To investigate the clinical characteristics, diagnosis, and clinical treatment of submucosal cystic adenomyosis. The clinical data of five cases of patients with submucosal cystic adenomyosis in our hospital from January 2020 to June 2023 were retrospectively analyzed. The average age of the patients was 37.8 ± 4.5 years old, three of them experienced prolonged menstruation and heavy menstrual bleeding. All patients had a history of abnormal uterine bleeding and mild to moderate dysmenorrhea, with a VAS score of 2.8 ± 1.6. The average Carbohydrate antigen 125 (CA125) value was 29.9 ± 23.6U/ml. Two out of the five patients (40%) had CA125 values above the upper limit of normal. The nodules had a diameter of 3.2 ± 1.3 cm and a cavity size of 1.3 ± 0.7 cm. Color ultrasound revealed hypo or iso or anechoic echoic cysts, and blood flow signals were detected. The magnetic resonance imaging (MRI) findings varied among each patient. All the patients underwent hysteroscopy and resection of uterine cavity-occupying lesions, and no recurrence was observed. The clinical features of submucosal cystic adenomyosis include abnormal uterine bleeding and menstrual changes, and the degree of dysmenorrhea is generally not severe. The diagnostic utility of CA125 in submucosal cystic adenomyosis may be limited. The three-dimensional ultrasound and MRI are valuable preoperative examination methods currently. Hysteroscopy can not only diagnose submucosal cystic adenomyosis, but also treat it, and preserve the fertility function of the patient.

Endometriosis (EMs) is a chronic disease affecting millions of women worldwide, yet its pathogenesis remains unclear, and current diagnostic methods are limited. This study based on the EMs dataset from Gene Expression Omnibus (GEO), key genes related to cell apoptosis in EMs were identified through methods such as differential expression analysis and machine learning. Furthermore, analyses including nomogram construction, immune infiltration analysis, and drug prediction were performed based on these key genes. Three apoptosis-related genes—FAS, PRKAR2B and CSF2RB were identified as key genes. The nomogram constructed based on these key genes has good predictive performance. Immune infiltration analysis revealed associations between CSF2RB and activated B cells and immature dendritic cells, while FAS correlated with myeloid-derived suppressor cells (MDSCs). Additionally, potential therapeutic agents targeting these genes were identified. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) analysis revealed that FAS and CSF2RB expression levels were significantly downregulated in the EMs group compared to controls (P < 0.05). In conclusion, FAS, PRKAR2B and CSF2RB are promising diagnostic biomarkers for EMs and are associated with specific immune cell populations, offering potential targets for future therapeutic interventions.

Introduction: Managing biopsy-confirmed cervical intraepithelial neoplasia grade 2 (CIN2) in women of reproductive age poses clinical challenges. Immediate treatment with large-loop excision of the transformation zone (LLETZ) is associated with a substantial risk of adverse obstetric outcomes. This study aimed to identify the risk factors for predicting CIN3+ lesions in reproductive-aged women with biopsy-diagnosed CIN2, to inform personalized management strategies that are particularly relevant to China’s evolving fertility policies. Methods: This retrospective cohort study analyzed the data from a regional cervical lesion screening database. Reproductive-aged women (<45 years) with biopsy-confirmed CIN2 who underwent subsequent LLETZ between 2016-2024 were included in the study (n=516). Pathological upgrade was defined as CIN3+ in the LLETZ specimen. Univariate and multivariate logistic regression analyses identified independent risk factors for pathological upgrade. Results: Following LLETZ, 18.4% (95/516) of the women had CIN3+ lesions, indicating biopsy underestimation. HPV 16 (56.3%) and HPV 52 (27.5%) were the most prevalent genotypes in CIN3+ and CIN2- groups, respectively. Multivariable analysis identified three independent predictors: liquid-based cytology (TCT) ≥HSIL (OR = 6.308; 95% CI: 2.390-16.650; P <0.001); specific HR-HPV genotypes: HPV 16 infection (OR = 2.372; 95% CI: 1.165-4.831; P =0.017) and HPV 33 infection (OR = 3.263; 95% CI: 1.035-10.292; P =0.044); endocervical curettage (ECC) ≥CIN2 (OR = 3.067; 95% CI: 1.474-6.384; P =0.003). Age did not increase the risk of developing CIN3+ lesions. Conclusion: This risk-stratification model offers evidence-based guidance for optimizing individualized treatment decisions in clinical settings where fertility preservation is prioritized.

Ovarian cancer (OC) is characterised by high malignancy. Tumour immune microenvironment (TME) may serve as a breakthrough for therapy. Chemokines are responsible for the recruitment of diverse immune cells in TME. We identify the association between chemokines and T and NK cells. This study was conducted to screen the chemokine derived from T and NK cells in OC single‐cell RNA sequencing (scRNA‐seq) dataset was acquired from the GEO database. Total 64 genes were collected. The intersection of marker genes of T and NK cells and chemokine‐related genes was considered as key chemokine‐related genes. Then, cell‐cell communication analysis, pseudotime analysis and transcription factors (TFs)–target genes regulatory network construction, were performed. Immunohistochemical staining experiments and wound healing assays are performed. The results found 21 distinct cell subgroups and 8 core cell types. Total 667 and 611 marker genes were identified in T and NK cells, respectively. Eight key chemokine‐related genes were found. Also, 49 TFs‐related to cell subtypes were obtained, and the TFs with the highest activation degree was SPI1. Eight key chemokine‐related genes were mainly distributed in T cells, NK cells and monocyte cells. The pseudotime trajectory shown that key chemokine‐related genes were highly expressed in T and NK cells in the later stage of differentiation. CCL5 exhibits differences in ovarian malignant tumour tissues compared with normal ovarian tissues. These findings provide novel insights for subsequent exploration in OC.

Background: The levonorgestrel-releasing intrauterine system (LNG-IUS) is effective for adenomyosis, yet expulsion frequently limits its clinical application. This study aimed to compare clinical outcomes of three hysteroscopic LNG-IUS placement techniques for adenomyosis. Methods: This retrospective cohort recruited 131 adenomyosis patients (non-suture fixation n = 32, suture fixation n = 23, conventional placement n = 76) at Fujian Maternity and Child Health Hospital from October 2024 to October 2025. The primary outcome was LNG-IUS expulsion or displacement. Follow-up assessments were performed at baseline, 1 month and 6 months after placement for uterine volume, endometrial thickness, hemoglobin, carbohydrate antigen 125, dysmenorrhea and menstrual blood loss. Intraoperative parameters and postoperative adverse events were recorded. Between-group comparisons used ANOVA or Kruskal-Wallis tests; within-group changes used repeated-measures ANOVA or the Friedman test, with Bonferroni correction for multiple comparisons. Subgroup analysis was stratified by uterine cavity depth (cut-off 9.0 cm). Propensity-score matching (1:1:1), generalized estimating equations (GEE) and Cox regression were applied for data analyses. Results: Expulsion or displacement rates at 1 and 6 months were 0% in both fixation groups versus 19.74% and 27.63% in the conventional group ( P < 0.01). All groups achieved significant improvements in clinical parameters ( P < 0.001). For patients with uterine cavity depth > 9.0 cm, fixation techniques yielded lower expulsion or displacement rates and superior 6-month clinical improvements versus conventional placement; comparable efficacy was observed among all groups for depth ≤ 9.0 cm. Operation time was shorter for non-suture fixation and conventional placement than suture fixation ( P < 0.001), whereas intraoperative blood loss and adverse reactions were similar ( P > 0.05). In the PSM-matched cohort ( n = 23 per group), expulsion-displacement remained 0% in fixation groups vs. 69.56% conventional. GEE analysis in the matched cohort further revealed significant group × time interactions across the longitudinal clinical outcomes ( P < 0.05). Cox regression identified uterine volume > 150 cm³ as the only independent risk factor (HR = 8.822, 95% CI 3. 172–24. 530, P < 0.001). Conclusions: All three methods effectively improve clinical outcomes in adenomyosis patients. For patients with cavity depth > 9.0 cm, hysteroscopic fixation methods were associated with significantly lower observed expulsion rates compared with conventional placement. Non-suture fixation has practical merits of shorter operative time and lower technical requirements. Further prospective studies are required for external validation.