Objective To investigate the prevalence of macrosomia in China and the risk factors.Methods By stratified cluster random sampling,the medical records of 101 723 singleton term infants born in 37 hospitals nation wide (in 14 provinces) from January 1,2011 to December 31,2011 were reviewed.Adjusted odd ratio (aOR) and 95％ confidence interval (CI) were used to describe the risk factors.Population attribute risk (PAR) was used to quantitatively describe the associations between risk factors and the prevalence of macrosomia.Results The general prevalence of macrosomia was 7.3％ (7403/101 723).The prevalence varied among provinces (4.1％ to 13.4 ％).Logistic regression analysis showed that macrosomia were positively associated with living in northern China (aOR =1.4,95 ％ CI:1.2 ～ 1.6,PAR =19.9 ％),maternal age ≥ 35 (aOR =1.1,95％ CI:0.9～1.3,PAR=8.7％),pre-pregnant BMI≥28 (aOR=3.6,95％ CI:2.9～4.5,PAR=15.1％),gravidity＞1 (aOR=1.2,95％ CI:1.1～1.4,PAR=10.8％),parity＞1 (aOR=1.8,95％ CI:1.5～ 2.1,PAR=10.1％),maternal height≥160 cm (aOR =1.6,95％ CI:1.4～ 1.9,PAR=29.5％),gestational weight gain (GWG) ≥16 kg (aOR=2.2,95％ CI:1.9～2.4,PAR=25.2％),gestational diabetes mellitus (aOR=1.2,95％ CI:1.0～ 1.3,PAR =3.2％),gestational weeks≥40(aOR=2.4,95％ CI:2.1～ 2.7,PAR=34.4％)and baby boy (aOR=l.6,95％ CI:1.4～1.8,PAR=25.4％).Maternal BMI,gestational week and GWG were most strongly associated with macrosomia.Conclusions The prevalence of macrosomia varied dramatically between different areas in China.Pre-pregnancy BMI,gestational week and GWG,as the main modifiable risk factors for macrosomia,need more attention from health care providers.

AIM:To observe the changes of macular thickness in patients after cataract operation.
METHODS: A total of 126 patients ( 133 eyes ) were divided into two groups that were included in this study. The group (68 eyes of 64 case) with phacoemulsification combined intraocular lens implantation and ( 65 eyes of 62 cases ) with manual small incision cataract surgery ( MSICS) . There was no complication before and during the surgery. Optical coherence tomography ( OCT) was examined 1, 3mo before and after surgery. The visual acuity and macular thickness were compared after surgery. The SPSS 17. 0 software was used for statistical analysis. The paired t-test was used before and after surgery. Independent-samples t test was used in two groups before and after surgery,α=0. 05.
RESULTS: The cataract phacoemulsification group:preoperative and 1mo after surgery, the mean macular thickness was 241. 3±10. 9μm and 279. 7±16. 5μm, with significant difference ( P < 0. 01 ). The mean macular thickness was 245. 6±12. 6μm 3mo after surgery without statistical difference compared with preoperative ( P>0-05). The mean macular thickness was 279. 7±16. 5μm 1mo after surgery and 245. 6±12. 6μm 3mo after surgery with statistical difference(P<0. 05). Three eyes displayed cystoid macular edema at 1mo after surgery and 2 eyes of them was resolved 3mo after surgery. The group of MSICS: preoperative and 1mo after surgery, the mean macular thickness was 240-5±11. 9μm and 280. 7±16. 8μm, with significant difference (P<0. 01). The mean macular thickness was 246. 6±13. 2μm 3mo after surgery without statistical difference compared with preoperative ( P >0-05). One month after surgery and 3mo after surgery, the mean macular thickness were 280. 7±16. 8μm and 246-6±13. 2μm, with statistical difference (P<0. 05). Two eyes displayed cystoid macular edema at 1mo after surgery and 2 eyes were resolved 3mo after surgery. Between the two groups pre-operation or after operation for 1, 3mo respectively P values were without statistical difference (P>0. 05).
CONCLUSION: The macular thickness and macular edema can be found 1mo after cataract phacoemulsification and MSICS. Three months post-operatively, macular edema disappears and does not show statistical difference compared with preoperative. The increase of macular thickness has no obvious relationship with the choice of surgery.

PURPOSETo evaluate the performance of a prehospital trauma diversion system in Hong Kong, China.

METHODSA retrospective analysis of prospectively collected data in the trauma registry of Queen Mary Hospital, Hong Kong from 1 January 2009 to 31 December 2013 was done. All adult patients aged 18 years or above, either primarily or secondarily diverted to Queen Mary Hospital according to the trauma patient diversion protocol, were recruited. Need for trauma center level of care was based on a consensus-based criterion standard published in 2014. Performance of the protocol in terms of over- diversion and under-diversion was determined.

RESULTSA total of 209 patients were included for analysis. About 30% of the patients required trauma center level of care. The most common reason was the need for vascular, neurologic, abdominal, thoracic, pelvic, spine or limb-conserving surgery within 24 h of presentation. The over-diversion rate and under- diversion rate were 69.6% and 19.7% respectively.

CONCLUSIONThe trauma patient diversion protocol currently in use in Hong Kong is not accurate enough. Further revision and refinement is needed.

Adult ; Aged ; Aged, 80 and over ; Emergency Medical Services ; Female ; Hong Kong ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Trauma Centers

Objective To evaluate the maternal and fetal outcomes of planned delay in treatment for cervical microinvasive squamous cancer during pregnancy.Methods A prospective study of pregnant women was done from August 1,2007 to May 31,2010.Pregnant women who had not been carried out cervical cytological screening within one year were got thin-prep cytology test (TCT) screening at their initial prenatal visit.Patients with abnormal cytological results were performed colposcopic examination and directed biopsy.Women with cervical microinvasive cancer were followed up every 8 to 12 weeks.If lesion progression were suspected,compared with previous image,repeated biopsy directed by colposcopy should be performed.Once worsening invasive cancer was confirmed,the pregnancy should be terminated timely.All patients should be reevaluated 6 to 12 weeks postpartum with repeated colposcopic examination and biopsy.All mothers were performed cold knife conization (CKC) at 6 to 12 weeks postpartum.Results We totally diagnosed 17 cases cervical microinvasive squamous carcinoma during pregnancy.The positive rate is 6.2/10 000 (17/27 230).After informed consent,15 pregnant women decided to delay treatment until fetal maturation.The mean gestational age of initial diagnosis was (19.3 ± 5.9) weeks.The women were followed up 2 to 4 times during pregnancy.Only 1 patient was verified lesion progression by directed biopsy at 34 weeks and delivered by cesarean section.The progression rate during pregnancy was 1/15.The mean delivered time was (37.1 ± 1.8) weeks (ranged from 34 to 40 weeks).The mean diagnosis-to-delivery interval was (18.4 ± 5.2) weeks.All patients were delivered by cesarean section and all newborns had good outcomes.Finally we confirmed 1 case with cervical cancer stage Ⅰ a2,11 cases with stage Ⅰ al,3 cases with cervical intraepithelial neoplasia (CIN) Ⅲ by pathological diagnosis after CKC during 6 to 12 weeks postpartum.All cases were disease free after follow-up ranged from 22 to 48 months.Conclusions It is necessary to perform TCT screening for pregnant women who have not been carried out cervical cytology screening within 1 year.If cervical microinvasive squamous cancer were suspected during pregnancy,in order to achieve fetal maturity it is acceptable for the women who desired pregnancy to delay treatment under closely monitoring until postpartum.

Objective To investigate the value and safety of biopsy guided by colposcopy in diagnosis of cervical diseases in pregnant women.Methods From Aug.2007 to Feb.2009.17 828 pregnant women who receive antenatal examination underwent cervical cytological screening thinprep cytology test(TCT)in Beijing Obstetrics and Gynecology Hospital.If abnormal cytological results were found,those preguant women were administered by eolposcopic examination and biopsy after they signed informed consent.Results (1)TCT:the abnormal TCT results of 1502 preguant women(8.425%,1502/17 828) were found in 17 828 cases.(2)Colposeopie examination:two hundred and four pregnant women underwent colposcopic examination.The rate of satisfied colposcopic imaging wag 92.6%(189/204),colposcopic examination identified 125 cages with cervical inflammation or cervical intraepithelial neoplasia (CIN)Ⅰ,25 cases with CIN Ⅱ and 54 cases with CIN Ⅲ or microinvasive squamous carcinoma (MIVC) of squamous cervical carcinoma(SCC).(3)The results of biopsy guided by colposcopy:among 204 cases,it was found 33 cases with cervical inflammation or wart,95 cases with CIN Ⅰ,28 CIN Ⅱ,36 cases with CIN Ⅲ and 12 cases with MIVC. (4) The rate of concordance: compared with biopsy pathologic examination, colposcopy examination found 113 cases with cervical inflammation and CIN Ⅰ , the rate of concordance was 90. 4%(113/125). And 54 cases with CIN Ⅲ or SCC diagnosed by colposcopy examination, however biopsy pathologic examination confirm 23 cases with CIN % and 10 cases with SCC at stage Ⅰ a, the concordance rate was 61% (33/54). (5) Complication: eight (3.9%, 8/204) pregnant women underwent cervical wound suturing due to continuous bleeding after colposcopy exam or biopsy. No other complications were recorded. Conclusions It is necessary that TCT should be performed in pregnant women without cytological screening within one year. Colposcopic examination and biopsy were indicated if pregnant woman with abnormal cytological result were found. Pregnant women with cervicitis or CIN Ⅰ diagnosed by colposcopy should be followed up. If pregnant woman was suspected with CIN Ⅱ or advanced disease, biopsy guided by colposcopy should be performed.

OBJECTIVETo investigate the occupational exposure levels of dust in new suspension preheated dry process (NSP) cement production line and put forward rectification measures for dust-exposed posts, and to provide ideas for the modern cement production enterprises in dust control and occupational health management.

METHODSOccupational health field investigation combined with field test were used to measure the time-weighted average concentration (C(TWA)) of the dust in the workplace. Rectification measures were taken for the dust-exposed posts with unqualified dust concentration, and the protective effects of dustproof facilities in the rectified workplace were evaluated.

RESULTSThe field investigation revealed incompletely closed dustproof facilities, improperly set dust hoods, excess of dust leakage points, and other problems in the dust-exposed posts of an NSP cement production line before rectification, and the dustproof facilities could hardly exert dust removal effect. The field test showed that the vast majority of dust-exposed posts had the dust concentrations exceeding the occupational exposure limits (OELs), with a qualified rate as low as 31.8%. A series of rectification measures were taken for these posts. After the rectification, the dust-exposed posts demonstrated dramatically dropped C(TWA), and the qualified rate of dust concentration in the dust-exposed posts rose to 90.9%.

CONCLUSIONThe dust hazards in NSP cement production line cannot be ignored. Taking appropriate protective measures are critical for curbing dust hazards in modern cement production.

Air Pollutants, Occupational ; analysis ; Construction Materials ; Dust ; analysis ; Humans ; Occupational Exposure ; analysis ; prevention & control ; Workplace

Abstract: Objective　To analyze the influencing factors of mother-to-child transmission of hepatitis B virus after combined immunological blockade, and to evaluate the effect of mother-to-child blockade, and to provide a basis for health policies and health interventions for preventing mother-to-child blockade of hepatitis B virus. Methods A total of 11 363 pairs of HBsAg positive pregnant women and their infants aged 7-12 months in Hainan Province from 2015 to 2020 were included in the study. The general situation, the situation of health care and delivery in this pregnancy and perinatal period, the detection of hepatitis B markers, the situation of antiviral therapy, the general situation of mother and infant during delivery and the implementation of blockade measures for mother-to-child transmission of hepatitis B were collected and analyzed. Results Among the 11 363 pairs of HBsAg positive pregnant women and their infants delivered in hospitals in Hainan province from 2015 to 2020, the positive rate of HBsAg in children at 7-12 months after birth was 1.47 %, and the difference in HBsAg positive rate of infants born in different years was not statistically significant (P>0.05). There were no significant differences in the positive rate of HBsAg among children born to pregnant women with different nationalities, educational levels, occupations, delivery modes, delivery places, obstetric operations and perineal laceration, abnormal perinatal period, children with different genders and premature delivery and perinatal (all P<0.05). There was significant difference in HBsAg positive rate among infants born to pregnant women of different ages, the positive rate of HBsAg of infants born to young pregnant women was higher than that of older pregnant women (P<0.05). The rate of antiviral therapy was low in HBeAg positive pregnant women, and the positive rate of HBsAg in their infants was 2.54%, which was higher than 0.83% in HBeAg negative pregnant women (P<0.05). Conclusions Combined immunological blockade with hepatitis B vaccine and hepatitis B immunoglobulin can effectively prevent the mother-to-child transmission of HBV. HBsAg-positive women can give birth at the right age, and HBeAg-positive pregnant women can be treated with antiviral therapy to block mother-to-child transmission, providing the important basis for the formulation of hepatitis B prevention and control strategies and measures.

OBJECTIVETo investigate the effect of moxibustion at Sanyinjiao (SP 6) for uterine contraction pain in labor, and evaluate the safety of the parturient and newborn.

METHODSOne hundred and seventy-four cases of singleton pregnancy and cephalic presentation primipara were single blinded and randomly divided into three groups: observation group (59 cases), placebo treated group (57 cases) and blank group (58 cases). The observation group was treated with moxibustion at Sanyinjiao (SP 6) for 30 min when the uterus cervix openning at 3 cm, the placebo treated group was treated with moxibustion at no acupoint for 30 min and the blank group was treated with routine labor nursing, the uterine contraction pain and the safety of the mother and infant were compared among three groups.

RESULTS1) The uterine contraction pain was tested by Visual Analogue Scale (VAS): the scores of VAS in the observation group were obviously decreased after 15 min and 30 min of moxibustion (both P<0.05), there were no obvious changes of the VAS scores in placebo treated group and the blank group, the scores of VAS in observation group decreased much more obviously than those in the other two groups (all P<0.05); 2) Midwife rating of the uterine contraction pain: after 30 min of moxibustion, the effective rate of labor analgesia was 69.5% (41/59) in observation group, which was higher than that of 45.6% (26/57) in placebo treated group and 43.1% (25/58) in blank group, with significant differences between them (both P<0.05); 3) The postpartum hemorrhage amount of the observation group was obviously lower than those of placebo treated group and blank group (both P<0.05); 4) The Apgar score of newborn was higher in observation group and placebo treated group than that of blank group (both P<0.05).

CONCLUSIONMoxibustion at Sanyinjiao (SP 6) can relieve the uterine contraction pain, and has no side effect to mother and infant, it is one of the safe, effective and simple non-drug analgesia methods.

Acupuncture Points ; Adult ; Female ; Humans ; Labor Pain ; physiopathology ; therapy ; Labor, Obstetric ; Moxibustion ; Pregnancy ; Treatment Outcome ; Uterine Contraction ; Young Adult

OBJECTIVETo study the relationship between aldehyde dehydrogenase (ALDH) gene polymorphism and alcoholic liver disease, and investigate the genetic pathogenesis of alcoholic liver disease (ALD).

METHODSPCR, restriction endonuclease and electrophoresis were used, to detect the genotypes and alleles frequencies of ALDH gene in patients in the control group, alcohol dependent group and ALD group, and each group contained 20 patients.

RESULTSThe frequencies of ALDH2*1 and ALDH2*2 allele had statistic significance between control group and ALD group (x2=4.80, P<0.05), and no statistic significance between control group and alcohol dependent group. ALDH2*1/*1 was predominant in alcohol dependent group and ALD group, while ALDH2*2/*2 was not detected.

CONCLUSIONSThe gene polymorphism of ALDH is close to ALD. The allele of ALDH2*2 may be a negative risk factor for the developing of ALD

Adult ; Aldehyde Dehydrogenase ; genetics ; Alleles ; Gene Frequency ; Humans ; Liver Diseases, Alcoholic ; genetics ; Male ; Polymorphism, Genetic ; Risk Factors

Objective:To analyze the risk factors for the occurrence of intradialytic hypotension (IDH) in elderly maintenance hemodialysis (MHD) patients based on longitudinal multidimensional data.Methods:This was a single-center, retrospective observational study. Data of MHD patients were retrospectively analyzed from April 3, 2017 to December 31, 2021 in the blood purification center of National Clinical Research Center for Kidney Diseases, General Hospital of Eastern Theater Command. IDH defined by the Kidney Disease Outcomes Quality Initiative was used as outcome indicator. Generalized estimating equations were used for univariate and multivariate regression analysis. The importance of each factor on the occurrence of IDH was evaluated by chi-square statistic minus degrees of freedom, and sensitivity analysis was performed by 5-fold interpolation of missing data.Results:A total of 156 elderly patients were enrolled, 91(58.3%) of whom were male, and 2 681 dialysis data recordings were included. The incidence of IDH from 2017 to 2021 fluctuated from 8.3% to 13.2%, with an average incidence of 11.0% by 2021. The results of multivariate regression showed pre-dialysis systolic pressure of 140-159 mmHg (1 mmHg=0.133 kPa, 90-139 mmHg as reference: OR=0.482, 95% CI 0.273-0.851, P=0.012), pre-dialysis diastolic pressure ≥ 90 mmHg (60-89 mmHg as reference, 90-99 mmHg: OR=4.081, 95% CI 2.132-7.809, P < 0.001; ≥ 100 mmHg: OR=8.547, 95% CI 3.233-22.597, P < 0.001), albumin (34-48 as reference, < 34 g/L: OR=2.677, 95% CI 1.592-4.502, P < 0.001; > 48 g/L: OR=2.692, 95% CI 1.102-6.577, P=0.030), C-reactive protein ≥ 8 mg/L (< 8 mg/L as reference: OR=1.787, 95% CI 1.216-2.628, P=0.003), hemodiafiltration as the dialysis mode (hemodialysis as the reference: OR=2.256, 95% CI 1.395-3.648, P=0.001), actual ultrafiltration volume/dry body mass (per 1% increase, OR=1.539, 95% CI 1.139-2.080, P=0.005), and ultrafiltration rate (per 100 ml/h increase, OR=1.641, 95% CI 1.389-1.939, P < 0.001) were independently associated with the occurrence of IDH. Contribution analysis showed that the top three factors related to IDH were ultrafiltration rate ( χ 2- df=32.798), pre-dialysis diastolic pressure ( χ 2- df=20.757) and albumin ( χ 2- df=19.971). The sensitivity analysis showed that the regression results were robust. Conclusions:The risk factors of IDH in elderly MHD patients are increasing ultrafiltration rate, higher pre-dialysis diastolic pressure(≥ 90 mmHg), lower albumin (< 34 g/L), HDF, higher c-reactive protein(≥ 8 mg/L) and increasing actual ultrafiltration volume/dry body mass. Higher pre-dialysis systolic pressure (140-159 mmHg) is a protective factor.