Objective: To evaluate the efficacy of Cangfu Daotan Decoction and Zhibai Dihuang Decoction in the differential treatment of polycystic ovary syndrome (PCOS), based on the core indicator target evaluation. Methods: Using a random number table method, 6 rats were randomly selected from 54 female SD rats as the blank group (no modeling). The remaining rats were randomly divided into groups for the construction of obese PCOS and non-obese PCOS models, with 24 rats in each category. Each model category was further divided into the control group (obese control group/non-obese control group), the Diane-35 group, the Cangfu Daotan Decoction group and the Zhibai Dihuang Decoction group, with 6 rats in each group. The rat morphology, body mass, estrous cycle, ovarian morphology, serum sex hormones, and glucose and lipid metabolism levels were compared. Results: After modeling, except for the blank group, the rats in both the obese and non-obese control groups lacked a regular estrous cycle. The obese PCOS rats exhibited characteristics of spleen deficiency and phlegm-dampness syndrome, while the non-obese PCOS rats showed characteristics of kidney yin deficiency syndrome. After modeling, serum testosterone (T), luteinizing hormone (LH), fasting blood glucose (FBG), fasting insulin (FINS), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) in the obese and non-obese control groups were significantly higher than those in the blank group. LH in the non-obese control group was significantly higher than in the obese control group, while TC, TG, and LDL-C in the obese control group were significantly higher than in the non-obese control group (all P<0.05). After administration, serum T and LH in the Diane-35 group and Cangfu Daotan Decoction group were significantly lower than in the obese control group, and FINS, TC, TG, LDL-C, ovarian volume, and mass in the Cangfu Daotan Decoction group were lower than in the obese control group (all P<0.05). In non-obese PCOS rats, after administration, serum T and LH in the Diane-35 group and Zhibai Dihuang Decoction group were significantly lower than those in the non-obese control group, and FINS, TG, LDL-C, ovarian volume, and mass in the Zhibai Dihuang Decoction group were lower than those in the non-obese control group (all P<0.05). Conclusions: This study experimentally confirms that obesity can serve as a typical characteristic for the differential diagnosis of PCOS. The treatment of obese PCOS with Cangfu Daotan Decoction and non-obese PCOS with Zhibai Dihuang Decoction yields significant effects. This highlights the wisdom of the traditional Chinese medicine principle of "treating the same disease with different methods" and provides animal experimental data supporting the syndrome differentiation and classification treatment of PCOS in traditional Chinese medicine.

Objective: To examine the impact of prenatal intrauterine exposure to high anti-Müllerian hormone (AMH) and androgen on the gut microbiota in F1 offspring mice. Methods: Pregnant F0 dams were randomly allocated into three groups. To simulate altered prenatal hormonal environments, F0 dams received daily subcutaneous injections from embryonic day 16.5 to embryonic day 18.5 as follows: benzyl benzoate with sesame oil, benzyl benzoate with sesame oil and anti-Müllerian hormone (AMH), or benzyl benzoate with sesame oil and dihydrotestosterone. Their female F1 offspring were correspondingly designated as the control group (Con group), prenatal AMH group (PAMH group), and prenatal androgenized group (PNA group). Upon reaching adulthood, the estrous cycle of F1 female offsprings were monitored and assessed for regularity. Ovarian tissue and cecal contents were collected for histological evaluation and gut microbiota profiling via 16S amplicon sequencing. Results: Compared to the Con group, the PNA and PAMH groups exhibited disrupted estrous cyclicity and notable histological abnormalities in ovarian morphology, while F1 offspring mice showed significant alterations in gut microbial composition. Functional predictive analysis indicated that the differentially enriched microbial taxa were predominantly involved in immune regulation and metabolic pathways. Conclusions: Prenatal intrauterine exposure to high AMH and androgen reshaped the gut microbiota structure of F1 offspring mice, which may be associated with the immune system and metabolic pathways.

Objective: To analyze the spatiotemporal evolution characteristics of online claims for free contraceptive supplies in Guangzhou and to construct a time series prediction model, thereby providing a quantitative basis for resource optimization and policy adjustment of "Internet-based services" for free contraceptives. Methods: Based on 308 419 online claim records from the Guangdong Province Free Essential Contraceptive Service Management System (2020—2024) and data of the permanent resident women of reproductive age, we conducted multi-time-scale trend analysis and spatial autocorrelation analysis. For the demand forecasting, six time-series models—seasonal autoregressive integrated moving average model (SARIMA), autoregressive integrated moving average model (ARIMA), exponential smoothing state space model (ETS), trigonometric, box-cox transformation, ARMA errors, trend and seasonal components model (TBATS), neural network autoregression model (NNAR), and Prophet model—were compared. These approaches were used to characterize the spatiotemporal patterns of online contraceptive requisitions across the 11 districts of Guangzhou and to project monthly demand for 2025—2026. Results: ①Temporal characteristics. From 2020 to 2024, the annual volume of claims was increased from 0.409 million to 3.702 million units (CAGR=65.2%), showing a step-like climb. The monthly distribution was exhibited seasonality with a "primary peak in March, and secondary peaks in September and December". The claims peaked on Mondays within the week, triggered by official account push notifications from the online platform. ② Spatial characteristics. The per capita claim volume was increased across all districts, during 2020—2024, with Baiyun and Tianhe districts having the highest volumes. The global Moran's I was consistently negative (-0.416- -0.360, P>0.05), indicating no significant spatial clustering, which suggests that the online distribution can break geographical barriers and promote service equity. ③Forecasting models. The highest accuracy of SARIMA (1,1,1) (1,1,1)[12] model was demonstrated, among the six models (MAPE=10.85%). The projected monthly online claims for free contraceptives citywide were expected to increase gradually from 316 800 units in January 2025 to 476 900 units in December 2026. The projected year-on-year growth rates for 2025 and 2026 were 20.14% and 19.01%, respectively, indicating a steady growth across all districts. Conclusions: The demand for online contraceptives in Guangzhou shows seasonality and a sustained upward trend, while demonstrating a pronounced pattern of spatial dispersion. The SARIMA model has a strong adaptability. The spatiotemporal patterns revealed by this study may provide scientific support for the precise supply of contraceptives and the optimization of digital services.

Oculocerebrorenal syndrome is an X-linked recessive genetic disorder caused by the absence or mutation of the OCRL gene, which leads to a deficiency in OCRL1 protein expression and a decrease in phosphatidylinositol 5-phosphatase activity, resulting in abnormal accumulation of substrate phosphatidylinositol-4,5-bisphosphate. This leads to the triad of ocular symptoms, severe intellectual disability, abnormal renal tubular function accompanied by chronic progressive renal failure. This disease lacks effective treatment methods and has a poor prognosis. We report a case of a fetus with enhanced bilateral lens echoes detected by prenatal ultrasound at 23⁺³ weeks of gestation in a 35 years old pregnant woman. Through genomic copy number variation sequencing and whole exome sequencing, it was found that the fetal Xq25q26.1 region was missing 741.71 kb and the OCRL gene was completely absent. The disease was ultimately diagnosed as oculocerebrorenal syndrome, and the pregnancy was terminated at 27⁺² weeks. Most of child patients were diagnosed after birth, and the life quality was poor, imposing a heavy burden on families and society. Therefore, clinical attention should be paid to abnormal manifestations of prenatal ultrasound, and prenatal genetic diagnosis should be performed promptly to make an early diagnosis, avoiding the birth of severely affected children.

Complex cortical dysplasia with other brain malformations type 1 (CDCBM1) is a disorder characterized by abnormal neuronal migration and axonal guidance defects, clinically presenting with intellectual disability, strabismus, reduced axial tone, and epilepsy. We report a case of a child presenting with developmental delay, cognitive impairment, and abnormal brain development. Trio-whole exome sequencing revealed a heterozygous missense mutation c.862G>A(p.Glu288Lys) in exon 4 of the TUBB3 gene, validated by Sanger sequencing. Neither parent carried this variant. According to the American College of Medical Genetics and Genomics (ACMG) criteria, this variant is classified as likely pathogenic (PS2+PM2+PP2). The TUBB3 gene encodes β-Ⅲ tubulin. The genetic testing results indicated that this case of CDCBM1 was caused by the heterozygous missense mutation c.862G>A(p.Glu288Lys) in TUBB3 gene, providing the evidence for the clinical diagnosis and genetic counseling of this family.

We report two cases of Crigler-Najjar syndrome (CNS). Both children presented with recurrent neonatal pathological jaundice with the increased unconjugated bilirubin. During the treatment period, blue light photo therapy was effective. However, the condition of pathological jaundice relapsed after the treatment was stopped. Genetic testing revealed respectively a homozygous mutation of c.1091C>T (p.Pro364Leu) in the uridine diphosphate glucuronosyl transferase 1A1 (UGT1A1) gene in one child, and a homozygous mutation of c.211G>A (p.Gly71Arg) combined with a heterozygous mutation of c.322C>T (p.Arg108Cys) in another one. Based on the family history, comprehensive clinical manifestations, and genetic testing, both children were diagnosed with CNS Ⅱ. CNS is a rare genetic disorder caused by mutations in the UGT1A1 gene. Genetic testing is the key to diagnosis. For neonatal recurrent pathological jaundice with the increased unconjugated bilirubin, this genetic disease should be suspected, and genetic testing should be completed as soon as possible. Early identification and individualized treatment can significantly improve the prognosis and reduce the rate of neonatal disability and mortality.

Cervical lymphoepithelioma-like carcinoma (LEC) is a rare malignant tumor of the cervix, and its pathogenesis is still unclear. We report a case of 49-year-old female patient who presented with human papillomavirus 16 (HPV 16) infection and post-coital hemorrhage. She was diagnosed as papillary squamous cell carcinoma by histopathological biopsy under colposcope. She underwent laparoscopic transabdominal hysterectomy without uterine manipulator+bilateral adnexectomy+bilateral ovarian arteriovenous high ligation+pelvic lymph node dissection + tumor chemotherapy (intraperitoneal infusion of lobaplatin 50 mg). After surgery, she was diagnosed as cervical LEC by pathology and immunohistochemistry. The postoperative chemotherapy of adjuvant paclitaxel albumin+carboplatin was for a total of 6 cycles. No recurrence or metastasis was found through the follow-up until November 22, 2025. This case suggests that in HPV infection-related cervical tumors, the possibility of cervical LEC should be alerted. Pathological and immunohistochemical examinations are of great value in clarifying the diagnosis. Standardized surgical treatment combined with adjuvant chemotherapy may improve the prognosis of patients.

We reported a case of the pregnancy with intrauterine devices (IUD) and uterine perforation. A 28-year-old female had a history of two full-term natural deliveries in 2018 and 2022, respectively and an IUD for one year. Due to 50 days of amenorrhea and 7 days of the displaced and incarcerated IUD, she came to our hospital for treatment. Preoperative examination, combined with serum human chorionic gonadotropin (hCG) and transvaginal ultrasound, confirmed the diagnosis of the pregnancy with IUD and uterine perforation. The IUD was completely removed, and bilateral tubal ligation was performed, under the combined hysteroscopy and laparoscopy while the negative pressure aspiration induced abortion was smoothly performed under hysteroscopy. The patient was discharged 2 days after the operation. After two weeks of postoperative follow-up, hCG was decreased to the normal range. It is suggested that the diagnosis of the pregnancy with IUD complicated by uterine perforation need a comprehensive consideration of multiple factors such as the first implantation of the IUD, improper placement of the IUD, recent pregnancy and metal IUD. Taking appropriate treatment is crucial for the prognosis of the patient.

Sperm cryopreservation is a critical step of assisted reproductive technology. However, the oxidative stress induced during freeze-thawing can lead to sperm membrane damage, reduced motility, and DNA damage. Currently used antioxidants are often limited by their single-target mechanism. As a natural polyphenol, resveratrol not only directly scavenges reactive oxygen species, but also upregulates the intracellular endogenous antioxidant defense system by activating signaling pathways such as nuclear factor-erythroid 2-related factor 2 (Nrf2)/antioxidant response element (ARE), sirtuin 1 (SIRT1)/forkhead box O (FoxO), and phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt). Furthermore, resveratrol may mitigate cryodamage in sperm through multidimensional strategies, including epigenetic regulation of histone modifications and DNA methylation. Preclinical studies have demonstrated that resveratrol can effectively enhance the post-thaw sperm motility, membrane integrity, and DNA integrity across multiple animal species. Nevertheless, its clinical translation still faces challenges such as undetermined optimal dosage, limited human trial data, and low bioavailability. This review systematically elaborates on the antioxidant effects and molecular mechanisms of resveratrol, aiming to provide a theoretical reference for the development of novel cryoprotectants for sperm.

Cell-free fetal DNA (cffDNA) serves as the core biomarker for noninvasive prenatal test (NIPT), yet its low abundance in maternal plasma and the substantial maternal background interference significantly limit the sensitivity and applicability of NIPT. Leveraging the characteristic shorter fragment length of cffDNA compared to maternal cell-free DNA (cfDNA), various fragment length-based enrichment techniques have been developed, ranging from early methods such as gel electrophoresis and magnetic bead size selection to polymerase chain reaction (PCR)-based mutation sequencing, computational simulation approaches, and microfluidic systems. The technique development has markedly improved the separation efficiency and purity of cffDNA. Clinical studies demonstrate that after enrichment of the fetal fraction (FF), NIPT exhibits significantly enhanced sensitivity and specificity for common trisomy syndromes in high-risk populations (including those with low FF, advanced maternal age, obesity, and early pregnancy) while also reducing sequencing depth requirements and improving cost-effectiveness. Future research on cffDNA fragment enrichment technology will continue to evolve toward further increasing enrichment efficiency, lowering costs, simplifying operational procedures, expanding clinical applications, and promoting the integration of multiple techniques.

Oocyte senescence is the core link of fertility decline in older women. Studies have found that the decline of oocyte quality is related to the disturbance of ovarian immune microenvironment in ageing women. Imbalanced proportions of immune cells such as macrophages and T lymphocytes disrupts the immune homeostasis and drives ovarian fibrosis. The overexpression of inflammatory factors and inflammasomes directly destroys the spindle structure of oocytes and interferes with meiosis. The local chronic inflammation mediated by senescence-associated secretory phenotype (SASP) disrupts the local immune homeostasis of ovary. Mitochondrial dysfunction leads to dysfunction of immune axis, and ferroptosis activates a new type of ovarian immunosenescence, which is closely related to the synergistic regulatory effects. By destroying the oocyte skeleton, reducing meiosis ability, exacerbating oxidative stress and inducing apoptosis, these disorders directly or indirectly lead to the decline of oocyte quality and the impairment of embryonic development potential. This paper reviews the mechanisms of age-related oocyte quality decline from the perspective of immunology, and provides a reference for the subsequent development of fertility improvement strategies targeting the ovarian immune microenvironment.

Cervical cancer is one of the most common malignancies in women worldwide, and its initiation and progression are closely associated with the persistent infection of high-risk human papilloma virus (HPV). Interferon-α (IFN-α), as an important immunoregulatory cytokine, has been used as an adjuvant therapy for cervical cancer, but its efficacy varies among individuals and the mechanisms remain unclear. Bone marrow stromal cell antigen 2 (BST2) is a key downstream effector of IFN-α with distinctive antiviral function. IFN-α exerts antiviral and antitumor effects by inducing interferon-stimulated genes including BST2. Two main roles of the overexpressed BST2 in cervical cancer are: on one hand, BST2 as an innate immune factor restricts viral release; on the other hand, BST2 within the tumor microenvironment promotes tumor cell proliferation, inhibits apoptosis, and regulates macrophage polarization toward the M2 phenotype and suppresses natural killer cell cytotoxicity by activating signaling pathways such as nuclear factor-κB (NF-κB) and mitogen-activated protein kinase (MAPK) /extracellular signal-regulated kinase (ERK) pathway, thereby shaping an immunosuppressive microenvironment and facilitating immune evasion. In addition, BST2 expression is regulated by epigenetic mechanisms such as DNA hypomethylation and the long non-coding RNA FGD5 antisense 1 (lncRNA FGD5-AS1) /microRNA-129-5p (miR-129-5p) axis. The IFN-BST2-HLA (human leukocyte antigen) axis also plays a role in immune recognition and escape. This review summarizes the relationship and molecular mechanisms between IFN-α/BST2 and the occurrence and development of cervical cancer, providing a basis for developing new targeted therapies.

Polycystic ovary syndrome (PCOS), a prevalent endocrine and metabolic disorder among women of reproductive age, is one of the primary causes of female infertility. Recent studies have demonstrated that the level of vitamin D (VD) was correlated with the clinical characteristics and pathogenesis of PCOS, influencing reproductive function and outcomes of assisted reproductive technology (ART). VD may improve ART outcomes through multiple mechanisms: by regulating the hypothalamic-pituitary-ovarian axis to improve insulin resistance and hyperandrogenemia, thereby optimizing follicular development and ovulation; and by modulating the endometrial microenvironment via key receptivity genes and uterine adipokines to support embryo implantation. However, its impact on ART outcomes of PCOS women remains controversial, with the indeterminacy in optimal dosage, route and safety. Future large-scale, high-quality randomized controlled trials are needed to clarify its effects on pregnancy outcomes and establish standardized supplementation strategies.

Polycystic ovary syndrome (PCOS) is a common gynecological endocrine disorder characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology as its core features. It is often accompanied by insulin resistance (IR), metabolic syndrome and an increased risk of type 2 diabetes, impairing the reproductive health and metabolic functions of women of childbearing age. In recent years, metabolomic studies have revealed that amino acid metabolic disorders are closely associated with the occurrence and progression of PCOS. Branched-chain amino acid (BCAA) interfere with insulin signaling by activating the mammalian target of rapamycin(mTOR) pathway; abnormal metabolism of aromatic amino acid (AAA) impairs oocyte development and exacerbates inflammation; an imbalance in glutamine/glutamic acid (Gln/Glu) aggravates IR and hyperandrogenism; and homocysteine (Hcy) exacerbates IR through endoplasmic reticulum stress and inflammation. Targeting these metabolic abnormalities, intervention strategies include lifestyle modifications and nutritional supplements such as insulin sensitizers (e.g., metformin), inositol and N-acetylcysteine, which can improve IR, optimize follicular development and pregnancy outcomes. This paper reviews the mechanisms underlying the role of key amino acid metabolic disorders in PCOS and the corresponding intervention strategies, aiming to provide a new perspective for the precise diagnosis and treatment of PCOS.

Recurrent spontaneous abortion (RSA) is a common pregnancy-associated disorder in women of childbearing age. The etiology of RSA is complex, and the imbalance of immune cell homeostasis at the maternal-fetal interface represents a key pathogenic mechanism. This review summarizes the abnormal changes of major immune cell subsets and their interaction networks in RSA. T cell dysfunction is characterized by the following aspects: the reduced number and impaired function of regulatory T cells (Treg cells), especially CCR8+ decidual Treg cells; the abnormal activation of helper T cells 1 (Th1 cells) and Th17 cells; the dysfunction of immune checkpoints in CD8+ T cells; and the metabolically abnormal activation of γδT cells. Collectively, these disorders disrupt the immune tolerance at the maternal-fetal interface. Decidual natural killer cells interfere with the vascular remodeling and inflammatory homeostasis through the imbalance of receptor-ligand signaling, the loss of exosomal regulatory function, and metabolic abnormalities. The polarization imbalance of M1/M2 macrophages and the dysfunction of the ENPP2-lysophosphatidic acid (LPA) autophagy axis also contribute to the pathogenesis of RSA. In addition, the decrease or functional impairment of decidual dendritic cells impairs their ability to induce immune tolerance. These immune cells form a regulatory network, and their mutual interactions create a vicious cycle that exacerbates inflammatory responses. To summarize the core pathogenic mechanisms of various immune cells may provide an important reference for further exploration of novel diagnostic markers and therapeutic targets for RSA.

Intrahepatic cholestasis of pregnancy (ICP), an idiopathic liver disease in pregnancy, is characterized by pruritus and the elevated level of serum bile acid, which can lead to the adverse perinatal outcomes and even fetal death. This review systematically summarizes the research progress in the genomics, transcriptomics, proteomics, and metabolomics of ICP, revealing its complex molecular mechanisms and various novel biomarkers. Drug therapy of ICP focuses on the existing first-line drug: ursodeoxycholic acid, supplemented by new drugs such as rifampicin and integrated traditional Chinese and Western medicine therapy. The AI-driven nonlinear prediction models, integrating high-risk factors with clinical and laboratory data, may provide powerful decision-making tools for the early prediction, intervention, and personalized management of ICP. Multidisciplinary management emphasizes the importance of comprehensive ICP care from the perspectives of obstetrics, hepatology, and nutritional metabolism. Future research should integrated the artificial intelligence and big data, the construction of accurate prediction models, the preventive intervention strategies and the long-term management of maternal and infant health, so as to improve the adverse perinatal outcomes.