中华妇产科杂志最新文献

{"title":"[Clinical analysis of 9 cases of maternal positive anti-Ro/SSA and (or) anti-La/SSB antibodies complicated with fetal arrhythmia].","authors":"C M Zhang, J R Jin, J N Lu, K X Zheng, S P Yu, D Yang","doi":"10.3760/cma.j.cn112141-20260513-00258","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20260513-00258","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the management of pregnant women with positive anti-Ro/Sjögren's syndrome antigen A (SSA) antibody and (or) anti-La/Sjögren's syndrome antigen B (SSB) antibody complicated with fetal arrhythmia. <b>Methods:</b> Clinical data of pregnant women with positive anti-Ro/SSA and (or) anti-La/SSB antibodies complicated with fetal arrhythmia who delivered in Beijing Anzhen Hospital, Capital Medical University from January 2020 to June 2026 were retrospectively collected. Maternal autoantibody profiles, types of fetal arrhythmia and pregnancy outcomes were analyzed. <b>Results:</b> A total of 9 cases of pregnant women with positive anti-Ro/SSA and (or) anti-La/SSB antibodies complicated with fetal arrhythmia were included. All 9 cases were positive for anti-Ro/SSA antibody, including 6 strongly positive, 2 moderately positive and 1 weakly positive; among them, 6 cases were concomitantly positive for anti-La/SSB antibody. Among the 9 fetuses, 4 presented with third-degree atrioventricular block (AVB), 1 with first-degree AVB, 1 with transient bradycardia, 2 with supraventricular tachycardia, and 1 with atrial premature beats. Two cases of fetal third-degree AVB and one case of atrial premature beats failed to restore sinus rhythm after in utero pharmacological treatment, while one fetus with transient bradycardia and one fetus with supraventricular tachycardia achieved rhythm conversion after treatment. Among all 9 cases, 5 resulted in live births, including 4 cesarean deliveries and 1 vaginal delivery. Of these live-born infants, 2 were delivered at term and 3 were preterm. The other 4 pregnancies were terminated by induction of labor. <b>Conclusions:</b> AVB is the most common type of fetal arrhythmia induced by maternal positive anti-Ro/SSA and (or) anti-La/SSB antibodies. The utero pharmacological treatment is unlikely to reverse third-degree AVB in the fetus.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 9","pages":"717-723"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069287","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":"[Inhibition of RBM5 expression by the interaction between hsa_circ_0006200 and EIF4A3 and its impact on cervical cancer progression].","authors":"R Chen, Y Yuan, Z Zhang, N Yang, X Q Cao","doi":"10.3760/cma.j.cn112141-20260402-00180","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20260402-00180","url":null,"abstract":"<p><p><b>Objective:</b> To reveal the biological function and potential molecular mechanism of hsa_circ_0006200 in cervical cancer. <b>Methods:</b> Quantitative polymerase chain reaction (qPCR) was utilized to analyze the expression differences of hsa_circ_0006200 in cervical cancer cell lines versus normal cervical epithelial cells. 5-ethynyl-2'-deoxyuridine (EdU) method was applied for cell proliferation assessment, Transwell assays were for the detection of cell migration and invasion. RNA pull down assay and RNA immunoprecipitation (RIP) assay were applied to determine the interplay between hsa_circ_0006200 and eukaryotic translation initiation factor 4A3 (EIF4A3) and the binding between EIF4A3 and RNA binding motif protein 5 (RBM5). Western blot was carried out to determine protein expression levels of EIF4A3 and RBM5 in SiHa and HeLa cells. <b>Results:</b> In contrast to normal cervical epithelial cells, hsa_circ_0006200 expression was markedly upregulated in cervical cancer cell lines (<i>P</i><0.001). In vitro, overexpression of hsa_circ_0006200 dramatically enhanced the proliferative, migratory and invasive capacities of cervical cancer cells (<i>P</i><0.001), whereas hsa_circ_0006200 knockdown restrained the proliferation, migration, and invasion of cervical cancer cells (<i>P</i><0.05). RNA pull down assay showed that hsa_circ_0006200 could bind to EIF4A3 in cervical cancer cells. RIP assay validated the interaction of EIF4A3 with both hsa_circ_0006200 and RBM5. Knockdown of hsa_circ_0006200 observably upregulated RBM5 protein expression in cervical cancer cells, whereas further EIF4A3 overexpression resulted in downregulated RBM5 protein expression (<i>P</i><0.01). EdU method and Transwell assays demonstrated that RBM5 knockdown weakened the suppressive impacts of downregulating hsa_circ_0006200 on cervical cancer cell proliferation, migration and invasion (<i>P</i><0.01). <b>Conclusion:</b> hsa_circ_0006200 expression is upregulated in cervical cancer cells, where it drives cancer cell proliferation, as well as migration and invasion, by repressing RBM5 expression through interaction with EIF4A3.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 9","pages":"748-759"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069229","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":"[Clinical observational study on detection and treatment of adenocarcinoma in situ of the cervix].","authors":"Y Ling, M X Wu, Z X You","doi":"10.3760/cma.j.cn112141-20260210-00100","DOIUrl":"10.3760/cma.j.cn112141-20260210-00100","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the related factors of residual cervical adenocarcinoma in situ (AIS) or cervical adenocarcinoma (CAC) after loop electrosurgical excision procedure (LEEP). <b>Methods:</b> Clinical data were collected from patients who were admitted to the First Affiliated Hospital of Nanjing Medical University from April 2014 to February 2026. Patients with AIS diagnosed by colposcopy-guided sampling or LEEP and underwent total extrafascial hysterectomy within 4 months after LEEP were included in the study. Patients with, invasive squamous cell carcinoma or adenocarcinoma were excluded. The clinicopathological characteristics of the patients and the related factors affecting the detection of AIS or CAC in hysterectomy specimens were analyzed. <b>Results:</b> A total of 117 AIS patients were included in this study, with an age of (45.9±8.2) years at diagnosis. The results of high-risk human papillomavirus (HPV) test were all positive in 114 cases. Among 106 cases of cervical cytology, 32 cases (27.4%, 32/117) had negative for intraepithelial lesion or malignancy (NILM), 55 cases (47.0%, 55/117) had squamous cell abnormality, and 19 cases (16.2%, 19/117) had glandular cell abnormality. Seventy-seven cases (65.8%, 77/117) of AIS were detected by colposcopic sampling, and 40 cases (34.2%, 40/117) were detected by LEEP. Ninety-eight patients (98/117, 83.8%) and 19 patients (19/117, 16.2%) received LEEP once and twice, respectively. The positive rate of surgical margins after the last LEEP was 16.2% (19/117), and the residual rate of lesions in 19 patients with positive margins was 8/19, including 5 cases (5/19) of AIS and 3 cases (3/19) of CAC. The rate of negative margins after the last LEEP was 83.8% (98/117). The residual rate of lesions in 98 patients with negative margins was 17.4% (17/98), all of which were AIS residual, and no CAC residual. Univariate analysis showed that the risk of residual AIS or CAC in patients with positive resection margin was significantly higher than that in patients with negative resection margin (<i>OR</i>=3.465, 95%<i>CI</i>: 1.212-9.904; <i>P</i>=0.016). <b>Conclusions:</b> The efficiency of cervical cytology and colposcopy in the identification of AIS is low. Positive surgical margin after LEEP is associated with a higher residual risk of AIS and CAC. Patients with negative surgical margins have a low risk of residual invasive lesions, and fertility preservation treatment can be considered.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 9","pages":"739-747"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069250","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":"[A national questionnaire survey of the current status of diagnosis and treatment of endometriosis in China in 2024].","authors":"X Y Li, Y Dai, J H Shi, Y S Wu, Z Y Gu, C Y Zhang, Q T Li, H L Yan, Y Y Li, H Yu, J H Leng","doi":"10.3760/cma.j.cn112141-20260427-00229","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20260427-00229","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the current status of clinical practice and the implementation of existing guidelines for endometriosis in China, and to provide a reliable basis for relevant continuing medical education and future guideline revisions. <b>Methods:</b> A nationwide cross-sectional survey was conducted using convenience sampling. Doctors in obstetrics and gynecology or reproductive medicine were invited to complete an online questionnaire. The main survey contents included: the availability of specialized endometriosis clinics at the respondents' hospitals; the respondents' experience in diagnosing and surgically managing endometriosis; and their awareness and implementation of established clinical practice guidelines. Statistical analysis was performed on the collected valid questionnaires. <b>Results:</b> A total of 651 respondents from 30 provinces, municipalities, and autonomous regions across China participated, with 633 valid questionnaires collected. Obstetricians and gynecologists accounted for 92.73% (587/633) of the respondents, and over 90% held the professional title of attending physician or higher. 83.41% (528/633) of the respondents had performed or participated in surgical treatment for endometriosis. Compared to data from the survey in 2018, several indicators showed improvement: the establishment of specialized endometriosis clinics [9.97% (149/1 494) vs 22.91% (145/633)], the clinical implementation of the long-term management concept for endometriosis [35.54% (531/1 494) vs 54.34% (344/633)], and the routine clinical use of endometriosis fertility index scoring system [18.74% (280/1 494) vs 37.31% (197/528)]. Pain or dysmenorrhea (96.52%, 611/633) was the most valued diagnostic basis, and \"alleviating or eliminating pain\" (94.94%, 601/633) was the top treatment goal.\"How to prevent and protect fertility impaired by endometriosis\" (91.82%, 438/477) was the most anticipated topic for future guideline updates. 68.09% (431/633) of the respondents preferred combined estrogen-progestogen regimens for perimenopausal endometriosis, and 84.36% (534/633) of the respondents reported utilizing an add-back regimen to alleviate menopausal symptoms induced by gonadotropin-releasing hormone agonist. Furthermore, 90.36% (572/633) of the respondents reported observing mental and psychological disorders in patients with endometriosis. <b>Conclusions:</b> This survey provides contemporary insights into the diagnosis and management of endometriosis in China, revealing a clear trend toward increasingly standardized and refined practices. Furthermore, the survey identifies unmet clinical expectations regarding current guidelines, thereby providing valuable references for the panel to more effectively promote and guide the advancement of clinical practices for endometriosis in China.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 9","pages":"760-767"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069244","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":"[Analysis of risk factors for pathological upgrading after cervical conization in patients with CIN1].","authors":"Q Wang, Y Xiao, J Z Chao, Z L Ma, L Y Li, K J Tu","doi":"10.3760/cma.j.cn112141-20260224-00109","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20260224-00109","url":null,"abstract":"<p><p><b>Objective:</b> To explore the risk factors for pathological upgrading after cervical conization in patients with cervical intraepithelial neoplasia 1 (CIN1). <b>Methods:</b> A retrospective cohort study was conducted. A total of 1 416 CIN1 patients who underwent cervical conization in Jiangxi Provincial Maternal and Child Health Hospital from January 2021 to December 2023 were enrolled. According to whether the postoperative pathology was upgraded, they were divided into the pathological upgrading group (156 cases) and the pathological non-upgrading group (1 260 cases). The clinical data of the two groups were collected and compared, and the independent risk factors of pathological upgrading were screened by univariate analysis and multivariate binary logistic regression analysis. Based on binary logistic regression, a nomogram was constructed to predict the individualized probability of postoperative pathological escalation in CIN1 patients. <b>Results:</b> Among the 1 416 CIN1 patients diagnosed preoperatively, the postoperative pathological upgrade rate was 11.02% (156/1 416). Univariate analysis showed that there were statistically significant differences in the proportions of Thin-prep cytologic test (TCT) infection history in the past 5 years, TCT examination results>low-grade squamous intraepithelial lesion (LSIL), the number of lesions involved quadrants >2, and cervical biopsy pathology ≥CIN1 between the pathological upgrading group and the pathological non-upgrading group (all <i>P</i><0.05). Multivariate logistic regression analysis showed that TCT results >LSIL (<i>OR</i>=4.017, 95%<i>CI</i>: 2.375-6.791; <i>P</i><0.001), the number of involved quadrants >2 (<i>OR</i>=1.818, 95%<i>CI</i>: 1.257-2.627; <i>P</i>=0.001) were the independent risk factors for pathological upgrading after CIN1 surgery. The nomogram model was constructed based on the above two independent factors. When the patient had the two high-risk features of TCT results >LSIL and the number of involved quadrants >2, the total score reached the full score of 15.72, and the maximum risk of pathological upgrading was 41%. <b>Conclusions:</b> For patients with colposcopic biopsy confirmed CIN1, if TCT results>LSIL and/or lesion involved quadrants>2, the risk of missed high-grade squamous intraepithelial lesion (HSIL) is significantly increased. Therefore, more active diagnosis or treatment strategies should be taken for these high-risk patients. In addition, it is necessary to pay attention to colposcopy in postmenopausal women to reduce the missed diagnosis of HSIL.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 9","pages":"733-738"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069280","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":"[Predictive value of a combined prediction model for pathologic upgrade to endometrial carcinoma after hysterectomy in patients with endometrial hyperplasia].","authors":"L Han, L J Yao, D C Zhang, Z J Ma, X Y Li, Y F Zhang, Y Yan, S S Zhao, H Y Zhang, W Y Tian, Y M Wang, F X Xue","doi":"10.3760/cma.j.cn112141-20260421-00221","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20260421-00221","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the predictive value of combined prediction model for pathological upgrading to endometrial carcinoma (EC) after hysterectomy in patients with endometrial hyperplasia (EH). &lt;b&gt;Methods:&lt;/b&gt; A total of 109 EH patients who underwent hysterectomy in Tianjin Medical University General Hospital from March 2017 to January 2023 were retrospectively enrolled. According to the postoperative pathological results, they were divided into EC group (63 cases) and EH group (46 cases). The clinical data, hysteroscopic manifestations, ultrasound, pelvic magnetic resonance imaging (MRI) and tumor markers were collected. Binary logistic regression was used to analyze the independent risk factors and establish a combined prediction model, which was internally validated by Bootstrap repeated sampling method to evaluate the discrimination and calibration of the combined prediction model (hysteroscopy performance, ultrasound, MRI, tumor markers). The receiver operating characteristic curve and decision curve were drawn to analyze the predictive efficacy and net clinical benefit. &lt;b&gt;Results:&lt;/b&gt; (1) Univariate analysis showed that compared with the EH group, the EC group had a higher proportion of diabetes mellitus, a younger age at menarche, a longer duration of irregular menstruation, and a higher proportion of nulliparous and non-pregnant patients (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Under hysteroscopy, the proportion of endometrial polypoid change, irregular polypoid change, tumor necrosis and rupture, brain circuit or dendritic growth and hysteroscopy score in EC group were significantly higher than those in EH group (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Imaging examination showed that the endometrial thickness, detection rate of the mass, the proportion of enhanced endometrial echo, the abundance of endometrial blood flow, the proportion of unclear boundary between the endometrium and the muscle layer, the proportion of increased diffusion-weighted imaging (DWI) signal of the endometrium or the mass, and the proportion of interrupted combined zone in the EC group were higher than those in the EH group (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). The results of tumor marker detection showed that the serum human epididymis protein 4 (HE4) level in EC group was significantly higher than that in EH group (&lt;i&gt;P&lt;/i&gt;=0.005). (2) Multivariate analysis showed that diabetes mellitus (&lt;i&gt;OR&lt;/i&gt;=4.884), enhanced intimal echo under ultrasound (&lt;i&gt;OR&lt;/i&gt;=11.234), heterogeneous high signal on DWI (&lt;i&gt;OR&lt;/i&gt;=7.031), and elevated serum HE4 level (&lt;i&gt;OR&lt;/i&gt;=1.032) were independent risk factors for postoperative pathological upgrading of EH patients to EC (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). (3) The combined prediction model was established by combining the above indicators, and the area under the corrected curve was 0.811 (95%&lt;i&gt;CI&lt;/i&gt;: 0.720-0.902). The sensitivity of the combined prediction model in predicting postoperative pathological upgrade to EC in patients with EH was higher than that of hysteroscopy score (82.1","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 9","pages":"724-732"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069252","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":"[Value of serum estradiol and progesterone levels on hCG trigger day on clinical outcomes after fresh embryo transfer with GnRH antagonist regimen].","authors":"H F Wang, S Y Zhang, C Y Jiang, Y Zhang, C Yuan, J Y Liu, X Ma, Y Qian","doi":"10.3760/cma.j.cn112141-20260522-00277","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20260522-00277","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To evaluate estrogen and progesterone levels' impact and combined effects on clinical pregnancy rate and live birth rate in gonadotropin-releasing hormone antagonist regimen with fresh embryo transfer on human chorionic gonadotropin (hCG) trigger day. &lt;b&gt;Methods:&lt;/b&gt; The data of patients who underwent in vitro fertilization or intracytoplasmic sperm injection at The First Affiliated Hospital of Nanjing Medical University from January 2011 to January 2021 were collected. According to the number of retrieved oocytes, they were divided into the normal response group (5-15 oocytes) and the low response group (&lt;5 oocytes). The ovulation induction outcomes and pregnancy outcomes of the two groups were compared. Statistical analysis was conducted using &lt;i&gt;t&lt;/i&gt; test or chi-square test, and confounding factors were adjusted through multivariate regression models, and the hormone cut-off values were determined. &lt;b&gt;Results:&lt;/b&gt; Among 3 595 patients, compared with the normal response group (&lt;i&gt;n&lt;/i&gt;=2 614), the age of women in the low response group (&lt;i&gt;n&lt;/i&gt;=981) had a negative impact on pregnancy outcomes (&lt;i&gt;P&lt;/i&gt;&lt;0.001), while the number of antral follicles, anti-Müllerian hormone, endometrial thickness and embryo quality were positively correlated with pregnancy outcomes (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Multivariate regression analysis indicated that in the normal response group, a higher level of estradiol on hCG trigger day were significantly associated with decreases in clinical pregnancy rate (&lt;i&gt;OR&lt;/i&gt;=0.965, 95%&lt;i&gt;CI&lt;/i&gt;: 0.946-0.984; &lt;i&gt;P&lt;/i&gt;&lt;0.001) and live birth rate (&lt;i&gt;OR&lt;/i&gt;=0.973, 95%&lt;i&gt;CI&lt;/i&gt;: 0.954-0.993; &lt;i&gt;P&lt;/i&gt;=0.008). In the low response group, higher progesterone level was associated with poorer pregnancy outcomes (clinical pregnancy rate: &lt;i&gt;OR&lt;/i&gt;=0.875, 95%&lt;i&gt;CI&lt;/i&gt;: 0.794-0.961, &lt;i&gt;P&lt;/i&gt;=0.006; live birth rate: &lt;i&gt;OR&lt;/i&gt;=0.876, 95%&lt;i&gt;CI&lt;/i&gt;: 0.793-0.966, &lt;i&gt;P&lt;/i&gt;=0.009). The hormone cut-off values: the estradiol cut-off values for the normal and low response groups were 14 000 pmol/L and 6 000 pmol/L respectively, and the progesterone cut-off values for the normal and low response groups were 5.8 nmol/L and 4.0 nmol/L. When hormone levels exceed the cut-off values, pregnancy outcomes significantly decline, and the negative impact on pregnancy outcomes was most significant when both hormones increase (clinical pregnancy rate: normal response group &lt;i&gt;P&lt;/i&gt;=0.010，low response group &lt;i&gt;P&lt;/i&gt;=0.020; live birth rate: normal response group &lt;i&gt;P&lt;/i&gt;=0.028，low response group &lt;i&gt;P&lt;/i&gt;=0.014). &lt;b&gt;Conclusions:&lt;/b&gt; In patients with normal response, compared with progesterone on hCG trigger day, the increase in estradiol significantly reduces the clinical pregnancy rate and live birth rate of fresh embryo transfer, which should be paid attention to. In patients with poor response, both higher progesterone and estradiol levels on hCG trigger day could significantly reduce the clinical pregnancy rate and live birth rate of fresh em","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 8","pages":"640-648"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905119","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":"[Inhibitory effect of phloroglucinol on eutopic stromal cells and ectopic stromal cells from endometriosis and its mechanism].","authors":"Y J Feng, L Zhang, M X Wang, Y B Hu, P Jin","doi":"10.3760/cma.j.cn112141-20260417-00214","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20260417-00214","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the inhibitory effects of phloroglucinol on eutopic stromal cells and ectopic stromal cells from endometriosis and its molecular mechanism. &lt;b&gt;Methods:&lt;/b&gt; The effect of phloroglucinol on the survival rate of endometriosis-derived eutopic stromal cells hEM15A and ectopic stromal cells ihESCs was detected by cell counting kit 8 method. The effect of phloroglucinol on cell migration were evaluated by scratch test and Transwell migration test. The level of reactive oxygen species (ROS) in cells was detected by the fluorescence probe method. The expression of nuclear factor erythroid 2-related factor 2 (NRF2), kelch like ECH associated protein 1 (KEAP1), glutathione peroxidase 4 (GPX4) proteins in KEAP1/NRF2/GPX4 pathway was detected by western blot. &lt;b&gt;Results:&lt;/b&gt; (1) The results of cell counting kit 8 method showed that phloroglucinol significantly reduced the cell viability of hEM15A and ihESCs [(47.89±1.93)% and (81.55±6.16)% after treatment with 5.550 mmol/L for 48 hours, (18.44±6.64)% and (66.09±1.63)% after treatment with 5.550 mmol/L for 72 hours, (23.20±4.95)% and (51.05±7.16)% after treatment with 11.100 mmol/L for 48 hours, (3.62±0.23)% and (40.14±2.63)% after treatment with 11.100 mmol/L for 72 hours; all &lt;i&gt;P&lt;/i&gt;&lt;0.05]. (2) Scratch test results showed that the cell migration rates of hEM15A cells and ihESCs cells at 24 hours time points without phloroglucinol (0 mmol/L) were (41.02±2.85)% and (41.60±1.77)%, respectively. Compared with the 0 mmol/L group of the respective cells, the migration rates of hEM15A and ihESCs cells treated with different concentrations (2.775, 5.550, 8.325, 11.100, 13.875 mmol/L) of phloroglucinol at 24 hours were significantly decreased [hEM15A cells were (21.28±2.96)%, (9.97±3.42)%, (3.39±0.79)%, (3.26±0.47)% and (2.38±0.11)%, ihESCs cells were (20.31±2.17)%, (17.17±1.44)%, (3.68±0.94)%, (2.96±1.19)% and (2.57±0.43)%; all &lt;i&gt;P&lt;/i&gt;&lt;0.05]. (3) The results of Transwell migration test showed that the numbers of migrated hEM15A and ihESCs cells were 196.00±14.00 and 73.67±5.51, respectively, at 24 hours without phloroglucinol (0 mmol/L) treatment. Compared with the respective 0 mmol/L group of the respective cells, there were no significant changes in the numbers of migration of the two cells in the 2.775 mmol/L group at 24 hours (190.30±42.59 and 68.33±16.56, respectively; all &lt;i&gt;P&lt;/i&gt;&gt;0.05). After treatment with the remaining higher concentration of phloroglucinol, the migration ability of hEM15A and ihESCs cells were significantly reduced (hEM15A cells were 131.70±29.96, 117.70±4.51, 83.33±12.42 and 42.33±13.87, ihESCs cells were 42.33±8.51, 41.00±9.54, 18.33±7.37 and 15.67±2.52; all &lt;i&gt;P&lt;/i&gt;&lt;0.05). (4) The results of ROS level detected by the fluorescence probe method showed that there were no significant changes in ROS levels in hEM15A cells and ihESCs cells after treatment with 2.775 mmol/L phloroglucinol for 24 hours (1.21±0.12 and 1.16±0.11, respectively; all &lt;i&gt;P&lt;/i&gt;","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 8","pages":"669-677"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905126","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":"[Efficacy and safety of hexaminolevulinate photodynamic therapy for CIN2].","authors":"F Chen, H J Ruan, X Y Chen, Y Wang, Y Z Zhang, Z X You, B Wei, W G Lyu, J Yu, X J Sheng, L M Feng, Q Zhou, L Sui, J D Wang, J L Wang, L Zhu, J H Lang","doi":"10.3760/cma.j.cn112141-20260311-00131","DOIUrl":"10.3760/cma.j.cn112141-20260311-00131","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the efficacy and safety of hexaminolevulinate photodynamic therapy (HAL-PDT) for the treatment of cervical intraepithelial neoplasia 2 (CIN2). <b>Methods:</b> Data of this study were derived from an international multicenter, randomized, double-blind, placebo-controlled phase Ⅲ clinical trial (the APRICITY study) conducted between October 2020 and July 2023, with medical records obtained from 61 medical centers across 7 countries. A subgroup analysis was performed in patients with histologically confirmed CIN2 from this trial. Participants were randomly assigned in a 2∶1 ratio to the HAL-PDT group [5% hexaminolevulinate ointment and a light-emitting diode (LED) light source device] or the placebo group (placebo ointment with a non-illuminating device). The primary endpoint was the response rate at 6 months after the initial treatment. Secondary endpoints included histological regression rate, high-risk human papillomavirus (HR-HPV) clearance rate. Safety endpoints included treatment-related adverse events (TRAEs). <b>Results:</b> A total of 182 patients with CIN2 were included (120 in the HAL-PDT group, 62 in the placebo group). Baseline characteristics were balanced between the two groups (all <i>P</i>>0.05). At 6 months, the response rate [49.2% (59/120) vs 22.6% (14/62), <i>P</i>=0.001] and histological regression rates [57.5% (69/120) vs 30.6% (19/62), <i>P</i>=0.001] in the HAL-PDT group were significantly higher than those in the placebo group. The colposcopic lesion clearance rate at 6 months was also higher in the HAL-PDT group than in the placebo group [60.6% (60/99) vs 32.7% (17/52), <i>P</i>=0.001]. The risk of disease progression was lower in the HAL-PDT group (<i>RR</i>=0.55, 95%<i>CI</i>:0.29-1.06; <i>P</i>=0.068). Analyses stratified by age, HR-HPV infection status, region, and lesion size consistently demonstrated benefit in the HAL-PDT group regarding response and histological regression rates. At the 12-month follow-up, HR-HPV clearance rates in the HAL-PDT group were significantly improved, reaching 45.9% for any HR-HPV subtype, 58.8% for HPV 16, and 55.4% for HPV 16/18. There was no statistically significant difference in the incidence of TRAEs between the two groups [31.1% (37/119) vs 25.8% (16/62), <i>P</i>=0.496]. The most commonly reported adverse events in the HAL-PDT group were increased vaginal discharge, abdominal pain, and vulvovaginal pain, all of which were mild and self-limiting. <b>Conclusion:</b> HAL-PDT demonstrated favorable efficacy and safety in patients with CIN2, providing a non-surgical treatment alternative for patients seeking fertility preservation and the maintenance of cervical integrity.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 8","pages":"649-657"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905185","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":"[Clinical evaluation of practical clinical classification system for cesarean scar pregnancy].","authors":"C Wang, Y Yao, Y Wang, R Li, J Qiao","doi":"10.3760/cma.j.cn112141-20260525-00279","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20260525-00279","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the clinical application value of practical clinical classification system for cesarean scar pregnancy (CSP). <b>Methods:</b> A total of 1 076 patients with CSP admitted to Peking University Third Hospital from January 2014 to December 2023 were retrospectively included in the study. According to the practical clinical classification system for CSP, the patients were divided into 5 groups (type Ⅰ, Ⅱa, Ⅱb, Ⅲa and Ⅲb). The clinical characteristics, diagnosis and treatment variance of different types of CSP patients were analyzed, and the treatment strategy recommended by this study was compared with that recommended by the practical clinical classification system. <b>Results:</b> The prevalence of type Ⅰ, Ⅱa, Ⅱb, Ⅲa and Ⅲb were 37.1% (399/1 076), 42.0% (452/1 076), 8.5% (91/1 076), 10.5% (113/1 076) and 2.0% (21/1 076), respectively. The median gestational age at diagnosis was 47 days, the median length of hospital stay was 2 days, the median hospitalization cost was 5 816 yuan, the median operation time was 36 minutes, the median intraoperative blood loss was 23 ml, and 5.6% (60/1 076) patients had intraoperative blood loss≥300 ml; 2.6% (28/1 076) patients received blood transfusion, 94.9% (1 021/1 076) patients underwent minimally invasive surgery. There were significant differences in the above indicators between the 5 groups (all <i>P</i><0.05). The treatments of 86.0% (925/1 076) patients were consistent with the recommendations of the practical clinical classification system. There were 7.7% (83/1 076) patients had more minimally invasive treatment compared with the recommendations, all of which were type Ⅲ patients. There were 6.3% (68/1 076) patients had more invasive treatment compared with the recommendations, mainly were type Ⅱa, Ⅱb and Ⅲa patients. The first-line treatment was successful in 96.4% (1 037/1 076) patients. <b>Conclusions:</b> Practical clinical classification system for CSP has good discrimination and clinical applicability, and provides the principle of minimally invasive surgery. For the management of type Ⅲ patients, individualized evaluation should be carried out on the basis of flexible application of the practical clinical classification system, combined with the diagnosis and treatment conditions of medical institutions and the patient's condition.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 8","pages":"632-639"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905200","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}