Zinner syndrome is a rare congenital defect of the male reproductive organs, which is traditionally characterised by the presence of the triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and obstruction of ejaculatory ducts. It is a result of malformed development of the mesonephric (Wolffian) duct during embryogenesis, commonly asymptomatic, and is discovered incidentally by imaging. Mass effect can cause symptomatic patients to present with lower urinary tract symptoms, lower abdominal or pelvic pain, reproductive dysfunction, and bowel symptoms, uncommonly. Magnetic Resonance Imaging (MRI) is the diagnostic gold standard, Computed Tomography (CT), Ultrasound (US) and emerging modalities can help in early detection. Individualised management includes conservative observation and minimal invasive, robotic-assisted or endoscopic intervention with new therapies emerging to help relieve the symptoms and preserve fertility. Genetic research, such as whole exome sequencing, has proposed a role of genetic factors such as GATA3 and PAX8, among others, in the pathogenesis. The present article is a review of clinical presentation, imaging, pathogenesis, and treatment.

Background: Iliopsoas abscess (IPA) is a rare but potentially life-threatening condition characterized by purulent infection within the psoas compartment. Immunocompromised patients, particularly those with malignancy, are at increased risk due to factors such as neutropenia, mucosal barrier injury, and prior instrumentation. While both hematogenous and contiguous sources of infection are described, there is limited literature characterizing IPA specifically in cancer patients. Methods: We conducted a focused literature review of IPA in oncologic populations and present a case series of 3 patients with active or recently diagnosed malignancy who developed psoas abscesses. Each case was examined for clinical presentation, diagnostic findings, microbiologic profile, and management strategies. Results: The first patient, with metastatic colon cancer and a chronic enterocutaneous fistula, developed a polymicrobial left psoas abscess including Escherichia coli , Veillonella , and Streptococcus anginosus . The second patient, with therapy-related acute myeloid leukemia (AML), presented with profound neutropenia and a monomicrobial MRSA abscess. The third patient, with newly diagnosed multiple myeloma, had a small left-sided psoas abscess in the context of MRSA bacteremia, spinal discitis, and paraspinal extension. All patients underwent CT-guided drainage and received targeted antimicrobial therapy based on culture data. Discussion: This series highlights the heterogeneity of IPA in cancer patients, including varied routes of infection (fistula formation and hematogenous spread), microbial profiles (polymicrobial vs. MRSA), and radiographic findings. The diagnostic challenge is compounded by nonspecific symptoms and frequent absence of the classic psoas triad, especially in neutropenic individuals. Imaging remains central to diagnosis, and management requires individualized antimicrobial therapy and source control. As cancer survival improves and immunosuppressive therapies expand, clinicians should maintain a high index of suspicion for IPA in oncologic patients with abdominal or hip pain, even in the absence of systemic signs.

Klebsiella spp. are frequently found as commensals of the gastrointestinal tract in infants, and their presence in stool cultures is often dismissed as colonization. However, their role in causing severe diarrhea in previously healthy infants remains unclear. We retrospectively analyzed 4 cases of previously healthy term infants under 3 months of age hospitalized between 2016 and 2024 with unusually severe diarrhea. All had Klebsiella spp. isolated in stool cultures as the sole pathogen. Clinical and laboratory features were evaluated. Additional hospital records from 2020 to 2024 were reviewed to identify other infants with Klebsiella spp. in stool. All 4 infants presented with profound watery diarrhea, lethargy and poor general condition, requiring intensive fluid resuscitation. Stool cultures revealed monoculture or abundant growth of Klebsiella pneumoniae (n = 3) or Klebsiella oxytoca (n = 1). No viral or bacterial co-pathogens were identified. All patients had elevated inflammatory markers and methemoglobinemia. Symptoms improved following antibiotic therapy, and hospital stays ranged from 11 to 24 days. This case series highlights a potentially underrecognized role of Klebsiella spp. in severe infantile gastroenteritis. In young infants with unusually severe diarrhea and no other identifiable cause, Klebsiella may be pathogenic. These findings support the need for further investigation into its clinical significance and management strategies.

Modular alginate-based hydrogels embedding multilayer nanofibers: A synergistic strategy for hemostasis, antibacterial, and immunomodulatory therapy.

Female sterilization is one of the most commonly adopted permanent methods of contraception worldwide and is generally considered highly effective. Despite its low failure rate, pregnancy can occur following sterilization, and such pregnancies are associated with a disproportionately higher risk of ectopic implantation. Ectopic pregnancy after sterilization often presents diagnostic challenges, as prior sterilization may lead to a false sense of security and delayed clinical suspicion, thereby increasing the risk of tubal rupture and maternal morbidity. To describe the clinical presentation, diagnostic evaluation, management strategies, and maternal outcomes of ectopic pregnancies occurring after tubal sterilization. This case series includes four women with a previous history of tubal sterilization who were diagnosed with ectopic pregnancy at Vinayaka Mission's Kirupananda Variyar Medical College and Hospitals. Detailed clinical information, including age, parity, method and timing of sterilization, presenting symptoms, diagnostic findings, site of ectopic pregnancy, treatment approach, and outcomes, was collected and analyzed. Diagnosis was confirmed using urine pregnancy testing, serum beta human chorionic gonadotropin levels, and transvaginal ultrasonography. All cases were managed surgically and followed through the postoperative period. All four women presented with lower abdominal pain with or without amenorrhea. The interval between sterilization and occurrence of ectopic pregnancy ranged from 1 to 8 years. Tubal ectopic pregnancy was identified in all cases, with one patient presenting in a ruptured state requiring emergency surgical intervention. Timely diagnosis and appropriate surgical management resulted in favorable maternal outcomes in all cases, with no major postoperative complications. Ectopic pregnancy can occur even several years after tubal sterilization and should always be considered in women of reproductive age presenting with abdominal pain or menstrual irregularities, regardless of sterilization history. Maintaining a high index of clinical suspicion and ensuring early diagnostic evaluation are crucial for preventing maternal morbidity and achieving optimal outcomes.

Abstract Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that primarily affects the colon. Among its extraintestinal complications, cerebral venous sinus thrombosis (CVST) is a rare yet potentially life-threatening emergency that can manifest as headaches, seizures, and/or neurological deficits. This review aims to characterize the clinical presentation, diagnostic modalities, and management strategies for CVST in UC patients. A comprehensive search of case reports and series yielded 1,156 studies, of which 39 met the inclusion criteria. A total of 47 patients were identified; the majority of whom were adult males (33.3%) and commonly presented with headaches (67.4%). Multi-symptom presentations were more prevalent in adults (66%; p = 0.038) and were often associated with UC flare-ups (56.4%). Patients with multiple symptoms had a higher frequency of straight and sphenoid sinus involvement compared with those with an isolated symptom (p < 0.001). Anemia was correlated with poorer clinical outcomes (p = 0.009). Computed tomography (CT) was the most frequently used initial imaging modality, whereas magnetic resonance imaging (MRI) was more sensitive. Anticoagulation therapy with low-molecular-weight heparin and warfarin, alongside endovascular thrombectomy in select cases, was effective in improving outcomes. This review underscores the importance of early recognition, MRI-based imaging, and timely anticoagulation to improve outcomes in UC-associated CVST.

Nerve injury is an uncommon but consequential complication following total hip arthroplasty (THA), with outcomes that range from full recovery to persistent long-term deficits. Despite decades of research, uncertainty remains regarding its true incidence, risk factors, and prognosis. This systematic review and meta-analysis synthesized data from 17 studies encompassing diverse designs, including large database analyses and focused case series. Clinical characteristics, surgical factors, nerve-injury patterns, management strategies, and recovery outcomes were extracted. Pooled proportions were calculated using a random-effects model, and predictors were assessed through meta-regression. Across 17 studies, the most frequently affected nerves were the sciatic, peroneal, and femoral branches, with the peroneal division consistently identified as most vulnerable. Immediate postoperative presentation was common, particularly in injuries related to traction, limb lengthening, or retractor compression, while delayed-onset injuries were often linked to hematoma, screw prominence, or pseudotumor formation. Pooled incidence of nerve injury after THA was 0.36% (95% CI 0.35-0.37%). Complete recovery occurred in 48.6% (95% CI 33.9-63.3%), whereas 50.5% (95% CI 36.0-65.0%) experienced residual deficits. Reoperation was required in 33.1% (95% CI 4.2-62.0%), and 39.8% (95% CI 25.1-54.4%) had permanent neurological impairment. Orthotic use was common due to persistent dorsiflexion weakness. Meta-regression identified comorbidity burden as the only significant predictor of nerve injury. Nerve injuries after THA remain clinically significant, with substantial variability in presentation, recovery, and long-term disability. Early detection, careful surgical technique, and risk stratification especially in patients with the multiple comorbidities are very important for prevention and improved outcomes.

Collagen VI–related myopathies (COL6-RM) encompass a broad clinical spectrum of inherited neuromuscular disorders ranging from severe Ullrich congenital muscular dystrophy to milder Bethlem myopathy, caused by pathogenic variants in COL6A1, COL6A2, and COL6A3. The pathogenic disruptions in collagen VI compromise extracellular matrix stability, impair autophagic flux, promote mitochondrial permeability transition, and alter fibroblast–myofiber signaling. These disorders are characterized by proximal muscle weakness, joint contractures, distal hyperlaxity, and respiratory compromise. Advances in basic science have revealed that collagen VI deficiency disrupts extracellular matrix (ECM) integrity, impairs autophagy, induces mitochondrial dysfunction, and alters the myomatrix microenvironment, collectively driving progressive muscle degeneration. Diagnosis relies on a multimodal approach that integrates clinical assessment with muscle MRI, histopathology, and next-generation sequencing. Management remains largely supportive; however, emerging strategies, including autophagy enhancers, mitochondrial permeability transition pore (mPTP) inhibitors, extracellular matrix–targeting agents, and genebased therapies show promise for disease modification. Advances in molecular biology have reshaped the understanding of COL6-RM and opened new avenues for targeted treatment. Robust natural history studies and biomarker development are needed to accelerate translational progress. The objective is to synthesize current evidence regarding pathogenesis, clinical presentation, diagnostic modalities, and evolving therapeutic approaches in COL6-RM. This review integrates and synthesizes findings from molecular pathogenesis, diagnostic tools, clinical spectrum, imaging studies, and evolving management while highlighting future therapeutic directions with emphasis on recent mechanisms involving extracellular matrix dysfunction, autophagy impairment, mitochondrial dysregulation, and myomatrix remodeling.

Abstract Background Cervical compartment syndrome is an exceptionally rare but potentially life-threatening condition characterized by increased intercompartmental pressure within the neck, leading to neurovascular compromise, airway obstruction, and tissue necrosis. Due to its rarity and nonspecific presentation, diagnosis and timely intervention remain challenging. This study aims to present three cases of cervical compartment syndrome and contextualize their clinical presentation, etiology, management, and outcomes through a narrative review of the literature. Methods We present a retrospective case series of three patients who developed cervical compartment syndrome from varied etiologies: prolonged immobilization, subclavian central line infiltration during trauma resuscitation, and prolonged intraoperative neck positioning. A comprehensive literature review was also conducted to contextualize clinical presentation, diagnostic approaches, and management strategies. Results All patients exhibited rapid neck swelling with neurological deficits or hemodynamic instability. One case was managed conservatively; the others required emergency surgical decompression. Etiologies included pressure-induced rhabdomyolysis, iatrogenic fluid extravasation, and venous outflow obstruction. Airway compromise and elevated compartment pressures were common themes. Two patients demonstrated complete neurological recovery during follow-up, while one patient died due to complications of massive hemorrhage unrelated to cervical decompression. Conclusion Compartment syndrome of the neck, also known as cervical compartment syndrome, though rare, should be considered in rapidly expanding neck swellings with signs of airway or vascular compromise. It is a critical condition that requires a high index of suspicion, especially in trauma, postoperative, or iatrogenic settings. Early recognition, timely airway protection, and prompt surgical decompression when indicated may be lifesaving and are often required to reduce the risk of irreversible neurovascular injury and adverse outcomes.

Esophageal squamous cell carcinoma (ESCC) is a highly prevalent and lethal malignancy in China and other East Asian countries. For patients with locally advanced disease, neoadjuvant chemotherapy or chemoradiotherapy followed by surgery has become the standard treatment paradigm. However, despite improvements in local tumor control and surgical outcomes, long-term survival remains unsatisfactory, largely due to the high incidence of distant metastasis and systemic disease progression. Therefore, optimizing perioperative systemic therapy represents a critical unmet clinical need in ESCC. In recent years, the introduction of immune checkpoint inhibitors (ICIs) has profoundly reshaped the perioperative treatment landscape of ESCC. This review comprehensively summarizes recent clinical advances in perioperative immunotherapy for ESCC, including neoadjuvant immunotherapy alone, neoadjuvant immunotherapy combined with chemotherapy, neoadjuvant immunotherapy combined with chemoradiotherapy, and postoperative adjuvant immunotherapy. Current data indicate that neoadjuvant chemoradiotherapy remains highly effective in improving local control, downstaging tumors, and increasing the rate of R0 resection. Nevertheless, its ability to translate these advantages into durable survival benefit is limited, and distant recurrence remains a major cause of treatment failure. In contrast, neoadjuvant immunotherapy combined with chemotherapy has demonstrated a marked improvement in pathological complete response (pCR) rates across multiple early-phase trials. More importantly, this strategy appears to provide supe-rior systemic disease control, thereby reducing the risk of distant metastasis and offering a promising avenue for improving long-term survival. Neoadjuvant immunotherapy combined with chemoradiotherapy has shown further enhancement of local response and tumor regression; however, this approach is asso-ciated with increased treatment-related toxicity, and robust evidence supporting a clear survival advantage is still lacking. As a result, the optimal integration of radiotherapy into immunotherapy-based perioperative regimens remains an area of active investigation. Given the heterogeneity of ESCC, perioperative treatment strategies should evolve toward individualized, risk-adapted approaches. For patients with a high local tumor burden (advanced T stage), the incorporation of radiotherapy may be beneficial to reinforce local control and improve resectability. Conversely, for patients with extensive lymph node involvement (advanced N stage) and a high risk of distant relapse, immunotherapy-based systemic treatment should be prioritized. In the postoperative setting, adjuvant immunotherapy has been shown to improve outcomes in patients who fail to achieve pCR after neoadjuvant chemoradiotherapy. Looking forward, the integration of dynamic biomarkers, such as circulating tumor DNA (ctDNA), along with the identification of novel immune targets and predictive biomarkers, is expected to further refine patient selection and optimize precision perioperative treatment strategies for ESCC.

Chitosan-based (CS-based) materials have attracted considerable attention owing to their excellent biocompatibility and intrinsic hemostatic activity, rendering them promising candidates for emergency hemorrhage control. Nevertheless, their clinical performance is often constrained by inadequate wettability and limited mechanical strength. In this study, we developed a superelastic hemostatic sponge (HMCT-NP) through a facile freeze-drying approach by incorporating hydrophobically modified CS, tannic acid (TA)-mediated cross-linking, and functional Fe-baicalin nanoparticles (Fe-Ba NPs). The grafted hydrophobic alkyl chains can insert into the membranes of red blood cells (RBCs) and platelets, thereby promoting their active adhesion and aggregation to accelerate rapid coagulation. TA enhances the mechanical properties of the sponge via hydrogen-bond-mediated cross-linking while also providing antibacterial and antioxidant functionalities. The incorporation of nanoparticles enhanced the antibacterial and antioxidant properties of the sponge and, notably, led to a significant improvement in its mechanical robustness. Through this modular design and synergistic functional enhancement, HMCT-NP effectively mitigates the intrinsic poor wettability of CS-based hemostatic sponges, demonstrating a water uptake capacity of approximately 95 g/g and a volumetric expansion greater than 200% upon hydration, thereby enabling rapid fluid imbibition and enhancing blood cell aggregation at the bleeding interface. Furthermore, its high compressibility and rapid fluid-triggered shape recovery enable effective deployment in narrow or deep wounds while maintaining biosafety and minimizing tissue irritation. In various bleeding models, HMCT-NP sponge demonstrated enhanced procoagulant activity and hemostatic performance. Meanwhile, the sponge effectively accelerated the healing of infected wounds. Collectively, these results underscore the potential of the HMCT-NP sponge as a versatile and promising strategy for clinical hemorrhage management.

The Bridging the Gaps (BTG) in Leukemia, Lymphoma and Multiple Myeloma Consensus Conference 2025 brought together a multidisciplinary group of oncology experts to address the complexities of lymphoma management, focusing on mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL), and diffuse large B-cell lymphoma (DLBCL). This article presents consensus recommendationsdeveloped through a modified Delphi process, which emphasize the need for tailored therapeutic strategies in light of recent advancements in treatment options. Key recommendations include the screening for high-risk features in MCL, use of the BOVen regimen (zanubrutinib, obinutuzumab, and venetoclax) for TP53-aberrant cases, and integration of chimeric antigen receptor T-cell therapy for patients with mantle cell lymphoma that is refractory to covalent Bruton tyrosine kinase inhibitors. For CLL, recommendations include consideration of time-limited therapies for younger patients and a "watch and wait" strategy for asymptomatic patients despite the improved activity and safety of current treatment regimens. For DLBCL, this article highlights the challenges in treatment sequencing and the role of circulating tumor DNA and minimal residual disease testing in monitoring disease progression. Overall, the conference describes the importance of ongoing research to refine management strategies and improve patient outcomes in lymphoma care, addressing the gaps in clinical practice where high-level evidence is lacking.

Chlorfenapyr (CFP) is a halogenated pyrrole insecticide that requires metabolic activation to exert toxicity and has been associated with severe poisoning in humans. However, the metabolic pathways underlying CFP bioactivation and detoxification in humans remain poorly defined. In this study, we systematically investigated the metabolic fate of CFP and its toxic metabolite tralopyril (TLP) using in vitro human drug-metabolizing enzyme systems. Screening of ten human cytochrome P450 (CYP) isoforms at 5 and 50µM CFP indicated that CYP2B6 is the major contributor to CFP bioactivation, which was further supported by selective inhibition and correlation analyses. CFP metabolism by CYP2B6 followed Michaelis-Menten kinetics, with showing a Km of 1.80 ± 0.57μM, a Vmax of 0.24 ± 0.02pmol/min/pmol P450, and an CLint of 139.78 ± 33.70 nL/min/pmol P450. In addition, incubations using 50 or 100µM TLP and varying concentrations of glutathione (0.1 to 1mM GSH) showed the formation of a novel GSH conjugate of TLP (TLP-GSH), of which level was markedly enhanced by human glutathione S-transferases (GSTs). Among six recombinant human GST isoforms tested, GSTA1, GSTA2, GSTM1, and GSTP1 showed significant catalytic activity in TLP-GSH formation compared with non-enzymatic reactions. Moreover, extracellular flux analysis revealed that TLP dose-dependently inhibited basal and maximal oxygen consumption rates, an effect exacerbated by GST inhibition, indicating a protective role of GSTs in TLP-induced mitochondrial toxicity. Together, these findings delineated metabolic enzymes-mediated bioactivation and detoxification pathways governing CFP toxicity in humans and provided a new perspective on clinical management strategies for CFP poisoning.

To identify clinical and imaging predictors influencing the success rate of disc reduction following mandibular manipulation (MM). Participants with anterior disc displacement without reduction (ADDwoR) who visited Peking University Hospital of Stomatology and underwent MM assisted by arthrocentesis were included. Demographic, clinical, and imaging data of all participants were collected. Qualitative and quantitative assessments were conducted. All statistical analyses were performed using IBM SPSS Statistics version 27.0. A total of 197 patients were included in the study, with 71.6% achieving successful disc reduction (DR). The average age of all participants was 23.45 ± 8.83 years, with 89.3% being female. The multivariate logistic model revealed that angle β (OR = 1.04; 95% CI = 1.01-1.07) and disc length (OR = 1.57; 95% CI = 1.15-2.15) were significantly associated with increased odds of successful disc reduction, while duration of jaw lock (OR = 0.66; 95% CI = 0.53-0.80) and thickness of the intermediate zone (OR = 0.26; 95% CI = 0.09-0.75) were significantly associated with decreased odds. Shorter duration of jaw lock, milder disc deformation, and less severe disc displacement indicate higher success rates of disc reduction using MM. The established cut-off values were 2.75 months for disease duration of jaw lock, 8.39 mm for disc length and 96.7° for the intersection angle β. Future development of a multivariate prediction model may help optimize clinical management strategies for ADDwoR.

Inborn errors of metabolism (IEM) are frequently underdiagnosed in low-resource settings due to limited diagnostic infrastructure. We hypothesized that an integrated clinical-genomic approach could improve diagnosis and management of these conditions. Nineteen Pakistani families with clinically suspected IEM underwent systematic clinical assessment, available biochemical testing, and whole-exome sequencing (WES). Variants were classified according to ACMG/AMP guidelines using evidence from population databases, in silico prediction tools, segregation analysis, and genotype-phenotype correlation. Clinical diagnoses and management strategies were reassessed based on molecular findings. WES provided a molecular diagnosis in 90% (17/19) of families and enabled targeted therapeutic interventions in 70% (13/19). However, clinical outcomes were variable due to advanced disease in some cases and limited follow-up. Seven novel variants were identified in CYP27B1, DYM, MTTP, ALDH3A2, USP53, BRAF, and JAG1, while twelve recurrent mutations were detected in PIGN, GCDH, CLCN7, RNASEH2C, ABCB11, MPV17, IDUA, SMPD1, FBP1, SLC37A4, ACADM, and UGT1A1. Integrating genomic findings with clinical reassessment improved diagnostic precision. An integrated clinical-genomic approach enabled accurate diagnosis of pediatric IEM in resource-limited settings, with particular utility in children with metabolic disorders in a consanguineous population. Identification of both novel and recurrent variants expanded the genotypic and phenotypic spectrum of these disorders and highlighted the clinical utility of genomic diagnostics in optimizing patient care.

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic, symmetric polyarticular synovitis, with a global prevalence of approximately 0.5%-1%. Its pathogenesis involves a complex interplay of genetic and environmental factors, as well as abnormal immune activation. RA patients face a significantly increased risk of cardiovascular disease, with atherosclerosis (AS) and its complications being the leading cause of mortality. Chronic systemic inflammation has long been considered the core pathological bridge linking RA and AS, whereby inflammatory cytokines drive cardiovascular events by impairing endothelial function and promoting arterial plaque formation and destabilization. However, recent research has yielded critical breakthroughs, revealing that dyslipidemia plays a vital role in RA pathogenesis and its comorbidity with AS. It goes beyond a traditional secondary effect, serving as an active participant intertwined with the immune-inflammatory network. This review specifically focuses on lipid-immune crosstalk in RA-AS comorbidity. To this end, we aim to systematically outline the epidemiological evidence for this association, summarize current clinical management strategies and their impact on cardiovascular risk, analyze shared risk factors, and explore in depth the central role of lipid metabolism in their shared pathophysiological mechanisms. We focus on cutting-edge topics such as the “lipid paradox” phenomenon, lipoprotein dysfunction, lipid metabolic dysregulation in macrophages and the imbalance of bioactive lipid mediators to provide a comprehensive perspective and theoretical basis for understanding their common pathophysiological pathways and developing novel therapeutic strategies targeting the metabolism-immune axis.

Malaria and HIV remain two of the most serious public health threats in sub-Saharan Africa (SSA), where both infections occur at disproportionately high levels. Their co-occurrence within the same populations presents a complex clinical and epidemiological challenge that con-tributes substantially to morbidity and mortality across the region. This review examines current evidence on the epidemiology of malaria and HIV co-infection in SSA, with particular attention to key risk factors and the health outcomes associated with dual infection. It also evaluates chal-lenges in the clinical management of co-infected individuals, including diagnostic limitations, treatment interactions, and health system constraints. Evidence from recent studies indicates that closer coordination of malaria and HIV services may improve patient outcomes while increasing the efficiency of health delivery systems. Continued progress in diagnostic capacity, antimalarial therapies, and antiretroviral treatment, alongside improvements in health infrastructure, will be important for addressing this dual disease burden. International health initiatives and collabora-tive research programs may further strengthen integrated approaches and expand regional capac-ity for surveillance and treatment. Community engagement and targeted health education also play a critical role in encouraging timely care seeking and reducing stigma related to HIV infec-tion. This review identifies persistent gaps in surveillance systems, clinical management, and in-tegrated control strategies for malaria and HIV co-infection in SSA. Addressing these gaps will be important for informing future research priorities and supporting public health policies aimed at reducing the burden of both diseases in the region.

Background/Objectives: Gastric-type endocervical adenocarcinoma (G-EAC) is a rare, aggressive, and HPV-independent subtype of cervical cancer with a poor prognosis. Due to its rarity, existing literature is often limited by small sample sizes, which hinders the development of evidence-based clinical management strategies. This study aims to evaluate the clinicopathological features, prognostic factors, and responses to postoperative adjuvant therapy in a large cohort of G-EAC patients compared with those with usual endocervical adenocarcinoma (UEA). Methods: We conducted a nested case-control study within a prospectively maintained surgical cohort at a national referral center in China. The study population included 195 pathologically confirmed G-EAC cases and 765 UEA cases. Patients were followed longitudinally with comprehensive clinical and survival data collection. One-to-one propensity score matching (PSM) was performed to balance demographic, clinical, and treatment variables between the groups. Survival outcomes were compared using Kaplan-Meier analysis, and independent prognostic factors were identified via Cox regression. Results: G-EAC patients demonstrated significantly worse survival outcomes than matched UEA patients, with 3-year progression-free survival (PFS) of 66.1% vs. 79.8% (p = 0.014) and 3-year overall survival (OS) of 74.9% vs. 84.6% (p = 0.033). Parametrial involvement and pelvic lymph node metastasis were identified as independent risk factors for both recurrence and death (p < 0.05). Regarding adjuvant treatment, combined radiotherapy and chemotherapy significantly improved survival compared with single-modality treatments (PFS: 65.2% vs. 43.6%; OS: 74.3% vs. 54.5%; p < 0.05); however, G-EAC remained less responsive to these therapies than UEA. Conclusions: G-EAC exhibits more aggressive clinical behavior and poorer survival outcomes compared to UEA. While combined radiotherapy and chemotherapy offer survival benefits, outcomes remain suboptimal. These findings underscore the urgent need for early detection strategies and the development of more effective targeted therapies for this specific subtype.

Background. Dentistry is a highly demanding profession that requires specific physical postures during clinical procedures. The prolonged adherence to such postures throughout a practitioner’s career can lead to musculoskeletal discomfort and chronic pain. These physical and ergonomic challenges may contribute to occupational burnout and reduced job satisfaction. Aim. The aim of this study is to identify the most prevalent sites of musculoskeletal at dentists and to discuss evidence-based strategies for alleviating such discomfort, with the ultimate objective of enhancing occupational longevity in the dental workforce. Material and methods. A systematic search of high-quality academic databases was conducted to identify peer-reviewed studies reporting statistical data and clinical management strategies related to the most prevalent musculoskeletal disorders among dental professionals. From the initial pool of literature, 56 studies - comprising randomized controlled trials, systematic reviews, and clinical studies - were selected for the further and more precise review and selected to discuss in this paper. Results. Mostly cited musculoskeletal disorders among dental professionals include neck pain, low back pain, hip pain, shoulder pain, and forearm and wrist pain, with carpal tunnel syndrome and forearm discomfort. For neck pain, evidence-based recommendations are manual therapy and therapeutic exercise programs, which have demonstrated efficacy in reducing pain and improving function. Low-back and hip pain are best addressed through mind-body and core-stabilizing interventions: tai chi, yoga, and Pilates, as well as core-based or stabilization exercises, which enhance postural control and reduce mechanical stress. In the case of shoulder pain, treatment protocols suggest a combination of stretching exercises and radiofrequency ablation. In Forearm pain and carpal tunnel syndrome, a multimodal approach is recommended.

Denervation induces severe muscle atrophy characterized by inflammatory responses and tissue degradation, with limited effective therapeutic options. This study investigates the role of the α7 nicotinic acetylcholine receptor (α7nAChR) in denervation-induced muscle atrophy and evaluates electroacupuncture (EA) as a potential treatment strategy. Using a sciatic nerve transection mouse model, we observe that denervation decreases α7nAChR expression, activates proteolytic pathways. We find that α7nAChR degradation is associated with the activation of inflammatory cytokines and the caspase pathway. In α7nAChR knockout mice, we demonstrate that α7nAChR modulates mitochondrial metabolism and fiber-type composition. It exerts protective effects by activating the AKT-FOXO1 pathway, thereby reducing inflammation and apoptosis, processes that are critical for muscle regeneration. Additionally, treatment with PNU120596 or EA restores α7nAChR function and alleviates muscle atrophy. Our findings suggest that targeting α7nAChR offers a promising therapeutic approach for muscle wasting following denervation, with potential implications for clinical management and future intervention strategies.