Meta-analysis of efficacy and safety of terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures / 中国组织工程研究

OBJECTIVE:To compare the efficacy and safety of terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures through a Meta-analysis. METHODS:By searching PubMed,Cochrane Library,EMbase,CNKI,WanFang and VIP databases,18 randomized controlled studies on terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures were included according to inclusion and exclusion criteria.Endnote X9 software was used to manage the literature and Revman 5.3 software was used to perform a Meta-analysis on the extracted data.The incidences of vertebral fracture,non-vertebral fracture and adverse reaction in postmenopausal osteoporosis patients treated with terlipatide and bisphosphate were analyzed. RESULTS:A total of 18 randomized controlled studies were included,of which 10 were of medium and high quality and 8 were of low quality.Meta-analysis results showed that the fracture incidence in the teriparatide group[risk ratio(RR)=0.56,95%confidence interval(CI):0.48-0.66,P＜0.000 01]was lower than that in the bisphosphonate group,and teriparatide was superior to alendronate in preventing fractures in postmenopausal women with osteoporosis(RR=0.50,95%CI:0.35-0.69,P＜0.000 1)and other bisphosphonates(RR=0.58,95%CI:0.49-0.70,P＜0.000 01).During the follow-up over 18 months,teriparatide was superior to bisphosphonates in preventing fractures in postmenopausal women with osteoporosis(RR=0.56,95%CI:0.48-0.69,P＜0.000 01).In addition,we found that teriparatide was superior to bisphosphonates in preventing vertebral fractures(RR=0.48,95%CI:0.37-0.62,P＜0.000 01)and non-vertebral fractures(RR=0.63,95%CI:0.51-0.78,P＜0.000 1)in postmenopausal women with osteoporosis.Teriparatide was superior to bisphosphonates in increasing lumbar bone density[odds ratio=4.16,95%CI:2.96-5.36,P＜0.000 1)and femoral neck bone density(odds ratio=1.02,95%CI:0.04-2.01,P=0.04).There was no significant difference in adverse reactions between teriparatide and bisphosphonates(RR=0.95,95%CI:0.85,1.06,P=0.37). CONCLUSION:Teriparatide is superior to bisphosphonates in preventing vertebral and non-vertebral fractures in postmenopausal women with osteoporosis,but the safety and adverse drug reactions of teriparatide and bisphosphonates are basically similar.Teriparatide is superior to bisphosphonate in preventing fracture and improving lumbar and femoral neck bone density regardless of short-term(＜18 months)or long-term(≥18 months)use.

Evaluation of diagnostic efficacy of artery elasticity and endothelial function indexes for coronary heart disease with blood stasis syndrome in postmenopausal women by Logistic regression combined with ROC curve model / 中国中药杂志

The present study explored the correlation of coronary heart disease(CHD) with blood stasis syndrome in postmenopausal women with artery elasticity and endothelial function indexes and evaluated the diagnostic efficacy of the prediction model via logistic regression and receiver operating characteristic(ROC) curve model. A retrospective comparison was made between 366 postmenopausal CHD patients from August 1, 2020, to September 30, 2021, in the Department of Cardiology of Integrated Traditional Chinese and Western Medicine of China-Japan Friendship Hospital, who were divided into the blood stasis syndrome group(n=196) and the non-blood stasis syndrome group(n=170). General clinical characteristics of the two groups were compared. Multivariate logistic regression analysis was used to probe the correlation of CHD with blood stasis syndrome in postmenopausal women with brachial-ankle pulse wave velocity(baPWV), ankle-brachial index(ABI), and flow-mediated dilatation(FMD), and the ROC curve was drawn to evaluate the diagnostic efficiency of the prediction model. Multivariate logistic regression analysis showed that the correlation coefficients of CHD with blood stasis syndrome in postmenopausal women with baPWV, ABI, and FMD were 1.123, 0.109, and 0.719, respectively(P=0.004, P=0.005, P<0.001),and the regression equation for predicting probability P was P=1/[1+e~(-(3.131+0.116×baPWV-2.217×ABI-0.330×FMD))]. ROC curve analysis suggested that in the context of baPWV≥19.19 m·s~(-1) or ABI≤1.22 or FMD≤9.7%, it was of great significance to predict the diagnosis of CHD with blood stasis syndrome in postmenopausal women. The AUC of baPWV, ABI, FMD, and prediction probability P was 0.763, 0.607, 0.705, and 0.836, respectively. The AUC of prediction probability P was higher than that of each index alone(P<0.001), and the sensitivity and specificity were 0.888 and 0.647, respectively. The results demonstrate that baPWV, ABI, and FMD are independently correlated with CHD with blood stasis syndrome in postmenopausal women, and show certain independent predictive abilities(P<0.05). The combined evaluation of the three possesses the best diagnostic efficiency.

Relationship between exercise and bone strength, body composition, sex hormones in postmenopausal women / 解剖学报

Objective To investigate the effects of exercise on bone strength, body composition, sex hormones and their relationship in postmenopausal women of Han nationality in Lanzhou. Methods From Jan. 2018 to Jun. 2019, 233 cases postmenopausal women of Han nationality in Lanzhou (110 cases in exercise group and 123 cases in non exercise group) were selected by stratified random sampling method, whose bone strength, body composition indexes and sex hormone were measured by ultrasonic bone mineral density meter, body composition analyzer and electrochemiluminescence automatic immune analyzer, respectively. Results There were lower body weight, body mass index and fat tissue composition of postmenopausal women of Lanzhou Han nationality (P<0.05), and there was higher bone strength, estradiol and muscle tissue composition in the exercise group (P< 0.01). The prevalence of osteoporosis and obesity was lower in the exercise group (P< 0.01). Pearson correlation analysis showed that estradiol and muscle tissue composition were positively correlated with the bone strength (P< 0.05), and it was negatively correlated with fat tissue composition in postmenopausal women (P<0.01). Logistic regression analysis showed that limb muscle mass and estradiol were protective factors for bone, and visceral fat content was the risk factor of bone abnormality in postmenopausal non-exercise women. Estrogen was the protective factor of bone in postmenopausal exercise women. Conclusion The bone strength of postmenopausal women is determined by muscle and fat tissue, and the relationship between the both is affected by exercise. Exercise could effectively prevent and control osteoporosis in postmenopausal women of Lanzhou Han nationality by promoting estrogen production, increasing limb muscle and reducing visceral fat mass.

Monsters Egg: The Mystery Behind

Mature cystic teratomas (MCTs) (dermoid cyst) make up almost 20% of all ovarian neoplasms and 88% are unilateral. They constitute the most common ovarian tumor in childhood. However, it is sparsely seen in postmenopausal woman. Malignant transformation is seen in approximately

Masa anexial complicada en mujer postmenopáusica: tumor de Brenner de ovario izquierdo torcido / Dough adnexal complicated in woman postmenopausal: ovarian Tumor Brenner left twisted Case Report And Review

Los tumores anexiales representan una patología ginecológica frecuente e importante. El tumor de Brenner es una neoplasia poco frecuente que constituye 1.5-2.5% del total de neoplasias ováricas. Se presenta una paciente de sexo femenino de 62 años que acude por dolor intenso en flanco izquierdo, indicándose estudios complementarios, entre ellos, ecografía abdominal que informa masa de contenido mixto. Se realiza laparotomía exploradora, se constata tumor de ovario izquierdo, torcido, procediéndose a anexo ooforectomía izquierda. Posteriormente, estudio de biopsia informa diagnóstico de tumor de Brenner. Los tumores anexiales pueden representar un verdadero desafío, y requieren un diagnóstico certero y manejo adecuado. Es fundamental sospechar malignidad. El presente caso manifestó numerosos rasgos de malignidad, resultando fortuitamente ser benigno. Se optó por cirugía de laparotomía exploradora más anexo ooforectomia izquierda, decisión bastante controversial debido a la falta de un diagnóstico anatomopatólogico, pero necesaria por la presentación complicada del cuadro.

The adnexal tumors represent a frequent and important gynecological pathology. The Brenner tumor is a rare neoplasm constituting 1.5-2.5% of all ovarian neoplasms. A 62-year-old female patient is presents intense pain in the left flank, and complementary studies are indicated, including abdominal ultrasound that reports mass of mixed content. Exploratory laparotomy is performed, left ovary tumor is twisted, and left oophorectomy is performed. Subsequently, biopsy study reports diagnosis of Brenner's tumor. Adnexal tumors can be a real challenge, requiring accurate diagnosis and proper management. It is fundamental to suspect malignancy.The present case manifested numerous traits of malignancy, being fortuitously benign.We opted for exploratory laparotomy surgery plus left oophorectomy, a rather controversial decision due to the lack of an anatomopathological diagnosis, but necessary due to the complicated presentation of the picture.

Effect of Hormone Replacement Therapy on Dry Eye Syndrome in Postmenopausal Women: A Prospective Study

PURPOSE: To evaluate the effects of conjugated hormone replacement therapy (HRT) on dry eye syndrome in postmenopausal women. METHODS: Thirty-six healthy postmenopausal women (72 eyes) were included in this three-month prospective study. Schirmer test, tear film break-up time (BUT), fluorescein staining score and symptom score were performed on all patients at the time of enrollment, one month and three months after initiation of HRT. All patients received HRT consisting of conjugated estrogen and progesterone taken orally in a continuous combined regimen. RESULTS: Symptom score significantly decreased from 2.10+/-0.79 before HRT to 1.32+/-0.84 after one month and to 0.88+/-0.67 after three months (p<0.001). In addition, tear film BUT measurements significantly increased from 6.04+/-2.54 seconds to 7.99+/-2.43 seconds after one month and to 8.93+/-2.20 after three months (p<0.001). The fluorescein staining score was 0.94+/-0.71 before HRT and decreased to 0.42+/-0.60 after one month and to 0.22+/-0.42 after three months (p<0.001). CONCLUSIONS: Hormone replacement therapy consisting of conjugated estrogen and progesterone significantly improved the symptoms and signs of dry eye syndrome in postmenopausal women.

Effects of Estrogens and Isoflavones on the Collagen Synthesis / 대한피부과학회지

BACKGROUND: The aging of skin is influenced by genetic, environmental, and hormonal factors. Estrogens are the "missing" player in the skin of postmenopausal women. In postmenopausal women, loss of collagen was related to decreased estrogen level. Phytoestrogens, i.e. isoflavone, are plant compounds with estrogen-like biologic activities. OBJECTIVE: The effects of 18beta-estradiol, and isoflavones on production of type I collagen in the fibroblast of postmenopausal woman, keloid and Detroit cell line were examined. METHODS: Type I collagen was measured with procollagen type I C-peptide EIA KIT. RESULTS: 18beta-estradiol and isoflavone enhanced the production of type I collagen in cultured fibroblast of postmenopausal woman and keloid. But isoflavone inhibited the production of collagen in cultured fibroblast of Detroit cell. CONCLUSION: 18beta-estradiol and isoflavone can prevent and improve the cutaneous alterations caused by loss of collagen of postmenopausal women.

A Case of Lymphocytic Hypophysitis in a Postmenopausal Woman / 대한내분비학회지

A 64-year-old Korean woman presented with a 3-week history of severe headache and ocular pain. Her brain MRI showed a cystic pituitary mass compressing the optic chiasm. A hormonal study revealed anterior pituitary insufficiency and a slightly increased prolactin level. We performed a transsphenoidal resection of the pituitary mass. A pathological examination revealed the presence of a heavy inflammatory infiltrate, composed of lymphocytes and plasma cells, and destruction of the adenohypophysial structures. Five months after surgery, her hormonal levels had nearly normalized, without hormone replacement therapy. A follow-up MRI showed no recurrence. We conclude that lymphocytic hypophysitis should be included in the differential diagnosis of pituitary mass at any age. We discuss the features that can help to make a preoperative differential diagnosis, and selection of the appropriate treatment.