With the rapid development of human genomics technologies and their clinical applications， relevant ethical issues have induced complex ethical governance challenges. These challenges mainly manifest in the dilemma of reconstructing a new social contract under data open sharing， the moral conflict between the collective nature of group data and individual benefits， the problem of structural inequality under precision medicine， the risk of imbalance between costs and benefits， the dilemma of genetic modification from a eugenic perspective， and the issue of proxy consent and privacy protection. International governance practices indicate that these challenges can be addressed to some extent by improving legislation， issuing initiatives， strengthening the functions of ethics committees and corresponding institutions， and focusing on the ethicality of research projects. However， issues such as legal lag and insufficient binding force of initiatives still exist. Meanwhile， although China’s ethical governance work has made continuous progress in top-level design， international exchanges and theoretical research， specialized legislation and cross-subject collaboration mechanisms still necessitate improvement. A systematic ethical governance framework requires establishing a pre-regulatory system， refining ethical review， and promoting specialized legislation and case approval systems. It is also vital to improve genomic data governance， refine cloud platform management mechanisms， and promote hierarchical governance of the data. Furthermore， it is crucial to clarify the responsibilities of the scientific research community， standardize ethical review， strengthen public communication， and build a moral community with the collaborative cooperation of the government， medical and healthcare institutions and their technical personnel， the public， and research subjects. Through the construction of an ethical governance system for human genomics research， this ensures that genomics technologies benefit humanity without transgressing ethical boundaries， thereby achieving the safety， fairness， and sustainability of their research and application.

Objective To develop a platform for reporting medication near miss events and evaluate its application effectiveness,aiming to enhance medication safety of patients.Methods Based on literature review,qualitative interviews,and expert group meetings,a medication near-miss event reporting platform was constructed,including 4 modules:event content filling,event risk grading,event handling,and statistical analysis.50 nurses were conveniently selected from the pediatric ward of a tertiary grade A hospital in Henan Province as the application subjects.The reporting situation and filling duration of medication near miss events,the score of the Medication Near Miss Reporting Disorder Scale,and the incidence of medication near miss events were compared after the application of the platform(from March to August 2023)and before the application(from September 2022 to February 2023).Results The reporting rate of medication near miss events after the application of the platform was higher than that before the application of the platform,and the comparison of the distribution of event nature and occurrence links showed statistically significant differences(P＜0.05).After the application of the platform,the reporting duration of medication near miss events was shorter than that before the application of the platform,and the score of the Medication Near Miss Reporting Disorder Scale was lower than that before the application of the platform.The differences were statistically significant(P＜0.001).There was no statistically significant difference in the incidence of medication near miss events before and after the application of the platform(P=0.241).Conclusion Using this platform can help improve the reporting rate of medication near miss events,reduce the time taken to fill out reports,and minimize reporting barriers for nurses.

Objective To construct fluorescent molecular probes targeting at tumor heat shock protein 90(Hsp90)in order to enhance tumor-specific recognition.Methods The human pancreatic adenocarcinoma cell line PANC-1 and the human small cell lung cancer cell line NCI-H446 were used as the research targets to study the uptake and clearance of Cy5-P7 by tumor cells with flow cytometry as well as immune-fluorescence technology;The mechanism to mediate entrance of Cy5-P7 into the cells by Hsp90 was investigated by blocking of the PANC-1 cell surface pro-teins with monoclonal antibody to Hsp90;Human pancreatic cancer cell line PANC-1 was subcutaneously injected into posterior dorsum of BALB/c nude mice to construct a xenogeneic subcutaneous tumor model to validate the in vivo tumor recognition ability by Cy7-P7 as well as its in vivo distribution in mice.Results The uptake of Cy5-P7 by cells was significantly reduced in low temperature(P<0.05);An average fluorescence intensity in Cy5-P7-trea-ted cells was significantly reduced after blocking with a monoclonal antibody to Hsp90(P<0.05);The fluorescence intensity at the tumor site of Cy7-P7 group was higher than that of control group(P<0.05),and there was a significant presence of Cy7-P7 in the kidney and tumor fluorescence.Conclusions Cy5-P7 can effectively target at Hsp90,and its specific binding significantly enhanced the cellular uptake of Cy5-P7 fluorescent probe,which im-proved the sensitivity and accuracy of fluorescence imaging.Cy7-P7 showed good tumor active recognition in vivo,and was able to be enriched at the tumor site and metabolized out of the body in 48 h,which may effectively sup-port accurate tumor recognition.

Objective To investigate the safety and validity of laparoscopic autologous lingual mucosal graft ureteroplasty for the treatment of complex ureteral stricture.Methods A total of 10 patients who underwent laparoscopic autologous lingual mucosal graft ureteroplasty in our hospital from May 2021 to October 2023 were retrospectively analyzed.During the operation,the narrow segment was longitudinally dissected,and according to the length of stricture,the lingual mucosal graft of 2.0-7.0 cm in length and 1.0-1.5 cm in width was harvested and precisely anastomosed with the stenosed ureter,followed by double J stent placement.Results All the operations were successfully completed with no conversion to open surgery or intraoperative complications.The operative duration was(237.0±67.1)min,the estimated blood loss was 25.0(20.0,30.0)ml,the duration of drainage tube indwelling was 4.0(4.0,4.8)d,the duration of urinary catheter indwelling was 6.5(6.0,9.5)d,and the duration of postoperative hospitalization was 6.0(6.0,6.8)d.All the patients'oral function recovered well within 1 week,and the double J stent was removed 1-2 months after the surgery.The mean follow-up time was(12.3±7.1)months.One case of aggravated hydronephrosis on the affected side underwent a second laparoscopic ureteral stricture resection and end-to-end anastomosis.The remaining 9 cases showed significant improvement in hydronephrosis on the affected side,with improved renal pelvis separation[(2.9±1.2)cm,t=8.022,P=0.000]and renal function compared to before surgery.Their blood creatinine was(74.3±25.5)μmol/L,with no significant difference compared to preoperation[(80.1±26.6)μmol/L,t=1.825,P=0.105].Conclusion Laparoscopic autologous lingual mucosal graft ureteroplasty for the treatment of complex ureteral stricture is a safe and feasible ureteral reconstruction technique with advantages of quick recovery and reliable outcomes.

Objective To investigate the safety and validity of laparoscopic autologous lingual mucosal graft ureteroplasty for the treatment of complex ureteral stricture.Methods A total of 10 patients who underwent laparoscopic autologous lingual mucosal graft ureteroplasty in our hospital from May 2021 to October 2023 were retrospectively analyzed.During the operation,the narrow segment was longitudinally dissected,and according to the length of stricture,the lingual mucosal graft of 2.0-7.0 cm in length and 1.0-1.5 cm in width was harvested and precisely anastomosed with the stenosed ureter,followed by double J stent placement.Results All the operations were successfully completed with no conversion to open surgery or intraoperative complications.The operative duration was(237.0±67.1)min,the estimated blood loss was 25.0(20.0,30.0)ml,the duration of drainage tube indwelling was 4.0(4.0,4.8)d,the duration of urinary catheter indwelling was 6.5(6.0,9.5)d,and the duration of postoperative hospitalization was 6.0(6.0,6.8)d.All the patients'oral function recovered well within 1 week,and the double J stent was removed 1-2 months after the surgery.The mean follow-up time was(12.3±7.1)months.One case of aggravated hydronephrosis on the affected side underwent a second laparoscopic ureteral stricture resection and end-to-end anastomosis.The remaining 9 cases showed significant improvement in hydronephrosis on the affected side,with improved renal pelvis separation[(2.9±1.2)cm,t=8.022,P=0.000]and renal function compared to before surgery.Their blood creatinine was(74.3±25.5)μmol/L,with no significant difference compared to preoperation[(80.1±26.6)μmol/L,t=1.825,P=0.105].Conclusion Laparoscopic autologous lingual mucosal graft ureteroplasty for the treatment of complex ureteral stricture is a safe and feasible ureteral reconstruction technique with advantages of quick recovery and reliable outcomes.

To construct a recombinant fowl adenovirus 4(FAdV-4)expressing the Cap protein of goose astrovirus genotype 2(GoAstV-2),the expression cassette of Cap gene was inserted into the natural 1 966 bp deletion region of the FAdV-4 genome in the infectious clone p15A-cm-FAdV4-HNJZ.The resulted recombinant plasmid p15A-cm-FAdV4-HNJZ-Cap/GoAstV-2 was linearized with restriction enzyme and transfected into chicken hepatoma cell line(LMH)to rescue the recombinant FAdV-4 expressing the Cap protein of GoAstV-2,rF Ad V4-Cap/GoAstV-2.After 15 passages in LMH cells,the recombinant rFAdV4-Cap/GoAstV-2 was identified by PCR using primers flanking the insertion site of the Cap gene expression cassette and using viral genome DNA extracted from rFAdV4-Cap/GoAstV-2 infected LMH cells as template.LMH cells were in-fected with 15th passage rFAdV4-Cap/GoAstV-2 and indirect immunofluorescence was performed with a polyclonal antibody against Cap protein as the primary antibody.Western blot was carried out with lysates of rFAdV4-Cap/GoAstV-2 infected LMH cells.The in vitro replication dynamic of the 15th passage of the rFAdV4-Cap/GoAstV-2 was also investigated in LMH cells.The results demonstrated that the Cap gene of GoAstV-2 was presented in the genome of the recombinant vi-rus rF AdV4-Cap/Go Ast V-2,and could be expressed stably.The prepared recombinant virus in this study will lay a foundation for developing inactivated bivalent vaccine candidate against co-in-fection of FAdV-4 and GoAstV-2 in goose.

To construct a recombinant fowl adenovirus 4(FAdV-4)expressing the Cap protein of goose astrovirus genotype 2(GoAstV-2),the expression cassette of Cap gene was inserted into the natural 1 966 bp deletion region of the FAdV-4 genome in the infectious clone p15A-cm-FAdV4-HNJZ.The resulted recombinant plasmid p15A-cm-FAdV4-HNJZ-Cap/GoAstV-2 was linearized with restriction enzyme and transfected into chicken hepatoma cell line(LMH)to rescue the recombinant FAdV-4 expressing the Cap protein of GoAstV-2,rF Ad V4-Cap/GoAstV-2.After 15 passages in LMH cells,the recombinant rFAdV4-Cap/GoAstV-2 was identified by PCR using primers flanking the insertion site of the Cap gene expression cassette and using viral genome DNA extracted from rFAdV4-Cap/GoAstV-2 infected LMH cells as template.LMH cells were in-fected with 15th passage rFAdV4-Cap/GoAstV-2 and indirect immunofluorescence was performed with a polyclonal antibody against Cap protein as the primary antibody.Western blot was carried out with lysates of rFAdV4-Cap/GoAstV-2 infected LMH cells.The in vitro replication dynamic of the 15th passage of the rFAdV4-Cap/GoAstV-2 was also investigated in LMH cells.The results demonstrated that the Cap gene of GoAstV-2 was presented in the genome of the recombinant vi-rus rF AdV4-Cap/Go Ast V-2,and could be expressed stably.The prepared recombinant virus in this study will lay a foundation for developing inactivated bivalent vaccine candidate against co-in-fection of FAdV-4 and GoAstV-2 in goose.

Objective To develop a platform for reporting medication near miss events and evaluate its application effectiveness,aiming to enhance medication safety of patients.Methods Based on literature review,qualitative interviews,and expert group meetings,a medication near-miss event reporting platform was constructed,including 4 modules:event content filling,event risk grading,event handling,and statistical analysis.50 nurses were conveniently selected from the pediatric ward of a tertiary grade A hospital in Henan Province as the application subjects.The reporting situation and filling duration of medication near miss events,the score of the Medication Near Miss Reporting Disorder Scale,and the incidence of medication near miss events were compared after the application of the platform(from March to August 2023)and before the application(from September 2022 to February 2023).Results The reporting rate of medication near miss events after the application of the platform was higher than that before the application of the platform,and the comparison of the distribution of event nature and occurrence links showed statistically significant differences(P＜0.05).After the application of the platform,the reporting duration of medication near miss events was shorter than that before the application of the platform,and the score of the Medication Near Miss Reporting Disorder Scale was lower than that before the application of the platform.The differences were statistically significant(P＜0.001).There was no statistically significant difference in the incidence of medication near miss events before and after the application of the platform(P=0.241).Conclusion Using this platform can help improve the reporting rate of medication near miss events,reduce the time taken to fill out reports,and minimize reporting barriers for nurses.

Objective:To evaluate the safety and validity of perioperative antimicrobial prophylaxis with different administration period in patients undergoing transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH).Methods:This prospective randomized controlled clinical trial was conducted on patients who underwent TURP in the Second Affiliated Hospital of Anhui Medical University from July 2022 to December 2023. The patients were randomly assigned to the experimental group and the control group in a 1∶1 ratio using a randomized block design. Inclusion criteria: age 55-78 years old, the indication of benign prostatic hyperplasia surgery, preoperative urine routine examination showed no pyuria or bacteriuria, preoperative catheterization being not reserved, postoperative pathology confirmed BPH and informed consent obtained. Exclusion criteria: severe heart, lung, brain and other diseases which could not tolerate anesthesia and surgery, complicated with bladder stones or bladder tumors, diabetic patients with poor glycemic control, immunosuppressive agents being administered. Patients in the experimental group received a single dose of cephalosporins or fluoroquinolones 30 minutes or 2 hours before surgery, while patients in the control group received a second dose 12 hours or 24 hours after the first dose. The primary outcome was the incidence of urinary tract infectious presenting fever (body temperature ≥38.5℃) within 1 week after surgery, while the white blood cell count, C-reactive protein concentration, serum heparin-binding protein concentration, red and white blood cell count in urine, the incidence of bacteriuria, pulmonary infection, and postoperative hospital stay were defined as secondary outcomes. The safety index was the incidence of adverse reactions of antibiotics.Results:A total of 180 patients were enrolled in this study, including 90 cases in each experimental group or control group. Two groups of patients had no significant difference ( P>0.05) in age [(71.7±3.9) and (69.9±4.8) years], prostate volume [55.0 ml(39.5, 62.0) and 52.5(45.5, 68.5) ml], operation time [(58.8±17.0) min vs. (60.9±16.7) min], and postoperative indwelling catheter days [3.0(3, 4) d vs. 3.8(3, 4) d]. The incidence of fever within 1 week after surgery was 7.8%(7/90) in the experimental group and 5.6%(5/90) in the control group, respectively, and the difference was not statistically significant ( P=0.550). Our data demonstrated that the white blood cell count [(10.5±1.2)×10 9/L vs. (9.7±4.1)×10 9/L], C-reactive protein concentration [(43.0±27.9) mg/L vs. (53.1±29.9) mg/L] and heparin-binding protein concentration [(44.7±19.4) ng/ml vs. (37.8±23.5) ng/ml], urine red blood cell count [4 768.2(2 387.9, 10 496.5)/μl vs. 6 577.2(3 691.5, 7 636.8) /μl], urine white blood cell count [447.1(283.9, 637.0)/μl vs 242.8(109.7, 691.8)/μl] were mildly elevated in two groups without significant difference ( P>0.05). The incidence of postoperative pulmonary infection [3.3% (3/90)] vs. 2.2% (2/90)], bacteriuria [6.7% (6/90) vs. 8.9% (8/90)], postoperative hospital stay [4.5(4.0, 5.1) days vs. 4.5(4.0, 5.5) days] also showed no significant difference ( P>0.05). While the incidence of adverse reactions of antibiotics in the experimental group 3.3% (3/90) was significantly lower than that in the control group 11.1% (10/90) ( P=0.044). Conclusions:A single-dose antibiotic administration as a perioperative antimicrobial prophylaxis is safe and effective for patients undergoing TURP who do not have preoperative pyuria or indwelling catheter.

Objective:To analyze the epidemic characteristics of brucellosis in China from 2004 to 2018, in order to understand the development trend of brucellosis.Methods:The surveillance data of brucellosis in China from 2004 to 2018 were collected from National Public Health Science Data Center. Joinpoint regression was used to analyze the trend of brucellosis incidence in China and various provinces. Overall trends were estimated by the average annual percentage change (AAPC). Seasonal and trend decomposition using loess (STL) was used to analyze the seasonal characteristics of brucellosis in China and various provinces. The age-related thermodynamic diagram of incidence rate was used to analyze the characteristics of age-onset changes.Results:From 2004 to 2018, a total of 524 980 brucellosis cases and 16 deaths were reported nationwide, with a incidence rate of 2.61/100 000 and a case fatality rate of (3.05 × 10 -3)%. The incidence of brucellosis in China was on the rise (AAPC = 11.58%, 95% CI: 7.91% - 15.25%, P < 0.001). There was no significant trend of change in Inner Mongolia Autonomous Region, Shanxi and Shaanxi provinces ( P > 0.05). Tibet Autonomous Region showed a downward trend (AAPC = - 55.19%, P < 0.001). All other provinces were showing an upward trend (AAPC > 0, P < 0.05). The peak incidence in China occurred from April to June. In terms of provinces, the peak incidence in Hainan, Sichuan, Guizhou, Fujian and Anhui provinces occurred from April to August, the peak incidence in Chongqing and Shanghai cities occurred from June to August, and the peak incidence in other provinces was generally from April to June. There were reports of brucellosis cases in all age groups nationwide, and the age distribution showed an inverted "V" shape. The peak incidence occurred in the 50 - 54 years old (5.43/100 000), followed by the 60 - 64 years old (4.94/100 000). From 2004 to 2018, the top 3 age groups of incidence rate changed from 40 - 44, 50 - 54 and 35 - 39 years old in 2004 to 50 - 54, 60 - 64 and 55 - 59 years old in 2018. Conclusions:The incidence of brucellosis is on the rise nationwide and in most provinces from 2004 to 2018. The high incidence age is gradually changing to the elderly population.