Knee osteoarthritis in women

Osteoarthritis is a disease that progresses over time and culminates in the destruction of articular cartilage and joints. Thus, with an increasing elderly population the treatment of knee osteoarthritis has become a major healthcare issue. It has been shown that women are more severely impacted by knee osteoarthritis. Differences in knee anatomy, kinematics, previous knee injury, and hormonal influences may play a role. Sex difference with respect to osteoarthritis presentation, treatment, and the allocation of resources also exists. In general, women present for treatment in more advanced stages of osteoarthritis and have more debilitating pain than their male counterparts. In addition, healthcare providers are more likely to recommend total joint arthroplasty for their male patients. Understanding how and why these gender differences occur is instrumental in formulating an inclusive strategy for combating osteoarthritis in the future.     

Vitamin D, parathyroid hormone levels and bone mineral density in community-dwelling older women: The Rancho Bernardo Study

Vitamin D (25(OH)D) increases the efficiency of intestinal calcium absorption. Low levels of serum calcium stimulate the secretion of parathyroid hormone (PTH), which maintains serum calcium levels at the expense of increased bone turnover, bone loss and increased risk of fractures. We studied the association between 25(OH)D and PTH levels, and their associations with bone mineral density (BMD), bone loss, and prevalence of hip fractures in 615 community-dwelling postmenopausal aged 50–97 years. Mean level of 25(OH)D and PTH were 102.0 nmol/l±35.0 nmol/l and 49.4 ng/l±23.2 nmol/l, respectively; 49% of women were current hormone therapy users. The overall prevalence of vitamin D insufficiency (25(OH)D<50 nmol/l) was 2%, and prevalence of high PTH levels (>65 ng/l) was 17.4%. In multiple linear regression analyses hip BMD was negatively and independently associated with PTH levels ( p =0.04), and positively and independently associated with 25(OH)D levels ( p =0.03). There were only 23 women (3.7%) who experienced a hip fracture. In age-adjusted analyses there were no significant differences of 25(OH)D and PTH levels by hip fracture status. Across the entire range of values, the overall correlation between 25(OH)D and PTH was moderate ( r =–0.20). However, after the threshold vitamin D level of 120 nmol/l, all PTH values were below 65 ng/l. Further studies are necessary to identify the optimal vitamin D levels necessary to prevent secondary hyperparathyroidism.     

育龄期女工生殖道感染现状调查及相关因素分析

目的:了解社区工厂育龄女性生殖道感染发生情况,并分析影响生殖道感染发生的的相关因素.方法:采用匿名问卷调查,了解对象的年龄、文化程度、收入、职业等社会学信息和1年内生殖道感染发生情况和个人卫生行为习惯,使用统计学软件分析生殖道感染发生和相关因素的关系.结果:(1)深圳市工厂育龄女性近1年内生殖道感染炎症发生率为9.8％;(2)生殖道感染高危行为方面,洗脚盆与洗外阴的盆共用的占34.5％,内裤与袜子一起混洗的占45.7％,经期有性生活的占15.8％;(3)工厂育龄女性生殖道感染发生率随着年龄增长、学历提高、家庭收入提高而增加;(4)户籍人口的生殖道感染发生率为12.8％,比流动育龄女性的发病率9.5％高.结论:由于深圳工厂育龄女性的家庭收入、学历影响对象的性生活频率,从而影响对象生殖道感染的发生,因此有必要针对这些群体开展个性化健康教育.     

16例孕妇梅毒血清学分析

目的：了解孕妇梅毒感染治疗情况及对新生儿的影响。方法：收集2007年在我院分娩的孕产妇梅毒血清学检查结果,并对血清学检查异常的孕妇治疗情况及新生儿检查情况进行分析。结果：梅毒血清学检查异常孕妇共16例,占同期孕产妇0．66％,其中接受苄星青霉素治疗的10例,占62．5％。14例新生儿接受TRUST检查,占应检查数的87．5％,其中TRUST阳性5例（35．7％）,但滴度均未高过母亲滴度。结论：孕妇梅毒感染有增加的趋势,但正规治疗率低,应在产前门诊加强梅毒的筛查及治疗,同时加强对梅毒孕妇所产新生儿的梅毒筛查及治疗。     

孕妇药物临床试验中的伦理问题及其解决方案综述

由于孕妇及胎儿对药物较为敏感、孕妇用药具有普遍性以及孕妇药物临床试验的缺失,孕妇进行药物临床试验是必要的。然而,目前此类试验在开展过程中面临诸多伦理问题,主要包括孕妇受试者招募不足、风险与受益难以平衡以及孕妇受试者保护体系不够完善。因此,可通过有效地招募和保留孕妇受试者、防控风险和提高受益以及完善保护孕妇受试者的相关体系等科学对策解决。     

The effect of physical activity on weight loss is mediated by eating self-regulation

Objective

This study tested whether different forms of physical activity (PA) were associated with eating self-regulation during weight control, and if changes in eating behavior mediated the relationship between PA and weight loss, in overweight/obese women.

Methods

239 women (37.6 ± 7.0 years; 31.3 ± 4.1 kg/m²) participated. The intervention group received a 12-month group behavioral treatment designed to increase autonomy and self-regulation for weight control. Controls received a health education program. Assessments included body weight, structured and lifestyle exercise/PA, and eating self-regulation.

Results

Moderate + vigorous and lifestyle PA were associated with 12-month change in most eating variables (p < 0.05) and with body weight change (p < 0.01). Mediation analysis showed that flexible cognitive restraint and emotional eating fully mediated the relation between lifestyle PA and weight change (effect ratio: 0.63). About 34% of the effect of moderate + vigorous PA on weight change was explained by these same mediators (partial mediation).

Conclusion

Exercise and PA may positively influence weight control through eating self-regulation. Flexible dietary control and reduced emotional overeating are mechanisms by which an active lifestyle can contribute to long-term weight management.

Practice implications

Regular exercise and PA can contribute to improved eating behaviors during weight management. This could represent an important incentive for people seeking weight control.     

家庭诸多因素对育龄妇女碘营养水平影响的研究

目的分析碘缺乏病防治难点地区家庭诸多因素对育龄妇女碘营养水平的影响程度,提出有针对性的防治措施。方法依据《我国碘缺乏病高危地区重点调查方案》要求,在和田地区进行入户调查,调查内容包括：家庭主妇文化程度、碘营养水平、碘缺乏病防治知识知晓率、食盐种类、家庭经济状况、家庭子女数量等。结果（1）碘盐覆盖率与尿碘水平呈现正相关关系（r=0.142,P〈0.05）,碘盐覆盖率越高,尿碘水平也越高（χ^2134.58,P〈0.05）;（2）家庭主妇防治碘缺乏病知识知晓率对碘盐覆盖率（χ^263.069,P〈0.05）和尿碘水平（χ^27.081,P〈0.05）有显著影响;（3）家庭主妇生育子女数量越多,尿碘水平越低（χ^217.43,P〈0.05）;（4）尿碘与文化程度及人均收入水平呈正相关关系（r=0.091,P〈0.05;r=0.078,P〈0.05）;（5）不同生理状况的育龄妇女碘营养水平没有显著差异。结论诸多单因素对尿碘的影响程度由大到小依次为碘盐覆盖率、生育子女数、防治碘缺乏病知识知晓率,而家庭人均收入、文化程度、生理状况等因素没有明显影响。在多个因素对尿碘影响的分析中,只有人均平均收入与盐的种类因素有影响。     

妊娠期维生素D水平与母婴结局的相关性

[目的] 探讨妊娠期妇女血清维生素D(VD)水平与母婴结局的相关性.[方法] 选择2015年1月至2016年1月在本院行产检的中晚期妊娠孕妇100例(观察组),另外选择同期健康体检正常女性(非妊娠)60例(对照组),采用酶联免疫吸附法检测两组血清25羟维生素D3[25(OH)D3] 水平,观察组根据25(OH)D3水平将其分为缺乏组、不足组与正常组,比较各组母婴结局.[结果] 观察组血清平均25(OH)D3水平为(42.58±11.34)nmol/L,显著低于对照组的(53.36±10.82)nmol/L,差异有统计学意义(P<0.05).观察组中VD正常组、不足组、缺乏组胎儿窘迫(3.85% vs 11.67% vs 35.71%)、流产(3.85% vs 10.00% vs 35.71%)、细菌性阴道病(0.00% vs 10.00% vs 28.57%)、分娩孕周[(39.50±1.42)vs(38.10±2.00)vs(37.28±0.50)周] 比较差异均有统计学意义(P<0.05),各组妊娠期糖尿病、妊娠期高血压、剖宫产、贫血、新生儿出生体质量、身长及头围比较差异均无统计学意义(P<0.05).[结论] 妊娠期妇女血清VD不足或缺乏会增加胎儿窘迫、流产及细菌性阴道病发生风险,明显缩短分娩孕周,但妊娠期VD水平与新生儿出生体格生长无关.