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Purpose@#This study attempted to detect the changes of cervical cancer screening rate and willingness among female migrants, and the associated socio-demographic factors in Shenzhen city. @*Materials and Methods@#Two citywide surveys were conducted using a multistage random cluster sampling method in 2011 and 2014, respectively. Data on demographic characteristics, screening participation, and willingness to screen were collected. Logistic regression models were applied to detect possible associated socio-demographic characteristics, and their variations with survey years. @*Results@#In total, 12,017 female migrants were enrolled, with a mean age (standard deviation) of 36.73 (6.55) years. From 2011 to 2014, the screening rate increased (25.8% vs. 35.1%, p < 0.001), while the willingness to screen remained stable (82.2% vs. 82.8%, p=0.46). Overall, socio-demographic characteristics of female migrants, including age, marital status, education, monthly income, employment, and medical insurance, were found to be positively associated with screening participation. Similar impacts in relation to willingness were observed except for age. However, these associations varied with survey years, mainly in the contributions of education and monthly income to screening participation, as well as age, monthly income, and medical insurance to willingness of being screened. @*Conclusion@#Identifying changes of associated socio-demographic factors precisely is warranted of necessity, which provides novel clues to adjust targeted actions regularly in promoting cervical cancer screening participation among female migrants in Shenzhen.
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Objective To explore the correlation between social support and pregnancy depression in Shenzhen. Methods From August 2018 and June 2020, a structured questionnaire survey was conducted among pregnant women who underwent pregnancy examination in a 3A-grade maternal & child health care hospital. A total of 1 396 questionnaires with complete information were collected. Chi-square test and Wilcoxon rank sum test were used to analyze the baseline characteristics. The odds ratio (OR) and 95% CI confidence interval between social support and pregnancy depression were estimated using logistics regression model. Subgroup analysis was also conducted. Results There were statistically significant differences in education level, medical insurance rate, household registration, family monthly income, proportion of multiparas, proportion of husbands being the only child, pregnancy stress and social support between the depression group and non-depression group. After multi-factors adjustment, the OR (95% CI) of the total social support score was 0.97(95%CI 0.95-0.99), the OR (95% CI) of the objective support dimension was 0.90(95% CI 0.87-0.94), and the P value of the interaction term multiplied by pregnancy term was less than 0.05. According to the stratified analysis of pregnancy, the total score of social support was significantly correlated with the depression status only in the third trimester, with an OR (95% CI) of 0.97 (95% CI 0.94-0.99). The objective support dimension was significantly correlated with depression status in the first and third trimesters, and the OR (95% CI) was 0.78 (95% CI 0.61-0.99) and 0.89 (95% CI 0.84-0.94), respectively. The OR of support utilization score in the third trimester was 0.91 (95% CI 0.83-0.99). Conclusion Social support was negatively correlated with depression during pregnancy and was particularly important in the third trimester. Various dimensions of social support were differentially correlated with pregnancy depression in each trimester. The objective support dimension was particularly important in the first and third trimesters.
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Purpose@#A cross-sectional survey was conducted to evaluate the differences on awareness and attitude towards human papillomavirus (HPV) and its vaccine between local and migrant residents who participated in cervical cancer screening in Shenzhen, China. @*Materials and Methods@#A total of 9,855 females sampled from healthcare institutions in 20 street blocks through the Cervical Cancer Prevention Network were surveyed in this study by a self-administered questionnaire. Multivariate logistic regression was conducted to explore the role of the hukou and resident status in the willingness to receive HPV vaccination. @*Results@#Local residents had a relatively higher awareness of HPV (62.0% vs. 35.6% vs. 29.9%, p 0.05). @*Conclusion@#Inequalities in awareness and attitude towards HPV and its vaccine existed between local and migrant residents in Shenzhen. The hukou and resident status did impact on the willingness to receive HPV vaccination, therefore, it is critical to implement effective health education campaigns on HPV and its vaccine among internal migrants.
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Objective To establish a suitable model for predicting the success of trial of labor after cesarean section (TOLAC) during the pregnancy at term.Methods Data for all deliveries at term with one cesarean delivery history in Shenzhen Maternity and Child healthcare hospital during 1 January 2012 to 31 December 2014 were reviewed.Variables associated with VBAC were identified and used to build a model to predict the outcome of TOLAC with multivariable logistic regression.Godness of fit and accuracy of the model were evaluated by ROC.Results A total of 531 women met inclusion criteria and underwent TOLAC.Of the women who underwent trial of labor, 448 (84.4％) had a successful VBAC, 83 failed, and 2 (0.38％) had uterine rupture.Multivariable logistic regression analysis showed that previous cesarean section (CS) time interval, neonatal birth weight (BW) and premature rupture of membranes (PROM) were independent factors affecting TOLAC outcome, and their Odds Ratios were 2.79, 1.002 and 0.244, respectively.The Logistic regression model was expressed as follows:P =1/[1 + exp (2.4 × neonatal BW + 1.03 × previous CS time interval-1.41 × PROM-10.24)].The Hosmer-lemeshow test showed that the model fitted well (x2 =123.45, P =0.996), and the prediction accuracy of the model was 86.77％.The model performed well with an AUC of 0.794 (P =0.000).Conclusions A predictive model, which contains three variables (previous CS time interval, neonatal BW and PROM), has been developed and its prediction efficiency and accuracy are satisfactory.The larger birth weight, the longer time interval from previous CS, and the absence of PROM are more likely to be failed in TOLAC.
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Objective@#To analyze the epidemiological genotype features of human papillomavirus (HPV) in cervical infection and their risks for cervical precancers among women in Shenzhen area.@*Methods@#A total of 2 717 individuals ranging in age from 30~59 years were recruited in 18 community health centers of Shenzhen city from March 1 to June 15, 2015 by a cluster sampling method. The results of genotype of HPV, liquid-based cytology (LBC), colposcopy and pathology were analyzed. The clinical sensitivity and specificity as well as positive (PPV) and negative (NPV) predictive values of the combination of different HPV genotype in screening the cervical intraepithelial neoplasia (CIN) 2 and above were estimated.@*Results@#The HPV infection rate in Shenzhen area was 15.9% (432/2 717). The most common HPV genotype was HPV52 (22.9%), followed by HPV16 (12.7%), HPV53 (10.0%), HPV51 (8.6%) and HPV58 (8.1%). Compared with HPV16/18 genotyping, HPV33/16 genotyping had a higher sensitivity (57.1% vs. 42.9%, P<0.05) and an analogous specificity (87.3% vs. 86.9%, P>0.05) in predicting CIN2+ . The sensitivity of combination of HPV33/16 genotyping and low grade squamous intraepithelial lesion (LSIL) positive tested by LBC in predicting CIN2+ was 75.0%, significantly higher than 64.3% of atypical squamous cells of undetermined significance (ASC-US) positive tested by LBC alone (P<0.05). The specificities of these two methods mentioned above in predicting CIN2+ were 83.5% and 89.2%, respectively, without statistical difference (P>0.05).@*Conclusions@#Women infected by HPV have distinct risks for CIN2+ according to different high-risk HPV genotypes. The top five risks were HPV 33, 16, 58, 56, and 68. HPV-positive women triaged by LBC LSIL+ combined with HPV33/16 genotyping may be a potential strategy for cervical cancer screening in developed urban area.
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Objective@#To analyze the distribution and associated factors of high-risk genotypes of HPV in cervical infection among women in Shenzhen.@*Methods@#The information on sociodemographic characteristics and HPV genotypes of HPV-positive women who participated cervical screening test from January 2014 to December 2016 was downloaded from Shenzhen Maternity and Child Healthcare Management Information System. According to the pathogenicity, the high-risk HPV genotypes were divided into 15 types including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68; and there were 6 low-risk genotypes including HPV 6, 11, 42, 43, 44, and 81. Chi-square tests were applied to compare the proportions of high-risk HPV infection among women who had different sociodemographic characteristics. A non-conditional logistic regression model was used to analyze the associated factors for high-risk HPV infection.@*Results@#In total, all HIV positives received HPV genotyping, with an average age of (38.08±9.38) years old. There were 9 979 (93.9%) high-risk and 645 (6.1%) low-risk HPV infections. The proportions of HPV infections for high-risk type in each year were 91.5%, 93.8%, and 95.6%, increasing with the screening years (χ2=54.79, P<0.001). Multivariate logistic regression analysis showed that compared with women younger than 25 years old, women in other age groups (at age 26 to 30 years, 31 to 35 years, 36 to 40 years, 41 to 45 years, and 50 years or older) had increased risks of high-risk HPV infection, with OR (95%CI) of 1.67 (1.20-2.31), 1.49 (1.09-2.03), 1.71 (1.23-2.37), 1.65 (1.19-2.31), and 1.84 (1.26-2.67), respectively; compared with the married, single women had a decreased risk of high-risk HPV infection (OR (95%CI): 0.71 (0.50-1.00)); women received HPV testing in 2015 and 2016 showed higher risk of high-risk HPV infection than those in 2014 (OR (95%CI): 1.43 (1.17-1.74) and 2.03 (1.68-2.46)). The 5 most common HPV genotypes were HPV52 (25.1%, 2 670 cases), followed by HPV16 (19.2%, 2 041 cases), HPV58 (13.3%, 1 413 cases), HPV18 (9.9%, 1 048 cases), and HPV51 (9.3%, 993 cases).@*Conclusion@#Age, marital status, and screening year were associated with high-risk HPV infections. Besides HPV16 and HPV18, the prevention and control on HPV infections for HPV52, HPV58, and HPV51 should be prioritized in Shenzhen area.
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Objective To evaluate the effect of postural drainage assisting trachea suction on meconium aspiration syndrome. Methods Total 61 cases of asphyxia neonates with MAS who were born in our hospital from Jan,2007 to Dec,2008, were divided into control group (24 cases) and observing group( 37 cases). The neonates in control group had endotracheal suction directly after intubation. But the infant in observing group was treated with endotracheal suction after postural drainage. The amount of suction from endotracheal tube,the complication of MAS and the outcome of these newborns were evaluated. Results The total amount of meconium drainage from endotrachea in observing group was statistics significantly more than that in control group [( 2. 16 ± 1.82) ml vs ( 1.23 ± 0. 97 ) ml, P ＜ 0. 05 )]; The intubating times in observing group were statistical significantly less than that in control group[( 1.19 ± 0. 46) vs ( 1.79 ± 0. 83 ) times, P ＜0. 01 ). The incidence of complication in observing group was 8. 11% ,which was significantly lower than that in control group(29. 17% ,P ＜0. 05). There were shorter needing oxygen time [(21.30 ± 22. 38) h vs (52. 91 ±39. 20) h,P ＜0. 01]and shorter hospitalization days [(9. 24 ±3.94) d vs ( 14. 39 ±6. 49) d,P ＜0.01 )]in observing group than those in control group respectively. The mortality in control group was 4. 17%, and no death occurred in observing group. Apgar scores of the first minute was similar in both groups ( P ＞ 0. 05 ). But there was significant difference(70. 16% vs 58. 34% ,respectively;P ＜0. 05) in the fifth minute Apgar scoring of 8 ～ 10 scores between the observing group and the control group. Conclusion Postural drainage assisting endotracheal suction may remove meconium in trachea effectively, decrease the complications of MAS and shorten the oxygen days and hospitalization time.