Breast milk is the optimal natural food for newborns. However， some newborns cannot receive maternal breast milk due to reasons such as mother-infant separation or insufficient lactation. The establishment of human milk banks （HMB） can effectively address these issues， thereby increasing the breastfeeding rate among hospitalized newborns and improving their quality of survival. However， HMB in China is still in the development and improvement stage. Its implementation involves a series of ethical issues， such as informed consent， privacy protection， economic incentives， quality and safety， and fair resource distribution， which hinder HMB’s widespread promotion. Therefore， discussing the ethical dilemmas faced by the widespread establishment of HMB in China’s hospitals and analyzing coping strategies are crucial for improving the breastfeeding rate of newborns. This paper deeply analyzed and sorted out the ethical issues and challenges currently faced by HMB in China， and proposed corresponding strategies， including “ensuring informed consent and voluntary participation of both donors and recipients，” “protecting the privacy of donors and recipients，” “establishing an ethics-based moral incentive and social support system，” “strictly controlling quality and safety issues”， and “developing fair and rational policies，” aiming to provide a reference solution for addressing ethical concerns in the establishment and operation of HMB.

The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine. Despite their reliability, traditional laboratories often lag in terms of rapid diagnosis. Point-of-care testing (POCT) has emerged as a promising alternative, which is awaiting rigorous validation. We assessed 226 samples from patients at the First Affiliated Hospital of Guangzhou Medical University using a Beckman Coulter AU5821 and a PUSHKANG POCT Biochemistry Analyzer MS100. Furthermore, 350 samples were evaluated with a Stago coagulation analyzer STAR MAX and a PUSHKANG POCT Coagulation Analyzer MC100. Metrics included thirteen biochemical indexes, such as albumin, and five coagulation indices, such as prothrombin time. Comparisons were drawn against the PUSHKANG POCT analyzer. Bland-Altman plots (MS100: 0.8206‒0.9995; MC100: 0.8318‒0.9911) evinced significant consistency between methodologies. Spearman correlation pinpointed a potent linear association between conventional devices and the PUSHKANG POCT analyzer, further underscored by a robust correlation coefficient (MS100: 0.713‒0.949; MC100: 0.593‒0.950). The PUSHKANG POCT was validated as a dependable tool for serum and whole blood biochemical and coagulation diagnostics. This emphasizes its prospective clinical efficacy, offering clinicians a swift diagnostic tool and heralding a new era of enhanced patient care outcomes.
Humans ; Point-of-Care Testing ; Critical Care ; Blood Coagulation Tests/methods* ; Male ; Blood Coagulation ; Female ; Middle Aged ; Reproducibility of Results ; Prothrombin Time ; Aged ; Adult ; Point-of-Care Systems

The red doctors spirit is a special cultural form formed by the Chinese Communist Party in the long-term revolutionary struggle practice, and it has important practical significance and value of the times in the new era. Medicine is a subject integrating natural science and humanities. The element of "emotion" is the embodiment of traditional Chinese medical culture. It plays a role in cultivating doctors’ spirit and solving practical problems in current medical activities. By digging the four aspects of the "emotion" element in red doctors spirit of political loyalty to the party, the moral sentiment of saving the dying and healing the wounded, the rational decision-making under the transformation of medical situation, the response and processing ability of bad public opinion, and integrating it into the humanistic education of medical students. This paper explored the effective ways and promotion models of the element of "emotion" education in the growth of medical talents, so as to promote the cultivation of medical talents’ moral cultivation and ethical decision-making ability, enhance the professionalism and humanistic cultivation of medical students, and cultivate a group of medical talents with political firmness and reasonable consideration for the country.

Coronavirus disease 2019 (COVID-19) has continued to spread globally since late 2019, representing a formidable challenge to the world's healthcare systems, wreaking havoc, and spreading rapidly through human contact. With fever, fatigue, and a persistent dry cough being the hallmark symptoms, this disease threatened to destabilize the delicate balance of our global community. Rapid and accurate diagnosis of COVID-19 is a prerequisite for understanding the number of confirmed cases in the world or a region, and an important factor in epidemic assessment and the development of control measures. It also plays a crucial role in ensuring that patients receive the appropriate medical treatment, leading to optimal patient care. Reverse transcription-polymerase chain reaction (RT-PCR) technology is currently the most mature method for detecting viral nucleic acids, but it has many drawbacks. Meanwhile, a variety of COVID-19 detection methods, including molecular biological diagnostic, immunodiagnostic, imaging, and artificial intelligence methods have been developed and applied in clinical practice to meet diverse scenarios and needs. These methods can help clinicians diagnose and treat COVID-19 patients. This review describes the variety of such methods used in China, providing an important reference in the field of the clinical diagnosis of COVID-19.
Humans ; Artificial Intelligence ; China ; COVID-19/diagnosis* ; COVID-19 Testing

In the emergency response to public health emergencies, a series of ethical issues will be faced. One of the core issues is that the ethical conflict between personal freedom of medical staff and common good has not been effectively resolved, and the moral responsibility boundaries of medical staff have not been clearly defined. The personal freedom rights of medical staff are constrained in the emergency response to public health emergencies due to the prior moral requirements and regulations for them that emphasizes the priority of safeguarding public interests. Therefore, it is important to consider elements such as voluntariness, proportionality, priority, and fairness when balancing the tension between personal freedom of medical staff and common good. It is recommended to establish a rating system that endangers the life safety of medical staff, list the ethical list of "legitimate reasons" by the health administrative department, and improve the reward system of "moral and welfare consistency" to solve the ethical conflict between personal freedom of medical staff and common good, so as to better achieve common good.

In order to explore the ethical review experience of organ donation and transplantation after the death of citizens, and provide reference value for medical institutions to carry out corresponding ethical review. By using descriptive research, purpose sampling method and the principle of data saturation, 10 members and secretaries of ethics committee on clinical application of organ transplantation technology were finally selected as respondents for semi-structured interviews. The Colaizzi 7-step analysis method was adopted to analyze, summarize and refine the theme. The results showed that the ethical review experience of organ donation and transplantation after the death of citizens included four themes: the responsibilities of ethics committee, the key points of ethics review, the form of ethics review conference and its advantages and disadvantages, and the construction of the ethics committee of organ transplantation. Therefore, there are defects in the ethical review of organ donation and transplantation in medical institutions at present. These can be remedied by enriching elements of the ethical review following the four principles of medical ethics, refining the laws related to organ donation after citizens’ death, constructing a reasonable and efficient pattern of ethical review conference, and establishing a robust and appropriate operation mode of organ transplantation ethics committee.

The red doctors spirit is a special cultural form formed by the Chinese Communist Party in the long-term revolutionary struggle practice, and it has important practical significance and value of the times in the new era. Medicine is a subject integrating natural science and humanities. The element of "emotion" is the embodiment of traditional Chinese medical culture. It plays a role in cultivating doctors’ spirit and solving practical problems in current medical activities. By digging the four aspects of the "emotion" element in red doctors spirit of political loyalty to the party, the moral sentiment of saving the dying and healing the wounded, the rational decision-making under the transformation of medical situation, the response and processing ability of bad public opinion, and integrating it into the humanistic education of medical students. This paper explored the effective ways and promotion models of the element of "emotion" education in the growth of medical talents, so as to promote the cultivation of medical talents’ moral cultivation and ethical decision-making ability, enhance the professionalism and humanistic cultivation of medical students, and cultivate a group of medical talents with political firmness and reasonable consideration for the country.

Objective:To develop early warning systems for unplanned extubation in critical patients to give the early warning and interference in order to reduce the risks of unexpected drawn tubes and guarantee the security of the patients.Methods:Took the model of risk warning system for unplanned extubation in critical patients as the core, obeyed the guide of the nursing intervention program, based on the information system of patients in ICU and relied on computer science technology to design the architecture for the interface layout, the partitions, the modular structure, the content and the function of the system. This warning system was designed from multiple angels and directions. This research retrospectively analyzed the 18 cases for unplanned extubation from January to December in 2016 using this system to verify its warning effectiveness.Results:The prototype of this warning system included login module, evaluation module, decision module, warning module, directive module and the module for canal fixed scheme. The system automatically determined the level of risk for critical patients to implement the layered pre-warning and screen the high-risk patients. Finally, individual nursing interfering method could be supplied. The detection rate of this warning system was 88.89% after retrospective analysis.Conclusion:The warning system for unplanned extubation patients is an automated, intellectualized and informationalized platform. It can effectively warn the high risk of the extubation patients and evade the risk of canal nursing.

Objective To establish a comprehensive,simple,and effective scoring model for predicting the recurrence risk after endovascular embolization of intracranial aneurysms in order to assess the possibility of recurrence and to provide guidance for the selection of surgical protocols and postoperative management.Methods From May 2012 to May 2014,434 patients (441 aneurysms) with intracranial aneurysm treated with endovascular embolization at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled retrospectively,and they were used as a modeling group.After modeling,109 patients (109 aneurysms) were used as a validation group.In the modeling cohort,a predictive scoring model of recurrence risk was established according to the results of multivariate logistic regression analysis;the model was validated in the validation cohort.According to the scoring model of the modeling group,the scoring table of best cut-off value of the receiver operating characteristic (ROC) curves was divided into a low-risk and a high-risk of recurrence.The recurrence risk score model was compared with the North America aneurysm recanalization stratification scale (ARSS) model,and Raymond grade.Results Multivariate logistic regression analysis showed that the 3 factors included in the scores and finally,a established scoring model of recurrence risk prediction were non-stent assisted embolization (1 point),Raymond grade ≥Ⅱ (1 point),and the size of aneurysm (aneurysm >25 mm[3 points)],aneurysm 10-25 mm[1 point],and aneurysm <10 mm[0 point]).The validation indicated that the scoring system had higher predictive value (AUC=0.738,95%CI 0.641-0.834,P<0.05) and goodness of fit (Hosmer-Lemeshow χ2=2.109,P=0.146).The scoring table was further divided into the low-risk recurrence (0-1 point) and high-risk recurrence (2-5 points),its sensitivity was 72.73% (48/66) and specificity was 68.80% (258/375).The predictive ability of the aneurysm recurrence risk score model was similar to that of the ARSS score (χ2=0.54,P=0.462),and it was better than the Raymond grade (χ2=15.10,P<0.01).Conclusion The established simple aneurysm recurrence risk predicting score model in this study may accurately predict the recurrence of aneurysms,however,a multicenter,large sample prospective study is needed for further validation.

Objective To evaluate the safety and effectiveness of Pipeline embolization device (PED) for the treatment of large and giant intracranial aneurysms.Methods Frorn November 2014 to May 2016,the clinical and radiological data of 33 patients with intracranial aneurysm confirmed by DSA or head CT angiography (CTA) or head magnetic resonance angiography (MRA) at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled retrospectively.Its safety and effectiveness were evaluated.Results The Pipelines were successfully released in 33 patients with 35 aneurysms,10 aneurysms were implanted by using PED alone,25 were implanted by using PED combined with coil embolization (including 2 were implanted by using Pipeline bridging technology).During the perioperative period,1 thrombotic event(one aneurysm) occurred and had hemorrhagic transformation.One(one aneurysm) died of fatal aneurysm delayed bleeding.Thirty-one patients (33 aneurysms) were followed up clinically,the follow-up time was 4-18 months,no bleeding or thrombosis events occurred.Eighteen aneurysms received a short-term postoperative imaging follow-up (3-5 months,enhanced MRA or DSA),of which 10 had neck residue or aneurysm development,and 8 aneurysms did not have development at all,and 19 achieved postoperative mid-term imaging follow-up (6-16 months,enhanced MRA or DSA).Two of them had neck residue and 17 did not develop at all.Conclusion Pipeline for the treatment of intracranial large and giant aneurysms may be safe and effective.However,the complications of intracranial hemorrhage cannot be ignored after implantation of embolization device.Its related mechanism needs to be further studied.