Complementary and alternative medicine (CAM) is increasingly integrated into oncology care, yet significant communication gaps persist between patients and healthcare professionals concerning its use. This study aimed to identify the barriers that hinder the exchange of information between oncology patients and healthcare professionals.

A cross-sectional study was conducted from November 2022 to May 2023. The sample consisted of 832 respondents, comprising 411 oncology patients and 421 healthcare professionals, including 100 physicians and 321 nurses. Data was collected using a survey questionnaire based on modified CAM Health Belief Questionnaire and Integrative Medicine Attitude Questionnaire instruments. Descriptive and inferential statistics methods were applied, including one-way analysis of variance and Tukey's test to identify differences among groups.

Only 23.5% of respondents reported discussing or planning to discuss CAM with a healthcare professional. Primary communication barriers included a lack of initiative from healthcare professionals (70.2%), perceived insufficient knowledge about CAM (37%), and patients' fear of adverse effects from medical staff (15.1%). Statistically significant differences in attitudes were identified between patients and healthcare professionals regarding information sources, trust in CAM, and willingness to discuss the topic (p<0.05).

The findings underscore the need to improve healthcare professionals' education on alternative medicine and promote open communication with patients. Integrating CAM into medical education and development guidelines for its incorporation into clinical practice could enhance patient awareness and safety.

Objective: To investigate the impact of the size of the liver tumor diameter on the prognosis of patients with hepatitis B-related hepatocellular carcinoma (HCC)-inducing acute-on-chronic liver failure (HBV-HCC/ACLF). Method: A retrospective cohort study was conducted. Clinical data of patients with hepatitis B-related acute-on-chronic liver failure (HBV-ACLF) diagnosed according to the Asia-Pacific Association for the Study of the Liver (APASLT) guidelines who were admitted to the Fifth Medical Center of PLA General Hospital between January 2016 and January 2021 were collected. The patients were enrolled in the HBV-HCC/ACLF group (116 cases) and the HBV-ACLF group (348 cases). General information, medical history, biochemical parameters, complications, and liver cancer status were collected. Clinical data and prognoses at 28 days and 12 months of follow-up were compared between the two groups. Factors influencing mortality in the HBV-HCC/ACLF group were analyzed to determine the prognostic significance of tumor diameter. The t test, χ² test, and multivariate logistic regression analysis were used to analyze factors influencing mortality. Receiver operating characteristic (ROC) curves were used to assess the sensitivity and specificity of tumor diameter for 28-day prognosis, and Kaplan-Meier curves were used for survival analysis. Result: There were statistically significant differences in the 28-day mortality rate [(55.17%, 64/116) vs. (38.51%, 134/348)] and 12-month mortality rate [(78.45%, 91/116) vs. (55.75%, 194/348)] between the HBV-HCC/ACLF group and the HBV-ACLF group (P<0.05). The area under the ROC curve analysis for HBV-HCC/ACLF patients indicated that the tumor diameter was 0.707 (95%CI: 0.615-0.788). The survival group (52 cases) and the mortality group (64 cases) were divided into the HBV-HCC/ACLF group based on 28-day mortality. Univariate analysis showed that the levels of aspartate aminotransferase (AST), alkaline phosphatase, creatinine, alpha-fetoprotein, white blood cell count, international normalized ratio, model for end-stage liver disease score, acute kidney injury (AKI), the occurrence of infections and complications, and others were all significantly higher in the mortality group compared to the survival group (P<0.05).The mortality group had a larger tumor diameter than the survival group (P<0.01). The incidence of portal vein tumor thrombosis and distant liver cancer metastasis was also higher in the survival group (P<0.01). The mortality group had a higher rate of HCC-related minimally invasive treatment within three months before ACLF diagnosis than the survival group (P<0.01). AST levels, infection, size of tumor diameter, and minimally invasive treatment within three months before onset were independent risk factors for 28-day mortality in the HBV-HCC/ACLF group. The optimal significant value for tumor diameter affecting prognosis was 3.3 cm, with a sensitivity of 67.19% and a specificity of 73.08%. Patients with liver tumor diameters >3.3 cm had significantly lower 28-day survival rates than those with a tumor diameter ≤3.3 cm [(24.56%, 14/57) vs. (64.41%, 38/59)]. Eighty case analyses had the same findings in patients who had not previously received any therapy. Conclusion: Patients with HBV-HCC/ACLF had a high 28-day mortality rate, and the size of the tumor diameter is important in determining the 28-day prognosis.

After the release of the guideline for HER2 testing in breast cancer (2024 version), in order to improve the implementation of the guidelines, the Chinese Breast Pathology Group conducted a nationwide survey, gathering feedback from pathologists across China. Based on this, we analyzed and summarized seven key issues commonly encountered in pathological practice. These issues include the heterogeneity of HER2 protein and gene expression, reporting of HER2-ultralow, testing and interpretation issues of HER2 low-level expression, the establishment of external controls for HER2 testing, the interpretation standards for rare staining patterns, and the role of new technologies in HER2-low expression testing. These findings reflect the effectiveness and challenges in the implementation of the guidelines and provide valuable insights for the further optimization of the HER2 testing guidelines in the future.

Colorectal cancer (CRC) is becoming increasingly common in adults ≥ 60 years old, yet postoperative prognosis of curative-intent surgery for the advanced elderly (≥ 80 years) remains controversial.

A retrospective cohort study included 971 CRC patients aged ≥ 60 years who underwent curative-intent surgery from January 2018 to December 2023 in Beijing Chaoyang Hospital. Patients were stratified into "ordinary elderly group" (OE) (60-79 years, n = 800) and "advanced elderly group" (AE) (≥ 80 years, n = 171). Clinicopathological variables, 30-day morbidity/mortality, disease-free survival (DFS), and overall survival (OS) were collected and analyzed the differences between the two groups. The study was presented in accordance with the STROBE reporting checklist.

The AE had more right-sided CRC (P < 0.001) and higher rate of preoperative obstruction (P < 0.001). They underwent more emergency (P = 0.002) and open procedures (P < 0.001), resulting in longer postoperative stays P = 0.030). Overall, 30-day morbidity was comparable (P = 0.76), but perioperative mortality rate was higher in AE (P = 0.041). The median follow-up was 36.1 ± 22.1 months, and recurrence rates (P = 0.58) and 5-year DFS (log-rank P = 0.42) did not differ between groups. Multivariate analysis identified TNM stage, perineural invasion, vascular invasion, preoperative intestinal obstruction, and proficient Mismatch Repair (pMMR) as independent predictors of DFS; age ≥ 80 years was not prognostic (p = 0.81).

Despite a higher burden of comorbidities and increased perioperative mortality, no statistically significant difference in long-term oncological outcomes was observed between AE and OE following rigorous patient selection and perioperative management in CRC patients. Advanced age alone should not preclude standard curative resection.

Myeloproliferative neoplasms (MPNs) are a spectrum of clonal hematologic malignancies, characterized by an acquired somatic mutation in hematopoietic stem cells (HSC). Consequent constitutive activation of the JAK/STAT signaling pathway ultimately leads to HSC clonal expansion, a heightened inflammatory state, and aberrant trafficking of the malignant stem cells to sites of extramedullary hematopoiesis. While polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF) are distinct disease entities, each with their own diagnostic criteria, risk stratification, and molecular profiles, they share a common pathogenesis and exist on a spectrum, with overlapping clinical features, propensity for thrombohemorrhagic events, and risk for transformation to acute leukemia. Interferon alpha (IFN-α) has both anti-proliferative and immunomodulatory effects on MPN HSCs, and therefore is an effective treatment modality for PV, ET, and MF. In this review, we discuss the rationale for IFN-α use in MPNs, examine the evidence supporting its use, and convey practical considerations.

Mitochondrial transfer to recipient cells triggers a respiratory burst by increasing ATP production and cellular energy metabolism. However, its impact on intracellular metabolic shifts remains unclear. This study introduces a novel methodological approach and new biological insights into mitochondrial dynamics in cancer cells. We developed fluorescence-lifetime imaging microscopy (FLIM) intensity-based image segmentation (FIBIS), an algorithm optimized for single-mitochondrion analysis. FIBIS utilizes NADH autofluorescence, eliminating the need for biomarker staining, and improves mitochondrial detection accuracy by 35% compared to raw intensity thresholding. This method is particularly effective for analyzing dynamic mitochondria in live cells. Using FIBIS, we show that normal epithelial mitochondria uptake alters the free NADH-to-bound NADH ratio, increasing bound NADH in both estrogen- and progesterone receptor-positive and triple-negative breast cancer cells. Additionally, mitochondrial transfer enhances cancer cell sensitivity to oxidative stress-inducing anti-cancer drugs, suggesting a potential restoration of normal reactive oxygen species tolerance. Overall, FIBIS is a robust methodological approach that uses the phasor-FLIM technique to analyze NADH levels (free and bound) at the single-mitochondrion level, providing new biological insights into transferred mitochondrial dynamics in cancer cells.

A cancer diagnosis is an emotionally and physically overwhelming experience. For patients with stomas, this journey is further complicated by unique challenges that demand specialist care and attention. The presence of a stoma introduces additional layers of complexity, making the role of a specialist stoma nurse indispensable. Their expertise not only helps in preventing severe complications but also ensures timely management of issues, empowering patients to navigate their treatment with confidence and dignity. This article explores common side-effects of systemic anti-cancer therapy and how these complications specifically impact stoma care, with specialist-tailored management strategies for each stoma type.

Phosphatase and tensin homolog (PTEN) acts as a tumor suppressor gene, and loss or dysregulation thereof plays a central role in leukemogenesis processes, disease progression, and resistance to anticancer therapy in myeloid and lymphoid leukemias. Growing research highlights the complex regulatory landscape involving noncoding RNAs (ncRNAs), particularly microRNAs (miRNAs), long noncoding RNAs (lncRNAs), and circular RNAs (circRNAs), providing overwhelming evidence that supports the critical role of these molecules in regulating PTEN expression and functionality in leukemia scenarios. The therapeutic potential of regulating PTEN through ncRNAs reveals selective targets that potentially break anticancer resistance and enhance patient outcomes. A host of ncRNAs holds promise as potential diagnostic and prognostic markers for leukemia. A critical analysis of the complex interactions that explain the various roles of the ncRNAs in the regulatory landscape surrounding PTEN can form the basis for developing RNA-targeted new therapeutic strategies aimed at hematopoietic malignancies. The review aims to provide a thorough and critical evaluation of the regulatory influence of ncRNAs on the expression and functionality of PTEN in myeloid and lymphoid leukemias. Focusing on the molecular mechanisms that facilitate modulation by various classes of RNAs (miRNAs, lncRNAs, circRNAs), we aim to bring into sharper focus the contributions of these RNAs to leukemic progression and therapeutic response, as well as provide valuable insights into potential targets and markers for the development of innovative therapeutic approaches.

Granular cell tumor (GCT) is a rare mesenchymal neoplasm that is believed to originate from Schwann-like mesenchymal cells. It affects more women than men with an F:M ratio of 5:4 and can involve various body sites such as peripheral soft tissues, trunk, and head and neck. Multiple lesions can be seen in up to 15% patients. Most of GCT are benign with indolent behavior. Rare cases show cytological atypia and considered histologically malignant; or show metastasis and considered clinically malignant. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is widely used nowadays for the diagnosis of epithelial malignancies of the gastrointestinal tract and pancreatobiliary tract. Its efficacy for submucosal and intramural mesenchymal lesions is focused primarily on gastrointestinal stromal tumors (GIST) because of their higher incidence compared with other mesenchymal lesions. Biliary tract GCT is rarely reported in the literature. Preoperative diagnosis of GCT has important therapeutic and prognostic value. Formulating such a diagnosis using cytologic smears alone is extremely challenging, but a definitive and accurate diagnosis is possible when cytomorphology is coupled with optimal cellularity and immunohistochemistry studies on the concurrent cellblock or tissue biopsy. Here we report the first case of biliary GCT diagnosed by EUS-FNA cytology and concurrent biopsy without surgical resection, which endorses the clinical utility of EUS-FNA cytology on evaluating biliary lesions and broaden our differential diagnosis of biliary neoplasms.

This study aimed to identify a novel prognostic signature derived from an EGFR Tyrosine kinase inhibitors (TKI-resistant) macrophage subpopulation and to evaluate its clinical and therapeutic relevance in HCC. We utilized single-cell RNA sequencing data from HCC patients. An EGFR-TKI resistance score was calculated across all cell types. Macrophages, which exhibited the highest resistance score, were sub-clustered to identify the most resistant subpopulation. Marker genes from this sub-cluster were intersected with differentially expressed genes (DEGs) from the TCGA-LIHC cohort. A robust prognostic model was constructed. The model's performance was rigorously validated, and the signature was further characterized through multi-omics analysis and its correlation with immune checkpoint blockade (ICB) response and drug sensitivity. scRNA-seq analysis unequivocally identified macrophages as possessing the highest EGFR-TKI resistance score. We identified seven key prognostic genes: SLC41A3, DCAF13, PPM1G, NDC80, FAM83D, FUCA2, and UQCRH. A risk model built on these seven genes effectively stratified patients into high- and low-risk groups with significantly different overall survival (OS) in the TCGA cohort, a finding successfully validated in the independent GSE76427 cohort. A clinical nomogram integrating the risk score demonstrated excellent predictive accuracy, with AUC values for 1-, 3-, and 5-year OS of 0.816, 0.781, and 0.799, respectively. The low-risk group was associated with a favorable immune-infiltrated phenotype and was predicted to be more sensitive to immunotherapy. Conversely, the high-risk group exhibited distinct genomic features and was predicted to be more sensitive to specific targeted agents, including Navitoclax and Sorafenib. We identified and validated a novel 7-gene prognostic signature derived from a subpopulation of EGFR-TKI-resistant macrophages. This signature accurately predicts patient survival, offers insights into the molecular mechanisms of therapy resistance in HCC, and provides a promising tool for improved patient stratification and the development of personalized treatment strategies.