Pulmonary rehabilitation (PR) has become an indispensable component of the modern care continuum for lung cancer. Substantial evidence confirms its definitive value in improving perioperative outcomes, mitigating treatment-related side effects, and enhancing quality of life in patients with advanced disease. However, a significant "implementation gap" exists between its proven clinical benefits and widespread application, primarily characterized by the lack of standardized protocols, uncertainty in optimal timing, and low patient adherence. Bridging this gap requires a dual-driven approach: harnessing technological innovations such as telerehabilitation, wearable devices, and artificial intelligence to enhance accessibility and personalization, alongside optimizing care models through multidisciplinary team collaboration. This review systematically analyzes the evidence, implementation barriers, and innovative pathways for PR in lung cancer care, aiming to catalyze its transition from an ancillary option to a core standard of care, and envisions a new paradigm of personalized PR that is patient-centered, data-driven, and technologically integrated.

Objective: To develop a prediction model for mild cognitive impairment (MCI) risk among the elderly, so as to provide a tool for MCI early screening. Methods : From July 2022 to September 2024, a multi-stage stratified random cluster sampling method was used to recruit permanent residents aged ≥65 years from the Xinjiang Uygur Autonomous Region as study participants. Data on sociodemographic characteristics, nutritional status, body composition indices, bone mineral density, and handgrip strength were collected through questionnaires and physical examinations. Sarcopenia was defined based on appendicular skeletal muscle index and handgrip strength. MCI was assessed using the Mini-Mental State Examination, with adjustments for educational level. Participants were randomly divided into a training set and a validation set in a 7∶3 ratio. LASSO regression and multivariable logistic regression models were employed to screen for predictors and construct an MCI risk prediction model. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve and decision curve analysis (DCA). Results: A total of 1 641 participants were surveyed, including 755 males (46.01%) and 886 females (53.99%). The majority of participants were aged 65-<75 years, comprising 1 154 individuals (70.32%). MCI was detected in 517 participants, corresponding to a detection rate of 31.51%. Resultsfrom LASSO regression and multivariate logistic regression analysis showed that residence (rural, OR = 2.323, 95% CI: 1.682-3.210), age (75-<85 years, OR = 1.405, 95% CI: 1.019-1.937; ≥85 years, OR = 3.655, 95% CI: 1.696-7.875), educational level (primary school, OR = 0.341, 95% CI: 0.247-0.472; junior high school, OR = 0.255, 95% CI: 0.160-0.408; high school, OR = 0.286, 95% CI: 0.154-0.531; bachelor's degree or above, OR = 0.120, 95% CI: 0.041-0.351), history of alcohol consumption (yes, OR = 3.216, 95% CI: 2.164-4.779), risk of malnutrition (yes, OR = 1.464, 95% CI: 1.064-2.014), sarcopenia (yes, OR = 3.197, 95% CI: 2.332-4.385), and waist-to-hip ratio (abnormal, OR = 1.540, 95% CI: 1.159-2.048) were identified as predictive factors for MCI among the elderly. In the training set, the area under the ROC curve, sensitivity, and specificity were 0.788, 0.719, and 0.712, respectively. In the validation set, the corresponding values were 0.784, 0.913, and 0.542, respectively. DCA demonstrated that the model provided a higher clinical net benefit for predicting MCI risk when the risk threshold probability ranged from 0.124 to 0.764. Conclusion The prediction model developed in this study demonstrates good discriminative ability and clinical utility, indicating its substantial value for predicting the MCI risk among the elderly.

The ultimate goal of enhanced recovery after surgery (ERAS) is to achieve risk-free and pain-free care. It is necessary in establishing perioperative comfort-oriented wards for medical technology advancement and economic development. This article discusses the clinical practices of comfort-oriented wards at the Lung Cancer Center of West China Hospital, Sichuan University and focuses on the following aspects: concept, framework, and team-building; current clinical application status, challenges, and implementation strategies; analysis of related construction models and plans; and clinical outcomes and future prospects. This work aims to promote a shift in the ERAS evaluation system toward a patient-centered concept and the application of comfort-oriented wards.

Objective To compare the analgesic effects and adverse reactions between intercostal nerve block (ICNB) and patient controlled intravenous analgesia (PCIA). Methods From August 2022 to January 2023, 180 patients with lung cancer who underwent thoracoscopic surgery were randomly divided into two groups: ICNB group (n=90) and PCIA group (n=90). The postoperative pain degree (VAS), location, nature; adverse events, such as nausea, vomiting, and dizziness; and other clinical symptoms were analyzed. Results The most common site of postoperative pain in both groups was surgical incision, and the nature of pain was distending pain. At 12 and 24 h after the operation, the pain degree in the ICNB group (1.10±0.91, 3.12±1.29) was markedly lower than that in PCIA group (1.44±0.86, 4.32±1.30, P=0.010, P<0.001). The incidence of nausea, vomiting, and dizziness in the ICNB group (5.56%, 23.33%) was noticeably lower than that in the PCIA group (35.56%, 51.11%, P<0.001, P<0.001). Total hospitalization expense in the ICNB group (41 043.16±10 885.63 yuan) was significantly lower than that in PCIA group (45 283.99±11 036.36 yuan, P=0.010). Conclusion The analgesic effect of intercostal nerve block is better than that of patient-controlled intravenous analgesia pump in patients with lung cancer after minimally invasive surgery, and the incidence of adverse reactions is low.

Although multidisciplinary team(MDT)diagnosis and treatment model can improve the quality of life and survival prognosis of the patients,why does it not reach the expected goal of the MDT diagnosis and treatment model?The main reason is that the diagnosis and treatment mode of MDT in lung cancer lags behind the progress of various treatment methods.By analyzing the latest research results of MDT diagnosis and treatment of lung cancer at home and abroad,com-bined with the experience of MDT diagnosis and treatment of lung cancer in the Lung Cancer Center of West China Hospital of Sichuan University,this article will discuss and summarize the progress and future direction of MDT in lung cancer from the following aspects:(1)The connotation and extension of MDT diagnosis and treatment mode of lung cancer need to be changed and adapted to new methods of diagnosis and treatment;(2)The clinical decision making in the diagnosis and treat-ment of MDT in lung cancer should be transformed from"multidisciplinary consultation(MDC)"to"MDT";(3)The diag-nosis and treatment process of MDT in lung cancer should shift from"fire brigade mode"to"firewall mode",and finally imple-ment"individualized whole-process management mode";(4)The path of MDT diagnosis and treatment of lung cancer should be changed from"temporary convening mode"to"single disease center system mode of lung cancer".

To alleviate the medical burden of lung cancer surgery and facilitate the implementation of the national hierarchical diagnosis and treatment policy,it is imperative to establish a hierarchical diagnosis and treatment system for day surgery of lung cancer.Identifying key quality control checkpoints in day surgery of lung cancer is essential to enhance medical quality,ensure safety,and improve the efficiency of medical services.These efforts aim to uphold a safe and well-structured pro-gression of day surgery practices in China.The Chinese Expert Consensus Group on Day Surgery Management of Lung Cancer has convened national experts in relevant fields and integrated the latest research findings from both domestic and international sources to craft the Chinese Expert Consensus on Day Surgery Management of Lung Cancer(2024 Edition).This consensus is founded on the principles of holistic management of lung cancer surgery and comprehensive patient care throughout their medical journey It encompasses preoperative assessments,anesthesia protocols,surgical procedures,postoperative care,hos-pital-community collaboration initiatives,and emergency response strategies.The primary objective of this expert consensus is to furnish research assistance and clinical recommendations to advance the practice of day surgery for lung cancer patients in China.

Background and objective A reasonable and standardized dietary plan and procedure can help patients recovering quickly from lung cancer surgery.The aim of this study is to optimize the diet plan and procedure mainly based on medium chain triglyceride(MCT)diet and explore its clinical advantages for postoperative lung cancer patients.Methods From October 2023 to December 2023,a total of 156 patients were collected,who underwent lung cancer surgery in Lung Cancer Cen-ter,West China Hospital of Sichuan University.The patients were randomized into MCT group(76 cases)and routine diet(RD)group(80 cases).Clinical symptoms,biochemical index,postoperative hospitalization time and cost,dietary satisfaction and hospitalization comfort between the two groups were analyzed.Results The mean anus exhausting time in MCT group[24.00(9.75,36.97)h]was significantly shorter than that in RD group[28.50(24.00,48.00)h](P＜0.001).And the incidence of dizzi-ness(18.42％),nausea and vomiting(6.58％)in MCT group were remarkably lower than those in RD group(51.25％,31.25％)(P＜0.001).Hospitalization comfort score in MCT group[(16.74±1.70)]was significantly higher than that in RD group[(14.83±2.34)](P=0.016).Meanwhile,the average hospitalization cost in MCT group[(39,701.82±8105.47)￥]showed an obvious decrease compared with RD group[(44,511.79±9593.19)￥](P=0.007).Conclusion Optimizing the dietary plan and procedure mainly based on MCT diet for postoperative lung cancer patients can help the recovery of gastrointestinal function and improve hospitalization comfort,which promoted overall postoperative rehabilitation of patients with lung cancer surgery.

Perioperative pulmonary rehabilitation may effectively reduce the incidence of postoperative pulmonary complications and improve the quality of life of lung cancer patients and its clinical application value in lung cancer patients has been widely recognized.However,there is still no international consensus or guideline for pulmonary rehabilitation regi-men,lacking standardized criteria when pulmonary rehabilitation applied in perioperative clinical practice for lung cancer.The consensus provides implementation regimen and process of pulmonary rehabilitation,aiming to promote the reasonable and standardized application of perioperative pulmonary rehabilitation training in clinical practice,sequentially enable patients to maximize benefits from the rehabilitation.

Background::The incidence rate of lung cancer in women has significantly increased over the past decade, and previous evidence has indicated a significant relationship between the elevated levels of sex hormones and the risk of lung cancer. Therefore, we hypothesized that female hormone-related cancer (FHRC) patients, including breast, endometrial, cervical, and ovarian cancer patients, may experience a higher risk of developing subsequent lung cancer. This meta-analysis aimed to identify the risk of lung cancer among FHRC patients compared to the general population.Methods::The PubMed, Web of Science, EMBASE, Cochrane Library, and CNKI databases were searched up to May 11, 2022. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were used to identify the risk of subsequent lung cancer after FHRC. Subgroup analyses based on the follow-up time and tumor type were also conducted.Results::A total of 58 retrospective cohort studies involving 4,360,723 FHRC participants were included. The pooled results demonstrated that FHRC patients had a significantly increased risk of developing subsequent primary lung cancer (SIR = 1.61, 95% CI: 1.48-1.76, P <0.001). Subgroup analysis revealed an obvious trend of increasing lung cancer risk over time (SIRs for <5 years, ≥5 years, ≥10 years, ≥20 years, and ≥30 years after FHRC: 1.32, 1.59, 1.57, 1.68, and 1.95, respectively). In addition, subgroup analysis stratified by tumor type indicated an increased risk of developing subsequent lung cancer after breast (SIR = 1.25, P <0.001), endometrial (SIR = 1.40, P = 0.019), cervical (SIR = 2.56, P <0.001), and ovarian cancer (SIR = 1.50, P = 0.010). Conclusion::FHRC patients are more likely to develop lung cancer than the general population. Furthermore, the increased risk of subsequent primary lung cancer is more obvious with a longer survival time and is observed in all types of hormone-related cancer.Registration::International Platform of Registered Systematic Review and Meta-analysis Protocols: No. INPLASY202270044; https://inplasy.com/

Objective    To explore the association of pretreatment hyponatremia with clinicopathological and prognostic characteristics of non-small cell lung cancer (NSCLC) patients. Methods    The PubMed, EMbase, Web of Science, VIP, CNKI and WanFang databases were searched from the inception to July 12, 2021 for relevant literatures. The quality of included studies was assessed by the Newcastle-Ottawa Scale (NOS) score. The relative risk (RR) and hazard ratio (HR) with 95% confidence interval (CI) were combined to assess the relationship between pretreatment hyponatremia and clinicopathological and prognostic characteristics. The prognostic indicators included the overall survival (OS) and progression-free survival (PFS). All statistical analysis was conducted by the STATA 15.0 software. Results    A total of 10 high-quality studies (NOS score≥6 points) involving 10 045 patients were enrolled and all participants were from Asian or European regions. The pooled results demonstrated that male [RR=1.18, 95%CI (1.02, 1.36), P=0.026], non-adenocarcinoma [RR=0.86, 95%CI (0.81, 0.91), P<0.001] and TNM Ⅲ-Ⅳ stage [RR=1.17, 95%CI (1.12, 1.21), P<0.001] patients were more likely to experience hyponatremia. Besides, pretreatment hyponatremia was significantly related to worse OS [HR=1.83, 95%CI (1.53, 2.19), P<0.001] and PFS [HR=1.54, 95%CI (1.02, 2.34), P=0.040]. Pretreatment hyponatremia was a risk factor for poor prognosis of NSCLC patients. Conclusion    Male, non-adenocarcinoma and advance stage NSCLC patients are more likely to experience hyponatremia. Meanwhile, the pretreatment sodium level can be applied as one of the prognostic evaluation indicators in NSCLC and patients with hyponatremia are more likely to have poor survival. However, more researches are still needed to verify above findings.