Ethical review represents the core of the scientific and technological ethical governance， and its quality depends on the participation of ethics. The absence of ethics and ethical experts will compromise the quality of the review. According to the spirit of the Guidelines on Strengthening the Governance over Ethics in Science and Technology， this paper analyzed the process of separating scientific and technological ethics from the field of scientific research morality， clarified the ethical attributes of ethical review， and argued that scientific research and technological innovation activities originated from ethics. On this basis， the fundamental principle of “ethics first” was proposed， aiming to proactively embed ethical considerations throughout the entire process of scientific and technological activities. This principle was the primary requirement for ensuring governance effectiveness and can also eliminate the risk of ethics being obscured in ethical governance. In practice， “ethics first” manifested specifically in dimensions such as prioritizing academic systems， prioritizing publicity， education， and training， as well as further advancing ethical considerations.

“Integrated elderly care and medical services” is a new model of elderly care that relies on medical care as a guarantee， rehabilitation as a support， and combines ongoing medical treatment with nurturing， offering comprehensive therapy. This new type of elderly care model also poses new job requirements for elderly care workers. However， there is currently a large shortage of elderly care workers， along with prevalent issues such as low professional quality， low education level， and an older average age. The main reasons for this situation are low welfare benefits， low social status， and an incomplete promotion system in the industry， resulting in low social recognition of the industry， a shortage of employees， and a high number of resignations. Based on this， it is suggested to expand the number of the elderly care team and enhance the quality of the elderly care team by improving the career development system， increasing salary and welfare benefits， and expanding social recognition.

Objective to investigate the mapping and ablation strategy of premature ventricular contraction(PVC)originating from the free wall of tricuspid annulus.Methods With the Carto3 three-dimensional electro-anatomical mapping system and long sheath supporting,the PVC originating from the free wall of the tricuspid annulus was mapped and ablated by inverted U-shaped catheter via the femoral vein access.Results In 19 patients with PVC originating from the free wall of the tricuspid annulus,mapping and ablation with an inverted U-shaped catheter under the free wall of tricuspid annulus was carried out.The treatment was immediately successful in all the 19 patients,and no complications occurred.During the 6-month follow-up period,one patient developed recurrence of PVC.Conclusion The PVC originating from the free wall of the tricuspid annulus can be roughly judged by the features of the electrocardiogram of the body surface before operation,and the mapping and ablation treatment by using inverted U-shaped catheter is technically-simple and clinically-safe with reliable therapeutic efficacy.

The release of Guidelines to Strengthen the Governance over Ethics in Science and Technology marked that China's ethical governance system of science and technology has entered a new stage.The research and practice on ethics in science and technology in China are carried out along two approaches.One approach is to derive the rules of specific science and practice from the principles of general ethics.The other is to gradually form ethical governance principles and consensus for a specific type of phenomenon or problem in the process of science and technology,starting from scientific research problems and scientific and technological events and cases.Medical ethics research has also formed the tradition of medical ethics and modern bioethics in this way.In the practice of ethical governance,medical ethics is at the forefront of scientific and technological ethics,forming a"pilot area"for the research and development of scientific and technological ethics,an"explorer"for the institutionalization of ethical review,and a"demonstration area"for scientific and technological ethical governance.The release of ethical governance opinions is not the end of research on medical ethics governance,and medical ethics needs to have new achievements.Firstly,rethinking the theoretical basis and methodology of medical ethics and adhering to the guidance of Marxist theory.Secondly,a rethinking of the two research paths and how they can balance development and support each other.Thirdly,rethinking the relationship between ethics and the rule of law,and continuously improving the level of legalization of ethical governance.

Objective:To investigate the efficacy of trimetazidine in the treatment of atrial arrhythmias in patients with ischemic cardiomyopathy and heart failure and analyze the effect of trimetazidine on cardiac function and atrial arrhythmias.Methods:A total of 79 patients with ischemic cardiomyopathy and heart failure who received treatment at the Second Hospital of Jiaxing from December 2018 to June 2020 were included in this study. These patients were randomly divided into an observation group ( n = 41) and a control group ( n = 38). Patients in the control group received conventional drugs, while those in the observation group received trimetazidine sustained-release tablets twice daily, each time taking 35 mg in addition to conventional drugs. The treatment lasted for 24 weeks. Before and after treatment, cardiac function indicators (left ventricular ejection fraction, B-type brain natriuretic peptide, 6-minute walking distance), cardiac color Doppler ultrasound indicators [ratio of early to late peak filling rate (E/A ratio)], left ventricular fractional shortening), electrocardiogram parameters (maximum P-wave duration, minimum P-wave duration, and P-wave dispersion), dynamic electrocardiogram parameters [number of single atrial premature beats, total number and duration of paroxysmal atrial tachycardia episodes, total number and duration of paroxysmal atrial flutter/fibrillation attacks, standard deviation of RR intervals, root mean square of successive differences between normal heartbeats, proportion of successive RR intervals that differ by more than 50 ms divided by the total number of NN intervals (PNN50), standard deviation of average NN intervals, high frequency and low frequency], as well as changes in high sensitivity C-reactive protein were analyzed in each group. Results:After treatment, left ventricular ejection fraction, B-type brain natriuretic peptide, 6-minute walking distance, maximum P-wave duration, P-wave dispersion, total number of atrial flutter/atrial fibrillation attacks, and duration of atrial flutter/atrial fibrillation in the observation group were (51.05 ± 7.68)%, (1 615.59 ± 1 129.78) ng/L, (350.02 ± 62.99) m, (99.73 ± 11.60) ms, (22.44 ± 12.03) ms, (0.22 ± 0.61), and (4.59 ± 12.30) minutes, respectively, which were significantly superior to (46.82 ± 7.34)%, (2 267.47 ± 1 539.03) ng/L, (294.16 ± 58.20) m, (111.71 ± 10.00) ms, (36.77 ± 15.07) ms, (0.76 ± 1.13), (15.66 ± 22.30) minutes in the control group, t = -2.95, 2.16, -4.08, 4.89, 4.68, 2.69, 2.76, all P < 0.01). Conclusion:Trimetazidine can effectively reduce atrial arrhythmias and improve the prognosis of patients with ischemic cardiomyopathy and heart failure, which warrants clinical promotion.

Objective:To investigate the value of digital medical 3D technology versus traditional 2D technology in the diagnosis and treatment of solid abdominal tumors in children. Methods:A total of 80 children with solid abdominal tumors who received surgical treatment guided by digital medical 3D technology at Guigang People's Hospital from January 2018 to January 2022 were included in the observation group. An additional 80 children with solid abdominal tumors who received surgical treatment guided by traditional 2D technology at the same hospital from January 2014 to December 2017 were included in the control group. Clinical efficacy was compared between the two groups.Results:The surgical time, intraoperative blood loss, postoperative exhaust time, postoperative hospital stay in the observation group were (111.8 ± 28.9) minutes, (26.8 ± 25.2) mL, (2.2 ± 1.2) days, (7.5 ± 1.4) days, respectively, which were significantly shorter or less than those in the control group [(193.1 ± 66.0) minutes, (86.2 ± 47.0) mL, (3.7 ± 0.9) days, (12.2 ± 3.5) days, t = 7.00, 6.88, 5.87, 7.53, all P < 0.05]. The complete surgical resection rate in the observation group was significantly higher than that in the control group [92.5% (74/80) vs. 81.3% (65/80), χ2 = 4.44, P < 0.05]. The incidence of complications in the observation group was significantly lower than that in the control group [6.3% (5/80) vs. 16.3% (13/80), χ2 = 4.00, P < 0.05]. Conclusion:The utilization of digital medical 3D technology in the surgical treatment of solid abdominal tumors in children can markedly decrease surgical time, reduce intraoperative blood loss, promote postoperative recovery, achieve a high surgical resection rate, and minimize postoperative complications.

Public health emergencies pose severe challenges to the public health sector and emergency management work in hospitals.Enhancing the emergency management capabilities in general hospitals is of great significance in promoting high-quality development of hospitals,improving the government's public governance system,alleviating social panic,and other aspects.However,there are the practical dilemmas of insufficient monitoring and early warning,imperfect guarantee systems,and lack of technological innovation in emergency management in general hospitals.The emergency management capabilities in general hospitals can be improved through normalized monitoring and disposal,standing facility and material teams,information-based power systems,and standardization of technical support,further promoting the innovation and development of the emergency management system in general hospitals.

ObjectiveTo develop and validate a predictive model to individually predict the risk of patients with stroke in the eICU Collaborative Research Database for early clinical identification and intervention. MethodIndividual patient data （200 859 cases） from a national multicenter cohort study （eICU database） were selected， and the patients with stroke in neurological diseases （9 037 cases） were selected for statistical analysis. The main outcome was hospital mortality. The Glasgow Coma scale （GCS） was used to divide all patients with stroke into stroke in meridian and stroke in viscera （GCS≤14 for stroke in viscera and GCS=15 for stroke in meridian）. The patients were then divided into a training set and a test set according to 7∶3， respectively， to evaluate the differences in hospital mortality between the two groups. The multivariate logistic regression was used to analyze the related factors affecting the prognosis of the two groups， and a predictive model was established. Receiver operator characteristic （ROC） curves were used to assess the discrimination of the predictive model. ResultThe predictive model based on 9 037 patients with stroke was established. The predictors of the stroke in meridian （4 475 cases） included pulmonary infection， mechanical ventilation， acute physiology， and chronic health status scoring system Ⅳ （APACHE Ⅳ） score. The predictors of the stroke in viscera （4 562 cases） included anticoagulation therapy （AT）， mechanical ventilation， acute physiology， and APACHE Ⅳ score. According to the predictors， the predictive models of the stroke in meridian and the stroke in viscera were constructed， respectively. The areas under the curve （AUC） of ROC of the training set and the test set of the predictive models of the stroke in meridian were 0.845 ［95% confidence interval （CI） （0.811， 0.879）］ and 0.807 ［95% CI （0.751， 0.863）］， respectively. The areas under the ROC curve of the training set and test set of the predictive models of the stroke in viscera were 0.799 ［95% CI （0.781， 0.817）］ and 0.805 ［95% CI （0.778， 0.832）］， respectively. The AUC of the predictive model of the training set and the test set were both above 0.7. ConclusionThe model established in this study can conveniently， directly， and accurately predict the hospital mortality risk of patients with stroke. Physicians and other healthcare professionals can use this predictive approach to provide early care planning and clinical interventions for patients with stroke during their hospital stay.

Acute myeloid leukemia is a clonal malignant proliferative disease of myeloid blasts of the hematopoietic system. The leukemia cell population is composed of cells of different stages. Acute myeloid leukemia stem cells are the cells that may cause diseases in immunodeficient animals and can regenerate themselves through continuous transplantation, which causes leukemia. Since more than 96% of leukemia stem cells are in the G0 stage, they may escape the effects of chemical drug stabbing, leading to drug resistance and recurrence of leukemia. Therefore, the key to the treatment of acute myeloid leukemia has always been how to remove leukemia stem cells without damaging hematopoietic stem cells. This review paper addresses the new developments in the immunophenotype of leukemia stem cells and leukemia stem cells-targeting therapy for acute myeloid leukemia.

" Filial piety" is China's traditional culture.It not only educates the offspring to be grateful and to repay good deeds,but more importantly guides people to take up social responsibilities and obligations.However,there are always contradiction dilemmas between loyalty and filial piety in reality.With the change of the times,this kind of contradiction is getting more prominent.Rethinking the choice of " raising the children but not provi-ding for the elderly" or choosing for helplessness,the causes of which include: the development of medical technol-ogy aggravates the contradiction between the ability and the cost of providing for the elderly,the contradiction be-tween the prolongation of the life of the elderly and the limitation of their children's ability to support them; Chi-na's one-child policy for more than 30 years has weakened the support capacity of the offspring; urban develop-ment leads to population migration and challenges family pension; the instability of family structure affects providing for the elderly; social pension is inadequately prepared and so on.To guarantee intergenerational equity and im-prove people's quality of life,it should advocate the scientific view of providing for the elderly,which must respect the elderly's autonomy,improve and promote the assessment and supervision of basic needs such as living will,hospice care,and medical abandonment.Through carrying out relevant research,it should establish a systematic project of good Chinese-style scientific pension and improve the social pension security system.