Objective: The diversity of opinions on the adverse effects of medications used to treat postmenopausal symptoms has prompted the use of various routes and mechanisms of action that need to be explored because bioavai...Objective: The diversity of opinions on the adverse effects of medications used to treat postmenopausal symptoms has prompted the use of various routes and mechanisms of action that need to be explored because bioavailability of the medications can vary. In order to select the appropriate route of administration for hormonal therapy (HT), it is necessary to determine baseline therapeutic efficacy. Design: We designed a prospective, randomized study consisting of four groups of postmenopausal wo-men: group 1 received oral conjugated estrogens, group 2 received a synthethic steroid, group 3 received estradiol nasally in spray form, and group 4 used transdermal estradiol in the form of patches. Criteria used to evaluate effectiveness was the Greene scale, which evaluate six components. These criteria were applied to each patient before hormonal intervention and then each month for 6 months. Luteinizing hormone (LH), follicle stimulating horone (FSH) and estradiol concentration were determined by chemiluminescence. Student’s t-test was used for intra-group comparisons before and after treatment. Results: There was a significant decrease in the vasomotor and sexual component (p < 0.05) with the use of four HT types. For depression, a difference was observed with synthetic steroids and oral estrogens. Upon analyzing the somatic component there was a decrease in symptoms with nasal and transdermal routes. Psychological changes were observed with the use of oral synthethic steroids and transdermal patches. Anxiety component demonstrated differences with nasal spray and oral estrogens, although all HT forms in this component showed a pattern of irregular changes. Conclusions: Changes in the response could be due each route of administration and medication used. Absorption variability may exist, which has repercussions in the control of symptoms and should be taken into consideration when selecting the appropriate route of administration for patients beginning HT.展开更多
Background:Electroacupuncture(EA)may affect the severity of hot flashes(HFs)associated with natural menopause and provide additional benefits for postmenopausal women.However,the evidence for its effectiveness in the ...Background:Electroacupuncture(EA)may affect the severity of hot flashes(HFs)associated with natural menopause and provide additional benefits for postmenopausal women.However,the evidence for its effectiveness in the management of early postmenopausal HFs remains inadequately understood.Objective:We designed this trial to assess the efficacy and safety of EA for relieving early postmenopausal HFs.Design,setting,participants and interventions:This randomized sham-controlled trial involved 72 women with HFs.The participants were divided equally into the intervention and control groups.The intervention group was treated with EA,while the control group was treated with sham acupuncture.The main acupoints used were Hegu(LI4),Guanyuan(RN4),Sanyinjiao(SP6),Taixi(KI3),Fuliu(KI7)and Shenshu(BL23).All participants received 18 treatment sessions,distributed across a 6-week period.The treatment was administered on three occasions per week,adhering to a fixed weekday schedule(Monday,Wednesday,Friday or Tuesday,Thursday,Saturday)with a minimum interval of one day between sessions.Each patient received a 12-week follow-up.Main outcome measures:The HF score was the primary outcome.Participants documented the frequency and severity of HFs in a 7-day symptom diary,which provided data for calculating the HF score.Secondary outcomes were the Menopause Rating Scale(MRS),Menopause-Specific Quality of Life Questionnaire(MENQOL),Pittsburgh Sleep Quality Index(PSQI)and Traditional Chinese Medicine Syndrome Score Scale(TCMSSS),as well as estradiol(E2),luteinizing hormone(LH)and folliclestimulating hormone(FSH)levels.Results:Both groups demonstrated significant reductions in HF scores after the treatment and during the follow-up(P<0.001).Immediately after completion of the 6-week treatment cycle and at 12 weeks postintervention,the HF scores were similar in both groups.At week 6,the intervention group showed significantly greater improvements in MRS,MENQOL(vasomotor,psychosocial,and physical),PSQI and TCMSSS scores(P<0.05).The improvements in the MENQOL(vasomotor,and psychosocial)and PSQI total scores persisted through the follow-up(P<0.05).However,the results showed no significant inter-or intragroup differences in sexual scores on the MENQOL(P>0.05).EA did not significantly decrease E2,LH or FSH levels compared to placebo.The incidence of adverse events was similar in both groups.Conclusion:EA does not significantly improve HFs in early postmenopausal patients.However,it enhances the quality of sleep and decreases menopausal symptoms across vasomotor,psychosocial and physical domains.Trial registration:Chinese Clinical Trial Registry(http://www.chictr.org.cn);Trial ID:Chi CTR2300072002.Please cite this article as:Wang HX,Yu XT,Hu J,Chen JJ,Mei YT,Chen YF.Electroacupuncture for hot flashes in early menopause:A randomized sham-controlled trial.J Integr Med.2025;23(5):519-527.?2025 Shanghai Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.Published by Elsevier B.V.All rights are reserved,including those for text and data mining,AI training,and similar technologies.展开更多
As of 2023, endometrial cancer (EC) ranks second among malignant tumors of the female reproductive system in China, following cervical cancer, posing a significant burden on the country’s healthcare system. Postmenop...As of 2023, endometrial cancer (EC) ranks second among malignant tumors of the female reproductive system in China, following cervical cancer, posing a significant burden on the country’s healthcare system. Postmenopausal asymptomatic endometrial thickening is primarily benign, often involving endometrial polyps. However, previous clinical studies indicate a relatively high malignancy rate for postmenopausal endometrial polyps, suggesting the necessity for active intervention, particularly in cases with high-risk factors for EC. This article reviews the research progress on risk factors for endometrial lesions in postmenopausal patients with asymptomatic endometrial thickening, aiming to provide insights for clinical diagnosis and treatment.展开更多
Background:Menopausal symptoms and sleep difficulty were physiological processes that were affected by genetic and other factors.This study was to investigate the prevalence of menopausal symptoms and sleep quality in...Background:Menopausal symptoms and sleep difficulty were physiological processes that were affected by genetic and other factors.This study was to investigate the prevalence of menopausal symptoms and sleep quality in menopausal transition(MT)and postmenopause(PM)women in Taiyuan,Shanxi.Methods:A community-based survey of women's menopausal symptoms and sleep quality was conducted between July 2012 and May 2013 at six municipal districts of Taiyuan,Shanxi.A sample of 2429 women aged 40-59 years was divided into four groups:early MT,late MT,early PM,and late PM.Sleep quality in the past 2 weeks before the interview was recorded.The data were analyzed using SPSS 16.0.Results:The prevalence of menopausal symptoms was 49.8%.Mild,moderate,and severe symptoms were observed in 28.9%,18.5%,and 2.5%of participants,respectively.The highest prevalence of menopausal symptoms occurred in the early postmenopausal stage;the subsequences were the late postmenopausal stage and the early MT stage.Interestingly,among the 13 items of modified Kupperman index,the five most common symptoms were fatigue,arthralgia and myalgia,decreased libido,insomnia,and nervousness.Meanwhile,55%perimenopausal women had poor sleep.Conclusions:Menopausal symptoms are common but mild among women in Taiyuan,Shanxi during MT and PM.In these stages,the prevalence of poor sleep is high.展开更多
Depression is highly prevalent among postmenopausal women with osteoporosis,driven by the combined effects of hormonal changes,reduced bone density,and psychosocial stress.A recent study by Cui and Su reported that 73...Depression is highly prevalent among postmenopausal women with osteoporosis,driven by the combined effects of hormonal changes,reduced bone density,and psychosocial stress.A recent study by Cui and Su reported that 73.3%of affected women exhibited depressive symptoms,with low bone mineral density,chronic comorbidities,and reduced serotonin(5-hydroxytryptamine)levels as key risk factors.Notably,nurse-led psychological interventions improved both mood and quality of life.This editorial underscore the need to integrate mental health support into standard osteoporosis care.Simple,scalable strategies such as routine screening and nurse-delivered emotional support may help bridge the gap between physical and psychological health.These approaches are especially relevant for aging populations across diverse healthcare settings.A dual focus on bone and emotional well-being is essential to improving outcomes in this vulnerable group.展开更多
Chinese dwarf cherry(Cerasus humilis)is a fruit unique to China,which is considered to have osteoprotective effects.However,no systematic experimental characterization was available.In this study,the osteoprotective a...Chinese dwarf cherry(Cerasus humilis)is a fruit unique to China,which is considered to have osteoprotective effects.However,no systematic experimental characterization was available.In this study,the osteoprotective activity and mechanism of Chinese dwarf cherry polyphenol extract(OPE)was studied.In vitro,OPE stimulated the alkaline phosphatase activity in the early differentiation stage,increased the osteocalcin level in the middle differentiation stage,and induced the formation of more bonemineralized nodules in the late osteogenic stage.In vivo,OPE improved cancellous bone structure and maximum load of the femur in ovariectomized(OVX)rats.The balance between bone formation and resorption was regulated.Oxidative stress levels in the peripheral blood,liver and femur were reduced.OPE alleviated the disturbance in energy metabolism,muscle development,and muscle regulation-related signaling pathways caused by OVX and activated the calcium/adenosine monophosphate-activated protein kinase signaling pathway.Therefore,OPE is a potential dietary supplement for the prevention and treatment of osteoporosis.展开更多
BACKGROUND Postmenopausal women face an increased risk of cardiovascular disease(CVD)due to estrogen withdrawal,which exacerbates traditional cardiovascular risk factors such as dyslipidemia,glucose intolerance,and hy...BACKGROUND Postmenopausal women face an increased risk of cardiovascular disease(CVD)due to estrogen withdrawal,which exacerbates traditional cardiovascular risk factors such as dyslipidemia,glucose intolerance,and hypertension.Coronary Artery Calcium Score(CACS),a well-established marker of subclinical atherosclerosis,has emerged as a key predictor of adverse cardiovascular events.Despite the recognized association between menopause and heightened CVD risk,there remains a paucity of literature exploring the specific role of menopause in influencing CACS and its implications for cardiovascular morbidity and morta lity.AIM To examine the interplay between menopause,CACS,and cardiovascular health by synthesizing existing literature.METHODS A comprehensive literature search was conducted using PubMed and Google Scholar,focusing on studies that analyzed CACS in postmenopausal women,including the influence of factors such as hormone therapy,Triglyceride-Glucose index,bone mineral density,lipid metabolism,and type-1 diabetes.Data extraction and synthesis emphasized key patterns,metabolic influences,and potential mechanisms driving coronary calcification in menopause.RESULTS Findings suggest that menopause contributes to increased CACS through multiple pathways,including altered lipid metabolism,insulin resistance,and arterial stiffness.Additionally,premature menopause is associated with higher CACS and elevated CVD risk.While hormone replacement therapy(HRT)appears to have a protective effect against coronary calcification,further research is needed to clarify its long-term benefits and risks.CONCLUSION We introduce a novel framework combining CACS with metabolic and hormonal markers,and discuss estrogendriven mechanisms and HRT considerations in postmenopausal cardiovascular risk.This review underscores the need for targeted cardiovascular risk assessment in postmenopausal women,integrating CACS with other metabolic markers to improve early detection and prevention of CVD in this high-risk population.展开更多
Studies have shown that differentiated embryo-chondrocyte expressed gene 1(DEC1)promotes osteoblast osteogenesis.To investigate the role of DEC1 in postmenopausal osteoporosis,we used the two genotypes of mice(Dec1+/+...Studies have shown that differentiated embryo-chondrocyte expressed gene 1(DEC1)promotes osteoblast osteogenesis.To investigate the role of DEC1 in postmenopausal osteoporosis,we used the two genotypes of mice(Dec1+/+and Dec1-/-)to establish an ovariectomy model and found that the bone loss was significantly lower in Dec1-/-ovariectomy mice than in Dec1+/+ovariectomy mice.The expression levels of RUNX2 and OSX were significantly increased in Dec1-/-ovariectomy mice,compared with Dec1+/+ovariectomy mice;however,the expression levels of NFATc1,c-Fos,CTSK,and RANKL/OPG ratio were significantly decreased in Dec1-/-ovariectomy mice,compared with those in Dec1+/+ovariectomy mice.Likewise,DEC1 deficiency also suppressed the expression levels of IL-6 and IL-1β.Further results showed that the mRNA expression levels of Runx2,Osx,and Alp were significantly increased in bone marrow mesenchymal stem cells of Dec1-/-ovariectomy mice,compared with those of Dec1+/+ovariectomy mice.Moreover,the mRNA levels of Il1b,Il6,Tnfa,and Ifng were significantly increased in bone marrow-derived macrophages(BMMs)of Dec1+/+ovariectomy mice,compared with those of Dec1+/+sham mice,but not in Dec1-/-ovariectomy BMMs,when compared with those in Dec1-/-sham BMMs.Additionally,the expression levels of p-IκBαand p-P65 were significantly increased in Dec1+/+ovariectomy BMMs,compared with those in Dec1+/+sham BMMs,but did not increase in Dec1-/-ovariectomy BMMs,compared with those in Dec1-/-sham BMMs.Taken together,DEC1 deficiency inhibited the NF-κB pathway induced by ovariectomy,thereby decreasing cytokines and subsequently inhibiting the decrease of osteo-genesis and the increase of osteoclastogenesis caused by ovariectomy.The findings may provide a novel under-standing of postmenopausal osteoporosis development,and offer potential avenues for the disease intervention.展开更多
OBJECTIVE: To explore the multi-component synergistic mechanism of Zuogui Wan(左归丸, ZGW) in treating postmenopausal osteoporosis(PMOP). METHODS: The main components and target genes of ZGW were screened via the Trad...OBJECTIVE: To explore the multi-component synergistic mechanism of Zuogui Wan(左归丸, ZGW) in treating postmenopausal osteoporosis(PMOP). METHODS: The main components and target genes of ZGW were screened via the Traditional Chinese Medicine Systems Pharmacology(TCMSP). In addition, the target gene sets of PMOP were derived from the Gene Cards and Online Mendelian Inheritance in Man databases. The search tool for recurring instances of neighbouring genes(STRING) 11.0 software was used to analyze the interaction among intersecting genes. Cytoscape 3.6.1 software and the Matthews correlation coefficient(MCC) algorithm were used to screen the core genes. Fifty Sprague-Dawley female rats were randomly divided into the sham-operated(Sham) group and the four ovariectomized(OVX) subgroups. Rats subjected to Sham or OVX were administered with the vehicle(OVX, 1 m L water/100 g weight), 17β-estradiol(E2, 50 μg·kg-1·d-1), and lyophilized powder of ZGW at a low dose of 2.3(ZGW-L) and high dose of 4.6(ZGW-H) g·kg-1·d-1 for three months. The bone density and bone strength were assessed using dual-energy X-ray and three-point bending tests, respectively. Furthermore, enzyme-linked immunosorbent assay, Hematoxylin-eosin staining, and western blot analysis were used to determine the potential pharmacological mechanisms of action of ZGW in PMOP. RESULTS: A total of 117 active compounds of ZGW were screened from the TCMSP. Furthermore, 108 intersecting genes of drugs and diseases were identified. Using STRING software and the MCC algorithm, ten core genes, including C-X-C chemokine living 8(CXCL8), C-C chemokine receptor type 2(CCR2), alpha-2a active receptor(ADRA2A), melatonin receptor type 1B(MTNR1B), and amyloid-beta A4 protein(APP), were identified. The anti-osteoporosis regulation network of ZGW was constructed using the Cytoscape software. The animal experiments demonstrated that ZGW groups significantly reduced the serum levels of β-C-terminal telopeptide of type I collagen(β-CTX) and increased serum levels of bone-specific alkaline phosphatase(BALP)(P < 0.05, P < 0.01). The OVX group exhibited a significant decrease in bone mineral density and bone strength compared with the Sham group(P < 0.01). Moreover, treatment with ZGW resulted in increased trabecular thickness, improved arrangement of trabecular structure, and reduced empty bone lacunae. Furthermore, treatment with ZGW significantly increased the protein expression of CXCL8, ADRA2A, and CCR2(P < 0.05, P < 0.01), and significantly decreased the protein expression of Runx2(P < 0.01). Furthermore, the ZGW and E2 groups demonstrated significantly increased BMD(P < 0.05, P < 0.01), improved bone strength(P < 0.05, P < 0.01), reduced expression of CXCL8, ADRA2A, and CCR2, and increased runt-related transcription factor 2 levels in bone tissue(P < 0.05, P < 0.01) compared with the OVX group. However, there were no significant differences in MTNR1B and APP expression among the groups. CONCLUSION: ZGW shows synergistic mechanisms in PMOP through multiple components, targets, and pathways.展开更多
The aging of the global population has made postmenopausal osteoporosis prevention essential;however,pharmacological treatments are limited.Herein,we evaluate the effect of calcium-fortified fresh milk(FM)in ameliorat...The aging of the global population has made postmenopausal osteoporosis prevention essential;however,pharmacological treatments are limited.Herein,we evaluate the effect of calcium-fortified fresh milk(FM)in ameliorating postmenopausal osteoporosis in a rat model established using bilateral ovariectomy.After 3 months of FM(containing vitamin D,and casein phosphopeptides,1000 mg Ca/100 g)or control milk(110 mg Ca/100 g milk)supplementation,bone changes were assessed using dual-energy X-ray absorptiometry,microcomputed tomography,and bone biomechanical testing.The results revealed that FM can regulate bone metabolism and gut microbiota composition,which act on bone metabolism through pathways associated with steroid hormone biosynthesis,relaxin signaling,serotonergic synapse,and unsaturated fatty acid biosynthesis.Furthermore,FM administration significantly increased bone mineral content and density in the lumbar spine and femur,as well as femoral compressive strength,while improving femoral trabecular bone parameters and microarchitecture.Mechanistically,we found that the effects may be due to increased levels of estrogen,bone formation marker osteocalcin,and procollagen typeⅠN-propeptide,and decreased expression of the bone resorption marker C-telopiptide and tartrate-resistant acid phosphatase 5b.Overall,the findings suggest that FM is a potential alternative therapeutic option for ameliorating postmenopausal osteoporosis.展开更多
BACKGROUND Rhabdomyosarcoma(RMS)of the vagina in postmenopausal women is an extre-mely rare malignant tumor that was originally described as a unique group of soft tissue sarcomas originating from primitive mesenchyma...BACKGROUND Rhabdomyosarcoma(RMS)of the vagina in postmenopausal women is an extre-mely rare malignant tumor that was originally described as a unique group of soft tissue sarcomas originating from primitive mesenchymal cells.It was first re-ported in postmenopausal women in 1970,and fewer than 50 postmenopausal patients have been reported to date.CASE SUMMARY A 68-year-old multiparous female was admitted to the hospital on October 11,2023,with the chief complaint of a mass causing vaginal prolapse with incomplete urination that had persisted for 4 months.The vaginal mass was approximately the size of a pigeon egg;after lying down,the vaginal mass retracted.Complete resection was performed,and vaginal pleomorphic RMS was diagnosed based on pathology and immunohistochemical staining features.The patient is currently undergoing chemotherapy.The present study also reviewed the clinical,histolo-gical,and immunohistochemical features and latest treatment recommendations for vaginal RMS.Any abnormal vaginal mass should be promptly investigated through pelvic examination and appropriate imaging.The current initial treat-ment for vaginal RMS is biopsy and primary chemotherapy.CONCLUSION When surgery is planned for vaginal RMS,an organ-preserving approach should be considered.展开更多
BACKGROUND Postmenopausal osteoporosis(PMOP)is the most common form of primary osteoporosis among women,and the associated pain often drives patients to seek clinical intervention.Numerous studies have highlighted the...BACKGROUND Postmenopausal osteoporosis(PMOP)is the most common form of primary osteoporosis among women,and the associated pain often drives patients to seek clinical intervention.Numerous studies have highlighted the unique clinical benefits of exercise therapy(ET)in alleviating PMOP-related pain.However,bibliometric analyses examining collaboration,development trends,and research frontiers in the field of ET for PMOP pain remain scarce.AIM To explore the research trends in ET for pain treatment in PMOP patients over the past decade.METHODS All scholarly works were meticulously sourced from the Science Citation Index-Expanded within the prominent Web of Science Core Collection.Utilizing the capabilities of CiteSpace 6.2.R5,we conducted a thorough analysis of publications,authors,frequently cited scholars,contributing nations,institutions,journals of significant citation,comprehensive references,and pivotal keywords.Additionally,our examination explored keyword cooccurrences,detailed timelines,and periods of heightened citation activity.This comprehensive search,from 2014 through 2023,was completed within a single day,on October 11,2023.RESULTS In total,2914 articles were ultimately included in the analysis.There was a rapid increase in annual publication output in 2015,followed by stable growth in subsequent years.Boninger,Michael L,is the most prolific author,whereas Ware JE has the most citations.The United States’global influence is significant,surpassing all other nations.The University of California System and Harvard University are the most influential academic institutions.J Bone Joint Surg Am is the most influential journal in this field.“Spinal cord injury”is the keyword that has garnered the most attention from researchers.The developmental pattern in this field is characterized by interdisciplinary fusion,with different disciplines converging to drive progress.CONCLUSION The academic development of the field of ET for pain in PMOP has matured and stabilized.Clinical management and rehabilitation strategies,along with the mechanisms underlying the relationship between ET and bone resorption analgesia,continue to be the current and future focal points of research in this field.展开更多
Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several...Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.展开更多
Objectives: To explore the relationship between adiponectin (APN) and bone mineral density in this Zhuang ethnic group, thus providing a basis underpinning the prevention and treatment of osteoporosis (OP). Methods: Z...Objectives: To explore the relationship between adiponectin (APN) and bone mineral density in this Zhuang ethnic group, thus providing a basis underpinning the prevention and treatment of osteoporosis (OP). Methods: Zhuang women over 50 years old in Guangxi Zhuang Autonomous Region were included in the study. The broadband ultrasound attenuation (BUA) was adopted as the reference to calculate the T value. Quantitative ultrasonic bone density was measured on the right. Body composition measuring instrument was used to measure weight, fat, and muscle mass. Plasma APN level was detected by ELISA and blood lipids were detected by enzymatic method. Results: Plasma APN level was found with significant differences in the normal bone mineral density group, bone mineral density reduction group, and osteoporosis group (P β = −0.176, P = 0.001) when the partial correlation coefficient of APN is −0.210. Elevated APN was an independent risk factor for bone mineral density reduction (OR = 1.191, 95%CI: 1.004 - 1.407, P = 0.04) and OP (OR = 1.1337, 95%CI: 1.137 - 1.572, P Conclusion: Increased APN in postmenopausal women of Zhuang is an independent risk factor for OP. The application of APN in the OP screening and prevention of middle-aged and ageing Zhuang women still needs further research.展开更多
Objective:To study the screening for cervical cancer in postmenopausal women in liquid-based cell test(TCT)application value.Methods:From January 2023 to March 2024 hospital check-ups and outpatient reached 400 cases ...Objective:To study the screening for cervical cancer in postmenopausal women in liquid-based cell test(TCT)application value.Methods:From January 2023 to March 2024 hospital check-ups and outpatient reached 400 cases of postmenopausal women,and they were TCT and HPV detection,during the study period to pathological diagnosis of numerical results as the standard,analysis of TCT detection application of screening for cervical cancer in postmenopausal women and the effect.Results:After the TCT detection,the inflammation group and normal group by use of HPV testing positive rate higher than other groups(P<0.05).Hospital after pathological diagnosis and research,after the screening system found CINⅠlevel and above cases about 39 cases,the TCT and HPV detection rate of positive difference is not obvious,and there is no statistical significance(P>0.05).Joint test analysis,the sensitivity and specificity were higher than that of TCT and HPV testing positive(P<0.05).Conclusion:TCT detection screening for cervical cancer in postmenopausal women is of great importance to the application,if you can join HPV testing,help to improve the detection sensitivity,avoid missed diagnosis of problems,and then for treatment and later restore to lay a solid foundation.展开更多
Objective:To compare the efficacy of Wumei Decoction in pre and postmenopausal patients and its effect on follicle-stimulating hormone(FSH)and estradiol(E2).Methods:Sixty-four patients who attended the Department of T...Objective:To compare the efficacy of Wumei Decoction in pre and postmenopausal patients and its effect on follicle-stimulating hormone(FSH)and estradiol(E2).Methods:Sixty-four patients who attended the Department of Traditional Chinese Medicine I in Cangzhou City Central Hospital from January 2020 to January 2022 were selected and randomly divided into treatment group and control group,32 cases in each group.The treatment group took modified Wumei Decoction orally,1 dose of water boiled 2 times a day,divided into 2 warm doses;the control group took Livial orally,2.5 mg/times,1 time/day,and the observation cycles were all for 3 months.Kupperman score,FSH,E2,clinical symptoms and clinical efficacy were compared between the two groups before and after treatment.Results:The Kupperman score of the two groups decreased after treatment,and the difference was statistically significant;the total effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant;there was no statistical significance in the comparison of FSH before and after the treatment of the two groups,but the FSH values of the two groups were significantly lower than those before,and the difference was statistically significant;there was no statistically significant difference in the comparison of E2 of the two groups before treatment,and the E2 values of the two groups were higher than those of the control group after the treatment.After the treatment,E2 of the two groups of patients was significantly higher than before,and the difference was statistically significant.After treatment,E2 of the treatment group was higher than that of the control group,and the comparison between the groups was statistically significant.Conclusion:There was no significant difference between modified Wumei Decoction and Livial in lowering follicle-stimulating hormone levels;modified Wumei Decoction was superior in raising oestradiol;and modified Wumei Decoction was relatively effective in improving clinical symptoms.展开更多
OBJECTIVE: To assess the effectiveness and safety of Kuntai capsule and hormone replacement therapy in treatment of perimenopausal syndrome.METHODS: Articles were retrieved from the databases Cochrane Database of Syst...OBJECTIVE: To assess the effectiveness and safety of Kuntai capsule and hormone replacement therapy in treatment of perimenopausal syndrome.METHODS: Articles were retrieved from the databases Cochrane Database of Systematic Reviews,Pub Med, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database. Only randomized controlled trials were included; 15 trials involving1243 patients were identified from January 2005 to April 2015. A systemic review and Meta-analysis of publications was performed. The review was limit-ed to randomized controlled trials that compared Kuntai capsule and hormone replacement therapy to treat perimenopausal syndrome for at least 3months. The primary outcome assessed was the treatment efficacy at 3 months, including effective rate of Kupperman menopausal scores, Kupperman menopausal scores, and blood estradiol(E2) or blood follicle stimulating hormone(FSH) levels.Other outcomes assessed were safety or adverse events, such as gastrointestinal complaints, breast distending pain, or vaginal bleeding.RESULTS: Kupperman menopausal scores showed no significant difference in effective rate [odds ratio(OR): 1.05, 95% confidence intervals(CI): 0.71 to1.55] and changes in FSH level [mean difference(MD): 2.14, 95% CI:-2.36 to 6.65]. There was a significant statistical difference in Kupperman menopausal scores(MD:-1.14, 95% CI:-2.03 to-0.25)and changes in E2level(MD:-16.41, 95% CI:-18.83to-13.69). There were fewer adverse events in the Kuntai capsule group than in the hormone replacement therapy group(OR: = 0.35, 95% CI: 0.25 to0.48, P < 0.01).CONCLUSION: Compared with hormone replacement therapy, Kuntai capsule can improve perimenopausal symptoms and blood E2 levels, and reduce the incidence of adverse events.展开更多
Objective To evaluate the role of sclerostin in bone loss of postmenopausal Chinese women with type 2 diabetes me｜litus. Methods The postmenopausal patients suffering from type 2 diabetes mellitus and age, body mass...Objective To evaluate the role of sclerostin in bone loss of postmenopausal Chinese women with type 2 diabetes me｜litus. Methods The postmenopausal patients suffering from type 2 diabetes mellitus and age, body mass index, and duration of menopause matched healthy controls were enrolled into this cross-sectional study according to criteria of inclusion and exclusion.展开更多
Purpose： This study aimed to assess whether the benefits of exercise on central adiposity and insulin resistance （HOMA-IR） are maintained after discontinuation of intervention in the overweight/obese （OWOB） women...Purpose： This study aimed to assess whether the benefits of exercise on central adiposity and insulin resistance （HOMA-IR） are maintained after discontinuation of intervention in the overweight/obese （OWOB） women. Methods： The study subjects were from 2 independent studies with similar aerobic exercise （AE） intervention programs. In study I, I50WOB postmenopausal women with pre-diabetes （body mass index, BMI = 24-33 kg/m2, aged 52-65 years） completed an 8-month exercise intervention and were followed for 2 years after the intervention. In study lI, 12 OWOB （BM1 = 25-35 kg/m2, aged 30-50 years） premenopausal women participated in a 6-week AE and were followed for 4 years after the intervention. The exercise program consisted of progressive AE with intensity of 60%-75% of initial fitness level, 30-60 min/time and 3-5 times/week. Fat mass （FM） was assessed by Dual Energy X-ray Absorptiometry （DXA Prodigy; study I） or bioelectrical impedance device （Inbody 720; study II）. Plasma glucose and insulin were assessed by chemiluminescent immunoassay and HOMA-IR was calculated. Results： Both 8-month and 6-week moderate AE were effective in reducing HOMA-IR （-18.9%, p = 0.012 and -26.7%, p = 0.046, respectively）, and 8-month AE reduced FM at upper abdominal region （-6.2%, p = 0.021）. However, these improvements were not maintained in either study at the follow-up. Conclusion： The AE program used in these studies was effective to reduce insulin resistance and/or FM in central body region among overweight and obese women. However, when exercise intervention was discontinued, the beneficial effects following both short- and long-term intervention disappeared. Thus maintaining exercise seems to be required if one wants to reap the benefits of exercise in the long-term.展开更多
BACKGROUND Postmenopausal bleeding and an endometrial thickness≥5 mm on sonograms of menopausal women can indicate the presence of endometrial lesions.Diagnostic hysteroscopy is a powerful method for endometrial dise...BACKGROUND Postmenopausal bleeding and an endometrial thickness≥5 mm on sonograms of menopausal women can indicate the presence of endometrial lesions.Diagnostic hysteroscopy is a powerful method for endometrial diseases.AIM To investigate the pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or asymptomatic thickened endometrium diagnosed by hysteroscopy.METHODS A total of 187 postmenopausal women with bleeding or asymptomatic thickened endometrium underwent diagnostic hysteroscopy.The women were subsequently divided into three groups:Postmenopausal bleeding(PMB)group(n=84),asymptomatic group(n=94),and additional group(n=9).Women in the additional group manifested abdominal pain and leukorrhagia.RESULTS Among the 187 patients examined,84(44.9%)were diagnosed with PMB and 94(50.3%)with asymptomatic thickened endometrium.Endometrial polyp was the most common endometrial abnormality,which was detected in 51.2%,76.6%and 77.8%of the PMB,asymptomatic,and additional groups,respectively.In the PMB group,7(8.3%)women had hyperplasia with atypia and 14(16.7%)had endometrial adenocarcinoma.Fewer malignant lesions were detected in the asymptomatic group.Endometrial hyperplasia without atypia was found in 8.3%of the PMB group and 7.4%of the asymptomatic group.CONCLUSION Endometrial polyp was the most common pathology in the PMB group.Diagnostic hysteroscopy is recommended for women with PMB and asymptomatic thickened endometrium.展开更多
文摘Objective: The diversity of opinions on the adverse effects of medications used to treat postmenopausal symptoms has prompted the use of various routes and mechanisms of action that need to be explored because bioavailability of the medications can vary. In order to select the appropriate route of administration for hormonal therapy (HT), it is necessary to determine baseline therapeutic efficacy. Design: We designed a prospective, randomized study consisting of four groups of postmenopausal wo-men: group 1 received oral conjugated estrogens, group 2 received a synthethic steroid, group 3 received estradiol nasally in spray form, and group 4 used transdermal estradiol in the form of patches. Criteria used to evaluate effectiveness was the Greene scale, which evaluate six components. These criteria were applied to each patient before hormonal intervention and then each month for 6 months. Luteinizing hormone (LH), follicle stimulating horone (FSH) and estradiol concentration were determined by chemiluminescence. Student’s t-test was used for intra-group comparisons before and after treatment. Results: There was a significant decrease in the vasomotor and sexual component (p < 0.05) with the use of four HT types. For depression, a difference was observed with synthetic steroids and oral estrogens. Upon analyzing the somatic component there was a decrease in symptoms with nasal and transdermal routes. Psychological changes were observed with the use of oral synthethic steroids and transdermal patches. Anxiety component demonstrated differences with nasal spray and oral estrogens, although all HT forms in this component showed a pattern of irregular changes. Conclusions: Changes in the response could be due each route of administration and medication used. Absorption variability may exist, which has repercussions in the control of symptoms and should be taken into consideration when selecting the appropriate route of administration for patients beginning HT.
基金supported by Shanghai Clinical Research Center for Acupuncture and Moxibustion(No.20MC1920500)National Administration of Traditional Chinese Medicine High-Level Disciplines Construction Project(No.ZYYZDXK-2023068)Three Year Action Plan for Shanghai to Further Accelerate the Inheritance,Innovation and Development of Traditional Chinese Medicine(2025-2027)(No.1-1-2)。
文摘Background:Electroacupuncture(EA)may affect the severity of hot flashes(HFs)associated with natural menopause and provide additional benefits for postmenopausal women.However,the evidence for its effectiveness in the management of early postmenopausal HFs remains inadequately understood.Objective:We designed this trial to assess the efficacy and safety of EA for relieving early postmenopausal HFs.Design,setting,participants and interventions:This randomized sham-controlled trial involved 72 women with HFs.The participants were divided equally into the intervention and control groups.The intervention group was treated with EA,while the control group was treated with sham acupuncture.The main acupoints used were Hegu(LI4),Guanyuan(RN4),Sanyinjiao(SP6),Taixi(KI3),Fuliu(KI7)and Shenshu(BL23).All participants received 18 treatment sessions,distributed across a 6-week period.The treatment was administered on three occasions per week,adhering to a fixed weekday schedule(Monday,Wednesday,Friday or Tuesday,Thursday,Saturday)with a minimum interval of one day between sessions.Each patient received a 12-week follow-up.Main outcome measures:The HF score was the primary outcome.Participants documented the frequency and severity of HFs in a 7-day symptom diary,which provided data for calculating the HF score.Secondary outcomes were the Menopause Rating Scale(MRS),Menopause-Specific Quality of Life Questionnaire(MENQOL),Pittsburgh Sleep Quality Index(PSQI)and Traditional Chinese Medicine Syndrome Score Scale(TCMSSS),as well as estradiol(E2),luteinizing hormone(LH)and folliclestimulating hormone(FSH)levels.Results:Both groups demonstrated significant reductions in HF scores after the treatment and during the follow-up(P<0.001).Immediately after completion of the 6-week treatment cycle and at 12 weeks postintervention,the HF scores were similar in both groups.At week 6,the intervention group showed significantly greater improvements in MRS,MENQOL(vasomotor,psychosocial,and physical),PSQI and TCMSSS scores(P<0.05).The improvements in the MENQOL(vasomotor,and psychosocial)and PSQI total scores persisted through the follow-up(P<0.05).However,the results showed no significant inter-or intragroup differences in sexual scores on the MENQOL(P>0.05).EA did not significantly decrease E2,LH or FSH levels compared to placebo.The incidence of adverse events was similar in both groups.Conclusion:EA does not significantly improve HFs in early postmenopausal patients.However,it enhances the quality of sleep and decreases menopausal symptoms across vasomotor,psychosocial and physical domains.Trial registration:Chinese Clinical Trial Registry(http://www.chictr.org.cn);Trial ID:Chi CTR2300072002.Please cite this article as:Wang HX,Yu XT,Hu J,Chen JJ,Mei YT,Chen YF.Electroacupuncture for hot flashes in early menopause:A randomized sham-controlled trial.J Integr Med.2025;23(5):519-527.?2025 Shanghai Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.Published by Elsevier B.V.All rights are reserved,including those for text and data mining,AI training,and similar technologies.
文摘As of 2023, endometrial cancer (EC) ranks second among malignant tumors of the female reproductive system in China, following cervical cancer, posing a significant burden on the country’s healthcare system. Postmenopausal asymptomatic endometrial thickening is primarily benign, often involving endometrial polyps. However, previous clinical studies indicate a relatively high malignancy rate for postmenopausal endometrial polyps, suggesting the necessity for active intervention, particularly in cases with high-risk factors for EC. This article reviews the research progress on risk factors for endometrial lesions in postmenopausal patients with asymptomatic endometrial thickening, aiming to provide insights for clinical diagnosis and treatment.
基金supported by grants from the scientific and technological projects of Shanxi Provincial Health Office.China(No.200918).
文摘Background:Menopausal symptoms and sleep difficulty were physiological processes that were affected by genetic and other factors.This study was to investigate the prevalence of menopausal symptoms and sleep quality in menopausal transition(MT)and postmenopause(PM)women in Taiyuan,Shanxi.Methods:A community-based survey of women's menopausal symptoms and sleep quality was conducted between July 2012 and May 2013 at six municipal districts of Taiyuan,Shanxi.A sample of 2429 women aged 40-59 years was divided into four groups:early MT,late MT,early PM,and late PM.Sleep quality in the past 2 weeks before the interview was recorded.The data were analyzed using SPSS 16.0.Results:The prevalence of menopausal symptoms was 49.8%.Mild,moderate,and severe symptoms were observed in 28.9%,18.5%,and 2.5%of participants,respectively.The highest prevalence of menopausal symptoms occurred in the early postmenopausal stage;the subsequences were the late postmenopausal stage and the early MT stage.Interestingly,among the 13 items of modified Kupperman index,the five most common symptoms were fatigue,arthralgia and myalgia,decreased libido,insomnia,and nervousness.Meanwhile,55%perimenopausal women had poor sleep.Conclusions:Menopausal symptoms are common but mild among women in Taiyuan,Shanxi during MT and PM.In these stages,the prevalence of poor sleep is high.
基金Supported by the National Natural Science Foundation of China,No.82260873.
文摘Depression is highly prevalent among postmenopausal women with osteoporosis,driven by the combined effects of hormonal changes,reduced bone density,and psychosocial stress.A recent study by Cui and Su reported that 73.3%of affected women exhibited depressive symptoms,with low bone mineral density,chronic comorbidities,and reduced serotonin(5-hydroxytryptamine)levels as key risk factors.Notably,nurse-led psychological interventions improved both mood and quality of life.This editorial underscore the need to integrate mental health support into standard osteoporosis care.Simple,scalable strategies such as routine screening and nurse-delivered emotional support may help bridge the gap between physical and psychological health.These approaches are especially relevant for aging populations across diverse healthcare settings.A dual focus on bone and emotional well-being is essential to improving outcomes in this vulnerable group.
基金supported by the National Natural Science Foundation of China(32470399)Beijing Natural Science Foundation(5212014)Key Research and Development Program in the Ningxia Hui Autonomous Region,China(2020BBF02027).
文摘Chinese dwarf cherry(Cerasus humilis)is a fruit unique to China,which is considered to have osteoprotective effects.However,no systematic experimental characterization was available.In this study,the osteoprotective activity and mechanism of Chinese dwarf cherry polyphenol extract(OPE)was studied.In vitro,OPE stimulated the alkaline phosphatase activity in the early differentiation stage,increased the osteocalcin level in the middle differentiation stage,and induced the formation of more bonemineralized nodules in the late osteogenic stage.In vivo,OPE improved cancellous bone structure and maximum load of the femur in ovariectomized(OVX)rats.The balance between bone formation and resorption was regulated.Oxidative stress levels in the peripheral blood,liver and femur were reduced.OPE alleviated the disturbance in energy metabolism,muscle development,and muscle regulation-related signaling pathways caused by OVX and activated the calcium/adenosine monophosphate-activated protein kinase signaling pathway.Therefore,OPE is a potential dietary supplement for the prevention and treatment of osteoporosis.
文摘BACKGROUND Postmenopausal women face an increased risk of cardiovascular disease(CVD)due to estrogen withdrawal,which exacerbates traditional cardiovascular risk factors such as dyslipidemia,glucose intolerance,and hypertension.Coronary Artery Calcium Score(CACS),a well-established marker of subclinical atherosclerosis,has emerged as a key predictor of adverse cardiovascular events.Despite the recognized association between menopause and heightened CVD risk,there remains a paucity of literature exploring the specific role of menopause in influencing CACS and its implications for cardiovascular morbidity and morta lity.AIM To examine the interplay between menopause,CACS,and cardiovascular health by synthesizing existing literature.METHODS A comprehensive literature search was conducted using PubMed and Google Scholar,focusing on studies that analyzed CACS in postmenopausal women,including the influence of factors such as hormone therapy,Triglyceride-Glucose index,bone mineral density,lipid metabolism,and type-1 diabetes.Data extraction and synthesis emphasized key patterns,metabolic influences,and potential mechanisms driving coronary calcification in menopause.RESULTS Findings suggest that menopause contributes to increased CACS through multiple pathways,including altered lipid metabolism,insulin resistance,and arterial stiffness.Additionally,premature menopause is associated with higher CACS and elevated CVD risk.While hormone replacement therapy(HRT)appears to have a protective effect against coronary calcification,further research is needed to clarify its long-term benefits and risks.CONCLUSION We introduce a novel framework combining CACS with metabolic and hormonal markers,and discuss estrogendriven mechanisms and HRT considerations in postmenopausal cardiovascular risk.This review underscores the need for targeted cardiovascular risk assessment in postmenopausal women,integrating CACS with other metabolic markers to improve early detection and prevention of CVD in this high-risk population.
基金supported by the National Natural Science Foundation of China(Grant Nos.82073934 and 81872937 to J.Y.)the Special Foundation for Clinical Science and Technology of Jiangsu Province(Grant No.JX10114120).
文摘Studies have shown that differentiated embryo-chondrocyte expressed gene 1(DEC1)promotes osteoblast osteogenesis.To investigate the role of DEC1 in postmenopausal osteoporosis,we used the two genotypes of mice(Dec1+/+and Dec1-/-)to establish an ovariectomy model and found that the bone loss was significantly lower in Dec1-/-ovariectomy mice than in Dec1+/+ovariectomy mice.The expression levels of RUNX2 and OSX were significantly increased in Dec1-/-ovariectomy mice,compared with Dec1+/+ovariectomy mice;however,the expression levels of NFATc1,c-Fos,CTSK,and RANKL/OPG ratio were significantly decreased in Dec1-/-ovariectomy mice,compared with those in Dec1+/+ovariectomy mice.Likewise,DEC1 deficiency also suppressed the expression levels of IL-6 and IL-1β.Further results showed that the mRNA expression levels of Runx2,Osx,and Alp were significantly increased in bone marrow mesenchymal stem cells of Dec1-/-ovariectomy mice,compared with those of Dec1+/+ovariectomy mice.Moreover,the mRNA levels of Il1b,Il6,Tnfa,and Ifng were significantly increased in bone marrow-derived macrophages(BMMs)of Dec1+/+ovariectomy mice,compared with those of Dec1+/+sham mice,but not in Dec1-/-ovariectomy BMMs,when compared with those in Dec1-/-sham BMMs.Additionally,the expression levels of p-IκBαand p-P65 were significantly increased in Dec1+/+ovariectomy BMMs,compared with those in Dec1+/+sham BMMs,but did not increase in Dec1-/-ovariectomy BMMs,compared with those in Dec1-/-sham BMMs.Taken together,DEC1 deficiency inhibited the NF-κB pathway induced by ovariectomy,thereby decreasing cytokines and subsequently inhibiting the decrease of osteo-genesis and the increase of osteoclastogenesis caused by ovariectomy.The findings may provide a novel under-standing of postmenopausal osteoporosis development,and offer potential avenues for the disease intervention.
基金the National Natural Science Foundation of China:Research on Mechanism of Zuogui Wan in Treating Postmenopausal Osteoporosis by Regulating Feed-forward Loop of Oxytocin/Oxytocin Receptor Based on Transcriptome so as to Explain the Theory of “All Marrows Dominated by Brain”(No. 82104730)Based on Protein Kinase Cθ/Nuclear Factor Kappa-B Signal Transduction Regulation,Shexiang Huangqi Compound Dropping Pills Regulate the Migration and Differentiation Mechanism of Mesenchymal Stem Cells Through the Blood-brain Barrier after Cerebral Ischemia (No. 81974564)+1 种基金The 72nd Batch of China Postdoctoral Science Foundation (2022M721065)Central Plains Talent Program-science and Technology Innovation Leading Talent Project (224200510027)。
文摘OBJECTIVE: To explore the multi-component synergistic mechanism of Zuogui Wan(左归丸, ZGW) in treating postmenopausal osteoporosis(PMOP). METHODS: The main components and target genes of ZGW were screened via the Traditional Chinese Medicine Systems Pharmacology(TCMSP). In addition, the target gene sets of PMOP were derived from the Gene Cards and Online Mendelian Inheritance in Man databases. The search tool for recurring instances of neighbouring genes(STRING) 11.0 software was used to analyze the interaction among intersecting genes. Cytoscape 3.6.1 software and the Matthews correlation coefficient(MCC) algorithm were used to screen the core genes. Fifty Sprague-Dawley female rats were randomly divided into the sham-operated(Sham) group and the four ovariectomized(OVX) subgroups. Rats subjected to Sham or OVX were administered with the vehicle(OVX, 1 m L water/100 g weight), 17β-estradiol(E2, 50 μg·kg-1·d-1), and lyophilized powder of ZGW at a low dose of 2.3(ZGW-L) and high dose of 4.6(ZGW-H) g·kg-1·d-1 for three months. The bone density and bone strength were assessed using dual-energy X-ray and three-point bending tests, respectively. Furthermore, enzyme-linked immunosorbent assay, Hematoxylin-eosin staining, and western blot analysis were used to determine the potential pharmacological mechanisms of action of ZGW in PMOP. RESULTS: A total of 117 active compounds of ZGW were screened from the TCMSP. Furthermore, 108 intersecting genes of drugs and diseases were identified. Using STRING software and the MCC algorithm, ten core genes, including C-X-C chemokine living 8(CXCL8), C-C chemokine receptor type 2(CCR2), alpha-2a active receptor(ADRA2A), melatonin receptor type 1B(MTNR1B), and amyloid-beta A4 protein(APP), were identified. The anti-osteoporosis regulation network of ZGW was constructed using the Cytoscape software. The animal experiments demonstrated that ZGW groups significantly reduced the serum levels of β-C-terminal telopeptide of type I collagen(β-CTX) and increased serum levels of bone-specific alkaline phosphatase(BALP)(P < 0.05, P < 0.01). The OVX group exhibited a significant decrease in bone mineral density and bone strength compared with the Sham group(P < 0.01). Moreover, treatment with ZGW resulted in increased trabecular thickness, improved arrangement of trabecular structure, and reduced empty bone lacunae. Furthermore, treatment with ZGW significantly increased the protein expression of CXCL8, ADRA2A, and CCR2(P < 0.05, P < 0.01), and significantly decreased the protein expression of Runx2(P < 0.01). Furthermore, the ZGW and E2 groups demonstrated significantly increased BMD(P < 0.05, P < 0.01), improved bone strength(P < 0.05, P < 0.01), reduced expression of CXCL8, ADRA2A, and CCR2, and increased runt-related transcription factor 2 levels in bone tissue(P < 0.05, P < 0.01) compared with the OVX group. However, there were no significant differences in MTNR1B and APP expression among the groups. CONCLUSION: ZGW shows synergistic mechanisms in PMOP through multiple components, targets, and pathways.
基金supported by the National Natural Science Foundation of China (32072191)Daxing District Major Scientific and Technological Achievements Transformation Project (2020006)+1 种基金Beijing Innovation Team Project of Livestock Industry Technology SystemBeijing Science and Technology Special Project (Z201100002620005)。
文摘The aging of the global population has made postmenopausal osteoporosis prevention essential;however,pharmacological treatments are limited.Herein,we evaluate the effect of calcium-fortified fresh milk(FM)in ameliorating postmenopausal osteoporosis in a rat model established using bilateral ovariectomy.After 3 months of FM(containing vitamin D,and casein phosphopeptides,1000 mg Ca/100 g)or control milk(110 mg Ca/100 g milk)supplementation,bone changes were assessed using dual-energy X-ray absorptiometry,microcomputed tomography,and bone biomechanical testing.The results revealed that FM can regulate bone metabolism and gut microbiota composition,which act on bone metabolism through pathways associated with steroid hormone biosynthesis,relaxin signaling,serotonergic synapse,and unsaturated fatty acid biosynthesis.Furthermore,FM administration significantly increased bone mineral content and density in the lumbar spine and femur,as well as femoral compressive strength,while improving femoral trabecular bone parameters and microarchitecture.Mechanistically,we found that the effects may be due to increased levels of estrogen,bone formation marker osteocalcin,and procollagen typeⅠN-propeptide,and decreased expression of the bone resorption marker C-telopiptide and tartrate-resistant acid phosphatase 5b.Overall,the findings suggest that FM is a potential alternative therapeutic option for ameliorating postmenopausal osteoporosis.
文摘BACKGROUND Rhabdomyosarcoma(RMS)of the vagina in postmenopausal women is an extre-mely rare malignant tumor that was originally described as a unique group of soft tissue sarcomas originating from primitive mesenchymal cells.It was first re-ported in postmenopausal women in 1970,and fewer than 50 postmenopausal patients have been reported to date.CASE SUMMARY A 68-year-old multiparous female was admitted to the hospital on October 11,2023,with the chief complaint of a mass causing vaginal prolapse with incomplete urination that had persisted for 4 months.The vaginal mass was approximately the size of a pigeon egg;after lying down,the vaginal mass retracted.Complete resection was performed,and vaginal pleomorphic RMS was diagnosed based on pathology and immunohistochemical staining features.The patient is currently undergoing chemotherapy.The present study also reviewed the clinical,histolo-gical,and immunohistochemical features and latest treatment recommendations for vaginal RMS.Any abnormal vaginal mass should be promptly investigated through pelvic examination and appropriate imaging.The current initial treat-ment for vaginal RMS is biopsy and primary chemotherapy.CONCLUSION When surgery is planned for vaginal RMS,an organ-preserving approach should be considered.
文摘BACKGROUND Postmenopausal osteoporosis(PMOP)is the most common form of primary osteoporosis among women,and the associated pain often drives patients to seek clinical intervention.Numerous studies have highlighted the unique clinical benefits of exercise therapy(ET)in alleviating PMOP-related pain.However,bibliometric analyses examining collaboration,development trends,and research frontiers in the field of ET for PMOP pain remain scarce.AIM To explore the research trends in ET for pain treatment in PMOP patients over the past decade.METHODS All scholarly works were meticulously sourced from the Science Citation Index-Expanded within the prominent Web of Science Core Collection.Utilizing the capabilities of CiteSpace 6.2.R5,we conducted a thorough analysis of publications,authors,frequently cited scholars,contributing nations,institutions,journals of significant citation,comprehensive references,and pivotal keywords.Additionally,our examination explored keyword cooccurrences,detailed timelines,and periods of heightened citation activity.This comprehensive search,from 2014 through 2023,was completed within a single day,on October 11,2023.RESULTS In total,2914 articles were ultimately included in the analysis.There was a rapid increase in annual publication output in 2015,followed by stable growth in subsequent years.Boninger,Michael L,is the most prolific author,whereas Ware JE has the most citations.The United States’global influence is significant,surpassing all other nations.The University of California System and Harvard University are the most influential academic institutions.J Bone Joint Surg Am is the most influential journal in this field.“Spinal cord injury”is the keyword that has garnered the most attention from researchers.The developmental pattern in this field is characterized by interdisciplinary fusion,with different disciplines converging to drive progress.CONCLUSION The academic development of the field of ET for pain in PMOP has matured and stabilized.Clinical management and rehabilitation strategies,along with the mechanisms underlying the relationship between ET and bone resorption analgesia,continue to be the current and future focal points of research in this field.
文摘Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.
文摘Objectives: To explore the relationship between adiponectin (APN) and bone mineral density in this Zhuang ethnic group, thus providing a basis underpinning the prevention and treatment of osteoporosis (OP). Methods: Zhuang women over 50 years old in Guangxi Zhuang Autonomous Region were included in the study. The broadband ultrasound attenuation (BUA) was adopted as the reference to calculate the T value. Quantitative ultrasonic bone density was measured on the right. Body composition measuring instrument was used to measure weight, fat, and muscle mass. Plasma APN level was detected by ELISA and blood lipids were detected by enzymatic method. Results: Plasma APN level was found with significant differences in the normal bone mineral density group, bone mineral density reduction group, and osteoporosis group (P β = −0.176, P = 0.001) when the partial correlation coefficient of APN is −0.210. Elevated APN was an independent risk factor for bone mineral density reduction (OR = 1.191, 95%CI: 1.004 - 1.407, P = 0.04) and OP (OR = 1.1337, 95%CI: 1.137 - 1.572, P Conclusion: Increased APN in postmenopausal women of Zhuang is an independent risk factor for OP. The application of APN in the OP screening and prevention of middle-aged and ageing Zhuang women still needs further research.
文摘Objective:To study the screening for cervical cancer in postmenopausal women in liquid-based cell test(TCT)application value.Methods:From January 2023 to March 2024 hospital check-ups and outpatient reached 400 cases of postmenopausal women,and they were TCT and HPV detection,during the study period to pathological diagnosis of numerical results as the standard,analysis of TCT detection application of screening for cervical cancer in postmenopausal women and the effect.Results:After the TCT detection,the inflammation group and normal group by use of HPV testing positive rate higher than other groups(P<0.05).Hospital after pathological diagnosis and research,after the screening system found CINⅠlevel and above cases about 39 cases,the TCT and HPV detection rate of positive difference is not obvious,and there is no statistical significance(P>0.05).Joint test analysis,the sensitivity and specificity were higher than that of TCT and HPV testing positive(P<0.05).Conclusion:TCT detection screening for cervical cancer in postmenopausal women is of great importance to the application,if you can join HPV testing,help to improve the detection sensitivity,avoid missed diagnosis of problems,and then for treatment and later restore to lay a solid foundation.
文摘Objective:To compare the efficacy of Wumei Decoction in pre and postmenopausal patients and its effect on follicle-stimulating hormone(FSH)and estradiol(E2).Methods:Sixty-four patients who attended the Department of Traditional Chinese Medicine I in Cangzhou City Central Hospital from January 2020 to January 2022 were selected and randomly divided into treatment group and control group,32 cases in each group.The treatment group took modified Wumei Decoction orally,1 dose of water boiled 2 times a day,divided into 2 warm doses;the control group took Livial orally,2.5 mg/times,1 time/day,and the observation cycles were all for 3 months.Kupperman score,FSH,E2,clinical symptoms and clinical efficacy were compared between the two groups before and after treatment.Results:The Kupperman score of the two groups decreased after treatment,and the difference was statistically significant;the total effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant;there was no statistical significance in the comparison of FSH before and after the treatment of the two groups,but the FSH values of the two groups were significantly lower than those before,and the difference was statistically significant;there was no statistically significant difference in the comparison of E2 of the two groups before treatment,and the E2 values of the two groups were higher than those of the control group after the treatment.After the treatment,E2 of the two groups of patients was significantly higher than before,and the difference was statistically significant.After treatment,E2 of the treatment group was higher than that of the control group,and the comparison between the groups was statistically significant.Conclusion:There was no significant difference between modified Wumei Decoction and Livial in lowering follicle-stimulating hormone levels;modified Wumei Decoction was superior in raising oestradiol;and modified Wumei Decoction was relatively effective in improving clinical symptoms.
文摘OBJECTIVE: To assess the effectiveness and safety of Kuntai capsule and hormone replacement therapy in treatment of perimenopausal syndrome.METHODS: Articles were retrieved from the databases Cochrane Database of Systematic Reviews,Pub Med, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database. Only randomized controlled trials were included; 15 trials involving1243 patients were identified from January 2005 to April 2015. A systemic review and Meta-analysis of publications was performed. The review was limit-ed to randomized controlled trials that compared Kuntai capsule and hormone replacement therapy to treat perimenopausal syndrome for at least 3months. The primary outcome assessed was the treatment efficacy at 3 months, including effective rate of Kupperman menopausal scores, Kupperman menopausal scores, and blood estradiol(E2) or blood follicle stimulating hormone(FSH) levels.Other outcomes assessed were safety or adverse events, such as gastrointestinal complaints, breast distending pain, or vaginal bleeding.RESULTS: Kupperman menopausal scores showed no significant difference in effective rate [odds ratio(OR): 1.05, 95% confidence intervals(CI): 0.71 to1.55] and changes in FSH level [mean difference(MD): 2.14, 95% CI:-2.36 to 6.65]. There was a significant statistical difference in Kupperman menopausal scores(MD:-1.14, 95% CI:-2.03 to-0.25)and changes in E2level(MD:-16.41, 95% CI:-18.83to-13.69). There were fewer adverse events in the Kuntai capsule group than in the hormone replacement therapy group(OR: = 0.35, 95% CI: 0.25 to0.48, P < 0.01).CONCLUSION: Compared with hormone replacement therapy, Kuntai capsule can improve perimenopausal symptoms and blood E2 levels, and reduce the incidence of adverse events.
文摘Objective To evaluate the role of sclerostin in bone loss of postmenopausal Chinese women with type 2 diabetes me｜litus. Methods The postmenopausal patients suffering from type 2 diabetes mellitus and age, body mass index, and duration of menopause matched healthy controls were enrolled into this cross-sectional study according to criteria of inclusion and exclusion.
基金financially supported by the China State Sport General Administration(No.2013B040,2015B039)the University of J yvaskyla Wellness program and the Shanghai Jiao Tong University Zhiyuan Foundation(No.CP2014013)
文摘Purpose： This study aimed to assess whether the benefits of exercise on central adiposity and insulin resistance （HOMA-IR） are maintained after discontinuation of intervention in the overweight/obese （OWOB） women. Methods： The study subjects were from 2 independent studies with similar aerobic exercise （AE） intervention programs. In study I, I50WOB postmenopausal women with pre-diabetes （body mass index, BMI = 24-33 kg/m2, aged 52-65 years） completed an 8-month exercise intervention and were followed for 2 years after the intervention. In study lI, 12 OWOB （BM1 = 25-35 kg/m2, aged 30-50 years） premenopausal women participated in a 6-week AE and were followed for 4 years after the intervention. The exercise program consisted of progressive AE with intensity of 60%-75% of initial fitness level, 30-60 min/time and 3-5 times/week. Fat mass （FM） was assessed by Dual Energy X-ray Absorptiometry （DXA Prodigy; study I） or bioelectrical impedance device （Inbody 720; study II）. Plasma glucose and insulin were assessed by chemiluminescent immunoassay and HOMA-IR was calculated. Results： Both 8-month and 6-week moderate AE were effective in reducing HOMA-IR （-18.9%, p = 0.012 and -26.7%, p = 0.046, respectively）, and 8-month AE reduced FM at upper abdominal region （-6.2%, p = 0.021）. However, these improvements were not maintained in either study at the follow-up. Conclusion： The AE program used in these studies was effective to reduce insulin resistance and/or FM in central body region among overweight and obese women. However, when exercise intervention was discontinued, the beneficial effects following both short- and long-term intervention disappeared. Thus maintaining exercise seems to be required if one wants to reap the benefits of exercise in the long-term.
基金Supported by Key Research and Development Project in Department of Science and Technology,Liaoning Province,No.2017225025
文摘BACKGROUND Postmenopausal bleeding and an endometrial thickness≥5 mm on sonograms of menopausal women can indicate the presence of endometrial lesions.Diagnostic hysteroscopy is a powerful method for endometrial diseases.AIM To investigate the pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or asymptomatic thickened endometrium diagnosed by hysteroscopy.METHODS A total of 187 postmenopausal women with bleeding or asymptomatic thickened endometrium underwent diagnostic hysteroscopy.The women were subsequently divided into three groups:Postmenopausal bleeding(PMB)group(n=84),asymptomatic group(n=94),and additional group(n=9).Women in the additional group manifested abdominal pain and leukorrhagia.RESULTS Among the 187 patients examined,84(44.9%)were diagnosed with PMB and 94(50.3%)with asymptomatic thickened endometrium.Endometrial polyp was the most common endometrial abnormality,which was detected in 51.2%,76.6%and 77.8%of the PMB,asymptomatic,and additional groups,respectively.In the PMB group,7(8.3%)women had hyperplasia with atypia and 14(16.7%)had endometrial adenocarcinoma.Fewer malignant lesions were detected in the asymptomatic group.Endometrial hyperplasia without atypia was found in 8.3%of the PMB group and 7.4%of the asymptomatic group.CONCLUSION Endometrial polyp was the most common pathology in the PMB group.Diagnostic hysteroscopy is recommended for women with PMB and asymptomatic thickened endometrium.
