中华妇产科杂志最新文献

{"title":"[Prospective clinical study on non-invasive prenatal testing for severe thalassemia using tag-labeled targeted capture sequencing combined with a modified Bayesian model].","authors":"X Xiao, Q M Li, Z L Wu, J X Yang, A H Yin","doi":"10.3760/cma.j.cn112141-20251107-00539","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20251107-00539","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the clinical performance of a non-invasive prenatal testing (NIPT) approach for fetal severe thalassemia based on tag-labeled targeted capture sequencing combined with a modified Bayesian model (referred to as noninvasive thalassemia testing). <b>Methods:</b> This study was a prospective cohort study involving 452 couples of the Southeast Asian deletion (SEA) type α-thalassemia carriers who were enrolled in Guangdong Women and Children Hospital from June 2018 to July 2021. Maternal peripheral blood was collected at 11-34 gestational weeks. Cell-free fetal DNA (cffDNA) in maternal plasma was analyzed by tag-labeled targeted capture sequencing, and fetal genotypes were inferred using a modified Bayesian algorithm to determine the risk of fetal severe α-thalassemia. The results of invasive prenatal diagnosis were taken as the \"gold standard\" to evaluate the clinical detection efficacy of this method. <b>Results:</b> Among the 452 pregnant women, 5 cases declined further invasive prenatal diagnosis and 5 cases failed testing due to unsatisfactory sample quality control. The remaining 442 cases were included in the testing performance evaluation. Noninvasive thalassemia testing showed a sensitivity of 97.89%, specificity of 98.56%, positive predictive value of 94.90%, and negative predictive value of 99.42%. Consistency analysis demonstrated that the prediction of severe thalassemia by noninvasive thalassemia testing was highly consistent with invasive prenatal diagnosis (<i>κ</i>=0.954, 95%<i>CI</i>: 0.920-0.988; <i>P</i><0.001). The noninvasive thalassemia testing results included 2 false-negative and 5 false-positive cases, with an overall concordance rate of 98.42% (435/442) compared with the gold standard. <b>Conclusion:</b> The proposed noninvasive thalassemia testing method achieved good diagnostic performance for severe thalassemia without relying on parental haplotype information, providing a new prenatal testing pathway for couples in high-prevalence thalassemiat regions who are both carriers of the SEA deletion α-thalassemia.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 4","pages":"269-276"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Experimental study on the inhibitory effects of recombinant bee venom peptide on the malignant biological behavior of cervical cancer].","authors":"S Y Wu, D Y Wang, J X He, H X Wang, M H Cui, T M Xu","doi":"10.3760/cma.j.cn112141-20251117-00551","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20251117-00551","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effects and underlying mechanisms of the recombinant bee venom peptide LSSDR412 on the malignant biological behavior of cervical cancer in vitro and in vivo, and to provide a theoretical basis for its potential clinical translation<b>.</b> <b>Methods:</b> Peptide LSSDR412 was obtained by chemical synthesis. Different concentrations of LSSDR412 were used as treatment groups. The effects of peptide LSSDR412 on the survival and proliferation of cervical cancer cell lines (Hela cells and Caski cells) were detected by cell counting kit-8 (CCK-8) and clone formation assay. Transwell chamber assay was used to detect the effect on cell migration and invasion. Western blot and co-immunoprecipitation assay were used to detect the expression and interaction of epithelial-mesenchymal transition (EMT) and Wnt/β-catenin signaling pathway related proteins. The cervical cancer xenograft model was established in nude mice, and the volume of subcutaneous xenograft tumor was detected after intraperitoneal injection of LSSDR412. The expression of the proliferation associated nuclear antigen (Ki-67) was detected by immunofluorescence. The lung metastasis model of cervical cancer bearing nude mice was established, and HE staining was used to detect the effect of intraperitoneal injection of LSSDR412 on lung metastasis. <b>Results:</b> Compared with the cells without LSSDR412 treatment, the survival rate, clone number, invasive and migratory cell number of Hela and Caski cells were significantly decreased after LSSDR412 treatment (all <i>P</i><0.05), and showed a concentration-dependent trend. LSSDR412 could inhibit the EMT process of cervical cancer and inhibit the Wnt/β-catenin signaling pathway through Claudin-4 (CLDN4) to play an anti-cervical cancer effect. The results of in vivo experiments showed that the tumor weight of the LSSDR412 group was significantly lower than that of the control group [(0.292±0.073) vs (0.480±0.117) g; <i>t</i>=3.341, <i>P</i>=0.008]. The positive rate of Ki-67 in tumor tissue was significantly lower than that in the control group (21.95%±5.60% vs 87.27%±6.35%; <i>t</i>=26.72, <i>P</i><0.001), and the proportion of intrapulmonary metastases was significantly lower than that of the control group [25.0% (16.3%, 45.0%) vs 39.1% (31.3%, 48.3%); <i>U</i>=31.00, <i>P</i>=0.044]. There was no significant pathological change in liver and kidney tissue structure in the LSSDR412 group. <b>Conclusions:</b> Peptide LSSDR412 shows significant inhibitory effects on the proliferation, migration and invasion of cervical cancer cells both in vitro and in vivo with no apparent toxic side effects. Its antitumor activity is primarily mediated through the suppression of the CLDN4-mediated Wnt/β-catenin signaling pathway.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 4","pages":"316-327"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Investigation of pharmacological regimens combined with focused ultrasound ablation surgery for alleviating dysmenorrhea in extrinsic adenomyosis].","authors":"K Ding, Q L Shi, C M Sang, L Zhao, S P Zhao","doi":"10.3760/cma.j.cn112141-20250915-00433","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250915-00433","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate optimal long-term medication regimens combined with focused ultrasound ablation surgery (FUAS) for alleviating dysmenorrhea in patients with extrinsic adenomyosis. &lt;b&gt;Methods:&lt;/b&gt; A retrospective research enrolled patients with extrinsic adenomyosis diagnosed by pelvic magnetic resonance imaging and presenting with significant dysmenorrhea symptoms, who underwent FUAS treatment at Qingdao Women and Children's Hospital from December 2019 to December 2023. Patients were divided into two groups based on postoperative treatment regimens: FUAS+gonadotrophin-releasing hormone agonist (GnRH-a)+levonorgestrel-releasing intrauterine system (LNG-IUS) group (Group LNG-IUS) and FUAS+GnRH-a+dienogest group (Group DNG). Clinical characteristics, imaging data, and treatment outcomes of the patients were retrospectively analyzed. Patients were followed up for 12 to 60 months to compare symptom improvement, recurrence rates, and adverse events among different treatment modalities. &lt;b&gt;Results:&lt;/b&gt; (1) Clinical data: a total of 87 patients were included, with a mean age of (39.0±5.2) years, a median dysmenorrhea score of 8 and a median course of disease of 5 years. Group LNG-IUS comprised 53 patients with an average age of (40.2±5.2) years and a median dysmenorrhea score of 7 (including 34 cases of severe pain and 17 cases of moderate pain), among whom 24 patients (45.3%, 24/53) had deep infiltrating endometriosis (DIE). Group DNG had 34 patients with an average age of (37.1±4.5) years and a median dysmenorrhea score of 8 (including 21 cases of severe pain and 11 cases of moderate pain), among whom 25 patients (73.5%, 25/34) had DIE. (2) FUAS treatment information: in Group LNG-IUS, the average operation time was (82±29) minutes, with a median irradiation time of 570 s and an average ablation rate of (60.4±22.6)%. In Group DNG, the average operation time was (80±35) minutes, with a median irradiation time of 518 s and an average ablation rate of (58.7±17.8)%. No significant differences were observed in FUAS treatment parameters between the two groups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). (3) Follow-up: dysmenorrhea scores of both groups were significantly lower post treatment (all &lt;i&gt;P&lt;/i&gt;&lt;0.001). Different postoperative treatment regimens affected treatment outcomes (&lt;i&gt;P&lt;/i&gt;=0.018). Long-term follow-up showed a significant difference in treatment effectiveness between the two groups (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Uterine volume had significantly decreased in both groups compared to before treatment (all &lt;i&gt;P&lt;/i&gt;&lt;0.001). (4) Adverse events: adverse events during FUAS procedure were all classified as Society of Interventional Radiology (SIR) A-B, and drug-related adverse events were all grade 1-2, with no serious adverse events occurring in either group. &lt;b&gt;Conclusions:&lt;/b&gt; Adjuvant therapy with GnRH-a and LNG-IUS or sequential dienogest after FUAS could effectively relieve dysmenorrhea in extrinsic adenomyosis patients, achieving favorable medium- and long","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 4","pages":"277-288"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[2019-2021 baseline status, trends of and risk factors of repeat induced abortion among women seeking abortion in the Prospective Cohort of Induced Abortion and Future Pregnancy Outcomes].","authors":"X M Jiang, K Y Pei, Wei-Hong Zhang, S C Wu, L X Chen, Y Q Shao, L N Zhang, R S Na, X Q Zhang, X W Luo, F Y Ren, X L Guo, Q W Qi, J Ge, D H Hu, X Jiang, S Liu, L Shen","doi":"10.3760/cma.j.cn112141-20250930-00466","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250930-00466","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the baseline demographic characteristics of women seeking induced abortion, the proportion of repeat induced abortion, the trend from 2019 through 2021 and risk factors of repeat induced abortions within the framework of the Prospective Cohort of Induced Abortion and Future Pregnancy Outcomes. &lt;b&gt;Methods:&lt;/b&gt; Based on the Prospective Cohort of Induced Abortion and Future Pregnancy Outcomes, women seeking abortion due to unwanted pregnancy were recruited from 10 clinical research centers across the country, and a structured questionnaire was used to collect information on age, marital status, pregnancy and childbirth status, and induced abortion and so on. Baseline data of subjects recruited from the beginning of the cohort in 2019 to the end of 2021 were extracted for this study, and were statistically analyzed using the SPSS 22.0 software. &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test was used to compare the differences between years and characteristics associated with repeat induced abortion, linear by linear association test was used for the trend test, and logistic regression analysis was performed to identify risk factors of repeat induced abortion. &lt;b&gt;Results:&lt;/b&gt; A total of 8 990 women with complete key baseline information from the beginning of the cohort in 2019 to the end of 2021 were included in this study. (1) The average age at the time of induced abortion was (28.9±5.1) years (range: 16-49 years); among all these women, 64.2% (5 776/8 990) were aged 25-34 years, 27.8% (2 496/8 990) were unmarried, 70.9% (6 378/8 990) had junior college or above educational background, and 48.8% (4 391/8 990) were clerks (including teachers, doctors, civil servants, etc.). (2) The proportion of repeat induced abortion was 43.3% (3 897/8 990), with no statistical significance between different years (&lt;i&gt;P&lt;/i&gt;&gt;0.05). (3) Age, marital status, education, occupation, smoking, alcohol consumption, number of children and reason for current unintended pregnancy were independent risk factors for repeat induced abortion (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). The strongest factors associated significantly with repeat induced abortion were: age≥40 years (&lt;i&gt;OR&lt;/i&gt;=17.249, 95%&lt;i&gt;CI&lt;/i&gt;: 9.535-31.203), remarried, divorced or widowed (&lt;i&gt;OR&lt;/i&gt;=2.209, 95%&lt;i&gt;CI&lt;/i&gt;: 1.595-3.059), frequency of alcohol consumption&gt;1 drink/week (&lt;i&gt;OR&lt;/i&gt;=2.098, 95%&lt;i&gt;CI&lt;/i&gt;: 1.239-3.550), frequency of smoking≥5 cigarettes/day (&lt;i&gt;OR&lt;/i&gt;=1.938, 95%&lt;i&gt;CI&lt;/i&gt;: 1.267-2.966), number of children≥2 (&lt;i&gt;OR&lt;/i&gt;=1.643, 95%&lt;i&gt;CI&lt;/i&gt;: 1.356-1.992), master's degree or higher education level (&lt;i&gt;OR&lt;/i&gt;=0.351, 95%&lt;i&gt;CI&lt;/i&gt;: 0.267-0.460). &lt;b&gt;Conclusions:&lt;/b&gt; The 2019 to 2021 baseline information of the cohort reveals the characteristics of women seeking abortions, with the situation of repeated induced abortion still serious. Women who are with advanced maternal age, low educational level, unstable marital status, unemployed, smoking, drinking, with high frequency of sexual exposure, having more childre","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 4","pages":"305-315"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Attach great importance to the comprehensive management of coagulation dysfunction and termination of pregnancy in patients with adenomyosis in early pregnancy complicated with anemia].","authors":"X M Zhang","doi":"10.3760/cma.j.cn112141-20251104-00535","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20251104-00535","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 4","pages":"265-268"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Evaluating the efficiency of 24 secondary triage strategies for detecting cervical lesions of self-collected high-risk HPV-positive women].","authors":"Z P Deng, D Wu, W X Lai, L N Geng, A M Xiao, J C Bao, X F Qu, W K Dai, H Du, R F Wu","doi":"10.3760/cma.j.cn112141-20250905-00411","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250905-00411","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To evaluate the screening efficiency of gene DNA methylation testing, p16 staining, human papillomavirus (HPV) genotyping, and liquid-based cytology (LBC), and their combined strategies in self-collected high-risk HPV (HR-HPV) positive individuals. &lt;b&gt;Methods:&lt;/b&gt; This study analyzed a subset of data from a free self-sampling cervical cancer screening program conducted in Baise, Guangxi Zhuang Autonomous Region (from May 2023 to April 2024). HR-HPV positive self-collected cases with complete data and quality control were included. Using the triage strategy recommended by the 2019 American Society for Colposcopy and Cervical Pathology (ASCCP) risk-based management guideline and the Chinese cervical cancer screening guideline [ie, HPV16/18 positivity and (or) LBC of atypical squamous cell of undetermined significance (ASCUS) or worse] as reference standard, the sensitivity, specificity, colposcopy referral rate, and the number needed to colposcopy (NNC) of various secondary triage approaches were assessed. &lt;b&gt;Results:&lt;/b&gt; (1) A total of 777 HR-HPV positive women with complete data were analyzed. (2) Methylation positivity was significantly higher in high-risk group HPV16/18 (20.5%, 25/122) and high-intermediate-risk group HPV31/33/35/45/52/58 (17.2%, 66/381) than that in the low-risk group HPV39/51/56/59/66/68 (9.6%, 26/371; &lt;i&gt;χ&lt;/i&gt;²=8.85 and &lt;i&gt;χ&lt;/i&gt;²=7.59, &lt;i&gt;P&lt;/i&gt;=0.003 and &lt;i&gt;P&lt;/i&gt;=0.006). (3) Methylation positivity of cervical intraepithelial neoplasia (CIN)Ⅲ and cervical cancer cases (67.5%, 27/40) was significantly higher than CINⅠ cases (12.9%, 31/240), and CINⅡ cases (16.4%, 12/73), with statistically significant differences (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The p16 positivity increased with lesion severity in all pairwise comparisons (&lt;i&gt;P&lt;/i&gt;≤0.005 after correction). (4) When the guideline-recommended triage strategy [HPV16/18 positivity and (or) LBC≥ASCUS] was applied to this study population, using colposcopy-directed biopsy pathology as the reference standard, the sensitivity and specificity for detecting CINⅡ&lt;sup&gt;+&lt;/sup&gt; and CINⅢ&lt;sup&gt;+&lt;/sup&gt; were 69.03%, 65.21%, and 95.00%, 63.23%, respectively; the colposcopy referral rate was 39.77% (309/777), and NNC was 3.96 for CINⅡ&lt;sup&gt;+&lt;/sup&gt; and 8.13 for CINⅢ&lt;sup&gt;+&lt;/sup&gt;. (5) Methylation performance: for CINⅡ&lt;sup&gt;+&lt;/sup&gt;, sensitivity was 34.51% and specificity was 88.25%; for CINⅢ&lt;sup&gt;+&lt;/sup&gt;, sensitivity was 67.50% and specificity was 87.79%. (6) p16 performance: the sensitivity for detecting CINⅡ&lt;sup&gt;+&lt;/sup&gt; and CINⅢ&lt;sup&gt;+&lt;/sup&gt; were 72.57% and 92.50%, respectively, which did not differ significantly from the guideline-recommended strategy (all &lt;i&gt;P&lt;/i&gt;&gt;0.05), whereas the specificity for CINⅡ&lt;sup&gt;+&lt;/sup&gt; and CINⅢ&lt;sup&gt;+&lt;/sup&gt; were 68.67% and 65.60%, respectively, similar to the guideline-recommended strategy (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). The colposcopy referral rate was lower with p16 testing alone compared with the guideline-recommended strategy [37.32% (290/777) vs 39.77%; &lt;i&gt;P&lt;/i&gt;&gt;0.05]. (","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 4","pages":"289-304"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Correlation study of blood lipid indexes and body mass index with clinical characteristics of cervical squamous cell carcinoma].","authors":"J J Xiao, Q Cong, L Sui","doi":"10.3760/cma.j.cn112141-20250920-00443","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250920-00443","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To analyze the body mass index (BMI) and blood lipid indexes of patients with cervical high-grade squamous intraepithelial lesion (HSIL) and cervical squamous cell carcinoma (CSCC), and to explore the relationship between blood lipid indexes and the risk, clinical stage and postoperative pathological characteristics of CSCC. &lt;b&gt;Methods:&lt;/b&gt; A total of 52 HSIL patients (HSIL group) and 52 CSCC patients (CSCC group) who underwent surgical treatment in Obstetrics and Gynecology Hospital of Fudan University from January to December 2023 were enrolled. The general clinical data, parametrial invasion, lymphovascular space invasion and lymph node metastasis of the two groups were collected. The differences of clinical characteristics between the two groups were compared by parametric or non-parametric tests. Multivariate logistic regression analysis was used to analyze the risk factors of CSCC. Pearson or Spearman correlation analysis was used to explore the correlation of BMI and lipid indicators with the degree of cervical lesions and the International Federation of Gynecology and Obstetrics (FIGO) stage of CSCC patients. &lt;b&gt;Results:&lt;/b&gt; (1) Comparison of clinical data between the two groups: the age, BMI, parity and menopausal proportion of CSCC group were significantly higher than those of HSIL group (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). The level of apolipoprotein A1 (ApoA1) in CSCC group was significantly lower than that in HSIL group, while the level of apolipoprotein B (ApoB), ApoB/ApoA1 ratio and low density lipoprotein cholesterol (LDL-c) level in CSCC group were significantly higher than those in HSIL group (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Multivariate logistic regression analysis showed that BMI (&lt;i&gt;OR&lt;/i&gt;=1.25, 95%&lt;i&gt;CI&lt;/i&gt;: 1.07-1.45), ApoB level (&lt;i&gt;OR&lt;/i&gt;=23.96, 95%&lt;i&gt;CI&lt;/i&gt;: 1.47-390.28), ApoB/ApoA1 ratio (&lt;i&gt;OR&lt;/i&gt;=23.96, 95%&lt;i&gt;CI&lt;/i&gt;: 1.32-25.09) were independent risk factors for CSCC (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). (2) Correlation between BMI and blood lipid indexes: the ApoB level and ApoB/ApoA1 ratio were significantly increased with the increase of BMI in patients with cervical lesions (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Correlation analysis showed that ApoB level (&lt;i&gt;r&lt;/i&gt;=0.218, &lt;i&gt;P&lt;/i&gt;=0.026) and ApoB/ApoA1 ratio (&lt;i&gt;r&lt;/i&gt;=0.272, &lt;i&gt;P&lt;/i&gt;=0.005) were positively correlated with BMI, while high density lipoprotein cholesterol (HDL-c) level was negatively correlated with BMI (&lt;i&gt;r&lt;/i&gt;=-0.217, &lt;i&gt;P&lt;/i&gt;=0.027). (3) Correlation of BMI and blood lipid indexes with the severity of cervical lesions: BMI (&lt;i&gt;r&lt;/i&gt;=0.351, &lt;i&gt;P&lt;/i&gt;&lt;0.001), ApoB level (&lt;i&gt;r&lt;/i&gt;=0.325, &lt;i&gt;P&lt;/i&gt;&lt;0.001) and ApoB/ApoA1 ratio (&lt;i&gt;r&lt;/i&gt;=0.387, &lt;i&gt;P&lt;/i&gt;&lt;0.001) were positively correlated with the degree of cervical lesions, and ApoA1 level (&lt;i&gt;r&lt;/i&gt;=-0.240, &lt;i&gt;P&lt;/i&gt;=0.014) was negatively correlated with the degree of cervical lesions. (4) Correlation of BMI and blood lipid indexes with CSCC stage and pathological features: with the upgrading of CSCC stage (stage Ⅰ-Ⅲ), ApoB level and ApoB/ApoA1 ","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 3","pages":"236-245"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cumulative live birth rates after repeat IVF cycles in women with diminished ovarian reserve: a 7-year retrospective cohort of 3 740 patients].","authors":"X Wang, C Y Dong, J Lu, P Z Tian, C L Zhang","doi":"10.3760/cma.j.cn112141-20250822-00394","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250822-00394","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the cumulative live birth rate (CLBR) based on oocyte retrieval cycles in patients with diminished ovarian reserve (DOR) after repeat in vitro fertilization (IVF) and to explore the related influencing factors. <b>Methods:</b> Data from 3 740 DOR patients (8 386 IVF cycles) treated at Reproductive Medicine Center, Henan Provincial People's Hospital from January 2017 to December 2022 (follow-up until December 31, 2023) were collected. Kaplan-Meier curves analysis was used to assess the trend of CLBR, and Cox proportional hazards regression model was applied to identify factors influencing CLBR. <b>Results:</b> Among 3 740 patients with DOR, 981 cases achieved at least one live birth, CLBR was 26.23% (981/3 740). CLBR increased with the number of oocyte retrieval cycles, reaching 35.49% in the 3rd cycle and 50.40% in the 7th cycle. However, the CLBR growth rate declined after the 3rd cycle, with 92.35% (906/981) of live births occurring in the first 3 cycles. Factors associated with reduced CLBR included advanced maternal age, higher basal follicle stimulating hormone level, and a history of recurrent miscarriage (all <i>P</i><0.01). Conversely, higher anti-Müllerian hormone (AMH) and antral follicle count were positively correlated with CLBR (all <i>P</i><0.001). Notably, patients with AMH<0.68 μg/L had a significantly reduced CLBR (<i>P</i><0.001). <b>Conclusions:</b> Adhering to three IVF cycles significantly improves CLBR in DOR patients, with younger individuals benefiting particularly significantly. Factors such as age≥40 years, AMH<0.68 μg/L, and a history of recurrent miscarriage are associated with poorer CLBR. Beyond three cycles, the incremental gain in CLBR generally declines. It is recommended that younger patients persist with IVF treatment, while older patients should seek individualized counseling and consider alternative options.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 3","pages":"203-210"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Incidence and influencing factors of urinary incontinence during pregnancy and after childbirth].","authors":"X W Zhong, Y L Ouyang, X F Zhao","doi":"10.3760/cma.j.cn112141-20250622-00286","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250622-00286","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the incidence of urinary incontinence during pregnancy and within 6 months postpartum among primiparous women with singleton pregnancy, and to study the risk factors for postpartum urinary incontinence in these women. &lt;b&gt;Methods:&lt;/b&gt; A bidirectional cohort study was conducted, enrolling 426 primiparous women with singleton pregnancy who were hospitalized for delivery at Wenzhou Central Hospital between September 2022 and March 2023. According to the mode of delivery, the participants were divided into three groups: the elective cesarean section group (&lt;i&gt;n&lt;/i&gt;=116), the intrapartum cesarean section group (&lt;i&gt;n&lt;/i&gt;=92), and the vaginal delivery group (&lt;i&gt;n&lt;/i&gt;=218). The incidence of urinary incontinence was assessed during pregnancy and at 42 days, 3 months, and 6 months postpartum in the three groups. Baseline characteristics, intrapartum data, and postpartum pelvic floor rehabilitation data were collected. Binary logistic regression analysis was performed to identify the risk and protective factors for postpartum urinary incontinence in primiparous women with singleton pregnancy. &lt;b&gt;Results:&lt;/b&gt; (1) Among the 426 primiparous women with singleton pregnancy, the incidence of urinary incontinence during pregnancy and at 42 days, 3 months, and 6 months postpartum was 27.7% (118/426), 20.2% (86/426), 16.2% (69/426), and 14.3% (61/426), respectively. (2) At 42 days, 3 months, and 6 months postpartum, the incidence of urinary incontinence in the vaginal delivery group were 6.430, 5.709, and 6.981 times higher, respectively, than those in the elective cesarean section group (all &lt;i&gt;P&lt;/i&gt;&lt;0.001). Women with urinary incontinence during pregnancy had a significantly higher incidence of urinary incontinence at 42 days, 3 months, and 6 months postpartum than those without urinary incontinence during pregnancy, with relative risks of 3.605, 4.398, and 3.362, respectively (all &lt;i&gt;P&lt;/i&gt;&lt;0.001). In the elective cesarean section group, women aged≥35 years had a significantly higher incidence of urinary incontinence at 42 days postpartum than those aged&lt;35 years (relative risk: 7.721, &lt;i&gt;P&lt;/i&gt;&lt;0.05). Compared with the elective cesarean section group, the intrapartum cesarean section group showed higher incidence of urinary incontinence at 42 days, 3 months, and 6 months postpartum; however, after adjustment for confounding factors using binary logistic regression analysis, no significant differences were observed between the two groups at three time points (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). (3) Among women with urinary incontinence at 42 days postpartum, postpartum pelvic floor rehabilitation was identified as a protective factor against urinary incontinence at 6 months postpartum (&lt;i&gt;OR&lt;/i&gt;=0.885,95%&lt;i&gt;CI&lt;/i&gt;: 0.806-0.971; &lt;i&gt;P&lt;/i&gt;&lt;0.05). In contrast, among women without urinary incontinence at 42 days postpartum, postpartum pelvic floor rehabilitation had no significant effect on urinary incontinence at 6 months postpartum (&lt;i&gt;P&lt;/i&gt;&gt;0.05","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 3","pages":"211-217"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Oncological and reproductive outcomes in patients with malignant transformation of ovarian mature cystic teratoma].","authors":"Y J Li, S P Yan, F Ya, G Zheng, H L Fu, M Mao, R X Guo","doi":"10.3760/cma.j.cn112141-20251126-00578","DOIUrl":"10.3760/cma.j.cn112141-20251126-00578","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the oncological outcomes of patients with malignant transformation of ovarian mature cystic teratoma (OMCT) and the reproductive outcomes of young patients undergoing fertility sparing surgery (FSS). &lt;b&gt;Methods:&lt;/b&gt; Clinicopathological data of 39 patients with malignant transformation of OMCT enrolled at the First Affiliated Hospital of Zhengzhou University from August 2011 to December 2024 were retrospectively collected. Their oncological outcomes were analyzed. Univariate and multivariate Cox proportional hazards regression models were used to identify factors associated with disease free survival (DFS) and overall survival (OS). Reproductive outcomes were analyzed in patients under 45 years old who underwent FSS. Furthermore, the clinicopathological data and oncological outcomes of 8 concurrently enrolled patients of OMCT with carcinoid tumor were analyzed and compared. &lt;b&gt;Results:&lt;/b&gt; (1) The mean age of patients with malignant transformation of OMCT was (52.7±14.0) years, and the mean maximum tumor diameter was (10.8±0.8) cm. Surgical treatment was performed in all patients, intraoperative tumor rupture occurred in 8 patients (21%, 8/39). The pathological types included squamous cell carcinoma in 29 cases (74%, 29/39), mucinous adenocarcinoma in 9 cases (23%, 9/39), and malignant melanoma in 1 case (3%, 1/39).27 patients (69%, 27/39) were classified as stage Ⅰ, 4 patients (10%, 4/39) as stage Ⅱ, and 8 patients (21%, 8/39) as stage Ⅲ. (2) The median follow-up duration for these patients was 86.0 months. During follow-up, recurrence was observed in 12 patients (31%, 12/39), all of whom died. In addition, one patient died of non-cancer causes. At the last follow-up, 13 patients (33%, 13/39) died; while the remaining patients were alive with no evidence of disease. The 5-year disease free survival (DFS) and overall survival (OS) rates were 67% and 65%, respectively. Cox regression analysis identified a maximum tumor diameter≥13 cm, stageⅡ-Ⅲ and intraoperative tumor rupture as independent risk factors for both DFS and OS (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). (3) Among the 5 patients under 45 years old with malignant transformation of OMCT who underwent FSS, 4 were staged as Ⅰa and 1 as Ⅱ. Three of the patients with Ⅰa stage successfully conceived naturally and delivered at full term within 1-2 years after surgery. The patient with stage Ⅱ died due to disease progression, while the remaining 4 patients were alive with no evidence of disease.(4) The mean age of the 8 patients of OMCT with carcinoid tumor was (42.4±18.0) years, the mean maximum tumor diameter was (15.0±9.1) cm. No recurrence was observed during follow-up, and all patients were alive with no evidence of disease at the last follow-up date on May 30, 2025. Survival analysis indicated no statistically significant difference in OS between patients with malignant transformation of OMCT and those of OMCT with carcinoid tumors (&lt;i&gt;P&lt;/i&gt;=0.102). &lt;b&gt;Conclusions:&lt;/b&gt; The ","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 3","pages":"227-235"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}