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【Objective】 To investigate the correlation between body composition and thyroid function indicators in type 2 diabetic patients with euthyroidism of different genders. 【Methods】 Type 2 diabetic patients with euthyroidism who were hospitalized in the Endocrinology Department of The Second Affiliated Hospital of Xi’an Jiaotong University from February 2016 to September 2018 were enrolled in this study. Bioelectric impedance analysis was used to measure body composition, and the thyroid function indicators (FT3, FT4, and TSH) were tested. The male and female subjects were matched according to the ratio of 2:1 using the propensity score matching method, and the correlation between body composition and thyroid function indicators was studied in different genders by correlation analysis. 【Results】 The basal metabolic rate, trunk fat mass, fat-free mass, fat-free mass index, bone mass, water mass, total body muscle mass, skeletal muscle mass, and skeletal muscle index were positively correlated with FT3 in male patients (P<0.05). The percentage of body fat mass and fat mass index were positively correlated with FT3 and TSH (P<0.05), and the percentages of lean mass, water mass, and total body muscle mass were negatively correlated with FT3 and TSH (P<0.05), and the basal metabolic rate was negatively correlated with FT4 (P<0.05) in female. 【Conclusion】 In euthyroid type 2 diabetic patients, the correlation between body composition and thyroid function indicators are different between males and females. In males, only FT3 is positively correlated with basal metabolic rate, trunk fat mass, and fat free-related composition; while in females, both FT3 and TSH are positively correlated with fat-related composition, but negatively correlated with fat-free-related composition.
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Background Since the outbreak of the COVID-19 epidemic, staff of the centers for disease control and prevention (CDC) have been burdened with heavy epidemic prevention control, and excessive occupational stress can cause depression and other psychological problems. Objective To explore the status of occupational stress, resilience, and depression of CDC staff and potential relationships between them. Methods From December 2020 to April 2021, a survey was conducted at provincial and municipal levels, and the stratified cluster sampling method was used at county (district) level to select a total of 3514 samples. Their occupational stress, resilience, and depression status were evaluated using the Chinese Effort-Reward Imbalance Scale (ERI), the Chinese Connor-Davidson Resilience Scale (CD-RISC), and the Patient Health Questionnaire (PHQ-9). Independent sample t test, analysis of variance, χ2 test, Pearson correlation analysis, and mediation test (structural equation model) were conducted. Results The positive rate of occupational stress was 34.29% in the CDC staff, the resilience score was 66.28±15.32, and the positive rate of depression was 48.58%. Significant differences were found in the positive rates of occupational stress among different groups of gender, age, education background, marital status, administrative duty, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P<0.05); in the resilience scores among different groups of gender, age, administrative duty, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P<0.05); in the positive rates of depression among different groups of gender, age, educational background, personal monthly income, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P<0.05). Occupational stress was negatively correlated with resilience (r=−0.165, P<0.01). Resilience was negatively correlated with depression (r=−0.383, P<0.01). Occupational stress was positively correlated with depression (r=0.343, P<0.01). The structural equation embracing a partial mediating effect of resilience on the relationship occupational stress and depression was established, and the partial mediating effect was 0.039, accounting for 10.46% of the total effect. Conclusion High positive rates of occupational stress, reduced resilience, and depression are shown among CDC staff in the context of the COVID-19 epidemic, and resilience partially mediates the effect of occupational stress on depression. The study findings suggest that improving resilience may reduce occupational stress and depression in CDC staff.
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Objective:To determine the current situation of food safety risk monitoring ability of centers for disease control and prevention （CDCs） in a province， and provide reference for strengthening the construction of food safety monitoring ability in the future. Methods:A self-administered questionnaire survey was conducted among 14 CDCs who are responsible for food safety risk monitoring in the province in 2018. Results:The ratio of food inspection staff with senior， middle， and primary professional titles was 1∶1∶1. The educational background of food inspection staff at the provincial and municipal levels was mainly bachelor degree or above， while that of county level directly under the administration of the province was mainly college degree. The age composition of the staff at the provincial level tended to be elder； however， there were more staff with less working experience at the county level. The qualification proportion of laboratory area was 50%. The distribution proportion of food inspection equipment in the CDC at all levels was 83.3%， 79.5% and 36.3%， respectively. In total， 14 CDCs completed the monitoring task as required. They were all accredited with laboratory qualifications； however， one CDC did not conduct re-evaluation after the certification of food inspection qualification expired. Each CDC ensured the accuracy and reliability of monitoring data through the supervision in food testing. Conclusion:The food safety risk monitoring ability of the CDCs in the province is continuously improved， which can meet the needs of routine monitoring. However， the composition of professional titles of food inspection staff is not very reasonable. There is still a gap between the equipment configuration and the national requirements. The ability of food inspection needs to be improved， in which quality management and laboratory qualification should be further strengthened.
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Objective To explore the association between maternal respiratory infection in early pregnancy and gestational age of single live birth.Methods A face to face questionnaire survey was conducted among child bearing aged women in 30 counties (district) of Shaanxi province selected through stratified multistage sampling.Propensity score (PS) matched (1 ∶ 1) analysis was used to match participants with respiratory infections to those without respiratory infections.A multilevel linear model was used to investigate the association between respiratory infections and gestational age.Through the control of the confounders step by step,three models were established in this study:model 1 for the variable of respiratory infections before PS matching,model 2 was adjusted for variables in model 1 plus some other individual differences of mother and baby,and model 3 for the variable of respiratory infections after PS matching.Results Of 28 848 child bearing aged women surveyed,3 676 (12.74％) had respiratory infections in early pregnancy.After PS matching,2 762 pairs were matched.Analysis with model 1 indicated that a decrease of 0.111 week (P＜0.001) in gestational age was associated with a respiratory infection during the first trimester.Analysis with model 2 and model 3 indicated that a decrease of 0.058 week (P=0.025) and a decrease of 0.076 week (P=0.036) were associated with respiratory infection during the fast trimester,respectively.Conclusion The respiratory infection during the first trimester was associated with the decrease of the gestational age of newborn.
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Objective·To analyze the basic medical insurance policies for children in Shanghai in 2011 and 2017, and compare with those of the other three municipalities to understand the basic medical security status of children in four municipalities in China and analyze the existing problems. Methods?·?The current effective children's basic medical insurance policies and child critical illness insurance policies and related insurance systems in four municipalities were collected systematically. The types of basic medical insurance for children in various municipalities and their funding standards, their own expenses and the proportion of government subsidies, the proportion of outpatient emergency payoff lines and reimbursement at all levels of medical institutions, and the coverage and coverage of major illness insurance reimbursement were collected and compared mainly. Results?·?The basic medical insurance for children in Shanghai is a "double insurance" system, which contained children's hospitalization fund and basic medical insurance for urban and rural residents. The basic medical insurance for children in other municipalities mainly consisted of basic medical insurance for urban (rural) residents. Compared with 2011, the level of financing and the reimbursement of the basic medical insurance for urban and rural residents and of the children's hospitalization fund in Shanghai in 2017 was increased. In 2017, the level of financing of basic medical insurance for urban and rural residents in Shanghai was 1?100 yuan, which was slightly lower than that of Beijing medical insurance for urban residents and new rural cooperative medical insurance and was higher than that of basic medical insurance for urban and rural residents in Tianjin and Chongqing, and the individual payment level of Shanghai was the lowest. The hospitalization payoff lines in Shanghai were lower than those of other municipalities. Shanghai's outpatient and inpatient reimbursement levels were higher those of than other municipalities. There wasn't a capping line in Shanghai. There were capping lines in other municipalities. There was a great difference in the insurance policy of the major diseases in four municipalities. Conclusion?·?According to their own actual conditions, models for children's medical care systems that suited each municipalities’ social and economic development have been established. Shanghai children's basic medical insurance basically meets the needs of children's growth but needs improvement in terms of the type and level of medical security for major illnesses.
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Objective To explore the association between maternal respiratory infection in early pregnancy and gestational age of single live birth.Methods A face to face questionnaire survey was conducted among child bearing aged women in 30 counties (district) of Shaanxi province selected through stratified multistage sampling.Propensity score (PS) matched (1 ∶ 1) analysis was used to match participants with respiratory infections to those without respiratory infections.A multilevel linear model was used to investigate the association between respiratory infections and gestational age.Through the control of the confounders step by step,three models were established in this study:model 1 for the variable of respiratory infections before PS matching,model 2 was adjusted for variables in model 1 plus some other individual differences of mother and baby,and model 3 for the variable of respiratory infections after PS matching.Results Of 28 848 child bearing aged women surveyed,3 676 (12.74％) had respiratory infections in early pregnancy.After PS matching,2 762 pairs were matched.Analysis with model 1 indicated that a decrease of 0.111 week (P＜0.001) in gestational age was associated with a respiratory infection during the first trimester.Analysis with model 2 and model 3 indicated that a decrease of 0.058 week (P=0.025) and a decrease of 0.076 week (P=0.036) were associated with respiratory infection during the fast trimester,respectively.Conclusion The respiratory infection during the first trimester was associated with the decrease of the gestational age of newborn.
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Objective To understand the prevalence of prenatal supplementations of iron, iron-containing multi-micronutrients (IMMN) and antianemic Chinese patent medicines (ACPM) and associated factors in women in Shaanxi province. Methods A sample of 28367 childbearing-age women who gave birth during 2010-2013 and had specific information of the prenatal nutrients supplementation were recruited using stratified multistage cluster random sampling in Shaanxi province. The information about their basic characteristics and prenatal supplementation of nutrients were collected by a questionnaire survey. Descriptive analysis method was used to analyze the intake rate of iron, IMMN and ACPM during each period of pregnancy, and logistic regression model was used to identify associated factors. Results The overall prevalence of prenatal iron, IMMN and ACPM supplementation was low (28.99%), and the intake rate of iron was the lowest (5.33%). The prevalence of prenatal supplementation of iron, IMMN and ACPM were lower before pregnancy and in the first trimester than in the second and third trimester. The intake rates for consecutive 2 periods were very low (all were lower than 2.00%). The intake rates of iron, IMMN and ACPM significantly increased year by year. Women living in central Shaanxi had relatively high intake rates of iron (7.22%) and IMMN (16.55%), and women in southern Shaanxi had relatively high intake rate of ACPM (18.50%). The results of logistic regression analysis showed that higher educational level(OR=1.920, 95%CI: 1.617-2.279), antenatal care times≥6 (OR=1.832, 95%CI: 1.604-2.091), etc. were the positive factors for iron intake, and these positive factors were similar to those for IMMN intake. Additionally, rural residence was the negative factor for IMMN intake (compared with urban residence, OR=0.872, 95%CI:0.788-0.966). Conversely, higher educational level (OR=0.855, 95%CI:0.746-0.979), higher household income (OR=0.864, 95%CI: 0.796-0.938) were negative factors for ACPM intake, and rural residence was its positive factor (OR=1.285, 95% CI: 1.141-1.447). Conclusions The prevalence of prenatal supplementation of iron, IMMN and ACPM were low in women in Shaanxi, especially the intake rate of iron was the lowest. The prophylactic iron supplementation before pregnancy or in the first trimester was rare. Measures should be taken to improve the prenatal supplementation of iron in Shaanxi and to standardize the clinical use of ACPM.
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Objective To explore the association between exposure to ambient air pollution during pregnancy and congenital heart disease so as to provide evidence for primary prevention of congenital heart disease.Methods Epidemiologic studies on ambient air pollution and congenital heart diseases were reviewed.Summary risk estimates were calculated at high versus low exposure levels and risk per-unit-increase in continuous pollutant concentration.Meta-analysis was conducted with Stata 12.0 software.Results A total of 20 articles in English were qualified for inclusion.Results from Meta-analysis showed that CO exposures were related to the increase on the risk of tetralogy of fallot (high versus low exposure level OR=1.22,95％CI:1.03-1.44),while the exposures to NO2 were related to the increase on risk of coarctation of aorta (per 10 mm3/m3 OR=1.01,95％CI:1.01-1.20).Exposures to O3 were related to the increase on risk of atrial septal defect (per 10 mm3/m3 OR=1.14,95％CI:1.03-1.26),and PM10 exposures were related to the increase on risk of atrial septal defect (per 10 μg/m3 OR=1.10,95％CI:1.03-1.19).In addition,there were inverse associations between CO and atrial septal defect and between PM10 and ventricular septal defect.Conclusion Exposures to CO,NO2,O3,PM10 during pregnancy seemed to be associated with congenital heart diseases.
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Objective To explore the relationship of four kinds of lifestyle factors,namely,prenatal passive smoking,hair dyeing or perming,exposure to noise,living in a house renovated in the past one year,with congenital heart disease.Methods A hospital-based case-control study was conducted.Totally 270 mothers in the case group and 1633 mothers in the control group were interviewed through a face-to-face questionnaire survey.A generalized linear model was employed to investigate the association between congenital heart disease and prenatal lifestyle factors.Results Both in Model 1 and Model 2,prenatal hair dyeing or perming had no association with congenital heart disease.On the other hand,prenatal passive smoking,exposure to noise and living in a house renovated in the past one year all increased the risk of congenital heart disease.After adjustment for all confounders,the OR values were 1.771 (95％ CI:1.079-2.909),2.079 (95％ CI:1.310-3.298),and 2.494 (95％ CI:1.511-4.116),respectively.Conclusion Prenatal passive smoking,exposure to noise and living in a house renovated in the past one year are the risk factors for congenital heart disease.It is very important to avoid such factors during pre-pregnancy and pregnancy.
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Objective To explore the relationship between first trimester pregnancy infection and congenital malformation in the cardiovascular system.Methods A hospital-based study was conducted from June 2014 to June 2016.Totally 1618 mothers of infants with cardiovascular system malformation and normal infants were interviewed through a face-to-face questionnaire survey.A propensity score-matched study was conducted to investigate the association between first trimester pregnancy infection and congenital malformation in the cardiovascular system.Results All important covariates were balanced after matching.First trimester pregnancy infection increased the risk of congenital malformation in the cardiovascular system,single congenital malformation in the cardiovascular system and multi-congenital malformation in the cardiovascular system.After matched,the OR values were 1.65 (95％ CI:1.21-2.24;P=0.001),1.50 (95％ CI:1.02 2.20;P=0.037),and 1.90 (95％ CI:1.18-3.06;P=0.008),respectively.Conclusion First trimester pregnancy infection increases the risk of congenital malformation in the cardiovascular system.Avoiding infectious diseases during the first trimester in pregnancy is important in decreasing the incidence of congenital malformation in the cardiovascular system.
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Objective:To evaluate the association with serum Interleukin-17 ( IL-17 ) and multiple sclerosis ( MS ) systematically evaluated .Methods:The retrieval words of "multiple sclerosis or MS"and "interleukin-17 or IL-17"were searched in PubMed,SpringerLink,Embases,OVID,China National Knowledge infrastructure (CNKI),Chinese VIP database,Chinese Biomedical Literature Database (CBM),Wan Fang Database through computer.Review Manager 5.3.was selected as the software edition.The time frame was ranged from January 1,2000 to March 10,2017.The language was not restricted .Results: Eventually 8 case-control studies were included with 544 cases.We found that the serum IL-17 level was associated with MS according to the weighted mean difference and 95%confidence interval ( WMD =38.65;95%CI:18.66 ,58.63 ) ,which had significant difference in statistics .Conclusion:The serum IL-17 level increases the risk of MS , suggesting that the serum IL-17 level can be used as a predictive biomarker for MS development and a target for MS effective prevention and treatment .
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Objective To understand the prevalence of prenatal supplementations of iron, iron-containing multi-micronutrients (IMMN) and antianemic Chinese patent medicines (ACPM) and associated factors in women in Shaanxi province. Methods A sample of 28367 childbearing-age women who gave birth during 2010-2013 and had specific information of the prenatal nutrients supplementation were recruited using stratified multistage cluster random sampling in Shaanxi province. The information about their basic characteristics and prenatal supplementation of nutrients were collected by a questionnaire survey. Descriptive analysis method was used to analyze the intake rate of iron, IMMN and ACPM during each period of pregnancy, and logistic regression model was used to identify associated factors. Results The overall prevalence of prenatal iron, IMMN and ACPM supplementation was low (28.99%), and the intake rate of iron was the lowest (5.33%). The prevalence of prenatal supplementation of iron, IMMN and ACPM were lower before pregnancy and in the first trimester than in the second and third trimester. The intake rates for consecutive 2 periods were very low (all were lower than 2.00%). The intake rates of iron, IMMN and ACPM significantly increased year by year. Women living in central Shaanxi had relatively high intake rates of iron (7.22%) and IMMN (16.55%), and women in southern Shaanxi had relatively high intake rate of ACPM (18.50%). The results of logistic regression analysis showed that higher educational level(OR=1.920, 95%CI: 1.617-2.279), antenatal care times≥6 (OR=1.832, 95%CI: 1.604-2.091), etc. were the positive factors for iron intake, and these positive factors were similar to those for IMMN intake. Additionally, rural residence was the negative factor for IMMN intake (compared with urban residence, OR=0.872, 95%CI:0.788-0.966). Conversely, higher educational level (OR=0.855, 95%CI:0.746-0.979), higher household income (OR=0.864, 95%CI: 0.796-0.938) were negative factors for ACPM intake, and rural residence was its positive factor (OR=1.285, 95% CI: 1.141-1.447). Conclusions The prevalence of prenatal supplementation of iron, IMMN and ACPM were low in women in Shaanxi, especially the intake rate of iron was the lowest. The prophylactic iron supplementation before pregnancy or in the first trimester was rare. Measures should be taken to improve the prenatal supplementation of iron in Shaanxi and to standardize the clinical use of ACPM.
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Objective To explore the association between exposure to ambient air pollution during pregnancy and congenital heart disease so as to provide evidence for primary prevention of congenital heart disease.Methods Epidemiologic studies on ambient air pollution and congenital heart diseases were reviewed.Summary risk estimates were calculated at high versus low exposure levels and risk per-unit-increase in continuous pollutant concentration.Meta-analysis was conducted with Stata 12.0 software.Results A total of 20 articles in English were qualified for inclusion.Results from Meta-analysis showed that CO exposures were related to the increase on the risk of tetralogy of fallot (high versus low exposure level OR=1.22,95％CI:1.03-1.44),while the exposures to NO2 were related to the increase on risk of coarctation of aorta (per 10 mm3/m3 OR=1.01,95％CI:1.01-1.20).Exposures to O3 were related to the increase on risk of atrial septal defect (per 10 mm3/m3 OR=1.14,95％CI:1.03-1.26),and PM10 exposures were related to the increase on risk of atrial septal defect (per 10 μg/m3 OR=1.10,95％CI:1.03-1.19).In addition,there were inverse associations between CO and atrial septal defect and between PM10 and ventricular septal defect.Conclusion Exposures to CO,NO2,O3,PM10 during pregnancy seemed to be associated with congenital heart diseases.
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Objective To explore the effect of mental nursing intervention on gastric cancer with liver metastasis patients treated with TACE sequential chemotherapy.Methods Sixty four gastric cancer patients with liver metastasis,no hopes of accepting operations,were included.All patients were divided into control group (32 cases) and observation group (32 cases).The former received routine nursing care and the later received extra mental nursing intervention.The anxiety,depression and quality of life in both groups were evaluated and compared.Results After extra mental nursing intervention,the SDS and SAS scores of the observation group [(41.6 ± 1.8) points and (41.6 ± 2.3) points] were significantly lower than those of the control group [(50.9 ± 1.9) points and (53.0 ± 3.5) points,P =0.040,P =0.036,respectively].The quality of life scores,including the physiological function,body pain,general self rating,vitality,social function,emotional function and mental health score were (45.26 ± 38.26)points vs (35.17 ± 33.65) points (P =0.044),(71.98 ± 17.36) points vs (63.01 ± 18.41) points (P =0.039),(55.59 ± 12.78) points vs (49.67 ± 12.43) points (P =0.048),(74.82 ± 14.23) points vs (55.61 ± 10.58) points (P =0.027),(75.47 ± 12.15) points vs (57.22 ± 14.78) points (P =0.031),(70.24 ± 22.00) points vs (45.92 ± 34.76) points (P =0.004),(78.31 ± 19.11) points vs (67.23 ± 11.96) points (P =0.037),respectively,the scores in the observation group were significantly higher than those in the control group (all P ＜ 0.05).Conclusion The extra mental nursing intervention on gastric cancer with liver metastasis patients,treated with TACE sequential chemotherapy,can not reduce the patients'negative mood,improve the patients'compliance with chemotherapy and the confidence to treatment,but improve the quality of patients'life effectively.
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<p><b>OBJECTIVE</b>To observe analgesic effect of electroacupuncture ( EA) on rats with chronic inflammatory pain and its regulatory mechanism on ispilateral dorsal root ganglion (DRG) and spinal dorsal horn (SDH) Mas-related G protein-coupled C receptor (MrgprC).</p><p><b>METHODS</b>Totally 40 healthy male SD rats were divided into 4 groups according to random number table, i.e., the normal (N) group, the model (M) group, the acupuncture (Acu) group, the EA group, 10 rats in each group. The model of chronic inflammatory pain was established by subcutaneous injecting 0. 1 mL complete Freund's adjuvant (CFA) into right hind paw. Paw withdrawal thresholds (PWTs) were measured before modeling, at day 1, 3, 5, 7, and after CFA injection, respectively. Expression levels of MrgprC in ispilateral DRG and SDH were detected by Western blot. The content of bovine adrenal medulla 22 (BAM22) in SDH was detected by immunohistochemical assay.</p><p><b>RESULTS</b>Compared with N group at each time point, PWTs significantly decreased in M group (P <0. 01). Compared with M group, PWTs significantly increased at day 5 of EA and after EA in EA group (P < 0.05, P < 0.01). Compared with Acu group at each time point, post-EA PWTs significantly increased in the EA group (P < 0.05). Compared with N group, expression of MrgprC in ispilateral DRG and ratio of BAM22 positive cells in ispilateral SDH increased in M group (P < 0.01). Compared with M group, expression of MrgprC in ispilateral DRG and ratio of BAM22 positive cells in ispilateral SDH increased in the EA group (P < 0.05).</p><p><b>CONCLUSION</b>EA had favorable analgesic effect on chronic inflammatory pain induced by CFA, and its mechanism might be possibly associated with up-regulating MrgprC expression in ispilateral DRG and BAM22 content in ispilateral SDH.</p>
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Animals , Male , Rats , Analgesia , Electroacupuncture , Enkephalins , Metabolism , Freund's Adjuvant , Ganglia, Spinal , Inflammation , Drug Therapy , Pain Management , Methods , Peptide Fragments , Metabolism , Posterior Horn Cells , Random Allocation , Rats, Sprague-DawleyABSTRACT
<p><b>BACKGROUND</b>Patient trust in physicians, which can be considered a collective good, is necessary for an effective health care system. However, there is a widespread concern that patient trust in physicians is declining under various threats to the physician-patient relationship worldwide. This article aimed to assess patient trust in physicians through a quantitative study in Shanghai, China, and to provide appropriate suggestions for improving the trust in China.</p><p><b>METHODS</b>The data from a survey conducted in Zhongshan Hospital and Shanghai Tenth People's Hospital, which are two tertiary public hospitals in Shanghai, were used in this study. Patient trust in physicians was the dependent variable. Furthermore, a 10-item scale was used to precisely describe the dependent variable. The demographic characteristics were independent variables of trust in physicians. Binomial logistic regression was employed to analyze the factors associated with the dependent variable, which was divided into two categories on the basis of the responses (1: Strongly agree or agree and 0: Strongly disagree, disagree, or neutral).</p><p><b>RESULTS</b>This study found that 67% of patients trusted or strongly trusted physicians. The mean score of patient trust in physicians was 35.4 from a total score of 50. Furthermore, patient trust in physicians was significantly correlated with the age, education level, annual income, and health insurance coverage of the patients.</p><p><b>CONCLUSIONS</b>Patient trust in physicians in Shanghai, China is higher than previously reported. Furthermore, the most crucial reason for patient distrust in physicians is the information asymmetry between patients and physicians, which is a natural property of the physician-patient relationship, rather than the so-called for-profit characteristic of physicians or patients' excessive expectations.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , China , Logistic Models , Physician-Patient Relations , TrustABSTRACT
Objective To analyze the incidence of low birth weight among single live birth neonates and identify the influencing factors in Shaanxi province.Methods A questionnaire survey was conducted among the childbearing aged women selected through multi stage stratified random sampling in Shaanxi during 2010-2013, all of these childbearing aged women were in pregnancy or had definite pregnancy outcomes.Results A total of 28 164 childbearing aged women and their infants were investigated.The overall incidence of low birth weight among the single live birth neonates surveyed was 3.4％ during 2010-2013 (4.1％ in 2010, 4.4％ in 2011,3.1％ in 2012, 2.6％ in 2013, respectively).The incidence of the low birth weight was 3.8％ in southern Shaanxi, 3.4％ in northem Shaanxi and 3.2％ in central area of Shaanxi.The incidence of the low birth weight was 2.5％ in urban area and 3.6％ in rural area.Compared with the low birth weight incidence of 2.6％ in full-term infant, the low birth weight incidence was 32.0％ in preterm infants.The results of logistic regression analysis suggested that being female infant (OR=1.57, 95％ CI: 1.36-1.81) , preterm delivery (OR =18.28, 95％ CI: 15.23-21.96), lower educational level of mothers (OR =1.27, 95％ CI:1.06-1.52), antenatal care times ＜4 (compared with 4-7,OR=1.36, 95％CI: 1.14-1.63) ,antenatal care times ≥8 (compared with 4-7, OR=1.84, 95％ Ch 1.48-2.29), gestational hypertension (OR=3.07, 95％ CI: 2.12-4.43) , being multipara (OR=1.21,95％ CI: 1.03-1.41) , taking no folic acid during pregnancy (OR=1.30, 95％ CI: 1.12-1.52) were risk factors for the low birth weight of neonate.Conclusion The incidence of low birth weight among single live birth neonates was in decline in Shaanxi.The incidence of the low birth weight was higher in rural area than in urban area.The incidence of the low birth weight was lower than national level.Being female neonate, preterm delivery, lower education level of mothers, irregular antenatal care, gestational hypertension, being multipara, taking no folic acid during pregnancy were the risk factors for low birth weight of neonates.
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This study analyzed the current situation and problems of two-way referral between wound healing department of general hospitals and community health service centers through stipulated interview with physicians in general hospitals and community health service centers, and patients visiting these organizations from March 2011 to April. It was found that the current two-way referral process for wound repair were facing a series of problems, including hospitals-transfer difficulty, incomplete two-way referral policy and undefined practice protocol, information-sharing obstacle between general hospitals and community health service centers. The critical countermeasures for overcoming these obstacles in two-way referral of wound ailments shall include construction of further linkage mechanism among all levels of hospitals, establishment of the drug-obtaining mechanism, establishment of an explicit two-way referral process of wound repair, and establishment of a database of diagnosis and treatment information of patients that can be accessed by doctors of different levels of hospitals, etc.
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Humans , Community Health Planning , Community-Institutional Relations , Hospitals, Special , Referral and Consultation , Wound HealingABSTRACT
<p><b>BACKGROUND</b>Work-related musculoskeletal disorders (WMSDs) have high prevalence in sewing machine operators employed in the garment industry. Long work duration, sustained low level work and precise hand work are the main risk factors of neck-shoulder disorders for sewing machine operators. Surface electromyogram (sEMG) offers a valuable tool to determine muscle activity (internal exposure) and quantify muscular load (external exposure). During sustained and/or repetitive muscle contractions, typical changes of muscle fatigue in sEMG, as an increase in amplitude or a decrease as a shift in spectrum towards lower frequencies, can be observed. In this paper, we measured and quantified the muscle load and muscular activity patterns of neck-shoulder muscles in female sewing machine operators during sustained sewing machine operating tasks using sEMG.</p><p><b>METHODS</b>A total of 18 healthy women sewing machine operators volunteered to participate in this study. Before their daily sewing machine operating task, we measured the maximal voluntary contractions (MVC) and 20%MVC of bilateral cervical erector spinae (CES) and upper trapezius (UT) respectively, then the sEMG signals of bilateral UT and CES were monitored and recorded continuously during 200 minutes of sustained sewing machine operating simultaneously which equals to 20 time windows with 10 minutes as one time window. After 200 minutes' work, we retest 20%MVC of four neck-shoulder muscles and recorded the sEMG signals. Linear analysis, including amplitude probability distribution frequency (APDF), amplitude analysis parameters such as roof mean square (RMS) and spectrum analysis parameter as median frequency (MF), were used to calculate and indicate muscle load and muscular activity of bilateral CES and UT.</p><p><b>RESULTS</b>During 200 minutes of sewing machine operating, the median load for the left cervical erector spinae (LCES), right cervical erector spinae (RCES), left upper trapezius (LUT) and right upper trapezius (RUT) were 6.78%MVE, 6.94%MVE, 6.47%MVE and 5.68%MVE, respectively. Work load of right muscles are significantly higher than that of the left muscles (P < 0.05); sEMG signal analysis of isometric contractions indicated that the amplitude value before operating was significantly higher than that of after work (P < 0.01), and the spectrum value of bilateral CES and UT were significantly lower than those of after work (P < 0.01); according to the sEMG signal data of 20 time windows, with operating time pass by, the muscle activity patterns of bilateral CES and UT showed dynamic changes, the maximal amplitude of LCES, RCES, LUT occurred at the 20th time window, RUT at 16th time window, spectrum analysis showed that the lower value happened at 7th, 16th, 20th time windows.</p><p><b>CONCLUSIONS</b>Female sewing machine operators were exposed to high sustained static load on bilateral neck-shoulder muscles; left neck and shoulder muscles were held in more static positions; the 7th, 16th, and 20th time windows were muscle fatigue period that ergonomics intervention can protocol at these periods.</p>
Subject(s)
Adult , Female , Humans , Young Adult , Electromyography , Methods , Muscle Fatigue , Physiology , Muscle, Skeletal , Physiology , Neck Muscles , Physiology , Shoulder , Physiology , Textile Industry , WorkloadABSTRACT
<p><b>BACKGROUND</b>According to the regulations of the Chinese and Shanghai governments, migrant workers employed in Shanghai should all be entitled to Shanghai Migrant Worker Hospitalization Insurance (SMWHI) without premium and the vast majority should also have the New Rural Cooperative Medical System (NRCMS). This study aimed to examine the status of the coverage and utilization of health insurance among migrant workers employed in Shanghai.</p><p><b>METHODS</b>Quantitative and qualitative research methods were employed in the study. A survey of 1020 migrant workers employed in Shanghai was conducted in 2010 with a structured questionnaire. Focus group discussions were held with respondents who were unable to maintain health insurance coverage through NRCMS or SMWHI. In-depth interviews were held with village heads and employers of the migrant workers, migrant workers who were hospitalized within the last year, and various individuals employed by the insurance agencies.</p><p><b>RESULTS</b>The study found that 72.9% and 36.5% of migrant workers were covered by NRCMS or SMWHI, respectively, while 16.7% of them had no health insurance. The coverage by NRCMS among migrant workers correlated significantly with education level and workplace, while the coverage by SMWHI correlated significantly with the length of employment in Shanghai and workplace. The qualitative results confirmed that migrant workers were the main group who were not covered by NRCMS, and the coverage by SMWHI was completely dependent upon the employers of the migrant worker. The results also showed that health insurance utilization among migrant workers was strongly limited by hospital location.</p><p><b>CONCLUSIONS</b>We observed that the status of health insurance among migrant workers was not accordant with theory, and that Chinese health insurance policy should be further reformed in order to realize full coverage and equal utilization of health insurance among migrant workers in China.</p>