Folic Acid Supplementation in Chinese Peri-conceptional Population: Results from the SPCC Study / 生物医学与环境科学（英文）

Objective@#To determine the prevalence and determinants of folic acid (FA) supplementation in Chinese couples planning for pregnancy and in women during early pregnancy.@*Methods@#This was a cross-sectional study based on the Shanghai PreConception Cohort (SPCC) study. Data on FA supplementation and socio-demographic features were collected using questionnaires. Couples visiting clinics for pre-pregnancy examination and pregnant women at < 14 gestational weeks were recruited in Shanghai, China, between March 2016 and September 2018.@*Results@#Among the pregnancy planners, 42.4% (4,710/11,099) women and 17.1% (1,377/8,045) men used FA supplements, while 93.4% (14,585/15,615) of the pregnant women used FA supplements. FA supplement use was higher in female pregnancy planners who were older ( : 1.13, 95% : 1.08-1.18), had higher education ( : 1.71, 95% : 1.53-1.92), and were residing in urban districts ( : 1.06, 95% : 1.01-1.11) of FA supplementation; female pregnancy planners with alcohol consumption ( : 0.95, 95% : 0.90-0.99) had lower odds of FA supplementation. In early pregnancy, women with higher educational level ( : 1.04, 95% : 1.03-1.06), who underwent pre-pregnancy examination ( : 1.02, 95% : 1.01-1.03) had higher odds of using an FA supplement; older aged ( : 0.99, 95% : 0.98-0.99), and multigravida ( : 0.97, 95% : 0.96-0.98) had lower odds of FA supplementation.@*Conclusion@#Although the majority of pregnant women took FA supplements, more than half of the women planning for pregnancy did not. Urgent strategies are needed to improve pre-conception FA supplementation.

Socioeconomic and Environmental Determinants to Preterm Birth in Tibetan Women: An Analysis Based on the Hierarchically Conceptual Frame / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Preterm birth is a common cause of death in newborns and may result from many determinants, but evidence for the socioeconomic and environmental determinants of preterm birth in Tibetan women of childbearing age is limited. The aim of this study was to understand the current status of preterm birth in native Tibetan women and investigate the socioeconomic and environmental determinants.</p><p><b>METHODS</b>Data were drawn from a cohort study which was conducted from August 2006 to August 2012 in rural Lhasa, Tibet, China. A total of 1419 Tibetan pregnant women were followed from 20 weeks' gestation until delivery; the loss to follow-up rate was 4.69%. The incidence of preterm birth was estimated to show the status of preterm births in Tibet. Logistic regression models for longitudinal data were established, and odds ratios (ORs) together with 95% confidence intervals (CIs) were used to evaluate the association between the occurrence of preterm birth and 16 selected potential determinants based on the hierarchical conceptual frame.</p><p><b>RESULTS</b>The incidence of preterm birth was 4.58% (95% CI = 3.55-5.80%). After adjusting for health-related variables of the mothers and newborns, socioeconomic and environmental determinants associated with preterm birth included season (spring: OR = 0.28, 95% CI = 0.09-0.84; autumn: OR = 0.21, 95% CI = 0.06-0.69; and winter: OR = 0.31, 95% CI = 0.12-0.82) and calendar year of delivery (2010: OR = 5.03, 95% CI = 1.24-20.35; 2009: OR = 6.62, 95% CI = 1.75-25.10; and 2007-2008: OR = 5.93, 95% CI = 1.47-23.90).</p><p><b>CONCLUSIONS</b>The incidence of preterm birth among native Tibetan women was low and there was a decreasing trend in recent years; however, it is still essential to strengthen seasonal maternal care, extend the spacing between pregnancies, and reinforce adequate maternal nutrition.</p>

Effects of music therapy on depression and duration of hospital stay of breast cancer patients after radical mastectomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Breast cancer remains the most important cancer among women worldwide. The disease itself and treatment may have a profound impact on the patients' psychological well being and quality of life. Depression is common in breast cancer patients and affects the therapeutic effects as well as prolongs the duration of hospital stay. However, few studies reported the effectiveness of music therapy on depression and duration of hospital stay of female patients with breast cancer after radical mastectomy.</p><p><b>METHODS</b>One hundred and twenty subjects were recruited to this clinical trial and randomly allocated to two groups. The experimental group (n = 60) received music therapy on the basis of routine nursing care, whereas the control group (n = 60) only received the routine nursing care. The whole intervention time was from the first day after radical mastectomy to the third time of admission to hospital for chemotherapy. Data of demographic characteristics and depression were collected by using the General Questionnaire and Chinese version of Zung Self-rating Depression Scale (ZSDS) respectively. One pre-test (the day before radical mastectomy) and three post-tests (the day before discharge from hospital, the second and third admission to hospital for chemotherapy) were utilized. Duration of hospital stay was calculated from the first day after radical mastectomy to the day of discharged from hospital.</p><p><b>RESULTS</b>The mean depression score of all subjects was 37.19 ± 6.30. Thirty-six cases (30%) suffered from depression symptoms, with 26 (72.2%) mild depression cases, 9 (25.0%) moderate depression cases, and 1 (2.8%) severe depression case. After music therapy, depression scores of the experimental group were lower than that of the control group in the three post-tests, with significant differences (F = 39.13, P < 0.001; F = 82.09, P < 0.001). Duration of hospital stay after radical mastectomy of the experimental group ((13.62 ± 2.04) days) was shorter than that of the control group ((15.53 ± 2.75) days) with significant difference (t = -4.34, P < 0.001).</p><p><b>CONCLUSIONS</b>Music therapy has positive effects on improving depression of female patients with breast cancer, and duration of hospital stay after radical mastectomy can be reduced. It is worthy of applying music therapy as an alternative way of nursing intervention in clinical nursing process of caring female patients with breast cancer.</p>

The Chinese registry on reperfusion strategies and outcomes in ST-elevation myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the current use of reperfusion strategies and the outcomes of patients with ST elevation acute coronary syndromes (ACS) in China.</p><p><b>METHODS</b>A total of 518 consecutive patients (371 male and 147 females, mean age 65 +/- 11) with ST elevation ACS or newly discovered left bundle branch block were registered from 20 hospitals from 5 regions (ranging from large regional centre hospitals to small county hospitals) in China. Patient general characteristics, reperfusion patterns and outcomes were analyzed. Patients were followed up for 3 months.</p><p><b>RESULTS</b>The median time from pain onset to presentation at the hospital was 4 hours. Pre-hospital delay > 12 hours was found in 20% patients. Fifty-six percent patients (292/518) underwent reperfusion therapy (134 with primary percutaneous coronary intervention and 158 with fibrinolysis). The median time from admission to reperfusion (door-to-needle) was 65 min in fibrinolysis group and 110 min (door-to-cath) in primary PCI group respectively. Urokinase was used in 67% (106/158) patients underwent fibrinolysis. Multivariate logistic regression analysis showed that age >/= 75 years (P < 0.01), previous myocardial infarction (P < 0.01) and history of congestive heart failure (P < 0.05) were associated with no reperfusion therapy. Mortality and congestive heart failure rates were significantly higher in patients with no reperfusion therapy not only at discharge (P < 0.01) but also at 3 months (P < 0.01) compared to patients underwent reperfusion. The incidence of combined outcomes (death or MI, and death, MI or Strobe) was also higher in patients without reperfusion therapy at 3 months (all P < 0.01) compared to patients underwent reperfusion. There were no differences on combined outcomes between fibrinolysis and primary PCI subgroups.</p><p><b>CONCLUSION</b>Reperfusion therapy was the primary treatment of choice to improve the outcomes of patients with ST elevation ACS. Strategies to increase reperfusion therapy rate for ST elevation ACS are urgently needed in China.</p>

Chinese version of SF-36 in the quality of life assessment among community-dwelling elders / 中南大学学报(医学版)

OBJECTIVE@#To obtain scores in a community-dwelling population over 60 using the SF-36, to assess the reliability and validity of this general health questionnaire, and to analyze the difference in dimension scores among the elderly Chinese in Changsha.@*METHODS@#We randomly selected 602 elders, aged 60 to 91 years, in multi-phases. All the subjects had resided in Changsha for at least one year. The reliability of the SF-36 was assessed by split-half reliability and Cronbach's alpha coefficient and the validity through factor analysis and correlation analysis, etc. The dimension scores of different people were obtained by analysis of variance and independent-samples t-test.@*RESULTS@#The split-half reliability was 0.72 and the Cronbach's alpha coefficients of all the 8 dimensions were more than 0.8; the Pearson correlate coefficients of all the items to their dimensions were more than 0. 59. SF-36 contained 8 domains and 2 summary scales in the factor analysis. Health-related quality was different in different elders.@*CONCLUSION@#The SF-36 is practical in studying the quality of life among community-dwelling elders.