Objective To investigate the effect of different antiplatelet or anticoagulation therapy on postoperative pocket hematoma after electrophysiological devices placements (EPD). Methods The clinic data of 410 patients who took anti-platelet or anticoagulation therapy and needed to be implanted EPD from February 2012 to February 2015 were selected. According to the type of therapy, patients were divided into 4 groups:dual anti-platelet drug (DAP) treatment group (DAP group, 114 cases), low-molecular-weight heparin (LMWH) bridging treatment group (LMWH group, 98 cases), aspirin (ASA) alone group (ASA group, 94 cases) and warfarin group (104 cases). The incidence of pocket hematoma after electrophysiological devices placements was observed. The risk factors of pocket hematoma were analyzed. Results The incidence of pocket hematoma was higher in LMWH group than that in the other 3 groups: 18.4% (18/98) vs. 4.4% (5/114), 3.2% (3/94) and 2.9% (3/104), and there was statistical difference (P<0.05). But there were no significant differences in the incidence of pocket hematoma among DAP group, ASA group and warfarin group (P>0.05). The multiple Logistic regression analysis revealed that LMWH bridging therapy was an independent risk factor for the development of pocket hematoma (OR=7.105, 95%CI 1.872-17.283). Conclusions LMWH bridging therapy can increase the risk of development of pocket hematomas after electrophysiological devices placement.

Objective:To investigate parents′ knowledge and attitude toward post-operative pain management in pediatric orthopedics and analyze influencing factors.Methods:A total of 170 parents of 6 to 16 years old children who underwent selective surgeries and were hospitalized because of limb fracture were conveniently selected in Children′s Hospital of Soochow University from April to December in 2019, They were investigated using the general data questionnaire, Pain Management Knowledge and Attitudes Questionnaire.Results:There were 167 parents completed questionnaires in our study. The mean score of parents′ knowledge, general attitude and negative attitude to pain medication were 15.0(3.00), 24.0(4.00) and 17.0(3.00) respectively. There were statistical differences between different educational levels of parents′ knowledge ( χ2 value was11.599, P=0.021), as well as different age of parent′s general attitude ( χ2 value was 7.053, P=0.029). Spearman-related results showed that parents′ cognition was positively correlated with general attitudes ( r value was 0.394, P<0.01). Conclusions:The majority of parents are at moderate to high level of knowledge, general attitude and negative attitude to pain medication. Pediatric nurses should pay more attention to parents′ knowledge deficit of and negative attitude toward pain assessment tools and pain-drugs to develop targeted educational intervention programs for promoting parental involvement.

Aim To study the inhibitory activities of potential new anti-influenza virus agents,3-O-β-chaco-triosyl pentacyclic triterpenoids against the entry of H5N1influenza viruses.Methods Three target com-pounds were designed and synthesized structurally re-lated to the lead compound 3-O-β-chacotriosyl dioscin derivative (1 )with inhibitory activities against H5N1 influenza viruses.The inhibitory activities of these tar-get compounds were tested at a cellular level pseudo vi-rus system targeting H5N1 influenza viruse entry.Re-sults All the compounds 1 a,1 b and 1 c showed po-tent inhibitory activities against the entry of A/Thai-land/Kan353/2004 pseudo virus into the target cells, of which compound 1 b showed the best inhibitory activ-ity with an IC50 value of (1.25 ±0.22)μmol·L-1. Conclusion The SARs analysis of these compounds indicated that replacement of the aglycone moiety of compound 1 with pentacyclic triterpenoids could in-crease antiviral activity.Different types of pentacyclic triterpen as aglycone residue had the significant influ-ence on the inhibitory activity (1 b >1 c >1 a),sug-gesting ursane type of triterpenes was superior to the two other kinds of triterpenes as aglycone residue.

The aim of the present study was to evaluate the effect of storage conditions,pretreatment,temperature,time and excystation solutions on in vitro excystation of Cryptosporidium oocyst.Cryptosporidium andersoni oocyst was used as a model and the results showed that 0.5% sodium hypochlorite could enhance the excystation rates.But there was no significant difference compared with oocysts untreated by sodium hypochlorite(P＞0.05).0.75% synthetic sodium taurocholate and 1% bile solution could urge the excystation of oocysts,which were significantly different compared with the excystation rate of oocysts in 0.25% trypsin solution or in PBS(P<0.05).The excystation rates of oocysts in acidic water (pH =3) were similar with the rates in PBS (pH =7.2) but significantly different from the rates in alkaline water (pH =9) (P<0.01).Additionally,the excystation rate of oocysts in water of 24℃ was significantly lower than in water of 37℃(P<0.01),and the excystation rate of oocysts raised gradually at 37℃ with the passage of time.It's concluded that temperature,acidity and excystation solution were vital factors for the in vitro excystation of Cryptosporidium oocyst.A higher excystation rate could be observed when oocysts were pretreated with 0.5% sodium hypochlorite and treated with 0.75% synthetic sodium taurocholate at 37℃ for 3 hours.

Objective:To investigate parents′ proxy-assessment post-operative pain intensity of orthopedic children, and to analyze the relevant influencing factors.Methods:Using the purposive sampling method, 200 children and their parents who met the inclusion and exclusion criteria were mainly selected in pediatric orthopedics of Children′s Hospital of Soochow University from August to December in 2020. A general information questionnaire and the Wong-Baker Facial Pain Rating Scale (WBFP) were used to survey.Results:One hundred and ninety-five questionnaires were effectively recovered. Nearly 44.6%(87/195) and 28.7%(56/195), 36.9%(72/195) and 5.1%(10/195), 8.2%(16/195) and 1.0%(2/195) of parents reported (using WBFP Rating Scale) moderate to severe pain intensity of 1 d, 2 d and 3 d after surgery and the Cohen′s Kappa coefficient with child′s self-report which ranged from 0.556 to 0.631 were all higher than child-nurse (Cohen′s Kappa coefficient ranged from 0.318 to 0.406). The results of multiple linear regression analysis showed that using painkillers by children entered in the regression equation, which could explain the variation of 13.5% ( R 2=0.135). Conclusions:The self-report of the children was in good agreement with the assessment of the pain intensity by the parental agent, and the assessment of the pain intensity was affected by the painkillers used by the children. Therefore, medical institutions and personnel should create a supportive environment that values the positive role of parents to promote the management of children′s post-operative pain.

Objective:To explore the reports on the pain intensity and the use of pain relief strategies of parents in postoperative pain management of orthopedic children, and analyze related influencing factors.Methods:From January to August 2020, purpose sampling was used to select 200 parents of children who underwent elective surgery in the Department of Orthopedics of a Class Ⅲ Grade A children hospital in Suzhou City. The survey was conducted using the General Information Questionnaire, Wong-Baker FACES Pain Rating Scale, and Parents' Use of Pain Relief Strategies (PUPRS) Questionnaire. A total of 200 questionnaires were distributed, and 197 were effectively returned, with an effective rate of 98.5%.Results:The 197 orthopedic children's parents reported a score of (6.75±2.19) on the pain intensity of the children, 36.5% and 53.3% of them were moderate and severe respectively. The PUPRS score was 52.0 (9.00) , 70.6% and 28.4% were at medium and high levels, respectively. Multivariate analysis showed that parents' gender and education level were the influencing factors of PUPRS ( P<0.05) . Conclusions:Parents of most orthopedic children report severe postoperative pain intensity, and their use of pain relief strategies is at a medium to a high level, and is affected by gender and education level. However, the use of painkillers and certain pain relief strategies is lacking. In the future, clinical medical and nursing staff should formulate reasonable health education programs to further promote and improve parents' pain management practices.

Objective:To investigate the etiology, pathogenesis, clinical manifestations, and treatment of acute pancreatitis (AP) complicated with spleen infarction.Methods:A case of AP combined with splenic infarction was retrospectively analyzed and the literature was reviewed.Results:AP complicated with splenic infarction suggested that the patient′s condition was serious. The impairment of splenic immune function caused by splenic infarction may be an important cause of severe acute pancreatitis (SAP). Early detection and active treatment can obtain a good prognosis, and anticoagulant or antiplatelet aggregation treatment was not the key treatment.Conclusions:AP combined with splenic infarction may be an risk factor for SAP.

Objective To investigate the ADC value and intravoxel incoherent motion (IVIM) parameters to predict the early response to chemotherapy in patients with locally advanced non-small cell lung cancer (NSCLC). Methods Twenty-six patients with pathologically confirmed NSCLC in our hospital from June 2015 to January 2017 were prospectively studied. MR routine scan, DWI and IVIM scans were performed before and at the end of the first cycle of chemotherapy. The ADC value, pure diffusion parameter (D), perfusion parameter (D*) and perfusion fraction (f) before and after chemotherapy were recorded respectively, and the maximum diameter of tumor (MDMRI) was measured on T2WI. The effective group and the ineffective group were divided according to RECIST 1.1. Intra- and interobserver reproducibility were assessed with intraclass correlation coefficient (ICC). The differences of the parameters and their change rate were compared pre-and posttreatment, in the effective and the ineffective groups by using t test. Receiver operating characteristic (ROC) curves were generated to explore the optimal parameters and thresholds for early prediction of the efficacy of chemotherapy. Z test was used to compare the differences in the areas under the ROC curves. Results The repeatability of D*was relatively poor (ICC 0.507-0.716). The ADC and D values of the effective group before chemotherapy were (1.28±0.21)×10-3 and (1.05±0.14)×10-3mm2/s, respectively, and those of the ineffective group were (1.55 ± 0.25) × 10-3 and (1.29 ± 0.18) × 10-3mm2/s, respectively. The differences between two groups were statistically significant (t=-2.989, -3.755, respectively, P all<0.05). While there was no significant difference in f between the effective and ineffective groups before chemotherapy (t=-1.034, P=0.312). The ADC, D and f values of the effective group before chemotherapy were lower than those after chemotherapy, and the differences were statistically significant (t=-3.969,-5.617 and-2.876, respectively, P all<0.05). While there was no significant difference in ADC and D values in ineffective group (t=-0.737, -0.866, P>0.05, respectively). The difference of f was statistically significant (t=-2.731, P<0.05).ΔADC％,ΔD％andΔMDMRI％in effective group were (23.90 ± 22.28)％, (32.58 ± 20.63)％ and (18.77 ± 10.36)％, respectively, and those in ineffective group were (1.19 ± 11.35)％, (6.22 ± 21.63)％ and (9.35 ± 8.26)％, respectively. The differences between two groups were statistically significant (t=3.393, 3.154 and 2.487, respectively, P all<0.05). There was no significant difference inΔf％between two groups (t=1.346, P=0.191). ROC curve analysis showed that the area under curve (AUC) of preADC, preD, ΔADC％, ΔD％ and ΔMDMRI％ was 0.788, 0.848, 0.800, 0.830 and 0.727, respectively. When setting the preD=1.20×10-3 mm2/s as the boundary under the largest AUC, however, there was no significant differences in AUC compared with preADC, ΔADC％, ΔD％ and ΔMDMRI％ (Z=1.336, 0.363, 0.136, 1.395, P>0.05). Conclusion The ADC value, D value before chemotherapy and the early change rate after chemotherapy can better predict the early response of chemotherapy in NSCLC patients.