Objective To investigate the risk factors for drug resistance‐tuberculosis(DR‐TB) ,and to establish a clinical risk predictive model .Methods A total of 126 cases of DR‐TB patients and 126 cases of non‐DR‐TB patients treated in our hospital from January 2014 to January 2015 were included in this study .The clinical data of these patients were collected .We used univariate and multivariate logistic regression analysis to determine the independent risk factors and established a risk predictive model .The calibration and discrimination of the model were assessed by the H‐L test and the area under the ROC curve ,respectively .Results Statistical analysis showed that the risk factors included previous treatment ,a duration of first treatment of more than 8 months ,ad‐verse effects of anti‐TB medication ,more than three TB foci in the lung and diabetes mellitus .H‐L statistic(χ2 =8 .760 ,P=0 .363) . The area under the ROC was 0 .826 ,95% CI(0 .766 ,0 .886) .Conclusion Logistic regression model established in the study can pre‐dict the incidence of DR‐TB with high prediction accuracy .

AIM: To establish the method for determination of gentiopicrin, palmatine hydrochloride and berberine hydrochloride in Ertong Ⅱ Oral Liquid (Cortex Phellodendri, Radix Gentianae, Rhizoma Anemarrhenae, etc.) by RP HPLC. METHODS: The column was a Diamonsil TM C 18 column (250mm?4.6mm, 5?m); the mobile phase was CH 3CN H 3PO 4 C 6H 15 N H 2O; The ultraviolet detection was set at 270nm; the flow rate was 1mL?min -1 . RESULTS: The linear ranges of gentiopicrin, palmatine hydrochloride and berberine hydrochloride were 72.8～728?g?mL -1 ( r=0.9998 ), 7.55～75.5?g?mL -1 ( r=0.9998 ), 12.45～124.5?g?mL -1 ( r = 0.9999 ), respectively. The average recoveries ( n =6) of gentiopicrin, palmatine hydrochloride and berberine hydrochloride were 98.17%, 98.78%, 98.60%; RSD were 1.60%, 1.35%, 1.25%, respectively. CONCLUSION: The method is accurate, reproducible and highly selective, thus suitable for quality control of Er Tong Ⅱ Oral Liqual.

Objective:To analyze the risk factors of Intensive Care Unit-Acquired Weakness, and to develop and verify the model.Methods:A total of 247 patients admitted to ICU patients from November 2018 to October 2019 were selected, and risk factors between ICU acquired weakness group ( n=106) and non-ICU acquired weakness group( n=141)were compared using logistic regression for model construction.The Hosmer-Lemeshow test was used to verify the goodness of fit of the model. The area under the ROC curve was used to test the model to predict the effects. From November 2019 to May 2020, 106 patients were recruited for application of the model. Results:The incidence of ICU acquired weakness in this study was 42.91%(106/247), and 44.34%(47/106),the study finally included age ( OR=1.043) ,mechanical ventilation time ( OR=1.140) , APACHE II score ( OR=1.081) , blood sugar ( OR=1.117) , lactic acid( OR=1.459) ,and neuromuscular blockers ( OR=3.499) to construct the risk prediction. The model formula was P=1/1+exp (- Z) =1/1+exp (8.808-0.042×age -1.252×neuromuscular blockers-0.078×APACHE II score -0.110×blood sugar -0.378×lactic acid -0.131×mechanical ventilation time. The area under the ROC curve of this model was 0.896 (95% CI: 0.824-0.914) , the maximum value of the Youden index was 0.577, and the corresponding sensitivity was 0.754,the specificity was 0.823,the cutoff value was 0.503. The model verification results the sensibility of 70.2%, the specificity of 88.1%, and the accuracy of 80.2%. Conclusion:The predictic model of ICU acquired weakness couducted in this study has satisfactory prediction effect, which can provide a reference for clinical screening of high-risk patients.

ObjectiveTo explore the risk factors of VAP among multiple injury patients in comprehensive ICU so as to provide the basis for prevention and cure of VAP.MethodsThe retrospective analysis was made to the clinical data from 126 patients with mechanical ventilation for over 48 hours in ICU at the Third People's Hospital of Zhenjiang,the Affiliated Hospital of Jiangsu University,from January 2014 to December 2015. The Logistic regression analysis was performed to research related data in order to identify the risk factors of VAP.ResultsIn 126 patients,there were 37 (29.37％) patients with VAP. Single factor analysis showed that the risk factors were the time of mechanical ventilation,score of the injury severity scale (ISS), time of being admitted to ICU,coma,sedation and analgesia,hormone use,medical history of chronic lung disease,combined antibiotic (>2 kinds),craniocerebral trauma,thoracic injury,spinal injury with significant differences (t/χ2=3.382,20.241,4.212,29.837,7.616,5.322,4.384,8.246,5.677,15.394,4.864;P<0.05). Logistic regression analysis revealed that the risk factors of VAP in multiple injury patients were the time of mechanical ventilation,score of ISS,coma,combined antibiotic (>2 kinds),medical history of chronic lung disease,craniocerebral trauma,thoracic injury (OR=3.897,6.697,5.506,5.104,10.984,4.911,6.046;P<0.05). ConclusionsThe incidence of VAP is high among multiple injury patients in comprehensive ICU. The monitor of risk factors of VAP in multiple injury patients should be enhanced. Moreover,the effective intervention on prevention and cure of VAP should be taken for patients with long time of mechanical ventilation,high score of ISS,coma,combined antibiotic (>2 kinds),medical history of chronic lung disease,craniocerebral trauma, thoracic injury and so on so as to reduce the incidence of VAP.

Objective:To evaluate the effect of problem-based learning (PBL) combined with scene simulation in the cardiopulmonary resuscitation (CPR) teaching of standardized training of general practitioner, and explore a high-quality teaching method that will help students develop their clinical thinking and practical skills.Methods:Forty students of the Grade 2018 general practitioner training program in Yixing Hospital Affiliated to Jiangsu University were randomly divided into experimental group ( n=20) given PBL combined with scene simulation teaching method and control group ( n=20) given traditional teaching method. The pre-class preparation, classroom discussions, actual combat simulations, and analysis and summary were conducted in the experimental group (4-hour CPR training), while classroom teaching, teaching rounds, analysis and discussion, skills training were conducted in the control group (4-hour CPR training). Furthermore, both groups received the same theoretical test, skill assessment, and questionnaires. t-test or chis-quare test was performed for comparison between the two groups using SPSS 18.0. Results:The average score of theoretical test in the experimental group was significantly higher than that in the control group [(87.5±4.3) vs. (81.2±4.7), P<0.05]; the average score of the skill assessment in the experimental group was significantly higher than that in the control group [(91.0±1.5) vs. (83.1±1.8), P<0.05]. The questionnaire survey showed more students of the experimental group who reported greater improvement in their abilities than those of the control group ( P<0.05). Conclusion:PBL combined with scene simulation teaching method can effectively improve the quality of CPR teaching for standardized training of general practitioners, help students improve clinical thinking and comprehensive processing capabilities.

Objective:To explore the risk factors for myelosuppression in elderly lung cancer patients undergoing chemotherapy and construct a risk prediction model for myelosuppression in elderly lung cancer patients undergoing chemotherapy.Methods:Using the convenient sampling method, data of 228 elderly patients with lung cancer undergoing chemotherapy in Respiratory Department of a Class Ⅲ Grade A hospital in Zhenjiang from May 2018 to May 2019 were selected, and risk factors of adverse reactions of myelosuppression in patients were analyzed statistically. The binomial Logistic regression was applied to construct the prediction model and the area under the ROC curve was used to test the prediction effect of the model. The patient data from January to May 2020 were collected to validate the model.Results:Among the 228 patients, 75 patients developed myelosuppression, with an incidence of 32.89%. Multivariate analysis results showed that platinum-containing chemotherapy regimens, combined with other adverse reactions, decreased albumin before chemotherapy and decreased hemoglobin before chemotherapy were independent risk factors for myelosuppression in elderly lung cancer patients during chemotherapy ( P<0.05) , which were included in the model. The area under the ROC curve of the final model was 0.823, the maximum Youden index was 0.5, sensitivity was 81.3%, and specificity was 70.5%. The results of the verification data showed that the area under the ROC curve was 0.846, sensitivity was 90.4% and specificity was 68.2%. Conclusions:The prediction effect of this model is good, which can provide reference basis for clinical treatment and formulating nursing measures to prevent myelosuppression.

Objective:To analyze the research hotspots and evolution trends of diabetes patients with sarcopenia in the past decade, and to provide ideas for domestic research on diabetics patients with sarcopenia.Methods:Relevant literature on diabetics patients with sarcopenia included in the Web of Science from 2011 to 2021 was retrieved. CiteSpace software was used to analyze country, cited journals, cited literature and high-frequency keywords.Results:A total of 606 papers were included, and the number of papers published increased in the past decade. The country with the most publications was Japan. Research hotspots included the use of diabetic sarcopenia assessment tools, pathogenesis, and the prediction of other disease-related factors. However the number of intervention research was small.Conclusions:In clinical work, health care professionals and related workers should pay attention to the importance of disease care and self-management of diabetic patients, provide personalized care and treatment to reduce or prevent the occurrence of sarcopenia, so as to promote the research of diabetic sarcopenia in China.

Objective To compare the biomechanical characteristics of lengthened sacroiliac screw and long sacroiliac screw fixated in different ways for the treatment of central vertical sacral fractures to provide reference for clinical practice.Methods A finite element model with three dimensions of Tile type C pelvic ring injury (central type Denis Ⅲ fracture of sacrum) was produced.The central sacral fractures were fixated with lengthened sacroiliac screw or long sacroiliac screw in 7 types of models respectively as follows.(1) One long sacroiliac screw was fixated in S1 segment from the right (C1);(2) One long sacroiliac screw was fixated in S2 segment from the right (C2);(3)Two long sacroiliac screws were fixated in S1 and S2 segments respectively from the right (C12);(4) One long sacroiliac screw was fixated in S1 segment from the right and one long sacroiliac screw was fixated in S2 segment from the left (C12hybrid);(5) One lengthened sacroiliac screw was fixated in S1 segment from the right (J1);(6) One lengthened sacroiliac screw was fixated in S2 segment from the right (J2);(7)Two lengthened sacroiliac screws were fixated in S1 and S2 segments respectively from the right (J12).The shift and angle displacement of the central superior surface of sacrum in the case of standing on both feet were measured and compared.The maximum Von Mises stresses in different positions were measured.And various mechanical indices (including stresses of various parts and stress distribution of screws and pelvis,etc) were also quantified and compared.Results The stability of the posterior ring-screw complex was optimal when the sacrum was fixated with S1 & S2 lengthened sacroiliac screws.The maximum Von Mises stresses of screw were affected by sacral segments,namely,S1 ＞ S2 ＞ S1& S2.The maximum Von Mises stress of screws in S1 and S2 segments were similar.The maximum stress of the lengthened sacroiliac screw was lower than that of the long sacroiliac screw.The maximum Von Mises stress of bilateral sacroiliac joints in the lengthened sacroiliac screw fixation model was similar to that of normal pelvis.The maximum stress in the left sacroiliac joint of the long sacroiliac screw fixation model was larger than that of the normal pelvis.The maximum Von Mises stress of screw-bone interface of the long sacroiliac screw fixation model was larger than that of the lengthened sacroiliac screw fixation model.The screw stress distribution of the lengthened sacroiliac screw was superior to that of the long sacroiliac screw,and the screw stress distribution of the double segment fixation was superior to that of the single segment fixation.There was relatively less difference between the pelvic stress distribution of double segment fixation model and that of the normal pelvic model.Conclusion The fixation of S1 & S2 lengthened sacroiliac screws utilized in central sacral fractures of Tile C pelvic ring injury results in a more stable posterior pelvic ringscrew complex,more dispersed screw stress and better pelvic stress distribution which is closed to normal,and can also reduce the risk of internal fixation failure as well as lower back pain.

This paper intends to summarize the disaster nursing in recent 10 years, including the content of clinical research, educational research information, theoretical research results, academic exchange organizations, periodicals and magazines,aiming to provide a reference for the development of disaster nursing in China. Compared with developed countries, China Disaster Nursing Research started relatively late and is still in its infancy, there are many projects to be studied and developed in disaster nursing.

This article discussed the establishment of disaster nursing academic organization, the development of disaster nursing education, the strengthening of disaster nursing comprehensive ability training, the development of disaster nursing rescue, the organization of disaster nursing academic activities, the development of disaster nursing research and other aspects, to provide a reference for the formation of a unified standard, professional and promotional development system of disaster nursing.