The Healthy China Strategy launched by China is not only a practical policy, but also an ethical revolution in the field of health. Under the Healthy China Strategy, the health field and its sub-field health care are defined as areas with "public" ethics as the fundamental ethical principles. Reconstructing the health care with "public" ethics should get rid of the health care oriented market lead and technical lead, and return to its "public" nature. In terms of concrete realization, the state and the government need to be the power backing of the "public" ethics of the health and medical care, the reconstructing must be leaded by Chinese Communist Party, and the fundamental realization of the "public" ethics of the health and medical care should take the institutions as the fundamental approach.

Safeguarding biosecurity is an important subject under the rapid development of biotechnology. There are four explicit references to ethical concepts in Biosecurity Law of the People’s Republic of China. This paper interpreted and analyzed Biosecurity Law from three perspectives of ethical stipulation, ethical connotation and institutional construction. By clarifying the ethical content involved in the national Biosecurity Law, explaining the ethical connotation, and putting forward suggestions on the construction of ethical related systems. So as to provide reference for the understanding of the law and promote the protection of national biosecurity.

To review the concept development,characteristics,measurement tools,influencing factors,effects,and cultivation of moral resilience among medical staff at home and abroad.The characteristics of moral resilience of medical staff include personal integrity,adaptability,self-regulation,self-management,and moral efficacy of medical personnel,as well as the relational integrity of the medical team.The influencing factors of medical staff's moral resilience include the support system of the medical team,personal qualities of medical staff,and their understanding of events.Moral resilience can promote the physical and mental health of medical staff,effectively cope with moral injury,reduce occupational fatigue and turnover intention of medical staff,as well as alleviate the moral dilemmas of medical staff.Cultivate moral resilience to enhance the ability of medical staff to resist moral dilemmas.

Moral resilience is the ability to positively respond to moral dilemmas,consisting of firm beliefs,tenacious willpower,harmonious relationships,and a peaceful mind.The Chinese nation is a resilient nation,its excellent traditional Chinese culture is vast and profound,containing extremely rich ideas about moral resilience.For example,"being erudite and determined,eager to ask and thinking closely,and benevolence lies in it"and"if one aspires to pursue benevolence,they will not do evil things".The ancients believed that human resilience could correct moral motives and enable people to overcome difficulties and forge ahead in adversity.The intellectual wisdom of the ancients can provide advice and consultation for cultivating moral resilience today.Therefore,need drawing on traditional culture to strengthen moral resilience.

Objective:To investigate the prognostic value of albumin (ALB), aspartate aminotransferase/alanine aminotransferase ratio (AST/ALT) in patients with acute liver failure (ALF) in hyperacute phase of sepsis which provided the basis for clinical evaluation and prognostic judgment and corresponding treatment options.Methods:A multicenter retrospective cohort study was conducted. Patients with ALF in hyperacute phase of sepsis admitted to Zhoupu Hospital Affiliated to Shanghai Health College, Shanghai Pudong New Area People's Hospital, and Shanghai Oriental Hospital from January 2019 to February 2024 were enrolled. General data such as gender and age of the patients were collected. Lactate dehydrogenase (LDH), liver function indexes [total bilirubin (TBIL), direct bilirubin (DBIL), AST, ALT, AST/ALT, ALB, total protein (TP), globulin (GLB), ALB/GLB ratio (A/G), blood amine, γ-glutamyl transpeptidase (γ-GT)], platelet count (PLT), creatinine, activated partial thromboplastin time (APTT), severity of illness scores [acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), sequential organ failure assessment (SOFA)], serum procalcitonin (PCT), N-terminal pro-brain natriuretic peptide (NT-proBNP), arterial blood lactic acid (Lac) within 24 hours after admission, and whether to use mechanical ventilation, whether to use vasoactive drugs, whether to use artificial liver treatment and prognosis during hospitalization also were collected. The differences of clinical data between patients with different prognosis were compared. The variables with statistically significant differences in univariate analysis were included in multivariate Logistic regression analysis to determine the independent risk factors for death of patients with ALF in hyperacute phase of sepsis during hospitalization. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of ALB and AST/ALT for death of patients with ALF in hyperacute phase of sepsis during hospitalization.Results:A total of 73 patients with ALF in hyperacute phase of sepsis were included, with 22 survived and 51 died during hospitalization and the mortality of 69.86%. Compared with the survival group, the patients in the death group had lower ALB, γ-GT within 24 hours after admission and proportion of artificial liver treatment, and higher AST/ALT, SOFA score, LDH and proportion of use of vasoactive drugs. The differences were statistically significant. Multivariate Logistic regression analysis showed that ALB and AST/ALT were the independent risk factors for death in patients with ALF in hyperacute phase of sepsis during hospitalization [ALB: odds ratio ( OR) = 0.856, 95% confidence interval (95% CI) was 0.736-0.996, P = 0.044; AST/ALT: OR = 2.018, 95% CI was 1.137-3.580, P = 0.016]. ROC curve analysis showed that the area under the curve (AUC) of ALB for predicting in-hospital death in patients with ALF in hyperacute phase of sepsis was 0.760 (95% CI was 0.637-0.884, P < 0.001). When ALB ≤ 29.05 g/L, the sensitivity was 68.2%, and the specificity was 76.5%. The AUC of AST/ALT for predicting in-hospital death in patients with ALF in hyperacute phase of sepsis was 0.764 (95% CI was 0.639-0.888, P < 0.001). When AST/ALT ≥ 1.26, the sensitivity was 59.1%, and the specificity was 90.2%. Conclusions:The lower the ALB level, and the higher the AST/ALT within 24 hours after admission, the worse the prognosis of patients with ALF in hyperacute phase of sepsis. ALB and AST/ALT can be used as clinical indicators to evaluate the severity and prognosis of patients with ALF in hyperacute phase of sepsis.

Due to the specialty of the profession, nursing staff often face more traumatic events in which their self-moral cognition is contrary to the reality, and gradually turn to moral injury on this basis. The level of nursing ethical literacy of nursing staff greatly affects their differences in moral cognition and the strength of moral resilience, thus determining the development and recovery of moral injury. The latest ethical code for nurses, the Expert Consensus on Nursing Ethics for the Prevention and Control of Major Infectious Diseases, has improved the rights and interests of nursing staff. The active practice of this code can help nursing staff effectively respond to the endogenous and exogenous injury sources brought about by the epidemic, eliminate negative moral cognition, improve the moral resilience of nursing staff, as well as has positive effects on the prevention of moral injury for nursing staff.

To strengthen the construction of the doctor-patient community in the context of COVID-19 prevention and control, it is necessary to analyze the components and environmental variables of the doctor-patient relationship model, and propose targeted ways to strengthen it. The constituent elements of the doctor-patient relationship model can be analyzed as medical care group organizations, hospital management organizations, third-party service organizations, patients and patient stakeholders. Environmental variables mainly include education, technology and system. The doctor-patient, doctor-doctor, and patient-patient relationship are included in the doctor-patient relationship model, and each relationship is a combination of both internal and external relationships. Based on the influence of environmental variables on each component in the doctor-patient relationship model, efforts should be made from aspects: emphasizing , medical humanistic literacy and the popularization of medical knowledge, supporting the development of online medical care, simplifying redundant offline medical treatment, and protecting the doctor-patient relationship with policies and regulations.

Medical Ethics is an important course of "establish morality and cultivate people" in medical colleges and universities, which has the dual characteristics of medical humanities and medical practice. The course of medical ethics should conform to the development trend of the times, make full use of the new teaching mode, change the teaching methods, and promote the deep integration of medical humanities course and information technology. As a new teaching mode, immersion teaching can effectively focus on teaching needs, stimulate students’ interest, improve teaching effectiveness, and effectively make up for the shortcomings of the current teaching of medical ethics. This paper aimed to explore the immersion teaching of medical ethics. Firstly, it analyzed the necessity of adopting immersion teaching from two aspects: the characteristics of immersion teaching and the existing problems of medical ethics teaching. Secondly, combined with the current teaching conditions, it put forward two implementation paths and main instructional design of immersive teaching of medical ethics. At the same time, it analyzed the main influencing factors of the realization of immersive teaching of medical ethics from teaching subject and teaching object.

The Healthy China Strategy launched by China is not only a practical policy, but also an ethical revolution in the field of health. Under the Healthy China Strategy, the health field and its sub-field health care are defined as areas with "public" ethics as the fundamental ethical principles. Reconstructing the health care with "public" ethics should get rid of the health care oriented market lead and technical lead, and return to its "public" nature. In terms of concrete realization, the state and the government need to be the power backing of the "public" ethics of the health and medical care, the reconstructing must be leaded by Chinese Communist Party, and the fundamental realization of the "public" ethics of the health and medical care should take the institutions as the fundamental approach.

The previous moral injury theory implied the premise of taking individual as the research object, while there were few studies on collective moral injury. Collective moral injury is defined as a series of consequences of violating widely accepted moral beliefs rather than simply adding up symptoms of injured individuals within a group. From the America "Floyd Case", this paper analyzed the functional elements and generating mechanism of collective moral injury, that was, the diversification of trauma sources events could appear alone or interweave, collective moral resilience showed the characteristics of social integrity and time accumulation, the interaction between collective trauma sources and collective moral resilience determined whether collective moral injury occurs. As the We-Media become popular, collective feature of moral injury is more evident, which presents two new features that the Internet platform becomes a hub for trauma events and the information Internet recorded consolidates collective moral resilience. To deal with collective moral injury, it was needed to respond to social concerns and guidance moral public opinion, respect the original endogenous order and inherit the traditional culture, satisfy reasonable moral needs and enlighten moral sense of people as well.