Early death and causes of death of patients with autism spectrum disorders: A systematic review / 北京大学学报(医学版)

To study of premature/early death of autistic patients from the perspective of life course can help families, medical institutions and policy makers better deal with the adverse effects of autism. Several studies have shown that autistic patients have a high risk of death, however, the results are still inconsistent. To assess the risk of mortality among the autistic patients, we undertook a comprehensive search of MEDLINE, Web of Science and EMBASE databases. This paper reviewed the studies on the negative disease outcomes of autism spectrum disorders, including the risk of death, causes of death and several research hotspots in this field. Strict inclusion/exclusion criteria were used. Information was extracted from selected papers, tabulated and synthesized. In the study, 15 studies were included, with a total of 216 045 individuals. The main outcome was all-cause mortality in association with autism and the secondary outcome was cause-specific mortality. The results showed that all-cause mortality was higher for the autistic patients (RR=2.32, 95%CI: 1.98-2.72, I2=87.1%, P < 0.001). Risk ratio showed a greater inequality for female than male (male: RR=2.00, 95%CI: 1.57-2.55, I2=93.2%, P < 0.001; female: RR=4.66, 95%CI: 3.30-6.58, I2=92.0%, P < 0.001). Compared with the unnatural death, the risk of natural death was higher (RR=3.44, 95%CI: 1.27-9.26, I2=80.2%, P=0.025). As autism had many comorbidities, which would bring more health risks and natural deaths possibilities. There were some structural differences in unnatural death. Accidental injury death and suicide were two kinds of causes. Lacking social skills would weaken the ability to ask for help when encountering injuries. This paper put forward some suggestions for futures. First, to well study the comorbidity can reduce the risk of death from a medical point of view. Second, the scientists and policymakers should pay attention to the social environment and provide a safer environment for the autistic patients. Third, for women and for adolescents without cognitive impairment, due to their high risk of suicide, the society should provide them with more supportive social networks and improve their life satisfaction. Fourth, it is necessary to balance the rehabilitation resources in various regions in China and provide more high-quality lifelong rehabilitation monitoring and care services.

Quality evaluation of Commelina communis from different origins based on multicomponent content determination combined with chemometrics / 中国中药杂志

This research established a high-performance liquid chromatography(HPLC) method for simultaneous determination of isoorientin, orientin, vitexin, and isovitexin in Commelina communis to conduct content difference analysis and quality evaluation of 62 batches of C. communis from different origins. The HPLC content determination was performed on a Dikma Platisil ODS chromatographic column(4.6 mm×250 mm, 5 μm), with acetonitrile-0.1% formic acid(14∶86) as the mobile phase. The detection wavelength was set at 348 nm, the flow rate was 1.0 mL·min~(-1), and the column temperature was 35 ℃. The differences in origins and quality of 62 batches of C. communis were studied by chemometrics. The results showed that the determination of four components mani-fested a good linear relationship in the range of mass concentration(r>0.999 9), and the average recovery rate was 96.17%-103.0%. The relative standard deviations(RSDs) of precision, stability, and repeatability were all less than 2.0%. The content of four components from high to low was isoorientin>isovitexin>orientin>vitexin. Forty-seven batches of C. communis with clear origins were classified into six categories by chemometrics. C. communis from different origins had different qualities. Generally, C. communis from Western China, Central China, and South of China had superior qualities. The HPLC method established in this study is specific, simple, and efficient, which provides references for the comprehensive evaluation of the quality of C. communis. The chemometrics shows that the qualities of C. communis from different origins are largely different. Isoorientin can be used as an index to determine the content of C. communis, and its content limit should be set no less than 0.023%.

Nomogram to predict pregnancy outcomes of emergency oocyte freeze-thaw cycles / 中华医学杂志(英文版)

BACKGROUND@#Existing clinical prediction models for in vitro fertilization are based on the fresh oocyte cycle, and there is no prediction model to evaluate the probability of successful thawing of cryopreserved mature oocytes. This research aims to identify and study the characteristics of pre-oocyte-retrieval patients that can affect the pregnancy outcomes of emergency oocyte freeze-thaw cycles.@*METHODS@#Data were collected from the Reproductive Center, Peking University Third Hospital of China. Multivariable logistic regression model was used to derive the nomogram. Nomogram model performance was assessed by examining the discrimination and calibration in the development and validation cohorts. Discriminatory ability was assessed using the area under the receiver operating characteristic curve (AUC), and calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test and calibration plots.@*RESULTS@#The predictors in the model of "no transferable embryo cycles" are female age (odds ratio [OR] = 1.099, 95% confidence interval [CI] = 1.003-1.205, P = 0.0440), duration of infertility (OR = 1.140, 95% CI = 1.018-1.276, P = 0.0240), basal follicle-stimulating hormone (FSH) level (OR = 1.205, 95% CI = 1.051-1.382, P = 0.0084), basal estradiol (E2) level (OR = 1.006, 95% CI = 1.001-1.010, P = 0.0120), and sperm from microdissection testicular sperm extraction (MESA) (OR = 7.741, 95% CI = 2.905-20.632, P 10 mm on the day of hCG administration.

Utilization and Demand of Health Care Service for Children with Mental Disabilities in China / 中国康复理论与实践

Objective:To investigate the utilization and demand of health care services for children with mental disabilities and provide implications for the development and update of related policies. Methods:Data of utilization and demand of health care services for children with mental disabilities aged 0 to 17 years were selected from The Second China National Sample Survey on Disability in 2006. The difference of utilization and demands of health care services for children was analyzed in socio-economic characteristics including gender, age, urban and rural areas, disabled level, parents' highest level of education and family income. Results:The utilization rate of health care service was relatively low (44.35%), and the demands was high (98.26%) among children with mental disabilities. Medical services and assistance, rehabilitation training and services, and aid and support for poor people with disabilities were the most-utilized and most-demanded services for children with mental disabilities. In terms of utilization, the utilization rates of medical services and assistance, and rehabilitation training and services were higher among children with mental disabilities in urban areas than in rural areas (χ2 > 11.028, P < 0.01). And the utilization rate of these two services also was higher among mentally disabled children from family with higher parental education and income than among the counterparts from families with low socioeconomic status (χ2 > 9.169, P < 0.05). In terms of demand, children with more severe mental disability had higher demand of aid and support for poor people with disabilities (χ2 = 17.822, P < 0.001). And higher demand of rehabilitation training and services was found among mentally disabled children with better family socio-economic status (χ2 = 7.797, P < 0.05). Conclusion:The demands for health care services among children with mental disabilities urgently need to be further met. Reinforcing the development of above three types of services, addressing the imbalance of health care services allocation between urban and rural areas, and improving the economic conditions of disabled families will effectively improve the utilization of the health care service for mentally disabled children.

Association between Socio-economic Status and Rehabilitation Service Utilization for Adults with Different Disabilities / 中国康复理论与实践

Objective:To analyze the relationship between socio-economic status and utilization of rehabilitation services for adults with different disabilities. Methods:Adults with single disability were selected from the Second China National Sample Survey on Disability. Their education level and per capita household income were used as socio-economic index, controlled with sex, age group, residence, disabled level and marriage. Results:The prevalence of rehabilitation service utilization was 2.98% to 15.97%, and it was more in urban people than in rural ones. Education level trended to be a positive factor to utilization of rehabilitation service, but different with the types of disabilities. Per capita household income was mixed for the utilization of rehabilitation service, which was positive for some disabilities, negative for some ones, and no significant for others. Conclusion:The utilization of rehabilitation services needs to improve for adults with disabilities. Policies can be made targeting to the people with different disabilities.

Effect of Magnesium Sulfate, Nifedipine Tablet Combined Salvia Injection on ET-1/NO, TXA2/PGI2 and Hemorheology of Preeclampsia Patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of magnesium sulfate, Nifedipine Tablet (NT) combined Salvia Injection (SI) on endothelin-1 (ET-1), nitric oxide (NO), thromboxane A2(TXA2), prostacyclin I2(PG2), and hemorheology of preeclampsia patients.</p><p><b>METHODS</b>Totally 704 preeclampsia patients were randomly assigned to the treatment group and the control group, 352 cases in each group. All patients were treated with magnesium sulfate combined NT (on the first day: slow intravenous injection of magnesium sulfate 5 g + intravenous dripping of magnesium sulfate injection 10 g + oral administration of NT 30 mg; on the second and third day, intravenous dripping of magnesium sulfate injection 10 g + oral administration of NT 30 mg), while those in the treatment group were dripped with SI additionally at 20 mL per day for 3 consecutive days. Before and after treatment plasma levels of endothelin-1 (ET-1), nitric oxide (NO), TXA2, PGi2, and hemorheology indicators [such as high blood viscosity (HBV), low blood viscosity (LBV), plasma viscosity (PV), erythrocyte rigidity index (ERI), fibrinogen (FIB)] of two groups were detected.</p><p><b>RESULTS</b>Compared with the same group before treatment, serum levels of ET-1, TXA2, HBV, LBV, PV, ERI, and FIB decreased in the two groups after treatment (P <0. 05), but levels of NO and PG2 increased (P <0. 05). Compared with the control group in the same period, levels of ET-1, TXA2, HBV, LBV, PV, ERI, and FIB decreased in the treatment group after treatment (P <0. 05), but levels of NO and PGI2 increased (P <0. 05).</p><p><b>CONCLUSION</b>Magnesium sulfate, NT combined SI could effectively regulate the balance of ET-1/NO and TXA2/PGI2, and improve hemorheology of preeclampsia patients.</p>

Amelioration of diabetic nephropathy in rats by resveratrol: involvement of anti-inflammatory effect / 中国药学杂志

OBJECTIVE: To observe the protective effect of resveratrol (Rev) on diabetic nephropathy in rats with inflammation impairment. METHODS: Male rats were divided into two groups and fed with commercially available normal pellet diet (NPD) or in-house prepared high-fat diet (HFD), respectively. After 4 weeks of dietary feed, the rats from HFD group were injected intraperitoneally with low dose of streptozotocin (STZ) (40 mg·kg-1). Half of the rats from both groups were administered with a dose of Rev(50 mg·kg-1·d-1)for 32 weeks. The rats were allowed to continue to be feed on their respective diets until the end of the study. After 32 weeks, the body weight, levels of FPG, TC, TG, BUN, SCr, Cys C, and urine protein and kidney vascular permeability were assayed; the contents of IL-1β, IL-6 and ICAM-1 in serum were detected by ELISA; the vascular permeability of kidney was detected by Evans blue; glomerular morphological analysis was performed in PAS stained pathological section; the levels of ICAM-1 mRNA and the expression of ICAM-1 in kidney were detected by RT-PCR and Immunohistochemistry and Western blot. RESULTS: Rev had remarkably suppressed weight gain and lowered levels of FPG, TC, TG, BUN, SCr, Cys C, IL-1β, IL-6 and ICAM-1 in serum (P<0.05), decreased urine protein (P<0.05), and reduced kidney vascular permeability (P<0.05). Increased indices for glomerular injury were significantly ameliorated by Rev treatment (P<0.05). The expression of ICAM-1 mRNA was markedly up-regulated in the kidneys of diabetic rats, which was effectively suppressed by Rev treatment (P<0.05). Western blot and immunohistoehemistry analysis showed that the expression of ICAM-1 was reduced significantly by Rev treatment. CONCLUSION: Rev can ameliorate diabetic nephropathy damage in rats, and the protection role may be attributed to its effect to lower lipid and glucose levels in serum and inhibit inflammation in kidney.

Impact of periconceptional multi-micronutrient supplementation on gestation: a population-based study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To examine the effect of periconceptional multi-micronutrient supplementation on gestation and birth outcomes.</p><p><b>METHODS</b>A population-based community intervention program was conducted in 18 counties in China. Participants were divided into an intervention group, who received multi-micronutrient supplementation from at least 3 months before pregnancy throughout the first trimester, and a control group. Pregnant women were followed up to record information about birth outcomes. Maternal socio-economic characteristics and main birth outcomes were evaluated. Gestational age was further analyzed using survival analysis, to determine the time distribution of delivery.</p><p><b>RESULTS</b>Periconceptional multi-micronutrient supplementation was associated with higher birth weight, birth length and occipitofrontal head circumference, and with lower incidence rates for stillbirth, low birth weight, and preterm birth. Moreover, periconceptional multi-micronutrient supplementation changed the time distribution of delivery, making the deliveries more clustered in the period between day 275 and day 295 of gestation.</p><p><b>CONCLUSION</b>Our study shows that periconceptional multi-micronutrient supplementation is beneficial for fetal development and optimizes all measured aspects of health in neonates in socioeconomically disadvantaged areas in China. The change in time distribution of deliveries caused by multi-micronutrient supplementation needs further clarification.</p>

PSO/ACO algorithm-based risk assessment of human neural tube defects in Heshun County, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To develop a new technique for assessing the risk of birth defects, which are a major cause of infant mortality and disability in many parts of the world.</p><p><b>METHODS</b>The region of interest in this study was Heshun County, the county in China with the highest rate of neural tube defects (NTDs). A hybrid particle swarm optimization/ant colony optimization (PSO/ACO) algorithm was used to quantify the probability of NTDs occurring at villages with no births. The hybrid PSO/ACO algorithm is a form of artificial intelligence adapted for hierarchical classification. It is a powerful technique for modeling complex problems involving impacts of causes.</p><p><b>RESULTS</b>The algorithm was easy to apply, with the accuracy of the results being 69.5%±7.02% at the 95% confidence level.</p><p><b>CONCLUSION</b>The proposed method is simple to apply, has acceptable fault tolerance, and greatly enhances the accuracy of calculations.</p>

An evaluation of the investment for child development in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study estimated the investment in child development from three aspects-public health, public education, and family investment to establish the level of investment, to provide reference information for government decision making and to provide international comparisons.</p><p><b>METHODS</b>Public investment in health was measured with macro data related to public health spending and child development in government expenditure. Public education investment was based on basic education data. Family investment evaluation was based on per capita family consumer spending data in different age groups to estimate the input for child development.</p><p><b>RESULTS</b>Both public health investment level and the proportion of GDP rose for all age groups over time, but the overall investment level was still insufficient. Public investment in children's education has increased year by year, but the trends in all age groups are unbalanced with much lower investment in early childhood education. Private investment in children has increased over the period, but has declined as a percentage of GDP. International comparisons show that Chinas investment in child development is much lower than OECD countries.</p><p><b>CONCLUSION</b>The private investment in child development was the main way in China, with public finance contributing only a small proportion. Given the poor international comparisons, the government needs to review the balance of public investment to redirect more towards the development of children under the age of six to their health and education.</p>

Maternal periconceptional consumption of pickled vegetables and risk of neural tube defects in offspring / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Maternal exposure to nitrate, nitrite, and N-nitroso compounds from drinking water or diet has been associated with an increased risk of neural tube defects (NTDs) in some studies. Pickled vegetables contain relatively large amounts of nitrite and N-nitroso compounds. We examined the association between maternal periconceptional consumption of pickled vegetables and NTDs in Shanxi Province of northern China.</p><p><b>METHODS</b>Data were derived from a population based case-control study of major external birth defects in four counties of Shanxi Province. Participants included 519 NTDs cases identified between 2003 and 2007 and 694 healthy controls. Exposure information was collected within 1 week after delivery. Multivariable non-conditional Logistic regression model was used to estimate the adjusted odds ratio (OR) controlling for potential confounding variables.</p><p><b>RESULTS</b>The risk of NTDs was positively associated with the frequency of the consumption of pickled vegetables by the mother. Compared with pickled vegetables consumption at < 1 meal/week, the adjusted OR for consumption at 1 - 3, 4 - 6, and > 6 meals/week were 1.3 (95% confidence interval (CI): 1.0, 1.8), 1.9 (1.1, 3.2), and 3.6 (1.9, 6.9), respectively. A protective effect was found for maternal meat consumption at ≥ 1 meal/week (adjusted OR: 0.6, 95%CI: 0.4, 0.7) and egg or milk consumption at ≥ 1 meal/week (adjusted OR: 0.6, 95%CI: 0.4, 0.8).</p><p><b>CONCLUSION</b>Maternal periconceptional consumption of pickled vegetables may increase the risk for NTDs in Shanxi Province.</p>

Cesarean delivery on maternal request and childhood intelligence: a cohort study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cesarean section births have been steadily increasing over the past decade and have become an epidemic in China. Cesarean delivery on maternal request is a major contributor to this upward trend, and there has been of much concern about its impact on maternal and child health. Most of mothers believe that cesarean delivery on maternal request can improve the child's intelligence, but direct evidence is sparse. In this cohort study, we aimed to directly assess the impact of cesarean delivery on maternal request on childhood intelligence.</p><p><b>METHODS</b>Intelligence quotient (IQ) of 4144 preschool children from 21 cities/counties of Zhejiang and Jiangsu province whose mothers were registered in a population-based perinatal surveillance program during 1993-1996 was assessed with Chinese Wechsler Young Children Scale of Intelligence (C-WYCSI) in 2000. The outcomes were full-scale IQ, verbal IQ, and performance IQ of C-WYCSI. Mode of delivery and covariates were obtained from the surveillance program. We estimated unadjusted and adjusted effects of cesarean delivery on maternal request and assisted vaginal delivery on IQ scores compared with spontaneous vaginal delivery using regression analysis.</p><p><b>RESULTS</b>The mean full-scale, verbal, and performance IQ for all children was 99.3 ± 16.1, 93.6 ± 17.7, and 105.3 ± 14.3. In crude analysis, cesarean delivery on maternal request versus spontaneous vaginal delivery was associated with an increase of 3.9 (95% confidence interval, 0.6 to 7.2) points in full-scale IQ, 4.8 (1.2 to 8.4) points in verbal IQ, and 2.4 (-0.6 to 5.3) points in performance IQ. After adjusting for maternal education, occupation, and IQ, the advantage was reduced to 1.6 (-1.3 to 4.5), 2.3 (-0.8 to 5.5), and 0.6 (-2.0 to 3.3) points for full-scale, verbal, and performance IQ, respectively. Assisted vaginal delivery versus spontaneous vaginal delivery was not associated with IQ scores in any analysis.</p><p><b>CONCLUSION</b>Neither cesarean delivery on maternal request nor assisted vaginal delivery affected children's IQ.</p>

Single nucleotide polymorphisms of the maternal Msx2 gene and their association with fetal neural tube defects in Han ethnic group in Shanxi Province, China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Neural tube defects are the most common human birth defects. The causes are multifactorial with complex genetic and environmental factors, although the exact genetic causes are unknown. This research was conducted to study the frequency of Msx2 gene polymorphisms in 59 women with a history of pregnancy with a neural tube defect and in 73 healthy controls. We aimed to determine the effect of this genetic polymorphism on the incidence of neural tube defects in the Han Chinese population.</p><p><b>METHODS</b>We studied 59 mothers with at least one previous child with a neural tube defect (the case group) and 73 case-control subjects during the same period, from Shanxi Province, China. We analyzed the genotypic distributions and allele frequencies of Msx2 C386T polymorphisms in DNA samples from the case and control groups. A three-dimensional protein model was predicted using Swiss-Pdb Viewer software version 4.0. Disease association was analyzed using chi-square tests.</p><p><b>RESULTS</b>Significant differences were observed in the genotypes and allele frequencies of the Msx2 C386T allele between the case and control groups (CT: 32% vs. 15%, P = 0.0073 and TT 15% vs. 4%, P = 0.013, respectively). Logistic regression analysis showed that the C386T mutation is a potential risk factor for neural tube defects (P < 0.05; OR: 3.466; 95%CI: 1.831 - 6.560). Three-dimensional structure prediction revealed that the Msx2 C386T mutation results in a threonine substitution for methionine at position 129 of exon 2, which might lead to structural mutations or dysfunctions in the protein encoded by Msx2.</p><p><b>CONCLUSION</b>Maternal Msx2 C386T gene polymorphisms were associated with fetal neural tube defects in Han Chinese women in Shanxi Province.</p>

Life expectancy of people with physical disabilities in China / 中华流行病学杂志

Objective To estimate the life expectancy of persons with physical disabilities in China based on data related to representative national disability.Methods Life table technique was used to estimate the life expectancy and its standard error by various characteristics on the basis of average mortality rates from the monitoring cases during 2007-2010.Results (1)Females were expected to live longer than males.The life expectancy at birth for females was 63 years with standard error(SE)=2.6 while for males it was 55 years(SE=3.1).(2)Persons aged 35-50 in urban areas had higher life expectancy than those in rural areas.(3)Life expectancy of persons with mild disability [62.5 years(SE=2.4)] was higher than that of persons with severe disability[42 years(SE=5.4)].(4)Life expectancies of persons with physical disability were much lower than that of the Chinese general population.Gaps of male and female life expectancy at birth were 17.1 years and 12.7 years,respectively.Conclusion Persons with physical disability had higher mortality and actions should be taken to improve their life expectancy,accordingly.

Prediction of neural tube defect using support vector machine / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To predict neural tube birth defect (NTD) using support vector machine (SVM).</p><p><b>METHOD</b>The dataset in the pilot area was divided into non overlaid training set and testing set. SVM was trained using the training set and the trained SVM was then used to predict the classification of NTD.</p><p><b>RESULT</b>NTD rate was predicted at village level in the pilot area. The accuracy of the prediction was 71.50% for the training dataset and 68.57% for the test dataset respectively.</p><p><b>CONCLUSION</b>Results from this study have shown that SVM is applicable to the prediction of NTD.</p>

Study on the changing structure of disabled population caused by birth defects in China / 中华流行病学杂志

Objective To Compare the differences of classification and grading on disability between the TWO National Sample Surveys on Disability in 1987 and 2006, and to analyze the change of structure on disabled population with birth defects (BD). Methods Quantitative analysis had been carried out based on the investigation of two national sample surveys. Results (1)Prevalence rates of Disabilities caused by BD of 0-14, 15-64 and ≥65 age groups in 2006 were 0.1%, 0.28% and 1.15% respectively, all higher than those in 1987. There was significant difference among the age group of ≥65, between the two standard periods of survey. (2) The difference of prevalence rates on Disabilities caused by BD between males and females in 2006 was 0.03% higher than that of 1987 and the difference of proportion on Disability caused by BD between males and females in 2006 was 0.08%, which was lower than those data from the year 1987 (2006: x2=66.254,P＜0.001; 1987: x2=22.895, P＜0.001 ). (3) Prevalence rate of Disabilities caused by BD in rural area was 0.49% in 1987, and 0.74% in 2006 after standardization, which had an 50% increase during the past 19 years. Prevalence rate of Disabilities caused by BD in urban area was 0.35% in 1987 and 0.50% in 2006, which had an 43%. Increase during the past 19 years. (4) Percentage of grade 1 listen-speech disability caused by BD in 2006 deceased 17.35%, and the intelligent disability caused by BD increased 18.21% in 2006. (5) Compared with 1987, the difference of percentage on primary and higher education among disabled persons with BD disabled population and total population,became smaller in 2006. Conclusion To carry on a better study on disability, evaluation criteria of disability classification and grading standards should not only be taken into account on the continuity of the investigation, but also be better integrated with the international standards in terms of longitudinal comparison of data. Age structure of total population had a significant effect on the changing of structure on disabled persons caused by BD. Rural area was the high-risk area for disability caused by BD in China while female population should be viewed as the focus group of disability caused by BD.

Epidemiological study on disabilities among ethnic minorities in China / 中华流行病学杂志

Objective To explore the prevalence rates of disabilities among the ethnic minority people in China. Methods Utilizing stratified, multiphase, and cluster probability sampling design, 2 526 145 persons were investigated and screened by trained interviewers,including 297 761 persons with ethnic minority backgrounds. Respondents scoring positive for potential problems were referred to physician for further diagnosis on disability and on scale measurement.Results The overall prevalence rate of disability for both ethnic minority and Han population were 6.24% (95%CI:6.16%-6.51% ) and 6.41% (95% CI: 6.38%-6.51% ) respectively. The total aggregate age-adjusted prevalence rate of disability was 7.31% for persons with ethnic minority. The prevalence rate of disabilities in male was significantly higher than that in females (7.31% vs. 6.75% ). The ranking of prevalence rates on different type of disabilities were: physical disability 1.90% (95%CI:1.89%-1.91%), hearing disability 1.34%(95%CI: 1.33%-1.35%), multiple disability 1.14%(95%CI:1.13%-1.15% ), vision disability 0.99% (95%CI: 0.97%-1.01% ), psychiatric disability 0.38%(95%CI:0.37%-0.40% ), intellectual disability 0.38% (0.37%-0.39%) and speech disability 0.12% (0.11%-0.13% ). Cerebral Palsy, genetic diseases, tympanitis, cerebral disease and mental retardation (not including unknown items) were the major causes for disabled children with ethnicity background.Degenerated diseases, including osteoarthropathy, cerebrovascular disease, elderly-related deafness or cataract were most important causes for ethnic minority persons aged 60 or over. Injury, including traffic accident was important disabled-related factor for persons with minority ethnicity aged 15-59.The main causes and ranking of causes for ethnical minority were similar with that for Han population.Conclusion The prevalence rate of disability for ethnic minority persons was significantly higher than that for Han population in China. Prevention for different types of disability should be provided accordingly to persons with ethnic minority, in different age groups.

Unusual patterns of neural tube defects in a high risk region of northern China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the prevalence of different types of neural tube defects (NTDs) in Luliang Prefecture, Shanxi province, where the prevalence of NTDs is unusually high and the correlation between NTDs prevalence and patterns.</p><p><b>METHODS</b>A surveillance population-based birth defects was performed in Luliang Prefecture, Shanxi province.</p><p><b>RESULTS</b>The results of our study showed that the prevalence of NTDs was 2-fold higher in Luliang Prefecture than in other areas of Shanxi province. Unusual patterns of NTDs were found, however, multiple NTDs were relatively common in Luliang Prefecture, accounting for over 13% of all NTDs cases in China.</p><p><b>CONCLUSION</b>The prevalence of NTDs is associated with its patterns.</p>

Effect of pathoanatomic diagnosis on the quality of birth defects surveillance in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To provide evidence for more accurate diagnosis of birth defects based on the pathoanatomy of congenital malformations.</p><p><b>METHODS</b>Data used in this study were obtained from Luliang City Hospital and three county hospitals of Shanxi province between February 2004 and March 2006. Autopsy and pathological examination of 160 dead fetuses and stillbirths were performed. Photos of dead fetuses and stillbirths were taken, tissues were cut into sections for pathological examination under microscope, all pathological information was recorded, and percentage of birth defects was calculated.</p><p><b>RESULTS</b>The proportion of dead fetuses and stillbirths with or without congenital malformations was 84.4% (135/160) and 15.6% (25/160), respectively. There were 16 categories of major external and internal birth defects in 135 cases of such defects. Congenital heart defects, anencephaly and spina bifida had a higher prevalence rate in the study period. The prevalence rate of non-malformation death and birth defects < 28 gestational weeks and internal anomalies > or = 28 gestational weeks was 14.61% (61/4175) and 17.25% (72/4175), respectively. A total of 413 in situ anomalies were found in 135 cases of autopsy. Spina bifida, anencephaly, congenital heart defects, aplasia or accessory lobe of lung, renal agenesis and dysplasis and congenital hydrocephaly were more closely associated with severe malformations than with mitis malformations. The cases of dead fetuses and stillbirths with multiple malformations (> or = 2 in situ anomalies) had a higher proportion (74.1%), whereas those with isolated malformations had a lower proportion (25.93%).</p><p><b>CONCLUSION</b>The occurrence of congenital malformations in different embryonic developmental stages affects multiple organs. Postmortem examination of internal and multiple malformations of fetal deaths and stillbirths can provide more accurate diagnostic information for birth defects.</p>

Application of 'Family-Based Association Test' in studying genetic epidemiology / 中华流行病学杂志

To introduce the application of Family-Based Association Test (FBAT) in detecting the association or linkage between marker alleles and phenotype or traits in genetic epidemiology. A brief overview on basic steps involved in design, implementation, principles of application, available software as well as the use and feature of FBAT method, were explained based on data from nuclear family. Advantages of FBAT were compared to conventional genetic statistics approaches. Data showed that this approach might make the most use of parental genotype,genotype of affected offspring and their phenotype to test the association between biallelic or multi-allelic markers, phenotype or traits to their conditional distributions given the minimal sufficient statistics under the null hypothesis for the genetic model. Covariates, such as traits or environmental exposures, might be included into this proudure so as to effectively control the bias of population admixture through adjustment of variables. FBAT could be used for genetic analysis with data from nuclear family since it is more advantageous than the conventional statistical methods.