简介：AbstractObjective:To assess the clinical features of fetal growth restriction (FGR) in women with hypertensive disorders of pregnancy in China.Methods:This is a retrospective cohort study. The clinical data of 4 451 women with hypertensive disorders of pregnancy were retrospectively collected from 11 tertiary hospitals across ten provinces in China during January 2015 to December 2015. The mean maternal age was (31.0±5.4) years old. Participants were divided into FGR group (n= 670) and non-FGR group (n= 3 781). The incidence and clinical features of FGR, and its correlation with gestational age, previous FGR history, 24-hour urinary protein excretion, and hemolysis, elevated liver enzyme and low platelet count (HELLP) syndrome were analyzed. Student’s t-test and Chi-square test were used when comparing clinical features between FGR and non-FGR groups.Results:The overall incidence of FGR was 15.1% (670/4 451). The FGR incidence was 22.4% (433/1 937) in women with severe preeclampsia and 18.6% (68/365) in women with chronic hypertension with superimposed preeclampsia, respectively. FGR was more prevalent in women who had preterm births than those who had term births (22.8% (432/1 898) vs. 9.3% (238/2 553), P < 0.001). It was also more prevalent in women with early-onset preeclampsia than those with late-onset preeclampsia (18.4% (189/1 025) vs. 14.0% (481/3 426), P= 0.001). Women with a previous FGR history had a significantly higher FGR incidence than those without an FGR history (66.7% (4/6) vs. 15.7% (250/1 596), P= 0.007). The presence of abnormal results of the umbilical artery Doppler (13% (87/670) vs. 2.4% (89/3 781), P < 0.001) and the middle cerebral artery Doppler (3.3% (22/670) vs. 0.4% (15/3 781), P < 0.001) was higher in the FGR group compared with the non-FGR group, while the presence of increased uterine artery resistance was not statistically different (1.5% (10/670) vs. 0.8% (29/3 781), P= 0.072). The FGR group delivered earlier than the non-FGR group ((35.3±3.0) weeks vs. (36.4±4.3) weeks, P < 0.001) with lower birth weight (1 731.0±574.5) g vs. (2 753.9±902.1) g, P < 0.001, higher fetal or neonatal death (9.4% (63/670) vs. 4.2% (157/3 781), P < 0.001), and higher cesarean section rate (82.5% (553/670) vs. 70.2% (2 656/3 781), P < 0.001). In the FGR group, more neonates had 5-minute Apgar score ≤7 (7.9% (53/670) vs. 3.9% (149/3 780), P < 0.001), with higher neonatal intensive care unit admission rate (48.1 % (322/670) vs. 23.3% (881/3 781), P < 0.001). More cases of HELLP syndrome occurred in the FGR group (6.9% (46/670) vs. 3.2% (122/3 781), P < 0.001). Women with FGR had heavier 24-hour urinary protein excretion than those without FGR ((3.9±3.7) g vs. (3.1±4.2) g, P= 0.005).Conclusion:In pregnancies with hypertensive disorders, increased risks of FGR are associated with preterm birth, birth before 34 weeks, and a previous FGR history. FGR is related to higher occurrence of abnormal uterine artery Doppler and umbilical artery Doppler. When hypertensive disorders is complicated by FGR, there appears to be higher maternal morbidity including higher rate of HELLP syndrome, cesarean section, and heavier proteinuria, as well as worse neonatal outcomes.

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简介：AbstractBackground:Obesity and insulin resistance (IR) are common features of polycystic ovary syndrome (PCOS). Metformin (MET) increases insulin sensitivity, but it is associated with unsatisfactory weight loss. The glucagon-like peptide-1 receptor agonist exenatide has been shown to reduce weight and IR in patients with diabetes. This study aimed to explore the therapeutic effects of exenatide once-weekly (QW) combined with MET on body weight, as well as metabolic and endocrinological parameters in overweight/obese women with PCOS.Methods:Fifty overweight/obese women with PCOS diagnosed via the Rotterdam criteria were randomized to one of two treatment groups: MET (500 mg three times a day [TID]) or combination treatment (COM) (MET 500 mg TID, exenatide 2 mg QW) for 12 weeks. The primary outcomes were anthropometric changes associated with obesity, and the secondary outcomes included changes in reproductive hormone levels, glucose and lipid metabolism, and C-reactive protein.Results:Forty (80%) patients completed the study. COM therapy was superior to MET monotherapy in reducing weight (P = 0.045), body mass index (BMI) (P = 0.041), and waist circumference (P = 0.023). Patients in the COM group on an average lost 3.8 ± 2.4 kg compared with 2.1 ± 3.0 kg in the MET group. In the COM group, BMI and waist circumference decreased by 1.4 ± 0.87 kg/m2 and 4.63 ± 4.42 cm compared with 0.77 ± 1.17 kg/m2 and 1.72 ± 3.07 cm in the MET group, respectively. Moreover, levels of fasting glucose, oral glucose tolerance test (OGTT) 2-h glucose, and OGTT 2-h insulin were significantly lower with COM therapy than with MET (P < 0.050). Mild and moderate gastrointestinal reactions were the most common adverse events in both groups.Conclusions:COM therapy was more effective than MET alone in reducing body weight, BMI, and waist circumference, and improving insulin sensitivity in overweight/obese women with PCOS, with acceptable short-term side effects.Trial registration:ClinicalTrials.gov, NCT04029272. https://clinicaltrials.gov/ct2/show/NCT04029272

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简介：Objectives:Todeterminetheaetiologiesofvaginaldischargesyndromes,tocalculatetheperformanceofdifferentmanagementalgorithms,andvalidatethesealgorithmsinSTDclinicsinChina.ThesealgorithmswereadoptedfromthoseproposedbytheWorldHealthOrganization.Methods:Atotalof315consecutivepatientswithvaginaldischargewereenrolledatthreeSTDclinics.CervicalinfectionwasdefinedaspresenceofNeisseriagonorrhoeaeoncultureand/orChlamydiatrachomatisbypolymerasechainreaction.OtherlaboratorytestsincludedwetmountmicroscopyandpHtestingofvaginalfluid.Sensitivity,specificity,andpositivepredictivevalueofdifferentalgorithmsweredeterminedusingstandardmethods.Results:Cervicalinfectionwasidentifiedin37.8%ofpatients(20.6%gonorrhea,12.7%chlamydialinfection,4.4%gonorrheaincombinationwithchlamydialinfection).Thesensitivity,specificity,andpositivepredictivevalueofalgorithmsAandBfortheidentificationofNeisseriagonorrhoeaeand/orChlamydiatrachomatiswererespectively71.4%and90.8%,65.3%and46.9%,55.6%and50.9%.Conclusions:Thevaginaldischargealgorithmscouldbeappliedforclinicalmanagement.Theirsensitivitiesareacceptable.However,thereisaneedtofurtherimprovetheirspecificityandpositivepredictivevalue.Thetwoalgorithmscouldbeusedinclinicalsettingswithdifferentfacilities.Thesealgorithmsshouldalsobevalidatedinpopulationswithlowerdiseaseprevalence.

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简介：Theliberationofwomenisthehistoricalprocessinwhichwomenhavestrivenforgenderequality,freedomfromoppression,confinementanddiscrimination,andarebecomingthemastersofthesocietyandtheirowndestinies.Accordingtothediversityinhistoryandthestate,theprocesscanbedividedintoaserialofcorrelatedphases,witheachphasefocusingondifferentissues.SexismorderinChinahadremainedstableinthetraditionalsocietyforcenturiesthroughasetofinstitutions.Womenhadbelievedinasexualorderandtherulesofpropriety,whichadvocatedthatmenweresuperiortowomen.AfterthePeople’sRepublicofChinawasfoundedin1949,women’srightsinpolitics,economy,society,andevenfamilywererecognizedandsecuredbytheConstitutionandlawsjustasmen’sduringashortperiod.Women’sliberationinChinahasmadeasignificantprogress.

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简介：AbstractObjective:To characterize and compare the microbiome signature in the maternal, intrauterine, and fetal environments and the associated bacterial species in women who experienced preterm birth and term birth.Methods:A total of 140 women with singleton pregnancies were enrolled in this study. Among them, 31 experienced spontaneous preterm delivery (gestational age < 37 weeks), and 28 of them experienced vaginal delivery at term. Maternal peripheral blood, saliva, and vaginal discharge samples and fetal membrane, amniotic fluid, and cord blood samples were collected immediately after delivery under sterile conditions. DNA was isolated from the fetal membrane and umbilical cord blood samples, and the V3-V4 region of the bacterial 16S rRNA gene was sequenced. The sequence data were quality-filtered, chimera-checked, and organized into operational taxonomic units (OTUs) based on phylogeny. Principal coordinate analysis of beta diversity measures was used for visualization. The linear discriminant analysis effect size (LEfSe) algorithm and Wilcoxon test were used to differentiate the microbiomes found in the fetal membranes and cord blood in the cases of preterm birth.Results:OTU analysis based on the 16S rRNA gene showed similar microbiomes in the maternal peripheral blood, amniotic fluid, fetal membranes, and cord blood. However, the LEfSe algorithm revealed significantly different bacterial compositions in the fetal environment between the preterm and term groups, with some of the bacterial species originating from the maternal peripheral blood or saliva.Conclusions:The bacteria in the intrauterine and fetal environments may originate from other body sites through hematogenous transmission, and may cause the occurrence of preterm birth.

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简介：Thirty-ninewomenofreproductiveagesufferingfromchronicpelvicinflammatorydisease(PID)foratleasttwoyears,previouslytreatedpharmacologicallywithnoeffect,wereenrolledinafour-weektherapeuticprotocolconsistingof12acupuncturetreatmentsperformedwiththefrequencyofthreeperweek.Ineachfemalepatientatbaselineandafterthestudy,painscoreandthefollowingparametersinbloodserumwereevaluated:concentrationofimmunoglobulinM(IgM),albumins,alphal-globulins,alpha2-globulinsandgamma-globulins,erythrocytesedimentationrate(ESR)andwhitebloodcell(WBC)count.Duringthestudy,weobtainedasignificantdropinESRandIgMlevelstogetherwithariseingamma-globulinconcentrations.Asignificantdecrease(from4.89±0.82to0.63±1.05)inpainscorewas

简介：AbstractObjective:Androgenetic alopecia (AA) is a progressive hair loss disorder mediated by systemic androgens and genetic factors. A variety of AA treatments have been investigated. Currently, there is emerging evidence and growing interest in the use of platelet-rich plasma (PRP) for AA. This study describes a single-center experience using PRP to treat AA in women.Methods:A retrospective observational study design was employed. The study cohort comprised 20 women >18 years of age who were diagnosed with AA. PRP was prepared using a commercially available PRP kit. Each patient received six PRP treatment sessions at 4-week intervals. The severity of alopecia tool (SALT) scoring system was used to measure the severity of alopecia, and a paired t-test was used to calculate significance levels.Results:The mean pre-intervention and post-intervention total SALT score was 27.5 ± 6.35 and 9.41 ± 3.71, respectively. The difference in the total mean SALT score was 18.33 ± 1.64 and the effect size was 3.52. The scalp area with the largest effect size was the vertex (Cohen d= 2.53). The effect size was similar across other scalp areas (Cohen d= 1.91-2.09). There were no serious adverse effects of the treatment; only mild transient adverse effects were reported.Conclusion:The present study demonstrated the efficacy and safety of PRP injections in treating AA in women. However, these findings require confirmation in well-designed studies using standardized treatment protocols and evaluation methods.

简介：AbstractBackground:As one of the most common endocrinal disorders for women at childbearing age, the diagnostic criteria of polycystic ovary syndrome (PCOS) have been defined differently among different international health organizations. Phenotypic heterogeneity of PCOS also brings about difficulties for its diagnosis and management assessment. Therefore, more efficient biomarkers representing the progression of PCOS are expected to be integrated into the monitoring of management process using metabolomic approaches.Methods:In this prospective randomized controlled trial, 117 PCOS patients were enrolled from December 2016 to September 2017. Classical diagnostic parameters, blood glucose, and metabolome were measured in these patients before and at 2 months and 3 months of different medical interventions. The receiver operating characteristic (ROC) curves were built based on multivariate statistical analysis using data at baseline and 3 months’ management, and combinational biomarkers with appreciable sensitivity and specificity were selected, which then validated with data collected at 2 months.Results:A set of metabolites including glutamic acid, aspartic acid, 1-methylnicotinamide, acetylcarnitine, glycerophosphocholine, and oleamide were filtered out with high performance in representing the improvement through 3-month management of PCOS with high sensitivity and specificity in ROC analysis and validation with other two groups showed an appreciable area under the curve over 0.96.Conclusions:The six metabolites were representative of the remission of PCOS through medical intervention, making them a set of potential biomarkers for assessing the outcome of PCOS management.Trial Registration:ClinicalTrials.gov, NCT03264638.