Songjiang District Research Articles

Low birthweight of children is positively associated with mother\u2019s prenatal tobacco smoke exposure in Shanghai: a cross-sectional study

IntroductionLow birthweight (LBW) is a significant public health issue, and maternal smoking is the most prevalent preventable cause of LBW. But there is limited evidence on association of LBW among children and cigarette smoke exposure in mothers in China. In this cross-sectional study, we try to explore if the LBW in children is positively associated with mothers’ prenatal cigarette smoke exposure.MethodsWe selected 8, 586 mothers and their singleton children in 2018 in Songjiang district, Shanghai. Birthweight of children and gestational weeks of mother was identified by birth records in the hospital, we classified mothers’ prenatal cigarette smoke status into the first-hand smoke (FHS) exposure and the second-hand smoke (SHS) exposure. We use SAS 9.1.3 software to calculate the prevalence of children’s LBW and the prevalence of mothers’ prenatal cigarette smoke exposure including FHS and SHS. Chi-square test and logistic regression were used to analyze the difference.ResultsIn 8, 586 women, The prenatal FHS and SHS exposure prevalence was 0.9 and 20.8%, respectively. The mean birthweight of children was 3315.5 g with a standard deviation of 497.2 g, the mean birthweight was 167.7 g and 66.1 g lower in children born to mothers with prenatally FHS and SHS exposure compared with those children whose mother were not exposed, respectively. The children’s LBW prevalence was 4.7% in this study. By comparing with children whose mother were not exposed, the LBW prevalence was higher among children whose mother were prenatally exposed to FHS [OR (Odds Ratios) = 2.91, 95% confidence interval (CI) (1.49, 5.68)], and SHS [OR = 2.35, 95% CI (1.90, 2.89)].ConclusionsChildren’s LBW is positively associated with mothers’ prenatal tobacco smoke exposure both for FHS and SHS. So implementing tobacco control measures is crucial to lower smoking prevalence among women, and decrease smoking prevalence of their family members as well as work fellows.

Catastrophic costs of tuberculosis care in a population with internal migrants in China

BackgroundThe internal rural-to-urban migration is one of the major challenges for tuberculosis (TB) control in China. Patient costs incurred during TB diagnosis and treatment could cause access and adherence barriers, particularly among migrants. Here, we estimated the prevalence of catastrophic costs of TB patients and its associated factors in an urban population with internal migrants in China.MethodsA cross-sectional survey was conducted to enroll culture-confirmed pulmonary TB patients in Songjiang district, Shanghai, between December 1, 2014, and December 31, 2015. Consenting participants completed a questionnaire, which collected direct and indirect costs before and after the diagnosis of TB. The catastrophic cost was defined as the annual expenses of TB care that exceeds 20% of total household disposable income. We used logistic regression to identify factors associated with catastrophic costs.ResultsOverall, 248 drug-susceptible TB patients were enrolled, 70% (174/248) of them were from migrants. Migrant patients were significantly younger compared to resident patients. The total costs were 25,824 ($3689) and 13,816 ($1974) Chinese Yuan (RMB) in average for resident and migrant patients, respectively. The direct medical cost comprised about 70% of the total costs among both migrant and resident patients. Overall, 55% (132 of 248) of patients experienced high expenses (>10% of total household income), and 22% (55 of 248) experienced defined catastrophic costs. The reimbursement for TB care only reduced the prevalence of catastrophic costs to 20% (49 of 248). Meanwhile, 52% (90 of 174) of the internal migrants had no available local health insurance. Hospitalizations, no available insurance, and older age (> 45-year-old) contributed significantly to the occurrence of catastrophic costs.ConclusionsThe catastrophic cost of TB service cannot be overlooked, despite the free policy. Migrants have difficulties benefiting from health insurance in urban cities. Interventions, including expanded medical financial assistance, are needed to secure universal TB care.

Effects of ventilation on leakage and diffusion law of gas pipeline in utility tunnel

The gas pipeline in the utility tunnel locates at an underground closed space. Once the gas leaks, the accident consequence will be more serious. Therefore, it is very important to study the effect of ventilation on leakage and diffusion of the gas pipeline in the utility tunnel. This paper takes the gas pipeline in the utility tunnel in Songjiang District of Shanghai as the study object. Based on the computational fluid dynamics (CFD) theory, a simulation model of gas pipeline in the utility tunnel is established, and the scenarios of gas leakage and diffusion under different ventilation velocities and ventilation outlet’s sizes are simulated respectively. The results show that: (1) Gas diffusion time has an exponential relationship with both ventilation velocity and side length of ventilation outlet. (2) Alarm time on the downwind side in the gas tunnel has a linear relationship with both ventilation velocity and ventilation outlet’s size. (3) Gas volume ratio has a power function relationship with both ventilation velocity and side length of ventilation outlet. (4) Gas average concentration has an exponential relationship with ventilation velocity and a logarithmic relationship with side length of ventilation outlet, and the effects of ventilation velocity and ventilation outlet’s size on the gas concentration along the distance are similar. (5) In practical engineering, it is an optimal selection that the ventilation velocity is between (5 m/s, 7 m/s) and the side length of ventilation outlet is between (1 m, 1.25 m).

Establishment and Practice of the Statistical Indicator System for All-Area-Advancing Tourism in China

As a new concept and mode in China to promote the coordinated development of the regional economy and society driven by the tourism industry, All-area-advancing tourism refers to the unified planning and layout, optimization of public services, comprehensive overall management, and marketing of a certain region as a complete destination with tourism as the dominant industry. This research established the All-area-advancing tourism statistical indicator system which is committed to calculate the contribution of All-area-advancing tourism to the national economy from both the supply and demand sides within the framework of the system of national account (SNA). Meanwhile, the established indicator system of All-area-advancing tourism has been applied to calculate the output of the tourism industry in Songjiang district, Shanghai, China. The results indicate that the All-area-advancing tourism indicator system can better fit the current system of national account and reflect the contribution of the tourism industry to the national economy in a more comprehensive way.

Cohort profile: protocol and baseline survey for the Shanghai Suburban Adult Cohort and Biobank (SSACB) study

PurposeThe Shanghai Suburban Adult Cohort and Biobank (SSACB) was established to identify environmental, lifestyle and genetic risk factors for non-communicable chronic diseases (NCDs) in adults (20–74 years old) living in...

Influence of dietary patterns on type 2 diabetes mellitus in local residents aged 40 years and above in Songjiang district, Shanghai

Objective: To evaluate the association between dietary pattern and type 2 diabetes mellitus (T2DM) in local residents aged 40 years and above in Songjiang district of Shanghai. Methods: Data was obtained from the baseline investigation of Shanghai Peak-Plan cohort. According to inclusion and exclusion criteria, we selected people with T2DM as the case group, and people without T2DM as controls, matched with gender, age and alcohol intake status. Dietary patterns were established by factor analysis. Conditional logistic regression model (CLRM) was used to explore the relationship between different dietary patterns and T2DM, as well as the association between multiplicative interactions of dietary patterns and T2DM. Results: We used factor analysis to obtain six dietary patterns: including meat, desserts-coarse cereals, condiment-egg, beverage, cereals-tubers and fruit-vegetable. Data from multivariate condition logistic regression suggested that condiment-egg patterns as (OR=0.543, 95%CI: 0.377-0.781), beverage (OR=0.590, 95%CI: 0.409-0.852), cereals-tubers (OR=0.592, 95%CI: 0.414-0.848), fruit-vegetable (OR=0.604, 95%CI: 0.417-0.876) were associated with the reduced risks for T2DM. After analyzing the multiplicative interactions between dietary patterns, there were three interaction items associated with T2DM with statistical significances: the multiplicative interaction between meat pattern and condiments-egg pattern was related with the increased risk for T2MD, and the multiplicative interactions between cereal-tubers pattern, meat pattern between cereal-tubers pattern and fruit-vegetable pattern were related with the reduced risks for T2MD. Conclusions: In the six dietary pattern under study, cereals-tubers pattern undwr studly, fruit-vegetable pattern might be more practical in preventing T2DM. In addition, the dietary pattern with cereals and potatos as the main ingredients, appropriate meat and reduced condiment intake might also play positive roles in reducing the risk for T2DM.

Gastric adenocarcinoma of the fundic gland type: clinicopathological analysis of six cases

Objective: To investigate the clinicopathological characteristics of gastric adenocarcinoma of the fundic gland(GA-FG). Methods: A total of 6 patients with GA-FG admitted from January 2014 to May 2019 were identified at Shanghai Songjiang District Central Hospital.Analyzed endoscopic findings, pathological characteristics and immunohistochemical staining of the lesions and reviewed relevant literatures. Results: Among the 6 patients, 3 were male, 3 were female, and the mean age was 66 years. The most common clinical presentation was epigastric discomfort. Gastroscopic examination revealed an elevated or flat lesion in the body of the stomach, with a diameter of 0.4 to 1.0 cm. Histopathologically, they mainly composed of main cells, but there were also scattered parietal cells, arranged in an irregular tubular or cord-like structure, and formed anastomosis branches. The tumor cells were immunohistochemically positive for MUC6 and pepsinogen 1. Conclusions: GA-FG is a rare variant of well-differentiated adenocarcinoma. It is important to understand its clinical features and histological morphology for more accurate diagnosis.

Mothers' prenatal tobacco smoke exposure is positively associated with the occurrence of developmental coordination disorder among children aged 3-6 years: A cross-sectional study in a rural area of Shanghai, China.

INTRODUCTIONPrenatal tobacco smoke exposure is a potential risk factor for developmental coordination disorder (DCD) in children, but evidence on the relationship between DCD in children and tobacco smoke exposure in women is limited in China. We conducted a cross-sectional study to understand the prevalence of prenatal tobacco smoke exposure among mothers and the prevalence of DCD among children and to explore if mothers’ prenatal tobacco smoke exposure is positively associated with the occurrence of DCD among children.METHODSDuring 2018, we sampled 8586 children aged 3–6 years and their mothers in Songjiang district, Shanghai. DCD in children was identified by MABC-2 screening combined with pediatrician confirmation. Prenatal tobacco smoke exposure among mothers was classified into firsthand smoke (FHS) and secondhand smoke (SHS) exposure. SAS 9.2 software was applied to calculate the prevalence of DCD in children, the prevalence of prenatal FHS and SHS exposure in mothers and to analyze the differences by chi-squared test and logistic regression.RESULTSAmong the 8586 women, the prevalence of prenatal FHS and SHS exposure was 0.94% and 20.79%, respectively. The prevalence of DCD in children was 6.65%, which was significantly higher in boys (7.64%) than in girls (5.51%), and children aged 3 years (9.77%) had a higher prevalence of DCD than children aged 4, 5 or 6 years (7.44%, 5.27% and 4.28%, respectively). In comparison with children whose mother was not exposed to prenatal FHS or SHS, the odds of having DCD was higher in children whose mother was exposed to prenatal FHS (OR=4.42; 95% CI: 2.62–7.44) and SHS (OR=1.77; 95% CI: 1.47–2.14), even after adjustment for potential confounders.CONCLUSIONSThe occurrence of DCD among children is positively associated with prenatal tobacco smoke exposure among the mothers. It is crucial to implement tobacco control measures to decrease the prevalence of smoking among pregnant women and SHS exposure at home as well as in the work environment.ABBREVIATIONSDCD: developmental coordination disorder, ADHD: attention deficit hyperactivity disorder, FHS: firsthand smoke, SHS: secondhand smoke, MABC-2: movement assessment battery for children-2nd edition, GATS: global adult tobacco survey, SD: standard deviation, OR: odds ratio, CI: confidence interval, DAGs: directed acyclic graphs.

Exposure Levels, Sources, and Health Risks of Heavy Metal Components of PM2.5 in Housewives in Rural Shanghai

To investigate exposure characteristics and potential health risk of PM2.5-bound heavy metals in housewives in rural areas, 265 personal exposure samples from 143 subjects were collected in the Songjiang district, Shanghai from February 2017 to June 2018. Mass concentrations of 13 elements in PM2.5 were determined by energy-dispersive X-ray fluorescence spectrometry (ED-XRF). The sources of heavy metal components in PM2.5 were analyzed using positive matrix factorization (PMF). The inhalation health risks of exposure to Ni, V, Cr, Mn, As, and Pb were analyzed using the US EPA health risk assessment model. The results showed that the average concentration of personal exposure to PM2.5 was 40.61 μg·m-3 in housewives, which was higher than the concentration at peripheral monitoring stations. The carcinogenic risks of Cr(Ⅵ)and As exceeded the acceptable risk level (10-6). The non-carcinogenic risks of V, Cr(Ⅵ), Mn, Ni, and As were all below the safety threshold, while the total non-carcinogenic risks of these five elements were higher than the safety threshold (>1). The results of PMF indicated that resuspended dust and indoor dust(43.8%), the metallurgy industry(34.6%), coal combustion(14.5%), and fossil-fuel combustion(7.2%)were the major sources of ten elements (Al, Ti, V, Cr, Mn, Fe, Ni, Zn, As, and Pb) in PM2.5. Based on the results of health risk assessment of pollution sources, control measures on the metallurgy industry and fossil-fuel combustion should be further strengthened.

Simulation modeling and optimization for ambulance allocation considering spatiotemporal stochastic demand

To ensure a timely response to emergencies, governments are obliged to implement effective ambulance allocation plans. In practice, an emergency medical service (EMS) system works in an uncertain environment, with stochastic demand, response-times, and travel-times. This uncertainty significantly affects ambulance allocation planning. However, few studies in this field adequately consider the effect of spatiotemporal uncertainty in demand, because it is difficult to measure it quantitatively. As a result, few analytic models capture the dynamic nature of an EMS system and, thus, the allocation plans they generate are not efficient in practice. Therefore, this study proposes a simulation-based optimization method for ambulance allocation. A simulation model is constructed to mimic the operational processes of an EMS system, and to evaluate the performance of an ambulance allocation plan in an uncertain environment. Gaussian mixture model clustering is used to derive the uncertain spatial demand. Then, the simulation generates emergency demand based on the obtained spatial distribution. A Gaussian-process-based search algorithm is used together with the simulation model to identify optimal solutions. To validate the proposed method, a case study is conducted using data on emergency patients in the Shanghai Songjiang District. Compared with the current plan adopted in Songjiang, the experimental results demonstrate that the delay time and frequency of the EMS system can be reduced significantly by employing the proposed methods. Furthermore, nearly 41% of the allocation cost can be saved.

Sleep quality of Shanghai residents: population-based cross-sectional study.

To estimate the prevalence of poor sleep and its risk factors for adults living in a suburban area of Shanghai with rapid urbanization. A total of 37,545 residents who were aged 20 to 74years and from the "Peak Program," a community-based natural population cohort study, were included. Data on demographics, lifestyle, and physical health-related factors were collected using a face-to-face questionnaire interview. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and poor sleep was defined as a PSQI score above 7. The overall mean of PSQI score was 3.69 ± 2.57 while the prevalence of poor sleep was 8.3%. The prevalence of poor sleep quality was higher in participants who were older than 40years, had less education, smoked tobacco, had anxiety, and had a chronic disease (p < 0.05 for all comparisons). After adjustment for confounding, a logistic regression model indicated that poor sleep was associated with advanced age, smoking, anxiety, cardiovascular and cerebrovascular diseases, respiratory diseases, and other chronic diseases (p < 0.05 for all comparisons). In addition, compared to women who were premenopausal, the naturally postmenopausal women (OR 1.675, 95% CI 1.44-1.94) and induced menopausal women (OR 2.26, 95% CI 1.81-2.82) were more likely to report poor sleep. The prevalence of poor sleep among individuals who lived in the Songjiang District of Shanghai and were aged 20 to 74years was remarkably lower than in the general population of China. Poor sleep was generally more common in middle-aged and elderly residents and in those suffering from anxiety and chronic diseases. Regular exercise, anxiety relieving, and treatment improvement of different chronic diseases may help sleep better.

Smoking cessation mutually facilitates alcohol drinking cessation among tobacco and alcohol co-users: A cross-sectional study in a rural area of Shanghai, China.

INTRODUCTIONTobacco smoking and alcohol drinking are strongly paired behaviours, affecting millions of people worldwide. Studies in western countries demonstrate that alcohol use among smokers makes it harder to quit smoking, and addressing alcohol use is particularly important for smoking cessation, but the evidence is limited in China. We conducted a cross-sectional study to understand the prevalence of smoking, drinking, as well as tobacco and alcohol co-use, and to explore how smoking cessation mutually facilitates drinking cessation among tobacco and alcohol co-users.METHODSDuring 2016 and 2017, we sampled 36698 participants aged >18 years in Songjiang district, Shanghai. A questionnaire was designed to collect data, and participants were classified into non-smokers and smokers (current and former smokers), as well as non-alcohol drinkers and alcohol drinkers (current and former alcohol drinkers). SAS software was applied to analyse the differences by weighted logistic regressions.RESULTSThe prevalence of tobacco smoking, alcohol drinking, and tobacco and alcohol co-use was 23.53%, 13.52% and 9.85%, respectively. Smoking cessation prevalence was 15.93%, which was higher than drinking cessation prevalence (8.22%). Tobacco and alcohol co-users had a higher prevalence of smoking cessation (16.95%) than participants who were only smokers (15.20%) and had higher prevalence of alcohol drinking cessation (8.71%) than residents who were only drinkers (6.91%). Tobacco and alcohol co-users who stopped alcohol drinking were much more likely to stop smoking than those who still drank alcohol (OR=8.83; 95% CI: 6.91–11.28) or those who only smoked (OR=7.51; 95% CI: 5.93–9.52).CONCLUSIONSDrinking cessation prevalence was lower than that of smoking cessation, and drinking cessation could mutually facilitate smoking cessation among tobacco and alcohol co-users. Tobacco smoking cessation programs could incorporate alcohol drinking cessation measures to achieve higher public health benefits.

Ambulance allocation considering the spatial randomness of demand

To guarantee that emergency calls can be responded to in time, the government is obliged to implement an effective ambulance location plan. In practice, emergency medical service (EMS) systems work in an uncertain environment with stochastic demand, response time, and travel time. The uncertainty of these factors significantly affects ambulance location planning. However, most recent studies in this field fail to adequately consider the effect of the spatial uncertainty of demand since it is difficult to describe quantitatively. As a result, most allocation plans are not efficient. In this study, Gaussian mixture model clustering is innovatively utilized to quantitatively describe spatially uncertain demand. Accordingly, the chance constraint programming model for ambulance allocation planning is developed. The objective is to minimize the sum of the cost of patient lives lost and the operational cost of the emergency facilities. Two years of data from the Shanghai Songjiang District are used to validate the proposed method. The data from 2013 are utilized to fit the spatial distribution of demand. The data from 2014 are used to test and verify the obtained models. The experimental results demonstrate that the delay time can be significantly decreased with the proposed methods. Furthermore, compared with other classic assumptions for the spatial randomness of demand in this field, better service performance and lower cost are obtained with the proposed methods.

Association of Metabolic Syndrome and Its Components with Decreased Estimated Glomerular Filtration Rate in Adults

Background/Aims: Metabolic syndrome (MetS) and its metabolic components, the common risk factors, may be involved in the development and progression of decreased estimated glomerular filtration rate (eGFR). The aim of this study was to examine the association of MetS and its metabolic components with eGFR status and severity among Chinese adults. Methods: The population-based, cross-sectional study recruited a total of 33,300 Chinese adults (aged ≥18 years) from 4 study community sites in Songjiang District, Shanghai, between June 2016 and December 2017. Decreased eGFR was defined as a value of eGFR below 60 mL/min/1.73 m². Weighted multiple logistic regression models were used to examine the association of MetS and its components with eGFR status and severity. Results: After adjusting for potential confounders, subjects with MetS had an increased risk of decreased eGFR with an adjusted OR of 1.76 (95% CI 1.53–2.01), and subjects with increasing numbers of MetS components had a gradually increased risk for decreased eGFR (p trend <0.001). The multivariable-adjusted ORs (95% CI) of decreased eGFR were 1.66 (1.44–1.93) for abdominal obesity, 1.37 (1.18–1.60) for elevated triglycerides, 1.13 (0.96–1.33) for reduced high-density lipoprotein cholesterol, 0.84 (0.72–0.98) for elevated fasting glucose, and 1.92 (1.57–2.35) for elevated blood pressure (BP). Furthermore, these associations remained in most of the subgroups analyses. Significant associations between elevated BP and the risks of mildly, moderately, and severely decreased eGFR were also found. Conclusions: MetS was independently associated with an increased risk of decreased eGFR, and individual components of MetS each play a different role in decreased eGFR. Elevated BP may be an important risk factor for the progression of renal dysfunction or even chronic kidney disease.

Surveillance of schistosomiasis 34 years after transmission interruption in Songjiang District, Shanghai City

To analyze the surveillance data after schistosomiasis transmission interruption from 1985 to 2018, so as to provide scientific basis for the future prevention and control of schistosomiasis. The data pertaining to snail survey, surveillance of schistosomiasis in humans and livestock, and health education were collected and analyzed in Songjiang District after schistosomiasis transmission interruption from 1985 to 2018. From 1985 to 2018, there were 8 townships, 68 villages and 1 462 settings with snails in Songjiang District, covering an area of 96.399 hm2. There were 4 townships and 59 villages with snails newly identified in previously schistosomiasis non-endemic areas, with emerging snail habitats of 60.161 hm2. A total of 26 148 snails were captured, and no infections were detected. The snail habitats were mainly distributed in the river course, ditches and farmlands, which accounted for 45.28%, 33.17% and 21.55% of total snail habitats, respectively. A total of 245 955 humans were subjected to the serological test, with a positive rate of 0.03%, and 37 humans were subjected to the parasitological test, with 3 positives detected. These three egg-positives were all imported chronic cases with schistosomiasis. A total of 9 109 livestock were detected using the serological test, and no infection was found. Most of the awareness rate of schistosomiasis control knowledge and the rate of correct behavior formation were over 80% in residents and students. The achievements of schistosomiasis control are consolidated in Songjiang District; however, there are still risk factors of schistosomiasis transmission, including residual snails, snail diffusion and importation of external source of infection. The future surveillance of schistosomiasis should focus on snails and sources of infection.

Relationships between smoking duration, smoking intensity, hypothetical tobacco price increases, and smoking habit change intention among current smokers in Shanghai.

ObjectivesWe conducted a cross-sectional study to explore the effect of a hypothetical tobacco retail price increase on smoking habit change intention, and the role of smoking duration and intensity in smoking change intention.MethodsIn 2016 and 2017, we collected questionnaire data from 36,698 residents aged over 18 years in Songjiang district, Shanghai. Chi-square tests and weighted logistic regression were used for data analyses.ResultsThe prevalence of current smoking was 19.78% (men: 48.36% and women: 0.22%). A total of 10.83% (men: 10.89% and women: 2.04%) and 9.39% of smokers (men: 9.42% and women: 6.12%) expressed the intention to smoke less or quit, respectively, given tobacco retail price increases. If the current tobacco retail price doubled, 75% of smokers stated that they would smoke less and 60% of smokers would consider quitting. Smokers with longer smoking duration and lower smoking intensity were more sensitive to tobacco price increases and more likely to change their smoking habits.ConclusionsAn increase in tobacco retail prices could induce some smokers to change their smoking behavior, particularly those with longer smoking duration and lower smoking intensity. A tobacco retail price increase is recommended, which should apply to all cigarette brands.

Thyroid hormone concentrations in second trimester of gestation and birth outcomes in Shanghai, China

Background Previous studies suggested that thyroid function in the first trimester of gestation played an important role in fetal growth. However, limited clinical data are available to support this relationship in the second trimester of gestation. Objective We examined the relationship of maternal thyroid function parameters in early second trimester of gestation with birth outcomes in China. Methods Participating 5016 mother–infant pairs were recruited from the Songjiang District Maternity and Infant Hospital, Shanghai, China, between July and December 2016. Linear regression assessed the associations of thyroid hormones with birthweight. Logistic regression tested the correlations between thyroid hormones and low birthweight, macrosomia, small for gestational age , and large for gestational age infants. Maternal serum TSH, TT3, TT4, FT3, and FT4 concentrations were measured in 16–20 weeks of gestation. Results TT3 and FT3 were positively associated with birthweight, while TT4 and FT4 were negatively associated with birthweight, respectively. Furthermore, higher TT3 and FT3 were associated with increased risks of LGA infants (OR = 1.48, 95% CI: 1.15–1.9; OR = 1.22, 95% CI: 1.01–1.46), respectively. Higher TT3 was associated with an increased risk of macrosomic infants (OR = 1.35, 95% CI: 1.04–1.74). In contrast, higher FT4 was associated with decreased risks of LGA (OR = 0.87, 95% CI: 0.81–0.93) and macrosomic infants (OR = 0.90, 95% CI: 0.84–0.96), respectively. No associations were found between TSH and any of the outcomes. Conclusions TT3 and FT3 were positively associated with fetal growth, while TT4 and FT4 were negatively associated with fetal growth. Our findings suggested that thyroid function in early second trimester of gestation is a potential risk factor for abnormal fetal growth.

Simulation and prediction of Shanghai urban spatial change based on random forest and CA-Markov model

Abstract. In the context of rapid urbanization, accurate assessment of urban expansion has become increasingly important for urban sustainable development, and smart growth theory has been put forward to avoid urban sprawl. Previous studies about urban expansion simulation focused only on ecological constrain which prevent urban growth from developing in specific regions. However, government decision-making and urban planning greatly influence urban development and limit the disorderly expansion of the urban. In this paper, we consider planning policies into urban simulation and uses the ecological protection red line, farmland protection red line and cultural protection control line as limiting factors for future urban simulation. Choosing Shanghai as the study area, we integrated Random Forests Algorithm (RFA), Markov chain and Cellular Automata (CA) to simulate urban expansion in 2015, and further predict the urban expansion in 2020, 2025 and 2030. The results show that the overall accuracy of urban land use simulation in 2015 is 93.86%, and the kappa coefficient is 0.8577. The model has a good simulation effect. Furthermore, the predicted results in 2020, 2025 and 2030 show that the urban land area in Shanghai is still increasing, and the spatial distribution of urban land has obvious circle structure and regional differences. The urban areas within 10km from the city center are growing slowly, and the region within 30km from the city center is growing faster, and there are more new urban points from 2025 to 2030. But in the area 30km away from the city center, different administrative areas show different urban growth phenomena. Among them, there are a large number of new urban points in the junction area between Songjiang District and Jinshan District, which may be the focus of future urban development planning in Shanghai. The proposed model and the results can help planners study the evolution of urban patterns and develop further urban planning.

Prevalence of tobacco related chronic diseases and its role in smoking cessation among smokers in a rural area of Shanghai, China: a cross sectional study

BackgroundTobacco smoking is a recognized risk factor for many chronic diseases and previous study evidences have indicated that smokers receive smoking cessation service after the diagnosis of chronic diseases increases successful rate in quitting. But the prevalence of tobacco related chronic diseases (TCD) among smokers, as well as the role of TCD diagnosis in smoking cessation is still unclear in China.MethodsFrom June 2016 to December 2017, we sampled 36, 698 residents aged over 18 years by a three stage sampling in Songjiang district, Shanghai. We conducted a cross-sectional study to understand the prevalence of TCD among smokers, and the role of TCD diagnosis in smoking cessation among ex-smokers as well as the smoking cessation attempt among current smokers.ResultsOver all, the prevalence of current smoking is 19.78% (48.36% for male and 0.22% for female). 15.93% of smokers have stopped smoking successfully (1, 376/8, 636). The prevalence of ten selected TCDs among smokers range from 0.63% (Chronic Obstructive Pulmonary Disease, COPD) to 36.31% (hypertension). All of 1, 376 ex-smokers had at least one kind of TCD, and 52.33% of them stop smoking after the diagnosis of TCD, the time interval between TCD diagnosis and smoking cessation ranges from 0 to 65 years, with a median of 9 years. Smokers with TCD had higher prevalence of quit smoking, and current smokers with TCD had higher smoking cessation attempt proportion.ConclusionsThe prevalence of current smoking is still very high among male residents in rural area of Shanghai, and the occurrence of TCD even non-lethal one could provide an opportunity for doctors to assist the smoking cessation among smokers.

Body weight and gestational outcomes in women with high normotension during pregnancy

To investigate the pre-pregnancy body mass index(BMI), gestational weight gain(GWG)and gestational outcomes in women with high normotension during pregnancy. The clinical data of 1500 pregnant women who recieved antenatal care and delivered in Songjiang District Maternal and Child Hospital, Shanghai from 2015 to 2017 were retrospectively analyzed. The women were divided into high normotension group, normotension group and hypertensive disorder of pregnancy (HDP) group with 500 cases in each group. The general information, pre-pregnancy body mass index, gestational weight gain and gestational outcomes were analyzed. There were significant differences in pre-pregnancy BMI and GWG between the high normotension group and the normotension group (all P<0.017), and there was significant difference in pre-pregnancy BMI between the high normotension group and HDP group (P<0.017). In terms of adverse pregnancy outcomes, the incidence of oligohydramnios, placental abruption, postpartum hemorrhage, fetal distress and small for gestational age infant were higher in the high normotension group than those in the normotension group, but the differences were not of statistical significance (all P>0.017); the incidence of oligohydramnios, placental abruption, cesarean section, postpartum hemorrhage, premature delivery and small for gestational age infant in HDP group were higher than those in high normotension group (all P<0.01). In high normotension women with adverse gestational outcomes, the proportion of low GWG or too much GWG was higher and the proportion of normal GWG was lower than those in high normotension women without adverse gestational outcomes (all P<0.01). Pre-pregnancy BMI and GWG are correlated with pregnancy blood pressure and gestational outcomes. Reasonable intervention to gestational weight gain of pregnant women with high normotension is of significance to improve the gestational outcomes.