Objective: To explore the relationship between life skills, psychological resilience and subjective well-being among primary and secondary school students, so as to provide evidence for targeted adolescent mental health education. Methods: From September to November, 2025, a total of 5 831 primary and secondary school students from five cities (Beijing, Guangzhou, Shenzhen, Chongqing, Urumqi) were selected by convenience sampling. The Adolescent Subjective Well being Scale, School based Adolescents Life Skills Scale, and Adolescent Psychological Resilience Scale were used for investigation. Data were analyzed using t-tests, one way ANOVA, and linear regression. Results: The total mean score of students subjective well being was (5.46± 0.91) ; the total mean score of life skills was (3.69±0.64); the total mean score of psychological resilience was (3.66±0.69). Statistically significant differences in subjective well being scores were found among students grouped by gender, grade, school stage, residential city, living with parents or living with siblings ( t/F =4.14, 53.92, 14.53, 49.99, 13.49, 2.18, all P <0.01). Stratified regression analyses were performed by gender (adjusting for school stage, residential city and living arrangement) and by school stage (adjusting for gender, residential city and living arrangement), the regression results indicated that life skills of boys, girls, primary school students and junior high school students( β =0.54, 0.53, 0.50, 0.57) and their psychological resilience ( β = 0.56 , 0.60, 0.56, 0.60) were positively associated with subjective well being (all P <0.01). Conclusions Life skills and psychological resilience may be important protective factors for subjective well being among primary and secondary school students. School based mental health education should emphasize life skills training and resilience building to promote students subjective well being.

Objective To evaluate the effect of target oriented infusion guided by stroke volume variation(SVV)in elderly lumbar surgery.Method From January to December 2023,80 elderly patients undergoing elective general anesthesia for prone lumbar surgery were divided into two groups by random number table method:SVV guidance target-oriented infusion group(SVV group)and conventional infusion group(conventional group),with 40 cases in each group.The amount of infusion,blood loss,urine volume and use of vasoactive drugs in the two groups were recorded.MAP,HR,blood lactate concentration(Lac),base residual value(BE),and PaO2 were recorded at the time of entry(T1),before cuticle(T2),1 hour after prone position(T3),and after surgery(T4).Pulmonary ultrasound examinations were performed at 4,8,12 and 24 hours after surgery,and B-line scores were calculated,as well as the incidence of cardiac insufficiency,nausea,vomiting,delirium and hospital stay at 24 hours after surgery.Result Compared with normal group,in group SVV,intraoperative infusion volume[(1123+532)ml],vascular active drug utilization rate(15.0％),postoperative each point B line score[(1.55±1.32),(1.22±0.94),(1.01±0.93),(1.07±0.90)]were reduced(P＜0.05).HR at T2～T4[(67±8,71±11,73±12)times/min]、PaO2 at T3,T4[(438±41,423±44)mmHg]were increased,Lac and BE at T2～T4 were(0.3±0.5,1.4±0.5,1.4±0.3)mmol/L.(0.3±0.6,0.3±1.0,0.3±1.1)was decreased(P＜0.05).There were no significant differences between the two groups in cardiac dysfunction,nausea,vomiting,delirium and hospital stay after a 24-hour postoperative period(P＞0.05).Conclusion SVV guided target oriented infusion in elderly lumbar surgery is beneficial to circulation stability and tissue perfusion,and reduces the production of lung water.

Objective To evaluate the effect of target oriented infusion guided by stroke volume variation(SVV)in elderly lumbar surgery.Method From January to December 2023,80 elderly patients undergoing elective general anesthesia for prone lumbar surgery were divided into two groups by random number table method:SVV guidance target-oriented infusion group(SVV group)and conventional infusion group(conventional group),with 40 cases in each group.The amount of infusion,blood loss,urine volume and use of vasoactive drugs in the two groups were recorded.MAP,HR,blood lactate concentration(Lac),base residual value(BE),and PaO2 were recorded at the time of entry(T1),before cuticle(T2),1 hour after prone position(T3),and after surgery(T4).Pulmonary ultrasound examinations were performed at 4,8,12 and 24 hours after surgery,and B-line scores were calculated,as well as the incidence of cardiac insufficiency,nausea,vomiting,delirium and hospital stay at 24 hours after surgery.Result Compared with normal group,in group SVV,intraoperative infusion volume[(1123+532)ml],vascular active drug utilization rate(15.0％),postoperative each point B line score[(1.55±1.32),(1.22±0.94),(1.01±0.93),(1.07±0.90)]were reduced(P＜0.05).HR at T2～T4[(67±8,71±11,73±12)times/min]、PaO2 at T3,T4[(438±41,423±44)mmHg]were increased,Lac and BE at T2～T4 were(0.3±0.5,1.4±0.5,1.4±0.3)mmol/L.(0.3±0.6,0.3±1.0,0.3±1.1)was decreased(P＜0.05).There were no significant differences between the two groups in cardiac dysfunction,nausea,vomiting,delirium and hospital stay after a 24-hour postoperative period(P＞0.05).Conclusion SVV guided target oriented infusion in elderly lumbar surgery is beneficial to circulation stability and tissue perfusion,and reduces the production of lung water.

The cultivation of top innovative nursing talents with Chinese characteristics in the new era lends critical support to the accomplishment of the strategic goal of the Healthy China Initiative.Herein,we reviewed the historical development of nursing science in China,clarified the conceptual framework of nursing science with Chinese characteristics in the new era,and identified the essential qualities and competencies required for top innovative nursing talents.Furthermore,we analyzed the mission and challenges in cultivating these nursing talents,and put forward new approaches,including formulating new ethics and political education theories specific to nursing science with Chinese characteristics,establishing a cross-disciplinary educational model of Nursing+X,and creating a new nursing talent cultivation ecosystem adapted to the era of human-machine symbiosis.This study provides theoretical insights into the cultivation of top innovative nursing talents who align their development well with national strategic needs,embody patriotism,and possess a strong sense of contemporary responsibility.

OBJECTIVE To understand the drug resistance among the acquired immune deficiency syndrome(AIDS)population who failed in the antiviral therapy from 2022 to 2023 and analyze the molecular network.METHODS The plasma specimens were collected from the population with viral load no less than 1000 cps/ml who received antiviral therapy for more than 6 months in Aksu area from 2022 to 2023,which were delivered to Aksu Regional Center for Disease Control and Prevention for test.MEGA5 and the Stanford University drug resistance database were employed to determine the subtypes and drug resistance after the sequences of human immunodefi-ciency virus type Ⅰ polymerase gene region(HIV-1pol)were obtained,and the molecular network was established by HIV-trace.RESULTS Totally 648 sequences of HIV-1pol region were obtained,CRF07_BC(97.69％)was the major subtype,and the drug resistance rate was 58.33％;the drug resistance rates to non-nucleoside reverse transcriptase inhibitor(NNRTI),nucleoside reverse transcriptase inhibitor(NRTI)and protease inhibitor(PI)were 51.70％,19.75％and8.64％,respectively.The univariate analysis showed that year(x2=6.341),age(x2=18.455)and route of infection(x2=14.061)had remarkable effects on the drug resistance among the population with failed ART(P＜0.05).Multivariate regression analysis indicated that the drug resistance rate was higher in 2022 than in 2023(95％CI:1.132 to 2.191),and the drug resistance rate was higher among the population aged less than 60 years old than among the population more than 6 years old(95％CI:3.647 to 70.268,95％CI:1.435 to 8.235,95％CI:1.061 to 6.164,re-spectively).With 1.5％of the genetic distance set as the threshold,the molecular network was established,the network access rate was 49.07％,77.14％of the clusters had drug-resistant mutation sites,and the male population was at higher risk of network access than the female population.CONCLUSIONS The drug resistance rate is relatively high among the AIDS population with failed ART,and the drug-resistant strains appear in clusters in the molecular network.It is neces-sary to further strengthen the monitoring of drug resistance and improve the quality of the follow-up so as to reduce the occurrence of drug resistance and transmission of virulent strains.

OBJECTIVE To understand the drug resistance among the acquired immune deficiency syndrome(AIDS)population who failed in the antiviral therapy from 2022 to 2023 and analyze the molecular network.METHODS The plasma specimens were collected from the population with viral load no less than 1000 cps/ml who received antiviral therapy for more than 6 months in Aksu area from 2022 to 2023,which were delivered to Aksu Regional Center for Disease Control and Prevention for test.MEGA5 and the Stanford University drug resistance database were employed to determine the subtypes and drug resistance after the sequences of human immunodefi-ciency virus type Ⅰ polymerase gene region(HIV-1pol)were obtained,and the molecular network was established by HIV-trace.RESULTS Totally 648 sequences of HIV-1pol region were obtained,CRF07_BC(97.69％)was the major subtype,and the drug resistance rate was 58.33％;the drug resistance rates to non-nucleoside reverse transcriptase inhibitor(NNRTI),nucleoside reverse transcriptase inhibitor(NRTI)and protease inhibitor(PI)were 51.70％,19.75％and8.64％,respectively.The univariate analysis showed that year(x2=6.341),age(x2=18.455)and route of infection(x2=14.061)had remarkable effects on the drug resistance among the population with failed ART(P＜0.05).Multivariate regression analysis indicated that the drug resistance rate was higher in 2022 than in 2023(95％CI:1.132 to 2.191),and the drug resistance rate was higher among the population aged less than 60 years old than among the population more than 6 years old(95％CI:3.647 to 70.268,95％CI:1.435 to 8.235,95％CI:1.061 to 6.164,re-spectively).With 1.5％of the genetic distance set as the threshold,the molecular network was established,the network access rate was 49.07％,77.14％of the clusters had drug-resistant mutation sites,and the male population was at higher risk of network access than the female population.CONCLUSIONS The drug resistance rate is relatively high among the AIDS population with failed ART,and the drug-resistant strains appear in clusters in the molecular network.It is neces-sary to further strengthen the monitoring of drug resistance and improve the quality of the follow-up so as to reduce the occurrence of drug resistance and transmission of virulent strains.

Objective:To explore the influencing factors of all-cause death in patients with acute myocardial infarction (AMI) and renal insufficiency(RI), and establish a clinical prediction tool.Methods:Collected 727 patients who were hospitalized in Beijing Anzhen Hospital from January 1st 2014 to April 31th 2019, and diagnosed as AMI with RI. Recorded the patients' baseline characteristics, past medical history, current complications, laboratory and auxiliary examination results, treatment methods (included target vessel reconstruction methods, medications, etc.), and follow-up patients for all-cause deaths. Firstly, multivariate Cox regression analysis was used to construct the model in the training set(485 cases). Secondly, the receiver operating characteristic curve ( ROC), calibration curve and clinical decision curve analysis (DCA) were drawn in the validation set(242 cases) to further verify the effect of the prediction model. Finally, a nomogram was developed based on the verified risk factors. Results:Multivariate Cox regression analysis found that there were nine predictors for the prognosis of all-cause death in patients with AMI & RI, the dangerous factors included women, comorbidities, high direct bilirubin, cardiogenic shock, respiratory failure, co-infection and hemofiltration; the protective factors included PCI and taking aspirin. Model evaluation results showed that the AUC of the validation set was 0.82; the calibration line was close to the ideal calibration line, and the slope≈1, the intercept≈0, and the fitting effect was good. Clinical decision-making when the all-cause mortality rate was 35%, the net benefit of active intervention patients based on the Cox model was 38%. A visual nomogram model was developed based on the prognostic risk factors that have been evaluated and predicted to be good. Conclusion:Women, with a history of comorbidities, direct high bilirubin, combined with cardiogenic shock, combined with respiratory failure, combined infection, hemofiltration, PCI and taking aspirin, these nine factors will affect all causes of AMI & RI. For the probability of death, the model developed in this research has high accuracy.

COVID -19 poses a major threat to safety and health of human life. Vaccination has become an important means to resist and prevent COVID -19. Under the background of limited global supply of COVID -19 vaccine and its initial application, it is extremely necessary to discuss its ethical principles. Based on the bioethics theory and in accordance with relevant laws and regulations on vaccine use in China, this paper put forward the ethical principles of COVID -19 vaccine use, including safety principle, respect principle, fairness and justice principle, optimization principle and humanitarianism principle, which provided reference for scientifically formulating COVID -19 vaccination strategy and forming a group immune barrier to effectively control the epidemic situation in COVID -19.

The construction of clinical teaching faculty team in the practice base for master of nursing specialist plays an important role in the clinical practice and training process of nursing postgraduates with professional master's degree. This study comprehensively retrieves relevant domestic literature, summarizes the current status, core competence, access standards, training requirements and other research progress of teaching faculty team construction in the domestic practice base for master of nursing specialist and explores the urgent need for teaching faculty team construction in practice bases for master of nursing specialist, so as to provide a reference for construction of teaching faculty team in the practice base for master of nursing specialist.

Objective:To investigate the awareness and knowledge of influenza and vaccine among primary care providers in Shanghai.Methods:An online questionnaires survey was conducted by Shanghai Alliance for Respiratory Diseases in Primary Care from December 2017 to August 2018, healthcare providers in district central hospitals and community health care centers of Shanghai were invited to participate in the survey. The questionnaire contained the following items: the basic information of respondents; knowledge of influenza and its vaccine; current status of influenza vaccination; factors affecting promoting vaccination; the intention, attitude, perception of promoting vaccination and the influencing factors, and suggestions on promoting influenza vaccination.Results:A total of 1 542 valid questionnaires were collected, 88.3% (1 361/1 542) responders correctly recognized main symptoms of influenza; 58.2% (898/1 542) ignored the contact transmission of influenza; 41.6% (641/1 542) didn′t know the frequency of influenza vaccination; 82.7% (1 276/1 542) failed to recognize that pregnant women should also receive influenza vaccination. The survey showed that 31.2% (481/1 542) of responders had been vaccinated against influenza. The vaccination rate in community health care institutions was significantly higher than that in district central hospitals [39.1% (304/778) vs. 23.2% (177/764), χ 2=45.44, P<0.05]. Factors affecting vaccination for healthcare providers were: influenza antigen was variable, and vaccination had no effects [49.5% (404/816)]; the efficacy of the flu vaccine was doubt [48.8% (634/1 298)]; the vaccine wasn′t free [46.5%(604/1 298)]. The respondents believed that the main ways to improve the influenza vaccination were to formulate relevant national vaccination policies [79.7%(1 229/1 542)], to regularly publicize knowledge of influenza and influenza vaccine to residents through communities [65.8% (1 015/1 542)], and to recommend the patients by primary care medical staff [64.4% (993/1 542)]. Conclusion:Many healthcare providers have insufficient knowledge about influenza and vaccine. The vaccination rate of community health institutions is higher than that in district central hospitals in Shanghai. The willingness to promote influenza vaccination can be influenced by some factors. Increasing the willingness of healthcare providers might be helpful to improve the vaccination coverage among residents in the community.