Objective To analyze the clinical characteristics and risk factors of extreme thrombocytosis caused by piperacillin sodium and tazobactam sodium injection, and provide reference for medical treatment and pharmaceutical care of such patients. Methods Extreme thrombocytosis of a patient treated with piperacillin sodium and tazobactam sodium injection was found by clinical pharmacists, who participated in clinical diagnosis and treatment by analyzing of the adverse drug reaction, optimization of the medical treatment and pharmaceutical care. Results After correlation analysis, the patient's extreme thrombocytosis was likely to be an adverse reaction caused by the piperacillin sodium and tazobactam sodium injection. The medication was immediately discontinued, and antiplatelet therapy with aspirin was administered. Two weeks later, the patient's platelet count had significantly decreased compared to before. Conclusion Clinical pharmacists participated in patients’ clinical diagnosis and treatment, carried out pharmaceutical care and assisted physicians in adjusting treatment plans, which ensured the safety and effectiveness of patients' clinical drug therapy.

Objective To analyze chemical constituents of compound Maxing Shigan decoction by ultra-high perfor-mance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS). Methods The separation was performed on a UPLC BEH C₁₈ column (2.1 mm×100 mm, 2.5 µm)，with a gradient elution applying 0.1% aqueous formic acid solution and 0.1% formic acid acetonitrile as a mobile phase. The column temperature was 40 °C. The flow rate was 0.4 ml/min and the analysis time was 15 min. Mass spectrometry (MS) data were collected in both positive and negative ESI ion modes. Results Through UPLC-QTOF/MS analysis and reference validation, a total of 59 chemical components in Maxing Shigan decoction were identified. Conclusion An ultra-high performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS) method was established to identify the chemical components of Maxing Shigan decoction. This method is simple, efficient, sensitive and accurate, and provides a basis for the elucidation of the pharmacodynamic material basis and mechanism of Maxing Shigan decoction. It can provide data reference for the optimization of the compatibility of traditional Chinese medicine in the treatment of COVID-19.

Objective : To analyze the influencing factors associated with the coexistence of multidrug-resistantEscherichia coli(MDR-ECO) infection and active tuberculosis(ATB) in patients with lung infections. Methods: A total of 204 hospitalized patients with lung infections caused by MDR-ECO were enrolled. Among them, patients with coexisting ATB were identified and assigned to the observation group. Univariate and multivariate Logistic regression analysis were performed to identify the risk factors for the coexistence of MDR-ECO lung infection and ATB. Results : Factors such as patient age, neutrophil count, hemoglobin level, malignancy, rheumatoid arthritis, history of antibiotic exposure, and history of surgery within the past year were found to be influencing factors for the coexistence of MDR-ECO lung infection and ATB(allP<0.05). Specifically, advanced age(95%CI: 0.949-0.992,P=0.008), decreased neutrophils(95%CI: 0.750-0.922,P<0.001), and a history of antibiotic exposure(95%CI: 1.202-2.596,P=0.004) were identified as risk factors. Conclusion Some patients with MDR-ECO lung infections are prone to coexisting with ATB. Therefore, it is recommended to strengthen ATB screening among high-risk patients, including those at peak ages for susceptibility, with low neutrophil counts, and with a history of antibiotic exposure.

OBJECTIVE To explore the effect of the comprehensive unit-based safety program(CUSP)collaborative action strategy on reducing the incidence of catheter-associated urinary tract infection(CAUTI)in elderly patients.METHODS From Jun.to Nov.2024,the Seventh Medical Center of the PLA General Hospital implemented the CUSP collaborative action strategy for intervention.Comparisons were made between pre-intervention(from Dec.2023 to May 2024)and post-intervention(from Jun.to Nov.2024)regarding nurses' know ledge-attitude-practice(KAP)scores on CAUTI prevention,implementation rates of key nursing measures for elderly CAUTI prevention and CAUTI incidence rates among elderly patients.RESULTS The pre-intervention KAP score of nurses from geriatric de-partment on CAUTI prevention was(83.44±6.67),significantly lower than the post-intervention score(108.19±16.27)(P＜0.001).The implementation rates of 10 key nursing measures for elderly CAUTI prevention improved(P＜0.05).The incidence rate of CAUTI was 2.88‰(16/5 546)among 5 546 catheter days before the intervention,and the incidence rate of CAUTI was 0.73‰(4/5 496)among 5 496 catheter days after the intervention(P=0.008).CONCLUSIONS The CUSP collaborative action strategy effectively enhances the KAP levels of nurses from geriatric department on CAUTI prevention,improves the implementation rates of key nursing measures,and reduces CAUTI incidence rates among elderly patients.

OBJECTIVE To explore the effect of the comprehensive unit-based safety program(CUSP)collaborative action strategy on reducing the incidence of catheter-associated urinary tract infection(CAUTI)in elderly patients.METHODS From Jun.to Nov.2024,the Seventh Medical Center of the PLA General Hospital implemented the CUSP collaborative action strategy for intervention.Comparisons were made between pre-intervention(from Dec.2023 to May 2024)and post-intervention(from Jun.to Nov.2024)regarding nurses' know ledge-attitude-practice(KAP)scores on CAUTI prevention,implementation rates of key nursing measures for elderly CAUTI prevention and CAUTI incidence rates among elderly patients.RESULTS The pre-intervention KAP score of nurses from geriatric de-partment on CAUTI prevention was(83.44±6.67),significantly lower than the post-intervention score(108.19±16.27)(P＜0.001).The implementation rates of 10 key nursing measures for elderly CAUTI prevention improved(P＜0.05).The incidence rate of CAUTI was 2.88‰(16/5 546)among 5 546 catheter days before the intervention,and the incidence rate of CAUTI was 0.73‰(4/5 496)among 5 496 catheter days after the intervention(P=0.008).CONCLUSIONS The CUSP collaborative action strategy effectively enhances the KAP levels of nurses from geriatric department on CAUTI prevention,improves the implementation rates of key nursing measures,and reduces CAUTI incidence rates among elderly patients.

OBJECTIVE To investigate the current status of occupational hazards among nursing staff in general hospitals,explore the influencing factors and analyze the prevalence of occupational exposure among the nursing staff.METHODS A survey was conducted for the nursing staff who were selected from 8 general hospitals in Bei-jing through convenience sampling method,and the data regarding the occupational exposure among the nursing staff from 2023 to 2024 were summarized and analyzed.Statistical analyses were performed for the survey data by SPSS 23.0 software.RESULTS Among 963 nursing staff included in the survey,the average index of total occupa-tional risk was 311.55;19 of 28 items of occupational hazard risks were intolerable risks.There were no significant differences in the risk indexes among the nursing staff with different education backgrounds and working years;there were significant differences in the hazard risk indexes of body mechanics,psychological society and organiza-tional factors among the nursing staff with different titles(P＜0.05).There were significant differences in acci-dent hazard,physical hazard,body mechanics,psychological society,organizational hazard and biological hazard among the different departments of nursing staff(P＜0.05).There were totally 184 case-times of occupational ex-posures that were actively reported by nursing staff in 2023 and 2024.CONCLUSIONS The status of occupational exposure among the nursing staff in the general hospitals remains concerning.The structure of occupational haz-ards has shifted from predominantly physical risks to psychosocial risks.The perceptions of occupational risks vary significantly among the nursing staff with different titles,the occupational risk vary among the departments,and a cognitive-behavioral dissociation in occupational protection practices persists to some extent among the nursing personnel.Healthcare institutions must continuously strengthen occupational protection system through multidi-mensional approaches to address these evolving challenges.

OBJECTIVE To investigate the current status of occupational hazards among nursing staff in general hospitals,explore the influencing factors and analyze the prevalence of occupational exposure among the nursing staff.METHODS A survey was conducted for the nursing staff who were selected from 8 general hospitals in Bei-jing through convenience sampling method,and the data regarding the occupational exposure among the nursing staff from 2023 to 2024 were summarized and analyzed.Statistical analyses were performed for the survey data by SPSS 23.0 software.RESULTS Among 963 nursing staff included in the survey,the average index of total occupa-tional risk was 311.55;19 of 28 items of occupational hazard risks were intolerable risks.There were no significant differences in the risk indexes among the nursing staff with different education backgrounds and working years;there were significant differences in the hazard risk indexes of body mechanics,psychological society and organiza-tional factors among the nursing staff with different titles(P＜0.05).There were significant differences in acci-dent hazard,physical hazard,body mechanics,psychological society,organizational hazard and biological hazard among the different departments of nursing staff(P＜0.05).There were totally 184 case-times of occupational ex-posures that were actively reported by nursing staff in 2023 and 2024.CONCLUSIONS The status of occupational exposure among the nursing staff in the general hospitals remains concerning.The structure of occupational haz-ards has shifted from predominantly physical risks to psychosocial risks.The perceptions of occupational risks vary significantly among the nursing staff with different titles,the occupational risk vary among the departments,and a cognitive-behavioral dissociation in occupational protection practices persists to some extent among the nursing personnel.Healthcare institutions must continuously strengthen occupational protection system through multidi-mensional approaches to address these evolving challenges.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective: To analyze the correlation between preschool children s emotional competence and home rearing environment in Shangrao City, so as to provide support for improving children s emotional competence development as well as their home rearing environment. Methods: A total of 1 242 children aged 3-6 years old from 10 kindergartens in Shangrao City were retrospectively investigated by stratified cluster random sampling method in December 2022, and the Children s Emotional Adjustment Scale-Preschool Version (CEAS-P) and the Home Nurture Environment Scale for children aged 3-6 were surveyed on parents of preschool children. The t-test was used to test the difference, Spearman correlation analysis and multiple linear regression were used to analyze the influencing factors of preschool children s emotional competence. Results: There were significant differences in emotional competence scores of preschool children for demographic indicators including age, place of residence, health status and whether they were only children ( F/t =5.98, 6.56, 38.00, 2.23, P <0.01). The emotional competence of preschool children was positively correlated with the home rearing environment ( r=0.62, P <0.01). Multiple linear regression analysis showed that diverse activities/play participation, social adaptation/self management, and emotional warmth/self expression in home rearing environment were positive predictors of children s emotional ability ( β =0.30, 0.28, 0.16), while neglect/intervention/punishment were negative predictors ( β =-0.09)( P <0.05). Conclusions The home rearing environment is a factor related to young children s emotional competence. It is suggested specific parenting initiatives such as enriching family activities and play, strengthening children s self adaptation and management, giving warmth and let children express emotions, and preventing child neglect, interference and punishment should be conducted to improve children s emotional competence.