Objective:To explore the current status of catheterization technology training for tunnel peripherally inserted central catheter (PICC) intravenous therapy specialist nurses, so as to provide reference for promoting the application of this technology and conducting systematic specialized training.Methods:From May to June 2023, convenience sampling was used to select 279 intravenous therapy specialist nurses from 150 hospitals in 24 provinces, autonomous regions, and municipalities directly under the central government as the research subject. A self-designed questionnaire was used to survey the research subject in the form of an electronic questionnaire.Results:A total of 279 questionnaires were distributed, and 279 valid questionnaires were collected, with an effective response rate of 100.0% (279/279). The hospitals where 141 nurses were located implemented tunnel PICC catheterization technology, of which 93 nurses implemented this technology in their departments, 34 nurses were able to independently complete this technique. A total of 113 nurses received tunnel PICC training, and 141 nurses believed that the primary factor affecting the implementation and development of this technology was the level of technical mastery of specialist nurses, 248 nurses expressed that training effectiveness could be effectively improved through workshops.Conclusions:The training and promotion of tunnel PICC catheterization technology need to be strengthened. It is urgent to further increase the re-certification of intravenous therapy specialist nurses and perfect the platform and standardization of specialized training to improve the nursing quality of intravenous therapy.

Objective:To construct a hypoglycemia random forest prediction model for older adults with type 2 diabetes, and assess the model′s prognostication performance through internal and external verification.Methods:From August 2022 to January 2023, 300 older adults with type 2 diabetes in Beijing Hospital were selected. The demographic characteristics, medical history, laboratory tests, and other data of the patients were collected, and the data set was randomly divided into the training set and verification set in a ratio of 7∶3. The hypoglycemia prediction model for older adults with type 2 diabetes was constructed and optimized based on the random forest algorithm. The calibration curve was used to evaluate the model′s calibration, and the ROC was used to evaluate the model′s discrimination. The clinical applicability of the model was assessed by the decision curve analysis. The risk factors for hypoglycemia in the older adults were explored by prioritizing the contributions of variables in prediction. The Bootstrap method was used for internal validation, and the validation set was used for external validation.Results:Among the 300 older adults with type 2 diabetes, 128 cases (42.67%) experienced hypoglycemia within one week. The predictive contributions of risk factors in the model were ranked as follows: the number of episodes of hypoglycemia in one month, HDL-C, heart disease, diabetes knowledge and education, combination therapy, age, duration of diabetes, staple food restriction, glycosylated hemoglobin, and gender. The internal and external calibration curves of the hypoglycemia random forest model for the older adults with type 2 diabetes fluctuated around the diagonal, indicating that the calibration degree of the predictive model is good. The AUROC of internal verification was 0.823 (95% CI 0.752-0.894), the sensitivity and specificity were 0.867 and 0.698, respectively. The external verification was 0.859 (95% CI 0.817 - 0.902), and sensitivity and specificity were 0.789 and 0.804, respectively, showing that the overall discrimination of the prediction model was good. The DCA curves were far from the all-positive line and all-negative line, which indicated that the prediction model had good clinical applicability. Conclusions:The predictive effect of this model is good, and it is suitable for predicting the risk of hypoglycemia in older adults with type 2 diabetes, and it provides a reference for early hypoglycemia screening and predictive intervention for this kind of patients.

Objective To study the effect of self-monitoring of blood glucose information management platform based on the medical consortium on the level of blood glucose control by improving the implementation rate of self-monitoring of blood glucose prescriptions for type 2 diabetes patients in the community.Methods A convenient sampling method was used to select 121 patients with type 2 diabetes from April 2021 to April 2023 who were enrolled in a community of a tertiary hospital medical consortium in Beijing.They were randomly divided into 61 patients in an experimental group and 60 patients in a control group.The control group received routine blood glucose monitoring and guidance education,while the experimental group was managed by a self-monitoring of blood glucose information management platform based on the medical consortium with nurses as the main body.Glycated hemoglobin,glucose test,fasting blood sugar,blood glucose 2 hours after meal,and the completion of self blood glucose monitoring prescriptions were evaluated and analyzed in the first week and the twelfth week of the 2 groups.Results 61 cases in the experimental group and 58 cases in the control group completed the follow-up,and the patients who completed the follow-up were analyzed.There was no statistically significant difference in glycated hemoglobin between the 2 groups at baseline(P=0.117).After 12 weeks,the reduction standard-reaching rate in glycated hemoglobin in the experimental group was significantly different from that in the control group(P=0.014).The number of self-monitoring of fasting blood glucose and the total number of other time periods in experimental group were significantly higher than those in the control group(P＜0.001);the implementation rate of self-monitoring prescription in the experimental group was better than that in the control group(P＜0.001).Conclusion A self blood glucose monitoring information platform was built to manage community type 2 diabetes patients,so that patients can master and implement the personalized blood glucose monitoring prescription formulated by the medical union team with nurses as the main body,and it is conducive to improving the frequency of blood glucose monitoring and the level of blood glucose control of diabetes patients.

Objective:To explore the experience and demand of diabetic patients for exercise management platform and provide reference for building scientific exercise management platform module content for diabetic patients.Methods:Using the phenomenological research method, with data saturation as the sample size selection criteria, a total of 11 diabetic patients from Department of Endocrinology of two Class Ⅲ Grade A hospitals in Beijing from June to August 2021 were selected for semi-structured in-depth interviews. Colaizzi 7-step analysis method was used to analyze data and extract themes.Results:Diabetic patients had a high degree of acceptance to use the exercise management platform. The demand could be summarized into five themes, which are professional service demand, effect analysis demand, personalized monitoring demand, simplicity of operation demand and interest stimulating demand.Conclusions:The development of diabetes exercise management platform should be diversified and personalized. Multi-disciplinary professional cooperation teams should be used to provide scientific and high-quality services and guidance for diabetes patients on the platform, so as to help diabetes patients form regular and effective exercise habits.

Objective:To analyze the feasibility of free disinfection of central venous catheter infusion connector after using disposable disinfection caps.Methods:Using the convenient sampling method, a total of 132 patients who were hospitalized in the Department of Hematology of a Class Ⅲ Grade A hospital in Beijing from January to August of 2020 were selected as the research objects. According to the order of hospitalization, they were divided into the experimental group (group A) and the control group (group B) . Group A used disposable disinfection caps to connect the infusion connector, while group B repeatedly wiped the infusion connector for 15 s with 70%-80% alcohol cotton before infusion. According to infusion interval of 8 and 12 h and sampling timing, group A was divided into group A1-8 h and group A2-12 h, while group B was divided into group B1-8 h and group B1-12 h, with 33 cases in each group. Samples from infusion connectors of the 4 groups were collected for bacterial culture and bacterial inhibition on the surface of infusion connectors was compared.Results:There were 2 cases of detachment in A1-8 h group, 3 cases in A2-12 h group and 1 case in B2-12 h group. A total of 126 patients completed the study. A total of 18 patients in group A had bacteria at the infusion connector, which was more than 0 patients in group B, and the difference was statistically significant ( P<0.01) . In A1-8 h group, there was statistically significant difference in the presence of bacteria before and after using disinfection caps ( P<0.01) . There was no statistically significant difference in the presence or absence of bacteria in the infusion connector before and after the use of the infusion caps in the A2-12 h group ( P>0.05) . Conclusions:The disinfection effect of the disposable infusion connector disinfection cap is not the same as that of the disposable alcohol cotton pad disinfection method, but it can inhibit the growth of bacteria on the infusion connector surface within 8 h.

Objective To investigate the effect and mechanism of miR-885-3p on the radiosensitivity of colorectal cancer cell HT-29. Methods The expression of miR-885-3p in HT-29 cells irradiated with different doses (0, 2, 4, 6, 8 Gy) of X-rays was detected by qPCR. The effect of miR-885-3p in modulating cell radiosensitivity was assessed in HT-29 cells with miR-885-3p overexpression. Bioinformatics prediction and dual luciferase reporter gene assay were employed to identify the direct target gene of miR-885-3p. Relationship between miR-885-3p and target gene tyrosine kinase 1 (AKT1) was investigated via regulation of miR-885-3p expression. The effect of AKT1 on radiosensitivity in HT-29 cells was evaluated through knockdown AKT1. The effect of AKT1 on miR-885-3p-induced radiosensitivity was detected by co-transferring miR-885-3p and AKT1 gene into HT-29 cells. Results miR-885-3p expression was up-regulated in radiation-induced HT-29 cells (F=46. 64, P<0. 05). Over-expression of miR-885-3p and knockdown of AKT1 enhanced cell radiosensitization by inhibiting survival and promoting apoptosis (t=12. 33, 12. 95, P <0. 05) with SER of 1. 602 and 1. 946, respectively. Inhibition of miR-885-3p promoted radioresistance by increasing cell survival and inhibiting apoptosis (t=11. 94, P<0. 05) with a SER of 0. 839. AKT1 is a target gene downstream of miR-885-3p, overexpression of AKT1 reversed the effect of miR-885-3p on cell radiosensitivity with a SER of 0. 680. Conclusions miR-885-3p can enhance the radiosensitivity of colorectal cancer HT-29 cells by directly targeting AKT1, which provides a target for improving the radiosensitivity of clinical colorectal cancer.

Objective To explore the best method for first Rituximab transfusion, in order to reduce the incidence of anaphylaxis. Methods A total of 157 non Hodgkin lymphoma patients with first Rituximab transfusion were divided into three groups according to random number table, within 55 cases in control group and the patients of control group undergoing Rituximab instruction advised transfusion method (50 ml/h). There were 62 patients in observation 1 group who received the beginning transfusion speed 10 ml/h and changed the speed every 30 min. There were 40 cases in observation 2 group who accepted the beginning speed 20 ml/h and changed speed every 30 min. The anaphylaxis in the three groups were observed and statistically analyzed. Results The anaphylaxis rates were 9. 7% in the observation 1 group and 25. 7% in the observation 2 group and 30. 9% in the control group. Compared three groups, the differences of anaphylaxis incidence were statistically significant between observation 1 group and the observation 2 group, control group (P<0. 05). The difference of anaphylxis incidences were not statistically significant between the observation 2 group and the control group (P>0. 05). Conclusions For first Rituximab transfusion, the beginning of 10 ml/h transfusion speed and changing speed every 30 min can effectively minimize anaphylxis incidence caused by Rituximab transfusion.

An analytical method was developed for the simultaneous extraction and determination of three quaternary ammonium compouds ( QACs) in soil samples using ultrasonic extraction and gas chromatography-mass spectrometry( GC-MS) . The qualitative and quantitative analysis of the three analytes dodecyltrimethyl ammonium chloride ( DTAC) , cetyltrimethyl ammonium bromide ( CTAB) and didodecyldimethyl ammonium chloride ( DDAC) were conducted by application of EI mass spectra and selected ion monioring ( SIM ) . Characteristic ions of the QACs were m/z 58 ( DTAC and CTAB) and m/z 212 ( DDAC) . To achieve optimum extraction efficiency, several impact factors including types of extractants, pH of extraction, concentration of linear alkylbenzene sulfonates ( LAS) , extraction times and content of purification column were investigated. Methanol with pH 3. 5 and 40 μg/L LAS solution were selected as extractant. Soil sample was extracted by treated methanol each 10 mL for 20 min every time. Extract of the soil sample was purified by neutral alumina column with 4 cm in length and 1cm in diameter, and then was determineted by GC-MS. Good linear relationships of all the three QACs were obtained in the range of 0. 02-2. 0 mg/L. The limits of determination (LOD, S/N=3) was 1. 2-4. 5 μg/kg. The method was used to analyse real soil samples ( paddy soil, lateritic red soil, and ore tailings) collected from a mining district in south China. Results of determination exhibited the concerntrations of the three analytes in real soil samples ranged from 0 . 24 mg/kg to 0. 41 mg/kg, and their recoveries ranged from 76% to 113% with relative standard deviations ( RSD) of 1. 1%-12. 9% in three different spiked concentrations of 0. 2, 0. 5 and 1. 0 mg/kg.

Objective To investigate caregiver's physical and mental status for allogeneic hematopoietic stem cell transplantation patients during the transplant , explore their physical and psychological problems , analyze the reasons and propose related countermeasures .Methods Phenomenological method in the qualitative research was used to collect the data of 12 caregivers by direct interviewing , and records as well as phenomenological analysis was used for analysis .Results Caregivers endured great physical and psychological pressure, whose quality of life was affected and economic burden was too heavy .They had a strong sense of confusion due to the heavy responsibility of caring patients .Conclusions Except for the allogeneic hematopoietic stem cell transplantation patients , doctors and nurse should pay more attention to the pressure of caregivers, try to reduce their psychological burden and call for more love and caring from medical institutions and community .

Objective To observe the clinical effect of alginate dressing with silver ( sliver ions dressing) on puncture site of PICC catheter in agranulocytosis patients .Methods Seventy-six cases of agranulocytosis patients after PICC were randomly divided into the observation group ( n=39 ) and the control group (n=37).The observation group received alginate dressing with silver on puncture site , while the control group was given sterile gauze on puncture site .Infection incidence , times of dressing change and pressure days were compared between two groups .Results The pressure days in the observation group was (2.77 ±1.27)d and there was no cases of swell or pain .The pressure days was (4.51 ±1.41)d and there was one case of swell and pain in the control group .The difference of pressure days was statistically significant ( t=-5.687,P<0.05).The times of dressing change was (2.74 ±0.99) in the observation group and (4.73 ±1.41) in the control group, with a statistically significant difference (t =-7.140,P <0.05).Conclusions Alginate dressing with silver on puncture site of PICC catheter for agranulocytosis patients can reduce the time of dressing change and pressure days , and accelerate their healing .