Objective To analyze the current status of bone mineral density(BMD)in women with early menopause and explore the correlations between BMD with age,body mass index(BMI),total body fat mass,spinal fat mass,femoral fat mass,follicle-stimulating hormone(FSH),estradiol(E2),and testosterone(T).Methods A total of 106 women with early menopause,who first visited the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2023 to May 2025,were recruited after meeting the inclusion and exclusion criteria.The spinal BMD,femoral BMD,total body fat mass,femoral fat mass,and spinal fat mass were measured with dual-energy X-ray absorptiometry(DXA).The age,height,and weight of the patients were recorded,and serum levels of FSH,E2,and T were measured.Spearman correlation analysis was used to explore the correlations between spinal and femoral BMD and age,FSH,E2,T,BMI,total body fat content,femoral fat content,and spinal fat content.The patients were divided into three groups based on BMD:normal bone mass,osteopenia,and osteoporosis.Non-parametric Kruskal-Wallis H test was used to compare BMI,fat content,age,FSH,E2,and T levels among the three groups.Bonferroni-corrected Mann-Whitney U test was used for pairwise comparisons of significant differences.Multiple linear regression analysis was conducted to explore the influencing factors for femoral BMD T-score.Results Among the 106 patients with early menopause,30(28.3%)had normal bone mass,64(60.4%)had osteopenia,and 12(11.3%)had osteoporosis,with an average age of(43.99±0.16)years.Femoral BMD was positively correlated with BMI,total body fat mass,and spinal fat mass(all P<0.05).No significant differences were found in femoral fat mass,age,FSH,and T levels among the different bone mass groups,but,BMI,total body fat mass,spinal fat mass,and E2 were significantly different(P<0.05).BMI,total body fat mass,spinal fat mass and E2 were significantly higher in the normal bone mass group compared to the osteopenia group(P<0.05).The BMI of the normal bone mass group was significantly higher than that of the osteoporosis group(P<0.05).Multiple linear regression analysis showed that FSH were influencing factors for femoral BMD T-scores(P<0.05).Conclusion The osteoporosis is more prevalent in women with early menopause.Femoral BMD is positively correlated with BMI,total body fat mass and spinal fat content.Elevated FSH is a risk factor for reduced femoral BMD T-score.Attention should be paid to the risk of osteoporosis in women with early menopause,and individualized treatment plans should be developed to reduce the prevalence of osteoporosis.

Objective To compare ovulation recovery rate and metabolic indicators between ethinyl-estradiol/drospirenone(EE/DRSP)combined with orlistat and EE/DRSP alone in overweight/obese patients with polycystic ovary syndrome(PCOS).Methods This study was a randomized controlled clinical trial conducted based on the 2004 Rotterdam criteria.From October 2020 to December 2023,180 overweight/obese PCOS patients aged 20-40 were recruited from the Department of Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University.The patients were randomly divided into two groups in a 1∶2 ratio.Among them,60 patients received treatment with EE/DRSP(EE20 μg,DRSP 3 mg),while 120 patients received a combination treatment of EE/DRSP and orlistat(360 mg/d).The height,weight,waist circumference,hip circumference,and blood pressure of the patients were measured before treatment and after 12 weeks of treatment.Laboratory tests included measurements of follicle-stimulating hormone(FSH),luteinizing hormone(LH),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),free androgen index(FAI),alanine transaminase(ALT),aspartate transaminase(AST),gamma-glutamyl transferase(GGT),fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),lipoprotein(a)[Lp(a)],sex hormone-binding globulin(SHBG),total testosterone(T),and free testosterone(FT).After 12 weeks of treatment,the medication was discontinued,and natural ovulation was observed.Results After 12 weeks of treatment,the ovulation rate of the EE/DRSP combined with orlistat group reached 70.8%,while the natural ovulation rate of the EE/DRSP group alone was only 35%,indicating that the ovulation rate was significantly increased after EE/DRSP combined with orlistat treatment.After 12 weeks of treatment,both groups showed a significant decrease in total testosterone,free testosterone,and low-density lipoprotein levels(all P<0.05),and the decrease in BMI,waist circumference,fasting insulin,and HOMA-IR in the EE/DRSP combined with orlistat group was greater than that in the EE/DRSP group alone(P<0.05).After treatment,both groups showed a significant increase in high-density lipoprotein and triglyceride levels(all P<0.05),with no significant changes in total cholesterol and fasting blood glucose(all P>0.05).Conclusion After 12 weeks of treatment,EE/DRSP combined with orlistat can significantly improve the ovulation rate of PCOS patients.It is superior to EE/DRSP alone in reducing androgen levels,body weight,insulin resistance,and low-density lipoprotein levels.

Objective To analyze the current status of bone mineral density(BMD)in women with early menopause and explore the correlations between BMD with age,body mass index(BMI),total body fat mass,spinal fat mass,femoral fat mass,follicle-stimulating hormone(FSH),estradiol(E2),and testosterone(T).Methods A total of 106 women with early menopause,who first visited the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2023 to May 2025,were recruited after meeting the inclusion and exclusion criteria.The spinal BMD,femoral BMD,total body fat mass,femoral fat mass,and spinal fat mass were measured with dual-energy X-ray absorptiometry(DXA).The age,height,and weight of the patients were recorded,and serum levels of FSH,E2,and T were measured.Spearman correlation analysis was used to explore the correlations between spinal and femoral BMD and age,FSH,E2,T,BMI,total body fat content,femoral fat content,and spinal fat content.The patients were divided into three groups based on BMD:normal bone mass,osteopenia,and osteoporosis.Non-parametric Kruskal-Wallis H test was used to compare BMI,fat content,age,FSH,E2,and T levels among the three groups.Bonferroni-corrected Mann-Whitney U test was used for pairwise comparisons of significant differences.Multiple linear regression analysis was conducted to explore the influencing factors for femoral BMD T-score.Results Among the 106 patients with early menopause,30(28.3%)had normal bone mass,64(60.4%)had osteopenia,and 12(11.3%)had osteoporosis,with an average age of(43.99±0.16)years.Femoral BMD was positively correlated with BMI,total body fat mass,and spinal fat mass(all P<0.05).No significant differences were found in femoral fat mass,age,FSH,and T levels among the different bone mass groups,but,BMI,total body fat mass,spinal fat mass,and E2 were significantly different(P<0.05).BMI,total body fat mass,spinal fat mass and E2 were significantly higher in the normal bone mass group compared to the osteopenia group(P<0.05).The BMI of the normal bone mass group was significantly higher than that of the osteoporosis group(P<0.05).Multiple linear regression analysis showed that FSH were influencing factors for femoral BMD T-scores(P<0.05).Conclusion The osteoporosis is more prevalent in women with early menopause.Femoral BMD is positively correlated with BMI,total body fat mass and spinal fat content.Elevated FSH is a risk factor for reduced femoral BMD T-score.Attention should be paid to the risk of osteoporosis in women with early menopause,and individualized treatment plans should be developed to reduce the prevalence of osteoporosis.

Objective To compare ovulation recovery rate and metabolic indicators between ethinyl-estradiol/drospirenone(EE/DRSP)combined with orlistat and EE/DRSP alone in overweight/obese patients with polycystic ovary syndrome(PCOS).Methods This study was a randomized controlled clinical trial conducted based on the 2004 Rotterdam criteria.From October 2020 to December 2023,180 overweight/obese PCOS patients aged 20-40 were recruited from the Department of Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University.The patients were randomly divided into two groups in a 1∶2 ratio.Among them,60 patients received treatment with EE/DRSP(EE20 μg,DRSP 3 mg),while 120 patients received a combination treatment of EE/DRSP and orlistat(360 mg/d).The height,weight,waist circumference,hip circumference,and blood pressure of the patients were measured before treatment and after 12 weeks of treatment.Laboratory tests included measurements of follicle-stimulating hormone(FSH),luteinizing hormone(LH),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),free androgen index(FAI),alanine transaminase(ALT),aspartate transaminase(AST),gamma-glutamyl transferase(GGT),fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),lipoprotein(a)[Lp(a)],sex hormone-binding globulin(SHBG),total testosterone(T),and free testosterone(FT).After 12 weeks of treatment,the medication was discontinued,and natural ovulation was observed.Results After 12 weeks of treatment,the ovulation rate of the EE/DRSP combined with orlistat group reached 70.8%,while the natural ovulation rate of the EE/DRSP group alone was only 35%,indicating that the ovulation rate was significantly increased after EE/DRSP combined with orlistat treatment.After 12 weeks of treatment,both groups showed a significant decrease in total testosterone,free testosterone,and low-density lipoprotein levels(all P<0.05),and the decrease in BMI,waist circumference,fasting insulin,and HOMA-IR in the EE/DRSP combined with orlistat group was greater than that in the EE/DRSP group alone(P<0.05).After treatment,both groups showed a significant increase in high-density lipoprotein and triglyceride levels(all P<0.05),with no significant changes in total cholesterol and fasting blood glucose(all P>0.05).Conclusion After 12 weeks of treatment,EE/DRSP combined with orlistat can significantly improve the ovulation rate of PCOS patients.It is superior to EE/DRSP alone in reducing androgen levels,body weight,insulin resistance,and low-density lipoprotein levels.

Objective:To explore the curative effect of abdominal flap carried with combined perforating vessels in reconstruction of extra large and complicated defect in extremities.Methods:A retrospective analysis was conducted on 16 patients who were admitted to the Department of Hand Surgery, the Affiliated Traditional Chinese Medicine Hospital for treatment of extra large and complex wounds in extremities, from January 2020 to December 2023. There were 6 defects in upper limbs and 10 in lower limbs. Fourteen patients had a combination of fracture and 6 of tendon defects. The defects were large and sized from 30.0 cm×9.0 cm to 35.0 cm×15.0 cm. The defects were reconstructed by large sized abdominal flaps at 32.0 cm×10.0 cm to 36.0 cm×16.0 cm. According to the size of the defect, perforators of different arteries carried by the abdominal flap were combined by anastomosis in a manner of internal and external supercharging in order to boost the blood supply of the flap. The supercharging vessel anastomosis was as follows: one superficial circumflex iliac artery (or superficial inferior epigastric artery) was anastomosed with the contralateral branch of the deep inferior epigastric artery, with the veins were anastomosed with the corresponding veins, and the main trunk of the deep inferior epigastric artery was anastomosed end-to-end or end-to-side with the main branch of the recipient artery. Alternatively, both of the left and right superficial iliac circumflex (or inferior epigastric) arteries were directly anastomosed end-to-side or end-to-end with the main trunk or its branches in the recipient site, and the veins were anastomosed end-to-side or end-to-end with the adjacent veins. The donor site was pulled and relaxed by a pull-rod wound expander and sutured layer by layer. After surgery, routine anti-infection, anti-vasospasm, anticoagulation, enhancement of blood circulation and other symptomatic treatment were given. Postoperative follow-ups were conducted at outpatient clinic and via telephone and WeChat interviews. The colour and the sign of capillary reflux of the flap were closely observed.Results:All patients were included in the postoperative follow-up for 6-26 months, with an average of 13 months. Fifteen flaps survived after surgery. One flap had partial necrosis and the necrosis was found being caused by a thrombosis at the vessel anastomotic site. The necrotic tissue was removed and the defect was reconstructed by a flap transfer. The abdominal donor sites healed by first intention, and the navel was normal in terms of location and shape. There was no muscle hernia, except a minor scar hyperplasia. The flaps healed well, with satisfactory appearance and soft texture, without obvious bloating. The donor site healed well with partial scar formation.Conclusion:When an abdominal flap is used to reconstruct an extremely large and complex defect in extremities, the perforating vessels of different source arteries carried by the flaps can be anastomosed in a manner of combination, hence the flap can be flexibly freed, with satisfactory treatment effects.

Objective:To explore the clinical efficacy of acupuncture combined with hemoperfusion in hemodialysis patients with intractable pruritus.Methods:A retrospective clinical study was conducted. A total of 126 hemodialysis patients with intractable pruritus were enrolled from June 2023 to June 2024 and divided into two groups (63 cases each) based on treatment modalities. The control group received hemoperfusion alone, while the observation group received acupuncture combined with hemoperfusion. Both groups were treated for 3 months. The Modified Pruritus Duo's Score was used to evaluate pruritus severity, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, and the 36-Item Short Form Health Survey (SF-36) for quality of life before and after treatment. Serum β 2-microglobulin (β 2-MG) and parathyroid hormone (PTH) levels were measured using immunoturbidimetry and chemiluminescence, respectively. Clinical efficacy was assessed. Results:The total effective rate was 98.42% (62/63) in the observation group and 78.77% (49/63) in the control group, with a statistically significant difference ( χ2=16.90, P<0.001). Post-treatment scores for pruritus severity, affected areas, frequency, sleep interference, and total pruritus score in the observation group were significantly lower than those in the control group ( t values were 16.94, 12.23, 12.67, 12.71, 23.91, respectively, P<0.001). The observation group also exhibited lower post-treatment serum β 2-MG [(13.24±3.11) mg/L vs. (17.61±4.58) mg/L, t=10.46] and PTH [(198.11±96.12) ng/L vs. (249.27±88.45) ng/L, t=6.72] levels were lower than those in the control group ( P<0.001). Additionally, the observation group demonstrated significantly lower scores in subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, daytime dysfunction, and total PSQI score ( t values were 14.97, 6.98, 2.06, 23.63, 2.68, 3.56, 14.89, respectively, P<0.001), as well as higher scores in physical health, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health domains of SF-36 ( t values were -3.13, -4.35, -6.34, -7.90, -4.49, -5.30, -5.00, -3.95, respectively, P<0.05). Conclusion:Acupuncture combined with hemoperfusion effectively alleviates pruritus, reduces serum β 2-MG and PTH levels, improves sleep quality, and enhances overall quality of life in hemodialysis patients with intractable pruritus, demonstrating superior efficacy compared to hemoperfusion alone.

Objective:To explore the curative effect of abdominal flap carried with combined perforating vessels in reconstruction of extra large and complicated defect in extremities.Methods:A retrospective analysis was conducted on 16 patients who were admitted to the Department of Hand Surgery, the Affiliated Traditional Chinese Medicine Hospital for treatment of extra large and complex wounds in extremities, from January 2020 to December 2023. There were 6 defects in upper limbs and 10 in lower limbs. Fourteen patients had a combination of fracture and 6 of tendon defects. The defects were large and sized from 30.0 cm×9.0 cm to 35.0 cm×15.0 cm. The defects were reconstructed by large sized abdominal flaps at 32.0 cm×10.0 cm to 36.0 cm×16.0 cm. According to the size of the defect, perforators of different arteries carried by the abdominal flap were combined by anastomosis in a manner of internal and external supercharging in order to boost the blood supply of the flap. The supercharging vessel anastomosis was as follows: one superficial circumflex iliac artery (or superficial inferior epigastric artery) was anastomosed with the contralateral branch of the deep inferior epigastric artery, with the veins were anastomosed with the corresponding veins, and the main trunk of the deep inferior epigastric artery was anastomosed end-to-end or end-to-side with the main branch of the recipient artery. Alternatively, both of the left and right superficial iliac circumflex (or inferior epigastric) arteries were directly anastomosed end-to-side or end-to-end with the main trunk or its branches in the recipient site, and the veins were anastomosed end-to-side or end-to-end with the adjacent veins. The donor site was pulled and relaxed by a pull-rod wound expander and sutured layer by layer. After surgery, routine anti-infection, anti-vasospasm, anticoagulation, enhancement of blood circulation and other symptomatic treatment were given. Postoperative follow-ups were conducted at outpatient clinic and via telephone and WeChat interviews. The colour and the sign of capillary reflux of the flap were closely observed.Results:All patients were included in the postoperative follow-up for 6-26 months, with an average of 13 months. Fifteen flaps survived after surgery. One flap had partial necrosis and the necrosis was found being caused by a thrombosis at the vessel anastomotic site. The necrotic tissue was removed and the defect was reconstructed by a flap transfer. The abdominal donor sites healed by first intention, and the navel was normal in terms of location and shape. There was no muscle hernia, except a minor scar hyperplasia. The flaps healed well, with satisfactory appearance and soft texture, without obvious bloating. The donor site healed well with partial scar formation.Conclusion:When an abdominal flap is used to reconstruct an extremely large and complex defect in extremities, the perforating vessels of different source arteries carried by the flaps can be anastomosed in a manner of combination, hence the flap can be flexibly freed, with satisfactory treatment effects.

Objective:To investigate the results of coryoint flap harvested from lower abdominal wall for covering extremely soft tissue circular defects on limbs.Methods:From March 2018 to June 2020, 15 patients who suffered from severe degloved injury were admitted into the Department of Hand Surgery, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University. The injuries were characterised as extreme circular defects on limbs. The dimension of defects ranged from 25.0 cm×9.0 cm to 30.0 cm×18.0 cm. All wounds were taken through emergency debridement and managed by VSD. Using lower abdomen as a donor site, a conjoined flap was dissected when the wound surface became granulating. The perforator vessels of the flaps included vessels of deep inferior epigastric artery(DIEA), superficial inferior epigastric artery(SIEA) and superficial circumflex iliac artery(SCIA). The donor sites were primary closed. Postoperative follow-ups were conducted by the surgeons in the same surgical team at outpatient clinic.Results:Fourteen flaps survived completely without significant complications. Distal necrosis occurred in 1 flap, which healed with a skin graft in the second stage surgery. All flaps were reviewed during the postoperative follow-up that lasted for 18-24(mean 20) months. The aesthetic outcomes were achieved on the recipient site without hairy nor hyper-pigmentation. A concealed linea scare left at the donor sites without hernia and limited function. At the last follow-up, 5 patients were in excellent and 2 in good evaluated by following the Disabilities of the arm, shoulder and hand(DASH). With the Lower extremity functional scale(LEFS), 5 patients were in excellent and 3 in good.Conclusion:The simultaneous reconstruction of extremely large soft tissue circular defects on limbs with best possible salvage surgery can be achieved by a conjoined flap. A conjoined flap offers a concealed donor site, easy to design, flexible perforators design and larger size of soft tissue.

Objective:To investigate the curative effects of bi-pedicled deep inferior epigastric perforator (DIEP) flap in repairing large soft tissue defects in the lower limbs.Methods:A retrospective observational study was conducted. From February 2016 to June 2020, 16 patients with large soft tissue defects in the lower limbs caused by trauma or after tumor/scar resection were admitted to the Department of Hand Surgery of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, including 9 males and 7 females, aged 25-58 years, with the area of soft tissue defects ranging from 14.0 cm×8.0 cm to 32.0 cm×18.0 cm. Using the abdomen as the donor site, the conjoined abdominal wall flap, i.e., the bi-pedicled DIEP flap (with an area ranging from 15.0 cm×9.0 cm to 32.0 cm×20.0 cm) carrying two sets of the trunk of the deep inferior epigastric artery was designed and resected to repair the wound. The donor site wound was sutured directly. The flap survival and wound healing in the donor and recipient areas were observed after operation. The curative effect was evaluated during the follow-up. At the last follow-up, the American Knee Society score and lower extremity functional scale were used to assess the functions of knee joint and lower limb, respectively.Results:The flaps of 15 patients survived after operation; the flap of one patient had partial infection at the edge after operation but healed after debridement and dressing change. The wounds in the donor and recipient areas of 16 patients all healed well. Follow-up of 16-28 months showed that the recipient area had a good shape and pliable texture, and there was no obvious swollen appearance, hyperpigmentation, or abnormal hair growth; the donor site had linear scar only, with no complications such as abdominal hernia or hyperplastic scar; the functions of knee joint and lower limb were well reconstructed, with no recurrence of tumor. At the last follow-up, among the 4 patients with knee joint injury, 3 cases were excellent and 1 case was good in the evaluation of knee joint function; among the 12 patients with lower limb injury, 9 cases were excellent and 3 cases were good in the evaluation of lower limb function.Conclusions:The donor site of bi-pedicled DIEP flap is concealed with abundant tissue and large area for resection, with which can be used to repair large soft tissue defects in the lower limbs, achieving good short-term results of appearance and function restoration.

Objective:To investigate the efficacy and safety of distal transradial access for cerebral angiography and neurointervention.Methods:The literature about distal transradial access for cerebral angiography and neurointervention were searched in PubMed, EMbase, the Cochrane Library, CNKI, WanFang Data, and VIP database from January 2015 to September 2021. Two reviewers independently screened the literature and extracted data according to the inclusion and exclusion criteria, evaluated the literature quality according to the Newcastle-Ottawa scale. The R 4.0.5 software was used for meta-analysis.Results:A total of 12 articles with 987 patients were enrolled. All the studies were retrospective design and did not compare with the results of proximal transradial access and transfemoral access. A meta-analysis of the operation success rate and complication rate using a fixed effect model showed that the operation success rate of distal transradial access was 96% (95% confidence interval 95%-97%), and the incidence of minor complications was 3% (95% confidence interval 2%-4%). One patient had serious complications.Conclusion:The distal transradial access is a safe and effective alternative approach for cerebral angiography and neurointervention.