ABSTRACT
Objective To investigate the status and associated factors with maternal health service in Chengdu China.Methods A cross-sectional survey was conducted in Chengdu between September to December in 2016;1 000 delivery women were recruited to finish the questionnaire and informed consents were obtained by investigators face to face.Cluster random sampling was adopted to select subjects from public health centers of different townships in Chengdu.The multivariate logistic regression model was used to analyze the associated factors with maternal health service.Results The record rate of early pregnancy,the postpartum visit rate and the maternal system management rate were 88.9％,90.4％ and 78.6％ respectively.The survey rates were significantly lower than the reported rates (x2=6.28,P＜0.01).The attitude of medical staff (OR=2.16,95％ CI:1.0d-4.48),perceived making the record of the first trimester of pregnancy (OR=2.88,95％ CI:1.03-8.14),pregnant women receiving maternal knowledge through doctors (OR=0.29,95％CI:0.13-0.64),through social activities (OR=0.40,95％CI:0.23-0.70),through advertisements (OR=3.42,95％ CI:1.54-7.58),from internet (OR=1.71,95％ CI:1.08-2.71) and from newspapers and magazines (OR=3.80,95％ CI:1.30-11.11) were associated with record filing during early pregnancy.Delivery women who were in the maternal age between 31 to 35 (OR=0.26,95％CI:0.08-0.87) and choosing hospitals close to home is the determinant of prenatal examination (OR=0.51,95％ 6I:0.31-0.82) were less likely to accept the postpartum visit.Delivery women who chose district hospitals(OR=3.21,95％ CI:1.26-8.19),provincial (OR=4.33,95％ CI:1.72-10.91) and municipal (OR=4.24,95％CI:1.38-12.99) maternal and child care service centers to do prenatal examination were more likely to receive the postpartum visit.The attitude of medical staff (OR=1.69,95％ CI:1.04-2.73),perceived making the record of the first trimester of pregnancy (OR=2.58,95％CI:1.04-6.42),pregnant women getting maternal knowledge by internet (OR=1.63,95％ CI:1.20-2.23),Delivery women who chose township health center (OR=6.60,95％ CI:1.27-34.48),provincial (OR=2.40,95％CI:1.07-5.39) and municipal (OR=3.72,95％CI:1.41-9.79)maternal and child care service centers to receive prenatal examinations might affect the maternal system management.Conclusion The maternal system management rate was low and there was significant difference between the survey rates and the reported rates.The attitude of medical staff,the channel of getting maternal knowledge and the choices of hospitals for receiving prenatal examinations affected the maternal health service.
ABSTRACT
The association between thyroglobulin gene polymorphism and autoimmune thyroid disease was investigated.A total of eight case-control studies were included.E33SNP was associated with increased susceptibility of autoimmune thyroid disease in recessive model (OR =1.54,95 ％ CI 1.21 ～ 1.97,P =0.024),while E12SNP was associated with increased susceptibility of autoimmune thyroid disease in allele model (OR =1.12,95％ CI 1.05 ～1.21,P =0.033).Thyroglobulin gene polymorphism seems to be associated with autoimmune thyroid disease.
ABSTRACT
ObjectiveTo observe β cell function in newly diagnosed diabetic patients with ketosis before and in remission period and evaluate its classification and predictive value.MethodsA total of 206 patients newly diagnosed as diabetic ketosis who had been treated with intensive insulin therapy in our hospital and entered in the honeymoon after the withdraw of insulin therapy were followed for 36 months from onset of diabetes.They were divided into two groups of type 1 and type2 diabetes ( group A and B),according to the dependence or independence on insulin treatment. The β cell function of the two groups before and in remission period was compared by oral glucose tolerance test (OGTF).β cell function was measured with the AUC of insulin and C-peptide and homeostatic model assessment β-cell function (HOMA-β),while homeostatic model assessment insulin resistant (HOMA-IR) for insulin resistant.The duration of the honeymoon and the change of insulin and C-peptide curve before and in honeymoon were also observed.ResultsThe AUC of insulin and C-peptide,the HOMA-β and the HOMA-IR before and after the intensive insulin treatment were lower in group A than that in group B [ before the insulin treatment:(10.18 ±2.36)mIU · h · L-1 vs (20.28 ±6.89)mIU · h · L-1,(1.56 ±0.53) μg · h · L-1 vs (3.75 ±0.67) μg · h · L-1,3.68 ± 1.08 vs 18.20 ±6.59,1.22 ±0.49 vs 3.06 ± 1.54,respectively;after the insulin treatment:(29.86 ± 8.65 ) mIU · h · L-1 vs (93.35 ± 19.42 ) mIU · h · L-1,( 3.99 ± 0.79 )μg · h · L-1 vs ( 12.54 ±3.83) μg · h · L-1,8.50 ±2.46 vs 56.17 ± 19.42,0.63 ±0.56 vs 1.42 ±0.78,respectively ].The duration of the honeymoon in group A was significantly shorter than in group B [ (7.9 ±5.2) months vs (20.9 ± 9.9 ) months ].In oral glucose insulin and C-peptide release test,the peak of insulin and C-peptide releasing curve in group A was brought forward by a half to 1 hour after intensive treatment while delayed in group B by 1 or 2 hours.The releasing peak of insulin and C-peptide in group A was less than two folds of the basic value,while four to ten fold of the basic value in group B.The positive ratio of glutamic acid decarboxylase antibody,insulin autoantibody and insular cellular antibody in group A and group B were 21.2％ vs 4.8％,18.1％ vs 3.3％,9.2％ vs 10.6％,respectively.ConclusionsOf all the patients newly diagnosed as diabetes ketosis who had entered into the honeymoon after intensive insulin therapy,91％ were type 2 diabetes.Inferior β cell function before insulin therapy,weaker remission after insulin therapy and shorter duration of remission period suggest the classification of type 1 diabetes.