Objective:To investigate the genotype and epidemiological characteristics of human metapneumovirus (HMPV) among hospitalized cases with acute respiratory infections (ARI) in children in Changchun City, Jilin Province, China.Methods:From June 2019 to June 2023, throat swabs of ARI inpatients in Changchun Children′s Hospital were collected, and their epidemiological and clinical information were also collected. Quantitative reverse transcription-PCR was used to identify HMPV-positive cases, followed by the amplification of the G gene and genetic analysis in the HMPV-positive cases.Results:A total of 3 311 children hospitalized with ARI were included in this study. Their age ranged from 0 to 17 years old, and the M ( Q1, Q3) of age was 2 (1, 3) years. About 1 811 (54.70%) cases were males. A total of 167 HMPV-positive cases were detected with a positive rate of 5.04%, of which 92.81% (155/167) were children under 5 years old. The positive rate of HMPV in 2019 was 6.37% (30/471), which dropped to the lowest in 2020 (2.31%, 10/432). The HMPV-positive rate was then rebounded in 2021 (4.70%, 60/1 277) and 2022 (4.56%, 21/461), which increased to 6.87% (46/670) in 2023. The difference in HMPV-positive rate among each year was statistically significant ( P<0.05). The prevalence peak of HMPV varied in different years, showing either a unimodal or bimodal distribution in one year. A total of 79 HMPV G gene sequences were obtained, of which subtype A and subtype B accounted for 48.10% and 51.90%, respectively. All of the subtype A sequences were clarified as A2c duplicated variants, and subtype B was mainly B2 genotype. Besides, subtypes A and B were prevalent alone or co-circulated in different years, and there was a subtype replacement pattern in HMPV. Conclusion:The positive rate of HMPV in hospitalized ARI cases in children is significantly different from 2019 to 2023 in Changchun City. Notably, there are certain switch patterns of HMPV subtypes A and B in different years.

Objective:To understand the epidemiological characteristics of human respiratory syncytial virus (HRSV) among acute respiratory infection (ARI) cases in 16 provinces of China from 2009 to 2023.Methods:The data of this study were collected from the ARI surveillance data from 16 provinces in China from 2009 to 2023, with a total of 28 278 ARI cases included in the study. The clinical specimens from ARI cases were screened for HRSV nucleic acid from 2009 to 2023, and differences in virus detection rates among cases of different age groups, regions, and months were analyzed.Results:A total of 28 278 ARI cases were enrolled from January 2009 to September 2023. The age of the cases ranged from<1 month to 112 years, and the age M ( Q1, Q3) was 3 years (1 year, 9 years). Among them, 3 062 cases were positive for HRSV nucleic acid, with a total detection rate of 10.83%. From 2009 to 2019, the detection rate of HRSV was 9.33%, and the virus was mainly prevalent in winter and spring. During the Corona Virus Disease 2019 (COVID-19) pandemic, the detection rate of HRSV fluctuated between 6.32% and 18.67%. There was no traditional winter epidemic peak of HRSV from the end of 2022 to the beginning of 2023, and an anti-seasonal epidemic of HRSV occurred from April to May 2023. About 87.95% (2 693/3 062) of positive cases were children under 5 years old, and the difference in the detection rate of HRSV among different age groups was statistically significant ( P<0.001), showing a decreasing trend of HRSV detection rate with the increase of age ( P<0.001). Among them, the HRSV detection rate (25.69%) was highest in children under 6 months. Compared with 2009-2019, the ranking of HRSV detection rates in different age groups changed from high to low between 2020 and 2023, with the age M (Q1, Q3) of HRSV positive cases increasing from 1 year (6 months, 3 years) to 2 years (11 months, 3 years). Conclusion:Through 15 years of continuous HRSV surveillance analysis, children under 5 years old, especially infants under 6 months old, are the main high-risk population for HRSV infection. During the COVID-19 pandemic, the prevalence and patterns of HRSV in China have changed.

Objective:To investigate the genotype and epidemiological characteristics of human metapneumovirus (HMPV) among hospitalized cases with acute respiratory infections (ARI) in children in Changchun City, Jilin Province, China.Methods:From June 2019 to June 2023, throat swabs of ARI inpatients in Changchun Children′s Hospital were collected, and their epidemiological and clinical information were also collected. Quantitative reverse transcription-PCR was used to identify HMPV-positive cases, followed by the amplification of the G gene and genetic analysis in the HMPV-positive cases.Results:A total of 3 311 children hospitalized with ARI were included in this study. Their age ranged from 0 to 17 years old, and the M ( Q1, Q3) of age was 2 (1, 3) years. About 1 811 (54.70%) cases were males. A total of 167 HMPV-positive cases were detected with a positive rate of 5.04%, of which 92.81% (155/167) were children under 5 years old. The positive rate of HMPV in 2019 was 6.37% (30/471), which dropped to the lowest in 2020 (2.31%, 10/432). The HMPV-positive rate was then rebounded in 2021 (4.70%, 60/1 277) and 2022 (4.56%, 21/461), which increased to 6.87% (46/670) in 2023. The difference in HMPV-positive rate among each year was statistically significant ( P<0.05). The prevalence peak of HMPV varied in different years, showing either a unimodal or bimodal distribution in one year. A total of 79 HMPV G gene sequences were obtained, of which subtype A and subtype B accounted for 48.10% and 51.90%, respectively. All of the subtype A sequences were clarified as A2c duplicated variants, and subtype B was mainly B2 genotype. Besides, subtypes A and B were prevalent alone or co-circulated in different years, and there was a subtype replacement pattern in HMPV. Conclusion:The positive rate of HMPV in hospitalized ARI cases in children is significantly different from 2019 to 2023 in Changchun City. Notably, there are certain switch patterns of HMPV subtypes A and B in different years.

Objective:To understand the epidemiological characteristics of human respiratory syncytial virus (HRSV) among acute respiratory infection (ARI) cases in 16 provinces of China from 2009 to 2023.Methods:The data of this study were collected from the ARI surveillance data from 16 provinces in China from 2009 to 2023, with a total of 28 278 ARI cases included in the study. The clinical specimens from ARI cases were screened for HRSV nucleic acid from 2009 to 2023, and differences in virus detection rates among cases of different age groups, regions, and months were analyzed.Results:A total of 28 278 ARI cases were enrolled from January 2009 to September 2023. The age of the cases ranged from<1 month to 112 years, and the age M ( Q1, Q3) was 3 years (1 year, 9 years). Among them, 3 062 cases were positive for HRSV nucleic acid, with a total detection rate of 10.83%. From 2009 to 2019, the detection rate of HRSV was 9.33%, and the virus was mainly prevalent in winter and spring. During the Corona Virus Disease 2019 (COVID-19) pandemic, the detection rate of HRSV fluctuated between 6.32% and 18.67%. There was no traditional winter epidemic peak of HRSV from the end of 2022 to the beginning of 2023, and an anti-seasonal epidemic of HRSV occurred from April to May 2023. About 87.95% (2 693/3 062) of positive cases were children under 5 years old, and the difference in the detection rate of HRSV among different age groups was statistically significant ( P<0.001), showing a decreasing trend of HRSV detection rate with the increase of age ( P<0.001). Among them, the HRSV detection rate (25.69%) was highest in children under 6 months. Compared with 2009-2019, the ranking of HRSV detection rates in different age groups changed from high to low between 2020 and 2023, with the age M (Q1, Q3) of HRSV positive cases increasing from 1 year (6 months, 3 years) to 2 years (11 months, 3 years). Conclusion:Through 15 years of continuous HRSV surveillance analysis, children under 5 years old, especially infants under 6 months old, are the main high-risk population for HRSV infection. During the COVID-19 pandemic, the prevalence and patterns of HRSV in China have changed.

Objective:To apply CBL combined with PBL based on SMART (specific, measurable, attainable, relevant and time-based) principle in nursing practice teaching in radiotherapy.Methods:A total of 100 nurses who performed nursing practice in the Department of Radiotherapy in Guangdong Provincial Hospital of Traditional Chinese Medicine from May 2016 to May 2020 were selected as the research objects. They were divided into a control group and a study group according to their admissions, with 50 people in each group. The study group used CBL combined with PBL teaching based on SMART principle, and the control group used traditional practice teaching. After the clinical practice, the two groups were assessed on theoretical and clinical practice skills, and the two groups' teaching satisfaction and teaching effects were evaluated through seminars and questionnaire surveys. SPSS 22.0 was used for t test and chi-square test. Results:The theoretical and clinical practice performance assessment scores of the practical nurses in the study group were higher than those in the control group, with statistically significant differences ( P<0.001). The teaching satisfaction rate of the practice nurses in the control group was 62.00% (31/50), and that of the practice nurses in the study group was 96.00% (48/50), with significant differences ( P<0.001). In terms of improving independent learning ability, information acquisition and problem analysis ability, improving clinical thinking ability, mobilizing learning enthusiasm, enhancing teamwork ability, nurse-patient communication ability, and recognition of innovation ability, the teaching satisfaction of the research group was higher than that of the control group. Conclusion:The application of SMART principle in teaching has the advantages of clear goals and quantifiable evaluation. The combination of CBL and PBL based on SMART principle can help to improve the mastery of theoretical and practical skills of radiotherapy practice nurses, and achieve satisfactory teaching results.

Objective:To explore how to make transplantation strategy for patients of different ages in frozen-thawed embryo (FET) cycle.Methods:A retrospective cohort analysis of the first FET cycles during the period from January 2018 to April 2020 in Reproductive Center of Ningbo Women & Children Hospital was performed. Based on the age of the patients, they were divided into three groups: ≤30 years old group (1150 cycles), 30-35 years old group (932 cycles) and >35 years old group (405 cycles). In each age group, according to the grade and number of transferred embryos, they were divided into the single cleavage stage embryo transplant (SET3) subgroup, the single 5th day blastocyst transplant (SET5) subgroup, the single 6th day blastocyst transplant (SET6) subgroup, the double cleavage stage embryos transplant (DET3) subgroup, the double 5th day blastocyst transplant (DET5) subgroup and the double 6th day blastocyst transplant (DET6) subgroup. All patients were followed up until June 30, 2020. The clinical outcomes of each subgroups within the same age group were compared.Results:1) In ≤30 years old group: the clinical pregnancy rate, the persistent pregnancy rate and the live birth rate in SET5 subgroup were 66.17% (221/334), 60.48% (202/334), 35.93% (120/334), respectively, which were higher than those in SET3 subgroup [41.18% (28/68), 36.76% (25/68), 25.00% (17/68); P<0.001, P=0.001, P=0.045] and that in SET6 subgroup [54.42% (80/147), 43.54% (64/147), 27.21% (40/147); P<0.001, P=0.001, P<0.001]. The multiple rate in DET5 subgroup was 47.80% (76/159), which was higher than that in DET6 subgroup [29.49% (23/78), P=0.007]. 2) In 30-35 years old group: the clinical pregnancy rate, the persistent pregnancy rate and the live birth rate in SET5 subgroup were 63.59% (138/217), 55.30% (120/217) and 29.95% (65/217), which were higher than those in SET3 subgroup [30.65% (19/62), 27.42% (17/62),14.52% (9/62); P<0.001, P<0.001, P=0.015]. The multiple rate in DET5 subgroup was 56.86% (58/102), which was higher than that in DET3 subgroup [32.54% (41/126)] and DET6 subgroup [28.57% (16/56)], and the differences were statistically significant ( P<0.001, P=0.001). 3) In >35 years old group: the clinical pregnancy rate, the sustained pregnancy rate and the live birth rate in DET5 subgroup were 53.45% (31/58), 39.66% (23/58), 20.69% (12/58), compared with those in SET6 subgroup [43.75% (21/48), 35.42% (17/48), 16.76% (8/48)], the differences were not statistically significant ( P=0.320, P=0.655, P=0.583), while compared with SET3 subgroup [16.98% (9/53), 15.09% (8/53), 7.55% (4/53)], the differences were statistically significant ( P<0.010, P=0.004, P=0.049). The clinical pregnancy rate and the sustained pregnancy rate in DET5 subgroup were 66.67% (26/39), 53.85% (21/39), which were higher than those in DET3 subgroup [33.89% (61/180), 27.22% (49/180)], and the differences were statistically significant ( P<0.001 , P=0.001). The clinical pregnancy rate in DET5 subgroup was higher than that in DET6 subgroup [51.85% (14/27)], and the difference was statistically significant ( P=0.001) .Conclusion:For patients of all ages, single embryo transfer should be selected, and avoid the transfer of two 5th day blastocysts as far as possible. The 5th day single blastocyst is preferred for embryo transfer.

Objective:To explore how to make transplantation strategy for patients of different ages in frozen-thawed embryo (FET) cycle.Methods:A retrospective cohort analysis of the first FET cycles during the period from January 2018 to April 2020 in Reproductive Center of Ningbo Women & Children Hospital was performed. Based on the age of the patients, they were divided into three groups: ≤30 years old group (1150 cycles), 30-35 years old group (932 cycles) and >35 years old group (405 cycles). In each age group, according to the grade and number of transferred embryos, they were divided into the single cleavage stage embryo transplant (SET3) subgroup, the single 5th day blastocyst transplant (SET5) subgroup, the single 6th day blastocyst transplant (SET6) subgroup, the double cleavage stage embryos transplant (DET3) subgroup, the double 5th day blastocyst transplant (DET5) subgroup and the double 6th day blastocyst transplant (DET6) subgroup. All patients were followed up until June 30, 2020. The clinical outcomes of each subgroups within the same age group were compared.Results:1) In ≤30 years old group: the clinical pregnancy rate, the persistent pregnancy rate and the live birth rate in SET5 subgroup were 66.17% (221/334), 60.48% (202/334), 35.93% (120/334), respectively, which were higher than those in SET3 subgroup [41.18% (28/68), 36.76% (25/68), 25.00% (17/68); P<0.001, P=0.001, P=0.045] and that in SET6 subgroup [54.42% (80/147), 43.54% (64/147), 27.21% (40/147); P<0.001, P=0.001, P<0.001]. The multiple rate in DET5 subgroup was 47.80% (76/159), which was higher than that in DET6 subgroup [29.49% (23/78), P=0.007]. 2) In 30-35 years old group: the clinical pregnancy rate, the persistent pregnancy rate and the live birth rate in SET5 subgroup were 63.59% (138/217), 55.30% (120/217) and 29.95% (65/217), which were higher than those in SET3 subgroup [30.65% (19/62), 27.42% (17/62),14.52% (9/62); P<0.001, P<0.001, P=0.015]. The multiple rate in DET5 subgroup was 56.86% (58/102), which was higher than that in DET3 subgroup [32.54% (41/126)] and DET6 subgroup [28.57% (16/56)], and the differences were statistically significant ( P<0.001, P=0.001). 3) In >35 years old group: the clinical pregnancy rate, the sustained pregnancy rate and the live birth rate in DET5 subgroup were 53.45% (31/58), 39.66% (23/58), 20.69% (12/58), compared with those in SET6 subgroup [43.75% (21/48), 35.42% (17/48), 16.76% (8/48)], the differences were not statistically significant ( P=0.320, P=0.655, P=0.583), while compared with SET3 subgroup [16.98% (9/53), 15.09% (8/53), 7.55% (4/53)], the differences were statistically significant ( P<0.010, P=0.004, P=0.049). The clinical pregnancy rate and the sustained pregnancy rate in DET5 subgroup were 66.67% (26/39), 53.85% (21/39), which were higher than those in DET3 subgroup [33.89% (61/180), 27.22% (49/180)], and the differences were statistically significant ( P<0.001 , P=0.001). The clinical pregnancy rate in DET5 subgroup was higher than that in DET6 subgroup [51.85% (14/27)], and the difference was statistically significant ( P=0.001) .Conclusion:For patients of all ages, single embryo transfer should be selected, and avoid the transfer of two 5th day blastocysts as far as possible. The 5th day single blastocyst is preferred for embryo transfer.

Objective:To analyze the clinical outcomes and cost-effectiveness ratio of the patients with ovarian reserve dysfunction in three different ovulation induction protocols during in vitro fertilization-embryo transfer (IVF-ET), and to explore a cost-effective ovulation induction protocol. Methods:A retrospective analysis was made on the low prognosis in IVF-ET of elderly patients with low ovarian reserve function (according to POSEIDON criteria, group 4) in Reproductive Center of Ningbo Women & Children Hospital during January 2017 to October 2018. According to the different ovarian stimulation protocols used, they were divided into three groups: antagonist group (group A, 169 cycles), micro-stimulation group (group B, 57 cycles), and progestin-primed ovarian stimulation (PPOS) group (group C, 59 cycles). The clinical outcome and cost-effectiveness of three ovulation-promoting protocols were analyzed.Results:In group A, compared with group B and group C, both the number of obtained eggs [4.46±1.45, 2.42±1.12, 3.28±1.62, respectively in the three groups ( P=0.013, P=0.021)] and the cumulative clinical pregnancy rate were higher (35.50%, 21.43%, 23.73%, respectively in the three groups)( P=0.012, 0.021). In group A, the rate of cycle cancellation was the lowest in the three groups (0.95%, 21.05%, 15.24%, respectively). In group A, the average cost of each egg acquisition was the lowest [(3817±1450) yuan, (5868±1820) yuan, (4484±1678) yuan, respectively in the three groups)]( P=0.001, P=0.012, P=0.017), and the cost of each available embryo was the lowest too [(7276±2329) yuan, (7978±2560) yuan, (7466±2175) yuan, respectively in the three groups)]( P=0.001, P=0.021, P=0.033).The cost per clinical pregnancy was lower in group A than in group B and group C [(47 957±22 388) yuan, (67 450±35 210) yuan, (61 984±33 463) yuan, respectively in the three groups)]( P=0.012, P=0.021). Conclusion:For patients aged over 35 years with poor ovarian reserve before stimulation, antagonist protocol was superior to micro-stimulation and PPOS, considering the clinical outcome and cost-effectiveness ratio, and it was an ideal ovary stimulation protocol.

Objective:To analyze the clinical outcomes and cost-effectiveness ratio of the patients with ovarian reserve dysfunction in three different ovulation induction protocols during in vitro fertilization-embryo transfer (IVF-ET), and to explore a cost-effective ovulation induction protocol. Methods:A retrospective analysis was made on the low prognosis in IVF-ET of elderly patients with low ovarian reserve function (according to POSEIDON criteria, group 4) in Reproductive Center of Ningbo Women & Children Hospital during January 2017 to October 2018. According to the different ovarian stimulation protocols used, they were divided into three groups: antagonist group (group A, 169 cycles), micro-stimulation group (group B, 57 cycles), and progestin-primed ovarian stimulation (PPOS) group (group C, 59 cycles). The clinical outcome and cost-effectiveness of three ovulation-promoting protocols were analyzed.Results:In group A, compared with group B and group C, both the number of obtained eggs [4.46±1.45, 2.42±1.12, 3.28±1.62, respectively in the three groups ( P=0.013, P=0.021)] and the cumulative clinical pregnancy rate were higher (35.50%, 21.43%, 23.73%, respectively in the three groups)( P=0.012, 0.021). In group A, the rate of cycle cancellation was the lowest in the three groups (0.95%, 21.05%, 15.24%, respectively). In group A, the average cost of each egg acquisition was the lowest [(3817±1450) yuan, (5868±1820) yuan, (4484±1678) yuan, respectively in the three groups)]( P=0.001, P=0.012, P=0.017), and the cost of each available embryo was the lowest too [(7276±2329) yuan, (7978±2560) yuan, (7466±2175) yuan, respectively in the three groups)]( P=0.001, P=0.021, P=0.033).The cost per clinical pregnancy was lower in group A than in group B and group C [(47 957±22 388) yuan, (67 450±35 210) yuan, (61 984±33 463) yuan, respectively in the three groups)]( P=0.012, P=0.021). Conclusion:For patients aged over 35 years with poor ovarian reserve before stimulation, antagonist protocol was superior to micro-stimulation and PPOS, considering the clinical outcome and cost-effectiveness ratio, and it was an ideal ovary stimulation protocol.

Objective:To seek the short term standardization study nurses training education content and the ap-proach to learning, provide theoretical basis for improving the study effect of nurse training.Methods:Choosing 3 ~6 months in 2014 in our hospital study questionnaire survey was conducted among 114 nurses, questionnaire by general in-formation, content of training needs, demand method of three parts and using SPSS19.0 to analyze the collected data. Results:The 82.7%of study nurses think pre-service training is very necessary.Pre-service training demand of the top three comprises:occupational protection (82.7%), health care, with communication skills (80.0%) and infection prevention and control (78.2%).Refresher training needs during the top three in turn:specialized rescue of critically ill patients and cooperation (88.2%), clinical application and nursing adverse event processing (79.1%), effective communication nurses and patients (79.1%).Demand content score between the different degree and the title of ad-vanced nurse was statistically difference (P<0.05).The training methods, in the first three order practice (89.10%), seminar (74.5%), case analysis and discussion (67.30%).Conclusion:According to the study demand of nurse stand-ardized training content and ways of learning, considering the influence factors such as education, job title, targeted training plan, improve the effect of short-term training.