1.Single-center analysis of unplanned reoperation case after liver transplantation
Zhi CHEN ; Qingqing DAI ; Fan HUANG ; Guobin WANG ; Xiaojun YU ; Ruolin WU ; Liujin HOU ; Zhenghui YE ; Xinghua ZHANG ; Wei WANG ; Xiaoping GENG ; Hongchuan ZHAO
Organ Transplantation 2026;17(3):452-459
Objective To analyze the main causes and risk factors of unplanned reoperation after liver transplantation. Methods The clinical data of 242 liver transplant recipients in the First Affiliated Hospital of Anhui Medical University from January 2015 to December 2024 were retrospectively analyzed. According to whether unplanned reoperation was performed during the same hospitalization after surgery, the recipients were divided into the reoperation group (n=36) and the non-reoperation group (n=206). The preoperative, intraoperative and postoperative data of the two groups, as well as donor and graft-related data, were compared to analyze the risk factors of unplanned reoperation after liver transplantation and the survival status of the two groups. Results Among the 242 liver transplant recipients, 36 underwent unplanned reoperations, with a total of 54 procedures including various laparotomies, endoscopic and interventional surgeries, among which there were 20 laparotomies, 18 endoscopic surgeries and 16 interventional surgeries. The most common cause of unplanned reoperation was biliary complications (20 times), followed by vascular complications (17 times). Compared with the non-reoperation group, the reoperation group had longer graft cold ischemia time, higher postoperative fatality rate of recipients, longer length of stay in the intensive care unit and postoperative hospital stay, and higher total hospitalization costs (all P<0.05). The incidence of unplanned reoperation was higher in recipients who underwent split liver transplantation (P<0.05). Multivariate analysis showed that intraoperative blood loss ≥1 000 mL, positive culture of graft perfusate and split liver transplantation were independent risk factors for unplanned reoperation (all P<0.05). The postoperative 7-day, 1-month, 3-month and 6-month survival rates of recipients in the reoperation group and the non-reoperation group were 100% vs. 98.1%, 88.9% vs. 94.2%, 69.4% vs. 90.8% and 66.7% vs. 90.8%, respectively, and the postoperative survival rate of recipients in the reoperation group was lower than that in the non-reoperation group (P<0.05). Conclusions The main causes of unplanned reoperation after liver transplantation are biliary complications, vascular complications, abdominal incision infection and intra-abdominal hemorrhage. Intraoperative massive blood loss, positive culture of graft perfusate and split liver transplantation are the risk factors associated with unplanned reoperation after liver transplantation.
2.Current Status of Early Surgical Site Infection Following Prosthetic Implantation in Aesthetic and Reconstructive Surgery and Evaluation of Quality Control Improvement Outcomes
Mingzi ZHANG ; Loubin SI ; Jiaojie ZHENG ; Shujuan SHAN ; Qianyu LI ; Jingya WANG ; Xiaojun WANG ; Xiao LONG ; Xiao XU
Medical Journal of Peking Union Medical College Hospital 2026;17(4):1174-1180
To assess the current status of early surgical site infections following prosthetic implantation in plastic surgery across four provincial-level administrative regions in China, and to explore the effectiveness of standardized training for infection prevention and control. From January to May 2025, an online questionnaire survey was conducted to perform a baseline investigation in medical institutions performing plastic and aesthetic prosthetic implant surgeries in Chongqing, Shaanxi, Jiangxi, and Guizhou provinces. Data were collected on the volume of various types of prosthetic implant surgeries and the corresponding incidence of early surgical site infections. Improvement strategies for the prevention and control of early surgical site infections in prosthetic implant surgeries were jointly developed by the National Medical Quality Control Center for Plastic and Aesthetic Surgery and the National Medical Quality Control Center for Hospital Infection Management, followed by promotion and training. Subsequently, post-implementation data from June to October 2025 were collected from the above regions, and comparisons were made between pre- and post-implementation periods across different regions and surgical categories. A total of 209 medical institutions were included in the baseline period, with a questionnaire response rate of 99.52% and a total of 7475 prosthetic implantation surgeries. In the post-implementation period, 624 medical institutions were included, with a response rate of 96.00% and a total of 4813 surgeries. The combined proportion of breast prosthesis implantation and nasal/nasal base prosthesis implantation surgeries consistently exceeded 80% across all regions and periods. Regarding the distribution of infection cases, among different types of prosthetic implant surgeries, nasal/nasal base prostheses accounted for the highest proportion, with 57.50%(23/40) at baseline and 62.86% 22/35) post-implementation. The proportion of breast prosthesis infections decreased from 40.00%(16/40) at baseline to 17.14%(6/35) post-implementation. Across different regions, infection cases in Jiangxi (post-implementation)(100%), Guizhou[both baseline(100%) and post-implementation(100%)] were all concentrated in nasal/nasal base prostheses. Shaanxi reported four cases of chin prosthesis infections (22.22%) during the post-implementation period, and Chongqing reported three cases of metal-related infections(27.27%) during the post-implementation period. In terms of infection rates, Chongqing(0.55% Breast prostheses and nasal/nasal base prostheses currently represent the main types of implants used in prosthetic implantation surgeries. The improvement strategies implemented in this study were associated with decreased early surgical site infection rates in multiple regions, suggesting that these strategies provide clinical insights for the prevention and control of early infections following prosthetic implantation surgeries in China.
3.A Comparative Study of Artificial Intelligence-based Classification Versus Manual Classification of Medical Adverse Events: Taking the DeepSeek Large Language Model As an Example
Rui WANG ; Xutong TAN ; Congpu ZHAO ; Shuchang WANG ; Zheng CHEN ; Xiaojun MA ; Zhiling CAI
Medical Journal of Peking Union Medical College Hospital 2026;17(3):828-833
To analyze the application value of artificial intelligence (AI)-based classification in the categorization of medical adverse events. Medical adverse events reported to the Adverse Event Reporting System of Peking Union Medical College Hospital from September 1, 2023, to August 31, 2024, were retrospectively collected as the study subjects. After de-identification of adverse events meeting the inclusion criteria, conventional manual classification and AI-based classification using a large language model (DeepSeek-R1 Full-Context Internet Edition) were performed. The time required for classification using both methods was recorded, and the consistency and discrepancies between the two methods were compared. Using manual classification as the gold standard, the accuracy of AI-based classification was comprehensively evaluated. A total of 273 medical adverse events were analyzed. Manual classification took 38 838 seconds in total, with an average of 14.22 seconds per event. AI-based classification took 600 seconds in total, with an average of 2.19 seconds per event. The two methods showed consistent classification in 202 events and inconsistent classification in 71 events, yielding an overall agreement rate of 73.99% and a Kappa coefficient of 0.646 (95% CI: 0.575-0.717), with a standard error of 0.0362. Using manual classification as the gold standard, AI-based classification achieved accuracy ranging from 80% to 100%, precision from 30% to 100%, recall from 40% to 100%, F1 scores from 0.46 to 0.79, and specificity from 46% to 98%. Notably, AI-based classification demonstrated balanced and overall excellent performance in the categorization of device-related and drug-related adverse events. The DeepSeek large language model can assist in improving the efficiency of medical adverse event classification, showing promising application potential, particularly in the categorization of device-related and drug-related adverse events.
4.Diagnosis of bovine piroplasmosis: a review
Lin SHEN ; Yingying SUN ; Wei WANG ; Cheng DU ; Xiaojun WANG
Chinese Journal of Schistosomiasis Control 2026;38(3):314-322
Bovine piroplasmosis, caused by infections with genus of Babesia and Theileria, is a tick-borne hemoparasitic disease. Recovered cattle often become asymptomatic persistent carriers, which represent potential sources of infection, and the pathogens of some forms of bovine piroplasmosis have zoonotic potential, which greatly threatens the public health security. Currently, the etiological diagnostic approaches of bovine piroplasmosis mainly include microscopy of blood smears, PCR assay, fluorescent quantitative real-time PCR assay, and loop-mediated isothermal amplification, and serological assay mainly includes indirect fluorescent antibody assay, enzyme-linked immunosorbent assay and immunochromatographic assay. This article systematically reviews the advances in the application of etiological approaches and serological assay for diagnosis of bovine piroplasmosis, and proposes future directions in the development of bovine piroplasmosis diagnosis, so as to provide insights into effective surveillance and precision control of bovine piroplasmosis in China.
5.Research progress on outdoor wet bulb globe temperature prediction models and their application to early warning for occupational heat stress
Xiaojun ZHANG ; Luyang WANG ; Xin SUI ; Xiaoshun WANG ; Tian LAN ; Yun ZHENG ; Dongsheng NIU ; Xiaowen DING
Journal of Environmental and Occupational Medicine 2026;43(8):1032-1038
In the context of global warming, protecting outdoor workers from occupational heat exposure has become an important public health concern. This review summarized the principle, applicability, and limitation of three categories of wet bulb globe temperature (WBGT) prediction models: empirical regression models, heat-balance models, and machine-learning models. Drawing on international experience from the United States, Europe, and Japan, this review further examined the technical challenges of applying WBGT-based prediction models to large-scale occupational heat stress early warning systems. In response to gaps in occupational heat stress management in China, WBGT should be considered a core assessment indicator to support a transition from passive response to proactive intervention. A localized implementation pathway is proposed, incorporating mechanism-based model calibration, regional parameter adaptation, and multi-source data fusion. Strengthening collaboration between public health and meteorological departments and developing platform-based flexible intervention strategies for workers in new forms of employment may improve the targeting of occupational heat stress early warning and health protection. Future research should focus on physics-constrained machine learning, refined microenvironmental prediction, and individualized risk assessment to support the development of a digitally enabled occupational heat-health protection framework.
6.Epidemiological characteristics and ARIMA model-based prediction of pulmonary tuberculosis and diabetes mellitus comorbidity in Wuhan in 2020–2024
Tiantian WANG ; Zefang ZHANG ; Haozhe ZHANG ; Xiaojun WANG ; Yuehua LI ; Yan ZHOU ; Jun WU ; Gang WU
Journal of Public Health and Preventive Medicine 2026;37(5):36-40
Objective To investigate the registration rate and trend of pulmonary tuberculosis complicated with diabetes mellitus (PTB-DM) in Wuhan from 2020 to 2024, and to provide scientific evidence for formulating PTB-DM prevention and control policies. Methods PTB-DM case data in Wuhan (2020-2024) were collected through the Infectious Disease Registration and Management Information System. Joinpoint regression model was employed to analyze the trend of registration rates of PTB-DM among the general population and across different regions, genders, and age groups. ARIMA model was used to predict the short-term prevalence of PTB-DM. Results Among 26275 pulmonary tuberculosis cases registered in Wuhan (2020-2024), 2669 cases (10.16%) were PTB-DM. The average annual registration rate of PTB-DM was 3.96/100,000, increasing from 2.74/100,000 in 2020 to 5.40/100,000 in 2024 (APC=19.07%, 95% CI:12.99%-26.92%, P<0.001). The PTB-DM registration rates showed an upward trend across different regions, genders, and age groups in Wuhan, with higher registration rates observed in near urban area, males, and individuals aged 60~64 and 65 years and above (χ2=99.566, P<0.001; χ2=781.891, P<0.001; χ2=2211.930, P<0.001). ARIMA model predicted that the prevalence of PTB-DM in Wuhan would remain stable and fluctuating in the short time. Conclusion PTB-DM registration rate in Wuhan increases from 2020 to 2024. Near urban area, males, and elderly populations are high risk groups. Future efforts should focus on strengthening the prevention and control of PTB-DM among these populations.
7.Qualitative research on issues related to the welfare protection of animals after medical experiments
Jiayi PAN ; Xuesong WU ; Yu WANG ; Xiaojun CAI
Chinese Medical Ethics 2026;39(8):1005-1012
In-depth interviews were conducted with medical doctoral students engaged in animal experiments, animal laboratory management personnel, and ethics committee members, exploring the current status, challenges, and countermeasures regarding animal welfare protection after medical experiments based on NVivo 12 software. The study found that some laboratory animals still meet the conditions for continued breeding after the experiments, but face multiple challenges such as physiological health, psychological stress, adoption and placement, as well as ethical and legal issues. On this basis, this paper proposed countermeasures such as establishing adoption mechanisms, enhancing public awareness, and improving the ethical review system. This aimed to achieve a balance between the development of medical science and animal welfare, thereby ensuring that laboratory animals receive due respect and care after contributing to the cause of human health.
8.Full-Lifecycle Management Practice of Laboratory-Developed Tests in a Grade A Tertiary Hospital: A Case Study of Peking Union Medical College Hospital
Hui WANG ; Yueming TANG ; Junxiong ZHOU ; Xiaojun MA ; Qian CHEN ; Wenting ZHENG ; Xinqi CHENG
Medical Journal of Peking Union Medical College Hospital 2026;17(5):1319-1325
This paper provides a systematic review of the policies, regulations, and management requirements in the development and use of
9.Cost and Medical Efficiency Analysis of Indocyanine Green Fluorescence-Guided Thoracoscopic Resection of Lung Lesions under the DRG Payment System
Qian CHEN ; Chao GUO ; Shuchang WANG ; Wenhao DENG ; Tianan YANG ; Jiong ZHOU ; Xiaojun MA
Medical Journal of Peking Union Medical College Hospital 2026;17(5):1380-1389
To investigate the clinical application value of indocyanine green(ICG) fluorescence-guided thoracoscopic lung lesion resection under the diagnosis related group(DRG) payment system, and to provide reference for the management of new medical technologies in healthcare institutions. Discharged patients who underwent thoracoscopic segmentectomy and/or wedge resection at Peking Union Medical College Hospital from January 1, 2016 to May 31, 2024 were enrolled. Patients who received ICG fluorescence guidance were assigned to new technology group, while those who did not receive ICG fluorescence guidance were assigned to control group. Operative time, length of stay, cost consumption index, time consumption index, duration of ventilator use, total hospitalization cost, and 10 representative cost items were compared between the two groups. Propensity score matching(PSM) was further used to analyze the changes in these indicators after controlling for confounding factors including age, sex, DRG code, and surgical type. A total of 7999 patients who met the inclusion and exclusion criteria were enrolled, including 1392 patients(17.4%) in the new technology group and 6607 patients(82.6%) in the control group. Compared with the control group, the new technology group showed significantly shorter operative time and length of stay, and significant reductions in time consumption index, consultation and diagnostic fees, nursing fees, therapeutic medical material fees, bed fees, oxygen therapy fees, antibiotic fees, and albumin product fees, while the cost consumption index, total hospitalization cost, surgical fees, and surgical medical material fees were significantly increased(all ICG fluorescence-guided thoracoscopic lung lesion resection can significantly improve medical efficiency, optimize cost structure, and reduce perioperative supportive resource consumption. However, its clinical benefits vary significantly among patients with different surgical types or different DRG groups, so clinicians are advised to strengthen preoperative precise evaluation.
10.Dilemmas and optimization strategies of scientific research integrity governance in China from the perspective of policy evolution (2004-2025)
Jiena CHEN ; Rongqing SHAO ; Xuesong WU ; Yu WANG ; Xiaojun CAI
Chinese Medical Ethics 2026;39(10):1314-1321
ObjectiveTo systematically analyze the evolution characteristics and practical dilemmas of China’s scientific research integrity policies from 2004 to 2025, and to provide a reference for improving the governance system of science and technology ethics. MethodsBased on 53 policy documents retrieved from authoritative sources, such as the State Council policy document database, this study employed a three-stage coding process with NVivo 14, combined with word frequency analysis and policy metrology. ResultsThe policy evolution progressed through three phases regarding “partial exploration, system construction, and technological governance.” It demonstrated three characteristics, including systematic top-level design, rigid disciplinary mechanisms, and technologized supervision means. Nevertheless, the current governance system was still confronted with dilemmas such as biased institutional incentives, insufficient deterrence of disciplinary measures, and lagging technological supervision means. ConclusionThe study attempts to build a closed-loop governance paradigm of “institution-technology-culture,” deepen institutional reform to rectify incentive biases, adopt technology empowerment to promote full-process evidence preservation, and reshape academic culture to foster conscious integrity. This can systematically solve the problems of scientific research integrity anomie, thereby providing strong support for the high-quality development of scientific and technological innovation and the improvement of human well-being.


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