The increasing prevalence of refractive errors in children has raised interest in exploring potential associations with physical development. This study aimed to explore a potential relationship between refractive status and growth parameters among children aged 7–10 years. A multistage stratified random sampling method was adopted to select 1260 primary school students in Pinggu District of Beijing in 2023, to measure their height and weight to calculate the body mass index (BMI). The height-for-age z-score (HAZ) and body mass index z-score(z-BMI) were calculated using the Least Mean Squares (LMS) method. Cycloplegic refraction was performed to determine spherical equivalent (SE). Ocular biometric data were collected, including axial length (AL) and anterior chamber depth (ACD). The ratio of AL to average corneal curvature (AL/CR) were calculated. Group comparisons used χ² test, t-test, analysis of variance (ANOVA) and Wilcoxon rank-sum test. Multiple linear regression models were used to analyze correlations between HAZ, z-BMI and ocular parameters. The myopia rate was 21.19

Assessing myopia risk can help clinicians intervene as early as possible. There is still a lack of reference values for predicting myopia based on the axial length (AL) of children. The study aims to explore the relationship between AL and myopia, and to predict the risk thresholds of AL in children of different age and sex groups. Visual acuity examination, refractive screening and ocular axis examination of 2388 children aged 7–18 (4776 eyes) from 8 schools in a certain area of Beijing were used as the data source, we evaluated the predictive ability of AL for myopia in children using Receiver Operating Characteristic (ROC) curves, and constructed Logistic Regression to analyze the reference value of AL threshold for children of different age and sex groups. The myopia rate among children and adolescents was 51.47

The prevalence of visual impairment (VI) increases with axial length (AL) and spherical equivalent (SE). This study aims to explore the prevalence and associated factors of myopia and AL-related VI in children and adolescents, including analysis of sex-specific differences. This cross-sectional survey included 2595 children and adolescents aged 4-18 years from nine educational institutions in a large municipality. The survey comprised a questionnaire, visual acuity examination, refractive screening and AL measurement. The prevalence of myopia and AL-related VI were 56.53% and 50.98% respectively and increased with age (P < 0.01). The myopia rate was higher in females than in males (60.23% vs. 52.71%, χ2 = 14.93, P < 0.05), with a significant difference observed in those aged 9 years and older. However, there was no sex difference between in the prevalence of AL-related VI (51.37% vs. 50.61%, χ2 = 0.15, P = 0.70). The research showed that older adolescent was a risk factor for both myopia (OR = 2.28, 95%CI = 2.06-2.53) and AL-related VI (OR = 2.49, 95%CI = 2.23-2.77). Having a myopic parent was also significantly associated with myopia (OR = 1.21, 95%CI = 1.12-1.32) and AL-related VI (OR = 1.25, 95%CI = 1.16-1.36). The prevalence of myopia and AL-related VI were high and increased with age in children and adolescents, with sex-specific differences in myopia but not in AL-related VI. Therefore, it is possible to predict the risk of myopia by considering age- and sex-specific factors.

BackgroundPre-pregnancy body mass index (BMI), gestational diabetes mellitus (GDM), and gestational weight gain (GWG) are interlinked and may play a complex role in fetal growth. We aimed to examine the relationship between pre-pregnancy BMI, GDM, GWG, and fetal growth outcomes and explore the contribution of GDM and GWG to the relationship between Pre-pregnancy obesity/overweight and large-for-gestational-age (LGA) in a prospective cohort.MethodsWe prospectively recruited women in the first trimester and having one-step GDM screened with a 75-g oral glucose tolerance test between 24 and 28 weeks of gestation (n = 802). Outcomes included LGA, small-for-gestational-age (SGA), and preterm birth. To assess the individual and cumulative associations between pre-pregnancy BMI, GDM, GWG, and these outcomes, we used multivariate logistic regression analysis. Furthermore, we employed structural equation modeling (SEM) to investigate the mediating role of GDM and excessive GWG in the correlation between pre-pregnancy overweight/obesity and LGA.ResultsPre-pregnancy obesity, GDM, and excessive GWG were all independently associated with increased odds of LGA. Inadequate GWG was associated with higher odds of preterm birth. Compared with women unexposed to pre-pregnancy overweight/obesity, GDM, or excessive GWG, women exposed any two conditions had higher odds for LGA (AOR 3.18, 95% CI 1.25–8.11) and women with coexistence of all had the highest odds for LGA (AOR 8.09, 95% CI 2.18–29.97). The mediation analysis showed that GDM explained 18.60% (p < 0.05) of the total effect of pre-pregnancy overweight/obesity on LGA, and GWG explained 17.44% (p < 0.05) of the total effect.ConclusionPre-pregnancy obesity/overweight, GDM, and excessive GWG are associated with higher odds of fetal growth disturbances as individual factors and when they co-exist. The effect of pre-pregnancy overweight/obesity on LGA is partially achieved through GDM and excessive GWG.

目的 了解儿童家长对《母子健康手册》的认知及利用情况,为进一步推广普及母子健康手册提供参考依据.方法 采用定性研究方法,于2018年10-11月对北京、天津、广东、广西、四川省内选取5所妇幼保健院55名0～3岁儿童的家长进行一对一深入访谈.访谈内容包括儿童及家长基本情况,家长对母子健康手册的认知,家长对儿童保健知识的知晓、态度和行为,对母子健康手册的利用情况及满意度等.结果 73.3％的儿童家长在怀孕时领取母子健康手册,备孕时和宝宝出生时领取的家长较少;绝大多数家长都读过手册中的内容,有66.7％的儿童家长认为手册对自己帮助很大.儿童家长对手册内相关知识的知晓率较高,均在85.0％以上.绝大多数儿童家长会按母子健康手册的要求定期带儿童做健康检查.部分家长不能按时进行健康检查的原因包括:辖区医疗卫生机构的服务内容不能满足需求、上班不方便请假、没有必要或距离太远.使用母子健康手册过程中面临的困难包括:纸质版不便于保存和携带、容易破损或丢失,忘记携带手册导致无法及时记录保健服务,老人文化水平低不会使用手册进行自我记录.结论 儿童家长对母子健康手册的认知度和利用度较好.未来应继续完善手册的知识内容,推行电子化手册传播方式,提升母子健康手册的利用率,并开展更多高质量的应用效果评价研究.

目的 探讨北京市6～35月龄流动儿童营养性贫血现况及其与维生素A关联分析,为有效地预防流动儿童营养性贫血提供科学依据.方法 采用方便整群抽样方法,2017年从北京市流动人口聚居区(朝阳、海淀、昌平)的308例6～35月龄的流动儿童及家长进行问卷调查,同时采集流动儿童末梢血进行血红蛋白、维生素A测定.结果 6～35月龄流动儿童贫血患病率为27.92％,其中男童为29.19％,女童为26.53％.贫血患病率在不同年龄组和区域间的差异有统计学意义(P＜0.001),6～11月龄婴幼儿贫血患病率最高(52.63％).食用配方奶、瘦肉与动物肝脏类食物对儿童贫血有显著影响(P＜0.05或＜0.01).贫血儿童维生素A的含量显著低于非贫血儿童(P＜0.001).Logistic回归分析显示居住地区、年龄、维生素A含量是6～35月龄流动儿童营养性贫血的影响因素(P＜0.05或＜0.01).结论 北京市6～35月龄流动儿童的营养性贫血患病率较高,尤其6～11月龄儿童最高,VA含量在贫血儿童体内较低,应加强对流动儿童家长普及科学喂养知识,指导其合理调整膳食结构.

目的 调查孕妇孕期抑郁状况,研究孕期抑郁的影响因素.方法 采用抑郁自评量表(Self-rating depres-sion scale,SDS)和日常生活调查表开展问卷调查.以2016年6月-12月在北京、海南、安徽和云南4个地区调查的362名孕妇为研究对象,描述其人口学特征,采用χ2检验进行孕妇行为习惯对抑郁影响的单因素分析,采用Logistic回归分析进行孕妇孕期抑郁影响多因素分析.结果 362例孕妇,抑郁患者102例(28.2％),其中轻度抑郁71例(19.6％),中度抑郁28例(7.7％),重度抑郁3例(0.8％).孕妇怀孕前后行为习惯对抑郁状态影响单因素分析显示,妊娠前行为习惯对抑郁状态影响因素为失眠、饮酒、腿部抽筋、便秘或腹泻等消化功能紊乱和贫血,妊娠后行为习惯对抑郁状态影响因素为锻炼、失眠、熬夜、骨质疏松和便秘或腹泻等消化功能紊乱(P<0.05).Logistic回归分析结果显示,孕期抑郁影响因素保护因素为孕后睡眠(OR=0.53,95％CI 0.40-0.68)、计划怀孕(OR=0.44,95％CI 0.25-0.75)、孕后锻炼(OR=0.71,95％CI 0.52-0.97)及孕周(OR=0.96,95％CI 0.94-0.99),危险因素为孕后便秘或腹泻等消化功能紊乱(OR=1.79,95％CI 1.11-2.90)、家庭人口(OR=1.24,95％CI 1.02-1.52)(P<0.05).结论 孕妇改变不良的行为习惯、是预防孕期抑郁发生的重要手段.为预防孕妇抑郁发生,建议孕期检查中实施精神障碍早期筛查,关注孕妇孕期情绪,适时进行评估及心理疏导,加强对孕妇的行为习惯进行管理,以降低孕期抑郁的发生率.

维生素D是类固醇类激素超家族中的一员,除调节钙磷代谢,维持儿童骨骼健康的经典作用外,维生素D还具有重要的免疫调节作用.近年来多项研究表明,维生素D低水平与儿童多种感染性疾病的发生、进展相关,维生素D增补被用于治疗与预防多种儿童感染性疾病.本文就维生素D营养状况与儿童感染性疾病的相关性及其抗感染机制进行简要综述.

BACKGROUND:Inositol is an essential nutrient for cell growth, survival and embryonic development. Myo-inositol is the predominant form in natural. To investigate the correlation between inositol metabolism and embryonic development, we assessed the metabolic characteristics of myo-inositol, phosphatidylinositol 4,5-bisphosphate (PI(4,5)P₂) and phosphatidylinositol 3,4,5-trisphosphate (PI(3,4,5)P₃) of pregnant women in the North China (Yangquan and Weihai) and South China (Nanchang and Haikou) China. MATERIAL AND METHODS:All data were collected by face-to-face interview during pregnant women health visits using a questionnaire. Plasma levels of myo-inositol, PI(4,5)P₂ and PI(3,4,5)P₃ from 89 randomly collected pregnant women were detected by gas chromatography-mass spectrometry and enzyme linked immunosorbent assay. RESULTS:A total of 400 pregnant women were included in this survey. The plasma levels of myo-inositol and PI(4,5)P₂ in the North China group of pregnant women were significantly higher than that in the South China group (P<0.01). The birth weight of fetuses in the North China group was heavier than that in the South China group (P<0.01). The birth length of fetuses in Yangquan was the longest among the 4 cities (P<0.01). The incidence rate of birth defects was 3.05% in the North China group, and 0.0% in the South China group. In bivariate linear correlation analysis, the body weight correlated with myo-inositol (r=0.5044, P<0.0001), PI(4,5)P₂ (r=0.5950, P<0.0001) and PI(3,4,5)P₃ (r=0.4710, P<0.0001), the body length was correlated with PI(4,5)P₂ (r=0.3114, P=0.0035) and PI(3,4,5)P₃ (r=0.2638, P<0.0130). CONCLUSIONS:The plasma levels of myo-inositol and PI(4,5)P₂ in pregnant women had significant difference between the North and the South of China, which might be correlated with fetal development and birth defects.

Objective To investigate the incidence and risk factors of peripartum mood disorder (PPMD) in order to improve clinical prevention and intervention of this condition.Methods This was a prospective cohort study recruiting first-trimester pregnant women (＜13 gestational weeks) from Beijing Daxing Maternal and Child Care Hospital from October 1,2016 to December 31,2017.Zung Self-rating Anxiety Scale (SAS) and Zung Self-rating Depression Scale (SDS) were used to evaluate the anxiety and depression status in the second and third trimesters,respectively.Their life styles,social and environmental factors exposure during pregnancy were also collected.Statistical analysis was conducted using Chi-square test,student's t test,MannWhitney U test and multivariate logistic regression.Results (1) A total of 478 subjects were enrolled in early pregnancy and 460 (96.2％) and 431 (90.2％) of them completed SAS and SDS assessment in the second and third trimesters,respectively,and 413 (86.4％) of the subjects finished both assessments on two occasions.(2) The prevalence of anxiety and depression was 7.1％ (30/425) and 13.9％ (59/425) in the second trimester,and 11.2％ (44/392) and 21.5％ (84/390) in the third.The incidence of anxiety and depression in the third trimester was 7.7％ (26/336) and 9.6％ (30/313).(3) Cross-sectional data analysis showed that prolonged television watching was a risk factor of anxiety in the second (OR=1.216,95％CI:1.055-1.402) and third (OR=1.166,95％CI:1.044-1.303) trimester,while exercise was a protect factor (OR=0.238,95％CI:0.105-0.541;OR=0.432,95％CI:0.212-0.879).Pregnant women with longer sleeping time had lower risks of depression in the second trimester (OR=0.725,95％CI:0.554-0.950);those who did exercise had lower risks of depression in the third trimester (OR=0.450,95％CI:0.252-0.803).(4) Longitudinal-data analysis revealed that longer television watching time in the second trimester was a risk factor for anxiety (OR=1.264,95％CI:1.117-1.432) and depression (OR=1.119,95％CI:1.005-1.246) in the third trimester.Conclusions The prevalence of anxiety and depression in the third trimester is higher than that in the second trimester.The incidence of depression is higher than that of anxiety in the third trimester.Prolonged television viewing time in the second trimester is a risk factor for both anxiety and depression in the third trimester.

Objective To examine the association between the levels of serum vitamin A,D,E with recurrent respiratory tract infection (RRTI) in children and to provide evidence for clinical diagnosis and treatment.Methods Totally 66 children with recurrent respiratory tract infections and 66 health children were selected as cases and controls in Child H ealthcare Department of Changchun Children's Hospital in 2015,respectively.The levels of vitamin A,D,E were detected using high performance liquid chromatography and tandem mass spectrometry.Results The prevalences of RRTI in different age groups were significantly different (x2=13.516,P =0.001).Cases had significantly lower serum level of vitamin A and higher rate of vitamin A deficiency than healthy controls (t=3.536,P=0.001;x2 =16.901,P=0.000).But serum levels of vitamin D and E were not significantly different between cases and controls,as well as rate of vitamin D deficiency and vitamin E deficiency(P＞0.05).Conclusions Recurrent respiratory tract infection may be related to vitamin A defi ciency.It is recommended to strengthen nutrition health education and advocacy activities,such as providing scientific feeding guidance to the parents and vitamin supplements to children,monitoring the levels of vitamin A,D,E in children regularly.

Objective To investigate parents' utilization of and satisfaction with community health services for 0-6 years old migrant children in a community of Xicheng district,Beijing,and to provide evidence for improving the health management of migrant children.Methods A cross-sectional survey was conducted to investigate the utilization and satisfaction of community health services for 0-6 year old migrant children.Results 81.5％ of 0-6 year old migrant children were included into the health record in the community health service center.96.5％ of children received vaccinations within 1 year prior to the investigation.The ovcrall satisfaction of children's parents with the community health service center was 79.7％,with 77.7％ satisfied with transportation convenience,and 74.1％ satisfied with the environment.Conclusions The utilization of and satisfaction with community health services were low in parents of migrant children.Effective measures should be taken to further strengthen primary healthcare services for children.

目的 探讨我国居民对社区卫生服务利用及满意度的情况,为提高社区卫生服务质量提供参考依据.方法 采用多阶段分层整群随机抽样方式,于2010年对8个项目试点区的26 385名居民进行问卷调查.结果 居民对社区卫生服务机构的知晓率和利用率分别为93.1％和77.9％.非条件logistic回归分析结果显示,文化程度(OR=0.76,95％CI:0.73～0.79)、婚姻状况(OR=1.08,95％CI:1.04～1.13)、职业(OR=0.77,95％CI:0.74～0.79)、社会医疗保险(OR=1.25,95％CI:1.16～1.35)、步行时间(OR=0.58,95％CI:0.56～0.60)、担心被传染(OR=1.53,95％CI:1.36～1.71)和误诊(OR=0.89,95％CI:0.80～0.99)及知晓社区卫生服务机构(OR=0.08,95％CI:0.07～0.10)是居民常去社区卫生服务的独立影响因素.居民对社区医务人员的服务态度满意度平均值最高[(3.91±0.84)分],其次是解释交流[(3.89±0.82)分],就医环境[(3.80±0.79)分],服务价格和看病花费的满意度平均值最低.结论 应落实国家政策和法规、加大宣传、增加投入、加强人才建设等措施,提升社区卫生服务质量,提高居民对社区卫生服务的满意度.

INTRODUCTIONStudies have been conducted to investigate the association between rs10830963 of MTNR1B and the risk of gestational diabetes mellitus (GDM), but with inconclusive results. We aimed to clarify these controversies, especially with regard to the association in the Chinese population.MATERIAL AND METHODSA systemic literature reference search inclusive to August 12, 2016 yielded 35 articles, from which 11 studies met the inclusion criteria for the final meta-analysis, including 3889 patients with GDM and 6708 controls.RESULTSWe found statistically significant associations between rs10830963 and GDM using odds ratios (ORs) and 95% confidence intervals (CIs) [GG genotype vs. CC genotype: OR = 1.70, 95% CI: 1.38-2.10; G allele vs C allele: OR = 1.27, 95% CI: 1.20-1.36; GG+CG vs. CC (dominant model): OR = 1.31, 95% CI: 1.20-1.44; GG vs CG+CC (recessive model): OR = 1.41, 95% CI: 1.26-1.58]. In subgroup analyses stratified by ethnicity, we also observed rs10830963 to be associated with significantly increased risk of GDM in all genetic models in the Chinese population.CONCLUSIONSOur meta-analysis indicated that the rs10830963 polymorphism might serve as a risk factor of GDM in the Chinese population.

目的:构建北京市社区卫生服务项目成本测算模型,测算北京市社区卫生服务项目成本.方法:通过文献查阅、专家研讨、现场观察等方法,构建北京市社区卫生服务项目分类及子项目,确定服务当量值;从北京市抽取17家服务功能健全、信息系统相对完善的社区卫生服务中心,利用其过去1年的支出情况和各服务项目服务量的信息,测算了1个标准服务当量的成本.结果:北京市主要的社区卫生服务项目分类共计5大类65项,分别是基本医疗服务项目23项、护理服务项目9项,药剂服务3项,辅助检查项目14项,公共卫生服务18项.以标准服务当量作为参照,急诊服务当量值为3.2,肌肉注射1.2,高血压患者管理服务当量值为8.5.1个标准服务当量的理论成本为11.80元,每服务人口基本公共卫生服务成本(不含药品)49.26元.结论:社区卫生服务项目成本城区和郊区有一定差异,主要表现在人力成本和材料成本;基本公共卫生服务项目补助严重不足;应建立成本测算动态管理机制.

通过对社区卫生服务项目进行分类,明确各服务项目的子项目和各子项目的当量值,收集成本和服务量相关信息并测算成本,实践证明:此“当量法”具有很好的科学性和简便性.

目的：探讨2型糖尿病（T2DM）患者血浆C反应蛋白（CRP）水平及其影响因素。方法将T2DM 患者按照年龄、性别、不同肥胖程度分组，并比较各组患者的血浆CRP水平，采用多元线性回归分析CRP的影响因素。结果 T2DM患者血浆CRP水平随着年龄、肥胖程度增加而升高，且与空腹血糖（FPG）、高密度脂蛋白胆固醇（HDL－C）、低密度脂蛋白胆固醇（LDL－C）等水平相关（P＜0．05）。结论 T2DM患者血浆CRP水平受多种因素的影响。

目的 了解亚运村地区北京户口与非京户口儿童保健服务现状与需求.方法 选择前来亚运村社区卫生服务中心进行日常保健的0～3岁儿童家长作为调查对象.采用文献法和专家咨询法制定0～3岁儿童家长调查问卷,对其进行拦截调查的方式问卷调查.率的比较采用x2检验.结果 在调查的195名0-3岁儿童家长中,母亲占42.0％,儿童户口为非京占32.8％,单因素分析发现北京户口儿童与非京户口儿童以及儿童主要抚养人对于亚运村地区儿童保健服务满意度差异有统计学意义(P＜0.05).儿童家长主要选择到社区卫生服务中心进行儿童保健,体检时医生主要提供身高体重的测量,儿童家长主要通过书刊、电视和媒体获得育儿知识.分别有41.2％的本市儿童家长和66.1％的非京户口儿童家长认为目前儿童保健内容可以满足需求,儿童家长最希望社区卫生服务中心开展的服务均为健康咨询服务.大多数的儿童家长认为应当由专业的儿童保健医生来进行儿童保健.结论 儿童保健服务应当针对不同层次人群开展能够满足自身需求的服务项目,服务项目的提供应当多样化,健康咨询服务有必要在社区卫生服务机构当中开展.社区卫生服务中心应当重视对于家长提供正确育儿知识,同时适当增加社区卫生服务机构专业儿童保健医师数量,并增加这部分医师的交流、培训机会.

BACKGROUND:In order to address several health challenges, the Chinese government issued the National Essential Public Health Services Package (NEPHSP) in 2009. In China's large cities, the lack of funding for community health centers and consequent lack of comprehensive services and high quality care has become a major challenge. However, no study has been carried out to estimate the cost of delivering the services in the package. This project was to develop a cost estimation approach appropriate to the context and use it to calculate the cost of the NEPHSP in Beijing in 2011.METHODS:By adjusting models of cost analysis of primary health care and workload indicators of staffing need developed by the World Health Organization, a model was developed to estimate the cost of the services in the package through an intensive interactive process. A total of 17 community health centers from eight administrative districts in Beijing were selected. Their service volume and expenditure data in 2010 were used to evaluate the costs of providing the NEPHSP in Beijing based on the applied model.RESULTS:The total workload of all types of primary health care in 17 sample centers was equivalent to the workload requirement for 14,056,402 standard clinic visits. The total expenditure of the 17 sample centers was 26,329,357.62 USD in 2010. The cost of the workload requirement of one standard clinic visit was 1.87 USD. The workload of the NEPHSP was equivalent to 5,514,777 standard clinic visits (39.23 % of the total workload). The model suggests that the cost of the package in Beijing was 7.95 USD per capita in 2010. The cost of the NEPHSP in urban areas was lower than suburban areas: 7.31 and 8.65 USD respectively.CONCLUSIONS:The average investment of 3.97 USD per capita in NEPHSP was lower than the amount needed to meet its running costs. NEPHSP in Beijing is therefore underfunded. Additional investment is needed, and a dynamic cost estimate mechanism should be introduced to ensure services remain adequately funded.

Objective To study the awareness of prevention and treatment knowledge and self-management ability among community patients with type 2 diabetes mellitus and to provide the base for prevention and treatment of type 2 diabetes mellitus.Methods By conventional sampling method,1 006 patients with type 2 diabetes mellitus in 8 community health centers from 5provinces or municipalities in China were selected as the subjects. The investigation was performed by self-designed questionnaire and face to face manner for awareness of prevention and treatment knowledge and self-management ability. The data were analyzed statistically with χ2-test. The multi-regression logistic model was used to screen the factors of influencing the awareness rates of fasting plasma glucose and regular plasma glucose measurement. Results The average age of 1 006 subjects was(65.2±10.4) years,63.42% of subjects was females. The awareness rate of plasma glucose level was 74.75%(547/1 006),the proportion of regular plasma glucose measurement one time a week was 27.44%(276/1 006),the proportion of regular plasma glucose measurement at least one time a month was 54.37%(547/1 006). The multi-regression logistic analysis indicated that the awareness rate of plasma glucose level in subjects with high education level,medical insurance for urban workers or free medical care,and the new rural cooperative medical insurance was higher(OR=1.300,95%CI: 1.040-1.625; OR=2.047,95%CI: 1.340-3.127; OR=1.829,95%CI: 1.125-2.974,respectively); also the rate of regular plasma glucose measurement in subjects with elder,higher income,medical insurance for urban workers or free medical care and the new rural cooperative medical insurance was higher(OR=1.479,95% CI: 1.155-1.893; OR =1.452,95% CI: 1.026-2.055; OR =3.107,95% CI: 1.932-4.999; OR =2.019,95% CI: 1.215-3.353,respectively). Conclusion The health education and promotion among community patients with type 2 diabetes mellitus should be improved for enhancing the awareness rate of prevention and treatment of type 2 diabetes mellitus and self-management ability.