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OBJECTIVE To evaluate the cost-effectiveness of denosumab and teriparatide in the treatment of postmenopausal osteoporosis in Chinese women， and provide reference for relevant decision-making. METHODS From the perspective of health system in China， Excel 2003 was used to establish Markov model， and cost-utility analysis was used to evaluate the cost- effectiveness of denosumab or teriparatide combined with Calcium carbonate D3 tablets in the treatment of postmenopausal osteoporosis in Chinese women. Pharmacotherapy effects were obtained with network meta-analysis， and cost and health utility value data were obtained from published literature. The model cycle was 1 year， and the simulation time limit was the patient’s lifetime. Univariate sensitivity analysis and probabilistic sensitivity analysis were used to evaluate the effects of model parameter changes on the robustness of the results. Through scenario analysis， the cost-effectiveness of domestic drug cost used as drug cost of terlipatide group was discussed； the influence of residual effects of teriparatide on the results and the cost-effectiveness of sequential use of desumamab after terlipatide withdrawal were also discussed. RESULTS The effect of denosumab regimen was better than that of terlipatide regimen [13.24 quality-adjusted life years （QALYs） vs. 12.96 QALYs]， with lower cost （51 224.64 yuan vs. 167 102.67 yuan）， denosumab regimen was the absolutely superior regimen. The results of single factor sensitivity analysis showed that the cost and discount rate of Terlipatide injection had greater impact on the results. The results of probability sensitivity analysis showed that when three times of China’s per capita gross domestic product （GDP） in 2021 was used as the threshold of willingness to pay， the probability of cost-effectiveness of denosumab regimen was 93.5%. The results of scenario analysis showed that， whether the drug cost of terlipatide regimen which was replaced by domestic drugs， or the residual effect of terlipatide was considered， or desulmonab was used sequentially after two years of terlipide treatment， denosumab regimen was always the absolute advantage regimen. CONCLUSIONS Denosumab combined with Calcium carbonate D3 tablets is more cost-effective than teriparatide combined with Calcium carbonate D3 tablets in the treatment of postmenopausal osteoporosis in Chinese women.
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Objective: To explore the possibility of prophylactic nipple-sparing mastectomy and immediate reconstruction in healthy Chinese women with BRCA1/BRCA2 germline mutation. Methods: From January 2018 to February 2019, three healthy Chinese women with a BRCA1/ BRCA2 germline pathogenic mutation were treated at the Department of Breast Surgery, Peking University International Hospital (2 cases of BRCA1 mutation and 1 case of BRCA2 mutation); these three women (aged 34-36 years) had a strong family history of breast cancer. Thus, they underwent prophylactic nipple-sparing mastectomy and immediate reconstruction. Results: The operations were successfully completed, and no complications occurred. After a median 18-month follow-up, no breast cancer occurred in the three women; they were satisfied with the reconstructed breast's shape, and their anxiety also significantly reduced. Conclusions: Healthy Chinese women with a BRCA1/ BRCA2 germline mutation and a strong family history of breast cancer can possibly consider prophylactic nipple-sparing mastectomy and immediate reconstruction as options.
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OBJECTIVE:To evaluate the effectiveness of mifepristone in the treatment of abnormal uterine bleeding in Chinese women during perimenopause period,and to provide evidence-based reference in clinic.METHODS:Retrieved from CJFD,SinoMed,VIP,Wanfang database,randomized controlled trials (RCTs) about mifepristone in the treatment of abnormal uterine bleeding in Chinese women during perimenopause period were collected,data extraction was conducted for clinical studies meeting inclusion criteria.Meta-analysis was conducted by using Stata 8.0 statistical software after quality evaluation with Cochrane manual 5.1.0.RESULTS:A total of 49 RCTs were included,involving 5 082 patients.Meta-analysis showed that the response rate of mifepristone high-dose group (12.5 mg/d)was significantly higher than that of mifepristone low-dose group (≤ 6.5 mg/d)[OR=2.13,95％ CI(1.53,2.97),P＜0.001],and response rate of mifepristone group was significantly higher than that of progesterone drug group [OR=6.05,95％CI(3.92,9.34),P＜0.001].There was no statistical significance in response rate between mifepristone group and estrogen drug group [OR=1.52,95％ CI (0.45,5.16),P=0.499].CONCLUSIONS:Mifepristone is better than progesterone drug and similar to hormone drug in the treatment of abnormal uterine bleeding during perimenopause period.High-dose of mifepristone is better than low-dose of mifepristone in the treatment of abnormal uterine bleeding during perimenopause period.
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Objective To explore the risk factors of lung cancer in non-smoking Chinese women and to provide evidence for lung cancer prevention and control.Methods Information was collected on case-control studies published in the journals,both nationally and internationally from January,1995 to November,2014 that reported correlations between lung cancer and risk factors.Pooled odds ratio (OR) and 95％ confidence interval (CI) of risk factors on lung cancer in non-smoking Chinese women were calculated,using the Meta-analysis method,with sensitivity and publication bias tested.Results Information on 24 case-control studies was selected including 11 946 cumulative cases and 12 596 controls.Pooled ORs (95％CI) were shown as:history of lung diseases 1.89 (1.57,2.27),history of tuberculosis 1.86 (1.53,2.27),history of chronic bronchitis 1.51 (1.04,2.19),family history of cancers 2.02 (1.67,2.44),family history of lung cancers 2.45 (1.80,3.34),passive smoking (at workplace in adult period 1.47 (1.28,1.69),at home in adulthood 1.22 (1.09,1.36),in all life's time 1.52 (1.29,1.79),kitchen smog while cooking 2.21 (1.27,2.96),position of kitchen 1.76 (1.48,2.09),and frequency of deep frying per week 2.24 (1.61,3.12) etc.respectively.Conclusion Major risk factors related to lung cancer in non-smoking Chinese women would include lung diseases,family history of cancers,and passive smoking (tobacco smog and cooking smog).Particularly,the combination of family history and the degree of cooking presented stronger correlation effects,indicating that genetic and environmental factors jointly played an important role in the development of lung cancer.
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Objective To explore the risk factors of lung cancer in non-smoking Chinese women and to provide evidence for lung cancer prevention and control.Methods Information was collected on case-control studies published in the journals,both nationally and internationally from January,1995 to November,2014 that reported correlations between lung cancer and risk factors.Pooled odds ratio (OR) and 95％ confidence interval (CI) of risk factors on lung cancer in non-smoking Chinese women were calculated,using the Meta-analysis method,with sensitivity and publication bias tested.Results Information on 24 case-control studies was selected including 11 946 cumulative cases and 12 596 controls.Pooled ORs (95％CI) were shown as:history of lung diseases 1.89 (1.57,2.27),history of tuberculosis 1.86 (1.53,2.27),history of chronic bronchitis 1.51 (1.04,2.19),family history of cancers 2.02 (1.67,2.44),family history of lung cancers 2.45 (1.80,3.34),passive smoking (at workplace in adult period 1.47 (1.28,1.69),at home in adulthood 1.22 (1.09,1.36),in all life's time 1.52 (1.29,1.79),kitchen smog while cooking 2.21 (1.27,2.96),position of kitchen 1.76 (1.48,2.09),and frequency of deep frying per week 2.24 (1.61,3.12) etc.respectively.Conclusion Major risk factors related to lung cancer in non-smoking Chinese women would include lung diseases,family history of cancers,and passive smoking (tobacco smog and cooking smog).Particularly,the combination of family history and the degree of cooking presented stronger correlation effects,indicating that genetic and environmental factors jointly played an important role in the development of lung cancer.
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Female sexual dysfunction (FSD) is a public health problem because of its high prevalence and harmful impacts on women’s physical health, psychological well-being, and overall quality of life. The objective of this exploratory study was to identify risk factors of sexual dysfunction and assess the sexual function of Hong Kong Chinese women. Results were compared with findings on American women. A questionnaire survey was conducted to collect data via convenience sampling. Participants of the study (N = 1011) were women (aged 18 or above) from diverse demographic backgrounds. Sexual function of Hong Kong Chinese women was generally adequate, but significantly lower than that of American women. Women of older age (41 years old or above), lower education (primary or below), divorced, in menopause or with oophorectomy were at risk of FSD. Women at risk of FSD also exhibited a decline of sexual frequency which implicated poor sexual health. With the risk factors identified, public health professionals could implement targeted health services that would tackle the problems of FSD in good time and promote the sexual health of women who are distressed by the problems.
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Evidence from Western countries suggests that built environmental attributes can influence the physical activity participation in adults, but whether or not this is the case for Chinese is unknown. Also, the strength of the relationship of environment to physical activity may differ by age group. The present study examined age-related differences in associations between perceived neighborhood environment and walking in Chinese women dwelling in Beijing. Cross-sectional data were collected through an internet-based survey. Total of 737 women aged 30 to 59 years responded. All of them were then divided into three groups based on the age: aged from 30-39, from 40-49 and from 50-59. In addition to socio demographic information, the perceived neighborhood environment was measured by Neighborhood Environment Walkability Scale Questionnaire, and their walking time per week was collected through International Physical Activity Questionnaire. To measure relationship between perceived neighborhood environment and walking time, partial correlations were computed, adjusting for socio demographics. Walking time was significantly related to residential density in aged 40-49 years, and land use mix-access, walking/cycling facilities, traffic safety variables in aged 50-59 years. The present study indicates that there would be differences in associations between neighborhood attributes by age-groups. Future, public health promotion of walking activity and the design of interventions need to consider the contribution of neighborhood level built environment influences.
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Objective Both decreased glomerular filtration rate (GFR) and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese women are rare. Our aim was to explore the relationship between GFR and regional arterial stiffness in Chinese women. Methods In this cross-sectional study, we randomly recruited 1131 adult women residents with GFR ≥ 60 mL/min per 1.73 m2 estimated by the Chinese Modification of Diet in Renal Disease equation from three large communities. Central and peripheral arterial stiffness were estimated simultaneously by measuring carotid-femoral pulse wave velocity (PWVcf) and carotid-radial PWV (PWVcr) using a validated automatic device. Augmentation Index at heart rate 75 beats/minutes (AIx-75) was measured by pulse wave analysis as a composite parameter reflecting both large and distal arterial properties. Results The mean estimated GFR (eGFR) of the study group was 100.05 ± 23.26 mL/minute per 1.73 m2. Subjects were grouped by tertiles of eGFR level. PWVcf and AIx-75 increased ongoing from the top to the bottom eGFR tertile, while the values of PWVcr were comparable. Both univariate Pearson correlations and multiple stepwise regression analyses showed that eGFR significantly correlated to PWVcf, but not to PWVcr and AIx-75. Conclusions In Chinese women with normal to mildly impaired renal function, decreased eGFR affected carotid-to-femoral rather than carotid-to-radial stiffening. This provides rational to conduct future prospective studies to investigate predictors of atherosclerosis in this population.
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Objective: To analyze the cost-effectiveness of mammography screening for Chinese women. Methods: A model of Markov process adapted with clinical data about breast cancer and population of Chinese women was developed to simulate the progression of breast cancer. The model was running over ten cycles (each cycle represents one year) and then to estimate the total cost/effectiveness of mammography screening by summing across those cycles. Results: For women groups aged between 35-59 years and 35-69 years, ICER (incremental cost-effectiveness ratio) of mammography screening group will be 216 656.00 yuan/QALY (quality adjusted life year) and 248 727.50 yuan/QALY respectively compared with non-screening group, and mammography screening can reduce the mortality of breast cancer by 14.66% and 14.79%, respectively. The ICER is closely correlated with the incidence of breast cancer, sensitivity and specificity of mammography screening and the costs for screening. Conclusion: The result of this analysis indicates that mammography screening in Chinese women can reduce the breast cancer mortality about 15%. According to the incidence rate, mean screening performance (including sensitivity and specificity) and screening costs of breast cancer in Chinese women, the mammography screening is not of cost-effectiveness at present. However, the cost-effectiveness of mammography screening is closely correlated with the incidence rate of breast cancer, screening performance and screening costs, the screening for breast cancer in Chinese women will be of or even good costeffectiveness with the increased incidence of breast cancer, the decreased costs of screening and the improved performance of screening. © 2012 by Tumor.
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Bone health status was investigated in 178 free-living Chinese post-menopausal women in Kuala Lumpur. Body mass index (BMI), body composition (using whole body DXA), calcium intake and serum 25-OH vitamin D status were measured along with biochemical markers of bone turnover, that is, pro-collagen Type 1 N-terminal peptide (P1NP), osteocalcin (OC) and C-telopeptide ß cross link of Type 1 collagen (CTX- β). Bone mineral density (BMD) was measured using DXA (Hologic, USA) at the lumbar spine, femoral neck and total hip. Results showed that osteopenia was present in 50% of the subjects at the spine and 57.9% at the femoral neck. Osteoporosis was diagnosed in 10% of the subjects at both the femoral neck and spine. A total of 29.3% of the subjects had high levels of CTX- ß. Mean serum level of 25-OH vitamin D was 60.4+15.6 nmol/L and 50.6% of the subjects had hypovitaminosis D (defined as <50 nmol/l). Mean total calcium intake of the subjects was 497 + 233 mg, of which only 14% met the RNI for calcium with the additional intake of calcium supplements. Body fat was also significantly correlated (r=0.181, p<0.05) with BMD at the spine but not BMD at the femoral neck. Lean body mass was positively correlated with BMD at the spine (r=0.289, p<0.001) and femoral neck (r=0.295, p<0.001). CTX-β was negatively correlated with BMD at the spine (r= -0.235, p<0.001), whereas P1NP (r=-0.215, p<0.001) and osteocalcin (r=-0.265, p<0.001) were both negatively correlated with BMD at the femoral neck. Generally, the study found that women with osteopenia had higher levels of bone turnover markers, less lean body mass and lower calcium intake than women with normal BMD. In conclusion, this study demonstrated that the majority of free living Chinese post-menopausal women in Kuala Lumpur have low calcium intake, low 25-OH vitamin D status and low bone mass and elevated biochemical markers of bone turnover.
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Objective : To explore the prevailing conditions in the childcare environment and to clarify the factors influencing the stress of parenting for Chinese mothers living in Japan, and to discuss the childcare support desired by these mothers.<br> Methods : One hundred thirty-two Chinese mothers with 0～6-year-old children living in the Kanto area with their spouses participated in a questionnaire survey aimed at the childcare environment and parenting stress in Japan.<br> Results : ①The proportion of Chinese mothers in employment was low, but most of those in work had part-time jobs. ②Those who had lived in Japan for longer periods had two or more children, although many Chinese women had only one child, and the birth interval was 4.9 years. ③Many of these mothers wanted to entrust their children to a day nursery in Japan.<br> Conclusion : Mothers raising their children in Japan require childcare support including prompt and effective harmonization with Japanese society, easy-to-use child care facilities and the chance to study Japanese or a well-baby clinic conducted in Chinese.
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PURPOSE: The aim of the study was to assess the prevalence, knowledge and behavior about reproductive tract infections (RTIs) among rural Chinese women in Hunchun, China. METHODS: The study employed a cross-sectional research design with a convenience sample of 190 participants who had received microfinancing. Data were collected by trained research staff, utilizing face to face interviews and physical examinations. RESULTS: About 1 in 5 participants (20.3%) had had more than 5 pregnancies and 26.7% had had 3 or more abortions. More than half (57.3%) of study participants had an RTI at the time of examination, and 92.3% reported having had at least one RTI symptom. Nearly half (49.6%) of the women who exhibited RTI symptoms reported no utilization of any healthcare services. Age, number of pregnancies, RTI knowledge, and behavior were found to be significant correlates in the sample. CONCLUSIONS: The prevalence of RTI among low-income rural Chinese women were extremely high, indicating the urgent need for effective and culturally sensitive health education, particularly targeted to the poor rural population.