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 explore the effect of disposable electronic soft mirror and conventional repeatable soft mirror on the renal function and prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)levels in patients with upper ureteral calculi and analyze the factors influencing recurrence after retrograde intrarenal surgery(RIRS).Methods 114 patients with upper ureteral calculi from March 2022 to March 2023 were selected and randomly divided into two groups,with 57 cases forming the observation group and 57 cases forming the control group.The observation group was administrated with RIRS via disposable electronic soft mirror,while the control group accepted RIRS via conventional repeatable soft mirror.The two groups were compared in the aspect of surgical data.Patients'serum renal function indicators[blood urea nitrogen(BUN),creatinine(Cr),cystatin C(CysC)],PGE2 and 5-HT levels were tested preoperative and postoperative 24 h.Postoperative complications and recurrence were compared between the two groups after 6 months follow-up.The patients were grouped according to whether there was recurrence or not.The medical records of recurrence group and non-recurrence group were collected,and the risk factors of recurrence were analyzed statistically.Results There was no sxtatistically significant difference between the observation group and the control group in terms of surgical time,intraoperative bleeding,one-time stone removal rate,and hospital stay(P>0.05).After operation both groups saw much higher levels of BUN,Cr,CysC,PGE2 and 5-HT than they did before the operation(P<0.05),but no significant difference in the aforementioned indicators was seen between the two groups either before or after the operation(P>0.05).The incidence of complications and recurrence rate of the observation group were 3.51%and 15.79%respectively,seeing no big difference from 12.28%and 21.05%of the control group(P>0.05).The body mass index(BMI),postoperative residual calculi and urinary tract infections in the recurrence team were remarkably higher than those in the non recurrence team(P<0.05).The results of multivariate Logistic regression analysis showed that after adjusting for confounding factors such as gender,age,course of disease,maximum diameter of calculi,number of calculi,location of calculi,and surgical method,postoperative residual calculi and postoperative urinary tract infections were independent risk factors for postoperative recurrence of upper ureteral calculi after RIRS(P<0.05).Conclusion Both disposable electronic soft endoscopy and conventional repeatable soft endoscopy can achieve satisfactory results in the treatment of upper ureteral calculi,both can impact the renal function and serum PGE2,5-HT levels in patients to a certain extent,and both present a risk of recurrence after surgery.Residual postoperative calculi and postoperative urinary tract infections are independent risk factors inducing recurrence of upper ureteral calculi after RIRS.

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

Novel model systems have provided powerful tools for the research of human biology. Despite of being widely used, the conventional research models could not precisely describe the human physiological phenomenon. Organoids are three-dimensional multicellular aggregates derived from stem cells or organ progenitors that could differentiate and self-organize to recapitulate some specific functionalities and architectures of their in vivo counterpart organs. Organoids can be used to simulate organogenesis because of their human origin. In addition, the genomic stability of organoids could be well maintained during long-term amplification in vitro. Moreover, organoids can be cryopreserved as a live biobank for high-throughput screening. Combinatorial use of organoids with other emerging technologies (e.g. gene editing, organ-on-a-chip and single-cell RNA sequencing) could overcome the bottlenecks of conventional models and provide valuable information for disease modelling, pharmaceutical research, precision medicine and regenerative medicine at the organ level. This review summarizes the classifications, characteristics, current applications, combined use with other technologies and future prospects of organoids.
Gene Editing ; Humans ; Models, Biological ; Organoids ; Regenerative Medicine ; Stem Cells

Objective To explore the clinical value of precision hepatectomy in primary hepatocellular carcinoma (HCC) with liver cirrhosis.Methods The clinical data of 115 cases of HCC with liver cirrhosis treated in the Second Affiliated Hospital of Chongqing Medical University from January 2015 to October 2017 were retrospectively analyzed,including 94 males and 21 females with an average age of 52.6 years.Based on whether the operation was performed according to the concept of precision hepatectomy,the patients were divided into two groups:the traditional group (49 cases with liver resection in accordance with traditional surgical procedures) and the precision group(66 cases with liver resection in accordance with precise surgical procedures).The follow-up observation by telephone lasted one year after surgery,focusing on postoperative tumor recurrence and survival of the patients.Comparison of operation time,intraoperative blood loss,perioperative blood transfusion rate,total hepatic blood flow block rate,postoperative complication rate,postoperative hospital stay,postoperative pathology and follow-up results were made.Measurement data with normal distribution were expressed as mean ±standard deviation (Mean±SD),and the comparative analysis between the groups was performed by t test;Measurement data with skewed distribution were expressed as M(P25,P75),and comparison between groups was analyzed using Wilcoxon rank sum test.Count data and grade data were analyzed by chi-square test or Fisher exact test.Results In terms of some parameters of the traditional group in the perioperative period,the operation time,intraoperative blood loss,perioperative blood transfusion rate,total hepatic blood flow block rate,postoperative complication rate,postoperative hospital stay were respectively (201.4 ±79.1) min,250(80,500) ml,57.1％ (28/49),71.4％ (35/49),57.1％ (28/49) and (14.3 ± 3.7) d;and those of the precision group were respectively (188.3 ± 59.3) min,200 (50,350) ml,15.2％ (10/66),47.0％ (31/66),27.3％ (18/66) and (8.2 ± 4.4) d,the results in precision group were all significantly better than those in the traditional group.The difference between the two groups was statistically significant (P ＜0.05).In postoperative pathological examination and follow-up observation,results show that:the residual cancer rate of the precision group [1.5％ (1/66)] was significantly lower than that of the traditional group [12.2％ (6/49)] (P ＜ 0.05).As to the cumulative survival rate after surgery,the traditional group was 67.3％ (33/49) and the precision group was 77.3％ (51/66),with the precision group a little higher.But the difference was not statistically significant (P ＞ 0.05).As to the tumor recurrence rate,the traditional group was 63.3％ (31/49) and 28.8％ (19/66) in the precision group.The difference was statistically significant(P ＜ 0.05).Conclusion Precise hepatectomy can effectively reduce the surgical risk of HCC and improve the prognosis of patients with liver cancer,and has good clinical application value.

De novo variants (DNVs) are one of the most significant contributors to severe earlyonset genetic disorders such as autism spectrum disorder, intellectual disability, and other developmental and neuropsychiatric (DNP) disorders. Presently, a plethora of DNVs have been identified using next-generation sequencing, and many efforts have been made to understand their impact at the gene level. However, there has been little exploration of the effects at the isoform level. The brain contains a high level of alternative splicing and regulation, and exhibits a more divergent splicing program than other tissues. Therefore, it is crucial to explore variants at the transcriptional regulation level to better interpret the mechanisms underlying DNP disorders. To facilitate a better usage and improve the isoform-level interpretation of variants, we developed NeuroPsychiatric Mutation Knowledge Base (PsyMuKB). It contains a comprehensive, carefully curated list of DNVs with transcriptional and translational annotations to enable identification of isoformspecific mutations. PsyMuKB allows a flexible search of genes or variants and provides both table-based descriptions and associated visualizations, such as expression, transcript genomic structures, protein interactions, and the mutation sites mapped on the protein structures. It also provides an easy-to-use web interface, allowing users to rapidly visualize the locations and characteristics of mutations and the expression patterns of the impacted genes and isoforms. PsyMuKB thus constitutes a valuable resource for identifying tissue-specific DNVs for further functional studies of related disorders. PsyMuKB is freely accessible at http://psymukb.net.

Objective:To study the expression levels of nuclear factor kappa B, Bcl-2 associated K and TNF-αproteins to discuss the effects of NF-κB and Bak proteins in the pathogenesis of UC.Methods:Eighty clean grade of adult Sprague-Dawley( SD) rats were used,male and female in half and then rando mly selected sixty as the model group,another twenty as the control group.SD rats model were manufactured by a compound method:Trinitrobenzene sulfonic acid ( TNBS )+ethanol.We observed and assessed colonic mucosa by the general morphology and histological changes.To applicated immunohistochemistry and RT-PCR methods to detected the protein and mRNA expression levels of NF-κB,Bak and TNF-αin the model groups and the control group and to analysed their relationships.Results:The successful rate of making model was 97%.The number of inflammatory cells in the model groups more than the control(P<0.01).Group immunohistochemical and RT-PCR,NF-κB and TNF-αproteins and mRNA in UC colon epithelium cells and inflammatory cells were higher than the control(P<0.01).Bak protein in inflammatory cells were lower than the control(P<0.01),but there was no statistical significance in epithelial cells(P>0.05).The expression levels of NF-κB,TNF-αincreased as the histological grade increased(P<0.05),however,the expression level of Bak decreased(P<0.05).NF-κB in colonic mucosa of rats with UC had a significantly positive correlation with that of TNF-α(r=0.892,P<0.01),and negatively correlated with that of Bak(r=-0.793,P<0.01).Conclusion:The levels of NF-κB and Bak may be related to the occurrence and development of UC.

Objective Using evidence-based nursing method to formulate an nursing program for one heat stroke ( HS) with rhabdomyolysis ( RM) and multiple organ dysfunction syndrome ( MODS) patient, who were treated by continuous renal replacement therapy( CRRT) . Methods Based on fully assessing the patients′conditions, the clinical problems were put forward according to PICO principles. The Cochrane library, MEDLINE, PubMed, EBMR inquiry evidence-based medicine databases, National Guideline Clearinghouse, RNAO, CBM, WanFang database, CNKI and Critical Care Medicine Branch of Chinese Medical Association clinical guidelines were retrieved to collect high quality clinical evidence, and then the optimum nursing program was designed in line with patients′conditions and relatives′willingness. Results Ten trials and one application guideline were included. The available clinical evidence displayed that:(1)HS patient with RM should be given CRRT as soon as possible, it could not only reduce core body temperature, but also effectively removed myoglobin and significantly improved renal function; ( 2 ) Femoral vein catheter was the first choice for establishing vascular access;(3)The systemic anticoagulation with un-fractionated heparin should be scheduled for coagulation laboratory examination and closely observed the hemorrhage; ( 4 ) Routine use of intermittent saline flush pipes was not recommended. So finally a nursing plan was made in combination with literature evidence, patients′ condition and relatives′ willingness: we used CRRT early; choose femoral vein catheter;closely observed of hemorrhage and adjusted the dose of heparin according to activated partial thromboplastin time ( APTT) when using systemic anticoagulation with un-fractionated heparin, not used intermittent saline flush pipes. After CRRT and other comprehensive treatment, the patient regained consciousness after seven days. Myoglobin was down to 200 ng/ ml from 1 455 ng/ ml admission, with astable vital signs. Conclusions HS patients with RM should be given CRRT as soon as possible. Femoral vein catheter is the first choice for establishing vascular access. The systemic anticoagulation with un-fractionated heparin should be scheduled for coagulation laboratory examination and closely observed of hemorrhage. Routine use of intermittent saline flush pipes is not recommended.

OBJECTIVETo investigate the correlation between infection with L-form of Helicobacter pylori (Hp-L) and the expressions of macrophage migration inhibition factor (MIF), matrix metalloproteinase 9 (MMP9), and vascular endothelial growth factor (VEGF) in gastric cancer.

METHODSHp-L was examined in 80 gastric carcinoma and 50 adjacent normal tissues by Gram staining and immunohistochemical staining, and the expressions of MIF, MMP9 and VEGF were detected by immunohistochemical staining; the expression of MIF mRNA was detected by RT-PCR and the expression of MIF, MMP9 and VEGF proteins were detected by Western blotting in 30 fresh gastric cancer tissues and the corresponding adjacent tissues.

RESULTSOf the 80 gastric carcinoma tissues, 57 (71.25%) showed Hp-L positivity detected by both Gram staining and immunohistochemical staining, as compared with a rate of only 14% in the adjacent normal tissues (P<0.05). The gastric carcinoma tissues showed higher expression levels of MIF, MMP9 and VEGF proteins than the corresponding adjacent normal mucosa; the positivity MIF, MMP-9 and VEGF proteins were significantly higher in Hp-L-positive gastric carcinoma than in Hp-L-negative cases (P<0.05). Positive correlations were found between Hp-L positivity and the expressions of MIF, MMP-9 and VEGF (r=0.598, 0.292, 0.341, respectively, P<0.05). The 30 fresh gastric cancer tissues showed also significantly higher MIF mRNA expression and MIF, MMP-9 and VEGF protein expressions than the adjacent tissues (t=3.729, P<0.01). The expressions of MIF and MMP-9 were also related to the clinicopathological factors including lymph node metastasis and depth of invasion (P<0.05).

CONCLUSIONInfection with L-form of Hp-L can be an important factor that contributes to the invasion and metastasis of gastric carcinoma, the mechanism of which involves up-regulated expressions of MIF, MMP-9 and VEGF.

Adult ; Aged ; Aged, 80 and over ; Female ; Helicobacter Infections ; metabolism ; pathology ; Helicobacter pylori ; Humans ; L Forms ; Lymphatic Metastasis ; Macrophage Migration-Inhibitory Factors ; metabolism ; Male ; Matrix Metalloproteinase 9 ; metabolism ; Middle Aged ; Stomach Neoplasms ; metabolism ; microbiology ; pathology ; Vascular Endothelial Growth Factor A ; metabolism

Some locally advanced tumors involving multiple abdominal organs without distal metastasis may cause digestive tract obstruction.Some of these patients can achieve long-term survival after Ro resection,others can obtain digestive tract obstruction relief,pain anesis and survival prolongation after R1 resection combined with postoperative comprehensive treatment.In this review,the efficacy of complex pancreaticoduodenectomy combined with organs resection was introduced based on reviewing the literatures.After the surgery,some patients achieved R0 resection and long-term survival,and the quality of life was significantly improved in some patients.