Objective: To delineate the epidemiologic profile of rifampicin resistant pulmonary tuberculosis (RR-PTB) among students in Chongqing, so as to provide evidence for effectively controlling RR-PTB outbreaks in schools. Methods: Individual level surveillance records of 395 student RR-PTB cases reported from 2015 to 2024 were extracted from the China Information System for Disease Control and Prevention. The Joinpoint regression analysis was employed to quantify temporal trends in the registration rate of student RR-PTB cases, and the comparison of RR-PTB registration rates with different demographic characteristics and different regions was performed using Chi-square test. Results: From 2015 to 2024, a total of 395 student RR-PTB cases were identified, with the registration rate ranged from 0.07 per 100 000 to 1.47 per 100 000, showed a fluctuating upward trend ( AAPC= 35.22%, t =4.13, P <0.01). A turning point was detected in 2017, rates rose during 2015-2017 (APC=295.23%， t =4.62， P < 0.01 ) and plateaued thereafter (APC=-0.47%， t =-0.12， P =0.91). The proportion of RR-PTB cases occurring among students increased both among all RR-PTB cases (1.54% in 2015, 7.48% in 2024) and all student pulmonary tuberculosis cases (0.20% in 2015, 7.17% in 2024), with significant linear trends ( χ 2 trend =33.55,159.98, both P <0.01). The majority of cases were enrolled in senior high school (50.38%), classified as retreatment (53.92%), of Han ethnicity (75.95%), and diagnosed with multidrug resistant tuberculosis(53.16%). There were significant differences in the composition of different ethnicity, registration category and resistance pattern between different years( χ 2=23.47, 17.23, 59.64，all P <0.05). The South-Eastern Wuling Mountainous Region exhibited the highest notification rate (3.96 per 100 000), whereas the western region had the lowest rate ( 0.47 per 100 000). County level jurisdictions reported higher rates than district level ones (2.16 per 100 000 vs 0.63 per 100 000 ). Statistically significant differences were observed in the RR-PTB reported rates among students across different districts and counties( χ 2=418.05,167.05,both P <0.01). Conclusions From 2015 to 2024, the registration rate of detected student RR-PTB cases in Chongqing showed an increasing trend. Students have become one of the key populations for drug resistant TB prevention and control. Intensified health education and active case finding should be implemented to enhance proactive surveillance capabilities.

Objective To explore the application of case-based learning(CBL)approach in the basic medical stage for eight-year clinical medical program.Methods A total of 320 students from the eight-year clinical medicine pro-gram at Peking Union Medical College in the grades of 2014-2015 and 2019-2020 were selected as the study subjects.These students were divided into two groups,162 students in the classes of 2014 and 2015 as the control group,and 158 students in the classes of 2019 and 2020 as the experimental group.The students in the control group received classic teaching in the basic medicine stage characterized by traditional lectures as the main teaching method.The students in the experimental group received traditional lectures supplemented by CBL.In this study,the cardiovascular system was taken as an example,and the assessment scores and questionnaires of the two groups of students were collected in order to evaluate the teaching effectiveness and to obtain timely teaching feedback.Results Traditional lecture combined with CBL method significantly improved the theory assessment scores of students in the experimental group,stimulated learning interest and intrinsic motivation,and enhanced team learn-ing and problem-solving ability.Students believed that CBL teaching could effectively improve the ability to link theory to clinical practice.In addition,CBL teaching method encouraged the interaction between teachers and students and improved teaching efficiency.Conclusions Well-designing and well-organized CBL teaching from multiple levels,including teachers,students,and curricula,can be better accepted and acknowledged by students from eight-year clinical medical program at the stage of basic medical education.

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.