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。

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.

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.

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 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 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.

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。

Objective To observe the efficacy of pembrolizumab combined with Taxol+Cpthalon (TC) in the treatment of advanced endometrial cancer (EC). Methods A retrospective study was conducted on 102 patients with advanced EC in the hospital from October 2021 to June 2024. Patients treated with pembrolizumab combined with TC regimen were selected as the combined group (n=52), while patients treated with TC regimen alone were selected as the control group (n=50). The treatment efficacy was evaluated after 3 cycles of treatment. The tumor response rate, tumor markers [serum carbohydrate antigen (CA) 125, CA199, human epididymal protein (HE4)], survival time, and adverse drug events (ADE) were compared between two groups. Results The objective response rate (ORR) of the combined group was higher than that of the control group (P<0.05). After 3 cycles of treatment, the serum CA125, CA199, and HE4 levels in both groups of patients decreased compared to before treatment, and the combined group was lower than the control group (P<0.05). The median OS and PFS of the combined group were longer than those of the control group (P<0.05). The incidence of hypothyroidism in the combined group was higher than that in the control group (P<0.05). Conclusion The combination of pembrolizumab and TC regimen in the treatment of advanced EC can improve tumor response rate, reduce tumor marker levels, and prolong patient survival time, but long-term treatment increases the risk of hypothyroidism.

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.

Objective To analyze the relationship between insulin resistance (IR) and clinical pregnancy rate of intrauterine insemination (AIH) with husband's sperm in infertility patients with polycystic ovary syndrome (PCOS). Methods Retrospective analysis of 200 PCOS patients with infertility who were diagnosed and treated in the Second Affiliated Hospital of Soochow University from March 2020 to February 2023. All patients received AIH assisted pregnancy. All patients received AIH assisted pregnancy, and were divided into two groups based on whether the ultrasound evaluation at 4 weeks after AIH was a clinical pregnancy: the non pregnancy group (133 cases) and the pregnancy group (67 cases). According to the occurrence of IR in 200 patients, they were divided into IR group and N-IR group. Logistic regression was used to analyze the influencing factors of AIH clinical pregnancy rate in patients with PCOS infertility. Results The non pregnancy group aged≥35 years old had a higher proportion of obesity and insulin resistance than the pregnancy group. The level of glycated hemoglobin (HbA1c) was higher than that of the pregnancy group, while the antral follicle count (AFC), serum anti Mullerian hormone (AMH), estradiol (E2) levels on hCG day, and endometrial thickness on hCG day were lower than those of the pregnancy group (P<0.05). Logistic regression model was constructed, the AIH assisted pregnancy outcomes of PCOS infertility patients were related to age, obesity, IR, hCG day endometrial thickness, AFC, AMH, E2, and HbA1c (P<0.05). Conclusions PCOS infertility patients' AIH clinical pregnancy rate is associated with IR. IR is a risk factor for increased AIH non-pregnancy rate. Improving IR status has clinical significance for enhancing AIH pregnancy success rate.

Objective To investigate the clinical therapeutic effects of progressive step training combined with neuromuscular electrical stimulation (NMES) on postpartum patients with diastasis recti abdominis (DRA). Methods A total of 100 patients with DRA were prospectively enrolled and randomly assigned into two groups using a randomly divided into the control group (NMES only) and the observation group (NMES combined with progressive stepwise training), with 50 patients in each group. The treatment period lasted 5 weeks. Changes in inter-rectus distance (IRD), abdominal muscle strength, and lower back pain (assessed by VAS score) were compared before and after treatment. Results The total effective rate in the observation group was 97.9%, significantly higher than that in the control group (89.8%, P<0.01). Both groups showed significant post-treatment improvements in inter-rectus distance, muscle strength scores, and VAS scores compared with baseline (P<0.05), with the observation group demonstrating greater improvement than the control group (P<0.05). No serious adverse events occurred during the treatment period. A few of patients experienced mild skin tingling or transient muscle soreness, which were well tolerated. Conclusions Progressive stepwise training combined with NMES can effectively reduce inter-rectus distance, enhance abdominal muscle strength, and relieve lower back pain, and has clinical application value.

下生殖道感染性疾病是女性常见的妇科疾病，可能增加盆腔炎、不孕及早产等疾病的风险。目前，临床治疗面临失败率高和复发率高的挑战。本文通过对下生殖道感染性疾病患者的阴道黏膜屏障损伤及修复进行综述，旨在深入探讨下生殖道感染的发病机制，从而提高疾病的治愈率，并降低复发率。

Objective Exploring the characteristic trends and survival outcomes of distant metastasis in cervical cancer populations, providing reference opinions for clinical prevention and treatment. Methods This study was a retrospective cohort study, selecting 29 345 cervical cancer patients who met the inclusion criteria in the SEER database. The study subjects were enrolled from January 2005 to December 2015, and the patients had complete follow-up outcome data. The incidence of distant tumor metastasis and the trend of metastasis rate over time were analyzed in patients with different clinical and pathological characteristics such as age, race, primary site, and histological subtype; Survival analysis of 1 990 cervical cancer patients with distant metastasis. Results The risk of distant metastasis of cervical cancer in patients over 45 years of age increases year by year. In addition, lung metastases due to cervical cancer are also increasing in black and Caucasian patients. For 1990 patients with distant cervical cancer metastasis, those that occurred in multiple sites such as bone, brain, liver and lung significantly shortened survival time (P<0.05). COX model analysis also confirmed that multi-site metastasis significantly shortened the survival of cervical cancer patients. Conclusions There are many clinical and pathological factors that affect the occurrence of distant metastasis in cervical cancer patients. Among them, patients with different ages, races, lesion sites, and lung metastases have a significant upward trend in the time of distant metastasis. The survival time of cervical cancer patients with distant metastasis is influenced by the number of metastasis sites and the number of affected bone, brain, liver, and lung metastasis sites.

Objective To explore the risk of hiding HSIL in patients over 50 years old who have been suffering from LSIL for 2 years or more and the necessity of diagnostic cervical conization. Methods From January 2013 to October 2023, the clinical data of 136 women with LSIL who were over 50 years old and lasted for 2 years or more in Peking University First Hospital were retrospectively summarized, and the risk of hiding HSIL and the necessity of diagnostic cervical conization were evaluated. Results Among the 136 cases diagnosed as LSIL by colposcopy biopsy for 2 years or more, 47 cases (34.56%, 47/136) were diagnosed as HSIL after diagnostic cervical conization. There were 16 cases of HSIL (CIN 2) (11.76%, 16/136) and 31 cases of HSIL (CIN 3) (22.79%, 31/136). Pathology upgraded to cancer in 0 cases. Univariate analysis showed that the detection of pathological HSIL (CIN2+) and above after cervical conization was related to HPV positive (P=0.002), and logistic regression analysis showed that the OR value of HPV positive was 11.571 (95%CI: 1.491-89.724). Univariate analysis showed that pathological HSIL(CIN3) after cervical conization was related to age (P=0.045) and high-grade cytological abnormality (P=0.018). Logistic regression analysis showed that the OR value of high-grade cytological abnormality was 2.828 (95%CI: 1.237-6.469). Conclusions The risk of hiding HSIL is moderate in women over 50 years old with LSIL lasting for 2 years or more. Diagnostic cervical conization is recommended for those with high risk factors, such as HPV positive or high-grade cytological abnormalities.

Objective To analyze the clinical characteristics and surgical management of postmenopausal ovarian endometriosis, exploring its pathogenesis and malignant potential. Methods Retrospective analysis of 130 postmenopausal patients with ovarian endometriosis who underwent surgery at Peking University People's Hospital (Jan 2014 - Aug 2023) were retrospectively analyzed, with surgical outcomes and clinical features evaluated. Results Among the 130 patients, the mean age of (58.36±5.66) years, with a mean menopausal age of (49.6±5.18) years. Postoperative pathology confirmed ovarian endometriomas in 69.23% (90/130) of cases, while 16.92% (22/130) exhibited malignant transformation. The malignancy rates were 35.71% (20/56) for cysts>4 cm and 73.68% (14/19) for those >10cm. Patients with elevated CA125 (>35 U/mL) showed a 44.44% (12/27) malignancy rate. Conclusions Asymptomatic postmenopausal ovarian endometriomas ≤4 cm may be monitored. Persistent cysts>4 cm warrant surgery. Cysts>10 cm or with elevated tumor markers require MRI evaluation for malignancy risk, with cautious selection of approach and scope.

Objective To synthesize a MRI/near-infrared (NIR) fluorescence dual-modal molecular probe and evaluate its specificity in targeting ovarian cancer in vivo. Methods The MRI/NIR dual-modal probe USPIOs-COC183B2-IRDye800CW was prepared. The hydrodynamic size and zeta potential of ultrasmall superparamagnetic iron oxides and dual-modal probes were measured. The subcutaneous xenografted tumor model of ovarian cancer was established. At different time points post-injection, the nude mice were scanned using MRI and NIR imaging systems to study the distribution and targeting of the probe. Vital organs and tumor tissues were isolated for ex-vivo fluorescence imaging and pathology validation. Results The average sizes of USPIOs and bimodal probe under TEM were (3.5±0.3) nm and (3.7±0.4) nm, respectively; Zeta potentials of (10.2±0.7) mV, (-10.3±0.8) mV, respectively. Both MRI and NIR imaging showed that the dual-modal probe could specifically aggregated in tumor. The probes were mainly distributed in liver and tumor sites of nude mice in the test group. Prussian blue staining indicated iron deposits in tumor of the test group. Conclusions The dual-modal molecular probe USPIOs-COC183B2-IRDye800CW can accurately indicate ovarian cancer lesions in vivo both MR and NIR imaging.

Objective To investigate the effect of MTNR1B gene polymorphisms and basic body mass index (BMI) on susceptibility to gestational diabetes mellitus (GDM). Methods  From March to December 2021, 292 pregnant women diagnosed with GDM were randomly selected from Gansu Provincial Maternal and Child Health Hospital as the GDM group, with age as the matching condition. And 1:1 matching of healthy pregnant women with prenatal examination as the control group. The peripheral blood of the two groups was collected, and the genotype of single nucleotide polymorphism (SNP) at rs10830963 of melatonin recepters 1B (MTNR1B) gene was detected and analyzed by im-LDR technology, and the risk factors were screened by logistic regression, and a multiplicative model was employed to analyze the effects of the interaction between the rs10830963 SNP and basal BMI on GDM susceptibility. Results The basal BMI≥24.0 kg/m2 (OR=2.467, 95%CI: 1.684~3.615) was a risk factor for GDM, and carried GC (OR=1.484, 95%CI: 1.015~2.170) or GG (OR=1.840, 95%CI: 1.135~2.983) and allele G (OR=1.347, 95%CI: 0.069~1.697) and those with GC+GG dominant model (OR=1.572, 95%CI: 1.096~2.257) had the highest risk of GDM, and those with the GG genotype of rs10830963 of MTNR1B gene and a basal BMI of ≥24.0 kg/m2 had the highest risk of GDM (OR=3.504, 95%CI: 1.299~9.451). Conclusions The susceptibility to GDM in women with the MTNR1B rs10830963 GG and an underlying BMI of≥24.0 kg/m2 is greatly increased. Health education and bariatric prevention should be focused on this population to promote maternal and infant health outcomes.