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Zhu Zhenheng, the last generation and sole representative from Southern China among the four masters of Jin-Yuan medicine, synthesized the evolution of Chinese medicine from the Song to the Yuan dynasties, profoundly impacting East Asian medical history. Zhu, identified as a Neo-Confucian scholar, appears in the Scholarly Records of the Song-Yuan Dynasties and in ‘the Biographies of Confucians’ rather than ‘the Biographies of Experts’ in the Official History of the Yuan Dynasty. His close association with the Jinhua school of Daoxue is noteworthy. Zhu’s career, as well as his medical theory and practice, exemplify the influence of Zhu Xi’s Neo-Confucianism, which was a significant intellectual resource among the literati during the late Yuan period, on medicine. Zhu Zhenheng’s model of a Confucian physician later became a paradigm in East Asia, as Neo-Confucianism gained mainstream acceptance among the literati. This paper offers a detailed exploration of the specific contexts of Zhu’s social and intellectual networks as well as an examination of the characteristics of his medical theories and practices. It explores how Zhu’s career and identity as a Neo-Confucian physician were shaped through the local and empire-wide networks of the Jinhua school of Neo-Confucianism within the broader context of the Mongol empire, a global power in the late Yuan period. The paper also examines in depth how Zhu’s medical practices were influenced by Neo-Confucianism, and it investigates the real nature and significance of the integration of medicine and Neo-Confucianism, two distinctly different realms of knowledge. Zhu Zhenheng’s medical theories were formed through concerns about jufang medicine and the active presentation of alternatives. A notable aspect of his integration of medicine and Confucianism was the adoption of Neo-Confucian terminologies, concepts, and philosophical and ethical theses, while ensuring that the unique and independent domain of medicine was not subordinated to abstract philosophical theories. This is especially evident through his active and effective use of medical cases. Unlike previous studies, this paper demonstrates that Zhu Zhenheng’s integration of medicine and Neo-Confucianism was mostly a metalevel process, involving methodology and knowledge reproduction patterns, and was driven by a belief in the possibility of harmonizing with Daoxue’s ultimate principle without undermining the autonomy of medical knowledge.

In clinical medicine, due to some accidents will inevitably produce the situation of missing data, this study for its with missing and truncated data, the use of mathematical statistics methods for inference supplement. After classifying the types of incomplete data, the article utilizes the great likelihood and empirical likelihood to form a linear statistical model to infer such data. It verifies it through simulation experiments and example analysis. In the simulation experiment, for the case of the same missing probability, as the number of samples increases from 150 to 300, the bias, variance, and mean square error of this paper’s algorithm in parameter β1 are reduced to 0.0122, 0.1435, and 0.1441, respectively. In the actual statistical inference analysis of cardiac disease and heart transplantation, the standard error of this paper’s method reduces by 0.0576 compared with that of CAA, and the inference The results are by the reality. In clinical medicine, this study proposes a practical statistical extrapolation method and a realization path for objective interpretation when incomplete data is present.

Abstract Background Scientific research ability (SRA) is very important for clinical postgraduates. However, the factors affecting students' SRA are constantly changing with the development of medicine. The aim of this study was to investigate the current situation of SRA in clinical postgraduates and exploring the potential factors and the corresponding countermeasures under the background of new medical science. Methods A total of 133 postgraduates (first- or second-year) were investigated by questionnaire in the Second Affiliated Hospital of Fujian Medical University. All results were analyzed by R software. Results In terms of the SRA, academic-degree postgraduate students (ADPSs) were significantly better than professional-degree postgraduate students (PDPSs) (P = 0.001), the students with scientific research interest were remarkably better than those without scientific research interest (P = 0.004), the students who mastered statistical analysis methods were more prominent than those who did not (P = 0.007), the students with paper-writing skills were obviously superior to those without it (P = 0.003), and the second-year students were notably better than the first-year students (P = 0.003). Stratified analysis by the above factors except the degree type showed no significant difference in the first-year postgraduates. In the second-year postgraduates, the ADPSs were remarkably superior to the PDPSs (P = 0.002), the students with scientific research interest were obviously better than those without scientific research interest (P = 0.014), the students with more time investment in scientific research were more prominent than those with less time investment in scientific research (P = 0.025), the students with paper-writing skills were notably superior to those without it (P = 0.031), and the students with plotting ability were better than those without it (P = 0.013). Conclusion The important factors affecting the SRA of clinical postgraduates include the degree type, the grade of student, scientific research interest, time investment in scientific research, statistical analysis methods, paper-writing skills, plotting ability. In short, earlier systematic SRA training contributes to the improvement of SRA in clinical postgraduates, especially in PDPSs.

Breast cancer remains a significant public health issue, being a leading cause of cancer-related mortality among women globally. Timely diagnosis and efficient treatment are crucial for enhancing patient outcomes, reducing healthcare burdens and advancing community health. This systematic review, following the PRISMA guidelines, aims to comprehensively synthesize the recent advancements in computer-aided diagnosis and treatment for breast cancer. The study covers the latest developments in image analysis and processing, machine learning and deep learning algorithms, multimodal fusion techniques and radiation therapy planning and simulation. The results of the review suggest that machine learning, augmented and virtual reality and data mining are the three major research hotspots in breast cancer management. Moreover, this paper discusses the challenges and opportunities for future research in this field. The conclusion highlights the importance of computer-aided techniques in the management of breast cancer and summarizes the key findings of the review.

Neonatal hypoxic ischemic encephalopathy is a common disease, which is caused by fetal hypoxia, asphyxia, and other reasons. It may cause sequelae of the nervous system and even death in children. Computer tomography examination can clarify the scope and location of the disease and provide the basis for clinical treatment and prognosis. Relevant personnel analyzed the symptoms of ischemic hypoxia and found that ischemia and hypoxia were the main causes of encephalopathy. Neonatal ischemia and hypoxia are easy to cause serious damage. At present, with the development of medicine, the function of the human brain is the most important issue in natural science. The law of neural activity and the role of molecular cells, organs, and systems have fundamental construction significance for the prevention and treatment of nerve and mental diseases. By analyzing the value of the diagnosis of neonatal hypoxic-ischemic encephalopathy in the analysis of experimental data, by setting the newborns in the controlled group and the trial group as experimental subjects, this paper analyzed the situation of newborns in terms of body temperature, body weight, and respiratory rate, and used Apgar score to score these standards. It was found that the score of the controlled group was 7 and above, and the score of the trial group was below 7. It was found that the Apgar scoring method was more simple. Then, the newborns were analyzed by cord blood gas analysis. It was found that most of the data in the control group were between 7.8 and 8.4, and the data in the trial group were between 5.8 and 7.1. The umbilical blood gas analysis score of the experimental group was lower than that of the control group. By comparing the satisfaction of cord blood gas analysis and the Apgar score, it was found that the satisfaction of cord blood gas analysis was 24.06% higher than that of the Apgar score.

The purpose of exploring the application of mixed reality technology in clinical medicine teaching is to enhance the learning effect in clinical teaching. This paper utilizes the mixed reality technology framework to create a scene for clinical medicine teaching and simulation training and defines the interaction and teaching process for clinical medicine teaching simulation training. Based on the CT/MRI images of patients, the neural radiation field algorithm is combined to reconstruct the 3D model in the clinical medicine simulation scene, the Laplacian edge detection operator is used to preprocess the images, and the probabilistic-based importance sampling strategy is introduced to ensure the accuracy of the 3D reconstruction model. A comparative clinical medicine teaching experiment was designed to evaluate the teaching effect of the simulation training model with students from TR Hospital. The lowest ATE value of the 3D model obtained by the NeRF algorithm was only 0.011, while the result of the importance sampling strategy improved the PSNR value by 6.17% compared with that of the uniform sampling. The learning interest of the students in the observation group increased from 71.06±0.57 points before the experiment to 96.53±0.21 points after the experiment, and the 3D stereoscopic sense of the students in the observation group improved by 32.38% compared to the students in the control group. It is highly feasible to construct clinical medical simulation teaching based on mixed reality technology, which can improve students’ theoretical knowledge and practical skills in clinical medicine while effectively enhancing their learning interests.

The goal of clinical practice education is to develop the ability to apply theoretical knowledge in a clinical setting and to foster growth as a professional healthcare provider. One effective method of achieving this is through the utilization of Standardized Patients (SP) in education, which familiarizes students with real patient interviews and allows educators to assess their clinical performance skills. However, SP education faces challenges such as the cost of hiring actors and the shortage of professional educators to train them. In this paper, we aim to alleviate these issues by utilizing deep learning models to replace the actors. We employ the Conformer model for the implementation of the AI patient, and we develop a Korean SP scenario data generator to collect data for training responses to diagnostic questions. Our Korean SP scenario data generator is devised to generate SP scenarios based on the provided patient information, using pre-prepared questions and answers. In the AI patient training process, two types of data are employed: common data and personalized data. The common data are employed to develop natural general conversation skills, while personalized data, from the SP scenario, are utilized to learn specific clinical information relevant to a patient’s role. Based on these data, to evaluate the learning efficiency of the Conformer structure, a comparison was conducted with the Transformer using the BLEU score and WER as evaluation metrics. Experimental results showed that the Conformer-based model demonstrated a 3.92% and 6.74% improvement in BLEU and WER performance compared to the Transformer-based model, respectively. The dental AI patient for SP simulation presented in this paper has the potential to be applied to other medical and nursing fields, provided that additional data collection processes are conducted.

Biosocial Medicine, with its emphasis on the full integration of the person's biology and biography, proposes a strategy for clinical research and the practice of medicine that is transformative for the care of individual patients. In this paper, we argue that Biology is one component of what makes a person unique, but it does not do so alone. Biography, the lived experience of the person, integrates with biology to create a unique signature for each individual and is the foundational concept on which Biosocial Medicine is based. Biosocial Medicine starts with the premise that the individual patient is the focus of clinical care, and that average results for “ideal” patients in population level research cannot substitute for the “real” patient for whom clinical decisions are needed. The paper begins with a description of the case-based method of clinical reasoning, considers the strengths and limitations of Randomized Controlled Trials and Evidence Based Medicine, reviews the increasing focus on precision medicine and then explores the neglected role of biography as part of a new approach to the tailored care of patients. After a review of the analytical challenges in Biosocial Medicine, the paper concludes by linking the physician's commitment to understanding the patient's biography as a critical element in developing trust with the patient.

Abstract Background E-learning is recognised as a useful educational tool and is becoming more common in undergraduate medical education. This review aims to examine the scope and impact of e-learning interventions on medical student learning in clinical medicine, in order to aid medical educators when implementing e-learning strategies in programme curricula. Methods A systematic review compliant with PRISMA guidelines that appraises study design, setting and population, context and type of evaluations. Specific search terms were used to locate articles across nine databases: MEDLINE/PubMed, ScienceDirect, EMBASE, Cochrane Library, ERIC, Academic Search Complete, CINAHL, Scopus and Google Scholar. Only studies evaluating e-learning interventions in undergraduate clinical medical education between January 1990 and August 2021 were selected. Of the 4,829 papers identified by the search, 42 studies met the inclusion criteria. Results The 42 studies included varied in scope, cognitive domain, subject matter, design, quality and evaluation. The most popular approaches involved multimedia platforms (33%) and case-based approaches (26%), were interactive (83%), asynchronous (71%) and accessible from home (83%). Twelve studies (29%) evaluated usability, all of which reported positive feedback. Competence in use of technology, high motivation and an open attitude were key characteristics of successful students and preceptors. Conclusions Medical education is evolving consistently to accommodate rapid changes in therapies and procedures. In today’s technologically adept world, e-learning is an effective and convenient pedagogical approach for the teaching of undergraduate clinical medicine.

Summary: Background: Development and evaluation of diagnostics for diseases of epidemic potential are often funded during epidemics, but not afterwards, leaving countries unprepared for the next epidemic. United Nations Children's Emergency Fund (UNICEF) partnered with the United States Agency for International Development (USAID) to address this important gap by investing in an advance purchase commitment (APC) mechanism to accelerate the development and evaluation of Zika rapid diagnostic tests (RDTs) for case detection and surveillance. This paper describes the performance evaluation of five Zika RDTs eligible for procurement. Methods: A network of European Union-funded ZikaPLAN sites in Africa, Asia, Latin America with access to relevant serum specimens were selected to evaluate RDTs developed for the UNICEF APC mechanism. A standardised protocol and evaluation panels were developed and a call for specimens for the evaluation panels issued to different sites. Each site contributed specimens to the evaluation from their biobank. Data were collated, analysed and presented to the UNICEF Procurement Review Group for review. Findings: Three RDTs met the criteria for UNICEF procurement of sensitivity and specificity of 85% against a refence standard. The sensitivity/specificity of the ChemBio anti-Zika Virus (ZIKV) immunoglobulin M (IgM) test was 86.4 %/86.7% and the ChemBio ZCD system for anti-ZIKV IgM was 79.0%/97.1%, anti-dengue virus (DENV) IgM 90.0%/89.2%, anti-Chikungunya virus (CHIKV) IgM 90.6%/97.2%. The sensitivity/specificity of the SD Biosensor anti-ZIKV IgM was 96.8 %/90.8%, anti-DENV IgM 71.8%/83.5%, the DENV nonstructural protein 1 (NS1) glycoprotein 90.0%/90.2%, anti- yellow fever virus (YFV) IgM 84.6%/92.4%, anti-CHIKV IgM 86.3%/97.5%. Interpretation: Three RDTs fulfilled the performance thresholds set by WHO and were eligible for UNICEF procurement. These tests will improve the diagnosis of ZIKV and other arboviral infections as well as providing countries with better tools for surveillance and response to future epidemics. Funding: This work was supported by the USAID grant GHA-G-00-07-00007 and ZikaPLAN (European Union's Horizon 2020 Research and Innovation Programme under Grant Agreement No. 734584).

There was a gap between the level of clinical performance /research in Western China and that in Eastern China. Through the investigation and comparison of the staff composition, beds number and research publication in the Department of Otolaryngology of two affiliated hospitals of Western and Eastern medical colleges in 2020, the weakness and barriers of medical personnel in Western China were found out. The regular Journal Clubs(JCs) is an effective method which may stimulate the interest of faculty at hospital in clinical research, enhance research level and arouse the enthusiasm of paper publication with extensive view of latest medical progress and improve the quality of healthcare service.

The role of phosphatidylethanol (PEth) as an alcohol consumption marker is increasing in clinical and forensic medicine. During the COVID-19 pandemic, the role of hygiene increased, and it became common practice to use disinfectants almost everywhere. This paper highlights a possible source of false positive results (by the vapors of alcohols during the blood spot drying process) in dried blood spots (DBS) by LC-MS/MS quantitation of PEth. To achieve this, the PEth quantitation method was validated according to FDA guidelines. Additionally, the synthesis of phosphatidyl derivatives by phospholipase D (PLD) in the presence of methanol and 2-propanol vapors during the DBS process was determined. Each PEth-negative sample from a healthy male patient incubated in the presence of ethanol vapor becomes PEth-positive. After 4 h of DBS drying, teetotalers become “moderate drinkers”. It is necessary to avoid using alcohol-containing disinfectants in treatment rooms, where DBS is sampled.

Background and Aims: The advent of social networking sites has facilitated the dissemination of scientific research. This article aims to investigate the presence of Iranian highly cited clinicians in social networking sites. Materials and Methods: This is a scientometrics study. Essential Science Indicator (ESI) was searched for Iranian highly cited papers in clinical medicine during November–December 2015. Then, the authors of the papers were checked and a list of authors was obtained. In the second phase, the authors' names were searched in the selected social networking sites (ResearchGate [RG], Academia, Mendeley, LinkedIn). The total citations and h-index in Scopus were also gathered. Results: Fifty-five highly cited papers were retrieved. A total of 107 authors participated in writing these papers. RG was the most popular (64.5%) and LinkedIn and Academia were in 2nd and 3rd places. None of the authors of highly cited papers were subscribed to Mendeley. A positive direct relationship was observed between visibility at social networking sites with citation and h-index rate. A significant relationship was observed between the RG score, citations, reads indicators in RG, and citation numbers and there was a significant relationship between the number of document indicator in Academia and the citation numbers. Conclusion: It seems putting the papers in social networking sites can influence the citation rate. We recommend all scientists to be present at social networking sites to have better chance of visibility and also citation.

With the diversified development in training clinical students, an impeccable system in clinical on-job postgraduates training has been established. It has been being an important problem for colleges and tutors to improve the quality in the postgraduates training program in the specialty of ophthalmology. This paper analyzed the problems in the training of clinical postgraduates and explored the ways to resolve the problems.

En este artículo analizo la construcción del riesgo en la medicina clínica del Sida a partir del estudio de las argumentaciones y las formas retóricas puestas en juego en la presentación de la etiología de la enfermedad, la trasmisión viral y la relación entre procesos orgánicos y procesos sociales por parte de un conjunto de profesionales comprometidos en la atención de personas viviendo con VIH (PVVIH) y entrevistados en dos momentos de la epidemia (1993-1994 y 1998-2000). En la reconstrucción de la trama narrativa que pone en relación hallazgos científicos, evidencias epidemiológicas, síntomas y signos relevados en la atención de los pacientes, clasificaciones diagnósticas, presentaciones patogénicas, etc., destaco un conjunto de desplazamientos de sentido mediante procesos de tipo metonímico que vinculan vías de trasmisión, comportamientos sociales, causa y riesgo. A partir de allí desarrollo la cuestión de la individualización del riesgo en la atención de las PVVIH especificando qué componentes o aspectos de la vida sexual, las relaciones de género, el consumo de drogas y los modos de vida de los afectados juegan roles significativos en el accionar clínico y permiten establecer criterios o indicadores para definir la posibilidad individual de contraer y/o desarrollar la enfermedad y de adoptar comportamientos de cuidado en especial en la implementación de los tratamientos antirretrovirales.In this article, the construction of risk in AIDS related clinical Medicine is analyzed. The arguments and rhetoric in the presentation of the etiology of the illness, viral transmission and the relationship between organic and social processes by a group of medical professionals engaged in the care of persons living with HIV and interviewed during two moments of the epidemic (1993-1994 and 1998-2000) are studied. The paper reconstructs the narrative plot that relates scientific findings, epidemiological evidence, signs and symptons identified in patient care, diagnostic classifications, pathogenic presentations, and so on. It further identifies metonymies that link trasmission routes, social behaviors, cause and risk. The question of risk individualization in medical attention is addressed through the identification of aspects of sexual lives, gender relationships, drug consumption and ways of living of the affected persons that play significant roles in clinical work and contribute to the establishment of the individual possibility of contracting and/or developing AIDS and of adopting care behaviors, especially regarding the application of antiretroviral therapies.

A medicina antienvelhecimento visa a interferir no processo de envelhecimento humano biológico normal. Haveria base científica para justificá-la como especialidade médica e não ramo de ciências biológicas básicas? Esta revisão avaliou 110 artigos, dos quais nove artigos (8,2% do total) em humanos. Apenas um desses estudos era randomizado e duplo-cego (Jadad 2). A categoria de recomendação e o grau de evidência desses trabalhos foram considerados como CII. Periódicos com fator de impacto acima de 1,110 publicaram três dos nove artigos. Dessa forma, não parece haver sólidas evidências científicas e/ou clínicas que justifiquem a aplicabilidade da medicina antienvelhecimento na presente prática médica.The objective of antiaging medicine is to interfere in the normal human biological aging process. Is there any scientific basis to justify classifying antiaging medicine as a medical specialty and not a branch of basic biological science? This review evaluated 110 papers, nine of which (8.2% of the total) reported studies involving human subjects. Only one of these studies was randomized and double-blinded (Jadad 2). In accordance with their classification of recommendations and level of evidence, these studies were considered CII. Three of the nine articles were published in journals with an impact factor over 1.110. Therefore, there does not appear to be any solid scientific and/or clinical evidence that would justify the application of antiaging medicine in current medical practice.

The author maintains that a physician must publish because the knowledge is property of the entire mankind, because scientific journals offer the most reliable (medical) information, and because the process of publishing serves also as a final education of true experts. Publishing can become relatively easy if the investigation is properly planned and the report is adequately written. Both should be a joint effort of all authors of the study. It is easier to publish in clinical than in preclinical research field for at least seven reasons: 1) in clinical work the variety of patients stimulate formulation of hypothesis, 2) the spectrum of possible and desirable research themes is rather wide, researchers can make use of hospital routine laboratories, and even individual cases are acceptable as research reports 3) it is acceptable, even desirable, to repeat already published studies, 4) multicentric studies enable weaker institutions to join strong and more experienced ones and thus participate in high-quality research, 5) imperfection of the studies is tolerated because journal editors are aware of the complexity of clinical work, 6) there is a degree of automatic financing of research, and 7) there is a large number of both general and highly specialized journals which yearn for papers.

In 2006 there is the 110th jubilee of D.D. Yablokov – phthisiatrician and pulmonologist, radiologist and pathologist, parasitologist and physician, rheumatologist and balneologist. He is one of the best representatives and followers of the traditions of Russian doctors. The biographic paper about D.D. Yablokov from the book Tomsk Dynasties. Twentieth Century (Tomsk, 1996) by the well-known journalist T.Yu. Kupert.

In 2006 there is the 110th jubilee of D.D. Yablokov – phthisiatrician and pulmonologist, radiologist and pathologist, parasitologist and physician, rheumatologist and balneologist. He is one of the best representatives and followers of the traditions of Russian doctors. The biographic paper about D.D. Yablokov from the book Tomsk Dynasties. Twentieth Century (Tomsk, 1996) by the well-known journalist T.Yu. Kupert.

The Human Genome Project (HGP) provided the initial draft of mankind′s DNA sequence in 2001. The HGP was produced by 23 collaborating laboratories using Sanger sequencing of mapped regions as well as shotgun sequencing techniques in a process that occupied 13 years at a cost of ~$3 billion. Today, Next Generation Sequencing (NGS) techniques represent the next phase in the evolution of DNA sequencing technology at dramatically reduced cost compared to traditional Sanger sequencing. A single laboratory today can sequence the entire human genome in a few days for a few thousand dollars in reagents and staff time. Routine whole exome or even whole genome sequencing of clinical patients is well within the realm of affordability for many academic institutions across the country. This paper reviews current sequencing technology methods and upcoming advancements in sequencing technology as well as challenges associated with data generation, data manipulation and data storage. Implementation of routine NGS data in cancer genomics is discussed along with potential pitfalls in the interpretation of the NGS data. The overarching importance of bioinformatics in the clinical implementation of NGS is emphasized. [7] We also review the issue of physician education which also is an important consideration for the successful implementation of NGS in the clinical workplace. NGS technologies represent a golden opportunity for the next generation of pathologists to be at the leading edge of the personalized medicine approaches coming our way. Often under-emphasized issues of data access and control as well as potential ethical implications of whole genome NGS sequencing are also discussed. Despite some challenges, it′s hard not to be optimistic about the future of personalized genome sequencing and its potential impact on patient care and the advancement of knowledge of human biology and disease in the near future.