中华妇产科杂志最新文献

{"title":"[Chinese Expert Consensus on GnRH-a in Obstetrics and Gynecology].","authors":"J H Lang, J H Leng, Q Yang, R Li, K Q Hua, G N Zhang, W W Cheng, C D Liu, S Z Yao, Y Dai, X L Fang, H Jiang, Z Q Liang, C Peng, R C Chian, G Y Wang, L J Wang, B R Xia, H Xu, T M Zhang, S M Zhou, Y F Xu, Y J Zhu, W Di","doi":"10.3760/cma.j.cn112141-20250529-00244","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250529-00244","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 12","pages":"913-925"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849051","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 body composition in infertile patients with endometriosis complicated with endometrial polyps].","authors":"X Feng, X Qin, F Tan, D M Xu, Q H Qu, L J Hao","doi":"10.3760/cma.j.cn112141-20250428-00177","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250428-00177","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the risk factors of endometrial polyps (EP) in patients with endometriosis (EM) and to analyze the predictive value of body composition measurement for EP. <b>Methods:</b> From January 1st, 2022 to June 30th, 2024, patients with EM who underwent hysteroscopy combined with laparoscopy in Chongqing Health Center for Women and Children due to \"infertility\" were enrolled. According to whether they had EP or not, they were divided into EP group and non-EP group. The general data and body composition (including skeletal muscle mass, body fat mass, body fat percentage and visceral fat level, waist-to-hip ratio, neck circumference, chest circumference, arm circumference, thigh circumference, etc.) of the two groups were compared. Univariate and multivariate logistic regression were used to analyze the high-risk factors of EP in infertile patients with EM. Body type was classified according to body fat percentage combined with lean body mass index. Body type classification and normal weight obesity rate were compared between the EP group and the non-EP group. <b>Results:</b> (1) A total of 180 patients with EM were enrolled, including 77 patients (42.8%, 77/180) in the EP group and 103 (57.2%, 103/180) patients in the non-EP group. There were no significant differences in body mass index (BMI), fasting blood glucose and blood lipid levels between the two groups (all <i>P</i>>0.05). The incidence of primary infertility, body fat mass, body fat percentage, visceral fat level, and thigh circumference in the EP group were higher than those in the non-EP group, and the differences were statistically significant (all <i>P</i><0.05). (2) Multivariate logistic regression analysis showed that age≥30 years old (<i>OR</i>=3.079, 95%<i>CI</i>: 1.594-5.947), primary infertility (<i>OR</i>=2.914, 95%<i>CI</i>: 1.482-5.729), visceral fat level ≥10 grade (<i>OR</i>=2.838, 95%<i>CI</i>: 1.584-5.729) were the risk factors of EP in infertile patients with EM (all <i>P</i><0.05). (3) In the EP group, there were no significant differences in BMI and body composition between single and multiple polyps, and between the largest polyp diameter <1 cm and ≥1 cm (all <i>P</i>>0.05). (4) The proportion of obese and puffy type in the EP group was higher than that in the non-EP group, and the difference in body type classification between the two groups was statistically significant (<i>P</i>=0.026). The proportion of patients with normal weight obesity in the EP group was significantly higher than that in the non-EP group [92.1% (35/38) <i>vs</i> 64.3% (36/56); <i>χ</i>²=9.480, <i>P</i>=0.002]. <b>Conclusions:</b> The occurrence of EP in infertile patients with EM is closely related to the increase of body fat mass, body fat percentage and visceral fat level, but not to BMI. The measurement of body composition is of great value for assessing the hidden obesity in infertile patients with EM.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 12","pages":"951-957"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849056","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 of low-dose mifepristone in patients with thrombotic disorders complicated by heavy menstrual bleeding].","authors":"X L Jiang, M Y Zhang, H N Su, X Yang","doi":"10.3760/cma.j.cn112141-20250415-00149","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250415-00149","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To evaluate the efficacy and safety of low-dose mifepristone (10-25 mg) in patients with thromboembolic disorders complicated by heavy menstrual bleeding (HMB). &lt;b&gt;Methods:&lt;/b&gt; The data of 13 patients (median age:37 years) with thrombotic disorders and HMB treated with low-dose mifepristone in Peking University People's Hospital from January 2020 to March 2025 were retrospectively analyzed. The changes of acute bleeding control, menstrual blood loss [assessed by pictorial blood loss assessment chart (PBAC)], hemoglobin level, coagulation function and quality of life [assessed by menorrhagia multi-attribute scale (MMAS)] were evaluated. &lt;b&gt;Results:&lt;/b&gt; (1) Among the 13 patients, venous thrombosis occurred in 8 cases (8/13), arterial thrombosis in 3 cases (3/13), and other types of thrombosis in 2 cases (2/13), including 1 case of local thrombosis after stent placement for anastomotic stenosis after renal transplantation, requiring long-term aspirin and clopidogrel, and 1 case of arteriovenous fistula thrombosis in a renal failure patient with long-term dialysis. (2) Nine patients (9/13) received antithrombotic medication, 1 patient (1/13) received inferior vena cava filter, and 3 patients (3/13) did not receive antithrombotic therapy due to platelet count &lt;50×10⁹/L and high risk of bleeding. (3) Management of acute bleeding stage: 6 patients with massive vaginal bleeding in emergency department were treated with dose reduction or withdrawal of antithrombotic drugs, 5 cases were treated with intrauterine Foley balloon compression hemostasis combined with mifepristone, 1 case was treated with oral norethindrone combined with mifepristone, and the bleeding was successfully stopped, and the antithrombotic therapy was resumed after 1-2 days. (4) Mifepristone treatment (median course: 6 months): 7 patients without bleeding were treated with oral mifepristone directly. All patients had amenorrhea after 1 month of treatment, and PBAC score (1, 3, 6 months), hemoglobin level and quality of life were significantly improved (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). During the follow-up period, there was no recurrence or new onset of thrombosis, and there were no statistically significant differences in coagulation function indexes (including prothrombin time, activated partial thromboplastin time, fibrinogen) compared with those before treatment (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). The level of D-dimer was lower than that before treatment, considering that it was related to the control of thrombotic diseases. Patients were subsequently transitioned to other modalities for long-term menstrual management. &lt;b&gt;Conclusions:&lt;/b&gt; Low-dose mifepristone is a viable bridging therapy for patients with thromboembolic disorders and HMB. It effectively induces amenorrhea, enabling patients to safely navigate high-risk periods for both thrombosis and bleeding without significantly impacting coagulation function. This approach facilitates subsequent long-term menstrual management and tr","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 12","pages":"943-950"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848854","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 characteristics and maternal and fetal outcomes of pregnancy complicated with chronic kidney disease stage 4-5].","authors":"X Z Zuo, X L Yang, X Mao, J R Yang, L R Lin, E Tian, X Xi, J Huang, L Y Wang, M F Zhou, Y Fan, P Yi, L L Yu","doi":"10.3760/cma.j.cn112141-20250712-00320","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250712-00320","url":null,"abstract":"<p><p><b>Objective:</b> To summarize the clinical characteristics, management and short-term and long-term outcomes of pregnant women with chronic kidney disease (CKD) stage 4-5. <b>Methods:</b> The clinical data of pregnant women with CKD stage 4-5 admitted by the multidisciplinary team (MDT) of CKD pregnancy management in the Third Affiliated Hospital of Chongqing Medical University from September 2019 to July 2024 were collected and retrospectively analyzed, including medical history, laboratory examination, pregnancy outcome, treatment options, and renal function outcome. To summarize the experience of prenatal counseling, pregnancy management, dialysis indications and lifestyle intervention in pregnant women with CKD stage 4-5. <b>Results:</b> A total of 10 pregnant women with CKD stage 4-5 were enrolled, aged (29.0±4.2) years (range: 23 to 36 years). Among the 10 cases, 3 cases were induced abortion in the second trimester, 1 case had missed abortion in the first trimester, and 6 cases were finally delivered successfully. Renal biopsy was performed in 4 cases to determine the type of primary nephropathy, and genetic testing was performed in 4 cases to confirm the diagnosis of hereditary nephropathy. Among the six CKD stage 4-5 pregnant women who successfully delivered, three started dialysis treatment in the second and third trimesters of pregnancy, and the other three started dialysis treatment immediately, 5.5 months and 18.3 months after delivery, respectively. All pregnant women were terminated by cesarean section and none of them had postpartum hemorrhage. The gestational age at delivery was (33.8±1.1) weeks (range: 32⁺¹ to 35⁺¹ weeks). All neonates were premature, with no fetal death and neonatal death. Two cases were small for gestational age and the other four were appropriate for gestational age. The length of neonatal intensive care unit (NICU) stay was (23.0±11.0) days (range: 10 to 38 days). No serious complications occurred during NICU stay. All newborns grew and developed well during the follow-up period of 10-60 months. <b>Conclusions:</b> CKD stage 4-5 is not an absolute contraindication for pregnancy. Comprehensive evaluation of doctor-patient shared decision-making on the premise of sufficient doctor-patient communication, precise management of MDT, close maternal and fetal monitoring, lifestyle medical intervention and timely initiation of dialysis can help pregnant women with CKD stage 4-5 achieve safe pregnancy and good maternal and fetal outcomes.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 12","pages":"934-942"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848898","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 outcomes of people with abnormal cervical cancer screening results but normal colposcopy findings].","authors":"J Zhang, J Zhao, R R Cui, T T Wang, H Feng, J X Li, J X Dong, Y Zhang","doi":"10.3760/cma.j.cn112141-20250423-00166","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250423-00166","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To analyze the clinical outcomes of people with abnormal cervical cancer screening results but normal colposcopic findings, and explore the reasons for missed detection high-grade cervical intraepithelial neoplasia Ⅱ and worse (CINⅡ&lt;sup&gt;+&lt;/sup&gt;). &lt;b&gt;Methods:&lt;/b&gt; People who underwent colposcopy at the Department of Obstetrics and Gynecology, Peking University First Hospital from January 1st, 2019 to December 31st, 2019 were selected. Those with normal colposcopic findings were included, some of them underwent biopsy, others were followed up for one year. Data including thinprep cytologic test (TCT) and high-risk human papillomavirus (HR-HPV)screening results, colposcopic image characteristics, and histopathological outcomes were collected for statistical analysis. Based on cytology results, people with normal colposcopic findings were divided into two groups: the low-risk group [negative for intraepithelial lesion and malignancy (NILM), atypical squamous cell of undetermined signification (ASCUS), and low grade squamous intraepithelial lesion (LSIL)] and the high-risk group [high-grade squamous intraepithelial lesion (HSIL), atypical squamous cells cannot exclude high-grade lesion (ASC-H), and atypical glandular cells (AGC)]. The detection performance of normal colposcopic findings was evaluated by calculating sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy. Furthermore, based on follow-up results, the missed detection rate of CINⅡ&lt;sup&gt;+&lt;/sup&gt;in these people and the reasons for missed detection were analyzed. &lt;b&gt;Results:&lt;/b&gt; A total of 1 584 women with normal colposcopic findings were included in this study; the median age was 39.0 years. Among them, 1 419 cases were in low-risk group, and 165 cases were in high-risk group. (1) All of the women in high-risk group underwent cervical biopsy, the CINⅡ&lt;sup&gt;+&lt;/sup&gt; missed detection rate was 37.58% (62/165). In contrast, 133 cases in low-risk group underwent cervical biopsy, of which 14 cases were immediate missed detection, while 1 068 cases who did not undergo cervical biopsy completed one year of follow-up, 16 and 6 new cases of CINⅡ&lt;sup&gt;+&lt;/sup&gt; were detected at 6 months and 1 year, respectively. Among the 16 new detected cases at 6 months, 12 of them were CINⅡ (1 was focal CINⅡ and 11 were multifocal CINⅡ) and 4 of them were CINⅢ. Among the 6 new detected cases at 1 year, 4 of them were CINⅡ (2 were focal CINⅡ and 2 were multifocal CINⅡ) and 2 of them were CINⅢ. (2) The immediate missed detection rate of CINⅡ&lt;sup&gt;+&lt;/sup&gt; in low-risk group was 1.17% (14/1 201), and the cumulative missed detection rate at one year was 3.00% (36/1 021). Normal colposcopic findings demonstrated a high negative predictive value (92.83%) for identifying CINⅡ&lt;sup&gt;+&lt;/sup&gt;, particularly in low-risk group (97.00%). However, the specificity was only 74.97%. (3) The TCT and HR-HPV results of women with missed detection of colposcopy were analyzed. All o","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 12","pages":"958-967"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848838","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":"[Practice effect of bundled management strategies for induction of labor: a single-center historical controlled study].","authors":"Q Sheng, S Q Zhang, T T Sha, Y Y Zhao, L Chen","doi":"10.3760/cma.j.cn112141-20250603-00252","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250603-00252","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the impact of bundled management of late-pregnancy induction strategies on induction time and maternal and perinatal clinical outcomes. &lt;b&gt;Methods:&lt;/b&gt; This was a historical control study, including 61 pregnant women before the implementation of the bundled management strategies for induction protocol in September 2024, and 78 pregnant women after the implementation in December 2024, who received regular prenatal check-ups and finally admitted to Peking University Third Hospital for elective induction of labor at term. The rate of successful induction, the rate of reaching active phase, induction to labor length, duration of labor, hospital stay, and adverse maternal and preinatal outcomes and other information were compared between two groups. Logistic regression model was used to analyze the factors affecting the rates of successful labor induction and reaching active phase. Kaplan-Meier survival curves were plotted for induction to labor length and duration of labor, and the Cox proportional hazards regression model was used to analyze the impact of the bundled management strategies for induction strategies on the above indicators. &lt;b&gt;Results:&lt;/b&gt; (1) Compared with the group before implementation, the group after implementation had a shorter induction to labor length (median: 47.4 vs 35.1 h), a shorter duration of labor (median: 14.0 vs 10.5 h), and a shorter hospital stay (median: 6 vs 4 d). The rate of successful induction increased [87% (53/61) vs 97% (76/78)], and the rate of reaching active phase increased [70% (43/61) vs 86% (67/78)]; the differences were statistically significant (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). (2) Multivariate logistic regression analysis showed that the implementation of the bundled management strategies promoted successful induction (&lt;i&gt;OR&lt;/i&gt;=7.299, 95%&lt;i&gt;CI&lt;/i&gt;: 1.189-44.800; &lt;i&gt;P&lt;/i&gt;=0.032) and reaching active phase (&lt;i&gt;OR&lt;/i&gt;=2.640, 95%&lt;i&gt;CI&lt;/i&gt;: 1.003-6.951; &lt;i&gt;P&lt;/i&gt;=0.049). A pre-pregnancy body mass index&lt;18.5 kg/m² promoted successful induction (&lt;i&gt;OR&lt;/i&gt;=9.142, 95%&lt;i&gt;CI&lt;/i&gt;: 1.154-72.423; &lt;i&gt;P&lt;/i&gt;=0.036). (3) Kaplan-Meier curve analysis indicated that compared with the group before the implementation, the group after the implementation had a significantly shorter induction to labor length (&lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=13.883, &lt;i&gt;P&lt;/i&gt;&lt;0.001) and a shorter duration of labor (&lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=5.72, &lt;i&gt;P&lt;/i&gt;=0.017). Cox proportional hazards regression analysis showed that the implementation of the bundled management strategies for induction protocol was a protective factor for shortening induction to labor length (&lt;i&gt;HR&lt;/i&gt;=1.806, 95%&lt;i&gt;CI&lt;/i&gt;: 1.186-2.749; &lt;i&gt;P&lt;/i&gt;=0.006) and duration of labor (&lt;i&gt;HR&lt;/i&gt;=1.677, 95%&lt;i&gt;CI&lt;/i&gt;: 1.066-2.637; &lt;i&gt;P&lt;/i&gt;=0.025). A cervical Bishop score &gt;3 at admission was a protective factor for shortening the induction to labor length (&lt;i&gt;HR&lt;/i&gt;=1.627, 95%&lt;i&gt;CI&lt;/i&gt;: 1.110-2.384; &lt;i&gt;P&lt;/i&gt;=0.013), and parity was a protective factor for shortening the duration of ","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 11","pages":"842-851"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647662","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 analysis of 33 cases of fetomaternal hemorrhage syndrome].","authors":"W J Hao, X X Wang, K X Ma, L Y Zou","doi":"10.3760/cma.j.cn112141-20250603-00251","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250603-00251","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the clinical characteristics, diagnosis and prognosis of pregnant women with fetomaternal hemorrhage (FMH) syndrome, and to guide the management of pregnant women with FMH syndrome. <b>Methods:</b> The clinical data of 33 pregnant women with FMH syndrome admitted to Beijing Obstetrics and Gynecology Hospital, Capital Medical University, from January 2010 to December 2024 were collected, and the general information, diagnostic characteristics, treatment and maternal and fetal prognosis were retrospectively analyzed. <b>Results:</b> The incidence of FMH syndrome in our hospital was 1.7/10 000 (33/194 272). The gestational age of onset of FMH syndrome in 33 pregnant women was (35.6±3.1) weeks, 15 cases (45%, 15/33) were full-term delivery and 18 cases (55%, 18/33) were preterm delivery. Decreased fetal movement (51%, 17/33) was the most common initial symptom, followed by abnormal electronic fetal monitoring (33%, 11/33). Thirty-two cases (97%, 32/33) underwent cesarean section, and only one case had spontaneous delivery. Postpartum hemorrhage occurred in 11 cases (33%, 11/33). All the neonates were transferred to neonatal intensive care unit for treatment. Two of them were treated with intrauterine blood transfusion, and the neonates did not receive blood transfusion after birth. The neonatal mortality rate was 6% (2/33), and the remaining 31 cases (94%, 31/33) survived. Complications occurred in 3 premature infants, including 1 case of neonatal neurodevelopmental disorder with cochlear implantation, 1 case of pulmonary artery stenosis, and 1 case of retinopathy of prematurity. Three pregnant women were pregnant again, and none of them had FMH syndrome. <b>Conclusions:</b> Decreased fetal movement or abnormal electronic fetal monitoring in late pregnancy should be alert to the occurrence of FMH syndrome. Early diagnosis and intervention are critical to improve the prognosis of FMH syndrome.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 11","pages":"860-867"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647705","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":"[Expert consensus on the clinical application of endometrial ablation].","authors":"H Zhao, L Li, L M Chen, Q Chen, S Deng, X Du, T Gao, Y Gao, L P Han, L Hong, X W Huang, X F Huang, Q Liu, X C Liu, L Sui, X L Sun, S Tang, Q J Tian, J L Tong, L Q Wang, G Y Wang, L H Wang, S M Wang, H Xu, M Xue, X Yang, X S Yang, J J Yu, L Q Zeng, P Zhang, Y Zhang, Y L Zhang, J W Zhou, J H Zhou, W P Zhu, Y J Zhu, J Zhu, L Zhu, L M Feng","doi":"10.3760/cma.j.cn112141-20250325-00106","DOIUrl":"10.3760/cma.j.cn112141-20250325-00106","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 11","pages":"833-841"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647666","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 implications of morular metaplasia in fertility-preserving treatment for endometrial hyperplasia and grade 1 endometrial endometrioid carcinoma patients].","authors":"S S Zhao, D C Zhang, T Li, Y Yan, B N Wang, T Q Wang, H Y Zhang, W Y Tian, X Zhao, D F Zhang, Y M Wang","doi":"10.3760/cma.j.cn112141-20250621-00285","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250621-00285","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the clinical significance of morular metaplasia (MM) in fertility-preserving treatment for young patients with endometrial hyperplasia and grade 1 endometrial endometrioid carcinoma. <b>Methods:</b> Clinical data was retrospectively collected from patients diagnosed with endometrial hyperplasia or grade 1 endometrial endometrioid carcinoma under 40 years old who underwent progestin-based fertility-sparing treatmentat in Tianjin Medical University General Hospital between January 2018 and November 2022.Patients were divided into the MM group (37 cases) and the non-MM group (63 cases) based on pathological findings. Clinical characteristics, hysteroscopic features, treatment efficacy and fertility outcomes were compared between the two groups. The MM group was further stratified into three subgroups based on the timing of MM occurrence:(1) MM-Bef group (<i>n</i>=10): MM was present in the initial endometrial curettage or hysteroscopic biopsy pathology before fertility-sparing treatment and disappeared after treatment; (2) MM-Sus group (<i>n</i>=14): MM persisted consistently before and after therapy;(3) MM-Aft group (<i>n</i>=13): MM was absent before therapy but appeared after treatment. The risk factors which had impact on the treatment outcomes of the patients were analyzed using univariate and multivariate Cox regression analysis. <b>Results:</b> The rate of polycystic ovary syndrome were higher in the MM group than the non-MM group [51% (19/37) vs 27% (17/63), <i>P</i>=0.014]. The complete response (CR) rate was significantly lower in the MM group than in the non-MM group [73% (27/37) vs 95% (60/63), <i>P</i>=0.006], and the median time to CR was significantly longer in the MM group (6.0 vs 5.0 months, <i>P</i>=0.005).Multivariate analysis identified that MM-Sus (<i>HR</i>=0.355, 95%<i>CI</i>:0.174-0.723; <i>P</i>=0.004) and MM-Aft (<i>HR=</i>0.314, 95%<i>CI</i>:0.145-0.681; <i>P</i>=0.003) were independent risk factors for delayed CR in fertility-sparing treatment. The patients in the MM group and non-MM group underwent hysteroscopic biopsy for 76 and 131 times. \"Gravel-like change\" was a more frequent hysteroscopic manifestation in the MM group than that in the non-MM group [18% (14/76) vs 2% (2/131), <i>P</i><0.001]. <b>Conclusions:</b> Patients in the MM group have poorer treatment outcomes than patients in the non-MM group. MM-Sus and MM-Aft are risk factors for fertility-preserving treatment in young patients with endometrial hyperplasia or grade 1 endometrial endometrioid carcinoma. \"Gravel-like change\" is the characteristic hysteroscopic manifestations of MM.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 11","pages":"868-875"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647640","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":"[Effects of hsa_circ_0019217 on the biological functions of human trophoblast cells and its mechanism in pre-eclampsia].","authors":"R T Shi, Y Q Chen, H N Liu, M W Li, Y M Wang","doi":"10.3760/cma.j.cn112141-20250525-00232","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250525-00232","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objectives:&lt;/b&gt; To investigate the effect of circular RNA (circRNA) hsa_circ_0019217 on the biological function of chorionic trophoblast cell line (HTR8/SVneo) and its mechanism in the occurrence of pre-eclampsia (PE). &lt;b&gt;Methods:&lt;/b&gt; The circRNA expression database was used to analyze the differentially expressed circRNA in placental tissues of PE women. The expression levels of hsa_circ_0019217 and miR-526b-5p were detected by reverse transcription real-time fluorescent quantitative PCR (RT-qPCR), and the subcellular localization of hsa_circ_0019217 was detected by fluorescence in situ hybridization. The proliferation, migration and invasion of trophoblast cells were detected by cell counting kit-8 (CCK-8) assay and transwell assay. Western blot and enzyme-linked immunosorbent assay (ELISA) were used to verify the effects of hsa_circ_0019217, miR-526b-5p and decorin (DCN) on matrix metalloproteinase 2 (MMP2), tissue inhibitor of metalloproteinase 2 (TIMP2), placental growth factor (PlGF) and human chorionic gonadotropin (hCG) protein expression levels. Dual luciferase reporter gene assay and RNA immunoprecipitation (RIP) assay were used to verify the interaction between hsa_circ_0019217, miR-526-5p and DCN. &lt;b&gt;Results:&lt;/b&gt; (1) The analysis of circRNA expression database showed that the expression level of hsa_circ_0019217 was significantly increased in the placental tissues of PE women (fold change=67, &lt;i&gt;P&lt;/i&gt;&lt;0.05), and it was mainly located in the cytoplasm. (2) Knockdown of hsa_circ_0019217 promoted the proliferation, migration and invasion of HTR8/SVneo cells, increased the expression levels of MMP2 and PlGF, and decreased the expression levels of TIMP2 and hCG in HTR8/SVneo cells. (3) Hsa_circ_0019217 targeted adsorption of miR-526b-5p, and inhibition of miR-526b-5p reduced the proliferation, migration and invasion of HTR8/SVneo cells. The expression levels of MMP2 and PlGF in HTR8/SVneo cells were increased, and the expression levels of TIMP2 and hCG were decreased. Hsa_circ_0019217 knockdown and inhibiting miR-526b-5p could reverse the effect of hsa_circ_0019217 knockdown on promoting the proliferation, migration and invasion of HTR8/SVneo cells, and reversed the effect of hsa_circ_0019217 knockdown on the protein expression levels of MMP2, PlGF, TIMP2 and hCG. (4) miR-526b-5p targeted DCN in HTR8/SVneo cells, hsa_circ_0019217 knockdown reduced the expression level of DCN, and inhibiting miR-526b-5p increased the expression level of DCN. When hsa_circ_0019217 and miR-526b-5p were inhibited simultaneously, there was no significant change in the protein expression level of DCN. (5) Overexpression of miR-526b-5p promoted the proliferation, migration and invasion of HTR8/SVneo cells, while overexpression of DCN inhibited the proliferation, migration and invasion of HTR8/SVneo cells. Simultaneous overexpression of miR-526b-5p and DCN reversed the effects of miR-526b-5p overexpression on cell proliferation, migration and invasion. Ov","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 11","pages":"876-889"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647634","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}