1.Advances in the multidimensional applications of artificial intelligence in pulmonary nodule management: From early detection to surgical decision support
Zheng ZHOU ; Junhan WU ; Guojie LU ; Guibin QIAO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(12):1786-1791
With the widespread adoption of lung cancer screening and growing public awareness, the detection rate of pulmonary nodules has increased substantially, posing new challenges for clinical management. Artificial intelligence (AI) has emerged as a powerful tool across the entire management spectrum of pulmonary nodules. Beyond improving detection sensitivity and consistency in chest radiographs and low-dose CT, AI has demonstrated promising applications in malignancy risk assessment, molecular subtype prediction, preoperative 3D planning, intraoperative navigation, and postoperative monitoring. This review summarizes recent advances in the application of AI to pulmonary nodule screening, longitudinal evaluation, pathology prediction, multi-omics integration, and perioperative management. It also discusses the technical characteristics, clinical performance, current limitations, and future prospects of various AI models. The continuous development of AI is reshaping the clinical pathway of pulmonary nodules toward more efficient and individualized care.
2.Assessment value of echocardiogram combined with serum hs-CRP and NT-proBNP levels on cardiac function of patients with coronary heart failure
Fengjin LU ; Xin LI ; Meng LI ; Guojie CHENG
China Medical Equipment 2024;21(2):84-88,93
Objective:To explore the assessment value of echocardiogram combined with serum high-sensitivity C-reactive protein(hs CRP)and N-terminal pro brain natriuretic peptide(NT proBNP)levels on cardiac function of patients with coronary heart failure.Methods:A total of 306 patients with coronary heart failure admitted to Beijing Daxing District People's Hospital from November 2021 to November 2022 were selected as the study group.Among of them,144 cases were grade Ⅱ,103 cases were grade Ⅲ and 59 cases were grade Ⅳ as the classification of New York Heart Association(NYHA)for cardiac function.A total of 108 healthy examinees who underwent physical examinations in our hospital during the same period were selected as the healthy control group.All examinees were classified as the NYHA for cardiac function,and left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left ventricular ejection fraction(LVEF),peak ejection rate(PER)and peak filling rate(PFR)of them were measured by echocardiogram.The NT proBNP and hs CRP levels of all examinees were measured.Receiver operating characteristic(ROC)curve was used to analyze the values of single LVEDV,LVESV,LVEF,PER,PFR,hs CRP and NT-proBNP,and the combination of them.Results:LVEDV(122.69±18.24)ml and LVESV(70.79±10.03)ml of the study group were significantly higher than(92.27±15.22)ml and(33.16±7.22)ml of the healthy control group,and the LVEF(42.26±5.13)%,PER(2.49±0.22)EDV/s and PFR(1.79±0.26)EDV/s of the study group were significantly lower than(69.34±5.27)%,(3.56±0.27)EDV/s,and(2.59±0.23)EDV/s of the healthy control group,with statistical significances(t=15.526,35.837,46.828,40.825,28.302,P<0.05),respectively.The levels of hs CRP and NT proBNP of the study group were significantly higher than those of the healthy control group,with statistical significance(t=88.000,29.099,P<0.05),respectively.The LVEDV and LVESV of grade Ⅱ/Ⅲ patients were significantly lower than those of grade Ⅳ patients,while LVEF,PER and PFR of grade Ⅱ/Ⅲ patients were significantly higher than those of grade Ⅳ patients,with statistically significant differences(t=53.391,92.658,32.140,240.474,116.921,P<0.05),respectively.The levels of hs CRP and NT proBNP of grade Ⅱ/Ⅲ patients were significantly lower than those in grade Ⅳ patients,with statistical significance(t=41.037,5.955,P<0.05),respectively.The results of ROC curve analysis showed that the sensitivities of single LVEDV,LVESV,LVEF,PER,PFR,hs CRP,NT proBNP and the combined examination of them were respectively 45.00%,50.00%,70.00%,70.00%,75.00%,70.00%and 90.00%,and the specificities of them were respectively 76.70%,57.00%,82.60%,44.20%,58.10%,52.30%and 96.50%.The area under curve(AUC)values of LVEDV,LVESV,LVEF,PER,PFR,hs CRP,NT proBNP and the combined examination of them were 0.592(95%CI:0.441-0.743),0.615(95%CI:0.468-0.761),0.766(95%CI:0.634-0.899),0.717(95%CI:0.575-0.860),0.674(95%CI:0.536-0.812),0.734(95%CI:0.592-0.876),0.581(95%CI:0.469-0.694)and 0.978(95%CI:0.947-1.000),respectively.Conclusion:The serum hs CRP,NT proBNP levels and function parameters of left heart in patients with coronary heart failure have occurred corresponding changes,and the above indicators have higher assessment value for the heart function of coronary heart failure,and the value of combined assessment is higher.
3.Status and influencing factors of participation in cardiac rehabilitation of cardiovascular nurses
Guozhen SUN ; Yunlan LU ; Yuan CHEN ; Ying WANG ; Li ZHU ; Guiying YOU ; Qi YE ; Jie WANG ; Yi ZHANG ; Guojie LIU ; Guihua HOU
Chinese Journal of Modern Nursing 2023;29(14):1827-1832
Objective:To explore the status and influencing factors of participation in cardiac rehabilitation of cardiovascular nurses.Methods:This is a cross-sectional study. From January to February 2022, a total of 3 047 cardiovascular nurses in members of China Cardiovascular Health Alliance were selected as research objects by convenience sampling method. General data questionnaire and Cardiovascular Nurses Participated in the Cardiac Rehabilitation Questionnaire (CNPCRQ) were used to investigate cardiovascular nurses. Multiple linear regression analysis was used to investigate the influencing factors of participation in cardiac rehabilitation of cardiovascular nurses. A total of 3 047 questionnaires were distributed in this study, and 2 704 valid questionnaires were effectively received, with an effective recovery rate of 88.74%.Results:The total score of CNPCRQ of cardiovascular nurses was (93.23±31.58), which was at a moderate level. Multiple linear regression analysis results showed that age, education, professional title, hospital location, hospital level, position type and hospital type were the influencing factors of participation in cardiac rehabilitation of cardiovascular nurses.Conclusions:The status of participation in cardiac rehabilitation of cardiovascular nurses in China needs to be improved. Role and job content of cardiovascular nurses should be further clarified, and cardiac rehabilitation knowledge and skills training should be strengthened in the future, so as to promote the profession development of cardiac rehabilitation and improve patients' health outcomes.
4.Establishment and application of a clustered management plan for pulmonary care of massive burn casualties
Shujun WANG ; Chunting MA ; Hongyan LU ; Xihe SONG ; Yuezeng NIU ; Guojie CHEN ; Ti ZHOU ; Chuan′an SHEN
Chinese Journal of Burns 2020;36(8):665-670
Objective:To establish a clustered management plan for pulmonary care of massive burn casualties (hereinafter referred to as the clustered management plan for pulmonary care), and to explore its application effects.Methods:(1) A clustered care intervention group was established, including the medical and nursing staff from the Department of Burns and Plastic Surgery, Department of Respiratory Medicine, and Department of Infection Control at the Fourth Medical Center of PLA General Hospital (hereinafter referred to as our hospital). Four major links, including pulmonary care assessment, chest and lung physical therapy, artificial airway management, and specialized infection control were sorted out according to the key points and difficulties in pulmonary care for massive burn casualties. Evidence-based nursing methods were employed to retrieve articles related to the above-mentioned four links from PubMed, Chinese Journal Full- Text Database, VIP Database and Wanfang Data using terms of " mass burn, respiratory management and airway management" and terms of "成批烧伤,肺部护理,集束化管理" , and the clustered management plan for pulmonary care was established based on reading and discussion in combination with clinical practice and experience. (2) In this non-randomized controlled study, the clustered management plan for pulmonary care was applied to 73 massive burn patients (48 males and 25 females, aged 32 (25, 38) years) who were admitted to our hospital from January 2016 to December 2019 and met the inclusion criteria, and they were included into the clustered care group; 43 massive burn patients (25 males and 18 females, aged 35 (17, 45) years) who were admitted to our hospital from January 2013 to December 2015, received routine care and met the inclusion criteria were retrospectively included into routine care group. The pulmonary infection rate and mortality of patients in the two groups were recorded during the hospital stay. Data were statistically analyzed with chi-square test, Mann-Whitney U test, and independent sample t test. Results:(1) The clustered management plan for pulmonary care included a total of 12 specific measures covering four aspects of pulmonary care. The contents in pulmonary care assessment clearly stated to include the previous medical history, history of injury, respiratory status, hoarseness, pulmonary auscultation, etc. Chest and lung physical therapy included how to guide patients to effectively cough and do pursed lip breathing and abdominal breathing exercise, etc. Artificial airway management specified the preparation for the establishment of artificial airway at clinical reception, the observation index and frequency after tracheotomy, the method of humidification, the method and frequency of sputum suction, and the management of mechanical ventilation, etc. Specialized infection control required to strengthen hand hygiene and ventilator management. (2) The pulmonary infection rate and mortality of patients in the clustered care group were 2.74% (2/73) and 4.11% (3/73), respectively, significantly lower than 25.58% (11/43) and 18.60% (8/43) in routine care group ( χ2=11.986, 5.043, P<0.05 or P<0.01). Conclusions:The clustered management plan for pulmonary care developed for massive burn casualties focuses on the major links and key points. The measures are systemic and comprehensive, simple but precise, and highly operable, covering the entire process of massive burn care, hereby reducing the pulmonary infection rate significantly and improving the success rate of treatment.
6.Enternal nutrition support of Nutrison fibre in neurosurgical coma patients
Guojie YAO ; Qulu ZHANG ; Jian LU ;
Parenteral & Enteral Nutrition 1997;0(04):-
Objectives:To discuss clinical significance of enternal nutrition of Nutrison fibre in neurosurgical coma patients. Methods:The study group(20 cases,GCS≤5) was fed gastrically with Nutrison fibre by a nasal feeding tube, and the control group(20 cases,GCS≤5) was supported with common fluid diet.In all cases,triceps skin fold,blood sugar,albumin,total lymphocyte count,complications and nitrogen balance were observed. Results:There were not significant differences between the study group and the control group in nutritional status,but the rate of complication in study group was obviously lower than that in control group. Conclutions:Enteral nutrition with Nutrison fibre can decrease the complications in nurosurgical coma patients and improve the quality of life.

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