Objective To investigate the distribution of Streptococcus,sensitivity to commonly used antibiotics,and prognosis of the patients with bloodstream infections,and provide evidence for early diagnosis and selection of antibiotics.Methods The Streptococci i-solated from the blood samples of the First Affiliated Hospital of Nanjing Medical University from 2017 to 2022 were collected and di-vided into α-and β-hemolytic Streptococci according to the type of hemolysis.Their sensitivity to commonly used antibiotics was ana-lyzed.The differences in clinical data and prognosis between the two groups were also compared.Results A total of 314 strains of Streptococcus were isolated from 305 patients,including 270 strains of α-hemolytic Streptococcus and 44 β-hemolytic Streptococcus.The results of the drug sensitivity test showed that the proportion of Streptococcus strains with a diameter of 17-19 mm in the inhibition zone of vancomycin increased year by year.The positive alarm time of blood culture for β-hemolytic Streptococcus was significantly shorter than that for α-hemolytic Streptococcus(P＜0.001).Using 10.5 hours as the diagnostic threshold could assist in distinguishing blood-stream infections caused by α-and β-hemolytic Streptococcus.The overall mortality rate of patients with streptococcal bloodstream infec-tion was 15.1％,and there was no statistically significant difference in the mortality rate between the two groups(P=0.813).Conclu-sion The main Streptococcus causing bloodstream infections in our hospital is α-hemolytic Streptococcus.There are differences in the antimicrobial sensitivity and clinical characteristics among patients with different streptococcal bloodstream infections.The positive a-larm time of blood culture can assist in distinguishing the type of streptococcal bloodstream infections.In addition,the diameter of the inhibition zone of vancomycin against Streptococcus has drifted towards the breakpoint of drug resistance.

Objective To investigate the distribution of Streptococcus,sensitivity to commonly used antibiotics,and prognosis of the patients with bloodstream infections,and provide evidence for early diagnosis and selection of antibiotics.Methods The Streptococci i-solated from the blood samples of the First Affiliated Hospital of Nanjing Medical University from 2017 to 2022 were collected and di-vided into α-and β-hemolytic Streptococci according to the type of hemolysis.Their sensitivity to commonly used antibiotics was ana-lyzed.The differences in clinical data and prognosis between the two groups were also compared.Results A total of 314 strains of Streptococcus were isolated from 305 patients,including 270 strains of α-hemolytic Streptococcus and 44 β-hemolytic Streptococcus.The results of the drug sensitivity test showed that the proportion of Streptococcus strains with a diameter of 17-19 mm in the inhibition zone of vancomycin increased year by year.The positive alarm time of blood culture for β-hemolytic Streptococcus was significantly shorter than that for α-hemolytic Streptococcus(P＜0.001).Using 10.5 hours as the diagnostic threshold could assist in distinguishing blood-stream infections caused by α-and β-hemolytic Streptococcus.The overall mortality rate of patients with streptococcal bloodstream infec-tion was 15.1％,and there was no statistically significant difference in the mortality rate between the two groups(P=0.813).Conclu-sion The main Streptococcus causing bloodstream infections in our hospital is α-hemolytic Streptococcus.There are differences in the antimicrobial sensitivity and clinical characteristics among patients with different streptococcal bloodstream infections.The positive a-larm time of blood culture can assist in distinguishing the type of streptococcal bloodstream infections.In addition,the diameter of the inhibition zone of vancomycin against Streptococcus has drifted towards the breakpoint of drug resistance.

The meridian theory is the pioneer of clinical diagnosis and treatment of diseases in Traditional Chinese Medicine (TCM). From Shang Han Lun to Pi Wei Lun, the meridian theory has contributed important theoretical organization materials and clinical practice experience to the establishment of the diagnosis system of external and internal injuries. The acupoints contained in its clinical acupuncture and moxibustion record symptoms, and some laws summarized have been absorbed and used for reference. It shows the positive significance of its exploration in clinical diagnosis and treatment. A system of differentiation and treatment of external and internal injuries with acupuncture has not been formed, even though the meridian theory of TCM has a long history with many areas being explored, such as diseases, acupoints, acupuncture methods and stimulation amount. Therefore, this paper starts from the academic development history of meridians, reviews and analyzes the contribution and limitations of TCM acupuncture and moxibustion in the diagnosis and treatment of internal injury, in order to enlighten the current study and understanding of TCM.

Objective:To investigate the current status of emotional intelligence of standardized training nurses and explore the influencing factors.Methods:A total of 312 standardized training nurses from the Fifth Affiliated Hospital of Sun Yat-sen University and the First Affiliated Hospital of Nanchang University were investigated from May to June 2020 with general information questionnaire and Nurses′ Emotional Intelligence Scale, and analyze the influencing factors of nurses′ emotional intelligence during the standar dized training period.Results:The total score of standardized training nurses′ emotional intelligence was (59.01 ± 8.24), the scoring rate was 73.76%, and the total average score of items was (3.69 ± 0.52). The average scores of the four dimensions from low to high were: self emotion assessment (3.86 ± 0.66), self emotion management (3.67 ± 0.71), self emotion application (3.64 ± 0.67) and emotion assessment of others (3.58 ± 0.65). Multiple linear regression analysis showed that political outlook, whether it was an only child, and training time and willingness to engage in nursing work for a long time were the main influencing factors of standardized training nurses′ emotional intelligence, accounting for 32.6% of the variance.Conclusions:The emotional intelligence of standardized training nurses is at the medium level, which needs to be further improved. Hospital managers need to carry out positive intervention combined with relevant influencing factors to cultivate more excellent nursing talents for clinical practice.

Objective:To investigate the current status of emotional labor of nurses in standardized training period, and to analyze the relationship between emotional labor and emotional intelligence.Methods:From May to June 2020, 312 nurses in the standardized training period were selected as the research objects, which were investigated with general information questionnaire, Emotional Labor Scale and Emotional Intelligence Scale.Results:The total score of standardized training nurses' emotional labor was (52.27±10.18) points, and the total average score of items was (3.73±0.73) points. The average scores of the three dimensions from high to low: deep acting (4.62±0.86) points, expression of genuine emotion (3.62±0.99) points and surface acting (3.42±0.95) points. There was a correlation between emotional intelligence and emotional labor. Multiple linear regression analysis showed that the emotional evaluation of others ( β value was -0.189, P<0.05) ( β value was -0.255, P<0.01). Self emotional assessment ( β value was 0.297, P<0.01) ( β value was 0.177, P<0.05). Self emotional assessment ( β value was 0.269, P<0.05), which had a positive predictive effect on emotional expression requirements. Conclusions:The emotional labor of nurses in standardized training period is at the medium level, and the deep acting score is the highest between three dimensions. Hospital managers could promote nurses to use appropriate emotional labor strategies by strengthening the cultivation of emotional intelligence during standardized training period.

Objective:To explore the mediating role of occupational benefit in the emotional intelligence and emotional labor of nurses during the standardized training period, so as to provide references for enhancing the professional adaptation potential of nurses during the standardized training period.Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 318 standardized training nurses from the Fifth Affiliated Hospital of Sun Yat-sen University and the First Affiliated Hospital of Nanchang University were selected as research objects from May to June 2020. They were investigated by general data questionnaire, Emotional Intelligence Scale, Occupational Benefit Scale and Emotional Labor Scale. Structural equation model (SEM) was used to explore the mediating effect of occupational benefit on emotional intelligence and emotional labor.Results:A total of 318 questionnaires were collected in this study, among which 312 were valid. The mean scores of items of emotional intelligence and occupational benefits of 312 nurses were (3.69±0.52) and (3.97±0.54) , respectively. The average scores of the three dimensions of emotional labor were surface acting (3.42±0.95) , emotional expression requirements (3.62±0.99) and deep acting (4.62±0.86) . There were correlations between emotional intelligence, occupational benefit and emotional labor (all P<0.05) . The structural equation model showed that the emotional intelligence and occupational benefit of nurses in the standardized training period had direct predictive effects on emotional labor, and emotional intelligence also indirectly affected emotional labor with occupational benefit as an intermediary variable. The structural equation fitting index χ 2/ df was 1.731, the goodness of fit index was 0.949, the adjusted goodness of fit index was 0.912 and the root mean square error of approximation was 0.058. Conclusions:Occupational benefit has a partial mediating effect between the emotional intelligence and emotional labor of nurses during the standardized training period. Nursing managers can take effective measures to improve the emotional intelligence level of nurses during the standardized training period, enhance the sense of occupational benefit and optimize their emotional labor performance from individual factors.

Objective? To explore the risk factors of incontinence-associated dermatitis(IAD) in intensive care uni(t ICU) patients, so as to provide evidence for early clinical prevention of IAD. Methods? The relevant literature about IAD in ICU patients were retrieved from multiple electronic databases including Cochrane library, PubMed, Ovid Medline, Web of Science, CBM, CNKI, Wanfang Data and VIP from buiding database to November 2018. The Meta-analysis was performed after searching databases, extracting data and assessing quality of included studies using the software of RevMan 5.3. Results? Finally, 14 articles were included with totally 691 case groups, and 1 377 cases in the control group with 2 068 subjects, the incidence of IAD was 20.00%-50.00%. The results of Meta-analysis indicated that feve[r OR=1.79, 95%CI (1.43-2.26), P＜0.05], diabetes[OR=2.73, 95%C(I 1.77-4.21), P＜0.05], the use of antibiotics[OR=2.45, 95%C(I 1.71-3.53), P＜ 0.05], level of albumin[OR=-3.81, 95%C(I -4.61- -3.00), P＜ 0.05], Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ) score[OR=1.70, 95%C(I 0.06-3.33), P＜0.05], fecal incontinence[OR=1.80, 95%C(I 1.07-3.03), P＜ 0.05], incontinence frequency (＞ 3 times/day) [OR=1.86, 95%CI(1.56-2.22), P＜ 0.05]and watery stoo[l OR=2.22, 95%CI(1.81-2.73), P＜0.05]significantly associated with the onset of IAD. Through the sensitivity analysis of the combined effect of the fixed effect model and the random effect model, it was found that the combined effect values were close, indicating that the analysis results were robust and credible. Conclusions? According to the present evidence, the risk factors of IAD in ICU patients are fever, diabetes, antibiotics, low albumin level, high APACHE score, fecal incontinence, incontinence frequency (＞ 3 times/day) and watery stool. Medical staff should pay attention to these risk factors in clinical practice, and actively implement targeted preventive measures to reduce the incidence of IAD in ICU patients and improve the quality of nursing practice.

Objective To compare the effects of gastric residual volume (GRV) set at different thresholds on intensive care patients receiving enteral nutrition (EN),so as to inform clinical practice.Methods Controlled clinical trials involving different GRV thresholds in ICU patients undergoing EN were retrieved from multiple electronic databases (including Cochrane Library,PubMed,Ovid Medline,Web of Science,CBM,CNKI,Wanfang Data,and VIP).Quality of the retrieved studies was evaluated for data extraction,and meta-analysis was performed.Results Four randomized controlled trials and one clinically controlled trial were included in the study,with a total of 658 subjects.Results of the meta-analysis suggested no statistically significant difference between the group with GRV threshold≥250 ml and the one with GRV threshold＜250 ml in the rates of pneumonia (OR =1.19,95％ CI =0.77-1.82,P =0.43),aspiration.(OR =1.59,95％ CI =0.42-6.03,P=0.50),vomiting (OR=1.35,95％ CI=0.48-3.80,P=0.57),reflux (OR=1.29,95％ CI=0.58-2.88,P=0.53),and diarrhea (OR=1.36,95％ CI=0.87-2.13,P=0.17).Nutrient intake and several other outcome measures were unable to be included in the meta-analysis for either the scarcity of studies or inconsistency in the measures adopted,and descriptive analysis was therefore employed instead.Conclusion There was no significant difference between the two groups in terms of complications,but the group with GRV threshold≥250 ml had higher intake of EN.