Cervical cancer is one of the most common gynecological tumors in females, which is closely related to high-rate HPV infection. Methylation alteration is a type of epigenetic decoration that regulates the expression of genes without changing the DNA sequence, and it is essential for the progression of cervical cancer in pathogenesis while reflecting the prognosis and therapeutic sensitivity in clinical practice. Hydroxymethylation has been discovered in recent years, thus making 5-hmC, the more stable marker, attract more attention in the field of methylation research. As markers of methylation, 5-hmC and 5-mC together with 5-foC and 5-caC draw the outline of the reversible cycle, and 6-mA takes part in the methylation of RNA, especially mRNA. Furthermore, methylation modification participates in ncRNA regulation and histone decoration. In this review, we focus on recent advances in the understanding of methylation regulation in the process of cervical cancer, as well as HPV and CIN, to identify the significant impact on the prospect of overcoming cervical cancer.
Background and Purpose Previous studies exploring stroke-related caregiving focused solely on informal caregiving and a relatively limited set of activities. We sought to determine whether, and at what cost, stroke survivors receive more care than matched controls using an expanded definition of caregiving and inclusion of paid caregivers. Methods Data were drawn from the National Health and Aging Trends Study (NHATS), a nationally representative survey of Medicare beneficiaries. NHATS personnel conducted in-person interviews with respondents or proxies to determine the weekly hours of care received. We compared hours of assistance received between self-reported stroke survivors (N=892) and demographic- and comorbidity-matched non-stroke controls (N=892). The annual cost of stroke caregiving was estimated using reported paid caregiving data and estimates of unpaid caregiving costs. Results Of community dwelling elderly stroke survivors, 51.4% received help from a caregiver. Stroke survivors received an average of 10 hours of additional care per week compared to demographic- and comorbidity-matched controls (22.3 hours vs. 11.8 hours, p<0.01). We estimate that the average annual cost for caregiving for an elderly stroke survivor is approximately $11,300, or about $40 billion annually, for all elderly stroke survivors, of which $5,000 per person, or $18.2 billion annually, is specific to stroke. Conclusions Although stroke survivors are known to require considerable caregiving resources, our findings suggest that prior assessments may underestimate hours of care received and hence costs.
Background and Purpose Black stroke survivors experience greater post-stroke disability than whites. Differences in post-acute rehabilitation may contribute to this disparity. Therefore, we estimated racial differences in rehabilitation therapy utilization, intensity and the number post-acute care settings in the first year after a stroke. Methods We used national Medicare data to study 186,168 elderly black and white patients hospitalized with a primary diagnosis of stroke in 2011. We tabulated the proportion of stroke survivors receiving physical, occupational and speech and language therapy in each post-acute care setting (inpatient rehabilitation facility, skilled nursing facility and home health agency), minutes of therapy, and number of transitions between settings. We then used generalized linear models to determine whether racial differences in minutes of physical therapy were influenced by demographics, comorbidities, thrombolysis, and markers of stroke severity. Results Black stroke patients were more likely to receive each type of therapy than white stroke patients. Compared to white stroke patients, black stroke patients received more minutes of physical therapy (897.8 vs. 743.4; p<0.01), occupational therapy (752.7 vs. 648.9; p<0.01), and speech and language therapy (865.7 vs. 658.1; p<0.01). There were no clinically significant differences in physical therapy minutes after adjustment. Blacks had more transitions (median 3, IQR (1–5)) than whites (median 2, IQR (1–5), p < 0.01). Conclusions There are no clinically significant racial differences in rehabilitation therapy utilization or intensity after accounting for patient characteristics. It is unlikely that differences in rehabilitation utilization or intensity are important contributors to racial disparities in post-stroke disability.
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