To compare the differences in clinical characteristics between different types of abdominal wall endometriosis (AWE) according to the invasive levels of tissue mass. 122 patients, who had undergone resection of AWE lesions at our hospital from January 2011 to January 2023, were retrospectively analyzed. The patients were divided into three types according to their deepest level of lesion invasion. Type I designated invasion of skin and subcutaneous tissue; type II, of the fascial rectus abdominis; and type III, of the muscle and/or peritoneum. The general conditions, clinical manifestations, auxiliary examinations, surgical and postoperative conditions, and recurrence, were classified, compared, and analyzed. Of the 122 patients, type I patients accounted for 23.0

[This corrects the article DOI: 10.3389/fendo.2025.1561673.].

Objective:To examine trends in endometrial cancer (EC) mortality among U.S. adult women from 1999 to 2020, with particular attention to the acceleration after 2013, and to assess disparities by race/ethnicity, urbanization, age, and geography. Methods:EC mortality data (ICD-10: C54) were extracted from the CDC WONDER database. Age-adjusted mortality rates (AAMRs) per 100,000 (2000 U.S. standard population) were calculated annually from 1999 to 2020. Joinpoint regression was used to estimate annual percent changes (APCs) and identify inflection points. Subgroup analyses were stratified by race/ethnicity, urbanization level (2013 NCHS classification), age group, and census region/state. Results:EC deaths increased 134% (2.34-fold), from 3,087 in 1999 to 7,230 in 2020. The joinpoint analysis showed stable phase from 1999 to 2013 (APC = -0.22; 95% CI, -0.49 to 0.04) followed by a sharp rise from 2013 to 2020 (APC = 6.25; 95% CI, 5.62 to 6.88). Black women had the highest mortality rate (5.41 per 100,000), followed by White, Asian, and American Indian/Alaska Native women. Age-related trends showed a significant rise in mortality, with the steepest increases observed in women aged 65+ years. Geographic variation was also observed, with the Northeast and Urban areas exhibiting high mortality rates. Conclusion:Endometrial cancer (EC) mortality among women has increased markedly since 2013, in particular for Black women, older people (aged 65+) and urban people. These findings underscore the urgent need for risk reduction and early detection strategies in high-burden populations.

Ovarian endometriosis (OEM) is characterised by ectopic endometrial tissue growth within the ovary. In these ectopic lesions, the ectopic epithelium plays a crucial role in OEM progression and has been associated with malignant transformation in a subset of cases. However, conventional histology limits understanding of ectopic epithelial distribution, structure, and its perivascular microenvironment, thus impeding pathogenesis studies. To address this, we employed a modified tissue-clearing method and  three-dimensional (3D) imaging to systematically characterise OEM, revealing key, previously unreported spatial characteristics. We found significantly higher densities of ectopic epithelium and vasculature in the outer cystic wall versus the inner. Furthermore, our method improved the detection rate of ectopic epithelium and revealed its morphological polymorphism at both tissue and cellular levels. Besides, we demonstrated that vessels preferentially cluster around ectopic epithelium, with their distribution pattern strongly linked to the location of ectopic epithelium. Strikingly, we observed endometrial-like structures in lesional vasculature in 3 of 49 cases, representing a novel morphological observation that warrants further investigation. This study significantly advances our understanding of OEM histopathology, offering insights for clinical diagnosis and treatment.

Background:Endometriosis is a common disease among women of childbearing age (WCBA), significantly affecting their physiological health. This study systematically analyzes the global, regional, and national burden of endometriosis in WCBA based on the Global Burden of Disease 2021 (GBD 2021) database. Methods:This study focuses specifically on the WCBA population, evaluating the burden of endometriosis in terms of incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Results:Globally, the number of prevalent cases of endometriosis among WCBA increased from 19.08 million in 1990 to 21.05 million in 2021, marking a 10% rise; incident cases grew from 3.326 million to 3.439 million, an increase of 3%; DALYs rose from 1.759 million to 1.939 million, a 10% increase; and deaths increased from 21.55 to 46.72, a rise of 117%. However, the age-standardized incidence, prevalence, and DALY rates showed downward trends, with EAPCs of -0.94, -1.12, and -0.93, respectively. Regions with a middle SDI level recorded the highest numbers of prevalent cases, incident cases, DALYs, and deaths. In 2021, endometriosis exhibited marked age-related differences worldwide. Women aged 25-29 had the highest number of prevalent cases and DALYs, those aged 20-24 had the highest incidence, and those aged 45-49 had the highest number of deaths. Conclusion:The global distribution of endometriosis varies significantly across regions, highlighting the need for public health policies to be tailored to regional contexts to optimize healthcare resource allocation.

BackgroundEndometriosis is a hormone-dependent disease, which can usually be divided into peritoneal endometriosis (PEM), deep-infiltrating endometriosis (DIE) and ovarian endometriosis (OEM). Although the three pathologic types are essentially the same disease, they differ in pathological manifestations, molecular features, pain symptoms and hormonal responsiveness. However, there is limited literature focusing on the differences among these types. In this study, we employed single-cell RNA sequencing (scRNA-seq) to profile the transcriptome of each type using surgical biopsy samples obtained from six patients. We aimed to explore and elucidate the variations among these different types of endometriosis.ResultsWe identified five major cell types and 44 subpopulations, including the presence of mesothelial cells in all pathological types, including OEM. Furthermore, we characterised the variations in cell types across different pathological types by employing enrichment analysis to assess functions and pathways. Notably, our findings reveal distinct levels of epithelial-mesenchymal transition (EMT) processes experienced by mesothelial cells within the microenvironment of endometriotic lesions. Through ligand-receptor analysis and referencing relevant literature, we propose that mesothelial cells exert an influence on progesterone resistance in stromal cells through intercellular communication mediated by the FN1-AKT pathway.ConclusionsOur study comprehensively characterises the heterogeneity of the different pathologic types of endometriosis and offers valuable insights into the underlying mechanisms contributing to variations in progesterone resistance across the three subtypes.Key points Single-cell RNA (ScRNA) atlas across types of endometriosis is established. Mesothelial cells are founded in ovarian endometriosis. Endometriosis-associated mesothelial cells (EAMCs) experience various level of epithelial-mesenchymal transition (EMT) process in different subtypes. EAMCs may exert an influence on progesterone resistance in stromal cells through intercellular communication mediated by the FN1-AKT pathway.

Local estrogen therapy is clinically employed for pelvic organ prolapse (POP) management, demonstrating efficacy in promoting collagen synthesis and maintaining pelvic connective tissue integrity. This study aimed to investigate the roles and mechanisms of estrogen 17β-estradiol (E2) in regulating proliferation, migration, and collagen production of human uterosacral ligament fibroblasts (hUSLFs) from POP patients. Primary hUSLFs from POP patients and controls were isolated and treated with 10− 7, 10− 8, 10− 9 M E2, respectively. Cell proliferation, migration, apoptosis, collagen I/III levels, and matrix metalloproteinase 2 (MMP2)/MMP9 expression were examined. Homeobox A13 (HOXA13) levels were measured in clinical uterosacral ligament (USL) tissues and E2-treated hUSLFs. Gain- and loss-of-function experiments were conducted to investigate the role of HOXA13 in hUSLFs. Chromatin immunoprecipitation (ChIP) and luciferase assays verified HOXA13-mediated transcription regulation of tissue inhibitor of metalloproteinase 1 (TIMP1) in hUSLFs. Rescue experiments was conducted to investigate the roles of E2/HOXA13/TIMP1 axis in hUSLF functions. E2 remarkably promoted proliferation, migration, and collagen production while inhibiting apoptosis and MMP2/MMP9 expression in hUSLFs. The concentration at 10− 8 M showed the optimal efficacy. HOXA13 was downregulated in USL tissues of POP patients compared with controls. HOXA13 overexpression promoted proliferation, migration, and collagen production while reducing apoptosis in hUSLFs. Whereas HOXA13 knockdown showed the opposite results. E2 treatment upregulated HOXA13 expression in hUSLFs. HOXA13 knockdown abrogated E2-mediated functional enhancement of hUSLFs. Moreover, HOXA13 transcriptionally activated TIMP1 expression. TIMP1 knockdown reversed the positive effects of HOXA13 on the proliferation, migration, and collagen production of hUSLFs. E2 facilitates proliferation, migration, and collagen production of hUSLFs from POP patients through upregulating the HOXA13/TIMP1 axis. Our findings provide important mechanistic insights into the protective effects of estrogen on POP fibroblasts and identify HOXA13 as a potential therapeutic target worthy of further investigation.

Background Endometriosis is a chronic disease characterised by dysmenorrhoea and pelvic pain. There is an urgent unmet need for non-hormonal therapies for endometriosis, particularly for women in their reproductive years. Dysregulation of prolactin signalling, including systemic hyperprolactinaemia, augmented endometrial prolactin synthesis, and aberrant prolactin receptor activation, are implicated in the pathogenesis of endometriosis. This proof-of-concept study assessed the safety and efficacy of HMI-115, a human monoclonal antibody that blocks the prolactin receptor, for the treatment of moderate-to-severe endometriosis-associated pain in premenopausal women. Methods This multicentre, placebo-controlled, double-blind, randomised, proof-of-concept phase 2 study was conducted at 21 centres (including university-based hospitals, specialised clinics, and clinical research sites) in China, Poland, and the USA. Premenopausal women aged 18–49 years with endometriosis diagnosed surgically via laparoscopy or laparotomy and moderate-to-severe endometriosis-associated pain were eligible for enrolment. Pain was defined by a score of 6 or more on the Composite Pelvic Signs and Symptoms Score, and participants also had to report a numerical rating scale (NRS) score of 4 or higher for dysmenorrhoea and non-menstrual pelvic pain for at least 2 days in the 35-day pre-randomisation period. Participants were randomly assigned (1:1:1:1) using an interactive response technology system to receive subcutaneous doses of either HMI-115 (60 mg, 120 mg, or 240 mg) or placebo; doses were administered every other week for 12 weeks. Randomisation was stratified by region and participation in the intensive pharmacokinetic sampling subset. Participants, investigators, site staff, and the trial sponsor remained masked to treatment assignment throughout the study. The primary outcome was change in dysmenorrhoea NRS score from baseline to week 12, assessed in the primary analysis set (PAS), which included all participants with a surgical diagnosis of endometriosis who took at least one dose of study drug and were analysed in the treatment group to which they were randomly assigned. Safety outcomes included treatment-emergent adverse events, vital signs, physical examinations, electrocardiograms, clinical laboratory tests, and bone mineral density, assessed in the PAS. The trial is completed and registered with ClinicalTrials.gov (NCT05101317). Findings Between Feb 18, 2022 and Dec 14, 2024, 108 premenopausal women were randomly assigned and received treatment. 27 (25%) were assigned to HMI-115 60 mg, 27 (25%) to HMI-115 120 mg, 24 (22%) to HMI-115 240 mg, and 30 (28%) to placebo and were included in the PAS. At week 12, the least-squares mean percentage change from baseline in dysmenorrhoea NRS score was –27·35% (SE 9·57; placebo-adjusted difference –8·74 [SE 10·58, 95% CI –29·48 to 11·99]; p=0·409) for the HMI-115 60 mg group, –34·72% (9·63; –16·11 [10·68,–37·03 to 4·82]; p=0·131) for the HMI-115 120 mg group, and –41·57% (10·23; –22·96 [10·96, –44·44 to 1·47]; p=0·036) for the HMI-115 240 mg group. Treatment-emergent adverse events occurred in 15 (56%) of 27 participants in the HMI-115 60 mg group, 16 (59%) of 27 in the HMI-115 120 mg group, 18 (75%) of 24 in the HMI-115 240 mg group, and 11 (37%) of 30 in the placebo group. The most common treatment-emergent adverse events were injection-site pruritus and rash, dizziness, nausea, nasopharyngitis, and headache. Headaches were more frequent in the HMI-115 240 mg group (four [17%] participants) than in the other groups, but it did not correlate with serum prolactin levels. One (4%) participant in the HMI-115 240 mg group reported a serious adverse event, which was a pre-existing unilateral breast nodule that needed surgery during the study and was deemed not related to study treatment by the investigator. No fatal adverse events were reported. Interpretation In this proof-of-concept phase 2 trial, blocking the prolactin receptor with HMI-115 showed an acceptable tolerability profile and promising efficacy in alleviating endometriosis-associated pain. These findings support further investigation of HMI-115 in a phase 3 trial with a longer treatment duration to confirm clinical benefits and assess risk of harm. Funding Hope Medicine and the National Key R&D Program of China (grant numbers 2024YFF1503900 and 2022YFA1303000).

Background:Hypertensive disorders of pregnancy (HDP) are a significant cause of maternal and perinatal morbidity and mortality worldwide. This study aims to use the Global Burden of Disease 2021 database to analyze the prevalence trends and disease burden of HDP across the globe from 2019 to 2021. Methods:We analyzed four key metrics related to HDP (prevalence, incidence, mortality, and DALYs) using data from the GBD Database. Trends were assessed using the estimated annual percentage change (EAPC) and changes in disease burden. Results:In 2021, global HDP prevalence cases, incidence cases, mortality cases, and DALYs were 3.51 million, 18.00 million, 37.58 million, and 2.44 million, respectively, with percentage changes of 14%, 15%, -29%, and -29% over the study period. Prevalence and incidence rates increased (EAPCs: -0.7 and -0.67), while mortality and DALYs rates decreased (EAPCs: -2.29 and -2.28). Low Socio-demographic Index (SDI) regions had the highest HDP burden, accounting for about half of the global total. The 25-29 age group had the highest incidence cases. Conclusion:Over the past 32 years, HDP prevalence cases and incidence cases have risen globally, but death cases and DALYs cases have significantly decreased, particularly in low SDI regions and the 25-29 age group. The global HDP burden is higher in regions with lower SDI. Our findings highlight regional and age-related disparities in HDP, providing a basis for targeted interventions and prevention strategies.

Umbilical endometriosis (UE) is a rare condition. We have documented the clinical characteristics, management strategies, and follow-up results for five cases treated at our hospital between 1998 and 2020, with patients aged between 31 and 44 years. Patients typically presented with umbilical swelling. In all cases, surgical removal was effective and no complications were reported. Two patients had concurrent ovarian endometriosis and one adenomyosis. No umbilical recurrence was recorded during follow-up. We believe that these findings offer valuable insights for the management of this patient population. Clinical management strategies for this disease should be tailored to each patient and carried out collaboratively by both general and gynaecological physicians.

Objective This study aimed to investigate the potential role of galectin-3 (Gal-3) in the pathogenesis of fibrotic alterations in ovarian endometriosis (OVE). Methods In this study, we collected the ectopic endometrial tissues and eutopic endometrial tissues from 31 OVE patients treated by laparoscopy, and the eutopic endometrial tissues from 23 non-OVE patients with leiomyoma or other benign diseases were used as control. Hematoxylin and eosin (H&E) and Masson’s trichrome staining were utilized for histopathological assessment. The primary normal endometrial stromal cells (NESC), ectopic endometrial stromal cells (ECSC), and eutopic endometrial stromal cells (EUSC) were isolated. Gal-3 overexpression plasmids (Gal-OE) and short hairpin RNA targeting Gal-3 (Gal-3-shRNA) were transfected into the immortalized human endometriotic cell line 12Z, respectively. RT-qPCR, Western blot analysis, and immunohistochemistry were used to detect the mRNA and protein expression levels of Gal-3, type I collagen (COL-1), connective tissue growth factor (CTGF) and α-smooth muscle actin (α-SMA), respectively. Results H&E and Masson staining showed that ovarian ectopic endometrium exhibited glandular hyperplasia, high columnar glandular epithelium, apical plasma secretion, more subnuclear vacuoles, and obvious fibrosis, compared with normal endometrium. The mRNA and protein levels of Gal-3 , CTGF, α-SMA, and COL-1 were all upregulated in the ectopic endometrial tissues of OVE patients compared to the eutopic endometrial tissues from OVE patients and non-OVE patients. Moreover, ECSC expressed higher levels of Gal-3, CTGF, α-SMA, and COL-1 than EUSC and NESC. Follow-up investigations demonstrated that the Gal-3 overexpression substantially increased fibrosis-related markers including CTGF, α-SMA, and COL-1 within the 12Z cell line. Conversely, Gal-3 knockdown showed the opposite effects. Conclusion Gal-3 promotes fibrosis in OVE, positioning it as a prospective therapeutic target for mitigating fibrosis in endometriosis.

Purpose Epithelial ovarian cancer (EOC) is a prevalent gynecological malignancy with a notoriously poor prognosis. Recent oncological research has highlighted ferroptosis and disulfidptosis as novel forms of cell death with potential therapeutic implications. However, the relationship between these processes and their role in EOC remains poorly understood. Methods Through comprehensive bioinformatics analyses, we identified six disulfidptosis-related ferroptosis genes in EOC samples. A prognostic model was developed utilizing these genes to assess their predictive power for EOC survival prognosis. We further investigated the dual role of BCAT2 in regulating ferroptosis and modulating GYS1, which is implicated in disulfidptosis. The influence of BCAT2 on cell proliferation, migration, and invasion was examined through its regulation of c-MYC and its impact on G2M phase and EMT-related proteins. Results Our findings reveal that BCAT2 plays a pivotal role in both ferroptosis and disulfidptosis in EOC. It not only regulates ferroptosis but also modulates GYS1, thereby influencing disulfidptosis. We observed a strong correlation between BCAT2 and GYS1 expression. Additionally, BCAT2's interaction with GYS1 extends its influence beyond ferroptosis, significantly disrupting disulfidptosis as well. Conclusion This study provides valuable insights into the complex interplay between disulfidptosis and ferroptosis in EOC, our findings underscore the potential of targeting BCAT2 and GYS1 as a therapeutic strategy for EOC.

Objective: This study aims to investigate how changes in peripheral blood metabolites in Alzheimer’s Disease (AD) patients affect the development of Pelvic Organ Prolapse (POP) using a multi-omics approach. We specifically explore the interactions of signaling pathways, gene expression, and protein-metabolite interactions, with a focus on GZMA and cysteine in age-related diseases.Methods: This study utilized multi-omics analysis, including metabolomics and transcriptomics, to evaluate the perturbations in peripheral blood metabolites and their effect on POP in AD patients. Additionally, a comprehensive pan-cancer and immune infiltration analysis was performed on the core targets of AD combined with POP, exploring their potential roles in tumor progression and elucidating their pharmacological relevance to solid tumors.Results: We identified 47 differential metabolites linked to 9 significant signaling pathways, such as unsaturated fatty acid biosynthesis and amino acid metabolism. A thorough gene expression analysis revealed numerous differentially expressed genes (DEGs), with Gene Set Enrichment Analysis (GSEA) showing significant changes in gene profiles of AD and POP. Network topology analysis highlighted central nodes in the AD-POP co-expressed genes network. Functional analyses indicated involvement in critical biological processes and pathways. Molecular docking studies showed strong interactions between cysteine and proteins PTGS2 and GZMA, and molecular dynamics simulations confirmed the stability of these complexes. In vitro validation demonstrated that cysteine reduced ROS levels and protected cell viability. GZMA was widely expressed in various cancers, associated with immune cells, and correlated with patient survival prognosis.Conclusion: Multi-omics analysis revealed the role of peripheral blood metabolites in the molecular dynamics of AD and their interactions with POP. This study identified potential biomarkers and therapeutic targets, emphasizing the effectiveness of integrative approaches in treating AD and POP concurrently. The findings highlight the need for in-depth research on novel targets and biomarkers to advance therapeutic strategies.

Background: This study aimed to analyze the risk factors that affect recurrence in patients with borderline ovarian tumors （BOTs） after radical surgery and the risk factors that influence recurrence and pregnancy in patients after fertility-sparing surgery (FSS). Methods: This retrospective cohort study collected data from clinical records of patients in the Beijing Chaoyang Hospital affiliated to Capital Medical University from January 2005 to November 2021. Clinicopathological and surgical variables were analyzed using univariate analyses and survival curves. Results: 169 BOT patients were included in this study, with a median age of 45 years and a median follow-up time of 81months. Among these patients, 21 had relapsed. Of the 60 patients who received FSS, 16 attempted to conceive, and 13 successfully conceived spontaneously. In univariate analyses, FIGO stage and invasive implantation were risk factors for recurrence of BOTs. After multivariate analysis, FIGO stage was the only identified risk factor. Tumor site was risk factor for recurrence of BOTs receiving FSS. No risk factors for pregnancy in BOTs receiving FSS were found. Conclusion: After univariate analysis and multivariate analysis, we identified some risk factors for recurrence after radical surgery or FSS, but they did not affect the overall survival rate and pregnancy rate. Laparoscopy procedures are recommended, and chemotherapy is not recommended for patients receiving FSS. We suggest that patients who preserve fertility should try to conceive as soon as possible and follow up closely.

OBJECTIVE:To explore the effectiveness of HPV 16/18 E7 oncoprotein in detecting high-grade cervical intraepithelial neoplasia (CIN) and predicting disease outcomes in HPV 16/18-positive patients. METHODS:The present study was a cross-sectional study with a 2-year follow up. We collected 915 cervical exfoliated cell samples from patients who tested positive for HPV 16/18 in gynecologic clinics of three tertiary hospitals in Beijing from March 2021 to October 2022 for HPV 16/18 E7 oncoprotein testing. Subsequently, 2-year follow up of 408 patients with baseline histologic CIN1 or below were used to investigate the predictive role of HPV 16/18 E7 oncoprotein in determining HPV persistent infection and disease progression. RESULTS:The positivity rate of the HPV 16/18 E7 oncoprotein assay was 42.06% (249/592) in the inflammation/CIN 1 group and 85.45% (277/324) in the CIN2+ group. For CIN2+ detection, using the HPV 16/18 E7 oncoprotein assay combined with HPV 16/18 testing, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 85.45%, 57.94%, 52.57%, and 87.95%, respectively. During the 2-year follow up, the sensitivity, specificity, PPV, and NPV for predicting persistent HPV infection were 48.44%, 58.21%, 34.64%, and 71.18% in the baseline inflammation and CIN1 group. CONCLUSIONS:As a triage method for high-grade CIN screening in HPV 16/18-positive patients, HPV 16/18 E7 oncoprotein demonstrated a relatively high NPV, making it suitable for clinical use in triaging HPV 16/18-positive cases and potentially reducing the colposcopic referral rate. HPV 16/18 E7 oncoprotein exhibited a preferably predictive value in determining HPV infection outcomes and disease progression.

Endometriosis (EMS) is a common benign gynecological disease affecting women of reproductive age. It is characterized by abnormal growth of endometrial tissue outside the uterine cavity, resulting in chronic pelvic pain and infertility. Endometrial physiological and pathological processes are intimately connected to autophagy. Mitophagy is an essential selective mode that protects cells from metabolic stress and hypoxia. Mitochondrial autophagy mediated by prohibitin 2 (PHB2) is dependent on the PRKN/Parkin pathway and is involved in numerous human diseases. Uncertainty remains as to whether mitophagy regulation by PHB2 contributes to the occurrence and progression of EMS. This study aims to investigate the mechanism underlying the role of PHB2 in EMS. This study detected the protein and mRNA expression of PHB2 in ectopic and normal endometrial tissues of ovarian EMS, in addition to ectopic endometrial cell line 12Z and endometrial stromal cell line KC02-44D for gene overexpression or knockdown. Cell function experiments and mitochondrial function experiments were conducted to investigate the role of PHB2 in the endometrium. Bioinformatic analysis and experiments were also used to investigate the upstream transcription factors that influence PHB2 expression. PHB2 was downregulated in ectopic endometrium, and PHB2 overexpression inhibited cell proliferation, migration, and invasion and promoted apoptosis. The upregulation of mitophagy markers, including Parkin and LC3II/I, and the downregulation of autophagy degradation markers P62 and TOMM20 in EMS suggest that PHB2 may contribute to cell proliferation, migration, invasion, and apoptosis via PRKN/Parkin-mediated mitophagy. Analysis and validation of bioinformatics data revealed that the transcription factor GABPA binds directly to the PHB2 promoter region and controls the transcriptional expression of PHB2. This study investigated the role of PHB2 in the onset of EMS. It inhibits EMS growth via PRKN/Parkin-mediated mitophagy, and GABPA controls the transcriptional disorder of PHB2. This study’s findings suggest a novel method for investigating the clinical potential of PHB2 in EMS.

目的 探讨基于国家免费孕前优生健康检查的不同年龄段女性检查方案的优化.方法 选取2021年1月至12月在北京市西城区妇幼保健院进行免费孕前检查的800名备孕女性作为研究对象,采用随机数字表法分为实验组与观察组,每组各400名.其中实验组高龄段100名(年龄≥35岁)、适龄段300名(年龄<35岁).观察组高龄段100名(年龄≥35岁)、适龄段300名(年龄<35岁).观察组仅接受免费孕前检查;实验组适龄段在免费孕前检查基础上增加游离甲状腺素及抗甲状腺过氧化物酶抗体检测,实验组高龄段在免费孕前检查基础上增加抗米勒管激素、糖化血红蛋白检测.比较两组甲状腺功能与血糖状态,比较适龄段与高龄段促甲状腺激素与空腹血糖异常情况及实验组高龄段的卵巢储备功能减退检出情况.结果 适龄段的促甲状腺激素异常检出率高于高龄段,高龄段的空腹血糖检出率高于适龄段,差异有统计学意义(P<0.05);实验组适龄段的甲状腺功能异常检出率高于观察组适龄段,实验组高龄段的血糖异常检出率高于观察组高龄段(P<0.05);实验组高龄段检出卵巢储备功能减退28例(28％).结论 针对不同年龄段女性,在现有免费孕前优生健康检查基础上增加相关检查,能提升甲状腺功能、血糖异常检出率,根据检查结果及时进行干预,进而缩短妊娠等待时机,对改善备孕女性健康有积极意义.

Recently, sentinel lymph node（SLN） mapping has been widely used in surgery for gynecological malignancies, especially endometrial carcinoma. Compared with systematic lymphadenectomy, SLN biopsy can shorten operation time and reduce the incidences of wounds and surgical complications. However, SLN are currently widely used in low-grade endometrial carcinoma.The application of SLN in high-grade endometrial carcinoma is controversial. This review summarizes the progress of SLN in highgrade endometrial carcinoma, providing evidence and guidance for clinical practice.

BACKGROUND:Ureteral injury is common during gynaecological laparoscopic surgery. Real-time auto-segmentation can assist gynaecologists in identifying the ureter and reduce intraoperative injury risk. METHODS:A deep learning segmentation model was crafted for ureter recognition in surgical videos, utilising 3368 frames from 11 laparoscopic surgeries. Class activation maps enhanced the model's interpretability, showing its areas. The model's clinical relevance was validated through an End-User Turing test and verified by three gynaecological surgeons. RESULTS:The model registered a Dice score of 0.86, a Hausdorff 95 distance of 22.60, and processed images in 0.008 s on average. In complex surgeries, it pinpointed the ureter's position in real-time. Fifty five surgeons across eight institutions found the model's accuracy, specificity, and sensitivity comparable to human performance. Yet, artificial intelligence experience influenced some subjective ratings. CONCLUSIONS:The model offers precise real-time ureter segmentation in laparoscopic surgery and can be a significant tool for gynaecologists to mitigate ureteral injuries.

PurposeThe use of mesh for vaginal repair is currently problematic; consequently, there is increased interest in native tissue repair. Combining native tissue repair with sufficient mesh-applied apical repair might provide effective treatment. We describe the study focusing on the combination of pectopexy and native tissue repair.MethodsBetween April 2020 and November 2021, 49 patients with symptomatic stage III or IV were treated with laparoscopic pectopexy combined with native tissue repair. The mesh was solely used for apical repair. All other clinically relevant defects were treated with native tissue repair. The perioperative parameters including surgical time, blood loss, hospital stay, and complications were recorded. The anatomical cure rate was evaluated according to the Pelvic Organ Prolapse Questionnaire (POP-Q) assessment. Validated questionnaires of the Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) were recorded to evaluate the symptom severity and quality of life.ResultsThe mean duration of follow-up was 15 months. All domains of POP-Q, PFDI-20, and PFIQ-7 scores improved significantly after surgery. No major complications, mesh exposure, or mesh complication occurred during the follow-up period.ConclusionThe overall repair concept of laparoscopic pectopexy as the core, assisted by vaginal natural tissue repair for severe pelvic organ prolapse can achieve satisfactory clinical results and improve patient satisfaction.