Myasthenia gravis is an autoimmune disorder characterized by impaired neuromuscular transmission. Thymectomy is one of the therapeutic options for acetylcholine receptor antibody-positive myasthenia gravis patients. The quality of perioperative care is directly associated with surgical safety and patient outcomes. However, there is currently a lack of specialized nursing consensus or guidelines specifically addressing the care of these patients domestically or internationally. To promote the standardization and normalization of perioperative nursing care for myasthenia gravis patients undergoing thymectomy and to ensure treatment efficacy, a panel of 57 experts from relevant fields was convened. Based on evidence-based medicine and clinical practice experience, discussions were held on various aspects including condition assessment, nutritional support, medication management, and airway care, resulting in a consensus with 18 final recommendations by using the Delphi method through two rounds of expert consultation. This consensus aims to provide a scientific reference for the perioperative nursing care of myasthenia gravis patients undergoing thymectomy.

Objective:To evaluate the clinical significance of morular metaplasia (MM) in fertility-preserving treatment for young patients with endometrial hyperplasia and grade 1 endometrial endometrioid carcinoma.Methods:Clinical data was retrospectively collected from patients diagnosed with endometrial hyperplasia or grade 1 endometrial endometrioid carcinoma under 40 years old who underwent progestin-based fertility-sparing treatmentat in Tianjin Medical University General Hospital between January 2018 and November 2022.Patients were divided into the MM group (37 cases) and the non-MM group (63 cases) based on pathological findings. Clinical characteristics, hysteroscopic features, treatment efficacy and fertility outcomes were compared between the two groups. The MM group was further stratified into three subgroups based on the timing of MM occurrence:(1) MM-Bef group ( n=10): MM was present in the initial endometrial curettage or hysteroscopic biopsy pathology before fertility-sparing treatment and disappeared after treatment; (2) MM-Sus group ( n=14): MM persisted consistently before and after therapy;(3) MM-Aft group ( n=13): MM was absent before therapy but appeared after treatment. The risk factors which had impact on the treatment outcomes of the patients were analyzed using univariate and multivariate Cox regression analysis. Results:The rate of polycystic ovary syndrome were higher in the MM group than the non-MM group [51% (19/37) vs 27% (17/63), P=0.014]. The complete response (CR) rate was significantly lower in the MM group than in the non-MM group [73% (27/37) vs 95% (60/63), P=0.006], and the median time to CR was significantly longer in the MM group (6.0 vs 5.0 months, P=0.005).Multivariate analysis identified that MM-Sus ( HR=0.355, 95% CI:0.174-0.723; P=0.004) and MM-Aft ( HR=0.314, 95% CI:0.145-0.681; P=0.003) were independent risk factors for delayed CR in fertility-sparing treatment. The patients in the MM group and non-MM group underwent hysteroscopic biopsy for 76 and 131 times. "Gravel-like change" was a more frequent hysteroscopic manifestation in the MM group than that in the non-MM group [18% (14/76) vs 2% (2/131), P<0.001]. Conclusions:Patients in the MM group have poorer treatment outcomes than patients in the non-MM group. MM-Sus and MM-Aft are risk factors for fertility-preserving treatment in young patients with endometrial hyperplasia or grade 1 endometrial endometrioid carcinoma. "Gravel-like change" is the characteristic hysteroscopic manifestations of MM.

Under the multi-campus development model of public hospitals,cultural integration and innovation face nu-merous challenges due to spatial constraints,personnel structure differences,and functional positioning across campuses.System-atic cultural development is required to bridge these gaps and enhance the sense of belonging among both patients and staff in new campuses.This case study focuses on the Huangpu Campus of Sun Yat-sen University Cancer Center,launched in 2021,explo-ring a dual-dimensional approach to multi-campus cultural integration through"healing spaces."The practical strategies include:①Direct Space Construction:Establishing patient-centered healing environments through service hubs to optimize clinical experi-ences and humanistic care;(②Inidirect Environment Development:Leveraging staff service centers to foster the integration of the hospital's"collaborative,fulfilling,and striving culture,"thereby strengthening employee engagement.Post-implementation,significant improvements were observed in both patient and staff satisfaction metrics.The initiative has yielded a replicable cultur-al management framework for multi-campus public hospitals,offering valuable insights for cultural innovation in similar healthcare settings.

Purpose To investigate the clinicopathological features,diagnostic approaches,and differential diag-nosis of chordoid glioma(CG)and chordoid meningioma(CM)of the central nervous system(CNS).Methods Clinical data from 4 cases of CG and 10 cases of CM were collected.Immunohistochemistry was used to detect the ex-pression of GFAP,EMA,TTF-1,and other markers.Molecular genetic alerations were identified using sequencing techniques and relevant literature was reviewed.Results CG predominantly occurred in the third ventricle but could also arise outside of it.Tumors showed well-defined borders with surrounding tissues.Microscopically,tumor cells were arranged in cords or clusters within a myxoid stroma and expressed GFAP,TTF-1,and other markers.No PRKCA(D463H)mutations were detected in 3 CG cases,however,one case harbored an FLCN ∷ PRKD2 fusion.CM predom-inantly occurred in the supratentorial region but also appeared in the subtentorial area.Histologically,chordoid compo-nents were mixed with classic meningioma features.Chronic inflammatory cell infiltration was noted in the stroma.Tumor cells expressed EMA,PR and SSTR2.One case harbored NF2 mutation and homozygous CDKN2A deletion.Conclusion CG and CM of the CNS shared overlapping morphological characteristics,making histological distinction difficult.Accurate diagnosis required integration of clinical,imaging,immunohistochemical,and molecular pathologi-cal findings.

Objective:To analyze the changes of peripheral blood CD 4+ T lymphocyte subsets caused by nanosecond pulse ablation in C57BL/6J liver cancer mice and its effect on the immunity of liver cancer mice. Methods:According to the randomallocation, 32 female C57BL/6J mice weighing 18-20 g and aged 8-10 weeks were divided into the blank control group (Group A), the liver cancer control group (Group B), the radical liver lobectomy group (Group C), and the nanosecond pulse ablation treatment group (Group D), with 8 mice in each group. The in situ liver cancer models for mice in groups B, C, and D were established using Hepa 1-6 hepatoma cell line. On the 7th day after modeling, group C underwent liver lobectomy, and group D underwent nanosecond pulse ablation. After 7 days of treatment, the subtypes Th1, Th2, Th17 and Treg cell levels of CD 4+ T cells in the peripheral blood of the four groups of mice were detected by flow cytometry. Results:Flow cytometry was used to detect and analyze the proportions of CD 4+ T cell subsets Th1, Th2, Th17 and Treg in the peripheral blood of four groups of mice. Comparisons of each index among the groups showed statistically significant differences (all P<0.001). The proportion of Th1 cells detected by flow cytometry was (8.4±1.1) % in group A, (8.5±1.5)% in group D, (3.5±0.5)% in group B, and (2.4±0.5)% in group C. Both group A and Group D were higher than group B and group C, and the differences were statistically significant (all P<0.001). The proportion of Th2 cells detected by flow cytometry was (5.1±0.8)% in group A, (5.1±1.3)% in Group B, (5.4±0.9)% in group C, and (3.6±0.9)% in group D. The proportion of Th2 cells in groups A, B, and C was higher than that in group D, and the differences were statistically significant (all P<0.05). The proportion of Th17 cells detected by flow cytometry was (1.5±0.6)% in group A, (8.6±1.3)% in group B, (8.2±1.5)% in group C, and (1.7±0.3)% in group D. The proportion of Th17 cells in both group B and group C was higher than that in group A and group D, and the differences were statistically significant (all P<0.001). The proportion of Treg cells detected by flow cytometry was (7.0±0.9)% in group B, (6.8±0.9)% in group C, (3.8±0.8)% in group D, and (0.9±0.2)% in group A. The proportion of Treg in group B and group C was higher than that in group A and group D, and the difference was statistically significant (all P<0.001). Conclusion:Nanosecond pulse ablation for liver cancer in mice can regulate CD 4+ T cell subsets in peripheral blood, enhance the immune response of Th1 cells, inhibit the expression of Th2, Th17 and Treg cells, and improve the immunosuppressive state caused by liver cancer.

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.

Objective To explore the effect of enhanced recovery after surgery(ERAS)nursing combined with isokinetic muscle strength visual feedback training on postoperative patients with knee joint injury.Methods A total of 100 patients with knee joint injury who were treated in 909th Hospital(Southeast Hospital Affiliated of Xiamen University)from May 2022 to May 2023 were selected as the subjects.According to a random number table method,the patients were divided into control group(n=50)and observation group(n=50).The control group received ERAS nursing,and observation group received isokinetic muscle strength visual feedback training on the basis of control group.The pain,knee function recovery,quality of life and complications of two groups were compared.Results At 1 day,1 month,3 months and 6 months after operation,the pain visual analogue scale scores of observation group were lower than those of control group(P＜0.05).At 6 months after operation,the scores of knee joint function scale and World Health Organization quality of life scale in two groups were higher than before operation,and observation group were higher(P＜0.05).The total incidence of complications in observation group was lower than chat in control group(P＜0.05).Conclusion ERAS nursing combined with isokinetic muscle strength visual feedback training can significantly reduce postoperative pain in patients with knee joint injury,effectively promote the recovery of knee joint function.

A retrospective analysis was conducted on a case of recurrence during pregnancy of early-stage endometrial cancer (EEC) after fertility-preserving treatment, and literature review was conducted. The patient underwent two cycles of controlled ovarian stimulation and three cycles of frozen-thawed embryo transfer after fertility-preserving treatment, early abortion after the third transfer and meanwhile the recurrence of endometrial cancer was found. Fertility-preserving retreatment was given after multidisciplinary discussion based on the patient's fertility intention, ultrasound, pelvic magnetic resonance imaging and other examinations. After complete remission, the remaining cryopreserved embryos of the patient were tested for euploidy by preimplantation genetic testing, and the euploid embryo was transferred and delivered at term successfully. Fertility-preserving treatment for patients with EEC need comprehensive management to reduce the recurrence rate. Recurrent patients can choose fertility-preserving retreatment under a comprehensive evaluation.

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.

With the progression of liver cirrhosis， patients often develop sarcopenia and lipid metabolism disorders， and the complex interaction between p sarcopenia and lipid metabolism disorders not only promotes the progression of liver cirrhosis， but also affects the prognosis and quality of life of patients. As an effective intervention for alleviating complications associated with liver cirrhosis， transjugular intrahepatic portosystemic shunt （TIPS） can improve sarcopenia to a certain degree by improving hepatic hemodynamics and reducing portal venous pressure. In addition， there might be varying degrees of changes in blood lipid levels after TIPS， which may be closely associated with the recovery of liver metabolic function and the alterations in hemodynamics. This article introduces the association between liver cirrhosis， sarcopenia， and lipid metabolism disorders， elaborates on the effect of TIPS on sarcopenia and abnormal lipid metabolism， and discusses related mechanism and clinical significance， in order to provide a theoretical basis for clinical treatment.