Objective To examine the mediating role of empathy and emotional competence in the association between family functioning and internalizing and externalizing problem behaviors among adolescents in China.Methods In this study,we used the data from the June-July 2022 survey of Chengdu Positive Child Development(CPCD)cohort.All respondents were 5th-9th graders from six primary or secondary schools in Chengdu.The Achenbach Child Behavior Checklist(CBCL),the Chinese Family Assessment Instrument(C-FAI),the empathy subscale of the Chinese version of the Interpersonal Reactivity Index(C-IRI),and the emotional competence(EC)subscale of the Chinese Positive Youth Development Scale(CPYD)were used to evaluate the respondents'internalizing and externalizing problem behaviors,family functioning,empathy,and emotional competence,respectively.The average score derived from the total score of a scale divided by the number of entries in each dimension was used as the final score of the scale.Independent samples t-tests or one-way analysis of variance(ANOVA)were performed to examine the differences in family functioning,empathy,emotional competence,and internalizing and externalizing problem behaviors across student groups with different demographic characteristics(sex,grade,and region).Pearson correlation analysis was conducted to examine the relationship between family functioning,empathy,emotional competence,and internalizing and externalizing problem behaviors.AMOS 24.0 was used to validate the hypothesized model and structural equation modeling was used to analyze the mediating effects of empathy and emotional competence between family functioning and internalizing and externalizing problem behaviors among adolescents.Results A total of 3026 eligible participants were included,including 1548(51.16%)male students and 1478(48.84%)female students.Among the respondents,798(26.37%)were 5th graders,738(24.39%)were 6th graders,567(18.74%)were 7th graders,614(20.29%)were 8th graders,and 309(10.21%)were 9th graders.In addition,2064(68.21%)of all respondents were from urban areas and 962(31.79%)were from rural areas.The results of the difference analysis showed that the differences in adolescents'internalizing and externalizing problem behaviors were statistically significant between students of different grades(P=0.004),and that the differences in family functioning and empathy scores were also statistically significant between students of different grades(all P<0.001),whereas the differences in adolescents'internalizing and externalizing problem behaviors were not statistically significant between sexes and regions(P=0.919,0.959).The results of correlation analysis showed that family functioning scores(the higher the score,the worse the family functioning)were significantly negatively correlated with empathy and emotional competence(r=-0.482,-0.432,P<0.01),and significantly positively correlated with internalizing and externalizing problem behaviors(r=0.220,P<0.01).Empathy was significantly positively correlated with emotional competence(r=0.402,P<0.01).Empathy and emotional competence were significantly negatively correlated with all the dimensions of internalizing and externalizing problem behaviors(r=-0.115,-0.305,P<0.01).Emotional competence partially mediated the relationship between family functioning and adolescents'internalizing and externalizing problem behaviors,with a mediation effect value being 0.042(95%[confidence interval]CI:0.031-0.057).Empathy and emotional competence had chain mediation effect between family functioning and adolescents'internalizing and externalizing problem behaviors,with the value of the mediation effect being 0.010(95%CI:0.007-0.014).Conclusion Family functioning influences adolescents'internalizing and externalizing problem behaviors in a direct way and through the chain-mediating roles of empathy and emotional competence.

Objective To investigate the effect of empathy on depressive symptoms in adolescents and to explore the potential mediating role of family functioning in the effect of empathy on depressive symptoms.Methods The 2022 cross-sectional data from the Chengdu Positive Child Development(CPCD)cohort were analyzed in the study.A survey was conducted in Chengdu in June 2022,involving 3 020 students in grades 5-8 from three randomly selected stratified schools.The Interpersonal Reactivity Index(IRI-C),the Chinese Family Assessment Instrument(C-FAI),and the Center for Epidemiologic Studies Depression Scale for Children(CES-DC)were used in the survey.Chi-square test or one-way analysis of variance was performed to examine the differences in various demographic characteristics(sex,grade,region,and total monthly household income)between groups of respondents,as well as the differences in family functioning,empathy,and depression.Pearson correlation coefficient was used to examine the correlation between family functioning,empathy,and depressive symptoms.Structural equation modeling and SPSS PROCESS component Model 4 were used to analyze whether family functioning played a mediating role in the effect of empathy on depressive symptoms in adolescents.Results The detection rate of depressive symptoms among survey respondents was 25.40%.The results of the difference analysis revealed significant differences in the detection rates of depressive symptoms among respondents of different grades,regions,and monthly household incomes(P<0.05).There was no significant difference in the detection rates of depressive symptoms between male and female students.There was a significant difference in the detection rate of depressive symptoms between respondents with different scores for family dysfunction and empathy ability(P<0.001).Correlation analysis results showed that empathy scores were negatively correlated with depression(r=-0.11,P<0.001),that family dysfunction was positively correlated with depression(r=0.29,P<0.001),and that empathy scores were negatively correlated with family functioning(r=-0.37,P<0.001).The mediating role of family dysfunction in the relationship between empathy and depressive symptoms was established,with the direct effect being 0.039(95% confidence interval[CI]:0.010-0.069,P<0.001)and the indirect effect value being-0.096(95% CI:-0.115--0.079,P<0.001).The direct effect value accounted for 28.89% of the total effect value,while the mediation effect value accounted for 71.11% of the total effect value.Conclusion The empathy ability of adolescents is correlated to depressive symptoms,and family functioning plays a mediating role between empathy and depressive symptoms in adolescents.It is suggested that adolescents'empathy ability and family functioning should be enhanced through multiple channels to reduce the occurrence of depressive symptoms.

Objective To understand the cleanliness of hands and uniforms of health care workers(HCWs)while they were working in a hospital.Methods Specimens of hands and uniforms of HCWs while they were working were collected and detected.Results A total of 342 specimens were collected, 173 were specimens from hands and 169 were from uniforms, the total qualified rate was 78.65%,qualified rates of hands and uniforms were 76.30% and 81.07% respectively.Qualified rates of hands and uniforms of different HCWs were compared respectively, differences were both statistically significant (both P<0.05);qualified rates of hands and uniforms of nurses were both highest (87.93% and 92.86% respectively), followed by doctors (75.86% and 87.72% respectively), while medical auxiliary persons were the lowest(64.91% and 62.50% respectively).Correlation analysis between qualified rates of hands and uniforms of HCWs in general wards showed that the correlation coefficient was 0.930 (P<0.01).Conclusion Cleanliness of hands and uniforms of HCWs needs to be further improved, especially medical auxiliary persons;cleaning frequency and cleanliness standard of HCWs' uniforms needed to be studied further.

Objective To explore the effect of comprehensive intervention measure on antimicrobial use and incidence of healthcare-associated infection(HAI)in patients in sports medicine department.Methods Antimicrobial use and incidence of HAI in hospitalized patients in the surgical departments (sports medicine department and other surgical departments)of a hospital between January 2006 and December 2010 were analyzed retrospectively(before intervention),from January 2011, comprehensive intervention based on clinical-centered multi-department cooperation was adopted by sports medicine depart-ment,the other surgical departments over the same period were not comprehensively intervened;antimicrobial use and inci-dence of HAI in patients in surgical departments between January 2012 and December 2013 were monitored prospectively (after intervention ),effectiveness of intervention was evaluated.Results Antimicrobial use and incidence of HAI in pa-tients in sports medicine department after intervention were both lower than before intervention (55.75% vs 95.26%,χ2=753.42;0.10% vs 0.32% ,χ2 =15.13,both P <0.01).Antimicrobial use in patients in other surgical departments after intervention was lower than that before intervention(65.63% vs 73.79% ,χ2 =251.57,P <0.01 );incidence of HAI was higher than that before intervention(0.55% vs 0.42% ,χ2 =19.04,P <0.01).Conclusion Comprehensive in-tervention measure based on clinical-centered multi-department cooperation is safe and effective,it can reduce antimicrobial use and incidence of HAI in patients in sports medicine department.

Objective To study the risk factors for surgical site infections (SSIs)in patients with hepatobiliary and pancreatic surgery.Methods Sixty patients who received hepatobiliary and pancreatic surgery and suffered SSIs from January 2006 to January 2010 were selected as infections group,119 patients who also received hepatobiliary and pancreatic surgery but didn’t develop infection were as control group,retrospective investigation was per-formed.Results Univariate analysis revealed the associated factors for post-operative SSIs were age,history of car-diocerebrovascular disease,history of abdominal surgery,history of smoking,preoperative anemia,abnormal pre-operative coagulation and blood sugar,pre-operative infection,use of laparoscope,incision type,duration of opera-tion,ASA score,post-operative drainage and dressing chang within 24 hours of post-operation(all P<0.05).Mult-ivariate analysis revealed that abdominal surgery history (OR95%CI:3.09 [1.21 -7.91 ]),high NISS score (OR95%CI:6.18[2.41-15.85])were risk factors of SSIs in patients with hepatobiliary and pancreatic surgery, and dressing chang within 48 hours of post-surgery were protective factor (OR95%CI:3.81 [1.56-9.34]). Conclusion History of abdominal surgery and high score of NISS are major risk factors for SSIs in patients with hepatobiliary and pancreatic surgery.To reduce the risk of SSIs,blood glucose should be actively adj usted,anemia and coagulation abnormalities should be treated;duration of operation should be shortened as far as possible,wound should be kept clean and dressing should be changed timely after surgery.

OBJECTIVE To investigate the distribution and drug resistance of nosocomial infection pathogens.METHODS The data of pathogen′s origin and antibacterial resistance of Intensive Care Unit(ICU) inpatients from Apr 2008 to Mar 2009 in a Hospital were analyzed.RESULTS There were 226 strains pathogens isolated from 116 nosocomial infection cases,from which the Gram-negative bacteria were predominate(63.27%).The resistance rates of Acinetobacter baumannii was the highest in Gram-negative bacteria,more than 70% isolates resistant to almost antibacterial.The main Gram-positive bacteria were Staphylococcus aureus,and the rate of meticillin-resistant S.aureus(MRSA) was 41.3%.All S.aureus were sensitive to vancomycin and Linezolid.CONCLUSIONS To control the antibacterial resistance of pathogens and decrease the nosocomial infection,it is important to strengthen the appropriate use of antibiotics.

OBJECTIVE To investigate a case of nosocomial infection incident in a hospital,analyze the reasons and put forward preventive measures.METHODS Investigation was carried out on the related people and environment in the department where the incident occurred.Analysis was made on the reasons and processing.RESULTS The nosocomial infection incident was caused by Norovirus;fecal-oral transmission and contact transmission were 2 main pathways of Norovirus.There were 7 persons who had been contaminated by Norovirus,included 5 old inpatients,1 doctor and 1 nurse.CONCLUSIONS Many people should work to prevent and control the infections in hospital,such as doctors,nurses,inpatients,hospital works etc.Hand-washing and disinfection isolation should be enhanced among the hospital staffs in the normal works.

Objective This study compared the cleaning effect of gastroscope by different cleaning mehtods and discuss practical and reliable evaluation method for the cleaning degree of gastroscope.Methods Three cleaning methods were selected and used in the cleaning of gastroscope.The Endocheck lumen was used to examine the cleaning degree of gastroscope and the effects of different methods were compared. Results The qualification rate by using ordinary cleaning method was 50.0%and it reached 60.0%and 73.3%by elevation of polyenzyme concentration and adding bedside pre-washing.which Was statistically different from that by using ordinary cleaning method(P＜0.05).Conclusions Bedside pre-washing could increase the cleaning degree of gastroscope;Endocheck lumen could be regarded as an evaluation method for the cleaning degree of gastroscope.

OBJECTIVE To investigate predisposing factors of candidemia in nosocomial infections.METHODS To retrospectively review the clinical features of 120 cases,including 59 who developed candidemia and 61 cases with bacteremia during the period of 1990-2004.RESULTS The incidence of candidemia was stable over a 14-year period.Candida albicans remained the predominant Candida species recovered(30.5%),followed by C.tropicalis(25.7%),C.glabrata(12.9%),C.parapsilosis(12.9%) and others(17.1%).Of the total 59 cases of candidemia,were administrated by broad spectrum antibiotic therapy for long time,urinary catheters,malignant tumor,etc.Multivariate analysis showed that candidemia was related with many factors.CONCLUSIONS C.albicans was the major pathogen in our hospital during 14 years;the candidemia is related with the use of quinolones,ventilator,central venous catheters and radiation-chemotherapy(P

OBJECTIVE To understand the situation of the nosocomial infection among the hospital inpatients in a grade-A hospital in Beijing.METHODS Surveillance on nosocomial infection was performed among the hospital inpatients from Jan 2005 to Dec 2007.RESULTS From Sept 2006 to Aug 2007,803 cases were infected,the incidence was 1.99%.The lower respiratory tract ranked the first place(38.97%)and the highest infected rate was in ICU(16.16%).The species were predominated by Gram-negatives.The main pathogenic microorganisms were Pseudomonas aeruginosa,Staphylococcus aureus,Escherichia coli,Acinetobacter baumannii,Klebsiella pneumoniae and Candida albicans,etc.From 2005 to 2007,the infections caused by P.aeruginosa increased gradually,and the infections caused by C.albicans reduced gradually.CONCLUSIONS Many people should work to prevent and control the infections in hospital,such as doctors,nurses,inpatients,management workers,etc.