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Objective To investigate the current status of semen testing in the hospitals without assisted reproductive technology in Hu-nan Province,propose improvement strategies to enhance the diagnosis of male infertility and promote reproductive health services in these hospitals.Methods Questionnaire surveys and on-site investigations were conducted to examine the semen testing status in 67 hospitals without assisted reproductive technology in Hunan Province.The existing problems were summarized,and improvement strate-gies were suggested.Results Among the 67 hospitals,59.7%(40/67)performed semen testing.Of these,45%(18/40)possessed dedicated personnel,60%(24/40)possessed staff received relevant training,and 22.5%(9/40)held certificates.Only 30%(12/40)conducted sperm morphology testing,among them 20%(8/40)able to stain and interpret following WHO standards.The hospitals of 37.5%(15/40)used computer-assisted sperm analysis(CASA)systems,and 22.5%(9/40)were equipped with phase-contrast microscopes.30%(12/40)had dedicated examination areas,and 32.5%(13/40)had independent ejaculation rooms,17.5%(7/40)used disposable slides to observe sperm concentration.In 2022,the hospitals of 57.5%(23/40)had an average daily sample volume<1.The hospital of 67.5%(27/40)performed standard operating procedures,40%(16/40)followed the WHO 5th la-boratory manual for routine testing,15%(6/40)conducted internal quality control,and 12.5%(5/40)participated in external quali-ty assessment(EQA).Another 55%(22/40)wished to participate in EQA.Conclusion The semen testing capacity in the hospitals,in which assisted reproductive technology is not yet carried out currently,urgently requiring multifaceted improvements.The proposed strategies include emphasizing semen testing,establishing reproductive medicine consortia for comprehensive support,establishing a provincial quality control center for EQA,founding a professional committee for a learning platform,offering training to enhance staff expertise,and including the pre-pregnancy semen testing in public health programs.
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【Objective】 To investigate the relationship between the initial serum ammonia level and the risk of ICU and hospital mortalities in critically ill patients without hepatic disease. 【Methods】 A retrospective cohort study was conducted among patients admitted to the eICU Collaborative Research Database (eICU-CRD) for a single admission who had serum ammonia test records within 48 hours of the first ICU admission and had no hepatic disease. The age, sex, ethnicity, Acute Physiologic and Chronic Health Evaluation Ⅳ score (APACHE Ⅳ score), treatment methods, complications, and outcomes were extracted. Univariable and multivariable Logistic regression were used to analyze the relationship between serum ammonia level and the risk of mortality. Interactions were used to analyze whether the relationship between serum ammonia level and the risk of mortality differed in subgroups of APACHE Ⅳ scores, age, sex, and ethnicity; subgroup analyses were made. 【Results】 A total of 1 674 patients were included. The multivariable Logistic regression showed that for every 10 μg/dL increase in ammonia, the risk of ICU death increased by 6.9% (OR=1.069, 95% CI: 1.036-1.104), and the risk of hospital death increased by 4.6% (OR=1.046, 95% CI: 1.017-1.076). The risk of ICU death was 1.7 times greater in patients with initial ammonia level of 49-82 μg/dL than in those with <49 μg/dL (OR=1.700, 95% CI: 1.165-2.482), the risk of ICU death was 2.862 times greater in patients with a level of ≥82 μg/dL compared to those with <49 μg/dL (OR=2.862, 95% CI: 1.792-4.570), and the risk of hospital death was 1.844 times higher in the ≥82 μg/dL group than in the <49 μg/dL group (OR=1.844, 95% CI: 1.213-2.804). There were no significant differences between initial ammonia level and the risk of mortalities in different subgroups of APACHEⅣ scores, age, sex, or ethnicity. 【Conclusion】 In critically ill patients without hepatic disease, elevated initial serum ammonia level after ICU admission is associated with a high risk of ICU and hospital mortality.
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Objective:To investigate the clinical and pathological features and improve the acknowledgement of intraductal tubulopapillary neoplasm (ITPN) of pancreas.Methods:Six cases with ITPN in the Shandong Provincial Hospital Affiliated to Shandong First Medical University combined with 40 cases from PubMed and CNKI were retrospectively analyzed. There were 25 males and 21 females, aged (58.6±16.0) years. The clinical manifestations, pathological features, treatment and so on were analyzed.Results:All cases were treated with surgery. The main clinical symptoms were upper abdominal pain and discomfort (23 cases, 50.0%), followed by jaundice (9 cases, 19.6%). Seven cases (15.2%) had no clinical symptoms. Three cases (6.5%) had low back discomfort, chills and other rare symptoms, and 4 cases (8.7%) had no clinical symptoms mentioned in the literature. Tumors of 27 cases (58.7%) located in the head of the pancreas, 9 cases (19.6%) in the body and tail, 4 cases (8.7%) in the whole pancreas, 3 cases (6.5%) in the body, 2 cases (4.3%) in ampulla and 1 case (2.2%) in head and body. Most of the tumors located in the main pancreatic duct. Microscopically, back-to-back tubular glands were densely arranged, parts of them with papillary structure, with obvious cell atypia and many mitoses. Twenty-two cases (47.8%) of ITPN were completely confined to the pancreatic duct, and 24 cases (52.2%) were with associated invasive carcinoma. Tumor cells were positive for cytokeratin 7 and mucin 1, but negative for cytokeratin 20, synaptophysin, chromogranin and trypsin. Mucin 2, mucin 5AC and mucin 6 were negative in most cases. Ki-67 ranged from 10% to 70%.Conclusion:Pancreatic ITPNs were mostly located in the pancreatic head, confined to the main pancreatic duct, and were mostly manifested as pain and discomfort in the upper abdomen. Surgery was the main treatment. Tumors cells of ITPN were arranged in tubular and papillary, with severe epithelial atypia and special immunophenotype, parts of cases accompanied with associated invasive carcinoma.
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Considering that photodynamic therapy (PDT)-induced oxygen consumption and microvascular damage could exacerbate hypoxia to drive more glycolysis and angiogenesis, a novel approach to potentiate PDT and overcome the resistances of hypoxia is avidly needed. Herein, morpholine-modified PEGylated bilirubin was proposed to co-deliver chlorin e6, a photosensitizer, and diclofenac (Dc). In acidic milieu, the presence of morpholine could enable the nanocarriers to selectively accumulate in tumor cells, while PDT-generated reactive oxidative species (ROS) resulted in the collapse of bilirubin nanoparticles and rapid release of Dc. Combining with Dc showed a higher rate of apoptosis over PDT alone and simultaneously triggered a domino effect, including blocking the activity and expression of lactate dehydrogenase A (LDHA), interfering with lactate secretion, suppressing the activation of various angiogenic factors and thus obviating hypoxia-induced resistance-glycolysis and angiogenesis. In addition, inhibition of hypoxia-inducible factor-1α (HIF-1α) by Dc alleviated hypoxia-induced resistance. This study offered a sequentially responsive platform to achieve sufficient tumor enrichment, on-demand drug release and superior anti-tumor outcomes in vitro and in vivo.
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Objective:To provide theoretical reference for the construction of effective prevention and control strategies. The study deeply investigates the impact of traumatic birth events on compassion fatigue and inner feelings of midwives.Methods:Fifteen midwives from five tertiary hospitals in Guangzhou were interviewed in depth by semi-structured interview method from April to June 2021. Colaizzi analysis and Nvivo12 plus software were used to analyze and integrate the data and extract themes.Results:Three main themes were extracted, including the characteristics of traumatic birth events (high incidence, sudden and dangerous, preventable and controllable); exacerbating compassion fatigue (reducing compassion satisfaction levels; exacerbating burnout; and aggravating traumatic stress responses); and exploring effective coping strategies (time required for adjustment, seeking stress release).Conclusions:As a strong stressor, traumatic birth events aggravate the symptoms of compassion fatigue in midwives. Managers should pay attention to the occupational exposure of traumatic childbirth events, actively guide midwives to make psychological adjustments. In addition, managers can increase social support and strengthen the ideological and political education of midwives, so that they have good stress tolerance and excellent professional psychological quality.
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Objective:To study the clinical, imaging and pathological features of duodenal gangliocytic paraganglioma (DGP).Methods:The clinical, imaging and pathological data of patients with DGP treated at the Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2012 to October 2021 were retrospectively analyzed.Results:Of 8 patients with DGP, there were 7 males and 1 female, with a median age of 52 years (range 37 to 57 years). Five patients were asymptomatic and they were diagnosed on physical examination followed by investigations. Three patients presented with black stools. CT examination showed localized nodular thickening of the duodenum, with enhanced scanning showing obvious progressive contrast enhancement. Endoscopic ultrasonography showed a hypoechoic submucosal lesion in duodenal wall. Histologically, the neoplasm composed of three different cell types which included Schwann cells, epithelioid cells, and ganglioid cells. The Schwann cells expressed NF, NSE and S-100 proteins; the epithelioid cells expressed CK, NSE, Syn and CgA proteins; while the ganglioid cells expressed NSE, Syn, CgA and NF proteins. Endoscopic submucosal dissection was performed in 2 patients and surgical resection was performed in 6 patients.Conclusion:DGP is a rare benign neurogenic tumor which is most commonly found in the duodenum. It has a good prognosis. Imaging and endoscopic examinations demonstrated a submucosal mass. The main treatment are endoscopic resection and local surgical resection.
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【Objective】 To investigate the relationship between the level of thrombin-antithrombin complex (TAT)/α2-plasmin inhibitor-plasmin complex (PIC) and the utilization rate of mechanical ventilation (MV) in critically ill patients. 【Methods】 For the cross-sectional study, adult patients who had been admitted to the intensive care unit (ICU) for one day or longer and had a record of the first four tests for thrombosis were enrolled. Age, gender, the results of TAT and PIC, disseminated intravascular coagulation score, treatment, and diagnostic information were retrospectively collected from the hospital information system and laboratory information system. Logistic regression model was used to explore the relationship between TAT/PIC and the MV utilization rate. Interaction analysis and subgroup analysis were conducted to explore whether there was any difference between patients with different age and gender, patients with/without DIC, and with/without infection. 【Results】 A total of 1 176 patients were enrolled in this study. The median of the first TAT/PIC was 15.84 (8.13-33.11) in all the patients. The multivariable Logistic regression model results showed that for every 5 increase in TAT/PIC, the possibility of using MV increased by 2.9% (OR=1.029, 95% CI: 1.008-1.050), and the possibility of using MV in Q3 patients was 1.566 times than that in Q1 patients (OR=1.566, 95% CI: 1.095-2.239); the possibility of using MV in Q4 patients was 2.457 times than that in Q1 patients (OR=2.457, 95% CI: 1.694-3.563). Interaction results showed that the relationship between the level of TAT/PIC and MV usage was different in patients with and without infection (Pinteraction=0.02). Further subgroup analysis showed that in the infected patients (674 cases), the possibility of using MV increased by 5.9% for every 5 increase in TAT/PIC (OR=1.059, 95% CI: 1.022-1.097, P=0.001), while there was no significant difference between different TAT/PIC and MV usage in non-infected patients (502 cases) (OR=1.012, 95% CI: 0.984-1.040, P=0.405). 【Conclusion】 There is a correlation between the level of TAT/PIC and mechanical ventilation in patients with infection in the ICU.
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Parkinson's disease (PD), known as one of the most universal neurodegenerative diseases, is a serious threat to the health of the elderly. The current treatment has been demonstrated to relieve symptoms, and the discovery of new small-molecule compounds has been regarded as a promising strategy. Of note, the homeostasis of the autolysosome pathway (ALP) is closely associated with PD, and impaired autophagy may cause the death of neurons and thereby accelerating the progress of PD. Thus, pharmacological targeting autophagy with small-molecule compounds has been drawn a rising attention so far. In this review, we focus on summarizing several autophagy-associated targets, such as AMPK, mTORC1, ULK1, IMPase, LRRK2, beclin-1, TFEB, GCase, ERR
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Objective To investigate the effect of circadian heart rate variation on short-term and long-term mortality in intensive care unit (ICU) patients. Methods A retrospective cohort study was conducted. A total of 32 536 ICU patients were recorded from 2001 to 2008 published by Multiparameter Intelligent Monitoring in Intensive Care Ⅱ(MIMIC-Ⅱ v2.6) in April 2011. The circadian heart rate variation was defined as the ratio of mean nighttime (23:00 to 07:00) heart rate to mean daytime (07:00 to 23:00) heart rate. The 28-day mortality and 1-year mortality were defined as outcome events. The information such as age, gender, ethnicity, first sequential organ failure assessment (SOFA) score, first simplified acute physiology score Ⅰ (SAPSⅠ), usage of sedatives and catecholamines within 24 hours admission of ICU, clinical complications [hypertension, chronic obstructive pulmonary disease (COPD), diabetes with or without complications, congestive heart failure, liver disease, renal failure, etc.], and the complete heart rate records within 24 hours after ICU admission were collected. Cox proportional risk regression models were used to investigate the association between circadian heart rate variation and 28-day mortality and 1-year mortality in ICU patients. Besides, subgroup analysis was also performed in patients with different first SOFA scores. Results Totally 15 382 ICU patients in MIMIC-Ⅱ database were enrolled, excluding the patients without heart rate records or death records, using pacemaker with arrhythmia, without SOFA or SAPSⅠ score records. Finally, 9 439 patients were enrolled in the study cohort. ① Cox regression analysis of the whole patient showed that the higher circadian heart rate variation was correlated with the increased 28-day mortality [hazard ratio (HR) = 1.613, 95% confidence interval (95%CI) was 1.338-1.943, P < 0.001] and 1-year mortality (HR = 1.573, 95%CI was 1.296-1.908, P < 0.001). After adjustment for demographic factors (age, gender and ethnicity), severity of illness (SOFA and SAPS Ⅰ scores), clinical complications (hypertension, COPD, diabetes with or without complications, congestive heart failure, liver disease, renal failure, etc.), and influence of medications (sedatives and catecholamines), the night-day heart rate ratio was also correlated with 28-day mortality (HR = 1.256, 95%CI was 1.018-1.549, P = 0.033) and 1-year mortality (HR = 1.249, 95%CI was 1.010-1.545, P = 0.040). ② According to the SOFA score (median value of 5), the patients were divided into two subgroups, in which 5 478 patients with SOFA score ≤ 5 and 3 961 patients with SOFA score > 5. Cox regression subgroup analysis showed that circadian heart rate variation was related with higher 28-day mortality (HR = 1.430, 95%CI was 1.164-1.756, P = 0.001) and 1-year mortality (HR = 1.393, 95%CI was 1.123-1.729, P = 0.003) in patients with SOFA score > 5. After adjustment for covariates, the 28-day mortality (HR = 1.279, 95%CI was 1.032-1.584, P = 0.025) and 1-year mortality (HR = 1.255, 95%CI was 1.010-1.558, P = 0.040) also increased with the increasing of night-day heart rate ratio in patients with SOFA score > 5. However, the relationships did not exist in patients with SOFA score ≤ 5. Conclusion In ICU patients, the 28-day mortality and 1-year mortality increase with the higher circadian heart rate variation, which indicates that the circadian heart rate variation in ICU patients is positively correlated with the short-term and long-term mortality, especially in patients with relatively severe illness.
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Objective@#To investigate the effect of circadian heart rate variation on short-term and long-term mortality in intensive care unit (ICU) patients.@*Methods@#A retrospective cohort study was conducted. A total of 32 536 ICU patients were recorded from 2001 to 2008 published by Multiparameter Intelligent Monitoring in Intensive Care Ⅱ (MIMIC-Ⅱ v2.6) in April 2011. The circadian heart rate variation was defined as the ratio of mean nighttime (23:00 to 07:00) heart rate to mean daytime (07:00 to 23:00) heart rate. The 28-day mortality and 1-year mortality were defined as outcome events. The information such as age, gender, ethnicity, first sequential organ failure assessment (SOFA) score, first simplified acute physiology score Ⅰ (SAPSⅠ), usage of sedatives and catecholamines within 24 hours admission of ICU, clinical complications [hypertension, chronic obstructive pulmonary disease (COPD), diabetes with or without complications, congestive heart failure, liver disease, renal failure, etc.], and the complete heart rate records within 24 hours after ICU admission were collected. Cox proportional risk regression models were used to investigate the association between circadian heart rate variation and 28-day mortality and 1-year mortality in ICU patients. Besides, subgroup analysis was also performed in patients with different first SOFA scores.@*Results@#Totally 15 382 ICU patients in MIMIC-Ⅱ database were enrolled, excluding the patients without heart rate records or death records, using pacemaker with arrhythmia, without SOFA or SAPSⅠ score records. Finally, 9 439 patients were enrolled in the study cohort. ① Cox regression analysis of the whole patient showed that the higher circadian heart rate variation was correlated with the increased 28-day mortality [hazard ratio (HR) = 1.613, 95% confidence interval (95%CI) was 1.338-1.943, P < 0.001] and 1-year mortality (HR = 1.573, 95%CI was 1.296-1.908, P < 0.001). After adjustment for demographic factors (age, gender and ethnicity), severity of illness (SOFA and SAPS Ⅰ scores), clinical complications (hypertension, COPD, diabetes with or without complications, congestive heart failure, liver disease, renal failure, etc.), and influence of medications (sedatives and catecholamines), the night-day heart rate ratio was also correlated with 28-day mortality (HR = 1.256, 95%CI was 1.018-1.549, P = 0.033) and 1-year mortality (HR = 1.249, 95%CI was 1.010-1.545, P = 0.040). ② According to the SOFA score (median value of 5), the patients were divided into two subgroups, in which 5 478 patients with SOFA score ≤ 5 and 3 961 patients with SOFA score > 5. Cox regression subgroup analysis showed that circadian heart rate variation was related with higher 28-day mortality (HR = 1.430, 95%CI was 1.164-1.756, P = 0.001) and 1-year mortality (HR = 1.393, 95%CI was 1.123-1.729, P = 0.003) in patients with SOFA score > 5. After adjustment for covariates, the 28-day mortality (HR = 1.279, 95%CI was 1.032-1.584, P = 0.025) and 1-year mortality (HR = 1.255, 95%CI was 1.010-1.558, P = 0.040) also increased with the increasing of night-day heart rate ratio in patients with SOFA score > 5. However, the relationships did not exist in patients with SOFA score ≤ 5.@*Conclusion@#In ICU patients, the 28-day mortality and 1-year mortality increase with the higher circadian heart rate variation, which indicates that the circadian heart rate variation in ICU patients is positively correlated with the short-term and long-term mortality, especially in patients with relatively severe illness.
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Esophageal collision tumor is an extremely rare tumor which defined as the concrescence of two distinct primary neoplasms.The pathobiological mechanism of collision tumors is yet to be understood.Clinical symptoms,endoscopic examination and imaging are all lack of specificity.Diagnosing a collision tumor prior to surgery is difficult.Careful pathological examination is crucial for accurately diagnosing the neoplasms in a collision tumor and ensuring appropriate management and a favorable prognosis.Esophageal collision tumors have been increasingly reported in recent years.With the aim of improving the knowledge level of esophageal collision tumor,the clinical and pathological features of this tumor is needed to be summarized.
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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 analyze the incidence of preterm delivery among single live neonates and the association between maternal reproductive history and preterm birth.Methods A questionnaire survey was conducted on reproductive history among women at childbearing age who were selected through multi-stage stratified random sampling method in Shaanxi,during 2010-2013.Samples would include women at childbearing age and in pregnancy or having had definite pregnancy outcomes.Results A total of 29 608 women at childbearing age with their infants,were studied.The overall incidence of premature delivery among the single live birth neonates under this study,was 2.7% during 2010-2013.Results from the logistic regression model showed that factors as:having had history with preterm delivery (OR=7.99,95%CI:5.59-11.43),age of the mothers,older than 35 (OR=2.03,95%CI:1.59-2.59) and with history of birth defects (OR=1.54,95%CI:1.01-2.34) were at higher risks for premature delivery in neonates.Intervals on pregnancies between 3-4 years (compared with ≤2 years,OR=0.74,95%CI:0.58-0.93),between 5-6 years (compared with ≤2 years,OR=0.66,95%CI:0.52-0.82),or >6 years (compared with ≤2 years,OR=0.48,95%CI:0.37-0.61)together with numbers of parity as 1 (compared with primiparas,OR=0.80;95%CI:0.67-0.95),as ≥2 (compared with primiparas,OR=0.62,95% CI:0.39-0.97) etc.were protective factors to preterm delivery.Factors as:history of preterm delivery,mothers age (older than 35 years) and intervals of pregnancy,appeared influential to the age of gestation,under the ordinal polytomous logistic regression analysis.Conclusion The incidence of preterm births among single live birth neonates in Shaanxi was lower than the average national level.Programs related to health care services prior to conception and during pregnancy,together with increasing the self-care consciousness of childbearing aged women etc,should all be strengthened in order to reduce the occurrence of preterm birth,in Shaanxi province.
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Objective To investigate the relationship between frequencies of prenatal care and neonatal low birth weight (LBW) among women of childbearing age from the rural areas of Shaanxi province.Methods A questionnaire survey was conducted among the childbearing-aged women from the rural areas.Samples were selected through multi stage stratified random sampling method.The childbearing aged women were in pregnancy or having had definite outcomes of pregnancy.Measurement of data was described by median ± standard deviation,and chi square test was used to compare the rates.Neonatal low birth weight and frequencies of prenatal care were dependent variables and independent variables grouped into the generalized Poisson regression model.Confounding factors were under control.Results The overall incidence rate of LBW was 3.75% among 18 911 rural women of childbearing age during 2010-2013.Frequencies on pregnancy care were up to 15 times (0.70%),with a minimum of 0 (0.70%),an average of 5.65± 2.74 times (including ≥ 10 times accounted for 12.37%;≥7 times accounted for 28.52%;≥5 times accounted for 62.80% and <4 times accounted for 21.49%).After controlling confounding factors,results from the generalized Poisson regression analysis revealed that the difference was statistically significant when compared to the reference group.The incidence of neonatal LBW in the <4 group was 1.61 times of the one in the >7 group (OR=1.61,95%CI:1.31-2.00) while in the <4 group it was 1.23 times of the 4-7 group (OR=1.23,95% CI:1.04-1.45).Conclusion In the rural areas of Shaanxi province,the incidence of neonatal LBW was gradually reduced through the increasing number of frequencies on prenatal care,among women of childbearing age.
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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 analyze the incidence of preterm delivery among single live neonates and the association between maternal reproductive history and preterm birth.Methods A questionnaire survey was conducted on reproductive history among women at childbearing age who were selected through multi-stage stratified random sampling method in Shaanxi,during 2010-2013.Samples would include women at childbearing age and in pregnancy or having had definite pregnancy outcomes.Results A total of 29 608 women at childbearing age with their infants,were studied.The overall incidence of premature delivery among the single live birth neonates under this study,was 2.7% during 2010-2013.Results from the logistic regression model showed that factors as:having had history with preterm delivery (OR=7.99,95%CI:5.59-11.43),age of the mothers,older than 35 (OR=2.03,95%CI:1.59-2.59) and with history of birth defects (OR=1.54,95%CI:1.01-2.34) were at higher risks for premature delivery in neonates.Intervals on pregnancies between 3-4 years (compared with ≤2 years,OR=0.74,95%CI:0.58-0.93),between 5-6 years (compared with ≤2 years,OR=0.66,95%CI:0.52-0.82),or >6 years (compared with ≤2 years,OR=0.48,95%CI:0.37-0.61)together with numbers of parity as 1 (compared with primiparas,OR=0.80;95%CI:0.67-0.95),as ≥2 (compared with primiparas,OR=0.62,95% CI:0.39-0.97) etc.were protective factors to preterm delivery.Factors as:history of preterm delivery,mothers age (older than 35 years) and intervals of pregnancy,appeared influential to the age of gestation,under the ordinal polytomous logistic regression analysis.Conclusion The incidence of preterm births among single live birth neonates in Shaanxi was lower than the average national level.Programs related to health care services prior to conception and during pregnancy,together with increasing the self-care consciousness of childbearing aged women etc,should all be strengthened in order to reduce the occurrence of preterm birth,in Shaanxi province.
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Objective To investigate the relationship between frequencies of prenatal care and neonatal low birth weight (LBW) among women of childbearing age from the rural areas of Shaanxi province.Methods A questionnaire survey was conducted among the childbearing-aged women from the rural areas.Samples were selected through multi stage stratified random sampling method.The childbearing aged women were in pregnancy or having had definite outcomes of pregnancy.Measurement of data was described by median ± standard deviation,and chi square test was used to compare the rates.Neonatal low birth weight and frequencies of prenatal care were dependent variables and independent variables grouped into the generalized Poisson regression model.Confounding factors were under control.Results The overall incidence rate of LBW was 3.75% among 18 911 rural women of childbearing age during 2010-2013.Frequencies on pregnancy care were up to 15 times (0.70%),with a minimum of 0 (0.70%),an average of 5.65± 2.74 times (including ≥ 10 times accounted for 12.37%;≥7 times accounted for 28.52%;≥5 times accounted for 62.80% and <4 times accounted for 21.49%).After controlling confounding factors,results from the generalized Poisson regression analysis revealed that the difference was statistically significant when compared to the reference group.The incidence of neonatal LBW in the <4 group was 1.61 times of the one in the >7 group (OR=1.61,95%CI:1.31-2.00) while in the <4 group it was 1.23 times of the 4-7 group (OR=1.23,95% CI:1.04-1.45).Conclusion In the rural areas of Shaanxi province,the incidence of neonatal LBW was gradually reduced through the increasing number of frequencies on prenatal care,among women of childbearing age.
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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 preliminarily study the stability of 3 pieces of Chinese medicinal formula(CMF)after decoction, and provide reference for guaranteeing storage quality of decocted liquid and improving safety of drug use. METHODS:3 represen-tative formulas of Gegen Huangqin Huanglian decoction(A formula),Wuling powder(B formula)and Didang decoction(C for-mula)from Shanghan Zabing Lun were selected,the decocted liquid were stored under ambient temperature(25 ℃)and refrigerat-ed temperature (4 ℃) after decocting by automatic boiling-machine and packing. The microorganism,precipitation,pH and con-tents of total flavonoids,alkaloid,polysaccharide,total protein after 1,7,14,21,28 d were detected. RESULTS:Compared with the first day,contents of total flavonoids,polysaccharide in formula A at ambient temperature group were significantly in-creased on the 28th(P<0.05),content of polysaccharide in refrigerated temperature group was significantly increased(P<0.05). Content of polysaccharide in formula B at ambient temperature group was significantly decreased(P<0.05). The pH and content of total flavonoids in formula C at ambient temperature group and refrigerated temperature group were significantly increased (P<0.05 or P<0.01). Other indexes showed no obvious changes during the trial period. CONCLUSIONS:Under ambient temperature and refrigerated temperature,liquid ingredients of above decocted CMF will change when storing for 4 weeks. It indicates that the storage time of decocted CMF should not be more than 3 weeks.