Objective: To investigate the status of condom use and its influencing factors among men who have sex with men (MSM), so as to provide a basis for improving condom utilization rates and AIDS prevention and control in this population. Methods: From May to October 2024, a snowball sampling method was employed to recruit MSM in Songjiang District, Shanghai Municipality. Self-administered questionnaires were used to collect data on demographic characteristics, AIDS-related knowledge, sexual behaviors, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), and condom use in the past six months. Multivariable logistic regression model was used to analyze the influencing factors for consistent condom use. Results: A total of 921 MSM were surveyed, with a median age of 29.00 (interquartile range, 9.00) years. Among them, 697 (75.68%) were aware of AIDS-related knowledge, 826 (89.69%) expressed willingness to use PrEP, and 835 (90.66%) were willing to use PEP. Additionally, 787 (85.45%) MSM reported their age at first homosexual intercourse as ≥18 years, while 519 (56.35%) reported consistent condom use in the past six months. Multivariable logistic regression analysis revealed that MSM who were aware of AIDS-related knowledge (OR=0.582, 95% CI: 0.423-0.801), willing to use PrEP (OR =0.611, 95% CI: 0.385-0.969), and whose age at first homosexual intercourse was <18 years (OR=0.480, 95% CI: 0.330-0.700) were less likely to consistent use condoms. Conclusion The proportion of consistent condom use among the MSM remains relatively low, which is primarily associated with AIDS-related knowledge, willingness to use PrEP, and the age at first homosexual intercourse.

Objective To explore the application value of computed tomography (CT) three-dimensional reconstruction in total knee arthroplasty (TKA). Methods A total of 102 patients who underwent TKA in our hospital between April 2022 and April 2025 were enrolled and divided using a random number table into a traditional group (51 cases, routine preoperative evaluation) and a study group (51 cases, CT three-dimensional reconstruction-assisted surgery). The therapeutic efficacy at 3 months postoperatively and perioperative indicators were compared between the two groups. The hip-knee-ankle (HKA) angle was measured preoperatively and at 3 months postoperatively. The Hospital for Special Surgery (HSS) knee score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were recorded preoperatively and at 3 and 6 months postoperatively. Complications were documented. Results The excellent/good rate in the study group (92.16%) was higher than that in the traditional group (74.51%) (P<0.05). The operation time, intraoperative blood loss, postoperative drainage volume, and hospital stay in the study group were (69.52 ± 7.11) min, (102.69 ± 8.54) mL, (167.33 ± 12.35) mL, and (10.93 ± 2.37) days, respectively, which were shorter than those in the traditional group [(78.45 ± 5.98) min, (108.36 ± 10.02) mL, (175.96 ± 14.93) mL, and (12.04 ± 1.95) days] (P<0.05). At 3 months postoperatively, the HKA angle was 178.02° ± 1.05° in the study group and 177.45° ± 1.34° in the traditional group, both were significantly improved compared with those before operation, with the study group showing better improvement (P<0.05). The HSS knee and WOMAC scores in both groups at 3 and 6 months postoperatively were improved compared with preoperative scores (P<0.05). At 3 and 6 months postoperatively, the study group showed higher HSS knee score and lower WOMAC score than the traditional group (P<0.05). The incidence of complications in the study group (3.92%) was lower than that in the traditional group (17.65%) (P<0.05). Conclusion TKA guided by CT three-dimensional reconstruction improved the excellent/good rate, optimized HKA angle and knee function, shortened operation time and hospital stay, reduced intraoperative blood loss and postoperative drainage volume, and decreased the incidence of complications.

Objective To explore the application value of computed tomography (CT) three-dimensional reconstruction in total knee arthroplasty (TKA). Methods A total of 102 patients who underwent TKA in our hospital between April 2022 and April 2025 were enrolled and divided using a random number table into a traditional group (51 cases, routine preoperative evaluation) and a study group (51 cases, CT three-dimensional reconstruction-assisted surgery). The therapeutic efficacy at 3 months postoperatively and perioperative indicators were compared between the two groups. The hip-knee-ankle (HKA) angle was measured preoperatively and at 3 months postoperatively. The Hospital for Special Surgery (HSS) knee score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were recorded preoperatively and at 3 and 6 months postoperatively. Complications were documented. Results The excellent/good rate in the study group (92.16%) was higher than that in the traditional group (74.51%) (P<0.05). The operation time, intraoperative blood loss, postoperative drainage volume, and hospital stay in the study group were (69.52 ± 7.11) min, (102.69 ± 8.54) mL, (167.33 ± 12.35) mL, and (10.93 ± 2.37) days, respectively, which were shorter than those in the traditional group [(78.45 ± 5.98) min, (108.36 ± 10.02) mL, (175.96 ± 14.93) mL, and (12.04 ± 1.95) days] (P<0.05). At 3 months postoperatively, the HKA angle was 178.02° ± 1.05° in the study group and 177.45° ± 1.34° in the traditional group, both were significantly improved compared with those before operation, with the study group showing better improvement (P<0.05). The HSS knee and WOMAC scores in both groups at 3 and 6 months postoperatively were improved compared with preoperative scores (P<0.05). At 3 and 6 months postoperatively, the study group showed higher HSS knee score and lower WOMAC score than the traditional group (P<0.05). The incidence of complications in the study group (3.92%) was lower than that in the traditional group (17.65%) (P<0.05). Conclusion TKA guided by CT three-dimensional reconstruction improved the excellent/good rate, optimized HKA angle and knee function, shortened operation time and hospital stay, reduced intraoperative blood loss and postoperative drainage volume, and decreased the incidence of complications.

Objective To explore the application value of computed tomography (CT) three-dimensional reconstruction in total knee arthroplasty (TKA). Methods A total of 102 patients who underwent TKA in our hospital between April 2022 and April 2025 were enrolled and divided using a random number table into a traditional group (51 cases, routine preoperative evaluation) and a study group (51 cases, CT three-dimensional reconstruction-assisted surgery). The therapeutic efficacy at 3 months postoperatively and perioperative indicators were compared between the two groups. The hip-knee-ankle (HKA) angle was measured preoperatively and at 3 months postoperatively. The Hospital for Special Surgery (HSS) knee score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were recorded preoperatively and at 3 and 6 months postoperatively. Complications were documented. Results The excellent/good rate in the study group (92.16%) was higher than that in the traditional group (74.51%) (P<0.05). The operation time, intraoperative blood loss, postoperative drainage volume, and hospital stay in the study group were (69.52 ± 7.11) min, (102.69 ± 8.54) mL, (167.33 ± 12.35) mL, and (10.93 ± 2.37) days, respectively, which were shorter than those in the traditional group [(78.45 ± 5.98) min, (108.36 ± 10.02) mL, (175.96 ± 14.93) mL, and (12.04 ± 1.95) days] (P<0.05). At 3 months postoperatively, the HKA angle was 178.02° ± 1.05° in the study group and 177.45° ± 1.34° in the traditional group, both were significantly improved compared with those before operation, with the study group showing better improvement (P<0.05). The HSS knee and WOMAC scores in both groups at 3 and 6 months postoperatively were improved compared with preoperative scores (P<0.05). At 3 and 6 months postoperatively, the study group showed higher HSS knee score and lower WOMAC score than the traditional group (P<0.05). The incidence of complications in the study group (3.92%) was lower than that in the traditional group (17.65%) (P<0.05). Conclusion TKA guided by CT three-dimensional reconstruction improved the excellent/good rate, optimized HKA angle and knee function, shortened operation time and hospital stay, reduced intraoperative blood loss and postoperative drainage volume, and decreased the incidence of complications.

With the rapid advancement of medical technology and the increasing complexity of clinical environments, competence in clinical ethical decision-making has become an indispensable core competency for exemplary physicians. However, traditional medical ethics education has long been confronted with the persistent challenges of theory-practice dissociation and the disconnect between pedagogical settings and clinical realities. Thus, how to construct a "Clinical Ethics" curriculum that aligns with the objectives of training high-caliber medical professionals has emerged as a critical and challenging issue in current medical education reform. To effectively address this challenge, the Office of Education at Peking University Third Hospital, since 2021, has assembled a multidisciplinary "Clinical Ethics" teaching and management team comprising faculty from Peking University School of Humanities and key clinical specialists from the hospital. In 2022, the "Clinical Ethics" elective course was formally launched for fourth-year students in the eight-year MD program who had completed coursework in "Medical Ethics" and organ-system-based curricula, with the aim of exploring and operationalizing a pre-clinical ethics education model tailored for senior medical students. The course employs a modular instructional design encompassing "theoretical review-case-based deliberation-clinical workshop", which effectively facilitates the deep integration of medical humanities with clinical practice.Following four years of iterative refinement through the "plan-act-observe-reflect" cycle, the course has demonstrated positive outcomes in enhancing students' ethical awareness and decision-making capabilities, and has preliminarily established a sustainable collaborative mechanism among the multidisciplinary faculty team. This article systematically delineates the course development background, pedagogical model and methodological innovations, and the multidisciplinary collaborative framework, alongside reflections and summaries based on implementation outcomes, with the intent of providing references for the future development of "Clinical Ethics" curricula.

Objective To explore the predictive value of serum C-reactive protein(CRP)/albumin(Alb)ratio,cystatin C(CysC),procalcitonin(PCT),and serum amyloid A(SAA)levels for urinary tract infection after percutaneous nephrolithotripsy in patients with upper urinary tract calculi.Methods A retrospective se-lection was made of 127 patients with upper urinary tract calculi who underwent percutaneous nephrolithotrip-sy in this hospital from January 2021 to January 2024 as the research subjects.The patients were divided into the infection group(n=66)and the non-infection group(n=61)according to their postoperative urinary tract infection conditions.Analyze the distribution of pathogenic bacteria in the infection group,as well as the com-parison of clinical data,CRP/Alb ratio,CysC,PCT and SAA levels between the two groups.Multivariate Lo-gistic regression was used to analyze the influencing factors of postoperative urinary tract infection in patients.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of CRP/Alb ratio,CysC,PCT and SAA levels for postoperative urinary tract infection in patients.Results The pathogenic bacte-ria in the infection group were mainly Gram-negative bacteria[44(66.67％)].The proportions of smoking history and operation duration ≥60 minutes in the infection group were higher than those in the non-infection group,and the difference was statistically significant(P＜0.05).The CRP/Alb ratio,CysC,SAA and PCT levels in the infection group were higher than those in the non-infection group,and the difference was statisti-cally significant(P＜0.05).The results of multivariate Logistic regression analysis showed that smoking his-tory,operation duration ≥60 min,upregulation of CRP/Alb ratio,CysC,SAA,and PCT levels were risk fac-tors for postoperative urinary tract infection in patients(P＜0.05).The results of ROC curve analysis showed that the combined prediction of CRP/Alb ratio,CysC,SAA and PCT for postoperative urinary tract infection in patients had a sensitivity of 89.41％,a specificity of 90.22％,and an area under the curve(AUC)of 0.933.The AUC of the combined prediction was higher than that of the individual predictions of CysC,SAA and PCT(Z=3.564,2.846,2.644,P＜0.05).Conclusion The serum CRP/Alb ratio,CysC,PCT,and SAA levels have important predictive value for urinary tract infection after percutaneous nephrolithotripsy in patients with up-per urinary tract calculi.

Objective:To investigate the effects and mechanism of Qiangjin Zhuanggu Capsules in bone remodeling in ovariectomized osteoporotic mice.Methods:Totally 75 8-week-old C57BL/6 female mice were divided into a sham-operation group of 15 mice and a modeling group of 60 mice. The model was created using bilateral ovariectomy (OVX) to replicate a postmenopausal osteoporosis mouse model. The successfully modeled mice were divided into model group, estradiol group, and Qiangjin Zhuanggu Capsules low-, medium-, and high-dosage groups using a random number table method, with 10 mice in each group. The estradiol group was given a 0.013 mg/ml solution of estradiol valerate tablets by gavage; Qiangjin Zhuanggu Capsules low-, medium-, and high-dosage groups were orally administered with Qiangjin Zhuanggu Capsule solution at dosages of 46.0, 92.0, and 184.0 mg/ml. The sham-operation group and model group were orally administered with equal volumes of physiological saline once a day for 8 consecutive weeks. After the intervention, the femoral trabecular bone structure, bone mineral density (BMD), bone volume/total volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), bone surface area/bone volume (BS/BV), and trabecular separation (Tb.Sp) were assessed using Micro-CT. Serum levels of bone metabolism markers such as calcium (Ca), phosphorus (P), bone alkaline phosphatase (BALP), osteocalcin (OCN), and cathepsin K (CTSK) were measured by ELISA. Hematoxylin and eosin (HE) and Masson staining were used to observe the morphological changes in femoral trabecular bone structure and collagen fibers. Western blot analysis was employed to detect the protein expression of Runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP), and bone morphogenetic protein-2 (BMP-2), .Results:Compared with the model group, the levels of BMD, BV/TV, Tb. N, and Tb.Th ( P<0.01 or P<0.05) in estradiol group and Qiangjin Zhuanggu Capsule medium- and high-dosage groups increased ( P<0.01, P<0.05), and BS/BV and Tb.Sp decreased ( P<0.01, P<0.05)serum levels of Ca, P, BALP, and OCN were elevated ( P<0.01, P<0.05), while CTSK was reduced ( P<0.01); the expression of Runx2, ALP and BMP-2 proteins significantly increased ( P<0.01, P<0.05). Conclusion:Qiangjin Zhuanggu Capsules exhibit preventive and therapeutic effects on postmenopausal osteoporosis, potentially through the regulation of Runx2, ALP and BMP-2.

Objective To investigate the immediate therapeutic efficacy of Kuanxiong Aerosol on improving the angina pectoris in the patients complicated with intermediate coronary stenosis(ICS),and to observe its effect on resting full-cycle ratio(RFR),corrected TIMI(thrombolysis in myocardial infarction)frame count(CTFC)in angiography,and coronary serum inflammatory factors.Methods Sixty angina pectoris patients with ICS admitted to the Cardiovascular Department of Dade Road Hospital,Guangdong Provincial Hospital of Traditional Chinese Medicine from March 2023 to March 2024 were randomly divided into the trial group and the control group,with 30 patients in each group.The trial group was given four consecutive sprays of Kuanxiong Aerosol by sublingual spray,and the control group had no intervention but just was given the monitoring for 10 minutes.Before and after the intervention,the changes of coronary RFR,CTFC,Visual Analogue Scale(VAS)score of chest pain,and the serum levels of C-reactive protein(CRP),interleukin 6(IL-6)and lipoprotein-associated phospholipase A2(Lp-PLA2)in the two groups were observed.Moreover,the incidence of adverse reactions during the intervention in the two groups of patients was compared.Results(1)After the intervention,the coronary RFR value of the trial group was increased significantly compared with that before intervention(P<0.01),while the coronary RFR value of the control group was not increased significantly compared with that before intervention(P>0.05);the comparison between the two groups showed that the effect on increasing the coronary RFR value in the trial group was superior to that in the control group(P<0.05).(2)After intervention,the CTFC value of the trial group was significantly decreased compared with that before intervention(P<0.01),while the CTFC value of the control group was not significantly decreased compared with that before intervention(P>0.05);the intergroup comparison showed that the trial group tended to have a better effect on the decrease of CTFC value than the control group,but the difference being not statistically significant(P>0.05).(3)After the intervention,the chest pain VAS score of the trial group was significantly reduced compared with that before intervention(P<0.01),while the pre-and post-treatment changes of the score in the control group was not significant(P>0.05);the intergroup comparison showed that the decrease of the chest pain VAS score in the trial group was superior to that in the control group(P<0.01).In particular for immediate therapeutic efficacy,Kuanxiong Aerosol achieved the effective rate of 96.67%(29/30)for relieving chest pain 10 minutes after sublingual spraying,which was significantly superior to that of the control group[10.00%(3/30)],and the comparison between the two groups showed that the difference was statistically significant(P<0.001).(4)After the intervention,the Lp-LPA2 value of the trial group was decreased compared with that before intervention(P<0.05),while the CRP and IL-6 values of the trial group as well as the CRP,IL-6,and Lp-LPA2 values of the control group were all not significantly decreased compared with those before intervention(P>0.05).The intergroup comparison showed that the trial group's effect on the decrease of Lp-LPA2 value was significantly superior to that of the control group(P<0.05).(5)Before and after the intervention,no obvious changes of the general vital signs in the two groups were shown,no drug-related adverse occurred,either.Conclusion Kuanxiong Aerosol can immediately improve the coronary physiological function indicators of angina pectoris patients with ICS,increase the coronary flow rate,and inhibit inflammatory response of the coronary artery to some degree,thus to alleviate the symptoms of angina pectoris in patients with ICS.

Objective To investigate the therapeutic mechanism of Nuanxin Capsules(NXC)in ischemic heart failure(IHF)using network pharmacology and in vivo experimental validation.Methods Active components of NXC were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and SwissTargetPrediction database.Potential IHF-related targets were predicted via OMIM and GeneCards databases.Shared targets between NXC and IHF were identified to construct a"NXC-shared targets-IHF"network.Key bioactive components were screened,and protein-protein interaction(PPI)networks were built using STRING database.Core target modules were analyzed via CytoHubba plugin in Cytoscape 3.7.2.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analyses were performed using Metascape.For in vivo validation,an IHF mouse model was established by permanent ligation of the left anterior descending coronary artery.After 4-week intervention,cardiac function/structure was assessed by echocardiography,histopathology by hematoxylin-eosin(HE)staining,lymphatic vessel density by immunofluorescence,and protein expression of vascular endothelial growth factor C(VEGFC)and vascular endothelial growth factor receptor 3(VEGFR3)by Western Blot.Results Network pharmacology identified 242 shared targets between NXC and IHF,with core components including apigenin,pongapin,naringenin,4',5,7,8-tetramethoxyflavone,and tangeretin.Four core molecular clusters were identified(e.g.,VEGFC,FLT4/VEGFR3).GO analysis revealed enrichment in cellular response to nitrogen compounds,positive regulation of cell migration/phosphorus metabolism,and inflammatory response modulation.KEGG pathways included cancer,lipid/atherosclerosis,and endocrine resistance pathways.In vivo experiments demonstrated that NXC significantly improved cardiac function,attenuated pathological changes and inflammatory infiltration,promoted lymphangiogenesis,and upregulated VEGFC/VEGFR3 protein expression in IHF mice.Conclusion NXC may ameliorate IHF by promoting cardiac lymphangiogenesis via VEGFC/VEGFR3 signaling.

Objective To investigate the expression level and diagnostic value of serum cysteine protease inhibitor S(CST4)in patients with gastric cancer.Methods Clinical data of 115 patients with suspected gastric cancer who complained of gastric discomfort were retrospectively analyzed,and they were divided into benign disease group(n=50),precancerous disease group(n=26)and gas-tric cancer group(n=39).The levels of serum CST4,carcinoembryonic antigen(CEA),carbohy-drate antigen 19-9(CA19-9)and carbohydrate antigen 72-4(CA72-4)were analyzed in the three groups.The positive rates of CST4 among the three groups were compared.Binary Logistic regression analysis was used to screen for independent risk factors for gastric cancer occurrence.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of CST4 in gastric cancer.Results The positive rate of CST4 was 6.00％(3/50)in the benign gastric disease group,30.77％(8/26)in the gastric precancerous lesion group,and 66.67％(26/39)in the gastric canc-er group.The positive rate of CST4 in the gastric cancer group was higher than that in the gastric pre-cancerous lesion group and the benign gastric disease group(P＜0.05).The results of binary Logistic regression analysis showed that advanced age,high levels of serum CST4 and high levels of CEA were independent risk factors for gastric cancer occurrence(P＜0.05).The area under the curve(AUC)for CST4 alone in diagnosing gastric cancer was 0.847(95％CI,0.760 to 0.934),with an optimal cut-off value of 94.6 U/mL,the Youden index of 0.638,sensitivity of 71.8％,and specificity of 92.0％.The AUC for the combined diagnosis of gastric cancer using CST4,age and CEA was 0.959(95％CI,0.919 to 0.992),with sensitivity of 94.9％and specificity of 86.0％.Conclusion As a novel se-rum marker,CST4 has high predictive value in the auxiliary diagnosis of gastric cancer.