In women with high-grade squamous intraepithelial lesion(HSIL)undergoing excision therapy,vaccination with human papillomavirus(HPV)vaccine may reduce the risk of postoperative recurrence.However,research data and clear application guidelines are currently limited in China.The Cervical Cancer Prevention and Control Research Committee of the China Maternal and Child Health Research Association gathered a team of relevant experts to develop the consensus based on the characteristics of clinical practice in China.This expert consensus suggests that women of appropriate age,without contraindications,with histopathological confirmation of HSIL,and who underwent excision treatment should receive a prophylactic HPV vaccine to reduce the risk of recurrence.The recommended vaccination time is as early as possible after HSIL diagnosis or after resection treatment,and the recommended vaccination procedure is three doses.For women who have already received an HPV vaccine before treatment,there is no need to receive again after excision therapy.For women who underwent resection treatment,even if they have received HPV vaccines,regular follow-up should still be conducted in accordance with the post-treatment management guidelines.Vaccination cannot replace routine follow-up.

Objective:Acute myocardial infarction (AMI) secondary to acute gastrointestinal bleeding (AGIB) is a common severe condition in emergency department. Currently, there is a lack of sufficient data regarding the use of emergency endoscopy in patients suffering from acute gastrointestinal bleeding (AGIB) complicated with acute myocardial infarction (AMI). The objective of this study is to examine the present status, effectiveness, and safety of emergency endoscopy in such patients, and to determine the factors that influence clinicians' decision-making regarding the use of emergency endoscopy.Methods:Clinical data of AGIB patients complicated with AMI who were admitted to the emergency department of the First Affiliated Hospital of Nanjing Medical University from January 2020 to June 2023 were respectively collected. Based on their survival status at discharge, patients were categorized into survival and non-survival groups. Additionally, according to whether emergency endoscopy was performed, patients were further classified into the emergency endoscopy group and the conventional treatment groupStabilized inverse probability of treatment weighting (SIPTW) and logistic regression analysis were used to explore the correlation between emergency endoscopy and prognosis. A paired wilcoxon test was used to analyze whether emergency endoscopy could worsen myocardial injury. A multiple logistic regression model was used to explore the factors influencing clinicians to make emergency endoscopic decisions.Results:A total of 106 patients with AMI secondary to AGIB were included, and 22 patients underwent emergency endoscopy. After weighing, logistic regression analysis showed that emergency endoscopy was a protective factor for patients' survival after discharge ( OR = 0.808, 95% CI: 0.6755-0.967, P = 0.022). In the emergency endoscopy group, there was no significant change in hypersensitive troponin T before and after emergency endoscopy [ 61.1 (35.4, 164.1) ng/L vs 69.8 (60.1, 159.5) ng/L, P = 0.078]. Previous history of coronary heart disease ( OR = 0.098, 95% CI: 0.015-0.381, P = 0.003) was an independent negative factor for emergency endoscopic decision-making. Glasgow Blatchford Score (GBS) on admission ( OR = 1.217, 95% CI: 1.019-1.482, P = 0.038) was an independent positive factor for emergency endoscopic decision-making. Conclusions:Emergency endoscopy is safe and effective in patients with AMI secondary to AGIB. GBS score and previous history of coronary heart disease were the main factors affecting emergency endoscopic decision-making.

Objective To establish a DNA quantitation method based on dithiothreitol(DTT)-crystal vio-let.Methods DTT was used to decolorize crystal violet,mixed with different concentrations of λ-DNA and salmon sperm DNA standard samples or concentration standard samples,and the absorbance was read at 595 nm wavelength by microplate reader,and compared with the results of ultraviolet absorbance method.DTT-crystal violet method and ultraviolet absorbance method were used to compare the concentration of plasmid samples and the concentration of genomic DNA samples of cervical exfoliated cells.The protein tolerance of the two methods was assessed by simulating protein contaminants with bovine serum albumin(BSA).Results In the quantification of λ-DNA and salmon sperm DNA,the DTT-crystal violet method had a robust linear correlation between the absorbance at 595 nm and DNA concentration(r2＞0.95),and the measured concentrations of the standard samples were not significantly different from the theoretical concentrations of the prepared standard samples(P＞0.05).There was no significant difference in the concentration of plasmid samples measured by DTT-crystal violet method and ultraviolet absorption method(P＞0.05).The concen-tration of DNA samples from cervical exfoliated cells measured by ultraviolet absorption method was positive-ly correlated with that by DTT-crystal violet method(r=0.94,P＜0.01).The concentration of the standard sample containing BSA 1 μg/μL measured by ultraviolet absorption method was higher than that of the con-trol sample,and the difference was statistically significant(P＜0.01),whereas the DTT-crystal violet method was not significantly affected(P＞0.05).Conclusion DTT-crystal violet method has obvious advantages over the existing DNA quantitation method,and is suitable for DNA quantitative analysis in scientific research and clinic.

Radiotherapy is main method in treating cervical cancer,and the rapid advancement of artificial intelligence(AI)technique is providing entirely new solutions for radiotherapy for cervical cancer.The AI means that is represented by deep learning is deeply integrating into the whole process of diagnosis,treatment and management for cervical cancer,which can promote intelligent and precise development of radiotherapy workflows.Currently,the applied cores of AI in radiotherapy for cervical cancer include image registration,target delineation,optimization of radiotherapy planning and risk assessment,which can significantly enhance efficiency and precision of treatment.But,AI is facing some challenges in clinical applications include data quality,and algorithm's robustness and interpretability at the same time.Depended on the above analyses,this paper systematically reviewed the frontier applications and progress in practice of AI in radiotherapy for cervical cancer,which especially analyzed technical advantages and limitations of AI in key link,and explored its development path and coping strategy in clinical promotion and standard application in future.It is purpose to provide theoretical references for clinical practice of precise and accurate radiotherapy for cervical cancer.

Objective To analyze the mechanism of action of Sini Jia Renshen decoction in the treatment of myocardial infarction complicated with heart failure based on network pharmacology.Methods Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform was used to search the active ingredients of Sini Jia Renshen decoction.The target of Sini Jia Renshen decoction was obtained by using String and UniProt database.Targets related to myocardial infarction complicated with heart failure were searched through GeneCards database,OMIM database,etc.Obtain the intersection of the target of the active ingredient and the disease-related target.Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis of intersection targets were carried out.Results There were 112 active ingredients of Sini Jia Renshen decoction,233 active ingredients and 4980 associated targets of myocardial infarction complicated with heart failure.The intersection targets of drugs and diseases were 188.Quercetin,β-sitosterol,isorhamnetin and naringenin were the core active ingredients of Sini Jia Renshen decoction treatment of myocardial infarction complicated with heart failure.The pathway enrichment analysis showed that it was mainly involved in lipid and atherosclerosis,advanced glycation end product(AGE)/AGE receptor,vascular endothelium activated by shear stress,interleukin-17 and other signaling pathways.Conclusion The treatment of myocardial infarction complicated with heart failure by Sini Jia Renshen decoction has the characteristics of multi-components,multi-targets and multi-pathways.It may play a role in myocardial infarction complicated with heart failure through lipid and atherosclerosis pathways and so on.

Objective:To investigate the treatment and prognosis of esophageal cancer patients with pulmonary resection history.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 58 esophageal cancer patients with pulmonary resection history who were admitted to Chest Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Jiangxi Provincial People's Hospital from May 2019 to April 2024 were collected. There were 52 males and 6 females, aged (69±3)years. Observation indicators: (1) surgical and postopera-tive conditions; (2) postoperative pathological examination results; (3) follow-up; (4) stratified analysis. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data between groups was conducted using the non-parametric rank sum test. The Kaplan-Meier method was used to plot survival curve and calculate survival rate, and the Log-rank test was used for survival analysis. Results:(1) Surgical and postoperative conditions. Of the 58 esophageal cancer patients, 49 patients underwent transthoracic approach (26 cases of ipsilateral approach and 23 cases of contralateral approach of pulmonary resection history), and 9 patients underwent mediastinoscopic-laparoscopic approach. There were 57 cases with R 0 resection and 1 case with R 2 resection because of tumor invading carina. The total operation time of 58 patients was (246±27)minutes, and the volume of intraoperative blood loss was (114±29)mL. There was no unplanned reoperation or perioperative death for all patients. The duration of postoperative hospital stay of 58 patients was (10.4±4.6)days, and time for intensive care unit stay was (1.4±0.5)days, and no patient readmitted to intensive care unit due to changes in conditions. The postoperative total incidence of complications of 58 patients was 41.4%(24/58). The Clavien-Dindo grading of complications for all patients was 1-2 grade. (2) Postoperative pathological examination results. Results of postoperative pathological examination showed there were 51 cases of squamous cell carcinoma, 6 cases of adenocarcinoma, and 1 case of melanoma. Number of lymph node dissected of 58 patients was 27±6. The ratio of patient with positive lymph node was 37.9%(22/58). One patient may experience more than 1 region of positive lymph node metastasis. Results of postoperative pathological staging showed 5 cases of ⅠA stage, 2 cases of ⅠB stage, 13 cases of ⅡA stage, 15 cases of ⅡB stage, 4 cases of ⅢA stage, 16 cases of ⅢB stage, and 3 cases of ⅣA stage. Thirteen of the 58 patients underwent neoadjuvant therapy, with the pathological staging as 6 cases of Ⅰ stage, 4 cases of Ⅱ stage, 3 cases of ⅢB stage after therapy. Results of postoperative tumor regression grade for the 13 patients with neoadjuvant therapy showed 4 cases of grad 0, 3 cases of grade 1, 6 cases of grade 2. (3) Follow-up. All 58 patients were followed for 24 (4, 50)months, and no patient died within 90 days after surgery. During the follow-up period, 19 patients experienced tumor recurrence and metastasis and 17 patients died. Twenty-one patients underwent postoperative adjuvant therapy, including 7 cases with chemoradiotherapy, 7 cases with chemotherapy, 3 cases with chemotherapy and immunotherapy, 2 cases with immuno-therapy, 2 cases with radiotherapy. The postoperative 1-, 2-year overall survival rates of the 58 patients were 91.3%, 78.7%, respectively, of whom undergoing McKeown surgery and mediastinoscopic-laparoscopic surgery with postoperative 1-, 2-year overall survival rates as 89.2%, 83.1% and 85.7%, 53.6%, respectively. The postoperative 1-, 2-year esophageal cancer specific survival rates for patients undergoing McKeown surgery and mediastinoscopic-laparoscopic surgery were 94.4%, 87.9% and 85.7%, 71.4%, respectively. There was no significant difference in postoperative 1-, 2-year overall survival rates and postoperative 1-, 2-year esophageal cancer specific survival rates between patients undergoing McKeown surgery and mediastinoscopic-laparoscopic surgery ( P>0.05). (4) Stratified analysis. Of the 49 patients underwent transthoracic approach for esophageal cancer, there were significant differences in surgical method, surgical type, time of chest surgery, cases with upper mediastinal lymph node dissection, and duration of postoperative hospital stay between patients with pulmonary resection history as ipsilateral approach and contralateral approach ( χ2=11.74, 11.68, t=-2.25, χ2=8.45, t=-2.17, P<0.05), and there was no significant difference in total operation time, volume of intraoperative blood loss, the number of lymph node dissected, post-operative total complications, and postoperative pathological TNM staging ( P>0.05). For patients with pulmonary resection history as ipsilateral approach and contralateral approach, the postopera-tive 1-, 2-year esophageal cancer specific survival rates were 95.5%, 95.5% and 81.4%, 71.1%, showing a significant difference between them ( χ2=5.63, P<0.05). Conclusions:The transthoracic approach and mediastinoscopic-laparoscopic approach are safe and feasible for esophageal cancer patients with pulmonary resection history. Compared with patients with pulmonary resection history as contralateral approach, patients with pulmonary resection history as ipsilateral approach have a higher ratio of McKeown surgery, minimally invasive surgery and upper mediastinal lymph node dissection, shorter time of chest surgery and duration of postoperative hospital stay, better esophageal cancer specific survival rate. And there is no increase in perioperative risk.

Objective To analyze the mechanism of action of Sini Jia Renshen decoction in the treatment of myocardial infarction complicated with heart failure based on network pharmacology.Methods Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform was used to search the active ingredients of Sini Jia Renshen decoction.The target of Sini Jia Renshen decoction was obtained by using String and UniProt database.Targets related to myocardial infarction complicated with heart failure were searched through GeneCards database,OMIM database,etc.Obtain the intersection of the target of the active ingredient and the disease-related target.Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis of intersection targets were carried out.Results There were 112 active ingredients of Sini Jia Renshen decoction,233 active ingredients and 4980 associated targets of myocardial infarction complicated with heart failure.The intersection targets of drugs and diseases were 188.Quercetin,β-sitosterol,isorhamnetin and naringenin were the core active ingredients of Sini Jia Renshen decoction treatment of myocardial infarction complicated with heart failure.The pathway enrichment analysis showed that it was mainly involved in lipid and atherosclerosis,advanced glycation end product(AGE)/AGE receptor,vascular endothelium activated by shear stress,interleukin-17 and other signaling pathways.Conclusion The treatment of myocardial infarction complicated with heart failure by Sini Jia Renshen decoction has the characteristics of multi-components,multi-targets and multi-pathways.It may play a role in myocardial infarction complicated with heart failure through lipid and atherosclerosis pathways and so on.

Objective:To investigate the treatment and prognosis of esophageal cancer patients with pulmonary resection history.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 58 esophageal cancer patients with pulmonary resection history who were admitted to Chest Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Jiangxi Provincial People's Hospital from May 2019 to April 2024 were collected. There were 52 males and 6 females, aged (69±3)years. Observation indicators: (1) surgical and postopera-tive conditions; (2) postoperative pathological examination results; (3) follow-up; (4) stratified analysis. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data between groups was conducted using the non-parametric rank sum test. The Kaplan-Meier method was used to plot survival curve and calculate survival rate, and the Log-rank test was used for survival analysis. Results:(1) Surgical and postoperative conditions. Of the 58 esophageal cancer patients, 49 patients underwent transthoracic approach (26 cases of ipsilateral approach and 23 cases of contralateral approach of pulmonary resection history), and 9 patients underwent mediastinoscopic-laparoscopic approach. There were 57 cases with R 0 resection and 1 case with R 2 resection because of tumor invading carina. The total operation time of 58 patients was (246±27)minutes, and the volume of intraoperative blood loss was (114±29)mL. There was no unplanned reoperation or perioperative death for all patients. The duration of postoperative hospital stay of 58 patients was (10.4±4.6)days, and time for intensive care unit stay was (1.4±0.5)days, and no patient readmitted to intensive care unit due to changes in conditions. The postoperative total incidence of complications of 58 patients was 41.4%(24/58). The Clavien-Dindo grading of complications for all patients was 1-2 grade. (2) Postoperative pathological examination results. Results of postoperative pathological examination showed there were 51 cases of squamous cell carcinoma, 6 cases of adenocarcinoma, and 1 case of melanoma. Number of lymph node dissected of 58 patients was 27±6. The ratio of patient with positive lymph node was 37.9%(22/58). One patient may experience more than 1 region of positive lymph node metastasis. Results of postoperative pathological staging showed 5 cases of ⅠA stage, 2 cases of ⅠB stage, 13 cases of ⅡA stage, 15 cases of ⅡB stage, 4 cases of ⅢA stage, 16 cases of ⅢB stage, and 3 cases of ⅣA stage. Thirteen of the 58 patients underwent neoadjuvant therapy, with the pathological staging as 6 cases of Ⅰ stage, 4 cases of Ⅱ stage, 3 cases of ⅢB stage after therapy. Results of postoperative tumor regression grade for the 13 patients with neoadjuvant therapy showed 4 cases of grad 0, 3 cases of grade 1, 6 cases of grade 2. (3) Follow-up. All 58 patients were followed for 24 (4, 50)months, and no patient died within 90 days after surgery. During the follow-up period, 19 patients experienced tumor recurrence and metastasis and 17 patients died. Twenty-one patients underwent postoperative adjuvant therapy, including 7 cases with chemoradiotherapy, 7 cases with chemotherapy, 3 cases with chemotherapy and immunotherapy, 2 cases with immuno-therapy, 2 cases with radiotherapy. The postoperative 1-, 2-year overall survival rates of the 58 patients were 91.3%, 78.7%, respectively, of whom undergoing McKeown surgery and mediastinoscopic-laparoscopic surgery with postoperative 1-, 2-year overall survival rates as 89.2%, 83.1% and 85.7%, 53.6%, respectively. The postoperative 1-, 2-year esophageal cancer specific survival rates for patients undergoing McKeown surgery and mediastinoscopic-laparoscopic surgery were 94.4%, 87.9% and 85.7%, 71.4%, respectively. There was no significant difference in postoperative 1-, 2-year overall survival rates and postoperative 1-, 2-year esophageal cancer specific survival rates between patients undergoing McKeown surgery and mediastinoscopic-laparoscopic surgery ( P>0.05). (4) Stratified analysis. Of the 49 patients underwent transthoracic approach for esophageal cancer, there were significant differences in surgical method, surgical type, time of chest surgery, cases with upper mediastinal lymph node dissection, and duration of postoperative hospital stay between patients with pulmonary resection history as ipsilateral approach and contralateral approach ( χ2=11.74, 11.68, t=-2.25, χ2=8.45, t=-2.17, P<0.05), and there was no significant difference in total operation time, volume of intraoperative blood loss, the number of lymph node dissected, post-operative total complications, and postoperative pathological TNM staging ( P>0.05). For patients with pulmonary resection history as ipsilateral approach and contralateral approach, the postopera-tive 1-, 2-year esophageal cancer specific survival rates were 95.5%, 95.5% and 81.4%, 71.1%, showing a significant difference between them ( χ2=5.63, P<0.05). Conclusions:The transthoracic approach and mediastinoscopic-laparoscopic approach are safe and feasible for esophageal cancer patients with pulmonary resection history. Compared with patients with pulmonary resection history as contralateral approach, patients with pulmonary resection history as ipsilateral approach have a higher ratio of McKeown surgery, minimally invasive surgery and upper mediastinal lymph node dissection, shorter time of chest surgery and duration of postoperative hospital stay, better esophageal cancer specific survival rate. And there is no increase in perioperative risk.

In women with high-grade squamous intraepithelial lesion(HSIL)undergoing excision therapy,vaccination with human papillomavirus(HPV)vaccine may reduce the risk of postoperative recurrence.However,research data and clear application guidelines are currently limited in China.The Cervical Cancer Prevention and Control Research Committee of the China Maternal and Child Health Research Association gathered a team of relevant experts to develop the consensus based on the characteristics of clinical practice in China.This expert consensus suggests that women of appropriate age,without contraindications,with histopathological confirmation of HSIL,and who underwent excision treatment should receive a prophylactic HPV vaccine to reduce the risk of recurrence.The recommended vaccination time is as early as possible after HSIL diagnosis or after resection treatment,and the recommended vaccination procedure is three doses.For women who have already received an HPV vaccine before treatment,there is no need to receive again after excision therapy.For women who underwent resection treatment,even if they have received HPV vaccines,regular follow-up should still be conducted in accordance with the post-treatment management guidelines.Vaccination cannot replace routine follow-up.