Objective To explore the effectiveness of the cumulative sum (CUSUM) and the exponentially weighted moving average (EWMA) for early warning of influenza epidemic using two datasets of reported influenza cases and influenza-like illness (ILI) cases. Methods Using the reported cases of influenza and ILI in Daxing District, Beijing, from week 23 of 2018 to week 22 of 2024 as data sets, the CUSUM and EWMA models were established, respectively. The positive rate of influenza etiology was used as the ^“gold standard^”, and the Youden index was used as the evaluation index to compare the early warning effect of the two models under different data sets and different parameters. Results In CUSUM, the optimal Youden indices of the reported influenza cases set and the ILI cases set were 0.751 and 0.635, respectively. In EWMA, the optimal Youden indices of the reported influenza cases set and the ILI cases set were 0.544 and 0.464, respectively. The optimal EWMA and CUSUM models could both issue early warning signals in advance of the ^“gold standard^”. Conclusion In the influenza epidemic early warning in Daxing District, Beijing, the CUSUM model established with the reported cases of influenza can achieve good early warning effects, but the model parameters need to be dynamically adjusted according to the local epidemic characteristics.

Objective:To explore the mediating effect of job embeddedness and job satisfaction on psycholog-ical capital and organizational silence in clinical nurses.Methods:Totally 412 clinical nurses(145 males and 267 females)were selected and assessed with the Nurse Organizational Silence Assessment Questionnaire(NOSAQ),Psychological Capital Questionnaire-24(PCQ-24),Job Embedding Scale(JES)and Nurses Job Satisfaction Scale(NJSS).SPSS macro program PROCESS and Bootstrap method were used to explore the role of mediation.Results:The NOSAQ scores were negatively correlated with the scores of PCQ-24,JES and NJSS(r=-0.55,-0.59,-0.51,Ps＜0.01).Job embeddedness and job satisfaction played a chain mediating role between psychological capital and organizational silence of clinical nurses(95％CI:-0.26--0.04),and the mediating effect accounted for 14.7％of the total effect.Conclusion:It suggests that organizational silence is closely related to psychological capital,job embeddedness and job satisfaction in clinical nurses.

Objective:To observe and analyze the correlation between ectopic foveal inner layer (EIFL) and the EIFL-based idiopathic epiretinal membrane (ERM) staging system and the anatomic and functional prognosis of ERM eyes post pars plana vitrectomy (PPV).Methods:A retrospective study. From January 1, 2020 to October 30, 2023, 345 eyes of 330 patients diagnosed with idiopathic ERM in Department of Ophthalmology of Peking University People's Hospital and treated with standard transciliary flat three-channel 25G PPV combined with ERM and internal limiting membrane exfoliation were included in the study. Among them, 96 were males (111 eyes) and 234 were females (234 eyes). The mean age was (66.8±7.7) years. All study eyes received standard three-port 25G PPV combined with ERM and internal limiting membrane peeling. All study eyes underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations. BCVA was performed using a standard logarithmic visual acuity chart and converted to logarithm of the minimum angle of resolution visual acuity for statistical analysis. EIFL thickness and central foveal thickness (CFT) on OCT were measured. ERM eyes were grouped into stage Ⅰ, Ⅱ, Ⅲ and Ⅳ according to ERM staging scheme based on EIFL; disorganization of the retinal inner layers (DRIL) of study eyes were assessed and grouped into no, mild and severe groups. The correlation between ERM staging as well as EIFL thickness and the anatomical and functional prognosis 6 months post-PPV were analyzed.Results:Among 345 study eyes, 12, 87, 174 and 72 eyes were stage Ⅰ-Ⅳ ERM respectively, 63 with no DRIL, 216 with mild DRIL and 66 with severe DRIL. Among the 153 eyes with macular edema, the edema subsided in 66 eyes (43.1%, 66/153) 6 months after the operation. Eighty-seven eyes (56.9%, 87/153) did not regress. The edema subsided 6 months after the operation was not significantly correlated with the ERM stage before the operation ( χ2=3.331, R=?0.145, P=0.304) or the degree of DRIL ( χ2=0.655, R=?0.108, P=0.445). The results of the correlation analysis showed that logMAR BCVA 6 months after the surgery was positively correlated with the degree of DRIL before the surgery ( Tau-b=0.236), ERM stage ( Tau-b=0.194), CFT ( r=0.383), and EIFL thickness ( r=0.317) ( P<0.05). There was no significant correlation with the thickness of the outer nuclear layer before the operation ( r=0.004, P>0.05). Preoperative ERM stage ( Tau-b=0.303, P<0.001) and DRIL severity ( Tau-b= 0.238, P=0.001) were positively correlated with CFT at 6 months after surgery. Conclusion:The ERM stage and EIFL thickness before the operation are positively correlated with logMAR BCVA and CFT 6 months after the operation.

Objective:To construct a classification management model on the basis of Kraljic matrix for electrocardiogram(ECG)monitoring equipment in emergency intensive care unit(ICU),so as to explore its application value in the management for ECG monitoring equipment in emergency ICU.Methods:The classification management model on the basis of index for ECG monitoring equipment in emergency ICU was constructed.According to two classification dimensions included the market supply risk and the self-value,an indicator system of classification management,which aimed at strategic materials with high value and high risk,leverage materials with high value and low risk,bottleneck materials with low value and high risk,and conventional materials with low value and low risk,was constructed.A total of fifty-one ECG monitoring equipment in the emergency ICU of The People's Hospital of Longhua of Shenzhen from January to December 2023 were selected,and they were managed respectively by conventional management mode(25 sets)and classification management mode(26 sets)according to different management modes.The standardization level of operation management for equipment,the occurrence of safety risk and the level of management for equipment of the two management modes were compared,and the satisfaction of 30 relative personnel,who used and managed these equipment,for classification management of equipment also were compared.Results:The average values of the percentage of standardization level of normality of equipment operation,disinfection and sterilization,maintenance and fault repair of using classification management mode were respectively(91.58±4.33)%,(92.1±3.28)%,(91.49±3.54)%and(92.58±3.32)%,all of which were higher than those of conventional management mode,and the differences were statistically significant(t=12.537,15.706,14.196,18.946,P<0.05),repsectively.The average incidences of the risk of pressure injury,electrical injury and body fluid extravasation of adopting classification management mode were respectively(2.54±0.87)%,(3.02±0.82)%and(1.29±0.65)%,all of which were lower than those of adopting conventional management mode,and the differences were statistically significant(t=22.825,17.453,24.424,P<0.05),respectively.The satisfaction scores of 30 relative management personnel,who used equipment on the process rationality,system standardization and quality effectiveness,of adopting classification management mode were respectively(94.26±3.54),(92.57±4.36)and(91.87±3.69),all of which were higher than those of conventional management mode,and the differences were statistically significant(t=14.052,13.991,13.551,P<0.05),respectively.The reasonable placement rate,recording rate of standardization,and intact rate of equipment in the 26 equipment by adopting classification management mode were respectively 92.31%,92.31%and 88.46%,all of which were significantly higher than those by adopting conventional management mode,and the differences were statistical significant(x2=12.052,10.398,11.338,P<0.05).Conclusion:The classification management model of ECG monitoring equipment in emergency ICU can increase the management efficiency for the equipment in operating room of hospital,and improve the operation quality of equipment,and enhance the safety of equipment in clinical use,and the standardization of operation management for equipment.

Objective:To explore the mediating effect of job embeddedness and job satisfaction on psycholog-ical capital and organizational silence in clinical nurses.Methods:Totally 412 clinical nurses(145 males and 267 females)were selected and assessed with the Nurse Organizational Silence Assessment Questionnaire(NOSAQ),Psychological Capital Questionnaire-24(PCQ-24),Job Embedding Scale(JES)and Nurses Job Satisfaction Scale(NJSS).SPSS macro program PROCESS and Bootstrap method were used to explore the role of mediation.Results:The NOSAQ scores were negatively correlated with the scores of PCQ-24,JES and NJSS(r=-0.55,-0.59,-0.51,Ps＜0.01).Job embeddedness and job satisfaction played a chain mediating role between psychological capital and organizational silence of clinical nurses(95％CI:-0.26--0.04),and the mediating effect accounted for 14.7％of the total effect.Conclusion:It suggests that organizational silence is closely related to psychological capital,job embeddedness and job satisfaction in clinical nurses.

Objective:To construct a classification management model on the basis of Kraljic matrix for electrocardiogram(ECG)monitoring equipment in emergency intensive care unit(ICU),so as to explore its application value in the management for ECG monitoring equipment in emergency ICU.Methods:The classification management model on the basis of index for ECG monitoring equipment in emergency ICU was constructed.According to two classification dimensions included the market supply risk and the self-value,an indicator system of classification management,which aimed at strategic materials with high value and high risk,leverage materials with high value and low risk,bottleneck materials with low value and high risk,and conventional materials with low value and low risk,was constructed.A total of fifty-one ECG monitoring equipment in the emergency ICU of The People's Hospital of Longhua of Shenzhen from January to December 2023 were selected,and they were managed respectively by conventional management mode(25 sets)and classification management mode(26 sets)according to different management modes.The standardization level of operation management for equipment,the occurrence of safety risk and the level of management for equipment of the two management modes were compared,and the satisfaction of 30 relative personnel,who used and managed these equipment,for classification management of equipment also were compared.Results:The average values of the percentage of standardization level of normality of equipment operation,disinfection and sterilization,maintenance and fault repair of using classification management mode were respectively(91.58±4.33)%,(92.1±3.28)%,(91.49±3.54)%and(92.58±3.32)%,all of which were higher than those of conventional management mode,and the differences were statistically significant(t=12.537,15.706,14.196,18.946,P<0.05),repsectively.The average incidences of the risk of pressure injury,electrical injury and body fluid extravasation of adopting classification management mode were respectively(2.54±0.87)%,(3.02±0.82)%and(1.29±0.65)%,all of which were lower than those of adopting conventional management mode,and the differences were statistically significant(t=22.825,17.453,24.424,P<0.05),respectively.The satisfaction scores of 30 relative management personnel,who used equipment on the process rationality,system standardization and quality effectiveness,of adopting classification management mode were respectively(94.26±3.54),(92.57±4.36)and(91.87±3.69),all of which were higher than those of conventional management mode,and the differences were statistically significant(t=14.052,13.991,13.551,P<0.05),respectively.The reasonable placement rate,recording rate of standardization,and intact rate of equipment in the 26 equipment by adopting classification management mode were respectively 92.31%,92.31%and 88.46%,all of which were significantly higher than those by adopting conventional management mode,and the differences were statistical significant(x2=12.052,10.398,11.338,P<0.05).Conclusion:The classification management model of ECG monitoring equipment in emergency ICU can increase the management efficiency for the equipment in operating room of hospital,and improve the operation quality of equipment,and enhance the safety of equipment in clinical use,and the standardization of operation management for equipment.

Objective:To observe and analyze the correlation between ectopic foveal inner layer (EIFL) and the EIFL-based idiopathic epiretinal membrane (ERM) staging system and the anatomic and functional prognosis of ERM eyes post pars plana vitrectomy (PPV).Methods:A retrospective study. From January 1, 2020 to October 30, 2023, 345 eyes of 330 patients diagnosed with idiopathic ERM in Department of Ophthalmology of Peking University People's Hospital and treated with standard transciliary flat three-channel 25G PPV combined with ERM and internal limiting membrane exfoliation were included in the study. Among them, 96 were males (111 eyes) and 234 were females (234 eyes). The mean age was (66.8±7.7) years. All study eyes received standard three-port 25G PPV combined with ERM and internal limiting membrane peeling. All study eyes underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations. BCVA was performed using a standard logarithmic visual acuity chart and converted to logarithm of the minimum angle of resolution visual acuity for statistical analysis. EIFL thickness and central foveal thickness (CFT) on OCT were measured. ERM eyes were grouped into stage Ⅰ, Ⅱ, Ⅲ and Ⅳ according to ERM staging scheme based on EIFL; disorganization of the retinal inner layers (DRIL) of study eyes were assessed and grouped into no, mild and severe groups. The correlation between ERM staging as well as EIFL thickness and the anatomical and functional prognosis 6 months post-PPV were analyzed.Results:Among 345 study eyes, 12, 87, 174 and 72 eyes were stage Ⅰ-Ⅳ ERM respectively, 63 with no DRIL, 216 with mild DRIL and 66 with severe DRIL. Among the 153 eyes with macular edema, the edema subsided in 66 eyes (43.1%, 66/153) 6 months after the operation. Eighty-seven eyes (56.9%, 87/153) did not regress. The edema subsided 6 months after the operation was not significantly correlated with the ERM stage before the operation ( χ2=3.331, R=?0.145, P=0.304) or the degree of DRIL ( χ2=0.655, R=?0.108, P=0.445). The results of the correlation analysis showed that logMAR BCVA 6 months after the surgery was positively correlated with the degree of DRIL before the surgery ( Tau-b=0.236), ERM stage ( Tau-b=0.194), CFT ( r=0.383), and EIFL thickness ( r=0.317) ( P<0.05). There was no significant correlation with the thickness of the outer nuclear layer before the operation ( r=0.004, P>0.05). Preoperative ERM stage ( Tau-b=0.303, P<0.001) and DRIL severity ( Tau-b= 0.238, P=0.001) were positively correlated with CFT at 6 months after surgery. Conclusion:The ERM stage and EIFL thickness before the operation are positively correlated with logMAR BCVA and CFT 6 months after the operation.

Objective To investigate the changes in the position of the fibular sesamoid bone with hallux valgus aggravated under two conditions:the foot bearing anteroposterior radiography(reflecting the static bearing state of the foot)and the sesamoid bone bearing axial radiography(reflecting the foot movement state).Methods Seventy-four feet with clinically suspected hallux valgus were finally enrolled in 49 feet,including 14 in the mild group,23 in the moderate group,and 12 in the severe group.Three indica-tors were measured on anteroposterior and axial radiographs:the position of the fibular sesamoid bone in anteroposterior radiographs(SP)and sesamoid axial position(SAP),and the rotation angle of the fibular sesamoid articular surface(RAf).The vertical distance between the fibular sesamoid bone and the second metatarsal bone was used to represent the position of the fibular sesamoid bone,then the position of the fibular sesamoid in the anteroposterior and axial positions was specifically marked as SPf-2 and SAPf-2.To cor-rect the anatomical differences of each foot,the ratio of the measured distance index to the length of the second metatarsal bone(AB),namely SPf-2/AB,SAPf-2/AB,was included in the statistical analysis.Results SPf-2/AB and SAPf-2/AB had no significant difference between hallux valgus groups(P＞0.05).The mean values of SPf-2/AB and SAPf-2/AB were significantly different(P＜0.05).RAf was positively correlated with hallux valgus angle(HVA)(r=0.725,P＜0.001),increased as HVA increased.Conclusion Both weight-bearing anteroposterior and sesamoid axial radiographs(foot at rest and in motion),the position of the fibular sesamoid bone is not affected by hallux valgus,and the distance from the center of the fibular sesamoid bone to the second metatarsal bone remains unchanged.The position of the fibular sesamoid bone is not the same between the anteroposterior and axial radiographs,so it is necessary to evaluate the position of the fibular sesamoid bone in the two states respectively and combine the two methods.RAf increases with the increase of HVA in axial view,it is considered that although the central position of the fibular sesamoid bone remains the same under foot movement,it does reverse spin movement toward the tibial side with the aggravation of hallux valgus.

Objective:To establish an ICP-MS method for the determination of 23 potential risk elemental im-purities including As,Cd,Hg,Pb,Co,Ni,V,Ag,Au,Ir,Os,Pd,Rh,Ru,Se,Tl,Ba,Cr,Cu,Li,Mo,Sb,Sn in nedaplatin for injection,nedaplatin and excipients.Methods:Inductively coupled plasma mass spec-trometry(ICP-MS)was used to establish a method for the contents of 23 elemental imputities in nedaplatin for in-jection,nedaplatin and excipients,and relevant methodological validation were carried out.The samples were pre-treated by directly dissolution.Results:The method simultaneously determined 23 elemental impurities.The re-sponse values of the 23 elemental impurities showed a good linear relationship with their mass concentrations(r≥0.99).The relative standard deviations(RSDs)of the repeatability tests were less than 9％(n=6),and the av-erage recovery rates ranged from 94％to 116％(n=9),which all met the requirements of methodological valida-tion.The contents of 23 elemental impurities in total 16 batches from 4 manufacturers of nedaplatin for injection were all below 30％of the limits specified by ICH Q3D.Conclusion:The established ICP-MS method is simple,sensitive,accurate,and has good specificity and repeatability.It can be used as a quality control detection method for 23 elemental impurities in the platinum based anti-tumor drug substances and products.

Objective:To investigate the delay in medical care-seeking and diagnosis of human brucellosis cases in Daxing District, Beijing City, and analyze the relevant influencing factors.Methods:Retrospective analysis method was used to collect the information on brucellosis cases reported by the Infectious Disease Reporting Information Management System of the China Disease Prevention and Control Information System in Daxing District, Beijing City from January 1, 2013 to December 31, 2022. And the case information was reviewed, including demographic information, clinical manifestations, medical care-seeking, diagnosis, etc. Binary logistic regression was used to analyze the influencing factors of delayed diagnosis.Results:A total of 120 cases of brucellosis were included, including 91 males and 29 females, with a male-to-female ratio of 3.14 ∶ 1.00. The majority were aged 40 - 79 years, accounting for 81.7% (98/120). Farmers and unemployed household workers were the main occupations, accounting for 67.5% (81/120). The main clinical manifestations were fever (85.8%, 103/120), hyperhidrosis (65.8%, 79/120), fatigue (61.7%, 74/120), and muscle soreness (60.0%, 72/120). The delay rate of medical care-seeking was 33.3% (40/120), with a median medical care-seeking time of 6 days (interquartile range: 2 - 22 days, range: 0 - 727 days). The diagnosis delay rate was 50.8% (61/120), with a median diagnosis time of 10 days (interquartile range: 3 - 22 days, range: 0 - 1 530 days). The results of binary logistic regression analysis showed that the reasons for initial diagnosis were severe or recurrent symptoms ( OR = 6.76, 95% CI: 2.40 - 19.01), serological monitoring or other diseases ( OR = 36.00, 95% CI: 3.57 - 362.72), and delayed medical care-seeking ( OR = 4.30, 95% CI: 1.68 - 11.01) were risk factors for delayed diagnosis of brucellosis cases. The location of the diagnostic hospitals outside the city ( OR = 0.27, 95% CI: 0.08 - 0.92) was a protective factor for delayed diagnosis of brucellosis cases. Conclusions:The medical care-seeking and diagnosis of brucellosis cases in Daxing District, Beijing City have been delayed to varying degrees. The reasons of initial diagnosis are severe or recurrent symptoms, serological monitoring or other diseases, and medical care-seeking delay are the risk factors for the delayed diagnosis of brucellosis cases. The location of the diagnostic hospitals outside the city is a protective factor for delayed diagnosis of brucellosis cases.