OBJECTIVE To comprehensively evaluate the quality of Sanzi powder from different batches based on 12 components quantitative analysis combined with chemical pattern recognition and entropy weight-TOPSIS method. METHODS The contents of 12 components in 15 batches of Sanzi powder （No. S1-S15） were determined by HPLC-MS/MS， such as ethyl gallate， gallic acid， ferulic acid， corilagin， genipin-1-O-β-D-gentiobioside， toosendanin， geniposide， caffeic acid， methyl deacetylated coumarinate， tannic acid， rutin， quercetin. Cluster analysis （CA）， principal component analysis （PCA）， and orthogonal partial least squares-discriminant analysis （OPLS-DA） were conducted on the assay results. Using variable importance projection （VIP） value＞1 and P＜0.05 as the evaluation criteria， the quality differential markers in Sanzi powder were screened. The entropy weight method was used to calculate the weight value， and TOPSIS method was used to rank the quality of 15 batches of Sanzi powder from superior to inferior. RESULTS The contents of the 12 components were 13.494-24.292， 2 069.608-3 188.100， 1.410-3.616， 1 065.030-2 630.584， 1 404.704-1 838.078， 101.640-354.268， 9 193.720-14 777.854， 1.240-5.060， 148.028-5 541.990， 4 261.422-5 607.438， 107.560- 195.512， 2.226-4.192 μg/g， respectively. The results of CA， PCA and OPLS-DA indicated that 15 batches of Sanzi powder could be clustered into two groups. Specifically， batches S3， S7， S10 and S15 were grouped into one category， and remaining batches were grouped into one category. VIP values of geniposide， quercetin， caffeic acid， and methyl deacetylated coumarinate were all greater than 1， with corresponding P-values less than 0.05. The results of the entropy weight-TOPSIS analysis revealed that methyl deacetylate exhibited the smallest information entropy and the highest weight. The relative closeness degrees of samples S3， S7， S10 and S15 ranged from 0.789 to 0.973， while the remaining samples ranged from 0.054 to 0.172. CONCLUSIONS The contents of 12 components in Sanzi powder could be determined accurately by using HPLC-MS/MS technology. Methyl deacetylated coumarinate， geniposide， quercetin and caffeic acid were identified as the quality differential markers. It was found that the overall quality of samples S3， S7， S10 and S15 were superior to that of other batches. Notably， the quality of Gardeniae Fructus decoction pieces emerges as a critical factor in ensuring the consistency of the preparation’s quality.

Objective To explore the relationship among serum vitamin D,calcium ion,blood lipid lev-els and preeclampsia in pregnant women,and analyze the pregnancy outcomes of pregnant women with pre-eclampsia.Methods A total of 166 pregnant women with preeclampsia who underwent pregnancy examina-tion and delivered in Urumqi Municipal Maternal and Child Health Care Hospital from January 1,2021 to Jan-uary 1,2023 were selected as the observation group,and 200 healthy pregnant women during the same period were selected as the control group.The levels of serum vitamin D,calcium ion,phosphorus ion,blood lipid in-dicators,uric acid,and creatinine were detected in the two groups,and the pregnancy complications and preg-nancy outcomes were observed.The influencing factors of preeclampsia were analyzed by using multivariate logistic regression model.Results The levels of serum vitamin D,calcium ion,and high density lipoprotein in the observation group were lower than those in the control group,and the levels of serum uric acid and creati-nine were higher than those in the control group,with statistical significance(P＜0.05).The incidence of fetal growth retardation,placental abruption,oligohydramnios,cesarean section,low birth weight infants,premature delivery,and postpartum hemorrhage in the observation group were significantly higher than those in the con-trol group(P＜0.05).Multivariate logistic regression analysis showed that serum vitamin D(OR=15.141,95％CI:1.831-125.204,P=0.012),calcium ion(OR=4.625,95％CI:2.654-8.059,P＜0.001),high-den-sit y lipoprotein(OR=0.395,95％CI:0.235-0.666,P＜0.001),creatinine(OR=1.034,95％CI:1.005-1.063,P=0.020)and uric acid(OR=1.006,95％CI:1.003-1.010,P＜0.001)were independent factors for the occurrence of preeclampsia in pregnant women.Conclusion The levels of serum vitamin D,calcium ions,blood lipids,uric acid and creatinine may be correlated with the occurrence of preeclampsia.

Objective To evaluate the potential clinical value of T2 mapping and mDixon Quant in the diagnosis of early interver-tebral disc degeneration.Methods A total of 79 volunteers who underwent lumbar MRI examination were enrolled.All subjects were examined for 3.0T MR with T2WI,T2 mapping,and mDixon Quant while recording the condition of low back pain.The differ-ences between T2 mapping(map)value and fat fraction(FF)values of the vertebral(V)and nucleus pulposus(NP)within the Pfir-rmann Ⅰ and Pfirrmann Ⅱ intervertebral disc(grade Ⅰ 76,grade Ⅱ 87)were statistically analyzed.Receiver operating characteristic(ROC)curve analyses were performed for meaningful parameters.Results V-FF showed a mild positive correlation with degenera-tive intervertebral disc lesions,and NP-FF and NP-map values showed a mild negative correlation with lesions.There were statistically significant differences between the two groups in V-FF(P＜0.001),NP-FF(P=0.005),and NP-map(P＜0.001).Some measure-ments had statistically significant differences when different intervertebral disc segments were compared.Conclusion V-FF,NP-FF,and NP-map are associated with intervertebral disc degeneration.T2 mapping and mDixon Quant are potentially valuable as diagnostic tools to quantitatively assess early intervertebral disc degeneration and help diagnose.

Objective To noninvasively predict isocitrate dehydrogenase(IDH)status of glioma via combining imaging and clini-cal features before surgery,so as to provide basis for individualized clinical treatment decision.Methods A total of 47 patients with glioma confirmed by pathological and molecular genetic tests were included,including 20 with IDH mutant type and 27 with IDH wild type.After diffusion tensor imaging(DTI)scanning,fractional anisotropy(FA)and mean diffusivity(MD)values of tumor paren-chyma were calculated.Combining DTI parameters with MRI morphological features of tumor,blood neutrophil/lymphocyte ratio(NLR)and patient's age,binary logistic regression model was established to effectively predict IDH status of glioma patients before surgery.Results There were significant differences in FAmean/FANAWM,MDmin,NLR,tumor location and age between IDH mutant type and IDH wild type groups(P<0.05).The binary logistic regression model concluding,FAmean/FANAWM,MDmin,cystic degeneration,NLR and age,predicted IDH status of glioma with area under the curve(AUC)of 0.961 and 95%confidence interval(CI)of 0.914-1.00.Conclusion The regression model established via combining DTI,MRI morphological features and blood NLR has great performance in classifying IDH status of glioma,and can help predict IDH status noninvasively before surgery,so as to assist clinical individualized treatment.

Objective:To establish an environmental management strategy for the prevention of ventilator-associated pneumonia from the perspective of etiological characteristics and to verify its application effect.Methods:Based on a sampling survey, this study constructed preventive management strategies for ventilator-associated pneumonia by blocking pathogen characteristics from the perspective of both colonization and infection management in patients. From July 2021 to June 2023, a non-synchronous randomized controlled study was conducted, including a control group of 59 cases and an experimental group of 57 cases from ICU of Tianjin Teda Hospital, all of them were mechanically ventilated patients. The effectiveness of the strategy was confirmed.Results:In the control group, there were 35 males and 24 females, with an average age of (46.97 ± 18.84) years. In the experimental group, there were 39 males and 18 females, with an average age of (47.49 ± 13.85) years. During the study period, there were 9 cases of ventilator-associated pneumonia (VAP) in the control group and 2 cases in the experimental group, the difference between the two groups was statistically significant (exact odds ratio=0.031). The duration of mechanical ventilation in the experimental group (122.41 ± 18.36) h, which was shorter than that in the control group (187.62 ± 18.05) h, and the difference was statistically significant ( t=19.28, P<0.05). The length of ICU stay in the experimental group was (8.38 ± 0.79) d, in the control group was (10.99 ± 1.10) d, the difference between them was statistically significant ( t=14.66, P<0.05). On the 7th day, there were 7 cases of positive pathogenic bacteria in sputum culture in the experimental group, which was significantly different from the 29 cases in the control group ( χ2=16.73, P<0.05). Conclusions:The vector management strategy for preventing ventilator-associated pneumonia by blocking etiological characteristics can reduce the incidence of VAP, shorten the duration of mechanical ventilation and ICU stay, and reduce the pathogen load in the sputum of mechanically ventilated patients on the 7th day.

【Objective】 To analyze the contributing factors of attention deficit hyperactivity disorder (ADHD) in children and the correlation between bone mineral density and physical growth, in order to provide new clues for the prevention and early intervention of ADHD. 【Methods】 A total of 116 children with ADHD were included into the observation group from June 2020 to June 2022, while another 80 healthy children in the same period were included as the control group.Clinical data of the two groups were compared, and the factors influencing ADHD in children were analyzed using multivariate Logistic regression. Children with ADHD were further divided into boys group and girls group based on gender. Bone mineral density (BMD) and physical growth (height and body weight) of the two groups were measured, and the correlation between the two was analyzed. 【Results】 In the observation group, the proportion of boys, maternal bad behaviors during pregnancy, their educational level below high school, critical parenting, and parental stress index were significantly higher compared to the control group (χ²=14.430, 5.689, 5.630, 6.738, t=6.936, P<0.05). Additionally, family environment score was significantly lower than that in the control group (t=6.328, P<0.05). Logistic regression analysis revealed that factors including boys (OR=3.298, 95%CI: 1.759 - 6.184), maternal bad behaviors during pregnancy (OR=2.730, 95%CI: 1.169 - 6.375), maternal education level of senior high school or below (OR=2.032, 95%CI: 1.127 - 3.663), critical parenting (OR=2.349, 95%CI: 1.223 - 4.513), and parental stress index (OR=1.089, 95%CI: 1.055 - 1.124) were positively correlated with ADHD in children (P<0.05), while family environment score was negatively related to ADHD (OR=0.868, 95%CI: 0.820 - 0.919, P<0.05). There were no significant differences in BMD, height and body weight between boys and girls in ADHD group (P>0.05). Pearson correlation analysis indicated a positive correlation of BMD with height and body weight (r=0.409, 0.317, P<0.05). 【Conclusions】 The development of ADHD in children is associated with gender, maternal bad behavior during pregnancy, family parental style and so on. Bone mineral density is closely related to physical growth in children with ADHD, clinical interventions can be implemented to prevent or early intervene ADHD.

Objective To explore the clinical effect of hydrocolloid silver-containing dressing combined with Jiedu Shengji ointment in the nursing of venous ulcer wounds of lower limbs.Methods A total of 84 patients with venous ulcer wounds of lower limbs admitted to the wound ostomy clinic of Jiading Central Hospital,Shanghai University of Medicine&Health Sciences from October 2022 to May 2023.Patients were divided into observation group and control group according to the method of single and double days of admission,with 42 cases in each group.The patients in two groups were treated with"three-step dressing change",the patients in control group were treated with conventional external dressing,and the patients in observation group were treated with reticular hydrocolloid silver dressing and Jiedu Shengji ointment for local use.The nursing effects of the two groups were compared.Results The total effective rate of observation group was higher than that of the control group(P<0.05).The wound healing time,treatment time and dressing change times in the observation group were lower than those in control group(P<0.05).The levels of interleukin(IL)-6 and IL-8 in observation group were lower than those in control group(P<0.05).The score of self-conscious pain in observation group was lower than that in control group(P<0.05).The total nursing satisfaction rate of observation group was higher than that of control group(P<0.05).Conclusion"Three-step dressing change"is an effective wound treatment method in the nursing care of patients with deep venous ulcer of lower limbs.It can further accelerate the wound healing process and effect with the local use of reticular hydrocolloid silver-containing dressing and Jiedu Shengji ointment.

Objective To investigate the current status of nurses'knowledge,attitude and practice regarding sleep management of critically ill children in pediatric ICU,and to analyze its impact factors.Methods A self-designed questionnaire on general information and a questionnaire on knowledge and practical behaviors of pediatric ICU nurses on child's sleep management were used.In March 2023,902 pediatric ICU nurses from 24 hospitals in China were surveyed using a convenient sampling method,and the impact factors were analyzed using multiple stepwise linear regression.Results 893 valid questionnaires were collected and the recovery rate of valid questionnaires was 99.00％.Nurses in pediatric ICU scored(33.71±7.76)in knowledge dimension,(37.38±4.86)in attitude dimension and(80.60±16.78)in practice dimension,with a total score of(151.78±24.27).The scores of knowledge and attitude,knowledge and practice,attitude and practice are all positively correlated(r=0.393,P＜0.001;r=0.495,P＜0.001;r=0.320,P＜0.001).The results of multiple stepwise linear regression analysis showed that gender,region,whether they had received sleep management training were the influencing factors of pediatric ICU nurses'total score of knowledge,attitude and practice towards children's sleep management(P＜0.05).Conclusion Nurses in pediatric ICU are positive about sleep management for critically ill children,but their knowledge and practice levels need to improve.Nursing managers should strengthen the theoretical knowledge and practical behavioral training of pediatric ICU nurses on child sleep management,develop scientific sleep management plans,and guide nurses to make reasonable evaluation and interventions to improve children's sleep quality.

Dimethyl oxalate is one of the occupational toxic chemicals and causes strong renal toxicity. On May 16, 2023, a patient with acute dimethyl oxalate poisoning was admitted to Dingxi People's Hospital. The patient presented with nausea, vomiting, lumbar distension, weakness, poor appetite, anuria, and rapidly progressing acute kidney injury. Renal biopsy confirmed acute oxalate nephropathy. After symptomatic supportive treatments such as blood purification, anti-oxidative stress, glucocorticoid, fluid supplementation, alkalized urine, anti-infection, controlling blood pressure, calcium supplementation and anemia correction, the patient's symptoms disappeared, and the kidney function basically returned to normal. This case suggested that the etiology of patients with acute kidney injury must be clearly identified, and renal biopsy was an important examination method. For patients suffering from acute dimethyl oxalate poisoning, comprehensive treatment based on blood purification should be performed as soon as possible, aiming to improve the prognosis.

Dimethyl oxalate is one of the occupational toxic chemicals and causes strong renal toxicity. On May 16, 2023, a patient with acute dimethyl oxalate poisoning was admitted to Dingxi People's Hospital. The patient presented with nausea, vomiting, lumbar distension, weakness, poor appetite, anuria, and rapidly progressing acute kidney injury. Renal biopsy confirmed acute oxalate nephropathy. After symptomatic supportive treatments such as blood purification, anti-oxidative stress, glucocorticoid, fluid supplementation, alkalized urine, anti-infection, controlling blood pressure, calcium supplementation and anemia correction, the patient's symptoms disappeared, and the kidney function basically returned to normal. This case suggested that the etiology of patients with acute kidney injury must be clearly identified, and renal biopsy was an important examination method. For patients suffering from acute dimethyl oxalate poisoning, comprehensive treatment based on blood purification should be performed as soon as possible, aiming to improve the prognosis.