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.

AIM: To assess the gap between the peak of the base curve to the surface of the cornea, as well as examines the correlation between the thickness of the tear film and the fitting of the orthokeratology lens through optical coherence tomography(OCT), providing an intuitive and quantitative clinical evaluation method for the fitting of the orthokeratology lens.METHODS: Myopia patients who fitted orthokeratology at our hospital from January to December 2023 were included. Examinations, including naked vision, slit lamp, non-contact intraocular pressure, ocular fundus, eye position, corneal diameter, corneal topography, tear film rupture time, optometry, etc., were performed on all patients before fitting. The trial lens parameter was selected according to the examination results, and fluorescein staining was performed to evaluate lens fitting state after patients adapted to wearing glasses. According to the performance of fluorescein staining, the inspected eyes are divided into three groups: lens loose group, lens fitting group, and lens tight group. In addition, the tear film thickness of three groups of subjects was measured by OCT, and the differences between the three groups of data were evaluated.RESULTS: A total of 49 myopic patients(77 eyes)were included. The average sphere degree was -3.10±1.25 D, the average cylinder degree was -0.43(-0.75, 0)D, the average horizontal keratometry(HK)was 42.48±0.81 D, and vertical keratometry(VK)was 42.98(42.25, 43.50)D. There were 21 cases(34 eyes)in the lens fitting group, with 13 cases of bilateral eyes, 8 cases of one eye, 14 cases(22 eyes)in the lens loose group, with 8 cases of bilateral eyes, 6 cases of one eye, and 14 cases(21 eyes)in the lens tight group, with 7 cases of bilateral eyes, 7 cases of one eye. There was no statistical difference in the main basic data of the subjects in the three groups(all P>0.05). OCT showed that the tear film thickness of the lens fitting group, the lens loose group, and the lens tight group was 231.18(219.0, 243.0), 220.41(214.0, 224.3), and 249.00(241.5, 258.0)μm, respectively, and there was statistical significance in the thickness among the three groups(P<0.05).CONCLUSION: OCT can serve as a safe and reliable method for measuring the tear film thickness, which can help evaluate the suitability of orthokeratology and provide a non-invasive, more intuitive, and quantitative evaluation method for the fitting and evaluation of orthokeratology.

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.

Objective To assess the clinical efficacy of butylphthalide sequential therapy(BST)as an adjuvant therapy for delayed onset encephalopathy caused by acute carbon monoxide poisoning(DEACMP).Methods DEACMP patients who visited the department of neurology at Yan'an People's Hospital from January 2018 to June 2023 were selected as the research subjects.Using a random number table method,DEACMP patients were randomly divided into hyperbaric oxygen therapy(HBOT)group,glucocorticoid(GC)group(GC combined with,HBOT),and BST group(HBOT,GC combined with BST),all of which were treated continuously for 30 days.The incidence of adverse reactions and clinical efficacy during the treatment among three groups of DEACMP were observed and compared.Inflammation indicators,neurological damage indicators,cognitive function,neurological function,and daily living ability before and after treatment among three groups were compared.Results A total of 120 patients were included in the study,with 40 patients in each group.During the treatment period,no serious adverse reactions were observed in any of the three groups of patients,and no patient terminated treatment due to adverse reactions.The total effective rate of BST group was significantly higher than those of GC group and HBOT group,while the total effective rate of GC group was higher than that of HBOT group(P<0.05).Before treatment,there was no statistically significant difference(P>0.05)in the scores of inflammation indicators,neurological damage indicators,cognitive function,neurological function,and daily living function among the three groups.After treatment,the serum LP-PLA2,SIRI,TNF-α,S100-β,and the NSE levels decreased compared to before treatment(P<0.05),and the indicators of the BST group was lower than those of the HBOT group and GC group,while the indicators of the GC group was lower than those of the HBOT group(P<0.05).After treatment,the MMSE,MoCA,and BI scores of the three groups increased compared to before treatment(P<0.05),but the NIHSS score decreased(P<0.05).In addition,the MMSE,MoCA,and BI scores of the BST group were higher than those of the HBOT and GC groups(P<0.05),while the NIHSS scores were lower than those of the HBOT and GC groups(P<0.05).The MMSE,MoCA,and BI scores in the GC group were higher than those in the HBOT group,while the NIHSS scores were lower than those in the HBOT group(P<0.05).Conclusion Compared with HBOT treatment and HBOT combined with GC treatment,BST adjuvant therapy can improve the clinical efficacy,inflammatory status,cognitive function,and daily living ability of DECAMP patients.

Objective:To investigate the current status of therapeutic relationships, organizational support, and compassion fatigue among psychiatric nurses, and to analyze the mechanism of action between these variables.Methods:This was a cross-sectional study. From August to September 2023, totally 310 psychiatric nurses were selected from three ClassⅢ Grade A psychiatric hospitals in Qingdao, Jinan, and Linyi by convenience sampling. Data were collected using a general information questionnaire, the Therapeutic Relationship Assessment Scale-Nurse (TRAS-N), the Perceived Organizational Support Scale (POSS), and the Chinese version of Compassion Fatigue short Scale (CCFS). SPSS 22.0 and the Process macro plugin were used for data analysis.Results:A total of 310 questionnaires were distributed, with 282 valid responses, yielding a response rate of 90.97%. The total score for TRAS-N among the 282 psychiatric nurses was (95.59±18.75), the total score for CCFS was 45.50 (24.75, 68.25), and the total score for POSS was (43.66±13.34). Therapeutic relationships were positively correlated with organizational support and negatively correlated with compassion fatigue, while organizational support was negatively correlated with compassion fatigue (all P< 0.01). Organizational support had a direct positive effect on therapeutic relationships (β=0.291, P<0.01) and also had an indirect effect through the mediating effect of compassion fatigue (β=0.212, P<0.01), with the mediation effect accounting for 42.15% of the total effect. Conclusions:Compassion fatigue partially mediates the relationship between organizational support and therapeutic relationships in psychiatric nurses. Nursing managers should enhance organizational support for psychiatric nurses to reduce their levels of compassion fatigue, thereby improving therapeutic relationships.

Objective:To identify the risk factors, and develop and validate a risk prediction model for abnormal bone mass in end-stage renal disease (ESRD) patients.Methods:It was a retrospective cross-sectional study. The clinical and laboratory data of ESRD patients who were hospitalized in the Department of Nephrology, Zhongda Hospital Affiliated to Southeast University from January 2022 to May 2023 were collected retrospectively. The patients were randomly divided into training and validation cohorts at a ratio of 7∶3. They were further divided into normal and abnormal bone mass groups according to the T value measured by dual-energy X-ray absorptiometry (DXA). Then, backward stepwise regression and least absolute shrinkage and selection operator (LASSO) were respectively used to develop the risk prediction model for abnormal bone mass in ESRD patients. Akaike information criterion (AIC), bayesian information criterion (BIC), and accuracy were used to evaluate the performance of these two models, after which the preferable model was selected. Moreover, the receiver operating characteristic (ROC) curve, calibration curve, Hosmer-Lemeshow test, and decision curve analyses (DCA) were applied to evaluate the diagnostic performance of the preferable model. Finally, a dynamic nomogram for individual assessment was constructed based on the preferable model.Results:A total of 254 ESRD patients were enrolled, including 160 (63.0%) males, 161 (63.4%) hemodialysis patients, and 202 (79.5%) patients with abnormal bone mass. There was no significant difference in the prevalence of abnormal bone mass between training group ( n=178) and validation group ( n=76) (79.2% vs. 80.3%, χ2=0.036, P=0.849). The final variables and variable parameters included in the LASSO and stepwise regression models were the same, which were five variables: age, body mass index, hypertension, diabetes, and osteocalcin. Both models also had the same AIC, BIC, and accuracy in the training group, which were 113.45, 132.54, and 0.837, respectively. Therefore, the LASSO model and the stepwise regression model performed consistently in this study and could be considered as the same model, hereafter referred to as the Model. The Model's area under the ROC curve in the training and validation groups was 0.923 (95% CI 0.884-0.963) and 0.809 (95% CI 0.675-0.943), respectively. The optimal cutoff for the training group was 0.858, with a sensitivity of 0.801, a specificity of 0.973 and an accuracy of 0.837; when this cutoff value was taken, the validation group's sensitivity was 0.689, specificity was 0.800, and accuracy was 0.711. The Model demonstrated excellent performance in the calibration curve, Hosmer-Lemeshow test ( P>0.05), and DCA. Finally, based on the five predictors of the Model, a dynamic nomogram was created for clinicians to enter baseline clinical parameters for early identification of high-risk patients with abnormal bone mass. Conclusions:A dynamic nomogram for abnormal bone mass in ESRD patients is constructed with good predictive performance based on the prediction model, which can be used as a practical approach for the personalized early screening and auxiliary diagnosis of the potential risk factors and assist physicians in making a personalized diagnosis for patients.

The purpose of this paper is to review the relationship between dietary inflammatory index and mental disorders， so as to provide references for nutritional interventions for patients with mental disorders. The high disability rate and intractability of mental illness bring huge economic burden and medical pressure to patients' families and society. Dietary nutrition is crucial to the rehabilitation of mental illness. As a new type of index to measure food pro-inflammatory index， dietary inflammatory index is closely related to the occurrence and development of mental illness. Therefore， this paper reviews the development， calculation and correlation with mental illness of dietary inflammatory index.

Objective:To study the application of scenario simulation teaching combined with modular training in nursing education of medical rescue in manned space flight.Methods:Twenty nurses from the medical rescue team of Strategic Support Force Characteristic Medical Center were selected as the research objects. The research objects were randomly divided into the scenario simulation combined with practical training group (practical training group, n=10) and traditional teaching group (control group, n=10). Scenario simulation teaching combined with modular training and traditional teaching were used to carry out nursing training. After the training, theoretical assessment, operation assessment and satisfaction survey were organized. Results:The scenario simulation teaching combined with modular training group was significantly better than the traditional training group in theory assessment, operation assessment and satisfaction survey of nursing staff (all P<0.05). Conclusions:Scenario simulation teaching combined with modular training has obvious teaching effect, which can improve the ability and quality of nursing staff, and help to complete the manned space medical rescue mission efficiently.

Objective To retrieve,appraise and integrate the relevant evidence of non-pharmacological sleep management measures in critically ill children.Methods We conducted a systematical search on the topic of non-pharmacological sleep management measures in critically ill children across multiple databases,including BMJ best practice,UpToDate,International Guidelines International Network,National Institute for Health and Care Excellence,Scottish Intercollegiate Guidelines Network,Registered Nurses'Association of Ontario,Joanna Briggs Institute Library,the American Academy of Sleep Medicine,International Pediatric Sleep Association,CNKI,WanFang database,VIP database,SinoMed,Cochrane Library,PubMed,Web of Science,and CINAHL.The literature retrieval time limit was from the establishment of the database to February 2023.The study design includes clinical practice guideline,evidence summary,clinical decision-making,expert consensus,and systematic review.The evidence was extracted and summarized according to the subject after the independent literature quality evaluation by 2 researchers.Results 10 relevant pieces of literature were identified,including 2 guidelines,1 consensus statement,4 systematic reviews,2 evidence summaries,and 1 top clinical decision.These sources provided a total of 28 pieces of evidence across 5 key themes,including sleep assessment,management principles and education,environmental management and sleep promotion.Conclusion This study summarizes the best available evidence on non-pharmacological sleep management measures in critically ill children.It is recommended that healthcare professionals should consider the clinical context when implementing evidence-based interventions,aiming to reduce nocturnal awakenings,extend sleep duration,and improve sleep quality in critically ill children.

Objective:To search, review and summarize the best evidence on promoting maturation of autologous arteriovenous fistula (AVF) in patients undergoing maintenance hemodialysis (MHD) .Methods:In accordance with the relevant methods of evidence-based nursing, evidence was retrieved from relevant websites and databases according to the "6S" pyramid model, including clinical decision-making, guidelines, expert consensus, group standards, and systematic reviews. The search time limit was from April 20, 2012 to April 20, 2022. Two investigators assessed the quality of the evidence, and the evidence team extracted and summarized the evidence.Results:A total of 17 articles were included, including 1 clinical decision-making, 6 guidelines, 1 expert consensus, 1 group standard and 8 systematic reviews. Totally 28 best evidences were summarized from 6 aspects: team education, perioperative management, functional exercise, physical therapy, drug application, first puncture timing and scheme.Conclusions:The best evidence provides a reference for medical staff to standardize the management of AVF in MHD patients. It is recommended that medical staff develop individualized plans based on medical conditions, clinical judgment, and patient wishes when applying relevant evidence.