高危型人乳头瘤病毒（HR-HPV）持续感染是导致子宫颈癌的主要病因，近年来，HPV核酸检测已逐渐成为子宫颈癌筛查的重要手段。随着对HPV基因型分布的深入研究和检测技术的不断进步，HR-HPV DNA载量(HR-HPV载量）作为一种反映疾病风险的重要指标，逐渐受到关注。当前研究显示，HR-HPV载量与病变的严重程度存在一定的相关性，同时，不同的检测技术也为其临床应用提供了多样化的选择。如何有效地基于HR-HPV载量进行风险分层和管理仍然面临诸多挑战,本专家共识阐述了HR-HPV载量与子宫颈上皮内病变和子宫颈癌的关系、HR-HPV载量的检测方法以及HR-HPV载量检测的临床应用，根据HR-HPV载量情况在子宫颈癌筛查和分流等方面提出推荐意见。

Persistent infection with high-risk human papillomavirus (HR-HPV) is the primary etiological factor for cervical intraepithelial neoplasia grade 2 (CIN 2). The accuracy of CIN 2 diagnosis is affected by the limitations of colposcopic biopsy and the variability in pathological interpretation. Underdiagnosis or overdiagnosis may lead to missed detection of more severe lesions or overtreatment. Particularly for young women and those with fertility requirement, overtreatment can increase the risk of adverse pregnancy outcomes in the future. Based on evidence-based medicine and China's national conditions, this consensus proposes refined management strategies for the CIN 2 women. Comprehensive consideration of multiple factors (including age, fertility needs, and lesion characteristics, etc) is required, for low-risk individuals eligible for conservative observation, close monitoring and dynamic assessment should be implemented. For high-risk individuals ineligible for conservative observation, it is recommended to undergo excisional treatment to reduce the risk of missed diagnosis and disease progression. For special populations of CIN 2: follow-up is the mainstay for pregnant women, with reassessment post-delivery; excisional treatment is preferred for postmenopausal women; and immunocompromised women require individualized assessment, enhanced monitoring, or active treatment.

近年来的研究已证实人类宫腔并非“无菌”状态，而是定植着多种微生物菌群。子宫腔内微生物的多样性及其代谢产物可以通过调节局部免疫环境影响生殖健康稳态，与复发性流产、反复种植失败、子宫内膜炎、子宫内膜异位症以及子宫内膜癌变等密切相关。然而，由于宫腔内的微生物群落丰度较低，属于典型的低生物量样本，其研究结果易受研究对象的选择、微生物取样、测序分析及污染控制等因素的影响，并可能导致无效或错误的分析结果。因此，本共识通过组织国内相关专家，系统整合国内外最新研究成果与实践证据，围绕子宫腔微生物组学研究的关键环节——包括研究设计、样本量计算、标准化采样流程、测序分析方法及污染控制等方面——形成系列推荐意见，旨在为相关领域研究提供兼具科学性与实操性的技术规范。

目的 观察促性腺激素释放激素激动剂（GnRH-a）结合戊酸雌二醇（EV）或替勃龙（TB）反向添加疗法在Ⅲ~Ⅳ期子宫内膜异位症（EMT）腹腔镜保留生育功能术后的应用及安全性。方法 选取2020年11月至2023年1月青岛大学附属青岛市海慈医院收治的147例行Ⅲ~Ⅳ期EMT腹腔镜保留生育功能术的患者进入研究，按随机数字表法将患者分为49例对照组（单纯GnRH-a），49例EV组（GnRH-a+EV）和49例TB组（GnRH-a+TB），均治疗6个月。比较三组间治疗前后子宫内膜异位症生育力指数（EFI）及子宫内膜厚度，卵巢功能，性激素指标[卵泡刺激素（FSH）、促黄体生成素（LH）和雌二醇（E2）]、骨代谢指标[骨钙素（BGP）、血钙及血磷]，血清糖类抗原125（CA125）、抗苗勒氏管激素（AMH）和抗子宫内膜抗体（EMAb）水平，记录三组不良反应的发生及术后复发情况。结果 治疗后，EV组和TB组EFI评分、卵巢窦卵泡数和卵巢储备功能正常率、BGP、血钙、AMH显著高于对照组（P＜0.05）；治疗后，EV组和TB组FSH、LH、E2、血磷、CA125、EMAb水平显著低于对照组（P＜0.05），但EV组和TB组间无显著性差异（P>0.05）。EV组和TB组间潮热盗汗发生率显著低于对照组（P＜0.05），三组间复发率无显著差异（P>0.05）。结论 GnRH-a结合EV或TB反向添加疗法应用于Ⅲ~Ⅳ期EMT腹腔镜保留生育功能术后，能有效地改善患者的卵巢功能及骨代谢状态，减少不良反应。

目的 探讨保妇康栓联合克林霉素磷酸酯阴道凝胶治疗细菌性阴道炎（BV）的临床疗效及对Th1/Th2平衡的调节作用。方法 选取2023年1-8月安徽医科大学附属安庆第一人民医院收治的BV患者90例，47例BV患者（对照组）采取克林霉素磷酸酯阴道凝胶治疗、43例BV患者（研究组）采取保妇康栓联合克林霉素磷酸酯阴道凝胶治疗，比较两组的治疗效果、阴道微生态恢复情况、阴道灌洗液Th1/Th2细胞因子水平和T淋巴细胞亚群变化，记录不良反应。结果 复诊时，与对照组相比，研究组胺试验阳性、阴道pH值>
4.5占比和阴道灌洗液IL-4、IL-10、IL-13水平均降低（均P<0.05），阴道微生态恢复率和阴道灌洗液IL-2、TNF-α、INF-γ、CD3+、CD4+和CD4+/CD8+水平升高（均P<0.05）。两组无不良反应发生。结论 保妇康栓联合克林霉素磷酸酯阴道凝胶治疗能提高BV疗效，恢复阴道微生态，调节阴道局部Th1/Th2失衡和免疫状态。

Objective By investigating the compositional characteristics of vaginal microbiome in vaginal laxity patients and the distributional/functional differences compared with non-laxity populations, this study explores the correlation between vaginal microbiome and vaginal laxity, providing novel insights for its diagnosis and treatment. Methods A total of 30 vaginal laxity reproductive-aged patients (case group) and 30 non-laxity women (control group) were recruited from Peking University People's Hospital between May and November 2024. Vaginal secretion samples were collected, and bacterial 16S rDNA amplification technology was used to extract vaginal microbiome genomic DNA. Bioinformatics software was employed for data processing to compare the composition, distribution, and genetic function differences of vaginal microbiome between the two groups. Results The case group was predominantly composed of Prevotella, Atopobium, and Anaerococcus, while the control group showed Lactobacillus dominance with slightly higher Streptococcus abundance compared to cases. No significant α-diversity differences were observed (P>0.05), with highly overlapping Rank Abundance curves. β-diversity analysis demonstrated significant separation (Anosim R=0.117, P=0.01; Adonis R2=0.072, P=0.015). LEfSe-ROC integrated analysis identified biomarker genera: Peptoniphilus (AUC=0.74), Finegoldia (AUC=0.72), Prevotella (AUC=0.71), Porphyromonas (AUC=0.70), Atopobium (AUC=0.69), and Corynebacterium (AUC=0.69). Significant differential expression (P<0.05) was detected in multiple metabolic pathways and enzymatic synthesis gene pathways between groups. Conclusions Vaginal laxity in reproductive-aged women is correlated with vaginal microbiome composition.

Objective To analyze the effects of phloroglucinol on the process of vaginal delivery, maternal-infant outcomes and neonatal umbilical artery blood gas. Methods A total of 800 parturients who underwent vaginal delivery in Jiaozhou Central Hospital of Qingdao from January 2020 to December 2022 were selected as the study subjects. They were divided into a control group (400 cases, routine obstetric intervention) and an observation group (400 cases, treatment with phloroglucinol during labor based on the control group) using the random number table method. Labor process, pregnancy outcomes, neonatal outcomes and neonatal umbilical artery blood gas analysis results were compared between the two groups. Results The first and second stages of labor in the observation group were shorter than that in the control group (P<0.05). The incidence rates of postpartum massive hemorrhage and laceration of the cervix were lower in the observation group (P<0.05). The fetal distress rate was lower, and the 1-minute Apgar score was higher in the observation group (P<0.05). At 1 min, PaO2 and pH values in the observation group were higher, and PaCO2 was lower as compared to the control group (P<0.05). Conclusion Applying phloroglucinol during labor can significantly shorten the labor process, improve pregnancy outcomes, reduce adverse neonatal outcomes, and improve neonatal blood gas indicators to a certain extent.

Objective To establish and verify the risk prediction nomogram model of abnormal lipid metabolism in women with gestational diabetes mellitus (GDM). Methods From June 2022 to December 2023, 1246 patients with GDM who visited Lianyungang First People's Hospital were stochastically separated into a training set (623 cases) and a validation set (623 cases) in a 1:1 ratio. According to the incidence of abnormal lipid metabolism in GDM pregnant women, they were assigned into two groups: GDM complicated with abnormal lipid metabolism group and GDM uncomplicated with abnormal lipid metabolism group. Logistic regression analysis was used to screen for risk factors, and a column chart was drawn to evaluate its discrimination and consistency. Results Age of ">35 years old" (OR=2.084, P=0.000), first-time delivery (OR=2.619, P=0.000), family history of hyperlipidemia (OR=2.588, P=0.000), concurrent PCOS (OR=3.665, P=0.000), and insulin resistance (OR=2.192, P=0.001) were independent risk factors for GDM complicated with abnormal lipid metabolism. In the training set, the area under the ROC curve was 0.711 (95% CI: 0.666-0.756), the slope of the calibration curve was close to 1, and the Hosmer-Lemeshow goodness of fit test had (χ2=6.028, P=0.420). In the validation set, the area under the ROC curve was 0.682 (95% CI: 0.633-0.730), and the slope of the calibration curve was close to 1. Conclusions The nomogram model for predicting the risk of GDM complicated with lipid metabolism abnormalities based on the age of ">35 years old", first-time delivery, family history of hyperlipidemia, concurrent PCOS, and insulin resistance has good discrimination and consistency.

Objective To explore the abnormal early cleavage development and pregnancy outcomes of embryos in vitro fertilization embryo transfer using time-lapse imaging. Methods 232 patients who underwent in vitro fertilization embryo transfer (IVF-ET) in Nanyang First People's Hospitalfrom June 2021 to June 2023 were selected, and the early cleavage of the embryos was observed using Time Lapse technology. The differences in various indicators between normal cleavage and abnormal cleavage were analyzed. At the same time, 200 conventional IV-ET patients were selected as the control group. Results The number of transplantable embryos and blastocysts formed in the observation group were (4.65±1.01) and (2.66±0.94), respectively, which were higher than those in the control group (P<0.05). A total of 
2 250 embryos with normal cleavage after fertilization were obtained, the normal cleavage rate was 59.20% and an abnormal cleavage rate was 40.80%.Direct cleavage was the main type of abnormal cleavage, the incidence rate was 16.71%. The incidence of abnormal cleavage in patients aged≥35 years old was 49.73%, which was significantly higher than that in patients aged <35 years old (P<0.05). The high-quality embryo rates of disordered cleavage and mixed abnormal cleavage D3 were 0.00% and 13.21%, respectively, was lower than those of normal cleavage (P<0.05). The formation rate of normal cleavage blastocysts was 76.88%, was higher than that of all abnormal cleavage embryos (P<0.05). The rates of high-quality blastocysts in reverse cleavage, disordered cleavage, and mixed abnormal cleavage were 20.69%, 0.00%, and 4.46%, respectively, was lower than those in normal cleavage (P<0.05). The clinical pregnancy rate of cleavage stage embryos in the normal cleavage group was 74.55%, was higher than that in the direct cleavage and cytoplasmic abnormalities fluctuation group (P<0.05). Conclusions Time capture helps to observe the early abnormal cleavage development of IVF-ET embryos, and early abnormal cleavage embryos can be utilized through blastocyst culture.

Objective To investigate the serum levels of miR-136 and miR-889 in patients with gestational diabetes mellitus (GDM) and their clinical significance. Methods 108 cases of GDM patients diagnosed and treated at Qingdao Women's and Children's Hospital from June 2020 to June 2023 (as the study group), and another 108 cases of normal pregnant women who underwent pregnancy test in the same period of time in our hospital were selected (as the control group); real-time fluorescence quantitative PCR (qRT-PCR) was applied to detect serum levels of miR-136 and miR-889; Pearson method was applied to analyze the correlation between serum miR-136, miR-889, fasting blood glucose (FBG), and insulin resistance index (HOMA-IR); Factors affecting pregnancy outcome in GDM patients were analysed by logistic regression; the value of serum miR-136 and miR-889 in predicting pregnancy outcome in GDM patients was analysed by ROC curve analysis. Results The FBG, HOMA-IR, and serum miR-136 levels in the test group were obviously higher than the reference group (P<0.05), while serum miR-889 level was obviously lower (P<0.05). The FBG, HOMA-IR, and miR-136 levels in the adverse group were obviously higher than those in the good group (P<0.05), while the miR-889 level was obviously lower (P<0.05). According to Pearson correlation analysis, serum miR-136 and miR-889 levels were negatively correlated (P<0.05), and serum miR-136 and miR-889 were associated with both FBG and HOMA-IR (both P<0.05). Conclusions Serum miR-136 levels are increased and miR-889 levels are decreased in GDM patients, both of which are associated with pregnancy outcomes in GDM patients.

Objective To investigate the significance of vaginal microbiota testing in the early and late pregnancy. Methods A total of 2 142 pregnant women who gave birth at term in Beijing Tsinghua Changgung Hospital from June 2022-December 2023 were selected, study on vaginal microecosystem of the prenatal examination conducted using a self-controlled case series design was included in the descriptive differences of 2 142 full-term deliveries during early and late pregnancy, the differences in flora and morphology of vaginal discharge, as well as thepathogenesis characteristics of vaginitis, were compared with 6~8 weeks of gestation as the early pregnancy group and 36~38 weeks of pregnancy as the late pregnancy group. Results ① In the late pregnancy group, the proportion of vaginal microbiota diversity and microbiota density of ++~+++ were 63.6% and 99.5%, respectively, the proportion of G+b(L) lactobacillus as the dominant bacteria in the vagina was 93.7%, and the proportion of Lactobacillus gradeⅠ~Ⅱa was 93.6%, which were higher than those in the early pregnancy group (60.4%, 98.0%, 91.8% and 91.3%, respectively), and the differences were statistically significant (all P<0.05). ② The infection rate of vaginitis in the late pregnancy group (10.4%) was lower than that in the early pregnancy group (15.9%), and the difference was statistically significant (P<0.001), among which the incidence of simple aerobic vaginitis (AV), bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) in the late pregnancy group were 1.9%, 0.7% and 6.3%, which were lower than those in the early pregnancy group (3.1%、1.4% and 9.2%), and the differences were statistically significant (all P<0.05). The incidences of mixed vaginitis in early and late pregnancy were 2.3% and 1.5%, respectively, and the difference was not statistically significant (P=0.057), the mixed infection rate of AV+BV in early pregnancy (1.0%) was higher than that in late pregnancy (0.4%), and the difference was statistically significant (P=0.028). ③ A total of 67 cases of AV alone in the early pregnancy, of which 10 cases (14.9%) were still in the state of AV infection in the late pregnancy, which was a state of continuous infection during pregnancy. 57 cases were cured, with a cure rate of 85.1%; There were 29 patients with BV alone and 196 patients with VVC alone in the early pregnancy, and 89.7% and 67.4% were cured during pregnancy, respectively. A total of 41 patients with AV alone were detected in the late pregnancy, of which 31 (75.6%) were newly infected. There were 15 patients with BV alone and 135 patients with VVC alone in late pregnancy, of which 12 (80.0%) and 71 (55.6%) were newly infected, respectively. Conclusions There are differences in the types, distribution and morphology of vaginal microbiota in the early and late pregnancy, and the vaginal microbiota detection is used for asymptomatic screening during pregnancy, and the precise treatment of vaginitis is carried out in combination with the clinical symptoms of pregnant women, so as to reduce the incidence of vaginitis in late pregnancy.

女性肿瘤生殖研究（reproductive research in female cancer）逐渐成为当前的热点领域，涉及内容涵盖肿瘤生殖学的定义、发展历程以及国内外研究重点的差异；包括卵巢移位、卵子冷冻与胚胎冷冻等生育保护技术在临床中的应用成效，以及放化疗对生育功能的影响及其面临的伦理、法律与管理挑战。研究这些因素的作用有助于揭示肿瘤的发生机制，并为早期诊断和精准治疗提供新的思路。本文将回顾女性肿瘤生殖研究的最新进展，为未来相关领域的研究提供参考。

压力性尿失禁（SUI）是中老年女性的常见病，本共识在2012年《北京大学女性压力性尿失禁诊疗指南（草案）》的基础上，通过整合多学科专家意见，结合最新循证医学证据和临床实践进展，对女性SUI的诊治进行了全面更新，系统阐述了该疾病的流行病学特征、发病机制、临床评估方法及分级治疗方案，旨在为SUI女性患者的诊断、咨询和治疗提供一个临床标准化框架。

Objective To explore the molecular typing of elderly endometrial cancer and its clinical significance, and to provide a basis for individualized treatment. Methods A retrospective analysis was conducted on the general conditions, molecular typing, pathological features, surgical methods, and adjuvant therapy of 54 patients with endometrial cancer admitted to the Department of Obstetrics and Gynecology of the Third Center of the PLA General Hospital from May 2021 to August 2024. The oncological outcomes of the patients were followed up. Results The average age of the patients was (68±5.59) years, the average BMI was (26.6±3.92) kg/m2, and the average age of menopause was (54±3.63) years. There was a significant difference in the distribution of the p53abn subtype among different age groups (P=0.039). There were no significant differences in FIGO stage, pathological type, pathological grade, myometrial invasion, LVSI, risk factors, surgical methods, and adjuvant therapy among different age groups (P>0.05). The median follow-up time was 21.2 months (3 to 60 months), and there was no significant difference in overall survival among different age groups (P>0.05). Conclusions The introduction of molecular typing provides a new direction for individualized treatment decisions for elderly endometrial cancer, and emphasizes the survival concern for elderly patients, especially those over 70 years old.

晚期上皮性卵巢癌的高复发率和死亡率推动了对一线维持治疗的探索。近年来，贝伐珠单抗、聚腺苷二磷酸核糖聚合酶（PARP）抑制剂和免疫治疗的单药或联合治疗作为一线维持治疗取得了新的进展。本文综述了其在无进展生存期（PFS）和总生存期（OS）中的影响，及其对不同BRCA/HRD基因状态患者的疗效，并为个体化治疗提供参考。研究表明，贝伐珠单抗针对卵巢上皮癌患者PFS获益显著，PARP抑制剂对BRCA突变患者更为敏感，同源重组修复缺陷（HRD）阳性患者对联合用药表现出更积极的反应。此外，免疫治疗仍在研究阶段，但在HRD阳性和PD-L1高表达者中显示出潜在疗效。

叶酸代谢是胚胎发育过程中必需的营养物质，在临床研究中发现还原型叶酸转运蛋白SLC19A1表达异常导致叶酸的转运异常，导致胚胎停育的发生，并在多种先天性疾病及肿瘤的发生和发展中发挥重要的调控作用，但其确切机制尚未被完全揭示。本文就SLC19A1在妊娠相关疾病的研究进展进行综述，以期为科学研究和临床治疗提供新的方向。

目的 探讨IRF 8基因甲基化水平与PCOS患者胰岛素抵抗、血糖水平和胰岛素水平之间的关系，以期为糖尿病的分子机制研究和新的治疗策略的开发提供新的线索。方法 选择2022年1月至2023年12月武汉科技大学附属普仁医院内分泌科及妇产科收治的86例PCOS患者作为实验组，选择同期本院86例健康女性作为对照组。测定两组的空腹血糖（FBG）、空腹胰岛素（FINS）水平，计算胰岛素抵抗指数（HOMA-IR），通过加甲基化特异PCR（MSP）检测IRF 8甲基化状态，并用Logistics回归分析IRF 8甲基化水平对糖代谢指标的关系。结果 PCOS组IRF甲基化水平、胰岛素抵抗指数明显高于健康对照组，同时IRF 8的甲基化水平在高胰岛素抵抗组、高血糖组和高胰岛素组中都明显高于对应的低组。实验结果表明IRF 8的甲基化水平与胰岛素抵抗、血糖水平和胰岛素水平都有显著的正相关。结论 本研究结果揭示了IRF 8的甲基化水平可能是导致PCOS患者胰岛素抵抗、血糖升高和胰岛素升高的一个重要因素，为进一步研究PCOS患者糖尿病的分子机制，以及开发新的治疗策略提供了新的线索。

Objective To investigate the expression of serum interleukin-1β(IL-1β) and matrix metalloproteinase-2 (MMP-2) in patients with intrauterine infection of Group B streptococcus (GBS) in late pregnancy and their relationship with neonatal outcomes. Methods Data from 140 patients with late pregnancy GBS intrauterine infection in the Second Affiliated Hospital of Soochow University from January 2020 to December 2023 were collected and set as the study group. Data from 140 healthy late-pregnancy pregnant women during the same period were collected and divided into the control group. Serum IL-1β and MMP-2 tests were performed on both groups upon admission. The incidence of adverse neonatal outcomes in the study group was statistically analyzed and grouped. The levels of serum IL-1β and MMP-2 in each group were compared. The levels of serum IL-1β and MMP-2 in each group were compared. The relationship between serum IL-1β and MMP-2 expression levels and adverse neonatal outcomes was analyzed. Results The serum levels of IL-1β and MMP-2 in patients with GBS intrauterine infection in late pregnancy were higher than those in the control group (P<0.05). Among 140 patients with late pregnancy GBS intrauterine infection, 41 had adverse neonatal outcomes, with an incidence rate of 29.29%. The serum IL-1β and MMP-2 levels in the adverse outcome group were higher than those in the good outcome group (P<0.05). The Logistic regression analysis results showed that adverse neonatal outcomes in patients with GBS intrauterine infection in late pregnancy may be related to the upregulation of serum IL-1β and MMP-2 levels (OR>1, P<0.05). There was an interaction between serum IL-1β and MMP-2 on adverse neonatal outcomes in patients. Conclusions The abnormal up-regulation of serum IL-1β and MMP-2 expression in patients with GBS intrauterine infection in late pregnancy may indicate the risk of neonatal adverse outcomes.

Objective To explore the relationship between peripheral blood NOD-like receptor protein 3 (NLRP3), C1q/tumor necrosis factor-related protein 6 (CTRP6), interleukin-1β (IL-1β) and pregnancy outcomes of in vitro fertilization-embryo transfer (IVF-ET) in infertility patients with polycystic ovary syndrome (PCOS). Methods A total of 132 infertility patients with PCOS who underwent IVF-ET in Gynecology Department of Nantong Hospital of Traditional Chinese Medicine, Jiangsu, were enrolled between July 2022 and May 2024. According to pregnancy status after IVF-ET, they were divided into a pregnancy group (63 cases) and a non-pregnancy group (69 cases). The clinical data and levels of serum NLRP3, CTRP6 and IL-1β in the two groups were compared. The influencing factors of pregnancy rate were analyzed by Logistic regression analysis. The predictive value of serum NLRP3, CTRP6 and IL-1β before IVF-ET in pregnancy rate was analyzed by receiver operating characteristic (ROC) curves. Results The age, body mass index(BMI), triglyceride, testosterone, serum NLRP3, CTRP6 and IL-1β in the non-pregnancy group were higher than those in the pregnancy group, and the number of dominant follicles was less than that in the pregnancy group (P<0.05). Increased BMI, serum NLRP3 and IL-1β were risk factors for  pregnancy failure, while increased CTRP6 was a protective factor (P<0.05). The AUC and sensitivity of serum NLRP3 combined with CTRP6 and IL-1β before IVF-ET for predicting pregnancy failure were 0.902 and 88.89%, respectively (P<0.05). Conclusions NLRP3, CTRP6 and IL-1β before IVF-ET have certain predictive efficiency for pregnancy outcomes in infertility patients with PCOS.

目的 为探究miR-195-5p表达水平异常在妊娠期高血压孕产妇胎盘绒毛滋养细胞凋亡中的作用。方法 选取2022年6月至2023年12月在南通市妇幼保健院收治的妊娠期高血压疾病（HDP）患者84例，根据临床诊断，分为妊娠期高血压组（n=48）和子痫前期组（n=36），同时选取同期本院的健康产检孕妇为对照组（n=80）。HE染色法检测各组胎盘组织的病理学变化、qPCR检测血清中miR-195-5p表达量、TUNEL染色检测胎盘绒毛细胞凋亡情况，Peason相关性分析miR-195-5p表达与胎盘绒毛细胞凋亡的相关性。结果 对照组胎盘结构完整，绒毛排列规则，滋养细胞层清晰，血管生成良好；妊娠期高血压组胎盘中部分绒毛结构紊乱，滋养细胞排列稍不规则，血管生成较正常组减少；子痫前期组胎盘中绒毛结构紊乱明显，滋养细胞排列紊乱，血管生成减少。miR-195-5p在妊娠期高血压、子痫前期中的表达水平显著低于对照组（P<0.05），且随疾病严重程度增加，miR-195-5p的表达水平逐渐降低。对照组滋养细胞凋亡较少，妊娠期高血压组、子痫前期组滋养细胞凋亡显著增加（P<0.05）。Peason相关性分析结果显示，血清miR-195-5p表达水平与胎盘绒毛细胞凋亡呈显著负相关（r=-0.642, P<0.05）。结论 miR-195-5p表达水平的异常可能参与了妊娠期高血压孕产妇胎盘绒毛滋养细胞的凋亡过程，有望成为HDP潜在的生物标志物及治疗靶点。

目的 分析血清血管内皮生长因子VEGF）、白细胞介素-8（IL-8）与宫腔粘连（IUA）患者宫腔镜下粘连分离术（TCRA）后再粘连的相关性。方法 回顾性采集2020年6月至2023年6月邢台市人民医院及河北医科大学第二医院妇科收治的110例IUA患者临床资料，根据患者术后1年内是否再粘连分为再粘连组和非再粘连组，并分析血清VEGF、IL-8与IUA患者TCRA后再粘连的关系。结果 再粘连组粘连性质为肌性占比、粘连范围＞2/3占比、粘连程度为重度占比、血清VEGF、IL-8水平均高于非再粘连组（P＜0.05）；Lasso回归及多因素Logistic回归分析，粘连性质为肌性、粘连程度为重度、VEGF、IL-8为IUA患者TCRA后再粘连的影响因素（P＜0.05）；绘制受试者工作特征（ROC）曲线显示，血清VEGF、IL-8单独及联合预测IUA患者TCRA后再粘连的曲线下面积分别为0.738、0.703、0.795；血清VEGF、IL-8对IUA患者TCRA后再粘连风险具有正向交互作用。结论 血清VEGF、IL-8与IUA患者TCRA后再粘连存在相关性，二者对再粘连风险具有正向交互作用，且可对预测TCRA后再粘连具有一定的价值。

DNA甲基化是表观遗传调控的重要机制之一。不断有研究表明DNA甲基化与肿瘤的发生发展有密切联系，利用DNA甲基化检测有望早期筛查肿瘤。宫颈脱落细胞是易于获得的临床样本，广泛应用于子宫颈癌的早期筛查中，但研究发现宫颈脱落细胞同样可以揭示其他部位肿瘤的存在。本文针对利用宫颈脱落细胞进行DNA甲基化检测在不同女性恶性肿瘤筛查中的应用进展进行综述，进一步为该项检测的临床应用提供参考资料。

Objective To observe the postoperative changes of transforming growth factor-β (TGF-β), stromal cell-derived factor-1 (SDF-1) and tight adhesion protein 1 (ZO1) levels in patients with endometrial polyps (EP), and to analyze the predictive value on the risk of intrauterine adhesion. Methods Patients with EP admitted to Sichuan People's Hospital from May 2021 to May 2023 were included. The levels of TGF-β, SDF-1 and ZO1 were determined after surgery, and their predictive value for intrauterine adhesion was analyzed. Results There were no obvious differences in the levels of TGF-β, SDF-1 and ZO1 between the intrauterine adhesion group and the non-intrauterine adhesion group before surgery (P>0.05). The expressions of TGF-β, SDF-1 and ZO1 3 days after surgery and the last follow-up revealed differences (P<0.05). The history of uterine curettage and multiple polyps were associated with postoperative intrauterine adhesion in EP patients (P<0.05). The TGF-β, SDF-1 and ZO1 levels were different among different degrees of intrauterine adhesion (P<0.05). The level of TGF-β in the severe adhesion group was higher than that in the mild adhesion group (P<0.05), and the level of SDF-1 in the moderate and severe adhesion groups was lower compared with that in the mild adhesion group (P<0.05), and the level of ZO1 in the severe adhesion group was lower compared to the mild and moderate adhesion groups (P<0.05). Spearman correlation suggested that the TGF-β level was positively correlated with the degree of postoperative intrauterine adhesion in EP patients (r=0.540, P<0.05), while the levels of SDF-1 and ZO1 were negatively correlated with the degree of postoperative adhesion (r=-0.478, -0.560, P<0.05). Logistic regression analysis indicated that history of uterine curettage, multiple polyps and TGF-β level were risk factors for postoperative intrauterine adhesion in EP patients (P<0.05), while SDF-1 and ZO1 were protective factors (P<0.05). ROC curve manifested that the AUCs of TGF-β, SDF-1 and ZO1 in evaluating postoperative intrauterine adhesion were 0.765, 0.709 and 0.866，respectively. Conclusions Postoperative intrauterine adhesion in patients with EP are related to abnormal levels of TGF-β, SDF-1 and ZO1, and these three indicators have certain predictive value on postoperative intrauterine adhesion.

目的 本研究旨在探讨妊娠期孕妇血清TTR、PLGF水平的变化，并评估其在诊断子痫前期中的价值。方法 选取南通大学附属医院2021年1月至2023年12月确诊为子痫前期的孕妇61例，另选取同期在本院正常孕检的孕妇61例，检测两组孕妇的血清TTR和PLGF水平。采用受试者工作特征（ROC）曲线分析TTR、PLGF在诊断子痫前期中的效能。结果 与正常妊娠组相比，子痫前期组的血清TTR水平和PLGF水平均显著降低（P<0.05）。logistics回归分析结果显示，BMI、自然流产史、妊娠期糖尿病、羊水过少、TTR、PLGF均是子痫前期发生的独立影响因素（P<0.05），ROC曲线分析显示，TTR和PLGF在诊断子痫前期时均有较高的准确性，其中TTR的曲线下面积（AUC）为0.911，PLGF的AUC为0.868。当TTR和PLGF联合应用时，诊断子痫前期的AUC可达0.949。结论 妊娠期孕妇血清TTR水平下降、PLGF水平下降均与子痫前期的发生发展有关。TTR和PLGF可作为诊断子痫前期的新型生物标志物，尤其在联合应用时，可提高诊断的准确性和敏感性。

目的 分析胎盘植入性疾病（PAS）患者产后大出血（PPH）的影响因素。方法 回顾性分析2020年1月至2023年1月成都市锦江区妇幼保健院收治的78例PAS患者的临床资料，根据是否发生PPH分为PPH组与非PPH组，比较两组的临床资料，采用logistic回归分析PPH危险因素。结果 26例发生PPH，发生率为33.33%。单因素及Logistic回归分析显示，孕期血小板减少（<150×109/L）、孕期贫血（Hb<110 g/L）、合并前置胎盘、超前超声评分≥10分、PPP、穿透型胎盘植入（PP）是PAS患者发生PPH的独立危险因素（P<0.05），术前纤维蛋白（FIB）水平是保护性因素（P<0.05）。结论 PAS患者具有较高的产后大出血发生风险，主要与孕期血小板减少、贫血、合并前置胎盘及胎盘植入类型等有关。

Objective Investigate the expression of hypoxia-inducible factor-1 (HIF-1), NADPH oxidase 4 (NOX4), NOD-like receptor protein 3 (NLRP3) in placenta and the value of combined detection on maternal and infant outcomes of preeclampsia patients. Methods 80 preeclampsia women who underwent regular prenatal examination and delivered in the Affiliated Hospital of Weifang Medical College from January 2024 to December 2024 were selected as the preeclampsia group, 50 normal pregnant women were selected as control group. The expression of HIF-1, NOX4, and NLRP3 in the placenta and their adverse evaluation value for maternal and infant outcomes in patients with preeclampsia were determined by Logistic multivariate regression analysis and ROC curve. Results The positive expression rates of HIF-1, NOX4 and NLRP3 in the preeclampsia group were 45.00%, 85.00% and 75.00% , respectively, which were higher than those in the control group (12.00%, 20.00% and 30.00%) (P<0.05). Compared with the good maternal and infant outcome group, the levels of 24 h urinary protein, D-dimer (D-D) and lactate dehydrogenase (LDH) at the last prenatal examination were higher in the poor maternal and infant outcome group, and the positive expression rates of HIF-1, NOX4 and NLRP3 were higher in poor maternal and infant outcome group (P<0.05). Logistic regression analysis showed that 24 h urinary protein, D-D, LDH, HIF-1 positive expression rate, HIF-4 positive expression rate, NLRP3 positive expression rate at the last delivery test were associated with adverse maternal and infant outcomes of preeclampsia patients (P<0.05). The sensitivity and AUC of HIF-1, NOX4 and NLRP3 in evaluating adverse maternal and infant outcomes in preeclampsia patients were 89.50% and 0.897, respectively. Conclusions HIF-1, NOX4 and NLRP3 have high positive expression rates in placental tissues of preeclampsia patients, and the combined detection has certain reference value in evaluating maternal and infant outcomes of preeclampsia patients.