OBJECTIVE:This article reports the second live birth in China after frozen-thawed ovarian tissue transplantation to prevent iatrogenic premature ovarian insufficiency (POI). METHOD:A patient with aplastic anemia received ovarian tissue cryopreservation before hematopoietic stem cell transplantation, and four ovarian cortex strips were thawed and transplanted into her peritoneal pocket 18 months later. RESULTS:Pregnancy occurred spontaneously 5 years after grafting, and a healthy girl was born at 39 weeks of gestation. Until now, the child has developed normally without any major diseases. CONCLUSION:Ovarian tissue cryopreservation and transplantation (OTCT) can be assessed as a successful method especially to prevent iatrogenic POI. In our cryobank for OTCT, which is the first official one in China, intensive research to improve this method has been performed, and we propose after our success for the second pregnancy in China to include this method in the official guidelines for prevention and treatment of (especially iatrogenic) POI.

OBJECTIVE:To evaluate whether hypoxia-preconditioned human umbilical cord mesenchymal stem cells (hUCMSCs) can protect frozen-thawed human ovarian tissue via in vitro co-culture. METHODS:Frozen-thawed ovarian cortical pieces from 10 patients were randomly divided into a control group (no co-culture), N‑MSCs group (normoxia‑preconditioned hUCMSCs co-culture), and H‑MSCs group (hypoxia‑preconditioned hUCMSCs co-culture). Tissues in the co-culture groups were subjected to 48 h indirect Transwell co-culture. Apoptosis was assessed by TUNEL. Metabolic changes in the culture medium were measured, such as glucose consumption and lactate production, and AMH levels were determined. Oxidative stress in ovarian tissue was evaluated by measuring ROS and TAC. RNA-seq was performed, and key pathways were analyzed by GSEA. The protein expression of HIF-1α, VEGFA, GDF9, AKT, and p-AKT was examined by Western blot. RESULTS:Compared with both the control and N-MSCs groups, co-culture with H‑MSCs significantly reduced follicular atresia and apoptosis, while preserving a greater proportion of resting follicles. The H‑MSCs group presented lower glucose consumption and lactate production and elevated AMH levels in the culture medium. H‑MSCs markedly decreased reactive oxygen species (ROS) and enhanced total antioxidant capacity (TAC). Transcriptomic analysis showed that H‑MSCs induced a distinct gene expression profile characterized by upregulation of the HIF‑1 signaling pathway. H‑MSCs significantly upregulated HIF‑1α, VEGFA, and phosphorylated AKT at the protein level. CONCLUSIONS:This in vitro study showed that co-culture of ovarian tissue with H-MSCs provides stronger protection than N-MSCs. This effect likely involves the HIF-1α/VEGFA pathway, with enhanced pro-angiogenic signaling, reduced apoptosis and oxidative stress, and preservation of the follicular reserve.

ObjectiveTo evaluate the efficacy and safety of the Peiyu Granules (PYG) compared with placebo on early miscarriage rates among women undergoing embryo transfer.MethodsA double-blind, parallel-group randomized clinical trial between February 15, 2017, and June 17, 2019, within 10 months of pregnancy follow-up until March 2020. This clinical trial was conducted at Beijing Obstetrics and Gynecology Hospital, Capital Medical University. A total of 886 women were included in this study. The intervention group (n = 443) received PYG on the night of Embryo Transfer (ET) until the day of the hCG test. If it was negative, the patient stopped taking medicine. In contrast, the treatment continued until 70 days after ET. The women in the control group (n = 443) consumed the same amount of placebo as the intervention group. All women enrolled were subject to the same follow-up protocols. The primary outcome was early miscarriage rate. The secondary outcomes were clinical intrauterine pregnancy rate and live birth rate.ResultsAmong the 886 randomized women (mean [SD] age, 32.8 [3.6] years), 854 women (96.4%) underwent ET and followed the treatment of random grouping. Early miscarriage occurred among 17 of 133 women (12.8%) receiving PYG compared with 35 of 156 women (22.4%) receiving placebo (relative risk[RR], 0.51 [95% CI, 0.27 to 0.95], P = 0.02). Clinical intrauterine pregnancy rates were 30.0% (133 of 443) in the intervention group and 35.2% (156 of 443) in the control group (relative risk[RR], 0.79 [95% CI, 0.60 to 1.05], P = 0.10). Live-birth rates were 25.3% (112 of 443) in the intervention group and 25.7% (114 of 443) in the control group (relative risk[RR], 0.98 [95% CI, 0.72 to 1.32], P = 0.88). Live birth rates in the clinical pregnant population were 84.2% (112/133) in the intervention group and 73.7% (115/156) in the control group (relative risk [RR], 1.14 [95% CI, 1.01 to 1.29], P = 0.03).ConclusionThe findings suggested that PYG reduced early miscarriage rates among women undergoing embryo transfer. However, there were no significant improvement in clinical pregnancy rates and live birth rates.Clinical trial registrationhttps://www.chictr.org.cn/showproj.html?proj=12343 identifier, ChiCTR-inr-16010087.

ObjectiveTo evaluate the relationship of leiomyoma characteristics with perinatal outcomes.MethodsA retrospective cohort study was conducted. Women whose pregnancy was complicated with leiomyoma were recruited, and pregnant women without leiomyomas were enrolled as a control group. Demographic data, leiomyoma ultrasound characteristics, and pregnancy outcomes were collected. Subsequently, antepartum, intrapartum, postpartum, and neonatal complications were analyzed.ResultsThe overall rate of leiomyomas in pregnancy was 5.46% (4393/80510). Out of the 932 pregnancies studied, 632 were affected by leiomyoma. Women with leiomyomas exhibited significantly higher age, pre-pregnancy BMI, gravidity, and in vitro fertilization-embryo transfer rate. The occurrence of antepartum, intrapartum, and postpartum complications was influenced by different features of leiomyomas. Among leiomyoma with diameter of 9 cm or greater, cervical or submucous types were detrimental. In the multivariate linear regression analyses, a leiomyoma with diameter of at least 9 cm during pregnancy was independently associated with preterm birth, cesarean section, preterm premature rupture of membranes, and postpartum hemorrhage.ConclusionThe presence of leiomyoma of 9 cm or more increases the risk of antepartum, intrapartum, and postpartum complications; therefore, pre-conception myomectomy can be considered. For leiomyoma 7-9 cm, extensive discussions between patients and clinicians should be conducted. In women with leiomyomas smaller than 7 cm, the risk of obstetric complications is similar to that in women without leiomyomas, except for those with cervical or submucous leiomyomas.

Irpex lacteus is a fungus typically found on angiosperm branches and trunks. Here, we report the isolation of a novel strain of I. lacteus from the cervix uteri of a female patient diagnosed with endometriosis and COVID-19 at Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Using whole-genome sequencing, we generated a high-quality draft genome for this human-derived strain. Comparative genomic analysis revealed significant variations amongst I. lacteus strains colonizing distinct environments. Functional annotations indicated that environmental adaptation has influenced specific functional traits in the strains. Moreover, potential virulence factors were identified, implying a risk of opportunistic infections associated with I. lacteus. This study elucidates the adaptive characteristics of I. lacteus across ecological niches and provides genomic insights into its opportunistic colonization.

Objective To evaluate the effect of oral contraceptive (OC) pretreatment on in vitro fertilization (IVF) outcomes in women with polycystic ovary syndrome (PCOS) undergoing the GnRH agonist (GnRH-a) long protocol, compared with other ovarian stimulation protocols.Methods This retrospective study included 121 women with PCOS, diagnosed according to the Rotterdam criteria, who underwent IVF/intracytoplasmic sperm injection (IVF/ICSI) between January and September 2018 at Beijing Obstetrics and Gynecology Hospital. Patients were assigned to one of four protocols: the OC pretreatment + GnRH-a long protocol (three cycles of OC), the standard GnRH-a long protocol, the GnRH antagonist protocol, or the GnRH-a ultralong protocol. Ovarian stimulation characteristics, embryo development, and clinical outcomes were compared among the groups.Results The GnRH-a ultralong protocol required significantly higher total Gn doses and longer stimulation duration than the OC + GnRH-a long protocol. Compared with the standard GnRH-a long protocol, OC pretreatment showed trends toward lower rates of moderate-to-severe ovarian hyperstimulation syndrome (OHSS) and higher biochemical and clinical pregnancy rates, though these differences were not statistically significant. No significant differences were observed among the groups for the number of retrieved oocytes, mature oocytes, fertilized oocytes, or normally developing embryos.Conclusion In PCOS patients, OC pretreatment showed trends toward higher pregnancy rates and lower OHSS, without adverse effects on clinical outcomes. These findings highlight a potentially promising approach, warranting confirmation in larger, high-quality randomized controlled trials.

Intrauterine adhesion (IUA) refers to endometrial fibrosis resulting from endometrial injury and infection. In promoting the repair of the endometrium, mesenchymal stem cells therapy has shown great potential. However, adult-derived mesenchymal stem cells (MSCs) are associated with several challenges, including invasive manipulation, susceptibility to contamination, and low proliferative capacity. Immunity-and-matrix-regulatory cells (IMRCs) derived from human embryonic stem cells exhibit enhanced immunomodulatory and anti-fibrotic capabilities. Despite their success in treating lung injury and fibrosis, membranous nephropathy, and acute liver failure, their therapeutic potential in IUA remains undetermined. TGF-β1-induced human endometrial stromal cells (HESCs) were utilized to construct the IUA cell model and were treated with IMRCs conditioned medium. Morphological changes in the cells were observed, and RT-qPCR and Western blot analyses were employed to detect the expression of relevant markers during the process of epithelial-mesenchymal transition (EMT) in vitro. The IUA rat model was established using the dual injury method and subsequently treated with intrauterine infusion of IMRCs. HE and Masson staining were used to assess endometrial damage, repair and the extent of fibrosis. Fertility assays were performed to compare the effectiveness of IMRCs and umbilical cord mesenchymal stem cells (UCMSCs) in improving endometrial function in IUA rats. Sequencing analysis of IMRCs-derived exosomes (Exos) was conducted to identify specific miRNAs and the pathways they target. TGF-β1 treatment induced HESCs to undergo fibrotic transformation and express fibrosis-related markers, while treatment with IMRCs conditioned medium inhibited TGF-β1-induced fibrosis. IUA rats were treated with intrauterine infusion of IMRCs. IMRCs facilitated the repair of damaged endometrium, restored the structure of the uterine cavity, and reduced collagen deposition. IMRCs reversed the process of endometrial EMT in rats with IUA, upregulated the expression of epithelial markers, and downregulated the expression of mesenchymal markers. IMRCs further exerted antifibrotic effects by reducing inflammatory responses. Fertility recovery in rats receiving intrauterine infusion of IMRCs was superior to that in rats receiving intrauterine infusion of UCMSCs. Specific miRNAs in Exos, including miR-27b-3p, miR-145-5p, and miR-16-5p, directly target Smad2, inhibit Smad2 phosphorylation, and modulate the TGF-β/Smad pathway. Our study demonstrated that IMRCs inhibited TGF-β1-induced fibrosis in HESCs, suppressed the EMT process ex vivo, reduced the inflammatory response, and reversed endometrial damage and fibrosis in IUA rats. IMRCs exerted their effects through the paracrine pathway, with specific miRNAs in Exos downregulating the TGF-β/Smad signaling pathway to inhibit uterine endometrial fibrosis. IMRCs provide a new direction for the treatment of IUA.

BACKGROUND:Premature Ovarian Failure (POI), a prevalent gynecological, endocrine disease, significantly impairs the reproductive health of women of childbearing age and presents a formidable challenge to clinicians. Until now, there has been a lack of effective treatments to fundamentally improve ovarian function in patients with POI. Stem cell therapy has emerged as a promising treatment in the field of POI, with notable research progress achieved to date. OBJECTIVES:This review sought to analyze the current status and hotspots of research on stem cell therapy for POI, forecasting future directions through bibliometrics. METHODS:Research related to stem cell therapy for POI from 2000 to 2023 was searched in the Web of Science Core Collection (WOSCC) database by setting subject-term, and the literature was analyzed econometrically using VOSviewer, CiteSpace, and the R package "bibliometrix." RESULTS:According to our search and screening strategy, 203 pieces of literature related to stem cell therapy for POI were obtained and analyzed. There is a marked annual increase in publications, with a particularly rapid ascent in recent years. China has become the most prolific country in this field, with 136 publications. Shanghai Jiao Tong University ranked first among many universities and institutions in terms of the number of publications and citations. Stem Cell Research & Therapy was the most popular and influential journal in the field of stem cell therapy for POI. Lai Dongmei has published the most papers, while Liu Te boasts the highest frequency of co-citations. Investigation into the mechanisms of exosomes derived from stem cells and their associated signaling pathways is anticipated to be a crucial research topic in stem cell therapy for POI. CONCLUSION:This review offers the first comprehensive and systematic analysis of the field of stem cell therapy for POI, with a visual representation of the findings. By summarizing the current status and projecting forthcoming trends, this study aims to offer guidance and a reference for scholars in the field.

It is well known that premature ovarian insufficiency (POI) seriously affects the fertility, quality of life, and health of young women. A meta-analysis of global data indicated that the current population prevalence of POI is as high as 3.7 %, but exceeds 10 % in some countries and regions. When POI is caused by disease treatment, it is termed iatrogenic POI. Iatrogenic factors are the most common identifiable cause of POI, and iatrogenic POI has a high prevalence in young cancer survivors. Overall, iatrogenic POI accounts for approximately half of all cases, but data show that its prevalence in female cancer survivors under the age of 24 can reach up to 82.2 %. With the improvement of cancer treatment, this incidence is still rising. It arises in the context of a variety of diseases and has a complex etiology. Patients with iatrogenic POI tend to be younger than those with other types of POI, which means they can experience more harm from the condition, and there is an urgent need to diagnose, treat, and manage them as early as possible. However, there is currently no relevant consensus or guideline either within China or indeed internationally. This guideline expert group gathered data from doctors and patients in 34 provinces, municipalities, and autonomous regions across China through questionnaires to determine guideline-related issues and searched the literature in English-language databases such as Cochrane and PubMed since their establishment. After merging and deduplicating, literature evaluation and evidence grading were carried out. After discussion and induction, the clinical treatment and management guidelines for iatrogenic POI were formulated and combined with China's national conditions. The expert group ultimately addressed 19 clinical questions, as determined through a questionnaire survey and field investigation, and produced 26 recommendations based on international and domestic evidence from evidence-based medicine and clinical practice experience, to provide a reference for colleagues in clinical practice. The recommendations primarily reflect the context and needs within China and are intended for broad nationwide applicability, though regional adaptations based on local resources and practices may be necessary.

Intrauterine adhesions(IUAs)are a form of uterine fibrotic scar tissue that develops in response to traumatic injury to the endometrial basal layer.Patients with IUAs can suffer from menstrual abnormalities and various obstetric complications[1].

Premature ovarian insufficiency (POI) refers to the decline of ovarian function before the age of 40. POI causes a reduction in or loss of female fertility, accompanied by different degrees of menopausal symptoms, which increases the risk of chronic diseases related to early menopause and seriously affects patients' quality of life and health. It is conservatively estimated that at least one million prepubertal girls and women of reproductive age in China are at risk of iatrogenic POI caused by radiotherapy and chemotherapy every year. With the development of medical technology and the breakthrough of scientific and technological advances, preventing and treating iatrogenic POI have become possible. International and national guidelines consider cryopreserved ovarian tissue transplantation to be the most promising method of preserving the ovarian function and fertility of prepubertal girls and women of reproductive age who cannot delay radiotherapy and chemotherapy. In order to guide the clinical application of ovarian tissue cryopreservation and transplantation technology in China, the Guideline Working Group finally included 14 scientific questions and 18 recommendations through a questionnaire survey, field investigation, and consultation of a large number of Chinese and English literature databases in order to provide a reference for colleagues in clinical practice.

目的 探究lncRNA FAM95B1及蛋白编码基因胰岛素样生长因子2（insulin-like growth factor 2,IGF2）对宫腔粘连发生的作用，为宫腔粘连的防治提供新的分子靶点。方法 在宫腔粘连组织中采用反转录实时定量聚合酶链反应（reverse transcription-quantitative polymerase chain reaction, RT-qPCR）方法检测lncRNA FAM95B1的mRNA表达水平，采用Western blotting方法检测IGF2及纤维化标志物α-平滑肌肌动蛋白（α-smooth muscle actin, α-SMA）、I型胶原蛋白（collagen type I alpha 1 chain protein, COL1A1）的蛋白表达水平。在经过转化生长因子-β1（transforming growth factor-β1,TGF-β1）处理的子宫内膜基质细胞（endometrial stromal cells, ESCs）中，采用RT-qPCR方法检测lncRNA FAM95B1、IGF2、纤维化标志物（α-SMA、COL1A1、Snail）及上皮标志蛋白E-cadherin的mRNA表达水平。在ESCs中，分别下调lncRNA FAM95B1和IGF2基因，验证二者的调控关系；免疫共沉淀实验检测lncRNA FAM95B1与IGF2的结合关系。然后，si-FAM95B1转染入ESCs中并经过TGF-β1处理，进一步探究lncRNA FAM95B1及IGF2在ESCs向成纤维细胞分化的上皮-间质转化（epithelial-to-mesenchymal transition, EMT）过程中的作用。结果 宫腔粘连组织中lncRNA FAM95B1、IGF2及纤维化标志物α-SMA、COL1A1的表达水平上调；经过TGF-β1处理的ESCs中lncRNA FAM95B1、IGF2、纤维化标志物（α-SMA、COL1A1、Snail）的表达水平上调，上皮标志蛋白E-cadherin的表达水平下调。IGF2随lncRNA FAM95B1的变化而变化，而下调IGF2后，lncRNA FAM95B1的表达无明显变化，lncRNA FAM95B1正向调节IGF2;lncRNA FAM95B1与IGF2在TGF-β1处理的ESCs中结合。si-FAM95B1在ESCs向成纤维细胞分化的EMT过程中抑制IGF2的表达，发挥抗纤维化作用。结论 si-FAM95B1可通过下调IGF2的表达抑制宫腔粘连的发生，lncRNA FAM95B1/IGF2轴可能为宫腔粘连的靶向治疗提供新的分子靶点。

目的 观察宫颈锥切术及锥切术后至开始妊娠的时间间隔对分娩方式的影响.方法 选择2016年5月—2018年4月在首都医科大学附属北京妇产医院建档的有锥切术史的足月妊娠初产妇115例作为观察组,年龄26～41岁;随机选择同期无锥切术史的足月妊娠初产妇222例作为对照组,年龄24～40岁.按分娩方式将产妇分为自然分娩组、产钳助产组、剖宫产组.通过回顾性研究,用卡方检验比较两组产妇分娩方式差异,用Fisher精确检验和卡方检验分别比较两组产妇产钳和剖宫产指征的差异,用Kruskal-Wallis检验分析宫颈锥切术后至开始妊娠的时间间隔对分娩方式的影响.结果 观察组使用产钳的病例数显著高于对照组(12.2％vs 5.9％,P=0.043),其中为了缩短第二产程而使用产钳的病例数显著高于对照组(50％vs7.7％,P=0.033).观察组中的自然分娩组、产钳助产组和剖宫产组,三组在宫颈锥切术后至开始妊娠的时间间隔的比较上,无显著性差异(P＞0.05).结论 与对照组相比,有宫颈锥切术史的初产妇因第二产程延长导致产钳助产概率增加.宫颈锥切术后至妊娠的时间间隔不影响分娩方式.

Cervical cancer is the fourth most common malignancy tumor worldwide with high incidence and mortality. Accumulating evidence indicated that through an m6A-dependent or m6A-independent mechanism, fat mass and obesity associated gene (FTO) exhibits the tumor-promoting and suppressive roles of FTO involved in various cancers, including cervical cancer. This study aims to verify the biological function and potential mechanisms of FTO in cervical cancer cell proliferation, colony formation, migration, and invasion in vitro as well as tumor growth in vivo. Herein, we confirmed that knockdown of FTO inhibits cell proliferation, colony formation, migration, and invasion of cervical cancer cells in vitro via cell counting kit-8 (CCK8) assay, colony formation assay, and transwell migration and invasion assay. The demethylase activity of FTO is required for cell proliferation, colony formation, migration, and invasion of cervical cancer cells in vitro. RNA sequencing, online database analysis, and western blotting revealed that FTO regulated the BMP4/Hippo/YAP1/TAZ pathway. In addition, FTO upregulates the expression of BMP4 in an m6A-dependent manner and binds to the N-terminal of BMP4 to form a dimer at the C-terminal in cervical cancer cells through protein-protein interaction. We further discovered that BMP4 treatment promoted cell proliferation, colony formation, migration, and invasion of cervical cancer cells, and rescue experiments validated that BMP4 treatment reversed the inhibition of FTO knockdown on the Hippo/YAP1/TAZ pathway and the progression of cervical cancer cells in vitro. Notably, the knockdown of FTO significantly suppressed xenograft tumor growth and the protein level of BMP4 in vivo. Collectively, our results demonstrate that the FTO promotes cervical cancer progression in vitro and in vivo via the regulation of the BMP4/Hippo/YAP1/TAZ pathway, suggesting that FTO acts as an oncogenic molecule and the FTO/BMP4 Hippo/YAP1/TAZ axis may serve as valuable targets for cervical cancer treatment.

目的 探讨长链非编码RNA（lnc RNA）生长停滞特异基因转录的反义RNA（GAS6-AS1）靶向调控白细胞介素11（IL-11）对子宫内膜基质细胞（ESCs）向成纤维细胞分化的影响。方法 体外传代培养ESCs，取传3～6代、对数生长期、生长状态良好的ESCs，随机分为TGF-β1未干预组和TGF-β1干预组。TGF-β1未干预组不予TGF-β1干预，TGF-β1干预组用无血清培养基饥饿培养后予TGF-β1干预，收集细胞，采用RT-q PCR法检测lnc RNA GAS6-AS1、IL-11及纤维化标志物α平滑肌肌动蛋白（α-SMA）、Ⅰ型胶原蛋白α1（COL1A1）m RNA表达。另取传3～6代、对数生长期、生长状态良好的ESCs，分别转染三条si-GAS6-AS1序列以及si-Control序列，采用RT-q PCR法验证转染效率。将转染si-GAS6-AS1的ESCs用无血清培养基饥饿培养后予TGF-β1干预，收集细胞，采用Western blotting法检测IL-11、α-SMA、COL1A1蛋白表达，采用CCK-8法检测细胞增殖活性，采用Annexin V-FITC/PI双染法检测细胞凋亡率。结果 与TGF-β1未干预组比较，TGF-β1干预组lnc RNA GAS6-AS1、IL-11、α-SMA、COL1A1 m RNA相对表达量均显著升高（P均＜0.01）。转染si-GAS6-AS1-1、si-GAS6-AS1-2、si-GAS6-AS1-3及si-Control序列的ESCs GAS6-AS1 m RNA相对表达量分别为0.22±0.04、0.27±0.06、0.81±0.07、1.00±0.00。与转染si-Control序列的ESCs比较，转染si-GAS6-AS1-1、si-GAS6-AS1-2序列的ESCs GAS6-AS1 m RNA相对表达量显著降低（P均＜0.01），而转染si-GAS6-AS1-3序列的ESCs GAS6-AS1 m RNA相对表达量降低不明显（P＞0.05）。因此，选择si-GAS6-AS1-1、si-GAS6-AS1-2序列进行后续实验。与si-Control+TGF-β1组比较，si-GAS6-AS1-1+TGF-β1组和si-GAS6-AS1-2+TGF-β1组IL-11、α-SMA、COL1A1蛋白相对表达量及细胞增殖活性均显著降低，细胞凋亡率均显著升高（P均＜0.01）。结论 lnc RNA GAS6-AS1通过靶向调控IL-11表达抑制ESCs向成纤维细胞分化。

OBJECTIVEEstrogen (E2) is the main contributor to the progression of endometrial cancer (EC). The long noncoding RNA HOX antisense intergenic RNA (HOTAIR) is emerging as a new regulator in several cancer types. This study aimed to investigate the role of HOTAIR in EC development and identify the underlying molecular mechanisms.METHODSHOTAIR expression levels in human EC tissues and the corresponding adjacent tissues and human EC Ishikawa cells were determined by quantitative PCR. Ishikawa cells were treated with E2 or estrogen receptor (ER) inhibitor ICI182780, transfected with siHOTAIR oligo, or infected with lentivirus expressing shHOTAIR/shNC, alone or in combinations. The protein expression of polycomb repressive complex 2 (PRC2) was evaluated by western blotting, and cell migration was measured by transwell assays. A xenograft tumorigenic model was established by inoculating control or stable shHOTAIR-infected Ishikawa cells into nude mice and implanting 17β-estradiol release pellets.RESULTSHOTAIR expression was significantly elevated in human EC tissues. E2 exposure markedly increased HOTAIR levels in Ishikawa cells. Notably, E2 increased the protein expression of PRC2 and promoted EC cell migration, which were dependent on HOTAIR expression, as HOTAIR knockdown abolished these effects of E2. Similarly, E2 promoted the in vivo proliferation of grafted Ishikawa cells via upregulated HOTAIR expression in nude mice.CONCLUSIONSHuman EC tissues highly express HOTAIR, and E2-induced EC progression depends on HOTAIR expression. This work suggests that the E2-HOTAIR axis is a potential therapeutic target in EC therapy.

目的 探讨子宫腺肌病（AM）的临床特征、诊疗方案及腺肌病病灶切除术的疗效，以期提高对该疾病的认识及诊疗水平。方法 回顾性分析2017年7月至2022年7月于首都医科大学附属北京妇产医院妇科行AM病灶切除术的82例患者的临床资料，术后病理均确诊为AM且未合并子宫肌瘤等其他子宫良恶性疾病。将纳入患者按照症状分为4组：经量增多组（A组）10例，痛经加重组（B组）22例，经量增多合并痛经加重组（C组）42例，子宫增大无痛经及经量增多组（D组）8例。对患者的临床特点及诊治情况等进行统计学描述，比较各组的一般情况、临床检验和影像学指标、术中及术后情况。结果 82例患者平均年龄（38.2±6.9）岁，平均病程（5.99±4.53）年。4组患者一般情况比较，妊娠次数的总体分布有显著性差异（P＜0.05）,组间两两比较显示B组的妊娠次数显著高于C组（χ~2=13.111,P=0.011）;其余指标各组间比较均无显著性差异（P＞0.05）。4组患者超声结果比较，子宫肌层点状回声发生率总体分布有显著性差异（P＜0.05）,组间两两比较显示C组显著高于A组（χ~2=8.390,P=0.004）;其余指标各组间比较均无显著性差异（P＞0.05）。4组患者术中及术后情况（包括手术时间、术中出血量、术后最高体温及住院时间）比较，均无显著性差异（P＞0.05）。4组患者超声检查结果显示子宫体积、腺肌瘤体积与视觉模拟评分（VAS）及月经失血图评分（PBAC）均无线性相关。4组患者术后VAS、PBAC评分及子宫体积较术前有所下降，总体分布有极显著差异（P＜0.001）;组间两两比较显示，术后3个月、1年及5年的VAS评分、PBAC评分显著低于术前（P＜0.05）,术后3个月及1年的子宫体积显著低于术前（P＜0.05）。仅行手术治疗的患者中有6例（14.29%）因症状复发行子宫切除术，其复发率显著高于术后联合左炔诺孕酮宫内节育系统（LNG-IUS）或地诺孕素治疗的患者（P＜0.05）。结论 子宫体积及腺肌瘤体积与症状无明显相关性，超声检查提示肌层内点状回声可能是痛经的特征性表现；AM病灶切除术可持久缓解症状、5年内子宫体积缩小作用明显，术后联合LNG-IUS或地诺孕素治疗可减少复发风险。

异位妊娠是一种常见的妇科急腹症,也是孕早期孕妇死亡的主要原因.目前异位妊娠的发病机制尚不明确,且在妊娠早期异位妊娠与宫内孕特别是宫内孕发育不良鉴别困难,同时异位妊娠早期检测指标缺乏特异性,这些因素均可导致患者病情延误或宫内妊娠不必要丢失.因此,深入研究异位妊娠的发病机制,寻找异位妊娠早期检测指标,可以为异位妊娠早期诊断提供依据.微RNA(miRNA)可稳定存在于外周血中,且部分miRNA与妊娠密切相关,因此,深入研究特异性较高的miRNA在异位妊娠中的作用并将其作为异位妊娠的早期检测指标具有一定临床意义.

妊娠合并子宫肌瘤孕妇的剖宫产率高达50%。为避免严重产后出血、弥漫性血管内凝血和子宫切除术等，传统上并不主张在剖宫产术时行子宫肌瘤剔除术。但近些年不断有研究表明，剖宫产术同时行子宫肌瘤剔除术并不增加产后出血和其他术后并发症的风险，对于有指征的子宫肌瘤孕妇，由经验丰富的医师行剖宫产+子宫肌瘤剔除术是安全可行的。目前，对于不同特征的子宫肌瘤，剖宫产术时是否剔除尚无统一标准。.