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 provide a reference for anticoagulation therapy， adverse drug reaction monitoring， and individualized medication adjustment in complex cases， such as those with thrombocytopenia following bioprosthetic heart valve replacement. METHODS Clinical pharmacists participated in the pharmaceutical care of a patient with thrombocytopenia following bioprosthetic heart valve replacement. For cardiac insufficiency， the pharmacists recommended maintaining oral bisoprolol， sacubitril/valsartan， spironolactone， furosemide， and potassium chloride， with levosimendan added to enhance myocardial contractility， while monitoring blood pressure， heart rate and serum potassium levels. For thrombocytopenia， based on literature- based risk assessment， the pharmacists advised administering recombinant human interleukin-11 （rhIL-11）， platelet transfusion， and employing anticoagulation therapy with nadroparin calcium bridging to warfarin， with warfarin dosage adjusted according to the international normalized ratio （INR）. For rapid ventricular rate atrial fibrillation， amiodarone and digoxin were recommended. For acute liver injury， suspected to be induced by amiodarone and rhIL-11， the pharmacists suggested discontinuing the relevant drugs and treating with ademetionine 1，4-butanedisulfonate combined with polyene phosphatidylcholine for liver protection treatment. The patient received anticoagulation medication education emphasizing strict INR monitoring and close observation for bleeding or thrombotic events. RESULTS The clinicians adopted these recommendations. Following the intervention， the patient’s liver function showed significant improvement， with alanine aminotransferase decreasing to 70 U/L and aspartate aminotransferase to 42 U/L. The ventricular rate stabilized at 70-100 beats per minute， cardiac function remained stable， the INR was maintained within the target range of 1.80-2.50， and the patient was ultimately discharged with improved condition. CONCLUSIONS Through balancing anticoagulation and bleeding risks， the clinical pharmacists applied pharmaceutical expertise to assist in developing personalized anticoagulation regimens， conducted adverse drug reaction monitoring and evaluation， and optimized medication strategies， thereby effectively ensuring patient safety and therapeutic efficacy.

Abstract The prevention and control of myopia in Chinese children and adolescents has become a major public health issue. While maintaining increased outdoor activity as a cornerstone intervention, there is an urgent need to explore new complementary approaches that can be effectively implemented in both indoor and outdoor settings. In recent years, environmental spatial frequency has gained increasing attention as one of the key environmental factors influencing the development and progression of myopia. Both animal studies and human research have confirmed that indoor environments lacking mid to high spatial frequency components, often characterized as "visually impoverished", can promote axial elongation and myopia through mechanisms such as disruption of retinal neural signaling, impaired accommodative function, and altered expression of related molecules. Based on the scientific consensus, it is recommended that "enriching of environmental spatial frequency" should be integrated into the myopia prevention and control framework. Following the principles of schoolled organization, family cooperation, community involvement, and student participation, specific measures are put forward in three areas：optimizing school visual settings, improving home spatial environments, and promoting healthy visual behavior. The aim is to create "visually friendly" indoor environments as an important supplement to outdoor activity, thereby providing a novel perspective and strategy for comprehensively advancing myopia prevention and control among children and adolescents.

Objective To explore the construction of heart preservation model of empty beating donor based on extracorporeal membrane oxygenation (ECMO). Methods From January 2022 to August 2023, 20 Guangxi Bama miniature pigs weighing 25-30 kg were selected, half male and half female. Under general anesthesia and heparinization, a midline thoracotomy was performed. The pericardium was cut after freeing the anterior and posterior vena cavae, and a perfusion needle was inserted near the brachiocephalic artery in the ascending aorta, connected to a blood collection bag to collect 500-600 mL of blood. The anterior and posterior vena cavae were ligated, the aorta was blocked and perfused with HTK solution to stop the heart beating. The superior and inferior vena cavae were cut off, the right pulmonary vein was decompressed, the aorta and left and right pulmonary arteries and veins were cut off, and the whole heart was removed. An ECMO device was used to continuously perfuse a cardioprotective solution mainly composed of oxygenated warm blood, maintaining the isolated pig heart beating for 8 hours, monitoring (once/hour) ECMO perfusion parameters, blood gas indicators, perfusate electrolytes, inflammatory factors, myocardial enzymes, myoglobin, and troponin levels. Myocardial tissue was taken for hematoxylin-eosin (HE) staining to observe myocardial cell damage and evaluate the quality of heart preservation. Results Among the 20 isolated beating pig hearts, 17 successfully resumed beating, 3 experienced ventricular fibrillation, resuscitated after intracardiac electrical defibrillation, and all 20 pig hearts successfully beat for 8 hours. There was no statistical difference in ECMO perfusion parameters, blood gas indicators, perfusate electrolytes, and inflammatory factors at each time point (P>0.05). There were statistical increases in myocardial enzymes, myoglobin, and troponin levels (P<0.05). HE staining results suggested that there was no severe myocardial damage. Conclusion ECMO technology can be used for pig heart preservation with good results, and this study provides experimental evidence for improving heart preservation research in clinical heart transplantation.

Objective To analyze the disease burden and trends of bladder cancer in China and globally from 1992 to 2021.  Methods Using the GBD 2021 database, the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) rates of bladder cancer in China and globally from 1992–2021 were analyzed. Average annual percentage change (AAPC) was calculated using Joinpoint regression. Subgroup analyses by sex and age were conducted, and a Bayesian age-period-cohort (BAPC) model was used to predict trends in age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for the next 15 years.  Results In 2021, China reported 106 000 new cases (ASIR: 5.14/100 000), 571 000 prevalent cases (age-standardized prevalence rate, ASPR: 26.61/100 000), 43 000 deaths (ASMR: 2.34/100 000), and a DALY rate of 45.31/100 000. From 1992–2021, China showed upward trends in ASIR and ASPR but declines in ASMR and DALYs, while global ASIR, ASMR, and DALYs decreased overall with slow ASPR growth. The peak cases in China and globally were both concentrated in the 65-79 age group, with a significantly higher burden on males than females. In China, smoking-related ASMR and ASDR exceeded global averages and rose, whereas high glucose-related indexes were lower and declined. Projections for 2021–2036 indicated that the global incidence and mortality rates would be rising, but ASIR/ASPR would be declining, while in China, the incidence rate would continue to rise, and the mortality rate will stabilize, with a significant increase in ASIR and a gradual decrease in ASPR.  Conclusion From 1992 to 2021, the incidence of bladder cancer in China has shown a continuous upward trend and is projected to persist in the future, with significant gender and age differences. Particular attention should be given to elderly males aged 85-89. The disease burden of bladder cancer attributable to smoking continues to rise, highlighting the urgent need to strengthen tobacco control policies.

ObjectiveTo investigate the effects of three-dimensional foot-ankle exercises (3DFAE) on mild-to-moderate hallux valgus in young women. MethodsFrom October to December, 2024, 45 female patients aged 18 to 26 years with hallux valgus were recruited from Capital University of Physical Education and Sports. They were randomly divided into control group (n = 15), toe-spread-out (TSO) group (n = 15) and 3DFAE group (n = 15). The control group only received foot health education, while the two intervention groups performed corresponding exercise training, for four weeks. Hallux valgus angle (HVA) was measured with photographic method, abductor hallucis activation was detected with surface electromyography, cross-sectional area of abductor hallucis was measured with Doppler ultrasound, and active ankle dorsiflexion range of motion (ROM) was assessed with a goniometer, before intervention, immediately after intervention, and four weeks after training cessation. A perceived difficulty scale was adopted to evaluate the training difficulty of TSO group and 3DFAE group at the first training session and upon completion of intervention. ResultsThe effects of time and interaction were significant for bilateral HVA, abductor hallucis activation, cross-sectional area of abductor hallucis and ankle dorsiflexion ROM (F > 2.728, P < 0.05), and the effect of group of left ankle dorsiflexion ROM was also significant (F = 4.995, P < 0.05). After intervention, bilateral HVA, abductor hallucis activation, cross-sectional area of abductor hallucis and ankle dorsiflexion ROM were all better than those before intervention (P < 0.05), and most indicators were superior to those measured at the 4-week follow-up (P < 0.05). The left ankle dorsiflexion ROM was better in 3DFAE group than in the control group and TSO group (P < 0.05). At the first intervention session, the perceived training difficulty was lower in 3DFAE group than in TSO group (t = 3.334, P = 0.002), and it decreased (t = 5.292, P < 0.001) after four weeks of training in TSO group, with no significant difference compared with 3DFAE group (P > 0.05). Conclusion3DFAE can improve ankle dorsiflexion ROM in young female patients with hallux valgus, with no more difficulty than TSO, and lower initial operation difficulty.

BACKGROUND:Socket-shield technique can effectively maintain labial soft and hard tissues,but the incidence of postoperative complications such as exposure and displacement of root shield is relatively high.It is speculated that the root shield may be exposed and displaced due to excessive load after long-term function of dental implants. OBJECTIVE:Through three-dimensional finite element analysis,we aim to study the influence of varying root shield thicknesses on the stress distribution,equivalent stress peaks,and displacement in the root shield,periodontal ligaments,implant,and surrounding alveolar bone under normal occlusal loading.We also attempt to analyze the correlation between the thickness of the root shield and occurrence of mechanical events such as root shield exposure,displacement,and fracture. METHODS:Cone-beam CT data of a patient who met the indication standard of socket-shield technique for maxillary central incisor were retrieved from database.Reverse engineering techniques were used to build models of the maxillary bone and root shield,while forward engineering was used to create models for the implant components based on their parameters.Models depicting various root shield thicknesses(0.5,1.0,1.5,and 2.0 mm)were created using Solidworks 2022 software.ANSYS Workbench 2021 software was then used to simulate and analyze the effects of varying root shield thicknesses on stress distribution,equivalent stress peaks,and displacement of the root shields,periodontal ligaments,implants,and surrounding alveolar bone under normal occlusion. RESULTS AND CONCLUSION:(1)In all root shield models,the stress was concentrated on the palatal cervical side,both sides of the edges and the lower edge of the labial side.As the thickness of the root shield increased,the equivalent stress peak and displacement showed a decreasing trend.The 0.5 mm thickness model produced a stress concentration of 176.20 MPa,which exceeded the yield strength(150 MPa)of tooth tissue.(2)The periodontal ligament stress in each group was concentrated in the neck margin and upper region.With the increase of root shield thickness,the equivalent stress peak and displacement of periodontal ligament showed a decreasing trend.(3)Implant stress in all models was concentrated in the neck of the implant and the joint of the implant-repair abutment,and the labial side was more concentrated than the palatal side.With the increase of root shield thickness,the equivalent stress peak of the implant in the model showed an increasing trend.(4)In each group of models,stress of cortical bone concentrated around the neck of the implant and the periphery of the root shield,and the labial side was more concentrated than the palatal side.With the increase of the thickness of the root shield,the equivalent stress peak around the root shield decreased;the peak value of the equivalent stress of the bone around the neck of the implant showed an increasing trend.In the model,the stress of cancellous bone was mainly concentrated around the neck of the lip of the implant,the top of the thread,the root tip and the lower margin of the root shield,and the labial side was more concentrated than the palatal side.With the increase of the thickness of the root shield,the peak value of the equivalent stress of the bone around the root shield in the model showed a decreasing trend.The minimum principal stress of cortical bone in each group of models was concentrated around the neck of the implant,exhibiting a fan-shaped distribution.As the thickness of the root shield increased,the minimum principal stress of cortical bone showed an increasing trend.(5)These results indicate that different thicknesses of the root shield have different biomechanical effects.The root shield with a thickness of 0.5 mm is easy to fracture.For patients with sufficient bone width,the root shield with a thickness of 2.0 mm is an option to reduce the risk of complications such as root shield exposure,fracture,and displacement.Meanwhile,it should be taken into account to protect the periodontal ligament in the preparation process,and rounding treatments ought to be carried out on both sides and the lower edge of the root shield.

Objective: To investigate the association of moderate to vigorous intensity physical activity (MVPA) and screen time (ST) with emotional and behavioral problems in middle school students, so as to provide a basis for improving the mental health level of adolescents. Methods: Four public junior high schools in Jinshan District, Shanghai were selected by random cluster method from September 19 to October 18, 2023, with 779 first grade students included. Strengths and Difficulties Questionnaire (SDQ), as well as physical activity and screen time were collected. Binary Logistic regression analysis was used to investigate the association between MVPA, ST and different dimensions of emotional and behavioral problems. Results: Students with MVPA<60 min/d accounted for 82.4%, and with ST>2 h/d accounted for 29.5%. The abnormal rate of SDQ dimensions among students ranged from 6.8 % to 19.3%, with the highest abnormal rate observed in behavioral problems. The results of binary Logistic regression analysis showed that, compared with high level of MVPA, students with low level of MVPA had a significantly increased risk of developing problems in prosocial behavior [ OR (95% CI )=2.16(1.37-3.41), P <0.05]. Compared with low level ST, students with high level had an increased risk of experiencing emotional symptoms, behavioral problems and peer interaction problems [ OR (95% CI )=2.00(1.25-3.22), 2.00(1.41-2.84), and 1.69(1.22-2.33), P <0.05]. Compared with high MVPA and low ST, students with low MVPA and high ST had an increased risk of developing problems in the dimensions of conduct problems, prosocial behavior, and overall difficulty score [ OR (95% CI )=1.92(1.13-3.23), 2.73(1.56-4.77), and 2.07(1.19-3.60), P <0.05]. Conclusions Physical activity and screen time are related to emotional and behavioral problems in middle school students. Insufficient physical activity time and excessive screen time might increase the risk of emotional and behavioral problems. Interventions can be administered on physical activity and screen time among adolescents to promote their mental health.

Objective To observe the therapeutic effect of Qiwei Tangmaishu capsules on type 2 diabetes mice,and explore the mechanisms of its treatment of type 2 diabetes based on network pharmacology.Methods TCMSP,ETCM databases were used to query all components and of Qiwei Tangmaishu capsules and their targets.OMIM and DrugBank databases were used to search for targets of type 2 diabetes.The targets of type 2 diabetes and Qiwei Tangmaishu capsules were intersected by Venny 2.1.0.to perform GO and KEGG pathway enrichment analysis on those intersecting targets using the Metascape website.Then,a mouse model of type 2 diabetes was established,and Qiwei Tangmaishu capsules were given to low,medium,and high dose groups(234,468,and 936 mg/kg,respectively),and metformin(MET)group(200 mg/kg)for 2 weeks.The weight of each mouse was measured before and after treatment,and fasting blood glucose was also measured.After the 2 weeks,fasting insulin was measured;ELISA was used to detect levels of inflammatory factors IL-1β,TNF-α,IL-6,TLR4,and NF-κB in serum;Hematoxylin eosin staining was used to observe the morphology of pancreatic islets;and Caspase 3 and INS immunofluorescence were used to detect apoptosis of pancreatic islet cells and the number of pancreatic beta cells.Western Blot assay was used to detect the expression levels of pancreatic tissue proteins such as p-Akt,Akt,p-PI3K,PI3K,Bax,Bcl2.Results 1260 active ingredient targets were identified in Qiwei Tangmaishu capsules;1205 targets of type 2 diabetes were found.Of these,312 targets were intersected by Venny,with core targets involving Akt1,TNF,IL-6,TLR4,among others.Enrichment analysis identified 240 KEGG pathways,among which"insulin resistance""PI3K/Akt signaling pathway"were the key pathways enriched.The animal experiment result showed that compared with the model group,the intervention of Qiwei Tangmaishu capsules and metformin significantly improved blood glucose and insulin resistance;the content of inflammatory factors in serum decreased,and the apoptosis rate of pancreatic islet cells significantly decreased;the number of pancreatic beta cells significantly increased;the expression of pro-apoptotic protein Bax decreased,the expression of anti-apoptotic protein Bcl2 significantly increased,and the expression of p-PI3K and p-Akt was upregulated.Conclusions Qiwei Tangmaishu capsules can significantly reduce blood glucose levels,restore insulin sensitivity,and reduce islet cell apoptosis in type 2 diabetic mice.The mechanism may be related to the activation of the PI3K/Akt signaling pathway.

Biofilm is one of the important reasons for bacterial resistance and persistent infection in Staphylococcus aureus,which poses a significant threat to the dairy farming industry in southern Xinjiang.Although quercetin has antibacterial properties,its poor hydrophilicity and low solubility limit its clinical application.Therefore,quercetin nanogel was prepared by the electrostatic interac-tion between guar gum(positive charge)and hyaluronic acid(negative charge)under the action of sodium tripolyphosphate in this study.Using encapsulation efficiency and loading capacity as indi-cators,the optimal formula was screened through single factor experiments and response surface methodology,and characterized.The minimal inhibitory concentration(MIC)and minimal mem-brane inhibitory concentration(MBIC)of quercetin nanogel against Staphylococcus aureus were determined by micro broth dilution method and micro plate semi quantitative method.The results showed that the optimal formulation of quercetin nanogel was 11.6 g/L guar gum,10.0 g/L hyalu-ronic acid and 50.0 g/L sodium tripolyphosphate.The encapsulation efficiency and loading capacity were 79.4％and 7.6％,respectively.The particle size and Zeta potential were(396.0±4.2)nm and(-25.0±0.8)mV,respectively,indicating that the nanogel had good dispersion,high stability and excellent drug loading capacity.The MIC and inhibitory rate of quercetin nanogel against Staphy-lococcus aureus were 8.0 mg/L and 83.8％,respectively.The MBIC and inhibitory rate of quercetin nanogel against Staphylococcus aureus were 8.0 mg/L and 38.3％,respectively.Therefore,the pre-pared quercetin nanogel solved the problems of low solubility and poor hydrophilicity of quercetin,improved the inhibitory effect of quercetin on the membrane of Staphylococcus aureus,and was expected to be further applied to the treatment of cow bacterial diseases in southern Xinjiang.