BackgroundPostpartum depression （PPD） is a prevalent postpartum complications that significantly compromises women's psychological and physical well-being. Repetitive transcranial magnetic stimulation （rTMS）， a conventional neuromodulation technique， has been increasingly used in the treatment of PPD. However， high-quality evidence regarding its efficacy and safety remains limited. ObjectiveTo evaluate the efficacy and safety of rTMS in the treatment of PPD， thereby providing references for clinical treatment. MethodsDatabases including Cochrane Library， PubMed， Embase， CNKI， Wanfang， VIP and China Biology Medicine disc （CBM） were electronically searched for randomized controlled trials （RCTs） on rTMS for PPD， with the search spanning from database inception to February 8， 2025. Study quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions 5.0.1， and the certainty of evidence was graded according to the Grading of Recommendations Assessment， Development and Evaluation （GRADE） approach. Meta-analysis was conducted using RevMan 5.3 and Stata 12.0. The outcomes of the Meta-analysis included the total effective rate， Edinburgh Postnatal Depression Scale （EPDS） score， Hamilton Depression Rating Scale （HAMD） score， and adverse reactions （dizziness， headache， nausea， diarrhea， and the overall incidence of adverse reactions）. ResultsA total of 11 studies involving 729 patients with PPD were included. Meta-analysis results showed that the total effective rate in the study group was significantly higher than that in the control group （OR=5.54， 95% CI： 3.07–10.01， P<0.01）. Both EPDS score （SMD=-2.38， 95% CI： -3.39–-1.37， P<0.01） and HAMD score （SMD=2.53， 95% CI： 1.21–3.85， P<0.01） in the study group were significantly lower than those in the control group， with statistically significant differences. Comparisons between the study group and control group reveal no significant differences in the incidence of dizziness and headache （RR=1.47， 95% CI： 0.63–3.43， P>0.05）， nausea （RR=1.46， 95% CI： 0.55–3.86， P>0.05）， diarrhea （RR=0.71， 95% CI： 0.23–2.20， P>0.05）， and overall adverse reactions （RR=1.30， 95% CI： 0.79–2.15， P>0.05）. GRADE assessment rated the four indicators of dizziness and headache， diarrhea， overall incidence of adverse reactions， and EPDS score as "moderate-certainty evidence"， and rated the total effective rate， nausea， and the HAMD score as "low-certainty evidence". ConclusionrTMS demonstrates certain therapeutic efficacy for PPD， with a safety profile comparable to conventional treatment. ［Funded by Sichuan Psychological Society Research Planning Project （number， SCSXLXH202403099）； Guiding Science and Technology Plan Project of Guangyuan （number， 23ZDYF0095）］

Objective To construct a key nursing technology system for the treatment of patients exposed to nuclear radiation in hospitals,and provide technical guidance and support for emergency nursing rescue in hospitals of nuclear radiation accidents.Methods A research group was composed of a team with rich experience in nuclear radiation accidents.Based on 4 scenarios of nuclear radiation accidents(including external irradiation,internal irradiation,external contamination,internal contamination),the literature search was conducted to form the first draft of the system.Delphi method was used to complete 2 rounds of expert letter consultation,and the final draft of the key nursing technology system for hospital treatment of patients with nuclear radiation exposure was constructed according to the revised opinions of experts.Results A total of 16 experts completed 2 rounds of correspondence.The effective recovery rates were 100％and 80％;the recommendation rates were 65％and 50％;the authority coefficients(Cr)were 0.778 and 0.797;the coefficient of variation(CV)of the 2 rounds of expert letter consultation was ≤0.25.Finally,a key nursing technology system for in-hospital treatment of patients with nuclear radiation exposure was formed,including 5 first-level indicators,26 second-level indicators and 74 third-level indicators.Conclusion The constructed key nursing technology system for hospital treatment of patients with nuclear radiation exposure is highly practical and scientific,and it is conducive to the formation of standardized nuclear radiation exposure treatment procedures,and provides a theoretical basis for the training and evaluation of nursing staff related to nuclear radiation exposure.

Objectives The combined use of bedaquiline and delamanid(BDQ-DLM)is limited by an increased risk of prolonging the QTc interval.We retrospectively evaluated patients who received DLM/BDQ-containing regimens at a TB-specialized hospital.We aimed to present clinical efficacy and safety data for Chinese patients. Methods This case-control study included patients with multidrug-resistant tuberculosis(MDR-TB)treated with BDQ alone or BDQ plus DLM. Results A total of 96 patients were included in this analysis:64 in the BDQ group and 32 in the BDQ+DLM group.Among the 96 patients with positive sputum culture at the initiation of BDQ alone or BDQ combined with DLM,46 patients(71.9%)in the BDQ group and 29(90.6%)in the BDQ-DLM group achieved sputum culture conversion during treatment.The rate of sputum culture conversion did not differ between the two groups.The time to sputum culture conversion was significantly shorter in the BDQ-DLM group than in the BDQ group.The most frequent adverse event was QTc interval prolongation;however,the frequency of adverse events did not differ between the groups. Conclusion In conclusion,our results demonstrate that the combined use of BDQ and DLM is efficacious and tolerable in Chinese patients infected with MDR-TB.Patients in the BDQ-DLM group achieved sputum culture conversion sooner than those in the BDQ group.

Objective:To construct a structured education course for patients with neurogenic bladder during the rehabilitation period.Methods:This study consisted three stages of current situation survey, literature search, and expert consultation. From February 2022 to February 2023, a current survey was conducted on the self-management needs of 62 patients with neurogenic bladder. In April 2023, a literature search was conducted to summarize the best evidence on nursing and management of neurogenic bladder, and form the initial version of course indicators and content. From April to May 2023, 14 experts were selected for consultation, and the Delphi method was used to demonstrate the course indicators and content, and to construct the final draft of the course.Results:A total of 62 patients with neurogenic bladder were included, they have requirements for water management, bladder function training, and dietary requirements, etc. A total of 2 053 articles were retrieved, and 14 articles were ultimately included, including eight guidelines, four evidence summaries, one expert consensus, and one systematic review. The expert authority coefficients for the two rounds of expert consultation were 0.93 and 0.92, respectively. The Kendall coordination coefficient of various indicators in the second round of expert consultation was 0.227 to 0.288 ( P<0.01). After two rounds of expert consultation, a structured education course for patients with neurogenic bladder during the rehabilitation period was finally developed, including six primary indicators, 21 secondary indicators, and 30 tertiary indicators. Conclusions:The structured education course for patients with neurogenic bladder during the rehabilitation period, based on current situation survey, high-quality evidence, and expert consultation, is comprehensive in content and reasonably designed, which can provide supportive assistance for future nursing health education and management for patients with neurogenic bladder.

Objective:To establish a competency assessment system for nutritional support specialist nurses, so as to provide reference basis for training reform, functional performance, and improvement of nursing service quality for nutritional support specialist nurses.Methods:Based on the practice standards of nutrition support specialist nurses published by American Society for Parenteral and Enteral Nutrition, the draft of the competency assessment system for nutrition support specialist nurses was developed through literature search and group discussion. From November 2021 to February 2022, two rounds of expert letter consultation were conducted with 15 experts by Delphi method, indicators were screened and modified according to expert suggestions, and the final competency assessment system for nutrition support specialist nurses was formed.Results:The effective response rates of the two rounds of expert inquiry questionnaires were 93.3% (14/15) and 100.0% (15/15) , with expert authority coefficients of 0.922 and 0.917, respectively. In the first round of expert consultation, 50.0% (3/6) of the first-level indicators agreed with a percentage≥80.0%, and 64.9% (24/37) of the second-level indicators agreed with a percentage≥80.0%. In the second round of expert letter consultation, the agreement percentage of the first and second indicators were≥80.0%. The final competency assessment system for nutrition support specialist nurses included 6 first-level indicators (practical ability, communication and coordination ability, education and consultation ability, legal and ethical decision-making ability, scientific research ability, leadership) and 29 second-level indicators.Conclusions:The competency assessment system for nutritional support specialist nurses constructed in this study is scientific, reasonable, and highly reliable, which can be used to standardize the training process of nutritional support specialist nurses, promote personal development.

COVID-19 pandemic caused by SARS-CoV-2 infection severely threatens global health and economic development. No effective antiviral drug is currently available to treat COVID-19 and any other human coronavirus infections. We report herein that a macrolide antibiotic, carrimycin, potently inhibited the cytopathic effects (CPE) and reduced the levels of viral protein and RNA in multiple cell types infected by human coronavirus 229E, OC43, and SARS-CoV-2. Time-of-addition and pseudotype virus infection studies indicated that carrimycin inhibited one or multiple post-entry replication events of human coronavirus infection. In support of this notion, metabolic labelling studies showed that carrimycin significantly inhibited the synthesis of viral RNA. Our studies thus strongly suggest that carrimycin is an antiviral agent against a broad-spectrum of human coronaviruses and its therapeutic efficacy to COVID-19 is currently under clinical investigation.

Objective:To investigate the status of secondary victim effect of nurses in tertiary hospitals after adverse events and analyze its influencing factors.Methods:This study was a cross-sectional study. The convenient sampling method was used to select nurses from tertiary hospitals in Beijing, Shanxi and Shandong Province from October to December 2019 as the survey objects. The general information questionnaire and the Second Victim Experience and Support Tool (SVEST) were used to investigate them. Through single factor analysis of variance and multiple linear regression analysis, influencing factors of second victims of nurses were analyzed. A total of 2 163 online questionnaires were distributed and 2 040 were effectively recovered, with an effective recovery rate of 94.3%.Results:Among them, 813 nurses reported adverse event experiences, which were included in the study analysis. The total score of second victim effect of 813 nurses was (58.01±15.32) . Among the average scores of each dimension item, the score of "psychological distress" was the highest and the score of "management support" was the lowest, which were respectively (3.20±1.04) and (2.02±0.90) . The results of univariate analysis showed that there were statistically significant differences in the total scores of the second victim effect of nurses in different departments, marital status, professional title and employment nature ( P<0.05) . The results of multiple linear regression analysis showed that department, professional title and employment nature were the influencing factors of the second victim effect of nurses. The employment nature, marital status and departments had effects on the physiological distress of the second victim, and adverse event classification and departments had an effect on the psychological distress of second victims. Conclusions:The occurrence of adverse events has a moderate impact on the second victim of nurses in tertiary hospitals. Nurses are faced with more serious psychological distress, and the support they feel mainly depends on "management support", which is affected by many factors. Hospital administrators should take a positive view of the second victim effect, pay attention to the physical and mental health of nurses experiencing the role of second victim and provide effective support for different influencing factors.

Objective:To evaluate the effects of different sphere volumes, target background ratio (T/B) and post-processing correction techniques on the quantitative results of 99Tc m SPECT/CT. Methods:Six spheres with different diameters (37, 28, 22, 17, 13, 10 mm) in National Electrical Manufacturers Association International Electrotechnical Commission (NEMA IEC) models were filled with a mixture of 0.54 MBq/ml 99Tc m and iodixanol. The mixture iodine content was about 0.3%(135 mg), which led to different T/B (32∶1, 16∶1, 8∶1, 4∶1) by changing the radioactivity concentration of the cylinder. Routine imaging was performed on different T/B phantoms which were scanned by SPECT/CT. The CT threshold method was used for the delineation of volume of interest (VOI). Then the same processing correction technique and ordered-subsets expectation maximization (OSEM) parameters were used to calculate the radioactivity concentrations of different spheres, and further compared with the true values, and the accuracies were calculated. Pearson correlation analysis was applied to evaluate the relationships between sphere volume, T/B and quantitative results. The sphere with T/B of 32∶1 and diameter of 37 mm were processed by 3 correction techniques (CT attenuation correction (CTAC)+ scatter correction (SC)+ resolution recovery (RR); CTAC+ SC; CTAC+ RR). One-way analysis of variance and the least significant difference t test were used to analyzed the effects of 3 correction techniques on the quantitative results and image contrasts. Results:There were significant relationships between the sphere volumes, T/B and the quantitative accuracy ( r values: 0.757, 0.409, both P<0.05). There were significant differences of 3 correction techniques on the quantitative results and image contrast ( F values: 139.665 and 38.905, both P<0.001). Among them, the quantitative error of CTAC+ SC+ RR was lower than that of CTAC+ SC ((9.63±8.82)% vs (38.89±2.17)%; P<0.001), and similar to that of CTAC+ RR ((8.70±6.64)%; P>0.05). The quantitative error of CTAC+ RR was lower than that of CTAC+ SC ( P<0.001). The image contrast of CTAC+ SC+ RR was higher than that of CTAC+ SC ((93.45±0.91)% vs (92.41±0.25)%; P<0.001) and the image contrast of CTAC+ SC was higher than that of CTAC+ RR ((91.37±0.87)%; P<0.001). Conclusions:The larger sphere volume and the higher T/B, the more quantitative accuracy. The volume has a more significant effect on quantitative accuracy than T/B. Choosing the appropriate correction technique is helpful to quantitative accuracy improvement. It is suggested to use CTAC+ SC+ RR in quantitative processing.

Objective:To construct the teaching quality evaluation index system for clinical teachers of undergraduate nursing students based on teaching managers' perspective so as to provide a basis for clinical teaching management of undergraduate nursing students.Methods:From May 2018 to September 2019, the expert enquiry questionnaire on the teaching quality evaluation index system for clinical teachers of undergraduate nursing students based on teaching managers' perspective was developed by the literature review and expert interview. Delphi technique was used to select 20 nursing teaching management experts, 16 of them from 4 ClassⅢ Grade A teaching hospitals in Beijing, 4 of them from a nursing undergraduate university to carry out two rounds of expert enquiry.Results:The initial construction of the teaching quality evaluation index system for clinical teachers of undergraduate nursing students based on teaching managers' perspective included 5 first-level indexes and 30 second-level indexes. The valid recovery rates, expert authoritative coefficients, Kendall coordination coefficients of two rounds of expert enquiry questionnaire were 100%, 0.83 and 0.86, 0.395 and 0.554 respectively ( P<0.01) with the satisfied consistency test results and credible enquiry results. Conclusions:The construction of the teaching quality evaluation index system for clinical teachers of undergraduate nursing students based on teaching managers' perspective is scientifically rigorous. The system has definite evaluation indexes, rational administrative levels, objective and reliable system which could provide a basis for clinical teaching management of undergraduate nursing students.

Objective:To explore the status quo of nurse-patient communication ability in undergraduate nursing students in the early stage of clinical practice and its influencing factors, and provide a basis for clinical nursing education managers to formulate a training plan for communication skills of undergraduate nursing students in the clinical practice stage.Methods:From August to September 2019, totally 960 undergraduate nursing students engaging in clinical nursing practice for≤3 months were investigated. The survey content included demographic data, training content of nurse-patient communication ability, and clinical communication ability of nursing students. The status quo and influencing factors of communication ability of undergraduate nursing students in the early stage of clinical practice were analyzed.Results:The nurse-patient communication ability score of 960 undergraduate nursing students in the early stage of clinical practice was (2.18±0.21) , with the highest score in the dimension of acute listening (2.42±0.51) and the lowest score in the dimension of verification feeling (1.88±0.51) . Univariate analysis showed that there were statistically significant differences in the nurse-patient communication ability in the early stage of clinical practice between undergraduate nursing students with different gender, with or without training for nurse-patient communication in the early stage of clinical practice in the hospital and with different training forms ( P<0.05) . Pearson correlation analysis revealed that the nurse-patient communication ability score of undergraduate nursing students in the early stage of clinical practice was positively correlated with the number of nurse-patient communication training sessions in the hospital ( r=0.456, P<0.01) . According to multiple linear regression analysis, the number of training sessions and training forms in the hospital were main influencing factors to the nurse-patient communication ability of undergraduate nursing students in the early stage of clinical practice ( P<0.05) . Conclusions:The level of nurse-patient communication ability in undergraduate nursing students in the early stage of clinical practice is low and needs to be further improved. Clinical nursing teaching managers should formulate effective training programs based on its influencing factors to strengthen training accordingly.