Effect of alanine aminotransferase in early pregnancy on neonatal birth weight / 中华内分泌代谢杂志

Objective:To investigate the effect of alanine aminotransferase(ALT) level in early pregnancy and its interaction with maternal body mass index(BMI) on neonatal birth weight.Methods:Data of full-term singleton delivery mother-infant pairs from 2014 to 2016 in Wenzhou were collected. The exposure(ALT>40 U/L) and non-exposure(ALT≤40 U/L) groups were matched using 1∶4 propensity score matching. Logistic regression analysis was used to analyze the relationship between increased ALT level in the first trimester and abnormal birth weight as well as the effect of its interaction with BMI on abnormal birth weight.Results:Multivariate analysis showed that the risks of macrosomia and large for gestational age(LGA) in pregnant women with ALT>40 U/L were 1.584(95% CI 1.323-1.896) and 1.292(95% CI 1.142-1.461) compared with those with ALT≤40 U/L. ALT in the first trimester displayed an additive interaction with BMI on the risk of macrosomia [the relative excess risk due to interaction( RERI)=2.032, 95% CI 0.307-3.757, the attributable proportion due to interaction( API)=0.448, 95% CI 0.221-0.684, the synergy index( S)=2.348, 95% CI 1.274-4.324]. In addition, there was no interaction between ALT and BMI on the risk of LGA, and nor did the association of ALT in the first trimester with low birth weight or small for gestational age exist. Conclusion:ALT>40 U/L in the first trimester increases the risk of high birth weight, especially in overweight or obese pregnant women in the first trimester. Therefore, it is suggested to strengthen the monitoring of ALT level in obese pregnant women during the first trimester.

Epidemiological investigation of macrosomia-related knowledge awareness among pregnant women in Zhejiang province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the awareness rate of macrosomia related knowledge and influencing factors among pregnant women in Zhejiang province and provide evidence for the improvement of pre-gestational and prenatal care.</p><p><b>METHODS</b>A face to face questionnaire survey was conducted among 1 512 pregnant women selected through multistage cluster random sampling from 20 counties (district) in Zhejiang. Macrosomia-related awareness and related factors were analyzed.</p><p><b>RESULTS</b>A total of 1 494 valid questionnaires were analyzed, the awareness rate was 40.7% for macrosomia diagnostic criteria (95% CI: 38.2%-43.2%), 55.0% for the cause of macrosomia (95% CI: 52.4%-57.6%) and 62.4% for prevention related knowledge (95% CI: 59.9%-64.9%) and the awareness rate of both the cause and the prevention related knowledge was 49.0% (95% CI: 46.4%-51.6%). Multivariate logistic regression analysis showed that the third trimester of pregnancy (OR = 1.906, 95% CI: 1.128-3.221), urban residence (OR = 1.335, 95% CI: 1.014-1.756), educational level of junior college (OR = 2.474, 95% CI: 1.635-3.744) and educational level of regular college or above (OR = 2.072, 95% CI: 1.338-3.209), receiving health education about health pregnancy (OR = 1.936, 95% CI: 1.509-2.484) and self-learning about the knowledge of health pregnancy (OR = 2.065, 95%CI: 1.338-3.189) were the influencing factors to the awareness rate of macrosomia diagnostic criteria and prevention related knowledge of macrosomia among pregnant women. The awareness rate of the cause and prevention related knowledge of macrosomia was higher in older age group (OR = 2.103, 95% CI: 1.330-3.323).</p><p><b>CONCLUSION</b>Among the pregnant women in Zhejiang, the awareness rate of macrosomia diagnostic criteria was less than 50%. Therefore, it was necessary to strengthen the health education during pre-gestational and gestational periods among reproductive women, especially the education about pregnancy health in rural area.</p>

Epidemiological investigation of macrosomia-related knowledge awareness among pregnant ;women in Zhejiang province / 中华流行病学杂志

Objective To understand the awareness rate of macrosomia related knowledge and influencing factors among pregnant women in Zhejiang province and provide evidence for the improvement of pre-gestational and prenatal care. Methods A face to face questionnaire survey was conducted among 1 512 pregnant women selected through multistage cluster random sampling from 20 counties(district)in Zhejiang. Macrosomia-related knowbedge awareness and related factors were analyzed. Results A total of 1 494 valid questionnaires were analyzed,the awareness rate was 40.7%for macrosomia diagnostic criteria(95%CI:38.2%-43.2%),55.0%for the cause of macrosomia(95%CI:52.4%-57.6%) and 62.4% for prevention related knowledge(95%CI:59.9%-64.9%) and the awareness rate of both the cause and the prevention related knowledge was 49.0%(95%CI:46.4%-51.6%). Multivariate logistic regression analysis showed that the third trimester of pregnancy(OR=1.906,95%CI:1.128-3.221),urban residence(OR=1.335,95%CI:1.014-1.756),educational level of junior college(OR=2.474,95%CI:1.635-3.744)and educational level of regular college or above (OR=2.072,95%CI:1.338-3.209),receiving health education about health pregnancy(OR=1.936, 95%CI:1.509-2.484)and self-learning about the knowledge of health pregnancy(OR=2.065,95%CI:1.338-3.189)were the influencing factors to the awareness rate of macrosomia diagnostic criteria and prevention related knowledge of macrosomia among pregnant women. The awareness rate of the cause and prevention related knowledge of macrosomia was higher in older age group(OR=2.103,95%CI:1.330-3.323). Conclusion Among the pregnant women in Zhejiang,the awareness rate of macrosomia diagnostic criteria was less than 50%. Therefore,it was necessary to strengthen the health education during pre-gestational and gestational periods among reproductive women,especially the education about pregnancy health in rural area.

Epidemiological investigation of macrosomia-related knowledge awareness among pregnant ;women in Zhejiang province / 中华流行病学杂志

Objective To understand the awareness rate of macrosomia related knowledge and influencing factors among pregnant women in Zhejiang province and provide evidence for the improvement of pre-gestational and prenatal care. Methods A face to face questionnaire survey was conducted among 1 512 pregnant women selected through multistage cluster random sampling from 20 counties(district)in Zhejiang. Macrosomia-related knowbedge awareness and related factors were analyzed. Results A total of 1 494 valid questionnaires were analyzed,the awareness rate was 40.7%for macrosomia diagnostic criteria(95%CI:38.2%-43.2%),55.0%for the cause of macrosomia(95%CI:52.4%-57.6%) and 62.4% for prevention related knowledge(95%CI:59.9%-64.9%) and the awareness rate of both the cause and the prevention related knowledge was 49.0%(95%CI:46.4%-51.6%). Multivariate logistic regression analysis showed that the third trimester of pregnancy(OR=1.906,95%CI:1.128-3.221),urban residence(OR=1.335,95%CI:1.014-1.756),educational level of junior college(OR=2.474,95%CI:1.635-3.744)and educational level of regular college or above (OR=2.072,95%CI:1.338-3.209),receiving health education about health pregnancy(OR=1.936, 95%CI:1.509-2.484)and self-learning about the knowledge of health pregnancy(OR=2.065,95%CI:1.338-3.189)were the influencing factors to the awareness rate of macrosomia diagnostic criteria and prevention related knowledge of macrosomia among pregnant women. The awareness rate of the cause and prevention related knowledge of macrosomia was higher in older age group(OR=2.103,95%CI:1.330-3.323). Conclusion Among the pregnant women in Zhejiang,the awareness rate of macrosomia diagnostic criteria was less than 50%. Therefore,it was necessary to strengthen the health education during pre-gestational and gestational periods among reproductive women,especially the education about pregnancy health in rural area.

Discussion of operative management of posterior marginal bone block in thoraco-lumbarvertebral burst fracture / 中国矫形外科杂志

[Objective]To discuss the surgical treatment,the proper application,and the respective effect of the therapy of burst fracture in the posterior marginal vertebral bone block and the thoraco-lumbar vertebra.[Method]Thirty-eight patients with thoraco-lumbar burst fracture induced by high energy injury were hospitalized from July 2002 to June 2006.Through the were assessed application of section and ORIF(open reduction internal fixation),decompression of vertebral canal by bone grafting and fusion,the clinical effect of therapy by rechecking the postoperative thoracic-lumbar function and radiographic information.[Result]All the 38 patients were followed up for 12-18 months(average 14.4 months).The fracture were all healed and lumbar pain disappeared,the vertebral height restored,and well-fused.According to Frankel ranking,the neurological function recovered,with the degree varying from 1 to 3.[Conclusion]It's a good method to apply the open and reduction,decompression of spinal canal with bone grafting and fusion operation.This kind of operation can get perfect treating effect by providing good fixation and reducing the complications.

The clinical characteristics of acute renal failure in the elderly / 中华老年医学杂志

Objective To elucidate the clinical characteristics and the outcome of acute renal failure (ARF) in the elderly. Methods Clinical data of 109 elderly patients(≥60 years) with ARF were analysed and compared with that of 175 younger adult ARF patients(18 40 years) in the same period. Results 109 out of 422 patients(25 8%) with ARF were more than 60 years. The mortality rate of ARF in these patients was 58 7%. ARF was induced mainly by prerenal factors (20 2%) and sepsis (15 6%). Complications such as infections (52 3% vs 29 7%), cardiovascular events (64 2% vs 38 3%), respiratory failure (43 1% vs 20 0%) and hyperkalemia (29 4% vs 15 4%) were more prevalent in elderly patient than that in the younger adult ARF patients ( P