Objective:To explore the spatial distribution and clustering in birth defects from 2010 to 2013 in Shaanxi Province.Methods:Spatial distribution was used to describe the birth defects,while ordinary Kriging method was used to predict the status of birth defects in Shaanxi province.The spatial characteristics for the birth defects at the county/district level were analyzed by spatial autocorrelation.Results:The overall incidence of birth defects was 219.196/10 000;Birth defect did not appear to be a random distribution but show a significant spatial aggregation.Spatial interpolation predicted the geographic distribution for occurrence of birth defects in Shaanxi Province.Local autocorrelation analysis showed nine hot spot areas for birth defects,such as Qian County,Liquan County,Yongshou County,Bin County,Fufeng County,Jingyang County,Chunhua County,Wugong County and Xingping City,and seven cold spot areas including Jia County,Yuyang District,Mizhi County,Suide County,Wubu County,Qingjian County and Zizhou District.Conclusion:There are spatial clustering in birth defects from 2010 to 2013 in Shaanxi Province.Spatial interpolation and spatial autocorrelation can be used to predict the spatial features of birthdefects in the whole province and provide evidence for the further intervention.

Objective To investigate the effect of folic acid supplementation in childbearing aged women during pregnancy on the birth weight of newborns in Shaanxi province.Methods A questionnaire survey was conducted among the childbearing aged women selected through multistage stratified random sampling in Shaanxi during 2010-2013,all of these childbearing aged women were in pregnancy or had definite pregnancy outcomes.The birth weight of newborns and folic acid supplementation during pregnancy were used as the dependent variables and independent variables respectively in multiple linear regression model and quantile regression model and confounding factors were controlled.Results Multiple linear regression analysis showed that the birth weight of newborns whose mothers had folic acid supplementation during pregnancy were significantly higher than those whose mothers had no folic acid supplementation during pregnancy,an average increase of 29.56 g (B=29.56,t=4.69 and P＜0.01).Quantile regression analysis showed from very low to higher percentiles (q=0-0.55,q=0.65,q=0.75-0.80),the birth weights of newborns whose mothers supplemented folic acid were higher than those whose mother did not supplement folic acid,the difference was significant,but the increase varied.As the increase of the percentiles of birth weight,the body weight increase declined gradually in those whose mothers had folic acid supplementation compared with those whose mothers had no folic acid supplementation.Conclusion Folic acid supplementation during pregnancy can increase the birth weight of newborns,the influence was greater in newborns with lower body weight than in newborns with higher body weight.

Objective To analyze the incidence and influencing factors on fetal macrosomia among single live birth neonates in Xi'an.Methods A questionnaire survey was conducted among women at the childbearing age who were selected through multi stage stratified random sampling in Xi'an during 2010-2013.All the childbearing aged women involved,were in pregnancy or having definite pregnancy outcomes.Results A total of 4 970 women at childbearing age and their infants were investigated.The overall incidence of fetal macrosomia weight among the single live birth neonates under study,was 9.7％ during 2010-2013 (8.9％ in 2010,8.1％ in 2011,10.0％ in 2012 and 10.1％ in 2013,respectively).The incidence rates of fetal macrosomia appeared 10.5％ in the central district and,8.6％ in the rural-urban area of Xi'an.There were statistically significant differences (P＜0.05) seen between the two areas.Results of logistic regression analysis suggested that factors as:having male newborn (OR=1.717,95％ CI:1.402-2.102),drinking during pregnancy (OR=2.174,95％ CI:1.042-4.533),gestational diabetes (OR=1.680,95％CI:1.100-2.568) gestational age≥42 (compared with 37-41,OR=2.565,95％CI:1.306-5.039),being multipara (OR=1.874,95％CI:1.492-2.354)were risk factors for the fetal macrosomia.Conclusion The incidence of fetal macrosomia in Xi'an was higher than the national figures.The incidence of fetal macrosomia was higher in the central district than in rural-urban area.Having male neonate,postmature birth,gestational diabetes,being multipara,drinking during pregnancy were the risk factors related to fetal macrosomia.

Objective To compare the differences in the incidence of adverse pregnancy outcome in different area,and confirm if the incidence of adverse pregnancy outcomes is closely associated with air pollution.Methods A cross-sectional study was conducted in the central urban area and the rural-urban area of Xi'an through a questionnaire survey conducted among the local reproductive women selected through multistage stratified random sampling during 2010-2013,all the reproductive women surveyed were in pregnancy or had definite pregnancy outcomes.Results The annual average of SO2 concentration in the central urban area was 38-54 μg/m3,higher than that in the rural-urban area (29-43 μg/m3).The annual average NO2 concentration in the central urban area was 29-87 μg/m3,higher than that in the rural-urban area (22-42 μg/m3).The incidence of birth defects was higher in the central urban area than in the rural-urban area (2.1％ vs.1.0％),the difference was significant (P＜0.05).After adjusting for confounding factors,logistic regression analysis showed the incidence of birth defects in the central urban area was still significantly higher than that in the rural-urban area,the difference was significant (P＜0.05).Conclusion The incidence of adverse pregnancy was closely associated with the level of air pollution.

Objective To analyze the temperature modification effect on emergency room visits for circulatory and respiratory diseases caused by air pollution,in Beijing,Methods Data on both circulatory and respiratory diseases in 2010 and 2011 were collected,Both meteorological and air pollutants related data were obtained from the National Scientific Data Sharing Platform for Population and Health.By using the stratified time-series models,we analyzed the effects of air pollution on emergency room visits for circulatory and respiratory diseases under different temperature zones,from 2010 to 2011,in Beijing.Results Low temperature (daily average temperature ＜-4.9 ℃) seemed to have obviously enhanced the effect of air pollution index (API) on emergency room visits for circulatory diseases,Under 10 units of API,the relative risks and confidence interval appeared as 1.067 (1.054-1.080).However,high (daily average temperature between 24.4 ℃ and 28.5 ℃) and extra-high temperature (daily average temperature ＞28.5 ℃) could enhance the effect of API on emergency room visits for respiratory diseases,Under 10 units of API,the relative risks and confidence interval were 1.021 (1.015-1.028) and 1.006 (1.003-1.008),respectively.Conclusion Temperature seemed to have modified the association between air pollution and both circulatory and respiratory diseases.

This article introduces American development process of quality-oriented education in colleges and universities which symbolizes practical teaching theory, and analyzes the reason that it is hard for colleges and universities to develop medical talents with strong humanistic quality and innovative ability. This article points out that medical colleges and universities need to make systematic standard and plan for quality-oriented education of practical teaching. The role of teachers is converting from single disseminator of theory knowledge to the instructor, organizer and participant of study. Meanwhile, the information technology should be embedded in practical teaching, which has profound effects on quality-oriented education development of medical students.

Objective To understand the incidence and epidemiological characteristics of adverse pregnancy outcome in Shaanxi province.Methods General information of the study was derived from the prevalence and risk factors of birth defects in Shaanxi province in 2010-2013.Descriptive epidemiological method was used to analyze the data of adverse pregnancy outcome.Results The overall incidence of adverse pregnancy outcome was 25.45％ during 2010-2013 (26.84％ in 2010,26.11％ in 2011,24.96％ in 2012 and 24.80％ in 2013,respectively).Fetal macrosomia and low birth weight accounted for 31.91％ and 23.42％,spontaneous abortion and premature delivery accounted for 18.94％ and 16.65％,while birth defects and embryo death in the palace accounted for 7.38％ and 1.70％,respectively.There were significant differences in distribution of adverse pregnancy outcome among different age groups (P＜0.001) and different years (P＜0.05).Age was positively associated with risk on adverse pregnancy outcomes (P＜0.001).The incidence of adverse pregnancy outcome were high in Liquan (37.49％),Wugong (35.50％) and Qianxian counties (35.13％).Conclusions The overall incidence of adverse pregnancy outcome was 25.45％ in Shaanxi.Fetal macrosomia,low birth weight and spontaneous abortion were the three major types of adverse pregnancy outcome,while age and area were related factors.Targeted strategies should be taken to reduce the incidence of adverse pregnancy outcome in Shaanxi.