Objective To explore the effectiveness of the generative large language model MedGo in nursing decision-making for elderly patients with multimorbidity. Methods A quasi-randomized controlled trial study was conducted involving 6 junior nurses, 6 senior nurses and the MedGo model from January 1, 2025 to March 31, 2025 at the Emergency Internal Medicine Ward of Shanghai East Hospital Affiliated to Tongji University. Clinical data of 120 elderly patients with multimorbidity were analyzed to compare the performance of the three groups in four tasks (nursing diagnosis assessment, nursing intervention formulation, complication identification, and complication prevention) from three evaluation dimensions: decision-making time consumption, decision accuracy, and decision-making quality. Results In terms of decision-making time, the senior nurse group completed all four tasks faster than the junior nurse group (P＜0.01), and the MedGo group completed all four tasks faster than the junior nurse group (P＜0.001) and the senior nurse group (P＜0.001). In terms of decision-making accuracy, senior nurse group scored higher than junior nurse group in all four tasks (P＜0.001), while the MedGo group outperformed the senior nurse group only in complication identification (P＜0.001). In terms of decision-making quality, the MedGo group scored higher than junior nurse group (P＜0.001) and senior nurse group (P＜0.001) in all four tasks. Conclusions The MedGo model demonstrates advantages of high efficiency, accuracy, and quality in nursing decision-making for elderly patients with multimorbidity; senior nurses outperform junior nurses in decision-making, providing diverse references for clinical nursing decision-making.

The deep integration of Party building and professional work is crucial for promoting high-quality development in university-affiliated hospitals.To address the current insufficient integration of Party building and operational development in such hospitals,the Tuina Department of the Second Affiliated Hospital of Anhui University of Chinese Medicine has adopted the"Seven Ones"Party building brand as a carrier.Using Party building as a driving force and traditional Chinese medicine culture as the core,the department has actively implemented a series of innovative Party building initiatives.By deeply integrating Party build-ing with medical services,it explores pathways for the fusion of"Party building+professional work,"leveraging high-quality Party building to facilitate the high-quality development of the hospital and contribute to the realization of the Healthy China strategy.

Objective:To assess the efficacy and safety of Gongxuening Capsules in reducing post-abortion bleeding following artificial abortion.Methods:A multicenter, randomized, double-blind study was conducted. From May 31, 2022 to March 31, 2023, 484 women who underwent vacuum aspiration abortion for early intrauterine pregnancy were enrolled in 11 centers and randomly assigned to control group and the study group at a 1∶1 ratio using a center-block randomization method. Control group were administered a placebo of Gongxuening Capsules for 9 d, while the study group received the actual Gongxuening Capsules for the same duration. The outcomes measured included vaginal bleeding volume, duration of vaginal bleeding, endometrial thickness, time to menstrual recovery, and complications.Results:1) A total of 484 subjects were enrolled, and 472 completed the study. Totally 450 subjects were included in the efficacy analysis set, with 224 in control group and 226 in the study group; 468 subjects were included in the safety analysis set, with 236 in control group and 232 in the study group. The baseline characteristics of the two groups were comparable (all P>0.05). 2) The vaginal bleeding volume was lower in the study group [(13.30±12.14) mL] than in control group [(19.00±17.67) mL, P<0.001]. The proportion of subjects in the study group with bleeding days less than 4 d [29.65% (67/226)] was higher than that in control group [19.20% (43/224), P=0.010]. 3) No significant differences were observed between the two groups in terms of time to menstrual recovery and endometrial thickness (all P>0.05). 4) In the study group, 3 subjects experienced non-therapeutic-related complications, while 11 subjects in control group. The incidence of complications was lower in the study group [1.29% (3/232)] than in control group [4.66% (11/236), P=0.033]. Conclusion:The administration of Gongxuening Capsules to women following artificial abortion significantly reduced vaginal bleeding volume and was associated with good safety, with the treatment being well-tolerated by the subjects.

Objective:To investigate the efficacy of combined sufentanil and remifentanil in pediatric ear, nose, and throat surgeries.Methods:This study used a prospective study design. A total of 110 pediatric children who underwent elective ear, nose, and throat surgery at Xi'an Children's Hospital from January 2022 to December 2023 were included in this study. The patients were randomly divided into a control group ( n = 55) and an observation group ( n = 55) using a random number table method. In the control group, only sufentanil was used for general anesthesia, while the observation group received both sufentanil and remifentanil during the anesthesia process. The changes in average arterial pressure and heart rate were compared between the two groups at five time points: T1 (before anesthesia induction), T2 (during tracheal intubation), T3 (at the start of surgery), T4 (5 min after the start of surgery), and T5 (immediately after surgery). Additionally, the recovery time for spontaneous breathing, the time to open eyes, extubation time, and adverse reactions were compared between the two groups. Ramsay sedation scores were compared between the two groups at three time points: T6 (5 min after extubation), T7 (15 min after extubation), and T8 (30 min after extubation). Pain Visual Analog Score was compared between the two groups at T8 (30 min after extubation), T9 (60 min after extubation), and T10 (90 min after extubation). Results:The differences in average arterial pressure and heart rate between the two groups at time points T1-T5, as well as Ramsay sedation scores at T6-T8 and Visual Analog Score scores at T8-T10, were all statistically significant ( F = 152.93, 2 718.29, 2 347.47, 751.77, all P < 0.05). In the observation group, the recovery time for spontaneous breathing [(5.37 ± 2.18) min vs. (6.74 ± 2.42) min], the time to open eyes [(9.03 ± 2.02) min vs. (10.84 ± 3.11) min], and extubation time [(13.22 ± 4.22) min vs. (16.47 ± 5.14) min] were significantly shorter in the observation group than in the control group ( t = 3.11, 3.62, 3.62, all P < 0.001). The incidence of adverse reactions was significantly lower in the observation group than in the control group [3.64% (2/55) vs. 16.36% (9/55), χ2 = 4.94, P < 0.05]. Conclusions:Both sufentanil alone and in combination with remifentanil yield effective anesthesia outcomes in pediatric ear, nose, and throat surgeries. However, the combination of sufentanil and remifentanil significantly shortens the recovery time for spontaneous breathing, the time to open eyes, and extubation time. This combined approach also lowers the incidence of adverse reactions, improves surgical outcomes, and promotes postoperative recovery of children.

OBJECTIVE To investigate the current status of prevalence of hand eczema(HE)among the health care workers,explore the influencing factors and analyze the association with hand hygiene.METHODS A questionnaire survey was conducted for the health care workers.The health care workers who had HE were followed up by the dermatology department and were completed the assessment of severity.Logistic regression analysis was per-formed for the influencing factors.RESULTS The questionnaires were distributed to the health care workers of Shanghai First Peoples Hospital in Jul.2024,and 659 valid questionnaires were recycled.The prevalence rate of HE by self-report was 37.03％in recent almost one year.The finger and dorsal hand were the predilection sites of skin damage,with the symptom dominated by itching;dryness,desquamation and vesicles were the primary man-ifestations of skin damage,most of which(64.81％)were moderate.Wearing gloves in work environment and contact with hand sanitizer and disinfectants could make the HE symptoms ever more severe.The use of hand san-itizer/frequent hand washing with soap lye and prolonged glove-wearing were the leading causes of HE.The nurses were dominant among the health care workers with HE(P=0.003),and the proportion of those with allergic his-tory was even higher(P＜0.001).As for the health care workers who washed hands for surgeries,high volume of daily surgical procedures(OR=1.325,95％CI:1.121 to 1.567)and glove-wearing duration more than 120 min(OR=3.177,95％CI:1.087 to 9.281)were the risk factors for HE.As for the common hand-washing health care workers,daily hand washing more than 15 times(OR=3.199,95％CI:1.014 to 10.137),glove-wearing dura-tion more than 120 min(OR=2.216,95％CI:1.117 to 4.391)and use of powdered latex glove(OR=1.591,95％CI:1.058 to 2.390)were the risk factors for HE.CONCLUSION The prevalence rate of HE is high among the health care workers.It is necessary to attach great importance to the hand skin health of the health care work-ers and take comprehensive intervention measures for prevention of HE such as optimization of hand hygiene pro-cedure,enhancement of barrier protection and stress on occupational health education so as to achieve the dual goals of infection control and skin health.

Objective To investigate the mechanism by which blue light irradiation-activated microglia mediate immune cell recruitment and exacerbate retinal damage,and to explore the role of microglial depletion in inhibiting immune infiltration and protecting the retina.Methods SPF-grade C57BL/6J mice were randomly divided into control group,blue light irradiation group,and PLX5622 pretreatment blue light irradiation group.A retinal injury model was established by continuous LED blue light irradiation for 2 days.In the PLX5622 pretreatment group,microglia were specifically depleted before blue light irradiation.After modeling,HE staining and OCT examination were used to examine retinal histomorphological changes;ERG examination was performed to evaluate retinal function;DHE staining and RT-qPCR were used to detect oxidative stress and inflammatory responses,and Iba1,CD68,CD11b immunofluorescence staining and flow cytometry were used to analyze microglial activation status and immune cell infiltration.Results After blue light irradiation,the retinal outer nuclear layer thickness was significantly reduced;ERG a-wave and b-wave amplitudes decreased;expression of oxidative stress-related genes Nrf2,Sod2,and HO-1 was upregulated;expression of inflammatory factors IL-1β,TNF-α,and ICAM-1 increased;the number of Iba1-positive microglia increased and migrated extensively to the outer nuclear layer;the proportion of CD68+cells and CD11b+immune cells was elevated;and activated microglia aggregated around blood vessels to mediate immune cell infiltration.After PLX5622 pretreatment to deplete microglia,immune cell infiltration was significantly reduced;inflammatory responses were alleviated;retinal structural damage was markedly improved,and visual function was protected.Conclusions Blue light irradiation activates microglia and promotes their migration to the injury area.Activated microglia mediate immune cell recruitment and infiltration,exacerbating retinal inflammatory damage.Microglial depletion can effectively inhibit immune infiltration,rescue retinal structure and function,and provide new therapeutic strategies for the prevention and treatment of blue light-related ocular diseases.

Objective To analyze the active screening results on bacteria from neonates from different sources in the neonatal ward of a tertiary general hospital in Shanghai,provide a basis for the prevention and control of neo-natal infections.Methods The monitoring results of active screening on all neonates admitted to the neonatal ward of the hospital from 2017 to 2023 were collected retrospectively.Changes in bacterial detection among neonates ad-mitted from the obstetrics department and the community were compared and analyzed.Results From 2017 to 2023,a total of 4 265 neonates were admitted to the hospital,including 3 339 from department of obstetrics(obste-trics source group)and 926 from community(community source group).Active screening showed that 490 and 572 neonates were detected with bacteria,respectively.Bacterial detection rate of neonates in obstetrics source group was lower than community source group(14.68％vs 61.77％,P＜0.001);detection rates of bacteria from pha-rynx and umbilical site of neonates in community source group were both higher than obstetrics source group(both P＜0.001);detection rate of bacteria from neonates'umbilical site was higher than that from pharynx of both ob-stetrics source group and community source group(both P＜0.001).A total of 1 348 bacterial strains were detec-ted,detection rates of Escherichia coli,Staphylococcus epidermidis,Enterococcus faecalis,Streptococcus agalac-tiae,and Acinetobacter baumannii in the obstetrics source group were all higher than community source group(all P＜0.05),detection rates of Staphylococcus aureus and Enterobacter cloacae in the obstetrics source group were both lower than community source group(both P＜0.05).66 neonates were detected multidrug-resistant organism(MDRO),14 were from obstetrics source group and 52 from community source group,63 neonates were detected methicillin-resistant Staphylococcus aureus(MRSA).The detection rates of MDRO and MRSA from community source group were both higher than obstetrics source group(both P＜0.001);detection rate of MDRO from neo-nates'umbilical site was higher than that from the pharynx of the community source group(P＜0.001).Conclusion Bacteria detected in the obstetrics source group is mainly Escherichia coli,while that detected from community source group is mainly Staphylococcus aureus.MRSA is the main MDRO from neonates,and bacterial screening of neonates admitted from the community should be strengthened to prevent and control the spread of MDRO,espe-cially community-acquired MRSA in neonatal wards.

Objective:To investigate the effect of emergency whole course optimized management model based on first aid effect and blood gas index on the outcome and prognosis of patients with acute myocardial ischemia.Meth-ods:A total of 105 patients with acute myocardial ischemia admitted in People's Hospital of Hai'an City between May 2020 and January 2023 were enrolled in this randomized controlled study.Patients were divided into control group(n=53)and intervention group(n=52).Patients in the control group received routine emergency nursing mode,while those in the intervention group received whole course optimized management mode of emergency nurs-ing.Patients in both groups received a one-week nursing intervention.The indexes of emergency time,cardiac function,psychological condition,blood gas indexes and incidence of adverse events during nursing were compared between the two groups.Results:Compared to those in the control group,participants in the intervention group had significant lower triage assessment time[(0.59±0.22)min vs.(3.57±0.38)min,P＜0.001],time of the first ECG[(5.30±0.84)min vs.(9.58±1.02)min,P＜0.001],venous passage time[(6.22±1.27)min vs.(15.20±2.29)min,P＜0.001],anticoagulant administration time[(9.56±1.46)min vs.(16.23±2.17)min,P＜0.001],total emergency time[(52.50±2.99)min vs.(70.34±5.32)min,P＜0.001],significant higher partial pressure of oxygen in arterial blood(PaO2)[(78.24±3.25)mmHg vs.(70.20±3.02)mmHg,P＜0.001],and sig-nificant lower left ventricular end-diastolic diameter(LVEDd)[(52.27±4.37)mm vs.(57.86±5.59)mm,P＜0.001],left ventricular end-systolic diameter(LVESd)[(35.25±3.77)mm vs.(42.51±4.29)mm,P＜0.001],scores of self-rating anxiety scale(SAS)[(31.17±5.06)points vs.(48.62±5.60)points,P＜0.001],self-rating depression scale(SDS)[(32.19±4.78)points vs.(44.93±5.91)points,P＜0.001]and partial pres-sure of carbon dioxide in arterial blood(PaCO2)[(33.00±2.70)mmHg vs.(40.72±3.15)mmHg,P＜0.001].We detected lower adverse event occurrence(12.00％vs.28.00％)in the intervention group(P=0.046).Conclu-sion:The emergency whole course optimized management may reduce the time consuming of all aspects of emergen-cy,alleviate the anxiety and depression,improve blood gas indexes,and reduce the occurrence of adverse events in patients with acute myocardial ischemia.

The deep integration of Party building and professional work is crucial for promoting high-quality development in university-affiliated hospitals.To address the current insufficient integration of Party building and operational development in such hospitals,the Tuina Department of the Second Affiliated Hospital of Anhui University of Chinese Medicine has adopted the"Seven Ones"Party building brand as a carrier.Using Party building as a driving force and traditional Chinese medicine culture as the core,the department has actively implemented a series of innovative Party building initiatives.By deeply integrating Party build-ing with medical services,it explores pathways for the fusion of"Party building+professional work,"leveraging high-quality Party building to facilitate the high-quality development of the hospital and contribute to the realization of the Healthy China strategy.

Objective To investigate and compare the epidemiological characteristics of common respiratory viruses among influenza-like illness(ILI)and severe acute respiratory infection(SARI)cases in Huzhou,Zhejiang Province before and after the COVID-19 pandemic,so as to provide a basis for formulating and adjusting the prevention and control strategies for viral respiratory infectious diseases.Methods ILI and SARI cases at two influenza surveillance sentinel hospitals in Huzhou and had throat swab samples collected during Nov 2017 to Feb 2020(pre-COVID-19 pandemic period)and Dec 2022 to Apr 2024(post-COVID-19 mitigation phase)were selected as the participants.Seven common viral respiratory pathogens were tested,including influenza A virus(H1N1 and H3N2 subtypes),influenza B virus(Victoria lineage,FluB),respiratory syncytial virus(RSV),rhinovirus(HRV),adenovirus(ADV),and severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).The positive rates of respiratory pathogens before and after the COVID-19 pandemic were compared across different age groups and different time.Results A total of 7 948 ILI samples and 2 294 SARI samples were included.The overall positive rate of ILI samples increased from 33.6%to 47.1%,primarily due to the increase in influenza and COVID-19 infections;the overall positive rate of SARI samples decreased from 31.4%to 24.8%,mainly due to the reduction in HRV and ADV infections.During the post-COVID-19 mitigation phase,SARS-CoV-2(22.1%),H3N2(12.7%),and FluB(6.0%)were the primary pathogens in ILI samples,while RSV(7.1%),H3N2(5.3%),and HRV(4.5%)dominated in SARI samples.During the post-COVID-19 mitigation phase,the influenza virus circulation period was shortened.Before the COVID-19 pandemic,RSV was mainly detected in autumn and winter,while during the post-COVID-19 mitigation phase,out-of-season RSV epidemics were observed in spring and summer.Co-infection rate in ILI cases increased significantly in the post-COVID-19 mitigation phase,predominantly consisting of co-infections of COVID-19 and influenza A virus,while co-infection rate in SARI cases showed a decline.Conclusion We found important epidemiological changes in respiratory viruses in Huzhou during the post-COVID-19 mitigation phase compared to pre-COVID-19 period,including increased positive rates of influenza and COVID-19,and disruptions to the seasonal patterns of influenza and RSV.The prevention and control strategies should be adjusted in a timely manner based on the monitoring data.