Objective:To understand the current status of pubertal sexual characteristics development of girls aged 6-18 years in Tongzhou District of Beijing and to compare the differences in sexual characteristics development among girls characterized as thin, normal, overweight, and obese.Methods:A cross-sectional survey was conducted among 2 844 girls aged 6-18 years in Tongzhou District of Beijing from September 2022 to July 2023. The developmental stages of breast and pubic hair were assessed on site, and menarche status was inquired. Weight and height were measured. The girls were subsequently characterized into thin, normal, overweight and obese groups. Basic information (including family and personal history) was obtained through questionnaires. Probit probability unit regression was applied to calculate the age of each Tanner stage of sexual characteristics development and the age of menarche. The χ 2 test was applied to compare the counting data between two or multiple groups. Results:A total of 2 844 girls were surveyed and 2 704 girls met the inclusion criteria, resulting in a valid response rate of 95.1%. Among these girls, 1 105 (40.9%) were aged 6-9 years, 1 053 (38.9%) were aged 10-13 years, and 546 (20.2%) were aged 14-18 years. The of height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and body mass index-for-age Z-score (BAZ) were 0.46(-0.23,1.16), 0.69(-0.16,1.67), and 0.67(-0.27,1.73) respectively. The prevalences of thin, overweight, and obesity were respectively 1.7% (45/2 704), 17.3% (467/2 704), and 19.9% (538/2 704), respectively. There were 45 girls in the thin group, 1 654 girls in the normal weight group, 1 005 girls in the overweight and obesity group. The age of Tanner stage breast 2 (B2), Tanner stage pubic hair 2 (P2), and menarche was 9.0 (95% CI 8.9-9.1), 10.5 (95% CI 10.4-10.6), and 11.4 (95% CI 11.3-1.5) years, respectively. The current status of breast and pubic hair maturity in girls with pubertal development shows that 64.6% (1 211/1 874) of these girls had breast development preceding pubic hair development, 32.4% (607/1 874) had concurrent breast and pubic hair development, and 3.0% (56/1 874) had pubic hairs development preceding breast development. The interval age between B2 and B5 was 4.7 (95% CI 4.6-4.8) years, between P2 and P5 was 4.5 (95% CI 4.4-4.6) years, and between B2 and menarche was 2.4 (95% CI 2.3-2.5) years. The ages of sexual characteristics development in overweight and obese groups were earlier than that in normal and thin groups. The ages of B2 in thin, normal, overweight, and obese groups were 10.0 (95% CI 9.5-10.6), 9.3 (95% CI 9.2-9.4), and 8.6 (95% CI 8.4-8.7) years, respectively. The age of menarche in thin, normal, overweight, and obese groups were 13.1 (95% CI 12.4-13.7), 11.6 (95% CI 11.4-11.7), and 11.1 (95% CI 11.0-11.2) years, respectively. The interval ages between B2 and B5 and between P2 and P5 was 4.5 and 4.1 years, respectively in the overweight and obese groups, and those in normal group and thin group was 4.7 and 4.5 years, 4.6 and 4.7 years, respectively. Conclusions:The ages of sexual characteristics development and menarche tend in Tongzhou District of Beijing to be earlier than that being reported of Beijing's survey 20 years ago. Girls characterized as overweight and obese not only start puberty at an earlier age than girls of normal weight, but also have a shorter developmental process.

Objective:To explore the clinical value of 18F-fluoromisonidazole (FMISO) PET/CT hypoxia imaging in early response to heavy ion radiotherapy in patients with non-small cell lung cancer(NSCLC). Methods:From April 2018 to January 2021, the 18F-FMISO PET/CT images of 23 NSCLC patients (19 males, 4 females; age (64.9±10.3) years) who received heavy ion radiotherapy in Shanghai Proton and Heavy Ion Center were retrospectively analyzed. The evaluation parameters included tumor volume (TV), tumor to background ratio (TBR) before and after radiotherapy. Patients were divided into hypoxia group and non-hypoxia group with the baseline TBR value≥1.4 as hypoxia threshold. Wilcoxon signed rank test was used to compare the differences of TV and TBR before and after radiotherapy in 2 groups. Results:Of 23 NSCLC patients, 17 were hypoxia and 6 were non-hypoxia. Compared with the baseline, TV after the radiotherapy (59.44(22.86, 99.43) and 33.78(8.68, 54.44) cm 3; z=-3.05, P=0.002) and TBR after the radiotherapy (2.25(2.09, 2.82) and 1.42(1.24, 1.67); z=-3.39, P=0.001) of the hypoxia group were significantly lower, while TV (16.19(6.74, 36.52) and 8.59(4.38, 25.47) cm 3; z=-1.57, P=0.120) and TBR (1.19(1.05, 1.27) and 1.10 (0.97, 1.14); z=-1.89, P=0.060) of the non-hypoxia group decreased with no significant differences. Conclusions:Hypoxic NSCLC tumors are sensitive to heavy ion radiation. Compared with non-hypoxic tumors, hypoxic tumors respond more quickly, and a significant reduction in TV can be observed early after radiotherapy. Heavy ion radiation can significantly improve tumor hypoxia.

Objective:To explore the effect of continuing care based on the WeChat public platform questionnaire star on the fluid replacement operation of peritoneal dialysis patients.Methods:Convenience sampling method was used to select 210 patients undergoing peritoneal dialysis in the Panyu Central Hospital, Guangzhou from January to June 2019. They were divided into a experimental group and a control group by random number table method, each with 105 cases. The patients of the control group were given routine continuous care for peritoneal dialysis, such as outpatient follow-up, telephone follow-up, home visit, etc., and oral education. On this basis, in the experimental group, the patients first joined the WeChat public platform, implementing network-based health education and questionnaire stars for real-time testing, and multi-dimensional communication with patients. The knowledge of the peritoneal dialysis fluid replacement operation, the fluid replacement operation evaluation score, the catheter outlet replacement drug evaluation score, the fluid replacement operation self-management score and compliance were compared before and after intervention in the two groups. And the incidence of complications related to the peritoneal dialysis fluid exchange operation of the two groups were compared before and after intervention.Results:The experimental group′s knowledge of peritoneal dialysis fluid exchange operation, examination score of fluid exchange operation, and abnormal situation management score of fluid exchange operation management were 55.88±8.97, 92(89, 96), 12(11, 12) after three-month intervention, and higher than the control group [51.88±10.24, 91 (86, 94), 12 (9, 12)], with statistically significant difference ( t value was 3.00, Z value was -2.483, -2.308, P<0.05). After six-month intervention, the relevant knowledge of peritoneal dialysis fluid replacement operation, fluid replacement operation evaluation score, catheter outlet replacement drug evaluation score and fluid replacement operation management score (routine fluid replacement operation, abnormal situation handling) of the experimental group were 57.52±9.41, 93 (90,96), 90 (87,94), 18 (17,18), 12 (11,12), which were higher than the control group [53.61±10.29, 90 (86,94), 90 (87,92), 17 (15,17), 12 (9,12)], with statistically significant difference ( t value was 2.87, Z value was from -7.181 to -2.664, P<0.01). The difference between the groups was statistically significant ( χ2 value was 4.21-7.517, all P<0.05); and the difference between the intervention time points was statistically significant ( χ2 value was 11.805-164.95, all P<0.05). After six-month intervention, the complications of catheter infection, peritonitis, and poor drainage were 9 (8.91%), 5 (4.95%), and 5 (4.95%) in the experimental group, which were significantly lower than those in the control group [21 (20.39%), 14 (13.59%), 15 (14.56%)], with statistically significant differences ( χ2 value was 5.36, 4.51, 5.33, both P<0.05). Conclusions:The continuous care of the WeChat public platform questionnaire star has a significant promotion effect on the improvement of the knowledge, operation ability, compliance and self-management behavior of the peritoneal dialysis patients, and can effectively reduce the complications caused by the peritoneal dialysis operation.

Objective:To study the clinical value of the ISBAR communication model based on nursing priorities in nursing ward rounds.Methods:Using a quasi-experiment method, 104 patients who received secondary and tertiary care from April to June 2020 were set as the control group, and 122 patients who received secondary and tertiary care from July to September 2020 were set up as the experimental group, with non-randomized method. The experimental group used the ISBAR communication model based on nursing priorities for nursing ward rounds, and the control group used the traditional method for nursing ward rounds. The abilities of bedside nurses collecting the patients′condition, the bedside nurses′ condition observation and the nurses′ critical thinking were compared between the two groups, and the patients' nursing quality and satisfaction were also compared.Results:The scores of the bedside nurses′ knowledge of the patients′ condition were 81.14±3.09 in the test group and 75.90±2.84 in the control group, with statistically significant difference ( t value was -12.88, P<0.01). The scores of the bedside nurses′ ability in observing patients′ condition were 140.50 (137.00, 144.50) in the experimental group and 135.50 (128.75, 139.00) in the control group, with statistically significant difference ( Z value was -3.399, P<0.01). The scores of the Critical Thinking Disposition Inventory Chinese-version (CTDI-CV) were 309.82±36.33 in the experimental group and 286.86±33.54 in the control group, with statistically significant difference ( t value was -2.177, P<0.05). The scores of patient care quality evaluation were 62.50 (60.00, 64.00) in the experimental group and 59.00 (55.00, 61.50) in the control group, with statistically significant difference ( Z value was -6.47, P<0.01). The patient discharge satisfaction score of the experimental group was 53.00 (48.75, 55.00), and that of the control group was 51.00 (44.00, 54.00), with statistically significant difference ( Z value was -3.56, P<0.01). Conclusions:The application of ISBAR communication model based on nursing priorities in nursing ward rounds had a significant promotion effect on the improvement of nurses' abilities of collecting the patients′ condition, observing patients′ condition, and critical thinking, and can effectively improve nursing care quality and patients′ satisfaction.

Objective: To investigate the effects of two different sorbents(Carbon perfusion apparatus and Resin perfusion apparatus)in Double plasma molecular absorb syetem for liver failure treatment. Methods: A total of 152 cases with liver failure who were admitted to The Sixth People's Hospital of Zhengzhou, from June 2016 to May 2018 were selected and divided into DPMARS Carbon group (77 cases) and Resin group (75 cases). The two groups were observed in terms of liver function, prothrombin activity(PTA),Plasma albumin ,tumor necrosis factor alpha and interleukin-6 were detected and compared between the two groups before and after treatment. Results: ①The clinical symptoms improved in different degree in two groups, the recovery rate of Carbon cans Carbon perfusion apparatus group and Resin group separately were89.6% (69/77)、90.7% (68/75)(χ² = 0.048, P = 0.975), there were no statistical differences. There were no statistical differences between the two groups in untoward reactions(χ² = 0.235, P = 0.995), ②Compared with before treatment, TBil(t = 3.735, 3.728; P = 0.000, 0.000)、ALT(t = 5.117, 5.203; P = 0.000, 0.000)、TNF-α (t = 3.158, 3.094; P = 0.000, 0.002)、IL-6(t = 3.647, 3.559; P = 0.002, 0.003)decreased and ALB (t = 2.300, 3.065; P = 0.024, 0.003) increased significantly after treatment in both groups, and there were statistical differences. There were no signifiant differences in the changes in ALB(t = 0.316, 0.209; P = 0.657, 0.720) and PTA(t = 0.810, 0.843; P = 0.429, 0.516). ③After treatment, there were no signifiant differences in the changes in TBil、ALT、ALB、PTA、TNF-α、IL-6(t = 0.377、0.904、-1.133、-1.552、0.841、0.401; P = 0.952、0.283、0.826、0.094、0.154、0.457). Conclusion Double plasma molecular absorb syetem is effective in treating liver failure. Carbon perfusion apparatus or Resin perfusion apparatus can be combined with Specific bilirubin adsorption column for DPMARS in clinical treatment,and their effects are similar.

Objective To explore the application effect of the multidisciplinary collaborations in control of peritoneal dialysis patients with hypertension. Methods A total of 220 cases of peritoneal dialysis patients divided into experimental group and control group (each group had 110 cases) according to the random number table. In which, the control group received routine capacity control and health education with a total of 105 patients finished the study. The experimental group received of multidisciplinary collaborations on the basis of routine capacity control and health education with a total of 107 patients finished the study. Observe changes with knowledge of drugs, medication compliance, self-management behavior and blood pressure of patients before and after the intervention respectively. Results In experimental group,the scores of drug knowledge, medication compliance and self-management behaviors were (0.93 ± 0.49), 0.00 (0.00, 0.25), (2.69 ± 0.25) points before the intervention, 6 months after the intervention were (1.17 ± 0.54), 0.25 (0.00, 0.50), (2.86 ± 0.15) points, the difference between the groups was statistically significant (t=38.60, Z=4.34, t= 2.45, P < 0.01 or 0.05). In control group,the scores of drug knowledge, medication compliance and self-management behaviors were (0.87 ± 0.45), 0.00 (0.00, 0.25), (2.64 ± 0.27) points before the intervention, 6 months after the intervention were (0.89 ± 0.43), 0.00 (0.00, 0.38), (2.73 ± 0.27) points, there was no significant difference between drug knowledge and medication compliance (t=0.44, Z=1.83, P > 0.05), there were statistically significant differences in self-management behavior (t=6.23, P<0.01);there was no difference between the statistical significance between the 2 groups before intervention (t=1.02, Z=1.46, t=1.32, P > 0.05); there was significant difference between the 2 groups after intervention (t=4.11, Z=4.03, t=4.34, P<0.01). Patients in the experimental group with the systolic and diastolic blood pressure were (147.11 ± 14.31), (90.16 ± 13.02) mmHg (1 mmHg=0.133 kPa) respectively, before the intervention; 6 months after the intervention were (139.39 ± 17.05), (83.76 ± 12.52) mmHg respectively, the difference was statistically significant (t=3.59, 2.92, P<0.01). The control group before intervention were (149.56 ± 18.11), (93.56 ± 15.09) mmHg respectively, 6 months after the intervention were (145.14±20.50), (88.14±10.88) mmHg respectively, the difference was statistically significant (t=2.02, 2.72, P<0.05 or 0.01);there was no significant difference between the two groups before intervention (t=1.09, 1.82, P>0.05);6 months after the intervention there was significant difference between the 2 groups (t=2.22, 2.72, P < 0.05 or 0.01). Conclusions Multidisciplinary collaborations have a significant role in patients with peritoneal dialysis, especially in blood pressure control, medication compliance and self-management behavior.

Objective To explore the method and the effects of defect sharing applied for the nursing safety training.Methods The plan of nursing safety training was worked out.The defect sharing method,its mechanism and assessment criteria were made.Twenty nurses in Department of Nephrology were trained for half a year.The nurses were assessed for the safe quality of patients before and after the training.The incidence rate of nursing defects,the initiative reporting rate,the incidence rate and the classification rate of nursing adverse events were compared between before and after the training.Results After the application of defect sharing method,the incidence rate of nursing defects decreased significantly (P <0.01 ).The incidence rate of nursing adverse events and its classification rate both decreased significantly (P <0.01 ).The initiative reporting rate increased significantly (P <0.05).The score of the safety quality evaluation of patients given by nurses was significantly higher than that before the application of the method (P <0.01 ).Conclusions The implementation of defect sharing method in the nursing safety training can increase the safety awareness of nurses,reduce the incidence rate of nursing defects and adverse events,and improve the safety quality of patients.

Objective To investigate effect of the transtheoretical model and stages of change (TTM) on self-management paradigm,serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis (MHD).Methods Total 140 MHD patients were separated into two groups as the intervention group (65 of 70 cases completed with TTM) and the control group (63 of 70 cases completed with routine nursing care) by random number table.Data obtained by using hyperphosphatemia related knowledge questionnaires and Self-management Rating Scale before and after intervention.The levels of serum calcium and phosphorus between the above groups were compared.Results The scores of self-management behavior were higher in control group after 3 months intervention,the differences was statistically significant (P ＜ 0.05),in which the scores of problem solving (2.97 ± 0.28),self care activities (2.99±0.28),relationships (3.13±0.35) and emotional treatment (2.80 ± 0.32) in experimental group was apparently higher than control group at the same time,the scores were (2.63±0.32),(2.67±0.38),(2.76±0.42),(2.44±0.36) respectively in conrtol group,t values were-0.907,-7.68,-6.03 and-8.43,respectively.And also,there was statistically significant difference between the two groups in serum phosphorus level [(1.81±0.49) mmol/L vs.(2.56±0.69) mmol/L],the product of calcium and phosphorus [(55.33±14.45) mg2/dl2 vs.(72.35±20.94) mg2/dl2],serum parathyroid hormone [238.00 (130.35,413.85) ng/L vs.297.75 (155.02,760.37) ng/L] (t=11.01,8.43,Z=-2.09,P＜0.05).Conclusions TTM is conducive to promote behavior change,improve self-management conduct,and also reduce serum phosphorus level in MHD patients.

Objective:To assess the possibility of suicide in setting condition among urban and rural residents samples in northern China.Methods:By randomly sampling,1007 persons aged 18 years or older were selected from 10 urban neighborhoods in Beijing and from 10 rural village in Hebei province.The Survey Schedule of Atti-tudes in China in which 24 negative life events were listed,and the possibility of committing suicide was asked to the subjects when they encountered the supposed events.Results:The rates of thinking about committing suicide when encountered the supposed life events were 65.2% of incurable illness,62.0% of burden on other and no future hope,61.2% of drug dependence,57.3% of large debt due to gambling,54.2% of being raped, 51.6% of severe depression,50.7% of being elderly and no family to provide support.Only 14.6% of the ur-ban and rural residents would not consider suicide when encountered any type of supposed problems.Conclusion:There is higher possibility of considering suicide in urban and rural residents when encountered negative life events, so it is important to give support to the residents with one or more life events.

Objective To study the risk factors for surgical site infections (SSIs)in patients with hepatobiliary and pancreatic surgery.Methods Sixty patients who received hepatobiliary and pancreatic surgery and suffered SSIs from January 2006 to January 2010 were selected as infections group,119 patients who also received hepatobiliary and pancreatic surgery but didn’t develop infection were as control group,retrospective investigation was per-formed.Results Univariate analysis revealed the associated factors for post-operative SSIs were age,history of car-diocerebrovascular disease,history of abdominal surgery,history of smoking,preoperative anemia,abnormal pre-operative coagulation and blood sugar,pre-operative infection,use of laparoscope,incision type,duration of opera-tion,ASA score,post-operative drainage and dressing chang within 24 hours of post-operation(all P<0.05).Mult-ivariate analysis revealed that abdominal surgery history (OR95%CI:3.09 [1.21 -7.91 ]),high NISS score (OR95%CI:6.18[2.41-15.85])were risk factors of SSIs in patients with hepatobiliary and pancreatic surgery, and dressing chang within 48 hours of post-surgery were protective factor (OR95%CI:3.81 [1.56-9.34]). Conclusion History of abdominal surgery and high score of NISS are major risk factors for SSIs in patients with hepatobiliary and pancreatic surgery.To reduce the risk of SSIs,blood glucose should be actively adj usted,anemia and coagulation abnormalities should be treated;duration of operation should be shortened as far as possible,wound should be kept clean and dressing should be changed timely after surgery.