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 application of painless diagnosis and treatment technology in children's peripherally inserted central catheter(PICC)guided by ultrasound.Methods Totally 82 children who planned to undergo PICC in the hospital from January 2021 to January 2023 were selected and randomly divided into a control group and an observation group using a random number table method,with 41 cases in each group;The control group underwent conventional ultrasound guided PICC catheterization,while the observation group underwent painless diagnostic and therapeutic techniques using ultrasound guided PICC catheterization;Compare the success rate of catheterization,completion time of catheterization,degree of pain in the child pain[children's pain behavior scale(FLACC)],tolerance[Houpt behavior scale(HBS)],compliance[Frankl scale(FCS)],and family satisfaction between the two groups.Results The success rate of catheterization in the observation group was higher than that in the control group,and the catheterization time was shorter than that in the control group,with a statistically significant difference(P<0.05).The FLACC score of the observation group was lower than that of the control group,while the HBS score and FCS score were higher than those of the control group,with a statistically significant difference(P<0.05);The total satisfaction of family members in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of painless diagnosis and treatment technology in ultrasound-guided PICC catheterization in children can improve the success rate of catheterization,shorten the catheterization time,reduce the degree of pain in children,enhance tolerance and compliance,and improve family satisfaction.

Objective:Public health emergencies expose a significant threat to human life and health. How to efficiently conduct biomedical research while complying with ethical norms is an important way to response to public health emergent events such as pandemic outbreak. In 2023, the National Health Commission, the Ministry of Education, the Ministry of Science and Technology, and the National Administration of Traditional Chinese Medicine jointly issued the " Measures for Ethical Review of Life Sciences and Medical Research Involving Human Subjects", which requires the ethics committee to construct an ethical review system in advance, including, generally, the ethics committee should conduct ethical review and provide review opinions within 72 hours. Is this measure feasible and does it have any unreasonable aspects?Methods:Literature review and status quo analysis are two main methods, this article combs the international guidelines issued by World Health Organization, the Council for International Organizations of Medical Sciences and the Nuffield Council of Bioethics, selects the content related to research under the circumstances of public health emergencies, take the Hofstede′s Cultural Dimensions Theory into consideration of the complexity of quality and quantity of research during the COVID-19 pandemic in China.Results:After analyzing, this article argues preliminarily that the requirement and emphasize on ethical review system development issued by the four ministries in China is very timely and necessary. However, the requirements for review time limits is inconsistent with international consensus, and might pose substantive challenges to the independence of the ethics committee's work.Conclusions:Scientificity and ethics are the soul of biomedical research, and the basic requirements of these two aspects cannot be undermined due to the special nature of public health emergencies. However, procedures simplifiable are worth exploring.

Toxoplasma gondii cathepsin C proteases (TgCPC1, 2, and 3) are important for the growth and survival of T. gondii. In the present study, B-cell and T-cell epitopes of TgCPC1 were predicted using DNAstar and the Immune Epitope Database. A TgCPC1 DNA vaccine was constructed, and its ability to induce protective immune responses against toxoplasmosis in BALB/c mice was evaluated in the presence or absence of the adjuvant α-GalCer. As results, TgCPC1 DNA vaccine with or without adjuvant α-GalCer showed higher levels of IgG and IgG2a in the serum, as well as IL-2 and IFN-γ in the spleen compared to controls (PBS, pEGFP-C1, and α-Galcer). Upon challenge infection with tachyzoites of T. gondii (RH), pCPC1/α-Galcer immunized mice showed the longest survival among all the groups. Mice vaccinated with DNA vaccine without adjuvant (pCPC1) showed better protective immunity compared to other controls (PBS, pEGFP-C1, and α-Galcer). These results indicate that a DNA vaccine encoding TgCPC1 is a potential vaccine candidate against toxoplasmosis.
Animals ; B-Lymphocytes ; Cathepsin C* ; Cathepsins* ; DNA* ; Epitopes, T-Lymphocyte ; Immunoglobulin G ; Interleukin-2 ; Mice* ; Peptide Hydrolases ; Spleen ; Toxoplasma* ; Toxoplasmosis* ; Vaccines, DNA*

Starting on the research findings from a study on cancer patients decision making,the author tried to further analyze the Doctor-Patient-Relationship in China from the historical perspective.Having the disease re-moved or treat the patient responsibly,represents different meaning and implication on how a society regards the medicine as profession,and how define the role of physicians.Considerations on these issues are hoped to facilitate the improvement of doctor-patient relationship in China.

The ambiguous diagnosis,the public's insufficient understanding of AMR and improper use of antibiotics in agriculture are the main reasons for accelerating antibiotic resistamce(AMR).At present,the main coping strategies are limited to technical means while lacking ethical consideration.The related ethical issues are,mainly,tensions of personal health interests and public health interests,the conflicts between agricultural development and human health benefits,the distributive justice,inter-generational justice.Understandings and addressing these issues rely on value judgments based on the moral theories.And then it will form an effective and reasonable antibiotic management solution which will help to deal with AMR fundamentally.

The defense for paternalism is based on that family members' decisions are usually beneficial for patients' best interests.However,this premise remains to be demonstrated.The moral theory of maintaining family members' interests challenged the ethical principle of respecting patients' autonomy,which believed that treatment decisions should be discussed by the whole family members.However,the principle of autonomy does not always dissever the relationship between individual and family members.It resorted East Asia family autonomy of Chinese traditional culture and emphasized on the value of objective goodness and family dependence.However,patients often do not play a proper role in families' decision-making.Besides,the Confucian bioethics also needs to provide more sufficient argumentation to deal with the relationship between subjective goodness and objective goodness.The unconditional acquiescence of family members' domination in decision-making is worthy reflecting in the current medical environment.

Objective To evaluate the ethical management status quo of Capital Medical Research Fund in 2007.Methods Cross-sectional study was applied to analyze the ethics management and ethics self-evaluation in applications.Results There were 652 applications,covering with 14 districts and 2 counties in Beijing,from 128 Hospitals.Applicants have some knowledge of the ethical issues in clinical research accounted for 88.7％ ; informed consent of subjects considered in 72.5％ ;the potential risk and protection involved in application accounted for 62.0％; personal privacy protection of subject accounted for 49.4％.Unfortunately,the benefit vs risk assessment was only involved in 28.7％ applications.Applicants from general hospitals had more ethical issue knowledge (90.2％) than those from community hospitals (84.6％).Applicants from university hospitals had more ethical issue knowledge (93.9％) than those from military hospitals (80.2％).Applicants aged 55 0r over had less ethical issue knowledge (70.0％) than other applicants (89.2％).The applicants to study on descriptive research and etiological research had less ethical issue knowledge than others.578 applications filled out the approval from ethics committee or research management department.62.6％ of the written were acceptable.Conclusion The applicants for clinical research had preliminary understanding for ethical issues in Beijing in 2007.Hospital ethics committees or research management departments had conducted clinical research ethical review applications for funds management.It has taken place the external conditions to carry out the ethical management in clinical research fund management.

As human subject protection become more and more significant in China,it' s imperative for China to learn more experiences from U.S for which developed a normative and well designed HRPP system during past decades.In this article,we gave a brief introduction of the Human Subject Protection Program at Duke University to help us have a better understanding of the HRPP at institutional level.After which we have further discussion of the status quo and challenges facing in HRPP construction in China,especially,Peking University as an example.

OBJECTIVEComparative study on the immunologic functions of total flavones of Epimedium (TFE) in two species in Guizhou on CTX mice.

METHODTo set up a hypoimmunity mouse model by CTX and give TFE in 10 days, the enhancement of immunologic functions of TFE of two species were observed with the indice of the weight of body and spleen, the spleen-index, the serum level of hemolysin, TNF-alpha and IL-2.

RESULTThe spleen-index, the level of hemolysin, TNF-alpha and IL-2 of the mice decreased apparently (P < 0.01) by single ip in CTX 80 mg x kg(-1). The weight of body and spleen, the spleen-index of the mice increased, the decreased serum level of hemolysin TNF-alpha and IL-2 increased significantly (P < 0.01), by TFE of two species of 1.3, 0.65 g x kg(-1) from the mice ig.

CONCLUSIONThe TFE of two species of Epimedium in Guizhou have an obvious immune enhancement effect on the non-specific immunity and specific immunity of CTX model mice. But the immune enhancement effects of the TFE from the stem and leaves of two species of Epimedium contrast insignificantly. This indicates that in addition to ICA, there must be other bioactive components that can enhance immunity.

Animals ; Cyclophosphamide ; pharmacology ; Epimedium ; chemistry ; Female ; Flavones ; pharmacology ; Immunity ; drug effects ; Interleukin-2 ; blood ; Male ; Mice ; Tumor Necrosis Factor-alpha ; blood