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。

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。

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

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。

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。

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 By comparing the latency and amplitude differences of sacral nerve magnetic stimulation evoked potentials between patients with pelvic organ prolapse (POP) and those without POP, this study aims to investigate whether pelvic floor nerve conduction dysfunction exists in patients with POP. Methods Fifty-five patients with POP who visited Peking University People's Hospital from October 2024 to January 2025 (POP group) and 52 patients with non-POP who visited due to benign diseases during the same period (control group) were selected. Both groups of patients underwent sacral nerve magnetic stimulation motor evoked potential examination. The differences in latency and amplitude of motor evoked potentials between the two groups were compared, and the influencing factors of motor evoked potentials in patients with pelvic floor organ prolapse were analyzed. Results Compared with the control group, the latency of the sacral nerve magnetic stimulation motor evoked potential in the POP group was significantly prolonged [(7.50±3.49) ms, (5.11±3.49) ms; P<0.001], and there was no significant difference in wave amplitude between the two groups [(69.55±33.21) uV, (76.70±33.21) uV, P=0.339]; The weakening of pelvic floor muscle strength was significantly correlated with the prolonged latency of magnetic stimulation motor evoked potentials (P=0.014). Conclusions Patients with POP have significantly slower latency of motor evoked potentials induced by sacral nerve magnetic stimulation compared to POP patients, suggesting that POP patients may have pelvic nerve damage. This examination is expected to become a non-invasive electrophysiological indicator for evaluating pelvic nerve function of POP patients.

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.

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。

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。

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.

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。

Objective Compare the differences in survival prognosis of cervical cancer patients with lymph node metastasis under different treatment modalities, and explore the influence of related high-risk factors in the prognosis with different treatment. Methods The clinical data of a total of 102 cervical cancer patients  accompanied by lymph node metastasis admitted to Peking University People's Hospital from January 2016 to January 2024 were reviewed. The survival outcomes of radical surgical followed by adjuvant therapy and radical concurrent chemoradiotherapy (CCRT) in patients with various high-risk factors were analyzed to guide the selection of clinical treatment regimens. Results ①A total of 52 patients in stageⅢCr, 44 patients in stage ⅢCp and 6 patients in stage Ⅳ were included. Among whom 65 patients underwent lymph node dissection followed by adjuvant therapy and 37 patients chose radical CCRT. There was no significant difference in the overall survival and disease-free survival between these two groups (P=0.934). ② Histopathological type,diameter of tumor lesion and parametrial infiltration were independent predictors of tumor recurrence and patient survival outcomes (P<0.05). The size of preoperative metastatic lymph nodes affects the choice of treatment methods. ③ The incidence of toxic and side effects in patients receiving dual treatment was 40.00%, which was significantly higher than that in the CCRT group. The incidences of hematological toxicity, radiation enteritis and cystitis in the latter group were higher than those in the former group. Conclusions Pathological type,diameter of tumor lesion,parauterine invasion, and the size of metastatic lymph nodes are important factors guiding the selection of treatment plans for cervical cancer patients accompanied by lymph node metastasis. It is necessary to combine clinical high-risk factors, the patient's general condition and will, and comprehensively formulating individualized treatment strategies.

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.

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 To evaluate the effect of exercise intervention on the management of lower extremity lymphedema after gynecological cancer surgery. Methods PubMed, the Cochrane Library, Embase, Wanfang Database, China National Knowledge Infrastructure (CNKI) and other databases were searched for randomized controlled trials (RCT) until September 2023. RevMan5.4 was used for Meta-analysis. Results A total of 11 RCTs meeting the inclusion criteria were included, involving 854 study subjects. Meta-analysis showed that exercise reduced the incidence of lower limb lymphedema (OR=0.35, 95% CI: 0.24-0.51, P<0.001) and moderate to severe lymphedema (OR=0.33, 95%CI: 0.19-0.58, P<0.001), reduced leg volume (SMD=-1.31, 95%CI: -2.44~-0.18, 
P=0.02), delayed onset of lymphedema (MD=3.42, 95%CI: 2.56-4.28, P<0.001), reduced symptoms (MD=-2.10, 95%CI: -3.45--0.76, P=0.002) and pain (SMD=-1.46, 95%CI: -32.86--0.06, P=0.002), improved quality of life (SMD=0.75, 95%CI: 0.03-1.47, P=0.04). Conclusions Exercise reduces the lower limb lymphedema incidence, delays the onset, alleviates symptoms, and improves the quality of life for post-gynecological cancer surgery patients. However, there were heterogeneous in the exercise modes and the sample sizes were small in included studies. More large-sample, high-quality studies are needed in the future.

Objective To evaluate whether pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS) can be improved by extraperitoneal high uterosacral ligament suspension (EHUS). Methods The clinical data of patients who visited Peking University People's Hospital due to POP and underwent EHUS from January to September 2021 were retrospectively collected. The patients were followed up before surgery, 1 month after surgery, 6 months after surgery, and 12 months after surgery. The POP-Q score was used to evaluate the postoperative anatomical repositioning effect of the patients, the overactive bladder symptom score questionnaire (OABSS) was used to evaluate the improvement of LUTS after surgery, and the pelvic floor dysfunction inventory-20 (PFDI-20) was used to evaluate the improvement of quality of life after surgery. Results Twelve months after EHUS, the location of POP-Q points was significantly higher than preoperative location (P<0.001). Twelve months after EHUS, the median OABSS score was 1 (0, 2) and the median PFDI-20 score was 0.00 (0.00, 0.83), both significantly lower than the preoperative scores (P<0.05). Conclusions EHUS can improve LUTS and quality of life in patients with POP while achieving anatomical restoration.

Objective To analyze the characteristics of abnormal colposcopic images and evaluate the diagnostic value of abnormal colposcopic images for CIN2+ and its related influencing factors by 2017 ASCCP colposcopy criteria. Methods A total of 1 762 patients who underwent colposcopy in the First Affiliated Hospital of Nanjing Medical University from May 2017 to January 2021 due to abnormal cervical cancer screening and found abnormal colposcopy images accompanied by corresponding targeted biopsy and obtained  pathological results were selected. The correlation between abnormal colposcopy images and histopathology was retrospectively analyzed  and the occurrence of colposcopic images and the risk of CIN2+ detection in different age groups and HPV genotypes were compared. Results ① In the patients with histological diagnosis of LSIL, HSIL and cancer, the complete coincidence rate with abnormal colposcopic impression of low grade, high grade abnormality and suspected cancer were. No significantly different (73.51%, 69.88%, 62.96%; P＞0.05). The proportions of CIN2+ detected by colposcopy increased significantly with the increase of impression grade (27.46%, 74.00%, 100%; P＜0.05). ② The detection rate of CIN2+ in the low grade impression of ≥50 years old (34.88%) was higher than that of＜50 years old (23.13%, P＜0.05). ③ The detection rate of CIN2+ in thin acetowhite epithelium and fine punctation in≥50 years old was significantly higher than that in＜50 years old（35.77%， 23.80%; 62.50%, 21.52%; P＜0.05).④ HPV16-positive patients were more likely to have a high-grade colposcopic impression (57.10%, 38.20%; P＜0.05). The positive rate of CIN2+ was higher in HPV16-positive patients than in non-HPV16 positive patients (79.66%, 63.43%; P＜0.05). ⑤ The detection rate of CIN2+ in HPV16-positive patients with dense acetowhite epithelium and  inner border was higher than that in non-HPV16-positive patients (76.61%, 63.57%; 90.63%, 67.74%; P＜0.05). Conclusions The detection rate of CIN2+ in low-grade colposcopic images, especially thin acetowhite epithelium and fine punction is higher in patients aged≥50 years old, so this population should pay attention to the targeted biopsy of these two low-grade images to prevent missed CIN2+ diagnosis. The occurrence of high-grade colposcopic images is not only closely related to HPV16 type, but also the combination of the two is an effective evidence for predicting CIN2+.

子宫内膜基底层损伤导致子宫内膜再生障碍，主要表现为宫腔粘连和薄型子宫内膜，严重危害女性生殖健康，目前临床常用的治疗方法疗效欠佳。富血小板纤维蛋白（platelet-rich fibrin, PRF）是第二代血小板浓缩物，可通过促进血管修复与再生、调节免疫应答、促进子宫内膜细胞的增殖和迁移的同时抑制子宫内膜纤维化，修复受损子宫内膜，改善子宫内膜容受性。目前有限的文献报道显示，其可促进子宫内膜细胞增殖，改善妊娠率。本文总结PRF在修复子宫内膜损伤中的相关研究进展，旨在为子宫内膜损伤修复提供一个新的参考方案。