Comparison of hospital delivery costs between cesarean section and natural delivery and analysis of influencing factors / 中南大学学报(医学版)

OBJECTIVES@#The increasing costs of hospital delivery have increased the economic burden of pregnant women, and the mode of delivery is the main factor affecting the costs of hospital delivery. This study aims to explore the difference in costs between cesarean section and natural delivery, and to provide reference for controlling the increase of hospital delivery costs.@*METHODS@#The data of inpatient delivery in the Hunan Maternal and Child Health Care Hospital from January 2016 to December 2020 were selected to compare the total inpatient costs and average daily costs of cesarean section and natural delivery. The linear trend model was used to analyze the trend change of inpatient delivery costs and the generalized linear model was used to analyze the influential factors for inpatient delivery costs.@*RESULTS@#The average hospitalization costs of cesarean section (10 447.25 yuan) were higher than that of natural delivery (5 567.95 yuan), and the average daily costs of cesarean section (1 902.57 yuan) were higher than those of natural delivery (1 666.40 yuan). There was no significant increase or decrease in trend for cesarean section, while the average annual growth rate of the costs of natural delivery was 11.79%. The main factors affecting the hospitalization costs of cesarean section and natural delivery included age, occupation, medical insurance, route of admission, length of stay, premature delivery and complications (all P<0.05).@*CONCLUSIONS@#The total hospitalization costs and average daily costs of cesarean section are higher than those of natural delivery, but the costs of natural delivery show a faster growth trend, and the hospitalization costs of cesarean section and natural delivery should be controlled by targeted measures.

Association of insulin signaling pathway -related gene polymorphisms and gene -gene interactions with MAFLD in obese children / 中南大学学报(医学版)

OBJECTIVES@#Insulin signaling pathway plays an important role in metabolic associated fatty liver disease (MAFLD), however, the association between polymorphisms of genes related to insulin signaling pathway and MAFLD remains unclear. This study aims to investigate the association between insulin signaling pathway-related gene polymorphisms and gene-gene interactions with MAFLD susceptibility in obese children so as to provide scientific basis for further study of genetic mechanism.@*METHODS@#A total of 502 obese children with MAFLD who admitted to Hunan Provincial Children's Hospital from September 2019 to October 2021, were recruited as a case group, and 421 obese children with non-MAFLD admitted during the same period were recruited as a control group. Socio-demographic information, preterm birth history, eating habits, and exercise status of the subjects were collected by inquiry survey, and anthropometric information was collected by physical measurement. At the same time, 2 mL of venous blood was collected to extract DNA, and the polymorphism of insulin signaling pathway-related genes (5 representative candidate genes, 12 variants) was detected. Multivariate Logistic regression analysis was used to investigate the association between insulin signaling pathway-related gene polymorphisms and MAFLD in obese children.@*RESULTS@#After adjusting for confounder factors, INS rs3842748 was significantly associated with the risk of MAFLD in obese children in allele, heterozygous, and dominant models [OR and 95% CI 1.749 (1.053 to 2.905), 1.909 (1.115 to 3.267), 1.862 (1.098 to 3.157), all P<0.05]; INS rs3842752 was significantly associated with the risk of MAFLD in obese children in heterozygous and dominant models [OR and 95% CI 1.736 (1.028 to 2.932), 1.700 (1.015 to 2.846), all P<0.05]. NR1H3 rs3758674 was significantly correlated with the risk of MAFLD in obese children in allele model [OR and 95% CI 0.716 (0.514 to 0.997), P<0.05]. SREBP-1c rs2297508 was significantly associated with the risk of MAFLD in obese children in allele and dominant models [OR and 95% CI 0.772 (0.602 to 0.991) and 0.743 (0.557 to 0.991), all P<0.05]. SREBP-1c rs8066560 was significantly associated with the risk of MAFLD in obese children in allele, heterozygous, and dominant models [OR and 95% CI 0.759 (0.589 to 0.980), 0.733 (0.541 to 0.992), 0.727 (0.543 to 0.974), all P<0.05]. NR1H3 rs3758674 mutant C and SREBP-1c rs2297508 mutant G had interaction in the development of MAFLD in obese children [OR and 95% CI 0.407 (0.173 to 0.954), P<0.05].@*CONCLUSIONS@#The INS, NR1H3, and SREBP-1c gene polymorphisms in the insulin signaling pathway are associated with the susceptibility of MAFLD in obese children, but the functions and mechanisms of these genes need to be further studied.

Influencing factors and risk prediction model for cervical cancer recurrence / 中南大学学报(医学版)

OBJECTIVES@#Cervical cancer is the most common malignant tumor in the female reproductive system worldwide. The recurrence rate for the treated cervical cancer patients is high, which seriously threatens women's lives and health. At present, the risk prediction study of cervical cancer has not been reported. Based on the influencing factors of cervical cancer recurrence, we aim to establish a risk prediction model of cervical cancer recurrence to provide a scientific basis for the prevention and treatment of cervical cancer recurrence.@*METHODS@#A total of 4 358 cervical cancer patients admitted to the Hunan Cancer Hospital from January 1992 to December 2005 were selected as research subjects, and the recurrence of cervical cancer patients after treatment was followed up. Univariate analysis was used to analyze the possible influencing factors. Variables that were significant in univariate analysis or those that were not significant in univariate analysis but may be considered significant were included in multivariate Cox regression analysis to establish a cervical cancer recurrence risk prediction model. Line graphs was used to show the model and it was evaluated by using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis.@*RESULTS@#Univariate analysis showed that the recurrence rates of cervical cancer patients with different age, age of menarche, parity, miscarriage, clinical stage, and treatment method were significantly different (all P<0.05). Multivariate Cox regression analysis showed that RR=-0.489×(age≥55 years old)+0.481×(age at menarche >15 years old)+0.459×(number of miscarriages≥3)+0.416×(clinical stage II)+0.613×(clinical stage III/IV)+0.366×(the treatment method was surgery + chemotherapy) + 0.015×(the treatment method was chemotherapy alone). The area under the ROC curve (AUC) of the Cox risk prediction model for cervical cancer recurrence constructed was 0.736 (95% CI 0.684 to 0.789), the best prediction threshold was 0.857, the sensitivity was 0.576, and the specificity was 0.810. The accuracy of the Cox risk model constructed by this model was good. From the clinical decision curve, the net benefit value was high and the validity was good.@*CONCLUSIONS@#Patient age, age at menarche, miscarriages, clinical stages, and treatment methods are independent factors affecting cervical cancer recurrence. The Cox proportional hazards prediction model for cervical cancer recurrence constructed in this study can be better used for predicting the risk of cervical cancer recurrence.

Association between sibling violence experience and emotional and behavioral problemsamong children and adolescents aged 9-18 years in rural areas / 中国心理卫生杂志

Objective:To explore the association between sibling violence experience and emotional and behavioral problems.Methods:A Multistage stratified cluster sampling was used in Hunan province, 1735 participants from multiple-child family were recruited to survey the prevalence of sibling violence and the occurrence of emotional and behavioral problems with the Strength and Difficulties Questionnaires (SDQ).Results:According to SDQ total score, the rate of abnormal emotion and behavior in children and adolescents involved in sibling violence was higher than that in students who were not experienced sibling violence [45.6％ (236/518) vs.26.8％ (326/1217) ], the rate in bully-victim was higher than that in pure-victim and pure-bully [52.8％ (132/250) vs.37.9％ (74/195) vs.41.1％ (30/73) ].The rates in children and adolescents who were bullied and perpetrated more than 4 sub-types of sibling violence were 63.4％ (53/93) and 76.9％ (60/78).Conclusion:There is an association between sibling violence experience and emotional and behavioral problems among children and adolescents in rural areas.

Treatment and intervention effect of Atrovent aerosol inhalation analysis in patients with chronic obstructive pulmonary disease respiratory failure / 中国生化药物杂志

Objective To investigate the effects of Atrovent aerosol inhalation in the treatment of respiratory failure and nursing intervention of chronic obstructive pulmonary disease effect. Methods January 2016 to December 2016 in Huzhou Central Hospital for diagnosis and treatment of chronic obstructive pulmonary disease patients with respiratory failure in 50 cases dewided into control group and observationgroup: the control group treated with conventional methods, the observation group treated with Atrovent aerosol inhalation therapy and conventional methods; the patients in the two groups of experimental data were recorded in detail, and the obtained data were analyzed. Results The observation group was better than that of treatment and intervention control group, clinical symptoms improved better than the control group, the adverse reaction rate were lower than the control group, there is significant statistical difference (P<0.05). Conclusion The patients with chronic obstructive pulmonary disease with respiratory failure choose conventional and Atrovent aerosol inhalation treatment effect significantly, can effectively improve the patient clinical symptoms and adverse reactions are few and deserve to be widely used in the treatment of chronic obstructive pulmonary diseaseand respiratory failure patients.

Therapeutic effect of one-day outpatient on gestational diabetes mellitus patients / 中南大学学报(医学版)

Objective:To study the effect of one-day outpatient intervention on gestational diabetes mellitus (GDM) patients,and to explore the pregnancy outcome relevant to GDM patients and their fetus.Methods:The GDM patients were divided into two groups according to their own intention to the one-day outpatient.According to systematic sampling method,we chose 200 GDM patients from the above 2 groups,respectively.The 200 GDM patients in the control group were matched the observation group with the age and gestational age,then the pregnancy outcome was tracked.Results:The control level and success rate for the two hours blood sugar after breakfast and hemoglobin A1c (HbA1c) in the observation group were better than those in the control group (P<0.001).The maternal complication rate (46.50%) and neonatal complication rate (21.50%) in the observation group were lower than those in the control group (71.50%,41.50%;P<0.001).The maternal complications rate of fetal distress,premature and the neonatal complications rate of fetal macrosomia,neonatal respiratory distress syndrome (NRDS),low weight,congenital heart disease,neonatal pneumonia,and rate in neonatal NICU were significantly lower than those in the control group (P<0.05).Conclusion:One-day outpatient intervention could control blood sugar effectively,reduce the maternal and neonatal complications.It is worth promoting.

Prevalence of dyslipidemia and its influential factors in 2 028 students from primary and middle schools in Changsha / 中南大学学报(医学版)

Objective:To determine the prevalence of dyslipidemia in students from the primary and middle schools and the influential factors,and to provide evidence for the prevention and control of dyslipidemia and relevant chronic diseases in primary and middle schools.Methods:A total of 2 028 students aged 7 to 17 from the primary and middle schools in Changsha were selected by stratified random cluster sampling.The contents of the study included questionnaire survey,physical measurement and blood tests for fasting blood triglyceride (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),and high-density lipoprotein cholesterol (HDL-C) levels.Non-high-density lipoprotein cholesterol (non-HDL-C) level was calculated by TC level minus HDL-C level.Chi-square test and non-conditional logistic regression model were used to analyze the factors that contributed to dyslipidemia.Results:The dyslipidemia rate was 18.6％,and the abnormal rates of TG,TC,LDL-C,non-HDL-C and HDL-C were 6.8％,5.6％,2.3％,4.2％ and 8.6％,respectively.By chi-square test,the dyslipidemia rate in students with different ages,home locations,BMI groups,central obesity,time on watching TV or playing computer per day,and daily sleep time was statistically significant.Non-conditional logistic regression analysis showed that home location for the city (OR=1.332),overweight (OR=1.548),obesity (OR=2.201),central obesity (OR=1.695),watching TV or playing computer for more than 2 hours per day (OR=1.357),daily sleep time longer than 11 hours (OR=2.518) were the risk factors for dyslipidemia in students from the primary and middle schools.Conclusion:Nearly 1/5 primary and middle school students show dyslipidemia,which is associated with obesity and other bad behaviors.

Factors associated with malnutrition among infants and young children aged 6-23 months in poor rural areas in Hunan Province, China / 中华预防医学杂志

Objective@#To describe the situation and identify factors associated with malnutrition among infants and young children aged 6-23 months in poor rural areas in Hunan Province in 2015.@*Methods@#8 735 rural infants and young children aged 6-23 months in 30 poor counties of Wuling Mountains and Luoxiao Mountains in Hu'nan province were selected by township-level probability proportional to size sampling (PPS) in August 2015, infants' body length and weight were measured, and questionnaires were used to collect infants' information on personal and family, and feeding status in the past 24 h. The prevalence of stunting, underweight and wasting were calculated according to the Growth Standards of Child Aged Under 7 in China which was established in 2009 by Community Health Department of National Health and Family Planning Commission, China (formerly Chinese MOH), and the prevalence of malnutrition was calculated according to the classification of children with anthropometric failure. Multi non-conditional logistic regression model were used to analyze factors associated with malnutrition among infants and young children aged 6-23 months.@*Results@#The prevalence of malnutrition among infants and young children aged 6-23 months was 13.7% (1 198/8 735), the prevalence of stunting, underweight and wasting among infants and young children aged 6-23 months were 4.8% (419/8 735), 9.7% (849/8 735) and 6.1% (531/8 735) respectively. Compared with male group, the OR value of malnutrition for the female group was 1.16; Compared with Han ethnic group, the OR value of malnutrition for the Miao and Tujia ethnic group were 0.83 and 0.66, respectively; Compared with mother with an education level of primary school or below, the OR value of malnutrition for the mother with junior high school, senior high school and university or above education were 0.65, 0.61 and 0.56, respectively; Compared with father with an education level of primary school or below, the OR value of malnutrition for the father with senior high school and university or above education were 0.71 and 0.61 respectively; Compared with normal birth weight group, the OR value of malnutrition for the low birth weight group and high birth weight group were 2.85 and 0.27 respectively; Compared with normal delivery group, the OR value of malnutrition for the premature delivery group was 1.37; all P values<0.05.@*Conclusion@#The prevalence of malnutrition among infants and young children aged 6-23 months in poor rural areas in Hunan province in 2015 was high; Infants and young children who were female, Han ethnic, parents with low education, low birth weight and premature delivery had higher risk of malnutrition.

Study of Basal metabolic rate of 81 young adults aged 20-29 years old in Changsha / 中华预防医学杂志

Objective@#To determine the basal metabolic rate (BMR) of young adults aged between 20-29 years old in Changsha.@*Methods@#We recruited volunteers to join in our research project from April to May, 2015. All recruited volunteers must meet the inclusion criteria: aged 20-29 years old, height between 164-180 centimeters in males and 154-167 centimeters in females, in good health condition, and with no habit of regular physical exercise in last year. Finally, 81 qualified volunteers were selected as research objects, including 43 males and 38 females. The BMR, resting lying metabolism rate and resting sitting metabolism rate of the subjects were detected, and the determined BMR was compared with the calculated@*results@#from the adjusted Schofield equation. Results The BMR, resting lying metabolism rate and resting sitting metabolism rate among males were (166.10±22.09), (174.22±24.56), and (179.54±23.35) kJ·m-2·h-1, respectively, which were all higher than those among females were (137.70±20.04), (149.79±19.25), and (167.78±26.02) kJ·m-2·h-1, respectively, (P<0.001). The BMR of males and females calculated from the adjusted Schofield equation were (160.83±3.93), and (140.29±4.18) kJ·m-2·h-1, respectively, and there was no significantly statistical difference found between the determined BMR and the calculated results from Schofield equation (adjusted) classified by sex, all P values >0.05.@*Conclusion@#The BMR of young adults aged 20-29 years old in Changsha was in the national average level, and the adjusted Schofield equation displayed fine accuracy in predicting BMR of young adults aged 20-29 years old in Changsha.

Status of, and factors associated with, complementary feeding among infants and young children aged 6- 23 months in poor rural areas of Hunan Province, China / 中华预防医学杂志

Objective@#To describe the status of, and to identify the factors associated with, complementary feeding among infants and young children aged 6- 23 months in poor rural areas of Hunan Province, China.@*Methods@#A total of 8 735 infants and young children aged 6- 23 months from 30 poor rural counties in the Wuling and Luoxiao Mountains in Hunan Province were selected by township-level probability-proportional-to-size sampling in August 2015. Questionnaires were used to collect information on the feeding status of the infants in the previous 24 hours, along with personal/family information. The qualified rate of minimum dietary diversity (MDD), the minimum meal frequency (MMF) and the minimum acceptable diet (MAD) were calculated according to the WHO indicators for assessing infant and young child feeding practices. Multi non-conditional logistic regression models were used to analyze factors associated with complementary feeding among infants and young children aged 6- 23 months.@*Results@#The findings indicated that 73.9% (6 452/8 735) of infants and young children aged 6-23 months received the minimum dietary diversity, 81.6% (7 124/8 735) of infants and young children aged 6- 23 months received the minimum meal frequency and 49.0% (4 276/8 735) of infants and young children aged 6- 23 months received an acceptable diet. Compared with the boys, the OR for the MMF and MAD for the girls were 1.15 and 1.11, respectively. Compared with the 6-11 month group, the OR for the MDD for the 12-17 month and 18-23 month groups were 0.41 and 0.38, respectively; the OR for the MMF for the 12-17 month and 18-23 month groups were 1.53 and 2.46, respectively; and the OR for the MAD for the 12-17 month and 18-23 month groups were 0.60 and 0.60, respectively. Compared with the Han ethnic group, the OR for the MDD, MMF and MAD for the Miao ethnic group were 1.43, 1.72 and 1.56, respectively; for the Tujia ethnic group were 2.21, 2.02 and 2.11, respectively; and for the Dong ethnic group were 0.62, 0.61 and 0.64, respectively. When analyzing data related to the children's mothers, compared with women who gestated at the age of 25- 29, the OR for the MMF for women who gestated at less than 20 years of age was 1.59 and at greater than or equal to 35 years of age was 1.33. Compared with women with primary school education or below, the OR for the MDD, MMF and MAD for women with junior high school education were 0.77, 0.74 and 0.80, respectively; for women with senior high school education were 0.67, 0.65 and 0.68, respectively; and for women educated to university level or above were 0.66, 0.47 and 0.60, respectively. Compared with the normal birth weight group, the OR for the MMF for the low birth weight group was 0.71, and for the high birth weight group was 1.30. Compared with the caregivers who provided qualified feeding knowledge, the OR for the MDD, MMF and MAD for the caregivers who provided unqualified feeding knowledge were 1.45, 1.30 and 1.40, respectively. Compared with the breastfed group, the OR for the MDD and the MMF for the non-breastfed group were 0.53 and 0.36, respectively. All P values were <0.05.@*Conclusion@#Most infants and young children aged 6-23 months in poor rural areas of China met the MDD and MMF requirements, but fewer met the MAD requirements. The risk factors in infants and young children for complementary feeding included being of female gender, lower in age (months), of Miao or Tujia ethnicity, being born to a mother who gestated at less than 20 or ≥35 years of age, being born to a mother of low education, having a high birth weight, having a caregiver who provided unqualified feeding knowledge and being breastfed.

Nested case-control study on associated factors for anemia during pregnancy / 中华流行病学杂志

Objective To explore the related factors of anemia during pregnancy and provide scientific evidence for the primary prevention of anemia during pregnancy.Methods The pregnant women (≤ 12 pregnant weeks) who received the first pregnancy care in a local medical institution in Hunan province from June 2013 to November 2014 were included in this cohort study,and for them anemia had been excluded by physical examination.Baseline survey and follow up till childbirth were conducted for them.A queue-based nested case-control study (1 ∶ 2) was conducted (380 pregnant women with anemia detected in this study as case group,760 pregnant women without anemia randomly selected and matched by age,habitual residence during pregnancy as control group.And t test,x2 test and logistic regression analysis were conducted to identify related factors of anemia during pregnancy.Results Multivariate logistic regression analysis indicated that low family annual income level (net income) (OR=2.08,95％CI:1.22-3.59),low educational level (OR=2.09,95％CI:1.22-3.59),pre-pregnancy perm/hair dye (OR=2.23,95％ CI:1.63-3.05),early pregnancy vomiting (OR=2.51,95％ CI:1.56-4.03) were the risk factors for anemia during pregnancy.Intake of vitamin and trace element supplements (OR=0.69,95％ CI:0.50-0.94),frequent meat,fish,shrimp,egg intakes (OR=0.68,95％CI:0.49-0.92),frequent soy milk,milk intakes (OR=0.51,95％CI:0.27-0.95) were the protective factors for anemia during pregnancy.Conclusion A number of factors,such as family annual income level,education level,poisonous and harmful material contact,pregnancy reaction,nutrition,are related to the incidence of anemia during pregnancy,it is necessary to take preventive measures to reduce the incidence of anemia during pregnancy.

Nested case-control study on associated factors for anemia during pregnancy / 中华流行病学杂志

Objective To explore the related factors of anemia during pregnancy and provide scientific evidence for the primary prevention of anemia during pregnancy.Methods The pregnant women (≤ 12 pregnant weeks) who received the first pregnancy care in a local medical institution in Hunan province from June 2013 to November 2014 were included in this cohort study,and for them anemia had been excluded by physical examination.Baseline survey and follow up till childbirth were conducted for them.A queue-based nested case-control study (1 ∶ 2) was conducted (380 pregnant women with anemia detected in this study as case group,760 pregnant women without anemia randomly selected and matched by age,habitual residence during pregnancy as control group.And t test,x2 test and logistic regression analysis were conducted to identify related factors of anemia during pregnancy.Results Multivariate logistic regression analysis indicated that low family annual income level (net income) (OR=2.08,95％CI:1.22-3.59),low educational level (OR=2.09,95％CI:1.22-3.59),pre-pregnancy perm/hair dye (OR=2.23,95％ CI:1.63-3.05),early pregnancy vomiting (OR=2.51,95％ CI:1.56-4.03) were the risk factors for anemia during pregnancy.Intake of vitamin and trace element supplements (OR=0.69,95％ CI:0.50-0.94),frequent meat,fish,shrimp,egg intakes (OR=0.68,95％CI:0.49-0.92),frequent soy milk,milk intakes (OR=0.51,95％CI:0.27-0.95) were the protective factors for anemia during pregnancy.Conclusion A number of factors,such as family annual income level,education level,poisonous and harmful material contact,pregnancy reaction,nutrition,are related to the incidence of anemia during pregnancy,it is necessary to take preventive measures to reduce the incidence of anemia during pregnancy.

Influential factors associated with 2-week prevalence of fever and diarrhea among infants and young children at the age of 6-23 months in poor rural areas / 中南大学学报(医学版)

Objective:To investigate the status and influential factors associated with 2-week prevalence of fever and diarrhea among infants and young children at the age of 6-23 months in poor rural areas.Methods:A total of 8 735 rural infants and young children aged 6-23 months in 30 poor counties of Wuling Mountains and Luoxiao Mountains in Hunan Province were selected in August 2015,and the questionnaires were used to collect information on the prevalence of fever and diarrhea,person and families,and feeding status.The data for prevalence of fever and diarrhea in infants and young children were calculated,and multi-non-conditional logistic regression model were used to analyze the influential factors.Results:The 2-week prevalence of fever and diarrhea in infants and young children was 20.8％ and 12.2％ respectively.The ages (OR=0.66,95％CI 0.58 to 0.75),Dong ethnicity(OR=1.42,95％CI 1.17 to 1.74) and low body weight (OR=1.31,95％CI 1.11 to 1.54) were influential factors for fever among infants and young children in poor rural areas;female (OR=0.86,95％CI 0.76 to 0.98),12-17 months (OR=0.80,95％CI 0.69 to 0.93),18-23 months (OR=0.51,95％CI 0.43 to 0.60),other ethnic minorities (OR=1.70,95％CI 1.13 to 2.56),non-complementary feeding (OR=1.65,95％CI 1.05 to 2.59) and low body weight (OR=1.39,95％CI 1.14 to 1.70) were the influential factors of diarrhea among infants and young children.Conclusion:The 2-week prevalence of fever and diarrhea among infants and young children aged 6-23 months in poor rural areas were quite serious.Low age,Dong ethnicity,and low birth weight are high risk factors for fever.Male,no addition of complementary feeding,and low birth weight are high risk factors for diarrhea.

Prevalence of myopia and influencing factors among primary and middle school students in 6 provinces of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the prevalence of myopia in primary and middle school students in 6 provinces and the possible influencing factors.</p><p><b>METHODS</b>Primary and middle school students were selected through multistage cluster sampling in 60 primary and middle schools in 6 provinces in China. The questionnaire survey and eyesight test were conducted among all the students selected according to the national student's physique and health survey protocol. Pearson chi-square test and binary multivariate logistic regression analysis were done to identify the influencing factors for myopia in students.</p><p><b>RESULTS</b>The prevalence of myopia among primary and middle school students surveyed was 55.7%, the gender specific difference was statistically significant (59.7% for girls, 51.9% for boys) (P<0.01). The prevalence of myopia increased with age obviously. The prevalence was 35.8% in age group 6-8 years, 58.9% in age group 10-12 years, 73.4% in age group 13-15 years and 81.2% in age group 16-18 years, the differences were statistically significant (P<0.001). Single factor and multivariate analysis showed that parents' myopia, distance between computer screen and eyes, distance less than 30 cm between eyes and book while reading, distance less than 10 cm between chest and the table edge while studying, distance less than 3 cm between fingers and pen tip, sleep time, average outdoor activity time during last week, school sport activities in the afternoon, the size of television set at home, time spent on watching TV and playing computer were the influencing factors for myopia.</p><p><b>CONCLUSIONS</b>The prevalence of myopia is till high in primary and middle school students. Myopia is associated with both genetic factors and individual eye health related behaviors.</p>

Behaviours related to infectious disease and family factors in primary and middle school students / 中南大学学报(医学版)

OBJECTIVE@#To explore the behaviors related to infectious disease and family factors in primary and middle school students, and to provide evidence for improving behaviors related to infectious disease.
@*METHODS@#A total of 8465 students were randomly surveyed by a standard questionnaire of behaviors related to infectious disease. Chi-square test was used to analyze the influential factors for behaviors related to infectious disease, and non conditional logistic regression analysis was used to analyze the multiple factors.
@*RESULTS@#The total formation rate of behaviors related to infectious disease was 66.4%. The rates for primary and middle school students were 69.4% and 62.8% respectively, with significant difference (P<0.05). There were significant differences in the following behaviors, such as washing hands before eating food, rarely buying snacks on outside stalls, informing teachers when showing infectious disease symptoms (all P<0.05), the degree for such behaviors in primary school students was higher than that in middle school students. There were also significant differences in the following behaviors, such as washing hands after using the toilet, blocking with a handkerchief, wiping while coughing and sneezing (all P<0.05), the degree for such behaviors in middle school students was higher than that in primary school students. Non conditional logistic regression analysis showed that the behaviors related to infectious disease in primary and middle school students were associated with parents' education degree, mother's occupation and living status with parents.
@*CONCLUSION@#Behaviors related to infectious disease in primary and middle school students need to be improved, and the formation of these behaviors may be related to many family factors.

Influence of mediating/moderating effects of health skills on the relation between knowledge and behaviors in health, among college students / 中华流行病学杂志

Objective To study the influence of mediating/moderating effects of health skills on the relations between health knowledge and health behaviors in college students.Methods Stratified cluster random sampling was used among 2 181 students,selected in several colleges in Changsha,Hunan province.EpiData 3.0 was adopted to establish the database.Correlation and regression analyses were performed by SPSS 17.0.Results Positive correlations were seen on:1)Knowledge and skills on health (r=0.592,P＜0.01),2)Knowledge and behaviors on health (r=0.647,P＜0.01),3)Health skills and health behaviors (r=0.629,P＜0.01).The mediating effect of health skills on the relations between health knowledge and health behaviors was significant (34.55％).The interaction effect of "health skill × (times) related knowledge" was significant (β =-0.093,t =-5.212,P=0.000).New variables that were produced by the interaction also reached significant level (△R2=0.006,P=0.000),resulted in increasing the explanation function to health behaviors by 0.6％.Conclusion Health skills could partially mediate the effects and moderate the relationship between health knowledge and health behaviors among college students.

Complications and related determinants in 13669 pregnant women / 中南大学学报(医学版)

OBJECTIVE@#To investigate pregnancy complications and related determinants, and provide scientific evidence for maternal health care.@*METHODS@#A total of 13669 pregnant women who planned to deliver in the hospital were randomly identified and surveyed by questionnaire. Chi-square test and logistic regression models were used to screen the influencing factors for pregnancy complications.@*RESULTS@#The incidence of pregnancy complication was 13.94%. The following diseases had higher incidence than others: anemia (2.95%), premature rupture of membranes (2.51%), diabetes (1.92%), severe preeclampsia (1.43%), mild preeclampsia (1.27%), and hypertensive disorder complicating pregnancy (1.27%). Data from logistic regression models showed that pregnancy complications were related to maternal age, education level, number of caesarean sections, ways to terminate pregnancy, gestation weeks and number of fetuses.@*CONCLUSION@#The rate of pregnant complication is high, which should be treated in time to ensure the safety of pregnant women.

Modified Delphi method in the constitution of school sanitation standard / 中南大学学报(医学版)

OBJECTIVE@#To constitute school sanitation standard using modified Delphi method, and to explore the feasibility and the predominance of Delphi method in the constitution of school sanitation standard.@*METHODS@#Two rounds of expert consultations were adopted in this study. The data were analyzed with SPSS15.0 to screen indices of school sanitation standard.@*RESULTS@#Thirty-two experts accomplished the 2 rounds of consultations. The average length of expert service was (24.69 ±8.53) years. The authority coefficient was 0.729 ±0.172. The expert positive coefficient was 94.12% (32/34) in the first round and 100% (32/32) in the second round. The harmonious coefficients of importance, feasibility and rationality in the second round were 0.493 (P<0.05), 0.527 (P<0.01), and 0.535 (P<0.01), respectively, suggesting unanimous expert opinions. According to the second round of consultation, 38 indices were included in the framework.@*CONCLUSION@#Theoretical analysis, literature review, investigation and so on are generally used in health standard constitution currently. Delphi method is a rapid, effective and feasible method in this field.

Relationship between caregivers' nutritional knowledge and children's dietary behavior in Chinese rural areas / 中南大学学报(医学版)

OBJECTIVE@#To explore the relationship between caregivers' nutritional knowledge and children's dietary behavior in rural areas of China.@*METHODS@#A cross-sectional study was conducted. 3361 rural caregivers and their children, aged 2 to 7 years old, were selected randomly and surveyed by questionnaire. Logistic regression models were used to identify the relationship between caregivers' nutritional knowledge and the children's dietary behaviors.@*RESULTS@#The awareness level of nutritional knowledge among rural caregivers was 57.9%; among the children surveyed, 79.6% did not like to drink milk, 66.0% were considered choosy of food, 84.1% regularly snacked, 24.4% frequently skipped breakfast, and 13.7% did not come to meals on time. Logistic regression models indicated that a caregiver with a low level of nutritional knowledge is a risk factor for a child's unhealth dietary behaviors (snacking excepted): the odds ratios (OR) of not liking to drink milk, being choosy about food, skipping breakfast or not having meals on time are 1.665, 1.338, 1.330 and 1.582, respectively.@*CONCLUSION@#Caregivers' nutritional knowledge is strongly associated with children's dietary behavior. Nutrition education programs are urgently wanted to improve caregiver's knowledge and thus to improve children's dietary behavior in rural areas of China.

Case-control study on environmental factors in congenital heart disease / 中南大学学报(医学版)

OBJECTIVE@#To explore the relation between environmental factors and the occurrence of congenital heart disease (CHD).@*METHODS@#A hospital-based case-control study was conducted. Mothers of 123 patients with congenital heart disease and 246 normal newborns were interviewed with standardized questionnaires. Chi-square test and logistic regression models were performed to analyze the influencing factors.@*RESULTS@#As shown in multivariable logistic model, gravida with occupational exposure (OR=4.10), or gravida with chronic diseases during progestational pregnancy (OR=5.95), gravida with abnormal childbearing history (OR=6.27), and gravida catching a cold in the early stage of pregnancy (OR=2.07) would increase the risk of CHD. On the contrary, eating meat, egg (OR=0.18) and milk (OR=0.23), and taking multivitamin and microelement (OR=0.35) during the pregnancy reduced the risk of CHD.@*CONCLUSION@#The risk of the offspring developing CHD is associated with gravida's exposure to many environmental factors during pregnancy. It is time to strengthen the intervention measures to reduce the occurrence of CHD.