Objective To detect and analyse the levels of nitrite in marketed milk powder.Methods 6 brands of maketed milk powder were selected in this study.Interferents,such as protein,were removed from milk powder preliminarily by using potassium ferrocynide and zinc acetate.The levels of nitrite were detected by using fluorospectrophotometry method,and compared with na-tional standard(2 mg/kg).Results The levels of nitrite in the 6 brands of maketed milk powder were lower than the national stand-ard limit,had statistically significant differences(P <0.05).Conclusion The levels of nitrite of 6 brands of milk powders do not ex-ceed the national standard.

Objective:To investigate the status of clinical nurses′ professional identity, structural empowerment and psychological empowerment, analyze the correlation between professional identity and structural empowerment and psychological empowerment, and establish a multiple stepwise regression model to discuss the dependence between professional identity and structural empowerment and psychological empowerment in clinical nurses.Methods:A total of 1 008 clinical nurses from Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University were selected as the subject by using the convenience sampling method. The General Information Questionnaire, Professional Identity Scale, Conditions of Work Effectiveness Scale, and Psychological Empowerment Scale were used to questionnaire.Results:The professional identity of nurses was at medium level (104.49±19.54), the total scores of structural and psychological empowerment of nurses were 60.09±13.49 and 42.59±7.31. Correlation analysis showed that the total score of professional identity of clinical nurses was positively correlated with the total score of structural empowerment, psychological empowerment and theirs dimensions ( r values were 0.436-0.715, P<0.01). Multivariate stepwise regression results showed that the nurse working years, health status self-assessment, formal empowerment, informal empowerment, work meaning, self-efficacy, work influence was the main influencing factors of nurses professional identity, which explained 60.5% of the total variation. Conclusions:Nursing managers should focus on the professional identity of clinical nurses, by optimizing the management organizational structure and pay attention to the perception of empowerment behavior to improve the comprehensive empowerment level, so as to enhance the professional identity of nurses.

Objective:To explore the incidence and degree of compassion fatigue in clinical nurses, and the effects of psychological empowerment on nurses' compassion fatigue level.Methods:A total of 1 005 clinical nurses were investigated with the general information, Chinese version of Professional Quality of Life Scale, Psychological Empowerment Scale. And the relationship between different degrees of compassion fatigue and psychological empowerment were analyzed by ordinal regression analysis.Results:The incidence of sympathetic fatigue was 93.0%,(935/1 005), mild was 53.8%(541/1 005), medium was 22.7%(228/1 005), severe was 16.5%(166/1 005). The score of Chinese version of Professional Quality of Life Scale three dimensions: compassion satisfaction, burnout, and secondary traumatic stress of clinical nurses were 34.15±5.53, 23.96±5.10, 23.73±5.92. The degree of compassion fatigue was negatively correlated with psychological empowerment score and score of each dimension( r values were 0.094-0.468, all P<0.05). The ordinal regression analysis indicated that job impact(odds ratio(OR) value was 1.095, 95% credible interval( CI) 0.094-0.236, P<0.01), self-efficacy( OR value was 0.920, 95% CI 0.250-0.054 , P<0.01) and job meaning( OR value was 0.820, 95% CI 0.431-0.240, P<0.01) were the independent risk factor of compassion fatigue level. Conclusions:The nurses mainly showed mild compassion fatigue, and main manifestation is secondary traumatic stress. The nurses who had more higher job impact scores were more likely to report higher levels of empathy fatigue, while nurses who had higher job meaning and self-efficacy scores were more likely to have low levels of empathy fatigue. Therefore, it is suggested that nursing managers should carry out timely intervention and management in accordance with the different level of compassion fatigue:improve nurses' perception of work meaning and self-efficacy, and avoid increasing workload while paying attention to the influence of work on perception level.

Objective To explore the multiple mediating role of positive psychological capital and adaptive emotion expression between individual social capital and humanistic care ability in nursing students. Methods From December 2018 to August 2019,the study selected 238 undergraduate nursing students of Grade 2015 to 2018 by cluster stratified sampling as subjects in a medical university. All of students were investigated with the Caring Ability Inventory, Individual Social Capital Questionnaire, Positive Psychological Capital Scale and Emotional Expression Questionnaire in college students of China. Structure equation model was used to analyze the correlations among the variables. Results Among 238 nursing students, the scores of humanistic care ability, individual social capital, positive psychological capital, inhibitory emotion expression, adaptive emotion expression and excessive emotion expression were (185.79±17.52), (20.26±2.38), (125.24±17.71), (17.23±3.86), (20.85±3.91) and (9.70±3.97) respectively. Individual social capital, positive psychological capital, adaptive emotion expression and humanistic care ability had positive correlations with each other (r=0.223-0.627,P<0.01). Multiple mediating effect model analysis showed that the positive psychological capital and adaptive emotion expression had multiple mediating roles between individual social capital and humanistic care ability in nursing students(P<0.05). The relative mediating effects of positive psychological capital, adaptive emotion expression and chain mediation were 83.37％, 11.64 ％ and 4.77％ respectively. Conclusions Nursing students have a low level of humanistic care ability with the adaptive emotion expression. Nursing educators can improve nursing students' individual social capital, enrich their positive psychological capital and strengthen their adaptive emotion expression so as to cultivate the humanistic care ability.

Objective:To explore the current status of career self-efficacy and positive psychological capital among undergraduate nursing students and to analyze the correlation between them.Methods:From May to June 2018, we selected 255 undergraduate nursing students in the first to the fourth grade of a medical university in Nanjing as the research objects by cluster sampling. All students were investigated with the General Information Scale, Career Self-efficacy Questionnaire for Nursing Students and Positive Psychological Capital Scale.Multiple linear regression was used to analyze the influencing factor.Results:255 questionnaires were distributed, and 238 valid questionnaires were recoverd. Among 238 undergraduate nursing students, the total score of career self-efficacy was (90.88±12.15) with 67.32% for the total scoring rate. The total score and item average score of positive psychological capital was (125.24±17.71) and (4.82±0.68) respectively. Ungraduate nursing students' professional self-efficacy is positively correlated with positive psychological capital ( r=0.571, P<0.01) . The influencing factors of career self-efficacy of undergraduate nursing students included the positive psychological capital, initial intention to choose nursing specialty and willingness to engage in nursing work after graduation which explained 40.5% of total variation in career self-efficacy of nursing students. Conclusions:Nursing educators should pay attention to career self-efficacy of undergraduate nursing students and improve its level by developing positive psychological capital of nursing students, cultivating professional interest as well as laying emphasis on the curriculum design related to career planning.

Objective:To analyze the risk factors of fatal outcome in patients with severe COVID-19.Methods:The clinical characteristics of 107 patients with severe COVID-19 admitted in Renmin Hospital of Wuhan University from February 12 to March 12, 2020 were retrospectively analyzed. During the hospitalization 49 patients died (fatal group) and 58 patients survived (survival group). The clinical characteristics, baseline laboratory findings were analyzed using R and Python statistical software. The risk factors of fatal outcome in patients with severe COVID-19 were analyzed with multivariate logistic regression.Results:Univariate analysis showed that the two groups had statistically significant differences in age, clinical classification, dry cough, dyspnea and laboratory test indicators ( P<0.05 or <0.01). The random forest model was used to rank the significance of the statistically significant variables in the univariate analysis, and the selected variables were included in the binary logistic regression model. After stepwise regression analysis, the patient’s clinical type, age, neutrophil count, and the proportion of CD3 cells are independent risk factors for death in severe COVID-19 patients. Dry cough is an independent protective factor for the death of severe COVID-19 patients. Conclusion:COVID-19 patients with fatal outcome are more likely to have suppressed immune function, secondary infection and inflammatory factor storm. These factors may work together in severe patients, leading to intractable hypoxemia and multiple organ dysfunction and resulting in fatal outcome of patients. The study indicates that timely intervention and treatment measures against above factors may be effective to save the lives of patients with severe COVID-19.

Objective: To understand the status quo and correlation between problem solving ability and positive mental capital of nursing undergraduates. Methods: A total of 238 nursing undergraduate were investigated with the Problem Solving Scale and the Positive Mental Capital Scale. Results: In terms of each dimension in Problem Solving Ability Inventory, the scores from high to low respectively were rational problem solving, positive problem orientation, avoidance style, negative problem orientation, impulsivity/carelessness style, the total score of positive mental capital was 125.24±17.71. Multivariate stepwise regression analysis showed that self-efficacy, hope explained for 29.4% of positive problem orientation variation and 15.4% of explaining rational problem solving variation. Resiliency, self-efficacy explain for 35.8% of the negative problem orientation variation. Hoped, resiliency explained for 9% of impulsive/carelessness style variation and 21.8% of avoidance style variation. Conclusions The problem solving ability of nursing undergraduates was weak, which was closely related to positive psychological capital, and can improve the overall problem solving ability of nursing students by improving their self-efficacy, hope and resiliency.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Mandibular defects caused by injuries, tumors, and infections are common and can severely affect mandibular function and the patient's appearance. However, mandible reconstruction with a mandibular bionic structure remains challenging. Inspired by the process of intramembranous ossification in mandibular development, a hierarchical vascularized engineered bone consisting of angiogenesis and osteogenesis modules has been produced. Moreover, the hierarchical vascular network and bone structure generated by these hierarchical vascularized engineered bone modules match the particular anatomical structure of the mandible. The ultra-tough polyion complex has been used as the basic scaffold for hierarchical vascularized engineered bone for ensuring better reconstruction of mandible function. According to the results of in vivo experiments, the bone regenerated using hierarchical vascularized engineered bone is similar to the natural mandibular bone in terms of morphology and genomics. The sonic hedgehog signaling pathway is specifically activated in hierarchical vascularized engineered bone, indicating that the new bone in hierarchical vascularized engineered bone underwent a process of intramembranous ossification identical to that of mandible development. Thus, hierarchical vascularized engineered bone has a high potential for clinical application in mandibular defect reconstruction. Moreover, the concept based on developmental processes and bionic structures provides an effective strategy for tissue regeneration.
Bone Regeneration ; Bone Transplantation/methods* ; Hedgehog Proteins ; Humans ; Mandible/surgery* ; Osteogenesis