To identify the related substances of cyclosporin A by LC-MS techniques, the separation of cyclosporin A and its related substances was carried out on a Hypersil BDS C18(100 mm×4. 6 mm, 2. 4 μm)column with isocratic elution by a mixture of acetonitrile-water-MTBE and formic acid(430 ∶520 ∶50 ∶1)as the mobile phase. Cyclosporin A and its 29 related substances(9 process related and 20 degradants)were well separated under the established conditions. Among them, 13 were listed in EP and the rest 16 were unknown products having not been reported before. Electrospray positive ionization high resolution TOF/MS was used for the determination of the accurate mass and elemental composition of parent ions of all the components, and triple quadrupoles tandem mass was employed for the product mass spectra determination. Thence, the structures of all the 29 detected substances were successfully characterized through spectra elucidation and the fragmentation pathways analysis. The established LC-MS method was successfully employed for the separation and identification of the related substances of cyclosporin A and it is useful for its fermentation processes and quality control.

Objective:To explore the effects of knowledge-to-action (KTA) frame and evidence-based electronic care delivery sheet among ICU patients.Methods:A total of 122 ICU patients from the First Affiliated Hospital of Zhengzhou University from June 2018 to May 2019 were selected as the research subjects by convenient sampling. Under the guidance of KTA frame, this study designed the electronic care delivery sheet based on identification-situation-background-assessment-recommendation (ISBAR) standard communication tool. A total of 122 ICU patients were divided into control group ( n=62) and intervention group ( n=60) . Control group carried out the routine delivery form, while intervention group applied the electronic care delivery sheet. We compared the delivery quality of charge nurses between two groups. Results:The delivery time of patients between intervention group and control group was (2.78±1.12) min and (6.52±1.45) min respectively with a statistical difference ( P<0.05) . The incidences of delivery omitted item and nursing risk event in intervention group were 3.33% (2/60) and 0 respectively lower than those in control group with a statistical difference ( P<0.05) . The total scores of care delivery of patients in intervention group was (69.75±12.86) , and control group was and (58.68±9.87) , there was a statistical difference ( P<0.05) . Conclusions:The electronic care delivery sheet based on KTA frame and evidence for ICU patients can improve the care delivery quality and nursing quality which is worthy of clinical generalization.

Objective:To explore the current status of postoperative life meaning in patients with colorectal cancer, and analyze its influencing factors, so as to provide a basis for clinical intervention.Methods:From May to October 2020, 90 cases of postoperative colorectal cancer patients in the First Affiliated Hospital of Zhengzhou University were selected as the research object by convenience sampling. The cross-sectional survey was conducted with the General Information Questionnaire, Cancer Patient Life Meaning Scale and Social Support Rating Scale. Multivariate linear regression analysis was used to analyze the influencing factors. A total of 90 questionnaires were distributed in this survey, and 83 valid questionnaires were returned.Results:Among 83 patients with colorectal cancer, the total score of the Cancer Patient Life Meaning Scale was (55.01±13.43) , and the two dimensions with low scores were life goals (2.13±0.47) and acceptance and adaptation (2.04±0.44) . Pearson correlation analysis showed that the total score and dimension scores of the Social Support Rating Scale of colorectal cancer patients were positively correlated with the total score of the Cancer Patient Life Meaning Scale with statistical differences ( P<0.05) . The results of multiple linear regression analysis showed that the influencing factors of the life meaning of patients with colorectal cancer were age, family monthly income, disease stage, stoma and social support ( P<0.05) . Conclusions:The life meaning of patients with colorectal cancer is at a moderately lower level. Clinical medical and nursing staff should pay attention to patients with young age, poor income, high disease stages and stoma, and enhance their level of social support, so as to increase the life meaning of colorectal cancer patients and ultimately improve their quality of life.