A systematic study on the prevention and treatment of retinopathy of prematurity in China.

BACKGROUND: To identify the prevention situation, the main factors influencing prevention effects and to develop control measures over retinopathy of prematurity in China. METHODS: Using stratified random sampling method, we randomly selected 23 provincial and ministerial hospitals (8 in Guangdong province, 5 in Hunan province and 10 in Shaanxi province), 81 municipal hospitals (38 in Guangdong province, 19 in Hunan province and 24 in Shaanxi province), 180 district and county hospitals (76 in Guangdong province, 57 in Hunan province and 47 in Shaanxi province) in China. A total of 284 hospitals were enrolled in the study, with questionnaires distributed investigating the status and constrain factors of ROP presentation. Significant outcomes were analyzed thereafter by SPSS 19.0. RESULTS: The screening rate of ROP in medical institutions from eastern, central and western China were 84.6%, 35.0% and 56.7%, respectively. The screening rate of tertiary and secondary medical institutions were 84.6% and 25.7% in the eastern, 35.0% and 4.9% in the central, 56.7% and 5.9% in the western region. Screening was carried out better in the tertiary than that in the secondary and primary institutions. Treatment for ROP was available in 15.7% of all the tertiary hospitals surveyed. Lack of professionals, equipments and technologies were considered to be major restrain factors for screening. CONCLUSIONS: The ROP screening and treatment status have demonstrated significant regional diversity due to uneven distribution of medical resources in China. Developed areas had established intraregional cooperation models, whereas less-developed areas should consider set up a large-scale, three-level ROP prevention network. It is of paramount importance that education and training towards ophthalmologists should be vigorously strengthened. It is strongly recommended that implement ROP telemedicine and integrated ROP prevention and management platforms through the Internet should be established.

[Factors associated with introduction of solid, semi-solid or soft foods among infants aged 6-8 months in poor rural areas in Hunan Province in 2015].

OBJECTIVE: To describe the rate of and identify the factors associated with introduction of solid, semi-solid or soft foods among infants aged 6-8 months in poor rural areas. METHODS: A total of 1449 rural infants aged 6-8 months in 30 poor counties of Wuling Mountains and Luoxiao Mountains in Hunan Province were selected by probabilityproportional-to-size sampling( PPS) in August 2015. And designed questionnaires were used to collect information of infants feeding in the past 24 h and information of personal and family. The rate of introduction of solid, semi-solid or soft foods among infants aged 6-8 months was calculated according to WHO Indicators for Assessing Infant and Young Child Feeding Practices. Logistic regression analysis were used to analyze factors influencing introduction of solid, semi-solid or soft foods on infants aged 6-8 months. RESULTS: 95. 4%( 1382/1449) of infants aged 6-8 months received solid, semi-solid or soft foods. Multi factors analysis showed that Tujia ethnic infants( OR = 2. 32, 95% CI1. 55-3. 47) and main caregivers' unqualified feeding knowledge( OR = 1. 39, 95% CI1. 10-1. 75) were risk factors of introduction of solid, semi-solid or soft foods. CONCLUSION: Most infants aged 6-8 months in poor rural areas received solid, semi-solid or soft foods. Infants who were Tujia ethnic or with unqualified caregivers ' feeding knowledge had higher risk of introduction of solid, semi-solid or soft foods.

[Factors associated with taking Yingyangbao efficiently among infants and young children aged 6-24 months in poor rural areas of Hunan Province, China].

OBJECTIVE: To describe the status and identify factors associated withtaking Yingyangbao efficiently among infants and young children aged 6- 24 months in poor rural areas. METHODS: A total of 7481 rural infants and young children aged between6 and 24 months in 25 poor counties of Wuling Mountains and Luoxiao Mountains in Hunan Province were selected by Probability-Proportional-to-Size Sampling( PPS), and designed questionnaires to collect infants and young children's information of personal, family and taking Yingyangbao. Non-conditional Logistic regression analysis was used to analyze the factors associated with taking Yingyangbao among infants and young children aged 6- 24 months. RESULTS: The findings indicated that 90. 4%( 6762 /7481) of infants and young children had got Yingyangbao, and 69. 2%( 4677 /6762) of infants and young children took Yingyangbao efficiently, 62. 5%( 4677 /7481) of all investigative infants and young children took Yingyangbao efficiently. The result of multivariate non-conditional logistic regression analysis showed that, compared with 6- 11 months, 12- 17 and18- 24 months were protective factors of infants and young children took Yingyangbao efficiently( OR = 0. 839, 95% CI 0. 735- 0. 959. OR = 0. 854, 95% CI 0. 748-0. 974). Compared with Han ethnic, Miao, Tujia, Dong and other minority ethnic were risk factors of infants and young children took Yingyangbao efficiently( OR = 1. 243, 95%CI 1. 07- 1. 443. OR = 2. 352, 95% CI 2. 008- 2. 755. OR = 1. 801, 95% CI 1. 453-2. 233. OR = 1. 675, 95% CI 1. 192- 2. 355). Compared with father with primary school education or below, father with senior high school education and educated to university level or above were protective factors of infants and young children took Yingyangbao efficiently( OR = 0. 774, 95% CI 0. 618- 0. 970. OR = 0. 570, 95% CI 0. 428-0. 760). Compared with famer father, worker or cadre father was risk factor of infants and young children took Yingyangbao efficiently( OR = 1. 279, 95% CI 1. 104- 1. 482). Compared with parents as caregivers, grandparents as caregivers was protective factor of infants and young children took Yingyangbao efficiently( OR = 0. 651, 95% CI 0. 581-0. 729). Compared with taking Yingyangbao with no adverse reaction, taking Yingyangbao with adverse reaction was risk factor of infants and young children took Yingyangbao efficiently( OR = 2. 759, 95% CI 2. 346- 3. 245). CONCLUSION: The rate of taking Yingyangbao efficiently among infants and young children in poor rural areas is low. The risk factors of infants and young children taking Yingyangbao efficiently include lower in age( months), of minority ethnic, of father with lower education, of father who is worker or cadre, of parents as caregiver, and of taking Yingyangbao with adverse reaction.

[Influential factors associated with 2-week prevalence of fever and diarrhea among infants and young children at the age of 6-23 months in poor rural areas].

OBJECTIVE: To investigate the status and influential factors associated with 2-week prevalence of fever and diarrhea among infants and young children at the age of 6-23 months in poor rural areas.
 Methods: A total of 8 735 rural infants and young children aged 6-23 months in 30 poor counties of Wuling Mountains and Luoxiao Mountains in Hunan Province were selected in August 2015, and the questionnaires were used to collect information on the prevalence of fever and diarrhea, person and families, and feeding status. The data for prevalence of fever and diarrhea in infants and young children were calculated, and multi-non-conditional logistic regression model were used to analyze the influential factors.
 Results: The 2-week prevalence of fever and diarrhea in infants and young children was 20.8% and 12.2% respectively. The ages (OR=0.66, 95%CI 0.58 to 0.75), Dong ethnicity(OR=1.42, 95%CI 1.17 to 1.74) and low body weight (OR=1.31, 95%CI 1.11 to 1.54) were influential factors for fever among infants and young children in poor rural areas; female (OR=0.86, 95%CI 0.76 to 0.98), 12-17 months (OR=0.80, 95%CI 0.69 to 0.93), 18-23 months (OR=0.51, 95%CI 0.43 to 0.60), other ethnic minorities (OR=1.70, 95%CI 1.13 to 2.56), non-complementary feeding (OR=1.65, 95%CI 1.05 to 2.59) and low body weight (OR=1.39, 95%CI 1.14 to 1.70) were the influential factors of diarrhea among infants and young children.
 Conclusion: The 2-week prevalence of fever and diarrhea among infants and young children aged 6-23 months in poor rural areas were quite serious. Low age, Dong ethnicity, and low birth weight are high risk factors for fever. Male, no addition of complementary feeding, and low birth weight are high risk factors for diarrhea.

A discriminant analysis prediction model of non-syndromic cleft lip with or without cleft palate based on risk factors.

BACKGROUND: A risk prediction model of non-syndromic cleft lip with or without cleft palate (NSCL/P) was established by a discriminant analysis to predict the individual risk of NSCL/P in pregnant women. METHODS: A hospital-based case-control study was conducted with 113 cases of NSCL/P and 226 controls without NSCL/P. The cases and the controls were obtained from 52 birth defects' surveillance hospitals in Hunan Province, China. A questionnaire was administered in person to collect the variables relevant to NSCL/P by face to face interviews. Logistic regression models were used to analyze the influencing factors of NSCL/P, and a stepwise Fisher discriminant analysis was subsequently used to construct the prediction model. RESULTS: In the univariate analysis, 13 influencing factors were related to NSCL/P, of which the following 8 influencing factors as predictors determined the discriminant prediction model: family income, maternal occupational hazards exposure, premarital medical examination, housing renovation, milk/soymilk intake in the first trimester of pregnancy, paternal occupational hazards exposure, paternal strong tea drinking, and family history of NSCL/P. The model had statistical significance (lambda = 0.772, chi-square = 86.044, df = 8, P < 0.001). Self-verification showed that 83.8 % of the participants were correctly predicted to be NSCL/P cases or controls with a sensitivity of 74.3 % and a specificity of 88.5 %. The area under the receiver operating characteristic curve (AUC) was 0.846. CONCLUSIONS: The prediction model that was established using the risk factors of NSCL/P can be useful for predicting the risk of NSCL/P. Further research is needed to improve the model, and confirm the validity and reliability of the model.

[Impact factors analysis on child neglect of children aged 3-6 year-old in rural areas of China].

OBJECTIVE: To investigate the major influence factors of child neglect among rural areas children aged 3-6 years in China. METHODS: According to multi-stage stratified cluster sampling, distribution characteristics and the level of economic development, we randomly sampled 10 provinces, 26 cities (8 capital cities, 16 prefecture-level cities and 2 municipalities) using lottery method. Depending on the different level of economic and cultural, we sampled one medium county from each city (municipalities sampled two counties), a total of 28 counties. All towns were divided into high, medium and low three levels in accordance with economic and cultural, each level sampled one town, each conty sampled three towns, a total of 84 towns were sampled. Each town sampled 40 children, including 20 boys and 20 girls (including each 10 children aged 3 to 6, half and half boys and girls). 4 096 rural children aged 3-6 years old were sampled and surveyed of China. Based on "the Neglect Norms for Children Aged 3 to 6 Years Old in Rural Areas of China" explored the risk factors of child neglect. SPSS 18. 0 for windows was employed for statistics analysis. Multifactorial analysis was conducted through multivariate Logistic Regression. RESULTS: The total neglected rate of the rural children aged 3 to 6 was 53.7% (2,047/3,810), and the total neglected degree was 44.42±7.57. The multivariate logistic regression analysis showed that, neglected risk of the boys was higher than the girls (OR=1.30, 95% CI: 1.13-1.49), neglected risk of children were higher, when their mothers were migrant workers (OR=2.18, 95% CI: 1.59-3.00); the lower educational level of mothers, the higher neglected risk of children, the children in families that mothers only received primary education or was uneducated were most likely to be neglected (OR=2.92, 95% CI: 1.91-4.47), the second was the families that mothers received primary education (OR=1.86, 95% CI: 1.29-2.69); the lower the household income, the easier to be neglected the children, the easiest one was the household income less than 5000 RMB (OR=2.85, 95% CI: 2.14-3.79), the second was 5000-9,999 RMB (OR=1.76, 95% CI: 1.40-2.20); the relationship between children and mothers was distanced, neglect risk of children was higher (OR=3.88, 95% CI: 1.31-11.52); left behind children were easier to be neglected (OR=1.30, 95% CI: 1.09-1.54). CONCLUSION: The influence factors among children aged 3-6 years in the rural areas of China were boys, mother's occupation, maternal education level, the relationship between children and mothers, household income and left-behind children.

[Development of national neglect norms for children aged 3 to 6 years in rural areas of China].

OBJECTIVE: To develop the national neglect norms for rural children aged 3 to 6 years, which are suitable for Chinese situations. METHODS: According to the multi-stage stratified cluster sampling principle, 84 towns of 10 provinces or municipalities were selected in China. Children aged 3 to 6 years were surveyed in November 2010, the sample of analysis were 3240 (of whom males were 49.6% (1608/3240) and the Han nationality were 93.3% (3023/3240)). Questionnaire was designed by authors and deleted items that did not meet the requirements through several statistical analysis methods, such as item analysis method, factor analysis method, reliability analysis method. The reliability analysis and validity analysis were used to test the stability and reliability of the norm. The evaluation criteria of the scale was determined by the percentile method, then the initial development of the norm completed. RESULTS: After deleting inappropriate items by statistical processing, finally, the scale consisted of 57 items, and included 6 neglected dimensions (physical neglect, emotional neglect, educational neglect, safe neglect, medical neglect and social neglect). Its item loadings ranged from 0.359 to 0.789, which met the statistical requirements. The scale's total Cronbach α coefficients 0.904, the total split-half reliability coefficients were 0.820, the 6 neglect dimensions' Cronbach α coefficients ranged from 0.620 to 0.815, the 6 neglect dimensions' split-half reliability coefficients ranged from -0.034 to 0.789, the scale's parallel reliability were 0.785 and it's re-test reliability were 0.613. After construct validity, external validity and content validity testing, the result showed that this scale could effectively reflect the real neglected status of children investigated. The total neglect cut-off score of this scale were 121. CONCLUSION: The scale has good stability and reliability. And it adapts Chinese conditions and it's convenient to operate.

[The status of child neglect among rural areas children aged 0 - 6 years in China].

OBJECTIVE: To explore the status of child neglect among rural areas children aged 0 - 6 years in China. METHODS: A total of 7411 rural children aged 0 - 6 years old who were composed of two age groups (3315 children aged 0 - 2 years old and 4096 children aged 3 - 6 years old) were multistage stratified randomly sampled from 84 villages which were representative of 10 provinces of China, in accordance with sex and age in November 2010. To identify the child neglect based on the Neglect Norms for Children Aged 0 to 2 and 3 to 6 Years Old in Rural Areas of China, SPSS 13.0 was employed for analyzing neglect frequency and degree for every group of different age, sex and neglect type (including physical, emotional, educational, medical, safety and social neglects). χ(2) test and analysis of variance were also used. RESULTS: The degree of child neglect for the children aged 0 - 2 years old was 45.01 ± 7.56, the neglect frequency was 54.9% (1819/3315); the degree of child neglect for the children aged 3 - 6 years old was 44.42 ± 7.57, the neglect frequency was 53.8% (2203/4096). The neglect frequency of children aged 0, 1, 2 years old were 58.5% (654/1117), 52.2% (597/1144), 53.9% (568/1054) (P < 0.05). For children aged 3 - 6 years old, the degrees of emotional and safety neglect for males (44.60 ± 7.86, 36.82 ± 9.03) were higher than females (44.03 ± 7.72, 36.25 ± 9.05) (P < 0.05); and the frequencies of emotional and social neglect for males (16.8% (349/2072), 28.3% (586/2072)) were also higher than females (14.1% (286/2024), 24.8% (503/2024)) (P < 0.05). All children of two age groups suffered neglect mainly on one of the six neglect types (incidences were 20.6% (683/3315) and 22.7% (931/4096)). For 0-2 age groups, the higher neglect frequencies happened in the single-parent family and the remarried family (62.5% (15/24) and 63.2% (12/19)), but for children aged 3 - 6 years old groups, it happened in the single-parent family (60.0%, 27/45). CONCLUSION: Degree and frequency of child neglect among children aged 0 to 6 years old in the rural areas of China are high, and we should find out risk factors and provide efficient prevention measures.

Relationship between caregivers' nutritional knowledge and children's dietary behavior in Chinese rural areas.

OBJECTIVE: To explore the relationship between caregivers' nutritional knowledge and children's dietary behavior in rural areas of China. METHODS: A cross-sectional study was conducted. 3361 rural caregivers and their children, aged 2 to 7 years old, were selected randomly and surveyed by questionnaire. Logistic regression models were used to identify the relationship between caregivers' nutritional knowledge and the children's dietary behaviors. RESULTS: The awareness level of nutritional knowledge among rural caregivers was 57.9%; among the children surveyed, 79.6% did not like to drink milk, 66.0% were considered choosy of food, 84.1% regularly snacked, 24.4% frequently skipped breakfast, and 13.7% did not come to meals on time. Logistic regression models indicated that a caregiver with a low level of nutritional knowledge is a risk factor for a child's unhealth dietary behaviors (snacking excepted): the odds ratios (OR) of not liking to drink milk, being choosy about food, skipping breakfast or not having meals on time are 1.665, 1.338, 1.330 and 1.582, respectively. CONCLUSION: Caregivers' nutritional knowledge is strongly associated with children's dietary behavior. Nutrition education programs are urgently wanted to improve caregiver's knowledge and thus to improve children's dietary behavior in rural areas of China.

[Case-control study on environmental factors in congenital heart disease].

OBJECTIVE: To explore the relation between environmental factors and the occurrence of congenital heart disease (CHD). METHODS: A hospital-based case-control study was conducted. Mothers of 123 patients with congenital heart disease and 246 normal newborns were interviewed with standardized questionnaires. Chi-square test and logistic regression models were performed to analyze the influencing factors. RESULTS: As shown in multivariable logistic model, gravida with occupational exposure (OR=4.10), or gravida with chronic diseases during progestational pregnancy (OR=5.95), gravida with abnormal childbearing history (OR=6.27), and gravida catching a cold in the early stage of pregnancy (OR=2.07) would increase the risk of CHD. On the contrary, eating meat, egg (OR=0.18) and milk (OR=0.23), and taking multivitamin and microelement (OR=0.35) during the pregnancy reduced the risk of CHD. CONCLUSION: The risk of the offspring developing CHD is associated with gravida's exposure to many environmental factors during pregnancy. It is time to strengthen the intervention measures to reduce the occurrence of CHD.

Mother-to-child transmission prevention of human immunodeficiency virus, syphilis and hepatitis B virus.

BACKGROUND: China is the first country to initiate a nationwide program for prevention of mother-to-child transmission of human immunodeficiency virus, syphilis and hepatitis B virus by an integrated approach. However, the progress of this program remains unreported at national or local level for China. Therefore, we performed a hospital-based longitudinal study to assess the integrated prevention effect in Hunan, South-central China. METHODS: This study was conducted at 123 counties in Hunan and covered all local hospitals providing midwifery and antenatal care services from 2010 to 2016. We used the Cochran-Armitage test to examine the temporal changes of the indicators related with prevention of mother-to-child transmission. Besides, we used Spearman rank correlation analysis to assess the association between mother-to-child transmission rates and the process indicators related with prevention of mother-to-child transmission. RESULTS: After implementation of integrated prevention program, the indicators related with prevention of mother-to-child transmission are moving in the right direction. From 2010 to 2016, mother-to-child transmission rates significantly decreased from 19.4% to 9.6% for human immunodeficiency virus, and from 116.3 to 13.6 cases per 100,000 live births for syphilis. The proportion of children receiving hepatitis B immunoglobulin injection within 24h after birth increased from 95.2% to 98.9% among exposed neonates. Mother-to-child transmission rates were negatively associated with the process indicators related with prevention of mother-to-child transmission (all P<0.05). CONCLUSIONS: Our prevention program of mother-to-child transmission for three diseases by an integrated approach proved to be viable and effective. Our model may be of interest to other countries.

An artificial neural network prediction model of congenital heart disease based on risk factors: A hospital-based case-control study.

An artificial neural network (ANN) model was developed to predict the risks of congenital heart disease (CHD) in pregnant women.This hospital-based case-control study involved 119 CHD cases and 239 controls all recruited from birth defect surveillance hospitals in Hunan Province between July 2013 and June 2014. All subjects were interviewed face-to-face to fill in a questionnaire that covered 36 CHD-related variables. The 358 subjects were randomly divided into a training set and a testing set at the ratio of 85:15. The training set was used to identify the significant predictors of CHD by univariate logistic regression analyses and develop a standard feed-forward back-propagation neural network (BPNN) model for the prediction of CHD. The testing set was used to test and evaluate the performance of the ANN model. Univariate logistic regression analyses were performed on SPSS 18.0. The ANN models were developed on Matlab 7.1.The univariate logistic regression identified 15 predictors that were significantly associated with CHD, including education level (odds ratio  = 0.55), gravidity (1.95), parity (2.01), history of abnormal reproduction (2.49), family history of CHD (5.23), maternal chronic disease (4.19), maternal upper respiratory tract infection (2.08), environmental pollution around maternal dwelling place (3.63), maternal exposure to occupational hazards (3.53), maternal mental stress (2.48), paternal chronic disease (4.87), paternal exposure to occupational hazards (2.51), intake of vegetable/fruit (0.45), intake of fish/shrimp/meat/egg (0.59), and intake of milk/soymilk (0.55). After many trials, we selected a 3-layer BPNN model with 15, 12, and 1 neuron in the input, hidden, and output layers, respectively, as the best prediction model. The prediction model has accuracies of 0.91 and 0.86 on the training and testing sets, respectively. The sensitivity, specificity, and Yuden Index on the testing set (training set) are 0.78 (0.83), 0.90 (0.95), and 0.68 (0.78), respectively. The areas under the receiver operating curve on the testing and training sets are 0.87 and 0.97, respectively.This study suggests that the BPNN model could be used to predict the risk of CHD in individuals. This model should be further improved by large-sample-size research.

Biodiesel production from soybean oil by quaternized polysulfone alkali-catalyzed membrane.

A series of alkalized polysulfones (APSF) were synthesized by several chemical reactions (chloromethylation, quaternization and alkalization). Among these reactions, chloromethylation and quaternization are two key reactions and have been studied in detail regarding the optimization of both chloromethylation and quaternization. FTIR and (1)H NMR spectrum confirmed the successful preparation of chloromethylated polysulfone. The best IEC of APSF was obtained for 1.68meqg(-1) under reaction time of 10h and reaction temperature of 45°C. The APSF membrane as a heterogeneous catalyst for the transesterification of soybean oil with methanol was prepared through the method of solvent evaporation phase inversion. The effects of co-solvent types, mass ratios of soybean oil/co-solvent, water content and free fatty acids (FFAs) content in soybean oil on the conversions using the APSF membrane during transesterification were studied. The reusability of the APSF membrane and the kinetics of the reaction catalyzed by the APSF membrane were also investigated.

Surface glycosylation of polysulfone membrane towards a novel complexing membrane for boron removal.

In this study, a novel complexing membrane was synthesized for boron removal from aqueous solution. A glycopolymer, poly(2-gluconamidoethyl methacrylate) (PGAMA), was grafted onto the chloromethylated polysulfone (CMPSF) microporous membrane via surface-initiated ATRP (SIATRP). The glycosylated PSF (GlyPSF) membrane was characterized by attenuated total refection-Flourier transform infrared spectroscopy (ATR-FTIR), X-ray photoelectron spectroscopy (XPS), and field emission scanning electron microscopy (FESEM). It was demonstrated that PGAMA was successfully anchored onto the membrane surface and the grafting yield can be tuned in a wide range up to 5.9 mg/cm(2) by varying the polymerization time. The complexing membrane can adsorb boron rapidly with the equilibrium reached within 2h and has a remarkable high boron adsorption capacity higher than 2.0 mmol/g at optimized conditions. Freundlich, Langmuir, and Dubinin-Radushkevich adsorption isotherms were applied, and the data were best described by Langmuir model. Kinetic data were analyzed, and the data fitted very well to the pseudo-second-order rate expression. The optimal pH for boron uptake is in a wide range of 6-9, and the optimal initial boron concentration is over 300 mg/L. Studies of ionic strength effects indicated the formation of inner-sphere surface complexes. The complexed boron can be leached quantitatively under acid condition.

[Influencing factors on depression among medical staff in Hunan province under ordinal regression analysis].

OBJECTIVE: To understand the situation of depression and its related influencing factors among medical staff in Hunan province. METHODS: Data were collected through random sampling with multi-stage stratified cluster. Wilcoxon rank sum test, Kruskal-Wallis H test and Ordinal regression analysis were used for data analysis by SPSS 17.0 software. RESULTS: This survey was including 16,000 medical personnel with 14, 988 valid questionnaires and the effective rate was 93.68%. RESULTS: from the single factor analysis showed that factors as: level of the hospital grading, gender, education background, age, occupation, title, departments, the number of continue education, income, working overtime every week, the frequency of night work, the number of patients treated in the emergency room etc., had statistical significances (P < 0.05). Data from ordinal regression showed that the probabilities related to depression that clinicians and nurses suffering from were 1.58 times more than the pharmacists (OR = 1.58, 95%CI: 1.30 - 1.92). The probability among those whose income was less than 2000 Yuan/month was 2.19 times of the ones whose earned more than 3000 Yuan/month (OR = 2.19, 95%CI: 2.05 - 2.35). The higher the numbers of days with working overtime every week, the frequencies of night work, and the numbers of patients being treated at the emergency room, with more probabilities of the people with depression seen in our study. CONCLUSION: Depression seemed to be common among doctors and nurses. We suggested that the government need to increase the monthly income and to reduce the workload and intensity, lessen the overworking time, etc.

[Development of the National Norms of Negligence on children aged 0 to 35 months in rural areas of China].

OBJECTIVE: To develop the National Norms of Negligence (NNN) for rural children aged 0 to 35 months. METHODS: According to multi-stage stratified cluster sampling principle, 10 provinces or municipalities (Jilin, Shanxi, Shanxi, Beijing, Anhui, Jiangsu, Hunan, Hubei, Yunnan, Chongqing) in China were selected. A national research group was formed collaboratively. A questionnaire was designed by ourselves. According to several statistical analysis methods, such as item, factor and reliability analysis etc. we determined the norm. The evaluation criteria of the scale were determined by percentile method. Finally, the reliability and validity of the norm were evaluated. RESULTS: In total, 2310 children were surveyed, in which the effective sample were 2227, with an effective rate as 96.4%. The scale consisted of 6 neglected dimensions and 65 items in total. The total Cronbach's a coefficient of the scale was 0.903, with the split-half reliability coefficient as 0.829, the parallel reliability as 0.720 and the re-test reliability as 0.678, respectively. The total neglect cut-off score of this scale was 139. CONCLUSION: The scale seemed to have perfect stability and reliability and all the statistical indicators met the psychometric demands.

[Analysis on influences of guardians on behavior of left-behind children aged 3 to 7 years in countryside].

OBJECTIVE: To explore the influences of guardians on emotion and behavior of rural left-behind children aged 3 to 7 years. METHODS: A self-designed questionnaire of children's condition and Children Strengths and Difficulties Questionnaire (the edition for parents, SDQ) were used to investigate 805 left-behind children aged 3 to 7 years in countryside. RESULTS: The prevalence of difficulty among left-behind children was 3.5%, in male it was 4.1% and in female 2.7%, the difference was not significant (chi(2) = 1.154, P > 0.05) between male and female. The scores of peer communication problems among associate the left-behind children were (2.30 +/- 1.86), which was significantly higher than that (2.09 +/- 1.74) of not left-behind children (P < 0.05). The score of emotion symptom was (2.76 +/- 1.84) and the total score of difficulty was (11.41 +/- 4.77) among left-behind children was significantly higher than those of left-behind children with one parent stayed out (2.29 +/- 1.64) and (10.41 +/- 5.18), were significantly different (t = -2.489 - 2.006, P < 0.05), the score of social behavior (6.39 +/- 2.26) was significantly lower than that of left-behind children with father or mother stayed out (7.34 +/- 2.18, P < 0.001). The score of social behavior of children whose guardians had higher education level (7.02 +/- 2.21) was significantly higher than those with guardians who were illiterate or semiliterate (6.20 +/- 2.44, P < 0.01). CONCLUSIONS: There are evident problems in emotion and behavior among left-behind children with parents staying out. One of parents should stay home to care for children. To improve educational level of guardian will be beneficial to development of physical and mental health among left-behind children.

[Study on emotional, behavioral problems and related determinants among stranded children aged 4 to 7 years in the rural areas of China].

OBJECTIVE: To understand emotional, behavioral problems and related determinants among rural stranded children and to provide evidence for further psychological support. METHODS: A total of 3944 caregivers of children in the rural areas and aged 4 to 7 years but without parents around, were randomly selected. Data were collected through Strengths and Difficulties Questionnaires (the edition for parents, SDQ). RESULTS: The overall prevalence of children with behavioral/emotional problems was 43.6% among those stranded children including 8.3% having experienced emotional symptoms, 9.5% reported to be displaying 'conduct' problems, 8.7% exhibited significant hyperactivity/inattention, 18.9% experienced peer relationship problems and 16.8% having prosocial behaviors. The prevalence of behavioral/emotional problems was significantly higher in boys than those in girls and in lower age groups. Significant differences were also found in conduct problems, hyperactivity/inattention and prosocial behaviors (P<0.01). The result from logistic regression analysis showed that factors as education level and motivation of the caregivers as well as financial support from the parents were related to emotional/ behavioral problems among the stranded children. CONCLUSION: The prevalence of emotional and behavioral problems was high among children living the rural areas but without their parents around which should call for psychological intervention.

[A case-control study on genetic and environmental factors regarding polydactyly and syndactyly].

OBJECTIVE: To explore the genetic and environmental factors related to the development of polydactyly and syndactyly, and to provide evidence for prevention on birth defects. METHODS: A hospital-based case-control study was conducted. 111 cases and 222 controls were interviewed with standardized questionnaires. Logistic regression models were used to select risk factors. RESULTS: Research data through univariate analysis showed that the occurrence of polydactyly and syndactyly were associated with educational level, annual average income per family member, meat and egg intake during early pregnancy, family heredity history, exposure to hazardous substance before pregnancy, serious pregnant reaction etc. of the pregnant women. As shown in multivariable logistic model, some factors, including annual average income of per family member (OR = 0.240), meat and egg intake during early pregnancy (OR = 0.182), could reduce the risk of the development of polydactyly and syndactyly. Other factors including family heredity history (OR = 10.187), exposure to hazardous substance before pregnancy (OR = 3.029), could increase the risk of developing polydactyly and syndactyly. The attributable risks (%) of family heredity history and exposure to hazardous substance before pregnancy were 90.18% and 66.99% respectively. CONCLUSION: Genetic factor was the leading cause on the development of polydactyly and syndactyly. In addition, environmental factors, such as family economic condition, nutritional status during early pregnancy and working condition before pregnancy were associated with the development of polydactyly and syndactyly.