Objective The aim of this study is to present two novel technique?Lying on position and rotational board TSEI in which uniform dose to the whole body as well as the soles and vertex of scalp can be achieved in one electron beam treatment fraction. Methods Patients are treated with two groups in prone and supine position by leaning on inner rotational board in prone and supine position, each group can further be separated into two subgroup with tilting and rotation positions for treatment. By incorporating all these setting on the aswirl board with the optimal gantry angle, the patient will final accumulate compensated dosages on whole body surface. Results The dose uniformity for the rotational board?TSET or Lying on position could be control within ±10%. Conclusions The two TSEItechnique?Lying on and Rotational board TSEI techniques presented in this study is able to deliver a uniform dose to the patient’s skin surface as well as to the vertex and the soles all in one time, eliminating the troubles of having to further boost fields for these two regions when using the Stanford Six Field Technique.

Objective: To investigate the prevalence of calf muscle cramps and possible influencing factors for pregnant women in China. Methods: Using a multi-stage stratified probability proportional to size cluster randomization sampling method during 2010-2012. A total of 3 582 pregnant women were investigated at 150 counties from 31 provinces in China mainland. Information on calf muscle cramps, demographic socio-economic status, pregnancy information, and the physical activities was collected through questionnaires. The semi-quantitative food frequency questionnaire (FFQ) was used to collect food intake of pregnant women. Dynamic cluster analysis was used to assess dietary pattern. Multiple logistic regression was used to investigate the possible influencing factors for calf muscle cramps. Results: The prevalence of calf muscle cramps was 32.9% (1 180/3 582) in Chinese pregnant women, which was 11.6% (87/748), 28.2% (420/1 492), and 50.2% (673/1 342), respectively, during the first, second and third trimester. There were significant differences between them (χ²=349.16, P<0.001). Dietary patterns of the pregnant women were classified into three groups, which called relatively balanced pattern, high vegetables and fruits pattern, and high dairy pattern. Among the three groups, the prevalence of calf muscle cramps was 32.0% (952/2 971), 37.2% (186/500), and 37.8% (42/111), with significant differences (χ²=6.39, P=0.041). The OR (95%CI) values of calf muscle cramps in the second and third trimester was 2.96 (2.28-3.83), and 8.02 (6.16-10.44), respectively, comparing with the first trimester. The OR (95%CI) values of calf muscle cramps in the women taking calcium before pregnant was 1.45 (1.19-1.76), comparing with the one who was not taken. The OR (95%CI) values of calf muscle cramps in the women who had been diagnosed by pregnancy-induced hypertension was 5.76 (2.06-16.12), comparing with the one who had not been diagnosed. The OR (95%CI) values of calf muscle cramps in the high vegetables and fruits pattern and high dairy pattern was 1.13 (0.91-1.41), and 1.18 (0.76-1.81), respectively, comparing with the relatively balanced pattern. Conclusion The prevalence of calf muscle cramps was relatively high in Chinese pregnant women, which was significantly different among three trimesters. The residential areas, occupation, and pregnancy-induced hypertension might be related to the prevalence of calf muscle cramps. However, there was no significant difference among different dietary patterns.

Objective: To investigate the prevalence of anemia and related risk factors for pregnant women in China. Method: Based on Chinese National Nutrition and Health Surveillance 2010-2012, a total of 3 501 pregnant women were investigated from 150 counties of 31 provinces, municipalities and autonomous regions in China, using a multi-stage stratified cluster randomization sampling method. General information of pregnant women, health status, and food intake during the gestation, was collected through a questionnaire investigation. 6 ml fasting venous blood was collected for the determination of hemoglobin concentration. Data were analyzed using multiple logistic regression to investigate the prevalence of anemia and the related influencing factors. Results: The 605 of 3 501 pregnant women had anemia. The prevalence of anemia was 17.2%; and mild anemia accounted for about 61.0% (369/605). Compared with the pregnant women living in the large cities, the OR (95%CI) of those living in the poor rural areas was 1.46 (1.08-1.98). Compared with the pregnant women living in the south area of China, the OR (95%CI) of those living in the north area of China was 1.39 (1.15-1.68); Compared with the pregnant women in the first trimester, the OR (95%CI) of those in the second trimester and the third trimester were 1.79 (1.33-2.43) and 2.11 (1.56-2.85), respectively. The OR (95%CI) of pregnant women who had used folic acid supplementation within the 6 months prior to gestation was 0.76 (0.63-0.93) compared with those who had not used. Conclusion From 2010 to 2012, the epidemic characteristics of anemia was mild for the pregnant women in China, and pregnant women residential areas, periods of pregnancy and whether to take folic acid were related to anemia.

Objective: To examine the status and related factors for gestational weight gain of Chinese pregnant women at different trimesters in 2010-2012. Methods: Participants were from Chinese National Nutrition and Health Surveillance in 2010-2012. Using a multi-stage stratified cluster random sampling method, we recruited 2 805 singleton pregnant women with gestational age 13 weeks or more from 31 provinces of China. A standard questionnaire was used to collect general information and pre-pregnancy weight; body weight and height of pregnant women were measured using a unified weighing scale and stadiometer, dietary intake during the previous year was collected using a food frequency questionnaire. A multiple logistic regression was used to analyze potential factors associated with appropriate gestational weight gain. Results: Among 2 805 pregnant women, 1 441 were in the second (13-27 weeks) and 1 364 in the third trimesters (≥28 weeks) . In the 2^nd trimester, 229 cases (15.9%), 440 cases (30.5%) and 772 cases (53.6%) were insufficient gestational weight gain, appropriate gestational weight gain and excessive gestational weight gain respectively. So were 256 cases (18.8%), 474 cases (34.8%), 634 cases (46.5%) in the 3^rd trimester respectively. In the multivariate unconditional logistic model, less fruit intake was associated with insufficient weight gain for women in the 2^nd trimester (OR (95%CI): 1.58 (1.06-2.34)). Pregnant women with Han ethnicity who live in the small/medium city had lower risk of insufficient weight gain in the 3^rd trimester (OR (95%CI): 0.58 (0.34-0.98)). Those pregnant women with physical activity <1 hour/day had a higher risk of excessive weight gain (OR (95%CI): 1.33 (1.02-1.73)). Conclusion The prevalence of appropriate gestational weight gain was low in China. Our study suggests that pregnant weight gain is associated with fruit intake, types of residential area and physical activity.

Objective The study aimed to assess the folic acid status of lactating women in China and to analyze factors related to folic acid deficiency in these subjects. Methods The data on lactating women were extracted from the Chinese National Nutrition and Health Surveillance in 2013. By a multi-stage stratified cluster random sampling method, 10 331 lactating women were selected for the study. The lactating women, 0-24 months postpartum, were from 55 sites in 30 provinces of China, excluding the Tibet Autonomous Region. A standard questionnaire was used to obtain general information and dietary intake during the previous one month period was collected using a food frequency questionnaire. A total of 20% of the total number of lactating women were randomly selected to analyze serum folic acid. Finally, 1 894 lactating women, with questionnaire results and serum folic acid data, were included in the study. Serum folic acid concentrations were analyzed using an electro-chemiluminescence immunoassay method. Folic acid deficiency was defined as a serum folic acid level<2 ng/ml. A multiple logistic regression analysis was used to analyze the factors associated with folic acid deficiency in these women. Results After excluding abnormal values, 1 894 lactating women were included in the study. Based on our findings, the prevalence of folate deficiency was 3.0% (56/1 894) in lactating women in China. The prevalence of folic
acid deficiency was 0.3% (1/388), 1.3% (7/550), 6.0% (38/639) and 3.2% (10/317) in larger, medium or small cities, general rural counties and poor rural counties, respectively. The prevalence of folic acid deficiency was 6.3% (17/269) and 2.4% (39/1 623) for minority and Han ethnic groups, respectively, and was 6.3% (52/823) and 0.4% (4/1 071) for subjects in northern and southern areas of China, respectively. Binary unconditionally logistic regression was used to analyze the factors associated with folic acid deficiency in the lactating women. The results showed that, compared with those living in the south and those in the Han ethnic group, those living in the north and belonging to the minority ethnic group had a greater risk of folic acid deficiency, with (OR=3.63, 95%CI: 1.64-8.05) and (OR=5.42, 95%CI: 1.75-16.74), respectively. With each month of age during childhood, the prevalence of folic acid deficiency decreased by 10%(OR=0.90, 95%CI:0.85-0.96). Compared with low income subjects, those with middle incomes had OR (95%CI) of 0.25 (0.10-0.60) for folic acid deficiency. A lesser intake of cereal was associated with a greater risk of folic acid deficiency in lactating women (OR=3.04, 95%CI:1.18-7.79). A lesser intake of tubers was a protective factor for folic acid deficiency in lactating women (OR=0.29, 95%CI:0.12-0.70). Conclusion The folic acid status of Chinese lactating women has, in general, recently improved. However, living in northern areas, during early lactating periods, belonging to an ethnic minority, living in rural areas, having a low income, lower intake of cereal and excessive intake of tubers were risk factors for folic acid deficiency in lactating women. In these women, folic acid intervention should be considered a priority.

Objective The study aimed to assess the folic acid status of lactating women in China and to analyze factors related to folic acid deficiency in these subjects. Methods The data on lactating women were extracted from the Chinese National Nutrition and Health Surveillance in 2013. By a multi-stage stratified cluster random sampling method, 10 331 lactating women were selected for the study. The lactating women, 0-24 months postpartum, were from 55 sites in 30 provinces of China, excluding the Tibet Autonomous Region. A standard questionnaire was used to obtain general information and dietary intake during the previous one month period was collected using a food frequency questionnaire. A total of 20% of the total number of lactating women were randomly selected to analyze serum folic acid. Finally, 1 894 lactating women, with questionnaire results and serum folic acid data, were included in the study. Serum folic acid concentrations were analyzed using an electro-chemiluminescence immunoassay method. Folic acid deficiency was defined as a serum folic acid level<2 ng/ml. A multiple logistic regression analysis was used to analyze the factors associated with folic acid deficiency in these women. Results After excluding abnormal values, 1 894 lactating women were included in the study. Based on our findings, the prevalence of folate deficiency was 3.0% (56/1 894) in lactating women in China. The prevalence of folic
acid deficiency was 0.3% (1/388), 1.3% (7/550), 6.0% (38/639) and 3.2% (10/317) in larger, medium or small cities, general rural counties and poor rural counties, respectively. The prevalence of folic acid deficiency was 6.3% (17/269) and 2.4% (39/1 623) for minority and Han ethnic groups, respectively, and was 6.3% (52/823) and 0.4% (4/1 071) for subjects in northern and southern areas of China, respectively. Binary unconditionally logistic regression was used to analyze the factors associated with folic acid deficiency in the lactating women. The results showed that, compared with those living in the south and those in the Han ethnic group, those living in the north and belonging to the minority ethnic group had a greater risk of folic acid deficiency, with (OR=3.63, 95%CI: 1.64-8.05) and (OR=5.42, 95%CI: 1.75-16.74), respectively. With each month of age during childhood, the prevalence of folic acid deficiency decreased by 10%(OR=0.90, 95%CI:0.85-0.96). Compared with low income subjects, those with middle incomes had OR (95%CI) of 0.25 (0.10-0.60) for folic acid deficiency. A lesser intake of cereal was associated with a greater risk of folic acid deficiency in lactating women (OR=3.04, 95%CI:1.18-7.79). A lesser intake of tubers was a protective factor for folic acid deficiency in lactating women (OR=0.29, 95%CI:0.12-0.70). Conclusion The folic acid status of Chinese lactating women has, in general, recently improved. However, living in northern areas, during early lactating periods, belonging to an ethnic minority, living in rural areas, having a low income, lower intake of cereal and excessive intake of tubers were risk factors for folic acid deficiency in lactating women. In these women, folic acid intervention should be considered a priority.

Objective To assess the dietary intake status of Chinese lactating women during the first month postpartum. Methods Data were extracted from Chinese National Nutrition and Health Surveillance, children aged 0-5 years and lactating women (2013). A total of 55 counties from 30 provinces in China (excluding the Tibet Autonomous Region) were selected using a multi-stage stratified cluster randomization sampling method. A group of 3 623 lactating women, at 1-6 months after delivery, were investigated in the study. The semi-quantitative food frequency questionnaire (FFQ) was used to collect information on frequencies and amounts of food consumed. Differences in food consumption rates and dietary intake in lactating women having different characteristics were analyzed and compared. Results To eliminate abnormal values, 3 300 lactating women were included in the study. During the first month postpartum, food types with higher consumption rates were animal products (98.2%,3 239) and vegetables (90.7%,2 987), in addition to cereals (100%) and liquids (100%). The consumption rate of fruits was 67.4%(2 222) and the lowest consumption rate was for dairy products (38.3%, 1 262). The median intake of cereals, vegetables, fruits and animal products were 247.8, 150.0, 40.0 and 178.6 g/d, respectively. The daily median intake of dairy products and soybean/nut products was 0.0 g/d. Overall, the lactating women consumed 895.7 ml/d liquids. About 49.3% (1 627) of the subjects consumed less than the recommended intake for animal products in Chinese Dietary Guideline (2016). More than 50% of the lactating women consumed less than the recommended intakes for the other types of food, especially dairy, soybean/nut and liquids. The consumption rates for dairy products were 26.9%, 29.4%, 31.8% and 33.8% and those for soybean/nut products were 33.9% , 35.8% , 37.5% and 41.7% for the lactating women living in rural areas, with educations at junior high school level and below, with average family incomes under 15 000 yuan per capita in 2012 and who work as household mothers, respectively. These consumption rates for dairy and soybean/ nuts were significantly lower than those in women living in cities (48.4%, 55.0%), with an education level of senior high school or above (48.8%, 55.7%), with average family income over 15 000 yuan per capita in 2012 (45.5% , 52.8% ) and who work outside the home (43.7% , 49.4% ). P values were <0.05 for all comparisons. Conclusion The daily intake of all foods by lactating women during the first month postpartum was lower than the levels recommended in Chinese Dietary Guideline (2016). The consumption rate of dairy and soybean/nut products during this time period was low, especially for those living in rural areas, with education levels of junior high school and below, with average family incomes less than 15 000 yuan per capita in 2012 and who are housemothers.

Objective To study the prevalence of delayed onset of lactation (later than 3 days) in lactating women in China and to analyze its influencing factors. Methods Data were extracted from Chinese National Nutrition and Health Surveillance-Mothers, from mothers with children under 2 years of age (in 2013). A total of 11 178 women who were lactating or had lactated were selected from 55 counties of 30 provinces (excluding the Tibet Autonomous Region) in China, using the multi-stage stratified cluster randomization sampling method. Basic information, including onset of lactation, initiation of breastfeeding, breastfeeding difficulties and breastfeeding knowledge were collected using a questionnaire investigation. The prevalence of delayed onset of lactation were analyzed by the weighted processing of complex sampling from the 6th national population census data. A multiple logistic regression was used to analyze the factors associated with delaged onset of lactation. Results Among 11 178 lactating women, 3 388 had an onset of lactation later than 3 d. The prevalence of delayed onset of lactation was 30.3%. After complex weighting, the prevalence of delayed onset of lactation was 31.2% (95%CI: 25.7%-36.8%) for lactating women in China. Delivery by Caesarean section (OR=1.28, 95%CI:1.06-1.53) and initiating breastfeeding≥4 h (OR=
2.34, 95%CI:1.76-3.11) were the negative factors for delayed onset of lactation. Compared with those living in large cities, lactating women living in medium or small cities (OR=1.39, 95%CI:1.05-1.84) had a higher risk of delayed onset of lactation. Compared with the lactating women doing housework, the risk of delayed onset of lactation was lower (P<0.05) among those whose occupations were as leaders of Enterprises/Institutions (OR=0.68, 95%CI:0.47-0.99), in catering and service trades (OR=0.61, 95%CI:0.43-0.86), in agriculture/forestry/fishery/herdsmen fields (OR=0.65, 95%CI:0.44-0.96) and who were unemployed (OR=0.64, 95%CI:0.46-0.90). Breastfeeding education during pregnancy might lower the risk of delayed onset of lactation (OR=0.78, 95%CI: 0.62-0.98). Conclusion The prevalence of delayed onset of lactation was relatively high for Chinese lactating mothers. Caesarean section and late initiation of breastfeeding were the primary risk factors. Lactating mothers living in medium or small cities and those doing housework appear to be high-priority groups for intervention. Based on our findings, breastfeeding education during pregnancy is recommended to lower the risk of delayed onset of lactation.

Objective To assess the dietary intake status of Chinese lactating women during the first month postpartum. Methods Data were extracted from Chinese National Nutrition and Health Surveillance, children aged 0-5 years and lactating women (2013). A total of 55 counties from 30 provinces in China (excluding the Tibet Autonomous Region) were selected using a multi-stage stratified cluster randomization sampling method. A group of 3 623 lactating women, at 1-6 months after delivery, were investigated in the study. The semi-quantitative food frequency questionnaire (FFQ) was used to collect information on frequencies and amounts of food consumed. Differences in food consumption rates and dietary intake in lactating women having different characteristics were analyzed and compared. Results To eliminate abnormal values, 3 300 lactating women were included in the study. During the first month postpartum, food types with higher consumption rates were animal products (98.2%,3 239) and vegetables (90.7%,2 987), in addition to cereals (100%) and liquids (100%). The consumption rate of fruits was 67.4%(2 222) and the lowest consumption rate was for dairy products (38.3%, 1 262). The median intake of cereals, vegetables, fruits and animal products were 247.8, 150.0, 40.0 and 178.6 g/d, respectively. The daily median intake of dairy products and soybean/nut products was 0.0 g/d. Overall, the lactating women consumed 895.7 ml/d liquids. About 49.3% (1 627) of the subjects consumed less than the recommended intake for animal products in Chinese Dietary Guideline (2016). More than 50% of the lactating women consumed less than the recommended intakes for the other types of food, especially dairy, soybean/nut and liquids. The consumption rates for dairy products were 26.9%, 29.4%, 31.8% and 33.8% and those for soybean/nut products were 33.9% , 35.8% , 37.5% and 41.7% for the lactating women living in rural areas, with educations at junior high school level and below, with average family incomes under 15 000 yuan per capita in 2012 and who work as household mothers, respectively. These consumption rates for dairy and soybean/ nuts were significantly lower than those in women living in cities (48.4%, 55.0%), with an education level of senior high school or above (48.8%, 55.7%), with average family income over 15 000 yuan per capita in 2012 (45.5% , 52.8% ) and who work outside the home (43.7% , 49.4% ). P values were <0.05 for all comparisons. Conclusion The daily intake of all foods by lactating women during the first month postpartum was lower than the levels recommended in Chinese Dietary Guideline (2016). The consumption rate of dairy and soybean/nut products during this time period was low, especially for those living in rural areas, with education levels of junior high school and below, with average family incomes less than 15 000 yuan per capita in 2012 and who are housemothers.

Objective To study the prevalence of delayed onset of lactation (later than 3 days) in lactating women in China and to analyze its influencing factors. Methods Data were extracted from Chinese National Nutrition and Health Surveillance-Mothers, from mothers with children under 2 years of age (in 2013). A total of 11 178 women who were lactating or had lactated were selected from 55 counties of 30 provinces (excluding the Tibet Autonomous Region) in China, using the multi-stage stratified cluster randomization sampling method. Basic information, including onset of lactation, initiation of breastfeeding, breastfeeding difficulties and breastfeeding knowledge were collected using a questionnaire investigation. The prevalence of delayed onset of lactation were analyzed by the weighted processing of complex sampling from the 6th national population census data. A multiple logistic regression was used to analyze the factors associated with delaged onset of lactation. Results Among 11 178 lactating women, 3 388 had an onset of lactation later than 3 d. The prevalence of delayed onset of lactation was 30.3%. After complex weighting, the prevalence of delayed onset of lactation was 31.2% (95%CI: 25.7%-36.8%) for lactating women in China. Delivery by Caesarean section (OR=1.28, 95%CI:1.06-1.53) and initiating breastfeeding≥4 h (OR=
2.34, 95%CI:1.76-3.11) were the negative factors for delayed onset of lactation. Compared with those living in large cities, lactating women living in medium or small cities (OR=1.39, 95%CI:1.05-1.84) had a higher risk of delayed onset of lactation. Compared with the lactating women doing housework, the risk of delayed onset of lactation was lower (P<0.05) among those whose occupations were as leaders of Enterprises/Institutions (OR=0.68, 95%CI:0.47-0.99), in catering and service trades (OR=0.61, 95%CI:0.43-0.86), in agriculture/forestry/fishery/herdsmen fields (OR=0.65, 95%CI:0.44-0.96) and who were unemployed (OR=0.64, 95%CI:0.46-0.90). Breastfeeding education during pregnancy might lower the risk of delayed onset of lactation (OR=0.78, 95%CI: 0.62-0.98). Conclusion The prevalence of delayed onset of lactation was relatively high for Chinese lactating mothers. Caesarean section and late initiation of breastfeeding were the primary risk factors. Lactating mothers living in medium or small cities and those doing housework appear to be high-priority groups for intervention. Based on our findings, breastfeeding education during pregnancy is recommended to lower the risk of delayed onset of lactation.