Limin Feng

Background: BPA is a ubiquitous endocrine disruptor linked to ovarian cancer, yet its effect on chemotherapy efficacy is unknown. CAFs drive drug resistance via microenvironment remodeling. We investigated whether BPA exposure is associated with chemoresistance via CAF-mediated stromal reprogramming. Methods: We performed single-cell RNA sequencing on ovarian cancer samples across treatment-naive, post-chemotherapy, and recurrent states (n = 10). BPA target gene set activity was quantified across cell types using AUCell scoring. Fibroblasts were re-clustered to characterize CAF subtypes. BPA target genes were integrated from public databases, with core targets prioritized through protein-protein interaction networks and molecular docking. Machine learning models were built for chemoresistance prediction, and in vitro validation was performed; CellChat inferred intercellular communication dynamics. Results: Fibroblasts exhibited the highest BPA-driven activity among all tumor cells. The extracellular matrix CAF (ecmCAF) subtype showed elevated BPA scores. Integration of BPA targets, ecmCAF markers, and recurrence signatures yielded hub genes, with molecular docking predicting favorable BPA binding to PTGS2 (−7.7), MMP2 (−7.6), and SERPINE1 (−7.5 kcal/mol). CellChat revealed heightened CAF-to-epithelial pro-EMT and CAF-to-immune suppressive signaling in the recurrent sample. In vitro validation further showed that BPA treatment increased ACTA2 and COL1A1 expression in CAFs and that conditioned medium from BPA-treated CAFs enhanced SKOV3 resistance to cisplatin. Conclusion: The BPA-ecmCAF axis represents a novel mechanism linking environmental exposure to ovarian cancer chemoresistance through microenvironment remodeling. These findings identify ecmCAF effectors as candidate exposure biomarkers and suggest that environmental risk assessment should consider the potential of BPA to compromise cancer treatment outcomes.

Objectives: To identify molecular and clinical predictors of cervical lesion progression and construct an integrated nomogram model for personalized risk assessment in patients with LSIL. Methods: Transcriptomic data from the GEO database were analyzed for differentially expressed genes (DEGs). GO and KEGG enrichment analyses identified biological functions and pathways, while STRING network screened candidate core genes. Immunohistochemistry was performed on patient samples to evaluate the expression of key proteins associated with progression. A prediction model using Cox regression and a random forest algorithm was developed based on clinical data and immunohistochemical markers, with model discrimination and potential clinical net benefit assessed by ROC and decision curve analysis (DCA). Results: We identified 221 upregulated and 161 downregulated DEGs. Key progression-related genes included CDKN2A, CALML5, GINS2, KCNH1, MCM2, MKI67 , and ESR1 . Immunohistochemical validation in 155 patients showed that Eag1, p16INK4a, and Ki-67 correlated with poor outcomes. Colposcopic lesion involvement across cervical quadrants showed an inverse association with progression, while bacterial vaginosis was a risk factor. The prediction model showed favorable discrimination (AUC: 0.914/0.753 for 1-year and 0.941/0.769 for 2-year progression). DCA suggested potential clinical net benefit across selected threshold probabilities. External validation is needed to confirm the generalizability and clinical utility of the model. Conclusion: This study identifies candidate biomarkers and clinical factors associated with cervical lesion progression and provides a preliminary prediction model for risk stratification.

Objective: This study aimed to assess the safety of vaginoscopic polypectomy for managing cervical polyps during pregnancy and to identify factors influencing postoperative obstetric outcomes. Methods: We conducted a retrospective analysis of 99 pregnant patients who underwent vaginoscopic polypectomy for cervical polyps at Beijing Tiantan Hospital between January 2017 and February 2025. Based on pregnancy outcomes, patients were categorized into three groups: term delivery ( n = 88), preterm delivery ( n = 6), and spontaneous abortion ( n = 5). Clinical characteristics were compared, and risk factors associated with pregnancy outcomes were analyzed. Patients were also classified into the cervical polyp group ( n = 67) and the cervical decidual polyp group ( n = 32) based on pathological diagnosis for further comparison of clinical features and prognosis. Results: All cervical polyps were resected successfully in a single procedure without any perioperative complications during pregnancy. The rates of term delivery, preterm delivery, and spontaneous abortion were 88.88% (88/99), 6.06% (6/99), and 5.05% (5/99), respectively. Preoperative vaginitis and postoperative recurrent bleeding differed significantly among the outcome groups (both p < 0.001) and were significantly associated with adverse pregnancy outcomes. Compared with the cervical polyp group, the decidual polyp group had a significantly greater polyp width, an earlier gestational age at diagnosis, and a higher rate of postoperative bleeding ( p = 0.005, 0.013, and 0.036, respectively). However, the incidence of adverse pregnancy outcomes (preterm delivery and abortion) did not differ significantly between the two pathological groups ( p > 0.05). Conclusion: In this observational clinical study, vaginoscopic polypectomy appeared to be a feasible and well-tolerated intervention for symptomatic cervical polyps during pregnancy. Preoperative vaginitis and postoperative rebleeding were identified as key factors associated with adverse obstetric outcomes. These findings highlight the importance of rigorous perioperative infection control and the prompt management of bleeding in this specific population. Further large-scale, prospective, controlled studies are warranted to confirm the procedure’s therapeutic effect and to validate the factors identified in this analysis.

Aplastic anemia (AA) is a rare childhood blood disease characterized by anemia, infection, and a tendency for hemorrhage. AA may present as abnormal uterin

Background: Recurrent intrauterine adhesions (IUAs) after hysteroscopic adhesiolysis severely compromise fertility. This randomized trial investigated the efficacy of a pioneering silicone rubber uterine stent in preventing adhesion reformation. Methods: In a single-center, double-blind trial, 45 patients with moderate-to-severe IUAs underwent hysteroscopic adhesiolysis. The patients were randomized to receive a silicone rubber uterine stent (treatment group) or an auto-crosslinked hyaluronic acid gel. Intrauterine device (IUD) and 12-f Foley balloon catheter at the end of surgery (control group). All patients underwent second-look hysteroscopy at 2–3 months and hormonal therapy for two cycles after surgery. Pregnancies over 5 years were followed up. Results: Both groups had reduced American Fertility Society (AFS) scores postoperatively ( P < 0.005), but the stent group achieved significantly greater reductions ( P = 0.003). Severe IUA subgroup analyses revealed near-doubled AFS score improvements with stents versus controls ( P = 0.023). The stent group demonstrated superior uterine cavity restoration, with markedly better involvement range scores ( P < 0.05). The long-term data revealed that stent-treated patients had higher cumulative pregnancy rates (59.1% vs. 34.8%), with advantages emerging as early as 6 months post-surgery. Conclusion: Silicone uterine stents represent a breakthrough in preventing post-adhesiolysis IUAs, particularly for severe cases, offering enhanced anatomical recovery and fertility outcomes. This innovation addresses a critical unmet need in reproductive surgery, providing a robust strategy to safeguard fertility potential.

Intrauterine adhesion (IUA) is a common cause of clinically refractory infertility, and there exists significant heterogeneity in the treatment outcomes among IUA patients with the similar severity after transcervical resection of adhesion(TCRA). The underlying mechanism of different treatment outcomes occur remains elusive, and the precise contribution of various cell subtypes in this process remains uncertain. Here, we performed single-cell transcriptome sequencing on 10 human endometrial samples to establish a single-cell atlas differences between patients who responded to estrogen therapy and those who did not. The results showed increased infiltration of immune cells such as monocyte macrophages, T cells, and natural killer (NK) cells in patients who did not respond to estrogen therapy. Our findings indicate that distinct fibroblast subsets are implicated in the modulation of the Wnt, Hippo, and Hedgehog signaling pathways, as evidenced by functional enrichment analyses. This may have implications for the therapeutic efficacy in patients with IUA. Furthermore, we delineated the markers and transcriptional status of different macrophage subsets and identified two cell clusters, CXCL10high and CCL4L2high macrophage subsets, which are intimately associated with inflammation and fibrosis. The state of fibrosis and inflammatory response in human endometrial tissues with disparate treatment outcomes is revealed, and providing evidence to clarify the underlying determinants of sensitivity to estrogen therapy. We described the transcriptional status of different cell subtypes in the two groups of patients, providing new ideas for exploring the molecular mechanism of the difference in the effectiveness of estrogen therapy in patients, and providing theoretical basis for providing precise and individualized treatment plans for IUA patients.

BackgroundThe study aims to investigate the application of surgical vaginoscopy via a no-touch hysteroscopic approach for the management of female genital polyps. The primary objective is to assess the feasibility of this technique in treating intrauterine pathologies in both pregnant and non-pregnant women.MethodsA total of forty-six patients diagnosed with genital polyps underwent operative vaginoscopy at a university-affiliated hospital between April 1, 2017 and May 31, 2023. A retrospective analysis was conducted on the collected data, encompassing patient complaints, clinical presentations, surgical outcomes, and pathological diagnoses. Additionally, the success rate of the vaginoscopic procedures was determined.ResultsForty-six patients with an average age of 33.0 +/- 8.8 years were included in this study. Among them, 25 were non-pregnant (3 with and 22 without a sexual history). The most common clinical manifestation was irregular vaginal bleeding (11/25, 44%) followed by conscious vaginal protrusion (10/25, 40%). Among the 21 pregnant patients, the main symptom was irregular vaginal bleeding during pregnancy (100%). The postoperative pathological diagnoses included 11 endometrial polyps, 33 cervical polyps, 1 multiple vaginal polyps, and 1 vaginal stump polyps. The coincidence rate between the intraoperative vaginoscopic diagnosis and postoperative pathological diagnosis was 100%. Among the non-pregnant patients, 11 were diagnosed with endometrial polyps, with an average length of 2.2 +/- 1.2 cm, 1 patient had vaginal residual polyps after total hysterectomy, with a polyp length of 0.3-0.7 cm, and 1 had multiple vaginal polyps, with a length of 0.5-3 cm. Twelve patients had cervical polyps with an average length of 3.4 +/- 1.2 cm. Twenty-one pregnant patients were diagnosed with cervical polyps, the average length of 2.4 +/- 1.4 cm. All patients successfully underwent vaginoscopic surgery, for an average surgical duration of 23.5 +/- 14.9 min, a bleeding volume of 1-10 mL(4.5 +/- 3.4 mL), and an average hospitalisation of 2.7 +/- 1.3 days. Throughout the surgical procedures, no complications were encountered, including water intoxication or uterine perforation. Postoperatively, no patients experienced discomforts such as fever or moderate to severe abdominal pain. Furthermore, all non-pregnant women were monitored for a two-month period following surgery, and throughout this interval, there were no reports of abnormal vaginal bleeding, unusual vaginal discharge, or abdominal pain. None of the 21 pregnant women experienced abnormal vaginal bleeding after the surgery. Nineteen of them delivered at full term, and one underwent caesarean delivery at 31 weeks owing to placental abruption. All the newborns had Apgar scores of 10, 10, and 10, and one had a miscarriage at 18 weeks of gestation.ConclusionVaginoscopic surgery through no-touch hysteroscope represents a minimally invasive and highly effective method for addressing female reproductive tract polyps. This approach holds significant clinical value, particularly in the management of cervical polyps during pregnancy.

Krukenberg tumor is a relatively uncommon metastatic ovarian cancer, typically presenting with abdominal pain and distension, primarily due to bilateral ovarian involvement. Pseudo-Meigs' syndrome, caused by a Krukenberg tumor originating from gastric cancer, is extremely rare. In this study, we report the case of a 39-year-old woman who presented with unusual manifestations of a Krukenberg tumor, where abdominal distension and dyspnea were the primary symptoms. After surgical treatment, a histopathological examination of the ovary revealed the presence of signet ring cell carcinoma. We concluded that this case coincided with Pseudo-Meigs' syndrome. Clinicians should note that Pseudo-Meigs' syndrome should be considered in patients with Krukenberg tumor, ascites, and pleural effusion, as resection of the tumor may provide long-term palliation.

Purposes This study aims to assess the effectiveness and safety of cervical polypectomy performed via vaginoscopy in pregnant women. Methods Pregnant patients diagnosed with cervical polyps were retrospectively included in Beijing Tiantan Hospital between April 2017 and April 2023. Group A underwent cervical polypectomy using a vaginoscopy technique without speculum, cervical forceps and anesthesia, while Group B received conservative management. The incidence of spontaneous abortion, preterm birth, preterm rupture of membranes (PROM), visual analog scale (VAS) scores, timing and method of delivery, and neonatal outcomes were analyzed. Results Of 90 pregnant patients included in the study, 48 patients receiving polypectomy under vaginoscopy were included into group A while 42 patients receiving conservative treatment were assigned into group B. At baseline, group A exhibited higher rates of vaginal bleeding pre-operation, as well as larger cervical polyp dimensions compared to group B. The median interval between vaginal bleeding and polypectomy was 3.5 weeks, with the median procedure typically performed at gestational week 19 in group A. There was no significant difference in the incidence of spontaneous abortion between the two groups (4.2% vs. 4.8%, p = 1.000). However, group A showed a significantly lower frequency of preterm birth (4.2% vs. 21.4%, p = 0.030) and premature rupture of membranes (PROM) (18.8% vs. 45.2%, p = 0.025) compared to group B. No disparities were observed in the timing, mode of delivery, and neonatal outcomes between the two groups. Conclusions The utilization of vaginoscopy for cervical polypectomy has been shown to decrease the likelihood of preterm delivery and premature rupture of membranes in pregnant women with symptomatic cervical polyps. Therefore, performing cervical polypectomy via vaginoscopy without anesthesia provide a feasible and optimal ways in the management of this population.