Medical artificial intelligence （AI） is a new type of application formed by the combination of machine learning， computer vision， natural language processing， and other technologies with clinical medical treatment. With the continuous iteration and development of relevant technologies， medical AI has shown great potential in improving the efficiency of diagnosis and treatment， and service quality， but it also increases the possibility of triggering ethical issues. Ethical issues resulting from the clinical application of medical AI were analyzed， including the lack of algorithmic interpretability and transparency of medical AI， leading to information asymmetry and cognitive discrepancies； the concerning status of security and privacy protection of medical data； and the complex and unclear division of responsibilities due to the collaborative participation of multiple subjects in the clinical application of medical AI， resulting in increased difficulty in the identification of medical accidents and clarification of responsibilities. The paper proposed the principles of not harming patients’ interests， physician’s subjectivity， fairness and inclusiveness， and rapid response. It also explored the strategies and implementation paths for responding to the ethical issues of medical AI from multiple perspectives， including standardizing the environment and processes， clarifying responsibility attribution， continuously assessing the impact of data protection， guaranteeing data security， ensuring model transparency and interpretability， carrying out multi-subject collaboration， as well as the principles of being driven by ethical values and adhering to the “human health-centeredness.” It aimed to provide guidance for the healthy development of medical AI， ensuring technological progress while effectively managing and mitigating accompanying ethical risks， thereby promoting the benign development of medical AI technology and better serving the healthcare industry and patients.

On the premise of respecting the objective law of the occurrence and development of traditional Chinese medicine（TCM） dispensing granules， relevant national departments have gradually formed the research and formulation ideas of national drug standards for dispensing granules based on the experiences and lessons learned in the development process of quality standards， as well as the formation mechanism of national standards for dispensing granules. This has certain reference significance for the formulation path of TCM quality standards. Combined with the general situation of the published standards and specific cases， the research concepts of the national standards for dispensing granules were analyzed and summarized in this paper， and the analysis of the technical characteristics of the issued national standards was focused， including the introduction of standard decoction， the overall quality control of TCM， the whole process quality control and other research ideas. At the same time， it summarized the industry common problems in the research and development process of national standards for dispensing granules， such as the source and process control of medicinal materials， and strived to solve them together， encouraging the demonstration and application of new technological means in the field of TCM dispensing granules. Finally， based on the literature analysis， the shortcomings of the current national standards were discussed， and relevant suggestions were put forward to further improve the national standards for dispensing granules. Through the overall analysis， it is helpful to comprehensively understand the technical characteristics of the national standards for TCM dispensing granules， and provide reference for the scientific exploration and practice of quality control methods for TCM.

Objective: To analyze the results of national external quality assessment (EQA) for transfusion compatibility test from 2018 to 2023, with the aim of providing references for improving laboratory testing quality and ensuring the safety of clinical blood transfusion. Methods: Three EQA programs were conducted annually, each distributing 22 quality assessment samples. Participating transfusion laboratories were required to complete testing within specified deadlines and to submit results along with documentation of testing methodologies, reagents, and equipment used. National Center for Clinical Laboratories (NCCL) conducted statistical analysis of laboratory results, evaluated testing outcomes and related circumstances, and provided feedback to participating laboratories. EQA data from transfusion laboratories across China from 2018 to 2023 were collected and systematically analyzed. Results: From 2018 to 2023, the qualification rates for all five items (ABO forward typing, ABO reverse typing, Rh blood group typing, antibody screening, and cross-matching) were 67.59%, 77.11%, 77.38%, 72.78%, 79.96%, and 85.16%, respectively. The mean qualification rates for ABO forward typing, ABO reverse typing, RhD blood group typing, antibody screening, and cross-matching over the past six years were 96.25%±0.59%, 90.45%±4.52%, 96.05%±0.71%, 90.88%±2.86%, and 88.34%±3.48%, respectively. The qualification rates in 2019, 2020, 2022, and 2023 all showed a stable trend of "blood stations>tertiary hospitals>secondary hospitals". The mean qualification rate of laboratories in secondary hospitals from 2018 to 2023 was significantly lower than those of laboratories in tertiary hospitals and blood stations (P<0.05), while no significant difference was observed between laboratories in tertiary hospitals and blood stations (P>0.05). The micro column agglutination method was the most widely used in all five tests. In the four test items, namely ABO forward typing, ABO reverse typing, antibody screening, and cross-matching, there was a statistically significant difference in the qualification rate of micro column agglutination method compared to other methods (P<0.05). There was a statistical difference in the qualification rate between manual and automated detection using micro column agglutination method in the cross-matching tests (P<0.05), whereas no significant difference was noted for the other test items (P>0.05). Conclusion: From 2018 to 2023, the number of laboratories participating in EQA activities has been increasing year by year, and the qualification rate has shown an overall upward trend. The type of laboratory is a key factor affecting the qualification rate, and the testing capabilities of some laboratories still need to be improved. The micro column agglutination method is widely used in transfusion compatibility tests. The established EQA program effectively monitors quality issues in laboratories, drives continuous improvement, and ensures sustained enhancement of testing standards to safeguard clinical blood safety.

Objective:To analyze the results of national external quality assessment (EQA) for transfusion compatibility test in 2023, and provide reference for quality management of clinical transfusion compatibility testing.Methods:The EQA of clinical transfusion compatibility testing by NCCL was performed 3 times in 2023 among included laboratories. The panel consisting of 22 samples was distributed to 4 186 laboratories across 31 provinces (Including 2 961 tertiary hospital laboratories, 1 085 secondary hospital laboratories, 23 primary hospital laboratories, 106 blood station laboratories and 11 independent clinical laboratories). Each panel contains 11 red blood cell and 11 plasma samples per 1.5 ml/tube. Each participant laboratory of the EQA program was required to carry out the detection and return results in expected time. Statistical analysis and evaluation on the reported results were conducted by NCCL from the aspects of regional distribution, laboratory grading, testing methodology, reagent and testing system usage.Results:The qualification rates of EQA for five items including ABO positive typing, ABO reverse typing, RhD blood type, antibody screening, and cross matching were 96.68%, 95.10%, 96.46%, 95.32%, and 91.04%, respectively. The EQA qualification rate of tertiary hospital laboratories was 87.77% (2 599/2 961), which was significantly higher than the 77.79% (844/1 085) of secondary hospital laboratories. There were significant differences in the qualification rate of participating laboratories among different regions. The utilization rates of micro column agglutination method in ABO positive typing, ABO reverse typing, RhD blood type, antibody screening, and cross matching were 80.81% (10 080/12 474), 75.06% (9 337/12 440), 81.38% (10 118/12 433), 89.59% (11 104/12 394) and 76.25% (9 495/12 453), respectively. The qualification rate of micro column agglutination method was significantly higher than that of saline slide method in ABO positive typing detection ( P<0.05). The qualification rate of micro column agglutination method was significantly higher than that of the polyamine method and anti-human globulin test tube method in antibody screening ( P<0.05). There were statistically significant differences in qualification rate of 7 reagents in ABO reverse typing, antibody screening and cross matching ( P<0.05). There was no statistically significant difference in the qualification rate between the two detection systems for other reagents, except for the ABO reverse typing where the qualification rate of reagent 1 in a single system was higher than that in a mixed system ( P<0.05). Conclusion:The testing capabilities of clinical laboratories in different regions and different type varied significantly in China. Micro column agglutination method was the most popular selection in transfusion compatibility testing. The regents used in these laboratories showed good performance. However, the detection efficiency of some reagents still need to be improved. EQA could be used to evaluate, monitor, and improve the quality of testing.

Objective:To analyze the results of national external quality assessment (EQA) for transfusion compatibility test in 2023, and provide reference for quality management of clinical transfusion compatibility testing.Methods:The EQA of clinical transfusion compatibility testing by NCCL was performed 3 times in 2023 among included laboratories. The panel consisting of 22 samples was distributed to 4 186 laboratories across 31 provinces (Including 2 961 tertiary hospital laboratories, 1 085 secondary hospital laboratories, 23 primary hospital laboratories, 106 blood station laboratories and 11 independent clinical laboratories). Each panel contains 11 red blood cell and 11 plasma samples per 1.5 ml/tube. Each participant laboratory of the EQA program was required to carry out the detection and return results in expected time. Statistical analysis and evaluation on the reported results were conducted by NCCL from the aspects of regional distribution, laboratory grading, testing methodology, reagent and testing system usage.Results:The qualification rates of EQA for five items including ABO positive typing, ABO reverse typing, RhD blood type, antibody screening, and cross matching were 96.68%, 95.10%, 96.46%, 95.32%, and 91.04%, respectively. The EQA qualification rate of tertiary hospital laboratories was 87.77% (2 599/2 961), which was significantly higher than the 77.79% (844/1 085) of secondary hospital laboratories. There were significant differences in the qualification rate of participating laboratories among different regions. The utilization rates of micro column agglutination method in ABO positive typing, ABO reverse typing, RhD blood type, antibody screening, and cross matching were 80.81% (10 080/12 474), 75.06% (9 337/12 440), 81.38% (10 118/12 433), 89.59% (11 104/12 394) and 76.25% (9 495/12 453), respectively. The qualification rate of micro column agglutination method was significantly higher than that of saline slide method in ABO positive typing detection ( P<0.05). The qualification rate of micro column agglutination method was significantly higher than that of the polyamine method and anti-human globulin test tube method in antibody screening ( P<0.05). There were statistically significant differences in qualification rate of 7 reagents in ABO reverse typing, antibody screening and cross matching ( P<0.05). There was no statistically significant difference in the qualification rate between the two detection systems for other reagents, except for the ABO reverse typing where the qualification rate of reagent 1 in a single system was higher than that in a mixed system ( P<0.05). Conclusion:The testing capabilities of clinical laboratories in different regions and different type varied significantly in China. Micro column agglutination method was the most popular selection in transfusion compatibility testing. The regents used in these laboratories showed good performance. However, the detection efficiency of some reagents still need to be improved. EQA could be used to evaluate, monitor, and improve the quality of testing.

Medical insurance fund is the foundation for the healthy operation of the medical insurance system, which is related to the well-being of the people and social stability. Medical institutions, as important entities in the implementation of medical insurance policies and the use of medical insurance funds, should continuously improve and optimize their self-management, and strengthen the prevention and control of clean risks in the use of medical insurance funds. This is not only a necessary response measure in the context of strict supervision of national medical insurance funds, but also an inevitable choice for hospitals under the trend of high-quality development. This article took a certain hospital as an example to illustrate the practice of sorting out the relevant authority directory for the use of medical insurance funds, analyze the integrity risk points of doctors, patients, and medical insurance reimbursement auditors; And introduced the practice of using a clean risk prevention and control grid to strengthen the hospital′s medical insurance fund, including improving the medical insurance management system, cultivating a sustainable culture of integrity, optimizing process design, improving information system construction, and improving medical insurance service modes, so as to provide reference for other medical institutions.

The effect of Radix isatidis polysaccharide(IRPS)on TLR3/TRIF innate immune path-way and type Ⅰ interferon secretion in 3D4/21/CD163 cells infected by porcine reproductive and re-spiratory syndrome virus(PRRSV)was tested by Western blot and ELISA;moreover,the effect of IRPS on the immunosuppression infected by PRRSV was further verified with the TLR3 agonist poly(I∶C).The results showed that the protein levels of TLR3,TRIF,IRF3,IRF7 and type Ⅰ in-terferon secretion were significantly decreased at 18,24 h of PRRSV infection,while IRPS signifi-cantly inhibited this process;poly(I∶C)alleviated the protein levels of TRIF,IRF3 and IRF7 as well as the phosphorylation levels of IRF3 and IRF7 infected by PRRSV;at the same time,IRPS is synergistic with poly(I∶C).The results indicate that IRPS is able to alleviate immunosuppression caused by PRRSV infection via the TLR3/TRIF pathway.

Objective To systematically review the efficacy and safety of mini-percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopic lithotripsy (FURL) in management of lower pole kidney stones.Methods PubMed, Embase, Scopus, Cochrane library, CNKI, VIP and Wanfang Data were searched from the beginning of database to September 2016 and clinical trials that compared the two above operation for treatment of lower pole stones were collected.Two researchers independently filtered literature,extracted data and evaluated the methodological quality of research papers.The meta-analysis was performed using the RevMan 5.3 software.Results One randomized and seven non-randomized studies were analyzed, which consists of 621 patients including MPCNL group 327 cases, FURL group 294 cases.The results of meta-analysis showed that MPCNL was better than FURL in stones clearance (OR =2.65,95％ CI 1.58-4.46,P ＜ 0.01) and operative time (WMD =-21.86,95％ CI-28.52--15.20, P ＜ 0.01).FURL was better in hospital stay time (WMD =2.28,95％ CI 0.29-4.28, P =0.02), decrease in haemoglobin levels (WMD =0.78,95 ％ CI 0.68-0.89, P ＜ 0.01), bleeding (OR =5.11,95 ％ CI 1.12-23.31,P =0.04), transfusion(OR =7.04,95％ CI 1.59-31.15, P =0.01).There was no significant difference in fever,urinary tract infection, hematuria (P ＞ 0.05).Conclusions Both MPCN and FURL are safe and effective for the treatment of lower pole stones, MPCNL can get higher stone clearance rates and shorter operation time.However, FURL can get shorter hospitalization time and lower complication rates.

Biogenic molluscicides refer to the use of plants,animals and micro?organisms or their metabolites,and synthesis biomimetic molluscicides to kill Oncomelania hupensis snails. With the rapid development of science and technology,new bio?genic molluscicides are continuously emerging and the category also continues to expand. According to the molluscicidal active ingredient and sources,at present,the biogenic molluscicides with in?depth studies include plant?derived molluscicides,micro?organism molluscicides,microbial metabolite molluscicides and animal molluscicides. This paper reviews the advances in the re?searches of biogenic molluscicides in recent years.

Objective To describe the growth and development of Schistosoma japonicum in goat and the intensity and tem?poral distribution of eggs excreted by goat feces,so as to provide baseline data for the control and elimination of the role of goat in the transmission of schistosomiasis. Methods The goat animal models of schistosomiasis were established,and stool sam?ples were collected for parasitological examinations. The number of adult worms recovered,variation of schistosomes in goat at different time points post?infection,number of eggs in schistosomes,variation in number and temporal profiles of eggs excreted from goat feces were observed. Results Of the 6 schistosome?infected goat,415 adult worms were recovered,with a mean adult worm recovery of 34.58%(range,23.00%to 45.50%). Among the 5 goat infected with 200 cercariae each,47,93,77, 74 and 73 adult worms were recovered 2,5,8,11 and 14 months post?infection,respectively. There were(200.00 ± 42.33), (226.20±45.88),(168.20±25.85),(183.80±55.13)and(190.80±53.53)eggs detected in female schistosomes. The mean pre?patent period of eggs excreted by 10 infected goat was(37.7±3.02)d. From 2 to 14 months post?infection,7 batches of goat fe?ces were hatched,and there were 30,23,14,1 and 2 times for miracidium intensity of“++++”,“+++”,“++”,“+”and“-”, respectively,with 42.86%,32.86%,20.00%,1.43%and 2.86%constituent ratios of miracidium intensity. Conclusions Ap?proximately 1/3 S. japonicum cercariae may develop to adults in goats post?infection,and the prepatent period of eggs is(37.7± 3.02)d. There is no remarkable decrease seen in the number of adult worms,eggs in female schistosomes and eggs in goat feces within 14 months post?infection. Our findings suggest a long duration for infected goat in the transmission of schistosomiasis ,and there is no evidence to prove the“self?cure”phenomenon in goat,indicating that goat is an important source of infection for schistosomiasis japonica.