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.

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.

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.

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.

Objective To summarize the clinical features,characteristics of cerebrospinal fluid,electrophysiological manifestations,imaging changes,treatment strategies,and prognosis of patients with varicella zoster virus(VZV)complicated by neurological involvement.Methods A retrospective analysis was conducted on 33 patients diagnosed with VZV-associated neurological infections and treated at Beijing Jishuitan Hospital,Capital Medical University,between 2013 and 2024.The clinical characteristics of these patients were thoroughly examined.Results Among the 33 patients,22 were males(66.7%)and 11 were females(33.3%),with a mean age of(60.7±14.3)years.All patients presented with cutaneous herpes zoster,with 22 cases(66.7%)starting with herpes zoster and 11 cases(33.3%)starting with symptoms of neurological damage.Neurological involvement predominantly affected the cranial nerves in 27 cases(81.8%),with facial nerve being the most commonly involved(51.5%).The most common manifestation was facial paralysis(51.5%),followed by head and facial pain(33.3%).It could also be manifested as dizziness(12.1%),ophthalmoplegia(9.1%),hearing loss(9.1%),fever(3.0%),hoarseness(3.0%),and bucking(3.0%).Spinal nerve was involved in 3 cases(9.1%):2 with spinal radiculitis and 1 with Guillain-Barré syndrome,which was characterized by limb numbness,weakness,and dysuria.Additionally,spinal cord was involved in 3 cases(9.1%)including 2 involving the thoracic spinal cord and 1 involving the cervical spinal cord,which was presented as limb numbness,pain,and weakness.No cases of VZV-induced encephalitis,meningitis,or vasculitis were reported.14 patients underwent cerebrospinal fluid examination,and 5 patients(35.7%)had elevated pressure,11 patients(78.6%)had elevated white blood cells,and 5 patients(35.7%)had elevated protein.Neuroimaging did not revealed any responsible lesion in 21 patients with cranial nerve involvement who underwent cranial magnetic resonance image.Among the three patients with spinal cord involvement,the lesion segment was all one vertebral segment.Two cases(2/3)showed circular or mild enhancement after enhancement,while one case(1/3)had no enhancement.Except for one patient who was transferred to another hospital due to HIV infection,all other patients showed clinical improvement upon discharge following antiviral therapy,with or without adjunctive glucocorticoid treatment.Conclusions The primary neurological complications of VZV include cranial nerve paralysis,spinal radiculitis,Guillain-Barré syndrome and myelitis.Early initiation of antiviral therapy,particularly when combined with glucocorticoids,is associated with improved clinical outcomes.

Objective:To explore the feasibility and effect of remote medical education model using online film reading training to improve the ability of ophthalmologists in the Xinjiang Uygur Autonomous Region (hereinafter referred to as "Xinjiang Region" ) in diagnosing fundus diseases.Methods:The three-level film reading training system of Xinjiang Production and Construction Corps system division hospital-Corps Hospital-Peking Union Medical College Hospital was established. From June 2022 to January 2023, 4 159 posterior color fundus images were continuously collected from Department of Ophthalmology of Xinjiang Corps Hospital and 4 divisional hospitals in the Corps medical system. Among them, hypertensive retinopathy, diabetic retinopathy, exudative age-related macular degeneration (AMD), atrophic AMD and retinal vein occlusion were 3 073, 651, 43, 186 and 206 cases, respectively. The images were divided into 3 rounds (first, second and last) according to the proportion of diseases. The doctors who participated in the training (hereinafter referred to as the "training") were 15 ophthalmologists from the Corps Hospital of Xinjiang Region and the division hospital of the Corps system. There were 7 male and 8 female. Age was (38.1±4.0) years. The titles of senior, deputy senior, intermediate and junior are 1, 6, 5 and 3 respectively; Bachelor's degree and master's degree are 13 and 2 respectively. The working time of fundus disease specialty was (9.6±3.3) years. The film reading system training was conducted before the first round of labeling, and after each round of film reading, the doctors of Peking Union Medical College Hospital gave feedback and explanation on the film reading results. The diagnostic consistency, sensitivity and specificity were compared by paired sample t test. Spearman or Pearson correlation analysis was conducted between the improvement of diagnostic level and professional title, education, age and working hours of ocular fundus disease. Results:All the participating doctors completed the first, second and last reading. After each round of film reading, the film reading summary was carried out for 2 hours. The average diagnostic agreement rates of participating physicians were 53.0%, 67.0% and 75.0%, respectively. The sensitivity and specificity were 0.38, 0.69, 054 and 0.66, 0.85, 0.96, respectively. There was significant difference between the first and last examination ( P<0.001). The sensitivity of the second reading was significantly higher than that of the first reading, and the sensitivity of the last reading was significantly lower than that of the second reading, with statistical significance ( P<0.05). The specificity of the second reading was significantly higher than that of the first reading, and the last reading was significantly higher than that of the second reading, with statistical significance ( P<0.05). There was no significant correlation ( P>0.05) between the improvement of diagnostic level of participating physicians and educational background ( Rho=0.07), professional title ( Rho=0.13), age ( r=0.20), and working time of ophthalmofundus disease specialty ( r=0.26). Conclusions:Relying on the three-level online telemedicine training, it can improve the ability of ophthalmologists in Xinjiang region to diagnose fundus diseases. The preliminary telemedicine education model has demonstrated potential for feasibility and effectiveness in remote areas with inadequate medical resources.

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.

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.

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.