Current medical education faces an imbalance between technical rationality and humanistic spirit,with medical students' empathy declining as their training progresses.Narrative medicine offers a new path for reform.This paper systematically elaborates on the talent cultivation pathway of "five-dimension education integration and innovation" constructed by Sun Yat-sen University since 2017 under the guiding principle of five-dimension education (moral,intellectual,physical,aesthetic,and labor education) based on narrative medicine.This study innovatively proposes a teaching framework of "one body and two wings" and extends GUO Liping's "little red flower" model to construct a "five-dimension education-little red flower" interdisciplinary collaborative teaching model,which takes the narrative medicine course cluster as the "body" and clinical practice and humanistic experience as the two "wings," achieving deep integration of the five dimensions of education.At the practical level,a three-stage progressive closed loop of "sprouting-deepening-transformation" has been established,with a four-step teaching method of "demonstration analysis-collaborative writing-independent writing-reflection internalization" formed at the transformation stage,along with a "1∶1 interdisciplinary collaboration" general education course for all first-year students.Teaching evaluations show that the curriculum effectively enhances medical students' empathy and communication initiative,with non-medical students benefiting particularly significantly.This practical model validates and extends the application boundaries of localized narrative medicine theory,realizing a conceptual leap from cultivating "technical executors" to nurturing future caregivers" and providing a practical model and operational experience for reference in the reform of medical humanities education in the context of emerging medical education in China.
It has been 15 years since the introduction of narrative medicine into China.The growing of medical humanistic demand,the gradual improvement of industry recognition,and the continuous support of relevant national policies have provided good opportunities for the development of narrative medicine.The current development of narrative medicine faces both opportunities and challenges.The continuous accumulation of favorable conditions provides strong support for the standardized promotion of narrative medicine,while there are still obvious shortcomings,mainly manifested in the weak foundation of the discipline and the unclear path of practice and research.Although the exploration of localization has begun to bear fruit,the overall development still needs to be deepened.China has an improving environment and outstanding potential for the development of narrative medicine.At the same time,it faces many problems such as discipline construction,practical research,and localization deepening,presenting a pattern characterized by coexistence of opportunities and challenges.
Assessment is a critical link in the transition of narrative medicine education from concept to institutionalized curriculum,yet its methods have long faced challenges such as insufficient standardization,poor cross-institutional comparability,and a lack of long-term outcome tracking,while few studies have traced how this situation arose.Focusing on assessment in the educational measurement sense-the measurement of learners' outcomes,as distinct from the evaluation of programs as a whole-and adopting an abductive approach that infers epistemological foundations from actual assessment practices,this article divides the evolution of assessment methods in narrative medicine education since 2001 into three stages according to their epistemological foundations and methodological features.The first stage (2001-2008),grounded in phenomenology and constructivism,was dominated by qualitative text analysis such as reflective writing,emphasizing lived experience and reflection but lacking standardized,generalizable instruments.The second stage (2009-2016),responding to the evidence-based medicine paradigm and seeking disciplinary legitimacy,widely borrowed generic instruments such as the Jefferson Scale of Physician Empathy and the Maslach Burnout Inventory and made initial attempts at mixed methods,thereby exposing an epistemological conflict between positivism and interpretivism.The third stage (2017-present) has shifted toward developing specialized instruments for assessing narrative competence,reflecting a pragmatist integration of quantitative and qualitative approaches,though its maturation remains constrained by weak measurement standardization and the absence of long-term behavioral and clinical outcome assessment.This study suggests that the evolution of assessment methods in narrative medicine education is essentially an ongoing dialogue between humanistic and positivist epistemological traditions,through which the field continually clarifies its assessment aims and defines its disciplinary identity.
Through literature review and analysis of clinical practice cases,this paper proposes that narrative dialogue refers to the conscious expression and communication between physicians and patients,with a clear narrative orientation within specific clinical contexts.Its core lies in externalizing patients' implicit,unspoken suffering and establishing empathic connections.Narrative dialogue comprises four constituent elements-context,subject,orientation,and connection-and manifests distinct objectives and characteristics at three levels:value,narrative essence,and practice.This article synthesizes the general core principles and practical steps of narrative dialogue and argues that narrative dialogue constitutes a recognizable,analyzable,and teachable core component in the clinical practice of narrative medicine.It bridges narrative medicine theory with clinical practice and provides a new breakthrough point for the systematic construction of narrative medicine education and clinical paths.
Objective To systematically assess the global,regional,and national burdens of rheumatic heart disease (RHD) from 1990 to 2021 and to examine their associations with the sociodemographic index (SDI). Methods Data were obtained from the Global Burden of Disease Study 2021 (GBD 2021).We analyzed RHD-related deaths,prevalent cases,age-standardized death rates (ASDRs),and age-standardized prevalence rates (ASPRs),stratified by age,sex,region,and SDI.Estimated annual percentage changes (EAPCs) were calculated to evaluate temporal trends.Spearman correlation analysis was performed to explore the associations between EAPCs and baseline burden in 1990,as well as SDI in 2021.An autoregressive integrated moving average (ARIMA) model was employed to project the future trend of RHD through 2030. Results In 2021,the global ASDR and ASPR of RHD were estimated at 4.47 (95%UI:3.89-5.31) and 488.19 (95%UI:442.57-539.76) per 100 000 population,respectively.Females exhibited higher ASDR and ASPR than males,and the burden was more pronounced among older age groups.From 1990 to 2021,global deaths due to RHD declined by 10.8%,and ASDR decreased by 56.2%,with an EAPC of -2.71% (95%CI=-2.75--2.67).The ARIMA model projected a continued decline in both the number of deaths and ASDR through 2030.In contrast,the number of prevalent cases and ASPR increased by 69.4% and 12.6%,respectively.The highest absolute numbers of deaths and prevalent cases were observed in populous countries,notably India and China.From 1990 to 2021,ASDR and ASPR declined in most countries,while the disease burden in some countries in Africa,the Middle East,and South Asia experienced increasing trends.Both ASDR and ASPR were negatively correlated with SDI (r=-0.511 and -0.762,respectively,both P<0.001).The EAPCs of ASDR and ASPR were associated with both baseline burden in 1990 and SDI in 2021.Countries with higher SDI experienced more substantial declines in RHD burden.However,the declines were limited in areas with high baseline prevalence,and some regions even showed upward trends. Conclusions Between 1990 and 2021,although the global mortality of RHD steadily declined,the prevalence slightly increased,with females and older adults bearing a disproportionate burden.Significant regional disparities in disease burden were observed.More pronounced declines occurred in countries with a high SDI,whereas some low-SDI and high-baseline-burden regions showed little or no decline,which suggested the need for sustained and targeted comprehensive prevention and control strategies in key areas.
Objective To assess the forensic application value of 59 InDel loci and two miniSTR loci in Chinese Kyrgyz group,and to explore the genetic structure and genetic background of this group. Methods A total of 99 Kyrgyz individuals were genotyped through the 64-plex panel,which was developed independently by our lab.Allele frequencies and forensic parameters were calculated for the InDel loci and miniSTR loci included in the 64-plex panel.The application potential of these loci for full sibling identification was assessed by simulating 5 000 pairs of full siblings and unrelated individuals,respectively,via Familias v3 software.Additionally,various population analysis methods were employed to systematically explore the genetic relationships among the Kyrgyz group and 35 reference populations from five continents. Results The average polymorphism information content of the 59 InDel loci and two miniSTR loci in the Kyrgyz group were 0.365 1 and 0.753 6,respectively.The cumulative discrimination power and cumulative probability of exclusion of the 61 loci mentioned above were 1-1.928 4×10-27 and 0.999 996 539 2,respectively.When the likelihood threshold was set at 100,the accuracy of this panel in distinguishing full siblings from unrelated individuals reached 93.93%.The results of population genetic analyses indicated that the Kyrgyz group had the mixed genetic components of East Asian and European populations,and was genetically closer to the East Asian populations,particularly the Mongolian group. Conclusions The 59 InDel loci and two miniSTR loci show high forensic application value in individual identification and parentage testing and demonstrate certain application potential in full sibling relationship identification.Meanwhile,the results further reveal the mixed East Asian-European genetic background of the Kyrgyz group.This study enriches the genetic resource information on Chinese ethnic minorities and provides basic data to support forensic practice.
Objective To compare research hotspots and development trends regarding freezing of gait in Parkinson's disease between Chinese and English articles,thus providing reference for related studies in China. Methods The articles about freezing of gait in Parkinson's disease that were published from 2001 to 2025 was retrieved from the China National Knowledge Infrastructure,Wanfang Data,VIP,and Web of Science Core Collection.Visual analyses were conducted on the distribution of countries,authors,institutions,and keywords. Results A total of 177 Chinese articles and 1 095 English articles were included.The global annual number of published articles showed an overall upward trend with fluctuations.The articles in Chinese maintained steady growth while those in English slightly declined over the past three years.The United States led in the number of published articles,followed by China and Italy.The authors and institutions of Chinese articles exhibited greater independence than those of English articles.Current research hotspots on freezing of gait in Parkinson's disease focus on pathogenesis,assessment methods,and treatment strategies.Chinese articles emphasize clinical interventions,while English articles prioritize mechanism exploration and emerging physical therapies. Conclusions The research on freezing of gait in Parkinson's disease remains active,though differences exist in research focus between Chinese and English articles.Compared with Chinese articles,English articles reported early on freezing of gait in Parkinson's disease.In the future,China should deepen international exchanges and cooperation to actively draw on advanced findings and experience and work jointly to achieve breakthrough progress in both research and clinical practice,ultimately improving patients' quality of life.
Objective To investigate and discuss the current status of discharge readiness of patients with special positions after ophthalmologic surgery and analyze its influencing factors,thus providing more accurate,higher-quality,and humane perioperative nursing and guidance. Methods A cross-sectional study design was adopted,and the consecutive sampling method was used to select 200 pre-discharge patients in the ophthalmology ward of Peking Union Medical College Hospital from March 2024 to September 2024.The general data questionnaire,Readiness for Hospital Discharge Scale (RHDS),and Quality of Discharge Teaching Scale (QDTS) were used to explore the influencing factors through univariate analysis and multivariate linear regression analysis. Results The total score of discharge readiness of patients with special positions after silicone oil or gas filling was (103.44±15.30) points,with the average item score of (8.62±1.28) points.The results of one-way ANOVA showed that marital status,occupation,income level,degree of self-care,whether the medical resources in the place of residence could meet the needs of subsequent treatment,and postoperative visual acuity were influencing factors of discharge readiness (all P<0.05).The results of multivariate linear regression analysis showed that the quality of discharge teaching,income level,and self-care degree of patients were independent factors influencing the discharge readiness of patients with special positions after silicone oil or gas filling.Pearson correlation analysis showed that the quality of discharge teaching was positively correlated with discharge readiness (r=0.482,P<0.001). Conclusions Patients with special positions after silicone oil or gas filling had better outcomes of discharge readiness and quality of discharge teaching.However,the patients exhibited altered emotions after surgery and weak ability to understand the disease.The nursing staff should not only meet the life needs of the patients during the period of taking special positions in hospital but also pay attention to the emotional changes of the patients.At the same time,attention should be paid to personalized discharge teaching,which is both professional and practical,so that patients can obtain self-care knowledge and skills that are more valuable and more suitable for discharge and return home.
Objective To investigate the pathological mechanism by which fine particulate matter (PM2.5) exacerbates asthma,with a focus on SQSTM1/p62-mediated mitophagy,and to evaluate the regulatory and therapeutic potential of dusquetide in this process. Methods A house dust mite (HDM)-induced asthma model was established with 6- to 8-week-old female C57BL/6 mice,which were then exposed to PM2.5.Control,HDM,HDM+PM2.5 (HP),and intervention (HP+Mdivi-1 and HP+dusquetide) groups were established.Airway hyperresponsiveness was assessed through whole-body plethysmography,and airway inflammation and mucus secretion were evaluated by HE and PAS staining.Immunofluorescence assay was employed to detect the co-localization of TOMM20 and LC3B.Key factors were screened and validated by LC-MS/MS-based mitochondrial proteomics. Results PM2.5 exposure enhanced airway hyperresponsiveness (P<0.01),exacerbated inflammation and mucus secretion (P<0.01),and increased TOMM20 and LC3B co-localization signals (P<0.01) in HDM-sensitized mice.Mdivi-1 inhibition of mitophagy reduced inflammation (P<0.01).Mitochondrial proteomics identified SQSTM1/p62 as a core regulatory factor,whose expression was up-regulated after PM2.5 exposure (P<0.01).Dusquetide intervention inhibited SQSTM1/p62 function and mitophagy (P<0.01),reduced airway hyperresponsiveness in mice of the HP group (P<0.01),and alleviated inflammatory manifestations (P<0.01). Conclusion PM2.5 exacerbates HDM-induced asthma pathology by activating SQSTM1/p62-mediated mitophagy,while dusquetide effectively alleviates this process,demonstrating the potential as a therapeutic target for PM2.5-related asthma.
Objective To explore the change trajectories of frailty in middle-aged and elderly patients undergoing radiotherapy for lung cancer and their influencing factors,thus providing a theoretical basis for targeted frailty management. Methods A prospective longitudinal study was conducted.Middle-aged and elderly patients with lung cancer who received radiotherapy in Yunnan Cancer Hospital were recruited by convenience sampling from January 2023 to December 2024.The general information questionnaire was used to investigate the baseline and disease-related data of patients at three time points:1 day before radiotherapy,at the end of radiotherapy,and 1 month after radiotherapy.The Fried Frailty scale was adopted to identify frailty at each time point.A latent class growth model was employed to analyze the change trajectories of frailty in middle-aged and elderly patients undergoing radiotherapy for lung cancer.Multinomial logistic regression was performed to analyze the influencing factors of different trajectories. Results A total of 327 middle-aged and elderly patients completed the follow-up.The incidence of frailty was 27.83% before radiotherapy,48.32% at the end of radiotherapy,and 29.36% one month after radiotherapy.The frailty trajectory categories of patients undergoing radiotherapy for lung cancer could be classified into a pre-frailty-decline group (56.58%),a frailty-gentle increase group (27.83%),and a severe frailty-continuous increase group (15.60%).Age,nutritional score,disease stage,and the therapy received were the influencing factors of frailty trajectory category (all P<0.05). Conclusions There is heterogeneity in the frailty trajectories of middle-aged and elderly patients with lung cancer before and one month after radiotherapy.Medical staff can formulate targeted frailty management strategies according to the heterogeneity and influencing factors of frailty trajectories to help patients prevent or reverse the occurrence of frailty and further improve the quality of life of patients.
The pharmaceutical industry is a strategic sector bearing on national economy,development,and security.It represents one of the fields featuring highly active scientific innovation,fierce international competition,and high policy attention.Amidst profound adjustments in the global pharmaceutical landscape and the deep advancement of a new round of scientific and technological revolution and industrial transformation,the 15th Five-Year Plan period marks a critical stage for China's pharmaceutical industry to achieve high-quality development.This article systematically analyzes the characteristics and strategic positioning of the pharmaceutical industry,reviews the development landscape and trends of the global pharmaceutical industry,and objectively summarizes China's current status of this industry in terms of industrial scale,innovation capability,industrial clustering,and internationalization.The study suggests that during the 15th Five-Year Plan period,China's pharmaceutical industry faces five major new situations-new strategic positioning,new market demands,emerging technologies,fresh growth drivers,and a reshaped industrial landscape,with opportunities outweighing challenges.To achieve high-quality development during the 15th Five-Year Plan period,the industry should adhere to five principles:prioritizing scale-driven expansion to enlarge industrial footprint,boosting technological foundation to anchor innovation-led development,advancing business model innovation to foster new application scenarios,adhering to people-centered development to ramp up high-quality product supply,and optimizing the industrial ecosystem to refine supporting guarantee systems.
Splenic angiosarcoma is a rare aggressive tumor originating from vascular endothelial cells of the spleen,typically presenting with splenomegaly,fatigue,and weight loss.Patients accompanied by anemia,thrombocytopenia,and bone marrow biopsy showing fibrosis are prone to be misdiagnosed with primary myelofibrosis.This article retrospectively analyzes the clinical characteristics of two cases initially diagnosed as primary myelofibrosis but negative for common driver gene mutations (JAK2,CALR,and MPL).One case was confirmed through splenectomy due to progressive splenomegaly,while the other was identified via bone marrow biopsy indicating angiosarcoma invasion.Both cases were ultimately pathologically confirmed as primary splenic angiosarcoma after splenectomy.Through literature review,we aim to enhance awareness of this rare disease,emphasizing that primary splenic tumors secondary to myelofibrosis should be differentially diagnosed in the cases of driver gene mutation-negative myelofibrosis.
Functional single ventricle (FSV) is a complex congenital heart defect characterized by a single functional ventricle responsible for supporting both systemic and pulmonary circulations.Patients with FSV may undergo non-cardiac surgeries at various stages of life,and their unique anatomical and physiological features present significant challenges to anesthetic management.This case report describes the perioperative anesthetic management of a patient with FSV who underwent epicardial pacemaker implantation.Particular attention is given to the preoperative evaluation and intraoperative strategies,providing clinical insights for the anesthetic care of patients with similar congenital cardiac anomalies.
Complete hydatidiform mole with coexisting fetus (CHMCF) represents a rare and clinically distinct subtype of molar pregnancy.Current diagnostic approaches primarily rely on early ultrasonographic examination combined with serial monitoring of serum levels of free β-human chorionic gonadotropin.However,the diagnostic accuracy of ultrasonography alone during early gestation remains suboptimal,and definitive diagnosis still requires histopathological confirmation and genetic analysis.This article presents a case of CHMCF that was accurately diagnosed at the 10th week of gestation through multimodal imaging combined with magnetic resonance imaging and ultrasonography.This case provides valuable insights for optimizing early diagnosis.
Objective To explore the risk factors for secondary uterine arteriovenous fistula (UAVF) after induced abortion. Methods A retrospective case-control study was conducted.Fifty-two patients with secondary UAVF after induced abortion in Peking Union Medical College Hospital between January 2013 and January 2025 were enrolled in the patient group.According to a 1∶3 ratio,patients who underwent the same method of abortion to terminate pregnancy within the same two weeks but did not develop UAVF post-surgery were selected and included in the control group (n=156).The basic information was compared between the two groups. Multivariate logistic regression analysis was performed to identify the risk factors for UAVF after induced abortion. Results Multivariate logistic regression analysis showed that residual pregnancy tissue in the uterus was an independent risk factor for the occurrence of UAVF (OR=16.02,P=0.037).The patients with residual pregnancy tissue after induced abortion had a 16 fold higher incidence of secondary UAVF than the control group. Conclusions Residual pregnancy tissue in the uterus is an independent risk factor for secondary UAVF after induced abortion.Avoiding residual pregnancy tissue may reduce the occurrence of UAVF.
Objective To investigate the value of super-resolution ultrasound (SRUS) imaging in the diagnosis of American College of Radiology Thyroid Imaging Reporting and Data System category 4 and 5 thyroid nodules diagnosed by routine ultrasound examination. Methods This study prospectively included the patients who were scheduled for ultrasound-guided aspiration biopsy due to suspicious thyroid nodules found on routine ultrasound.Contrast-enhanced ultrasound (CEUS) examination and SRUS analysis were performed to observe the enhancement characteristics of the nodules and conduct quantitative analysis.With pathological results as the gold standard,various quantitative parameters were compared between the benign and malignant groups. Results The benign group had higher peak intensity,microvascular ratios (VRs) during the peak and decay phases,mean density,mean blood flow,mean velocity,and perfusion index than the malignant group (all P<0.05).The area under the receiver operating characteristic (ROC) curve (AUC) for the diagnosis of thyroid cancer based on the peak intensity of CEUS and the VRs during the peak and decay phases of SRUS were 0.76,0.80,and 0.76,respectively.The combined diagnosis utilizing all three parameters yielded an AUC of 0.80,with accuracy,sensitivity,and specificity all being 80.0%. Conclusion SRUS can quantitatively assess the microvascular distribution and circulation status within nodules,addressing the limitations of current ultrasound techniques and CEUS and providing accurate assistance for clinical diagnosis and treatment.
Objective To compare the imaging efficacy and patient tolerability of a novel cellulose-based oral contrast agent with a conventional starch-based agent in gastric contrast-enhanced ultrasound,thus providing evidence-based support for clinical practice. Methods A prospective,single-center,double-blind,randomized controlled trial was conducted,enrolling 100 healthy volunteers who were randomly assigned to either the experimental group (cellulose-based agent,n=50) or the control group (starch-based agent,n=50).All examinations were performed by the same sonographer.The clarity of gastric wall layers,homogeneity of the contrast agent,and degree of bubble interference were scored.The time required for oral contrast intake was recorded,and a questionnaire was used to evaluate taste acceptability and subjective tolerability after the examination. Results Baseline characteristics were balanced between the two groups.There were no statistically significant differences in image quality scores for various gastric regions,contrast agent homogeneity,or bubble interference scores (all P>0.05).No significant difference was observed in oral contrast agent intake time (P=0.081).Neither taste acceptability (96% of participants in both groups scored≥2) nor subjective tolerability (92% in the experimental group vs. 82% in the control group scored≥3) showed significant between-group differences (P>0.05). Conclusions In gastric contrast-enhanced ultrasound,the novel cellulose-based contrast agent shows no significant difference from the conventional starch-based contrast agent in terms of imaging efficiency and patient tolerability.With ready-to-use and easy-to-operate features,it holds significant potential for clinical adoption.
Objective To explore the consistency and clinical application value of transabdominal intestinal ultrasound (IUS) and computed tomography enterography (CTE) in the diagnosis of inflammatory bowel disease (IBD) complicated with intestinal stenosis. Methods A retrospective study was conducted on 115 patients diagnosed with IBD in Beijing Friendship Hospital,Capital Medical University from 2015 to 2024 and who underwent both IUS and CTE examinations during the same period.Clinical and imaging data were collected.Endoscopy was used as the gold standard to compare the detection,localization,and diagnostic efficacy of the two methods for intestinal stenosis and evaluate their consistency. Results A total of 115 patients (70 with Crohn's disease,22 with ulcerative colitis,and 23 with unclassified IBD) were included.In the diagnosis of stenosis among all the IBD patients,the sensitivity of IUS (86.2%) was higher than that of CTE (66.7%),while the specificity of CTE (57.1%) was better than that of IUS (35.7%).The two methods exhibited poor consistency in diagnosing intestinal stenosis (κ=0.056),while they were consistent in identifying pre-stenotic dilation (κ=0.614) and localizing the affected intestinal segments (κ=0.691).The intestinal wall thickness values measured by CTE were systematically higher than those by IUS. Conclusions IUS and CTE have complementary values in the diagnosis of IBD complicated with intestinal stenosis.IUS with higher sensitivity is suitable for screening and long-term follow-up,and CTE with better specificity is suitable for comprehensive anatomical assessment.Clinically,the appropriate choice and application should be made based on specific scenarios and IBD subtypes.
Objective To investigate the associations between metabolic obesity phenotypes and the risk of developing sarcopenia among middle-aged and older Chinese adults,and further examine the potential moderating roles of age and sex in the associations. Methods On the basis of the data from the China Health and Retirement Longitudinal Study conducted in 2011-2012,a total of 7 421 participants aged 45 years and older were enrolled in this study.Sarcopenia was diagnosed according to the 2019 criteria established by the Asian Working Group for Sarcopenia.According to the body mass index and overall metabolic status,the participants were classified into four metabolic obesity phenotypes:metabolically healthy normal weight,metabolically healthy overweight/obesity,metabolically unhealthy normal weight,and metabolically unhealthy overweight/obesity (MUOO).A multivariate logistic regression model was adopted to assess the association between each metabolic phenotype and the risk of sarcopenia.Stratified analyses were performed by sex and age groups,accompanied by heterogeneity testing.Additionally,Bayesian statistical methods were utilized to verify the reliability and robustness of the findings,particularly within the older age subgroup. Results The analysis revealed a significant moderating effect of age on the association between MUOO and sarcopenia risk.Specifically,among individuals younger than 60 years old,those with MUOO exhibited a significantly elevated risk of sarcopenia (OR=1.56,95%CI=1.03-2.37).This association was further supported by Bayesian analysis,which confirmed the consistency and robustness of the observed trend in the older age group.Stratified analyses by both sex and age uncovered notable heterogeneity:MUOO was identified as a significant risk factor for sarcopenia among men under 60 years old (OR=2.01),whereas it was associated with a significantly lower risk of sarcopenia among women aged 75 years and older (OR=0.13). Conclusions The association between MUOO and sarcopenia risk is markedly influenced by both age and sex.Middle-aged men with MUOO show increased susceptibility to sarcopenia,while MUOO may exert a potential protective effect among older women.These findings underscore the importance of incorporating metabolic status,age,and sex into the design of sarcopenia prevention and management strategies,advocating for personalized precision interventions.
Objective To understand the current status and influencing factors of knowledge,attitudes,and behaviors regarding sexual and reproductive health (SRH) among adolescents in Luzhou city and propose intervention strategies from multiple dimensions to provide an evidence-based basis for optimizing SRH education for adolescents. Methods From November to December 2024,a multi-stage sampling method was employed to include 2 377 adolescents from vocational high schools,junior colleges,and universities in Luzhou city,and a self-administered anonymous questionnaire survey was conducted.Binary Logistic regression analysis was performed to analyze the current situation and influencing factors of the knowledge,attitudes,and behaviors regarding SRH among adolescents. Results The average ages of menarche and nocturnal emission in sexual development among adolescents in Luzhou City were (12.33±1.22) years old and (12.73±1.88) years old,respectively.The reported prevalence rates of sex-related behaviors were as follows:viewing pornographic materials (37.8%),masturbation (31.0%),kissing (21.5% among heterosexual individuals and 3.5% among homosexual individuals),and sexual intercourse (2.6% among heterosexual individuals and 0.4% among homosexual individuals).The good rates of knowledge,attitudes,and behaviors regarding SRH among adolescents were 45.0%,49.3%,and 33.2%,respectively.The results of binary Logistic regression analysis showed that adolescents in universities had higher good rates of knowledge (OR=3.10),attitudes (OR=2.20),and behaviors (OR=1.41) regarding SRH than those in vocational high schools or junior colleges.The adolescents from original (OR=1.69) and single-parent families (OR=1.54) had higher good rates of SRH attitudes than those from reconstituted families.Compared with adolescents whose mothers had the education background of junior college/university or higher,those whose mothers had the education background of senior high school/technical school/technical secondary school (OR=0.55 and OR=0.51),junior high school (OR=0.54 and OR=0.49),primary school or lower (OR=0.48 and OR=0.48) showed decreased good rates of knowledge and behaviors regarding SRH.Compared with adolescents from families with poor economic conditions,those from families with moderate (OR=1.43) and good (OR=1.49) economic conditions had increased good rates of SRH knowledge.The good rate of SRH knowledge among adolescents who had received school-based sex education was higher (OR=1.56).The good rates of attitudes (OR=1.38) and behaviors (OR=1.79) regarding SRH among adolescents who had participated in peer discussions were higher.The good rates of knowledge (OR=1.81),attitudes (OR=1.61),and behaviors (OR=2.24) regarding SRH among adolescents who had received peer education were higher (all P<0.05). Conclusions The knowledge,attitudes,and behaviors of SRH among adolescents in Luzhou City are at a low level,with the behavioral level lagging significantly.There are significant differences among different groups.It is necessary to strengthen sex education in vocational high schools,optimize peer education,enhance the communication effectiveness of parents,and construct a multi-dimensional coordinated intervention strategy covering micro,meso,and macro levels for SRH to promote the transformation of sexual health behaviors.
