In recent years, the prevalence of gestational diabetes mellitus (GDM) has significantly increased, leading to various adverse outcomes for mothers and their offspring. Early diagnosis and good blood glucose control can significantly improve pregnancy outcomes. Currently, the diagnosis of GDM mainly relies on the oral glucose tolerance test (OGTT), but there are many limitations in clinical application. The new biological marker glycosylated CD59 is a glycosylation product of complement regulatory proteins that can stably exist in body fluids and is linearly related to blood glucose levels, which has the advantages of simple testing and good reproducibility, and has been developed into a stable reagent kit. It has shown good value in the early diagnosis, standard diagnosis, and prediction of pregnancy outcomes of GDM.

Objective To investigate the impact of the Shared Medical Appointment (SMA) model on blood glucose levels and self-management behaviors in patients with gestational diabetes mellitus (GDM). Methods A total of 87 pregnant women diagnosed with GDM at the Obstetrics and Gynecology and Endocrinology Outpatient Departments of the Affiliated Suqian Hospital of Xuzhou Medical University from October 2021 to October 2022 were enrolled and divided into treatment group (n=44) and control group (n=43). The treatment group received SMA-based GDM management, while the control group underwent routine outpatient follow-up. Baseline data, flash glucose monitoring (FGM)-related indicators before and after treatment, and self-management behavior scale scores were compared between the two groups. Results No statistically significant differences were observed between the two groups in age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), blood urea nitrogen (BUN), creatinine (Cr), uric acid (UA), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and glycated hemoglobin (HbA1c) (P>0.05). After treatment, the time in range (TIR) of glucose was higher in the treatment group than that in the control group, while mean amplitude of glycemic excursions (MAGE), standard deviation of blood glucose (SDBG), coefficient of variation (CV), and mean blood glucose (MBG) were lower in the treatment group (P < 0.05). Within the treatment group, post-treatment TIR was higher, and MAGE, CV, SDBG, and MBG were lower than pre-treatment levels (P < 0.05). In the control group, post-treatment TIR was higher, and SDBG and MBG were lower than pre-treatment levels (P < 0.05). After treatment, the total score and scores for dietary management, exercise management, medication management, and blood glucose monitoring management in the self-management behavior scale were significantly higher in the treatment group than in the control group (P < 0.05). In the treatment group, post-treatment scores for all self-management behaviors were higher than pre-treatment levels, while post-treatment total scores and scores for medication management and blood glucose monitoring management in the control group were higher than pre-treatment levels (P < 0.05). Conclusion SMA management model can comprehensively improve blood glucose levels and enhance self-management behavior capabilities in GDM patients.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.

Since the outbreak of COVID-19, the hospital is faced with such challenges as sustained input in patient screening, referral and rescue, supportive medical supplies including the management of personal protective supplies and the maintenance of medical equipment. In the face of increasing workload, the medical materials support team of the hospital took the following measures in the principles of " discovering new sources of supplies and minimizing consumption" . These measures taken include proactive supply procurement strategy, prioritizing allocations based on risk exposure, uniform distribution of supplies based on inventory and usage, and traceable management for donated supplies; optimal and central deployment of equipments, emergency installation, pre-maintenance and emergency repairs for equipments; efficient and safe sterilization of reusable materials and equipments using sterilizers; enhanced personnel training and management to keep updating the medical supplies capacity of the team. All these efforts have contributed significantly to the orderly work of epidemic control.

Objective: To explore the risk factors of deep venous thrombosis(DVT) in lower limbs of orthopedic inpatients, and provide reference for clinical nursing and prevention of thrombosis. Methods: A retrospective case-control approach was used in this study. A total of 148 orthopedic inpatients diagnosed with DVT in the First Affiliated Hospital of Soochow University from February 2014 to October 2018 were selected as the case group. At the same time, 148 orthopaedic inpatients with undiagnosed DVT in the same Department were randomly selected as the control group. The electronic medical history data and related laboratory examination indexes of the two groups of patients during hospitalization in Orthopedics Department were analyzed retrospectively. Gender, age, seven indicators of blood coagulation, as well as history of hypertension, diabetes, history of DVT and other common risk factors of DVT in the two groups were statistically analyzed. Results: In the case group, 63 patients (42.5%) DVT developed in the right lower extremity. The differences in the clinical symptoms and characteristics of fever, pulmonary infection, cough, expectoration, chest distress and shortness of breath, pleural effusion and constipation between the two groups were statistically significant (χ² value was 5.688-12.312, P<0.01 or 0.05). Single factor analysis of related risk factors showed the differences of age, type of injury, lower limb joint replacement, a plaster cast, hypertension, history of DVT, central venous catheter, D-dimer and preoperative albumin levels, fibrinogen degradation products, and red blood cell count between the two groups were statistically significant (t value was-7.275-3.998, χ² value was 4.889-13.305, Z value was-3.500--3.454, P < 0.01). Multivariate Logistic regression analysis showed that lower limb joint replacement(OR=0.383, 95%CI0.190-0.773), cough (OR=0.085, 95%CI0.010-0.731), chest distress and shortness of breath (OR=0.240, 95%CI0.077-0.745), constipation (OR=0.312, 95%CI0.135-0.718), red blood cell count (OR=3.314, 95%CI 2.105-5.216), hypertension (OR=0.534, 95%CI0.292-0.976) were independent risk factors for DVT formation in orthopedic inpatients (P<0.01 or 0.05). Conclusions DVT in orthopedic inpatients is a common result of multiple factors, among which, lower limb joint replacement, cough, chest distress and shortness of breath, constipation, red blood cell count and hypertension are independent risk factor, which should be monitored and given preventive care.

Objective To evaluate the effective e measures of the prevention and treatment of venous thrombosis in hospital and evaluate the effect of"antibolt work"in patients with multidisciplinary cooperation. Methods Compare the level of venous thromboembolism (VTE) incidence, average hospital day, patient satisfaction and the level of knowledge of medical staff in the high risk department of VTE. Results After intervention in high-risk departments staff VTE related knowledge level improved, 2013 high- risk departments medical staff about the basic knowledge, risk assessment, VTE prevention knowledge of three dimensional awareness were 34.7％ (26/75), 49.3％ (37/75), 32.0％ (24/75), respectively, 2016 were 56.0％(42/75), 69.3％(52/75), 90.7％(68/75), respectively, two groups compare the difference was statistically significant (χ2=6.887, 6.217, 54.423, P<0.01 or 0.05). Reduced incidence of VTE 2 groups, 2013 annual incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) were 31.7％ (38/120), 11.7％ (14/120), respectively, in 2016 the annual incidence of DVT and PE were 14.2％(17/120), 4.2％(5/120), respectively, two groups compare the difference was statistically significant (χ2 =10.402, 4.630, P<0.01 or 0.05). VTE in 2016 patients with high-risk departments the average hospitalization time significantly below 2013, 2013 was (18.3 ± 3.5) days while 2016 was (12.7 ± 2.9 )days, two groups compare the difference was statistically significant (t = 13.496, P < 0.01). In 2016, the satisfaction rate of patients with VTE was higher than that in 2013, 77.5％(93/120) in 2013, 90.8％(109/120) in 2016, and the difference between the two groups was statistically significant (χ2=8.004, P=0.005). Conclusion The prevention and control of venous thrombosis based on multi-disciplinary integration is effective in preventing the occurrence of thrombosis in hospitalized patients and is worthy of clinical promotion.

Objective To investigate the self-perceived burden (SPB) of diabetic retinopathy (DR) patients after diabetic retinopathy and its influencing factors, and analyze the correlation between them. Methods Self-designed general questionnaire and self-rating questionnaires including SPB scale, etc. were used in the survey. All survey information was imported into Excel database. SPSS 18.0 statistical software was used for the descriptive analysis, single-factor analysis and multiple-factor analysis. Results The average SPB score of DR patients after surgery was (28.22±7.11) points, and was in a mild level. Working condition, children condition, the time span since diagnosis and the knowledge of vitrectomy all had positive effect on SPB. Conclusions The SPB of DR patients after surgery is at a mild level. The SPB of patients after DR surgery is mainly influenced by their working condition, children condition, the time span since diagnosis and the knowledge of vitrectomy.

Objective To establish thyrotropin( TSH) and thyroid hormones reference ranges during the neonatal period for the healthy term newborns in Suqian. Methods Blood samples from a heel-prick were collected from 500 healthy newborns 72 hours after birth to determine the level of TSH. 200 healthy newborns were chosen to determine the levels of serum TSH and thyroid hormones on the 14th day of life, and then compared with the results from 120 healthy adults. Results The reference range of TSH at 72 hours after birth was 0. 46-6. 59 mIU/ L. The reference ranges of TT3 , TT4 , TSH, FT3 , FT4 on the 14th day of life were 1. 10-2. 62 nmol/ L, 81. 10-158. 28 nmol/ L, 0. 83-6. 39 mIU/ L, 3. 76-6. 66 pmol/ L, and 10. 67-22. 27 pmol/ L, respectively. There was no significant difference in the interval of TSH between newborns and adluts, whereas there were significant difference in the intervals of TT3 , TT4 , FT3 , and FT4 between the two groups. Conclusions The establishment of TSH and thyroid hormone reference ranges during the neonatal period for the healthy term newborns could improve our understanding of the thyroid function during the neonatal period for the healthy term newborns, and our data suggests lowing the initiatory screening cut-off point of congential hypothyroidism.

Objective To explore the effects of training evaluation cycle mode applied for enhancement of core competence of nurses in Ophthalmic Operating Room .Methods A total of 60 nurses were assessed evaluation of training requirements , training plans , training implementation and training results by using training evaluation cycle mode , and promptly revised scheme based on the assessment results .The investigation had been carried out for nurses′professional knowledge , skills and comprehensive ability , satisfaction of nurses , doctors and patients in 2011 , 2012 and 2013 .Results Professional knowledge and skills , comprehensive response ability gained (84.63 ±4.69),(83.27 ±3.79) and (88.67 ±4.66),which were all statistically higher than those in 2011 and 2012 (F=20.24, 14.30, 32.45;P<0.01).The satisfactions of nurses, doctors and patients had no statistical difference between 2011 and 2012 (P >0.05), but had statistical difference between 2012 and 2013 (P<0.05).Conclusions Training evaluation cycle mode is feasible to improve the core competence of nurses in Ophthalmology Operation Room .

Objective To explore the effects of directive game in preoperative visit of preschool children with strabismus.Methods 109 children were randomly assigned into the control group and the experimental group.The control group was given conventional preoperative interview,based on the general preoperative visit,the experimental group was given preoperative visit-playing directive game.The nursing effect was compared be4wecn two groups.Results Induction compliance scores of the experimental group were obviously higher than those of the control group.Preoperative anxiety scores of the experimental group were obviously lower than those of the control group.Restlessness during recovery of the experimental group was obviously lower than that of the control group.Conclusions The application of directive game can reduce preoperative anxiety of the children with strabismus,and make children cooperate better with the induction of anesthesia.