A cross-sectional study of contraceptive use and healthcare status among women at different times in the postpartum period / 上海预防医学

ObjectiveTo investigate the use of contraceptive methods， and to evaluate maternal healthcare services utilization among women within 2 years in Pudong New Area of Shanghai. MethodsA cross-sectional survey was conducted using a questionnaire for women at different postpartum periods who visited a community health clinic with their children from June to November 2021. Data were analyzed using χ2 test and binary logistic regression. ResultsAmong the 1 946 postpartum women surveyed， 1 934 were either married or cohabiting， and1 430 had resumed their sexual life. Among women at 4， 6， 12， 18 and 24 months postpartum， the contraceptive prevalence rates （CPR） were 92.34% （193/209）， 92.16% （235/255）， 87.31% （282/323）， 91.95% （297/323） and 90.00% （288/320）， respectively. The modern contraceptive prevalence rates （mCPR） were 87.08% （182/209）， 87.06% （222/255）， 82.04% （265/323）， 83.09% （271/323） and 85.31% （273/320）， respectively， while the unmet contraceptive needs （UMNs） were 7.66% （16/209）， 7.84% （20/255）， 11.46% （37/323）， 6.81% （22/323） and 10.00% （32/320）， respectively. The use rates of long-acting reversible contraceptive （LARC） methods among women at 6， 12， 18 and 24 months postpartum period were 0.39% （1/255）， 2.17% （7/323）， 0.31% （1/323）， and 2.81% （9/320）， respectively. Among all surveyed subjects， 32.17% （626/1 946） had received postpartum contraceptive services only once， while 27.85% （542/1 946） had not received any postpartum contraceptive services. Binary logistic regression analysis indicated that the use of contraceptive methods among postpartum women was associated with whether relevant educational services were received after childbirth and during postpartum home visits （all P<0.05）. ConclusionPostpartum women have unmet needs for contraception. Contraceptive guidance at the 42-day postnatal healthcare visit needs to be further strengthened and postpartum contraceptive education could be integrated into the pregnancy care. The quality and effectiveness of contraceptive education during delivery and postpartum home visits， and even at the 42-day postnatal healthcare visit need to be further explored.

Development of a self-assessment questionnaire of abnormal menstruation and evaluation of its reliability and validity / 上海预防医学

ObjectiveTo develop a self-assessment questionnaire for menstrual abnormalities and test its reliability and validity. To provide an assessment tool for self-identification of abnormal menstruation in young women and to investigate the health seeking situation of abnormal menstruation in the population. MethodsFifteen physicians with clinical experience were invited to participate in the Delphi expert consultations. Medical indications for menstrual abnormalities were constructed and questionnaires were formed based on domestic and international literature， expert meetings and 2 rounds of Delphi expert consultations. A whole-group sampling was used to select 923 female college students from a medical school in Shanghai for the survey， and 306 of them were retested. The internal consistency， retest correlation， researcher-investigator evaluation correlation， and structural and response validity of the questionnaire were examined. ResultsThe questionnaire formed 6 dimensions with 17 indications. The positive coefficients for the two rounds of consulting experts were >90%. The mean authority coefficient was 0.857. The Kendall W coordination coefficient was 0.465 and 0.455， respectively （P<0.001）. The questionnaire Cronbach's alpha coefficient was 0.622. The retest correlation coefficient was 0.459. The correlation coefficient between the researcher's score and the respondents' self-assessment was 0.562. The five common factors extracted by factor analysis were consistent with the structure of the questionnaire， and the cumulative contribution of variance was 54.4%. Total questionnaire scores were moderately to highly correlated with each dimension score （0.409 to 0.699）. There was low correlation between the dimensions （-0.002 to 0.203）. Girls who had sought medical care had higher scores on the total questionnaire， category A， category B， cycle dimension， menstrual dimension， and dysmenorrhea/PMS dimension than girls who had not sought medical care （P<0.01）， and the difference between the two groups in menstrual volume dimension scores was not statistically significant. ConclusionThe self-assessment questionnaire for menstrual abnormalities developed in this study has acceptable reliability， good structure validity and response validity. It can provide a self-examination tool and medical consultation guidance for young women with abnormal menstruation.

Factors affecting microvascular complications among patients with type 2 diabetes mellitus / 预防医学

Objective @#To identify the factors affecting microvascular complications among patients with type 2 diabetes (T2DM), so as to provide insights into the management of microvascular complications of T2DM.@*Methods@#T2DM patients hospitalized in the Department of Endocrinology of a tertiary hospital in Weifang City, Shandong Province from January 2021 to January 2022 were enrolled, and subjects' basic information, lifestyle and medical history were collected using questionnaire surveys. Fasting insulin, fasting blood glucose and glycated hemoglobin were measured, and factors affecting microvascular complications were identified among T2DM patients using a multivariable logistic regression model and a decision tree model.@*Results@#Totally 1 003 T2DM inpatients were enrolled, including 515 men (51.35%) and 488 women (48.65%), and the prevalence of microvascular complications was 40.18%. Multivariable logistic regression analysis showed that age of 60 years and older (OR=2.510, 95%CI: 1.441-4.374), T2DM duration of 10 years and longer (OR=3.205, 95%CI: 2.242-4.581), fasting insulin of lower than 3.21 μIU/mL (OR=1.749, 95%CI: 1.239-2.469), using of agents or insulin to control blood glucose (OR=1.880, 95%CI: 1.143-3.092), glycated hemoglobin level of 7% and higher (OR=1.751, 95%CI: 1.172-2.615) as factors affecting microvascular complications among T2DM patients. Decision tree analysis identified course of T2DM as a major factor affecting the risk of microvascular complications among T2DM patients, and the prevalence of microvascular complications was 70.22% among T2DM patients with disease course of 10 years and longer and fasting insulin of lower than 3.21 μIU/mL or 16.32 μIU/mL and higher, 44.23% among T2DM patients with disease course of 5 to 10 years and at ages of 60 years and older, and 43.10% among T2DM patients with disease course of less than 5 years and fasting insulin of lower than 3.21 μIU/mL. @*Conclusion@#Advanced age, long course of T2DM, low fasting insulin and high glycated hemoglobin may increase the risk of microvascular complications among T2DM patients.

Factors affecting diabetic retinopathy among Chinese adults: a meta-analysis / 预防医学

Objective@#To systematically evaluate the factors affecting diabetic retinopathy (DR) among Chinese adult patients with type 2 diabetes mellitus (T2DM), so as to provide insights into establishment of personalized risk prediction models for DR.@*Methods@# Case-control studies pertaining to factors affecting DR among Chinese adults were retrieved from international and national databases, including CNKI, Wanfang Data, SinoMed, PubMed, Web of Science, Embase and CINAHL from inception to March 31, 2023. A meta-analysis was performed using the software Stata 17.0, and subgroup analysis was performed to explore the source of heterogeneity. Sensitivity analysis was performed using the leave-one-out method, and the publication bias was evaluated using the Egger's test and trim-and-fill method. @*Results@#Totally 4 969 publications were retrieved, and 35 case-control studies were finally enrolled, including 32 high-quality publications (91.43%). The included studies involved 29 228 participants and 10 568 DR patients, and the prevalence of DR was 36.16%. Meta-analysis revealed that age (OR=1.06, 95%CI: 1.00-1.13), duration of T2DM (OR=1.09, 95%CI: 1.08-1.11), systolic blood pressure (OR=1.02, 95%CI: 1.01-1.03), glycated hemoglobin A1c (OR=1.38, 95%CI: 1.26-1.50), fasting blood glucose (OR=1.57, 95%CI: 1.07-2.31), urinary albumin to creatinine ratio (OR=1.50, 95%CI: 1.10-2.04), serum uric acid (OR=1.01, 95%CI: 1.00-1.01), urine microprotein (OR=2.01, 95%CI: 1.96-2.07), triglyceride (OR=1.77, 95%CI: 1.42-2.21), and total cholesterol (OR=1.82, 95%CI: 1.50-2.21) were risk factors for DR, and glomerular filtration rate (OR=0.98, 95%CI: 0.97-0.98) and C-peptide (OR=0.79, 95%CI: 0.68-0.93) were protective factors for DR. Sensitivity analysis of age effects was not robust. Following adjustment for glomerular filtration rate with the trim-and-fill method, there was still a publication bias, and the publication bias of other influencing factors had no impact on pooled effects. @*Conclusions@#Age, course of T2DM, systolic blood pressure, glycated hemoglobin A1c, fasting blood glucose, urinary albumin to creatinine ratio, serum uric acid, urine microprotein, triglyceride and total cholesterol were risk factors, and glomerular filtration rate and C-peptide were protective factors for DR among Chinese adults.

Practical value and thought on "co-regulation of body and mind" in treatment of post-stroke spasticity with acupuncture / 中国针灸

This paper reviews the application of "co-regulation of body and mind" of acupuncture for post-stroke spasticity. It is found that acupoints on the head and the back of the governor vessel, as well as Jiaji (Ex-B 2) points are mainly used for regulating the mind, and the local sites of spastic muscles and the points on the antagonistic muscles are for regulating the body specially. It is believed that regulating the mind should be integrated with regulating the body, while, the acupoint selection be associated with needling methods so as to fully achieve the "co-regulation of body and mind" and enhance the practical value of acupuncture for post-stroke spasticity. It is proposed that the classical anti-spastic needling techniques, such as huici (relaxing needling) and guanci (joint needling), should be more considered.

Synthesis and Biological Activity of Trolox Amide Derivatives

Abstract A series of Trolox amide derivatives were synthesized by modifying the carboxyl groups of Trolox. Thirty target compounds were obtained and characterized through nuclear magnetic resonance and mass spectrometry. Trolox derivatives were employed to explore the potential structure-antioxidant activity relationships. The antioxidant activities of these compounds were evaluated using 1,1-diphenyl-2-picrylhydrazyl (DPPH), 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), ferric reducing antioxidant power (FRAP) and hydroxyl radical assays. DPPH scavenging activity test results illustrated that compounds exhibited scavenging activities similar to L-ascorbic acid and Trolox, with compounds 14a, 18a, 24a and 26a in particular exhibiting higher scavenging activities than L-ascorbic acid. The results demonstrated that compounds displayed ABTS scavenging activities similar to L-ascorbic acid and Trolox, with compounds 26a and 29a in particular having potency twofold higher. FRAP assay results indicated that compounds 11a, 19a, 25a, 29a and 30a had activity similar to Trolox. The results revealed that compounds 6a and 19a had similarly high hydroxyl radical-scavenging activities as Trolox. The results of α-glucosidase experiments uncovered that compounds 10a, 25a, 28a and 29a had excellent inhibitory activity, which was similar to that of acarbose and different from Trolox. The results of acetylcholinesterase and butyrylcholinesterase experiments demonstrated that some compounds had weak anticholinesterase activities. 26a and 29a are important Trolox derivatives with better biological activity profiles and deserve further study

Research progress of artificial intelligence in glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#Currently, the early diagnosis of glaucoma and monitoring of disease progression is difficult and requires assessment of structural(fundus photo/ optical coherence tomography scan)and functional damage(visual fields)of the optic nerve head(ONH). It requires the clinical knowledge of glaucoma experts and is highly labor intensive. Artificial intelligence(AI)applications have been proposed to improve the understanding of glaucoma and help to reduce the time and manpower required for such clinical tasks. With the advent of deep learning(DL), many tools for ophthalmological image enhancement, segmentation and classification have also emerged. Especially in the last three years, a large number of algorithms suitable for analyzing the ONH structure and/or function, which have been proposed to help in glaucoma detection. AI tools have also been developed to predict the early progression of the disease. Bring the possibility of personalized precision treatment. However, these algorithms are yet to be tested in the real world. This review summarizes the diverse landscape of AI algorithms developed for glaucoma. We also discuss the current limitations and challenges that we need to overcome.

Changing trend and influencing factors of health literacy among residents in Ningbo from 2015 to 2019 / 预防医学

Objective@#To learn the health literacy status, trend and associated factors of Ningbo residents from 2015 to 2019, so as to provide basis for developing health policies and interventions. @*Methods@#The monitoring data of health literacy of Ningbo residents from 2015 to 2019 was collected. The health literacy level was calculated and standardized by the population data of the sixth national census of Ningbo in 2010; five-year absolute growth and growth rate were used to reflect the changing trend. Multivariate logistic regression model was employed to analyze the influencing factors for the health literacy level. @*Results@#The health literacy levels from 2015 to 2019 were 15.44%, 21.73%, 22.41%, 27.60% and 30.03%, with an annual increase trend ( P<0.05 ). The five-year absolute growth and growth rate were 14.59% and 94.49%. The Results of multivariate logistic regression analysis indicated that the year ( OR=1.158, 95%CI: 1.132-1.184 ), age ( 25-<35岁 years, OR=1.235, 95%CI: 1.039-1.468; 35-<45岁 years, OR=1.416, 95%CI: 1.193-1.681; 45-<55岁 years, OR=1.221, 95%CI: 1.024-1.455 ) , education level ( primary school, OR=1.790, 95%CI: 1.461-2.195; junior high school, OR=2.574, 95%CI: 2.102-3.154; high school/vocational high school/technical secondary school, OR=4.863, 95%CI: 3.943-5.998; college or above, OR=8.829, 95%CI: 7.109-10.965 ) , urban areas ( OR=0.934, 95%CI: 0.874-0.998 ) and occupation ( farmers, OR=0.692, 95%CI: 0.608-0.787; workers, OR=0.746, 95%CI: 0.664-0.837; enterprise staff, OR=0.822, 95%CI: 0.745-0.906; others, OR=1.106, 95%CI: 1.009-1.211 ) were the influencing factors for health literacy level. @*Conclusion@# The health literacy level of Ningbo residents shows an upward trend from 2015 to 2019, which are associated with age, education level, area and occupation.

Comparación de las estructuras de difusión de información errónea y verídica en las redes sociales durante una emergencia de salud pública / Contrasting Misinformation and Real-Information Dissemination Network Structures on Social Media During a Health Emergency

RESUMEN Objetivos. Elaborar un esquema operativo integral para detectar la información errónea principal sobre el zika distribuida en Twitter® en el 2016; reconstruir las redes por las que se difunde información mediante retuiteo; contrastar la información verídica frente a la errónea con diversos parámetros; e investigar cómo se difundió en las redes sociales la información errónea sobre el zika durante la epidemia. Métodos. Revisamos sistemáticamente los 5 000 tuits más retuiteados con información sobre el zika en inglés, definimos "información errónea" a partir de la evidencia, buscamos tuits que tuvieran información errónea y conformamos un grupo equiparable de tuits con información verídica. Elaboramos un algoritmo para reconstruir las redes de retuiteo de 266 tuits con información errónea y 458 tuits equiparables con información verídica. Calculamos y comparamos nueve parámetros para caracterizar la estructura de las redes a varios niveles, entre los dos grupos. Resultados. En los nueve parámetros se aprecian diferencias estadísticamente significativas entre el grupo de información verídica y el de información errónea. La información errónea en general se difunde mediante estructuras más sofisticadas que la información verídica. También hay una considerable variabilidad intragrupal. Conclusiones. Las redes de difusión de la información errónea sobre el zika en Twitter fueron sustancialmente diferentes que las de información verídica, lo cual indica que la información errónea se sirve de mecanismos de difusión distintos. Nuestro estudio permitirá formar una comprensión más holística de los desafíos que plantea la información errónea sobre salud en las redes sociales.

ABSTRACT Objectives. To provide a comprehensive workflow to identify top influential health misinformation about Zika on Twitter in 2016, reconstruct information dissemination networks of retweeting, contrast mis- from real information on various metrics, and investigate how Zika misinformation proliferated on social media during the Zika epidemic. Methods. We systematically reviewed the top 5000 English-language Zika tweets, established an evidence-based definition of "misinformation," identified misinformation tweets, and matched a comparable group of real-information tweets. We developed an algorithm to reconstruct retweeting networks for 266 misinformation and 458 comparable real-information tweets. We computed and compared 9 network metrics characterizing network structure across various levels between the 2 groups. Results. There were statistically significant differences in all 9 network metrics between real and misinformation groups. Misinformation network structures were generally more sophisticated than those in the real-information group. There was substantial within-group variability, too. Conclusions. Dissemination networks of Zika misinformation differed substantially from real information on Twitter, indicating that misinformation utilized distinct dissemination mechanisms from real information. Our study will lead to a more holistic understanding of health misinformation challenges on social media.

An overview of official measures for COVID-19 prevention and control in maternal and neonatal population in some areas of China / 上海预防医学

Coronavirus disease 2019(COVID-19) has become a global public health problem.China′s epidemic prevention and control measures prove to be effective, that can be reference for other countries in their epidemic work.As a special group, the pregnant women and newborns have been given priority attention.This paper overviews our measures to prevent and control GOVID-19 for pregnant women and newborns.These official measures were issued by either the central government at the national level or provincial health administrative departments, covering 7 aspects as home protection for pregnant women, obstetric outpatient prevention and control, pregnancy management, referral for diagnosis and treatment of suspected or confirmed pregnant women, hospital deliveries, nosocomial prevention and control for newborns and others.It is to share China′s measures for special populations during COVID-19 pandemic.

Effect of pre-pregnancy BMI on gestational diseases and pregnancy outcomes / 上海预防医学

Objective To explore the effect of body mass index before pregnancy on various gestational diseases and adverse pregnancy outcomes. Methods Related cohort studies at home and abroad from 2014 to 2019 in China, the United States, Canada, Vietnam and Indonesia were reviewed to evaluate the effects of pre-pregnancy BMI on the risk of gestational disease and pregnancy outcomes.The number of 773 articles was collected and 8 cohort studies were selected in accordance with the inclusion criteria for this study. Results Low pre-pregnancy BMI could significantly increase the risk of postpartum hemorrhage (OR=7.1, 95%CI:2.7-13.6), acute renal failure (OR=1.6, 95%CI:0.1-5.3), low birth weight (OR=3.1, 95%CI:1.5-6.2), less than gestational age (OR=2.9, 95%CI: 1.9-4.5) and so on.High pre-pregnancy BMI could significantly increase the risk of preeclampsia (OR=1.09, 95%CI:1.04- 1.14), gestational hypertension (OR=5.49-11.42), cesarean section (OR=1.94, 95%CI:1.80-2.08), obstetric complications (OR=4.4-8.2), fetal macrosomia (OR=2.36, 95%CI:2.15-2.59) and other diseases.Spontaneous abortion, ectopic pregnancy were significantly associated with abnormal pre-pregnancy BMI (too high or too low). Conclusion Pre-pregnancy BMI is significantly associated with severe maternal diseases such as gestational hypertension, preeclampsia, gestational diabetes and adverse pregnancy outcomes like premature birth, abnormal birth weight, cesarean section.It suggests that more population-based prospective cohort studies are needed in this field to provide stronger evidence for pre-pregnancy weight management.

Effect evaluation of public health education for on-the-job master students / 上海预防医学

Objective The shortage of health human resources highlights the necessity of high-level public health education.Master of Public Health (MPH) education is an important aspect to improve the ability of public health talents.The purpose of this study is to explore the impact of MPH project on graduates′ career and application of their learned ability in Fudan University. Methods An online questionnaire survey was conducted among Masters of Public Health who graduated from Fudan University from 2006 to 2013 to investigate the impact of MPH learning on their career and public health competency. Results The contribution of MPH project reported by graduates to the improvement of public health professional competence after graduation ranged from 74.7% to 96.5%.Over 90% graduates thought there were 9 competencies among the 23 public health professional competencies in the study of MPH had certain or greater help to their work.And 49.5% of the graduates thought that their leadership level had improved, and 33% participators thought their personal remuneration increased after graduation. Conclusion This study shows that MPH project can help graduates improve their professional ability, promote the construction of public health leadership, and enhance their self-identity.MPH education project still has room to improve in the ability development of graduates regarding community work and policy making.

Application of a modified M-shaped flap in defect repair after resection of lower lip cancer / 口腔疾病防治

Objective@# To observe the clinical effect of the modified M-shaped flap for repairing defects following resection of lower lip cancer and to provide a reference for clinical application.@*Methods @#Fourteen cases using modified M-shaped flaps to repair lower lip cancer surgery defects were retrospectively analyzed. The postoperative follow-up patients’ flap survival, mouth opening, denture use, bilateral mouth angle symmetry, recurrence and survival were analyzed.@*Results @#Fourteen patients with lower lip cancer underwent reconstruction immediately after surgery, and the defect range after tumor resection was 30% to 50% of the lower lip. The continuity of the orbicularis oculi muscle is reconstructed by modified M-shaped flap to transfer bilateral residual lip tissue. The blood supply to the flap is stable. All patients’ flaps survived completely without complications, such as hemorrhage, infection or flap necrosis, and their lip movement and sensation recovered well. There were no obvious obstacles in opening and closing or pronunciation and dietary function, and the mean maximum opening was (3.06 ± 0.23) cm. Three patients used active dentures, which could be removed normally. All patients’mouths were preserved. Approximately 85.7% of patients (12/14) had bilateral symmetry of the bilateral mouth, the flaps matched the facial color, and the lower lip was naturally beautiful, as the scar was not obvious. After 6 months to 4 years of follow-up (mean 2 years and 6 months), no recurrence or death occurred.@*Conclusion @#The modified M-shaped valve design is simple and easy to operate. This method can be applied to 30% to 50% defect reconstructions of the lower lip to retain the corner of the mouth.

Effects of different developmental patterns on thyroid morphological changes among children in pre-puberty and puberty / 中国学校卫生

Objective@#To investigate the effects of different developmental patterns on the increases of thyroid volume in children from different genders and periods, and to explore whether there is a synergistic effect on the initiation of puberty in girls, so as to provide a theoretical basis for reducing the risk of thyroid abnormalities in adulthood.@*Methods@#A multi-stage cluster sampling was used to select a primary school in Minhang District of Shanghai, Haimen City of Jiangsu Province and Yuhuan city of Zhejiang Province. A total of 784 children aged 8-10 years old were included in "8-10 years school-aged children cohort". At the same time, a total of 491 girls aged 11-13 years were included in the "11-13 years adolescent girls cohort". The content of survey on follow-up was consistent with the one on baseline. B-ultrasonography was used to measure thyroid volume. The physical development indexes such as height (H), weight (W) and waist circumference (WC) were measured. The morning urine samples were collected and the urinary iodine content was detected. The changes of body mass index (BMI), waist circumference (WC), and thyroid volume (V) were calculated (d BMI, d WC, and d V, respectively). According to the changes of BMI and WC, the subjects were classified into four types of developmental changes, namely "B-LW-L (low d BMI, low d WC)" "B-LW-H (low d BMI, high d WC)" "B-HW-L (high d BMI, low d WC)" and "B-HW-H (high d BMI , high d WC)". Results In partial correlation analysis, thyroid volume was significantly correlated with BMI and WC at baseline or follow-up(P<0.05). The changes of thyroid volume in 8-10 years old boys were related to the changes of BMI and WC (P<0.05), the changes of thyroid volume in 8-10 year old girls were only associated with the changes of WC (P=0.03), and no association was found in 11-13 year old girls(P>0.05). In multivariate logistic regression analysis, after adjusting for baseline age, region, and differences of urinary iodine, the risk of thyroid volume increasing in B-HW-H was 2.70 times (95%CI=1.29-5.66) higher than that of B-LW-L in boys aged 8-10 years; among girls aged 11-13 years, the risk of thyroid volume increasing in B-LW-H, B-HW-L and B-HW-H were 2.46 times (95%CI=1.31-4.61), 2.16 times (95%CI=1.15-4.03) and 1.79 times (95%CI=1.07-2.99), respectively; there was no interaction between menarche age and developmental pattern on thyroid volume change trend (P=0.49).@*Conclusion@#The thyroid volume in children and adolescents increases with the development of physical development. Different developmental patterns and estrogens have certain effects on thyroid morphological changes. To avoid obesity in childhood (especially with central obesity), timely identify and effectively intervene thyroid morphological abnormalities in childhood，and to reduce the risk of thyroid diseases in adulthood.

Transnational preconception cohort studies: a review / 中华围产医学杂志

Preconception cohort studies allow us to conduct in-depth investigations on exposures and heath related factors of couples before pregnancy, and to explore the impact on reproductive health of the couples and on short- and long-term health of the offspring. As a critical window into early life, this area has been gradually gaining much attention worldwide. This paper summarized the characteristics of 21 transnational preconception cohort studies with large samples size, to provide information for relevant researchers in China. Emphasis on international cooperation, application of highly efficient data systems or research tools, and long-term longitudinal survey on parents and their offspring are the direction of further preconception cohort researches.

Review on preconception cohort studies in China / 中华流行病学杂志

The preconception cohort is of great importance to explore and analyze the impact of multiple factors before and during pregnancy on human reproductive health, pregnancy outcomes and offspring health. This paper summarizes the information and characteristics of the preconception cohort studies in recent years in China.

Cost-effectiveness Analysis of Hospital Rehabilitation and Hospital-family Rehabilitation in Children with Cerebral Palsy / 中国康复理论与实践

@#Objective To analyze the cost-effectiveness of hospital rehabilitation and hospital-family rehabilitation in children with cere-bral palsy. Methods From January to December, 2016, 60 cases of children aged one to three years with cerebral palsy were divided into hospital rehabilitation group and hospital-family rehabilitation group, with 30 cases in each group. The hospital rehabilitation group received rehabilitation of traditional Chinese and Western medicine treatment, including exercise therapy, physical therapy and Chinese Medical ther-apy; while the hospital-family rehabilitation group received family rehabilitation. The Gross Motor Function Measure (GMFM) and Pea-body Developmental Motor Scale-fine Motor (PDMS-FM) were used to evaluate the motor function and fine motor function before and af-ter treatment. Results The GMFM score was higher (t=5.333, P<0.001), and the total medical cost was higher (t=23.614, P<0.001) in the hospital rehabilitation group than in the hospital-family rehabilitation group. However, the cost of medical care was significantly lower for every 1-point increase in GMFM and visual-motion integration of PDMS-FM in the hospital rehabilitation group than in the hospital-family rehabilitation group (t>2.065, P<0.05). Conclusion The hospital rehabilitation model may be a more economical and effective treatment for younger age children with cerebral palsy, and the hospital-family rehabilitation model could be used as an effective complementary rehabili-tation model for this age group.

Cost-effectiveness Analysis of Hospital Rehabilitation and Hospital-family Rehabilitation in Children with Cerebral Palsy / 中国康复理论与实践

@#Objective To analyze the cost-effectiveness of hospital rehabilitation and hospital-family rehabilitation in children with cere-bral palsy. Methods From January to December, 2016, 60 cases of children aged one to three years with cerebral palsy were divided into hospital rehabilitation group and hospital-family rehabilitation group, with 30 cases in each group. The hospital rehabilitation group received rehabilitation of traditional Chinese and Western medicine treatment, including exercise therapy, physical therapy and Chinese Medical ther-apy; while the hospital-family rehabilitation group received family rehabilitation. The Gross Motor Function Measure (GMFM) and Pea-body Developmental Motor Scale-fine Motor (PDMS-FM) were used to evaluate the motor function and fine motor function before and af-ter treatment. Results The GMFM score was higher (t=5.333, P<0.001), and the total medical cost was higher (t=23.614, P<0.001) in the hospital rehabilitation group than in the hospital-family rehabilitation group. However, the cost of medical care was significantly lower for every 1-point increase in GMFM and visual-motion integration of PDMS-FM in the hospital rehabilitation group than in the hospital-family rehabilitation group (t>2.065, P<0.05). Conclusion The hospital rehabilitation model may be a more economical and effective treatment for younger age children with cerebral palsy, and the hospital-family rehabilitation model could be used as an effective complementary rehabili-tation model for this age group.

Dietary Restriction Reduces Blood Lipids and Ameliorates Liver Function of Mice with Hyperlipidemia / 华中科技大学学报（医学）（英德文版）

Dietary restriction (DR) can delay senescence,prolong lifespan of mammals and improve their learning-memory activity.The purpose of the study was to explore the effects of DR on hypolipidemic action and liver function of mice with hyperlipidemia.To investigate these effects,hyperlipidemia mouse models were established with high-fat diet (HFD) (34％ of energy),then randomly divided into HFD group,DR30％ group and DR50％ group.Mice in DR30％ and DR50％ group were respectively supplied with HFD as much as about 70％ and 50％ of the consumption of HFD in the mice of HFD group.Rats in control group were fed routinely.After DR for 5 weeks,the average body weight,liver weight,liver index,serum lipids and glucose levels in both DR groups decreased significantly as compared with the HFD group (P＜0.05 or P＜0.01),so did alanine aminotransferase (ALT),aspartate aminotransferase (AST),lactate dehydrogenase (LDH) levels and the ratio of LDL-C/HDL-C in the DR50％ group (P＜0.05 or P＜0.01).Histopathology examination of liver tissues further proved ameliorative effect of DR on liver function.Western blotting showed that DR significantly increased the expression of silent mating type information regulation 2 homolog 1 (SIRT1) in liver and adipose,while notably decreased the expression of peroxisome proliferators-activated receptors-gamma (PPARγ) in adipose (P＜0.05 or P＜0.01).The increase of SIRT1 and decrease of PPARγ may be a mechanism by which DR reduces blood lipids and ameliorates liver function.

Association of Dietary Pattern during Pregnancy and Gestational Diabetes Mellitus: A Prospective Cohort Study in Northern China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To examine the association of maternal dietary patterns during pregnancy with gestational diabetes mellitus (GDM) in northern China.</p><p><b>METHODS</b>The dietary intakes of pregnant women were recorded twice by 24-hour dietary recalls for three days prior to having been diagnosed with GDM, at 5-15 and 24-28 gestational weeks, respectively. GDM was diagnosed, and serum glycosylated hemoglobin (HbA1c) was measured at 24-28 weeks. Dietary patterns were assessed by factor analysis. The association of the dietary pattern with GDM and HbA1c was examined by multiple logistic models.</p><p><b>RESULTS</b>Of 753 participants, 64 (8.5%) were diagnosed with GDM. Four dietary patterns were identified: Western pattern (dairy, baked/fried food and white meat), traditional pattern (light-colored vegetables, fine grain, red meat and tubers), mixed pattern (edible fungi, shrimp/shellfish and red meat) and prudent pattern (dark-colored vegetables and deep-sea fish). Compared with the prudent pattern, both the Western pattern and the traditional pattern were associated with an increased risk of GDM (aOR = 4.40, 95% CI: 1.58-12.22; aOR = 4.88, 95% CI: 1.79-13.32) and a high level of HbA1c (aOR = 12.37, 95% CI: 1.47-103.91; aOR = 26.23, 95% CI: 2.54-270.74). Compared to the lowest quartile (Q), Q3 of the Western pattern scores and Q3-Q4 of the traditional pattern scores were associated with a higher risk of GDM.</p><p><b>CONCLUSION</b>The consumption of the Western pattern or the traditional pattern during pregnancy may increase the risk of GDM.</p>