简介：ＡｓｐｉｒａｔｉｏｎｓｏｆｍｏｔｈｅｒｓＬｉｆｅＥｘｐｅｒｉｅｎｃｅｏｆＴｈｒｅｅＧｅｎｅｒａｔｉｏｎｓＴｗｅｎｔｉｅｔｈＣｅｎｔｕｒｙｄｅｓｔｉｎｙｄｉｃｔａｔｅｓｅｘｐｅｃｔａｔｉｏｎｓＦｏｒｔｈｒｅｅｇｅｎｅｒａｔｉｏｎｓｏｆＣｈｉｎｅｓｅｗｏ...

简介：Background:AlthoughTaiJiQuanhasbeenshowntorelievepainandimprovefunctionalmobilityinpeoplewithkneeosteoarthritis(OA),littleisknownaboutitspotentialbenefitsongaitcharacteristicsamongolderChinesewomenwhohaveahighprevalenceofbothradiographicandsymptomatickneeOA.ThisstudyaimstoassesstheefficacyofatailoredTaiJiQuaninterventionongaitkinematicsforolderChinesewomenwithkneeOA.Methods:Arandomizedcontrolledtrialinvolving46olderwomeninShanghai,China,withclinicallydiagnosedkneeOA.Randomized(1:1)participantsreceivedeithera60minTaiJiQuansession(n=23)3timesweeklyora60minbi-weeklyeducationalsession(n=23)for24weeks.Primaryoutcomeswerechangesingaitkinematicmeasuresfrombaselineto24weeks.SecondaryoutcomesincludedchangesinscoresontheWesternOntarioandMcMasterUniversityOsteoarthritisIndex(WOMAC)andShortPhysicalPerformanceBattery(SPPB).Results:After24weekstheTaiJiQuangroupdemonstratedbetterperformanceingaitvelocity(meandifference,8.40cm/s,p=0.01),steplength(meandifference,3.52cm,p=0.004),initialcontactangle(meandifference,2.19°,p=0.01),andmaximalangle(meandifference,2.61°,p=0.003)offlexedkneesduringstancephasecomparedtothecontrolgroup.Inaddition,theTaiJiQuangroupshowedsignificantimprovementinWOMACscores(p<0.01)(meandifference,-4.22pointsinpain,p=0.002;-2.41pointsinstiffness,p<0.001;-11.04pointsinphysicalfunction,p=0.006)andSPPBscores(meandifference,1.22points,p<0.001).Conclusion:AmongolderChinesewomenwithkneeOA,atailoredTaiJiQuaninterventionimprovedgaitoutcomes.TheinterventionalsoimprovedoverallfunctionasindexedbytheWOMACandSPPB.TheseresultssupporttheuseofTaiJiQuanforolderChineseadultswithkneeOAtobothimprovetheirfunctionalmobilityandreducepainsymptomatology.

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简介：Therearefewpopulation-baseddataininvestigatingtheimpactofdiabetesonchemotherapyadverseeffectsandtreatmentoutcomesofnon-metastaticbreastcancer.Thepurposeofthisstudyistoevaluatewhetherdiabetesaffectsthepatternsofuseinchemotherapy,toxiceffectsofchemotherapy,andtreatmentoutcomesfornon-metastaticbreastcancerinTaiwan.Thestudyresultscanprovidephysiciansformakingadecisionwhetherornottousechemotherapybasedontheindividualpatients’condition.

简介：Objective:Upto40%ofwomenover70yearswithprimaryoperablebreastcancerintheUKaretreatedwithprimaryendocrinetherapy(PET)asanalternativetosurgery.Avarietyoffactorsareimportantindeterminingtreatmentforolderbreastcancerpatients.Thisstudyaimedtoidentifythepatientandtumorfactorsassociatedwithtreatmentallocationinthispopulation.Methods:Prospectivelycollecteddataontreatmentreceived(surgeryvs.PET)wereanalysedwithmultivariablelogisticregressionusingthevariablesage,modifiedCharlsonComorbidityIndex(CCI),activitiesofdailyliving(ADL)score,Mini-MentalStateExamination(MMSE)score,HER2status,tumoursize,gradeandnodalstatus.Results:Datawereavailablefor1,122cancersin1,098patientsrecruitedbetweenFebruary2013andJune2015from51UKhospitals.About78%ofthepopulationweretreatedsurgically,withtheremainderbeingtreatedwithPET.Increasingpatientageatdiagnosis,increasingCCIscore,largetumorsize(5cmormore)anddependenceinoneormoreADLcategorieswereallstronglyassociatedwithnon-surgicaltreatment(P<0.05).Conclusion:Increasingcomorbidity,largetumorsizeandreducedfunctionalabilityareassociatedwithreducedlikelihoodofsurgicaltreatmentofbreastcancerinolderpatients.However,ageitselfremainsasignificantfactorfornon-surgicaltreatment;reinforcingtheneedforevidence-basedguidelines.

简介：Toinvestigatethemutationsintheupstreamregulatoryregion(URR)ofhumanpapillomavirustype16(HPV-16)fromthecervicalcancerbiopsiesinXinjiangUygurwomenanditsrelationshiptothehighincidenceofcervicalcancerinthesouthernXinjiang,thetissueDNAwasextractedfromthecervicalcancerbiopsies,andtheURRsegmentofHPV-16DNAwasamplified,sequencedandanalyzed.Thereafter,thepolymorphismofURRinHPV-16wasthenanalyzed.ItwasdemonstratedthatthepositiveratedetectedforthepresenceofURRinHPV-16was89.47%(17/19).ComparedwiththepreviouslypublishedsequenceinURRofprototypeHPV-16,somemutationsweredetectedinthesequenceofURR.Themutationsin17URRfragmentsofHPV-16couldbedividedinto11patterns(XJU-1toXJU-11)atnucleicacidlevel,inwhicheachofXJU-1andXJU-4accountedfor23.53%(4/17),andotherpatternsofmutationaccountedfor5.88%(1/17).IncomparisonwiththeURRofprototypeHPV-16,theDNAidentityofthesepatternswas98.50%-99.68%.Inthese17URRfragments,twopointmutationsoccurredatposition7192(GtoT)andposition7520(GtoA)andtheyappearedtobeconstantinXinjiangarea.ThesetwomutationswereubiquitousintheAsia-Americantypeandconferredstronginfectionactivityandcarcinogenicityofthisvirus.Inaddition,themutationsatposition7729(AtoC),position7843(AtoG)andposition7792(CtoT)couldenhanceitstranscriptionactivityconsiderably.ItisconcludedthatsomemutationsoccurinURRgeneofHPV-16inthecervicalcancerbiopsiestakenfromUygurwomeninXinjiangarea,suggestingthatcertainrelationshipexistsamongthemutationsinURRofHPV-16,thephylogenyofHPV-16andthehighincidenceofcervicalcancerinsouthernpartofXinjiangarea.

简介：AbstractObjective:To investigate the effect of early versus late amniotomy after induction of labor (IOL) with vaginally administered misoprostol.Methods:This randomized clinical trial was conducted at the Department of Obstetrics and Gynecology, Menoufia University, from May 2019 to March 2020, and included 120 nulliparous women at term (≥ 37 weeks’ gestation) undergoing IOL. Computer-generated randomization was used to randomize the participants into either the early amniotomy group (3 cm cervical dilatation; n = 60) or the late amniotomy group (7 cm cervical dilatation; n = 60). All participants received misoprostol (25 µg) vaginally to induce labor. The primary outcome was the induction-to-delivery interval, defined as the time from the initiation of IOL to the time of delivery.Results:Women in the early amniotomy group had a shorter duration of labor (12.60 ± 5.36 h) than those in the late amniotomy group (16.67 ± 7.26 h). The mean time from rupture of the fetal membrane to delivery was significantly shorter in the late (2.51 ± 0.36 h) than in the early amniotomy group (3.1 ± 0.89 h). There was no statistically significant difference between the groups in terms of maternal complications (fever, nausea, vomiting, and uterine hyperstimulation) or neonatal complications (meconium-stained liquor, APGAR score <7 at 1 and 5 min, and neonatal intensive care unit admission).Conclusions:IOL using vaginally administered misoprostol followed by early amniotomy was accompanied by a shorter duration of labor and decreased use of oxytocin. There was no significant difference between the early and late amniotomy groups in terms of the rate of cesarean section or maternal and neonatal complications.

简介：AbstractBackgrounds:At present, there is no consensus on the induction methods in term pregnancy with borderline oligohydramnios. This study aimed to compare the effectiveness and pregnancy outcomes of labor induction with dinoprostone or single-balloon catheter (SBC) in term nulliparous women with borderline oligohydramnios.Methods:We conducted a retrospective cohort study from January 2016 to November 2018. During the study period, a total of 244 cases were enrolled. Of these, 103 cases were selected for induction using dinoprostone and 141 cases were selected for induction with SBC. The pregnancy outcomes between the two groups were compared. Primary outcomes were successful vaginal delivery rates. Secondary outcomes were maternal and neonatal adverse events. Multivariate logistic regression was used to assess the risk factors for vaginal delivery failure in the two groups.Results:The successful vaginal delivery rates were similar between the dinoprostone group and the SBC group (64.1% [66/103] vs. 59.6%, [84/141] P = 0.475), even after adjustment for potential confounding factors (adjusted odds ratio [aOR]: 1.07, 95% confidence interval [CI]: 0.57-2.00, P = 0.835). The incidence of intra-amniotic infection was lower in the dinoprostone group than in the SBC group (1.9% [2/103] vs. 7.8% [11/141], P < 0.001), but the presence of non-reassuring fetal heart rate was higher in the dinoprostone group than in the SBC group (12.6% [13/103] vs. 0.7%, [1/141] P < 0.001). Multivariate logistic regression showed that nuchal cord was a risk factor for vaginal delivery failure after induction with dinoprostone (aOR: 6.71, 95% CI: 1.96-22.95). There were three factors related to vaginal delivery failure after induction with SBC, namely gestational age (aOR: 1.51, 95% CI: 1.07-2.14), body mass index (BMI) >30 kg/m2 (aOR: 2.98, 95% CI: 1.10-8.02), and fetal weight >3500 g (aOR: 2.49, 95% CI: 1.12-5.50).Conclusions:Term nulliparous women with borderline oligohydramnios have similar successful vaginal delivery rates after induction with dinoprostone or SBC, with their advantages and disadvantages. In women with nuchal cord, the risk of vaginal delivery failure is increased if dinoprostone is used in the induction of labor. BMI >30 kg/m2, large gestational age, and estimated fetal weight >3500 g are risk factors for vaginal delivery failure after induction with SBC.

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简介：一个:马修,中年男人。八个:马修的岳母,马修的妻子家琵,马修的大女儿素湘和小女儿嘉芙莲,马修家的黑人女佣香奈儿和白人女佣露薏丝,家琵的妹妹汀,马修的妹妹贝丽。一个与八个:某天早晨,马修一家人正在忙着庆贺圣诞节,当白人女佣露薏丝端着早点一走进马修卧室,她立即发出惊声尖叫,原来马修背上插着一把尖刀,已经被人杀死在床上。全家乱作一团,有人打电话叫警察,可电话线被人剪断了。有人要开车去

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简介：AbstractObjective:To investigate cumulative live birth rate (cLBR) per oocyte retrieval in infertile patients aged 40 years and over undergoing their first in vitro fertilization/intracytoplasmic sperm injection cycles and to identify the possible predictors.Methods:A total of 1,613 patients at a university hospital in China from January 2013 to May 2017 were enrolled in this retrospective study. All data for fresh and subsequent frozen-thawed cycles were analyzed. Multivariate logistic regression analysis with stepwise selection of possible predictors for cLBR was performed, and Loess curve was constructed to determine the association between cLBR and the number of oocytes retrieved.Results:cLBR significantly increased with the number of oocytes retrieved and reached up to 75% when > 20 oocytes were retrieved (P < 0.001). Variables of antral follicle count (AFC) and the number of oocytes retrieved were selected using multiple logistic regression analysis with stepwise selection to predict the significance of cLBR. cLBR demonstrated an obvious upward trend as the number of oocytes retrieval increased in the Loess curve.Conclusions:For patients aged 40 years and over, AFC and the number of oocytes retrieved were two key predictors for cLBR and maximization of ovarian reserve exploitation was pivotal to increase the chance of live birth.

简介：Abstract: This article is a research paper on the impact of occupational stress on women's mental health and coping strategies.

简介：AbstractObjective:This study aimed to determine the likelihood of gestational diabetes mellitus (GDM) in subsequent pregnancy among women without GDM history and to identify risk factors for GDM in subsequent pregnancy.Methods:This retrospective cohort study involved participants who delivered twice in same hospital of 18 research centers when delivered the second baby from January 2018 to December 2018. Finally 6204 women were enrolled and 5180 women without GDM history were analyzed further. Women were categorized as non-GDM or GDM based on the blood glucose values of the subsequent pregnancy, and the characteristics and GDM risk of these groups were compared. A univariate analysis of potential risk factors was performed using the Chi-squared test and/or t-test for qualitative or quantitative variables, respectively. Associations with P values <0.1 were chosen to be included in the multivariate binary logistic regression model.Results:In primary analysis of 6204 women, the incidence of GDM in subsequent pregnancy is 48.9% (490/1002) in women with GDM history and 16.1% (835/5202) in women without GDM history. In a further analysis for 5180 women without GDM at index pregnancy, compared with the non-GDM group, the GDM group had a significantly higher age, prepregnancy body mass index, and blood glucose value at each oral glucose tolerance test (OGTT) timepoint (fasting, 1 h and 2 h) during the index and subsequent pregnancies, as well as higher weight retention during the interval between the two pregnancies (P<0.001). Age above 35 years in subsequent pregnancy (odds ratio (OR)=1.540, 95% confidence interval (CI) = 1.257-1.886, P<0.001), macrosomia in index pregnancy (OR=1.749, 95% CI=1.277-2.395, P=0.001), OGTT blood glucose values in index pregnancy (fasting, OR=2.487, 95% CI=1.883-3.285, P<0.001; 1 h, OR=1.142, 95% CI=1.051-1.241, P=0.002; 2 h, OR=1.290, 95% CI=1.162-1.432, P<0.001) and weight retention (OR=1.052, 95% CI=1.035-1.068, P<0.001) were independent risk factors for GDM in subsequent pregnancy.Conclusion:For women without GDM history, GDM risk factors including age, macrosomia history, OGTT value, and weight retention, these can be evaluated before a subsequent pregnancy. Early warning and interventions are needed for women at high risk.

简介：AbstractBackground:It is still unclear if and to what extent antenatal or infant or childhood vitamin D supplementation would affect the development of allergy diseases later in life. This study aimed to review the efficacy of vitamin D supplementation in pregnant women, infants, or children for the prevention of allergies.Methods:MEDLINE (PubMed), EMBASE (OVID), and the Cochrane Central Register of Controlled Trials were searched up to March 1, 2020. We included only randomized controlled trials (RCTs). We performed a systematic review and meta-analysis for vitamin D supplementation in primary allergy prevention. These trials were assessed for risk of bias using the Cochrane Collaboration domains and the consensus was reached via discussion with the full study group. We descriptively summarized and quantitatively synthesized original data to evaluate vitamin D supplementation in primary allergy prevention by using Review Manager software for meta-analysis.Results:The search yielded 1251 studies. Seven RCTs were included in this analysis. A meta-analysis revealed that vitamin D supplementation for pregnant women or infants may not decrease the risk of developing allergic diseases, such as asthma or wheezing (supplementation for pregnant women, risk ratio [RR]: 1.01, 95% confidence interval [CI]: 0.81-1.26, P = 0.90, I2 = 47%; supplementation for infants, RR: 1.00, 95% CI: 0.70-1.43, P = 0.99, I2 = 0%; supplementation for pregnant women and infants, RR: 0.35, 95% CI: 0.10-1.25, P= 0.11), eczema (supplementation for pregnant women, RR: 0.95, 95% CI: 0.80-1.13, P= 0.77, I2= 0%; supplementation for infants, RR: 0.84, 95% CI: 0.64-1.11, P= 0.19, I2= 42%), allergic rhinitis (supplementation for pregnant women, RR: 0.93, 95% CI: 0.78-1.11, P = 0.15, I2 = 47%), lower respiratory tract infection (LRTI) (supplementation for pregnant women, RR: 0.97, 95% CI: 0.85-1.11, P = 0.59, I2 = 0%), or food allergy.Conclusions:Supplementation of vitamin D in pregnant women or infants does not have an effect on the primary prevention of allergic diseases.Systematic Review Registration:PROSPERO (CRD42020167747)

简介：AbstractBackground:Endometrial cancer is one of the most common malignancies of the reproductive system. Effective and cost-effective screening method for populations at high risk is not available. This study aimed to investigate specimen adequacy and the influencing factors in microscale endometrial sampling biopsy and to evaluate the diagnostic accuracy and medical cost of biopsy in endometrial cancer and atypical hyperplasia screenings in comparison with hysteroscopic endometrial biopsy.Methods:A total of 1551 patients at high risk for endometrial lesions who required hysteroscopic endometrial biopsy from November 2017 to August 2018 were included. Microscale endometrial sampling biopsy was performed, followed by hysteroscopic endometrial biopsy. We evaluated the specimen adequacy and influencing factors of microscale endometrial sampling. Diagnostic consistency between microscale endometrial sampling biopsy and hysteroscopic endometrial biopsy was evaluated. The sensitivity, specificity, positive predictive value, and negative predictive value of microscale endometrial sampling biopsy in screening for endometrial cancer and atypical hyperplasia were analyzed, and the medical costs of the two procedures were compared.Results:The specimen adequacy was 81.2%. Patient age, menopausal status, endometrial thickness, and endometrial lesion type were correlated with specimen adequacy. There was good consistency in distinguishing benign and malignant endometrial diseases between microscale endometrial sampling biopsy and hysteroscopic biopsy (kappa 0.950, 95% CI 0.925-0.975). The sensitivity, specificity, positive predictive value, and negative predictive value of microscale endometrial sampling biopsy were 91.7%, 100.0%, 100.0%, and 99.3% for endometrial cancer screening, respectively, and 82.0%, 100.0%, 100.0%, and 99.4% for atypical hyperplasia screening. The medical cost of endometrial sampling biopsy was only 22.1% of the cost of hysteroscopic biopsy.Conclusions:Microscale endometrial sampling biopsy is a minimally invasive alternative technique for obtaining adequate endometrial specimens for histopathological examination. It has the potential to be used in detecting endometrial cancer and atypical hyperplasia with high efficiency and low cost.

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简介：AbstractThe management of preterm prelabor rupture of membranes (PPROM) before 34 weeks of gestation is intractable, due to pulmonary immaturity, many complications, poor pregnancy outcomes. In particular, the pre-viable PPROM (<23 weeks of gestation) is much more difficult to be treated. The clinical recommendation is to terminate the pregnancy as soon as possible. The pregnancy outcomes of PPROM in the early second-trimester of two twin pregnant women in our hospital were reported to explore the treatment protocols. The pregnancies of the two women developed PROM at 12 and 16 weeks of gestation, respectively. After expectant treatment, they were deliveried successfully at 34+6 and 34+4 weeks of gestation, respectively. The assessment of growth and development of infants was normal during the following six months after birth. Therefore, if PPROM occurs in the early second-trimester of pregnancy, the management of PPROM should be individualized, it’s a long process which should include comprehensive communication between patients and families regarding alternative treatment options (including expectant management) and risks and benefits of the procedure. In the absence of spontaneous labor or occurrence of complications that would prompt delivery (intra-amniotic infection, abruptio placenta, cord prolapse), and fetal status is normal, the patients should proceed with expectant treatment, induction of labor is commonly performed in pregnancies with PPROM ≥34 weeks of gestation.

简介：AIM:TodeterminetheassociationbetweenchlamydialconjunctivitisandgenitalinfectionbyChlamydiatrachomatis,MycoplasmagenitaliumandCandidaalbicans,inadditiontothepossiblerelationshipbetweenculturedbacterialpathogensandoculogenitalchlamydialinfection.METHODS:Thisstudywasperformedon100(50symptomaticand50asymptomatic)womenattendingtheGynecologicalandObstetricoutpatientclinicofAlzahrahospital,AlazharUniversity.Simultaneouslyaconjunctivalswabwastakenfromthesepatients.Polymerasechainreaction(PCR)wasdoneonDNAextractedfrombothvaginalandconjunctivalswabsamples.Cultureforbothvaginalandconjunctivalswabswasalsodone.RESULTS:Candidaalbicanswasthepredominantorganismisolatedbyculturein20%and40%ofconjunctivalandvaginalswabsrespectively.BythePCRmethod,ocularChlamydiatrachomatiswaspresentin60%ofsymptomaticwomen,whilegenitalChlamydiatrachomatisinfectionwaspresentin30%ofsymptomaticwomen.Theresultsofthismethodalsoindicatedthat25/50(50%)vaginalswabswerepositivewithPCRforCandidaalbicansversus15/50(30%)werePCRpositiveinconjunctivalswab.Mycoplasmagenitaliumwaspresentinonly10%ofvaginalswabs.ConcomitantoculogenitalPCRpositiveresultsforChlamydiatrachomatisandCandidaalbicanswere30%and28%respectively.CONCLUSION:OcularChlamydiatrachomatiswasassociatedwithgenitalChlamydiatrachomatisinahighpercentageofwomenfollowedbyCandidaalbicans.CulturedbacterialorganismsdonotplayaroleinenhancementofChlamydiatrachomatisinfection.