Objective:To explore the clinical value of syndecan-1 (SDC1), asymmetric dimethylarginine (ADMA) assessment in the early diagnosis and course monitoring of patients with type 2 diabetic kidney disease (DKD).Methods:This is a cross-sectional study. A total of 232 patients with type 2 diabetes admitted to the Department of Endocrinology of Kailuan General Hospital from December 2020 to December 2021 were included. The general biochemical indexes, SDC1 and ADMA were detected. According to urinary albumin/creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR), patients were divided into simple diabetes group (50 cases) and DKD group (182 cases). According to the risk of progression of DKD, the DKD group was further divided into low-progression diabetic nephropathy (LDKD) subgroup (90 cases), medium-progression diabetic nephropathy(MDKD)subgroup (55 cases), and high-progression diabetic nephropathy(HDKD) subgroup (37 cases). Forty healthy people undergoing physical examination during the same period in our hospital were selected as the healthy control group. According to the quartile value of N-acetyl-β-D-glucosaminase/urinary creatinine (NAG/Ucr), the DKD group was divided into Q1- Q4 subgroups, with 45, 45, 46 and 46 cases, respectively. Spearman correlation was used to analyze the correlation between SDC1, ADMA and glomerular and renal tubule injury indexes in DKD patients. Multifactor ordered Logistic regression was used to analyze the influencing factors of the progression risk of DKD and renal tubular injury. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of SDC1 and ADMA for DKD. Results:The levels of systolic blood pressure, diastolic blood pressure, triglyceride (TG), serum creatinine (Scr), uric acid (UA), NAG/Ucr, SDC1 and ADMA in DKD group were higher than those in SDM group and healthy control group (all P<0.05). The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), and hemoglobin A1c (HbA 1c) in DKD group were higher than those in healthy control group, and the level of high density lipoprotein cholesterol (HDL-C) was lower than that in healthy control group (all P<0.05). The SDC1 level in HDKD subgroup was higher than that in SDM group and LDKD subgroup, and the ADMA level was higher than that in SDM group and lower than that in LDKD subgroup (all P<0.05). SDC1 level in MDKD subgroup was higher than that in SDM group and LDKD subgroup, ADMA level was higher than that in SDM group, but lower than that in LDKD subgroup (all P<0.05).The levels of SDC1 and ADMA in LDKD subgroup were higher than those in SDM group (all P<0.05). The levels of TC, AporB, HbA 1c, Scr, UACR and SDC1 in NAG/Ucr Q4 subgroup were higher than those in Q1 subgroup, the levels of Scr, UACR and SDC1 were higher than those in Q2 subgroup, and the levels of HbA 1c, Scr, UACR and SDC1 in Q3 subgroup were higher than those in Q1 subgroup (all P<0.05). Spearman correlation analysis showed that SDC1 was positively correlated with UACR, NAG/Ucr ( r=0.757, 0.566, all P<0.05),and was negatively correlated with eGFR ( r=-0.337, P<0.05). ADMA was positively correlated with UACR, NAG/Ucr ( r=0.197, 0.142, all P<0.05). Multifactor ordered Logistic regression analysis showed that SDC1, NAG/Ucr and Scr were the independent influencing factors of progression risk in DKD patients ( OR=2.043, 1.067, 1.047, 0.660, 1.394, all P<0.05), while SDC1, HbA 1c and ACR were the independent influencing factors of renal tubule injury in DKD patients ( OR=1.177, 1.193, 1.002,all P<0.05). ROC curve showed that the area under the curve (AUC) of SDC1 for DKD diagnosis was 0.979, the sensitivity was 92.31%, and the specificity was 92.22%, while the AUC of ADMA for DKD diagnosis was 0.745, the sensitivity was 81.32%, and the specificity was 60.00%. The AUC, sensitivity and specificity of the combined diagnosis of DKD were 0.981, 90.66% and 95.66%. Conclusions:SDC1 is an independent risk factor of DKD progression and tubular injury in DKD patients, which can be used to diagnose early DKD and monitor the progression of DKD. ADMA is suitable for early screening of DKD.

Objective:To explore the effect of continuous nursing based on Siebens domain management model in patients with Parkinson's disease after deep brain stimulation.Methods:From January 2021 to June 2022, convenience sampling was used to select 169 Parkinson's disease patients who underwent deep brain electrical stimulation in the Functional Neurosurgery of Beijing Tiantan Hospital as the study subject. The patients were divided into a control group of 84 cases and an observation group of 85 cases using the random number table method. The control group received routine continuous nursing, while the observation group received the continuous nursing based on Siebens domain management model on the basis of the control group. This study compared the Activity of Daily Living (ADL) Scale, Morisky Medication Adherence Scale (MMAS), 39-item Parkinson Disease Questionnaire (PDQ-39), Parkinson's Disease Sleep Scale (PDSS) scores, and unexpected program control rate between two groups of patients after six months of discharge.Results:After six months of discharge, the ability of daily living score, quality of life score, and sleep quality score of both groups of patients improved compared to before intervention ( P<0.05), and the medication adherence of the observation group patients improved compared to before intervention ( P<0.05), and the differences were statistically significant. The ability of daily living score, medication adherence, quality of life score, and sleep quality score of the observation group patients after six months were higher than those of the control group, and the differences were statistically significant ( P<0.05). Within six months after discharge, the unexpected program control rate of the observation group was statistically lower than that of the control group ( P<0.05) . Conclusions:In the treatment and discharge rehabilitation process of Parkinson's patients treated with deep brain electrical stimulation, adopting continuous nursing based on the Siebens domain management model can help ensure patient medication compliance, improve postoperative sleep quality and quality of life, reduce unexpected program control frequency, and have certain clinical practice value.

Objective:To explore the application value of E-learning+mind mapping in nursing internship teaching in the department of neurology.Methods:A total of 215 nursing students admitted for internships in February 2021 were selected as research subjects. They were randomly divided into two groups. The observation group received teaching method combining E-learning and mind mapping, while the control group received conventional teaching method. The two groups of nursing students were compared in terms of internship assessment results, learning engagement (learning engagement scale), clinical thinking ability (clinical thinking ability evaluation scale), and student self-recognition. SPSS 20.0 was used for t test and chi-square test. Results:After 1 month of internship, the scores of theories and practical operation were significantly higher in the observation group than in the control group [(90.05±3.02) vs. (85.29±4.17) and (81.33±5.26) vs. (78.62±4.69), all P<0.05]. The score of learning engagement scale, score of clinical thinking ability evaluation scale, and self-recognition rate were significantly higher in the observation group than in the control group (all P<0.05). Conclusions:E-learning+mind mapping can significantly enhance the learning efficiency of intern nursing students in the department of neurology and improve their clinical nursing thinking ability, making it worthy of widespread application.

Objective:To select and summarize the best evidence related to skin management in glioblastoma patients treated with tumor treating fields (TTFields) at home and abroad, so as to provide reference for clinical decision-making.Methods:Cochrane Library, UpToDate, PubMed, Embase, CINAHL, Web of Science, CNKI, Wanfang Database, VIP, SinoMed, Guideline Network and professional association websites were searched by computer. Clinical practice guidelines, expert consensus, clinical decision-making, systematic review and evidence summary related to skin management in patients with glioblastoma treated with TTFields were included, and the retrieval time was from establishment of databases to March 31, 2022. Two researchers independently evaluated the quality of literature and extracted evidence.Results:A total of 9 literatures were included, including 2 guidelines, 4 expert consensus, 2 systematic reviews and 1 clinical decision-making. A total of 31 pieces of best evidence were formed from 5 aspects, including risk factors, nursing evaluation, preventive intervention measures, drug therapy and adverse skin reactions and treatment.Conclusions:This study summarizes the best evidence for skin management of glioblastoma patients treated with TTFields. Medical staff should fully evaluate the skin condition of patients according to the clinical scenario and the actual situation of patients and do a good job in skin management to reduce the incidence of skin injury of patients.

Objective To study the predictive value of hemodynamic monitoring in the responsiveness of fluid therapy in neonatal septic shock.Method The 96 neonates with septic shock admitted to the NICU from Wuhan Children's Hospital and Tongji Hospital between March 2014 to May 2017 were enrolled.Hemodynamics parameters of neonates pre-,1 hour and 6 hour post-fluid therapy were supervised by ultrasonic cardiac output monitor.The hemodynamics parameters included cardiac index (CI),systemic vascular resistance (SVR),stroke volume (SV),stroke volume variation (SVV),stroke volume index (SVI) and corrected flow time (FTc).The SVI variation (△ SVI) were calculated based on the SVI among pre-and post-fluid therapy.According to the △ SVI,these samples were assigned into two groups,responsive group with a △ SVI ≥10％,and the other was nonresponsive group respectively.T-test was applied to analyze the differences of hemodynamic parameters between two groups.The associations between SVV、FTc and △ SVI were evaluated by bivariate correlation.Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of SVV and FTc in fluid responsiveness.All statistical analyses were performed by SPSS 19.0,P＜0.05 was considered as statistically significant.Result A total of 96 cases were enrolled,of which 54 were fluid responsive group,while 42 were nonresponsive group.(1) Before fluid resuscitation,the FTc in responsive and nonresponsive groups were (317.1±22.2) ms and (326.8± 21.2) ms (P＜0.05) respectively,SVV were(18.3±2.0)％ and (15.0±2.6)％ (P＜0.05).SVV was significantly associated with △ SVI (r=0.542,P＜0.05).(2) There were statistically significant differences in heart rate,mean arterial pressure,cardiac output,cardiac index,stroke volume and systemic vascular resistance index before treatment,1 h and 6 h after treatment (P＜0.05).(3) The area under the ROC of SVV (AUC) was 0.838 (95％CI 0.749～0.906).A sensitivity of 98.2％,and specificity 73.8％ when SVV defined as 15.5％,with a significant difference when compared with FTc (AUC=0.642,95％CI 0.538～0.737) (P＜0.01).Conclusion SVV could be a reliable predictive index in estimating fluid responsiveness of neonatal septic shock and could be helpful parameter in clinic diagnosis.

Objective? To explore the effects of enhanced recovery after surgery (ERAS) in perioperative care for intracerebral aneurysm. Methods? Totally 353 patients with intracerebral anterior circulation aneurysm who were treated with the craniotany clipping technique in a ClassⅢ Grade A hospital from November 2016 to November 2018 were selected. A total of 291 patients admitted from November 2016 to December 2017 were included in the control group which received conventional perioperative nursing care, while 62 patients admitted between January and November 2018 were included into the ERAS group which received ERAS nursing care. The length of hospital stay, Glasgow Outcome Scale (GOS) and incidence of complications were compared between the two groups. Results? The length of hospital stay and the GOS score of the ERAS group was (14.426±4.264) d and (4.019±0.533), respectively, while those of the control group were (15.931±6.814) d and (4.676±0.705), respectively (t'=2.117, 7.937; P＜0.05). There was no statistical difference in the incidence rate of central nervous system infection (CNSI) and pulmonary infection between the two groups (P＞0.05). However, the incidence rate of lower limb vein thrombosis of the ERAS group was 4.61% (1/62), while that of the control group was 9.32% (27/219) (χ2=6.185,P＜ 0.05). Conclusions? The ERAS perioperative care for intracerebral aneurysm helps to reduce the length of hospital stay, improve GOS scores and curtail the incidence rate of lower limb vein thrombosis in these patients.

A valve-free continuous flow method and instrument were established,with only a multi-channel pump for delivering the sample and reagent,and without any injection or solenoid valves and sample loop for selecting and adding the sample or reagent.Nitrate was reduced to nitrite with Cu-Cd reductant column,and then detected with spectrophotometric detector.The proposed method was suitable for determination of nitrate at normal level in most of estuary and coastal seawaters.With the optimum parameters,the linear range and detection limit were 5-180 μmol/L and 0.27 μmol/L,respectively.The samples of 10 and 80 μmol/L nitrate were continually measured for 11 times,and the relative standard deviations were 1.4％ and 1.3％,respectively.The recovery of real samples at different salinity ranged between 99.4％ and 106.1％.There was no significant difference in the analytical results between the proposed method and the flow injection analysis (FIA).In comparison with FIA,the method and instrument were less cost and easy to operate,and was suitable to be applied in general laboratories and field for continuous monitoring.The method was successfully used to measure the nitrate in seawater samples in Xiamen's Western Harbor and monitor nitrate in Jiulongjiang estuary.

Objective:To develop murine models of Th2 response induced by shrimp tropomyosin (ST). Methods:Mice were sensitized with ST for 6 weeks. The serum antigen-special IgE (sIgE),total IgE and sIgG level,Th1/Th2 cytokines production were measured by ELISA. The basophil activation in mice was measured by flow cytometry. Results:The intraperitoneal sensitization with ST for 6 weeks induced significant increase of serum sIgE,total IgE and sIgG (sIgG1,sIgG2a and sIgG2b) level in mice. Th2 cell response was induced and cytokines (IL-4,IL-5,IL-10 and IL-13) production increased in splenocytes stimulated by ST,while Th1 cytokine (IFN-γ) production decreased. As the markers of basophil activation,CD200R and CD41 expression also increased in response to ST. Conclusion:The Th2 response is dominant in ST-induced anaphylaxis in mice.

Objective To explore the effects of intermittent catheterization conducted by bladder safe capacity on bladder function rehabilitation among patients with spinal injury.Methods A total of 60 patients with spinal injury and neurogenic bladder of Rehabilitation Department of Spine were selected as subjects by convenience sampling from January 2015 to January 2016. They were randomly divided into intervention group (intermittent catheterization conducted by the bladder capacity scanner) and control group (routinely regular intermittent catheterization). And then, this study compared the recovery of bladder function and the incidence of urinary tract infection of patients in two groups.Results At the fourth week, there were 9 patients with reflex bladder in intervention group more than that (4 patients) in control group with a significant difference (P<0.05). At discharge, there were 18 patients with reflex bladder in intervention group, while there were 14 patients in control group with a significant difference (P<0.05). After intervention, the residual urine volume of intervention group was significantly higher than that of control group (P<0.05). There was no statistically significant difference in bladder compliance between two groups (P>0.05). The difference on cases with urinary tract infection in control group (66 times) and intervention group (35 times) was significant (P<0.05). The times of reflex urination for the first time and bladder functional reconstruction in intervention group were lower than those in control group with significant differences (P<0.05).Conclusions Intermittent catheterization based on individual bladder safe capacity can effectively shorten the times of reflex urination for the first time and bladder functional reconstruction, reduce the residual urine and decrease the incidence of urinary infection.

Objective To develop nursing quality indicators for preoperative patients with brain arteriovenous malformations. Methods On the basis of Donabedian's "structure-process-outcome" quality theory, from May to September 2017, we adopted literature research, interviewing method, text analysis and Delphi method to determine the nursing quality indicators. Results After two rounds expert advisory, the effective response rates were both 100.00%;the Cr coefficient was 0.89. The nursing quality indicator system consisted of 3 first-level indicators, 8 second-level indicators, and 28 third-level indicators. 94.87% of the index score was greater than or equal to 4 points, the variation coefficients were all less than 0.2, and 71.79% of the index had the full rate of more than 50%. Conclusions The nursing quality indicators for preoperative patients with brain arteriovenous malformations are scientific and practical.