Résumé
Objective To investigate natural spontaneous menopausal age , menstruation span and their relationship with menarche age and parity in Pudong district of Shanghai. Methods From Jan 2007 to Jul 2008, 15 083 spontaneous menopause women undergoing cervical cancer screening were enrolled in this study. The questionnaire included menarche age, parity, spontaneous menopausal age and menstruation span. Those women were divided into four groups based on age, which were group of 56 -60, 61 -65, 66 -70 and more than 70. Analysis of variance (ANOVA) was used for comparing difference between menopausal age and menstruation span. Multiple factor regressions was used to analyze the relationship between menarche age, parity and menopausal age and menstruation span. Results (1) Spontaneous menopausal age: the minimum was 29 years old, the maximum was 61 years old, and the mean age was (50.6 ±3.7)years old. The mean spontaneous menopause age were (50.9 ± 3.4), ( 50.7 ± 3.7 ), (50.0 ± 4.1 ), (49.6 ±4.0) years in groups of 56 -60, 61 -65, 66 -70 and more than 70 years. With the increasing age range in four groups, the increasing trends of menopausal age were observed, which the difference of 1.36 year was shown between groups of 56 - 60 and more than 70 years. (2) Menstruation span: the mean of menstruation span was (34.3 ± 4.1 ) years, which the minimal age of 12 years and maximal age of 48 years were recorded. (34.6 ± 3.8), (34.3 ± 4.1 ), (33.9 ± 4.6), (33.2 ± 4. 5) were observed in groups of 56 - 60,61 -65, 66 -70 and more than 70 years. With the increasing age range in four groups, the increasing trends of menstruation span were observed, which the difference of 1.41 year was shown between groups of 56 –60 and more than 70 years. (3)The impact of menarche age on menopausal age and menstruation span: there was no correlation between menarche age and menopausal age ( r = 0.02); however, menstruation span was found to be negatively correlated with the menarche age ( r = - 0.43 ). (4) The impact of parity on menopausal age and menstruation span: the mean menopausal age of women who had 1 -2 deliveries was significantly higher than those had no delivery or more than 3 deliveries ( P < 0.05 ). However, there was no difference in menopausal age between women with 1 and 2 deliveries or between women without delivery and more than 3 deliveries (P > 0.05). Menstruation span of women with 1 delivery was significantly longer that those with more than 1 delivery( P < 0.05 ), similarly, women with 2 deliveries had longer menstruation span than women without delivery or more than 3 deliveries(P < 0.05 ). There were no difference in menstruation span between women with more than 3 deliveries and without delivery ( P >0.05 ). (5) Multifactor regression analysis for menstruation span: menarche age was correlated with menstruation span negatively ( r = - 0.97,P <0.001 ). There was significantly different menstruation span between group of 61 -65, 66 -70 or more than 70 years and group of 56-60 (r= -0. 18, P=0.020; r= -0.78,P <0.001 and r= - 1.23,P<0.001). Menstruation span in women with 1 -2 deliveries was significantly longer than that of women without delivery or more than 3 deliveries. (6)Multifactor logistic analysis of menopausal age: there was no association between menarche age and menopausal age, however, significant differences were found in mean menopausal age between different groups, which show that menopausal age of group 56 - 60 years was significant higher than the other groups, including age-group 61 -65 years ,66 -70 years and over 70 years ( r = - 0.18, P = 0.020; r = - 0.78,P < 0.001; r = - 1.23, P < 0.001 ). Menopausal age in women with 1 - 2 deliveries was significantly higher than those of women without delivery or with more than 3 deliveries,however, no difference between women with 1 and 2 deliveries or between women without deliveries and more than 3 deliveries was observed. Conclusion (1) Menopausal age and menstruation span exhibited increasing trends in Pudong district of Shanghai. (2) Menarche age and parity were the important factors influencing menopausal age and menstruation span. (3) With younger age of menarche, the menstruation span become longer. (4) Deliveries of 1 -2 times can significantly delay the menopause and prolong menstruation span, however, the multiple deliveries ( ≥ 3 times) had no significant impact on menopausal age and menstruation span.
Résumé
Objective To survey age of menarehe in Pudong district in Shanghai. Methods Data in this study were derived from 56 924 women at age of 20 -81 years in screening for cervical cancer between January 2007 and July 2008 in Pudong district. The age of menarche were recorded in a questionnaire. To investigate the trends in age at menarehe in different socioeconomic status, the subjects were divided into 12 groups in 5-year birth cohorts. The mean menarche age in each group was analyzed by analysis of variance(ANOVA). The percentage of menarche age at 10- 12 years and more than 18 years was analyzed by χ2 method. Results (1 ) The minimum age of menarcbe recorded is 10 years old, and the maximum is 28 years old, with average age of menarche at 15.7 years. In all groups, the smallest average age of menarcbe is 14. 6 years in 26 - 30 years old age group, while the biggest average age of menarche age is 16. 5 years in ＞ 75 years old group; The difference showed statistical significance (P ＜ 0. 01 ). (2) The percentages for participants with early menarehe age (10 - 12 years old) or late menarehe age (＞ 18-year-old menarche) were 1.82% (1034/56 924 ) and 5.20 % (2959/56 924 ) respectively. However, the maximum percentage for early menarche was recorded in 31 -35 years old group (4. 45% ,197/4431 ), only 0. 84% (10/1191 ) of participants in ＞75 years old group was classified as early menarebe. Meanwhile, the lowest percentage for late menarehe was 0. 38% (17/4431 ) in 31 - 35 years old group, and the highest percentage was 14. 70% (91/619) in ＞ 75 years old group. The changes in the percentages for early menarche or late menarche are significantly associated with age differences (P ＜ 0. 01 ). Conclusion The study suggested that the average of onset age of menarche in Pudong district has declined over the past decades in an age-based way, accompanied with the increase of the percentage for early menarche and the decrease of percentage for late menarehe.
Résumé
Objective To compare the effects of classic intrafascial supracervical hysterectomy(CISH)and laparoscope-assisted vaginal hysterectomy(LAVH)on structure and function of the pelvic floor in women.Methods From March 2003 to December 2005,totally 35 cases of CISH and 44 cases of LAVH were performed in our hospital.The patients were followed up for 22 to 38 months after the operations.During the period,they received physical examination and life quality questionnaire,by which the degree of pelvic organ prolapse and pelvic floor function were evaluated.Results The incidence of cystocele in CISH group was significantly lower than that in LAVH group [11.4%(4/35)vs 34.1%(15/44),?2=5.481,P=0.019],whereas,no significant difference was found in the incidence of rectocele between the two groups [17.1%(6/35)vs 13.6%(6/44),?2=0.186,P=0.666].Seven(15.9%)patients in the LAVH group developed cervix prolapse,while none of the CISH group had such a situation(P=0.016).Life quality questionnaire showed that 5 patients in CISH group and 16 patients in LAVH group were satisfied with their sexual life [14.3%(5/35)vs 38.1%(16/42),?2=5.456,P=0.019].Conclusion CISH is superior to LAVH in protecting the structure and function of the pelvic floor.
Résumé
Objective To investigate the roles of matrix metalloproteinase-9, -2 (MMP-9, 2), and tissue inhibitors of metalloproteinase-1,2 (TIMP-1, 2) in pathogenesis of the accretio placenta. Methods The women with the placenta accrete were recruited and the placenta (23) and deciduas tissues (9) after labor were obtained, and the placenta (28) and deciduas (11) from women without the placenta accreta were obtained as control to get, too. The expressions of MMP-9, -2, TIMP-1, 2 in the placental and decidual tissues were analyzed by real-time PCR. Results mRNA expression of MMP-9 in the placenta accreta was (3.21?0.76) copies/?g total RNA, significantly higher (P