Objective:To analyze the injury factors and prognosis of children with traumatic brain injury (TBI), and to explore the risk factors affecting its severity, so as to provide evidence for the prevention and intervention of TBI in children.Methods:A total of 6 040 children with TBI who were admitted to the Department of Neurosurgery of Children's Hospital of Soochow University from January 1, 2011 to December 31, 2020 were selected. The injury factors and prognosis were retrospectively analyzed. Univariate and multivariate Logistic regression analysis was used to analyze the factors affecting the severity of TBI in children.Results:Of the 6 040 children, 3 681 were males and 2 359 were females. The patients aged 1 to 3 years accounted for the highest proportion (34.0%, 2 056/6 040), and most of them were mild injuries (93.2%, 5 631/6 040). The main injury sites of children with TBI were road (35.9%, 2 167/6 040) and home (31.1%, 1 881/6 040), and the main causes of injury were falling from height (34.9%, 2 107/6 040) and falling (34.5%, 2 085/6 040). Children aged 1 to 3 years were most likely to be injured at home(41.9%, 861/2 056), mainly due to falling from height, while children aged 4 to 6 years were most likely to be injured on the road(43.8%, 828/1 891), mainly due to falling. Logistic regression analysis showed that children's residence, the presence of multiple injuries and the location of brain injury were independent influencing factors for the severity of TBI in children ( χ2=6.58, 138.15, 4.25, all P <0.05). Conclusions:TBI in children aged 1 to 3 years mainly occurred at home, and in children aged 4 to 6 years mainly occurred on the road. Falling from height and falling are the main causes of TBI in children. The society, schools and families should take targeted prevention education and intervention measures according to different age groups. Children who live in rural areas, have multiple injuries, and have multiple brain injury sites are more severely injured. In the process of treating children with TBI, the severity can be quickly predicted based on this, and the treatment efficiency of children with TBI can be improved.

目的 了解婴幼儿股骨干骨折住院患儿的流行病学特征,并探讨预防对策.方法 对2015年1月—2019年12月本科收治的195例股骨干骨折婴幼儿信息进行回顾性流行病学分析.结果 婴幼儿股骨干骨折患儿平均年龄为(22.3±8.5)月;男女性别比为1.83:1;受伤季节以春夏季为主;每天的12时～18时为事故高发时段;受伤原因以摔伤为主,占57.4％;受伤地点以家中为主,占69.2％;治疗方式主要采取垂直悬吊皮肤牵引后髋人字石膏固定,占68.2％;平均住院时间为(16.9±6.38)d.结论 本研究结果显示了苏州地区婴幼儿股骨干骨折住院患儿的流行病学特征及变化趋势,为降低婴幼儿股骨干骨折的发生率,本研究从年龄、性别、季节、骨折好发地点等方面采取针对性及重点性的预防干预,着重加强监护人安全教育,并借助社区力量,为婴幼儿健康成长创造良好的环境.

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.

目的 探讨快速康复外科在儿童先天性髋关节脱位矫正术中的应用效果.方法 选取2018年1月—12月在本科行髋关节切开复位+Salter骨盆截骨+股骨近端旋转短缩内翻截骨+钢板内固定+髋人字石膏固定术的患儿62例,随机分为干预组和对照组,各31例,对照组给予常规护理,干预组给予快速康复护理措施,观察两组患儿术后疼痛评分、功能锻炼依从性、患儿家属护理满意度、住院天数、住院费用等情况.结果 干预组术后12h、24h、48h、72h疼痛评分明显低于对照组(P<0.05);干预组术后功能锻炼依从性明显高于对照组(P<0.05);干预组术后住院天数、住院费用明显少于对照组(P<0.05).结论 快速康复外科理念在儿童先天性髋关节脱位矫正术中的应用可以减少患儿住院天数,缓解患儿术后疼痛,有效提高患儿术后功能锻炼的依从性,提高患儿家属满意度.

[目的]调查江苏省三级儿童医院护士疼痛管理的知识及态度并探讨其影响因素,为针对性制订儿科护士疼痛管理培训方案提供科学依据.[方法]采用问卷星电子问卷填写方式,采用一般资料调查表、中文版儿科护士疼痛知识与态度调查量表对江苏省三级儿童医院的649名在职护士进行问卷调查.描述一般人口学及疼痛管理现状、疼痛知识与态度得分及正确率,分析其影响因素.[结果]江苏省三级儿童医院护士疼痛知识与态度总分为17.10分±3.95分.多因素线性回归结果显示:是否正在或曾经担任护士长、学历、科室是影响护士疼痛管理知识及态度的因素,可解释28.4％的变异量.[结论]儿童专科医院护士疼痛管理知识及态度存在缺陷,建议构建与临床实践密切相关的儿童疼痛管理培训项目,以提高护士疼痛管理知识.

目的 探讨基于微信平台的延伸护理在肘部骨折患儿术后功能锻炼中的应用效果.方法 选取2017年1月-2017年8月在本科住院的肘部骨折患儿102例,随机分为实验组51例和对照组51例,对照组术后进行常规的功能锻炼指导,实验组术后实行常规的功能锻炼指导及微信平台延伸护理服务,两组锻炼时间一致,观察时间为12周.结果 实验组患儿第12周时Mayo肘关节评分为(97.30±2.64),肘关节活动能力明显优于对照组,两组差异有统计学意义(P<0.01),患儿功能锻炼的依从性为(1.99±0.81),明显高于对照组,两组差异有统计学意义(P<0.01).结论 基于微信平台的延续护理服务有利于提高肘部骨折患儿术后功能锻炼的依从性,提高锻炼效果,促进骨折的恢复.

Obj ective:To probe into the influence of therapeutic game on treatment compliance of hospitalized children in orthopedic department. Methods:According to the random sampling method,a total of 120 cases of hospitalized patients who were in line with the sample standard were divided into control group and intervention group,60 cases in each.The patients in control group received treatment and care according to the orthopaedic care routine,patients in intervention group were brought to our department for therapeutic game for 20 min before routine treatment (Children who can not get out of bed can be at the bedside),then to observe and compare the status of ill children matching clinical treatment between both groups.Results:There was statistically significant difference in the status of ill children matc-hing clinical treatment between both groups (P<0.05).Conclusion:Thera-peutic game for ill children before routine treatment can significantly reduce ill Children’s fear and can help children with clinical treatment.

Objective To explore the short-term,medium-and long-term bone stability difference between bone level implant(ANKYLOS) and soft tissue level implant(XIVE).Methods Dental films and panoramic radiographs in 50 cases of XIVE and 68 cases of ANKYLOS single dental implant were used for observation of the height changes of the alveolar bones around the implant bones implanted for 3,6 and 12 months,in single dental implants restration in 50 cases of XIVE and 68 cases of ANKYLOS.The observation was also made for bone resorption with statistical analysis.Results One year after implantation,alveolar bone around the XIVE implant made absorption progressively and alveolar bone around the ANKYLOS implant did evenly and slowly;Observation and analysis on two kinds of implants in different observation period were made,the level of bone resorption in ANKYLOS was better in ANKYLOS implant than that in XIVE.Conclusion With exception of the surface treatment technology and impact loading conditions,and other important conditions,in bone resorption areas around the implant,the bone level implant is superior to the soft tissue level implants.

Objective To evaluate the fracture resistance of anterior teeth restored with glass fiber post and resin core restoration as well as cobalt-chromium alloy post and core restoration.Methods 251 patients with maxillary anterior teeth defects were collected.326 teeth were randomly divided into two groups(A,B).The patients in group A were restored with glass fiber post and resin core;the patients in group B were restored with cobalt-chromium alloy cast post and core.Observe the fracture of maxillary anterior teeth in 2 to 3 years.Results Significant difference was found in fracture resistance of teeth with two restorations(P<0.05).Conclusions The fracture resistance of anterior teeth with glass fiber post and resin core restoration was significantly better than that with the cobalt-chromium alloy post and core restoration.

Objective By observing and analyzing the different expressions of Cyclin D1 at nor-mal oral mucous、oral atypical hyperplasia and oral squamous cell carcinoma(OSCC),to investigate the relationship of its abnormal expressions,cancerate and metastasis.Methods With immunohistochem-istry the different expression of Cyclin D1 in 17 cases of normal oral mucous,6 cases of oral atypical hyperplasia and 52 OSCC was detected.Results(1)There were different expressions at normal oral mucous,oral atypical hyperplasia and OSCC for Cyclin D1.There was lower positive ratio in normal oral mucous,and oral atypical hyperplasia for Cyclin D1 than that in OSCC;The positive expression ratio of Cyclin D1 decreased with the differentiations degree.(2)There were relations with metastasis of carcinoma.Conclusion Cyclin D1 has important effect on metastasis and differentiations of OSCC.There was relationship with metastasis or differentiation of carcinoma for the expressions of Cyclin D1.

选择上前牙缺失兼前牙反(牙合)8例,采用正畸方法矫治后,以固定桥修复缺失牙,并观察其效果.结果:所有患者在治疗完成后,达到了良好的美观和功能稳定的效果,患者基本满意.认为对上前牙缺失兼前牙反牙合患者,运用正畸与修复相结合的方法,能取得美观、功能稳定的效果.