Objective:To explore how nurses respond to and experience task uncertainty in prehospital emergency care.Methods:Using purposive sampling, 13 prehospital emergency nurses from two tertiary hospitals in Shandong Province were selected between June and August 2024. Semi-structured interviews were conducted face-to-face. The interview data were analyzed using Colaizzi's seven-step method.Results:Four main themes were identified: a certain degree of task uncertainty exists in prehospital emergency care; nurses have varied emotional and cognitive responses to such uncertainty; nurses adopt diverse coping strategies; organizational-level interventions are essential to improving nurses' experiences.Conclusions:Nurses recognize the presence of task uncertainty in prehospital emergency care and demonstrate different responses and coping strategies. This highlights the need for both nurses and healthcare managers to acknowledge this characteristic of emergency work, help nurses alleviate negative experiences, foster positive coping mechanisms, and ensure the quality of prehospital emergency nursing services.

Objective:To explore how nurses respond to and experience task uncertainty in prehospital emergency care.Methods:Using purposive sampling, 13 prehospital emergency nurses from two tertiary hospitals in Shandong Province were selected between June and August 2024. Semi-structured interviews were conducted face-to-face. The interview data were analyzed using Colaizzi's seven-step method.Results:Four main themes were identified: a certain degree of task uncertainty exists in prehospital emergency care; nurses have varied emotional and cognitive responses to such uncertainty; nurses adopt diverse coping strategies; organizational-level interventions are essential to improving nurses' experiences.Conclusions:Nurses recognize the presence of task uncertainty in prehospital emergency care and demonstrate different responses and coping strategies. This highlights the need for both nurses and healthcare managers to acknowledge this characteristic of emergency work, help nurses alleviate negative experiences, foster positive coping mechanisms, and ensure the quality of prehospital emergency nursing services.

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:To evaluate the effect of N-acetylcysteine (NAC) in relieving discomfort symptoms after esophageal Lugol′s iodine staining.Methods:From April 1 to September 30, 2023, a total of 204 subjects who received endoscopy at the First Affiliated Hospital of Shihezi University were enrolled. All the subjects were stained with 10 mL 1.5% compound iodine solution after endoscopy. According to random number table method, the 204 subjects were randomly divided into two groups which received 20 mL 0.9% sodium chloride solution (sodium chloride group, 103 cases) and 10% NAC (NAC group, 101 cases) to neutralize the iodine, respectively. The primary outcome indicators of the subjects of the two groups were analyzed, including the incidence of retrosternal burning sensation and pharyngeal discomfort 15 and 30 min after spraying the neutralization solution, and the degree of discomfort was evaluated by visual analogue scale (VAS). Fisher′s exact probability method and non-parametric test were used for statistical analysis.Results:The incidence of retrosternal burning sensation and pharyngeal discomfort 15 and 30 min after spraying the neutralization solution in the sodium chloride group were higher than those in the NAC group (15 min: 17.5% (18/103) vs. 2.0% (2/101), 10.7% (11/103) vs. 1.0% (1/101); 30 min: 11.7%(12/103) vs. 1.0% (1/101), and 5.8% (6/103) vs. 0 (0/101)), and the differences were statistically significant (Fisher′s exact probability method, P<0.001, =0.005, =0.003, and =0.029). There was no significant difference in the VAS score 15 min after spraying neutralization solution between the sodium chloride group and the NAC group (3.00 (3.00, 4.25) vs. 4.00 (3.00, 5.25), P>0.05). At 30 min after spraying the neutralization solution, the VAS score of the sodium chloride group was higher than that of the NAC group (4.00(3.75, 5.00) vs. 1.50(1.00, 1.50)), and the difference was statistically significant ( Z=-2.37, P=0.007). Conclusion:NAC can effectively relieve the discomfort caused by esophageal iodine staining.

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 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.

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 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 evaluate the effect of N-acetylcysteine (NAC) in relieving discomfort symptoms after esophageal Lugol′s iodine staining.Methods:From April 1 to September 30, 2023, a total of 204 subjects who received endoscopy at the First Affiliated Hospital of Shihezi University were enrolled. All the subjects were stained with 10 mL 1.5% compound iodine solution after endoscopy. According to random number table method, the 204 subjects were randomly divided into two groups which received 20 mL 0.9% sodium chloride solution (sodium chloride group, 103 cases) and 10% NAC (NAC group, 101 cases) to neutralize the iodine, respectively. The primary outcome indicators of the subjects of the two groups were analyzed, including the incidence of retrosternal burning sensation and pharyngeal discomfort 15 and 30 min after spraying the neutralization solution, and the degree of discomfort was evaluated by visual analogue scale (VAS). Fisher′s exact probability method and non-parametric test were used for statistical analysis.Results:The incidence of retrosternal burning sensation and pharyngeal discomfort 15 and 30 min after spraying the neutralization solution in the sodium chloride group were higher than those in the NAC group (15 min: 17.5% (18/103) vs. 2.0% (2/101), 10.7% (11/103) vs. 1.0% (1/101); 30 min: 11.7%(12/103) vs. 1.0% (1/101), and 5.8% (6/103) vs. 0 (0/101)), and the differences were statistically significant (Fisher′s exact probability method, P<0.001, =0.005, =0.003, and =0.029). There was no significant difference in the VAS score 15 min after spraying neutralization solution between the sodium chloride group and the NAC group (3.00 (3.00, 4.25) vs. 4.00 (3.00, 5.25), P>0.05). At 30 min after spraying the neutralization solution, the VAS score of the sodium chloride group was higher than that of the NAC group (4.00(3.75, 5.00) vs. 1.50(1.00, 1.50)), and the difference was statistically significant ( Z=-2.37, P=0.007). Conclusion:NAC can effectively relieve the discomfort caused by esophageal iodine staining.