Arthritis, Rheumatoid ; complications ; Cardiovascular Diseases ; complications ; Humans ; Risk Management

Objective To investigate the effect of recombinant human growth hormone (rhGH) on the growth rate, glucose and lipid metabolism and bone metabolism in children with idiopathic short stature (ISS). Methods The clinical data of 150 children with ISS admitted to the hospital from January 2010 to January 2015 were collected. The children were divided into the routine group (68 patients) and rhGH group (82 patients) according to the treatment methods. The routine group was given enhanced nutritional guidance, enhanced protein and calcium intake, and guidance for exercise. On this basis, rhGH group was additionally treated with rhGH. The intervention lasted for 12 months, and changes of height, weight, bone age (BA) and growth velocity (GV) in two groups were statistically analyzed. Changes in fasting blood glucose (FBG), insulin (INS), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and other glucose and lipid metabolism indicators before and after treatment were detected. The insulin sensitivity index (ISI) was calculated, and changes in serum insulin-like factor 1 (IGF-1), osteocalcin (OC), bone alkaline phosphatase (BAP), typeⅠprocollagen amino-terminal propeptide (PINP), β-collagen degradation products (β-CTX) and other bone metabolism parameters before and after treatment were determined. The incidence of adverse reactions in both groups was statistically analyzed. Results There were no significant differences in height, weight, BA or GV between two groups before treatment (P>0.05). After 12 months of treatment, the above indicators in both groups were increased (P<0.05). The height, weight, BA and GV were (132.12 ± 7.26) cm, (26.21 ± 1.74) kg, (9.41 ± 0.37) years old and (10.03 ± 2.41) cm/year of the rhGH group, which were significantly higher than those of the routine group [(124.22 ± 6.31) cm, (24.13 ± 1.92) kg, (8.96 ± 0.42) years old and (5.85 ± 1.76) cm/year (P<0.05)]. There were no significant differences in glucose and lipid metabolism levels between two groups before and after treatment (P>0.05). There was no statistical difference in bone metabolism indexes between two groups before treatment (P>0.05). After 12 months of treatment, PINP, IGF-1, OC and BAP in both groups increased while β-CTX decreased (P<0.05). PINP, IGF-1, OC and BAP in rhGH group [(598.21 ± 78.57) μg/L, (301.23 ± 51.45) μg/L, (78.52 ± 12.65) μg/L, (171.26 ± 42.17) U/L] were higher than those in routine group [(520.14 ± 47.55)μg/L, (244.35 ± 46.38)μg/L, (70.25 ± 9.77) μg/L, (120.55 ± 38.42) U/L] (P<0.05), whileβ-CTX was lower than that in routine group [(0.48 ± 0.26)μg/L vs (0.63 ± 0.24) μg/L] (P<0.05). There were no significant difference in adverse reaction between two groups [3.66％(3/82) vs. 0, P>0.05]. Conclusions The rhGH treatment of children with ISS can obviously promote the growth and improve bone metabolism and growth rate of children, without significant adverse effect on their glucose and lipid metabolism and with certain safety.

Objective:To explore the status quo and influencing factors of caregivers' perception of nurses' empowerment behavior in children with type 1 diabetes mellitus (T1DM) , and to provide scientific basis for focusing on and efficiently empowering caregivers of children with T1DM.Methods:This study was a cross-sectional survey. A total of 360 children with T1DM who were admitted to 2 tertiary hospitals in Zhejiang Province from January 2019 to May 2020 were selected by the convenient sampling method. General information questionnaire, Patient Perceptions of Patient-Empowering Nurse Behaviors Scale (PPPNBS) and General Self-Efficacy Scale (GSES) were used to investigate and analyze the influencing factors. A total of 360 questionnaires were issued and 347 valid questionnaires were recovered, with an effective response rate of 96.4%.Results:The PPPNBS score of caregivers of 347 children with T1DM was (185.85±50.05) . Multiple linear regression analysis showed that the course of the disease, the age of the caregiver, the education background of caregivers and self-efficacy sense were influencing factors of perception of empowerment behavior of caregivers of children with T1DM ( P<0.05) . Conclusions:The perception of caregivers of T1DM children with nurses' empowerment behavior is at a moderate level. The course of the disease, age of caregivers, the education background of caregivers and self-efficacy are the influencing factors in perception of caregivers' empowerment behaviors of T1DM children. Medical staff should formulate targeted intervention measures based on the influencing factors of the perception of empowerment behaviors to improve the perception of nurses' empowerment behaviors by caregivers of patients.