On August 2-4,2023,the"Third Summit Forum on'Building a Community of Shared Future for Doctors and Patients'"was jointly organized by institutions such as the Chinese Medical Ethics,the Hospital Humanities Management and Talent Training Special Committee of the China Population and Culture Promotion Association,Center for Ethical Studies of Renmin University of China,the Newspaper for China's Physicians,the China Health Law Society,the China Anti-Cancer Association,and the China Association For Ethical Studies in Harbin.The conference arranged a sub-forum for the"Seminar on the Construction of Chinese Medical Humanities",with domestic medical humanities scholars attending the conference.After heated discussions at the seminar,the Scholars'Consensus on the Construction and Development of Chinese Medical Humanities was formed.It was proposed that in the new era,it is urgent to build the medical humanities discipline,as well as lead the academic integration and development of medical humanities under the core socialist values.At the same time,for the construction of the medical humanities discipline,it is necessary to optimize the organizational mechanism,prosper and develop the overall framework of the medical humanities discipline,accelerate the construction of a professional teaching team for the medical humanities discipline,promote the establishment of a new carrier medical humanities education and teaching in cultivating morality and nurturing talents,as well as focus on solving problems related to the cultivation of medical humanities graduate students.

Pancreaticoduodenectomy (PD) resects many organs, and has complex digestive tract reconstruction and a wide variety of postoperative complications. The clinicians mainly focus on the prevention and treatment of common complications after PD, but lack sufficient knowledge and attention to rare complications. This article combines the clinical practice and research reports of the author's team to describe the potential etiology, clinical manifestations, diagnostic points and prevention strategies of six rare complications (liver abscess, acute pancreatitis, pancreatic endoprosthetic tube-related complications, pseudoaneurysm, non-alcoholic fatty liver disease, hepatic lymphatic leakage) after PD, so as to provide references for the clinicians to improve the ability of early identification and diagnosis, and standardised treatment.

Pancreaticoduodenectomy (PD) resects many organs, and has complex digestive tract reconstruction and a wide variety of postoperative complications. The clinicians mainly focus on the prevention and treatment of common complications after PD, but lack sufficient knowledge and attention to rare complications. This article combines the clinical practice and research reports of the author's team to describe the potential etiology, clinical manifestations, diagnostic points and prevention strategies of six rare complications (liver abscess, acute pancreatitis, pancreatic endoprosthetic tube-related complications, pseudoaneurysm, non-alcoholic fatty liver disease, hepatic lymphatic leakage) after PD, so as to provide references for the clinicians to improve the ability of early identification and diagnosis, and standardised treatment.

Constructing a doctor-patient community with a shared future requires efforts from both the medical supply side and the patient demand side, with special attention to the needs of patients. Continuously meeting and improving the needs of patients is the starting point, ultimate goal, and evaluation standard for constructing a doctor-patient community with a shared future. Therefore, this paper proposed the proposition of "what patients need", that is, what needs do patients have and how to meet their needs. The fundamental needs of patients are to diagnose and treat diseases and recover from illness, which are specifically manifested in the demands to narrate the disease’s feelings, the willingness to participate in medical decision-making, the experience of diagnosis and treatment in the process of medical treatment, and the satisfaction evaluation of the hospital’s performance appraisal. On the basis of clarifying the needs of patients, this paper proposed the paths and methods to meet patients’ needs, and provided new ideas for constructing a doctor-patient community with a shared future.

Objective::Calcific aortic valve disease (CAVD) affects millions of elderly people, and there is currently no effective way to stop or slow down its progression. Therefore, exploring the pathogenesis of CAVD is very important for prevention and treatment. Cartilage oligomeric matrix protein (COMP) have important role in cell phenotype change. This study is aimed to confirm whether COMP participate in CAVD and try to find the possible mechanisms.Methods::Human aortic valve tissues from Nanjing First Hospital (CAVD group, n=20; control group, n=11) were harvested. The expression level of COMP was tested by western blot and immunohistochemistry. Dual immunofluorescence staining was used for locating COMP. Bone morphogenetic protein-2 (BMP2) signalling were tested by western blot. The animal model was also used to detect COMP level by immunohistochemistry. Results::The results showed that the expression level of COMP was significantly increased in the calcific valve samples when compared with that of the control valve ( P<0.05); COMP was expressed near the calcific nodules and co-localized with α-smooth muscle actin (α-SMA). The protein levels of BMP2 and p-Smads 1/5/9 were markedly more highly expressed in the CAVD group than the control group ( P<0.05). Furthermore, immunofluorescence detection showed that COMP and BMP2 were co-located in calcific valves. Conclusions::The above results suggested that upregulation of COMP and BMP2 may be associated with aortic valve calcification and that COMP may become a potential therapeutic target in human CAVD.

Objective::Calcific aortic valve disease (CAVD) affects millions of elderly people, and there is currently no effective way to stop or slow down its progression. Therefore, exploring the pathogenesis of CAVD is very important for prevention and treatment. Cartilage oligomeric matrix protein (COMP) have important role in cell phenotype change. This study is aimed to confirm whether COMP participate in CAVD and try to find the possible mechanisms.Methods::Human aortic valve tissues from Nanjing First Hospital (CAVD group, n=20; control group, n=11) were harvested. The expression level of COMP was tested by western blot and immunohistochemistry. Dual immunofluorescence staining was used for locating COMP. Bone morphogenetic protein-2 (BMP2) signalling were tested by western blot. The animal model was also used to detect COMP level by immunohistochemistry. Results::The results showed that the expression level of COMP was significantly increased in the calcific valve samples when compared with that of the control valve ( P<0.05); COMP was expressed near the calcific nodules and co-localized with α-smooth muscle actin (α-SMA). The protein levels of BMP2 and p-Smads 1/5/9 were markedly more highly expressed in the CAVD group than the control group ( P<0.05). Furthermore, immunofluorescence detection showed that COMP and BMP2 were co-located in calcific valves. Conclusions::The above results suggested that upregulation of COMP and BMP2 may be associated with aortic valve calcification and that COMP may become a potential therapeutic target in human CAVD.

Objective To comprehensively consider the effect of low diverter (FD) implantation on aneurysmal sac and its branches, so as to provide references for making a more reasonable surgical strategy for intracranial aneurysm embolization in clinical practice. Methods Based on computational fluid dynamics (CFD) method, the FD implantation procedure was simulated by using porous media model innovatively. Changes in hemodynamic parameters of aneurysmal sac and side branch with different diameters before and after FD implantation were compared and analyzed, such as blood flow field, velocity, wall pressure and wall shear stress (WSS). Results FD changed the hemodynamic characteristics of aneurysms. The blood flow velocity decreased significantly. The WSS on aneurysmal neck increased, while the difference of WSS between proximal and distal cervical area reduced conversely. Different side branch diameters of vessels had different effects on hemodynamic characteristic changes. The larger diameter would cause the greater blood flow reduction in side branch after FD implantation, but the decrease in velocity of aneurysmal sac and pressure on aneurysmal roof became smaller simultaneously. Meanwhile, the increase of WSS on aneurysmal neck was inversely proportional to the diameter of side branch. Conclusions The larger branch diameter of vessels would cause the worse effect of FD embolization therapy for intracranial aneurysm, worse atherosclerosis improvements and greater possibilities of branch occlusion or other ischemic complications. Doctors should pay more attention to such cases in FD interventional intravascular embolization in clinic.

The main contents of doctor - patient consensus, including that the history of human diseases is much earlier than the history of medical science; in the process of medical progress, diseases are also constantly e-volving; people generally pay more attention to medicine and have prejudice to the disease; doctors focus more on"diseases" while what patients feel is"sickness"; the power of medicine is always limited and the evolution of dis-ease is infinite. On this basis,this paper analyzed the obstacles in the formation process of doctor - patient consensus and put forward the improvement countermeasures from the angle of doctor, patient and society respectively.

This paper analyzed the main cause of the alienation of doctor-patient trust,the poor complaint channels of medical dispute,the lack of credibility for medical and judicial authentication,citizens' consciousness and other medical violence.Aiming at medical violence,we should popularize the concept of law firstly.Secondly,we should revise and perfect the act of medical violence,and promote the institutionalization of handling medical disputes.Then,we should strengthen the construction of physicianprofessionalism and perfect the medical identification.Third,we should strengthen the construction of mediation mechanism and import medical liability insurance appropriately.

The scenario simulation teaching method created a novel teaching mode for medical ethics and explored the new methods to enhance the teaching level.Through 6-year practice teaching,the authors made a comprehensive summary,refined the process,and resolved the existing problems.Several experiences gained in the process.The form of scenario simulation is novel,which is loved by the students.It is helpful to achieve the teaching goal that class should be led by students,cultivate medical students' humanistic quality,and make teaching benefits teachers as well as students.