. Propensity score matching (PSM) was applied to reduce intergroup bias.Results:The overall survival (OS) rates for all patients at 1, 3, and 5 years were 95.5%, 79.9%, and 63.5%, respectively. The recurrence-free survival (RFS) rates were 81.5%, 59.0%, and 43.7%, respectively. There was a statistically significant difference in RFS rate between the AR group and the NAR group prior to PSM, but no statistically significant difference in OS rate (RFS rate: 47.0% vs. 41.9%, P<0.05; OS rate: 64.4% vs. 62.9%, P>0.05). The postoperative RFS rate and OS rate were significantly superior in the WSM group than those of the NSM group (RFS rate: 47.8% vs. 37.2%, P<0.001; OS rate: 69.0% vs. 57.3%, P<0.001). There was no statistically significant difference in OS rate and RFS rate between the AR group and the NAR group following PSM (RFS: 46.3% vs. 45.1%, P>0.05; OS rate: 64.0% vs. 64.3%, P>0.05).The 5-year OS and RFS rates in the WSM group were 66.8% and 60.2%, respectively. The 5-year OS and RFS rates for the NSM group were 48.7% and 41.4%, respectively, with a statistically significant difference ( P<0.05). Cox multivariate analysis indicated that serum albumin, tumor diameter, microvascular invasion, and surgical margin were independent prognostic factors affecting OS and RFS. The Child-Pugh grade and satellite lesions were independent prognostic factors affecting OS. Conclusion:Anatomical liver resection is not an independent risk factor for prognosis, but the state of the resection margin determines the prognosis of patients with solitary HCC combined with cirrhosis. Therefore, hepatic resection margins should be prioritized in such patients.

Objective:To examine the validity and reliability of the DSM-5 Social Anxiety Disorder Severity Scale(SAD-D)in a Chinese adult population.Methods:The Chinese version of the DSM-5 Social Anxiety Disor-der Severity Scale was administered via online data collection platform Credamo to 300 adults(Sample 1,for item analysis,exploratory factor analysis and item selection of brief version of SAD-D)and 528 adults(Sample 2,for confirmatory factor analysis,criterion validity test,measurement invariance analysis and internal consistency reliabil-ity analysis for both SAD-D and its brief version).Criterion validity was tested with the Social Phobia Scale(SPIN)and Personal Report of Confidence as a Speaker(PRCS).A brief version of the scale was developed by u-sing the Ant Colony Optimization(ACO).A retest was conducted with 152 participants from Sample 2 after three weeks.Results:Exploratory factor analysis indicated that the SAD-D was a unidimensional scale with factor load-ings ranging from 0.49 to 0.82,and the results of the confirmatory factor analysis also supported the unidimension-al structure(x2/df=3.49,RMSEA=0.069,CFI=0.971,TLI=0.962,SRMR=0.028).The scores of Chinese version of the SAD-D were positively correlated with the SPIN scores(ICC=0.70,P＜0.001)and PRCS scores(ICC=0.73,P＜0.001).The Cronbach'α of the scale was 0.92,and the retest reliability was 0.85.The scale dem-onstrated cross-gender measurement invariance(△CFI＜0.01,△RMSEA＜0.01).The brief version of the SAD-D was selected as items 2,5,and 6,and its Cronbach'α coefficient was 0.86.Conclusion:The Chinese version of the SAD-D has satisfactoryvalidity andreliability,making it suitable for the assessment of social anxiety symptoms with Chinese adults.

Objective To construct the core outcome set(COS)for clinical research on Uyghur medicine in treating psoriasis by using internationally-recognized research methods,thus to aid the researchers in choosing the standardized outcomes and to enhance the quality of evidence from research findings.Methods A systematic retrieval of Chinese and English databases was conducted to collect outcomes from clinical studies,systematic reviews,and registered protocols of Uyghur medicine for treating psoriasis.An outcome pool was constructed based on the results of literature review.The outcomes were supplemented after qualitative surveys of patients and physicians,and then an initial list of outcomes was formed.Two rounds of Delphi surveys on the initial list were conducted for obtaining Likert scale ratings from different stakeholder groups to evaluate the importance of outcomes.After that,a consensus meeting was held to finalize the COS for clinical research on Uyghur medicine in treating psoriasis.Results The COS for clinical research on Uyghur medicine in treating psoriasis comprises six domains,totaling 14 outcomes.The 14 outcomes were psoriasis symptoms(psoriasis area and area severity index),skin manifestations(erythema,scaling,infiltration,etc.),investigator global assessment,patient global assessment,treatment satisfaction,health-related quality of life,recurrence rate,adverse events,drug adverse reactions,blood routine,urine routine,liver and kidney function,Uyghur medicine symptom assessment,and fluid changes.Conclusion The COS for clinical research on Uyghur medicine in treating psoriasis has been constructed,and will provide a reference for the selection of efficacy-evaluation outcomes and for the reporting of outcomes in related studies.

Objective To develop a core outcome set(COS)for treatment of progressive vitiligo in Uyghur medicine,and to standardize the selection and reporting of outcome measures in relevant studies.Methods Based on the existing core outcome domain set of randomized controlled trials for vitiligo,additional outcome indicators reflecting the advantages and characteristics of Uyghur medical treatment were developed.Specific indicators for Uyghur medical treatment of progressive vitiligo were collected through literature review and semi-structured questionnaire surveys,and then a list of indicators were formed.The Delphi survey and consensus meetings were used to select core indicators.Results A total of 54 studies were included,and 86 questionnaires were collected.Through literature review and questionnaire surveys,a list of 28 indicators were obtained.After two rounds of Delphi survey and one consensus meeting,12 outcome indicators in 7 domains were finally determined,including vitiligo lesion area,repigmentation,disease control time,maintenance of repigmentation,recurrence rate,immune indicators,psychological health,patients' quality of life,adverse events,adverse reaction incidence,liver and kidney function monitoring,and Uyghur medicine syndrome differentiation of mucus.Additionally,some measurement tools for certain indicators were recommended.Conclusion The development of the COS for vitiligo treatment in Uyghur medicine helps to comprehensively evaluate the efficacy of Uyghur medicine,and will provide a model for establishing efficacy evaluation methods that conform to the characteristics of ethnic minority medicine.

[Objective] To report a new technique that combines microfracture surgery under local anesthesia with injection of platelet-rich plasma (PRP) at the fracture site, so as to improve fracture healing rates. [Methods] Data from patients who visited our hospital from March 2020 to June 2023 and underwent the treatment for delayed union of limb fractures were retrospectively analyzed. Under local infiltrative anesthesia, with the assistance of a C-arm X-ray machine or ultrasound, percutaneous loosening was done at the fracture site and the medullary cavity, followed by cortical drilling around the fracture. The previously prepared PRP was then injected locally at the fracture site. Patients were followed up and their postoperative recovery was recorded. [Results] All patients were followed up, and the fracture healing rate was 94.12% (16/17), with an average healing duration of (5.88±2.50) months. None of the patients experienced any neural or vascular injuries, nor adverse events such as wound infections or osteomyelitis. Before the operation and at the last follow-up, the patients' pain visual analogue scores were (5.12±1.11) vs (0.71±1.21) respectively. The postoperative VAS scores showed a significant decrease compared to preoperative values (P<0.05). The excellent and good rate for limb function on the affected side was 88.24% (14/17) at the last follow-up, which was a significant increase from 0.00% before surgery (P<0.05). [Conclusion] The injection of PRP at the fracture site combined with microfracture surgery at the fracture site is minimally invasive, simple to perform, and well-accepted by patients. It has demonstrated some clinical efficacy in treating delayed fracture healing.

Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.

Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.

DSA is an essential technology for diagnosing and treating cerebrovascular diseases.Detailed vascular structures and hemodynamic information can be acquired through image post-processing technology from raw DSA images.Presently,DSA image analysis technology encompasses several methodologies,including automatic vascular segmentation and feature extraction,hemodynamic parameter derivation,and more intricate multimodal imaging fusion.This review elaborated on the development status of these techniques at the current stage and their probable application in clinical practice.