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。

细胞间信息交流是维持机体各种组织器官发育的基本作用机制。众所周知，良好的子宫内膜容受性能够提高胚胎种植，依赖于细胞间信息传递的主要调节因素-外泌体。在外泌体合成过程中，不同细胞的囊泡中含有不同的物质，因此，外泌体包含的遗传和蛋白质组信息有望成为子宫内膜疾病的生物标记物或治疗靶点。本文对外泌体在子宫内膜方面的应用进行了文献综述, 以便为临床研究提供理论依据。

全氟化合物（per and polyfluoroalkyl substances, PFAS）是具有生殖毒性的环境内分泌干扰物，已经在包括卵泡液在内的人体多种体液中检测到，流行病学研究发现与女性月经稀发或闭经、多囊卵巢综合征（polycystic ovarian syndrome, PCOS）、不良妊娠结局等有关。颗粒细胞对于维持卵母细胞的发育和卵巢功能有重要作用，而卵泡液中PFAS主要作用于颗粒细胞造成颗粒细胞功能障碍、卵母细胞发育异常、卵巢功能损伤，进而损害女性生育能力。近年来，PFAS对卵巢功能的影响及其机制研究正广泛进行，本文关注PFAS对颗粒细胞影响的研究现状并进行综述。

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。

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

类器官作为拥有三维结构的微型组织，具备自我更新、自我组装以及维持来源组织结构和生理功能的能力，被视为理想的临床研究模型。在妇产科领域，类器官展现出巨大的潜力，为精准治疗和个体化医疗提供了重要支持。在女性生殖系统中，类器官可用于研究疾病的发生发展机制、个体化治疗方案的制定以及临床前药物筛选等领域。本文着重就类器官在女性生殖系统相关疾病诊治研究中，特别是妇科良性疾病、恶性疾病及母胎医学中应用的研究进展作一简要综述。

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。

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.

Objective To observe the effect of total pelvic floor reconstruction with laparoscopic implantation of TiLOOP mesh (light titaniumized polypropylene TiLOOP anterior pelvic floor repair system) and transvaginal hysterectomy (TVH) plus anterior and posterior vaginal wall repair (APR) on pelvic floor function and postoperative recurrence in patients with pelvic organ prolapse (POP). Methods The study subjects were 92 patients with POP who received treatment in Taizhou Municipal Hospital from January 2018 to February 2022, and were divided into control group (traditional vaginal surgery: TVH+APR, 43 cases) and study group (laparoscopic implantation of TiLOOP mesh for total pelvic floor reconstruction, 49 cases) by means of surgical methods. Pelvic organ prolapse grading, surgical indicators, hospitalization cost, postoperative recurrence rate, sexual life quality, postoperative long-term complications and quality of life scores were compared. Results At 12 months after surgery, the proportions of pelvic organ prolapse gradeⅡand above in study group were less than those in control group (P<0.05). The study group had shorter postoperative hospital stay, less intraoperative blood loss, urinary catheterization time, and less postoperative residual urine volume (P<0.05), and the hospitalization cost was higher (P<0.05). The total incidence rate of complications such as postoperative pain, urinary retention, vaginal bleeding, bladder damage and incision infection was lower in study group compared with that in control group (P<0.05). The scores of PFIQ-7 and PFDI-20 in study group after surgery were lower than those in control group while the score of PISQ-12 was higher than that in control group (P<0.05). The recurrence rate was lower in study group (P<0.05). Conclusion The application of laparoscopic implantation of TiLOOP for total pelvic floor reconstruction has strong clinical practicability in treating POP, and can effectively control complications and recurrence rate after treatment, and it has certain safety and can greatly improve the quality of life of patients.

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 To explore the hemodynamic changes of umbilical artery, middle cerebral artery and venous duct in fetal growth restriction (FGR), and to construct a prediction model for poor pregnancy outcomes of FGR. Methods The clinical data of 197 pregnant women with FGR (FGR group) and 75 healthy pregnant women (control group) who gave birth in the 2nd Affiliated Hospital of Chengdu Medical College, Nuclear Industry 416 Hospital from February 2019 to January 2022 were retrospectively analyzed. All patients received color Doppler ultrasound. All pregnant women were followed up to the pregnancy outcome. Logistic regression analysis was used to analyze the risk factors for poor pregnancy outcomes, and the prediction model was established and ROC curve was adopted to analyze the predictive value of the prediction model on poor pregnancy outcomes. Results The pulsatility index (PI), resistance index (RI) and systolic phase/diastolic phase (S/D) of umbilical artery and venous duct S/a value in FGR group were higher while the PI, RI and S/D of middle cerebral artery and S peak flow velocity and a peak flow velocity of venous duct were lower than those in control group (P<0.05). Logistic regression analysis showed that poor pregnancy history, brain placenta rate<1, abnormal spectrum of venous duct, PLGF lower than normal value, presence of pregnancy complications and intrauterine infection were risk factors for poor pregnancy outcomes (P<0.05). The risk prediction model for poor pregnancy outcomes in pregnant women with FGR was obtained and represented as P=-1.053+0.492×poor pregnancy history+0.635×brain placental rate+0.473×abnormal spectrum of venous duct+0.614×PLGF+0.535×pregnancy complications+0.821×intrauterine infection . ROC curve revealed that the AUC, SE and 95%CI of the prediction model in predicting poor pregnancy outcomes in pregnant women with FGR were 0.929, 0.022 and 0.886-0.973. Conclusions Pregnant women with FGR have abnormal blood flow phenomena in umbilical artery, middle cerebral artery and venous duct. The prediction model established according to the risk factors of poor outcomes in pregnant women with FGR has high predictive value on the occurrence of poor pregnancy outcomes.

Objective To explore the correlation between vaginal flora and cervical flora and cervical squamous intraepithelial lesion (SIL) in women with HR-HPV  infection. Methods A total of 700 HR-HPV-infected women from Qingdao Haici Hospital affiliated with Qingdao University (Qingdao Hospital of Traditional Chinese Medicine) were selected as the study group, and 420 HPV-negative physical examination data during the same period were selected as the control group. The distribution of vaginal and cervical microflora in the study group and the control group were compared, and the patients in the study group were divided into SIL group (n=278) and non-SIL group (n=422) according to whether SIL occurred. Vaginal and cervical microflora distribution and microflora microecology were compared between SIL group and non-SIL group, and the correlation between vaginal microecology of HR-HPV infected women and HR-HPV infection and SIL was analyzed. Results The negative rate of vaginal and cervical lactobacilli, the infection rate of bacteria and mycoplasma in the study group were significantly higher than those in the control group (P<0.05). The proportion of vaginal and cervical lactobacilli negative and bacterial infection in SIL group was significantly higher than that in non-SIL group (P<0.05). The normal rate of colony density, the normal rate of bacterial diversity, the proportion of lactic acid bacteria as the dominant bacteria, the proportion of pH≤4.5, the proportion of sialidase negative and the proportion of leucocyte esterase negative in SIL group were significantly lower than those in non-SIL group (P<0.05), and the vaginal Nugent score was significantly higher than that in non-SIL group (P<0.05). The proportion of normal colony density, normal flora diversity and negative leukocyte esterase in LSIL group was significantly higher than that in HSIL group (P<0.05). The vaginal Nugent score was significantly lower than that in the HSIL group (P<0.05).  Spearman correlation coefficient analysis showed that the vaginal Nugent score of women with HR-HPV infection was significantly positively correlated with HR-HPV infection and SIL (P<0.05). Conclusion The vaginal flora and cervical flora of women with high-risk HPV infection have pathogenic microbial infection and microecological imbalance, and the microecology of vaginal flora are significantly correlated with SIL.

Objective To observe the application of different doses of mifepristone combined with dienogest in the treatment of endometriosis (EMT) and analyze its influence on angiogenesis. Methods A total of 204 patients with EMT from Jan 2021 to Jan 2023 were enrolled in the secoand Affiliated Hospital of Chengdu Medical College ·China National Nuclear corporation 4l6 Hospital as the study subjects. The patient were equally divided into four group using a numerical randomization method, including untreated group, mifepristone group, dienogest group and combined group. The efficacy, sex hormones, inflammatory factors, oxidative stress factors and angiogenesis indicators were compared among the groups. Results There was no significant difference in the clinical efficacy among the three treated groups (P>0.05). After treatment, the levels of estradiol (E2), progesterone (P), follicle stimulating hormone (FSH), interleukin-1 β (IL-1β), interleukin-17 (IL-17), matrix metalloproteinase-9 (MMP-9), vascular endothelial growth factor (VEGF), angiopoietin-Ⅱ(Ang-Ⅱ), reactive oxygen species (ROS) and superoxide dismutase (SOD) in the four groups were significantly different (P<0.05), and the E2, P, FSH, IL-1β, IL-17, MMP-9, Ang-Ⅱ, VEGF and ROS levels in dienogest group, mifepristone group and combined group were significantly lower than those in untreated group (P<0.05), and the above levels in combined group were significantly lower than those in dienogest group and mifepristone group (P<0.05), and the level of SOD was significantly higher than that in untreated group (P<0.05), and the level was significantly higher in combined group compared to dienogest group and mifepristone group (P<0.05). There was no obvious difference in the total incidence rate of adverse drug reactions among the three treated groups (P>0.05). Conclusion The combination of small-dose mifepristone and dienogest in the treatment of EMT can effectively inhibit body’s inflammation, oxidative stress and angiogenesis factors, and it has good safety.

Objective The analysis showed the value of predicting non-estrogen-dependent endometrial cancer based on preoperative MRI radiomic characteristics. Methods A total of 160 patients with endometrial cancer admitted to The First Affiliated Hospital of Bengbu Medical College from January 2018 to May 2023 were selected as the study objects, 80 patients diagnosed with non-estrogen-dependent endometrial cancer were selected as the study group, and the remaining 80 patients with estrogen-dependent endometrial cancer were selected as the control group. All subjects underwent MRI examination and serum carbohydrate antigen 125(CA125), carbohydrate antigen 153(CA153) and carcinoembryonic antigen (CEA) levels were detected before surgery. Results Compared with the control group, the maximum diameter of tumor in the study group was higher, the Apparent diffusion coefficients (ADC) mean level was lower, and the proportion of diffuse type was higher. In the study group, the boundary was blurred, the T1WI signal was equal or slightly lower, the T2WI signal was mixed with high signal, and the DWI signal was slightly higher (P>0.05). Compared with patients with stageⅠ toⅡnon-estrogen-dependent endometrial carcinoma, patients with stageⅢtoⅣnon-estrogen-dependent endometrial carcinoma had higher tumor maximum diameter, higher serum CA125, CA153 and CEA levels, and lower ADCmean levels (P<0.05). Compared with MRI parameters of maximum tumor diameter, ADCmean, CA125, CA153 and CEA, combined diagnosis had higher sensitivity, specificity and accuracy in predicting non-estrogen-dependent endometrial carcinoma (P<0.05). Conclusion MRI radiomic features combined with serum CA125, CA153 and CEA have high value in predicting non-estrogen-dependent endometrial carcinoma.