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.

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.

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.

Purpose To investigate the clinicopathological features,diagnosis,and molecular genetic characteris-tics of central nervous system(CNS)high-grade neuroepithelial tumors with BCOR alterations.Methods Five cases of CNS high-grade neuroepithelial tumors harboring BCOR alterations were collected.Using immunohistochemistry and molecular detection to analyze its clinical and histological characteristics,and review relevant literatures.Results A-mong the 5 patients,3 cases with EP300 ∷ BCOR tumor(male-to-female ratio 2∶1).These tumors were located in supratentorial regions(right temporal lobe,right frontotemporal lobe,and right frontal lobe).The 2 patients with BCOR-ITD tumors were younger,both with tumors located in the left cerebellum.Imaging studies revealed well-defined large mass lesions in all cases.Histologically,all 5 cases tumor exhibited ependymoma-like or oligodendroglioma-like morphology,featuring uniformly oval or round cells.Focal areas showed increased cellular density,nuclear enlarge-ment,and readily identifiable mitotic figures indicative of anaplastic features.A rich capillary network was frequently observed in the stroma.Palisading necrosis,microcystic changes,and microcalcifications were present in 3 cases.Im-munohistochemically,all 5 cases consistently expressed vimentin and CD56,focal Olig-2 positivity,variable S-100 ex-pression,and were uniformly negative for GFAP.BCOR immunostaining was weakly positive in 1 case with an EP300∷ BCOR fusion and strongly positive in 2 cases with BCOR-ITD.NGS identified an EP300 ∷ BCOR fusion in 3 cases,and Sanger sequencing confirmed the ITD in exon 15 of BCOR gene in 2 cases.During a follow-up period of 8 to 77 months,one pediatric patient with a BCOR-ITD tumor died,while the remaining four patients were alive with no evi-dence of recurrence or metastasis.Conclusion BCOR-ITD and EP300 ∷ BCOR fusion tumors are similar in morphology and immunophenotype,and the incidence rate of BCOR fusion tumors may be underestimated.NGS sequencing based on DNA and RNA and DNA methylation spectrum analysis are helpful for accurate diagnosis of this type of tumor.

Radiotherapy is a crucial component of the treatment of tumors. In addition to directly causing DNA damage in tumor cells and inducing cell apoptosis, radiotherapy is also involved in the regulation of systemic immune status. Increasing evidence indicates that radiotherapy can remodel the tumor immune microenvironment (TIME) and reverse the immunosuppressive state, thereby enhancing anti-tumor effects and demonstrating stronger immune responses and therapeutic benefits when combined with immune checkpoint inhibitors. Taking lung cancer as an example to explore the impacts and potential mechanisms of radiotherapy on the TIME and anti-tumor immunity, which can provide a scientific basis for optimizing the treatment strategies of lung cancer.

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.

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.

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.

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.

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.