【Objective】 To investigate the morbidity trend of the preterm delivery.【Methods】 A retrospective study was done on the delivery data in our hospital from 1969 to 1998. Select the cases on annual August as the sam pling units, and divided those 253 cases into three decade groups, to analyze th e obsterical factors affecting the preterm delivery.【Results】 ① The morbidity of the preterm delivery in thirty years was 4.72%(95% CI 4.16, 5.32). ② The re were no obvious changes of the morbidity among the years, and had no seasonal aggregation. ③ The cesarean section rates in the third decade increased signif icantly than those in former two decades (P<0.05). ④ As time goes on, the i ncidence of premature rupture of membrane increased, and that of the preterm del ivery with no obvious complication decreased. The cases with the intrauterine fe tal distress and IVF-ET in the third decade were significantly increased. ⑤ Th e gestation age and birth weight increased significantly, especially in the thir d decade, but the neonatal mortality had no obvious change. 【Conclusions】 Ther e was no reduction of the morbidity of the preterm delivery, further studies sho uld be emphasized. It seems unlikely the increased of cesarean section rates wil l reduce the neonatal mortality. PROM is important factors affecting the preterm delivery, and the IVF women may be at higher risk of preterm delivery.

Objective:To investigate the public cognition,attitude and coping style of medical disputes among 2910 citizens from Hangzhou,Ningbo and Wenzhou and other cities in Zhejiang Province.Methods:Totally 11 cit-ies in Zhejiang Province were selected using the method of random sampling and a questionnaire survey was conduc-ted based on the principle of voluntary.Results:The public legal awareness was not strong,of which the primary influencing factors were the excessive prescription and medical professionals'unsatisfying attitude.Conclusion:In view of the existing problems,this paper put forward the optimization countermeasures including popularizing legal knowledge,enhancing citizens' sense of security,strengthening media management,correctly guiding public opin-ion,strengthening psychological intervention,and avoiding emotional stress.

Objective To study the related factors of no or weak immune response after inoculation of hepatitis B vaccine .Meth‐ods 120casesofadultreceivedinoculationofhepatitisBvaccineinourhospitalwereenrolled,including60casesofnoweakre‐sponse and 60 cases of normal response ,they were divided into non response group and response group .Related factors of no or weakimmuneresponsewereanalyzed.Results (1)singlefactoranalysis:Therewerestatisticalsignificanceofage,gender,BMI, smoking history ,HBV potential infection ,CD4+ T cells and CD8+ T cell content ,IFN‐γand IL‐2 content between two groups ;(2) logistic regression analysis :old age ,male ,smoking history ,high values of BMI ,HPV latent infection ,low content of CD4+ T cells and IFN‐γand IL‐2 ,high content of CD8+ cells were risk factors of no or weak immune response after inoculation of hepatitis B vaccine .Conclusion No or weak immune response after inoculation of hepatitis B vaccine is affected by gender ,age ,smoking ,obesi‐ty ,potential infection of HPV and immune function ,and necessary measure should be taken .

Objective:To explore the regional brain activities in healthy adolescent subjects after sleep deprivation (SD) using amplitude of low-frequency fluctuation (ALFF) method.Methods:Total of 16 healthy adolescent subjects (8 males,8 females;aged 13-20 years) were recruited in the community and the campus through the internet and posters.Each of the 16 healthy adolescent subject underwent the attention network test and magnetic resonance imaging (MRI) session twice:once was after rested wakefulness (RW condition),and the other was after SD condition.Amplitude of low frequency fluctuation (ALFF) method was used to assess the local brain features.The mean ALFF signal values of the different brain areas were performed to investigate their relationships with the accuracy rate,reaction time and lapse rate in the attention network test,and were analyzed with a receiver operating characteristic (ROC) curve to investigate their sensitivities and specificities to distinguish the SD condition from the RW condition.Results:Subjects showed a lower response accuracy rate [(83 ± 12) ％ vs.(97 ± 4) ％,P ＜ 0.05],a longer response time [(832 ± 134) ms vs.(715 ± 97) ms,P ＜ 0.05] and a higher lapse rate [(15 ± 11)％ vs.(2.4 ±7.3)％,P ＜0.05] under SD condition than under RW condition.They showed higher ALFF area in the right cuneus (BA 17,BA 18),and lower ALFF areas in the right lentiform nucleus,right claustrum,left dorsolateral prefrontal cortex (BA 46) and left inferior parietal cortex (BA 39) under SD condition than under RW condition.Under SD condition,the mean ALFF signal value of the right claustrum showed a significant positive correlation with the accuracy rate (r =0.69,P ＜0.05),and a negative correlation with the lapse rate (r =-0.71,P ＜0.05).The mean ALFF signal value of the dorsolateral prefrontal cortex showed a significant positive correlation with the reaction time (r =0.68,P ＜ 0.05).The values of area under the curve of the right cuneus,right lentiform nucleus,right claustrum,left dorsolateral prefrontal cortex and left inferior parietal cortice were 0.9,0.8,0.9,0.8 and 0.9,respectively.These different ALFF areas also showed high degree of sensitivities and specificities.Conclusion:Sleep deprivation leads to the dysfunction in the default mode network,anticorrelatedtask-positive network,and advanced cognitive function brain areas,and the functional compensation in the visual network.

OBJECTIVETo evaluate efficacy and optimal cut-off-point through cerebral vascular hemodynamic indexes (CVHI) examination to predict stroke.

METHODSA number of 20,333 people at 35 years old and over were checked by CVHI and accumulative score was calculated according to the value of detected indexes. Risk factors of stroke were investigated simultaneously. One hundred and sixty-eight patients with stroke occurred during 4-year following up. Typical syndromes and signs stroke were used as golden standard to evaluate screening efficacy of CVHI.

RESULTSScore of optimal cut-off-point of cerebral vascular hemodynamic indexes was under 75 in ROC curve analyses. Sensitivity, specificity, accuracy, positive and negative predictive values, positive and negative likelihood ratios as well as Youden's index for predicting stroke within 4 years after examination were found to be 87.50%, 67.70%, 67.86%, 2.21%, 99.85%, 2.71, 0.18 and 0.55 respectively. Sensitivity and positive predict values for predicting cerebral vascular thrombosis were superior to predicting cerebral hemorrhage. Positive predicting value in risk exposure population was higher than that of overall population. Coefficiency of variation of cerebral vascular hemodynamic examination was 4.03%. The agreement rate of examination between two physicians was 97.62% and Kappa value was 0.94.

CONCLUSIONThe score of optimal cut-off-point of cerebral vascular hemodynamic indexes examination was 75. Both Efficacy and reliability for predicting stroke seemed to be good, especially for predicting cerebral vascular thrombosis.

Adult ; Aged ; Brain ; physiopathology ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Stroke ; diagnosis ; physiopathology

Objective:To observe the role of Huaiqihuang Granules (HQ) in the long-term management of bronchial asthma in young children, and the effective effect on concomitant rhinitis.Methods:A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department (from April 2016 to March 2019)who received either inhaled corticosteroid (ICS)/leukotriene receptor antagonist (LTRA)(control group); inhaled ICS/LTRA plus HQ(combination group), or HQ alone(HQ group). All patients were followed up at week 4, 8, 12 after treatment. The number of days with asthma symptoms, the frequency of severe asthma attacks, the level of asthma control, and the days with rhinitis symptoms in the last 4 weeks were recorded. Differences before and after treatment, and those among groups after treatment were compared using Kruskal- Wallis H test or Wilcoxon rank-sum test. Results:A total of 2 234 eligible patients were recruited, and 2 147 cases completed followed-up visits, including 477, 1 374 and 296 cases in the control group, combination group, and HQ group, respectively. After the treatment, all 3 groups showed significant declines in the days with asthma symptoms, frequency of severe asthma attack and the days with rhinitis symptoms (all P<0.01), and the rate of well-controlled asthma increased significantly ( P<0.01). It lasted until the end of follow-up. Among groups, patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0, 0.9) d vs.0(0, 0.3) d, P<0.05; 0(0, 0.1) d vs. 0(0, 1.0) d, P<0.01]. Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12 [0(0, 1), 0(0, 1), 0(0, 2), all P<0.05]. The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12 (89.6% vs. 85.9% vs.82.1%, H=15.28; 90.9% vs. 84.1% vs. 81.8%, χ2=29.32, all P<0.01). Conclusions:HQ can significantly alleviate symptoms of asthma and rhinitis, severe attack of asthma, and increase the control rate of asthma when used as an additional treatment or used alone.