Objective To understand the extent and relative changes of equities in using the prenatal care services among premature delivery women from 4 counties/cities in Jiangsu and Zhejiang provinces, from 1995 to 2000. Methods The study population consisted of 97 537women who delivered singleton live birth of 28 to 41 gestational weeks in 4 counties/cities of Jiangsu and Zhejiang provinces, from 1995 to 2000. The proportions of women with early prenatal visit, of those with at least five prenatal visits and the hospital delivery rates between premature and term delivery groups were calculated. Inequalities in the above indictors by comparing rate difference ( RD), rate ratio ( RR ) and concentration index ( CI ) among women with different educational levels,were examined. Chi-square and One-way ANOVA were used to compare the differences. Results The proportions of having received early prenatal among those women with premature delivery in different education levels were 82.89%, 91.06%, 93.96%, 93.11% respectively, which were less than that of those with full term delivery (86.36%, 93.95%, 95.65%, 96.41%, P=0.008). The proportions of having received early prenatal among the women with high educational levels were higher (RD=-10.05, RR=0.90, CI=0.0104) than those with low educational attainment (RD=-10.22, RR=0.89, CI=0.0131); The proportions of having received at least five prenatal visits among those women with premature delivery in different education levels were 86.54%, 93.17%, 92.99%, 96.49%,respectively, which were less than those with full term delivery (94.60%, 96.65%, 96.15%, 96.66%,P=0.005). The proportions of having had at least five prenatal visits among the women with high educational attainment were higher (RD=-2.06, RR=0.98, CI=0.0006) than those with lower educational attainment (RD=-9.95, RR=0.90, CI=0.0077); The proportions of hospital delivery among the women with full term delivery in different education levels were significantly higher (99.45%, 99.75%, 99.83%, 99.77% ) than those with premature deliveries (98.42%, 99.54%, 99.61%,100.00%, P=0.005). The proportions of hospital delivery among women with high educational attainment was higher (RD =-0.32, CI= 0.0003 ) than those with lower educational attainment ( RD =-1.58, CI=0.0013). Conclusion Education related inequities in prenatal care utilization had not been improved among the Chinese women under our study. Inequities were seen in those women with full-term delivery the preterm delivery ones.

Objective To report 11 cases with the tissue defects of their upper or lower limbs repaired with the anastomsed medial sural artery perforator flaps.Methods The free medial sural artery perforator flaps,with length of 8 cm to 15 cm and width of 6 cm to 14 cm were used for tissue defect reconstruction of the distal upper or lower limbs in 11 cases,including 6 females and 5 males.The flap was harvested from the ho- mo-lateral calf,confined between the posterior-medial edge of the tibia and the middle line of the calf and a- bove the distal half part of the medial sural muscle,with a same axis of this muscle.Results Ten cases survived very well,which was relatively thin,and the donor site can be acceptable.One case resulted in a complete flap necrotized and covered with a split skin graft.No obvious motor function defect was observed of the donor leg.Conclusion The anastomsed medial sural artery perforator flap is alternative donor flap for the upper or lower limb tissue defect repair,especially for the defect in the hand or foot.

Objective: To chine and express the recombinant human endothelial monocyte-activating polypeptide-Ⅱ(EMAP-Ⅱ)and identify its anti-tumor biological activities.Methods: EMAP-Ⅱ_(147-312)was expressed by the expression vector pMAL-p2x and E.coli BL-21 and the product was purified.The production of tissue factor(TF)in human umbili- cal vein endothelial cell ECV-304 mediated by the recombinant EMAP-Ⅱwas determined by chemiluminescence sub- strate.The promoting effect of recombinant EMAP-Ⅱon TNF?-induced ECV-304 cell.Apoptosis was determined by flow cytometry.Its inhibitory effect on human pancreaic cancer cell SW1990 proliferation was determined by MTT method. Results:DNA sequencing verified that EMAP-Ⅱwas correctly cloned.The molecular mass of the protein identified by SDS-PAGE was consistent with the theoretic value.The productivity of recombinant EMAP-Ⅱwas 500?g per 1 g bacteria (wet mass).The purified product induced expression of tissue factor(TF)in ECV-304 cells;it also enhanced the sensi- tivity of ECV-304 cells to the apoptotic effect of TNF?([16.6?2.5]% vs[25.6?2.3]%,P

In this article,we presented the rationale and calculation procedures of a propensity score weighting method,with its application in epidemiological studies.The rationale for propensity score weighting method is similar to those for traditional standardization methods.Propensity score is used to estimate the weight for each individual.As the propensity score serves the function of observed covariates,the propensity score weighting can balance the distribution of the observed covariates between the comparison groups.There are two weighting methods according to the target standard populations:the Inverse probability of treatment weighting(IPTW)and the Standardized mortality ratio weighting(SMRW).Results of the example show that the distribution of the covariates tended to be consistent after weighting,and the IPTW and SMRW methods showed similar effect estimates.Propensity score weighting method can effectively balance the distribution of the confounding factors between the compared groups in non-randomized controlled trials.

Objective To understand the status of post-term pregnancy and associated social factors among pregnant women in Jiaxing city, from 1993 to 2000. Methods The study population consisted of 16 033 women who had delivered singleton live births in Jiaxing city, Zhejiang province, from 1993 to 2000. Chi-square test was employed to test the difference of proportions between respective groups. Multivariate logistic regression was conducted to examine the factors associated with post-term pregnancy. Results The incidence rates of post-term pregnancy were 8.7%, 10.6%, 9.4%, 7.4%, 4.3%, 2.6%, 3.3% and 4.0% from 1993 to 2000, respectively. Women who received premarital health care serviees had lower (5.6%) post-term incidence than those who did not (7.8%). Women who received county or above level health care services had lower (4.3%) post-term incidence than women who receive township level service (8.5%). Women who had primary school education had higher (11.5%) post-term incidence than women who received junior higher school education (6.8%), senior high school education (3.8%), or college education (2.9%), (P< 0.001). Farmers had higher (9.5%) post-term incidence than workers in the rural areas (8.9%), in urban areas (4.3%) or women with other professions (4.2%). Women whose husbands were rural workers had higher (9.8%) post-term incidence than farmers (9.4%), urban workers (5.0%)or with other professions (3.6%, P<0.001). Data from multivariate logistic regression showed that the risk of post-term pregnancy was associated with the length and the level of using health care services together with schooling and occupation. Conclusion The incidence of post-term pregnancy was decreasing in Jiaxing city during the period from 1993 to 2000 and the risk was associated with the length and level of health care service as well as the level of education and occupation of those women.

0.05)between the two groups.Conclu- sion The long-term outcomes of e-CHB is not markedly different compared with that of e+CHB.

Objective:To express Tumstatin_(183-230)-TRAIL fusion protein and to observe its biological functions.Methods: SOE-ing PCR was employed to amplify the recombinant sequence of Tumstatin_(183-230)and TNF-related apoptosis-inducing ligand (TRAIL_(114-281)).An expression vector pMAL-Tu-T was constructed by inserting Tu-T sequence into pMAL-c_2;the vector was used to transfect E.coli BL21(DE3)and expression of MBP-Tu-T fusion protein was induced by IPTG.Amylose Resin columns were employed to purify the fusion protein.The biological functions of MBP-Tu-T protein was examined by inhibitory test of endothelial cell proliferation,standard tumor cell cytotoxic assay,in vitro tube formation inhibition,and electron microscopic observation(apoptosis).Results:The expression rate of MBP-Tu-T fusion protein in E.coli was about 20%. Purified recombinant protein obviously inhibited endothelial cell proliferation(IC_(50)12.5?g/ml),induced apoptosis of pancreatic cancer cells,and inhibited tube formation.Conclusion:Constructed MBP-Tu-T fusion protein is bifunctional,which lays a solid foundation for further investigation of antitumor effect of Tumstatin_(183-230)-TRAIL in vivo.

trimester. Conclusion Moderate and severe PIH early developed during pregnancy could increase the risk of perinatal mortality, while cesarean delivery could decrease the risks in women with PIH.

Objective To study the current status of spontaneous abortion of primigravid women in Jiaxing areas of Zhejiang province of China. Methods We analyzed the data from both perinatal healthcare surveillance program and spontaneous abortion, collected in Jiaxing areas by the Institute of Reproductive and Child Health, Peking University. The study population consisted of 14 769 primigravid women (excluding induced abortion, ectopic pregnancy and molar pregnancy as outcomes) attempting to become pregnant who registered between 1993 and 1995. Results 1454 spontaneous abortion cases were identified, with the spontaneous abortion rate as 9.8% (95% CI:9.3%-10.3%). The mean gestational weeks at pregnancy diagnosis were 7.6±2.1 weeks, the mean gestational weeks at miscarriage were (10.1±3.1) weeks and the incidence of first-trimester (≤12 weeks) spontaneous abortion was 7.3%(95%CI: 6.8%-7.7%), accounting for 73.7% of all the spontaneous abortion cases. A peak for risk of miscarriage was around 8-13 weeks, accounting for 37.7% of all spontaneous abortion. The observed multiple Cox regression model showed that increased spontaneous abortion rates were observed in women with age at pregnancy ≥30, being peasants and with higher education level. Conclusion The spontaneous abortion rate of primigravid women in Jiaxing areas was higher than in other areas of China. The maximum occurrence of spontaneous abortions was during period of 8-13 gestation weeks.

OBJECTIVEDietary factors that could potentially be related to the risk of birth defects are still unknown in Shanxi province, a region with high prevalence of neural tube defects(NTDs) in China. The main aim of this study was to evaluate the association between NTDs and local dietary factors.

METHODSA population-based case-control study was conducted during 2003-2005 in four selected counties of Shanxi province with 363 NTDs cases ascertained and 523 control babies without any external birth defects.

RESULTSBy multivariate logistic regression analysis, we found the NTDs risk was significantly associated with low consumption of meat and legume, high consumption of pickled vegetables, noncentralized supply of drinking water and drinking tea after adjusting for maternal education level and birth defects history. A significant dose response trend was found between the NTDs risk and the lower frequencies of meat and legume consumption and higher frequency of pickled vegetable consumption, with population attributable risks (PAR) of 69.4%, 22.0% and 18.5%, respectively. Mothers who got their drinking water from river or pond during periconceptional period were more likely to have a NTD-affected pregnancy [OR = 3.42, 95% CI: 1.44-8.09, population attributable risk (PAR) = 4.7%] compared with those who utilized tap or well water. Those who drank tea everyday had an elevated risk of having a NTD-affected pregnancy compared with those who didn't (OR = 4.65, 95% CI: 1.41-15.36, PAR = 2.6%).

CONCLUSIONHigher intake of meat and legume protects a woman from having a NTD-affected pregnancy, and consumption of pickled vegetables, drinking water from river or pond and drinking tea everyday increase the risk of having such a pregnancy in the study population.

Case-Control Studies ; China ; epidemiology ; Diet ; Female ; Humans ; Meat ; Neural Tube Defects ; epidemiology ; Pregnancy ; Risk Factors ; Vegetables ; Water Supply