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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Hashimoto's thyroiditis (HT) is an autoimmune disease, and a major cause of hypothyroidism. Due to its insidious nature, non-presence of clear clinical symptoms, there is often a delay in getting a diagnosis for HT, which leads to irreversible damage. Therefore, early screening and improving diagnostic accuracy are essential to the treatment of HT. There are few studies on the application of infrared thermal imaging technology as an auxiliary diagnostic tool for HT.

To explore the features of metabolic calorific values measured by infrared thermal imaging in female adults with HT.

Participants were recruited from the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from April 2019 to June 2021, including 100 adult gynecological outpatients with HT, and 100 healthy, adult female physical examinees. Both groups completed the Classification and Determination of Constitution in TCM (ZYYXH/T157-2009) for assessing the constitution in TCM. Thyroid function test was performed to understand levels of thyroid function parameters〔thyroglobulin antibody (TGAb) , thyroid peroxidase antibody (TPOAb) , thyroid-stimulating hormone (TSH) , free triiodothyronine (FT₃) , free thyroxine (FT₄) 〕. Full body thermography using infrared thermal imaging was implemented to examine the calorific values of the left and right lobes of the thyroid gland, the uterus, the Shenque acupoint and the Governor vessel. The aforementioned parameters were compared between HT patients and physical examinees to identify intergroup differences. The calorific values of thyroid left and right lobes, the uterus, the Shenque acupoint and the Governor vessel were compared across HT patients with 9 types of constitution in TCM, and the associations of them with thyroid function parameters were explored, then their associations with infertility in HT were evaluated using binary logistic regression analysis.

The top 4 types of constitution in TCM in HT patients were yang-deficiency, qi-stagnation, damp-heat, and phlegm-dampness. The calorific values of Shenque acupoint and the Governor vessel varied significantly across HT patients by types of constitution (n=9) in TCM (P<0.05) . Compared with the control group, the levels of TGAb, TPOAb and TSH in HT group increased (P<0.05) . There was no significant difference in FT₃ and FT₄ levels between the two groups (P>0.05) . HT patients had higher calorific values of thyroid left and right lobes and lower calorific values of the uterus, Shenque acupoint and the Governor vessel than physical examinees (P<0.05) . In the HT group, the calorific value of the left or right lobe of the thyroid gland was positively correlated with TGAb (r_s=0.260, 0.198, P<0.05) , and the calorific value of the uterus was negatively correlated with TSH (r_s=-0.313, P<0.05) . The calorific values of the uterus〔OR=0.413, 95%CI (0.180, 0.945) 〕, the Governor vessel〔OR=0.270, 95%CI (0.075, 0.971) 〕, and the Shenque acupoint〔OR=0.264, 95%CI (0.073, 0.954) 〕were associated with infertility in HT (P<0.05) .

In adult female HT patients, the most common four types of constitution in TCM were yang-deficiency, qi-stagnation, damp-heat, and phlegm-dampness. The metabolic calorific values measured by infrared thermal imaging were featured by higher values of thyroid left and right lobes, and lower values of the uterus, Shenque acupoint and the Governor vessel, which may be new theoretical evidence obtained from clinical practice explaining infertility in HT. Furthermore, the calorific values of thyroid left and right lobes could be used as parameters for early screening or identifying HT. So infrared thermal imaging could be used as an auxiliary diagnostic tool to improve the diagnostic efficiency of HT.

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.