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.

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 explore Professor Cheng Wanjun's medication law in the treatment of hemospermia through data mining techniques combined with expert interviews.Methods The outpatient medical records of Cheng Wanjun for the treatment of hematospermia in the People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine were collected from January 2019 to May 2023,which were organized and summarized into a medical prescription database.The database was statistically analyzed by using Ancient and Modern Medical Case Cloud Platform 2.3.9,Excel 2019,Cytoscape 3.10.1 and SPSS Statistics 25.0 software to statistically analyze age stratification,drug frequency,efficacy frequency,property and taste and meridian,as well as association rules analysis,systematic clustering analysis and factor analysis.Combined with expert interviews,final conclusions were achieved.Results A total of 111 medical prescriptions of Professor Cheng Wanjun for the treatment of hematospermia were included,involving 119 kinds of Chinese materia medica,with a total frequency of 1 853 times.Among them,carbonized hair and processed Sanguisorbae Radix were used most frequently;most of them were used for tonifying deficiency,stopping bleeding,clearing heat and activating blood circulation and removing blood stasis;the main properties were cold and warm,and the main tastes were bitter and sweet,and most of them belonged to liver and lung meridians;the association rules analysis yielded 9 groups of medicinal pairs,12 groups of combinations with three kinds of Chinese materia medica,and 4 groups of combinations with four kinds of Chinese materia medica;the clustering analysis yielded three new prescriptions;the factor analysis extracted seven common factors.Conclusion Professor Cheng Wanjun's treatment of hemospermia is based on soothing the liver,clearing heat and dampness,activating blood circulation,removing blood stasis,clearing heat and cooling blood,and supplemented with nourishing yin,clearing heat and stopping bleeding,strengthening the spleen,nourishing blood and benefiting the qi.

Objective To explore Professor Cheng Wanjun's medication law in the treatment of hemospermia through data mining techniques combined with expert interviews.Methods The outpatient medical records of Cheng Wanjun for the treatment of hematospermia in the People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine were collected from January 2019 to May 2023,which were organized and summarized into a medical prescription database.The database was statistically analyzed by using Ancient and Modern Medical Case Cloud Platform 2.3.9,Excel 2019,Cytoscape 3.10.1 and SPSS Statistics 25.0 software to statistically analyze age stratification,drug frequency,efficacy frequency,property and taste and meridian,as well as association rules analysis,systematic clustering analysis and factor analysis.Combined with expert interviews,final conclusions were achieved.Results A total of 111 medical prescriptions of Professor Cheng Wanjun for the treatment of hematospermia were included,involving 119 kinds of Chinese materia medica,with a total frequency of 1 853 times.Among them,carbonized hair and processed Sanguisorbae Radix were used most frequently;most of them were used for tonifying deficiency,stopping bleeding,clearing heat and activating blood circulation and removing blood stasis;the main properties were cold and warm,and the main tastes were bitter and sweet,and most of them belonged to liver and lung meridians;the association rules analysis yielded 9 groups of medicinal pairs,12 groups of combinations with three kinds of Chinese materia medica,and 4 groups of combinations with four kinds of Chinese materia medica;the clustering analysis yielded three new prescriptions;the factor analysis extracted seven common factors.Conclusion Professor Cheng Wanjun's treatment of hemospermia is based on soothing the liver,clearing heat and dampness,activating blood circulation,removing blood stasis,clearing heat and cooling blood,and supplemented with nourishing yin,clearing heat and stopping bleeding,strengthening the spleen,nourishing blood and benefiting the qi.

Objective To investigate the clinical manifestations,molecular genetics and gonadal pathol-ogy characteristics of patients with disorders of sex development(DSD),and to summarize the clinical experi-ence of identifying rare diseases from common symptoms.Methods The clinical data of 416 patients with DSD diagnosed and treated in the multidisciplinary center of DSD of Guangzhou Women and Children's Medical Cen-ter from May 2018 to August 2023 were retrospectively analyzed,summarized and discussed.Results Accord-ing to chromosome karyotype,416 cases of DSD were classified into three types:92 cases(22.1％)of abnormal sex chromosome karyotype,285 cases(68.5％)of 46,XY karyotype and 39 cases(9.4％)of 46,XX karyotype.Among the 92 patients with abnormal sex chromosome karyotype,59 cases were raised as males,18 cases(30.5％)complained of short penis with hypospadias and cryptorchidism.The most common karyotype was 45,X/46,XY(58 cases,63.0％).Among the 285 patients with 46,XY karyotype,238 cases were raised as males,and 63 cases(26.5％)complained of short penis and hypospadias;47 cases were raised as females,and 13 ca-ses(27.7％)complained of inguinal mass.A total of 216 patients with 46,XY karyotype were subjected to whole exome gene detection,and 155 cases(71.8％)were found to have molecular pathogenesis with the clinical phe-notype.Among the 39 patients with 46,XX karyotype,19 cases were raised as males,and 8 cases(42.1％)com-plained of short penis and hypospadias.In the 18 cases of gonad biopsy,17 cases showed testicular tissue in go-nads.Whole exome sequencing was performed in 14 cases.NR5A1 gene heterozygous mutation,SRY gene muta-tion and SOX3 gene mutation were found in 2 cases,respectively(14.3％).Twenty cases were raised as females,and 14 cases(70.0％)complained of clitoral hypertrophy.Gonad biopsy was performed in 8 cases,with 7 cases of ovotestis(87.5％)and 1 case of NR5A1 gene heterozygous mutation(14.3％).Conclusions The etiologies of DSD are complex and diverse,and the clinical manifestations are various,which can be manifested as hypospa-dias,micropenis,cryptorchidism and other common symptoms of the urinary system.Different etiologies have dif-ferent treatment options.Therefore,chromosome karyotype,molecular genetic testing and gonadal pathology can be used to clarify the cause of disease,especially for rare diseases,improve the detection rate,reduce the rate of missed diagnosis,and ensure reasonable treatment,especially sex selection.

Background::A phase II trial on recombinant human tenecteplase tissue-type plasminogen activator (rhTNK-tPA) has previously shown its preliminary efficacy in ST elevation myocardial infarction (STEMI) patients. This study was designed as a pivotal postmarketing trial to compare its efficacy and safety with rrecombinant human tissue-type plasminogen activator alteplase (rt-PA) in Chinese patients with STEMI.Methods::In this multicenter, randomized, open-label, non-inferiority trial, patients with acute STEMI were randomly assigned (1:1) to receive an intravenous bolus of 16 mg rhTNK-tPA or an intravenous bolus of 8 mg rt-PA followed by an infusion of 42 mg in 90 min. The primary endpoint was recanalization defined by thrombolysis in myocardial infarction (TIMI) flow grade 2 or 3. The secondary endpoint was clinically justified recanalization. Other endpoints included 30-day major adverse cardiovascular and cerebrovascular events (MACCEs) and safety endpoints.Results::From July 2016 to September 2019, 767 eligible patients were randomly assigned to receive rhTNK-tPA ( n = 384) or rt-PA ( n = 383). Among them, 369 patients had coronary angiography data on TIMI flow, and 711 patients had data on clinically justified recanalization. Both used a –15% difference as the non-inferiority efficacy margin. In comparison to rt-PA, both the proportion of patients with TIMI grade 2 or 3 flow (78.3% [148/189] vs. 81.7% [147/180]; differences: –3.4%; 95% confidence interval [CI]: –11.5%, 4.8%) and clinically justified recanalization (85.4% [305/357] vs. 85.9% [304/354]; difference: –0.5%; 95% CI: –5.6%, 4.7%) in the rhTNK-tPA group were non-inferior. The occurrence of 30-day MACCEs (10.2% [39/384] vs. 11.0% [42/383]; hazard ratio: 0.96; 95% CI: 0.61, 1.50) did not differ significantly between groups. No safety outcomes significantly differed between groups. Conclusion::rhTNK-tPA was non-inferior to rt-PA in the effect of improving recanalization of the infarct-related artery, a validated surrogate of clinical outcomes, among Chinese patients with acute STEMI.Trial registration::www.ClinicalTrials.gov (No. NCT02835534).

Objective:To analyze the trends and related factors of HIV self-testing willingness in young students in Zhejiang Province, and provide evidence for the development of AIDS prevention and control measures in young students.Methods:From 2017 to 2021, HIV/AIDS sentinel surveillance was carried out in students of colleges and universities in all 11 cities of Zhejiang Province. One university or vocational and technical college in each city was selected as a sentinel school. An anonymous questionnaire survey was conducted among 800 students aged ≥16 years and selected by phased cluster sampling in each university or college from April to June in each year to collect information about their social demographic characteristics, sexual behavior, HIV prevention and test services acceptance. The HIV self-testing willingness and the influencing factors were analyzed.Results:A total of 45 483 students were surveyed from 2017 to 2021, and the proportions of those with willingness of HIV self-testing were 0.4% (35/9 107), 3.7% (334/9 150), 5.2% (475/9 203), 6.3% (563/8 962)and 7.4% (674/9 061) respectively (trend χ2=582.74, P< 0.001). Among young students who had sexual contact history, the multivariate logistic regression analysis showed that factors related with higher willingness of HIV self-testing included those majoring in medicine ( OR=1.57, 95% CI:1.06-2.33), seeking sexual partners through internet or social-dating application ( OR=1.96, 95% CI:1.33-2.89), receiving HIV prevention services in the last year ( OR=1.33, 95% CI:1.02-1.74), and being heard of vending machines selling HIV test kits ( OR=1.80, 95% CI:1.34-2.41). The factors related with lower willingness of HIV self-testing inclued those who had multiple heterosexual partners ( OR=0.57, 95% CI: 0.36-0.89). Conclusions:The willingness of HIV self-testing in young students increased in Zhejiang during 2017-2021, the young students who had sex were more willing to self-test among them but the level was still low. It is necessary to further strengthen the health education of HIV/AIDS prevention and control and provide better testing services to promote HIV self-testing.

Objective Excimer laser coronary atherecomy ( ELCA) has been recently used for the treatment of complex coronary lesions including calcified stenosis , chronic total occlusions and in-stent restenosis. Such complex lesions are difficult to adequately treat with balloon angioplasty and /or intracoronary stenting.The aim of this study was to introduce our early experiences in using ELCA in China . Methods Fifteen patients were enrolled through our center from March 2015 to April 2016 , and excimer laser coronary angioplasty was performed on 15 lesions.Eleven patients were previously failed cases either from uncrossable balloon ( 9 lesions ) or expandable balloon ( 6 lesions ) . The procedure and clinical endpoints were recorded .Results Laser catheter with 0.9 mm diameters were used in all 15 coronary lesions.All the lesions were successfully crossed with laser catheter and finally dilated with balloon .The procedural success rate was 100%.Drug eluting stents ( DES ) were implanted in 86.7% lesions and 2 cases were treated with drug eluting balloon .Clinical success was obtained in all patients (100%).There was no dissection , major side branch occlusion , spasm, no-reflow phenomenon nor acute vessel closure . Conclusions This study shows that laser-facilitated coronary angioplasty is a simple , safe and effective device for the management of complex coronary lesions .

Objective To evaluate the clinical effects of two different revascularization approaches,one via percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and the other via coronary artery bypass graft (CABG),on short-and long-term prognosis in elderly patients with diabetes and multi-vessel coronary artery disease.Methods A retrospective analysis was conducted on 254 elderly patients with diabetes and multi-vessel coronary artery disease.Based on the revascularization approach,patients were divided into the PCI group (n=93) and the CABG group (n =161).The incidence of major cardiovascular events (MACE) were observed during hospitalization and 1-year after follow-up.Results All-cause mortality and the incidence of non-fatal myocardial infarction were higher in the CABG group than in the PCI group during hospitalization [4.9％ (8 cases) vs.1.1％ (1 cases),5.6％ (9 cases) vs.2.2％ (2 cases),each P＜0.05],while there was no significant difference in the incidence of MACE between the two groups1-year after follow-up (P＞ 0.05).The incidence of cerebrovascular events was lower in the PCI group than in the CABG group [2.2 ％ (2 cases) vs.6.2％ (10 cases),P＜0.05],while the rate of revascularization was higher in thePCI group than in the CABG group [6.5％ (6 cases) vs.1.9％ (3 cases),P＜0.05].Cox regression analysis showed that diabetes (OR =1.65,95％ CI:1.013-1.926,P =0.024) and left ventricular ejection fraction (OR =1.30,95 ％ CI:1.018-1.652,P =0.027) were independent risk factors for revascularization and cerebrovascular events.Conclusions MACEs during hospitalization are fewer in elderly patients with diabetes and multi-vessel coronary artery heart disease who received PCI than in those who received CABG.PCI has a similar mid-and long-term effect as CABG,bur PCI has a higher revascularization rate and lower risk of MACEs than CABG.

Objective To investigate the value of qualitative and quantitative parameters of MRI on diagnosis of benign and malig-nant breast lesions.Methods Patients were scanned with MRI who were confirmed as breast lesions verified by histopathology,and the time-signal curve(TIC),Slopemax ,the apparent diffusion coefficient values (ADC)were deduced.Results There were 24 benign and 11 malignant lesions.Features of benign lesions were shown as follow:The TIC type wasⅠmostly 91.7%,Slopemax was 0.65 %/s,the ADC values was 1.31×10 -3 mm2/s.Features of malignant lesions were shown as follow:The TIC type were Ⅱ and Ⅲ mostly (100%), Slopemax was 1.63 %/s,the ADC values was 1.06 ×10 -3 mm2/s.Conclusion Types of TIC,Slopemax ,the ADC values of MRI are valuable in the diagnosis of benign and malignant breast lesions,integrated functional parameters are better than an individual param-eters in that they can improve the accuracy of diagnosis.