无张力性吊带术治疗女性压力性尿失禁

目的探讨无张力阴道吊带术(tension-free vaginal tape，TVT)治疗女性压力性尿失禁的疗效。方法13例经尿动力学检查证实为压力性尿失禁在连续硬膜外麻醉下经阴道前壁行无张力阴道吊带术，低平截石位，经阴道前壁向上穿刺尿道两侧间隙，从耻骨上腹壁引出TVT吊带，调整张力，关闭切口。结果手术时间15～45min，平均35min。13例随访6～24个月，平均13个月，12例治愈，1例改善，无尿失禁复发或排尿困难。结论TVT操作简单，创伤小，手术时间短，术后恢复快，治疗压力性尿失禁疗效好。     

Development of nocturia in relation to health, age and the menopause

Objectives:To analyse the relationship between nocturia, age, the menopausal transition, parturition and hormone replacement treatment (HRT) in women.Material and methods:A questionnaire study was carried out in 3669 randomly selected women (out of 6000 invited) in the County of Jämtland, Sweden. Questions were asked about health, the occurrence of somatic diseases and symptoms, habits, health care and medication.Results:In univariate analyses age, menopausal state and HRT, but not parturition, were associated with increased nocturia. In a multiple logistic regression analysis, independent correlates for two or more nocturnal micturition episodes versus no more than one episode were: health, poor versus good 2.9 (2.1–3.8); <5 years after the menopause versus before 1.8 (1.3–2.5); 5–9 years after the menopause versus before 2.1 (1.5–3.0); ≥10 years after the menopause versus before 3.1 (2.3–4.2). Age and HRT were deleted by the logistic regression model.Conclusion:The present data indicate that menopausal state, but not age, parturition and HRT are independent correlates of nocturia in 40–64-year-old women.     

宁夏川区和山区妇女抑郁情绪现状及影响因素分析

目的了解宁夏川区和山区妇女抑郁情绪现状及影响因素的差异,为制定基于地区的妇女抑郁防控措施提供依据。方法2020年7—8月以方便抽样法选取调查对象,采用自制一般人口学问卷、患者健康问卷(PHQ-9)及精神卫生与心理保健知识问卷对1816名妇女进行面对面问卷调查。结果川区和山区妇女抑郁总分分别为(5.04±3.55)分和(4.20±3.49)分,情感维度得分分别为(3.11±2.33)分和(2.69±2.28)分,身体症状维度得分分别为(1.93±1.60)分和(1.51±1.49)分,差异均有统计学意义(t=4.892,3.766,5.510,均P<0.05)。多元线性回归分析结果显示:影响川区妇女抑郁得分的因素包括年龄、文化程度、家庭年收入、精神卫生与心理保健知识水平(均P<0.05);影响山区妇女抑郁得分的因素包括户籍、年龄、职业及家庭常住人口数(均P<0.05)。结论宁夏川区妇女抑郁情绪比山区妇女更突出,川区和山区妇女抑郁情绪的影响因素有一定差异。今后应基于川区和山区社会环境的差异评估妇女抑郁情绪的流行状况,开展监测与差异化干预。     

孕妇维生素营养状况对胎儿生长发育的影响

目的探讨孕妇维生素营养状况对胎儿生长发育的影响。方法以湖南省长沙市224名孕妇为调查对象,测定不同孕龄孕妇的血清维生素水平及胎儿生长发育评价指标,并对孕妇的膳食营养摄入,生活因素进行了调查。结果孕妇血清维生素E水平随妊娠进展明显上升,叶酸水平则下降,孕晚期尤为明显,逐步回归分析显示,孕妇血清维生素A、维生素E、叶酸水平均影响胎儿的生长发育(P＜0.05),维生素E的作用最大;典型相关分析显示,孕妇的四项血清维生素水平与孕妇产前宫高、腹围、胎儿股骨长、新生儿出生体重、新生儿Apgar评分五项指标呈正相关(P＜0.05)。结论孕妇维生素营养状况与胎儿生长发育密切相关。     

142例女性肺癌的临床特点

目的：对肺癌病人中女性患进行分析，探讨女性肺癌的临床特点，根据这些临床特点指导手术前诊断及肺癌的分型。方法：调集本院10年来142例女性肺癌资料，对其年龄、吸咽情况、辅助诊断和病理资料等进行分析。结果：经本组资料分析发现女性肺癌在年龄分布、X线摄片及纤维支气管镜分型、病理类型等方面有明显特征。结论：女性肺癌随年龄增长发病比重增大，以5O岁～59岁年龄组比重最大；周围型肺癌占59．3％，肺腺癌占57．0%。     

Gender differences in actual and preferred nocturnal sleep duration among Finnish employed population

ObjectiveSufficient sleep is essential for health and working capacity. Shorter sleep duration on workdays is often compensated by sleeping longer during leisure days. Gender dissimilarities in sleep quality are acknowledged. Our aim was to study the less known gender differences in sleep duration.MethodsA population based study with a total of 1049 middle-aged regularly working women (n = 524) and men (n = 525). A questionnaire of sleep durations on workdays and leisure days, preferred sleep duration, with health-related quality of life and health behavior.ResultsWomen slept 14 min longer on workdays (p < 0.002) and 27 min longer on leisure days (p < 0.002) and had 32 min longer preferred sleep duration (p < 0.001) than men. Compared to workdays, women slept 1 h 57 minutes longer and men 1 h 42 min longer on leisure days (gender p < 0.001). On workdays, both women and men slept less than their preferred sleep duration and again, with more extensive difference in women (gender-interaction p < 0.001). On leisure days the excessive sleep time did not differ between genders (p = 0.346). None of the explanatory variables explained the gender differences in sleep durations.ConclusionsSleep loss on workdays is presumably more pronounced in women, since despite their longer sleep on workdays, the gender differences persist in both sleep duration on leisure days and in preferred sleep duration.     

La mort subite cardiaque chez la femme,registre du nord de la Tunisie

BackgroundSudden cardiac death is a major public health problem. Epidemiological and clinical differences according to gender have been described in sudden cardiac death. The aim of this study was to examine the gender differences between autopsy findings and circumstance of occurrence associated with sudden cardiac death.MethodsWe prospectively collected epidemiological and autopsy data of victims of sudden cardiac death occurring in the northern governorates of Tunisia between January 2013 and December 2019. Symptoms preceding death, circadian, weekly and seasonal variations of sudden death were also analyzed.ResultsThe study population included 1834 men and 468 women with a mean age of 56.5 ± 14.2 years. All cardiovascular risk factors except smoking were significantly more frequent among women but ischemic heart disease was the most common cause of death in men (51.3 %, versus 28 %, P < 0.001). Women were more likely to have a negative macroscopic autopsy than men (34 % versus 23.6 %, P < 0.001). Chest pain preceding sudden death was more frequent in male (24 % versus 13.2 %, P < 0.001). In contrast, women were more likely to have dyspnea (8.1 % versus 15.6 %, P < 0.001). Sudden death in women occurred indoors more often than in men (63.9 % versus 54.5 %, P < 0.001) and also more often during night (midnight to 6 am). We also recorded an excess cardiac mortality in winter in both sexes.ConclusionsWomen had considerably more cardiovascular risk factors and more commonly negative macroscopic autopsy. Death occurred indoors and during night more often than in men.     

雌激素替代治疗对绝经后妇女血管内皮舒张功能的影响

为了探讨雌激素抗动脉粥样硬化和降低冠心病发病危险的机制 ,采用无创性高分辨超声法观察雌激素替代治疗对绝经后妇女血管内皮依赖性舒张功能的影响 ,于治疗前后测量血清雌二醇、一氧化氮和血脂水平。结果发现 ,绝经后妇女较绝经前妇女血清雌二醇和一氧化氮下降 (P <0 .0 0 1) ,肱动脉血流介导的舒张反应较绝经前明显下降 (3.84 %± 2 .18%比 10 .0 5 %± 3.18% ,P <0 .0 0 1) ;短期雌激素替代治疗后雌二醇和一氧化氮水平较治疗前极显著升高 (P <0 .0 0 1) ,肱动脉血流介导的舒张反应也显著改善 (9.16 %± 3.0 2 % ,P <0 .0 0 1) ,而雌激素替代治疗并未使血脂发生明显改善 (P >0 .0 5 )。相关分析发现肱动脉血流介导的舒张反应与雌二醇和一氧化氮呈正相关(r值分别为 0 .5 6 4和 0 .72 9,P <0 .0 0 1) ,与总胆固醇呈负相关 (r为 - 0 .36 9,P <0 .0 5 )。结果提示短期雌激素替代治疗可明显改善绝经后妇女内皮依赖性舒血管功能障碍 ,且与血脂的改善无关 ,可能与雌激素的直接血管保护作用有关。     

重庆黔江地区230例育龄期妇女乳腺增生状况调查及相关因素分析

目的探讨重庆黔江地区育龄期妇女乳腺增生状况及相关危险因素。方法选取2016年1-12月重庆市黔江中心医院行乳腺增生普查的育龄期妇女行问卷调查、乳房触诊、乳腺B超或乳腺X线钼靶,对难以诊断的情况可采用乳腺组织穿刺病理活检以明确诊断。结果参与本次普查的230例育龄期妇女中,共发现137例患有乳腺疾病的患者,患病率为59.57%。其中患乳腺增生者113例,患病率为49.13%;患乳腺纤维肿瘤者11例,患病率为4.78%;乳腺囊肿7例,患病率3.04%,乳腺炎3例,患病率1.30%,乳头内陷1例,患病率0.43%,乳腺癌者2例,患病率为0.87%。单因素分析结果提示,年龄、流产史、职业、家族史、初潮年龄、情绪状态、避孕方式是乳腺增生发病的相关因素(P<0.05)。多因素分析结果提示,流产史、初潮年龄、家族史、情绪状态是乳腺增生的危险因素(P<0.05)。结论重庆黔江地区育龄期妇女乳腺增生的发病率较高,应加强该地区育龄期妇女有关疾病知识的教育宣讲,加强普查次数,从而降低乳腺疾病对女性的影响,提高其生活质量。