Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of national bloodstream infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:During the study period，9 035 strains of Gram-negative bacteria were collected from 51 hospitals，of which 7 895（87.4%）were Enterobacteriaceae and 1 140（12.6%）were non-fermenting bacteria. The top 5 bacterial species were Escherichia coli（ n=4 510，49.9%）， Klebsiella pneumoniae（ n=2 340，25.9%）， Pseudomonas aeruginosa（ n=534，5.9%）， Acinetobacter baumannii complex（ n=405，4.5%）and Enterobacter cloacae（ n=327，3.6%）. The ESBLs-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus spp. were 47.1%（2 095/4 452），21.0%（427/2 033）and 41.1%（58/141），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（58/4 510）and 13.1%（307/2 340）；62.1%（36/58）and 9.8%（30/307）of CREC and CRKP were resistant to ceftazidime/avibactam combination，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 59.5%（241/405），while less than 5% of Acinetobacter baumannii complex was resistant to tigecycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 18.4%（98/534）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of main Gram-negative bacteria resistance among different regions，with statistically significant differences in the prevalence of CRKP and CRPA（ χ2=20.489 and 20.252， P<0.001）. The prevalence of CREC，CRKP，CRPA，CRAB，ESBLs-producing Escherichia coli and Klebsiella pneumoniae were higher in provinicial hospitals than those in municipal hospitals（ χ2=11.953，81.183，10.404，5.915，12.415 and 6.459， P<0.01 or <0.05），while the prevalence of CRPA was higher in economically developed regions（per capita GDP ≥ 92 059 Yuan）than that in economically less-developed regions（per capita GDP <92 059 Yuan）（ χ2=6.240， P=0.012）. Conclusions:The proportion of Gram-negative bacteria in bloodstream infections shows an increasing trend，and Escherichia coli is ranked in the top，while the trend of CRKP decreases continuously with time. Decreasing trends are noted in ESBLs-producing Escherichia coli and Klebsiella pneumoniae. Low prevalence of carbapenem resistance in Escherichia coli and high prevalence in CRAB complex have been observed. The composition ratio and antibacterial spectrum of bloodstream infections in different regions of China are slightly different，and the proportion of main drug resistant bacteria in provincial hospitals is higher than those in municipal hospitals.

Objective:To explore the developmental characteristics of event-related potential(ERP) in cognitive function of recognition memory in children aged 6-12.Methods:A total of 130 normal children were divided into seven age groups (6 ( n=20), 7 ( n=17), 8 ( n=23), 9 ( n=24), 10 ( n=19), 11 ( n=15), and 12 years old ( n=12)) to perform a picture study-recognition task and record the reaction time, accuracy, and ERP components of all participants. SPSS 22.0 software was used for data analysis. Single factor analysis of variance and trend of variance were used to compare the response time and accuracy of 7 groups of children during the recognition stage. Pearson correlation analysis was used to study the correlation between the amplitude of the central midline N2 component and age. Paired t-test was used to examine the old/new effects of the amplitude of midfrontal N2 and midparietal P3 waves. Results:(1) The differences of recognition ability ( F(6, 123)=2.476, P<0.05), old picture reaction time ( F(6, 123)=6.461, P<0.001), and new picture reaction time ( F(6, 123)=4.163, P<0.001) among 7 age groups of children were statistically significant. Recognition ability of children aged 6 (0.61±0.24) was lower than those of 8-12 years old children((0.76±0.27), (0.76±0.10), (0.73±0.11), (0.75±0.10), (0.70±0.17) respectively)(all P<0.05). The reaction time of the old picture showed no difference among the children aged 6-9 (all P>0.05), and the reaction time of old picture of children aged 12 was shorter than those of 6-10 years old children (all P<0.01). There was no significant difference in the reaction time of new pictures among the children aged 6-10 (all P>0.05), and which in children aged 12 was shorter than those in 6-10 years old children(all P<0.01). (2) Age was positively correlated with the amplitude of the N2 component in the central region under the new ( r=0.488, P<0.001) and old picture( r=0.452, P<0.001) conditions. (3)At 6 years old, children showed old/new effects on the mid-frontal electrodes. At 7 years old, there were no old/new effects in either the mid-frontal or mid-parietal regions. From 8 to 9 years old, old/new effects appeared in the mid-parietal lobe. At 10 years old, old/new effects were present in both the mid-frontal and mid-parietal regions. At 11 years old, the mid-parietal lobe showed old/new effects. Finally, at 12 years old, negative old/new effects could be observed in both the mid-frontal and mid-parietal regions. Conclusion:There are three periods of changes in the behavior of picture recognition memory in school-age children. At ages 6-7, the accuracy rate is relatively low; at ages 8-9, it improves; and between ages 10-12, the accuracy rate stabilizes while also enabling faster judgments.Children's recognition memory retrieval process is more complex than their behavioral performance. Children have different tendencies toward strategies, but strategic transitions in recognition processing are not always beneficial for performance.

Objective This study aims to investigate the feasibility and safety of Da Vinci robotic-assisted thoracoscopy for resecting mediastinal tumors in pediatric patients.Methods From November 2020 to June 2023,a total of 80 pediatric patients undergoing mediastinal tumor resection at Wuhan Children's Hospital were randomly assigned into two groups,with each group consisting of 40 participants.The control group underwent conventional thoracoscopy,while the observation group underwent Da Vinci robotic-assisted thoracoscopy.This study aimed to compare perioperative indicators between the two groups and establish learning curves based on surgical duration and intraoperative blood loss.Additionally,it assessed levels of pain mediators and stress response markers before surgery and at 24 hours post-surgery,as well as postoperative complications.Inflammatory marker levels were evaluated one month after surgery,and the children's quality of life was measured using the Pediatric Quality of Life Inventory(PedsQL)Generic Core Scales before surgery and one month post-surgery.Results The surgical duration for the observation group and the control group was(1.76±0.33)hours and(2.82±0.62)hours,respectively,and the intraoperative blood loss was(49.83±6.39)mL and(71.55±8.19)mL,respectively.Furthermore,the post-operative drainage time,drainage volume,and hospital stay for the observation group were all lower than those for the control group(P<0.05).After surgery,the levels of BK,5-HT,NPY,and PGE2 in the observation group were(8.06±1.06)mg/L,(170.20±13.21)ng/L,(201.82±13.52)mg/L,and(241.82±15.32)ng/L,respectively,indicating lower levels of pain mediators,stress response markers,and inflammatory factors compared to the control group(P<0.05).he overall incidence of complications was 2.50%in the observation group as opposed to 20.00%in the control group.Moreover,there was a statistically significant improvement in quality of life after surgery within the observation group when compared to that within the control group(P<0.05).Conclusion Da Vinci robotic-assisted thoracoscopy demonstrates enhanced feasibility and safety in pediatric mediastinal tumor resection,thereby justifying its clinical promotion.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-positive bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-positive bacteria from blood cultures in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:A total of 3 163 strains of Gram-positive pathogens were collected from 51 member units，and the top five bacteria were Staphylococcus aureus（ n=1 147，36.3%），coagulase-negative Staphylococci（ n=928，29.3%）， Enterococcus faecalis（ n=369，11.7%）， Enterococcus faecium（ n=296，9.4%）and alpha-hemolyticus Streptococci（ n=192，6.1%）. The detection rates of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）were 26.4%（303/1 147）and 66.7%（619/928），respectively. No glycopeptide and daptomycin-resistant Staphylococci were detected. The sensitivity rates of Staphylococcus aureus to cefpirome，rifampin，compound sulfamethoxazole，linezolid，minocycline and tigecycline were all >95.0%. Enterococcus faecium was more prevalent than Enterococcus faecalis. The resistance rates of Enterococcus faecium to vancomycin and teicoplanin were both 0.5%（2/369），and no vancomycin-resistant Enterococcus faecium was detected. The detection rate of MRSA in southern China was significantly lower than that in other regions（ χ2=14.578， P=0.002），while the detection rate of MRCNS in northern China was significantly higher than that in other regions（ χ2=15.195， P=0.002）. The detection rates of MRSA and MRCNS in provincial hospitals were higher than those in municipal hospitals（ χ2=13.519 and 12.136， P<0.001）. The detection rates of MRSA and MRCNS in economically more advanced regions（per capita GDP≥92 059 Yuan in 2022）were higher than those in economically less advanced regions（per capita GDP<92 059 Yuan）（ χ2=9.969 and 7.606， P=0.002和0.006）. Conclusions:Among the Gram-positive pathogens causing bloodstream infections in China， Staphylococci is the most common while the MRSA incidence decreases continuously with time；the detection rate of Enterococcus faecium exceeds that of Enterococcus faecalis. The overall prevalence of vancomycin-resistant Enterococci is still at a low level. The composition ratio of Gram-positive pathogens and resistant profiles varies slightly across regions of China，with the prevalence of MRSA and MRCNS being more pronounced in provincial hospitals and areas with a per capita GDP≥92 059 yuan.

Objective To explore the correlations between triglyceride glucose index(TyG)and its derivatives TyG-body mass index(BMI)and TyG-alanine transaminase(ALT)with the risk of lean metabolic associated fatty liver disease(MAFLD).Methods A total of 207 patients diagnosed with lean MAFLD and 100 lean healthy controls who received annual health examination in Health Management Center of our hospital from Jul.to Dec.2023 were enrolled.Plasma lipids,blood glucose,liver function,TyG,TyG-BMI and TyG-ALT were compared between the 2 groups.The influencing factors of lean MAFLD were analyzed by univariate and multivariate logistic regression models.All subjects were divided into 4 subgroups(Q1-Q4)according to the quartile of TyG and its derivatives,and the prevalence of lean MAFLD in each subgroup was observed.The receiver operating characteristic(ROC)curves of TyG,TyG-BMI and TyG-ALT for lean MAFLD were plotted to evaluate the prediction efficiency.Results Of the 8 764 health examination cases included,2 350(26.8％)had MAFLD,of which 207 were lean MAFLD(8.8％,207/2 350).Compared with the lean healthy controls,the patients in the lean MAFLD group were older,with more male and high BMI,and their fasting blood glucose,total cholesterol,triglyceride,low density lipoprotein-cholesterol,ALT,aspartate transaminase,γ-glutamyl transpeptidase,alkaline phosphatase,total bilirubin,TyG,TyG-BMI and TyG-ALT were significantly increased,while high density lipoprotein-cholesterol was significantly decreased(all P＜0.01).Logistic regression analysis showed that age,male,and elevated ALT level were independent risk factors for lean MAFLD.The prevalence of lean MAFLD in the Q4 subgroup of TyG was significantly higher than that in the Q1 and Q2 subgroups(34.3％[71/207]vs 10.6％[22/207]and 24.2％[50/207],both P＜0.05).The prevalence rates of lean MAFLD in the Q4 subgroup of TyG-BMI and the Q4 subgroup of TyG-ALT were significantly higher than those in the corresponding Q1,Q2,and Q3 subgroups(35.3％[73/207]vs 8.2％[17/207],24.6％[51/207],and 31.9％[66/207];33.8％[70/207]vs 14.0％[29/207],23.2％[48/207],and 29.0％[60/207];all P＜0.05).The area under curve(AUC)of TyG-BMI in predicting lean MAFLD was 0.869 0(95％confidence interval[CI]0.825 5-0.912 6,P＜0.001),which was higher than that of TyG(AUC=0.818 8[95％CI 0.768 0-0.869 6,P＜0.001])and TyG-ALT(AUC=0.772 5[95％CI 0.718 7-0.826 2,P＜0.001]).Conclusion TyG,TyG-BMI,and TyG-ALT are associated with lean MAFLD,and have predictive value for lean MAFLD.TyG and its derivatives are easy to calculate and cheap,and can be used for preliminary clinical assessment of lean MAFLD.

Objective:To analyze the current research status of ideological and political education content in domestic nursing courses and facilitate nursing education reform.Methods:Using purposeful sampling, 25 exemplary cases of ideological and political education in nursing courses from Xinhua Net were selected. NVivo 12 software was employed for content analysis, summarizing the ideological and political elements, carriers of these elements, and types of integration methods in nursing courses.Results:Nursing educators have thoroughly explored ideological and political elements, with the most attention given to professional ethics, though less focus was placed on personality development. A variety of carriers for ideological and political elements were utilized, with practical experience being the most common, but there was a lack of integration with policy and regulations. Various integration methods were applied, with interactive methods being the most frequently used, while practical approaches were less common.Conclusions:Future nursing education should emphasize fostering students' sense of national identity and focus more on personality development. It is important to promote a more balanced use of carriers for ideological and political elements, paying particular attention to policy-related content. The use of information technology in teaching should also be explored to flexibly apply various teaching methods, achieving the subtle integration of ideological and political education within nursing curricula.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical bacterial isolates from bloodstream infections in China in 2021.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2021 to December 2021. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 11 013 bacterial strains were collected from 51 hospitals, of which 2 782 (25.3%) were Gram-positive bacteria and 8 231 (74.7%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.6%), Klebsiella pneumoniae (18.9%), Staphylococcus aureus (9.8%), coagulase-negative Staphylococci (6.3%), Pseudomonas aeruginosa (3.6%), Enterococcus faecium (3.6%), Acinetobacter baumannii (2.8%), Enterococcus faecalis (2.7%), Enterobacter cloacae (2.5%) and Klebsiella spp (2.1%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 25.3% and 76.8%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci was detected; more than 95.0% of Staphylococcus aureus were sensitive to ceftobiprole. No vancomycin-resistant Enterococci strains were detected. The rates of extended spectrum B-lactamase (ESBL)-producing isolated in Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 49.6%, 25.5% and 39.0%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.2% and 15.8%, respectively; 7.9% of carbapenem-resistant Klebsiella pneumoniae was resistant to ceftazidime/avibactam combination. Ceftobiprole demonstrated excellent activity against non-ESBL-producing Escherichia coli and Klebsiella pneumoniae. Aztreonam/avibactam was highly active against carbapenem-resistant Escherichia coli and Klebsiella pneumoniae. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii (5.5% and 4.5%). The prevalence of carbapenem-resistance in Pseudomonas aeruginosa was 18.9%. Conclusions:The BRICS surveillance results in 2021 shows that the main pathogens of blood stream infection in China are gram-negative bacteria, in which Escherichia coli is the most common. The MRSA incidence shows a further decreasing trend in China and the overall prevalence of vancomycin-resistant Enterococci is low. The prevalence of Carbapenem-resistant Klebsiella pneumoniae is still on a high level, but the trend is downwards.

Objective:To systematically analyze the concept evolution, defining attributes, cases, antecedents, and consequences of family resilience in children with chronic diseases, and to clarify the concept connotation of family resilience in children with chronic diseases from the perspective of nursing practice.Methods:The article on family resilience in children with chronic diseases was systematically searched in PubMed, Web of Science, Embase, Scopus, Cochrane Library, APA PsycNet, China National Knowledge Infrastructure, WanFang Data, VIP, and SinoMed. The retrieval period was from the establishment of the database to July 1, 2022. The Walker Avant concept analysis method was applied to the analysis.Results:Family resilience in children with chronic diseases had five defining attributes, including optimistic attitudes towards life, open communication styles, intimate family relationships, positive coping styles, and sufficient social support. The antecedents included demography characteristics, disease diagnosis, disease cognition, family rearing patterns and social and cultural environment. The consequences included both family and individual levels.Conclusions:Based on conceptual analysis, this study clarifies the conceptual attributes of family resilience in children with chronic diseases and its uniqueness compared to adult family resilience, providing a theoretical basis for constructing operational definitions, developing evaluation tools, and conducting precise interventions for future related research.

Objective:To explore the developmental characteristics of Chinese semantic and orthographic processing in normal school-age children by event-related potential (ERP) technique.Methods:Children aged 7-11 in an ordinary primary school in Changzhou were randomly selected and divided into 7-year old group ( n=21 ), 8-year old group ( n=21), 9-year old group ( n=19), 10-year old group ( n=20) and 11- year old group ( n=22) according to their age.ERP was recorded while subjects completed the Chinese character semantic activation task and pseudo word judgment task. Then the N400 and P200 amplitudes of school-age children under the conditions of semantic correlation, semantic uncorrelation and pseudo word judgment were collected, and the data were analyzed by three factors mixed design ANOVA.Data of behavioral accuracy and response time were analyzed by one-way ANOVA and Bonferroni correction was used for multiple hypothesis testing. The statistical software was SPSS 25.0. Results:(1)Behavioral results: the accuracy of semantic related and semantic unrelated tasks of children in the five groups aged 7, 8, 9, 10 and 11 were statistically significant ( F=15.55, 4.01, both P<0.01), and the accuracy of children in the 7-year old group was significantly lower than those in the other four groups (all P<0.05). There was no significant difference in the accuracy of pseudo word judgment task among the five groups ( F=0.68, P=0.609). The response time of children in the five groups under semantic related and semantic unrelated tasks was significantly different ( F=3.90, 3.13, both P<0.05). The response time of the 11-year old group under semantic related tasks was significantly shorter than those of the 7-, 8- and 9-year old groups (all P<0.05). The response time of the 7-year old and 11-year old groups under semantic unrelated tasks was significantly shorter than those of the 8-, 9- and 10-year old groups (all P<0.05). (2)ERP results: N400 amplitudes of 7-, 8-, 9-, 10- and 11-year old children under semantic related tasks were significantly smaller than those under semantic unrelated tasks and pseudo word judgment tasks (all P<0.05). The N400 amplitude of the subjects gradually decreased with the increase of age, except that there was no statistical difference between the 10-year old and 11-year old groups under the semantic related task, between the 8-year old and 9-year old groups under the semantic unrelated task and the pseudo word judgment task, and between the 10-year old and 11-year old groups (all P>0.05), there were statistical differences between the other age groups (all P<0.05). P200 amplitude of semantic related task at 7-, 8-, 9- and 10-year old was significantly higher than that at semantic unrelated task (all P<0.05), and the amplitude of semantic related task at 7-, 8-, 10- and 11-year old was significantly higher than that at pseudo word judgment (all P<0.05). The amplitude of P200 gradually increased with age, and there were significant differences in pairwise comparison among other age groups ( P<0.05), except semantic related task and unrelated task among 7-, 8- and 9-year old groups, between 10- and 11-year old groups, and pseudo word task between 7- and 8- years old groups, 10- and 11- year old groups (all P>0.05). Conclusion:The semantic processing and orthographic processing of school-age children develop with age in a unique way. The age of 7 is an important period for cognitive development of Chinese language.The age of 8-9 may be a sensitive period for the development of brain plasticity, and the development slows down at the age of 10-11.

Objective:To investigate the traditional Chinese medical (TCM) constitution status of young and middle-aged residents and to analyze related influencing factors.Methods:A cross-sectional study was conducted to obtain data of 1 082 young and middle-aged residents in China from April to May 2019. The general characteristic, habits, emotional status and TCM constitution types of young and middle-aged residents were been collected.Results:The number of normal constitution types was 415(38.35%, 415/1 082), and the number of biased constitution types was 667(61.65%, 667/1 082) which was dominated by qi-deficiency constitution (16.70%, 344/2 060), yang-deficiency constitution (16.17%, 333/2 060) and damp-heat constitution (15.97%, 329/2 060). The Logistic regression analysis showed that the dietary regularity, taking vigorous exercise and taking moderate exercise were the protective factors of the biased constitution types of young and middle-aged residents( OR values were 0.624, 0.704, 0.704, all P<0.05), while the female, meat-based diet, anxiety and depression were the risk factors of the biased constitution types of young and middle-aged residents( OR values were 2.009-2.568, all P<0.01). Conclusions:The biased constitution is common among young and middle-aged residents. The risk factors of biased constitution are unhealthy lifestyle, anxiety and depression,which suggest the community to develop actively interventions to adjust the lifestyle and strengthen the maintenance of mental health of young and middle-aged residents.