ObjectiveTo analyze the epidemiological characteristics of clustered vomiting and diarrhea outbreaks in Minhang District of Shanghai, to identify the influencing factors of outbreak scale and duration of epidemic, and to provide scientific evidence for further strengthening surveillance early-warning efforts in key settings and for optimizing prevention and control measures. MethodsThe data for describing epidemiological characteristics of clustered vomitting and diarrhea outbreaks in Minhang District from 2018 to 2023 were collected, multivariable logistic regression models were applied to analyze the influencing factors for epidemic scale,and Spearman rank correlation analyses were applied to analyze the factors duration. ResultsA total of 136 clustered vomiting and diarrhea outbreaks were reported in Minhang District from 2018 to 2023, all occurring in school settings, with an overall attack rate of 0.90%. The outbreaks exhibited distinct seasonality, predominantly occurring from October to December (43.38%) and March to May (32.35%). The primary settings were preschools (45.59%) and elementary schools (44.12%), with students accounted for the majority of cases (99.48%). The predominant clinical manifestation was vomiting (90.44%), with person-to-person contact being the primary transmission route (98.53%). Norovirus genogroup Ⅱ was identified as the main pathogen (71.32%). Standardized terminal disinfection of outbreak sites (OR=0.39, 95%CI=0.20‒0.74) and effective isolation of affected classes (OR=0.23, 95%CI=0.09‒0.57) were significant protective factors for reducing outbreak scale. Both response time (r=0.64, P<0.001) and the number of case generations (r=0.71, P<0.001) showed positive correlations with outbreak duration. ConclusionSchools are the key settings for the prevention and control of clustered vomiting and diarrhea outbreaks in Minhang District, with peak occurring in autumn and spring. Early detection, timely reporting, and prompt response to outbreaks are crucial. Strengthening school-based surveillance systems and standardizing outbreak management protocols are of particular importance.

Objective To compare the clinical efficacy of high-dose tigecycline(TGC)and polymyxin B(PMB)in the treatment of pulmonary infection due to carbapenem-resistant organism(CRO).Methods Clinical data of pa-tients with CRO pulmonary infection and received PMB or high-dose TGC combined with other antimicrobial treat-ment regimens in Department of Critical Care Medicine of Xiangya Hospital,Central South University from January 2019 to March 2022 were analyzed retrospectively,including basic information,pathogen detection results,antimi-crobial use regimen,clinical efficacy,30-day mortality,bacterial clearance rate,etc.Results A total of 173 pa-tients were included in analysis,with 103 in the TGC group and 70 in the PMB group.Compared with TGC group,PMB group had a higher score of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)(25.0 vs 20.0,P＜0.001),but clinical efficacy rates were not statistically different(67.1％vs 52.4％,P=0.054).Stratified analysis revealed that when the APACHE Ⅱ score was ≥15 points,compared with TGC group(n=78),PMB group(n=66)had a higher APACHE Ⅱ score(27.0 vs 22.0,P=0.005)and a higher clinical efficacy rate(66.7％vs 47.4％,P=0.020).After adjusting confounding factors through logistic regression analysis,it was found that PMB treatment was a protective factor for clinical efficacy rate compared with TGC treatment.Conclusion For treating pulmonary infection caused by CRO in patients,PMB-based treatment regimen has a significant protec-tive effect on the clinical efficacy rate compared with the high-dose TGC-based treatment regimen.

Objective To compare the clinical efficacy of high-dose tigecycline(TGC)and polymyxin B(PMB)in the treatment of pulmonary infection due to carbapenem-resistant organism(CRO).Methods Clinical data of pa-tients with CRO pulmonary infection and received PMB or high-dose TGC combined with other antimicrobial treat-ment regimens in Department of Critical Care Medicine of Xiangya Hospital,Central South University from January 2019 to March 2022 were analyzed retrospectively,including basic information,pathogen detection results,antimi-crobial use regimen,clinical efficacy,30-day mortality,bacterial clearance rate,etc.Results A total of 173 pa-tients were included in analysis,with 103 in the TGC group and 70 in the PMB group.Compared with TGC group,PMB group had a higher score of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)(25.0 vs 20.0,P＜0.001),but clinical efficacy rates were not statistically different(67.1％vs 52.4％,P=0.054).Stratified analysis revealed that when the APACHE Ⅱ score was ≥15 points,compared with TGC group(n=78),PMB group(n=66)had a higher APACHE Ⅱ score(27.0 vs 22.0,P=0.005)and a higher clinical efficacy rate(66.7％vs 47.4％,P=0.020).After adjusting confounding factors through logistic regression analysis,it was found that PMB treatment was a protective factor for clinical efficacy rate compared with TGC treatment.Conclusion For treating pulmonary infection caused by CRO in patients,PMB-based treatment regimen has a significant protec-tive effect on the clinical efficacy rate compared with the high-dose TGC-based treatment regimen.

Objective: To ensure the quality of Perilla frutescens (L.) Britt. and improve the associated benefits for stakeholders, this study analyzed the influences of different circulation channels and stakeholders on the quality, price, and other factors of P. frutescens with consideration to P. frutescens distribution. Method: We interviewed the local stakeholders and e-commerce platforms in Oroqen Autonomous Banner and Morin Dawa Daur Autonomous Banner regarding the origin, circulation, distribution, and prices of different medicinal parts of P. frutescens. In addition, the maximum entropy model was used to predict the potential distribution of P. frutescens in the study area. According to the Chinese Pharmacopeia (2020 edition), we measured the content of index components in the collected Perillae Folium, Perillae Caulis, and Perillae Fructus samples and evaluated the quality of the samples by quantitative and cluster analyses. Remote sensing was employed to distinguish and calculate the P. frutescens area in highly suitable regions. The autoregressive integrated moving average model was adopted to analyze the Perillae Fructus price in the study area. Result: The results showed 8 value chains for P. frutescens. The cooperation chain between farmers and enterprises in the study area could maximize the benefits for all stakeholders and guarantee the quality of the medicinal materials. The results of the regionalization analysis showed that themost suitable area for planting P. frutescens was the junction between Oroqen Autonomous Banner and Morin Dawa Daur Autonomous Banner. Chemical results showed that Perillae Fructus and Perillae Caulis samples were unqualified andmostly purchased from e-commerce platforms. We identified 5 land types, among which the cultivated land area was 3247.7501 km . The price of Perillae Fructus in the study area showed a rising trend, although this trend slowed down. Conclusion: This study involved various links in the production and circulation of medicinal materials from planting to consumption by consumers, which can help to facilitate the future research on any link. The findings help to guarantee the quality of medicinal materials and benefits of all stakeholders and promote the development of the P. frutescens industry in the study area.

ObjectiveTo develop a new mosquito trap and evaluate its effectiveness in Aedes albopictus monitoring in an urban community. MethodsThe first-round field test was conducted in a well-greened residential neighborhood with high Aedes albopictus density calculated by human landing catch in August 2022， in Minhang District， Shanghai. 65 new test containers with different designs were randomly deployed in the field. These trap containers were designed by different material， color， hole size， shape and top cover colors. The results of mosquito and its egg trapping were observed and recorded continuously for 7 days. In September 2022， the second round of experiment was conducted. After comparison， an optimized trap container was designed. 140 new trap containers were compared with 140 traditional ones to evaluate the effectiveness. SPSS 22.5 software was used for statistical analysis. ResultsThere were significant changes in the outcome of mosquito and its egg trapping on the 4th and 7th day of the pre-experiment deployment of the three kinds of containers. The 200 ml container cup with three round holes in the body had the best effect on trapping mosquitos and eggs， with a positive rate of 45.5% （5/11）， while other type of contrainer cup only had a positive rate of 12% （6/50） in trapping mosquitos and eggs. Statistical significant differences （χ²=45.443，P <0.001） existed between the two tpyes of cups within the first kind of trapping container. The second kind of trapping container showed round and oval holes had better effect on mosquito trapping， with a positive rate of 55.6% （5/9）. The third kind of hanging container can resist strong wind. The best mosquito trapping effect of three round holes was 66.7% （2/3）. The container wall should not be made of rough material， which was easy to cause the escape of adult mosquitoes. Combined with the three types of containers， the new contariner should be top transparent， and the top 1/3 of the side should paint black with 3 round holes. The effective recovery rate of the new container was higher than that of the traditional one under the exclusion of human factors， and had the advantage of preventing rain， wind and rollover， but the effect of trapping mosquito and its egg was comparable to the traditional one（χ²_D4=0.197，P=0.658； χ²_D7=0.125 ，P=0.724）. ConclusionThis new type of mosquito trap is worth further exploration and research， which can improve the trapping efficiency， overall recovery rate and the accurate confirmation of the mosquito density.

Objective:To explore the effect of short-term mindfulness behavior training on body image, negative emotions and mindfulness level of pregnant women with recurrent spontaneous abortion (RSA) .Methods:From October 2020 to October 2021, 50 RSA pregnant women admitted to the Department of Gynecology of Wuxi Woman and Enfants Care Hospital were selected as the study subject using convenience sampling. Pregnant women were divided into an intervention group and a control group using a random number table method, with 25 cases in each group. During the research process, two cases were lost in the intervention group and two cases in the control group, and 46 cases were ultimately completed, with 23 cases in each group. The control group received routine nursing, while the intervention group received a 4-week mindfulness behavior training on this basis. Body Image in Pregnancy Scale (BIPS), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Mindful Attention Awareness Scale (MAAS) were used to evaluate the effect of intervention.Results:After intervention, the BIPS, SAS, SDS scores of pregnant women in the intervention group were lower than those in the control group, while the MAAS scores were higher than those in the control group, with statistically significant differences ( P<0.05) . Conclusions:Short-term mindfulness behavior training can improve the body image and negative emotions of pregnant women with RSA, and can improve the level of mindfulness attention awareness.

Objective:To compile the knowledge, attitude and practice questionnaire for primiparas with breast-feeding mastitis and test its reliability and validity.Methods:Guided by the knowledge-attitude-practice (KAP) theory, the first draft of the test questionnaire was formed through literature review, qualitative interviews, the Delphi method and pre-experiments. Totally 623 primiparas who attended a ClassⅢ Grade A obstetrics and gynecology hospital in Shanghai from February to June 2021 were selected by convenient sampling and formally investigated 42 days after delivery. Item analysis was used to select items; exploratory factor analysis, confirmatory factor analysis and expert consultation were employed to evaluate the validity of the questionnaire; test-retest reliability, half-reliability and internal consistency coefficient were used to evaluate the reliability of the questionnaire. A total of 623 questionnaires were distributed and 614 questionnaires were recovered, of which 609 were valid, with an effective recovery rate of 97.75%.Results:The questionnaire finally contained 26 items. Totally 6 common factors were extracted through exploratory factor analysis, and the cumulative variance contribution rate was 63.141%. Confirmatory factor analysis showed that the ratio of chi-square to degrees of freedom (χ 2/ df) =1.952, root mean square of root mean square error of approximation ( RMSEA) =0.056, comparative fit index ( CFI) = 0.922, incremental fit index ( IFI) =0.923, parsimonious normed fit index ( PNFI) =0.746, and parsimonious comparative fit index ( PCFI) =0.806. The content validity index at the questionnaire level was 0.91, and the content validity index at the item level was 0.81~0.98. The Cronbach's α coefficient of the total questionnaire was 0.863、the half-reliability coefficient was 0.714, and the test-retest reliability coefficient was 0.865. Conclusions:The KAP questionnaire for primiparas with breast-feeding mastitis has good reliability and validity, which can be used to assess the current status of primiparous women's KAP of breast-feeding mastitis.

OBJECTIVE: To investigate the interventional effect of the Chinese herbal preparation Xi Fu Pai Chen(XFPC) on pulmonary inflammation and fibrosis in rats with silicosis. METHODS: A total of 144 adult specific pathogen free male SD rats were randomly divided into 6 groups: blank control group, silicosis model group, drug administration control group and groups of low-dose,medium-dose and high-dose XFPC, with 24 rats in each group. Lung silicosis model was established by single inhalation tracheal instillation method, which was treated with 50.0 g/L silica suspension, in groups except in the blank control group. On the 7 th day of modeling, the rats in the drug administration control group were orally given tetrandrine(5 mg/kg body weight), while those in the low-, medium-and high-dose groups were given 43, 86 and 192 g/L of XFPC by atomization inhalation once a day for 20 minutes, 5 days a week for 4 weeks. At the end of drug administration, the histopathological changes of the lung were observed. The number and classification of cells in bronchoalveolar lavage fluid(BALF)were examined, and the levels of malondialdehyde(MDA) and interferon-gamma(IFN-γ) in BALF were measured by enzyme-linked immunosorbent assay. RESULTS: On the 7 th day after modeling, the body weight in the drug administration control group and XFPC high-dose group decreased compared with the blank control group(P<0.05). On the 35 th day after modeling, the body weights of rats in the other 5 groups were lower than that in the blank control group(P<0.05). The pathological changes of lung tissue(infiltration of inflammatory cells, fibrosis and size of silicon nodule) in drug administration control group and XFPC low-dose group were better than those in silicosis model group by naked eyes and under light microscope. The lung coefficient, the proportion of neutrophils and the level of MDA and IFN-γ in BALF of the drug administration control group and XFPC low-dose group decreased(P<0.05), and the proportion of macrophages in BALF increased(P<0.05) compared with the silicosis model group. There was no significant difference in lung coefficients and the relevant indices of BALF between XFPC medium-, high-dose groups and silicosis model group(P>0.05). CONCLUSION: Low dosage XFPC can improve pulmonary fibrosis and inflammation in rats with silicosis, and its mechanism of action may be related to reducing the levels of IFN-γ and MDA in BALF.

This article reviews the current research status, main measurement tools, influencing factors and intervention measures of parenting stress in very low birth weight (VLBW) premature infants after discharge from hospital.This article points out the problems in current research and suggests that we should pay more attention to parenting stress in VLBW premature infants after discharge from hospital, and further understand its influencing factors, so as to provide a basis for future nursing interventions to reduce the parenting stress of VLBW premature infants in my country.

Objective? To understand the psychological stress and main influencing factors of the stress after implementing kangaroo mother care (KMC), and to explore the changes of the mothers＇ stress under different frequencies of KMC. Methods? Totally 586 participants including 105 mothers having KMC were selected from the newborn infant intensive care unit in a Class Ⅲ Grade A maternal and infant health care hospital admitted during the period of October, 2016 to December, 2017. According to the frequency of KMC, the participants were divided into two groups: group 1(1-3 times) and group 2 (≥ 4 times). Parent Stressor Scale: Neonatal Intensive Care Uni(t PSS:NICU) was used to evaluate the parents＇ stress, and the results of the two groups were compared. Results? In the first three times of KMC,the preterm mothers had high levels of stress. Since the fourth time, the stress gradually declined. The score of the overall stress degree was (1.90±0.73), and the high scores went to "sudden alarm of the monitor machines" (1.90±1.00), "feeling helpless about being unable to get the infants out of pain" (2.11±1.13), "seeing the infants' apnoea" (2.11±1.54). There were statistical significance in "auditing factors" "parents＇ role adaptability" and "infants＇ behavior and state" between the two groups (P＜0.05). Conclusions? Preterm infants＇ mothers have moderate amount of stress. The main causes of the stress include the change of the infants＇ vital signs, the use of breathing machine, the feeling of helplessness from being unable to get the babies out of pain and separation with the babies. After several times of KMC, the mothers gradually adapt to the new roles and their stress drops dramatically.