Mechanisms of Lung Cancer Caused By Cooking Fumes Exposure: A Minor Review△.

Cooking fumes (CFs) are mixtures of many toxic components, such as aldehydes, heterocyclic amines, polycyclic aromatic hydrocarbons, fat aerosols and particulate matters. CFs exposure has been proven to be associated with many diseases. Lung cancer takes the leading place among the diseases being reported caused by CFs exposure. Molecular and biochemical studies have found that CFs exposure may lead to lung cancer by gene damage, formation of reactive oxygen species, blockage of related proteins' function, and even cell death. However, reviews about the mechanisms of how CFs exposure leads to lung cancer are still lacking. Elucidation of the mechanisms of lung cancer caused by CFs exposure may provide a new insight into the prevention of lung cancer caused by CFs exposure, as well as laying the foundation for the toxicity study of CFs. In this minor review, the mechanisms of how CFs exposure leads to lung cancer were summarized and discussed.

COMPARISON OF MEDICAL COSTS AND CARE OF APPENDECTOMY PATIENTS BETWEEN FEE-FOR-SERVICE AND SET FEE FOR DIAGNOSIS-RELATED GROUP SYSTEMS IN 20 CHINESE HOSPITALS.

The objective of this study was to compare the fee-for-service and set fee for diagnosis-related group systems with regard to quality of medical care and cost to appendectomy patients. We conducted a retrospective study of 208 inpatients (from 20 hospitals) who undergone appendectomy in Changsha, China during 2013. Data were obtained from databases of medical insurance information systems directly connected to the hospital information systems. We collected and compared patient ages, length of study, and total medical costs for impatient appendectomies between patients using fee-for-service and set fee for diagnosisrelated group systems. One hundred thirty-three patients used the fee for service system and 75 used the set fee diagnosis related group system. For those using the diagnosis-related group system, the mean length of hospitalization (6.2 days) and mean number of prescribed antimicrobials (2.4) per patient were significantly lower than those of the patients who used the fee-for-service system (7.3 days and 3.0, respectively; p = 0.018; p < 0.05) and were accompanied by lower medical costs and cost of antimicrobials (RMB 2,518 versus RMB 4,484 and RMB476 versus RMB1,108, respectively; p = 0.000, p = 0.000). There were no significant differences in post-surgical complications between the two systems. The diagnosis-related group system had significantly medical costs for appendectomy compared to the fee-for-service system, without sacrificing quality of medical care.

Diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life over time in Chinese youth with type 1 diabetes.

AIMS AND OBJECTIVES: To describe the patterns of diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life over time in a cohort of Chinese youth with type 1 diabetes and to determine the relationships between these variables over time. BACKGROUND: Nurses have an important role in facilitating optimal self-management and health outcomes in youth with type 1 diabetes. Only a few studies have focused on patterns of diabetes adaptation over time in youth with type 1 diabetes, especially in China. Understanding changes in diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life can facilitate assessment and intervention. DESIGN: This is a multi-site longitudinal descriptive study. Data for this report were collected at baseline with 136 eligible Chinese youth and 86 of them were followed up for the second time, 6-12 months after baseline data collection. METHODS: Instruments to measure diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life were collected at two time points. The data were collected from July 2009-October 2010. Linear mixed model analysis was used to analyse the longitudinal data. RESULTS: Self-management decreased over time; however, depressive symptoms, metabolic control and satisfaction with quality of life did not change from baseline to 6-12 months in this sample of Chinese youth with type 1 diabetes. A decrease in diabetes self-management over time was associated with worse metabolic control, while an increase in depressive symptoms over time was associated with poorer quality of life satisfaction in this sample. CONCLUSIONS: Chinese youth faced difficulties with diabetes adaptation, especially with the deterioration of diabetes self-management. Improving self-management and decreasing depressive symptoms may enhance diabetes adaptation with respect to metabolic control and quality of life. RELEVANCE TO CLINICAL PRACTICE: The deterioration of diabetes self-management over time in youth with type 1 diabetes in China deserves nurses' careful surveillance. Clinical interventions appropriate to the Chinese culture and health care system are needed to improve self-management and depressive symptoms in Chinese youth with type 1 diabetes.

[Changes in fasting serum cortisol levels in adolescents with type 1 diabetes and elevated depressive symptoms].

OBJECTIVE: To study the changes in serum cortisol levels in adolescents with type 1 diabetes (T1DM) and elevated depressive symptoms. METHODS: Twenty-eight adolescents with T1DM and 31 healthy peers were assessed for depressive symptoms using a depression self-rating scale developed by the Epidemiological Survey Center. Selected subjects were classified into four groups: T1DM with elevated depressive symptoms group (n=15), T1DM without elevated depressive symptoms group (n=13), elevated depressive symptoms without T1DM group (n=15), and normal control group (n=16). Fasting blood samples were collected in the morning, and the levels of serum cortisol were compared among the four groups. The correlations of serum levels of cortisol and glycosylated hemoglobin A1c (HbA1c) with the score of depression self-rating scale were evaluated by Pearson correlation analysis. RESULTS: The fasting serum cortisol levels in the 28 T1DM patients were significantly higher than in the 31 healthy peers (P<0.01). The fasting cortisol levels in the T1DM with elevated depressive symptoms group were significantly higher compared with those in the elevated depressive symptoms without T1DM group and normal control group (P<0.01). In adolescents with T1DM, serum HbA1c level was positively correlated with the score of depression self-rating scale (r=0.481, P=0.010). CONCLUSIONS: The fasting serum cortisol levels in adolescents with T1DM and elevated depressive symptoms are significantly increased, suggesting that the patients with comorbidity of T1DM and depression develop dysfunction of the corticotropin-releasing hormone-adrenocorticotropic hormone-cortisol axis. The elevated depressive symptoms may be associated with a poor control of glucose metabolism.

Family caregiver challenges in dementia care in Australia and China: a critical perspective.

BACKGROUND: Both Australia and China have a large proportion of people with dementia and the prevalence will triple in Australia and increase five times in China by 2050. The majority of people with dementia are reliant on family caregivers to provide daily care and to maintain the dignity in both countries. As a consequence, caregiver burden has become a major concern because of the negative impact on the care recipients' and the caregivers' health. It is strongly recommended that cross-national collaboration should be conducted to share experiences in fighting dementia. The aim of this study was to compare socially and culturally constructed enablers and barriers pertinent to dementia caregivers in one capital city in Australia and one capital city in China through critical reflection on the caregivers' subjective and objective experiences for the improvement of dementia care services in both countries. METHODS: Giddens' Structuration Theory was used as a framework to guide a concurrent mixed methods design with the qualitative strand as a priority. In the qualitative strand, data were collected by focus groups and in-depth interviews while in the quantitative strand, data were collected by questionnaire survey. RESULTS: In total 148 caregivers participated in the project with 57 of them from Australia (26 and 31 in the qualitative and quantitative strands respectively) and 91 of them from China (23 and 68 in the qualitative and quantitative strands respectively). Findings from the qualitative and quantitative strands were presented as three categories: A higher objective burden in the Chinese cohort versus a higher subjective burden in the Australian cohort; Unmet need for caregiver support in Australia and China; and Expectations for improving dementia services in Australia and for developing dementia services in China. CONCLUSIONS: Dementia policy, services and resources need to be grounded on current research evidence in an ever-changing society like China. In Australia, dementia services need to have more components of preventing or reducing caregivers' subjective burden. As subjective burden is mediated by culture, caregiver support mechanisms should consider caregivers' needs associated with their cultural values.

Factors contributing to caregiver burden in dementia in a country without formal caregiver support.

OBJECTIVES: To investigate caregiver burden in dementia and explore factors associated with different types of burden in a country without formal caregiver support using a province in China as a case. METHOD: Cross-sectional questionnaire survey was used to collect data. One hundred and fifty-two family caregivers of people with dementia in community settings were recruited from 2012 to 2013 using convenience sampling. Objective burden was measured by caregiving hours and dementia-related financial burden. Subjective burden was measured and analysed using the Caregiver Burden Inventory and the Neuropsychiatric Inventory-Questionnaire. Multivariate regression models were employed to analyse factors associated with each type of subjective burden. RESULTS: Five types of subjective burden were measured by the Caregiver Burden Inventory, namely, physical burden, emotional burden, time-dependence burden, developmental burden, and social burden. Caregiver distress, as a subjective burden, was measured by the Neuropsychiatric Inventory-Questionnaire and reported by relating to the severity of care recipients' behavioural and psychological symptoms of dementia. This caregiver cohort showed a high level of physical, time-dependence, and developmental burdens, but a low level of emotional and social burdens. Factors contributing to each type of subjective burden measured by the Caregiver Burden Inventory differed from each other. CONCLUSION: The high level of objective and subjective burdens identified in this study suggests that government-funded formal caregiver support should be established and services should be designed to target different types of burdens and factors contributing to these burdens.

Family caregiver challenges in dementia care in a country with undeveloped dementia services.

AIMS: To examine socially, culturally and politically constructed factors affecting family caregiver practice in dementia care, and to identify possible changes in a country with undeveloped dementia services. BACKGROUND: In China and many other low- and middle-income countries, social transformations are weakening the family care model, which has an impact on the population with dementia. Exploring the challenges that caregivers face may help the international healthcare community to improve dementia services. DESIGN: A double hermeneutic approach informed by Giddens' Structuration Theory was used. METHODS: In-depth semi-structured interviews with 23 family caregivers of people with dementia were conducted in 2012. The interviews were audiotaped, transcribed and analysed. FINDINGS: Analyses revealed three consequences of socially constructed factors in dementia care, which constrained caregiver practice. First, caregivers were unable to manage behavioural and psychological symptoms of dementia. Untreated aggressive behaviours caused harm to the person with dementia and endangered the caregiver and the public. Second, the burden on the primary caregiver was evident and caregivers received limited support. Third, there was little coordination between primary and specialist care services for people with dementia. On critical reflection of potential changes that could improve dementia services, caregivers suggested that community nurses have a leading role in coordinating dementia services and supporting caregivers. CONCLUSION: Relying on family caregivers to care for people with dementia without the prevision of dementia services by the public healthcare system generates negative health outcomes for both care recipients and caregivers. The nursing workforce should be developed to support dementia services.

Relationship between cancer-related fatigue and personality in patients with breast cancer after chemotherapy.

BACKGROUND: This study aimed to explore the relationship between cancer-related fatigue (CRF) and personality in patients with breast cancer after chemotherapy. METHODS: A cross-sectional study was conducted to study the relationship between CRF and personality in breast cancer patients after chemotherapy. CRF and personality were measured by the cancer fatigue score and the Eysenck Personality Questionnaire, respectively. RESULTS: A total of 300 breast cancer patients who had received chemotherapy were recruited to this study. Eysenck Personality Questionnaire scores of psychoticism, introversion, and extroversion in the patients were lower than the norm level (p < 0.01), but those of neuroticism and lie were higher than the norm level (p < 0.01). Multivariate analyses showed positive correlation between psychoticism and affective fatigue, neuroticism and total fatigue, and physical fatigue and cognitive fatigue. Multivariate analyses also showed negative correlation between introversion or extroversion and total fatigue, physical fatigue or affective fatigue, and lie and total fatigue or cognitive fatigue. CONCLUSIONS: There was CRF in patients with breast cancer after chemotherapy. Psychoticism, extroversion/introversion, neuroticism, and lie are correlated with CRF in breast cancer patients after chemotherapy.

Instrument translation and initial psychometric evaluation of the Chinese version of the Self-Management of Type 1 Diabetes for Adolescents scale.

AIM: To translate the validated measure, Self-Management of Type 1 Diabetes in Adolescents, into the Mandarin Chinese language and to test the psychometric properties of the Chinese version. BACKGROUND: Although research on self-management of Type 1 diabetes has been increasing over the past 20 years, few health-related instruments have been available in the Chinese language for youth with Type 1 diabetes. DESIGN: A two-phase design was used in this study, including instrument translation and psychometric testing. METHODS: The instrument translation, from October 2008-April 2009, included three steps: forward translation, back translation, and comparison of versions via Translation Validity Index - with multiple rounds, group discussion, and achievement of consensus at each step. Psychometric properties of the Chinese version Schilling's Self-Management of Type 1 Diabetes for Adolescents scale was assessed in a convenience sample of 136 Chinese youth (ages 8-19) with Type 1 diabetes between June 2009-August 2009. RESULTS: The internal consistency and test-retest reliabilities indicated generally good consistency and temporal stability of the Chinese version. Evidence of construct validity and criterion-related validity was obtained via correlations of subscales with established measures of diabetes adherence and quality of life and also with haemoglobin A1c. Results from hypothesis testing also supported construct validity. CONCLUSION: The Chinese version of Self-Management of Type 1 Diabetes for Adolescents scale is sound and will facilitate cross-cultural studies, while also enabling nurses to monitor and enhance the diabetes self-management of Chinese youth with Type 1 diabetes.

Diabetes self-management, depressive symptoms, quality of life and metabolic control in youth with type 1 diabetes in China.

AIMS AND OBJECTIVES: To assess diabetes self-management, depressive symptoms, quality of life and metabolic control in a cohort of youth with type 1 diabetes in mainland China. Predictors of self-management and depressive symptoms were also explored. BACKGROUND: Studies have shown that adaptation to childhood chronic illness is important in determining outcomes. Few studies have been reported on the behavioural, psychosocial and physiological adaptation processes and outcomes in Chinese youth with type 1 diabetes. DESIGN: This is a cross-sectional study as part of a multi-site longitudinal descriptive study. Data for this report were collected at baseline. METHODS: A convenience sample of 136 eligible youth was recruited during follow-up visits in hospitals in 14 major cities of Hunan Province (located in central southern mainland China) from July 2009-October 2010. Data were collected on socio-demographic background, clinical characteristics, diabetes self-management, depressive symptoms, quality of life and metabolic control. RESULTS: Diabetes self-management was lower in Chinese youth compared with a US cohort and was associated with insulin treatment regimen, treatment location, depressive symptoms and gender. A total of 17·6% of youth reported high depressive symptoms, and depressive symptoms were correlated with family annual revenue, school attendance, peer relationship and parent-child relationship. The mean score of global satisfaction with quality of life was 17·14 ± 3·58. The mean HbA1c was 9·68%. CONCLUSIONS: Living with type 1 diabetes poses considerable challenges, and Chinese youth report lower self-management than US youth and high depressive symptoms. Metabolic control and quality of life were sub-optimal. RELEVANCE TO CLINICAL PRACTICE: More clinic visits, treatment for high depressive symptoms and an intensive insulin regimen may improve diabetes self-management for youth with type 1 diabetes in China. Culturally appropriate interventions aimed at helping them adapt to living with the disease and improving outcomes are urgently needed.

Knowledge of stroke warning signs and risk factors among patients with previous stroke or TIA in China.

AIMS AND OBJECTIVES: The purpose of this study was to describe knowledge about stroke warning signs and risk factors in patients with previous stroke or transient ischaemic attacks in China and to investigate the relationship between socio-demographic characteristics & health status and patients' knowledge about stroke. BACKGROUND: Stroke is the leading cause of death and functional impairment in China. Survivors are at high risk of new vascular events. Secondary prevention after stroke or transient ischaemic attacks is not satisfactory. Previous research suggests that awareness of stroke plays an important role in facilitating secondary prevention. However, little is known about knowledge of stroke warning signs and risk factors among patients with previous stroke/transient ischaemic attacks. DESIGN: A cross-sectional questionnaire study. METHODS: This study was conducted in Hunan Province, China, between July and December in 2010. Subjects were recruited using a cluster sampling method. A questionnaire was administered to 1600 patients with stroke/transient ischaemic attacks diagnose from eight hospitals, and 1200 patients (75%) responded. Patients' knowledge about stroke warning signs and risk factors were collected and analysed. Results. Patients' knowledge about stroke warning signs was very poor (only 3.3% identified all warning signs and 28.3% identified three). Patients' knowledge about important risk factors (e.g. atrial fibrillation, diabetes, metabolic syndrome, etc.) was also very poor (<30%). Patients' action in emergency was extremely poor (only 9.2% reported to call emergency service). The age, education, stroke-related diagnoses and family history of cardiovascular disease were significantly associated with patients' knowledge about stroke. CONCLUSIONS: Knowledge about stroke warning signs and risk factors was very poor in patients with previous stroke or transient ischaemic attacks in China. RELEVANCE TO CLINICAL PRACTICE: Dissemination of stroke knowledge should be a core responsibility for Chinese clinical nurse. Future clinical education to improve patient's knowledge about stroke and further intervention to manage cardiovascular risk factors are indicated.

[How to establish the monitoring and evaluation system in elimination stage of malaria in China: the experience from Malaria Indicator Survey system].

Malaria is one of the most important public health problems around the world. Most region of China has embarked a transition from interruption of malaria transmission to elimination. This paper summarizes the main function and construction, the key parts, and the advantages in national field work of Malaria Indicator Survey (MIS) system, indicates the difficulties of establishing a Monitoring and Evaluation (M&E) System in malaria elimination in China and draws lessons from the MIS.

The relationship between diabetes self-management and metabolic control in youth with type 1 diabetes: an integrative review.

AIMS: The purpose of this integrative review was to describe the relationship between diabetes self-management and metabolic control in youth with type 1 diabetes and to explore factors which affect this relationship. BACKGROUND: In the past 15 years, research has indicated that youth with type 1 diabetes face considerable self-management challenges and are at increased risk for poor metabolic control. To enhance the development of behavioural interventions for youth with type 1 diabetes, the relationship between diabetes self-management and metabolic control needs to be more clearly elucidated. DATA SOURCES: Research studies that examined the relationship between diabetes self-management and metabolic control in youth with type 1 diabetes were included (n = 18). The electronic databases searched included OVID, MEDLINE (1996 to present), SCOPUS (1996 to January 2010) and PubMed (1996 to January 2010). REVIEW METHOD: An integrative literature review was carried out using Whittemore's modified framework for data collection, analysis and synthesis. RESULTS: A positive relationship between diabetes self-management and metabolic control in youth with type 1 diabetes was supported in longitudinal studies and in studies where the mean age was >13 years. Factors influencing this relationship are identified. Measurement of self-management was quite variable. CONCLUSION: Interventions targeting self-management in youth with type 1 diabetes are indicated, particularly in families of diverse race and ethnicity globally. Further evaluation of the measures of self-management and more longitudinal research are also indicated.

Psychometric testing of the Health Quotient questionnaire: a measure of self-reported holistic health.

AIM: This paper is a report of a test of the psychometric properties of the Health Quotient questionnaire. BACKGROUND: The Health Quotient questionnaire is an existing self-reported holistic health measure developed by integrating Western and Eastern perspectives, but limited psychometric properties have been reported. METHODS: Content validity was estimated by five experts. A pilot study allowed for feasibility testing and examination of reliability and validity. A total of 1874 Chinese college undergraduates took part in the study in 2007-2008. Internal consistency reliability of the five dimensions (Self-Care, Health Knowledge, Lifestyle, Mind Health and Life Skills) of the Health Quotient questionnaire was examined and item-to-dimension score correlation analysis was also completed. Construct validity was determined using the convergent validity, hypothesis testing approach and factor analysis. The single-item self-rated health status assessment by the American College Health Association-National Council was used to measure health status. RESULTS: Strong content validity and internal consistency reliability correlations were demonstrated. Test-retest reliability was acceptable, ranging from 0.72 to 0.82 for the five dimensions. Statistically significant relationships between the Health Quotient's total and dimension scores with self-rated health status (P < 0.001) provided evidence of convergent validity. In exploration of the factor structure by dimensions, four of five dimensions were consistent with the theoretical framework, with only the Life Skills dimension demonstrating lack of theoretical fit. CONCLUSION: The results provide some evidence for the reliability and validity of the Health Quotient questionnaire, as well as several recommendations for further research on the questionnaire.

Factors that influence health quotient in Chinese college undergraduates.

AIM AND OBJECTIVES: The purpose of this study was to describe the health quotient of Chinese undergraduates, to discern whether socio-demographic characteristics, academic achievements and perceived health status significantly affect the health quotient of Chinese college students and to identify the predictable factors of health quotient in undergraduates. BACKGROUND: Rapidly increasing enrollment in higher education in China in recent years has brought growing concern about undergraduate health and lifestyle. The Health Quotient profile questionnaire, which assesses self-reported holistic health, provides opportunity to study the health of Chinese undergraduates. DESIGN: A descriptive cross-sectional study. METHODS: The study was conducted with 1874 Chinese undergraduates aged 15-28 from eight colleges in Changsha. Students were recruited by a multistage cluster stratified random sampling method. RESULTS: The mean score of the Health Quotient questionnaire indicated a positive health quotient; however, 32.1% of the sample scored below the criterion score for a positive health quotient. Undergraduates scored low on knowledge of health. Gender, residence before university, father's educational background, self-rated health, college category, achievement in study and status as student chief significantly predicted health quotient scores. CONCLUSIONS: Holistic health of college students is important and implies positive health behaviours and a focus on health promotion. The overall holistic health of the subjects was good, and students appear capable of managing their own health. Poor health knowledge may be an important factor in college students' future health status. Risk factors associated with health quotient of undergraduates should be considered in college health care. RELEVANCE TO CLINICAL PRACTICE: The health quotient is one instrument that can be used to assess college students' holistic health and target health promotion interventions. Health knowledge dissemination could be a core task for Chinese college nurses. Further, international research that examines the relationship of student characteristics, college location, culture, health behaviours, health status and holistic health is indicated.

Association between knowledge and risk for cardiovascular disease among older adults: A cross-sectional study in China.

OBJECTIVES: This study aimed to describe cardiovascular risk and cardiovascular disease (CVD) knowledge among older adults, and further explore the association between knowledge and risk. METHODS: In this cross-sectional study, we enrolled 1120 older adults who received physical examination in health centers. The participants were interviewed to obtain their behavioral risk factors related to CVD and clinical characteristics. A risk prediction chart was used to predict participants' cardiovascular risk based on clinical characteristics and behavioral risk factors. Participants' CVD knowledge was collected with a pretested knowledge questionnaire. RESULTS: Among the 1120 participants, 240 (21.4%) had low cardiovascular risk, 353 (31.5%) had moderate cardiovascular risk, 527 (47%) had high and very high cardiovascular risk. The knowledge level about CVD among 0.8% of the 1120 participants was good while that of 56.9% was poor. Lower CVD knowledge level, older age, lower income, and lower educational level were the independent factors of higher cardiovascular risk level. CONCLUSIONS: This study highlights the need to reduce the cardiovascular risk among older adults. CVD knowledge should be considered when developing health interventions.

A study on the subjective well-being and its influential factors in chronically ill inpatients in Changsha, China.

The aim of this paper is to assess the subjective well-being of chronically ill inpatients to know which its influential factors are, what the significant predictors of SWB are, and what we can do in nursing care. A sample of 290 inpatients with chronic respiratory diseases, diabetes, and cardiovascular diseases responded to questionnaires assessing well-being, anxiety, and depression and gave suggestions about nursing during an interview. It was shown that these patients' subjective well-being was lower than that of the general population. Using ANOVA, Pearson correlations, and multivariate stepwise regression analysis, trait anxiety, anxiety, and means of payment were found to significantly influence subjective well-being. Interventions targeting trait anxiety, anxiety, and means of payments, such as paying more attention to individuals' psychological symptoms, implementing more cost-effective treatment or caring, and establishing positive relationship with patients are necessary to improve inpatients' subjective well-being.

[Application studies on the gene diagnosis and carrier detection of hemophilia A by using polymerase chain reaction-conformation sensitive gel electrophoresis].

OBJECTIVE: To establish a simple, rapid and easy method for screening the gene mutation in hemophilia A, which was further applied to a direct diagnosis and carrier detection at gene level. METHODS: Twenty-four clinically diagnosed hemophilia pedigrees, including all the hemophilia patients and female members, were tested for the introns 22 and 1 in factor VIII gene by using inversion polymerase chain reaction (PCR) and regular PCR techniques. All the 26 exons of factor VIII gene were consecutively screened in the 17 patients manifesting non-inverted sequences in intron 22 by using PCR, subsequently all the 37 amplicons resulted from 26 exons were analyzed by conformation sensitive gel electrophoresis (CSGE), finally the mutated exons were subjected to sequencing verification. According to the mutation results, mothers and twin sisters of the hemophilia probands were tested by CSGE or subjected to nucleotide sequencing directly, to ascertain if those individuals had the same mutation or were the carriers of disease-causing gene. RESULTS: Intron 22 inversion was detected in 7 hemophilia probands out of 24 hemophilia pedigrees, intron 1 inversion was not detected in these pedigrees. Single-base mutations distributed in different exons of factor VIII gene were detected in 13 pedigrees with family history and 3 sporadic pedigrees, diagnosed as non-inverted 22 intron patients. By comprehensive usage of PCR-CSGE and nucleotide sequencing, the positive rate and the diagnosable rate of gene diagnosis or carrier detection in the 24 hemophilia pedigrees was 94.12% and 100% respectively. CONCLUSION: PCR-CSGE is a highly sensitive and special assay for detecting single base mutation. By integrated utilization of introns 22 and 1 of factor VIII gene detection and PCR-CSGE genotyping, combining with nucleotide sequencing, a direct diagnosis of all hemophilia pedigrees be could nearly make at gene level, including the sporadic families. This method might be used to screen new mutation theoretically and ascertain the mutation type. It is a simple, rapid and low-cost method, possessing unique advantages in direct diagnosis of hemophilia A and carrier screening. It should have important application value in hemophilia diagnosis.

Pregnant women's awareness and knowledge of mother-to-child transmission of HIV in South Central China.

OBJECTIVE: China has, in recent years, seen an increase in the number of HIV-positive children due to the increase in number of HIV-positive women. The purpose of this study was to investigate the awareness and knowledge of mother-to-child transmission of HIV and its prevention among pregnant women attending the antenatal clinics in South Central China. METHODS: The study was carried out in three antenatal clinics of three hospitals from February 2005 to March 2006, and it was based on personal interviews and questionnaires designed to assess the pregnant women's awareness about HIV/AIDS, evaluate their knowledge of possible routes of transmission, particularly mother-to-child transmission, and determine their familiarity with measures that prevent vertical transmission from mother to child. Two thousand three hundred and ninety pregnant women were included in the study. RESULTS: All individuals were aware of HIV/AIDS. The majority (91%) of those women were aware that HIV/AIDS can coexist with pregnancy but only 64% had heard about mother-to-child transmission. Transplacental route, vaginal delivery and breastfeeding were identified as routes of transmission from mother to child by 85%, 60% and 20% of respondents, respectively. Cesarean section was believed to be a route of transmission by 55% of respondents, but no one identified cesarean section as a method of prevention of mother-to-child transmission. CONCLUSIONS: The level of awareness and knowledge of HIV/AIDS among pregnant women attending our antenatal clinics seems to be superficial; more education and knowledge about mother-to-child transmission are needed in China.

[Correlative analysis of postpartum depression].

OBJECTIVE: To explore the incidence of postpartal depression in the south and north and to comprehensively analyze the changes of sex hormone and neurotransmitter,and their relationship with postpartum depression. METHODS: All published articles on case-control studies on the changes of sex hormone and neurotransmitter,and their relationship with postpartum depression were collected by literature retrieval based on the selection criteria. Meta-analysis was applied to evaluate the data in published papers from 1994 to 2004 in China. RESULTS: The incidence of postpartal depression in the south was 15.63%. The combined P-valve was 0.0874, and 95% CI was 0.14 to 0.17. The incidence of postpartum depression in the north was 7.66%. The combined P-valve was 0.0252, and 95% CI was 0.05 to 0.08. There was significant difference between the incidence of postpartum depression in the south and north (P<0.01). Estrogen and 5-HT in the plasma of the 1st week after childbirth was obviously lower than the controls. Estrogen in the plasma of the 1st week after childbirth and the 6th week after childbirth decreased more quickly than the controls. Progesterone and orphanin FQ in the plasma of the 1st week after childbirth were higher than the controls. CONCLUSION: The incidence of postpartum depression in the south is higher than that of the north. Postpartum depression is related to the decrease in the plasma estrogen, 5-HT, dopamine, and noradrenaline, and to the increase in the plasma progesterone and Orphanin FQ.