Objective:To prepare capsaicin liposomes and study the feasibility by in vitro percutaneous penetration test. Meth-ods:Capsaicin liposomes were prepared by a film-ultrasonic method. The best formula was screened by orthogonal test based on single factor studies with the entrapment efficiency as the index. The improved Franz diffusion cells were used to study the transdermal pene-tration of capsaicin suspensions, capsaicin liposomes and capsaicin ointments, and the cumulative penetration amount through the isola-ted rat skin was compared. Results:The optimal formula of capsaicin liposomes were as follows:the ratio of capsaicin to lipids was 1∶5;the amount of Tween-80 was 100 mg;the amount of vitamin E was 50 mg;10 ml dichloromethane was used as the solvent. The op-timal pH value of the external phase was 6. 5 with the volume of 10 ml. The ultrasonic time was 8 min. The order of 12-hour cumulative penetration amount was capsaicin liposomes>capsaicin-PBS suspensions>capsaicin ointments. Capsaicin liposomes had the highest 12-hour cumulative penetration amount and showed obvious sustained-release property. Conclusion:Capsaicin liposomes have high en-trapment efficiency, good percutaneous penetration and sustained-release property, and the preparation technology is simple.

Objective:To compare the therapeutic effects of debris spondylectomy,piecemeal spondylectomy,total en bloc spomdylectomy in treating lumbar metastatic tumors. Methods:The clinical data of 20 patients with lumbar metastatic tu-mors treated from January 2008 to October 2013 were retrospectively reviewed. There were 8 males and 12 females ,aged from 35 to 65 years old with an average of (49.50±9.97) years. All patients had single solitary metastases. Four cases were in L 1,5 cases in L2,4 cases in L3,4 cases in L4,and 3 cases in L5. According to the type of Tomita,typeⅡhad in 4 cases,typeⅢin 6 cases,typeⅣin 6 cases,type V in 4 cases. Tokuhashi score was 12.50±1.97. All patients complained with back or leg pain , VAS score was 8.13±0.85. Among patients,7 cases were treated with debris spondylectomy (group A),7 cases with piecemeal spondylectomy (group B),6 cases with total en bloc spondylectomy (group C). Statistical analysis was used to compare the three groups with respect to surgical trauma (including operative time,transoperative bleeding,and intraoperative blood trans-fusion),clinical symptoms (by VAS score at 1 week after operation),surgical procedures conditions (by AP and lateral X rays),and long term results (by recurrence and death information). Results:All patients were followed up from 6 to 36 months with an average of (16.50±7.88) months. Operative time for debris spondylectomy was (6.14±0.68) h,intraoperative bleeding was(3 457.14±399.40) ml,and intraoperative blood transfusion was(2 771.43±423.14)ml. Operative time for piece-meal spondylectomy was(4.93±0.61) h,intraoperative bleeding was(1 942.86±378.51) ml,and intraoperative blood transfu-sion was (1 500.00±336.65)ml. Operative time for total en bloc spondylectomy was(4.17±0.67) h,intraoperative bleeding was (1 341.67±361.13) ml,and intraoperative blood transfusion was (916.67±321.66) ml. There was significant differences in op-erative time,intraoperative blood loss,and intraoperative blood transfusion between three groups (P<0.05). In terms of these factors,total en bloc spondylectomy had the best outcome followed by piecemeal spondylectomy. All pains had released ,VAS score decreased obviously at 1 week after operation(P<0.05),and there was no significant differences between three groups(P>0.05). Surgical effects were well with these methods according to the evaluation of AP and lateral X rays . At final follow up, group A had 4 recurrences(2 with breast cancer,1 with prostate cancer,and 1 with thyroid cancer) and 3 deaths (2 with lung cancer and 1 with thyroid cancer);group B had 2 recurrences (1 with breast cancer and 1 with prostate cancer) and 3 deaths (1 with lung cancer,1 with breast cancer and 1 with kidney cancer);group C had no recurrences and 2 deaths for lung cancer. There was significant differences in recurrence and death between three groups(P<0.05). In terms of these factors,total en bloc spondylectomy had the best outcome in three methods. Conclusion:Three kinds of operation method can relieve pain ,improve nerve function,increase the spinal stability,control the local lesions,improve the patient's quality of life in treating lumbar metastatic tumors,but total en bloc spendylectomy,respect to operative time,transoperative bleeding,intraoperative blood transfusion,tumor recurrence and death is clearly superior to other two methods.

Objective:To understand the epidemiology, clinical characteristics and associated risk factors of severe adenovirus(ADV)pneumonia in children, providing the basis for targeted prevention and treatment.Methods:Clinical features of children with ADV pneumonia at Children′s Hospital of Soochow University from January 2011 to December 2020 were retrospectively analyzed.According to the severity of the disease, cases were divided into severe ADV pneumonia group and common ADV pneumonia group.The epidemiological and clinical characteristics of two groups were compared, and risk factors for the occurrence of severe ADV pneumonia were analyzed.Results:A total of 1 158 patients with ADV pneumonia were enrolled, including severe ADV pneumonia 104 cases(8.98%) and ordinary ADV pneumonia 1 054 cases(91.02%).The median age of severe ADV pneumonia group was 1.17 (0.83, 2.73) years, which was significantly younger than that of common ADV pneumonia group 3.16 (1.50, 4.50) years( P<0.05), and 77.89% (81/104) of them were younger than 3 years old.The occurrence of severe ADV pneumonia was predominant in winter and spring, accounting for 71.15% (74/104).Cough was present in 89.42% (93/104) and fever in 99.01% (103/104) of the severe ADV pneumonia group.Compared with the common ADV pneumonia group, the severe ADV pneumonia group had a significantly longer febrile time[10(6, 14)d vs. 5(4, 7)d, P<0.05], significantly higher incidence of shortness of breath, wheezing, convulsions/coma[100% vs. 2.09%, 45.19% vs. 13.57%, 10.57% vs. 1.99%, P<0.05], and significantly higher incidences of emphysema, pleural effusion, bronchial signs, pulmonary solids, and atelectasis [21.15% vs. 2.09%, 5.77% vs. 0.19%, 4.81% vs. 0, 3.85% vs. 0.09%, P<0.05].Multivariable Logistic regression showed that age younger than 1.71 years old, wheezing, and the presence of underlying diseases (moderate to severe anaemia, congenital heart disease, neurological disease) were risk factors for the development of severe ADV pneumonia ( P<0.05).Receiver operating characteristic curve analysis showed that the sensitivity and specificity of age<1.71 years old(20 months old) for predicting the occurrence of severe ADV pneumonia were 65.4% and 71.5%, respectively. Conclusion:The age of most severe ADV pneumonia is less 3 years in Suzhou.It usually occurres in winter and spring, with fever, cough, shortness of breath, and wheezing as the main symptoms.Pulmonary manifestations such as pleural effusion, emphysema, pulmonary consolidation, and atelectasis may occur.The underlying disease, wheezing, and age of onset less than 1.71 years (20 months) old are independent risk factors for severe ADV pneumonia.

Objective To explore the nosocomial infection knowledge of medical staff in tertiary hospitals of Beijing,and identify the influencing factors of nosocomial infection knowledge among medical staff.Methods By random sampling method,848 medical workers in a tertiary hospital were investigated by the self-designed questionnaire of medical workers′ knowledge about nosocomial infection control questionnaire.Results The average score of medical workers′ knowledge about nosocomial infection control was(68.78±11.70). The univariate analysis on the influencing factors of nosocomial infection knowledge showed that,the scores of medical workers′ knowledge about nosocomial infection were significantly different among workers in different departments and with different professional titles (t=6.715,53.166;P<0.05).Conclusions The medical workers′ knowledge about nosocomial infection in tertiary hospitals is at a medium level. Aimed at the items with low knowledge score in different groups and different medical workers,we should enhance the training among medical workers to reduce the occurrence of nosocomial infection and the incidence rate of nosocomial infection.

Objective:To explore the experience and feelings of hip and knee replacement patients participating in the enhanced recovery after surgery (ERAS) model during hospitalization, so as to provide a reference for the improvement of ERAS perioperative and continuous nursing plans.Methods:From August to November 2019, purpose sampling was used to select 15 patients undergoing hip and knee replacement who were admitted to the Department of Joint Surgery of a ClassⅢ Grade A hospital in Guangdong Province for the semi-structured interview. Colaizzi's 7-step analysis method on phenomenology was used to analyze, summarize and refine the themes of the collected interview data.Results:The experience and feelings of joint replacement patients participating in the ERAS model during hospitalization can be summarized into 4 themes, namely uncertainty of information, being worried about the treatment effect, insecurity of early discharge, the contradiction between the desire to return and lack of confidence.Conclusions:Patients participating in ERAS had a short hospital stay after hip and knee replacement, and could not fully digest the information provided by the medical and nursing staff. Patients were also worried that they would not be able to cope after being discharged from the hospital. Clinical medical and nursing staff should fully evaluate the patient's readiness for discharge, provide personalized guidance, perfect out-of-hospital continuous nursing services and improve the patient's experience of early discharge.