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  • Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(5): 541-547. https://doi.org/10.19538/j.fk2025050113
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  • Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(7): 715-722. https://doi.org/10.19538/j.fk2025070111
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  • Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(4): 436-444. https://doi.org/10.19538/j.fk2025040113
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  • Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(7): 723-729. https://doi.org/10.19538/j.fk2025070112
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  • KE Han-wei, XU Ke-xin
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(5): 517-524. https://doi.org/10.19538/j.fk2025050110
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    Interstitial cystitis/bladder pain syndrome(IC/BPS) is a chronic condition primarily characterized by bladder pain,urinary urgency,urinary frequency,and other symptoms,severely affecting patients’ quality of life. Although the pathogenesis of this disease remains incompletely understood,clinical studies have revealed that it is associated with multiple complex factors,including neuroimmune abnormalities,disruption of the bladder epithelial barrier,chronic inflammatory responses,and neurogenic mechanisms. Current treatment methods have some efficacy but the effects are generally limited and unsustained,and there is a lack of specific treatments targeting the underlying pathological mechanisms. This review summarizes the latest researches on the pathogenesis of IC/BPS,with a focus on chronic bladder inflammation,neuroimmune responses,and the role of mast cells in the pathological process. Furthermore,the commonly used diagnostic approaches in clinical practice are evaluated,including medical history collection,cystoscopy,and urodynamic testing,and the identification of Hunner’s lesions in cystoscopy and the clinical application of bladder hydro-distension are discussed. In terms of treatment,the review highlights the limitations of existing therapies and explores emerging treatment options. In addition to traditional pharmacological treatments and bladder instillation therapies,targeted treatments such as platelet-rich plasma (PRP) injections and low-energy extracorporeal shock wave therapy are gaining attention in clinical practice,showing promising therapeutic prospects. Personalized treatment strategies will become a crucial direction for future therapy,especially for the disease in different stages and the patients with different clinical types. In conclusion,IC/BPS is a disease with complex and diverse etiologies. Future treatments should not only focus on symptom relief but also emphasize a deeper understanding of its pathological mechanisms,and more specific and long-lasting therapeutic strategies should be explored to improve patients’ quality of life.

  • Xiao-xia LI, Xiao-li GUO, Guo-lin HE
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 584-589. https://doi.org/10.19538/j.fk2025060103
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    Hypertensive heart disease in pregnancy is a serious complication of hypertensive disorder in pregnancy involving the heart and causing cardiac dysfunction.The disease often manifests as left heart failure and pulmonary edema,which is one of the important causes of maternal non-obstetric death.The key to its treatment lies in early identification and comprehensive management of multidisciplinary collaboration,including blood pressure control,rational drug use,volume management,delivery decision,perinatal safety,and many other aspects.

  • Rui-lin MA, Yin ZHAO
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 600-605. https://doi.org/10.19538/j.fk2025060106
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    Pulmonary arterial hypertension(PAH)poses significant maternal and fetal risks during pregnancy,including heart failure,PAH crisis,maternal death,fetal growth restriction,fetal distress,and preterm birth.In recent years,individualized management has gradually replaced the traditional strategy of absolute contraindication to pregnancy.This review summarizes risk assessment methods and management strategies for PAH in pregnancy,including preconception counseling,pregnancy monitoring,pharmacological and delivery management,and postpartum follow-up.Future efforts should focus on optimizing risk assessment systems of PAH and advance intelligent management in order to improve maternal and neonatal survival.

  • Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(7): 764-768. https://doi.org/10.19538/j.fk2025070121
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  • Yan-qing WEN, Wei ZHOU
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 622-626. https://doi.org/10.19538/j.fk2025060111
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    Cardiovascular disease is one of the important causes of maternal mortality.More than 25% of maternal deaths caused by heart disease can be prevented.Irrational drug use during the perinatal period and volume overload during fluid therapy increase the risk of heart disease in pregnant women,which are important causes of maternal mortality.This article briefly summarizes the drugs commonly used in pregnant women that may cause cardiac dysfunction and pregnancy-associated complications which are the causes of heart failure and pulmonary edema due to abnormal volume.The aim is to discuss how to reduce the incidence of perinatal heart disease in pregnant women through rational drug therapy and individualized fluid treatment strategies.

  • Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 580-583. https://doi.org/10.19538/j.fk2025060102
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  • Original article
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 633-638. https://doi.org/10.19538/j.fk2025060113
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  • Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(4): 385-388. https://doi.org/10.19538/j.fk2025040101
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  • Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(5): 534-540. https://doi.org/10.19538/j.fk2025050112
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  • Hai-tian CHEN, Li-sha YE, Cai-xia ZHU
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 589-594. https://doi.org/10.19538/j.fk2025060104
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    Peripartum cardiomyopathy(PPCM)is an unexplained decline in cardiac contractile function during late pregnancy and at several months after delivery,characterized by left ventricular dysfunction and heart failure.PPCM has not received significant attention from clinical practitioners due to its relative rarity,but its incidence rate has increased year by year in recent years, and it has become one of the leading causes of maternal mortality worldwide.The symptoms of peripartum heart failure often resemble the physiological changes associated with pregnancy,which usually makes early diagnosis difficult and leads to related complications.This article focuses on the diagnosis and therapeutic management of peripartum cardiomyopathy to enhance clinical physicians' understanding of this condition.

  • Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 577-579. https://doi.org/10.19538/j.fk2025060101
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  • Dun-jin CHEN, Cai-ping KE
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 609-613. https://doi.org/10.19538/j.fk2025060108
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    Maternal cardiac arrest is a rare complication in obstetrics. Although it has a low incidence rate,it is an important reason for seriously threatening the life safety of pregnant women and fetuses.The causes of maternal cardiac arrest include obstetric and nonobstetric factors.Resuscitation of maternal cardiac arrest is challenging and requires consideration of a range of pregnancy-related factors,including physiological changes of pregnant women during pregnancy,high-quality cardiopulmonary resuscitation,and the need for perimortem cesarean section.Resuscitation of pregnant patients presents unique challenges,and is the guideline for the standards that CPR and resuscitation strategies should follow, with a little modification.Multidisciplinary cooperation is essential to improving the success rate of rescue.This article reviews the key points of management and knowledge update of maternal cardiac arrest.

  • ZHU Hong-mei, SUN Xiu-li
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(5): 507-512. https://doi.org/10.19538/j.fk2025050108
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    This article systematically investigates the methodology of pelvic floor workout from the perspective of the pelvic floor integral theory. By integrating principles of functional anatomy and human biomechanics,a comprehensive intervention framework for pelvic floor training is proposed from two dimensions:conscious versus unconscious training modalities and regional versus holistic training approaches.It is necessary to focus on core-pelvic floor coordination,breathing training to stabilize intra-abdominal pressure,integrated reflexive pelvic floor muscle training incorporating movements like squats,as well as even pressure distribution along the spinal-pelvic-lower limb kinetic chain.Through the integration of clinical experience with related research findings,it provides theoretical evidence and practical guidance for implementing holistic pelvic floor rehabilitation strategies.

  • YANG Qing-qing, ZHU Jue, WANG Qi-ming, YANG Ming-jie, QIAN Miao-hong, ZHANG Jing
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(7): 734-737. https://doi.org/10.19538/j.fk2025070114
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    Objective To develop and internally validate a risk prediction model for postpartum stress urinary incontinence (SUI) in women using machine learning, aiming to provide evidence for early prevention. Methods This retrospective study included 516 postpartum women who underwent pelvic floor screening at 42 days after delivery at Ningbo University Women and Children's Hospital from October 2022 to June 2023 (a case group of 82 cases and a control group of 434 cases). The influencing factors were collected, including age, delivery mode, parity, electromyographic(EMG) data of pelvic floor and pelvic floor ultrasound data. Five machine learning algorithms such as random forest (RF) and support vector machine (SVM) were used to build predictive models. Model performance was evaluated using 10-fold cross-validation. Results The overall incidence of postpartum SUI was 15.89%. Among all models, the random forest model demonstrated the best performance, with an F1 score of 1.000 and AUC of 1.000 in the training set, and an F1 score of 0.776 and AUC of 0.837 in the validation set. The key influencing factors included pelvic floor EMG parameters (e.g., intense contraction and endurance contraction phases), age, parity, perineal injury, and BMI. Pelvic floor EMG parameters contributed the most to classification performance. Conclusions The random forest model shows the best predictive ability. Pelvic floor EMG parameters are strongly associated with postpartum SUI. This model offers a valuable tool for clinicians to accurately assess individual risk and guide early rehabilitation intervention, such as Kegel exercises and biofeedback therapy, which provides new tools for the prevention and treatment of postpartum SUI.

  • Yang ZHANG, Li ZOU
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 618-622. https://doi.org/10.19538/j.fk2025060110
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    Autoimmune diseases during pregnancy(such as systemic lupus erythematosus and antiphospholipid syndrome)are significant causes of fetal arrhythmia.Maternal anti-SSA/Ro and anti-SSB/La antibodies cross the placenta and attack the fetal cardiac conduction system,mediating myocardial injury and congenital heart block(CHB).Meanwhile, inflammatory factors and placental dysfunction further exacerbate fetal cardiac electrophysiological dysregulation.The clinical manifestations are primarily characterized by atrioventricular block(AVB),which may lead to heart failure or even intrauterine fetal demise in severe cases.Antenatal management requires a multidisciplinary approach,utilizing echocardiography to dynamically monitor fetal cardiac structure and electrophysiological activity and make early identification of incomplete AVB and myocardial injury markers.Hydroxychloroquine administration before and during pregnancy can reduce CHB risk,while glucocorticoid therapy may have potential interventional value for certain early lesions,though maternal-fetal safety must be rigorously evaluated.The evidence for intervention measures such as intravenous immunoglobulin and sympathomimetic agents remains limited,necessitating individualized risk-benefit assessment.This review systematically summarizes the pathological mechanisms,monitoring strategies,and intervention principles for fetal arrhythmia in pregnancy with autoimmune diseases,emphasizing the importance of integrated management across preconception,antepartum,and postpartum periods.Future research should focus on developing immune regulatory targets and precision diagnostic-therapeutic techniques to improve maternal-fetal outcomes.

  • Original article
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 667-672. https://doi.org/10.19538/j.fk2025060119
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  • WANG Jin-mei, QIAN Fang-bo, SHEN Ye
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(5): 557-560. https://doi.org/10.19538/j.fk2025050116
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    Objective To explore the clinical effect of applying estradiol gel after repeated induced abortion. Methods A total of 127 women who underwent induced abortion in Jiangnan University Affiliated Maternal and Child Health Hospital(Wuxi Maternal and Child Health Hospital)from January 2023 to December 2023 were retrospectively analyzed,and they were divided into basic treatment group,estradiol gel group and contraceptive group according to postoperative treatment methods,with 45 cases,40 cases and 42 cases in each group.The average number of induced abortion in the 3 groups was ≥2 times,and all groups received induced abortion with negative pressure suction. The basic treatment group was given oral administration of Leonurus and cefdinir for 1 week. On this basis,the estradiol gel group was given percutaneous application of estradiol gel for 28 days starting from the day receiving surgery (it was stopped during menstrual period),and the contraceptive group was given oral administration of drospirosterone ethinylestradiol tablets (Ⅱ) for 28 days starting from the day receiving surgery. The endometrial thickness,duration of postoperative vaginal bleeding,recovery time of first menstruation,liver and kidney function,complications and adverse reactions were compared among the three groups after 7 and 21 days of treatment. Results The endometrial thickness of estradiol gel group was higher than that of contraceptive group and basic treatment group at 7 and 21 days after treatment,and the difference was statistically significant (P< 0.05). The duration of postoperative vaginal bleeding in estradiol gel group was shorter than that in contraceptive group and basic treatment control group,and the incidence of uterine effusion and decreased menstrual volume was lower (P< 0.05). The recovery time of first menstruation in the contraceptive group was shorter than that in the estradiol gel group and the basic treatment group (P < 0.05). There was no difference between the time of menstruation after recovery and the pre-operative menstruation cycle in the estradiol group,and the time of menstruation after recovery in the basic treatment group was prolonged. There were no significant differences in the incidence of uterine cavity residue or liver and kidney function among the three groups(P>0.05). Conclusion The effect of percutaneous estradiol gel on endometrial recovery after induced abortion is better than that of oral drospiroone ethoestradiol tablets and natural recovery,with good prognosis and fewer drug complications and adverse reactions.

  • Tian-yi TANG, Yuan WEI
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 595-599. https://doi.org/10.19538/j.fk2025060105
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    Pregnancy complicated by rheumatic heart disease(RHD)represents a complex and high-risk obstetric condition that significantly impacts both maternal and fetal outcomes.This article provides a comprehensive review of the management strategies for RHD during pregnancy based on the latest epidemiological data,pathophysiological mechanisms,diagnostic criteria,and therapeutic approaches, highlighting the importance of multidisciplinary collaboration,pre-pregnancy evaluation,and personalized intervention,thereby offering evidence-based evidence for clinical practice.

  • Original article
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 662-666. https://doi.org/10.19538/j.fk2025060118
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  • Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(5): 525-533. https://doi.org/10.19538/j.fk2025050111
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  • XU Xian-ming, JIA Hao-yi
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(4): 414-418. https://doi.org/10.19538/j.fk2025040109
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    Hyperglycemia in pregnancy (HIP) is a common complication during pregnancy. Drug therapy plays a crucial role in the management of HIP. This article reviews the current status of drug therapy for HIP,with a focus on the clinical application of insulin and oral hypoglycemic agents,including the administration regimens of different insulin formulations,as well as the application of glibenclamide,metformin,and acarbose in HIP treatment.

  • WANG Wen-ying, LU Yong-xian
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(5): 484-487. https://doi.org/10.19538/j.fk2025050102
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    Pelvic organ prolapse (POP) significantly affects women’s quality of life. Anterior vaginal wall prolapse is the most common type,and its treatment faces many challenges. This article analyzes the surgical treatments for anterior vaginal wall prolapse based on the integral theory. The integral theory holds that the pelvic floor is an inter-related integrity ,and anterior vaginal wall prolapse is closely related to the prolapse of other pelvic compartment,especially middle compartement. Clinically,anterior pelvic prolapse is often accompanied by stress urinary incontinence.There are various surgical procedures at present,each with its own advantages and disadvantages,such as traditional native tissue anterior midline colporrhaphy and paravaginal repair,whose recurrence rate is still the highest among all the pelvic compartments. Anterior pelvic reconstruction with mesh implantation can reduce the recurrence rate but has the risk of mesh-related complications. In clinical practice,it is necessary to comprehensively consider the patient's condition to select an appropriate surgical procedure.

  • Original article
    Xiao-hua ZHENG, Yan-feng SONG, Chun-hua CHEN, Xiao-xiao WANG, Chao-qin LIN, Ying XU
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 658-661. https://doi.org/10.19538/j.fk2025060117
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    Objective To compare the mid-term and long-term clinical efficacy of transvaginal dot-matrix CO2 laser with that of AI temperature-controlled radiofrequency in the treatment of stress urinary incontinence. Methods Complete data of 100 patients who received treatment for stress urinary incontinence in outpatient department from January 2020 to May 2022 were retrospectively analyzed.Among them, 46 patients received dot-matrix CO2 laser therapy(laser group)and 54 patients received AI temperature-controlled RF therapy(RF group).At 6 and 12 months after the end of treatment the clinical efficacy(1-hour urine pad)and the Urinary Incontinence Questionnaire(ICI-Q-SF)score of the International Urinary Incontinence Committee were compared between the two groups. Results At 6 months,the effective rate of laser group and RF group was 91.3%(42/46)and 72.2%(39/54).The total effective rate in laser group was higher than that in RF group(P<0.05),especially in patients with mild urinary incontinence(96.4% vs. 60.0%)or age > 40 years old(88.5% vs. 60.0%).The ICI-Q-SF score of the two groups was lower than before treatment,and the score of the laser group was lower than that of the RF group[(5.21±3.07)vs. (6.59 ± 3.64), P<0.05].At 12 months,the effective rate in laser group was lower than that at 6 months(91.3% vs. 65.2%, P<0.05),but there was no significant difference in RF group(72.2% vs. 68.5%, P>0.05). There was no significant difference in effective rate or ICI-Q-SF score between the two groups. Conclusion Both transvaginal dot-matrix CO2 laser and AI temperature-controlled radiofrequency therapy are effective in the treatment of stress urinary incontinence,and the effect of laser therapy is better than that of radiofrequency after 6 months,especially for patients with mild urinary incontinence or age > 40 years,but the effect of them are similar after 12 months.

  • Original article
    Yan-ping XU, Ye TIAN, Xue-ru SONG
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 649-652. https://doi.org/10.19538/j.fk2025060115
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    Objective To assess the value of the serum luteinizing hormone(LH)level on the human chorionic gonadotropin(hCG)administration day for predicting the live birth rate(LBR)after in vitro fertilization-embryo transfer(IVF-ET)treatment. Methods This was a retrospective cohort study.A total of 378 female patients were included, who underwent IVF-ET treatment with the gonadotropin-releasing hormone(GnRH)antagonist protocol and had their first fresh cycle embryo transfer at Tianjin Medical University General Hospital from June 2017 to April 2024. All patients received ovulation induction treatment with the GnRH antagonist protocol and were divided into a low-LH group(LH ≤ 1.67U/L)and a high-LH group(LH>1.67U/L)according to the serum LH level on the hCG administration day.Evaluate the effects of such factors as the LH level on the hCG administration day,body mass index(BMI),and ovarian reserve function on the pregnancy outcome. Results There were no significant differences in the biochemical pregnancy rate,clinical pregnancy rate,or live birth rate between the low-LH group and high-LH group(P>0.05).However,the regression analysis showed that female age,the number of transferred embryos,and the thickness of the endometrium were significantly correlated with the live birth rate(P<0.05).The predictive role of the LH level on the hCG administration day in the pregnancy outcome did not show independence,while age and endometrial thickness might be stronger predictors for the live birth rate. Conclusions The LH level on the hCG administration day, as an independent predictor, does not play a significant role in the prediction of the live birth rate after treatment,indicating that it might not be a decisive factor affecting the pregnancy outcome.Nevertheless,such factors as age and endometrial thickness play an important role in predicting the live birth rate,suggesting that the success rate of IVF-ET treatment should be evaluated individually by combining multiple physiological indicators.

  • YAN Ying-yan, CHEN Xia-xia, YAN Zeng-ze, SHEN Long-hui, MAO Pei-zhi
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(7): 751-754. https://doi.org/10.19538/j.fk2025070118
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    Objective To analyze the differences in hematological indicators among patients with different stages of endometriosis (EM) and non-EM controls, and to explore their diagnostic value in the occurrence and progression of severe EM. Methods This retrospective study included 112 patients with stage Ⅰ or Ⅱ EM (mild group), 136 patients with stage Ⅲ or Ⅳ EM (severe group), and 136 patients without EM (control group), all treated at Ningbo Women and Children's Hospital of Ningbo University between December 2022 and May 2024. General and hematological data were collected. Differences among groups were analyzed using pair comparisons, and logistic regression analysis was used to identify factors associated with development of severe EM. The diagnostic performance of relevant markers was assessed using receiver operating characteristic (ROC) curves. Results No significant differences were found between the mild and control groups in general or hematological parameters. Compared with controls and mild cases, the severe group showed significantly elevated levels of fibrinogen (FIB), CA125, CA19-9, and plasma D-dimer (P < 0.05). Logistic regression identified CA125 and FIB as independent predictors of severe EM. The combination of CA125 and FIB yielded an area under the ROC curve (AUC) of 0.834 with sensitivity and specificity of 80.10% and 80.60%, respectively, surpassing single-indicator models. In distinguishing severe from mild EM, the combined model also improved diagnostic sensitivity. Conclution The combination of CA125 and FIB provides a more effective diagnostic approach for identifying and evaluating severe endometriosis, offering a promising noninvasive tool for clinical application.

  • Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(9): 865-868. https://doi.org/10.19538/j.fk2025090101
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  • GAO Di, WANG Xu, WANG Xue-yin, JUAN Juan, ZHAO Geng-li, ZHANG Xiao-song
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(8): 842-846. https://doi.org/10.19538/j.fk2025080115
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    Objective To investigate the distribution and risk factors of reproductive tract infection(RTI) in women of childbearing age visiting medical institutions. Methods A total of 3,159 women aged 18-49 years visting the gynecology outpatient department of six medical institutions from January 2021 to December 2022 were included in our study. Cervical exfoliated cells were collected for the detection of ten common RTI pathogens,and relevant demographic characteristics were also collected. The distribution of RTI infections was analyzed,and logistic regression was used to analyze the association of RTI with demographic characteristics and smoking status. Results The mean age of the study subjects was 34.6±6.7 years. The positive detection rate of any RTI pathogen was 45.7%,and the detection rate of any Ureaplasma species was 41.8%. The pathogens with the top three positive detection rates were Ureaplasma parvum3(Up3) (17.6%),Up6 (13.4%) and Ureaplasma urealyticum (Uu) (10.2%). Among those with RTI,78.0% were single infection and 22.0% were multiple infection. The rates of RTI were significantly higher in women with junior high school education or below,with average monthly family income more than 20 000 CNY,being unmarried,and with smoking habit(P<0.05). Conclusions The infection rates of RTI-related pathogens in women in gynecology outpatient department are relatively high. The most common RTI pathogens is Ureaplasma species,especially Up3,Up6 and Uu,and single infection is prevalent. At the same time,it is necessary to further strengthen health education for high-risk groups of RTI,such as those with lower education level,lower monthly family income,and smokers,to promote the reproductive health-related knowledge in them. Maintaining the balance of the vaginal microecology and actively treating lower reproductive tract infections in a standardized routine might play a crucial role in enhancing women's reproductive health.

  • Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(7): 673-678. https://doi.org/10.19538/j.fk2025070101
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  • Xiao-jing HU, Hua ZHANG
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 627-632. https://doi.org/10.19538/j.fk2025060112
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    Pregnancy with heart disease is a serious complication that threatens the health of both the mother and the fetus.During pregnancy,the risk of acute cardiovascular events such as heart failure increases due to hemodynamic changes.Early diagnosis is an important prerequisite to avoid acute cardiovascular events,and accurate auxiliary examination strategies are the key to achieving early diagnosis.There are many examination options for pregnancy with heart disease.A reasonable and personalized examination strategy should be developed based on the specific condition of the disease and the application characteristics of the examinations in order to enhance the effectiveness of the examinations and ensure the safety of both the mother and the fetus.

  • LIU Yao-dan, YI Xiao-fang, CHEN Yi-song
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(8): 797-802. https://doi.org/10.19538/j.fk2025080107
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    Myofascial pelvic pain syndrome is a major cause of chronic pelvic pain,often accompanied by lower urinary tract and bowel symptoms and sexual disorders,with a complex and highly heterogeneous pathophysiology,which makes diagnosis challenging and necessitates multidimensional assessment. Physical therapy is the first-line treatment,while multidisciplinary comprehensive intervention is recommended in complex cases. Establishing standardized diagnosis and treatment pathways,integrated with intelligent monitoring technologies,can optimize the entire cycle of patient management,which contributes to pelvic floor functional rehabilitation,and improves quality of life.

  • Original article
    Qian LIU, Hui-mei ZHOU, Jia-xin YANG, Dong-yan CAO, Yang XIANG, Keng SHEN
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 653-657. https://doi.org/10.19538/j.fk2025060116
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    Objective To explore the occurrence and high-risk factors affecting prognosis of micro-metastasis (occult metastatic lesions) in stage I ovarian clear cell carcinoma patients during comprehensive staging surgery or restaging surgery. Methods A retrospective analysis was performed on 160 patients with ovarian clear cell carcinoma admitted to Peking Union Medical College Hospital from February 2015 to December 2019,including 91 patients with lesions confined to the ovary at the time of surgery. Patients' age,surgical procedure,intraoperative findings,restaging surgery procedure, FIGO stage,pathological results and follow-up information were recorded in detail. Patients were divided into two groups based on the initial treatment approach:the comprehensive staging surgery group,who underwent comprehensive staging surgery at the initial treatment,and the restaging surgery group,who either did not undergo staging surgery or underwent incomplete staging at the initial treatment and subsequently underwent restaging surgery. Kaplan-Meier was used to plot survival curve and calculate and compare patients' overall survival and progression-free survival. COX risk regression model was used for prognostic analysis. Results The 91 patients was considered as clinical stage I with a median age of 49 years (22-71 years) and a mean tumor size of (10.6±4.6) cm at the time of initial surgical exploration. The level of preoperative CA125 increased in 35 patients (38.5%). Totally 51 cases (56.0%) underwent comprehensive staging in the primary surgery,and 40 cases (44.0%) underwent restaging surgery. The confirmed metastasis rate after comprehensive staging surgery and restaging surgery was 15.4% (14/91).FIGO stage was upgraded in 14 patients(15.4%),including 6 patients (6.6%) was upgraded to stage Ⅱ and 8 patients (8.8%) to stage Ⅲ. After operation,85 patients (93.4%) received platinum-based chemotherapy,and 6 patients (6.6%) did not receive chemotherapy. The mean follow-up time was (49.5±19.5) months,the recurrence rate was 19.8%, and the mortality rate was 8.8%. FIGO stage was upgraded to Ⅱ-Ⅲ in 17.6% (9/51) of the patients in the comprehensive staging group and 12.5% (5/40) in restaging group. The lymph node metastasis rate of the two groups was 7.8% (4/51) and 7.5% (3/40),respectively,the difference being with no statistical significance (P>0.05). The 5-year progression-free survival rate of patients in the comprehensive staging group and the restaging group was 74.2% and 92.0%,respectively (P=0.063). The 5-year overall survival rate of the two groups was 86.0% and 90.7%,respectively (P=0.676). Univariate analysis showed that FIGO stage (Ⅲ compared toⅠ, Ⅱ) had a statistically significant effect on progression-free survival (HR=4.158,95%CI 1.334-12.963,P=0.014),while restaging surgery, compared to comprehensive staging surgery, had no statistical effect on progression-free survival (HR=0.361,95%CI 0.117-1.109,P=0.075) and overall survival (HR=1.349,95%CI 0.337-5.401,P=0.672). Multivariate analysis showed that FIGO stage Ⅲ had a statistically significant effect on PFS compared with stage I and II (HR=5.570,95%CI 1.196-25.940,P=0.029). Conclusions The rates of upgrading of stage and lymph node metastasis of stage Ⅰovarian clear cell carcinoma are not low, and the upgrading of tumor stage is still an independent risk factor affecting prognosis. Therefore,the diagnosis rate of suspected early clear cell carcinoma of ovary should be increased in the initial operation,and the rate of incomplete surgical staging and restaging should be reduced.

  • WU Zhi-wei, WANG Xue-zhuo, XIAO Yun-shan, ZHANG Xue-qin
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(7): 760-763. https://doi.org/10.19538/j.fk2025070120
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    Objective To analyse the influencing factors related to the success of external cephalic version,and to construct a line chart model and verify the predictive efficacy. Methods A retrospective cohort study was conducted which included 230 pregnant women who underwent external cephalic version at Women and Children's Hospital Affiliated to Xiamen University from April 2018 to October 2022,of which 165 cases were successful and 65 failed. The cases were divided into training set and validation set according to the ratio of 7∶3. The clinical data and preoperative ultrasound indexes of the study subjects were collected,and the influencing factors of the success of external cephalic version were analysed by logistic regression. The line chart model was then established by R 4.2.3 software. The C-index and standard calibration curve were used to assess the efficacy of the model,and the decision curve was used to assess the clinical practicality of the model. Results Logistic regression analysis showed that frank breech,anterior placenta,amniotic fluid index <14.10 cm,and primiparity were the risk factors for the success of external cephalic version [odds ratio (OR) values being 0.173,0.170,1.335,and 1.975,P<0.05]. A line chart model was constructed based on the above influencing factors. The C-index of the training set was 0.838(95%CI 0.775-0.900),and the area under the ROC curve was 0.815;the C-index of the validation set was 0.822(95%CI 0.759-0.884) and the area under the ROC curve was 0.780. The model curves were closer to the ideal curves,and separated from the extreme curves. Conclusion The line chart prediction model based on placental position,breech presentation type,amniotic fluid index,and the number of deliveries has high efficacy and good clinical practicality,and it can be used as a tool for screening and assessing the population fit for external cephalic version.

  • HOU Qian-nan, HE Li
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(7): 706-710. https://doi.org/10.19538/j.fk2025070109
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    Transvaginal natural orifice transluminal endoscopic surgery (vNOTES),as an innovative minimally invasive technique in gynecology,enables scarless operations through endogenous pathways. However,its clinical application is limited by the mechanical coupling effect and the lack of a triangle of support in traditional single-port instruments. The robotic surgical system,with its multi-degree-of-freedom wristed instruments,three-dimensional high-definition imaging,and motion scaling technology,effectively addresses the vision-operation axis collinearity challenge of vNOTES and overcomes the spatial constraints within narrow cavities. Based on evidence-based medical evidence,this article systematically analyzes the key technical advantages of different robotic surgical platforms in various gynecological procedures. With the iterative improvement in miniaturized intracavitary robots and cross-modal surgical navigation systems,robotic vNOTES is driving gynecological surgery towards ultra-minimally invasive and intelligent directions,providing innovative solutions to high-risk procedures such as radical resection of malignant tumors.

  • Man-ling LUO, Li-ping HUANG
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(6): 605-609. https://doi.org/10.19538/j.fk2025060107
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    Arrhythmias are common cardiac conditions during pregnancy,and severe arrhythmias may endanger maternal and fetal health,leading to serious consequences.Therefore, it is essential to conduct risk assessments in high-risk women before pregnancy and provide close prenatal care during pregnancy.In terms of treatment,the drugs or other therapies with minimal impact on the mother and fetus should be the best options.The choice of delivery method should be made based on both cardiac function and obstetric considerations,with the recommendation of using anesthetic agents.After delivery,continuous monitoring of the mother's cardiac function is necessary,and treatment should be adjusted promptly while ensuring the safety of breastfeeding.It is hoped that multidisciplinary and individualized interventions will improve the pregnancy outcomes of patients with arrhythmias during pregnancy.

  • WU Xue-ju, WEI Huan-yu, DENG Yuan, DENG Li, TANG Shuai, WANG Yan-zhou
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(7): 730-733. https://doi.org/10.19538/j.fk2025070113
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    Objective To compare the perioperative outcomes of laparoendoscopic single-site myomectomy using the "chopstick" technique (cLESS-M) with those of conventional laparoscopic myomectomy (CLS-M). Methods A retrospective analysis was conducted on 255 patients who underwent laparoscopic myomectomy at the First Affiliated Hospital of Army Medical University between August 2018 and April 2020. Patients were divided into the cLESS group (n=117) and the CLS group (n=138) based on the surgical approach. Intraoperative parameters, postoperative recovery indicators, and incidence of perioperative complications were compared between the two groups. Results Baseline data were similar between the two groups (P > 0.05). There were no significant differences in operation time, estimated blood loss, or incidence of perioperative complications. Compared to the CLS group, the cLESS group had a significantly shorter postoperative hospital stay [4.0 (4.0, 5.0) vs. 5.0 (4.0, 6.0) days, P=0.006], lower pain scores at 1 hour postoperatively [2.0 (2.0, 3.0) vs. 3.0 (2.0, 3.0), P < 0.001], and lower pain scores at 24 hours after operation[1.0 (1.0, 1.0) vs. 1.0 (1.0, 2.0), P=0.008]. Conclusion The cLESS-M technique offers comparable surgical outcomes to CLS-M, with advantages of shorter hospital stay and less pain after operation.

  • NI Li, WANG Ying-ying, ZHU Chen-chen, WEI Ying, ZHAO Ting-ting, ZHANG Tian-jiao, LI Min, ZHU Jing, SHEN Zhen, ZHOU Ying
    Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(7): 738-741. https://doi.org/10.19538/j.fk2025070115
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    Objective To compare the clinical outcomes and beneficiary populations of prophylactic risk-reducing salpingo-oophorectomy (RRSO) for patients at high risk of ovarian cancer with those of opportunistic salpingo-oophorectomy (OS) due to other gynecological diseases. Methods This retrospective study involved 105 patients who underwent prophylactic resection (bilateral appendixes) at the Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China, from March 2020 to September 2023. Baseline clinical information, including preoperative CA125 levels and imaging findings, postoperative pathology, and immunohistochemical results were collected and analyzed. Results Among the 25 patients who completed homologous recombination deficiency (HRD)-related genetic testing, 20 carried pathogenic mutations in homologous recombination repair (HRR) pathway genes. Twenty-four patients underwent SEE-FIM (Sectioning and Extensively Examining the FIMbriated end) protocol sampling, and 4 were diagnosed with high-grade serous ovarian carcinoma (HGSC). In contrast, none of the 80 patients who underwent OS due to other gynecologic conditions were diagnosed with malignancy. Conclusions Genetic counseling and timely RRSO are recommended for individuals carrying pathogenic BRCA1/2 mutations, as RRSO can effectively reduce the incidence of ovarian cancer. The timing of surgery will affect the final beneficiary populations