Qingxin Zishen Decoction Treats Menopausal Syndrome Due to Yin Deficiency with Effulgent Fire by Regulating KNDy Neurons / 中国实验方剂学杂志

ObjectiveTo explore the comprehensive effects of Qingxin Zishen decoction on the symptom score and neuroendocrine indexes and the mechanism of the decoction in regulating KNDy neurons in the patients with menopausal syndrome. MethodA total of 60 patients with menopausal syndrome due to yin deficiency with effulgent fire who attended the menopausal outpatient of Jiangsu Province Hospital of Chinese Medicine were randomized into an experimental （Qingxin Zishen decoction） group （30 cases） and a control （femoston） group （30 cases）. The treatment lasted for 12 weeks in both groups. The two groups were compared in terms of the comprehensive efficacy， frequency and degree of hot flashes and sweating， modified Kupperman score， and the serum levels of hypothalamic peptide kisspeptin， neurokinin B （NKB）， dynorphin （Dyn）， follicle-stimulating hormone （FSH）， and estradiol （E2）. Result① Comprehensive efficacy： The comprehensive efficacy of the two groups was comparable. ② Frequency and degrees of hot flashes and sweating： After treatment， the frequency and degrees of hot flashes and sweating in the two groups were reduced （P<0.05） and the control group outperformed the experimental group （P<0.05）. ③ Modified Kupperman score and menopausal symptoms： After treatment， the modified Kupperman score decreased in both groups （P<0.05）. After 4 weeks of treatment， the experimental group was superior to the control group in terms of the scores of dizziness and headache （P<0.05）. ④ Serum levels of sex hormones： After treatment， the serum E2 level elevated and the FSH level lowered in both groups （P<0.05）， and the changes were more obvious in the control group （P<0.05）. ⑤ Neuroendocrine indexes： After treatment， the serum levels of kisspeptin and NKB in the two groups decreased （P<0.05）， and the serum Dyn level in the experimental group increased （P<0.05）. Moreover， the experimental group had higher Dyn level than the control group after treatment （P<0.05）. ConclusionQingxin Zishen decoction can alleviate hot flashes， sweating， and other symptoms in the women with menopausal syndrome by acting on the KNDy neurons to lower the kisspeptin and NKB levels and elevate the Dyn level. The findings provide new ideas for the clinical treatment of hot flashes in menopause.

Menopausia quirúrgica en pacientes con mutación BRCA, el papel de la terapia hormonal / Surgical Menopause in Patients with BRCA Mutation, the Role of Hormone Therapy

Introducción: las mujeres con mutación BRCA1/2 (mBRCA) tienen un riesgo aumentado de desarrollar cáncer de mama (CM) y ovario (CO). La salpingo-oforectomía bilateral (SOB) se asocia con la reducción del riesgo del 80% para CO y un 50% para CM. Se recomienda realizarla entre los 35 y 40 años. Como consecuencia se produce una menopausia prematura, con un impacto negativo sobre la calidad de vida por la presencia de síntomas climatéricos, aumento del riesgo de enfermedad cardiovascular, osteoporosis y riesgo de alteración cognitiva. La terapia hormonal (THM) es el tratamiento más eficaz para la prevención de estos síntomas. Estado del arte: distintos estudios han demostrado un mayor riesgo de CM en mujeres posmenopáusicas que reciben THM en particular con terapia combinada, estrógeno + progesterona (E+P). Según el metanálisis de Marchetti y cols., en las mujeres portadoras de mBRCA que recibieron THM, no hubo diferencias en el riesgo de CM comparando E solo con E+P. En el estudio de Kotsopoulos, incluso se encontró un posible efecto protector en aquellas que usaron E solo. Otro estudio en portadoras sanas demostró que, en las mujeres menores de 45 años al momento de la SOB, la THM no afectó las tasas de CM. Sin embargo, en las mujeres mayores de 45 años, las tasas de CM fueron más altas. Como el esquema de E+P se asocia con un mayor riesgo relativo (RR) de CM, las dosis de progestágenos utilizados se deberían limitar, eligiendo derivados naturales de progesterona, de uso intermitente para disminuir la exposición sistémica. Según diferentes guías internacionales, a las portadoras de mBRCA sanas que se someten a una SOB se les debe ofrecer THM hasta la edad promedio de la menopausia. Conclusión: la menopausia prematura disminuye la expectativa de vida; es por ello que una de las herramientas para mejorar y prevenir el deterioro de la calidad de vida es la THM. El uso de THM a corto plazo parece seguro para las mujeres portadoras de mBRCA que se someten a una SOB antes de los 45 años, al no contrarrestar la reducción del riesgo de CM obtenida gracias a la cirugía. (AU)

Introduction: women with BRCA1/2 (mBRCA) mutation have an increased risk of developing breast (BC) and ovarian (OC) cancer. Bilateral salpingo-oophorectomy (BSO) is associated with an 80% risk reduction for OC and 50% for BC. The recommended age for this procedure is 35 to 40 years. The consequence is premature menopause, which hurts the quality of life due to the presence of climacteric symptoms, increased risk of cardiovascular disease, osteoporosis, and a higher risk of cognitive impairment. Hormone therapy (MHT) is the most effective treatment for preventing these symptoms. State of the art: different studies have shown an increased risk of BC in postmenopausal women receiving MHT, particularly with combined therapy, estrogen + progesterone (E+P). According to the meta-analysis by Marchetti et al., in women carrying mBRCA who received MHT, there was no difference in the risk of BC compared to E alone with E+P. In the Kostopoulos study, there was also a possible protective effect in those who used E alone. Another study in healthy carriers showed that in women younger than 45 years at the time of BSO, MHT did not affect BC rates. However, in women older than 45 years, BC rates were higher. As the E+P scheme is associated with a higher RR of BC, the doses of progestogens should be limited, choosing natural progesterone byproducts of intermittent use to decrease systemic exposure. According to various international guidelines, healthy mBRCA carriers undergoing BSO should be offered MHT until the average age of menopause. Conclusion: premature menopause decreases life expectancy, which is why one of the tools to improve and prevent deterioration of quality of life is MHT. Short-term use of MHT appears safe for women with mBRCA who undergo BSO before age 45 as it does not counteract the reduction in the risk of MC obtained by surgery. (AU)

Postmenopausal Experiences and Constraints in Seeking Health Care in A Rural Area of West Bengal, India

Introduction: During menopause, women experience various psychological or physical changes which need adequate attention. Moreover, women don’t seek help for these problems due to their hesitancy, lack of awareness, socio-cultural, financial constraints or as they feel this is a natural-phenomenon. The study aims to explore the postmenopausal experiences faced by women during menopause and to elicit the constraints faced by them in seeking health-care services. Methodology: This was a qualitative study with phenomenological approach conducted among post-menopausal women (≥45 years) from Oct 2022-Jan 2023 with the help of In-Depth-Interview guide in four villages of Bhatar Block, Purba-Bardhaman District. Considering the availability of the study participants, they were selected purposively from the list prepared by ASHA of each village and recruitment done till the point of data-saturation. Inductive thematic-analysis was used to identify codes and themes. Results: During menopause, women experienced physical and psychological changes in the body, changes in social life and for these changes they had to adjust to cope-up. They felt various needs like empathy from hus-bands, children, peers. On the other hand, they did not seek help from health-care services due to their knowledge gap, dissatisfaction from previous-visit, cost-issue and unavailability of resources in health-care delivery system. Conclusion: Majority of the post-menopausal women faced various problems associated with menopause, but very few had sought help. So, health care providers have an important role to generate awareness among post-menopausal women regarding physical and mental changes during this phase.

The efficacy of short-term intramuscular injection of oryzanol for 5 days and 10 days in the treatment of menopausal syndrome: results from an exploratory study / 中国综合临床

Objective:To explore the clinical effects of intramuscular injection of oryzanol for 5 and 10 days in the treatment of menopausal syndrome.Methods:This study adopts a case-control study method.Twenty patients with menopausal syndrome admitted to Peking Union Medical College Hospital from July 2021 to March 2022 were selected and randomly divided into a control group and an observation group using a random number table method, with 10 patients in each group. The control group was given intramuscular injection of oryzanol once a day for 5 consecutive days on the basis of routine health education; On the basis of routine health education, the observation group was given intramuscular injection of oryzanol once a day for 10 consecutive days. Two groups of patients completed a total of 6 visits before treatment and on days 5, 10, 30, 60, and 90 of treatment. Baseline survey was conducted to record the basic information of patients, including demography data, menstruation, past history, surgical history, drug allergy and the main symptoms of climacteric syndrome, and the baseline hormone level of patients was detected. Compare the menopausal symptoms by modified K-score, Pittsburgh sleep quality index (PSQI) score, menopausal specific quality of life (MENQOL) score, post treatment injection site pain by visual analog score (VAS), and observe adverse reactions during treatment between the two groups of patients at each visit time point.The measurement data conforming to the normal distribution is expressed in xˉ± s. The comparison between the two groups is performed by t test, and the change trend of the two groups at each time point is compared by repeated measurement analysis of variance; The measurement data that do not conform to the normal distribution are represented by M( Q1, Q3), and the Kruskal Wallis test is used for comparison between groups; Counting data is represented by examples(%), Fisher's exact probability method is used for inter group comparison, and Wilcoxon rank sum test is used for rank data comparison. Results:The body mass of the control group was higher than that of the observation group [(62.50±11.88) kg vs (52.90±4.28) kg, t=2.40, P=0.027]. There was no statistical difference between the two groups in other demography data and previous history, sex hormone levels, menopausal symptoms, and menstrual conditions (all P>0.05). Compared with the baseline, the modified K-score, PSQI score, and MENQOL vascular dilation and contraction, psychological state, physiological state, and sexual life scores of the two groups of patients on the 5th, 10th, 30th, 60th, and 90th day of treatment were significantly reduced, and showed a gradually decreasing trend with the extension of observation time (the values in Group F were 36.37, 12.40, 18.69, 24.73, 40.77, and 18.39, respectively, P<0.001), but there was no statistically significant difference between the groups (all P>0.05). After treatment, the VAS score of the control group was 1 point in 2 cases, 2 points in 4 cases, and 3 points in 4 cases; The VAS score of the observation group was 1 in 4 cases, 2 in 3 cases, and 3, 5, and 6 in 1 case each. There was no statistically significant difference in VAS scores between the two groups ( Z=0.43, P=0.664), and no adverse events or serious adverse events were observed during the treatment period. Conclusions:Intramuscular injection of oryzanol injection for 5 and 10 days can improve menopausal symptoms, improve sleep quality and overall quality of life in patients with menopausal syndrome, and the overall effect is similar.

Research on serum metabolic markers of menopausal syndrome based on / 中国临床药理学与治疗学

AIM: To find specific metabolic markers for women entering peri-menopausal period and patients with menopausal syndrome based on

Analysis of medication rules of TCM for perimenopausal syndrome based on literature mining / 药学实践杂志

Objective To investigate the rules of Traditional Chinese Medicine in the treatment of perimenopausal syndrome (PMS) and provide a theoretical basis for the clinical treatment of PMS. Methods The literature related to PMS were collected from China Knowledge Network (CNKI), Wanfang database and Weipu database in the past 20 years, the herbal compound prescriptions for the treatment of PMS were screened and a relevant database were established and analyzed by SPSS. Results The relevant literatures contains 184 Chinese medicine prescriptions/proprietary Chinese medicines, 122 flavors of traditional Chinese medicines, and the drug categories were mainly tonic drugs, antipyretic drugs, astringent drugs, and tranquilizers. The core single-flavor Chinese medicines were Baishao(Radix Paeoniae Alba), Shudihuang(Rehmannia glutinosa ), Danggui(Radix Angelicae Sinensis), Fuling (Indian Buead). The property and flavor covered sweet, bitter, cold, etc.; and the channel tropism belonged to the liver, kidneys, heart, lungs, spleen and meridians. The cluster analysis of high-frequency Traditional Chinese Medicine obtained two main combinations. Conclusion TCM treatment of PMS focused on replenishing qi, soothing the liver, nourishing the kidneys, nourishing blood and calming the heart, and then according to clinical compatibility with drugs such as soothing the nerves, clearing heat and removing dampness; most of its clinical treatment were Xiaoyaosan, Liuwei Dihuang pills, and Zhibo Rehmanniae decoction and other prescriptions which were added and subtracted.

Treatment of Menopausal Syndrome Based on Phlegm，Stagnation，and Fire / 中医杂志

Menopausal syndromes are mostly based on kidney deficiency， which could be expalined that kidney governing essence storage and controlling innateness， so when the kidney water was deficient and the liver fail to nourish， then led to liver depression and transform into fire； deficiency of the kidney， loss of warmth of the spleen， and inability to transport and transform the water and dampness will easily lead to phlegm and fire； the decline of the kidney yin and loss of water and fire will easily cause the exuberance of heart fire. Therefore， clinical symptoms of hot flashes， insomnia， and palpitations are common due to phlegm， depressions， and fire. Based on this， at the beginning of the treatment， we should treat the symptoms firstly by resolving phlegm， relieving depression and clearing fire， and commonly use Huanglian Wendan Decoction （黄连温胆汤）， Yigan Powder （抑肝散）， Chaihu plus Longgu Muli Decoction （柴胡加龙骨牡蛎汤）， and Qingxin Zishen Decoction （清心滋肾饮）， etc. After improving the symptoms of hot flashes and sweating， irritability， dreaming and frightening， then we should give the prescriptions to tonify kidney yang and nourish kidney yin， in order to eliminate the pathogens and reinforce healthy qi， and to treat both the manifestations and the root cause， so that the symptoms of the patients can be better alleviated.

Associations Between Menopausal Symptoms with Socio-economic, Demographic and Lifestyle Variables among Postmenopausal Women of Assam, Northeast India.

Background: Menopausal health refers to the various biological, physiological, and psychological changes and imbalances that occur as a result of the severity of symptoms. However, low oestrogen production causes various changes and declinations in women, which manifest as menopausal symptoms. Objectives: Present study determines the prevalence of menopausal symptoms and associations between socio-economic, demographic and lifestyle variables among postmenopausal women in Assam, Northeast India. Methods: The study was undertaken on 300 postmenopausal women using stratified random sampling. A pre-structured interview schedule was used to collect relevant data on socioeconomic, demographic, and lifestyle variables, as well as menopausal symptoms and related self-reported diseases, through a household survey and interview methods. Results: The mean age of menopausal women was found to be 47.08±2.38 years. Change in sexual desire (96.33%), profuse sweating with hot flush (61.67%), hot flush (60.00%), pain during sexual intercourse (46.33%), difficulties sleeping (37.00%), and lack of energy (39.67%) were the most common menopausal symptoms. There were significant associations recorded between various menopausal symptoms and age, education, first pregnancy age, age at menarche, family size, family type, parity, age at menopause, physical weakness, family income, and house condition (p <0.05). Conclusion: Menopausal symptoms were found to be more prevalent, and to reduce the population's health-related threat, more awareness, knowledge dissemination, and assistance are required, particularly among rural women.

Age at natural menopause and factors affecting its onset: A cross-sectional study among postmenopausal females in District Dehradun

Background: Menopause has become a popular topic of study as life expectancy rises around the world. The average age at menopause in both developed and developing countries ranges from 45 to 53 years. Factors influencing the extent of ovarian follicle reserve dwindling, such as sociodemographic, menstrual, reproductive, and dietary factors. Aim and Objective: The present study aimed to determine the mean age of menopause and to find out the various factors affecting menopause onset. Methods: A community based cross-sectional study conducted in rural and urban areas of District Dehradun for a period of 1 year starting 1st August 2020 to 31st July 2021. Data were collected using multistage stratified random sampling from 211 cases of natural menopause. Chisquare was applied as statistical test of significance and p < 0.05 was considered statistically significant. Results: According to current study, average age menopausal age is 46 years. Variables like sociodemographic characteristics, lifestyle habits, reproductive and menstrual factors were found to have a significant relationship with onset of menopause. Conclusion: Menopause, whether it occurs early or late in life, several factors are responsible for deciding its onset. As a result, it is critical to identify the factors influencing the onset of menopause.

OBESITY AND GYNECOLOGICAL MALIGNANCIES:A MULTI-CENTRIC CROSS SECTIONAL STUDY

Introduction: Obesity is a growing problem and has signi?cant implications for a variety of diseases, including human cancers. Obesity has now become an epidemic so is the increase of gynecological malignancies in this era. So we review the association of obesity and gynecological malignancies like breast, endometrial, cervical, ovarian, tubal and Vulvo-vaginal carcinoma as an independent etiological risk factor. To Aims and objectives: estimate the prevalence of overweight and obese female in western Indian population. To ?nd the association of different gynecological malignancies and obesity. To evaluate the effect of obesity on different gynecological malignancies in accordance with age, reproductive life and socioeconomic status A cross sectional study in western . Materials and methods: Indian states Gujarat, Maharashtra and Rajasthan from January 2019 to December 2021, 10245 sample size and with overweight and obese post menarchal women up to 70 years of age with BMI >25 kg/m2 were compared to matched controls. All the consented subjects were initially screened by questionnaire by ?eld worker and examined for routine and advanced screening and examinations like Manual Palpation of breast, per abdomen, per speculum per vaginal examination and Pap smear by certi?ed professionals according to standard protocols. Investigation was performed when required like mammography, Ultrasonography and laboratory investigations. Positive association of breast and endometrial Results: carcinoma especially in postmenopausal women and cervical carcinoma. Weak positive association for ovarian carcinoma only in premenopausal woman (not statistically signi?cant). We do not ?nd enough cases to conclude anything for vulvo vaginal and tubal carcinoma. Growing epidemic of obesity can be statistically correlated with increasing Conclusion: incidence of gynecological malignancies like breast, endometrial, ovarian and cervical. Large scale studies further needed for evaluation of correlation of vulvo vaginal and tubal carcinomas

TO STUDY ASSOCIATION OF POST-MENOPAUSAL SYMPTOMS AND CLINICO-DEMOGRAPHIC PROFILE: A DESCRIPTIVE STUDY

Age at menopause influences the severity of post-menopausal symptoms to determine the symptoms and clinicodemographic links in post menopauseal women in a representative population from eastern Uttar Pradesh. All postmenopausal women presenting with symptoms in the Gynaecological Emergency Department for a period of one year were enrolled. Age and clinicodemographic details, symptoms severity, and reasons for delay in seeking treatment were noted. The data was analysed using Chi-square test. Overall 990/17,927 (5.52%) women visiting the gynaecological OPD presented with post-menopausal complaints. Among menopausal women, the mean age ranged from 40 to 60 years old with a mean age of 46.6012.48 years. Majority were para 3-4 (52.5%), age at menarche were >13 years (58.3%), uneducated (58.8 %) , lower/upper lower SES (57.5%), married (77.3%) and had BMI<18.5kg/m2 (62.1%). Tobacco/smoking addiction was reported in 55 (5.6%) women. A total of 145 (14.6%) were working women. Severity of symptoms was mild, moderate and severe in 57.2%, 28.3% and 14.5% cases. Majority had onset of symptoms for 4- 5 years (56.4%) after menopause. Joint pains and Backache/body ache were the most common presenting complaints (81.8%). A significant association of age at presentation was seen with parity, age at menarche, BMI category and occupational status. Severity of symptoms showed a significant association with age at presentation, parity, age at menarche, BMI category, occupational status and tobacco/smoking use. Most common reasons for delayed treatment were financial problems (22.2%), family problems (18.2%) and commonness of problem (12.6%). Only 2.1% women were aware about HRT. Among the relatively less informed members of our study population, low socioeconomic status, underweight, and menopause age were all influenced by clinicodemographic factors.

Blood formed elements of the women with uterine tumors as one of the criterion for assessment of severity of the pathology

The indicators for structural analysis of blood formed elements are prominent in the assessment of pathologies, diagnostics and the degree. Therefore, we aimed to evaluate the ongoing alterations that reflect on the structural characteristics of blood formed elements based on the hormonal imbalance among menopausal women with uterine tumors. Blood samples from the women with benign (n=20), malignant (n=20) uterine tumors, and healthy menopausal women (control, n=20) were used. Enzyme-linked Immunosorbent assay (ELISA) kits were used for the quantitative determination of hormones. The blood formed elements ultrastructure observations were conducted using transmission electron microscope. Compared to control (33.8±0.7 pg/mL), estradiol level was higher in benign (45.7±0.9 pg/mL) and malignant (70.7±3.7 pg/mL) cases (P< 0.001). Similar pattern was noted in testosterone levels [control=0.38±0.03 ng/mL, benign=0.55±0.04 ng/mL (P< 0.01), malignant=1.56±0.14 ng/mL (P< 0.001)] was higher in malignant cases. In contrast, progesterone levels were decreased in the disease cases [control=0.93±0.05 ng/mL, benign=0.44±0.003 ng/mL, malignant=0.31±0.02 ng/ml (P< 0.001)]. Assessments of the morphologic structure of erythrocytes revealed pathological forms of erythrocytes (poikilocytosis) in case of benign, as well as in malignant tumors. particularly target cells (codocytes), hamlet cells, teardrop cells (dacrocytes), sickle cell (drepanocytes) erythrocytes. Using ELISA and transmission electron microscopy our results demonstrate that in case of malignant uterine tumor quantitative/structural changes occur in blood formed elements indicating ongoing alterations in hormonal imbalance. Assessing these changes in structural characteristics would be useful in examining uterine pathologies and subsequent treatment plans

A Case of Excessive Sweating and Hot Flushes Successfully Treated with Yokukansan / 日本東洋医学雑誌

We report a case of a 49-year-old woman who presented with 6-month period menopausal syndrome including excessive sweating and hot flushes in her face, chest and back. She was also frustrated with her sons, but she reflected on her own anger and wondered why she got so irritated with them. We prescribed yokukansan to her and her all symptoms improved one month later. We need to differentiate between yokukansan and kamishoyosan in the treatment of menopausal syndrome and irritation, and it may be useful to evaluate the detail of irritation in selecting formula.

Effect of "Natural Polypill", Xuezhikang on Serum Cholesterol Metabolism Markers in Early Menopausal Women with Hypercholesterolemia / 中国结合医学杂志

OBJECTIVE@#To analyze the effect of Xuezhikang on the markers of the serum lipid levels of cholesterol synthesis and absorption in early menopausal women with hypercholesterolemia, and preliminarily explore its lipid-lowering mechanism.@*METHODS@#A total of 90 early menopausal women with hypercholesterolemia were enrolled from December, 2014 to May, 2016 from Beijing Anzhen Hospital, Capital Medical University, who were randomly allocated to receive Xuezhikang (1200 mg/d, orally) or atorvastatin (10 mg/d, orally) according to a random number table. Serum levels of some related biomarkers, including cholesterol synthesis markers (squalene, dihydrocholesterol, dehydrocholesterol, and lathosterol), and absorption markers (campesterol, stigmasterol, and sitosterol) as well as safety indices were obtained at baseline and after 8 weeks of the intervention.@*RESULTS@#Eight weeks after treatment, both Xuezhikang and atorvastatin significantly reduced the levels of total cholesterol, triglycerides, low density cholesterol compared to baseline (all P<0.01). Xuezhikang significantly reduced the levels of squalene, dehydrocholesterol and lathosterol compared to baseline (all P<0.01), but atorvastatin only significantly reduced the level of squalene (P<0.01), compared to baseline. All cholesterol absorption markers showed no significant differences before and after treatment (P>0.05), however, a more obvious downward trend was shown in the Xuezhikang group. In addition, all the safety indices showed no significant differences between the two groups. Although the creatinekinase level in the Xuezhikang group was significantly higher, it remained within the safe range.@*CONCLUSIONS@#Xuezhikang may have more comprehensive effects on the markers of cholesterol synthesis and metabolism in early menopausal women with hypercholesterolemia through ergosterol and flavonoids in its "natural polypill."

Effect of repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy on insomnia in menopausal women / 中华行为医学与脑科学杂志

Objective:To explore the effect of repetitive transcranial magnetic stimulation(rTMS) combined with cognitive behavioral therapy for insomnia(CBT-I)for menopausal women with insomnia.Methods:A total of 76 menopausal women with insomnia who were hospitalized from April 2020 to October 2021 were enrolled.Then they were randomly divided into observation group and control group, with 38 cases in each group.Both observation group and control group were treated with CBT-I. Meanwhile, the patients in observation group were treated with low-frequency repetitive rTMS, on the contrary, the patients in control group were treated with sham rTMS.The intervention lasted for 4 weeks.Insomnia severity index (ISI), Pittsburgh sleep quality index (PSQI) and polysomnography (PSG) were all recorded at baseline and 4 weeks after intervention, as well as adverse events. Data was analyzed by SPSS 22.0 software. Data which was normally distributed, was compared by independent t-test and paired t-test. Results:(1)The scores of ISI (16.39±4.03, 15.66±4.89) and the PSQI(14.97±2.70, 14.11±3.60) in observation group and control group at baseline were not significantly different( t=-0.716, -1.190, both P>0.05). After treatment, the ISI and PSQI scores of the observation group (10.08±3.65, 9.58±1.73)were lower than those of the control group (12.82±4.47, 12.13±2.32), and the differences were statistically significant ( t=2.926, 5.440, both P<0.05). (2) After treatment, all sleep parameters were significantly improved from baseline in observation group (all P<0.05). Sleep efficiency, wake time during sleep, and number of awakenings were significantly improved from baseline in control group(all P<0.05). Compared with control group((70.38±12.99)%, (17.39±11.75)%, (13.98±6.35)%), the observation group reported a greater statistically improvement in sleep efficiency, N3% and REM%((79.52±9.31)%, (22.80±6.05)%, (18.78±6.68)%, respectively)( t=-3.526, -2.524, -3.212, all P<0.05). Neither group had serious adverse effects. Conclusion:The rTMS combined with CBT-I can significantly improve the sleep quality in menopausal women with insomnia. With its high safety rTMS combined with CBT-I may be a recommended non-drug therapy among menopausal women with insomnia.

Estrogen and progesterone hormone receptor status in pre-menopausal and postmenopausal women with invasive ductal carcinoma in a private tertiary hospital in Cebu City, Philippines: A retrospective study

OBJECTIVE@#This study was conducted to determine the difference of hormone receptor status between pre-menopausal and postmenopausal women diagnosed with invasive ductal carcinoma in the local setting. @*METHODS@#This retrospective descriptive study used data gathered from chart review of premenopausal and postmenopausal female patients diagnosed with invasive ductal carcinoma by tissue biopsy and underwent determination of hormone receptor status (estrogen and progesterone receptor) by immunohistochemical staining (ICA) using biopsy samples taken from June 2016 to December 2019 at Cebu Velez General Hospital, Cebu City. The significance of the difference in the hormone receptor status with menopausal status was analyzed using Fisher’s exact test.@*RESULTS@#Comparing the two groups, 25 (60%) of the pre-menopausal women and 37 (73%) of the post-menopausal women were determined as hormone sensitive, while 17 (40%) pre-menopausal women and 14 (27%) post-menopausal women were hormone resistant. The Fisher’s exact test did not detect a statistically significant difference in the hormone receptor status of pre-menopausal and post-menopausal breast cancer patients.@*CONCLUSION@#There is no significant difference on the hormonal receptor status among pre-menopausal and post-menopausal women diagnosed with invasive ductal carcinoma. Thus, the need for hormone receptor status determination in these patients should be emphasized to aid in proper diagnosis, prognostication, and treatment planning.

Spermatogenesis of combined HCG and HMG in patients with idiopathic hypogonadotropic hypogonadism and congenital combined pituitary hormone deficiency / 中华内分泌代谢杂志

Objective:To compare the spermatogenes response of human chorionic gonadotropin(HCG)combined with human menopausal gonadotropin(HMG)in patients with idiopathic hypogonadotropic hypogonadism(IHH)and congenital combined pituitary hormone deficiency(CCPHD), and to explore related factors.Methods:Clinical data of 90 IHH patients and 61 CCPHD patients from January, 2014 to November, 2018 were retrospectively analyzed. Spermatogenesis was compared between the two groups receiving combined gonadotropin therapy. The patients were then divided into two subgroups: spermatogenesis subgroup and nonspermatogenesis subgroup. Related factors of spermatogenesis after the combined gonadotropin therapy were investigated.Results:After the combined treatment of HCG/HMG for 3, 6, and 9 months, the patients with CCPHD revealed lower testicular sizes than those with IHH( P=0.004, 0.021 and 0.032, respectively). Compared with IHH patients, CCPHD patients had larger testicular volume increments( P<0.001), higher spermatogenesis rates( P=0.048), and shorter initial time for sperm appearance( P<0.001)after 24-month treatment. Multivariate logistic regression analysis showed that lower total cholesterol(TC)(IHH group: OR=5.508, 95% CI 1.110-27.326, P=0.037; CCPHD group: OR=4.068, 95% CI 1.077-15.371, P=0.039)was an independent risk factor of poorer spermatogenesis in patients with IHH and CCPHD. Conclusions:The patients with CCPHD demonstrate a better response to combined gonadotropin treatment than those with IHH. Lower TC is an independent risk factor for poor spermatogenesis of combined HCG/HMG therapy in patients with IHH or CCPHD.

Aerobic and Resistance Exercises Modulate Fibroblast Growth Factor-21 Level in Menopause Women with Type II Diabetes

ABSTRACT Objectives: To determine the relationship between exercises with the serum fibroblast growth factor 21 (FGF21) levels and glucose and lipid profile in menopausal type II diabetic women. Methods: Menopausal women with type II diabetes mellitus were divided into three groups including control (n = 14), aerobic exercise (n = 14) and resistance exercise groups (n = 14). The mean levels of serum glucose, LDL-C, HDL-C, insulin, TG and cholesterol were measured in all participants after 8 weeks of exercise. Serum FGF21 was also measured by ELISA method. Results: The mean of FGF21 levels after exercise was increased significantly in the both aerobic (p < 0.001) and resistance exercise (p = 0.001) groups. The mean of glucose, LDL-C, TG and cholesterol was decreased significantly after exercise in the both exercised groups (p < 0.01). A significant decline had been found for insulin levels and also insulin resistance in the both aerobic (p = 0.001) and resistance (p = 0.003) groups. There was a negative and significant correlation between FGF21 levels with total cholesterol contents (p = 0.001). Conclusion: Aerobic and resistance exercises increase the mean value of FGF21 levels and as the result decline the mean levels of glucose and lipids in blood of menopausal women with type II diabetic mellitus.

Research Progress on Animal Models of Menopausal Syndrome： A Review / 中国实验方剂学杂志

In order to explore the pathological mechanism of perimenopausal syndrome and seek prevention and treatment measures， it is necessary to establish animal models that similar to human perimenopausal syndrome， so as to provide reference for drug research， new drug development and clinical application. In this paper， the keywords of "perimenopausal period" "perimenopausal syndrome" "menopause" "menopausal syndrome""menopausal period" "menopausal syndrome" and "animal" were searched in China National Knowledge Infrastructure （CNKI）， Chongqing Weipu， China Biomedical Literature Database （CBM） and Pubmed. In addition， the selection of domestic peripheral menopausal syndrome model animals in recent years and the advantages and disadvantages of corresponding models were summarized. A total of 673 studies were identified， of which 61 were included in the analysis. The most common animal model of perimenopausal syndrome is castration model， while the immunodeficiency model is less used. With the aging of the population and the rapid increase of psychosocial stress， the incidence of perimenopausal syndrome is high. Therefore， it is particularly important to explore the mechanism of perimenopausal syndrome. According to the experimental purpose， experimental period， experimental technology and other factors， the selection of appropriate model animals and modeling methods is the key of the success of the experiment of perimenopausal syndrome.

Prevalence of menopausal symptoms and its association with various factors among women in post menopausal age group: a cross-sectional study

Background: Menopause is an important time in women's life and it is a natural event in the process of aging. The onset of menopause heralds a time of diminished estrogen exposure, which may have both acute and chronic effect on health and quality of life.Methods: It was a cross sectional study, conducted for a period of 3months i.e. June to August 2018 among post menopausal women in 8 selected villages with a sample size of 247.Results: The common post- menopausal symptoms were joint and muscular discomfort, bladder problems, symptoms of dryness of vagina, physical and mental exhaustion. Factors like education, occupation, socio-economic status, marital status, parity, mode of delivery, age at menopause and BMI was related to one or more menopausal symptoms.  Conclusions: Proper and timely intervention among post menopausal women will help to reduce the symptoms and lead a better quality of life.