Environmental cadmium and lead exposure and anti-Müllerian hormone in pregnant women

BackgroundAnti-Müllerian Hormone (AMH) has been suggested as a marker for ovarian function. Cadmium and lead have been suggested to reduce female fecundity. In this study we aimed to investigate whether environmental exposure to cadmium and lead was associated with alterations in serum-AMH.Materials and methodThe associations between serum-AMH and whole blood cadmium or lead were investigated by general linear models in a population-based sample of 117 pregnant women.ResultsThe mean concentrations of blood cadmium and lead were 0.71 μg/L and 17.4 μg/L, respectively. The mean serum-AMH was 17.3 pmol/L. No association between lead and AMH was detected. In the cadmium analysis the adjusted mean AMH level (95% CI) in the highest exposure tertile was 12.4 (6.4;23.8) compared to 5.6 (2.7;11.4) in the lowest exposure tertile (p = 0.06).ConclusionThe study provides suggestive evidence that environmental exposure to cadmium, but not lead, may alter the level of AMH.     

女性性工作者艾滋病相关干预服务利用及影响因素研究

目的：探索女性性工作者艾滋病相关干预措施利用及影响因素。方法采用方便抽样,调查深圳市1656名女性性工作者艾滋病相关干预服务利用情况。对不进行艾滋病检测、不使用安全套以及不参与同伴教育的影响因素进行分析。同时评价未参加艾滋病检测、安全套使用与艾滋病相关知识水平之间的关系。结果女性性工作者的艾滋病检测率、安全套使用率和接受同伴教育率分别为21.5%、47.8%和28.0%。低年龄组和工作年限短与不利用3项干预服务有关。持续使用安全套和较高的艾滋病相关知识水平可提高艾滋病相关干预服务的利用率。结论深圳市女性性工作者艾滋病相关干预服务的利用率较低。鉴于安全套使用与艾滋病相关知识水平与干预措施的利用相关,应针对年轻和刚从事性服务工作者,提高其安全套使用率和艾滋病相关知识水平。     

补肾活血中药联合来曲唑片治疗枸橼酸氯米芬抵抗的多囊卵巢综合征不孕症临床观察

目的观察补肾活血中药联合来曲唑片治疗枸橼酸氯米芬(CC)抵抗的多囊卵巢综合征(PCOS)不孕症的临床疗效。方法将90例CC抵抗的PCOS不孕症患者随机分为3组,治疗组30例予补肾活血中药联合来曲唑片治疗,西药组30例予来曲唑片治疗,中药组30例予补肾活血中药治疗。连续治疗3个月经周期。比较3组疗效,B超监测卵泡大小、子宫内膜情况,观察3组妊娠情况。结果治疗组总有效率86.70%,西药组总有效率46.70%,中药组总有效率23.33%,治疗组总有效率高于西药组、中药组(P0.05);西药组总有效率高于中药组(P0.05)。治疗组成熟卵泡和排卵数均多于西药组和中药组(P0.05),西药组成熟卵泡和排卵数多于中药组(P0.05)。治疗组临床妊娠率26.67%,西药组临床妊娠率6.67%,中药组临床妊娠率10.00%,治疗组临床妊娠率高于西药组、中药组(P0.05)。结论补肾活血中药联合来曲唑片治疗CC抵抗的PCOS不孕症疗效满意,优于单纯应用来曲唑片或补肾活血中药治疗。     

Mammotome微创旋切系统在女性乳腺肿瘤中的应用价值

目的 探讨Mammotome微创旋切系统在女性乳腺肿瘤疾病中的应用价值.方法 分析女性乳腺肿瘤疾病患者173例,在超声引导下对患者行Mammotome微创旋切术切除病灶.结果 173例女性乳腺肿瘤患者共切除291个肿瘤病灶,良性肿瘤病灶259个以乳腺纤维腺瘤(67.35%)为主,恶性乳癌病灶32个以浸润性导管癌(9.97%)为主.Mammotome微创旋切术后患者满意度高,复查肿瘤病灶清除率100%且无复发迹象,术后不良事件以出现血肿为主,发生率为2.92%.结论 Mammotome微创旋切系统对女性乳腺肿瘤清除有很好的临床应用价值,而且术后不良事件发生率小.     

甲状腺乳头状癌女性患者血清25-羟维生素 D和触珠蛋白的水平及其临床意义

目的：观察甲状腺乳头状癌女性患者血清25-羟维生素D和触珠蛋白的水平及与临床病理因素间的相关性。方法选择甲状腺乳头状癌女性患者共31例,同期纳入体检健康者40例为对照组。测定2组血清25-羟维生素D和触珠蛋白水平;分析血清25-羟维生素D和触珠蛋白表达水平与患者的年龄、肿瘤直径大小、TNM分期及淋巴结转移等临床病理参数的相关性。所有患者行3年期随访,比较存活患者与死亡患者血清25-羟维生素D和触珠蛋白水平。结果与对照组比较,甲状腺乳头状癌组血清25-羟维生素D水平明显降低,而触珠蛋白明显升高,比较差异均有统计学意义（P＜0．01）。血清25-羟维生素D和触珠蛋白的表达水平与甲状腺乳头状癌的患者年龄、肿瘤直径大小无明显相关性（P＞0．05）,而与甲状腺乳头状癌的TNM分期、淋巴结转移呈明显相关（P＜0．01）。3年期内死亡患者入院时血清25-羟维生素D水平明显低于存活组,触珠蛋白水平明显高于存活组,比较差异有统计学意义（P＜0．01）。结论甲状腺乳头状癌患者血清25-羟维生素D水平明显降低,而触珠蛋白水平明显升高,与甲状腺乳头状癌的恶性程度呈明显性相关,可能是甲状腺乳头状癌患者预后的重要评价指标。     

The association between the masseter muscle, the mandibular alveolar bone mass and thickness in dentate women

Objective: Since muscle strength has been demonstrated to affect the bone in the long bones and spine, the possibility exists that the bone mass and dimension of the alveolar processes could be influenced by the function of the masticatory muscles. Therefore, the purpose of this study was to investigate whether two local factors (ultrasonographic masseter thickness, and occluding teeth) plus the skeletal bone mineral density (BMD) affect the mandibular alveolar bone mass (MABM) and the bucco-lingual alveolar thickness of the alveolar process.

Design: The thickness of the masseter muscle was evaluated by ultrasound imaging in 62 dentate women (40–75 years) with no periodontal disease and no dental infection in the premolar region consecutively selected from the patients in a public dental clinic. MABM was evaluated using periapical radiographs. The bucco-lingual thickness of the alveolar process was measured on dental casts with a dial calliper. BMD of the forearm was determined with dual energy X-ray absorptiometry.

Results: Multiple regression analyses demonstrated that masseter thickness and the number of occluding mandibular teeth in the lateral segment were significant determinants of MABM and of the interdental thickness, but BMD was not. The number of years after menopause and struma/gastro-intestinal disease influenced MABM but not the alveolar thickness.

Conclusion: The local factors played an important role in the posterior mandibular segment and their effect might partly explain the low correlation between MABM and skeletal BMD.     

A multi-level examination of the experiences of female sex workers living with HIV along the continuum of care in the Dominican Republic

Female sex workers (FSWs) are disproportionately affected by HIV, but there is limited research on their HIV care experiences. This study explored the experiences of 44 FSWs living with HIV in Santo Domingo, Dominican Republic along the HIV care continuum using in-depth interviews and focus groups. Data were analysed through narrative and thematic analysis. Individual-level factors that facilitated engagement in HIV care were physical and mental health. At the interpersonal level, disclosure of HIV or sex work status and receipt of emotional and economic support were important influences on engagement. Yet, negative reactions to or lack of disclosure of these statuses compromised engagement, further highlighting the role of stigma and discrimination. At the environmental level, FSWs described considerable challenges with the health system including long waits and treatment stock-outs at their clinics, but were generally satisfied with HIV clinic staff. At the structural level, lack of economic resources complicated care and treatment adherence. Findings underscore the need for psychosocial and economic support tailored to the unique needs of FSWs to maximise the individual and public health benefits of HIV care.     

Obesity and contraceptive use among women 20–44 years of age in the United States: results from the 2011–15 National Survey of Family Growth (NSFG)

Objective

Obesity has increased dramatically in the United States in recent decades. Our objective was to explore associations of contraceptive choices of US women, aged 20–44 years, with body mass index (BMI) and relevant covariates.

35岁及以上低档暗娼安全套使用及梅毒感染情况分析

目的 针对年龄≥ 35岁低档暗娼（大龄暗娼）开展两轮横断面调查,观察大龄暗娼的安全套使用和梅毒感染状况,为大龄暗娼干预工作提供参考依据。方法 选择异性性传播感染HIV情况较严重的6个市（县）作为研究现场,分别为广西壮族自治区柳州市和贵港市平南县、云南省西双版纳傣族自治州景洪市和大理白族自治州大理市、湖南省张家界市和永州市江华瑶族自治县。在低档的性交易场所招募大龄暗娼,排除开展调查前已经在艾滋病综合防治信息系统网络直报为HIV阳性者,收集社会人口学特征、性行为等信息,采血做梅毒血清学试验。分别于2012年10月至2013年1月完成第1轮调查、2015年6-9月完成第2轮调查。每轮调查样本量约为360人。采用EpiData 3.0软件和SPSS 22.0软件进行数据整理和统计学分析。结果 第1轮和第2轮调查的研究对象人数分别为371人和403人;年龄分别为（42.4±5.1）岁和（43.8±5.1）岁（t=3.537,P<0.001）;性交易价格分别为（36.8±13.7）元/次和（49.5±15.8）元/次（t=11.961,P<0.001）;性交易工作年限>2年的构成比分别为46.9%（174/371）和61.3%（247/403）（χ²=16.125,P<0.001）;性交易坚持使用安全套的比例,第1轮和第2轮调查的比例分别为46.9%（174/371）和64.3%（259/403）（χ²=23.641,P<0.001）;梅毒感染比例,第1轮和第2轮的比例分别为15.9%（59/371）和7.2%（29/403）（χ²=14.533,P<0.001）。结论 两轮横断面调查比较,大龄暗娼的性交易坚持使用安全套的比例有所提高、梅毒感染比例有所下降。但是,还不能满足梅毒等性传播疾病的防治目标。应继续重点关注大龄暗娼,切实有效推进干预措施。     

山东省某蔬菜基地女性从业人员肌肉骨骼系统损伤情况及相关因素研究

目的 了解女性蔬菜大棚从业人员肌肉骨骼系统损伤的发生及其相关因素,为采取针对性的干预措施提供依据。方法 2015年采取问卷调查的方式对山东省某蔬菜种植基地851名女性从业人员进行面对面调查。结果 蔬菜大棚女性作业人员肌肉骨骼系统损伤发生率为82.79%。身体主要部位肌肉骨骼系统损伤发生率由高到低依次为下背部（65.82%）、膝部（49.10%）、颈部（25.75%）、肩部（23.47%）。多因素分析结果显示,年龄≥50岁（OR=2.098,95% CI：1.353～3.252）、工作年数≥20年（OR=1.703,95% CI：1.116～2.599）、每天重复性工作（OR=1.903,95% CI：1.183～3.061）、长时间站立工作（OR=2.902,95% CI：1.183～7.120）、经常稍微弯腰（OR=2.979,95% CI：1.823～4.867）为女性蔬菜大棚作业人员肌肉骨骼损伤发生的危险因素,工作中使用助力工具为女性蔬菜大棚作业人员肌肉骨骼损伤发生的保护因素（OR=0.400,95% CI：0.229～0.697）。结论 女性蔬菜大棚劳动者肌肉骨骼损伤发生率较高,亟待采取合理的预防和控制措施来减少其发生。