Objective To investigate the drainage volume and nursing method of lifted tube drainage and continuous negative pressure drainage after lower lumbar surgery.Methods A total of 248 consecutive patients undergoing the first or second lumbar spine surgery from January 2008 to July 2013 were prospectively randomly divided into two groups.116 patients in the experimental group (group A) took the lifted tube drainage and 132 patients in the control group (group B) took the normal continuous negative pressure drainage protocol after surgery.The total drainage volume,pre-and post-operative hemoglobin,post-operative temperature,complications and JOA score in the two groups were compared.Results The average drainage volume after single or two segment surgery were (97.0 ± 34.2)ml and (108.5 ± 32.7)ml in group A.The average drainage volume after single or two segment lower lumbar surgery were (393.4 ± 143.5) ml and (448.2 ± 169.6) ml in group B,the difference was statistically significant (t =14.43,17.55,respectively;P ＜ 0.01).There was no significant difference in drainage volume in single or two segment in group A and B (P ＞ 0.05).The post-operative hemoglobin level was (121.7 ± 13.4) and (117.8 ± 12.5) g/L in group A and B respectively,the difference was statistically significant (t =2.38,P ＜ 0.05).Conclusions Based on the findings in this study,lifting the drainage tube to an appropriate height is a simple and safe way to reduce postoperative drainage volume in lower lumbar spine surgery which is worthy of further investigations.

Placental and maternal-fetal circulation Doppler ultrasound are the main noninvasive means for maternal-fetal monitoring. However, Doppler studies on placental abnormalities are not well studied yet. Doppler monitoring of the maternal-fetal circulation, involving uterine arteries, umbilical arteries, and fetal vessels, is still used to screen diseases related to placental dysfunction (such as preeclampsia and fetal growth restriction) and to guide clinical management. This article reviews the advances in the clinical application of placental and maternal-fetal circulation Doppler in obstetrics to optimize the clinical management of disorders associated with abnormal placental structure and function.

ObjectiveTo explore the influence of the core symptoms of attention deficit hyperactivity disorder （ADHD） on behavioral problems of children with ADHD propensity， so as to provide references for early identification and targeted intervention for children with ADHD propensity. MethodsFrom July to August 2021， 25 children with ADHD propensity were screened as the ADHD propensity group， and 25 children matched for age， gender and grade were included as the normal group in an elementary school in Guangzhou. ADHD core symptoms were assessed by the Chinese version of the Swanson Nolan and Pelham， version IV-parent form for ADHD （SNAP-IV）， and behavioral problems were assessed by Questionnaire-Children with Difficulties （QCD） and Conners Parental Symptom Questionnaire （PSQ）. Spearman correlation analysis was used to examine the correlation between ADHD core symptoms and QCD and PSQ scores， and hierarchical linear regression analysis was used to explore the effect of ADHD core symptoms on behavioral problems. Results① The differences between the groups showed that both attention deficit and hyperactivity-impulsivity factor scores were higher in the ADHD propensity group than those in the normal group （t=7.771， 6.726， P<0.01）. ② Correlation analysis showed that the attention deficit factor score was negatively correlated with QCD total score （r=-0.440， P<0.05）， and positively correlated with the learning problem factor score of PSQ （r=0.457， P<0.05）. The score of hyperactivity-impulsivity was negatively correlated with score of anxiety factor in PSQ （r=-0.457， P<0.05）， and positively correlated with impulse-hyperactivity factor score （r=0.552， P<0.01）. ③ Hierarchical linear regression analysis showed that the attention deficit factor score negatively predicted the total score of QCD （B=-0.682， P<0.05， R²=0.468）. The hyperactivity-impulsivity factor score had a negative predictive effect on the anxiety factor score of PSQ （B=-0.048， P<0.05， R²=0.367）， and had a positive predictive effect on the impulsivity-hyperactivity factor score （B=0.077， P<0.01， R²=0.424）. ConclusionChildren with ADHD propensity have significant attention deficit symptoms， hyperactivity-impulsivity symptoms and behavioral problems， and the attention deficit may be the main cause of their daily behavioral problems， while hyperactivity-impulsivity may be the main cause of their impulsive-hyperactivity problems.