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Objective: To explore the association between the frequency of prenatal care in childbearing aged women and risk of small for gestational age (SGA) among neonatal twins in Shaanxi Province. Methods: From July to December 2013, a total of 30 027 childbearing aged women, who were pregnant from January 2010 to November 2013 and had definite outcomes, were selected from 30 districts (counties) of Shaanxi Province by using the multi-stage random sampling method. The questionnaires with a face-to-face survey method were used to retrospectively collect demographic information, pregnancy history, lifestyle during pregnancy, disease history, nutritional supplements, and health care during pregnancy. Information on the gestational age and birth weight of the newborn were obtained by consulting the medical certificate of birth and were registered as twin A and twin B by birth order. Finally, 356 childbearing aged women and their twin babies with complete data were included in the analysis. A generalized estimation equation model was used to analyze the association between the frequency of prenatal care and the risk of SGA among neonatal twins. Results: The age of childbearing aged women was (27.44±4.68) years old, of which 79.49% (283 women) were rural residents and 44.38% (158 women) had seven or more times prenatal care. The gestational age and birth weight were (37.64±2.51) weeks and (2 510±497) g, respectively. The prevalence of SGA was 51.40% (183/356) for twin A and 53.37% (190/356) for twin B, respectively. The prevalence of SGA was 44.30% (70/158) for twin A with seven or more times prenatal care and 42.41% (67/158) for twin B with seven or more times prenatal care, which was lower than that for twins with less than seven times prenatal care, respectively [57.07% (113/198) and 62.12% (123/198)] (P values were 0.017 and <0.001). The results of generalized estimation equation model suggested that compared to those with less than seven times prenatal care, after adjusting for parity, birth order, place of residence, maternal age, occupation, education, family wealth index, passive smoking, pregnancy-induced hypertension syndrome, folic acid, and iron supplement during perinatal period, and gender of the newborn, the OR (95%CI) of risk of SGA among childbearing aged women with seven or more times prenatal care was 0.60 (0.40-0.91). Conclusion: Seven or more times prenatal care could reduce the risk of SGA among neonatal twins in Shanxi Province.

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Objective: To explore the relationship between plasma amyloid-ß (Aß) and cognitive decline during 2 year follow-up in a population-based cohort in Xi'an rural areas. Methods: The study was conducted in Qubao village in Xi'an suburbs cognitively normal residents over 40 years old were recruited from October 2014 to March 2015 and given a face-to-face standardized interview. Mini-mental state examination (MMSE) was employed to evaluate the global cognitive function, and quantification of plasma Aß was measured by sandwich enzyme-linked immunosorbent assay (ELISA) at baseline. Two years later, MMSE was tested at the end of study. Then logistic regression was performed to analyze the relationship between baseline Aß and cognitive change during 2 year follow-up. Results: A total of 1 020 participants completed the study, among whom 223 subjects (21.9%) presented MMSE scores decline (defined as MMSE scores decreased ≥2 points). Compared with those without decline, participants in the MMSE decline group were older (P<0.001) and had lower education level (P<0.001), while gender, hypertension, hyperlipemia, diabetes mellitus and APOE genotype were not significantly different between two groups. One-way analysis of variance (ANOVA) showed that the MMSE score decline was slighter in the lower tertile of baseline Aß(1)-40 compared with middle tertile (P=0.012), while MMSE decline were similar between different Aß(1)-42 level groups and Aß(1-42)/Aß(1-40) ratio groups (P=0.758, P=0.671, respectively). Multivariable logistic regression analysis showed that MMSE scores in the lower baseline plasma Aß(1-40) level declined more slowly (OR=0.565, 95%CI 0.379-0.845, P=0.005). However, the MMSE decline were also similar among different baseline plasma Aß(1-42) levels groups and Aß(1-42)/Aß(1-40) ratio groups. Conclusion: Population with lower level of baseline plasma Aß(1-40) manifests lower cognitive decline during 2 years, however further investigation on dynamics of plasma Aß and long term follow up are needed.

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Objective: To investigate the interaction of pregnancy-induced hypertension and history of preterm birth on the risk of small for gestational age. Methods: Stratified multistage random sampling method was used to choose samples from 30 districts and counties of Shaanxi province. Information on childbearing-age women with their children between January 2010 and November 2013 was retrospectively collected through face-to-face questionnaire survey. The childbearing-aged women were in pregnancy or having had definite outcomes of pregnancy. Enumeration data were described by percentage, and measurement data were described by Mean±SD, and χ(2) test was used to compare the rates. Unconditional logistic regression analysis was performed to estimate the interaction between pregnancy-induced hypertension and history of preterm birth on the risk of small for gestational age, and by using small for gestational age as dependent variables, pregnancy-induced hypertension and history of preterm birth as independent variables. Confounding factors were under control. Firstly, the association between pregnancy-induced hypertension and small for gestational age has been analyzed in primiparas, secondly, interaction of pregnancy-induced hypertension and history of preterm birth on the risk of small for gestational age has been analyzed in multiparas. Results: A total of 25 751 women of childbearing age and their children were recruited. 60.55% (15 592/25 751) were primiparas, 39.45% (10 159/25 751) were multiparas, the rate of history of preterm birth was 1.89% (192/10 159) for multiparas. The incidence rates of pregnancy-induced hypertension and small for gestational age were 1.55% and 15.49% in pregnant woman (400/25 751) and their newborns (3 990/25 751). Unconditioned logistic regression analysis showed that compared with woman without pregnancy-induced hypertension, primiparas with pregnancy-induced hypertension had increased risk of small for gestational age (OR=1.43, 95%CI: 1.02-2.00, P=0.041). Regarding multiparas, the main effect of pregnancy-induced hypertension had a positive correlation with small for gestational age (OR=1.34, 95%CI: 0.91-1.96), but there was no statistical significance (P=0.138). The main effect of history of preterm birth was positively correlated with small for gestational age (OR=1.61, 95%CI: 1.13-2.31, P=0.009). The interaction term "pregnancy-induced hypertension×history of preterm birth" was positively associated with risk of small for gestational age (OR=5.93, 95%CI: 1.19-29.61, P=0.030). Conclusions: Pregnancy-induced hypertension was associated with increased risk for small for gestational age in both primiparas and multiparas, and history of preterm birth further increased risk for small for gestational age in pregnant women with pregnancy-induced hypertension, indicating that there was multiplication interaction between pregnancy-induced hypertension and history of preterm birth.

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INTRODUCTION: Teacher-centred education dominates dental education in China. Student-centred education has recently been introduced in the School of Stomatology, Wuhan University, and the effectiveness of such methods needs to be tested. The purpose of this study is to compare the learning outcomes of case-based learning (CBL) and lecture-based education (LBE) in an oral medicine curriculum. MATERIALS AND METHODS: We chose oral leukoplakia as the learning subject for dental students. Forty fourth-year dental students participated in the study. First, they were presented to basic knowledge of oral leukoplakia and related oral mucosal diseases. Then, they were divided into a CBL group (n=20) and an LBE group (n=20) by random numbers. The groups experienced the remaining course in separate groups. All students answered a questionnaire on their satisfaction with the education and the same standardised written test to analyse their learning outcomes. RESULTS: Both CBL and LBE courses were well accepted by students according to the satisfactory scores of the questionnaire. The test scores of the CBL group (90.00±6.69) were significantly higher (P<0.01) than those of the LBE group (83.00±6.77). The percentage of high test score (test score≥85) of the CBL group (85%) was also significantly higher (P<0.01) than that of the LBE group (45%). CONCLUSIONS: In this example, CBL was found to be more effective than LBE to teach dental students. These findings suggest that CBL should be added in our future oral medicine curriculum for dental students.

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Tobacco (Nicotiana tabacum L.) is a leafy, annual, solanaceous plant grown commercially for its leaves. China accounts for more than 39.6% of total global tobacco production (3). In May 2012, seedlings of tobacco cv. Honghuadajinyuan in a Guiyang tobacco commercial field (Guizhou, China, 26.35° N, 106.42° E) developed symptoms of severe wilting, chlorosis, and stunting. The main stem and taproot exhibited reddish to light brown vascular discoloration; further progression of these symptoms eventually caused mortality of infected seedlings. To isolate the causal agent, necrotic tissues from the symptomatic root were placed on potato dextrose agar (PDA) and incubated at 25°C in darkness. Colonies with white to rose mycelia and red-brown colony colors developed on PDA after 5 days of incubation. Microconidia were abundant, straight or slightly curved, clavate, 0- to 3-septate, and 7.5 to 20.0 × 2.5 to 5.0 µm. Macroconidia were straight or slightly curved, slender, 3- to 5-septate, and 25.0 to 45.0 × 3.3 to 5.0 µm. Based on the observed colony attributes, growth patterns, absence of chlamydospores, micro- and macro-spore attributes (1), and PCR amplification (using primers ITS1/4) combined with translation elongation factor primers (EF1/2) (2), the fungus was identified as F. kyushuense O'Donnell & T. Aoki. Sequence of ITS1-5.8s-ITS2 region of rDNA (GenBank Accession No. JX235957) exactly matched the sequences of F. kyushuense accession AB587020.1 (100% similarity). Analysis of the elongation factor (EF-1alpha) gene of the fungus (JX658565) resulted in a 99% match for F. kyushuense accession AB674297.1. Pathogenicity of the fungus was confirmed by performing Koch's postulate as follows. Pure cultures of the fungus F. kyushuense obtained from symptomatic tissues of tobacco seedlings were grown on PDA for 6 days. Tobacco plants to be used in pathogenicity tests were germinated and grown on potting soils in a plastic container. Additional fertilization was supplied by adding 0.2 g/L of 20-20-20 (N-P-K) in the float water. When seedlings got 6-leaf stage, they were ready for pathogenicity tests. Spores harvested from these culture plates were suspended in sterile distilled water, adjusted to a concentration of 1 × 104 conidia/ml, and inoculated by irrigating 10 ml of the conidia suspension onto roots of each of the 12 tobacco seedlings with 6-leaf stage. A group of 12 seedlings of the same age treated with sterile water served as control. Inoculated seedlings were maintained at 25°C, 100 µE m-2.s-1, relative humidity >70%, and 16 h light per day, and monitored for 9 days for symptom development. Seedlings inoculated with conidia developed disease symptoms with roots with vascular discoloration of roots whereas control seedlings remained symptomless. F. kyushuense was reisolated from the symptomatic seedlings 9 days after inoculation. F. kyushuense has also been isolated from rice seeds in China (4), and from diseased wheat in Japan (1). The common tobacco Fusarium disease reported in China was caused by F. oxysporium f. sp. nicotianae. However, to the best of our knowledge, this is the first report of F. kyushuense causing wilt on tobacco in China and the disease must be considered in existing disease management practices. References: (1) T. Aoki and K. O'Donnell. Mycoscience. 39:1, 1998. (2) D. M. Geiser et al. Eur. J. Plant Pathol. 110:473, 2004. (3) US Census Bureau. Foreign Trade Statistics. Washington DC, 2005. (4) Z. H. Zhao and G. Z. Lu. Mycotaxon. 102:119, 2007.