Objective:To analyze the cytological, histological, immunohistochemical, and molecular pathological features of hyalinizing trabecular tumor (HTT).Methods:Clinical and pathological data of the HTT cases diagnosed at Shanghai Sixth People′s Hospital affiliated to Shanghai Jiao Tong University School of Medicine between 2020 and 2024 were collected and analyzed. HE staining, special staining, immunohistochemical staining, and next-generation sequencing were performed on all cases.Results:Among the 10 HTT patients, 4 were male and 6 were female. The age at onset ranged from 29 to 85 years, with a median age of 49 (35,61) years. The maximum tumor diameter ranged from 0.3 to 5.3 cm. Cytologically, the smears were hypercellular and showed tumor cells arranged in nested clusters with visible basement membrane-like material. The nuclei were oval with finely granular chromatin, and nuclear pseudoinclusions were readily identifiable. Histologically, the tumors were well demarcated. The tumor cells were arranged in a paraganglioma-like pattern, exhibiting typical nuclear features of papillary thyroid carcinoma and psammoma bodies. Yellow bodies were observed in the cytoplasm. The stroma was rich in hyalinized material, which was periodic acid-Schiff stain (PAS)-positive. Immunohistochemically, the tumor cells showed diffuse expression of TTF-1 and focal expression of thyroglobulin. Aberrant immunoreaction with Ki-67 was present in the cytoplasm and membrane of the tumor cells. Molecular testing was performed on 8 cases. The PAX8-GLIS3 gene fusion was detected in 7 cases. Among these fusion-positive cases, 4 exhibited additional genetic abnormalities: one concurrent TSHR point mutation (p.D617H); one concurrent HRAS point mutation (p.Q61R); one concurrent LRP1B point mutation (p.S1752L), SUGCT point mutation (p.K137), and TERT point mutation (p.P785L); one concurrent MTOR mutation (7528+27A>T) and FLT3 mutation (p.E77K). The key initiating factors for thyroid carcinoma, including the BRAF V600E mutation and RET rearrangements, were absent in all cases tested.Conclusions:Cellular pleomorphism, yellow bodies and basement membrane-like material constitute important cytological and histological features for the differential diagnosis of HTT. Immunophenotypically, thyroglobulin may show focal expression, while Ki-67 is typically localized in the tumor cell membrane and cytoplasm. This study also demonstrates that PAX8-GLIS3 fusion is a characteristic molecular abnormality in HTT, although cases with wild type of GLIS gene may also present. Although rare, HTT may harbor point mutations in HRAS and TSHR, and other uncommon genetic alterations.

Objective:To investigate the role of iron death in paraquat (PQ) -induced alveolar epithelial mesangialization (EMT) .Methods:In August 2023, the appropriate PQ staining concentration as well as the intervention concentration of lipoinhibitor-1 (Lip-1) were screened by CCK8 method. The RLE-6TN cells were divided into three groups, which were control group, PQ group and iron death inhibition group, 200 μmol/L PQ solution was given to the PQ group, and PQ 200 μmol/L and 0.1 μmol/L Lip-1 solution was given to the iron death inhibition group, the control group was added the same amount of cell medium. morphological changes and migratory viability of the cells in each group were observed at 12 h, 24 h and 48 h after the poisoning, and the contents of ferrous ions (Fe 2+), reactive oxygen radicals (ROS), glutathione (GSH), superoxide dismutase (SOD), and malondialdehyde (MDA) were detected in each group; meanwhile, qRT-PCR and western-blot were used to determine the molecular expression of E-cadherin, α-smooth muscle actin (α-SMA), and Collagen I in the cells in each group. The difference between group was compared by ANOVA, and the further pairwise comparison was conducted by Bonferroni method. Results:Cell viability was detected using CCK8, and the results showed that the cell survival rate of RLE-6TN cells treated with 200 μmol/L PQ+0.1 μmol/L Lip-1 solution was 56.6%. The migration activity of RLE-6TN cells in the iron death inhibition group was weaker than that in the PQ group after 24 and 48 hours of exposure, and the degree of EMT changes in the cells was reduced compared to the PQ group. After 12, 24, and 48 hours of exposure, the Fe 2+ concentration, ROS fluorescence intensity, and MDA content in the iron death inhibition group decreased compared to the corresponding time points in the PQ group ( P<0.05/3), while compared with PQ group, the GSH concentration and SOD concentration increased compared to the corresponding time points in the PQ group ( P<0.05/3). The results showed that compared with the control group, the expression levels of E-cadherin mRNA and protein in PQ group and iron death inhibition group were both decreased ( P<0.05/3), while compared with PQ group, the expression levels of E-cadherin mRNA and protein in iron death inhibition group were increased ( P<0.05/3) ; Compared with the control group, the expression levels of α-SMA, Collagen I mRNA and protein in PQ group and iron death inhibition group cells increased ( P<0.05/3), while compared with PQ group, the expression levels of α-SMA, Collagen I mRNA and protein in iron death inhibition group cells decreased ( P<0.05/3) . Conclusion:Ferroptosis is involved in the EMT process of alveolar epithelial cells induced by PQ. Inhibiting ferroptosis can reduce cellular oxidative damage and alleviate the degree of cellular EMT.

Objective:To analyze the comparative results of computed tomography(CT)of inter-laboratory,and grasp the existed problems in quality control for CT examination in technical service institution of radiation health,so as to improve the ability of examination,and provide technical support for CT quality control of medical institutions.Methods:Cluster sampling method was used to extract 18 institutions with radiological health technical service,which took part in the inter-laboratory comparison for CT examination ability in Guangzhou city in December 2023.A total of 6 items,which included weighted CT dose index(CTDIw),CT value(water),noise,uniformity,high contrast resolution,and low contrast detectability,were used as the compared items.The method that single evaluation combined with comprehensive evaluation was used to analyze the submitted comparative data.The evaluation of single comparative index adopted"satisfaction","basic satisfaction"and"nonsatisfaction"to conduct evaluation,and the comprehensive evaluation used"excellent","favorable","qualified"and"unqualified"to conduct evaluation.Results:In terms of single evaluation,18 institutions with technical service participated in the comparison of 108 indicators,of which 85 items(accounting for 78.7%)were"satisfaction",and 21 items(accounting for 19.4%)were"basic satisfaction",and 2 items(accounting for 1.9%)were"nonsatisfaction".In terms of comprehensive evaluation,the result of comprehensive evaluation of 6 institutions(accounting for 33.3%)was"excellent",and that of 6 institutions(accounting for 33.3%)was"favorable",and that of 4 institutions(accounting for 22.2%)was"qualified",and that of 2 institutions(accounting for 11.1%)was"nonqualified"in the 18 technical service institutions that took part in the comparison.Conclusion:The testing capabilities and levels of various institutions with radiation health technology service for CT quality control are uneven,and there are unqualified situation in part of detection indicators.Therefore,it is necessary to pay attention to the training for the detection ability of technical personnel,and improve their detection skills to ensure the quality of technical services.

Objective To investigate the executive condition of Enhanced Recovery After Surgery(ERAS)measures among the hospitalized surgical patients in secondary and tertiary medical institutions of Chongqing City.Methods Using a multicenter cross-sectional survey approach,patients undergoing elective surgeries admitted and treated in 40 member units under the Chongqing Anesthesiology and Perioperative Medicine Specialized Alliance from July 11 to 30,2024 were selected as the survey subjects.Adherence to and completion of ERAS measures were calculated.Factors influencing measures with low completion rates were analyzed.Results A total of 2 100 questionnaires were issued,1 708 effective questionnaires were recovered with an effective recovery rate of 81.33％.Among them,there were 1 017 questionnaires in the tertiary medi-cal institutions and 691 questionnaires in the secondary medical institutions.The age of 1 708 patients ranged from 19-78 years old with a median age of 52 years old.Females were dominant.The proportion of patients from gastrointestinal surgery and those with secondary school education or above was high.Hypertension and diabetes were the main complication types.The surgical grade was concentrated at grades Ⅲ and Ⅳ.The ASA grading was concentrated at the grade Ⅰ/Ⅱ.The NYHA heart function grade was mainly the grade Ⅰ/Ⅱ.The ERAS measures compliance rate ranged from 36.36％to 95.45％,averaged 73.47％.The compliance rate of ERAS measures in the tertiary hospitals was higher than that in the secondary hospitals(75.82％vs.70.01％),and the difference was statistically significant(P<0.05).The average completion rate of ERAS measures was 74.08％.The top three in the completion rate were preoperative education(95.78％),preven-tive antibiotics and skin preparation(92.62％),and preoperative interview and evaluation(88.58％).The completion rates of Prehabilitation(55.27％)and preoperative fasting(57.67％)urgently needed to be in-creased.The completion rate of other measures was lower than 60％.Conclusion The compliance rate of ERAS measures needs to be increased,moreover there are significant differences among various hospitals.Fu-ture practices should focus on two measures:preoperative pre-rehabilitation exercises and preoperative oral intake of carbohydrates.

Objective:To analyze the comparative results of computed tomography(CT)of inter-laboratory,and grasp the existed problems in quality control for CT examination in technical service institution of radiation health,so as to improve the ability of examination,and provide technical support for CT quality control of medical institutions.Methods:Cluster sampling method was used to extract 18 institutions with radiological health technical service,which took part in the inter-laboratory comparison for CT examination ability in Guangzhou city in December 2023.A total of 6 items,which included weighted CT dose index(CTDIw),CT value(water),noise,uniformity,high contrast resolution,and low contrast detectability,were used as the compared items.The method that single evaluation combined with comprehensive evaluation was used to analyze the submitted comparative data.The evaluation of single comparative index adopted"satisfaction","basic satisfaction"and"nonsatisfaction"to conduct evaluation,and the comprehensive evaluation used"excellent","favorable","qualified"and"unqualified"to conduct evaluation.Results:In terms of single evaluation,18 institutions with technical service participated in the comparison of 108 indicators,of which 85 items(accounting for 78.7%)were"satisfaction",and 21 items(accounting for 19.4%)were"basic satisfaction",and 2 items(accounting for 1.9%)were"nonsatisfaction".In terms of comprehensive evaluation,the result of comprehensive evaluation of 6 institutions(accounting for 33.3%)was"excellent",and that of 6 institutions(accounting for 33.3%)was"favorable",and that of 4 institutions(accounting for 22.2%)was"qualified",and that of 2 institutions(accounting for 11.1%)was"nonqualified"in the 18 technical service institutions that took part in the comparison.Conclusion:The testing capabilities and levels of various institutions with radiation health technology service for CT quality control are uneven,and there are unqualified situation in part of detection indicators.Therefore,it is necessary to pay attention to the training for the detection ability of technical personnel,and improve their detection skills to ensure the quality of technical services.

Objective:To investigate influence of different phantoms on the results of quality control for the images of cone beam computed tomography(CBCT)for breast on the basis of quality control for breast CBCT.Methods:Five different manufacturers'phantoms were selected,and they were placed at the position of testing breast in clinical examination to conduct position for phantom according to the method of the national health industry standard WS 818-2023.The analysis focused on the differences of evaluation results of using different phantoms for image quality on the basis of a series of parameters included uniformity,resolution of high contrast,resolution of low contrast,and CT value of water in scanning images of different phantoms.Data collection and image reconstruction were performed respectively by using commonly clinical procedures.Corresponding module images were selected from the reconstructed images of standard breast phantom.The common layer thickness and projection method of the system were set to record and analyze data.Results:The image uniformity of measured results of the five phantoms were respectively 42.37±2.01,-5.83±0.15,3.76±0.15,2.16±0.06,3.60±0.10.The differences of the image uniformities among the five phantoms were statistically significant(F=1310.02,P<0.001),and the differences of the CT values of the measured water among the five phantoms were statistically significant(F=9 846.46,P<0.001).The differences in the resolution of low contrast among them were also statistically significant(F=27.50,P<0.001).However,the results of the resolution of high contrast were stability,and there was no significant difference in that among the five phantoms.Conclusion:The measured results of quality control of different phantoms are different.

Objective:To analyze the cytological, histological, immunohistochemical, and molecular pathological features of hyalinizing trabecular tumor (HTT).Methods:Clinical and pathological data of the HTT cases diagnosed at Shanghai Sixth People′s Hospital affiliated to Shanghai Jiao Tong University School of Medicine between 2020 and 2024 were collected and analyzed. HE staining, special staining, immunohistochemical staining, and next-generation sequencing were performed on all cases.Results:Among the 10 HTT patients, 4 were male and 6 were female. The age at onset ranged from 29 to 85 years, with a median age of 49 (35,61) years. The maximum tumor diameter ranged from 0.3 to 5.3 cm. Cytologically, the smears were hypercellular and showed tumor cells arranged in nested clusters with visible basement membrane-like material. The nuclei were oval with finely granular chromatin, and nuclear pseudoinclusions were readily identifiable. Histologically, the tumors were well demarcated. The tumor cells were arranged in a paraganglioma-like pattern, exhibiting typical nuclear features of papillary thyroid carcinoma and psammoma bodies. Yellow bodies were observed in the cytoplasm. The stroma was rich in hyalinized material, which was periodic acid-Schiff stain (PAS)-positive. Immunohistochemically, the tumor cells showed diffuse expression of TTF-1 and focal expression of thyroglobulin. Aberrant immunoreaction with Ki-67 was present in the cytoplasm and membrane of the tumor cells. Molecular testing was performed on 8 cases. The PAX8-GLIS3 gene fusion was detected in 7 cases. Among these fusion-positive cases, 4 exhibited additional genetic abnormalities: one concurrent TSHR point mutation (p.D617H); one concurrent HRAS point mutation (p.Q61R); one concurrent LRP1B point mutation (p.S1752L), SUGCT point mutation (p.K137), and TERT point mutation (p.P785L); one concurrent MTOR mutation (7528+27A>T) and FLT3 mutation (p.E77K). The key initiating factors for thyroid carcinoma, including the BRAF V600E mutation and RET rearrangements, were absent in all cases tested.Conclusions:Cellular pleomorphism, yellow bodies and basement membrane-like material constitute important cytological and histological features for the differential diagnosis of HTT. Immunophenotypically, thyroglobulin may show focal expression, while Ki-67 is typically localized in the tumor cell membrane and cytoplasm. This study also demonstrates that PAX8-GLIS3 fusion is a characteristic molecular abnormality in HTT, although cases with wild type of GLIS gene may also present. Although rare, HTT may harbor point mutations in HRAS and TSHR, and other uncommon genetic alterations.

Objective:To investigate the role of iron death in paraquat (PQ) -induced alveolar epithelial mesangialization (EMT) .Methods:In August 2023, the appropriate PQ staining concentration as well as the intervention concentration of lipoinhibitor-1 (Lip-1) were screened by CCK8 method. The RLE-6TN cells were divided into three groups, which were control group, PQ group and iron death inhibition group, 200 μmol/L PQ solution was given to the PQ group, and PQ 200 μmol/L and 0.1 μmol/L Lip-1 solution was given to the iron death inhibition group, the control group was added the same amount of cell medium. morphological changes and migratory viability of the cells in each group were observed at 12 h, 24 h and 48 h after the poisoning, and the contents of ferrous ions (Fe 2+), reactive oxygen radicals (ROS), glutathione (GSH), superoxide dismutase (SOD), and malondialdehyde (MDA) were detected in each group; meanwhile, qRT-PCR and western-blot were used to determine the molecular expression of E-cadherin, α-smooth muscle actin (α-SMA), and Collagen I in the cells in each group. The difference between group was compared by ANOVA, and the further pairwise comparison was conducted by Bonferroni method. Results:Cell viability was detected using CCK8, and the results showed that the cell survival rate of RLE-6TN cells treated with 200 μmol/L PQ+0.1 μmol/L Lip-1 solution was 56.6%. The migration activity of RLE-6TN cells in the iron death inhibition group was weaker than that in the PQ group after 24 and 48 hours of exposure, and the degree of EMT changes in the cells was reduced compared to the PQ group. After 12, 24, and 48 hours of exposure, the Fe 2+ concentration, ROS fluorescence intensity, and MDA content in the iron death inhibition group decreased compared to the corresponding time points in the PQ group ( P<0.05/3), while compared with PQ group, the GSH concentration and SOD concentration increased compared to the corresponding time points in the PQ group ( P<0.05/3). The results showed that compared with the control group, the expression levels of E-cadherin mRNA and protein in PQ group and iron death inhibition group were both decreased ( P<0.05/3), while compared with PQ group, the expression levels of E-cadherin mRNA and protein in iron death inhibition group were increased ( P<0.05/3) ; Compared with the control group, the expression levels of α-SMA, Collagen I mRNA and protein in PQ group and iron death inhibition group cells increased ( P<0.05/3), while compared with PQ group, the expression levels of α-SMA, Collagen I mRNA and protein in iron death inhibition group cells decreased ( P<0.05/3) . Conclusion:Ferroptosis is involved in the EMT process of alveolar epithelial cells induced by PQ. Inhibiting ferroptosis can reduce cellular oxidative damage and alleviate the degree of cellular EMT.

Objective:To investigate influence of different phantoms on the results of quality control for the images of cone beam computed tomography(CBCT)for breast on the basis of quality control for breast CBCT.Methods:Five different manufacturers'phantoms were selected,and they were placed at the position of testing breast in clinical examination to conduct position for phantom according to the method of the national health industry standard WS 818-2023.The analysis focused on the differences of evaluation results of using different phantoms for image quality on the basis of a series of parameters included uniformity,resolution of high contrast,resolution of low contrast,and CT value of water in scanning images of different phantoms.Data collection and image reconstruction were performed respectively by using commonly clinical procedures.Corresponding module images were selected from the reconstructed images of standard breast phantom.The common layer thickness and projection method of the system were set to record and analyze data.Results:The image uniformity of measured results of the five phantoms were respectively 42.37±2.01,-5.83±0.15,3.76±0.15,2.16±0.06,3.60±0.10.The differences of the image uniformities among the five phantoms were statistically significant(F=1310.02,P<0.001),and the differences of the CT values of the measured water among the five phantoms were statistically significant(F=9 846.46,P<0.001).The differences in the resolution of low contrast among them were also statistically significant(F=27.50,P<0.001).However,the results of the resolution of high contrast were stability,and there was no significant difference in that among the five phantoms.Conclusion:The measured results of quality control of different phantoms are different.

Objective:To investigate the role of connective tissue growth factor (CTGF) and PI3K/Akt signaling pathways in paraquat (PQ) -induced alterations in alveolar epithelial cell mesenchymalization (EMT) .Methods:In February 2023, RLE-6TN cells were divided into 2 groups, which were set as uncontaminated group and contaminated group (200 μmol/L PQ), and cellular EMT alteration, CTGF and PI3K/Akt signaling pathway related molecules expression were detected by cell scratch assay, qRT-PCR and western-blot assay. Using shRNA interference technology to specifically inhibit the expression of CTGF, RLE-6TN cells were divided into four groups: control group, PQ group (200 μmol/L PQ), interference group (transfected with a plasmid with shRNA-CTGF+200 μmol/L PQ), and null-loaded group (transfected with a plasmid with scramble- CTGF+200 μmol/L PQ), qRT-PCR and western blot were used to examine the alteration of the cellular EMT and the expression of molecules related to the activity of PI3K/Akt pathway. The PI3K/Akt signaling pathway was blocked by the PI3K inhibitor LY294002, and the expression of EMT-related molecules in cells of the control group, PQ group (200 μmol/L PQ), and inhibitor group (200 μmol/L PQ+20 μmol/L LY294002) was examined by qRT-PCR and western blot.The t-test was used to compare the differences between the two groups, while the analysis of variance (ANOVA) was applied to compare the differences among multiple groups. For further pairwise comparisons, the Bonferroni method was adopted.Results:The results of cell scratch test showed that compared with the uncontaminated group, RLE-6TN cells in the contaminated group had faster migration rate, lower mRNA and protein expression levels of E-Cadherin, and higher mRNA and protein expression levels of α-SMA, CTGF, PI3K and Akt, with statistical significance ( P<0.05). After specific inhibition of CTGF expression, the mRNA and protein expression of CTGF, PI3K, Akt, and α-SMA in the cells of the interference group were significantly lower than that of the PQ group and the null-loaded group ( P<0.05/6), whereas that of E-Cadherin was higher than that of the PQ group and the null-loaded group ( P<0.05/6). Specifically blocking the PI3K/Akt signaling pathway, the mRNA and protein expression of PI3K, Akt and α-SMA in the cells of the inhibitor group was decreased compared with that of the PQ group ( P<0.05/3), while the expression of E-Cadherin was elevated compared with that of the PQ group ( P<0.05/3) . Conclusion:CTGF may promote PQ-induced alveolar epithelial cell EMT through activation of the PI3K/Akt signaling pathway. Inhibition of CTGF expression or blockade of PI3K/Akt signaling pathway activity can alleviate the extent of PQ-induced alveolar epithelial cell EMT.