Objective To study the correlation of cognitive dysfunction with autonomic nerve function damage in patients with cerebral small vessel disease (CSVD). Methods A total of 310 patients with CSVD admitted from June 2022 to June 2025 were included. Montreal Cognitive Assessment Scale (MoCA) was applied for cognitive function assessment, and Scale for Outcomes in PD for Autonomic Symptoms (SCOPA-AUT) was used to evaluate autonomic nerve function damage. The incidence rate of autonomic nerve function damage, total score and dimensions scores of SCOPA-AUT were counted. According to the presence or absence of autonomic nerve function damage, the enrolled patients were categorized into damage group and non-damage group. The total score of MoCA and scores of dimensions were compared between both groups. Pearson correlation analysis model was utilized to analyze the correlation between total score of MoCA and scores of dimensions of SCOPA-AUT in patients with CSVD. Results Among the 310 patients, 63.87% cases (198 / 310) had autonomic nerve function damage. The SCOPA-AUT total score and scores of dimensions of gastrointestinal function, urinary system function, cardiovascular function, body temperature regulation, pupil movement and sexual function were (34.16 ± 10.41) points, (10.25 ± 3.31) points, (9.44 ± 2.89) points, (4.02 ± 1.66) points, (6.41 ± 2.35) points, (1.35 ± 0.49) points and (2.69 ± 0.81) points. The total score of MoCA and scores of language function, naming, delayed recall and attention in the damage group were lower than those in the non-damage group (P < 0.05). Pearson correlation analysis results revealed that the total score, urinary system score, cardiovascular function score and body temperature regulation score of SCOPA-AUT were negatively correlated with the total score of MoCA (r = -0.545, -0.598, -0.607, -0.615, P < 0.05), and the gastrointestinal function score, pupil movement score and sexual function score were not significantly associated with total score of MoCA (P > 0.05). Conclusion The risk of autonomic nerve function damage is high in patients with CSVD, and it involves multiple systems and is closely related to the cognitive function of patients.

Objective To explore the differences between various monitoring methods of anesthetic depth during total knee arthroplasty under general anesthesia combined with ultrasound-guided femoral nerve block.Methods From January 2021 to March 2021,60 patients undergoing total knee arthroplasty under ultrasound-guided femoral nerve block combined with general anesthesia were randomly divided into IoC group and BIS group,30 cases in each group.IoC group awareness index(Index of Consciousness,IoC)monitoring;bIS group was monitored by bispectral index(BIS)to guide the use of sedative and analgesic drugs during operation.The primary outcome measure was the time of first eye opening,and the secondary outcome measures included the average target concentration of sedative and analgesic drugs during operation,the number of perioperative adverse events and the quality of recovery.Results The average difference in the first eye opening time between the two groups was 1.57 min(95％confidence interval:-0.61～2.63).The upper limit of the 95％confidence interval was 2.63 min,which was less than the non-inferiority boundary value(δ=2.8 min),suggesting that the non-inferiority hypothesis of the main efficacy indicators was established.There was no significant difference in the dosage of propofol and sufentanil and the quality of recovery between the two groups(P＞0.05).The target-controlled concentration of remifentanil in IoC group(8.55±1.45)ng/ml was significantly higher than that in BIS group(4.62±0.96)ng/ml,and the difference was statistically significant(P＜0.05).At the same time,compared with BIS group,the number of stress hypertension(10 vs 32)in IoC group was significantly reduced and the number of bradycardia(17 vs 6)was significantly increased,the difference was statistically significant(P＜0.05).At the same time,no intraoperative awareness and body movement were found in both groups.Conclusion During total knee arthroplasty surgery under general anesthesia combined with ultrasound-guided femoral nerve block:1.IoC monitoring is not inferior to BIS monitoring in terms of awakening speed and quality.2.The increased use of remifentanil in the IoC group and the reduced incidence of hypertension may indicate that IoC monitoring is more sensitive to intraoperative nociceptive stimuli.

To promote the understanding of the requirements for metal materials and containers used for drug packaging in the 2025 edition of the Pharmacopoeia of the People's Republic of China for related enterprises.Based on this edition of the Chinese Pharmacopoeia,national standards for drug packaging materials,and relevant international standards such as the United States Pharmacopoeia(USP).The raw material selection,production process,and quality control indicators of metal pharmaceutical packaging materials were systematically sorted out.It was necessary to clarify that for the metal material itself,the base material and coating type should be selected based on the characteristics of the medicine.In terms of the production process,attention should be paid to the impact of the forming process on the material performance.In terms of quality control,it is necessary to combine the material characteristics and the drug requirements,and ensure its protection,safety,and functionality through standardized testing methods.By strengthening the quality control of metal pharmaceutical packaging materials,product quality can be ensured,and the innovative development of the industry can be promoted.

To analyze the standard establishment approach and compilation rationale for metallic pharmaceutical packaging standard development in the 2025 edition of the Pharmacopeia of the People's Republic of China.This article systematically explained the background and process of establishing the guiding principles for metallic materials and containers used in pharmaceutical packaging in the Chinese Pharmacopoeia through basic information,relevant domestic and international standards,the establishment of key quality attributes of metallic pharmaceutical packaging materials,and the construction of metallic pharmaceutical packaging material standards.The newly established guidelines,the Pharmacopeia of the People's Republic of China 9625,prioritized product critical quality attributes(CQAs)and real-world applicability.This dual emphasis on rigidity and adaptability enhances drug safety,meets the regulatory requirements,and promotes the globalization and scientific advancement of China's pharmaceutical packaging industry.

Objective To investigate the status of management of iodinated contrast media(ICM)extravasation in Henan Province,as well as nurses' knowledge and influencing factors,in order to provide a basis for optimizing management strategies.Methods A self-designed questionnaire was applied,employing convenience sampling,to survey nursing administrators and nurses in the radiology departments of 55 tertiary hospitals across 16 regions of Henan Province,from December 2024 to January 2025.Multiple linear regression analysis was conducted to explore the factors influencing nurses' knowledge.Results A total of 55 nursing administrators and 64 nurses participated,with a valid questionnaire response rate of 100％.The survey results reveal that only 5.45％of radiology depart-ments utilized high-pressure central venous catheters,and 32.73％employed vascular visualization techniques.When setting the high-pressure injection speed for ICM,only 54.55％of radiology departments required an assessment of the type and model of intravenous access.Additionally,only 9.09％of radiology departments mandated an observa-tion for 2 to 4 hours following ICM extravasation.Furthermore,only 50.91％of radiology departments had estab-lished an information system for ICM use.The nurses' knowledge score regarding the prevention and management of ICM extravasation was(90.00±17.59),influenced by years of experience in radiology and professional titles(P＜0.05).Conclusion The prevention and management measures for ICM in radiology departments in Henan Province need further improvement.Nursing administrators should optimize management strategies,improve relevant training systems,and continuously enhance nurses' knowledge and practical abilities.

Objective:To investigate the application and management status of midline catheters in 1 954 hospitals, providing a basis for optimizing intravenous therapy nursing practices.Methods:This study used convenience sampling. From November 2023, members of the Intravenous Therapy Nursing Professional Committee of the Chinese Nursing Association selected 1 954 hospitals across various regions of China. Questionnaire on the Current Status of Intravenous Therapy in Hospitals at All Levels designed by the committee, based on literature review and expert discussions, was used to collect data on intravenous therapy practices in different hospitals. Multiple response analysis was applied to analysis the results of multiple-choice questions, where response numbers represent the total number of times each option was selected, and response rates refer to the proportion of selected times for each option out of all selected responses.Results:A total of 1 954 questionnaires were distributed across 31 provinces/municipalities/autonomous regions, and 1 954 valid questionnaires were returned, achieving a 100.0% valid response rate. Among the hospitals surveyed, 844 used midline catheters. Regarding the skin disinfection area for midline catheter insertion, the highest response rate was for a range of>20 cm. The highest response rate for catheter insertion techniques was ultrasound-guided Seldinger puncture. The highest response rate for maintenance interval was once a week. The top three responses for nursing documentation related to midline catheters were informed consent for intubation, puncture record, and maintenance record. The most frequently chosen processes were catheter placement, maintenance, removal, and complication management processes. The qualification for midline catheter intravenous therapy specialist nurses was mostly obtained through specialized nurse training, followed by hospital-based and department-based training.Conclusions:The application of midline catheters has rapidly developed but still reveals some deficiencies, including the choice of puncture tools, infection control, and catheter maintenance. It is recommended to improve nursing documentation and management processes related to midline catheters, establish industry standards suitable for China's national conditions, and strengthen and standardize the specialized training of intravenous therapy nurses to promote the healthy development of intravenous therapy in China.

To promote the understanding of the requirements for metal materials and containers used for drug packaging in the 2025 edition of the Pharmacopoeia of the People's Republic of China for related enterprises.Based on this edition of the Chinese Pharmacopoeia,national standards for drug packaging materials,and relevant international standards such as the United States Pharmacopoeia(USP).The raw material selection,production process,and quality control indicators of metal pharmaceutical packaging materials were systematically sorted out.It was necessary to clarify that for the metal material itself,the base material and coating type should be selected based on the characteristics of the medicine.In terms of the production process,attention should be paid to the impact of the forming process on the material performance.In terms of quality control,it is necessary to combine the material characteristics and the drug requirements,and ensure its protection,safety,and functionality through standardized testing methods.By strengthening the quality control of metal pharmaceutical packaging materials,product quality can be ensured,and the innovative development of the industry can be promoted.

To analyze the standard establishment approach and compilation rationale for metallic pharmaceutical packaging standard development in the 2025 edition of the Pharmacopeia of the People's Republic of China.This article systematically explained the background and process of establishing the guiding principles for metallic materials and containers used in pharmaceutical packaging in the Chinese Pharmacopoeia through basic information,relevant domestic and international standards,the establishment of key quality attributes of metallic pharmaceutical packaging materials,and the construction of metallic pharmaceutical packaging material standards.The newly established guidelines,the Pharmacopeia of the People's Republic of China 9625,prioritized product critical quality attributes(CQAs)and real-world applicability.This dual emphasis on rigidity and adaptability enhances drug safety,meets the regulatory requirements,and promotes the globalization and scientific advancement of China's pharmaceutical packaging industry.

Objective To explore the differences between various monitoring methods of anesthetic depth during total knee arthroplasty under general anesthesia combined with ultrasound-guided femoral nerve block.Methods From January 2021 to March 2021,60 patients undergoing total knee arthroplasty under ultrasound-guided femoral nerve block combined with general anesthesia were randomly divided into IoC group and BIS group,30 cases in each group.IoC group awareness index(Index of Consciousness,IoC)monitoring;bIS group was monitored by bispectral index(BIS)to guide the use of sedative and analgesic drugs during operation.The primary outcome measure was the time of first eye opening,and the secondary outcome measures included the average target concentration of sedative and analgesic drugs during operation,the number of perioperative adverse events and the quality of recovery.Results The average difference in the first eye opening time between the two groups was 1.57 min(95％confidence interval:-0.61～2.63).The upper limit of the 95％confidence interval was 2.63 min,which was less than the non-inferiority boundary value(δ=2.8 min),suggesting that the non-inferiority hypothesis of the main efficacy indicators was established.There was no significant difference in the dosage of propofol and sufentanil and the quality of recovery between the two groups(P＞0.05).The target-controlled concentration of remifentanil in IoC group(8.55±1.45)ng/ml was significantly higher than that in BIS group(4.62±0.96)ng/ml,and the difference was statistically significant(P＜0.05).At the same time,compared with BIS group,the number of stress hypertension(10 vs 32)in IoC group was significantly reduced and the number of bradycardia(17 vs 6)was significantly increased,the difference was statistically significant(P＜0.05).At the same time,no intraoperative awareness and body movement were found in both groups.Conclusion During total knee arthroplasty surgery under general anesthesia combined with ultrasound-guided femoral nerve block:1.IoC monitoring is not inferior to BIS monitoring in terms of awakening speed and quality.2.The increased use of remifentanil in the IoC group and the reduced incidence of hypertension may indicate that IoC monitoring is more sensitive to intraoperative nociceptive stimuli.

Objective To investigate the value of patient data-based real-time quality control(PBRTQC)in internal quality control(IQC)for blood cells analysis based on the data from patients.Methods The data of patients'blood cells,including white blood cell count(WBC),hemoglobin(Hb),red blood cell count(RBC),hematocrit(HCT),mean corpuscular volume(MCV),mean cor-puscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC),and platelet(PLT)were collected from August 1,2023 to February 26,2024,and the extracted patient data were analyzed on the AI-based real-time quality control intelligent moni-toring platform.The corresponding IQC data for this period were reviewed,and the results of PBRTQC and IQC were compared and an-alyzed.The causes of the emerging warning or alarm prompts were checked and analyzed to explore the application value of PBRTQC in the IQC process of blood cell analysis.Results It is found that when the quality control product was unstable due to overlong opening time of the reagent or improper storage conditions,and the performance changes of the operating system during the detection process,the PBRTQC intelligent monitoring platform was able to issue risk warning or alarm prompt in advance.PBRTQC may have certain limi-tations,such as the error of red blood cell count,which need to be identified.Conclusion PBRTQC is superior to IQC in blood cell analysis and may play a complementary role in IQC.Meanwhile,it is necessary to exclude the possibility that PBRTQC is significantly influenced by the patient population in medical laboratories.