Objective To evaluate the maternal age at delivery in Beijing and the effect of maternal age on pregnancy outcomes.Methods A retrospective analysis was conducted on 14 970 singleton pregnancies from 15 hospitals in Beijing from June 20th to November 30th in 2013.These hospitals were sorted by the numbers of delivery and chosen as clusters by systemic cluster sampling method.The data of age,diagnosis with gestational diabetes mellitus (GDM) and pre-eclampsia (PE),neonatal birth weight,gestational age at delivery,postpartum hemorrhage and infants admitted to the neonatal ICU (NICU) were collected.The 14 970 women were divided into 5 groups according to their ages at delivery:(1) less than 20 years (n=205),(2)20-＜30 years (n=9 228),(3)30-＜35 years (n=4 365),(4)35-＜40 years (n=1 017),and (5) 40 years and older (n=155).T-test and x2 test were used for between-group comparison,and logistic regression analysis was used to examine the association between age and the risk of adverse pregnancy outcomes.Results (1) The mean maternal age at delivery in 2013 in Beijing was (28±4) years old.Among them,205 (1.4％,205/14 970) delivered under 20 years of age;1 172 (7.8％,1 172/14 970) ≥35 years;and 155 (1.O％,155/14 970) at 40 years and older.(2) The prevalence of diabetes,hypertension,overweight and obesity increased with age,and the incidence of these conditions were 3.4％,4.3％ and 31.4％ in women with advanced age,respectively.(3) Compared with 20-＜30 years group,less than 20 years was associated with significantly lower incidence of GDM [adjust OR (aOR)=0.393,95％ CI:0.222-0.696] and cesarean section rate (aOR=0.549,95％CI:0.391-0.771),and higher incidence of preterm birth (aOR=2.144,95％CI:1.256-3.662).Moreover,30-＜35 years,35-＜40 years and 40 years and older groups all had significantly higher risk of GDM (30-34 years,aOR=1.513,95％CI:1.374-1.666;35-＜40 years,aOR=2.094,95％CI:1.786-2.455;≥40 years,aOR=2.174,95％CI:1.492-3.167),preterm birth (aOR=1.219,95％CI:1.021-1.455;aOR=1.644,95％CI:1.251-2.161;aOR=2.141,95％CI:1.209-3.792),cesarean section (aOR=1.373,95％ CI:1.268-1.486;aOR=2.960,95％ CI:2.550-3.435;aOR=4.332,95％CI:2.920-6.426) and NICU admission rate (aOR=1.236,95％CI:1.059-1.443;aOR=1.337,95％CI:1.018-1.756;aOR=2.389,95％CI:1.385-4.121),when compared to the 20-＜30 years of age group.Higher incidence of PE (aOR=1.292,95％CI:1.007-1.659) and postpartum hemorrhage (aOR=1.224,95％CI:1.048-1.429) were also noted in women of 30-＜35 years,compared to 20-＜30 years group respectively.Conclusion Both advanced maternal age and adolescent pregnancy are associated with increasing risk of adverse pregnancy outcomes.

Objective To compare the diagnostic values of the detection of urine exfoliated cells by FISH and cytology technolo‐gy in bladder urothelial tumor .Methods The combination probes of CSP3/CSP7 and GLPp16/CSP17 were both used in the FISH detection of urine exfoliated cells from suspected patients with bladder urothelial tumor .The urine exfoliated cells were detected by cytology technology at the same time .The sensitivity and the specificity of the two methods were compared .Results The sensitivi‐ty and specificity of FISH for bladder urothelial tumor screening were 92 .5% and 85 .0% respectively ,and those of cytology tech‐nology were 27 .5% and 90 .0% respectively .The sensitivity of FISH was significantly higher than that of cytology technology (P<0 .05) ,however ,the specificity differences between FISH and cytology technology were not statistically significant (P>0 .05) .Conclusion FISH is expected to become a new method for the screening of bladder urothelial tumor .

ObjectiveTo understand the implementation effect and its influencing factors of clinical medical undergraduates' talents cultivation scheme in Xinjiang Medical University. Methods 421 clinical medical students completed questionnaire. The main contents of the survey are general situation, the factors and the implementation effect of the cultivation scheme, and so on. Results①The talents cultivation scheme is reasonable and feasible. ②The main factors which affect talents cultivation scheme of our school are the teaching plan arrangement and practical course arrangement. ③Talents cultivation scheme in the implementation process achieved some success, but the cultivation of humanistic quality should be enhanced, etc. ConclusionRenewed the education conception, optimize the clinical teaching structure, integrated teaching contents, updated teaching methods and means, and strengthened students' humanistic quality are the key factors of the higher medical institutions to cultivate high quality and comprehensive talents.

With the increasingly tense doctor-patient relationship,the practice teaching of laboratory medicine has obviously been affected.For example,the practice teachings systems do not adapt to the updated situations,and practice teaching has been simplified and communication training ignored.In order to deal with these problems and ensure the goals of practice teaching,various measures have been taken in training hospitals.Firstly,the practice system has been further improved and implemented effectively by strengthening mobilization and adopting qualification licensing before practice and interaction practice between teachers and students and regular communication between school and training hospital during practice and strict assessment after practice.Secondly,medical ethics educations and laboratory biological safety have been strengthened.Thirdly,the modem automation and classic morphology should be integrated.Finally,the ability of communication between medical laboratory and doctor and patients should be cultivated,and so on.These measures are to ensure the effect of the practice teaching and cultivate excellent students.

Clear thermoplastic retainer is one of the most commonly used retention devices in orthodontics.However, studies about the electromyography (EMG) of temporalis muscle (TM) and masseter muscle (MM) in people with clear thermoplastic retainer are few. The purpose of this study was to observe the influence of clear thermoplastic retainer on the EMG of TM and MM in mandible posture position (MPP) , speaking [s] ,[z] and [a]. Choose people according to the standards, decide the situation by preliminary experiment. The EMG of TM, MM was studied before and after clear thermoplastic retainer was worn. Variance analysis was used to evaluate the differences. The results revealed that the EMG activity of TM?MM, viewed in MPP and when people said [s] ,[z] , was higher after clear thermoplastic retainer was worn. When people said [a], there was no significant difference.

Objective To learn students' satisfaction with the general education courses, discuss the problems in comprehensive general education courses in local medical colleges , and provide the basis and reference for the medical general education courses reform. Methods Using the stratified random sampling method, self-designed questionnaire to local medical colleges of 575 different professions stu-dents. The questionnaire had the total of 54 topics whose contents were related to the basic situation aware-ness and satisfaction, the demand for general education courses, general education curriculum problems and suggestions. The survey data were analyzed using SPSS 19.0 software and the results were expressed by the relative number(rate and percentage). The differences between different majors and different grade student satisfaction were analyzed by using rank-sum test, showing statistical significance(P<0.05). Results The total satisfaction was not very high, only 219 students(38%) were satisfied with general curriculum;256 students(45%) thought it didn't matter whether to set general education courses;100 students(17%) were not satisfied. In addition, satisfaction with different grades was undifferentiated (P=0.798), but there was a statistical difference among the students of different professions(P=0.007). Conclusion The general education curriculum of medical schools should not blindly pursue being wide and full. Instead, it should be built from three aspects such as core curriculum, flexible teaching methods, teaching methods reform to enhance teaching effectiveness.

Objective To investigate the clinical characteristics (social background,comorbidity,complications and outcomes of pregnancy) of multipara in Beijing area.Methods A systematic cluster sampling survey was conducted on 15 194 pregnant women who gave birth at 15 hospitals in Beijing from January to June in 2013.The age,gestational weeks at delivery,education background,geographical distribution,health insurance coverage,mode of delivery,comorbidity and complications of pregnancy,pregnant outcomes and other relevant clinical data were collected and analyzed with two-sample t test or Chi-square test.Results The proportion of multipara in Beijing area was 21.12％ (3 209/15 194),the per capita number of delivery was 1.23 (18 745/15 194).The ratio of women with higher education background,average monthly household income over 3 000 yuan,urban residence and social insurance in multipara were much lower than those in primipara (all P＜0.05).The mean maternal age of multipara was (30.02±4.88) years,pre-pregnancy body mass index was 22.24 ± 3.48,which were all higher than those of primipara [(27.82 ± 4.03) years and 21.54 ± 3.29,respectively,t=23.440 and 11.115,all P＜0.01].And the gestational weeks at delivery and mean weight gain during pregnancy of multipara was less than that of primipara [(39.15 ±1.67) vs (39.49 ± 1.67) weeks,t=-14.044,P=0.000;(14.66±6.24) vs (15.81 ± 5.86) kg,t=-9.448,P=0.000],while the levels of total cholesterol,triglyceride and low density lipoprotein-cholesterol and the incidence of macrosomia were significantly higher [(5.59± 1.14) vs (5.24± 1.15) mmol/L,(2.31± 1.38) vs (1.96± 1.34) mmol/L,(3.03±0.91) vs (2.82±0.87) mmol/L,t=12.867,15.718 and 10.275,all P＜0.01;9.29％ (298/3 209) vs 7.24％ (868/11 985),x2=14.926,P=0.000].Significantly lower incidences of abnormal amniotic fluid volume,premature rupture of membranes,fetal distress,abnormal labor and vaginal delivery (all P ＜ 0.01),but higher neonatal birth weight [(3 374.38 ±504.57) vs (3 328.39±488.70) g,t=4.839,P=0.000] and cesarean section rate [45.96％ (1 475/3 209) vs 42.49％(5 092/11 985),x2=12.477,P＜0.01] were found in multipara than in primipara.Compared with primipara,multipara had higher incidence of gestational diabetes mellitus,diabetes during pregnancy,pregnancy complicated with cardiovascular problems,hypertensive disorder complicating pregnancy [adjusted OR(95％CI):1.265 (1.135-1.411),1.799 (1.215 2.663),1.567 (1.221-2.347),1.647 (1.300-2.086),all P＜0.01].Conclusions The primipara is the major reproductive population in Beijing area.However,the multipara requires close antenatal care because of their susceptibility to pregnant complications.

Objective To evaluate the prevalence of macrosomia in Beijing in 2013 and identify its risk factors. Methods Retrospective six months analysis of 14 188 full-term singleton pregnant women from 15 hospitals with different levels in Beijing in 2013. Each participant′s demographic data and medical information were collected individually by questionnaires. Multiple logistic regression analysis was used to examine the associations between variables and the risk of macrosomia. Results (1)The total prevalence of macrosomia was 7.069%(1 003/14 188) in Beijing in 2013. (2)The prevalence varied between the 15 hospitals, the lowest was 5.36%(89/1 659), while the highest reached 8.80%(46/523). Furthermore, the incidence of macrosomia was 1.284 times (95%CI: 1.114-1.480, P=0.001) higher in the second graded hospitals than that in the tertiary hospitals. (3) Multiple logistic regression analyses showed that risk factors for macrosomia were maternal height≥160 cm (adjusted OR=1.875, 95%CI: 1.559-2.256), pre-pregnant body mass index (p-BMI) ≥24.0 kg/m2 (24.0-27.9 kg/m2:adjusted OR=1.696, 95%CI: 1.426-2.018; p-BMI≥28.0 kg/m2:adjusted OR=2.393, 95%CI: 1.831-3.127), gestational weight gain (GWG)≥15.9 kg (adjusted OR=2.462, 95%CI: 2.125-2.853), gravidity>1 (adjusted OR=1.408, 95%CI: 1.224-1.620), gestational weeks≥40 (adjusted OR=2.007, 95%CI:1.745-2.308) and gestational diabetes mellitus (adjusted OR=1.522, 95%CI:1.298-1.784). GWG≥15.9 kg, p-BMI≥28.0 kg/m2 and gestational weeks≥40 were three risk factors that had the strongest associations with macrosomia (all P<0.01). Conclusions The prevalence of macrosomia in hospitals with different levels is obvious different. Gestational weeks, p-BMI and GWG are three main controllable risk factors for macrosomia, thus should receive more attentions.

Objective To investigate the prenatal diagnosis and prognosis of fetuses with mild ventriculomegaly in order to provide evidence for clinical consultation and treatment.Methods The data of 116 mothers with fetal ventriculomegaly who received prenatal care in Peking University First Hospital between January 1,2013 and May 31,2015 were retrospectively analyzed.All cases of fetal ventriculomegaly were found by ultrasound screening,and were subsequently diagnosed by ultrasound consultation as mild ventriculomegaly.The results of fetal cerebral MRI and invasive prenatal diagnosis were analyzed and the growth and development of babies were followed up by telephone using the Gesell developmental scale.All data was analyzed by descriptive statistics.Results Of the 88 cases of solitary ventriculomegaly,48 (54.5％) received karyotype analysis or screening,and only one case was found to be abnormal,which was an unbalanced translocation.Of the 83 mothers with normal delivery,only one infant (1.2％) showed retardation of intelligence and motor development.Of the 28 cases of non-solitary ventriculomegaly,17 (60.7％) received karyotype analysis or screening,and no abnormalities were found.Of the 18 mothers with normal delivery,only one infant showed retardation of growth and development,and was found to have brain hypoplasia before delivery by MRI with normal karyotype.Conclusions The rate of abnormal karyotype in mild vetriculomegaly is very low in this study.The width of the lateral ventricles is stable during pregnancy and the prognosis of infants is good.Thus,whether invasive prenatal diagnosis is necessary for all the fetuses with isolated mild ventriculomegaly remains to be confirmed.

Objective To evaluate the video urodynamic abnormalities of women with lower urinary tract symptoms.Methods 38 females with lower urinary tract symptoms underwent video urodynamic test.Filling cystometry was done with 15% urographin saline fluid.A diagnosis was made in each case based on cystometrography finding,voiding pressure flow study,EMG and fluoroscopic appearance.Results Video urodynamic showed abnormalities in 23 cases(60.5%),including sensory urgency in 6,detrusor instability(DI) in 5,pseudodyssynergia(PDS) in 4,PDS+DI in 2,urethral orifice stricture in 2,DI+urgency incontinence in 1,impaired compliance in 1,bladder neck stricture in 1 and urethral diverticulum in 1.Conclusion Video urodynamic is useful not only for understanding the abnormalities of functions and morphology of women with lower urinary tract symptoms,but also for properly diagnosing and treating such cases.