Objective:To develop a Knowledge-Attitude-Practice (KAP) Scale for Dietary Management During Hemodialysis and to test its reliability and validity.Methods:Based on the KAP theoretical framework, an initial version of the scale was developed through a literature review and expert consultations. A convenience sampling method was used to recruit hemodialysis patients from four hospitals in Suzhou in March 2024. Questionnaire item analysis and reliability and validity tests were conducted.Results:A total of 460 questionnaires were distributed and 438 valid responses were collected, with an effective response rate of 95.22%. The final scale included three dimensions (knowledge, attitude, and practice) with 34 items. Content validity at the scale level was 0.910, and the item level ranged from 0.800 to 1.000. Exploratory factor analysis extracted three common factors, with a cumulative variance contribution rate of 74.520%. Confirmatory factor analysis showed a good model fit. The total Cronbach's α coefficient of the scale was 0.971, and the Cronbach's αcoefficients for the three dimensions were 0.963, 0.933, and 0.934, respectively. The test-retest reliability coefficient was 0.839.Conclusions:The Knowledge-Attitude-Practice Scale for Dietary Management During Hemodialysis demonstrates good reliability and validity, making it a valuable tool for assessing the KAP level of dietary management in hemodialysis patients.

Objective To investigate the correlation and predictive value of serum ferritin(SF),25(OH)D and early renal damage in children with new type 1 diabetes mellitus(T1DM).Methods A total of 102 newly diagnosed T1DM children admitted to the Department of Endocrinology,Genetics and Metabolism of our hospital from January 2020 to June 2023 were collected as the study objects.According to UACR,the study subjects were divided into T1DM group<30 mg/g(n=50),microalbuminuria group 30～300 mg/g(MUAlb)group(n=32),and macroalbuminuria group>300 mg/g(CUAlb)group(n=20).Another 65 healthy children who underwent physical examination during the same period were selected as normal control(NC)group.General data and biochemical indexes of all groups were compared to analyze the correlation and predictive value of changes in SF and 25(OH)D levels with early renal damage.Results The levels of SF and TG in NC,T1DM,MUAlb and CUAlb groups increased in turn(P<0.05),while 25(OH)D decreased in turn(P<0.05).The levels of TC,FC-P,FPG and HbA1c in the T1DM,MUAlb and CUAlb groups were higher than those in the NC group(P<0.05),and the levels of FIns was lower than that in the NC group(P<0.05).The level of LDL-C in MUAlb and CUAlb groups were higher than in NC group(P<0.05),the levels of TC,FPG and HbA1c in MUAlb and CUAlb groups were higher than those in T1DM group(P<0.05),and UACR was higher than that in NC and T1DM groups(P<0.05).LDL-C in MUAlb group was higher than that in T1DM group(P<0.05).Blood urea in the CUAlb group were higher than those in the NC group(P<0.05),Scr and UACR was higher than that in the MUA1b group(P<0.05),and eGFR was higher than that in the T1DM,MUAlb,and CUAlb groups(P<0.05).Spearman correlation analysis showed that SF were positively correlated with TC,LDL-C,TG,UACR and HbA1c(P<0.05)and negatively correlated with 25(OH)D(P<0.05).25(OH)D was negatively correlated with TC,LDL-C,TG,UACR,HbA1c(P<0.05).Logistic regression analysis showed that SF and 25(OH)D were the influencing factors of early renal injury in children with T1DM.ROC curve analysis showed that the area under the curve of SF and 25(OH)D was 0.813 and 0.808,with the sensitivity 67.3%and 78.8%,the specificity 80.0%and 72.0%,and the cut-off values were 113.6 ng/ml and 54.17 nmol/L,respectively.Conclusions The changes in serum SF and 25(OH)D levels are associated with different stages of early renal damage and may be involved in the occurrence and development of early renal damage in children with T1DM.

Objective To investigate the correlation and predictive value of serum ferritin(SF),25(OH)D and early renal damage in children with new type 1 diabetes mellitus(T1DM).Methods A total of 102 newly diagnosed T1DM children admitted to the Department of Endocrinology,Genetics and Metabolism of our hospital from January 2020 to June 2023 were collected as the study objects.According to UACR,the study subjects were divided into T1DM group<30 mg/g(n=50),microalbuminuria group 30～300 mg/g(MUAlb)group(n=32),and macroalbuminuria group>300 mg/g(CUAlb)group(n=20).Another 65 healthy children who underwent physical examination during the same period were selected as normal control(NC)group.General data and biochemical indexes of all groups were compared to analyze the correlation and predictive value of changes in SF and 25(OH)D levels with early renal damage.Results The levels of SF and TG in NC,T1DM,MUAlb and CUAlb groups increased in turn(P<0.05),while 25(OH)D decreased in turn(P<0.05).The levels of TC,FC-P,FPG and HbA1c in the T1DM,MUAlb and CUAlb groups were higher than those in the NC group(P<0.05),and the levels of FIns was lower than that in the NC group(P<0.05).The level of LDL-C in MUAlb and CUAlb groups were higher than in NC group(P<0.05),the levels of TC,FPG and HbA1c in MUAlb and CUAlb groups were higher than those in T1DM group(P<0.05),and UACR was higher than that in NC and T1DM groups(P<0.05).LDL-C in MUAlb group was higher than that in T1DM group(P<0.05).Blood urea in the CUAlb group were higher than those in the NC group(P<0.05),Scr and UACR was higher than that in the MUA1b group(P<0.05),and eGFR was higher than that in the T1DM,MUAlb,and CUAlb groups(P<0.05).Spearman correlation analysis showed that SF were positively correlated with TC,LDL-C,TG,UACR and HbA1c(P<0.05)and negatively correlated with 25(OH)D(P<0.05).25(OH)D was negatively correlated with TC,LDL-C,TG,UACR,HbA1c(P<0.05).Logistic regression analysis showed that SF and 25(OH)D were the influencing factors of early renal injury in children with T1DM.ROC curve analysis showed that the area under the curve of SF and 25(OH)D was 0.813 and 0.808,with the sensitivity 67.3%and 78.8%,the specificity 80.0%and 72.0%,and the cut-off values were 113.6 ng/ml and 54.17 nmol/L,respectively.Conclusions The changes in serum SF and 25(OH)D levels are associated with different stages of early renal damage and may be involved in the occurrence and development of early renal damage in children with T1DM.

Objective:To develop a Knowledge-Attitude-Practice (KAP) Scale for Dietary Management During Hemodialysis and to test its reliability and validity.Methods:Based on the KAP theoretical framework, an initial version of the scale was developed through a literature review and expert consultations. A convenience sampling method was used to recruit hemodialysis patients from four hospitals in Suzhou in March 2024. Questionnaire item analysis and reliability and validity tests were conducted.Results:A total of 460 questionnaires were distributed and 438 valid responses were collected, with an effective response rate of 95.22%. The final scale included three dimensions (knowledge, attitude, and practice) with 34 items. Content validity at the scale level was 0.910, and the item level ranged from 0.800 to 1.000. Exploratory factor analysis extracted three common factors, with a cumulative variance contribution rate of 74.520%. Confirmatory factor analysis showed a good model fit. The total Cronbach's α coefficient of the scale was 0.971, and the Cronbach's αcoefficients for the three dimensions were 0.963, 0.933, and 0.934, respectively. The test-retest reliability coefficient was 0.839.Conclusions:The Knowledge-Attitude-Practice Scale for Dietary Management During Hemodialysis demonstrates good reliability and validity, making it a valuable tool for assessing the KAP level of dietary management in hemodialysis patients.

Objective:To design a continuous renal replacement therapy (CRRT) waste liquid bag disposal vehicle and explore its effectiveness.Methods:In February 2024, convenience sampling was used to select 100 waste liquid bags generated during CRRT in the ICU of Zhejiang Provincial Hospital of Chinese Medicine as research subjects. The waste liquid bags were divided into an observational group ( n=50) and a control group ( n=50) using a random number table method. The control group was treated using usual method, while the observational group was treated using a CRRT waste liquid bag disposal vehicle. The emptying time of a single bag of waste liquid, the number of splashes per unit area, and operator satisfaction were compared between two groups. Results:The emptying time of a single waste liquid bag in the observational group was lower than that in the control group [ (38.34±1.98) vs. (315.46±11.23) s, P<0.01]. The number of splashes per unit area of 5 cm × 5 cm in the observational group was less than that in the control group [ (0.28±0.09) vs. (8.62±0.64), P<0.01]. The operator satisfaction score of the observational group was higher than that of the control group [ (4.88±0.05) vs. (1.44±0.10) points, P<0.01] . Conclusions:The CRRT waste liquid bag disposal vehicle can reduce the emptying time of waste liquid bags and the pollution to the surrounding environment during the discharge process, improve operator satisfaction, and is worthy of promotion in clinical practice.

ObjectiveTo detect the flexibility differences of Plasmodium berghei K173 （PbK173）-infected red blood cells with varying degrees of sensitivity to artemisinin-based drugs and to preliminarily explore the underlying mechanisms of the differences. MethodA total of 102 specific-pathogen-free （SPF） male C57BL/6 mice were randomly divided into three groups， with 30 mice each in the control group and PbK173-resistant （PbK173-R） group， and 42 mice in the PbK173-sensitive （PbK173-S） group. Except for the control group， the rest groups were vaccinated with 1×10⁷ PbK173-S/PbK173-R infected red blood cells to establish a mouse malaria model. During the administration and recovery periods （control group， PbK173-R/PbK173-S）， dihydroartemisinin （DHA， 40 mg·kg^-1） and malaridine （MD， 6 mg·kg^-1） were administered continuously for four days. Peripheral blood was taken from the PbK173-S/PbK173-R groups with an infection rate equal to or greater than 20%. Peripheral blood and each organ were taken on the first day at the end of administration （dosing period） and on the fifth day at the end of administration （recovery period）， and blood parameters and organ indices of each group were examined. The osmotic fragility of peripheral blood red blood cells in each group was detected using the red blood cell osmotic fragility test. Western blot was applied to determine the levels of Piezo1 and Band3 proteins in the red blood cell membrane. ResultDuring the administration and recovery periods， there were no significant differences between the PbK173-S MD group and the DHA group. During the administration period， there were no significant differences in hematological parameters between PbK173-S and PbK173-R in the MD group. However， during the recovery period， the red blood cell count， hemoglobin concentration and hematocrit of the PbK173-R group were significantly higher than those of the PbK173-S group （P<0.05） in the MD group. Compared with that of the control group， the osmotic fragility of the PbK173-S/PbK173-R groups was significantly enhanced （P<0.01）， and the osmotic fragility of the PbK173-S group was significantly stronger than that of the PbK173-R group （P<0.01）. The osmotic fragility of red blood cells in the PbK173-S group during the administration period was significantly stronger than that in the control group and PbK173-R group during the administration period （P<0.01）. The osmotic fragility of red blood cells in the PbK173-R group during the recovery period was significantly higher than that in the control group during the administration period and the PbK173-S group during the recovery period （P<0.05）. Compared with those in the control group， the Piezo1 protein and Band3 protein in the red blood cell membrane of the PbK173-S group were significantly reduced （P<0.01）. Compared with those in the PbK173-R group， the Piezo1 protein and Band 3 protein in the red blood cell membrane of the PbK173-S group were significantly reduced. ConclusionThe flexibility of PbK173-infected red blood cells with different sensitivities to artemisinins differed. Plasmodium-infected red blood cells significantly reduced the levels of Piezo1 and Band3 proteins in the red blood cell membrane， and the erythrocyte flexibility exhibited a decreasing trend in the following order： normal group， PbK173-R group， and PbK173-S group.

Objective:To explore the feasibility of actively screening patients with chronic obstructive pulmonary disease (COPD) among inpatients in county territory-level hospitals based on the collection of comorbidity-related diseases and questionnaire surveys.Methods:This study was a cross-sectional study. From April 1, 2023, to November 30, 2023, a total of 1 392 inpatients who met the screening criteria in county territory-level hospitals within the Western Medical Group of Baiyun District, Guangzhou, were included in the study. General information, disease data, and COPD screening data of the patients were collected. A total of 1 392 questionnaires were distributed, all of which were returned and included in the analysis. Descriptive analysis, comparative analysis, and association rule mining were conducted, including the distribution of general information, distribution of common comorbidity-related diseases in COPD, distribution of questionnaire screening and pulmonary function test results, comparison of screening results based on comorbidity-related diseases grouping, comparison of screening results based on questionnaire screening results grouping, comparison of screening results based on smoking total score grouping, and association rules between screening results and pulmonary function test results and other research data.Results:Among the 1 392 study subjects, 334 cases (24.0%) had a positive self-screening questionnaire for COPD, 44 cases (13.2%) completed pulmonary function tests, and 17 cases (38.6%) were diagnosed with COPD. The positive rate of the screening questionnaire among inpatients was lowest in surgical patients without comorbidity-related diseases and highest in male patients with single/multiple comorbidity-related diseases and symptoms of chronic respiratory system diseases. The group with multiple comorbidity-related diseases had a significantly higher positive rate in the screening questionnaire than the group with single comorbidity-related diseases and the group without comorbidity-related diseases. Only 13.2% of inpatients with a positive screening questionnaire completed pulmonary function tests, with residents covered by medical insurance with multiple comorbidity-related diseases, including cardiovascular diseases, having the lowest rate, and patients with symptoms of chronic respiratory system diseases and single comorbidity-related diseases having the highest rate.Conclusions:Based on the collection of comorbidity-related diseases and questionnaire surveys, it is feasible to actively screen COPD patients among inpatients in county territory-level hospitals. However, efforts are needed to further increase the proportion of inpatients with positive screening questionnaires undergoing pulmonary function tests.

Reactive arthritis(ReA) is a kind of sterile, non-purulent arthritis that occurs after microbial infections far from the joints.The disease has a broad spectrum, and it can be classified into three categories based on clinical characteristics: human leukocyte antigen B27(HLA-B27)-associated ReA, acute rheumatic fever(ARF), and post-streptococcal reactive arthritis(PSRA).In addition to joints, it may also involve the gastrointestinal tract, skin, eyes, and heart.Unlike adults, the pathogenesis of ReA in children is more complex.HLA-B27-associated ReA is more common after gastrointestinal and respiratory infections, with less involvement of the central axis and sacroiliac joints and more involvement of the hip and peripheral joints and attachment point inflammation.ARF is most common in children aged 5 to 15 years, characterized by migratory and multiple arthritis.The duration of onset of PSRA in children is shorter than that in adults.This article reviews the epidemiology, clinical manifestations, diagnosis and treatment of ReA in children to improve clinicians′ understanding of ReA in children.

Objective:To retrieve, evaluate, and integrate the best evidence for prevention of hemodialysis catheter thrombosis, so as to provide evidence-based basis for catheter thrombosis prevention in hemodialysis patients.Methods:Guidelines, clinical decisions, evidence summaries, systematic reviews, and expert consensus on the prevention of hemodialysis catheter thrombosis were systematically searched on Guidelines International Network, Scottish Intercollegiate Guidelines Network, Agency for Healthcare Research and Quality, Registered Nurses' Association of Ontario, National Institute for Health and Clinical Excellence, UpToDate, British Medical Journal (BMJ) Best Practice, Joanna Briggs Institute Evidence-Based Health Care Center Database, European Renal Association, National Kidney Foundation, UK Kidney Association, Canadian Society of Nephrology, Japanese Society for Dialysis Therapy, Medlive, Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure, VIP, and Wanfang Data and Chinese Biomedical Database. The search period was from database establishment to March 31, 2023. Investigators conducted quality evaluations separately and extracted and summarized evidence based on the theme.Results:A total of 16 articles were included, including five clinical decisions, four guidelines, two evidence summaries, and five expert consensuses. Finally, 15 best pieces of evidence were formed, including four themes of indwelling dialysis catheters, anticoagulation strategies, flushing and sealing techniques, and daily management.Conclusions:Nursing staff should choose the best evidence for preventing thrombosis in hemodialysis catheters based on clinical situations, reduce the occurrence of catheter thrombosis, extend the usage time of catheters, and improve patient outcomes.

ObjectiveTo observe the clinical effect and safety of Governer Vessel （督脉） moxibustion on amyotrophic lateral sclerosis （ALS） patients with spleen and kidney yang deficiency. MethodsForty-four ALS patients with spleen and kidney yang deficiency were finally enrolled， and they were divided into 22 cases each in the treatment group and the control group. The control group was treated with oral riluzole tablets， intravenous drip of edaravone injection， oral Qiu's Wenshen Zhiwei Decoction （裘氏温肾止痿汤）， and conventional rehabilitation nursing， while the treatment group was additionally given Governer Vessel moxibustion based on the control group. The moxibustion treatment was applied once a week for a course of 2 weeks. Both groups were treated for 3 months. The scores of amyotrophic lateral sclerosis symptom score in integrative treatments （ALS-SSIT） for evaluating therapeutic effect of traditional Chinese medicine and amyotrophic lateral sclerosis functional rating scale-revised （ALSFRS-R） were assessed before treatment and after 1 month， 2 months and 3 months treatment， and the occurrence of adverse reactions in both groups was observed. ResultsThe treatment group showed a significant decrease in oropharyngeal function score， muscle function score， and non-motor symptom score， and an increase in ALSFRS-R scale scores after 1， 2， and 3 months of treatment （P＜0.05）. The scores of oropharyngeal function and muscle function in the control group increased， while the ALSFRS-R score decreased after 1， 2 and 3 months of treatment， and the non-motor symptom score decreased after 2 and 3 months of treatment （P＜0.05）. The scores of muscle function and non-motor symptoms in the treatment group were lower than those in the control group after 1 month of treatment； the scores of oropharyngeal function， muscle function and non-motor symptoms were lower than those in the control group， while the ALSFRS-R score was higher after 2 months and 3 months of treatment （P＜0.05）. Constipation （3 cases）， skin itching （2 cases）， skin rash （1 case）， and dry mouth and tongue （1 case） occurred in the treatment group， while there were 2， 1， 2， and 2 cases of each adverse reaction in the control group， respectively， with no significant difference in the incidence of adverse reactions between the two groups （P＞0.05）. ConclusionDu mai moxibustion on the basis of integrated Chinese and western medication and conventional rehabilitation care can help improve some clinical symptoms of ALS patients with spleen-kidney yang deficiency， and has good safety.