The elderly population in our country is large and growing rapidly, and depression is a common emotional disorder and mental health problem among the elderly population. The mental health of the female elderly population is increasingly becoming a focus of social concern.

To explore the influencing factors of depression symptoms in the female elderly population from a multi-level and comprehensive perspective of health ecology, and provide theoretical basis for identifying and intervening in depression symptoms in the elderly female population in China.

In January 2024, we extracted for the 2020 survey data from the China Health and Retirement Longitudinal Survey (CHARLS), and a group of female elderly adults aged 60 years and above were selected for the study (n=4 594). Based on the health ecology model, the influencing factors were divided into five levels: personal characteristics layer, behavioural characteristics layer, interpersonal network layer, living and working conditions layer, and policy environment layer. The χ² test and binary Logistic regression model were used to explore the influencing factors of depression symptoms and to establish a health ecology model of depression symptoms in the Chinese female elderly population.

The detection rate of depression symptoms in the Chinese female elderly population was 48.06% (2 208/4 595). Logistic regression analysis showed that age of ≥80 years (OR=0.601, 95%CI=0.449-0.804), sleep duration of≥6 h (OR=0.561, 95%CI=0.493-0.639), satisfaction with life (OR=0.256, 95%CI=0.199-0.330), better self-rated physical health (OR=0.459, 95%CI=0.395-0.533), urban household registration (OR=0.717, 95%CI=0.603-0.853), satisfaction with children (OR=0.666, 95%CI=0.472-0.940), education level of junior high school and above (OR=0.712, 95%CI=0.582-0.871), family income >50 000 yuan (OR=0.822, 95%CI=0.704-0.959) and the per capita GDP of the city is 50 000 to 100 000 yuan (OR=0.841, 95%CI=0.730-0.970) were the protective factors for the development of depression symptoms in the Chinese female elderly population (P<0.05). Having become disabled (OR=1.786, 95%CI=1.556-2.050), suffering from chronic diseases (OR=1.159, 95%CI=1.014-1.324), central region (OR=1.298, 95%CI=1.107-1.522) and western region (OR=1.407, 95%CI=1.183-1.675) were the risk factors for depression symptoms in the Chinese female elderly population (P<0.05) .

The detection rate of depression symptoms in the Chinese female elderly population is relatively high, and there are many influencing factors, including: age in the personal characteristics layer; sleep time, satisfaction with life, self-related of physical health, disability, and chronic disease in the behavioral characteristics layer; household registration type, satisfaction with children, and geographical distribution in the interpersonal network layer; education and family income in the living and working conditions layer; the per capita GDP of the city in the policy environment layer. Effective intervention measures should be taken at all layers, targeting key populations, in order to reduce the incidence of depression symptoms among the Chinese elderly women.

The majority of caregivers of left-behind children in rural China are their mothers and grandmothers. The mental health of children's caregivers is one of the significant factors affecting the early development of children. Currently, there is a lack of research and comparison on the factors influencing depression among mothers and grandmothers of left-behind children in rural China.

To investigate the determinants of depression among female caregivers of left-behind children in rural China.

Data were collected from the baseline survey of the Home Visit Intervention Evaluation Segment of the Health and Development Promotion Program for Left-behind Children, conducted by UNICEF from April to July in 2018. The villages were selected through multi-stage stratified sampling. 1 or 2 towns were chosen as program towns in each of the 5 impoverished counties in 5 provinces. Villages in program towns were stratified by number of under-3-year-old children except Pingshan, where all villages from the program town were included. Three villages were randomly selected in each stratum as intervention villages, matched with control villages of similar number of under-3-year-old children, socioeconomic status and the distance from county. Ultimately 113 villages in 27 towns were included in the survey. This study focused on the mothers and grandmothers of left-behind children under 3. Questionnaire was used to collect the data of left-behind children under 3 years old and their main caregivers participating in the survey, and Zung Self-rating Depression Scale (ZSDS) was used to assess the depression status of caregivers. Multivariate Logistic regression was used to analyze the determinants of depression in the main caregivers of left-behind children.

A total of 728 subjects were included in this study, including 282 mothers and 446 grandmothers. The overall incidence of depressive symptoms was 32.8% (239/728) . The prevalence of depression among mothers and grandmothers of left-behind children was 29.8% (84/282) and 34.8% (115/446) respectively, with no statistical significance between two groups (P>0.05) . Multivariate Logistic analysis revealed that for mothers, caring for 1-year-old children (OR=2.041, 95%CI=1.065-3.913) , 2-3-year-old children (OR=2.128, 95%CI=1.023-4.425) , and experiencing caregiving stress (OR=4.043, 95%CI=2.152-7.594) were risk factors for depression (P<0.05) . A mean communication time ≥10 minutes per time with absent fathers (OR=0.396, 95%CI=0.175-0.898) was a protective factor against maternal depression (P<0.05) . For grandmothers, looking after girls rather than boys (OR=0.506, 95%CI=0.331-0.772) was a protective factor for depression (P<0.05) . Conversely, being 60 years or older (OR=1.879, 95%CI=1.082-3.261) , self-rated health status affecting caregiving (OR=2.402, 95%CI=1.364-4.231) and children's mothers cumulative longer absence from home (OR=2.468, 95%CI=1.059-5.751) were the risk factors for depression (P<0.05) .

The incidence of depression among female caregivers of left-behind children in rural China is high. Mothers and grandmothers, as the primary caregivers of most left-behind children, experience different factors affecting depression. Older children, high caregiving stress are risk factors for maternal depression, whereas greater communication with the children's fathers is protective factor for maternal depression. Grandmothers face a higher risk of depression when advanced age, self-report health status affacts caregiving, and children's mothers are absent from home for extended period, while caring for a granddaughter is a protective factor against grandmother's depression.

China's aging population is expanding rapidly, highlighting the imperative of successful aging as a critical health management goal. Effective menopause management plays a crucial role.

To construct a comprehensive health management evaluation indicator system for menopausal women based on the modified Delphi method.

Between September 2023 and February 2024, a preliminary construction of the comprehensive health management evaluation indicator system for menopausal women was executed via literature review and group discussion. 25 experts in the realms of climacteric health and related fields were selected as conference participants and correspondence subjects. Two rounds of electronic questionnaires using modified Delphi method were conducted, and the survey results were statistically analyzed using SPSS 24.0 software.

The positive coefficients of the two rounds of expert correspondence were 100%, with the authoritative degree of expert opinions were 0.932 and 0.949, respectively. In the initial round, the primary and secondary indicators were assigned mean importance scores ranging from 4.44 to 4.84 and 4.00 to 4.88, respectively, alongside Kendall's W coefficients of concordance at 0.194 (P=0.001) and 0.187 (P<0.001) . The second round yielded mean importance scores for the primary and secondary indicators within the ranges of 4.44 to 4.84 and 3.84 to 4.96, with corresponding Kendall's W coefficients of 0.146 (P=0.006) and 0.326 (P<0.001) , reflecting a notable enhancement in expert agreement for the secondary indicators. The tertiary indicators received mean rationality scores of 4.24 to 4.68 (4.47±0.10) in the first round and 4.08 to 4.72 (4.51±0.15) in the second, with Kendall's W coefficients of 0.063 (P=0.025) and 0.129 (P<0.001) , indicating a trend towards uniformity in expert opinions. The ultimate construction of the comprehensive health management evaluation indicator system for menopausal women encompasses five primary indicators: basic information, lifestyle, symptom assessment, laboratory tests, and key disease screenings. Additionally, it includes 34 secondary indicators such as age, duration since menopause, BMI, and waist circumference, and so on. Each of these secondary indicators is meticulously subdivided and quantified to establish tertiary indicators, thereby providing a granular framework for assessment.

The indicator system, constructed through the modified Delphi method, is endowed with substantial authority and scientific rigor. It offers a holistic assessment of the health status of menopausal women, with a detailed classification and valuation of specific indicators. This systematic approach is conducive to comprehensive and stratified patient management by clinical practitioners, providing a valuable framework for clinical guidance and reference. Nonetheless, the efficacy of its practical application merits ongoing validation through empirical research.

Cardiac emergencies occur rapidly and pose a serious threat to the health and lives of patients. Female cardiac emergencies have been under-researched, under-diagnosed and under-treated due to gender bias and atypical symptoms for a long time. There are clear gender differences in the pathophysiological mechanisms, risk factors, management and outcomes of female cardiac emergencies. In China, the prevalence of female cardiac emergencies is notably high, and research on it has commenced relatively late. There is no authoritative guideline for female cardiac emergencies, so it is urgent to enhance the management strategies for these conditions. To standardize the management of cardiac emergencies in women and enhance health outcomes, clinicians from general medicine, cardiology and emergency medicine were convened to interpret the clinical statement titled Management of Female Cardiac Emergencies published in 2024 by the Association for Acute Cardiovascular Care and other organizations.

The rate of participation in standard pregnancy health care in China is gradually increasing, highlighting the imbalance and insufficiency in women's and children's health development between urban and rural areas. The potential of rural women's self-management as the cornerstone of pregnancy health care has not been fully utilized.

To examine the current status of standard pregnancy health care among rural women, assess their level of self-management behavior, and identify the factors influencing their self-management behavior in pregnancy health care.

The research was conducted from January to August 2023, involving rural women in Suihua City and Daqing City in Heilongjiang Province, as well as Changchun City in Jilin Province, all selected through convenience sampling. Various tools such as the Basic Information Questionnaire, Maternal Self-Management Scale, A5-item Short Form of the Edinburgh Postnatal Depression Scale (EPDS-Dep-5), and Maternal Social Support Scale (MSSS) were employed to gather data. Data in relation to the present condition of standard pregnancy health care among rural women were counted. The self-management behavior scores of different characteristics of rural women in pregnancy health care were compared. Multiple linear regression was used to assess the factors that impact rural women's self-management behavior in pregnancy health care.

A total of 493 questionnaires were distributed, and 470 valid questionnaires were collected, with a valid questionnaire collection rate of 95.33%. The findings revealed that 218 rural women (46.4%) underwent pre-pregnancy checkups, with 388 (82.6%) having their first checkups within 12 weeks. There were 303 cases (64.5%) where obstetric examinations took place in medical and health institutions at the county level or higher. Of 276 cases (58.7%), the number of obstetric examinations satisfied the requirements for the respective pregnancy week. However, only 103 cases (21.9%) adhered to the required number of obstetric examination items for the pregnancy week. The average score for self-management of health care during pregnancy was (70.18±16.42). The scoring indicators for each dimension, in descending order, were medical compliance behavior (79.75%), routine life behavior management (77.33%), self-protection behavior (76.73%), and fetal monitoring behavior management (70.43%). The findings from the multiple linear regression analysis indicated that the distance of family residence from the closest antenatal care facility (B=0.732, 95%CI=0.139-1.325), gestational week (B=-1.336, 95%CI=-2.119 to -0.553), pregnancy complications (B=3.776, 95%CI=1.532-6.019), risk of depression during pregnancy (B=-0.356, 95%CI=-0.663 to -0.049), and social support status (B=2.635, 95%CI=2.508-2.762) were identified as significant factors influencing the self-management behaviors of pregnancy health care among rural women (P<0.05) .

Rural women exhibited low rates of participation and eligibility for standardized pregnancy health care, along with moderate scores for self-management behaviors related to pregnancy health care. The distance of family residence from the nearest antenatal care facility, gestational week, pregnancy comorbidities, risk of depression during pregnancy, and social support were found to be the factors influencing the self-management behaviors of pregnancy health care among rural women. It is recommended that health care providers at all levels focus on rural women during pregnancy, standardize their pregnancy health care behaviors, enhance their self-management skills, and establish a scientifically sound, cost-effective, simple, and easily operable self-management intervention model for pregnancy health care among rural women.

The association between female reproductive factors and cognitive function was unclear, there still lack studies on female reproductive factors and subjective cognitive function.

Exploring the relationship between female reproductive factors and subjective or objective cognitive function, and providing theoretical basis for the prevention and intervention of cognitive decline and dementia.

The baseline survey was conducted in July 2023 in Pingyin, Jinan (in three townships). After using a multi-stage cluster random sampling method, 2 165 valid participants aged 45-70 were recruited at baseline. We collected sociodemographic data, medical histories, lifestyle factors, and female reproductive factors through a self-designed comprehensive questionnaire. The subjective and objective cognitive function of participants were evaluated by the Subjective Cognitive Decline-Questionnaire 9 (SCD-Q9) and Montreal Cognitive Assessment Scale-Basic (MoCA-B), respectively. In addition, we also collected anthropometric data (included height and weight) and blood samples (to get APOE e4 alleles). Multivariate Logistic regression and Local weighted regression (Loess) were used to analyze the influence of female reproductive factors on cognitive function and to detect potential nonlinear relationships between age at menarche, age at menopause, length of reproductive period and MoCA-B scores.

This study was based on a baseline population and included 1 044 postmenopausal women. The prevalence of abnormal SCD-Q9 scores was 48.37% (505/1 044), while the prevalence of abnormal MoCA-B scores was 67.43% (704/1 044). Women who had 3 or more children had a lower risk of subjective cognitive decline compared with those who had 1 or fewer children (OR=0.59, 95%CI=0.36-0.98). Women with a breastfeeding duration <6 months had a higher risk of subjective cognitive decline compared with those with a breastfeeding duration of 6-12 months (OR=3.69, 95%CI=1.03-13.16). Age at menarche >18 years (OR=1.91, 95%CI=1.09-3.35), age at menopause ≤45 years (OR=1.61, 95%CI=1.00-2.62), and reproductive period ≤30 years (OR=1.56, 95%CI=1.07-2.29) or >40 years (OR=2.22, 95%CI=1.05-4.72) were all associated with poorer objective cognitive function (P<0.05). Loess analysis revealed an inverted "J-shaped" relationship between age at menarche, age at menopause, reproductive period and MoCA-B scores.

Women with more children (≥3) have a lower risk of subjective cognitive decline and women with shorter breastfeeding duration (<6 months) have a higher risk of subjective cognitive decline. Age at menarche >18 years, early menopause (≤45 years), and excessively long or short reproductive periods are all associated with poorer objective cognitive function. We should pay attention to the influence of female reproductive factors on cognitive function in order to delay the process of cognitive decline.

Postmenopausal women with hypertension are susceptible to coronary heart disease (CHD), and their prevalence and mortality of CHD are significantly higher than those before menopause. Based on the team's previous research, this study further combined with glucose and lipid metabolism, vascular elasticity and other related indicators to diagnose CHD in postmenopausal women with hypertension, in order to provide new ideas for clinical identification of CHD risk in postmenopausal women with hypertension.

To explore the correlation and predictive value of triglyceride glucose (TyG) index, ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), pulse pressure index (PPI) and arteriosclerosis index (AI) in postmenopausal women with hypertension.

From January 2019 to December 2022, this study selected postmenopausal women with hypertension who underwent coronary angiography for the first time in the Department of Integrative Cardiology of China-Japan Friendship Hospital, and divided them into CHD group and non-CHD group according to the results of coronary angiography. The clinical data such as TyG index, ABI, baPWV, PPI, AI were collected at the time of admission. Multivariate Logistic regression analysis was used to construct a CHD risk prediction model for postmenopausal women with hypertension, and a nomogram was drawn. Calibration curve, receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to evaluate the diagnostic efficiency.

In this study, 300 postmenopausal women with hypertension who underwent coronary angiography for the first time were included, including 141 cases in non-CHD group and 159 cases in CHD group. Multivariate Logistic regression analysis showed that ABI, baPWV, TyG index, PPI and AI were the influencing factors of CHD in postmenopausal women with hypertension (P<0.05), and a nomogram was drawn according to which. The ROC curve analysis results showed that area under the curve (AUC) for ABI, baPWV, TyG index, PPI, AI and joint predictive model were 0.662, 0.687, 0.659, 0.700, 0.612 and 0.808, the sensitivity and specificity of the predictive model were 0.780 6 and 0.741 0, respectively. The calibration curve showed that the predicted results were in good agreement with the actual results. The decision curve analysis showed that the nomogram has good clinical value.

ABI, baPWV, TyG index, PPI and AI are independent influencing factors for the occurrence of CHD in postmenopausal women with hypertension. The newly developed model can better predict the risk of CHD.

Stress urinary incontinence (SUI) is one of the common diseases in middle-aged and elderly women, which seriously affects their quality of life and physical and mental health. Internet medicine has the advantages of flexibility, privacy and accessibility, which can be used as an effective approach of self-management intervention for urinary incontinence patients. However, its effectiveness on the clinical treatment of middle-aged and elderly female SUI patients is unclear.

To explore the effects of Internet-based self-management intervention on improving clinical symptoms, self-efficacy, and psychological status in middle-aged and elderly female SUI patients.

A total of 120 middle-aged and elderly female SUI patients treated in the Air Force 986 Hospital of PLA from January to December 2022 were recruited. They were randomly assigned into control group (n=60) and experimental group (n=60) by double-blind random number table method. Patients in both groups were given conventional pelvic floor muscle training (PFMT), with 20 minutes per day, once every other day for a course of 10 times of PFMT, and those in the experimental group were additionally given Internet-based self-management intervention for 6 months. Outpatient re-examination and follow-up visits were conducted before treatment and 3 and 6 months after treatment. Clinical symptoms of SUI in middle-aged and elderly female patients were evaluated by surveying the International Consultation on Incontinence Questionnaire Short Form (ICI-Q-SF) and 1-hour pad test, thus determining the clinical efficacy. The Broome Pelvic Muscle Self-efficacy Scale (BPMSES) was used to evaluate the self-management efficacy. The Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to evaluate the anxiety and depression status, respectively.

The ICI-Q-SF scores of experimental group at 3 months [ (6.58±3.91) points vs. (9.27±3.11) points, P<0.05] and 6 months [ (3.37±2.74) points vs. (7.41±3.55) points, P<0.001] after treatment were significantly lower than those of control group. Urinary loss in 1-hour pad test at 3 months [ (4.83±1.64) g vs. (5.29±2.34) g, P<0.05] and 6 months [ (2.16±0.88) g vs. (3.87±1.66) g, P<0.01] after treatment was significantly less in the experimental group than that of control group. The total clinical effective rate of the control group was significantly lower than that of the experimental group (78.33%, 47/60, vs. 91.67%, 55/60, χ²=6.227, P=0.044). The total scores of BPMSES in the experimental group at 3 months [ (105.70±15.68) points vs. (77.90±17.52) points, P<0.05] and 6 months [ (126.61±16.64) points vs. (108.12±15.74) points, P<0.05] after treatment were significantly higher than those of control group. The expected self-efficacy scores of the experimental group at 3 months [ (69.27±5.91) points vs. (59.08±6.84) points, P<0.05] and 6 months [ (79.71±10.41) points vs. (61.17±6.92) points, P<0.001) ] after treatment were significantly higher than those of control group. The expected efficacy scores at 3 months [ (58.17±8.69) points vs. (50.26±9.04) points, P<0.05] and 6 months [ (64.93±7.84) points vs. (50.17±8.76) points, P<0.001) after treatment were significantly higher in the experimental group than those of the control group. The SAS scores [3 months (43.29±7.71) points vs. (45.25±7.50) points, P<0.05; 6 months (39.18±8.32) points vs. (42.58±8.39) points, P<0.001] and SDS scores [3 months (46.86±10.62) points vs. (47.17±10.22) points, P<0.05; 6 months (38.68±11.24) points vs. (42.54±10.31) points, P<0.001] at 3 months and 6 months were significantly lower in the experimental group than those of the control group.

Internet-based self-management intervention can significantly improve the self-management efficacy of middle-aged and elderly female SUI patients and alleviate psychological states of depression and anxiety, thus enhancing the clinical efficacy of PFMT on middle-aged and elderly female SUI patients. It provides unique advantages in improving treatment compliance and relieving negative psychological factors in middle-aged and elderly female SUI patients. Serving as a safe, effective and economic friendly intervention, Internet-based self-management intervention is worthy of clinical promotion to middle-aged and elderly female SUI patients.

With the continuous development of society and technological innovations, the average life expectancy of human beings has gradually increased, leading to the gradual increase in the number of perimenopausal women. This trend poses a serious challenge to the management of perimenopausal health in the community.

To understand the health characteristics and health needs of perimenopausal women in the community, explore the relationship between the two, and provide evidence to support the development and improvement of perimenopausal health management in community health service organisations.

Perimenopausal women (n=260) who attended or were accompanied to the Huamu Community Health Service Centre and its subordinate stations in Pudong New Area, Shanghai, from February to March 2023 were selected as study subjects. Questionnaires were used to collect information on the health characteristics of the study subjects (related to physiological stage, social characteristics, disease status, lifestyle, and quality of life), their knowledge of menopause and attitudes toward treatment, as well as their needs for knowledge related to menopause and preventive health care for menopausal diseases.

Fifty percent (130/260) of perimenopausal women had a current history of chronic disease, 51.9% (135/260) of perimenopausal women had a past history of chronic disease, 73.8% (192/260) of perimenopausal women had fair/poor quality of sleep, 33.5% (87/260) of perimenopausal women did little exercise. 58.5% (152/260) of perimenopausal women were completely unaware or had only heard of menopause, 41.9% (109/260) of perimenopausal women had a negative attitude towards menopause treatment, 45.0% (117/126) of perimenopausal women needed menopause-related knowledge, and 66.6% (173/260) of perimenopausal women needed preventive health care for menopausal diseases. The results of ordered multicategorical Logistic regression analyses showed that literacy, the number of menopausal symptoms in the last 3 monthss, and attitudes toward menopause treatment were the factors influencing perimenopausal women's need for menopause-related knowledge (P<0.05), and literacy and attitudes toward menopause treatment were the factors influencing perimenopausal women's need for preventive health care for menopausal diseases (P<0.05) .

This study reveals the influence of health characteristics (e.g., literacy level, symptom severity) on health needs of perimenopausal women. Community health service providers should optimise health management programmes for perimenopausal women based on accurate data and provide comprehensive and personalised health management services for perimenopausal women in the community.

Previous studies have found associations between monocyte count, high-density lipoprotein cholesterol (HDL-C), and thyroid-stimulating hormone (TSH) with acute coronary syndrome (ACS). However, research on the correlation between the monocyte count to high-density lipoprotein cholesterol ratio (MHR) and the onset of ACS is limited. The association between MHR, TSH, and the onset of ACS in postmenopausal women remains unclear.

To explore the predictive value of MHR and TSH for the onset of ACS in postmenopausal women and to investigate the correlation between these indicators and the degree of coronary artery stenosis in patients.

A total of 325 postmenopausal women hospitalized in the Department of Cardiology at Northern Jiangsu People's Hospital, from 2020 to 2021 and who underwent coronary angiography were selected as the study subjects. Patient general information was collected through the electronic medical record system. Venous blood was collected upon admission to measure monocyte count, total cholesterol (TC), triglycerides (TG), HDL-C, low-density lipoprotein cholesterol (LDL-C), and TSH. Left ventricular ejection fraction (LVEF) was measured using the biplane Simpson method, and coronary artery lesions were observed through coronary angiography. The Gensini scoring system was used to uniformly measure the extent of coronary artery lesions. Patients meeting the diagnostic criteria for ACS were classified as the ACS group (n=184), and non-ACS patients as the control group (n=141). The ACS group was further divided into subgroups based on the tertiles of the Gensini score: ≤36.5 as the low-risk subgroup (n=59), 36.6-66.5 as the moderate-risk subgroup (n=64), and >66.5 as the high-risk subgroup (n=61). Univariate and multivariate Logistic regression analyses were used to explore the influencing factors of ACS. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of TSH, MHR, and combined detection for ACS and to calculate the area under the curve (AUC). Spearman's rank correlation analysis was used to explore the correlation between TSH, MHR, and combined detection indicators with the Gensini score.

The baseline data of patients in the ACS and control groups showed that BMI, smoking rate, hypertension, diabetes, LDL-C, monocytes, TSH, and MHR in the ACS group were higher than in the control group, while LVEF and HDL-C were lower (P<0.05). Multivariate Logistic regression analysis showed that smoking, hypertension, BMI≥24.0 kg/m², LDL-C≥3.30 mmol/L, TSH≥2.1 mU/L, and MHR≥0.25 were risk factors for the occurrence of ACS in postmenopausal elderly women, and HDL-C≥1.2 mmol/L was a protective factor (P<0.05). The ROC curve analysis demonstrated that the AUC for MHR, TSH, and the combined predictive index in diagnosing ACS in postmenopausal women were 0.777 (95%CI=0.725-0.830, P<0.001), 0.747 (95%CI=0.694-0.800, P<0.001), and 0.810 (95%CI=0.764-0.857, P<0.001), respectively. In the moderate and high-risk subgroups, MHR and TSH were higher than in the low-risk subgroup, and the high-risk subgroup had higher MHR and TSH than the moderate-risk subgroup (P<0.05). Spearman's rank correlation analysis showed that in the ACS group, MHR (r_s=0.497, P<0.01), TSH (r_s=0.498, P<0.01), and the combined predictive indicators were positively correlated with the Gensini score (r_s=0.600, P<0.001) .

Elevated TSH and MHR are independent risk factors for the occurrence of ACS in postmenopausal women. Both indicators and their combination have certain sensitivity and specificity for disease prediction and are correlated with the extent of coronary artery lesions in patients, which has certain clinical application value for the early identification and risk assessment of ACS in postmenopausal women.

Urinary incontinence often occurs in women aged 40-60 years and contributes to a significant impact on women's physical health and quality of life.

To explore the prevalence and influencing factors of urinary incontinence and its impact on quality of life in women aged 40-60 years in Guizhou Province.

From June 2022 to January 2023, women aged 40-60 years who underwent health checkups in 10 hospitals in 7 regions of Guizhou Province were selected as the study subjects. A self-designed general data questionnaire was used to collect the basic data of the study subjects, and International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and Incontinence Quality of Life Measure (I-QoL) were used to determine the severity of urinary incontinence and the level of quality of life of the study subjects, respectively. Different types of incontinence, including stress incontinence, urge incontinence, and mixed incontinence, were determined according to the diagnostic criteria established by the International Continence Society (ICS). Multivariate Logistic regression analysis was used to explore the influencing factors of urinary incontinence, and explore the effects of different types and severity levels of urinary incontinence on patients' quality of life.

A total of 3 000 questionnaires were distributed, and 2 966 valid questionnaires were collected, with a valid recovery rate of 98.9%. The prevalence of urinary incontinence among the 2 966 study subjects was 33.4% (991/2 966), including 20.1% (596/2 966) for stress incontinence, 2.0% (58/2 966) for urge incontinence, and 11.4% (337/2 966) for mixed incontinence. Multivariate Logistic regression analysis showed that physical exercise, menstrual status, parity, history of pelvic organ prolapse, perineal laceration, and lateral episiotomy were the influencing factors of stress incontinence (P<0.05) ; history of pelvic surgery, number of miscarriages, and neonatal weight were the influencing factors of urge incontinence (P<0.05), waist circumference, history of chronic pelvic pain, pelvic organ prolapse, perineal laceration were factors associated with mixed incontinence (P<0.05). The total score of I-QoL, scores of behavioral limitations, psychological impact, and social activities impairment were lower in patients with mixed incontinence than those with stress and urge incontinence (P<0.05) ; the total score of I-QoL, scores of behavioral limitations, psychological impact, and social activity impairment were lower in the severe incontinence patients than those with mild and moderate incontinence (P<0.05) .

Guizhou Province has a higher prevalence of urinary incontinence of 33.41% in women aged 40-60 years, influencing factors differ for different types of urinary incontinence, mixed incontinence and severe urinary incontinence have the greatest impact on patients' quality of life, to provide a reference basis for prevention and health management in this population.

Carotid plaque is an important early predictive signal of clinical carotid atherosclerosis, the association between homocysteine (Hcy) and carotid plaque is well recognized, however, the correlation between Hcy and carotid plaque in postmenopausal middle-aged women is not established.

To analyze the impact of Hcy within the normal reference range on the risk of carotid plaque in postmenopausal middle-aged women and determine the risk threshold.

A total of 1 465 postmenopausal women (Hcy<15 μmol/L) who underwent health examinations at the Affiliated Hospital of Guizhou Medical University between January 2020 and June 2023 were randomly selected. The general information, blood biochemical indicators, and carotid ultrasound indicators of patients were collected, and multivariate Logistic regression analysis was used to explore the association between Hcy and carotid plaque. The cutoff value of Hcy for predicting the risk of carotid plaque in postmenopausal middle-aged women with normal Hcy range was determined by plotting the receiver operating characteristic (ROC) curve.

Six hundred and forty-four (43.96%) out of 1 465 study subjects had carotid artery plaques. Age, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triacylglycerol (TG), and Hcy were higher in the plaque group than in the non-plaque group, high-density lipoprotein cholesterol (HDL-C) was lower than in the non-plaque group (P<0.05). Logistic regression analysis showed that age (OR=1.100, 95%CI=1.070-1.130), SBP (OR=1.021, 95%CI=1.012-1.030), LDL-C (OR=1.232, 95%CI=1.077-1.411), HDL-C (OR=0.568, 95%CI=0.387-0.835) and Hcy (OR=1.142, 95%CI=1.080-1.207) were independent risk factors for carotid plaque in postmenopausal middle-aged women. ROC curve analysis indicated that Hcy≥11.87 μmol/L was the optimal cutoff value for predicting carotid plaque in postmenopausal middle-aged women within the normal Hcy range, with the area under curve (AUC) of 0.605, specificity of 75.8% and sensitivity of 40.4%.

Hcy is an independent risk factor for carotid plaque in postmenopausal middle-aged women, and Hcy≥11.87 μmol/L is the optimal cutoff value for predicting carotid plaque in postmenopausal middle-aged women with normal Hcy. This threshold may provide an important reference for clinical assessment of carotid plaque risk in postmenopausal middle-aged women.

With the aging of the population, the health threat of osteoporosis (OP) has become more prominent. The prevalence of OP in postmenopausal women will further increase to three times of that in men due to the reduction of ovarian estrogen secretion. The prevalence and risk factors of OP in postmenopausal women have been widely reported and systematically summarized, however, there are few systematic reviews of relevant studies worldwide.

To systematically review the prevalence and influencing factors of OP in postmenopausal women.

PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP and CBM were searched for studies on the prevalence and influencing factors of OP in postmenopausal women from 2002-11-01 to 2022-11-01; in addition to literature tracking based on the references in the included studies. Two reviewers independently conducted literature screening and information extraction, the quality was evaluated using the risk of bias assessment criteria recommended by the Agency for Healthcare Research and Quality. A Meta-analysis on the prevalence and influencing factors of OP in postmenopausal women was performed using Stata 16.0 software.

A total of 68 articles were included, with a total sample size of 112 097 cases. Meta-analysis showed that the prevalence of OP and osteopenia in postmenopausal women was 34.73% (95%CI=31.02%-38.44%) and 41.83% (95%CI=38.19%-45.47%), respectively. Subgroup analysis showed that the highest prevalence was found in the age≥80 years group (68.72%, 95%CI=59.81%-77.62%), followed by the age of 70-79 years group (57.20%, 95%CI=50.53%-63.87%) and the age of 60-69 years group (37.46%, 95%CI=28.95%-45.98%), the age of 50-59 years group (24.94%, 95%CI=15.50%-34.39%), the age of 40-49 years group (14.01%, 95%CI=6.64%-21.38%) ; the prevalence rate of <2 births (34.24%, 95%CI=24.08%-44.41%) was lower than that of ≥2 births (39.27%, 95%CI=30.10%-48.44%) ; the prevalence of age ≥10 years menopause (47.15%, 95%CI=42.27%-52.04%) was higher than that of <10 years menopause (34.18%, 95%CI=33.30%-35.06%) ; the prevalence in developing countries (35.87%, 95%CI=31.39%-40.34%) was higher than that in developed countries (30.10%, 95%CI=23.97%-36.23%). The influencing factors of OP in postmenopausal women included diabetes (OR=2.79, 95%CI=1.75-4.46, P<0.05) ; high BMI (OR=0.53, 95%CI=0.43-0.64, P<0.05) ; exercise (OR=0.43, 95%CI=0.28-0.65, P<0.05) ; number of births (OR=2.52, 95%CI=1.72-3.67, P<0.05) ; duration of menopause (OR=1.88, 95%CI=1.43-2.46, P<0.05) ; family history (OR=1.92, 95%CI=1.38-2.67, P<0.05) ; alcohol consumption (OR=1.95, 95%CI=1.54-2.47, P<0.05), menopausal hormone therapy (OR=0.34, 95%CI=0.25-0.44, P<0.05) ; non-violent fracture history (OR=3.83, 95%CI=1.88-7.98, P<0.05) ; and age (OR=1.43, 95%CI=1.29-1.59, P<0.05) .

The prevalence of OP and osteopenia in postmenopausal women is high, with about one third of postmenopausal women suffering from osteoporosis, and about half of postmenopausal women suffering from osteopenia. High BMI, regular exercise, and use of menopausal hormone therapy are protective factors for OP in postmenopausal women, while diabetes, high number of births, long years of menopause, family history of disease, alcohol consumption, non-violent fracture history, and advanced age are risk factors. The evaluation and intervention of OP should be strengthened in clinical practice, and it is also necessary to promote healthy lifestyle to postmenopausal women to improve their quality of life.

In recent years, women with polycystic ovary syndrome (PCOS) have had a higher prevalence of lipid metabolism disorders, which are strongly associated with obesity and insulin resistance (IR) . Higher levels of lipid metabolism have been also found in PCOS women with normal body mass index (BMI) , but there are fewer studies on dyslipidemia in this population.

To investigate the factors influencing the development of hyperlipidemia in PCOS women with normal BMI.

Based on the data of the clinical trial Effect of Acupuncture and Clomiphene on Live Birth Rate in Women with Polycystic Ovary Syndrome (PCOSAct) , a total of 428 subjects with complete baseline data and meeting the study criteria were selected. The evaluation criteria for determining hyperlipidemia included total cholesterol (TC) 6.22 mmol/L and/or triglycerides (TG) 2.26 mmol/L and/or low-density lipoprotein (LDL) 4.14 mmol/L and/or high-density lipoprotein (HDL) <1.04 mmol/L, which was used to divide patients into the hyperlipidemia group (n=138 patients) and no hyperlipidemia group (n=290 patients) . The demographic characteristics, sex hormones, glucose and lipid metabolism, as well as cardiac enzymes and liver function were compared between patients with hyperlipidemia and those without hyperlipidemia, and multivariate logistic regression analysis was used to explore the factors influencing hyperlipidemia in PCOS women with normal BMI.

The prevalence of combined hyperlipidemia in PCOS women with normal BMI was 32.24% (138/428) , and the most common type of dyslipidemia was reduced HDL levels with a high prevalence (21.73%, 93/428) of a single phenotype. There were 138 cases in the hyperlipidemia group and 290 cases in the no hyperlipidemia group. The hyperlipidemic group had higher age, proportion of family history of diabetes, body mass, waist circumference, BMI, WHR, longer duration of attempted pregnancy, higher levels of free androgen index, fasting insulin, insulin resistance index (HOMA-IR) , LDL, TC, TG, apolipoprotein B, alanine aminotransferase, aspartate aminotransferase, LDH than the no hyperlipidemia group, and higher levels of sex hormone binding globulin, anti-mullerian hormone, HDL, apolipoprotein A, total bilirubin, and direct bilirubin lower than the no hyperlipidemia group (P<0.05) . Multivariate logistic regression analysis revealed that age, BMI, HOMA-IR, and LDH were independent risk factors for the development of hyperlipidemia in PCOS patients with normal BMI (OR=1.170, 1.348, 1.172, 1.009) , and sex hormone binding globulin was independent protective factor (OR=0.979, P<0.05) .

The incidence of hyperlipidemia in PCOS women with normal BMI was 32.24%. Age, BMI, HOMA-IR, LDH, and SHBG are influencing factors of the development of hyperlipidemia in women with PCOS, and clinical measures should be taken to prevent or delay the occurrence and development of hyperlipidemia in women with PCOS according to the causative factors.

Menopause will cause series of pathophysiologic changes and long-term complications (coronary heart disease, cerebrovascular disease, osteoporosis, etc.), among which coronary heart disease is a major health threat.

To investigate the effects of menopausal status and aging on common risk factors for coronary heart disease (CHD) in middle-aged women, such as increased carotid intima-media thickness (CIMT), hypertension, dyslipidemia, diabetes, and obesity.

A total of 556 healthy premenopausal women aged 45 to 54 years who received regular physical examinations at the physical examination center of Beijing Shijitan Hospital affiliated to Capital Medical University in 2018 were initially selected, with 89 excluded according to relevant criteria, and 467 women were finally included as study subjects. The included subjects were divided into the pre-menopausal group (n=176) and postmenopausal group (n=291) according to whether they were postmenopausal during a 3-year follow-up period. Changes in BMI, waist circumference, blood glucose, blood pressure, blood lipids and other indicators were monitored, inter- and intra-group comparisons were performed before and after the follow-up period. Multivariate Logistic regression analysis was used to explore the effects of menopausal status and age on the incidence of risk factors for coronary heart disease in middle-aged women.

The average age of 467 subjects was (47.6±2.3) years old. Compared with baseline, waist circumference, uric acid (UA), total cholesterol (TC), triglyceride (TG), and low density lipoprotein cholesterol (LDL-C) levels increased, fasting blood glucose (FBG) level decreased after 3 years (P<0.05). The results of inter-group comparison showed that there was no significant difference in waist circumference, BMI, TG, FBG and high density lipoprotein cholesterol (HDL-C) levels between the two groups after three years (P<0.05) ; the levels of UA, TC and LDL-C in the menopausal group were higher than those in the pre-menopausal group, and the difference was statistically significant (P<0.05). The results of intra-group comparison showed that the waist circumference in the two groups after 3 years was higher than baseline (P<0.05) ; the levels of UA, TC and TG in the pre-menopausal group after 3 years were higher than the baseline (P<0.05) ; the levels of UA, TC, TG and LDL-C in the postmenopausal group after 3 years were higher than the baseline (P<0.05). Multivariate Logistic regression analysis showed that age ≥50 years old was a high-risk factor for increased CIMT in middle-aged women (OR=2.475, 95%CI=1.049-5.838, P=0.038) .

The changes in waist circumference and TG in middle-aged women are mainly affected by age, the changes of LDL-C are mainly affected by menopausal status, and the changes of TC and UA are affected by both menopausal status and increased age. Age ≥50 years is a high risk factor for increased CIMT in middle-aged women, and the changes of metabolic indicators such as UA, TC and LDL-C precede changes in CIMT after menopause.

Earlier studies have investigated the association between overweight/obesity and an elevated risk of breast cancer in women. However, some studies have found that it may not be scientifically accurate to solely analyze the association between overweight/obesity and breast cancer in women for overweight/obesity can be classified into different metabolic phenotypes. The current findings on the association of different metabolic phenotypes with breast cancer remain inconsistent.

To prospectively analyze the associations of different metabolic obesity phenotypes with the risk of breast cancer in women.

In this prospective cohort study, female employees (n=23 406) of Kailuan Group who participated in physical examinations for the first time in Kailuan General Hospital and its 11 affiliated hospitals from 2006 to 2008 were selected as the study subjects and received questionnaire investigation, physical examination and laboratory tests. The study subjects were divided into the four groups based on the types of metabolic syndrome and BMI, including metabolically healthy normal weight (MHNW) group (n=12 739), metabolically unhealthy normal weight (MUNW) group (n=1 060), metabolically healthy overweight/obese (MHO) group (n=6 394), and metabolically unhealthy overweight/obese (MUO) group (n=3 213). The subjects were followed up, with the first physical examination attended as the starting point, and new onset breast cancer, death, or the end of follow-up time (2020-12-31) as the endpoints. Multivariate Cox proportional hazard regression model was used to estimate the association of the four groups with the risk of breast cancer.

During an average follow-up of (13.26±1.85) years, with 353 new cases of breast cancer and an incidence density of 11.38 cases per 10 000 person-years in the total population. The incidence cases in the MHNW, MUNW, MHO, and MUO groups were 154, 21, 113, and 65, respectively, with the incidence density of 9.08, 15.37, 13.27, and 15.49 per 10 000 person-years, and the cumulative incidence of 1.22%, 2.01%, 1.67%, and 1.93%, respectively. Multivariate Cox proportional hazard regression model analysis, after adjusting for confounders, showed that compared with the MHNW group, the risk of breast cancer was increased by 42% (HR=1.42, 95%CI=1.11-1.82) and 59% (HR=1.59, 95%CI=1.17-2.17) in the MHO group and MUO group, respectively. Stratified analysis by menopausal status showed that compared to the MHNW group, the MUO group was associated with a 69% increase in risk of premenopausal breast cancer (HR=1.69, 95%CI=1.01-2.83). The risk of postmenopausal breast cancer was increased by 85% (HR=1.85, 95%CI=1.09-3.14), 50% (HR=1.50, 95%CI=1.06-2.13), and 55% (HR=1.55, 95%CI=1.05-2.28) for the MUNW, MHO, and MUO groups, respectively, compared to the MHNW group.

Overweight/obesity is a risk factor for female breast cancer, and overweight/obesity with metabolic abnormalities further increases the risk of breast cancer. Additionally, normal weight postmenopausal women who are metabolically unhealthy may be at an increased risk of postmenopausal breast cancer.

As an objective index to evaluate chronic stress, allostatic load (AL) is associated with adverse pregnancy outcomes. At present, there are few longitudinal studies to analyze the influencing factors of AL among pregnant women.

To investigate the status of AL and its influencing factors in pregnant women at different trimesters.

This study was designed as a prospective study. Questionnaire survey, physical examination and laboratory examination were administered to 152 women in the first (≤14 weeks), second (23-27 weeks) and third (30-34 weeks) trimesters of pregnancy collected in the obstetrics outpatient clinics of the 901 Hospital, Joint Logistic Support Force of the Chinese People's Liberation Army, Jin'an Maternal and Child Health Care Hospital from November 2021 to November 2022 by using convenience sampling method. The Edinburgh Postpartum Depression Scale (EPDS) was used to assess the depression during pregnancy. Referring to previous studies, the relevant assessment indexes of metabolic system, cardiovascular system, and immune system were used to calculate the total score of AL, and AL≥3 score was used as a criterion for determining high AL level at different trimesters of pregnancy. Multivariate Logistic regression analysis was used to explore the influencing factors of AL in the first, second and third trimesters.

Among 152 pregnant women, the mean total AL score was (2.06±1.68), (2.07±1.84) and (2.07±1.68) in the first, second and third trimesters; 52 (34.2%), 54 (35.5%) and 50 (32.9%) women were in high level of AL (total score of AL≥3) in the first, second and third trimesters. The results of multivariate Logistic regression analysis showed that occupations {business service employees〔OR=0.229, 95%CI (0.062, 0.845), P=0.027〕, office staff〔OR=0.164, 95%CI (0.051, 0.528), P=0.002〕, professional and technical personnel〔OR=0.278, 95%CI (0.099, 0.784), P=0.015〕}, unemployment〔OR=5.516, 95%CI (1.044, 29.144), P=0.044〕and depression〔OR=6.241, 95%CI (1.403, 27.757), P=0.016〕were the influencing factors of AL in the first trimester. Age〔OR=1.098, 95%CI (1.002, 1.202), P=0.045〕and AL in the first trimester〔OR=9.965, 95%CI (4.402, 22.561), P<0.001〕were the influencing factors of AL in the second trimester. Sleep duration in the third trimester〔≥9 h/d: OR=0.176, 95%CI (0.044, 0.703), P=0.014〕, AL in the first trimester〔OR=4.697, 95%CI (1.852, 11.908), P<0.001〕and AL in the second trimester〔OR=9.426, 95%CI (3.728, 23.834), P<0.001〕 were the influencing factors of AL in the third trimester.

More than 30% of women are at high levels of AL at different trimesters and the influencing factors of AL at different trimesters are different. Occupation, unemployment status, and depression are the influencing factors of AL in the first trimester; age and AL in the first trimester are the influencing factors of AL in the second trimester; sleep duration in the third trimester and AL in the first and second trimesters are the influencing factors of AL in the third trimester.

The incidence of adverse pregnancy outcomes has remained high in recent years, which poses a serious threat to maternal and neonatal life and health. Chronic stress is known to be a risk factor for adverse pregnancy outcomes, while the relationship between allostatic load (AL) as a composite physiological index of chronic stress, and adverse pregnancy outcomes has not been clarified.

To explore the effect of AL on adverse pregnancy outcomes in women in late pregnancy.

Women in late pregnancy who met the study requirements were recruited as study subjects by using the convenience sampling method from November 2021 to November 2022 in the obstetrics outpatient clinics of the 901 Hospital, Joint Logistic Support Force of the Chinese People's Liberation Army, Jin'an Maternal and Child Health Care Hospital. Basic information such as general and obstetric data were collected through questionnairs, biological indicators were collected through physical examination and laboratory tests, and AL scores of the study subjects were calculated by referring to AL-related literature; pregnancy outcome information was obtained by reviewing the hospital electronic medical record system. Multivariate Logistic regression analysis was used to explore the effect of AL on adverse pregnancy outcomes in women in late pregnancy.

A total of 354 women in late pregnancy with an average age of (29.3±4.1) years and upper quartile of AL total score of 3 were included in this study. The upper quartile of the total AL score of the study subjects was used as the high-risk threshold, and they were divided into low-level AL (AL <3) and high-level AL (AL ≥3) according to their AL scores. High AL pregnant women accounted for 32.8% (116/354) and low AL pregnant women accounted for 67.2% (238/354). The prevalence of adverse pregnancy outcomes was 15.5% (55/354), including 9.9% (35/354) of macrosomia, followed by preterm birth〔5.4% (19/354) 〕and low birth weight〔2.3% (8/354) 〕. The incidence of adverse pregnancy outcomes was higher in women in late pregnancy with high AL (26.7%, 31/116) than in women in late pregnancy with low AL (10.1%, 24/238) (P<0.05) ; the incidence of preterm birth (10.3%, 12/116) and delivery of macrosomia (15.5%, 18/116) was higher in women in late pregnancy with high AL than in women in late pregnancy with low AL (2.9%, 7/238; 7.1%, 17/238) (P<0.05). Multivariate Logistic regression analysis showed that women in late pregnancy with high AL had a 2.465-fold increased risk of adverse pregnancy outcomes compared to women in late pregnancy with low AL〔95%CI (1.315, 4.622), P<0.05〕. High AL level was a risk factor for preterm birth〔OR=4.832, 95%CI (1.545, 15.114) 〕and delivery of macrosomia〔OR=2.868, 95%CI (1.392, 5.909) 〕in women in late pregnancy compared to low AL level (P<0.05) .

High level of AL in women in late pregnancy increase the risk of adverse pregnancy outcomes, especially the risk of preterm birth and delivery of macrosomia. Attention to AL in women during pregnancy should be enhanced to provide a theoretical basis for preventing adverse pregnancy outcomes.

With the rapid development of economy and society in China, the living standards and health care awareness have been improved significantly, the average life expectancy of our population is gradually prolonged, causing increasing population of perimenopausal women, therefore, the health management of perimenopausal women has become more important. Perimenopausal syndrome can be seen in women aged 40-65 years, which can seriously affect the physical and mental health and quality of life of patients.

To systematically review the incidence of perimenopausal syndrome in Chinese women aged 40-65 years.

PubMed, Embase, Web of Science, CNKI, Wanfang Data, CBM and VIP were searched by computer to collect cross-sectional studies on the occurrence of perimenopausal syndrome in Chinese women aged 40-65 years from inception to February 1, 2023. Two investigators independently screened the literature, extracted data and evaluated the quality of included literature. Meta-analysis was performed using Stata 17.0 software.

A total of 62 cross-sectional studies were included, with a total sample size of 82 340 cases. Meta-analysis showed that the incidence of perimenopausal syndrome in Chinese women aged 40-65 years was 61.0%. The results of subgroup analysis showed that the incidence of perimenopausal syndrome in women aged 40-45 years, >45-50 years, >50-55 years, >55-60 years and >60 years was 42.6%, 53.8%, 64.6%, 59.7% and 56.1%, respectively. The incidence of perimenopausal syndrome in women aged 40-65 years with normal, disordered and postmenopausal menstrual status was 43.6%, 56.9% and 61.3%, respectively. The incidence of perimenopausal syndrome in women aged 40-65 years with and without chronic diseases was 85.9% and 68.3%, respectively. The incidence of perimenopausal syndrome was highest in women aged 40-65 years in Southwest China at 71.3%, and at 57.4%, 57.9%, 50.5%, 59.2%, 69.5%, and 68.6% in North, East, South, Northwest, Northeast, and Central China, respectively. The incidence of perimenopausal syndrome in women aged 40-65 years with education level of junior high school and below, high school or technical secondary school, university and above was 54.1%, 55.7% and 49.6%, respectively. The incidence of perimenopausal syndrome in Han Chinese and ethnic minority women aged 40-65 years was 62.1% and 64.7%, respectively.

The incidence of perimenopausal syndrome is high in women aged 40 to 65 years in China. Among them, women aged >50-55 years, menopausal, suffering from chronic diseases, living in southwest region, with education level of high school or below, and ethnic minorities are at high risk of perimenopausal syndrome. We should pay attention to the prevention, screening and intervention of perimenopausal syndrome in relevant population to lay the foundation of elderly health in women.

With the population aging, mental health of the middle-aged and elderly adults is of great concern, especially in middle-aged and elderly women. Compared with urban women, rural women are more likely to suffer from mental diseases due to their poorer health status, lower education level and backward living conditions, however, the accessibility of mental health services among them is low.

To understand the prevalence of depression among middle-aged and elderly women in rural China and analyze its influencing factors, in order to provide empirical evidence for improving the mental health of middle-aged and elderly women.

From May to July 2021, the follow-up data of the 2018 China Health and Retirement Longitudinal Study (CHARLS) was extracted, and rural women aged 45 years and above were selected as the study subjects (n=6 736) . The scores of the simplified version of the Center for Epidemiologic Studies Depression Scale (CES-D) were used to determine the depression status of rural middle-aged and elderly women. Chi-square tests and multivariate Logistic regression model were used to analyze the influencing factors of the occurence of depressive symptoms among rural middle-aged and elderly women (including individual characteristics, health behaviors, social participation and utilization of medical services utilization) .

The CES-D score of 6 736 rural middle-aged and elderly women was (20.0±6.9) , 42.46% (2 860/6 736) of whom had depressive symptoms. The results of multivariate Logistic regression analysis showed that satisfication with health status〔OR (95%CI) =0.40 (0.36, 0.45) 〕, sleep duration ≥6 h〔OR (95%CI) =0.48 (0.43, 0.54) 〕, Internet use〔OR (95%CI) =0.63 (0.50, 0.80) 〕 and satisfication with life 〔OR (95%CI) =0.25 (0.21, 0.30) 〕 were correlated with lower risk of depression; hysical disability〔OR (95%CI) =1.41 (1.16, 1.71) 〕, suffering from chronic diseases〔OR (95%CI) =1.35 (1.21, 1.50) 〕, receiving outpatient services within 1 month〔OR (95%CI) =1.25 (1.09, 1.43) 〕 and hospitalization services within 1 year〔OR (95%CI) =1.31 (1.13, 1.52) 〕 were correlated with higher risk of depression.

Based on the results of this study, the depression status of middle-aged and elderly women in rural China is relatively severe and affected by individual characteristics, health behaviors, social participation, and the medical services utilization. It is recommended that governments and civil affairs departments at all levels pay close attention to the mental health of rural middle-aged and elderly women, especially through the intervention and prevention from multiple dimensions such as health promotion and education, medical service quality, and accessibility of information, in order to promote the construction of healthy villages and process of health aging in China.

The aim and mission of the new healthcare reform in China, namely, the healthcare reform initiated in 2009, are effectively implementing health policies to improve people's livelihood and well-being. As a domestic hot research topic, studies on the effectiveness of the new healthcare reform mainly focus on current cross-sectional data, but rarely involve longitudinal or panel data.

To explore the changes in health service utilization in married women of childbearing age in rural mountainous areas of southern Ningxia before and after 10 years of the new healthcare reform, and to identity the major causal factors of inequalities in the utilization.

This study used the results of the Rural Household Health Survey conducted in 2009 (baseline data) and in 2019 (10-year follow-up data). The direct standardization method was used to comparatively analyze the status of health service utilization in married female surveyees of childbearing age living in rural mountainous areas of southern Ningxia before and after the implementation of the new healthcare reform. The inequality in health service utilization and the contribution level of its associated contributory factors were measured by calculating and decomposing the concentration index (CI) .

The number of eligible participants was 4 935 in 2009, and 3 509 in 2019. Compared with 2009, the two-week hospital visit rate showed a slight increase (1.29%) in 2019, but the rate of consultation for chronic diseases decreased significantly (18.77%). In addition, the rates of hospitalization for those requiring hospitalization, gynecological examination, antenatal examination, hospital delivery and postnatal visits increased significantly, by a factor of 10.44%, 8.53%, 24.05%, 36.52% and 23.62%, respectively. The CI values for all indicators in both surveys were greater than 0, except for those for postpartum visit rate in the 2009 survey (-0.034 5) and two-week hospital visit rate in the 2019 survey (-0.016 9). Economic income, literacy, family size and age were major contributory factors of the inequality in health service utilization.

After 10 years of the new healthcare reform, the utilization of health services in married women of childbearing age in the areas of Ningxia improved, and tended to be more equitable, but a slightly higher utilization rate was found in high-income individuals.

Chronic stress is known to be associated with the onset of depression, allostatic load (AL) may play a significant role in the pathogenesis of depression as a comprehensive physiological index to evaluate response to the chronic stress.

To identify the association between AL level and depression among women in early pregnancy.

630 Women in early pregnancy who underwent prenatal examination in the 901 Hospital, Joint Logistic Support Force of the Chinese People's Liberation Army, Jin'an Maternal and Child Health Care Hospital from November 2021 to June 2022 were selected as the research subjects by using convenience sampling method, and were divided into the depression group (n=162) and non-depression group (n=468) according to presence or absence of depression. The general information questionnaire, Pregnancy-specific Anxiety Questionnaire and Edinburgh Postnatal Depression Scale were used for questionnaire survey, AL-related data were collected by physical examination and laboratory tests. Multivariate Logistic regression model was used to analyze the association between AL level and depression among women in early pregnancy.

A total of 630 pregnant women in early pregnancy were enrolled with the depression incidence of 25.7% (162/630) , including 427 pregnant women (67.8%) with low AL level (AL<3) and 203 (32.2%) with high AL level (AL≥3) . Multivariate Logistic regression analysis showed that high AL level was the risk factor for depression among women in early pregnancy〔OR=1.651, 95%CI (1.096, 2.489) , P<0.05〕.

There is a positive association between AL level and depression among women in early pregnancy, high AL level will increase the risk of depression.

The associations of muscle and adipose tissue with bone mineral density (BMD) in perimenopausal women has been studied, but there are differences in site distribution, which lead to that the effect of muscle and adipose tissue on BMD and the site of action are still unclear.

To analyze the relationships of BMD in lumbar spine, femoral neck, total hip and adipose, muscle tissue in perimenopausal women, and provide theoretical basis for improving the quality of life of middle-aged and elderly and preventing and treatment of osteoporosis (OP) .

2 355 women aged 40-60 years who underwent medical examination in the Health Management Center, Affiliated Hospital of Guizhou Medical University from January 2018 to October 2021 were retrospectively selected and divided into pre-menopausal women (n=1 261) and post-menopausal women (n=1 094) according to whether they were menopausal or not. BMD of lumbar spine, femoral neck, and total hip were measured by Dual energy X-ray Absorptiometry (DXA) . Adipose and muscle tissue were measured by Bioelectrical Impedance Analysis (BIA) . To explore the association of adipose and muscle tissue with BMD of different site in perimenopausal women by Pearson correlation and multiple linear regression analysis. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of appendicular lean mass (ALM) for postmenopausal OP.

Pearson correlation analysis showed that adipose mass, total body muscle mass, trunk muscle mass and ALM were positively correlated with BMD of lumbar spine, femoral neck and total hip in premenopausal, postmenopausal and overall women (P<0.05) .Multiple linear regression analysis showed that total body muscle mass and trunk muscle mass were the influencing factors of femoral neck BMD in overall female (β=-0.051, 0.099, P<0.05) , ALM was an influencing factor of BMD of lumbar spine, femoral neck and total hip in overall female (β=0.244, 0.199, 0.199, P<0.05) ; total body muscle mass was an influencing factor for BMD of femoral neck and total hip in postmenopausal women (β=-0.125, -0.075, P<0.05) . Trunk muscle mass was an influencing factor for BMD of femoral neck in postmenopausal women (β=0.150, P<0.05) . ALM was the influencing factor for BMD of lumbar spine, femoral neck and total hip in postmenopausal women (β=0.226, 0.216, 0.188, P<0.05) . ROC curve analysis showed that the AUC of ALM for predicting OP of total hip in postmenopausal women was 0.825〔95%CI (0.742, 0.908) 〕, with 81.82% sensitivity and 76.59% specificity when the cut-off value was 16.24 kg. The AUC of ALM for predicting OP of femoral neck in postmenopausal women was 0.760〔95%CI (0.692, 0.829) 〕, with 75.61% sensitivity and 61.89% specificity when the cut-off value was 16.68 kg. The AUC of ALM for predicting OP of lumbar spine in postmenopausal women was 0.641〔95%CI (0.603, 0.679) 〕, with 60.85% sensitivity and 60.17% specificity, when the cut-off value was 17.20 kg. The best site of ALM for predicting OP in postmenopausal women was the total hip (Z_{femoral neck}=-9.89, P<0.05) .

ALM is positively correlated with BMD of lumbar spine, femoral neck and total hip in postmenopausal women. ALM can predict the occurrence of OP at different body parts of postmenopausal women, of which the optimal site of prediction for OP is the total hip.

People with normal weight obesity (NWO) are prone to cardiovascular diseases in their middle and old age. High-intensity interval training (HIIT) has been demonstrated to effectively improve cardiovascular health. However, whether HIIT can decrease the risk of cardiovascular diseases in NWO population is not clear.

To explore the effects of HIIT on the advanced glycation end-products (AGEs) and the risk of cardiovascular disease in NWO female university students.

From November to December 2020, 137 female college students were recruited in Shanghai University of Medicine & Health Sciences, among whom 40 NWO cases were screened out as subjects by the Asian female NWO standard. They were equally and randomly divided into a control group (n=20) and a HIIT intervention group (n=20) to receive no interventions or weekly five-day interventions, for consecutive four weeks after one-week adaptive training. Body weight, body mass index (BMI) , body fat percentage (BF%) , visceral fat level (VFL) , visceral fat area (VFA) , waist circumference, levels of four blood lipids 〔high-density lipoprotein (HDL) , low-density lipoprotein (LDL) , triglyceride (TG) , and total cholesterol (TC) 〕, cardiovascular disease risk (assessed by the China-PAR model) , AGEs, and fasting blood glucose of two groups were observed before and after intervention. The correlation between AGEs and cardiovascular disease risk was analyzed.

Except for 10 dropouts, the remaining 30 cases (13 in the control group and 17 in the HIIT intervention group) were finally included for analysis. After intervention, the average BMI, BF%, VFA, VFL, waist circumference, TC/HDL ratio, LDL/HDL ratio, TG/HDL ratio, AGEs and fasting blood glucose in HIIT intervention group were lower than those in control group (P<0.05) . Nine subjects in the HIIT intervention group were evaluated for the risk of cardiovascular and cerebrovascular diseases as the China-PAR model was applicable to subjects aged 20 years or older. The risk of cardiovascular disease was (11.82±0.47) % and (9.79±0.57) % in control group and HIIT intervention group, respectively, before intervention, and (14.13±0.97) % and (6.93±1.17) % in the two groups, respectively, after intervention. The post-intervention risk of cardiovascular disease in HIIT intervention group was lower than that in control group (P<0.05) . Spearman rank correlation analysis showed that AGEs were not correlated with cardiovascular disease risk (r_s=-0.006, P=0.979) .

The four-week HIIT can effectively reduce the body fat, the levels of AGEs and fasting blood glucose as well as the risk of cardiovascular disease in NWO female university students.

Persistent genital arousal disorder (PGAD) and genito-pelvic dysesthesia (GPD) are jointly known as PGAD/GPD, which is a newly discovered condition in recent years, featured by spontaneous or secondary persistent genital arousal and/or dysesthesia in the genital and pelvic areas. PGAD/GPD mainly affects women, which can seriously influence the physical and mental health of the sufferers due to the specificity of its symptoms. Most patients have anxiety, depression, and even the suicidal tendency. The medical community abroad has paid attention to PGAD/GPD, and included it in the International Classification of Diseases-11th Revision (ICD-11) . Given the fact that this newly discovered condition is under-recognized among domestic health providers at present, we summarized the current research on PGAD/GPD abroad and introduced the epidemiological characteristics, pathophysiological mechanisms, diagnosis and treatment methods of PGAD/GPD based on the review of the latest expert consensus of the International Society for the Study of Women's Sexual Health (ISSWSH) , and discussed the future research direction of PGAD/GPD and the coping strategies that should be taken by the domestic medical community, with a view to arousing medical workers' attention to the disease in China.

Sleep duration is strongly associated with hypertension, but its effect on H-type hypertension in female population is not well characterized.

The examine the effect of sleep duration on the prevalence of H-type hypertension in female population.

A cross-sectional study design was used. One thousand seven hundred and nine female hypertensive inpatients were selected from Department of General Medicine and Geriatric Department of Hunan Provincial People's Hospital from July 2018 to December 2020, among whom those who with serum Hcy≥10 μmol/L and the others were assigned into H-type hypertension and non-H-type hypertension groups, respectively. Binary Logistic regression was used to assess the correlation of between sleep duration and H-type hypertension across three groups with different self-reported mean daily sleep durations in the past month (<7 h, 7-8 h, and >8 h) , and to further assess the correlation between the two across by age (≤60 and >60) .

The distribution of age, education level and marital status differed across three groups with different daily sleep durations (P<0.05) . 901 (52.72%) with daily sleep duration of <7 h, 697 (40.78%) with daily sleep duration of 7-8 h, and 111 (6.50%) with daily sleep duration of >8 h. The distribution of age, education level, living area (urban or rural) , marital status, BMI, exercise status, and daily sleep duration, as well as prevalence of drinking between H-type hypertension group〔973 (56.93%) 〕 and non-H-type hypertension group〔736 (43.07%) 〕 (P<0.05) . The risk of H-type hypertension in those with <7 h of daily sleep duration was 1.291 times higher than that in those with 7-8 h of daily sleep duration〔95%CI (1.032, 1.615) , P<0.05〕after adjusting for confounding factors such as age, education level, living area, marital status, BMI and exercise status. Further analysis revealed that <7 h of daily sleep duration was associated with increased risk of H-type hypertension only in those aged greater than 60 years〔OR (95%CI) =1.421 (1.021, 1.978) , P<0.05〕.

Less than 7 h of daily sleep duration was a risk factor for H-type hypertension in female over 60 years old. In view of this, it is suggested to put more attention to sleep health to improve blood pressure in this group.

Breast cancer is the leading cause of death among women worldwide, characterized by high incidence and heavy disease burden.

To assess the secular trend of breast cancer incidence and mortality in Chinese females from 1990 to 2019.

The data on breast cancer incidence and mortality in Chinese females aged ≥15 years from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019. The Bayesian age-period-cohort (APC) model was used to fit breast cancer incidence and mortality trends during 1990—2019 to assess the effects of age, period and cohort on breast cancer incidence and mortality.

The crude incidence of breast cancer among Chinese females increased from 14.14/100 000 to 52.81/100 000, and the crude mortality increased from 7.22/100 000 to 13.40/100 000 during 1990—2019.The standardized incidence of breast cancer showed an increasing trend in general (17.07/100 000 in 1990, 35.61/100 000 in 2019) , while the standardized breast cancer mortality was basically stable (9.16/100 000 in 1990, 8.98/100 000 in 2019) .The results of the APC model showed that the average net drift value of breast cancer incidence in females of all age groups was 2.58%〔95%CI (2.34%, 2.83%) 〕, and the highest value of local drift was 3.46%〔95%CI (3.11%, 3.80%) 〕 in the 65-69 years old group. The average net drift value of mortality was -0.75%〔95%CI (-1.09%, -0.41%) 〕. The local drift value was stable in 15-44-year-olds, and was above 0 in age groups above 60 years old. The incidence and mortality of breast cancer increased with age. The period effect of incidence showed an increasing trend (RR: 0.79-1.47) , while the period effect of mortality showed a decreasing trend (RR: 1.08-0.90) when the period of 2000—2004 was set as the control group. The cohort effect of breast cancer incidence increased (RR: 0.27-2.48) , and the cohort effect of breast cancer mortality risk increased firstly and decreased after then (RR: 0.78-1.06-0.44) when the cohort of 1955—1959 was set as the control group.

The incidence and mortality of breast cancer in Chinese females increased continuously from 1990 to 2019, which was dominantly influenced by age and cohort.

The overall incidence of breast cancer in Chinese women is on the rise, seriously threatening their physical and mental health. Breast cancer prevention and treatment behaviors are critical to the outcomes of affected women in the community. However, these behaviors vary across individuals. And measures should be explored to improve the efficacy of such behaviors.

To perform a latent class analysis of breast cancer prevention and treatment behaviors among community-living women, and to explore the associated factors, providing evidence for individualized prevention and management of female breast cancer in the community.

A total of 1 355 community-living women were selected from in 15 towns/subdistricts of 5 counties/districts in Yinchuan and Zhongwei cities of Ningxia, China by use of convenience sampling method from November 2019 to August 2020. They were surveyed using a questionnaire consisting of baseline characteristics, and breast cancer prevention and treatment behaviors (relevant questions used are belonging to the part of breast cancer prevention and treatment in the Knowledge, Attitude and Practice of Breast and Cervical Cancer Prevention and Treatment Among Women in Ningxia) . The latent classes of breast cancer prevention and treatment behaviors were presented, and their influencing factors were identified by multivariable logistic regression analysis.

The survey achieved a response rate of 97.93% (1 327/1 355) .By use of latent class analysis, breast cancer prevention and treatment behaviors of the respondents were classified into four latent classes, including positive prevention and treatment (n=522, 39.34%) , high-risk behaviors plus positive treatment (n=449, 33.83%) , high-risk behaviors plus negative treatment (n=229, 17.26%) , and general prevention and treatment (n=127, 9.57%) . The overall median score of breast cancer prevention and treatment behaviors was 9.00 (7.00, 11.00) points for all respondents. The median score of breast cancer prevention and treatment behaviors was 11.00 (11.00, 12.00) points for respondents with positive prevention and treatment behaviors, 9.00 (8.00, 10.00) points for those with high-risk behaviors plus positive treatment behaviors, 6.00 (5.00, 6.00) points for those with high-risk behaviors plus negative treatment behaviors, and 8.00 (6.00, 9.00) points for those with general prevention and treatment behaviors, with significant difference across the groups (H=1 008.493, P<0.001) . Multivariable Logistic regression analysis showed that, compared with general prevention and treatment behaviors, living in Zhongwei and having a history of childbirth were associated with increased possibility of being classified into positive prevention and treatment behaviors, having health insurance〔urban resident basic medical insurance (URBMI) , commercial health insurance, or other types〕, self-pay treatment, and a history of hormone replacement therapy were associated with increased possibility of being classified into general prevention and treatment behaviors (P<0.05) , having a history of childbirth were associated with increased possibility of being classified into high-risk behaviors plus positive treatment behaviors, having health insurance (URBMI or commercial health insurance) , as well as a history of hormone replacement therapy were associated with increased possibility of being classified into general prevention and treatment behaviors (P<0.05) , and primary education or below, household monthly income per person of 1 000-2 999 yuan were associated with increased possibility of being classified into high-risk behaviors plus negative treatment behaviors, and having URBMI were associated with increased possibility of being classified into general prevention and treatment behaviors (P<0.05) .

In general, breast cancer prevention and treatment behaviors in this group could be definitely classified, all being performed at a moderate level. To improve the level of breast cancer prevention and treatment behaviors of Ningxia's community-living women, focus should be on those who have high-risk behaviors and negatively seek for treatment. Moreover, the problems in positive breast cancer prevention and treatment behaviors in women with other three classes of behaviors should also be intervened and corrected to improve the outcomes of them.

There are few epidemiological analyses on mental illness deaths among Chinese residents. As an economically developed region, Shanghai has more complete health information system, which can provide data support for deeper analysis of smaller categorical disease characteristics and causes of death among residents, and analysis of the circumstances and trends of deaths related to mental disorders among women in Shanghai will help to understand the local burden of mental disorders in women.

To analyze the death status and trend of mental disorders among female residents in Pudong New Area of Shanghai from 2005 to 2021.

Cause of death monitoring data of registered residents of the whole population in Pudong New Area from 2005 to 2021 were collated, and deaths of local female residents with mental disorders were analyzed by using indicators such as crude mortality rate, standardized mortality rate, years of life loss and rate of life loss, and annual percentage change (APC) and average annual percentage change (AAPC) were calculated by using Joinpont regression model for trend analysis.

From 2005 to 2021, there were 1 165 female deaths from mental disorders in Pudong New Area of Shanghai, accounting for 0.32% of the total deaths in the same period. The crude mortality rate was 4.82/100 000, and the standardized mortality rate was 1.85/100 000. The crude mortality rate of female mental disorders in Pudong New Area of Shanghai showed a downward trend from 2005 to 2012 (APC=-13.05%, P=0.002), and an upward trend from 2012 to 2021 (APC=7.66%, P=0.012). The standardized mortality rate showed a downward trend from 2005 to 2012 (APC=-16.79%, P<0.001), and a overall downward trend from 2005 to 2021 (AAPC=-4.93%, P=0.009). The life loss rate showed a downward trend from 2005 to 2012 (APC=-13.79%, P<0.001), and an upward trend from 2012 to 2021 (APC=6.93%, P=0.011). From 2005 to 2021, the death age of female mental disorders in Pudong New Area of Shanghai was 50.8-105.8 years old, and the death age distribution was dominated by ≥80 years old (79.48%), and the death rate of female mental disorders ≥80 years old showed an overall upward trend (AAPC=0.98%, P=0.027). From 2005 to 2021, the proportion of women who died at aged 70-79 with mental disorders was 16.57%. The death rate (AAPC=-5.13%, P=0.026), crude mortality rate (AAPC=-7.20%, P=0.003) and life loss rate (AAPC=-6.89%, P=0.005) showed a downward trend as a whole.

From 2005 to 2021, the standardized mortality rate of female mental disorders in Pudong New Area of Shanghai showed a downward trend as a whole, but the death rate of female mental disorders≥80 years old showed an overall upward trend. The burden of mental disorders among elderly female residents deserves attention of local authorities. Promoting the mental health of elderly women is conducive to improving the health level of local women.

It is sometimes difficult to distinguish osteitis condensans ilii (OCI) from other diseases, and exploring biochemical markers of bone turnover may contribute to the differential diagnosis.

To evaluate the characteristic and significance of biochemical markers of bone turnover in patients with OCI.

Participants were retrospectively selected from Beijing Jishuitan Hospital from June 2013 to February 2022, including 61 female outpatients and inpatients with OCI {observation group: 15-50 years old〔mean age of (33.8±6.6) years〕, duration of OCI of two weeks to 15 years}, and 61 healthy female physical examinees{control group: 15-48 years old〔mean age of (35.6±7.6) years〕}. The clinical data and biochemical markers of bone turnover were compared between the two groups. The correlations of biochemical markers of bone turnover with OCI-related indices were analyzed.

The serum albumin of the observation group was significantly lower than that of the control group〔 (45.4±2.9) g/L vs (46.5±2.8) g/L〕 (t=2.190, P<0.05) . In terms of biochemical markers of bone turnover, the observation group had significantly lower serum β-isomerised carboxy-terminal cross-linking telopeptide of type 1 collagen (β-CTX) 〔0.28 (0.23, 0.37) μg/L vs 0.36 (0.29, 0.48) μg/L〕, N-terminal osteocalcin (OC) 〔13.1 (11.2, 16.2) μg/L vs 15.6 (13.7, 17.3) μg/L〕, and 25- (OH) VD₃ 〔 (14.1±5.1) μg/L vs (17.5±6.6) μg/L〕 than the control group (Z=-2.983, -3.255, t=3.081, P<0.05) . OCI patients with a longer disease duration had significantly higher serum OC〔14.6 (12.4, 18.5) μg/L vs 11.7 (10.2, 14.0) μg/L〕 than those with a shorter duration (Z=-2.407, P<0.05) . OCI patients with two or more pregnancies had significantly lower serum β-CTX〔0.25 (0.22, 0.32) μg/L vs 0.33 (0.26, 0.44) μg/L〕 and OC〔12.2 (10.3, 15.0) μg/L vs 13.4 (12.0, 18.8) μg/L〕 than those with no or one pregnancy (Z=-2.486, -1.897, P<0.05) . Correlation analysis showed that, in OCI patients, the procollagen type 1 N-terminal propeptide (tP1NP) was negatively correlated with the number of pregnancies and deliveries (r_s=-0.276, -0.298, P<0.05) . Serum OC level was negatively correlated with BMI, VAS score and the number of pregnancies (r_s=-0.284, -0.374, -0.360, P<0.05) . The serum 25- (OH) VD₃ level was positively correlated with BMI (r_s=0.275, P<0.05) .

The serum levels of OC and β-CTX in female patients with OCI were significantly lowered, which could be used for distinguishing OCI and other diseases. The serum level of OC may be a predictor of the severity of OCI, which was related to the number of pregnancies. The level of tP1NP was related to the number of pregnancies and deliveries.

The pain induced by degenerative knee osteoarthritis (KOA) is common in postmenopausal women, but there is a lack of clinical evidence on whether it has an association with decreased sex hormone levels and inflammatory cytokines in the synovial fluid.

To assess the associations of degenerative KOA pain with sex hormones in the serum 〔estradiol (E₂) , testosterone (T) , prolactin, luteinizing hormone (LH) , follicle-stimulating hormone (FSH) and progesterone (P) 〕, and inflammatory cytokines in synovial fluids 〔interleukin-1 (IL-1) , IL-6, IL-10 and tumor necrosis factor-α (TNF-α) 〕 in postmenopausal women, providing a novel basis for estrogen hormone treatment of pain induced by degenerative KOA.

Ninety postmenopausal women with pain induced by degenerative KOA were recruited from the Sixth Affiliated Hospital of Xinjiang Medical University from June 2019 to June 2021, including 30 with mild pain (VAS score ≤ 3) , 30 with moderate pain (VAS score higher than 4 but lower than 7) , and 30 with severe pain (VAS score higher than 7 but lower than 10) . They were compared to 30 postmenopausal women with knee effusion (controls) undergoing physical examination in the hospital during the same period. The levels of serum sex hormones and inflammatory cytokines in synovial fluids were measured in all cases. All subjects were tested for sex hormones in the serum and inflammatory cytokines in synovial fluids.

The BMI differed across mild, moderate, and severe pain subgroups and the controls (P<0.05) . In particular, severe pain subgroup had higher BMI than did controls and mild pain subgroup (P<0.05) . The serum levels of E₂ and T differed across mild, moderate, and severe pain subgroups and the controls (P<0.05) . Specifically, the controls had higher levels of E₂ and T than did moderate and severe pain subgroups (P<0.05) . The E₂ level in the moderate pain subgroup was lower than that of mild pain subgroup (P<0.05) . The E₂ and T levels in the severe pain subgroup were lower than those in the mild pain subgroup (P<0.05) . There were no significant differences in prolactin, LH, FSH and P between controls, and mild, moderate and severe pain subgroups (P>0.05) . The levels of IL-1, IL-6, and IL-10 as well as TNF-α varied across mild, moderate, and severe pain subgroups and the controls (P<0.05) . Compared with controls, mild pain subgroup had higher IL-1 level, and moderate and severe pain subgroups had higher IL-1, IL-6, IL-10 and TNF-α levels (P<0.05) . The levels of IL-6, IL-10 and TNF-α in severe pain subgroup were higher than those in mild pain subgroup (P<0.05) . E₂ and T levels were negatively correlated with VAS score for degenerative knee pain (r_s=-0.686, -0.454, P<0.05) ; IL-1, IL-6 and TNF-α levels were positively correlated with VAS score for degenerative knee pain (r_s=0.517, 0.665, 0.319, P<0.05) . There was no correlation between IL-10 and VAS score for degenerative knee pain (r_s=0.162, P>0.05) .

In postmenopausal women, VAS score for degenerative knee pain was negatively correlated with E₂ and T levels. There was no significant difference in prolactin, LH, FSH and P levels among degenerative KOA patients with different pain levels. The IL-1, IL-6 and TNF-α levels in synovial fluids were positively correlated with the VAS score of degenerative knee pain. So reducing the levels of IL-1, IL-6 and TNF-α could improve the tolerance of knee pain, which may be a reference for clinical treatment of degenerative knee pain.

In the social situation of "three child" policy opening and late marriage to become the norm, the topic of female reproduction and health has attracted increasing attention. As one of the important markers of ovarian reserve in women, the relationship between anti-Mullerian hormone (AMH) and cardiovascular disease and cardiovascular risk indicators has become a hot research issue.

To establish a reference range of AMH in healthy women of reproductive age in Urumqi region, and to investigate the association between AMH and risk factors associated with cardiovascular disease.

From May to July 2018, healthy women aged 19-50 years who met the criteria were selected from the natural population of a community-based epidemiological survey with four living residents area in Urumqi city by targeted sampling, and the serum AMH, fasting plasma glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triacylglyceride (TG), serum uric acid, and thyroid stimulating hormone (TSH) levels of the survey subjects were tested. Height, body mass, abdominal circumference, hip circumference, blood pressure, and other indicators were measured to analyze the relationship between AMH and the above indicators related to cardiovascular risk factors.

The median AMH among 855 healthy women of reproductive age was 1.58 (0.01, 8.78) μg/L. The reference range of AMH in healthy women of reproductive age in our region was established, that was, 0.89 to 10.94μg/L for 19-24 years old, 0.66 to 11.77 μg/L for 25-29 years old, 0.27 to 8.25μg/L for 30-34 years old, 0.01 to 6.87μg/L for 35-39 years old, 0.01 to 3.98μg/L for 40-44 years old, <0.01-1.87μg/L for 45-50 years old. Spearman correlation analysis showed that AMH was negatively correlated with age, body fat index (BMI), abdominal circumference, hip circumference, systolic blood pressure, diastolic blood pressure, TSH, TC, LDL-C (P<0.05), but not with blood glucose, TG, HDL-C, uric acid (P>0.05) .

In this study, the reference range of serum AMH in healthy women of reproductive age in Urumqi was established, which may provide a basis for the functional assessment of ovarian reserve in women of different ages. Low AMH levels in women of reproductive age are associated with cardiovascular risk factors such as increased age, obesity, abdominal obesity, hypertension, and hyperlipidemia.

Female railway workers are a high-risk group for obesity. Information technology is increasingly used in interventions for weight loss in overweight and obese populations. Daily self-weighing is a cognitive-behavioral strategy for self-monitoring of weight, but its effect on weight loss remains still controversial.

To investigate the effect of daily self-weighing plus online group interaction on weight loss and development of healthy lifestyle in overweight and obese female workers in Beijing Railway Bureau.

A prospective randomized controlled study was conducted. Participants were 72 overweight or obese female workers of Beijing Railway Bureau voluntarily recruited from June 1 to September1, 2019. They were equally randomized into an experimental group and a control group, receiving different weight loss interventions for 3 months (intervention scheme for the experimental group: individualized diet and exercise recommendations, daily self-weighing plus online group-based cognitive-behavioral therapy for weight loss, and that for the control group: individualized diet and exercise recommendations, and self-measurement of body weight with weight management counseling during the telephone or hospital follow-up once a month). Baseline and post-intervention data of both groups were collected, including composition indices (body weight, BMI, body fat percentage, fat content, waist circumference, hip circumference, waist-to-hip ratio), blood lipid indices〔total cholesterol (TC), triacylglyceride (TG), high-density liptein cholesterol (HDL-C), low-density liptein cholesterol (LDL-C) 〕and total score and dimension scores of the Health Promoting Lifestyle Profile-Ⅱ (HPLP-Ⅱ). Univariate and multivariate Logistic regression was used to explore factors associated with a 5% or more weight loss from baseline.

Seventy-one participants (35 cases and 36 controls) who completed the study were finally included for analysis. The each body composition index, each blood lipid index, and total score and dimension scores of the HPLP-Ⅱ were similar in both groups at baseline (P>0.05). After the intervention, the experimental group showed a significant decrease in the body composition indices (except the waist-to-hip ratio), blood lipid indices (except the HDL-C), and a significant increase in the total score and dimension scores of the HPLP-Ⅱ (P<0.05). However, no significant differences were found in each observation index in the control group before and after the intervention (P>0.05). Compared with the control group, the experimental group showed lower post-intervention body composition indices (except the waist-to-hip ratio) and blood lipid indices (except the HDL-C), and higher post-intervention total score and dimension scores of the HPLP-Ⅱ (P<0.05). A total of 22 participants (31.0%) had a weight loss of ≥5% from the baseline, including 16 cases (72.7%), and 6 controls (27.3%). Both univariate and multivariate Logistic regression analyses showed that intervention scheme and baseline nutrition status were the influencing factors of a 5% or more weight loss from baseline.

Daily self-weighing and online group-based cognitive-behavioral interventions contributed to weight loss, formation of a healthy lifestyle, and improvement in quality of life in overweight and obese female workers in Beijing Railway Bureau.

Chronic endometritis (CE) refers to chronic inflammatory condition of the endometrium. Recent studies have found that CE is closely associated with infertility, recurrent miscarriage, and recurrent implantation failure. However, there are no studies on CE prevalence in patients with first implantation failure and the outcome of re-pregnancy by assisted reproductive technology in these patients after antibiotic treatment.

To investigate CE prevalence in women who used in vitro fertilization & embryo transfer (IVF-ET) to assist in achieving a pregnancy but had failed first implantation and the impact of antibiotic treatment on the outcome of the next frozen-thawed embryo transfer in this group.

Women (n=381) who received IVF-ET to assist in achieving a pregnancy but had failed first implantation were selected from Henan Provincial People's Hospital from May 2017 to May 2021. 333 patients without CE were according to hysteroscopic and endometrial histopathological findings. 37 of CE patients were found with reversed (cured) clinical condition, but the other 11 still with unreversed (uncured) condition who were received antibiotic treatment . Clinical data and the outcome of the second assisted conception were compared between cured and uncured CE patients, as well as non-CE patients.

Cured and uncured CE patients and non-CE patients had no statistical differences in mean age, BMI, endometrial thickness on the day of embryo transfer, years of infertility, and number of embryos transferred, as well as the distribution of infertility type (P>0.05) . But they had statistical differences in success rates of embryo retransfer and pregnancy (P<0.05) . Cured CE patients and non-CE patients had higher success rates of embryo retransfer and pregnancy than did uncured CE patients (P<0.05) . There were no statistical differences in early abortion rates were found across cured and uncured CE patients and non-CE patients (P>0.05) .

CE should be treated by standard antibiotic treatment. Uncured CE may negatively influence the outcome of frozen-thawed embryo retransfer. So it is recommended that women with first implantation failure actively undergo hysteroscopy and endometrial histopathology so as to find possible causes of implantation failure.

The prevention and treatment of depression is a priority among mental health issues in China, and pregnant women are a key target group. Prenatal depression is easily ignored although it is highly prevalent and harmful. To reduce its prevalence, it is crucial to identifying the interaction mechanism between psychosocial factors (such as marital satisfaction and partner support) associated with prenatal depression, and controlling the modifiable risk factors.

To explore the relationship between marital satisfaction, partner phubing and depression in late-pregnancy women, and to assess the level of mediating effect of marital satisfaction on the relationship between the latter two, providing maternal and child healthcare professionals with evidence on interventions for prenatal depression.

Convenience sampling method was used to select women in late pregnancy who underwent routine prenatal check-ups in the Obstetrics Clinic, the First Affiliated Hospital of Anhui Medical University from October 2020 to May 2021. A self-designed general information questionnaire was used to collect sociodemographic and obstetric data. The Partner Phubbing Scale (PPS) was used to assess partner phubbing prevalence. The Quality of Marriage Index (QMI) was used to measure the level of marital satisfaction. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the prenatal depression prevalence. Mplus 8.3 was used to establish a structural equation model for mediation analysis.

Altogether, 300 cases were recruited. All of them were included for analysis except nine cases who returned unresponsive questionnaires, obtaining a survey response rate of 97.00%. The prenatal depression prevalence in the respondents was 40.89% (119/291) . The mean scores of PPS, QMI, and EPDS for them were (25.6±6.3) , (37.9±6.0) , and (8.0±3.5) , respectively. Correlation analysis showed that partner phubbing was negatively associated with marital satisfaction (r=-0.292, P<0.01) , and positively associated with prenatal depression (r=0.350, P<0.01) . Marital satisfaction level was negatively correlated with prenatal depression (r=-0.338, P<0.01) . Mediation analysis revealed that the size of direct effect of partner phubbing on prenatal depression was 0.214, accounting for 82.63% of the total effect. Marital satisfaction partially mediated the relationship between partner phubbing and prenatal depression, with a size of mediation effect of 0.045, accounting for 17.37% of the total effect.

Partner phubbing could positively predict depression in late pregnancy, and their relationship may be partially mediated by marital satisfaction. To reduce the prevalence of depression in late pregnancy, maternal and child healthcare professionals could improve the marriage of pregnant woman via providing them with interventions to decrease the prevalence of partner phubbing.