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Objective@#To explore the impact of adverse childhood experiences on pubertal development,and to provide a reference for conducting the targeted intervention in the early stage.@*Methods@#A cluster sampling method was used to randomly select students of grades 3 to 4 from three primary schools in Ma’anshan municipality of Anhui province in October 2017. Self-reported childhood adverse experiences (ACEs), including physical, emotional and sexual abuse, as well as physical and emotional neglect were collected. Testicular volume and breast Tanner stage were assessed. A follow-up survey was conducted one year later to assess ACEs and pubertal development. ACEs of each dimension were divided into non-exposure group, transient exposure group and sustained exposure group according to ACEs exposure at baseline and follow-up. Multivariate linear regression model was used to analyze the relationship between ACEs exposure and pubertal development after 1-year follow-up.@*Results@#Sustained emotional abuse was positively associated with increased breast Tanner stage and testicular volume (breast: β=0.36, 95%CI=0.09-0.63, P<0.01; testicular volume: β=1.07, 95%CI=0.47-1.66, P<0.01); sustained physical abuse was positively associated with decreased testicular volume (β=-0.83, 95%CI=-1.58--0.08, P<0.05); sustained and transient sexual abuse were significant positively associated with decreased breast Tanner stages (sustained: β=-1.43, 95%CI=-2.86--0.02, P<0.05; transient: β=-0.45, 95%CI=-0.73--0.19, P<0.05); sustained emotional neglect was positively associated with increased breast Tanner staging (β=0.33, 95%CI=0.06-0.61, P<0.05) and decreased testicular volume (β=-0.19, 95%CI=-1.38--0.19, P<0.01).@*Conclusion@#Sustained emotional abuse was associated with early pubertal development in boys and girls,and the specitic mechanisam differences of different ACES puberty development effects and the gender differences of the same ACES puberty development effects need to be furthur explored.
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Objective To study the association between morning surge (MS) of systolic blood pressure (SBP) and white matter lesions in elderly essential hypertensive (EH) patients.Methods Three hundred and thirty-seven elderly EH patients from Zhangqiu of Shandong Province were divided into MS group (n=150) and non-MS group (n=187).Their 24 h ambulatory SBP was monitored.Their white matter hyperintensity (WMH) was assessed according to their brain MRI.Results The total WMH,periventricular WMH,and deep WMH were significantly higher in MS group than in non-MS group (P＜0.01).The MS of SBP was positively related with the total WMH,periventricular WMH,and deep WMH (r=0.561,r=0.563,r=0.283,P＜0.01),and was an independent risk factor for total WMH,periventricular WMH,and deep WMH after adjustment for confunders (r=0.479,r=0.486,r=0.208,P＜0.01).Conclusion MS of SBP is an independently risk factor for WMH in elderly EH patients.
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Objective To study the effect of telmisartan combined with rosuvastatin on white matter lesion (WML) in elderly hypertensive patients.Metheds Three hundred and twenty-nine elderly patients with mild-moderate essential hypertension (EH) were divided into control group (n=167) and combined treatment group (n=162).The patients in control group were treated with telmisartan (40 mg/d) and those in combined treatment group were treated with telmisartan plus rosuvastatin (10 mg/d).Their white matter hyperintensivity (WMH),periventricular white matter hyperintensity (PWMH),and deep white matter hyperintensity (DWMH) were measured by head MRI.Results The total WMH,PWMH and DWMH were significantly higher in two groups in the third and fifth years than at the baseline (P＜0.05).The growth rate of total WMH,PWMH and DWMH was significantly lower in combined treatment group than in control group in the third and fifth years (P＜0.05).Conclusion Telmisartan combined with rosuvastatin plays an important role in stablizing blood pressure,regulating blood lipids,and delaying WML.
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Objective To study the effect of empty-nest (EN) on the variability of HBPV in elderly hypertensive patients.Methods 457 elderly essential hypertensive patients admitted to our hospi tal were divided into non EN group (A group,n =183),EN couple group (B group,n =150),and EN single group (C group,n=124).They underwent 7-day HBPV,their BPV was detected,their loneliness and depressive symptoms were assessed according to the UCLA-LS and GDS.Results The variability of self-measured DPB and SBP,UCLA-LS and GDS score were significantly higher in B and C groups than in A group (P＜0.05).The variability of SBP,UCLA-LS and GDS score were significantly higher in C group than in B group (46.06±7.98 vs 38.95±8.11;7.67±2.58 vs 6.48±2.60,P＜0.05).Partial correlation analysis showed that the variability of SBP and DBP was positively related with the UCLA-LS and GDS score (P＜0.05).The variability of SBP was significantly higher in B and C groups than in A group after adjustment of confounding factors (P=0.000).Conclusion EN,an independent influencing factor for the variability of blood pressure in elderly hypertensive patients,is related with their loneliness and depression.
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Objective To study the effect of masked hypertension (MH) and white coat hypertension (WCH) on vascular elasticity and endothelial function in elderly patients.Methods Four hundred and eighty-seven elderly patients who underwent physical examination in our our hospital were divided into normotension group (n=128),WCH group (n=115),MH group (n=112) and hypertension group (n=132) according to their diagnostic office blood pressure and 24 h ambulatory blood pressure.The brachial artery FMD,serum NO and endothelin-1 (ET-1) levels,and cfPWV were measured.Results The FMD and serum NO level were significantly lower while the serum ET-1 level and cfPWV were significantly higher in WCH group,MH group and hypertension group than in normotension group (P＜0.05).The FMD and serum NO level were significantly higher while the serum ET-1 and cfPWV were significantly lower in WCH group and MH group than in hypertension group (P＜ 0.05).Multivariate linear stepwise regression analysis showed that WCH,MH and hypertension were the independent influencing factors for FMD,serum NO and ET-1 level and cfPWV with normotension used as reference after adjustment of confounding factors (P＜0.01).Conclusion MH and WCH are the risk factors for the decreased vascular elasticity and endothelial dysfunction in elderly patients.
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OBJECTIVE:To evaluate the role of PDCA cycle management on standardizing clinical use of atomization inhala-tion drug. METHODS:Using a retrospective method,300 medical records of atomization inhalation drug use were collected from our hospital during Jan.-Dec. in 2013(non-intervention group),200 medical records collected during Apr.-Jun. in 2014(one cycle intervention group),and 180 medical records collected during Oct.-Dec. in 2014(two rounds of cycle intervention group). The use of atomization inhalation drugs was compared before and after the application of PDCA cycle management. Before and after two cy-cle intervention,4 types of medical staff were investigated on cognition of the related knowledge of atomization inhalation drugs, as physicians,pharmacists,nurses and mechanic. RESULTS:After two rounds of PDCA cycle management and intervention,the proportion of unsuitable route of administration of antibiotics,long acting glucocorticoid,non-atomization inhalation dosage form of resolving phlegm drugs,protease decreased from 54.0%,62.0%,59.7%,44.7% before intervention to 0.6%,1.1%,15.0%, 1.1% after intervention;those phenomena had not been found,such as unsuitable route of administration of TCM injection and non-atomization dosage form of theophyllines,unsuitable atomization frequence,unsuitable indication,drug mixture for preventing and controlling symptom,etc. The proportion of medical staffs being familiar with medical device,drug classification,drug selec-tion for prerention and treatment and the proportion of hospital drug stock to 93.4%,86.7%,92.4%,96.2% after intervention from 38.0%,79.0%,49.0%,39.5%before intervention. CONCLUSIONS:The application of PDCA cycle management can effec-tively regulate the use of atomization inhalation drugs in our hospital;the method can be promoted and applied.