To thoroughly implement the strategic deployment outlined in the Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovative Development of Traditional Chinese Medicine regarding research on dominant diseases of traditional Chinese medicine and to uphold the development philosophy of equal emphasis on traditional Chinese medicine and western medicine，the China Association of Chinese Medicine has fully played a leading academic role by systematically organizing and conducting a series of academic youth salons on clinical dominant diseases of traditional Chinese medicine. On September 13，2024，the 36^th Youth Salon on Clinical Dominant Diseases was successfully held in Nanjing，focusing on the advantages of traditional Chinese medicine and the integrative traditional Chinese medicine and western medicine in the diagnosis and treatment of erectile dysfunction （ED）. The conference brought together leading experts from traditional Chinese medicine，western medicine，and interdisciplinary fields，facilitating in-depth multidisciplinary discussions that led to key consensus on optimizing traditional Chinese medicine treatment protocols for ED，researching and developing new drugs of traditional Chinese medicine，and advancing interdisciplinary development in traditional Chinese medicine. This salon systematically sorted out the clinical strengths and distinctive features of traditional Chinese medicine in the diagnosis and treatment of ED. Based on current research foundations and clinical needs，it identified key directions for future scientific layout and scientific research tackling： （1） Standardization of syndrome differentiation system of traditional Chinese medicine for ED. （2） Optimization and standardization of intervention methods of integrated traditional Chinese medicine and western medicine. （3） High-quality clinical research guided by evidence-based medicine. （4） In-depth analysis of the pharmacological mechanisms of traditional Chinese medicine in the treatment of ED. （5） Clinical translation and application promotion of new drugs of traditional Chinese medicine. （6） Interdisciplinary integration and innovation in traditional Chinese medicine. For each research direction，key focus areas，expected objectives，and clinical value were further refined，along with the establishment of a scientifically sound priority funding level evaluation system. Therefore，building on the series of salons on the ED-focused dominant diseases of traditional Chinese medicine，this paper provides standardized guidance for clinical practice of traditional Chinese medicine in ED management，effectively contributing to the high-quality development of traditional Chinese medicine. It serves as a valuable reference for national scientific and technological strategic layout， research and development decision-making in new drugs of traditional Chinese medicine，research topic planning，and clinical guideline formulation.

BackgroundPreventing and intervening in adolescent gaming disorder is of significant practical importance. Gaming motivation is strongly linked to gaming addiction and serves a key function in comprehending and addressing addictive gaming behaviors. However， the relationship between components of gaming motivation and symptoms of gaming disorder remains unclear. ObjectiveTo explore the relationship between components of gaming motivation and symptoms of gaming disorder among adolescents， so as to provide references for the prevention and intervention of gaming disorder in this population. MethodsFrom January to February 2024， a cluster sampling method was employed to select 1 414 adolescents from four middle schools in Sichuan Province and Chongqing Municipality as participants in the study. Online Game Motivation Scale （OGMS） and Gaming Disorder Scale for Adolescents （GADIS-A） were administered. Network analysis methods were utilized to investigate the relationships between components of gaming motivation and symptoms of gaming disorder. ResultsThe network edge weights revealed that achievement motivation was positively correlated with impaired game control ability， continued gaming despite negative consequences and the frequency of symptom occurrence （r=0.115， 0.050， 0.076， P<0.05）. Social motivation was negatively correlated with negative consequences （r=-0.054， P<0.05），while immersion motivation was positively correlated with continued gaming despite negative consequences （r=0.032， P<0.05）. Achievement motivation exhibited the highest strength centrality （1.157） among the three components of gaming motivation. ConclusionThe connections between components of gaming motivation and symptoms of gaming disorder exhibit distinct patterns， with each motivational component influencing gaming disorder through specific symptom pathway. Among these components， achievement motivation plays the most critical role in the interplay between gaming motivation and symptoms of gaming disorder. ［Funded by Chongqing Science and Health Joint Medical Science and Technology Innovation Projects General Projects （number， 2023MSXM133）］

BACKGROUND: While emotional distress, encompassing anxiety and depression, has been associated with negative clinical outcomes, its impact across various clinical departments and general hospitals has been less explored. Previous studies with limited sample sizes have examined the effectiveness of specific treatments (e.g., antidepressants) rather than a systemic management strategy for outcome improvement in non-psychiatric inpatients. To enhance the understanding of the importance of addressing mental health care needs among non-psychiatric patients in general hospitals, this study retrospectively investigated the impacts of emotional distress and the effects of early detection and management of depression and anxiety on hospital length of stay (LOS) and rate of long LOS (LLOS, i.e., LOS >30 days) in a large sample of non-psychiatric inpatients. METHODS: This retrospective cohort study included 487,871 inpatients from 20 non-psychiatric departments of a general hospital. They were divided, according to whether they underwent a novel strategy to manage emotional distress which deployed the Huaxi Emotional Distress Index (HEI) for brief screening with grading psychological services (BS-GPS), into BS-GPS ( n = 178,883) and non-BS-GPS ( n = 308,988) cohorts. The LOS and rate of LLOS between the BS-GPS and non-BS-GPS cohorts and between subcohorts with and without clinically significant anxiety and/or depression (CSAD, i.e., HEI score ≥11 on admission to the hospital) in the BS-GPS cohort were compared using univariable analyses, multilevel analyses, and/or propensity score-matched analyses, respectively. RESULTS: The detection rate of CSAD in the BS-GPS cohort varied from 2.64% (95% confidence interval [CI]: 2.49%-2.81%) to 20.50% (95% CI: 19.43%-21.62%) across the 20 departments, with a average rate of 5.36%. Significant differences were observed in both the LOS and LLOS rates between the subcohorts with CSAD (12.7 days, 535/9590) and without CSAD (9.5 days, 3800/169,293) and between the BS-GPS (9.6 days, 4335/178,883) and non-BS-GPS (10.8 days, 11,483/308,988) cohorts. These differences remained significant after controlling for confounders using propensity score-matched comparisons. A multilevel analysis indicated that BS-GPS was negatively associated with both LOS and LLOS after controlling for sociodemographics and the departments of patient discharge and remained negatively associated with LLOS after controlling additionally for the year of patient discharge. CONCLUSION Emotional distress significantly prolonged the LOS and increased the LLOS of non-psychiatric inpatients across most departments and general hospitals. These impacts were moderated by the implementation of BS-GPS. Thus, BS-GPS has the potential as an effective, resource-saving strategy for enhancing mental health care and optimizing medical resources in general hospitals.
Humans ; Retrospective Studies ; Male ; Length of Stay/statistics & numerical data* ; Female ; Middle Aged ; Adult ; Psychological Distress ; Inpatients/psychology* ; Aged ; Anxiety/diagnosis* ; Depression/diagnosis*

Objective:To analyze differences on characteristics of HIV/AIDS knowledge, beliefs and behavior among female college students who reported having sex in Zhejiang Province between 2018 and 2020, and provide reference for HIV/AIDS prevention and control among female college students.Methods:Cross-sectional surveys were conducted in October-November 2018 and November-December 2020 among female college students in 13 universities in 11 cities in Zhejiang Province, and female college students who self-reported having sexual intercourse in the past year were included as study subjects, with sample size estimates of 5 265 and 9 466 for the two surveys, respectively. The factors related to the change of relevant characteristics of the two survey subjects were analyzed. The χ2 test was used for univariate analysis and logistic regression model was used for multivariate analysis.Statistical analyses were performed with SPSS 23.0 software. Results:Of the 17 354 and 20 675 female college students surveyed in 2018 and 2020, respectively, the proportion who self-reported having had sex in the past year was 6.56% (1 139/17 354) and 4.19% (866/20 675). Multivariate logistic regression analysis showed that compared with female college students in 2018, the students who have sexual behaviour, receiving health education class by their university in the past year (a OR=1.57, 95% CI:1.29-1.91), receiving HIV testing promotion by the university in the past year (a OR=2.59,95% CI:2.13-3.14), receiving self-assessment of HIV risk by the university in the past year (a OR=2.97,95% CI:2.43-3.65), high self-efficacyfor condom use (a OR=2.00, 95% CI:1.66-2.41), receiving voluntary counseling and HIV testing (VCT) (a OR=1.81,95% CI: 1.41-2.87), perceived risk of HIV infection (a OR=2.44, 95% CI:1.32-4.54), using condoms whenever having casual sexual behaviour in the past year (a OR=3.35,95% CI:1.66-6.77) were significantly higher in 2020. Conclusions:Compared with female college students in 2018, the proportion of female college students who self-reported sexual activity decreased slightly in 2020, and the proportion of receiving HIV/AIDS lectures or health education classes, the proportion of self-rated at risk of HIV infection, the proportion of receiving VCT, the proportion of using condoms with very high confidence in self-efficacy and condom use had an increased.

Objective:To understand the prevalence of psychoactive substance use and related factors in men who have unprotected sex with men in Zhejiang Province.Methods:Men who have unprotected sex with men were recruited by snowball sampling through men who have sex with men (MSM) social organization in Zhejiang to conduct a cross-sectional investigation from January 2022 to December 2023. The sample size was estimated to be 1 169 individuals. The information about their socio-demographic information, sexual behaviors, psychoactive substance use, and HIV testing were collected through on-site questionnaire survey. Logistic regression analysis model was used to analyze related factors about psychoactive substance use in this population.Results:A total of 1 914 men who have unprotected sex with men were included in the study, the average age of the study subjects was (31.43±10.46) years, and most of them were aged ≤35 years (70.8%, 1 356/1 914). Those with education level of high school or below accounted for 50.1% (960/1 914) and those who were not married accounted for 63.5% (1 216/1 914). Psychoactive substance use in the past 3 months was reported in 19.7% (377/1 914) of the subjects. Multivariate logistic regression analysis showed that the factors associated with psychoactive substance use in the past 3 months included age 26-35 years (a OR=1.65, 95% CI: 1.24-2.19), ≥2 sexual partners in the past 3 months (a OR=2.33, 95% CI: 1.82-2.97), STD diagnosed in the past 3 months (a OR=2.62, 95% CI: 1.45-4.74), and awareness of the HIV infection status of sexual partners (a OR=2.83, 95% CI: 2.12-3.78). Conclusions:The prevalence of psychoactive substance use in men who have unprotected sex with men was high in Zhejiang. It is necessary to strengthen the intervention in this population.

Objective:To investigate the level of urinary serine protease(Corin) in early diabetic kidney disease(DKD) and its correlation with clinical stage.Methods:One hundred and seventy-three patients with type 2 diabetes mellitus(DM) from two tertiary A hospitals in Henan, diagnosed between April 2023 and December 2023 were selected as the research group, and 120 healthy subjects were selected as the control group. Basic clinical information and laboratory data were collected, and urinary Corin level was detected. DM patients were classified into G1-G5 stages based on estimated glomerular filtration rate(eGFR), and those in the early DKD stages(G1-G3) were further divided into A1-A3 subgroups based on urinary albumin/creatinine ratio(ACR). Spearman correlation analysis was performed to assess relationships between urinary Corin and other indicators, linear regression analysis identified factors influencing urinary Corin in early DKD patients, logistic regression analysis evaluated the risk factors for early DKD, and receiver operating characteristic(ROC) curve analysis determined the diagnostic value of urinary Corin in early DKD. Results:Urinary Corin levels were significantly higher in early DKD patients compared to healthy controls, with levels increasing as ACR rose( P<0.05). Urinary Corin was positively associated with serum creatinine( r=0.570), urea( r=0.458), cystatin C( r=0.693), ACR( r=0.616), urinary transferrin( r=0.448), urinary α1 microglobulin( r=0.507), urinary n-acetyl-β-D-glucosaminase( r=0.388) and A subgroup( r=0.692) while was negatively correlated with eGFR( r=-0.647), albumin( r=-0.312)(all P<0.05). eGFR was the only independent factor affecting urinary Corin. After adjusting for confounding factors in logistic regression analysis, urinary Corin was still an independent influencing factor for early DKD. ROC curve analysis indicated that urinary Corin had a diagnostic AUC of 0.842(95% CI 0.791-0.892, P<0.001), with a cut-off value of 2 226.04 pg/mL, sensitivity of 0.712, and specificity of 0.858 for early DKD diagnosis. Conclusions:Urinary Corin was elevated in early DKD patients and correlated with clinical stage. Urinary Corin is an independent factor of early DKD, and a reliable predictor of early DKD diagnosis.

Objective To explore the feasibility of a deep learning model based on early fundus lesions without manual segmentation in pan-retinal images for predicting diabetic kidney disease(DKD)and evaluating the enhancing effects of different binocular fusion strategies.Methods A retrospective cohort of 353 patients with type 2 diabetes mellitus(T2DM)admitted to the Endocrinology Department of Jiangdu People's Hospital Affiliated to Yangzhou University between December 2022 and March 2024 was analyzed.Patients were divided into DKD(n=114)and non-diabetic kidney disease(NDKD)(n=239)group based on the presence of DKD.First,a U-Net-based pre-trained automatic segmentation model was developed to process panoramic fundus retinal images.Subsequently,left and right eye deep learning models were constructed using ResNet152 under a five-fold cross-validation framework(70%training,30%validation).Three binocular fusion strategies were implemented:result fusion,feature fusion,and image fusion models.Model performance was evaluated using the area under the receiver operating characteristic(ROC)curve(AUC).DeLong test was used to compare AUC differences among models,while net reclassification index(NRI)and decision curve analysis(DCA)were used to assess clinical utility.Results Six prediction models were developed:clinical parameter model,left fundus model,right fundus model,binocular image fusion model,binocular result fusion model,and binocular feature fusion model.The Transformer-based binocular feature fusion model achieved the highest AUC in both training and validation sets(0.864 and 0.658,respectively).DeLong tests revealed significant AUC superiority of the Transformer model over the other five models in the training set(all P<0.001),though no significant differences were observed in the validation set(all P>0.05).NRI analysis showed negative values for all comparisons with the Transformer model(training set:-0.255,-0.244,-0.289,-0.426,-0.163;validation set:-0.060,-0.016,-0.028,-0.105,-0.033,respectively),indicating its optimal predictive performance.DCA further demonstrated greater net benefit for the Transformer-based fusion model.Conclusions The deep learning model constructed using early fundus lesions without manual segmentation in pan-retinal images can predict DKD.The Transformer-based fusion strategy present the best performance,providing a novel approach for further optimization and development of tools to predict DKD in the future.

Objective:To analyze differences on characteristics of HIV/AIDS knowledge, beliefs and behavior among female college students who reported having sex in Zhejiang Province between 2018 and 2020, and provide reference for HIV/AIDS prevention and control among female college students.Methods:Cross-sectional surveys were conducted in October-November 2018 and November-December 2020 among female college students in 13 universities in 11 cities in Zhejiang Province, and female college students who self-reported having sexual intercourse in the past year were included as study subjects, with sample size estimates of 5 265 and 9 466 for the two surveys, respectively. The factors related to the change of relevant characteristics of the two survey subjects were analyzed. The χ2 test was used for univariate analysis and logistic regression model was used for multivariate analysis.Statistical analyses were performed with SPSS 23.0 software. Results:Of the 17 354 and 20 675 female college students surveyed in 2018 and 2020, respectively, the proportion who self-reported having had sex in the past year was 6.56% (1 139/17 354) and 4.19% (866/20 675). Multivariate logistic regression analysis showed that compared with female college students in 2018, the students who have sexual behaviour, receiving health education class by their university in the past year (a OR=1.57, 95% CI:1.29-1.91), receiving HIV testing promotion by the university in the past year (a OR=2.59,95% CI:2.13-3.14), receiving self-assessment of HIV risk by the university in the past year (a OR=2.97,95% CI:2.43-3.65), high self-efficacyfor condom use (a OR=2.00, 95% CI:1.66-2.41), receiving voluntary counseling and HIV testing (VCT) (a OR=1.81,95% CI: 1.41-2.87), perceived risk of HIV infection (a OR=2.44, 95% CI:1.32-4.54), using condoms whenever having casual sexual behaviour in the past year (a OR=3.35,95% CI:1.66-6.77) were significantly higher in 2020. Conclusions:Compared with female college students in 2018, the proportion of female college students who self-reported sexual activity decreased slightly in 2020, and the proportion of receiving HIV/AIDS lectures or health education classes, the proportion of self-rated at risk of HIV infection, the proportion of receiving VCT, the proportion of using condoms with very high confidence in self-efficacy and condom use had an increased.

Cardiovascular nursing research focuses on solving practical nursing problems, and nursing practice is continuously improved based on nursing research. This article provides an overview of the development of cardiovascular nursing research, summarizes and generalizes the current research status and future research hotspots in cardiovascular nursing according to the Fuwai Subject Headings, aiming to provide references for nursing staff.