OBJECTIVETo study the dispersivity of baicalin solid dispersion by Raman spectrometry and infrared spectrometry in order to obtain a new and simple method in examining the dispersivity of solid dispersion.

METHODBaicalin solid dispersion was prepared by solvent method. The Raman spectra, infrared spectra and X-ray powder diffraction patterns of crude baicalin, PVP K30, physical mixture, solid dispersion were acquired by Raman and Fourier transform infrared spectrometers and X-ray powder diffractometry. Then the spectra were compared with each other in order to find out the differences between baicalin solid dispersion and other materials.

RESULTThe result of Raman spectrometry was that amorphous baicalin presented in the solid dispersion, which was in agreement with that of X-ray powder diffractometry.

CONCLUSIONRaman spectrometry which is fast, direct and non-destructive is an ideal method for examining the dispersivity of solid dispersion.

Objective:To explore transition care needs among the parents of children with primary nephrotic syndrome and analyze the influencing factors.Methods:With convenient sampling method, parents of children with primary nephrotic syndrome were selected in the children's nephrology department of a tertiary grade A hospital in Shandong province. A total of 240 parents were enrolled in the study and they were investigated by using a self-designed questionnaire of transitional care needs of parents of children with primary nephrotic syndrome.Results:The total score of transitional care needs for parents was (4.12±1.08) points. The demand for disease knowledge, complication prevention and condition monitoring was the highest (4.67±0.53) points. 52.80% (113/214) of parents hope to receive transitional care services through network communication. 64.49% (138/214) of the parents want specialist doctors and nurses to provide nursing services for them. Multivariate stepwise regression analysis showed that age, education level, monthly income, hospitalization time and hormone use time of the children were the factors influencing the parents' demand for transitional care services ( P < 0.01). Conclusion:Parents of children with primary nephrotic syndrome have a high demand for transitional care. It is suggested to give full play to the leading role of professional medical teams and gradually form a hospital-community linkage transitional nursing mode; Parents of children with different age, education level, monthly income, hospitalization time and hormone use time have different needs for transitional care thus individualized transitional nursing for different patients are expected.

Objective:To investigate the status of the professional construction of head nurses in the tertiary hospitals of Shandong Province, and to master the professional cognition and attitude of the head nurses, and to provide reference for the formulation of the professional construction plan for the head nurses in the tertiary hospitals.Methods:A cross-sectional survey of 2 629 head nurses from 55 tertiary hospitals in Shandong Province was conducted using a self-designed questionnaire survey on the status of professional construction of head nurses in tertiary hospitals in Shandong Province.Results:The selection and training system of the head nurses in the tertiary hospitals in Shandong Province was mature. 93.00%(2 357/2 534) of the head nurses were undergraduate degrees, 18.40%(465/2 534) of the head nurses used all the working hours for nursing management, and 86.00%(2 179/2 534) were the main economic sources with the current position; 68.20%(1 728/2 534) were believed that the head nurse should be a trained nurse, 87.90%(2 227/2 534) thought that the head nurse′s professional construction was necessary, and the professional feasibility score was 77.93±19.75. The regression analysis showed that the factors affecting the head nurse′s own professional construction were age, satisfaction with salary satisfaction and self-worth ( P<0.05); 32.50%(257/791) of the head nurses suggested improving the management training system, 20.61%(163/791) recommended that the hospital should pay attention to the professional construction of the head nurse, and 7.33%(58/791) recommended establishing the standardization of professional standards. Conclusions:To improve the investment time of the head nurses and encourage the head nurses to continue the education management; the hospital should appropriately reduce the age requirements of the head nurses and improve the salary; establish a sound professional system and management training system for the head nurses, and comprehensively recommend the head nurses. Promote the professional development of the head nurse team

Objective To explore the impact of postpartum fatigue on the onset of lactation.Methods Totally 553 mother-infant dyads were enrolled from three hospitals in Nantong City using sampling method of probability proportional to size.The timing of the onset of lactation,delayed onset of lactation and maternal postpartum fatigue were measured during the period of hospitalization.Postpartum fatigue was measured by Fatigue Scale-14.The timing of onset of lactation was determined by matemal perception of breast fullness.One-way analysis of variance was used to compare the difference of onset of lactation in four groups with varied fatigue scores.Impact of the maternal fatigue on the onset of lactation was analyzed by multiple linear regression.Results Mothers' fatigue score was related to the onset of lactation(r-0.15,P＜0.001).Mothers with postpartum fatigue scores ranging from 9 to 14 had delayed onset of lactation compared with those with fatigue score ranging from 0 to 3 and from 4 to 5,and the differences were significant (P=0.004),and the rate of delayed onset of lactation was increased (P=0.020).Postpartum fatigue was an independent risk factor,after controlling mode of delivery,mode of anesthesia,duration of infant sucking,maternal pain,and infant sucking gesture(t=3.26,P=0.001).Conclusion Postpartum fatigue is one of reasons leading to delayed onset of lactation.Health care providers and family members should pay more attention to postpartum fatigue and take effective measures to promote a successful onset of lactation and breastfeeding.

Objective:To measure the anatomical parameters of three-dimensional available space of S 1 and S 2 vestibules on Chinese adults by imaging methods, and discuss their clinical values. Methods:Data of 200 cases of pelvic CT with complete posterior ring were collected from January 2015 to January 2021, included 110 males and 90 females. The ages ranged from 21 to 63 years (average, 40.72±10.70 years). Then the parameters of both the left vestibule and the right vestibule of S 1 and S 2 such as vestibular width, vestibular height and vestibular area were measured by the three-dimensional CT reconstructions. Statistical analyses were performed among the groups which were classified according to the gender, side of vestibule to compare the difference of vestibular morphological characteristics among different groups. Results:The average vestibular area of S 1 was 425.71± 45.07 mm 2 (range, 296.3-604.4 mm 2), which was 449.80±28.62 mm 2 (range, 338.3-604.4 mm 2) in males and 388.25±34.01 mm 2 (range, 296.3-498.4 mm 2) in females. The average vestibular width was 28.52±4.34 mm (range, 17.1-36.3 mm), 31.77±2.33 mm (range, 22.46-36.30 mm) in males and 24.55±2.55 mm (range, 17.1-26.1 mm) in females. The mean vestibular height was 21.05±2.29 mm (range, 17.5-32.0 mm), with 21.34±2.37 mm (range, 18.5-32.0 mm) of men and 20.69±1.60 mm (range, 17.5-25.6 mm) of women. The mean S 2 vestibular area was 230.19±35.57 mm 2 (range, 142.5-297.3 mm 2), which was 258.91±28.04 mm 2 (range, 218.3-297.3 mm 2) in males and 205.61±24.12 mm 2 (range, 142.5-258.6 mm 2) in females. The average vestibular width was 15.94±1.72 mm (range, 12.4-20.3 mm), 16.51±1.59 mm (range, 14.4-20.3 mm) in male and 15.25±1.63 mm (range, 12.4-18.1 mm) in female. The mean vestibular height was 14.30±1.20 mm (range, 12.9-17.8 mm), 15.49±1.46 mm (range, 13.6-17.8 mm) in males and 13.73±0.93 mm (range, 12.9-16.1 mm) in females. There were significant differences in vestibular width, height and area between S 1 and S 2 (vestibular width t=3.934, P< 0.001; vestibular height t=3.692, P< 0.001; vestibular area t=4.816, P< 0.001). There were significant differences in S 1 vestibular width, S 1 vestibular height, S 1 and S 2 vestibular area between male groups and female groups (S 1 vestibular width: t=2.969, P=0.003; S 1 vestibular height: t=0.316, P=0.049; S 1 vestibular area: t=1.975, P=0.049; S 2 vestibular area: t=2.023, P=0.044). While there was no significant difference in S 2 vestibular width and height between the two gender groups. There were significant differences in S 1 and S 2 vestibular width, height and area between male and female groups ( P < 0.001). There were no significant difference in parameters between the left and right values of the same vestibular site. Conclusion:The parameters of S 1 sacral vestibule are larger than that of S 2. It implies that S 1 was more feasible to insert iliosacral screws than S 2; lesser diameter iliosacral screws should be selected to insert into S 2. The female S 1 vestibule is smaller than the male, so the iliosacral screws placement has more stringent requirements on the selection of the insertion point and the direction of the screw. And the surgeon can utilize the intact contralateral sacral vestibule as the damaged side to proceed the iliosacral screw inserted simulation.

Objective:To discuss the clinical value of magnetic resonance neurography (MRN) on diagnosis and treatment of lumbosacral nerve injury associated with sacral fractures and analyze the characters of nerve injury which was caused by sacral fractures.Methods:The clinical data of 40 patients who had lumbosacral nerve injury associated with sacral fractures and accepted treatment in Tianjin hospital from August 2018 to December 2020 were collected based on inclusion and exclusion criteria. Twenty-four patients had unilateral sacral fractures (Tile C1) which included 16 Denis II type fractures and 8 Denis III type fractures. Sixteen patients had bilateral sacral fractures which were all Tile C3, U shaped and Denis II type sacral fractures. All patients had symptoms or signs of lumbosacral nerve injury, and accepted contrast-enhanced three-dimensional magnetic resonance neurography (CE-3D MRN) to diagnose the injury part and severity degree. The L 5-S 4 nerves were separated to three parts based on injured side and intraspinal type (IS), intraforaminal type (IF) and extraforaminal type (EF) location, and were judged the mild, medium or severe degree of nerve injury severity. Overall and pairwise Chi-square test was performed on the number of nerve injuries. Eleven patients accepted the operation of nerve dissection and exploration. The nerve injury part and severity were recorded under direct vision, and were statistically analyzed with CE-3D MRN outcome. Results:The outcome of 239 lumbosacral nerve injuries which had different part and severity were found by MRN, and all combined with sacral fractures of the same side. The nerves which ranked from largest to fewest according to injured numbers were L 5, S 1, S 2, S 3 and S 4. The statistical analysis showed that there were significant differences of injured nerve numbers except between S 1 and S 2, S 3 and S 4, and there were no significant difference of nerve injury part and severity degree between the direct visual judgement intraoperatively and preoperative CE-3D MRN examination. Conclusion:MRN can reveal the part and severity degree of lumbosacral nerve injury associated with sacral fracture clearly and accurately, which has important clinical value and should become the preferred examination of such injuries. The lumbosacral nerve injury has the most frequent features of S 1 and S 2, followed by L 5, and the least in S 3 and S 4.

Objective To investigate the clinical values of Dynamic changes of evaluation of central venous pressure (△CVP) combining with the pulse Doppler records of early mitral dilatation of blood flow velocity and peak atrial systolic blood flow velocity ratio (E/A) in the diagnosis and prognosis assessment of septic patients.Methods The study totally enrolled patients who were admitted to Intensive Care Unit of the Central Hospital of Puyang during January 2013 to June 2016.By the standard of 28 days,all the cases were divided into the survival group and the dead group.All patients admitted in the intensive treatment unit (ICU) in the same period were recorded of the acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) score and sequential organ failure score (SOFA).Observe the dynamic changes of the two groups of patients on central venous pressure (△CVP) and E/A changes record into the family,after 6 hours and 24 of the related E/A value on each node,at the same time record the related CVP values,calculated the absolute value of the dynamic change of each node in the comparison after 6 h and 24 hours,the records of the node values mapped the receiver-operating characteristic curve (ROC) to evaluate the value of each index for prognosis.Results A total of 233 cases of sepsis patients enrolled,28 d survival of 122 cases,survival rate was 52.4％;111 cases died,mortality was 47.6％.The ICU blood lactate,APACHE Ⅱf,SOFA score of the dead group was significantly higher than the survival group,and their stay in ICU was significantly shorter than the survival group (P＜0.05),other clinical features of the difference was not statistically significant(P＞0.05).The E/A value differences between the dead group and survival group into the ICU 0h and 6h were 0.54±0.17,0.69±0.24;0.57±0.28,0.85±0.25 (P＜0.05),the ROC curve analysis is 0.792,0.818,and there are different CVP change value △h2 CVP change value △h1,24 hours and after 6 hours of the patient,namely:5.67 ± 4.16,7.82 ±4.81;6.58±3.89,8.82±2.40 (P＜0.05) the area under the ROC curve it was,0.778,0.705,wherein when the 6h,the cutoff value E/A 0.75 area taken under the ROC curve (AUC) was 0.818 for the highest single index,the sensitivity and specificity were forecast 74.16％,95.45％,which the ICU 6 when E/A area under the ROC curve of dynamic changes in the value of a ACVP with CVP (AUC) of up to 0.844;0.471 to take their cut-off point,the sensitivity of the prognosis was 88.32％,specificity degree of 90.71％,better predictive strength thanthe other indicators,as well as sensitivity and specificity.Conclusion Early E/A can be used as prognostic evaluation of sepsis as new and important indicator,combining with dynamic changes of the early CVP as an early assessment of the clinical condition of patients with sepsis,and can be prediction of the prognosis of patients,as well as reference for the therapeutic intervention on high-risk patients.

Objective:To explore the mediating effect of perceived organizational support on the relationship between personality traits and perceived self-efficacy of male nurses.Methods:A total of 766 male nurses from 20 level-A general hospitals in Shandong province were selected by convenience sampling method in December 2020. The general status questionnaire, the simplified version of Big Five Personality Inventory, the Perceived Organizational Support Scale and the General Self-efficacy Scale were used to investigate them.Results:The total score and average item score of 766 male nurses' sense of organizational support was 44.05±9.31, 3.38±0.72, and the total score and average item score of general self-efficacy was 26.19±5.65, 2.62±0.57. In 766 male nurses, perceived organizational support had a partial mediating effect on neuroticism and openness, with effect values of 21.71% and 10.19%, respectively. In addition, perceived organizational support had a complete mediating effect on conscientiousness and self-efficacy.Conclusions:The organizational support and self-efficacy of 766 male nurses were above average, and organizational support played a mediating role in the relationship between neuroticism, openness, conscientiousness and general self-efficacy.Nursing managers should give more organizational support to male nurses to change the influence of neuroticism, responsibility, agreeableness and open personality traits on self-efficacy, so as to improve the level of self-efficacy of male nurses.

Objective:To upgrade the wisdom of traditional wards through the internet of things platform to achieve intelligent and refined management of wards, and to evaluate the effect of the upgrade.Methods:In June 2020, the convenience sampling method was used to selecte two wards of the cardiology department of Shandong First Medical University as the pilot units of the affiliated provincial Hospital to implement the intelligent ward management mode. Based on the principle of easy transformation, easy construction and easy maintenance, on the basis of realizing the full coverage of the internet of things, the hardware and software system were connected to complete the intelligent upgrade of the traditional ward, and the structured observation and semi-structured interview methods were adopted to evaluate the upgraded work efficiency and the use experience of patients.Results:The time spent on vital sign collection and recording, nursing risk assessment and time spent, and signage production and hanging were (4.24 ± 0.87), (4.07 ± 0.86) and 0 min respectively, which were effectively reduced than those before the upgrade (6.50 ± 2.95), (4.73 ± 1.62) and (1.13 ± 0.43) min, with statistically significant differences ( t=8.04, 3.99, 28.96, all P<0.01). The results of semi-structured interviews showed that patients perceived the smart ward as intelligent, saving manpower and waiting time; simple to operate, improving the experience of healthcare workers and patients in using it; and untimely system updates. Conclusions:The wisdom upgrade of traditional wards can help refine patient management, improve work efficiency, and improve the experience of health care workers and patients in using them, which will be continuously improved in future development and can provide practical paths for reference for the wisdom upgrade of similar wards.

Objective To investigate the antimicrobial resistance of clinical strains of K lebsiella spp .isolated from 15 hospitals in China CHINET during 2012 .Methods Kirby-Bauer method and automatic microbiology analysis system were employed to study the antimicrobial resistance . WHONET 5 .6 software was applied for data analysis according to Clinical and Laboratory Standards Institute (CLSI) 2012 breakpoints .Results A total of 9 621 clinical K lebsiella isolates were analyzed ,including 8 772 strains of K . pneumoniae and 804 strains of K . oxytoca . About 54 .9% (5 285/9 621) of the K lebsiella strains were isolated from sputum ,and 16 .3% (1 564/9 621) were isolated from pediatric patients .Antimicrobial susceptibility testing showed that about 8 .9% ,10 .8% and 12 .9% of the strains were resistant to imipenem ,meropenem and ertapenem ,respectively .About 14 .1% and 17 .0% of the strains were resistant to piperacillin-tazobactam and cefoperazone-sulbactam , respectively . Carbapenem-resistant K lebsiella strains were identified from all the 15 hospitals ,including 945 strains of K .pneumoniae and 45 strains of K .oxytoca ,which were resistant to either imipenem ,meropenem or ertapenem .Conclusions The Klebsiella isolates collected from 15 hospitals in China during 2012 are relatively sensitive to carbapenems ,cefoperazone-sulbactam and piperacillin-tazobactam .The prevalence of carbapenem-resistant strains is still increasing in China ,about 10 .3% in 2012 ,and relatively higher in Eastern China .More efforts should be made to control the superbug .