2015年 · 第95卷第03期

The prevention of birth defects is a worldwide problem. To achieve the goal of completely overcoming birth defects, we need to do a good job persistently. Pre-pregnancy eugenic health examination is one of the key measures for the primary prevention of birth defects, and it is the first line of defense to prevent and control birth defects. Pre-pregnancy eugenics health examination is carried out before pregnancy. It mainly screens whether there are risk factors affecting eugenics in pregnant couples from environmental and genetic factors, and provides guidance and intervention, including extensive and sustained social publicity and health education activities, popularizing eugenics scientific knowledge, checking and evaluating the health status of target populations, and conducting eugenics consultation, treatment referral and follow-up for key populations, which greatly helps to reduce the risk of birth defects and the occurrence of common and major birth defects and disabilities.

Preventing birth defects and improving the quality of birth population are one of the important issues that our government has been paying attention to. In 2006, the State Council of the People's Republic of China promulgated the National Medium-and Long-Term Science and Technology Development Plan (2006 – 2020), which listed birth defect prevention as a priority theme in the key area of population and health^[1]。 Eugenic health examination before pregnancy is the key link to prevent birth defects and an important means of primary prevention of birth defects. It can not only reduce the risk of birth defects, but also reduce the risk of adverse pregnancy outcomes and improve the quality of the birth population. According to the data released by the Ministry of Health of the People's Republic of China (now National Health and Family Planning Commission) in 2012, the incidence of birth defects in China is 5.6%, and the number of new birth defects is about 900,000 every year. Birth defects have become a prominent public health and social problem in China^[2]。 Birth defects not only affect children's life health and quality of life, but also affect the quality of the entire national population. Carrying out free pre-pregnancy eugenics health examination can reduce the exposure of risk factors of birth defects from the source, minimize the risk of birth defects, improve the quality of birth population, change China's population pressure into human resource advantages, and create a good population environment for the coordinated and sustainable development of economy and society.

Since oral folic acid before pregnancy can prevent neural tube malformation, cardiovascular malformation and other diseases, the concept of pre-pregnancy examination and pre-pregnancy health care has gradually formed^[1]。 In 2006, the U.S. Centers for Disease Control and Prevention (CDC) proposed the concept of pre-pregnancy care: before pregnancy, use prevention and intervention methods such as changing the biomedical, behavioral habits and social environment of expectant couples to change the pregnancy outcome^[2]。 Therefore, it is further proposed to use the "knowledge, attitudes and behaviors (KAB) model" to improve the health care status of couples of childbearing age before pregnancy. Specifically, all pre-pregnant couples are screened for relevant risk factors, health promotion and possible interventions. However, there is no systematic and actionable intervention strategy and method for all couples of childbearing age.

With the development of medicine, laboratory medicine has changed from simple prompting in the past to multi-faceted evaluation at present, which makes it no longer just post-facto and passive in the past, but an important discipline with forward-looking, foreseeable and active. The test results are an important objective indicator for clinical medical staff to diagnose diseases, formulate treatment plans, evaluate curative effects and evaluate prognosis. It is an important basis for patients to understand the disease condition and diagnosis and treatment results, and for healthy people to understand all aspects of their own functions and metabolic status. It is also an important indicator for evaluating physical health status in special physiological stages such as pregnancy, pregnancy and postpregnancy. The accuracy and stability of clinical test results are the premise for the application of test results, but the accuracy of test results is affected by many factors, which is closely related to the professional level of inspectors, standard operation, instruments and reagents and other testing systems. Therefore, it is very necessary to establish the quality assurance system of the national free pre-pregnancy eugenics health examination program. Now, the methods and results of establishing the national free pre-pregnancy eugenics health examination program quality assurance system are introduced as follows.

computer assisted navigation system (computer assisted navigation system) uses X-ray, CT, MRI and other image information to combine spatial stereoscopic positioning system, computer image processing and visualization technology with clinical surgery to display human anatomical structure, dynamically track the relative positional relationship between surgical instruments and anatomical structure during surgery, so as to realize frameless stereoscopic positioning, avoid important anatomical structures and ensure the safety of surgery. According to the different establishment of navigation images, the current navigation systems used in spinal surgery mainly include four types: preoperative CT imaging navigation, intraoperative X-ray two-dimensional imaging navigation, intraoperative three-dimensional C-arm (ISO-C 3D) imaging navigation and intraoperative O-arm imaging navigation.

stiff person syndrome (SPS) is a rare disease, which is typically characterized by axial and lower extremity muscle tissue rigidity, muscle spasm and pain. Moersch and Woltman^[1]It was first reported as "stiff person syndrome" in 1956. The discovery of anti-glutamate decarboxylase antibodies (anti-GADAb) indicates that SPS is an autoimmune disease^[2]。 1976 Whiteley et al.^[3]Two cases of encephalomyelitis with rigidity and myoclonus (PERM) were reported, associated with stiff person syndrome (SPS) and subacute myoclonus spinal neuronitis. They were classified as stiff person superposition syndrome and later confirmed as progressive encephalomyelitis with rigidity and myoclonus (PERM). PERM is a serious life-threatening autoimmune disease characterized by rigidity, muscle pain and spasm, deep and superficial sensory impairment and brainstem and spinal cord symptoms, autonomic function, dyspnea, sudden spontaneity, and stimulation-induced myoclonus. However, SPS and PERM are closely related, and over the years SPS may develop into PERM with occult development of new symptoms and signs such as chorioretinopathy, weakness, positive Pap sign, or sensory impairment^[4]。 This paper summarizes the development status and research progress of PERM, aiming at strengthening the understanding of PERM and providing reference for better diagnosis and treatment.

The receiver operating characteristic (ROC) curve is a curve drawn according to a series of different binary classifications, with sensitivity (true positive rate) as the ordinate and 1 – specificity (false positive rate) as the abscissa. ROC curve analysis is a commonly used statistical analysis method, which is mainly used in medical research to evaluate the efficacy of diagnostic tests^[1]。 With the deepening of ROC curve analysis in medical diagnosis, this method has been widely paid attention to and used by medical imaging researchers^[2]。 A large number of studies and practices have shown that ROC curve analysis is the most effective method to evaluate whether there are differences in the performance of two or more medical imaging diagnostic systems^[3]。 Therefore, this paper summarizes and summarizes ROC curve analysis from its development history, necessity, classification, main evaluation indicators and clinical application, and gives the commonly used ROC curve analysis tools and the advantages and disadvantages of each tool, in order to provide convenient and comprehensive resources for researchers who need to use ROC curve analysis in the future.