Background: The vaginal microbiome is closely associated with the onset and recurrence of bacterial vaginosis (BV). In the present study, the state of vaginal microbiota during the onset and post-treatment asymptomatic stages of BV were compared to that of a healthy population to evaluate the changes in different characteristic bacteria during the onset, progression, and remission of BV. Methods: A case–control study was performed to explore these changes. Women with clinical symptoms of BV were divided into the disease group (M) and case–control group (C) based on the Nugent score. Subjects in the disease group whose symptoms were resolved after the treatment were assigned to the treated group (T) and healthy subjects were recruited into the normal control (N) group. The V3–V4 hypervariable regions of bacterial 16S rRNA genes were sequenced on the Illumina MiSeq platform. Results: The N harbored the highest number of detected species and a higher abundance of microbiota; they had a significantly higher abundance of Lactobacillus and different bacterial community composition compared to the other three groups. In group M, Gardnerella vaginalis was the dominant species, whereas Lactobacillus iners was predominant in the other three groups. While Lactobacillus was more commonly present in Group C compared to group M. it was significantly increased in group T. Alpha diversity analysis of bacterial communities revealed significant differences in community richness and diversity among all four groups (p < 0.05). Significant differences in the distribution of various bacterial communities among the different groups were also observed (p < 0.05). Specifically, the abundance of eight bacterial taxa (Megasphaera, Aerococcus christensenii, Clostridiales, Gardnerella, Peptostreptococcus, Veillonellaceae, Akkermansia, Coriobacteriales) differed significantly among the four groups (p < 0.05). Conclusion: Significant differences in the composition and alpha diversity of the vaginal microbiota at different stages of BV and the distribution of bacterial communities were observed among the investigated groups. In addition to Gardnerella, Sneathia sanguinegens and Prevotella timonensis play an important role in the pathogenesis of BV. The appearance of BV-like clinical symptoms was closely associated with the decrease in Prevotella and Atopobium vaginae populations.

Vulvovaginal candidiasis (VVC) represents a global health issue. However, epidemiological data on VVC in eastern China are scarce, limited, and outdated. To address this gap, we conducted a six-year retrospective study (2019–2024), investigating the epidemiological characteristics, species distribution, and antifungal susceptibility patterns of VVC patients in Shanghai, China. VVC was confirmed based on clinical symptoms combined with laboratory examination. Candida species were identified by MALDI-TOF MS, and in vitro antifungal susceptibility testing (AFST) was carried out using the ATB FUNGUS 3 method. The epidemiological changes over time were analyzed using the χ 2 test for trend. In total, 7,894 VVC episodes were identified among 7,167 individuals. Of these, 39 patients (0.54%) exhibited mixed Candida infections. Candida albicans was the predominant species (77.26%), followed by Candida glabrata (17.63%), Candida parapsilosis (1.53%), Candida tropicalis (1.17%), and Candida krusei (1.00%). Other species were rare, each accounting for less than 1.0%. VVC shows high prevalence in our region, with C. albicans as the most prevalent pathogen, followed by C. glabrata . And an increasing trend in C. glabrata VVC was observed, accompanied by consistently high rates of voriconazole resistance. Fluconazole resistance was observed in 18.82% of C. albicans with cross-resistance to other azoles. Thus, our findings highlight the significance of Candida species identification and accurate diagnosis in VVC, underscoring the necessity for targeted antifungal management. IMPORTANCE: Vulvovaginal candidiasis is a widespread condition among women, associated with significant emotional, physical, and economic burdens, and presents ongoing challenges in diagnosis and management. Our six-year Shanghai study reveals Candida species caused 9.66% of vaginitis cases, with C. albicans remaining predominant and showing alarming fluconazole resistance (18.82%). Particularly concerning is the rising trend of non-albicans Candida , especially C. glabrata . These findings critically emphasize the necessity of implementing routine species identification and continuous antifungal susceptibility testing in China to guide targeted therapy, curb resistance spread, and optimize VVC management strategies.

Background: Dyslipidemia plays a significant role in the pathogenesis of gestational diabetes mellitus (GDM). However, the association between lipoprotein(a) (Lp(a)), a known predictor of cardiovascular disease, and GDM remains unclear. This study aimed to investigate the association between serum Lp(a) levels within the first 20 weeks of gestation and the subsequent risk of developing GDM. Methods: We conducted a retrospective cohort study of 14,527 pregnant women between September 2021 and January 2024. Using propensity score matching (PSM), 922 women with GDM were matched with 922 women with normal glucose tolerance (NGT). Lp(a) levels measured within the first 20 gestational weeks were compared between the two groups. A logistic regression model was employed to assess the association between Lp(a) levels and the later development of GDM. Additionally, restricted cubic spline regression models were applied to examine whether a nonlinear relationship existed between Lp(a) and GDM risk. Finally, sensitivity analyses across subgroups were conducted to assess the robustness of the findings. Results: Serum Lp(a) levels within the first 20 weeks of gestation were significantly lower in the GDM group compared to the NGT group ( p = 0.013). After adjustment for potential confounders, compared to the group with Lp(a) ≥300 mg/L, those with Lp(a) levels of 50–300 mg/L and ≤50 mg/L exhibited a higher risk of developing GDM, with adjusted odds ratios of 1.354 (95% CI: 1.059-1.732; p = 0.016) and 1.454 (95% CI: 1.073-1.970; p = 0.016), respectively. Subgroup analysis indicated that maternal age, pre-pregnancy body mass index (BMI) and gestational weeks of Lp(a) measurement did not significantly influence the association between Lp(a) levels and GDM. Conclusion: Low Lp(a) levels within the first 20 weeks of gestation were associated with the subsequent development of GDM, independent of maternal age and pre-pregnancy BMI.

Objective: The aim of this study was to investigate the relationship between human epididymis protein 4 (HE4) levels in seminal plasma and semen liquefaction in males. Methods: A total of 314 healthy men from the andrology department were included. The correlations between HE4 levels and prostate‐specific antigen (PSA) levels as well as conventional semen parameters (sperm density, the proportion of non‐progressively motile spermatozoa, seminal liquefaction time) were analyzed, and logistic regression was further employed to examine the association between HE4 levels and the risk of poor semen liquefaction. Results: The level of HE4 in seminal plasma was negatively correlated with semen liquefaction time (r = −0.207, p < 0.001) and positively correlated with seminal plasma PSA levels ( r = 0.280, p < 0.001), suggesting a potential link to the process of semen liquefaction. Continuous HE4 levels were standardized by dividing by 100, and participants were then categorized into quartiles (Q1–Q4) based on the standardized HE4 values. After adjusting for confounding factors, the risk of poor semen liquefaction in the Q3, Q2, and Q1 groups of the lower HE4 level was 4.024 times (95% CI: 1.908–8.485; p < 0.001), 6.320 times (95% CI: 2.818–14.175; p < 0.001), and 5.190 times (95% CI: 2.217–12.15; p < 0.001) higher, respectively, compared to the highest HE4 quartile (Q4). Conclusion: This suggests that a low level of HE4 in seminal plasma is an independent risk factor for poor semen liquefaction.

Background With the gradual severe bacterial resistance and slow development of antibiotics, drug-resistant bacterial strains are widely distributed and have become a serious public health problem. Group B Streptococcus (GBS) which cause Group B strep-related disease is the major cause of severe infection in newborns. However, Clindamycin resistance of GBS induced by Erythromycin is emerging and become important clinical concerns today. Methods A retrospective study was conducted on the drug resistance analysis of GBS strains isolated from Obstetrics and Gynecology Hospital from Jan 2016 to Dec 2017. The clinical and microbiological data including patient demographics, antimicrobial susceptibility testing, relative distribution drug resistance-associated genes mefA & ermB to Erythromycin, and multilocus sequence typing (MLST typing) were collected and analyzed. The Kirby-Bauer and VITEK2-compact were used to perform the susceptibility testing. The double disk diffusion method (D-test) was used for the detection of inducible clindamycin resistance. MLST was employed to identify sequence types of these strains. Polymerase Chain Reaction (PCR) was conducted to detect the drug resistance genes mefA & ermB to Erythromycin. Results A total of 1021 strains were cultured and isolated from 31894 specimens. Erythromycin and clindamycin resistance was 53.6%（547/1021）and 50.1 % (512/1021), respectively, in which 74.4%（407/547）had harbored constitutive macrolide, lincosamide and streptogramin B resistance (cMLS B ), 45.0%（63/140）were inducible MLS B (iMLS B ). Additionally, MLST identified 12 different ST types including a new ST type ST1072 in 63 iMLS B GBS strains and the dominant STs were ST12 (30.1%) and ST19 (25.4%). The resistance ratio of ST19 to Levofloxacin (75.0%) was higher than that of other ST types. The relevance resistance ratio of mefA and ermB was respectively 27.0% and 41.3% among 63 GBS isolates. Conclusion Our study not only demonstrated a genetic diversity in iMLS B GBS in Shanghai through the analysis of MLST typing and resistance genes, but also found that there exist different distribution patterns of resistance and related resistance genes between different ST types. These findings would provide theoretical support for clinical prevention and treatment of resistant iMLS B GBS infection.