No abstract

Gene therapy is becoming an important treatment modality for gravely ill patients, and today's medical students and postgraduates are both potential consumers and future providers of gene therapy. Therefore, their attitudes and concerns about gene therapy may directly influence its long-term development and implementation in the clinic. We performed a cross-sectional survey of medical students and postgraduates at West China Medical School of Sichuan University. A custom-designed questionnaire was distributed to 600 students, and 579 were valid (96.98% response). Most respondents (84.46%) indicated little prior knowledge about gene therapy. The proportion of respondents considering gene therapy as acceptable ranged from 63.73% for serious illness to 17.72% for genetic enhancement. Adverse side effects were the most frequent concern among respondents when asked to imagine that they would receive gene therapy to treat a severe brain-related illness. These results suggest that medical students in China consider gene therapy's acceptability to be rather low, and are most concerned about its adverse side effects.

The aim of this study is to evaluate the ability of the random forest algorithm that combines data on transrectal ultrasound findings, age, and serum levels of prostate-specific antigen to predict prostate carcinoma. Clinico-demographic data were analyzed for 941 patients with prostate diseases treated at our hospital, including age, serum prostate-specific antigen levels, transrectal ultrasound findings, and pathology diagnosis based on ultrasound-guided needle biopsy of the prostate. These data were compared between patients with and without prostate cancer using the Chi-square test, and then entered into the random forest model to predict diagnosis. Patients with and without prostate cancer differed significantly in age and serum prostate-specific antigen levels (P < 0.001), as well as in all transrectal ultrasound characteristics (P < 0.05) except uneven echo (P = 0.609). The random forest model based on age, prostate-specific antigen and ultrasound predicted prostate cancer with an accuracy of 83.10%, sensitivity of 65.64%, and specificity of 93.83%. Positive predictive value was 86.72%, and negative predictive value was 81.64%. By integrating age, prostate-specific antigen levels and transrectal ultrasound findings, the random forest algorithm shows better diagnostic performance for prostate cancer than either diagnostic indicator on its own. This algorithm may help improve diagnosis of the disease by identifying patients at high risk for biopsy.

The cases of caozheng 漕政 (The government administration of the collection and transport of grain taxes by water in the former times) are present in all stages in the Qing Dynasty. The social interaction and interest dispute involve the commoners, officials, and gentries in the localities in all kinds of caozheng cases. Caozheng cases that are inspired by lofty motives and filed under the established procedure are often mingled with trumped-up charges that are pressed through illegitimate means. They are employed as conventional methods by both commoners and officials for their own interests. By virtue of an in-depth analysis of such representative cases as the lawsuit issued by Kuang Guangwen, it is plainly evident that caozheng cases happen on many occasions because the long-standing malpractices spread uncontrollably in the middle and late stages of the Qing. It is both the attitude taken by the local officials towards the management of caozheng and their rationale behind the exercise of power that always dictated how such incidents take place and come to an end and therein lies the crux of a persistent problem. The caozheng cases reflects the pervasive influence that the collection of grain taxes extends on the life of the *

Based on the investigation of local chronicles, it is found that the litigation environment of Fujian province in Qing dynasty has certain regional characteristics. Compared with inland provinces, the types of litigation in Fujian province in Qing dynasty showed the characteristics of sea frontier areas. The frequently occurred armed fight (fight with weapons between groups of people), false incrimination (the false accusation of the other side in a murder case), farmland dispute (a dispute over land) and dispute over water conservation, truly reflected the governance dilemma of population explosion and insufficient survival resources faced by local social governance of Fujian province in the Qing dynasty. Through the comparison of prefectures in Fujian province, it is also found that the typical lawsuit types and causes are different in southern Fujian, western Fujian and central Fujian. Behind the different causes of litigation, the unique regional governance problems in different regions are reflected. In dealing with local government affairs and lawsuits, local officials should understand local characteristics and learn how to "enforce law according to local conditions".