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

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.

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.

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.

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 investigate the significance of vaginal microbiota testing in the early and late pregnancy. Methods A total of 2 142 pregnant women who gave birth at term in Beijing Tsinghua Changgung Hospital from June 2022-December 2023 were selected, study on vaginal microecosystem of the prenatal examination conducted using a self-controlled case series design was included in the descriptive differences of 2 142 full-term deliveries during early and late pregnancy, the differences in flora and morphology of vaginal discharge, as well as thepathogenesis characteristics of vaginitis, were compared with 6~8 weeks of gestation as the early pregnancy group and 36~38 weeks of pregnancy as the late pregnancy group. Results ① In the late pregnancy group, the proportion of vaginal microbiota diversity and microbiota density of ++~+++ were 63.6% and 99.5%, respectively, the proportion of G+b(L) lactobacillus as the dominant bacteria in the vagina was 93.7%, and the proportion of Lactobacillus gradeⅠ~Ⅱa was 93.6%, which were higher than those in the early pregnancy group (60.4%, 98.0%, 91.8% and 91.3%, respectively), and the differences were statistically significant (all P<0.05). ② The infection rate of vaginitis in the late pregnancy group (10.4%) was lower than that in the early pregnancy group (15.9%), and the difference was statistically significant (P<0.001), among which the incidence of simple aerobic vaginitis (AV), bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) in the late pregnancy group were 1.9%, 0.7% and 6.3%, which were lower than those in the early pregnancy group (3.1%、1.4% and 9.2%), and the differences were statistically significant (all P<0.05). The incidences of mixed vaginitis in early and late pregnancy were 2.3% and 1.5%, respectively, and the difference was not statistically significant (P=0.057), the mixed infection rate of AV+BV in early pregnancy (1.0%) was higher than that in late pregnancy (0.4%), and the difference was statistically significant (P=0.028). ③ A total of 67 cases of AV alone in the early pregnancy, of which 10 cases (14.9%) were still in the state of AV infection in the late pregnancy, which was a state of continuous infection during pregnancy. 57 cases were cured, with a cure rate of 85.1%; There were 29 patients with BV alone and 196 patients with VVC alone in the early pregnancy, and 89.7% and 67.4% were cured during pregnancy, respectively. A total of 41 patients with AV alone were detected in the late pregnancy, of which 31 (75.6%) were newly infected. There were 15 patients with BV alone and 135 patients with VVC alone in late pregnancy, of which 12 (80.0%) and 71 (55.6%) were newly infected, respectively. Conclusions There are differences in the types, distribution and morphology of vaginal microbiota in the early and late pregnancy, and the vaginal microbiota detection is used for asymptomatic screening during pregnancy, and the precise treatment of vaginitis is carried out in combination with the clinical symptoms of pregnant women, so as to reduce the incidence of vaginitis in late pregnancy.

目的 探讨止痛化癥胶囊联合促性腺激素释放激素-a（GnRH-a）治疗子宫腺肌症的效果及对卵巢功能、痛经程度的影响。方法 选择2022年1月至2024年1月在青岛市海慈医院接受治疗的子宫腺肌症患者125例，采用随机数表法分为试验组（n=63）和对照组（n=62）。对照组给予GnRH-a治疗，试验组给予止痛化癥胶囊联合GnRH-a治疗。比较两组的临床治疗效果、卵巢功能、痛经程度、子宫动脉血流参数及不良反应的发生情况。结果 试验组总有效率高于对照组，差异显著（P<0.05）；治疗后，两组E2、LH及FSH也降低，其中试验组降低水平相较于对照组更为显著（P<0.05）；治疗后，两组月经量评分、痛经VAS评分也降低，试验组降低水平相较于对照组更为显著（P<0.05）；治疗后，两组Vmax、Vmin水平也降低，且试验组水平低于对照组，两组RI也升高，其中试验组更高（P<0.05）；两组不良反应主要为腹痛、阴道出血及月经不调，但无明显差异（P>0.05）。结论 在子宫腺肌症患者中止痛化癥胶囊联合GnRH-a治疗有较好的效果，可有效改善患者的卵巢功能和痛经程度。

女性肿瘤生殖研究（reproductive research in female cancer）逐渐成为当前的热点领域，涉及内容涵盖肿瘤生殖学的定义、发展历程以及国内外研究重点的差异；包括卵巢移位、卵子冷冻与胚胎冷冻等生育保护技术在临床中的应用成效，以及放化疗对生育功能的影响及其面临的伦理、法律与管理挑战。研究这些因素的作用有助于揭示肿瘤的发生机制，并为早期诊断和精准治疗提供新的思路。本文将回顾女性肿瘤生殖研究的最新进展，为未来相关领域的研究提供参考。

Objective To analyze the effects of phloroglucinol on the process of vaginal delivery, maternal-infant outcomes and neonatal umbilical artery blood gas. Methods A total of 800 parturients who underwent vaginal delivery in Jiaozhou Central Hospital of Qingdao from January 2020 to December 2022 were selected as the study subjects. They were divided into a control group (400 cases, routine obstetric intervention) and an observation group (400 cases, treatment with phloroglucinol during labor based on the control group) using the random number table method. Labor process, pregnancy outcomes, neonatal outcomes and neonatal umbilical artery blood gas analysis results were compared between the two groups. Results The first and second stages of labor in the observation group were shorter than that in the control group (P<0.05). The incidence rates of postpartum massive hemorrhage and laceration of the cervix were lower in the observation group (P<0.05). The fetal distress rate was lower, and the 1-minute Apgar score was higher in the observation group (P<0.05). At 1 min, PaO2 and pH values in the observation group were higher, and PaCO2 was lower as compared to the control group (P<0.05). Conclusion Applying phloroglucinol during labor can significantly shorten the labor process, improve pregnancy outcomes, reduce adverse neonatal outcomes, and improve neonatal blood gas indicators to a certain extent.

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 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.

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 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 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 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.