OBJECTIVE：Probe into the feasibility of preparation of diclofenac sodium with β-cyclodextrins in 1∶1 and 2∶1 inclusion compounds ,and find out the affection in solubility of diclofenac sodium. METHODS:The 1∶1 and 2∶1 melusion compounds were prepared by liquid-phase an alysis the content and determination them solubility.RESULT:The 1 ∶1 and 2∶1 inclusion compounds were prepared by different ratio of reactants and etermined them mp were 299～300.5℃ and 302～303℃ respectively. CONCLUSION：Of us is that solubilits of the 1∶1 and 2∶1 inclusion compounds increase 0.65 and 1 times respetively comparing with declofenac sodium.

Objective To investigate the effect of Kangaroo care(KC)on diminishing neonatal pain during heel lancing. Methods Sixty neonates were divided randomly into two equal groups:intervention group and control group,which 30 cases in each group.In the intervention group,neonates were treated with KC(neonates were put in direct and continuous skin-to-skin contact with his/her mom)from 20 mins before heel lancing to 1 mins after the end of the lancing.In the control group,neonates were treated with regular care.The differences in heart rate,blood oxygen saturation,facial pain expression,crying duration and DAN(Douleur Aigue Nouveaune)scores between two groups were compared at 7 time points from 10s before the heel lancing to 10s after the lancing. Results The results of repeated measu te at 7 time points after heel lancing.There were significant interaction effect between time and main effect(P<0.01),which showed that the heart rate of two groups were not equal at different time points.Compared with the time effects(P<0.01)which showed that two groups of neonatal heart rate of the two groups would accelerate with time extension. There were significant differences(all P<0.05)in heart rate at 7 time points between two groups and smaller heart rate varied range in intervention group.The results of repeated measures analysis for neonatal blood oxygen saturation at 7 time points after heel lancing. There were significant interaction effect between time and main effects(P<0.01),which showed that the blood oxygen saturation of two groups were not equal at different time points.Compared with the time effect(P<0.01),which showed that two groups of neonatal blood oxygen saturation would reduce with time extension.There were significant differences(all P<0.05)in blood oxygen saturation of two groups at 30s,40s and 50s after heel lancing and smaller blood oxygen saturation varied range in intervention group.The crying duration and DAN scores in intervention group were significantly reduced compared with the controls(all P<0.05).Conclusions
Heel lancing could lead to moderate to severe pain of neonates.KC could effectively diminish the neonatal pain degree caused by heel lancing.

Objective To raise risk exposure awareness for spreading pathogenic microorganisms in anesthesia procedures and normalize aseptic technique of anesthesiologists,thus minimizing postoperative infection.Methods Choose 45 cases of general anesthesia.Respectively before anesthesia induction (Time0),five minutes after induction (Time1) and two hours after anesthesia (Time2),make bacteriological tests on seven spots vulnerable to contamination,including the three-way stopcock,screwtype hose coupling,oxygen flux knob,pressure-release valve surface,exhaled breath entry of the anesthesia machine,oxygen intake of the breathing loop of the anesthesia machine,and operating desktop of the anesthesia cart.Results Contamination risk exposure of the stopcock extends with the operative time.At Time 0,it is sterile; at Time 1,84.4％of the 45 cases are found with bacteria growth,with colony count of 1～2CFU/ml; at Time2,colony counts at various monitoring points range 7～21 CFU/ml,of which the differences between Timel group and Time0,as well as Time2 and Time0 are statistically significant(P＜0.05).Colony counts at other monitoring points comply with the regulations.Conclusion Three-way stopcocks are highly vulnerable to contamination during operative anesthesia.Regular sterile operations can effectively prevent and lower postoperative infection of the patients.

Objective To evaluate the effect of positive experience intervention on anxiety, depression and quality of life among rural empty nesters. Methods A total of 115 rural empty nesters were divided into the intervention group (n=58) and the control group (n=57). Both groups received routine community activities. In addition, participants in the intervention group received positive experience intervention. Geriatric Depression Scale, Self-Rating Anxiety Scale and 12-item Short-Form Health Survey were adopted to measure the related items before and after the intervention. Results The intervention group showed a significant decrease in anxiety (1.54±0.07) and depression (7.28±3.82), compared with the control group (1.64±0.09, 11.81±6.38), the difference was significant (t=-5.960,-4.613, P<0.01). The Physical Component Summary (PCS) and Mental Component Summary (MCS) was 47.01±6.47 and 52.13±6.22 in the intervention group, which were significantly higher than those in the control group (41.37±8.71, 48.71±6.13), the differences were significant (t=3.937, 2.970, P < 0.01). Conclusions Positive experience intervention can decrease anxiety and depression, and improve quality of life of rural empty nesters.

Objective To evaluate the predictive effect of Braden scale for the risk of development of pressure ulcers (PU) in the department of neurology bedridden patients and to explore subgroup preventive measures. Methods 400 cases newly hospitalized bedridden patients in the department of neurology were collected with no pressure ulcers at the first evaluation and pressure ulcer risk was continuously predicted by a Braden scale skin assessment. The high-risk, middle-risk and low-risk groups were randomized into the experimental group and the control group respectively. Routine preventive measures were taken for the control group while the air fluidized bed for the high-risk group, the sponge mattress for the middle-riskgroup, and turning the body over every 4 hours for low-risk group. Other preventive procedures were undertaken simultaneously in beth the experimental and the control groups. Results The area under the ROC curve (AUC)was 0.771 and 0.828 at the first and last time Braden scale scores respectively. Such vMues as sensitiveness, specificity, positive predictive value, negative predictive value were found in higher level,when the diagnosis value was 17. There was no significant difference of incidence rate of the subgroup pressure ulcers between the high-risk, middle-risk, low-risk groups compared to the control group. Conclusions The effect of predicting pressure ulcer risk for bedridden patients in the department of neurology with Braden scale was fairly good, while the score 17 as the diagnosis value was ideal. The air fluidized bed for the high-risk group and the sponge mattress for the middle-risk group resulted in no significant decrease of incidence rate of the pressure ulcer, while taming over the patients' body every 4 hours for low-risk groups showed acceptable and therefore saving medical resources.

Objective To explore the effects of three-subject double-track interactive nursing intervention model on self-management and liver function in patients with cirrhosis.Methods A total of 120 cirrhosis patients who were discharged from Nanxishan hospital from January 2015 to June 2016 were divided into control group and observation group according to random number table,60 patients respectively. Patients in control group received routine double-track nursing interventions,while patients in observation group were treated with additional three-subject double-track interactive nursing intervention mode. The self-management ability and liver function of patients were compared between two groups before and after intervention.Results There was no significant difference in self-management ability between two groups before the intervention. The score of self-management ability of patients in observation group was significantly higher than that of control group after the intervention (P<0.05). Before the intervention, no differences were observed in TBIL,ALT,ALB,A/G values between two groups. However,TBIL,ALT,ALB,A/G values of patients in observation were better than those of control group after the intervention,the differences were statistically significant (P<0.05).Conclusions Three-subject double-track interactive nursing intervention model effectively improves the self-management ability and facilitates the recovery of liver function of patients with cirrhosis.

Objective To explore the effects of gratitude intervention on the hope level and self-efficacy of patients with compensatory phase cirrhosis.Methods Totally 120 patients with compensatory phase cirrhosis were equally divided into observation group and control group by random number table. Patients in the control group received conventional health education and rehabilitation instruction, while patients in the observation group was emotionally intervened with gratitude record, gratitude reflection and gratitude expression for 4 weeks on this basis. Then their hope level and self-efficacy before and after the intervention was evaluated with Herth Hope Index (HHI) and Chronic Disease Self-Efficacy Scale (CDSES).Results After the intervention, the scores of the patients in the observation group for HHI, positive attitude to the reality and future, taking positive attitudes and acts and maintaining close ties with others were (37.33±6.37), (12.04±2.62), (13.14±2.35) and (12.15±2.32), respectively, all higher than the figures of the patients in the control group (t=8.773, 7.034, 7.725, 7.858;P<0.05); The self-efficacy score of the patients in the observation group after the intervention was (46.84±6.53), higher than that of the patients in the control group (t=8.741,P<0.05), which was (37.51±5.42).Conclusions Gratitude intervention, which is applied in the patients with compensatory phase cirrhosis in the treatment process, can improve their hope level and self-efficacy effectively.

?? [Abstract]? Objective? To explore the effects of reciprocal behavior on perceived stress among nurses during the second pregnancy. Methods? From January to March 2018, we selected clinical nurses during the second pregnancy at five Class Ⅲ hospitals in Zhejiang as subjects by convenience sampling. The questionnaire survey was carried out with the employee reciprocal behavior questionnaire and the Chinese version Perceived Stress Scale (CPSS) to explore the correlation between them. A total of 500 questionnaires were sent out and 482 valid of them were collected with 96.40% for the valid recovery rate. Results? Among 482 nurses during the second pregnancy, the scores of reciprocal behavior and perceived stress were (42.35±8.65) and (38.38±7.58) respectively. Perceived stress of 33.61% of nurses during the second pregnancy was at a normal level. Reciprocal behavior had a negative correlation with the perceived stress (r=-0.411,P＜ 0.01). Hierarchical regression analysis showed that reciprocal behavior was the influencing factor of the perceived stress of nurses during the second pregnancy. Conclusions? Reciprocal behavior has the influence on perceived stress among nurses during the second pregnancy which points out that managers and individuals can improve reciprocal behavior so as to reduce the stress of nurses during the second pregnancy.

To address the issue that the existing weakly supervised segmentation methods have difficulties in obtaining fine-grained glandular features from colorectal pathological images,leading to the inability to generate high-quality pseudo-labels and compromising the gland segmentation performance,a dual-branch network based on weakly supervised learning is proposed for gland segmentation in colorectal pathological image.The patch-level colorectal pathological images are input into the first branch network,where the interaction and fusion of local and global features of patch-level images are achieved through the feature interaction module and affinity attention fusion module,and fine-grained glandular features are obtained.Subsequently,image-level colorectal pathological images are input into the second branch network,where the gland locations are located using the partial class activation attention module,and coarse-grained class activation maps are obtained.Finally,high-quality pseudo-labels are derived from the fine-grained glandular features and coarse-grained class activation maps,and gland segmentation is realized in the segmentation network through the cross-scale connected spatial perception module.The tests on two colorectal pathological image datasets(GlaS and CRAG)reveal that the proposed method is superior to other segmentation methods in segmentation performance,confirming its effectiveness.

High-precision segmentation of melanoma images is crucial for early diagnosis and improving patient survival.However,the blurring of the edge region of melanoma,which presents irregular shapes,makes it difficult for existing segmentation methods to obtain edge feature information,affecting the accuracy of melanoma image segmentation.To solve this problem,a melanoma image segmentation method based on edge key points and edge attention is proposed.An edge key point selection module for point rendering and a combined convolution transformer block are designed in the encoder to guide the acquisition of local and global features of the edge by selecting edge key points.Then,the edge refinement module is designed in the encoder to refine the edge features of the deep network,and finally,the multi-scale edge attention module is designed in the skip connection,which enables the capture of the edge shape features at multiple scales.The tests on two datasets(ISIC 2018 and PH2)demonstrate that the proposed method has better segmentation performance than the existing segmentation methods.