To investigate the clinical value of early (≤7 days) versus delayed (>6 weeks) laparoscopic cholecystectomy (LC) after ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGBD) in high-risk acute cholecystitis (AC), with PTGBD serving as a bridging intervention. A retrospective analysis was performed on 110 high-risk AC patients admitted between August 2021 and January 2025. Patients were divided into an early LC group (52 cases) and a delayed LC group (58 cases). Surgical indicators, inflammatory response control, hospitalization duration, treatment costs, quality of life, and postoperative complications were compared between the two groups. The early LC group demonstrated significantly superior outcomes in operative time (22.51 ± 4.32 vs. 65.28 ± 15.12 minutes, p < 0.001), intraoperative blood loss (12.16 ± 2.13 vs. 52.47 ± 6.11 mL, p < 0.001), length of hospital stay (7.12 ± 0.58 vs. 10.11 ± 1.62 days, p < 0.001), and total treatment costs (2.36 ± 0.32 vs. 3.80 ± 0.52 ten thousand yuan, p < 0.001, 1 dollar = 6.91 yuan). The incidence of moderate to severe adhesions was significantly lower in the early LC group (28.85% vs. 56.90%, p = 0.003). However, the delayed LC group exhibited lower postoperative C-reactive protein levels (12.45 ± 2.23 vs. 15.32 ± 2.78 mg/L, p < 0.001) and procalcitonin levels (0.25 ± 0.06 vs. 0.38 ± 0.05 ng/mL, p < 0.001), as well as significantly higher quality-of-life scores at 3 months postoperatively (all p < 0.001). No statistically significant differences were observed in complication rates (9.62% vs. 15.52%) or conversion-to-laparotomy rates (3.85% vs. 10.34%) between groups (p > 0.05). Early LC following PTGBD effectively shortens overall treatment duration, reduces healthcare costs, and lowers surgical complexity. However, careful consideration should be given to the potential influence of residual inflammation on long-term quality of life. Further multi-center prospective studies are warranted to validate long-term safety and to optimize individualized treatment strategies.
Objective To evaluate the value of dual-layer spectral CT-derived iodine concentration (IC) and extracellular volume (ECV) in the portal venous phase in assessing hepatic functional reserve. Methods A total of 24 patients who underwent triphasic abdominal spectral CT enhancement scanning between January 2020 and August 2022 were retrospectively enrolled.IC and ECV maps were generated from spectral base data of the portal venous phase,and IC and ECV values were measured in the left lobe,right lobe,and caudate lobe of the liver.Differences in parameters among hepatic lobes were compared by the Kruskal-Wallis test.Pearson or Spearman correlation analysis was performed to assess the relationships of IC and ECV with parameters of the indocyanine green (ICG) clearance test.The key parameters analyzed included the ICG retention rates at 5 min (ICGR5),at 10 min (ICGR10),at 15 min (ICGR15),and the ICG clearance rate (ICG-CR).On the basis of correlation results,multivariate linear regression models were constructed. Results ECV in the right hepatic lobe showed negative correlations with ICGR5 (r=-0.48,P=0.019),ICGR10 (r=-0.48,P=0.019),and ICGR15 (r=-0.47,P=0.021) and a positive correlation with ICG-CR (r=0.48,P=0.019).IC in the right hepatic lobe also showed negative correlations with ICGR5 (r=-0.52,P=0.009),ICGR10 (r=-0.52,P=0.009),and ICGR15 (r=-0.53,P=0.008) and a positive correlation with ICG-CR (r=0.52,P=0.009).IC in the right hepatic lobe demonstrated the best predictive performance for ICGR5 (y=0.62-0.16×IC,R2=0.26,P=0.011) and ICG-CR (y=0.09-0.07×IC,R2=0.32,P=0.004),whereas ECV was not selected in the multivariate regression model. Conclusion The dual-layer spectral CT-derived IC in the portal venous phase of the right hepatic lobe demonstrates significant clinical relevance with hepatic functional reserve,potentially serving as a non-invasive imaging biomarker for liver function assessment. 目的 探讨双层探测器光谱CT门脉期碘浓度(IC)和细胞外容积(ECV)定量参数对肝功能储备的评估价值。方法 回顾性纳入2020年1月至2022年8月行腹部光谱CT三期增强检查的24例患者,基于门脉期能谱基数据生成IC及ECV图,测量肝左叶、右叶及尾状叶的IC与ECV值。通过Kruskal-Wallis检验比较各肝叶参数差异,采用Pearson/Spearman法分析IC及ECV与吲哚菁绿(ICG)清除试验参数之间的相关性。分析的关键参数包括:ICG 5 min滞留率(ICGR5)、ICG 10 min滞留率(ICGR10)、ICG 15 min滞留率(ICGR15)及ICG血浆清除率(ICG-CR),并基于相关性分析结果进一步构建多元线性回归模型。结果 肝右叶ECV与ICGR5(r=-0.48,P=0.019)、ICGR10(r=-0.48,P=0.019)、ICGR15(r=-0.47,P=0.021)均呈显著负相关,与ICG-CR呈显著正相关(r=0.48,P=0.019)。肝右叶IC与ICGR5(r=-0.52,P=0.009)、ICGR10(r=-0.52,P=0.009)、ICGR15(r=-0.53,P=0.008)均呈显著负相关,与ICG-CR呈显著正相关(r=0.52,P=0.009)。肝右叶IC对ICGR5(y=0.62-0.16×IC,R2=0.26,P=0.011)及ICG-CR(y=0.09-0.07×IC,R2=0.32,P=0.004)的预测效能最佳,而ECV未通过多元回归筛选。结论 双层探测器光谱CT门脉期肝右叶IC值可作为评估肝功能储备的潜在影像标志物,其与ICG清除试验的强相关性为无创肝功能定量评估提供了新思路。.
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Pancreatic acinar cell carcinoma (PACC) is a rare malignancy, and clinical data on managing bulky hepatic metastases from PACC remain limited. Conventional radiotherapy is restricted by normal tissue tolerance, while stereotactic body radiation therapy (SBRT) leads to prohibitive toxicity when applied to large tumor volumes. Spatially fractionated radiation therapy (SFRT) creates a deliberate non-uniform peak-valley dose distribution, delivering ablative doses to discrete tumor vertices while sparing the surrounding hepatic parenchyma. This approach may enhance local control and antitumor immunity, supporting its use in combination with immunotherapy for large hepatic metastases. A 35-year-old female with metastatic PACC and a solitary 12-cm hepatic metastasis (clinical stage TxN3M1) experienced disease progression despite multiple surgical resections and six lines of systemic chemotherapy. The enlarging hepatic metastasis caused portal vein compression and anasarca. The patient received Lattice SFRT (40 Gy in four fractions) to the hepatic lesion, combined with the PD-1/CTLA-4 bispecific antibody cadonilimab and the multi-targeted tyrosine kinase inhibitor anlotinib. The target lesion decreased by 34% at 1 month and nearly 50% at 5 months, meeting RECIST partial response. No grade ≥3 toxicities were observed. This case provides clinical experience supporting the use of SFRT combined with immunotherapy for bulky refractory PACC. The combination of Lattice SFRT, dual immune checkpoint blockade, and targeted therapy appears feasible and well-tolerated in this patient. Further clinical trials are warranted to validate this combined approach.
The continued rise in cancer-related deaths suggests that the precise nature of the disease remains poorly understood. In the field of cellular mechanics, researchers have identified mechanobiological aspects of cancer cells by examining the link between their physical and molecular properties and functions, thereby revealing some of their previously unknown characteristics. Therefore, expanding scientific insight in this area may deepen our understanding of genetic and mechanical interactions and clarify the functional mechanisms at both the cellular and subcellular levels. Accordingly, in this review, we first evaluated the cytoskeletal filaments and their structural dynamics from a mechanobiological perspective. Then, the characteristics of the mechanical behavior of cells were discussed, and the potential correlations between the mechanical and rheological properties of normal and cancer cells, alongside alterations in their genetic components, were highlighted. Subsequently, we reviewed the simulationary capabilities of existing in vitro methods for estimating the biomechanical properties of cells. Finally, by outlining the challenges and opportunities associated with this approach, we aimed to present a clearer picture of its potential in practice. We believe that this study, by providing a comprehensive overview of various mechanobiological aspects of cancer at the cellular and subcellular levels, can help researchers in developing bioengineering-based in vitro platforms to decipher the unknown traits of cancer cells, paving the way for novel diagnostic biomarkers and mechano-targeted therapies.
Regioselective polymerization of isoprene enables the synthesis of polymers with well-defined microstructures, in which the ancillary ligand at the metal center plays a critical role in modulating polymerization performance. To investigate the effect of the ligand framework on polymerization reactivity, in this work, a series of guanidinate rare-earth metal bis(silylamide) complexes {(2,6-iPr2C6H3NH)[PhNC(2,6-iPr2C6H3N)]}Ln[N(SiHMe2)2]2(THF) (Ln = Sc (1), Y (2), Lu (3), Sm (4), Nd (5)), {(2,6-iPr2C6H3NH)[(2-OMe-C6H4)NC(2,6-iPr2C6H3N)]Nd[N(SiHMe2)2]2(THF) (6), and {(2,6-iPr2C6H3NH)[(2-F-C6H4)NC(2,6-iPr2C6H3N)]Nd[N(SiHMe2)2]2(THF) (7) were synthesized via amine elimination reactions involving sterically demanding guanidines and one equivalent of Ln[N(SiHMe2)2]3(THF)n (Ln = Sc, n = 1; Ln = Y, Lu, Sm, Nd, n = 2). Upon activation with 1 equiv of [Ph3C][B(C6F5)4] and in the presence of excess AlMe3, these complexes exhibited catalytic activity for isoprene polymerization. The cis-1,4 selectivity was found to be strongly dependent on both the rare-earth metal center and the electronic properties of the ligand framework. Notably, the catalytic system 7/[Ph3C][B(C6F5)4]/AlMe3 not only afforded polyisoprene with high cis-1,4 selectivity (up to 99%) but also demonstrated well-controlled polymerization behavior at room temperature. Furthermore, a heterometallic Nd/Al alkyl complex, like {(2,6-iPr2C6H3NH)[(2-OMe-C6H4)NC(2,6-iPr2C6H3N)]}Nd[(μ-Me)2AlMe2]2 was experimentally identified as the precatalyst for the cationic polymerization of isoprene.
This paper reported a case of giant renal hamartoma complicated with renal venous tumor thrombus.MRI was used for diagnosis and renal function evaluation on the affected side before surgery,and the patient underwent robot-assisted laparoscopic radical resection of the left kidney and left renal venous tumor thrombus embolectomy.The operation was successfully completed,and there were no complication or tumor recurrence during the 20-month follow-up after surgery.This case,combined with the literature review,suggests that MRI has important guiding significance in the preoperative evaluation and surgical modality selection of giant renal hamartoma. 分析1例巨大肾错构瘤合并肾静脉瘤栓的病例,术前应用MRI进行诊断及患侧肾功能评估,予该患者行机器人辅助腹腔镜下左肾根治性切除术+左肾静脉瘤栓取出术。手术顺利完成,术后20个月随访期间未见并发症发生及肿瘤复发。结合文献综述,MRI在诊治巨大肾错构瘤的术前评估及手术选择上具有重要的指导意义。.
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HIV-associated diffuse large B-cell lymphoma (DLBCL) is an aggressive malignancy with poor outcomes despite combination antiretroviral therapy (cART). Spontaneous regression in advanced-stage disease is exceptionally rare. A 66-year-old male with stage IV, non-germinal center DLBCL involving the liver achieved complete radiographic resolution of multifocal hepatic lesions without cytotoxic therapy following cART initiation. Remission has been sustained for over 36 months. Effective viral suppression and CD4+ T-cell recovery (from 200 to 571 cells/μL) were temporally correlated with tumor regression. Spontaneous regression of stage IV diffuse large B-cell lymphoma (DLBCL) is exceedingly rare among individuals with HIV infection. This case underscores the critical role of immune reconstitution via cART in treating HIV-associated lymphoma. Therefore, it is recommended to initiate cART as early as possible in HIV-positive lymphoma patients to restore immune function, which can positively influence lymphoma management.
All-solid-state lithium metal batteries are widely considered promising next-generation energy storage systems owing to high specific energy and enhanced safety. However, their practical deployment is hindered by high stack pressure and inferior electrochemical performance. Here, we exploit the fast thermodynamic diffusion of fluorine atoms to design a core-shell structured sulfide electrolyte, Li5.4PS4.4Cl1.4F0.2-0.2LiF, featuring 50 nm LiF nanoshell and F-enriched bulk. During electrochemical operation, fluorine atoms diffuse into the LiNi0.83Co0.12Mn0.05O2 positive electrode lattice, enhancing structural robustness and mitigating mechanochemical failure, while the LiF nanoshell stabilizes both the Li metal negative electrode and positive electrode interfaces through spontaneous fluorination diffusion. As a result, full cells demonstrate good electrochemical performance, including long cycle life, high-voltage stability, and robust operation across a wide temperature window. Furthermore, all-solid-state pouch cells operated under a low stack pressure of 2.5 MPa exhibit stable cycling over 350 cycles (1 C) with 85% capacity retention, and achieve a high specific energy of over 400 Wh/kg (based on solid electrolyte, Li metal, and positive electrode materials). This bulk-to-interface fluorination strategy effectively mitigates mechanochemical failures, offering an alternative pathway toward low-pressure, long-life, and high-energy all-solid-state batteries.
Multiple small diameter fan-shaped and parallel core decompression are the surgical procedure used to treat the early osteonecrosis of the femoral head. However, It is not known which method is more appropriate from biomechanical perspective. Therefore, we aimed to analyze the mechanical stability of different distribution parameters of the two drilling methods using finite element analysis. Ten finite element models were established, including different drilling number (three-hole, four-hole, five-hole, seven-hole and nine-hole) based on fan-shaped and parallel core decompression. The stress and strain of the proximal femur was calculated to evaluate the biomechanical stability. Results showed that maximum equivalent stress in the entire structure, greater trochanter's lateral wall, and bone tunnels increased with more drill holes in both groups, following the order: three-hole < four-hole < five-hole < seven-hole < nine-hole. At the same hole count, fan-shaped core decompression had higher maximum equivalent stress in the greater trochanter's lateral wall, cortical bone tunnel, cancellous bone tunnel, and bone tunnel in the osteonecrosis area compared to parallel core decompression, with notable percentage increases in the cancellous bone tunnel (21.18%-585.71%). Additionally, fan-shaped drilling exhibited higher average stress and local strain, especially in the cancellous bone tunnel, whereas parallel drilling maintained lower stress and strain levels across most regions. From a biomechanical perspective, multiple small-diameter parallel core decompression is superior to fan-shaped decompression, offering better stability and reduced stress concentration in the proximal femur for early femoral head osteonecrosis.
Duchenne muscular dystrophy is a fatal disease characterized by persistent skeletal muscle degeneration, inflammation, and fibrosis. Gene therapy using an adeno-associated virus-derived vector and a microdystrophin transgene is currently under investigation in patients, but the impact of physical activity on long-term therapeutic outcome remains poorly understood. Recently, we reported that 21 weeks of voluntary wheel running complemented the positive endurance and muscle function outcomes of gene therapy in mdx mice. In the present study, we performed a transcriptomic analysis of the gene expression changes associated with functional recovery in the diaphragm with a focus on genes and signaling pathways related to the inflammatory response. RNA sequencing and bioinformatic analysis revealed 2,881 dysregulated genes in untreated and unexercised mdx mice including inflammatory and fibrotic signaling pathways frequently affected in Duchenne muscular dystrophy patients. Among the dysregulated genes, 774 were rescued toward WT level after adeno-associated virus microdystrophin injection. Importantly, 93% of the rescued genes were maintained by voluntary running, which indicates that physical exercise has no significant impact on the outcome of gene therapy-rescued genes in the mdx diaphragm. Our study provides vital information that could help guide DMD patient follow-up protocols after treatment with gene therapy.
Crohn's disease (CD) is a chronic inflammatory bowel condition with increasing global incidence. Diet is a key modulator of chronic inflammation, often assessed by the Dietary Inflammatory Index (DII). However, prospective evidence linking the DII to CD risk remains limited in large populations. This study used the UK Biobank (UKB) to address this gap. Cox regression models were used to examine the association between the energy adjusted dietary inflammation index (E-DII) quartiles and CD with sequential adjustment for confounding variables. Restricted cubic spline regression (RCS) was additionally adopted to determine the association of the continuous E-DII and CD risk. Furthermore, sensitivity and subgroup analyses were conducted to explore the consistency of the results. Among 207,582 participants included in the analysis, 455 incident CD cases were documented over a mean follow-up period of 12.65 years. A positive association was observed between higher E-DII scores, indicating a more pro-inflammatory diet, and an increased risk of CD. In a fully adjusted multivariable model, participants in the highest quartile of E-DII had a significantly elevated risk of CD [HR:1.45, 95% CI (1.11-1.90); p < 0.01] compared to those in the lowest quartile. This association remained consistent across several sensitivity analyses. In this large prospective cohort, a pro-inflammatory dietary pattern, as reflected by higher E-DII scores, was associated with a significantly increased risk of developing CD. From a public health perspective, this finding highlights the potential importance of dietary inflammation in CD prevention, warranting further investigation into targeted interventions.
Objective To quantitatively evaluate China's core research integrity policies by constructing an evaluation index system specific to the medical field and reveal the applicability and structural shortcomings of these policies,thereby providing empirical evidence and optimization pathways for enhancing the scientific rigor and practical effectiveness of research integrity governance in China. Methods Eighteen research integrity policy documents issued at the national level by the central government and ministries from January 2010 to January 2025 were collected.An evaluation framework based on the policy modeling consistency index model was constructed via text mining and keyword analysis to quantitatively assess the consistency and effectiveness of these policies.According to their scores,the policies were rated as excellent,good,medium,or bad grade. Results The 18 policies showed the average policy modeling consistency index of 6.27 and the sag index of 2.73,which indicated good overall performance but with clear disparities.Among them,3 policies were rated as excellent,6 as good,and 9 as medium.Analysis of the dimensional averages revealed that while the policies performed robustly in terms of policy function and policy timeliness,they exhibited significant shortcomings in the dimensions of policy target and policy scope,with average scores of 0.59 and 0.44,respectively. Conclusions While China's medical research integrity policy framework is generally effective,it exhibits clear structural shortcomings,including a lack of international perspective,monolithic policy targets,insufficient enforcement rigidity,and low operability.Accordingly,it is recommended that measures such as aligning with global standards,establishing a multi-stakeholder collaborative governance network,strengthening policy enforcement,and improving policy operability should be adopted.These measures will help to systematically optimize China's medical research integrity policy system,thereby enhancing the overall governance level in this domain. 目的 通过构建医学领域科研诚信政策评价指标体系,对我国主要科研诚信政策进行量化评估,旨在揭示科研诚信政策在医学领域的适用性水平与结构性短板,从而为提升我国医学领域科研诚信治理的科学性与实践效能提供实证依据与优化路径。方法 收集2010年1月至2025年1月国家及部委层面发布的18项科研诚信政策文件,通过文本挖掘和关键词分析构建基于政策一致性指数模型的评价指标体系,量化评估政策的一致性与有效性,并依据得分范围将政策分为优秀、良好、中等、不良4个等级。结果 18项政策一致性指数均值为6.27,整体呈现良好水平,凹陷指数均值为2.73,但存在明显参差,其中优秀级3项、良好级6项、中等级9项。从各维度均值看,政策功能与政策时效维度表现稳固,但在政策客体与政策作用范围维度上存在显著不足,其均值分别为0.59和0.44。结论 我国医学领域科研诚信政策整体表现良好,但存在缺乏国际化视野、政策客体单一、政策执行刚性和实操性不足等短板,建议采取与全球标准对接、构建多元主体协同治理网络、增强政策执行刚性、提升内容可操作性等措施,系统性地优化我国医学领域科研诚信政策体系,以整体提升我国医学领域科研诚信治理水平。.
[This corrects the article DOI: 10.3389/fphys.2026.1793389.].
Extracellular matrix is a 3D reticular molecular structure that maintains the structures and functions of cells and provides biomechanical support for cell proliferation and differentiation.The increase in extracellular matrix hardness can destroy the ecological structures and biological functions of normal organs and affect the signal transduction of normal tissue and cells,being a key driver of organ fibrosis.Therefore,reducing the extracellular matrix hardness by inhibiting key signaling pathways and activating fibroblasts can reverse organ fibrosis and promote the steady development of extracellular matrix.This paper expounds the key role of extracellular matrix hardness in fibrosis diseases,providing key therapeutic targets and clinical research directions for ameliorating and reversing organ fibrosis. 细胞外基质是维持细胞结构和功能的一种3D网状分子结构,为细胞的增殖、分化提供了生物力学支撑。细胞外基质的硬度增加可以破坏正常脏器的生态结构和生物功能,影响正常组织细胞的信号传导,是脏器纤维化的关键驱动要素。因此,通过抑制关键信号通路、成纤维细胞活化等手段可以降低细胞外基质的硬度,逆转脏器纤维化,促进细胞外基质的稳态发展。本文主要对细胞外基质硬度在纤维化疾病中的关键作用进行阐述,为改善和逆转脏器纤维化提供关键治疗靶点和临床研究方向。.
Kleine-Levin syndrome is an extremely rare sleep disorder.In addition to recurrent daytime sleepiness,symptoms such as overeating,hypersexuality,cognitive impairment,and mental and behavioral abnormalities usually occur.Hypothalamic dysfunction may be the underlying pathogenesis.Cases with headache are rare.We reported a case of Kleine-Levin syndrome with headache symptoms during narcolepsy,and his headache was characterized by both migraine and cluster headache.It is hypothesized that Kleine-Levin syndrome may have a potential common pathogenesis with functional headaches such as migraine or cluster headache,which may be related to hypothalamic dysfunction. Kleine-Levin综合征是一种极罕见的睡眠障碍疾病,除复发性日间嗜睡外,通常还可出现摄食过多、性欲亢进、认知障碍及精神行为异常等症状,下丘脑功能异常可能是其潜在的发病机制,合并头痛的病例较为罕见。本文报道1例Kleine-Levin综合征患者,发作嗜睡期间出现头痛症状,且其头痛兼具偏头痛及丛集性头痛特点,推测Kleine-Levin综合征可能与偏头痛或丛集性头痛等功能性头痛有潜在共同的发病机制,可能与下丘脑功能异常相关。.
Sugar content is a key determinant of apple (Malus × domestica) fruit quality, yet the genetic control of sugar composition remains poorly understood. Here, through QTL mapping in a 'Honeycrisp' × 'Qinguan' F1 population, we identified a genetic switch governing carbon partitioning during fruit maturation: THIOREDOXIN M-TYPE 4 (TRX-M4). Furthermore, a coding-region SNP revealed the genetic basis for the contrasting carbohydrate profiles-high starch/low sugar in 'Qinguan' versus high sugar/low starch in 'Honeycrisp'. The TRX-M4Y139 allele in 'Qinguan' exhibited enhanced thioredoxin activity. Transgenic lines carrying this allele showed increased activities of two starch synthesis enzymes-ADP-glucose pyrophosphorylase and starch synthase 1 (SS1). Consequently, TRX-M4Y139 promoted starch synthesis, diverting photoassimilates into a large transient starch pool and reducing sugar accumulation in developing fruits. In contrast, the TRX-M4F139 allele showed attenuated catalytic efficiency and weaker promotion of ADP-glucose pyrophosphorylase and SS1, leading to less starch accumulation and allowing a greater share of carbon to bypass the starch pool and accumulate as soluble sugars in fruit cells. This study advances our understanding of carbon flux in fruits and demonstrates how a naturally occurring thioredoxin variant functions as a molecular switch for carbon partitioning, ultimately determining fruit sweetness. The derived dCAPS marker enables rapid marker-assisted selection or precision editing of fruit sweetness, offering immediate applications for apple breeding.
Individuals who are at risk of or diagnosed with breast and ovarian cancer often face barriers in seeking help due to embarrassment, complex information needs, and limited access to timely support. Chatbots provide a private, non-judgmental communication interface that may help overcome these barriers. This scoping review systematically examines chatbot applications in breast and ovarian cancer care, focusing on their design, functionalities, evaluation outcomes, and implementation barriers and facilitators. A comprehensive search was conducted through PubMed, Medline, Embase, CINAHL, Cochrane Library, and Web of Science databases using keywords related to chatbots, breast cancer, and ovarian cancer. Studies were screened and reviewed following PRISMA-ScR guidelines. Nineteen studies met the inclusion criteria, covering educational support (n=16), clinical support (n=14), and psychosocial support (n=11). NLP served as the primary technical foundation (n=12), with rule-based and retrieval-based approaches equally represented (n=7 each) and a growing adoption of LLM-driven approaches (n=5). Studies reported consistently high user satisfaction, though RCT evidence on clinical efficacy showed mixed results with benefits varying by patient subgroups. Qualitative studies identified adoption barriers including data privacy concerns and patient expectations exceeding chatbot scope. While breast cancer applications showed promising outcomes, research on diagnosed ovarian cancer patients remains limited. Chatbots show potential as complementary tools in breast and ovarian cancer care. Future development should focus on standardised evaluation frameworks, specialized ovarian cancer applications, and optimizing the balance between automation and human oversight in clinical settings.