Isolated maternal hypothyroxinemia (IMH) is a manifestation of thyroid hormone deficiency during pregnancy, which may affect fetal neurodevelopment and increase the risk of miscarriage, preterm birth, and gestational diabetes. However, uncertainties remain regarding its specific mechanisms, optimal treatment plan, and long-term effects. This paper summarizes the differences in thyroid hormone levels between pregnancy and non-pregnancy states. By reviewing relevant literature, we provide a comprehensive analysis of the disease's etiology, its impact on both mother and infant, and treatment strategies. The paper suggests that iodine deficiency and iron deficiency are the primary causes of isolated hypothyroxinemia during pregnancy. However, conclusive evidence regarding the association of factors such as placental growth factor with the disease is still lacking. At present, the negative effects of IMH on perinatal motor and neurodevelopment are relatively clear, but the adverse pregnancy events associated with it have not been conclusively confirmed, and the underlying pathological mechanisms remain insufficiently understood. Regarding treatment, the efficacy and timing of thyroid hormone replacement therapy remain controversial and require further investigation. This paper reviews the current state of research on IMH, aiming to raise awareness among clinicians, promote early identification and intervention, and reduce the occurrence of related adverse maternal and neonatal outcomes.

Osteoporosis (OP) is a common clinical phenomenon in patients with knee osteoarthritis (KOA), but there lacks an unified homotherapy for heteropathy of OP and KOA.

To explore the multi-dimensional relationship of "traditional Chinese medicine (TCM) syndrome type- clinical feature-molecular typing" in patients with postmenopausal KOA, thus providing references for homotherapy for heteropathy of OP and KOA.

A total of 300 patients with postmenopausal KOA and treated with knee replacement surgery at the Joint Center of the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from 2021 to 2023 were retrospectively included. According to the results of bone density measurement (BMD), patients were divided into three groups: normal bone density group, osteopenia group, and osteoporosis group, with 100 patients in each group. The correlation between the TCM syndrome type and BMD was analyzed in postmenopausal KOA patients by a correspondence analysis. The clinical symptoms [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score], laboratory indicators [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum calcium, phosphorus, alkaline phosphatase (ALP), and lipids)], and imaging indicators [Kellgren-Lawrence (K-L) grade, hip knee ankle angle (HKA), joint line convergence angle (JLCA), tibial plateau subchondral area, and low-density area] were investigated and compared among postmenopausal KOA patients with different TCM syndrome types. The knee joint tissues of KOA patients with different TCM syndrome types were analyzed by molecular biology, and the key target molecules were clarified. Subsequently, the key targets obtained by bioinformatics were detected by Western Blotting and immunohistochemistry experiments, and their expression differences were compared. An initial molecular classification of TCM syndrome types was established in patients with postmenopausal KOA.

The main TCM syndrome types in postmenopausal women with KOA included the liver and kidney deficiency (n=122), Qi stagnation and blood stasis (n=96), cold and damp obstruction (n=72), and phlegm and blood stasis (n=10). Qi stagnation and blood stasis was the major TCM syndrome type in postmenopausal KOA patients with a normal BMD, while the liver and kidney deficiency dominant in those with decreased bone density and osteoporosis. There was a significant difference in the distribution of TCM syndrome times among the three groups (χ2=55.27, P<0.001). Logistic regression analysis showed that patients with the TCM syndrome of liver and kidney deficiency had a significantly higher risk of decreased bone density (OR=2.37, 95%CI=1.20-4.69, P=0.013) and osteoporosis (OR=3.39, 95%CI=2.41-4.76, P<0.001). Patients with the TCM syndrome of liver and kidney deficiency had significantly higher WOMAC body function scores and total WOMAC scores than those with Qi stagnation and blood stasis (P<0.05). There were no significant differences in ESR, CRP, total calcium, phosphorus, ALP, and four blood lipids between patients with the TCM syndrome types of liver and kidney deficiency, and Qi stagnation and blood stasis (P>0.05). The HKA was significantly smaller in patients with the TCM syndrome of liver and kidney deficiency than those with Qi stagnation and blood stasis, and the JLCA and tibial plateau subcutaneous low-density area were significantly larger (P<0.05). There was no significant difference in the area of the tibial plateau between the two TCM types of patients (P> 0.05). There was a significant difference in K-L grade between the TCM syndrome types of liver and kidney deficiency and Qi stagnation and blood stasis (P<0.05), with the former being R- significantly greater than the latter (P<0.05). Western Blotting and immunohistochemistry experiments showed that the expression levels of C-X-C chemokine ligand 8, tumor necrosis factor-alpha and interleukin-1beta molecules were significantly higher in patients with the TCM syndrome type of Qi stagnation and blood stasis, while the expression levels of peroxisome proliferator-activated receptor gamma, stearoyl-CoA desaturase and CCAAT/enhancer-binding protein alpha molecules were significantly higher in patients with the TCM syndrome type of liver and kidney deficiency (P<0.05).

The multidimensional relationships between "TCM syndrome type-clinical features-molecular typing" in postmenopausal KOA patients are as follows: patients with Qi stagnation and blood stasis have normal bone mass and increased expressions of inflammation-related molecules, and those with liver and kidney deficiency have decreased/osteoporotic bone mass and increased expressions of lipid metabolism-related molecules. Compared with Qi stagnation and blood stasis, patients with liver and kidney deficiency have a higher risk of decreased bone mass, osteoporosis, and lower limb inversion deformity. Their tibial plateau subchondral low-density area is significantly larger, knee function is significantly impaired, and the K-L grade is more severe.

In an environment where conventional therapeutic methods have limited effectiveness in treating endometrial hypoplasia, cellular therapies, especially stem cell technology, have demonstrated significant potential for innovation and efficacy. This review explored the advancements in menstrual stem cell (MenSC) research and examined the outcomes and future prospects of combining MenSCs with Chinese medicine for tonifying kidney and activating blood. We investigated the mechanisms of endometrial hypoplasia from the perspectives of pharmacological prescriptions and MenSCs, and subsequently discussed the potential of MenSCs, along with Chinese medicine for tonifying kidney and activating blood, within the innovative field of treating this condition. The purpose of this review was to promote the deep integration of regenerative medicine with Chinese medicine and materials science through summarizing the effectiveness of stem cell therapy, thereby revealing new strategies for more comprehensive and personalized treatment approaches.

With economic development and urbanization accelerating, rural women have become the primary labor force in their families, yet their health-related quality of life (HRQOL) is not optimistic. In the southern mountainous regions of Ningxia Hui Autonomous Region, due to geographical remoteness and limited educational levels, local rural women are more prone to neglecting their own health status.

To investigate the HRQOL of rural women in the southern mountainous regions of Ningxia Hui Autonomous Region and its impact on health service utilization, providing a theoretical basis for improving rural women's quality of life and rationally allocating health resources.

From July to October 2019, a multi-stage cluster random sampling method was used to survey 4 682 women from four counties in Ningxia Hui Autonomous Region. Demographic characteristics, family characteristics, health service accessibility, health status, HRQOL, and health service utilization information were collected. HRQOL was measured using the European Quality of Life-5 Dimensions-3 Levels (EQ-5D-3L) scale. A conditional Logistic regression model was used to analyze the impact of HRQOL on health service utilization.

The two-week outpatient visit rate for women in the southern mountainous regions of Ningxia Hui Autonomous Region was 12.43% (582/4 682), the one-year hospitalization rate was 22.53% (1 055/4 682), and the mean health utility value was (0.88±0.15). Among the five dimensions of the EQ-5D-3L, self-reported pain/discomfort had the greatest impact on outpatient service utilization (OR=1.797, 95%CI=1.470-2.196, P<0.05) and inpatient service utilization (OR=1.791, 95%CI=1.512-2.121, P<0.05). Multivariate Logistic regression analysis showed that, after adjusting for confounding factors, health utility values had an impact on both outpatient service utilization (OR=0.291, 95%CI=0.172-0.494, P<0.05) and inpatient service utilization (OR=0.239, 95%CI=0.146-0.391, P<0.05).

The quality of life of rural women in western China is not optimistic, and HRQOL is closely related to health service utilization. Therefore, it is necessary to further strengthen the construction of the primary health service system.

Delayed onset of lactogenesis (DOL) is an important cause for reduced exclusive breastfeeding rates. The dietary inflammatory index (DII) has been shown to be associated with a variety of adverse health outcomes, but the relationship with DOL is not well understood.

Understanding DII levels of women in the third trimester and exploring the impact on DOL.

A convenience sampling method was used to select women in the third trimester who underwent routine obstetric examinations in the First Affiliated Hospital of Anhui Medical University from December 2023 to June 2024 as the study subjects and were followed up until 72 hours postpartum, and the maternal self-perceived breast distension method was used to determine whether they were in the DOL population. General demographic characteristics and information related to pregnancy and childbirth were collected using a general information questionnaire, a food frequency questionnaire (FFQ) was used to collect information on dietary intake and calculates the DII, and the delivery and postpartum data questionnaire were used to collect relevant information about labor and postpartum. Exploring the relationship between DII and DOL using binary Logistic regression analysis and stratified the factors of age, preconception BMI, and presence of gestational diabetes mellitus.

A total of 228 questionnaires were distributed and 217 questionnaires were validly returned, with an effective recovery rate of 95.2%. Among them, 68 (31.3%) with DOL. The DOL and the non-DOL mothers were statistically different in terms of the number of pregnancies, the quality of sleep, gestational weight gain, and the presence of mother-infant separation after delivery (P<0.05). The pregnant women in the high DII group had a higher incidence of DOL than those in the middle and low DII groups according to the three quartiles of DII scores from smallest to largest (P<0.017). The results of binary Logistic regression analysis showed that the risk of DOL was 2.817 times higher in the high DII group than in the low DII group (95%CI=1.244-6.381, P=0.013). In the third trimester group of women aged<35 years with preconception BMI<24.0 kg/m², the risk of DOL in women with high DII levels was 3.144 times (95%CI=1.346-7.344, P<0.05) and 2.666 times (95%CI=1.072-6.630, P<0.05) higher than in women with low DII levels, respectively.

There was a correlation between DII and DOL, with higher DII increasing the risk of DOL, especially in the group of women in late pregnancy who are <35 years of age and with preconception BMI <24.0 kg/m². Maternal and child health care providers should provide individualized dietary guidance to pregnant women, increase the intake of anti-inflammatory diets to reduce the incidence of DOL and increase the rate of exclusive breastfeeding.

Endometriosis (EMT) is a common gynecological disorder. Although Kuntai capsule has been shown to alleviate EMT-related symptoms, its pharmacological and molecular mechanisms remain to be systematically elucidated.

To explore the mechanism of action of Kuntai capsule in the treatment of EMT.

From January 1 to April 30, 2024, the active components and corresponding targets of Kuntai capsule were obtained from the TCMSP, BATMAN-TCM, Pubchem, and SwissTargetPrediction databases. EMT-related disease targets were retrieved from GeneCards, DisGeNET, TTD, OMIM, and Drugbank. A Venn diagram was employed to identify the intersection targets of Kuntai capsule and EMT. The disease-component-target network was constructed using Cytoscape, and the common target protein-protein interaction (PPI) network was built using the STRING database. Topological analysis of the PPI network was performed using Cytoscape to screen for core targets. Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed using the DAVID database. Molecular docking was performed with AutoDockTools. The stability of the optimal binding energy model was further validated using GROMACS molecular dynamics simulations.

A total of 182 common targets were identified. The core components included sitosterol, panicolin, and rivularin. Among them, TNF, GAPDH, and AKT1 were found to play significant roles in the biological network of Kuntai capsule in treating EMT. These core targets were primarily involved in processes such as the negative regulation of apoptosis pathway and oncogenic pathway such as the PI3K-Akt signaling, which plays a ther-apeutic role in EMT. Molecular docking and molecular dynamics simulations further confirmed the stable and tight binding of sitosterol to AKT1.

Kuntai capsule may exert therapeutic effects in EMT by activating multiple signaling pathways through the regulation of core targets such as TNF. These findings not only enhance our understanding of the mechanism of action of Kuntai capsule but also provides new insights into the potential clinical applications of traditional Chinese medicine (TCM) in EMT treatment. Future research can further explore how TCM drugs can intervene in the pathological processes of EMT.

Perimenopausal depressive disorder (PDD) is a serious mood disorder that occurs before and after menopause, traditional Chinese medicine have advantages such as holistic regulation and syndrome differentiation and treatment in treating PDD, but currently lacks a specialized traditional Chinese medicine efficacy evaluation tool for PDD.

To introduce patient-reported outcomes (PROs) and construct a PDD-PROs scale and its theoretical model under the guidance of traditional Chinese medicine theory.

From April to June 2022, computer searches were conducted on databases such as CNKI, Wanfang Data, VIP, SinoMed, PubMed, Web of Science, and Cochrane Library for literature on traditional Chinese medicine treatment of PDD published up to April 17, 2022, and literature analysis was performed. From September to November 2022, a retrospective analysis of the medical records of 136 PDD patients who visited the outpatient departments of Shenzhen Hospital (Longgang), Beijing University of Chinese Medicine, and Dongfang Hospital of Beijing University of Chinese Medicine from January 2017 to August 2022 was conducted. Based on a self-designed interview outline, one-to-one semi-structured interviews with PDD patients were conducted to establish an item pool. A multidisciplinary expert consultation group related to PDD was selected and established, and three rounds of expert consensus using the Delphi method began in December 2022.

A total of 123 articles were included, involving 5 categories and 12 postmenopausal depression outcome evaluation scales. Retrospective medical record analysis and patient interviews showed that, the cumulative frequency of clinical symptoms of PDD was 1 465 times, involving 176 clinical symptoms. After three rounds of expert consensus using the Delphi method, the Traditional Chinese Medicine PROs Scale for PDD and its theoretical model were ultimately formed, including 4 dimensions (psychological dimension, physiological dimension, social dimension, and overall evaluation) and 43 items.

This study introduced the internationally mature PROs, used literature analysis, medical record review, and patient interview methods to construct an item pool, and successfully constructed the PDD-PROs scale and its theoretical model through three rounds of expert consensus using the Delphi method under the guidance of traditional Chinese medicine theory, which can be used in the research of efficacy evaluation of traditional Chinese medicine TCM treatment for PDD.

According to WHO, 37% of pregnant women suffer from anemia. Anemia in pregnant women increases the risk of adverse pregnancy outcomes, with inflammatory anemia being particularly common. During pregnancy, the body experiences chronic low-grade inflammation, and dietary quality plays a crucial role in linking inflammation levels to pregnancy outcomes. The Dietary Inflammatory Index (DII) is a tool to assess the inflammatory potential of diets, and various dietary patterns exert distinct effects on inflammation.

To assess the dietary inflammatory potential of pregnant women using the DII, identify predominant dietary patterns, and explore the association between the DII and the risk of developing anemia in pregnancy across different dietary patterns.

Pregnant women aged ≥18 years who regularly attended maternity checkups at the First Affiliated Hospital of Shihezi University from April 2023 to April 2024 were enrolled in the study. Data on demographics, lifestyle behaviors, and dietary intake were collected. Socio-demographic and lifestyle behavioral information were obtained through questionnaires. The Food Frequency Questionnaire (FFQ) was used to assess dietary intake, calculate the DII, and stratify pregnant women into tertiles based on the DII: the lowest tertile (T1), the second tertile (T2), and the highest tertile (T3). Principal component analysis was used to assess food groups and extract dietary patterns. Multivariable Logistic regression analysis was performed to estimate the association between the DII, dietary patterns, and the risk of anemia in pregnancy. Dose-response relationships were analyzed using restricted cubic spline (RCS) plots.

A total of 653 pregnant women were included, with DII scores ranging from -4.87 to 3.37, the average value was (0.36±1.94). Participants were stratified into tertiles: 217 in T1, 218 in T2, and 218 in T3. Among them, 172 (26.3%) were diagnosed with anemia during pregnancy, with a mean DII of (0.64±1.95). Four dietary patterns were identified: diversity, fish-shrimp-legumes, milk-egg, and processed food patterns. Multivariable Logistic regression analysis revealed a positive association between DII and the risk of anemia during pregnancy after adjusting for confounders (OR=1.21, 95%CI=1.05-1.39, P<0.05). In the overall population, the risk of anemia in the T3 group was 3.05 times higher than in the T1 group (95%CI=1.62-5.75, P<0.05). Among women characterized by milk-egg and processed food patterns, the risk of anemia in the T3 group was 7.69 times (95%CI=1.67-35.45, P<0.05) and 5.17 times (95%CI=1.29-20.63, P<0.05) higher than in the T1 group, respectively. RCS analysis showed that in the overall population, a DII>0.7 was associated with an increased risk of anemia during pregnancy.

The inflammatory potential of the diet is positively associated with the risk of anemia during pregnancy, particularly among women characterized by milk-egg and processed food patterns. Therefore, reducing the consumption of pro-inflammatory foods and promoting a balanced diet are essential.

In rural areas, the self-management levels of pregnant women not only remain generally low but also vary significantly among individuals, thereby necessitating a detailed investigation into their behavioral patterns to facilitate their classification into distinct groups.

This analysis explores the types and characteristics of self-management among pregnant women in rural areas to provide references for devising targeted management strategies.

From January to August 2023, a convenience sampling method was employed to select pregnant women from Suihua City and Daqing City in Heilongjiang Province, and Changchun City in Jilin Province. Surveys were conducted using a general data questionnaire, a self-management scale for pregnant women, a general self-efficacy scale, an internal motivation scale, and a prenatal care knowledge scale. Cluster analysis was performed using SPSS 25.0 to classify the subjects into different types based on their self-management traits and compare their general characteristics.

A total of 481 questionnaires were distributed, and 470 valid questionnaires were retrieved, with a valid questionnaire recovery rate of 97.7%. It was found that the total score for self-management behaviors among the surveyed rural pregnant women stood at (70.2±16.4). Four distinct types were identified through optimal clustering: typeⅠ, characterized by low awareness non-participants (25.3%, n=119) ; typeⅡ, those who engage through guided cooperation (29.4%, n=138) ; typeⅢ, those under supervised directive (18.7%, n=88) ; and typeⅣ, proactive participants (26.6%, n=125). Noteworthy were the significant statistical differences that emerged across such variables as educational backgrounds, occupations, annual incomes, number of pregnancies, gestational weeks, whether pregnancies were planned, histories of chronic diseases, and complications during pregnancy among the four types (P<0.05). Furthermore, the comparison of scores across different self-management dimensions revealed significant statistical differences, with adherence to medical advice scoring the highest and fetal monitoring behavior scoring the lowest (P<0.05) .

The four types of self-management among rural pregnant women, identified based on differentiated characteristics in prenatal care knowledge, self-efficacy, and behavioral motivation, exhibit a high degree of heterogeneity. Type Ⅰ, characterized by low awareness non-participants, faces the dual challenge of inadequate knowledge reserves and lack of behavioral motivation. Type Ⅱ, those who engage through guided cooperation, is marked by low self-efficacy but good compliance with external guidance. TypeⅢ, those under supervised directive, lacks intrinsic motivation and relies heavily on external supervision for regulating self-management behaviors. Type Ⅳ, proactive participants, represents the most optimal group, possessing strong prenatal care knowledge, high self-efficacy, and effective self-management behaviors. Therefore, in clinical practice, targeted intervention strategies can be developed according to each type, in order to further enhance the self-management capabilities of rural pregnant women and optimize prenatal care services.

Depression and anxiety are among the most frequently observed adverse emotional states in pregnant women. The inadequacy of mental health services and the paucity of external support often result in the psychological well-being of rural expectant mothers being overlooked, thereby exerting a profound impact on both maternal and neonatal health.

This study, adopting a socio-ecological framework, explores the emotional regulation experiences of rural pregnant women in China, aiming to furnish empirical insights that may inform early intervention strategies for primary healthcare practitioners.

A purposive sampling strategy was utilized to recruit rural pregnant women exhibiting negative emotional experiences from villages under the jurisdiction of Anda City, Suihua, Heilongjiang Province, and Honggang District, Daqing, Heilongjiang Province, during the period spanning October 1 to December 1, 2023. Participants were enlisted through outreach medical consultations and maternal health record registration conducted by higher-tier maternal and child health institutions. Semi-structured interviews were employed for data collection, with information gathered via audio recordings and subsequently transcribed verbatim. The collected data underwent rigorous analysis through Colaizzi's descriptive phenomenological framework, executed by two independent coders.

A total of 13 participants were incorporated into the study. Through meticulous examination of the interview data, three principal themes and eleven subordinate sub-themes were delineated: (1) Microsystemic level: the ramifications of somatic symptoms, amplified anxieties regarding childbirth, perturbations in self-perception, and substantive alterations in lifestyle. (2) Mesosystemic level: the precipitous escalation in child-rearing expenditures, pronounced familial discord, and a dearth of peer support mechanisms. (3) Macrosystemic level: suboptimal healthcare encounters, insufficiencies in informational support, structural disequilibrium between service provision and demand, and intensifying societal pressures.

The emotional adversities confronted by rural pregnant women emanate from a constellation of interwoven determinants. Mitigating these psychological challenges necessitates a holistic and stratified approach that engages the expectant mothers themselves, their familial environments, and the grassroots medical infrastructure. Recognizing and refining the emotional regulation experiences of rural pregnant women through empirically substantiated, tailored interventions is paramount. Such efforts are pivotal in augmenting their emotional resilience and, consequently, advancing maternal and neonatal health outcomes.

Cardiovascular disease (CVD) is a major threat to the health of women, particularly postmenopausal women, who are at higher risk. The reduction in estrogen levels following menopause may contribute to visceral fat accumulation, which is closely linked to insulin resistance, chronic inflammation, and lipid metabolism disorders, potentially increasing the risk of CVD. However, the relationship between Chinese visceral adipose index (CVAI) and CVD risk in this population remains insufficiently explored.

To explore the relationship between CVAI and CVD in postmenopausal women, and thereby provide information on the prevention of CVD in this high-risk population.

Based on the data of China Health and Retirement Longitudinal Study (CHARLS) from 2015 to 2020, we enrolled 4 743 postmenopausal women aged≥45 years free of CVD at baseline in 2015. The CVAI at baseline was used as the exposure, while incident CVD events during follow-up in 2018 and 2020 served as the outcome. Cox proportional hazards regression models were employed to assess the association between CVAI and CVD risk. Restricted cubic spline (RCS) analysis was further applied to evaluate potential dose-response relationships.

At the end of the follow-up period, the incidence rates of CVD, heart disease, and stroke among the 4 743 postmenopausal women were 20.2% (958/4 743), 13.6% (645/4 743), 8.3% (393/4 743), respectively. The participants were stratified into quartiles based on their baseline CVAI levels, with the following cutoff values: Q1 (≤84.78)(n=742), Q2 (84.78, 108.49)](n=1 249), Q3 (108.49, 132.01](n=1 463), and Q4 (>132.01)(n=1 289). After adjustment for confounding factors, Cox proportional hazards regression showed that compared to the Q1 reference group, women in the CVAI Q2, Q3 and Q4 groups faced significantly elevated risks, the risk of CVD increased by 33% (HR=1.33, 95%CI=1.00-1.76) in Q2, 69% (HR=1.69, 95%CI=1.29-2.21) in Q3 and 82% (HR=1.82, 95%CI=1.38-2.14) in Q4, the risk of stroke increased by 76% (HR=1.76, 95%CI=1.10-2.82) in Q3, 95% (HR=1.95, 95%CI=1.21-3.14) in Q4, and the risk of heart disease increased by 57% (HR=1.57, 95%CI=1.14-2.15) in Q3, and 68% (HR=1.68, 95%CI=1.21-2.33) in Q4, respectively. RCS analysis confirmed dose-response relationships between CVAI and risks of CVD, heart disease, and stroke (P<0.05). Subgroup analyses further indicated that the association between CVAI and CVD risk remained significant only among women aged <65 years, ≥65 years, those with BMI<24.35 kg/m², and rural residents (P<0.05).

Elevated CVAI significantly increases CVD risk in postmenopausal women, particularly in those with lower BMI, or residing in rural areas. Targeted monitoring and management of visceral obesity in these high-risk subgroups are warranted to mitigate CVD incidence.

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.

Protecting female fertility stands as a central goal and vision in a fertility-friendly society, and fallopian tube recanalization offers the possibility of pregnancy for patients with tubal infertility.

This study aims to accurately identify the influencing factors affecting successful pregnancy after fallopian tube recanalization and explore the application of the random forest algorithm in screening and predicting pregnancy influencing factors in such patients.

The study collected and analyzed data from 170 patients who underwent laparoscopic combined with hysteroscopic fallopian tube recanalization at Capital Medical University Affiliated Beijing Shijitan Hospital between 2016 and 2018. Based on whether the patients achieved successful natural pregnancy within 2 years after the surgery, they were divided into the pregnancy and non-pregnancy groups. Using the R software, a random forest model for predicting pregnancy risk after tube recanalization was established on the training data set (108 cases, 63.2% of cases, extracted via Bootstrap method), and its prediction accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC) were evaluated on the verification data set.

The study comprised 82 cases in the pregnancy group and 88 in the non-pregnancy group, with a spontaneous pregnancy rate of 48.2% post-surgery. The random forest algorithm, trained on the training set, demonstrated robust predictive capability upon validation, with an accuracy of 87.1%, sensitivity of 93.1%, specificity of 81.8%, positive predictive value of 81.8%, negative predictive value of 93.1%, and an AUC of 0.921. The random forest algorithm was employed to rank the importance of factors influencing pregnancy following fallopian tube recanalization by using variable importance scores. The analysis identified the top three significant predictor variables: duration of infertility, history of previous pregnancies, and patient age.

The random forest algorithm emerges as a viable tool for predicting factors influencing pregnancy after fallopian tube recanalization. The predictive model, predicated on infertility duration, history of prior pregnancies, and age, exhibits notable discrimination and accuracy. Early identification of key factors post-recanalization allows for timely and effective interventions. We recommend that patients presenting risk factors consider utilizing assisted reproductive technology to improve pregnancy rates.

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.

Accurate preoperative assessment of lymph node metastasis in patients with epithelial ovarian cancer is of great significance for formulating treatment plans and assessing prognosis. Radiomics technology has been used as a non-invasive means to predict lymph node metastasis in various cancers before surgery, but there are few research reports on its application effects in the field of gynecological cancer.

To construct a predictive model for lymph node metastasis in patients with epithelial ovarian cancer using radiomics technology based on ¹⁸F-fluorodeoxyglucose positron emission tomography with integrated computed tomography (¹⁸F-FDG PET/CT) .

A total of 98 patients with epithelial ovarian cancer admitted to the Department of Gynecology, the Second Xiangya Hospital of Central South University from September 2020 to December 2022 were selected, according to the lymph node metastasis status, they were divided into lymph node metastasis group (n=65) and non-lymph node metastasis group (n=33), into training set of 68 cases and validation set of 30 cases in a 7∶3 ratio at the same time. All patients' clinical characteristics were analyzed, and the lymph node metastasis status was used as the result label for model construction.

The lymph node metastasis rate in patients with epithelial ovarian cancer was 66.3% (65/98) in this study. There was a statistically significant difference in the level of human epididymal protein 4 (HE4) and location of the primary lesion between lymph node metastasis group and non-lymph node metastasis group (P<0.05). Multivariate Logistic regression analysis showed that, HE4 level, location of the primary lesion, and Radscore were predictive factors for lymph node metastasis in patients with epithelial ovarian cancer (P<0.05). The clinical predictive model was constructed using HE4 level and location of the primary lesion, the combined predictive model was constructed using HE4 levels, location of the primary lesion, and Radscore. Delong's test showed that, the combined predictive model had an AUC of 0.80 (95%CI=0.70-0.90) for predicting lymph node metastasis in the training set of patients with epithelial ovarian cancer, which was higher than that of the clinical predictive model (AUC=0.73, 95%CI=0.61-0.85) (P=0.042). The calibration curve showed that, the combined predictive model passed the calibration test (P=0.990), had good discrimination ability. Decision curve (DCA) analysis showed that, both the clinical and combined predictive models had good predictive performance, but the net benefit of the combined predictive model was higher.

We successfully constructed the combined predictive model for lymph node metastasis in patients with epithelial ovarian cancer using radiomics technology based on ¹⁸F-FDG PET/CT, with high robustness, good discrimination ability, and relatively high net benefit, which can be used for clinical doctors to formulate individualized treatment plans for patients and assess patients' prognosis.

Limited research currently exists on the relationship between remnant cholesterol (RC) and maternal depression as well as pregnancy stress.

To explore the relationship between factors such as RC and maternal depression and pregnancy stress in the second trimester, providing a scientific foundation for clinical identification and intervention strategies.

Pregnant women in early pregnancy (6 to 13⁺⁶ weeks of gestation) who attended regular prenatal check-ups at the Obstetrics Department of the Second Affiliated Hospital of Xinjiang Medical University from June 2020 to April 2024 were recruited as study participants. A longitudinal study design was adopted to collect baseline data and blood lipid indicators of pregnant women, followed up until the second trimester, and used the Edinburgh Postpartum Depression Scale (EPDS) and Pregnancy Pressure Scale (PPS) to evaluate the depression and stress of pregnant women. Multi-factor Logistic regression analysis was used to construct a prediction model for maternal depression and pregnancy stress. In order to further determine the factors that have the greatest impact on the outcome, the random forest (RF) algorithm was used to build the model again, and the SHAP tool was used to visually analyze the RF model results.

This study followed 403 pregnant women from the first trimester to the second trimester, with 323 valid responses collected, resulting in a follow-up loss rate of 19.9%. After excluding inaccurate baseline data, 279 pregnant women were included in the final analysis. Results indicated that the incidence of depression was 38.7% (108/279), and the incidence of pregnancy stress was 20.8% (58/279). RC levels were significantly higher in pregnant women with depression and pregnancy stress than in those without (P<0.05). Multivariate Logistic regression identified pregnancy planning (OR=0.441, 95%CI=0.251-0.775), breakfast frequency (OR=5.086, 95%CI=2.105-12.270), and RC (OR=2.759, 95%CI=1.157-6.580) as significant factors influencing depression during the second trimester (P<0.05). Additionally, taking a midday rest (OR=0.513, 95%CI=0.276-0.953) and RC (OR=3.747, 95%CI=1.519-9.246) were significant factors associated with pregnancy stress (P<0.05). The SHAP analysis indicated that RC was the most influential factor affecting maternal depression and pregnancy stress in the second trimester.

Elevated RC levels may increase the risk of depression and stress-related events in pregnant women during the second trimester. Future research involving larger cohort studies or clinical trials is necessary to confirm these findings and elucidate causal relationships.

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.

Hypertensive disorders of pregnancy (HDP) is one of the most common complications of pregnancy and one of the leading causes of maternal mortality worldwide. In 2023, the Society of Obstetricians of Australia and New Zealand released the A Summary of the 2023 Society of Obstetric Medicine of Australia and New Zealand Hypertension in Pregnancy Guideline. This article interprets its key contents and proposes suggestions on non-drug intervention measures and refined management processes for HDP in China, in order to provide a new basis for the management of HDP in China.

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.

Cervical cancer, a prevalent malignancy in women, has a well-established etiology and can be effectively prevented through standardized screening. The WHO recommends HPV testing as the primary method for cervical cancer screening. Understanding the status of high-risk human papillomavirus (hrHPV) infection in Chengdu is crucial for optimizing primary hrHPV screening.

To investigate the hrHPV infection status among cervical cancer screening participants aged 35-64 years in Chengdu, and explore the related factors affecting the positive detection rate of hrHPV.

We retrospectively analyzed data from 459 433 women who received free cervical cancer screening in Chengdu in 2023, sourced from the "Chengdu Reproductive Health Database of Women of Childbearing Age". We analyzed the overall distribution of different hrHPV genotypes and the distribution of hrHPV subtypes in patients with cervical lesions, and compared the hrHPV infection in different populations. Multivariate Logistic regression models identified factors affecting the positive detection rate of hrHPV.

The hrHPV prevalence among participants was 11.65% (53 509/459 433), with an increase observed with age (χ²=1 501.082, P<0.001). Among cervical cancer patients, 82.39% (131/159) were infected with HPV 16 or 18, predominantly with simple HPV 16 infection (52.20%, 83/159). Multivariate Logistic regression analysis revealed that age, education level, marital status, menopausal status, contraceptive method, gravidity, and parity were significant factors influencing the positive detection rate of hrHPV (P<0.05) .

The hrHPV infection prevalence in Chengdu is slightly lower than the national average. The findings suggest a need for targeted health education and follow-up, particularly for patients positive for HPV 16 or 18. Emphasis should be placed on carrying out related publicity to groups such as the elderly, less educated, unmarried or divorced/widowed, postmenopausal women, those not using contraception or using methods other than condoms, and women with gravidity and parity more than twice, so as to strengthen the publicity of the core knowledge of cervical cancer prevention and control and reproductive health knowledge, and improve women's health literacy.

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.

Gestational diabetes mellitus (GDM) is closely related to the short-term and long-term health outcomes of the mothers and offspring. Pre-pregnancy BMI is strongly associated with GDM, nevertheless, it does not distinguish between body fat content and fat distribution. Only using it to assess obesity is flawed. Normal weight obesity (normal BMI but body fat percentage above 30%) and normal weight with central obesity (normal BMI but visceral fat area above 80 cm²) show different degree of metabolic dysregulation. However, those population are usually overlooked in clinical practice and there is a paucity of research on those population and GDM.

To explore the correlation between body composition in early pregnancy and GDM in a population of normal pre-pregnancy BMI, and to investigate the relationship between fat distribution and GDM.

We performed a study that included 1 938 singleton pregnant women registered in the obstetric out-patient clinic of Beijing Obstetrics and Gynecology Hospital, Capital Medical University from October 2018 to October 2022. They voluntarily underwent nutritional assessment in early pregnancy and had regular pregnancy check-ups until 24-28 weeks of gestation, who underwent body composition testing in early pregnancy (6-16 weeks) and oral glucose tolerance test (OGTT) at 24-28 weeks. According to the OGTT results, the study population were divided into the GDM group (n=382) and the normal group (n=1 556). We estimated the relationship between body composition and fat distribution with GDM in early pregnancy with binary Logistic regression.

Body fat mass (BFM), visceral fat area (VFA), percentage body fat (PBF), and fat mass index (FMI) in the GDM group were higher than in the normal group (P<0.05). BFM, VFA, PBF, FMI (OR=1.044, 95%CI=1.012-1.078; OR=1.007, 95%CI=1.002-1.012; OR=1.041, 95%CI=1.012-1.070; OR=1.138, 95%CI=1.043-1.241) (P<0.05) and central obesity (VFA≥80 cm²) (OR=1.396, 95%CI=1.101-1.770, P<0.05) associated with a significant increased risk for GDM with binary Logistic regression analysis. Spearman rank correlation analysis showed that BFM, VFA, PBF, FMI and blood glucose of the OGTT test were positively correlated (P<0.05) .

Among normal pre-pregnancy BMI women, BFM, VFA, PBF, and FMI in early pregnancy were the risk factors of GDM. Central obesity (VFA≥ 80 cm²) could independently predict the development of GDM. It is necessary to pay attention to fat distribution during pregnancy check-ups and to strengthen the pregnancy management for central obesity women.

Given the increased risk of adverse pregnancy outcomes in pregnant women with type 2 diabetes, in addition to glycemic control, it is crucial to understand the relationship between gestational weight gain and adverse pregnancy outcomes.

To investigate the gestational weight gain in pregnant women with type 2 diabetes and its relationship with pregnancy outcomes.

A retrospective analysis was conducted on 691 cases of pregnant women with type 2 diabetes who underwent prenatal care and delivery at Beijing Obstetrics and Gynecology Hospital, Capital Medical University, from 2012 to 2020. According to the Chinese "Standard of Recommendation for Weight Gain during Pregnancy Period", the participants were categorized into the inadequate weight gain group (n=143), appropriate weight gain group (n=289), and excessive weight gain group (n=259). The gestational weight gain characteristics, maternal outcomes, and neonatal outcomes were compared among the three groups. Multivariate Logistic regression analysis was employed to explore the impact of gestational weight gain on pregnancy outcomes.

The results of multivariate Logistic regression analysis showed that compared to the appropriate weight gain group, the excessive weight gain group had increased risks of cesarean section (aOR=1.626, 95%CI=1.110-2.382), preeclampsia (aOR=1.997, 95%CI=1.071-3.677), macrosomia (aOR=1.948, 95%CI=1.175-3.230), and large for gestational age (LGA) (aOR=2.090, 95%CI=1.321-3.306), while reducing the rate of vaginal delivery (aOR=0.617, 95%CI=0.415-0.918). The inadequate weight gain group was associated with a reduced risk of delivering LGA (aOR=0.497, 95%CI=0.255-0.970), with no impact on small for gestational age (SGA) (P>0.05). Further stratified analysis revealed that excessive weight gain group with pre-pregnancy BMI≥24.0 kg/m² increased the risks of cesarean section, preeclampsia, LGA [aOR and 95%CI were 1.673 (1.082-2.587), 1.961 (1.022-3.761), 2.031 (1.221-3.379), respectively], while reducing the rate of vaginal delivery (aOR=0.589, 95%CI=0.372-0.933). The inadequate weight gain group with pre-pregnancy BMI≥24.0 kg/m² showed a decreased risk of delivering LGA (aOR=0.487, 95%CI=0.237-0.999). Excessive weight gain during early, middle, and late pregnancy was identified as a risk factor for macrosomia [aOR and 95%CI were 1.07 (1.00-1.15), 1.16 (1.03-1.31), and 1.16 (1.06-1.27), respectively] and LGA [aOR and 95%CI were 1.08 (1.01-1.16), 1.13 (1.02-1.26), and 1.16 (1.07-1.26), respectively]. Excessive weight gain during late pregnancy was associated with gestational hypertension and preeclampsia (aOR=1.13, 95%CI=1.02-1.24; aOR=1.14, 95%CI=1.03-1.26), while excessive weight gain during middle and late pregnancy was a risk factor for cesarean section (aOR=1.11, 95%CI=1.02-1.21; aOR=1.09, 95%CI=1.02-1.17) .

Excessive gestational weight gain increases the risk of adverse pregnancy outcomes such as LGA, macrosomia, preeclampsia, and cesarean section in women with type 2 diabetes during pregnancy. Inadequate gestational weight gain reduces the risk of LGA, but does not increase the risk of SGA. There is a clear correlation between gestational weight gain during different stages of pregnancy and adverse pregnancy outcomes. Therefore, optimizing blood glucose levels during pregnancy in patients with type 2 diabetes should be accompanied by enhanced education and interventions on weight gain management from preconception and early pregnancy stages.

Hypertensive disorders of pregnancy (HDP) is one of the leading causes of maternal and perinatal mortality worldwide, with increasing incidence and mortality year by year. In 2023, the U.S. Preventive Services Task Force (USPSTF) updated the recommendation statement on screening for hypertensive disorders of pregnancy by evaluating the latest research evidence and analyzing the benefits and harms of screening for HDP. The recommendation, compared with the 2017 version, further affirms the importance of blood pressure measurement in screening for HDP, affirms substantial net benefit, and recommends blood pressure measurement throughout pregnancy to screen for HDP. This article explores and analyzes the key points of this recommendation based on the RIGHT statement for introductions and interpretations of guidelines in Chinese (RIGHT for INT) and its implications for guiding general practitioners in China.

Polycystic ovary syndrome with insulin resistance (PCOS-IR) is recognized as one of the most challenging subtypes of PCOS to treat due to its intricate pathogenesis and significant individual variability. Although Metformin, as a first-line medication, can ameliorate blood glucose levels and enhance insulin sensitivity, its efficacy in regulating hormonal imbalances and improving ovarian function is limited. Additionally, its gastrointestinal side effects often hinder patient adherence.

To evaluate the efficacy and safety of Yishen Quzhuo Formula compared to metformin in the treatment of PCOS-IR.

A prospective study enrolled 102 PCOS-IR patients from June 2022 to October 2023 at the Department of Gynecology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University. Patients were randomly assigned in a 2∶1 ratio to the experimental group (n=68) treated with Yishen Quzhuo Formula or the control group (n=34) treated with metformin. The comparison was made between the two groups in terms of ovulation rate, pregnancy rate, sex hormones [follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH ratio, testosterone (T), anti-Müllerian hormone (AMH) ], glucose and lipid metabolism indicators, BMI, waist-hip ratio (WHR), and incidence of adverse reactions.

After treatment, the basal body temperature (BBT) ovulation rate in the experimental group increased compared to before treatment (P<0.05). Among patients with a desire for fertility in the experimental group, 13 cases resulted in pregnancy, while in the control group, with 5 such cases, only 1 resulted in pregnancy. The comparison of pregnancy rates between the two groups after treatment showed no statistically significant difference (χ²=1.154, P>0.05). After treatment, both groups showed a decrease in LH/FSH compared to before treatment (P<0.05). Following treatment, both groups showed a decrease in fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), and triglycerides (TG) compared to before treatment (P<0.05). Following treatment, there was no statistically significant difference in high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) between the two groups compared to before treatment (P>0.05). After treatment, the waist circumference of the control group was lower than that of the experimental group (P<0.05). After treatment, the BMI, waist circumference, hip circumference, and waist hip ratio of both groups of patients decreased compared to before treatment (P<0.05). After treatment, alanine aminotransferase (ALT) and uric acid (UA) in the experimental group decreased compared to before treatment, while UA in the control group increased compared to before treatment (P<0.05). After treatment, there was no statistically significant difference in other indicators between the two groups compared to before treatment (P>0.05). During treatment, adverse reactions such as hypoglycemia, fatigue, epigastric discomfort, and diarrhea occurred in patients, with a lower incidence of adverse reactions in the experimental group (5/68, 7.35%) than in the control group (15/31, 48.39%) (χ²=20.404, P<0.001) .

Yishen Quzhuo Formula regulates hormone imbalance, improves glucose and lipid metabolism abnormalities, and is as effective as metformin in treating PCOS-IR. It exerts protective effects on liver and kidney function and exhibits superior tolerance over metformin in reducing adverse reactions. Given metformin's gastrointestinal side effects, patients demonstrate better tolerance and acceptance of Yishen Quzhuo Formula, thus warranting its clinical promotion and application.

Adenomyosis (AM) is a common and difficult gynecological disease, but its specific mechanism has not been fully elucidated. Traditional Chinese Medicine (TCM) has certain advantages in the treatment of AM, preliminary studies have shown that Guilou compound-releasing intrauterine system can significantly reduce the proliferation and invasion ability of endometrial cells in rats with AM model.

To investigate the effect of Guilou compound on the migration and invasion of human adenomyosis derived cells (AMDC), and study its effect on Rho/ROCK signaling pathway.

The experiment was completed from October 2021 to April 2023 in Central Laboratory of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine. The CCK-8 assay was used to detect AMDC cell viability and screen the optimal drug concentration. AMDC were treated with Guilou compound (50 and 100 mg/L), and the cell migration viability was detected by scratch assay, and cell invasion ability was detected by Transwell assay. The expression of RhoA, RhoB, RhoC, ROCK1, and ROCK2 at protein and mRNA levels was detected by Western Blotting/RT-qPCR assay. In the Rescue experiment, AMDC were treated with agonist U-46619 (1 μmol/L) and Guilou compound (100 mg/L), and the protein expression of RhoA, RhoB, RhoC, ROCK1, and ROCK2 was detected by Western Blotting.

Compared with the control group, the survival rate of AMDC treated with 100 mg/L mass concentration of Guilou compound was not significantly decreased (P>0.05), which was the optimal drug concentration without affecting the cell viability, 50 and 100 mg/L mass concentrations of Guilou compound were selected for subsequent experiments. Compared with the control group, the migration and invasion ability of AMDC in the Guilou compound (50 mg/L, 100 mg/L) group was significantly inhibited (P<0.001), the protein and mRNA expression levels of RhoA, RhoC, ROCK1, and ROCK2 were significantly down-regulated (P<0.001), while the protein expression of RhoA, RhoC, ROCK1 and ROCK2 in the U-46619 1 μmol/L group were significantly up-regulated (P<0.001). Compared with the U-46619 1 μmol/L group, the protein expression of RhoA, RhoC, ROCK1, and ROCK2 in the U-46619 (1 μmol/L) combined with Guilou compound (100 mg/L) group was significantly down-regulated (P<0.001). There was no significant difference in protein and mRNA expression levels of RhoB in the control group and Guilou compound (50 mg/L, 100 mg/L) group (P>0.05) .

Guilou compound can effectively inhibit the migration and invasion ability of AMDC with the optimal drug concentration of 100 mg/L that does not affect the cell viability, Guilou compound can reverse the up-regulation of U-46619 on the protein expression of RhoA, RhoC, ROCK1 and ROCK2, thus inhibiting the the continuous progression of ectopic lesions of AM, which may be closely related to the regulation of Rho/ROCK pathway.

The prevalence of pelvic floor dysfunction in postmenopausal women is progressively increasing, leading to a significant impact on both physical and mental well-being due to stress urinary incontinence (SUI) .

To investigate the impact of menopausal hormone therapy (MHT) in conjunction with Kegel exercises on pelvic floor structure and clinical symptoms in individuals experiencing mild to moderate SUI.

A total of 75 patients with menopausal syndrome accompanied by mild to moderate SUI who visited the Menopause Clinic at Beijing Shijitan Hospital, Capital Medical University in 2022 were selected. They were allocated into the MHT group and the control group in a 2∶1 ratio using a random number table method, and the MHT group was further randomly divided into subgroups receiving Tibolone and estrogen combined with progestogen therapy (EPT) in a 1∶1 ratio. Both the control group and the MHT group underwent pelvic floor muscle training (PFMT), commonly referred to as Kegel exercises, for 15-30 minutes per session, 2-3 times daily, and 2-3 d per weekly, over a continuous period of 12 months. The control group received Kuntai capsules orally in combination with PFMT, with 4 capsules taken per dose, 3 times a day, for 12 months. The MHT group received menopausal hormone therapy in conjunction with PFMT. The EPT subgroups include continuous combined estrogen-progestin therapy (1 mg estradiol valerate + 10 mg dydrogesterone, once daily), continuous sequential estrogen-progestin therapy (femoston 12 courses), and the Tibolone subgroup takes tibolone orally, all of which were administered continuously for 12 months. The study examined serum estradiol (E2) and follicle-stimulating hormone (FSH) levels within and between groups and subgroups before and after treatment. In addition, measurements were obtained for urethral rotation angle (URA), bladder detrusor thickness (BDT), posterior vesicourethral angle (PVUA), levator hiatus area (LHA), urinary incontinence quantification, ICI-Q-SF score, clinical efficacy, as well as changes in the modified Kupperman Menopausal Index (KMI) score, and the modified oxford staging (MOS) .

Upon completion of the study, 7 participants from the MHT group were lost to follow-up (5 in the Tibolone subgroup and 2 in the EPT subgroup), with 3 participants from the control group also lost to follow-up. In the end, a total of 65 participants were included. After 1 year of treatment, there were no statistically significant differences in FSH, E2, and MOS between the MHT group and the control group (P>0.05). After 1 year of treatment, there were no statistically significant differences in PUVA, BDT, and URA between the MHT group and the control group (P>0.05). However, the LHA of the MHT group was significantly lower than that of the control group (P=0.028). After 1 year of treatment, there were no statistically significant differences in PUVA, BDT, URA, and LHA between the EPT and Tibolone subgroups (P>0.05). Statistically significant differences were found in the comparison of clinical efficacy between the control group and the MHT group (P=0.005). Conversely, no statistically significant differences were observed in the comparison of clinical efficacy between the EPT and Tibolone subgroups (P=0.727). After 1 year of treatment, the MHT group showed lower urinary incontinence quantity, ICI-Q-SF score, and KMI score compared to the control group (P<0.05). Before and after the treatment, there were no statistically significant differences in urinary incontinence quantity, ICI-Q-SF score, and KMI score between the EPT and Tibolone subgroups (P>0.05) .

The combination of MHT with PFMT yields a positive effect on the pelvic floor structure and markedly alleviates symptoms of urinary incontinence. Nevertheless, there is no significant differences between EPT and Tibolone in the improvement of pelvic floor structure and alleviation of clinical symptoms in patients.

Carotid atherosclerosis (CAS) is a significant indicator of early systemic atherosclerosis. Previous studies have demonstrated a close relationship between elevated remnant cholesterol (RC) levels and the pathogenesis of CAS. However, limited information is available regarding the association between RC and the development of CAS in menopausal women.

To investigate the correlation between RC and the pathogenesis of CAS in menopausal women.

A total of 307 menopausal women from Fengxiang Town, Anding District, Dingxi City were selected as the research subjects. These women had participated in the national high-risk stroke screening project and completed carotid artery ultrasound examination between January 2020 and October 2023. General information on the ordinary people was collected and participants' characteristics of the carotid artery intima were analyzed by means of using color doppler ultrasound. Based on the cervical ultrasound results, the subjects were divided into CAS group and non-CAS group. Spearman rank correlation analysis was used to explore the correlation between RC and other risk factors for CAS. Furthermore, multifactor Logistic regression was employed to analyze and explore the correlation between RC and CAS in menopausal women.

The findings revealed that participants in the CAS group (n=130) has higher levels than those in the non-CAS group (n=177) in terms of menopausal female age, history of stroke and transient ischemic attack (TIA), fasting plasma glucose (FPG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), RC and pulse pressure (P<0.05). Spearman rank correlation analysis indicated a positive correlation between RC and FPG as well as TC (r_s=0.113, 0.280, P<0.05), while a negative correlation was observed with LDL-C (r_s=-0.112, P<0.05). Furthermore, multivariate logistic regression analysis identified high RC levels (OR=1.539, 95%CI=1.185-1.999, P=0.001), age (OR=1.059, 95%CI=1.003-1.117, P=0.038), and history of stroke and TIA (OR=1.910, 95%CI=1.047-3.485, P=0.035) as risk factors for the onset of CAS in menopausal women. The menopausal women were further divided into high RC (RC≥0.70 mmol/L, n=155) and low RC (RC<0.70 mmol/L, n=152) groups based on the median RC. The high RC group had a higher proportion of women with dyslipidemia, CAS, waist circumference, BMI, and TG compared to the low RC group (P<0.05). Additionally, the high RC group had lower levels of high density lipoprotein cholesterol (HDL-C) compared to the low RC group (P<0.05) .

High RC levels are associated with CAS in menopausal women and may be an independent risk factor for CAS in menopausal 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.

In recent years, the symptoms of perimenopausal hearing loss (PMS-HL) have received widespread attention, but there is no targeted treatment. Zuoci pill has been used clinically for a hundred years, but there is no relevant research on the treatment of PMS-HL with this drug.

To explore the mechanism and therapeutic targets of Zuoci pill on PMS-HL through further validation of animal experiments based on the network pharmacology and molecular docking technology.

The active components and action targets of Zuoci pill were obtained through TCMSP and Uniprot databases, and the protein targets of PMS-HL were obtained through GeneCards, OMIM, TTD, DrugBank, and PharmGKB databases according to the composition of Zuoci pill from inception to February 2023, the intersection was taken to screen the potential therapeutic targets of Zuoci pill for the treatment of PMS-HL, and the "drug-active ingredient-target" interaction network diagram was constructed. The protein interaction analysis function of the String database was utilized to screen core targets. The Metascape database was used for enrichment analysis of the function of the proteins and pathways. Molecular docking of the core proteins was performed using Autodock and Pymol software to determine the binding capacity between key active ingredients and core targets. The menopausal animal model was established from September 2022 to January 2023, including Sham operation group (SHAM) group, ovariectomized (OVX) group, and Zuoci pill (ZCW) group, and serum level of the key protein interleukin 1β (IL-1β) was detected and statistically analyzed using SPSS 26.0.

There were 90 active components, 226 potential protein targets, 2 481 PMS-HL related targets, and 150 Zuoci pill and PMS-HL intersection targets for the compounds in the Zuoci pill formula. A total of 183 items for biological process, 103 items for molecular function, and 103 items for cellular components were obtained in the Gene Ontology (GO) function. The top three Kyoto Encyclopedia of Genes and Genomes (KEGG) were cancer pathways, lipid and atherosclerotic lesion pathway, and receptor activation pathway for chemical carcinogenesis. Molecular docking showed that the main active ingredients of Zuoci pill in treating PMS-HL were quercetin, kaempferol, stigmasterol, β- Sitosterol, isorhamnetin, diosgenin, tetrahydrostilbene and kaempferone; the active components of Zuoci pill can bind to the core target proteins of serine/threonine kinase 1 (AKT1), cellular tumor antigen p53 (TP53), interleukin 6 (IL-6), vascular endothelial growth factor (VEGFA), cystatinase 3 (CASP3), IL-1β, epidermal growth factor receptor (EGFR), and estrogen receptor 1 (ESR1) stably. Comparison of serum IL-1β level among the three groups of rats showed statistically significant difference (F=11.73, P<0.001) .

The 90 active ingredients in Zuoci pill, such as quercetin, act on 226 potential proteins such as AKT1 to regulate the antioxidant stress of tissues and cells, metabolism of blood lipids and glucose, and anti-tumor pathway, directly or indirectly protect the perimenopausal hearing function, IL-1β may be one of the key target proteins.

With the mature application of assisted reproductive technologies, the incidence of multiple pregnancies has increased dramatically, and complications including premature labor, fetal malformations, preeclampsia, and gestational diabetes have also increased. Perinatal prognosis and fetal survival quality can be improved through fetal reduction. Selective fetal reduction in the first trimester may result in a better prognosis than selective fetal reduction in the second trimester, suggesting that early assessment of pregnancy outcome in early pregnancy will provide a significant improvement in maternal and fetal prognosis.

To explore the relationship of ultrasonographic soft markers in early pregnancy and twin-specific markers with the pregnancy outcome of double chorionic double amniotic sac twins (DCDA) .

Pregnant women and fetuses with DCDA twin pregnancies in early pregnancy (11-13⁺⁶ weeks) attending the Department of Ultrasound Medicine of Longgang District Maternity&Child Healthcare Hospital of Shenzhen City from May 2018 to May 2022 were retrospectively selected for the study. The detection rates of ultrasonographic soft markers and twin-specific markers in DCDA twin pregnancies in early pregnancy and their association with adverse pregnancy outcomes. Ultrasonographic soft markers included thickened nuchal translucency (NT), choroid plexus cyst, nasal bone dysplasia, ventricular punctate strong echo, tricuspid regurgitation, absence or inversion of ductus venosus A wave, intestinal echo enhancement, mild dilatation of the renal pelvis, single umbilical artery and right subclavian artery vagus. Twin-specific markers included differences in twin crown-rump length (CRL), twin NT, and twin umbilical cord insertion (UCI). Adverse pregnancy outcomes included miscarriage, stillbirth, neonatal death, structural abnormalities, and genetic abnormalities, with the addition of positive weight gain (≥25% difference in twin weights) as a specific adverse pregnancy outcome. Logistic regression analysis was used to explore the correlation of ultrasonographic soft markers and twin-specific markers of DCDA twin pregnancies in early pregnancy with adverse fetal pregnancy outcomes.

Finally, 418 cases pregnant women of DCDA twin pregnancies in the first trimester were included, of which 342 cases (81.82%) had normal pregnancy outcomes and 76 cases (18.18%) had adverse pregnancy outcomes. The total detection rate of positive ultrasonographic soft markers in twin pregnancies in the first trimester was 10.53% (53/418) ; a total of 61 ultrasonographic soft markers were detected in 53 fetuses with positive ultrasonographic soft markers, and the top three detection rates were NT thickening in 6.94% (29/418), choroid plexus cyst in 2.39% (10/418) and nasal bone dysplasia in 1.67% (7/418). The incidence rate of adverse pregnancy outcomes for fetuses with positive ultrasonographic soft markers was 30.19% (16/53), and the incidence rate of adverse pregnancy outcomes for fetuses with negative ultrasonographic soft markers was 16.44% (60/365) ; the incidence rate of adverse pregnancy outcomes for fetuses with positive ultrasonographic soft markers in the first trimester was higher than fetuses with negative ultrasonographic soft markers (χ²=5.882, P=0.015). Binary Logistic regression analysis results showed that a twin CRL difference≥15% was a risk factor for adverse pregnancy outcomes in twin pregnancy (OR=9.955, 95%CI=1.882-52.662, P=0.007), and a positive twin UCI difference was a risk factor for positive fetal weight in twin pregnancy (OR=3.733, 95%CI=1.300-10.720, P=0.014). The total detection rate of positive twin-specific markers in fetuses with twin pregnancies in early pregnancy was 27.27% (114/418), including 12 cases with a twin CRL difference≥15% and a negative twin UCI difference, 100 cases with a twin CRL difference<15% and a positive twin UCI difference, and 2 cases with a twin CRL difference≥15% and a positive twin UCI difference. The total detection rate of fetuses with ultrasonographic soft markers but positive twin-specific markers in early pregnancy was 25.12% (105/418). The incidence of adverse pregnancy outcomes and positive weight gain among fetuses with negative ultrasound soft markers but positive twin-specific markers was 27.6% (29/105), and the incidence of adverse pregnancy outcomes among fetuses with negative ultrasound soft markers alone was 16.4% (60/365). The incidence of adverse pregnancy outcomes and positive weight gain in fetuses with negative ultrasonographic soft markers but positive twin-specific markers in early pregnancy was higher than the incidence of adverse pregnancy outcomes in fetuses with negative ultrasonographic soft markers alone (χ²=6.641, P=0.010). The total detection rate of positive ultrasonographic soft markers combined with positive twin-specific markers in fetuses with twin pregnancies in early pregnancy was 2.15% (9/418), and the incidence of adverse pregnancy outcomes combined with positive weight gain in fetuses with positive ultrasonographic soft markers combined with positive twin-specific markers was 44.4% (4/9), and the incidence of adverse pregnancy outcomes in fetuses with positive ultrasonographic soft markers alone was 30.2% (16/53). There was no statistically significant difference in the incidence of adverse pregnancy outcomes combined with positive weight gain in fetuses with positive ultrasonographic soft markers combined with positive twin-specific markers compared with the incidence of adverse pregnancy outcomes in fetuses with positive ultrasonographic soft markers alone (χ²=0.212, P=0.645). The results of multivariate Logistic regression analysis showed that NT thickening (OR=2.576, 95%CI=1.146-5.791, P=0.022), twin-fetal CRL difference≥15% (OR=13.167, 95%CI=3.595-48.229, P<0.001), and positive twin-fetal UCI difference (OR=2.369, 95%CI=1.049-5.348, P=0.038) were risk factors for adverse fetal pregnancy outcome and positive weight gain in DCDA twin pregnancies in early pregnancy.

NT thickening, twin-fetal CRL difference≥15%, and positive twin-fetal UCI difference may be risk factors for adverse fetal pregnancy outcomes and positive weight gain in DCDA twin pregnancies in early pregnancy. The fetus with positive ultrasonographic soft markers or positive twin-specific markers should be vigilant, and comprehensive evaluation and close follow-up should be carried out.

The current classification of cesarean scar pregnancy (CSP) is only based on the ultrasonic characteristics. At present, there is a lack of analysis and summarization of the clinical characteristics of different types of CSP cases under this classification criteria.

To investigate the clinical characteristics and management variance of different types of CSP.

A total of 862 patients with CSP admitted to the Department of Obstetrics and Gynecology, Peking University Third Hospital from July 2014 to June 2022 were enrolled and divided into the type Ⅰ, type Ⅱ and type Ⅲ groups. The clinical characteristics and indicators of diagnosis and treatment were analyzed retrospectively.

Among the total CSP patients, 36.5% (315/862) were typeⅠ, 53.1% (458/862) were typeⅡ, and 10.3% (89/862) were type Ⅲ. The incidence of abdominal pain was 24.2% (209/862) and vaginal bleeding was 65.0% (560/862) in CSP patients. There was no statistically significant difference in the age, history of pregnancy and childbirth, and proportion of previous uterine cavity surgery among the three groups of patients (P>0.05). There was no significant difference in abdominal pain (P=0.261) and vaginal bleeding (P=0.062) among the three groups. In typeⅢ patients, the average gestational age was 55 (46, 64) days, the average diameter of gestational mass was 29.6 (19.1, 43.3) mm, and the serum β-HCG level was 60 673 (17 164, 122 203) mU/mL at diagnosis. The proportion of patients who needed adjuvant pharmacologic embryocidal therapy, laparoscopic surgery and uterine artery occlusion was 27% (24/89), 33.7% (30/89) and 32.6% (29/89), respectively. The operation duration was 101 (67, 125) min, the hospitalization duration was 4 (3, 7) days, and the treatment cost was 11 933.7 (8 760.7, 15 250.6) CNY for typeⅢpatients. The accumulated bleeding volume within 24 hours after surgery, the proportion of patients with perioperative bleeding≥200 mL and requiring blood transfusion was 24.7% (22/89) and 7.9% (7/89) in typeⅢ patients, respectively, which were higher than the other two groups (P<0.001). The incidence of persistent CSP was 3.1% (27/862) in all patients, and there was no significant difference among the three groups (χ²=3.353, P=0.187) .

There is no significant difference in age, maternal history, gravidity and parity, and clinical characteristics such as abdominal pain and vaginal bleeding in patients with different types of CSP. The treatment of typeⅠand typeⅡpatients is less invasive and consumes less medical resources, while typeⅢpatients consume more medical resources and have high requirements for multidisciplinary team and individualized management. The prognosis of all three types of patients is ideal after standardized management.

Due to economic development changes in domestic fertility policy, the incidence of acute pancreatitis in pregnancy (APIP) has been gradually increasing. The clinical characteristics of APIP of different etiologies are different, and there may be significant differences in the prognosis for mothers and infants, but previous studies on this are relatively few.

To analyze the clinical characteristics and maternal and neonatal outcomes in pregnancy complicated with acute pancreatitis patients of different etiologies.

A total of 48 inpatients with APIP in Beijing Friendship Hospital, Capital Medical University from 2016 to 2022 were collected, which were divided into the biliary group (n=27) and hyperlipidemic group (n=21). The laboratory indicators and maternal and infant outcomes in the two groups were compared.

The biliary group had a longer time of onset to visit, a smaller gestational week at admission, more previous pregnancies, and lower percentage of diarrhea and cessation of defecation than the hyperlipidemic group (P<0.05). There was no statistically significant difference in severity between the two groups of patients (P=0.912). The levels of hemoglobin, platelets, C-reactive protein, cholesterol, and triacylglycerol in the biliary group were lower than those in the hyperlipidemia group, while the levels of total bilirubin, direct bilirubin, alanine transaminase, alkaline phosphatase, glutamyltranspeptidase, creatinine, calcium, sodium, amylase, and N-terminal brain natriuretic peptide precursor were higher than those in the hyperlipidemia group (P<0.05). The gestational week at delivery of the biliary group was shorter than the hyperlipidemia group (P<0.05). There was no statistically significant difference in premature delivery rate, cesarean section rate, and artificial intervention termination of pregnancy rate between the biliary group and hyperlipidemia group (P>0.05). The birth weight of the biliary group was smaller than the hyperlipidemia group, while the birth length was shorter than the hyperlipidemia group. The incidence of neonatal jaundice, respiratory distress, and ventilator-assisted breathing was higher than the hyperlipidemia group (P<0.05) .

Biliary diseases are still the first cause of APIP patients, which can significantly shorten the maternal gestational week, cause low fetal body mass, increase the incidence of pathological jaundice, respiratory distress, and ventilator-assisted breathing in the fetus, leading to a more severe prognosis for the fetus.

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.