[Objective] To investigate the infection status and characteristics of HEV among voluntary blood donors in Ningbo, and to provide a basis for improving the blood screening strategy. [Methods] A total of 12 227 blood samples from voluntary blood donors in Ningbo from June 2022 to May 2023 were tested for HEV serology, enzymology, and nucleic acid testing. Furthermore, HEV gene sequencing was performed for genotyping analysis, and donors with reactive nucleic acid testing results were followed up to confirm their infection status. [Results] The reactivity rate of HEV Ag, anti-HEV IgM and anti-HEV IgG was 0.098%, 0.899% and 29.198%, respectively. There was no difference in the reactivity of anti-HEV IgM and anti-HEV IgG between genders, donation frequencies and donation types (P>0.05). The reactivity rate increased significantly with age (P<0.05). The rate of ALT disqualification (ALT>50U/L) was significantly higher than that in non-reactive samples (P<0.05). The HEV Ag reactivity rate (0.098%) was not correlated with gender, donation frequency, donation type or age. One HEV RNA positive case was found, with a positive rate of 0.008%(1/12 227). It was confirmed to be hepatitis E virus genotype 3 by sequencing analysis. Apart from HEV Ag reactivity, all other blood safety screening items were non-reactive, suggesting this case might be in the acute infection phase. The follow-up results showed that all indicators of the donor's previous blood donation were non-reactive. [Conclusion] Pre-donation ALT detection can reduce the risk of transfusion-transmitted HEV (TT-HEV) to a certain extent, and the effective way to prevent TT-HEV is to detect HEV RNA and serology of donor blood.

In July 2023， the National Medical Products Administration issued the Measures for the Administration of Standards for Medicinal Products （hereinafter referred to as the Measures）. This article interprets the main content of the Measures， and analyzes its shortcomings as unclear definition of the drug standard code and the goals of drug standard information construction. It is recommended that the national drug regulatory department promptly apply to the standardization authority for the confirmation of the drug standard code “YB” letter， and the drug standard code and numbering rules would be included in the next round of amendments to the Measures. It is necessary to clarify the construction goals of the information system for drug standards at the same time， and build a national drug standard data-sharing platform based on the basic framework of user interface layer， computing processing layer， and data storage layer. Digital drug standards will be free， and access and download services for the public will be provided.

BACKGROUND:Confirming the reliability and validity of the My jump 2 application for measuring lower limb vertical stiffness may offer the possibility of it as an alternative to the Kistler three-dimensional force platform for measuring lower limb stiffness. OBJECTIVE:To verify the reliability and validity of the My Jump 2 application in measuring lower limb vertical stiffness of college students. METHODS:The drop jump data of the participants were collected through the Kistler three-dimensional force platform and the My Jump 2 application,and the vertical stiffness of the participants'lower limb vertical stiffness was calculated.The intraclass correlation coefficient was used to analyze the data measured by the My Jump 2 application and the Kistler three-dimensional force platform,attempting to verify the reliability of the My Jump 2 application.The bias and average between the two devices were drawn into a Bland-Altman diagram to verify the consistency between the two test methods.Finally,the test-retest reliability of the My Jump 2 applications at 30 cm and 40 cm was analyzed using the Cronbach's alpha(α)and coefficient of variation.Pearson product-moment correlation was used to analyze the correlation of My Jump 2 applications. RESULTS AND CONCLUSION:My Jump 2 application has high reliability and validity when measuring the vertical stiffness of the lower limb.At the same time,due to its advantages of low cost,convenient portability and field testing for large samples,it can be used as an alternative to the Kistler three-dimensional force platform to test the vertical stiffness of the lower limb in college students and similar populations.

Objective To analyze the influencing factors of peritoneal dialysis associated peritonitis(PDAP)and the distribution characteristics of pathogenic bacteria.Methods The clinical data of 257 patients who underwent peritoneal dialysis(PD)and regular follow-up in Meizhou People's Hospital from January 2012 to October 2022 were retrospectively analyzed.According to the occurrence of PDAP,the patients were divided into the PDAP group(n=102)and the non-PDAP group(n=155).The exhaled liquid(5-10 mL)was extracted with a sterile syringe,and the pathogen was identified by blood culture method.General data such as gender,age,primary disease,education level,whether complicated with hypertension/diabetes/cardiovascular diseases,whether keeping pets or poultry,body mass index(BMI)and dialysis duration were collected.Fasting elbow venous blood was drawn in the morning of the next day after diagnosis,the levels of hemoglobin(Hb),albumin(ALB),serum potassium,serum phosphorus,and serum calcium were detected.The estimated glomerular filtration rate(eGFR)and urea clearance index(UCI)were recorded.Multivariate logistic regression was used to analyze the risk factors of PDAP in PD patients.Results There were 217 cases of PDAP in 102 patients with PDAP,and 124 cases(57.14％)were positive for pathogen culture.A total of 127 pathogenic bacteria were isolated,including 84 Gram-positive strains(66.14％),39 Gram-negative strains(30.71％)and 4 Fungi strains(3.15％).Among the 84 strains of Gram-positive bacteria,there were 25 strains of staphylococcus epidermidis(29.76％),17 strains of staphylococcus aureus(20.24％),12 strains of staphylo-coccus haemolyticus(14.29％),8 strains of staphylococcus warneri(9.52％),10 strains of streptococcus salivarius(11.90％),5 strains of streptococcus sanguis(5.95％),and 7 other strains(8.33％).Among the 39 strains of Gram-nega-tive bacteria,there were 20 strains of escherichia coli(51.28％),6 strains of pseudomonas aeruginosa(15.38％),6 strains of acinetobacter baumannii(15.38％),5 strains of klebsiella pneumoniae(12.82％),and 2 strains of enterobacter cloacae(5.13％).Among the 4 strains of Fungi,there were 3 strains of near-smooth candida(75.00％)and 1 strain of candida glabrata(25.00％).There was no significant difference in gender,age,primary disease,education level,BMI,and the propor-tion of comorbidities with hypertension,diabetes and cardiovascular diseases between the PDAP and non-PDAP groups(P＞0.05).The proportion of patients keeping pets or poultry in the PDAP group was higher than that in the non-PDAP group,and the dialysis duration was longer than that in the non-PDAP group(P＜0.05).There was no significant difference in serum phosphorus,serum calcium,eGFR and UCI between the PDAP and non-PDAP groups(P＞0.05).The levels of Hb,ALB and serum potassium in the PDAP group were significantly lower than those in the non-PDAP group(P＜0.05).Logistic regression analysis showed that keeping pets or poultry and long dialysis duration were risk factors for PDAP in PD patients(P＜0.05).High Hb and ALB levels were protective factors for PDAP in PD patients(P＜0.05).There was no correlation between serum potassium and PDAP in PD patients(P＞0.05).Conclusion Gram-positive bacteria are the main pathogenic bacteria of PDAP,among which staphylococcus epidermidis is the predominant one.Keeping pets or poultry and long dialysis duration are risk factors for PDAP,while high Hb and ALB levels are protective factors for PDAP in PD patients.

Objective:To explore the mediating effect of professional self-efficacy between professional values and willingness to work on gerontological care of nursing students in higher vocational colleges.Methods:A total of 391 nursing students from Chengdu area full-time university were investigated by general information questionnaire, gerontological nursing career motivation questionnaire, professional values scale, and professional self-efficacy scale. Pearson correlation analysis and descriptive statistical analysis were performed by SPSS 21.0. Amos 26.0 was used to establish mediating effect model and verify the mediating effect.Results:The total score of 391 nursing students' willingness to work on gerontological care was (47.05±6.93), the willingness to work on gerontological care was positively correlated with professional self-efficacy and professional values ( r = 0.826, 0.775, respectively, all P<0.01), and professional self-efficacy played a partial mediating role between professional values and willingness to work on gerontological care, accounting for 64.82% of the total effect. Conclusions:The willingness to work on gerontological care of nursing students in higher vocational colleges is at a middle level. Professional values not only directly affect the willingness to work on gerontological care, but also indirectly take function through the professional self-efficacy. Professional self-efficacy plays a mediating role in professional values and willingness to work on gerontological care of nursing students in higher vocational colleges.

Objective To explore the influencing factors of the career plateau among hospital administrators,to provide scientific reference for enhancing the quality of hospital management and operation.Methods The interview data were analyzed by grounded theoretical research methods.It conducted semi-structured interviews with 22 tar-get objects and conducted qualitative research on the influencing factors of hospital administrators'career plateau with the help of NVivo 11.0 software.Results After a three-level coding,114 initial concepts,30 subcategories,10 main categories,and 3 core categories were summarized.A theoretical model was developed,encompassing three dimensions:aggravating factors,dissipating factors,and convertible factors.Conclusion The career plateau of hospi-tal administrators is affected by a complex interplay of aggravating,dissipating and convertible factors.Hospitals need to provide regular vocational training to cultivate organizational loyalty for their employees.Hospital administra-tors should engage in proactive career planning and skill diversification.and the government should coordinate the es-tablishment of links between hospitals and the external system to promote the openness and connection of the healthcare system to the outside world.

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 influencing factors of the career plateau among hospital administrators,to provide scientific reference for enhancing the quality of hospital management and operation.Methods The interview data were analyzed by grounded theoretical research methods.It conducted semi-structured interviews with 22 tar-get objects and conducted qualitative research on the influencing factors of hospital administrators'career plateau with the help of NVivo 11.0 software.Results After a three-level coding,114 initial concepts,30 subcategories,10 main categories,and 3 core categories were summarized.A theoretical model was developed,encompassing three dimensions:aggravating factors,dissipating factors,and convertible factors.Conclusion The career plateau of hospi-tal administrators is affected by a complex interplay of aggravating,dissipating and convertible factors.Hospitals need to provide regular vocational training to cultivate organizational loyalty for their employees.Hospital administra-tors should engage in proactive career planning and skill diversification.and the government should coordinate the es-tablishment of links between hospitals and the external system to promote the openness and connection of the healthcare system to the outside world.

Objective To explore the influencing factors of the career plateau among hospital administrators,to provide scientific reference for enhancing the quality of hospital management and operation.Methods The interview data were analyzed by grounded theoretical research methods.It conducted semi-structured interviews with 22 tar-get objects and conducted qualitative research on the influencing factors of hospital administrators'career plateau with the help of NVivo 11.0 software.Results After a three-level coding,114 initial concepts,30 subcategories,10 main categories,and 3 core categories were summarized.A theoretical model was developed,encompassing three dimensions:aggravating factors,dissipating factors,and convertible factors.Conclusion The career plateau of hospi-tal administrators is affected by a complex interplay of aggravating,dissipating and convertible factors.Hospitals need to provide regular vocational training to cultivate organizational loyalty for their employees.Hospital administra-tors should engage in proactive career planning and skill diversification.and the government should coordinate the es-tablishment of links between hospitals and the external system to promote the openness and connection of the healthcare system to the outside world.

Objective To explore the influencing factors of the career plateau among hospital administrators,to provide scientific reference for enhancing the quality of hospital management and operation.Methods The interview data were analyzed by grounded theoretical research methods.It conducted semi-structured interviews with 22 tar-get objects and conducted qualitative research on the influencing factors of hospital administrators'career plateau with the help of NVivo 11.0 software.Results After a three-level coding,114 initial concepts,30 subcategories,10 main categories,and 3 core categories were summarized.A theoretical model was developed,encompassing three dimensions:aggravating factors,dissipating factors,and convertible factors.Conclusion The career plateau of hospi-tal administrators is affected by a complex interplay of aggravating,dissipating and convertible factors.Hospitals need to provide regular vocational training to cultivate organizational loyalty for their employees.Hospital administra-tors should engage in proactive career planning and skill diversification.and the government should coordinate the es-tablishment of links between hospitals and the external system to promote the openness and connection of the healthcare system to the outside world.