Objective:To describe the secular trends of premarital medical examination ( PME ) in China during 1996 and 2013 and to assess the impacts of national health policies on the PME rate. Methods:The information on marriage and PME for districts and counties in 31 provinces of China was annually collected by the Office for National Maternal & Child Health Statistics of China, and the infor-mation on the health policies was from official governmental websites. According to the main health poli-cies, the calendar years were categorized into 3 periods:1996 to 2003 was mandatory PME period;2004 to 2008 was encouraged voluntary PME period; and 2009 to 2013 was free-paid voluntary PME period. Results: During the 18-year period, 284 242 719 people were registered for a marriage in which 107 198 795 were examined, giving the PME rate of 37. 7%. During the mandatory PME period, the rate ranged 52 . 7% -67 . 7% with an average of 60 . 9% ( urban 71 . 5%, and rural 51 . 7%) . In 2004 , the first year when the PME became voluntary, the rate was abruptly dropped to 2. 6%, and thereafter gradually increased to 11 . 5% in 2008 . As the policies of the free-paid voluntary PME were subsequently issued, the rate was quickly increased to 52. 3% (urban 49. 8%, and rural 54. 6%) in 2013. The in-creasing trend was consistently observed both in urban and rural areas, and across East, Middle, West, and Northeast economical regions. However, the rates differed greatly among provinces. In 2013, 5 pro-vinces had rates of >90% ( Guangxi 97 . 5%, Fujian 96 . 0%, Ningxia 95 . 4%, Zhejiang 93 . 4% and Anhui 90. 1%), whereas some provinces were stuck at a low rate, including developed and underdeve-loped provinces/cities. The PME rate in 2013 was 27. 4% for Shanghai, 25. 5% for Guangdong, 12. 4%for Chongqing, 5. 8% for Beijing and 4. 6% for Tianjin. Underdeveloped provinces were Guizhou (6. 4%) and Qinghai (1. 8%). Conclusion:As various national policies to promote voluntary PME were issued, the PME rate was significantly increased after a sharp decline, though it varied greatly by provinces. For provinces with high PME rate, PME-related health benefits need to be evaluated;for provinces with low rate, it is of important practical significance to explore a cost-effective health service model that is likely incorporated with pre-pregnancy examination.

PURPOSE: An older female predominance has been reported among chronic cough patients in Western countries, which is considered to be associated with a higher cough sensitivity in females. However, the characteristics of Chinese chronic cough patients remain unclear. This study aimed to explore the age and sex distribution as well as their relationship with cough reflex sensitivity to capsaicin in Chinese chronic cough patients. METHODS: We analyzed the demographic features of 1,882 consecutive chronic cough patients who attended our cough clinic in Guangzhou, China. Cough sensitivity to capsaicin, which was defined as the lowest concentration of capsaicin causing 5 coughs or more (C5), was measured in 539 of the 1,882 patients and 68 healthy volunteers. RESULTS: The mean age of the patients was 43.0 ± 13.7 years and patients aged <50 years accounted for more than two-thirds of the study population. Around 87% of the patients were never-smokers. The proportion of females (51.5%) was almost equal to that of males (48.5%). The pattern of the age and sex distribution was consistently reflected within most common causes of chronic cough, while a female predominance was shown in patients with cough-variant asthma and patients aged ≥50 years. Female patients had higher cough sensitivity to capsaicin than male patients (log C5: 1.58 ± 0.84 vs. 2.04 ± 0.84 μmol/L, P = 0.001), and patients aged ≥50 years had higher cough sensitivity to capsaicin than patients aged <50 years. CONCLUSIONS: In China, patients with chronic cough have a roughly equal sex distribution and a middle-aged predominance, irrespective of a higher cough sensitivity to capsaicin in females and older patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02591550
Age Distribution ; Asian Continental Ancestry Group ; Asthma ; Capsaicin ; China ; Cough ; Female ; Healthy Volunteers ; Humans ; Male ; Reflex ; Sex Distribution

Objective:To investigate the sleep of infants aged 0 to 5 months and explore its association with feeding patterns.Methods:A cross-sectional survey on infant sleep was conducted from February to August 2019 using "Brief Infant Sleep Questionnaire" posted on a WeChat public account, which mainly included two dimensions of sleep duration and habits. In addition, information on maternal and infant characteristics as well as feeding patterns was also collected. Multiple linear regression and multinomial logistic regression were used to analyze the association between sleep and feeding patterns.Results:This study included 28 444 singleton infants aged 0 to 5 months and their mothers from 31 provincial-level administrative regions in mainland China. The median sleep duration of infants at night and during the day was 9 h and 6 h, respectively. These infants sharing the bed with their parents accounted for 53.5% (15 221/28 444). Of all infants, 46.0% (13 092/28 444) slept on their backs; 84.7% (24 078/28 444) woke up two times or more at night; 58.3% (16 597/28 444) stayed awake 2 h or more at night; 89.7% (25 523/28 444) had a sleep latency of 1 h or more. Falling asleep while being fed was the most common way to fall asleep (40.2%, 11 426/28 444). The numbers of infants who were exclusively breastfed, exclusively formula-fed and mixed-fed were 7 164 (25.2%), 4 097 (14.4%) and 17 183 (60.4%), respectively. Compared with exclusively breastfed infants, exclusively formula-fed infants slept for shorter periods at night (a β=－0.14, 95% CI:－0.22 to－0.06, P<0.05), while mixed-fed infants slept longer (a β=0.08, 95% CI: 0.02-0.13, P<0.05). Exclusively formula-fed infants had less overall sleep time than recommended ( aOR=1.10, 95% CI: 1.00-1.21, P<0.05). Exclusively formula-fed and mixed-fed infants were less likely to sleep in cribs in separate rooms ( aOR=0.50, 95% CI: 0.44-0.56; aOR=0.35, 95% CI: 0.32-0.38; both P<0.05). Exclusively formula-fed infants were less likely to share the bed with their parents ( aOR=0.91, 95% CI: 0.83-0.99, P<0.05), but the likelihood in mixed-fed infants was high ( aOR=1.19, 95% CI: 1.11-1.27, P<0.05). Mixed-fed infants were more likely to sleep on their backs ( aOR=1.12, 95% CI: 1.06-1.18, P<0.05). Exclusively formula-fed infants were more likely to stay awake for four hours or more at night ( aOR=1.12, 95% CI: 1.01-1.25, P<0.05). Conclusions:Exclusively breastfeeding was the best feeding pattern for infant sleep quantity. But much attention should be paid to sleeping habits including sleeping place and sleeping position associated with exclusively breastfeeding to improve infant sleep and feeding.

Objective:To evaluate the nutritional status of vitamin A(VitA)in breast milk and its influencing factors among lactating women in the Weihai,Yueyang,and Baotou of China.Methods:From May to July 2014,403 lactating mothers at(42±7)d postpartum were recruited from three Chinese cities,Weihai in Shandong Province,Yueyang in Hunan Province,and Baotou in Inner Mongolia.Basic information of lactating women and newborns and fish intake information of the lactating women in the last month were collected.The concentration of retinol in breast milk was collected and measured using high-performance liquid chromatography to determine the levels of VitA.According to the breast milk retinol concentration,the nutritional status of breast milk VitA among the lactating women was divi-ded into deficiency(＜1.05 μmol/L)and sufficient(≥1.05 μmol/L).The multivariate quantile regres-sion was used to calculate the adjusted breast milk retinol concentrations.The Kruskal-Wallis H test and the Mann-Whitney U test were used to test the difference of breast milk retinol concentration according to the characteristics of the lactating women.The Logistic regression was used to analyze the effect of char-acteristics of lactating women on breast milk VitA deficiency.Results:The M(P25,P75)of breast milk retinol concentration among the Chinese lactating women was 1.15(0.83,1.49)μmol/L.Multivariate analysis showed that the adjusted breast milk retinol concentration was related to the regions,maternal age,ethnicity,education levels,body mass index(BMI),parity,gestational age,delivery modes,breastfeeding practice,fish intake and birth weight of the infants.The prevalence of VitA deficiency in breast milk among all the lactating women was 41.9％.In Weihai,Yueyang,and Baotou,the preva-lence rates were 34.8％,39.6％,and 51.5％,respectively.Compared with the women in Weihai,the adjusted OR for breast milk VitA deficiency among the women in Baotou was 1.75(95％CI:1.05-2.92).Compared with the women having college and above education,the adjusted OR for breast milk VitA deficiency among those having junior high school and below education were 2.16(95％CI:1.10-4.24).Compared with women with low fish intake,the adjusted OR for breast milk VitA defi-ciency among those with high fish intake were 0.55(95％CI:0.36-0.84).Conclusion:The preva-lence of breast milk VitA deficiency among the Chinese lactating women was 41.9％,suggesting that breast milk VitA deficiency in lactating women and inadequate VitA intake for infants were common in China.The women in Baotou,low educational status and low fish intake increased the risk of breast milk VitA deficiency,suggesting that attention should be paid to the nutritional status of lactating women in underdeveloped regions such as inland region,and education for health should be enhanced and food con-taining VitA such as fish intake should be increased.

Objective:To compare improved microbial assay (IMA) and electrochemiluminescence (ECL) for measuring serum folate, and to investigate the linear or non-linear correlation between the results of the two methods.Methods:This comparative study was conducted in National Health Commission Key Laboratory of Reproductive Health from October 2020 to February 2021, in which the folate concentration of 251 serum samples were measured by IMA and ECL. According to the serum folate concentration, the folate status was divided into sufficient (≥13.5 nmol/L), marginal deficiency (6.8≤serum folate<13.5 nmol/L), and deficiency (<6.8 nmol/L). Pearson correlation analysis and multivariate fractional polynomial (MFP) model were used to evaluate the correlation between the results measured by the two methods. The sensitivity of ECL for detecting folate status were calculated based on the IMA results as the golden standard.Results:The average folate concentrations in serum samples measured by ECL and IMA were (19.8±8.2) nmol/L and (23.0±9.7) nmol/L, respectively ( P<0.001). The Pearson correlation coefficient ( r) of the two methods was 0.894 ( P<0.001), yet the MFP model demonstrated non-linear correlation between the two methods. When the IMA results were≤9.1 nmol/L, the r was 0.070 ( P>0.05); when the IMA results were>9.1 nmol/L, the r was 0.867 ( P<0.001); for non-hemolytic serum samples ( n=221), the r was 0.902 ( P<0.001). Additionally, the sensitivity of ECL detecting folate deficiency was 27.78%, and the sensitivity of ECL detecting folate insufficiency (deficiency and marginal deficiency) was 93.33%. Conclusion:When folate concentrations was>9.1 nmol/L), the results of ECL and IMA were highly correlated; yet the correlation between the two methods was weak at lower folate concentrations, indicating that ECL was not applicable for serum folate measurement among folate insufficiency population.