Objective To study the effect of transient intensive insulin treatment on the serum free fatty acid (FFA) in newly diagnosed type 2 diabetic patients.Methods Sixty-four newly diagnosed type 2 diabetic patients were treated with transient intensive insulin.The fasting plasma glucose (FPG),2 hours post-prandial glucose (2hPG),lipid,fastin insulin (FINS),and serum FFA was examined hefore and after treatment.Results The levels of FPG,2hPG,total cholesterol (TC),triglycerides (TG),low density lipoproteins cholesterol (LDL-C),FFA and HOMA-IR after treatment were (9.68 ± 2.02) mmol/L,(12.77 ± 1.35) mmol/L,(4.26 ± 1.07) mmol/L,(1.52 ± 0.58) mmol/L,(2.50 ±0.75) mmol/L,(435.84 ± 190.94) μmol/L,0.51 ± 0.62,and they decreased obviously compared with those before treatment [(14.66 ± 3.50) mmol/L,(17.43 ±4.89) mmol/L,(5.03 ±0.94) mmol/L,(2.05 ± 1.42) mmol/L,(2.91 ±0.78) mmol/L,(586.68 ±229.45)μmol/L,0.65 ± 0.89](P＜0.05).The level of HOMA-β increased obviously (2.70 ± 0.83 vs.1.74 ± 1.04)(P＜0.05).The increase of HOMA-β and the decrease of HOMA-IR was positively correlated with the decrease of FFA.Conclusion The transient intensive insulin treatment can evidently decrease the level of FFA that can improve beta-cell function and relieve insulin resistance in newly diagnosed type 2 diabetic patients.

Objective:To provide evidence for guiding enteral nutrition programs for critically ill patients by evaluating the application effect of ultrasonic monitoring gastric residual volume.Methods:CNKI, China Biology Medicine disc, Wanfang, VIP, Chinese Clinical Trial Registry, PubMed, Embase, Cochrane Library, ClinicalTrials.gov and other databases were systematically searched to collect randomized controlled trails (RCTs) of application of ultrasonic monitoring of gastric residual volume in enteral nutrition of critically ill patients. The search time limit was from the establishment of the database to December 31, 2019. Two researchers independently searched literature, screened literature, extracted data and evaluated the quality of the literature. RevMan 5.3 software was used for Meta-analysis.Results:A total of 10 articles were included, involving 897 patients. Compared with the syringe withdrawal method, ultrasonic monitoring of gastric residual volume could reduce the incidence of reflux or vomiting [ RR=0.53, 95% CI (0.38-0.75) ] and the incidence of aspiration [ RR=0.48, 95% CI (0.30-0.77) ], increase albumin level [ MD=1.53, 95% CI (0.71-2.35) ] and reduce operating time of nurses [ MD=-5.62, 95% CI (-7.59--3.65) ], and the combined effects were statistically significant ( P<0.05) . However, the incidence of diarrhea [ RR=0.77, 95% CI (0.53-1.11) ] and in-hospital mortality [ RR=0.73, 95% CI (0.41-1.28) ] were not changed, and the combined effects were not statistically significant ( P>0.05) . Conclusions:Ultrasonic monitoring of gastric residual volume in enteral nutrition of critically ill patients may be helpful to reduce the incidence of complications and improve the nutritional status of patients.

Objective To investigate the current status of application of the Confusion assessment method for the Intensive Care Unit (Cam-ICU),and to explore its influencing factors.Methods A total of 300 patients admitted to were enrolled.The researchers and nurses used Cam-ICU to assess patients' delirium,respectively,and the differences in deliriun assessment were analyzed.Results For delirium assessment,the Kappa value was 0.546 between the researchers and nurses.The consensus rate was 17.6％ for hypoactive delirium,and 77.8％ for hyperactive delirium in 44 delirium patients.Logistic regression analysis showed that APACHE Ⅱ score,RASS score and delirium type were influencing factors of accurate assessment of delirium.Conclusion The consistence of assessment of delirium by ICU nurses is generally good,but the accuracy of assessment of hypoactive delirium is the worst.

Objective To explore the nursing effect of modified prone position and traditional prone position in the skin protection of patients with prone position in ICU. Methods A total of 60 ICU patients with prone position treatment were selected in June 2014 to May 2015. According to the digital method the patients were randomly divided into the control group and the experimental group with 30 cases in each.The control group adopted traditional way of prone position with the head and chest pad pushed up. used by patients not pad up way of improvement of prone position. The incidence of skin pressure injury and the incidence of stress in the two groups were compared. Results The incidence of skin pressure injury was 20.0％(6/30) in the experimental group and 66.7％(20/30) in the control group, and the difference was statistically significant (χ2=13.30, P < 0.05). Conclusions Modified prone position has obvious advantages in reducing the incidence of skin pressure ulcer and is suitable for patients with clinical prone position.

Objective:To analyze the correlation between capillary filling time (CRT) and lactate clearance rate in patients with septic shock, so as to provide reference for the clinical application of CRT in patients with septic shock.Methods:A prospective study was conducted on 70 patients with septic shock. CRT, mean arterial pressure (map) and sequential organ failure (SOFA) score, Acute Physiology and Chronic Health Evaluation Scoring System (APACHE Ⅱ) score, mechanical ventilation and lactate clearance rate were collected at 3 sites (forehead, knee and nail bed) respectively at 2 time points after admission and 6 hours after admission. The correlation between CRT changes and lactate clearance rate was compared.Results:When lactate clearance rate of more than 10% in 6 hours, the Pearson coefficients of the three sites were 0.823 for nail bed ( P<0.05), 0.232 for forehead and 0.254 for knee ( P>0.05). When lactate clearance rate of less than 10% in 6 hours, the Pearson coefficients of the three sites were 0.299 for nail bed, 0.247 for forehead and 0.254 for knee ( P>0.05). Conclusion:When lactate clearance rate of more than 10% in 6 hours, there is a good correlation between the CRT of nail bed and the lactate clearance rate of patients. The CRT of nail bed can be a practical tool for clinical evaluation of microcirculation.

Objective:To analyze the late gadolinium enhancement (LGE) manifestations, cardiac function, and myocardial strain by feature tracking (FT) in Takayasu arteritis (TA) with pulmonary artery involvement (PTA) using cardiac MR (CMR), and then to investigate manifestations of the impaired myocardial structure and function.Methods:A retrospective study was performed on 32 patients with PTA and 21 healthy subjects without cardiopulmonary diseases from January 2017 to December 2020. All of them underwent CMR examinations. According to the presence of pulmonary arterial hypertension (PAH),PTA patients were divided into two groups including PAH group (11 cases) and non-PAH group (21 cases). LGE manifestations were observed and Fisher exact test was used for statistical analysis between the two groups. Cardiac function parameters and FT values including global peak strain of the left and right ventricle were calculated separately in PAH, non-PAH group of patients and healthy controls, using One-way ANOVA or non-parametric Kruskal-Wallis test for statistical analysis including a pairwise comparison between groups. The correlations between FT values of the PAH group and parameters measured by right heart catheterization test (RHC) and transthoracic echocardiography were analyzed using Pearson or Spearman correlation analysis.Results:There were 23 PTA patients (71.9%) with LGE. LGE in the interventricular insertion points (IPs)(11/11), and in the mid-wall (11/11) or epicardial (10/11) myocardium was more common ( P values were 0.006,<0.001 and 0.011, respectively) in PAH group, compared with LGE in the IPs (11/21), and in the mid-wall (7/21) or epicardial (9/21) myocardium in non-PAH group. The absolute values of left ventricular global peak circumferential strain (LVGPCS), left ventricular global peak longitudinal strain (LVGPLS) and right ventricular global peak longitudinal strain in PAH group were smaller than those in healthy subjects ( P<0.05). The absolute values of LVGPCS and LVGPLS in non-PAH group were smaller than those in healthy subjects ( P<0.05). In PAH group, mean pulmonary artery pressure of RHC was correlated with several FT parameters ( P<0.05), especially left ventricular global peak radial strain ( r=-0.807, P=0.009) and LVGPCS ( r s=0.817, P=0.007). Conclusions:Myocardial injury can be seen in PTA patients. And LGE in the IPs and LGE in the mid-wall or epicardial myocardium is more common in PTA patients with PAH. LVGPCS and LVGPLS can early indicate left heart dysfunction in PTA patients without PAH.

Objective:To retrieve, evaluate, and summarize the best evidence for the assessment of gastrointestinal function in critically ill patients by bedside ultrasound.Methods:Guidelines, evidence summaries, group standards, expert consensus, systematic reviews, and randomized controlled trials on the assessment of gastrointestinal function in critically ill patients by bedside ultrasound were retrieved by computer on domestic and foreign guideline websites, society websites and databases based on evidence-based nursing. The search period was from January 1, 2010 to April 30, 2021. The quality of the article was independently assessed by two researchers using the Appraisal of Guidelines for Research and Evaluation Ⅱ and the critical appraisal tool of the Joanna Briggs Institute (JBI) in Australia (2016) . Combined with the judgment of the research team, the data from the article that met the criteria were extracted and the evidence was graded and recommended according to the JBI quality level of evidence system (2014 Edition) .Results:A total of 22 articles were included, involving 5 guidelines, 1 evidence summary, 1 group standard, 6 expert consensuses, 4 systematic reviews, and 5 randomized controlled trials. A total of 33 pieces of evidence were summarized from 6 aspects, namely, the feasibility of nurses applying bedside ultrasound, fundamentals of ultrasound assessment of gastrointestinal tract, ultrasound assessment of gastric contents, ultrasound assessment of gastric motility, ultrasound assessment of bowel, ultrasound guided enteral nutrition program.Conclusions:Nurses who have been systematically trained can use ultrasound to assess gastrointestinal function in critically ill patients in real time. Ultrasound-guided enteral nutrition for critically ill patients needs to be standardized and improved, and many studies need to be carried out.

Objective: We reported nursing care of a patient with postpartum cardiomyopathy treated by extracorporeal membrane oxygenation (ECMO) combined with intra-aortic balloon pump (IABP), continuous renal replacement therapy (CRRT) and prone position ventilation. Methods: Multidisciplinary cooperation was made to guide the monitor of patients' condition. Refined integrated management measures of multi-equipment were adopted and standardized management process was formulated. Strict requirements were made in treatment and nursing care to prevent hospitalized infection, humanistic care and rehabilitation exercise were conducted to improve patient′s quality of life. Results: After 47 days of nursing care, the patient′s vital signs were stable, the condition was improved and then discharged. Conclusions Close observation under the guidance of multiple disciplines is an important prerequisite for the treatment. Integrative management of multi-equipment, strict control of hospitalized infection, humanistic care and rehabilitation exercise can effectively improve the prognosis and quality of life of perinatal cardiomyopathy patient.

Coronavirus disease 2019(COVID-19),which is caused by SARS-CoV-2,varies with regard to symptoms and mortality rates among populations.Humoral immunity plays critical roles in SARS-CoV-2 infection and recovery from COVID-19.However,differences in immune responses and clinical features among COVID-19 patients remain largely unknown.Here,we report a database for COVID-19-specific IgG/IgM immune responses and clinical parameters(named COVID-ONE-hi).COVID-ONE-hi is based on the data that contain the IgG/IgM responses to 24 full-length/truncated proteins corresponding to 20 of 28 known SARS-CoV-2 proteins and 199 spike protein peptides against 2360 serum samples collected from 783 COVID-19 patients.In addition,96 clinical parameters for the 2360 serum samples and basic information for the 783 patients are integrated into the database.Furthermore,COVID-ONE-hi provides a dashboard for defining samples and a one-click analysis pipeline for a single group or paired groups.A set of samples of interest is easily defined by adjusting the scale bars of a variety of parameters.After the"START"button is clicked,one can readily obtain a comprehensive analysis report for further interpretation.COVID-ONE-hi is freely available at www.COVID-ONE.cn.