With the rapid advancement of medical technology and the increasing complexity of clinical environments, competence in clinical ethical decision-making has become an indispensable core competency for exemplary physicians. However, traditional medical ethics education has long been confronted with the persistent challenges of theory-practice dissociation and the disconnect between pedagogical settings and clinical realities. Thus, how to construct a "Clinical Ethics" curriculum that aligns with the objectives of training high-caliber medical professionals has emerged as a critical and challenging issue in current medical education reform. To effectively address this challenge, the Office of Education at Peking University Third Hospital, since 2021, has assembled a multidisciplinary "Clinical Ethics" teaching and management team comprising faculty from Peking University School of Humanities and key clinical specialists from the hospital. In 2022, the "Clinical Ethics" elective course was formally launched for fourth-year students in the eight-year MD program who had completed coursework in "Medical Ethics" and organ-system-based curricula, with the aim of exploring and operationalizing a pre-clinical ethics education model tailored for senior medical students. The course employs a modular instructional design encompassing "theoretical review-case-based deliberation-clinical workshop", which effectively facilitates the deep integration of medical humanities with clinical practice.Following four years of iterative refinement through the "plan-act-observe-reflect" cycle, the course has demonstrated positive outcomes in enhancing students' ethical awareness and decision-making capabilities, and has preliminarily established a sustainable collaborative mechanism among the multidisciplinary faculty team. This article systematically delineates the course development background, pedagogical model and methodological innovations, and the multidisciplinary collaborative framework, alongside reflections and summaries based on implementation outcomes, with the intent of providing references for the future development of "Clinical Ethics" curricula.

Objective To explore the latent profiles of kinesiophobia among patients with peritoneal dialysis and analyze the influencing factors of different categories.Methods A convenience sampling method was used to select peritoneal dialysis patients treated in the outpatient and ward of nephrology department in 7 tertiary A hospitals in Jiangsu Province from December 2023 to March 2024.General data questionnaire,Tampa Kinesiophobia-11 Scale,Exercise Self-efficacy Scale,Exercise Social Support Scale and Self-Rating Anxiety Scale were used for investigation.Results A total of 291 cases were included,and 3 potential categories of kinesiophobia were finally identified,namely low kinesiophobia-active exercise group(20.96％),high kinesiophobia-exercise avoidance group(24.06％),and moderate kinesiophobia-general exercise group(54.98％).Exercise self-efficacy,exercise social support,anxiety,monthly per capita household income,marital status and daily number of dialysis dose were influencing factors of kinesiophobia in peritoneal dialysis patients(P＜0.05).Conclusion There are significant category characteristics of kinesiophobia in patients with peritoneal dialysis.Medical staff should judge the category and influencing factors of kinesiophobia in time,and take targeted interventions to reduce the level of kinesiophobia in patients.

The integration of medical treatment and disease prevention(hereinafter referred to as"med-prevent integra-tion")constitutes a vital strategy for achieving universal health objectives.Party-building initiatives in university-affiliated hospi-tals present a novel approach to enhance this integration at the primary care level.This study identifies three major challenges in current practice,including insufficient conceptual integration between medical and preventive services,inadequate cross-depart-mental coordination and resource allocation,and imperfect accountability mechanisms within Party-building frameworks.From the perspective of integrated governance,we propose a comprehensive pathway where party-building facilitates the systematic conver-gence of ideological orientation,organizational structure,cultural values,and institutional mechanisms.These findings provide both theoretical framework and practical guidance for university-affiliated hospitals to deepen primary-level med-prevent integration through Party-building initiatives.

Dental implantology has developed rapidly for over half a century,since pure titanium(99.7％)dental cylindrical threaded implants were exploited and osseointegration was introduced in 1960s by Prof.Br?nemark.The long term retention rates of 10 years or more are over 95％.However,the biological complications jeopardize the long term effects of dental implant treatment seriously.The prevalence of dental implant biological complications varies greatly among different reports resulting from the disparities on the defini-tions of dental implant biological complications.After analyzing and summarizing the major opinions proposed internationally in recent years,the consensus for the definition of dental implant biological complications has been reached.Generally the dental implant biologi-cal implications can be classified into early stage(before restoration)biological complications and late stage(after restoration)biological complications.The early stage biological complications include acute and chronic infections,pain,soft tissue deficiency,and osseointegration failure,etc.The late stage complications include peri-implant diseases(peri-implant mucositis and peri-implantitis),soft tissue deficiency around implant,implant loosening and dropping off,etc.The various risk factors related to different dental implant biological complications,the strategies of the prevention and treatment for the dental implant biological complications have been discussed comprehensively,and the consensus has been reached.It is aimed to advocate the dentist to pay more attention to the early prevention of the biological implant complications,to promote more researches on the implant biological complications,and to help elevate the level of dental implantology in our country.

OBJECTIVE: To investigate chronic hepatitis C virus (HCV) infection's effect on gestational liver function, pregnancy and delivery complications, and neonatal development. METHODS: A total of 157 HCV antibody-positive (anti-HCV[+]) and HCV RNA(+) patients (Group C) and 121 anti-HCV(+) and HCV RNA(-) patients (Group B) were included as study participants, while 142 anti-HCV(-) and HCV RNA(-) patients (Group A) were the control group. Data on biochemical indices during pregnancy, pregnancy complications, delivery-related information, and neonatal complications were also collected. RESULTS: Elevated alanine aminotransferase (ALT) rates in Group C during early, middle, and late pregnancy were 59.87%, 43.95%, and 42.04%, respectively-significantly higher than Groups B (26.45%, 15.70%, 10.74%) and A (23.94%, 19.01%, 6.34%) ( P < 0.05). Median ALT levels in Group C were significantly higher than in Groups A and B at all pregnancy stages ( P < 0.05). No significant differences were found in neonatal malformation rates across groups ( P > 0.05). However, neonatal jaundice incidence was significantly greater in Group C (75.16%) compared to Groups A (42.25%) and B (57.02%) ( χ ² = 33.552, P < 0.001). HCV RNA positivity during pregnancy was an independent risk factor for neonatal jaundice ( OR = 2.111, 95% CI 1.242-3.588, P = 0.006). CONCLUSIONS Chronic HCV infection can affect the liver function of pregnant women, but does not increase the pregnancy or delivery complication risks. HCV RNA(+) is an independent risk factor for neonatal jaundice.
Humans ; Female ; Pregnancy ; Adult ; Pregnancy Complications, Infectious/epidemiology* ; Retrospective Studies ; Pregnancy Outcome ; Infant, Newborn ; Viremia/virology* ; Hepatitis C ; Hepacivirus/physiology* ; Hepatitis C, Chronic/virology* ; Young Adult ; Alanine Transaminase/blood*

Objective To explore potential categories of post-stroke depression in acute-phase stroke patients and its correlation with the degree of neurological deficits,and to provide references for healthcare professionals in developing targeted interventions.Methods Using convenience sampling,patients with acute stroke who were hospitalized in neurological ward of 2 tertiary general hospitals in Henan Province from January to April 2024 were selected as the survey participants.The investigation was conducted using the General Information Questionnaire,the National Institute of Health Stroke Scale,and the Patient Health Questionnaire-9.The correlation between potential categories of post-stroke depression and the degree of neurological deficit was analysed using unordered multiclassified logistic regression.Results Post-stroke depression score was 10.22±3.61 in 193 acute-phase stroke patients,and post-stroke depression could be categorized into 3 potential categories,namely"low depressive symptoms"(44.6％),"melancholic depression"(15.0％),and"atypical depression"(40.4％).There was a significant difference in the degree of neurological deficits(H=38.074,P＜0.001).Compared with severe neurological deficits,patients with mild deficits were more likely to be categorized as"melancholic depression"(OR=0.016,P=0.001)and"atypical depression"(OR=0.040,P＜0.001),and patients with moderate deficits were more likely to be classified as"atypical depression"(OR=0.085,P=0.001).Conclusion Post-stroke depression in acute-phase stroke patients has obvious categorization characteristics,and it is recommended that healthcare professionals should pay more attention to patients with different degrees of neurological deficits and adopt targeted interventions according to the different categories of post-stroke depression in order to alleviate their depressive symptoms.

Objective:To retrospectively analyze the cases of inflammatory myofibroblastic tumor (IMT) involving the sinonasal skull base, and to investigate their clinical characteristics, diagnostic approaches, and treatment outcomes, in order to improve understanding of this rare entity.Methods:Clinical data from five patients with pathologically confirmed sinonasal skull base IMT who underwent surgical treatment at Xiangya Hospital of Central South University between April 2010 and June 2023 were reviewed. Information on clinical presentation, laboratory findings, imaging features, histopathological and immunohistochemical results, treatment strategies, and follow-up outcomes was collected. A comprehensive analysis was performed in combination with a literature review to summarize the clinical features, diagnostic methods, and therapeutic approaches for sinonasal skull base IMT.Results:The five patients (aged 18 to 68 years) were all diagnosed based on histopathological and immunohistochemical examinations. The lesions primarily involved the nasopharynx, clivus, sphenoid sinus, and maxillary sinus. Major clinical symptoms included nasal obstruction, headache, blood-tinged nasal discharge, and facial numbness or pain. All patients underwent surgical resection; two of them also received adjunctive glucocorticoid therapy. During follow-up ranging from 1 to 143 months, two patients experienced tumor recurrence, three patients had no recurrence with significant symptomatic improvement.Conclusions:Histopathology combined with immunohistochemistry is critical for the diagnosis of sinonasal skull base IMT. Complete surgical excision when feasible remains the primary treatment strategy.

Objective:To assess the efficacy and safety profile of antaitasvir phosphate combined with yiqibuvir in the treatment of chronic hepatitis C (CHC) of various genotypes, without cirrhosis or with compensated cirrhosis.Methods:394 cases with CHC from 22 centers were collected from October 2021 to April 2023. They were randomly assigned to receive either the experimental drugs (antaitasvir phosphate 100 mg+yiqibuvir 600 mg) or placebo treatment in a 3∶1 ratio. The patients were administered drugs once a day for 12 consecutive weeks, and then followed up for 24 weeks after treatment cessation. All subjects were unblinded at the four-week follow-up following drug discontinuation, with the experimental drug group continuing to complete subsequent post-discontinuation follow-up. The placebo group was switched to receive the experimental drugs for a repeated 12-week treatment period and followed up for another 24 weeks after discontinuation of the drug (placebo delayed treatment phase).The sustained virologic response rate (SVR12) was observed for subjects in the double-blind phase and the placebo delayed-treatment phase at 12 weeks after treatment cessation.Virological resistance analysis was performed on subjects who failed treatment. The primary efficacy endpoint was SVR12. The number and percentage of subjects who achieved "HCV RNA

Objective:To explore the need for parental involvement in treatment decision-making for children with type 1 diabetes mellitus, so as to provide basis for medical and nursing staff to formulate targeted intervention strategies.Methods:This was a qualitative study. From April to May 2024, 15 parents of children with type 1 diabetes mellitus admitted to the Department of Endocrine Genetics and Metabolism at Children's Hospital of Soochow University were selected as research subjects for face-to-face semi-structured interviews. Inductive content analysis was used for data analysis.Results:Among the 15 children patients, there were 4 males and 11 females, with an age of (37.61±5.93) years old. Four themes were extracted, including the need for decision-making involvement and expression, the need for diversity decision-making information, the need for multi-channel decision-making communication and the need for diversified decision-making support.Conclusions:Medical and nursing staff should pay attention to decision-making needs of the parents of children with type 1 diabetes when they participate in treatment decision-making, and improve their parents' decision-making self-efficacy and promote their decision-making involvement by adopting diversified decision-making aids and effective decision-making communication.

Objective To explore the latent profiles of kinesiophobia among patients with peritoneal dialysis and analyze the influencing factors of different categories.Methods A convenience sampling method was used to select peritoneal dialysis patients treated in the outpatient and ward of nephrology department in 7 tertiary A hospitals in Jiangsu Province from December 2023 to March 2024.General data questionnaire,Tampa Kinesiophobia-11 Scale,Exercise Self-efficacy Scale,Exercise Social Support Scale and Self-Rating Anxiety Scale were used for investigation.Results A total of 291 cases were included,and 3 potential categories of kinesiophobia were finally identified,namely low kinesiophobia-active exercise group(20.96％),high kinesiophobia-exercise avoidance group(24.06％),and moderate kinesiophobia-general exercise group(54.98％).Exercise self-efficacy,exercise social support,anxiety,monthly per capita household income,marital status and daily number of dialysis dose were influencing factors of kinesiophobia in peritoneal dialysis patients(P＜0.05).Conclusion There are significant category characteristics of kinesiophobia in patients with peritoneal dialysis.Medical staff should judge the category and influencing factors of kinesiophobia in time,and take targeted interventions to reduce the level of kinesiophobia in patients.