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Objective@#To analyze the correlation between the scores of masculinity and femininity and parental rearing pattern in lower grade primary school students in Xiamen, and to provide a policy suggestions and reference basis for establishing a correct concept of gender role among children and adolescents.@*Methods@#A cluster random sampling method was used to select 823 students from two primary schools in Xiamen. Masculinity and femininity scores were assessed by Children s Sex Role Inventory(CSRI), while attitudes and behaviors of parental rearing pattern were obtained through EMBU. Regression analyses were used to analyze the correlation between masculinity and femininity scores and parental rearing pattern.@*Results@#Masculinity scored 2.82 ( 2.41 ,3.24) and 2.82 (2.47,3.18), femininity scored 2.87 (2.40,3.20) and 3.13 (2.73,3.47) among boys and girls, with no significant gender difference ( P >0.05). Masculinity and femininity scores varied significantly by parental emotional warmth and understanding(father: Z/H =44.61, 37.24；mother: Z/H=41.68, 46.64, P <0.05). Among boys, increasing parental emotional warmth and understanding and paternal excessive interference were associated with higher masculinity and femininity scores. Increasing rejection and maternal deny were associated with lower masculinity scores. Among girls, increasing the understanding of emotional warmth of fathers was associated with masculinity and femininity scores, increasing excessive interference from mothers was associated with lower masculinity scores ( P <0.05).@*Conclusion@#There are gender differences in the relationship between parental rearing pattern and masculinity and femininity scores. In particular, increasing parents emotional warmth and understanding and reducing mothers punishment and harshness, rejection and denial, and other negative parenting styles could facilitate healthy development of masculinity and femininity among primary school students.
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Objective@#To analyze the association between masculine and feminine traits, gender role in students and family factors, and to provide a scientific basis for promoting the healthy development of children and adolescents gender role.@*Methods@#Cluster random sampling method was used to selected 823 students from 2 schools of Xiamen in May, 2018, participants were asked to report individual masculine and feminine traits through the Child s Sex Role Inventory, and then gender role was divided into four types (masculine, feminine, androgynous, undifferentiated). Non parametric tests, generalized linear model, and Logistic regression model were used to explore the association between masculine and feminine traits, gender role and family factors.@*Results@#Compared with the boys from the nuclear family, the masculine traits were lower in boys of other families by 0.282( 95% CI = -0.452 --0.110), and the feminine traits were also lower by 0.192 (95% CI =-0.369--0.014). Compared with boys of middle socioeconomic status (SES), the masculine traits of boys from low SES decreased by 0.157 (95% CI =-0.286--0.029), and the feminine traits decreased by 0.140 (95% CI =-0.274--0.005). The proportion of androgynous in boys from other families was significantly lower than boys from the nuclear family ( OR =0.45, 95% CI =0.21-0.94), with the proportion of undifferentiated significantly higher than nuclear family 2.33 (95% CI =1.22-4.44). The proportion of androgynous in boys from low SES was significantly lower than boys from middle SES ( OR =0.59, 95% CI =0.35-0.99), with the proportion of undifferentiated significantly higher than middle SES 1.62 (95% CI =1.00-2.65). Among girls, the differences in masculine and feminine traits and gender role of different family factors were not statistically significant ( P >0.05).@*Conclusion@#The masculine and feminine traits and gender role in students are associated with family structures and socioeconomic status, especially in boys. Therefore, the family environment is an important factor affecting children s gender role, and the healthy development of children s gender role needs parents attention and correct guidance.
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Objective@#To analyze the association between sleep duration and social anxiety in Chinese children and adolescents to provide evidence for promoting healthy lifestyle and mental health in children and adolescents.@*Methods@#A total of 1 145 children and adolescents aged 7-16 were recruited by cluster random sampling in Beijing in 2020, and received a series of body measurements and questionnaire survey. Social Anxiety Scale for Children (SASC) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the social anxiety symptoms and sleep duration of children and adolescents. T test was used to compare the differences of social anxiety level in different groups, and multivariate linear regression analysis was used to analyze the relationship between sleep duration and social anxiety.@*Results@#The average score of social anxiety was (5.47±4.18). The social anxiety score of girls, participants aged 13-16, with insufficient physical activity and insufficient sleep duration were higher ( t =-4.34, -6.14, 3.35, 2.93, P < 0.05). The results of multivariate linear regression model showed that after adjusting confounding factors, social anxiety decreased by 0.78 for each additional hour of sleep duration ( β =-0.78, 95% CI =-1.03--0.54, P <0.01), with 0.60 in boys (95% CI = -0.95 --0.25), 0.90 in girls (95% CI =-1.24--0.56), 0.75 among participants aged 7-12 (95% CI =-1.11--0.40) and 0.76 among participants aged 13~16 (95% CI =-1.11--0.41)( P <0.01), respectively. Social anxiety among participants who were not over weight or obese decreased by 0.78(95% CI =-1.09--0.48) and 0.81 among overweight and obese group (95% CI =-1.22- -0.41 )( P <0.01) for each additional hour of sleep duration, respectively.@*Conclusion@#Substantial differences in social anxiety are observed in children and adolescents by gender, age group and nutritional status. Sufficient sleep duration is significantly related to the decrease of social anxiety, and improve the overall level of student mental health.
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Objective@#To analyze the association between sleep duration and social anxiety in Chinese children and adolescents to provide evidence for promoting healthy lifestyle and mental health in children and adolescents.@*Methods@#A total of 1 145 children and adolescents aged 7-16 were recruited by cluster random sampling in Beijing in 2020, and received a series of body measurements and questionnaire survey. Social Anxiety Scale for Children (SASC) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the social anxiety symptoms and sleep duration of children and adolescents. T test was used to compare the differences of social anxiety level in different groups, and multivariate linear regression analysis was used to analyze the relationship between sleep duration and social anxiety.@*Results@#The average score of social anxiety was (5.47±4.18). The social anxiety score of girls, participants aged 13-16, with insufficient physical activity and insufficient sleep duration were higher ( t =-4.34, -6.14, 3.35, 2.93, P < 0.05). The results of multivariate linear regression model showed that after adjusting confounding factors, social anxiety decreased by 0.78 for each additional hour of sleep duration ( β =-0.78, 95% CI =-1.03--0.54, P <0.01), with 0.60 in boys (95% CI = -0.95 --0.25), 0.90 in girls (95% CI =-1.24--0.56), 0.75 among participants aged 7-12 (95% CI =-1.11--0.40) and 0.76 among participants aged 13~16 (95% CI =-1.11--0.41)( P <0.01), respectively. Social anxiety among participants who were not over weight or obese decreased by 0.78(95% CI =-1.09--0.48) and 0.81 among overweight and obese group (95% CI =-1.22- -0.41 )( P <0.01) for each additional hour of sleep duration, respectively.@*Conclusion@#Substantial differences in social anxiety are observed in children and adolescents by gender, age group and nutritional status. Sufficient sleep duration is significantly related to the decrease of social anxiety, and improve the overall level of student mental health.
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Objective@#To explore the association between growth patterns and blood pressure in children and adolescents with different nutritional status.@*Methods@#A total of 38 839 children and adolescents aged 6 to 8 years old were included in this study by stratified cluster sampling. The American Academy of Pediatrics 2017 Guideline was used to evaluate the blood pressure, the US 2000 CDC standard was used to determine different growth patterns, and the WHO Child and Adolescent Growth and Development Standard issued in 2007 was used to evaluate nutritional status. Variance analyses were used to compare the levels of systolic and diastolic blood pressure and growth patterns by nutritional status, and χ 2 test was used to compare the difference of prevalence. Multivariate Logistic regression model was used to analyze the association between growth patterns and blood pressure.@*Results@#The proportion of normal growth, catch up growth and catch down growth was 33.2%, 41.6% and 25.2%, respectively. Under different growth patterns, systolic blood pressure (105.17±12.33) mm Hg and diastolic blood pressure (66.55±8.75) mm Hg of catch up growth were higher than those of normal growth and catch down growth. In overweight and obesity, the prevalence of hypertension (24.9%), high systolic blood pressure (18.9%) and high diastolic blood pressure (15.0%) in catch up growth were higher than those in normal growth and catch down growth ( P <0.05). The risk of catch up growth to hypertension was higher in overweight and obesity ( OR =1.18, 95% CI =1.06-1.31) than in normal children and adolescents ( OR =1.15, 95% CI =1.05-1.27).@*Conclusion@#In catch up growth children and adolescents, hypertension and high blood pressure are higher than normal growth and catch down growth. Overweight and obesity than normal children and adolescents have a higher risk of hypertension.
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Objective@#To analyze the trend of percentile changes in body composition among children and adolescents aged 7 to 18 by gender and age, and to provide a scientific basis for reference value.@*Methods@#A stratified cluster random sampling method was used to select 1 585 children and adolescents from September to December 2020. Use the GAMLSS to estimate the P 25 , P 50 and P 75 percentile value of gender, age specific body fat percentage (BF%), fat mass index (FMI) and fat free mass (FFM).@*Results@#In different age groups, body fat percentage of boys with normal nutritional status peaked at around 10-year old, among them, body fat percentage of 10-year old P 25 , P 50 and P 75 were 22.2%, 26.1% and 30.1%, respectively. Body fat percentage of obese boys was at a high level. Among girls, body fat percentage under different nutritional status did not change. With the increase of age, fat mass index plateaued slightly in normal and overweight boys. However, in obese boys, with the increase of age, FMI gradually increased with the increase of percentile, while the value of FMI gradually decreased in girls. Whether in boys or girls, with the increase of age, fat free mass index shows an increasing trend, and boys increase faster.@*Conclusion@#Under different nutritional status, there are differences in the percentile value of body fat percentage, fat mass index and fat free mass by gender and age, which can provide a scientific basis for reference value of body composition in children and adolescents.
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Objective@#To investigate the association between the combined effect of height growth and overweight/obesity with elevated blood pressure in Chinese children.@*Methods@#Based on a cohort study of puberty development in Xiamen, a cluster sampling method was used to select 1 313 children whose complete height, weight and blood pressure levels at baseline were obtained in 2017 and during a follow up in 2019. The incidence of elevated blood pressure was compared between four different subgroups, and multivariate Logistic regression was performed to analyze the combined effect in boys and girls.@*Results@#Among 1 313 children, the prevalence of elevated blood pressure at baseline was 25.2%. After 2 years of follow up, the incidence of elevated blood pressure was 19.7% and 23.4% in boys, and 16.6% in girls. After adjusting for factors including age, sex, family history of hypertension, sleep time, intake of fruits, vegetables, sugar sweetened beverages, and meat products, multivariate Logistic regression analyses showed that children in the high height growth and overweight/obesity group were more likely to exhibit a higher incidence of elevated blood pressure (overall:RR=2.41，95%CI=1.44-4.04；boys：RR=2.69，95%CI=1.45-5.02). Among girls, the risk of elevated blood pressure in the low height growth and overweight/obesity group also increased significantly (RR=4.47, 95%CI=1.45-13.75).@*Conclusion@#A large magnitude of height growth and being overweight/obesity were associated with elevated blood pressure in children, especially boys. Therefore, interventions that are targeted toward obesity prevention in children before pubertal growth spurts in height may be beneficial to reduce childhood high blood pressure.
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Objective@#To analyze the cumulative effect of preadolescent lifestyles on the prevalence and incidence of elevated blood pressure (EBP) in children, and to provide evidence for early hypertensive intervention.@*Methods@#In 2017, a cohort study on pubertal development was conducted in Xiamen, Fujian Province. Participants underwent a physical examination and questionnaire survey. Between 2017 and 2019, this study carried out a 2-year follow-up of 1 316 students whose complete data were obtained. Preadolescent lifestyles were assessed by referring to baseline survey results obtained in 2017, and the prevalence and incidence of EBP were determined according to blood pressure levels that were determined in 2019. The logistic regression model was used to analyze the influence of healthy lifestyles on the prevalence and incidence of EBP after adjusted for confounding factors.@*Results@#The prevalence of EBP in 2017 and 2019 was 25.0% and 23.3%, respectively, and its incidence was 18.9% after the 2-year follow-up. Children with a healthy lifestyle had a lower prevalence and incidence of EBP. The regression analysis showed that children who have more healthy lifestyle factors were at a lower risk of EBP (P<0.05). Compared with students with 0-2 healthy lifestyle factors, the OR value of EBP prevalence was 0.52 (95% CI=0.30-0.90) and the RR value of EBP incidence was 0.60(95%CI=0.29-1.22) in children with 4-5 healthy lifestyle factors. Among them, children who were overweight or obese were at a significantly lower risk of EBP prevalence (OR=0.29, 95%CI=0.10-0.81).@*Conclusion@#Preadolescent lifestyles seemed to have a cumulative effect on the occurrence of EBP. Maintaining a healthy lifestyle had a positive effect on reducing the risk of EBP, particularly in overweight and obese children, and this was due to their adoption of a comprehensive healthy lifestyle.
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Objective@#To explore the relationship between nutritional status and puberty onset in boys, and to provide a reference for promoting the development of physical and mental health of boys.@*Methods@#A total of 2 724 boys aged 7 to 12 years from grade 2 to 6 were recruited from Xiamen city by cluster sampling method in 2017. The nutritional status was assessed by physical examination, pubertal developmental status was evaluated by rating scales of Tanner and Prader orchidometer, and puberty timing was determined by the P25 age of puberty onset. The association between nutritional status and puberty onset was estimated by logistic regression model.@*Results@#Pubertal onset was found in 29.0% of the boys and the incidence of early pubertal timing was 2.9%. The prevalence of puberty onset in wasting, normal weight, overweight and obesity boys was 19.6%, 28.7%, 34.4% and 31.5%, respectively. The age of puberty onset was significantly earlier in obese boys (F=3.23, P<0.05). The results of Logistic regression analysis showed that with the increase of BMI, the possibility of puberty onset and risk of early pubertal timing increased. After adjusting for confounding factors, the odds of puberty onset in boys with wasting decreased by 64.0% (OR=0.36, 95%CI=0.22-0.60), the possibility of puberty onset and risk of early pubertal timing in boys with obesity increased by 78.3% (OR=1.78, 95%CI=1.14-2.79) and 192.9% (OR=2.93, 95%CI=1.46-5.86), respectively. These relationships were more pronounced in boys of households with lower economic level (P<0.05).@*Conclusion@#BMI was positively correlated with puberty onset in boys, the odds of puberty onset and risk of early pubertal timing were significantly increased in obese boys, especially in those with low household economic level.
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Objective@#To explore the relationship between one-child and low height level classification among children and adolescents, and the effects of fruits, vegetables and physical activities on this association, and to provide as cientific reference for probing into and improving the differences of their height level between one child and child with siblings.@*Methods@#Using stratified cluster sampling method, 93 primary and secondary schools in 7 provinces and cities in China were selected for physical examination and questionnaire surveys. A total of 40 978 primary and middle school students aged 7-17 were selected. A multilevel Logistic regression model was used to analyze.@*Results@#Univariate analysis found that being one-child was less likely to be classified as low height level(OR=0.63, 95%CI=0.58-0.67); the multilevel model also found that the probability that one-child being at low height level was still lower(OR=0.78, 95%CI=0.73-0.85), and daily vigorous-intensity physical activities ≥1 h (OR=0.92, 95%CI=0.85-0.99) and daily vegetables and fruits intake ≥5 servings (OR=0.83, 95%CI=0.75-0.92) could also reduce the probability of being at low height level. Hierarchical analysis found that when vegetables and fruits intake and physical activities time were sufficient, there was no longer a significant difference in the height level classification between one-child and child with siblings(P>0.05).@*Conclusion@#Being one-child could be a protective factor for the height level classification of children and adolescents. Adequate intake of vegetables and fruits and time of vigorous-intensity physical activities could fill the gap of height level classification between of being one-child and child with siblings. Effective behavioral intervention measures should be taken to protect the healthy growth of height among children and adolescences.
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Objective@#To understand the distribution of masculine and feminine traits and gender roles in primary school students who did not enter the Tanner Ⅱ stage in Xiamen and to provide a reference for promoting the development of mental and physical health of children.@*Methods@#The present study was based on the blood pressure cohort of children in Xiamen. All 823 participants were from grade two, three, four of primary school. Participants were asked to obtain children’s masculine and feminine traits, gender role types (masculine, feminine, androgynous, undifferentiated) and heterogeneity through the Children’s Sex Role Inventory. In this study, non-parametric tests and chi-square tests were used to compare the differences of masculine and feminine traits, gender role types and heterogeneity rates between different groups.@*Results@#The masculine traits of this study scored (2.80±0.52), and the feminine traits scored (2.95±0.55). The proportion of masculine, feminine, androgynous and undifferentiated was 12.8%, 11.9%, 39.1% and 36.2%, respectively. The proportion of undifferentiated among boys (41.8%) was higher than girls (31.5%), while the proportion of androgynous (34.6%) was lower than girls (43.0%), the differences were of statistical sigificance(χ2=9.22, 6.02, P<0.05). The rate of gender role heterogeneity was 7.0%, and there was no significant difference between different gender and age groups(P>0.05).@*Conclusion@#The gender roles of primary school students in Xiamen are mainly androgynous and undifferentiated, and the distribution of gender role is different in boys and girls. More specifically, the gender roles of boys were mainly undifferentiated, and girls were mainly androgynous. In general, the proportion of gender role heterosexuals is a little higher, which should be paid more attention and appropriate guidance by schools and parents.
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Objective To explore the efficacy and safety of coflex interspinous dynamic fixation device implantation in the lumbar spinal stenosis. Methods Eighty-three patients with lumbar spinal stenosis were randomly divided into two groups, and 80 cases were followed up. Coflex group (38 patients) received coflex implantation,posterior lumbar interbody fusion (PLIF) group(42 patients) received PLIF treatment. Indicators of surgical trauma degree (operation time, blood loss volume, wound drainage volume within 48 hours, incision pain (VAS) score after surgery 3 days,postoperative ambulation time),indicators of clinical effect (waist and leg pain VAS scores,Japan Orthopaedic Association JOA score,Oswestry functional disability index ODI score),intervertebral space height and median sagittal diameter (MSO) were measured and compared between the two groups. Results In the Coflex group, the operation time, blood loss volume, wound drainage volume within 48 hours, incision pain (VAS) score after surgery 3 days,postoperative ambulation time were (104.3 ±9.5) min,(230. 7 ±29.6) ml,(110. 6 ±34. 5)ml,3. 2 ±1.3, (13. 6 ±2.0) d,which were significantly lower than those of (174. 6 ±24. 2) min,(536. 8 ±163.3) ml, (319. 2 ± 142. 8) ml,4. 8 ±2. 7, (15. 7 ±2. 6) d in the PLIF group(t= 16. 720,11. 380,8. 771,3. 320,4.018,Ps 0. 05) on severe complications such as internal fixation loosening and spinous process fractures.Conclusion The two surgical methods both can effectively increase the foraminal area and intervertebral height to maintain the stability of the spinal posterior colum. However, Coflex interspinous dynamic fixation device implantation had more advantages,such as shorter operation time,less bleeding,less trauma,and early functional exercises.