1.Pathological characteristics of cytologically diagnosed metastatic clear cell renal cell carcinomas
Wenjing CUI ; Peizhen HU ; Yingmei WANG ; Jiayan LIU ; Zhe WANG ; Xin FU
Chinese Journal of Pathology 2025;54(11):1180-1185
Objective:To investigate the clinical, cytopathological characteristics, and differential diagnosis of metastatic clear cell renal cell carcinomas (CCRCC).Methods:Nine cases of metastatic CCRCC cytologically diagnosed in the Department of Pathology, the First Affiliated Hospital of Air Force Medical University from July 2021 to December 2024 were collected. The HE staining, May-Grunewald-Giemsa staining, liquid-based slides, cell block preparation, and immunocytochemistry of EnVision two-step staining were performed. The clinical and cytopathological features, treatments and follow-up data were analyzed in combination with literature review.Results:Among the 9 cases of metastatic CCRCC, there were 7 males and 2 females. The age range was 43-78 years, and the average age was 63.6 (57.5, 72.5) years. The metastatic sites were lymph node in 3 cases (2 cases of mediastinal lymph nodes and 1 case of left cervical lymph node), bone in 3 cases (pubis, thoracic vertebrae and femur, respectively), thyroid in 2 cases, and adrenal gland, lung and pancreas in 1 case, respectively. Two of the 9 cases had two metastatic sites (case 8 had metastases of lung and mediastinal lymph nodes; case 9 had metastases of thyroid and cervical lymph nodes). The median time from the diagnosis to metastasis was 9.4 years (range 1.1 to 13.8 years). The tumor cells were arranged in papillary, acinar, sheet, cluster or single scattered pattern. Most cases had uniform nuclei with mild atypia and inconspicuous nucleoli, while some cases had variable nuclei with prominent nucleoli. The cytoplasm of the tumor cells was abundant. Some cases showed clear cytoplasm with small vacuoles, while some of them showed eosinophilic and granular cytoplasm. Immunocytochemically, the tumor cells were positive for CKpan(AE1/AE3,6/6), PAX8 (9/9), CAⅨ (9/9), CD10 (9/9), and vimiten (8/8). Patients were treated primarily with targeted therapy and/or immunotherapy and curettage and radiation therapy for bone lesions. The follow-up time ranged from 1.0 month to 41.5 months (median, 20 months), and all patients survived at the end of follow-up.Conclusions:The cytology of metastatic CCRCC often shows uniform cell size, abundant and clear cytoplasm, low nuclear/cytoplasmic ratio, and mild nuclear atypia. Its cytological diagnosis is challenging because it occurs in various sites and needs to be differentiated from primary tumors of these sites. Emphasis should be placed on the morphological recognition of CCRCC, and immunocytochemical staining should be used to improve diagnosis. When necessary, molecular testing can be employed for diagnosis. Meanwhile, the medical history should be carefully inquired by pathologists to avoid missed diagnosis and misdiagnosis.
2.The application value of deep learning in imaging studies for predicting the conversion of Alzheimer's disease
Yingmei HAN ; Yijie LI ; Heng ZHANG ; Weiqing LI ; Ze FENG ; Feng WANG
The Journal of Practical Medicine 2025;41(9):1413-1424
Alzheimer's disease(AD),a neurodegenerative disorder,manifests pathological changes in the brain even during the asymptomatic stage.As the pathological burden intensifies,patients experience functional decline in multiple cognitive domains,including memory,language,spatial perception,executive function,and calculation,and may also exhibit emotional abnormalities.Once AD progresses,treatment becomes extremely chal-lenging.Therefore,early diagnosis and accurate prediction of disease conversion are core tasks in the prevention and treatment of AD,and they are also urgent scientific research challenges to be overcome.Deep learning(DL)models demonstrate considerable advantages in the diagnosis,prediction,classification,and feature extraction of AD,offering new hope for solving this challenging problem.This research commences with a concise introduction to the outcomes of AD and the fundamental knowledge of deep learning.Subsequently,it offers an overview of the imaging studies on the utilization of deep learning for predicting disease transformation from two perspectives.Firstly,it systematically summarizes the existing DL models that have demonstrated innovation in the classification and prediction performance of AD.Secondly,it provides a comprehensive outline of the DL fusion models applied to the diagnosis,classification,and prediction of AD.Finally,this paper expounds upon the impending challenges in the research of this domain.This article demonstrates that deep learning models is cutting-edge trends in the ex-ploration of AD research.
3.Practice exploration of cultural integration driven by cultural and creative work in multi-campus hos-pitals from the perspective of cultural confidence
Yingmei JIE ; Weiwei CAO ; Yao WANG ; Xiaorui ZHANG ; Ping YIN
Modern Hospital 2025;25(4):529-533
To address the challenge of cultural integration in multi-campus public hospitals,the Cancer Center of Sun Yat-Sen University has embarked on a practical exploration using cultural and creative work as a vehicle,guided by cultural confi-dence.The center has created a cultural and creative matrix for its 60th anniversary,systematically innovating the cultural and creative work mechanism,vertically activating historical and cultural resources,and linking both inside and outside the hospital campuses.Additionally,a"full-cycle"cultural and creative system has been designed for the Huangpu campus,covering multi-ple scenarios and horizontally strengthening cross-campus identity.Following the principle of"appreciating the beauty of diversity while cherishing our own,"the Cancer Center of Sun Yat-Sen University aims to transform cultural soft power into a driving force for high-quality development and enhance cultural confidence through party building leadership.The"Cancer Center of Sun Yat-Sen University approach"of promoting cultural integration in multi-campus hospitals through cultural and creative work provides an empirical example for transforming cultural soft power into a driving force for high-quality development and enhancing cultural confidence in multi-campus public hospitals.The key lessons lie in deeply tapping into historical and cultural resources,emphasi-zing identity,building a collaborative innovation mechanism,and realizing the organic integration of cultural integration and high-quality hospital development.
4.Clinicopathological,immunophenotypic,and HPV infection status analysis of cer-vical carcinoma with adenoid cystic carcinoma-like features
Xiangchao MENG ; Yingmei WANG ; Xuan LI ; Wenjing NI ; Yang QIN ; Hong XU ; Shujun ZENG ; Jing ZHANG
Chinese Journal of Clinical and Experimental Pathology 2025;41(4):432-437,443
Purpose To investigate the clinicopathological characteristics,immunophenotype,high-risk human papillomavirus(hrHPV)infection status,treatment,and prognosis of cervical carcinoma exhibiting adenoid cystic car-cinoma(ACC)features.Methods Clinical data from 10 cases of cervical cancer with ACC features were collected.A retrospective analysis was proformed on the patients'clinicopathological data,histological features,and immunopheno-type(EnVision method),along with in situ hybridization detection of hrHPV E6/E7 mRNA covering 18 hrHPV types.Results The median age of the patients was 67.5 years,comprising 4 biopsy specimens and 6 surgical specimens.Except for 2 cases detected incidentally during physical examination,the remaining 8 cases presented with unexplained vaginal bleeding or contact bleeding.The mean tumor diameter was 4.5 cm(range:2.5 to 9.0 cm),and tumor stages were available for 8 patients(5 cases in stage Ⅰ and 1 case each in stages Ⅱ,Ⅲ,and Ⅳ).The follow-up period was 8 to 42 months,excluding 1 case lost to follow-up,2 cases(Ⅲ C1 and ⅣB)died within 1 year after surgery.Histologi-cally,4 cases exhibited pure ACC morphology,while 5 cases were mixed carcinomas(combined with squamous cell carcinoma,adenoid basal cell carcinoma,high-grade neuroendocrine carcinoma,or carcinosarcoma,respectively).The characteristic ACC morphology manifested as cribriform,pseudo-glandular,tubular,trabecular,and/or solid pat-terns with one case mixed carcinoma's lymph node metastasis showing only ACC morphology.Immunohistochemically,all 10 tumors exhibited diffuse strong positivity for p16 and p63,a high Ki67 proliferation index(40%to 90%),and wild-type p53 expression,and in 50%of cases,only a minority of cells were positive for c-MYB.Additionally,SOX10 was positive in 8 of 9 cases and CD117 was positive in 7 of 10 cases,respectively.In situ hybridization for hrHPV E6/E7 mRNA confirmed the presence of transcriptionally active HPV infection in all cases.Conclusion Cervical cancer with ACC features is rare,and predominantly occurs in postmenopausal elderly women.It represents an HPV-associat-ed high-grade carcinoma in which clinical stage is a critical prognostic factor.Immunohistochemical staining for CD117 and SOX10 aids in the pathological diagnosis of this tumor type.
5.Pathological characteristics of cytologically diagnosed metastatic clear cell renal cell carcinomas
Wenjing CUI ; Peizhen HU ; Yingmei WANG ; Jiayan LIU ; Zhe WANG ; Xin FU
Chinese Journal of Pathology 2025;54(11):1180-1185
Objective:To investigate the clinical, cytopathological characteristics, and differential diagnosis of metastatic clear cell renal cell carcinomas (CCRCC).Methods:Nine cases of metastatic CCRCC cytologically diagnosed in the Department of Pathology, the First Affiliated Hospital of Air Force Medical University from July 2021 to December 2024 were collected. The HE staining, May-Grunewald-Giemsa staining, liquid-based slides, cell block preparation, and immunocytochemistry of EnVision two-step staining were performed. The clinical and cytopathological features, treatments and follow-up data were analyzed in combination with literature review.Results:Among the 9 cases of metastatic CCRCC, there were 7 males and 2 females. The age range was 43-78 years, and the average age was 63.6 (57.5, 72.5) years. The metastatic sites were lymph node in 3 cases (2 cases of mediastinal lymph nodes and 1 case of left cervical lymph node), bone in 3 cases (pubis, thoracic vertebrae and femur, respectively), thyroid in 2 cases, and adrenal gland, lung and pancreas in 1 case, respectively. Two of the 9 cases had two metastatic sites (case 8 had metastases of lung and mediastinal lymph nodes; case 9 had metastases of thyroid and cervical lymph nodes). The median time from the diagnosis to metastasis was 9.4 years (range 1.1 to 13.8 years). The tumor cells were arranged in papillary, acinar, sheet, cluster or single scattered pattern. Most cases had uniform nuclei with mild atypia and inconspicuous nucleoli, while some cases had variable nuclei with prominent nucleoli. The cytoplasm of the tumor cells was abundant. Some cases showed clear cytoplasm with small vacuoles, while some of them showed eosinophilic and granular cytoplasm. Immunocytochemically, the tumor cells were positive for CKpan(AE1/AE3,6/6), PAX8 (9/9), CAⅨ (9/9), CD10 (9/9), and vimiten (8/8). Patients were treated primarily with targeted therapy and/or immunotherapy and curettage and radiation therapy for bone lesions. The follow-up time ranged from 1.0 month to 41.5 months (median, 20 months), and all patients survived at the end of follow-up.Conclusions:The cytology of metastatic CCRCC often shows uniform cell size, abundant and clear cytoplasm, low nuclear/cytoplasmic ratio, and mild nuclear atypia. Its cytological diagnosis is challenging because it occurs in various sites and needs to be differentiated from primary tumors of these sites. Emphasis should be placed on the morphological recognition of CCRCC, and immunocytochemical staining should be used to improve diagnosis. When necessary, molecular testing can be employed for diagnosis. Meanwhile, the medical history should be carefully inquired by pathologists to avoid missed diagnosis and misdiagnosis.
6.Research progress and therapeutic prospects of visfatin in tumor immunity
Liu SHIQI ; Bai JUNYI ; Feng XINYU ; Wang YINGMEI ; Xue FENGXIA
Chinese Journal of Clinical Oncology 2025;52(10):533-538
Visfatin,also known as nicotinamide phosphoribosyl transferase(NAMPT)or pre-B-cell colony-enhancing factor,is a proinflam-matory adipokine.Its immunomodulatory effects are closely associated with its pro-inflammatory activity,influencing the secretion of vari-ous cytokines and the function of immune cells.Visfatin exerts pro-tumorigenic effects in most cancers.The tumor immune microenviron-ment(TIME)comprises immune cells within the tumor tissue and an array of secreted cytokines.Growing evidence suggests that visfatin plays a regulatory role in the TIME by promoting inflammatory responses and modulating the polarization of immune cells,their secretory functions,surface protein expression,and energy metabolism,thereby influencing cancer progression.These newly discovered mechanisms provide a critical foundation for the application of NAMPT inhibitors(NAMPTi)in cancer immunotherapy.This review summarizes recent ad-vances in understanding the role of visfatin in tumor immunology and explores the therapeutic potential of NAMPTi in oncology.
7.A case of using acceptance and commitment therapy matrix for pre-exam anxiety
Yingmei XU ; Lulu GE ; Yan ZONG ; Fenfen WANG
Chinese Mental Health Journal 2025;39(9):759-764
Objective:To explore the effect of acceptance and commitment therapy matrix(ACT Matrix)for somatic symptoms associated with pre-exam anxiety in a high school student.Methods:An 8-session intervention was conducted,conceptualized by the ACT Matrix.The comprehensive assessment of Acceptance and Commitment Therapy processes(CompACT)and the evaluation of inverted U-shaped pressure curve were used for pre-and post-assessment.Results:The client's CompACT score increased from 56 to 71,and his stress level score decreased from 9 to 6.The client's somatic symptoms were significantly alleviated,the sleep improved,the relationship with his par-ents enhanced.Furthermore,The client exceeded expectation in the final semester exam.Conclusion:ACT Matrix effectively alleviated pre-exam anxiety-related somatic symptoms in a high school student,which is a useful tool to guide and facilitate the counseling.
8.Optimization strategy for patient experience on the new campus of a cancer-specialized hospital from the perspective of peak experience
Yingmei JIE ; Weiwei CAO ; Yao WANG ; Xiaorui ZHANG ; Ping YIN
Modern Hospital 2025;25(2):216-219
Tumor diseases have emerged as a major threat to human health.In this case,cancer hospitals must optimize patient experience while developing their facilities and medical resources.This paper takes the Huangpu Campus of Sun Yat-Sen University Cancer Center as an example to explore the strategies and practical effects of optimizing patient experience on the cam-pus from the perspective of peak experience.This hospital has successfully created high-quality peak experiences across multiple dimensions such as visual perception,trust,emotion,operations,efficiency,and lifestyle.The results indicated that Huangpu Hospital significantly improved patient satisfaction,medical resource expansion,operational efficiency,and social recognition.These achievements have validated the effectiveness of peak experience theory in the field of medical services,providing valuable insights for other hospitals.
9.Research progress and therapeutic prospects of visfatin in tumor immunity
Liu SHIQI ; Bai JUNYI ; Feng XINYU ; Wang YINGMEI ; Xue FENGXIA
Chinese Journal of Clinical Oncology 2025;52(10):533-538
Visfatin,also known as nicotinamide phosphoribosyl transferase(NAMPT)or pre-B-cell colony-enhancing factor,is a proinflam-matory adipokine.Its immunomodulatory effects are closely associated with its pro-inflammatory activity,influencing the secretion of vari-ous cytokines and the function of immune cells.Visfatin exerts pro-tumorigenic effects in most cancers.The tumor immune microenviron-ment(TIME)comprises immune cells within the tumor tissue and an array of secreted cytokines.Growing evidence suggests that visfatin plays a regulatory role in the TIME by promoting inflammatory responses and modulating the polarization of immune cells,their secretory functions,surface protein expression,and energy metabolism,thereby influencing cancer progression.These newly discovered mechanisms provide a critical foundation for the application of NAMPT inhibitors(NAMPTi)in cancer immunotherapy.This review summarizes recent ad-vances in understanding the role of visfatin in tumor immunology and explores the therapeutic potential of NAMPTi in oncology.
10.Exploring Mechanism of Polygoni Cuspidati Rhizoma et Radix in Treating Respiratory Syncytial Virus Infection Based on Pulmonary Surfactant Lipid Homeostasis
Xiaorong WANG ; Keyu TAO ; Jianjian JI ; Yingmei DONG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):102-108
ObjectiveTo investigate the efficacy and mechanism of Polygoni Cuspidati Rhizoma et Radix (Huzhang) in treating respiratory syncytial virus(RSV) infection by regulating pulmonary surfactant lipid homeostasis through lipidomics. MethodsSixty BALB/c mice were randomly divided into the blank group, model group, positive group(ribavirin group, 46 mg·kg-1), and low- and high-dose Huzhang groups(0.75, 2.25 g·kg-1), with 12 mice in each group. Except for the blank group, all other groups were infected with RSV via intranasal instillation. The drug intervention groups were given corresponding doses of drug by gavage for 3 consecutive days, while normal saline was used in the blank and model groups. Hematoxylin-eosin(HE) staining was used to observe pathological changes in mouse lung tissue. Real-time fluorescence quantitative polymerase chain reaction(Real-time PCR) was employed to detect viral loads[RSV-nucleoprotein(N) and RSV-glycoprotein(G) mRNA] and inflammatory factor levels[interleukin(IL)-1β and tumor necrosis factor(TNF)-α mRNA] in the lung tissue. Mouse bronchoalveolar lavage fluid was collected to detect the levels of pulmonary surfactant lipids through ultra-high performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry(UPLC-Q-Exactive Orbitrap-MS), followed by principal component analysis and differential lipid identification. ResultsCompared with the blank group, the model group exhibited extensive inflammatory cell infiltration, congestion, and tissue damage in the lungs, and the pathological score and lung index of lung tissue significantly increased(P<0.01), along with significantly elevated mRNA expressions of RSV-N, RSV-G, IL-1β, and TNF-α(P<0.01). Compared with the model group, different doses of Huzhang and ribavirin significantly reduced the pathological scores of the lung tissue and lung index(P<0.01). In addition, the mRNA levels of RSV-N, RSV-G and TNF-α in the lungs significantly decreased in the Huzhang high dose group(P<0.01). Lipidomics analysis identified multiple significantly changed differential metabolites. Compared with the blank group, the model group showed obvious abnormal lipid metabolism, which was manifested by the elevated levels of prostaglandin(PG), ceramide(Cer), phosphatidylcholine(PC), phosphatidylethanolamine(PE), phosphatidylinositol(PI), sphingomyelin(SM), and the decreased levels of diglycerides(DG) and acylethanolamine(NAE). After the intervention of low dose of Huzhang, the above lipid metabolites showed a significant reversal trend, while the intervention of high dose of Huzhang could regulate levels of PI lipids, PG lipids and PC lipids. ConclusionHuzhang can significantly reduce the viral load of lung tissue and improve lung inflammation in RSV-infected mice. The underlying mechanism may be related to the maintenance of homeostasis in pulmonary surfactant lipids such as PI and PG.

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