NK model simulation study of intelligent manufacturing transformation path selection in pharmaceutical manufacturing enterprises.

Under the wave of Industry 4.0, traditional pharmaceutical manufacturing enterprises are in urgent need of intelligent manufacturing transformation and upgrading, and exploring the optimal realization path of intelligent manufacturing transformation can help accelerate the transformation process of pharmaceutical manufacturing enterprises. This paper uses grounded theory research methods to conduct a multi-case study to summarize six influencing factors of the intelligent manufacturing transformation of Chinese pharmaceutical manufacturing enterprises; and then analyzes the correlation between the intelligent manufacturing influencing factors based on the DEMATEL method and the NK model, and identifies the key influencing factors according to this, and then draws the fitness landscape map of the intelligent manufacturing transformation, and finally arrives at the optimal path selection of the intelligent manufacturing transformation of pharmaceutical manufacturing enterprises. The study enriches and extends the research paradigm of intelligent manufacturing transformation, and provides lessons for pharmaceutical manufacturing enterprises to realize intelligent manufacturing transformation and upgrading.

Cognitive Workload Detection of Air Traffic Controllers Based on mRMR and Fewer EEG Channels.

For air traffic controllers, the extent of their cognitive workload can significantly impact their cognitive function and response time, consequently influencing their operational efficiency or even resulting in safety incidents. In order to enhance the accuracy and efficiency in determining the cognitive workload of air traffic controllers, a cognitive workload detection method for air traffic controllers based on mRMR and fewer EEG channels was proposed in this study. First of all, a set of features related to gamma waves was initially proposed; subsequently, an EEG feature evaluation method based on the mRMR algorithm was employed to pinpoint the most relevant indicators for the detection of the cognitive workload. Consequently, a model for the detection of the cognitive workload of controllers was developed, and it was optimized by filtering out channel combinations that exhibited higher sensitivity to the workload using the mRMR algorithm. The results demonstrate that the enhanced model achieves the accuracy and stability required for practical applications. Notably, in this study, only three EEG channels were employed to achieve the highly precise detection of the cognitive workload of controllers. This approach markedly increases the practicality of employing EEG equipment for the detection of the cognitive workload and streamlines the detection process.

GDNF's Role in Mitigating Intestinal Reactive Gliosis and Inflammation to Improve Constipation and Depressive Behavior in Rats with Parkinson's disease.

Constipation is a common symptom in patients with Parkinson's disease (PD) and is often associated with depression. Enteric glial cells (EGCs) are crucial for regulating intestinal inflammation and colon motility, and their activation can lead to the death of intestinal neurons. Glial cell line-derived neurotrophic factor (GDNF) has been recognized for its neuroprotective properties in various neurological disorders, including PD. This study explores the potential of GDNF in alleviating intestinal reactive gliosis and inflammation, thereby improving constipation and depressive behavior in a rat model of PD. A PD model was established via unilateral stereotaxic injection of 6-hydroxydopamine (6-OHDA). Five weeks post-injury, AAV5-GDNF (2 ~ 5 × 10^11) was intraperitoneally injected into experimental and control rats. Fecal moisture percentage (FMP) and colonic propulsion rate (CPPR) were used to evaluate colon motility. Colon-related inflammation and colonic epithelial morphology were assessed, and depressive behavior was analyzed one week before sampling. PD rats exhibited reduced colonic motility and GDNF expression, along with increased EGC reactivity and elevated levels of pro-inflammatory cytokines IL-1, IL-6, and TNF-α. Additionally, there was an up-regulation of CX43 and a decrease in PGP 9.5 expression. The intraperitoneal injection of AAV-GDNF significantly protected colonic neurons by inhibiting EGC activation and down-regulating CX43. This treatment also led to a notable reduction in depressive-like symptoms in PD rats with constipation. GDNF effectively reduces markers of reactive gliosis and inflammation, and promotes the survival of colonic neurons, and improves colonic motility in PD rats by regulating CX43 activity. Furthermore, GDNF treatment alleviates depressive behavior, suggesting that GDNF or its agonists could be promising therapeutic agents for managing gastrointestinal and neuropsychiatric symptoms associated with PD.

An assessment of the antihyperlipidemic ingredients of Qi Ge Decoction based on metabolomics combined with serum pharmacochemistry.

This study aims to explore the pharmacological substance basis of Qi Ge Decoction (QG) in antihyperlipidemia through a combination of metabolomics and serum pharmacochemistry. We used ultra-performance liquid chromatography quadrupole-time-of-flight/MS (UPLC Q-TOF/MS) to analyze and identify the chemical constituents of QG in vitro and in blood chemical components. The metabolomics technology was used to analyze serum biomarkers of QG in preventing and treating hyperlipidemia. We constructed a mathematical model of the relationship between constituents absorbed into the blood and endogenous biomarkers and explored the potential therapeutic application of QG for the prevention and treatment of hyperlipidemia. Compared with the model group, the levels of total cholesterol and triglyceride in the QG group were significantly decreased (P < 0.01). A total of 12 chemical components absorbed into the blood were identified, and 48 biomarkers of the hyperlipidemia model were obtained from serum metabolomic analysis, of which 15 metabolites were backregulated after QG intervention. Puerarin, hesperetin, puerarin xyloside, calycosin, and monohydroxy-tetramethoxyflavone had a high correlation with the biomarkers regulated by QG. This study elucidated the material basis of QG in the intervention of hyperlipidemia, thereby facilitating future research aimed at further revealing the pharmacodynamic material basis of QG's antihyperlipidemic effects.

Alkali-Induced Protein Structural, Foaming, and Air-Water Interfacial Property Changes and Quantitative Proteomic Analysis of Buckwheat Sourdough Liquor.

In this study, the protein structural, foaming, and air-water interfacial properties in dough liquor (DL) ultracentrifugated from buckwheat sourdough with different concentrations of an alkali (1.0-2.5% of sodium bicarbonate) were investigated. Results showed that the alkali led to the cross-linking of protein disulfide bonds through the oxidation of free sulfhydryl groups in DL. The alterations in protein secondary and tertiary structures revealed that the alkali caused the proteins in DL to fold, decreased the hydrophobicity, and led to a less flexible but compact structure. The alkali accelerated the diffusion of proteins and decreased the surface tension of DL. In addition, the alkali notably improved the foam stability by up to 34.08% at 2.5% concentration, mainly by increasing the net charge, reducing the bubble size, and strengthening the viscoelasticity of interfacial protein films. Quantitative proteomic analysis showed that histones and puroindolines of wheat and 13S globulin of buckwheat were closely related to the changes in the alkali-induced foaming properties. This study sheds light on the mechanism of alkali-induced improvement in gas cell stabilization and the buckwheat sourdough steamed bread quality from the aspect of the liquid lamella.

Changes in rheology and components during the processing of Chinese traditional handmade hollow dried noodle.

The study of the changes in rheological properties and components during the processing of Chinese traditional handmade hollow dried noodle (HHDN) is essential to explaining the excellent quality of HHDN. The dynamic oscillation frequency sweep, stress relaxation, and uniaxial extension characteristics of the dough after kneading, stretching, and resting were investigated at six sampling points during the processing of HHDN. The result showed that stretching led to an increase in G' and G0, and a significant decrease (P < 0.05) in extensibility from 131.02 mm to 57.99 mm. Confocal laser scanning microscopy (CLSM) was used to observe the microstructure of the gluten network, which was destroyed during stretching and restored during resting. Studies of changes in components showed that the stretching process resulted in a decrease in GMP content from 3.24 (g/100 g) to 3.18 (g/100 g), and the resting process resulted in ß-sheets decreasing significantly (P < 0.05). The degree of starch pasting increased significantly (P < 0.05) after stretching. The results of the correlation analysis showed that components changes were highly correlated with the rheological properties during the processing of HHDN.

Nanostructured lipid carriers promote percutaneous absorption and hair follicle targeting of tofacitinib for treating alopecia areata.

Alopecia areata affects over 140 million people worldwide and causes severe psychological distress. The Janus kinase (JAK) inhibitor, tofacitinib, shows significant potential in therapeutic applications for treating alopecia areata; however, the systemic adverse effects of oral administration and low absorption rate at the target site limit its application. Hence, to address this issue, we designed topical formulations of tofacitinib-loaded cationic lipid nanoparticles (TFB-cNLPs) with particle sizes of approximately 200 nm. TFB-cNLPs promoted percutaneous absorption and hair follicle targeting in an ex vivo pig ear model. TFB-cNLP decreased IFN-γ-induced alopecia areata symptoms in an in vitro follicle model by blocking the Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway. It also reduced the number of CD8+NKG2D+T cells in a C3H mouse model of alopecia areata in vivo, thereby inhibiting the progression of alopecia areata and reversing hair loss. These findings suggest that TFB-cNLP enhanced hair follicle targeting and has the potential for topical treatment or prevention of alopecia areata.

CPPs-modified chitosan as permeability-enhancing chemotherapeutic combined with gene therapy nanosystem by thermosensitive hydrogel for the treatment of osteosarcoma.

BACKGROUND: Chemotherapy resistance of osteosarcoma (OS) is still the crux of poor clinical curative effect.E3 ubiquitin-protein ligase Rad18 (Rad18) contributed to doxorubicin resistance in OS, which ultimately mediated DNA damage tolerance and led to a poor prognosis and chemotherapy response in patients. METHODS: In this study, doxorubicin was loaded in the process of Fe2+ and siRad18 forming nanoparticles(FSD) through coordination, chitosan modified with cell penetrating peptide (H6R6) was synthesized and coated on the surface of the NPs(FSD-CHR). FSD-CHR was then dispersed in thermosensitive hydrogel(PPP) for peritumoral injection of osteosarcoma in situ. Subsequently, the physicochemical properties and molecular biological characteristics of the drug delivery system were characterized. Finally, an osteosarcoma model was established to study the anti-tumor effects of multifunctional nanoparticles and the immunotherapy effect combined with αPD-L1. RESULTS: FSD-CHR has enhanced tumor tissue permeability, siRad18 can significantly reduce Dox-mediated DNA damage tolerance and enhance anti-tumor effects, and iron-based NPs show enhanced ROS upregulation. FSD-CHR@PPP showed significant inhibition of osteosarcoma growth in vivo and a reduced incidence of lung metastasis. In addition, siRad18 was unexpectedly found to enhance Dox-mediated immunogenic cell death (ICD).FSD-CHR@PPP combined with PD-L1 blocking significantly enhanced anti-tumor effects due to decreased PD-L1 enrichment. CONCLUSION: Hydrogel encapsulation of permeable nanoparticles provides an effective strategy for doxorubicin-resistant OS, showing that gene therapy blocking DNA damage tolerance can enhance treatment response to chemotherapy and appears to enhance the effect of ICD inducers to activate the immune system.

UPLC-Q-TOF/MS analysis of chemical components of single decoction and combined decoction of Qige decoction reveals the differences between various preparation processes.

The aim of this work was to explore the differences between various pharmaceutical processes in combined solutions of a single decoction (QGHBY) and a combined decoction (QGHJY) of Qi-Ge decoction from the perspective of chemical composition changes, so as to further guide the clinical application of drugs. A combined solution of a single decoction and a combined decoction of Astragali Radix, Puerariae Lobatae Radix and Citri Reticulatae Chachiensis Pericarpium was prepared with the same technological parameters. The chemical components of the two were detected and identified based on UPLC-Q-TOF/MS, and the different components were determined by principal component analysis. Eighty-eight compounds were identified in the pharmaceutical solution of Qi-Ge decoction. Principal component analysis revealed 11 different components of QGHBY and QGHJY with the conditions of Variable Importance in Projection (VIP) ≥ 1, fold change ≥ 2 and p < 0.05, among which hesperidin, hesperitin, isosinensetin, sinensetin and 5-demethylnobiletin were the components of Citri Reticulatae Chachiensis Pericarpium. The levels of these 11 different components in QGHJY were higher than those of QGHBY. The combined decoction is beneficial for the dissolution of flavonoids and other chemical components, and there is a significant difference in the content of chemical components between modern herbal concentrate granules and traditional decoctions.

Comparative analysis and evaluation of wild and cultivated Radix Fici Simplicissimae using an UHPLC-Q-Orbitrap mass spectrometry-based metabolomics approach.

Radix Fici Simplicissimae (RFS) is widely studied, and is in demand for its value in medicines and food products, with increased scientific focus on its cultivation and breeding. We used ultra-high-performance liquid chromatography quadrupole-orbitrap mass spectrometry-based metabolomics to elucidate the similarities and differences in phytochemical compositions of wild Radix Fici Simplicissimae (WRFS) and cultivated Radix Fici Simplicissimae (CRFS). Untargeted metabolomic analysis was performed with multivariate statistical analysis and heat maps to identify the differences. Eighty one compounds were identified from WRFS and CRFS samples. Principal component analysis and orthogonal partial least squares discrimination analysis indicated that mass spectrometry could effectively distinguish WRFS from CRFS. Among these, 17 potential biomarkers with high metabolic contents could distinguish between the two varieties, including seven phenylpropanoids, three flavonoids, one flavonol, one alkaloid, one glycoside, and four organic acids. Notably, psoralen, apigenin, and bergapten, essential metabolites that play a substantial pharmacological role in RFS, are upregulated in WRFS. WRFS and CRFS are rich in phytochemicals and are similar in terms of the compounds they contain. These findings highlight the effects of different growth environments and drug varieties on secondary metabolite compositions and provide support for targeted breeding for improved CRFS varieties.

The Effect of Carboxymethyl Cellulose Sodium on the Proofing Tolerance and Quality of Frozen Dough Steamed Bread.

This study investigated the effects of dough proofing degree (1.1, 1.3, 1.5, and 1.7 mL/g) and carboxymethyl cellulose sodium (CMC-Na) on the quality of frozen dough steamed bread (FDSB). As the dough proofing degree was increased from 1.1 to 1.7 mL/g, the specific volume of FDSB initially increased and then decreased, with the maximum at 1.3 mL/g, and then dramatically decreased at 1.5 and 1.7 mL/g, accompanied by a harder texture and secession of crust and crumb, which were the detrimental effects brought by over-proofing. The optimal amount of CMC-Na effectively alleviated the deterioration associated with over-proofing, and the proofing tolerance of FDSB was increased from 1.3 mL/g to 1.7 mL/g. Fermentation analysis showed that CMC-Na significantly improved the extensibility and gas-holding capacity of the dough by increasing the maximum height of the dough (Hm) and the emergence time (T1) of Hm. Frequency sweep tests indicated that CMC-Na improved the plasticity of proofed dough by increasing loss factor tan δ. Significant reductions were found in peak viscosity and complex modulus G* in pasting properties tests and temperature sweep measurements, respectively, suggesting that CMC-Na influenced starch gelatinization and dough stiffening during steaming, which promoted the extension of the network structure, thus facilitating gas expansion and diffusion. These property changes theoretically explained the improvement in the proofing tolerance of FDSB by CMC-Na.

Insights into the effect mechanism of acidic pH condition on the in vitro starch digestion of black highland barley semi-dried noodles.

In this study, black highland barley semi-dried noodles (BHBSNs) were adjusted to acidic pH (5.0, 4.5, 4.0) with an acidity regulator (monosodium fumarate) for obtaining low glycemic index (GI) BHBSNs, and the changes in the in vitro starch digestion, free phenolic content, and α-amylase activity in BHBSNs were investigated. The estimated glycemic index (eGI) of BHBSNs decreased from 59.23 to 52.59, 53.89 and 53.61, respectively, as the pH was adjusted from 6.0 to 5.0, 4.5, 4.0. As the pH of BHBSNs decreased, the equilibrium hydrolysis (C∞) decreased, and kinetic coefficient (k) decreased and then increased. Compared to the control, the pH of the digestive fluid decreased during digestion with decreasing pH, and the α-amylase inhibition of BHBSNs with pH 5.0, 4.5, and 4.0 increased by 56.54 %, 75.18 %, and 107.98 %, respectively. In addition, as the pH of BHBSNs decreased, the free phenolic content and the content of released phenolics during digestion increased. Pearson correlations analysis showed that the increase in α-amylase inhibition and phenolic release during digestion induced by acidic pH was negatively correlated with the eGI and C∞ of BHBSNs. This study indicated that acidic pH condition could modulate starch digestion for preparing low GI BHBSNs.

Review on toxicology and activity of tomato glycoalkaloids in immature tomatoes.

Owing to the lack of selection and limited intelligence in mechanical picking, some immature tomatoes that contain alkaloids are thrown away. Tomatine alkaloids are steroidal alkaloids naturally present in Solanaceae plants, which are distributed in small amounts in immature tomato fruits and decrease as the fruits ripen. Tomato glycoalkaloids are harmful to human health. However, in small quantities, there is some evidence that these compounds might be beneficial, as other non-antioxidant bioactivities. This article considers recent research on the biological effects of tomato glycoalkaloids in immature tomatoes, providing reference value for the potential development of these compounds.

Preimplantation genetic testing for aneuploidy optimizes reproductive outcomes in recurrent reproductive failure: a systematic review.

Introduction: Recurrent reproductive failure (RRF) is a common pregnancy complication, imposing great physical, emotional and financial burden for the suffered couples. The leading cause of RRF is believed to be aneuploid embryo, which could be solved by preimplantation genetic testing for aneuploidy (PGT-A) in theory. With molecular genetic development, PGT-A based on comprehensive chromosomal screening (CCS) procedures and blastocyst biopsy is widely applied in clinical practice. However, its effects in RRF were not defined yet. Methods: A systematic bibliographical search was conducted without temporal limits up to June, 2023. Studies about the effects of PGT-A based on CCS procedures and blastocyst biopsy in RRF were included. Results: Twenty studies about the effects of PGT-A based on CCS procedures and blastocyst biopsy in RRF were included. It revealed that PGT-A could optimise the reproductive outcomes of RRF sufferers, especially in those with advanced age. However, in patients with multiple occurrences of pregnancy losses, the benefits of PGT-A were limited. Discussion: More randomized controlled trials with large sample size are required to evaluate the benefits of PGT-A in RRF sufferers and identify which population would benefit the most.

Insights into the enhancement mechanism of immersion resistance of cooked noodles induced by wheat flour post-ripening: The view from protein cross-linking.

To overcome the problem that takeaway noodles possessed poor immersion resistance, in this study noodles were prepared from post-ripened wheat flour, and changes in textural properties, protein components, and water status of noodles were determined. The firmness and tensile distance of noodles were gradually increased by 7.40%-35.88% when wheat flour was post-ripened for 20-40 d. Afterwards, noodle textural qualities were slightly decreased. Compared with control groups, contents of glutenin macropolymer (GMP) and disulfide bonds were significantly (p<0.05) increased and protein network was also more compact, whereas the Glutenin/Gliadin ratio and free sulfhydryl groups content were significantly (p<0.05) reduced. Contents of sodium dodecyl sulfate extractable protein (SDSEP) were reduced by 3.22%-6.23%. Meanwhile, the decrease in A23 indicated that wheat flour post-ripening limited water-absorbing capacity of noodles during immersion. In conclusion, wheat flour post-ripening promoted the immersion resistance of noodles by inducing protein cross-linking, and the best post-ripening time was 20-40 d.

Insights into the mechanisms underlying ethanol-induced changes in the dough mechanical properties and quality characteristics of fresh noodles.

This study investigated the effects of ethanol (0 %∼6%) on the dough mechanical properties and quality characteristics of fresh noodles and elucidated the relationship between the above changes and physicochemical, structural, and molecular properties of gluten. Ethanol reduced the water absorption (from 59.00 % to 52.33 %), stability time (from 8.17 min to 3.33 min) and viscoelasticity of dough, and increased the development time, weakening degree and compliance. Ethanol also decreased the fracture stress of dough sheet, and increased fracture elongation and adhesiveness (from 46.15 g·s to 75.88 g·s). Ethanol decreased the noodles' hardness (from 5347.41 g to 4442.34 g), break force, tensile distance, and water absorption, while cooking loss was increased. SEM and CLSM showed that ethanol destroyed the compactness of internal structure and inhibited the formation of gluten network in noodles. According to the results of SE-HPLC and RP-HPLC, ethanol dissolved part of the gliadin and inhibited the polymerization of protein.

Humidity-controlled heat treatment of fresh spinach noodles for color preservation and storage quality improvement.

The high sensitivity to color browning during room-temperature storage was a significant factor in limiting the development of fresh spinach noodles (FSN). The practice of humidity-controlled heat treatment (HCHT) at varying temperatures, relative humidity, and time was carried out to limit enzyme activity and improve the quality of FSN. Results showed that HCHT could maximize the color preservation of fresh spinach noodle quality while effectively inactivating polyphenol oxidase and the yeasts, and mold count in FSN during storage was almost undetectable after mild conditions (80 °C). The hardness and chewiness of HCHT noodles were significantly increased, but the free sulfhydryl content was reduced. At 80 °C, 90 %, 5 min, protein structural aggregation was found in the microstructure of HCHT fresh spinach noodles. HCHT also caused partial gelatinization, as evidenced by the decrease in starch gelatinization enthalpy from 5.49 to 4.77 J/g, although the gelatinization degree of FSN was comparatively low.

Does endometrial receptivity array improve reproductive outcomes in euploid embryo transfer cycles? a systematic review.

Besides chromosomal normality, endometrial receptivity is an important factor in determining successful pregnancies. Endometrial receptivity array (ERA), a promising endometrial receptivity test, was speculated to improve the reproductive outcomes. However, its effectiveness is controversial in clinical practice. Therefore, we conducted this review to investigate its role in in vitro fertilization (IVF) treatment. To eliminate the interference of embryo quality, we only analyzed studies that originally reported the reproductive outcomes of patients who underwent ERA-guided euploid embryo transfer (EET). Unexpectedly, it revealed that ERA could not optimize the reproductive outcomes in EET cycles, no matter in general infertile population or in patients with a history of previous failed embryo transfers.

Pregnancy prediction via ultrasound-detected endometrial blood for hormone replacement therapy-frozen embryo transfer: a prospective observational study.

BACKGROUND: This study aimed to assess the predictive value of endometrial blood flow branches on pregnancy outcomes after hormone replacement therapy-frozen embryo transfer (HRT-FET). METHODS: This prospective observational study involved 292 reproductive-aged women who underwent endometrial receptivity assessment in a tertiary care academic medical center in southwest China using power Doppler ultrasonography during HRT-FET. Three-dimensional power Doppler ultrasound was performed on the day of endometrial transformation and the day before embryo transfer. The endometrial blood flow branches of the endometrial and subendometrial regions were compared in the non-pregnant and pregnant groups at the two time points mentioned above. RESULTS: The endometrial blood flow branches were higher in pregnant patients than in non-pregnant patients on the day of endometrial transformation (P = 0.009) and the day before embryo transfer (P = 0.001). Changes in endometrial blood flow pattern and endometrial blood flow branches at the two time points did not differ among the pregnancy outcome samples. After adjusting for age, antral follicles, and embryos transferred, the endometrial blood flow branches on the day before embryo transfer was the independent factor influencing the chance of clinical pregnancy, with an odds ratio of 3.001 (95% confidence interval: 1.448 - 6.219, P = 0.003). CONCLUSIONS: Endometrial blood flow perfusion during the peri-transplantation period of the HRT-FET cycle is a good indicator of pregnancy outcomes, suggesting that valuation of endometrial branches via power Doppler ultrasound is a simple and effective approach for achieving indicator measurements.

Cutaneous metastasis from cervical cancer to the scalp and trunk: a case report and review of the literature.

BACKGROUND: An estimated 119,300 new cases of cervical cancer occur annually in China, accounting for 372,00 deaths. Cutaneous metastasis from cervical cancer is a rare event, with an incidence of 0.1-1.3% and typically a preterminal occurrence. Scalp metastasis from cervical cancer is exceptionally anecdotal, with only a dozen examples well documented. CASE PRESENTATION: The patient is a 33-year-old Chinese woman who was diagnosed with International Federation of Gynecology and Obstetrics stage IVB cervical cancer in November 2021. From December 2021 to April 2022, the patient was enrolled in the clinical trial of sintilimab combined with chemotherapy and radiotherapy for treatment of stage IV cervical cancer and underwent six cycles of immunotherapy and chemotherapy (sintilimab plus paclitaxel liposome and cisplatin). Treatment was well tolerated and led to a partial response. The masses adjacent to the spine and iliac bone was largely reduced. Thus, radiotherapy of the metastatic residues was carried out and followed by radiotherapy to the primary tumor at the cervix uteri. However, by the time of the radiotherapy completion in October 2022, the patient noticed painless nodules at the left scapular region and the right hypochondrium. The following month, more nodules occurred on the scalp and trunk, including the left axilla, anterior abdomen, and left back, along with a lesion invading the sternum that caused acute bone pain. The cutaneous masses were white, discrete with a rubbery consistency, and fixed to the skin. Several nodules increased in size and eventually ulcerated. Fine­needle aspiration cytology of the left back swellings revealed metastatic squamous cell carcinoma, P16 positive. No visceral or brain metastasis was observed at this point. CONCLUSIONS: Cervical cancer metastases to the scalp are extremely uncommon. When a scalp metastasis is present, it might be the only symptomatic sign of disease progression or widespread metastatic lesions. So far, there is no clear guideline regarding skin metastases treatment. Such skin lesions warrant a thorough radiologic and pathologic workup to form a comprehensive management plan.