Women In Mainland China Research Articles

Whole-exome sequencing in cervical adenocarcinoma in mainland Chinese patients.

BackgroundCervical cancer is the most common gynecological malignancy worldwide. Adenocarcinoma is an important pathological type of cervical cancer. In recent years, the incidence of adenocarcinoma is rising in some countries and the prognosis of it remains poor. A precise description of the mutational landscape in cervical adenocarcinoma may provide insights into a better selection of treatments and improve prognosis.MethodsIn this study, we conducted whole-exome sequencing (WES) for cervical adenocarcinomas and matched blood samples from a cohort of 24 mainland Chinese patients. Additionally, the Human-Papilloma virus (HPV) infection statuses of these tumor samples were detected, and the genes that were enriched in both HPV positive and negative samples were also analyzed.ResultsThe results of WES revealed the gene expression profile of cervical adenocarcinoma of women in mainland China and identified multiple genes/pathways, which are frequently mutated in these tumors, including the PI3K-AKT (KRAS, PIK3CA and PTEN), estrogen signaling (KRAS, PIK3CA and GNAS) and NK cell-mediated antibody-dependent cellular cytotoxicity pathways. Besides, seven patients had HPV infection, and the mutated genes in HPV-positive tumor tissues were relatively consistent, while the mutation profiles of HPV-negative tumor tissues were relatively scattered.ConclusionsTaken together, these findings provide novel insights into the pathogenesis of cervical adenocarcinomas. They suggest the potential for individualized treatment of cervical adenocarcinoma according to genomic information.

Decision-making, abortion narratives and identity construction towards abortion among rural–urban single migrant women in mainland China: Insights for social work practice and education

Semi-structured interviews were conducted with 33 single internal migrant women who induced abortion in mainland China. Results indicate that their abortion decisions were made through careful and rational consideration due to their vulnerable and marginalised position, which is maintained by China’s household registration system and migrant labour regime. Confucian, neoliberal and religious discourses shape these single women’s perceptions of abortion and affect their abortion narratives. They form different identities, which have a great impact on their utilisation of post-abortion care resources and their perception of abortion stigma. Implications for social work practice and education are subsequently discussed.

Bidirectional Intimate Partner Violence Among Chinese Women: Patterns and Risk Factors.

Bidirectional intimate partner violence (BIPV) refers to the co-occurrence of violence perpetration by both partners. BIPV has been analyzed using samples from different sociodemographic contexts but has yet to be fully explored in China. The present study employed a latent class approach to identify BIPV patterns, rates of prevalence, and associated risk factors among a sample of 1,301 heterosexual adult women in mainland China. Five distinct patterns of BIPV were identified, including (a) bidirectional psychological aggression, (b) bidirectional violence of all types, (c) multi-type victimization with psychological aggression, (d) minimal violence, and (e) bidirectional multi-types without physical violence. Marital status, education, employment status, acceptance of male dominance, and justification of intimate partner violence (IPV) were found to be predictive of different types of BIPV. Our findings suggest a need for a conceptual recognition of the heterogeneity and bidirectionality of IPV among Chinese women. Future research should extend to other diverse populations and sociocultural or clinical contexts in China. IPV assessments, research, and social programs ought to recognize the complexity of IPV and consider various IPV patterns specific to heterosexual women.

Safety of medication use during pregnancy in mainland China: based on a national health insurance database in 2015

BackgroundMedication safety during pregnancy has drawn global attention, little of which has been reported about the Chinese population. This study aims to describe patterns and risks of medication use among pregnant women in mainland China with reference to the U.S. Food and Drug Administration (FDA) pregnancy risk category.MethodsHospital diagnostic and drug dispensing information of a national representative sample of basic medical insurance (BMI) beneficiaries was obtained from the China Health Insurance Association (CHIRA) database in 2015. Prevalence of use and number of medicines involved in each risk category were calculated. Most commonly used medicines from each risk category were illustrated. Factors associated with the use of category D/X medicines were evaluated through multiple logistic regression.ResultsOut of 11,373 women who had singleton deliveries in 2015, there were 2896 women with records covering their entire pregnancies, 5377, and 7946 women with records through the 2nd, and the 3rd trimester, respectively. It was found that 11.1% pregnant women used at least one medication and a total of 321 medications had been used during pregnancy. Most pregnant women used medicines which were classified FDA category C (66.2%), followed by category B (57.8%), category A (16.8%), category X (7.5%) and category D (5.0%). The most commonly used medicines from category D and X were anxiolytics and hormonal preparations respectively. Women who were from mid-western area (p = 0.045) or used four or more medications (p < 0.001) were more likely to use category D/X medicines.ConclusionsThis study revealed that about one in ten pregnant women used at least one medication during pregnancy in China and a significant number of them used FDA Category D or X medicines. The usage patterns identified in the present study indicate that sub-optimal medicine use might exist warranting further evaluation and intervention in future studies. More efforts are needed to uncover the safety concerns about medication use during pregnancy and improve current information system for clinical practice.

Predicting the intervention threshold for initiating osteoporosis treatment among postmenopausal women in China: a cost-effectiveness analysis based on real-world data

SummaryThis study built a micro-simulation Markov model to determine the treatment threshold of osteoporosis in postmenopausal women in Mainland China. Treatment with zoledronate is cost-effective when FRAX-based (Fracture risk assessment tool) fracture probability is over 7%.IntroductionThe purpose of this study is to estimate FRAX-based fracture probabilities in Mainland China using real-world data, at which intervention could be cost-effective.MethodsWe developed a micro-simulation Markov model to capture osteoporosis states and relevant morbidities including hip fracture, vertebral fracture, and wrist fracture. Baseline characteristics including incidences of osteoporosis and distribution of risk factors were derived from the Peking Vertebral Fracture study, the largest prospective cohort study of postmenopausal women in Mainland China. We projected incidences of fractures and deaths by age groups under two treatment scenarios: 1) no treatment, and 2) zoledronate. We also projected total quality-adjusted life-years (QALY) and total costs including fracture management and osteoporosis drugs for cost-effectiveness analysis. Cost-effective intervention thresholds were calculated based on the Chinese FRAX model.ResultsTreatment with zoledronate was cost-effective when the 10-year probability of major osteoporotic fracture based on FRAX was above 7%. The FRAX threshold increased by age from 51 to 65 years old, and decreased in elder age groups, ranging from 4% to 9%.ConclusionsUsing real-world data, our model indicated that widespread use of zoledronate was of both clinical and economic benefit among Chinese postmenopausal women. Using a FRAX-based intervention threshold of 7% with zoledronate should permit cost-effective access to therapy to patients and contribute to reducing the disease burden of osteoporosis in Mainland China.

Incident Fracture Risk in Type 2 Diabetic Postmenopausal Women in Mainland China: Peking Vertebral Fracture Study.

Using data from the Peking Vertebral Fracture Study, we conducted a longitudinal cohort study to investigate the association between type 2 diabetes mellitus (T2DM) and the risk of incident fractures, especially of vertebral fractures (VFs), and we also examined the modifying effect of body mass index (BMI) on this association and the effect of bone mineral density (BMD) T-score as a risk factor for incident fractures in T2DM. Chinese postmenopausal women were enrolled (n = 982), among whom 186 had T2DM. Incident VFs were confirmed by lateral radiographs of the thoracolumbar spine (T4-L5), while incident clinical non-VFs were self-reported. BMDs at the lumbar spine (LS) and femoral neck (FN) were measured by dual-energy X-ray absorptiometry. T2DM and non-DM women were at similar risk for VFs (OR 0.74, 95% CI 0.32-1.74), even adjusting for age, BMI, BMD, and previous fractures. Meanwhile, T2DM women had nearly twice the risk for non-VFs (HR 1.95, 95% CI 1.11-3.35) compared with non-DM women. After stratifying by BMI, the risk of VFs remained similar between diabetics and non-diabetics despite their BMI status (p for interaction = 0.470), and the risk of non-VFs was positively associated with T2DM only in women with BMI ≥ 25kg/m2 (HR 3.59, 95% CI 1.68-7.65) (p for interaction = 0.065). Although LS BMD T-score was similarly and negatively associated with incident VFs both in T2DM (OR 0.34, 95% CI 0.12-0.88) and non-DM women (OR 0.60, 95% CI 0.44-0.82) (p for interaction = 0.430), the FN BMD T-score was not found to be significantly associated with either non-VFs or VFs among T2DM women. Comparing T2DM and non-DM women with similar fracture risks, the mean difference in LS T-score was - 0.36 (95% CI - 1.77 to 1.04) for VF, and difference in FN T-score was 1.61 (95% CI - 0.11 to 3.34) for non-VF. In conclusion, Chinese postmenopausal women with T2DM had a similar risk of incident VFs, but a significantly higher risk of incident non-VF, compared to women without DM. Higher BMI did not modify the effect of T2DM on risk of VFs, but it increased the association between T2DM and risk of non-VFs. LS BMD T-score was similarly and negatively associated with VF risk in T2DM and non-DM women and appear to be useful for clinical evaluation of VF risk.

Factors associated with breast cancer screening participation among women in mainland China: a systematic review

ObjectivesAlthough detecting breast cancer at an early stage through screening has been clearly shown to be an effective strategy, the screening participation rate in China remains low. This systematic review...

The distribution and prevalence of human papillomavirus in women in mainland China.

We conducted a systematic review of the epidemiology of high-risk human papillomavirus (HPV) infections in mainland Chinese women to provide a general profile for the application and subsequent effectiveness evaluation of HPV vaccines. The PubMed, Web of Science, Medline (Ovid), China National Knowledge Infrastructure, and Wanfang databases were used for the literature search. The epidemiological studies published from January 2000 to June 2018 on high-risk HPVs in mainland Chinese women were investigated to systematically evaluate their epidemiological status. A total of 198 eligible studies were included. The results of meta-analysis showed that the overall infection rate of high-risk HPVs in mainland Chinese women was 19.0% (95% confidence interval [CI], 17.1%-20.9%), and the top 5 subtypes with the highest infection rates were 16, 52, 58, 53, and 18. The overall infection rates of cervical intraepithelial neoplasia I (CINI), CINII+, and cervical cancer patients were 59.6% (95% CI, 52.7%-66.4%), 84.8% (95% CI, 81.2%-88.5%), and 89.9% (95% CI, 86.6%-93.1%), respectively. The high-risk HPV infections and common subtypes in women of various ages in various regions were different, and the high-risk HPVs and subtypes in cervical cancer patients in various regions were also different. In conclusion, we systematically analyzed the HPV infections in women who live on the Chinese mainland. The epidemiology of high-risk HPVs in mainland Chinese women is basically consistent with that for the rest of the world. The HPV vaccines currently licensed in China could cover the major prevalent high-risk HPV subtypes in China, providing a basis for the development of a cervical cancer screening strategy and vaccine implementation in China.

Psychosocial Interventions for Perinatal Depression in China: A Systematic Review and Meta-Analysis

Background: The prevalence of perinatal depression is 16.3% in China and has shown a rising trend in the last decade. However, very few studies were found comparing and summarizing psychosocial interventions for perinatal depression. This study aimed at evaluating and characterizing psychosocial interventions for perinatal depression in Mainland China. Methods: In this systematic review and meta-analysis, ten major English and Chinese language electronic bibliographic databases were searched for randomized controlled trials examining the effect of psychosocial interventions for perinatal depressed women in Mainland China. Studies meeting eligibility criteria and published before 25th February 2019 were included, while those focusing on a very specific sub-population or reporting non-psychosocial interventions were excluded. Data was extracted from articles by a standard form. Meta-analysis was conducted to obtain a summary measure of the effectiveness of the interventions in reducing perinatal depressive symptoms. The theoretical underpinnings and implementation processes of the interventions were also characterised. Findings: A total of 6,857 articles were identified in the initial database searching, of which, 26 studies were eligible for data analysis, representing a sample size of 4,673. Meta-analysis indicated that psychosocial interventions in China significantly reduced perinatal depressive symptoms (standard difference in means 0·81, 95% confidence intervals -1·03 to -0·58, P<0·001). However, the overall evidence presented substantial heterogeneity (I 2 =91·12%). Most interventions were implemented in hospitals in urban areas by non-specialist health care providers. Few studies reported details of implementation procedures or scale-up strategies. Interpretation: Current psychosocial interventions in China are somewhat effective in reducing perinatal depressive symptoms. High quality randomized controlled trials on scale-up interventions are required, especially in rural areas. Funding Statement: This study was supported by the Chinese Nursing Association (ZHKY201809). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This review was registered with PROSPERO (CRD42018115934).

Muslim Women in Mainland China and Macau Old Barriers, New Solutions

Using as a springboard the wide spectrum of Chinese racial groups and ethno-linguistic, “foreign”(sub)groups residing in the Celestial Empire, this study concentrates on the last one hundred and six years of Chinese history (1912-2018), thus analyzing howsome Chinese cities and/or regions, including the Macau Special Administrative Region of the People’s Republic of China,have managed to reconcile past with present, thus transforming once-troubled or troublesome issues, as in the case of Muslim presence within China, into a positive and reinvigorating force.Besides the obvious economic drive, there appears to have been a sincere desire to include and integrate this “foreign”element into the daily life of the new Republic of China 中華民國Zhōnghua Minguo, (1912-1949). Thus, particular attention will be given to the role played by Chinese women within these post-1912, “foreign”communities and, as for 澳門Macau, the post-1999 handover to China by the Portuguese on December 20, 1999.Though oftentimes considered as mere “consumers”and not “makers;”hence, allegedly not contributing to the overall “welfare”of the Country, Chinese women of “foreign”ethnicity who also happened to be Muslim, were eventually able to show the New Republicthat the 女工, nǚgōng—work done by women, in and outside the household—should instead be considered “productive”and, better yet, it should be seen as a positive sign within the new vision of Chinese nationalism where social class, race, ethnicity, language/dialect, religion, and gender all contributed to the welfare of the Country, or rather, the then-young Republic of China 中華民國,Zhōnghua Minguo. Finally, I will look at Muslim women of Uighur維吾爾, wei wuĕr, and Hui回background who also contributed to this new vision

HIV epidemic among pregnant women in China, 2016: trend and spatial analysis

Objective: To describe the spatial distribution characteristics of the HIV prevalence among pregnant women in mainland China in 2016, providing scientific evidence for the prevention of mother-to-child transmission of HIV. Methods: Data on pregnant women and those living with HIV in 2016 for all counties in mainland China is from the National Maternal & Child Health Statistics dataset. To obtain robust estimates, 2 964 counties were merged into 344 cities. Spatial autocorrelation analysis and trend analysis were performed based on the city-level dataset to detailedly describe the characteristics of the spatial distribution. Results: A total of 14 879 082 pregnant women were included in the analysis, among whom 5 051 were diagnosed to be infected with HIV, giving an overall prevalence of 34.0 per 100 000 pregnant women. The prevalence was higher in the south than in the north, and decreased from the west (93.5/100 000) to the east(8.6/100 000 ), more specifically, the prevalence in the West region was 11 times as high as that in the East region(χ(trend)(2)=68.61, P<0.01). Stratified analysis by provinces showed that there were 6 provinces whose prevalence was >50.0 per 100 000, and they (Yunnan, Xinjiang, Sichuan, Guangxi, Guizhou and Chongqing) were all located in the West Region; pregnant women in these provinces accounted for 21% of all pregnant women, but the HIV cases accounted for 76% of all cases diagnosed in mainland China. Stratified analysis by cities showed that there were 30 cities whose prevalence was >100.0 per 100 000, and 28 of these cities were also located in the western provinces above. Furthermore, the global Moran's I (0.5, P<0.01) indeed indicated a strong clustered distribution across mainland China; 2 hot spots were observed in the Midwest of Xinjiang, and Yunnan and its bordering areas (Sichuan, Guizhou, Guangxi and Chongqing), while 1 cold spot in the central and east China. The HIV prevalence in the hot spots (183.6/100 000) was 23 times as much as that in the cold spot (8.1/100 000). Conclusion: The overall HIV prevalence for pregnant women who lived in mainland China in 2016 (34.0/100 000) ranked at low-level worldwide, but varied markedly across the whole country with 2 high-prevalence-clustered areas: the Midwest of Xinjiang Uygur Autonomous Region, and Yunnan province along with its bordering areas, indicating comprehensive intervention strategies especially targeted to the areas with high HIV prevalence should be developed.

Repeat abortion and determinants of Chinese women: A systematic review and meta-analysis

Background Repeat abortion is a public health problem globally and has adverse impacts on women's reproductive health. Risk factors associated with repeat abortion have been well-established in many studies; however, studies documenting the prevalence of repeat abortions and associated risk factors in China are hard to access, due to the language barrier, as they are mostly published in Chinese. Meanwhile, the two-child policy in China may increase the risk of repeat abortions among women in China, hence, the need to review and document existing evidence on repeat abortions in China. Methods For this systematic review, we searched through six electronic databases, including PubMed, EMBASE, Cochrane Library, China Academic Journal Network Publishing Database, China Science Period Database, and China Biology Medicine disc. The focus of the review was on original studies, with no restrictions on language or publication date. The last search was run on May 5, 2017. The studies, which presented data on repeat abortion and related risk factors of women in mainland China were selected for the review. Two reviewers reviewed all the articles and extracted relevant data from the selected full-text studies. Meta-analyses were performed using RevMan 5.3 and the odds ratios with 95% confidence intervals were calculated in fixed or random effects models based on the results of the Q test. The publication bias was quantitatively evaluated by Egger's linear regression analysis using Stata 13.0. A narrative approach was used to analyze exposures; for which a meta-analysis was not possible. We used descriptive statistics to assess whether the percentage of repeat abortion varied significantly among women in different groups of each exposure. Results Of 3015 records initially identified, 29 studies met our inclusion criteria, representing 36,879 individuals from China. Of 36,879 individuals in 28 cross-sectional studies, 43.0% (15854) had a repeat abortion. Of 48 exposures identified, 25 were significantly associated with repeat abortions of Chinese women. Meta-analyses indicated that women who were older (≥ 20 years, OR: 2.08, 95% CI: 1.72–2.50), multiparous (≥ 1 child, 4.99, 2.18–11.43), migrant (1.62, 1.34–1.96), unemployed (2.20, 1.65–2.93), tobacco/alcohol users (2.35, 1.66–3.32), with early sexual debut ( Conclusions Chinese women with a repeat abortion account for a large percentage of the total sample of women in the included studies. Despite significant heterogeneity of some risk factors, there is evidence that repeat abortions of women are associated with individual, sexual-partner's, and parental risk factors. More targeted strategies should be developed to reduce the high-risks of repeat abortions of women.

Breast cancer screening behaviors among Chinese women in Mainland China.

In the present study, we reported on the current breast cancer screening rates among Chinese women in China and examined whether demographic factors and cultural beliefs were associated with their screening behavior. A cross-sectional survey was conducted with a convenience sample of 494 Chinese women who completed the modified Breast Cancer Screening Beliefs Questionnaire (BCSBQ). Two-sample t-tests and multivariable logistic regression were employed to analyze the data. The results indicated that participation in screening practices ranged from 27.5% for breast self-examination (BSE), 36.4% for clinical breast examination, 23.5% for mammography, and 40% for ultrasonography. Women who had previously engaged in one of the four screening practices had significantly higher scores on the three subscales of the modified BCSBQ. Being older and having a friend who had been diagnosed with breast cancer were shown to be predictors for BSE and participation in either mammography or ultrasonography, respectively. Education levels were also shown to be positively associated with the four screening measures. We suggest that cultural beliefs about breast cancer and screening practices play a significant role in Chinese women's screening behavior.

Prevalence of gestational diabetes mellitus inmainland China: A systematic review and meta-analysis.

Aims/IntroductionPregnant women with gestational diabetes mellitus (GDM) are at a higher risk of adverse pregnancy outcomes. The aim of the present study was to estimate the pooled prevalence of GDM in mainland China according to International Association of Diabetes and Pregnancy Study Groups criteria.Materials and MethodsWe carried out a systematic review by searching both English and Chinese literature databases. Random effects models were used to summarize the prevalence of GDM in mainland China. Subgroup and sensitivity analyses were carried out to address heterogeneity. Publication bias was evaluated using Egger's test.ResultsA total of 25 papers were included in the meta‐analysis, involving 79,064 Chinese participants. The total incidence of GDM in mainland China was 14.8% (95% confidence interval 12.8–16.7%). Subgroup analysis showed that the age, bodyweight and family history of diabetes mellitus could significantly increase the incidence of GDM.ConclusionsTo the best of our knowledge, this systematic review is the first to estimate the pooled prevalence of GDM among women in mainland China according to International Association of Diabetes and Pregnancy Study Groups criteria. The results of our systematic review suggest a high prevalence of GDM in mainland China, indicating that this country might have the largest number of GDM patients worldwide.

Health and health care disparities among women in mainland China

PurposeWomen’s health is considered a big public health issue, impacting personal well-being, family reproduction, and society’s development. Since the foundation of the People’s Republic of China, major improvements in women’s social status and health have been made. However, far less has been achieved with respect to gender equality and women still face health disparities. The purpose of this paper is to provide a better understanding of health and health care disparities among women and their determinants in China today.Design/methodology/approachThis paper used the Statistical Yearbook of Health and Family Planning 2014, the 2010 Women’s Social Status Survey and 2010 census data from the National Bureau of Statistics to give an overall description of disparity in health care and health outcome facing women.FindingsProgress in health is not equally shared by the female population, and the differences in women’s health by region and in urban and rural areas are considerable. The existing health disparities are still faced by women in terms of life expectancy, hazardous working environment, and health care services. As to gender differences among the elderly aged 60+, men have better health status compared to women. In addition, women are more financially dependent on other family members for the main source of daily living, reflecting their economic disadvantages.Originality/valueThis study gives a comprehensive and the latest overview of trends of women’s health progress, disparities in health care, and health outcomes both in female population and between genders by using three data sources.

AB084. The fertility quality of life (FertiQol) in Chinese infertile women

ObjectiveInfertility is defined as the failure to achieve clinical pregnancy after twelve months of regular unprotected sexual intercourse. In recent years, there is a rising trend of infertility in China, data shows that every eight couples have a pair of infertility, and the number of Chinese infertility patients has more than 50 million. Female infertility has various negative impacts on quality of life. In the past, various generic measurement tools were used for assessing Qol in infertile patients. Recently, a specifically Qol tool designed for infertile couples, has been developed and used internationally—The Fertility Quality of life(FertiQol)-questionaire. To the best of our knowledge, there was no published data regarding the general Qol in infertile women in mainland china. Our goal of this study is to understand the preliminary level of Qol in infertile women in mainland china, secondary aims was to compare Qol in women with primary and secondary infertility.MethodsThe FertiQol tool, a self-report questionnaire, was distributed to our department of Reproductive Center for infertile women who undergoing the treatment of in vitro fertilization from 2015.1 to 2015.4. Patients with primary and secondary infertility were compared for Qol subscales, and other confounding factors were investigated using multiple regression analysis.ResultsA total of 230 copies of eligible FertiQol questionnaires were collected, among them, 162 cases for primary infertility and 68 cases for Secondary infertility. The mean age of participants was 32.6±3.3 years and years of marriage was 4.2±1.3. Scores of mind-body (55.4), relational (57.4), environment (54.0), and tolerability (45.0) subscales in Chinese infertile women were lower than those (54.8, 68.7, 61.5 and 58.8) in western infertile women. According to the increase of infertility time, relational score (relation with husband) was decreased. Women with secondary infertility obtained higher scores in emotional, mind/body of the core subscale, and tolerability of the treatment subscale (P<0.05). Multiple regression analysis showed that the status of educational and secondary infertility had a positive impact.ConclusionsFertiQol scores were better in patients with secondary infertility and higher educational status. This is the first validation study of mainland Chinese FertiQoL, and potentially used as a guide for clinical counseling and future works.

Consequences of Delayed Prenatal Diagnosis of β-Thalassemia in Mainland China

β-Thalassemia (β-thal) is one of the most common inherited single gene disorders in the world. The aim of this study was to describe the gestational age at prenatal diagnosis (PND) for β-thal in at-risk women in mainland China. All pregnant women at-risk for β-thal and undergoing PND at a Mainland Chinese tertiary obstetric center between January 2005 and December 2014 were included. Information required for the survey was obtained from prenatal records and delivery charts. In total, 1307 women underwent PND for β-thal. The mean gestational age for the procedure was 18.5 weeks. There were 384 (29.0%) women with fetal diagnosis in early trimester (<14 weeks), 715 (55.0%) in early second trimester (14–24 weeks), and 208 (16.0%) in late second trimester or beyond (>24 weeks). Although the proportion of patients undergoing early PND increased along with the time span, the mean n gestational age was not decreased significantly during the study period. The delay in PND deprived couples of the opportunity to make informed decisions early in pregnancy.

Psychosocial Predictors and Outcomes of Delayed Breast Reconstruction in Mastectomized Women in Mainland China: An Observational Study.

BackgroundThe aim of the present study was to evaluate potential psychosocial factors that impact Chinese female breast cancer patients to select breast reconstruction (BR), and potential connection of psychosocial outcomes with their satisfaction with BR.MethodsA total of 264 female breast cancer patients with mastectomy were recruited from 2012 to 2014. All patients were informed with BR options at their first visit. Personal and medical profiles were collected. Body image, self-esteem, depression and anxiety were assessed using validated scales. Patients who were selected to undergo BR after the first visit were followed up for six months. The same assessment was performed at 6 months post BR, and their satisfaction with BR was evaluated using the Alderman scale. Multivariate linear and logistic regressions were performed.ResultsForty-seven percent of the patients (126/264) opted to undergo BR within six months after the initial visit. Multivariate logistic regression analysis revealed that self-esteem (P < 0.05), body image (P < 0.01), education level (P < 0.05), and their husband’s recommendation (P < 0.05) were highly related to the patients’ decision to undergo BR. In addition, multivariate linear regression analysis showed that patient satisfaction with BR was significantly associated with preoperative body image (P < 0.01), postoperative improvement in self-esteem (P < 0.01), improvement in body image (P < 0.01), reduction in depression (P < 0.05), pain (P < 0.05), and scarring (P < 0.01).ConclusionsThe psychosocial factors including self-esteem and body image are highly related to selecting the BR option and post-BR satisfaction in Chinese female breast cancer patients.

Restless legs syndrome among pregnant women in China: prevalence and risk factors.

The goal of this study was to identify the prevalence and clinical correlates and severity of restless legs syndrome (RLS) among pregnant women in mainland China. This cross-sectional study enrolled 1584 women (18-40 years old) who came to a prenatal outpatient clinic to consult an obstetrician. Pregnant women were studied in each trimester, and assessments included interviews about RLS symptoms and related questions. Standardized questionnaires include the International Restless Syndrome Scale and the Pittsburgh Sleep Quality Questionnaire. Blood tests included levels of hemoglobin and mean corpuscular volume. RLS was diagnosed in 177 of 1584 women (11.2%); 4.2% were categorized as having pre-existing RLS and 54.8% reported onset of RLS symptoms after the 24th week. Multivariate analysis revealed that anemia was positively correlated with RLS. For the participants who first experienced RLS in pregnancy, RLS severity in the third trimester was more severe when compared with the first and second trimesters. Sleep disorders occurred more frequently in the third trimester. In our study, RLS was frequent in pregnant Chinese women, and anemia was identified as an independent predictor of the disease. Further, most participants reported their symptoms during the third trimester, and the severity of RLS and sleep disorders of participants was more prominent in the third trimester.

Joint Associations of Physical Activity and Hypertension with the Development of Type 2 Diabetes among Urban Men and Women in Mainland China

BackgroundPhysical activity (PA) and hypertension (HTN) are important influences on the development of type 2 diabetes (T2D). However, the joint impact of PA and HTN on T2D development is unknown.MethodsTwo community-based prospective cohort studies, with the same protocols, instruments and questionnaires, were conducted among adults in urban areas of Nanjing, China, during 2004–2007 and 2007–2010. T2D was defined using World Health Organization criteria based on physicians' diagnosis and fasting blood glucose concentration. PA level (sufficient/insufficient) and blood pressure status (hypertensive/normotensive) were assessed at baseline and the third year of follow-up. We pooled and analyzed data from these two studies.ResultsAmong 4550 participants aged 35 years or older, the three-year cumulative incidence of T2D was 5.1%. After adjusting for potential confounders, participants with sufficient PA were less likely to develop T2D than those with insufficient PA (OR = 0.43, 95%CI = 0.27, 0.68) and those who were normotensive were less likely to develop T2D than those who were hypertensive (OR = 0.39, 95%CI = 0.29, 0.51). Compared to participants with insufficient PA and who were hypertensive, those with sufficient PA and hypertension were at lower risk of developing T2D (OR = 0.36, 95%CI = 0.19, 0.69), as were those with insufficient PA who were normotensive (OR = 0.37, 95%CI = 0.28, 0.50) and those with sufficient PA who were normotensive (OR = 0.19, 95%CI = 0.10, 0.37).ConclusionsInsufficient PA was found to be associated with the development of T2D among adults with and without hypertension. These findings support a role for promoting higher physical activity levels to lower T2D risk in both hypertensive and non-hypertensive individuals.