Cervical cancer (CC) remains a major health challenge worldwide. Early detection methods and screening strategies are important for reducing both incidence and mortality rates. This study evaluates the clinical performance of the real-time optoelectronic device, TruScreen (TS), in detecting high-grade cervical precancers compared to standard methods [high-risk human papillomavirus (hrHPV) testing, cytology, and colposcopy) in a Chinese hospital-based opportunistic screening cohort. In addition, assess the clinical effectiveness of the TS strategies alongside current guidelines and methodologies in cervical cancer screening. A multicenter, cross-sectional study was conducted across 64 hospitals between September 2018 and June 2021 in China. Participants (n = 14,982 women aged ≥ 20 years) underwent TS test, hrHPV test, liquid-based cytology (LBC), and colposcopy with biopsy confirmation. Diagnostic performance [sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV)] were calculated using histopathology as the gold standard. Strategies incorporating TS test were compared to WHO-recommended guidelines. For cervical intraepithelial neoplasia grade 2 and servier lesions (CIN2+), TS test demonstrated comparable sensitivity (87.0

Purpose:To characterize longitudinal changes in routine blood count-derived inflammatory indices throughout pregnancy and the early postpartum period in women with diet-controlled gestational diabetes mellitus (GDM A1) compared with normoglycemic controls. Methods:This retrospective cohort study included 366 pregnant women, comprising 170 women with GDM A1 and 196 normoglycemic controls, who received antenatal care at Beijing Friendship Hospital. Routine complete blood count parameters were collected at seven clinically relevant time windows: 8-12, 16-20, 24-28, 28-32, and 36 weeks of gestation, immediately before delivery, and postpartum. The aggregate index of systemic inflammation (AISI), systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), lymphocyte-to-monocyte ratio (LMR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) were calculated. Exploratory unadjusted between-group comparisons were performed using Mann-Whitney U-tests. Adjusted linear mixed-effects models were used to evaluate group-by-time interactions while accounting for within-subject correlation and baseline covariates. Results:Women with GDM A1 were older and had higher early-pregnancy BMI than normoglycemic controls. After adjustment for maternal age, early-pregnancy BMI, gravidity, parity, and history of macrosomia, significant group-by-time interactions were observed for all six inflammatory indices, including AISI (P < 0.001), SIRI (P < 0.001), SII (P = 0.017), LMR (P = 0.011), MLR (P = 0.011), and PLR (P = 0.022). In Holm-adjusted post hoc comparisons, SIRI was higher in the GDM A1 group during the postpartum period (adjusted ratio = 1.204, 95% CI: 1.066-1.360, P = 0.020), and PLR was higher immediately before delivery (adjusted ratio = 1.123, 95% CI: 1.036-1.217, P = 0.032). Conclusion:Women with GDM A1 showed altered longitudinal trajectories of CBC-derived inflammatory indices, with the most robust adjusted time-specific differences involving postpartum SIRI and pre-delivery PLR. These indices may provide accessible research markers for characterizing stage-specific inflammatory patterns in diet-controlled GDM, but prospective studies incorporating direct inflammatory and metabolic measurements are required to establish clinical utility.

Endometrial cancer (EC) is the most common gynecological malignancy, frequently characterized by PTEN deletion, activation of the AKT/mTOR pathway, and limited effective treatment options for recurrent and advanced patients. High-dose ascorbate or combined with other chemotherapeutic agents shows potent antitumor effects in vitro and in vivo. In this study, high-dose ascorbate significantly inhibited cell proliferation and invasion, increased cellular stress and DNA damage, and induced cell cycle arrest and apoptosis in EC cells. Oral or intraperitoneal injections of high-dose ascorbate for 4 weeks effectively inhibited tumor growth in LKB1fl/flp53fl/fl -mouse model of EC, with intraperitoneal injections being more effective than oral administration. N-acetylcysteine partially reversed the antitumor effects of ascorbate in EC cells and tumor growth in LKB1fl/flp53fl/fl -mice. PTEN knockdown by shRNA reduced the antitumor sensitivity of EC cells to ascorbate, while inhibition of the AKT/mTOR pathway by Ipatasertib significantly enhanced the antitumor activity of ascorbate in EC cells. Ascorbate combined with paclitaxel synergistically inhibited tumor growth compared to either agent alone in LKB1fl/flp53fl/fl -mice. Overall, high-dose ascorbate exhibits antitumor activity partially through PTEN/AKT/mTOR and cell stress pathways, and these antitumor effects were heightened when combined with paclitaxel in EC. Clinical trials of ascorbate combined with paclitaxel deserve further investigation in EC patients.

Objective:To evaluate the efficacy of a real-time photoelectric element (TruScreen) for identifying cervical precancerous lesions in middle-aged women. Methods:We conducted a retrospective analysis of data collected from 100 women aged 25-55 years who underwent colposcopy at Beijing Obstetrics and Gynecology Hospital between June and July 2018. We obtained the results of the ThinPrep cytologic test/HPV tests and TruScreen tests conducted before colposcopy as well as the histopathological results from postoperative multi-site biopsies. Patients were divided into two groups based on histopathological findings: CIN II or higher, and CIN I. We analyzed the diagnostic efficacy of different testing methods, alone and in combination, for cervical precancerous lesions. Results:TruScreen demonstrated good specificity (74.4%) and sensitivity (86.4%) for detecting CIN II or higher lesions, superior to those of TCT alone (sensitivity, 81.8%; specificity, 38.2%) and HPV testing alone (sensitivity, 81.8%; specificity, 28.2%). When different testing methods were combined, the sensitivity of TCT+HR-HPV, TruScreen+HR-HPV, and TruScreen+HR-HPV+TCT reached 100%, while the highest specificity was observed with TruScreen+HR-HPV (25.6%). Conclusion:TruScreen showed high accuracy and specificity for screening cervical precancerous lesions in middle-aged women. The sensitivity and specificity can be improved when combined with HR-HPV test and TCT test. TruScreen has low sampling requirements for clinicians and does not require laboratory doctors or pathologists equipped with PCR equipment to verify. Given its minimal dependence on medical conditions, TruScreen can be considered a potential supplementary screening tool for cervical precancerous lesions.

Objective:To understand whether human papillomavirus (HPV) and cytological testing (TCT [ie, "thinprep" cytological testing]) results can provide more information beyond visual information for vaginal colposcopy examinations to upgrade or downgrade the visual diagnosis of vaginal colposcopy. Patients and Methods:Data from 519 patients, who underwent vaginal colposcopy at the Beijing Obstetrics and Gynecology Hospital (Beijing, China) between January and June 2020, were included. Preoperative HPV and TCT results were statistically analyzed, and were divided into 3 groups according to postoperative cervical tissue pathological diagnosis: negative; low-grade squamous intraepithelial (LSIL); and high-grade squamous intraepithelial lesion (HSIL). Positive and negative predictive values for cervical inflammation, LSIL, and HSIL in patients diagnosed using vaginal colposcopy, based on cervical pathological grouping, and differences in HPV and TCT results among patients who underwent vaginal colposcopy, were analyzed. Results:The age of patients diagnosed with cervicitis, LSIL, and HSIL using colposcopy gradually decreased, and the proportion of HPV16/18 infection in the HSIL group was significantly higher than the other 2 groups. There were significant differences in TCT results among the groups. According to pathological results from cervical tissue specimens, among all groups diagnosed using colposcopy, the age of the HSIL group was significantly younger than that of the other groups, and the proportion of patients with a TCT greater than LSIL was significantly higher than that of the other groups. Conclusion:HPV did not provide additional information for vaginal colposcopy. Young(er) patients and those with a TCT greater than LSIL may consider upgrading the vaginal colposcopy diagnosis based on imaging information.

Ovarian cancer, particularly epithelial ovarian cancer (EOC), is the most aggressive and lethal gynecologic malignancy, necessitating the development of innovative and potent therapies to improve its prognosis. Human polo-like kinase 1 (PLK1), a key regulator of cell division, is crucial for driving mitosis and cytokinesis and maintaining genomic stability through phosphorylation of a few different substrates. PLK1 is found to be overexpressed in EOC tissues compared with normal ovarian tissues and is strongly associated with the prognosis of patients with stage I and II EOC. Targeting PLK1 markedly inhibits cell proliferation, causes cell cycle G2 phase arrest and DNA damage, induces apoptosis, and reduces tumor growth in preclinical models of EOC. In addition, the combination of PLK1 inhibitors with chemotherapeutic agents such as paclitaxel, cisplatin, doxorubicin, and PARP inhibitors exhibits effective synergistic effects in cell proliferation and tumor growth in EOC. Phase I and II clinical trials of PLK1 inhibitors in patients with EOC have shown favorable safety but inconsistent clinical efficacy. This review analyzes the existing preclinical and clinical data on PLK1 and evaluates the antitumor effects of PLK1 in EOC, offering perspectives on the potential application of PLK1 in the treatment of EOC.

This study aims to evaluate the impact of gynecologic oncologists' laparoscopic proficiency on survival outcomes in cervical cancer patients. A cohort of 1,965 cervical cancer cases from four clinical centers in China was analyzed, including abdominal radical hysterectomy (ARH), laparoscopic radical hysterectomy (LRH), and robotic radical hysterectomy (RRH). The median operative time (MOT) for LRH was used as a measure of surgical proficiency. Survival outcomes of ARH vs. LRH were compared in early-stage cervical cancer patients without adjuvant therapy to identify a critical MOT threshold. Below this threshold, no significant differences in prognosis were observed between ARH and LRH. Propensity score matching and mixed-effects Cox regression were used to adjust for baseline risk factors and random effects, validating the finding across all LRH cases. The Kaplan–Meier analysis showed that improved prognosis was associated with reduced MOT. When gynecologic oncologists had an MOT within 210 min, LRH vs ARH was no longer a significant risk factor (HR 1.1998; 95

Objective:To evaluate the differences in efficacy between polyvinyl alcohol colorless embolic microspheres (8Spheres®) and gelatin embolic microspheres (Embosphere®) in uterine artery embolization for symptomatic uterine fibroids. Methods:We included 259 patients from 12 hospitals who underwent uterine artery embolization for symptomatic uterine fibroids. We collected preoperative general conditions, menstrual status, and uterine and fibroid sizes as indicated by magnetic resonance imaging, as well as changes in ovarian hormone levels before and 6 months after the procedure. Differences in uterine fibroid scores and health-related quality of life scores between the two types of microspheres were compared using analysis of covariance (ANCOVA). Differences in the largest fibroid volume, uterine volume, total menstrual bleeding score, and ovarian hormone levels were compared using T-tests or Mann-Whitney U-tests. Results:There was no significant difference in clinical efficacy between the two types of microspheres at 6 months postoperatively (P=0.4081). No significant differences were observed in uterine fibroid volume or symptom-related scores.There were no significant differences in ovarian hormone levels between the two groups or within each group before and after the procedure. Conclusion:The use of 8Spheres® is effective for symptomatic uterine fibroids and is comparable to the currently clinically used Embosphere® microspheres in terms of efficacy for symptomatic uterine fibroids.

To evaluate the efficacy of urine-based human papillomavirus detection in detecting high-grade cervical lesions (CIN2+) compared to cervical cytology examination. The data of 458 patients with cytological abnormalities and/or positive human papillomavirus test results were retrospectively selected from December 1, 2017, to March 31, 2022, at the Beijing Obstetrics and Gynecology Hospital affiliated with Capital Medical University. Cervical cytology and urine samples were used to detect human papillomavirus status and analyze the correlation between the results and cervical biopsy results. Among the selected 458 samples, 386 were positive for human papillomavirus through cervical cytology examination, with a detection rate of 84.3

Epidemiological and clinical evidence have extensively documented the role of obesity in the development of endometrial cancer. However, the effect of fatty acids on cell growth in endometrial cancer has not been widely studied. Here, we reported that palmitic acid significantly inhibited cell proliferation of endometrial cancer cells and primary cultures of endometrial cancer and reduced tumor growth in a transgenic mouse model of endometrial cancer, in parallel with increased cellular stress and apoptosis and decreased cellular adhesion and invasion. Inhibition of cellular stress by N-acetyl-L-cysteine effectively reversed the effects of palmitic acid on cell proliferation, apoptosis, and invasive capacity in endometrial cancer cells. Palmitic acid increased the intracellular formation of lipid droplets in a time- and dose-dependent manner. Depletion of lipid droplets by blocking DGAT1 and DGAT2 effectively increased the ability of palmitic acid to inhibit cell proliferation and induce cleaved caspase 3 activity. Collectively, this study provides new insight into the effect of palmitic acid on cell proliferation and invasion and the formation of lipid droplets that may have potential clinical relevance in the treatment of obesity-driven endometrial cancer.

Ascorbate (vitamin C) is an essential vitamin for the human body and participates in various physiological processes as an important coenzyme and antioxidant. Furthermore, the role of ascorbate in the prevention and treatment of cancer including gynecological cancer has gained much more interest recently. The bioavailability and certain biological functions of ascorbate are distinct in males versus females due to differences in lean body mass, sex hormones, and lifestyle factors. Despite epidemiological evidence that ascorbate-rich foods and ascorbate plasma concentrations are inversely related to cancer risk, ascorbate has not demonstrated a significant protective effect in patients with gynecological cancers. Adequate ascorbate intake may have the potential to reduce the risk of human papillomavirus (HPV) infection and high-risk HPV persistence status. High-dose ascorbate exerts antitumor activity and synergizes with chemotherapeutic agents in preclinical cancer models of gynecological cancer. In this review, we provide evidence for the biological activity of ascorbate in females and discuss the potential role of ascorbate in the prevention and treatment of ovarian, endometrial, and cervical cancers.

Purpose: To evaluate the insulin resistance in patients with menopause who were newly diagnosed with endometrial cancer and its association with disease development. Methods: The study included 356 patients with menopause who underwent hysteroscopy at Beijing Obstetrics and Gynecology Hospital between September 2013 and July 2018. Data on age, height, weight, menarche and menopausal age, pregnancies, births, and family history of tumors, hypertension, and diabetes were collected. Blood tests provided fasting blood glucose, triglycerides, total cholesterol, high-density lipoprotein, and low-density lipoprotein levels. Pathological testing determined whether patients had endometrial cancer or precancerous lesions. Differences in influencing factors between patients with endometrial cancer or precancerous lesions and those with normal or benign conditions were analyzed using univariate analysis. Quartile grouping of the Metabolic Score for Insulin Resistance (METS-IR) and Triglyceride-Glucose (TyG) index were applied to examine the impact of different insulin resistance on the development of endometrial cancer or precancerous lesions. Results: Univariate analysis revealed that the proportion of patients with hypertension and diabetes was significantly higher among those with endometrial cancer and precancerous lesions. METS-IR and TyG levels were significantly increased in patients with endometrial cancer and precancerous lesions. The quartile grouping results of METS-IR and TyG suggested that age, BMI, FBG, TG, hypertension, and diabetes prevalence rates increased with an increase in METS-IR or TyG, whereas lipid indicators were negatively correlated and unstable Logistic regression suggested that none of the above influencing factors and METS-IR or TyG were related to the pathological results of the patients. Conclusion: Patients with endometrial or precancerous lesions showed evidence of insulin resistance compared to others, though this was not directly associated with disease presence. This study provides relevant information for preventing of endometrial cancer in the future. Larger studies are needed to evaluate the role of METS-IR and TyG in endometrial cancer prevention.

Epidemiological and clinical evidence have extensively documented the role of obesity in the develop-ment of endometrial cancer. However, the effect of fatty acids on cell growth in endometrial cancer has not been widely studied. Here we reported that palmitic acid significantly inhibited cell proliferation of endometrial cancer cells and primary cultures of endometrial cancer, and reduced tumor growth in a transgenic mouse model of endometrial cancer, in parallel with increased cellular stress and apoptosis and decreased cellular adhesion and invasion. Inhibition of cellular stress by N-acetyl-L-cysteine effec-tively reversed the effects of palmitic acid on cell proliferation, apoptosis and invasive capacity in the endometrial cancer cells. Palmitic acid increased the intracellular formation of lipid droplets in a time- and dose-dependent manner. Depletion of lipid droplets by blocking DGAT1 and DGAT2 effectively increased the ability of palmitic acid to inhibit cell proliferation and induce cleaved caspase 3 activity. Collectively, this study provides new insight into the effect of palmitic acid on cell proliferation, inva-sion and the formation of lipid droplets that may have potential clinical relevance in the treatment of obesity-driven endometrial cancer

IntroductionEndometrial cancer is the most common malignancy of the female reproductive system in the United States. Asparagus officinalis is a versatile, nutrient-dense, low-calorie vegetable that contains various bioactive metabolites that have shown a variety of biologic functions beneficial to health. The metabolites from asparagus officinalis extracts or asparagus officinalis extracts exhibit significant anti-tumorigenic activity in some pre-clinical models of cancer.MethodsEndometrial cancer cells were used to study the effects of asparagus officinalis on anti-proliferation, anti-invasion and increased sensitivity to cisplatin, and obese and lean Lkb1fl/flp53fl/fl mouse model of endometrial cancer was used to study the role of asparagus officinalis in tumor growth.ResultsTreatment with increasing concentrations of Asparagus officinalis extracts significantly inhibited cell proliferation, reduced glycolytic activity, induced cellular stress and apoptosis, caused cell cycle G1 arrest, increased the sensitivity of cells to cisplatin, reduced cell adhesion and invasion, and activation of AMPK and inhibition of the AKT/mTOR and MAPK signaling pathways in endometrial cancer cells. Moreover, asparagus officinalis extracts suppressed cell adhesion and invasion through the modulation of the epithelial-to-mesenchymal transition process. Asparagus officinalis extract treatment for 4 weeks resulted in a significant reduction in tumor growth in Lkb1fl/flp53fl/fl mice under both obese and lean conditions, with a decrease in Ki-67 and vascular endothelial growth factor expression and an increase in Bip expression in endometrial tumors.DiscussionThese findings provide strong preclinical evidence for the potential therapeutic benefit of asparagus officinalis extract as a novel dietary strategy in the treatment of endometrial cancer. Further clinical trials of dietary intervention of asparagus officinalis or combination with cisplatin in patients with endometrial cancer are warranted.

Objective:Overweight/obesity is the strongest risk factor for endometrial cancer (EC), and weight management can reduce that risk and improve survival. We aimed to establish the differential abilities of intermittent energy restriction (IER) and low-fat diet (LFD), alone and in combination with paclitaxel, to reverse the procancer effects of high-fat diet (HFD)-induced obesity in a mouse model of EC. Methods:Lkb1 fl/fl p53 fl/fl mice were fed high-fat diet (HFD) or LFD to generate obese and lean phenotypes, respectively. Obese mice were maintained on HFD or switched to LFD (HFD-LFD) or IER (HFD-IER). Ten weeks after induction of endometrial tumor, mice in each group received paclitaxel or placebo for 4 weeks. Body and tumor weights; tumoral transcriptomic, metabolomic and oxylipin profiles; and serum metabolic hormones and chemocytokines were assessed. Results:HFD-IER and HFD-LFD, relative to HFD, reduced body weight; reversed obesity-induced alterations in serum insulin, leptin and inflammatory factors; and decreased tumor incidence and mass, often to levels emulating those associated with continuous LFD. Concurrent paclitaxel, versus placebo, enhanced tumor suppression in each group, with greatest benefit in HFD-IER. The diets produced distinct tumoral gene expression and metabolic profiles, with HFD-IER associated with a more favorable (antitumor) metabolic and inflammatory environment. Conclusion:In Lkb1 fl/fl p53 fl/fl mice, IER is generally more effective than LFD in promoting weight loss, inhibiting obesity-related endometrial tumor growth (particularly in combination with paclitaxel), and reversing detrimental obesity-related metabolic effects. These findings lay the foundation for further investigations of IER as a EC prevention strategy in women with overweight/obesity.

Objective Uterine serous carcinoma is a highly aggressive non-endometrioid subtype of endometrial cancer with poor survival rates overall, creating a strong need for new therapeutic strategies to improve outcomes. High-dose ascorbate (vitamin C) has been shown to inhibit cell proliferation and tumor growth in multiple preclinical models and has shown promising anti-tumor activity in combination with chemotherapy, with a favorable safety profile. We aimed to study the anti-tumor effects of ascorbate and its synergistic effect with carboplatin on uterine serous carcinoma cells. Methods Cell proliferation was evaluated by MTT and colony formation assays in ARK1, ARK2 and SPEC2 cells. Cellular stress, antioxidant ability, cleaved caspase 3 activity and adhesion were measured by ELISA assays. Cell cycle was detected by Cellometer. Invasion was measured using a wound healing assay. Changes in protein expression were determined by Western immunoblotting. Results High-dose ascorbate significantly inhibited cell proliferation, caused cell cycle arrest, induced cellular stress, and apoptosis, increased DNA damage, and suppressed cell invasion in ARK1 and SPEC2 cells. Treatment of both cells with 1 mM N-acetylcysteine reversed ascorbate-induced apoptosis and inhibition of cell proliferation. The combination of ascorbate and carboplatin produced significant synergistic effects in inhibiting cell proliferation and invasion, inducing cellular stress, causing DNA damage, and enhancing cleaved caspase 3 levels compared to each compound alone in both cells. Conclusions Ascorbate has potent antitumor activity and acts synergistically with carboplatin through its pro-oxidant effects. Clinical trials of ascorbate combined with carboplatin as adjuvant treatment of uterine serous carcinoma are worth exploring.

梅核气以咽喉如有物梗阻,吞之不下,吐之不出为临床特征,类似于现代医学之慢性咽炎、咽神经症及反流性食管炎等 [1-4],受情绪影响较大 [5].关于该病的记载最早可以上溯到《金匮要略·妇人杂病篇》:"妇人咽中如有炙脔,半夏厚朴汤主之."形象地描述了梅核气的症状,并给出了治疗方剂.

Purpose: To reveal the clinical status and construct a predictive prognostic model for patients with uterine leiomyosarcoma (uLMS) at International Federation of Gynecology and Obstetrics (FIGO) stage I.Patients and Methods: The medical records of patients with stage I uLMS during the study period were retrospectively reviewed. Multiple imputation, Martingale residuals and restricted cubic spline were used for data processing. Univariate and multivariate analyses were used to determine independent prognostic factors. The Schoenfeld individual test was used to verify the proportional hazards (PH) assumption. The predictive ability of the nomogram was validated internally.Results: Ultimately, 102 patients were included. The median age at diagnosis was 51 years old. During the medium follow-up time of 68 months, 55 (53.9%) patients developed recurrence. The median recurrence interval was 32 months. The most common metastatic site was the lung (27 cases). Eventually, 38 (37.3%) patients died of uLMS. The 3-year and 5-year overall survival rates were 66.0% and 52.0%, respectively. Age at diagnosis >49 years, larger tumor size, MI>10/10HPF, presence of LVSI and Ki-67 labeling index (LI) >25% (P=0.0467, 0.0077, 0.0475, 0.0294, and 0.0427, respectively) were independent prognostic factors. The PH assumption remained inviolate. The concordance index was 0.847, the area under the time-dependent receiver operating characteristic curve surpassed 0.7, and the calibration curve showed gratifying consistency.Conclusion: Age at diagnosis, tumor size, MI, LVSI, and Ki-67 LI were identified as independent prognostic factors for stage I uLMS. This prognostic nomogram would provide personalized assessment with superior predictive performance.

Objective: To evaluate the efficacy and safety of Nocardia rubra cell wall skeleton (Nr-CWS) in the treatment of persistent cervical high-risk human papillomavirus (HR-HPV) infection. Methods: A randomized, double blind, multi-center trial was conducted. A total of 688 patients with clinically and pathologically confirmed HR-HPV infection of the cervix diagnosed in 13 hispital nationwide were recruited and divided into: (1) patients with simple HR-HPV infection lasting for 12 months or more; (2) patients with cervical intraepithelial neoplasia (CIN) Ⅰ and HR-HPV infection lasting for 12 months or more; (3) patients with the same HR-HPV subtype with no CINⅡ and more lesions after treatment with CINⅡ or CIN Ⅲ (CINⅡ/CIN Ⅲ). All participants were randomly divided into the test group and the control group at a ratio of 2∶1. The test group was locally treated with Nr-CWS freeze-dried powder and the control group was treated with freeze-dried powder without Nr-CWS. The efficacy and negative conversion rate of various subtypes of HR-HPV were evaluated at 1, 4, 8, and 12 months after treatment. The safety indicators of initial diagnosis and treatment were observed. Results: (1) This study included 555 patients with HR-HPV infection in the cervix (included 368 in the test group and 187 in the control group), with an age of (44.1±10.0) years. The baseline characteristics of the two groups of subjects, including age, proportion of Han people, weight, composition of HR-HPV subtypes, and proportion of each subgroup, were compared with no statistically significant differences (all P>0.05). (2) After 12 months of treatment, the effective rates of the test group and the control group were 91.0% (335/368) and 44.9% (84/187), respectively. The difference between the two groups was statistically significant (χ2=142.520, P<0.001). After 12 months of treatment, the negative conversion rates of HPV 16, 18, 52, and 58 infection in the test group were 79.2% (84/106), 73.3% (22/30), 83.1% (54/65), and 77.4% (48/62), respectively. The control group were 21.6% (11/51), 1/9, 35.1% (13/37), and 20.0% (8/40), respectively. The differences between the two groups were statistically significant (all P<0.001). (3) There were no statistically significant differences in vital signs (body weight, body temperature, respiration, pulse rate, systolic blood pressure, diastolic blood pressure, etc.) and laboratory routine indicators (blood cell analysis, urine routine examination) between the test group and the control group before treatment and at 1, 4, 8, and 12 months after treatment (all P>0.05); there was no statistically significant difference in the incidence of adverse reactions related to the investigational drug between the two groups of subjects [8.7% (32/368) vs 8.0% (15/187), respectively; χ2=0.073, P=0.787]. Conclusion: External use of Nr-CWS has good efficacy and safety in the treatment of high-risk HPV persistent infection in the cervix.

HPV genotyping before and after follow-up