Objective: To establish a fast quantitative detection method for tartrazine, sunset yellow, orange Ⅱ sodium salt and allura red in safflower by solid phase extraction-electrospray ionization-high performance ion mobility spectrometry (SPE-ESI-HPIMS).Methods: The pigments were extracted by 70% ethanol with ultrasonic treatment, and then a polyamide SPE column was used to remove the complex matrix interference in safflower.The purified sample was then dissolved in 90% methanol and analyzed under the optimized IMS parameters.Results: The detection time of all the pigments was less than 20 ms.The limit of detection of tartrazine, sunset yellow, orange Ⅱ sodium salt and allura red was 0.17 , 0.15 , 0.30 and 0.25 μg·ml-1 , respectively.All the pigments showed excellent linearity within the range of 0.5-20 μg·ml-1 (r＞0.990 0), the method recovery was 88.0%-98.9% , and the RSD was 1.5%-5.2% (n =6).Conclusion: The method is rapid, simple, highly sensitive and reproducible, and suitable for the rapid quantitative detection of illegal added staining substances in safflower.

OBJECTIVE To investigate the prevalence,antibiotic resistance and genotype of the extended-spectrum ?-lactamases(ESBLs)-producing clinical isolates of Klebsiella pneumoniae.METHODS A total of 104 isolates of K.pneumoniae were examined for the ESBLs production and the susceptibilities of the bacteria to 15 antimicrobial agents.PCR was performed to detect the genes encoding the ESBLs belonging to SHV and TEM families as well as CTX-M-1 and CTX-M-9 groups.RESULTS The ESBLs-producers of K.pneumoniae were 54.0% in the total of 104 isolates.Almost all of the ESBLs-producing isolates were resistant to the antibiotics commonly used,and only remained susceptible to carbapenems and the combination of cefoperazone with sulbactam.The genes of SHV,CTX-M-1 and TEM groups were detected in the ESBLs-producing isolates by 64.3%,46.4%,and 32.1%,respectively,and 35.7% and 8.9% of ESBLs-producing K.pneumoniae strains carried two and three genes.CONCLUSIONS The clinical isolates of K.pneumoniae in Tianjin Nankai Hospital are shown a high rate of ESBLs-producing and antibiotic resistance.SHV and CTX-M-1 groups of ESBLs are the dominant genotypes in the isolates of ESBLs-producing K.pneumoniae.

Objective To investigate the application value of CT venography(CTV) in the diagnosis and treatment of Budd‐Chiari syndrome(BCS) .Methods 58 patients with BBCS in our hospital from January 2012 to January 2014 were performed the CTV examination .The inferior vena cava ,hepatic vein ,portal vein and collateral vessels were performed the reconstruction analysis . Results All the patients were definitely diagnosed as BCS after completing CTV examination ,including :19 cases of inferior vena cava(IVC) diaphragm type ,15 cases of short IVC segment occlusion ,8 cases of long IVC segment occlusion ,9 cases of hepatic vein stenosis or occlusion ,7 cases complicated by fresh thrombosis .In addition ,the different degrees of compensatory expansion of col‐lateral vesse ,intuition and comprehensiveness ,can display the position ,character and length of lesion vessel ,also observes the de‐grees of collateral vessels expansion and liver cirrhosis .

Objective To evaluate the efficacy of endoscopic nasopharyngectomy in the management of recurrent nasopharyngeal cancers (NPC) and to identify the prognostic factors.Methods Between september 2010 and october 2016,31 patients who received endoscopic nasopharyngectomy in our hospital for recurrent NPC were retrospectively reviewed.The clinical and pathological features of the patients,such as sex,age,T stage,pathological type,recurrence location,operation time,bleeding volume,perioperative complications,postoperative recurrence time,location and survival were recorded and analyzed,and the prognosis was observed.Results All patients underwent endoscopic resection of nasopharyngeal carcinoma locally,and no 1 cases received external nasal route surgery.All patients underwent successful endoscopic nasopharyngectomy.No patient was transferred to open approach.The mean operative time was (108.55 ± 34.36)min.The average blood loss was (23.05 ± 16.11)rnl.No serious postoperative complications occurred,no surgical deaths,and 1 cases had positive edge.Postoperative follow-up time was 3-82 months.During follow-up,29 cases survired,including that 9 patients survived with disease,1 patient concurrent oropharyngeal carcinoma,1 patient lost and 1 patient died.There were 6 cases of local recurrence,1 cases of liver metastasis and 2 cases of cervical lymph node metastasis after operation,2 patients with recurrent postoperative received endoscopic nasopharyngectomy and no recurrence of postoperative follow-up.One-year overall survival rate,disease-free survival rate and no local recurrence survival rate were 96.67％,80.00％ and 86.67％ respectively.Five-year disease-free survival rate was 61.80％.The progression free survival time was 2-82 (31.87 ± 23.26) months.Multivariate analysis showed that sex,age,first diagnosed T stage,and tumor necrosis were not the independent prognostic factor for survival in recurrent nasopharyngeal carcinoma patients.Conclusions Endoscopic nasopharyngectomy is a safe and effective procedure for the treatment of recurrent nasopharyngeal carcinoma.

Objective To explore the effects of the Calgary-Cambridge Guide training for practice nurses in promoting the nurse-patient relationship .Methods Totals of 52 practice nurses in our hospital from June 2012 to December 2012 were selected and randomly divided into the experimental group ( 25 cases ) and the control group (27 cases).Communication skills training based on the Calgary-Cambridge Guide was applied in the experimental group, while the general training materials were distributed in the control group .Nurse-patient relationship was assessed with the trust scale and the Calgary-Cambridge Guide Scale .Results After the training , the scores of respect, consistency, the authority of knowledge and technology , the sense of security and the confidence in the future of the experimental group were (3.65 ±0.45),(3.68 ±0.58),(3.62 ±0.51), (3.81 ±0.45) and (3.67 ±0.64), which were significantly higher than the scores before the training (t =-2.664,-2.712,-2.435,-3.429,-3.431, respectively;P<0.05).The scores of respect, consistency, the sense of security in the experimental group were significantly higher than those of the control group after the training ( t=2.560, 2.513, 2.231, respectively;P <0.05 ).The general score and the scores of eight dimensions of Calgary-Cambridge were significantly higher than those before (P<0.05).The general score and the scores of eight dimensions of Calgary-Cambridge of the experimental group were significantly higher than those of the control group (P<0.05).Conclusions The nurse-patient communication skills training based on the Calgary-Cambridge Guide can effectively improve the communication skills of practice nurses , and promote the nurse-patient relationship .

Objective To study the effect of reflective learning on professional training in ICU nurses . Methods Totals of 30 nurses from ICU were included and divided into observation group and control group according to the working years , degree, and they were given reflective learning and routine training .They were followed up for 3 months, and the professional training was compared .Results The scores of basic theoretical knowledge , basic technical skills , communication ability , observation ability , responsibility , management ability and ability to analyze problems after training in the observation group were (90.45 ±7.12), (91.44 ± 6.12), (18.55 ±1.23), (17.64 ±1.65), (18.43 ±1.25), (18.16 ±1.24), (17.19 ±1.76), respectively , which were significantly higher than those in the control group which were ( 82 .89 ±7 .75 ) , (83.54 ±7.54),(17.25 ±1.65),(16.45 ±1.65),(17.89 ±1.26),(17.36 ±1.22)and(16.73 ±1.75), respectively.The differences were statistically significant ( t=8.330, 5.951, 3.684, 4.205, 4.226, 4.635, 5.656, respectively;P <0.05).The scores of nursing discipline, collaborative, enthusiasm, responsibility, nurses′confidence in the observation group were significantly higher than that in the control group .The difference was statistically significant (P<0.05).The satisfaction rate in the observation group was significantly higher than the control group.The difference was statistically significant (Z=-2.141,P<0.05).Conclusions Reflective learning can effectively improve the effect of the professional training , and promote the nurses to improve the overall quality and the satisfaction of nursing quality .

Objective: To explore the related factors for primary hepatic carcinoma (PHC) caused by chronic hepatitis B (CHB) and hepatitis C (CHC). Methods: According to the principle of cross-sectional study, a cluster random sample method was used, a total of 366 chronic hepatitis patients in hospitals were recruited from three provincial tertiary hospitals in Shanxi, Henan and Jilin between July 2016 and October 2016, respectively. Using a self-designed unified questionnaire, face-to-face interviews was conducted on subjects, including sex, age, alcohol consumption, coffee consumption, green tea consumption, fish consumption, smoking, HBV/HCV diagnosis and treatment, diabetes mellitus, family history of PHC (whether PHC in first-degree relatives), etc. Multivariate unconditional logistic regression were performed to identify the related factors for PHC with CHB and CHC. According to the clinical diagnosis the patients were divided into a chronic hepatitis group (not developing to PHC) and a PHC group. Results: Among 366 cases patients, 287 (78.4%) cases were male, 79 cases were female (21.6%), average age was (52.7±9.3) years. 202 cases were chronic hepatitis group, 164 cases were PHC group. Multivariate unconditional logistics regression analysis indicated that alcohol consumption (odds ratio (OR)=2.11, 95%CI: 1.18-3.75), family history of PHC (OR=5.12, 95%CI: 2.60-10.08) were positively correlated with the development of PHC in chronic b, green tea consumption (OR=0.45, 95%CI: 0.23-0.88), antiviral treatment (OR=0.19, 95%CI: 0.11-0.32) were negatively correlated. Alcohol consumption (OR=3.98, 95%CI: 1.14-13.85) was positively correlated with the development of PHC in chronic c, antiviral treatment (OR=0.14, 95%CI: 0.04-0.50) was negatively correlated. Conclusion Alcohol consumption, family history of PHC, green tea consumption and antiviral treatment were the related factors for the development of PHC in chronic hepatitis b. Alcohol consumption and antiviral treatment were the related factors for the development of PHC in chronic hepatitis c.

Objective To investigate the effects of goal setting nursing strategy on behavior of patients with metabolic syndrome. Methods A total of 100 patients with the metabolic syndrome in our hospital for treatment from May to September in 2012, as research object, and all patients were divided into control group and observation group on average according to random number table. The patients of control group were given routine care, while the observation group underwent goal setting nursing. The self-efficacy and health behavior of patients with metabolic syndrome were evaluated by Exercise of Self-Care Agency Scale ( ESCA ) and the“whirlpool” way of life assessment questionnaire. Results After nursing care, the health knowledge score of observation group (47. 45 ± 6. 23) was significantly higher and that of the control group (42. 26 ± 5. 65);the sense of self responsibility score of observation group (25. 17 ± 5. 26) was significantly higher than that of the control group (18. 95 ± 4. 38);self care skill score the observation group (27. 49 ± 4. 63) was beyond (22. 76 ± 4. 26) in the control group;self concept scores in observation group (27. 02 ± 4. 51) was significantly higher than that of control group (23. 83 ± 4. 47);self-efficacy in observation group (127. 13 ± 10. 42) was significantly higher than that of the control group (107. 80 ± 9. 74). The score between the observation group and the control group with total score of self-efficacy and the 4 dimensions of the score and self-care behaviors were statistically significant ( t=3. 927, 7. 025, 4. 251, 5. 462, 8. 731;P <0. 05 ); patients in the two groups were compared after nursing care. The difference of the proportional distribution of dietary structure, movement and stay up index in two groups of healthy behavior was statistically significant (Z =4. 290,10. 097, 4. 702;P <0. 05). Conclusions Goal setting nursing strategy can effectively improve the metabolic syndrome patients′ self-care behavior and self-efficacy, and is worthy to promote in the clinical.

Objective:To investigate the clinical characteristics and prognosis of patients with left ventricular assist device (LVAD) implantation during the perioperative period.Methods:This retrospective study included 14 patients with end-stage heart failure who underwent LVAD implantation in the department of intensive care medicine of Nanjing Hospital Affiliated to Nanjing Medical University from February 2022 to March 2023, including 12 males and 2 females patients, the mean age was (57.6±9.8)years old. All patients were implanted with Corheart 6 implantable left ventricular assist system, did not use other mechanical assisted circulatory devices. The clinical data of enrolled patients were collected, and the clinical characteristics and prognosis during ICU treatment were analyzed.Results:Dilated cardiomyopathy (DCM) was the most common primary cause of heart failure. The results of transthoracic echocardiography showed that the left ventricular ejection fraction (0.297±0.074 vs. 0.238±0.064, P=0.031) of patients was significantly increased, while the left ventricular end diastolic diameter[69.0(65.8, 74.3)mm vs. 76.5(72.8, 83.0)mm, P=0.003]and systolic end systolic diameter[61.5(53.7, 65.3)mm vs. 68.3(63.8, 71.9)mm, P=0.005]were significantly decreased post LVAD implantation as compared to before LVAD implantation. Within one week after implantation, there was no significant difference in LVAD rotational speed, flow rate, and pulsation index ( P>0.05). During ICU treatment, dobutamine (13 cases) was the most commonly used vasoactive agent. 9 patients used phosphodiesterase Ⅲ inhibitors for perioperative pulmonary hypertension. Targeted management of volume and pressure indicators was conducted for enrolled patients to prevent postoperative right heart failure and to reduce right heart burden. Within 72 hours after LVAD implantation, the average pulmonary artery pressure of patients was 24 (22, 26) mmHg to 26 (21, 28)mmHg (1 mmHg=0.133 kPa), while the fluid balance was(-581±778)ml to(-1 209±1 134)ml. All enrolled patients survived to 28 days after LVAD implantation. The length of stay in the ICU was (8.0±1.8) days and the total length of hospital stay was 33 (29, 41)days, while the time of mechanical ventilation was 8 (5, 28)h. Conclusion:LVAD implantation can help improve left ventricular systolic function, prolong survival time so as to serve as an important means of terminal treatment or bridging therapy for heart transplantation of patients with end-stage heart failure. To strengthen the perioperative hemodynamic regulation and maintain the cardiac function of patients with LVAD implantation is the important purposes of ICU postoperative management.

Objective:To comprehensively evaluate the clinical application status of oral movement intervention in preterm infants, analyze the obstacles in the process of clinical application of the best evidence and formulate countermeasures, so as to provide reference for clinical evidence transformation.Methods:Based on the theoretical guidance of the "Clinical Application Model of Evidence" of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center in Australia, 12 pieces of the best evidence for oral movement intervention in premature infants were included, and 13 review indicators were formulated. From May to July 2021, a status review was conducted in Department of Neonatology in Suzhou Hospital Affiliated to Nanjing Medical University. The Ottawa Model of Research Use (OMRU) was used to analyze the barriers and facilitators in the process of evidence application and formulate effective intervention strategies and action plans.Results:Among the 13 reviewed indicators, only 2 items had a compliance rate of 100%, 2 items had a compliance rate of more than 60%, 6 items had a compliance rate of less than 60%, and 3 items had a compliance rate of 0. The main obstacle factors were lack of standardized process and assessment tools, lack of oral motor intervention related knowledge and training for preterm infants, increased clinical workload due to evidence transformation and the low level of knowledge and action among medical staff. The main promoting factors were support from managers for the development and reform of evidence-based learning, good learning atmosphere for doctors and nurses, departments with material and hardware conditions for evidence transformation, effective evidence, and parents' willingness to accept the reform. Through analysis, countermeasures were drawn up to formulate feasible and suitable standardized procedures and introduce assessment tools. Managers formulated and implemented incentive policies, adopted various training methods, strengthened quality supervision in the process of evidence transformation, timely gave feedback of progress results and improved human resource allocation.Conclusions:There is a certain gap between the best evidence of oral movement intervention in premature infants and the current clinical nursing practice. It is necessary to formulate corresponding countermeasures according to the obstacle factors and promoting factors, promote the evidence transformation and constantly promote the evidence-based practice of oral movement intervention in premature infants.