Objective To evaluate the performance characteristics of the second trimester double-marker test for the detection of fetal Down's syndrome in mainland China. Methods This prospective national multi-centered study used alpha-fetoprotein (AFP) and free β-subunit of human chorionic gonadotrophin( free β-hCG)as the serum markers. From May 2004 to September 2006, 11 centers participated in the collection and analysis of maternal serum AFP and free β-hCG between 14 and 20+6 weeks of pregnancy. The screening results were calculated using the standard algorithm based on the standard database provided with the analytic software. Patients with an increased risk of Down's syndrome pregnancy (≥1/270) were offered genetic anmiocentesis. Outcomes of all pregnancies were obtained.Results A total of 66 132 singleton pregnancies were included in the study. The median maternal age was 27 years. At a cut-eft of 1 in 270, the detection rate (DR) based on a Caucasian database was 72% corresponding to a false positive rate (FPR) of 5%, and the DR based on the Chinese database was raised to 76% corresponding to an FPR of 5%. Conclusion The double-marker test using AFP and free β-hCG is an effective screen strategy for second-trimester detection of fetal Down's syndrome in mainland China. Ethnic variance exists between the Caucasian and Chinese populations. The accuracy of screening is increased by the use of race-specific medians.

Objective:To compare and analyze the pricing units and prices of traditional Chinese medicine (TCM) medical services in 4 provinces of the Yangtze River Delta, for reference for the integrated development of TCM medical service project setting and price coordination in the Yangtze River Delta region.Methods:The medical service price project specifications published on the official websites of relevant departments in 4 provinces of the Yangtze River Delta (updated to March 2022) were obtained to extract data such as project names and pricing units. The pricing units and prices of TCM medical service projects in each province were compared and analyzed; The Jevons index method was used to analyze comparable project prices.Results:The numbers of TCM medical service projects in Shanghai, Jiangsu, Zhejiang, and Anhui were 113, 146, 117, and 198, respectively. The types of pricing units were 15, 24, 13, and 12, respectively. There were differences in the setting of pricing units, especially in acupuncture and moxibustion, which had more decomposition projects. The average price of overall medical services in the Yangtze River Delta was 9.81 times that of TCM medical services. There were differences in the prices of comparable TCM medical service projects among the four provinces. Based on Anhui province, the inter provincial Jevons index of other categories of TCM medical service projects except for TCM massage were all less than 1.00.Conclusions:There were significant differences in the pricing units and prices of TCM medical service projects in the four provinces of the Yangtze River Delta, with Anhui province having the most significant difference compared to the other three provinces; The overall price of TCM medical service projects was relatively low.