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 compare the association of the incidence and mortality of leukemia and the human development index(HDI)in different countries or regions in 2022,and the trend of leukemia incidence and mortality with age in countries with different HDI levels.Methods GLOBOCAN 2022 data related to leukemia incidence and mortality in different countries or regions worldwide and HDI were evaluated by Pearson correlation analysis and Kruskal-Wallis test.The incidence and mortality rates of each age and the age change trend were analyzed using the Joinpoint Regression model.Results Age-standardized incidence rate(ASIR),age-standardized mortality rate(ASMR),and mortality to incidence ratio(M/I)were statistically significantly different among the four groups of HDI countries(P<0.001).HDI was positively correlated with ASIR and ASMR and negatively correlated with M/I.Among all ages,ASIR and ASMR of leukemia of the four groups had similar trends with age,and the risk of leukemia was high at ages less than 15 and more than 40.The incidence of leukemia in all age groups in China differed from those in other countries with high HDI,while the mortality rate was lower than those in other countries with high HDI.Conclusion Countries or regions with higher HDI have higher ASIR and ASMR and lower M/I because of their better medical condition.

Humans ; Staphylococcus lugdunensis/genetics* ; Peptides, Cyclic ; Chromosomes ; Operon/genetics* ; Staphylococcal Infections/genetics* ; Bacterial Proteins/genetics* ; Anti-Bacterial Agents

Objective:To explores the relationship between self-efficacy and marital adjustment in infertile couples based on Actor-Partner Interdependence Model (APIM) .Methods:This study was a cross-sectional survey. A total of 310 infertile couples who underwent in vitro fertilization-embryo transfer cycle treatment in Reproductive Center of Peking University Third Hospital from January to April 2022 were selected as the research objects by the convenient sampling method. General Self-Efficacy Scale and Locke-Wallace Marital Adjustment Test were used to investigate. The relationship between self-efficacy and marital adjustment of infertile couples was analyzed by Pearson correlation analysis and APIM. A total of 310 groups of questionnaires were distributed (1 group was 1 couple) , and 293 groups of effective questionnaires were collected, with an effective recovery rate of 94.5%. Results:The self-efficacy scores of infertile couples were (25.08±5.54) for wives and (27.08±5.35) for husbands, and the self-efficacy scores of wives were lower than those of husbands ( P<0.01) . In the score of marital adjustment, the wives scored (109.39±23.13) and the husbands scored (111.99±20.87) . The APIM analysis results show that in terms of subjective effects, the self-efficacy of both infertile couples could affect their own marital adjustment (β=0.166, 0.408; P<0.01) . In terms of object effects, the husbands' self-efficacy could affect the wives' marital adjustment (β=0.117, P<0.05) . Conclusions:The self-efficacy of infertile couples undergoing in vitro fertilization-embryo transfer cycle treatment is at the middle level, and the marriage adjustment is generally good. The self-efficacy of couples is closely related to their own marital adjustment, and the self-efficacy of husbands can also positively affect the wifes' marital adjustment. In clinical work, infertile couples should be regarded as a whole, focusing on the binary interaction between both parties, and developing targeted measures to help infertile couples improve their self-efficacy, thereby improving marital adjustment, improving health outcomes, and stabilizing family relationships.

Malignant tumors can be classified into three categories， rapidly progressing tumors， slowly progressing tumors， and "indolent" tumors. Rapidly progressing tumors （such as liver cancer， pancreatic cancer， and cholangiocarcinoma） have acute onset， shorter time duration from onset to death， and poorer treatment effects， which warrants primary prevention. Slowly progressing tumors （such as lung cancer， colorectal cancer， breast cancer， and gastric cancer） have slow onset， clear precancerous lesions， longer time duration from onset to death， and better therapeutic effects， which is accordingly suitable for secondary prevention. “Indolent” tumors （such as prostate and thyroid cancer） do not affect the life expectancy and are suitable for tertiary prevention. Early screening of “indolent” tumors may lead to overtreatment. Furthermore， early screening of rapidly progressing tumors is difficult to identify early cancers， which results in low cost-effectiveness. In contrast， for slowly progressing tumors suitable for secondary prevention， early screening may have cost-effectiveness， though there might be over-diagnosis. It is crucial to adopt appropriate prevention and treatment strategies for diverse types of tumors. Currently， large-scale cohort studies and randomized controlled clinical trials with complete follow-up may accurately evaluate the effect of cancer prevention strategies. This review discusses the significance of screening in precision prevention of tumors based on the characteristics of tumor progression and patients’ prognosis.

Objective:To investigate the clinical characteristics and the risk of major adverse cardiac events within 1 year of middle-aged and elderly in-patients with acute decompensated and mid-range ejection fraction heart failure(HF)in the medical alliance setting.Methods:A retrospective cohort study was conducted among a total of 180 in-patients with acute decompensated heart failure in Cardiovascular Hexi Hospital Consulting Area of Tianjin Chest Hospital.According to ejection fraction measured by echocardiogram, the in-patients were classified into three groups: heart failure with reduced ejection fraction(HFrEF)group(n=70, 38.9%), HFmEF group(n=50, 27.8%), and heart failure with preserved ejection fraction(HFpEF)group(n=60, 33.3%). Clinical feature and 1-year prognosis between different groups were compared.Results:Univariate Cox regression analysis of 1-year all-cause death and cardiovascular death showed that there was no significant difference between HFrEF group and HFmEF group, HFpEF group and HFmEF group(all P>0.05); 1-year readmission analysis of heart failure showed that 47.1%(33 cases)of HFrEF group was higher than 24.0%(12 cases)of HFmEF group, 48.3%(29 cases)of HFpEF group was higher than HFmEF group( HR=2.307, 2.368, 95% CI: 0.187-4.480, 1.207-4.644, respectively, all P<0.05); The major 1-year cardiovascular events were 57.1%(40 cases)higher in the HFrEF group than 34.0%(17 cases)in the HFmEF group( HR=2.053, 95% CI: 0.187-4.408, P< 0.05). Multivariate analysis showed that the 1-year risk of major cardiovascular events was significantly different between HFmEF group and HFpEF group( HR=0.477, 95% CI: 0.241-0.941, P< 0.05). Pulmonary heart disease( P< 0.05), atrial flutter and/or atrial fibrillation( P< 0.01), New York Cardiology class Ⅳ( P< 0.01)were risk factors for death.Hypertension and cor pulmonale were the risk factors for readmission in patients with heart failure(all P< 0.01). Conclusions:The clinical characteristics of inpatients with HFmEF in the medical alliance setting tended to be consistent with those with HFrEF, while the feature of ischemic heart disease was more prominent in HFmEF.The 1-year risk of heart failure readmission in HFmEF group was significantly lower than that in HFpEF and HFrEF group, and the risk of all-cause mortality and cardiovascular mortality at 1 year was not significantly different among the three groups.

Non-Hodgkin lymphoma （NHL） is a malignant tumor that occurs in immune cells， including B， T and NK cells. Viral infection， such as infection with Epstein-Barr virus （EBV） and hepatitis virus， plays an important role in the development of NHL. The role and mechanism of hepatitis B virus （HBV） infection in the development and progression of hepatocellular carcinoma through gene integration， mutation， and viral replication have been researched in depth. Mutations induced by apolioprotein B mRNA-editing enzyme catalytic polypeptide （APOBEC） family members are one of the major sources of HBV and host genetic variation， and APOBEC family members act as bridges between HBV-related chronic inflammation and the mutations of HBV and its host genome. Therefore， we suspect that HBV infection plays a significant role in the occurrence of HBV-associated NHL. This review summarizes the role and mechanism of HBV in the occurrence and development of NHL from the aspects of HBV infection， chronic inflammation and immunity， viral variation， signaling pathways， high-frequency mutant genes and epigenetic modification， hoping to provide a theoretical basis for HBV-associated NHL research.

Objective:To evaluate the efficacy and safety of focused radiofrequency in facial wrinkle and laxity.Methods:Seventeen female patients (47.71±1.56 years of age) were involved in our study during January to June 2018, treated with focused radiofrequency on the whole face. The treatments were performed monthly for three consecutive months. Their photographs were taken before treatment and one week after the last treatment, and then the wrinkle severity rating scale (WSRS) and global aesthetic improvement scale (GAIS) were evaulated.Results:After three times＇ treatment, the wrinkle was improved, WSRS of 1 week after the last treatment (2.71±0.47) was much lower than the baseline (3.00±0.79) ( P<0.05). 88.24% patients were satisfied with the improvement. There was no severe adverse effects during this whole procedure. Conclusions:Focused radiofrequency therapy for facial wrinkle and laxity is effective and safe.

Objective To explore the application of the standard of Chinese lymph node dissection in minimally invasive esophagectomy.Methods Methods Between April 2014 to September 2015,63 patients with esophageal carcinoma received minimally invasive esophagectomy by the same group of surgeons.Wedescribed in detail the methods of thoracic esophagus mobilization and lymph node dissection in the peri-esophageal space.We analyzed the surgical effect,postoperative complications and follow-up results.Resnits The average operation time was(280.48 ± 44.28) mins,the median intraoperative blood loss was 100 ml,the mean number of lymph nodes was 22.25-± 11.18;the incidence of postoperative pulmonary infection in 28.57％,hoarseness was 17.46％,anastomotic leakage was 12.70％,postoperative 1 year survival rate was 84.1％,3 year survival rate of 61.1％.Conclusion Mobilization of thoracic esophagus based on peri-esophageal space and dissection lymph nodes guided by the Chinese standard of grouping lymph node would achieve good clinical effects.

OBJECTIVETo evaluate the ovarian response and pregnancy outcomes in patients with excessive ovarian response receiving long-protocol pituitary down-regulation during repeated in vitro fertilization and embryo transfer (IVF-ET).

METHODSSixty IVF-ET cycles from January 2008 to December 2011 were analyzed retrospectively. The clinical characteristics were compared between the various treatment cycles.

RESULTSCompared with those with the first treatment cycle, the patients receiving repeated cycles had a significantly older age (P<0.001), reduced initial doses of Gn (P=0.049), and moderately lowered estrogen level on the day of hCG administration (E₂) (P=0.027) and the number of oocytes retrieved (P=0.030). The high-quality embryo formation rate (P<0.001) and clinical pregnancy rate (P=0.009) were both significantly higher in patients with repeated cycles. The dose for down-regulation, total Gn dose, duration of Gn stimulation, number of two pronuclei (PN), number of fertilized oocyte, and the cancellation rate for a high risk of ovarian hyperstimulation syndrome (OHSS) were all comparable between the two groups (P>0.05). The recurrence rate of ovarian excessive respond was 40% (12/30).

CONCLUSIONSFor patients receiving repeated IVF treatment cycle with a high ovarian response, a smaller initial dose of Gn should be used to minimize the risk of hyper-response and improve the outcome of assisted reproductive treatment.

Down-Regulation ; Embryo Transfer ; Female ; Fertilization in Vitro ; Gonadotropins ; therapeutic use ; Humans ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Risk Factors