Objective To investigate the effectiveness of system approach to management on prenatal health care in floating population. Methods The prenatal care was managed through establishing "Contact handbook on the health of pregnant women in Shanghai" for 505 lying-in women from the floating population of Minhang District. The condition of antenatal health care, the outcome of gestation and related factors were investigated and the results were compared to those reported in literatures. Results After system approach to management, the rate of having 1 - 3 antenatal examinations accounted for 32.1% ( 162/505 ), that of 4 - 8 examinations accounted for 43.0% ( 217/505 ), that ≥ 9 examinations accounted for 15.6% (79/505), which were higher than that reported by Zhuang Chanjuan (P = 0.001 ). Among 458 responders 185 (40.4% ) thought the cost for prenatal examination was "high" or "too high". Among 293 responders, 211 (72.0%) did not establish the contact handbook due to "not knowing the handbook" or "not clear about the process". The frequency of antenatal examination was associated with education levels of the lying-in women ( P =0.000) , whether their husbands being native Shanghainese or not ( P =0.002)and establishing contact handbood ( P = 0.002). Conclusions System approach to management promotes the utilization of antenatal health care for floating population, establishing contact handbook is a workable method to promote the utilization.

Objective To explore the effectiveness of dietary treatment in reducing macrosomia risks for pregnancies with borderline gestational glucose intolerance (BGGI).Methods From July 2009 to June 2011,a total of 1046 pregnant women with BGGI were randomized into group A (intervention,n =525) and group B (non-intervention,n =521).Another 521 pregnancies with normal glucose screening were assigned into group C (normal control).Randomization was applied following stratification according to age,body mass index (BMI),prior Cesarean section (C-section) and multiparity,etc.Women in group A underwent the examinations of fasting plasma glucose (FPG),2 h-post prandial glucose and HbA1c once every 2 weeks.Their newborn outcomes were collected for analysis.Results Women of three groups were similar in age,parity,initial BMI and initial FPG.Dietary treatment for group A improved glucose-related indices and women's pregnancy weight gain (P ＜0.0l).Also,in comparison with group B,the intervention of group A reduced risk of macrosomia (9.14％ vs.13.82％,P =0.02),prior C-section rate (43.87％ vs.56.07％,P ＜ 0.01) and postpartum hemorrhage (3.81％ vs.7.10％,P =0.02).However these indices were no better than group C.Dietary treatment did not increase the risk of fetal growth restriction,neonatal hypoglycemia and hyperbilirubinemia.Conclusion As a simple noninvasive therapeutic measure for improved glucose tolerance,BGGI may reduce the risk of risk of macrosomia and prior C-section rate.

Background and purpose:DNA methylation is a common epigenetic alteration in cervical carcino-genesis. The aim of this study was to measure the levels of LMX1A and PAX1 gene methylation in cervical cancer and pre-cursors and to identify their potential in clinical application. Methods:Cervical specimens were collected from 121 female patients including 27 cases with invasive cervical cancers (ICC), 34 cases with high-grade cervical intraepithelial neoplasia (HG-CIN), 32 cases with low-grade cervical intraepithelial neoplasia (LG-CIN) and 28 cases with chronic cervicitis as normal controls (NLM). DNA methylations of the LMX1A and PAX1 gene were quantified using the techniques of nest PCR and pyrosequencing. The mean methylation values of the 6 gene loci on the LMX1A gene and the 9 gene loci on the PAX1 gene were respectively calculated for a given sample. Receiver operating characteristic (ROC) curve was used to evaluate the accuracy of gene methylation analysis to discriminate the cervical diseases. Results:The mean methylation value of the LMX1A gene in ICC was 14.36%, which was significantly higher than those in HG-CIN (4.70%), LG-CIN (5.05%) and NLM (4.53%) (P<0.01). The mean methylation value of the PAX1 gene in ICC was 41.97%, which was significantly higher than those in HG-CIN (10.21%), LG-CIN (5.55%) and NLM (4.92%) (P<0.01). The area under the ROC curve (AUC) was 0.603 for LMX1A gene methylation, and was 0.883 for PAX1 gene methylation, to discriminate ICC from HG-CIN, LG-CIN, and NLM (P=0.104 and<0.001, respectively). The optimal cut-off value for PAX1 gene methylation was set at 20.50%with the sensitivity of 81%and with the specificity of 93%. If the cut-off value was set at 9.58%, the sensitivity and the specificity of PAX1 gene methylation were 89%and 84%respectively. Conclusion:Quantitative analysis of the PAX1 gene methylation in cervical tissue might be helpful to differentiate invasive cancers from precursors, while the clinical applica-tion of the LMX1A gene methylation was limited.

To explore the potential effects of intrauterine device ( IUD) usage in reproductive ages on women′s postmenopausal reproductive health.Women in Shanghai Minhang district were enrolled and categorized into group Ⅰ( IUD) , groupⅡ( tubal ligation ) and control group ( external ejaculation ).Their data were collected and analyzed retrospectively.A total of 2 744 women during postmenopausal period were enrolled (group Ⅰ=2 253, group Ⅱ=202, control =289).Pearl index of each group was 1.08 (groupⅠ) , 0.00 ( group Ⅱ) and 15.22 ( control ) , respectively.Women with IUD usage in reproductive ages were less likely to develop reproductive benign diseases after menopause (χ2 =67.51, P=0.00, OR=0.44, 95%CI:0.32-0.59).Logistic regression indicated pregnancy history (OR=3.85), child-bearing history ( OR =0.52 ) , IUD usage ( OR =0.48 ) , tubal ligation ( OR =1.74 ) , longer duration using contraceptive methods ( OR =0.99 ) , contraception failure ( OR =1.74 ) and family planning surgical procedures(OR=1.73) were risk factors for reproductive benign diseases after menopause.IUD utility in reproductive ages may reduce the risks of benign diseases in reproductive system for postmenopausal women .

lymphocytic thyroiditis.

Objective:To explore the clinical diagnostic value of quantitative detection of the paired‐boxed gene1 (PAX1 ) methylation for cervical high grade precancerous lesions .Methods:According to pathological diagnosis ,which was set as the gold standard ,122 patients infected with high risk subtype HPV were divided to the normal cervix group(group I ,n=39) ,the cervical low grade precancerous lesions group(group II ,n=40) ,and the cervical high grade precancerous lesions group(group III ,n=43) .The cervical tissue samples from each group were collected .The methylation level of PAX1 from each sample was measured by pyrosequencing and the statistical analysis was done .The diagnostic threshold of PAX1 methylation level for cer‐vical high‐grade precancerous lesions was verified by receiver operator characteristic(ROC) curve .Results:The PAX1 methyla‐tion level of group I ,group II ,group III was (4 .77 ± 2 .43)% ,(3 .75 ± 2 .36)% ,(13 .51 ± 5 .31)% ,respectively .And the differences among them were statistically significant (F=23 .13 ,P<0 .001) .The area under the ROC curve was 0 .73 .The diagnostic threshold of PAX1 methylation level for cervical high grade precancerous lesions was 4 .15% ,and its sensitivity and specificity was 89 .39% and 79 .15% ,respectively .Conclusions:Quantitative detection of PAX1 methylation level in cervical tissue by pyrosequencing could reach effective diagnosis for cervical precancerous lesions .