Analysis of the current status and regulatory effectiveness of daylighting and artificial lighting in primary and secondary school classrooms in Shanghai / 中国学校卫生

Objective@#To understand the current situation and regulatory effectiveness of daylighting and artificial lighting in primary and secondary school classrooms in Shanghai, so as to provide a basis for enhancing the visual environment of school classrooms.@*Methods@#From April 2021 to December 2023, the daylighting and artificial lighting conditions of classrooms in 1 735 regular primary and secondary schools currently in operation in Shanghai were monitored, and the qualified rate of each indicator was calculated. The Chisquare test or Fisher exact probability method were used to compare the differences in qualification rates across different educational stages, regions, school type, both before and after the implementation of regulatory measures. The regulatory measures included convene interview, propaganda and education, supervision order, supervisory opinion paper, rectification requests and offenses and punishment.@*Results@#The qualified rate of daylighting and artificial lighting in primary and secondary school classrooms was 30.1%, with a qualified daylighting rate of 85.6% and a qualified artificial lighting rate of 32.9%. There was no statistically significant differences in the qualified rate of daylighting and artificial lighting in primary and secondary schools (32.4%，28.1%；χ2=3.76，P＞0.05). However, statistically significant differences were found in the qualified rate of daylighting and artificial lighting in urban and rural school classrooms (32.6%，26.7%), as well as in public and private schools (31.4%, 20.6%) (χ2=6.99，9.92，P＜0.05). Following the implementation of regulatory measures, the qualified rate of classroom daylighting and artificial lighting improved from 30.1% to 83.2%, while the respective qualified rates of daylighting and artificial lighting increased from 85.6% to 91.1% and 32.9% to 90.5%. Compared to the preimplementation period, the qualified rate of classroom daylighting and artificial lighting, as well as the respective rates of daylighting and artificial lighting, all showed statistically significant differences after the implementation of regulatory measures (χ2=995.29，25.34，1 219.87，P<0.01).@*Conclusions@#Effective regulatory measures can promote enhanced classroom daylighting and artificial lighting. Attention should be paid to improving classroom artificial lighting, in order to provide students with enhanced visual environment.

Clinical analysis of uterine arterial embolization combined with hysteroscopy in the treatment of cesarean scar pregnancy / 中国基层医药

Objective To investigate the clinical efficacy of uterine arterial embolization combined with hysteroscopy in the treatment of cesarean scar pregnancy.Methods From September 2016 to March 2018, 68 patients with cesarean scar pregnancy in the People's Hospital of He'nan Province were collected .According to different treatment methods ,the patients were divided into observation group and control group .The observation group (42 cases) firstly received bilateral uterine artery embolization ,then hysteroscopy pregnancy lesion was resected after 2 -3 days.The control group (26 cases) directly received hysteroscopy endoscopic pregnancy lesion resection . Results There were 42 cases in the observation group,2 cases(all of them III type)failed,of which 1 case was treated with laparoscopy ,and 1 case was converted to transvaginal focus clearance .In the control group ,26 cases of cesarean scar pregnancy were treated directly by hysteroscopy ,and 6 cases were failed(1 case of type I,4 cases of type II,1 case of type III),among which 3 cases were treated with uterine artery embolization .Then hysteroscopic surgery was performed in 2 cases,combined with laparoscopy for pregnancy focus debridement .One case of severe hemorrhage occurred in III type operation ,which was immediately converted to open operation .The operation time,intraoperative blood loss ,surgical success rate , length of hospital stay , blood β-HCG return to normal time , menstrual recovery time,postoperative vaginal bleeding , postoperative vaginal bleeding time in the observation group were ( 17.09 ± 3.62)min,(32.6 ±5.6)mL,95.2％(40/42),(4.76 ±1.63)d,(18.00 ±6.62)d,(30.28 ±4.23)d,(32.75 ± 8.32)mL,(3.26 ±1.06)d,respectively,which in the control group were (49.51 ±3.41)min,(60.3 ±13.6)mL, 76.9％(20/26),(7.23 ±1.96)d,(22.00 ±6.91)d,(36.41 ±7.62)d,(46.23 ±11.73)mL,(6.42 ±2.45)d, respectively,the differences between the two groups were statistically significant (t=36.68,14.09,χ2 =5.189,t=5.62,2.30,4.27,5.54,7.35,all P <0.05).Conclusion Bilateral uterine artery embolization combined with hysteroscopy in the treatment of cesarean scar pregnancy has some advantages including high successful rate , short operation time,less bleeding,hospitalization time and postoperative recovery ,etc.It is a safe and effective treatment especially for type I and type II scar pregnancy .

Clinical analysis of uterine arterial embolization combined with hysteroscopy in the treatment of cesarean scar pregnancy / 中国基层医药

Objective@#To investigate the clinical efficacy of uterine arterial embolization combined with hysteroscopy in the treatment of cesarean scar pregnancy.@*Methods@#From September 2016 to March 2018, 68 patients with cesarean scar pregnancy in the People's Hospital of He'nan Province were collected.According to different treatment methods, the patients were divided into observation group and control group.The observation group (42 cases) firstly received bilateral uterine artery embolization, then hysteroscopy pregnancy lesion was resected after 2-3 days.The control group (26 cases) directly received hysteroscopy endoscopic pregnancy lesion resection.@*Results@#There were 42 cases in the observation group, 2 cases(all of them III type)failed, of which 1 case was treated with laparoscopy, and 1 case was converted to transvaginal focus clearance.In the control group, 26 cases of cesarean scar pregnancy were treated directly by hysteroscopy, and 6 cases were failed(1 case of type I, 4 cases of type II, 1 case of type III), among which 3 cases were treated with uterine artery embolization.Then hysteroscopic surgery was performed in 2 cases, combined with laparoscopy for pregnancy focus debridement.One case of severe hemorrhage occurred in III type operation, which was immediately converted to open operation.The operation time, intraoperative blood loss, surgical success rate, length of hospital stay, blood β-HCG return to normal time, menstrual recovery time, postoperative vaginal bleeding, postoperative vaginal bleeding time in the observation group were (17.09±3.62)min, (32.6±5.6)mL, 95.2%(40/42), (4.76±1.63)d, (18.00±6.62)d, (30.28±4.23)d, (32.75±8.32)mL, (3.26±1.06)d, respectively, which in the control group were (49.51±3.41)min, (60.3±13.6)mL, 76.9%(20/26), (7.23±1.96)d, (22.00±6.91)d, (36.41±7.62)d, (46.23±11.73)mL, (6.42±2.45)d, respectively, the differences between the two groups were statistically significant(t=36.68, 14.09, χ2=5.189, t=5.62, 2.30, 4.27, 5.54, 7.35, all P<0.05).@*Conclusion@#Bilateral uterine artery embolization combined with hysteroscopy in the treatment of cesarean scar pregnancy has some advantages including high successful rate, short operation time, less bleeding, hospitalization time and postoperative recovery, etc.It is a safe and effective treatment especially for type I and type II scar pregnancy.

Cost-utility Analysis of Alendronate Sodium Preventing Osteoporotic Fractures in Postmenopausal Women / 中国药房

OBJECTIVE:To evaluate the economics of alendronate sodium preventing osteoporotic fractures in postmenopausal women,and to provide reference for osteoporotic and osteopenia patients to select economical and effective therapy plan. METH-ODS:Using Markov economic model,TreeAge Pro 2011 software was used for cost-utility analysis using RCTs literature data of basic medication(calcium and vitamin D3)and basic medication combined with alendronate sodium as baseline data. Using quality adjusted life years(QALYs)and incremental cost utility ratio(ICUR)as economics evaluation indexes,the stability of established model was investigate by single factor sensitivity analysis. RESULTS:QALYs of the basic treatment group was 0.704 years,and QALYs of drug combination group was only 0.708 years. However,ICUR of two groups reached 714252.44. For the late period of hip fracture and other fractures,drug combination group was in high cost and low benefit,obviously had no economic advan-tage. For vertebral fractures,the cumulative probability of fracture in drug combination group was significantly lower than basic treatment group,and ICUR of the two groups was only 13902.17,with economic advantage. For hip fracture,the cumulative prob-ability of fracture in basic treatment group was the same as drug combination group,and ICUR was 19109.00,with economic ad-vantage. For wrist fractures,curative effect and economy needed further study. CONCLUSIONS:For the low-risk population with osteoporotic fractures,calcium and vitamin D3 are more economical in preventing osteoporosis fractures. For the high-risk popula-tion with vertebral and hip fractures,alendronate sodium combined with basic treatment is effective and economical.