Coexistent cervical intraepithelial neoplasia (CIN) and vaginal intraepithelial neoplasia (VaIN) is problematic, posing challenges for patient management. This study focused on the clinical characteristics of coexistent CIN 2/3 and VaIN (all degrees), evaluating the proclivity for disease recurrence/persistence at 6 months after treatment.

A retrospective case-control study of women treated for coexistent CIN 2/3 and VaIN (CE group) was undertaken between January 2018 and December 2020. During the same period, women with CIN 2/3 only were selected chronologically (1:2 ratio) for comparison (sCIN group). A loop electrosurgical excision procedure (LEEP) was the standard treatment for CIN 2/3, performing electrofulguration of VaIN in tandem. First follow-up visits at 6 months thereafter entailed testing for human papillomavirus (HPV). Univariate and multivariate analyses served to assess pertinent risk factors.

There were 91 CE group members, each treated for coexistent CIN 2/3 and VaIN (VaIN 1, 35; VaIN 2/3, 56). Age ≥50 years (OR = 3.362, 95% CI: 1.421-7.954) emerged as an independent risk factor for coexistent disease. Positive margins and persistent high-risk HPV (HR-HPV) infection after treatment were more common in the CE (vs. sCIN) group (p = 0.012 and p < 0.001, respectively), as was recurrent/persistent high-grade disease (17.6% vs. 2.2%; p < 0.001). In the CE group, persistent HR-HPV infection 6 months after treatment (OR = 21.320, 95% CI: 2.509-181.188) was the sole independent risk factor for disease recurrence/persistence at 6 months.

Comprehensive vaginal wall examinations are warranted for women with CIN 2/3, particularly those >50 years old. Close follow-up by HPV test is also indicated if CIN 2/3 and VaIN coexist, given a heightened incidence of recurrent/persistent disease.

HMGA2, as a transcription factor, facilitates oncogenesis and malignant progression by coordinating cell cycle dysregulation, compromising DNA repair machinery, and suppressing cancer cell apoptosis. However, its roles in prognostication and tumor immune microenvironment modulation in endometrial cancer (EC) remain incompletely defined.

We systematically analyzed HMGA2 expression patterns and clinical prognostic value in EC using bioinformatics strategies, including TCGA and GTEX data mining, as well as single gene expression analysis. Functional enrichment analysis (GSEA and KEGG) identified HMGA2-associated pathways. The correlation between HMGA2 and immune infiltration was assessed via TIMER and TISIDB. Subsequent in vitro (proliferation, migration, colony formation) and in vivo (xenograft models) experimental were used to validate HMGA2's role in promoting EC progression. The correlation between HMGA2 and macrophage markers (CD86 and CD206) was validated through clinical tissue samples by IHC. Finally, a recurrence-predictive nomogram incorporating HMGA2 with clinicopathological parameters was established.

HMGA2 exhibited significant upregulation in endometrial cancer (EC) tissues and correlated with poor patient prognosis. Immunoassay showed that high expression of HMGA2 was negatively correlated with infiltration of various immune cells, especially M1 macrophages. Cytological experiments showed that knocking down HMGA2 significantly inhibited EC cell proliferation, migration, invasion, and drug resistance, while overexpression of HMGA2 promoted the above phenotype; Animal experiments showed that knocking down HMGA2 significantly inhibited the growth of EC tumors and the expression of M1 macrophage marker CD86. The combination of HMGA2 inhibitors and targeted macrophage immunotherapy (CD47 monoclonal antibody) had the better tumor suppression effect. Clinical sample analysis found that high expression of HMGA2 was significantly negatively correlated with CD86 and positively correlated with CD206 expression. Patients with low HMGA2 expression showed enhanced immune therapy responsiveness. The nomogram model based on HMGA2 and clinical pathological parameters showed better predictive performance (AUC=0.855, sensitivity=79.0%, specificity=76.8%).

HMGA2 is a potential diagnostic and prognostic biomarker for the EC. HMGA2 may drive the occurrence and development of EC by inhibiting the infiltration of immune cells, especially M1 macrophages. Therapeutic targeting of HMGA2 is a novel strategy for EC intervention.

Hepatocellular carcinoma (HCC) is a highly malignant epithelial tumor characterized by global high incidence and poor clinical prognosis. Radical surgical resection, as the standard treatment for early-stage HCC patients, has been extensively validated for its therapeutic efficacy. However, epidemiological studies indicate that most patients are already in advanced stages at initial diagnosis, losing eligibility for radical treatment. Notably, HCC pathogenesis exhibits marked etiological heterogeneity, posing significant challenges for clinical management. Although significant breakthroughs have been made in understanding HCC drivers at pathophysiological levels, translational applications of these findings remain hindered by multiple barriers. Currently, elucidating the molecular mechanisms of HCC pathogenesis and identifying effective therapeutic targets constitute major research priorities in this field.Small extracellular vesicles (sEVs) are phospholipid bilayer vesicles (30-150 nm in diameter) carrying functional proteomes and nucleic acids (e.g., miRNAs, lncRNAs) with substantial biological activity. Studies demonstrate that sEVs contribute to malignant phenotype acquisition by modulating key signaling pathways such as PI3K/AKT and Wnt/β-catenin. These molecular cascades ultimately confer hallmark pathological features including aberrant proliferation, apoptosis resistance, and immune evasion to tumor cells. Within multi-network regulatory systems, sEVs serve as crucial intercellular messengers mediating tumor cell interactions with other tumor microenvironment (TME) components (e.g., cancer-associated fibroblasts, immune cells). Such communication facilitates TME reprogramming, pro-angiogenic phenotypic shifts, and therapy resistance development. Nevertheless, the precise molecular mechanisms of sEVs in HCC pathogenesis remain incompletely understood, warranting further exploration of their translational potential in clinical practice.

Background: Breast cancer patients often face the choice between breast-conserving surgery and mastectomy. From a shared decision-making perspective, it is crucial for patients to actively engage in the decision-making process, taking into account their own preferences and values. This approach can enhance treatment satisfaction and support the principles of precision nursing. Objective: To evaluate the level and classification of shared decision-making behavior in surgery, along with the influence of participation competence, perceived social support, and self-care self-efficacy, guided by the "Capacity, Opportunity, Motivation-Behavior" model. Method: A multicenter cross-sectional study was conducted in three hospitals in China from January 2021 to March 2022. The survey tools included self-designed demographic and clinical instrument, the Participation in Treatment Decision-Making Scale for cancer patients (PTDMS), the Participation Competence Scale (PCS), the Perceived Social Support Scale (PSSS), and the Strategies Used by People to Promote Health (SUPPH). Latent profile analysis was employed to assess the shared decision-making behavior in surgery. Multivariate logistic regression was applied to identify factors associated with the identified subtypes. Result: A total of 840 participants were ultimately analyzed. The best-fitting model identified three classes: active participation group (55.7%), moderate participation group (21.7%), and low participation group (22.6%). Logistic regression indicated that age, number of children, educational level, family income, employment status, cancer stage, type of surgery, participation competence, perceived social support, and self-care self-efficacy were main associated factors (all p < 0.05). Conclusion: The performance of shared decision-making behaviors in surgery needs improvement. This study may help nurses identify targeted intervention populations who are older, have more than three children, have a higher education level, have a lower family income, are employed, are at an advanced cancer stage, and are opting for mastectomy. It also emphasizes the importance of participation competence, social support, and self-care self-efficacy when designing intervention content.

Chimeric antigen receptor (CAR) T-cell therapy has transformed the treatment land-scape for childhood cancer. However, its global distribution remains unequal, with limited access in regions bearing a high burden of disease. This situation raises critical concerns about scientific equity in pediatric oncology research worldwide. To date, no study has systematically examined the scientific coherence between child health needs, global health indicators, and the frequency of CAR T-cell therapy clinical trials for childhood cancer. This omission represents a significant gap in the literature, with im-plications for global health equity and cancer research prioritization. A mixed-method analysis was conducted using global health metrics, child cancer indicators, and data from the Global Observatory on Health Research and Development. A total of 414 CAR T-cell therapy clinical trial participations across 30 countries were identified, with a heavy concentration in China (n = 161) and the United States (n = 84). High-income countries represented 73.3% of those participating. Multiple linear regression identified only one significant predictor for clinical trials participation: youth mortality (<15 years) (Coef. = 161.53; p = 0.045). The Lasso model revealed key predictors such as deaths due to alcohol use (Coef. = 29.99) and obesity (Coef. = 9.62) in children aged 5-14. Findings reveal a structural misalignment between childhood cancer disease burden and research activity in advanced therapies. Clinical trials are concentrated in countries with stronger scientific infrastructure rather than those with the greatest health needs, reinforcing cancer scientific inequities in the production and distribution of biomedical knowledge.

Multimodality imaging is an emerging research topic in neuro-oncology for its potential of being able to demonstrate tumours in a more comprehensive manner. Diffusion-weighted magnetic resonance imaging (dMRI) and proton magnetic resonance spectroscopy (¹H-MRS) allow inferring tissue cellularity and biochemical properties, respectively. Combining dMRI and ¹H-MRS may provide more accurate diagnosis for paediatric brain tumours than only one modality. This retrospective study collected 1.5-T clinical ¹H-MRS and dMRI from 32 patients to assess paediatric brain tumour classification with combined dMRI and ¹H-MRS. Specifically, spectral noise of ¹H-MRS was suppressed before calculating metabolite concentrations. Extracted radiomic features were apparent diffusion coefficient (ADC) histogram features through dMRI and metabolite concentrations through ¹H-MRS. These features were put together and then ranked according to the multiclass area under the curve (mAUC) and selected for tumour classification through machine learning. Tumours were precisely typed by combining noise-suppressed ¹H-MRS and dMRI, and the cross-validated accuracy was improved to be 100% according to naïve Bayes. The finally selected radiomic biomarkers, which showed the highest diagnostic ability, were ADC fifth percentile (mAUC = 0.970), myo-inositol (mAUC = 0.952), combined glutamate and glutamine (mAUC = 0.853), total creatine (mAUC = 0.837) and glycine (mAUC = 0.815). The study indicates combining MR imaging and spectroscopy can provide better diagnostic performance than single-modal imaging.

Immunotherapy with PD-1/PD-L1 inhibitors has transformed advanced non-small cell lung cancer (NSCLC) treatment, yet optimal strategies for elderly patients remain uncertain. Elderly patients (≥ 65 years) exhibit immune senescence (e.g., T-cell dysfunction, chronic inflammation), which may compromise immunotherapy efficacy and amplify toxicity risks, yet direct comparisons of monotherapy versus combination regimens in this population are lacking. Real-world comparisons of monotherapy versus combination therapy in this vulnerable group are lacking, hindering personalized clinical decisions.

This real-world study aimed to compare the efficacy and safety of PD-1/PD-L1 inhibitor monotherapy versus combination therapy with chemotherapy in elderly patients (≥ 65 years) with advanced NSCLC and develop a prognostic nomogram to guide personalized treatment decisions.

In this multicenter retrospective study, 641 patients (149 monotherapy, 492 combination therapy) with stage IIIB/IV NSCLC were analyzed. Primary endpoints included overall survival (OS), progression-free survival (PFS), and adverse events (AEs). A nomogram incorporating clinical variables was constructed using LASSO-Cox regression.

In a retrospective analysis of 641 elderly patients (≥ 65 years) with advanced NSCLC, combination therapy (n = 492) demonstrated superior median OS compared to monotherapy (n = 149) (35.37 vs. 20.53 months; HR = 0.62, 95% CI 0.48-0.80, P < 0.001), though PFS did not differ significantly (11.87 vs. 10.67 months; HR = 0.94, P = 0.535). Age-stratified analysis revealed marked OS benefits for patients < 75 years receiving combination therapy (36.10 vs. 18.67 months, P < 0.001), whereas no advantage was observed in those ≥ 75 years (29.23 vs. 34.93 months, P = 0.645). Cox regression identified combination therapy as a protective factor (HR = 0.54, P < 0.001), while ECOG PS ≥ 2 (HR = 1.87, P = 0.002), liver metastasis (HR = 1.62, P = 0.013), bone metastasis (HR = 1.84, P < 0.001), and malignant pleural effusion (HR = 1.64, P < 0.001) independently worsened prognosis. The incidence of AEs of any-grade (P < 0.001) and grade 3-4 (P = 0.003) in the immunotherapy combination group was significantly higher than that in the immunotherapy monotherapy group. A prognostic nomogram integrating treatment type, ECOG PS score, and other six variables had an AUC value of 0.70-0.71 for predicting 1-2 year OS.

For elderly patients with advanced NSCLC, immune combination therapy improved median OS over monotherapy. It was safe and effective, suggesting a viable treatment option, though further evaluation is needed for those aged 75 and older. A prognostic nomogram for OS following immunotherapy was developed, showing superior accuracy.

Chatbots driven by large language model artificial intelligence (AI) have emerged as potential tools to enhance health information access for patients with cancer. However, their integration into patient education raises concerns among oncologists. Limited literature has examined the perceptions and attitudes of oncologists in terms of endorsing AI-driven chatbots for health information.

This study aims to explore the perceptions and attitudes of Chinese oncologists toward endorsing AI-driven chatbots to patients with cancer.

In this phenomenological qualitative study, we purposively sampled oncologists from 4 hospitals in Southwest and East China and conducted semistructured interviews with 24 participants between November 19, 2024, and December 21, 2024. The data saturation principle was observed to determine the end point of data collection. Data were analyzed using the Colaizzi method.

The participants were aged 42.0 (range 29-53) years on average, including 9 (37%) female and 15 (62%) male participants. The participants had an average of 8.8 (range 1-25) years in oncology. Of the participants, 7 (29%) had recommended AI chatbots to patients. Three key themes were revealed from analysis of interview transcriptions, including perceived benefits, significant concerns, and impacts on doctor-patient dynamics. Benefits included enhanced accessibility and potential support for chronic condition management. Concerns centered on liability, misinformation, lack of personalization, privacy and data security risks, and patient readiness and education. Oncologists stressed a dual impact of AI chatbots on doctor-patient dynamics, recognizing the potential for improved communication and risks of trust erosion due to overreliance on AI.

While recognizing the potential of AI-driven chatbots to enhance accessibility of health information and chronic disease management, Chinese oncologists report significant concerns, including liability, misinformation, lack of personalization, privacy and data security risks, and patient readiness. Addressing the challenges requires comprehensive solutions, such as clear policies and guidelines, rigorous testing and validation, institutional endorsement, and robust patient and provider education. Future efforts should focus on resolving the barriers while leveraging the strengths of AI technology to support patient-centered care in a safe, effective, and ethical manner.

Colorectal cancer (CRC) screening disparities and opioid overdose (OD) deaths continue to pose significant public health challenges in Metro Detroit, particularly affecting African American and Middle Eastern North African (MENA) communities. The B.R.I.D.G.E. (Building Relationships to Impact Disparities and Generate Equity) initiative, a nurse-led, multimodal quality improvement (QI) program, demonstrates the vital role of nursing leadership in tackling these 2 pressing epidemics through community-focused, equity-driven strategies. Utilizing the Mobilizing for Action through Planning and Partnerships (MAPP) 2.0 framework, B.R.I.D.G.E. implements targeted interventions across clinical and community settings. These initiatives include enhancing CRC screening through clinic-based QI projects, educating providers, offering transportation assistance, and expanding OD prevention via Narcan administration training, Screening, Brief Intervention, Referral to Treatment (SBIRT), and Mental Health First Aid (MHFA). By empowering nurses as trusted community advocates and cultivating strong cross-sector partnerships, B.R.I.D.G.E. effectively improves care delivery, advances health equity, and nurtures sustainable community engagement. This case study illustrates how nurse-led interventions can dismantle structural barriers, enhance health outcomes, and serve as scalable models for addressing health disparities in marginalized populations. Utilizing the Mobilizing for Action through Planning and Partnerships (MAPP) 2.0 framework, B.R.I.D.G.E. implements targeted interventions across clinical and community settings. These initiatives include enhancing CRC screening through clinic-based QI projects, educating providers, offering transportation assistance, and expanding OD prevention via Narcan administration training, Screening, Brief Intervention, Referral to Treatment (SBIRT), and Mental Health First Aid (MHFA). By empowering nurses as trusted community advocates and cultivating strong cross-sector partnerships, B.R.I.D.G.E. effectively improves care delivery, advances health equity, and nurtures sustainable community engagement. This case study illustrates how nurse-led interventions can dismantle structural barriers, enhance health outcomes, and serve as scalable models for addressing health disparities in marginalized populations.

Desmoplastic fibroma of the bone (DFB) is a rare and locally aggressive tumor that originates from the bone. We present a case of DFB involving the ilium that progressed over a 4-month follow-up period. To our knowledge, this is the first report detailing the short-term follow-up of DFB.

A 28-year-old male patient was admitted to our institution because of unexplained right iliac pain. Radiological assessment revealed osteolytic and expansive bone destruction in the right ilium along with linear hypointensity on T2-weighted imaging. After the 4-month follow-up, computed tomography images demonstrated an increase in lesion size.

The initial diagnosis was a fibrous tumor. Histopathological examination after the operation confirmed a diagnosis of DFB.

The patient underwent extensive resection, reconstruction with bone cement, and internal fixation. No radiological evidence of tumor recurrence was observed 5 years after surgery.

This study provides the initial documentation of the short-term imaging progression characteristics of DFB in the iliac bone. Within the framework of the World Health Organization classification of bone tumors, DFB is categorized as an intermediate tumor based on its biological behavior. The case presented herein illustrates rapid progression of the tumor over a short period. Such findings underscore the paramount importance of achieving an accurate diagnostic evaluation through comprehensive imaging and the necessity of timely surgical intervention to effectively manage tumors and mitigate potential adverse outcomes.