Lymph node dissection before initial treatment for locally advanced cervical cancer: A systematic review and meta-analysis.

The effectiveness of removing lymph nodes before initial treatment in patients with locally advanced cervical cancer is still debated. This article presents a meta-analysis that systematically evaluates the impact of this approach on oncological outcomes. A systematic literature search of PubMed, Embase, Science Direct, and the Cochrane Database of Systematic Reviews (up to December 2023) was performed to obtain relevant studies. The findings were combined using fixed-effects models to address potential differences. Combined risk ratios (HR) and 95% confidence intervals (CI) were calculated. Egger's test was used to assess publication bias. Out of 1025 screened articles, four studies (involving 838 women) met the inclusion criteria. The results showed that lymph node dissection before initial treatment did not affect overall survival (OS) in patients with locally advanced cervical cancer compared to concurrent radiotherapy (HR = 1.11, 95% CI = 0.91-1.36, P = 0.30). It also did not increase the incidence of postoperative complications or cause delays in radiotherapy. In particular, removing larger lymph nodes (>2cm) aided in defining the radiation field and decreasing radiotherapy-related complications. The surgical technique also had some impact on postoperative complications. In summary, in order to obtain the best therapeutic outcomes, personalized plans should be developed for each patient, accounting for their individual circumstances to achieve precise treatment and enhance their quality of life.

Multi-omics analysis defines a cuproptosis-related prognostic model for ovarian cancer: Implication of WASF2 in cuproptosis resistance.

BACKGROUND: Ovarian cancer (OVC) is one of the deadliest and most aggressive tumors in women, with an increasing incidence in recent years. Cuproptosis, a newly discovered type of programmed cell death, is caused by intracellular copper-mediated lipoylated protein aggregation and proteotoxic stress. However, the role of cuproptosis-related features in OVC remains elusive. METHODS: The single-cell sequencing data from GSE154600 and bulk transcriptome data of 378 OVC patients from TCGA database. The RNA-seq and clinical data of 379 OVC patients in GSE140082 and 173 OV patients in GSE53963. The PROGENy score was calculated to assess tumor-associated pathways. Based on gene set enrichment analysis (GSEA) of the cuproptosis pathway, the single cells were divided into the cuproptosishigh and cuproptosislow groups. The differentially expressed genes (DEGs) between the two groups were screened, and 47 prognosis-related genes were identified based on univariate cox regression analysis. Randomforest was used to construct a prognostic model. Immuno-infiltration analysis was performed using ssGSEA and xCell algorithms. In vitro and in vivo experiments were used for functional verification. RESULTS: Six major cell populations was identified, including fibroblast, T cell, myeloid, epithelial cell, endothelial cell, and B cell populations. The PROGENy score which revealed significant activation of the PI3K pathway in T and B cells, and activation of the TGF-ß pathway in endothelial cells and fibroblasts. TIMM8B, COX8A, SSR4, HIGD2A, WASF2, PRDX5 and CLDN4 were selected to construct a prognostic model from the identified 47 prognosis-related genes. Furthermore, the cuproptosishigh and cuproptosislow groups showed significant differences in the expression levels of the model genes, immune cell infiltration, and sensitivity to six potential drug candidates. The functional experiments showed that WASF2 is associated with cuproptotic resistance and promotes cancer cell proliferation and resistance to platinum, and its high expression is associated with poor prognosis of OVC patients. CONCLUSION: A clinically significant cuproptosis-related prognostic model was identified which can accurately predict the prognosis and immune characteristics of OVC patients. WASF2, one of the cuproptosis-related gene in the risk model, promotes the proliferation and platinum resistance of OVC cells, and leads poor prognosis.

Ovarian cancer-associated immune exhaustion involves SPP1+ T cell and NKT cell, symbolizing more malignant progression.

Background: Ovarian cancer (OC) is highly heterogeneous and has a poor prognosis. A better understanding of OC biology could provide more effective therapeutic paradigms for different OC subtypes. Methods: To reveal the heterogeneity of T cell-associated subclusters in OC, we performed an in-depth analysis of single-cell transcriptional profiles and clinical information of patients with OC. Then, the above analysis results were verified by qPCR and flow cytometry examine. Results: After screening by threshold, a total of 85,699 cells in 16 ovarian cancer tissue samples were clustered into 25 major cell groups. By performing further clustering of T cell-associated clusters, we annotated a total of 14 T cell subclusters. Then, four distinct single-cell landscapes of exhausted T (Tex) cells were screened, and SPP1 + Tex significantly correlated with NKT cell strength. A large amount of RNA sequencing expression data combining the CIBERSORTx tool were labeled with cell types from our single-cell data. Calculating the relative abundance of cell types revealed that a greater proportion of SPP1 + Tex cells was associated with poor prognosis in a cohort of 371 patients with OC. In addition, we showed that the poor prognosis of patients in the high SPP1 + Tex expression group might be related to the suppression of immune checkpoints. Finally, we verified in vitro that SPP1 expression was significantly higher in ovarian cancer cells than in normal ovarian cells. By flow cytometry, knockdown of SPP1 in ovarian cancer cells could promote tumorigenic apoptosis. Conclusion: This is the first study to provide a more comprehensive understanding of the heterogeneity and clinical significance of Tex cells in OC, which will contribute to the development of more precise and effective therapies.

Comparative study of objective visual quality between FS-LASIK and SMART in myopia.

AIM: To compare the changes in the objective visual quality of patients with low and moderate myopia postoperatively after transepithelial photorefractive keratectomy using the smart pulse technology (SMART) and femtosecond laser in situ keratomileusis (FS-LASIK). METHODS: Corneal higher-order aberrations (HOAs), horizontal coma, vertical coma and spherical aberration were measured using Pentacam, and cutoff for modulation transfer function (MTF cutoff), objective scatter index (OSI) and Strehl ratio (SR) was measured using an optical quality analysis system (OQAS-II), before and after operation at 1, 3, and 6mo, and data were analyzed by repeated measurement two-way analysis of variance. RESULTS: The difference in uncorrected distance visual acuity between SMART and FS-LASIK was statistically significant only 1wk postoperatively. Approximately 86.36% and 80.69% of patients with spherical equivalent (SE) in ±0.50 D were observed in the SMART and FS-LASIK groups, respectively. No significant difference was observed in SE between the two groups (P=0.509). The HOAs increased postoperatively compared with those before surgery in both groups (P<0.05). No significant difference in HOA, corneal horizontal coma, spherical aberration, ΔHOA, Δhorizontal coma, and Δspherical aberration were observed between the two group (P>0.05). Corneal vertical coma and Δcorneal vertical coma in the FS-LASIK group were higher than those in the SMART group (P<0.05). The OSI of both groups at 1mo after surgery was higher than that before surgery (P<0.05). At 3 and 6mo postoperatively, the OSI in the FS-LASIK group was slightly higher than that in the SMART group (P=0.040 and 0.047, respectively). At 6mo after surgery, the MTF cutoff was statistically significant different between the two groups (P=0.026). No significant difference in SR between the FS-LASIK and SMART groups was observed at 1, 3, and 6mo postoperatively (P>0.05). CONCLUSION: The HOAs increase and visual quality is delayed in both groups postoperatively, and the long-term objective visual quality after SMART is slightly better than that after FS-LASIK.

Nomogram model for predicting postoperative survival of patients with stage IB-IIA cervical cancer.

To establish a prediction model based on clinical and pathological information for the long-term survival of patients with cervical cancer, we retrospectively analyzed the clinical data of patients pathologically diagnosed with stage IB-IIA cervical cancer between July 2007 and September 2017 in the Chinese Academy of Medical Sciences Cancer Hospital. Factors affecting the overall survival of the patients were analyzed using a Cox model, and a cervical cancer patient prediction nomogram model was established. A total of 2,319 patients were included in the study. According to the multivariate Cox regression analysis, number of complications, surgical methods, neoadjuvant treatment, lymph node metastasis, postoperative treatment, lymphovascular space invasion (LVSI), and other independent factors affecting prognosis were included to establish a nomogram. The nomogram consistency index in the training and validation cohorts was 0.691 and 0.615, respectively. The study established a highly accurate predictive model for the postoperative survival of cervical cancer patients.

Association between childhood neglect and the autonomic nerves disorder in students of sixth graders / 中国学校卫生

Objective@#To explore prevalence of childhood neglect and autonomic nervous function, and its association in sixth graders students in Harbin, and to provide clues to improve physical and mental health of children and adolescents.@*Methods@#Cluster sampling method was used to select 1 259 students from grade 6 in 5 schools in two districts of Harbin, and Childhood Trauma Questionnaire-Short Form (CTQ-SF) and TOHO University Medical Index (TMI) were filled in.@*Results@#The total rate of childhood neglect was 45.7%, of which the rate of emotional neglect and physical neglect were 18.8%, 40.8%. The rate of autonomic nerves disorder was 47.2%. The rate of autonomic nerves disorder in students suffered from neglect, emotional neglect, physical neglect are higher than those without any of neglect(χ2=50.52, 32.02, 43.61, P<0.01), and with the increase of the degree of neglect, the rate of autonomic nervous disorder were gradually increasing(χ2=47.99, 47.07, 49.24, P<0.01). After controlled for gender, neglect, emotional neglect, physical neglect were positively associated with autonomic nerves disorder(OR=1.53-2.34, P<0.05), and the odd ratio for autonomic nerves disorder among those with mild-to-moderate,moderate-to-severe and extremely servere neglect was 1.37, 1.83, 5.10 compared to those with none or mild neglect.@*Conclusion@#Childhood neglect is closely related to adolescent the autonomic nerves disorder in sixth graders students in Harbin. Moreover, the more serious the childhood neglect is, the higher the detection rate of autonomic nerves disorder is. In order to improve the physical and mental health of children and adolescents, it is necessary to pay attention to childhood neglect and early assessment of their autonomic function.