Shixuan Wang

Revolutionizing the female reproductive system research using microfluidic chip platform

AbstractComprehensively understanding the female reproductive system is crucial for safeguarding fertility and preventing diseases concerning women's health. With the capacity to simulate the intricate physio- and patho-conditions, and provide diagnostic platforms, microfluidic chips have fundamentally transformed the knowledge and management of female reproductive health, which will ultimately promote the development of more effective assisted reproductive technologies, treatments, and drug screening approaches. This review elucidates diverse microfluidic systems in mimicking the ovary, fallopian tube, uterus, placenta and cervix, and we delve into the culture of follicles and oocytes, gametes’ manipulation, cryopreservation, and permeability especially. We investigate the role of microfluidics in endometriosis and hysteromyoma, and explore their applications in ovarian cancer, endometrial cancer and cervical cancer. At last, the current status of assisted reproductive technology and integrated microfluidic devices are introduced briefly. Through delineating the multifarious advantages and challenges of the microfluidic technology, we chart a definitive course for future research in the woman health field. As the microfluidic technology continues to evolve and advance, it holds great promise for revolutionizing the diagnosis and treatment of female reproductive health issues, thus propelling us into a future where we can ultimately optimize the overall wellbeing and health of women everywhere. Graphical Abstract

Postoperative Adjuvant Treatment in Women with Stage I Endometrial Cancer: A Retrospective Study

Objective. To evaluate whether postoperative adjuvant treatment is beneficial for patient survival after surgery for early stage endometrial cancer (EC). We analyzed the outcomes of patients treated with radiotherapy, chemotherapy, or progestagen combined with other adjuvant treatments. Methods. We analyzed the outcomes of patients treated with radiotherapy alone, chemotherapy alone, or progestagen treatment with other adjuvant treatments. Women without any adjuvant treatment after operation were used as controls. We retrospectively examined disease-free survival (DFS), overall survival (OS), and high-risk factors that affected the survival status of all patients who received different postoperative adjuvant therapies. Results. In all 192 patients, the total relapse and mortality rates were 5.57% and 1.68%, respectively. Fourteen patients (7.29%) developed isolated local recurrence, and 2 patients died (1.04%) of recurrence during the follow-up period. The 5-year DFS and OS rates of all patients were 95.83% and 93.75%, respectively. No significant differences were observed in the 5-year DFS, 5-year OS, OS, or DFS among the four groups of patients with FIGO stage I endometrial cancer ( P = 0.9849 , 0.7430, 0.9754, and 0.4534, respectively). The differences in the log-rank test results of the estimates of the 5-year DFS, 5-year OS, DFS, and OS of patients with different disease stages and different ages were all significant, but no differences were observed in these parameters among patients with varying degrees of differentiation. Histologic grade, CA125 level, ER and PR status, and adjuvant therapy had no significant effect on the DFS and OS of all patients according to univariate and multivariate regression analyses, but a significant effect on DFS and OS was found when the patients were stratified by age. Conclusion. This retrospective study showed that adjuvant therapy after surgery was not significantly associated with improved DFS or OS in patients with early stage endometrial cancer. However, FIGO stage and age affected the survival of patients with stage I endometrial cancer.

Functionalized Mildly Oxidized MXene-Based Injectable Hydrogel with Enhanced Photothermal Performance for Precision Therapy of Uterine Sarcoma

Uterine sarcoma is an extremely malignant gynecological tumor, characterized by rapid growth, early metastasis, and a high recurrence rate. Current treatments like surgery, radiotherapy, and chemotherapy, have limited effectiveness, highlighting the urgent need for innovative noninvasive alternatives. Here, we report a novel photosensitive nanocomposite hydrogel (O1-M&F) designed for NIR-induced photothermal therapy (PTT), comprising mildly oxidized MXene (O1-M) and a thermosensitive Pluronic F127 hydrogel. Unlike conventional approaches that aim to prevent MXene oxidation, we demonstrate that mild oxidation significantly enhances both the photothermal conversion efficiency and reactive oxygen species (ROS) generation of MXene nanosheets. The incorporation of F127 hydrogel further ensures the long-term dispersion stability and biocompatibility of the composite system. In vitro and in vivo studies demonstrated potent tumor ablation capability with minimal side effects. Increased apoptosis of uterine sarcoma cells was further observed. The biocompatibility of the O1-M&F hydrogel was validated, indicating its potential for safe and effective therapeutic application. These findings suggest that O1-M&F-based PTT is a promising, noninvasive, effective treatment for uterine sarcoma, offering a novel therapeutic approach with reduced risks and enhanced patient outcomes.

Evaluating the psychometric measurement properties of patient-reported outcome measures for uterine fibroids using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines: a systematic review

Objectives To systematically evaluate the psychometric measurement properties of existing patient-reported outcome measures (PROMs) for uterine fibroids using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines and to provide recommendations for the most appropriate tools in clinical and research settings. Design Systematic review using the COSMIN guidelines and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Data sources The Medline, CINAHL, Embase and Web of Science databases were searched for relevant studies published up to 28 February 2025. Eligibility criteria were studies that targeted patients with uterine fibroids using a PROM instrument and were published as full-text, English-language articles in peer-reviewed journals. Studies that used only a portion or an unvalidated short form of the PROMs, non-English publication or non-peer-reviewed formats were excluded. Data extraction and synthesis Two independent reviewers extracted the data using EndNote V.X9 (Clarivate, London, UK). The PROM quality assessment adhered to the COSMIN guidelines. The level of evidence for the psychometric properties of each PROM was determined using a modified GRADE approach. Results Of 678 records retrieved in the literature search, 11 were included. Six uterine fibroid-specific PROMs were identified and evaluated according to the COSMIN guidelines. The Uterine Fibroid Symptom and Quality of Life (UFS-QoL) and the Bleeding and Pelvic Discomfort Scale (BPD) received class A recommendations (recommended) for sufficient content and structural and internal consistency. However, four other PROMs, namely the Perioperative Anxiety Scale for Uterine Fibroids, Fibroid Symptom Diary, Uterine Fibroid Daily Bleeding Diary and Menstrual Pictogram Superabsorbent Polymer-containing Version 3, received class B recommendations (further research required) due to poor measurement properties, including inadequate reliability and unquantified measurement error. Conclusion The results of the present study fill a knowledge gap in the systematic and comprehensive evaluation of uterine fibroid-related PROMs. These findings provide valuable insights and recommendations for clinicians and researchers seeking reliable PROMs for this patient population. The UFS-QoL and BPD were classified as ‘A’ and were recommended, demonstrating the potential to promote outcome measurements in future studies. PROSPERO registration number CRD42023474806.

Utility of a Metabolic-Associated Nomogram to Predict the Recurrence-Free Survival of Stage I Cervical Cancer

Status and treatment of patients with uterine fibroids in hospitals in central China: a retrospective study from 2018 to 2021

ObjectiveTo evaluate the hospitalised patients with uterine fibroids (UFs) and describe treatment patterns in hospital-treated patients in central China from 2018 to 2021.DesignA retrospective analysis.SettingThe gynaecology departments of class A and class B secondary and tertiary hospitals in Hubei Province, China.Participants101 008 patients diagnosed with UFs from 1 January 2018 to 31 December 2021.ResultsThe hospitalised patients with UFs increased with age, reaching a peak at ages 45–49 years and then gradually decreasing. Among these patients, 19.05% had anaemia symptoms. Women aged 25–29 years were more likely to be treated with laparoscopic myomectomy (62.22%), while women aged 20–24 years tend to choose open myomectomy (34.58%). Women over age 45 years who had entered perimenopause tended to be treated with laparoscopic hysterectomy (64.85% for those aged 65–69 years). Patients with fibroid with moderate-to-severe anaemia mostly chose hysterectomy. As a whole, the proportion of patients who chose laparoscopic hysterectomy was similar to that of patients who chose laparoscopic myomectomy (31.38% vs 31.14%). Only 2.08% of UFs were treated with high-frequency MRI-guided focused ultrasound surgery (MRgFUS). The number of patients who choose laparoscopic surgery or MRgFUS treatment was increasing year by year. After stratifying by hospital grade, we found that women treated at class A tertiary hospitals were more likely to have laparoscopic than open surgery (66.12% vs 31.26%). At class B secondary hospitals, 61.9% of the patients underwent myomectomy. By contrast, hysterectomy was used to treat the majority of patients at class A secondary hospitals and class B tertiary hospitals (57.79% and 57.57%, respectively). Use of MRgFUS was mainly concentrated within class A tertiary hospitals.ConclusionUFs affect mainly women in childbearing period. Most patients chose to receive treatment at class A tertiary hospitals, among which laparoscopic myomectomy was the mainstream surgical method for patients in Hubei Province.Trial registration numberNCT05840042.

Epidemiology and Risk Factors of Uterine Fibroids in China

Uterine fibroids are the most common form of benign uterine tumors in the uterine muscle layer, which had a certain rate of malignancy, but it is rare. The prevalence of uterine fibroids estimates range from 4.5% to 68.6% depending on study population and diagnostic methodology. The prevalence of fibroids has been historically underestimated by epidemiologic studies which focused mainly on symptomatic women, leaving behind a large population of asymptomatic women and women who underreport their symptoms. What investigators don't know was which women who have fibroids will develop clinical symptoms and which women who have an operation of myomectomy will relapse. The purpose of this study is to investigate the prevalence, incidence and risk factors for the development of uterine fibroids in Chinese women.