Objective To investigate the impact of parental career deficit on college students' career decision-making difficulties and analyze the mediating role of psychological capital and career exploration in this relationship.Methods The Perceived Parental Career-Related Behavior Scale,Career Decision-making Difficulty Scale,Psychological Capital Questionnaire,and Career Exploration Inventory were administered to 356 college students.Results Scores of parental career deficit,psychological capital,career exploration,and career decision-making difficulties were 1.84±0.64,4.55±0.77,3.17±0.67,and 5.19±1.12,respectively.Parental career deficit was negatively correlated with psychological capital and career exploration(r=-0.283,r=-0.134,both P＜0.05),but positively correlated with career decision-making difficulties(r=0.373,P＜0.01).The college students'psychological capital was positively correlated with their career exploration(r=0.589,P＜0.01),but negatively correlated with career decision-making difficulties(r=-0.457,P＜0.01).Career exploration was negatively correlated with career decision-making difficulties(r=-0.409,P＜0.01).Bootstrap mediation effect analysis revealed that psychological capital and career exploration acted as chain mediators in the relationship between lack of parental career support and career decision-making difficulties.The value of the chain-mediated effect was 0.068,accounting for 10.38％ of the total effect.Conclusion Parental career deficit not only directly impacts college students' career decision-making difficulties but also indirectly influences these difficulties through their effects on psychological capital and career exploration.

Objective:To investigate the experiences of residents in completing case reports, the support needed in writing case reports, and the necessary conditions for future case report education.Methods:Using purposive sampling, one-on-one semi-structured in-depth interviews were conducted with residents who had published case reports. A thematic analysis was employed to analyze the data.Results:The study included 15 residents [3 males, 12 females; mean age: (27.20±2.57) years], with 8 undergoing standardized residency training and 7 receiving specialized physician training. The study identified three themes, including the challenges, strategies, and desired support during data collection prior to writing the case report, the writing process, and the submission and publication. The following specific needs were identified. Before writing, residents sought access to free and official research resources, guidance on the value of case publication, high-quality case resources, comprehensive supervision of data collection, access to interdepartmental collaboration, and funding support. During the writing period, they sought case report templates, experiences in writing case reports, guidance on article composition, and motivational support. After writing, they expected operational guidance of submission websites, recommendations for target journals, and templates for revision response letters.Conclusions:This study explored the challenges, strategies, and expected support in the continuous stages of before, during, and after writing case reports, thereby initially identifying the essential support conditions for case report instruction from the perspective of resident physicians.

Objective:Kawasaki disease shock syndrome（KDSS）and macrophage activation syndrome（MAS）are both severe forms of Kawasaki disease. The coexistence of these two critical illnesses is extremely rare，which can be life-threatening in severe cases. The purpose of this study is to summarize the clinical features of children with KDSS complicated with MAS，and provide a basis for precise diagnosis and treatment.Methods:A retrospective analysis was conducted on the clinical manifestations，laboratory tests，imaging characteristics，treatment，and prognosis of 10 children with KDSS and MAS admitted to Beijing Children's Hospital，Capital Medical University from January 2021 to June 2024.Results:Among the 10 children，six were male and four were female，and the age of onset was three months to eleven years old. Acute kidney injury was observed in five patients. Laboratory tests revealed significant increases in serum ferritin，C-reactive protein，B-type natriuretic peptide，aspartate aminotransferase，alanine aminotransferase，creatinine，triglycerides，and interferon-γ，while platelet count and albumin were significantly decreased. Six patients had cardiac enlargement，three had reduced ejection fraction，seven had pericardial effusion，and seven had coronary artery damage. All children were treated with immunoglobulin and methylprednisolone pulse therapy，as well as vasoactive drug infusion to improve circulation and maintain blood pressure. All children were discharged after clinical improvement，and most had a good prognosis.Conclusion:Children with KDSS may develop MAS，which present a complex and rapidly progressing condition often accompanied by a significant increase in ferritin levels. Early diagnosis and treatment can lead to a favorable prognosis.

Donors with a serum sodium concentration of >155 mmol/L are extended criteria donors for liver transplantation (LT). Elevated serum sodium of donors leads to an increased incidence of hepatic dysfunction in the early postoperative period of LT; however, the exact mechanism has not been reported. We constructed a Lewis rat model of 70% hepatic parenchymal area subjected to ischemia-reperfusion (I/R) with hypernatremia and a BRL-3A cell model of hypoxia-reoxygenation (H/R) with high-sodium (HS) culture medium precondition. To determine the degree of injury, biochemical analysis, histological analysis, and oxidative stress and apoptosis detection were performed. We applied specific inhibitors of the epithelial sodium channel (ENaC) and Na⁺/Ca²⁺ exchanger (NCX) in vivo and in vitro to verify their roles in injury. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) levels and the area of hepatic necrosis were significantly elevated in the HS+I/R group. Increased reactive oxygen species (ROS) production, myeloperoxidase (MPO)‍-positive cells, and aggravated cellular apoptosis were detected in the HS+I/R group. The HS+H/R group of BRL-3A cells showed significantly increased cellular apoptosis and ROS production compared to the H/R group. The application of amiloride (Amil), a specific inhibitor of ENaC, reduced ischemia-reperfusion injury (IRI) aggravated by HS both in vivo and in vitro, as evidenced by decreased serum transaminases, inflammatory cytokines, apoptosis, and oxidative stress. SN-6, a specific inhibitor of NCX, had a similar effect to Amil. In summary, hypernatremia aggravates hepatic IRI, which can be attenuated by pharmacological inhibition of ENaC or NCX.
Animals ; Reperfusion Injury/drug therapy* ; Hypernatremia/complications* ; Rats ; Liver/metabolism* ; Rats, Inbred Lew ; Male ; Apoptosis ; Sodium-Calcium Exchanger/antagonists & inhibitors* ; Reactive Oxygen Species/metabolism* ; Oxidative Stress ; Epithelial Sodium Channel Blockers/pharmacology* ; Epithelial Sodium Channels ; Cell Line ; Liver Transplantation

Objective To investigate the impact of parental career deficit on college students' career decision-making difficulties and analyze the mediating role of psychological capital and career exploration in this relationship.Methods The Perceived Parental Career-Related Behavior Scale,Career Decision-making Difficulty Scale,Psychological Capital Questionnaire,and Career Exploration Inventory were administered to 356 college students.Results Scores of parental career deficit,psychological capital,career exploration,and career decision-making difficulties were 1.84±0.64,4.55±0.77,3.17±0.67,and 5.19±1.12,respectively.Parental career deficit was negatively correlated with psychological capital and career exploration(r=-0.283,r=-0.134,both P＜0.05),but positively correlated with career decision-making difficulties(r=0.373,P＜0.01).The college students'psychological capital was positively correlated with their career exploration(r=0.589,P＜0.01),but negatively correlated with career decision-making difficulties(r=-0.457,P＜0.01).Career exploration was negatively correlated with career decision-making difficulties(r=-0.409,P＜0.01).Bootstrap mediation effect analysis revealed that psychological capital and career exploration acted as chain mediators in the relationship between lack of parental career support and career decision-making difficulties.The value of the chain-mediated effect was 0.068,accounting for 10.38％ of the total effect.Conclusion Parental career deficit not only directly impacts college students' career decision-making difficulties but also indirectly influences these difficulties through their effects on psychological capital and career exploration.

Objective:To investigate the experiences of residents in completing case reports, the support needed in writing case reports, and the necessary conditions for future case report education.Methods:Using purposive sampling, one-on-one semi-structured in-depth interviews were conducted with residents who had published case reports. A thematic analysis was employed to analyze the data.Results:The study included 15 residents [3 males, 12 females; mean age: (27.20±2.57) years], with 8 undergoing standardized residency training and 7 receiving specialized physician training. The study identified three themes, including the challenges, strategies, and desired support during data collection prior to writing the case report, the writing process, and the submission and publication. The following specific needs were identified. Before writing, residents sought access to free and official research resources, guidance on the value of case publication, high-quality case resources, comprehensive supervision of data collection, access to interdepartmental collaboration, and funding support. During the writing period, they sought case report templates, experiences in writing case reports, guidance on article composition, and motivational support. After writing, they expected operational guidance of submission websites, recommendations for target journals, and templates for revision response letters.Conclusions:This study explored the challenges, strategies, and expected support in the continuous stages of before, during, and after writing case reports, thereby initially identifying the essential support conditions for case report instruction from the perspective of resident physicians.

Objective:Kawasaki disease shock syndrome（KDSS）and macrophage activation syndrome（MAS）are both severe forms of Kawasaki disease. The coexistence of these two critical illnesses is extremely rare，which can be life-threatening in severe cases. The purpose of this study is to summarize the clinical features of children with KDSS complicated with MAS，and provide a basis for precise diagnosis and treatment.Methods:A retrospective analysis was conducted on the clinical manifestations，laboratory tests，imaging characteristics，treatment，and prognosis of 10 children with KDSS and MAS admitted to Beijing Children's Hospital，Capital Medical University from January 2021 to June 2024.Results:Among the 10 children，six were male and four were female，and the age of onset was three months to eleven years old. Acute kidney injury was observed in five patients. Laboratory tests revealed significant increases in serum ferritin，C-reactive protein，B-type natriuretic peptide，aspartate aminotransferase，alanine aminotransferase，creatinine，triglycerides，and interferon-γ，while platelet count and albumin were significantly decreased. Six patients had cardiac enlargement，three had reduced ejection fraction，seven had pericardial effusion，and seven had coronary artery damage. All children were treated with immunoglobulin and methylprednisolone pulse therapy，as well as vasoactive drug infusion to improve circulation and maintain blood pressure. All children were discharged after clinical improvement，and most had a good prognosis.Conclusion:Children with KDSS may develop MAS，which present a complex and rapidly progressing condition often accompanied by a significant increase in ferritin levels. Early diagnosis and treatment can lead to a favorable prognosis.

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 explore the current status of quality of pediatric nurses ′ leader-member exchange, recovery experience, thriving at work, as well as to explore the correlation between leader-member exchange, recovery experience, and thriving at work. Methods:A convenience sampling method was used to select 312 pediatric nurses from four tertiary level A hospitals in Qingdao from September to November 2021 as the study population. A cross-sectional survey was conducted using the Leader-Member Exchange Scale, the Recovery Experience Scale, and the Thriving at work Scale. Descriptive statistical analysis, Pearson correlation analysis, and structural equation modeling were conducted on the data to analyze the mediating effect of recovery experience between leader-member exchange and thriving at work, and Bootstrap method was applied to validate the mediating effect.Results:The pediatric nurses ′ leader-member exchange score was (3.94 ± 0.90) points, recovery experience score was (3.47 ± 0.76) points, and thriving at work score was (3.71 ± 0.75) points. Leader-member exchange was positively correlated with recovery experience and thriving at work ( r=0.486, 0.575, both P<0.01); recovery experience was positively correlated with thriving at work ( r=0.711, P<0.01); the test of mediating effect showed that recovery experience partially mediated the effect between leader-member exchange and thriving at work, intermediary effect accounted for 66.9% of the total effect. Conclusions:Pediatric nurses have moderate levels of leader-member exchange, recovery experience, thriving at work. Leader-member exchange can affect pediatric nurses ′ thriving at work both directly and indirectly through the recovery experience. Nursing managers should strengthen the management of relationships with nurses, form good psychological and emotional bonds, and conduct recovery experience training to improve nurses ′ thriving at work, and improve the quality of care.

Workplace spirituality, as a powerful indicator of workplace outcomes, plays an important role in stabilizing nursing talents and improving nursing quality. This article aimed to summarize the overview, measurement tools, related factors and strategies of workplace spirituality from the field of healthcare, so as to promote nursing managers ′ understanding of workplace spirituality and provide a reference for improving the nursing environment.