Objective:To evaluate the efficacy and safety of Nimotuzumab combined with concurrent chemoradiotherapy in elderly women with locally advanced cervical cancer.Methods:A retrospective analysis was conducted among elderly patients with cervical cancer who received nimotuzumab combined with concurrent chemoradiotherapy in the gynecology department of Beijing Hospital from November 2018 to March 2023.Efficacy assessments included the objective response rate(ORR), recurrence rates after 1-3 years of follow-up, and comparisons of the levels of squamous cell carcinoma antigen(SCC), carcino-embryonic antigen(CEA), and carbohydrate antigen 125(CA125)before and after treatment.Adverse reactions were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events(NCI-CTCAE)version 5.0.Results:A total of 47 elderly patients aged 60 years and older with stage ⅠB3-Ⅳa cervical cancer were included, with ages ranging from 60 to 76 years[mean age: (65.8±4.3) years; median age: 65(62, 70) years].The patients were divided into three age groups: 60-64 years(21 cases), 65-69 years(14 cases), and ≥70 years(12 cases).After treatment, SCC and CEA levels significantly decreased compared to pre-treatment levels, with statistically significant differences ( W=5.281 and 2.607, respectively; both P<0.05).However, there was no significant difference in CA125 levels before and after treatment( W=1.591, P=0.112).Among the 47 patients, 3 did not undergo post-treatment imaging examinations.Efficacy evaluation results were collected from 44 patients, including 21 cases of complete response(CR)(47.7%), 21 cases of partial response(PR)(47.7%), 1 case of stable disease(SD)(2.3%), and 1 case of progressive disease(PD)(2.3%).The ORR was 95.5%(42/44), and the diseae control rate was 97.7%(43/44).There were statistically significant differences in efficacy among different age groups(Fisher's exact test P=0.015).During the treatment process, a total of 36 patients experienced grade 3 or higher adverse reactions during treatment.Among them, 14 cases(29.8%)with grade 3 or higher acute hematological adverse reactions, 11 cases(23.4%)with grade 3 or higher acute gastrointestinal reactions, and 6 cases(12.8%)with grade 3 or higher acute urinary symptoms.Additionally, 2 cases of radiation cystitis and 3 cases of radiation proctitis were reported.There was no statistically significant difference in recurrence rates among different age groups(Fisher's exact test P=0.292).The highest recurrence rate among elderly patients was observed at the 2-3 year follow-up. Conclusions:For elderly patients with good organ function status, standard concurrent chemoradiotherapy combined with nimotuzumab may be an effective treatment for locally advanced cervical cancer.

Objective:To explore the symptom management experience and needs of tuberculosis patients undergoing home-based anti-tuberculosis chemotherapy.Methods:This was a descriptive qualitative study. Purposeful sampling was used to select tuberculosis patients receiving home-based chemotherapy and healthcare professionals with tuberculosis experience from Beijing Chest Hospital, Capital Medical University between March and July 2024. Semi-structured interviews focused on the management experience and needs related to chemotherapy symptoms. Data were analyzed using thematic analysis.Results:A total of 13 tuberculosis patients and six healthcare professionals were interviewed. A total of four core themes were identified: multiple concurrent symptoms exacerbate the difficulty of home disease management and cause multidimensional distress; tuberculosis patients have insufficient self-management skills for symptoms; there is a high and diverse demand for symptom management during home chemotherapy; and the out-of-hospital follow-up and monitoring system struggles to address symptom management effectively.Conclusions:Tuberculosis patients undergoing home chemotherapy face significant and challenging symptom management burdens. Future improvements should include enhancing continuity of care outside the hospital, developing specific symptom assessment tools, and establishing an efficient, multi-symptom integrated management strategy combining home and hospital care to improve symptom management experience and outcomes for tuberculosis patients.

Objective:To evaluate the efficacy and safety of Nimotuzumab combined with concurrent chemoradiotherapy in elderly women with locally advanced cervical cancer.Methods:A retrospective analysis was conducted among elderly patients with cervical cancer who received nimotuzumab combined with concurrent chemoradiotherapy in the gynecology department of Beijing Hospital from November 2018 to March 2023.Efficacy assessments included the objective response rate(ORR), recurrence rates after 1-3 years of follow-up, and comparisons of the levels of squamous cell carcinoma antigen(SCC), carcino-embryonic antigen(CEA), and carbohydrate antigen 125(CA125)before and after treatment.Adverse reactions were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events(NCI-CTCAE)version 5.0.Results:A total of 47 elderly patients aged 60 years and older with stage ⅠB3-Ⅳa cervical cancer were included, with ages ranging from 60 to 76 years[mean age: (65.8±4.3) years; median age: 65(62, 70) years].The patients were divided into three age groups: 60-64 years(21 cases), 65-69 years(14 cases), and ≥70 years(12 cases).After treatment, SCC and CEA levels significantly decreased compared to pre-treatment levels, with statistically significant differences ( W=5.281 and 2.607, respectively; both P<0.05).However, there was no significant difference in CA125 levels before and after treatment( W=1.591, P=0.112).Among the 47 patients, 3 did not undergo post-treatment imaging examinations.Efficacy evaluation results were collected from 44 patients, including 21 cases of complete response(CR)(47.7%), 21 cases of partial response(PR)(47.7%), 1 case of stable disease(SD)(2.3%), and 1 case of progressive disease(PD)(2.3%).The ORR was 95.5%(42/44), and the diseae control rate was 97.7%(43/44).There were statistically significant differences in efficacy among different age groups(Fisher's exact test P=0.015).During the treatment process, a total of 36 patients experienced grade 3 or higher adverse reactions during treatment.Among them, 14 cases(29.8%)with grade 3 or higher acute hematological adverse reactions, 11 cases(23.4%)with grade 3 or higher acute gastrointestinal reactions, and 6 cases(12.8%)with grade 3 or higher acute urinary symptoms.Additionally, 2 cases of radiation cystitis and 3 cases of radiation proctitis were reported.There was no statistically significant difference in recurrence rates among different age groups(Fisher's exact test P=0.292).The highest recurrence rate among elderly patients was observed at the 2-3 year follow-up. Conclusions:For elderly patients with good organ function status, standard concurrent chemoradiotherapy combined with nimotuzumab may be an effective treatment for locally advanced cervical cancer.

Objective:To explore the symptom management experience and needs of tuberculosis patients undergoing home-based anti-tuberculosis chemotherapy.Methods:This was a descriptive qualitative study. Purposeful sampling was used to select tuberculosis patients receiving home-based chemotherapy and healthcare professionals with tuberculosis experience from Beijing Chest Hospital, Capital Medical University between March and July 2024. Semi-structured interviews focused on the management experience and needs related to chemotherapy symptoms. Data were analyzed using thematic analysis.Results:A total of 13 tuberculosis patients and six healthcare professionals were interviewed. A total of four core themes were identified: multiple concurrent symptoms exacerbate the difficulty of home disease management and cause multidimensional distress; tuberculosis patients have insufficient self-management skills for symptoms; there is a high and diverse demand for symptom management during home chemotherapy; and the out-of-hospital follow-up and monitoring system struggles to address symptom management effectively.Conclusions:Tuberculosis patients undergoing home chemotherapy face significant and challenging symptom management burdens. Future improvements should include enhancing continuity of care outside the hospital, developing specific symptom assessment tools, and establishing an efficient, multi-symptom integrated management strategy combining home and hospital care to improve symptom management experience and outcomes for tuberculosis patients.

ObjectiveTo investigate the application of endoscopy in obtaining the great saphenous vein （GSV） during coronary artery bypass grafting （CABG） and explore the learning curve， with a particular focus on common challenges encountered during the learning process and their impact on early clinical outcomes. MethodsA retrospective analysis was conducted on clinical data from 83 patients who underwent off-pump CABG with endoscopic GSV harvesting at the First Affiliated Hospital of Zhengzhou University from July 2013 to April 2014. Patients were categorized into four groups based on the chronological order of their hospitalization： Group A （novice group， n=20）， Group B （proficient group， n=20）， Group C （progressive group， n=20）， and Group D （mature group， n=23）. Differences in perioperative and midterm follow-up outcomes among the groups were analyzed to determine the learning curve period. ResultsThe study population had a mean age of （60.22±8.06） years and a mean body weight of （69.77±11.66） kg. Comorbidities included hypertension （24 cases）， diabetes （26 cases）， and subacute cerebral infarction （14 cases）. The novice group exhibited significantly shorter GSV length-to-harvest time ratio relative to the other three groups （P<0.001） and a significantly higher incidence of main vein damage （P=0.006）. However， there was no statistically significant difference in graft patency at the 1-year follow-up. ConclusionThorough and reliable technical training in endoscopic GSV harvesting is essential to minimize vascular injury caused by novice operators. Approximately 20 cases of hands-on experience and a careful self-analysis of procedural challenges are likely required to achieve proficiency in GSV harvesting.

Objective:To screen and diagnose cervical lesions in middle-aged and elderly postmenopausal women and analyze the characteristics of cervical lesions in middle-aged and elderly women.Methods:A retrospective analysis was conducted on the screening data of 1 337 postmenopausal women aged between 50 and 86 years who visited the outpatient clinics of the gynecology department of Beijing Hospital between January, 2015 and December, 2019.Participants were divided into groups based on age, with 787 in the 50-59 years old group, 483 in the 60-69 years old group, 60 in the 70-79 years old group, and 7 in the 80-89 years old group.Exfoliated cervical cells were collected, and high-risk human papillomavirus(HPV)detection and liquid-based cervical cytology examination were performed to confirm the diagnosis based on the pathological results of cervical biopsy.Cervical lesions were analyzed.Results:53.0%(708)of the 1 337 enrolled patients made their hospital visits because of symptoms.There were 666 patients(49.8%)with cervical lesions, including 357 with low-grade squamous intraepithelial lesions(LSIL), 252 with high-grade squamous intraepithelial lesions(HSIL)and 57(4.3%)with cervical cancer.The 70-79 group showed the highest incidence of HSIL at 30.0%(18/60), while the 50~59 group had the highest incidence of LSIL at 30.6%(241/787), and there were significant differences in different types of cervical lesions between different age groups( χ2=28.919, P<0.01). Liquid-based cervical cytology examination revealed a positive rate of 51.6%(166/322)for LSIL, a positive rate of 70.8%(143/202)for HSIL, and a rate of 71.4%(25/35)for cervical cancer.There were significant differences in LSIL, HSIL and other above-mentioned positive rates of lesions( P<0.05). In the cervical malignancy group, cytological high-grade squamous epithelial lesions made up 51.4%(18/35). Intraepithelial lesions or cancerous lesions represented 29.2%(59/202)in the HSIL group.The rate of intraepithelial lesions or cancerous lesions in the LSIL group was 48.4%(156/322), with statistically significance in these differences( χ2=118.806, P<0.01). Chronic cervicitis was found in 52.9%(109)of 206 patients with atypical squamous cells and positive HPV, and in 76.2%(16)of 21 patients without HPV.HPV examination was completed in 1 301 patients, with 69.4%(903)having infections by one HPV strain and 30.6%(398)having infections by mixed HPV strains.Biopsy results showed that the rates of HPV infections in LSIL, HSIL and cancer patients were 84.6%(302/357), 95.9(185/193)and 100%(54/54), respectively, and the differences in these pathological results were statistically significant( P<0.01). HPV16 was the most common subtype in single HPV strain infections.The most common subtypes of HPV infections in cervical lesions with HSIL and above were HPV16 and HPV18.The agreement rate was 52.4%(187/357)for LSIL, 60.7%(153/252)for HSIL, and 64.9%(37/57)for cervical cancer between diagnoses based on cervical biopsy and those based on colposcopy.As the severity of lesions increased, the accuracy of colposcopy also increased.Differences between colposcopic diagnosis and pathological diagnosis on different types of cervical lesions were statistically significant( χ2=550.382, P<0.01).1 310 patients underwent endocervical curettage, identifying 120 cases of HSIL and 39 cases of cervical cancer, with a detection rate of 55.8%(159/285). Conclusions:The incidence of cervical cancer is high in elderly women.The incidences of high-grade lesions and cervical cancer in patients with atypical squamous cells plus HPV infections in the cervix are also high.Postmenopausal patients with cervical lesions are mainly infected by a single HPV subtype, with subtype 16 being the most common one.With increasing severity of lesions, the accuracy of colposcopy-based diagnosis increases and the rate of missed diagnosis decreases.Cervical curettage is an important means to reduce missed diagnosis with colposcopy.

Objective:To investigate the clinical efficacy of ultrasound-guided vacuum-assisted excision (VAE) in the treatment of breast benign phyllode tumor and the risk factors of local recurrence after operation.Methods:A total of 256 cases of patients with breast benign phyllode tumor admitted to Yuncheng Central Hospital from January 2012 to January 2020 were included in the retrospective study, they were all female, of which 160 cases received ultrasound-guided VAE surgical treatment and 96 cases received open surgical treatment. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between groups. The Chi-square test or Fisher exact probability method was used to compare the data groups. Univariate analysis was performed on the factors related to the local recurrence of benign phyllode tumor after surgery, and then the factors with statistically significant differences in the univariate analysis were further incorporated into multivariate Logistic regression analysis. Results:Univariate analysis results showed that the maximum diameter of tumor ≥25 mm and the history of ipsilateral breast fibroadenoma were associated with postoperative local recurrence of breast benign phyllodes tumor ( P<0.05). Multivariate Logistic regression analysis results showed that tumor diameter ≥25 mm was an independent risk factor for postoperative local recurrence of breast benign phyllodes tumor ( P<0.05). Conclusion:Ultrasound-guided VAE in the treatment of breast benign phyllodes tumor patients with maximum diameter less than 25 mm can reduce the postoperative local recurrence rate, and patients with tumor maximum diameter greater than 25 mm should have the higher local recurrence risk.

Objective:To investigate the regulatory mechanism of miR-29a-3p/ SGMS2 axis on the inflammatory response of ovarian granulosa cells (KGN). Methods:By constructing and validating overexpression and knockdown of miR-29a-3p and SGMS2 transfected KGN cell models, dual luciferase reporter gene assay was used to detect the binding of miR-29a-3p to SGMS2. MTT assay was used for detecting the cell proliferation. Fluorescence intensity of proliferating cell nuclear antigen (PCNA) and Ki67 protein were detected by immunofluorescence. Apoptosis was detected by flow cytometry. The expression levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-1β and sphingomyelin in cell supernatant were detected by enzyme-linked immunosorbent assay. The protein expression levels of Caspase-3, cleaved-Caspase-3, SGMS2 and p-p65 in KGN were detected by Western blotting. Results:miR-29a-3p had site-specific binding to SGMS2 and can negatively regulated SGMS2 expression level. Overexpression of SGMS2 in KGN cells was able to increase their levels of absorbance ( P=0.007) and enhanced the immunofluorescence intensity of the protein of PCNA and Ki67 (all P<0.001). Overexpression of SGMS2 could reduce the apoptosis rate of KGN cells ( P=0.001). Overexpression of SGMS2 increased the expression levels of TNF-α, IL-6, IL-1β and sphingomyelin (all P<0.001). The expressions of cleaved-Caspase-3, p-p65 and SGMS2 proteins were elevated in KGN cells when SGMS2 was overexpressed ( P=0.001, P<0.001, P<0.001), while knock down SGMS2, the above results had a trend of change opposite to overexpression of SGMS2. Conclusion:There is a targeted negative regulatory relationship between miR-29a-3p and SGMS2, which can promote the inflammatory response of KGN and may provide a target for the treatment of polycystic ovary syndrome.

Objective:To investigate the regulatory mechanism of miR-29a-3p/ SGMS2 axis on the inflammatory response of ovarian granulosa cells (KGN). Methods:By constructing and validating overexpression and knockdown of miR-29a-3p and SGMS2 transfected KGN cell models, dual luciferase reporter gene assay was used to detect the binding of miR-29a-3p to SGMS2. MTT assay was used for detecting the cell proliferation. Fluorescence intensity of proliferating cell nuclear antigen (PCNA) and Ki67 protein were detected by immunofluorescence. Apoptosis was detected by flow cytometry. The expression levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-1β and sphingomyelin in cell supernatant were detected by enzyme-linked immunosorbent assay. The protein expression levels of Caspase-3, cleaved-Caspase-3, SGMS2 and p-p65 in KGN were detected by Western blotting. Results:miR-29a-3p had site-specific binding to SGMS2 and can negatively regulated SGMS2 expression level. Overexpression of SGMS2 in KGN cells was able to increase their levels of absorbance ( P=0.007) and enhanced the immunofluorescence intensity of the protein of PCNA and Ki67 (all P<0.001). Overexpression of SGMS2 could reduce the apoptosis rate of KGN cells ( P=0.001). Overexpression of SGMS2 increased the expression levels of TNF-α, IL-6, IL-1β and sphingomyelin (all P<0.001). The expressions of cleaved-Caspase-3, p-p65 and SGMS2 proteins were elevated in KGN cells when SGMS2 was overexpressed ( P=0.001, P<0.001, P<0.001), while knock down SGMS2, the above results had a trend of change opposite to overexpression of SGMS2. Conclusion:There is a targeted negative regulatory relationship between miR-29a-3p and SGMS2, which can promote the inflammatory response of KGN and may provide a target for the treatment of polycystic ovary syndrome.

Hypoxic microenvironment is a common phenomenon of liver diseases and runs through the whole process of the development and progression of liver diseases. In recent years, the research on liver fibrosis and hypoxic microenvironment of hepatocellular carcinoma has attracted more and more attention. Hypoxia-inducible factor (HIF) is the most important hypoxic stress factor found at present. This article reviews the characteristics of hypoxic microenvironment in the liver and liver diseases and further elaborates on the association of HIF overexpression with hepatocyte damage, formation of fibrosis, and malignant transformation of hepatocytes.