To establish a sensitive and specific method for simultaneous determination of gestodene, etonogestrel and ethinylestradiol in plasma by LC-MS/MS, plasma samples were extracted and derivatized before injection. An ESI ion source was used and operated in the positive ion mode with multiple reaction monitoring (MRM). Norgestrel was chosen as internal standard and performed on a C18 (100 mm x 2.1 mm, 5 microm) column. The concentrations of gestodene, etonogestrel and ethinylestradiol were measured, using step-gradient mobile phase and step-gradient flow rate. The method was validated over the concentration range of 0.1-20 ng x mL(-1) for gestodene and etonogestrel and 0.01-2 ng x mL(-1) for ethinylestradiol, and showed excellent linearity. The intra- and inter-assay accuracy and precision were below 10.0% and recovery was 93.6%-110.9% over the three concentration levels evaluated. The method was applied in pharmacokinetic study of the compound gestodene patch and the compound etonogestrel patch in rabbits. The LC-MS/MS method was selective, accurate and sensitive, especially the LOQ were 100 pg x mL(-1) for gestodene and etonogestrel and 10 pg x mL(-1) for ethinylestradiol. The method was successfully applied in pharmacokinetic study for contraceptives.

Objective:To explore the influence of group combined Internet+personalized health management mode on physiological indexes and self-management ability of physical examination population with chronic disease.Methods:A total of 88 people with abnormal chronic disease associated indicators who underwent physical examination in the Health Management Department of the First Hospital of Shanxi Medical University from May 2019 to December 2019 were recruited as the research subjects by purposive sampling. They were randomly divided into the control group and experimental group according to the random envelope method, with 44 patients in each group. The control group was treated with routine health return visit management, while the experimental group was treated with group combined Internet+personalized health management for 6 months, once a month. The differences of physiological indexes and self-management ability scores before and after the intervention were analyzed and compared between the two groups.Results:Comparison of physiological indicators: after intervention, systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, low density lipoprotein and fasting blood glucose in experimental group were significantly lower than those in control group[(138.5±16.7) vs (147.2±16.1) mmHg (1 mmHg=0.133 kPa), (82.3±9.4) vs (86.4±9.4) mmHg, (2.14±0.99) vs (2.96±2.43) mmol/L, (5.27±0.83) vs (6.09±1.02) mmol/L, (3.40±0.66) vs (3.96±0.72) mmol/L, (7.37±2.03) vs (8.67±2.90) mmol/L]( t=2.476, 2.046, 2.072, 4.132, 3.814, 2.437, all P<0.05). Comparison of self-management ability score: all scores and total scores of self-management ability in two groups after intervention were higher than those before intervention (all P<0.05 in experimental group, but all P>0.05 in control group), and all scores and total scores of self-management ability in experimental group were significantly higher than those in control group after intervention (all P<0.05). Conclusion:The application of group combined Internet+personalized health management mode in physical examination population with chronic disease is conducive to improving their physiological indicators of chronic diseases and enhancing their ability of self-management.

Objective:To explore the relationship between psychological capital, career decision-making difficulties, and employment anxiety among undergraduate nursing students, in order to help them improve their employability and mental health.Methods:From December 2022 to January 2023, a cross-sectional survey was conducted on 543 undergraduate nursing students from five medical colleges in Shanxi Province interning at the First Hospital of Shanxi Medical University, selected through convenience sampling method, using a General Information Questionnaire, Psychological Capital Scale, College Student Career Decision-making Difficulties Scale, and College Student Employment Anxiety Scale. Spearman correlation analysis was used to explore the relationship among them, and hierarchical model was used to explore the predictive ability of undergraduate nursing students ′ psychological capital and career decision-making difficulties on their employment anxiety by stratified regression analysis. Results:The score of College Student Employment Anxiety Scale of 543 undergraduate nursing students was 36(30, 44). The results of correlation analysis showed that employment anxiety was negatively correlated with psychological capital and its four dimensions (self-efficacy, hope, resilience and optimism), while employment anxiety was moderately correlated with career decision-making difficulties and its three dimensions (lack of preparation, difficulty in information exploration and conflict)( r values were -0.291 to 0.564, all P<0.05). The hierarchical model showed that psychological capital and career decision-making difficulties independently explained the 46.1% variation of employment anxiety after controlling the influence of general data. Conclusions:The score of employment anxiety of undergraduate nursing students is in the middle level, and the difficulty of career decision-making has a positive impact, while the psychological capital has a negative impact. College educators can continuously monitor the psychological capital and provide career development counseling for undergraduate nursing students through positive psychological intervention and effective management measures, so as to reduce the degree of employment anxiety of undergraduate nursing students.

Objective:To investigate the status quo and influencing factors of health self-management ability of scientific and technological workers in Shanxi Province.Methods:This study was a cross-sectional study. Using the general situation questionnaire and the adult health self-management ability evaluation scale, 467 scientific and technological workers who received physical examination in the First Hospital of Shanxi Medical University from January 2022 to September 2022 were investigated by questionnaire, and their height, weight, body mass index, fasting blood glucose, blood lipids and blood uric acid were collected on the day of physical examination. Multiple linear regression analysis was used to explore the influencing factors of health self-management ability, and Pearson and Spearman correlation analysis was used to analyze the correlation between health self-management ability and examination items.Results:The total score of health self-management ability of 467 scientific and technological workers was (153.7±16.5). The results of multiple linear regression showed that the type of medical insurance, self-assessment of health status, staying up late, and sleep quality were independent influencing factors of health self-management ability ( R2=0.141, adjusted R2=0.120, F=6.771; P<0.001). Health self-management ability was positively correlated with high-density lipoprotein ( r=0.114), behavioral subscale was positively correlated with high-density lipoprotein ( r=0.107), environmental subscale was negatively correlated with uric acid ( r=-0.103), triglyceride ( r=-0.118), and positively correlated with high-density lipoprotein ( r=0.129), and cognitive subscale was negatively correlated with triglyceride ( r=-0.125), all of which were statistically significant ( P<0.05). Conclusions:The ability of health self-management of scientific and technological workers in Shanxi Province belongs to the upper middle level, which is affected by the type of medical insurance, the self-assessment of health status, staying up late, and the quality of sleep. It is suggested that the ability of health self-management of scientific and technological workers can be improved by strengthening their health beliefs, providing a more convenient working environment, reducing the frequency of staying up late, and improving their sleep quality.

Objective To evaluate the impact of overall burden of cerebral small vessel disease(CSVD)combined with intracranial large artery atherosclerosis(ICAS)on cognitive function in very old patients.Methods A total of 178 advanced elderly patients admitted to Department of General Medicine of Wuhan Central Hospital between January 2013 and December 2022 were re-cruited in this retrospective study.According to the results of Montreal Cognitive Assessment Scale,they were divided into dementia group(n=83)and non-dementia group(n=95).All pa-tients underwent brain MRI imaging,MRI susceptibility weighted imaging and cerebral angiogra-phy.Based on these imaging findings of MRI,the effect of total burden score of CSVD and athero-sclerosis on cognition were evaluated.The volumes of 14 different gyri in the left and right brain were measured in the patients with CSVD burden score ≤2 and those &ge;3.Results There were significantly more patients with numbers of microbleeding foci＞10 and lacunar foci &ge;5 in the dementia group than the non-dementia group(P＜0.01).But,no statistical difference was seen in intracranial and extracranial arterial stenosis between the two groups(P＞0.05).The volumes of left and right anterior cingulate gyrus,left and right paracingulate cortex,right hippocampus,left parahippocampal gyrus,right transverse temporal gyrus and left inferior temporal gyrus were no-tably smaller in the CSVD score &ge;3 group than the CSVD ≤2 group(1723.444 vs 1867.167,1590.167 vs 1595.670,1481.466 vs 1509.540,1543.831 vs 1585.505,1038.345 vs 1305.831,1220.525 vs 1392.352,P＜0.05).Conclusion Cognitive function in the advanced elderly is mainly affected by the burden of CSVD,and atherosclerotic stenosis of large arteries is not the main fac-tor affecting cognitive function.The total burden of CSVD is correlated with atrophy of some gyri.

Objective:To analyze the status quo of intelligent health management services in health examination institutions in Shanxi Province.Methods:This study is a cross-sectional study. In October 2023, 292 health examination institutions in 11 cities of Shanxi Province were surveyed by convenient sampling with the help of “Questionnaire star” to investigate the health examination (management) institutions to carry out smart health management services from January to December 2022. It was mainly divided into three aspects: pre-inspection, in-inspection and post-inspection, including 6 dimensions, with a total of 21 items. A total of 300 questionnaires were distributed in this survey, and 292 were effectively collected, with an effective recovery rate of 97.33%. The 292 questionnaires were divided and compared according to four regions: the north of Shanxi Province, the middle of Shanxi Province, the south of Shanxi Province and the southeast of Shanxi Province.Results:The health examination (management) institutions were distributed in 11 prefectures and cities in Shanxi Province, and there were 56 (19.2%) tertiary health examination (management) institutions. There were 178 government organizations (61.0%) and 114 social organizations (39.0%). There were 256 (87.7%) that carried out smart health management services; among them, 229 (78.4%) had smart management service systems, and 58 (19.9%) had physical examination centers with smart health management clinics. A total of 108 institutions (36.99%) carried out follow-up visits after intelligent screening. The prevalence of intelligent referrals were 63.3%, 59.6%, 78.0% and 85.2% in the north of Shanxi Province, the middle of Shanxi Province, the south of Shanxi Province and the southeast of Shanxi Province, respectively ( χ2=14.02, P<0.05). The prevalence of self-service in the north of Shanxi Province, the middle of Shanxi Province, the south of Shanxi Province and the southeast of Shanxi Province were 39.2%, 52.3%, 62.0% and 37.0%, respectively ( χ2=9.75, P<0.05). Conclusions:The development of intelligent health management in health examination (management) institutions in Shanxi Province is good, and the service scale continues to grow, but the problem of uneven development among regions is severe. In addition, the proportion of institutions providing services through information technology is not high, and the rate of intelligent management outpatient service, intelligent post-examination follow-up and intelligent physical examination service satisfaction is low.