Objective To revise the Symptom Distress Scale for postoperative patients with pituitary tumor and to test its reliability and validity. Methods On the base of previous qualitative interview and literature review, Delphi consultation was performed to identify items of the Symptom Distress Scale for postoperative patients with pituitary tumor. By convenience sampling method, totally 191 patients from four first-class ternary hospitals in Jiangsu province were investigated effectively by this scale. Results A scale of 4 factors and 16 items was identified by expert interviews, item analysis, exploratory factor analysis and the four factors could explain 69.812%of the variance. The Cronbachαcoefficient of the scale was 0.920, the content validity index was 0.915, and the interrater reliability was 0.860. Conclusions Symptom Distress Scale for postoperative patients with pituitary tumor has good reliability and validity to assess the symptom distress of pituitary tumor patients after operation.

Objective To understand the prevalence and the nursing status of incontinence and incontinence-associated dermatitis (IAD),analyze the risk factors of the occurrence of IAD,and to provide effective measures for the prevention and management of IAD.Methods Using the questionnaire survey, 1 318 hospitalized patients in 2 grade three hospitals of Suzhou were investigated,and then the results were analyzed.Results The prevalence of incontinence was 10.70％(141/1 318),among the prevalence of urinary incontinence was 4.63％(61/1 318),fecal incontinence was 4.32％(57/1 318);with 24.11％(34/141) of incontinent patients having IAD;disposable pad and briefs were the most common containment devices,only 36.17％ (51/141) of the incontinent inpatients using skin protectant after perineal skin clean.Single factor analysis revealed that IAD was related with wards, types of incontinence, character of stools, frequency of feces, antibiotics, modes of nutrition support, Braden scores, level of albumin and prealbumin.Unconditional Logistic regression indicated that risk factors of IAD included the level of serum albumin (OR=0.769, P＜ 0.05), Braden scores(OR=0.335, P＜ 0.05) and frequency of feces(OR=11.076, P ＜ 0.05).Conclusions Incontinence and IAD are common in hospitalized patients,low serum albumin, low Braden scores and high frequency of feces are the risk factors of IAD.The clinical nurses have not paied enough attention on the prevention of IAD, lacked relevant knowledge and skin care regimen.

OBJECTIVE To establish and apply a method for the determination of plasma concentration of delamanid （DLM）. METHODS After plasma samples were treated with methanol precipitation， LC-MS/MS was adopted to determine the plasma concentration of DLM. The chromatographic column was Phenomenex SynergiTM Fusion-RP with mobile phase of methanol-0.1% formic acid solution （gradient elution）. The column temperature was 40 ℃ ， the flow rate was 0.3 mL/min， and the sample size was 1 μL. The ion source was electrospray ion source， and positive ion scanning was carried out in multi-reaction monitoring mode. The DLM ion pair used for quantitative analysis was m/z 535.0→352.0. The plasma concentration of DLM in 6 multidrug resistant tuberculosis （MDR-TB） patients were determined by the LC-MS/MS method. RESULTS The linear range of DLM was 0.05-8 μg/mL （r＝0.999 5）， and the lowest limit of quantitation was 0.05 μg/mL. RSDs of intra-batch and inter-batch precision were all less than 10%. The accuracy ranged 92.7%-104.9%. Average matrix effect was 94.3%-107.5%. Average recoveries were 93.2%-98.1%. The plasma concentration of DLM in 6 MDR-TB patients ranged from 0.61-2.76 μg/mL， with an average of （1.67± 0.74） μg/mL. CONCLUSIONS The established LC-MS/MS analysis method has good specificity， high sensitivity， accuracy and precision， and can be used to determine DLM plasma concentration in MDR-TB patients.

Objective To explore the coronary flow reserve (CFR) in patients with coronary slow flow (CSF) and the diagnostic value of non-invasive myocardial work indices derived from echocardiography for CSF. Methods A retrospective study was conducted on 65 patients who underwent coronary angiography at the Zhongshan Hospital (Xiamen Branch), Fudan University due to angina pectoris, coronary artery risk factors, or electrocardiographic abnormalities from August 2020 to November 2023. Patients were divided into two groups based on the corrected TIMI frame count (cTFC): the CSF group (n＝35) and the normal coronary blood flow velocity group (control group, n＝30). Both groups underwent an adenosine triphosphate (ATP) drug load test to measure their coronary flow reserve (CFR). Conventional indices and myocardial work indices via echocardiography and two-dimensional speckle-tracking imaging (2D-STI) were acquired: left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), E/e' ratio, global longitudinal strain (GLS), global constructive work (GCW), global wasted work (GWW), global work index (GWI), and global work efficiency (GWE). Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of myocardial work indices for CSF. Results There was no significant difference in CFR values between the two groups, but the proportion of CSF group with CFR less than 2 was higher than that of the control group (P＝0.023). Compared with the control group, the CSF group showed significantly lower levels of GLS, GWI, and GCW (P＜0.05). ROC curve analysis revealed that the GLS diagnostic threshold for CSF was −19.5%, with a sensitivity of 64.7%, specificity of 78.6%, and AUC of 0.793. Among the myocardial work indices, the AUC of GWI was the highest (0.825), with a sensitivity of 88.2% and specificity of 75.0%. Conclusions Some CSF patients retain coronary microcirculatory blood flow reserve function, but the proportion of patients with reduced CFR function is increasing. The left ventricular myocardial work indices can identify early myocardial work abnormalities and monitor myocardial ischemic damage in CSF patients.

OBJECTIVE To analyze the dose-adjusted concentrations of Posaconazole oral suspension in patients undergoing hematopoietic stem cell transplantation （HSCT） and their influential factors. METHODS Data were collected from hospitalized HSCT patients admitted to the First Affiliated Hospital of Shandong First Medical University （Shandong Provincial Qianfoshan Hospital） from January 2021 to April whtwhm@yeah.net 2023 who took Posaconazole oral suspension for the prevention of invasive fungal disease （IFD） and received blood concentration of posaconazole. The rate of concentration attainment and clinical failure rate of posaconazole for the prevention of IFD were evaluated， and one-way and multiple linear regression analyses were performed for the influential factors of dose-adjusted concentrations （C0/D） of posaconazole. RESULTS A total of 44 patients were enrolled； the mean C0 of posaconazole in patients was （0.99±0.94） µg/mL， and 20 patients had a C0≥0.7 μg/mL， with a concentration attainment rate of 45.45% for the prevention of IFD； 13 cases were clinical failures， with a clinical failure rate of 29.55%. Of 24 patients who did not achieve C0/D of posaconazole for IFD prophylaxis， one patient was a clinical failure despite timely dose adjustment of posaconazole in seven patients； seven of the thirteen patients who did not undergo dose adjustment were clinical failures； and the remaining four patients were switched to other antifungal agents. The results of univariate analysis showed that gender， body mass index （BMI）， renal function， combined use of sodium phenytoin， omeprazole and metoclopramide had a significant effect on the C0/D of posaconazole （P＜0.05）； the results of multivariate linear regression analysis showed that gender， BMI and combined use of sodium phenytoin were the independent factors affecting the C0/D of posaconazole （P＜0.05）. CONCLUSIONS Significant individual differences are reflected in the blood concentration of Posaconazole oral suspension； gender， BMI and combined use of sodium phenytoin are independent factors affecting the C0/D of posaconazole.