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【Objective:】 The data of the literature of the research progress on the assisted reproductive technology (ART) ethical issues in China in the past two decades were summarized to explore the research hotspots and frontiers of ethical issues in this field. 【Methods:】 The relevant literature records of China National Knowledge Infrastructure (CNKI) were retrieved from January 1, 2002 to October 30, 2022. CiteSpace 6.1.R2 software was used to visually analyze the authors, institutions, keywords, etc. 【Results:】 A total of 1274 papers were included, and the number of papers was on the rise. The hot topics covered three dimensions: surrogacy, ethics issues and laws of ART, and measures of ART. 【Conclusion:】 The combination of theory and practice on the ethical issues of ART is not close enough, the cooperation network of researchers need to be further strengthened. The relevant research on surrogacy, reproductive rights, gene editing, and embryo ownership has become a major hotspot and difficulty in recent years, which should be given full attention.
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The great anti-epidemic spirit is a magic weapon for the Chinese people to fight against the COVID-19. Taking the Dr. Zha’s Diary of Fighting the COVID-19 as an example to explore the practical basis and scientific connotation of the great anti-epidemic spirit is of great significance for telling Chinese stories and transmitting Chinese spirit. The anti-epidemic experience described in the book reflects the professional qualities of medical staff who are people-oriented and life first in the fight against the epidemic, the overall view of respecting science and precise prevention and control by various forces in society, and the overall pattern of national unity and shared destiny in China, vividly interprets the precious connotation of the new era medical and health professional spirit.
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Patient satisfaction is one of the core indicators to measure the service quality of medical institutions. To this end, a multi-campus public hospital in Shanghai constructed a management system of patient satisfaction evaluation. Since 2021, its call center has conducted a full coverage satisfaction assessment for discharged patients from its three campuses and collected dissatisfaction information feedback. The hospital organized relevant clinical departments and functional departments to fully communicate with the dissatisfied patients according to the feedback information, followed by a joint rectification. The hospital regularly conducts in-depth analysis of all complaints for timely discovery of common problems in different campuses for continuous improvement. This practice can provide reference for multi-campus hospitals to promote homogeneous management, to improve management efficiency, service quality and patient satisfaction.
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As the second most common cause of death in the world, cancer has become a persistent public health challenge. The incidence and mortality in different countries and regions or of multiple cancer types are significantly different, which is closely related to economic development level, lifestyle and environmental factors. A large number of epidemiological studies have focused on cancer burden, epidemic pattern, etiology and prevention, which is very important for the government to formulate cancer prevention policies based on medical evidence and protect population health. Therefore, based on the latest epidemiological publications, this paper reviews the incidence and mortality of cancer as well as the time trend in major countries and areas.
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Objective: To better understand surrogate technology,so as to enable surrogacy to be used more or-derly,rationally and legitimately in Chinese society as one of human assisted reproductive technologies.Methods:Through literature retrieval and other methods,this paper analyzed the possible risks of surrogate behavior at various stages.Results: China explicitly prohibited surrogacy,but surrogacy existed objectively.The risk of surrogacy ex-isted in the entire process of surrogacy,and the risks varied in different stages.There lacked perfect legal protec-tion for the rights and interests of all parties.Conclusion: It is not effective to ban surrogacy negatively in order to avoid ethical and legal disputes,and surrogacy is often illegal for many times.It should only formulate the authori-tative laws actively to respond to surrogacy issues,standardize the ethical principles of surrogacy,access condi-tions,and illegal punishment,and fundamentally deal with possible risks so as to effectively protect the rights and interests of all parties of surrogacy.Therefore,the introduction of the legislative regulation on surrogacy should not be delayed.
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Objective:To systematically and comprehensively expound the features and problems of ethics com-mittee for human organ transplantation in the ethical review work of living organ transplantation. Methods:We took interviews with insiders,literature research as the main research methods,supplemented by group discussion and other methods. Results:The ethical review of living organ transplantation has the characteristics of high require-ments of promptness,the need of protection for the rights of life and health for both parties,the complicated prepara-tion work,the need of weighing the risk and benefit of both parties at the same time and the lack of final judgment. In terms of the problems existing in the ethical review of living organ transplantation,it mainly had that the ethical review of living organ transplantation lacked supervision and guidance,the feasibility and scientificity of ethical re-view mode need to be improved,and the self - construction of ethics committee for human organ transplantation was insufficient. Conclusion:The ethics review of human organ transplant ethics committee should follow the principle of prudence,and improve the standardization and normalization of ethical review of human organ transplantation. Re-gional human organ transplant ethical review center should better conduct the ethical review work of living organ transplantation.
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Objective:To understand the current situation of medical students' professional attitude,find out the exiting problems and put forward some corresponding suggestions.Methods:The medical students' professional attitude was investigated using questionnaire in Shanghai.FResults:Some medical students lacked of professional confidence;the students expected highly towards compensation benefit;the professional satisfaction was low.There existed a correlation between professional values,expect and satisfaction.Conclusions:Perfecting pre-service training is a necessary prerequisite to improve medical students' professional confidence;compensation benefit is one of the referred factors for medical students to choose an occupation;improving medical students' professional view is the foundation of long-term development of medical enterprise;the professional counterpart is the key to ensure medical students' professional satisfaction.
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Objective:This paper aimed to investigate citizens' cognition and willingness to living organ dona-tion and to provide advice for the development of living organ donation.Methods:A sample of 1500 ordinary citi-zens in Shanghai was randomly selected and a self-administered questionnaire survey was conducted anonymously to investigate their cognition and willingness to living organ donation.Results:The citizens' awareness rate of liv-ing organs was not high;citizens obtained the information mainly through the network,television,newspapers and other mainstream media;citizens' s willingness rate of living organ donation was 14.6％,and the willingness wasin-fluenced by various factors.Conclusion:To promote citizens' correct understanding of living organ donation re-quires various efforts of governments,societies,families,hospitals and schools.
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Objective:To investigate the current situation of surrogate in China,analyze the reasons,and then provide effective suggestions and countermeasures.Methods:A questionnaire survey was conducted among medical staff and patients in an institution with assisted reproductive technology (ART),combining literature review and sociological research methods such as data maps,to explore and analyze the surrogacy.Results:The number of institutions with ART increased rapidly and its regulation became difficult.More surrogate network was observed in first-tier cities as well as the eastern and southeastern coastal provinces.That respondents agreeing with surrogacy was quite serious in some provinces.The reasons of surrogate were patients' needs,social concepts,weak government supervision,and so on.Conclusions:It should improve the laws of ART,explore long-term supervision mechanism,strengthen the management of internet,shield the information about surrogate,enhance medical ethics education for ART staff,and guide the infertility patients to establish the correct ethical concepts.
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Objective:To discuss the ethical issues of living organ donation in China systematically and comprehensively,from the perspective of society,institution,family,individual and other level.Methods:Literature research and expert interviews were used as main research methods,supplemented by group discussion,in-depth interviews and other methods.Results:In the development of living organ donation in China,from the social level,the relevant laws and regulations,civic education and supporting measures had problems.From the institutional level,hospital human organ transplant ethics committee also had some deficiencies in staff composition,review capacity and supervision.On the individual level,donors and receptors of living organ donation and related medical personnel also had their own ethical dilemma.Conclusion:It is beneficial to fully promote living organ donation and fully realize the purpose of living organ transplantation for the benefit of mankind through solving the ethical issues from social,institutional and individual levels.
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Objective:To inspect and improve physician professionalism effectively and preliminarily build eval-uation index system for physician professionalism. Methods:A sample of 240 physicians selected randomly from 8 Three-A hospitals in Shanghai were investigated using a self-designed questionnaire. Then the method of analyt-ic hierarchy process was performed in this study to construct the evaluation model of physician professionalism and determine every index weight. Results: An index system was initially built for physician professionalism evalua-tion. This system comprised three level-1 indexes namely moral quality characteristics, achievement action char-acteristics and vocational cognitive characteristics, as well as 14 level-2 indexes that drew from level-1 including responsibility etc. , at the same time determined their weight distribution. The judgment matrix had completely con-sistency through consistency check, indicating that the weight coefficient can reflect the relative importance of every index. Conclusion:Moral quality characteristics is one of the most important components of physician professional-ism evaluation; responsibility consciousness and vocational ideal are vital for the growth of physicians; lifelong learning and communication skills with high weight reflects needs of modern health care industry development;medical ethics consciousness has a trend of strengthening in physician groups, and enhancing evaluation index sys-tem for physician professionalism has the operability.
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Objective:To investigate and analyze of informed consent in assisted reproductive technology ( ART) institutions, understand the status and problems.Improve the content and methods of informed consent. Methods:A questionnaire was investigated for the medical staffs and patients anonymously in ART institutions. Results:The implementation of informed consent need to be improved.Medical staffs protect the patient privacy inadequately.The patients also not pay attention to the informed consent.Medical staffs look forward to ethics training.Conclusions:The current situation of informed consent is not optimistic in ART institutions.The ethics training need to be strengthen to improve the awareness of medical staffs about informed consent.The content and methods of informed consent should be standardized,and explore the evaluation methods to enhance the effect of in-formed consent.
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Background:With the increase in pace and pressure of modern life,the aging of population,the change in dietary pattern and the challenge of social psychological problems,the overall prevalence of chronic constipation is increasing in general population in recent decades. Aims:To investigate the prevalence and associated factors of chronic constipation in medical staff. Methods:A total of 1 000 medical staffs were enrolled at random in Shanghai Ren Ji Hospital for fulfilling a questionnaire on associated factors of chronic constipation. Diagnosis of chronic constipation met the Rome Ⅲ criteria. Chi-square test and Logistic regression model analysis were performed to screen the potential risk factors for chronic constipation. The statistically significant variables revealed by chi-square test were taken into the Logistic regression model. Results:Nine hundred and eighty-six medical staffs completed the questionnaire,of them 115 were diagnosed as chronic constipation with a prevalence of 11. 7% . Multivariate Logistic regression analysis revealed that reading/ playing cell phone when defecation,working pressure,anxiety,and depression were the risk factors,which might increase the prevalence of chronic constipation;while regular life style,regular diet,drinking water,and regular bowel movement were the protective factors,which might decrease the prevalence of chronic constipation. Conclusions:Chronic constipation is prevalent in medical staff in Shanghai. Psychological factors,dietary pattern and life style,etc. are considered to be implicated in the pathogenesis of chronic constipation. Favorable life style,dietary pattern,bowel habit and mental status are associated with the reduced risk of chronic constipation.
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Objective:To discuss the structure of medical humanistic curriculum system based on the research of quality features of excellent doctors .Methods:The goal , content and form of humanistic curriculum were based the factor of famous doctors'competencies which was build on the basis of literature review and experts'interview. Results:Ability and attitude or values accounted for high proportion of overall quality features .Humanities con-tained in most factors of excellent doctors'quality features;guiding significance of the structure of medical humanis-tic curriculum system is provided with excellent doctors'quality features .Conclusion:We should focus on the inte-gration of humanistic knowledge and practice , push humanities course into every stage of the medical education , further enrich category and quantity of medical humanities course and teaching form of medical humanities course , perfect the examination mode of medical humanities course in order to cultivate more excellent doctors .
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Objective:To explore the components of medical professionalism among excellent physicians , and discuss the approaches and ways of cultivating professionalism of physicians .Methods: We designed a question-naire, on the basis of literature retrieval , to investigate 50 excellent clinical doctors that came from 8 class 3A hos-pitals in Shanghai .Then we interviewed 20 famous doctors of them , who had good reputation and prestige .Re-sults:The components of excellent physician's professionalism include moral quality character , achievement behav-ior character and interpersonal communication character .And each character consists of a collection of different competencies .Conclusions:There is a stable positive correlativity relationship between the degree of excellence and physician's professionalism .The cultivation of medical professionalism should be based on ability , practice and humanistic quality , and through various ways and measures .
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Background:With the increasing of antibiotic resistance and decreasing of eradication rate of standard triple therapy, bismuth-containing quadruple regimens were recommended by the update Chinese consensus report for eradication of Helicobacter pylori( Hp ) infection. Aims:To evaluate the eradication rate of the recommended bismuth-containing quadruple regimens for guiding the choice of low cost and high efficiency eradication regimens. Methods:A search of online database( CNKI,Wanfang and VIP)was carried out. Clinical trials published in Chinese from 2011 to 2013 that evaluated the eradication rate of the recommended bismuth-containing quadruple regimens were retrieved. Data were extracted by standardized data forms. According to the categories raised by Dr. Graham,the eradication rates were graded and analyzed. Results:A total of 166 eligible articles including 192 clinical trials for eradication of Hp infection were obtained. Nationwidely,the eradication rates of amoxicillin-containing regimens were acceptable,among which PAFB( PPI+amoxicillin+furazolidone+bismuth)regimen was more prone to achieve excellent eradication rate(≥95%). PACB ( PPI+amoxicillin+clarithromycin+bismuth)regimen was optimal for Hp eradication in East China,and PAFB regimen was optimal in Central South China. A 14-day treatment course was appropriate. Conclusions:In the recommended bismuth-containing quadruple regimens,PAFB regimen might be the first choice nationwidely for eradication of Hp infection in individuals without amoxicillin-hypersensitivity because of its low cost and high efficiency. The recommended treatment course is 14-day.
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Graduate medical education, postgraduate medical education and continuing medi-cal education between China and the United States were compared in order to explore a better physi-cian training system of China. The physician training system of the United States has a series of ad-vantages such as strict access system, uniform training standard and closely linked among each stage, etc. We should make clear medical education standards and strengthen the cohesion between each stage, standardize the management mode and perfect the management system and promote regular as-sessment system.
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The college has been keeping its characteristics in the 7-year medical students training program in the pastten years. It is emphasized that the cultivating target in this program is to make the students become creative medicalprofessionals with lifelong study capacity by applying the humanistic spirit as the forerunner, and placing emphasis onthe practical and advanced feature, The training mode should fully incarnate the consistent characteristics of the bach-elor-and-master courses and the three-phrase tutor system, which aims to improve the practical and research competenceof the students. And the training outcome has been approved to be identical with the target set in advance.[