Obesity has become a social problem.Study shows that fat is closely related with chronic diseases.and the effect of body fat on body metabolism varies with its distribution.The discovery of fat as an endocrine organ provides a broad research areas for the relationship between body fat and chronic diseases.The difierense in fat distribution between different sexes suggests that gonadal hormone has obvious effects on body fat metabolism.As a result,hormone replacement therapy has become the optimal method for releasing climacteric symptom.With the development of people's living standards,the attention paid to the menopausal problem,the research on body fat changes and its relationship with chronic diseases,and the study on the effect of hormone replacement therapy on the body fat are of great importance.

OBJECTIVE: To analyze the relationship between female resting energy expenditure and obesity-related indicators, and to compare the differences of resting energy expenditure and resting energy expenditure per kilogrem between obese women and normal weight women.METHODS: A total of 565 healthy women who did medical examination or visited Department of Endocrinology in Beijing Obstetrics and Gynecology Hospital between 2004 and 2008 were recruited, their height and weight were measured. Human metabolic apparatus was used to measure resting energy expenditure, then body surface area, body mass index, resting energy expenditure per kilogram were calculated. According to the diagnostic cdtada of obesity by body mass index, the 565 cases were divided into two groups: obese group (n=179) and normal body weight group (n=240), and all the measurement results were calculated and did the tests of normality, correlation analysis and two independent samples rank sum test or t test. RESULTS: The resting energy expenditure of 565 healthy women were normality, the result was (5.793±0.940) k J/d, and resting energy expenditure showed a positive correlation with body weight, height, body mass index and body surface area (P < 0.05), while showed no significant correlation with age (P > 0.05), there was no significant difference of age end height between obese group and normal body weight group (P > 0.05), while a statistical significant difference was found in resting energy expenditure and resting energy expenditure per kilogram between obese group and normal body weight group (P > 0.05).CONCLUSION: There is a positive correlation that female resting energy expenditure with their height, weight, body mass index and body surface area, and the resting energy expenditure of obese women is higher than that of normal body weight women, while resting energy expenditure per kilogram of obese women is lower than that of normal body weight women.

OBJECTIVE: To learn the prevalence of abnormal components of metabolic syndrome in postmenopausal women, and to explore the optimal body composition indices to predict the abnormal components of metabolic syndrome in postmenopausal women. METHODS: A total of 181 participants were recruited from postmenopausal women who came to Beijing Obstetrics and Gynecology Hospital for health examination between July 2006 and August 2007. They were 41-60 years of age, and there were 1-9 years since menopause. Their clinical and biochemical parameters were measured, including body height, body weight, waist circumference, hip circumference, sagittal abdominal diameter, blood pressure, follicle stimulating hormone, luteinizing hormone, estradiol, triglyceride, high density lipoprotein-cholesterol, fasting,plasma glucose, fasting insulin and body fat. The prevalence of the abnormal components of metabolic syndrome in postmenopausal women was investigated. The correlations between body composition indices and the components of metabolic syndrome were analyzed by partial correlation analysis independent of age, years since postmenopause and the level of estradiol. The body composition indices to predict the abnormal components of metabolic syndrome in postmenopausal women were explored. RESULTS: ①The prevalence of central obesity (waist circumference ≥ 80 cm), hypertriglyceridemia (triglyceride ≥1.7 mmol/L), low high density lipoprotein-cholesterol (high density lipopretein-cholesterol < 1.29 mmol/L), hypertension (systolic pressure ≥ 130 mm Hg or diastolic pressure ≥ 85 mm Hg, 1 mm Hg=0.133 kPa) and high fasting glucose (fasting plasma glucose ≥ 5.6 mmol/L)was 48.1%, 31.5%, 16.6%, 38.7% and 50.3%, respectively. ②Through partial correlation analysis, body composition indices (body mass index, waist circumference, waist-hip ratio, sagittal abdominal diameter, and body fat) had a positive correlation with triglyceride, systolic pressure, diastolic pressure and fasting plasma glucose, while a negative correlation with high density lipoprotein-cholesterol, independent of age, years since postmenopause and the level of estradiol.③Body composition indices and critical value of them used to predict the abnormal components of metabolic syndrome in postmenopausal women were as follows: hypertriglyceridemia: body mass index ≥ 24.845 kg/m~2; low high density lipoprotein-cholesterol: sagittal abdominal diameter ≥ 18.85 cm; hypertension: body mass index ≥ 23.33 kg/m~2; high fasting glucose: sagittal abdominal diameter ≥ 18.10 cm or body fat ≥ 36.515%. CONCLUSION: Central obesity and high fasting glucose are the most common metabolic disorders in postmenopausal women. Obesity is an independent risk factor of metabolic syndrome for postmenopausal women. Body composition indices and their critical values to predict the abnormal components of metabolic syndrome in postmenopausal women are found.

BACKGROUND:Aging, lack of estrogen and few activities may lead to the decrease of resting energy expenditure in menopause women so as to induce the body composition changes, which can result in disease, such as obesity and fracture. OBJECTIVE:To explore the change of body composition and resting metabolic rate among premenopausal, perimenopausal and postmenopausal women. METHODS:2 312 women who came to outpatient clinic were recruited, including 1 310 premenopausal women, 790 perimenopausal women and 212 postmenopausal women. Body composition and resting energy expenditure were measured in each woman. RESULTS AND CONCLUSION:(1) Body fat percentage of perimenopausal and postmenopausal women was significantly higher than that of pre-menopausal women. (2) There was no significant difference in resting metabolic rate among the three groups. When adjusted body weight, the resting energy expenditure per kilogram was significantly lower in perimenopausal women than in premenopausal women. (3) Bone mineral density, femoral neck strength, lower limb maximal strength, and leg muscle distribution coefficient were significantly lower in postmenopausal women than in perimenopausal and premenopausal women (P < 0.05). (4) Weight and leg muscle distribution coefficient were positively correlated with the resting energy expenditure per kilogram, and height, body mass index, body fat percentage were negatively correlated with the resting energy expenditure per kilogram. These findings indicate that the body composition can change in women after menopause, such as body fat increasing, muscle content decreasing, and bone mass loss. There is a certain relationship between the change in body composition and resting energy expenditure.

Objective:To analyze the depression incidence in premenopausal or postmenopausal women, find out the countermeasures to control or eliminate depression. Methods:Randomly divided the menopause group and premenopausal group in 724 patients who were assessed using Zung depression scale and venous blood determination of endocrine hormone FSH, LH, E2. Zung score≥40 points can diagnose depression. Results:The incidence in premenopausal group of climacteric depression was 13.3%, and postmenopausal group was 5.6%. The incidence of climacteric depression premenopausal group was obviously higher than that after menopause (x2=12.797, P<0.05). Conclusion:Menopause depression patients often have some physical or mental factors as incentive, spirit and body disease, etc.;Patients often change in physical and psychological. So the comprehensive care in the biological, psychological and social are necessary.

In this paper,we explored to develop a new concept of computer-and internet-based learning and training method in medicine,especially in obstetrics and gynecology,which is named as Virtual Academy of Women'Health(VA).Especially in the times of infectious disease pandemics worldwide,learning at home rather than in big lectures hall,might be necessary and practical as never before.The VA is based on worldwide knowledge in medicine—free accessible on the internet—in terms of homepages,video and audio platforms,scientific papers,medical books,and different guidelines.A collection of different video-clips in various fields of women's health can assist the student or doctor in understanding the symptoms,diagnostics,and treatment of various diseases.There are two major targets of it—one is online education,and one is testing the knowledge by simulation of clinical cases.

After more than half a century of development,the intrauterine contraception (IUD) has become a relatively mature method of contraception and treatment of gynecological diseases.This paper reviewed the development of IUDs,different types of IUDs,and some problems due to them,such as bleeding,infection,malposition,dis-location,expulsion,etc.And the causes of clinical side effects,complications,and corresponding treatments of IUDs were overviewed as well.

Polycystic ovary syndrome(PCOS)is the most common endocrine and metabolic disease in women of reproduc-tive age.PCOS is characterized by ovulatory disruption,which can lead to infertility.Patients with PCOS are also more likely to have poor pregnancy outcomes.For obese women,lifestyle interventions are recommended first,which have general health benefits.For women who have difficulty changing their lifestyle,drugs for the treatment of obesity or bariatric surgery could be considered.Clomiphene citrate is the first-line medication after weight loss that has been utilized in the past.Letrozole is supplanting clomiphene as the best option for ovulation induction for now,particularly in patients with PCOS.Metformin can improve ovulation and pregnancy rates;however,it has minimal effects in terms of raising live birth rates.Second-line therapies include gonadotropins and laparoscopic ovary drilling.In vitro fertilization can be utilized as a third-line treatment for patients with PCOS who have failed ovulation induction therapy or have other infertility factors.In summary,to achieve fer-tility,patients with PCOS require standardized individualized therapy.

Objective:To investigate the effects of orlistat combined with drospirenone/ethinylestradiol tablets(DRSP/EE)on anthropometric indices,sexual hormones,hepatorenal function parameters of overweight or obese patients with polycystic ovary syndrome(PCOS).Methods:75 overweight or obese PCOS patients[body mass index(BMI)＞24 kg/m2]were recruited within the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical Uni-versity,from April 2019 to January 2020,for a prospective,randomized,open-labelled comparing study.They were numbered one by one according to the order of recruitement and randomly divided into two groups,group 1 included 50 patients,orlistat plus DRSP/EE;group 2 included 25 patients treated with DRSP/EE alone.Both groups got the same comprehensive intervention in terms of individualized,standardized managment and mon-itoring of life-style like diet and exercise.The changes of anthropometric indices,sexual hormones,hepatorenal function parameters before and after three months of treatment in the two groups were compared.Results:After three months of treatment,body weight,waist circumference(WC),hip circumference(HC)and BMI of both groups were significantly decreased(P＜0.05).The decrease of body weight,WC,HC and BMI in group 1 was significantly greater than those in group 2(P＜0.05).Free testosterone and sex hormone-binding globulin in both groups were significantly changed(P＜0.05).There was no significant difference in the hepatorenal function parameters between the two groups after three months treatment(P＞0.05).Conclusion:To our knowledge our study is the first to investigate the effects of orlistat combined with DRSP/EE in overweight or obese PCOS patients comparing with the effect of using DRSP/EE alone.Orlistat combined with DRSP/EE was better than use DRSP/EE alone in getting weight loss,which provides an evidence for the choice of rational drug use in clinical practice.

Objective:To explore the progress and prospect of evaluation methods for infertility patients.Methods:From September 2017 to December 2020,199 cases of infertility patients who have accepted mini-hysteroscopy examination in the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University.The patients who had primary ovary insufficiency,tubal infertility were excluded;patients with hysteroscopy contradiction,such as acute or sub-acute vaginal tract inflammation,en-dometrium lesion or endometrium carcinoma,severe cardiovascular,liver or kidney insufficiency were excluded.40 patients were excluded and 15 patients lost follow up,144 patients were eventually included in the analysis.The patient's age,body mass index,infertility etiology,preoperative and postoperative stimulate ovulation cycle,pregnancy state and pregnancy time were recorded.The effect of mini-hysteroscopy on ovulation induction cycle was analyzed in pregnant patients.Results:The average age of 144 patients was 32.10±4.67 years old.96 (66.67％) patients were found to have intrauterine abnormalities,while 48 (33.33％) patients were found to have normal intrauterine cavity.48 cases of pregnancy,accounting for 33.33％;the median and interquartile ranges[M (Q1,Q3)]of ovulation induction cycles before and after surgery were respectively[3 (0,5)],[2 (1,3)],the difference was statistically significant(P ＜ 0.05).Among the 48 pregnant patients,32 of them had no structural lesions in hysteroscopy,the ovula-tion induction cycle of these patients before and after hysteroscopy were respectively[5 (0,9)],[1 (0,3)],the difference was statistically significant (P ＜ 0.05).Conclusion:Uterine cavity evaluation is important for the assessments of fertility.As an advanced diagnosis instrument,mini-hysteroscopy can not only timely detect the intrauterine abnormalities of patients,but also with great application value in shorten the ovulation cycle in infertility patients and increase the pregnancy rate.