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Perimenopausal syndrome is a common uncomfortable symptom in women during the perimenopausal period, with a high incidence, a long duration, and adverse effects on physical and psychological, patients bear a heavy burden of symptoms, and increase the risk of adverse events in the elderly stage, increase the social medical burden. With the development of sports rehabilitation research, more and more attention has been paid to the effect of exercise on human health. This paper reviews the studies on exercise rehabilitation in women with perimenopausal syndrome, including exercise forms, exercise intensity, exercise time and exercise effect, in order to provide basis for the relevant research and practice.
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Objective:To evaluate the clinical efficacy and safety of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) for patients with advanced ovarian cancer as the first-line surgical treatment.Methods:The ovarian cancer patients with completed clinical data diagnosed as stage Ⅲ C-Ⅳ according to Federation International of Gynecology and Obstetrics (FIGO) who underwent CRS+HIPEC as the first-line treatment from December 2007 to November 2019 in Beijing Shijitan Hospital were retrospectively analyzed. Survival status was analyzed by using Kaplan-Meier method, and prognostic factors were analyzed by using Cox multivariate regression model. The primary endpoints were median overall survival (mOS) time and median progress-free survival (mPFS) time, and the secondary endpoint was safety in perioperative period. Results:Of 100 patients with advanced ovarian cancer, the median follow-up time was 18.4 months, and 75 (75.0%) patients were alive and 25 (25.0%) patients died, of which the mOS time was 87.6 months (95% CI 72.1-103.1 months), and 1-, 2-, 3-, 4- and 5-year survival rate was 94.1%, 77.2%, 68.2%,64.2% and 64.2%, respectively. Univariate analysis showed that the patients with age≤58 years old ( P = 0.023), Karnofsky≥80 scores ( P = 0.026), ascites ≤1 000 ml ( P = 0.041), peritoneal carcinomatosis index (PCI) score <19 ( P = 0.044) and completeness of cytoreduction (CC) score 0-1 ( P = 0.001) had better prognosis. Multivariate analysis showed that CC score 0-1 was independent prognostic factor, the mortality risk of resectable patients with CC score 2-3 was 3.2 times higher than that in patients with CC score 0-1 ( HR = 3.2, 95% CI 1.4-7.6, P = 0.008), and mPFS time was 23.3 months (95% CI 0-50.7 months) for patients with CC score 0-1. Grade Ⅲ-Ⅳ adverse event rate during perioperative period and mortality rate was 4.0% (4/100) and 2.0% (2/100), respectively. Conclusion:CRS+HIPEC could improve the survival of advanced ovarian cancer patients with good safety.
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Objective:To evaluate the effect of WeChat platform in the diagnosis and treatment of menopausal-related diseases for gynecologists.Methods:In March 2017, 47 gynecologists who voluntarily participated in the offline continuing medical education project "Diagnosis and Treatment training of menopause-related diseases" in Beijing Shijitan Hospital Affiliated to Capital Medical University were selected as the control group (traditional teaching mode), and 52 gynecologists who volunteered to participate in WeChat platform training were selected as the experimental group (WeChat teaching mode). The main outcome measure was the knowledge level of menopause-related diseases and curriculum satisfaction before and after training. SPSS was used to perform t-test or chi-square test for inter-group data. Results:All gynecologists completed the study, the recovery rate of the evaluation questionnaire before and after training was 100%. Before training, the average score of menopause-related disease knowledge and the test passing rate of knowledge examination in experimental group were (63.65±21.42) and 65.4%, while those in the control group were (60.85±24.83) and 63.8%, respectively. No significant difference was found ( P>0.05). After training, the knowledge level of menopause-related diseases and the test passing rate significantly improved in both groups ( P<0.05). The average score of students and the passing rate in the experimental group were (77.50±16.19) and 90.1%, which were better than those in the control group [(78.72±16.89), 87.2%]. However, there was no significant difference between the two groups ( P>0.05). Besides, the experimental group was more satisfied, but the difference was not statistically significant compared with control group ( P>0.05). Conclusion:WeChat platform training for gynecologists not only has the same effects as the traditional teaching model on menopausal disease diagnosis and treatment training, but also gains higher training satisfaction, suggesting WeChat platform training can be further applied to other subdisciplines.
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Objective:The aim of this study was to explore the relationship between nurses ′ work environment and menopausal symptoms. Methods:A multicenter, cross-sectional study was performed in Beijing, China, distributed to 2 194 registered nurses at 37 hospitals. Using a self-designed questionnaire included individual personal details, and the hospital working environment. Menopausal symptoms were evaluated using a modified Kupperman index (KMI) scoring system.Results:The average natural age at menopause stag was 47.64 years with 63.91% (1 328/2 078) nurses without menopausal symptoms. Logistic analysis showed that menopausal symptoms were co-dependently influenced by the following: to frequently contact with patient bodily fluids during your work ( P=0.037); be intimidated in your work ( P<0.01); to often or occasionally face death at work ( P=0.013 and P=0.002). Nurses suffered more stressful environment with high prevalence of menopausal symptoms. Conclusions:The mid-age nurses with menopausal symptoms were related with work environment. Managers should pay more attention to this problem.
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Objective To compare Masson staining,van Gieson staining,and Sirius red staining for evaluation of an intrauterine adhesion(IUA)model in rats. Methods In total,24 female adult Sprague-Dawley rats were selected and bilateral uteri exposed. To establish an IUA rat model, the left uterus was cut and the endometrium scraped using a scalpel. The right uterus was used as a control. Fourteen days after surgery, all uteri were collected for histological evaluation of IUA by hematoxylin and eosin(HE)staining,Masson staining,van Gieson staining,and Sirius red staining. Results HE staining showed that the endometrial epithelial layer of the uterus was absent, with a smaller number of endometrial glands than the control uterus(P < 0.01). Collagen fibers were clearly visible using all special staining method. The fibrotic area rate of uteri by Masson staining(using toluidine blue)was higher than Masson staining(using light green),van Gieson staining,and Sirius red staining(P< 0.01). Under polarized light,type I and type III collagen fibers were clearly distinguished by Sirius red staining,but not using Masson and van Gieson staining. Conclusions Sirius red staining is a superior method than Masson and van Gieson staining for evaluation of fibrosis in IUA and can also differentiate collagen fiber types.
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To observe and analyze the effect of conjugated estrogen cream in the treatment of postmenopausal atrophic vaginitis. The 160 patients clearly diagnosed with postmenopausal atrophic vaginitis and treated in our hospital were
selected as subjects and divided into study group and reference group with equal number of cases. The reference group was treated with compound metronidazole suppository, while the study group was treated with conjugated estrogen
cream. The treatment efficacy of the two groups was compared and observed. Comparison of estradiol and folliclestimulating hormone levels after treatment in the two groups show that the study group has obvious advantage over the
reference group, p<0.05; comparison of vagina cleanliness in the two groups after treatment shows the study group is significantly superior to the reference group, p<0.05; comparison of incidence of adverse reactions in the two groups
shows that the study group has lower incidence, with statistical significance in comparison between the groups, p<0.05. Treatment of postmenopausal atrophic vaginitis with combination of conjugated estrogen cream and compound
metronidazole suppository can achieve good results with high safety and reliability
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0bjective To explore the level of identification and related factors of depression in physicians of Beijing tertiary general hospitals.Methods A cross-sectional investigation was used to screen the outpatients,and depression was diagnosed according to Mini International Neuropsyehiatric Interview (MINI).Identification of depression was defined as referral to psychiatrist or managed with antidepressant or sedative hypnotics.Results Among 248 cases of depression,30(12.1%)were referred to psychiatrists,28(8.9%)managed with antidepressant or sedative hypnotics.The identification rate of depression by physicians was 21.0%.and the identification rate by neurologist was 40.4%,which is higher than the rate by cardiologist(22.4%),gastrointestinal physician(3.8%)and gynecologist(2.0%)(χ2=61.077,P<0.05).Visiting neurology department,severity of life impairment,with psychotic distress history,hadpsychological complaints.co-morbidity with anxiety related to the physician's identification of depression.Among the psychological complaints.only mood disorder and insomnia were related to the physician'sidentification of depression.Conclusions The level of depression identification by physician was low,the level of neurologist wag higher than that of cardiologist,gastrointestinal physician and gynecologist.The patient with serious life impairment,psychotic distress history,mood disorder and insomnia complaints was asily to be identified.
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Objective To explore the prevalence and physician's recognition of depression and anxiety disorder in gastrointestinal out-patients of three tertiary general hospitals in Beijing. Methods A hospital-based cross-sectional survey was conducted in the gastrointestinal out-patient departments of three tertiary general hospitals in Beijing from May to June 2007. Total 517 subjects were recruited consecutively within a one month period. All the subjects were screened with Hospital Anxiety Depression Scale (HADS). The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using Mini International Neuropsychiatric Interview (MINI). The physicians made the diagnosis and management without knowing the results of MINI and HADS score. Results Among the 517 cases, 301 had a HADS score of 8 and above and 244 were interviewed by psychiatrists; the response rate was 81.1%. The prevalence according to Diagnostic and Statistical Manual of Mental Disorders Fourth edition of depressive disorders and anxiety disorders in gastrointestinal outpatients were 15.3%, depressive disorders were 12. 0%, anxiety disorders were 6. 4%, depression combined anxiety disorder was 3. 0%. The prevalence of depression, anxiety, depression combined anxiety were not different between genders (x2 = 0. 874, x2 = 1.797,x2 =0.518, P >0.05) and among different age group ( 18-34, 35-54, ≥55 years old) (x2 = 1. 084,2 = 2. 735, 2 = 0. 350, P 0. 05 ). Gastritis and gastrointestinal dysfunction were the major diagnoses in patients with depression and/or anxiety disorders, the rates were 30. 6% and 26. 4% respectively. The rate of identification of depression and anxiety disorder by physicians was 2. 8%. Conclusion Gastrointestinal out-patients have a high prevalence of depression and anxiety disorder and the rate of identification by physicians was very low.
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rse effect when compared with tibolone.
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Objective To evaluate the relationship between abnormal lipid metabolism and the pathogenesis of pregnancy induced hypertension (PIH). Methods A prospective cohort study was carried out in 500 pregnant women. They were followed in the antenatal care outpatient clinic. Amcing them. 20 cases of mild PIH, 23 cases of moderate and severe PIH, 30 cases of normal pregnant women were studied. Serum lipid levels were measured before and after the onset of PIH (baseline and follow up). Data were analysed with F test. Results TG, VLDL, LP(a),FFA and FFA/Alb levels in all patients of PIH were significantly higher than those in the control group( P