Objective: To investigate the epidemiological characteristics and spatial-temporal clustering of varicella in Changchun City from 2020 to 2024, so as to provide the evidence for formulating local varicella prevention and control measures. Methods: The individual case data of varicella were collected through the Surveillance and Reporting Management System of the Chinese Disease Prevention and Control Information System in Changchun City from 2020 to 2024. Descriptive epidemiological methods were used to analyze the population ,regional, and temporal distribution. Spatial autocorrelation and spatio-temporal scanning analyses were used to identify the spatial-temporal clustering characteristics. Results: A total of 8 850 varicella cases were reported in Changchun City from 2020 to 2024, with an average annual incidence of 19.64/105. There were 4 929 male cases and 3 921 female cases, with a male-to-female ratio of 1.26∶1. The age was mainly 0-<20 years (6 649 cases, 75.13%), and students were the predominant occupation (6 036 cases, 68.20%). The top three counties (cities, districts) with the highest number of cases were Chaoyang District (1 944 cases), Gongzhuling City (1 054 cases) and Nanguan District (987 cases), accounting for 45.03%. The peak incidence periods were from April to June and from October to December, with 2 166 and 4 226 cases, accounting for 24.47% and 47.75%, respectively. Spatial autocorrelation analysis showed that spatial clustering existed from 2020 to 2024. The high-high clustering areas were mainly some townships (streets) in Chaoyang District, Nanguan District, Changchun New District and Jingyue District. Spatio-temporal scanning analysis identified 6 high-risk clustering areas. The class Ⅰ clustering area was Nanhu Street in Chaoyang District, with the clustering period from September 2020 to February 2022. Conclusions Varicella cases in Changchun City were mainly males and students aged 0-<20 years from 2020 to 2024. The peak incidence was mainly in winter. Chaoyang District was a high-risk area, with obvious spatial-temporal clustering.

Objective To investigate the correlation between spread through air space (STAS) of sub-centimeter non-small cell lung cancer and clinical characteristics and radiological features, constructing a nomogram risk prediction model for STAS to provide a reference for the preoperative planning of sub-centimeter non-small cell lung cancer patients. Methods The data of patients with sub-centimeter non-small cell lung cancer who underwent surgical treatment in Nanjing Drum Tower Hospital from January 2022 to October 2023 were retrospectively collected. According to the pathological diagnosis of whether the tumor was accompanied with STAS, they were divided into a STAS positive group and a STAS negative group. The clinical and radiological data of the two groups were collected for univariate logistic regression analysis, and the variables with statistical differences were included in the multivariate analysis. Finally, independent risk factors for STAS were screened out and a nomogram model was constructed. The sensitivity and specificity were calculated based on the Youden index, and area under the curve (AUC), calibration plots and decision curve analysis (DCA) were used to evaluate the performance of the model. Results A total of 112 patients were collected, which included 17 patients in the STAS positive group, consisting of 11 males and 6 females, with a mean age of (59.0±10.3) years. The STAS negative group included 95 patients, with 30 males and 65 females, and a mean age of (56.8±10.3) years. Univariate logistic regression analysis showed that male, anti-GAGE7 antibody positive, mean CT value and spiculation were associated with the occurrence of STAS (P＜0.05). Multivariate regression analysis showed that associations between STAS and male (OR=5.974, 95%CI 1.495 to 23.872), anti-GAGE7 antibody positive (OR=11.760, 95%CI 1.619 to 85.408) and mean CT value (OR=1.008, 95%CI 1.004 to 1.013) were still significant (P＜0.05), while the association between STAS and spiculation was not significant anymore (P=0.438). Based on the above three independent predictors, a nomogram model of STAS in sub-centimeter non-small cell lung cancer was constructed. The AUC value of the model was 0.890, the sensitivity was 76.5%, and the specificity was 91.6%. The calibration curve was well fitted, suggesting that the model had a good prediction efficiency for STAS. The DCA plot showed that the model had a good clinically utility. Conclusion Male, anti-GAGE7 antibody positive and mean CT value are independent predictors of STAS positivity of sub-centimeter non-small cell lung cancer, and the nomogram model established in this study has a good predictive value and provides reference for preoperative planning of patients.

Objective:To analyze the epidemiological and clinical characteristics of pertussis cases identified through active surveillance.Methods:Active surveillance for pertussis was conducted in three sentinel hospitals in Yiwu, Zhejiang Province, and Yongcheng, Henan Province. The study population included cases that met the surveillance case definition and sought medical care at outpatient/emergency departments or were hospitalized between June 1, 2021, and May 31, 2022. Samples were collected for bacterial culture and PCR detection. Case information and clinical data were collected. Differences in rates were assessed using the chi-square test or Fisher's exact probability test, and the differences in cough time were compared using the Mann-Whitney U test. Results:Among 1 423 cases of pertussis surveillance, the positive rate of pertussis was 28.11% (400/1 423), with a median age of 5 years (interquartile range: 2, 8). The positive rate in Yongcheng, Henan Province, and Yiwu, Zhejiang Province were 39.27% (216/550) and 21.08% (184/873), respectively; the positive rate of pertussis was highest in July 2021, and the highest positive rate of pertussis was among those aged 10-14. The positive rate of pertussis in hospitalized cases was higher than in outpatient/emergency cases (26.68%) ( χ2=4.16, P=0.041). Among the 400 laboratory test-positive cases, the highest proportion of atypical symptom cases was in adults aged 20-59 (43.33%, 13/30). The specificity rates of apnea and worsening nocturnal cough in monitored cases under 3 months of age were 100.00% and 73.81%, respectively. Among monitored cases aged 3 months to 9 years, the proportions of symptoms including worsening nighttime cough (63.00%) and night sweats (4.59%) in test-positive cases were significantly higher than those in the test-negative group (47.77% and 0.56%, respectively), with statistically significant differences (both P<0.05). The specificity rates of worsened nighttime coughing and night sweats were 52.23% and 99.44%, respectively. Conclusions:The active surveillance results for pertussis showed that the 10-14 age group exhibited the highest positivity rate. Active surveillance enhanced the detection rate of pertussis. Among laboratory-confirmed cases, the proportion of atypical symptoms was the highest in adults, suggesting that laboratory testing should be combined to diagnose programs of pertussis. For infants under 3 months, worsening nighttime cough and apnea increase the diagnostic specificity, while for individuals aged 3 to 9 years old, worsening nighttime cough and night sweats increase the diagnostic specificity.

Objective:To evaluate the intervention effectiveness of scenario simulation teaching based on the Eilks model on the social context integration ability, critical thinking, and humanistic care of resident physicians in the department of stomatology.Methods:A total of 94 resident physicians in the department of stomatology were included in the study, with 53 in the experimental group and 41 in the control group. The control group received traditional teaching, while the experimental group received scenario simulation teaching based on the Eilks model. Through the five-link design of "text analysis, scientific background, social context, viewpoint debate, and meta reflection", the integration of social science issues (such as ethical conflicts and economic costs) and clinical decision-making was strengthened. Trainees were evaluated for clinical decision-making ability, clinical reflection ability, and doctor-patient communication ability. The data were subjected to t-test and chi-square test using SPSS 24.0. Results:In terms of clinical decision-making ability, the experimental group outperformed the control group in ethical cost balance [(7.85±1.08) vs. (6.12±1.73), t=5.68, P<0.001], multidisciplinary collaboration [(8.25±0.73) vs. (5.83±0.82), t=6.01, P<0.001)], and complication planning [(7.98±1.02) vs. (5.34±1.42), t=6.79, P<0.001]. In terms of clinical reflection ability, the experimental group scored higher in depth of cost-benefit analysis, intensity of evidence-based reflection, and cognitive upgrading (all P<0.001). In terms of doctor-patient communication skills, the experimental group demonstrated superior performance compared to the control group in information collection [(10.25±1.28) vs. (7.53±1.33)] and emotional support [(10.97±1.18) vs. (6.53±1.23)]. Conclusions:Based on the Eilks model, scenario simulation teaching effectively enhances the ability of residents in the department of stomatology to integrate social factors, optimize ethical decision-making, and perform empathetic communication through social conflict simulation (such as three-way role debate) and dual path critical thinking training. In the future, further optimization is needed in terms of personalized expression and the timeliness of basic training.

Objective:To explore the current status and influencing factors of the core competencies of nursing interns based on a mixed-methods approach, with the goal of providing a reference for the reform of high-quality teaching models and the enhancement of nursing students' core competencies.Methods:An explanatory sequential research design of mixed-methods research was adopted. Using convenience sampling, 105 nursing interns who were on clinical practice at Beijing Tiantan Hospital, Capital Medical University, from July to August 2022, were selected as participants. A general information questionnaire and a core competency scale for nursing students were used for data collection, and multiple linear regression analysis was conducted to identify the factors influencing the core competencies. From September to October 2022, purposive sampling was used to select six nursing interns for semi-structured interviews. Thematic framework analysis was used to extract opinions, categorize inferences, and summarize themes.Results:The overall average score of the core competencies of the 105 nursing interns was (6.11±0.74). The highest mean score was for the "moral and responsibility" dimension, which was (6.36±0.93), while the lowest was for the "clinical biomedical science" dimension, with a mean score of (5.21±1.04). Parental recognition of the nursing profession was identified as a factor influencing the core competencies ( P<0.05). The qualitative interviews yielded three themes: the teaching ability of instructors directly impacts the enhancement of interns' core competencies; professional identity influences nursing interns' motivation to improve core competencies; clinical practice is an effective way to enhance the core competencies of nursing interns. Conclusions:In this study, the core competencies of nursing interns were found to be at a moderately high level, influenced by various factors. Insufficient teaching resources and clinical practice opportunities are objective factors affecting the development of core competencies. The ability of interns to gain recognition of the nursing profession through external or self-practice and gradually build professional confidence is an intrinsic motivation for the development of core competencies.

Objective:To analyze the epidemiological and clinical characteristics of pertussis cases identified through active surveillance.Methods:Active surveillance for pertussis was conducted in three sentinel hospitals in Yiwu, Zhejiang Province, and Yongcheng, Henan Province. The study population included cases that met the surveillance case definition and sought medical care at outpatient/emergency departments or were hospitalized between June 1, 2021, and May 31, 2022. Samples were collected for bacterial culture and PCR detection. Case information and clinical data were collected. Differences in rates were assessed using the chi-square test or Fisher's exact probability test, and the differences in cough time were compared using the Mann-Whitney U test. Results:Among 1 423 cases of pertussis surveillance, the positive rate of pertussis was 28.11% (400/1 423), with a median age of 5 years (interquartile range: 2, 8). The positive rate in Yongcheng, Henan Province, and Yiwu, Zhejiang Province were 39.27% (216/550) and 21.08% (184/873), respectively; the positive rate of pertussis was highest in July 2021, and the highest positive rate of pertussis was among those aged 10-14. The positive rate of pertussis in hospitalized cases was higher than in outpatient/emergency cases (26.68%) ( χ2=4.16, P=0.041). Among the 400 laboratory test-positive cases, the highest proportion of atypical symptom cases was in adults aged 20-59 (43.33%, 13/30). The specificity rates of apnea and worsening nocturnal cough in monitored cases under 3 months of age were 100.00% and 73.81%, respectively. Among monitored cases aged 3 months to 9 years, the proportions of symptoms including worsening nighttime cough (63.00%) and night sweats (4.59%) in test-positive cases were significantly higher than those in the test-negative group (47.77% and 0.56%, respectively), with statistically significant differences (both P<0.05). The specificity rates of worsened nighttime coughing and night sweats were 52.23% and 99.44%, respectively. Conclusions:The active surveillance results for pertussis showed that the 10-14 age group exhibited the highest positivity rate. Active surveillance enhanced the detection rate of pertussis. Among laboratory-confirmed cases, the proportion of atypical symptoms was the highest in adults, suggesting that laboratory testing should be combined to diagnose programs of pertussis. For infants under 3 months, worsening nighttime cough and apnea increase the diagnostic specificity, while for individuals aged 3 to 9 years old, worsening nighttime cough and night sweats increase the diagnostic specificity.

Objective:To evaluate the intervention effectiveness of scenario simulation teaching based on the Eilks model on the social context integration ability, critical thinking, and humanistic care of resident physicians in the department of stomatology.Methods:A total of 94 resident physicians in the department of stomatology were included in the study, with 53 in the experimental group and 41 in the control group. The control group received traditional teaching, while the experimental group received scenario simulation teaching based on the Eilks model. Through the five-link design of "text analysis, scientific background, social context, viewpoint debate, and meta reflection", the integration of social science issues (such as ethical conflicts and economic costs) and clinical decision-making was strengthened. Trainees were evaluated for clinical decision-making ability, clinical reflection ability, and doctor-patient communication ability. The data were subjected to t-test and chi-square test using SPSS 24.0. Results:In terms of clinical decision-making ability, the experimental group outperformed the control group in ethical cost balance [(7.85±1.08) vs. (6.12±1.73), t=5.68, P<0.001], multidisciplinary collaboration [(8.25±0.73) vs. (5.83±0.82), t=6.01, P<0.001)], and complication planning [(7.98±1.02) vs. (5.34±1.42), t=6.79, P<0.001]. In terms of clinical reflection ability, the experimental group scored higher in depth of cost-benefit analysis, intensity of evidence-based reflection, and cognitive upgrading (all P<0.001). In terms of doctor-patient communication skills, the experimental group demonstrated superior performance compared to the control group in information collection [(10.25±1.28) vs. (7.53±1.33)] and emotional support [(10.97±1.18) vs. (6.53±1.23)]. Conclusions:Based on the Eilks model, scenario simulation teaching effectively enhances the ability of residents in the department of stomatology to integrate social factors, optimize ethical decision-making, and perform empathetic communication through social conflict simulation (such as three-way role debate) and dual path critical thinking training. In the future, further optimization is needed in terms of personalized expression and the timeliness of basic training.

Objective:To explore the current status and influencing factors of the core competencies of nursing interns based on a mixed-methods approach, with the goal of providing a reference for the reform of high-quality teaching models and the enhancement of nursing students' core competencies.Methods:An explanatory sequential research design of mixed-methods research was adopted. Using convenience sampling, 105 nursing interns who were on clinical practice at Beijing Tiantan Hospital, Capital Medical University, from July to August 2022, were selected as participants. A general information questionnaire and a core competency scale for nursing students were used for data collection, and multiple linear regression analysis was conducted to identify the factors influencing the core competencies. From September to October 2022, purposive sampling was used to select six nursing interns for semi-structured interviews. Thematic framework analysis was used to extract opinions, categorize inferences, and summarize themes.Results:The overall average score of the core competencies of the 105 nursing interns was (6.11±0.74). The highest mean score was for the "moral and responsibility" dimension, which was (6.36±0.93), while the lowest was for the "clinical biomedical science" dimension, with a mean score of (5.21±1.04). Parental recognition of the nursing profession was identified as a factor influencing the core competencies ( P<0.05). The qualitative interviews yielded three themes: the teaching ability of instructors directly impacts the enhancement of interns' core competencies; professional identity influences nursing interns' motivation to improve core competencies; clinical practice is an effective way to enhance the core competencies of nursing interns. Conclusions:In this study, the core competencies of nursing interns were found to be at a moderately high level, influenced by various factors. Insufficient teaching resources and clinical practice opportunities are objective factors affecting the development of core competencies. The ability of interns to gain recognition of the nursing profession through external or self-practice and gradually build professional confidence is an intrinsic motivation for the development of core competencies.

Objective:To determine the erythromycin resistance of Bordetella pertussis isolates and their ptxP1 and ptxP3 phenotypic composition and compare clinical manifestations of children with pertussis caused by the two types of strains. Methods:This was a cross-sectional study, the pertussis cases diagnosed using bacterial culture from January 2019 to December 2022 in Beijing Children′s Hospital and the First People′s Hospital of Wuhu were collected.Any suspected Bordetella pertussis colonies were identified by the slide agglutination test.The susceptibility of isolates to erythromycin was detected by the E-test and K-B test.The ptxP gene was amplified by polymerase chain reaction and sequenced to determine its genotype. t-test, Mann-Whitney U-test, Chi-square test and Fisher′s exact test were use to statistical analysis. Results:A total of 192 strains of Bordetella pertussis were identified, including 188 (97.9%) erythromycin-resistant strains.Among the 188 strains, 30.3%(57/188) belonged to the ptxP1 genotype and 69.7%(131/188) belonged to the ptxP3 genotype.In children aged below 1 year old, the incidence of paroxysmal cough caused by infection with the ptxP3 strain was higher than that with the ptxP1 strain (57.1% vs.29.4%, P<0.05), and children infected with the ptxP3 strain were more likely to develop apnea or asphyxia (23.8% vs.17.6%), post-tussive vomiting (44.4% vs.32.4%), whooping cough (72.0% vs.50.0%) and pneumonia or bronchitis (85.7% vs.73.5%) compared to those infected with the ptxP1 strain, but the differences were not statistically significant(all P>0.05). In children aged 1 year old and above, the white blood cell count of children infected with the ptxP1 strain was higher than that of infections with the ptxP3 strain [13.5(9.9, 24.5)×10 9/L, 10.3 (7.0, 16.4)×10 9/L, P<0.05], and children infected with the ptxP1 strain were more likely to contract other pathogen infections than those infected with the ptxP3 strain (17.4% vs.4.4%, P>0.05). Conclusions:ptxP3 erythromycin-resistant Bordetella pertussis has become the main pathogen of pertussis.Infants with pertussis caused by the ptxP3 erythromycin-resistant strain show more significant manifestations and a higher possibility of severe symptoms than those infected with the ptxP1 erythromycin-resistant strain.

Objective To analyze the effect of neurofeedback training based on early start Denver model(ESDM)on children with autism spectrum disorder(ASD). Methods From August,2020 to May,2024,a total of 60 children with ASD from Hangzhou Children's Hospital were randomly divided into control group(n=30)and observation group(n=30).The control group received ESDM intervention,while the observation group received neurofeedback training in addition,for six months.They were assessed with Autism Treatment Evaluation Checklist(ATEC)and Psycho-Educational Profile-3rd Edition(PEP-3). Results After treatment,the score of ATEC was lower in the observation group than in the control group(t=3.545,P<0.05),the scores of cognition(t=2.236,P=0.029),emotional expression(t=2.293,P=0.025)and problem be-havior(Z=2.099,P=0.036)were higher in the observation group than in the control group.The score differenc-es of ATEC(Z=3.620,P<0.001),and cognition(Z=2.920,P<0.05)and problem behaviors(Z=4.209,P<0.05)of PEP-3 before and after intervention were higher in the observation group than in the control group. Conclusion Combination of neurofeedback training could improve the effect of ESDM on ASD.