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.

Objective:To analyze the correlation between the grouping and weighting of two sets of disease combination systems, namely diagnosis-related groups(DRG) and diagnosis-intervention packet(DIP), and to establish a multidimensional analysis and evaluation mode by applying DRG, DIP, and clinical pathway to guide the standardized diagnosis and treatment and management of disease types.Methods:DRG grouping and DIP simulation full enrollment were applied to patients discharged from a tertiary Grade A general hospital in 2019. The correlation analysis between DRG, DIP, and clinical pathway inclusion(entry), correlation analysis between relative weight of DRG group and DIP standard score, and correlation analysis between clinical pathway entry and cost structure of the two disease groups were conducted by using chi-square test, Pearson correlation analysis, t-test, structural change value, degree of structural change, and incremental contribution rate. Results:Among the 130 395 patients, 41 460 cases entered the clinical pathway, 127 535 cases were enrolled in DRG, and 104 227 cases were enrolled in DIP. There was a correlation between the enrollment of DRG, DIP, and clinical pathway( P<0.05), and there was also a correlation between the relative weight of DRG groups and the enrollment of clinical pathway. The relative weight of the DRG disease group was positively correlated with the DIP standard score( r2=0.761 7, P<0.001). There was a significant difference in hospitalization costs between patients with and without clinical pathway access for some diseases( P<0.05), and different cost categories had different impacts on the total costs. Conclusions:The weight assignment and value orientation of DRG and DIP disease types are consistent, and the multi-dimensional fusion evaluation mode for DRG-DIP-clinical pathway is feasible. The correlation analysis of DRG, DIP, and clinical pathways can serve as the basis for disease classification and cost structure evaluation, which could help to carry out hospital′s refined management and optimize disease structure.

BackgroundThe existing tools in China for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint do not sufficiently consider the specialty in psychiatric practice， and the scale items are somewhat cumbersome to use， which together restrict their further promotion and application. Accordingly， there is an urgent need for developing a more scientific assessment tool. ObjectiveTo construct a scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint and to verify its reliability and validity， so as to provide a generic tool for the assessment. MethodsBased on the theoretical framework of the knowledge-attitude-practice model， the preliminary scale was formed through systematic literature review， qualitative interview and Delphi method. From July to December 2021， a stratified sampling was utilized to select 729 psychiatric nurses from tertiary， secondary and primary （including unclassified medical institutions and grassroots hospitals） psychiatric hospitals in Guangdong Province. The formal scale was developed through item analysis， exploratory factor analysis and confirmatory factor analysis. The validity of the scale was evaluated by content validity and structure validity， and the reliability was verified by procedures including Cronbach's α coefficient， test-retest reliability， and split-half reliability. ResultsA total of 12 items of three dimensions （knowledge， attitude， practice） were included in the scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. The scale-level content validity index （S-CVI） was 0.941， and the item-level content validity index （I-CVI） ranged from 0.812 to 1.000. Exploratory factor analysis extracted three common factors， and the cumulative variance contribution rate was 62.948%. The confirmatory factor yielded adequate fit. Cronbach's α coefficient was found to be 0.887 for the scale， 0.819 for knowledge dimension， 0.842 for attitude dimension， and 0.831 for practice dimension. The split-half reliability and test-retest reliability for the scale were 0.712 and 0.922， respectively. ConclusionThe scale shows satisfactory reliability and validity， which can be used to assess psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. ［Funded by Guangdong Clinical Teaching Base Teaching Reform Research Project （number， 2021JD119）］

Objective To explore the diagnostic value of magnetic resonance imaging(MRI)and high-frequency ultrasound for synovitis of the hip in children(SHC).Methods A total of 107 children suffering from hip pain were enrolled and underwent MRI and ultrasound examinations.The value of MRI and ultrasound for diagnosing SHC and identifying different types of SHC was analyzed.Results The result consistency between high-frequency ultrasound and clinical diagnosis was higher than that between MRI and clinical diagnosis(Kappa:0.717 vs 0.586).The AUC of the combined detection for diagnosing SHC was greater than that of MRI(0.844 vs 0.812,P<0.05).For the differential diagnosis of different types of SHC,the result consistency between high-frequency ultrasound and clinical diagnosis was higher than that between MRI and clinical diagnosis(Kappa:0.813 vs 0.630).The AUC of high-frequency ultrasound and the combined detection for differentiation between joint swelling type and joint effusion type of SHC was 0.903 and 0.912,higher than 0.815 of MRI(P<0.05).The detection rates of joint space abnormality,joint effusion,joint swelling and joint cartilage changes were 92.45%(49/53),73.91%(17/23),90.70%(39/43),and 77.78%(14/18)when using MRI,and those were 96.23%(51/53),91.30%(21/23),95.35%(41/43),and 88.89%(16/18)when using high-frequency ultrasound.There was no significant difference in the detection rates of pathological changes such as joint space abnormality between the two methods(P>0.05).Conclusion The combined detection of MRI and high-frequency ultrasound has high diagnostic value for SHC.

Objective This study aims to establish a stable and efficient nursing information system in the context of smart hospital development.Methods Leveraging the hospital's health information exchange(HIE)platform,we optimized data collection strategies.Focusing on"patient's admission,transfer,and discharge",we analyzed nursing tasks at each link and created a comprehensive management task list based on the timeline.Key nursing steps incorporated intelligent assistive reminders and decision-making functions.The upgraded system was evaluated by comparing pre-and post-upgrade metrics:structured rates of documentation,daily time spent on the document entry,timeliness of rounds,rate of timely medication administration,and nursing satisfaction.Results The nursing documentation became highly structured and configurable,with daily documentation time reduced by approximately 1.16 hours.There were significant improvements in the timeliness of rounds and the rate of timely medication administration,alongside high nursing satisfaction.Conclusion The task-oriented nursing pattern can enhance nurs-ing efficiency and safety,facilitating a shift in the nursing model.

Decellularized matrix transplantation has emerged as a promising therapeutic approach for repairing tissue defects, with numerous studies assessing its safety and efficacy in both animal models and clinical settings. The host immune response elicited by decellularized matrix grafts of natural biological origin plays a crucial role in determining the success of tissue repair, influenced by matrix heterogeneity and the inflammatory microenvironment of the wound. However, the specific immunologic mechanisms underlying the interaction between decellularized matrix grafts and the host immune system remain elusive. This article reviews the sources of decellularized matrices, available decellularization techniques, and residual immunogenic components. It focuses on the host immune response following decellularized matrix transplantation, with emphasis on the key mechanisms of Toll-like receptor, T-cell receptor, and TGF-β/SMAD signaling in the stages of post-transplantation immunorecognition, immunomodulation, and tissue repair, respectively. Furthermore, it highlights the innovative roles of TLR10 and miR-29a-3p in improving transplantation outcomes. An in-depth understanding of the molecular mechanisms underlying the host immune response after decellularized matrix transplantation provides new directions for the repair of tissue defects.

Objective:To investigate the correlation between serum lipoprotein (a) [LP(a)] and the severity of white matter hyperintensities (WMHs) in the middle-aged and elderly people in the community.Methods:Consecutive middle-aged and elderly residents residing in the community underwent physical examinations in the Affiliated Jiangning Hospital of Nanjing Medical University from June 2016 to August 2021 were retrospectively collected. Fasting venous blood was collected on the next day of admission to detect the level of Lp(a). During hospitalization, cranial MRI examination was performed and the severity of WMHs was graded using the Fazekas visual scoring method. Ordinal multivariate logistic regression analysis was used to determine independent related factors for the severity of WMHs.Results:A total of 1 752 patients were included in the analysis. There were 969 males (55.31%) and 783 females (44.69%). Their age was 66.18±10.32 years old. There were 1 167 patients (66.61%) in the mild WMHs group, 407 (23.23%) in the moderate WMHs group, and 178 (10.16%) in the severe WMHs group. Ordinal multivariable logistic regression analysis showed that after adjusting for confounding factors, a higher serum Lp(a) level was independently related to the severity of WMHs (with the first quartile as a reference, the third quartile: odds ratio 1.441, 95% confidence interval 1.050-1.976, P=0.023; the fourth quartile: odds ratio 1.717, 95% confidence interval 1.252-2.354, P=0.001). Conclusion:Serum Lp(a) is independently correlated with the severity of WMHs.

The psychological health problems of the disabled elderly in China are closely related to physical diseases. Through combing the opening of psychological care services in the pilot cities of long-term care insurance in China, it is revealed that the current pilot cities do not pay much attention to psychological nursing services, the evaluation of psychological nursing needs is absent, and the implementation regulations of psychological nursing services are not perfect. Pilot cities should strengthen psychological care services for the disabled elderly; develop an evaluation system compatible with psychological care services; improve and implement psychological care services; developing information systems that match the needs of psychological care services to ensure the linkage of data in the transition between long-term care and medical needs; and the clients and service providers should cooperate to jointly promote the sustainable development of long-term care insurance psychological care services.

【Objective:】 To investigate the construction status of biomedical research ethics committee involving human beings in medical institutions in Guangzhou, and to provide the basis for the standardized management of ethics committee. 【Methods:】 The convenience sampling method was conducted to investigate the construction status of biomedical research ethics committee involving human beings in 58 medical institutions in Guangzhou. The SPSS 21.0 statistical software was used to analyze the data, and the chi-square test was used for difference analysis. 【Results:】 58 medical institutions had set up biomedical research ethics committee involving human beings. 50.00% of the ethics committees hired full-time secretaries, 33.96% of the ethics offices were administratively independent, 52.83% of the ethics offices were equipped with full-time staff, 79.17% of the ethics committees submitted paper documents for review, and 48.61% of ethics committees organized training irregularly. Comparison of the management of ethics committees of drug clinical trials and non-drug clinical trials was statistically significant (P<0.05). 【Conclusion:】 The management of ethics committee is generally good, but the standardization construction still needs to be further strengthened. It is recommended to strengthen the discipline construction and informatization construction of ethics committee, standardize the special training of ethics, improve the supervision systems of ethics committee, unify the construction standards of ethics committee, so as to improve the ability of ethics review, and effectively protect the safety, rights and interests of subjects.

Objective:To understand the iodine content of edible salt in residents of Xinjiang Production and Construction Corps (referred to as Corps), and provide scientific evidence for prevention and treatment of iodine deficiency disorders.Methods:According to the requirements of the "National Iodine Deficiency Disorders Surveillance Program" form 2015 to 2019, in accordance with the principle of random sampling, one regiment from each of the five directions of east, west, south, north and center in the Corps was selected, and four companies were selected from each regiment. Edible salt samples from the homes of 15 residents in each company were collected, and salt iodine content was quantitatively tested and the test results were analyzed.Results:From 2015 to 2019, 21 028 household salt samples were collected, qualified iodized salt were 20 204, non-qualified iodized salt were 712, non-iodized salt were 112, iodized salt coverage rate was 99.47% (20 916/21 028), iodized salt qualified rate was 96.60% (20 204/20 916), qualified iodized salt consumption rate was 96.08% (20 204/21 028). The average salt iodine content was (27.72 ± 4.81) mg/kg. From 2015 to 2019, the iodized salt coverage rates in the whole Corps were all > 95%, and the iodized salt qualified rates and the qualified iodized salt consumption rate were all > 90%. Among the 14 divisions of the Corps, iodized salt coverage rates were all > 95%, except for the 12th and 14th divisions, where the iodized salt qualified rates and qualified iodized salt consumption rates were < 90%, all other divisions were > 90%.Conclusions:Iodized salt coverage rate, iodized salt qualified rate and qualified iodized salt consumption rate have all reached the national standard for eliminating iodine deficiency disorders from 2015 to 2019, however, non-iodized salt exists in some areas, and the qualified iodized salt consumption rate is low. We should strengthen monitoring of iodized salt in key areas and promote health education, consolidate and maintain achievements in eliminating iodine deficiency disorders.