Objective To develop a core outcome set(COS)for clinical effectiveness trials of heart failure with preserved ejection fraction(HFpEF).Methods Outcome measures were collected through database literatures search,clinical experts questionnaire survey and semi-structured patients interview.Then,the outcome measures pool was constructed and domains were divided.Candidate outcome measures of COS were screened through two rounds of Delphi survey.Finally,a consensus meeting was held to determine COS and reach a consensus.Results A total of 317 outcome measures which could be divided into 6 domains were collected through literature research,questionnaire survey and semi-structured interview.15 candidate outcome measures of COS were screened through two rounds of Delphi survey.Finally,the consensus meeting reached consensus on a COS with 6 entries.Conclusion In this study,a COS for clinical effectiveness trials of HFpEF was developed,which is conducive to the standardization of efficacy evaluation.

Preimplantation polygenic testing， as a frontier technology in assisted reproduction， provides a new way to prevent genetic diseases and reduce birth defects. However， it may also trigger a series of ethical issues. Combined with the research progress of preimplantation polygenic testing， this paper explored the ethical issues that may be caused by this technology， including the risks and uncertain benefits for future offspring and the challenges of informed consent， the dilemmas of autonomous decision-making and genetic responsibility of prospective parents， as well as social risks such as the distortion of the view of life and health inequities. Given the technical safety issues and ethical challenges posed by preimplantation polygenic testing， it was proposed to revise the regulations related to preimplantation genetic testing， as well as improve the ethical review of preimplantation polygenic testing， genetic counseling services， and public education on genetic science and genetic ethics. These ethical countermeasures aim to prevent and mitigate risks and ensure that technology truly benefits human society.

Objective To develop a core outcome set(COS)for clinical effectiveness trials of heart failure with preserved ejection fraction(HFpEF).Methods Outcome measures were collected through database literatures search,clinical experts questionnaire survey and semi-structured patients interview.Then,the outcome measures pool was constructed and domains were divided.Candidate outcome measures of COS were screened through two rounds of Delphi survey.Finally,a consensus meeting was held to determine COS and reach a consensus.Results A total of 317 outcome measures which could be divided into 6 domains were collected through literature research,questionnaire survey and semi-structured interview.15 candidate outcome measures of COS were screened through two rounds of Delphi survey.Finally,the consensus meeting reached consensus on a COS with 6 entries.Conclusion In this study,a COS for clinical effectiveness trials of HFpEF was developed,which is conducive to the standardization of efficacy evaluation.

Objective To construct a prediction model for post-neoadjuvant therapy recurrent laryngeal nerve lymph node(RLN LN)status via clinical and CT image data in esophageal cancer patients pre-neoadjuvant therapy.Methods A retrospective analysis was conducted on 403 patients with locally advanced esophageal cancer who received neoadjuvant therapy and radical resection for esophageal cancer.All patients were divided into a training cohort(n=270)and a validation cohort(n=133)randomly according to a 2:1 ratio.Clinical and imaging features associated with positive RLN LN pathology were selected by univariate analysis.Multivariate logistic stepwise regression model was used to construct the prediction model.The prediction ability of the model was evaluated by receiver operating characteristic(ROC)curve.Results The basic model included neoadjuvant therapy and RLN LN short diameter,with an area under the curve(AUC)of 0.7(training cohort)and 0.65(validation cohort).The final prediction model included neoadjuvant therapy,human albumin,platelet count,largest lymph node enhancement characteristics,whether the largest lymph node was in the recurrent laryngeal region,and RLN LN short diameter,with AUC of 0.83[95％confidence interval(CI)0.768-0.899]and 0.76(95％CI 0.645-0.887)for the training and validation cohorts,respectively.Conclusion The model based on clinical data and imaging features pre-neoadjuvant therapy for esophageal cancer can assist in clinically predicting the post-neoadjuvant therapy RLN LN status.

Vulnerability is an inherent and ineradicable reality, and different contexts can exacerbate or induce different manifestations of vulnerability. By sorting out the meaning of vulnerability and identifying particular manifestations and attributions of children’ vulnerability in talent genetic testing situations, including the inherent vulnerability of children themselves, the situational vulnerability derived from talent genetic testing and educational environment, as well as the pathogenic vulnerability from the protection of minors. It was proposed that talent genetic testing of children should be guided by the principles of responsibility, no harm, and permission, so as to protect children from additional harm during testing and avoid exacerbating their vulnerability.

To realize the education and training program of excellent doctors in China and meet the ethical requirements of clinical practice, it is crucial to carry out clinical medical ethics education for medical staff. Clinical medical ethics education is an important component of medical education and a necessary and important way for doctors to practice medical professional ethics. Starting from the concept of clinical medical ethics, this paper discussed the meaning, objectives, and content of clinical medical ethics education, and then distinguished its substantive differences from existing medical ethics education, which were manifested in clinical practice ability, situational embodiment, and action standardization. Furthermore, by summarizing and analyzing the current situation of clinical medical ethics education, it was found that it has shown its shortcomings in insufficient practicality. Finally, based on sorting out the previous countermeasures, this paper proposed strategies to strengthen the practicality of clinical medical ethics education, including adopting the integration approach of "time-space-teacher" and establishing a three-level responsibility system of "government-institution-teacher".

Objective:To evaluate the application effect of a personalized nutritional program based on nutrition risk screening in kidney transplant patients.Methods:Using the convenient sampling method, a total of 90 patients who completed kidney transplantation in the Second Xiangya Hospital of Central South University from November 2020 to May 2021 were selected as the research objects. Envelopes were used to draw lots, and patients were randomly divided into the control group (45 cases) and the test group (45 cases) . The control group was given routine basic treatment and nursing care, while the test group was given a personalized nutrition plan based on nutritional risk screening at basis of the control group. The changes of nutritional indexes such as total protein, albumin, prealbumin, retinol-binding protein, serum iron, total iron-binding capacity, and hemoglobin were observed before operation and on the 3rd, 7th, and 14th days after operation in the two groups. The changes of renal function indicators (such as serum creatinine level, endogenous creatinine clearance rate, glomerular filtration rate) were compared between the two groups, and the incidence of readmission within 3 months of discharge was compared between the two groups.Results:The levels of retinol-binding protein in the experimental group on the 3rd, 7th, and 14th days of intervention were better than those in the control group, while the serum creatinine level and glomerular filtration rate were lower than those in the control group, and the differences were statistically significant ( P<0.05) . On the 14th day of intervention, the levels of total protein, hemoglobin, total iron binding capacity and serum iron in the test group were higher than those in the control group, and the clearance rate of endogenous creatinine was lower than that in the control group, and the differences were statistically significant ( P<0.05) . Repeated measures analysis of variance showed that time had an effect on the recovery of nutritional and renal function indexes of patients in both groups ( P<0.05) . There were statistically significant differences in the levels of total protein, hemoglobin, retinol-binding protein, serum creatinine and the main effect of glomerular filtration rate intervention between the two groups ( P<0.05) . And there was an interaction between intervening factors and time of hemoglobin, retinol-binding protein and serum iron levels ( P<0.05) . After 3 months of follow-up, the readmission rate of patients in the experimental group was 0, and that in the control group was 13.6% (6/44) , and the difference was statistically significant ( P<0.05) . Conclusions:Nutritional risk screening combined with personalized nutrition program can effectively improve the nutritional status of kidney transplant patients, promote the recovery of transplanted kidney function, reduce the readmission rate and improve the clinical outcome of patients.

With the maturity of genetic testing technology and the decrease of genetic sequencing cost, an emerging business model based on online platforms has emerged in direct-to-consumer genetic testing. This paper combed the process and methods of this type of genetic testing, and found that obtaining genome data is an indispensable part of the profit making of genetic testing companies. By analyzing the substantive and procedural ethical problems of genetic testing companies’ access to genome data, as well as the insufficient, hidden and misleading problems of informed consent, this paper proposed the principle of credibility, bottom line and minimum risk to protect the legitimate rights and interests of consumers and promote the positive development of direct-to-consumer genetic testing.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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It is known that LINC01018 and CDK6 are associated with the occurrence, progression and recurrence of malignant tumor. Our preliminary data showed that the expression of LINC01018 was down-regulated and that of CDK6 was up-regulated, which were related with the malignancy grade. Bioinformatics suggested that E2F1 binding site exist in the CDK6 promoter region, and LINC01018 might interact with E2F1. Thus we speculate that the expression of LINC01018 in malignant tumor is decreased. The interaction between LINC01018 and E2F1 activates E2F1, promotes the transcription activation of CDK6, and affects tumor proliferation, invasion and metastasis. All these are expected to reveal the effect and mechanisms of LINC01018 in the development and regulation of malignant tumor, and provide new ideas and evidences for its treatment.