Objective:To construct an evaluation index system for the core competence of emergency medical dispatchers, so as to provide a theoretical basis for the training, assessment and ability evaluation of emergency medical dispatchers.Methods:In September 2022, a research group was established to compile the first draft of the evaluation index system for the core competencies of emergency medical dispatchers through literature review, semi-structured interviews and group discussions. From October to November 2022, a total of 27 experts in related fields from nine provinces and municipalities directly under the Central Government in China were consulted by Delphi expert letters, items were screened and amended, and an evaluation index system for the core competence of emergency medical dispatchers was formed.Results:A total of two rounds of correspondence were conducted. The effective recovery rate of the questionnaire was 100%, and the authority coefficient of the experts was 0.856. Kendall's coordination coefficients were 0.402 and 0.414 ( P<0.01), respectively. Finally, a core competency evaluation index system for emergency medical dispatchers was constructed, which included seven primary indicators, 16 secondary indicators and 75 tertiary indicators. Conclusions:The core competence evaluation index system for emergency medical dispatchers is scientific, reliable and comprehensive, which can provide a theoretical basis for the training, assessment and ability evaluation of emergency medical dispatchers.

Objective To propose strategies for developing clinical predictive models,aiming to assist researchers in conducting standardized clinical prediction model studies.Methods Literature review was conducted to summarize the operational steps and content for developing clinical predictive models.Then,a methodological framework was summarized and refined through expert consultation.Results The 11-step methodological framework for developing clinical predictive models was obtained by synthesizing the experience of 456 clinical predictive modeling studies and expert consultation,and the details were analyzed and elaborated.Conclusions This study presents methodological strategies and recommendations for the development of clinical predictive models,intended to serve as a guide for researchers.

ObjectiveTo analyze the epidemic characteristics of measles and rubella in Pudong New Area of Shanghai from 2013 to 2022， and to provide data support for the elimination of measles and rubella. MethodsEnzyme linked immunosorbent assay was used to detect IgM antibodies in serum samples. The sequence of 630 nucleotides at the C-terminal of N gene of measles virus was amplified by reverse transcription-polymerase chain reaction and the phylogenic tree was constructed. ResultsA total of 1 529 suspected cases of measles were detected from 2013 to 2022， among which the positive rate of measles IgM antibody was 33.55% （513/1 529）. The highest positive rate （20.73%） was from March to May ， and the positive rate of rubella IgM antibody was 6.80% （104/1 529）. The positive rate of both IgM was higher in males than that in females （P<0.05）. The IgM against measles was mainly detected in 0‒ years old （63.16%， 96/152） and 20‒ years old （45.61%， 161/353）. The IgM against rubella was mainly detected in 10‒20 years old （27.27%， 18/66）. The IgM antibody could be detected more easily from 4 to 28 days after eruption， and the IgM antibody positive rate of measles/rubella from 2020 to 2022 was significantly lower than previous years （2013‒2019）. There were 2 D8 genotype strains， and the rest were H1a gene subtypes. ConclusionThe positive rate of IgM antibodies against measles/rubella in Pudong New Area of Shanghai decreased significantly. People aged 0‒ years and 20‒ years old are more susceptible to measles， and rubella is concentrated in 10‒ years old. It is necessary to strengthen the vaccination of school-age children， in order to achieve the goal of eliminating measles. The age group with high risk of exposure should be checked for vaccination status to ensure the enhanced immunization， and the surveillance of imported measles cases should be strengthened.

Objective:To investigate the risk factors of pulmonary invasive fungal disease (IFD) in patients with primary non-small cell lung cancer (NSCLC) after radiotherapy and to construct predictive model.Methods:A total of 298 patients with primary NSCLC who received radiotherapy in the Second People's Hospital of Yibin of Sichuan from January 2020 to January 2024 were retrospectively included as the study objects. The incidence of pulmonary IFD after radiotherapy was analyzed. Univariate and multivariate analyses were performed on the risk factors of pulmonary IFD in patients with primary NSCLC after radiotherapy. A logistic prediction model was constructed according to the results of multivariate analysis, and the predictive efficacy of each index was evaluated by receiver operator characteristic (ROC) curve.Results:There were 61 cases with pulmonary IFD after radiotherapy in all 298 patients, with the incidence of 20.47%. And 73 strains fungi were detected, including 57 strains for Candida and 16 strains for Aspergillus. There were statistically significant differences in age ( χ2=23.13, P<0.001), whether they had type 2 diabetes ( χ2=19.28, P<0.001), whether they underwent invasive procedures ( χ2=17.49, P<0.001), and concurrent chemoradiotherapy ( χ2=18.48, P<0.001) between IFD patients and non-IFD patients. Multivariate analysis showed that age≥65 years ( OR=4.64, 95% CI: 2.12-10.13, P<0.001), combined type 2 diabetes ( OR=5.63, 95% CI: 2.19-14.48, P<0.001), concurrent chemoradiotherapy ( OR=3.73, 95% CI: 1.74-8.02, P=0.001) and invasive procedures ( OR=5.11, 95% CI: 2.33-11.19, P<0.001) were independent risk factors for pulmonary IFD in patients with primary NSCLC after radiotherapy. Based on the above indexes, the logistic prediction model was constructed as follows: logit ( P) =-4.59+1.53×age+1.73×combined type 2 diabetes+1.32×concurrent chemoradiotherapy+ 1.63×acceptance of invasive procedures ( R2=0.852). ROC curve analysis showed that the area under the curve of pulmonary IFD in patients with primary NSCLC who were≥65 years old, combined with type 2 diabetes, receiving invasive procedures, concurrent chemoradiotherapy, and regression model P value were 0.68, 0.63, 0.68, 0.68, 0.82, respectively. Conclusion:The incidence of pulmonary IFD in patients with primary NSCLC after radiotherapy is independently related to age, type 2 diabetes, invasive procedures and concurrent chemoradiotherapy. The prediction model constructed by using the above four factors has good efficacy in predicting IFD in patients' lungs.

Objective:To evaluate the effect of different interventions in post-percutaneous coronary intervention (PCI) patients with kinesiophobia using network Meta-analysis.Methods:Computerized search of randomized controlled trials and quasi-experiment related to kinesiophobia interventions for post-PCI patients in WanFang database, China National Knowledge Infrastructure, China Biology Medicine, VIP database, Web of Science, PubMed, Cochrane Library and Embase was conducted with a time frame of searching from the establishment of the library to August 3, 2023. Literature screening, data extraction and literature quality evaluation were carried out independently by two researchers. Network Meta-analysis was performed using Stata 17.0 software.Results:A total of 13 literatures were included, including 9 randomized controlled trials and 4 quasi-experiments.Network Meta-analysis showed that cognitive behavioral therapy ( SMD = -4.08, 95% CI -6.49 --1.67), cognitive behavioral therapy combined with cardiac rehabilitation ( SMD = - 3.02, 95% CI -5.43 -- 0.61), dual heart medical intervention ( SMD = - 2.48, 95% , - 4.87 - - 0.09) can reduce the level of exercise fear in patients after PCI, and the difference were statistically significant compared with routine nursing (all P< 0.05). Ranked probability plots showed that the effects of the nine interventions in reducing kinesiophobia in post-PCI patients were cognitive behavioral therapy, cognitive behavioral therapy combined with cardiac rehabilitation, adaptive leadership theory-based intervention, dual heart medical intervention, COX health behavior interaction model, health education based on the behavioral change wheel, graded exposure therapy, mindfulness intervention, and high-intensity interval training in descending order of effectiveness. Conclusions:Cognitive behavioral therapy was the most effective intervention for kinesiophobia in post-PCI patients, but more high-quality randomized controlled trials are needed to further verify this conclusion.

Objective To observe the application effect of protease combined with quadruple therapy in the remedial treatment of Helicobacter pylori (Hp) eradication failure. Methods A total of 100 patients with Hp infection who failed in initial treatment were selected as the study objects, and were divided into control group (50 cases) and observation group (50 cases), and two groups received a course of treatment for 14 days. The control group was given esomeprazole enteric-coated tablets, amoxicillin capsules, furazolidone tablets and colloidal bismuth pectin capsules. The observation group was given streptomycin granule and sodium bicarbonate powder on the basis of the control group. Hp eradication rates were calculated for intention to treat (ITT) analysis and per protocol (PP) analysis. The symptoms and adverse drug reactions before and after treatment were recorded in two groups. Results In the control group, 18 cases were successfully eradicated, the eradication rate by ITT analysis was 36%, and the eradication rate by PP analysis was 36%. In the observation group, 37 patients had negative ¹⁴C breath test results, with an eradication rate of 74% by ITT analysis and 74% by TT analysis. There was statistical significance in the eradication rate between the two groups (P < 0.05). There was no significant difference in compliance between the two groups (P>0.05). The improvement of abdominal pain symptoms before and after eradication was statistically significant between the two groups (P < 0.05). There was no significant difference in adverse reactions between the two groups (P>0.05). Conclusion The remedial treatment regimen of streptomycin combined with quadruple therapy can improve the eradication rate of Hp infection patients whose initial eradication failed.

Objective:In order to explore the impact of corona virus disease 2019(COVID-19)on the hospitalization of children with bronchiolitis and to improve clinicians′ understanding of the characteristics of bronchiolitis during the COVID-19 epidemic.Methods:This was a multicenter clinical study, and the data have been collected from 23 children′s medical centers in China.All the clinical data were retrospectively collected from children with bronchiolitis who were hospitalized at each study center from January 1, 2019 to December 31, 2021.The results included gender, age at hospitalization, length of stay, respiratory syncytial virus(RSV) test results, severity rating, ICU treatment, and the total number of children hospitalized with respiratory tract infection during the same period.The clinical data of children with bronchiolitis in 2019 before COVID-19 epidemic and in 2020、2021 during COVID-19 epidemic were statistically analyzed and compared.Results:According to a summary of data provided by 23 children′s medical centers, there were 4 909 cases of bronchiolitis in 2019, 2 654 cases in 2020, and 3 500 cases in 2021.Compared with 2019, the number of bronchiolitis cases decreased by 45.94% in 2020 and 28.70% in 2021.In 2019, 2020 and 2021, there were no significant differences in gender ratio, age, and duration of hospitalization.Compared with 2019, the ratio of bronchiolitis to the total number of hospitalizations for respiratory tract infection decreased significantly in 2020 and 2021( χ2=12.762, P<0.05; χ2=84.845, P<0.05).The proportion of moderate to severe bronchiolitis cases in both 2020 and 2021 was lower than that in 2019, and the difference was statistically significant ( χ2=4.054, P<0.05; χ2=8.109, P<0.05).There was no statistically significant difference in the proportion of bronchiolitis cases requiring ICU treatment between 2019, 2020, and 2021 ( χ2=1.914, P>0.05).In 2019, a total of 52.60%(2 582/4 909) of children with bronchiolitis underwent RSV pathogen testing, and among them, there were 708 cases with RSV positive, accounting for 28.00%.In 2020, 54.14%(1 437/2 654) of children with bronchiolitis underwent RSV pathogen testing, and there were 403 cases with RSV positive, accounting for 28.04%.In 2021, 66.80%(2 238/3 500) of children with bronchiolitis underwent RSV pathogen testing, and there were 935 cases with RSV positive, accounting for 41.78%.Compared with 2019 and 2020, the RSV positive rate in 2021 showed a significant increase( χ2=99.673, P<0.05; χ2=71.292, P<0.05). Conclusion:During the COVID-19 epidemic, the implementation of epidemic prevention and control measures reduced the hospitalization rate and severity of bronchiolitis, but did not reduce the positive rate of RSV detection.

Objective:To analyze the features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infected with other common respiratory pathogens among coronavirus disease 2019 (COVID-19) patients in Shanghai City, and to provide a reference for scientific prevention and control of COVID-19 and other respiratory infectious diseases.Methods:Descriptive epidemiological approaches were used to analyze the data of COVID-19 reported cases in Shanghai City from January 2020 to February 2021 in the information system of Chinese Disease Prevention and Control. Clinical data of the participants were collected, and their SARS-CoV-2 nucleic acid-positive respiratory specimens were collected at the time of illness onset or admission. Multiplex reverse transcription-polymerase chain reaction (RT-PCR) was performed to detect the 22 respiratory pathogens. Independent-samples t test was used for statistical analysis. Results:Of the 272 patients with COVID-19, 15(5.5%) had co-infection of SARS-CoV-2 with other respiratory pathogens, all of which were double infection. There were three cases infected with enterovirus/rhinovirus, two of each with adenovirus, human metapneumovirus and coronavirus NL63/HKU1, and one of each with coronavirus 229E, influenza A virus H1N1, parainfluenza virus 1 and respiratory syncytial virus B. Two cases infected with Mycoplasma pneumoniae. Among the 272 COVID-19 patients, 212(77.9%) had fever, 117(43.0%) had cough, 46(16.9%) had fatigue, and 35(12.9%) had sore throat. The white blood cell count of co-infection cases was higher than that of non-co-infection cases ((6.8±1.7)×10 9/L vs (5.3±1.6)×10 9/L), and the difference was statistically significant ( t=3.09, P=0.008). Conclusions:There is a certain proportion of co-infection of SARS-CoV-2 with other respiratory pathogens among the COVID-19 cases in Shanghai City, mainly viral pathogens, especially enterovirus/rhinovirus. A rational combination of drugs was recommended to improve the cure rate. Surveillance of acute respiratory infection should be further strengthened as well.

The aging of the population has led to a sharp increase in the demand of the elderly for long-term care services. How to ensure the quality of long-term care services is a hot topic of widespread concern in society. In developed countries, long-term care services have been carried out early, a perfect service quality evaluation system has been formed, and the evaluation results have been effectively used. Long-term care services in China started late, there is no unified evaluation standard for the quality of long-term care services, and the evaluation indicators are diversified. It is necessary to explore a long-term care service quality evaluation system with Chinese characteristics based on foreign experience, covering the whole process of long-term care services. In addition, core indicators need to be selected to reflect the quality of long-term care services, strengthen the application of evaluation results, improve the effectiveness of long-term care service quality evaluation, and promote the sustainable development of long-term care in China.

Objective:To explore the construction of evaluation criteria for long-term care ability of the elderly suitable for China's national conditions.Methods:The evaluation criteria were initially established through literature research and field semi-structured interviews. Through the Delphi method, 15 experts were consulted and the evaluation criteria for the long-term care ability of the elderly were finally established.Results:The effective rate of the two rounds of expert consultation questionnaires was 100%, and the expert authority coefficients were 0.91 and 0.92 respectively. The evaluation criteria for long-term care ability of the elderly were established, including two first-level indicators of self-care ability and disease severity, four second-level indicators of abilities of daily living, mental state and social participation, perception and communication, and disease severity, as well as 39 third-level indicators including recumbent status, cognitive function, level of consciousness, illness and so on.Conclusions:The evaluation criteria for long-term care ability of the elderly are scientific and reliable, which can provide a reference for the classification of long-term care services for the disabled elderly in China.