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.

PARP抑制剂已在卵巢癌一线维持治疗等方面发挥重要作用，然而其耐药性问题也日渐凸显，确定耐药原因并提出克服耐药的策略将有助于改善患者预后。本文概述了PARP抑制剂耐药机制的研究进展，包括多药耐药基因导致的靶前耐药，PARP蛋白改变、同源重组恢复、复制叉保护导致的靶标耐药，以及凋亡通路等相关的靶后耐药。

Objective To investigate the expression of vimentin (VIM) in endometrial carcinoma and its relationship with prognosis. Methods A prospective cohort study was conducted to observe the expression of VIM in endometrial cancer tissues from 85 patients undergoing radical hysterectomy in our hospital from January 2015 to May 2020. All patients were followed up for 2 years, and were divided into poor prognosis group and good prognosis group according to their prognosis. The relationship between the expression of VIM and the prognosis of endometrial cancer patients were analyzed. Results There were 46 cases (54.12%) with positive VIM in endometrial carcinoma tissues. The positive rate of VIM in patients with endometrial carcinoma of typeⅡand with lymph node metastasis was higher than that in patients with type I and without lymph node metastasis. The positive rate of VIM in poorly differentiated and stageⅢendometrial carcinoma was the highest, followed by moderately differentiated and stageⅡ, and the lowest in highly differentiated and stageⅠ(P<0.05). The poor prognosis rate of 85 patients with endometrial cancer within 2 years after surgery was 22.35%. The positive rate of VIM in endometrial cancer tissue of poor prognosis group was higher than that of good prognosis group (P<0.05). The results of logistic regression analysis showed that positive VIM was a risk factor for poor prognosis of endometrial cancer after surgery (OR>1, P<0.05). Conclusion The expression of VIM in endometrial cancer patients with different clinicopathological featureshere are different, and is related to the clinical prognosis.

Objective The objective of this study was to investigate the clinical characteristics and prognosis of Chinese ovarian cancer patients with the BRCA1 c.5470_5477del germline mutation. Methods We conducted next-generation sequencing (NGS) for the entire coding regions and exon/intron boundaries of the BRCA1 and BRCA2 genes in 760 Chinese ovarian cancer patients treated at our institution from 2001 to 2020. Clinicopathological characteristics, treatment modalities, and outcomes were assessed for ovarian cancer patients with BRCA1 c.5470_5477del germline mutation. Results BRCA1/2 germline or somatic pathogenic mutations were detected in 28.2% (214/760) of patients in this cohort. BRCA1 c.5470_5477del germline mutation was detected in 2.8% (21/760) of patients, which was the most frequency BRCA1/2 pathogenic variant of these patients. 21 patients came from 21 unrelated families carried this pathogenic variant. This pathogenic mutation represented for 13.5% (21/156) of BRCA1 pathogenic mutations. In the current study, patients median age at diagnosis was 52 years (range: 36-67 years). 81.0% (17/21) of them were diagnosed after 50 years. Only one patient diagnosed before the age of 40. Nine patients (42.9%) had a family history of ovarian or breast cancer while four patients (19.0%) had a personal history of breast cancer. And 8 patients (38.1%) had no family history of ovarian or breast cancer, and no personal history of breast cancer. The majority of patients (90.5%) were diagnosed at stageⅢ/Ⅳ. Seven patients (33.3%) received PARP inhibitor first line maintenance therapy after adjuvant chemotherapy. The median follow-up was 34.5 months (range: 12.3-111.0 months). Median progression-free survival (PFS) for the entire cohort was 25.4 months. 2-year PFS was 57.4%. 2-year PFS for patients receiving PARPi maintenance was 80.0%. Conclusions The BRCA1 c.5470_5477del germline mutation is the most common BRCA1/2 pathogenic mutation in Chinese ovarian cancer patients. Even in the absence of a family or personal history of ovarian or breast cancer, individuals should be cautious about carrying this germline mutation. Unlike other BRCA1 mutations, prophylactic surgery may be appropriately delayed in carriers of this specific mutation. Patients with this mutation have a favorable prognosis and should consider receiving first-line maintenance therapy with PARP inhibitors.

盆底康复治疗是盆底功能障碍性疾病的重要非手术治疗。其康复治疗主要包括盆底肌锻炼（Kegel锻炼）、生物反馈、电刺激（electrical stimulation, ES）治疗及体外磁场盆底神经强化等。电刺激具有促进神经细胞再生、促进神经重塑、镇痛及组织兴奋性等作用。目前电刺激已在临床上用于神经肌肉相关性疾病的治疗，如脑血管疾病、周围神经病变、肌萎缩等疾病。而低频电刺激（low frequency electrical stimulation, LFES）具有疗效好、安全性高、患者依从性强等特点。近年来，研究发现LFES联合盆底肌锻炼及生物反馈等治疗对盆底功能障碍疾病具有良好的疗效。本文对LFES的机制、应用现状以及在盆底功能障碍疾病中的治疗进展进行了综述。

Objective To explore the feasibility of animal model of endometriosis fibrosis in nude mice using endometrium of endometriosis patients, and compare the influence of different injection methods on the effect of transplantation. Methods 24 BALB/c nude mice were divided into two groups with 12 mice in each group to establish the fibrosis mice model of endometriosis. The eutopic endometrial tissue of patients with endometriosis was collected, and the fragments of human endometrial tissue were grafted subcutaneously and intraperitoneally into the BALB/c nude mice respectively. The mice were sacrificed on the 14th day after implantation to verify the successful establishment of mice model by HE staining. The adhesion was observed, the collagen fiber was stained in blue by Masson's trichrome staining, red-stained collagen fiber was deceted by sirius red staining, and immunohistochemistry staining was used to evaluate the expression of Collagen 1, which was considered as fibrosis-related protein. The iron was deceted by prussian blue staining. Results The fibrosis model of endometriosis in nude mice was successfully established by both subcutaneous and intraperitoneal injection of human endometrium fragments. There are ten of twelve and two of twelve mice were successfully established by subcutaneous and intraperitoneally injection, respectively. The ectopic tissue was hard, adherent to the surrounding area, and had poor mobility. Endometrium-like glands, collagen deposition and iron deposition were found in ectopic tissues, which confirming the success establishment of mice model and the existence of iron in ectopic tissue. Conclusions The subcutaneous injection method has a higher success rate in the establishment of endometriosis fibrosis in nude mice compared with intraperitoneal injection, this study provides a model application for further exploration of endometriosis fibrosis and confirmed the iron deposition in ectopic tissue.

子宫颈高级别神经内分泌癌是一种特殊类型的恶性肿瘤，其发病率低，恶性度高。免疫组化标记物的联合诊断可提高病理诊断阳性率，胰岛素瘤相关蛋白1有待作为新的免疫组化诊断标记物。手术、放疗、化疗相结合的综合治疗模式总体预后不佳，识别合适的靶向治疗基因为个体化治疗提供了机会，抗程序性死亡受体-1/程序性死亡配体-1单抗在临床试验中表现出较好的应用前景。本文将围绕子宫颈高级别神经内分泌癌的病理诊断、临床影像、分子靶向药物、免疫治疗等方面的重要研究进展进行总结。

Objective To explore the triage effect of SEPT9 and PAX1 gene methylation in HPV16 or (and) HPV18 positive women. Methods 455 patients with HPV16 or (and) HPV18 positive infection in the Cervical Disease Clinic of Beijing Obstetrics and Gynecology Hospital， Capital Medical University from October 2020 to March 2021 were selected as the study objects. According to the pathological results, they were divided into normal cervix /cervicitis group (208 cases), low grade squamous intraepithelial lesion group (155 cases), high grade squamous intraepithelial lesion group (81 cases) (CIN2: 35 cases, CIN3: 46 cases), and cervical cancer group (11 cases). Taqman probe-based quantitative PCR (qPCR) was used to detect the methylation of SEPT9 and PAX1 promoter in different grades of cervical lesions. Results The positive rate of SEPT9 methylation in normal cervix /cervicitis group, low grade squamous intraepithelial lesion group, high grade squamous intraepithelial lesion group and cervical cancer group was 14.42% (30/208), 19.35% (30/155), 69.14% (56/81) and 100.00% (11/11) respectively, and that of PAX1 methylation were 5.29% (11/208), 10.97% (17/155), 41.98% (34/81) and 100.00% (11/11) respectively. There were significant differences among four groups (P＜0.05). In the two diagnostic classifications of CIN3+vs. CIN1 and below, CIN2+VS. CIN1 and below, the detection efficacy of SEPT9 methylation (AUC=0.854, 0.794) is better than that of PAX1 methylation (AUC=0.749, 0.684)in triage TCT negative HPV16 or (and) HPV18 positive patients, The combined detection efficiency of the two genes is equivalent to that of SEPT9 methylation alone (AUC=0.853, 0.787); And the efficiency of methylation detection in the detection of CIN3+vs CIN1 and below is better. Conclusions SEPT9 and PAX1 methylation have a certain predictive role in the severity of cervical intraepithelial neoplasia. They play a role in triaging TCT-negative women with HPV16 or (and) HPV18 positivity for HSIL and cervical cancer, with SEPT9 methylation testing alone showing advantages.

Objective To analyze the clinicopathological features of cervical HPV-associated adenocarcinoma in situ (AIS) and to explore the correlation and clinical significance between morphological differences and lesion progression. Methods 51 cases of AIS diagnosed by cervical conization or simple hysterectomy in Shaoxing Women and Children Health Hospital from January 2016 to September 2021 were collected. According to the WHO (2014) classification of tumours of female genital tumours, those with minimal nuclear atypia and slightly increased mitoses or apoptotic bodies were supported as morphologically incomplete AIS. TCT, HPV, age of onset, extent of lesion, treatment plan and follow-up results were compared in patients with different morphology. Results The 51 patients included 23 cases of AIS with morphologically incomplete, 21 cases of AIS with morphologically complete, and 7 cases of Silva A-type adenocarcinoma; There were significant differences in thickness and width between AIS with morphologically incomplete, AIS with morphologically complete and Silva A adenocarcinoma (P<0.05); The residual rates of AIS with morphologically complete and Silva A-type adenocarcinoma were higher than AIS with morphologically incomplete (P<0.05). Conclusions HPV-related glandular lesions of the cervix may progress through incomplete morphological AIS, complete morphological AIS, and Silva A-type adenocarcinoma before developing into invasive adenocarcinoma. Incomplete morphological AIS is suitable for conservative treatment. For complete morphological AIS and Silva A-type adenocarcinoma without fertility requirements, total hysterectomy is recommended. However, if the conization margins are negative, it indicates a good prognosis, and individualized treatment plans can be formulated to avoid overtreatment.

卵巢癌是致死率最高的妇科恶性肿瘤，无肉眼残留的肿瘤细胞减灭术对卵巢癌患者的长期生存至关重要。明确肿瘤边界且最大限度地切除肿瘤是卵巢癌手术的关键，因此术中肿瘤病灶的可视化非常重要。荧光成像技术能对特定组织显像，近年来在卵巢癌肿瘤细胞减灭术中被用于描绘肿瘤边界，明确手术范围，指导术中术者切除病灶。本文将围绕卵巢癌术中成像的必要性、如何对卵巢癌进行术中成像以及当前荧光成像在卵巢癌手术中的应用等方面进行阐述，以期促进卵巢癌的精准手术。

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。

To compare the consistency and feasibility of self-sampling for human papillomavirus (HPV) with physician-sampling as a method for cervical cancer screening. Methods 2 033 women aged 30 to 59 who involved in cervical cancer screening were selected for HPV self-sampling and physician-sampling, respectively, the collected specimens were tested for Cobas 4800 HPV and Seq HPV test. Any HPV positive was referred to colposcopy and cervical biopsy. The consistency of HPV positivity rates between self-sampling and physician-sampling, as well as the accuracy in detecting cervical intraepithelial neoplasia (CIN)2 or higher lesions (CIN2+) and CIN3+, were analyzed using histopathology as the gold standard. Results ① Among the 2 033 women, 249 cases (12.2%) were high-risk HPV positive of any type, There were 29 cases (1.4%) of histopathological CIN2+ and 13 cases (0.6%) of CIN3+. The detection rates for CIN2+ were consistent between Cobas-physician-sampling and self-sampling (28/2 033, 1.4%) as well as Seq-physician-sampling and self-sampling (Kappa=0.84). The detection rates for CIN3+were also consistent between Cobas-physician-sampling and self-sampling (13/2 033, 0.6%) as well as Seq-physician-sampling and self-sampling (Kappa=0.87). ② The sensitivity for detecting CIN2+was similar among Cobas-physician-sampling (96.6%), Cobas-self-sampling (96.6%), Seq-physician-sampling (96.6%), and Seq-self-sampling (100%) (P>0.05). The specificity for detecting CIN2+was not significantly different between Cobas-physician-sampling (92.2%), Seq-physician-sampling (92.6%), and Seq-self-sampling (92.4%) (P>0.05), but Cobas-self-sampling (90.9%) showed statistical significance (P<0.05). The negative predictive value (NPV) for detecting CIN2+was not significantly different among Cobas-physician-sampling (99.9%), Cobas-self-sampling (99.9%), Seq-physician-sampling (99.9%), and Seq-self-sampling (100%) (P>0.05).③ The sensitivity for detecting CIN3+was 100% for all four methods, with no statistically significant differences (P>0.05). The specificity for detecting CIN3+was not significantly different between Cobas-physician-sampling (91.5%), Seq-physician-sampling (91.9%), and Seq-self-sampling (91.7%) (P>0.05), but Cobas-self-sampling (90.2%) showed statistical significance (P<0.05). The NPV for detecting CIN3+was not significantly different among Cobas-physician-sampling (100%), Cobas-self-sampling (100%), Seq-physician-sampling (100%), and Seq-self-sampling (100%) (P>0.05). Conclusions HPV self-sampling demonstrated similar detection rates and sensitivity for detecting high-grade cervical lesions compared to physician-sampling, making it a viable option for population-based cervical cancer screening. The Seq HPV test showed similar sensitivity and NPV to the Cobas 4800 HPV test and can be used for HPV self-sampling.

代谢重编程作为癌症的重要标志，可以为大分子的生物合成提供能量和前体，以满足癌细胞的生存需求。近年来，癌症中各种代谢类型改变对细胞增殖、迁移和耐药性所产生的影响受到广泛关注。卵巢癌（ovarian cancer, OC）是妇科三大恶性肿瘤之一，由于缺乏典型症状和高效筛查方法，多数患者直到晚期才被明确诊断。p53作为OC最常见的突变类型之一，既可诱导细胞凋亡和周期阻滞，还与癌症代谢重编程息息相关。本文将综述p53及其突变体在OC代谢重编程中的最新进展，讨论其作为OC诊断和治疗靶点的潜力。

Objective To investigate the outcome of high-risk human papillomavirus (HR-HPV) infection and factors related to persistent infection of high-grade squamous intraepithelial lesion (HSIL) after conization. Methods From January 2018 to October 2021, 340 patients diagnosed with HSIL/CIN3 underwent cervical conization therapy in the Department of Gynecology, First Affiliated Hospital of Xinjiang Medical University. These patients were followed up for (20.4±12.8) months, with results of HPV test and other tests collected. We observed the outcome of HR-HPV infection, and analyzed the factors related to persistent HR-HPV infection. Results (1) In this study, the top 5 subtypes of HPV infection distributed as 16, 52, 58, 33 and 18, in which HPV16 infection rate reached 74.1% (160/216). The negative conversion rate of HPV infection in the first year was higher, showing 81.5% (159/195) at 6 months and 85.3% (157/184) at 12 months, respectively. Incidence of persistent HR-HPV infection was 12.4% (42/340), with single subtype infection accounting for main part as 85.7% (36/42), and with common subtypes ranking as HPV16, 58, 52, 53 and 56. (2) For persistent HPV infection of HSIL/CIN3 after conization, Bachelor's degree or above and the thickness of conization specimen >9 mm were protective factors (P<0.100, OR values were 0.448 and 0.151 respectively); HPV16 subtype infection before conization, points of HSIL/CIN3 >4 in specimen, vaginal environmental morphological abnormality >1 time or functional 
abnormality >1 time during follow-up were risk factors (P<0.100, OR values were 1.999, 13.327, 2.800 and 5.600 respectively). Conclusions Persistent HPV infection of HSIL/CIN3 after conization is common, influenced complicatedly by the preoperative HPV infection status, various surgical factors and postoperative vaginal environmental factors.

Objective To explore the prenatal ultrasound features of fetal isolated redundant foramen ovale valve, and to analyze the cause of small left heart and right heart failure through the motion trajectory of the foramen ovale valve using M-ultrasound. Methods 59 cases of isolated redundant foramen ovale valve were analyzed using echocardiography. M-ultrasound was used to analyze the motion curve of the foramen ovale valve, and pregnancy outcomes and prognosis were followed up. Results 59 cases of fetal isolated redundant foramen ovale valve showed excessive protrusion of the foramen ovale valve into the left atrium and small left heart in the four chamber view on echocardiography; In severe cases, the foramen ovale valve can reach the lateral wall of the left atrium, leading to enlargement of the right heart, and a few cases of right heart failure. The section of the foramen ovale channel shows that the opening of the foramen ovale valve tip is restricted, and in severe cases, there is no blood flow passing through. The motion trajectory of M-ultrasound consists of four points: S, A, D, and B. The S point occurs in the early period of ventricular systole, and is closest to the lateral wall of the left atrium. 13 cases reach the wall of the left atrium, and 
46 cases do not reach the wall of the left atrium, but≥2/3 of the left atrial transverse diameter. Among the 59 cases, 2 newborns died, both of which were cases of fetal right heart failure and foramen ovale valve reaching the wall of the left atrium. The remaining 57 fetuses were delivered at full term with good growth and development. Conclusion Most fetuses with isolated redundant foramen ovale valve have a good prognosis. When the foramen ovale valve reaches the lateral wall of the left atrium, the risk of fetal heart failure and neonatal death increases. Therefore, fetuses with foramen ovale valve reaching the lateral wall of the left atrium should strengthen monitoring and undergo regular echocardiography to reduce mortality and improve quality of life.

Objective To investigate the therapeutic effect of androtinib combined with doxorubicin hydrochloride liposome in the treatment of recurrent platinum resistant ovarian cancer and the influence on the tumor markers and apoptosis factors. Methods 120 patients with recurrent platinum resistant ovarian cancer admitted to Shaanxi Cancer Hospital from February 2019 to June 2021 were selected and divided into two groups using random number table. The control group was treated with doxorubicin hydrochloride liposomes, while the observation group was treated with androtinib combined with doxorubicin hydrochloride liposomes. The curative effect and adverse reaction rate of the two groups were compared, and the levels of serum tumor markers and serum apoptosis factors were detected. Results The disease control rate (DCR) in the observation group was 80.00% (48/60) higher than that in the control group 63.33% (38/60), but the objective response rate (ORR) was 21.67% (13/60) compared with 11.67% (7/60) in the control group, with no statistical difference (P>0.05). Before treatment, there was no statistical significance in serum tumor markers and serum apoptosis factors between the two groups (P>0.05). After treatment, carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199), human epididymal protein 4 (HE4), B-cell CLL/lymphomat2-associated anti-apoptotic gene 1 (Bag-1) and B-cell lymphomat-2 (Bcl-2) were decreased in both groups, and the above indexes in observation group were decreased more than those in control group (P<0.05). There were no significant differences in oral mucositis, neutropenia, anemia, thrombocytopenia and leukopenia between the two groups (P>0.05). Conclusion Androtinib combined with doxorubicin hydrochloride liposome can improve the efficacy of patients with recurrent platinum resistant ovarian cancer, which may be related to regulating the expression of serum tumor markers and serum apoptosis factors.

Objective To investigate the feasibility of ovarian tissue cryopreservation (OTC) in patients with hematological diseases and the impact of OTC on hematopoietic stem cell transplantation (HSCT). Methods The clinical data of eleven cases of patients with hematological diseases undergoing OTC admitted to Peking University People’s Hospital from April 2017 to July 2021 were retrospectively analyzed. Results The average age of 11 patients was (23.2±2.9) years (18~31 years). 10 patients had hematologic malignancy, including 6 acute myeloid leukemia, 3 acute lymphoblastic leukemia, and 1 myelodysplastic syndrome. 1 patient had aplastic anemia. 10 patients received laparoscopic bilateral partial ovariectomy, one underwent laparoscopic unilateral ovariectomy. The average time of OTC was (58.8±13.5) minutes (41~82 minutes), and the average intraoperative bleeding was (44.5±51.9) mL (10~200 mL). There were no significant changes in hemogram and coagulation index and no complications such as infection and bleeding after surgery. All patients underwent HSCT after surgery. The time from OTC to pretreatment of HSCT was (37.5±25.7) days (10~82 days). 4 patients began HSCT pretreatment within 20 days after OTC. Conclusions OTC has no adverse effect on patients with hematological diseases and does not delay HSCT treatment. For young patients with hematological diseases, OTC is an effective way to preserve fertility.