Contemporary bioethics （including medical ethics） encompasses three distinctly different theories： principlism， pluralistic casuistry， and ritual reconstruction. They differ in many respects， but the primary distinction lies in their respective starting points for ethical thinking： principlism begins with principles， pluralistic casuistry starts with cases， while ritual reconstruction is grounded in rituals. In fact， the first two theories have gained popularity worldwide， while the third theory requires us to construct it based on Confucian classical ethics. This paper explores how the characteristics of ritual guidance and the doctrine of the mean in Confucian classical ethics inspire us to propose this new theory， outlining its main points.

Myopia is a highly prevalent refractive error worldwide, with scleral remodeling accompanying excessive axial elongation being one of its core pathological features. As the crucial outer layer responsible for maintaining eyeball morphology and biomechanical stability, the sclera plays a decisive role in the pathogenesis and progression of myopia through abnormal alterations in its cellular components, extracellular matrix(ECM)metabolism, and regulatory networks. This review systematically summarizes recent research advances in scleral remodeling. It focuses on elucidating, from cellular and molecular perspectives, the mechanisms by which dysfunction of scleral fibroblasts, dysregulation of ECM metabolism(e.g., decreased collagen content, disrupted MMP-2/TIMP-2 balance), and complex regulatory networks involving multiple signaling pathways such as TGF-β, Wnt/β-catenin, and MAPK drive scleral thinning and reduced mechanical strength. Concurrently, the review provides a comprehensive analysis of the potential roles and existing controversies regarding factors like inflammatory responses and novel regulatory axes(e.g., FOXM1/METTL3/APOA1)in scleral remodeling. Furthermore, it discusses the current research status and application prospects of sclera-targeted intervention strategies(e.g., modulating specific pathways, supplementing exogenous factors), aiming to provide a theoretical basis and directional reference for a deeper understanding of myopia pathogenesis and the development of new prevention and treatment approaches.

Objective To explore the effect of core muscle stability training combined with biofeedback electrical stimulation on pelvic floor muscle function in postpartum women underwent episiotomy.Methods Clinical data of 98 parturients who underwent selective episiotomy during natural childbirth were retrospectively analyzed.According to different intervention methods,the included parturients were divided into the control group and the combination group,with 49 cases in each group.The control group was treated only with biofeedback electrical stimulation therapy,while the combination group was treated with core muscle stability training combined with biofeedback electrical stimulation therapy.The general information and pelvic floor muscle strength,pelvic floor electromyography values,pelvic floor dysfunction questionnaire(PFDI-20)scores and female sexual function score scale(FSFI)scores were compared between the two groups of parturients before and after intervention.Results There were no significant differences in age,gestational age,body mass index and pelvic floor muscle strength grading between the two groups(P＞0.05).Compared with before intervention,pelvic floor muscle strength,pelvic floor electromyography values and FSFI scores increased in both groups after intervention,while PFDI-20 scores decreased(all P＜0.05).After intervention,compared with the control group,the combination group showed more significant improvement in pelvic floor muscle strength,with an increase in class Ⅰ and class Ⅱ fiber electromyography values,a decrease in PFDI-20 score,and an increase in FSFI scores(all P＜0.05).The incidence of pelvic floor dysfunction in the two groups was statistically significant(22.45%vs.6.12%,P＜0.05).Conclusion Core muscle stability training combined with biofeedback electrical stimulation can effectively promote the recovery of pelvic floor muscle function and improve sexual function in postpartum women underwent episiotomy.

In recent years,the application of immunotherapy has improved the prognosis of relapsed/refractory(R/R)B cell-acute lympho-blastic leukemia(B-ALL).Blinatumomab,Inotuzumab ozogamicin(InO),and chimeric antigen receptor(CAR)T-cell therapies are the three major immunotherapeutic agents approved for the treatment of R/R B-ALL.This new strategy incorporates immunotherapy into the first line of treatment to reduce the adverse effects of chemotherapy,prolong survival,and expand treatment options for elderly patients.This art-icle discusses new approaches for incorporating immunotherapeutic agents into firstline B-ALL treatment regimens,exploring the potential value of chemotherapy-free regimens in specific patient subgroups,to provide guidance for clinical practice.

Objective:To analyze the risk factors of anxiety and depression in prostate cancer patients after castration, and establish a risk prediction model.Methods:A retrospective analysis was conducted on the data of 60 prostate cancer patients treated in Xi′an People′s Hospital from January 2019 to January 2022. The patients were divided into a training group ( n=42) and a validation group ( n=18) at a ratio of 7∶3. The patients received surgical castration and medical castration. One month after castration, the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to evaluate the anxiety symptoms and depression levels of the patients, respectively. Univariate and multivariate logistic regression analyses were used to identify the risk factors for negative emotions in prostate cancer patients after castration, and a risk prediction model was established. Results:In the training group, 19 patients had a SAS score ≥50, and 21 patients had an SDS score ≥50. Based on these scores, the training group was divided into a negative emotion group ( n=19) and an emotional stability group ( n=23). Multivariate logistic regression analysis showed that marital status, castration scheme, and postoperative Visual Analogue Scale (VAS) score were independent influencing factors for negative emotions in prostate cancer patients after castration ( OR=3.589, 3.364, 5.912, all P<0.05). In both the training group and the validation group, the risk scores of patients with negative emotions were significantly higher than those with emotional stability. In the training group, the area under the curve (AUC) of the risk prediction model for predicting negative emotions was 0.747, with a specificity of 71.02% and a sensitivity of 66.11%; in the validation group, the AUC, specificity, and sensitivity were 0.761, 66.59%, and 76.21%, respectively. The Hosmer-Lemeshow test showed that χ 2 was 4.285 6, P value was 0.830, and the c-index was 0.773(0.692-0.854). The calibration curve showed that the predicted curve was basically consistent with the actual curve, indicating that the prediction model had good discriminative ability and accuracy. Decision curve analysis showed that the model had high clinical significance. Conclusions:Marital status, castration scheme, and postoperative VAS score are important factors affecting anxiety and depression in prostate cancer patients after castration, and the regression model can successfully predict the risk of negative emotions.

At present,the laboratory medicine industry in China has developed rapidly,with various new technologies and methods emerge one after another. However,the current training process of laboratory medicine technology professionals still follows a training model that emphasizes theyory over practice,and the quality of training personnel is far from the requirments of the current development of the laboratory medicine industry in China. In order to effectively alleviate the current situation of the shortage of practical high-quality laboratory medicine talents,it is urgent to reform the teaching of laboratory medicine. The author of this paper puts forward the "Four-in-one" personnel training mode which is suitable for the development of laboratory medicine in China. It is proposed to explore a new teaching mode on the basis of the existing one,giving full play to the students' initiative and innovation,and providing new ideas for training high-quality laboratory medicine professionals.

Objective:To analyze the epidemic characteristics of human brucellosis in Inner Mongolia Autonomous Region, and to provide a basis for formulating targeted intervention strategies and implementation measures.Methods:The data of brucellosis cases with onset date from 2014 to 2023 and current address in Inner Mongolia Autonomous Region were collected from the Chinese Disease Control and Prevention Information System. Descriptive epidemiological method was used to analyze the three-dimensional distribution of human brucellosis in Inner Mongolia Autonomous Region.Results:From 2014 to 2023, a total of 131 201 brucellosis cases were reported in Inner Mongolia Autonomous Region, with no death and an average annual incidence rate of 52.90/100 000. The lowest incidence was in 2016 (6 567 cases, 26.15/100 000), and the highest was in 2021 (21 910 cases, 91.14/100 000). All 12 cities (leagues) in the region had reported cases of brucellosis, with Tongliao City (27 012 cases), Chifeng City (15 286 cases), Hinggan League (14 859 cases), Hulunbuir (12 235 cases) and Ulanqab (11 972 cases) ranking among the top 5 cities (leagues) in terms of reported cases. Among the cases, 90 455 (68.94%) were males, with a incidence rate of 70.93/100 000, and 40 746 (31.06%) were females, with a incidence rate of 33.70/100 000. The age of onset is mainly 50 and less than 60 years old (37 610 cases, 28.67%). The occupational distribution was mainly farmers (102 091 cases, 77.81%), followed by herdsmen (13 209 cases, 10.07%).Conclusions:The incidence of human brucellosis in Inner Mongolia Autonomous Region is at a relatively high level, particularly showing an upward trend from 2016 to 2021. Cities such as Tongliao City, Chifeng City and Hinggan League have a relatively high incidence of brucellosis. Therefore, it is necessary to strengthen the monitoring of brucellosis in these areas, implement prevention and control measures, and closely monitor the changes in the trend of human brucellosis outbreaks. Farmers and herdsmen are the primary high-risk groups, and it is recommended to enhance health education and behavioral interventions for these key populations.

Objective: To observe the clinical efficacy and safety of Yiqi Tongluo Decoction in the intervention of early traditional Chinese medicine (TCM) syndromes after ischemic cerebrovascular disease (ICVD) intervention. Methods: From October 2020 to July 2023, a randomized, double-blind, placebo-controlled study was conducted to include 60 patients with qi deficiency, blood stasis, and phlegm obstruction syndrome after ICVD interventional therapy. They were assigned to the Yiqi Tongluo Decoction treatment group (30 cases) and the TCM placebo routine treatment control group (30 cases) according to the randomized block design. Both groups received routine standardized treatment of Western medicine, including dual antiplatelet, lipid regulation, and control of risk factors for cerebrovascular disease. The treatment group was treated with Yiqi Tongluo Decoction based on the control group. The course of treatment was 60 days and follow-up was carried out 2 and 6 months after the operation. The improvement of qi deficiency syndrome, blood stasis syndrome, phlegm syndrome score and TCM syndrome score, modified Rankin score (mRS), Barthel index (BI) score, Fatty acid-binding protein 4 (FABP4) level, incidence of transient ischemic attack (TIA) and ischemic stroke (IS) and incidence of adverse reactions, Head and neck CT angiography (CTA) or digital subtraction angiography (DSA) examination were collected. The clinical efficacy of the patients 2 months after the operation was taken as the main outcome index to preliminarily evaluate the early and long-term efficacy of Yiqi Tongluo Decoction after the ICVD intervention. The early and long-term clinical efficacy and safety of Western medicine standardized treatment combined with TCM Yiqi Tongluo Decoction on patients with qi deficiency, blood stasis and phlegm obstruction syndrome after ICVD intervention were evaluated. The safety of Yiqi Tongluo Decoction in the treatment of patients after ICVD intervention with white blood cell (WBC), C-reactive protein (CRP), fibrinogen (FIB), plasminogen time (PT), recurrence of cerebral ischaemia and restenosis in patients at 2 and 6 months after treatment were evaluated. Results: Compared to the control group, the TCM syndrome scores for qi deficiency, blood stasis and phlegm syndrome in the treatment group reduced significantly, the clinical efficacy improved significantly, the mRS score and FABP4 were reduced, and the BI score was increased. Adverse events such as cerebral ischaemia were fewer in the treatment group than in the control group, but the difference was not statistically significant; levels of CRP, WBC and PT were reduced, and levels of FIB were reduced at 6 months post-treatment, all P<0.01, and images were intuitively compared. The treatment group was superior to the control group. Conclusion Yiqi Tongluo Decoction combined with Western medicine standard treatment can improve the early clinical efficacy of ICVD patients with qi deficiency, blood stasis and phlegm obstruction syndrome after interventional surgery, improve neurological impairment and daily living ability, reduce the state of qi deficiency syndrome, blood stasis syndrome and phlegm syndrome after interventional surgery, and improve the clinical efficacy of TCM. At the same time, it can reduce the level of FABP4, the target of atherosclerosis and restenosis after interventional surgery, reduce the level of inflammation after interventional surgery in patients with ICVD, regulate coagulation function, and reduce the incidence of long-term recurrence of cerebral ischemia after interventional surgery, with good safety.

Myopia is an increasingly prevalent public health concern globally, with a complex pathogenesis involving the interplay of multiple signaling pathways and genes. The Wnt signaling pathway plays a crucial role in biological processes such as cell proliferation, differentiation, apoptosis, and tissue remodeling, and its role in myopia development has garnered significant attention in recent years. Studies have demonstrated that the Wnt signaling pathway influences the occurrence and progression of myopia by regulating the proliferation, differentiation, and apoptosis of retinal cells(including RPE cells and ipRGCs), as well as the proliferation of scleral fibroblasts and the expression of extracellular matrix components(such as type I collagen), thereby affecting scleral remodeling and axial length elongation. This paper summarizes the roles of the Wnt signaling pathway in myopia development within different ocular tissues(retina and sclera)and explores potential myopia prevention and treatment strategies based on this pathway, providing insights for further research and clinical management of myopia.

In recent years, the role of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in the prevention and treatment of ischemic stroke has received widespread attention. Researches have shown that n-3 PUFAs can reduce the risk of stroke and improve stroke outcome through various mechanisms, including anti-inflammatory, antioxidant, improvement of endothelial function, promotion of angiogenesis, and anti-apoptotic effects, demonstrating potential in the prevention and treatment of ischemic stroke. This article reviews the mechanism of action and clinical research of n-3 PUFAs in ischemic stroke.