In order to make the shared traditional Chinese medicine （TCM） pharmacy develop more efficiently and normatively at the grass-roots level， using the “shared TCM pharmacy” as the retrieval word， this paper uses the literature research method to retrieve the reports， documents and policies from CNKI， the websites of people’s governments at all levels， the official websites of the State Administration of Traditional Chinese Medicine， people.com， China News Network， Xinhua News and other platforms before May 20， 2022， sort out the development mode and history of two “Internet plus” TCM pharmacies， namely “shared TCM pharmacies” and “smart TCM pharmacies”， and compare them with each other. Combined with the actual work of community hospitals and community service centers （stations）， the necessity and advantages （such as reducing the costs of the intermediate links of drug circulation and standardizing the grass-roots drug use process） of the development of “shared TCM pharmacy” are obtained from the perspective of primary medical care. Combined with the current situation of the promotion and application of shared TCM pharmacy in county medical communities， it is concluded that the shared TCM pharmacy should be further constructed from four aspects： improving the work process of drug centralized procurement under the background of normalization， improving the compatibility and synchronization of the whole process dispensing information system module， unifying pharmaceutical services and personnel training， defining the authority of data query and clarifying the boundaries of patient privacy to further build a shared TCM pharmacy. Finally， it integrates information technology， summarizes the definition of shared TCM pharmacy and its future construction direction， and provides reference for the next development of shared TCM pharmacy at the grass-roots level.

Objective:To understand the source and related factors among heterosexual casual partners among male college students for providing AIDS prevention strategies in this population.Methods:Stratified cluster sampling method was used to conduct a questionnaire survey among 31 674 college students in 13 colleges in Zhejiang Province, from October to November, 2018. A total of 2 665 male college students who reported having had heterosexual casual behavior and the source of their sexual partners were recruited. Data on demographic characteristics, knowledge of HIV/AIDS prevention, sexual behavior, and having received AIDS-related interventions were collected. The multivariable logistics regression model was used to analyze the related factors of the source of casual heterosexual behavior partners among male college students.Results:A total of 423 male college students having casual heterosexual sex were investigated, accounting for 15.9% (423/2 665) of the male college students who self-reported having sexual behaviors and informed their sexual partners. Among them, 39.4% (147/373), 37.5% (140/373), and 23.1% (86/373) of participants had 1, 2-4, and 5 or more heterosexual casual sexual partners, respectively. 40.1% (167/416) of participants used condoms consistently with casual partners. 143 (33.8%) participants with social individual's partners were an average age of (20.27±1.40) years old. Multivariate logistic regression analysis showed that: when compared with one person, common acquaintances, and no heterosexual casual partners in the previous year, the factors that related to the source of heterosexual casual partners of male college students appeared as follows: the number of heterosexual casual sexual partners ≥5 (a OR=3.00, 95% CI:1.53-5.89), seeking the casual sexual partners through entertainment venues (a OR=3.04,95% CI:1.64-5.64), male college students having sex with a regular partner in the last one year (a OR=0.41, 95% CI:0.25-0.68). Conclusions:Some of the male college students had heterosexual casual sexual behaviors, with the related factors as having five or more heterosexual casual sexual partners, seeking casual sex partners through entertainment venues, and low condom use. Self-protection awareness and ability should be emphasized to advocate safe sex to reduce the risk of AIDS transmission among college students.

OBJECTIVE To prepare and evalu ate doxorubicin-loaded red blood cell membrane chitosan-targeted nanoparticles of targeting tumor cell folate acid （FA）receptor（FA-RBC-DOX-CS-NPs）. METHODS Doxorubicin-loaded chitosan nanoparticles （DOX-CS-NPs） were prepared by ion cross-linking method. FA and amino polyethylene glycol phospholithin （NH2- PEG2000-DSPE）were covalently linked to modify the red blood cell membrane to construct FA-RBC-DOX-CS-NPS. FA-RBC- DOX-CS-NPs were characterized and investigated on in vitro drug release characteristics ，antitumor activity and endocytosis ability （investigation with human breast cancer MCF- 7 cells）. RESULTS Average particle size of FA-RBC-DOX-CS-NPs was （254.200± 2.651）nm，and polydispersity index was 0.199±0.031；Zeta potential was （－10.100±0.213）mV. FA-RBC-DOX-CS-NPs released fast in the tumor microenvironment （pH6.5）. Cellular experiments showed that ，the nanoparticles could inhibit the activity of MCF- 7 cell proliferation and improve the efficiency of endocytosis. CONCLUSIONS FA-RBC-DOX-CS-NPs are prepared successfully. The nanoparticles have good tumor cell targeting and endocytosis ability ，and can realize the enrichment of drugs in tumor cells.

Objective : To analyze the problems in the AIDS control strategy in key areas of Zhejiang Province, so as to provide insights into the improvement of the control strategy. Methods : The AIDS control data were collected from 10 key counties (districts) in Zhejiang Province, and the AIDS control strategy was comprehensively evaluated using a SWOT analysis. Results : The strengths of the AIDS control strategy in key counties (districts) of Zhejiang Province included distinct working objectives, well-organized leadership, and effective control measures, the weaknesses included large number of HIV-infected cases, high burden of disease, difficulty in management of AIDS transmission and insufficient AIDS control capability, and the opportunities included the AIDS control in key counties (districts) conforming to the current status of AIDS control, strong support of innovative strategies and technical support from professional teams, while the threats included insufficient working mechanisms for AIDS control, the gap between the effectiveness of AIDS control and the target goal and unverified scientific evidence of the control strategy. Supported policies should be fully used, working mechanisms need to be improved, control strategies need to be innovated, and assessments need to be implemented for AIDS control in key counties (districts). Conclusions There are both opportunities and challenges for AIDS control in key counties (districts) of Zhejiang Province. Optimization of the working mechanisms, promotion of precision interventions, and search for repeatable control strategy in other disease-affected regions are required for AIDS control.

The outbreak of coronavirus disease 2019 (COVID-19) was declared a global public health emergency on 31 January 2020. Emergency medicine procedures in Emergency Department should be optimized to cope with the current COVID-19 pandemic by providing subspecialty services, reducing the spread of nosocomial infections, and promoting its capabilities to handle emerging diseases. Thus, the Chinese Society of Emergency Medicine and Wuhan Society of Emergency Medicine drafted this consensus together to address concerns of medical staffs who work in Emergency Department. Based on in-depth review of COVID-19 diagnosis and treatment plans, literatures, as well as management approval, this consensus proposes recommendations for improving the rationalization and efficiency of emergency processes, reducing the risk of nosocomial infections, preventing hospital viral transmission, and ensuring patient safety.

Objective:To analyze the willingness of post-exposure prophylaxis (PEP) to prevent HIV transmission and related factors in men who have sex with men (MSM).Methods:Cross sectional survey design was used in this study. After informed consent, MSM aged 18 years or above and having had homosexual anal or oral sex in the past 6 months were recruited through "i WeChat" official account between September and November, 2019.Results:Of 1 517 MSM were surveyed, the proportion of MSM who had ever heard of PEP were 72.5% (1 100/1 517) and 87.9%(1 333/1 517) of the MSM said they would like to use PEP if it is needed.Multivariate logistic regression analysis suggested that aged above 25 year ( OR=1.807, 95% CI: 1.090-2.995), HIV test history ( OR=1.953, 95% CI: 1.171-3.256) and being aware of PEP ( OR=2.163, 95% CI: 1.468-3.186) were the positive factors for PEP use, but an aware of the HIV status of sexual partner was the negative factor for PEP ( OR=0.602, 95% CI: 0.407-0.890). Among MSM who had ever heard of PEP, the positive factors for PEP use included living in Zhejiang ( OR=1.942, 95% CI: 1.097-3.438), aged above 25 years ( OR=2.431, 95% CI: 1.331-4.439), being aware of PEP ( OR=3.714, 95% CI: 1.532-9.007) obtaining information about PEP service from MSM organization/volunteer/health organization. Conclusions:MSM's willingness to use PEP services was relatively high. Age, awareness of PEP related knowledge, and awareness of sexual partner's HIV infection status were the related factors. MSM organization/volunteer/health organization were the main forces for PEP promotion in MSM.

Objective: To evaluate the third round of Zhejiang Comprehensive AIDS Response (CARES) program (nine national areas and three provincial areas) and the control effect of AIDS, so as to provide reference for AIDS prevention and control. Methods: According to the final assessment protocol of the third round of China CARES, the data of 23 assessment items which were collected from online database and field investigation for 12 response areas of Zhejiang in 2014 and 2018 were evaluated. The endemic situation and detection of AIDS in CARES areas was compared with those in non-CARES areas, in order to evaluate the achievement of Zhejiang CARES areas. Results: The rates of reaching the standard ranged from 91.30% to 100.00% in 12 CARES areas. Six indexes in leadership and innovation, fifteen (seventeen in total) indexes in HIV/AIDS control and prevention reached the standard. The items that failed included the awareness rates of AIDS and indicators in “prevention and intervention”. The rates of of reaching the standard in “publicity and education”, “monitoring and testing”, “prevention and intervention”, and “treatment and follow-up” increased from 55.56%, 79.17%, 79.76% and 65.00% in 2014 to 91.67%, 100.00%, 90.48% and 100.00% in 2018, respectively. The proportion of HIV testing people in permanent residents was 30.94% in CARES areas in 2018, which was significantly higher than 20.70% in non-CARES areas (P<0.05). The proportion of new reported HIV/AIDS in CARES areas was 50.87%, and the average increase was 4.48%, which was lower than 9.95% in non-CARES areas. Conclusion The third round of Zhejiang CARES program has remarkable achievement and plays a positive role in the prevention and control of AIDS.

Objective:To analyze the prevalence of anal sex and related factors in low-tier female sex workers (FSWs) in the demonstration areas of comprehensive AIDS responses (DACAR) in Zhejiang province.Method:In 2013, a survey on low-tier FSWs was carried out in 21 Demonstration Areas of AIDS Responses in Zhejiang. Experience of having anal sex with clients in the last month was taken as dependent variable while independent variables would include perception and characteristics related to behavior of the FSWs. The multivariate logistic regression analyses were conducted to identify the factors related to anal sex in low-tier FSWs.Results:A total of 2 645 low-tier FSWs were interviewed. Among these FSWs, 67.9% (1 796/2 645) were over 26 years old, 89.9% (2 378/2 645) were with education level of junior high school or below, 58.4% (1 546/2 645) were married, 78.2% (2 068/2 645) were from other provinces, 68.6% (1 814/2 645) had income level less than 4 000 Yuan, and rates of anal sex with client in the last month were 5.03% (133/2 645). Results from the multivariate logistic regression analysis of related factors of anal sex with client in the last month showed that among the low-tier FSWs, the venues of having commercial sex were in hair salons/massage parlors ( OR=7.31, 95 %CI: 2.27-23.59), roadside shops ( OR=7.89, 95 %CI: 2.27- 27.40) or other places ( OR=4.65, 95 %CI: 1.23-17.53), when compared with the street-women service. FSWs often engaged in commercial sex business in three or more counties ( OR=1.68, 95 %CI: 1.01-2.81), when compared with FSWs often engaged in commercial sex business just one county. FSWs had sex with only middle-aged and the elderly clients ( OR=0.45, 95 %CI: 0.30-0.66), when compared with FSWs had sex with young or middle-aged and the elderly clients. FSWs had risk perception for sexually transmitted disease (STD) ( OR=2.00, 95 %CI: 1.20-3.32), when compared with FSWs with no risk perception. FSWs had oral sex experience with their clients in the last month ( OR=7.29, 95 %CI: 4.78-11.12), when compared with the ones without oral sex. The above said factors were all related to the incidence of anal sex. Conclusions:Certain numbers of low-tier FSWs had anal sex experiences with their clients, especially those who had oral sex were more likely to have anal sex in DACAR in Zhejiang province. Attention should be paid to anal sex behavior when conducting behavior-related intervention programs, targeting on the low-tier FSWs.

Objective: To study oral sexual behavior and related factors among male students. Methods: The male students from college graduation in Hangzhou were selected as the study objects, and the inclusion criteria were having had sex and informed the type of behavior. A total of 490 subjects were finally included. Results: Among 490 male students, the 20-22 years old, 23 years old and 24-27 years old age groups accounted for 38.8% (n=190), 37.8% (n=185) and 23.3% (n=114), respectively. A total of 99 (20.2%) cases had oral sexual behavior, of which only 14 (2.9%) cases used condom. After adjusting for unplanned pregnancy, stage of sexual behavior, sexually transmitted diseases infection possibility, sexual orientation factors, normal/unnormal family relationship, more than 2 sexual partners, casual sexual partners, sexual partners from other college, sexual partners from society, sexual behavior in past 1 year were positively associated with oral sexual behavior. The corresponding OR (95%CI) values were 2.77 (1.40-5.50), 2.29 (1.27-4.15), 2.68 (1.23-5.88), 2.45 (1.34-4.48), 2.47 (1.15-5.33) and 2.04 (1.05-3.96), respectively. Use of condoms was negatively associated with oral sexual behavior, the OR (95%CI) value was 0.20 (0.09-0.42). Conclusion Normal/unnormal family relationship, more than two sexual partners, casual sexual partners, sexual partners from other college, sexual partners from society, sexual behavior in last one year and condom use in each vaginal sexual behavior were associated with oral sexual behavior.

Objective: To understand the confidence-related factors of refusing unprotected sex behavior among college students in Zhejiang province. Methods: Stratified cluster random sampling method was conducted among college students from 13 colleges and universities in Zhejiang province, from October to November, 2018. A total of 3 718 students who self-reported "ever having had sexual contacts" were enrolled. Chi-square test was used to compare the confidence of rejecting unprotected sex under different demographic characteristics, sexual attitude/behaviors and different intervention approaches. Multivariate logistic regression model was used to analyze the related factors. Results: A total of 3 718 college students were involved in this study with average age as (20.17±1.38) years old and 70.5% (2 620/3 718) were male. The proportions of having confidence to refuse unprotected sex behavior were 74.9% (1 963/2 620) of male and 77.9% (896/1 098) of female students, respectively. According to the results from multivariate logistic regression analysis, factors that related to the confidence of refusing unprotected sex behavior in male students would include, did not accept casual sex behavior (compared with accepted students, OR=2.247, 95%CI: 1.828-2.762), did not accept homosexual behavior (compared with accepted students, OR=1.810, 95%CI: 1.302- 2.516), having casual sex behavior in the past one year (compared with having no sex behavior, OR=1.345, 95%CI: 1.051-1.721), aware of the availability of HIV self-test reagents service in college (compared with did not knew, OR=1.381, 95%CI: 1.011-1.887), having taken the HIV infection risk self-assessment in college (compared with did not take, OR=1.707, 95%CI: 1.374-2.121). In female students, the factors would include: being urban resident (compared with rural residence, OR=1.816, 95%CI: 1.225-2.693), 21 years old or above (compared with 20 years old or below, OR=1.469, 95%CI: 1.075-2.007), having taken the HIV infection risk self-assessment in college (compared with did not take, OR=1.597, 95%CI: 1.093-2.333), etc. Conclusions Both male and female college students had higher confidence in refusing unprotected sex behavior. For male students, refusing casual or homosexual contacts, having casual sex in the recent year, knowing HIV self-test reagents service and having had HIV-related risk self-assessment in college as related factors. However, for female students; city residence, 21 years old and above, and having a HIV infection risk self- assessment in college appeared as related factors. Sexual health education should be strengthened to reduce unprotective sex behavior and to promote HIV infection risk self-assessment among the college students.