Objective:To explore the necessity and basic connotation of building an integrated eye health service system and propose a systematic const ruction pathway.Methods:A multi-dimensional analytical framework for an integrated eye health service system was constructed using literature review,interviews,and the rainbow model theory.Results:Considering the current state of eye disease prevention and control in China,along with the practical need to address the imbalance in the supply and demand structure of ophthalmic resources,it is necessary to build an integrated eye health service system that is fair,accessible,systematic,continuous,high-quality and efficient.Conclusion:It is needed to further improve the top-level design framework,enhance system integration,consolidate the service network at the grassroots level,strengthen organizational coordination,establish specialized eye health prevention and treatment centers,promote professional collaboration,deliver integrated and proactive service models,optimize service integration,and reinforce enabling factors through functional unification and standardized protocols.

Objective To examine the changing prevalence and antimicrobial resistance profiles of Burkholderia cepacia in 52 hospitals across China from 2015 to 2021.Methods A total of 9 261 strains of B.cepacia were collected from 52 hospitals between January 1,2015 and December 31,2021.Antimicrobial susceptibility of the strains was tested using Kirby-Bauer method or automated antimicrobial susceptibility testing systems according to a unified protocol.The results were interpreted according to the breakpoints released in the Clinical & Laboratory Standards Institute(CLSI)guidelines(2023 edition).Results A total of 9 261 strains of B.cepacia were isolated from all age groups,especially elderly patients.The proportion was 11.1％(1 032 strains)in children,significantly lower than the proportion in adults.About half(46.5％,4 310/9 261)of the strains were isolated from patients at least 60 years old and 42.3％(3 919/9 261)of the strains were isolated from young adults.Most isolates(71.1％)were isolated from sputum and respiratory secretions,followed by urine(10.7％)and blood samples(8.1％).B.cepacia isolates were highly susceptible to the five antimicrobial agents recommended in the CLSI M100 document(33rd edition,2023).B.cepacia isolates showed relatively higher resistance rates to meropenem and levofloxacin.However,the resistance rates to ceftazidime,trimethoprim-sulfamethoxazole,and minocycline remained below 8.1％.The percentage of B.cepacia strains resistant to levofloxacin was the highest compared to other antibiotics in any of the three age groups(from 12.4％in the patients＜18 years old to 20.6％in the patients aged 60 years or older).Conclusions B.cepacia is one of the clinically important non-fermenting gram-negative bacteria.Accurate and timely reporting of antimicrobial susceptibility test results and ongoing antimicrobial resistance surveillance are helpful for rational prescription of antimicrobial agents and proper prevention and control of nosocomial infections.

Objective:To explore the effect of triple pre-rehabilitation strategy on improving nutritional status, negative emotions and quality of life in breast cancer patients undergoing neoadjuvant chemotherapy, so as to provide reference for clinical practice.Methods:A quasi experimental research was adopted. A total of 133 patients who underwent neoadjuvant chemotherapy for breast cancer at Gansu Provincial Cancer Hospital between December 2023 and December 2024 were recruited as research participants. Patients were stratified into the experimental group ( n = 66) and control group ( n = 67) according to their admission sequence. The control group received routine health guidance, while the experimental group was provided with a triple pre-rehabilitation strategy based on the control group. The serum albumin, body mass index, anxiety, depression scores and quality of life scores were compared between the two groups before intervention, 3 weeks after intervention and 2 weeks post-surgery. Results:Totally 64 patients in each group completed the study. The age of the experimental group was (49.50 ± 10.46) years, and that of the control group was (50.42 ± 12.50) years. All of them were females. After a 3-week intervention, the serum albumin levels in the experimental group were (42.62 ± 1.56) g/L, compared to (40.50 ± 1.31) g/L 2 weeks post-surgery. In the control group, these values were (40.98 ± 1.35) g/L and (40.00 ± 1.67) g/L, respectively. The differences between groups were statistically significant ( t = -6.38, -1.89, both P<0.05). Additionally, body mass index of the experimental group was (24.02 ± 1.35) kg/m 2 after the 3-week intervention and (23.48 ± 1.72) kg/m 2 2 weeks post-surgery, which were significantly higher than those of the control group (22.98 ± 1.72) kg/m 2 and (22.50 ± 1.31) kg/m 2, respectively ( t = - 3.81, - 3.61, both P<0.05). The anxiety scores in the experimental group were (6.00 ± 2.09) of 3 weeks after intervention and (7.00 ± 2.62) 2 weeks post-surgery, both of which were significantly lower than those in the control group (7.00 ± 2.26) and (8.00 ± 2.76), with statistically significant differences ( t = 2.60, 2.10, both P<0.05). Additionally, the depression scores in the experimental group were (5.00 ± 2.20) of 3 weeks after intervention and (6.00 ± 2.40) 2 weeks post-surgery, which were also significantly lower than those in the control group (6.00 ± 2.02) and (7.00 ± 2.09), with statistically significant differences ( t = 2.68, 2.52, both P<0.05). Furthermore, the quality of life scores in the experimental group were (94.84 ± 18.00) of 3 weeks after intervention and (84.02 ± 17.13) 2 weeks post-surgery, which were significantly higher than those in the control group (82.00 ± 18.75) and (72.03 ± 17.10), with statistically significant differences ( t = - 3.95, - 3.96, both P<0.05). Conclusions:The triple pre-rehabilitation strategy plays a crucial role in mitigating the nutritional risk for breast cancer patients undergoing neoadjuvant chemotherapy, alleviating their negative emotions, and enhancing their quality of life. This approach is anticipated to serve as a valuable reference for preoperative health guidance tailored to breast cancer patients undergoing neoadjuvant chemotherapy.

Objective:To assess the efficacy and safety of Gongxuening Capsules in reducing post-abortion bleeding following artificial abortion.Methods:A multicenter, randomized, double-blind study was conducted. From May 31, 2022 to March 31, 2023, 484 women who underwent vacuum aspiration abortion for early intrauterine pregnancy were enrolled in 11 centers and randomly assigned to control group and the study group at a 1∶1 ratio using a center-block randomization method. Control group were administered a placebo of Gongxuening Capsules for 9 d, while the study group received the actual Gongxuening Capsules for the same duration. The outcomes measured included vaginal bleeding volume, duration of vaginal bleeding, endometrial thickness, time to menstrual recovery, and complications.Results:1) A total of 484 subjects were enrolled, and 472 completed the study. Totally 450 subjects were included in the efficacy analysis set, with 224 in control group and 226 in the study group; 468 subjects were included in the safety analysis set, with 236 in control group and 232 in the study group. The baseline characteristics of the two groups were comparable (all P>0.05). 2) The vaginal bleeding volume was lower in the study group [(13.30±12.14) mL] than in control group [(19.00±17.67) mL, P<0.001]. The proportion of subjects in the study group with bleeding days less than 4 d [29.65% (67/226)] was higher than that in control group [19.20% (43/224), P=0.010]. 3) No significant differences were observed between the two groups in terms of time to menstrual recovery and endometrial thickness (all P>0.05). 4) In the study group, 3 subjects experienced non-therapeutic-related complications, while 11 subjects in control group. The incidence of complications was lower in the study group [1.29% (3/232)] than in control group [4.66% (11/236), P=0.033]. Conclusion:The administration of Gongxuening Capsules to women following artificial abortion significantly reduced vaginal bleeding volume and was associated with good safety, with the treatment being well-tolerated by the subjects.

Objective:To conduct a scoping review of the role responsibilities and competencies of oncology nurse specialist in the management of cutaneous immune-related adverse events (cirAEs), with a view to providing scientific guidance and reference for nursing practice in the field of oncology immunotherapy.Methods:Using the scoping review methodology as the framework, the relevant literatures on oncology nurse specialist in the management of cirAEs in databases including PubMed, Web of Science, CINAHL, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, and China Biology Medicine from their inception to September 20, 2024 were systematically searched. Two researchers independently screened the included literature, extracted information, and conducted a summary analysis.Results:A total of 24 articles were included. Based on the summary and categorization of the literature, six categories were identified, including dynamic monitoring and assessment, classification and intervention of cirAEs, precise symptom management, multidisciplinary management, continuity of care, and specialized training, along with 18 related responsibility items.Conclusions:Oncology nurse specialist plays a significant role in the management of cirAEs. In the future, it should draw on the training models and curricula of advanced practice oncology nurses from abroad to optimize oncology nurse specialist training and nursing practices, thereby enhancing the professionalism of nursing services and the quality of patient care.

The construction of the close-knit medical consortium is the starting point for realizing hierarchical diag-nosis and treatment,and the construction of the close-knit medical consortium requires the formation of prob-lem-oriented and interest-oriented cooperation between different types of hospitals.It selected typical cases of cooperation between different types of hospitals in the United States,Canada,Germany and Japan,and gave the key points of cooperation between different types of hospitals,such as agreement signing and cooperation frame-work,establishment of resource sharing and cooperation mechanism,expert exchange and training,case discus-sion and remote consultation,referral and continuum of care,and effect evaluation and continuous improvement.The practice of these hospital,cooperation provides a reference for the extension of high-quality urban resources to the county level in China.

Objective To explore the influence of different doses of remimazolam for general anesthesia induction on tracheal intubation stress response and hemodynamics in patients undergoing radical resection of colon cancer.Methods From August 2020 to August 2023,75 patients undergoing radical resection of colon cancer were induced by general anesthesia using remazolam.According to the random number table method,they were divided into group A(25 cases,0.2 mg/kg of remimazolam),group B(25 cases,0.3 mg/kg of remimazolam)and group C(25 cases,0.4 mg/kg of remimazolam).The stress response status[cortisol(Cor),epinephrine(E),norepinephrine(NE)]and hemodynamics[heart rate(HR),mean arterial pressure(MAP)]before anesthesia(T0),at tracheal intubation(T1),at 30 min after intubation(T2)and at 10 min after extubation(T3),anesthesia recovery status and total incidence rate of adverse anesthesia reactions were compared among the three groups.Results At T0,there were no obvious differences in the levels of Cor,E,NE,HR,SVI and MAP among the three groups(P＞0.05).At T1-T3,the levels of Cor,E and NE in group A[T1:(181.76±12.49)pg/ml,(67.94±2.66)ng/ml,(355.12±19.82)ng/ml;(231.90±15.82)pg/ml,(72.15±2.83)ng/ml,(379.86±20.31)ng/ml;T3:(300.65±17.43)pg/ml,(77.82±2.85)ng/ml,(405.31±24.36)ng/ml]were higher than those in group B[T1:(172.31±12.07)pg/ml,(66.22±2.73)ng/ml,(326.47±19.24)ng/ml;T2:(214.75±14.88)pg/ml,(70.34±2.79)ng/ml,(354.18±20.66)ng/ml;T3:(279.08±16.62)pg/ml,(75.03±2.81)ng/ml,(387.05±22.82)ng/ml]and group C[T1:(165.44±11.74)pg/ml,(64.01±2.75)ng/ml,(300.66±19.50)ng/ml;T2:(200.42±14.35)pg/ml,(67.59±2.80)ng/ml,(330.18±21.05)ng/ml;T3:(251.33±16.08)pg/ml,(72.44±2.70)ng/ml,(354.11±22.07)ng/ml](P＜0.05).At T1-T2,the HR and MAP were higher in group A[T1:(79.49±4.05)beats/min,(96.09±1.77)mmHg;T2:(76.55±3.83)beats/min,(94.88±1.55)mmHg]than those in group B[T1:(76.22±3.89)beats/min,(95.01±1.63)mmHg;T2:(74.23±3.76)beats/min,(93.89±1.51)mmHg]and group C[T1:(73.65±3.81)beats/min,(94.02±1.61)mmHg;T2:(71.55±3.61)beats/min,(92.97±1.46)mmHg](P＜0.05).There were no significant differences in HR and MAP among the three groups at T3(P＞0.05).The time of breathing recovery,open eye and extubation in group C was significantly longer compared with that in group A and group B(P＜0.05).There were no significant difference in total incidence rate of anesthesia adverse reactions between group B and group A,group C(P＞0.05).Conclusion 0.3 mg/kg remimazolam in patients undergoing radical resection of colon cancer has an ideal sedative effect,and it has small impact on stress response and hemodynamics,and has fast postoperative recovery and high safety.

The management of chronic diseases at the county-level faces the problems of low degree of standardized manage-ment,weak management capacity of chronic diseases at the grassroots level,and shedding management of chronic disease patients.The"county-level chronic disease management center"proposed in the"Thousand Counties Project"can promote the county-town-ship-village medical institutions to jointly provide integrated and continuous chronic disease management services for county resi-dents.The study conducted in-depth interviews and analyses on the construction of the centers in 10 county(district)hospitals.Con-clusion:Firstly,the construction of the centers is in its infancy,and the support of government investment,performance incen-tives,and informatization construction is insufficient;secondly,the service content of the current centers is not clear enough,and the collaborative management model of chronic diseases in counties and villages is not stable.Enlightenment:The county-level med-ical community has built an effective path for the centers and the construction of chronic disease management centers needs to be fur-ther strengthened in terms of finance,medical insurance,interest mechanism,informatization construction and awareness of chronic diseases.

Objective To investigate the efficacy and safety of esomeprazole combined with Biling Weitong granules in the treatment of epigastric pain syndrome(EPS).Methods A total of 114 patients with EPS treated in the First Hospital of Anhui University of Science and Technology from January to June 2024 were selected and divided into control group and observation group according to random number table method,with 57 cases in each group.The control group was given oral esomeprazole magnesium enteric-coated tablets,and the observation group was given Biling Weitong granules on the basis of control group,the courses of treatment lasted for 8 weeks.The peripheral blood gastrin-17(G-17)level,the comprehensive score of middle and upper abdominal pain and/or burning sensation and the occurrence of adverse reactions were compared between two groups.Results After 4 and 8 weeks of treatment,the comprehensive scores of two groups were significantly lower than before treatment(P＜0.05),and the comprehensive scores of observation group were significantly lower than those of control group(P＜0.05).After 8 weeks of treatment,the effective rate of observation group was significantly higher than that of control group(x2=7.600,P=0.006).After 8 weeks of treatment,the G-17 levels in both groups were significantly lower than before treatment(P＜0.05),and the G-17 level in observation group was significantly lower than that in control group(P＜0.05).There was no significant difference in the incidence of adverse reactions between two groups(x2=0.326,P=0.568).Conclusion Esomeprazole combined with Biling Weitong granules is more significant in improving the clinical symptoms of EPS patients,with higher treatment efficiency and good safety,which is worthy of clinical recommendation.

OBJECTIVE To investigate the suspected outbreak of one incident of carbapenem-resistant Acinetobacter baumannii(CRAB)infection in an intensive care unit(ICU)so as to provide experience and reference for preven-tion and control of multidrug-resistant organisms(MDROs)infections in a grass-root hospital.METHODS The epidemiological survey and environmental hygiene surveillance were performed for 8 patients with CRAB infection who were detected in ICU of Qingbaijiang District People's Hospital from Jul.21,2022 to Aug.6,2022 so as to find out the infection sources and transmission routes and take targeted intervention measures.RESULTS Totally 8 patients had CRAB infection in the ICU in a short time period,the drug resistance spectrum was basically the same;the CRAB infection/colonization rate was 12.50％(8/64),the incidence rate of CRAB infection was 7.81％(5/64),which was higher during this period than that during the same period in 2020 and 2021(P＜0.05).The environmental hygiene surveillance showed that the isolation rate of CRAB was 6.00％(3/50).The strains isolated from the hand washing sink between bed 2 and bed 3,the hanging tower of bed 13 and the countertops of treat-ment rooms showed the basically same result of drug susceptibility testing with CRAB strains isolated from the patients.This incident had been effectively under control through targeted prevention and control strategies such as the control and separation of the patients,subgrouping treatment and nursing,repeated deep cleaning and disinfec-tion as well as strict implementation of hand hygiene.CONCLUSION The overloaded enrollment of patients,insuf-ficient between-bed interval,poor and delayed cleaning and disinfection of environmental object surfaces,extensive contamination of instrument and facilities,spare supplies and hand washing sink are probably the leading causes of outbreak and prevalence of CRAB.