Xiaojun Tang

To assess the association between type 2 diabetes and rs10811661 polymorphism, upstream of CDKN2A/B, a literature-based search was conducted to collect data. The pooled OR (odds ratio) and 95 % confidence intervals (CI) were used to assess the strength of association between rs10811661 polymorphism and type 2 diabetes. OR with 95 % CI were performed for allele contrasts, additive genetic model, dominant genetic model and recessive genetic model, respectively. The effect model was used if there was heterogeneity between studies. Funnel plots were used to predict publication bias. 17 studies with 29,990 cases and 40,977 controls were enrolled in this meta-analysis. Significant association was found in all of the four genetic models: allele contrast (OR = 1.21, 95 % CI 1.18–1.24), additive genetic model (OR = 1.51, 95 % CI 1.40–1.63), dominant genetic model (OR = 1.37, 95 % CI 1.28–1.47) and recessive genetic model (OR = 1.25, 95 % CI 1.21–1.29). The meta-analysis indicated that rs10811661 polymorphism was significantly associated with the risk of type 2 diabetes.

Background: In China, the New Co-operative Medical System (NCMS), a rural health insurance system, has expanded nationwide since 2003. This study aims to describe prenatal care use, content and costs of care in one county where prenatal care is included in the NCMS and two counties where it is not. It also explores the perceptions of stakeholders of the prenatal care benefit package in order to understand the strengths and weaknesses of the approach in the context of rural China and to draw lessons from early implementation. Methods: This study is based on the data from a cross-sectional survey and a qualitative investigation conducted in 2009. A survey recruited women giving birth in 2008, including 544 women in RC County (which covered prenatal care) and 619, and 1071 in other two counties (which did not). The qualitative investigation in RC included focus group discussions with women giving birth before or after 2007, individual interviews with local policy makers and health managers, NCMS managers and obstetric doctors in township hospitals. Results: There were no significant differences in prenatal care use between RC County (which covered prenatal care) and other two counties (which did not): over 70% of women started prenatal visits early and over 60% had five or more visits. In the three counties: a small proportion of women received the number of haemoglobin and urine tests recommended by the national guideline; 90% of women received more ultrasound tests than recommended; and the out-of-pocket expenditure for prenatal care consumed a high proportion of women's annual income in the low income group. In RC: only 20% of NCMS members claimed the reimbursement; the qualitative study found that the reimbursement for prenatal care was not well understood by women and had little influence on women's decisions to make prenatal visits; and several women indicated that doctors suggested them taking more expensive tests. Conclusions: Whether or not prenatal care was included in the NCMS, prenatal care use was high, but the contents of care were not provided following the national guideline and more expensive tests were recommended by doctors. Costs were substantial for the poor.