1.Research on safeguarding the autonomy of artificial intelligence applications for pregnant and postpartum women’s health data
Deshun LI ; Jiahui LIU ; Yan HONG ; Jingxi CHEN
Chinese Medical Ethics 2026;39(3):314-319
From the patient’s perspective, taking the control right of artificial intelligence (AI) in the analysis of pregnant and postpartum women’s health data as the entry point, this paper constructed a patient-centered governance framework for AI medical data control. It defined the different stages and scenarios of applications related to the health data analysis of pregnant and postpartum women, conducted a comparative analysis that combines existing ethical issues concerning AI data control in the medical field, and discussed autonomy issues in health management scenarios from three dimensions, namely, voluntariness, purposiveness, and steadfastness. Based on these discussions, this paper highlighted the reflection on autonomy under the behavioral research paradigm. Starting from the basic actions such as provision, deletion, analysis, triggering, presentation, revision, and response, it regarded technical behaviors as a form of instrumental communication and emphasized ensuring patients’ ample opportunities to participate in interactive links such as “information provision and adoption” “analysis and judgment” “presentation and summarization,” and “feedback and revision.” This will lay a foundation for expanding the existing discussion on medical AI autonomy to the ethical category of information usage.
2.Impact of social capital, adverse childhood experiences and depressive symptoms on suicidal behavior among vocational high school students
YU Bin, YAN Jingyan, CHEN Xinguang, GUO Yan, LI Fang, YAN Hong, XIAO Chenchang
Chinese Journal of School Health 2026;47(4):506-511
Objective:
To explore the nonlinear dynamic effects of social capital, adverse childhood experiences (ACEs) and depressive symptoms on suicidal behavior among vocational high school students, so as to provide theoretical basis and practical references for formulating suicide prevention strategies.
Methods:
A convenience sampling method was employed to include 668 students from a vocational high school from Wuhan in March 2023. Social capital was used as the asymmetry variable, while ACEs and depressive symptoms were used as bifurcation variables, a cusp catastrophe model was constructed to analyze the nonlinear changes in suicidal behavior among vocational high school students, and its fit was compared with linear and Logistic regression models.
Results:
Among students in the health vocational high school in Wuhan, only suicidal ideation accounted for 8.5%, only suicide attempt for 18.6%, neither accounted for 31.9%, and both for 41.0%. Gender, left behind experience, family economic status, parental parenting styles, depressive symptoms, social capital, and ACEs were all related factors influencing suicidal behavior among vocational high school students ( χ 2/H=19.03, 13.33, 21.11, 46.70, 144.38, 24.61, 118.77, all P <0.05). Violin plots showed a bimodal distribution of suicidal behavior, indicating nonlinear variation characteristics. The cusp catastrophe model results showed that social capital was negatively correlated with suicidal behavior, but the relationship was bifurcated by ACEs ( α social capital = -0.006 , β ACEs =0.075) and depressive symptoms ( α social capital =-0.013, β depressive =0.028) (all P <0.05). When both ACEs and depressive symptoms coexisted, the impact of ACEs was stronger ( β ACEs =0.077, β depressive =0.014) (both P <0.05). The cusp catastrophe model fitted ( R 2=0.886, 0.881, 0.882) better than the linear ( R 2=0.258, 0.219, 0.258) and Logistic regression models ( R 2= 0.242, 0.211 , 0.176). Gender stratified analysis results showed that bifurcation effect of ACEs was stronger in males than in females( β boys =0.224, β girls =0.086); in females, both ACEs and depressive symptoms had a bifurcation effect, with the former showing a stronger effect ( β ACEs =0.062, β depressive =0.015) (all P <0.05).
Conclusions
Suicidal behavior among vocational high school students exhibits nonlinear characteristics. Improving social capital to reducing ACEs and depressive symptoms may contribute to decreasing adolescent suicidal behaviors.
3.The Thrombectomy Dilemma in Stroke Patients With Active Cancer: To Treat or Not to Treat?
Yohanna KUSUMA ; Mikiya BEPPU ; Beom Joon KIM ; Sung-Chun TANG ; Mikito HAYAKAWA ; Hiroshi YAMAGAMI ; Hiroyuki KAWANO ; Teruyuki HIRANO ; Shinichi YOSHIMURA ; Hamidon BASRI ; Richard LI ; Huy Thang NGUYEN ; Deidre Anne De SILVA ; Keun-Sik HONG ; Jiann-Shing JENG ; Than G. PHAN ; Henry MA ; Bernard YAN ;
Journal of Stroke 2026;28(2):218-227
Endovascular thrombectomy for acute large-vessel occlusion in patients with active cancer remains a difficult clinical decision. Multiple cohort studies and meta-analyses indicate that, when standard imaging and clinical criteria are applied, reperfusion success is high and symptomatic intracranial hemorrhage is broadly comparable with non-cancer populations, arguing against categorical exclusion. At the same time, registries show lower 90-day functional independence and higher 90-day mortality in active-cancer cohorts—effects likely driven by malignancy-related systemic factors and pre-existing functional compromise rather than procedural harm. This narrative review synthesizes efficacy and safety signals, highlights decision-grade outcomes that are seldom reported—early neurological change, performance status around 90 days, and whether systemic anticancer therapy is started or resumed. It sets out a clinical–ethical–economic framework to support selection, consent, and aftercare, including a pragmatic pathway for under-resourced settings based on non-contrast computed tomography (CT) or single-phase CT angiography where advanced perfusion imaging or magnetic resonance imaging are unavailable. We outline an Asia–Pacific collaborative program designed to identify subgroups that may benefit from reperfusion and initiation of active cancer care.
4.Identification and infection rate of densovirus in Culex pipiens pallens in Beijing in 2023
Xiu-yan XU ; Ting YAN ; Si-jie ZHU ; Jing LI ; Mei-de LIU ; Hong-jiang ZHANG ; Ting LIU ; Qiu-hong LI ; Xiao-jie ZHOU ; Ying TONG ; Yong ZHANG
Acta Parasitologica et Medica Entomologica Sinica 2026;33(1):25-30
Objective This study conducted molecular biological identification of the viruses carried by Culex pipiens pallens specimens collected in Shunyi District, Beijing in 2023, and observed the changes in the infection rate of the viruses carried by Cx. pipiens pallens at different collection times. Methods Cx. pipiens pallens were collected using carbon dioxide mosquito traps. The mosquito samples were ground in batches and analyzed by molecular biology technologies. The virus infection rate at different collection times was analyzed statistically. Results 17 strains of Culex pipiens pallens densovirus(CppDNV)were identified from Cx. pipiens pallens samples collected in Shunyi District, Beijing, in 2023. The nucleotide sequence analysis of the virus genome coding region showed that CppDNV was a single-stranded DNA virus with a total length of 3 335 nt, encoding 2 non-structural proteins(NS1, NS2)and 1 capsid protein(VP). The nucleotide(amino acid)sequence lengths of the three proteins were 2 376 nt(791 aa),1 092 nt(363 aa)and 1 071 nt(356 aa), respectively. Phylogenetic analysis showed that CppDNV was located in genus Brevihamaparvovirus. Statistical analysis showed no significant difference in infection rates across collection times(χ2=4.429, P=0.194). Conclusions CppDNV was identified in Cx. pipiens pallens in Beijing, and it was stably maintained in this natural population.
5.The first record of Anopheles messeae (Diptera: Culicidae) parasitized by water mites in China
Xue-ru CHEN ; Wen-zhen YAO ; Yu-hao LI ; Gui-chang LI ; Tao MENG ; Qun-ling FENG ; Xin-hui LIU ; Li-hong QIAO ; Xiang-ting WU ; Xue-feng ZHANG ; Cheng-lin LI ; Xue-cheng DONG ; Da-wei WANG ; Xiao-yan SI ; Yu-hong GUO
Acta Parasitologica et Medica Entomologica Sinica 2026;33(1):53-57
Objective This study reports on the obligatory parasitism of water mites Arrenurus sp. on Anopheles messeae at the Manzhouli Port, Inner Mongolia, China. Methods Duing July 2024, a survey on the mosquito diversity was conducted at the Manzhouli Port. Captured mosquitoes and their ectoparasites were identified to species level. Results A total of 1840 adult mosquitoes were collected, representing species from three genera: Culex(Cx. modestus, Cx. pipiens pallens), Aedes(Ae. dorsalis, Ae. flavidorsalis, Ae. flavescens), and Anopheles (An. messeae). Among all the mosqutioes specimens,3 out of 150 captured An. messeae were found to carry ectoparasitic mites, with number of 2,4,27 mites separately. Morphological and molecular identification reached the same result as water mites(Hydrachnidiae, Hydracrina). COI gene sequence showed 94% similarity with the closest species Arrenurus truncatellus. Conlusions Literature review suggests water mites are host-specific parasitism of mosquito species and herein with the first record of Arrenurus sp. parasiting on An. Messeae in the most high-latitude region globally.
6.Association of hippocampal subfield volumes and cross-domain associative memory impairment in patients with schizophrenia
Zhao-lin ZHAI ; Di CHANG ; Xuan LI ; Chang LU ; Yu-ke DONG ; Yan WANG ; Chun-hong SHAO ; Qing KANG ; Deng-tang LIU
Fudan University Journal of Medical Sciences 2025;52(6):775-782
Objective To investigate the possible association between cross-domain associative memory(AM)impairment and hippocampal subfield volumes in patients with schizophrenia(SCZ).Methods We enrolled 28 SCZ patients from Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,and 28 healthy controls(HCs)between 2019 and 2021.Based on an innovative AM paradigm and automated segmentation,3D-T1 weighted data of the objects were processed with PhiPipe and FreeSurfer.Differences in subfield volums between the two groups were analyzed using ANCOVA,while their relationship with AM scores was assessed using Pearson correlation.Results SCZ patients exhibited significantly poorer AM performance across three conditions compared with HCs.Marginally significant reductions were observed in the total volume of bilateral hippocampus,encompassing both the hippocampal head and body.Significant volume reductions were identified in the bilateral presubiculum and parasubiculum.The volumes of bilateral presubiculum head(r=0.273,P=0.042),parasubiculum(r=0.397,P=0.002),and CA1 head(r=0.382,P=0.004)exhibited positive correlations with cross-domain AM performance.Conclusion The bilateral presubiculum and parasubiculum,as hippocampal subregions significantly associated with cross-modal AM deficits in SCZ,may play a crucial role in the pathology of AM.
7.Development and application of a healthcare quality evaluation system for national regional medical centers based on the structure-process-outcome Theory
Lizhong LIANG ; Hongzhen ZHOU ; Yan LI ; Tong LI ; Yingzhe LIU ; Hong LI ; Jie ZHENG ; Chao YANG
Modern Hospital 2025;25(11):1651-1655
Objective To develop a scientific,systematic,and operable healthcare quality evaluation system for Nation-al Regional Medical Centers(NRMCs),providing a theoretical basis and practical tool for objectively assessing their construction outcomes and guiding high-quality development.Methods Based on the classic"Structure-Process-Outcome"(SPO)quality management model,and aligned with national policy directives and the functional positioning of regional medical centers,a pre-liminary set of evaluation indicators was screened and an indicator system was constructed through literature review,policy analy-sis,and field investigations.Guangxi Hospital Division of The First Affiliated Hospital,Sun Yat-sen University was selected as the study subject,and cross-sectional data from March 2023 to June 2025 were collected for empirical application.Results A healthcare quality evaluation system for NRMCs was established,comprising 3 first-level dimensions(Structure Quality,Process Quality,Outcome Quality),10 second-level indicators,and 66 third-level indicators.This system covers multiple aspects,inclu-ding resource allocation,healthcare service efficiency,clinical practices,patient outcomes,and social benefits.Empirical results indicated that the center demonstrated a consistent upward trend in key indicators such as"Proportion of Discharged Patients Un-dergoing Level-4 Surgeries"(O1.2)and"DRG-CMI Value"(O2.1),while"Average Length of Hospital Stay"(P3.1)and"Cost Consumption Index"(O2.3)showed a steady decline.The indicator system effectively revealed the center's progress in en-hancing regional influence and operational efficiency.Conclusion The developed healthcare quality evaluation system is well-grounded in theory and practice,combining scientific rigor with policy relevance,and can serve as a decision-support tool for quality assessment and improvement in National Regional Medical Centers.
8.Analysis of Risk Factors for Early Relapse/Progression in Patients with Multiple Myeloma and Development of a Nomogram Predic-tion Model
Mei-Jiao HUANG ; Yu LIU ; Hong-Yan WANG ; Tai-Ran CHEN ; Xing-Li ZOU
Journal of Experimental Hematology 2025;33(6):1655-1661
Objective:To analyze the potential risk factors for early relapse/progression in patients with multiple myeloma(MM)and develop a risk prediction model based on these factors.Methods:A retrospective analysis was conducted on 187 newly diagnosed multiple myeloma(NDMM)patients who treated at the Affiliated Hospital of North Sichuan Medical College from February 2014 to December 2020.The clinical,laboratory examination,and follow-up data of patients experiencing relapse/progression within 24 months after treatment(ER/EP24)were analyzed using univariate and multivariate analyses,and a nomogram prediction model was established.Results:Among the 187 patients,58(31.0%)experienced ER/EP24,with a median survival time of only 24 months.The results of multivariate logistic regression analysis showed that failure to achieve partial response(PR)or better after 3-4 cycles of chemotherapy and albumin(ALB)levels<35 g/L were independent risk factors for ER/EP24(P<0.05).These factors,along with other clinically relevant variables,were further incorporated into the nomogram prediction model.The model demonstrated a concordance index(C-index)of 0.784,indicating strong predictive accuracy.Conclusion:MM patients experiencing ER/EP24 exhibit poor outcome,and the nomogram model developed in this study effectively predicts the risk of ER/EP24 in NDMM patients,providing a valuable tool for clinical risk assessment.
9.Clinical study on the novel adjustable titanium mesh fixation tent screw in alveolar ridge augmentation
Yan HE ; Qinghui LIU ; Hong LYU ; Jiayi LI ; Duomu HE
STOMATOLOGY 2025;45(5):360-366
Objective This experiment aims to evaluate the clinical efficacy of a novel adjustable titanium mesh fixation tent screw by comparing its bone augmentation effects with those of conventional titanium screws combined with prefabricated titanium mesh in ca-ses where simultaneous implant placement is not feasible,thereby providing a new bone augmentation strategy.Methods This pro-spective study included 14 patients(20 bone augmentation sites)with severe alveolar bone defects treated at the Implant Center of the Department of Prosthodontics,Changsha Stomatological Hospital,from January 2023 to August 2023.The sites were randomly divided into two groups:the experimental group(novel tent screw group)received bone augmentation using novel tent screws combined with prefabricated titanium mesh,while the control group(conventional titanium screw group)underwent bone augmentation with conven-tional titanium screws combined with prefabricated titanium mesh.Cone beam computed tomography(CBCT)was performed preopera-tively(T0),immediately postoperatively(T1),and 6 months postoperatively(T2)to measure alveolar bone width at 2,6,and 10 mm below the crest and alveolar bone height at the intended implant sites.Vertical and horizontal bone volume changes,bone graft re-sorption,bone augmentation success rates,and postoperative complication rates were analyzed.Statistical analysis was conducted using SPSS 25.0.Results At 6 months postoperatively,vertical bone augmentation in the experimental group(3.26±2.02)mm was signif-icantly greater than in the control group(1.80±0.64)mm(P<0.05).Horizontal bone augmentation at 2 mm below the crest in the experimental group(4.45±2.46)mm was significantly higher than in the control group(2.45±1.02)mm(P<0.05),but no signif-icant differences were observed at 6 and 10 mm below the crest(P>0.05).Both groups exhibited low vertical and horizontal bone re-sorption with no significant differences.The bone augmentation success rate was 100%in both groups.The complication rate was 27.3% in the experimental group and 25% in the control group,with no statistically significant difference(P>0.05).Conclusion For severe alveolar bone defects where simultaneous implantation is not feasible,the novel tent screw combined with prefabricated titanium mesh achieves superior vertical and horizontal bone augmentation.Compared to conventional titanium screws,the novel tent screw demonstrates sig-nificantly better vertical bone augmentation and horizontal augmentation at 2 mm below the crest,effectively restoring alveolar ridge contours.
10.Assessment of the current status and economic burden of hospital-acquired infections in orthopedic patients based on DRG
Lin YANG ; Yan REN ; Yingnan CAO ; Lihui XU ; Hongxin WEI ; Luyao LI ; Hong LI ; Hui CHEN
Chinese Journal of Nosocomiology 2025;35(11):1718-1723
OBJECTIVE To assess the current status of hospital-acquired infections and their economic burden in or-thopedic patients based on diagnosis-related groups(DRG).METHOD Based on the National Health Insurance dis-ease diagnosis-related groups,32 413 orthopedic patients from a tertiary care hospital in Beijing in 2021 were grouped,hospital-acquired infections were retrospectively analyzed,and the direct and indirect economic burdens of different DRG groups were assess using indictors such as hospitalization time and cost,bed turnover loss,and labor time loss.RESULTS A total of 32 413 patients were included,the incidence of hospital-acquired infection was 0.47%(153/32 413),the site of infection was predominantly the surgical site(57.99%),and hospital-acquired infections in the hematologic system had a greater impact on cost-consumption indices and time-consumption indi-ces.The infection cases were concentrated in 19.58%of the DRGs groups.The IF23 group(lower limb bone sur-gery with complications and comorbidities)had the highest direct economic burden(24 010 yuan/case)due to hos-pital-acquired infections,and the increase in the cost of consumables and medication was the main factor causing the direct economic burden.At both the hospital level and family-society level,the top three DRG groups in terms of indirect economic burden due to hospital-acquired infections were IB15,IB13 and IF23.CONCLUSION Hospital-acquired infections in orthopedic patients have a tendency to be concentrated,quantitatively assessment of their e-conomic burden based on DRGs not only illustrates the importance of hospital-acquired infection prevention and control,but also accurately identifies the disease groups that require focused management,providing an evidence-based basis for precise prevention and control of hospital-acquired infections.


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