Objective To obtain a clear and qualified compound glycyrrhiza oral solution by using NaSO3 and EDTA as stabi-lizers and Tween80 as solubilizer so as to solve the problem of morphine content instability. Methods NaSO34g and EDTA 0.6 g as stabilizers,and Tween803 g as solubilizer were added in the traditional method. The pH of the solution was adjusted to 8.0. Then the solution was obtained and filled in the brown polyester bottle. Results The preparation was clear,qualified and the content of mor-phine was steady. Conclusion The improved method is feasible,simple,stabilized and suitable for manufacturing.

Objective To explore the relationships among social adaptation and the resilience,social support and coping style in undergraduate nursing students.Methods 758 students from two medical colleges in Shandong province were recruited by stratified random sampling method.They were assessed with China College Student Adjustment Scale (CCSAS),Resilience Scale for Adults (RSA),Social Support Rating Scale (SSRS),Simplified Coping Style Questionnaire (SCSQ).The data was analyzed with the structural equation mode.Results The social adaptation of undergraduate nursing students showed significantly positive association with the resilience,social support,positive coping style(r=0.113-0.607,P＜0.01),but the campus adaptation had negative association with negative coping style(r=-0.117,P＜0.01).The path analysis showed that the resilience,social support and coping style were the direct predictors of social adaptation (β=0.57,P＜0.05;β=0.0.26,P＜0.05;β=0.1,P＜ 0.05),and the resilience,active coping style played the mediating role between social support and social adaptation (β=0.31,P＜0.05;β=0.05,P＜0.05).Conclusion The social adaptation and the resilience,social support and active coping style of nursing undergraduates are closely related.

Objective To study the effects of parecoxib sodium combined with continuous femoral nerve block on the balance of Th1/Th2 in elderly patients after total knee arthroplasty. Methods Fifty elderly patients,33 males and 1 7 females,aged 65 to 80 years,with ASA Ⅰ or Ⅱtreated with total knee arthroplasty were randomly divided into two groups (n =25 each):parecoxib sodium combined with continuous femoral nerve block group (group A)and parecoxib sodium com-bined with intravenous analgesia group (group B).Quick induce laryngeal mask anesthesia and intra-venous parecoxib sodium 40 mg at 30 min before skin incision were adopted in both groups.After the first 8 h,parecoxib sodium of 40 mg was intravenously injected again.The patients in group A re-ceived femoral nerve puncture and continuous electronic analgesia pump.The patients in group B re-ceived postoperative intravenous electronic analgesia pump.Visual analogue score(VAS)during rest and movement at 6,12,24,36,48 h after operation,side effects in two groups were recorded,venous blood samples were taken before anesthesia (T0 ),at the end of operation (T1 ),and 24 h(T2 ),48 h (T3 ),72 h (T4 )after operation for determination of plasma IFN-γ,IL-10 and cortisol (Cor). Results The values of VAS were significantly lower in group A compared with group B in rest at 6, 12 h after operation,the values of VAS were significantly lower in group A compared with group B in moving at every time points after surgery (P <0.05 ).The plasma Cor concentrations were signifi-cantly increased at T1-T3 compared with baseline value at T0 in two groups(P <0.05 ).The plasma Cor concentrations in group A were significantly decreased compared with group B at T1-T3 (P <0.05).The plasma IFN-γconcentrations were significantly lower at T2 and T3 compared with baseline value at T0 in group A,the plasma IFN-γ concentrations were significantly lower at T2-T4 compared with baseline value at T0 in group B (P <0.05),the plasma IFN-γ concentrations were significantly increased in group A compared with group B at T2-T4 (P <0.05 ).The plasma IL-10 concentrations were significantly increased compared with baseline value at T1-T4 in two groups (P < 0.05 ),the plasma IL-10 concentrations were significantly decreased in group A compared with group B at T1-T4 (P <0.05).Compared with group B,the incidence of postoperative nausea,vomiting and pruritus in group A was lowered significantly (P <0.05).Conclusion Parecoxib sodium combined with continu-ous femoral nerve block on postoperative pain in elderly patients after total knee arthroplasty can a-chieve good effect of postoperative analgesia and fewer complications, lower cortisol secretion, slowing down the decrease of IFN-γ secretion and the increase of IL-10 secretion.This method could effectively protect the immune function of patients undergoing arthroplasty.

Objective: To evaluate the effect of low-dose of ionizing radiation on thyroid function of medical occupational group with long-term exposure, furthermore, to analyze the relationship between the thyroid hormones and the risk factors, such as exposure length, department and comulative radiation dose. Ultimately, providing the scientific basis for setting the ionizing radiation protection standards. Methods: The population who engaged radiodiagnosis and radiotherapy in a tertiary-A hospital was set up as occupational exposure, and the administrative staffs in a company were considered as control. According to the inclusion and exclusion criteria, 161 medical professionals and 159 administrative staffs as the research object.We figured out the basic information and general condition of the groups by face-to-face questionnaire survey, calculated the annual comulative radiation dose through local center for disease control and prevention, By means of the thyroid hormone testing, we analyzed the thyroid hormone levels with different population, occupational exposure factors. Applying Epidata、Excel in data management. All the data was analyzed by statistical software package Stata12.0. Descriptive statistics, single factor analysis of variance and other statistical methods were used for data analysis. Test standard: α=0.05、P<0.05 statistical significant. Results: Age, sex and seniority were proportionality between exposure and control groups. The dosages of occupational population exposure to ionizing radiation were about 1/10 of national permit value, belonging to low-dose exposure. The T₃, FT₃ level of the exposure group was decreased than the control group (P<0.001). especially the FT₃ level has statitical discrepancy among groups with different exposure length (P<0.05). Conclusion Long-term exposure to low-dose ionizing radiatiom can induce the thyroid damage of medical occupational population, which should be broader concerned.

Objective To retrieve,analyse and integrate the best evidences in perioperative fluid management for elderly patients with hip fracture,therefore to provide references for patient care.Methods Following the 6S evidence model,databases and websites were searched to collect the evidences on perioperative fluid management of elderly patients with hip fracture.The searched databases including BMJ Best Practice,UpToDate,AAOS Clinical Practice Guidelines,ASBMR,ANZHFR,ESTES,NICE,SIGN,JBI,Cochrane Library,CINAHL,Embase,PubMed,Web of Science,CNKI,Wanfang Data,VIP database,CEBM Database,Medive,China Science and Technology Journal Database,SinoMed,and other websites about orthopaedics.The searched literatures included guidelines,clinical decision-making,best practices,expert consensus and systematic reviews.The time span for the published literatures was from the inception of the databases and websites to August 2022.Two researchers independently completed quality evaluations of the retrieved literatures,as well as extraction,assessment and integration of the abstracted evidences.Results A total of 15 articles were included,they were 2 guidelines,3 clinical decision-makings,1 best practice,7 expert consensus,and 2 systematic reviews.Thirty pieces of evidence were summarised from 7 aspects,covering multidisciplinary team collaboration,dynamic assessment and monitoring of fluid status,fluid resuscitation,fluid management before and after the surgery and health education.Conclusions This study summarised the best evidences in perioperative fluid management for elderly patients with hip fracture.The evidences provide an evidence-based solution which will enable the healthcare workers to fully combine the clinical scenarios,evaluate changes in fluid volume status dynamically,develope personalised fluid management strategies and improve patient outcomes.

Objective:To explore the status of nursing information ability and its relationships with information consciousness, information anxiety in intern nursing students, provide basis for the cultivation of nursing information ability of intern nursing students.Methods:From December 2019 to January 2020,185 nursing students working as interns in Jinan Central Hospital Affiliated to Shandong University were surveyed by general information questionnaire, information anxiety questionnaire, information consciousness questionnaire and nursing information ability assessment scale.Results:The total score of nursing information ability of nursing students in practice was 111.6±19.7; nursing information ability was positively correlated with information consciousness ( r=0.358, P<0.001), and not related to information anxiety ( r=0.136, P=0.065); information consciousness had a predictive effect on nursing information ability( β=0.287, P<0.001), and information anxiety could moderate the relationship between information consciousness and nursing information ability ( β=0.175, P=0.011). Conclusions:The score of nursing information ability is above the medium level, while improving the nursing information ability through the development of information consciousness, and the information anxiety level of nursing students should also be paid attention to.

Objective To study the early physical growth pattern,catch-up growth situation,and the influencing factors of early growth in small for gestational age (SGA) preterm infants.Method Our study was a single center,retrospective study.Criteria for infant inclusion were prematurity,SGA (birth weight less than the 10th percentile of related gender and gestational week,according to Fenton curve 2013),born between January 2012 to October 2015,admitted to our neonatal intensive care unit (NICU) within 24 h after birth,hospitalization more than 7 days,and discharged with complete oral feeding.Corrected age (CA) was used to evaluate growth.According to our follow up plan,anthropometric data (weight,length,head circumference) were collected at corrected full term (40 ± 4 weeks),CA (3 ± 1.5) months and CA (6 ± 1.5) months.Catch-up growth was defined as ΔZ greater than 0.67 compared with that at birth,successful catch-up was defined as anthropometric data higher than 10th percentile in target population.The characteristics and influencing factors were compared between infants with and without catch-up growth.Result Eighty-one SGA preterm infants were involved,45 boys and 36 girls.The average gestational age was (34.6 ± 1.7) weeks,birthweightwas(1617 ± 348) g,birthlengthwas(41.0 ±3.2)cm and head circumference was (29.7 ± 2.0) cm.At corrected gestational age (40 ± 4) weeks,CA (3 ± 1.5) months and CA (6 ± 1.5) months,follow-up rate was 86.4％,66.7％ and 58.0％;catch-up growth in weight was 32.9％,55.6％ and 66.0％;successful catch-up growth in weight was 52.9％,64.8％ and 66.0％.At CA (40 ±4) weeks,there were more boys,sooner recover birth weight,and less patent ductus arteriosus (PDA) in catch-up infants (P ＜ 0.05).At CA (3 ± 1.5) months,catch-up infants had large gestational age,and they were longer at discharge,shorter hospital stay,less PDA,and greater body weight at CA 40 weeks,the difference was statistically significant (P ＜ 0.05).At CA (6 ± 1.5) months,there were difference in hospitalization days,percentile of body weight at CA 40 weeks and percentile of all three anthropometrics at CA (3 ± 1.5) months between catch-up and no catch-up growth infants (P ＜ 0.05).Multiple factor analysis showed that percentile of weight at CA 3 months was the independent risk factor of catch-up growth in weight at CA 6 months (P =0.002,OR =1.221,95％ CI 1.076 ～ 1.385).For every 5 percentile increase in body weight percentile at CA (3 ± 1.5) months of age,the likelihood of complete body weight catch-up growth at CA (6 ± 1.5) months increased 2.965 times (95％ CI 1.480 ～ 5.942).Conclusion Both weight and length of SGA preterm infants showed a trend of rapid gain between corrected gestational age (40 ± 4) weeks to CA (3 ± 1.5) months.The factors that influencing the completion of catch-up growth are different at different age.The weight,length,and head circumference percentile at CA about 3 months are good predictors of growth pattern and situation at CA 6 months for the SGA preterm infants.

Objective: We evaluated the effect of low-dose of ionizing radiation on thyroid function of medical occupational group with long-term exposure; furthermore; we analyzed the relationship between the thyroid hormones and the risk factors; such as exposure length; department. Ultimately; providing the scientific basis for setting the ionizing radiation protection standards. Methods: The population who engaged radiodiagnosis and radiotherapy in a tertiary-A hospital were set up as occupational exposure; 724 medical professionals as the research object. We figured out the basic information and general condition of the groups by face-to-face questionnaire survey; By means of the thyroid hormone testing; we analyzed the thyroid hormone levels with different population; occupational exposure factors. Then; obtained the prevalence of thyroid nodules by the thyroid ultrasound. Besides; we used the logistic regression model to analyze the risk factors related to thyroid nodule. Applying Epidata、Excel in data management. All the data was analyzed by statistical software package Stata12.0. Descriptive statistics; single factor analysis of variance and other statistical methods were used for data analysis. Test standard: α=0.05、P<0.05 statistical significant. Results: 1. Based on the work experience; we divided the study population into four groups; such as 1-9; 10-19; 20-29; and>30 years. The difference of the TSH level among the four groups was statistically significant (P<0.05) . 2. The multiple logistic regression showed that sex and seniority were the independent risk factors for the abnormal rate of thyroid nodules. Conclusion Long-term exposure to low-dose ionizing radiatiom could induce the thyroid damage of medical occupational population; which should be broader concerned.

Objective To explore the clinical effects of individualized nutritional support on patients with acute complete cervical spinal cord injury. Methods The patients with acute complete cervical spinal cord injury in the Trauma Emergency Center of a hospital between January 2011 and December 2012 were randomly divided into experimental group (n=49) and control group (n=54). The diets of patients in the control group were provided by family members guided by nurses in hospital, and the patients in the experimental group were given individualized nutritional supports which were formulated by nutrition consultation according to patients′specific conditions. The incidence of complications ( constipation, lung infection, hyponatremia and hypoproteinemia) within 14d and the average stay in hospital in two groups were compared. Results In the experimental group, the incidence of constipation, lung infection, hyponatremia and hypoproteinemia were significantly lower and the average stay in hospital was shorter than those in the control group. The differences between the two groups were statistically significant (P < 0. 05). Conclusions Providing individualized nutritional support for patients with acute complete cervical spinal cord injury can reduce the incidence of complications and the average stay in hospital.

Objective:To construct a virtual simulation training platform for peripheral inserted central catheter (PICC) catheterization and discuss its application in clinical training.Methods:A total of 118 nurses who attended the PICC professional and technical advanced training courses in a province in 2020 and 2021 were enrolled in this study. In 2020, the training was conducted in the form of theoretical teaching combined with practical training ( n=51), and in 2021, virtual simulation platform was introduced as a supplement on the basis of the original training ( n=67). SPSS 23.0 was used for independent-samples t-test to compare the theoretical and operational assessment results of the two years and evaluate the application effect of the platform. Through the satisfaction survey and learning log, the nurses' experience of using the platform was understood. Results:The theoretical performance and the operational performance of nurses who participated in the training in 2021 were (96.56±3.17) and (94.06±2.16) respectively, and the operational performance was better than that of nurses who participated in the training in 2020 ( t=-11.37, P<0.001), and the difference in theoretical performance was not statistically significant ( t=0.17, P=0.853). In 2021, 63 nurses (94.0%) who used the virtual simulation platform believed that the platform could assist to improve the training effect; 61 nurses (91.0%) expected the application of virtual simulation technology in the teaching and training of other knowledges. Conclusion:As a new teaching form, virtual simulation technology can significantly improve the training effect and satisfaction, and provide reference for the development of relevant teaching and training.