One of the important goals of assisted reproductive technology management is the safety of offspring. When the needs of patients conflict with the management of assisted reproductive technology, reproductive ethical problems arise. The storage and use of frozen embryos is a part of the management of assisted reproductive technology. When the patient has a conflict in the storage and use of frozen embryos, a small number of court decisions are consistent with the national management measures, but the vast majority of court decisions give the patient the right to ownership of frozen embryos, ruling that the patient has the right to custody and disposal, and the hospital will be difficult to implement embryo cryopreservation and management by national laws and regulations. In this paper, we review the ethical considerations in embryos, in order to provide beneficial references for embryo management in assisted reproductive technology.

To explore the role of the "Clinical Practice Guidelines" column and others in the Medical Joumnal of Peking Union Medical College Hospital (Med J PUMCH) in promoting diseiplinary development.

One of the important goals of assisted reproductive technology management is the safety of offspring. When the needs of patients conflict with the management of assisted reproductive technology, reproductive ethical problems arise. The storage and use of frozen embryos is a part of the management of assisted reproductive technology. When the patient has a conflict in the storage and use of frozen embryos, a small number of court decisions are consistent with the national management measures, but the vast majority of court decisions give the patient the right to ownership of frozen embryos, ruling that the patient has the right to custody and disposal, and the hospital will be difficult to implement embryo cryopreservation and management by national laws and regulations. In this paper, we review the ethical considerations in embryos, in order to provide beneficial references for embryo management in assisted reproductive technology.

Objective To describe and evaluate the clinical studies of postoperative pain sensitization caused by sleep deprivation through the evidence map system,understand the distribution of evidence in this field,and provide reference for subsequent evidence research.Methods A computer-based search of PubMed,EMBASE,Cochrane library,Web of Science,CNKI,Wanfang Data,VIP and Chinese Biomedical Literature Database from inception to August 2023 was conducted to obtain intervent ion studies,observational studies and systematic reviews/Meta-analysis of postoperative pain sensitization caused by sleep deprivation.The research characteristics and methodological quality were analyzed and evaluated.The Cochrane Handbook for Systematic Reviews,the Newcastle-Ottawa Scale(NOS)and the AMSTAR-2 scale were used to evaluate the quality of the included studies,and the evidence was comprehensively analyzed and displayed by means of bubble chart,table and text.Results A total of 35 observational studies(31 cohort studies and 4 case-control studies),15 randomized controlled trials and 4 systematic reviews/Meta-analyses were included.The number of publications increased rapidly after 2018 and peaked in 2022,and clinical studies in this field mainly fo-cused on cohort studies,with fewer randomized controlled trials and systematic reviews/Meta-analysis studies.The results of the evidence map showed that in terms of quality,22 studies were'high quality',24 studies were'medium quality',and 8 studies were'low quality'.Thirty studies showed that sleep deprivation could induce postoperative pain sensitization.Only 2 studies suggested that sleep disorders were not significantly asso-ciated with postoperative pain sensitization,and ten studies were uncertain whether sleep deprivation could in-duce postoperative pain sensitization.Conclusions Overall evidence shows that sleep deprivation can induce postoperative pain sensitization,but the evaluation dimensions are limited and the methodological quality of the included literature needs to be improved.More high-quality,large-sample and standardized clinical studies should be carried out in the future to provide better scientific basis for clinical work.

Objective:To review the literature on improving patients′medical experience, analyze the current research status in this field, and provide references for enhancing patients′medical experience.Methods:A search was conducted for studies related to improving patients′medical experience published from January 2015 to November 2024 in eight databases, including CNKI and Web of Science. Using software CiteSpace 6.4.R1 and VOSviewer 1.6.19 to analyze publication trends, keyword clustering, existing problems in the process of improving patients′medical experience, and the measures taken.Results:6 507 articles were included, of which 4 452 were in English (68.4%) and 2 055 were in Chinese (31.6%). The annual number of publications showed a nearly linear growth trend ( R2 = 0.983 9). The clustering analysis results indicated that domestic and international research mainly focused on patient-centered diagnostic and treatment systems, behaviors, services, and environments. Existing studies revealed that there were still problems such as long waiting times for appointments and consultations (292 articles), uneven distribution of medical resources (198 articles), and poor doctor-patient communication (155 articles). To improve patients′medical experience, the following intervention measures were proposed: accelerating the medical reform process and strengthening government responsibilities (169 articles); enhancing service concepts and innovating service models (363 articles); optimizing the consultation process and simplifying medical procedures (221 articles); improving the consultation environment and optimizing the facilities in the consultation area (181 articles); and integrating technological advantages to cover the entire medical process (346 articles). Conclusions:Research on improving patients' medical experience was increasingly attracting the attention of more and more scholars. Issues such as low service efficiency, unbalanced resource allocation, and poor doctor-patient communication need to be given special attention. In the future, it is recommended to enhance the experience of patients′ medical experience by strengthening policy and institutional guarantees, accelerating the construction of information technology, improving doctor-patient communication skills and humanistic care, and enhancing the capacity of primary medical services.

Objective:To review the literature on improving patients′medical experience, analyze the current research status in this field, and provide references for enhancing patients′medical experience.Methods:A search was conducted for studies related to improving patients′medical experience published from January 2015 to November 2024 in eight databases, including CNKI and Web of Science. Using software CiteSpace 6.4.R1 and VOSviewer 1.6.19 to analyze publication trends, keyword clustering, existing problems in the process of improving patients′medical experience, and the measures taken.Results:6 507 articles were included, of which 4 452 were in English (68.4%) and 2 055 were in Chinese (31.6%). The annual number of publications showed a nearly linear growth trend ( R2 = 0.983 9). The clustering analysis results indicated that domestic and international research mainly focused on patient-centered diagnostic and treatment systems, behaviors, services, and environments. Existing studies revealed that there were still problems such as long waiting times for appointments and consultations (292 articles), uneven distribution of medical resources (198 articles), and poor doctor-patient communication (155 articles). To improve patients′medical experience, the following intervention measures were proposed: accelerating the medical reform process and strengthening government responsibilities (169 articles); enhancing service concepts and innovating service models (363 articles); optimizing the consultation process and simplifying medical procedures (221 articles); improving the consultation environment and optimizing the facilities in the consultation area (181 articles); and integrating technological advantages to cover the entire medical process (346 articles). Conclusions:Research on improving patients' medical experience was increasingly attracting the attention of more and more scholars. Issues such as low service efficiency, unbalanced resource allocation, and poor doctor-patient communication need to be given special attention. In the future, it is recommended to enhance the experience of patients′ medical experience by strengthening policy and institutional guarantees, accelerating the construction of information technology, improving doctor-patient communication skills and humanistic care, and enhancing the capacity of primary medical services.

Gut microbiota plays an important role in maintaining metabolic homeostasis as well as the occurrence and development of metabolic diseases in the host. Physiological and pathological processes such as body metabolism and immune regulation are impacted by the interaction of metabolites of gut microbiota with the host. Early spontaneous abortion is one of the most common pregnancy complications, accounting for 10%-15% of all clinical pregnancies. According to the previous studies, gut microbiota had an important effect in the pathophysiological process of pregnancy complications and was expected to be a new candidate for clinical prevention and treatment of early spontaneous abortion. While the correlation between early spontaneous abortion and gut microbiota has gained attention, further investigation is needed to understand the mechanism by which the gut microbiota affects early abortion. In this review, we discussed the influence of gut microbiota on early spontaneous abortion. We found that gut microbiota may participate in the development of early spontaneous abortion by regulating human endocrine, immune functions and uterine environment, hoping to provide new ideas for clinical diagnosis and treatments.

Objective To study microbial characteristics of pulmonary in children with community-acquired pneumonia(CAP)of different severity,in order to provide a basis for accurate diagnosis and antibiotic treatment of pneumonia children,and provide new strategies and perspectives for the diagnosis and treatment of pulmonary microbiota in pneumonia children.Methods Bronchoalveolar lavage fluid(BALF)from 64 children with CAP of different severity hospitalized in Department of Pediatrics,Jingmen People's Hospital were collected from January to December 2023,the children were divided into severe pneumonia group(n=34)and common pneumonia group(n=30).Microbiome information of the lungs of children with CAP of different severity were obtained through metagenomic sequencing of BALF,microbial structure diversity analysis,species classification analysis,and differential analysis on the microbial bioinformatics data of two groups of samples obtained were performed.Results Alpha diversity analysis showed that there were statistically significant differences(P<0.05)in the Chao1 index,ACE index,Shannon index,and Simpson index between two groups.The principal coordinate analysis(PCoA)of Beta diversity showed a statistically significant difference in the composition of microbial communities between two groups(F=4.221,P=0.005).Through species classification analysis,it was found that at the genus level,mycoplasma was the main genus in the BALF samples of severe pneumonia group,followed by Streptococcus and Haemophilus,Streptococcus was the main genus in the BALF samples of common pneumonia group,followed by Mycoplasma and Haemophilus.Children of two groups showed statistically significant differences in microbial abundance among the top 20 species at the genus level(P<0.05),including Mycoplasma,Streptococcus,Rhodococcus,Neisseria,Prevotella,Corynebacterium,and Pseudomonas.Species diversity analysis showed that at the genus level,there were 47 species with differences(P<0.05).Conclusion There are differences in the abundance,diversity,structure,and composition of pulmonary microbiota in children with CAP of different severity.The dominant microbiota varies among children with CAP of different severity.This study enriches the pulmonary microbiome data of children with CAP.

Gut microbiota plays an important role in maintaining metabolic homeostasis as well as the occurrence and development of metabolic diseases in the host. Physiological and pathological processes such as body metabolism and immune regulation are impacted by the interaction of metabolites of gut microbiota with the host. Early spontaneous abortion is one of the most common pregnancy complications, accounting for 10%-15% of all clinical pregnancies. According to the previous studies, gut microbiota had an important effect in the pathophysiological process of pregnancy complications and was expected to be a new candidate for clinical prevention and treatment of early spontaneous abortion. While the correlation between early spontaneous abortion and gut microbiota has gained attention, further investigation is needed to understand the mechanism by which the gut microbiota affects early abortion. In this review, we discussed the influence of gut microbiota on early spontaneous abortion. We found that gut microbiota may participate in the development of early spontaneous abortion by regulating human endocrine, immune functions and uterine environment, hoping to provide new ideas for clinical diagnosis and treatments.

Objective To investigate the microbiota composition and diversity between autogenous and anautogenous Culex pipiens pallens, so as to provide insights into unraveling the pathogenesis of autogeny in Cx. pipiens pallens. Methods Autogenous and anautogenous adult Cx. pipiens pallens samples were collected at 25 ℃, and the hypervariable regions of the microbial 16S ribosomal RNA (16S rRNA) gene was sequenced on the Illumina NovaSeq 6000 sequencing platform. The microbiota abundance and diversity were evaluated using the alpha diversity index, and the difference in the microbiota structure was examined using the beta diversity index. The microbiota with significant differences in the abundance between autogenous and anautogenous adult Cx. pipiens pallens samples was identified using the linear discriminant analysis effect size (LEfSe). Results The microbiota in autogenous and anautogenous Cx. pipiens pallens samples belonged to 18 phyla, 28 classes, 70 orders, 113 families, and 170 genera, and the dominant phyla included Proteobacteria, Bacteroidetes, and so on. At the genus level, Wolbachia was a common dominant genus, and the relative abundance was (77.6 ± 11.3)% in autogenous Cx. pipiens pallens samples and (47.5 ± 8.5)% in anautogenous mosquito samples, while Faecalibaculum (0.4% ± 0.1%), Dubosiella (0.5% ± 0.0%) and Massilia (0.5% ± 0.1%) were specific species in autogenous Cx. pipiens pallens samples. Alpha diversity analysis showed that higher Chao1 index and ACE index in autogenous Cx. pipiens pallens samples than in anautogenous samples (both P values > 0.05), and lower Shannon index (P > 0.05) and Simpson index (P < 0.05) in autogenous Cx. pipiens pallens samples than in anautogenous samples. LEfSe analysis showed a total of 48 significantly different taxa between autogenous and anautogenous Cx. pipiens pallens samples (all P values < 0.05). Conclusion There is a significant difference in the microbiota diversity between autogenous and anautogenous Cx. pipiens pallens.