Percepciones sobre la aplicación de principios bioéticos en mujeres puérperas en un Hospital público del Ecuador

Fundamento: El puerperio es el periodo de tiempo que comienza en la finalización del parto hasta las seis semanas posparto; durante el cual, es necesario brindar atención conforme a los principios bioéticos inscritos en la normativa de salud vigente en el Ecuador. Objetivo: Analizar las percepciones que tienen las mujeres puérperas sobre la aplicación de los 4 principios bioéticos durante la atención en salud. Metodología: El estudio es de tipo descriptivo con enfoque cualitativo. Los datos corresponden a 10 mujeres puérperas mayores de edad, atendidas en el Hospital Gineco Obstétrico Pediátrico de Nueva Aurora "Luz Elena Arizmendi" de la ciudad de Quito, que respondieron a una entrevista sobre los principios bioéticos aplicados en la atención recibida. Se realizaron análisis de contenido a través del software ATLAS TI versión 23. Resultados: Se obtuvo una percepción positiva de las mujeres puérperas acerca de la aplicación del principio de justicia. Por otra parte, se evidencian dificultades en el de autonomía, sobre todo en la comprensión de la información brindada a la paciente acerca de los procedimientos durante el parto y puerperio, además de coacciones por parte del personal sanitario. Se percibe el consentimiento informado como un mero trámite administrativo. El principio de beneficencia se lo asume como parte de la vocación del personal y la no maleficencia genera malestar si no va acompañado de información clara y oportuna. Conclusiones: Los principios bioéticos son transversales en la normativa de salud vigente, pero sobresale el de justicia en la atención a mujeres puérperas.

Background: The puerperium is the period of time beginning at the end of labor until six postpartum weeks; during which it is necessary to provide attention in accordance with the bioethical principles included in the current health guidelines in Ecuador. Objective: To analyze the perceptions that postpartum women have about the 4 bioethical principles application during health care. Methodology: The study type is descriptive with a qualitative approach. The data correspond to 10 adult postpartum women assisted at the Nueva Aurora "Luz Elena Arizmendi" Pediatric Obstetric and Gynecological Pediatric Hospital in the Quito city, who responded to an interview about the bioethical principles applied in the received care. Content analysis was conducted through ATLAS TI version 23 software. Results: A positive perception was obtained from postpartum women concerning the application of the Justice principle. Furthermore, difficulties are evident in the Autonomy section, mainly in the comprehension of the information provided to the patient about the procedures during the labor and puerperium, as well as coercion by health personnel. Informed consent is perceived as a mere administrative formality. The Beneficence principle is assumed as part of the vocation of the personnel and Non-maleficence generates discomfort if it is not accompanied by clear and opportune information. Conclusions: Bioethical principles are transversal in current health guidelines, but that of Justice stands out in the care of postpartum women.

Considerações ético-legais sobre a sedação paliativa: a discussão que a pandemia trouxe à tona no norte do Brasil / Ethical and legal considerations for palliative sedation: the debate sparked by the pandemic in northern Brazil / Consideraciones ético-legales sobre la sedación paliativa: la discusión que la pandemia trajo a la luz en el norte de Brasil

Objetivo: analisar o cabimento ético-legal da sedação paliativa, distinguindo-a de condutas que possam ser consideradas eutanásicas e, portanto, penalmente vedadas pelo ordenamento jurídico pátrio e tradicionalmente rechaçadas pelos Códigos de Ética profissionais. Metodologia: mediante pesquisa exploratória bibliográfica, a partir de obras doutrinárias especializadas no tema dos conceitos associados a fim de vida e da disciplina normativa vigente, o estudo buscou cotejar o uso da sedação paliativa com outras condutas e situações relacionadas a terminalidade e morte, de sorte a procurar identificar com maior clareza a qualificação ética e jurídica da prática, sua relevância e licitude no campo dos cuidados paliativos. Resultados: verificou-se que, em meio à crise pandêmica, situações de mistanásia por carência de recursos nas unidades de saúde do estado do Amazonas levaram a uma indevida confusão na compreensão social entre sedação paliativa e eutanásia, impondo-se a necessidade de esclarecer os conceitos e limites entre as condutas. Conclusão: constatou-se a possibilidade jurídica de sedação paliativa como conduta ética e legal, desde que exercida dentro das exigências da boa prática clínica, sem intenção de deliberado encurtamento vital.

Objective: to examine the ethical-legal significance of palliative sedation and to distinguish it from acts that can be described as euthanasia and are therefore prohibited by law in the national legal system and generally rejected by professional ethical Codes. Methods:an exploratory literature review based on textbooks on end-of-life concepts and current normative discipline was conducted to further determine the ethical and legal qualifications of the practice, its relevance and legality in the field of palliative care. Results: The findings revealed that, during the pandemic crisis, misthanasia due to lack of resources in health facilities in the state of Amazonas has led to an undue confusion in social understanding of palliative sedation and euthanasia, so that clarification of the concepts and boundaries between conducts is necessary. Conclusion: the legality of palliative sedation has been confirmed as an ethical and legal behavior, provided it is used within the parameters of good clinical practice and without the intention of deliberately shortening life.

Objetivo: evaluar las implicaciones éticas y legales de la sedación paliativa, diferenciándola de acciones que podrían ser consideradas eutanásicas y, por lo tanto, prohibidas por la ley nacional y tradicionalmente rechazadas por los Códigos de Ética profesional. Metodología: a través de una investigación bibliográfica exploratoria, basada en trabajos doctrinales especializados en el tema de los conceptos asociados al final de la vida y la disciplina normativa actual, el estudio buscó comparar el uso de la sedación paliativa con otras conductas y situaciones relacionadas con la terminalidad y la muerte, con el fin de buscar identificar más claramente la calificación ético-legal de la práctica, su pertinencia y legalidad en el campo de los cuidados paliativos. Resultados: durante la crisis pandémica, las situaciones de mistanasia en las unidades de salud del estado de Amazonas debido a la falta de recursos causaron una confusión indebida en el entendimiento social entre la sedación paliativa y la eutanasia , imponiendo la necesidad de esclarecer los conceptos y límites entre conductas. Conclusión: la sedación paliativa es legal y ética si se realiza dentro de las normas de la buena práctica clínica y sin la intención de reducir deliberadamente la vida.

Estudio transversal en profesionales de la salud sobre aplicación y percepción de conocimientos bioéticos adquiridos en urgencias pediátricas / Estudio transversal en profesionales de la salud sobre aplicación y percepción de conocimientos bioéticos adquiridos en urgencias pediátricas

Introducción En comparación con ciencias clínicas básicas o aplicadas, la bioética es considerada una disciplina secundaria y subutilizada en la práctica diaria. Sin embargo, el razonamiento ético es indispensable para la calidad del cuidado. Existen pocos estudios sobre bioética en unidades de emergencia pediátrica. Nuestro objetivo fue evaluar la percepción sobre la importancia y la suficiencia del conocimiento teórico adquirido y la aplicación de los principios bioéticos en casos estandarizados. Métodos Realizamos un estudio descriptivo transversal en profesionales médicos y de enfermería que se desempeñan en unidades de emergencia pediátrica de Puerto Montt. Mediante una encuesta, evaluamos la percepción de la importancia y suficiencia del conocimiento bioético obtenido y la aplicación de los principios bioéticos en casos hipotéticos, pero probables, en la atención de urgencias pediátricas. Resultados De una población total de 50 médicos y 53 enfermeras, participaron en nuestro estudio 30 médicos (60%) y 20 enfermeras (37,7%). La mayoría reportó formación ética en pregrado (84%). Una minoría reportó formación durante la práctica (20%). Sin embargo, sólo 60% percibía tener conocimientos suficientes de bioética y 72% la consideraba importante para la práctica diaria. Además, al aplicar los principios de Beauchamp y Childress a casos clínicos estandarizados, el 82,7% no reconoció el principio de justicia y solo 50% reconoció los principios de autonomía y no maleficencia. Conclusión Aunque la mayoría de los profesionales de la salud tienen formación en bioética, el aprendizaje muchas veces se considera insuficiente y no se incorpora a la práctica diaria en las unidades de emergencia pediátrica.

Background Compared to basic or applied clinical sciences, bioethics is frequently considered as a secondary discipline and underutilized in daily practice. However, ethical reasoning is indispensable for the quality of care. There are few studies on bioethics in pediatric emergency units. Our objective was to evaluate the perception of the acquired bioethical knowledge and the application of bioethical principles in standardized cases. Methods We conducted a cross-sectional descriptive study in medical and nursing professionals working at pediatric emergency units in Puerto Montt. Through a survey, we assessed the perception of the sufficiency of the acquired bioethics knowledge and the application of bioethical principles on hypothetical, but probable cases in emergency pediatric care. Results Of a total population of 50 physicians and 53 nurses, 30 physicians (60.0%) and 20 nurses (38.7%) participated in our study. The majority reported ethics training in undergraduate education: 84%. A minority reported training during practice: 20%. However, only 60.0% perceived having sufficient knowledge of bioethics and 72.0% considered it important for daily practice. Further, when applying the principles of Beauchamp and Childress to standardized clinical cases, 82.7% did not recognize the justice principle and only 50.00% the principles of autonomy and nonmaleficence. Conclusion Although most health professionals undergo bioethics training, learning is often considered insufficient and not incorporated into daily practice at pediatric emergency units.

Controversias éticas en la atención del aborto, fertilización in vitro y anticoncepción en la mujer

En relación con los procesos de reproducción, las evidencias científicas de los últimos años y la vasta y mejor información con la que se cuenta para medir y estimar los indicadores de morbilidad y mortalidad en salud reproductiva han llevado a definir nuevas estrategias en el marco del derecho a la salud que tienen las mujeres. Para algunas personas son planteamientos claros, pero para otros no tanto, generando a la luz de los principios de ética controversias que es necesario plantear y, si es posible, resolver. En ese sentido, se ha seleccionado para esta presentación el aborto, la reproducción asistida y la anticoncepción, temas actuales que suscitan opiniones diferentes o contrapuestas de personas o instituciones, no siempre producto de una reflexión, justa, honrada, no ideologizada, buscando el bienestar de las personas. A veces, es el resultado de la satisfacción de un interés personal o institucional.

In relation to reproductive processes, the scientific evidence of recent years and the vast and better information available for measuring and estimating morbidity and mortality indicators in reproductive health have led to the definition of new strategies within the framework of women's right to health. For some people these approaches are clear, but for others they are not so clear, generating controversies in the light of ethical principles that need to be raised and, if possible, resolved. In this sense, we have selected for this presentation abortion, assisted reproduction and contraception, current issues that raise different or opposing opinions of individuals or institutions, not always the product of a reflection, fair, honest, non-ideologized, looking for the welfare of people. Sometimes, it is the result of the satisfaction of a personal or institutional interest.

Confessions of an Ayurveda professor

In this essay, I narrate my experiences of teaching Ayurveda physiology through an approach that involved laborious re-interpretation of ancient literature using the recent advances in the field of medical physiology. Though this approach made the ancient concepts and theories appear modern and relevant, it did not contribute much except for apparently reducing cognitive dissonance among students. I cite examples describing the processes of formation of shukra (semen) and rakta (blood) to show how we often overinterpret Ayurveda concepts to make them sound rational by proposing ad hoc conjectures. I illustrate why my previous writings were faulty by applying the falsification principle proposed by Karl Popper. I further explain how this approach made these concepts only verifiable but not refutable, and hence, non-falsifiable. I argue that instead of using such re-interpretation to prove obsolete concepts, they can be dropped altogether from the curricula of Ayurveda programmes. There is a need to develop a reliable method to identify such outdated content.

Personal glucose meters coupled with signal amplification technologies for quantitative detection of non-glucose targets:Recent progress and challenges in food safety hazards analysis / 药物分析学报

Ensuring food safety is paramount worldwide.Developing effective detection methods to ensure food safety can be challenging owing to trace hazards,long detection time,and resource-poor sites,in addition to the matrix effects of food.Personal glucose meter(PGM),a classic point-of-care testing device,possesses unique application advantages,demonstrating promise in food safety.Currently,many studies have used PGM-based biosensors and signal amplification technologies to achieve sensitive and specific detection of food hazards.Signal amplification technologies have the potential to greatly improve the analytical performance and integration of PGMs with biosensors,which is crucial for solving the challenges associated with the use of PGMs for food safety analysis.This review introduces the basic detection principle of a PGM-based sensing strategy,which consists of three key factors:target recog-nition,signal transduction,and signal output.Representative studies of existing PGM-based sensing strategies combined with various signal amplification technologies(nanomaterial-loaded multienzyme labeling,nucleic acid reaction,DNAzyme catalysis,responsive nanomaterial encapsulation,and others)in the field of food safety detection are reviewed.Future perspectives and potential opportunities and challenges associated with PGMs in the field of food safety are discussed.Despite the need for complex sample preparation and the lack of standardization in the field,using PGMs in combination with signal amplification technology shows promise as a rapid and cost-effective method for food safety hazard analysis.

Clinical study of acupuncture of Zhukeyuanluo principle combined with Buzhong Yiqi Decoction for the patients with obstructive sleep apnea hypopnea syndrome / 国际中医中药杂志

Objective:To evaluate the effect of acupuncture of Zhukeyuanluo principle and Buzhong Yiqi Decoction on obstructive sleep apnea hypopnea syndrome (OSAHS).Methods:Randomized controlled trial. A total of 104 patients with OSAHS in our hospital from January 2017 to January 2022 who met the inclusion criteria were divided into 2 groups according to random number table method, with 52 patients in each group. The Traditional Chinese Medicine (TCM) group was treated with Buzhong Yiqi Decoction on the basis of conventional western medicine treatment, and the acupuncture and medicine group was treated with the combination of primary and primary collaterals and acupoints. Both groups were treated continuously for 2 months. Epworth Lethargy Scale and Stanford Self-Rated Lethargy Scale (SSS) were used to assess the degree of lethargy. The serum levels of TNF-α, IL-6 and IL-8 were detected by ELISA. The hemoglobin, RBC and mean RBC volume levels were detected by automatic blood cell analyzer. apnea hypopnea index (AHI), apnea index (AI), hypopnea index (HI) and arterial oxygen saturation (SaO 2) were monitored by polysomnographic sleep monitor to evaluate the clinical effect. Results:The total effective rate was 94.2% (49/52) in the acupuncture group and 82.7% (43/52) in the TCM group, and there was significant difference between the two groups ( χ2=6.73, P=0.035). After treatment, the Epworth Lethargy Scale and SSS scores in the acupuncture and medicine group were significantly lower than those in the TCM group ( t=-8.19 and -5.48, respectively, P<0.01); AHI [(15.64±2.81) times/h vs. (19.82±3.05) times/h, t=-7.27], HI [(5.53±1.28) times/h vs. (7.37±1.34) times/h, t=-7.16], AI [(8.13±1.95) times/h vs. (10.98±2.26) times/h, t=-6.89] in the acupuncture and medicine group were significantly lower than those in the TCM group ( P<0.01), SaO 2 [(92.77±2.91) % vs. (89.53±2.44) %, t=6.15] in the acupuncture and medicine group was significantly higher than that of the TCM group ( P<0.01). The levels of TNF-α, IL-6 and IL-8 in serum in the acupuncture and medicine group were significantly lower than those in the TCM group ( t=-2.62, -3.14 and -6.58, P<0.01). The levels of hemoglobin, RBC and mean red blood cell volume were in the acupuncture and medicine group were significantly lower than those in the TCM group ( t=-2.11, -2.92, -2.48, P<0.05 or P<0.01). Conclusion:The acupuncture of Zhukeyuanluo principle combined with Buzhong Yiqi Decoction can reduce the serum inflammatory cytokines level in OSAHS patients, increase SaO 2, reduce AHI, HI, AI and lethargy degree, and improve clinical effects.

Technology and principle of improving solubility of Dioscoreae Rhizoma formula granules based on powder modification / 中国中药杂志

The powder modification technology was used to improve the powder properties and microstructure of Dioscoreae Rhizoma extract powder, thereby solving the problem of poor solubility of Dioscoreae Rhizoma formula granules. The influence of modifier dosage and grinding time on the solubility of Dioscoreae Rhizoma extract powder was investigated with the solubility as the evaluation index, and the optimal modification process was selected. The particle size, fluidity, specific surface area, and other powder properties of Dioscoreae Rhizoma extract powder before and after modification were compared. At the same time, the changes in the microstructure before and after modification was observed by scanning electron microscope, and the modification principle was explored by combining with multi-light scatterer. The results showed that after adding lactose for powder modification, the solubility of Dioscoreae Rhizoma extract powder was significantly improved. The volume of insoluble substance in the liquid of modified Dioscoreae Rhizoma extract powder obtained by the optimal modification process was reduced from 3.8 mL to 0 mL, and the particles obtained by dry granulation of the modified powder could be completely dissolved within 2 min after being exposed to water, without affecting the content of its indicator components adenosine and allantoin. After modification, the particle size of Dioscoreae Rhizoma extract powder decreased significantly, d_(0.9) decreased from(77.55±4.57) μm to(37.91±0.42) μm, the specific surface area and porosity increased, and the hydrophilicity improved. The main mechanism of improving the solubility of Dioscoreae Rhizoma formula granules was the destruction of the "coating membrane" structure on the surface of starch granules and the dispersion of water-soluble excipients. This study introduced powder modification technology to solve the solubility problem of Dioscoreae Rhizoma formula granules, which provided data support for the improvement of product quality and technical references for the improvement of solubility of other similar varieties.

Wounding characteristics and treatment principles of ground anti-armored vehicle ammunition against armored crew / 中华创伤杂志(英文版)

The wound mechanism, injury characteristics and treatment principles of anti-armored vehicle ammunition against armored crew in the past 20 years are summarized in this paper. Shock vibration, metal jet, depleted uranium aerosol and post armor breaking effect are the main factors for wounding armored crew. Their prominent characteristics are severe injury, high incidence of bone fracture, high rate of depleted uranium injury, and high incidence of multiple/combined injuries. During the treatment, attention must be paid on that the space of armored vehicle is limited, and the casualties should be moved outside of the cabin for comprehensive treatment. Especially, the management of depleted uranium injury and burn/inhalation injury are more important than other injuries for the armored wounds.

El trabajo educativo curricular desde el tema Medicamentos antiulcerosos en la asignatura Farmacología II / Curricular educational work on the topic of anti-ulcer medications in the subject Pharmacology II

El trabajo educativo consiste en transmitir un mensaje coherente desde la propia ciencia y estimula la motivación del aprendizaje de los estudiantes y su propia actividad cognoscitiva. El propósito de la educación médica superior es egresar un profesional integral; por tanto, se trata de instruir y educar a los estudiantes en los más altos valores patrióticos, morales y éticos en cada uno de los escenarios docentes, desde la propia ciencia. El objetivo de esta comunicación es ejemplificar algunos contenidos sobre la temática referente a medicamentos antiulcerosos en los que se puede intencionar el trabajo educativo desde la propia ciencia.

The educational work consists of transmitting a coherent educational message from science itself and stimulates the students' learning motivation and their own cognitive activity. The purpose of higher medical education is to graduate a comprehensive professional; therefore, it is about instructing and educating students in the highest patriotic, moral and ethical values in each of the teaching scenarios, from science itself. The objective of this research paper is to exemplify some content on the subject related to antiulcer drugs from which educational work can be intentioned from science itself.

ChatGPT y su impacto en la formación de competencias en terapeutas ocupacionales: una reflexión sobre la integridad académica / ChatGPT e seu impacto na formação de competências para terapeutas ocupacionais: uma reflexão sobre a integridade acadêmica / ChatGPT and its impact on competence training in occupational therapists: a reflection on academic integrity

Resumen El acceso público a la inteligencia artificial y específicamente el ChatGPT está presentando desafíos y retos en la formación profesional de los terapeutas ocupacionales. En este contexto, este ensayo busca describir el impacto de la inteligencia artificial, con énfasis en el ChatGPT, en la formación de terapeutas ocupacionales y proponer estrategias para integrar estas tecnologías en la educación superior desde una perspectiva integradora, ética y acorde a los valores y principios de la integridad académica. A pesar de que esta herramienta se puede utilizar para proporcionar conocimientos teóricos y favorecer el aprendizaje de contenidos, también representa un riesgo para las conductas deshonestas en el ámbito académico. Por tanto, es trascendental que los formadores puedan comprender su uso y fomentar metodologías experienciales que promuevan la creatividad, el pensamiento crítico y la reflexión. El desafío reside en la implementación de políticas y estrategias que promuevan el desarrollo de competencias profesionales y el uso ético y efectivo de estas tecnologías en la formación de futuros terapeutas ocupacionales, como declarar su uso en trabajos escritos, el modelaje por parte de los profesores y la integración en las metodologías de formación.

Resumo O acesso público à inteligência artificial e, especificamente, ao ChatGPT, está apresentando desafios na formação profissional dos terapeutas ocupacionais. Neste contexto, este ensaio procura descrever o impacto da inteligência artificial, com ênfase no ChatGPT, na formação de terapeutas ocupacionais e propõe estratégias para integrar estas tecnologias no ensino superior a partir de uma perspectiva integradora, ética e de acordo com os valores e princípios da integridade acadêmica. Embora esta ferramenta possa ser usada para fornecer conhecimento teórico e favorecer a aprendizagem de conteúdos, também representa um risco para comportamentos desonestos no âmbito acadêmico. Portanto, é fundamental que os educadores compreendam seu uso e promovam metodologias experienciais que estimulem a criatividade, o pensamento crítico e a reflexão. O desafio reside na implementação de políticas e estratégias que promovam o desenvolvimento de competências profissionais e o uso ético e eficaz destas tecnologias na formação de futuros terapeutas ocupacionais, como declarar seu uso em trabalhos escritos, modelagem por parte dos professores e integração nas metodologias de formação.

Abstract Public access to artificial intelligence, and specifically to ChatGPT, is presenting challenges in the professional training of occupational therapists. In this context, this essay aims to describe the impact of artificial intelligence, with an emphasis on ChatGPT, on the training of occupational therapists and proposes strategies to integrate these technologies into higher education from an integrative, ethical perspective, in line with the values and principles of academic integrity. While this tool can be used to provide theoretical knowledge and enhance content learning, it also poses a risk for dishonest behaviors in the academic realm. Therefore, it is essential that educators understand its use and promote experiential methodologies that encourage creativity, critical thinking, and reflection. The challenge lies in the implementation of policies and strategies that promote the development of professional skills and the ethical and effective use of these technologies in training future occupational therapists, such as declaring its use in written works, modeling by teachers, and integration into training methodologies.

Validez de la unidad nacional en el pensamiento de Fidel Castro para enfrentar la COVID-19 / Validity of national unity in the thought of Fidel Castro to face COVID-19

En el ideario de Fidel Castro se aprecian sus consideraciones acerca de la necesidad de la unidad para vencer cualquier obstáculo que pretenda detener el curso de la Revolución cubana, en lo fundamental dirigidas hacia las maniobras desestabilizadoras de los enemigos de la patria; sin embargo, esa convicción fidelista de que la unidad garantiza el triunfo está presente en la batalla que se ha librado, y aún se libra, contra la COVID-19, donde el pueblo, organizado en diversos sectores, continúa obteniendo resultados positivos en contra de esta pandemia. Es objetivo de estos autores compartir algunas de sus ideas que servirán de análisis e inspiración para su aplicación en el actual contexto epidemiológico.

In Fidel Castro's ideology, his considerations about the need for unity to overcome any obstacle that tries to stop the course of the Cuban Revolution are appreciated, fundamentally directed towards the destabilizing maneuvers of the enemies of the homeland; however, this Fidel´s conviction that unity guarantees victory is present in the battle that has been waged, and is still being waged, against COVID-19, where the people, organized in various sectors, continue to obtain positive results against this pandemic. It is the objective of these authors to share some of their ideas that will serve as analysis and inspiration for their application in the current epidemiological context.

Application of "Sancai principle" for needle-knife treatment of bi syndrome of neck region / 中国针灸

Under the guidance of the "Sancai principle", based on the understanding of the etiology and pathogenesis of the imbalance of muscles and bones in bi syndrome of neck region, holistic treatment should be used. The needle-knife release therapy is applied at corresponding acupoints in the three parts i.e. head, neck and back including Tiancai points (Naohu [GV 17] and Naokong [GB 19]), Rencai points (neck Jiaji [EX-B 2]), and Dicai points (Dazhui [GV 14], Quyuan [SI 13] and Tianzong [SI 11]). According to the layers of the lesion's meridians and muscles, the needle-knife is inserted into skin, muscle and bone to relax the tendons and treat bone disorders, and restore the normal mechanical balance of neck.

Analyzing the Ethical Challenges of Deep Brain Stimulation Technology for Patients, Doctors, and Researchers / 中国医学伦理学

Deep brain stimulation (DBS) is an invasive treatment that involves implanting electrodes into the brain to electrically stimulate specific brain regions, bringing new hope for the treatment of motor and psychiatric neurological diseases. This technology is closely related to human consciousness and has sparked heated debates on topics such as consciousness autonomy and personality integrity. Starting from the core principles of protecting patients, this paper explored the controversial issues of consciousness autonomy and medical autonomy principles in DBS practice, and discussed the ethical considerations in informed consent, patient inclusion, information collection, and cutting-edge scientific fields from the perspectives of patients, clinicians, and researchers.

Discussion on Conflict and Countermeasures of Beneficial and Non-maleficence Principles in Pediatric Nursing / 中国医学伦理学

In pediatric nursing, the conflict between the principle of beneficial and non-maleficence is a major challenge for nurses. To systematically understand the current situation of the conflict in the nursing practice of pediatric nurses at home and abroad, this paper reviewed four clinical situations where conflict occurs frequently: end-of-life decision-making of critically ill children, physical restraint, the child abuse case report, and new pediatric clinical therapies, and analyzed the factors influencing the conflict of pediatric nurses in China, so as to provide reference for pediatric nurses to cope with the conflict between the principle of beneficial and non-maleficence.

Considerations on investigation on quality standard of Chinese patent medicine / 药学学报

Chinese patent medicine (CPM) is an important part of traditional and Chinese medicine (TCM). Its quality has direct impact on the safety and effectiveness of clinical use. The quality standard is the pivotal approach to guarantee the quality of CPM. Due to the complex material basis, multitudinous quality influencing factors and unveiled active ingredients, dose-effect relationship and action mechanism, the investigation on quality standard faces many difficulties. This paper surveys the current quality status of CPM and the general situation of CPM standards. At present, the dosing problem has the crucial impact on the quality of CPM. The current quality standard system of CPM is confirmed and the limitations are indicated. Based on the above analysis, the principles and considerations on investigation of quality standard are proposed as follows: ① Adhere to safety as the bottom line, strengthen the risk-control ability of the standard of CPM; ② Adhere to theory of TCM and comprehensive quality, improve the integrative control level of the CPM standard; ③ Emphasize technological development and innovation, promote the quality control competence of CPM standard; ④ Facilitate planning and coordination, optimize the management of the CPM standard system; ⑤ Reinforce investigation on evaluation method, develop grade evaluation standard, accelerate high-quality development of CPM. Finally, the future perspective on investigation of CPM quality standard is prospected.

Advances in taste masking technology based on preparation technology / 药学学报

Good medicine tastes bitter, but it is often difficult to swallow because the drug is bitter and astringent, so that the compliance of patients with medication is poor. However, the use of taste masking technology can better improve this situation. Appropriate and effective taste masking technology can improve the drug compliance of patients, especially children, it can also improve the curative effect and the clinical value of drugs. Herein, we summarize the latest research progress of taste masking technology, and summarize the traditional taste masking technology from the aspects of action mechanisms and application scopes. Finally, the novel and efficient taste masking technologies were presented.

Recent advances of pharmaceutical 3D printing extrusion molding technology / 药学学报

3D printing is an additive manufacturing technology with the help of digital control. Since FDA approved the first 3D printing drug in 2015, its research enthusiasm in the pharmaceutical field has been increasing year by year. In printing technology, fused deposition molding (FDM) and semi-solid extrusion (SSE) are the two most widely used extrusion molding technologies. In this review, recent advances of pharmaceutical 3D printing extrusion molding technology are reviewed from six aspects: mechanism, equipment, pharmaceutical excipients, applications, design and industrialization prospects of extrusion molding technology.

Exploring the Principles， Limitations， and Error-Correction Methods of Traditional Chinese Medicine's Empirical Thinking / 中医杂志

From the perspective of cybernetics， this study investigated the fundamental principles of empirical thinking in traditional Chinese medicine， encompassing six stages： experience input and storage， experience extraction and activation， experience combination and reconstruction， judgment and decision-making based on experience， and experience evaluation and feedback. The potential limitations of empirical thinking in clinical applications were analyzed， mainly manifested as “individuality”， “superficiality”， “conservatism”， “prioritizing commonality over individuality”， and “cognitive inertia”. To overcome these limitations， this paper also explored strategies and methods for clinical error-correction from four points： the integration of rational and empirical thinking， the reinforcement of feedback mechanisms and transcendent correction， the integration of individualization and quantity-quality balance， and the management and transference of tacit knowledge under empirical thinking.

Ethical problems and solutions of experimental animals in functional experiment teaching / 中华医学教育探索杂志

Objective:To investigate the ethics and existing problems of experimental animals in medical experiments and experimental teaching, and to formulate countermeasures so that animal ethics and animal welfare can be truly reflected in medical experiments.Methods:In this study, a "Basic Function Experiment Center Animal Experiment Questionnaire" with 25 questions was formulated from three aspects: the ethical cognition of experimental animals, whether animal experiments are ethical or not, how to view the problems of animal ethics and experimental teaching and the cognition of virtual simulation experiment teaching. Questionnaire was sent to Hubei University of Medicine to investigate the international students of Batch 2017 (5-year program), undergraduates of Batch 2017 (5-year program) and nursing students of Batch 2018 (4-year program) as well as teachers, researchers and employees of laboratory animal center (all with bachelor degree or above). The survey results were expressed as percentage.Results:The recovery rate of the questionnaire in this study was 98.04%(2 451/2 500), among which the practitioners, teachers and researchers in the laboratory animal center clearly understood the ethics of experimental animals, but there was a widespread phenomenon of lagging ethics among the students. For example, 16.24% (398/2 451) students had not received animal experiment ethics education and training, 29.46% (722/2 451) were not clear about animal protection laws and regulations, 7.14% (175/2 451) thought animal experiments were immoral; 29.54% (724/2 451) had vague cognition of animal welfare and ethical knowledge; 25.91% (635/2 451) were not familiar with the operation steps; 9.38% (230/2 451) were indifferent to the extra treatment of animals due to operation errors, 7.83% (192/2 451) chose to give up the experiment in the treatment of animals after massive bleeding, only 5.43% (133/2 451) chose to continue the experiment after timely hemostasis and infusion, and 9.26% (227/2 451) chose to do operations unrelated to the experiment. After the experiment, 2.28% (56/2 451) chose to kill the animals by bloodletting, only 5.51% (135/2 451) chose excessive anesthesia euthanasia, and 1.96% (48/2 451) chose to kill the animals by cervical dislocation and violence. Only 15.79% (387/2 451) chose to remember the dead animal for 2 minutes. Only 32.56%(798/2 451) of the respondents understood virtual simulation experiment, 34.92% (856/2 451) of the respondents thought that virtual simulation experiment or experimental teaching video could be used to replace the existing live animal experiment, 77.56% (1 901/2 451) believed that the construction of virtual simulation laboratory should be strengthened.Conclusion:It is imperative to strengthen the education of students' ethics of experimental animals, which is conducive to the establishment of correct ethics of experimental animals for medical students, so that the "3R" principle and animal welfare can be truly implemented in experimental teaching and scientific research experiments.