Economic development drives the increase of endogenous demand,and Internet medicine integrates regional medical resources,expanding the fairness of the public's access to medical and health services.However,it is also accompanied an ethical crisis with the development of technology,which requires continuous standardization and practice.Starting from the principle of medical fairness,this paper sorted out the main advantaged characteristics of the development of Internet medicine from the aspects of data fairness,cost equity,opportunity equity,and educational equity.The existing ethical problems of Internet medicine were explored including unfair protection of ethical review mechanisms,unfair data collection of scientific and technological subjects,unfair distribution of benefits and risks,and unfair utilization of Internet medical resources.It also proposed the governance paths of compacting the subject responsibility,perfecting review and supervision,improving the sharing mechanism,bridging the digital divide,strengthening risk prevention,protecting the citizens'rights and interests,strengthening education and guidance,and increasing grassroots investment.

Objective:This study aimed to analyze the focuses and shortcomings of the current medical achievements transformation policy, and to put forward references and suggestions for the subsequent formulation of medical science and technology innovation achievement transformation policy.Methods:46 policy texts were retrieved from Peking University Magic Treasure, Law Star, and other related websites of the State Council, the National Health Commission, the State Administration of Traditional Chinese Medicine, and other relevant ministries and commissions, and the policy clauses were systematically quantitatively analyzed from three dimensions of supply, demand, and environment using policy tool theory.Results:The number of policy documents issued from 2015 to 2022 showed a fluctuating increase. There were 25 normative policies, accounting for 54.3%, and 21 guiding and operational policies, accounting for 45.7%. Environmental policies accounted for 74.9%, while demand-oriented policies accounted for 3.1% among the 587 codes.Conclusions:It is suggested to reduce the dependence on environment-based policy tools, optimize the distribution structure of sub-categories such as tax incentives and financial support, strengthen the support of supply-based policy tools to promote the high-quality development of the transformation of medical scientific and technological achievements, increase the driving role of demand-based policies to enhance the appropriate allocation of clinical demand, further optimize the policy system for the transformation of medical scientific and technological achievements, and strengthen the supporting measures of relevant special policies.

Objective:This study focused on the importance of mutual recognition of medical ethics review and the necessity of collaborative governance, combining with the current situation of mutual recognition of medical ethics review in China, and analyzing the difficulties in promoting mutual recognition of review and exploring improvement strategies.Methods:A literature research method was used to sort, summarize, refine and conclude the findings of the literature related to mutual recognition of medical ethics review.Results:Challenges persisted in the mutual recognition of medical ethics review in China, including inadequate impetus for mutual recognition among medical institutions, insufficient system and organizational support, limited acknowledgment of the audit unit's review capacity, and a lack of coordination and cooperation mechanisms.Conclusions:Implementing effective measures in benefit coordination, system and organization coordination, ability coordination, and platform coordination will facilitate the mutual recognition of medical ethics review.

Objective:To study the characteristics and patterns of medical research integrity cases reported by the Ministry of Science and Technology, and to explore the countermeasures to strengthen the management of medical research integrity.Methods:20 batches of 555 cases of scientific research integrity cases publicly reported by the Ministry of Science and Technology of the People's Republic of China from June 2021 to May 2022 were taken as the research objects, and the papers involved, regional distribution, scientific research dishonesty and disciplinary measures were classified and analyzed.Results:Data falsification was the most common problem of scientific research dishonesty, accounting for 47.39%. Shandong Province was the province with the most reported cases, accounting for 50.81%. 27.67% of the corresponding authors received 5 disciplinary measures, and 26.28% of the first authors received 6 disciplinary measures. Among the disciplinary measures, the proportion of suspension of applications for various scientific research projects was the highest, with 87.60% of corresponding authors and 91.42% of first authors receiving this punishment. The corresponing authors with 5 years suspension accounted for 49.24% of all years, and the first authors accounted for 57.48%.Conclusions:To promote the integrity governance of medical research, we should strengthen the supervision of medical journals, promote regional exchanges, encourage active error correction, and improve the construction of scientific research integrity database.

Objective:To explore the implementation path of scientific and technological achievement empowerment for researchers in public hospitals.Methods:Through literature research, theoretical research, policy research, etc, current situation and progress of the ownership management reform of scientific and technological achievements at home and abroad were sorted out, and the difficult problems in the empowerment of scientific and technological achievements were summarized in combination with its practice in domestic public hospitals.Results:The following problems existed in the empowerment of scientific and technological achievements in public hospitals: weak awareness of medical staff′s ownership protection imperfect empowerment system, lagging construction of management personnel, and constraints of state-owned assets management.Conclusions:It is suggested to improve the coordination mechanism of government departments, optimize related policy and law environment and innovation atmosphere, implement a categorized and tiered empowerment strategy for job scientific and technological achievements, set up a management platform of medical scientific and technological achievements, build a complete support service system, establish a mechanism for cultivating and producing high-value achievements, and strengthen the construction of achievement management personnel.

Objective:To review the concept of science and technology ethics, analyze the problems faced by science and technology ethics governance from the perspective of collaborative governance, and then propose suggestions.Methods:Using the literature review method, we searched and screened relevant literature on science and technology ethics governance, extracted the research content and results of such literature for systematically review and summarization.Results:The problems of China′s science and technology ethics governance include slow legalization progress, unclear disciplinary standards, unsound governance systems, and weak scientific and technological ethics awareness among researchers.Conclusions:Strengthening the governance of science and technology ethics requires a multi-level approach, including strengthening the legislation of science and technology ethics, improving the governance mechanism, and improving the awareness of science and technology ethics among the scientists and technologists.

As an important measure starting for hospital management, hospital accreditation can effectively guide hospitals to improve their comprehensive service capabilities and management level. The accreditation results of 38 tertiary general hospitals in Jiangsu province from 2018 to 2020 showed that there were weaknesses existing in the development of hospitals, including the radiosity and influence of tertiary hospitals, patient service mode, construction of medical technology capabilities and disciplines, medical quality and safety, nursing quality management and specialized nursing, and information construction. The author suggested that hospitals should return to functional positioning, improve the service quality, strengthen construction of hospital disciplines and technical projects, consolidate the foundation of quality and safety management, improve the level of information technology construction, for references for promoting the high-quality sustainable development of tertiary general hospitals.

Objective:To observe the effect of ventilator-induced lung injury (VILI) on blood-brain barrier permeability in rats.Methods:Forty-eight healthy clean male Sprague-Dawley (SD) rats were randomly divided into sham operation (Sham) group, low tidal volume (LVT) mechanical ventilation group (LVT group), normal tidal volume (NVT) mechanical ventilation group (NVT group) and high tidal volume (HVT) mechanical ventilation group (HVT group) with 12 rats in each group. After anesthesia, rats in the Sham group were intubated and kept spontaneous breathing. The rats in different tidal volume (VT) groups were mechanically ventilated by endotracheal intubation with VT of 6 mL/kg (LVT group), 10 mL/kg (NVT group), and 20 mL/kg (HVT group), respectively. The inspiration-expiration ratio of the three groups was 1∶1, the ventilation frequency was 40 times/min, and the ventilation time was 3 hours. At the end of the experiment, the bronchoalveolar lavage fluid (BALF) of rats was collected, and the levels of pro-inflammatory factors [tumor necrosis factor-α (TNF-α), interleukins (IL-1β and IL-6)] in BALF were detected by enzyme-linked immunosorbent assay (ELISA). The lung tissues of rats were collected, and the lung wet/dry weight (W/D) ratio was calculated. The pathological changes of lung tissues were observed under light microscopy after hematoxylin-eosin (HE) staining, and lung injury scores were performed. The brain tissue of rats was taken to measure the brain water content, and the Evans blue (EB) content of brain tissue was measured to reflect the permeability of the blood-brain barrier. The tight junction proteins in the brain tissues were detected by Western blotting.Results:After 3 hours of mechanical ventilation, with the increase of VT, the degree of lung injury in VILI rats gradually increased. When VT reached 20 mL/kg, lung tissue structure was significantly injured, alveolar wall edema, alveolar congestion, lung interstitial thickening, a large number of inflammatory cells infiltrated, and the lung injury score, lung W/D ratio, and the levels of TNF-α, IL-1β and IL-6 in BALF were significantly higher than those in the Sham group [lung injury score: 10.6±1.1 vs. 1.4±1.0, lung W/D ratio: 6.6±0.8 vs. 3.7±0.6, TNF-α(ng/L): 832.9±97.9 vs. 103.8±23.3, IL-1β (ng/L): 68.9±14.1 vs. 15.7±2.6, IL-6 (ng/L): 70.8±16.4 vs. 20.3±5.4, all P < 0.05]. Lung injury in rats was accompanied by aggravating brain injury. When VT reached 20 mL/kg, brain water content and EB content in brain tissue were significantly higher than those in the Sham group [brain water content: (85.4±3.6)% vs. (68.7±2.7)%, EB content in brain tissue (μg/g): 887±78 vs. 97±14, both P < 0.05], and the protein expressions of claudin-5, occluding and zonula occluden-1 (ZO-1) in the brain tissue were significantly lower than those in the Sham group [claudin-5 protein (claudin-5/β-actin): 0.67±0.12 vs. 1.45±0.19, occludin protein (occludin/β-actin): 0.48±0.11 vs. 0.99±0.21, ZO-1 protein (ZO-1/β-actin): 0.13±0.03 vs. 0.63±0.12, all P < 0.05]. Conclusion:VILI can induce brain edema and increase blood-brain barrier permeability in rats, which may be related to the down-regulation of tight junction protein expression in the brain tissue.

ObjectiveTo screen and validate key enzyme genes affecting the polysaccharide content in different Polygonatum species and perform in-depth amino acid sequence analysis by transcriptomic analysis of P. zanlanscianense， P. kingianum， and P. cyrtonema rhizomes to enrich the transcriptome data of Polygonatum plants and provide references for polysaccharide biosynthesis mechanism and genetic improvement. MethodThe Polygonatum transcriptome was sequenced and analyzed using the Illumina NovaSeq high-throughput sequencing platform， and the differences in the transcriptomes of the three Polygonatum species were compared and according to the annotations of Nr， Gene Ontology （GO）， and Kyoto Encyclopedia of Genes and Genomes （KEGG） databases. The key enzymes in the polysaccharide metabolism pathway were screened， and the expression of key enzyme genes was clustered and correlated with the polysaccharide content. Finally， Real-time polymerase chain reaction （Real-time PCR） was performed to validate the eight key enzyme genes， and the key genes of polysaccharide biosynthesis were further screened for homologous gene sequence analysis in combination with sequencing results， followed by constructing phylogenetic trees， predicting motifs， conserved structural domains， protein sequence isoelectric points， and molecular weights， and constructing 3D protein structures by using homology modeling method. ResultThe annotation of the Nr database revealed that three Polygonatum species had the highest gene homology with Asparagus officinalis. GO database annotation results showed that three Polygonatum species differed significantly in binding， catalytic activity， metabolic processes， and cellular components， while the KEGG pathway annotation results indicated that three Polygonatum species differed significantly in the starch and sucrose metabolic pathway and galactose metabolic pathway. According to clustering analysis， correlation analysis， Real-time PCR， expression profiles， and structural and functional predictions of amino acid sequences， the key enzyme significantly affecting the polysaccharide content in different Polygonatum species was inferred to be β-fructofuranosidase （sacA）. ConclusionSacA may be the main influencing factor for the difference in polysaccharide content of Polygonatum， and is also an important reason why Polygonatum polysaccharides are mainly fructans.

Objective:Through text mining, to clarify the change characteristics and evolution patterns of China's scientific research integrity policies, thereby providing a reference basis for the formulation and implementation of medical scientific research integrity governance policies.Methods:Using cost-CM6 and SPSS software, co-word analysis, social semantic network, and cluster analysis methods, data mining was conducted on 297 national scientific research integrity policy texts from 2002 to 2021.Results:China′s research integrity policies have experienced three development stages: academic ethics construction period(2002-2008), research integrity construction period(2009-2015), and academic environment optimization period(2016-2021), with the rapid development of both quantity and quality of policies, gradual clarification of rules for investigation and handling of research integrity cases, continuous improvement of accountability mechanism, and more powerful disciplinary measures for dishonesty. The construction of scientific research integrity formed a joint force pattern under the leadership of the central government and coordinated governance of multiple departments. Research misconduct incidents and public concern accelerated the improvement of the scientific research credibility policy system. Adhere to" no exclusion zone, full coverage, zero tolerance" has become the work guide of scientific research integrity governance.Conclusions:It is suggested to continuously improve the effectiveness of medical research integrity governance by strengthening medical integrity education and enhancing self-discipline consciousness, improving supervision mechanisms, strengthening process management and plagiarism checking of medical achievements, and adopting a two-pronged approach of " severe punishment" and " good governance" .