Background: Minimally-invasive 5-aminolevulinic acid photodynamic therapy (ALA-PDT) is used for treating cervical high-grade squamous intraepithelial lesions (HSIL/CIN2). The purpose of this study was to analyze the factors affecting the efficacy of ALA-PDT in the treatment of cervical HSIL/CIN2 in order to guide physicians in making appropriate treatment decisions. Methods: A retrospective study including 69 female patients with pathologically diagnosed HSIL/CIN2 was conducted. Patients were given six doses of 20% ALA-PDT at 7–14-day intervals. Cytology, HPV testing, colposcopy, and pathology were performed before treatment and at 6-month follow-up after treatment to assess efficacy. The main outcome of this study was the regression of HSIL/CIN2 and the clearance of high-risk HPV (hrHPV) infection after ALA-PDT treatment. Clinicopathological characteristics were collected to analyze the factors affecting the effectiveness of ALA-PDT treatment for HSIL/CIN2. Results: Between the successful and failed lesion regression group, there was a significant difference in sleeping disorders (p < 0.05). Between the successful and failed hrHPV clearance group, no statistically significant factors were found. With sensitivity values of 0.556 and 0.778, respectively, multivariate analysis showed that current smoking and sleeping disorders were independent prognostics of failure in lesion regression after ALA-PDT treatment. Conclusions: Smoking and sleep disorders were independent risk factors for failure in HSIL/CIN2 regression following ALA-PDT, suggesting the need for careful consideration of ALA-PDT for patients with these conditions.

High-grade squamous intraepithelial lesion (HSIL) is a precancerous lesion that requires timely and effective intervention. Photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) has emerged as a non-invasive, fertility-preserving alternative to excisional procedures. However, the ALA-PDT regimen remains to be optimized. To compare the efficacy and safety of three treatment strategies-three-session PDT (3PDT), six-session PDT (6PDT), and a single CO₂ laser ablation combined with six-session PDT (Laser + 6PDT)-for the management of cervical intraepithelial neoplasia grade 2 (HSIL/CIN2) in reproductive-age women. This retrospective cohort study included 158 women aged 20-45 years with biopsy-confirmed cervical HSIL/CIN2. Participants received one of three regimens: 3PDT (n = 49), 6PDT (n = 47), or Laser + 6PDT (n = 54). Lesion regression and high-risk HPV (hrHPV) clearance were assessed at 3-6 and 9-12 months post-treatment. A subset of patients was followed up to 18-24 months. Adverse events were also recorded. At the 3-6 months follow-up, the complete remission (CR) rates were 67.35 % (3PDT), 74.47 % (6PDT), and 79.63 % (Laser + 6PDT), with hrHPV clearance rates of 67.35 %, 72.34 %, and 77.78 %, respectively. Differences among groups were not statistically significant (P > 0.05). By 9-12 months, CR rates reached ≥90 % in all groups, and hrHPV clearance exceeded 80 %. At 18-24 months, hrHPV clearance reached 100 % in the 6PDT group, while three patients in the 3PDT group experienced HPV recurrence. All regimens were well tolerated, with only mild adverse events reported. All three ALA-PDT-based regimens were effective and safe in treating HSIL/CIN2 in reproductive-age women. Although not statistically significant, six-session PDT with or without laser pretreatment showed a trend toward higher lesion remission and hrHPV clearance. Individualized treatment decisions based on disease severity, patient preference, and cost factors are recommended to optimize outcomes.

Behçet's disease (BD) is a chronic systemic vasculitis characterized by recurrent oral and genital ulcers, skin lesions, and uveitis. The purpose of this study was to analyze the scientometric characteristics and research trends of BD. All the articles on BD were comprehensively retrieved from the Scopus database. Regional comparison (Turkey versus outside of Turkey) and chronological comparison (before 2010 versus after 2010) were performed. Among the 7023 articles on BD, Turkey was the country publishing most articles (2012 articles). In Turkey, questionnaire, quality of life, depression, and scoring system were distinctive keywords. In outside of Turkey, allele, gene expression, cytokine, interleukin 6, tumor necrosis factor-alpha, and phenotype were distinctive keywords. The trend of diagnostics mainly angiography before 2010 has changed to computed tomographic angiography, echocardiography, and optical coherence tomography. The trend of biology research has changed to research on metabolism, gene expression, allele, biomarkers, and genetic susceptibility after 2010. The trend of drug aspects mainly oral drug administration before 2010 has changed to drug withdrawal, drug dose reduction, drug safety, drug megadose, adalimumab, thalidomide, and salazosulfapyridine after 2010. This scientometric study elucidated the current scenario and research trends of BD, and would help in improving in reciprocal collaboration and communication for investigations on this disease.

Accumulating evidence indicates that methylation modification alterations involve in the development and progression of oral cancer. The purpose of this study was to analyze the scientometric characteristics of methylation modification in oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC). All the papers on methylation research in OPMD/OSCC were comprehensively retrieved from the Scopus database with emphasis on the identification of methylation related genes. A total of 365 papers on methylation research in OPMD/OSCC were retrieved. The total citation count was 9998 and the h index was 53 for all the papers. The common keywords included prognosis, sensitivity and specificity, smoking, cohort analysis, saliva, receiver operating characteristic, follow up, risk factor, cancer diagnosis, tumor suppressor gene, biological marker. Among the 365 papers, a total of 542 methylated genes and 65 microRNAs were identified. The most common methylated gene was p16, followed by MGMT, DAPK/DAPK1, E-cadherin, RASSF1/RASSF1A, KIF1A, TIMP3, RUNX3, LINE1, CDH1, TERT, ZAP70, FLI1, GP1BB, and ZNF582. The most frequent methylation related microRNA was miR-296, followed by miR-193 and miR-137. This study for the first time elucidated the scientometric characteristics of all the publications on methylation modification in oral carcinogenesis, and would provide new insights for researchers to comprehend the methylation specific gene profile related OPMD/OSCC.

Persistent high-risk human papillomavirus (hrHPV) infection is the principal cause of cervical cancer, and although 5-aminolevulinic acid photodynamic therapy (ALA-PDT) has emerged as a minimally invasive treatment for cervical low-grade squamous intraepithelial lesions (LSIL) with hrHPV infection, the optimal number of treatment sessions remains uncertain. We conducted a retrospective cohort study involving 326 women with histologically confirmed cervical LSIL and hrHPV infection from 11 medical centers in China between June 2019 and April 2023 to compare the effectiveness of three-session and six-session ALA-PDT regimens. A total of 268 women completed follow-up and were evaluated 3–6 months after treatment. Overall clinical remission, pathological remission, and hrHPV clearance rates were 77.24%, 91.42%, and 74.25%, respectively. Compared with the three-session regimen, the six-session regimen was associated with significantly higher clinical remission (82.61% vs. 71.54%, P = 0.041) and hrHPV clearance (84.06% vs. 63.85%, p < 0.001), whereas pathological remission did not differ significantly between groups. Subgroup analysis demonstrated that the six-session regimen was associated with significantly improved clinical remission, pathological remission, and hrHPV clearance in women with non-HPV16/18 infection, while no significant differences were observed among those with HPV16/18 infection. These findings suggest that an extended six-session ALA-PDT regimen may provide additional short-term benefit for selected patients with cervical LSIL and hrHPV infection, particularly those with non-HPV16/18 infection. Rather than routinely extending treatment for all patients, treatment duration should be individualized according to baseline characteristics and treatment response. Given the retrospective design and relatively short follow-up, prospective randomized studies with longer-term evaluation are warranted to determine the optimal ALA-PDT treatment strategy.