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.

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.

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.

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.

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.

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.

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.

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 and differential diagnosis of anaplastic large-cell lymphoma(ALCL)with the small cell variant.Methods The clinical data of 15 cases of small cell variant of ALCL were retrospectively analyzed.Hematoxylin-eosin staining,immunohistochemistry,EBER in situ hybridization,TCR and IgG rearrangement were performed.The clinicopathological features,prognosis and differential diagnosis were summarized with review of the literature.Results Among the 15 cases of small cell ALCL,5 were females and 10 were males,with a male-to-female ratio of 2:1.Among the 15 cases of small cell ALCL,14 were systemic ALCL[(12 cases of ALK+),and the age range was 5-63 years old(median age 20 years);There were 2 cases of ALK(-),aged more than 60 years],and 1 case of ALCL of primary cutaneous ALK(-).Microscopic features were dominated by small to medium-sized tumor cells,with irregular nuclear membranes,inconspicuous nucleoli,and a lack of or few iconic large cells.Immunohistochemically:3 cases were ALK-negative and 12 cases were ALK-positive.Tumor cells were CD30 positive in 14/15 cases,CD3 positive in 7/15 cases,CD2 positive in 2/6 cases,CD4 positive in 5/11 cases,CD5 positive in 2/8 cases,CD7 positive in 4/6 cases,CD8 positive in 1/8 cases,TIA-1 positive in 7/7 cases,Granzyme B positive in 4/6 cases and EMA positive in 6/7 cases.CD20 was negative in all cases.Immuno-globulin IgG and TCR gene rearrangement were negative in case 4 and case 11.Case 13 was positive for TCR rear-rangement and negative for immunoglobulin IgG.Twelve of the 15 patients were followed up for 0.7-165 months(me-dian,7 months),3 patients were lost to follow-up and 7 patients died.Conclusion Small cell variant ALCL is easily misdiagnosed as an inflammatory or infectious disease.A group of antibodies,including CD30 and ALK,should be routinely used in routine work,especially in young patients with systemic symptoms and leukemia manifestations or in small biopsies,to reduce misdiagnosis and missed diagnosis.