Objective To explore the needs of intensive care unit (ICU) patients in the intensive care unit from nurses' perspectives.Methods A descriptive qualitative study of data generated from individual in-depth interviews of eleven intensive care nurses was to learn about the needs of ICU dying patients.Colaizzi analysis was used to analysis the data.Result The ICU nurses' description for needs of ICU dying patients are described as:have no physical burden of pain,to maintain dignity,to be understood and to fulfill their wishes,and family members are able to calmly accept the fact that the patient is about to leave.Conclusion According to the needs of ICU dying patients,medical staff should further concern about the humane care for ICU dying patients,and provide quality nursing care to help them live peacefully through the final stages of life.

Based on the analysis of blended learning characteristics, a blended learning pro-cess model including preliminary analysis, learning activities design, blended evaluation was con-structed. Then, a blended learning case study was carried out by taking the Fourth Military Medical University Information Security course as an example. The implement methods of setting learning goal, selecting learning content, constructing learning environment, organizing learning activities and course evaluation, were described in detail. Lastly, from the effectiveness questionnaire, it could be shown that blended learning motivated the learners' enthusiasm significantly. In order to improve the learning performance, we proposed that blended learning activities must be flexible and adaptive,and integrate face-to-face learning with online learning effectively.

Objective To investigate the change of 25-hydroxyl vitamin D level and its impact on glucose metabolism and bone mineral density in type 2 diabetic patients.MethodsTwo hundred and fifty-eight cases of type 2 diabetic patients in our hospital were collected.In accordance with 25 (OH) D =50 nmol/L for the critical values,they were grouped into vitamin D deficiency group ( n =192) and the relative lack of vitamin D group ( n =66).Dual-energy X-ray absorptiometry (DXA) measurement of the lumbar vertebrae L2 - L4 and femoral neck bone mineral density were undertaking.Taking the total value of the lumbar spine,femoral neck and total value as judgment indicators,homeostasis model assessment of insulin resistance (HOMA-IR),we collected and statistically analyzed glucose metabolism and bone metabolism indicators in patients with diabetes.Results Among 258 cases of type 2 diabetes,there were 57 cases of osteoporosis accounting for 22.1％.There was significant difference on the duration of diabetes [ (7.98 ± 1.09 ) years old vs (3.77 ± 1.21 ) years old,t =4.849,P ＜0.05],FINS [ (6.42 ± 1.30) mU/L vs (5.79 ± 1.08) mU/L,t =3.871,P ＜0.05] and HOMA-IR [ (2.35 ±0.54) vs ( 1.85 ±0.41 ),t =2.705,P ＜0.05],but no significant difference on the FPG and HbA1c ( P ＞ 0.05 ) between two groups.PTH [ ( 36.51 ± 7.59) ng/L vs ( 32.02 ± 6.89 ) ng/L,t =2.008,P ＜ 0.05 ],bone mineral density in the lumbar total value [ (0.87 ±0.14) g/cm2 vs (0.99 ±0.12) g/cm2,t =2.799,P ＜0.05 ],femoral neck Neck [ ( 0.70 ± 0.10 ) g/cm2 vs ( 0.79 ± 0.11 ) g/cm2,t =2.564,P ＜ 0.05 ] and Total [ (0.84 ± 0.14) g/cm2 vs (0.97 ± 0.15 ) g/cm2,t =3.340 P ＜ 0.05 ] were statistically different,but no significant difference on the rest of the indicators.Conclusion The prevalence of vitamin D deficiency was found in patients with diabetes.Vitamin D level could affect insulin resistance and glycemic control and bone mineral density level.Therefore,routine vitamin D testing to the diabetic patients and giving vitamin D replacement therapy to vitamin D deficiency patients in a timely manner were necessary.