ABSTRACT
Objective@#To understand the status of child health services by primary medical institutions in less developed areas in Sichuan province and provide evidence for the development of health policy for poverty alleviation.@*Methods@#Annual child health records in the primary medical institutions selected through multistage stratified sampling in 21 prefectures in Sichuan were extracted during 2014-2018. Field survey and telephone interview were used to evaluate the performance of child health services provided and the child guardian’s satisfaction degree. Sample descriptive statistics, pair sample t-test, χ2 test, trend χ2 test, Pearson correlation analysis were used for statistical analysis.@*Results@#Except child system management rate, the other indicators reflecting the status of child health service in less developed areas in Sichuan were on rise (P<0.05), and close to average level of whole province in 2018. Except child system management rate, the other indicators reflecting the status of child health management in less developed counties were lower than those in developed counties in Sichuan, most differences were significant (P<0.05). Except child health management rate of traditional Chinese medicine, the other indicators reflecting the status of child health management in less developed counties were higher than those in poverty-stricken counties in Sichuan, most differences were not significant (P≥0.05). Except child systematic management rate, the gap in indicators reflecting child health service status between less developed area and developed area was in reduction, some difference were significant (P<0.05). The child guardian satisfaction degree was associated with true child health management rates (r=0.947, P=0.015), and child health management rate of traditional Chinese medicine (r=0.996, P<0.001).@*Conclusions@#Some achievements have been made in child health services provided by primary medical institutions in less developed areas in Sichuan. To achieve the 2020 poverty alleviation goal, it is necessary to take measures to increase input and improve service level.
ABSTRACT
Objective:To evaluate the performance of two-dimensional fundamental sonosalpingography combined with saline infusion pelvic sonosalpingography(abbreviated as "2DFS+ SIPS" in this article) for assessing fimbrial part′s morphology and function of fallopian tubes.Methods:A total of 246 infertile women were collected from Zhejiang Provincial People′s Hospital from May 2018 to December 2019. They underwent dynamic three-dimensional harmonic sonosalpingography(abbreviated as "4DHS" in this article) first. Cases which were diagnosed as bilaterally tubal obstruction would be excluded. 2DFS+ SIPS was performed in 230 patients. Among them, 21 underwent laparoscopy and dye test(LDT) within 6 months and the results were regarded as golden standard.Results:①Tubes which were diagnosed as complete obstruction would be excluded. The total display rate of remaining fimbrial parts by using 2DFS+ SIPS and 4DHS were 77.4% and 24.0% respectively, which had statistically difference( P<0.001). ②According to 2DFS+ SIPS, fimbrial parts were classified into 3 types: normal, suspected abnormal and abnormal.Normal fimbrial parts accounted for 86.4% while suspected abnormal ones accounted for 13.6% under the condition of patency; abnormal fimbrial parts accounted for 81.2% while suspected abnormal ones accounted for 18.8% under the condition of partial obstruction. The difference in the proportion of normal and abnormal fimbrial parts according to different tubal patency was statistically significant( P<0.001). ③Fimbrial parts were classified into normal (normal fimbrial parts) and abnormal (suspected abnormal and abnormal fimbrial parts) further according to 2DFS+ SIPS, the results were compared with LDT. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Youden′s index were 92.0%, 100%, 88.2%, 80.0%, 100%, 0.88, respectively. The consistency analysis showed the results of 2DFS+ SIPS and LDT were highly consistent (Kappa=0.828). ④All the side effects occured during the procedure or within 30 minutes after the procedure were self-limited.No serious complications were observed. Conclusions:2DFS+ SIPS is a preferred method for assessment of fimbrial part′s morphology and function, with its advantages of non-invasiveness, intuition, and accuracy. This combination could provide objective imaging basis for choosing clinical treatment strategies and predicting prognosis.