Objective To gain an in-depth understanding of influencing factors on the preventive behaviors of operating room nurses regarding hypothermia during cesarean sections,and to provide references for promoting the prevention of hypothermia during cesarean sections.Methods A descriptive qualitative research approach was adopted,based on the theoretical framework of the Precede-Proceed Model to develop an interview outline.Semi-structured interviews were conducted with 12 operating room nurses,and the interview data were analyzed using directed content analysis.Results The influencing factors were categorized into 3 main themes and 8 sub-themes.①Predisposing factors:insufficient theoretical knowledge,low risk awareness among healthcare providers.②Enabling factors:rational allocation of equipment/resources,proficient operational skills,targeted and effective training programs,and standardized preventive procedures.③Reinforcing factors:the need to enhance team cooperation,the need to improve the regulatory mechanism.Conclusion Nursing managers should strengthen education and training to enhance nurses'awareness and skill levels in preventing hypothermia,improve equipment resources and build an information-based assessment and decision support system to promote the implementation of hypothermia prevention behaviors.Additionally,facilitating team collaboration and utilizing information construction to collect and analyze quality indicators can strengthen quality management and promote continuous improvement in the quality of hypothermia prevention during cesarean sections.

Objective To translate the English version of the Acceptance and Action Question-naire-Stigma(AAQ-S)into Chinese and explore its application effect in patients with diabetes.Methods A convenience sampling method was used to select 255 patients with diabetes as the study subjects.Following the Brislin translation principles,the scale was translated,back-translated,cul-turally adapted and pre-tested to develop the Chinese version of the AAQ-S.A self-made general data questionnaire and Chinese version of AAQ-S were used to investigate the patients with diabetes,and the reliability and validity of the scale were tested.Results The scale level-content validity index/u-niversal agreement(S-CVI/UA)of the Chinese version of the AAQ-S was 0.95,and the average scale-level content validity index(S-CVI/Ave)was 0.99.The Chinese version of AAQ-S extracted psycho-logical rigidity and psychological flexibility factors,with a total of 21 items,and the cumulative vari-ance contribution rate of factors was 61.020％.The Cronbach's α of the Chinese version of the AAQ-S was 0.958,the test-retest reliability was 0.890,and the Guttman split-half reliability was 0.882.The item-level content validity index(I-CVI)of each item in the Chinese version of the AAQ-S ranged from 0.86 to 1.00,and the S-CVI/UA of the aggregate table was 0.95.Conclusion The Chinese version AAQ-S has good reliability and validity,and can be used as an evaluation tool to assess the acceptance of stigma in diabetic patients.

Objective To investigate the effects of meropenem and amikacin on gut microbiota diversity and composition in a neonatal rat model of necrotizing enterocolitis(NEC).Methods Neonatal SD rats(1～2 d,weighing 5～10 g,both sexes)were subjected to establish a NEC model through artificial formula feeding,hypoxic-cold stress,and lipopolysaccharide(LPS)gavage.The rats were randomly divided into normal control group(Group C,n=12),NEC group(Group N,n=20),meropenem intervention group(Group M,n=20),and amikacin intervention group(Group A,n=20).Following modeling,Group M and Group A received intraperitoneal injections of meropenem(125 mg/kg)or amikacin(468 mg/kg),twice daily for 3 consecutive days.Groups C and N were administered an equal volume of normal saline.At the end of the intervention,colonic contents or fecal samples were collected.The gut microbiota structure was analyzed using 16S rDNA high-throughput sequencing.Bioinformatics analysis was performed using the QIIME2 platform.Alpha diversity was evaluated using Chao1,Shannon,and Simpson indices.Beta diversity was assessed based on Bray-Curtis distance through principal coordinate analysis(PCoA)and non-metric multidimensional scaling(NMDS).Venn and UpSet plots were generated to visualize the composition and overlap of operational taxonomic units(OTUs).Linear discriminant analysis effect size(LEfSe)was applied to identify differentially abundant taxa across groups.Results High-throughput 16S rDNA sequencing showed that the N group had significantly lower 3 indices of α diversity than the C group(P<0.01),that is,a Chao1 index from 230 to 40,a Shannon index from 1.65 to 0.85,and a Simpson index from 0.65 to 0.42.After antibiotic intervention,both the M group and A group obtained obvious increases in the Chao1 index than the N group(P<0.001),with a greater increase observed in the M group than in the A group(P<0.05).However,neither antibiotic group exhibited notable improvements in the Shannon index or Simpson index compared with the N group(P>0.05).Venn and UpSet analyses revealed that the M group had the highest number of unique OTUs(283),while the A group shared the most OTUs(63)with the C group.PCoA and NMDS analyses indicated that the microbial structure of the A group was closer to that of the C group,with better clustering.Taxonomic composition and LEfSe analysis demonstrated that the N group was enriched with potentially pathogenic taxa such as Escherichia coli B2 and Klebsiella under the phylum Proteobacteria,while beneficial bacteria including Lactobacillaceae and Bifidobacteriaceae(phylum Firmicutes)were significantly reduced,indicating severe dysbiosis.In contrast,the A group exhibited a significant increase in beneficial bacteria and a structural tendency toward ecological recovery.The M group,however,was enriched with various conditionally pathogenic and environmentally associated genera,displaying a microbial configuration notably deviating from a healthy state.Conclusion Meropenem and amikacin exhibit differential regulatory effects on the intestinal microbiota in the context of NEC.Amikacin demonstrates superior efficacy in restoring microbial stability and levels of beneficial bacteria,whereas meropenem,although effective for early infection control,warrants caution due to its potential long-term impact on the gut microbiome.

Objective To observe the value of MR intravoxel incoherent motion(IVIM)for analyzing placental microcirculation and microstructures in plateau area of late pregnancy induced hypertension(PIH)and normal middle and late pregnancy.Methods Totally 26 cases of PIH in late-trimester of pregnancy(group A)and 46 normal pregnant women(including 18 normal middle-trimester[group B]and 28 normal late-trimester[group C])in plateau area were retrospectively analyzed.The perfusion fraction(f),true diffusion coefficient(D)and pseudo-diffusion coefficient(D*)values of the entire placenta and the fetal side,maternal side and central region of placenta were obtained based on MR IVIM data,intra-and inter-group comparisons were conducted.Pearson correlation analysis was used to explore the relationships of placental IVIM parameters and maternal age,gestational age,estimated fetal weight(EFW)and neonatal birth weight.Results Except for f value of placental maternal side was higher than of fetal side in group C(P＜0.05),no significant difference was found in pairwise comparisons of IVIM parameters between different placental regions within each group(all P＞0.05).f value of the entire placenta and its fetal side,as well as D value of the entire placenta and its maternal side in group A were all higher than those in group C(all adjusted P＜0.05).The f and D* values of the entire placenta,f,D and D*values of its maternal side,as well as f and D* values of the fetal side in group C were all higher than those in group B(all adjusted P＜0.05).In group C,f value of placental maternal side was negatively correlated with both gestational age and EFW(r=-0.441,-0.579,both P＜0.01).Conclusion MR IVIM could be used to non-invasively assess placental microcirculation and microstructures in plateau area of late PIH and normal middle and late pregnancy women.

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 observe the value of MR intravoxel incoherent motion(IVIM)for analyzing placental microcirculation and microstructures in plateau area of late pregnancy induced hypertension(PIH)and normal middle and late pregnancy.Methods Totally 26 cases of PIH in late-trimester of pregnancy(group A)and 46 normal pregnant women(including 18 normal middle-trimester[group B]and 28 normal late-trimester[group C])in plateau area were retrospectively analyzed.The perfusion fraction(f),true diffusion coefficient(D)and pseudo-diffusion coefficient(D*)values of the entire placenta and the fetal side,maternal side and central region of placenta were obtained based on MR IVIM data,intra-and inter-group comparisons were conducted.Pearson correlation analysis was used to explore the relationships of placental IVIM parameters and maternal age,gestational age,estimated fetal weight(EFW)and neonatal birth weight.Results Except for f value of placental maternal side was higher than of fetal side in group C(P＜0.05),no significant difference was found in pairwise comparisons of IVIM parameters between different placental regions within each group(all P＞0.05).f value of the entire placenta and its fetal side,as well as D value of the entire placenta and its maternal side in group A were all higher than those in group C(all adjusted P＜0.05).The f and D* values of the entire placenta,f,D and D*values of its maternal side,as well as f and D* values of the fetal side in group C were all higher than those in group B(all adjusted P＜0.05).In group C,f value of placental maternal side was negatively correlated with both gestational age and EFW(r=-0.441,-0.579,both P＜0.01).Conclusion MR IVIM could be used to non-invasively assess placental microcirculation and microstructures in plateau area of late PIH and normal middle and late pregnancy women.

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 gain an in-depth understanding of influencing factors on the preventive behaviors of operating room nurses regarding hypothermia during cesarean sections,and to provide references for promoting the prevention of hypothermia during cesarean sections.Methods A descriptive qualitative research approach was adopted,based on the theoretical framework of the Precede-Proceed Model to develop an interview outline.Semi-structured interviews were conducted with 12 operating room nurses,and the interview data were analyzed using directed content analysis.Results The influencing factors were categorized into 3 main themes and 8 sub-themes.①Predisposing factors:insufficient theoretical knowledge,low risk awareness among healthcare providers.②Enabling factors:rational allocation of equipment/resources,proficient operational skills,targeted and effective training programs,and standardized preventive procedures.③Reinforcing factors:the need to enhance team cooperation,the need to improve the regulatory mechanism.Conclusion Nursing managers should strengthen education and training to enhance nurses'awareness and skill levels in preventing hypothermia,improve equipment resources and build an information-based assessment and decision support system to promote the implementation of hypothermia prevention behaviors.Additionally,facilitating team collaboration and utilizing information construction to collect and analyze quality indicators can strengthen quality management and promote continuous improvement in the quality of hypothermia prevention during cesarean sections.

Objective:To systematically evaluate and integrate the qualitative research of Chinese nurses' experience of "Internet+ nursing service", aiming to provide reference for medical institutions to further promote and improve the "Internet+ nursing service" model.Methods:Chinese nurses' experience of cognition, practice and management of "Internet+ nursing service" was retrieved through computers in Cochrane Library, PubMed, Embase, Scopus, Web of Science, CINAHL, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biology Medicine disc. The retrieval time limit was from the establishment of the database to December 31, 2021. The included articles were integrated and analyzed according to the quality evaluation criteria for qualitative research of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center in Australia and integration methods.Results:A total of 11 articles were included and 46 results, 10 categories and 3 integration results were extracted, including integration result 1: nurses' positive experience of "Internet+ nursing service"; integration result 2: nurses' negative experience of "Internet+ nursing service"; integration result 3: nurses' demands and expectations for "Internet+ nursing service".Conclusions:Chinese nurses have both positive and negative experiences of "Internet+ nursing service", and have a clear intention to carry out the "Internet+ nursing service" project. The government and hospitals need to further provide policy support and platform support for nurses to promote the improvement and effective promotion of the "Internet+ nursing service" model.

Objective:To assess the prevalence of metabolic syndrome(MS) and its relationship with hyperuricemia(HUA) in perimenopausal women in Anning city, Yunnan province.Methods:This is a cross-sectional survey. In May 2021, a multi-stage stratified sampling method was used to collect demographics and clinical data [ethnicity, living community, height, weight, waist circumference, blood pressure, fasting plasma glucose, triglycerides(TG), serum uric acid, high density lipoprotein-cholesterol(HDL-C), alanine transaminase(ALT), etc] in a total of 6 721 perimenopausal women aged 45-60 years.Results:A total of 6 721 perimenopausal women were included in this study. The prevalences of MS and HUA were 14.05%(95% CI 13.22%-14.88%) and 6.46%(95% CI 5.88%-7.07%), respectively. The average age, HDL-C, urea, direct bilirubin, and albumin levels in the perimenstrual HUA population were lower than those in the non-HUA population while the levels of TG, ALT, heart rate, body mass index(BMI), and creatinine were higher(all P<0.05). The prevalence of HUA in perimenopausal women with ethnic minorities and family history of chronic diseases was higher than that in Han nationality and without family history of chronic diseases. The prevalence of MS in perimenopausal women was increased with the increase of serum uric acid( Z=-15.313 8, P<0.001). Multivariate logistic regression model showed that HUA was positively correlated with MS( OR=1.526, 95% CI 1.192-1.954) after adjusting for covariates such as BMI and ethnicity, and the incidence of MS in perimenopausal women in HUA group was 1.526 folds higher than that in non-hyperuricemia group. Conclusion:HUA is highly positively correlated with MS in perimenopausal women. The management of uric acid level in perimenopausal women should be strengthened.