Background: HPV vaccines have only been used in China for 8 years, and routine HPV test is not recommended before HPV vaccination, there is still a need to figure out HPV effectiveness, and the impact of pre-vaccination HPV infection status on the protective effect of HPV vaccines in Chinese women. Methods: From June 2022 to June 2023, women aged 18-50 years without history of cervical or uterine excision were recruited from three medical institutions. Basic characteristics were compared between vaccinated and unvaccinated participants, and inverse probability treatment weighting (IPTW) was used for confounding factors. HPV infection rates and vaccine effectiveness (VE) were calculated, and sub-group analysis in vaccinated women were conducted to explore impact of pre-vaccination HPV infection status. Results: After adjusting for group differences, the VE was observed as 76.1% (95% CI: 58.7%-86.2%) against new HPV16/18 infections among 2,285 participants. Older age and having a master’s degree or higher were protective factors, while increased parity and using oral contraceptives alone were risk factors for HPV16/18 infection. Women with unknown pre-vaccination HPV status had significantly higher post-vaccination rates of hrHPV (RR 4.278, 95% CI: 2.537-7.215) infections compared to those HPV-negative pre-vaccination. However, no significant difference in new hrHPV infection rates was observed between pre-vaccination HPV-negative and HPV-positive women. Conclusion: In addition to HPV vaccination, age, parity, using oral contraceptives alone, and master’s degree or higher were independent influencing factors of HPV16/18 infection. Pre-vaccination HPV infection status did not directly affect the protective effect of the HPV vaccine against uninfected types.

Background: The ectopic pregnancy(EP) patients requires the closely monitor. However, there is no international consensus through which method to select EP patients from the pregnancy of unknown location (PUL) patients. Objective: To summarize and review the protocols of screening patients with EP when being diagnosed with PUL. Search strategy: We searched MEDLINE, web of science and Embase from inception to May 2020. All the articles were dual-reviewed based on predetermined selection criteria. Selection criteria: Studies exploring PUL outcomes can be included. Data collection and analysis: Prediction results, final diagnosis, and expense depending on patient’s visits and examination were analyzed by R. version 3.6.3 and Revman version 5.4. Results: 29 studies were included. M6 model had the areas under the curve(AUC) of 0.944, the progesterone cut-offs an AUC of 0.725, and the M4 model an AUC of 0.871 respectively. When the sum of visits and examinations of the protocols increased from 3 to 5, the rate of lost to follow-up patients increased from 11.19% to 18.63%. The average production utility of progesterone cut-offs is 0.242, the M4 is 0.174, and the M6 is 0.157. Conclusions: The M6 model had the best performance to predict EP among the PUL patients. The progesterone cut-offs is the most cost-effective method to predict the final outcome of EP. Fundings: Project supported by National Natural Science Foundation of China (82073323) and the Joint Funds of the National Natural Science Foundation of China (U20A20368). Keywords: ectopic pregnancy, pregnancy of unknown location, predictive protocol，hCG，progesterone.