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AIM: To compare the efficacy of intravitreal injection of ranibizumab(IVR)and intravitreal injection of conbercept(IVC)in children with retinopathy of prematurity(ROP).METHODS: Retrospective study. A total of 1 100 eyes with ROP treated with intravitreal anti-VEGF at our hospital from January 2015 to June 2023 were included. According to the different therapeutic drugs, the children were divided into two groups: IVR group and IVC group. According to the degree of ROP, the patients were divided into three groups: aggressive ROP(A-ROP), Zone Ⅰ type 1 ROP and Zone Ⅱ type 1 ROP. The reactivation and retreatment between the two groups were compared after propensity score matching(PSM)analysis, and they were followed-up for at least 3 mo after surgery.RESULTS: In Zone Ⅱ type 1 ROP, there was a statistically significant difference in the rates of reactivation and retreatment between the IVR and IVC groups(P0.05). The risk of reactivation and retreatment of Zone I type 1 ROP was higher than the Zone II type 1 ROP. Furthermore, the use of drugs and corrected gestational age of first treatment were influencing factors of lesion recurrence and retreatment.CONCLUSION: There is a significant difference in the initial cure effect between the two drugs in Zone II type 1 ROP, with the reactivation and retreatment rates of the IVC group being much lower than those of the IVR group.

Poverty in the long run, as the long-term source of pressures, has strengthened the vulnerability of juveniles and has increased the incidence of psychological or behavioral problems during their growth. Therefore, it is necessary to strengthen preventive intervention for adolescents to avoid poverty's "scar effect" upon their physical and mental health. Explore the effect of group counseling using the Achieving Success Everyday (ASE) model on improving the resilience of junior high school students in impoverished areas. This single-blind, randomized controlled study adopted a within-subject experimental design of 2 (intervention group/control group) x 3 (pre- and post-treatment, subsequent follow-ups) and conducted group counseling intervention on seventh- to eighth-grade students in poor areas of southern Xinjiang Uyghur Autonomous Region (the group counseling lasted 8 weeks, with one session every week, 60 [approximately] 90 min for each session). The intervention effect was then evaluated using the Resilience Scale of Chinese Adolescent (RSCA), Core Self-evaluations Scale (CSES), and Simplified Coping Style Questionnaire (SCSQ). Before the intervention, there was no significant difference between RSCA, CSES, and SCSQ in the intervention group and the control group. After the intervention, the program significantly improved overall resilience scores, including three dimensions (goal focusing, positive cognition, and interpersonal assistance). And at the same time, the level of core self-evaluation and coping style has been improved, and the effect can last up to 3 months after the end of the intervention. Group counseling based on the ASE (Achieving Success Everyday) model can effectively improve students' resilience and has significant effects on improving the core self-evaluation and coping styles of the subjects.

Constructing a confidence interval for the ratio of bivariate normal means is a classical problem in statistics. Several methods have been proposed in the literature. The Fieller method is known as an exact method, but can produce an unbounded confidence interval if the denominator of the ratio is not significantly deviated from 0; while the delta and some numeric methods are all bounded, they are only first-order correct. Motivated by a real-world problem, we propose the penalized Fieller method, which employs the same principle as the Fieller method, but adopts a penalized likelihood approach to estimate the denominator. The proposed method has a simple closed form, and can always produce a bounded confidence interval by selecting a suitable penalty parameter. Moreover, the new method is shown to be second-order correct under the bivariate normality assumption, that is, its coverage probability will converge to the nominal level faster than other bounded methods. Simulation results show that our proposed method generally outperforms the existing methods in terms of controlling the coverage probability and the confidence width and is particularly useful when the denominator does not have adequate power to reject being 0. Finally, we apply the proposed approach to the interval estimation of the median response dose in pharmacology studies to show its practical usefulness.

Abstract Background Over the last decade, a few studies have investigated the possible adverse effects of ambient air pollution on preterm birth. However, the correlation between them still remains unclear, due to insufficient evidences. Methods The correlation between air pollution and preterm birth in Guangzhou city was examined by using the Generalized Additive Model (GAM) extended Poisson regression model in which we controlled the confounding factors such as meteorological factors, time trends, weather and day of the week (DOW). We also adjusted the co linearity of air pollutants by using Principal Component Analysis. The meteorological data and air pollution data were obtained from the Meteorological Bureau and the Environmental Monitoring Centre, while the medical records of newborns were collected from the perinatal health database of all obstetric institutions in Guangzhou, China in 2007. Results In 2007, the average daily concentrations of NO2, PM10 and SO2 in Guangzhou, were 61.04, 82.51 and 51.67 μg/m3 respectively, where each day an average of 21.47 preterm babies were delivered. Pearson correlation analysis suggested a negative correlation between the concentrations of NO2, PM10, SO2, and temperature as well as relative humidity. As for the time-series GAM analysis, the results of single air pollutant model suggested that the cumulative effects of NO2, PM10 and SO2 reached its peak on day 3, day 4 and day 3 respectively. An increase of 100 μg/m3 of air pollutants corresponded to relative risks (RRs) of 1.0542 (95%CI: 1.0080 ~1.1003), 1.0688 (95%CI: 1.0074 ~1.1301) and 1.1298 (95%CI: 1.0480 ~1.2116) respectively. After adjusting co linearity by using the Principal Component Analysis, the GAM model of the three air pollutants suggested that an increase of 100 μg/m3 of air pollutants corresponded to RRs of 1.0185 (95%CI: 1.0056~1.0313), 1.0215 (95%CI: 1.0066 ~1.0365) and 1.0326 (95%CI: 1.0101 ~1.0552) on day 0; and RRs of the three air pollutants, at their strongest cumulative effects, were 1.0219 (95%CI: 1.0053~1.0386), 1.0274 (95%CI: 1.0066~1.0482) and 1.0388 (95%CI: 1.0096 ~1.0681) respectively. Conclusions This study indicates that the daily concentrations of air pollutants such as NO2, PM10 and SO2 have a positive correlation with the preterm births in Guangzhou, China.

Background: To identify the prevention situation, the main factors influencing prevention effects and to develop control measures over retinopathy of prematurity in China.Methods: Using stratified random sampling method, we randomly selected 23 provincial and ministerial hospitals (8 in Guangdong province, 5 in Hunan province and 10 in Shaanxi province), 81 municipal hospitals (38 in Guangdong province, 19 in Hunan province and 24 in Shaanxi province), 180 district and county hospitals (76 in Guangdong province, 57 in Hunan province and 47 in Shaanxi province) in China. A total of 284 hospitals were enrolled in the study, with questionnaires distributed investigating the status and constrain factors of ROP presentation. Significant outcomes were analyzed thereafter by SPSS 19.0.Results: The screening rate of ROP in medical institutions from eastern, central and western China were 84.6%, 35.0% and 56.7%, respectively. The screening rate of tertiary and secondary medical institutions were 84.6% and 25.7% in the eastern, 35.0% and 4.9% in the central, 56.7% and 5.9% in the western region. Screening was carried out better in the tertiary than that in the secondary and primary institutions. Treatment for ROP was available in 15.7% of all the tertiary hospitals surveyed. Lack of professionals, equipments and technologies were considered to be major restrain factors for screening.Conclusions: The ROP screening and treatment status have demonstrated significant regional diversity due to uneven distribution of medical resources in China. Developed areas had established intraregional cooperation models, whereas less-developed areas should consider set up a large-scale, three-level ROP prevention network. It is of paramount importance that education and training towards ophthalmologists should be vigorously strengthened. It is strongly recommended that implement ROP telemedicine and integrated ROP prevention and management platforms through the Internet should be established. [ABSTRACT FROM AUTHOR]

Background: A few studies have examined the association between ambient temperature and preterm birth (PTB), and the results have been inconsistent. This study explored the association between ambient temperature and PTB in Shenzhen, China.Methods: Data of daily singleton PTB, air pollution and meteorological variables from 2005 to 2011 were collected in Shenzhen. A distributed lag non-linear model (DLNM) was used to investigate the association of the low and high temperatures (1st, 5th, 95th, and 99th percentiles) with PTB.Results: The median temperature was 24.5 °C and the 1st, 5th, 95th, and 99th percentiles of daily mean temperatures were 9, 12.5, 29.9 and 30.7 °C, respectively. The prevalence of singleton PTB was 5.61 % in Shenzhen. The association between temperature and PTB was not linear. There was an immediate positive association of low temperature (1st and 5th percentiles) and a negative association of high temperature (95th and 99th percentiles) with PTB. The effect of low temperature 9 °C (1st) on PTB on the current day was stronger than that of 12.5 °C (5th), with a relative risk (RR) of 1.54 (95 % CI: 1.36-1.75) and 1.49 (95 % CI: 1.35-1.63), respectively. The cumulative RR (up to 30 days) of 9 and 12.5 °C was 1.72 (95 % CI: 1.28-2.33) and 1.96 (95 % CI: 1.60-2.39), respectively. The cumulative effects (up to 30 days) of high temperature (95th and 99th percentiles) on PTB were 0.69 (95 % CI: 0.60-0.80) and 0.62 (95 % CI: 0.52-0.74), respectively. The cumulative effect (up to 30 days) of low temperatures on vaginal delivery PTB was lower than that of the cesarean section PTB with an RR of 1.58 (95 % CI: 1.12-2.22) and 1.93 (95 % CI: 1.21-3.08), respectively.Conclusions: This study suggests that low temperature might be a risk factor, while high temperature might be a protective factor of PTB in Shenzhen. [ABSTRACT FROM AUTHOR]

Background: Maternal exposure to fine particulate matter (PM2.5) has been associated with a few adverse birth outcomes. However, its effect on stillbirth remains unknown in China, especially the susceptible windows and potential modifiers.Objective: This study aimed to evaluate the associations between maternal PM2.5 exposure and stillbirth in seven Chinese cities.Methods: We used birth cohort data of 1,273,924 mother-and-birth pairs in seven cities in southern China between 2014 and 2017 to examine these associations. Pregnant women were recruited in the cohort at their first visit to a doctor for pregnancy, and stillbirths were recorded at the time of birth. Air pollution exposures were assessed through linking daily air pollutant concentrations from nearby monitoring stations to the mother's residential community. Cox regression models were applied to determine the associations between PM2.5 and stillbirth for different gestational periods.Results: Among the participants, 3150 (2.47‰) were identified as stillbirth cases. The hazard ratio (HR) of stillbirths was 1.52 (95% CI: 1.42, 1.62) for each 10 μg/m3 increase in PM2.5 during the entire pregnancy after controlling for some important covariates. Relatively stronger associations were observed during the second trimester [adjusted HR = 1.67 (95% CI: 1.57, 1.77)] than trimesters 1 [HR = 1.44 (95% CI: 1.37, 1.52)] and trimester 3 [HR = 1.23 (95% CI: 1.16, 1.30)]. Stratified analyses also showed a stronger association among pregnant women without previous pregnancy and previous delivery experiences.Conclusion: The study indicates that maternal exposure to PM2.5, especially during the midpoint period of pregnancy, might increase the risk of stillbirths. Maternal previous pregnancy and delivery may modify this association. [ABSTRACT FROM AUTHOR]

Objectives: Hepatitis B virus (HBV) infection is a global public health threat, and couples of reproductive age comprise a key population in aiming to reduce both the vertical and horizontal transmission of HBV. We aimed to update knowledge on the seroepidemiology status of HBV in Guangdong, China among a large number of couples planning conception, and to identify high-risk subgroups., Design: A cross-sectional study was performed in Guangdong, China from 2014 to 2017., Setting: The data were collected from 641 642 couples (1 283 284 individuals) participating in the National Free Preconception Health Examination Project in Guangdong, China from 1 January 2014 to 31 December 2017. For each participant, sociodemographic data were obtained and a serum sample was tested for HBV infection status., Results: 161 204 individuals (12.56%) were positive for hepatitis B surface antigen (HBsAg+), and 47 318 (3.69%) were positive for both HBsAg and hepatitis B e antigen (HBsAg+ and HBeAg+). There was a higher prevalence of HBsAg+ (12.77% vs 9.42%, p<0.05) and HBsAg+ and HBeAg+ (3.77% vs 2.45%, p<0.05) among the participants with a Guangdong household registration than a non-Guangdong household registration. Similarly, the prevalence of HBsAg (13.26% vs 11.72%, p<0.05) and HBsAg+ and HBeAg+ (4.31% vs 2.94%, p<0.05) was higher among participants not living in the Pearl River Delta than those living in the Pearl River Delta. At the couple level, 12 446 couples (1.94%) were both positive; in 51 849 (8.08%), only the wife was positive; in 84 463 (13.16%), only the husband was positive. Moreover, HBsAg+ prevalence was lowest in couples where both individuals were vaccinated (18.63%) and highest in couples where neither the wife or husband was vaccinated (24.46%)., Conclusion: There was a relatively high HBsAg+ prevalence in married couples in this high-epidemic region and urgent prevention strategies are required, such as ensuring access to health services for those not living in the Pearl River Delta, and expanding vaccine programmes to high-risk adults., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Previous studies have indicated maternal exposure to particles with aerodynamic diameter <2.5 μm (PM 2.5 ) is associated with preterm birth (PTB). However, no study has investigated this effect in pre-pregnancy impaired fasting glucose (IFG) women. This study aimed to differentiate the effects of maternal PM 2.5 exposure on PTB between pre-pregnancy IFG and normoglycemia women, and to further identify the susceptible window. This cohort study was conducted between January 2014 and December 2017 in 21 Chinese cities. All the recruited women received pre-pregnancy fasting serum glucose (FSG) tests and were followed up for their delivery outcomes. The PM 2.5 exposures were estimated by the daily air pollution concentrations of the nearby monitors. Women with FSG below 7.0 mmol/L were included in the analysis. We employed the Cox proportional hazards models to examine whether PM 2.5 exposure was associated with PTB. 237957 women were included and 7055 (3.0%) of them were pre-pregnancy IFG. During the entire pregnancy, we found 24.1% (HR = 1.241; 95% CI: 1.069, 1.439), 61.8% (HR = 1.618; 95% CI: 1.311, 1.997) and 18.6% (HR = 1.186; 95% CI: 1.004, 1.402) of increases in risk for all PTB, early PTB (20-33 gestational weeks) and late PTB (34-36 gestational weeks) among the pre-pregnancy IFG women, and 15.9% (HR = 1.159; 95% CI: 1.127, 1.192), 33.9% (HR = 1.339; 95% CI: 1.255, 1.430) and 13.2% (HR = 1.132; 95% CI: 1.098, 1.168) of increases in risk for all PTB, early PTB and late PTB among the normoglycemia women, with each 10 μg/m 3 increment of PM 2.5 exposure, respectively. Furthermore, PM 2.5 exposure had the strongest effect on all PTB during trimester 1 (0-12 gestational weeks) among the pre-pregnancy IFG women, compared with the less strong effect during trimester 1 among the normoglycemia women. In conclusion, pre-pregnancy IFG increases the risk of PTB attributed to PM 2.5 , especially during trimester 1. Moreover, the effects of PM 2.5 are greater on early PTB than late PTB for both pre-pregnancy IFG and normoglycemia women., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Maternal exposure to fine particulate matter (PM 2.5 ) has been associated with a few adverse birth outcomes. However, its effect on stillbirth remains unknown in China, especially the susceptible windows and potential modifiers., Objective: This study aimed to evaluate the associations between maternal PM 2.5 exposure and stillbirth in seven Chinese cities., Methods: We used birth cohort data of 1,273,924 mother-and-birth pairs in seven cities in southern China between 2014 and 2017 to examine these associations. Pregnant women were recruited in the cohort at their first visit to a doctor for pregnancy, and stillbirths were recorded at the time of birth. Air pollution exposures were assessed through linking daily air pollutant concentrations from nearby monitoring stations to the mother's residential community. Cox regression models were applied to determine the associations between PM 2.5 and stillbirth for different gestational periods., Results: Among the participants, 3150 (2.47‰) were identified as stillbirth cases. The hazard ratio (HR) of stillbirths was 1.52 (95% CI: 1.42, 1.62) for each 10 μg/m 3 increase in PM 2.5 during the entire pregnancy after controlling for some important covariates. Relatively stronger associations were observed during the second trimester [adjusted HR = 1.67 (95% CI: 1.57, 1.77)] than trimesters 1 [HR = 1.44 (95% CI: 1.37, 1.52)] and trimester 3 [HR = 1.23 (95% CI: 1.16, 1.30)]. Stratified analyses also showed a stronger association among pregnant women without previous pregnancy and previous delivery experiences., Conclusion: The study indicates that maternal exposure to PM 2.5 , especially during the midpoint period of pregnancy, might increase the risk of stillbirths. Maternal previous pregnancy and delivery may modify this association., (Copyright © 2021. Published by Elsevier GmbH.)

Background: Previous studies have reported that maternal exposure to particles with aerodynamic diameter <2.5 μm (PM 2.5 ) is associated with birth outcomes. However, a multicity birth cohort study has not been conducted in China, and the attributable fraction of adverse birth outcomes due to PM 2.5 exposure remains unknown., Methods: We examined associations in a birth cohort of 1,455,026 mother-and-live-birth pairs who were followed up from the first hospital visit for pregnancy until the birth of the baby during 2014-2017 in nine cites of the Pearl River Delta (PRD) region, China. The PM 2.5 exposures were estimated based on the air pollution concentrations of the nearby monitors. Cox proportional hazards regressions were employed to examine the associations., Results: We found 1% (HR = 1.01; 95% CI: 1.00, 1.02), 6% (HR = 1.06; 95% CI: 1.05, 1.07), and 7% (HR = 1.07; 95% CI: 1.06, 1.08) increases in risk of PTB and 20% (HR = 1.20; 95% CI: 1.18, 1.22), 18% (HR = 1.18; 95% CI: 1.15, 1.20), and 20% (HR = 1.20; 95% CI: 1.17, 1.23) increases in risk of LBW, with each 10 μg/m 3 increase in PM 2.5 from trimester 1 to trimester 3, respectively. For PTB, highest HRs were observed during trimester 3, as for LBW, stronger effect were observed during trimester 1 and trimester 3. We further estimated that 7.84% (95% CI: 6.21%, 9.50%) of PTB and 14.85% (95% CI: 13.00%, 16.61%) of the LBW cases could be attributable to PM 2.5 exposure during the third trimester., Conclusion: The results indicate that maternal PM 2.5 exposure is a risk factor for both LBW and PTB, and responsible for considerable burdens of PTB and LBW in the Pearl River Delta region., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)