Objective To investigate the occurrence and influencing factors of perimenopausal syndrome (MPS) and natural menopause women age 40-60 years in Guiyang city, with the purpose of providing information for planning care for menopausal women. Methods A convenient sampling was conducted among 40-60 years old healthy women visiting the three Medical Examination Centers of affiliated hospital of Guizhou Medical University, 1594 subjects were interviewed using a self-designed questionnaire. Improved Kupperman Scale was used to evaluate the MPS. Results The percentage of MPS in the 40-60 years old women is 61.60%, of them, the proportion of mild, moderate and severe cases were 38.96%, 21.52% and 1.13% respectively. Mild and moderate account for the most cases. The top 5 symptoms of MPS were:mood agitation (60.85%), wakefulness (58.22%), muscle or joint ache (57.40%) , fatigue (57.09%) and dizziness (48.68%). The incidence of MPS was related to the following factors: age, marital status, degree of education, family monthly income, current menstrual conditions, age of first sexual life and the frequency of pregnancies and deliveries. The occurrence of MPS were associated with age, educational status,family income,current menstruation condition, age of first sexual intercourse and number of pregnancies. As age increases, the severity of MPS arise. With menstrual changes from normal to irregular and menopause, the rate and severity of MPS increased. With the frequency of pregnancies increases, the possibility of moderate and severe degree of PMS increase. The natural menopause age of healthy women in Guiyang was 49.17 ± 3.12. Conclusion The occurrence of perimenopausal syndrome was related to age,current menstruation condition and frequency of pregnancies. Care for perimenopausal period should start as early as possible.

A summary of the reform for public hospitals'internal operating mechanism in 17 pilot cities identified its four main patterns,the internal decision-making machanism,human resource management mechanism,compensation allocation system,and business mechanism.It also analyzed the initial outcomes and problems encountered in the reform.On this basis,the authors proposed the direction for the reform pattern in designing the internal operating mechanism for reference of a wholescale reform of public hospitals in China.

In the context of ongoing health reform,it is important to establish and improve the regulation system of public hospitals.By defining the concept of regulation,regulation theories for public hospitals,the regulation systems of the typical countries,the paper summarizes the international experience enlightenment to China's public hospital regulation reform.

Objective To study the awareness of perimenopausal hormone replacement therapy (HRT) among a part of the medical care personnel in Guiyang . Methods A survey was conducted among 500 medical staff members in 4 hospitals of Guiyang by cluster random sampling using questionnaire about HRT. Results The survey showed that 74.6% (373/500) medical staff thought that the hormone replacement therapy was necessary to perimenopausal women; 96.7% (87/90) of obstetrics and gynecology doctors believed that it was necessary for perimenopausal women to use HRT,which was significantly higher than the doctors of other specialties 68.6% (166/242) and the nurses group 71.4% (120/168) (χ2=28.509, 23.537, P<0.01). Only 5.8%(29/500) of the medical personnel were willing to recommend HRT. In light of the attitude for recommending HRT, the obstetricians and gynecologists group was more significantly higher than the other specialties doctors group (χ2=86.781, P<0.01). Conclusion The knowledge of hormone replacement therapy in part of Guiyang medical personnel is not sufficient;the recommending rate of HRT was low;the side effects of HRT was still a concern. There are differences between obstetrics and gynecology doctors and doctors other specialties and nurses in HRT knowledge.

Objective To investigate the assessment and influencing factors of the cerebrovascular function in 40-60 years old women in Guiyang city,and to provide information for the prevention of stroke in menopausal women.Methods Self-designed questionnaire was used among randomly selected healthy women aged 40-60 years who received health checkup from April 2016 to April 2017 in the Medical Examination Center of Affiliated Hospital of Guizhou Medical University.Levels of height,weight,blood pressure,blood lipid,blood glucose,blood uric acid and the cerebral hemodynamics were checked,comparing the influence of different factors for cerebrovascular function integral value differences,and assess the risk of stroke.Results A total of 439 cases were included in the study,the number of cases with abnormal cerebro vascular function (the score of cerebro vascular function score ＜75) accounted for 13.2％ (58/439).Increased age,being ethnic minorities,menopause,obesity,high blood pressure,high blood sugar,high blood uric acid,increased high-density lipoprotein cholesterol (HDL-C),total cholesterol and triglycerides were related to the abnormal scores of brain function,and the difference was statistically significant (P＜0.05).Logistic regression analysis indicated that minority,High HDL-C [OR(95％CI):0.38 (0.25-0.58),P=0.036],obesity [OR(95％CI):11.62 (5.17-26.14),P=0.001] and hypertension [OR(95％CI):14.87(2.46-89.75),P=0.001] are the factors influencing the cerebro vascular function.Conclusion The proportion of abnormal cerebrovascular function was 13.2％.Increased HDL-C is the protective factor for perimenopausal cerebro vascular function.Minority,obesity and high blood pressure are risk factors for cerebro vascular function,of which,the association between hypertension and cerebro vascular function worsens with elevated blood pressure.

Objective To explore the relationship between blood lipid levels and cerebrovascular hemodynamic indices (CVHI) in a young and middle?aged population, and to identify reference values for early warning of stroke. Method Between June 2015 and June 2016, a total of 6 252 young and middle?aged patients were assessed for cerebrovascular function in The Health Management Center of Affiliated Hospital of Guizhou Medical University. Patients were divided into abnormal and normal blood lipid groups. Differences in CVHI indicators and scores between the groups were determined, and factors influencing CVHI indices were compared using multivariate logistic regression analysis. Results Mean (Vmean), maximum (Vmax), and minimum blood flow velocity (Vmin) and cumulative scores for CVHI indices in the abnormal blood lipid group were significantly lower than in the normal blood lipid group (P<0.001). However, pulse wave velocity, characteristic impedance, peripheral vascular resistance, dynamic resistance, critical pressure, and differences between diastolic blood pressure and critical pressure were greater than those in the normal blood lipid group (P<0.001). Multivariate logistic regression analysis indicated that a high triglyceride level, overweight or obesity, high systolic blood pressure, high diastolic blood pressure, and age were risk factors for low CVHI scores, with odds ratios (95% confidence intervals) of 1.455 (1.195- 1.771), 2.271 (1.782-2.895), 5.967 (4.557-7.815), 4.251 (3.349-5.396), 2.560 (1.993-3.287), and 1.448 (1.189-1.763). Conclusion Abnormal blood lipid levels can lead to abnormal cerebrovascular function in young and middle?aged population; elevated triglyceride level was an independent risk factor for impaired cerebrovascular function.

Caliciviridae Infections ; prevention & control ; therapy ; Disease Outbreaks ; prevention & control ; Humans ; Norovirus ; Practice Guidelines as Topic

Objective: This study aimed to analyze the influencing factors of cerebral hemodynamics index (CVHI) and provide evidence on early warning of stroke in ethnic minorities (Tujia, Buyi, Dong, Miao). Methods: From April 2017 to April 2019, ethnic minorities were examined in the Health Management Center of the Affiliated Hospital of Guizhou Medical University to determine the nationality, age, sex, medical history (such as hypertension, hyperlipidemia, and diabetes) and menstruation in women; measure physiological indexes, such as height and weight, and biochemical indexes, such as blood glucose, blood lipid, and serum uric acid levels; and conduct CVHI and bilateral arm ankle pulse wave conduction velocity (baPWV) detection. The CVHI integral was calculated and divided into normal CVHI group (≥75 points) and abnormal CVHI group (<75 points) to describe the characteristics of population distribution and analyze the related influencing factors of CVHI. Results: A total of 1 236 individuals belonging to ethnic minorities [age, 52.0±9.0 years; 575 men (46.52%) and 661 women (53.48%)]were included in the study. In ethnic minorities, 35.11% had abnormal CVHI. There was no significant difference in abnormal CVHI among ethnic groups, from highest to lowest, in Buyi nationality (38.22%), Miao nationality (37.93%), Dong nationality (32.70%), and Tujia nationality (32.36%). Minority women, menopausal patients, and patients with history of hypertension, diabetes, and hyperlipidemia more frequently had abnormal CVHI than men and non-menopausal and normal women (43.57%, 47.48%, and 57.66%, 76.19%, and 54.00% vs. 25.39%, 39.51%, and 32.30% 35.31%, and 34.74%, P<0.05). The mean BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), and FPG and TG levels, baPWV in the abnormal CVHI group were higher than those in the normal CVHI group, and height was lower the abnormal CVHI group than that in the normal group (P<0.05). The correlation analysis showed that height (r=0.309) was positively correlated with CVHI integral and SBP (r=-0.239), DBP (r=-0.189), and baPWV (r=-0.184) were negatively correlated with CVHI integral (P<0.001). The higher the height, the higher the CVHI and the lower the risk of stroke, and the higher the SBP, DBP, and baPWV, the lower the CVHI score and the higher the risk of stroke. The factor logistic regression analysis showed that old age (OR, 1.992; 95%CI, 1.405-2.825); female sex (OR, 2.240; 95%CI, 1.750-2.866); history of hypertension (OR, 3.363; 95%CI, 1.665-6.791), menopause (OR, 1.384; 95%CI, 1.016-1.885), and high SBP (OR, 1.031; 95%CI, 1.019-1.044), BMI (OR, 1.091; 95%CI, 1.048-1.135), FPG level (OR, 1.169; 95%CI, 1.017-1.344), and baPWV (OR, 1.002; 95%CI, 1.001-1.002) were risk factors for abnormal CVHI, and increased height (OR, 0.936; 95%CI 0.920-0.952) was the protective factor. Conclusion Individuals in ethnic minorities frequently have abnormal CVHI. The main risk factors of CVHI are the elderly, female, history of hypertension, menopause, systolic blood pressure, body mass index, fasting blood glucose and baPWV. It is necessary to strengthen the health management of ethnic minority gathering places, controling body weight, regularly monitoring of blood pressure and blood glucose and lipid levels, and examing cerebral vascular hemodynamics.

Objective:To explore the application value of two-dimensional speckle tracking echocardiography (2D-STE) in measuring the global longitudinal peak strain of the right atrium (PRAGLS) in normal fetuses and evaluating PRAGLS in assessing right atrial function in fetuses with moderate and severe tricuspid regurgitation (TR).Methods:A total of 25 fetuses diagnosed with moderate and severe TR, who underwent fetal echocardiography at Run Run Shaw Hospital, Zhejiang University College of Medicine between October 2020 and May 2022, were selected as the case group. Their gestational age ranged from 25.00(24.00, 30.00)weeks. Additionally, 100 normal singleton fetuses were chosen as the control group, with a gestational age of 25.83(23.00, 28.75)weeks. Standard basal or apical four-chamber clips were acquired and inputted into TOMTEC-ARENA offline cardiac analysis software for analysis. The fetal PRAGLS values of the two groups were obtained, as well as the routine obstetric ultrasound measurements and fetal echocardiographic parameters of both groups: fetal heart rate (FHR), biparietal diameter (BPD), femur length (FL), aortic annulus inner diameter (AO), pulmonary annulus inner diameter (PA), PA/AO ratio, right atrial end-systolic length (RAESL), right atrial end-systolic diameter (RAESD), right atrial end-systolic area (RAESA), right ventricular end-diastolic diameter (RVEDD), and tricuspid annular plane systolic excursion (TAPSE). The peak TR velocity and pressure gradient were simultaneously measured in the case group.The differences in fetal PRAGLS and other parameters between the two groups were compared and analyzed. The correlation between fetal PRAGLS and gestational age (GA) and routine measurements was assessed for both groups. Intra- and inter-observer repeatability tests were conducted using the intragroup correlation coefficient (ICC).Results:A significant difference in PRAGLS was observed between the two groups ( t=11.55, P<0.01). The TAPSE difference between the two groups was also statistically significant ( Z=3.45, P=0.01). Notable differences were found in AO, PA, PA/AO, RAESL, RAESD, and RAESA between the two groups (all P<0.05), but no significant differences were identified in age, GA, FHR, BPD, FL, and RVEDD between the two groups (all P>0.05). PRAGLS in the control group exhibited a moderate negative correlation with GA ( r=-0.47, P<0.01) and were correlated with BPD, FL, AO, PA, RAESL, RAESD, RAESA, and RVEDD ( r=-0.50, -0.46, -0.39, -0.43, -0.45, -0.36, -0.43, -0.32, all P<0.05). No significant correlation was observed with maternal age, FHR, PA/AO, and TAPSE (all P>0.05). No significant correlation between PRAGLS and GA or other conventional parameters was found in the case group (all P>0.05). The inter-measurer and intra-measurer ICC of PRAGLS in the control group were 0.87 and 0.79, respectively, while the inter-measurer and intra-measurer ICC of PRAGLS in the case group were 0.94 and 0.97, respectively, demonstrating good consistency. Conclusions:2D-STE exhibits strong feasibility and reproducibility in assessing fetal atrial function.Fetuses with moderate and severe TR display decreased PRAGLS, suggesting impaired right atrial reservoir function. Right atrial strain introduces a novel method for evaluating fetal cardiac function.

Objective:To investigate the relationship between abdominal visceral adipose tissue (VAT) and cardiometabolic risk (CMR) through quantitative computed tomography (QCT).Methods:The present study included 76226 participants. Abdominal fat areas were measured using the QCT Pro Model 4 system. Cardiometabolic indices were collected, including systolic and diastolic blood pressures, fasting plasma glucose, total cholesterol, triglyceride, and low-density and high-density lipoprotein cholesterols CMR score was the sum of abnormal blood pressure, fasting glucose, triglyceride, and high-density lipoprotein cholesterol. Restricted cubic spline and ordered logistic regression models were applied.Results:The mean age was 50±13 years and the percentage of men was 58.8%. The level of VAT area was higher in men than in women (191.7±77.1 cm 2 vs 116.4±56.2 cm 2, P<0.0001 for all). After adjustment for age, the cardiometabolic indices except high-density lipoprotein cholesterol increased with increasing VAT area. When VAT area was 300 cm 2, age-adjusted odds ratios and 95% confidence intervals of a CMR score ≥ 1 were 14.61 (13.31, 16.04) for men and 5.46 (4.06, 7.36) for women, and the age-adjusted probability of a CMR score ≥ 3 was 31.7% for men and 31.3% for women. Conclusions:QCT-derived VAT is closely related to CMR. The findings suggest that measurement of visceral fat is recommended for the management of abdominal obesity in subjects who agree to undergo lung cancer screening via low-dose CT without additional radiation exposure.