OBJECTIVE:To evaluate the effects of clinical pharmacists'intervention on prophylactic use of antibiotics in re-moval of internal fixation device for fracture. METHODS:Totally 117 patients underwent removal of internal fixation device for fracture were selected from some on third grade class A hospital during Mar.-Jul. 2015 as pre-intervention group. Totally of 266 pa-tients underwent removal of internal fixation device for fracture were selected during Aug. 2015-May 2016 as post-intervention group. Clinical pharmacists performed interventions based on Rationality Evaluation Criteria for Prophylactic Use of Antibiotics in Removal of Internal Fixation Device for Fracture. The prophylactic use of antibiotics was compared between 2 groups before and af-ter intervention. RESULTS:No unreasonable single dose or additional drug during surgery was found before and after intervention. After intervention,utilization rate of antibiotics for prophylactic use,the proportion of patients receiving antibiotics without indica-tions,the proportion of medication duration more than 24 h decreased from 84.6%,71.8%,48.7% to 17.3%,9.8%,4.9%,re-spectively. Average antibiotics cost,the proportion of total drug cost in hospitalization cost,the proportion of antibiotics cost in to-tal drug cost were all decreased significantly compared to before intervention,with statistical significance(P<0.05). There was no statistical significance in the proportion of patients with unreasonable drug choice,unreasonable initial prophylactic medication tim-ing and unreasonable drug combination,the proportion of different antibiotics types,average hospitalization cost and average drug cost(P>0.05). CONCLUSIONS:Clinical pharmacists'interventions significantly reduce the utilization rate of antibiotics for pro-phylactic use in patients underwent removal of internal fixation device for fracture,improve drug use without indications and ratio-nality of prophylactic use of antibiotics. There still are problems,such as unreasonable medication timing,continuous use time of more than 24 h,etc. It is necessary to continuous follow-up intervention.

Objective To introduce a new economical method which can be used for determination of urinary iodine of batch samples with low cost of arsenic trioxide,and decrease environmental pollution.Methods A catalytic spectrophotometry for measuring iodine content in a small volume of urine samples with low cost of arsenic and cerium was established based on the principle of ammonium persulfate digestion As3+-Ce4+ catalytic spectrophotometry.Ninety-six well polypropylene microplate was utilized as digestion and catalysis reaction vessel,conventional laboratory oven was used as a tool to digest and heat,ice plate was used to cool,and the absorbance was read with the Multimode Reader.The accuracy of the new method was evaluated with the current standard method (WS/T 107-2006) by simultaneous determination of urinary iodine of 24 urine samples.Results The linear range of this method was 0-300 μg/L,the linear correlative coefficient (r) was higher than 0.999,and the detection limit was 8.67 μg/L.The coefficient of variations was 2.15％,4.33％ and 3.48％ when measuring urine samples with high,medium and low iodine concentration,respectively.The test results of three national standard urinary iodine samples were all within the given value range and the relative deviation (RD) was-0.16％,1.81％ and-2.82％,respectively.The average recovery of the low concentration was 97.51％,and that of the high concentration was 96.01％.The two methods correlated well (r =0.995,P ＜ 0.01).Conclusions This method greatly reduces the arsenic waste,environmental pollution,consumables and labor.The new method is simple and efficient,accurate and reliable;it is suitable for application as a supplementary method for analyzing urinary iodine of a large number of samples.

Objective To explore the role of night waking in the cognitive development of infants and young toddlers. Method A total of 116 infants aged 2 to 30 months were randomly selected in Yiwu, Zhejiang from December 2011 to February 2013. Social-demographic factors were investigated through questionnaire;sleep information were collected via the Brief Infant Sleep Questionnaire (BISQ);Cognitive development was assessed in all infants using Baley development scale. Results The mean age was 12.99 month-old. 50.86%(59/116) were males. Ocassional night waking was reported in 5.26%, one night waking in 29.82%, multiple night waking accounted in 64.91%of children under one year old. Ocassional night waking was reported in 32.20%, one night waking in 45.76%, multiple night waking in 22.03%of children over one year old. The frequency of night waking was signiifcantly different between children under one year old and children over one year old (P<0.01). The average duration of waking was 0.49±0.31 h in children under one year old, and 0.31±0.48 h in children older than one year old, and the difference was signiifcantly different (Z=4.35, P<0.001). In children over one year old, the more frequent night waking, the lowered MDI scores (F=3.98, P=0.024). The waking duration was negatively correlated with MDI scores in children over one year old (r=-0.26, P=0.035). Neither night waking duration nor night waking frequency had signiifcant correlation with MDI scores in children under one year old. Multivariable linear regression conifrmed that night waking was an independent inlfuential factor of MDI and PDI scores in children over one year old. Conclusions Persistent night waking should warrant attention.

OBJECTIVEThe term "premature thelarche" refers to isolated breast development before 8 years of age in female, without any other signs of sexual maturation, while "gynecomastia" is the presence of breast tissue in males. This study aimed to investigate the prevalence of premature thelarche and gynecomastia in Chinese infants and toddlers, identify the potential risk factors, and explore the influence of early breast development on physical growth, mental development and psychomotor development.

METHODA total of 1 510 full term and healthy children at the age of 0-48 months were sampled by stratified cluster random sampling method from 8 provinces from 2011-2012. Weight, height and breast development were assessed by senior primary pediatricians, while Bayley Scale of Infant Development-I (BSID-I) was used to measure the mental developmental index (MDI) and psychomotor developmental index (PDI) for children aged 2-30 months. Social-demographic Questionnaires were completed by the caregivers.

RESULTThe combined prevalence of premature thelarche and gynecomastia was 1.6% (23/1 475), girls 2.2% (15/695), boys 1.0% (8/780), all within 2 years of age. The birth weight, feeding patterns in first 4 months, delivery mode, weaning time and social economic status were not significantly associated with the breast development. However, lower father's education level (OR = 3.632, 95%CI = 1.565-8.432) as well as smoking mother (OR = 18.960, 95%CI = 1.590-226.304) were significantly related to breast development even after adjusting for potential confounders. Lower weight (-0.479 ± 0.648 vs. 0.005 ± 0.987, P < 0.05) and height (-0.602 ± 1.042 vs. 0.008 ± 0.986, P < 0.05) Z score were found in breast development group, even after adjusting for age, gender and father' education level. Neither mental development (t = -0.082, P > 0.05) nor psychomotor development (t = 1.054, P > 0.05) was associated with breast development.

CONCLUSIONWe showed a similar prevalence of premature thelarche with the data reported in similar studies reported from other countries. Among the 0-48 months old infants and toddlers, Father's education level and smoking mother were both related to breast development. Breast development was significantly associated with physical growth, but had no correlation with the mental or psychomotor development.

African Continental Ancestry Group ; Body Height ; Body Weight ; Breast ; growth & development ; Child Development ; Child, Preschool ; Cross-Sectional Studies ; Environmental Exposure ; Female ; Gynecomastia ; epidemiology ; etiology ; Humans ; Infant ; Infant, Newborn ; Male ; Multivariate Analysis ; Prevalence ; Puberty, Precocious ; epidemiology ; etiology

Objective: To investigate the current bedtime routine among Chinese children less than 3 years of age and explore its dose-dependent association with sleep duration and sleep quality. Method: Healthy full-term born children aged 0-35 months were selected by stratified cluster random sampling method from 8 provinces in China following the "Hospital of Province-City-County" sampling technical route during 2012-2013.Brief Infant Sleep Questionnaire(BISQ) was used to assess sleep conditions of these children.Children′s personal and family information was obtained by Shanghai Children′s Medical Center Socio-demographic Questionnaire.Both of these questionnaires were filled in by parents. The effects of bedtime routine on children′s sleep duration and quality were analyzed by multivariate analysis of variance. Result: The children′s average age was(12±10) months(n=1 304), of whom 689 were males (52.8%, 689/1 304). There were 48.5%(632/1 304)of the parents reported that their children had not established regular sleep routines. There was a consistent dose-dependent association between bedtime routine and sleep duration, as well as other indicators for sleep quality (all P<0.05). The more regular the sleep routines, the longer the sleep duration, the earlier the children went to sleep, the shorter the sleep onset latency, the fewer the nighttime wakeup and the shorter the nighttime waking.The nighttime sleep duration was significantly longer for those with a bedtime routine 'every night’ than those who 'never’ had a bedtime routine (9.5(95%CI: 9.4-9.6)vs. 8.9(95%CI: 8.6-9.3)h, t=3.345, P=0.001). Compared with children who never had bedtime routines, children with regular bedtime routines had fewer night wakeup (1.3(95%CI: 1.2-1.4) vs. 2.4( 95%CI: 2.0-2.9), t=3.182, P=0.001) and shorter night waking duration(16.6(95%CI: 14.6-18.8) vs. 59.2 (95%CI: 47.0-72.7)min, t=6.383, P<0.01). Conclusion The percentage of children who have established regular bedtime routine is low in China. There is significant dose-dependent association between regular bedtime routine and sleep outcomes, especially sleep quality. The more regular the sleep routines, the better the sleep quality.

OBJECTIVETo explore the current television viewing situation among children less than 4 years of age in our country and investigate effects of television viewing on sleep quality.

METHODAccording to the"Hospital of Province-City-County"sampling technical route, a total of 1 046 full term healthy children at the age of 4-48 months were sampled by stratified cluster random sampling method from 8 provinces in China from 2012-2013. The information of television viewing and family and personal information was investigated by Shanghai Children's Medical Center Socio-demographic Questionnaire. Brief Infant Sleep Questionnaire (BISQ) and Brief Child Sleep Questionnaire (BCSQ) were employed to assess the sleep behaviors of children 0-3 years old and over 3 years old respectively.The effects of television viewing on sleep quality were analyzed by multiple linear regression analysis.

RESULTThe children's average age was (20±13) months, with boys accounted for 53.3% (558/1 046). The percentage of children who viewed television was 70.3% (735/1 046). Moreover, 58.7% (408/695) of infants and young children under the age of 2 viewed TV per day, and 19.9% (70/351) of 2 years and older infants and young children viewed television ≥2 hours per day. With the increase of age, the percentage of children who viewed television time gradually increased (P<0.001). Child sex, geographic area, paternal education, and family structure were not associated with television viewing time among children aged 4-48 months. However, the presence of a bedroom TV(χ(2)=13.682, P=0.001) and maternal employment (χ(2)=15.053, P=0.005) were commonly correlated with long screen-watching time among children. After adjusting for age, gender, mother' education level, and working state, it was revealed by multiple linear regression analysis that television viewing was not only positively correlated with later bedtime (t=5.49, P<0.001) and shorter night sleep duration (t=-3.49, P=0.001) but also significantly associated with longer sleep onset latency (t=2.63, P=0.009).

CONCLUSIONThe percentage of children under 4 years of age who viewed television is very high in our country, and many infants under 6 months of age exposed to TV environment. Bedroom TV and mother full-time job were associated with higher proportion of children viewing TV. In early childhood, television viewing was positively correlated with later bedtime, shorter sleep duration and longer sleep onset latency. There is a need for parents and pediatricians to pay more attention to the behavior of children viewing TV and improve sleep quality.

Child, Preschool ; China ; Family ; Female ; Humans ; Infant ; Male ; Parents ; Sleep ; Surveys and Questionnaires ; Television ; Time Factors