Objective:To evaluate the effectiveness of bloodletting puncture and cupping in relieving breast cancer-related lymphedema.Methods:We conducted a non-randomized controlled study at the Galactophore Department of the 3...Objective:To evaluate the effectiveness of bloodletting puncture and cupping in relieving breast cancer-related lymphedema.Methods:We conducted a non-randomized controlled study at the Galactophore Department of the 3rd Affiliated Hospital of Beijing University of Chinese Medicine from March 2013 to December 2014.Seventy-five patients undergoing treatment for breast cancer-related lymphedema were divided into two groups in accordance with the patients' treatment choices:the treatment group (n =50) underwent bloodletting puncture and cupping every 5 days for 15 min/session (one session per day) combined with exercise training once a day for 30 minutes;the control group (n =25) underwent the same exercise training alone.Evaluation indexes were measured before and after treatment;these included arm circumference (at the wrist crease,10 cm distal to the wrist crease,the elbow crease,and 10 cm distal to the elbow crease)and visual analogue scale (VAS) score for pain.The safety of the treatment was also evaluated.Results:The treatment period was 50 days for all 75 patients.At the end of the treatment period,the mean reduction in arm circumference was 1.21 (0.65) cm the treatment group,and 0.58 (0.78) cm in the control group.Compared with the control group,the treatment group had a significantly greater reduction in arm circumference (P =.03) and a significantly lower VAS score for pain (P =.01).No patient in either group experienced any adverse events.Conclusion:Bloodletting puncture and cupping effectively reduces arm circumference and relieves upper limb pain in patients with breast cancer-related lymphedema.Our results provide sufficient basis for exploring cupping as long-term therapy for managing breast cancer-related lymphedema.展开更多
The prevalence of childhood asthma has been increasing in China. This study aimed to compare the prevalence, diagnosis, and treatment of asthmatic children from urban and rural areas in Beijing, China. Methods： Schoo...The prevalence of childhood asthma has been increasing in China. This study aimed to compare the prevalence, diagnosis, and treatment of asthmatic children from urban and rural areas in Beijing, China. Methods： Schools, communities, and kindergartens were randomly selected by cluster random sampling from urban and rural areas in Beijing. Parents were surveyed by the same screening questionnaires. On-the-spot inquiries, physical examinations, medical records, and previous test results were used to diagnose asthmatic children. Information on previous diagnoses, treatments, and control of symptoms was obtained. Results： From 7209 children in rural areas and 13,513 children in urban areas who completed screening questionnaires, 587 children were diagnosed as asthma. The prevalence of asthma in rural areas was lower than in urban areas （1.25% vs. 3.68%, χ^2 = 100.80, P 〈 0.001）. The diagnosis of asthma in rural areas was lower than in urban areas （48.9% vs. 73.9%, χ^2 = 34.6, P 〈 0.001）. Compared with urban asthmatic children （56.5%）, only 35.6% of rural asthmatic children received inhaled corticosteroids （P 〈 0.05）. The use ofbronchodilators was also lower in rural areas than in urban areas （56.5% vs. 66.4%, χ^2 = 14.2, P 〈 0.01）. Conclusion： The prevalence of asthma in children was lower in rural areas compared with children in the urban area of Bcijing. A considerable number of children were not diagnosed and inadequately treated in rural areas,展开更多
Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous ca...Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous caesarean section (RCS group) admitted in Peking Union Medical College Hospital during a period from 2003 to 2011 were retrospectively reviewed and compared with those of 243 patients with placenta previa without a previous caesarean section (FCS group) during the same period. Results There was no difference in the mean age (28.9±3.6 vs. 28.1±4.5 years) and the average gravidity (2.35±1.48 vs. 2.21±1.53) between RCS group and FCS group (all P>0.05). The RCS group had more preterm births (24.1% vs. 13.2%), complete placenta previa (55.2% vs. 4.9%), placenta accreta (34.5% vs. 2.5%), more blood loss during caesarean section (1412±602 vs. 648±265 mL), blood transfusion (51.7% vs. 4.9%), disseminated intravascular coagulation (13.8% vs. 2.1%), and obstetric hysterectomy (13.8% vs. 0.8%) than the FCS group (all P<0.05). The preterm infant rate (30.0% vs. 13.0%), neonatal asphyxia rate (10.0% vs. 4.9%), and perinatal mortality rate (6.7% vs. 0.4%) of the RCS group were higher than those of the FCS group (all P<0.05). Conclusions More patients had complete placenta previa and placenta accreta, postpartum hemorrhage, transfusion, uterine packing, obstetric hysterectomy, and perinatal morbidity in the placenta previa patients with previous caesarean section. The patient should be informed of the risk and unnecessary first cesarean sections should be avoided.展开更多
What is already known about this topic?Elevated gestational weight gain(GWG)during pregnancy among women diagnosed with gestational diabetes mellitus(GDM)is correlated with an increased instance of large for gestation...What is already known about this topic?Elevated gestational weight gain(GWG)during pregnancy among women diagnosed with gestational diabetes mellitus(GDM)is correlated with an increased instance of large for gestational age(LGA)and macrosomia.However,it remains uncertain whether managing weekly GWG following a GDM diagnosis positively impacts fetal birth weight.What is added by this report?Our study found that GWG following GDM diagnosis correlates positively with the risk of LGA and macrosomia among all body mass index(BMI)subgroups,especially for overweight and obese women.What are the implications for public health practice?The results of this research highlight the importance of enforcing a more stringent regulation on GWG on a weekly basis for overweight and obese women diagnosed with GDM,particularly when considering neonatal growth.展开更多
INTRODUCTION Gestational diabetes mellitus （GDM） was earlier defined as ＂hyperglycemia first recognized during pregnancy＂ and has more recently been described by American Diabetes Association （ADA） （2012） as d...INTRODUCTION Gestational diabetes mellitus （GDM） was earlier defined as ＂hyperglycemia first recognized during pregnancy＂ and has more recently been described by American Diabetes Association （ADA） （2012） as diabetes diagnosed during pregnancy that is not clearly overt diabetes. The hyperglycemia and adverse pregnancy outcomes study （HAPO） demonstrated that the risk of adverse maternal,fetal,and neonatal outcomes continuously increase as a function of maternal glycemia at 24-28 weeks,even within ranges previously considered normal for pregnancy.展开更多
Summary What is already known about this topic?Joint effects of gestational weight gain(GWG)and hyperglycemia on adverse pregnancy outcomes suggest that lower optimal GWG is optimal for women with gestational diabetes...Summary What is already known about this topic?Joint effects of gestational weight gain(GWG)and hyperglycemia on adverse pregnancy outcomes suggest that lower optimal GWG is optimal for women with gestational diabetes mellitus(GDM).However,there is still a lack of guidelines.What is added by this report?Optimal weekly GWG range after diagnosis of GDM for underweight,normal-weight,overweight,and obese women was 0.37–0.56 kg/week,0.26–0.48 kg/week,0.19–0.32 kg/week,and 0.12–0.23 kg/week,respectively.What are the implications for public health practice?The findings may be used to inform prenatal counseling regarding optimal gestational weight gain for women with gestational diabetes mellitus,and suggest the need for weight gain management.展开更多
Objective:To build a reference fetal growth chart for the Chinese population based on fetal ultrasound measurements.Methods:This was a multicenter,population-based retrospective cohort study.Longitudinal ultrasound me...Objective:To build a reference fetal growth chart for the Chinese population based on fetal ultrasound measurements.Methods:This was a multicenter,population-based retrospective cohort study.Longitudinal ultrasound measurement data were collected from 24 hospitals in 18 provinces of China from 1st September through 31st October of 2019.The estimated fetal weight(EFW)was calculated based on head circumference,abdominal circumference,and femur length using Hadlock formula 3.Fetal growth curves were estimated using a two-level linear regression model with cubic splines.All participants were divided into two groups:the northern group(n=5829)and the southern group(n=3246)based on the geographical division of China and male fetus group(n=4775)and female fetus group(n=4300)based on fetal gender.The EFW was compared by fetal gender and geographical group.All statistical models were adjusted for maternal sociodemographic characteristics.Results:A total of 9075 participants with 31,700 ultrasound measurement records were included in this study.Male fetuses demonstrated significantly larger EFW compared to female ones starting at 16 weeks of gestation and extending to delivery(global testP<0.01).The overall geographic difference in EFW was significant(global testP=0.03),and week-specific comparisons showed that the northern group had a greater EFW starting at 15 weeks of gestation and extending to 29 weeks of gestation,although this difference did not extend to the time of delivery.TheZ-score of EFW confirmed that our Chinese fetal growth charts differed from previously published standards.Conclusion:This study provides EFW and ultrasound biometric reference measurements for Chinese fetuses and reveals differences from other fetal growth charts.The chart is worth promoting in more regions of China but should be tested prudently before use.展开更多
Background:Gestational diabetes mellitus(GDM)is usually diagnosed between 24th and 28th gestational week using the 75-g oral glucose tolerance test(OGTT).It is difficult to predict GDM before 24th gestational week bec...Background:Gestational diabetes mellitus(GDM)is usually diagnosed between 24th and 28th gestational week using the 75-g oral glucose tolerance test(OGTT).It is difficult to predict GDM before 24th gestational week because fast plasma glucose(FPG)decreases as the gestational age increases.It is controversial that if FPG≥5.1 mmol/L before 24th gestational week should be intervened or not.The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy body mass index(BMI).Methods:This was a multi-region retrospective cohort study in China.Women who had a singleton live birth between June 20,2013 and November 30,2014,resided in Beijing,Guangzhou and Chengdu,and received prenatal care in 21 selected hospitals,were included in this study.Pre-pregnancy BMI,FPG before the 24th gestational week,and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical charts and analyzed.The pregnant women were classified into four groups based on pre-pregnancy BMI:Group A(underweight,BMI<18.5 kg/m^2),Group B(normal,BMI 18.5-23.9 kg/m^2),Group C(overweight,BMI 24.0-27.9 kg/m^2)and Group D(obesity,BMI≥28.0 kg/m^2).The trend of FPG before 24th week of gestation was described,and the sensitivity and specificity of using FPG before the 24th gestational week to diagnose GDM among different pre-pregnancy BMI groups were reported.Differences in the means between groups were evaluated using independent sample t-test and analysis of variance.Pearson Chi-square test was used for categorical variables.Results:The prevalence of GDM was 20.0%(6806/34,087)in the study population.FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.FPG was higher in women with higher pre-pregnancy BMI.FPG before the 24th gestational week and pre-pregnancy BMI could be used to predict GDM.The incidence of GDM in women with FPG≥5.10 mmol/L in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG≥5.10 mmol/L and pre-pregnancy BMI<24.0 kg/m^2(78.5%[62/79]vs.52.9%[64/121],χ^2=13.425,P<0.001).Conclusions:FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week.FPG≥5.10 mmol/L between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.展开更多
文摘Objective:To evaluate the effectiveness of bloodletting puncture and cupping in relieving breast cancer-related lymphedema.Methods:We conducted a non-randomized controlled study at the Galactophore Department of the 3rd Affiliated Hospital of Beijing University of Chinese Medicine from March 2013 to December 2014.Seventy-five patients undergoing treatment for breast cancer-related lymphedema were divided into two groups in accordance with the patients' treatment choices:the treatment group (n =50) underwent bloodletting puncture and cupping every 5 days for 15 min/session (one session per day) combined with exercise training once a day for 30 minutes;the control group (n =25) underwent the same exercise training alone.Evaluation indexes were measured before and after treatment;these included arm circumference (at the wrist crease,10 cm distal to the wrist crease,the elbow crease,and 10 cm distal to the elbow crease)and visual analogue scale (VAS) score for pain.The safety of the treatment was also evaluated.Results:The treatment period was 50 days for all 75 patients.At the end of the treatment period,the mean reduction in arm circumference was 1.21 (0.65) cm the treatment group,and 0.58 (0.78) cm in the control group.Compared with the control group,the treatment group had a significantly greater reduction in arm circumference (P =.03) and a significantly lower VAS score for pain (P =.01).No patient in either group experienced any adverse events.Conclusion:Bloodletting puncture and cupping effectively reduces arm circumference and relieves upper limb pain in patients with breast cancer-related lymphedema.Our results provide sufficient basis for exploring cupping as long-term therapy for managing breast cancer-related lymphedema.
文摘The prevalence of childhood asthma has been increasing in China. This study aimed to compare the prevalence, diagnosis, and treatment of asthmatic children from urban and rural areas in Beijing, China. Methods： Schools, communities, and kindergartens were randomly selected by cluster random sampling from urban and rural areas in Beijing. Parents were surveyed by the same screening questionnaires. On-the-spot inquiries, physical examinations, medical records, and previous test results were used to diagnose asthmatic children. Information on previous diagnoses, treatments, and control of symptoms was obtained. Results： From 7209 children in rural areas and 13,513 children in urban areas who completed screening questionnaires, 587 children were diagnosed as asthma. The prevalence of asthma in rural areas was lower than in urban areas （1.25% vs. 3.68%, χ^2 = 100.80, P 〈 0.001）. The diagnosis of asthma in rural areas was lower than in urban areas （48.9% vs. 73.9%, χ^2 = 34.6, P 〈 0.001）. Compared with urban asthmatic children （56.5%）, only 35.6% of rural asthmatic children received inhaled corticosteroids （P 〈 0.05）. The use ofbronchodilators was also lower in rural areas than in urban areas （56.5% vs. 66.4%, χ^2 = 14.2, P 〈 0.01）. Conclusion： The prevalence of asthma in children was lower in rural areas compared with children in the urban area of Bcijing. A considerable number of children were not diagnosed and inadequately treated in rural areas,
基金Supported by Beijing Clinical Study(Z111107058811025)Beijing Government Excellent Person Sponsor Program
文摘Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous caesarean section (RCS group) admitted in Peking Union Medical College Hospital during a period from 2003 to 2011 were retrospectively reviewed and compared with those of 243 patients with placenta previa without a previous caesarean section (FCS group) during the same period. Results There was no difference in the mean age (28.9±3.6 vs. 28.1±4.5 years) and the average gravidity (2.35±1.48 vs. 2.21±1.53) between RCS group and FCS group (all P>0.05). The RCS group had more preterm births (24.1% vs. 13.2%), complete placenta previa (55.2% vs. 4.9%), placenta accreta (34.5% vs. 2.5%), more blood loss during caesarean section (1412±602 vs. 648±265 mL), blood transfusion (51.7% vs. 4.9%), disseminated intravascular coagulation (13.8% vs. 2.1%), and obstetric hysterectomy (13.8% vs. 0.8%) than the FCS group (all P<0.05). The preterm infant rate (30.0% vs. 13.0%), neonatal asphyxia rate (10.0% vs. 4.9%), and perinatal mortality rate (6.7% vs. 0.4%) of the RCS group were higher than those of the FCS group (all P<0.05). Conclusions More patients had complete placenta previa and placenta accreta, postpartum hemorrhage, transfusion, uterine packing, obstetric hysterectomy, and perinatal morbidity in the placenta previa patients with previous caesarean section. The patient should be informed of the risk and unnecessary first cesarean sections should be avoided.
文摘What is already known about this topic?Elevated gestational weight gain(GWG)during pregnancy among women diagnosed with gestational diabetes mellitus(GDM)is correlated with an increased instance of large for gestational age(LGA)and macrosomia.However,it remains uncertain whether managing weekly GWG following a GDM diagnosis positively impacts fetal birth weight.What is added by this report?Our study found that GWG following GDM diagnosis correlates positively with the risk of LGA and macrosomia among all body mass index(BMI)subgroups,especially for overweight and obese women.What are the implications for public health practice?The results of this research highlight the importance of enforcing a more stringent regulation on GWG on a weekly basis for overweight and obese women diagnosed with GDM,particularly when considering neonatal growth.
文摘INTRODUCTION Gestational diabetes mellitus （GDM） was earlier defined as ＂hyperglycemia first recognized during pregnancy＂ and has more recently been described by American Diabetes Association （ADA） （2012） as diabetes diagnosed during pregnancy that is not clearly overt diabetes. The hyperglycemia and adverse pregnancy outcomes study （HAPO） demonstrated that the risk of adverse maternal,fetal,and neonatal outcomes continuously increase as a function of maternal glycemia at 24-28 weeks,even within ranges previously considered normal for pregnancy.
基金funded by the Medical and Health Technology Innovation Project of the Chinese Academy of Medical Sciences(2020-I2M-2-009,2021-I2M-1-023)the Project of the National Health Commission of the People’s Republic of China(20191901)the National Natural Science Foundation of China(81973053).
文摘Summary What is already known about this topic?Joint effects of gestational weight gain(GWG)and hyperglycemia on adverse pregnancy outcomes suggest that lower optimal GWG is optimal for women with gestational diabetes mellitus(GDM).However,there is still a lack of guidelines.What is added by this report?Optimal weekly GWG range after diagnosis of GDM for underweight,normal-weight,overweight,and obese women was 0.37–0.56 kg/week,0.26–0.48 kg/week,0.19–0.32 kg/week,and 0.12–0.23 kg/week,respectively.What are the implications for public health practice?The findings may be used to inform prenatal counseling regarding optimal gestational weight gain for women with gestational diabetes mellitus,and suggest the need for weight gain management.
基金supported by the National Key R&D Program of China(2018YFC1002900)。
文摘Objective:To build a reference fetal growth chart for the Chinese population based on fetal ultrasound measurements.Methods:This was a multicenter,population-based retrospective cohort study.Longitudinal ultrasound measurement data were collected from 24 hospitals in 18 provinces of China from 1st September through 31st October of 2019.The estimated fetal weight(EFW)was calculated based on head circumference,abdominal circumference,and femur length using Hadlock formula 3.Fetal growth curves were estimated using a two-level linear regression model with cubic splines.All participants were divided into two groups:the northern group(n=5829)and the southern group(n=3246)based on the geographical division of China and male fetus group(n=4775)and female fetus group(n=4300)based on fetal gender.The EFW was compared by fetal gender and geographical group.All statistical models were adjusted for maternal sociodemographic characteristics.Results:A total of 9075 participants with 31,700 ultrasound measurement records were included in this study.Male fetuses demonstrated significantly larger EFW compared to female ones starting at 16 weeks of gestation and extending to delivery(global testP<0.01).The overall geographic difference in EFW was significant(global testP=0.03),and week-specific comparisons showed that the northern group had a greater EFW starting at 15 weeks of gestation and extending to 29 weeks of gestation,although this difference did not extend to the time of delivery.TheZ-score of EFW confirmed that our Chinese fetal growth charts differed from previously published standards.Conclusion:This study provides EFW and ultrasound biometric reference measurements for Chinese fetuses and reveals differences from other fetal growth charts.The chart is worth promoting in more regions of China but should be tested prudently before use.
文摘Background:Gestational diabetes mellitus(GDM)is usually diagnosed between 24th and 28th gestational week using the 75-g oral glucose tolerance test(OGTT).It is difficult to predict GDM before 24th gestational week because fast plasma glucose(FPG)decreases as the gestational age increases.It is controversial that if FPG≥5.1 mmol/L before 24th gestational week should be intervened or not.The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy body mass index(BMI).Methods:This was a multi-region retrospective cohort study in China.Women who had a singleton live birth between June 20,2013 and November 30,2014,resided in Beijing,Guangzhou and Chengdu,and received prenatal care in 21 selected hospitals,were included in this study.Pre-pregnancy BMI,FPG before the 24th gestational week,and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical charts and analyzed.The pregnant women were classified into four groups based on pre-pregnancy BMI:Group A(underweight,BMI<18.5 kg/m^2),Group B(normal,BMI 18.5-23.9 kg/m^2),Group C(overweight,BMI 24.0-27.9 kg/m^2)and Group D(obesity,BMI≥28.0 kg/m^2).The trend of FPG before 24th week of gestation was described,and the sensitivity and specificity of using FPG before the 24th gestational week to diagnose GDM among different pre-pregnancy BMI groups were reported.Differences in the means between groups were evaluated using independent sample t-test and analysis of variance.Pearson Chi-square test was used for categorical variables.Results:The prevalence of GDM was 20.0%(6806/34,087)in the study population.FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.FPG was higher in women with higher pre-pregnancy BMI.FPG before the 24th gestational week and pre-pregnancy BMI could be used to predict GDM.The incidence of GDM in women with FPG≥5.10 mmol/L in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG≥5.10 mmol/L and pre-pregnancy BMI<24.0 kg/m^2(78.5%[62/79]vs.52.9%[64/121],χ^2=13.425,P<0.001).Conclusions:FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week.FPG≥5.10 mmol/L between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.
