Ovarian and endometrial cancers pose significant therapeutic challenges due to late-stage diagnosis and resistance to traditional therapies. Recent progress in the development of multiscale, bioinspired, and stimuli-responsive nanocomposites presents promising avenues for targeted therapy. These nanocomposites, engineered across a range from micrometers to nanometers, utilize hierarchical structures to enhance drug delivery, reduce systemic toxicity, and improve therapeutic efficacy. Through the integration of nanoparticles, hydrogels, and polymeric nanocarriers, these materials can react to external stimuli such as pH, temperature, and magnetic fields, enabling precise and controlled release of therapeutic agents. This review examines the design principles of these sophisticated composites, concentrating on their capacity to replicate the tumor microenvironment and enhance targeting specificity in ovarian and endometrial cancers. Furthermore, it highlights current clinical obstacles, safety considerations, and the considerable potential of these materials in personalized gynecologic oncology, underscoring their efficacy at both macroscopic and nanoscopic levels.

Gynecological infections and implant-related complications, such as bacterial vaginosis (BV), pelvic inflammatory disease (PID), and endometritis, are exacerbated by biofilm-forming pathogens such as G. vaginalis, E. coli, and S. aureus, posing significant clinical challenges worldwide. These biofilms, resistant to antibiotics, contribute to chronic infections and device failures in gynecological implants. Rising antibiotic resistance underscores the need for innovative biomaterials. Chitosan, hyaluronic acid (HA) and alginate are three representative natural polysaccharides, showing broad application potential in antibacterial materials and tissue engineering due to their excellent biocompatibility, biodegradability and modifiable structures. In their natural forms, they exhibit a certain degree of anti-biofilm activity by inhibiting bacterial adhesion and disrupting bacterial membranes. Functional modification significantly enhances their antibacterial performance such as AMPs grafting, cross-linking, quaternization, and nanocomposites. This review explores the antibacterial mechanisms of natural polysaccharides in the vaginal microbiome and endometrial tissue, highlighting advances in functionalization with antimicrobial peptides, nanoparticles, and chemical modifications to enhance antibacterial efficacy. The toxicological effects of natural polysaccharide materials on gynecological tissues generally show the characteristics of mainly protective and restorative effects, rather than causing damage. Natural polysaccharides and their applications offer promising potential for infection-resistant, regenerative therapies in gynecology, promising safer and more effective interventions.

Placental microplastic exposure has emerged as a potential environmental risk factor affecting fetal development. This study investigates the association between placental microplastic burden and umbilical cord hormone levels in a cohort of pregnant women from Shenyang, China. A total of 1324 pregnant women during 2022-2023 were enrolled. Placental microplastics were quantified using a laser direct infrared (LD-IR) chemical imaging system, targeting polyvinyl chloride (PVC), polypropylene (PP), and polybutylene succinate (PBS). Umbilical cord blood cortisol, cortisone, dehydroepiandrosterone (DHEA), and androstenedione were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Regression models were applied to assess individual microplastic associations, while quantile-based g-computation (g-comp) and Bayesian Kernel Machine Regression (BKMR) were used to evaluate mixture effects. Microplastics were detected in all placental samples, with a median total concentration of 12 particles/10 g. Placental microplastic exposure was significantly associated with altered fetal hormone levels. Higher PVC, PBS, and total microplastic concentrations were linked to lower cortisol levels, while PVC, PP, and total microplastics were associated with reduced cortisone. In contrast, PBS and total microplastics were positively associated with DHEA, and PVC, PBS, and total microplastics correlated with increased androstenedione. The cortisol/DHEA and glucocorticoid/androgenic ratios were significantly reduced with higher microplastic exposure, suggesting endocrine disruption. Mixture analysis confirmed these trends, showing decreased glucocorticoids and increased androgens, with sex-stratified analysis indicating stronger cortisol reductions in boys and higher DHEA in girls. Overall, placental microplastic exposure was associated with altered fetal hormone levels, suggesting potential endocrine disruption while further studies are needed.

BJOG: An International Journal of Obstetrics & GynaecologyEarly View LETTER TO THE EDITOR Salpingo-oophorectomy and effects on cognition Daming Chu, Daming Chu Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, ChinaSearch for more papers by this authorHeng Wei, Corresponding Author Heng Wei [email protected] Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China Correspondence Heng Wei, Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Shenyang, Liaoning 110000, China. Email: [email protected]Search for more papers by this author Daming Chu, Daming Chu Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, ChinaSearch for more papers by this authorHeng Wei, Corresponding Author Heng Wei [email protected] Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China Correspondence Heng Wei, Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Shenyang, Liaoning 110000, China. Email: [email protected]Search for more papers by this author First published: 27 June 2023 https://doi.org/10.1111/1471-0528.17583Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. REFERENCES 1Terra L, Lee Meeuw Kjoe PR, Agelink van Rentergem JA, Beekman MJ, Heemskerk-Gerritsen BAM, van Beurden M, et al. Long-term effects of premenopausal risk-reducing salpingo-oophorectomy on cognition in women with high familial risk of ovarian cancer: a cross-sectional study. BJOG. 2023; 130(8): 968–77. 2Cournot M, Marquié JC, Ansiau D, Martinaud C, Fonds H, Ferrières J, et al. Relation between body mass index and cognitive function in healthy middle-aged men and women. Neurology. 2006; 67(7): 1208–14. 3Verdelho A, Madureira S, Moleiro C, Ferro JM, Santos CO, Erkinjuntti T, et al. White matter changes and diabetes predict cognitive decline in the elderly: the LADIS study. Neurology. 2010; 75(2): 160–7. 4Sabia S, Elbaz A, Dugravot A, Head J, Shipley M, Hagger-Johnson G, et al. Impact of smoking on cognitive decline in early old age: the Whitehall II cohort study. Arch Gen Psychiatry. 2012; 69(6): 627–35. Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation

Background Uterine Cervical Carcinoma (UCC) is the most prevalent gynecological malignancy globally, with a rising incidence in recent years. Accumulating evidence indicates that specific viral infections, including human papillomavirus (HPV), Epstein-Barr virus (EBV), Hepatitis B and C viruses (HBV and HCV), and human herpesvirus (HHV), may contribute to UCC development and progression. Understanding the complex interplay between viral infections and UCC risk is crucial for developing novel preventative and therapeutic interventions. Methods This comprehensive review investigates the association between viral infections and UCC risk by examining the roles of various viral pathogens in UCC etiology and pathogenesis, and possible molecular mechanisms. Additionally, we evaluate current diagnostic methods and potential therapeutic strategies targeting viral infections for UCC prevention or treatment. Results The prevention of UCC has been significantly advanced by the emergence of self-sampling for HPV testing as a crucial tool, allowing for early detection and intervention. However, an essential challenge in UCC prevention lies in understanding how HPV and other viral coinfections, including EBV, HBV, HCV, HHV, HIV, or their concurrent presence, may potentially contribute to UCC development. The molecular mechanisms implicated in the association between viral infections and cervical cancer development include: (1) interference of viral oncogenes with cellular regulatory proteins, resulting in uncontrolled cell proliferation and malignant transformation; (2) inactivation of tumor suppressor genes by viral proteins; (3) evasion of host immune responses by viruses; (4) induction of a persistent inflammatory response, contributing to a tumor-promoting microenvironment; (5) epigenetic modifications that lead to aberrant gene expression; (6) stimulation of angiogenesis by viruses; and (7) activation of telomerase by viral proteins, leading to cellular immortalization. Additionally, viral coinfections can also enhance oncogenic potential through synergistic interactions between viral oncoproteins, employ immune evasion strategies, contribute to chronic inflammation, modulate host cellular signaling pathways, and induce epigenetic alterations, ultimately leading to cervical carcinogenesis. Conclusion Recognizing the implications of viral oncogenes in UCC etiology and pathogenesis is vital for addressing the escalating burden of UCC. Developing innovative preventative and therapeutic interventions requires a thorough understanding of the intricate relationship between viral infections and UCC risk.

目的 研究自制心电定位系统及利伐沙班对卵巢癌患者经外周置入中心静脉导管(PICC)相关深静脉血栓(DVT)的预防效果.方法 选取2016年1月至2019年1月的卵巢癌术后化疗患者172例作为研究对象.将患者按随机数字表法分为观察组87例、对照组85例.其中观察组内又分为PICC术后使用利伐沙班组(44例)和不使用组(43例).所有患者均留置PICC行多西他塞+卡铂(DC)方案静脉化疗6个周期.观察组采用自制心电定位系统引导PICC尖端定位.其中使用利伐沙班组,留置PICC术后24 h始予口服利伐沙班预防性抗凝治疗3周.对照组采用体表外测量估计导管长度,采用改良塞丁格(Seldinger)穿刺技术留置PICC,穿刺后行胸部X线摄片确认导管尖端位置.观察记录PICC留置过程及术后并发症发生情况,护理满意度.结果 相比对照组患者,观察组患者PICC-DVT发生率明显更低,而护理满意度较高,差异具有统计学意义(P<0.05).观察组内使用利伐沙班组和不使用组之间DVT差异无统计学意义(P>0.05).结论 自制心电定位系统引导PICC尖端定位,可降低PICC-DVT发生率,提高患者满意度.预防性抗凝治疗对降低PICC-DVT是否有作用尚需进一步研究.

Cervical cancer (CC) is a common gynecological malignancy with high morbidity and mortality. Mounting evidence has highlighted that long noncoding RNAs are essential regulators in cancer development. Long intergenic non-protein-coding RNA 997 (LINC00997) was identified for study due to its high expression in CC tissues. The aim of the study was to investigate the function and mechanism of LINC00997 in CC. Reverse transcription-quantitative PCR (RT-qPCR) revealed that LINC00997 RNA expression was also increased in CC cells and LINC00997 copy number was upregulated in CC tissues. 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT), colony formation, and Transwell assays as well as transmission electron microscopy observation exhibited that LINC00997 depletion inhibited CC cell proliferation, migration, invasion, and autophagy. The relationship between LINC00997 and its downstream genes was confirmed by RNA pulldown, luciferase reporter, and RNA-binding protein immunoprecipitation assays. Mechanistically, LINC00997 upregulated the expression of cullin 2 (CUL2) by interacting with microRNA 574-3p (miR-574-3p). Moreover, Western blot analysis was employed to detect the protein levels of mitogen-activated protein kinase (MAPK) pathway-associated factors in CC cells. LINC00997 activated the MAPK signaling by increasing CUL2 expression, thus promoting malignant phenotypes of CC cells. In conclusion, the LINC00997/miR-574-3p/CUL2 axis contributes to CC cell proliferation, migration, invasion, and autophagy via the activation of MAPK signaling.

This study aims at exploring the effect of continuous catheterization on reducing postoperative urinary tract infection in cervical cancer patients with double J tube placement. To be specific, a retrospective analysis was performed on 120 cases of cervical cancer patients who underwent laparoscopic or open radical hysterectomy in Shengjing Hospital of China Medical University from January to December 2019. They were divided into a persistent group (n = 70) and a short-term group (n = 50) according to indwelling catheter time. The incidence of postoperative complications and the positive rate of bacterial culture in bladder urine and double J tube bacterial culture were compared between the two groups. As a result, it was found that the incidence of postoperative fever and urinary tract infection in the short-term group was significantly higher than that in the persistent group (P<0.05). There was no significant difference in the incidence of postoperative hematuria, bladder stimulation, and urinary system injury between the two groups. The positive rate of double J tube bacterial culture in both groups was also proved to be higher than that in bladder culture, and the difference was statistically significant (P<0.05). And in the short-term group (P<0.05), the difference in the positive rate of bladder culture between the two groups was not statistically significant. To conclude, we found that continuous catheterization can reduce the incidence of postoperative urinary tract infection in cervical cancer patients with double J tube placement, which might be helpful for the treatment of cervical cancer.

探讨卵巢癌根治术后24 h进流食对患者胃肠功能恢复的影响。将60例卵巢癌根治术后患者随机分为实验组和对照组,各30例。对照组采用常规护理,排气后进全流食。实验组在常规护理的基础上,术后24 h即进全流食。比较2组患者术后胃肠功能恢复情况及术后并发症发生率。实验组胃肠功能恢复时间短于对照组,并发症发生率无明显差异。卵巢癌根治术后24 h进流食可促进患者胃肠功能的恢复。

目的 探讨慢性肾功能不全(CRI)患者行经腹全子宫切除术的安全性及可行性.方法 回顾性分析67例行经腹全子宫切除术的CRI患者的临床资料,以同期患相同或相似疾病行相同手术但肾功能正常的30例患者作为对照组,比较组间差异,进行统计学分析.结果 在手术时间、术中出血量、术后48 h引流量等方面,慢性肾脏病(CKD)5期组高于其他3组,差异有统计学意义(P＜0.05).在术后并发症方面,CKD5期组发生率高于对照组和CKD3期组,差异有统计学意义(P＜ 0.001).结论 对于未进展到尿毒症期的CRI患者,围术期在积极治疗原发病、纠正贫血等对症治疗的基础上,实施经腹金子宫切除术是安全可行的;对于已进展到尿毒症期的患者,手术风险相对较大,围术期除积极治疗原发病,控制现有并发症,做好防治相关并发症的准备外,应常规透析,待病情控制平稳后,再行手术.

Ovarian cancer accounts for the major part of the mortality attributable to female reproductive system malignant tumors worldwide. Recently, the incidence of ovarian cancer has been increasing annually, and there remains a lack of suitable treatment methods that can significantly improve the 5-year survival rates of patients. Therefore, it is necessary to identify more effective treatments for ovarian cancer. It is established that microRNAs (miRNAs) have important roles in the diagnosis and treatment of ovarian cancer and a specific miRNA, miR-762, can promote the development of a variety of tumors. Menin is encoded by MEN1, a tumor suppressor gene, that is usually downregulated in ovarian cancer. In this study, we evaluated the expression levels of miR-762 and menin in ovarian cancer tissues and demonstrated that they were correlated. In addition, we found that miR-762 can downregulate the expression of menin through a binding site in its 3'-UTR and consequently upregulate the Wnt cell signaling pathway to promote the development of ovarian cancer. These results indicate that miR-762 is a promising potential target for the treatment of ovarian cancer.

Objective:To discuss the effect and advantage of uterine morcellator in the vaginal hysterectomy of large uteri.Methods:Retrospectively analyzing the clinical data of patients undergoing vaginal hysterectomy from January 2014 to December 2016 in the department of gynecology of our hospital.The uterine size all ranged from 12 to 16 gestational weeks.The experimental group contained 38 patients with uterine morcellator,and the control group included 45 patients without uterine morcellator.Comparatively analyzing the clinical data of two groups,including general condition,indicators related to the operation and postoperative related indicators for statistical analysis.Results:The intraoperative situation,the operation time of the experimental group was shorter than that of the control group,difference was statistically significant (P ＜ 0.05).Intraoperative blood loss in the experimental group was less than the control group (P ＜ 0.05).The postoperative situation,fever days in the experimental group was less than the control group (P ＜ 0.05).The changes of hemoglobin pre and post operation in the experimental group was less than the control group (P ＜ 0.05).Conclusion:For the patients undergoing vaginal hysterectomy,it is necessary to assess the size and activity level of uterus adequately.For patients with large uteri eligible for vaginal hysterectomy,application of uterine morcellator may have more advantages.

Objective To analyze the efficacy of conventional myomectomy and gonadotropin releasing hormone agonist (GnRH-a) combined treatment for diffuse uterine leiomyomatosis.Methods Six cases of diffuse uterine leiomyomatosis received conventional myomectomy with GnRH-a as a postoperative adjuvant therapy.The number of myomas enucleated was analyzed and all patients were followed-up postoperatively.Results The mean number of enucleated myomas was 68 (19-135).The mean blood loss during surgery was 283 mL (100-600 mL) and the mean operative time was 132 min (50-185 min).Postoperatively,regular menses were restored and anemia was relieved in all cases.Two patients became pregnant,with smooth antenatal course and postnatal period without any complication.Conclusion Conventional myomectomy with GnRH-a combined treatment can be considered as an option for women with diffuse uterine leiomyomatosis who wish to preserve fertility.

目的 探讨BRAF基因在子宫内膜异位症异位内膜及在位内膜中的表达.方法 采用实时聚合酶链反应技术及免疫组织化学SP法检测20例子宫内膜异位症患者的异位内膜和在位内膜及20例对照组正常子宫内膜中BRAF的表达.结果 在位内膜中BRAFmRNA相对表达量(0.000 067 897 0±0.000 114 528 6)明显高于正常内膜(0.000 009 543 1±0.000 006 454 3)(P＜0.05),而异位内膜(0.000 029 395 7±0.000 038 046 9)与在位内膜之间差异无统计学意义(P＞0.05).异位内膜和在位内膜中BRAF蛋白的阳性表达率和表达强度均明显高于正常内膜(P＜0.05),而异位内膜和在位内膜之间阳性表达率及表达强度的差异无统计学意义(P＞0.05).结论 在位内膜BRAF基因高表达可能在子宫内膜异位症发生中起重要作用,而与病情进展的相关性有待进一步验证.