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.

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。

随着子宫颈癌筛查策略的优化，子宫颈鳞状上皮内病变，尤其是高级别鳞状上皮内病变（HSIL）的检出率显著上升，其临床管理面临治疗与保护生育功能的双重挑战。子宫颈切除性治疗和消融治疗虽能有效清除病灶，但不同程度的会增加术后流产、早产、子宫颈管狭窄等风险，影响生育结局。光动力治疗（PDT）作为一种非切除性、无创的治疗手段，通过选择性破坏病变细胞并清除高危型人乳头瘤病毒，实现清除病灶的同时，能最大限度地保留子宫颈正常结构和功能，为有生育需求的女性提供新的治疗选择。本共识基于现有循证医学证据，系统阐述了PDT的作用机制、不同光敏剂的应用特点、操作规范及适应证，旨在为不同级别子宫颈鳞状上皮内病变的临床规范化治疗提供指导。

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.

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.

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 compare the clinical efficacy of single pelvic floor rehabilitation versus synchronous recti abdominis combined with pelvic floor rehabilitation in postpartum patients with diastasis recti abdominis (DRA) and pelvic floor muscle strength less than grade 3. Methods A total of 96 primiparous women diagnosed with DRA and weakened pelvic floor muscle strength during 42-day postpartum examination at Changzhou Maternal and Child Health Care Hospital from January 2023 to January 2024 were selected, computer-generated random number table method was used to randomly divided into single pelvic floor rehabilitation group (single pelvic floor rehabilitation group) and combined group(synchronous recti abdominis rehabilitation combined with pelvic floor rehabilitation group). Both groups underwent one treatment course (10 sessions), and statistical analysis was performed to compare the differences in therapeutic effects between the two groups. Results Both groups showed improvements in pelvic floor muscle strength (deep and superficial muscles) and Pelvic Organ Prolapse Quantification (POP-Q) (Aa, Ba, C, D) indicators before and after treatment, with statistically significant differences (P＜0.05). However, no statistically significant between-group differences were observed in terms of pelvic floor muscle strength grade (deep and superficial muscles) or POP-Q (Aa, Ba, C, D, Ap, Bp, TVL) before and after treatment (P＞0.05). Conclusions Synchronous rehabilitation for postpartum DRA combined with pelvic floor muscle strength less than grade 3 is effective, safe, and is conducive to promoting early postpartum recovery.

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 explore the curative efficacy of transcervical resection of polyp (TCRP) combined with levonorgestrel-releasing intrauterine system (LNG-IUS), and its influences on serum sex hormones and recurrence. Methods A retrospective analysis was performed on the clinical data of 280 patients with endometrial polyps (EP) who underwent TCRP from March 2022 to September 2023. According to presence or absence of LNG-IUS, patients were divided into LNG-IUS group (n=141) and control group (n=139). All were followed up for 12 months after surgery. The endometrial thickness, menstrual volume pictorial blood loss assessment chart (PBAC), uterine hemodynamics pulsatility index (PI), and resistance index (RI), levels of serum vascular endothelial growth factor (VEGF), luteinizing hormone (LH), and follicle stimulating hormone (FSH) were compared between the two groups, and recurrence rate was observed by follow-up. Results At 3, 6 and 12 months after surgery, endometrial thickness in LNG-IUS group was lower than that in control group (P<0.05), PBAC scores were lower than those in control group (P<0.05), and levels of serum VEGF, LH and FSH were lower than those in control group (P<0.05). At 12 months after surgery, PI and RI in LNG-IUS group were lower than those in control group (P<0.05). At 12 months after surgery, there were 2 recurrence cases (1.42%) in LNG-IUS group and 11 recurrence cases (7.91%) in control group, respectively. The recurrence rate in LNG-IUS group was lower than that in control group (χ2=6.670, P<0.05). Conclusions Hysteroscopic surgery combined with postoperative progesterone therapy is beneficial to reduce endometrial thickness, menstrual blood loss and risk of postoperative recurrence in patients with endometrial polyps, which has high safety.

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 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 analyze the therapeutic effect of GnRH-a combined with LNG-IUS on patients with adenomyosis (AM) after hysteroscopic lesion resection. Methods 152 patients with AM in the hospital were selected from April 2022 to May 2023, and were randomized into GnRH-a group (GnRH-a, n=76) and combined group (GnRH-a and LNG-IUS, n=76) by means of simple randomization method. The therapeutic effect was compared between both groups of patients. Results At 12 months after surgery, the uterine volume, PBAC score, dysmenorrhea score, LH, FSH, MMP-2, VEGF, OPN and CA125 in the two groups were lower than those before surgery (P<0.05) while the hemoglobin content was higher than that before surgery (P<0.05), and the differences between groups were statistically significant (P<0.05). The cumulative recurrence rates at 6 months and 12 months after surgery were lower in combined group than those in GnRH-a group (0% vs 10.53%, 5.26% vs 17.11%) (P<0.05). The pregnancy rate in combined group was higher compared to GnRH-a group (19.74% vs 7.89%) (P<0.05). Conclusion The application of LNG-IUS combined with GnRH-a after hysteroscopic lesion resection can reduce the uterine volume, control the disease progression, reduce the recurrence rate, and enhance the overall efficacy, and it has clinical application value.

Objective To observe the influence of recombinant human interferon α-2b on the disease outcomes in patients with cervical intraepithelial neoplasia CIN2~CIN3 after high-frequency loop electrosurgical excision procedure. Methods A total of 180 patients with CIN2~CIN3 in Zhongshan Hospital Affiliated to Xiamen University were enrolled from January 2021 to January 2024, and were divided into control group (high-frequency loop electrosurgical excision procedure) and study group (high-frequency loop electrosurgical excision procedure+recombinant human interferon α-2b) by simple randomization of the random number table method, 90 cases in each group. The disease outcomes and levels of immune inflammatory factors, vascular endothelial growth factor C (VEGF-C) and transforming growth factor-β (TGF-β) were observed after treatment. Results There was no significant difference in the positive incisal margin between groups (P>0.05). The negative conversion rate of human papillomavirus (HPV) in the study group was 72.22%, which was higher than 54.44% in the control group (P<0.05). The improvement of CIN grading was better than that in the control group (P<0.05). After treatment, pH value and Nugent score were significantly lower in the study group than those in the control group (P<0.05). The levels of Toll-like receptor (TLR) 4, TLR9, nuclear factor-kB, interleukin-4, VEGF-C and TGF-β in the study group after treatment were significantly lower (P<0.05) while the levels of helper T cell (Th) 1/Th2 and interferon-γ were significantly higher compared with those in the control group (P<0.05). Conclusion Combination of high-frequency loop electrosurgical excision procedure and recombinant human interferon α-2b can play a therapeutic effect by regulating the levels of TLRs/NF-kB, Th1/Th2, VEGF-C and TGF-β, and affect the disease outcomes in the treatment of CIN 2～CIN3.

Objective To construct a predictive model for pelvic infection in patients with endometrial cancer after laparoscopic extrafascial total hysterectomy. Methods A retrospective study was conducted on 150 patients with endometrial cancer who underwent laparoscopic extrafascial total hysterectomy in Women's Hospital of Nanjing Medical University from August 2021 to August 2024. According to whether pelvic infection occurred during hospitalization, patients were divided into an incidence group (n=19) and a non incidence group (n=131). LASSO and Logistic regression were used to analyze the predictors of postoperative pelvic infection, and the risk prediction model was constructed. Results LASSO regression and multifactorial Logistic regression analysis showed that diabetes, preoperative vaginal pH≥5.0, preoperative neutrophil/lymphocyte ratio (NLR), procalcitonin (PCT), perioperative maximum difference in blood glucose (MGD) and hospital stay were risk factors for postoperative pelvic infection (P<0.05). The construction of a column chart model showed that the model had good discrimination, accuracy, and practicality. Conclusions Preoperative vaginal pH≥5.0, NLR, PCT, perioperative MGD, and length of hospital stay are factors related to pelvic infection after endometrial cancer surgery. A column chart model constructed based on these factors can effectively predict the risk of pelvic infection after surgery.

经阴道骶棘韧带固定术（sacrospinous ligament fixation, SSLF）是妇科盆底重建手术中一种重要的术式，主要用于治疗中盆腔缺陷为主的盆腔器官脱垂（pelvic organ prolapse, POP）。SSLF因其疗效显著、恢复快等优点，在临床应用日益广泛。《经阴道骶棘韧带固定术专家共识（2025年版）》由中国妇幼保健协会妇科阴式手术专业委员会组织国内盆底专家共同制定，该共识从SSLF的适应证与禁忌证、术前评估、手术步骤及要点、并发症的处理与预防等方面进行了推荐，旨在规范该手术的临床应用，为临床医生提供实践指导。本文将对共识中的关键内容进行解读，以帮助临床医生更好地理解和应用这一术式。