Objective To study the epidemiological and clinical features of human parainfluenza virus (HPIV) infection in children in Suzhou,and to provide the evidence-based foundation for early warning,diagnosis and treatment of respiratory infection in children.Methods The sputum specimens and medical history were obtained from children with acute respiratory tract infection hospitalized at the Childen's Hospital Affiliated to Soochow University from January 2006 to December 2015.Seven kinds of common respiratory viruses including respiratory syncytial virus,influenza virus A,influenza virus B,HPIV Ⅰ,HPIV Ⅱ,HPⅣV Ⅲ and adenovirus were detected by using the direct im-munofluorescence.Mycoplasma pneumoniae(MP),chlamydia pneumoniae,human bocavirns (hBoV) were detected by using fluorescence quantitative PCR.Rhinovirus and human metapneumovirus were detected by using reverse transcription-PCR.Sputum was cultured for bacteria.Results In 21 769 cases,the detection rate of HPIV positive was 3.21％ (829 cases),among which,HPIV Ⅰ,HPIV Ⅱ,HPIV Ⅲ were respectively detected in 113 cases (0.52％),16 cases (0.07 ％) and 700 cases (3.21％),respectively.There were 378 cases of simple infection and 428 cases of mixed infection,and the mixed infection was very common in Streptococcus pneumoniae,Haemophilus influenza,MP and hBoV.There was a difference in HPIV infection among genders,and the detection rate of the boys was higher than that of girls[4.14％ (563/13 591 cases) vs.3.25％ (266/8 178 cases),x2 =11.036,P =0.001].In the 28 d-1 year old and ＞ 1-3 year old group,the detection rate of HPIV was higher[4.71％ (494/10 476 cases) and 4.21％ (244/5 793 cases),respectively].In spring and summer,there was a higher detection rate of HPIV infection.The clinical manifestations with simple infection of HPIV Ⅰ and HPIV Ⅲ were cough,fever and wheezing.The rate of fever and shortness of breath in those of HPIV Ⅰ was 71.74％ (33/46 cases),10.87％ (5/46 cases),and that in HPIV Ⅲ was 40.12％ (134/334 cases),2.10％ (7/334 cases),HPIV Ⅰ infection was more likely to cause fever and shortness of breath than those of HPIV Ⅲ,there were significant differences (x2 =16.410,P ＜ 0.001;x2 =10.177,P =0.001).Pneumonia had the highest detection rate of viral infection.Conclusions HPIV Ⅲ is the leading pathogen among the types of HPIV in the hospitalized children in Suzhou area.Among the subtypes of HPIV,the peak of HPIV infection occurs in spring and summer.The children less than 3 years old are the most susceptible to parainfluenza virus,and the HPIV detection rate is gradually declines with age.

Objective: To study the effect of three different doses of propofol, midazolam and etomidate on short latency somatosensory evoked potential(SLSEP). Method:Ninety patients undergoing elective operation were randomly divided into 3 groups with 3 subgroups each,and propofol,midazolam,etomidate were administered by bolus injection at propofol 1.5,2,3mg/kg, midazolam 0.2,0.3,0.4mg/kg, etomidate 0.15,0.3,0.4mg/kg accordingly. SLSEP was recorded before,during and after injection. Result:Propofol did not significantly change the latencies of the subcortical N_(14),cortical N_(20) and central conduction time(CCT)N_(14)-N_(20),decreased the interwave amplitude N_(20)-P_(25)(P

Objective: To compare the effect of scalp acupuncture and scalp acupuncture plus acupuncture exercise therapy (AET) on walking ability in children with spastic cerebral palsy (CP). Methods: A total of 60 spastic CP children with gross motor function classification system (GMFCS) grades Ⅰ-Ⅲ were divided into a control group and an observation group by the random number table method, with 30 cases in each group. Both groups were treated with the same conventional rehabilitation and scalp acupuncture therapy for CP. The control group received conventional rehabilitation first and then scalp acupuncture. The observation group received AET, which was to receive the conventional rehabilitation and scalp acupuncture simultaneously. Before and after treatment, the clinical efficacy was evaluated by the modified Ashworth scale (MAS) score, scores of dimensions D and E of the gross motor function measure (GMFM) scale, walking speed, and walking distance. Results: During treatment, there were 2 dropouts in the observation group. After 3 courses of treatment, the MAS scores in both the control group and observation group decreased compared with the same group before treatment (P<0.05), and the scores of dimensions D and E of the GMFM, walking speed, and walking distance were increased (P<0.05); the between-group comparison showed that the MAS score in the observation group was lower than that in the control group (P<0.05), and the scores of dimensions D and E of the GMFM, walking speed, and walking distance in the observation group were higher or longer than those in the control group (P<0.05). Conclusion: W ith the same treatments, scalp acupuncture combined with AET is superior to the conventional scalp acupuncture method in reducing lower-limb muscle tone, improving standing balance ability, and walking stability in children with spastic CP.

Objective To study the epidemiological and clinical features of viral pathogen of acute respiratory tract infection(ARTI)in children in Suzhou. To provide the evidence-based medicine for early warning,diagnosis and treatment of respiratory tract infection in children. Methods The study population comprised of all the children ranging from 28 days to 15 years old with ARTI admitted to Department of Respiration,the Childrenˊs Hospital Affiliated to Soo-chow University,between January 2006 and December 2015. The study cases were divided into 4 age groups based on ages(28 days to <1 year old,1- <3 years old,3- <5 years old and ≥5 years old). The nasopharyngeal aspirates and medical history were obtained by qualified medical personnel. Seven kinds of common respiratory virus were detec-ted by using the direct immunofluorescence. Mycoplasma pneumonia(MP),chlamydia pneumonia(CP)and human bo-cavirus(hBoV)were detected by adopting fluorescence quantitative PCR. Human rhinovirus(HRV)and human metap-neumovirus(hMPV)were detected by means of reverse transcriptionpolymerase chain reaction( RT -PCR). Sputum was cultured for bacteria. Results In 21 624 cases,17 618 cases were detected,and the positive detection rate of virus was 30. 74%(5 416 cases). The highest detection rate of virus was 44. 25%(881/1 991 cases)in 2011 in the 10 years. There were 3 317 cases of single virus pathogen infection,accounting for 18. 83%. Among them,respiratory syn-cytial virus(RSV)was the first with 9. 42%(1 660/17 618 cases),followed by HRV(5. 17%,278/5 372 cases), hBoV(3. 12%,351/11 263 cases),Pinf 3(2. 17%,383/17 618 cases),and the lowest rate was Pinf 2 with 0. 05%(8/17 618 cases). There were 2 099 cases of overlap infection,accounting for 11. 91%. The virus combined with bacte-rial infection accounted for 7. 86%(1 384/17 618 cases),which had the most positive cases. With the increase of age, the single virus pathogen infection rate gradually dropped. The highest detection rate was 22. 82%(1 976/8 656 cases) in the group between 28 days and <1 year old,and the lowest detection rate was 7. 81%(159/2 035 cases)of children over 5 years of age. The virus positive rate of the four seasons was 18. 28%(833/4 556 cases),13. 86%(625/4 508 cases),5. 91%(684/4 298 cases),27. 68%(1 178/4 256 cases),respectively,and detection rate in winter was the highest,and the least in summer. In the single virus infection,bronchiolitis had the highest percentage(36. 32%,25/69 cases),and the least rate was 5. 83%(63/1 080 cases)of lobar pneumonia. Conclusions Monitored for 10 years of the virus respiratory infection in Suzhou area,RSV,HRV and hBoV turned out to play an important role in respiratory tract infection in children. The children less than 3 years old are the most susceptible to virus infection. The epidemic season of each virus is different and characteristic.

Objective To evaluate the effects on catheter related blood stream infection by different dressing frequency of peripherally inserted central catheter(PICC)with neonates. Methods A systematic review of randomized controlled trials (RCTs) from databases, Data were searched about the transparent dressing replacement frequency for neonatal PICC catheterization. The meta-analysis was performed by using RevMan 5.2 software. Results Nine RCTs were included in a total of 1 730 patients. Meta analysis showed that there was no significant difference in the incidence of PICC puncture dressing, catheter-related infections (including puncture port infection, catheter-related blood flow infection, catheter bacterial colonization) at every 3, 5, and 7 days (P> 0.05). Conclusion the dressing of PICC catheter are replaced will not increase the incidence of catheter-related infections within 7 days, throughout the more appropriate frequency of dressing replacement is once every 7 days.

Objective:To explore the application value of transrectal ultrasound images classification network model of prostate cancer based on deep learning in the classification of benign and malignant prostate tissue in transrectal ultrasound images.Methods:A total of 1 462 two-dimensional images of transrectal prostate biopsy with clear pathologic results(including 658 images of malignant tumor, 804 images of benign tumor) from 203 patients with suspicious prostate cancer(including 89 cases of malignant tumor, 114 cases of benign tumor) were collected from May 2018 to May 2021 in the First Affiliated Hospital of Jinan University. They were divided into the training database, validation database, and test database. And the training and validation database were used to train and obtain the intelligence-assisted diagnosis network model, and then the test database was used to test the network model and two ultrasound doctors of different ages. With pathologic diagnosis as the gold standard, the diagnostic performance among them was evaluated.Results:①The sensitivity of network model was 66.7% the specificity was 91.9%, the accuracy was 80.5%, the precision(positive predictive value) was 87.1%. The area under the ROC curve was 0.922. ②The accuracy of the junior and senior ultrasound doctors was 57.5%, 62.0%; the specificity was 62.0%, 66.3%; the sensitivity was 51.5%, 56.8%; the precision was 53.1%, 58.1%, respectively. ③The accuracy, sensitivity, specificity, precision of classification: the network model > the ultrasound doctors, the differences were significant( P<0.05); the senior ultrasound doctor>the junior ultrasound doctor, the differences were not significant( P>0.05). Conclusions:The intelligence-assisted diagnosis network model based on deep learning can classify benign and malignant prostate tissue in transrectal ultrasound images, improve the accuracy of ultrasound doctors in diagnosing prostate cancer. It is of great significance to improve the efficiency of screening for patients with high clinical suspicion of prostate cancer.

Objective To explore the correlation between injection peak pressure and tubal patency during real-time three-dimensional hysterosalpingo-contrast sonography(RT 3D-HyCoSy).Methods One hundred and seven patients who were scheduled to undergo transvaginal RT 3D-HyCoSy with SonoVue contrast agent were included in the study.They were injected with contrast agent by an YLD-YZ-800 auto contrast agent injection device. The patients were divided into tubal patency included bilateral patency group,one side patency group and bilateral positive group according to imaging results. During the examination,the injection peak pressure was recorded to analyze whether there were significant differences among the three groups.Results The contrast agent injection peak pressures of bilateral patency group,one side patency group and bilateral positive group were (34.58 ± 8.25)kPa,(44.85 ± 10.05)kPa and (54.26 ± 11.65)kPa,respectively. The differences of injection pressure among the three groups were statistically significant ( F = 38.732; P = 0.000,0.000,0.033). The peak pressure was negatively correlated with tubal patency ( r = -0.653,P =0.000).Conclusions Contrast agent injection peak pressure is associated with tubal patency in RT 3D-HyCoSy,and can be quantitatively measured to help for assessing fallopian tube patency.

Objective:To compare the accuracy of IOLMaster 700 and IOLMaster 500 in intraocular lens (IOL) power calculation.Methods:A cross-sectional study was conducted.Two hundred and sixty-two eyes of 262 patients who underwent phacoemulsification combined with IOL implantation at the Eye Hospital of Wenzhou Medical University from November 2018 to November 2019 were enrolled.Preoperative biometry for cataract surgery was performed using IOLMaster 700 and IOLMaster 500.IOL power was calculated through the built-in formulas, Haigis, Holladay Ⅰ, Hoffer Q and SRK/T of the two devices.The difference in IOL power calculation between the two devices was analyzed through the prediction error of IOL power calculation using different formulas across different axial length (AL) ranges.This study complied with the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Eye Hospital of Wenzhou Medical University (No.2020-038-K-33). Written informed consent was obtained from each patient before the surgery.Results:There was no significant difference in mean absolute error (MAE) between IOLMaster 700 and IOLMaster 500 using Haigis, Hoffer Q and SRK/T over the entire AL range (all at P >0.05). The MAE of IOLMaster 500 was 0.47 (0.24, 0.90) D, which was significantly lower than 0.50 (0.28, 0.99) D of IOLMaster 700 using Holladay Ⅰ formula ( Z=-3.120, P=0.002). When AL was <22.0 mm and ≥24.5 mm-<26.0 mm, there was no significant difference in MAE between the two devices using the four formulas (all at P >0.05). When AL was ≥22.0 mm-24.5 mm, there was no significant difference in the MAE between the two devices using Haigis, Hoffer Q and SRK/T (all at P >0.05), but 0.42 (0.18, 0.75) D from IOLMaster 500 was smaller than 0.45 (0.25, 0.79) D from IOLMaster 700 using Holladay Ⅰ, showing a statistically significant difference ( Z=-3.487, P <0.001). But the difference was negligible and therefore was of no clinical significance.When AL was ≥26.0 mm, there was no statistically significant difference in the MAE between the two devices using Haigis, Holladay Ⅰ and SRK/T, but 0.66 (0.38, 1.00) D from IOLMaster 500 was significantly smaller than 0.98 (0.62, 1.32) D from IOLMaster 700 using Hoffer Q ( Z=-3.046, P=0.002). Conclusions:The refractive prediction accuracy of IOLMaster 700 and IOLMaster 500 using Haigis, Hoffer Q and SRK/T is similar over the entire AL range.For patient with long AL, the IOL calculation from IOLMaster 700 using Hoffer Q is significantly larger than that from IOLMaster 500, which requires extra caution in clinical practice.The accuracy of IOLMaster 700 and IOLMaster 500 for IOL prediction is very similar.

OBJECTIVE： To investigate the effects and its mechanism of calcium phosphate bone cement （CPC） loading total flavonoids of Davallia mariesii on osteogenic differentiation of induced membrane in rats. METHODS： Drug-loading CPC and drug-loading polymethyl methacrylate （PMMA） cement were prepared with the contents of Qianggu capsules （total flavonoids of D. mariesii as active ingredient） using CPC and PMMA cement as carrier. Totally 64 male SD rats were randomly divided into drug-loading CPC group， drug-loading PMMA cement group， no-drug CPC group， no-drug PMMA cement group， with 16 rats in each group. The femur of rats was separated and osteotomized to prepare bone defect model， and then the corresponding bone cement was implanted. Four weeks after modeling， the induced membranes of rats were cut and protected. Bone cement was taken out and autogenous cancellous bone was implanted. At the 4th week after modeling， X-ray photographs were taken on the hind limb bones of rats. At the 4th week after modeling and 6th week after bone grafting， induced membranes and new bone were taken from the bone defect area of rats respectively. HE staining was used to observe the morphology of induced membrane， and the width of bone rabecular and the number of osteoblasts of new bone tissue were measured. Immunohistochemistry was used to detect the protein expression of BMP-2 and VEGF in induced membrane. Western blotting assay was used to detect the protein expression of Smad1， Smad4 and Smad7 in new bone. RESULTS： Compared with other 3 groups， the degradation of bone cement in drug-loading CPC group was more obvious in the bone defect areas， which showed that the formation of induced membrane was observed and the bone defect areas were smaller； capillary endothelial cells were abundant and orderly arranged in the induced membranes， and the width of bone trabeculae and the number of osteoblasts in the new bone tissue increased significantly （P＜0.05）； the protein expression of BMP-2 and VEGF in the induced membrane， the protein expression of Smad1， Smad4 and Smad7 in new bone were increased significantly （P＜0.05）. CONCLUSIONS： CPC loading total flavonoids of D. mariesii promotes the formation of induced membrane osteoblast in bone defect model rats， which may be associated with regulating osteoblast differentiation by activating BMP-2/Smad pathway； at the same time， it can promote bone healing by promoting the differentiation of vascular endothelial cells， accelerating the formation of capillary network and increasing the expression of vascular endothelial cells.