Objective To explore the effect of the improved abdominal rotation card method in insulin injection. Methods A total of 100 hospitalized diabetes patients were randomly divided into control group (n=50) and observational group (n=50) according to the random number method. In the control group, insulin was injected to the subcutaneous tissue of abdomen with traditional method annular rotating method. Insulin was injected using improved abdominal rotation card method in the observational group. Compare accuracy and mastery rate of injection site rotation between the two groups. Compare fasting blood glucose (FBG), postprandial 2H blood glucose (PBG), HbA1c, the incidence of hypoglycemia and endermic induration between the two groups after three months. Results The nurses in the observation group had higher accuracy rate of the injection site rotation compared to the control group [98.6%(690/700) vs. 38.6%(270/700),χ2=584.66, P<0.01]. Mastery rate of the injection site rotation for the patients in the observation group were significantly higher than the control group [70.0% (35/50) vs. 20.0% (10/50), χ2=25.74, P < 0.01]. The incidence of endermic induration were significantly lower in observation group compared to the control group [2.0% (1/50) vs.16.0% (8/50), χ2=5.98, P < 0.01]. The incidence of hypoglycemia were significantly lower in observation group compared to the control group [4.0%(2/50) vs. 16.0%(8/50),χ2=4.00, P<0.01]. Conclusions The new abdominal rotation method in insulin injection can be a safe and effective therapy in patients with type 2 diabetes.

Objective To investigate the effect of all trans-retinoic acid (ATRA) combining with Interferon α-2a on bladder tumor and the possible mechanisms. Methods Fifty female Wistar rats with bladder tumor were established and separated into 4 groups randomly that are DMSO group (A), IFN-α-2a group(B), ATRA group(C) and ATRA+IFN-α-2a group(D). Then each group was treated by drugs indicated. Finally, the weight of bladder, the stage and grade of tumor, the apoptosis and proliferation index of tumor were determined to estimate the effect of ATRA+IFN-α-2a. Results The body weights in group D are the highest and the bladder weights in group D are the lowest. The stages and grades of tumor in group D were statistically decreased compared with those in the other 3 groups. Accordingly, the apoptosis of cancer cells in group D was enhanced, whereas the proliferation index in group D was decreased significandy. Conclusion The effect of ATRA combined with Interferonα-2a on the bladder tumor is better than that of monotherapy.

OBJECTIVETo make sure of the harmfulness degree of the dust in geological prospecting occupation.

METHODSThe determination of respirable dust, total dust and the free silica concentrations was carried out at different working spots exposed to dust. Personal sampling equipment was used to collect the respirable dust. The data of respirable dust concentration in the research was compared to the historical data.

RESULTSAs for respirable dust concentration level, 47.95% of 765 silica dust spots of geological prospecting occupation in 9 provinces(autonomous regions) were beyond the criteria. The profession and work type of the highest dust concentration was chiseling and sampling of geological prospecting [from 1996-2000, the dust concentration was (6.15 +/- 3.12) mg/m3]. The ratio of respirable dust to total dust was high in geological prospecting workers. The FSiO2 contentin dust to which geological prospecting workers exposed was high too.

CONCLUSIONSThe respirable dust concentration of some types of work in geological prospecting occupation was obviously higher than the national criteria, especially in chiseling, sampling and drilling workers.

Objective To study the efficacy of gamma globulin in the early treatment of severe or almost severe hand -foot -mouth disease.Methods 80 children with severe or almost severe hand -foot -mouth disease were randomly divided into treatment group and control group by the random number table.The treatment group received the treatment of early gamma globulin,whereas patients in the control group received conventional therapy.The effective rate of the treatment group was higher than that of the control group(95.0%vs 77.5%,χ2 =5.165,P <0.05).The recovery time of body temperature and hemogram,rash and other adverse symptoms disap-peared in the treatment group were significantly shorter than those of the control group[(2.1 ±0.9)d vs (3.0 ± 1.1)d,(1.9 ±0.8)d vs (2.8 ±1.1)d,(4.1 ±1.3)d vs (6.2 ±2.1)d,(2.6 ±0.8)d vs (4.8 ±1.5)d,t =3.934,3.723,5.378,7.357,all P <0.05].Conclusion Early application of gamma globulin is effective and safe in treating severe hand -foot -mouth disease,which can relieve symptoms,control the disease quickly and improve prognosis.

Objectives To investigate the effects of phytosterol intensive diet intervention on blood glucose, blood lipid and liver function in patients with type 2 diabetes mellitus combined with nonalcoholic fatty liver disease(NAFLD). Methods Patients with NAFLD admitted to the department of endocrinology, the Affiliated Hospital of Jiangsu University from January 2016 to June 2016 were recruited.We divided the groups according to the order of patient admission,with patients admitted from January to March who received conventional diabetes mellitus low-fat diet enrolled as control group,and patients admitted from April to June received extra phytosterol intensive diet on the basis of conventional diabetes mellitus diet as treatment group. The changes of blood glucose, blood lipid and liver function between two groups with a follow-up of six months before and after intervention were compared and analyzed. Results After intervention,the levels of fasting blood sugar(FPG)and blood glucose(2hPG), glycosylated hemoglobin (HbA1c), cholesterol (TG), triglyceride (TC), alanine aminotransferase (ALT) of patients in control group(11.13 ± 3.17)mmol/L,(18.65 ± 6.21)mmol/L,(9.82 ± 1.69)%,(2.81 ± 1.43) mmol/L、(5.40 ± 1.14)mmol/L,77.27%(51/66),which were lower than those before intervention((8.51 ± 2.83)mmol/L,(10.39 ± 3.62)mmol/L,(7.78 ± 1.46)%,(2.18 ± 1.13)mmol/L,(4.99 ± 1.04)mmol/L, 90.91%(60/66),P<0.05,and FPG,2 hPG,HbA1c,TG,TC,LDL-C,ALT and aspartate aminotransferase (AST) in the experimental group were(11.32 ± 3.64)mmol/L,(20.09 ± 4.83)mmol/L,(9.70 ± 2.12)%, (2.68 ± 1.74)mmol/L,(5.16 ± 1.10)mmol/L,(3.18 ± 0.92)mmol/L,(70.27)%(52/74),(86.49)%(64/74), which were significantly lower than those before intervention((7.37 ± 2.08)mmol/L,(9.20 ± 3.35)mmol/L, (6.75 ± 0.99)%,(1.86 ± 1.13)mmol/L,(4.69 ± 1.06)mmol/L,(2.67 ± 0.72)mmol/L, 91.89%(68/74), 98.65%(73/74), P<0.05, and the differences was statistically significant(t=4.584,9.329,7.349,2.823, 2.140,χ2=4.587, P<0.01 or 0.05 in control group;t=8.106,15.715, 10.826,3.393,2.651,3.755,P<0.01 in experimental group). The levels of FPG, 2 hPG and HbA1c were significantly lower in the experimental group compared with those in control group after intervention(P<0.05),and the positive-to-negative rate of fatty liver were found to be significantly higher (33.8%,25/74) than that (9.1%,6/66) in controls(P<0.05).There were not significantly differences in the level of TG,TC,high density lipoprotein(HDL-C), LDL-C, ALT and AST between the control group and experimental group(P>0.05). Conclusions Phytosterol intensive diet intervention can effectively reduce LDL-C,AST and the blood glucose level of type 2 diabetes patients with NAFLD, improving the positive-to-negative rate of fatty liver. Phytosterol intensive diet intervention can effectively reduce LDL-C, AST and the blood glucose level of type 2 diabetes patients with NAFLD,improve the positive-to-negative rate of fatty liver.

Objective:To explore the status quo of neonatal hypoglycemia (NH) prevention cognition and management among neonatal and obstetric nurses in Jiangsu Province and provide a reference for NH prevention and nursing.Methods:In this cross-sectional study, between May and June 2020, convenience sampling and a self-designed questionnaire were used to investigate neonatal and obstetric nurses from 21 hospitals in 13 cities across Jiangsu Province. The questionnaire encompassed general information, nurses' cognition of NH prevention and care, and differences between nurses' cognition and implementation of departmental NH preventive management system. Totally 331 questionnaires were distributed and 318 were collected, accounting for an effective recovery rate of 91.1%.Results:Among the 318 neonatal and obstetric nurses, the NH diagnosis and intervention thresholds in the hospitals where the neonatal and obstetric nurses worked were 2.2-2.9 mmol/L. Most nurses considered blood glucose levels≤ 2.2 and≤ 2.6 mmol/L as diagnostic and intervention thresholds, accounting for 59.75% (190/318) and 58.18% (185/318) , respectively. Among the open-ended questions, tremor, feeding difficulties, and hypotonia were the most common clinical manifestations of NH mentioned by nurses, and more than 60% of nurese knew that gestational diabetes and macrosomia were high-risk factors for NH.Neonatology and obstetric nurses' approval rate for the department's NH management system was 72.96%-87.11%, and the implementation rate was 46.77%-84.48%. In all projects, the approval rate was higher than the implementation rate. In terms of establishing NH risk assessment, formulating NH screening population table, organizing preventive health education for NH, and regularly analyzing the causes of NH, there were statistically significant differences between nurses' cognition and implementation rate ( P<0.05) . Conclusions:There is a lack of uniform standards for NH management in hospitals in Jiangsu Province. Nurses' cognition of NH assessment, screening and monitoring is quite different, and the recognition rate of NH management systems is higher than the implementation rate. It is necessary to establish a standardized NH prevention and management system and strengthen the implementation of specific systems within the department.

Objective:To retrieve, review and summarize the best evidence on nonpharmacologic prevention and management of venous thromboembolism (VTE) in patients with ischemic stroke (IS) .Methods:According to the "6S" model, Best Practice, UpToDate, Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, PubMed, CINAHL, SinoMed, CNKI, Wanfang, VIP Databases, and dedicated stroke websites in China and abroad were searched for the evidence of nonpharmacologic prevention and management of VTE in IS patients, including clinical decision-making, best practice, evidences summary, guidelines, systematic reviews, expert consensus and randomized controlled trials published up to March 20, 2022. Evidence was extracted and summarized after quality assessment of the literature.Results:A total of 19 articles were included, including 2 clinical decision-making articles, 2 evidences summaries, 8 guidelines, 3 systematic reviews, and 4 expert consensus. A total of 38 pieces of best evidence were collected from 6 aspects: organizational security, risk assessment, screening and diagnosis, basic prevention, mechanical prevention and health education.Conclusions:This study summarizes the best evidence for nonpharmaceutical prevention and management of VTE in IS patients. It is recommended to promote the clinical application of this evidence scientifically and in a planned way through multidisciplinary collaboration in combination with clinical situations, factors promoting and hindering the application of evidences, and patient wishes.

Objective:The evidence-based and Delphi methods were used to construct the exercise program for hospitalized patients with diabetes foot to provide guidance for clinical practice.Methods:Evidence on exercise management of diabetic foot patients was systematically searched from BMJ Best Practice, UpToDate, Registered Nurses′ Association of Ontario and other domestic and foreign databases and professional association websites. The retrieval period was from the establishment of the database to April 2021. The quality of the included literature was independently evaluated, and the evidence of the literature meeting the quality standards was extracted and summarized to form the first draft of exercise program for inpatients with diabetic foot. After two rounds of Delphi expert letter consultation, the program items were revised, and the final draft of the exercise program for inpatients with diabetic foot suitable for clinical practice was formed.Results:The effective recovery rate of the two rounds of expert correspondence questionnaire both were15/15. The expert authority coefficient was 0.865 and 0.895 respectively. And the Kendall coordination coefficient was 0.232 and 0.291 (both P<0.01). An exercise program for inpatients with diabetic foot had been formed, including 5 modules(exercise evaluation, exercise prescription, exercise monitoring, post-exercise evaluation and exercise management), 12 items and 40 operational items. Conclusions:The exercise program for inpatients with diabetic foot constructed in this study is scientific and clinically applicable, which provide scientific guidance for clinical medical staff to carry out exercise practice.

Objective:To build the standardized knowledge base for hierarchical prevention care of neonatal hypoglycemia based on the risk prediction model of neonatal hypoglycemia, and to provide a decision-making basis for risk management to achieve predicitive neonatal hypoglycemia.Methods:Based on the best evidence summarized in strategies for the prevention and management of neonatal hypoglycemia published in 2020, evidence on the prevention and management of neonatal hypoglycemia was searched from BMJ Best Practice, UpToDate, Registered Nurses Association of Ontario, CNKI and other domestic and foreign databases and professional association websites. The retrieval period was from September 1, 2019 to August 31, 2022. The quality of newly included literature was evaluated, new evidence was extracted, and the best evidence in the prevention and management strategy of neonatal hypoglycemia published in 2020 was summarized and combined to form the first draft of the knowledge base. Experts in the field of neonatal nursing were invited to revise and discuss each item of the knowledge base, and the final draft of the knowledge base was formed. The final draft of the knowledge base was coded using the 2.5 version of the Clinical care classification system as the standardized language.Results:The risk prediction model of neonatal hypoglycemia was used as a grading tool, the final draft of the knowledge included 1 nursing diagnosis, 6 modules and 18 specific preventive nursing measures.Conclusions:The knowledge base for hierarchical prevention care of neonatal hypoglycemia based on risk prediction model can realize the prospective hierarchical nursing of neonatal hypoglycemia, which is scientific and practical, and is the basis to assist nurses to make clinical decisions.

Objective To construct the diabetic home care platform and to explore its effects in follow-up man agement of patients with gestational diabetes mellitus.Methods The diabetic home care platform contained clientsides for both nurses and patients,who could use the platform via identification and binding technology.Totally 200 patients with gestational diabetes mellitus in outpatient department from November 2015 to December 2016 were recruited using convenience sampling.Patients were divided into the experimental group and the control group with 100 cases in each group based on the voluntary principle.Both groups received routine follow-up management,and the experimental group also used diabetic home care platform management.Results There were no differences in gestational weeks,mode of delivery,postpartum hemorrhage,other complications,fetal intrauterine distress,neonatal hypoglycemia,and deformity between two groups(P＞0.05).Rate of macrosomia in the experimental group was lower than that in the control group(P＜0.05),and rate of breastfeeding was higher than the control group(P＜0.05).The total score of Diabetes Self-Care Activeties-6 and scores of each dimension in the experiential group were higher than those in the control group 8 weeks after intervention(P＜0.001);the total score of Problem Areas in Diabetes Scale and scores of each dimension in the experimental group were lower than those in the control group(P＜0.05).Conclusion Application of diabetic home care platform is helpful for fetal weight control,and can improve rate of breastfeeding,promote women's self-management behavior and emotional disorders.