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Objective: To produce high‐quality, real‐world evidence for oncologists by collating scattered gynaecologic oncology (GO) medical records in China. Design: Retrospective study. Setting: The National Union of Real‐world Gynaecological Oncology Research and Patient Management Platform (NUWA platform). Sample Patient‐centred data pool. Methods: The NUWA platform integrated inpatient/outpatient clinical, gene and follow‐up data. Data of 11 456 patients with ovarian cancer (OC) were collected and processed using 91 345 electronic medical records. Structured and unstructured data were de‐identified and re‐collated into a patient‐centred data pool using a predefined GO data model by technology‐aided abstraction. Main Outcome Measures: Recent treatment pattern shifts towards precision medicine for OC in China. Results: Thirteen first‐tier hospitals across China participated in the NUWA platform up to 7 December 2021. In total, 3504 (30.59%) patients were followed up by a stand‐alone patient management centre. The percentage of patients undergoing breast cancer gene (BRCA) mutation tests increased by approximately six‐fold between 2017 and 2018. A similar trend was observed in the administration rate of poly(ADP‐ribose) polymerase inhibitors as first‐line treatment and second‐line treatment after September 2018, when olaparib was approved for clinical use in China. Conclusion: The NUWA platform has great potential to facilitate clinical studies and support drug development, regulatory reviews and healthcare decision‐making. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the effect of omentectomy on the prognosis and fertility in patients with clinically early‐stage (I, II) malignant ovarian germ cell tumours (MOGCT). Design: A retrospective multicentre study. Setting: Four university teaching hospitals in China. Population: A total of 268 patients with clinically apparent early‐stage (I, II) MOGCT. Methods: Data were obtained from the medical records. Additionally, the propensity score matching (PSM) algorithm was adopted. Main outcome measures: Prognostic outcomes were disease‐free survival (DFS) and overall survival (OS). Fertility outcomes were pregnancy and live birth rates. Results: A total of 187 (69.8%) patients underwent omentectomy. Kaplan–Meier analysis showed no significant differences in DFS and OS between the omentectomy and non‐omentectomy groups before and after PSM (p > 0.05). Additionally, subgroup analysis stratified by age (<18 and ≥18 years) showed similar results. International Federation of Gynecology and Obstetrics (FIGO) stage was the only risk factor associated with DFS (hazard ratio [HR] 14.71, 95% confidence interval [CI] 4.47–48.38, p < 0.001) and OS (HR 37.36, 95% CI 3.87–361.16, p = 0.002). Pregnancy and live birth rates in the total population were 80.3% and 66.7%, respectively. There were no significant differences between the two groups before and after PSM. Conclusions: Omentectomy did not improve survival or affect fertility in patients with clinically apparent early‐stage (I, II) MOGCT, regardless of the age. The clinical FIGO stage was an independent risk factor for recurrence and death. [ABSTRACT FROM AUTHOR]

Background: Limited information exists on the incidence of postoperative deep venous thromboembolism (DVT) in patients with isolated patella fractures. The objective of this study was to investigate the postoperative incidence and locations of deep venous thrombosis (DVT) of the lower extremity in patients who underwent isolated patella fractures and identify the associated risk factors. Methods: Medical data of 716 hospitalized patients was collected. The patients had acute isolated patella fractures and were admitted at the 3rd Hospital of Hebei Medical University between January 1, 2016, and February 31, 2019. All patients met the inclusion criteria. Medical data was collected using the inpatient record system, which included the patient demographics, patient's bad hobbies, comorbidities, past medical history, fracture and surgery-related factors, hematological biomarkers, total hospital stay, and preoperative stay. Doppler examination was conducted for the diagnosis of DVT. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors. Results: Among the 716 patients, DVT was confirmed in 29 cases, indicating an incidence of 4.1%. DVT involved bilateral limbs (injured and uninjured) in one patient (3.4%). DVT involved superficial femoral common vein in 1 case (3.4%), popliteal vein in 6 cases (20.7%), posterior tibial vein in 11 cases (37.9%), and peroneal vein in 11 cases (37.9%). The median of the interval between surgery and diagnosis of DVT was 4.0 days (range, 1.0-8.0 days). Six variables were identified to be independent risk factors for DVT which included age category (> 65 years old), OR, 4.44 (1.34-14.71); arrhythmia, OR, 4.41 (1.20-16.15); intra-operative blood loss, OR, 1.01 (1.00-1.02); preoperative stay (delay of each day), OR, 1.43 (1.15-1.78); surgical duration, OR, 1.04 (1.03-1.06); LDL-C (> 3.37 mmol/L), OR, 2.98 (1.14-7.76). Conclusion: Incidence of postoperative DVT in patients with isolated patella fractures is substantial. More attentions should be paid on postoperative DVT prophylaxis in patients with isolated patella fractures. Identification of associated risk factors can help clinicians recognize the risk population, assess the risk of DVT, and develop personalized prophylaxis strategies. [ABSTRACT FROM AUTHOR]

Objective: To study short-term type-specific human papillomavirus (HPV) persistence and associated predictors in an asymptomatic general female population in Zhejiang, China.Methods: Persistence was evaluated in women who were HPV positive at enrollment and who returned within 6-14 months. Liquid-based cytology screening was encouraged for returning women.Results: Persistence was evaluated in 548 women. Overall persistence was 49.1%, and established high-risk HPV persistence was 54.5%. The types associated with the highest level of persistence were HPV-52, HPV-58, HPV-56, and HPV-16-most of which belong to alpha9 species. In total, 252 women refused cytology screening. No differences were found regarding HPV persistence and other variables among women who returned for follow-up, women who accepted cytology screening, and women who refused cytology screening. Among women aged 35 years or older, there were no differences between those with normal cytology and those with abnormal cytology in the short-term persistence of HPV types, except for HPV-58 (P<0.01) and HPV-81 (P=0.04). Established high-risk HPV persistence increased with age, low income, and early sexual experience.Conclusion: The data support close surveillance of older women with established high-risk HPV infections, and conservative management of women with non-alpha9 HPV and no risk factors. [ABSTRACT FROM AUTHOR]

We report on a new species of enantiornithine bird from the Lower Cretaceous Qiaotou Formation of northern Hebei, China. The new taxon, Shenqiornis mengi gen. et sp. nov., possesses several enantiornithine synapomorphies but is unique from other known species. The specimen has a well-preserved skull that reveals new information about enantiornithine cranial morphology. The new taxon possesses a large postorbital with a long tapering jugal process indicating that some enantiornithines may have had a fully diapsid skull, as in Confuciusornis. The tooth morphology of the specimen is unique and likely represents a previously unknown trophic specialization within Enantiornithes. [ABSTRACT FROM AUTHOR]

Chronological sequences of Quaternary terrestrial mammalian faunas can provide important information about the evolutionary history of mammals, regional biostratigraphy and paleoenvironmental changes. Here we report the results of studies of a thick, nearly-continuous sedimentary sequence from Jinyuan Cave, in Liaoning Province, northeast China; the sequences contains four mammalian faunas ranging in age from the Late Pliocene to the late Middle Pleistocene. Detailed paleomagnetic and U-series age determinations date the upper unit of the sedimentary sequence to ~2.2–0.3 Ma. The results suggest that cave development and infilling were closely associated with the tectonic evolution of the Bohai Basin, including the subsidence of the basin and the uplift of the surrounding mountains, such as Luotuo Hill. Together with the large mammalian faunas from both south and north China, we suggest that these mammalian faunas were smaller in size and lower in species diversity during the Middle Pleistocene Transition (MPT) (1.2–0.7 Ma) than in the earlier and later Pleistocene. This indicates that major climatic variations during the MPT in north China may have reduced their taxonomic abundance and diversity. The extremely warm and wet interglacial climates that followed the MPT in monsoonal East Asia provided an ecological niche for the evolution and migration of these mammalian faunas, resulting in an increase in the numbers and diversity of mammals in East Asia. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The specific intratype HPV genome variations may be associated with the development of cervical cancer in specific geographic regions and a given population. Human papillomavirus (HPV) 58 and 52 have been found to be relatively prevalent among Asian women including Chinese women. This study aimed to assess the risk of HPV 58 and 52 variants for cervical cancer and its precursors in Chinese women. Methods: A total of 2021cervical samples were collected. After DNA extraction and genotyping, a total of 298 (177 HPV58-single positive and 121 HPV52-single positive) DNA samples were analyzed for E6 and E7 sequence variations by direct sequencing. Results: A total of 29 new reported variations of HPV 58 and 52 were found. For HPV58, the presence of C632T (T20I) and G760A (G63S) variants in E7 showed a positive trend of the association with the severity of neoplasia (P trend <0.05, χ 2 test for trend). Conclusions: These findings suggest that C632T (T20I) and G760A (G63S) variants in HPV58 E7 are probably risk factors associated with the development of cervical cancer in Chinese women. The presence of HPV58/52 E6 and E7 variants may be different in Chinese women. [Copyright &y& Elsevier]

Background: Rubella is a highly contagious viral infection with mild manifestations that occurs most often in children and young adults. Infection during pregnancy, especially during the first trimester, can result in an infant born with congenital rubella syndrome (CRS). The purpose of this paper is to analyze the characteristics of rubella epidemics in Anhui province from 2012 to 2021 and explore the prevention and control strategies of rubella., Methods: A descriptive epidemiological approach was used to examine the epidemiological characteristics of rubella in Anhui Province between 2012 and 2021., Results: From 2012 to 2021, a total of 4,987 cases of rubella were reported in Anhui province, with an average annual incidence of 8.11 per million, demonstrating an overall downward trend (χ 2 trend =3141.06, P < 0.01). The average yearly incidence of rubella in southern Anhui, central Anhui, and northern Anhui were 9.99 per million, 11.47 per million, and 4.50 per million, respectively, with statistically significant differences (χ 2 =792.50, P < 0.01). The male to female incidence ratio was 1.67:1, and the male incidence rate was higher than the female incidence rate. Most cases occurred among students, accounting for 56.59% of all cases, and the 10-34 age group accounted for ~73.71% of all cases. Regarding immunization history, 3.57% of cases had two doses or more, 6.62% had one dose, 16.40% had none, and the remainder were uncertain., Conclusion: The incidence of rubella in Anhui province from 2012 to 2021 continued to decline, with regional variations observed. The 10-34-year-old population without a history of rubella vaccination is at high risk for the disease. It is suggested to carry out rubella vaccination and congenital rubella syndrome monitoring according to the actual situation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhang, Cheng, Zhou, Wang, Luo, Chai, Tang, Su and Liu.)

BACKGROUND Pre-eclampsia is one of the primary causes of maternal and newborn mortality. The pathogenesis of pre-eclampsia is still unclear. We aimed to investigate the link between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and pre-eclampsia. MATERIAL AND METHODS A total of 102 pregnant women with hypertensive disorders of pregnancy who were hospitalized and delivered in Wenzhou People's Hospital from January 2019 to December 2019 were selected, including 43 patients with gestational hypertension, 32 patients with mild pre-eclampsia, and 27 patients with severe pre-eclampsia. Enzyme-linked fluorescence analysis was used to detect the serum NT-proBNP levels of the patients before delivery. We used the t test and ANOVA to compare differences between groups. Receiver operating curve (ROC) and the Youden index were used to evaluate the detection efficiency. RESULTS The average level of serum NT-proBNP in patients with mild pre-eclampsia was 197.12±105.80 pg/mL, which was significantly higher than that of patients with gestational hypertension (48.98±32.45 pg/mL) (P<0.05). Serum NT-proBNP in patients with severe pre-eclampsia (851.04±879.85 pg/mL) was higher than that in patients with moderate pre-eclampsia (P<0.05). The area under the ROC curve for diagnosing pre-eclampsia using NT-proBNP was 0.973, with NT-proBNP of 129.5 pg/mL as the cut-off value. The Youden index was 0.824, with a sensitivity for predicting pre-eclampsia of 84.7% and a specificity of 97.7%. CONCLUSIONS The level of serum NT-proBNP was as an effective indicator for predicting pre-eclampsia and judging the risk of pre-eclampsia.

Objective: Cervical HR-HPV persistence is the main risk factor for cervical cancer. We aimed to investigate the association of age and viral factors with HR-HPV persistence., Methods: From 2010 to 2017, 343,128 women underwent 390,411 tests performed by the Cervista HR-HPV assay (Data C3) and 157,123 women underwent 206,505 tests performed by the GenoArray HR-HPV assay (Data G14) in nine medical centers located in central and eastern China. We combined the test results and identified 9234 HPV-specific baseline-negative records for time-to-event analyses. The study endpoint event was defined as clearance of type/group-specific HPV. Therefore, hazard ratio (HR) < 1 indicated a higher risk of HPV persistence, which is contrary to the common meaning of HR., Results: The median persistence time was 375 and 541.5 days for Data C3 and Data G14, respectively. For every 5-year increase in age, a 15% (95% confidence interval [CI], 11%-19%) decrease in the clearance rate was observed only after 400 days of infection. For each additional co-infected HPV, the HR was 1.80 (95% CI, 1.63-1.97) on infection initiation but decreased by 22% (95% CI, 18%-26%) every 100 days. The HR of infection recurrence was 0.48 (95% CI, 0.32-0.72). The findings were consistent across different populations and test methods and were robust in sensitivity analysis., Conclusions: We found a time-dependent association of age and viral factors with HPV clearance. Older age reduced HPV clearance only after 400 days of infection. Co-infection promoted HPV clearance in the beginning, but the effect attenuated and reversed as infection persisted. Recurrent same-type infection cleared slower than the previous one., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Pregnancy with an adnexal mass is one of the most common complications during pregnancy and clinicians are sometimes caught in a dilemma concerning the decision to be made regarding clinical management., Objectives: The objective of this study was to outline and discuss the clinical features, management and outcomes of adnexal masses that were encountered during a cesarean section (CS) at a university affiliated hospital in China., Material and Methods: The medical records of the patients with an adnexal mass observed during a CS were retrospectively collected at Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China, from January 1991 to December 2011., Results: The incidence of adnexal masses was 16.40 per 1000 CSs. The most common pathologic diagnosis was benign ovarian tumor, the 2nd was ovarian endometrioma and the 3rd was theca lutein cyst. Thirteen cases of ovarian malignancies were diagnosed during a CS. Only 388 cases (29.78%) were detected by an ultrasonography (USG) examination before a CS. Eight cases required emergency CS due to abdominal pain; all other patients were clinically asymptomatic. The reasons for abdominal pain included torsion (n = 5), rupture (n = 2) and ovarian enlargement (n = 1). In 13 cases with ovarian endometrioma, cysts ruptured during a CS without any clinical manifestation. No maternal and fetal complications related to surgery were observed., Conclusions: Preconception care and routine prenatal care, including USG examination, may optimize the detection and management of an adnexal mass. The presumptive ovarian endometrioma detected before pregnancy could be the indication for surgery due to the possibility of spontaneous hemoperitoneum. Theca lutein cysts might be huge and exist throughout the whole pregnancy period. Expectant management is reasonable for an adnexal mass that emerged during pregnancy without suspicion of malignancy. Abdominal pain might be a clue for cyst torsion or rupture.

To identify new genetic risk factors for cervical cancer, we conducted a genome-wide association study in the Han Chinese population. The initial discovery set included 1,364 individuals with cervical cancer (cases) and 3,028 female controls, and we selected a 'stringently matched samples' subset (829 cases and 990 controls) from the discovery set on the basis of principal component analysis; the follow-up stages included two independent sample sets (1,824 cases and 3,808 controls for follow-up 1 and 2,343 cases and 3,388 controls for follow-up 2). We identified strong evidence of associations between cervical cancer and two new loci: 4q12 (rs13117307, Pcombined, stringently matched=9.69×10(-9), per-allele odds ratio (OR)stringently matched=1.26) and 17q12 (rs8067378, Pcombined, stringently matched=2.00×10(-8), per-allele ORstringently matched=1.18). We additionally replicated an association between HLA-DPB1 and HLA-DPB2 (HLA-DPB1/2) at 6p21.32 and cervical cancer (rs4282438, Pcombined, stringently matched=4.52×10(-27), per-allele ORstringently matched=0.75). Our findings provide new insights into the genetic etiology of cervical cancer.

Objective: Expression of the mitochondrial protein, nicotinamide adenine dinucleotide dehydrogenase (ubiquinone) Fe-S protein 3 (NDUFS3), down-regulates in some cancers including breast and kidney. This study evaluates NDUFS3 expression and its clinical significance in human serous ovarian adenocarcinoma., Methods: 30 ovarian normal epithelium, 30 benign serous adenoma, and 100 serous carcinoma tissues were collected, and the expression of NDUFS3 protein and messenger RNA was evaluated by immunohistochemistry, Western blot, and real-time reverse transcription-polymerase chain reaction, respectively. Relationships between NDUFS3 protein expression and clinicopathologic parameters and disease-free and overall survival were also studied., Results: The expression of NDUFS3 messenger RNA and protein was significantly decreased in serous ovarian adenocarcinoma compared with normal ovarian epithelium and benign serous adenoma (both P < 0.001). Reduced NDUFS3 immunostaining correlated with advanced Federation of Gynecology and Obstetrics stage (P = 0.002) and suboptimal residual disease after primary surgery (P = 0.021). Reduced NDUFS3 expression also correlated with shorter disease-free (P = 0.002) and overall survival (P = 0.004)., Conclusions: NDUFS3 expression is down-regulated in serous ovarian adenocarcinoma, suggesting that NDUFS3 may contribute to the development of serous ovarian cancer.

Background: Benign or malignant lesions caused by Human papillomavirus (HPV) produce considerable health burden worldwide. Since limited cross-protection would be offered between HPV types, heterogeneity in HPV type-specific distribution should be taken into account when predicting the effect of current prophylactic vaccines and forming the basic for the second-generation vaccines targeted to specific regions. Here, we investigated the prevalence of cervical HPV infection, as well as predictors concerned, in Zhejiang Province, southeast China., Results: Totally 4987 cervical samples from five randomly chosen counties in Zhejiang Province were detected. The overall HPV prevalence was 13.3%. Established high-risk (HR) HPV prevalence was 10.2%. HPV-52 was the most prevalent type (3.1%), followed by HPV-16 (2.5%), -58 (2.1%), -68 (1.0%) and -81 (0.9%). HPV-16 or -18 were present in 3.1% of the detected samples, while 174 specimens (3.5%) were positive for any of HPV-6, -11, -16 and -18. The prevalence of HPV vaccine types was consistently low across age groups. Bimodal age distribution in HR-HPV, including established HR and probably HR-HPV, was observed, with a clear second peak in perimenopausal women. Multivariate unconditional logistic regression models revealed that partner's lifetime number of partners was the only common independent predictor of overall, established HR, established low-risk, single-type and multiple-type HPV infection in current study., Conclusions: We have observed low prevalence of HPV vaccine types and relatively high prevalence of HPV-52 and -58 in our population. Our findings support universal "catch-up" vaccination of sexual experienced young women in Zhejiang Province, as well as enhance the hypothesis that the second-generation HPV prophylactic vaccines including HPV-52 and -58 may offer higher protection for women in China and other Asian areas. Furthermore, our data support close surveillance of perimenopausal women with HR-HPV infection.