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02 September 2022, Volume 38 Issue 9 Previous Issue   

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Etiology and pathogenesis of endometrial injury. CAI Hui-hua, HE Yuan-li 2022, 38(9): 869-873.  DOI: 10.19538/j.fk2022090102 Abstract ( )   Trauma and infection are important factors of endometrial injury.Severe endometrial injury as deep as the basal layer of endometrium can cause endometrial repair disorder，which is manifested as intrauterine adhesions（IUA）with partial or total occlusion.IUA often leads to hypomenorrhea，amenorrhea and infertility.The frequent and high recurrence of IUA after separation has become a clinical bottleneck.Thus，the prevention and treatment of its etiological mechanism urgently need to be solved.In this paper，the etiology and pathogenesis of endometrial injury，especially IUA，are reviewed.

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Clinical application of evaluation indicators of intrauterine adhesion with endometrial injury. PENG Yan-zhen, DUAN Hua 2022, 38(9): 873-877.  DOI: 10.19538/j.fk2022090103 Abstract ( )   Endometrial basal layer injury caused by various reasons can lead to endometrial fibrosis and uterine cavity morphological damage.The most common representative disease of endometrial injury in clinic is intrauterine adhesions.The common clinical manifestations of intrauterine adhesions with endometrial injury are hypomenorrhea，amenorrhea and infertility.The clinical evaluation indicators include imaging，hysteroscopic morphology and endometrial receptivity.The grading standard of intrauterine adhesions established by China Society of Gynecology Endoscopy has included more comprehensive and effective evaluation indicators，which has higher clinical application value for the accurate evaluation and diagnosis of endometrial injury and the effective prediction of reproductive prognosis.

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Standard operation and endometrial protection in uterine cavity reconstruction surgery.   GAO Ting 2022, 38(9): 878-881.  DOI: 10.19538/j.fk2022090104 Abstract ( )   Uterine cavity reconstruction surgery is an important way to treat congenital uterine abnormalities and acquired uterine abnormalities.The objective of  the surgery is to protect organs and promote and improve physiological and reproductive functions.Only by standardizing the operation and protecting the endometrium can we achieve the recovery from anatomy to function.Standardized operation involves strict control of surgical indications，perfect preoperative evaluation，standardized training of operators，intraoperative safety monitoring and relevant measures to protect endometrium.

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Prevention and treatment of re-adhesion after uterine cavity reconstruction surgery. LIN Feng 2022, 38(9): 881-885.  DOI: 10.19538/j.fk2022090105 Abstract ( )   Intrauterine adhesion occurs following the trauma in the basalt layer of uterine cavity，which not only influences the physical health of females but also damages fertility functions.With the expectation to restore the normal uterine anatomy and function，the first-choice treatment for intrauterine adhesion is hysteroscopic adhesiolysis，whereas the recurrence of adhesions is a great challenge.To date，prevention and treatment of the recurrence includes barrier therapy，hormonal therapy，and amniotic treatment.Other treatment options，such as stem cell therapy，aspirin，platelet-rich plasma，and sildenafil are still under study.It remains unclear which strategy is optimal，and further studies are needed to achieve the best effect.

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Treatment outcome of different methods for endometrial injury repair. WANG Su-min, HUA Xiang-dong 2022, 38(9): 885-891.  DOI: 10.19538/j.fk2022090106 Abstract ( )   Estrogen and other drugs are commonly used to promote endometrial growth and improve uterine blood flow after intrauterine adhesion surgery.Biological barriers or materials such as amniotic membrane and hyaluronic acid，as well as physical barriers such as intrauterine device and balloon are used to reduce the recurrence of adhesion and improve the reproductive outcomes，but the therapeutic effect on severe intrauterine adhesion is still limited.Some new treatment strategies such as stem cells，exosomes combined with biomaterials，tissue engineering and physiotherapy to promote the repair of endometrial injury are still in the research stage.Their clinical application needs further research to clarify the effect and safety.

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Fertility strategies and pregnancy and delivery management in endometrial injury diseases. KUANG Yan, QIN Gui-rong, MO Xiao-liang, ZHI Zhi-fu, ZHAO Fang-fang 2022, 38(9): 891-895.  DOI: 10.19538/j.fk2022090107 Abstract ( )   Endometrial injury diseases are closely associated with infertility and poor pregnancy outcomes，and intrauterine adhesions are the most common clinical manifestation of it.The main targets of treatment are to restore the morphology of uterine cavity and promote endometrial function reconstruction.In this paper，we analyze its main clinicopathological features and its relationship with pregnancy，explore effective treatment options，and provide pregnancy guidance and management strategies for patients with fertility requirements，hoping to help and ultimately achieve the protection of female fertility improve the pregnancy rate and live birth rate of patients.

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Effect of extracellular vesicles on improving endometrial receptivity and the research status.  JIN Xiao-ying, XIN Liao-bing, ZHANG Song-ying 2022, 38(9): 895-899.  DOI: 10.19538/j.fk2022090108 Abstract ( )   Endometrial receptivity is the key factor affecting embryo implantation.Abnormal endometrial receptivity leads to embryo implantation failure and abnormal placental development.In the process of embryo implantation，the orderly generation and precise coordination of extracellular vesicles between the maternal tissues and the embryo ensure the smooth embryo implantation.The extracellular vesicles derived from mesenchymal stem cells can improve the impaired endometrial receptivity.