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 guidelineⅡfor cervical cancer screening. This guide focuses on standardizing methods for triaging abnormal cervical cancer screening results, with the aim of reducing overdiagnosis and missed diagnosis through refined management. Cervical cytology is currently the main triage method for individuals with positive high-risk human papillomavirus (HR-HPV) detection. Primary screening with cytology is managed based on the different risks of their results. In addition, p16/Ki-67 dual stain (DS) is acceptable for triage HPV-positive test results without genotyping or those positive for other (non-16/18) HR-HPV types (12 HR-HPV). It can also be used for triage in co-testing with HPV-positive results (no genotyping or 12HR-HPV) when the cytology result shows NILM, ASC-US and LSIL. Methylation is acceptable for triage of individuals testing 12 HR-HPV-positive. HPV gene integration testing could be used for the triage of HR-HPV positive individuals based on current research results in China. All these new testing methods must utilize reagents that have been approved by authoritative institutions and clinically validated for relevant indications. Additional clinical evidence is required for other methods such as HPV extended genotyping or HPV viral load, etc.

预防性人乳头瘤病毒（human papilloma virus， HPV）疫苗接种是预防HPV感染的有效方法，可降低HPV 感染相关疾病的发生。目前国内外临床试验及真实世界研究均表明，预防性HPV疫苗是安全的，具有很好的免疫原性、保护效力和保护效果。优先推荐9~26岁女性接种HPV疫苗，重点是9~14岁女孩；同时推荐27~45岁女性和9~26岁男性接种，倡导男女共防。对于HPV感染或细胞学异常人群、HPV相关病变治疗史人群、遗传易感人群、子宫颈癌发病高风险生活方式人群，以及免疫功能低下人群均推荐预防性HPV疫苗接种。接种HPV疫苗后仍应定期进行子宫颈癌筛查。

The incidence and mortality rates of cervical cancer in China are continuously rising, presenting a severe challenge for prevention and control. The integration of HR-HPV genes into the human genomic DNA sequence is the key molecular basis for the occurrence of cervical cancer. With the advancement of precision diagnosis and treatment concepts, the rational application of new high-throughput viral integration testing technologies can achieve precise stratification and risk management of HR-HPV positive patients. This expert consensus aims to standardize the application of HR-HPV gene integration testing in cervical cancer screening. Additionally, this consensus will focus on elucidating the role and molecular mechanisms of HR-HPV gene integration in the occurrence and development of cervical cancer, the methods and processes. It will also focus on providing recommendations on HR-HPV gene integration testing for HR-HPV infected individuals, those with abnormal combined screening results, patients with persistent cervical LSIL(CIN1), follow-up of cervical HSIL(CIN2), and clinical management after treatment of cervical HSIL (CIN2，CIN3). These recommendations aim to provide references for clinicians in decision-making for cervical cancer screening management, with the goal of accelerating the elimination of cervical cancer in China

p16/Ki-67双重染色检测（双染）作为一种相对客观的检测方法，已在多个国家获批应用于临床。本共识基于循证医学证据，对双染样本的取材与制备、检测流程、结果判读及报告规范达成共识，并推荐双染可用于高危人乳头瘤病毒（high-risk human papillomavirus, HR-HPV）初筛不分型阳性或部分分型其他12种（HR 12）阳性人群的分流；也可用于联合筛查时HR-HPV不分型阳性或部分分型HR 12阳性，且细胞学正常或轻度异常时的人群分流；还可用于筛查结果异常（HR-HPV检测或HR-HPV联合细胞学检测）后随访人群的分流。通过本共识的制定，旨在规范双染检测技术的临床应用，实施子宫颈癌精准筛查。

阴道镜检查是宫颈癌筛查异常者进一步检查的重要工具，高质量的阴道镜检查能够提高风险评估的准确性，进而对检查异常者进行规范管理。因此，保证阴道镜检查的质量至关重要，也关系到宫颈癌筛查的整体效果。为了规范阴道镜检查的实施与操作、高质量开展宫颈癌防控工作，特编写本共识，希望为开展阴道镜检查和管理的相关专业人员提供参考。本共识主要内容围绕阴道镜检查过程中需要进行质量控制的相关环节制订指标，包括阴道镜检查开展前、操作过程中以及阴道镜检查后的管理等。各地区或医疗机构在开展阴道镜检查内部和外部质量评估时可根据实际情况进行参考或在此基础上制定适合本地区或医疗机构的阴道镜检查质量控制指标，最终达到提高宫颈癌筛查质量，促进本机构学科发展的目的。

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 compare ovarian function changes and the mechanisms of aging and apoptosis in mouse models of premature ovarian failure (POF) induced by different doses of cyclophosphamide (CTX), and to identify the optimal modeling method. Methods Thirty female C57BL/6 mice aged 6~8 weeks were randomly divided into six groups: the Control group, POF1 group 120 mg/kg, POF2 group 200 mg/kg, POF3 group 50 mg/kg×14 days, POF4 group 400 mg/kg, and POF5 group 25 mg/kg×14 days. The mice received intraperitoneal injections of cyclophosphamide (CTX), respectively. The ovarian function, as well as changes in senescence and apoptosis, were recorded and compared under different CTX doses and administration frequencies in the POF mouse models. Results Compared to the control group, all model groups exhibited disrupted estrous cycles, reduced sex hormone expression, increased ovarian fibrosis, and a decrease in follicle count (P<0.05). The expressions of anti-Müllerian hormone (AMH) and follicle-stimulating hormone receptor (FSHR) were significantly reduced (P<0.05), and the severity of ovarian damage was positively correlated with CTX dose (|r|>0.500, P<0.05). Additionally, all model groups showed increased cellular senescence and apoptosis. In the POF1, POF2, and POF5 groups, the expressions of senescence-related molecules such as cyclin-dependent kinase inhibitor 2A (p16), cyclin-dependent kinase inhibitor 1A (p21), and senescence-associated β-galactosidase (β-gal) were significantly higher than those in the POF3 group (P<0.05). Conversely, in the POF3 group, apoptosis-related molecules such as Bcl-2-associated X protein (Bax), cysteine-aspartic acid protease 3 (Caspase3), and phosphorylated H2A histone family member X (γ-H2AX) were significantly more highly expressed than in the POF2 and POF5 groups (P<0.05). Conclusions CTX at different doses can induce POF in mice, with the severity of ovarian damage increasing in a dose-dependent manner. Lower doses of CTX primarily cause ovarian damage through cellular senescence mechanisms, while higher doses primarily induce ovarian damage through apoptosis.

Objective To explore the rehabilitation effect of abdominal muscle group autonomous training under real-time ultrasound feedback on postpartum patients with diastasis recti abdominis. Methods A total of 86 patients with postpartum diastasis recti abdominis who were treated in the 903 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from April 2021 to April 2023 were randomly divided into a control group and an observation group, with 43 cases in each group. The control group received an autonomous training intervention for the abdominal muscle group, while the observation group received real-time ultrasound feedback. The two groups received a total of 2 weeks of intervention. Before and after the intervention, the separation distance, abdominal circumference, and abdominal muscle thickness were measured for both groups were measured. The root mean square (RMS) of the maximum autonomous isometric contraction amplitude of the rectus abdominis was measured using surface electromyography, and the degree of back pain in both groups was evaluated using visual analogue scoring (VAS). Results After the intervention，the separation distance between the rectus abdominis muscles 3cm above and 3cm below the umbilicus decreased in both groups, with the observation group showing greater changes (P<0.05). After the intervention, both groups showed a decrease in abdominal circumference, an increase in abdominal muscle thickness, and an increase in RMS of the rectus abdominis. The observed group had a greater amplitude of change than the control group (P<0.05). After intervention, the degree of lower back pain in the observation group was milder than that in the control group (P<0.05). Conclusions Autonomous training of abdominal muscle groups under real-time ultrasound feedback can effectively promote the rehabilitation of postpartum patients with diastasis recti abdominis. It has a significant effect in reducing the distance and circumference between the rectus abdominis muscles, increasing the thickness of the abdominal muscles, enhancing the strength of the rectus abdominis muscles, and reducing back pain.

子宫内膜癌发病呈上升及年轻化趋势，成为全球公共卫生问题。子宫内膜癌发病具有明确的高危因素，从二级预防角度出发，建立高危人群子宫内膜癌筛查策略是降低子宫内膜癌发病率及死亡率的根本途径。优化现有筛查方法，开发新的筛查技术，提高筛查效率，降低医疗成本，制定适合中国高危人群的子宫内膜癌筛查策略，具有重要临床价值及现实意义。

Objective To analyzes the clinical characteristics and treatment outcomes of ovarian teratomas in 100 children and adolescent patients. Methods The data of 100 patients under 18 years of age who underwent surgical treatment for ovarian teratoma in the Department of Obstetrics and Gynecology, Peking University First Hospital from January 2010 to May 2022 were collected and analyzed. Results The 100 cases of ovarian teratomas constituted for 46.3% (100/216) of all ovarian tumors in hospitalized children and adolescents during the study period. Among these, 97% (97/100) were mature teratomas, and 3% (3/100) were StageⅠimmature teratomas. Adnexal torsion was observed in 13% (13/100) cases. The preoperative diagnostic accuracy of imaging modalities for teratomas was 60% (60/100) for ultrasound, 90% (18/20) for CT, and 58.3% (7/12) for MRI. Ultrasound detected adnexal torsion with 46.2% (6/13) accuracy. All 100 patients received surgical treatment, including 87 cases by laparoscopy and 13 cases by laparotomy. The tumor diameter in the laparotomy group was larger than that in the laparoscopy group (P<0.001), and the operation times (P=0.009), hospital stays (P<0.001) were longer. There was no significant difference in the risk of postoperative recurrence between the two surgical approaches (P=0.438). During a follow-up period ranging from 1 to 13 years, 5.3% (4/76) of patients experienced recurrence, with initial bilateral teratomas being associated with a higher risk of recurrence (P=0.040). Conclusions Ovarian teratomas, which are common in children and adolescents, have a relatively high risk of adnexal torsion. Laparoscopic ovarian tumor resection is the preferred treatment method.

Objective To investigate the diagnostic efficacy of plasma exosomal microRNA (miR)-21-5p, miR-146a-5p, and miR-151a-3p in cervical cancer. Methods Fifty-five patients who underwent radical surgery for cervical cancer from January 2021 to December 2023 were selected as the cervical cancer group. Thirty healthy individuals undergoing routine physical examinations during the same period were selected as the control group. The levels of plasma exosomal miR-21-5p, miR-146a-5p, and miR-151a-3p were measured and compared between the two groups and patients with different pathological characteristics of cervical cancer. The diagnostic efficiency of individual and combined plasma exosomal miR-21-5p, miR-146a-5p, and miR-151a-3p levels for cervical cancer was analyzed using receiver operating characteristic (ROC) curves. Results The expression levels of plasma exosomal miR-21-5p, miR-146a-5p, and miR-151a-3p were significantly higher in the cervical cancer group compared to the control group (P<0.05). Patients with FIGO stageⅡA1~ⅡA2 or poorly differentiated cervical cancer had higher levels of plasma exosomal miR-146a-5p and miR-151a-3p compared to those with FIGO stageⅠA2~ⅠB3 or moderately-to-well-differentiated tumors. Additionally, poorly differentiated cervical cancer patients had higher plasma exosomal miR-21-5p levels compared to those with moderately-to-well-differentiated tumors (P<0.05). ROC curve analysis showed a certain predictive efficacy for miR-21-5p, miR-146a-5p, and miR-151a-3p with areas under the curve (AUCs) of 0.843, 0.871, and 0.876, respectively. Combined detection of these plasma exosomal indicators yielded an AUC for cervical cancer diagnosis of 0.939, with a diagnostic specificity of 96.67%, sensitivity of 85.45%. Conclusions The levels of plasma exosomal miR-21-5p, miR-146a-5p, and miR-151a-3p are elevated in cervical cancer patients, suggesting their potential as novel biomarkers for cervical cancer diagnosis.

Objective Extramammary Paget Disease of the Vulva (PDV) is a rare malignant tumor that is often mistaken for other benign conditions. This article retrospectively analyzed the clinical characteristics of patients with PDV admitted to our hospital and explores treatment methods. Methods We retrospectively analyzed PDV patients treated in the Department of Gynecology, Peking University People's Hospital from 2013 to 2023. All 8 cases underwent surgery, 4 cases underwent pedicle flap transfer surgery, and 2 cases underwent photodynamic therapy. Results A total of 5 cases showed positive margins. One case of wound rupture recovered well after secondary surgery. The average follow-up time of 8 patients was 53 months (range 13~130 months), and 1 recurrence was observed during the follow-up period. Currently, all patients are alive and there are no disease-related deaths. Conclusions PDV has a long course of disease, a wide range of lesions, a low degree of malignancy and a tendency of long-term recurrence. Early diagnosis should be made to avoid damage to the structure and function of the local vulva after major surgery. The cure rate can be improved with follow-up supplementary treatment such as photodynamic treatment.The course of PDV is prolonged, with extensive skin lesions and low malignancy, but it has a tendency for long-term recurrence. Early diagnosis is crucial to avoid extensive surgery that could damage the structure and function of the vulva. Photodynamic therapy and other supplementary treatments can be used to improve the cure rate.

随着肿瘤免疫学的深入，免疫疗法在肿瘤治疗领域中的潜力显著。鉴于子宫颈癌的病毒病因学，免疫治疗如今已崛起为继传统治疗之后的另一关键治疗策略，为患者带来新的生存和预后改善的希望。当前，多项免疫治疗相关的临床研究正如火如荼地展开，其成果备受全球医学界瞩目。本文综述了子宫颈癌免疫治疗的最新进展，并深入探讨了免疫单药及联合治疗的策略，旨在为探索更为高效的治疗策略提供有力支撑，以期为子宫颈癌患者带来更为安全、有效的治疗选择。

Objective To investigate the expression and significance of serum human chondroglycoprotein 39 (YKL-40), abnormal tumor protein (TAP) and macrophage colony-stimulating factor (M-CSF) in patients with cervical cancer. Methods A total of 102 patients of cervical cancer in Qingdao Haici Hospital affiliated to Qingdao University from February 2018 to 2023 were selected as the observation group, and another 90 healthy women were selected as the control group. The serum levels of YKL-40, TAP and M-CSF were compared between the two groups, and the serum levels of YKL-40, TAP and M-CSF in patients with different vascular invasion, TNM stage, histological differentiation, lymph node metastasis and prognosis of cervical cancer were compared. Results A total of 102 patients of cervical cancer in Qingdao Haici Hospital affiliated to Qingdao University from February 2018 to 2023 were selected as the observation group, and another 90 healthy women were selected as the control group. The serum levels of YKL-40, TAP and M-CSF were compared between the two groups, and the serum levels of YKL-40, TAP and M-CSF in patients with different vascular invasion, TNM stage, histological differentiation, lymph node metastasis and prognosis of cervical cancer were compared. Conclusions Serum YKL-40, TAP, and M-CSF expression levels are elevated in patients with cervical cancer, and their expression levels are closely related to the pathologic features and prognosis of cervical cancer, and detecting changes in the levels of serum YKL-40, TAP, and M-CSF can help to more accurately assess the progression of the patients' disease and prognosis.

Objective To investigate the oncological and fertility outcomes of cervical cancer after fertility-sparing surgery (FSS). Methods This study retrospectively collected the clinical data of 67 patients with cervical cancer who received FSS treatment in the First Affiliated Hospital of Zhengzhou University from January 2013 to August 2023. The patients were divided into 34 of non-radical FSS group [including cold knife conization (CKC) and simple trachelectomy (ST)]and 33 of radical FSS group (radical trachelectomy, RT) according to different surgical methods. The general data, pathological characteristics, surgical complications, prognosis and fertility outcomes of the patients were analyzed. Results The incidence of postoperative complications in the radical FSS group was higher than that in the non-radical FSS group (30.3% vs. 2.9%, P<0.05), including short-term complications (18.2% vs. 0.0%, P<0.05) and long-term complications (27.3% vs. 2.9%, P<0.05). The overall recurrence rate was 3.0% (2/67) in the two groups, and the 3-year disease-free survival rate and overall survival rate of both groups were 100.0% (P>0.05). The pregnancy rate (63.6% vs. 36.8%) and live-birth rate (62.5% vs. 37.5%) in the non- radical FSS group were higher than those in the radical FSS group (P>0.05). In the subgroup analysis, the live-birth rate of the cerclage group was higher than in the non-cerclage group (100.0% vs. 16.7%, P>0.05), while the abortion rate was lower than that in the non-cerclage group (0.0% vs. 66.7%, P>0.05). Conclusions FSS is a safe and feasible option for cervical cancer patients with fertility needs, but close follow-up is still required after surgery.

Objective To evaluate the application of microscale endometrial sampling biopsy in the follow-up of patients with endometrial cancer/atypical hyperplasia undergoing fertility-sparing treatment, and to provide evidence for the selecting the appropriate population for this technique. Methods A retrospective analysis was conducted on the clinical data of 222 patients who underwent atypical hyperplasia/endometrial cancer who underwent endometrial evaluation after fertility-sparing treatment at Peking University People’s Hospital between July 2023 and October 2024. All patients underwent hysteroscopic endometrial biopsy, with preoperative microscale endometrial sampling biopsy using the Li-brush. The sample adequacy, pathological diagnostic concordance rate, sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of the microscale endometrial sampling biopsy for diagnosing endometrial lesions were analyzed. Results Among the 222 patients, the specimen adequacy was 71.2%. The concordance rate was 73.9% (164/222), with a Kappa value of 0.258 (95% CI: 0.148-0.368). The sensitivity for diagnosing endometrial lesions was 20.5% (15/73), with specificity of 100% (149/149), NPV of 71.9% (149/207), and PPV of 100% (15/15). Conclusions Microscale endometrial sampling biopsy demonstrates relatively low concordance rate, sensitivity, and NPV in the pathological assessment of endometrium after fertility-sparing treatment. It is not recommended for clinical follow-up of endometrial cancer/atypical hyperplasia patients receiving fertility-sparing therapy.

Objective To analyze the relationship between thioredoxin reductase (TR) and the sensitivity of concurrent chemoradiotherapy (CCRT) in locally advanced cervical cancer. Methods The patients with locally advanced cervical cancer who underwent CCRT in 971 Hospital of the People's Liberation Army Navy from March 2020 to March 2023 were included in the analysis. The peripheral blood of the patients was routinely collected to detect serum TR and tumor markers, and the general clinical data of the patients were collected. At the end of treatment, the sensitivity of CCRT was evaluated using the Solid Tumor Efficacy Evaluation Criteria (RECIST 1.1) and divided into CCRT resistant group and CCRT sensitive group. Logistic regression was used to analyze the effect of serum TR on CCRT sensitivity in locally advanced cervical cancer. The restricted cubic spline method was used to analyze the dose-response relationship between serum TR and CCRT sensitivity in locally advanced cervical cancer. Results A total of 103 patients with locally advanced cervical cancer were included in this study, all of whom completed CCRT treatment and successfully obtained CCRT sensitivity evaluation results. Among them, 23 cases (22.33%) were resistant to CCRT and 80 cases (77.67%) were sensitive to CCRT. The proportion of FIGOⅢB andⅣA phases, total chemotherapy dose, and CCRT frequency in the CCRT-resistant group were higher than in the CCRT-sensitive group. The expression of serum cytokeratin 19 fragment (CYFRA21-1), TR, and vascular endothelial growth factor (VEGF) was higher than that in the CCRT-sensitive group, with a statistically significant difference (P<0.05). Logistic regression analysis showed that FIGO stageⅣA, total dose of chemotherapy, serum TR and VEGF expression were independent factors of CCRT resistance in locally advanced cervical cancer (P<0.05). The restricted cubic spline method was used for analysis, and there was a linear dose-response relationship between serum TR and CCRT sensitivity in locally advanced cervical cancer (P<0.05). The risk of CCRT resistance in locally advanced cervical cancer increased with the upregulation of serum TR expression. Conclusions Serum TR levels have been identified as an independent predictor of resistance to CCRT in patients with locally advanced cervical cancer. There is a linear correlation between the risk of CCRT resistance and serum TR levels; an increase in TR expression is associated with a higher risk of CCRT resistance.

传统的宫缩监测方法仅间接反应宫缩的频率和强度，在临床使用过程中有较大的局限性及判断上的主观性和经验性。子宫肌细胞中动作电位是宫缩产生和形成的基础，近年来随着子宫肌电信号采集技术的突破，为其在围产期临床应用提供了广阔前景。利用子宫肌电信号对宫缩进行分析评估，有望成为更精准的宫缩评估办法。