Objective To establish a central cutting two-dimensional liquid chromatography for the determination of lamotrigine in human plasma. Methods External standard method was used. The first dimensional chromatographic column: SNCB（T）-1A（silica gel, 4.6 mm×50 mm, 5 μm）, mobile phase A:VCV-1D mobile phase, flow rate: 0.4 ml/min; mobile phase B: water, flow rate: 1.0 ml/min; second dimensional chromatographic column: Symmetry C₁₈ （4.6 mm×250 mm, 5 μm）, mobile phase: acetonitrile-10 mmol/L ammonium acetate solution（V/V=25∶75）, flow rate: 1.0 ml/min；Intermediate column: SBX 4-MA（resin, 3.0 mm×10 mm, 5µm）. The UV detection wavelength：306 nm, the column temperature：45 ℃, and the injection volume：200 μl. Results The linear range of lamotrigine was 1.24-39.50 μg/ml, the lower limit of quantification was 1.24 μg/ml, the detection limit was 0.02 μg/ml, the intra-day precision RSD was less than 5%, the day-to-day precision RSD was less than 10%, the variation of intra-day accuracy ranged from 102.17% to 111.17%, and the daytime accuracy variation ranged from 99.80% to 107.31% the recovery RSD was less than 5%, and the variation range was 89.95% -96.16%. After 24 hours storage at room temperature, repeated freezing and thawing for 3 times and storage at −40 ℃ for 2 weeks, the ratio of the measured value/labeled value ranged from 87.01% to 115.88%. Conclusion In this study, a method with simple operation, good stability, high sensitivity and good reproducibility was established, which could be suitable for clinical monitoring of blood concentration of lamotrigine and provide reliable monitoring data support for clinical individualized medication guidance.

Objective To investigate the potential of one-stop multi-modality CT in the assessment of collateral circulation and prognosis in acute ischemic stroke(AIS).Methods From February 2022 to May 2024,115 patients diagnosed with AIS at Wuzhou Red Cross Hospital were enrolled in the study.All subjects were examined with one-stop multi-modality CT at admission and received endovascular therapy.According to the collateral circulation score derived from multi-phase CT angiography(mCTA)and the modified Rankin scale score at 90 days,these patients were divided into different groups:good(n=59)vs poor(n=56)collateral circulation groups,and favorable(n=48)vs unfavorable(n=67)outcome groups.Clinical and imaging parameters were compared between these groups.Independent risk factors for collateral circulation and prognosis of AIS patients were identified through multivariate Logistic regression analysis.A prediction model for unfavorable AIS prognosis was developed based on the results of multivariate Logistic analysis,and its predictive value was assessed using receiver operating characteristic(ROC)curve analysis.Results Poor collateral circulation group exhibited higher proportions of insular ribbon and gray-white matter junction blurring as compared with good collateral circulation group(P<0.05),while the ratio of hypoperfusion intensity ratio(HIR)<0.3 was lower in poor collateral circulation group(P<0.05).Relative cerebral blood volume(rCBV)<40%,relative cerebral blood flow(rCBF)<30%,peak time(Tmax)>8 s,and Tmax>10 s volume were all significantly higher in poor collateral circulation group(P<0.05),whereas the Alberta stroke program early CT score(ASPECTS)was lower(P<0.05).Multivariate Logistic regression analysis identified ASPECTS,rCBV<40%,rCBF<30%,and Tmax>10 s as independent risk factors for poor collateral circulation(P<0.05).Unfavorable outcome group had higher rates of hemorrhage following endovascular thrombectomy and mismatch ratio<1.8 than favorable outcome group(P<0.05),with a lower HIR<0.3 ratio(P<0.05).Compared with favorable outcome group,unfavorable outcome group also showed higher admission NIHSS scores,higher percentages of rCBV<40%,rCBF<30%,Tmax>4 s,Tmax>6 s,and Tmax>10 s volumes(P<0.05),but lower mCTA collateral circulation score(P<0.05).Multivariate Logistic regression analysis indicated that admission NIHSS score,mCTA collateral circulation score,rCBV<40%,rCBF<30%,and Tmax>10 s were independent risk factors for unfavorable outcomes(P<0.05).The regression equation was formulated as:Logit(P)=-0.184+(admission NIHSS score×0.134)+(mCTA collateral circulation score×-0.415)+(rCBV<40%×0.107)+(rCBF<30%×0.089)+(Tmax>10 s×0.028).ROC curve analysis demonstrated an area under the curve of 0.775(95 CI:0.689-0.860,P<0.001)for the prediction model in assessing unfavorable AIS prognosis.Conclusion One-stop multi-modality CT has significant application value in assessing collateral circulation and predicting prognosis in AIS patients.

Objective:Understanding of the psychological experiences of young and middle-aged male patients with schizophrenia regarding protective restraints.Methods:This study was qualitative study. Using purposive sampling, middle-aged and young male schizophrenia patients who had undergone protective restraints in the Affiliated Brain Hospital, Guangzhou Medical University were selected as participants from September to December 2022. Data were collected through semi-structured interviews and analyzed using Colaizzi 7-step analysis method.Results:A total of 12 young and middle-aged male schizophrenic patients were interviewed, and four themes were summarized, including patients' attitudes toward protective restraints, patients' emotional experiences, patients' physical experiences, and patients' needs during protective restraints.Conclusions:Protective restraints provide patients with safety in the acute phase, as well as a variety of positive and negative psychological experiences. Psychiatric nurses should grasp the patient's condition, dynamically assess the risk level, adopt appropriate restraint devices, improve restraint care based on the patient's needs, and actively seek alternative measures to restrain simultaneously.

Objective:Understanding of the psychological experiences of young and middle-aged male patients with schizophrenia regarding protective restraints.Methods:This study was qualitative study. Using purposive sampling, middle-aged and young male schizophrenia patients who had undergone protective restraints in the Affiliated Brain Hospital, Guangzhou Medical University were selected as participants from September to December 2022. Data were collected through semi-structured interviews and analyzed using Colaizzi 7-step analysis method.Results:A total of 12 young and middle-aged male schizophrenic patients were interviewed, and four themes were summarized, including patients' attitudes toward protective restraints, patients' emotional experiences, patients' physical experiences, and patients' needs during protective restraints.Conclusions:Protective restraints provide patients with safety in the acute phase, as well as a variety of positive and negative psychological experiences. Psychiatric nurses should grasp the patient's condition, dynamically assess the risk level, adopt appropriate restraint devices, improve restraint care based on the patient's needs, and actively seek alternative measures to restrain simultaneously.

Objective To investigate the potential of one-stop multi-modality CT in the assessment of collateral circulation and prognosis in acute ischemic stroke(AIS).Methods From February 2022 to May 2024,115 patients diagnosed with AIS at Wuzhou Red Cross Hospital were enrolled in the study.All subjects were examined with one-stop multi-modality CT at admission and received endovascular therapy.According to the collateral circulation score derived from multi-phase CT angiography(mCTA)and the modified Rankin scale score at 90 days,these patients were divided into different groups:good(n=59)vs poor(n=56)collateral circulation groups,and favorable(n=48)vs unfavorable(n=67)outcome groups.Clinical and imaging parameters were compared between these groups.Independent risk factors for collateral circulation and prognosis of AIS patients were identified through multivariate Logistic regression analysis.A prediction model for unfavorable AIS prognosis was developed based on the results of multivariate Logistic analysis,and its predictive value was assessed using receiver operating characteristic(ROC)curve analysis.Results Poor collateral circulation group exhibited higher proportions of insular ribbon and gray-white matter junction blurring as compared with good collateral circulation group(P<0.05),while the ratio of hypoperfusion intensity ratio(HIR)<0.3 was lower in poor collateral circulation group(P<0.05).Relative cerebral blood volume(rCBV)<40%,relative cerebral blood flow(rCBF)<30%,peak time(Tmax)>8 s,and Tmax>10 s volume were all significantly higher in poor collateral circulation group(P<0.05),whereas the Alberta stroke program early CT score(ASPECTS)was lower(P<0.05).Multivariate Logistic regression analysis identified ASPECTS,rCBV<40%,rCBF<30%,and Tmax>10 s as independent risk factors for poor collateral circulation(P<0.05).Unfavorable outcome group had higher rates of hemorrhage following endovascular thrombectomy and mismatch ratio<1.8 than favorable outcome group(P<0.05),with a lower HIR<0.3 ratio(P<0.05).Compared with favorable outcome group,unfavorable outcome group also showed higher admission NIHSS scores,higher percentages of rCBV<40%,rCBF<30%,Tmax>4 s,Tmax>6 s,and Tmax>10 s volumes(P<0.05),but lower mCTA collateral circulation score(P<0.05).Multivariate Logistic regression analysis indicated that admission NIHSS score,mCTA collateral circulation score,rCBV<40%,rCBF<30%,and Tmax>10 s were independent risk factors for unfavorable outcomes(P<0.05).The regression equation was formulated as:Logit(P)=-0.184+(admission NIHSS score×0.134)+(mCTA collateral circulation score×-0.415)+(rCBV<40%×0.107)+(rCBF<30%×0.089)+(Tmax>10 s×0.028).ROC curve analysis demonstrated an area under the curve of 0.775(95 CI:0.689-0.860,P<0.001)for the prediction model in assessing unfavorable AIS prognosis.Conclusion One-stop multi-modality CT has significant application value in assessing collateral circulation and predicting prognosis in AIS patients.

BackgroundThe existing tools in China for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint do not sufficiently consider the specialty in psychiatric practice， and the scale items are somewhat cumbersome to use， which together restrict their further promotion and application. Accordingly， there is an urgent need for developing a more scientific assessment tool. ObjectiveTo construct a scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint and to verify its reliability and validity， so as to provide a generic tool for the assessment. MethodsBased on the theoretical framework of the knowledge-attitude-practice model， the preliminary scale was formed through systematic literature review， qualitative interview and Delphi method. From July to December 2021， a stratified sampling was utilized to select 729 psychiatric nurses from tertiary， secondary and primary （including unclassified medical institutions and grassroots hospitals） psychiatric hospitals in Guangdong Province. The formal scale was developed through item analysis， exploratory factor analysis and confirmatory factor analysis. The validity of the scale was evaluated by content validity and structure validity， and the reliability was verified by procedures including Cronbach's α coefficient， test-retest reliability， and split-half reliability. ResultsA total of 12 items of three dimensions （knowledge， attitude， practice） were included in the scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. The scale-level content validity index （S-CVI） was 0.941， and the item-level content validity index （I-CVI） ranged from 0.812 to 1.000. Exploratory factor analysis extracted three common factors， and the cumulative variance contribution rate was 62.948%. The confirmatory factor yielded adequate fit. Cronbach's α coefficient was found to be 0.887 for the scale， 0.819 for knowledge dimension， 0.842 for attitude dimension， and 0.831 for practice dimension. The split-half reliability and test-retest reliability for the scale were 0.712 and 0.922， respectively. ConclusionThe scale shows satisfactory reliability and validity， which can be used to assess psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. ［Funded by Guangdong Clinical Teaching Base Teaching Reform Research Project （number， 2021JD119）］

The guidelines for curriculum ideological and political of nursing ethics explored the ideological and political elements of Chinese nursing,and proposed the curriculum's ideological and political goals.The development framework and basic ideas of guidelines were formed from the aspects of the integration path of curriculum ideological and political,and professional teaching,searching for the entry point of curriculum ideological and political,reforming the teaching methodology,enriching the form of teaching,and constructing the case base of curriculum ideological and political.It promoted the deep integration of nursing professional knowledge transmission and ideological value guidance,created a distinctive education system of curriculum ideological and political for nursing ethics,and provided a reference for the curriculum ideological and political construction of national nursing ethics.

OBJECTIVE To evaluate efficacy， safety and cost-effectiveness of edaravone dexborneol and compound porcine cerebroside ganglioside in the treatment of acute ischemic stroke， and to provide decision-making reference for clinical treatment selection. METHODS The medical records of 488 patients with acute ischemic stroke hospitalized from Jan. 2021 to Dec. 2021 were collected and divided into two groups according to the treatment plan， i.e. 268 patients in edaravone dexborneol group， and 220 patients in compound porcine cerebroside ganglioside group. After baseline levels of the two groups were balanced using propensity score matching method， curative effect was evaluated according to the changes of NIHSS scores before and after treatment； the occurrence of adverse drug reactions in patients were collected from the hospital adverse reaction reporting system； from the perspective of China’s health system， the cost-effectiveness of the two options were analyzed， and one-way sensitivity analysis was conducted. RESULTS After the propensity score matching， 125 patients were included in the edaravone dexborneol group and compound porcine cerebroside ganglioside group， respectively. The response rates were 81.6% and 74.4%， respectively， with no significant difference. The average costs were 13 560.30 yuan and 14 958.68 yuan， respectively； the cost of edaravone dexborneol group was lower than that of compound porcine cerebroside ganglioside group. No adverse reaction reporting information was retrieved in both groups. Results of one-way sensitivity analysis showed that other drug costs in compound porcine cerebroside ganglioside group was relatively sensitive parameters. CONCLUSIONS Short-term efficacy and safety of edaravone dexborneol are equivalent to those of compound porcine cerebroside ganglioside in treating acute ischemic stroke. But edaravone dexborneol regimen had lower cost and is a more economical scheme.

This paper introduces the concept, basic theory and interventions of reminiscence therapy, summarizes the application status of reminiscence therapy in elderly patients with mental disorders and puts forward the prospect, so as to provide reference for research in China.

This article gives a review on the application status and clinical effect of behavioral activation （BA） therapy for patients with late-life depression， in which the theoretical content， research status and the characteristics of clinical application of BA therapy for patients with late-life depression were introduced， and the existing limitations and possible directions for future research were summarized， so as to provide references for the localization of BA therapy for patients with late-life depression.