BACKGROUND:Radiotherapy for head and neck tumors can easily cause xerostomia,seriously affecting the quality of life of patients.In recent years,engineered stem cells and their paracrine factors have shown therapeutic potential in the repair of salivary gland injury.However,there is currently no experimental study on the application of amniotic mesenchymal stem cell-derived exosome in radiation-induced salivary gland injury.OBJECTIVE:To preliminarily explore the repair effect of exosome derived from human amniotic mesenchymal stem cells on radiation-induced submandibular gland injury.METHODS:H uman amniotic mesenchymal stem cell exosomes were extracted and identified by ultrafiltration and ultracentrifugation.SD rats were randomly divided into a control group,a radiation injury group,and a radiation injury+exosome group.An in vitro model of radiation-induced submandibular gland injury was constructed using the submandibular gland tissue of SD rats irradiated with 18 Gy of radiation.One day after radiation modeling,exosome derived from human amniotic mesenchymal stem cells was injected into the submandibular gland in situ.Samples are taken at 1,3,7,and 14 days to detect the resting salivary flow rate.The structure of the submandibular gland tissue was observed by hematoxylin-eosin staining.The expression of glycogen particles in the submandibular gland tissue was observed by Periodic Acid-Schiff staining.Fibrosis in the submandibular gland tissue was observed by Masson staining.The secretion of salivary amylase was detected by enzyme-linked immunosorbent assay.The expression of aquaporin and tight junction proteins in submandibular gland tissue was observed by immunofluorescence staining.Real-time fluorescence quantitative PCR was used to detect the relative expression levels of aquaporins and salivary amylase mRNA in submandibular gland tissue.TUNEL assay was used to detect the apoptosis rate of submandibular gland tissues in each group.RESULTS AND CONCLUSION:After radiomodeling,compared with the radiation injury group,(1)hematoxylin-eosin staining observed that the submandibular gland tissue structure in the radiation injury+exosome group was restored,the nucleoli increased,the number of acinus increased,and the acinar atrophy improved.(2)Glycogen staining observed that the number and density of positive zymogen granules in the acinar cytoplasm of the radiation injury+exosome group gradually increased.(3)Masson staining results observed that the number and density of positive collagen fibers in the interstitium and around the ducts in the radiation injury+exosome group gradually decreased,the degree of fibrosis decreased,and the collagen deposition decreased.(4)The salivary flow rate in the radiation injury+exosome group increased(P＜0.05).The fluorescence intensity of aquaporin-5 was enhanced(P＜0.05)and the gene expression was significantly enhanced(P＜0.01).The fluorescence distribution of tight junction protein 4 was weakened and the fluorescence intensity decreased(P＜0.05,P＜0.01).The content of salivary amylase increased(P＜0.05)and gene expression were significantly increased(P＜0.01).The number of positive apoptotic cells decreased(P＜0.05,P＜0.01).It is indicated that local injection of exosome derived from human amniotic mesenchymal stem cells could improve the pathological morphology of submandibular gland tissue,promote saliva flow rate and amylase expression,and may play a functional repair role in radioactive submandibular gland injury by inhibiting acinar apoptosis.

Cervical cancer is one of the most common malignant tumors among women worldwide and represents a significant public health issue threatening women's health. In recent years, the disease burden of cervical cancer in China has been increasing, with women aged 45 and older bearing a particularly heavy burden. This population not only has the highest incidence and mortality rates but also represents the second peak age group for high-risk human papilloma virus (HR-HPV) infection, with the HR-HPV infection rate remaining consistently high. The causes of this situation are multifaceted. On one hand, the target group for HPV vaccination in China is women aged 9-45, which has resulted in very limited vaccination rates among middle-aged and older women when they were within the recommended age range. Additionally, this demographic has relatively low awareness of the HPV vaccine. On the other hand, aging-related declines in immune function and hormonal changes increase the risk of persistent HR-HPV infection in this group. The latent nature of HPV infection further complicates the early detection of the disease. At the same time, cervical cancer screening coverage among middle-aged and older women in China remains low and shows significant regional disparities, with screening rates in economically disadvantaged areas being markedly lower than those in more affluent regions. Furthermore, physiological changes associated with aging reduce the accuracy of conventional screening methods in this population, leading to insufficient early detection and intervention for cervical cancer. As a result, many patients are diagnosed at an advanced stage of the disease, significantly increasing treatment difficulty and disease burden. This article reviewed the burden of cervical cancer and HR-HPV infection among middle-aged and older women in China, the associated influencing factors, and the status of comprehensive prevention and control measures, aiming to provide a reference for improving cervical cancer prevention strategies for middle-aged and older women in China and contribute to the country's efforts to eliminate cervical cancer.

Objective To analyze the prevalence and risk factors of underscreening among cervical cancer screening participants in Wuxiang County,Shanxi Province in 2019,providing evidence-based support for optimizing mobilization strategies.Methods Data from cervical cancer screening programs conducted between 2019 and 2024 in Wuxiang County were retrospectively collected.The follow-up screening behaviors of women screened in 2019 were analyzed,and factors associated with underscreening were identified.Results A total of 3759 women underwent cervical cancer screening in 2019.Among them,492 women(13.09％)with abnormal primary screening results requiring follow-up in 12 months,yet only 43(8.74％)completed;2154 women(57.30％)with negative liquid-based cytology testing(LCT)results needed re-screening after 3 years,701(32.54％)completed;1113 women(29.61％)with negative HPV/combined results needed re-screening after 5 years,734(65.95％)completed.Overall,2299 women(60.69％)exhibited underscreening.Multivariate analysis showed that underscreening was more likely among community residents than rural residents(OR=2.309,P=0.018),older women(OR=1.065,P＜0.001),those in organized screening compared to opportunistic screening(OR=3.789,P＜0.001),those undergoing LCT(OR=4.607,P＜0.001)or combined screening instead of human papillomavirus testing(OR=3.624,P＜0.001),and those with abnormal screening results(OR=6.859,P＜0.001).Conclusion Substantial proportions of cervical cancer screening participants demonstrate poor adherence to guideline-recommended screening intervals,and particularly need to focus on older women and those with abnormal screening results.Implementation of electronic screening record systems and emphasizing knowledge of periodical screening in health education could enhance compliance with"70％screening coverage"target for cervical cancer prevention.

Cervical cancer is one of the most common malignant tumors among women worldwide and represents a significant public health issue threatening women's health. In recent years, the disease burden of cervical cancer in China has been increasing, with women aged 45 and older bearing a particularly heavy burden. This population not only has the highest incidence and mortality rates but also represents the second peak age group for high-risk human papilloma virus (HR-HPV) infection, with the HR-HPV infection rate remaining consistently high. The causes of this situation are multifaceted. On one hand, the target group for HPV vaccination in China is women aged 9-45, which has resulted in very limited vaccination rates among middle-aged and older women when they were within the recommended age range. Additionally, this demographic has relatively low awareness of the HPV vaccine. On the other hand, aging-related declines in immune function and hormonal changes increase the risk of persistent HR-HPV infection in this group. The latent nature of HPV infection further complicates the early detection of the disease. At the same time, cervical cancer screening coverage among middle-aged and older women in China remains low and shows significant regional disparities, with screening rates in economically disadvantaged areas being markedly lower than those in more affluent regions. Furthermore, physiological changes associated with aging reduce the accuracy of conventional screening methods in this population, leading to insufficient early detection and intervention for cervical cancer. As a result, many patients are diagnosed at an advanced stage of the disease, significantly increasing treatment difficulty and disease burden. This article reviewed the burden of cervical cancer and HR-HPV infection among middle-aged and older women in China, the associated influencing factors, and the status of comprehensive prevention and control measures, aiming to provide a reference for improving cervical cancer prevention strategies for middle-aged and older women in China and contribute to the country's efforts to eliminate cervical cancer.

BACKGROUND:Radiotherapy for head and neck tumors can easily cause xerostomia,seriously affecting the quality of life of patients.In recent years,engineered stem cells and their paracrine factors have shown therapeutic potential in the repair of salivary gland injury.However,there is currently no experimental study on the application of amniotic mesenchymal stem cell-derived exosome in radiation-induced salivary gland injury.OBJECTIVE:To preliminarily explore the repair effect of exosome derived from human amniotic mesenchymal stem cells on radiation-induced submandibular gland injury.METHODS:H uman amniotic mesenchymal stem cell exosomes were extracted and identified by ultrafiltration and ultracentrifugation.SD rats were randomly divided into a control group,a radiation injury group,and a radiation injury+exosome group.An in vitro model of radiation-induced submandibular gland injury was constructed using the submandibular gland tissue of SD rats irradiated with 18 Gy of radiation.One day after radiation modeling,exosome derived from human amniotic mesenchymal stem cells was injected into the submandibular gland in situ.Samples are taken at 1,3,7,and 14 days to detect the resting salivary flow rate.The structure of the submandibular gland tissue was observed by hematoxylin-eosin staining.The expression of glycogen particles in the submandibular gland tissue was observed by Periodic Acid-Schiff staining.Fibrosis in the submandibular gland tissue was observed by Masson staining.The secretion of salivary amylase was detected by enzyme-linked immunosorbent assay.The expression of aquaporin and tight junction proteins in submandibular gland tissue was observed by immunofluorescence staining.Real-time fluorescence quantitative PCR was used to detect the relative expression levels of aquaporins and salivary amylase mRNA in submandibular gland tissue.TUNEL assay was used to detect the apoptosis rate of submandibular gland tissues in each group.RESULTS AND CONCLUSION:After radiomodeling,compared with the radiation injury group,(1)hematoxylin-eosin staining observed that the submandibular gland tissue structure in the radiation injury+exosome group was restored,the nucleoli increased,the number of acinus increased,and the acinar atrophy improved.(2)Glycogen staining observed that the number and density of positive zymogen granules in the acinar cytoplasm of the radiation injury+exosome group gradually increased.(3)Masson staining results observed that the number and density of positive collagen fibers in the interstitium and around the ducts in the radiation injury+exosome group gradually decreased,the degree of fibrosis decreased,and the collagen deposition decreased.(4)The salivary flow rate in the radiation injury+exosome group increased(P＜0.05).The fluorescence intensity of aquaporin-5 was enhanced(P＜0.05)and the gene expression was significantly enhanced(P＜0.01).The fluorescence distribution of tight junction protein 4 was weakened and the fluorescence intensity decreased(P＜0.05,P＜0.01).The content of salivary amylase increased(P＜0.05)and gene expression were significantly increased(P＜0.01).The number of positive apoptotic cells decreased(P＜0.05,P＜0.01).It is indicated that local injection of exosome derived from human amniotic mesenchymal stem cells could improve the pathological morphology of submandibular gland tissue,promote saliva flow rate and amylase expression,and may play a functional repair role in radioactive submandibular gland injury by inhibiting acinar apoptosis.

Objective To analyze the prevalence and risk factors of underscreening among cervical cancer screening participants in Wuxiang County,Shanxi Province in 2019,providing evidence-based support for optimizing mobilization strategies.Methods Data from cervical cancer screening programs conducted between 2019 and 2024 in Wuxiang County were retrospectively collected.The follow-up screening behaviors of women screened in 2019 were analyzed,and factors associated with underscreening were identified.Results A total of 3759 women underwent cervical cancer screening in 2019.Among them,492 women(13.09％)with abnormal primary screening results requiring follow-up in 12 months,yet only 43(8.74％)completed;2154 women(57.30％)with negative liquid-based cytology testing(LCT)results needed re-screening after 3 years,701(32.54％)completed;1113 women(29.61％)with negative HPV/combined results needed re-screening after 5 years,734(65.95％)completed.Overall,2299 women(60.69％)exhibited underscreening.Multivariate analysis showed that underscreening was more likely among community residents than rural residents(OR=2.309,P=0.018),older women(OR=1.065,P＜0.001),those in organized screening compared to opportunistic screening(OR=3.789,P＜0.001),those undergoing LCT(OR=4.607,P＜0.001)or combined screening instead of human papillomavirus testing(OR=3.624,P＜0.001),and those with abnormal screening results(OR=6.859,P＜0.001).Conclusion Substantial proportions of cervical cancer screening participants demonstrate poor adherence to guideline-recommended screening intervals,and particularly need to focus on older women and those with abnormal screening results.Implementation of electronic screening record systems and emphasizing knowledge of periodical screening in health education could enhance compliance with"70％screening coverage"target for cervical cancer prevention.