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 investigate the influence of oral midazolam on postoperative behavioral changes(NPOBCs)in preschool children undergoing laparoscopic inguinal hernia sac ligation.Methods A total of 197 preschool children,118 males and 79 females,aged 1-6 years,BMI 14.0-24.5 kg/m2,ASA physical status Ⅰ or Ⅱ,who undergoing laparoscopic inguinal hernia sac ligation from July 2022 to A-pril 2023 were selected.The children were divided into two groups by random number table method:the oral midazolam group(group M,n=100)and the oral saline group(group C,n=97).In the observation room,group M received an oral dose of 0.5 mg/kg midazolam while group C received an oral dose of 5％sa-line 0.25 ml/kg before being accompanied by a clown doctor to the operating room after 30 minutes.Modi-fied Yale preoperative anxiety scale(m-YPAS)scores before entering the observation room and before ente-ring the operating room,as well as induction compliance checklist(ICC)scores before anesthesia induction were recorded.Postoperatively,FLACC and PAED scores were recorded at immediately,6,and 24 hours after surgery along with occurrences of postoperative nausea and vomiting and hypoxemia.Family members of the children were followed up at 1 day,7,14,and 30 days after discharge using PHBQ to record NPOBCs occurrence in children.Results Compared with group C,m-YPAS score,ICC score before anesthesia in-duction,PAED score immediately after surgery,and the incidence of NPOBCs 1 day,7,14,and 30 days after surgery were significantly reduced in group M(P＜0.05).There were no significant differences in YPAS scores before entering the observation room,6 and 24 hours PAED scores,incidence of postoperative nausea and vomiting,hypoxemia between the two groups.Conclusion Preoperative oral administration of midazolam to children undergoing laparoscopic inguinal hernia sac ligation can effectively alleviate periopera-tive anxiety and reduce the incidence of NPOBCs.It does not increase the risk of delayed awakening or post-operative adverse reactions in children.