BACKGROUND:Ovarian cancer (OC) remains one of the most lethal gynecological malignancies worldwide, with a disproportionate burden in older women. This study aims to quantify and project the OC burden from 1990 to 2021 using data from the Global Burden of Disease Study 2021 (GBD 2021). METHODS:Leveraging data from the GBD 2021, this study comprehensively assessed trends in OC-related disability-adjusted life years (DALYs), deaths, incidence, and prevalence across 204 countries and 21 regions from 1990 to 2021, and age-standardized rates were calculated. Joinpoint regression and age-period-cohort (APC) modeling were used to identify temporal trends and cohort effects. Inequality was assessed using the Slope Index of Inequality (SII) and Concentration Index (CI). The Bayesian age-period-cohort (BAPC) model was applied to project OC burden through 2050. RESULTS:From 1990 to 2021, absolute DALYs, deaths, incidence, and prevalence of OC among women ≥50 years increased markedly, while ASRs declined globally. High and high-middle SDI regions exhibited the highest burden, particularly among women under 75 years. Australasia demonstrated sustained improvement, whereas Andean Latin America experienced worsening trends. Health inequality, reflected in declining SII and CI values, has narrowed since 1990. High BMI emerged as the dominant risk factor, especially in Central Europe. Occupational asbestos exposure remained regionally significant, particularly in Australasia. Projections indicate continued increases in OC burden through 2050, driven by demographic aging and rising life expectancy. CONCLUSION:Despite improvements in age-standardized OC metrics, the absolute burden continues to rise globally, underscoring the need for age- and region-specific strategies.

Mucinous ovarian carcinoma (MOC) represents a distinct entity within ovarian malignancies, characterized by diagnostic challenges due to its rarity and the potential overlap with other tumor types. The determination of tumor origin is important for precise postsurgical treatment. This article highlights the accurate diagnosis and management of MOC, including the use of imaging modalities, serological tumor markers, immunohistochemistry, and genomic analyses. Transabdominal and transvaginal ultrasonography, complemented by MRI and CT, plays a pivotal role in differentiating MOC from other mucinous tumors and in surgical planning, particularly for fertility preservation. Serological markers like CA19-9, CA-125, and CEA, though not definitive, provide valuable preoperative insights. Immunohistochemistry aids in distinguishing primary MOC from metastatic mucinous carcinomas, while genomic profiling offers the potential for precision medicine through the identification of specific molecular signatures and treatment susceptibilities. Despite advancements in diagnostic techniques, no single method conclusively differentiates between primary and metastatic tumors intraoperatively. The paper reviews the origins, diagnosis, and differential diagnosis of primary mucinous ovarian carcinoma highlights the need for a multimodal diagnostic approach and advocates for the inclusion of MOC patients in clinical trials for personalized therapies, recognizing the heterogeneity of the disease at the molecular level.

Background: Ovarian cancer (OC) is often associated with an unfavorable prognosis. Given the crucial involvement of lysosomes in tumor advancement, lysosome-related genes (LRGs) hold promise as potential therapeutic targets. Methods: To identify differentially expressed lysosome-related genes (DE-LRGs), we performed a matching analysis between differentially expressed genes (DEGs) in OC and the pool of LRGs. Genes with prognostic significance were analyzed using multiple regression analyses to construct a prognostic risk signature. The model's efficacy was validated through survival analysis in various cohorts. We further explored the model's correlation with clinical attributes, tumor microenvironment (TME), mutational patterns, and drug sensitivity. The quantitative real-time polymerase chain reaction (qRT-PCR) validated gene expression in OC cells. Results: A 10-gene prognostic risk signature was established. Survival analysis confirmed its predictive accuracy across cohorts. The signature served as an independent prognostic element for OC. The high-risk and low-risk groups demonstrated notable disparities in terms of immune infiltration patterns, mutational characteristics, and sensitivity to therapeutic agents. The qRT-PCR results corroborated and validated the findings obtained from the bioinformatic analyses. Conclusions: We devised a 10-LRG prognostic model linked to TME, offering insights for tailored OC treatments.

Circular RNA (circRNA), a type of non‑coding RNA, plays a regulatory role in biological processes. The special loop structure of circRNA makes it highly stable and specific in diseased tissues and cells, especially in tumors. Competing endogenous RNAs (ceRNAs) compete for the binding of microRNA (miRNA) at specific binding sites and thus regulate gene expression. ceRNAs play an important role in various diseases and are currently recognized as the most prominent mechanism of action of circRNAs. circRNAs can modulate the proliferation, migration, invasion and apoptosis of tumor cells through the ceRNA mechanism. With further research, circRNAs may serve as novel markers and therapeutic targets for ovarian cancer (OC). In the present review, the research progress of circRNAs as ceRNAs in OC was summarized, focusing on the effects of the circRNA/miRNA/mRNA axis on the biological functions of OC cells through mediating pivotal signaling pathways. The role of circRNAs in the diagnosis, prognostic assessment and treatment of OC was also discussed in the present review.

Background Ovarian endometrioid carcinoma (OEC) is the second most commonly occurring ovarian epithelial malignancy, but the associated prognostic factors remain obscure. This study aimed to analyze independent prognostic factors for patients with OEC and to develop and validate a nomogram to predict the overall survival (OS) of these patients. Methods Clinical information of patients with OEC (2000–2019) was obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox analyses were used to identify independent prognostic factors, and nomogram models were constructed using independent prognostic factors. Receiver operating characteristic (ROC) curve, calibration plots, and decision curve analysis (DCA) were used to verify the accuracy and validity of the nomogram. Kaplan–Meier curves were used to compare the differences in OS and cancer-specific survival (CSS) among subgroups. Results A total of 4628 patients with OEC were included, being divided into training ( n = 3238) and validation ( n = 1390) sets (7:3 ratio). On multivariate Cox analysis, AJCC stage, age, tumor size, differentiation, chemotherapy, and lymph node resection were significant predictors of survival outcomes ( P < 0.05). Resection of 1–3 lymph nodes in early-stage OEC patients did not significantly prolong OS ( P > 0.05), but resection of ≥ 4 lymph nodes in early-stage improved OS and CSS ( P < 0.05). The OS of early-stage patients was not related to whether or not they received chemotherapy ( P > 0.05). Lymph node resection and chemotherapy significantly improved the prognosis of patients with advanced OEC ( P < 0.05). The c-index of nomogram prediction model was 0.782. ROC with good discrimination, calibration plots with high consistency, and DCA with large net benefit rate result in large clinical value. Conclusion AJCC stage, differentiation, tumor size, age, chemotherapy, and lymph node dissection were prognostic factors of OEC. The constructed nomogram prediction model can effectively predict the prognosis of OEC patients and improve the accuracy of clinical decision-making.

PBL教学法自2000年传入我国医学教育界,随后被学者广泛应用于妇产专业的教学实践中.经过接近20年的教学应用探索,PBL教学法在与我国妇产专业教学相融合的过程中经历了怎样的发展历程?PBL教学改革在妇产专业涉及了哪些领域?本研究对已发表的妇产专业应用PBL开展教学研究的相关文献进行文献计量学分析,梳理该领域的发文趋势,发文期刊及机构分布,研究主题发展情况,以概览该领域的发展现状及热点趋势,为PBL教学法后续在妇产专业教学的进一步改革、推广及应用提供相关参考.

目的:探讨小规模限制性在线课程(small private online course,SPOC)线上互动教学联合教师模拟标准化病(teachers simulate standardized patient,TSSP)教学模式在妇产科急重症护理临床教学中的应用.方法:选择2020年6月至2022年6月在我院妇产科系统实习的护理专业学生198人作为研究对象.将2018级学生作为试验组,2017级学生作为对照组.试验组采用"SPOC线上互动+TSSP教学"的混合教学模式,对照组采用传统讲授式教学模式,比较测验成绩、自我导向学习能力及学生满意度是否有差异.结果:试验组课后测验成绩、自我导向学习能力以及学生满意度均高于对照组,差异有统计学意义.结论:SPOC线上互动+TSSP教学"混合教学模式能提高学生的主动学习能力和课堂教学效果,对于妇产科急重症的教学取得较好的效果,值得在妇产科急重症护理临床教学中推广应用.

目的 对较为罕见的妊娠相关子宫炎性肌纤维母细胞瘤(uIMT)临床特点、病理形态学特征、免疫组化、分子病理特征、鉴别诊断及相关治疗等方面进行归纳总结,以期提高对该肿瘤的认知.方法 以"炎性肌纤维母细胞瘤、子宫、妊娠、胎盘"为中文关键词,以"inflammatory myofibroblastic tumor,uterus,pregnancy,placenta"为英文关键词,检索PubMed和中国知网数据库1998-09-01-2022-11-30相关文献.纳入标准:(1)妊娠相关uIMT相关研究;(2)胎盘炎性肌纤维母细胞瘤(IMT)相关研究.排除标准:(1)与本研究相关性较小及质量较低的研究;(2)内容相似或重复的文献.最终纳入28篇文献(中文2篇,英文26篇).结果 妊娠相关uIMT临床症状不明显,确诊和鉴别诊断需依据组织病理学、免疫组化及分子检测.治疗方式尚未达成共识,妊娠期可严密随访观察,妊娠后再行手术治疗.若妊娠期症状明显,应及时终止妊娠.有生育需求的患者,若肿块娩出后未发现残留,密切随访后可再次妊娠.该病预后良好.结论 妊娠相关uIMT是一种罕见的间叶性肿瘤,深入了解其临床特征、组织病理表现、免疫组化和分子病理特点,有助于提高对该肿瘤的诊断及鉴别诊断水平.此类疾病的诊治规范需更深入的探讨.

期末课程考核是评价教师教学质量和检验学生对知识掌握程度的常用方法.为及时发现教学过程中存在的薄弱环节,全面提升医学人才培养质量,文章利用教育测量学理论,对中国医科大学2014-2019级临床医学专业3567名学生生理学期末考试成绩、分布情况、试卷难度、信度、评价指数等指标进行全面、客观、深入的分析.考试成绩和试题质量分析结果表明,在教学过程中,医学高校应不断完善教学设计,提高试题质量,有针对性地开展对低分段学生的帮扶工作,进一步推动新时代我国医学教育高质量发展.

Background: Poly ADP-ribose polymerase (PARP) inhibitors have emerged as maintenance therapy for advanced ovarian cancer. However, due to the development of drug resistance, combination of PARP inhibitors with other chemotherapeutic agents has become a contemporary research hotspot. Methods: We conducted a meta-analysis of phase II or III randomized controlled trials to analyze the efficacy and safety of combinations of PARP inhibitors with various chemotherapeutic agents on the progression-free survival (PFS) and overall survival (OS) of patients with ovarian cancer. Results: A total of eight trials that contained the combination of PARP inhibitors and chemotherapeutic agents were included. Combination of PARP inhibitors with bevacizumab benefited patients with BRCA mutations and HRD-positive status(HR=0.34 (95% Cl: 0.23–0.5; P<0.05); HR=0.35 (95% Cl: 0.27–0.45; P<0.05)), while combination with chemotherapy prolonged the PFS in the BRCA mutation, HRD, and homologous recombination proficiency subgroups(HR=0.39 (95% Cl: 0.26–0.58; P<0.05);HR=0.57 (95% Cl: 0.43–0.76; P<0.05); HR=0.79 (95% Cl: 0.64–0.98; P<0.05) ). However, patients with BRCA wild-type or unknown type benefited most from combination with cediranib. PARP inhibitors increased the risk of G≥3 neutropenia when combined with bevacizumab(RR=2.25, 95% Cl 1.09–4.62; P<0.05) and G≥3 anemia(RR=1.54, 95% Cl 1.16–2.05; P<0.05) and neutropenia(RR=1.25,95% CL 1.00-1.57; P<0.05) when combined with chemotherapy. Conclusion: Combination regimens of PARP inhibitors showed benefits in both primary and recurrent ovarian cancer, and the population subsets benefiting varied among different combinations. G≥3 adverse reactions were mainly hematological toxicities.

突如其来的新冠肺炎疫情给一线教师带来了巨大的挑战,同时也把教学一线背后的教学管理者推上了疫情防控大考的答题席.该文从中国医科大学附属盛京医院教学组织管理的实际工作出发,围绕课程的运行维护思路及流程.将疫情防控期间医院的线上教学创新管理工作经验进行凝炼.

随着医学技术的发展和社会对医学人才需求的提升,医学院校对医学生的培养已远不止于书本教学,人文教育、医学实践技能更是医学教育的重点.但因课时限制和某些不可预料因素干扰,医学生教育培养的需求与目标不能有效达成.近年来网络技术不断发展,网络教学在医学教育中展现出了巨大潜力.如何利用网络教学,让医学生时刻受到高质量临床医学教育而不受地域、时间、环境和突发公共事件等因素影响,提高医学生核心竞争力,增强医患沟通能力和临床事件处理能力是目前亟待解决的问题.文章通过对教师模拟标准化病人(teachers simulate standardized patient,TSSP)教学法在妇产科线上教学改革的应用研究,指出目前线上教学的不足与改进,并对未来临床线上教学探索提出了展望.

Ovarian cancer (OC) is a highly lethal disease among all gynecologic malignant tumor types. Accumulating studies have indicated that certain long non-coding RNAs (lncRNAs) serve important roles in the development and progression of OC. In a previous study by our group, lncRNA BC041954 was identified as one of the most upregulated lncRNAs in OC. In the present study, the clinical significance of lncRNA BC041954 in OC was evaluated. The expression of BC041954 was detected in OC and non-tumor tissue (NT) samples using reverse transcription-quantitative PCR. Furthermore, the association between BC041954 and clinicopathological variables was analyzed using the Chi-square test. Survival was determined using Kaplan-Meier analysis. The prognostic significance of BC041954 was evaluated using univariate and multivariate logistic regression analyses. MicroRNA (miRNA)-lncRNA and miRNA-mRNA pairs were used to construct the lncRNA-miRNA-mRNA competing endogenous RNA network with an in-house Perl script. BC041954 expression was increased in 103 OC tissues as compared with that in NT tissues. Upregulated BC041954 expression was significantly associated with the International Federation of Gynecology and Obstetrics stage and distant metastasis. Kaplan-Meier analysis demonstrated that patients with high BC041954 expression had lower overall survival (OS). In the multivariate logistic regression analysis, BC041954 was also identified as an independent poor prognostic factor for OS in patients with OC. The results suggested that overexpression of the lncRNA BC041954 is a poor prognostic indicator in patients with OC.

目的:探讨BOPPPS方法在妇产科线上PBL教学中的应用效果.方法:将参加妇产科线上PBL教学的医学生60名随机分为实验组和对照组.对比两组学生课堂参与度、理论考核成绩及调查问卷结果.结果:课堂参与度及理论考核成绩差异有统计学意义(P＜0.05),调查问卷结果显示在病例知识点融入合理性、课堂讨论效果及学生兴趣激发等9个方面,两组间比较差异均有统计学意义(P＜0.05).结论:在妇产科线上PBL课程中应用BOPPPS方法,可以在提高教学质量的同时提升学生参与度及学习效率,值得更好地推广.

Objectives: To investigate IFN-γ rs2430561 polymorphisms in Han women in northeast China and the relationship between the rs2430561 polymorphisms and the risk of cervical cancer. Methods: PCR-ASP was used for genotyping. IFN-γ rs2430561 polymorphism was detected in 173 cases of cervical invasive carcinoma and 422 healthy controls in Han women in northeast China. Results: The allele and genotype distributions of the IFN-γ rs2430561 polymorphism were not significantly different between each of the groups (P > 0.05). There was no significant relationship between rs2430561 polymorphism and invasive cervical cancer (TT vs AA, OR = 1.321, 95% CI: 0.423–4.121, P = 0.632). The rs2430561 genotype was not associated with major clinicopathological features of invasive cervical cancer (P > 0.05). The polymorphism had no significant effect on overall survival (P = 0.071) or progression free survival (P = 0.067) of invasive cervical carcinoma. Conclusions: Rs2430561 polymorphism had no effect on invasive cervical cancer susceptibility in Han females in northeastern China, and was not associated with the prognosis of invasive cervical carcinoma.

在妇产科学教学设计和实践过程中,通过分析教学现状,结合留学生特点,对教学模式进行深入探讨.同时,对近几年留学生教学质量进行评估和总结,针对留学生特点和现阶段我院妇产科学教学存在的问题提出几点建议,以提高教学质量.

目的 通过对选修妇科腔镜技术课程学生的学习成绩进行分析,探讨手术视频联合雨课堂的混合式教学模式对促进不同专业及年级选课学生达成同质化教学目标的效果和意义.方法 选取我校2019年选修妇科腔镜技术课程的各专业66名学生作为研究对象,分析选课学生人数的年级差异,并对学生的线上成绩、线下成绩及总成绩等展开分析.结果 3个年级整体以及任意两个年级间选课学生的人数均具有显著差异(P<0.001或P<0.05);但是不同性别、专业和年级的学生间的课程成绩均不具有统计学差异(P>0.05).结论 手术视频联合雨课堂的混合式教学模式有助于消除不同年级、专业学生间前期知识储备的差异,有利于学生初步形成临床综合思维,有效提升学生的学习兴趣和学习效果,促进同质化教学目标的达成.

应用整合型科技接受模型(UTAUT)探究新冠疫情防控期间临床教师线上教学接受度及其影响因素.研究发现临床教师易受到社群影响,这种影响在女性教师群体中更加显著,50岁以上的教师对社群影响不敏感,具有高级职称的教师更加期望线上教学易于开展.医学院校提供技术支持,出台“助教机制”等政策有利于线上教学模式在临床教师群体中的推广.

目的 探讨非线性教学软件Focusky在妇科理论教学中应用的效果.方法 选取中国医科大学124名临床医学五年制专业大四学生为研究对象,随机分为两个组,分别为实验组(63人)和对照组(61人).实验组采用Focusky演示文档教学,对照组采用传统的PowerPoint演示文档教学,最后采用主观调查问卷及客观专题考试成绩评估教学效果.结果 实验组在激发学生学习兴趣、提升学生学习效率及学生对课件满意度三个方面的得分均明显高于对照组,实验组的理论知识、病例分析及总成绩均明显高于对照组(所有P＜0.05).结论 Focusky可激发学生学习兴趣、提升学习效率,加强学生解决临床问题的能力,提升妇科理论教学的课堂教学效果,可期在医学教育领域中推广应用.