Objective:To search, evaluate and integrate the best evidence of the best evidence for emergency service surge capacity.Methods:According to the "6S" model of evidence resources, the related evidence on emergency service surge capacity in Guidelines International Network, National Guideline Clearinghouse, Canadian Medical Association CPG Infobase, Scottish Intercollegiate Guidelines Network, European Society for Emergency Medicine, the American College of Emergency Physicians, Emergency Nurses Association, Cochrane Library, PubMed, Embase, CINAHL, Web of Science, BMJ Best Practice, UpToDate,CKNI, Wanfang, and VIP database were searched by computer. The retrieval time limit was from the establishment of the database to Dec 31, 2023. Literature quality assessment and data extraction were performed by 2 researchers.Results:A total of 11 articles were included in this study, including 1 guideline, 7 expert consensuses and 3 systematic reviews, which summarized 43 pieces of evidence involving 7 categories, namely core elements, organizational management, space management, personnel allocation, material allocation, education and training, and support services.Conclusions:The best evidence summarized in this study can provide a reference for emergency service to improve surge capacity. In clinical application, emergency departments should focus on organizational, space, personnel and materials management, combined with the type of emergency events, to maximize their routine, emergency and crisis response capabilities, so as to respond to medical surges effectively.

Social anxiety disorder has a significant negative impact on individuals'social interaction and normal life,and childhood trauma plays an important role in the occurrence and development of SAD.Childhood trauma affects the development of self-awareness,impairs the ability of information processing,hinders the normal development of prefrontal cortex-limbic system loop and default mode network,and causes abnormal secretion of glucocorticoid and oxytocin,which leads to individuals'inability to correctly understand social clues and reasonably regulate emotions,and thus unable to produce adaptive emotional and behavioral responses in social situations,which may lead to SAD.In conclusion,childhood trauma has a lasting adverse effect on social function from both psychological and physiological aspects.

Objective:To investigate the differences in personality characteristics and cognitive functions in depression patients with and without obsessive-compulsive.Methods:From October 2020 to October 2021, 31 patients diagnosed as major depressive disorder(MDD) with obsessive-compulsive symptoms(OCS), totally 29 patients diagnosed as MDD without OCS, and 30 healthy controls(HC group) were recruited.The personality characteristics of all subjects were assessed with Eysenck personality questionnaire(EPQ), personality diagnostic questionnaire-4(PDQ-4) and Minnesota multiphasic personality inventory(MMPI), while cognitive functions were assessed with measurement and treatment research to improve cognition in schizophrenia(MATRICS)consensus cognitive battery(MCCB). SPSS 25.0 software was used for data processing, and univariate analysis of variance and simple effect analysis were used to compare the differences in personality characteristics and cognitive functions among the three groups of subjects.Results:The comparison of EPQ scores showed that the psychoticism scores of the group with and without OCS((50.32±10.08), (49.83±11.69)) were significantly lower than that of the HC group(59.47±10.41)( P=0.004, 0.003), while the neuroticism scores((61.94±12.36), (63.10±10.56)) were significantly higher than that of the HC group(46.13±8.33)(both P<0.05). The comparison of PDQ-4 scores showed that the schizoid score of the group with OCS(5.00(2.00, 7.00)) was significantly higher than that of the group without OCS(3.00(1.00, 5.00))( P=0.024). The comparison of MMPI scores showed that except for the two dimensions of masculinity-femininity and hypomania, the scores of the other eight dimensions in the group with and without OCS were significantly higher than those in the HC group(all P<0.01). The comparison of MCCB scores showed that the attention/alertness and visual learning scores of the group with OCS were significantly lower than those of the HC group( P=0.042, 0.004), meanwhile there was no difference of the all dimension scores of MCCB between the MDD patients with and without OCS. Conclusion:There are differences in personality and cognitive function between MDD patients with and without OCS and healthy controls.There is no difference in score of schizotypal personality traits between MDD patients with OCS and MDD patients without OCS, however the related cognitive function of MDD patients without OCS is not significantly different from that of MDD patients with OCS.It is suggested that MDD patients with OCS may have more deviated personality characteristics than those without OCS.Further research is needed to investigated the differences in cognitive impairment.

Objective:To understand the cognition and attitudes of Emergency Department nurses towards palliative care, and to explore the factors that hinder or promote the development of palliative care in the Emergency Department, so as to provide basic data for emergency palliative care.Methods:From March to June 2021, semi-structured interviews were conducted with 11 nurses in the Emergency Department of Peking Union Medical College Hospital using the purposeful sampling. The interview data were organized and analyzed using Colaizzi's 7-step analysis method.Results:A total of three themes were induced. The themes were that Emergency Department patients and their families were often caught in decision-making dilemmas, and Emergency Department nurses had a high degree of acceptance of palliative care, but there were barriers to implementation in the Emergency Department, and the implementation methods of emergency palliative care needed to be further explored, and Emergency Department nurses were willing to participate in palliative care training.Conclusions:Emergency palliative care needs to consider the characteristics of the Emergency Department work environment and explore appropriate implementation methods. Training related to palliative care can be increased, the palliative care literacy of Emergency Department nurses can be improved, so as to provide effective support for life-limited patients and their families.

Objective:To understand the cognition and attitudes of Emergency Department nurses towards palliative care, and to explore the factors that hinder or promote the development of palliative care in the Emergency Department, so as to provide basic data for emergency palliative care.Methods:From March to June 2021, semi-structured interviews were conducted with 11 nurses in the Emergency Department of Peking Union Medical College Hospital using the purposeful sampling. The interview data were organized and analyzed using Colaizzi's 7-step analysis method.Results:A total of three themes were induced. The themes were that Emergency Department patients and their families were often caught in decision-making dilemmas, and Emergency Department nurses had a high degree of acceptance of palliative care, but there were barriers to implementation in the Emergency Department, and the implementation methods of emergency palliative care needed to be further explored, and Emergency Department nurses were willing to participate in palliative care training.Conclusions:Emergency palliative care needs to consider the characteristics of the Emergency Department work environment and explore appropriate implementation methods. Training related to palliative care can be increased, the palliative care literacy of Emergency Department nurses can be improved, so as to provide effective support for life-limited patients and their families.

Objective:To prospectively explore the associations between total and different types of physical activities and gestational diabetes mellitus (GDM) in the first trimester of pregnant women, in Beijing.Methods:Data of 909 participants from the Chinese Pregnant Women Cohort study were extracted and studied. Four types of physical activities, including household/care-giving, occupational, sports/exercise and outdoor ways of transportation (walking/cycling/E-biking) in early pregnancy were studied by using the pregnancy physical activity questionnaire (PPAQ). All the participants were followed up and related data on GDM collected. Logistic regressions were conducted for data analysis on the associations of interests.Results:A total of 206 pregnant women (22.7 %) were diagnosed with GDM. After adjusting for age, pre-pregnancy BMI, family history of diabetes and other types of physical activities, results from the logistic regression showed that women with moderate level of household/care-giving activities were with the lower odds on GDM ( OR=0.654, 95 %CI: 0.436-0.980). Women who had met the guideline of exercise were less likely to have GDM ( OR=0.518, 95 %CI: 0.287-0.934). There was no significant association appeared between total physical, occupational and outdoor ways of transportation (walking/cycling/E-biking) activities with GDM. Conclusions:Sports/exercise and household/care-giving activities in early pregnancy appeared important on GDM prevention. Pregnant women are encouraged to wisely arranging their sports/exercise activities and engaging in moderate household/care-giving activities in the first trimester of pregnancy, to prevent GDM.

Objective? To explore the effects of systematic desensitization therapy on training for newly admitted emergency nurses. Methods? Totally 60 newly admitted nurses working in the Emergency Department, Peking Union Medical College Hospital between July 2014 and July 2017 were selected using convenient sampling and divided into the observation group (n=30) and the control group (n=30) according to the random number table. Patients in the control group received conventional training for newly admitted nurses, while patients in the observation group received systematic desensitization therapy. Self-Anxiety Scale (SAS), New Emergency Nurse Core Competency Questionnaire (NENCCQ) and New Emergency Nurse Teaching Satisfaction Questionnaire (NENTSQ) were used to evaluate the effects of intervention. Results? The SAS scores of the observation group were lower than those of the control group (P＜ 0.05); the total score and scores of various dimensions of NENCCQ of the observation group were higher than those of the control group (P＜ 0.05); and the satisfaction of the observation group was higher than that of the control group (P＜0.05). Conclusions? Systematic desensitization therapy in the training for newly admitted emergency nurses can effectively mitigate the anxiety in newly admitted emergency nurses and improve their core competency and satisfaction.

Objective? To investigate the current status and influencing factors on career decision-making self-efficacy among near-employment internship nursing students. Methods? By convenience sampling, the near-employment internship nursing students who voluntarily participant in this research were selected from April to May of 2018 from a ClassⅢ Grade A hospital in Beijing. The Career Decision-Making Self-Efficacy Scale (CDMSE) was used in the study to investigate the participants. A total of 178 questionnaires were distributed with 170 valid ones retrieved. Results? The total score of CDMSE of 170 near employment internship nursing students was (137.62±2.240). The linear-regression analysis showed that gender and satisfaction on hospitals were the influencing factors of their career decision-making self-efficacy. Conclusions? The career decision-making self-efficacy of internship nursing students is at an intermediate level. Hospitals and schools can develop individualized training methods for them in order to improve their career decision-making self-efficacy.

Objective: To evaluate the visual outcomes of patients with visual impairment after resecting skull base tumor via an endoscopic endonasal approach, and to analyze the factors affecting visual recovery. Methods: One hundred and fifty-three patients with skull base tumor who suffered from preoperative visual impairment from Skull Base Surgery Center of Xuanwu Hospital were operated through an endoscopic endonasal approach. Both preoperative and postoperative visual function outcomes as well as factors that might have affected their visual recovery were analyzed retrospectively by Chi square test and Logistic regression analysis. Results: Complete resection was achieved in 85.6% of the patients using this technique. The rate of postoperative visual recovery in the female group (86.1%) was higher than that in the male group (73.9%), the benign group (90.2%) higher than the malignant group (20.0%), the group without optic atrophy (97.1%) higher than the one with (51.2%), and the acute group (96.6%) higher than the chronic group (80.0%). Significant differences were found between the abovementioned groups (χ² value was 5.849, 87.860, 79.757, 4.745, respectively, all P<0.05). The degree of optic atrophy and the property of tumors were significantly associated with visual improvement after treatment (Wold χ² value was 18.597 and 35.623, all P<0.001). Conclusions Our results indicate that endoscopic endonasal surgery shows its ability both to resect skull base tumors and to improve visual function in the majority of patients. The timing of treatment for patients suffered from preoperative visual impairment should be selected in early stage before optic atrophy occurs.

OBJECTIVETo identify a rare subtype of the ABO blood group system and explore its molecular basis.

METHODSBased on a standard serological assay, ABO subtype and haplotype were analyzed through PCR amplification of the 7 exons and adjacent introns of the ABO gene and TA clone sequencing.

RESULTSForward typing showed a B type, while reverse typing demonstrated an extremely weak anti-B on routine gel analysis, which indicated a forward and reverse typing discrepancy. Absorption-elution testing confirmed that there was no A antigen on the surface of patient's red blood cells. Sequencing of the ABO gene showed a G>A exchange at position 523 in exon 7, which resulted in a Val to Met substitution at codon 175. Clone sequencing of the amplificons of the ABO gene showed an ABO* Bw14/O01 heterozygote genotype.

CONCLUSIONMolecular method is useful for the identification of ambiguous blood groups. A 523G>A substitution of the ABO gene resulting in a Bw14 subtype probably underlies the weak B phenotype noted in the patient.