中国医学科学院

Objective To investigate the awareness levels of human papillomavirus(HPV)and cervical cancer screening,as well as the acceptance of point-of-care testing(POCT)technology among women in Jinan,Shandong province,analyze the influencing factors,and assess their satisfaction with and attitudes toward the promotion of POCT technology.Methods A cross-sectional survey was conducted from May 2024 to June 2025 among 629 women aged 35-64 years who participated in the two-cancer screening program at two community health service centers in Jinan.Information on sociodemographic characteristics,awareness of HPV and cervical cancer screening,and acceptance of POCT technology was collected.Statistical analyses were performed with the chi-square test and binary logistic regression.Results A total of 629 valid questionnaires were obtained.Regarding awareness of HPV and cervical cancer screening,46.26%of participants had heard of HPV,among whom 70.10%knew it as the primary cause of cervical cancer.Overall,80.76%had heard of cervical cancer screening,whereas only 44.09%were aware of specific screening methods.The awareness rates of HPV testing,cytological examination,and visual inspection with acetic acid/Lugol's iodine(VIA/VILI)were 33.86%,24.61%,and 6.99%,respectively.Multivariable analysis showed that compared with women aged 35-44 years,those aged 55-64 years had the lowest awareness level of HPV and cervical cancer screening(OR=0.17,95%CI:0.10-0.31).Compared with women with primary school education or below,those with college education or above had the highest awareness level(OR=3.71,95%CI:1.44-9.56).Regarding acceptance of POCT,55.96%of women expressed willingness to use POCT in future screening.Multivariable analysis indicated that compared with women with primary school education or below,those with senior high school education(OR=0.43,95%CI:0.22-0.81)and those with college or undergraduate education and above(OR=0.37,95%CI:0.17-0.81)showed increased acceptance of POCT.Freelancers(OR=1.93,95%CI:1.08-3.42)and workers(OR=2.33,95%CI:1.10-4.92)showed lower acceptance of POCT technology than unemployed women.In terms of satisfaction and attitudes toward promotion,84.27%of participants believed that POCT could significantly save time and improve the efficiency of conventional screening;83.94%believed that it could significantly improve the accuracy of conventional screening;85.21%reported being very satisfied overall;83.78%held a positive attitude toward its long-term application;and 83.62%were willing to recommend the technology to others.Conclusions Women in Jinan have established basic awareness of HPV and cervical cancer screening,while their understanding of specific screening technologies remains insufficient.Acceptance of POCT technology is at a moderate level,whereas satisfaction with and willingness to promote this technology are relatively high.

Objective To systematically characterize N6-methyladenosine(m6A)modifications on mitochondrial messenger RNA(mt-mRNA),define its features,and investigate its changes during neurodevelopment and in brain tumors.Methods Thirteen sequencing datasets generated by seven m6A profiling techniques were integrated to com-pare m6A distribution and relative methylation levels across chromosomes and to delineate an m6A modification land-scape of mt-mRNA.In addition,mouse cerebral cortices and cerebella at different developmental stages,together with three brain tumor cell lines,were collected,and representative transcripts were validated by methylated RNA immu-noprecipitation followed by quantitative polymerase chain reaction(MeRIP-qPCR).Results m6A modifications on mt-mRNA were detected across multiple human,mouse and rat tissues and cell types,albeit at levels lower than those of nuclear-encoded transcripts.During mouse cortical and cerebellar development,mt-mRNA m6A levels showed stage-dependent changes.Compared with normal brain tissues,mt-mRNA m6A levels were decreased in glio-blastoma and medulloblastoma.Conclusions This study confirms the presence of m6A modifications in the mitochon-drial transcriptome and demonstrates their dynamic regulation during neurodevelopment and in the pathogenesis of brain tumors,providing a new perspective for understanding mitochondrial function and its involvement in diseases.

Objective To investigate the effect of heterozygous deletion of fibroblast growth factor receptor 1(FGFR1)on reproductive function in congenital hypogonadotropic hypogonadism(CHH).Methods A heterozy-gous FGFR1 knockout mouse model(FGFR1+/-)was established.Polymerase chain reaction(PCR)and Sanger sequencing were performed to confirm the deletion of the target exons.Immunohistochemistry and Western blot were used to detect FGFR1 protein expression.Reproductive capacity and function(including sperm concentration,mo-tility,and progressive motility)were evaluated.Additionally,body mass index(BMI),testicular weight,testicular volume,and various sex hormone levels(including T,E2,AMH,FSH,LH,and INH-B)were measured and analyzed statistically.Results The FGFR1 heterozygous knockout mouse model was successfully constructed.PCR and sequencing results confirmed the deletion of exons 4 and 5 of the FGFR1 gene.Western blot and immunohisto-chemistry demonstrated reduced FGFR1 protein expression.Compared with wild-type(WT)mice,FGFR1+/-mice exhibited significantly lower sperm motility(P<0.001)and fewer progressively motile sperm(P<0.01).Compared with WT mice,the INH-B level in FGFR1+/-mice was slightly elevated(P<0.05).Conclusions Heterozygous deletion of FGFR1 impairs sperm motility in mice,providing critical evidence for further elucidating the pathogene-sis of reproductive dysfunction in congenital hypogonadotropic hypogonadism.

Objective To detect changes in the metabolome and proteome of urine in a mouse model of chronic hy-poxia and to explore the correlation between the urinary proteome and metabolome.Methods Six C57BL/6J male mice were placed in an oxygen chamber with 14％oxygen concentration for 5 weeks of hypoxic exposure.Mouse urine was collected weekly with a control group established simultaneously.Non-targeted proteomics and metabolo-mics techniques were employed for dynamic analysis of urine samples.Results Compared to the control group,the urine of chronic hypoxia mice contained 458 differentially expressed proteins and 718 differential metabolites.These proteins and differential metabolites were functionally enriched primarily in glycolysis pathway,lysosomal pathway,and cholesterol synthesis pathway.Joint analysis of proteomics and metabolomics revealed that proteins with high correlation to differential metabolites were mainly enriched in PI3K-AKT,complement and coagulation cascades,and cell cycle pathways.Conclusions Urinary proteomics and metabolomics may reflect the changes induced by chronic hypoxic stimulation.

Objectives:To anticipate future trends in science and technology related to traditional Chinese medicine(TCM)and guide cutting-edge research directions,the China Association of Chinese Medicine(CACM)organized experts to deliberate and propose pivotal scientific questions,engineering challenges,and industrial technology issues in the TCM field for 2025.The aim is to address core bottlenecks impeding the high-quality development of TCM through original scientific research,thereby providing strategic technological support for improving the consistency of clinical efficacy,ensuring the sustainable utilization of resources,advancing intelligent industrial upgrading,and enhancing international influence. Methods:In accordance with the targeted commission requirements of the China Association for Science and Technology(CAST)and considering the disciplinary distribution characteristics,the CACM established an expert panel comprising five strategic scientists.Drawing on the major scientific questions selected by CAST and the CACM in previous years,the panel carried out a systematic process of deliberation and discussion,collation and review,evaluation and screening,as well as validation and refinement.Ultimately,two frontier scientific questions,one engineering challenge,and two industrial technology issues were identified and submitted to CAST. Results:This report focuses on key bottlenecks in transforming TCM from empirical inheritance to precision-driven science.It systematically elaborates on five core issues:the two frontier scientific questions aim to uncover the modern scientific underpinnings of classical TCM theories(e.g.,the spleen deficiency theory)and the core efficacy of Daodi Herbs;the engineering challenge is dedicated to constructing intelligent reasoning AI models capable of clarifying the scientific principles underlying TCM-based prevention and treatment of complex diseases(e.g.,gastric cancer);the two industrial technology issues address pressing industrial demands,namely,key technologies for the stable production of"three-excellence"medicinal materials based on molecular pharmacognosy,and the establishment of a quality homogenization technology system for TCM solid preparations based on multimodal data fusion. Conclusions:The five major scientific questions and engineering challenges selected and reported herein systematically target the core bottlenecks and frontier directions in TCM modernization,exhibiting distinct strategic,interdisciplinary,and forward-looking attributes.The development of TCM in the new era must be driven by cutting-edge multidisciplinary technologies to thoroughly elucidate the scientific core of traditional wisdom,thereby achieving comprehensive modernization covering basic research,industrial technology,and clinical application.This will lay a solid foundation for gaining strategic advantages in the global competition of traditional medicine science and technology.

Objective To evaluate the effectiveness of point-of-care ultrasound(POCUS)training in improving emergency physicians'skill of trauma assessment,confidence,and clinical decision-making capability.Methods This was a prospective study involving 80 emergency physicians without POCUS training experience.Participants were randomly assigned to a structured POCUS training group and a conventional training group.Both groups under-went standardized pre-and post-intervention assessments,including theoretical knowledge tests,practical skill eval-uations in simulated trauma scenarios,assessments of clinical decision-making accuracy,and self-rated confidence scoring.Results After the intervention,the POCUS group demonstrated significantly better performance than the control group in theoretical knowledge(88.3±6.4 vs.80.0±5.5,P＜0.001),practical skills(84.9±7.0 vs.75.3±6.9,P＜0.001),and self-confidence scores(median 8 vs.6,P＜0.05).Although there was no statistically significant difference in post-training clinical decision-making accuracy between the two groups(median 8 vs.7,P＞0.05),the POCUS group showed a significant improvement as compared to their baseline(median 8 vs.6,P＜0.01).Conclusions Structured POCUS training significantly enhances emergency physicians'trauma assessment capacities and confidence.It demonstrates strong educational effectiveness and contributing the capacity of medical students in terms of faster and more accurate clinical decision-making.

Objective To investigate the clinical manifestations of Cantu syndrome complicated with 22q11.2 du-plication syndrome and to raise awareness regarding the diagnosis of the co-occurrence of both genetic diseases.Methods Analyzing the clinical data and molecular genetic results of a patient with Cantu syndrome complicated with 22q11.2 duplication syndrome.Results The patient was an 11-year-old male who presented with chest tight-ness and shortness of breath for 3 days.He exhibited generalized hypertrichosis and distinctive facial features.Clini-cal examinations revealed that the patient had cardiac defects(patent foramen ovale and patent ductus arteriosus),tortuosity and dilation of cerebral blood vessels,and delayed bone age.Based on genetic testing,a heterozygous va-riant c.3605C>T in the ABCC9 gene,confirming a diagnosis of Cantu syndrome.Additionally,a copy number du-plication of approximately 2.87 Mb at the 22q11.21 chromosomal region was detected.Conclusions The 22q11.2 duplication syndrome exhibits incomplete penetrance.Its partial phenotypic overlap with Cantu syndrome pose a sig-nificant risk of missed diagnosis.

Objective:To evaluate the efficacy and safety of hexaminolevulinate photodynamic therapy (HAL-PDT) for the treatment of cervical intraepithelial neoplasia 2 (CIN2).Methods:Data of this study were derived from an international multicenter, randomized, double-blind, placebo-controlled phase Ⅲ clinical trial (the APRICITY study) conducted between October 2020 and July 2023, with medical records obtained from 61 medical centers across 7 countries. A subgroup analysis was performed in patients with histologically confirmed CIN2 from this trial. Participants were randomly assigned in a 2∶1 ratio to the HAL-PDT group [5% hexaminolevulinate ointment and a light-emitting diode (LED) light source device] or the placebo group (placebo ointment with a non-illuminating device). The primary endpoint was the response rate at 6 months after the initial treatment. Secondary endpoints included histological regression rate, high-risk human papillomavirus (HR-HPV) clearance rate. Safety endpoints included treatment-related adverse events (TRAEs).Results:A total of 182 patients with CIN2 were included (120 in the HAL-PDT group, 62 in the placebo group). Baseline characteristics were balanced between the two groups (all P>0.05). At 6 months, the response rate [49.2% (59/120) vs 22.6% (14/62), P=0.001] and histological regression rates [57.5% (69/120) vs 30.6% (19/62), P=0.001] in the HAL-PDT group were significantly higher than those in the placebo group. The colposcopic lesion clearance rate at 6 months was also higher in the HAL-PDT group than in the placebo group [60.6% (60/99) vs 32.7% (17/52), P=0.001]. The risk of disease progression was lower in the HAL-PDT group ( RR=0.55, 95% CI:0.29-1.06; P=0.068). Analyses stratified by age, HR-HPV infection status, region, and lesion size consistently demonstrated benefit in the HAL-PDT group regarding response and histological regression rates. At the 12-month follow-up, HR-HPV clearance rates in the HAL-PDT group were significantly improved, reaching 45.9% for any HR-HPV subtype, 58.8% for HPV 16, and 55.4% for HPV 16/18. There was no statistically significant difference in the incidence of TRAEs between the two groups [31.1% (37/119) vs 25.8% (16/62), P=0.496]. The most commonly reported adverse events in the HAL-PDT group were increased vaginal discharge, abdominal pain, and vulvovaginal pain, all of which were mild and self-limiting. Conclusion:HAL-PDT demonstrated favorable efficacy and safety in patients with CIN2, providing a non-surgical treatment alternative for patients seeking fertility preservation and the maintenance of cervical integrity.

Objective:To investigate the differences in apolipoprotein B mRNA editing enzyme, catalytic polypeptide-like (APOBEC) between human papillomavirus (HPV)-positive and HPV-negative head and neck squamous cell carcinoma (HNSCC) patients, analyze its association with the immune microenvironment and the cGAS-STING pathway, and evaluate its predictive value for immunotherapy efficacy.Methods:Whole-exome sequencing data from HNSCC patients (from September 2017 to March 2020 at the Third Affiliated Hospital of Kunming Medical University) were collected for somatic mutation profiling. APOBEC enrichment scores were calculated and integrated with differentially expressed genes (DEGs) to perform Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis and Gene Set Enrichment Analysis (GSEA). Single-cell RNA sequencing (scRNA-seq) data were utilized to validate the relationship between APOBEC3 expression, immune cell composition, and cGAS-STING module activity. Furthermore, an immunotherapy cohort was analyzed to evaluate the association of APOBEC3 family gene expression with immune checkpoint genes and therapeutic outcomes.Results:APOBEC mutational signatures were prevalent in both HPV-negative and HPV-positive HNSCC patients, but their driving patterns differed significantly: HPV-positive patients were dominated by APOBEC3A mutations, whereas the HPV-negative group exhibited a synergistic effect of multiple family members, including APOBEC3A/3B/3C/3D/3F. Pathway analysis indicated that in HPV-negative HNSCC, APOBEC activity was significantly associated with the enhancement of the cGAS-STING pathway, interferon response, and inflammatory response. Single-cell analysis confirmed that tumors with high APOBEC3 expression had richer immune cell infiltration, and the activities of four functional modules of the cGAS-STING pathway (cGAS-STING, NF-κB, interferon stimulation, and antigen presentation) were significantly upregulated. In the immunotherapy cohort, patients with high APOBEC3 expression exhibited higher expression of immune checkpoint molecules, and their treatment response rates were significantly superior to those in the low-expression group.Conclusions:APOBEC exhibits distinct driving mechanisms in HNSCC depending on HPV status. Its activity is closely related to cGAS-STING pathway activation, enhanced immune infiltration, and improved immunotherapy efficacy, suggesting potential predictive and therapeutic value.

Under the dual pressure of reduced funding and rising resource prices,the construction of foreign language digital resources in university libraries is facing the severe challenge of how to"spend money where it counts most".This paper introduces information foraging theory as an analytical framework.Taking the library of Capital Normal University as an example,the journals in foreign lan-guage databases are defined as efficient patches(frequently downloaded journals),restricted patches(frequently access-denied jour-nals),and inefficient patches(dormant journals).Through quantitative analysis and user interviews,the logic of user information be-havior is deeply explored.The research findings are as follows:users'information foraging behavior exhibits significant quality-first and discipline-oriented characteristics,with both efficient and restricted patches concentrated in high-quality journals in science and engineering.There are structural differences in the information foraging strategies of user groups from different disciplines.There is a mismatch between the current resource map constructed by libraries and users'actual foraging map.Based on these findings,this pa-per proposes optimization strategies for the construction of foreign language digital resources from five dimensions:optimization of infor-mation habitat structure,improvement of users'foraging ability,governance of foraging environment,data-driven decision-making,and upgrading of library-vendor negotiation strategies,aiming to provide theoretical reference and practical guidance for precise resource procurement and efficient services in university libraries under budget constraints.

Objective This study synthesizes field-based practices in public health emergency response during the 2025 summer flooding in Beijing,identifies prevailing gaps in current operations,and proposes targeted recommenda-tions to inform and strengthen flood-related health emergency governance systems in megacities.Methods Using retrospective analysis and focus group methods,the study summarizes the organization,implementation,material support,technical measures,and management mechanisms of Beijing's 2025 summer flood disaster health and epidemic prevention work.Results Through high-level overall planning,inter-departmental collaboration,targeted policy formulation,grassroots implementation and public engagement,Beijing has steadily advanced post-disaster health and epidemic prevention work in an orderly manner and realized the objective of"preventing major epidemics in the aftermath of disasters".Nevertheless,several challenges remain:imperfect cross-departmental coordination mechanisms,emergency plans lacking sufficient pertinence and operability,inadequate grassroots capacity and supporting resources for epidemic prevention,imprecise health education delivery,as well as disjointed efforts between health supervision and technical epidemic prevention work.Conclusion Beijing's overall response to the summer flood epidemic emergency was timely,with relatively systematic measures and strong execution.In the future,efforts should be made to further improve cross-departmental coordination mechanisms,refine plans and standardized procedures,strengthen grassroots epidemic prevention teams and funding assurance,enhance the accuracy of health education,clarify the boundaries between supervision and law enforcement and technical epidemic prevention responsibilities,and continuously improve the emergency management capabilities of epidemic prevention in capital city flood disasters.

Objective To screen the soluble hemagglutinin (HA) recombinant protein derived from B/Victoria lineages of influenza virus that possess hemagglutination activity. Methods Based on the B/Darwin/7/2019 (B/Victoria) strain, HA mutant genes BV-T1, BV-T2, and BV-T3 were obtained by fusing the leucine zipper GCN4pII and GCN4pLL trimerization motifs(T1 and T2), and bacteriophage T4 Foldon trimerization motifs(T3) to the C-terminus of the HA ectodomain. HA ectodomain mutant gene BV-ecto was also constructed as a control. These genes were inserted into pFastBac1 vector. The proteins were expressed using baculovirus-Sf9 insect cell expression system and culture supernatants of infected cells were harvested. Recombinant proteins were purified by Strep-Tactin affinity chromatography and subsequently characterized for their oligomerization degree and hemagglutination activity. Results All four mutant proteins were solubly expressed in the culture supernatant. BV-T2 and BV-T3 exhibited a high trimerization form, while BV-T1 formed predominantly trimers with minor low-order oligomers. BV-ecto existed as a monomer.BV-T1 and BV-T2 exhibited hemagglutination activity, in contrast, BV-T3 and BV-ecto lacked hemagglutination activity. Conclusions The soluble BV-T2 mutant protein present efficient trimer- ization and possesses hemagglutination activity.The leucine zipper trimerization motif GCN4pLL is suitable for the soluble expression of B/Victoria lineage HA recombinant protein and thus provides a reference for the development of soluble recombinant protein vaccines against B/Victoria virus.

Difficult airway intubation is a critical risk in clinical anesthesia.This study proposes an automated,objective airway assessment framework named MMAAF(Multi-Modal Airway Assessment Framework)based on static mouth-opening images of patients.Using com-puter vision techniques,the framework automatically extracts six key anatomical features from the dataset of patient mouth-opening images.These features are combined with actual difficult intubation labels to construct a structured multi-modal prediction dataset,which is pro-cessed with a random oversampling technique.The study employs two integrated machine learning algorithms—random forest and gradient boosting decision trees—for model training and evaluation.Results show that the gradient boosting and random forest models achieve pre-diction accuracies of 92%and 93%,respectively,on an independent test set,demonstrating good assessment performance.Concurrently,a logistic regression model is trained within the MMAAF framework.Features are weighted according to their importance weights,and a per-sonalized probability score for difficult intubation is calculated for each patient.This provides an intuitive quantitative reference based on multi-modal features to support clinical decision-making.

Objective To evaluate the clinical significance of local radiotherapy(LT)in oligo-residual lesions of advanced non-small cell lung cancer(NSCLC)treated with tyrosine kinase inhibitors(TKIs).Methods A retro-spective study was conducted in 61 patients with stage Ⅳ NSCLC who developed oligo-residual disease after TKI therapy at Peking Union Medical College Hospital from February 2018 to May 2024.The patients were stratified into two groups:the LT group(n=31,receiving local consolidative therapy or ablation while continuing systemic thera-py)and the non-LT group(n=30,receiving systemic therapy alone).Progression-free survival(PFS),overall sur-vival(OS),and treatment-related safety were compared between the groups.Results The LT group showed a pro-longed PFS compared to the non-LT group(31 vs.23 months,P=0.171),although the difference did not reach statistical significance.Patients undergoing LT also had a longer median OS(54 vs.42 months,P=0.713),although the difference did not achieve statistical significance.A total of 7 patients(22.6％)in the local radiotherapy group developed radiation pneumonitis of any grade,including 4 patients(12.9％)with grade 1 pneumonitis and 3 patients(9.7％)with grade 2 pneumonitis.Univariate and multivariate analyses indicated that the number of meta-static lesions,sex,ECOG performance status,targeted therapy regimen,and best response to targeted therapy were factors associated with patient prognosis.Among these variables,ECOG performance status and smoking status were identified as independent predictors of PFS.Conclusions In NSCLC patients with oligo-residual lesions after TKI therapy,LT preliminarily appears to prolong progression-free survival without significantly increasing treatment-re-lated adverse events.