Objective:To investigate differences in factors associated with vaginal intraepithelial neoplasia (presence/absence and grade) such as HPV, TCT results, and concurrent lesions across age groups, supporting precise prevention and screening strategies. Methods:A retrospective study included 212 patients undergoing colposcopy and vaginal biopsy (2020-2024), grouped as <50 years (n=88) and ≥50 years (n=124). Chi-square tests or Fisher's exact test were used to compare categorical variables between groups and to analyze associations between VaIN presence and clinical factors within each age group. Spearman rank correlation was used to evaluate the correlation between VaIN grade (ordinal) and ordinal clinical factors (eg, TCT result grade, grade of previous/concurrent cervical or vulvar lesions). Results:Age <50 years was significantly associated with VaIN occurrence (P<0.05). In the ≥50 years group, TCT results more often indicated high-grade lesions (P<0.05). Within the <50 years group, VaIN presence/grade showed no significant association with HPV, TCT, concurrent cervical/vulvar lesions, or lesion history. In the group aged ≥50 years, the presence or absence of VaIN was not associated with any of the factors. However, the grade of VaIN lesions was significantly positively correlated with the grade of previous/concurrent cervical or vulvar lesions (Spearman ρ = 0.208, P = 0.020), and showed a trend toward a positive correlation with TCT result severity (Spearman ρ = 0.154, P = 0.088). Conclusion:The correlation between VaIN grade and prior lower genital tract lesions reverses with age, being negative in younger women and positive in older women. These findings underscore the necessity for age-stratified screening and management strategies for VaIN. In clinical practice, for women aged ≥50 years, greater emphasis should be placed on TCT screening results and the history of previous cervical/vulvar lesions.

[This corrects the article DOI: 10.3389/fmed.2025.1635960.].

Adipose-derived stem cell exosomes (ADSCs-Exos) enhance endometrial carcinoma (EC) cell proliferation, migration, and invasion. Mechanistically, ADSCs-Exos downregulate MAGED4B and CDH1, reduce E-cadherin expression, and upregulate vimentin, promoting epithelial-mesenchymal transition (EMT). Overexpression of MAGED4B reverses these effects and inhibits malignant behaviors. Furthermore, ADSCs-Exos increase organoid viability and confirm key protein changes. These findings demonstrate that ADSCs-Exos promote EC progression via the MAGED4B/CDH1/EMT axis.

PurposeBased on electrophysiological assessment data of pelvic floor muscles from 1,781 women, this study systematically analyzes the association patterns among obstetric history, anthropometric indicators, and pelvic floor function through hierarchical regression modeling, aiming to provide a novel perspective for precise risk assessment.MethodsA retrospective analysis was conducted on data from 1,781 adult women, including age, height, weight, BMI, childbirth history, and pelvic floor screening results. Participants were grouped based on pelvic floor screening scores (above or below 80) and childbirth method (vaginal childbirth or cesarean section). Multiple linear regression was used to analyze risk factors for pelvic floor dysfunction, while t-tests, analysis of covariance, and Mann–Whitney U-tests were employed to assess the significance of differences between groups.ResultsPatients were divided into two groups based on pelvic floor screening scores (≥80 and <80). There were statistically significant differences between the <80 group and ≥80 group in age, weight, and BMI (age: 38.73 ± 9.95 years vs. 37.03 ± 8.27 years, weight: 57.26 ± 16.63 kg vs. 55.69 ± 7.22 kg, BMI: 22.67 ± 6.72 vs. 21.88 ± 2.56 kg/m², all p < 0.05). After adjusting for age, weight, height, and BMI, differences in time since the last childbirth to the current screening were also observed (7.20 ± 9.69 years vs. 4.78 ± 7.99 years, p < 0.05). Significant differences in weight were noted between the vaginal childbirth and cesarean section groups (56.32 ± 8.8 kg, P < 0.05 vs. 59.59 ± 30.50 kg, P < 0.05). After adjusting for the effects of age, weight, height, and BMI, the two groups showed statistically significant differences in the total score (cesarean section 66.13 ± 14.71 vaginal delivery 63.01 ± 16.69, p = 0.021), pre-resting stage score (cesarean section 51.28 ± 27.27, vaginal delivery 62.47 ± 25.04, p = 0.000), fast-twitch (Type II fibers) stage score (cesarean section 78.89 ± 18.21, vaginal delivery 72.76 ± 22.38, p = 0.001), slow-twitch (Type I fibers) stage score (cesarean section 60.93 ± 25.39, vaginal delivery53.21 ± 26.55, p = 0.000), post-resting stage score (cesarean section 53.21 ± 26.55, vaginal delivery 60.93 ± 25.39, p = 0), and time from the last childbirth to the current screening (cesarean section 7.27 ± 10.04, vaginal delivery 5.03 ± 6.46, p = 0.001). Pelvic floor screening total score was negatively correlated with the time since the last childbirth (B = −0.233, Beta = −0.135, p = 0.013) and number of deliveries (B = −1.511, Beta = −0.078, p = 0.022), while positively correlated with height (B = 1.447, Beta = 0.437, p = 0.043).ConclusionMultiple deliveries and longer inter-delivery intervals cumulatively impair pelvic floor function. Individualized rehabilitation should prioritize women with shorter stature, older age, or multiple births, alongside promoting a healthy BMI rather than weight loss alone. Postpartum training should be mode-tailored: activating after vaginal birth, relaxing after cesarean.

Background: Human papillomavirus (HPV) clearance is a key component of the natural history of HPV infection and is highly relevant to cervical cancer screening and follow-up. However, reported clearance estimates vary substantially across studies, partly because of differences in follow-up time points, outcome definitions, and units of analysis. Methods: PubMed, Embase, Web of Science, and the Cochrane Library were searched from January 1, 2000 to March 1, 2025 for longitudinal studies of women who were HPV-positive at baseline. Studies were classified by analytic unit, clearance definition, and follow-up interval. Random-effects meta-analyses were performed for comparable participant-level outcomes, while non-comparable outcomes were summarized descriptively. Findings: Fifty-seven reports representing 58 studies were included. The pooled participant-level fixed-time clearance proportion was 18.9% (95% CI, 10.4%–32.0%) at 3 months, 20.4% (9.7%–38.0%) at 6 months, and 46.1% (32.1%–60.8%) at 12 months. Restricted sensitivity analyses showed that the 12-month estimate remained stable. In an exploratory subgroup analysis, the 12-month fixed-time clearance proportion was 38.5% (19.4%–61.9%) in the PCR-based group and 58.7% (26.0%–85.1%) in the HC2-based group. A supplementary analysis of participant-level crude cumulative clearance suggested a time-dependent increase, although these findings should be interpreted cautiously because of the limited amount of data. Kaplan–Meier, CIF, and infection-level outcomes were summarized descriptively rather than quantitatively pooled. Interpretation: Natural clearance of high-risk HPV appears to be a gradual rather than a rapid process. Reported clearance estimates are strongly influenced by follow-up duration, outcome definition, analytic unit, detection method, and statistical approach. Greater methodological standardization is needed to improve comparability across studies and support follow-up decision-making in HPV-positive women.

Ovarian endometriotic cysts represent a prevalent form of endometriosis and are typically identifiable via imaging modalities. Nonetheless, differentiating endometriotic cysts from other benign non-endometriotic ovarian cysts, such as mature teratomas or serous and mucinous cystadenomas, can occasionally pose significant diagnostic challenges. This study aimed to develop a simplified diagnostic model integrating clinical symptoms, tumor markers, inflammatory indices, and coagulation parameters to distinguish endometriosis from other benign ovarian cysts. A retrospective analysis was conducted on 424 histopathologically confirmed ovarian endometrioma patients and 351 with non-endometriotic benign ovarian cysts (January 2024–March 2025). Clinical data (age, dysmenorrhea, cyst size), serum tumor markers (CA125, CA19-9, HE4), inflammatory indicators (WBC, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio ), and coagulation parameters (PT, APTT, TT) were collected. Independent predictors were identified via multivariable logistic regression, and diagnostic performance was assessed using ROC analysis. Dysmenorrhea prevalence (68.16

ObjectiveThis study aimed to delineate the clinical characteristics of endometriosis patients with dysmenorrhea and analyze the correlations between the presence, severity, and duration of dysmenorrhea and the severity of endometriosis.MethodsIn this retrospective study, a total of 489 patients with endometriosis were enrolled who had undergone laparoscopic surgery or had been diagnosed with endometriosis during surgery for benign ovarian tumors. The patients were categorized into dysmenorrhea-positive and dysmenorrhea-negative groups based on the presence of symptoms at diagnosis. Subgroup analyses were further performed within the dysmenorrhea group based on pain severity (mild/moderate/severe) and duration (years). The impact of dysmenorrhea on endometriosis severity was evaluated using clinical, surgical, and histopathological parameters.ResultsThe proportion of patients without dysmenorrhea was 29.4%, while the proportion of patients with dysmenorrhea was 70.6%. Patients with dysmenorrhea were found to be younger, had significantly higher CA125 levels, and had a higher surgical stage. Patients with dysmenorrhea were observed to be more likely to experience infertility and deep infiltrating nodules. Elevated CA125 levels and infiltrating nodules were found to be independent risk factors for dysmenorrhea. CA125 levels and surgical staging significantly increased with the severity of dysmenorrhea. CA199 levels increased with dysmenorrhea duration but decreased in patients with >10 years of symptoms. The longer the duration of dysmenorrhea, the more frequently adenomyosis was observed.ConclusionThe presence, severity, and prolonged duration of dysmenorrhea are strongly associated with advanced endometriosis, infertility, and adenomyosis. Young women with dysmenorrhea warrant heightened clinical suspicion for endometriosis to avoid delayed diagnosis.

Background Endometriosis (EMS) is associated with a markedly increased incidence of depression and anxiety, primarily due to cyclic pain, concerns about infertility from impaired ovarian function, and fear of disease recurrence. Surgery and its associated pain may trigger both emotional and physiological stress responses. Young, nulliparous patients with fertility intentions often experience additional psychological burdens related to surgical safety, postoperative recovery, and the potential impact on future fertility. Music has been shown to promote relaxation, reduce tension and anxiety, and alleviate pain. However, no studies have evaluated the postoperative effects of music therapy in this specific patient population.Objective To investigate whether music therapy can effectively reduce postoperative pain and alleviate perioperative anxiety in young patients with fertility desires undergoing laparoscopic cystectomy for endometriotic ovarian cysts, and to explore its potential as a simple, non-pharmacological intervention.Methods/Design A single-center, two-arm, single-masked randomized controlled trial (RCT).Setting The Third Affiliated Hospital of Sun Yat-sen University (a teaching hospital).Participants A total of 149 patients were included for analysis, with 75 assigned to the music group and 74 to the control group.Intervention Perioperative music therapy administered to young, nulliparous patients with fertility intentions undergoing laparoscopic cystectomy for EMS.Results One participant withdrew during follow-up, and 149 patients were included in the final analysis. Baseline characteristics—including age, BMI, marital status, preoperative VAS scores, and GAD-7 scores and anxiety levels—showed no significant differences between groups. Postoperative VAS scores at 6 h (p = 0.20), Day 1 (p = 0.438), Day 3 (p = 0.714), and Day 7 (p = 0.899) revealed no significant differences. Similarly, GAD-7 scores and anxiety severity levels on postoperative Day 1 (p = 0.541; p = 0.984), Day 3 (p = 0.287; p = 0.436), and Day 7 (p = 0.468; p = 0.703) showed no statistical significance between groups.Conclusion Music therapy may serve as an adjunctive intervention for young, nulliparous patients with fertility intentions undergoing laparoscopic cystectomy for endometriosis; however, no significant effects were observed in reducing perioperative anxiety or postoperative pain in this population.

This study aims to investigate HPV vaccine awareness and determinants among female university students in China—a key group for cervical cancer prevention. A cross-sectional study was conducted among 1434 female college students from four universities in Guangzhou in 2024 using non-probability sampling method. Data were collected via structured questionnaires that assessed HPV knowledge and vaccination attitudes. Descriptive statistics, chi-square tests, and multivariate logistic regression analysis were performed using SPSSAU and SPSS 25.0 to identify significant predictors of vaccination intention. Among 1,434 participants, 85.6% were aware of HPV, 93.3% aware of the HPV vaccine, and 87.1% willing to be vaccinated. Sexual transmission was recognized by 74.0% of participants, 42.7% were cognizant of the optimal timing for vaccination (before sexual debut), and 87.1% exhibited willingness or had a history of vaccination. Key predictors of vaccination intent were identified as worry about cervical cancer (OR=1.84, 95%CI=1.45–2.28), knowledge of transmission routes (OR=1.20, 95%CI=1.03–1.40), and belief in vaccine efficacy (OR=3.25, 95%CI=2.06–3.90). Among hesitant respondents (n=185), safety (47.1%) and cost (29.4%) were cited as the main concerns. Though awareness is high (93.3%), knowledge gaps remain. These findings highlight the urgent need for targeted public health interventions to improve vaccination rates and address vaccine hesitancy among female university students in China, which has significant implications for cervical cancer prevention not only in China but also in other low- and middle-income countries (LMICs) with similar challenges.

ABSTRACT Background Previously, anti‐CTLA4 and anti‐PD‐1/PD‐L1 immunotherapies have shown limited efficacy in MSI‐H/MMR‐D endometrial cancer, leading to poor clinical outcomes. The gelsolin superfamily, which includes GSN, SCIN, VILL, VIL1, CAPG, AVIL, SVIL, and FLII, plays crucial roles in cell motility and gene regulation. Aims The objective of this study is to explore the potential therapeutic and prognostic implications of the gelsolin superfamily in EC. Materials & Methods Data from TCGA, GEPIA, THPA, UALCAN, and Kaplan–Meier plotter databases were analyzed to investigate the expression and clinical relevance of gelsolin superfamily members. Co‐expression networks of the gelsolin superfamily were assessed using LinkedOmics, GeneMANIA, and NetworkAnalyst. The relationship between gelsolin superfamily and immune cell infiltration was investigated using TIMER, ImmuCellAI, and GEPIA. Results We found that high expressions of CAPG, AVIL, and SVIL were associated with poor prognosis, while high expressions of GSN and FLII were linked to better outcomes in EC. Functional enrichment analysis indicated the involvement of gelsolin superfamily members in pathways related to estrogen response, MYC targets, epithelial–mesenchymal transition, TGF beta signaling, MTORC1 signaling, oxidative phosphorylation, inflammatory response, and IL6‐JAK‐STAT3 signaling. Furthermore, gelsolin superfamily members demonstrated strong correlations with the levels of monocytes, natural killer T, naive CD4+ T, follicular helper T, and central memory T in EC. In vitro studies showed that silencing CAPG and FLII could inhibit proliferation and metastasis in endometrial cancer cell lines. Conclusion These findings indicate the significant association of gelsolin superfamily members with prognosis and immunological status in endometrial cancer.

The HPV vaccination rate of Chinese college students remains low. Therefore, there is an urgent need to provide health education regarding HPV vaccination among college students in China. We used a pre-test/post-test model to implement a health education intervention for the HPV vaccine among undergraduate medical students and subsequently evaluated its effectiveness. A total of 180 undergraduate medical students who were attending classes at the gynaecological department of the Third Affiliated Hospital of Sun Yat-sen University from October 2022 to March 2023 were selected for inclusion in the study. Before class, all students completed a questionnaire and a pre-class quiz to obtain key points in the course. The class regarding HPV and the HPV vaccine was taught by senior teachers. After the course, all students completed a post-class quiz consisting of the same questions as the pre-class quiz. The pre-class and post-class scores were compared to evaluate the effectiveness of this teaching model. After the HPV health education intervention in the pre-test/post-test model, the post-class scores were significantly higher than the pre-class scores for different gender, years of study, clinical majors, different willingness of vaccine to receive the vaccine(p < 0.05). A pre-test/post-test model may be an effective approach for HPV health education interventions.

BACKGROUND:Social and economic factors play significant roles in the incidence of uterine cancer. This study examined how age, time period and birth cohort affect incidence patterns across various regions. METHODS:Data on the incidence of uterine cancer from 1990 to 2021 were obtained from the Global Burden of Disease Study 2021. An age-period-cohort (APC) model was applied to evaluate the effects and geographical variations. RESULTS:In 2021, there were 473,614 [95 % uncertainty interval (UI) 429,916-513,667] cases of uterine cancer globally, resulting in an age-standardized incidence rate (ASIR) of 10.4/100,000 (95 % UI 9.4-11.2). ASIR was highest in High-income North America and Europe (high-income regions), and lowest in South Asia and most African regions. The incidence of uterine cancer has surged disproportionately over time, especially in high-income regions and areas with rapid socio-economic changes. High-income Asia Pacific saw the fastest growth, with an annual net drift of 2.43 % (95 % confidence interval 2.29-2.57). Age is a critical determinant of the incidence of uterine cancer, with notable regional variation. Globally, the peak incidence of uterine cancer occurs at 70-74 years of age, or older, in most regions. However, earlier peaks in incidence are observed in East Asia and Asia Pacific (both 55-59 years), as well as Central Asia (60-64 years). CONCLUSION:The incidence of uterine cancer is increasing globally, with marked geographical disparities in age distribution, temporal trends and cohort effects. While Europe and North America have the highest incidence rates globally, Asia faces a triple challenge: rising incidence, disproportionate caseloads, and younger age at diagnosis. Addressing geographical disparities is crucial in tackling the surge in cases of uterine cancer.

Ovarian cancer significantly contributes to cancer-related deaths among women. Resistance to anchorage-dependent cell death (anoikis) plays a vital role in facilitating metastasis and worsening patient prognosis. Recent developments in the field of cancer biology have underscored the importance of long noncoding RNAs (lncRNAs) as crucial regulatory entities. However, their functions in the context of anoikis, particularly in ovarian cancer patients, remain inadequately understood. We conducted a comprehensive analysis of transcriptome data obtained from public databases, with a focus on screening lncRNAs associated with anoikis-related genes. A novel prognostic model that integrates risk scores to evaluate the predictive efficacy for patient outcomes was developed. We subsequently assessed the expression levels and functional role of the lncRNA BMPR1B-DT in ovarian cancer tissues through various techniques, including Western blot analysis, quantitative real-time polymerase chain reaction (qRT‒PCR), cell counting kit-8 (CCK‒8) assays, and flow cytometry. Our research demonstrates that the anoikis-related lncRNA prognostic model has significant clinical value in predicting the survival outcomes of ovarian cancer patients. Additionally, our study revealed that expression of the lncRNA BMPR1B-DT is upregulated in ovarian cancer tissues and cell lines. Moreover, we revealed that BMPR1B-DT promotes anoikis and inhibits proliferation under suspension culture conditions in ovarian cancer cells. Our results suggest that BMPR1B-DT expression is critical in the process of anoikis in ovarian cancer patients. These insights underscore the necessity for further investigations aimed at translating these findings into clinical applications to improve diagnostic and therapeutic approaches for ovarian cancer patients.

The prevalence of human papillomavirus (HPV) genotype and cervical neoplasia in women older than 64 years, who are outside the age demographic of cervical cancer screening in China, has been under-researched. This study conducts a retrospective analysis of women from a tertiary hospital in Guangzhou, with the aim to offer valuable insights for cervical cancer prevention and control in elderly women. The study incorporated 876 women, all aged 64 and above. In this age bracket, the prevalence rate of any HPV genotype was found to be 19.27%. The top six HR HPV genotypes were HPV 16, HPV 52, HPV 58, HPV 31, HPV 33, and HPV 18. The persistence rate of any HPV type over a 24-month period in this age group was as high as 33.33%. Among women over 64, around 16.47% of HPV-positive patients were diagnosed with cervical cancer. HPV 58 infection was the most substantial risk factor for histological CIN2+ (OR 3.556; 95% CI, 1.107-11.415; p = 0.032) in women over 64 years of age with HPV-positive/NILM status. In conclusion, the burden of HPV infection is significant among women over 64 years in Guangzhou. Re-evaluation of cervical cancer screening strategies for women after the age of 64 is imperative. Moreover, the HPV 16/18/52/58 genotype model could serve as an alternative triage approach to identify histological CIN2+ among elderly women with HPV-positive/NILM status.

The prevalence of human papillomavirus (HPV) genotype and cervical dysplasia in women older than 64 years, who are outside the Chinese cervical cancer screening age, has not been extensively studied. Here we conducted a retrospective analysis of women from a tertiary hospital in Guangzhou, aiming to provide meaningful advice for cervical cancer prevention and control in Guangzhou, China. In this study, the age-specific prevalence of any HPV genotypes showed a U-shaped pattern, and the second peak was observed among women >64 years, which was 19.27%. The top six HR HPV genotypes were HPV 16, HPV 52, HPV 58, HPV 31, HPV 33, and HPV 18. The persistence rate of any HPV in 24 months among women > 64 years was 33.33%, which was higher than that of women among <25 years age group (20.75%), and 25-64 years age group (20.46%). For HPV-positive women aged >64 years, the proportion of cervical cancer (16.47%) was obviously higher than that in women aged 25-64 years (2.41%) ( P <0.001). The infection of HPV 58 was the greatest risk factor for the occurrence of HSIL+ (OR 3.556; 95% CI, 1.107-11.415; P =0.032) in women aged >64 years, with HPV+/NILM. In conclusion, the burden of HPV infection in women >64 years is heavy in Guangzhou. Re-evaluate cervical cancer screening strategies for women after age 64 is needed. And HPV 16/18/52/58 genotype model may be an alternative triage strategy to discover HSIL+ among women aged >64 years, with HPV+/NILM.

Ectopic pregnancy is a life-threatening disease and is an important cause of pregnancy-related mortality. MTX is the primary conservative treatment medicine of ectopic pregnancy, and mifepristone is also a promising medicine. Through studying the ectopic cases at the third affiliated hospital of Sun Yat-Sen University, the study aims to analyze the indication and treatment outcome predictors of mifepristone. The data of 269 ectopic pregnancy cases treated with mifepristone during the year 2011–2019 were retrospectively collected. Logistic-regression analysis was used to analyze the factors affiliated with the treatment outcome of mifepristone. Then ROC curve was used to analyze the indication and predictors. Through logistic-regression analysis, HCG is the only factor related to the treatment outcome of mifepristone. The AUC of ROC curve predicting treatment outcome with pre-treatment HCG is 0.715, and the cutoff value of ROC curve is 372.66 (sensitivity 0.752, specificity 0.619). The AUC of 0/4 ratio predicting the treatment outcome is 0.886, and the cutoff value is 0.3283 (sensitivity 0.967, specificity 0.683). The AUC of 0/7 ratio is 0.947, and the cutoff value is 0.3609 (sensitivity 1, specificity 0.828). Mifepristone can be used to treat ectopic pregnancy. HCG is the only factor related to the treatment outcome of mifepristone. Patients with HCG less than 372.66 U/L can be treated by mifepristone. If HCG descends more than 67.18% on the 4th day or 63.91% on the 7th day, it is more likely to have a successful treatment outcome. It is more precise to retest on the 7th day.

Background: To assess the prevalence and characteristics of human papillomavirus (HPV) genotypes and its associated cervical lesions in Guangzhou, China, which may be useful for adjusting area-specific cervical cancer prevention and control strategies. Methods: A total of 58630 women were enrolled. Cervical specimens were collected for HPV DNA testing and/or cervical cytology. Patients with visible cervical lesions or abnormal screening results underwent further cervical biopsies. Result: The overall HPV positive rate was 14.07%. The top five genotypes in Guangzhou were HPV 52 (3.06%), HPV 16 (2.28%), HPV 58 (1.80%), HPV 51 (1.32%), and HPV 39 (1.15%). The prevalence of overall HPV and vaccine-targeted HPV genotypes showed a significantly decreasing trend from 2016 to 2019 (P < 0.05). While, the infection rate of HPV 35 increased significantly during this time (P = 0.015). The age-specific prevalence of any HPV genotypes showed a bimodal curve, which peaked firstly among the < 20 y age group, and then peaked secondly among the > 59 y age group. Among HPV-positive women, the proportions of HSIL and cervical cancer increased significantly with age (P < 0.05). Among > 59 y age group, 9.35% HPV-positive cases were diagnosed as cervical cancer. HPV 16/18 was the most common cause of cervical cancer. While, the percentage of non-HPV 16/18 infection among cervical cancer patients increased over time, from 15.21% in 2015 to 26.32% in 2019 (P = 0.010). Besides that, the prevalence of non-HPV 16/18 genotypes among cervical cancer patients significantly increased with age, which peaked at the > 59 y age group (P = 0.014). Conclusion: Although the prevalence of any HPV and vaccine-targeted HPV genotypes decreased significantly with time, it is still important to follow the HPV genotypes and their associated cancer risk after the large-scale popularization of HPV vaccine. And age should be taken into consideration in screening strategies and risk-based management of cervical cancer in Guangzhou. (c) 2023 The Authors. Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).

(Abstracted from Gynecol Oncol 2023;178:8–13) High-risk human papillomavirus (hrHPV) infection is an essential factor in the development of cervical cancer, making timely treatment of this infection important. The number of individuals with persistent hrHPV in the gynecological outpatient setting remains high, and no effective hrHPV drug has been brought to market.

The authors report a case of a 29-year-old male presented with bilateral breast enlargement with no significant past medical history or estrogen exposure. Serum β-human chorionic gonadotropin (HCG) was 14,306.60 mIU and positron emission tomography-computed tomography discovered a malignant mass on the right side of anterior superior mediastinum. Magnetic resonance imaging demonstrated pituitary microadenoma. Pathological biopsy showed poorly differential pituitary adenoma and immunohistochemical staining displayed that CK(+), PLAP(−), AFP(−), HCG(+), CD30(−), Oct3/4(−), CK7(+), TTF-1(−), CD117(−), Ki 67(80+), CK5/6(−), EMA(partial+), inhibin(partial+). A diagnosis of primary anterior mediastinal choriocarcinoma metastasis to bilateral lungs accompanied with pituitary microadenoma was confirmed. Then the patient received chemotherapy combined with immunotherapy. But serum β-HCG level was still above the normal, and unfortunately, the patient died 6 months after his diagnosis. This case inspires us to think of the possibility of choriocarcinoma when a man presents gynecomastia or lung metastatic symptoms, adding Opdivo to the chemotherapy might not improve the poor treatment outcomes.

目的:了解中山大学妇产科住培学员的批判性思维的现况,以针对性地在培训中加以干预,提高其批判性思维能力.方法:采用批判性思维能力测量表(CTDI-CV)量表对2020年1月至2022年9月中山大学附属第三医院妇产科招录的60名住培学员进行在线调查.结果:60名学员的判性思维能力总分为(247.60± 22.20)分,仅2名学员(3.33％)分数大于280分,有正性评判性思维能力.批判性思维能力分数从高到低分别为:认知成熟度、寻找真理、开放思想、系统化能力、求知欲、分析能力、自信心,仅认知成熟度表现为正性批判性思维能力倾向.社会规培学员与并轨研究生、硕士以上学历学员与本科学历学员的CTDI-CV总分、7个特质的批判性思维能力的差异均无统计学意义.结论:妇产科住培学员的批判性思维能力仍然有待提高,带教老师应转变教学理念,改进教学方法,不断提高学员批判性思维能力.