Yield of capsule endoscopy in obscure gastrointestinal bleeding:A comparative study between premenopausal and menopausal women

AIM To evaluate differences in capsule endoscopy(CE) performed in the setting of obscure gastrointestinal bleeding(OGIB) among premenopausal women(PMW) and menopausal women(MW).METHODS Retrospective, single-center study, including female patients submitted to CE in the setting of OGIB between May 2011 and December 2016. Patients were divided into 2 groups according to age, considering fertile age as ≤ 55 years and postmenopausal age as > 55 years. The diagnostic yield(DY), the rebleeding rate and the time to rebleed were evaluated and compared between groups. Rebleeding was defined as a drop of Hb > 2 g/dL or need for transfusional support or presence of melena/hematochezia.RESULTS A hundred and eighty three female patients underwent CE for OGIB, of whom 30.6%(n = 56) were PMW and 69.4%(n = 127) were MW. The DY was 30.4% in PMW and 63.8% in MW. The most common findings were angiodysplasias in both groups(PMW: 21.4%, MW: 44.9%)(P = 0.003). In PMW, only 1.8% required therapeutic endoscopy. In 17.3% of MW, CE findingsled to additional endoscopic treatment. Rebleeding at 1, 3 and 5 years in PMW was 3.6%, 10.2%, 10.2% and 22.0%, 32.3% and 34.2% in MW. Postmenopausal status was significantly associated with higher DY(P < 0.001), TY(P = 0.003), rebleeding(P = 0.031) and lower time to rebleed(P = 0.001).CONCLUSION PMW with suspected OGIB are less likely to have significant findings in CE. In MW DY, need for endoscopic treatment and rebleeding were significantly higher while time to rebleed was lower.

Effect of"Natural Polypill",Xuezhikang on Serum Cholesterol Metabolism Markers in Early Menopausal Women with Hypercholesterolemia

Objective:To analyze the effect of Xuezhikang on the markers of the serum lipid levels of cholesterol synthesis and absorption in early menopausal women with hypercholesterolemia,and preliminarily explore its lipid-lowering mechanism.Methods:A total of 90 early menopausal women with hypercholesterolemia were enrolled from December,2014 to May,2016 from Beijing Anzhen Hospital,Capital Medical University,who were randomly allocated to receive Xuezhikang(1200 mg/d,orally)or atorvastatin(10 mg/d,orally)according to a random number table.Serum levels of some related biomarkers,including cholesterol synthesis markers(squalene,dihydrocholesterol,dehydrocholesterol,and lathosterol),and absorption markers(campesterol,stigmasterol,and sitosterol)as well as safety indices were obtained at baseline and after 8 weeks of the intervention.Results:Eight weeks after treatment,both Xuezhikang and atorvastatin significantly reduced the levels of total cholesterol,triglycerides,low density cholesterol compared to baseline(all P<0.01).Xuezhikang significantly reduced the levels of squalene,dehydrocholesterol and lathosterol compared to baseline(all P<0.01),but atorvastatin only significantly reduced the level of squalene(P<0.01),compared to baseline.All cholesterol absorption markers showed no significant differences before and after treatment(P>0.05),however,a more obvious downward trend was shown in the Xuezhikang group.In addition,all the safety indices showed no significant differences between the two groups.Although the creatinekinase level in the Xuezhikang group was significantly higher,it remained within the safe range.Conclusions:Xuezhikang may have more comprehensive effects on the markers of cholesterol synthesis and metabolism in early menopausal women with hypercholesterolemia through ergosterol and flavonoids in its"natural polypill."

Women at the Change of Life——Comparisons of Menopausal Symptoms of Women in Urban and Rural Areas

IT is very important to talk about women’s life quality when they approach the age of menopause. The results of a research investigation on the "Mental and Health Condition of Rural/Urban Women at Menopause" and the "Common Mental and Health Problems of Women at Menopause and its Treatment in Nanjing," reveal that the incidence

Acupuncture for Hot Flashes:A Literature Review of Randomized Controlled Trials Conducted in the Last 10 Years

Objective:To conduct a literature review of randomized controlled trials(RCTs)on the use of acupuncture for hot flashes to analyze the characteristics of each study,draw a conclusion on the advantages and disadvantages of previous studies and provide the suggestions for future studies on the same topic.Methods:We searched English and Chinese databases for the literature published from 2009 to 2019 restricted in the English and Chinese language,and we included RCT using acupuncture as the main observational intervention for hot flashes by the criteria.Results:Twenty studies met our eligibility criteria.All the studies were of high quality and confirmed the clinical efficacy of acupuncture for hot flashes,although they used different controlled interventions.The acupuncture treatment and theory of acupoints selection were relatively consistent among the studies,and they had close trial designs.Conclusions:These RCTs on acupuncture were nonuniform,which made the studies on this topic lack coherence,leading to unsatisfactory research outcomes.Therefore,more professional research teams are needed to perform studies on a definite topic and draw a specific conclusion to previous studies before the next step is taken.