Objective To explore the relationship between continuous glucose monitoring(CGM)parameters with diabetic kidney disease(DKD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 355 T2DM patients who were hospitalized in the Department of Endocrinology of Wuhan Central Hospital,Tongji Medical College,Huazhong University of Science and Technology,from August 2022 to February 2024 were included.According to uninary albumin/creatinine rate(UACR)and estimated glomerular filtration rate(eGFR)levels,the patients were divided into T2DM group(n=207)and DKD group(DKD,n=148).The general clinical data and CGM parameters of the two groups were compared.Results Age,systolic pressure,DM duration,proportion of Ins use,proportion of cerebral infarction and lumen infarction,proportion of lower limb arterial plaque formation,serum troponin I,D-dimer,erythrocyte deposition rate,UACR,blood urea nitrogen(BUN),serum creatinine,blood uric acid,mean glucose value(MG),blood glucose management index(GMI),time glucose below target range(TBR),glucose above target range time(TAR)and mean blood glucose fluctuation range(MAGE)were higher than those in T2DM group(P<0.05),while the proportion of fatty liver,eGFR,total bilirubin,direct bilirubin,indirect bilirubin,alanine aminotransferase,white ball ratio of liver function and TIR were lower than those in T2DM group(P<0.05).Pearson and spearman correlation analysis showed that HbA1c was negatively correlated with TIR(P<0.05),and positively correlated with TAR,MG,FPG,GMI,coefficient of variation,standard deviation,maximum blood glucose fluctuation and MAGE(P<0.05).Logistic regression analysis showed that TIR(OR 1.029,95%CI 1.012～1.047)and TAR(OR 0.974,95%CI 0.958～0.990)were the influencing factors for DKD in T2DM patients.ROC curve analysis showed that the area under the curve predicted by TIR for DKD was 0.651,with the sensitivity 64.2%,the specificity 60.9%,and the truncation value 53.46%.Conclusions TIR and TAR are the influencing factors of DKD in T2DM patients,and other CGM indicators such as MG,GMI and MAGE are related to HbA1c.

Objective To explore the relationship between continuous glucose monitoring(CGM)parameters with diabetic kidney disease(DKD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 355 T2DM patients who were hospitalized in the Department of Endocrinology of Wuhan Central Hospital,Tongji Medical College,Huazhong University of Science and Technology,from August 2022 to February 2024 were included.According to uninary albumin/creatinine rate(UACR)and estimated glomerular filtration rate(eGFR)levels,the patients were divided into T2DM group(n=207)and DKD group(DKD,n=148).The general clinical data and CGM parameters of the two groups were compared.Results Age,systolic pressure,DM duration,proportion of Ins use,proportion of cerebral infarction and lumen infarction,proportion of lower limb arterial plaque formation,serum troponin I,D-dimer,erythrocyte deposition rate,UACR,blood urea nitrogen(BUN),serum creatinine,blood uric acid,mean glucose value(MG),blood glucose management index(GMI),time glucose below target range(TBR),glucose above target range time(TAR)and mean blood glucose fluctuation range(MAGE)were higher than those in T2DM group(P<0.05),while the proportion of fatty liver,eGFR,total bilirubin,direct bilirubin,indirect bilirubin,alanine aminotransferase,white ball ratio of liver function and TIR were lower than those in T2DM group(P<0.05).Pearson and spearman correlation analysis showed that HbA1c was negatively correlated with TIR(P<0.05),and positively correlated with TAR,MG,FPG,GMI,coefficient of variation,standard deviation,maximum blood glucose fluctuation and MAGE(P<0.05).Logistic regression analysis showed that TIR(OR 1.029,95%CI 1.012～1.047)and TAR(OR 0.974,95%CI 0.958～0.990)were the influencing factors for DKD in T2DM patients.ROC curve analysis showed that the area under the curve predicted by TIR for DKD was 0.651,with the sensitivity 64.2%,the specificity 60.9%,and the truncation value 53.46%.Conclusions TIR and TAR are the influencing factors of DKD in T2DM patients,and other CGM indicators such as MG,GMI and MAGE are related to HbA1c.

Objective:To construct an "Internet+nursing service" model for elderly patients at home led by the continuing care service center from the perspective of the Internet, and to provide reference for different types of professional home care services for elderly patients.Methods:From March 2019 to December 2021, relying on the continuing care service center, six links of "discharge preparation, discharge follow-up service, home care service, online diagnosis and treatment, institutional return visit, health guidance" in Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology were interconnected to construct a closed-loop "Internet+nursing service" model for elderly patients at home. Summarized the workload after the implementation of "Internet+nursing service", and investigated the satisfaction of 149 patients and 112 home sevice nurses.Results:After 2 years and 9 months of implementation, the team provided 11 home care services for elderly patients with diabetes foot dressing change, PICC catheter maintenance, replacement of catheter, wound stoma care and home membrane dialysis etc, and provided 452 home care services for 149 patients. Patient satisfaction was (94.47 ± 3.07) points; the approval of this model by 112 home service nurses was (4.69 ± 0.43) points.Conclusions:The "Internet+nursing service" model for elderly patients at home, which is dominated by the continuous nursing service center, can meet the continuous nursing needs of elderly patients at home. At the same time, expanding nurses′ practice space and enhancing nurses′ professional value will play a positive role in promoting the development of nursing service industry.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.

Objective:To systematically retrieve, evaluate and summarize the research evidence on the measurement method of adult nasogastric tube indwelling length and provide a basis for clinical nursing practice.Methods:To search for Cochrane Library(CD-SR, DARE), Joanna Briggs(JBI), PubMed (MEDLINE), Web of Science electronic database, China Biomedical Literature Database (CBM), Wanfang Database, China Knowledge Network from the establishment of the database to December 2018. Two researchers independently evaluated the quality of the literature and extracted the data.Results:A total of 9 articles were included in the study. The recommended anatomical landmarks for measuring the length of the inserted gastric tube included XNE, NEX, XJN, Hanson method, GWNUF model, earlobe to xiphoid to navel-nose tip to earlobe NEX 10 cm. The tip of the nasogastric tube and all its lateral hole locations obtained by the Hanson method, the GWNUF model, and the XEN 10 cm method were more likely to be located in the stomach.Conclusion:Although NEX is an external measurement method that is widely used in clinical practice, it has proven to be insufficiently accurate and has considerable risks. Therefore, the method of measuring the length of the nasogastric tube insertion should be carefully selected for teaching or use in practice.

Objective For the care of the emergency department after the nursing staff to carry out the psychological scale score, construct the data model of prejudgment departure risk and verify its applicability. Methods Into the Central Hospital of Wuhan, Wuhan City Chinese Medicine Hospital, Wuhan Sixth Hospital emergency department from all three hospitals nursing disputes witnessed the event in February 2014 to February 2016 during the nursing staff(137 cases)continuity for the study cohort.The potential influencing factors were obtained and the follow-up period was 12 months.Based on the follow-up results, the risk of long-term resignation was predicted and the application was analyzed. Results The Cox regression analysis showed that the risk models of nursing staff were analyzed by the Mueller/McCloskey Satisfaction Scale (MMSS), the Self-rating Depression Scale (SDS), the Social Support Questionnaire (SSQ), MMSS scale which scores for the emergency department nurses after nursing care after the separation of independent protection factors, SDS scale and SSQ scale score were independent risk factors. MMSS <30.067 points, SDS≥40.784 points, SSQ ≥ 17.410 points in the emergency department of nursing staff,shorter time window,MMSS and SSQ scale which had a higher critical value of the effectiveness of indicators. Conclusions MMSS,SDS,SSQ are the emergency department of nursing staff to undergo care after the separation of independent factors,and MMSS<30.067 points,SSQ≥17.410 divided into emergency department nurses 1 year to leave the critical point.

Objective To explore clinical effect of modified postural drainage for treating pulmonary infection of senile patients with gastric cancer.Methods 107 cases of patients with gastric cancer were randomly divided into two groups:control group (n =53) and treatment group (n =54),which were respectively treated by routine postoperative therapy and nursing measures and modified postural drainage based on these routine measures,and compared daily amount of expectoration sputum,positive cases of sputum culture,restore time of postoperative blood test,postoperative fever time,cases of pulmonary infection on the postoperative tenth day and length of stay.Results Daily amount of expectoration sputum of patients in treatment group was significantly higher than that of control group [(185.7 ± 23.7) ml vs.(99.7 ± 17.6) ml] (P ＜ 0.05).However,restore time of postoperative characters of blood test [white blood cell count (2.9±0.9) d vs (5.0±0.7)d,C-reaction protein (35±0.7)d vs.(7.4±0.6) d],postoperative fever time [(1.9±0.5) d vs.(3.6±1.4) d],cases of atelectasis (5 cases vs.19 cases) and length of stay [(1.9±0.5) d vs.(3.6±1.4) d] were respectively significantly less than those of control group (P ＜ 0.05).Conclusions Modified postural drainage could effectively prevent postoperative atelectasis and pulmonary infection,significantly reduced incidence of postoperative atelectasis of senile patients with gastric cancer operation,and so it was worthy of clinical application.