ObjectiveTo examine the public cognition， preferences， and values regarding organ allocation， thereby enhancing the public trust in China’s organ allocation system and providing a theoretical basis for human organ allocation in China. MethodsBy drawing on foreign questionnaires and finalizing the questionnaire after two rounds of expert discussion and evaluation， a nationwide online survey was conducted to investigate the Chinese public’s cognition， attitudes， and preferences towards organ allocation. ResultsNearly half of the respondents reported that they had only heard of （45.44%） or had never heard of （46.90%） the Organ Procurement Organizations （OPOs）. Most respondents expressed limited understanding of China’s organ allocation policy （68.42%） or specific procedures （67.89%）. Only 9.65% of respondents expressed strong support for the current organ allocation policy， while 75.76% indicated that national allocation policies would influence their willingness or decision to donate organs. The public showed stronger endorsement of the principles of “prioritizing the sickest，” “first-come， first-served，” and “prioritizing those with better prognosis” for organ allocation. There were statistically significant differences in the public cognition， attitudes， and preferences for organ allocation by gender， age， education level， and occupation （all P<0.05）. ConclusionThe Chinese public’s cognition regarding organ allocation is generally low， and their willingness to donate organs is not high. The public attitude towards organ allocation policy remains unclear and is still in a “wait-and-see” state； the public prefers an ethical distribution model that balances fairness and efficiency. Increasing the public understanding of organ allocation procedures and incorporating public opinion into national organ allocation guidelines could play a significant role in enhancing public willingness to donate organs.

Chen Shigong is a renowned traditional Chinese medical surgeon in the Ming Dynasty， and his medical ethical thought is an important part of ancient Chinese medical ethical thought. The “five precepts of physicians” and the “ten essentials for physicians” in his book Orthodox Manual of External Diseases are regarded as the third monument in the history of the development of traditional Chinese medical ethics. Chen Shigong’s medical ethical thought was mainly influenced by the Song and Ming philosophies， forming the worldview of “unity of heaven and humanity” and a philosophy of life of “unity of knowledge and action.” He also advocated the values of benevolence among physicians and indifference to fame and fortune， the doctor-patient view of treating patients equally and preserving privacy， the medical view of respecting peers and spreading medical skills， and the diagnosis and treatment view of fulfilling duties and treating patients based on syndrome differentiation. Chen Shigong’s medical ethical thought advocated that medical ethics and skills should be given equal importance， which has a strong vitality and important reference value in strengthening medical ethical education， improving doctor-patient relationships， and cultivating the spirit of “benevolence” among physicians.

The 60th annual meeting of the European Association for the Study of Diabetes(EASD), held in Madrid, Spain, in September 2024, convened leading physicians and researchers from more than 130 countries. This premier event shared and discussed advances in diagnosis and treatment, as well as future trends in diabetes and metabolic disease research. Key topics included the presentation of the Claude Bernard Prize, advancements in diabetes management strategies, the interplay between obesity and diabetes, novel therapeutic developments, and emerging diagnostic and treatment approaches for metabolic dysfunction-associated steatotic liver disease.

Objective:To investigate the effectiveness and safety of secondary cytoreductive surgery (SCS) in patients with platinum-sensitive recurrent epithelial ovarian cancer who progressed after first-line maintenance therapy with poly adenosine diphosphate ribose polymerase inhibitor (PARPi).Methods:Clinical pathological data and prognostic information were retrospectively collected from 30 ovarian cancer patients who underwent SCS between January 2018 and June 2024. The Kaplan-Meier method was used to analyze the second progression-free survival (PFS2) time and 3-year overall survival (OS) rate.Results:(1) Primary treatment: the median age at diagnosis was 51.3 years. A total of 40% (12/30) patients underwent primary debulking surgery with an expectation of achieving no gross residual disease (R0), while 60% (18/30) received neoadjuvant chemotherapy and interval debulking surgery. Optimal cytoreduction was achieved in 93% (28/30) of patients. BRCA1/2 gene testing was performed in 29 patients (testing rate 97%, 29/30), identifying 11 BRCA-mutated (37%, 11/30) and 18 BRCA wild-type (60%, 18/30) patients. The median duration of PARPi maintenance therapy among the 30 patients was 11.9 months; patients with BRCA gene mutations had a median duration of 19.2 months, while those with BRCA wild-type had a median duration of 10.1 months. (2) Secondary surgery: pathologically confirmed recurrence patterns, single lesion in 9 patients (30%, 9/30), oligo-lesion (2 lesions) in 3 patients (10%, 3/30), and multi-lesion (≥3 lesions) in 18 patients (60%, 18/30). Among the 30 patients, optimal cytoreduction was achieved in 97% (29/30) of SCS patients, with suboptimal cytoreduction in 1 patient (3%, 1/30). Adjuvant chemotherapy included platinum+paclitaxel in 24 (80%, 24/30) patients and platinum+liposomal doxorubicin in 6 (20%, 6/30) patients. PARPi re-treatment was administered to 17 patients (57%, 17/30) after chemotherapy. (3) Efficacy and safety: as of the follow-up cutoff in June 2024, the median follow-up time was 28.0 months. A total of 19 (63%, 19/30) patients experienced the next recurrence. The median PFS2 time after SCS was 18.5 months. Recurrence occurred in 7 BRCA-mutated and 12 BRCA gene wild-type patients. Median PFS2 time was significantly longer in BRCA-mutated patients compared to BRCA wild-type patients (25.7 vs 14.1 months; P=0.028). Three deaths occurred during follow-up, resulting in a 3-year OS rate of 90%. Among the 30 patients, postoperative complications occurred in 4 patients (13%, 4/30). One patient developed a ureteral fistula on 7 days post-SCS requiring ureteral stenting, and one patient was transferred to the intensive care unit on 1 day post-SCS due to hypovolemic shock. No deaths occurred within 30 days after SCS. Conclusion:For platinum-sensitive recurrent ovarian cancer patients progressed after first-line PARPi maintenance therapy who are anticipated to achieve R0 resection, SCS represents a safe and effective second-line treatment option.

Objective To investigate the characteristics of traditional Chinese medicine(TCM)syndrome elements and the distribution patterns of TCM syndromes in senile osteoporosis(SOP),providing a reference for TCM treatment of SOP.Methods A cross-sectional study was conducted on 200 SOP patients aged over 70 years treated at Wuxi Huishan Chinese Medicine Hospital from January 2022 to June 2023.General information and TCM diagnostic data were collected.The syndrome element differentiation scoring method was employed for analysis.Results(1)Among the 200 SOP patients,the most prevalent disease-location syndrome element was kidney(61.50％),followed by liver(48.50％),bones and tendons(45.50％),spleen(37.00％),meridians(25.50％),heart(12.50％),and lung(10.50％).Statistical analysis showed significantly higher syndrome element scores for kidney,liver,bones and tendons,spleen,and meridians compared to heart and lung(P＜0.01).(2)Regarding disease-nature syndrome elements,deficiency-type elements predominated,with yang deficiency(52.50％)being most common,followed by blood deficiency(46.00％),essence depletion(45.50％),qi deficiency(45.50％),yin deficiency(37.00％),unconsolidation(25.50％),and qi sinking(15.50％).Yang deficiency,blood deficiency,essence depletion,qi deficiency,and yin deficiency scores were significantly higher than those of insecurity and qi sinking,the difference being statistically significant(P＜0.01).Among excess-type elements,cold(47.00％)was most prevalent,followed by blood stasis(45.00％),qi stagnation(43.50％),dampness(34.50％),phlegm(27.50％),and heat(25.00％).Cold and blood stasis scores were significantly higher than phlegm,while cold,blood stasis,qi stagnation,dampness,and phlegm scores were significantly higher than heat,the difference being statistically significant(P＜0.05).(3)Eighteen TCM syndrome patterns were identified.Spleen-kidney yang deficiency(40.00％)was most frequent,followed by liver blood deficiency(37.50％),kidney essence insufficiency(35.00％),qi stagnation and blood stasis(31.00％),cold congelation and obstruction(25.50％),phlegm-damp obstruction(27.50％),and qi-yin deficiency with qi insecurity(11.00％).Based on syndrome element scores,the primary syndromes were defiined as spleen-kidney yang deficiency(35.60％),liver blood deficiency(25.13％),kidney essence insufficiency(18.32％),and qi stagnation and blood stasis(13.09％),etc.Conclusion The characteristic TCM syndrome elements of SOP patients involve qi-blood-yin-yang deficiency of kidney,spleen,and liver,combined with cold congelation,blood stasis,and qi stagnation.The main TCM syndromes are spleen-kidney yang deficiency,liver blood deficiency,kidney essence insufficiency,and qi stagnation with blood stasis.

Medical ultrasound technology is widely used for diagnosis and therapy in clinical practice.Ultrasound probes,which are directly contact with patients,pose a potential risk of pathogen transmission.This expert consen-sus was developed by a multidisciplinary team based on international guidelines,standards in China,and the results of a national survey,aiming to reduce the risk of healthcare-associated infection through standardizing reprocessing of medical ultrasound probes,and formulating consensus recommendations with the Delphi method.The consensus clarifies the reprocessing principles for three types of ultrasound probes of different infection risks:external-use ul-trasound probes,interventional percutaneous ultrasound probes,and internal-use ultrasound probes,puts forward systematic suggestions on the reprocessing standards and disinfection levels of ultrasound probe isolation covers and coupling agents,the reprocessing procedures and methods of ultrasound probes,as well as architectural layout and management of reprocessing,so as to provide a scientific prevention and control framework for ensuring ultrasound diagnosis and therapy safety.

Objective To propose a novel method based on three-dimensional depthwise separable convolution network(3D DSN)for the separation of PET images with dual tracers of 18F-FDG and 18F-FAPI.Methods A total of 120 pairs of 18F-FDG and 18F-FAPI PET images of the same patient scanned separately at different time points were collected,and the dual-tracer PET image was generated through simulation.After the image registration of PET images of two tracers for ensuring spatial position matching,the registered PET images were forward-projected to generate sinogram data,and the sinogram data of two tracers were accumulated to obtain mixed sinogram data.Subsequently,the dual-tracer PET image was reconstructed using maximum likelihood expectation maximization and input into a 3D DSN based network for image separation,thereby obtaining PET images of two single tracers.Results Compared with 3D CNN method,the proposed method increased the structure similarity index measure(SSIM)of the separated 18F-FDG images to the real 18F-FDG images by 0.87%,increased the peak signal-to-noise ratio(PSNR)by 11.8%,and reduced the normalized root mean square error(NRMSE)by 52%.The SSIM of the separated 18F-FAPI images to the real 18F-FAPI images increased by 1.1%,PSNR increased by 17.0%,and NRMSE decreased by 51%.Conclusion The proposed method can be effectively applied to simultaneous PET imaging with dual PET tracers,reducing the number of scans and costs in time and money,and providing clinical doctors more accurate and abundant diagnostic information.

Objective:To investigate the effectiveness and safety of secondary cytoreductive surgery (SCS) in patients with platinum-sensitive recurrent epithelial ovarian cancer who progressed after first-line maintenance therapy with poly adenosine diphosphate ribose polymerase inhibitor (PARPi).Methods:Clinical pathological data and prognostic information were retrospectively collected from 30 ovarian cancer patients who underwent SCS between January 2018 and June 2024. The Kaplan-Meier method was used to analyze the second progression-free survival (PFS2) time and 3-year overall survival (OS) rate.Results:(1) Primary treatment: the median age at diagnosis was 51.3 years. A total of 40% (12/30) patients underwent primary debulking surgery with an expectation of achieving no gross residual disease (R0), while 60% (18/30) received neoadjuvant chemotherapy and interval debulking surgery. Optimal cytoreduction was achieved in 93% (28/30) of patients. BRCA1/2 gene testing was performed in 29 patients (testing rate 97%, 29/30), identifying 11 BRCA-mutated (37%, 11/30) and 18 BRCA wild-type (60%, 18/30) patients. The median duration of PARPi maintenance therapy among the 30 patients was 11.9 months; patients with BRCA gene mutations had a median duration of 19.2 months, while those with BRCA wild-type had a median duration of 10.1 months. (2) Secondary surgery: pathologically confirmed recurrence patterns, single lesion in 9 patients (30%, 9/30), oligo-lesion (2 lesions) in 3 patients (10%, 3/30), and multi-lesion (≥3 lesions) in 18 patients (60%, 18/30). Among the 30 patients, optimal cytoreduction was achieved in 97% (29/30) of SCS patients, with suboptimal cytoreduction in 1 patient (3%, 1/30). Adjuvant chemotherapy included platinum+paclitaxel in 24 (80%, 24/30) patients and platinum+liposomal doxorubicin in 6 (20%, 6/30) patients. PARPi re-treatment was administered to 17 patients (57%, 17/30) after chemotherapy. (3) Efficacy and safety: as of the follow-up cutoff in June 2024, the median follow-up time was 28.0 months. A total of 19 (63%, 19/30) patients experienced the next recurrence. The median PFS2 time after SCS was 18.5 months. Recurrence occurred in 7 BRCA-mutated and 12 BRCA gene wild-type patients. Median PFS2 time was significantly longer in BRCA-mutated patients compared to BRCA wild-type patients (25.7 vs 14.1 months; P=0.028). Three deaths occurred during follow-up, resulting in a 3-year OS rate of 90%. Among the 30 patients, postoperative complications occurred in 4 patients (13%, 4/30). One patient developed a ureteral fistula on 7 days post-SCS requiring ureteral stenting, and one patient was transferred to the intensive care unit on 1 day post-SCS due to hypovolemic shock. No deaths occurred within 30 days after SCS. Conclusion:For platinum-sensitive recurrent ovarian cancer patients progressed after first-line PARPi maintenance therapy who are anticipated to achieve R0 resection, SCS represents a safe and effective second-line treatment option.

Medical ultrasound technology is widely used for diagnosis and therapy in clinical practice.Ultrasound probes,which are directly contact with patients,pose a potential risk of pathogen transmission.This expert consen-sus was developed by a multidisciplinary team based on international guidelines,standards in China,and the results of a national survey,aiming to reduce the risk of healthcare-associated infection through standardizing reprocessing of medical ultrasound probes,and formulating consensus recommendations with the Delphi method.The consensus clarifies the reprocessing principles for three types of ultrasound probes of different infection risks:external-use ul-trasound probes,interventional percutaneous ultrasound probes,and internal-use ultrasound probes,puts forward systematic suggestions on the reprocessing standards and disinfection levels of ultrasound probe isolation covers and coupling agents,the reprocessing procedures and methods of ultrasound probes,as well as architectural layout and management of reprocessing,so as to provide a scientific prevention and control framework for ensuring ultrasound diagnosis and therapy safety.

Objective To develop a knowledge-attitude-practice assessment scale for home prevention and man-agement of parastostomy hernia in ostomy patients,and to test its reliability and validity,to provide a reliable tool for evaluating the knowledge and practice level of home prevention and management of parastostomy hernia in pa-tients with ostomy.Methods Based on the theory of knowledge,attitude and practice,the initial scale was generat-ed through literature review,semi-structured interviews,expert correspondence,research group discussion and pre-sur-vey.From May to December 2023,685 patients with ostomy from the ostomy clinic of a tertiary hospital in Tianjin were investigated by purpose sampling method,and the reliability and validity were tested.Results A total of 673 valid questionnaires were collected,the results showed that the knowledge-attitude-practice assessment scale for pre-venting and managing parastomal hernia of ostomy patients at home included 3 dimensions of knowledge,attitude and practice,with a total of 27 items.The response rates of 2 rounds of the questionnaire were both 100％;the au-thority coefficients were all 0.915;the Kendall's coefficients of concordance were 0.279 and 0.301,respectively.The content validity index of each item was 0.875～1.000;the content validity index of the average scale level was 0.988;after 2 exploratory factor analysis,the cumulative variance contribution rate was 65.920％.The results of con-firmatory factor analysis showed that the model had a good fit,with a chi-square degree of freedom ratio(/df)of 1.945,the fitting goodness index(GFI)of 0.851,the comparative goodness of fit index(CFI)of 0.919,the root means square error of approximation(RMSEA)of 0.060.The Cronbach's alpha coefficient result of the scale is 0.957,with a test-retest reliability of 0.826 and a half reliability of 0.934.Conclusion The knowledge-attitude-practice assessment scale has good reliability and validity,and can be used as an assessment tool for home prevention and management of parastostomy hernia in ostomy patients.