With the deepening of China's medical reform, people's demand for health is growing, which promotes the construction of "new medicine" and puts forward higher requirements for the cultivation and education of medical students. Undergraduate medical education is a crucial period for the growth of medical students, and how to do a good job in undergraduate teaching under the background of "new medicine" is currently a research hotspot. The clinical teaching stage is an important period for medical students to fully understand clinical disciplines and cultivate their understanding of specialties. Therefore, we should explore new teaching methods and means to adapt to the needs of the new era. In the context of "new medicine", the medical-engineering fusion diagnosis and treatment technology has become an important trend in the clinical diagnosis and treatment of oncology. In order to adapt to this change, clinical teaching and teaching management in oncology also need new exploration and research. Taking the clinical teaching of oncology as an example, this article discusses how to cultivate medical students' thinking of medical-engineering fusion.

【Objective】 To study the relationship between the key influencing factors and the short, medium and long term blood demand, so as to provide basis for building a blood demand prediction model with less prediction error and practical guidance. 【Methods】 Through literature research, the influencing factors of blood demand were preliminarily determined. Questionnaires were designed and distributed to relevant experts, and factor analysis was carried out on the survey results to obtain key influencing factors through Delphi method. 【Results】 Through literature research, 19 influencing factors of clinical blood demand were obtained, including policy factors, medical service demand, medical technology level, regional population, population characteristics, population structure, medical resource, number of beds, culture, natural environment, operation, patients outside the region, blood use in different departments, blood infusion, time trend, emergencies and disasters, the condition of disasters, hospitals in disaster area, limited diagnosis and treatment ability. Through Delphi method and data analysis, six key factors affecting blood demand were obtained, namely sudden disaster, medical resource, environmental factor, population, bed number and blood infusion. 【Conclusion】 The influence of key factors on clinical blood demand was divided into multiple hierarchies. Blood infusion and sudden disaster were short-term influencing factors. Medical resource, population and number of beds were medium influencing factors. Environmental factor was long-term influencing factor. Short, medium and long-term influencing factors were interrelated, and have different impacts on clinical blood demand. Based on the interaction relationship, a three-dimensional mathematical model of influencing factors of clinical blood demand was established, which provided a preliminary research basis for building a blood demand prediction model with less prediction error and practical guidance.

Objective: To investigate the experience of child sexual abuse (CSA) and depressive symptoms among young men who sex with men (YMSM) in Guangzhou, and then to explore the impact of CSA on depressive symptoms. Methods: A convenient sampling method was used to recruit MSM. YMSM who aged 18-24 and have lived in Guangzhou for more than 3 months were included in this study. Data on demographic characteristics, homosexual partners seeking behaviors, sexual orientation, CSA experience and depression were collected through an electronic questionnaire. χ 2 tests were used to compare the proportion of CSA and depressive symptoms among YMSM with different characteristics. Logistic regressions were preformed to assess the impact of CSA on depression. Results: The proportion of CSA experience and depressive symptoms among participants were 31.51% (115/365) and 47.95% (175/365), respectively. Participants with junior high school education or lower and who sought homosexual partners offline reported(75.00%,62.22%) a higher proportion of depressive symptoms( χ 2=7.97，4.19， P <0.05). After adjusting for factors e.g. ethnicity, residence, resident duration in Guangzhou, studentship, education, monthly income, sexual orientation and homosexual partners seeking behaviors, the multivariable Logistic regression model showed that YMSM with CSA experience (a OR=1.81, 95%CI =1.12-2.93) were more likely to have depressive symptoms than those without CSA experience. Conclusion The prevalence of CSA experience and depressive symptom is relatively high among YMSM in Guangzhou, and CSA experience is associated with higher risk of depressive symptoms. More attention should be paid to strengthen the psychological intervention for YMSM, especially for those who experienced CSA, so as to reduce the risk of depression and improve mental health among YMSM.

Objective:To investigate the preventive effects of hydroxyethyl starch and methoxamine on complications of combined spinal and epidural anesthesia in older adult patients and its influence on hemodynamics.Methods:The clinical data of 120 older adult patients who underwent combined spinal and epidural anesthesia in General Hospital of Armed Police and Marine Police between February 2017 and April 2019 were retrospectively analyzed. The included patients were divided into two groups according to the adverse reactions of drugs used to induce anesthesia: control group (methoxamine injection, n = 55) and observation group (methoxamine + hydroxyethyl starch, n = 65). The changes in hemodynamic index, complications and cognitive function were analyzed in each group. Results:Systolic blood pressures measured at 5, 15 and 30 minutes after anesthesia were (127.53 ± 10.63) mmHg, (119.85 ± 10.86) mmHg, (125.45 ± 10.74) mmHg, respectively in the observation group, which were significantly higher than (118.23 ± 11.32) mmHg, (114.34 ± 10.32) mmHg, (119.01 ± 10.34) mmHg in the control group ( t = 3.66, 2.24, 2.63, all P < 0.05). Diastolic blood pressures measured at 5, 15 and 30 minutes after anesthesia were (76.65 ± 9.07) mmHg, (78.43 ± 9.32) mmHg, (80.19 ± 9.43) mmHg, respectively in the observation group, which were significantly higher than (63.30 ± 9.43) mmHg, (65.98 ± 9.26) mmHg, (70.38 ± 9.17) mmHg in the control group ( t = 6.24, 5.78, 4.55, all P < 0.05). Heart rates measured at 5, 15 and 30 minutes after anesthesia were (73.65 ± 7.67) beats/min, (83.27 ± 9.57) beats/min, (84.10 ± 9.67) beats/min respectively in the observation group, which were significantly higher than (69.76 ± 7.82) beats/min, (64.70 ± 9.38) beats/min, (65.80 ± 9.43) beats/min in the control group ( t = 2.17, 8.46, 8.27, all P < 0.05). The incidences of hypotension and bradycardia in the observation group were 3.08% (2/65) and 3.08% (2/65), respectively, which were significantly lower than 25.45% (14/55) and 21.82% (12/55) in the control group ( χ2 = 12.91, 10.15, both P < 0.05). The Mini Mental State Examination scores measured at 1, 6 and 24 hours after surgery were (26.69 ± 2.51) points, (26.74 ± 2.75) points, and (26.99 ± 2.36) points, respectively in the observation group, which were significantly higher than (23.17 ± 2.41) points, (23.43 ± 2.36) points, and (24.18 ± 2.12) points in the control group ( t = 6.17, 5.55, 5.39, all P < 0.05). Conclusion:Hydroxyethyl starch combined with methoxamine for combined spinal and epidural anesthesia in older adult patients can effectively reduce the hemodynamic fluctuations, decrease the incidences of hypotension and bradycardia, and does not produce a remarkable effect on postoperative cognitive function.

Objective:To compare the clinical efficacy of extracorporeal membrane oxygenation (ECMO) and ventilation therapy in the treatment of severe blast lung injury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 37 patients with severe blast lung injury admitted to 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xianmen University Medical College) from January 2000 to December 2021, including 23 males and 14 females; aged 26-50 years [(36.3±11.1)years]. The chest abbreviated injury score (AIS) was 3-5 points. In all, 16 patients were treated with ECMO from January 2017 to December 2021 (ECMO group) and 21 with ventilator from January 2000 to December 2016 (ventilator group). Blood gas analysis indexes [arterial pH, partial pressure of carbon dioxide (PaCO 2), partial pressure of oxygen (PaO 2), blood lactate (Lac)] and hemodynamics indexes [central venous pressure (CVP), cardiac output index (CI), pulmonary arterial systolic pressure (PASP), pulmonary capillary wedge pressure (PAWP)] were compared in the two groups at 30 minutes before treatment and at 2, 4, 6 hours after treatment. The mechanical ventilation time, ICU length of stay, acute physiology and chronic health evaluation II (APACHE II) score and mortality were measured at 7 days after treatment. Results:All patients were followed up for 24-48 months [(33.6±8.2)months]. The blood gas analysis and hemodynamic indexes were significantly improved in the two groups at 2, 4, 6 hours after treatment when compared with those at 30 minutes before treatment (all P<0.05), and the improvements were still statistically significant in ECMO group at 4, 6 hours after treatment when compared with those at 2 hours after treatment (all P<0.05), while not in ventilator group (all P>0.05). There was no significant difference in blood gas analysis indexes or hemodynamic indexes between the two groups at 30 minutes before treatment (all P>0.05). After treatment for 2, 4, 6 hours, blood gas analysis indexes and hemodynamic indexes in ECMO group were statistically different from those in ventilator group (all P<0.05). After treatment for 7 days, the mechanical ventilation time, ICU length of stay, APACHE II score and mortality were (3.2±1.2)days, (5.4±1.3)days, (14.1±3.3)points and 12.5% (2/16) in ECMO group, significantly different from (5.1±1.6)days, (7.6±1.6)days, (10.2±2.6)days and 28.6% (6/21) in ventilator group (all P<0.05). Conclusion:For severe blast lung injury, ECMO can attain rapid and continuous improvement of refractory hypoxemia and dyspnea, shorten the duration of mechanical ventilation and ICU length of stay and reduce the mortality rate when compared with ventilator therapy.

The vagina contains at least a billion microbial cells,dominated by lactobacilli.Here we perform metagenomic shotgun sequencing on cervical and fecal samples from a cohort of 516 Chinese women of reproductive age,as well as cervical,fecal,and salivary samples from a second cohort of 632 women.Factors such as pregnancy history,delivery history,cesarean section,and breastfeeding were all more important than menstrual cycle in shaping the microbiome,and such information would be necessary before trying to interpret differences between vagino-cervical micro-biome data.Greater proportion of Bifidobacterium breve was seen with older age at sexual debut.The relative abundance of lactobacilli especially Lactobacillus crispatus was negatively associated with pregnancy history.Potential markers for lack of menstrual regularity,heavy flow,dysmenor-rhea,and contraceptives were also identified.Lactobacilli were rare during breastfeeding or post-menopause.Other features such as mood fluctuations and facial speckles could potentially be predicted from the vagino-cervical microbiome.Gut and salivary microbiomes,plasma vitamins,metals,amino acids,and hormones showed associations with the vagino-cervical microbiome.Our results offer an unprecedented glimpse into the microbiota of the female reproductive tract and call for international collaborations to better understand its long-term health impact other than in the settings of infection or pre-term birth.

OBJECTIVE：To investig ate the application and trend o f tranexamic acid in the orthopedic inpatient ，and to provide reference for rational drug use. METHODS ：The consumption of tranexamic acid ，the distribution of orthopedics diseases using tranexamic acid and route of administration were analyzed in 3 sub-departments （joint surgery department ，spinal surgery department，orthopedic trauma department ）from 4 third-grade class-A hospitals of Chongqing during 2017 to 2020. RESULTS ： The total consumption of tranexamic acid used in orthopaedic department had increased year by year in the past 4 years，with increase of 6.2％-52.2％，and the consumption of tranexamic acid in various departments also increased year by year ；from 2017 to 􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂 书辅料标明情况及风险控制建议 [J].中国药师，2018，21 中华中医药杂志，2018，33（6）：2225-2229. （18）：2020-2022. [10] 孟菲，李学林.中成药说明书中规格项存在的问题与探 [ 7 ] 国家药典委员会.中华人民共和国药典：二部[S]. 2010年 讨[J].当代医学，2015，21（12）：14-15. 版.北京：中国医药科技出版社，2010：1014. [11] 国家食品药品监督管理局 .中成药规格表述技术指导原 [ 8 ] 孟菲，李学林.中成药说明书中功能主治项表述方法的探 则：征求意见稿 [EB/OL].（2017-10-11）[2020-12-20]. 讨[J].中医药临床杂志，2015，27（1）：111-112. https：//www.nmpa.gov.cn/xxgk/zhqyj/zhqyjyp/20171011- [ 9 ] 田硕，郭晖，苗明三.中成药说明书完善的思考及实践[J]. 151401184.html. [12] 王裴芳.我国中成药说明书中老年人用药项的调查分 Δ基金项目：重庆市科技计划项目-技术预见与制度创新项目（No. 析[J].中国药房，2015，26（29）：4055-4057. cstc2018jsyj-zdcxX0052）；重庆市社会科学规划项目（No.2019QNGL31） [13] 林志健，周伟龙，张冰，等.中成药说明书中儿童用药信息 ＊硕士研究生 。研究方向 ：社会医学 、卫生事业管理 。电话： 023-68485178。E-mail：351389583@qq.com 的修订完善思考 [J].药物流行病学杂志 ，2018，27（4）： # 通信作者：教授，硕士生导师，硕士。研究方向：医事法学、卫生 244-248. 政策、卫生事业管理。电话：023-68485178。E-mail：puchuan68@sina. （收稿日期：2021-01-07 修回日期：2021-05-26） com （编辑：罗 瑞） ·1622· China Pharmacy 2021Vol. 32 No. 13 中国药房 2021年第32卷第13期 2019，joint surgery department accounted for the largest prop ortion（59.2％ ，53.5％ ，47.2％）to use tranexamic acid ，and orthopedic trauma department accounted for the largest proportion （39.2％）in 2020. On the whole ，top 4 orthopedic diseases in the list of the consumption of tranexamic acid were joint replacement （25.5％-29.6％），hip fracture （19.3％-23.6％），diaphysis fracture （13.5％-18.6％）and pelvic and acetabular fracture （8.2％-14.0％）. The route of administration for tranexamic acid in spinal surgery department ，joint surgery department and orthopedic trauma department was mainly intravenous application every year （accounting for 55.1％-81.0％，46.9％-77.1％，49.3％-73.3％，44.9％-71.5％）. CONCLUSIONS ：The consumption of tranexamic acid in orthopedic inpatients is increased year by year ，and is dominated by joint surgery department and orthopedic trauma department. The route of tranexamic acid is still mainly intravenous administration ，which is safe and reliable.

The adjacent anatomy of the pelvis is complicated, with digestive, urinary, reproductive and other organs as well as important blood vessels and nerves. Therefore, accurate resection of pelvic tumors and precise reconstruction of defects after resection are extremely difficult. The development of medical 3D printing technology provides new ideas for precise resection and personalized reconstruction of pelvic tumors. The “triune” application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis in pelvic tumor limb salvage reconstruction treatment has achieved good clinical results. However, the current lack of normative guidance standards such as preparation and application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis restricts its promotion and application. The formulation of this consensus provides normative guidance for 3D printing personalized pelvic tumor limb salvage reconstruction treatment.

With the rapid development of science and technology, more creative methods have been applied to the inheritance mode of traditional Chinese medicine, such as studying the inheritance process of famous doctorsin an objective and rigorous way. The bottleneck of information transmission from famous doctors is to collect data, process data, apply algorithms, analyze and summarize data. The integration of artificial intelligence and big data deep learning algorithm knowledge mapping technology and other technical methods has brought technological innovation for the inheritance of famous doctors. With such development, the team of the research center of TCM grand health intelligence, Institute of Information on Chinese Medicine, China Academy of Chinese Medical Science, has carried out a series of professional application system research in the field of traditional Chinese medicine, centering on the planning and inheritance of famous doctors. We developed the ancient and modern medical case cloud platform, medical big data analysis platform, cloud medical APP, and famous doctor inheritance workstation. In such way, the problems were solved of low efficiency of medical case collection and the lack of objective data support and information barriers in the experience summary of famous doctors. The artificial intelligence techniques are to promote the inheritance of famous doctors' experience and improve the teaching ability and efficiency.

Objective: To examine the prevalence and associated factors of seeking casual male sexual partners among men who have sex with men (MSM) students in Guangzhou, and to provide a reference for health education and intervention. Methods: A cross-sectional study was conducted to recruit 189 MSM students aged 18 and 28 via voluntary counseling and testing (VCT) clinics, Lingnan partners and Zhitong charity from May 2017 to April 2018. An anonymous electronic questionnaire was administrated to collect information on sociodemographic and sexual behavior characteristics. Chi-square test and non-conditional Logistic regression analysis were performed to explore the associated factors of casual homosexual behavior among MSM students. Results: In the past 6 months, 63.49% (120/189) of them reported casual male partners, and the rate of consistent condom use was 61.67%(74/120). Multivariate Logistic regression analysis showed that participants who had multiple sex partners in the past 6 months were more likely to seek male casual partners(aOR=9.13, 95%CI=4.27-19.53). Individuals who used recreational drugs before sex were at a higher risk of having casual sex behaviors(aOR=3.06, 95%CI=1.08-8.62). MSM students who had steady homosexual partners had a lower risk to seek casual sex(aOR=0.43, 95%CI=0.19-0.98). Conclusion The proportion of seeking casual male sexual partners among MSM students in Guangzhou was relatively high. The publicity and education should be strengthened among those who had multiple sex partners, with no steady homosexual partners and used recreational drugs before sex, to reduce the casual sex behaviors.