Cervical cancer, endometrial cancer, and ovarian cancer, are major causes of female mortality, with their incidence increasing annually and affecting younger populations. Current treatment modalities such as surgery, radiotherapy, chemotherapy and molecular targeted therapy can improve outcomes for some patients. However, the prognosis for those with recurrence or metastasis remains poor, highlighting an urgent need to identify novel therapeutic targets. N6-methyladenosine (m⁶A) modification is the most prevalent and central post-transcriptional RNA modification in eukaryotes. AlkB homolog 5 (ALKBH5), functioning as an m⁶A demethylase, regulates RNA transcription, degradation, and translation, thereby participating in key biological processes including the cell cycle, epithelial-mesenchymal transition (EMT), and remodeling of the immune microenvironment. It plays a significant role in the proliferation, invasion, metastasis, and drug resistance of cervical cancer, endometrial cancer, and ovarian cancer. This review summarizes the expression characteristics and core regulatory mechanisms of ALKBH5 in these three major gynecological malignancies, aiming to provide a theoretical reference for a deeper understanding of their pathogenesis and the exploration of potential diagnostic and therapeutic targets.

The cyclic GMP-AMP synthase (cGAS)-stimulator of interferon gene (STING) signaling pathway is a central hub connecting cytosolic DNA sensing to antitumor immune activation and plays a significant role in remodeling the immune microenvironment of gynecologic malignancies. The mechanisms of activation and biological effects of this pathway differ among ovarian cancer, cervical cancer, and endometrial cancer. It can enhance antigen presentation, promote T-cell recruitment, and activate antitumor immunity. But it may also induce immunosuppression. Its regulation involves BRCA/DNA polymerase epsilon (POLE)-related alterations, interference by human papilloma virus (HPV) proteins, as well as microRNAs (miRNAs), epigenetic modifications, mitochondrial stress, and others. Research focusing on strategies such as STING agonists, poly (ADP-ribose) polymerase (PARP) inhibitors, immune checkpoint inhibitors, and nanodelivery systems shows promising application prospects. However, precise patient stratification, local delivery, dose control, and optimization of combination timing remain key challenges for clinical translation.

Endometrial cancer is one of the most common gynecological malignancies, characterized by significant clinicopathological and molecular heterogeneity. Traditional single-modality information struggles to comprehensively reflect tumor biology and patient prognosis. With the rapid development of artificial intelligence technology, multimodal models provide a novel direction for precision diagnosis and treatment of endometrial cancer by integrating different types of data such as imaging, pathology, clinical information, and genomics, and performing joint analysis with advanced algorithms. This article provides an overview of the basic concepts, development processes, common fusion strategies, and data preprocessing methods for different modalities in multimodal models. It focuses on summarizing their application advances in preoperative evaluation and postoperative prognosis prediction for endometrial cancer, including preoperative differentiation of benign from malignant lesions, early-stage diagnosis, myometrial invasion assessment, and postoperative recurrence risk stratification. However, this field still faces challenges, including significant data heterogeneity, insufficient external validation, and limited interpretability. Future efforts should involve multicenter, prospective studies and enhanced standardization to promote the standardized application of multimodal models in the precise diagnosis and treatment of endometrial cancer.

Systems biology provides a holistic and multilayered analytical framework for investigating the tumor microenvironment of endometrial cancer (EC) by integrating genomics, transcriptomics, proteomics, metabolomics, and microbiomics. Current evidence indicates that genomics reveals the molecular classification characteristics of EC and their association with immune-related microenvironmental heterogeneity. Transcriptomics, particularly single-cell RNA sequencing and spatial transcriptomic technologies, deepens the understanding of tumor cell heterogeneity, spatial distribution, and cellular communication networks. Proteomics and metabolomics supplement the comprehension of EC invasive phenotypes, risk stratification, and prognostic differences from the perspectives of functional protein alterations and metabolic reprogramming, respectively. Microbiomics suggests that imbalances in gut and reproductive tract microbiota may participate in tumor microenvironment remodeling through inflammatory responses, immune regulation, and barrier dysfunction. Overall, multi-omics studies continuously enhance our knowledge of molecular heterogeneity and microenvironmental interaction mechanisms in EC, providing new bases for early identification, molecular classification, risk assessment, and individualized treatment. However, current challenges remain, including difficulties in multi-omics data integration, considerable heterogeneity in results, insufficient standardization, and limited evidence for clinical translation. Future efforts should strengthen the combined application of high-resolution single-cell and spatial multi-omics technologies and advance the standardized integration and prospective validation of multi-omics data to promote precise stratification and therapeutic optimization for EC.

Human papilloma virus (HPV) infection is a significant causative factor for lower female genital tract lesions. Persistent infection with high-risk HPV types is closely associated with the development and progression of vaginal intraepithelial neoplasia (VaIN) and vaginal cancer, particularly vaginal squamous cell carcinoma. As VaIN lacks typical clinical symptoms and is highly occult, VaIN2/3 represents a vaginal precancerous lesion prone to missed diagnosis in clinical practice. In recent years, with the standardized application of HPV testing and colposcopy in cervical cancer screening, the detection rates of early-stage vaginal cancer and VaIN have also significantly increased. This review systematically outlines recent clinical research progress on the correlation between HPV and VaIN as well as vaginal cancer, aiming to provide a reference for formulating clinical prevention and management strategies for these lesions.

Objective: To investigate whether miR-125b affects cisplatin (DDP) resistance in cervical cancer SiHa cells by targeting the regulating the expression of B-cell lymphoma-2 (BCL-2) and to explore its underlying mechanism. Methods: Using human cervical cancer cells (SiHa) and their DDP-resistant cell line SiHa/DDP as subjects, the following groups were established: SiHa group (SiHa cells transfected with mimic-NC), SiHa/DDP group (SiHa/DDP cells transfected with mimic-NC), SiHa+mimic-miR-125b group (SiHa cells transfected with miR-125b mimic), and SiHa/DDP+mimic-miR-125b group (SiHa/DDP cells transfected with miR-125b mimic). The expression of miR-125b was detected by real time fluorescent quantitative polymerase chain reaction (RT-qPCR). Cell viability was assessed using the CCK-8 assay, and the half maximal inhibitory concentration (IC₅₀) of DDP was calculated. Apoptosis was measured by flow cytometry, and the expression of BCL-2 protein was evaluated by Western blotting. The targeting relationship between miR-125b and BCL-2 was validated using a dual-luciferase reporter assay. Results: Compared with the parental SiHa group, the resistant SiHa/DDP group exhibited reduced miR-125b expression and apoptosis rate, along with increased BCL-2 protein expression (all P<0.05). After transfection with mimic-miR-125b, compared with the resistant SiHa/DDP group, the SiHa/DDP+mimic-miR-125b group showed increased miR-125b expression and apoptosis rate, and decreased BCL-2 protein expression (all P<0.05). However, miR-125b expression and apoptosis rate in the SiHa/DDP+mimic-miR-125b group remained lower than those in the SiHa+mimic-miR-125b group, while BCL-2 protein expression remained higher (all P<0.05). The IC₅₀ values of DDP were 7.21 μg/mL and 34.75 μg/mL for the SiHa group and SiHa/DDP group, respectively. The IC₅₀ values for the SiHa+mimic-miR-125b and SiHa/DDP+mimic-miR-125b groups were 5.13 μg/mL and 12.26 μg/mL, respectively. The dual-luciferase reporter assay showed that miR-125b mimic specifically reduced the luciferase activity of the wild-type BCL-2 reporter gene (P<0.05), while it had no effect on the mutant type (P>0.05). Conclusions: miR-125b can reverse DDP resistance in cervical cancer SiHa cells by targeting and inhibiting BCL-2 expression, thereby promoting apoptosis.

Radical surgery for cervical cancer combined with ovarian transposition is increasingly performed in young patients with cervical cancer. However, the occurrence of tumors in transposed ovaries is relatively rare. Tumors arising in transposed ovaries after cervical cancer surgery have an insidious onset and lack typical symptoms, posing certain challenges in clinical diagnosis and management. This report presents two cases admitted to the Affiliated Hospital of Guizhou Medical University in 2023. Both patients had previously undergone abdominal radical hysterectomy, bilateral salpingectomy, pelvic lymphadenectomy, and bilateral ovarian transposition for cervical cancer. During surgery, both ovaries were preserved and transposed to the ipsilateral paracolic gutters, located in the iliac fossae. During postoperative follow-up, neither patient reported discomfort such as abdominal pain or bloating. They were admitted to the hospital due to the discovery of pelvic masses on imaging studies, which were initially suspected to be metastasis to the transposed ovaries from cervical cancer. Postoperative pathological examination confirmed that one case was a primary benign cyst in the transposed ovary after cervical cancer surgery, and no abnormalities have been detected during follow-up to date. The other case was a primary malignant tumor of the transposed ovary after cervical cancer surgery. This patient received four cycles of supplemental chemotherapy with paclitaxel combined with carboplatin postoperatively. During follow-up, metastasis to the descending colon accompanied by mechanical intestinal obstruction was discovered. The patient did not attend scheduled follow-up visits after discharge. These cases suggest that when a tumor is detected in a transposed ovary after cervical cancer surgery, clinicians should not limit their differential diagnosis to metastasis from cervical cancer. They should also be vigilant about the possibility of primary tumors developing in the preserved ovaries to reduce misdiagnosis and mismanagement.

Recurrence of high-grade serous ovarian carcinoma (HGSOC) is usually confined to the peritoneal cavity, with vulvar metastasis being extremely rare. We report a case of HGSOCⅠC who achieved initial remission for over 5 years, and subsequently presented with isolated inguinal lymph node metastasis, followed by multiple vulvar nodules as the primary manifestation of extensive systemic recurrence. Biopsy pathology was consistent with metastatic HGSOC. PET/CT revealed metastases in multiple sites throughout the body, and carbohydrate antigen 125 (CA125) was significantly elevated. Following treatment with a regimen of albumin-bound paclitaxel+carboplatin+bevacizumab, the patient achieved biochemical and clinical remission. However, severe hematological toxicity occurred repeatedly, impacting treatment sustainability. This case suggests that rare vulvar metastasis may serve as a "sentinel" for systemic dissemination of HGSOC, highlighting the importance of comprehensive physical examination during follow-up. For patients experiencing recurrence after multiple lines of therapy, a balance must be sought between efficacy and tolerability, with individualized maintenance and subsequent treatment strategies explored based on molecular characteristics.

Endometriosis (EMs) is one of the common causes of infertility in women of reproductive age, posing a serious threat to female reproductive health. The pathogenesis of EMs-related infertility is complex. Current research indicates that impaired endometrial receptivity is a key factor leading to embryo implantation failure in patients with EMs. The specific mechanisms include: an imbalance in the quantity and proportion of endometrial immune cells secreting pro-inflammatory factors, disrupting the endometrial immune microenvironment; increased estrogen synthesis caused by ectopic lesions, downregulation of progesterone receptor expression leading to progesterone resistance, resulting in an imbalance in estrogen and progesterone signaling pathways and interference with cyclical endometrial changes; and abnormal expression of key receptivity genes and dysregulation at the epigenetic level, affecting the normal decidualization process of endometrial stromal cells. This review summarizes the relationship between the aforementioned mechanisms and impaired endometrial receptivity in EMs, providing a theoretical basis and new research directions for clinically improving endometrial receptivity and pregnancy outcomes in patients with EMs.

Pelvic organ prolapse (POP) is a common pelvic floor dysfunction disease, whose core pathophysiological basis is the homeostatic imbalance of extracellular matrix (ECM) metabolism. This process is not a passive tissue degeneration but an active remodeling disorder driven by multiple factors and involving multiple cell types, manifested as the disruption of the dynamic balance between ECM synthesis and degradation. Current treatment modalities, primarily surgical, face limitations such as a high recurrence rate. Therefore, novel diagnostic and therapeutic strategies targeting the essence of ECM metabolic imbalance have become a research focus, including cutting-edge directions such as targeted drugs, regenerative therapies, and tissue engineering. To facilitate the translation of these strategies from basic research to clinical application, deep integration and collaboration among basic medical science, biomaterials science, and clinical medicine are imperative. This ultimately aims to achieve a paradigm shift in POP treatment, moving from anatomical repositioning to the reconstruction of biological function.

Pelvic organ prolapse (POP) is a condition in which the pelvic floor muscles and fascial tissues are weakened, leading to the descent of pelvic organs such as the uterus and vagina from their normal anatomical positions, resulting in anatomical displacement and functional abnormalities of the corresponding organs. It severely impacts patients' quality of life. Its pathogenesis is complex and is primarily associated with disturbances in the extracellular matrix microenvironment of pelvic floor tissues. Abnormalities in the content or compositional ratios of structural proteins such as collagen in pelvic floor tissues, oxidative stress damage caused by reactive oxygen species accumulation, abnormal release of inflammatory factors such as interleukins, dysregulated expression of mitochondria-related proteins, and an imbalance between cellular senescence and apoptosis are considered important contributors to the development and progression of POP. Focusing on the aforementioned pathophysiological processes, disease-related microRNAs, and imaging indicators, this review summarizes potential biomarkers and therapeutic targets for POP. It aims to provide a theoretical basis for an in-depth exploration of POP pathogenesis and offer new perspectives for disease screening, diagnosis, treatment, and prediction of recurrence risk.

Postmenopausal bleeding (PMB) is a common gynecological symptom in postmenopausal women, harboring dual risks of benign and malignant lesions, making it a critical focus in the health management of postmenopausal females. Ovarian failure in postmenopausal women leads to estrogen deficiency, subsequently triggering a series of degenerative changes in the reproductive system. Considering the pathophysiological characteristics unique to the postmenopausal period, the etiologies of PMB can be primarily categorized as reproductive system inflammation, benign lesions, neoplasms, ovarian endocrine dysfunction, drugs and supplements, trauma and foreign bodies, and systemic diseases. In clinical practice, the diagnosis of PMB requires combining a detailed medical history, comprehensive physical examination, and targeted ancillary investigations, prioritizing the exclusion of malignant lesions while differentiating benign causes to ensure diagnostic accuracy. The management of PMB relies on a definitive etiological diagnosis, comprehensively considering the patient's individual circumstances, clinical characteristics, and treatment preferences. Standardized and individualized treatments are implemented according to different etiologies, including pharmacotherapy, surgical intervention, radiotherapy, Traditional Chinese medicine adjuvant therapy, and lifestyle modifications.

Objective: To explore the causal relationship between different subtypes of endometriosis (EMs) and serum uric acid (SUA) levels using Mendelian randomization (MR) analysis. Methods: The analysis utilized publicly available summary data from genome-wide association study (GWAS) of European ancestry. GWAS data for SUA were derived from the European subset of a trans-ancestry meta-analysis (sample size n=288 649). Exposure data for EMs and its subtypes were obtained from the Finnish population in the FinnGen cohort (total sample n=500 348, including 282 064 females). Seven EMs subtypes were analyzed: overall EMs, ASRM (American Society for Reproductive Medicine) stages Ⅲ-Ⅳ severe EMs, deep infiltrating EMs, ovarian EMs, pelvic peritoneal EMs, rectovaginal septum EMs, and uterine EMs. The inverse variance weighted (IVW) method served as the primary analysis. Complementary analyses were conducted using MR-Egger regression, weighted median, simple mode, and weighted mode methods. Heterogeneity was assessed using Cochran's Q test. Horizontal pleiotropy was evaluated via MR-Egger regression with its intercept test and the MR-PRESSO method. The robustness of results was tested using the leave-one-out sensitivity analysis. Results: In the forward MR analysis with EMs subtypes as exposures and SUA as the outcome, significant positive causal effects were observed for ASRM stage Ⅲ-Ⅳ severe EMs (β=0.025 9, SE=0.007 8, P=0.000 9), ovarian EMs (β=0.023 2, SE=0.006 6, P=0.000 4), and pelvic peritoneal EMs (β=0.025 2, SE=0.011 9, P=0.034 8), indicating these subtypes causally increased SUA levels. No significant causal effects were found for the other subtypes. Sensitivity analyses revealed no substantial heterogeneity or horizontal pleiotropy. In the reverse MR analysis with SUA as the exposure and EMs subtypes as outcomes, while all odds ratios from the IVW method were positive, none reached statistical significance (P>0.05). However, the weighted median method in the reverse analysis indicated statistically significant positive associations between SUA and the risk of ASRM stage Ⅲ-Ⅳ severe EMs and ovarian EMs (P<0.05). Conclusions: ASRM stage Ⅲ-Ⅳ severe EMs, ovarian EMs, and pelvic peritoneal EMs may causally increase SUA levels through genetic pathways. Conversely, evidence for a causal effect of elevated SUA on the risk of developing EMs was not significant.

Objective: To explore the application value of the Jiman double-ring fixation technique in patients with adenomyosis and enlarged uterine cavity who have a history of Mirena displacement or expulsion, and to evaluate its effectiveness and safety in reducing the recurrence of Mirena displacement/expulsion and improving clinical symptoms. Methods: Clinical data of 50 patients with adenomyosis who underwent Jiman double-ring fixation procedure at our hospital from January 2023 to June 2024 were retrospectively analyzed. The surgical technique involved anchoring the uterine myometrium with GyneFix to simultaneously secure the Mirena intrauterine system. Intraoperative real-time ultrasound monitoring was used to assess the safe placement of the Jiman double-ring. Postoperative follow-up was conducted for 12 months, during which the position of the Jiman double-ring, pictorial blood loss assessment chart (PBAC) scores, visual analogue scale (VAS) scores, and complications were recorded. Results: All 50 enrolled patients with adenomyosis successfully underwent the Jiman double-ring fixation procedure under ultrasound guidance. The average operative time was (12.6±3.1) minutes, and the average intraoperative blood loss was (4.8±1.5) mL. No severe intraoperative complications such as uterine perforation, major hemorrhage, or infection were observed. The expulsion rate of Mirena was 0%, and the displacement rate was 4.0% (2 cases of mild displacement without affecting efficacy). The preoperative PBAC score was (215.6±42.8) points. Postoperative PBAC scores at 3, 6, and 12 months were (92.3±21.5) points, (65.1±18.7) points, and (52.6±15.3) points, respectively. The preoperative VAS score was (7.3±1.5) points. Postoperative VAS scores at 3, 6, and 12 months were (4.2±1.3) points, (2.8±0.9) points, and (1.6±0.7) points, respectively. The differences between scores at all follow-up time points and preoperative scores were statistically significant (all P<0.001). The main postoperative adverse reaction was intermenstrual spotting within the first 3 months, which did not significantly affect daily life, with an incidence of 52.0%. No severe adverse reactions occurred. Conclusions: Utilizing the principle of synergistic anchoring and fixation, the Jiman double-ring fixation technique significantly reduces the expulsion and displacement rates of Mirena in patients with adenomyosis and an enlarged uterine cavity. Postoperatively, satisfactory hemostatic effects and significant relief of dysmenorrhea symptoms can also be achieved. This technique is simple and safe, offering a new method for clinically addressing the challenge of easy displacement and expulsion of Mirena.

In addition to symptoms such as menorrhagia, dysmenorrhea, and infertility, patients with adenomyosis may present with coagulation disorders, a hypercoagulable state, and thrombotic tendency. This article reports a case of adenomyosis complicated by deep vein thrombosis of the lower extremity and pulmonary embolism. The patient presented with abnormal uterine bleeding and lower limb pain. After hemostatic and anticoagulant therapy, she underwent total abdominal hysterectomy. Postoperative pathology confirmed the presence of intravascular microthrombi within the adenomyosis lesions. During the 1.5-year follow-up, the patient's D-dimer levels and carbohydrate antigen 125 levels returned to normal, and ultrasonography of both lower limbs indicated recanalization of the occluded vessels, with no new thrombotic events. This case suggests that patients with adenomyosis exhibit a hypercoagulable and prothrombotic tendency, making them susceptible to thrombotic disorders even in the presence of abnormal bleeding. During diagnosis and treatment, close attention should be paid to the patient’s arterial oxygen saturation and subjective complaints to improve clinical detection. The gradual normalization of coagulation parameters after hysterectomy further indicates a close association between adenomyosis and coagulation dysfunction. Removal of the uterus or adenomyotic lesions may potentially reverse the hypercoagulable state induced by adenomyosis.

Abnormal oxidative stress is a one of the key pathological features of the placenta in preeclampsia (PE) and affects trophoblast function and immune balance. Post-translational modifications (PTMs) refer to a series of covalent modifications occurring after protein translation. Numerous categories of PTMs have been identified in PE, and oxidative stress is extensively involved. Oxidative stress can regulate PTMs through direct protein damage, modulation of modifying enzyme activity, and alterations in metabolite levels, thereby coordinating PTMs in PE. Simultaneously, PTMs can influence cellular oxidative stress status. The two mutually regulate each other and jointly participate in placental oxidative stress regulation and placental function. However, the complexity of cellular oxidative metabolism in PE, the interactions among various PTMs, the mechanisms by which oxidative stress affects PTMs, and its regulatory role in PE pathogenesis remain unclear. This review summarizes the impact of oxidative stress on protein phosphorylation, ubiquitination, acetylation, lactylation, and other PTMs in PE by regulating the activity and expression levels of modifying enzymes. It also outlines the influence of glucose metabolism and lactate levels on placental oxidative stress status and function.

Spontaneous preterm birth (sPTB) is not only one of the leading causes of neonatal mortality but also has profound negative effects on the development of respiratory, neurological, and other systems. Therefore, establishing timely and effective prediction strategies is crucial. In recent years, with advances in preterm birth prediction research, the limitations of single indicators have become increasingly apparent. The combined application of ultrasound-based cervical assessment and biomarker detection has gained widespread clinical attention. Ultrasonography examination can dynamically reveal changes in cervical structure and function by measuring cervical length and cervical angle, observing the morphology of the internal cervical os, and utilizing elastography to assess cervical stiffness, providing intuitive evidence for identifying high-risk populations. Abnormalities in these structural indicators often precede the onset of clinical symptoms. Meanwhile, biomarkers can reflect underlying pathophysiological changes in the body, such as inflammatory responses and placental dysfunction, which often play key roles in the initiation of preterm birth. However, single modality prediction is often limited. Integrating multimodal data to construct a joint prediction model enables a systematic "structure-function" dual-dimensional assessment, promoting the development of preterm birth prediction toward earlier and more refined approaches. This review summarizes the research progress in combining ultrasound cervical assessment with biomarkers for predicting sPTB, aiming to provide references for clinical preterm birth risk screening and management.

Postpartum urinary incontinence (PPUI), postpartum depression and anxiety are common comorbidities in women after delivery. They often coexist and exacerbate each other, gradually becoming a hotspot in clinical interdisciplinary research in recent years. Existing evidence indicates that PPUI can increase the risk of postpartum depression by approximately 45%, and the risk of anxiety in patients with severe PPUI can be up to 3.77 times that of those without urinary incontinence. Moreover, stress urinary incontinence and depression, as well as urgency urinary incontinence and anxiety, show specific associations, respectively. The comorbidity mechanisms encompass psychosocial pathways (shame, social avoidance, decreased social support) and neurobiological pathways (estrogen fluctuations leading to serotonin dysfunction, central sensitization, etc.). Notably, cultural and economic backgrounds may modulate their association, for instance, religious and cultural factors that can exacerbate the psychological burden associated with urinary incontinence. Current research is predominantly based on cross-sectional designs, leaving the causal temporal sequence and dynamic evolution patterns unclear. Additionally, there is a lack of large-sample longitudinal evidence from large domestic studies. Future efforts should focus on conducting long-term cohort studies to clarify the causal relationship and establishing an interdisciplinary integrated intervention model combing pelvic floor rehabilitation with mental health support, aiming to provide more comprehensive health management strategies for postpartum women.

Labor pain is a distressing experience that parturients inevitably face during childbirth, exerting multiple adverse effects on their physiological and psychological well-being. Although epidural labor analgesia has become a mainstream clinical analgesic method, it is associated with limitations such as significant individual variability in analgesic efficacy, potential impacts on labor progression, and drug-related adverse effects, which impose certain restrictions on its clinical application. Press needle, as a characteristic therapy of Traditional Chinese Medicine, offers advantages including simple operation, safety, and absence of adverse reactions. It has been widely applied in the treatment of various pain conditions with confirmed efficacy. A systematic review of studies on press needle combined with epidural labor analgesia reveals that this combined regimen provides significantly superior analgesic effects for parturients undergoing natural childbirth compared to single analgesic modalities. It can effectively improve the maternal childbirth experience, optimize maternal and neonatal outcomes, and demonstrates high clinical value for broader application. However, current research on press needle combined with epidural analgesia still faces several issues, such as small clinical sample sizes, a scarcity of multicenter studies, insufficient fundamental research on molecular mechanisms, and a lack of unified clinical application standards. Future efforts should focus on addressing these aforementioned problems to provide a more scientific basis for the application of press needle in labor analgesia, enhance its clinical efficacy, and strengthen its utilization in the field of obstetrics.

Objective: To investigate the potential pathological mechanism of oxidative stress induced preeclampsia (PE) in HTR8/SVneo cell line. Methods: Placental tissue from one patient with severe PE was collected, and mitochondrial morphology was observed using biological transmission electron microscopy. HTR8/SVneo cells were treated with 10, 20, and 50 μmol/L H₂O₂ for 24 hours, with a control group established concurrently. Intracellular reactive oxygen species (ROS) levels, mitochondrial membrane potential, and the opening degree of the mitochondrial permeability transition pore (MPTP) were detected by flow cytometry in each group. Protein levels of epithelial-mesenchymal transition (EMT)-related marker proteins were measured by western blotting. Results: In the placental tissue from the severe PE patient, mitochondrial cristae appeared swollen, fractured, reduced, or disappeared (appearing vacuolated). In HTR8/SVneo cells, with increasing concentrations of H₂O₂, intracellular ROS levels gradually increased, the mitochondrial membrane potential gradually decreased, and MPTP opening degree progressively increased. The expression of the epithelial marker E-cadherin gradually increased, while the expression of the mesenchymal markers N-cadherin and Vimentin gradually decreased. Conclusions: This study preliminarily confirms altered mitochondrial morphology in the placental tissues of PE patients. Increased ROS levels may be involved in the pathogenesis of PE by inducing mitochondrial dysfunction and inhibiting the EMT process.

Ectopic pregnancy (EP) is one of the common acute abdominal conditions in gynecology. Multiple ectopic pregnancy (MEP) is often associated with assisted reproductive technology, while spontaneous multiple ectopic pregnancy (SMEP) is rarely reported. Its diagnosis and differential diagnosis are challenging, leading to a high rate of misdiagnosis. This report presents a case of SMEP. The patient presented with a 4-year history of dysmenorrhea and one episode of prolonged menstruation. Imaging studies suggested a left ovarian endometriotic cyst and a right uterine leiomyoma. During surgery, blue-purple masses were observed at the left tubal isthmus and the right uterus cornu, leading to a tentative diagnosis of left tubal isthmic pregnancy and leiomyoma of the right uterine wall. Laparoscopic procedures including left tubal methotrexate injection, right salpingectomy, right cornual pregnancy removal, and peritoneal drainage were performed. Postoperative pathological examination confirmed a left old tubal isthmic pregnancy and a right cornual pregnancy. By discussing the reasons for misdiagnosis, diagnosis, and differential diagnosis in this case, we aim to enhance clinicians' understanding of SMEP, aiming to improve its preoperative diagnostic accuracy and reduce the misdiagnosis rate.

The co-occurrence of partial hydatidiform mole (PHM) and severe preeclampsia in adolescents is extremely rare in clinical practice. This condition has an insidious onset and a complex clinical picture, with no clearly established diagnostic and therapeutic guidelines. A case of a 14-year-old patient admitted to Maoming Hospital of Guangzhou University of Chinese Medicine is reported. The patient was hospitalized with primary clinical manifestations of amenorrhea for over 10 weeks accompanied by abdominal pain, nausea and vomiting, and edema of bilateral lower limbs. The serum human chorionic gonadotropin-β (β-hCG) level was markedly elevated. Ultrasonography suggested features of PHM, and the patient also met the diagnostic criteria for severe preeclampsia. Treatment consisted of uterine evacuation combined with symptomatic management including antihypertensive and antispasmodic therapy. Postoperatively, the patient's symptoms gradually resolved, and her β-hCG levels progressively declined. The patient was lost to follow-up when her β-hCG level dropped to 28.725 U/L, and her long-term prognosis remains unknown. This case highlights the need for clinicians to strengthen their diagnostic and therapeutic awareness of such a unique disease entity. For such rare cases, it is crucial to obtain a timely history, achieve early and precise identification and diagnosis, manage the acute condition effectively, and emphasize follow-up management. This case provides practical reference for the clinical management of similar cases.