Objective A non-targeted metabolomics analysis of vitreous fluid from patients with proliferative diabetic retinopathy(PDR)is conducted to explore the"metabolic map"of PDR.This approach aims to deepen the understanding of the disease,identify potential biomarkers.Methods From 35 PDR patients and 30 fresh rhegmatogenous retinal de-tachment(RRD)patients,10 PDR patients with vitreoretinal abnormal adhesions were selected as the experimental group(PDR group),and 10 fresh RRD patients were chosen as the control group(RRD group).Using ultra-high-performance liq-uid chromatography-mass spectrometry non-targeted metabolomics technology,the metabolic profiles of vitreous fluid were analyzed to obtain metabolic spectra.One-dimensional and multidimensional statistical methods were used to analyze the differences in metabolites and metabolic pathways between the PDR and RRD groups.Results A total of 165 differential metabolites were identified in the vitreous humor samples of patients in the PDR and RRD groups,these differential metab-olites were significantly enriched in 21 metabolic pathways(P＜0.05),Among these pathways,those with at least 5 differ-ential metabolites include:methionine and cysteine metabolism;glycine,serine,and threonine metabolism;ascorbic acid and aldose metabolism;amino acid biosynthesis;and central carbon metabolism in cancer.Pyruvate,serine,D-2-phospho-glycerate,threonine,phosphoserine,and high serine are present in multiple metabolic pathways,the areas under the curve are 0.96,0.82,0.85,0.78,0.40,and 0.31,respectively.Conclusion There are 21 significantly different metabolic pathways between PDR and RRD patients.Pyruvate stands out in multiple pathways,potentially serving as a biomarker for PDR diagnosis.

Objective:To analyze the effects of the Focused Solution Model Nursing intervention on quality of life,negative emotions of the patients with prostate cancer.Methods:A total of 82 prostate cancer patients who were diagnosed and treated at the General Hospital of Eastern Theater Command between September 2022 and September 2024 were included and randomly divided into study group and control group by the method of random number table,with 41 patients in each group.The patients in the study group were treated with Focused Solution Model Nursing intervention.And the routine care was used in the control group The quality of life and negative emotions were compared between the two groups by using the scales of World Health Organization Quality of Life-Brief(WHOQOL-BREF),HAMA and HAMD.Results:Compared to the control group,the patients in the study group exhibited signifi-cantly higher scores in the physiological,psychological,environmental,and social relationship domains of the WHOQOL-BREF scale(P＜0.05).The scores of HAMA and HAMD in study group were lower than those of the control group(P＜0.05).Additionally,all subscales of the Social Impact Scale including social exclusion,internalized shame,social isolation and economic discrimination were significantly lower than those of the study group(P＜0.05).Conclusion:Focused Solution Model Nursing intervention can effec-tively improve the quality of life and negative emotions of the prostate cancer patients in the clinical treatment.

Objective:To investigate the current situation of adverse events in hemodialysis nursing in class-A tertiary hospitals in China and analyze their nursing human resources related influencing factors, aiming at provide references for hemodialysis centers to adjust nursing human resources scientifically to reduce the occurrence of nursing adverse events.Methods:A convenient sampling method was used. From August to October 2021, a self-designed questionnaire was used to investigate nursing adverse events in hemodialysis centers of 860 class-A tertiary hospitals during 2020 in China. Multivariate Logistic regression was used to analyze the influencing factors of blood loss, hemodialysis catheter-related blood stream infection (CRBSI) and venous needle dislodgement (VND) in hemodialysis centers.Results:A total of 826 valid questionnaires were received, with an effective response rate of 96.05%(826/860). There were 826 hemodialysis centers covering 31 provinces, municipalities and autonomous regions in China. The establishment period of each center was 24(18, 30) years. There were 45(30, 62) dialysis machines, 180(110, 260) patients and 19(13, 27) registered nurses. Blood loss, hemodialysis CRBSI and VND occurred in 70.94% (586/826), 68.04%(562/826) and 46.97% (388/826) of hemodialysis centers, respectively. Multivariate Logistic regression results showed that the daily treatment shift ( OR=0.730, 95% CI 0.536-0.994), the proportion of nurses with bachelor's degree or above ( OR=1.635, 95% CI 1.142-2.342), and whether nurses worked part-time on peritoneal dialysis treatment ( OR=0.225, 95% CI 0.052-0.965) were the influencing factors for blood loss in hemodialysis centers (all P<0.05). The daily treatment shift ( OR=0.566, 95% CI 0.413-0.777), the number of patients which each nurse was responsible for per shift simultaneously ( OR=0.549, 95% CI 0.400-0.753), proportion of blood purification specialized nurses ( OR=1.661, 95% CI 1.216-2.269), whether nurses worked part-time on CRRT ( OR=0.700, 95% CI 0.511-0.957), the education level of the nursing manager was junior college and below ( OR=3.789, 95% CI 1.576-9.113) and bachelor′s degree ( OR=2.585, 95% CI 1.328-5.033) were the influencing factors for the hemodialysis catheter-associated bloodstream infection in hemodialysis centers (all P<0.05). The number of patients which each nurse ( OR=0.580, 95% CI 0.433-0.777) was responsible for per shift simultaneously was the influencing factor in the occurrence of VND in hemodialysis centers ( P<0.05). Conclusions:The nursing adverse events of blood loss, hemodialysis catheter-associated bloodstream infection and VND were relatively common in hemodialysis centers. The hospital managers should take corresponding measures aiming at the above influencing factors to prevent the occurrence of nursing adverse events and improve the quality and safety of nursing.

Objective:The influencing factors of intraoperative hypoxemia in patients with benign central airway stenosis were investigated by machine learning algorithm, and the prediction model of hypoxemia was constructed and verified.Methods:A case-control study was used in this study. The clinical data of 650 patients with benign central airway stenosis who who received surgical treatment in the First Affiliated Hospital of PLA Naval Medical University from June 2022 to April 2024 were retrospectively analyzed. And they were divided into a training set ( n=455) and a test set ( n=195) according to 7:3. The training set was used for establishing Logistic regression model and conducting internal verification, and the test set was used for external verification. The least absolute shrinkage and selection operator (LASSO) regression and Boruta algorithm were used to select the factors affecting intraoperative hypoxemia in patients with benign central airway stenosis. A Logistic regression prediction model was constructed, and the model was evaluated using area under the receiver operating characteristic curve (AUC), decision curve analysis (DCA) and calibration curve. Shapley additive interpretation (SHAP) were used to analyze the importance of influencing factors. Results:Among 650 patients, 279 were males and 371 were females, aged (37.86 ± 8.82) years. Nine feature variables were screened by LASSO regression, while 7 feature variables were screened by Boruta algorithm, the intersection of the two was operation time, complications, degree of airway stenosis, thermal ablation therapy, balloon dilation, and airway stent, respectively, based on this, a logistic regression prediction model was constructed.The AUC values of the training set, validation set and test set of the model were 0.928 (95% CI 0.903-0.954), 0.922 (95% CI 0.843-0.995) and 0.919 (95% CI 0.872-0.965), respectively. The calibration curve showed that the predicted results of the model were in good agreement with the actual results, and the DCA curve showed that the model had clinical application value. SHAP analysis showed that the importance of variables affecting intraoperative hypoxemia in benign central airway stenosis patients was ranked as operation time, thermal ablation therapy, degree of airway stenosis, comorbidification, balloon dilation, and airway stent. Conclusions:The Logistic regression prediction model of intraoperative hypoxemia built based on machine learning algorithm has good prediction efficiency, which is helpful to early identification of risk groups and prevention of hypoxemia.

Objective To examine the changing prevalence and antimicrobial resistance profiles of Burkholderia cepacia in 52 hospitals across China from 2015 to 2021.Methods A total of 9 261 strains of B.cepacia were collected from 52 hospitals between January 1,2015 and December 31,2021.Antimicrobial susceptibility of the strains was tested using Kirby-Bauer method or automated antimicrobial susceptibility testing systems according to a unified protocol.The results were interpreted according to the breakpoints released in the Clinical & Laboratory Standards Institute(CLSI)guidelines(2023 edition).Results A total of 9 261 strains of B.cepacia were isolated from all age groups,especially elderly patients.The proportion was 11.1％(1 032 strains)in children,significantly lower than the proportion in adults.About half(46.5％,4 310/9 261)of the strains were isolated from patients at least 60 years old and 42.3％(3 919/9 261)of the strains were isolated from young adults.Most isolates(71.1％)were isolated from sputum and respiratory secretions,followed by urine(10.7％)and blood samples(8.1％).B.cepacia isolates were highly susceptible to the five antimicrobial agents recommended in the CLSI M100 document(33rd edition,2023).B.cepacia isolates showed relatively higher resistance rates to meropenem and levofloxacin.However,the resistance rates to ceftazidime,trimethoprim-sulfamethoxazole,and minocycline remained below 8.1％.The percentage of B.cepacia strains resistant to levofloxacin was the highest compared to other antibiotics in any of the three age groups(from 12.4％in the patients＜18 years old to 20.6％in the patients aged 60 years or older).Conclusions B.cepacia is one of the clinically important non-fermenting gram-negative bacteria.Accurate and timely reporting of antimicrobial susceptibility test results and ongoing antimicrobial resistance surveillance are helpful for rational prescription of antimicrobial agents and proper prevention and control of nosocomial infections.

Objective To summarize the changing prevalence of carbapenem resistance in Enterobacterales based on the data of CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021 for improving antimicrobial treatment in clinical practice.Methods Antimicrobial susceptibility testing was performed using a commercial automated susceptibility testing system according to the unified CHINET protocol.The results were interpreted according to the breakpoints of the Clinical & Laboratory Standards Institute(CLSI)M100 31st ed in 2021.Results Over the seven-year period(2015-2021),the overall prevalence of carbapenem-resistant Enterobacterales(CRE)was 9.43％(62 342/661 235).The prevalence of CRE strains in Klebsiella pneumoniae,Citrobacter freundii,and Enterobacter cloacae was 22.38％,9.73％,and 8.47％,respectively.The prevalence of CRE strains in Escherichia coli was 1.99％.A few CRE strains were also identified in Salmonella and Shigella.The CRE strains were mainly isolated from respiratory specimens(44.23±2.80)％,followed by blood(20.88±3.40)％and urine(18.40±3.45)％.Intensive care units(ICUs)were the major source of the CRE strains(27.43±5.20)％.CRE strains were resistant to all the β-lactam antibiotics tested and most non-β-lactam antimicrobial agents.The CRE strains were relatively susceptible to tigecycline and polymyxins with low resistance rates.Conclusions The prevalence of CRE strains was increasing from 2015 to 2021.CRE strains were highly resistant to most of the antibacterial drugs used in clinical practice.Clinicians should prescribe antimicrobial agents rationally.Hospitals should strengthen antibiotic stewardship in key clinical settings such as ICUs,and take effective infection control measures to curb CRE outbreak and epidemic in hospitals.

Objective To characterize the changing species distribution and antibiotic resistance profiles of respiratory isolates in hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Commercial automated antimicrobial susceptibility testing systems and disk diffusion method were used to test the susceptibility of respiratory bacterial isolates to antimicrobial agents following the standardized technical protocol established by the CHINET program.Results A total of 589 746 respiratory isolates were collected from 2015 to 2021.Overall,82.6％of the isolates were Gram-negative bacteria and 17.4％were Gram-positive bacteria.The bacterial isolates from outpatients and inpatients accounted for(6.0±0.9)％and(94.0±0.1)％,respectively.The top microorganisms were Klebsiella spp.,Acinetobacter spp.,Pseudomonas aeruginosa,Staphylococcus aureus,Haemophilus spp.,Stenotrophomonas maltophilia,Escherichia coli,and Streptococcus pneumoniae.Each microorganism was isolated from significantly more males than from females(P＜0.05).The overall prevalence of methicillin-resistant S.aureus(MRSA)was 39.9％.The prevalence of penicillin-resistant S.pneumoniae was 1.4％.The prevalence of extended-spectrum β-lactamase(ESBL)-producing E.coli and K.pneumoniae was 67.8％and 41.3％,respectively.The overall prevalence of carbapenem-resistant E.coli,K.pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa,and Acinetobacter baumannii was 3.7％,20.8％,9.4％,29.8％,and 73.3％,respectively.The prevalence of β-lactamase was 96.1％in Moraxella catarrhalis and 60.0％in Haemophilus influenzae.The H.influenzae isolates from children(＜18 years)showed significantly higher resistance rates to β-lactam antibiotics than the isolates from adults(P＜0.05).Conclusions Gram-negative bacteria are still predominant in respiratory isolates associated with serious antibiotic resistance.Antimicrobial resistance surveillance should be strengthened in clinical practice to support accurate etiological diagnosis and appropriate antimicrobial therapy based on antimicrobial susceptibility testing results.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

To establish a method for detecting Toxoplasma gondii based on recombinant polymerase amplification(RPA)technology and apply it to clinical sample validation of pet cats.Using the 529 repeat sequence of the Toxoplasma gondii gene as the target gene sequence,primers and probes were designed,and the Rep-529 recombinant plasmid was constructed as the standard.A fluorescent RPA reaction system was established.Dilute the plasmid standard 10 times to different concentrations as the detection template for sensitivity testing;Specific testing was conducted using genomic DNA from several parasitic spe-cies,including Toxoplasma gondii,Cryptosporidium,Neosporidium,Trichinella spiralis,Giardia flagellata,Babesia bo-vis and Theileria annulata as templates;Simultaneously,fluorescence RPA and RT-PCR were used to detect 52 positive and 40 negative cats clinical samples,and the coincidence rate of the detection results of the two methods were compared and ana-lyzed.The RPA reaction system was successfully established using PTRep recombinant plasmid as the standard,ToxD-F/ToxD-R as the primer,and RepD-P as the fluorescent probe.The reaction temperature was constant at 39 ℃,the reaction time was 30 minutes,and the detection sensitivity was 1 copy/μL.There is no significant cross reaction with parasites such as Cryptosporidium,Neosporidium,Trichinella spiralis,Giardia,Babesia bovis and Theileria annulata,and the specificity is good.A total of 92 clinical fecal samples from cats were tested,and the positive coincidence rate of fluorescence RPA detection method was higher than that of conventional RT-PCR method(98.08％vs.82.69％),and the difference of the positive rate was not statistically significant(X2=1.392,P＞0.05).The fluorescence RPA detection method for Toxoplasma gondii suc-cessfully established in this study has the characteristics of being fast,sensitive,specific,accurate,and reliable.It can be used as a rapid clinical detection kit for Toxoplasma gondii in cats and other animals,providing new technical support for the subsequent epidemiological monitoring and precise clinical diagnosis of toxoplasmosis in cats,other animals,and humans in the future.

Objective To explore theoretical application of health communication effect evaluation in order to provide support for health communication.Methods Using health communication,health activities,health science popularization,effect evaluation as precise keywords,literature collected by databases from built to May 27,2024 was searched,and literature was screened by removing duplicate literature and reading title and abstract of literature.A total of 121 literatures were selected as research samples.Results Most of literatures did not adopt theoretical framework,and only 33 literatures had theoretical applications,mainly in fields of public health and communication.The most widely used literatures were theory of knowing and believing,Lasswell's 5W mode of communication and theory of persuasion,which were dominated by Western theories and lacked application and innovation of localized theories.Conclusion The future health communication effect evaluation should use more theoretical framework to support research,learn from and integrate theories of different disciplines,and explore localization theory research path.