Objective To establish and optimize a method for simultaneous determination for the contents of sodium,potassium,calci-um and magnesium ions in serum using microwave digestion combined with ion chromatography,and evaluate its performance.Methods Serum samples were pretreated by microwave digestion,and four cations were quantitatively determined using ion chromatography.The linearity,precision,recovery and accuracy of the established method were verified with reference to the EP6-A and EP15-A3 docu-ments issued by the Clinical and Laboratory Standards Institute(CLSI).Results The imprecisions of determinations for sodium,po-tassium,calcium and magnesium ions expressed as coefficient of variation(CV)were 0.10％to 0.36％,0.15％to 0.48％,0.22％to 0.87％and 0.21％to 0.73％,respectively.The recoveries with adding standard of the four cations were between 97.3％and 103.0％.Referred to RELA2020 and RELA2021,the deviations of the analysis results were-0.57％to-0.14％,-0.84％to-0.16％,-1.82％to-0.37％,and-0.60％to 0.34％for sodium,potassium,calcium,and magnesium,respectively,and all the comparisons were pas-sed.The limits of detection/quantification were 0.017 5/0.058 3 mmol/L,0.000 5/0.001 7 mmol/L,0.009 9/0.032 9 mmol/L and 0.001 1/0.003 5 mmol/L for the four cations,indicating that after pretreatment,no significantly interfere from other impurities for the results of determination was found.Conclusion A method for simultaneous determination of sodium,potassium,calcium and magnesi-um ions in serum was successfully established and optimized using microwave digestion combined with ion chromatography.The method showed good precision and accuracy,simple operation,short time consumption and low cost,thus it could be used for quality improve-ment of clinical electrolyte testing in serum.

Objective:To evaluate the effect of workshop-based incontinence associated dermatitis (IAD) training course for geriatric nurse specialists, and to provide references and evidence for the application of workshop teaching model in specialized nursing training.Methods:The convenience sampling method was used to select 40 participants in the 9th Chongqing Geriatric Nurse Specialist Training Program in May 2021 as the intervention group, and IAD training was conducted using the workshop method. The 42 participants in the 8th Chongqing Geriatric Nurse Specialist Training Program in May 2020 were selected as the control group, who received IAD training through traditional teaching methods. After the training, the achievement of teaching objectives and teaching satisfaction were compared between the two groups using questionnaire survey, and IAD nursing knowledge and attitudes were compared using scales. SPSS 27.0 was used for the t-test and chi-square test. Results:The questionnaire survey showed that the intervention group achieved higher teaching objectives in all dimensions compared to the control group ( P<0.05). Compared with the control group, the intervention group had higher scores in teaching satisfaction regarding teaching format, interest in learning, practical skills, theoretical understanding, integration of theory and practice, and problem-solving abilities ( P<0.05). Compared with the control group, the intervention group demonstrated significantly higher scores in IAD nursing knowledge [(11.32±1.56) vs. (9.02±2.26), P<0.05] and attitudes [(37.63±3.54) vs. (32.81±2.97), P<0.05]. Conclusions:The workshop training has been highly recognized by the trainees, contributing to improved implementation effectiveness of teaching, enhancing the scores of IAD nursing knowledge and attitudes. This approach offers a new perspective for training with a practical focus in the specialized nursing field.

Objective:To develop a candidate reference method for cortisol in human serum by isotope dilution liquid chromatography-tandem mass spectrometry (ID-LC/MS/MS).Methods:An isotope-labeled internal standard was added to samples, followed by alkalizing with sodium carbonate solution and liquid-liquid extraction with n-hexane/ethyl acetate. Isoelution with a methanol aqueous solution was employed for liquid chromatographic separation, while ESI in the positive ion and multiple reaction monitoring mode were used for mass spectrometry. The volume of sample, standard, and internal standard solutions were all controlled by weighing, and the results were calculated by bracketing method. The accuracy, precision, specificity, linearity, LOD and LOQ of this method were evaluated referring to the CLSI C62-A and C50-A guidelines and the domestic expert consensus documents.Results:The method demonstrated excellent accuracy and precision with the bias of ERM-DA192, ERM-DA193 and RELA 2021-2023 all being less than 2%. The recovery of added cortisol ranged from 98.2% to 101.1%. Both intra- and inter-assay imprecisions was <2%. The method was free from interference by structural analogue and showed a good linearity in the range of 25-1 600 nmol/L. The LOD and LOQ were 0.5 nmol/L and 1.0 nmol/L, respectively. A cortisol assay kit (chemiluminescence immunoassay) traced to this candidate reference method was used to determine 46 clinical serum samples concurrently, and the two methods exhibited good correlation.Conclusions:A candidate reference method for the determination of cortisol in serum was established, demonstrating high sensitivity, good repeatability and accuracy. This method can serve as a reference for the measurement traceability and accuracy evaluation of routine methods.

Objective:To investigate the application effect of virtual simulation combined with flipped classroom in experimental teaching of the nursing care of falls in the elderly.Methods:The 497 nursing undergraduates in the class of 2019 in Chongqing Medical University were selected as subjects and were then divided into control group (two classes with 251 students) and intervention group (two classes with 246 students). The students in the control group received traditional experimental teaching, and those in the intervention group received blended experimental teaching with virtual simulation combined with flipped classroom. At the end of the course, the use of virtual simulation platform was analyzed for the students in the intervention group, and a questionnaire survey and theoretical examination were used to compare the effect of experimental teaching between the two groups. SPSS 27.0 was used for the t-test and the chi-square test. Results:The frequency of use of the virtual simulation platform was (2.65±1.38) times per person in the intervention group, with an online learning time of 54.12-147.32 minutes. The questionnaire survey showed that compared with the control group, the intervention group had significantly higher scores of the achievement of teaching objectives and teaching satisfaction ( P<0.05). Compared with the control group after teaching, the intervention group had significantly higher scores of teaching promotion in terms of stimulating learning interest, cultivating self-learning ability, developing clinical thinking ability, improving innovation, and enhancing health education ability ( P<0.05). The intervention group had a significantly higher theoretical examination score than the control group [(79.38±5.09) vs. (77.88±4.97), P<0.05]. Conclusions:In the blended experimental teaching of the nursing care of falls in the elderly, virtual simulation combined with flipped classroom can help students master related knowledge and skills and cultivate their self-learning ability, clinical thinking ability, innovation ability, and health education ability.

OBJECTIVES: Patients with classical type 1 diabetes mellitus (T1DM) require lifelong dependence on exogenous insulin therapy due to pancreatic beta-cell destruction and absolute insulin deficiency. T1DM accounts for about 90% of children with diabetes in China, with a rapid increase in incidence and a younger-age trend. Epidemiological studies have shown that the overall glycated haemoglobin (HbA1c) and compliance rate are low in Chinese children with T1DM. Optimal glucose control is the key for diabetes treatment, and maintaining blood glucose within the target range can prevent or delay chronic vascular complications in patients with T1DM. Therefore, this study aims to investigate the glycemic control of children with T1DM from Hunan and Henan Province with flash glucose monitoring system (FGMS), and to explore factors associated with glycemic variability. METHODS: A total of 215 children with T1DM under 14 years old were enrolled continuously in 16 hospitals from August 2017 to August 2020. All subjects wore a FGMS device to collect glucose data. Correlation of HbA1c, duration of diabetes, or glucose scan rates with glycemic variability was analyzed. Glucose variability was compared according to the duration of diabetes, HbA1c, glucose scan rates and insulin schema. RESULTS: HbA1c and duration of diabetes were positively correlated with mean blood glucose, standard deviation of glucose, mean amplitude of glucose excursions (MAGE), and coefficient of variation (CV) of glucose (all P<0.01). The glucose scan rates during FGMS wearing was significantly positively correlated with time in range (TIR) (P=0.001) and negatively correlated with MAGE and mean duration of hypoglycemia (all P<0.01). Children with duration ≤1 year had lower time below range (TBR) and MAGE when compared with those with duration >1 year (all P<0.05). TIR and TBR in patients with HbA1c ≤7.5% were higher (TIR: 65% vs 45%, TBR: 5% vs 4%, P<0.05), MAGE was lower (7.0 mmol/L vs 9.4 mmol/L, P<0.001) than those in HbA1c >7.5% group. Compared to the multiple daily insulin injections group, TIR was higher (60% vs 52%, P=0.006), MAGE was lower (P=0.006) in the continuous subcutaneous insulin infusion group. HbA1c was lower in the high scan rates (≥14 times/d) group (7.4% vs 8.0%, P=0.046), TIR was significantly higher (58% vs 47%, P<0.001), and MAGE was lower (P<0.001) than those in the low scan rate (<14 times/d) group. CONCLUSIONS The overall glycemic control of T1DM patients under 14 years old in Hunan and Henan Province is under a high risk of hypoglycemia and great glycemic variability. Shorter duration of diabetes, targeted HbA1c, higher glucose scan rates, and CSII are associated with less glycemic variability.
Adolescent ; Blood Glucose ; Blood Glucose Self-Monitoring ; Child ; Diabetes Mellitus, Type 1/drug therapy* ; Glucose ; Glycated Hemoglobin A/analysis* ; Humans ; Hypoglycemia/prevention & control* ; Hypoglycemic Agents/therapeutic use* ; Insulin/therapeutic use*

Objective:To explore the elements of the diversified caring bank based on long-term care insurance system to provide a basis for the construction of diversified caring bank framework system.Methods:The phenomenological research method was adopted to conduct semi-structured interviews with 15 nursing management personnel in pension institutions in Suzhou and Suzhou long-term care insurance policy implementation management personnel in March to May 2021. NVivo 11 was used to manage interview data, and applied Colaizzi 7-step analysis to conduct inductive analysis and extract the themes.Results:The elements of the diversified caring bank based on long-term care insurance system were divided into three main modules: diversified caring personnel, diversified caring content and diversified incentive measures. The diversified caring personnel module included full-time and part-time caring personnel. Diversified caring content included six elements: daily life assistance, professional life caring, professional medical caring, communication and emotional support, emergency caring and special disease caring. Diversified incentive measures module included two elements: labor currency and "benefit" care currency.Conclusions:The diversified caring personnel provides continuous power for disabled caring; diversified caring content provides ways to meet the various needs of the disabled elderly; diverse incentives are effective ways to attract and stabilize the caring workforce.

【Objective】 To evaluate the associations of total fat and fatty acid consumption with the risk of hypertension among rural residents in Hanzhong, Shaanxi Province. 【Methods】 A cross-sectional survey on dietary status with a semi-quantitative food frequency questionnaire was conducted among rural residents aged between 18 and 80 years old in Hanzhong of Shaanxi. Multivariate log-binomial regression models and restricted cubic spline were used to explore the associations of dietary total fat, saturated fatty acid, polyunsaturated fatty acid and monounsaturated fatty acids with hypertension and as well as association between dose and response. 【Results】 A total of 2241 individuals were included, with 774 males and 1467 females. Monounsaturated fatty acid accounted for 51.9% of total dietary fat intake, while the other two fatty acids for 48.1%. The intake of dietary fat and any fatty acid in men was significantly in men higher than in women (P<0.001). Results of multivariable log-binomial regression indicated that after adjustment of energy, socio-demographic and lifestyles, the risk of hypertension reduced significantly in Q4 group, compared with that in Q1 (PR: 0.71, 95% CI: 0.54-0.92; P-trend: 0.022) in females. A nonlinear dose-response relationship between monounsaturated fatty acids and hypertension was detected by restricted cubic spline in women (Pnon-linear<0.01). No association was observed of total fat, saturated fatty acid and polyunsaturated fatty acid with hypertension regardless of the gender. 【Conclusion】 In women, increased consumption of monounsaturated fats might play a positive role in reducing the risk of hypertension. Further research is warranted to verify the rationality of causal inference and break-point.

Neuromyelitis optica (NMO)/NMO spectrum disorder (NMOSD) is a chronic, recurrent, antibody-mediated, inflammatory demyelinating disease of the central nervous system, characterized by optic neuritis and transverse myelitis. The binding of NMO-IgG with astrocytic aquaporin-4 (AQP4) functions directly in the pathogenesis of >60% of NMOSD patients, and causes astrocyte loss, secondary inflammatory infiltration, demyelination, and neuron death, potentially leading to paralysis and blindness. Current treatment options, including immunosuppressive agents, plasma exchange, and B-cell depletion, are based on small retrospective case series and open-label studies. It is noteworthy that monoclonal antibody (mAb) therapy is a better option for autoimmune diseases due to its high efficacy and tolerability. Although the pathophysiological mechanisms of NMOSD remain unknown, increasingly, therapeutic studies have focused on mAbs, which target B cell depletion, complement and inflammation cascade inactivation, blood-brain-barrier protection, and blockade of NMO-IgG-AQP4 binding. Here, we review the targets, characteristics, mechanisms of action, development, and potential efficacy of mAb trials in NMOSD, including preclinical and experimental investigations.

Objective To investigate the effect of nursing intervention on deep vein thrombosis after major bone trauma.Methods 59 cases of bone trauma surgery were selected as the research subjects,according to random number table method,they were randomly divided into the observation group and the control group.The patients of the control group received routine nursing care,and the patients of the observation group were given nursing intervention for postoperative deep vein thrombosis on the basis of the conventional nursing care.The pulmonary embolism,deep vein thrombosis and lower extremity swelling occurred rate before and after intervention of venous blood flow velocity, patients hospitalization time and quality of care scores were compared.Results The incidence rates of pulmonary embolism (0.0%),deep vein thrombosis (11.1%)and lower extremity swelling with postoperation (14.8%)of the observation group were significantly less than those in the control group(15.6%,53.1%,46.9%),there was signifi-cant differences (χ2 =4.61,11.54,6.89,all P <0.05).After intervention,the lower extremity venous blood flow velocity of two groups [(20.9 ±5.3)cm/s,(27.5 ±7.4)cm/s]was significantly higher than before intervention [(19.2 ±4.6)cm/s,(19.8 ±5.3)cm/s],there was statistically significant difference (t =1.37,4.40,all P <0.05).The stem prognosis of lower extremity venous blood flow velocity of the observation group [(27.5 ±7.4)cm/s]was significantly higher than (20.9 ±5.3)cm/s of the control group,there was significant difference (t =3.98, P <0.05).The hospitalization time in the observation group (45.2 ±5.4)d was less than (62.3 ±7.5)d in the con-trol group,and the nursing quality score (98.7 ±1.1)was higher than (91.8 ±1.7)in the control group,and the differences were statistically significant (t =9.88,18.12,all P <0.05).Conclusion Comprehensive nursing inter-vention can help improve venous blood flow velocity,reduce the incidence of deep vein thrombosis,shorten the hospital stay,and improve the quality of nursing.

Objective To explore the influence of self care interaction mode on the health behavior of the patients with thoracolumbar fracture.Methods 127 cases of thoracolumbar fracture were randomly divided into the observation group (62 cases)and the control group (65 cases)according to random digital table method.The patients of the observation group were given self nursing interactive nursing.The patients of the control group were given rou-tine nursing.The comparative study of the following indicators of the two groups of patients:(1)activities of daily liv-ing (ADL);(2)bedridden patient self -care skills of and self -care knowledge assessment;(3)satisfaction,compli-cations,the average length of days and discharged patient telephone visit the initiative.Results The discharge self nursing ability raise,health behavior change,self -care knowledge and self -care skills of the observation group were significantly better than the control group,there were statistically significant differences(P <0.05);after discharge from the hospital,bed incidence of complications (6.5%)of the observation group was significantly lower than the control group (18.1%),the difference was statistically significant (χ2 =4.16,P <0.05)and satisfaction degree (91.7 ±6.5)was higher than the control group (87.3 ±7.5),with statistically significant difference (t =3.59,P <0.05),and the average hospitalization day (16.11 ±7.61 )d was lower than that of the control group (19.95 ± 11.55)d,there was statistically significant difference (t =2.20,P <0.05).Conclusion Self care interactive mode is conducive to mining the self -care ability of patients,improve the self -care ability of patients,and has good social benefits.