ObjectiveTo analyze the evolutionary characteristics and genetic variations of the HA (hemagglutinin) and NA (neuraminidase) genes of influenza A(H1N1) viruses in Shanghai during 2024, to investigate their transmission patterns, and to evaluate their potential impact on vaccine effectiveness. MethodsFrom January to October 2024, throat swab specimens were collected from influenza like illness (ILI) patients at 4 hospitals in Shanghai. Real-time fluorescence ploymerase chain reaction (RT-PCR) was used for virus detection and isolation of H1N1 influenza viruses. Forty influenza A(H1N1) virus strains were sequenced using Illumina NovaSeq 6000 platform, followed by phylogenetic analyses, genetic distance analysis, and amino acid variation analyses of HA and NA genes. ResultsPhylogenetic tree of the HA and NA genes revealed that the 40 influenza A(H1N1) virus strains circulating in Shanghai in 2024 exhibited no significant geographic clustering, with a broad origin of strains and complex transmission chains. Genetic distance analyses demonstrated that the average intra-group genetic distances of HA and NA genes among the Shanghai strains were 0.005 1±0.000 6 and 0.004 6±0.000 6, respectively, which were comparable to or higher than those observed in global surveillance strains. Both HA and NA genes displayed frequent mutations. Compared to the 2023‒2024 and 2024‒2025 Northern Hemisphere A(H1N1) vaccine strains (WHO-recommended), the HA proteins of 40 Shanghai strains exhibited amino acid substitutions at positions 120, 137, 142, 169, 216, 223, 260, 277, 356 and 451, with critical mutations at positions 137 and 142 located within the Ca2 antigenic determinant. Furthermore, mutations in the NA protein were observed at positions 13, 50, 200, 257, 264, 339 and 382. ConclusionThe genetic background of the 2024 Shanghai influenza A(H1N1) virus strains is complex and diverse, and antigenic variation may affect vaccine effectiveness. Therefore, it is recommended to enhance genomic surveillance of influenza viruses, evaluate vaccine suitability, and implement more targeted prevention and control strategies against imported influenza viruses.

Objective To explore the effects of prospective rewarming nursing on spontaneous hypothermia in traumatic patients in emergency service. Methods Totally 67 traumatic patients admitted in the Emergency Department of Armed Police Zhejiang Corps Jiaxing Hospital between January and August 2016 were selected as the control group, and another 72 traumatic patients admitted between January and August 2017 were selected as the observation group by purposive sampling. Patients in the control group received conventional emergency treatment, while patients in the observation group received prospective rewarming nursing care on this basis. Body temperature and the incidence of shivering, arrhythmia and spontaneous hypothermia were compared between the two groups. Results The body temperature of the observation group stood at (36.38±0.21)℃ and (36.72±0.38)℃ respectively at admission and 1 hour post admission, both higher than that of the control group (t=24.241, 18.039; P＜0.01). The incidence rate of shivering in the observation group was 15.94% and 17.39% respectively at admission and 1 hour post admission, both lower than that of the control group (χ2=19.326, 19.141; P＜0.01). The incidence rate of arrhythmia in the observation group was 30.43%, while that of the control group was 49.15% (χ2=4.681, P=0.030). Conclusions Prospective rewarming can reduce the risks of spontaneous hypothermia in traumatic patients in emergency service.

This article reviewed the concept,measuring methods,theoretical models and research progress of career resilience by retrieving and analyzing related literature at home and abroad. Besides,this paper also introduced its application in nursing management at home and abroad so as to provide the basis for nursing human resource management of China.