Nan Zhou

A retrospective study on the relationship between delirium and long-term cognitive function in elderly women following cervical cancer surgery

This study aimed to investigate the relationship between postoperative delirium and long-term cognitive function in elderly women undergoing cervical cancer surgery, providing insights into the long-term effects of postoperative cognitive alterations. A retrospective analysis was conducted on 120 elderly women (≥60 years) who underwent cervical cancer surgery over the past decade. Patients were categorized into a postoperative delirium group (n = 45) and a non-delirium group (n = 75) based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, with initial screening using the confusion assessment method. Cognitive function was assessed preoperatively, and at 1 year and 3 years postoperatively using the Mini-Mental State Examination (MMSE). Multivariate logistic regression analysis was performed to identify independent predictors of long-term cognitive decline, adjusting for potential confounders such as age, underlying health status, psychiatric history, and psychological distress. Postoperative delirium occurred in 37.5% (45/120) of patients. One year after surgery, MMSE scores were significantly lower in the delirium group (P < .05), and this difference persisted at 3 years (P < .05). Univariate regression analysis identified postoperative delirium, older age, poorer health status, psychiatric history, preoperative psychotropic drug use, longer hospital stay, pain scores, and psychological distress as significant risk factors for cognitive decline at both time points. Multivariate analysis confirmed that postoperative delirium (P < .001), age (P < .05), poorer health status (P < .05), psychiatric history (P < .001), preoperative psychotropic drug use (P < .05), and psychological distress (P < .001) were independent predictors of long-term cognitive decline. Length of hospital stay and pain scores were not significant in the multivariate model (P > .05). Postoperative delirium is a strong and persistent risk factor for long-term cognitive decline in elderly women following cervical cancer surgery. Psychiatric history and psychological distress further exacerbate cognitive deterioration. These findings highlight the urgent need for improved perioperative cognitive assessment and management strategies to reduce the long-term impact of postoperative delirium in this high-risk population.

Research Progress of RAD51AP1 in Malignant Tumors of the Female Reproductive System

ABSTRACT Genomic instability may contribute to the occurrence and progression of malignant tumors of the female reproductive system. Homologous recombination repair (HRR) is vital in maintaining cellular genomic stability. RAD51‐associated protein 1 (RAD51AP1) plays a vital role in HRR, mainly participating in the formation of displacement loop (D‐loop), and is an important molecule for maintaining cellular genomic stability. Recent studies showed that RAD51AP1 was significantly overexpressed in a variety of cancer types and correlated with prognosis, suggesting that it may have a significant pro‐carcinogenic effect. However, the mechanism underlying its pro‐carcinogenic effect remains unclear, which may be closely associated with cancer stemness. Meanwhile, RAD51AP1 also plays an important role in resistance to radiotherapy and chemotherapy. Exploring RAD51AP1 and its regulatory molecules may provide new targets for overcoming cancer progression and treatment resistance. Here, we reviewed the latest research on RAD51AP1 in female reproductive system tumors and summarized its differential expression and prognostic implications. In this review, we also outlined the potential mechanisms of its procancer and drug resistance‐promoting effects to provide several potential directions for further research.