The development of organ transplantation has brought new hope to many patients with organ failure and their families， but it has also raised numerous ethical issues. How to balance the rights and interests between organ donors and recipients， as well as ensure the fairness and transparency of the transplantation process has become an urgent problem to be solved. Based on the latest Regulations on Organ Donation and Transplantation and the Working Rules of the Ethics Committee for Human Organ Transplantation， the current difficulties and challenges in organ transplantation ethics were deeply analyzed. Taking the ethical review practice of Shenzhen Third People’s Hospital as an example， this paper explored issues such as full informed consent of both donors and recipients， risk assessment of marginal donors， and the review of relationships between donors and recipients. It also explored and constructed a set of complete ethical review models for organ transplantation through refined management. This model improved the efficiency and quality of ethical review as well as enriched the related knowledge system. It is expected that the implementation of this model can provide a reference for promoting effective ethical review nationwide， advancing the improvement and development of ethical review work in organ transplantation. Meanwhile， more medical ethics experts and practitioners are called upon to focus on and engage in the research and practice of ethical review in organ transplantation， jointly promoting progress in this field.

Objective To evaluate the interventional effects of virtual reality(VR)on cancer patients in pain,anxiety,cognitive function,upper limb function and quality of life.Methods Randomised controlled trials(RCTs)using VR technology on cancer patients were retrieved from databases of CNKI,Wanfang Database,SinoMed,VIP,PubMed,Web of Science,Embase,PsycINFO and Cochrane Library,from the inception of the databases to March 2023.Two reviewers independently examined and screened the literatures,followed by evaluation of the quality and extraction of relevant themes.Meta-analysis was conducted by using RevMan 5.3 to analyse the acquired data.Results A total of 9 RCTs involving 727 patients were included.The meta-analysis demonstrated that VR technology alleviated pain intensity in cancer patients[SMD=-1.31,95%CI(-1.96 to-0.66),P<0.001],relieved anxiety[SMD=-0.96,95%CI(-1.62 to-0.31),P=0.004],improved cognitive function[SMD=3.37,95%CI(1.74 to 5.00),P<0.001],and improved quality of life of cancer patients[SMD=0.67,95%CI(0.38 to 0.96),P<0.001].However,it posed unclear effect on upper limb function[SMD=-0.57,95%CI(-1.40 to 0.26),P=0.18].Conclusion VR technology shows potentials in alleviation of pain,reduction of anxiety and improvement of cognitive function and the quality of life in cancer patients,but it remains uncertain effect on upper limb function.However,due to heterogeneity in some of the results,more high-quality studies are required to validate the interventional effects of VR technology on cancer patients.

Objective:To explore the application effect of group guidance based on intelligent communication matrix in patients with type 2 diabetes mellitus (T2DM) .Methods:Using the convenient sampling method, a total of 60 T2DM patients with poor self-management ability who scored less than 19.6 on Summary of Diabetes Self Care Activities (SDSCA) in the Affiliated Chuzhou Hospital of Anhui Medical University were selected as the research objects from May to June 2020. They were randomly divide into the observation group ( n=30) and the control group ( n=30). The observation group was given continuous group guidance based on intelligent communication matrix, while the control group was given routine health guidance. The SDSCA score, body mass index and glycosylated hemoglobin (HbA1c) before and after intervention were compared between the two groups. Results:After intervention, the SDSCA score of the observation group was higher than that of the control group, HbA1c was lower than that of the control group and body mass index was lower than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The group guidance based on intelligent communication matrix can improve the self-management level of T2DM patients and reduce their body mass index and HbA1c levels, which has clinical application value.

Objective:To compare the similarities and differences of macrophage activation syndrome（MAS）combined with systemic juvenile idiopathic arthritis（sJIA）versus with juvenile onset systemic lupus erythematosus（JSLE）.Methods:The clinical data of 48 children with MAS admitted to the Department of Nephrology and Immunology in Children's Hospital of Hebei Province from May 2015 to January 2023 were retrospectively analyzed. The patients were divided into sJIA-MAS and JSLE-MAS group，and the clinical manifestations，laboratory indicators and treatment of the two groups were compared.Results:Among the 48 children（14 males and 34 females）with MAS，the average age of onset was 9.5（3.0，11.8）years. There were 28 cases（11males and 17 females）of sJIA-MAS and 20 cases（3 males and 17 females）of JSLE- MAS. All the 48 children with MAS had fever and hyperferinemia，and the fever with sJIA-MAS was mostly continued fever or remittent fever. Respiratory tract infection was the most common trigger in sJIA-MAS［15 cases（53.6%）］，and disease activity was the most common trigger in JSLE-MAS［13 cases（65.0%）］.Additionally，viral infections（EB virus and cytomegalovirus）were also one of the triggers in MAS［sJIA：7 cases（25%），JSLE：4 cases（20%）］.Compared with JSLE-MAS，the number of days with fever［15.0（12.0，21.0）days vs. 6.0（4.0，9.5）days， Z=-3.812， P=0.001］and the length of hospital stay［29.0（26.3，39.8）days vs.26.0（19.3，30.8）days， Z=-1.958， P=0.049］were longer in sJIA. Compared with JSLE-MAS，ALT［（685.32±561.67）U/L vs.（139.61±124.44）U/L， t=4.973， P=0.001］，AST［784.00（235.25，1 251.25）U/L vs.189.50（53.25，374.08）U/L， Z=-3.283， P=0.001］，CRP［11.48（3.56，28.89）mg/L vs.1.91（0.53，8.98）mg/L， Z=-3.200， P=0.001］，ferritin［32 167.0（12 384.8，65 963.8）μg/L vs.2 003.5（922.5，11 430.0）μg/L， Z=-4.130， P=0.001］，ferritin max/ESR min［1 353.35（355.75，4 342.53）vs.91.92（34.94，291.53）， Z=-4.120， P=0.001］were higher in sJIA.The decrease of CRP was greater in sJIA［80.04（45.64，143.71）mg/L vs.10.20（6.27，25.64）mg/L， Z=-4.433， P=0.001］.Compared with sJIA-MAS，peripheral white blood cell counting［4.05（2.90，7.73）×10 9/L vs.1.56（1.15，3.47）×10 9/L， Z=-3.577， P=0.001］and platelet counting［（162.68±92.19）×10 9/L vs.（110.10±72.99）×10 9/L， t=2.118， P=0.040］were lower in JSLE-MAS. Kidney involvement was more common in JSLE-MAS［10 cases（50%）vs.0 cases（0%）， χ 2=17.684， P=0.001］.There was no significant difference in the incidence of sJIA-MAS and JSLE-MAS meeting the criteria of hemophagocytic lymphohistiocytosis［6 cases（21.4%）vs.5 cases（25.0%）， χ 2=0.084， P=0.772］. Conclusion:Compared with JSLE-MAS，sJIA-MAS is more dangerous and difficult to control，while JSLE-MAS involves more organs，among which the blood system and kidney are more common.

Objective:To analyze and summarize the efficacy and safety of thalidomide in the treatment of refractory systemic juvenile idiopathic arthritis（sJIA）.Methods:The clinical data of ten patients with refractory sJIA admitted to Department of Nephrology and Immunology in Children's Hospital of Hebei Province from January 2015 to March 2022 were collected，and the clinical manifestations，efficacy and safety of thalidomide in the treatment of refractory sJIA were analyzed retrospectively. Systemic juvenile arthritis disease activity score（sJADAS）was used to evaluate the efficacy of the treatment. Statistical analysis was performed by repeated measurements using general linear models.Results:Among the 10 children（4 males and 6 females）with refractory sJIA，the average age of onset was（7.5±3.3）years. Seven patients were complicated with macrophage activation syndrome at an early stage of disease.The average course of disease was（4.4±1.7）years，and the longest course of disease was 8.3 years. Before the application of thalidomide，all the 10 children experienced relapses（ranging from 2 to 10 times）. The indices of 10 children treated with thalidomide at 6 months and 12 months were compared with those before treatment. Peripheral blood leukocytes［（10.19±3.67）×10 9/L，（8.53±2.83）×10 9/L vs.（16.11±7.81）×10 9/L， F=7.918，11.084， P=0.020，0.009］，C-reactive protein［19.13（0.38，35.21）mg/L，8.05（0.10，18.00）mg/L vs. 59.34（24.20，131.90）mg/L， F=7.030，12.731， P=0.026，0.006］，sJADAS scores［6.00（1.50，12.50）scores，3.00（0，12.50）scores vs. 20.00（11.50，28.00）scores， F=14.710，17.870， P=0.004，0.002］were decreased significantly. The doses of prednisone［0.13（0，0.45）mg/（kg·d），0.02（0，0.06）mg/（kg·d）vs. 0.42（0.16，1.47）mg/（kg·d）， F=5.890，7.623， P=0.041，0.022］were significantly decreased.All the differences were statistically significant. Prednisone was successfully discontinued in 7 cases. Tocilizumab was gradually withdrawn in 3 cases，and tocilizumab administration interval was prolonged in 1 case. None of the 10 children had serious adverse reactions. Conclusion:Thalidomide is clinically effective in the treatment of sJIA，and can reduce the required dose of prednisone and prolong the tocilizumab free remission.

Objective:To establish a green fluorescent protein(GFP)and firefly luciferase(Luc)double-labeled Epstein-Barr virus(EBV)infec-ted B lymphoblastoid cell lines(B-LCL)and apply them to mouse models,then compare the advantages and disadvantages of models inocu-lated by intravenous(IV)or subcutaneous(SC).Methods:B lymphoblastoid cell lines double-tagged with GFP/Luc(B-LCL-GL)were con-structed through lentivirus transduction,puromycin intervention.Subcutaneous xenograft and hematogenous metastasis models were re-spectively established by subcutaneous or intravenous injection of B-LCL-GL cells at three concentrations in(NOD)/Prkdcscid/IL-2Rγnull(NPG)mice for in vivo bioluminescence imaging.Results:In the B-LCL-GL group,the ratio of the GFP-positive cell population was 92.5%,and the average luminescence intensity was as high as 4.80E+08 Photons/s,which was considerably higher than that of untreated B-LCLs.In the hematogenous metastasis models,tumor bioluminescence was initially located in the peritoneal area and then spread throughout the en-tire body between 7 and 28 days.In the subcutaneous xenograft models,strong central and weak peripheral tumor-related biolumines-cence signal was detected on day 7 in the three groups,which then spread throughout the body on day 28 in the high-dose group.Taken to-gether,there was no significant difference in tumor progression between the two routes of administration when using the same dose of B-LCL-GL cells.However,the survival analysis indicated that the IV injection group,in which all the mice ultimately died,had a shorter time frame for testing than that of the SC injection group,in which the mice survived until day 100 in the low-dose and medium-dose groups,thus allowing for long-term testing.Conclusions:GFP and Luc dual-positive B-LCLs were successfully established to generate hematogenous metastasis and subcutaneous xenograft models,which allow the monitoring of the location and size of lymphomas in vivo.It provide plat-form for the study of tumor characteristics and selecting anti-tumor drugs.

The data of a child with sphingosine phosphate lyase insufficiency syndrome (SPLIS) admitted to Children′s Hospital of Hebei Province on February 4, 2020 were retrospectively analyzed.The child had edema, complicated with ichthyosis, adrenal calcification, and hearing loss from the early infancy.Laboratory examination results suggested a low albumin level, hypercholesterolemia, a high proteinuria level, abnormal liver and renal functions, and hyponatremia.The child gave up treatment and died at home.Whole Exome Sequencing (WES) results showed two hete-rozygous mutations of SGPL1 gene (chr10: 72604336, c.134G>A, p.W45X; chr10: 72629563, c.719G>T, p.S240I). SPLIS is inherited in an autosomal recessive manner.It starts in infancy, and affects the kidney, skin, endocrine, nervous and immune systems.It is suggested that SPLIS patients should take genetic examination.Early diagnosis, appropriate intervention, and vitamin B 6 treatment may relieve some symptoms of SPLIS patients.Adeno-associated virus mediated SGPL1 gene replacement therapy can be a novel cure of SPLIS and is worthy of investigation.

Premature ovarian insufficiency (POI) is a cause of infertility in women. It is characterized by menstrual disorders (such as menopause or sparse menstruation) with high gonadotropins and low estrogen levels in women younger than 40 years of age. Although some factors including ovarian surgery, chemotherapy, radiotherapy, chromosomal abnormalities or environmental have been reported to be involved in the development of POI, the underlying cause is not identified in the majority of cases. At present, there are mainly two kinds of POI animal models: rodent POI model and non-rodent POI model. Mouse POI model in rodent POI model has the most variety and mature method, and is most commonly used in POI related researches. Rat POI model is used less than mouse POI model, but it still has irreplaceable value for POI research. The ovarian morphology and oocytes of non-rodent POI model (rabbit, pig and non-human primate, etc.) can be easily observed, among which the non-human primate POI model is the most similar to human. However, due to the high experimental cost and strict feeding conditions, there is still little research on non-rodent POI model. Further research is needed to establish a complete model establishment system. This review summarized the established animal models for the POI which provides valuable information regarding the selection of suitable animal model for the research in the pathogenesis of POI.

Premature ovarian insufficiency (POI) is a cause of infertility in women. It is characterized by menstrual disorders (such as menopause or sparse menstruation) with high gonadotropins and low estrogen levels in women younger than 40 years of age. Although some factors including ovarian surgery, chemotherapy, radiotherapy, chromosomal abnormalities or environmental have been reported to be involved in the development of POI, the underlying cause is not identified in the majority of cases. At present, there are mainly two kinds of POI animal models: rodent POI model and non-rodent POI model. Mouse POI model in rodent POI model has the most variety and mature method, and is most commonly used in POI related researches. Rat POI model is used less than mouse POI model, but it still has irreplaceable value for POI research. The ovarian morphology and oocytes of non-rodent POI model (rabbit, pig and non-human primate, etc.) can be easily observed, among which the non-human primate POI model is the most similar to human. However, due to the high experimental cost and strict feeding conditions, there is still little research on non-rodent POI model. Further research is needed to establish a complete model establishment system. This review summarized the established animal models for the POI which provides valuable information regarding the selection of suitable animal model for the research in the pathogenesis of POI.

Objective:To explore the path of standardized training and quality supervision for geriatric nursing assistants basing on the three-way linkage of "hospital, government and market".Methods:From January 2019 to December 2020, we conducted standardized training and management for geriatric nursing assistants in 24 nursing institutions for the aged in Mianyang, Sichuan Province in batches. Through the three-way linkage of "hospital, government and market", the whole-process management mode of "standardized training of geriatric nursing assistants, one-to-many tracking service for three months after the training, and service quality supervision of nursing institutions for the aged" has been established. The theoretical and operational achievements of nursing staff before and after training, the service quality of nursing home and the incidence of adverse events before and after the implementation of the project were observed and compared.Results:From 2019 to 2020, a total of 224 geriatric nursing assistants were trained in five sessions. There were statistical differences in the theoretical and operational scores before and after the training ( t=-72.494, -26.150; P<0.01) . 13 nursing institutions participating in the training in 2019 were selected to compare the service quality before and after the project implementation, the difference was statistically significant ( t=-14.575, P<0.01) , and the incidence of nursing adverse events decreased (χ 2=-7.913, P<0.01) . Conclusions:The mode of geriatric nursing assistants training and quality supervision based on the three-way linkage of "hospital, government, market" is conducive to giving full play to the administrative function of the government and the professional function of the hospital, effectively integrating resources and improving the quality of geriatric nursing service in the region.