Objective:To construct an evaluation framework with detailed indices for demonstration units (wards) of enteral nutrition nursing, in order to improve the competence of nurses in enteral nutrition nursing and inform the specialized development of enteral nutrition demonstration units (wards).Method:On the basis of literature review and expert discussion, a preliminary draft was developed, and the Delphi expert consultation method was used to conduct two rounds of consultation with 15 clinical experts in the field of enteral nutrition nursing from 15 tertiary hospitals.Results:The effective response rates of questionnaires in two rounds of consultations were both 100%. The first round of expert consultation showed an authority coefficient of 0.90 and a coefficient of variation of 0 to 0.167, while the second round showed an authority coefficient of 0.93 and a coefficient of variation of 0 to 0.113. The Kendall harmony coefficients were 0.338 and 0.368, respectively. Finally, the evaluation framework with detailed indices for the demonstration unit (ward) of enteral nutrition nursing was formed, which consisted of 3 primary indicators, 16 secondary indicators, 54 tertiary indicators, and 62 detailed items.Conclusions:The evaluation framework we developed for the demonstration unit of enteral nutrition nursing follows the diagnosis and treatment process of enteral nutrition management for inpatients, including the triad of structure, process, and outcome. The framework is objective and practical, and can inform the daily practice of enteral nutrition nursing demonstration units (wards) and the development of enteral nutrition nursing specialties.

Objective:To understand the nutritional nursing competence in the enteral nutrition demonstration wards at this stage, so as to inform subsequent training plan.Methods:From September to October in 2023, nurses from 287 institutions involved in the enteral nutrition demonstration ward construction project were selected using convenience sampling. Questionnaires on general characteristics and self-assessment scale on nutrition nursing competence were used for online survey. The status quo and influencing factors of nutrition nursing competence in included institutions were analyzed.Results:A total of 5 409 valid questionnaires were collected, with a response rate of 62.63%. The total score of nutrition nursing competence was 74.74±16.11, with the least subtotals in the domain of nutrtion knowledge. Multiple linear regression showed that influencing factors of nutrition nursing competence includes years of working, department, registered dietitian or not, nutrition management specialist or not, completion of the curriculum in enteral nutrition demonstration ward construction project, and training/supervision arranged by their department concerning nutrtion nursing and relevant evaluation criteria ( P<0.05). Conclusions:The nutritional nursing competence of clinical nurses in the wards involved in enteral nutrition demonstration ward construction project still needs to be improved. Seniors should take into consideration the varying nutritional nursing competence among junior nurses and nurses from different departments, and strengthen the training on nutrition knowledge. It should be encouraged for nurses to actively participate in nutritionist training. Actions including enhancing nutrition specialist training, establishing the multidisciplinary collaborative nutrition care team and conducting regular supervision and assessment should be implemented in the future, to improve the nutritional nursing competence among nurses.

Objective To investigate the application of novel quantum dot fluorescence immunochromatog-raphy for the determination of serum amyloid A(SAA).Methods Using the principle of double antibody sandwich method and quantum dots fluorescence immunochromatography technology to prepare SAA detec-tion kit with Dinitrophenol(DNP)-Bovine serum albumin(BSA)system as the control line.The feasibility of using the DNP-BSA system as a quality control line was evaluated using the chicken IgY-sheep anti-chicken IgY system as a control,and further improve the performance of the reagent kit by optimizing the coupling conditions between quantum dot microspheres and antibodies.Evaluated the blank limit,detection limit,linear range precision,accuracy,specificity,stability,as well as clinical samples determination of the kit.Results The SAA kit using DNP-BSA system as the quality control line was less affected by the concentration of inter-fering components,had high stability,and good thermal stability.The optimal coupling effect was achieved when the coupling ratio between quantum dots and SAA antibodies was 100 μg/mg,and the coupling reaction solution was 25 mmol/L 3-morpholine propyl sulfonate pH 7.4,and the coupling ratio with DNP-BSA was 100 μg/mg and the coupling reaction solution was 25 mmol/L morpholine ethanesulfonate pH 6.0.The detec-tion limit of SAA kit was 0.5 mg/L;the linear range was 1-200 mg/L,R2≥0.99;the intra assay precision variation coefficient(CV％)≤5.31％,and the inter assay precision CV％≤15％;the recoveries in the low,and high concentrations were 101.42％and 98.83％,respectively.When hemoglobin concentration ≤5 g/L,bilirubin concentration ≤0.15 g/L,cholesterol concentration ≤15 g/L,triglyceride concentration ≤10 g/L,SAA detection results had no interference.The stability of the kit was good when it was stored at 50 ℃ for 21 days.The kit is highly consistent with that of Roche's SAA electrochemiluminescence kit in the simultaneous detection of 67 samples.Conclusion The sensitivity,linearity,precision,accuracy,specificity and accelerated stability of the SAA detection kit can meet the requirements of the kit.Compared with Chicken IgY-sheep an-ti-chicken IgY,DNP-BSA system has better independence as quality control line,and has better accuracy and thermal stability.

ObjectiveTo explore sleep disturbance in preschool children with autism spectrum disorder (ASD) and analyze the relationship between sleep disturbance and social behavior. MethodsFrom December, 2020 to December, 2022, 221 preschool children with ASD from Beijing Bo'ai Hospital and other two institutes, and 246 healthy preschool children socially recruited were investigated with Children's Sleep Habits Questionnaire (CSHQ). A total of 47 ASD children and 47 healthy children were selected from them to wear a sleep monitoring watch for seven days, while the ASD children were evaluated with Gesell Development Diagnosis Scale (GDDS), Psychoeducational Profile-Third Edition (PEP-3), Autism Diagnostic Observation Schedule-2 (ADOS), Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS) and Social Responsiveness Scale (SRS). ResultsAll the factor-scores were more in the ASD children than in the healthy children (t > 2.491, P < 0.05), except that of daytime sleepiness. The prevalence of sleep disturbance (CSHQ ≥ 41) was 89.6% in ASD children, which was more than that of the healthy children (76.8%) (χ² = 13.360, P < 0.001). The sleep problems in ASD children included bedtime resistance, sleep anxiety, sleep duration, sleep onset delay, parasomnias and sleep disordered breathing. ASD children were shorter in total bedtime, shorter in total sleep time, longer in sleep latency, longer in awake time and lower in sleep efficiency (|t| > 2.001, P < 0.05), compared with those of healthy children. For ASD children, the total bedtime negatively correlated with GDDS-language, PEP-3-expressive language, PEP-3-communication and PEP-3-maladaptive behaviors (r < -0.300, P < 0.05); the sleep efficiency negatively correlated with total score of CARS (r = -0.365, P < 0.05); sleep latency correlated with GDDS-social, PEP-3-cognitive, PEP-3-expressive language, PEP-3-receptive language, PEP-3-visual-motor imitation, PEP-3-characteristic verbal behaviors, PEP-3-communication, original score of ADOS, ADOS-social affect, and total score of CARS (|r| > 2.90, P < 0.05); and total awake time positively correlated with total score of CARS (r = 0.406, P < 0.05). ConclusionSleep disturbance is prevalent and various in preschool ASD children, and influence their social behaviors.

Objective:To explore the application of sound thinking combined with Sandwich teaching in oncology nursing practice teaching.Methods:A total of 68 nursing students who were interns in the Department of Oncology, The First Affiliated Hospital of Air Force Medical University from 2020 to 2021 were included in the study, and they were divided into a control group ( n=34) and an observation group ( n=34). The control group took routine teaching for interns, while the observation group took sound thinking combined with Sandwich teaching. The examination results, critical thinking abilities, and the evaluation of nursing teaching effectiveness of the two groups of nursing interns were evaluated. SPSS 22.0 was used for Chi-square test and t-test. Results:The examination scores of nursing students in the observation group were higher than those in the control group ( t=3.44, 2.87, 3.45, P<0.05). Compared with those before training, the scores of critical thinking ability of nursing interns in both groups increased after the training, and the observation group was better than the control group ( t=0.180, 3.64, 0.61, 2.92, 0.31, 2.74, 0.45, 2.65, 0.25, 3.58, 1.16, 2.85, 0.36, 3.20, 0.33, 2.38, P<0.05). The scores of autonomous learning ability, communication and collaboration ability, independent thinking ability, clinical reasoning ability, and problem-analyzing and -solving ability in the observation group were higher than those in the control group ( t=2.82, 3.46, 2.68, 3.29, 2.44, P<0.05). Conclusion:Combining sound thinking with Sandwich teaching in nursing clinical practice teaching in department of oncology can improve the examination scores of nursing students, improve their critical thinking abilities, and enable them to give a high evaluation of nursing teaching effectiveness.

The inconsistency of diagnostic criteria for malnutrition has confused clinicians since the 1980s. After the implementation of disease diagnosis related group payment (DRG) in China's public hospitals, the diagnosis of malnutrition and the correct documentation of nutrition-related diagnosis on the front sheet of medical records are related to the correct classification of the disease group and the medical insurance payment. Therefore, the reliable diagnostic criteria for malnutrition, especially disease-related malnutrition, is urgently needed in clinical practice. In September 2018, The global leadership Iinitiative on malnutrition (GLIM) diagnostic criteria consensus was launched. GLIM aimed to provide the explicit and unified diagnostic criteria for malnutrition in adult hospitalized patients. However, GLIM criteria was based on the voting by nutritional experts and was merely a consensus in nature. The clinical validity of GLIM criteria needs prospective verification, i.e., to demonstrate that patients with malnutrition as per GLIM criteria could have improved clinical outcomes with reasonable nutritional interventions. In November 2020, the article titled Nutritional support therapy after GLIM criteria may neglect the benefit of reducing infection complications compared with NRS 2002 was published on the journal Nutrition. It was the first study comparing nutritional risk screening 2002 (NRS 2002) and GLIM malnutrition diagnostic criteria among Chinese patients for the indication of nutritional support therapy. The clinical effectiveness of the two tools was retrospectively verified as well. Here we discussed the key points of this retrospective study, including the critical research methods, to inform the currently ongoing prospective validation of the GLIM malnutrition diagnostic criteria (the item of reduced muscle mass not included).

The aim of this work is to delineate the odyssey of parenteral nutrition (noun number: 01.080), which is also called intravenous nutrition. Robert Elman (a surgeon) administered fibrinogen hydrolysate intravenously to dogs and observed the positive nitrogen balance in 1937. Corresponding report about this clinical research was published later on. Oscar Schuberth (a surgeon) and Arvid Wretlind (an internist) developed the soybean oil emulsion with good tolerability and infused a mixture of glucose, amino acids and fat emulsion into patients for the first time. Stanley Dudrick (a surgeon) carried out laboratory studies, such as infusion of 30% glucose through the central vein, selection of materials for silicone rubber catheter, monitoring of nitrogen balance, and so on. He validated that the growth and development of beagle could be supported with parenteral nutrition. Douglas Wilmore (a surgeon) applied parenteral nutrition to a baby girl with congenital stenosis of alimentary tract and thus initially validated the effectiveness of parenteral nutrition in human after 18 months' observation. All mentioned above are landmarks in the history of parenteral nutrition.The development of it is a rugged but interesting journey parenteral nutrition, exemplifying the general principles and methodology of scientific researches. Fifty-six years passing by since the commencement, now, it is time to march into Phase 3 translational (T3) research for parenteral nutrition. T3 clinical researches in parenteral and enteral nutrition is now in the ascendant in China. By looking back at the odyssey, we would like to highlight the necessity of incessant optimization and standardization of parenteral and enteral nutrition practice, to eventually achieve the rational use of nutrition support therapy and bring about patient benefits.

Objective:To investigate clinical outcomes after embryo transfer again in in vitro fertilization and embryo transfer/frozen-thawed embryo transfer (IVF-ET/FET) patients with previous fetal chromosomal abnormalities. Methods:In this retrospective case-control study, data of patients who received IVF-ET/FET treatment at the Department of Reproductive Medicine, Yantai Yuhuangding Hospital between July 2015 and December 2019 and had embryo chromosomes tested after spontaneous abortion were analyzed. Among 299 patients, 172 cases were found to have fetal chromosomal abnormalities (abnormal group) and 127 cases were found to have normal results (normal group). We matched the above patients cycles with age, anti-Müllerian hormone and basal follicle-stimulating hormone using propensity score matching (PSM). Clinical data were analyzed again after PSM.Results:Before PSM, patients in abnormal group [34.0 (30.0,38.0) years] were significantly older than those in normal group [32.0 (30.0,36.0) years, P=0.015]. There were no statistically significant differences in clinical pregnancy rate, early miscarriage rate, approximate live birth rate and cumulative live birth rate (all P>0.05). After PSM matching, there were also no statistically significant differences in clinical pregnancy rate, early miscarriage rate, approximate live birth rate and cumulative live birth rate (all P>0.05). Conclusion:Patients with fetal chromosomal abnormalities can achieve similar clinical outcomes after embryo transfer again. Therefore IVF-ET or FET is recommended as early as possible.

Objective:To investigate clinical outcomes after embryo transfer again in in vitro fertilization and embryo transfer/frozen-thawed embryo transfer (IVF-ET/FET) patients with previous fetal chromosomal abnormalities. Methods:In this retrospective case-control study, data of patients who received IVF-ET/FET treatment at the Department of Reproductive Medicine, Yantai Yuhuangding Hospital between July 2015 and December 2019 and had embryo chromosomes tested after spontaneous abortion were analyzed. Among 299 patients, 172 cases were found to have fetal chromosomal abnormalities (abnormal group) and 127 cases were found to have normal results (normal group). We matched the above patients cycles with age, anti-Müllerian hormone and basal follicle-stimulating hormone using propensity score matching (PSM). Clinical data were analyzed again after PSM.Results:Before PSM, patients in abnormal group [34.0 (30.0,38.0) years] were significantly older than those in normal group [32.0 (30.0,36.0) years, P=0.015]. There were no statistically significant differences in clinical pregnancy rate, early miscarriage rate, approximate live birth rate and cumulative live birth rate (all P>0.05). After PSM matching, there were also no statistically significant differences in clinical pregnancy rate, early miscarriage rate, approximate live birth rate and cumulative live birth rate (all P>0.05). Conclusion:Patients with fetal chromosomal abnormalities can achieve similar clinical outcomes after embryo transfer again. Therefore IVF-ET or FET is recommended as early as possible.

In the 42 nd and 44 th workshops of CSPEN-nutritional risk-undernutrition-support-outcome-cost effectiveness ratio (NUSOC) multi-center database collaboration group, Jens Kondrup and Henrik Rasmussen described again the application of NRS 2002, the evidence-based basis of NRS 2002 development and the methodology for prospective validation of clinical effectiveness. There is no gold standard for validation. They both considered that malnutrition could be identified as a score of 3 or more for impaired nutritional status in NRS 2002. Although NRS 2002 is simple and easy to be applied, it is not comprehensive enough for malnutrition diagnosis. ASPEN and ESPEN on-line published the Global Leadership (nutritional) Initiative on Malnutrition(GLIM)diagnosis criteria in September 2018. With the gradual implementation of medicare payment based on diagnosis related groups(DRG)in China, the nutritional risk and the malnutrition diagnosis with Chinese version of ICD-10 (2016) code should be recorded in the first page of the medical records. In this terminology interpretations, the terms of nutritional risk screening(NRS 2002.01.016)and malnutrition diagnosis (GLIM-phenotypic criteria 01.028, etiologic criteria 01.029) published in Parenteral and Enteral Nutrition Terminology 2019 are discussed based on the reports given by Kondrup and Rasmussen in Beijing and Zhengzhou.