Role of blood pressure on stroke-related mortality: a 45-year follow-up study in China / 中华医学杂志(英文版)

BACKGROUND@#Hypertension is associated with stroke-related mortality. However, the long-term association of blood pressure (BP) and the risk of stroke-related mortality and the influence path of BP on stroke-related death remain unknown. The current study aimed to estimate the long-term causal associations between BP and stroke-related mortality and the potential mediating and moderated mediating model of the associations.@*METHODS@#This is a 45-year follow-up cohort study and a total of 1696 subjects were enrolled in 1976 and 1081 participants died by the latest follow-up in 2020. COX proportional hazard model was used to explore the associations of stroke-related death with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) categories and BP changes from 1976 to 1994. The mediating and moderated mediating effects were performed to detect the possible influencing path from BP to stroke-related deaths. E value was calculated in the sensitivity analysis.@*RESULTS@#Among 1696 participants, the average age was 44.38 ± 6.10 years, and 1124 were men (66.3%). After a 45-year follow-up, a total of 201 (11.9%) stroke-related deaths occurred. After the adjustment, the COX proportional hazard model showed that among the participants with SBP ≥ 160 mmHg or DBP ≥ 100 mmHg in 1976, the risk of stroke-related death increased by 217.5% (hazard ratio [HR] = 3.175, 95% confidence interval [CI]: 2.297-4.388), and the adjusted HRs were higher in male participants. Among the participants with hypertension in 1976 and 1994, the risk of stroke-related death increased by 110.4% (HR = 2.104, 95% CI: 1.632-2.713), and the adjusted HRs of the BP changes were higher in male participants. Body mass index (BMI) significantly mediated the association of SBP and stroke-related deaths and this mediating effect was moderated by gender.@*CONCLUSIONS@#In a 45-year follow-up, high BP and persistent hypertension are associated with stroke-related death, and these associations were even more pronounced in male participants. The paths of association are mediated by BMI and moderated by gender.

Problems and countermeasures in college students' teaching evaluation / 中华医学教育探索杂志

Objective To find deficiencies in the existing students' teaching evaluation by in-vestigation and to improve the work in teaching evaluation. Methods Totally 787 students and 261 teachers were investigated by the questionnaire. Contents of questionnaire include interference factors of students' teaching evaluation, experts and teachers' initiatives, students' opinions on how to play the role of evaluation, feedback from experts, etc. Results were analyzed by SPSS 17.0 t test and sta-tistical description. Results Teacher exerted less impact on students' initiative of teaching evaluation and 221(84.7%) teachers said that they would never relax requirements for students because of the evaluation. 37.0%(291/787) students said that experts took the initiative to understand the teaching condition and 65.9%(519/787) students said that teachers took the initiative to understand the study condition. Students thought that teaching evaluation can help improve teachers' teaching ability but lack of powerful guidance after evaluation, insufficient recognition on evaluation opinions and delayed feedback affected the progress of the evaluation work. Conclusions Teaching assessment is very im-portant. Therefore, we should improve the enthusiasm of students in the assessment and make use of student's academic performance rationally in order to make the teaching evaluation play a greater role in improving teaching quality.