1.Julia Annas’developmental virtue ethics: enlightenment for the construction of medical ethics
Hongyao ZHAO ; Xufeng LU ; Shan ZHANG
Chinese Medical Ethics 2026;39(3):377-383
Medical ethics aims to address moral issues in medical practice. When analyzing the right and wrong in medicine, it emphatically interprets “what medicine ought to be” and focuses on how physicians should act correctly. Hence, highly directive ethical theories such as deontology and utilitarianism have become the fundamental theories for medical decision-making. Nevertheless, as the concentrated embodiment of medical ethical values, virtue ethics also constitutes an important component of medical ethics. Drawing on Julia Annas’s creative development of virtue ethics theories regarding “right action” and “right emotion,” which is based on the distinction between “virtue learners” and “virtue possessors,” this paper provides a new theoretical perspective and practical approach for bridging the divide between heteronomy and autonomy in medical ethics, enhancing the care for medical staff’s emotions in medical ethics education, and promoting mutual understanding and communication between physicians and patients.
2.Dynamic compatibility of the sanctity of life with the dignity of life: the euthanasia issue from the perspectives of Confucian philosophy of death and relational ethics
Hongyao ZHAO ; Xufeng LU ; Shan ZHANG
Chinese Medical Ethics 2026;39(6):797-803
The development of modern medical technology has enabled human beings to intervene in the entire process of life. As an important issue at the end of life, euthanasia has triggered profound controversies in bioethics regarding the right to life, autonomy, and moral responsibility. However, influenced by rationalism and religious dimensions, Western philosophy of death focuses on the subjectivity and individuality of death, thereby confining ethical discussions on euthanasia to the category of individual rights and obligations. Distinct from Western individualistic ethics, Confucianism, grounded in the “virtue of generating life”, emphasizes the harmony between the dignity of life and social relations. Despite not directly addressing issues related to euthanasia, its philosophy of death and relational ethics provides unique interpretations of the value of life, family ethics, and social responsibility. These interpretations effectively deconstruct the major ethical controversies over euthanasia and provide an enlightening perspective for us to reflect on this modern social issue.
3.Chinese expert consensus on the application of jejunal interposition for esophageal reconstruction in complex esophageal cancer surgery (2026 edition)
Wenshu CHEN ; Lilan ZHAO ; Zhaoxian LIN ; Debin OU ; Zhigang LI ; Chengchu ZHU ; Longqi CHEN ; Shuoyan LIU ; Xiangnan LI ; Chao CHENG ; Ni ZHANG ; Songping XIE ; Xufeng GUO ; Xu LI ; Xinyu MEI ; Xuefeng LENG ; Jianqun MA ; Zhijun HUANG ; Guojun GENG ; Lin ZHANG ; Hongyan WANG ; Yi ZHANG ; Weijie WANG ; Jiangbo LIN ; Jinbiao XIE ; Jun GUAN ; Rongqi HE ; Xing LIN ; Xiuhua TU ; Yong LI ; Lijie TAN ; Xiaojie PAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(10):1527-1543
Objective Jejunal interposition is an important option for restoring gastrointestinal continuity in patients with complex esophageal cancer in whom the stomach is unavailable for reconstruction due to previous gastrectomy, tumor involvement, failed gastric conduit, or other constraints. Although the jejunum offers a caliber similar to the esophagus, a rich blood supply, and preserved peristaltic function, anatomical variations in mesenteric length and vascular arcades render long-segment and high-level reconstruction susceptible to excessive tension, mesenteric torsion, venous congestion, and inadequate distal perfusion. This consensus aims to provide standardized recommendations for the application of jejunal interposition in this specific patient population. Methods This consensus was developed in accordance with the WHO Handbook for Guideline Development and Chinese national guideline development standards, with reference to the Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ), Reporting Items for Practice Guidelines in Healthcare (RIGHT), and Scientific, Transparent and Applicable Rankings (STAR) checklists. The project was registered on the international practice guidelines registry platform (PREPARE-2026CN1384). The working group systematically searched Chinese and English evidence addressing 12 clinical questions. Evidence was graded using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2009 system, with structured appraisal of risk of bias, inconsistency, indirectness, and imprecision. Recommendations were formulated through two rounds of Delphi surveys and a face-to-face consensus meeting, with an agreement threshold of ≥75%. Results The consensus generated 12 recommendations covering indications, selection between jejunum and colon, preoperative assessment, surgical approach and reconstruction route, pedicled jejunal interposition (PJI), supercharged pedicled jejunal interposition (SPJ), indocyanine green (ICG) perfusion assessment, perioperative nutrition, management of anastomotic leakage, long-term follow-up, and special treatment scenarios. Given that the available direct evidence is predominantly derived from single-center retrospective cohorts and case series, recommendations extrapolated from general esophagectomy or other gastrointestinal surgical evidence are deliberately phrased with caution. Conclusion Jejunal interposition is a safe and effective approach for digestive tract reconstruction in patients with complex esophageal cancer in whom the stomach is unavailable. This consensus emphasizes that clinical decision-making should be individualized based on the patient's prior treatment history, reconstruction height, vascular anatomy, technical availability, and institutional experience in the Chinese context.
5.Application of an improved subretinal injection system in the treatment of submacular hemorrhage: a single-center, retrospective study
Ying HE ; Xufeng ZHAO ; Liwei WEI ; Zheng ZHANG ; Shengjie ZHANG ; Li LIU ; Youxin CHEN ; Weihong YU ; Hanyi MIN ; Huizhen WANG
Chinese Journal of Ocular Fundus Diseases 2025;41(10):769-774
Objective:To develop a simple and effective subretinal injection pipeline system to enhance the accuracy and precision of subretinal injection volume control.Methods:A retrospective case series study. From May to October 2023, 18 patients (18 eyes) with submacular hemorrhage (SMH) who continuously received modified subretinal injection treatment in Department of Ophthalmology of Peking Union Medical College Hospital were included in the study. Among them, there were 10 males and 8 females. The mean age was (60.00±7.41) years. The primary causes included polypoid choroidal vasculopathy (14 cases), retinal macroaneurysm (2 cases), traumatic retinopathy (1 case), and Valsalva retinopathy (1 case). Hemorrhage affected 14 eyes of the fovea centralis. All affected eyes underwent standard three-channel 25G vitrectomy via the flat part of the ciliary body combined with modified subretinal injection of recombinant tissue plasminogen activator. The improved injection system consisted of a 1 ml syringe, a Q-Syte TM connector, a 41G subretinal microinjection needle, a converter and a viscoelastic substance control pipeline. The drug preparation time for subretinal injection (i.e., the time consumed by the system connection step), the injection time, whether bubbles occur during the injection process, and the perioperative complications were recorded and analyzed. Results:The preparation time prior to drug injection ranged from 230 to 335 seconds, while the injection completion time varied between 43 and 75 seconds. Both times decreased progressively as operator proficiency improved. Among the treated eyes, five received a target injection dose of 0.05 ml and thirteen received 0.10 ml, with all eyes achieving the preset dose accurately. No subretinal bubbles were observed during the injection procedure. Additionally, no intraoperative complications such as retinal hemorrhage or tear secondary to mechanical trauma at the injection site were recorded. Postoperatively, one eye developed anterior chamber hemorrhage, which resolved following intraocular pressure-lowering treatment. No other postoperative complications, including hemorrhage, rhegmatogenous retinal detachment, or infection, were observed in the remaining eyes.Conclusion:The retinal drug injection system developed in this study has a simple structure, safe and stable operation, can achieve precise drug injection, and effectively avoid the formation of bubbles.
6.Application of an improved subretinal injection system in the treatment of submacular hemorrhage: a single-center, retrospective study
Ying HE ; Xufeng ZHAO ; Liwei WEI ; Zheng ZHANG ; Shengjie ZHANG ; Li LIU ; Youxin CHEN ; Weihong YU ; Hanyi MIN ; Huizhen WANG
Chinese Journal of Ocular Fundus Diseases 2025;41(10):769-774
Objective:To develop a simple and effective subretinal injection pipeline system to enhance the accuracy and precision of subretinal injection volume control.Methods:A retrospective case series study. From May to October 2023, 18 patients (18 eyes) with submacular hemorrhage (SMH) who continuously received modified subretinal injection treatment in Department of Ophthalmology of Peking Union Medical College Hospital were included in the study. Among them, there were 10 males and 8 females. The mean age was (60.00±7.41) years. The primary causes included polypoid choroidal vasculopathy (14 cases), retinal macroaneurysm (2 cases), traumatic retinopathy (1 case), and Valsalva retinopathy (1 case). Hemorrhage affected 14 eyes of the fovea centralis. All affected eyes underwent standard three-channel 25G vitrectomy via the flat part of the ciliary body combined with modified subretinal injection of recombinant tissue plasminogen activator. The improved injection system consisted of a 1 ml syringe, a Q-Syte TM connector, a 41G subretinal microinjection needle, a converter and a viscoelastic substance control pipeline. The drug preparation time for subretinal injection (i.e., the time consumed by the system connection step), the injection time, whether bubbles occur during the injection process, and the perioperative complications were recorded and analyzed. Results:The preparation time prior to drug injection ranged from 230 to 335 seconds, while the injection completion time varied between 43 and 75 seconds. Both times decreased progressively as operator proficiency improved. Among the treated eyes, five received a target injection dose of 0.05 ml and thirteen received 0.10 ml, with all eyes achieving the preset dose accurately. No subretinal bubbles were observed during the injection procedure. Additionally, no intraoperative complications such as retinal hemorrhage or tear secondary to mechanical trauma at the injection site were recorded. Postoperatively, one eye developed anterior chamber hemorrhage, which resolved following intraocular pressure-lowering treatment. No other postoperative complications, including hemorrhage, rhegmatogenous retinal detachment, or infection, were observed in the remaining eyes.Conclusion:The retinal drug injection system developed in this study has a simple structure, safe and stable operation, can achieve precise drug injection, and effectively avoid the formation of bubbles.
7.Epidemiology and exposure management of rabies in Shanxi Province, 2011‒2022
Weimin ZHAO ; Guohua LI ; Yunong ZHANG ; Ting FAN ; Xuefen GAO ; Xufeng DONG
Shanghai Journal of Preventive Medicine 2024;36(2):134-137
ObjectiveTo analyze the epidemiological features and influencing factors of rabies in Shanxi Province,and to provide evidence to further promote the elimination of rabies in Shanxi Province. MethodsThe incidence data of rabies in Shanxi from 2011 to 2022 were collected and subjected to descriptive analysis. ResultsFrom 2011 to 2022, a total of 348 rabies cases were reported in Shanxi Province, with an average annual incidence of 0.080 3/105. The incidence of rabies showed a downward trend overall. The highest incidence was in August. The cases were mainly farmers, mostly males, and most cases were reported between 50 and 69 years old. The data of cases showed that dogs were the main animals attacking human (93.96%). The incubation period of most cases was 1‒3 months (37.37%).The main exposure site was hand(51.33%). Only 2.66% cases with grade Ⅲ exposure were injected with passive immune agents. ConclusionThe incidence of rabies in Shanxi Province continues to decrease, but there are still loopholes in prevention and control measures. It is necessary to strengthen the management and immunization of dogs,health education, and standardized procedures after exposure to maintain the achievements in the prevention and control of rabies.
8.Verification of a method for measurement of tritium in liquid effluent of nuclear power plants
Hongshen DING ; Wanbing ZHAO ; Mengyu FU ; Lin ZHENG ; Long ZHOU ; Xufeng LI ; Weidong LIU ; Xianchen YU
Chinese Journal of Radiological Health 2024;33(3):293-298
Objective To explore the method for measurement of tritium in nuclear power plant liquid effluent purified by a mixed ion-exchange resin, to verify the feasibility of the method by experiments, and to provide technical support for the development of standard methods for the measurement of tritium in liquid effluent of nuclear power plants. Methods The purification effect of the mixed ion-exchange resin was determined by measuring the quenching factor, conductivity, and β-nuclide adsorption efficiency of the samples purified using the resin. A comparison was made between the ion-exchange resin method and the atmospheric distillation method for tritium determination. The precision and accuracy of the method were verified by calculating the relative standard deviation and the recovery in repeated measurement of samples with different activity concentrations and spiked samples. Results There were no significant differences in quenching factor, conductivity, and tritium activity concentration between the two methods. The adsorption efficiencies of EC20MB resin for common β-nuclides such as carbon, iron, nickel, strontium, yttrium, and cesium ranged from 99.28% to 99.88%. Repeated measurement of the same sample showed relative standard deviations of 5.2%-9.4% and recoveries of 86.8%-107%. Conclusion There were no significant differences between the results of the ion-exchange resin purification method and the atmospheric distillation method. The precision and accuracy of the method met the requirements of the ecological and environmental management authorities for monitoring tritium in liquid effluent from nuclear power plants. This method can be widely used in daily monitoring work.
9.A consistency comparison between next-generation sequencing and the FISH method for gene rearrangement detection in B-cell lymphomas
Zheng YAN ; Zhihua YAO ; Shuna YAO ; Shuang ZHAO ; Haiying WANG ; Junfeng CHU ; Yuanlin XU ; Jiuyang ZHANG ; Bing WEI ; Jiawen ZHENG ; Qingxin XIA ; Daoyuan WU ; Xufeng LUO ; Wenping ZHOU ; Yanyan LIU
Chinese Journal of Hematology 2024;45(6):561-565
Objective:To compare the consistency of lymphoma multigene detection panels based on next-generation sequencing (NGS) with FISH detection of B-cell lymphoma gene rearrangement.Methods:From January 2019 to May 2023, fusion genes detected by lymphoma-related 413 genes that targeted capture sequencing of 489 B-cell lymphoma tissues embedded in paraffin were collected from Henan Cancer Hospital, and the results were compared with simultaneous FISH detection of four break/fusion genes: BCL2, BCL6, MYC, and CCND1. Consistency was defined as both methods yielding positive or negative results for the same sample. The relationship between fusion mutation abundance in NGS and the positivity rate of cells in FISH was also analyzed.Results:Kappa consistency analysis revealed high consistency between NGS and FISH in detecting the four B-cell lymphoma-related gene rearrangement ( P<0.001 for all) ; however, the detection rates of positive individuals differed for the four genes. Compared with FISH, NGS demonstrated a higher detection rate for BCL2 rearrangement, a lower detection rate for BCL6 and MYC rearrangement, and a similar detection rate for CCND1 rearrangement. No correlation was found between fusion mutation abundance in NGS and the positivity rate of cells in FISH. Conclusions:NGS and FISH detection of B-cell lymphoma gene rearrangement demonstrate overall good consistency. NGS is superior to FISH in detecting BCL2 rearrangement, inferior in detecting MYC rearrangement, and comparable in detecting CCND1 rearrangement.
10.Methodology dilemma of Western bioethics and transcendent approach based on Confucian bioethics
Xufeng LU ; Dongli LIU ; Hongyao ZHAO ; Shan ZHANG
Chinese Medical Ethics 2024;37(12):1453-1458
Western bioethics,with its theoretical basis in individualism,is essentially a form of universalist ethics that makes it difficult to respond to the complexities of moral life.Scholars represented by Engelhardt and MacIntyre have profoundly reflected on universalist ethics from the perspective of moral pluralism,but they have not been able to fundamentally resolve the disputes.Grasping the theoretical lineage of the controversy between universalism and particularism can provide an important reference for the construction of bioethics based on Confucianism in contemporary China.Furthermore,from the perspective of opposing universalism and particularism,as well as in response to the issues of the era of life science and technology and the cultural background of China,it can not only realize the modern interpretation of Confucian ethics,but also promote the effective application of modern bioethics theory.

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