OBJECTIVE T o explore the long-term effect of multidimensional evidence-based interventions based on i-PARIHS theoretical framework on reduction of incidence of central line-associated bloodstream infections(CLABSI)in pediatric intensive care units(PICU)of pediatrics department and evaluate the impact on nurses'compliance to taking the interventions and use intensity of catheters.METHODS By means of quasi-experimental design,the multidimensional intervention system covering multidisciplinary collaboration,standardized operation procedures,information system optimization and hierarchical training was established and staged for implementa-tion of 5 years(from T0 baseline stage to T3 maintenance stage).The variations in implementation rates of cathe-ter maintenance(daily maintenance,dressings change,catheter removal)were analyzed by Chi-square test,and the change of incidence of CLABSI was monitored with the use of statistical process control U chart.RESULTS The nurses'compliance to operations was remarkably improved(P＜0.05)o The implementation rate of dressings change continuously increased from 52.91％in T0 to81.62％in T3(x2=72.444,P＜0.001),the implementa-tion rate of catheter removal increased from 48.72％to 79.31％(x2=8.179,P=0.042).The incidence rate of CLABSI decreased from 1.92％0 in 2019 to 0.5％0 in 2022,and the control chart showed that most of the months fluctuated within control limits.CONCLUSIONS The multidimensional evidence-based interventions can achieve a long term control of CLABSI by raising the nurses' compliance to operations.The information monitoring and closed-loop management are crucial to maintenance of the interventional effect,and the risk early warning system should be optimized with the combination of artificial intelligence technology.

Objective:To explore the risk factors of suicidal ideation in bereavement callers of Beijing psy-chological support hotline.Methods:Bereavement callers from 2022-2023 hotline callers who were assessed for grief reactions were included in this study.Callers were assessed for current suicidal ideation by asking them if they had suicidal ideation within two weeks.The general demographic data of bereavement callers were collected,and the distress,hope and suicide risk factors of bereavement callers were assessed by hotline interview.The depression de-gree of bereavement callers was assessed by diagnostic screening scale for depression.Logistic regression analysis was used to explore the risk factors of suicidal ideation.Results:Seventy-seven point two percent(1 028/1 332)of callers reported suicidal ideation.Those who were over 25 years old(OR=0.50),with 10-16 years of education(OR=0.59),with over 16 years of education(OR=0.28),and had a high sense of hope(OR=0.41)were less likely to have suicidal ideation.Those with previous suicide history(OR=2.70),high levels of distress(OR=1.72),and high levels of depression(OR=2.86)were more likely to have suicidal ideation.Conclusion:A history of previous suicide,high levels of distress,and high levels of depression among bereavement callers were risk fac-tors for suicidal ideation.

Objective:To explore the risk factors of suicidal ideation among callers with unemployment issues to the Beijing psychological assistance hotline.Methods:Totally 802 callers from the Beijing psychological assis-tance hotline from 2020 to 2023,who identified unemployment as their primary concern.Suicidal ideation was as-sessed by directly asking callers if they had experienced suicidal thoughts within the past two weeks.General demo-graphic information was collected,along with factors related to suicidal ideation,including distress,hope,depres-sion,substance abuse,physical problems,history of previous suicide attempts,chronic life events,acute life events,history of abuse,fear of being attacked,and family or friends' history of suicide.Results:A total of 517 individuals(64.4％)reported experiencing suicidal ideation within the two weeks prior to their call.Regression analysis indi-cated that high levels of hope(OR=0.32,95％CI:0.23-0.44)were a protective factor against suicidal ideation among unemployed callers.In contrast,severe depressive symptoms(OR=2.47,95％CI:1.77-3.45),a history of previous suicide attempts(OR=1.64,95％CI:1.05-2.56),and chronic life events(OR=1.55,95％CI:1.11-2.16)were identified as significant risk factors for suicidal ideation in this group.Conclusion:A history of prior suicide attempts,chronic life events,and high levels of depression are significant risk factors for suicidal idea-tion among unemployed callers,whereas a high level of hope serves as a protective factor.

Objective:To explore the risk factors of suicidal ideation among callers with unemployment issues to the Beijing psychological assistance hotline.Methods:Totally 802 callers from the Beijing psychological assis-tance hotline from 2020 to 2023,who identified unemployment as their primary concern.Suicidal ideation was as-sessed by directly asking callers if they had experienced suicidal thoughts within the past two weeks.General demo-graphic information was collected,along with factors related to suicidal ideation,including distress,hope,depres-sion,substance abuse,physical problems,history of previous suicide attempts,chronic life events,acute life events,history of abuse,fear of being attacked,and family or friends' history of suicide.Results:A total of 517 individuals(64.4％)reported experiencing suicidal ideation within the two weeks prior to their call.Regression analysis indi-cated that high levels of hope(OR=0.32,95％CI:0.23-0.44)were a protective factor against suicidal ideation among unemployed callers.In contrast,severe depressive symptoms(OR=2.47,95％CI:1.77-3.45),a history of previous suicide attempts(OR=1.64,95％CI:1.05-2.56),and chronic life events(OR=1.55,95％CI:1.11-2.16)were identified as significant risk factors for suicidal ideation in this group.Conclusion:A history of prior suicide attempts,chronic life events,and high levels of depression are significant risk factors for suicidal idea-tion among unemployed callers,whereas a high level of hope serves as a protective factor.

OBJECTIVE T o explore the long-term effect of multidimensional evidence-based interventions based on i-PARIHS theoretical framework on reduction of incidence of central line-associated bloodstream infections(CLABSI)in pediatric intensive care units(PICU)of pediatrics department and evaluate the impact on nurses'compliance to taking the interventions and use intensity of catheters.METHODS By means of quasi-experimental design,the multidimensional intervention system covering multidisciplinary collaboration,standardized operation procedures,information system optimization and hierarchical training was established and staged for implementa-tion of 5 years(from T0 baseline stage to T3 maintenance stage).The variations in implementation rates of cathe-ter maintenance(daily maintenance,dressings change,catheter removal)were analyzed by Chi-square test,and the change of incidence of CLABSI was monitored with the use of statistical process control U chart.RESULTS The nurses'compliance to operations was remarkably improved(P＜0.05)o The implementation rate of dressings change continuously increased from 52.91％in T0 to81.62％in T3(x2=72.444,P＜0.001),the implementa-tion rate of catheter removal increased from 48.72％to 79.31％(x2=8.179,P=0.042).The incidence rate of CLABSI decreased from 1.92％0 in 2019 to 0.5％0 in 2022,and the control chart showed that most of the months fluctuated within control limits.CONCLUSIONS The multidimensional evidence-based interventions can achieve a long term control of CLABSI by raising the nurses' compliance to operations.The information monitoring and closed-loop management are crucial to maintenance of the interventional effect,and the risk early warning system should be optimized with the combination of artificial intelligence technology.

Objective:To explore the risk factors of suicidal ideation in bereavement callers of Beijing psy-chological support hotline.Methods:Bereavement callers from 2022-2023 hotline callers who were assessed for grief reactions were included in this study.Callers were assessed for current suicidal ideation by asking them if they had suicidal ideation within two weeks.The general demographic data of bereavement callers were collected,and the distress,hope and suicide risk factors of bereavement callers were assessed by hotline interview.The depression de-gree of bereavement callers was assessed by diagnostic screening scale for depression.Logistic regression analysis was used to explore the risk factors of suicidal ideation.Results:Seventy-seven point two percent(1 028/1 332)of callers reported suicidal ideation.Those who were over 25 years old(OR=0.50),with 10-16 years of education(OR=0.59),with over 16 years of education(OR=0.28),and had a high sense of hope(OR=0.41)were less likely to have suicidal ideation.Those with previous suicide history(OR=2.70),high levels of distress(OR=1.72),and high levels of depression(OR=2.86)were more likely to have suicidal ideation.Conclusion:A history of previous suicide,high levels of distress,and high levels of depression among bereavement callers were risk fac-tors for suicidal ideation.

Objective To explore the risk factors for suicidal ideation among the relatives and friends of suicide victims through psychological support hotline.Methods Calls from the relatives and friends of suicide victims to the Beijing psychological support hotline between 2009 and 2023 were included.Their current suicidal ideation was assessed by asking whether they had suicidal thoughts in the past two weeks.Demographic information of the callers was collected and the severity of their depression was assessed using the depression diagnostic screening scale.Interviews were conducted to evaluate distress,sense of hope,history of suicide attempts,and suicide risk factors.Logistic regression analysis was used to explore the risk factors for suicidal ideation among callers.Results A total of 360 cases were included in this study.There were 50.3%(181 cases)of the callers reporting suicidal ideation within 2 weeks before the call.Years of education(OR=0.86,95%CI:0.79-0.94)and high levels of hope(OR=0.19,95%CI:0.11-0.32)were protective factors against suicidal ideation in callers.History of suicide attempts(OR=2.01,95%CI:1.20-3.36),high levels of distress(OR=3.28,95%CI:1.92-5.61),and high levels of depression(OR=1.73,95%CI:1.05-2.84)were independent risk factors for suicidal ideation in callers.Conclusions History of suicide attempts,high levels of distress and high levels of depression among the relatives and friends of suicide victims calling the psychological support hotline are risk factors for their own suicidal ideation.

Objective To explore the clinical efficacy of omacycline(OMC)in the treatment of diabetes mellitus complicated with community-acquired bacterial pneumonia(CABP).Methods Clinical data of T2DM patients with CABP admitted to The First Hospital of Jiaxing from August 2022 to July 2023 were divided into OMC group and non-OMC(NOMC)group according to wheter they received OMC treatment or not.The absorption of pulmonary lesions after treatment,changes in inflammatory indicators[white blood cell count(WBC),C-reactive protein(C-reactive protein,CRP),and anterior calcitonin(procalcitonin,PCT)],comprehensive index[hospitalization days,total hospitalization costs,blood glucose standard within 3 d and glucocorticoid use]and the occurrence of adverse reactions were analyzed and compared.Results A total of 100 diabetes mellitus patients with CABP were included in this study,including 36 cases in OMC group and 64 cases in NOMC group.The absorption of pulmonary inflammation in the OMC group was significantly higher than that in the NOMC group(P<0.05).Before treatment,there was no statistical difference in WBC,CRP and PCT between the two groups(P>0.05).After treatment,WBC,CRP,and PCT in both groups were significantly lower than those before treatment(P<0.05).Furthermore,WBC,CRP,PCT levels,hospital stay,total hospitalization costs and glucocorticoid use rate were significantly lower in the OMC group than in the NOMC group(P<0.05).The blood glucose compliance rate within 3 d in the OMC group was significantly higher than that in the NOMC group(P<0.05).None of the patients had serious complications during the treatment period.Conclusion OMC treatment of T2DM complicated with CABP is helpful for early disease control and rehabilitation,and reduces the treatment burden.

Objective To explore the effective components and possible targets and mechanism of Shenling Baizhu Powder in improving adipose tissue inflammation in children with obesity with the help of network pharmacology and molecular docking method;To conduct preliminary verification through animal experiments.Methods The active components and targets of Shenling Baizhu Powder were screened through the TCMSP database.GeneCards,OMIM,DisGeNET databases were used to obtain the disease targets.An active component-target network was constructed by taking the intersection of drug and disease targets.Protein-protein interaction networks were constructed and core targets were obtained for GO and KEGG pathway enrichment analysis.Molecular docking validation was performed to key components and core targets.Animal experiments were conducted by establishing a model of young obese rats induced by high fat diet,and Shenling Baizhu Powder were given for gavage.The contents of TG and TC in serum and mRNA expressions of TNF-α,IL-1β,INF-γ and Fas in rat adipose tissue of epididymis were detected.Results The key components of Shenling Baizhu Powder to improve the microinflammation of obesity in children were piperlonguminine,acacetin,luteolin,denudatin B,mandenol,inermine,etc.There were 515 common drug-disease targets,and the core targets were TP53,SRC,PIK3R1,HSP90AA1 and PIK3CA.The results of GO enrichment analysis included inflammatory response,positive regulation of MAPK cascade,membrane raft,protein serine/threonine/tyrosine kinase activity,etc.KEGG pathway enrichment analysis results included metabolic,immune,endocrine,cancer and related liver disease signaling pathways.The results of molecular docking showed that the key components could play a regulatory role on the core target.Animal experiments showed that Shenling Baizhu Powder could improve microinflammation and metabolic indexes of model rats.Conclusion Shenling Baizhu Powder can act on multiple targets through various active components and multiple signaling pathways,adjusting inflammatory response and immune process,alleviating insulin resistance,regulating glucose and lipid metabolism,thereby improving adipose tissue inflammatory in children with obesity.

Objective:To explore the survival prognosis of hepatocellular carcinoma patients over 60 years old with comorbidities treated with microwave ablation.Methods:A retrospective analysis of 267 patients with hepatocellular carcinoma aged 60 years or older admitted to the PLA General Hospital from April 2012 to September 2022 were analyzed, including 179 patients with preoperative comorbidities and 88 patients without comorbidities. The overall survival (OS) and progression-free survival (PFS) of the two groups were compared by the Log-rank test, and the Cox proportional hazards regression model was used to evaluate ablation-related risk factors.Results:A total of 267 patients were included (comorbidity group, n=179; no comorbidity group, n=88). There were no statistical differences in OS and PFS between the two groups (all P>0.05). Multivariate Cox regression analysis showed that comorbidities were not risk factors that affected the survival prognosis (OS and PFS) of patients with hepatocellular carcinoma after microwave ablation ( P>0.05). Total bilirubin (hazard ratio 0.356, 95% CI=0.174-0.731, P=0.005) was a risk factor affecting OS; tumor number (hazard ratio 0.538, 95% CI=0.365-0.793, P=0.002) and international coagulation normalized ratio (hazard ratio 1.022, 95% CI=1.001-1.043, P=0.040) were risk factors affecting PFS. Subgroup analysis showed that patients with a maximum diameter of >3 cm and female patients, the OS of the comorbidity group was significantly lower than that of the non-comorbidity group( P<0.05). Conclusions:Microwave ablation therapy remains an effective treatment modality in hepatocellular carcinoma patients over 60 years of age with comorbidities, and its survival prognosis is not inferior to patients with hepatocellular carcinoma without comorbidities.