Objective:To construct a risk assessment model based on hesitant probabilistic fuzzy set(HPFS)and to explore its application value in the risk control and management of safe operation of anesthesia equipment.Methods:Taking the whole life cycle safety and management safety as the important risk assessment dimensions,the risk index system of safe operation of anesthesia equipment was constructed,HPFS and hierarchical-superior-inferior solution distance method were used to realize the quantitative analysis of risks,and the safety self-inspection and risk control treatment strategies were formulated.A total of 150 surgical patients and 16 anesthesia equipment used in surgery used in the operation were selected from July 2020 to June 2023 in Tongzhou District Maternal and Child Health Hospital,and into control group and observation group according to different management modes of anesthetic equipment,with 75 cases in each group.The 10 anesthesia machines used during the surgical treatment of the control group adopted the conventional risk control mode,and the 12 anesthesia machines used in the observation group(including 6 in the control group and the 6 newly added ones)adopted the risk assessment control mode.The incidence of perioperative anesthesia equipment-related risk events,the awareness rate of anesthesia medical staff about potential safety risks,and the failure rate of anesthesia equipment were compared between the two groups.Results:The number of perioperative risk events of improper operation of anesthesia equipment,unreasonable dosage of anesthesia,associated infection and missing records in the observation group were 4 cases(5.3%),0 cases(0%),1 case(1.3%)and 1 case(1.3%),respectively,which was lower than that in the control group,the difference was statistically significant(x2=4.478,4.110,6.857,4.754;P<0.05).The average scores of theoretical knowledge of safety management,safe use,management awareness and fault judgment ability of medical staff operating anesthesia equipment in the observation group were(96.27±3.93)points,(94.31±2.69)points,(91.82±1.94)points and(84.97±4.36)points,respectively,which were higher than those in the control group,the difference was statistically significant(t=5.176,5.322,5.541,5.942;P<0.05).The total number of equipment operation setting,anesthetic gas path,anesthesia depth monitoring,threshold alarm and other faults in the two groups were 90,37,25,316 and 125,respectively,and the failure incidence rates in the observation group were 30%(27/90),35%(13/37),28%(7/25),22%(69/316)and 39%(49/125),respectively,which were lower than those in the control group,the difference was statistically significant(x2=28.800,6.541,9.680,200.532,11.664;P<0.05). Conclusion:The risk assessment model based on HPFS can reduce the incidence of risk events related to anesthesia equipment,enhance the awareness of safety risk control of anesthesia medical staff,and improve the quality of clinical operation of anesthesia equipment.

OBJECTIVE To investigate the effects of omeprazole on pharmacokinetic parameters of imatinib in rats. METHODS According to body weight， the rats were divided into imatinib+low-dose， medium-dose， and high-dose omeprazole groups， imatinib group， with 6 rats in each group. They were given omeprazole suspension at the doses of 1.8， 3.6 and 7.2 g/kg， or 0.5% sodium carboxymethyl cellulose solution intragastrically respectively； one hour later， imatinib suspension was administered by oral gavage at a the dose of 10 mg/kg. Blood sample （100 μL） was taken from the orbit before and 0.5， 1， 2， 2.5， 3， 4， 5， 6， 8， 12， 24 and 36 hours after intragastric administration of imatinib. Using imatinib-d3 as internal standard， the plasma concentrations of imatinib and its metabolite N-desmethyl imatinib in rat were determined by high performance liquid chromatography-tandem mass spectrometry. The pharmacokinetic parameters were calculated by DAS 2.0 software and compared. RESULTS Compared with imatinib group， AUC0－∞ and AUMC0－∞ of imatinib in rat plasma of imatinib+medium-dose omeprazole group， cmax， t1/2， AUC0－∞ and AUMC0－∞ of imatinib in rat plasma of imatinib+high-dose omeprazole group were all increased or prolonged significantly （P＜0.05）. Compared with imatinib group， AUC0－∞ and AUMC0－∞ of N-desmethyl imatinib in rat plasma of imatinib+medium-dose omeprazole group， and cmax and AUC0→∞ of N-desmethyl imatinib in rat plasma of imatinib+high-dose omeprazole group were decreased significantly （P＜0.05）. CONCLUSIONS Omeprazole may increase the plasma concentration of imatinib in rats and reduce the plasma concentration of N-desmethyl imatinib in rats， which may be associated with inhibiting the metabolism of imatinib.

Objective:To revise and evaluate the reliability and validity of the Healthcare Provider Perceptions of Team Effectiveness (Provider-PTE) .Methods:The English version of the Provider-PTE was translated literally and back in accordance with the Brislin translation principles. Questionnaire culture debugging and item revision were conducted through Delphi method and pre-survey. In March 2022, a survey was conducted among 641 nurses from two ClassⅢ Grade A hospitals in Qingdao to test the reliability and validity of the questionnaire. A total of 641 questionnaires were distributed, and 605 valid questionnaires were recovered, with an effective recovery rate of 94.4%.Results:The Chinese version of Provider-PTE included five dimensions, including role development, team support, team meetings, team operations, and care outcomes, with a total of 26 items. Through exploratory factor analysis, the cumulative variance contribution rate of the five common factors was 84.783%. The average scale content validity index of the Provider-PTE was 0.928, and the item content validity index was 0.875 to 1.000. The Cronbach's α coefficient of the Chinese version of Provider-PTE was 0.859, and the retest reliability was 0.873.Conclusions:The Chinese version of Provider-PTE has good reliability and validity, and can be used to assess the team effectiveness of nursing staffs.

Objective:To explore the of short-term psychodynamic psychotherapy on anxiety and depression of gout patients and its influence on well-being index, family function and compliance.Methods:60 gout patients were selected from June 2018 to December 2019 in the outpatient department of rheumatism and immunity department of Dongguan Kanghua Hospital by prospective case-control study. They were randomly divided into control group and treatment group, 30 cases respectively. Both groups were given gout related clinical treatment and routine nursing, and the treatment group was given short-term dynamic orientation psychotherapy. The treatment compliance, the psychological status, well-being index and blood uric acid (UA) level of the two groups were compared before intervention, immediately after intervention and 3 months after intervention.Results:The scores of Patient Health Questionnaire-9 (PHQ-9) and the generalized anxiety disorder 7-item scale (GAD-7) in the two groups were gradually decreased immediately and 3 months after intervention ( P<0.05), and the scores of well-being index were gradually increased ( P<0.05); Compared with the control group, the scores of PHQ-9 and GAD-7 in the treatment group decreased more significantly ( P<0.05), and the score of well-being index increased more significantly ( P<0.05); The scores of communication, behavior control and total function of family function in the treatment group decreased gradually immediately after intervention and 3 months after intervention ( P<0.05), and were significantly lower than those in the control group ( P<0.05); The level of serum UA in the two groups decreased gradually immediately after intervention and 3 months after intervention ( P<0.05), but there was no significant difference in UA level at each time point between the two groups. The treatment compliance of the treatment group was significantly better than that of the control group ( P<0.05). Conclusions:The short-term dynamic orientation psychotherapy for gout patients has obvious effect in improving the state of anxiety and depression, improving the index of well-being, family function and treatment compliance.

OBJECTIVE：To establish a method for the determination of pyrrotinib concentration in plasma ，and apply it in clinic. METHODS ：After precipitated with methanol ，the plasma sample was determined by LC-MS/MS using imatinib as internal standard. The determination was performed on Ultimate AQ-C 18 column with mobile phase consisted of methanol （containing 0.1％ formic acid ）and water （containing 0.1％ formic acid ）（gradient elution ）at the flow rate of 0.4 mL/min. The column temperature was 40 ℃，and the sample size was 5 µL. The ion source was electrospray ionization source ，and the positive ion scanning was carried out in multiple reaction mode. The ion pairs for quantitative analysis were m/z 583.4→138.3（pyrrotinib）and m/z 494.5→ 393.4（internal standard ），respectively. Thirty breast cancer patients taking pyrrotinib were collected from the Affiliated Hospital of Qingdao University during Jun.-Nov. 2020 to determine their steady-state trough concentrations of pyrrotinib after a week of treatment. RESULTS ：The linear range of pyrrotinib were 5-300 ng/mL（r＝0.999 3）. The lower limit of quantification was 5 ng/mL. RSDs of intra-day and inter-day were not higher than 9.30％，and relative errors （REs）ranged －6.70％-5.04％. REs of stability tests were in the range of －1.92％-5.42％. The extraction method ，matrix effect and residual effect did not affect the quantitative analysis of the substance to be tested. The steady-state trough concentrations of pyrrotinib were 32.6-82.8 ng/mL，with an average plasma concentration of 53.8 ng/mL；there was about 2.54 fold individual difference. CONCLUSIONS ：Established LC-MS/MS method is simple ，sensitive and accurate ，and can be used for the plasma concentration monitoring of pyrrotinib in breast cancer patient.

Objective:To translate and revise the Quality of Life Questionnaire for Women with Gestational Diabetes Mellitus (GDMQ-36) , and test its reliability and validity.Methods:Brislin translation mode was used to translate the GDMQ-36 forward and back. Cultural adjustment and revision of the translated questionnaire were conducted through Delphi method and pre-survey method to form GDMQ-34. From January to May 2020, the questionnaire was used to conduct quality of life survey on 220 patients with gestational diabetes mellitus (GDM) in the Obstetrics Department of four ClassⅢ Grade A hospitals in Qingdao to evaluate its reliability and validity.Results:A total of 220 questionnaires were issued and 203 were effectively returned, with an effective recovery rate of 92.3%. The Chinese version of GDMQ-34 had 34 items, including 6 dimensions of pregnancy worry, behavioral restraint, physical symptoms, psychological symptoms, medications and social support. The total Cronbach's α coefficient of the Chinese version of GDMQ-34 was 0.772, and the test-retest reliability was 0.820, and the Cronbach's α coefficients of each dimension were 0.855, 0.902, 0.868, 0.880, 0.896 and 0.880 respectively. The content validity index at the average scale level of the questionnaire was 0.982, and the content validity index at the item level was from 0.867 to 1.000. The exploratory factor analysis extracted 7 common factors, and the cumulative variance contribution rate was 68.591%.Conclusions:The Chinese version of GDMQ-34 has good reliability and validity, and it is scientific and practical, and can be used as a simple tool for evaluating the quality of life of patients with GDM.

When facing a sudden danger or aversive condition while engaged in on-going forward motion, animals transiently slow down and make a turn to escape. The neural mechanisms underlying stimulation-induced deceleration in avoidance behavior are largely unknown. Here, we report that in Drosophila larvae, light-induced deceleration was commanded by a continuous neural pathway that included prothoracicotropic hormone neurons, eclosion hormone neurons, and tyrosine decarboxylase 2 motor neurons (the PET pathway). Inhibiting neurons in the PET pathway led to defects in light-avoidance due to insufficient deceleration and head casting. On the other hand, activation of PET pathway neurons specifically caused immediate deceleration in larval locomotion. Our findings reveal a neural substrate for the emergent deceleration response and provide a new understanding of the relationship between behavioral modules in animal avoidance responses.

OBJECTIVE： To study the effects of Wuzhi soft capsule and imatinib mesylate tablet on the pharmacokinetics of imatinib in rats. METHODS： The rats were divided into single administration group and consecutive administration group. The single administration group was divided into imatinib group one （ig administration of blank soybean oil+imatinib suspension 10   mg/kg）， low-dose， medium-dose and high-dose of Wuzhi soft capsule+imatinib group （ig administration of Wuzhi soft capsule solution 134， 268， 536 mg/kg+imatinib suspension 10 mg/kg）， with 6 rats in each group. Each group was given imatinib suspension intragastrically 30 min after intragastric administration of blank soybean oil/Wuzhi soft capsule solution. The consecutive administration group was divided into imatinib group two （ig administration of blank soybean oil+imatinib suspension 10 mg/kg）， Wuzhi soft capsule low-dose+imatinib group （ig administration of Wuzhi soft capsule solution 134 mg/kg+imatinib suspension 10 mg/kg）， with 6 rats in each group. Each group was given blank soybean oil/Wuzhi soft capsule solution intragastrically for consecutive 14 d， once a day； 30 min after last administration， ig imatinib suspension. About 100 μL blood was collected before imatinib， 0.5， 1， 2， 2.5， 3， 4， 5， 6， 8， 12， 24 and 36 h after medication. The plasma concentration of imatinib was determined by HPLC-MS/MS. The pharmacokinetic parameters were fitted by using DAS 2.0 software. RESULTS： After single administration， compared with imatinib group one， cmax， t1/2， AUC0-36 h and AUMC0-36 h in low-dose， medium-dose and high-dose of Wuzhi soft capsule+imatinib group were increased significantly （P＜0.05 or P＜0.01）. After consecutive administration， compared with imatinib group two， cmax， t1/2 and AUMC0-36 h of imatinib+low-dose of Wuzhi soft capsule group were increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS： Single administration and consecutive administration of Wuzhi soft capsule influence the pharmacokinetics of imatinib， increase plasma concentration of imatinib and prolong half-time.

OBJECTIVETo compare the effects of acupuncture based on nourishing spleen and kidney and dre-dging the governor vessel (GV) combined with rehabilitation and simple rehabilitation for children with spastic cere-bral palsy.

METHODSOne hundred and twenty patients were randomly assigned into an observation group and a control group, 60 cases in each one. Physicotherapeutics and hand function training were used in the control group for 3 sessions with 20 d at the interval, 20 times as one session, once a day. Based on the treatment of the control group, acupuncture of nourishing spleen and kidney and dredging GV was applied in the observation group for 3 sessions with 20 d at the interval, 10 times as one session, once every other day. The acupoints were Baihui (GV 20), Fengfu (GV 16), Shenzhu (GV 12), Zhiyang (GV 9), Jinsuo (GV 8), Yaoyangguan (GV 3), Mingmen (GV 4), Pishu (BL 20), Shenshu (BL 23), Zusanli (ST 36) and Sanyinjiao (SP 6). Gross motor function measure (GMFM), Peabody developmental fine motor scale and activities of daily living (ADL) scale were observed before and after treatment in the two groups.

RESULTSAfter treatment, the scores of GMFM and Peabody fine motor were apparently improved compared with those before treatment in the two groups (<0.01,<0.05), with better results in the observation group (both<0.05). The total effective rate in the observation group was 76.7% (46/60), which was obviously better than 65.0% (39/60) in the control group (<0.05).

CONCLUSIONSAcupuncture based on nourishing spleen and kidney and dredging the governor vessel, as an assisted method for children with spastic cerebral palsy, can effectively improve gross and fine moter functions and activities of daily living.

Objective To discuss the clinical characteristics and efficacy analysis of children with cerebral palsy and neuronal migration disorders (NMD) by retrospective analysis. Methods From June, 2005 to June, 2015, 32 children with cerebral palsy and NMD were en-rolled as NMD group, while 60 children with cerebral palsy with periventricular leukomalacia (PVL) as PVL group. Both groups received comprehensive rehabilitation for three months. Their clinical classification, complications of epilepsy or epileptiform discharges, the score of Gross Motor Function Measure (GMFM), and development quotient (DQ) were compared, as well as the follow-up results of six months. Results There was significant difference in the clinical classification of cerebral palsy between two groups (χ2=24.529, P<0.001). The inci-dence of epilepsy and epileptiform discharges was higher in NMD group than in PVL group (χ2>4.605, P<0.05). After treatment, the score of GMFM improved with time in both groups (Ftime=6.850, P=0.010), and was significantly lower in NMD group than in GMFM group (Fgroup=29.885, P<0.001);the scores of DQ in all the functional areas improved with time in both groups (Ftime>25.041, P<0.001), and were signifi-cantly lower in NMD group than in GMFM group (Fgroup>32.347, P<0.001). Conclusion Children with cerebral palsy and NMD are charac-terized by mental retardation, epilepsy and spastic hemiplegia, and poor outcome.