1.Knowledge map and visualization analysis of pulmonary nodule/early-stage lung cancer prediction models
Yifeng REN ; Qiong MA ; Hua JIANG ; Xi FU ; Xueke LI ; Wei SHI ; Fengming YOU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(01):100-107
Objective To reveal the scientific output and trends in pulmonary nodules/early-stage lung cancer prediction models. Methods Publications on predictive models of pulmonary nodules/early lung cancer between January 1, 2002 and June 3, 2023 were retrieved and extracted from CNKI, Wanfang, VIP and Web of Science database. CiteSpace 6.1.R3 and VOSviewer 1.6.18 were used to analyze the hotspots and theme trends. Results A marked increase in the number of publications related to pulmonary nodules/early-stage lung cancer prediction models was observed. A total of 12581 authors from 2711 institutions in 64 countries/regions published 2139 documents in 566 academic journals in English. A total of 282 articles from 1256 authors were published in 176 journals in Chinese. The Chinese and English journals which published the most pulmonary nodules/early-stage lung cancer prediction model-related papers were Journal of Clinical Radiology and Frontiers in Oncology, respectively. Chest was the most frequently cited journal. China and the United States were the leading countries in the field of pulmonary nodules/early-stage lung cancer prediction models. The institutions represented by Fudan University had significant academic influence in the field. Analysis of keywords revealed that multi-omics, nomogram, machine learning and artificial intelligence were the current focus of research. Conclusion Over the last two decades, research on risk-prediction models for pulmonary nodules/early-stage lung cancer has attracted increasing attention. Prognosis, machine learning, artificial intelligence, nomogram, and multi-omics technologies are both current hotspots and future trends in this field. In the future, in-depth explorations using different omics should increase the sensitivity and accuracy of pulmonary nodules/early-stage lung cancer prediction models. More high-quality future studies should be conducted to validate the efficacy and safety of pulmonary nodules/early-stage lung cancer prediction models further and reduce the global burden of lung cancer.
2.Recent advances in the application of three dimensional reconstruction techniques in surgical treatment of early lung cancer
Tao LONG ; Zhengbing REN ; Aizhong SHAO ; Zhicheng HE ; Weibing WU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(01):121-128
Lung cancer is the leading cause of death worldwide. With the prevalence of CT screening and early diagnosis and treatment of lung cancer in China, more and more patients with early-stage lung cancer characterized with ground-glass opacity are discovered and urgently require treatment, which poses a significant challenge to surgeons. As an emerging technology, three dimensional reconstruction technology plays a crucial auxiliary role in clinical work. This review aims to briefly introduce this technology, focusing on its latest advances in surgical applications in early lung cancer screening, malignant risk assessment, and perioperative period application and medical education.
3.Recognition of breath odor map of benign and malignant pulmonary nodules and Traditional Chinese Medicine syndrome elements based on electronic nose combined with machine learning: An observational study in a single center
Shiyan TAN ; Qiong ZENG ; Hongxia XIANG ; Qian WANG ; Xi FU ; Jiawei HE ; Liting YOU ; Qiong MA ; Fengming YOU ; Yifeng REN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(02):185-193
Objective To explore the recognition capabilities of electronic nose combined with machine learning in identifying the breath odor map of benign and malignant pulmonary nodules and Traditional Chinese Medicine (TCM) syndrome elements. Methods The study design was a single-center observational study. General data and four diagnostic information were collected from 108 patients with pulmonary nodules admitted to the Department of Cardiothoracic Surgery of Hospital of Chengdu University of TCM from April 2023 to March 2024. The patients' TCM disease location and nature distribution characteristics were analyzed using the syndrome differentiation method. The Cyranose 320 electronic nose was used to collect the odor profiles of oral exhalation, and five machine learning algorithms including random forest (RF), K-nearest neighbor (KNN), logistic regression (LR), support vector machine (SVM), and eXtreme gradient boosting (XGBoost) were employed to identify the exhaled breath profiles of benign and malignant pulmonary nodules and different TCM syndromes. Results (1) The common disease locations in pulmonary nodules were ranked in descending order as liver, lung, and kidney; the common disease natures were ranked in descending order as Yin deficiency, phlegm, dampness, Qi stagnation, and blood deficiency. (2) The electronic nose combined with the RF algorithm had the best efficacy in identifying the exhaled breath profiles of benign and malignant pulmonary nodules, with an AUC of 0.91, accuracy of 86.36%, specificity of 75.00%, and sensitivity of 92.85%. (3) The electronic nose combined with RF, LR, or XGBoost algorithms could effectively identify the different TCM disease locations and natures of pulmonary nodules, with classification accuracy, specificity, and sensitivity generally exceeding 80.00%.Conclusion Electronic nose combined with machine learning not only has the potential capabilities to differentiate the benign and malignant pulmonary nodules, but also provides new technologies and methods for the objective diagnosis of TCM syndromes in pulmonary nodules.
4.Research on the goals and strategies of effective doctor-patient communication from the perspective of information ecology theory
Huayang SUN ; Dongmei ZHAO ; Sujuan REN
Chinese Medical Ethics 2025;38(1):109-115
Doctor-patient communication not only depends on the medical group but is also affected by the patient group and the specific situation. Effective doctor-patient communication requires the doctors to improve their communication skills, the patients to have relevant knowledge regarding a certain symptom or disease, and mutual trust between the doctor and patient. The information ecology theory mainly analyzes the relationships between various ecological elements and the ecological development mechanisms in the process of information activities from the perspective of the ecosystem, as well as attaches importance to the mutual influences and roles of information subjects and objects, information contents, information environment, and information technology within the system, which is consistent with the influencing factors of doctor-patient communication. Based on the information ecology theory, this paper analyzed the new problems faced by doctor-patient communication under the information technology environment from the four dimensions, including information subjects and objects, information itself, information context, and information technology. It was proposed that effective doctor-patient communication required to re-examine the influencing factors of doctor-patient communication, as well as construct a doctor-patient community, including a community of knowledge, communication, emotion, and interest, so that the four factors of doctor-patient communication can form a new balance in the dynamic development, with a view to providing practical guidance for doctor-patient trust and effective doctor-patient communication.
5.Exploration of the Intervention Mechanism of Qingshi Anti-itch Ointment (青石止痒软膏) on Psoriasis Model Mice Based on Caspase-1/GSDMD Protein Pathway
Yatong LI ; Yuanwen LI ; Yutong DENG ; Xuewen REN ; Xuewan WANG ; Xinhui YU ; Tangyunni LIU
Journal of Traditional Chinese Medicine 2025;66(2):170-177
ObjectiveTo explore the possible action mechanism of Qingshi Anti-itch Ointment (青石止痒软膏, QAO) in the treatment of psoriasis. MethodsForty mice were randomly divided into four groups, blank group, model group, calcipotriol group and QAO group, with 10 mice in each group. Except for the blank group, psoriasis was induced by applying imiquimod cream to the dorsal skin. After modeling for 6 hours daily, the calcipotriol group and QAO group were treated with 0.5 g of calcipotriol ointment or 0.5 g of QAO, respectively, applied to the treated dorsal skin. The blank group and the model group received no treatment. The skin lesions were observed, and the psoriasis area and severity index (PASI) score was assessed every other day. After 7 days, Hematoxylin and Eosin (HE) staining was performed on dorsal skin tissue to observe pathological changes. The levels of interleukin 1β (IL-1β) and interleukin 18 (IL-18) were determined by enzym-linked immunosorbent assay (ELISA). The protein levels of Caspase-1,Pro-Caspase-1, gasdermin D (GSDMD) and gasdermin-D-N (GSDMD-N) were detected by Western Blot (WB). The protein levels of GSDMD were observed by immunohistochemistry. ResultsCompared with the blank group, the model group mice showed redness, erythema, and white scales on their skin, with histological observations indicating epidermal thickening, elongated spines, and infiltration of inflammatory cells. The PASI scores of the skin tissue on days 1, 3, 5, and 7 were elevated; the IOD and AOD values of GSDMD protein increased; the protein levels of Caspase-1, Pro-Caspase-1,GSDMD, GSDMD-N, and IL-1β and IL-18 were significantly elevated (P<0.05 or P<0.01). Compared with the model group, the QAO group and calcipotriol group showed lighter skin lesions; the PASI scores on day 5 and day 7 in the QAO group, and on day 3, 5, and 7 in the calcipotriol group, were reduced; the IOD and AOD values of GSDMD protein, and the protein level of Caspase-1, GSDMD, and GSDMD-N, as well as level of IL-18 and IL-1β decreased in both groups; in the calcipotriol group, Pro-Caspase-1 protein level also decreased (P<0.05 or P<0.01). Compared with the calcipotriol group, the QAO group showed slightly redder skin, more obvious thickening of the stratum corneum, and less capillary dilation; the PASI scores on day 3 and day 7 increased, while the score on day 5 was reduced; the protein level of Pro-Caspase-1, GSDMD, GSDMD-N, and the level of IL-18 and IL-1β were increased in the QAO group (P<0.05). ConclusionQAO can effectively relieve psoriasis dermatitis in mice. Its potential mechanism may be related to the regulation of the Caspase-1/GSDMD protein pathway, down-regulation of IL-18 and IL-1β levels, and alleviation of pyroptosis.
6.Textual Research of Key Information of Classic Formula Xieqingwan Based on Ancient and Modern Literature
Yujie CHANG ; Lyuyuan LIANG ; Jialei CAO ; Xinghang LYU ; Wenxi WEI ; Xiaofang WANG ; Huizhen ZHANG ; Sai REN ; Mengqi WANG ; Bingqi WEI ; Bingxiang MA
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):226-234
ObjectiveThis paper aims to systematically collect and organize ancient and modern clauses and studies containing Xieqingwan, excavate and analyze the key information of Xieqingwan, and provide a reference for facilitating the development of the classic formula Xieqingwan. MethodsThe composition, dosage, decocting methods, usage, and other key information of Xieqingwan in ancient traditional Chinese medicine books were collected and analyzed by means of literature research and metrological methods. The modern clinical application of Xieqingwan was summarized. ResultsA total of 42 pieces of effective data involving 32 ancient traditional Chinese medicine books were collected. Xieqingwan was first recorded in Xiaoer Yaozheng Zhijue. The drug origin of this formula is basically clear in the ancient traditional Chinese medicine books. The modern drug usage and decocting method were as follows: Angelicae Sinensis Radix, Gentianae Radix et Rhizoma, Chuanxiong Rhizoma, Gardenia seeds, Radix et Rhizoma Rhei, Notopterygii Rhizoma et Radix, and Saposhnikoviae Radix were grounded to fine powder, decocted with honey, and finally formed into pills with the size of a chicken head (1.5 g). It was suggested that half a pill or one pill were taken for one dose with warm Lophatheri decoction and sugar. The indications and clinical application had developed from the recordings in Xiaoer Yaozheng Zhijue and evolved from pediatrics to ophthalmic otolaryngology, neurology, dermatology, digestion, and respiratory diseases. The main pathogenesis of these diseases is heat in the liver meridian and is treated. The effect of Xieqingwan is "clearing away heat and toxicity, removing fire and relaxing the bowels, and dispersing swelling and relieving pain". It is recommended to use the corresponding preparation methods in the 2020 Edition of Pharmacopoeia of the People's Republic of China. Modern clinical studies are centered around the clinical application of Xieqingwan, which is often modified and used in treating Tourette syndrome, herpes, febrile convulsion, sleepwalking, and insomnia. ConclusionThis paper conducts a thorough textual research of the key information of Xieqingwan, induces its historic evolution, and confirms its key information, so as to provide a reference for the future development of Xieqingwan.
7.Acute Inflammatory Pain Induces Sex-different Brain Alpha Activity in Anesthetized Rats Through Optically Pumped Magnetometer Magnetoencephalography
Meng-Meng MIAO ; Yu-Xuan REN ; Wen-Wei WU ; Yu ZHANG ; Chen PAN ; Xiang-Hong LIN ; Hui-Dan LIN ; Xiao-Wei CHEN
Progress in Biochemistry and Biophysics 2025;52(1):244-257
ObjectiveMagnetoencephalography (MEG), a non-invasive neuroimaging technique, meticulously captures the magnetic fields emanating from brain electrical activity. Compared with MEG based on superconducting quantum interference devices (SQUID), MEG based on optically pump magnetometer (OPM) has the advantages of higher sensitivity, better spatial resolution and lower cost. However, most of the current studies are clinical studies, and there is a lack of animal studies on MEG based on OPM technology. Pain, a multifaceted sensory and emotional phenomenon, induces intricate alterations in brain activity, exhibiting notable sex differences. Despite clinical revelations of pain-related neuronal activity through MEG, specific properties remain elusive, and comprehensive laboratory studies on pain-associated brain activity alterations are lacking. The aim of this study was to investigate the effects of inflammatory pain (induced by Complete Freund’s Adjuvant (CFA)) on brain activity in a rat model using the MEG technique, to analysis changes in brain activity during pain perception, and to explore sex differences in pain-related MEG signaling. MethodsThis study utilized adult male and female Sprague-Dawley rats. Inflammatory pain was induced via intraplantar injection of CFA (100 μl, 50% in saline) in the left hind paw, with control groups receiving saline. Pain behavior was assessed using von Frey filaments at baseline and 1 h post-injection. For MEG recording, anesthetized rats had an OPM positioned on their head within a magnetic shield, undergoing two 15-minute sessions: a 5-minute baseline followed by a 10-minute mechanical stimulation phase. Data analysis included artifact removal and time-frequency analysis of spontaneous brain activity using accumulated spectrograms, generating spectrograms focused on the 4-30 Hz frequency range. ResultsMEG recordings in anesthetized rats during resting states and hind paw mechanical stimulation were compared, before and after saline/CFA injections. Mechanical stimulation elevated alpha activity in both male and female rats pre- and post-saline/CFA injections. Saline/CFA injections augmented average power in both sexes compared to pre-injection states. Remarkably, female rats exhibited higher average spectral power 1 h after CFA injection than after saline injection during resting states. Furthermore, despite comparable pain thresholds measured by classical pain behavioral tests post-CFA treatment, female rats displayed higher average power than males in the resting state after CFA injection. ConclusionThese results imply an enhanced perception of inflammatory pain in female rats compared to their male counterparts. Our study exhibits sex differences in alpha activities following CFA injection, highlighting heightened brain alpha activity in female rats during acute inflammatory pain in the resting state. Our study provides a method for OPM-based MEG recordings to be used to study brain activity in anaesthetized animals. In addition, the findings of this study contribute to a deeper understanding of pain-related neural activity and pain sex differences.
8.Effect of Modified Chunzetang on Bladder Fibrosis and Detrusor Function in Rats with Neurogenic Bladder Urinary Retention Induced by Spinal Cord Injury via Regulating NF-κB/TGF-β1 Signaling Pathway
Zhenhua XU ; Yanjie LI ; Yafeng REN ; Haoyuan LIU ; Bochao ZHU ; Juan LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):95-103
ObjectiveTo investigate the therapeutic effect and mechanism of modified Chunzetang on bladder fibrosis and detrusor function in rats with neurogenic bladder urinary retention induced by spinal cord injury. MethodsIn this study, an improved Hassan Shaker spinal cord transection method was used to establish a model of neurogenic bladder urinary retention induced by spinal cord injury, and rats with a spinal cord injury behavior score of 0 were selected for follow-up experiments. The selected rats were randomly divided into a model group (normal saline gavage), low-dose traditional Chinese medicine (TCM) group (gavage of 14.4 g·kg-1 modified Chunzetang), high-dose TCM group (gavage of 28.8 g·kg-1 modified Chunzetang), positive drug group [intraperitoneal injection of 0.05 g·kg-1 nuclear transcription factor-κB (NF-κB) inhibitor pyrrolidine dithiocarbamate (PDTC)], and combination group (intraperitoneal injection of 0.05 g·kg-1 PDTC + gavage of 28.8 g·kg-1 modified Chunzetang). The rats in these groups were administrated with corresponding drugs once a day for four weeks. The BL-420s biofunction acquisition system was used in the experiment to calculate the urodynamic indexes, and the isolated bladder was quickly weighed. The detrusor traction experiment was used to record the minimum bladder contraction tension and frequency in each group. The pathological morphology and tissue fibrosis of detrusor in each group observed by Hematoxycin-eosin (HE) staining and Masson staining were compared. The expression level of α-smooth muscle actin (α-SMA) was detected by immunohistochemistry. Western blot was used to detect the protein expression of NF-κB p65, nuclear transcription factor-κB suppressor protein α (IκBα), transforming growth factor-β1 (TGF-β1), type Ⅰ collagen (ColⅠ), and type Ⅲ collagen (ColⅢ) in bladder tissue of rats in each group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the changes in serum levels of IL-6, IL-1β, and TNF-α. ResultsCompared with that in the sham operation group, the pressure at the urinary leakage point in the model group decreased (P<0.01), and the bladder mass, bladder contractile tension, maximum bladder capacity, and bladder compliance increased (P<0.05,P<0.01). HE staining showed that the arrangement of bladder epithelial cells was disordered, and the pathological manifestations such as mucosa and myometria neutrophil infiltration were obvious. The lamina propria structure was destroyed, and the muscle fiber arrangement was disordered. The interstitial widening and tissue edema were obvious. Masson staining showed that the bladder wall of the model group had more collagen fiber deposition, and the degree of detrusor fibrosis was more severe. The content of detrusor in the visual field was reduced. At the same time, the protein expressions of NF-κB p65, TGF-β1, IκBα, ColⅠ, and ColⅢ in bladder tissue of rats in the model group were significantly increased (P<0.01), and the serum levels of IL-6, IL-1β, and TNF-α were significantly increased (P<0.05). Compared with that in the model group, the pressure at the urinary leakage point in the modified Chunzetang and positive drug groups was increased (P<0.05), and the wet bladder weight, minimum bladder contractile tension, maximum bladder capacity, and bladder compliance were restored (P<0.05, P<0.01). HE and Masson showed that the bladder epithelial cells were relatively neatly arranged, and the structure of the bladder lamina propria was relatively stable. The detrusor bundles were arranged in an orderly manner, and the interstitium was narrow. The degree of tissue edema was relatively low, and the degree of bladder detrusor fibrosis in the modified Chunzetang and positive drug groups was reduced, while the degree of bladder detrusor fibrosis in the positive drug group and combination groups was not obvious. The results of Western blot showed that the expression of NF-κB p65, IκBα, TGF-β1, ColⅠ, and ColⅢ in bladder tissue, as well as the serum levels of IL-6, IL-1β, and TNF-α in modified Chunzetang and positive drug groups were significantly lower, and the expression of bladder tissue-related proteins and the serum levels of IL-6, IL-1β, and TNF-α in the TCM groups decreased significantly with the increase in dose (P<0.05). The results of immunohistochemistry suggested that modified Chunzetang could fully affect the expression of α-SMA in bladder tissue. ConclusionModified Chunzetang can inhibit collagen deposition in bladder tissue of rats with urinary retention induced by spinal cord injury, delay the occurrence and development of bladder fibrosis, and protect the normal contractile function of bladder detrusor, and its mechanism may be related to inhibiting the NF-κB/TGF-β1 signaling pathway, reducing the production of NF-κB p65, IκBα, TGF-β1, ColⅠ, ColⅢ, and other related proteins, and protecting the muscle strength of detrusor.
9.Traditional Chinese Medicine Regulates NF-κB Signaling Pathway for Treatment of Obesity: A Review
Zijing WU ; Jixin LI ; Linjie QIU ; Yan REN ; Chacha ZOU ; Meijie LI ; Wenjie LI ; Jin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):310-318
Obesity is a chronic low-grade inflammation and a risk factor for diseases such as diabetes, hypertension, dyslipidemia, and malignant tumors, demonstrating an increasingly grim development situation. The nuclear factor-kappa B (NF-κB) signaling pathway is a key signaling pathway involved in the immune response and inflammatory response. In obese individuals, the expression of NF-κB is overactivated, which leads to abnormal inflammatory responses in the body. Therefore, it is expected to alleviate inflammation and treat obesity by regulating the NF-κB signaling pathway, which has been proven effective by a large number of studies. The available studies on the NF-κB signaling pathway mostly focus on tumors, and there is no systematic review of the mechanism of this pathway in mediating obesity and the traditional Chinese medicine (TCM) treatment. We reviewed the research progress in the pathological and physiological processes of obesity mediated by NF-κB signaling pathway and TCM treatment, aiming to give insights into the clinical treatment of obesity with TCM and provide reference targets and research directions for exploring the biological foundations and the development of new TCM preparations.
10.DING Ying's Experience in Treating Children with IgA Nephropathy from the Perspective of "Wind-Induced Water Turbidity"
Yudi LI ; Yan XU ; Xiaodan REN ; Wenbo LIU
Journal of Traditional Chinese Medicine 2025;66(3):228-232
To summarize Professor DING Ying's clinical experience in treating children's IgA nephropathy from the perspective of "wind-induced water turbidity". It is believed that the core pathogenesis of IgA nephropathy in children is the wind stimμlating water to become turbidity, and the basic treatment principles are to eliminate wind and settle viscera, and to remove turbidity and drain water. For those with the syndrome of wind-heat invading the lungs and injury to blood collaterals, modified Yinqiao Powder (银翘散) combined with Xiaoji Decoction (小蓟饮子) could be used; for those with dampness-heat in Sanjiao, heavy dampness and light heat pattern, modified Sanren Decoction (三仁汤) combined with Bazheng Powder (八正散) could be used; for those with lung-spleen qi deficiency and kidney essence depletion pattern, modified Buzhong Yiqi Decoction (补中益气汤) combined with Wuzi Yanzong Pill (五子衍宗丸) could be used; for those with deficiency of both qi and yin, kidney deficiency with stasis pattern, self-prescribed Yishen Huazhuo Formula (益肾化浊方) could be used. Meanwhile on the basis of pattern identification and treatment, rattan-type herbs could be combined in use in order to unblock the meridians and collaterals.

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