Objective To understand the overall development of county-level Maternal and Child Healthcare(MCH)institutions in China in 2023,and to provide a basis for strengthening the standardisation and normative management of county-level MCH institutions in China.Methods Data from the National Monitoring Information System for MCH institutions were used to conduct descriptive analyses of the establishment of all county-level MCH institutions in China,the provision of outpatient and inpatient services,and statistical analyses of the rate of compliance with the construction of county-level MCH institutions throughout the country in accordance with the relevant standards.Results In 2023,there were 2 830 county-level administrative districts nationwide,with 2 683 county-level MCH institutions actually established,an establishment rate of 94.8%.The proportion of county-level MCH institutions that provide outpatient and inpatient services is 90.1%and 60.5%respectively,and the construction rate that meets the standards is 56.4%.Among them,the construction rate of county-level MCH institutions with a population of≥300 000 was 60.5%,with the highest rate(72.3%)in the western region and the lowest rate(26.3%)in the northeastern region.The construction rate of county-level MCH institutions for counties with populations of＜300 000 was 49.7%,with the highest rate in the eastern region(61.7%)and the lowest in the northeastern region(23.6%).Conclusion The overall development of MCH institutions at the county level in China is uneven,and the construction of institutions to meet the standards is unsatisfactory,especially in counties and districts with a population of＜300 000,where the construction and development of MCH institutions need to be continuously strengthened.

Objective To understand the overall development of county-level Maternal and Child Healthcare(MCH)institutions in China in 2023,and to provide a basis for strengthening the standardisation and normative management of county-level MCH institutions in China.Methods Data from the National Monitoring Information System for MCH institutions were used to conduct descriptive analyses of the establishment of all county-level MCH institutions in China,the provision of outpatient and inpatient services,and statistical analyses of the rate of compliance with the construction of county-level MCH institutions throughout the country in accordance with the relevant standards.Results In 2023,there were 2 830 county-level administrative districts nationwide,with 2 683 county-level MCH institutions actually established,an establishment rate of 94.8%.The proportion of county-level MCH institutions that provide outpatient and inpatient services is 90.1%and 60.5%respectively,and the construction rate that meets the standards is 56.4%.Among them,the construction rate of county-level MCH institutions with a population of≥300 000 was 60.5%,with the highest rate(72.3%)in the western region and the lowest rate(26.3%)in the northeastern region.The construction rate of county-level MCH institutions for counties with populations of＜300 000 was 49.7%,with the highest rate in the eastern region(61.7%)and the lowest in the northeastern region(23.6%).Conclusion The overall development of MCH institutions at the county level in China is uneven,and the construction of institutions to meet the standards is unsatisfactory,especially in counties and districts with a population of＜300 000,where the construction and development of MCH institutions need to be continuously strengthened.

Objective: To explore the influencing factors of role adaptation of college freshmen, so as to provide empirical support for developing adaptive education in college. Methods: A cluster sampling method was used to select 3 126 freshmen from six universities of Hefei City and Wuhu City in Anhui Province in October 2022, who were investigated with Positive Psychological Capital Questionnaire (PPQ), Freshmen s Role Adaptability Scale, Connor Davidson Resilience Scale (CD-RISC) and Life Satisfaction Scale. Independent sample t-test and oneway ANOVA were used to compare the scores (caverage score of items) of various variables of college freshmen with different demographic characteristics. Pearson correlation analysis and multiple linear regression analysis were conducted to analyze the correlation. Results: There were statistically significant differences in scores of psychological capital, resilience, life satisfaction and role adaptation among college freshmen of different origin (large and mediumsized cities: ３.６３± ０.５４，３.７３±０.６４，３.４７±０.８０，３.１４±０.６５；county level city or county seat:３.５７±０.５２，３.６１±０.６３，３.３５±０.７５，３.０９±０.６３；villages and towns:３.５０±０.５０，３.５４±０.５８，３.２３±０.７５，３.０６±０.６０), whether in class committee (yes:３.６３±０.５２，３.６９±０.６０，３.４０± ０.７６ ，３.１８±０.５９； no:３.４３±０.５０，３.４８±０.６４，３.２５±０.７７，２.９３±０.６５), father s education level (junior high school or below:３.５２± ０.５１ ，３.５７±０.６１，３.２７±０.７５，３.０７±０.６１； senior high school or technical secondary school:３.６２±０.５３，３.６８±０.６３，３.４４±０.７８，３.１２±０.６３；junior college or above:３.６８±０.５６，３.７８±０.６４，３.５７±０.８０，３.１９±０.６８)，mother s education level(junior high school or below:３.５３±０.５１，３.５８±０.６１，３.２８±０.７５，３.０６±０.６０；senior high school or technical secondary school:３.６３±０.５５，３.７０±０.６３，３.４８±０.７８，３.１５±０.６６；junior college or above:３.７２±０.５４，３.８６±０.６５，３.６２±０.８３，３.２７±０.７０) ( F / t =11.89,21.89,23.02,3.83；10.08，9.20， 5.20 ，10.63；19.34，20.76，29.52，6.44；22.51，26.79，30.94，13.92， P <0.05). The differences of scores in resilience and role adaptation of different genders (boys:3.66±0.64, 3.12±0.65; girls:3.56±0.59, 3.05±0.58) and in life satisfaction whether being an only child (yes:3.40±0.79; no:3.33±0.76) among college freshmen were statistically significant ( t =4.51, 2.75, 2.35, P <0.05). Pearson correlation analysis showed that psychological capital, resilience and life satisfaction of college freshmen were positively correlated with role adaptation ( r =0.49, 0.49, 0.36), while psychological capital, resilience and role adaptation were positively correlated ( r =0.60, 0.59) and Psychological capital was positively correlated with resistance ( r =0.81)( P <0.01). The results of multiple linear regression analysis showed that gender, whether in class committee, psychological capital, resilience and life satisfaction were positively associated with role adaptation among college freshmen ( R 2=0.28, β =0.04, 0.10, 0.23, 0.26, 0.07， P <0.05). Conclusions Role adaptation of college freshmen is related with psychological capital, resilience and life satisfaction. Schools should strengthen mental health education to promote smooth role transition for college freshmen.

Objective To analyse the health human resource allocation of all tertiary maternal and child healthcare(MCH)hospitals from 2015 to 2022 in China,and to propose basis for further strengthening the talent team construction and management of MCH hospitals.Methods Data were collected through the national MCH institution monitoring system to provide a descriptive analysis of the health human resources of all tertiary MCH hospitals in China.Results From 2015 to 2022,the number of health technicians in tertiary MCH hospitals increased with an average annual growth rate of 10.2%;The proportions of highly educated and professional health technicians increased year by year;The proportion of tertiary MCH hospitals with qualified health technicians has increased to 93.8%;The ratio of doctors to nurses has exceeded 1:1.4.Conclusion The allocation of health human resources in the tertiary MCH hospitals in China shows a good upward trend,which lays a foundation for improving the overall service level and service capacity of MHC hospitals.

Objective:To acquire the impact of COVID-19 pandemic on the operation of tertiary maternal and child health(MCH) hospitals in China, for decision making support of health administrative departments and hospital managers.Methods:The National Maternal and Child Health Institutions Resources and Operations Survey Direct Reporting System was used to collect the resource allocation, workload, treatment quality, work efficiency and asset operation of the tertiary MCH hospitals in China in 2019(pre pandemic) and 2020(during pandemic). Statistical descriptions were made using median.Results:In 2019 and 2020, the number of tertiary MCH hospitals in China was 236 and 258, respectively, and their relevant data were analyzed. In terms of resource allocation, the number of health technicians in 2019 and 2020 was 560 and 548, respectively, and the actual number of available beds was 308 and 305 respectively. In terms of workload, the annual outpatient visits in 2020 were 337 990, a decrease of 23.6%from that in 2019; The total number of emergency visits was 28 997, a decrease of 32.5%; The total number of discharged patients was 13 673, a decrease by 20.5%; A total of 4 723 training sessions on MCH were held for primary institutions, an increase of 1.2 percent. A total of 1 953 724 primary-level health technicians were trained, an increase of 175.2 percent. In terms of work efficiency, the average length of hospital stay of discharged patients decreased from 5.56 days in 2019 to 5.00 days in 2020. Bed utilization rate decreased from 88.90% to 69.15%; Bed turnover decreased from 53.69 to 44.22. In terms of treatment quality, the critical illness mortality rate of inpatients was 0.37% in 2020, 0.11% lower than that in 2019. The in-hospital mortality rate for neonatal patients was 0.04%, a 0.03% drop. In terms of asset operation, the total revenue in 2020 was 248.355 million yuan, an increase of 4.46% compared with 2019, in which the proportion of financial subsidies increased from 11.26% to 15.72%.Conclusions:The in-hospital services and institutional health care services of tertiary MCH hospitals in China were downsized by the COVID-19 pandemic, while the work efficiency was relatively stable, along with acceptable resource allocation, good treatment quality and asset operation.

Objective:To analyze the status of secondary maternal and child health hospital accreditation in China and the impact of such accreditation on their service improvement.Methods:The paper used the propensity score matching method to match the accreditation group and the non-accreditation group in 1∶1 ratio, and compared the related indicators of service capability of maternal and child health hospitals between the two groups by non-parametric test and Chi-square test.Results:A total of 842 maternal and child health care hospitals were matched. A comparison was made between the accreditation group and the non-accreditation group, and the differences of the following indicators of individual services within the hospital were statistically significant( P<0.01). These indicators were annual emergency attendance, the number of types of health services for women and children, the utilization rate of beds, the average daily hospital bed of each practicing physician; the following indicators of service management within their coverage were statistically significant: namely the proportion of institutions carrying out health education evaluation within their coverage, that of institutions producing uniform " Mother and Child Health Handbook", that of institutions carrying out information quality control, as well as analysis and utilization.These indicators of the accreditation group were higher than those in the non-accreditation group( P<0.01). Conclusions:Given the role played by maternal and child health institution accreditation in promoting secondary maternal and child health hospital regarding better service content, quantity, efficiency and the quality of business management within their coverage, there is still room for improvement.

Objective: To acquire the main result quality indicators status of tertiary maternal and child health(MCH) hospitals in China, supporting the decision making. Methods: The National Maternal and Child Health Institutions Resources and Operations Survey Direct Reporting System was used to collect the management operation, inpatient death, re-return, hospital-acquired infection, surgical complications and patient safety of these hospitals in China in 2017. Statistical descriptions were made using average, rate and composition comparison data. Results: The proportion of health technicians of tertiary MCH hospitals in China was 83.66%, the average hospitalization days were 5.96 days, with bed occupancy rate of 90.01%. The success rate of neonatal resuscitation was high. Meanwhile, the mortality rate of hospitalized maternal critical illness, the total hospitalization mortality rate of neonatal patients, the incidence of complications in surgical patients, the incidence of neonatal injury and the incidence of birth injury in vaginal delivery were higher in the institutions that had not participated in the MCH hospital accreditation. Conclusions The management of tertiary MCH hospitals in China was in good condition, and the relevant policies and projects have achieved remarkable results. Compared with general hospitals, hospital infection and re-return indicators were good. The quality and safety of tertiary MCH hospitals which have not participated in the MCH hospital assessment were poor. It is recommended to carry out MCH hospital accreditation to improve quality and safety.

Limonene (C₁₀H₁₆) and bisabolene (C₁₅H₂₄) are both naturally occurring terpenes in plants. Depending on the number of C₅ units, limonene and bisabolene are recognized as representative monoterpenes and sesquiterpenes, respectively. Limonene and bisabolene are important pharmaceutical and nutraceutical products used in the prevention and treatment of cancer and many other diseases. In addition, they can be used as starting materials to produce a range of commercially valuable products, such as pharmaceuticals, nutraceuticals, cosmetics, and biofuels. The low abundance or yield of limonene and bisabolene in plants renders their isolation from plant sources non-economically viable. Isolation of limonene and bisabolene from plants also suffers from low efficiency and often requires harsh reaction conditions, prolonged reaction times, and expensive equipment cost. Recently, the rapid developments in metabolic engineering of microbes provide a promising alternative route for producing these plant natural products. Therefore, producing limonene and bisabolene by engineering microbial cells into microbial factories is becoming an attractive alternative approach that can overcome the bottlenecks, making it more sustainable, environmentally friendly and economically competitive. Here, we reviewed the status of metabolic engineering of microbes that produce limonene and bisabolene including microbial hosts, key enzymes, metabolic pathways and engineering of limonene/bisabolene biosynthesis. Furthermore, key challenges and future perspectives were discussed.

Objective To determine the utility of musculoskeletal ultrasound imaging to support physical findings in different stages of recovery and in recommending treatment regimens.Methods Forty-three hemiplegic stroke survivors with shoulder pain were enrolled.Physical examinations were performed 3 and 6 months after the stroke using a visual analogue scale (VAS),a modified Ashworth scale,measurements of passive range of motion and Brunnstrom staging.This was coupled with sonography of the long head of the biceps,the subscapularis tendon,the supraspinatus tendon,the infraspinatus tendon,the acromioclavicular joint and the subacromial-subdeltoid bursa.Results Three months after the stroke the average VAS score correlated negatively with the average Brunnstrom stage of the shoulders (r=-0.39,P≤0.01),with the range of passive abduction (r=-0.56,P≤ 0.01),the range of passive external rotation (r=-0.36,P≤ 0.02),and the range of passive flexion (r=-0.37,P≤ 0.02).It was positively correlated with abnormal sonographic findings of the long head tendon of the biceps (r=0.32,P≤ 0.04),the subscapularis tendons (r=0.31,P≤0.04) and the supraspinatus tendons (r=0.53,P≤0.01).However,3 months later the VAS results were negatively correlated with Brunnstrom stage (r=-0.45,P ≤ 0.01),range of passive shoulder abduction (r=-0.60,P≤0.01),range of passive external rotation (r=-0.41,P≤0.01),and passive range of flexion (r=-0.52,P≤ 0.01),but positively correlated with spasticity (r=0.34,P≤ 0.03),biceps tendinopathy (r=0.45,P≤0.01),subscapularis tendinopathy (r=0.33,P≤ 0.03) and supraspinatus tendinopathy (r=0.56,P≤ 0.01).Rotator cuff injury was significantly more severe 6 months after stroke than at 3 months.The incidence of pain in the hemiplegic shoulder and abnormal sonographic findings of the biceps tendon and subscapularis tendon were significantly higher at 6 months than at 3 months after the stroke.Supraspinatus tendon problems were notable both at 3 and 6 months.Conclusions Pain in a hemiplegic shoulder is positively correlated with abnormal sonographic findings but negatively correlated with Brunnstrom stages and passive range of motion 3 and 6 months after stroke.Six months after stroke,pain is positively correlated with muscle tone.The tendon at the long head of the biceps and the rotator cuff are vulnerable to injury,especially at 6 months after stroke.

Objective: To estimate the prevalence of anxiety and depression symptoms during pregnancy among women from six districts of China and to explore the determinants of anxiety and depression during pregnancy. Methods: A cross-sectional study of maternal health status was conducted using the probability proportionate to size sampling method among pregnant women from six counties/districts in six provinces of China (Hebei, Liaoning, Fujian, Hunan, Sichuan and Yunnan). A questionnaire was completed by each of the women included in the study from August to December 2014. Women were recruited from three medical and health institutions with the most obstetrics patients in each district. A total of 4 210 pregnant women were included in the investigation. The hospital anxiety and depression (HAD) scale was applied to measure the symptoms of anxiety and depression in the pregnant women. Trend chi square test was used to assess the differences of anxiety and depression symptom among three trimesters. The multivariate logistic regression model was used to investigate potential contributory factors. Results: The detection rates for anxiety symptoms and depression symptoms during pregnancy were 8.5% (357/4 210) and 12.5% (525/4 210), respectively. The prevalence of anxiety symptoms during the first, second and third trimesters were 7.9% (110/1 392), 8.8% (124/1 413) and 8.8% (123/1 405), respectively (χ^2trend=0.89, P= 0.419). The prevalence of depression symptoms during the first, second and third trimesters were 14.0% (195/1 392), 12.6% (178/1 413) and 10.8% (152/1 405), respectively (χ² _trend=6.52, P=0.011). Multivariate logistic regression analysis showed an increased risk of anxiety and depression in women with an educational background of middle school rather than a college degree (OR=1.94, 95% CI: 1.44-2.63; OR=3.80, 95% CI: 2.45- 5.91). Furthermore, compared with planned pregnancies, women with unplanned pregnancies had a higher risk of anxiety and depression (OR=1.33, 95% CI: 1.06- 1.66; OR=1.35, 95% CI: 1.07- 1.71). Pregnant women who felt they lived in crowded residential conditions were at an increased risk of anxiety compared with those living in spacious residential environments (OR=1.82, 95% CI: 1.15- 2.87). Pregnant women with a household income of less than 10 000 yuan were at a higher risk of depression than living in a household with an income of ≥100 000 yuan (OR=1.91, 95% CI: 1.05-3.49). Similarly, multiparous women (≥2) were at higher risk of depression compared with nulliparous women (OR=1.88, 95% CI: 1.04- 3.41). Conclusion The prevalence of anxiety and depression symptoms during pregnancy appears to be associated with several demographic factors, along with a women's obstetrical history. Lower educational background, unplanned pregnancy, the feeling of living under crowded residential conditions were all found to be risk factors for anxiety during pregnancy. Similarly, lower educational background, unplanned pregnancy, a lower household income (<10 000) and a greater number of previous deliveries were all risk factors for depression during pregnancy.