Objective: To analyze the effects of maternal gestational weight gain and pre pregnancy body mass index (BMI) on the weight of preschool children,so as to provide scientific basis for prevention and treatment of overweight and obesity in children. Methods: Based on Jiangmen maternal and child health information platform, annual physical examination data of 3-6 years old preschool children from all nurseries and kindergartens in Jiangmen were collected from January to December 2024. A unique identification was made according to the mother s ID number and delivery date, and retrospective data collection was conducted on the platform to obtain pre pregnancy and pregnancy related information for 46 481 mothers. The Chi-square test,two way ordered variable analysis and Logistic regression analysis were used to compare the effects of maternal pre pregnancy BMI and gestational weight gain on overweight and obesity among preschool children. Results: A total of 5 168 (11.12%) children were overweight and obese, and the proportion of overweight and obesity in the 6 year old group was the highest (12.86%). There were significant differences in the detection rates of overweight and obesity between boys and girls ( χ 2=155.38), and there were also significant gender differences in the age groups of 4, 5 and 6 years ( χ 2=17.08, 96.97, 66.27)(all P <0.01). Through trend χ 2 test, the overall detection rates of overweight and obesity, as well as those for boys, increased with age ( χ 2 trend =49.36,60.54, both P <0.01). The BMI group of preschool children was correlated with the BMI group of their mothers before pregnancy and the weight gain group during pregnancy （χ 2= 1 250.64, 157.01, both P <0.01) and the proportion of children with higher BMI levels showed an upward trend with the improvement of their mothers pre-pregnancy BMI levels or gestational weight gain levels ( Gamma =0.13, 0.10, both P <0.01). Multiple Logistic regression analysis showed that pre pregnancy BMI groups as overweight ( OR =1.590, 1.922), obesity ( OR =2.100, 2.921 ), and male gender of the children ( OR =1.213, 1.763)，and newborns excessive birth weight( OR =1.001，1.001) increased the risks of overweight and obesity in preschool children; maternal gestational weight gain insufficiency ( OR =1.374) and advanced maternal age at the first prenatal visit ( OR =1.012) increased the risks of obesity in preschool children; maternal gestational weight gain deficiency or excess ( OR =1.324,1.118) increased the risk of overweight in preschool children (all P <0.01). Conclusions Maternal pre-pregnancy overweight and obesity and insufficient or excessive gestational weight gain increase the risk of overweight and obesity in preschool children. It is necessary to strengthen weight management before and during pregnancy to reduce the occurrence of childhood overweight and obesity.

Objective:To investigate the efficacy of combined pelvic magnetic therapy and pelvic floor electromyographic (EMG) biofeedback therapy in perimenopausal women with pelvic floor dysfunction (PFD), and its effects on bladder function and urodynamic status.Methods:A total of 137 perimenopausal women with PFD treated at Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine between February 2022 and May 2024 were enrolled. They were randomly divided into a control group ( n=68) and a study group ( n=69) by random number table method. Both groups received Kegel exercises. The control group additionally received pelvic floor EMG biofeedback therapy. The study group received combined pelvic magnetic therapy and pelvic floor EMG biofeedback therapy. The outcomes compared between groups were as follows: Bladder Function: First urge voiding volume (FVS), maximum urge voiding volume (MVS), post-void residual urine volume (PVR), prolapse of pelvic floor organs, urodynamics: Pressure of urethral maximum measurement (PUM), maximum urethral closure pressure (PMUC), bladder compliance (BC), pelvic floor muscle function: Pelvic floor muscle strength grade (PFMT), pelvic floor resting pressure (RP), vaginal dynamic pressure (VDPT). Normally distributed continuous data were presented as xˉ± s and compared by independent samples t-test. Categorical data were presented as case (%) and compared by χ2 test. Ranked data were compared by Kruskal-Wallis H test. A P-value<0.05 was considered statistically significant. Results:Baseline characteristics showed no significant differences between groups ( P>0.05). At post-treatment, the study group had a significantly higher clinical effective rate of 97.10% (67/69) compared to the control group, which was 88.24% (60/68) ( χ2=3.98, P=0.046). At post-treatment, the study group had significantly higher FVS [(238.29±10.22) mL vs. (229.37±10.54) mL, t=5.03, P<0.001] and MVS [(436.57±12.48) mL vs. (428.23±12.75) mL, t=3.87, P<0.001], and significantly lower PVR [(5.14±1.28) mL vs. (6.96±1.21) mL, t=8.55, P<0.001] compared to the control group. At post-treatment, urodynamic parameters were significantly higher in the study group: PUM [(10.08±0.97) kPa vs. (8.54±0.73) kPa, t=10.49, P<0.001], PMUC [(8.71±0.75) kPa vs. (7.68±0.64) kPa, t=8.64, P<0.001], and BC [(396.58±30.49) mL/kPa vs. (378.86±32.91) mL/kPa, t=3.27, P<0.001]. For pelvic organ prolapse (POP-Q), the distribution were as follows: Study Group: Grade 0: 16, Grade Ⅰ: 34, Grade Ⅱ: 18, Grade Ⅲ: 1, Grade Ⅳ: 0, control Group: Grade 0: 9, Grade Ⅰ: 31, Grade Ⅱ: 23, Grade Ⅲ:5, Grade Ⅳ: 0. The difference was statistically significant ( Z=2.08, P=0.037). At post-treatment, pelvic floor muscle function was significantly higher in the study group: PFMT [(4.21±0.29) vs. (3.84±0.23), t=8.27, P<0.001], RP [(9.59±1.26) cmH?O vs. (8.34±1.17) cmH?O, t=6.02, P<0.001], and VDPT [(82.74±3.36) cmH?O vs. (77.45±3.52) cmH?O, t=9.00, P<0.001]. Conclusion:Combined pelvic magnetic therapy and pelvic floor EMG biofeedback therapy demonstrates significant efficacy in treating PFD in perimenopausal women. It markedly improves bladder function and urodynamic status.

Objective Maternal-and-child health(MCH)hospitals simultaneously provide clinical care and manage community-based public-health projects for women and children.We aimed to design and test a performance-based salary and e-valuation system that recognizes this dual responsibility and incentivizes high-quality public-health work.Methods Aligned with the national tertiary-level MCH-hospital performance appraisal standards and local project realities,we applied four industrial-en-gineering techniques—empirical time-and-motion estimation,classification,analogy and work-study—to convert every public-health project into quantifiable modules with pre-set labor-hour quotas.Bonuses were calculated under"more work,more pay"and"increment incentive"rules,while appraisal covered two dimensions:(ⅰ)project-specific indicators(coverage,timeliness,completeness)and(ⅱ)outcome evaluation(health impact and user satisfaction).Performance pay was then approved and dis-tributed to staff responsible for project management.Results Analysis of the 2022-2024 implementation period showed clear gains:① Work-force mobilization:departments managing MCH projects grew from 17 to 22 and staff from 22 to 73;all core pro-ject indicators improved significantly.② Service expansion:valid service volume generated by jurisdiction-level MCH project ac-tivities rose by 62.31％.Conclusion The scientific,standardized and operable performance and evaluation system for maternity and child projects developed in this study can help effectively improve the management efficiency of maternity and child projects in the jurisdiction and promote the high-quality development of the hospital.

OBJECTIVE To observe the impact of drug-resistant bacterial infections on cost burden and payment of diseases under diagnosis-related group(DRG)payment system.METHODS The data regarding the payments un-der health insurance DRG were collected from pilots of 6 cities in Shandong Province from 2019 to 2021.The pa-tients were divided into the drug-resistant infection group and the non-drug-resistant infection group according to the type of infection and were matched 1∶1 using propensity score matching(PSM)with age,sex,type of health insurance and major diagnosis categories as covariates.The medical cost burden,related DRG payment standards,coverage rate of actual medical cost,components of medical costs and consumption of medical re-sources were observed.RESULTS The average hospitalization cost was 2.8 times in the drug-resistant infection group higher than that the non-drug-resistant infection group,the length of hospital stay was about 10 days,and the current hospitalization cost of only 19.12％of the patients with drug-resistant infections could be covered by DRG payment standards,far lower than 52.07％of the patients with non-drug-resistant infections(P＜0.05).CONCLUSIONS The burden of cost of the patients with drug-resistant infections is remarkably higher than that of the patients with non-drug-resistant infections,however,the current DRG payment standards are hard to cover the actual medical cost.It is suggested that the DRG grouping and payment policies should be further opti-mized so as to raise the affordability of both the patients with drug-resistant infections and the hospital.

Objective Maternal-and-child health(MCH)hospitals simultaneously provide clinical care and manage community-based public-health projects for women and children.We aimed to design and test a performance-based salary and e-valuation system that recognizes this dual responsibility and incentivizes high-quality public-health work.Methods Aligned with the national tertiary-level MCH-hospital performance appraisal standards and local project realities,we applied four industrial-en-gineering techniques—empirical time-and-motion estimation,classification,analogy and work-study—to convert every public-health project into quantifiable modules with pre-set labor-hour quotas.Bonuses were calculated under"more work,more pay"and"increment incentive"rules,while appraisal covered two dimensions:(ⅰ)project-specific indicators(coverage,timeliness,completeness)and(ⅱ)outcome evaluation(health impact and user satisfaction).Performance pay was then approved and dis-tributed to staff responsible for project management.Results Analysis of the 2022-2024 implementation period showed clear gains:① Work-force mobilization:departments managing MCH projects grew from 17 to 22 and staff from 22 to 73;all core pro-ject indicators improved significantly.② Service expansion:valid service volume generated by jurisdiction-level MCH project ac-tivities rose by 62.31％.Conclusion The scientific,standardized and operable performance and evaluation system for maternity and child projects developed in this study can help effectively improve the management efficiency of maternity and child projects in the jurisdiction and promote the high-quality development of the hospital.

OBJECTIVE To observe the impact of drug-resistant bacterial infections on cost burden and payment of diseases under diagnosis-related group(DRG)payment system.METHODS The data regarding the payments un-der health insurance DRG were collected from pilots of 6 cities in Shandong Province from 2019 to 2021.The pa-tients were divided into the drug-resistant infection group and the non-drug-resistant infection group according to the type of infection and were matched 1∶1 using propensity score matching(PSM)with age,sex,type of health insurance and major diagnosis categories as covariates.The medical cost burden,related DRG payment standards,coverage rate of actual medical cost,components of medical costs and consumption of medical re-sources were observed.RESULTS The average hospitalization cost was 2.8 times in the drug-resistant infection group higher than that the non-drug-resistant infection group,the length of hospital stay was about 10 days,and the current hospitalization cost of only 19.12％of the patients with drug-resistant infections could be covered by DRG payment standards,far lower than 52.07％of the patients with non-drug-resistant infections(P＜0.05).CONCLUSIONS The burden of cost of the patients with drug-resistant infections is remarkably higher than that of the patients with non-drug-resistant infections,however,the current DRG payment standards are hard to cover the actual medical cost.It is suggested that the DRG grouping and payment policies should be further opti-mized so as to raise the affordability of both the patients with drug-resistant infections and the hospital.

Objective:To investigate the efficacy of combined pelvic magnetic therapy and pelvic floor electromyographic (EMG) biofeedback therapy in perimenopausal women with pelvic floor dysfunction (PFD), and its effects on bladder function and urodynamic status.Methods:A total of 137 perimenopausal women with PFD treated at Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine between February 2022 and May 2024 were enrolled. They were randomly divided into a control group ( n=68) and a study group ( n=69) by random number table method. Both groups received Kegel exercises. The control group additionally received pelvic floor EMG biofeedback therapy. The study group received combined pelvic magnetic therapy and pelvic floor EMG biofeedback therapy. The outcomes compared between groups were as follows: Bladder Function: First urge voiding volume (FVS), maximum urge voiding volume (MVS), post-void residual urine volume (PVR), prolapse of pelvic floor organs, urodynamics: Pressure of urethral maximum measurement (PUM), maximum urethral closure pressure (PMUC), bladder compliance (BC), pelvic floor muscle function: Pelvic floor muscle strength grade (PFMT), pelvic floor resting pressure (RP), vaginal dynamic pressure (VDPT). Normally distributed continuous data were presented as xˉ± s and compared by independent samples t-test. Categorical data were presented as case (%) and compared by χ2 test. Ranked data were compared by Kruskal-Wallis H test. A P-value<0.05 was considered statistically significant. Results:Baseline characteristics showed no significant differences between groups ( P>0.05). At post-treatment, the study group had a significantly higher clinical effective rate of 97.10% (67/69) compared to the control group, which was 88.24% (60/68) ( χ2=3.98, P=0.046). At post-treatment, the study group had significantly higher FVS [(238.29±10.22) mL vs. (229.37±10.54) mL, t=5.03, P<0.001] and MVS [(436.57±12.48) mL vs. (428.23±12.75) mL, t=3.87, P<0.001], and significantly lower PVR [(5.14±1.28) mL vs. (6.96±1.21) mL, t=8.55, P<0.001] compared to the control group. At post-treatment, urodynamic parameters were significantly higher in the study group: PUM [(10.08±0.97) kPa vs. (8.54±0.73) kPa, t=10.49, P<0.001], PMUC [(8.71±0.75) kPa vs. (7.68±0.64) kPa, t=8.64, P<0.001], and BC [(396.58±30.49) mL/kPa vs. (378.86±32.91) mL/kPa, t=3.27, P<0.001]. For pelvic organ prolapse (POP-Q), the distribution were as follows: Study Group: Grade 0: 16, Grade Ⅰ: 34, Grade Ⅱ: 18, Grade Ⅲ: 1, Grade Ⅳ: 0, control Group: Grade 0: 9, Grade Ⅰ: 31, Grade Ⅱ: 23, Grade Ⅲ:5, Grade Ⅳ: 0. The difference was statistically significant ( Z=2.08, P=0.037). At post-treatment, pelvic floor muscle function was significantly higher in the study group: PFMT [(4.21±0.29) vs. (3.84±0.23), t=8.27, P<0.001], RP [(9.59±1.26) cmH?O vs. (8.34±1.17) cmH?O, t=6.02, P<0.001], and VDPT [(82.74±3.36) cmH?O vs. (77.45±3.52) cmH?O, t=9.00, P<0.001]. Conclusion:Combined pelvic magnetic therapy and pelvic floor EMG biofeedback therapy demonstrates significant efficacy in treating PFD in perimenopausal women. It markedly improves bladder function and urodynamic status.

Objective To observe the distribution and influence factors of serum high sensitivity C-reactive protein (hs-CRP) in general population. Methods In a cross-sectional population survey, a total of 101 510 subjects who were employed by Kailuan Group had been carried out a healthy examination in the period of 2006 to 2007. In the statistical analysis, we observed 91 123 subjects (males 72 805, females 18 318) who had full information and met the inclusion criteria of the study. Results ( 1 ) The geometric means of hs-CRP were 0. 70 mg/L, 0. 70 mg/L and 0. 73 mg/L in all subjects, males and females,respectively, the 95th percentiles were 6.28 mg/L, 6.20 mg/L and 6.49 mg/L, respectively. The concentrations of hs-CRP increased with age in both males and females (P trend = 0. 001 ). Serum hs-CRP geometric mean was 0. 54 mg/L and the 95th percentile was 5.40 mg/L in health group, while the geometric mean was 0. 80 mg/L and the 95th percentile was 6. 57 mg/L in non-health group. (2) Multiple linear regression analysis showed that concentrations of hs-CRP were positively associated with gender, age,systolic blood pressure, body mass index, total cholesterol, triglycerides, fasting blood glucose, smoking history, history of coronary heart disease and stroke history, but concentrations of hs-CRP were inversely related with diastolic blood pressure, high-density lipoprotein cholesterol and alcohol history. Conclusion Serum concentrations of hs-CRP level increased with age, concentrations of hs-CRP were higher in females than males; a variety of cardiovascular factors effected the concentrations of hs-CRP.