Elucidating the Role of circTIAM1 in Guangling Large-Tailed Sheep Adipocyte Proliferation and Differentiation via the miR-485-3p/PLCB1 Pathway.

Fat tissue-a vital energy storage organ-is intricately regulated by various factors, including circular RNA, which plays a significant role in modulating fat development and lipid metabolism. Therefore, this study aims to clarify the regulatory mechanism of sheep adipocyte proliferation and differentiation by investigating the involvement of circTIAM1, miR-485-3p, and its target gene PLCB1. Through previous sequencing data, circTIAM1 was identified in sheep adipocytes, with its circularization mechanism elucidated, confirming its cytoplasmic localization. Experimental evidence from RNase R treatment and transcription inhibitors highlighted that circTIAM1 is more stable than linear RNA. Additionally, circTIAM1 promoted sheep adipocyte proliferation and differentiation. Furthermore, bioinformatic analysis demonstrated a robust interaction between miR-485-3p and circTIAM1. Further experiments revealed that miR-485-3p inhibits fat cell proliferation and differentiation by inhibiting PLCB1, with circTIAM1 alleviating the inhibitory effect via competitive binding. In summary, our findings elucidate the mechanism through which circTIAM1 regulates Guangling Large-Tailed sheep adipocyte proliferation and differentiation via the miR-485-3p-PLCB1 pathway, offering a novel perspective for further exploring fat metabolism regulation.

A Temperature Compensation Approach for Micro-Electro-Mechanical Systems Accelerometer Based on Gated Recurrent Unit-Attention and Robust Local Mean Decomposition-Sample Entropy-Time-Frequency Peak Filtering.

MEMS accelerometers are significantly impacted by temperature and noise, leading to a considerable compromise in their accuracy. In response to this challenge, we propose a parallel denoising and temperature compensation fusion algorithm for MEMS accelerometers based on RLMD-SE-TFPF and GRU-attention. Firstly, we utilize robust local mean decomposition (RLMD) to decompose the output signal of the accelerometer into a series of product function (PF) signals and a residual signal. Secondly, we employ sample entropy (SE) to classify the decomposed signals, categorizing them into noise segments, mixed segments, and temperature drift segments. Next, we utilize the time-frequency peak filtering (TFPF) algorithm with varying window lengths to separately denoise the noise and mixed signal segments, enabling subsequent signal reconstruction and training. Considering the strong inertia of the temperature signal, we innovatively introduce the accelerometer's output time series as the model input when training the temperature compensation model. We incorporate gated recurrent unit (GRU) and attention modules, proposing a novel GRU-MLP-attention model (GMAN) architecture. Simulation experiments demonstrate the effectiveness of our proposed fusion algorithm. After processing the accelerometer output signal through the RLMD-SE-TFPF denoising algorithm and the GMAN temperature drift compensation model, the acceleration random walk is reduced by 96.11%, with values of 0.23032 g/h/Hz for the original accelerometer output signal and 0.00895695 g/h/Hz for the processed signal.

Vitamin E: An assistant for black soldier fly to reduce cadmium accumulation and toxicity.

Cadmium (Cd) is a toxic heavy metal associated with osteoporosis, liver, and kidney disease. The black soldier fly (BSF) Hermetia illucens may be exposed to Cd during the transformation of livestock manure. The BSF has a high tolerance to Cd. In the previous work of the laboratory, we found that vitamin E (VE) may play a role in the tolerance of BSF to Cd exposure. The main findings are as follows: The BSF larvae pretreated with exogenous VE had heavier body weight, lower content and toxicity of Cd under similar Cd exposure. Even in high Cd exposure at the concentrations of 300 and 700 mg/kg, the BSF larvae pretreated with exogenous VE at a concentration of 100 mg/kg still reduced the Cd toxicity to 85.33 % and 84.43 %, respectively. The best-fitting models showed that metallothionein (MT) content, oxidative damage (8-hydroxydeoxyguanosine content, malondialdehyde content), antioxidant power (total antioxidant power, peroxidase activity) had a great influence on content and toxicity of Cd bioaccumulated in the larvae. The degree of oxidative damage was reduced in the larvae with exogenous VE pretreatments. This variation can be explained by their changed MT content and increased antioxidant power because of exogenous VE. These results reveal the roles of VE in insects defense against Cd exposure and provide a new option for the prevention and therapy of damage caused by Cd exposure.

NK cells as powerful therapeutic tool in cancer immunotherapy.

BACKGROUND: Natural killer (NK) cells have gained considerable attention and hold great potential for their application in tumor immunotherapy. This is mainly due to their MHC-unrestricted and pan-specific recognition capabilities, as well as their ability to rapidly respond to and eliminate target cells. To artificially generate therapeutic NK cells, various materials can be utilized, such as peripheral blood mononuclear cells (PBMCs), umbilical cord blood (UCB), induced pluripotent stem cells (iPSCs), and NK cell lines. Exploiting the therapeutic potential of NK cells to treat tumors through in vivo and in vitro therapeutic modalities has yielded positive therapeutic results. CONCLUSION: This review provides a comprehensive description of NK cell therapeutic approaches for tumors and discusses the current problems associated with these therapeutic approaches and the prospects of NK cell therapy for tumors.

Effects of different conditions on the artificial incubation effect and physiological indexes of redclaw crayfish eggs.

We explored the effects of different conditions on the artificial incubation of redclaw crayfish eggs in an effort to improve this process. Samples at the egg and juvenile stages were selected. The samples at different stages were separated from the pleopods, then they were placed in incubator boxes and sterilized with different disinfectant solutions. The density was 300,400 and 500 eggs/incubator box, the vibration frequency was 11,16 and 26 vibrations/min, and the water circulation cycle was 2.1, 4.8 and 7.1 cycles/h. The results showed the eggs disinfected with 3000 ppm formaldehyde for 15 min had stronger antioxidant capacity. The hatching and survival rates of five pairs of appendage stage group were significantly lower than those of other groups. In the egg stage, acid phosphatase (ACP) level of compound eye pigmentation stage group was significantly higher than those of other groups. In the juvenile stage, malondialdehyde (MDA) content of five pairs of appendage stage group was significantly higher than those of other groups. The survival rate of 500 eggs/box group was significantly higher than that of other groups. In the egg stage, alkaline phosphatase (AKP) level of 400 eggs/box group was significantly higher than that of other groups. The survival rate of 11 vibrations/min group was significantly higher than that of other groups. In the egg stage, ACP and AKP levels of 11 vibrations/min group were significantly higher than those of 26 vibrations/min group. In the juvenile stage, superoxide dismutase (SOD), ACP and AKP levels of 11 vibrations/min group was significantly higher than those of 26 vibrations/min group. In the juvenile stage, AKP level of 4.8 cycles/h group was significantly lower than that of other groups. In conclusion, egg development at the stage after seven pairs of appendages, with a density of 400 eggs/box, vibration frequencies set at 11 vibrations/min achieved high hatching rates (93.58 %) and survival rates (75.67 %). Moreover, bronopol or hydrogen peroxide might have a better choice to replace formaldehyde if further exploration was conducted to reduce stimulation of the in vitro-grown egg. These conditions could be used on a large scale to optimize the production of redclaw crayfish.

Motivational simulated teaching of clinical skills using formative assessment methods for medical undergraduate students: between-group evaluation of a simulated course in a Chinese medical college.

OBJECTIVES: Teaching clinical skills is an important component of educational programmes for medical undergraduates. However, the extension of the interval between the completion of the course and qualification examination affects the performance of students in the skill examination. This study established a multisource evaluation system to determine whether formative assessment can enhance the instruction of clinical skills. METHODS: Formative assessment was introduced to the entire training course on clinical skills, in which diversified methods were used to observe the performance of students during training. Students in the experimental group received training for clinical skills using formative assessment (class of 2019, n=128), while students in the control group received traditional training without formative assessment (class of 2018, n=123). Both groups participated in the Objective Structured Clinical Examination (OSCE) conducted by Tongji Medical College, and the exam scores were taken as the objective measure of course outcome. After completing the course, all students in the experimental group were instructed to fill in a questionnaire to evaluate their experience in the training programme, as a subjective measure of course outcome. RESULTS: Compared with the control group, students in the experimental group received significantly better practical scores in the four clinical skills tested by the OSCE. The questionnaire results revealed that the majority of students who were trained using formative assessment methods considered the course helpful for learning, and appreciated the course for the clinical skills they had gained, and the opportunity to receive and give feedback to the instructors. CONCLUSIONS: The findings of this study suggest that formative assessment methods are beneficial for learning clinical skills through simulated teaching, as shown by the improved objective clinical skills evaluated by the structured clinical examination, and the self-reported satisfaction with the learning process.

Cellular and bioenergetic effects of polystyrene microplastic in function of cell type, differentiation status and post-exposure time.

The ubiquity of microplastics (MPs) in food sources and personal care products increasingly raises concerns on human health. However, little is known about the duration of the effects of MPs and whether effects depend on cellular differentiation status. Herein, cellular and bioenergetic effects of MPs in different exposure scenarios on four types of human cell lines derived from lung (A549 and BEAS-2B), colon (Caco-2) and liver (HepG2) were investigated. These cell lines are models for the major exposure routes in the body (inhalation, ingestion and physiological transport through the liver by the portal vein). To this aim, different scenarios were implemented by exposing undifferentiated and differentiated cells to single dosing of 2-µm polystyrene (PS) (102-105 particles/mL) for 48 h and 12 days. The undifferentiated Caco-2 cells with short exposure (48 h) showed the highest uptake rate of PS yet without significant cellular and mitochondrial responses. The biological effects, with the exception of ROS production, were not influenced by differentiation states of A549 and Caco-2 cells although differentiated cells showed much weaker ability to internalize PS. However, PS had significantly long-term impacts on cellular and mitochondrial functions even after the initial exposure period. In particular, Caco-2 cells that were post-exposed for 12 days after single PS dosing suffered higher oxidative stress and exhibited mitochondrial dysfunction than that for short exposure. Correspondingly, we observed that PS particles still remained in cell membrane and even in nuclei with high retention rate by 14-d post exposure during which metabolism and exchange of internalization and release occurred in cells. This indicates PS could induce chronic stress and even harmful effects on human cells after single intake that persists for a long time. This study paves the way for assessing the influence of PS on human health at low particle concentrations and with multiple exposure scenarios.

Effect of various repositioning regimens on pressure wound ulcer occurrence in at-risk adult persons without existing pressure wound ulcers: A meta-analysis.

Meta-analysis research was implemented to appraise the effect of various repositioning regimens (RRs) on pressure wound ulcer (PWU) occurrence in at-risk adult persons without existing PWUs. Inclusive literature research till April 2023 was done and 1197 interconnected researches were revised. The 15 picked researches, enclosed 8510 at-risk adult persons without existing PWUs persons were in the utilised researchers' starting point, 1002 of them were utilising repositioning, 1069 were control, 3443 were utilising 2-<4 h repositioning and 2994 were utilising 4-6 h repositioning. Odds ratio (OR) and 95% confidence intervals (CIs) were utilised to appraise the consequence of various RRs on PWU occurrence in at-risk adult persons without existing PWUs by the dichotomous approach and a fixed or random model. Repositioning had significantly lower PWU (OR, 0.49; 95% CI, 0.32-0.73, p < 0.001) compared to control in at-risk adult persons without existing PWUs persons. 2-<4 h repositioning had significantly lower PWU (OR, 0.62; 95% CI, 0.42-0.90, p = 0.01) compared to 4-6 h repositioning in at-risk adult persons without existing PWUs persons. Repositioning had significantly lower PWU compared to control in at-risk adult persons without existing PWU persons. 2-<4 h repositioning had significantly lower PWU compared to 4-6 h repositioning in at-risk adult persons without existing PWUs persons. However, caution needs to be taken when interacting with its values since there was a low sample size of some of the chosen research found for the comparisons in the meta-analysis.

Circular RNA circRILPL1 promotes nasopharyngeal carcinoma malignant progression by activating the Hippo-YAP signaling pathway.

Circular RNAs (circRNAs) play an important regulatory role in the pathogenesis and progression of nasopharyngeal carcinoma (NPC), which have not been thoroughly elucidated. In this study, we revealed for the first time that circRILPL1 was upregulated in NPC, weakened adhesion and decreased stiffness of NPC cells, and promoted NPC proliferation and metastasis in vitro and in vivo. Mechanistically, circRILPL1 inhibited the LATS1-YAP kinase cascade by binding to and activating ROCK1, resulting in decrease of YAP phosphorylation. Binding and cooperating with transport receptor IPO7, circRILPL1 promoted the translocation of YAP from the cytoplasm to the nucleus, where YAP enhanced the transcription of cytoskeleton remodeling genes CAPN2 and PXN. By which, circRILPL1 contributed to the pathogenesis of NPC. Our results demonstrated that circRILPL1 promoted the proliferation and metastasis of NPC through activating the Hippo-YAP signaling pathway by binding to both ROCK1 and IPO7. Highly expressed circRILPL1 in NPC may serve as an important biomarker for tumor diagnosis and may also be a potential therapeutic target.

Identification of Poly(ethylene terephthalate) Nanoplastics in Commercially Bottled Drinking Water Using Surface-Enhanced Raman Spectroscopy.

Micro/nanoplastics have emerged as global contaminants of serious concern to human and ecosystem health. However, identification and visualization of microplastics and particularly nanoplastics have remained elusive due to the lack of feasible and reliable analytical approaches, particularly for trace nanoplastics. Here, an efficient surface-enhanced Raman spectroscopy (SERS)-active substrate with triangular cavity arrays is reported. The fabricated substrate exhibited high SERS performance for standard polystyrene (PS) nanoplastic detection with size down to 50 nm and a detection limit of 0.001% (1.5 × 1011 particles/mL). Poly(ethylene terephthalate) (PET) nanoplastics collected from commercially bottled drinking water were detected with an average mean size of ∼88.2 nm. Furthermore, the concentration of the collected sample was estimated to be about 108 particles/mL by nanoparticle tracking analysis (NTA), and the annual nanoplastic consumption of human beings through bottled drinking water was also estimated to be about 1014 particles, assuming water consumption of 2 L/day for adults. The facile and highly sensitive SERS substrate provides more possibilities for detecting trace nanoplastics in an aquatic environment with high sensitivity and reliability.

Enhanced optical trapping of ZrO2@TiO2 photonic force probe with broadened solvent compatibility.

Optical trapping and manipulating nanoparticles are essential tools for interrogating biomedicine at the limits of space and time. Typically, silica or polystyrene microspheres are used as photonic force probes. However, adapting those probes to organic solvents is an ongoing challenge due to the limited solvent compatibility and low refractive index mismatch. Here we report on the optical force enhancement and solvent compatibility that utilizes ZrO2@TiO2 core-shell nanoparticles. We experimentally demonstrate that the 450-nm-diameter ZrO2@TiO2 core-shell nanoparticles achieve the lateral and axial trap stiffness up to 0.45 pN µm-1 mW-1 and 0.43 pN µm-1 mW-1 in water, showing more than fivefold and ninefold improvement on the ordinary SiO2 particle of the same size. In addition, ZrO2@TiO2 core-shell nanoparticles can realize stable three-dimensional trapping in both polyethylene glycol and glucose solutions. This optical trapping enhancement property, coupled with solvent compatibility, expands the range of feasible optical trapping experiments and will pave the way toward more advanced biological applications.

Manipulation force analysis of nanoparticles with ultra-high numerical aperture metalens.

Metalens optical tweezers technology has several advantages for manipulating micro-nano particles and high integration. Here, we used particle swarm optimization (PSO) to design a novel metalens tweezer, which can get 3-dimensional trapping of particles. The numerical aperture (NA) of the metalens can reach 0.97 and the average focusing efficiency is 44%. Subsequently, we analyzed the optical force characteristics of SiO2 particles with a radius of 350 nm at the focal point of the achromatic metalens. We found the average maximum force of SiO2 particles in the x-direction and z-direction to be 0.88 pN and 0.72 pN, respectively. Compared with the dispersive metalens, it is beneficial in maintaining the constant of optical force, the motion state of trapped particles, and the stability of the trapping position.

The spatial distribution of phytoliths and phytolith-occluded carbon in wheat (Triticum aestivum L.) ecosystem in China.

Phytolith is a form of SiO2 in plants. Carbon can be sequestrated as phytolith-occluded carbon (PhytOC) during the formation of phytoliths. PhytOC is characterized by its high resistance to temperature, oxidation and decomposition under protection of phytoliths and can be stored in the soil for thousands of years. Soil also is a huge PhytOC sink; however, most studies focus on PhytOC storage in straw and other residues. Wheat is a major staple food crop accumulating high content of Si and distributed widely, while its potential for PhytOC is not clear. At present, PhytOC storage only considers on the average value, but not on the relationship between ecological factors and the spatial distribution of PhytOC sequestration. Climatic factors and soil physiochemical properties together affect the formation process and stability of phytoliths. In our study, we collected wheat straw and soil samples from 95 sites among five provinces to extract phytolith and PhytOC. We constructed XGBoost model to predict the spatial distribution of phytolith and PhytOC across the country using the national soil testing and formula fertilization nutrient dataset and climate data. As a result, soil physiochemical factors such as available silicon (Siavail), total carbon (Ctot) and total nitrogen (Ntot) and climate factors related to temperature and precipitation have a great positive impact on the production of phytoliths and PhytOC. Meanwhile, PhytOC storage in wheat ecosystems was estimated to be 7.59 × 106 t, which is equivalent to 27.83 Tg of CO2. In China, the distribution characteristics of phytoliths and PhytOC in wheat straw and soil display a trend of decrease from south to north. He'nan Province is the largest wheat production area, producing approximately 1.59 × 106 t PhytOC per year. Therefore, PhytOC is a stable CO2 sink pathway in the agricultural ecosystems, which is of great importance for mitigating climate warming.

Oral-Gut Microbiome Analysis in Patients With Metabolic-Associated Fatty Liver Disease Having Different Tongue Image Feature.

Objective: The objective of this study was to identify the biological correlation between the tongue coating color and oral and gut micro-characteristics in metabolic-associated fatty liver disease (MAFLD) patients. Method: The characteristics of the tongue coating were examined using an automatic tongue diagnosis system. Tongue coating and stool samples were collected from 38 MAFLD patients, and 16S rDNA full-length assembly sequencing technology (16S-FAST) was used for bioinformatic analysis. Results: Twenty-two and 16 subjects were included in two distinct clusters according to the white/yellow color of the tongue coating, which was assessed by the L*a*b* values of the image. Upon analyzing the microorganisms in the tongue coating, 66 and 62 pathognomonic bacterial genera were found in the White and Yellow Coating Groups, respectively. The abundance of Stomatobaculumis positively correlated with the a* values of the tongue coating in the White Coating Group, while Fusobacterium, Leptotrichia, and Tannerella abundance was significantly correlated with the b* values in the Yellow Coating Group. Function prediction mainly showed the involvement of protein families related to BRITE hierarchies and metabolism. The MHR (MONO%/high-density lipoprotein cholesterol) of the Yellow Coating Group was higher than that of the White Coating Group. Conclusion: In MAFLD patients, lower a* values and higher b* values are indicators of a yellow tongue coating. There were also significant differences in the flora of different tongue coatings, with corresponding changes in the intestinal flora, indicating a correlation between carbohydrate metabolism disorders and inflammation in the oral microbiome.

Phytolith-occluded carbon in residues and economic benefits under rice/single-season Zizania latifolia rotation.

Zizania latifolia is a wild rice that contains phytoliths (Phyt) that have considerable potential for carbon sequestration. We hypothesized that the capacity of phytolith-occluded carbon (PhytOC) sequestration in residues might increase by 20%, and economic profit would be twice as high under a rice/single-season Z. latifolia rotation as under rice monoculture. To test this hypothesis, we collected rice and Z. latifolia plants and their corresponding soil samples from Zhejiang Province to determine the ability of both crops to fix carbon in the phytoliths. We showed that the soil concentrations of available Si, total carbon (Ctot) and total nitrogen (Ntot) were highly positively correlated with the concentrations of phytoliths and phytolith-occluded carbon in the residues of both crops. The cold waterlogged paddy fields in China have low productivity but their environmental conditions are suitable for planting Z. latifolia. Our model scenario, built on secondary data, demonstrated that, on a national basis, if the cold waterlogged paddy fields (occupying approximately 15% of the total paddy fields) were under rice/single-season Z. latifolia rotation, the contents of phytoliths and PhytOC in rice and Z. latifolia residues would be up to 19.46 × 106 t yr-1 and 8.82 × 104 t yr-1 (0.32 Tg CO2 yr-1), respectively. As a result, the economic benefit would be increased by 1.12 × 1011 USD per year compared to rice monoculture. Therefore, adopting rotational cropping of rice with single-season Z. latifolia will not only increase the content of PhytOC sequestration in residues and improve cold waterlogged paddy fields but also bring economic benefits to farmers.

Nano-Strategies for Enhancing the Bioavailability of Tea Polyphenols: Preparation, Applications, and Challenges.

Tea polyphenols (TPs) are among the most abundant functional compounds in tea. They exhibit strong antioxidant, anti-inflammatory, and anti-cancer effects. However, their instability and low bioavailability limits their applications. Nanotechnology, which involves the use of nanoscale substances (sizes ranging from 1 to 100 nm) to improve the properties of substances, provides a solution for enhancing the stability and bioavailability of TPs. We reviewed the preparation, performance, effects, and applications of different types of TPs nanocarriers. First, we introduced the preparation of different nanocarriers, including nanoparticles, nanoemulsions, nanomicelles, and nanolipids. Then, we discussed various applications of tea polyphenol-loaded nanocarriers in functional ingredient delivery, food quality improvement, and active food packaging. Finally, the challenges and future development directions of TPs nanocarriers were elucidated. In conclusion, a nano-strategy may be the "key" to break the application barriers of TPs. Therefore, the use of nano-strategies for the safe, stable, and efficient release of TPs is the direction of future research.

The influence of circular RNAs on autophagy and disease progression.

Circular RNAs (circRNAs) are non-coding RNAs that have attracted considerable attention in recent years. Owing to their distinct circular structure, circRNAs are stable in cells. Autophagy is a catabolic process that helps in the degradation and recycling of harmful or inessential biological macromolecules in cells and enables cells to adapt to stress and changes in the internal and external environments. Evidence has shown that circRNAs influence the course of a disease by regulating autophagy, which indicates that autophagy is involved in the onset and development of various diseases and can affect drug resistance (for example, it affects cisplatin resistance in tumors). In this review, we summarized the role of circRNAs in autophagy and their influence on disease onset and progression as well as drug resistance. The review will expand our understanding of tumors as well as cardiovascular and neurological diseases and also suggest novel therapeutic strategies.Abbreviations: ACR: autophagy-related circRNA; ADSCs: adipogenic mesenchymal stem cells; AMPK: AMP-activated protein kinase; ATG: autophagy related; BCL2: BCL2 apoptosis regulator; BECN1: beclin 1; ceRNA: competing endogenous RNA; circRNA: circular RNA; CMA: chaperone-mediated autophagy; EPCs: endothelial progenitor cells; LE/MVBs: late endosomes/multivesicular bodies; MAP1LC3/LC3: microtubule associated protein 1 light chain 3; MTOR: mechanistic target of rapamycin kinase; NSCLC: non-small cell lung cancer; PDLSCs: periodontal ligament stem cells; PE: phosphatidylethanolamine; PtdIns: phosphatidylinositol; PtdIns3K: phosphatidylinositol 3-kinase; PtdIns3P: phosphatidylinositol-3-phosphate 1,2-dipalmitoyl; PTEN: phosphatase and tensin homolog; RBPs: RNA-binding proteins; SiO2: silicon dioxide; TFEB: transcription factor EB; ULK: unc-51 like autophagy activating kinase 1.

Optical Pulling Using Chiral Metalens as a Photonic Probe.

Optical pulling forces, which can pull objects in the source direction, have emerged as an intensively explored field in recent years. Conventionally, optical pulling forces exerted on objects can be achieved by tailoring the properties of an electromagnetic field, the surrounding environment, or the particles themselves. Recently, the idea of applying conventional lenses or prisms as photonic probes has been proposed to realize an optical pulling force. However, their sizes are far beyond the scope of optical manipulation. Here, we design a chiral metalens as the photonic probe to generate a robust optical pulling force. The induced pulling force exerted on the metalens, characterized by a broadband spectrum over 0.6 µm (from 1.517 to 2.117 µm) bandwidth, reached a maximum value of -83.76 pN/W. Moreover, under the illumination of incident light with different circular polarization states, the longitudinal optical force acting on the metalens showed a circular dichroism response. This means that the longitudinal optical force can be flexibly tuned from a pulling force to a pushing force by controlling the polarization of the incident light. This work could pave the way for a new advanced optical manipulation technique, with potential applications ranging from contactless wafer-scale fabrication to cell assembly and even course control for spacecraft.

Tuberous sclerosis complex misdiagnosed as multiple metastases in a cervical cancer patient: case report and literature review.

Tuberous sclerosis complex (TSC) is an autosomal dominant disorder that affects multiple organs and is caused by inactive mutations in the TSC1 or TSC2 genes. The main symptoms of TSC are neurocutaneous syndrome and benign hamartoma formation. Notably, malignancy is not an indication of TSC. In this article, we present the case of a 48-year-old female with cervical cancer (CC) combined with TSC, who was misdiagnosed with multiple metastases. Toe masses, pelvic nodules, and multiple osteogenic lesions were initially observed. Multi-site puncture biopsies and a toe amputation were performed; the pathology results did not indicate malignancy. Subsequently, hypomelanotic macules on the back, subependymal nodules (SENs), ungual fibromas, multiple renal cysts, and sclerotic-bone-lesions (SBLs) of the skull, and vertebrae were observed, leading to a diagnosis of TSC. Given that TSC is a benign disease and has not yet caused any organ disfunction, no special treatment was provided to this patient. After a follow-up period of almost 65 months, the patient's quality of life remained good without therapy. Oncologists should pay attention to benign diseases in the face of multiple lesions to reduce misdiagnosis and overtreatment. In addition, TSC may interact with CC through molecular mechanisms, such as the mammalian target of rapamycin (mTOR) pathway.