Background Endometrial cancer significantly impacts women’s reproductive health and quality of life, with lymph node metastasis serving as a crucial prognostic factor. Given the low metastasis rate, not all early-stage patients require lymph node dissection. The NCCN upgraded Sentinel Lymph Node Biopsy (SLNB) technology to Class 2A evidence. However, the applicability of SLNB for Chinese patients remains uncertain. This study evaluates the efficacy and safety of SLNB in a Chinese population. Methods We conducted a retrospective cohort study at Guangdong Provincial Hospital of Chinese Medicine, involving 164 patients with early endometrial adenocarcinoma who underwent laparoscopic total hysterectomy with bilateral salpingo-oophorectomy from August 2019 to December 2022. Patients were divided into two groups based on the surgical approach: SLNB (N = 33) or systematic lymph node dissection (SLND, N = 33). The primary outcomes assessed were postoperative disease progression-free survival and complication incidence at one month. Secondary outcomes included surgery duration, blood loss, length of hospital stay, and total costs. Result Throughout the follow-up period, there were no recurrences case reported in either group. The complication rates were 6% for SLNB and 21% for SLND. In comparison to SLND, SLNB significantly reduced surgery duration (156.4 minutes vs. 267.18 minutes; p < 0.001), blood loss (33.90 ml vs. 98.18 ml; p < 0.01), length of hospital stay (13.48 days vs. 16.76 days; p < 0.01), and total costs (RMB47,203.88 vs. RMB57,969.58; p < 0.01). Conclusion SLNB is a less invasive and cost-effective alternative to SLND, offering comparable safety and efficacy for the management of early-stage endometrial cancer in Chinese patients.

目的 探索阴道菌群近10年来的研究现状并预测其发展趋势.方法 在Web of Science数据库中检索近10年阴道菌群相关的文献,运用可视化软件VOSviewer进行共词分析、文献耦合、合著分析等.结果 阴道菌群领域发文量呈整体上升趋势,目前的主要热点研究分为阴道菌群的多样性、传染病学、细胞生物和基因学、阴道菌群与生殖的关联四大方面.结论 文献可视化研究展现了阴道菌群的研究现状和发展趋势,为相关研究人员提供了借鉴.

Background: Persistent human papillomavirus (HPV) infection is a causative agent for the majority of cervical cancer cases. The traditional Chinese medicine formula Quyoufang (QYF), a herbal oral decoction therapy, has been widely applied in the treatment of various diseases caused by HPV infection, but the molecular mechanism of QYF in the treatment of HPV infection remains unclear. This study aimed to investigate the effect of drug-containing serum of QYF on the apoptosis of HPV16-positive cervical immortalized epithelial cell line H8 in vitro. Methods: Different concentrations of medicated serum were obtained by feeding QYF into the stomachs of rats. The effects of medicated serum on H8 cell proliferation and apoptosis were detected using the cell counting kit-8 assay (CCK-8) method, flow cytometry, and Hoechst 33342/PI apoptosis assays. The different expressions of E6, E7, p53, and pRb among H8 cells were detected by RT-PCR and Western Blot. Results: The results firstly indicated that the drug-containing serum of QYF induced apoptosis and suppressed the proliferation of H8 cells in a concentration-dependent manner. RT-PCR and Western Blot unveiled that in contrast to the control group, the QYF groups could markedly elevate the mRNA expression of P53 and pRb as well as promote the expression of p53 and pRb protein levels. The QYF groups suppressed the expression of E6 mRNA and inhibited the expression of E6 protein. Conclusion: The drug-containing serum of QYF could effectively inhibit the proliferation of H8 cells and induce their apoptosis, possibly through the E6/p53-related pathway

Spontaneous abortion (SA) is the most common adverse pregnancy outcome in the first trimester. The causal drivers of SA have become a substantial challenge to reveal and overcome.

The early diagnosis and treatment of ectopic pregnancy (EP) remains a major challenge. Despite a known link between vaginal microbiota and female reproductive health, few studies have focused on the association between vaginal microbiota and pregnancy location. This nested case-control study aimed to characterize the vaginal microbiota in tubal pregnancy (TP) among symptomatic women in early pregnancy. Women with symptomatic early pregnancy of unknown location (PUL) were included in this study. 16S rDNA gene sequencing was performed to assess vaginal microbial diversity and relative abundance. Machine learning and multivariate logistic regression were also used to evaluate the association between Gardnerella and TP. The results indicate that the vaginal microbiome in TP was more diverse (Shannon, p < 0.05) and was different in composition to that of women with intrauterine pregnancy (IUP) (weighted Unifrac, R = 0.08, p = 0.01). The genus Gardnerella was significantly enriched in TP. The XGBoost analysis was able to classify Gardnerella-induced TP more reliably (AUC = 0.621). Moreover, after adjusting potential confounders, our results indicate a robust association between Gardnerella and TP (as a continuous variable, adjusted OR: 12.0, 95% CI: 2.1–67.4, p < 0.01; as a categorical variable (≥0.85%), and adjusted OR: 4.2, 95% CI: 2.0–8.8, p < 0.01). In conclusion, we found that higher virginal Gardnerella levels were associated with TP in women with symptomatic early pregnancy.

Introduction Studies have suggested that the vaginal microbiome and gut microbiome are involved in pregnancy-related diseases, but little exploration of the link with early miscarriage or threatened miscarriage (TM) has been done. Whether the characteristics of the vaginal microbiome and gut microbiome in early pregnancy are related to TM and early pregnancy outcomes remains unclear.Methods and analysis The Microbiome Characteristics in Early Threatened Miscarriage Study (MCETMS) is a prospective investigation that will recruit 326 pregnant women with early TM. Pregnant women will be enrolled at 4–8 weeks of gestation, and their vaginal secretions, faecal samples, clinical data and sociodemographic characteristics will be collected prospectively. Pregnant women with TM will be followed up to 12 weeks of gestation to determine the early pregnancy outcomes (ongoing pregnancy or pregnancy loss). DNA will be extracted from the collected samples and will be analysed by 16S rRNA gene sequencing.Ethics and dissemination The MCETMS study protocol has been approved by the Ethics Committee of the First Affiliated Hospital of Guangzhou Traditional Chinese Medical University (ZYYECK[2020]051). Dissemination of study findings will occur through peer-reviewed journals, conferences and presentations.Trial registration number ChiCTR2000041172.

Background: Pregnancy of unknown location (PUL) is a kind of pregnancy that has a positive beta-human chorionic gonadotropin (β-hCG) test result but the location of pregnancy cannot be determined by ultrasound. Early determination of the location of the pregnancy is important for subsequent treatment. However, there is no study on the characteristics of vaginal microbiota in pregnant women with unknown locations and a model for judging it by vaginal microbiota combined with clinical indicators. Therefore, we designed this study to compare the characteristics of vaginal microbiota in intrauterine and ectopic pregnancy populations during pregnancy with unknown locations and to establish a prediction model for pregnancy locations in PUL populations with clinical indicators.Methods: This is a prospective, multicenter cohort study. 576 eligible participants will be included in this study. Vaginal microbiota was collected from all participants at inclusion, and color Doppler ultrasound was performed weekly. After the locations of pregnancy were determined, participants of intrauterine pregnancy were followed up to their early pregnancy outcome, and participants of ectopic pregnancy were followed up until a none-pregnancy level of β-hCG was confirmed. Discussion: The regular method of judging the location of pregnancy is by color Doppler ultrasound and β-hCG test. We hope to provide earlier clinical methods of prediction for women with unknown locations of pregnancy through this study.Trial registration: Chinese Clinical Trial Registry: ChiCTR2000035378, registration date: 9 August 2020. http://www.chictr.org.cn/index.aspx

Purpose: The aim of this study was to evaluate white blood cell (WBC) count as a risk factor related to methotrexate (MTX) treatment failure in patients with ectopic pregnancy (EP).Methods: A total of 236 women diagnosed with EP and treated with a single dose of MTX were included. The exposure variable was WBC count at baseline, and the outcome was MTX treatment outcome. Both a multivariate binary logistics regression model and subgroup analysis were performed to evaluate the association between WBC and MTX non-response.Results: WBC count was associated with the risk of treatment failure, and the odds ratio (OR) in different multivariate models was stable [minimally adjusted model: OR 1.2, 95% confidence interval (CI): 1.0–1.3, p = 0.008; fully adjusted model: OR 1.2, 95% CI: 1.0–1.4, p = 0.026]. For WBCs in group T3 (>8.9 × 109/L), the association between WBC count and treatment failure was significant (minimally adjusted model: OR: 2.0, 95% CI: 1.0–3.8, p = 0.050; fully adjusted model: OR: 2.2, 95% CI: 1.1–5.6, p = 0.034). Subgroup analysis showed that in participants with regular menstruation (OR 1.1, 95% CI: 1.0–1.3), WBC count was significantly different from irregular menstruation (OR 1.8, 95% CI: 1.2–2.8); p for interaction was 0.031.Conclusions: We found a reliable and non-linear relationship between WBC count and MTX treatment failure for EP.

Ethnopharmacological relevance: As one of the most common female malignant tumors mainly infected by human papillomavirus (HPV) worldwide, cervical cancer is widely distributed in about 90% developing countries. An in-hospital preparation derived from a traditional Chinese herbal formula, Youdujing (YDJ), has been developed and clinically used for more than 20 years in our hospital for treating multiple diseases caused by HPV infection, such as cervical precancerous lesions, recurrent condyloma acuminata, flat warts, etc. However, few investigations on the effect and mechanism of YDJ extract on treating and preventing HPV infection induced cervical cancer have been reported. Aim of the study: Previous reports showed that YDJ extract is effective in triggering human cervical cancer cells (ectocervical Ect1/E6E7) death in a necrotic manner. Herein, we aim to investigate the anti-proliferation effects and potential mechanisms of YDJ extract in inducing necroptosis in ectocervical Ect1/E6E7 cells. Materials and methods: The high-performance liquid chromatography (HPLC) fingerprint method was firstly used for better quality control of the chemical components in YDJ extract. MTT assay and flow cytometer were applied for evaluating cytotoxicity and necroptosis induced by YDJ extract in ectocervical Ect1/E6E7 cells. Besides, Western blotting, receptor-interacting protein serine-threonine kinase 1 (RIP1) inhibitor (necrostatin-1), and RIP1 shRNA and pCDNA transfection assays were employed for investigation on the underlying mechanisms and validation the role of RIP1 in YDJ extract induced necroptosis. Results: YDJ extract induced necroptosis in ectocervical Ect1/E6E7 cells both in time- and concentration-dependent manners, without affecting activation of caspases and elevation of intracellular reactive oxygen species (ROS) level. Moreover, a selective increasing in RIP1 expression was observed in YDJ extract treated ectocervical Ect1/E6E7 cells. The induction effect of necroptosis by YDJ extract was partially blocked by the addition of RIP1 inhibitor (necrostatin-1). Co-immunoprecipitation assay demonstrated that the treatment of YDJ extract in ectocervical Ect1/E6E7 cells promoted the combination of RIP1 with RIPS and MLKL to form necrosome, which facilitates the process of necroptosis. Conclusions: Taken together, YDJ preparation displays an effective ability of inducing necroptosis in cervical cancer cells through activation of RIP1 kinase. However, although the treatment efficacy and potential me chanisms of YDJ extract in vivo remain unclear and need further investigation, it is believed that YDJ extract has the great potential to be used as a starting point to develop more potent agent for treating or preventing cervical cancer and other proliferative diseases.