To analysis the risk factors of intraoperative blood glucose abnormalities（dysglycemia） in elderly patients without diabetes，and to develop a nomogram risk prediction model. Methods Convenience sampling was conducted in elderly patients aged ≥ 65 years without diabetes who received surgical treatment. Univariate analysis and binary logistic regression analysis were used to determine the risk factors of intraoperative blood glucose abnormalities，establish a risk prediction model and draw a nomogram. Receiver Operating Characteristic（ROC） and Hosmer-Lemeshow tests were used to verify the predictive effect of the model，and Bootstrap method was used for internal validation. Results The logistic regression analysis showed that type of anesthesia，duration of surgery，baseline operating room blood glucose level，and age were independent predictors of intraoperative dysglycemia. The predictive formula for intraoperative dysglycemia was established as follows：Logit P=-12.810+0.066 × age +1.966 × baseline operating room blood glucose level +0.008 × duration of surgery -2.778 × type of anesthesia. The area under the ROC curve was 0.815，and the optimal critical value boundary was 0.765. The sensitivity and specificity were 83.00% and 67.00%，respectively. The result of Hosmer-Lemeshow test was χ²=5.557（P=0.697）. The prediction curve fit well with the ideal curve，suggesting that the model has good predictive ability. External validation showed that the sensitivity of the model was 77.01%，the specificity was 75.36%，and the overall accuracy was 76.56%. Conclusion The prediction model constructed in this study has a good effect，which can provide a reference for clinical evaluation of the risk of abnormal blood glucose in elderly patients without diabetes.

Objective To compare the clinical effects of midline’s tip at different position. Methods From September 2020 to January 2021,a multi-center randomized controlled study was used to select 384 inpatients as the research subjects from 6 tertiary A general hospitals in Zhejiang province,Fujian province,Jiangsu province,and Liaoning province. They were randomly divided into 3 groups according to random numbers generated by Excel. The midline’s tips were located in the subclavian vein in the experimental group 1,in the axillary vein of the chest in the experimental group 2,and at the distal of the axillary vein in the control group. The incidences of catheter-related complications（including phlebitis,catheter-related thrombosis,catheter-related infections,catheter occlusion,catheter dislodgment,bleeding,oozing） were compared in 3 groups,as well as unplanned removal rate due to complications,catheter indwelling time,and the incidence of abnormal intima after midline removal. Results A total of 384 patients were included. The total incidence of catheter-related complications in experimental group 1,experimental group 2,and control group were 9.93%,14.63%,and 34.17%. Unplanned removal rate due to complications were 2.13%,4.07%,and 13.33% in 3 groups. Catheter indwelling time were 12.00（8.00,19.75） d,12.00（8.00,21.00） d,and 10.00（6.00,17.75） d. After the removal,the incidence of abnormal intima were 0.75%,1.69%,and 6.36%. The differences of 3 groups were statistically significant（P<0.05）. Among them,the differences in the total incidence of catheter-related complications and unplanned removal rate between the experimental group 1 and the control group,the experimental group 2 and the control group were statistically significant（P<0.017）;the difference between the experimental group 1 and the experimental group 2 was not statistically significant（P>0.017）. In terms of the catheter indwelling time,the difference was statistically significant between the experimental group 1 and the control group（P<0.017）. Conclusion When the tip of midline catheter is located in the axillary vein of the chest or subclavian vein,the incidence of catheter-related complications is lower,with longer indwelling time and better clinical outcome.

Objective To construct the gynecological early warning score（GEWS） of critical patients and to test its predicted performance. Methods Using retrospective case analysis,we collected 389 cases of critical illness changes in gynecological patients from January 1,2018 to July 31,2019 in a level A tertiary hospital in Nanjing. The data was analyzed by single factor and multi-factor analysis to determine the relevant factors of gynecological critical illness changes and construct the GEWS table of critical illness to test the predictive effect of the scale. Results GEWS included 12 early warning indicators,including disease type,respiration rate,heart rate,systolic blood pressure,blood oxygen saturation,oxygen inhalation,consciousness,body temperature,lower abdominal pain,hemoglobin content,vaginal bleeding and related symptoms. Oxygen,body temperature,lower abdominal pain and vaginal bleeding are valued of 0 to 2 points,while other indicators were 0 to 3 points,with a total score of 0 to 32 points for 12 indicators;the best cutoff point of ROC curve was 3.5 points,with a sensitivity of 92.32% and a specificity of 88.85%. Conclusion The GEWS table can effectively warn the changes of critical gynecological conditions and predict the risks of changes in critical gynecological conditions,and help to improve the success rate of gynecological critical patients.

Objective To construct a system of post-hospital health management for patients with gynecological malignant tumor and provide corresponding evidence. Methods The post-hospital rehabilitation management platform for patients with gynecological malignant tumor included four parts：electronic information system,online APP learning platform,WeChat doctor-patient communication platform and offline health management center. The use of platform from January 1,2018,to April 30,2019,online doctor-patient interaction,offline service status and patients' satisfaction with the platform were calculated. Results The platform had 9 registered medical staff,and 188 patients with gynecological malignant tumor. Averagely each individual logged in the platform for 8.98 times,read for 17.1 articles,and each article was read by 91.89 times. There were doctor-patient interactions for 928 times,381 questions were asked,355 problems were solved,93.17% of problems were solved online,the average waiting time for online response was 19.6 hours. There were offline services for 22,169 times,waiting time of offline reservation was 3.1 days. Conclusion Post-hospital rehabilitation management platform for patients with gynecological malignant tumor has five characteristics：scientific,professional,practical,dynamic and convenient. It can promote patients' participation in rehabilitation management and rehabilitation after hospital,improve the efficiency of rehabilitation management,improve patients' rehabilitation experience.