复发性宫颈癌患者缺少有效的治疗方案，盆腔中心性复发的宫颈癌患者经盆腔廓清手术后，部分患者可以延长无疾病生存期，但需要面对手术创伤大、围手术期并发症严重、术后的器官功能改变以及生活质量下降等巨大风险。因而，对于复发性宫颈癌患者的治疗方案选择需要经过多学科团队合作，制定个体化的治疗方案。经过术前充分评估，提高手术切缘阴性，降低围手术期并发症的发生，采用脏器功能重建的手术方案的优化，从而达到盆腔廓清术在治疗肿瘤的同时，改善患者生活质量的目的。本共识是在总结国内外研究以及专家经验的基础上形成，其主要针对复发性宫颈癌实施盆腔廓清术的分类、不同廓清术类型的定义、适应证、禁忌证、术前评估、手术要点、围手术期管理及并发症防治、术后辅助治疗、预后及随访等问题进行归纳整理，旨在为复发性宫颈癌患者实施盆腔廓清手术提供指导性意见。

In response to the incidence of cervical intraepithelial neoplasia and cervical cancer in China and global screening strategies, a collaborative effort was undertaken by seven Chinese medical societies to develop this guideline for cervical cancer screening. The guideline recommends high-risk human papillomavirus (hr-HPV) nucleic acid detection as the preferred method for primary screening, which should have been approved by authoritative institutions and clinically validated for primary screening. In areas without access to HPV nucleic acid testing, cytology can be used as an alternative. However, it is recommended to replace cytology with HPV-based screening as conditions permit. Cotesting (HPV testing in combination with cytology) is recommended for areas with sufficient medical resources, opportunistic screening populations, and partial special populations. The guideline recommends that individuals with a cervix initiate cervical cancer screening at age 25 years and undergo HPV testing alone or cotesting every five years, or cytology alone every three years. Women over the age of 65 who have had documented adequate negative prior screening in the past may discontinue screening. Corresponding screening programs are proposed for different special populations. The development of these guidelines is an important step in the effort to eliminate cervical cancer in China.

Anal intraepithelial neoplasia (AIN) is a precancerous condition that precedes anal squamous cell carcinoma. Diagnosis often involves the use of high-resolution anoscopy (HRA) and anal HPV examination. Unlike the well-established cervical cancer screening system, AIN research and clinical practice worldwide are relatively new, resulting in a lack of unified diagnostic and treatment standards for anal precancerous lesions. In recent years, international, American, and European institutions have introduced consensus guidelines on the diagnosis and treatment of HPV-related anal diseases, including HRA screening. However, misconceptions regarding the diagnosis and treatment of AIN still persist in clinical practice, leading to a significant number of missed diagnoses and misdiagnoses. This evidence-based consensus, based on existing international guidelines and the current situation in China, aims to summarize the terminology, epidemiology, etiology, clinical manifestations, diagnosis, treatment, and follow-up management of AIN. The goal is to comprehensively standardize the management of AIN, ultimately reducing the incidence of anal cancer.

出血性疾病所致的异常子宫出血是指由先天性及获得性因素导致血管、血小板、凝血、抗凝及纤维蛋白溶解等止血机制缺陷或异常而引起的女性月经过多、经期延长及经间期出血，可发生危及生命的阴道大出血。根据国内外研究结果和相关指南，结合临床实践经验，制定了本共识，共识中阐释出血性疾病所致的异常子宫出血的病因、分类、诊断、治疗、长期管理及其他需关注的问题，以便对临床医师起到指导作用。

Objective To investigate the clinical value of hysteroscopic resection of lesions combined with megestrol acetate (MA) in the treatment of endometrial carcinoma (EC) with fertility preservation. Methods The clinical data ofⅠa EC patients who received fertility preservation therapy from December 2012 to December 2020 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. A total of 53 patients underwent hysteroscopic surgery, including 31 EC patients treated with hysteroscopic resection of lesions combined with MA as the hysteroscopic electrotomy group and 22 EC patients treated with hysteroscopy curettage combined with MA as the hysteroscopic curettage group. Endometrial pathological examination was performed every 3 months to analyze the treatment effect and pregnancy outcome of the two groups, and to evaluate the clinical value of hysteroscopic electrotomy. Results (1) The complete remission rate of hysteroscopic electrotomy group and the hysteroscopic curettage group were 87.1%(27/31) and 72.7%(16/22), the recurrence rate were 22.2%(6/27) and 6/16,the pregnancy rate were 29.6%(8/27) and 3/16, the successful delivery rate were 5/8 and 2/3, and the intrauterine adhesions rate which were mild and moderate were 12.9% (4/31) and 9.1% (2/22).There was no significant difference in them between the two groups (P＞0.05). Logistic regression analysis showed that intrauterine adhesion was not a factor affecting recurrence and pregnancy of EC patients (P＞0.05). (2) The median time of complete response in the hysteroscopic electrotomy group was shorter than that in the hysteroscopic curettage group (3 months: 6 months, P=0.004). After 3 months of treatment, the rate of complete response in the hysteroscopic electrotomy group was significantly higher than that in the hysteroscopic curettage group (58.1%:9.1%, P=0.001). (3) The complete response rate, recurrence rate and pregnancy rate were 85.1% (40/47), 27.5% (11/40) and 25.0% (10/40) in highly differentiated EC patients. Among the six case of moderately differentiated EC patients, 
3 had complete remission, 1 had recurrence, and 1 had full-term pregnancy, and had no significant difference between them (P＞0.05). Three moderately differentiated EC patients showed no pathological remission after 3 months of treatment, and underwent comprehensive staging surgery for endometrial cancer. During conservative treatment, there was no risk of disease progression such as deep muscle invasion and distant metastasis. Conclusions The patients who treated with hysteroscopic electrotomy combined with MA can achieve a higher complete remission rate in a relatively short time, and the probability of postoperative intrauterine adhesion is low and it does not affect the pregnancy of EC patients.

Objective To analyze the effects and influencing factors of acute and severe abnormal uterine bleeding （AUB） patients with thrombocytopenia. Methods The clinical data of 43 patients with acute and severe abnormal uterine bleeding caused by thrombocytopenia in Peking University People's Hospital from January 2014 to January 2019 were collected. The efficacy of acute hemostasis and chronic maintenance were retrospectively analyzed. Results The mean age of 43 patients was (40.56±9.94) years, and the platelet count <50×109/L accounted for 60.4%(26/43). Within one week of hysteroscopic hemostasis, 37.20%(16/43) patients had complete hemostasis, and 62.80%(27/43) patients still had a small amount of bleeding. The follow-up period ranged from 6 months to 5 years, 30.2%(13/43) of AUB symptoms were completely relieved, 39.5% (17/43) of AUB symptoms were partially relieved, and 30.2%(13/43) of AUB symptoms were not relieved. Whether to use drugs to control menstruation after operation had a very significant impact on the long-term improvement of symptoms during maintenance period (χ⊃2;=15.84, P<0.001). Conclusions In patients with acute and severe bleeding who have thrombocytopenia, it is effective on hemostasis by intrauterine surgery. Long-term application of medicine treatment during the chronic maintenance period can effectively prevent recurrence.

卵巢肿瘤不仅危害患者的生存，还可能损害患者的生育能力，尤其对15~39岁处于或即将踏入育龄期的年轻女性而言，大部分患者为早期肿瘤，长期生存率较高、预后较好，在治疗肿瘤的同时需考虑保留生育功能。在妇科肿瘤中，保留生育功能手术（fertility-sparing surgery, FSS）的应用越来越广泛。妇科肿瘤中的FSS主要指保留卵巢和/或子宫，使患者可以自然受孕或通过卵子捐献完成生育。在年轻卵巢肿瘤中，交界性肿瘤、恶性生殖细胞肿瘤、性索间质肿瘤和上皮性癌是常见的病理类型。对于不同病理类型的卵巢肿瘤，FSS的指征、手术范围和术后辅助治疗等有所不同。