BACKGROUND The full implementation of the national two-child policy has presented significant challenges in ensuring the safety of pregnant women.AIM To investigate the effect of cervical balloon fluid volume on mater...BACKGROUND The full implementation of the national two-child policy has presented significant challenges in ensuring the safety of pregnant women.AIM To investigate the effect of cervical balloon fluid volume on maternal processes,maternal and infant outcomes,and anxiety during pregnancy.METHODS A total of 100 singleton term pregnancies with cervical maturity induction and anxiety were selected using a lottery method;50 women were included.Cervical balloons were used for all participants.In the control group,80 mL of fluid was injected into both balloons;in the observation group,80 and 100 mL were injected into the vaginal and cervical balloons,respectively.The two groups were compared for cervical maturity,labor duration,anxiety,maternal and infant outcomes,and effects on cervical ripening.RESULTS After treatment,the cervical maturity test(Bishop)score was significantly higher in the observation group(9.76±1.19)than in the control group(7.62±0.83),and the Hamilton Anxiety Scale score was lower in the observation group(7.32±0.85)than in the control group(13.05±1.12).The observation group showed higher rates of natural delivery and lower rates of cesarean section than the control group.The first and total stages of labor were shorter in the observation than in the control group;no significant differences were found in the second and third stages.The incidence of complications was lower in the observation group[1(2.00%)vs 9(18.00%)for complications;49(98.00%)vs 41(82.00%)for non-complications].CONCLUSION The selected fluid volumes to promote cervical maturity and induce labor stabilize maternal mood,increase the natural delivery rate,shorten labor,and improve maternal and infant outcomes.展开更多
Cervical cancer related to human papillomavirus(HPV)is a leading cause of cancer-related mortality among women worldwide.Cancer cells release fragments of their DNA,known as circulating tumor DNA(ctDNA),which can be d...Cervical cancer related to human papillomavirus(HPV)is a leading cause of cancer-related mortality among women worldwide.Cancer cells release fragments of their DNA,known as circulating tumor DNA(ctDNA),which can be detected in bodily fluids.A PubMed search using the terms“ctHPV”or“circulating tumor DNA”and“cervical cancer”,limited to the past ten years,identified 104 articles,complemented by hand-searching for literature addressing medico-legal implications.Studies were evaluated for relevance and methodological quality.Detection and characterization of circulating tumor HPV DNA(ctHPV DNA)have emerged as promising tools for assessing prognosis and disease recurrence in cervical cancer.Detection techniques include polymerase chain reaction(PCR),digital droplet PCR(ddPCR),and next-generation sequencing(NGS).This review summarizes current knowledge on ctHPV DNA in cervical cancer and explores its clinical and medico-legal implications,including management of discordant results,diagnostic errors,liability,and data protection compliance.展开更多
BACKGROUND： Stellate ganglion block （SGB） plays a protective role on the brain, but the precise mechanism of action is not clear. OBJECTIVE： To simulate SGB by transection of the cervical sympathetic trunk （TCST...BACKGROUND： Stellate ganglion block （SGB） plays a protective role on the brain, but the precise mechanism of action is not clear. OBJECTIVE： To simulate SGB by transection of the cervical sympathetic trunk （TCST） and to investigate the TCST effects on changes in cerebral infarct volume and oxygen free radical levels in rats with focal cerebral ischemia/reperfusion injury. DESIGN, TIME AND SETTING： A complete randomized control animal experiment was performed at the Institute of Neurological Diseases of Taihe Hospital, Yunyang Medical College from February to December 2005. MATERIALS： A total of 101 healthy Wistar rats, weighing 280-320 g, of both genders, aged 17-18 weeks, were used in this study. 2, 3, 5-triphenyltetrazolium chloride （TTC） was purchased from Changsha Hongyuan Biological Company. Superoxide dismutase （SOD）, malondialdehyde （MDA） and nitric oxide （NO） assay kits were provided by Nanjing Jiancheng Bioengineering Institute. METHODS： Rats were randomly divided into a TCST group, a model group and a sham operation group. Successful models were included in the final analysis, with at least 20 rats in each group. After TCST, rat models of focal cerebral ischemia/reperfusion injury were established in the TCST group by receiving middle cerebral artery occlusion （MCAO） by the intraluminal suture method for 2 hours, followed by 24 hours of reperfusion. Rat models of focal cerebral ischemia/reperfusion injury were made in the model group. Rats in the sham operation group underwent experimental procedures as for the model group, threading depth of 10 mm, and middle cerebral artery was not ligated. MAIN OUTCOME MEASURES： Brain tissue sections of ten rats from each group were used to measure cerebral infarct volume by TTC staining. Brain tissue homogenate of another ten rats from each group was used to detect SOD activities, MDA contents and NO levels. Rat neurological function was assessed by neurobehavioral measures. RESULTS： Cerebral infarct volume was bigger in the model group than in the TCST group （P 〈 0.05）. Twenty four hours after cerebral ischemia/reperfusion, SOD activities were lower, whereas MDA contents and NO levels were higher in the TCST and model groups, compared with the sham operation group （P 〈 0.05 or P 〈 0.01）. Compared with the model group, SOD activities were higher, whereas MDA contents and NO levels were lower in the TCST group （P 〈 0.05）. CONCLUSION： After TCST, cerebral infarct volume is reduced, SOD activities are increased, and MDA contents and NO levels are decreased compared to the model group in rats with focal cerebral ischemia/reperfusion injury. These changes may be associated with TCST.展开更多
<span style="font-family:Verdana;">Rationale and Objectives: Accurately establishing the diagnosis and staging of cervical and thyroid cancers is essential in medical practice in determining tumor exte...<span style="font-family:Verdana;">Rationale and Objectives: Accurately establishing the diagnosis and staging of cervical and thyroid cancers is essential in medical practice in determining tumor extension and dissemination and involves the most accurate and effective therapeutic approach. For accurate diagnosis and staging of cervical and thyroid cancers, we aim to create a diagnostic method, optimized by the algorithms of artificial intelligence and validated by achieving accurate and favorable results by conducting a clinical trial, during which we will use the diagnostic method optimized by artificial intelligence (AI) algorithms, to avoid errors, to increase the understanding on interpretation computer tomography (CT) scan, magnetic resonance imaging (MRI) of the doctor and improve therapeutic planning. Materials and Methods: The optimization of the computer assisted diagnosis (CAD) method will consist in the development and formation of artificial intelligence models, using algorithms and tools used in segmental volumetric constructions to generate 3D images from MRI/CT. We propose a comparative study of current developments in “DICOM” image processing by volume rendering technique, the use of the transfer function for opacity and color, shades of gray from “DICOM” images projected in a three-dimensional space. We also use artificial intelligence (AI), through the technique of Generative Adversarial Networks (GAN), which has proven to be effective in representing complex data distributions, as we do in this study. Validation of the diagnostic method, optimized by algorithm of artificial intelligence will consist of achieving accurate results on diagnosis and staging of cervical and thyroid cancers by conducting a randomized, controlled clinical trial, for a period of 17 months. Results: We will validate the CAD method through a clinical study and, secondly, we use various network topologies specified above, which have produced promising results in the tasks of image model recognition and by using this mixture. By using this method in medical practice, we aim to avoid errors, provide precision in diagnosing, staging and establishing the therapeutic plan in cancers of the cervix and thyroid using AI. Conclusion: The use of the CAD method can increase the quality of life by avoiding intra and postoperative complications in surgery, intraoperative orientation and the precise determination of radiation doses and irradiation zone in radiotherapy.</span>展开更多
Objective The aim of the study was to compare flattening filter-free(FFF) beams and conventional flattening filter(FF) beams in volumetric modulated arc therapy(VMAT) for cervical cancer after surgery, through a retro...Objective The aim of the study was to compare flattening filter-free(FFF) beams and conventional flattening filter(FF) beams in volumetric modulated arc therapy(VMAT) for cervical cancer after surgery, through a retrospective planning study.Methods VMAT plans of FFF beams and normal FF beams were designed for a cohort of 15 patients. The prescribed dose was 45 Gy to 1.8 Gy per fraction, and at least 95% of the planning target volume received this dose. Doses were computed with a commercially available treatment planning system using a Monte Carlo(MC) algorithm. Plans were compared according to dose-volume histogram analysis in terms of planning target volume homogeneity and conformity indices(HI and CI), as well as organs at risk(OAR) dose and volume parameters. Results FFF-VMAT was similar to FF-VMAT in terms of CI, but inferior to FF-VMAT considering HI. No statistically differences were observed between FFF-VMAT and FF-VMAT in following organ at risks including pelvic bone marrow, small bowel, bladder, rectum, and normal tissue(NT)..Conclusion For patients with cervical cancer after hysterectomy, the FFF beam achieved target and OAR dose distribution similar to that of the FF beam. Reduction of beam-on time in cervical cancer is beneficial.展开更多
To study the clinical significance of the morphological and volume changes in cervical cancer during an ongoing course of radiation therapy (RT) using MR imaging. Methods: Serial MR imaging examinations were performed...To study the clinical significance of the morphological and volume changes in cervical cancer during an ongoing course of radiation therapy (RT) using MR imaging. Methods: Serial MR imaging examinations were performed in 60 advanced cervical cancer patients. MR imaging was obtained at the start of RT, at 20-25 Gy (2-2.5 weeks of RT), at 45-50 Gy (4-5 weeks of RT), and 1-2 month post-RT. Tumor morphology was classified qualitatively as well-defined (round/oval with a well-demarcated smooth margin) vs. lobulated vs. irregular and tumor volume was assessed in each serial MR examination independently by ROI volumetry and diameter volumetry. ROI volumetry was traced on the computer workstation with a trackball in each sagittal T2-weighted image and calculated by the summation of all tumor areas in each slice and multiplication by the slice profile. Diameter volumetry was to measure the largest three orthogonal tumor diameters in each orthogonal measurement plane and calculate as an ellipsoid formula (V=d1 x d2 x d3 x p/6). Serial tumor volume was compared between the two measurement methods. Results: The proportion of lobulated and irregular tumors increased early during RT and declined lately post-RT (68% pre-RT, 80% at 2-2.5 weeks of RT, 72% at 4-5 weeks of RT, 33% post-RT). Accordingly, ROI volumetry and diameter volumetry correlated well pre-RT (r1=0.89) and post-RT (r4=0.80), but poorly during RT (r2 = 0.17 at 2-2.5 weeks of RT, r3 = 0.69 at 4-5 weeks of RT). Conclusions: Cervical cancers regress in a non-uniform fashion during RT and undergo increasingly irregular shrinkage. Measurement with ROI volumetry techniques, which can optimally measure irregular volumes, provides better assessment of radiation response during treatment than diameter volumetry.展开更多
Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical ca...Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical cancer as a major public health problem.Methods All data were extracted from the Global Cancer Observatory(GLOBOCAN)2022.Age-standardized incidence rate(ASIR)and mortality rates(ASMR)of cervical cancer were compared and linked to Human Development Index(HDI)between populations.The estimated annual percentage changes(EAPCs)were used to characterize the temporal trend in ASIR/ASMR,and demographic estimates were projected up to 2050.Results Globally,an estimated 662,044 cases(ASIR:14.12/100,000)and 348,709 deaths(ASMR:7.08/100,000)from cervical cancer occurred in 2022,corresponding to the fourth cause of cancer morbidity and mortality in women worldwide.Specifically,42%of cases and 39%of deaths occurred in China(23%and 16%)and India(19%and 23%).Both ASIR and ASMR of cervical cancer decreased with HDI,and similar decreasing links were observed for both early-onset(0–39 years)and late-onset(≥40 years)cervical cancer.Both ASIR and ASMR of overall cervical cancer showed decreasing trends during 2003–2012(EAPC:0.04%and-1.03%);however,upward trends were observed for early-onset cervical cancer(EAPC:1.16%and 0.57%).If national rates in 2022 remain stable,the estimated cases and deaths from cervical cancer are projected to increase by 56.8%and 80.7%up to 2050.Moreover,the projected increase of early-onset cervical cancer is mainly observed in transitioning countries,while decreased burden is expected in transitioned countries.Conclusions Cervical cancer remains a common cause of cancer death in many countries,especially in transitioning countries.Unless scaling-up preventive interventions,human papillomavirus(HPV)vaccination and cervical cancer screening,as well as systematic cooperation within government,civil societies,and private enterprises,the global burden of cervical cancer would be expected to increase in the future.展开更多
Degenerative cervical myelopathy is a common cause of spinal cord injury,with longer symptom duration and higher myelopathy severity indicating a worse prognosis.While numerous studies have investigated serological bi...Degenerative cervical myelopathy is a common cause of spinal cord injury,with longer symptom duration and higher myelopathy severity indicating a worse prognosis.While numerous studies have investigated serological biomarkers for acute spinal cord injury,few studies have explored such biomarkers for diagnosing degenerative cervical myelopathy.This study involved 30 patients with degenerative cervical myelopathy(51.3±7.3 years old,12 women and 18 men),seven healthy controls(25.7±1.7 years old,one woman and six men),and nine patients with cervical spondylotic radiculopathy(51.9±8.6 years old,three women and six men).Analysis of blood samples from the three groups showed clear differences in transcriptomic characteristics.Enrichment analysis identified 128 differentially expressed genes that were enriched in patients with neurological disabilities.Using least absolute shrinkage and selection operator analysis,we constructed a five-gene model(TBCD,TPM2,PNKD,EIF4G2,and AP5Z1)to diagnose degenerative cervical myelopathy with an accuracy of 93.5%.One-gene models(TCAP and SDHA)identified mild and severe degenerative cervical myelopathy with accuracies of 83.3%and 76.7%,respectively.Signatures of two immune cell types(memory B cells and memory-activated CD4^(+)T cells)predicted levels of lesions in degenerative cervical myelopathy with 80%accuracy.Our results suggest that peripheral blood RNA biomarkers could be used to predict lesion severity in degenerative cervical myelopathy.展开更多
This editorial explores the potential integration of non-Western medicine into radiotherapy for cervical cancer.While radiotherapy remains a radical treatment for cervical cancer,its associated toxicity and decline in...This editorial explores the potential integration of non-Western medicine into radiotherapy for cervical cancer.While radiotherapy remains a radical treatment for cervical cancer,its associated toxicity and decline in quality of life can significantly impact patients’lives.Currently,most treatments are supportive,with no specific treatment options available in Western medicine.Non-Western medicine,often less toxic and easier to administer,has shown promising results when used alongside radiotherapy for cervical cancer.Despite these potential benefits,challenges such as limited evidence and restricted application areas persist.While non-Western medicines may offer potential improvements in chemoradiotherapy outcomes for cervical cancer,further research is necessary to substantiate these benefits.展开更多
Objective:To carry out dosimetric comparison between volumetric modulated arc therapy(VMAT)and intensity-modulated radiation therapy(IMRT)in cervical cancer.Methods:50 postoperative cervical cancer patients were inclu...Objective:To carry out dosimetric comparison between volumetric modulated arc therapy(VMAT)and intensity-modulated radiation therapy(IMRT)in cervical cancer.Methods:50 postoperative cervical cancer patients were included in this study.The patients were admitted for treatment from January 2021 to January 2022.VMAT and IMRT plans were designed for each patient to analyze the dose distribution in the target area of the two treatment techniques.Results:Comparing the monitor unit for single treatment(638.21±116.21 MU)and time of single treatment(143.21±23.14 s)in the observation group and the monitor unit for single treatment(932.14±74.11 MU)and time of single treatment(223.14±17.26 s)in the control group,there was significant difference(P<0.05);there was also significant difference(P<0.05)between the normal tissue(bladder and rectum)of the observation group and that(bladder and rectum)of the control group.Conclusion:VMAT is more effective in cervical cancer,and it has a certain protective effect on normal tissues in patients and can reduce the radiation dose.展开更多
BACKGROUND Cervical cancer is a formidable global health issue,particularly affecting women in lower-middle-income countries with little or no access to preventative vaccines,screening programs,and treatment modalitie...BACKGROUND Cervical cancer is a formidable global health issue,particularly affecting women in lower-middle-income countries with little or no access to preventative vaccines,screening programs,and treatment modalities.The case report presents a unique case of a large cervical cancer achieving complete response(CR)with concurrent chemoradiotherapy(CCRT),highlighting the effectiveness of this treatment approach even in advanced stages and underscoring the importance of adaptive radiotherapy(RT)in optimizing patient outcomes.CASE SUMMARY We present the case of a 53-year-old woman who presented with four years of abnormal vaginal bleeding and was found to have p16-positive,moderately differentiated cervical squamous cell carcinoma.The tumor measured 14 cm×12 cm×8 cm,the largest size reported in the literature to achieve CR with CCRT.Despite this monumental feat,the patient remained disease-free and is currently on follow-up for 2 years;however,she continued to suffer from substantial morbidity caused by a vesicovaginal fistula and hydronephrosis,underscoring the continuing impact of cervical cancer on quality of life.CONCLUSION In this case report,we highlight the effectiveness of CCRT in achieving CR,even in cases of bulky cervical cancer,with adaptive RT offering a customized strategy to improve patient outcomes.We also emphasize the necessity for multidisciplinary team discussions and highlight the need for strategies to mitigate treatment-related toxicities and long-term complications.展开更多
Cervical cancer,a leading malignancy globally,poses a significant threat to women's health,with an estimated 604,000 new cases and 342,000 deaths reported in 2020^([1]).As cervical cancer is closely linked to huma...Cervical cancer,a leading malignancy globally,poses a significant threat to women's health,with an estimated 604,000 new cases and 342,000 deaths reported in 2020^([1]).As cervical cancer is closely linked to human papilloma virus(HPV)infection,early detection relies on HPV screening;however,late-stage prognosis remains poor,underscoring the need for novel diagnostic and therapeutic targets^([2]).展开更多
In May 2018,the Director-General of the World Health Organization(WHO)called for global action to eliminate cervical cancer~1.This call marked the beginning of an ambitious international effort to scale up 3 key strat...In May 2018,the Director-General of the World Health Organization(WHO)called for global action to eliminate cervical cancer~1.This call marked the beginning of an ambitious international effort to scale up 3 key strategies:human papillomavirus(HPV)vaccination,cervical cancer screening,and treatment of precancerous lesions and cancer.Subsequently,the WHO and its partners developed a global strategy to accelerate the reduction of cervical cancer incidence,with an ultimate goal of achieving elimination within the next century.This Global Strategy represents a formal international commitment and is anchored in the 90-70-90 targets to be achieved by 2030.In parallel,several countries have also set national commitments,such as Sweden's pledge to achieve elimination by 2027 and Australia's target of achieving elimination by 2035.展开更多
As the 30th anniversary of the landmark Beijing Fourth World Conference on Women approaches,the forthcoming 2025 World Women's Summit in Beijing offers a timely platform to reaffirm commitments to women's well...As the 30th anniversary of the landmark Beijing Fourth World Conference on Women approaches,the forthcoming 2025 World Women's Summit in Beijing offers a timely platform to reaffirm commitments to women's well-being worldwide.In alignment with this milestone,Cancer Biology&Medicine is proud to present this special issue dedicated to accelerating the global elimination of cervical cancer.展开更多
[Objectives]To observe the clinical efficacy of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of cervical spondylotic radiculopathy(CSR).[Methods]A total of 120 patie...[Objectives]To observe the clinical efficacy of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of cervical spondylotic radiculopathy(CSR).[Methods]A total of 120 patients diagnosed with CSR who received treatment at the International Mongolian Hospital of Inner Mongolia between October 2021 and October 2022 were selected and randomly divided into two groups:A test group and a control group,with 60 patients in each group.The patients in the test group received Mongolian medicine silver needle combined with cupping and bloodletting therapy,following the principles of syndrome differentiation in Mongolian medicine.In contrast,the patients in the control group received only the Mongolian medicine silver needle therapy.After treatment,the Mongolian medicine syndrome scores,visual analogue scale(VAS)scores,and total clinical therapeutic effects in the two groups of patients were compared both prior to and following the treatment.[Results]The improvement in VAS and Mongolian medicine syndrome scores in the test group was greater than that in the control group,with a statistically significant difference(P<0.05).The scores of the test group surpassed those of the control group,and this difference was also statistically significant(P<0.05).Furthermore,the overall therapeutic effect in the test group was 93.33%,which was markedly higher than 76.67%observed in the control group(P<0.05).[Conclusions]The therapeutic effect of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of CSR is remarkable.This approach has demonstrated efficacy in alleviating patient pain and improving the functionality of the cervical vertebrae,thereby warranting clinical promotion and application.展开更多
Objective:Cervical cancer is a growing concern in China,especially among women who reside in rural areas and older women.Understanding age-and region-specific trends in cervical cancer is vital for informing policy an...Objective:Cervical cancer is a growing concern in China,especially among women who reside in rural areas and older women.Understanding age-and region-specific trends in cervical cancer is vital for informing policy and assessing progress toward WHO elimination targets.Methods:The 2000±2020 data from 22 long-standing registries contributing to the China national cancer registry was analyzed to estimate age-standardized incidence and mortality rates(ASIR and ASMR,respectively).Joinpoint regression yielded an average annual percentage change(AAPC)stratified by age group(<35,35±64,65±74,and≥75 y)and by urban-rural area.The comparative analysis included GLOBOCAN Overtime data from selected Asia-Pacific countries.Results:The ASIR tripled in China between 2000 and 2020 before stabilizing(AAPC=6.5%),while the ASMR rose steadily(AAPC=3.9%).The urban incidence declined after 2009 among women<35 y,while rural trends were broadly stable.The ASIR and ASMR increased in urban areas among women 35±64 y of age,while rural areas had a rising ASIR and a stable ASMR,suggesting potential screening effects.In contrast,women≥65 y of age had a steadily increasing incidence and mortality in rural and urban areas.Australia and Republic of Korea had consistent declines in the ASIRs and ASMRs compared to other Asia-Pacific countries,whereas Japan exhibited rising trends.The Philippines experienced a surge in mortality rates,despite incidence rates remaining stable or declining.Conclusions:The cervical cancer burden in China has begun to plateau but large disparities persist by age and geography.To achieve elimination of cervical cancer,it is imperative to implement tailored strategies that prioritize the urgent expansion of HPV vaccination programs,the deployment of high-efficacy screening methods,and the universal access to treatment throughout the nation.展开更多
Objective:To investigate the therapeutic adjuvant potential of fucoidan in cervical cancer and to evaluate its efficacy in combination with immunotherapy.Methods:Fucoidan extracted from Fucus vesiculosus was dissolved...Objective:To investigate the therapeutic adjuvant potential of fucoidan in cervical cancer and to evaluate its efficacy in combination with immunotherapy.Methods:Fucoidan extracted from Fucus vesiculosus was dissolved in phosphate buffered saline and used to treat TC-1 cervical cancer cells in vitro as well as tumor-bearing C57BL/6 mice in vivo.Mice were divided into four groups:the vehicle control group,the mRNA therapy-alone group,the fucoidan-only group,and the combination group.MAPK signaling proteins(p-ERK,T-ERK,p-p38)were analyzed by Western blotting assays.T cell surface markers and intracellular cytokines in splenocytes were assessed by flow cytometry,and plasma cytokine levels were measured by ELISA.Results:Fucoidan decreased the p-ERK/T-ERK ratio and p-p38.Fucoidan combined with mRNA therapy did not significantly affect CD4^(+)T-cell activation but reduced CD8^(+)T-cell activation compared with mRNA therapy alone.MCP-1 and IFN-γwere significantly reduced in the combination therapy group compared with mRNA therapy alone,while IL-6,TNF-α,perforin,and granzyme B did not show significant changes between the two groups.Conclusions:These findings suggest that fucoidan could inhibit excessive T cell activation and cytokine production by suppressing MAPK p-p38 protein expression.展开更多
Background:Cervical and breast cancers are among the top 4 leading causes of cancer-related mortality in women.This study aimed to examine age-specific temporal trends in mortality for cervical and breast cancers in u...Background:Cervical and breast cancers are among the top 4 leading causes of cancer-related mortality in women.This study aimed to examine age-specific temporal trends in mortality for cervical and breast cancers in urban and rural areas of China from 2009 to 2021.Methods:Age-specific mortality data for cervical and breast cancers among Chinese women aged 20-84 years were obtained from China’s National Disease Surveillance Points system spanning the years 2009 to 2021.Negative binomial regression models were utilized to assess urban-rural differences in mortality rate ratios,while Joinpoint models with estimated average annual percent changes(AAPC)and slopes were employed to compare temporal trends and the acceleration of mortality rates within different age groups.Results:From 2009 to 2021,there was a relative increase in age-specific mortality associated with the two cancers observed in rural areas compared with urban areas.A rising trend in the screening age of 35-64[AAPC:4.0%,95%confidence interval(CI)0.5-7.6,P=0.026]for cervical cancer was noted in rural areas,while a stable trend(AAPC:-0.7%,95%CI-5.8 to 4.6,P=0.780)was observed in urban areas.As for breast cancer,a stable trend(AAPC:0.3%,95%CI-0.3 to 0.9,P=0.280)was observed in rural areas compared to a decreasing trend(AAPC:-2.7%,95%CI-4.6 to-0.7,P=0.007)in urban areas.Urban-rural differences in mortality rates increased over time for cervical cancer but decreased for breast cancer.Mortality trends for both cervical and breast cancers showed an increase with age across 4 segments,with the most significant surge in mortality observed among the 35-54 age group across urban and rural areas,periods,and regions in China.Conclusions:Special attention should be given to women aged 35-54 years due to mortality trends and rural-urban disparities.Focusing on vulnerable age groups and addressing rural-urban differences in the delivery of cancer control programs can enhance resource efficiency and promote health equity.展开更多
Traditional Mongolian Medicine(TMM)therapies have emerged as a prominent therapeutic option for Cervical Spondylotic Radiculopathy(CSR),owing to their demonstrated efficacy,cost-effectiveness,and high clinical accessi...Traditional Mongolian Medicine(TMM)therapies have emerged as a prominent therapeutic option for Cervical Spondylotic Radiculopathy(CSR),owing to their demonstrated efficacy,cost-effectiveness,and high clinical accessibility.This study systematically reviews classical Mongolian medical texts to synthesize CSR-related knowledge,including disease profiles,pathogenesis,and therapeutic strategies—through dual analytical perspectives from modern medicine and TMM theory.Furthermore,it critically evaluates recent clinical research on TMM interventions for CSR,encompassing manual therapies,herbal formulations,and holistic regimens.The integrated analysis aims to provide references for optimizing TMM clinical practices in CSR treatment.展开更多
BACKGROUND The special physiological changes during pregnancy pose a huge challenge to the diagnosis of cervical cancer in pregnancy(CCIP).However,due to the poor prognosis of advanced-stage CCIP,there is currently no...BACKGROUND The special physiological changes during pregnancy pose a huge challenge to the diagnosis of cervical cancer in pregnancy(CCIP).However,due to the poor prognosis of advanced-stage CCIP,there is currently no consensus or guideline for diagnosis and treatment.CASE SUMMARY In this case report,we presented the case of a 30-year-old woman at 30 weeks of gestation who presented with irregular vaginal bleeding and was admitted to a local hospital at 35 weeks of gestation with a sudden gush of fluid and underwent a C-section.During the surgery,a rotten fish-like solid mass in the lower segment of the posterior wall of the uterus was excised for biopsy.The patient was referred to our hospital because she experienced heavy vaginal bleeding 13 days after one chemotherapy session.The solid mass was initially misdiagnosed as uterine clearcell carcinoma at local hospital but later confirmed as cervical adenosquamous carcinoma by a multidisciplinary team.Three months posttreatment,she succumbed to multiple tumor metastases.The infant was healthy at the latest 2-year follow-up.CONCLUSION Obstetricians should expand differential diagnoses when obstetric factors cannot explain symptoms of persistent vaginal bleeding during pregnancy.Atypical and insidious clinical presentations are often concealed by physiological changes during pregnancy,which may increase the difficulty of diagnosis and result in misdiagnosis.展开更多
基金Supported by the Wuxi Municipal Health Commission Maternal and Child Health Research Project,No.FYKY202202.
文摘BACKGROUND The full implementation of the national two-child policy has presented significant challenges in ensuring the safety of pregnant women.AIM To investigate the effect of cervical balloon fluid volume on maternal processes,maternal and infant outcomes,and anxiety during pregnancy.METHODS A total of 100 singleton term pregnancies with cervical maturity induction and anxiety were selected using a lottery method;50 women were included.Cervical balloons were used for all participants.In the control group,80 mL of fluid was injected into both balloons;in the observation group,80 and 100 mL were injected into the vaginal and cervical balloons,respectively.The two groups were compared for cervical maturity,labor duration,anxiety,maternal and infant outcomes,and effects on cervical ripening.RESULTS After treatment,the cervical maturity test(Bishop)score was significantly higher in the observation group(9.76±1.19)than in the control group(7.62±0.83),and the Hamilton Anxiety Scale score was lower in the observation group(7.32±0.85)than in the control group(13.05±1.12).The observation group showed higher rates of natural delivery and lower rates of cesarean section than the control group.The first and total stages of labor were shorter in the observation than in the control group;no significant differences were found in the second and third stages.The incidence of complications was lower in the observation group[1(2.00%)vs 9(18.00%)for complications;49(98.00%)vs 41(82.00%)for non-complications].CONCLUSION The selected fluid volumes to promote cervical maturity and induce labor stabilize maternal mood,increase the natural delivery rate,shorten labor,and improve maternal and infant outcomes.
文摘Cervical cancer related to human papillomavirus(HPV)is a leading cause of cancer-related mortality among women worldwide.Cancer cells release fragments of their DNA,known as circulating tumor DNA(ctDNA),which can be detected in bodily fluids.A PubMed search using the terms“ctHPV”or“circulating tumor DNA”and“cervical cancer”,limited to the past ten years,identified 104 articles,complemented by hand-searching for literature addressing medico-legal implications.Studies were evaluated for relevance and methodological quality.Detection and characterization of circulating tumor HPV DNA(ctHPV DNA)have emerged as promising tools for assessing prognosis and disease recurrence in cervical cancer.Detection techniques include polymerase chain reaction(PCR),digital droplet PCR(ddPCR),and next-generation sequencing(NGS).This review summarizes current knowledge on ctHPV DNA in cervical cancer and explores its clinical and medico-legal implications,including management of discordant results,diagnostic errors,liability,and data protection compliance.
基金the Excellent Middle-aged and Youth Talent Program of Education Department of Hubei Province, No. 2002B03001
文摘BACKGROUND： Stellate ganglion block （SGB） plays a protective role on the brain, but the precise mechanism of action is not clear. OBJECTIVE： To simulate SGB by transection of the cervical sympathetic trunk （TCST） and to investigate the TCST effects on changes in cerebral infarct volume and oxygen free radical levels in rats with focal cerebral ischemia/reperfusion injury. DESIGN, TIME AND SETTING： A complete randomized control animal experiment was performed at the Institute of Neurological Diseases of Taihe Hospital, Yunyang Medical College from February to December 2005. MATERIALS： A total of 101 healthy Wistar rats, weighing 280-320 g, of both genders, aged 17-18 weeks, were used in this study. 2, 3, 5-triphenyltetrazolium chloride （TTC） was purchased from Changsha Hongyuan Biological Company. Superoxide dismutase （SOD）, malondialdehyde （MDA） and nitric oxide （NO） assay kits were provided by Nanjing Jiancheng Bioengineering Institute. METHODS： Rats were randomly divided into a TCST group, a model group and a sham operation group. Successful models were included in the final analysis, with at least 20 rats in each group. After TCST, rat models of focal cerebral ischemia/reperfusion injury were established in the TCST group by receiving middle cerebral artery occlusion （MCAO） by the intraluminal suture method for 2 hours, followed by 24 hours of reperfusion. Rat models of focal cerebral ischemia/reperfusion injury were made in the model group. Rats in the sham operation group underwent experimental procedures as for the model group, threading depth of 10 mm, and middle cerebral artery was not ligated. MAIN OUTCOME MEASURES： Brain tissue sections of ten rats from each group were used to measure cerebral infarct volume by TTC staining. Brain tissue homogenate of another ten rats from each group was used to detect SOD activities, MDA contents and NO levels. Rat neurological function was assessed by neurobehavioral measures. RESULTS： Cerebral infarct volume was bigger in the model group than in the TCST group （P 〈 0.05）. Twenty four hours after cerebral ischemia/reperfusion, SOD activities were lower, whereas MDA contents and NO levels were higher in the TCST and model groups, compared with the sham operation group （P 〈 0.05 or P 〈 0.01）. Compared with the model group, SOD activities were higher, whereas MDA contents and NO levels were lower in the TCST group （P 〈 0.05）. CONCLUSION： After TCST, cerebral infarct volume is reduced, SOD activities are increased, and MDA contents and NO levels are decreased compared to the model group in rats with focal cerebral ischemia/reperfusion injury. These changes may be associated with TCST.
文摘<span style="font-family:Verdana;">Rationale and Objectives: Accurately establishing the diagnosis and staging of cervical and thyroid cancers is essential in medical practice in determining tumor extension and dissemination and involves the most accurate and effective therapeutic approach. For accurate diagnosis and staging of cervical and thyroid cancers, we aim to create a diagnostic method, optimized by the algorithms of artificial intelligence and validated by achieving accurate and favorable results by conducting a clinical trial, during which we will use the diagnostic method optimized by artificial intelligence (AI) algorithms, to avoid errors, to increase the understanding on interpretation computer tomography (CT) scan, magnetic resonance imaging (MRI) of the doctor and improve therapeutic planning. Materials and Methods: The optimization of the computer assisted diagnosis (CAD) method will consist in the development and formation of artificial intelligence models, using algorithms and tools used in segmental volumetric constructions to generate 3D images from MRI/CT. We propose a comparative study of current developments in “DICOM” image processing by volume rendering technique, the use of the transfer function for opacity and color, shades of gray from “DICOM” images projected in a three-dimensional space. We also use artificial intelligence (AI), through the technique of Generative Adversarial Networks (GAN), which has proven to be effective in representing complex data distributions, as we do in this study. Validation of the diagnostic method, optimized by algorithm of artificial intelligence will consist of achieving accurate results on diagnosis and staging of cervical and thyroid cancers by conducting a randomized, controlled clinical trial, for a period of 17 months. Results: We will validate the CAD method through a clinical study and, secondly, we use various network topologies specified above, which have produced promising results in the tasks of image model recognition and by using this mixture. By using this method in medical practice, we aim to avoid errors, provide precision in diagnosing, staging and establishing the therapeutic plan in cancers of the cervix and thyroid using AI. Conclusion: The use of the CAD method can increase the quality of life by avoiding intra and postoperative complications in surgery, intraoperative orientation and the precise determination of radiation doses and irradiation zone in radiotherapy.</span>
基金Supported by a grant of the Military Medical Metrology Project(No.2011-JL2-005)
文摘Objective The aim of the study was to compare flattening filter-free(FFF) beams and conventional flattening filter(FF) beams in volumetric modulated arc therapy(VMAT) for cervical cancer after surgery, through a retrospective planning study.Methods VMAT plans of FFF beams and normal FF beams were designed for a cohort of 15 patients. The prescribed dose was 45 Gy to 1.8 Gy per fraction, and at least 95% of the planning target volume received this dose. Doses were computed with a commercially available treatment planning system using a Monte Carlo(MC) algorithm. Plans were compared according to dose-volume histogram analysis in terms of planning target volume homogeneity and conformity indices(HI and CI), as well as organs at risk(OAR) dose and volume parameters. Results FFF-VMAT was similar to FF-VMAT in terms of CI, but inferior to FF-VMAT considering HI. No statistically differences were observed between FFF-VMAT and FF-VMAT in following organ at risks including pelvic bone marrow, small bowel, bladder, rectum, and normal tissue(NT)..Conclusion For patients with cervical cancer after hysterectomy, the FFF beam achieved target and OAR dose distribution similar to that of the FF beam. Reduction of beam-on time in cervical cancer is beneficial.
文摘To study the clinical significance of the morphological and volume changes in cervical cancer during an ongoing course of radiation therapy (RT) using MR imaging. Methods: Serial MR imaging examinations were performed in 60 advanced cervical cancer patients. MR imaging was obtained at the start of RT, at 20-25 Gy (2-2.5 weeks of RT), at 45-50 Gy (4-5 weeks of RT), and 1-2 month post-RT. Tumor morphology was classified qualitatively as well-defined (round/oval with a well-demarcated smooth margin) vs. lobulated vs. irregular and tumor volume was assessed in each serial MR examination independently by ROI volumetry and diameter volumetry. ROI volumetry was traced on the computer workstation with a trackball in each sagittal T2-weighted image and calculated by the summation of all tumor areas in each slice and multiplication by the slice profile. Diameter volumetry was to measure the largest three orthogonal tumor diameters in each orthogonal measurement plane and calculate as an ellipsoid formula (V=d1 x d2 x d3 x p/6). Serial tumor volume was compared between the two measurement methods. Results: The proportion of lobulated and irregular tumors increased early during RT and declined lately post-RT (68% pre-RT, 80% at 2-2.5 weeks of RT, 72% at 4-5 weeks of RT, 33% post-RT). Accordingly, ROI volumetry and diameter volumetry correlated well pre-RT (r1=0.89) and post-RT (r4=0.80), but poorly during RT (r2 = 0.17 at 2-2.5 weeks of RT, r3 = 0.69 at 4-5 weeks of RT). Conclusions: Cervical cancers regress in a non-uniform fashion during RT and undergo increasingly irregular shrinkage. Measurement with ROI volumetry techniques, which can optimally measure irregular volumes, provides better assessment of radiation response during treatment than diameter volumetry.
基金supported by the National Key R&D Program of China(grant number:2021YFC2500400)National Natural Science Foundation of China(grant numbers:82172894,82073028,82204121)China Postdoctoral Science Foundation(grant number:2023M742617).
文摘Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical cancer as a major public health problem.Methods All data were extracted from the Global Cancer Observatory(GLOBOCAN)2022.Age-standardized incidence rate(ASIR)and mortality rates(ASMR)of cervical cancer were compared and linked to Human Development Index(HDI)between populations.The estimated annual percentage changes(EAPCs)were used to characterize the temporal trend in ASIR/ASMR,and demographic estimates were projected up to 2050.Results Globally,an estimated 662,044 cases(ASIR:14.12/100,000)and 348,709 deaths(ASMR:7.08/100,000)from cervical cancer occurred in 2022,corresponding to the fourth cause of cancer morbidity and mortality in women worldwide.Specifically,42%of cases and 39%of deaths occurred in China(23%and 16%)and India(19%and 23%).Both ASIR and ASMR of cervical cancer decreased with HDI,and similar decreasing links were observed for both early-onset(0–39 years)and late-onset(≥40 years)cervical cancer.Both ASIR and ASMR of overall cervical cancer showed decreasing trends during 2003–2012(EAPC:0.04%and-1.03%);however,upward trends were observed for early-onset cervical cancer(EAPC:1.16%and 0.57%).If national rates in 2022 remain stable,the estimated cases and deaths from cervical cancer are projected to increase by 56.8%and 80.7%up to 2050.Moreover,the projected increase of early-onset cervical cancer is mainly observed in transitioning countries,while decreased burden is expected in transitioned countries.Conclusions Cervical cancer remains a common cause of cancer death in many countries,especially in transitioning countries.Unless scaling-up preventive interventions,human papillomavirus(HPV)vaccination and cervical cancer screening,as well as systematic cooperation within government,civil societies,and private enterprises,the global burden of cervical cancer would be expected to increase in the future.
基金supported by Hunan Provincial Key Research and Development Program,No.2021SK2002(to BW)the Natural Science Foundation of Hunan Province of China(General Program),No.2021JJ30938(to YL)。
文摘Degenerative cervical myelopathy is a common cause of spinal cord injury,with longer symptom duration and higher myelopathy severity indicating a worse prognosis.While numerous studies have investigated serological biomarkers for acute spinal cord injury,few studies have explored such biomarkers for diagnosing degenerative cervical myelopathy.This study involved 30 patients with degenerative cervical myelopathy(51.3±7.3 years old,12 women and 18 men),seven healthy controls(25.7±1.7 years old,one woman and six men),and nine patients with cervical spondylotic radiculopathy(51.9±8.6 years old,three women and six men).Analysis of blood samples from the three groups showed clear differences in transcriptomic characteristics.Enrichment analysis identified 128 differentially expressed genes that were enriched in patients with neurological disabilities.Using least absolute shrinkage and selection operator analysis,we constructed a five-gene model(TBCD,TPM2,PNKD,EIF4G2,and AP5Z1)to diagnose degenerative cervical myelopathy with an accuracy of 93.5%.One-gene models(TCAP and SDHA)identified mild and severe degenerative cervical myelopathy with accuracies of 83.3%and 76.7%,respectively.Signatures of two immune cell types(memory B cells and memory-activated CD4^(+)T cells)predicted levels of lesions in degenerative cervical myelopathy with 80%accuracy.Our results suggest that peripheral blood RNA biomarkers could be used to predict lesion severity in degenerative cervical myelopathy.
文摘This editorial explores the potential integration of non-Western medicine into radiotherapy for cervical cancer.While radiotherapy remains a radical treatment for cervical cancer,its associated toxicity and decline in quality of life can significantly impact patients’lives.Currently,most treatments are supportive,with no specific treatment options available in Western medicine.Non-Western medicine,often less toxic and easier to administer,has shown promising results when used alongside radiotherapy for cervical cancer.Despite these potential benefits,challenges such as limited evidence and restricted application areas persist.While non-Western medicines may offer potential improvements in chemoradiotherapy outcomes for cervical cancer,further research is necessary to substantiate these benefits.
文摘Objective:To carry out dosimetric comparison between volumetric modulated arc therapy(VMAT)and intensity-modulated radiation therapy(IMRT)in cervical cancer.Methods:50 postoperative cervical cancer patients were included in this study.The patients were admitted for treatment from January 2021 to January 2022.VMAT and IMRT plans were designed for each patient to analyze the dose distribution in the target area of the two treatment techniques.Results:Comparing the monitor unit for single treatment(638.21±116.21 MU)and time of single treatment(143.21±23.14 s)in the observation group and the monitor unit for single treatment(932.14±74.11 MU)and time of single treatment(223.14±17.26 s)in the control group,there was significant difference(P<0.05);there was also significant difference(P<0.05)between the normal tissue(bladder and rectum)of the observation group and that(bladder and rectum)of the control group.Conclusion:VMAT is more effective in cervical cancer,and it has a certain protective effect on normal tissues in patients and can reduce the radiation dose.
文摘BACKGROUND Cervical cancer is a formidable global health issue,particularly affecting women in lower-middle-income countries with little or no access to preventative vaccines,screening programs,and treatment modalities.The case report presents a unique case of a large cervical cancer achieving complete response(CR)with concurrent chemoradiotherapy(CCRT),highlighting the effectiveness of this treatment approach even in advanced stages and underscoring the importance of adaptive radiotherapy(RT)in optimizing patient outcomes.CASE SUMMARY We present the case of a 53-year-old woman who presented with four years of abnormal vaginal bleeding and was found to have p16-positive,moderately differentiated cervical squamous cell carcinoma.The tumor measured 14 cm×12 cm×8 cm,the largest size reported in the literature to achieve CR with CCRT.Despite this monumental feat,the patient remained disease-free and is currently on follow-up for 2 years;however,she continued to suffer from substantial morbidity caused by a vesicovaginal fistula and hydronephrosis,underscoring the continuing impact of cervical cancer on quality of life.CONCLUSION In this case report,we highlight the effectiveness of CCRT in achieving CR,even in cases of bulky cervical cancer,with adaptive RT offering a customized strategy to improve patient outcomes.We also emphasize the necessity for multidisciplinary team discussions and highlight the need for strategies to mitigate treatment-related toxicities and long-term complications.
基金supported by a project funded by the Hebei Provincial Central Guidance Local Science and Technology Development Fund(236Z7714G)。
文摘Cervical cancer,a leading malignancy globally,poses a significant threat to women's health,with an estimated 604,000 new cases and 342,000 deaths reported in 2020^([1]).As cervical cancer is closely linked to human papilloma virus(HPV)infection,early detection relies on HPV screening;however,late-stage prognosis remains poor,underscoring the need for novel diagnostic and therapeutic targets^([2]).
基金supported by the CAMS Innovation Fund for Medical Sciences(No.2023-I2M-3-019)National Natural Science Foundation of China(No.82404366)。
文摘In May 2018,the Director-General of the World Health Organization(WHO)called for global action to eliminate cervical cancer~1.This call marked the beginning of an ambitious international effort to scale up 3 key strategies:human papillomavirus(HPV)vaccination,cervical cancer screening,and treatment of precancerous lesions and cancer.Subsequently,the WHO and its partners developed a global strategy to accelerate the reduction of cervical cancer incidence,with an ultimate goal of achieving elimination within the next century.This Global Strategy represents a formal international commitment and is anchored in the 90-70-90 targets to be achieved by 2030.In parallel,several countries have also set national commitments,such as Sweden's pledge to achieve elimination by 2027 and Australia's target of achieving elimination by 2035.
文摘As the 30th anniversary of the landmark Beijing Fourth World Conference on Women approaches,the forthcoming 2025 World Women's Summit in Beijing offers a timely platform to reaffirm commitments to women's well-being worldwide.In alignment with this milestone,Cancer Biology&Medicine is proud to present this special issue dedicated to accelerating the global elimination of cervical cancer.
基金Supported by Project of Science and Technology Department of Inner Mongolia Autonomous Region(2019GG125).
文摘[Objectives]To observe the clinical efficacy of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of cervical spondylotic radiculopathy(CSR).[Methods]A total of 120 patients diagnosed with CSR who received treatment at the International Mongolian Hospital of Inner Mongolia between October 2021 and October 2022 were selected and randomly divided into two groups:A test group and a control group,with 60 patients in each group.The patients in the test group received Mongolian medicine silver needle combined with cupping and bloodletting therapy,following the principles of syndrome differentiation in Mongolian medicine.In contrast,the patients in the control group received only the Mongolian medicine silver needle therapy.After treatment,the Mongolian medicine syndrome scores,visual analogue scale(VAS)scores,and total clinical therapeutic effects in the two groups of patients were compared both prior to and following the treatment.[Results]The improvement in VAS and Mongolian medicine syndrome scores in the test group was greater than that in the control group,with a statistically significant difference(P<0.05).The scores of the test group surpassed those of the control group,and this difference was also statistically significant(P<0.05).Furthermore,the overall therapeutic effect in the test group was 93.33%,which was markedly higher than 76.67%observed in the control group(P<0.05).[Conclusions]The therapeutic effect of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of CSR is remarkable.This approach has demonstrated efficacy in alleviating patient pain and improving the functionality of the cervical vertebrae,thereby warranting clinical promotion and application.
基金supported by a grant from the National Key Research and Development Program of China(No.2022YFC2409901)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1-011)。
文摘Objective:Cervical cancer is a growing concern in China,especially among women who reside in rural areas and older women.Understanding age-and region-specific trends in cervical cancer is vital for informing policy and assessing progress toward WHO elimination targets.Methods:The 2000±2020 data from 22 long-standing registries contributing to the China national cancer registry was analyzed to estimate age-standardized incidence and mortality rates(ASIR and ASMR,respectively).Joinpoint regression yielded an average annual percentage change(AAPC)stratified by age group(<35,35±64,65±74,and≥75 y)and by urban-rural area.The comparative analysis included GLOBOCAN Overtime data from selected Asia-Pacific countries.Results:The ASIR tripled in China between 2000 and 2020 before stabilizing(AAPC=6.5%),while the ASMR rose steadily(AAPC=3.9%).The urban incidence declined after 2009 among women<35 y,while rural trends were broadly stable.The ASIR and ASMR increased in urban areas among women 35±64 y of age,while rural areas had a rising ASIR and a stable ASMR,suggesting potential screening effects.In contrast,women≥65 y of age had a steadily increasing incidence and mortality in rural and urban areas.Australia and Republic of Korea had consistent declines in the ASIRs and ASMRs compared to other Asia-Pacific countries,whereas Japan exhibited rising trends.The Philippines experienced a surge in mortality rates,despite incidence rates remaining stable or declining.Conclusions:The cervical cancer burden in China has begun to plateau but large disparities persist by age and geography.To achieve elimination of cervical cancer,it is imperative to implement tailored strategies that prioritize the urgent expansion of HPV vaccination programs,the deployment of high-efficacy screening methods,and the universal access to treatment throughout the nation.
文摘Objective:To investigate the therapeutic adjuvant potential of fucoidan in cervical cancer and to evaluate its efficacy in combination with immunotherapy.Methods:Fucoidan extracted from Fucus vesiculosus was dissolved in phosphate buffered saline and used to treat TC-1 cervical cancer cells in vitro as well as tumor-bearing C57BL/6 mice in vivo.Mice were divided into four groups:the vehicle control group,the mRNA therapy-alone group,the fucoidan-only group,and the combination group.MAPK signaling proteins(p-ERK,T-ERK,p-p38)were analyzed by Western blotting assays.T cell surface markers and intracellular cytokines in splenocytes were assessed by flow cytometry,and plasma cytokine levels were measured by ELISA.Results:Fucoidan decreased the p-ERK/T-ERK ratio and p-p38.Fucoidan combined with mRNA therapy did not significantly affect CD4^(+)T-cell activation but reduced CD8^(+)T-cell activation compared with mRNA therapy alone.MCP-1 and IFN-γwere significantly reduced in the combination therapy group compared with mRNA therapy alone,while IL-6,TNF-α,perforin,and granzyme B did not show significant changes between the two groups.Conclusions:These findings suggest that fucoidan could inhibit excessive T cell activation and cytokine production by suppressing MAPK p-p38 protein expression.
基金supported by the High-Level Public Health Specialized Talents Project of Beijing Municipal Health Commission(YFH,2024-3-028)the National Natural Science Foundation of China(YFH,72061137007)SHV is supported,in part,by U.S.National Institutes of Health(P30CA016359).
文摘Background:Cervical and breast cancers are among the top 4 leading causes of cancer-related mortality in women.This study aimed to examine age-specific temporal trends in mortality for cervical and breast cancers in urban and rural areas of China from 2009 to 2021.Methods:Age-specific mortality data for cervical and breast cancers among Chinese women aged 20-84 years were obtained from China’s National Disease Surveillance Points system spanning the years 2009 to 2021.Negative binomial regression models were utilized to assess urban-rural differences in mortality rate ratios,while Joinpoint models with estimated average annual percent changes(AAPC)and slopes were employed to compare temporal trends and the acceleration of mortality rates within different age groups.Results:From 2009 to 2021,there was a relative increase in age-specific mortality associated with the two cancers observed in rural areas compared with urban areas.A rising trend in the screening age of 35-64[AAPC:4.0%,95%confidence interval(CI)0.5-7.6,P=0.026]for cervical cancer was noted in rural areas,while a stable trend(AAPC:-0.7%,95%CI-5.8 to 4.6,P=0.780)was observed in urban areas.As for breast cancer,a stable trend(AAPC:0.3%,95%CI-0.3 to 0.9,P=0.280)was observed in rural areas compared to a decreasing trend(AAPC:-2.7%,95%CI-4.6 to-0.7,P=0.007)in urban areas.Urban-rural differences in mortality rates increased over time for cervical cancer but decreased for breast cancer.Mortality trends for both cervical and breast cancers showed an increase with age across 4 segments,with the most significant surge in mortality observed among the 35-54 age group across urban and rural areas,periods,and regions in China.Conclusions:Special attention should be given to women aged 35-54 years due to mortality trends and rural-urban disparities.Focusing on vulnerable age groups and addressing rural-urban differences in the delivery of cancer control programs can enhance resource efficiency and promote health equity.
基金Supported by Science and Technology Program of Inner Mongolia Autonomous Region"Clinical Observation of Warm Needling Acupuncture of Mongolian Medicine in the Treatment of Lumbar Disc Herniation"(2019GG125).
文摘Traditional Mongolian Medicine(TMM)therapies have emerged as a prominent therapeutic option for Cervical Spondylotic Radiculopathy(CSR),owing to their demonstrated efficacy,cost-effectiveness,and high clinical accessibility.This study systematically reviews classical Mongolian medical texts to synthesize CSR-related knowledge,including disease profiles,pathogenesis,and therapeutic strategies—through dual analytical perspectives from modern medicine and TMM theory.Furthermore,it critically evaluates recent clinical research on TMM interventions for CSR,encompassing manual therapies,herbal formulations,and holistic regimens.The integrated analysis aims to provide references for optimizing TMM clinical practices in CSR treatment.
基金Supported by National Key Research and Development Program of China,No.2021YFC2701603.
文摘BACKGROUND The special physiological changes during pregnancy pose a huge challenge to the diagnosis of cervical cancer in pregnancy(CCIP).However,due to the poor prognosis of advanced-stage CCIP,there is currently no consensus or guideline for diagnosis and treatment.CASE SUMMARY In this case report,we presented the case of a 30-year-old woman at 30 weeks of gestation who presented with irregular vaginal bleeding and was admitted to a local hospital at 35 weeks of gestation with a sudden gush of fluid and underwent a C-section.During the surgery,a rotten fish-like solid mass in the lower segment of the posterior wall of the uterus was excised for biopsy.The patient was referred to our hospital because she experienced heavy vaginal bleeding 13 days after one chemotherapy session.The solid mass was initially misdiagnosed as uterine clearcell carcinoma at local hospital but later confirmed as cervical adenosquamous carcinoma by a multidisciplinary team.Three months posttreatment,she succumbed to multiple tumor metastases.The infant was healthy at the latest 2-year follow-up.CONCLUSION Obstetricians should expand differential diagnoses when obstetric factors cannot explain symptoms of persistent vaginal bleeding during pregnancy.Atypical and insidious clinical presentations are often concealed by physiological changes during pregnancy,which may increase the difficulty of diagnosis and result in misdiagnosis.
