Objective To study the effect of extended nursing on puerperal melancholia incidence.Methods Two hundred perpetrates received interventions of extended nursing after delivery,including education about puerperal state,turning on hot line and creation of QQ group,follow-ups and supporting from family members.Result The incidence rate of puerperal melancholia since performance of extended nursing was significantly lower than what is after its performance(P<0.01).Conclusions The extended nursing can help perpetrates to receive nursing knowledge,alleviate their anxiety,strengthen the confidence to take care of baby.As the result,it can reduce the incidence of puerperal melancholia.

Objective : To investigate the behavior problems and influencing factors of school-age students from the third to the sixth grade in Zhongshan,and to provide evidence for early intervention of behavior problems in children. Methods : According to the proportion of population in urban area and township in Zhongshan,students of Grade Three to Six from eight primary schools（three in urban area and five in township）were recruited by stratified sampling method. The behavior problems in children were assessed by the Conners Parent Symptom Questionnaire（PSQ）. Sociodemographic information,family discipline and so on was investigated by a general questionnaire. The influencing factors for behavior problems were analyzed by a logistic regression model. Results : A total of 2 292 questionnaires were issued,and 2 236 valid questionnaires were recycled,with an effective rate of 97.56%. The positive rate of behavioral problems was 11.72%. The results of multivariate logistic regression analysis showed that the risk factors for behavior problems were females（OR=1.594,95%CI：1.170-2.171）,birth asphyxia（OR=2.372,95%CI：1.320-4.261）,main family discipline（laissez-faire：OR=3.326,95%CI：1.450-7.630;doting：OR=3.244,95%CI：1.867-5.638;autocratic：OR=2.609,95%CI：1.584-4.296,mixed：OR=2.313,95%CI：1.669- 3.207）,less than four hours per week for father-child communication（OR=1.551,95%CI：1.052-2.286）,negative life events（OR=2.188,95%CI：1.448-3.308）,living in township（OR=2.031,95%CI：1.330-3.102）,academic performance （average：OR=2.786,95%CI：1.868-4.156;poor：OR=6.665,95%CI：3.236-13.727;very poor：OR=25.068,95%CI：5.786-108.617）;the protective factors were occupation of mother as civil servants or professional personnel（OR=0.449,95%CI：0.238-0.844）and higher grades（Grade Five：OR=0.496,95%CI：0.339-0.727;Grade Six：OR=0.468,95%CI：0.309-0.710）. Conclusion Females,birth asphyxia,main family discipline,less communication between father and child,occupation of mother,negative life events,place of residence,academic performance and grade were the influencing factors for behavior problems.

Objective:To investigate the clinical curative effect of closed reduction and internal fixation of Jakob type II lateral humeral condyle fractures in children under ultrasound guidance.Methods:A retrospective case series analysis was made on clinical data of 59 patients with Jakob type II lateral humeral condyle fractures treated at Children's Hospital of Chongqing Medical University from August 2016 to August 2017. There were 30 males and 29 females, with the age of 1.5-8.1 years [(4.0±1.8)years]. There were 34 patients treated by open reduction and internal fixation and monitored by the X-ray (control group), and 25 patients treated by closed reduction and internal fixation and monitored by ultrasound (study group). The operation time, bleeding volume, fracture healing time, and incidence of complications were compared between the two groups. The elbow joint function was evaluated by Broberg and Morrey standard at the latest follow-up.Results:All patients were followed up for 17-31 months[(23.2±4.2)months]. The operation time and bleeding volume in control group were (50.7±22.2)minutes and (6.1±3.8)ml, obviously higher than those in study group [(21.4±3.3)minutes, (1.1±0.3)ml] ( P<0.05). The fracture healing time was (8.0±0.8)weeks in control group and (7.8±0.7)weeks in study group ( P>0.05). According to the Broberg and Morrey standard, the good and excellent rate of elbow joint function in control group was 97%, with excellent results in 31 patients, good in 2, fair in 1, and poor in 0; the good and excellent rate of elbow joint function in study group was 100%, with excellent results in 22 patients, good in 3, fair in 0 and poor in 0 ( P>0.05). In study group, wound infection or malunion was not seen, and only two patients showed postoperative wire tail irritability and recovered after the removal of wires. While in control group, wound infection was seen in 3 patients and malunion was observed in 2 patients, but all patients were with distal humerus lateral bone formations. The incidence of complications was 15% in control group, higher than 0% in study group ( P<0.05). Conclusion:Compared to open reduction internal fixation, ultrasound-guided closed reduction and internal fixation of Jakob type Ⅱ lateral humeral condyle fractures in children has similar therapeutic effect, but it can shorten operation time and reduce bleeding and complications.

Objective:To summarize clinical manifestations and histopathological features of granular parakeratosis (GP) after exposure to benzalkonium chloride.Methods:A retrospective analysis was performed on 7 GP cases with a history of benzalkonium chloride exposure in the Department of Dermatology at Wuhan No.1 Hospital from April to August 2022. Data were collected on the general condition, skin lesion manifestations, pathological examination, treatment, and follow-up of the patients, and retrospectively analyzed.Results:The 7 adult patients with GP typically presented with erythema and brown scales in the intertriginous area, exhibiting an annular distribution pattern. All the 7 patients reported recent exposure to disinfectants containing benzalkonium chloride. A total of 10 skin biopsies were taken from the 7 patients. Histopathological examination showed characteristic hyperkeratosis and fine blue-gray parakeratotic granules in the stratum corneum. All skin lesions improved 1 month after cessation of exposure to benzalkonium chloride.Conclusion:GP has a distinct clinical pattern and histopathological manifestations, and a history of exposure to benzalkonium chloride can be helpful for the diagnosis of GP.

OBJECTIVE： To establish a method for the determination of levofloxacin concentration in human pleural effusion， to study its pharmaceutical characteristics. METHODS： Totally 6 patients with infectious pleural effusion received levofloxacin 0.4 g qd intravenous drip. Pleural effusion was collected at 0.5， 1， 2， 4， 8， 12 and 24 hours after administration. After treated with methanol precipitation protein， HPLC was used to determine the concentration of levofloxacin. The determination was performed on Agilent ZORBAX SB-C18 column with mobile phase consisted of methanol-0.02 mmol/L KH2PO4 buffer （containing 0.3％ triethylamine， 70 ∶ 30， V/V at the flow rate of 1.0 mL/min. The detection wavelength was set at 294 nm， and the column temperature was 35 ℃. The sample size was 20 μL. The pharmacokinetic parameters were calculated with WinNonlin 5.2 software. RESULTS： Under this chromatogram condition， retention time of levofloxacin was about 4.9 min， the peak shape was good， the baseline was stable， and the determination of endogenous substances in pleural effusion had no interference. The linear range of levofloxacin were 0.625-20 μg/mL（R2＝0.998 9）. The relative recovery rates were （83.75±1.66）％-（87.73±2.43）％ for low， medium and high concentration samples （n＝3）； RSDs of intra-day were 2.23％-4.96％ （n＝5）； RSDs of inter-day were 4.10％-4.78％（n＝5）； the accuracy ranged （97.76±4.85）％-（100.87±2.25）％（n＝5）； RSD of concentration was no more than 5％ in stability test （n＝3） for low， medium and high quality control sample. The pharmacokinetic parameters of levofloxacin included cmax were （2.21±0.87） μg/mL； AUC0-24 h were （37.31±11.94） μg·h/mL； t1/2 were （4.50±0.21） h. CONCLUSIONS： Established method is simple， reliable and sensitive， and can be used for the determination of levofloxacin concentration in human pleural effusion and its pharmacokinetic study.

Objective: To screen the hospitalized children with pectus excavatum for nutritional status, and to analyze the influencing factors of nutritional status, then to provide the scientific basis for comprehensive management of clinical nutrition. Methods: The body mass index (BMI) of 360 hospitalized children with pectus excavatum in Guangzhou Women and Children′s Medical Center from January 2013 to December 2017 were reviewed and compared with World Health Organization standard and the emaciation rate was calculated.The influencing factors such as CT index, age, weight, height, sex, the width of thorax and surgical treatment were analyzed with BMI. Results: Compared with the lowest standard of BMI, the whole emaciation rate of hospitalized children with pectus excavatum was 93.61% (337/360 cases): in which severe, moderate and slight emaciation were 74.17% (267/360 cases), 13.33% (48/360 cases), and 6.11% (22/360 cases), respectively.BMI was negatively related with CT index (r=-0.172, P=0.001), but positively related with age, weight, height, and the width of thorax (r=0.129, 0.342, 0.022, 0.179, P=0.014, 0.001, 0.673, 0.001). Three years after Nuss procedure, both the whole and severe emaciation rate decreased (93.62% vs. 95.74%; 65.96% vs. 78.72%), but the weight, height and BMI increased [25.5(12.5, 38.5) kg vs.17.0(10.0, 24.0) kg; 126.0(99.0, 153.0) cm vs.108.0(74.5, 143.5) cm; 14.69(12.38, 17.00) kg/m² vs. 14.36(12.17, 16.56) kg/m²], and the differences were significant (all P<0.01). Conclusions There is a high nutritional risk in hospitalized children with pectus excavatum, and the deformity severity is the main risk factor.Surgical treatment can improve the nutritional status effectively, but the malnutrition in pectus excavatum can not be corrected completely.