Objective:To investigate the genetic subtypes and drug resistance monitoring of newly reported human immunodeficiency virus (HIV) infection/AIDS virus in Anhui Province from 2020 to 2023.Methods:An observational design study was used to collect blood samples from patients diagnosed with HIV/AIDS in the AIDS Prevention and Control Department of Anhui Provincial Center for Disease Control and Prevention from January 2020 to December 2023.The HIV-1 pol gene was amplified by reverse transcription-nested PCR, and the genetic subtypes were identified by phylogenetic tree analysis using MEGA 7.0 software. The mutation sites of drug resistance were analyzed by the online software tool of Stanford University′s HIV Drug resistance database. The influencing factors of drug resistance before treatment were analyzed by multivariate logistic analysis.Results:A total of 335 plasma samples were collected, and 332 HIV-1 pol gene sequences were obtained successfully. The main gene subtypes were CRF01-AE, accounting for 35.55% (118/332), followed by CRF07-BC, B and B+C types [29.22% (97/332), 11.74% (39/332), 9.93% (33/332)]. The total drug resistance rate before treatment was 30.12%(32/100), and the drug resistance rate of protease inhibitor (PIs) in HIV-1 was 6.33% (21/332). The drug resistance rate of nucleoside reverse transcriptase inhibitors (NRTI) before treatment was 6.33% (21/332). The drug resistance rate of non-nucleoside reverse transcriptase inhibitors (NNRTI) before treatment was 17.47% (58/332).The comparison of drug resistance rate of different drug types showed statistical significance ( χ2=30.435, P<0.05).Among the 100 cases of drug resistance, the main mutation point of HIV-1 protease inhibitor was Q58E (21.00%), and the main mutation point of nucleoside reverse transcriptase inhibitor was M184V/I (6.00%). Non-nucleoside reverse transcriptase inhibitor resistance mutation points mainly K103N (22.00%).There were statistically significant differences in the starting time of antiviral therapy, the number of CD4 +T cells at baseline and the drug resistance rate of gene subtypes (the chi-square values are respectively 24.152, 32.516, 11.652, P<0.05).Multivariate logistic analysis showed that the baseline CD4 +T cell count was <200/μl, subtype B, subtype B+C, CRF01-AE subtype, CRF55-01B subtype and 01-BC subtype was the influential factor of drug resistance before treatment (the chi-square values are respectively 4.577, 8.202, 4.416, 5.206, 7.603 and 4.804, P<0.05). Conclusion:The newly reported HIV/AIDS population in Anhui Province from 2020 to 2023 has a variety of viral gene subtypes, and NNRTIs are the main types of drug resistance gene mutations before treatment. Attention should be paid to the number of baseline CD4 +T cells, the duration of antiviral treatment, and the distribution of gene subtypes to reduce the drug resistance of HIV/AIDS patients before treatment.

Objective:To investigate the genetic subtypes and drug resistance monitoring of newly reported human immunodeficiency virus (HIV) infection/AIDS virus in Anhui Province from 2020 to 2023.Methods:An observational design study was used to collect blood samples from patients diagnosed with HIV/AIDS in the AIDS Prevention and Control Department of Anhui Provincial Center for Disease Control and Prevention from January 2020 to December 2023.The HIV-1 pol gene was amplified by reverse transcription-nested PCR, and the genetic subtypes were identified by phylogenetic tree analysis using MEGA 7.0 software. The mutation sites of drug resistance were analyzed by the online software tool of Stanford University′s HIV Drug resistance database. The influencing factors of drug resistance before treatment were analyzed by multivariate logistic analysis.Results:A total of 335 plasma samples were collected, and 332 HIV-1 pol gene sequences were obtained successfully. The main gene subtypes were CRF01-AE, accounting for 35.55% (118/332), followed by CRF07-BC, B and B+C types [29.22% (97/332), 11.74% (39/332), 9.93% (33/332)]. The total drug resistance rate before treatment was 30.12%(32/100), and the drug resistance rate of protease inhibitor (PIs) in HIV-1 was 6.33% (21/332). The drug resistance rate of nucleoside reverse transcriptase inhibitors (NRTI) before treatment was 6.33% (21/332). The drug resistance rate of non-nucleoside reverse transcriptase inhibitors (NNRTI) before treatment was 17.47% (58/332).The comparison of drug resistance rate of different drug types showed statistical significance ( χ2=30.435, P<0.05).Among the 100 cases of drug resistance, the main mutation point of HIV-1 protease inhibitor was Q58E (21.00%), and the main mutation point of nucleoside reverse transcriptase inhibitor was M184V/I (6.00%). Non-nucleoside reverse transcriptase inhibitor resistance mutation points mainly K103N (22.00%).There were statistically significant differences in the starting time of antiviral therapy, the number of CD4 +T cells at baseline and the drug resistance rate of gene subtypes (the chi-square values are respectively 24.152, 32.516, 11.652, P<0.05).Multivariate logistic analysis showed that the baseline CD4 +T cell count was <200/μl, subtype B, subtype B+C, CRF01-AE subtype, CRF55-01B subtype and 01-BC subtype was the influential factor of drug resistance before treatment (the chi-square values are respectively 4.577, 8.202, 4.416, 5.206, 7.603 and 4.804, P<0.05). Conclusion:The newly reported HIV/AIDS population in Anhui Province from 2020 to 2023 has a variety of viral gene subtypes, and NNRTIs are the main types of drug resistance gene mutations before treatment. Attention should be paid to the number of baseline CD4 +T cells, the duration of antiviral treatment, and the distribution of gene subtypes to reduce the drug resistance of HIV/AIDS patients before treatment.

Objective:To review the scope of related factors that affect the elderly′s participation in digital health intervention, and to provide a certain reference for the application and development of smart elderly technology.Methods:Based on the scope review guidelines issued by the Joanna Briggs Institute in Australia in 2019, the inclusion and exclusion criteria were determined according to the PCCS principles. Chinese and English literatures were searched in PubMed, Cochrane Library, JBI, CINAHL, Web of Science, Scopus, CNKI, Wanfang database and Chinese biomedical literature database. The search time limit was from the establishment of the database to November 30, 2021. Two researchers independently read, and used EndNoteX9 and Excel tables to extract relevant data from the literature for summary and analysis.Results:Totally 20 articles were selected, including 2 mixed studies, 10 cross-sectional studies, 6 qualitative studies, and 2 quasi-experimental studies. Relevant factors affecting the participation of the elderly in digital health interventions involved the developers, users and the user himself of digital health intervention systems, including the degree of system integration of system development, the degree of autonomy of the elderly, the credibility and accessibility of system equipment and ease of use; the degree of compatibility of equipment in the process of use, the degree of digital infrastructure configuration, the degree of Internet penetration, the availability and reliability of health information resources, the degree of training and education, the degree of communication with the elderly in the process of participation, financial payment, etc.; the four inherent factors of the elderly included the cost of technology use, technical anxiety, privacy and safety, and health needs.Conclusions:The elderly, medical staff, developers and other stakeholders should jointly participate in decision-making on the development and management of the digital health intervention system for the elderly, especially by inviting and empowering the elderly , and improve the training and feedback of the system application and use process, accelerate the popularization and promotion of technical resources, and increase social capital and financial payment incentives to reduce the burden on the elderly and the medical system.

Objective:To compare the clinical characteristics and prognosis of bacterial liver abscess in patients with or without diabetes mellitus (DM), to provide a reference for clinical diagnosis and treatment.Methods:Patients with bacterial liver abscesses hospitalized in Tongren Hospital, Shanghai Jiao Tong University School of Medicine from January 2016 to August 2021 were enrolled, and their clinical data were collected. The patients were divided into diabetic and non-diabetic groups for comparison according to whether they had comorbid DM. Statistical analysis was performed by chi-square test or Fisher′s exact test, and multivariate logistic regression analysis.Results:A total of 131 patients with bacterial liver abscesses were included, including 47 cases in the diabetic group and 84 cases in the non-diabetic group. The percentages of platelet count <100×10 9/L, C-reactive protein>10 mg/L, and total bilirubin>17.5 μmol/L were lower in the diabetic group than that in the non-diabetic group, and the differences were all statistically significant ( χ2=3.90, 6.44 and 5.56, respectively, all P<0.05). The percentage of multiple abscesses in the diabetic group was 10.6%(5/47), which was lower than 29.8%(25/84) in the non-diabetic group, and the difference was statistically significant ( χ2=6.24, P=0.012). The positive rate of pus culture for Klebsiella pneumoniae was 64.9%(24/37) in the diabetic group, which was higher than 41.5%(27/65) in the non-diabetic group, with a statistically significant difference ( χ2=5.13, P=0.023). The incidences of pleural effusion and abscesses at other sites in the diabetic group were 29.8%(14/47) and 10.6%(5/47), respectively, which were both higher than 14.3%(12/84) and 1.2%(1/84) in the non-diabetic group, respectively, and the differences were statistically significant ( χ2=4.55, Fisher′s exact test, both P<0.05). The proportion of hospital stays>21 d was 34.0%(16/47) in the diabetic group, which was higher than 16.7%(14/84) in the non-diabetic group, with a statistically significant difference ( χ2=5.15, P=0.023). DM (odds ratio ( OR)=2.654, 95% confidence interval ( CI) 1.020 to 6.907, P=0.046) and abscess maximum diameter>10 cm ( OR=11.045, 95% CI 4.493 to 27.154, P<0.001) were significant risk factors for hospital stay>21 d. Conclusions:Bacterial liver abscesses combined with DM are more common with single abscess, a higher rate of Klebsiella pneumoniae infection, and more likely to develop pleural effusions and abscesses at other sites. Liver abscesses>10 cm in maximum diameter and comorbid DM would prolong hospital stay.

Objective:To explore the mindfulness level and self-management behaviors in young and middle-aged maintenance hemodialysis (MHD) patients, and to analyze the correlation between them.Methods:From August to November 2020, convenience sampling was used to select 170 young and middle-aged MHD patients admitted to the Blood Purification Center of People's Hospital of Hunan Province as the research object. The patients were investigated using the General Information Questionnaire, Five Facet Mindfulness Questionnaire (FFMQ) and Hemodialysis Self-Management Instrument (HD-SMI) . A total of 170 questionnaires were distributed, and 165 valid questionnaires were recovered, with a valid recovery rate of 97.06%.Results:Among 165 young and middle-aged MHD patients, the total scores of FFMQ and HD-SMI were (116.12±14.82) and (57.72±10.72) respectively. Pearson correlation analysis showed that the FFMQ total score and each dimension score were all positively correlated with the HD-SMI total score and each dimension score ( P<0.05) . Conclusions:The level of mindfulness and self-management behaviors of young and middle-aged MHD patients were in the middle level. Medical and nursing staff should conduct mindfulness interventions for young and middle-aged MHD patients to improve patients' initiative and further improve their self-management behaviors.

Objective:To understand the current situation of the demand for Internet plus nursing service among nurses at different levels, and analyze the influencing factors, so as to provide reference for the improvement of relevant national policies.Methods:A total of 19 762 in-service nurses from 32 provinces in China were investigated by cross sectional survey in April to May 2019. The demand for Internet plus nursing services was investigated, including 5 dimensions, including institutional demand, safety demand, demand for fees, quality demand and training needs.Results:Among the 19 762 nurses surveyed, there were 135, 4 736, 8 847, 4 827 and 1 217 nurses at N0-N4 levels respectively. The safety needs of nurses ranked first(4.68±0.52). The institutional needs of N3 and N4 nurses were the most significant, and the safety needs of N0-N2 nurses were the most significant; Training demand was the third demand of nursing staff at all levels. Multiple linear regression analysis showed that education and professional title were the factors that affected nurses′ demand for Internet plus nursing service( P<0.01). Conclusions:Nurses at different levels have a high and diversified demand for Internet+ nursing services.

Objective:To systematically review the influencing factors of nurses' clinical alarm response behavior.Methods:PubMed, Web of Science, Google Scholar, Spischolar, CNKI, Wanfang, VIP and other databases were searched from January 2004 to December 2019. Relevant studies on the influencing factors of nurses' clinical alarm response were searched, and the quality of articles meeting the inclusion criteria was evaluated, the contents were extracted and analyzed.Results:A total of 11 English articles were included, including 10 descriptive studies and 1 cohort study. Finally, 5 influencing factors ( P<0.01) related to nurses' response to clinical alarms were extracted, which were a large number of false alarms ( OR=0.84, 95% CI: 0.82-0.86) , nurses' risk assessment of patients' condition ( OR=0.77, 95% CI: 0.71-0.82) , clinical noise and multiple alarms ( OR=0.87, 95% CI: 0.85-0.89) , effective management of alarms ( OR=0.50, 95% CI: 0.43-0.58) and insufficient nursing staff ( OR=0.63, 95% CI: 0.57-0.68) . There is a lack of strong evidence on whether the nurses' work experience, clinical nurses' team cooperation degree, clinical alarm type identification, clinical alarm duration and working hours were the influencing factors of nurses' clinical alarm response. Conclusions:Nurses' clinical alarm response is affected by many factors. Targeted management should be carried out to improve response efficiency. More in-depth observational researches or intervention researches are suggested to be carried out to further improve the quality of nursing services.

Objective:To investigate the demand of patients for home care services under the background of "Internet+" and analyze its influencing factors of their participation status.Methods:A total of 494 patients from 7 ClassⅢ hospitals in Beijing, Guangzhou and Changsha from April to June 2019 were investigated by questionnaires. The research tools included general data questionnaire and questionnaire of patients' demands or "Internet+" home care service.Results:A total of 461 valid questionnaires were collected. The degree of patients' demand for "Internet+" home care services in descending score order was diagnosis and treatment information security [ (4.64±1.69) points], service capacity [ (4.62±1.77) points], health guidance [ (4.34±3.06) points], specialty nursing [ (4.24±3.79) points]. The results of binary Logistic regression analysis showed that monthly income, medical insurance type, main caregivers, and the number of diseases suffered by family members were the influencing factors of patients' participation in "Internet+" home care services ( P<0.05) . Conclusions:Patients have a realistic demand for "Internet+" home care services. It is recommended to establish a nursing service system based on patient needs, strengthen patients' information security, expand the radius of nurses' door-to-door service, enrich the list of service items and provide patients with professional and scientific services.

Objective:To understand the current status of the knowledge-attitude-practice of lower extremity deep venous thrombosis (DVT) prevention in patients after traumatic orthopedic surgery and its influencing factors, and to provide a reference for improving the behavioral intervention strategies.Methods:A convenient sampling method was adopted to select 150 orthopedic patients who were hospitalized in the Traumatic Orthopedics Department of a Class A tertiary hospital from January to April 2019. The general demographic data questionnaire and the lower extremity DVT development knowledge-attitude-practice questionnaire were used to collect data. Data analysis was performed using SPSS 18.0 statistical software.Results:The total score of knowledge-attitude-practice for DVT prevention in 150 patients was (77.78±8.16) , with knowledge (14.44±4.03) , attitude (54.21±5.34) , and practice (8.09±1.46) . Univariate analysis showed that ages, education levels, occupations, and surgical sites had statistically significant impact on knowledge scores for lower extremity DVT prevention ( F=2.075, 14.829, 10.312, 7.406; P<0.05) ; surgical sites had statistically significant impact on attitude scores ( F=9.765, P<0.05) ; educational levels, surgical sites and caregivers had statistically significant impact on practice scores ( F=3.151, 4.178, 2.810; P<0.05) . Multivariate analysis showed that education levels and occupation were the main influencing factors of knowledge score, and education and primary caregivers were the main influencing factors of practice score. Conclusions:The knowledge-attitude-practice of DVT prevention in patients after traumatic orthopedic surgery are affected by education level, occupation and primary caregiver. Patients lack relevant knowledge while having positive prevention attitude, and relatively high behavioral compliance.

Objective:To explore the effects of motivational interviewing strategy based on WeChat platform on blood glucose, self-management behavior and pain degree in young and middle-aged patients with type 2 diabetes mellitus (T2DM) .Methods:The convenience sampling method was used to select a total of 84 young and middle-aged patients with T2DM who were admitted to Department of Endocrinology of a ClassⅢ Grade A hospital from August to October 2018 as the research objects. According to the random number table, all patients were divided into the observation group and the control group with 42 cases in each group. The observation group was given the motivational interviewing strategy based on WeChat platform for intervention. The control group received routine diabetes education. Before and 6 months after the intervention, the blood glucose, self-management behavior and pain degree of the patients in the two groups were evaluated.Results:After 6 months of intervention, the patients' blood glucose, self-management behavior and pain degree were all better than those in the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The motivational interview strategy based on WeChat platform can improve the blood glucose level and self-management behavior of young and middle-aged T2DM patients, reduce the degree of pain, and provide a reference for the development of home care and continuous care.