With the global aging trend intensifying, the incidence of pelvic organ prolapse (POP) is rising annually, profoundly impacting the physical and mental health and quality of life of female patients. Surgery is currently the primary treatment for severe POP. Mesh is widely used in POP surgery, yielding satisfactory outcomes in both long-term and short-term follow-up clinical studies. While complications related to mesh in POP surgery are not common, they can be severe and significantly reduce the postoperative quality of life for POP patients. Previous domestic and international relevant guidelines and expert consensus, such as Chinese Expert Consensus on the Diagnosis and Treatment of Mesh or Sling Exposure Complications After Pelvic Floor Reconstructive Surgery, mainly focus on the identification and treatment of mesh exposure. In 2024, the French National Health Authority published the world′s first clinical practice guidelines on the management of postoperative mesh complications in POP, which was Diagnosis and Management of Complications Following Pelvic Organ Prolapse Surgery Using a Synthetic Mesh: French National Guidelines for Clinical Practice (hereinafter referred to as " This Guideline" ). This Guideline is a clinical practice guideline for the management of mesh-related complications after POP surgery, filling the gap of the lack of systematic and comprehensive guidelines and expert consensus on the management of mesh-related complications after POP surgery. The authors intend to provide a professional interpretation of the key points of The Guidelines regarding mesh-induced complications of the urinary system and anorectal system after POP surgery and their management; mesh exposure after POP surgery, mesh-induced infection-related complications and their management; mesh-induced postoperative pain, postoperative sexual difficulties, bleeding and hematoma, vaginal wall injury complications and their management, etc., aiming to provide guidance and reference for Chinese clinicians to manage postoperative complications of POP surgery using mesh.

To investigates the application of AI-assisted pelvic floor ultrasound combined with tomographic ultrasound imaging (TUI) in assessing the structure and function of pelvic floor muscles in patients with postpartum pelvic floor dysfunction (PFD).

A total of 115 postpartum PFD patients admitted to Cangzhou People′s Hospital from April 2021 to October 2023 were selected as the research subjects and included in the PFD group. Additionally, 96 primiparous women without PFD during the same period were selected as the control group. All subjects′ ultrasound images were independently diagnosed by two examiners using a double-blind method. The detrusor wall thickness (DWT), bladder neck descent (BND), retrovesical angle (RA), and urethral rotation angle (URA) measured by intelligent pelvic floor ultrasound under resting state and Valsalva maneuver were compared between the two groups. In addition, the levator hiatus (HA) area, anteroposterior diameter, transverse diameter, and thickness under resting state, anal contraction, and Valsalva maneuver were also compared. The intraclass correlation coefficient (ICC) was used to assess the consistency of parameter measurements from intelligent pelvic floor ultrasound between the two physicians. The diagnostic performance of intelligent pelvic floor ultrasound combined with TUI technology for PFD was evaluated by drawing receiver operating characteristic (ROC) curves. The procedures followed in this study were in accordance with the requirements of the Medical Ethics Committee of Cangzhou People′s Hospital and were approved (Approval No.K2020141). Informed consents were obtained from all subjects.

① There were no statistically significant differences between the two groups in age, postpartum body mass index (BMI), distribution of delivery modes, or episiotomy rates (P>0.05). ② Under both resting conditions and during the Valsalva maneuver, the DWT, BND, RA, and URA were significantly higher in the PFD group compared to the control group (P<0.05). Additionally, the HA area, anteroposterior diameter, transverse diameter, and levator ani muscle thickness were all significantly greater in the PFD group under resting, anal contraction, and Valsalva conditions (P<0.05). ③ The inter-observer agreement for AI-assisted pelvic floor ultrasound measurements was high, with ICC all exceeding 0.75. ROC curve analysis demonstrated that the area under the curve (AUC) for diagnosing PFD was 0.727 (95%CI: 0.657-0.797) using AI-assisted pelvic floor ultrasound alone, 0.777 (95%CI: 0.711-0.842) using TUI alone, and 0.884 (95%CI: 0.878-0.935) when the two modalities were combined.

AI-assisted pelvic floor ultrasound combined with TUI enables dynamic evaluation of structural and functional changes in the pelvic floor muscles of patients with PFD. The measurements demonstrate high reproducibility, providing a reliable imaging basis for the clinical diagnosis of PFD.

Advanced endometrial cancer/recurrent endometrial cancer (AEC/REC) has limited efficacy with conventional treatments and is a major challenge in gynecologic oncology. Platinum-based combination chemotherapy, as the traditional first- and second-line regimen, has limitations including suboptimal objective response rate (ORR) and short duration of response (DOR), highlighting the urgent to explore new strategies. Immune checkpoint inhibitors (ICI) show breakthrough efficacy in microsatellite instability-high (MSI-H)/mismatch repair-deficient (dMMR) subtypes, representing a key advance in precision immunotherapy. However, ICI monotherapy has poor efficacy in microsatellite stable (MSS)/mismatch repair-proficient (pMMR) subtypes, necessitating exploration of more effective combination strategies. This article systematically reviews the latest research status of targeted therapy combined with immunotherapy for AEC/REC domestically and internationally. Through exploring synergistic mechanisms, analyzing key clinical data, evaluating existing evidence, and forecasting trends, it deeply discusses current focal and challenging issues in this field, aiming to provide evidence-based support for clinical decision-making.

Endometrial polyps are a relatively common lesion in gynecological clinic. There are differences between pathological and clinical diagnoses of endometrial polyps. The malignant changes are found in some endometrial polyps cases. It is necessary to pay attention to this. This article focuses on the research progress of the pathological diagnosis criteria, the types of polyps and malignant transformation in endometrial polyps, so as to provide a reference for the accurate clinical diagnosis of endometrial polyps and the prevention of their malignant transformation.

To evaluate the auxiliary diagnostic value of an artificial intelligence (AI)-based automatic recognition model for cystocele in pelvic floor ultrasound examination.

A total of 200 female outpatients who underwent pelvic floor ultrasound examination at Shengjing Hospital of China Medical University between July and December 2024 were included. Among them, 103 cases were diagnosed with cystocele and 97 had normal anterior pelvic compartment structures. The subjects were randomly divided into a training set (n=140) and a testing set (n=60) in a 7∶3 ratio. In the training set, 73 had cystocele and 67 were normal; in the testing set, both groups included 30 cases. Dynamic pelvic floor ultrasound images at rest and during maximal Valsalva maneuver were collected. Urethral contours were manually delineated, and 13 urethral mobility parameters were extracted. Based on these features, support vector machine (SVM) and random forest (RF) models were trained using five-fold cross-validation, and the resulting five sets of weights were used to evaluate diagnostic performance in the testing set. The study was approved by the Ethics Committee of Shengjing Hospital, China Medical University (Approval No. 2024PS1218K), and all participants provided written informed consent.

①There were no statistically significant differences in age, body mass index (BMI), height, weight, gravidity, parity, ethnicity, or occupational composition between the training and testing sets (P>0.05). ②In the testing set, the SVM model demonstrated an accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (ROC-AUC) of 0.783, 0.718, 0.933, 0.811, and 0.893, respectively, all superior to those of the RF model (0.733, 0.659, 0.966, 0.783, and 0.876). Among the five SVM model, the first fold performed best with a ROC-AUC of 0.904. ③Confusion matrix analysis showed that the correct identification rates of cystocele by the SVM and RF models were 93.3% (28/30) and 96.7% (29/30), respectively; for normal anterior compartment structures, the rates were 63.3% (19/30) and 50.0% (15/30), respectively.

The AI-based automatic recognition model using full-length urethral dynamic parameters demonstrates favorable diagnostic performance in identifying cystocele and may serve as an objective auxiliary tool to conventional pelvic floor ultrasound. It holds promise for early screening, subtype classification, and postoperative follow-up of cystocele. However, further studies with larger sample sizes and multi-center validation are required to optimize the algorithm and facilitate clinical translation.

Attention deficit hyperactivity disorder (ADHD), as a common neurodevelopmental disorder in children, is a group of syndromes characterized by difficulty in concentrating, excessive activity or impulsivity that is disproportionate to the developmental level. It begins in childhood, and the symptoms of some children may persist into adulthood. Functional near-infrared spectroscopy (fNIRS) technology is a non-invasive optical detection technique. By monitoring the changes in oxyhemoglobin (HbO₂) and deoxygenated hemoglobin (DHB) levels in the cerebral cortex, it reflects the hemodynamic changes in the cerebral cortex in real time, thereby evaluating brain activity functions. Studies have shown that the fNIRS technology provides a new assessment tool and method for the treatment evaluation and monitoring of ADHD in children, and demonstrates its unique value. The authors intend to elaborate on the research progress of the application of fNIRS technology in the treatment and evaluation of children with ADHD, and focuses on analyzing the fNIRS manifestations of cerebral cortical activities in different regions of children with ADHD after treatment, aiming to provide a reference for clinical diagnosis and treatment of children with ADHD.

Fertility preservation (FP) in young women with gynecological malignancies has emerged as a critical component of clinical decision-making. With the increasing incidence of these malignancies among young women and advancements in therapeutic strategies, there is a growing demand for FP options among them. Current FP methodologies include embryo cryopreservation, oocyte vitrification, ovarian tissue cryopreservation (OTC), and in vitro maturation (IVM) of immature oocytes. This review systematically examines the clinical necessity of FP, elucidates standardized protocols for its implementation, and evaluates key technological innovations, aiming to provide evidence-based guidance for optimizing FP integration into gynecologic oncology practice and how to deal with the challenges in clinic.

In China, elderly patients are often diagnosed with cervical cancer at an advanced stage. Due to generally poor physical condition and limited willingness to undergo radical treatment, they frequently experience poor prognosis. The Gynecology Branch of Chines Geriatrics Society has developed the Chinese Expert Consensus on Standardized Diagnosis and Treatment of Cervical Cancer in the Elderly (2024 Edition) (hereinafter referred to as " the Consensus" ). The Consensus addresses challenges in diagnosis and assessment, key aspects of comprehensive functional evaluation, and hot topics in the integrated treatment of cervical cancer in elderly patients with cervical cancer. The Consensus defines elderly cervical cancer patients as those aged >60 years. For its effective implementation, multi-party collaboration is essential. These includes improving the coverage of cervical cancer screening for elderly patients, enhancing patient education, and optimizing the allocation of healthcare resources, thereby elevating the standardized diagnosis and treatment level in clinical practice. The author aims to interpret key recommendations from the Consensus, focusing on the diagnosis, comprehensive functional evaluation, and treatment principles for elderly cervical cancer patients. This interpretation seeks to provide detailed reference for the clinical management of elderly cervical cancer patients in gynecological practice.

To explore the clinical manifestations and genetic variation types of cystic fibrosis (CF) children with pulmonary infection as the initial symptom, and to review relevant literature to provide reference for early clinical diagnosis of CF children.

A case of CF child (child 1) with pulmonary infection as the first symptom admitted to the 980th Hospital of the Joint Logistics Support Force in March 2023 was selected as the research subject. Retrospective analysis method was used to analyze the clinical case data of child 1, including medical history, clinical manifestations and laboratory tests, lung CT examination results, genetic testing results, diagnosis and treatment process. The relevant research literature on Chinese children with CF both domestically and internationally was reviewed to summarize the clinical characteristics of CF children. The procedures followed in this study were in accordance with the standards established by the Ethics Committee of the 980th Hospital of the Joint Logistics Support Force and have been approved by the Ethics Committee (Approval No. 2023-KY-201).

①Child 1 was an 11-year-old male who visited our hospital due to " fever, cough for 3-4 days, and diarrhea for 2 days". CT scan of the lungs showed bronchiectasis, wall thickening, and mucus plugs in some bronchial tubes, accompanied by inflammatory lesions in the lungs. The culture results of pathogenic bacteria in sputum and bronchoalveolar lavage fluid both indicated positivity for Pseudomonas aeruginosa. The genetic testing results showed that the CFTR gene of child 1 developed compound heterozygous missense mutations c. 293A>G (p.Gln98Arg) and c. 1409T>A (p.Va1470Glu), which were inherited from his father and mother, respectively. According to the guidelines of the American Society for Medical Genetics and Genomics (ACMG), and they were classified as pathogenic and suspected pathogenic variants, respectively according to the American College of Medical Genetics and Genomics (ACMG) guidelines. According to the results of genetic testing, child 1 was diagnosed with CF. He was treated with clearing airway secretions and controlling infections. On the 29th day after admission, a CT scan of the lungs showed significant improvement in the inflammatory lesions in the lungs, and child 1 was discharged on the 30th day after admission. ②Literature review results: according to the literature retrieval strategy set in this study, 10 relevant studies on Chinese children with CF were retrieved from both domestic and foreign databases, involving 33 Chinese children with CF. Including child 1 in this study, a total of 34 Chinese children with CF were identified. Among these 34 cases, there were 21 male and 13 female patients, with onset ages ranging from 3 months to 16 years old. The main clinical manifestations were bronchiectasis (31 cases, 91.2%), often complicated by diarrhea (28 cases, 82.4%), sinusitis (19 cases, 55.9%), and respiratory tract infection (16 cases, 47.1%). The most common pathogen of lung infection was Pseudomonas aeruginosa (24 cases, 70.6%).

Chinese children with CF have diverse clinical manifestations. For those with bronchiectasis and recurrent respiratory infections, combined or not with other systemic diseases such as digestive and reproductive systems, as well as those with positive results for Pseudomonas aeruginosa in respiratory pathogen testing, it is important to be alert to the possibility of CF and undergo CFTR gene testing as soon as possible for a clear diagnosis.

To investigate the efficacy of placing a levonorgestrel-releasing intrauterine system (LNG-IUS) after hysteroscopic transcervical resection of polyps (TCRP) and its impact on the recurrence rate of endometrial polyps (EP) within 12 months postoperatively.

A total of 89 EP patients treated in Nantong Sixth People′s Hospital from December 2020 to December 2022 were selected as the study subjects. Using a prospective study design, the patients were randomly divided into an observation group (n=45, treated with hysteroscopic TCRP followed by LNG-IUS placement) and a control group (n=44, treated with hysteroscopic TCRP without LNG-IUS placement) according to the random number table method. The general clinical data, treatment effects, recurrence rates within 12 months after hysteroscopic TCRP, as well as clinical symptom assessment indicators, uterine hemodynamic parameters, inflammatory cytokine levels, and serum sex hormone levels before hysteroscopic TCRP and 12 months after hysteroscopic TCRP were statistically compared between two groups of EP patients using independent-samples t test and chi-square test. Repeated measures analysis of variance (ANOVA) was used to compare the endometrial thickness and pictorial blood loss assessment chart (PBAC) scores at four time points (before hysteroscopic TCRP and 3, 6, and 12 months after hysteroscopic TCRP) in two groups. This study was approved by the case collection hospital′s Ethics Committee (Approval No. NTLyLy2020042). All subjects signed informed consent forms for the clinical study.

① The total treatment efficacy rate in observation group (97.8%) was higher than that in control group (84.1%), while the recurrence rate within 12 months after hysteroscopic TCRP in observation group (4.4%) was lower than that in control group (18.2%), and the differences were statistically significant (χ²=5.09, 4.21; P=0.024, 0.040). ② Repeated measures ANOVA of endometrial thickness and PBAC scores before hysteroscopic TCRP and at 3, 6, and 12 months after hysteroscopic TCRP in two groups showed interaction effects between different treatment measures and time factors were statistically significont (F_{treatment×time}=18.48, 10.14; both with P_{treatment×time}<0.001). Analysis of the individual effects of different treatment measures in two groups revealed that the endometrial thickness and PBAC scores at 3, 6, and 12 months after hysteroscopic TCRP in observation group were thinner and lower than those in control group, and the differences were statistically significant (P<0.05). Analysis of the individual effects of time factors in observation group showed that the endometrial thickness at 3, 6, and 12 months after hysteroscopic TCRP was thinner than that before hysteroscopic TCRP, respectively, and the endometrial thickness at 12 months after hysteroscopic TCRP was thicker than that at 6 months, and the differences were statistically significant (P<0.05). The PBAC scores in observation group showed a decreasing trend at 3, 6, and 12 months after hysteroscopic TCRP, and the differences were statistically significant (P<0.05). Analysis of the individual effects of time factors in control group showed that the endometrial thickness showed an increasing trend, while the PBAC scores showed a decreasing trend at 3, 6, and 12 months after hysteroscopic TCRP, and the differences were statistically significant (P<0.05). ③ The visual analog scale (VAS) score for lower abdominal pain, irregular menstruation score, abnormal vaginal discharge score, uterine artery resistance index (RI) and pulsatility index (PI) values, and serum interleukin (IL)-1 and IL-6 levels at 12 months after hysteroscopic TCRP in observation group were all lower than those in control group, while the serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and anti-Müllerian hormone (AMH) levels in observation group were all higher than those in control group, and the differences were statistically significant (P<0.05).

Placing an LNG-IUS after hysteroscopic TCRP in EP patients can effectively reduce the recurrence rate of EP, improve clinical symptoms, and does not increase the incidence of adverse reactions.

To explore the prenatal ultrasonographic and genetic characteristics of fetus with Williams-Beuren syndrome (WBS) and provide basis for prenatal diagnosis.

A total of 25 pregnant women (one of them was a twin pregnancy) underwent prenatal examination and 25 fetuses (fetus 1 to 25, one of them was one of twins) diagnosed with WBS by chromosomal microarray analysis (CMA) at West China Second University Hospital, Sichuan University, from October 2018 to June 2023 were included in this study, and the clinical case data were retrospectively analyzed. A literature review was conducted by searching domestic and foreign databases for clinical studies related to the prenatal diagnosis of WBS. Prenatal sonographic findings, genetic test results, and pregnancy outcomes of WBS fetuses were summarized. The study procedures complied with the ethical standards of the World Medical Association Declaration of Helsinki revised in 2013.

① Among the 25 WBS fetuses in this study, 18 cases (72.0%, 18/25) had prenatal ultrasound findings, with cardiovascular abnormalities (55.6%, 10/18) being the most common, primarily including intracardiac echogenic foci and ventricular septal defects (VSD); followed by fetal growth restriction (FGR) (38.9%, 7/18). The length of the chromosomal deletion in the 25 WBS fetuses ranged from 1.39 to 23.41 Mb, of which 23 (92.0%) exhibiting deletions of 1.39 to 1.50 Mb. Parental verification in 7 cases of WBS fetuses revealed that the genovariation of 4 cases were de novo, 2 were maternally inherited, and one was paternally inherited. ② Literature retrieval results: According to the retrieval strategy set in this study, a total of 48 clinical studies about prenatal diagnosis of WBS fetus at home and abroad were retrieved, involving 173 WBS fetuses. Among these, 166 cases (93.8%) had prenatal phenotypes, mainly including FGR (49.4%, 82/166) and cardiovascular abnormalities (44.6%, 74/166, predominantly VSD and aortic stenosis). In 157 fetuses, 158 chromosomal deletions were identified, and the length of deletion was mainly 1.06-1.54 Mb (74.7%, 118/158). Among 90 fetuses underwent family validation, 74 cases (82.2%) were de novo, 13 cases (14.4%) were maternally inherited, and 3 cases (3.3%) were paternally inherited. ③ A comprehensive analysis of 166 cases of literature retrieval and 25 cases of this study, a total of 191 WBS fetuses were confirmed the diagnosis with the main genetic testing methods of CMA (85.3%, 163/191), fluorescence in situ hybridization (FISH) (22.0%, 42/191), and quantitative fluorescent-polymerase chain reaction (QF-PCR) (12.0%, 23/191), etc.. ④ Among the 184 WBS fetuses (18 cases of this study and 166 cases of literature retrieval) with available prenatal ultrasound results, the incidence rates of left ventricular outflow tract obstruction was 16.9% (31/184), VSD was 9.8% (18/184), and intracardiac echogenic foci was 9.2% (17/184).

Left ventricular outflow tract obstruction, including aortic stenosis, coarctation of aorta, etc., may be a prenatal sonographic feature of WBS fetus, while FGR is the most common nonspecific prenatal manifestation of WBS fetus.

To explore the impact of antenatal antipsychotic drug (APD) treatment on pregnancy outcomes in pregnant women with severe mental illness (SMI).

A total of 51 pregnant women with SMI admitted to Sichuan Mental Health Center and Guangyuan Mental Health Center from January 2021 to December 2023 were selected as research subjects. They were divided into observation group 1 (n=22, receiving continuous APD treatment during pregnancy) and observation group 2 (n=29, receiving APD treatment only when SMI symptoms worsened) based on clinical treatment regimens. A total of 68 healthy pregnant women who underwent prenatal examinations and delivered in the same two hospitals during the same period were included into control group. The Positive and Negative Syndrome Scale (PANSS), Social Disability Screening Schedule (SDSS), Suicide Risk Assessment Scale, and Risk Assessment Scale for Endangering Behavior were used to evaluate the disease symptoms of SMI pregnant women after delivery, and the aggravation/recurrence of SMI was recorded. The scores of disease symptoms and SMI aggravation/recurrence rates between observation group 1 and 2 were compared by independent-samples t test and chi-square test. Statistical analyses were performed on pregnancy complications, pregnancy outcomes, and neonatal outcomes, among the three groups. There were no statistically significant differences in general clinical data, such as age, educational level, residence, and parity between observation groups 1, 2 and the control group (P>0.05). Additionally, no significant differences were found in the course and type of SMI between observation group 1 and 2 (P>0.05). This study complied with the standards formulated by the Ethics Committees of Sichuan Mental Health Center and Guangyuan Mental Health Center, and was approved by the Ethics Committee of Sichuan Mental Health Center (Ethics No. 2021-1).

①There was a statistically significant difference in the overall incidence of gestational diabetes mellitus (GDM) among the three groups (χ²=13.08, P=0.003). Further pairwise comparisons showed that the incidence of GDM in observation group 1 was significantly higher than that in observation group 2 (χ²=6.30, P=0.012) and the control group (χ²=9.78, P=0.002). ②After delivery, the aggravation/recurrence rate of SMI, PANSS score, SDSS score, suicide risk score, and risk score for endangering behavior in observation group 1 were significantly lower than those in observation group 2 (P<0.05). ③There was a statistically significant difference in the proportion of newborns transferred to the neonatal intensive care unit (NICU) among the three groups (P<0.05). Further pairwise comparisons revealed that the proportion in observation group 1 was significantly higher than that in the control group (P=0.008), while no significant differences were found in other pairwise comparisons (P>0.05). No significant differences were observed in neonatal outcomes, such as birth weight, birth length, 5-minute Apgar score, and incidence of preterm birth and congenital malformation between observation group 1 and 2 (P>0.05).

APD treatment for pregnant women with SMI can improve their mental status, reduce the risk of SMI aggravation/recurrence during pregnancy, and does not significantly increase the risk of adverse maternal and neonatal outcomes.

To investigate the clinical characteristics and risk factors of severe pertussis in newborns.

A total of 71 newborns with pertussis who were hospitalized at the Children′s Hospital of Chongqing Medical University from August 2013 to July 2022 were selected as the study subjects. According to the diagnostic criteria for severe pertussis, the patients were divided into a severe group (n=20) and a non-severe group (n=51). A retrospective analysis was conducted on the general clinical data, laboratory test results, imaging findings, treatment, and outcomes of the two groups. The clinical value of the peak leukocyte count (WBC) in predicting the progression to severe pertussis was analyzed using the area under the curve (AUC) of receiver operating characteristic (ROC) curve. The procedures followed in this study were in accordance with the relevant standards approved by the Ethics Committee of the Children′s Hospital of Chongqing Medical University and obtained approval from the committee (Approval No.2024-13).

① The severe group had longer hospital stays, higher incidence of spasmodic cough, and higher rate of severe pneumonia complications compared with the non-severe group. The differences between the two groups were statistically significant (P<0.05). ② The severe group had higher peak WBC, peak platelet count (PLT) and proportion of elevated C-reactive protein (CRP) levels, compared with the non-severe group. The differences between the two groups were statistically significant (P<0.05). ③ The two groups had statistically significant differences in the duration of azithromycin use, mechanical ventilation rate, and non-invasive ventilation rate (P<0.05). ④ The ROC-AUC for diagnosing severe pertussis using peak WBC was 0.767 (95%CI: 0.646-0.888, P=0.010). According to the principle of maximum Youden index, the optimal cutoff value for diagnosing severe pertussis in newborns was 21.235×10⁹/L. At this cutoff, the sensitivity for diagnosing severe pertussis was 80.0%, and the specificity was 66.7%.

When the WBC level is greater than 21.235×10⁹/L, pertussis in newborns is more likely to progress to severe disease.

To evaluate the clinical auxiliary diagnostic value of super micro-vascular imaging (SMI) combined with shear wave elastography (SWE) for endometrial carcinoma (EC).

A total of 99 patients with endometrial lesions admitted to Panzhihua Integrated Traditional Chinese and Western Medicine Hospital from January 2022 to June 2023 were selected. All patients underwent transvaginal ultrasound (TVS), and SMI and SWE techniques were sequentially used to examine the endometrium. Endometrial tissue samples were obtained via diagnostic curettage for histopathological analysis. Based on histopathological results, patients were divided into EC group (n=38, diagnosed with EC) and control group (n=61, diagnosed with benign endometrial lesions). Vascularization index (VI) detected by SMI and maximum elasticity (Emax), mean elasticity (Emean), and standard deviation of elasticity (Esd) detected by SWE were compared between two groups using independent-samples t test or Mann-Whitney U test. Diagnostic accuracy of SMI, SWE, and SMI+ SWE for EC were compared by chi-square test. Receiver operating characteristic (ROC) curve analysis was performed to assess the clinical diagnostic performance of SMI, SWE, and SMI+ SWE for EC. The study protocol was performed in accordance with the Helsinki Declaration of the World Medical Association revised in 2013. There were no significant differences between the two groups in the age, portion of married, body mass index (BMI), and gravidity (P>0.05).

①Using histopathological diagnosis as the gold standard for clinical diagnosis of EC patients, the diagnostic accuracy of SMI+ SWE for EC was 96.0% (95/99), which was significantly higher than that of SMI (82.8%, 82/99) and SWE (79.8%, 79/99) alone (χ²=8.12, P=0.004; χ²=10.34, P=0.001). ②The EC group showed significantly higher VI, Emax, Emean, and Esd values than those of the control group (Z=5.32, P<0.001; t=3.21, P=0.002; t=4.87, P<0.001; Z=4.15, P<0.001). ③ROC analysis demonstrated that the area under the curve (AUC) for SMI+ SWE in diagnosing EC was 0.957 (95%CI: 0.908-0.992), which was significantly higher than the AUC for VI, Emax, Emean, and Esd alone [0.844(95%CI: 0.769-0.915), 0.869(95%CI: 0.794-0.936), 0.751(95%CI: 0.650-0.850), and 0.856(95%CI: 0.776-0.927)], with statistically significant differences (Z=3.27, P=0.001; Z=2.89, P=0.004; Z=4.52, P<0.001; Z=3.05, P=0.002).

SMI+ SWE provides high clinical auxiliary diagnostic efficacy for EC, demonstrating significant clinical value.

At present, the literature reports on the incidence of small for gestational age (SGA) infants in the world are not uniform, ranging from 6.61% to 12.28%. Compared with appropriate for gestational age (AGA) infants, SGA infants have higher mortality, and higher perinatal complications and long-term complications. Early identification of SGA infants related risk factors and complications, and timely intervention are the key to improve their long-term prognosis. The author intends to review the latest research progress in three aspects about epidemiological research status of SGA infants, high risk factors and prevention of SGA infants, perinatal complications and prognosis of SGA infants, and intervention measures for SGA infants after birth and related measures to improve prognosis, in order to provide reference for further clinical research on the diagnosis and treatment of SGA infants.

To investigate clinical characteristics and prognosis of children with autosomal dominant optic atrophy (ADOA) complicated with end-stage renal disease caused by SSBP1 gene mutation.

On March 31, 2021, a pediatric patient (Patient 1) with chronic kidney disease of unknown etiology who was treated at Xi′an Children′s Hospital was selected in this study. A retrospective analysis was performed to collect the clinical data of Patient 1, and whole-exome sequencing (WES) together with Sanger sequencing validation results were obtained. The pathogenicity of the detected variants was evaluated in accordance with the guidelines established by the American College of Medical Genetics and Genomics (ACMG). This study adhered to the requirements of the revised 2013 Declaration of Helsinki of the World Medical Association. Informed consent was obtained from the guardians of Patient 1.

① Patient 1 was a 6-year-6-month-old male who presented with a 1-year history of short stature and a 1-month history of abnormal renal function. He was admitted to the Department of Nephrology at Xi′an Children′s Hospital on March 31, 2021. Upon admission, auxiliary examinations revealed a blood urea level of 15.26 mmol/L, a serum creatinine level of 172 μmol/L, and an estimated glomerular filtration rate (GFR) of 31.05 mL/(min·1.73 m²), accompanied by mild metabolic acidosis and mild anemia. Cranial MRI indicated bilateral cerebellar atrophy, and visual acuity in both eyes was 0.06. Whole-exome sequencing (WES) identified a heterozygous c. 320G>A (p.Arg107Gln) variant in the SSBP1 gene, which was confirmed by Sanger sequencing to be of paternal origin. During follow-up, the GFR of patient 1 declined to 13.89 mL/(min·1.73 m²) by the age of 10 years and 3 months, at which point peritoneal dialysis was initiated. ② A literature review identified 14 reported patients with ADOA caused by SSBP1 gene variants and accompanied by renal impairment, including 10 males and 4 females. All patients had disease onset during infancy or childhood; however, diagnosis was delayed in all cases. Apart from renal involvement, the most common additional manifestations were sensorineural hearing loss and neurological symptoms. Among the identified variants, the heterozygous missense mutation c. 320G>A was the most frequent (8/14).

For pediatric patients presenting with optic atrophy accompanied by hearing loss, neurological involvement, and renal impairment-particularly when there is a positive family history-genetic testing should be performed when necessary to confirm the diagnosis.

With the increasing incidence of ovarian tumors among younger women, fertility-sparing surgery (FSS) has emerged as a strategy to balance oncologic control and fertility preservation. Ovarian tumors include borderline ovarian tumors (BOT), early-stage epithelial ovarian cancer (EOC), and non-epithelial ovarian cancer (NEOC). For BOT patients in childbearing age, unilateral salpingo-oophorectomy or cystectomy preserves fertility without significantly increasing recurrence risk. In early-stage EOC, especially International Federation of Obstetrics and Gynecology (FIGO) stage Ⅰ and well-differentiated EOC patients, FSS yields favorable overall survival (OS) in reproductive-aged patients, though certain subtypes, such as high-grade endometrioid carcinoma, may carry poorer prognosis. In NEOC patients with germ cell tumors and sex cord-stromal tumors meeting FSS indications, outcomes are favorable compared to non-FSS treatments. Assisted reproductive technology (ART), including oocyte, embryo, and ovarian tissue cryopreservation, offer additional fertility options. When applied to properly selected ovarian cancer patients, FSS is safe, feasible, and effective. However, challenges remain in indication criteria, surgical choice, long-term prognosis, and integration with ART. This review summarizes current evidence on FSS safety and fertility outcomes in childbearing age patients with BOT, early-stage EOC, and NEOC, aiming to provide clinical decision-making support and evidence-based guidance for fertility preservation in reproductive-aged patients.

To explore the breast ultrasound examination and histopathological findings of breast solid papillary carcinoma (SPC).

A total of 81 patients with breast SPC who underwent surgical treatment at Shanxi Provincial Cancer Hospital from January 2014 to May 2022 and were confirmed by pathological examination of surgically resected tissues were selected as the research subjects. According to pathological subtypes, they were divided into in situ group (n=34) and invasive group (n=47). Retrospective analysis methods were used to collect lesion location, onset age, initial symptoms, breast ultrasound results, and pathological results of the two groups. Statistical analysis was performed using chi-square test, continuity correction chi-square test, or Fisher′s exact probability method. This study followed the requirements of the 2013 revised World Medical Association Declaration of Helsinki.

① Patients with breast SPC were significantly older, with 56 cases (69.1%) aged ≥60 years. The first symptom of 61 cases (75.3%) was a palpable breast mass.There were no statistically significant differences in lesion location, onset age, and initial symptom composition between two groups (P>0.05). ② The results of breast ultrasound examination of these 81 patients showed SPC masses predominantly exhibited a single occurrence (65 cases, 80.2%), hypoechoic characteristics (72 cases, 88.9%), irregular morphology (50 cases, 61.7%), well-defined borders (48 cases, 59.3%), parallel growth orientation (68 cases, 84%), absence of calcification (75 cases, 92.6%), unchanged posterior echo (67 cases, 82.7%), Adler blood flow grade Ⅱ-Ⅲ (49 cases, 60.5%), no lymph node metastasis (80 cases, 98.8%), and no ductal ectasia (61 cases, 75.3%). However, no statistically significant differences were observed between in situ and invasive groups regarding these parameters (all P>0.05). In the invasive group, 89.4% (42/47) of those diagnosed with Breast Imaging Reporting and Data System (BI-RADS) category 4 by breast ultrasound were significantly higher than 67.6% (23/34) in the in situ group (χ²=5.87, P=0.015). ③The immunohistochemical results of surgically resected tissues from 81 patients showed that the estrogen receptor (ER) and progesterone receptor (PR) positive rates of SPC cells were 100.0% (81/81), the P63 positive rate was 39.5% (32/81), and the Syn and CgA positive rates were 63.0% (51/81) and 51.8% (42/81), respectively. The in situ group exhibited significantly higher P63 positive rate than the invasive group, with a statistically significant difference (P<0.001). However, no statistically significant differences were observed between the two groups in Syn and CgA positive rates (P>0.05).

The breast ultrasound examination results of patients with breast SPC have certain characteristics and are closely correlated with the SPC subtypes detected by histopathological examination. The expression of P63 in breast SPC cells is helpful for clinical differentiation of patients with in situ and invasive breast SPC.

With the development of molecular biology techniques, molecular diagnosis and treatment technologies can significantly improve the prognosis of ovarian cancer patients by precisely identifying the characteristics of tumor cells. Molecular diagnostic techniques for tumors mainly focus on analyzing the molecular features of tumor cells, including multiple levels such as genomics, transcriptomics, proteomics, and metabolomics. In the diagnosis and treatment of ovarian cancer, an increasing number of molecular targeted therapeutic drugs have been developed. Among them, the most widely used are poly-ADP-ribose polymerase (PARP) inhibitors and anti-angiogenic drugs, while others include immune checkpoint blockade (ICB), antibody-drug conjugate (ADC), and targeted drugs for other human signaling pathways. The main difficulty in molecular diagnosis and treatment of ovarian cancer lies in its heterogeneity. We need to develop more precise molecular typing methods and provide more targeted treatments for them. The focus of molecular diagnosis and treatment is to formulate individualized treatment plans through comprehensive analysis of patients′ genomic, transcriptomic, and proteomic data. The hotspots in the field of molecular diagnosis and treatment of ovarian cancer mainly include the application of PARP inhibitors in ovarian cancer, new ADC, research on drug resistance mechanisms, and the clinical application of artificial intelligence in complex data analysis. The author intends to systematically elaborate on the latest research status of the application of molecular diagnostic techniques in the clinical diagnosis of ovarian cancer, the clinical application of molecular targeted therapeutic drugs for ovarian cancer, the clinical exploration of new molecular targeted therapeutic drugs, and the clinical application of immunotherapy for ovarian cancer, aiming to provide a reference for the clinical application of molecular diagnosis and treatment for ovarian cancer patients.

To investigate the correlation between surgical complexity score (SCS), disease score (DS), and residual disease (RD) in patients with advanced epithelial ovarian cancer (EOC) undergoing interval debulking surgery (IDS), with the aim of informing individualized surgical decision-making.

A total of 160 patients with advanced EOC who underwent neoadjuvant chemotherapy (NACT) followed by IDS at West China Second University Hospital, Sichuan University, between September 2013 and June 2018 were retrospectively analyzed. According to whether complete cytoreduction (R0) was achieved, patients were categorized into the R0 group (n=86) and the RD group (n=74). Clinical data, including baseline characteristics, histopathological findings, laboratory results, postoperative complications, and prognosis, were collected for both groups. Statistical analyses were performed using the Mann-Whitney U test, Pearson′s chi-square test, or Fisher′s exact test, as appropriate, to compare clinical variables between the two groups. Multivariate unconditional logistic regression analysis was conducted to identify independent factors associated with achieving R0 resection in advanced EOC patients. The Mantel-Haenszel chi-square test was used to evaluate the correlation between SCS and DS. Kaplan-Meier survival analysis with the Log-rank test was employed to compare overall survival (OS) between the R0 and RD groups. This study was approved by the Ethics Committee of West China Second University Hospital, Sichuan University, and conducted in accordance with its ethical requirements (Approval No. 2022-167).

① The preoperative carbohydrate antigen 125 (CA125) level in the RD group was significantly higher than that in the R0 group (Z=-2.52, P=0.012). ② The distribution of DS grades between the two groups differed significantly was (χ²=10.92, P=0.004), the distribution of SCS between the two groups also differed significantly (χ²=15.41, P=0.001). DS was an independent risk factor for reaching R0 after receiving IDS, while SCS was an independent protective factor. Multivariate unconditional logistic regression analysis indicated that patients with moderate DS had a significantly lower likelihood of achieving R0 resection compared with those with low DS (OR=0.094, 95%CI: 0.021-0.431, P=0.002), whereas patients with moderate SCS were more likely to achieve R0 compared with those with low SCS (OR=13.660, 95%CI: 2.150-86.803, P=0.006). ③ Mantel-Haenszel χ² test revealed no significant trend correlation between DS and SCS in patients with advanced EOC (χ²=0.01, P=0.906). ④ The Log-rank test demonstrated that the survival curves of the two groups differed significantly (χ²=9.46, P=0.002). ⑤ Comparisons of age, American Society of Anesthesiologists (ASA) classification, DS grade, and SCS grade between patients with and without postoperative complications showed no significant differences (all P>0.05).

For patients with advanced EOC treated with NACT followed by IDS, increasing surgical complexity may facilitate the achievement of R0 resection and improve prognosis. However, such an approach requires careful consideration of tumor burden and the risk of postoperative complications. Preoperative comprehensive evaluation and individualized decision-making are therefore recommended.