Trajectories of Violent and Nonviolent Behaviors From Adolescence to Early Adulthood: Does Early Puberty Matter,and, If So,How Long?

PurposeIt is well known that pubertal timing affects adolescents' externalizing behaviors, but it is unknown if this effect lasts into adulthood. This study assessed if and when the early maturation effect wanes, specifically in two domains of externalizing behaviors: nonviolent and violent behaviors.MethodsUsing data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) that include age-appropriate items of violent and nonviolent behaviors assessed from ages 11–30 over four waves (N = 4,255), we conducted a series of longitudinal growth curve analyses to evaluate the effect of pubertal timing on the trajectories of nonviolent and violent externalizing behaviors for males and females.ResultsCompared to later maturing male peers, early maturing males reported significantly elevated overall externalizing, nonviolent, and violent behaviors throughout adolescence, but became indistinguishable from on-time and late-maturing counterparts in young adulthood. Similarly, early maturing females showed higher levels of overall externalizing and nonviolent behaviors than later maturing counterparts, but no effect of pubertal timing was seen on the trajectories of violent behaviors. However, early maturing females' overall externalizing and nonviolent behaviors also became indistinguishable from on-time and late-maturing females after adolescence.ConclusionsThese findings clarify the differential effect of early maturation on nonviolent and violent behaviors, especially in females, and highlight the short-lived nature of the effects of early pubertal timing.     

Maternal Age at Menarche and Pubertal Timing in Boys and Girls: A Cohort Study From Chongqing,China

PurposeThis study explored the association of maternal age at menarche (AAM) with pubertal timing among girls and boys in Chongqing, China.MethodsPubertal development of 1,237 children (542 girls and 695 boys) were examined half-yearly through inspection and palpation from April 2014 to June 2019. Characteristics of parents and maternal AAM were collected by a parental questionnaire at baseline. Maternal AAM was used both as a continuous and a categorical variable in Cox regression models.ResultsA total of 1,198 children (528 girls and 670 boys) were included in the study. In the simple Cox model, earlier maternal AAM was associated with girls' earlier menarche, breast and pubic hair development, and boys' first ejaculation, testicular development, and genital development. When adjusting for children's body mass index z-scores (BMIz) and socioeconomic covariates, we found that girls whose mothers had early AAM had a higher risk of earlier onset of menarche (hazard ratio [HR]: .922, 95% confidence interval [CI]: .852–.998 for continuous maternal AAM, HR: 1.297, 95% CI: 1.041–1.616 for maternal AAM ≤13 years), and boys whose mother achieved menarche earlier experienced a higher risk of earlier onset of first ejaculation (HR: .896, 95% CI: .830–.968). Children's BMIz were related to all nine pubertal milestones. Parental education and relationship, birth weight, parity, and family type were also associated with pubertal timing.ConclusionsEarlier maternal AAM was related to earlier pubertal timing in both girls and boys in Chongqing, especially girls' age at menarche and boys' first ejaculation. Children's BMIz was the most consistent factor for pubertal timing. Children's BMIz and socioeconomic conditions had greater influence on most pubertal milestones than maternal AAM.     

通州市五乡镇恶性肿瘤不同疗法的生存分析

目的：为了解恶性肿瘤不同疗法的治疗效果。方法：对通州市5乡镇1990－1999年诊断的所有恶性肿瘤不同疗法患者进行了生存分析。结果：539例手术治疗的恶性肿瘤生存率高于2289例未手术治疗的生存率;176例放射治疗的恶性肿瘤生存率高于2652例未放射治疗的生存率;596例化学治疗的恶性肿瘤生存率高于2232例未化学治疗的生存率,差异均有非常显著性。114例中药治疗的恶性肿瘤生存率与2714例未用中药治疗的生存率比较差异无显著性。结论：对恶性肿瘤实施正规治疗是提高恶性肿瘤患者生存率的重要措施。     

不同特征女性人工流产时焦虑、抑郁情绪及影响因素

目的:研究不同特征女性人工流产时焦虑、抑郁情绪评估及影响因素。方法:以2019年1-7月在本院择期行人工流产者105例,其中已婚54例、未婚51例,手术流产62例、药物流产43例。采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评价并比较不同特征者人工流产前焦虑及抑郁程度,多因素logistic分析可能影响因素。结果:不同婚姻状态、文化程度、孕次、产次、流产方式者发生术前焦虑及抑郁程度存在差异(P<0.05),不同年龄、流产次数者术前焦虑及抑郁程度评分未见差异(P>0.05);未婚及手术流产者术前焦虑及抑郁情况最高(P<0.05)。多因素分析,流产妇女婚姻状态、文化程度、产次、孕次以及流产方式均为产生术前焦虑情绪的独立危险因素。结论:未婚及手术流产者流产前负面情绪较高,提示临床在行人工流产中,及时开展健康教育,做好咨询工作,降低流产妇女的负面情绪,提升生殖健康质量。     

Head injuries coexistent with pelvic or lower extremity fractures-early or delayed osteosynthesis

Summary The authors compared the results of a retrospective analysis of two groups of head-injured patients who had coexistent pelvic or lower extremit fractures. One group was treated with early osteosynthesis within the first 12 hours after trauma, simultaneously with neurosurgical treatment, while the second group was treated neurosurgically and osteosynthesis was postponed for 4 to 10 days. The second group revealed a higher mortality, which was due to fat embolism. We conclude that early osteosynthesis is the treatment of choice in patients with coexistent head injury and lower extremity fractures.     

颅内破裂动脉瘤手术时机的选择

目的探讨颅内破裂动脉瘤不同手术时机与临床预后的关系.方法回顾性分析121例前循环动脉瘤,其中延期手术夹闭97例,早期24例,采用不同的统计方法分析不同手术时机对预后的影响.结果早期手术夹闭24例中除1例V级患者于术后3d死亡和1例Ⅲ级患者于术后2月因颅内感染死亡外,余22例均获得优或良疗效;平均住院18.2d,无1例再出血,延期手术的97例平均住院时间是前者的2倍,14例发生再出血.结论早期显微外科治疗颅内破裂动脉瘤,尤其对Hunt&HessI～Ⅲ级患者,有利于缩短住院时间,降低保守治疗期间再出血的危险性,而对于Ⅳ～V级脑肿胀患者,早期手术的困难程度相应增加.     

氯化磷酸三钠消毒不同水体应用试验研究

本文报告了氯化磷酸三销对医院污水、游泳池水、浅井水、河水的消毒试验方法和结果。结果表明：医院污水消毒加入有效氯9mg／L的氯化磷酸三钠,作用1h后可达到GBJ48—83医院污水排放标准;游泳池水消毒加入有效氯0．8mg／L作用1h后可达到游泳池水卫生标准;浅井水消毒加入有效氯0．8mg／L作用30min可达到饮用水有关卫生标准;河水消毒加放有效氯1．25mg／L作用1h,水质有很大改善,生物指标接近饮用水卫生标准。     

命门动静观——兼论中医关于内分泌学的早期发现

明代命门学说的形成是中国古代医家为探索生命的起源及其内在规律所作的伟大尝试,反映出中国医药学早期对人体内分泌功能的发现和认识[1]。明代医家关于命门的解剖位置及其功能的描述,与现代医学肾上腺的位置和生理功能基本相合。"命门动静观"——即命门是五脏整合的生殖调节中枢,平时处在半关闭的状态,静以蓄养,为生殖作物质和能量方面的储备;激发态下命门全面开放,整合脏腑,使之同步;奇经八脉为命门开放、整合五脏的通道。命门为生命之原,相火之主,具有阴阳相济的特性,因而有别于五脏、十二经脉,反映出太极层次下生命活动的内在规律和调节机制。这项研究澄清了长期以来"肾命不分"的混淆。命门学说研究的深入为在生命的高层次上探索中西医结合之路开辟了广阔的前景。     

青藏高原鼠疫耶尔森菌基因型分布

目的研究青藏高原鼠疫耶尔森菌（鼠疫菌）基因组型分布特征.方法对分离到的青藏高原鼠疫菌297株,根据已经证实的22个差异区段设计引物,每株鼠疫菌的每个基因差异区段都采用PCR技术进行验证.结果在喜马拉雅旱獭鼠疫自然疫源地中,鼠疫菌基因组型有9种,分别为1、5、6、7、8、10、11、新基因组型和Ype-ancestor型,其中以5、8和10型为主,3种基因组型合计所占比例为80.6%（204/253）,而且不同地区鼠疫菌基因组型的分布也不一致.青藏高原青海田鼠鼠疫疫源地鼠疫菌基因组型全部为14型.结论青藏高原鼠疫菌基因组型分布具有明显的地理特征.根据基因组型的分布状况推测出了鼠疫菌在青藏高原的传播路径.     

大鼠脑挫伤DNA含量变化与损伤时间的关系

目的观察大鼠脑挫伤后DNA含量的时序变化规律。方法建立自由落体打击大鼠脑挫伤动物模型，采用Feulgen’s DNA染色方法，结合图像分析技术。结果损伤侧大脑皮质浅层和海马区平均积分光密度（IOD）变化呈：24h内迅速下降，24—96h有缓慢上升趋势；伤后24h内上述两区域平均积分光密度均与损伤时间呈线性关系，R^2分别为0．668和0．615。可导出直线回归方程。结论采用Feulgen’s DNA染色法结合图像分析技术观察伤后DNA含量变化，可以应用于脑损伤时间推断的研究，探索推断脑损伤时间的新方法。