2 771名不同职业女性妇女病普查结果分析

目的:了解不同职业女性妇女病患病情况。方法:对2 771名不同职业的女性进行常规妇科检查、宫颈刮片、子宫及附件B超、乳腺红外线扫描等检查。结果:不同职业女性妇女病总患病率是64.49%,生殖道感染、乳腺增生、子宫肌瘤及宫颈癌的患病率分别是59.94%、37.96%、11.76%、0.18%;不同年龄妇女的生殖道感染、子宫肌瘤、乳腺增生的患病率有非常显著性差异(P<0.01)。30~岁年龄组生殖道感染患病率最高(62.30%),40~岁及50~岁年龄组子宫肌瘤患病率较高,分别为18.54%、19.79%。30~岁及40~岁年龄组乳腺增生的患病率较高,分别为44.05%、42.51%。宫颈癌患病率在各年龄组差异无显著性(P>0.05)。不同职业女性子宫肌瘤、乳腺增生的患病率有非常显著性差异(P<0.01),不同职业女性宫颈癌患病率有显著性差异(P<0.05)。不同职业女性生殖道感染患病率无显著性差异(P>0.05)。个体业户的子宫肌瘤和乳腺增生患病率最高,分别为12.80%、39.34%。干部和个体户宫颈癌患病率较高,分别为0.98%、0.95%。结论:开展不同职业女性妇女病普查普治,对于提高妇女生殖健康是十分重要的。     

激素治疗对绝经妇女子宫肌瘤的影响

目的:观察个体化周期序贯激素治疗对绝经妇女子宫肌瘤发生及生长的影响。方法:选择因绝经相关症状且合并单发性子宫肌瘤(肌瘤最大径线<5 cm)的绝经妇女60例,给予雌孕激素周期序贯方案,起始剂量为口服戊酸雌二醇1.0 mg,每日1次,连用21~25天,后10~14天加用甲羟孕酮每日4 mg。随后,根据每人对药物的不同反应,调整口服戊酸雌二醇的每日用量为0.5~2.0 mg,甲羟孕酮的每日用量相应为4~6 mg。不能连续应用激素治疗或失访者被排除。分别于治疗前及治疗3、6、122、43、6个月时采用阴道超声测定肌瘤大小及子宫内膜厚度。结果:53例患者完成了3年的观察,平均年龄51.4(44~57)岁,绝经年限平均2.3(1~7)年。激素周期序贯治疗3、6、12、24、36个月,肌瘤大小均无明显改变(P>0.05),没发现新生肌瘤(P>0.05),子宫内膜厚度均无明显增厚(P>0.05)。结论:根据个体对药物反应不同制定不同剂量的激素周期序贯方案,不促进绝经妇女子宫肌瘤的发生和生长。     

3022例绝经后妇女手术取环的总结与思考

目的：调查围绝经期妇女安环后适时取器时间知晓率；了解宫内IUD位置异常与手术取环难易程度的关系；了解绝经后时间长短与手术取环难易程度的关系。方法：对本站2003--2005年间3022例围绝经期妇女宫内IUD取出工作进行回顾性分析。结果：①绝经一年以内取器困难92例，占11％；一年以上290例，占22．4％；②取嵌环433例，取器困难375例，占86．8％；阴道、子宫、宫颈萎缩608例中取器困难177例，占19．1％；③适时取器时机知晓率仅占8．8％。结论：①适时取器时机知晓率低；②置器时间或绝经时间越长，取器越困难，绝经1年以上取器困难率是1年内的2倍。重视取环时机的宣传告知显得尤为重要。     

Lung cancer mortality in European women: recent trends and perspectives

Background: Lung cancer mortality in men has been decliningsince the late 1980s in most European countries. In women, althoughrates are still appreciably lower than those for men, steadyupward trends have been observed in most countries. To quantifythe current and future lung cancer epidemic in European women,trends in lung cancer mortality in women over the last fourdecades were analyzed, with specific focus on the young. Patients and methods: Age-standardized (world standard) lungcancer mortality rates per 100 000 women—at all ages,and truncated 35–64 and 20–44 years—were derivedfrom the WHO for the European Union (EU) as a whole and for33 separate European countries. Joinpoint regression analysiswas used to identify points where a significant change in trendsoccurred. Results: In the EU overall, female lung cancer mortality ratesrose by 23.8% between 1980–1981 and 1990–1991 (from7.8 to 9.6/100 000), and by 16.1% thereafter, to reach the valueof 11.2/100 000 in 2000–2001. Increases were smaller inthe last decade in several countries. Only in England and Wales,Latvia, Lithuania, Russia and Ukraine did female lung cancermortality show a decrease over the last decade. In several Europeancountries, a decline in lung cancer mortality in young women(20–44 years) was observed over the last decade. Conclusions: Although female lung cancer mortality is stillincreasing in most European countries, the more favorable trendsin young women over recent calendar years suggest that if effectiveinterventions to control tobacco smoking in women are implemented,the lung cancer epidemic in European women will not reach thelevels observed in the USA. Key words: Europe, lung cancer, mortality, trends, women     

A realist qualitative study to explore how low‐income pregnant women use Healthy Start food vouchers

Healthy Start is the UK government's food voucher programme for low‐income pregnant women and young children. It was introduced in 2006, but the impact of the programme on nutritional outcomes remains understudied. This study sought to explore potential outcomes of the Healthy Start programme (including intended and unintended outcomes) and develop explanations for how and why these outcomes might occur. A realist review preceded this study, in which programme theories were developed and tested using existing evidence. This qualitative study aimed to further refine and consolidate the programme theories from the realist review while remaining open to new and emerging theories (or hypotheses) about how low‐income pregnant women use Healthy Start vouchers. Semistructured interviews were conducted with 11 low‐income women from North West England, who received Healthy Start vouchers during pregnancy. A realist logic of analysis was applied to generate clear and transparent linkages between outcomes and explanations. The findings suggested that some women used the vouchers to improve their diets during pregnancy (intended outcome), whereas some women were diverted towards alternative or unintended outcomes. Women's circumstances, values, beliefs, and motivations influenced how they perceived and responded to the vouchers. This paper presents four evidence‐based programme theories to explain four contrasting (and potentially overlapping) outcomes: dietary improvements (theory refined from review), shared benefits (new theory), financial assistance (theory refined from review), and stockpiling formula (new theory). It considers how the Healthy Start programme could be improved, to increase the possibilities for low‐income women to experience the intended outcome of dietary improvements.     

Re‐detection vs. new acquisition of high‐risk human papillomavirus in mid‐adult women

To understand high‐risk (hr) human papillomavirus (HPV) epidemiology in mid‐adulthood, we assessed whether associations between incident detection of hrHPV DNA and recent sexual behavior differed according to whether or not there was serologic evidence of prior infection. From 2011 to 2012, we enrolled 409 women aged 30–50 years into a 6‐month longitudinal study. We collected health and sexual behavior histories, enrollment sera for HPV antibody testing, and monthly self‐collected vaginal swabs for HPV DNA genotyping. Generalized estimating equations logistic regression identified risk factors for type‐specific incident hrHPV DNA, stratified by type‐specific hrHPV serostatus at enrollment. Population attributable risks of hrHPV due to prior and recent exposure were estimated. When type‐specific hrHPV serology was negative, recent sexual risk behavior was positively associated with incident hrHPV DNA (odds ratio in women reporting ≥3 recent sexual risk behaviors [e.g., new or multiple partners] vs. no recent sexual activity = 9.8, 95% CI: 2.4–40.6). No associations with recent sexual behavior were observed with positive type‐specific hrHPV serology. Thirty percent of incident hrHPV DNA detection was attributable to prior infection (with positive serology) and 40% was attributable to recent sexual risk behavior (with negative serology). The proportion of incident hrHPV DNA detection attributable to recent sexual risk behavior decreased with increasing age. Among women with serologic evidence of prior infection, re‐detection of the same hrHPV type is likely due to reactivation or intermittent detection of persistent infection. Without serologic evidence of prior infection, new detection is likely due to new acquisition or to intermittent detection of persisting infection.     

Contraceptive acceptability and associated factors among young women (15–24) living with HIV/AIDS: a hospital-based study in Kampala,Uganda

IntroductionIn Uganda, over 43% of all pregnancies among young women (15–24 years) living with HIV are either unwanted or mistimed. Unintended pregnancies account for 21.3% of neonatal HIV infections. The objective was to determine acceptability of contraceptives and associated factors among young women living with HIV attending HIV clinics in Kampala.MethodsBetween February and May 2019, 450 young women attending public HIV clinics (Kisenyi HC IV, Kiswa HC III and Komamboga HC III) in Kampala were systematically enrolled in a cross sectional study and interviewed using structured questionnaires. We used modified Poisson regression to determine the factors associated with acceptability of contraceptive. Data were analyzed using STATA 13.0. Statistical significance was determined at a P values < 0.05.ResultsContraceptive acceptability was 40.7% (95% CI: 27.6%–53.6%). Older age group (20–24 years) (aPR; 2.42, 95%CI; 1.06–5.52, P = 0.035), age at sex debut ≥ 18 years (aPR;1.25,95%CI; 1.13–1.38, P<0.001), having friend on contraceptives (aPR; 1.90, 95%CI; 1.10 – 3.26; P =0.021) and being married (aPR; 1.20, 95%CI; 1.09 – 1.32, P<0.001) were significantly associated with acceptability of contraceptives.ConclusionThere is a low acceptability for contraceptives. Younger age group who are not yet married need to be targeted.     

孕妇及其新生儿血液中微量元素相关性的探讨

目的了解孕妇及其新生儿血液中微量元素的相关性。方法采用原子吸收光谱法对136例产妇及其新生儿血液中铜（Cu）、锌（Zn）、钙（Ca）、镁（Mg）、铁（Fe）5种微量元素进行测定,并做统计学分析。结果孕妇低钙、低铁者占较大比例,分别为44．44％和94．44％,新生儿低钙、低铁者占较大比例,分别为47．22％及22．20％,母婴间微量元素均值比较差异有统计学意义;相关性比较Cu和Mg相关系数（r）为0．3～0．7,呈中度相关;而Ca、Zn、Fe r〈0．3,无相关性。结论孕妇和新生儿应当定期检测血微量元素并适当补充,特别是孕晚期钙、铁的补充及新生儿钙的补充。胎盘对微量元素具有很强的主动转运功能。     

Mpox (formerly monkeypox) in women: epidemiological features and clinical characteristics of mpox cases in Spain,April to November 2022

Over 79,000 confirmed cases of mpox were notified worldwide between May and November 2022, most of them in men who have sex with men. Cases in women, for whom mpox might pose different risks, are rare, and Spain has reported more than one third of those in Europe. Using surveillance data, our study found similar time trends, but differences in delay of diagnosis, sexual transmission and signs and symptoms between men and women.