Objective To construct a lung cancer surgery-oriented disease-specific database covering the entire perioperative care pathway, thereby improving the quality and usability of key surgical data elements. Methods Real-world clinical data were extracted from a single-center thoracic surgery department. A standardized data model was established based on the open electronic health record (openEHR) standard. Large language model (LLM), optical character recognition (OCR), and artificial intelligence (AI)-driven techniques were employed to extract, structure, and perform quality control on unstructured clinical narratives, imaging reports, and radiological data, with a focus on capturing surgically relevant perioperative indicator. Results A multimodal database comprising 19 917 patients was established, including 7 930 males and 11 987 females, with ages ranging from 15 to 97 (61.7±9.7) years. The database includes 582 structured data variables, textual report data corresponding to 69 clinical indicators, 13 000 pulmonary function test PDF reports, and chest CT imaging data from 16 884 patients. This database comprehensively covers major information relevant to surgical diagnosis and treatment of lung cancer, significantly improving the completeness and granularity of surgical detail data. Large language models (LLMs) and optical character recognition (OCR) technologies enhanced the efficiency of converting unstructured data into structured formats, while a multi-level manual verification process ensured data accuracy and traceability. The database supports real-world research including comparisons of surgical procedures, prediction of postoperative complications, prognosis assessment, and multimodal data association analyses.

Background: and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis. Methods: This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed. Results: Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs. Conclusions Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.

ObjectiveTo generate cynomolgus and rhesus monkey models carrying the Booroola fecundity (FecB) variant of bone morphogenetic protein receptor type 1B (BMPR1B) gene (designated BMPR1B^FecB) using adenine base edit technology and to explore genetic improvement strategies for enhancing the reproductive performance of laboratory macaques. MethodsFour single-guide RNAs (sgRNAs) were designed to target the BMPR1B c.746A>G locus in cynomolgus and rhesus monkeys. The sgRNAs were combined with the ABE8e-SpRY base editor, and the resulting editing complexes were microinjected into zygotes of both macaque species. Following in vitro culture of the injected embryos, nested PCR amplification was performed to detect the base-editing efficiency at the target site to screen for highly efficient sgRNAs. Subsequently, normally developing gene-edited embryos were transferred into the oviducts of surrogates. Seven days after birth, ear skin or peripheral blood samples were collected from the newborn monkeys for genotyping and mosaicism analysis, and the growth, development, and health status of the gene-edited monkeys were monitored. ResultsAmong the four candidate sgRNAs, sgRNA4 was identified as achieving 100% editing efficiency at the c.746A>G site. A total of 17 live monkey offspring were obtained via embryo transfer, including 8 cynomolgus monkeys and 9 rhesus monkeys. Genotyping results showed that all 8 newborn cynomolgus monkeys carried the c.746A>G point mutation, with an editing efficiency of 100% (8/8), of which 37.50% (3/8) were mosaics. Among the 9 newborn rhesus monkeys, 8 individuals carried the c.746A>G mutation, with an editing efficiency of 88.89% (8/9), of which 75.00% (6/8) were mosaics. ConclusionThe ABE8e-SpRY base-editing system enables precise editing at the c.746A>G (p.Q249R) locus of the BMPR1B gene in both cynomolgus and rhesus monkey embryos, resulting in the successful establishment of laboratory monkey models carrying the BMPR1B^FecB variant. These models provide a valuable foundation for future studies of the regulatory role of the BMPR1B^FecB variant in reproductive performance at the non‑human primate level, as well as for exploring genetic improvement strategies to enhance reproductive performance in laboratory monkeys.

With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.

Objective: To investigate the expression of ribosomal protein L26 ( RPL26) in gastric cancer cells (GC) and its effect on cell apoptosis and proliferation . Methods: The expression of RPL26 in GES-1 and GC cell lines was detected by Western blot. GC cell line HGC-27 was used to construct RPL26 overexpression cell line , and GC cell lines HGC-27 and AGS cells were used to construct RPL26 knockdown cell line . The overexpression and knockdown efficiency of RPL26 were detected by Western blot. Cell counting kit-8 (CCK-8) , colony formation assay and Transwell assay were used to detect the effects of the overexpression and knockdown of RPL26 on the pro- liferation and migration of GC cells . Western blot was used to detect the expression of Phosphatidylinositol-3-kinase (PI3K) / protein kinase B (AKT) signaling pathway related factors PI3K , AKT , phosphorylated phosphatidylinosi- tol-3-kinase (p-PI3K) , phosphorylated protein kinase B ( p-AKT) and downstream factors B-Cell lymphoma-2 (Bcl-2) , Bcl-2 associated X protein (Bax) and Cyclin A , G1 /S-specific Cyclin D1(Cyclin D1) , Cyclin-depend- ent kinases (CDK)4 and CDK2 in overexpression and knockdown of RPL26 stably transfected cell lines . Results: Compared with GES-1 , RPL26 was highly expressed in HGC-27 cells ( tHGC-27 = 4. 97 ; P < 0. 01) and elevated in AGS , but the difference was not statistically significant. In HGC-27 and AGS cells , CCK-8 and colony formation assays showed that the proliferation ability of cells decreased after the knockdown of RPL26. Transwell assay showed that the migration ability of cells decreased after the knockdown of RPL26. Western blot showed that Bcl-2 expression was decreased in HGC-27 , AGS cells after the knockdown of RPL26 ( tHGC-27 = 11 . 50 , tAGS = 4. 77 ; P < 0. 001 , P < 0. 01) , and Bax expression increased ( tHGC-27 = 9. 63 , tAGS = 4. 05 ; P < 0. 001 , P < 0. 05) . In HGC-27 cells , the ratios of p-PI3K/PI3K and p-AKT/AKT significantly decreased after the knockdown of RPL26 ( tp-PI3K/PI3K = 3 . 86 , tp-AKT/AKT = 8. 29 ; P < 0. 05 , P < 0. 01) . Cyclin A , Cyclin D1 , CDK4 , CDK2 protein expressions de- creased ( t = 9. 61 , 5 . 10 , 11 . 64 , 7. 81 ; P < 0. 01 or P < 0. 001) , while the overexpression of RPL26 in HGC-27 cells showed the opposite trend . Conclusion The knockdown of RPL26 may arrest the cell cycle in G1 /S phase by inhibiting the PI3K/AKT signaling pathway , thereby inhibiting cell proliferation and promoting apoptosis .

Objective To perform a regression analysis on the predictive value of serum micro-RNAs(miR)for early neurological deterioration(END)in patients with branch atheromatous dis-ease(BAD).Methods A total of 134 BAD patients admitted in our department from February 2020 to February 2023 were enrolled,and according to the END status,they were divided into de-terioration group(28 cases)and non-deterioration group(106 cases).Serum levels of miR-130a,miR-210,miR-141-3p and miR-29a-3p were measured at admission.NIHSS score was used to eval-uate the END status at admission and at 7 d after admission.Binary logistic regression analysis was adopted to construct a model of above four miRs in predicting END in BAD patients.ROC curve was plotted to assess the predictive value of the four miRs alone or combined together for END.Results The serum levels of miR-130a and miR-210 were significantly higher,while those of miR-141-3p and miR-29a-3p were obviously lower in the deterioration group than the non-deterioration group(P＜0.01).Logistic regression analysis indicated that serum miR-130a,miR-210,miR-141-3p and miR-29a-3p were independent predictors of END in BAD patients(P＜0.05,P＜0.01).ROC curve analysis showed that the AUC value of the four miRs combined together in predicting END in BAD patients was 0.977(95％CI:0.936-0.995),with a sensitivity of 96.43％and a specificity of 90.57％,and the combined detection exhibited better predictive effi-ciency than each indicator alone(P＜0.01).Conclusion Serum miR-130a,miR-210,miR-141-3p and miR-29a-3p have certain value in predicting END in BAD patients,and their combined detec-tion can enhance its predictive efficiency.

Objective:To learn about the epidemic characteristics of human brucellosis in Baoji City, and to identify brucellosis strains, so as to provide scientific basis for precise prevention and control of brucellosis in the city.Methods:A retrospective analysis method was used to conduct a descriptive epidemiological analysis of brucellosis cases in Baoji City reported in the China Disease Prevention and Control Information System from 2009 to 2022. Bacteriology culture, serum agglutination, biochemical test, phage cleavage and PCR were used to identify the isolates and nucleic acids, respectively.Results:From 2009 to 2022, a total of 314 cases of human brucellosis were reported in Baoji City, with an average annual incidence rate of 0.62/100 000, The incidence rate of different years was compared, the difference was statistically significant (χ 2 = 51 748 520.36, P < 0.001). The gender ratio of male to female was 3.30 ∶ 1.00 (241 ∶ 73). The age distribution ranged from 2 to 84 years old, with a median of 50 years old. The cases were concentrated in the 30 - 59 age group (206 cases, 65.61%), followed by the 60 - 84 age group (80 cases, 25.48%) and the 2 - 29 age group (28 cases, 8.92%). The peak of incidence was from April to August, with a total of 205 cases, accounting for 65.29%. Cases were reported in 213 townships, with the number of townships increasing from 1 in 2009 to 29 in 2022. The median time interval between onset and diagnosis of the case was 11 days. There was no significant difference in the time interval between onset and diagnosis among different genders, occupation and regions ( P > 0.05). A total of 10 strains of Brucella were isolated and identified as Brucella genus by BCSP31-PCR, and as Brucella melitensis by AMOS-PCR. After comprehensive identification, 4 strains were Brucella melitensis 3, 3 strains were mutant Brucella melitensis, and 3 strains were Brucella melitensis 1. Conclusion:The epidemic of brucellosis in Baoji City shows a fluctuating upward trend, with the epidemic scope gradually expanding, and the infected strains are all Brucella melitensis.

Objective:To describe the positive rates of high-risk human papillomavirus (HR-HPV) DNA and serum-neutralizing antibody in cervical intraepithelial neoplasia (CIN) tissues of rural women in Xiangyuan County, Shanxi Province, and evaluate the association of HR-HPV DNA and neutralizing antibody positive status with the occurrence of CIN.Methods:In a cohort of 1 897 women aged 35-45 years established by the Shanxi Province Cervical Cancer Screening StudyⅠ, DNA typing (SPF10 PCR-DEIA-LiPA25) was performed by using tissue samples of women with positive HR-HPV test results [Hybrid CaptureⅡ(HC2)] or abnormal cytological or pathological results. Serum HR-HPV neutralizing antibody detection was conducted with multicolor pseudovirion-based neutralization assay. Cochran-Armitage trend test was used to analyze the changing trend of the positive rate of HR-HPV DNA and neutralizing antibody with the progression of CIN. Multivariate logistic regression models were used to evaluate the influence and multiplicative interaction of HR-HPV DNA and neutralizing antibody positive status on the occurrence of CIN. The relative excess risk ( RERI), attributable proportion of interaction ( AP), and the synergy index ( SI) of the interaction were calculated to evaluate the additive interaction of HR-HPV DNA and neutralizing antibody on the occurrence of CIN. Results:The positive rate of any type of HR-HPV DNA (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) in 479 women who were HC2 positive or had abnormal cytological or pathological detection results was 37.16%. In normal, CIN1, CIN2, and CIN3+ groups, the HR-HPV DNA positive rates were 18.03%, 49.53%, 90.24% and 94.59%, respectively. The positive rate of any type of HR-HPV neutralizing antibody was 63.88%. In normal, CIN1, CIN2, and CIN3+ groups, the positive rates of HR-HPV neutralizing antibody were 63.95%, 57.94%, 70.73%, and 72.97%, respectively. The positive rate of any type of HR-HPV neutralizing antibody was 53.31% in 1 418 women who were HC2 negative and had normal cytopathology, and the most common types were HPV51 (27.36%) and HPV39 (24.96%). Multivariate logistic regression analysis showed that any type of HR-HPV DNA positive status ( OR=9.15, 95% CI: 5.99-14.20, P<0.001) was the independent factor for the occurrence of CIN, HR-HPV neutralizing antibody positive status was not associated with the occurrence of CIN ( OR=0.95, 95% CI: 0.61-1.48, P=0.815). The OR value of the multiplication of HR-HPV DNA and neutralizing antibody positive status of the occurrence of CIN was 1.63 (95% CI: 0.67-3.95), P=0.283. Quantitative analysis of interaction showed that RERI was 1.65 (95% CI:-3.56-6.86), SI was 1.28 (95% CI: 0.58-2.82), and AP was 0.19 (95% CI:-0.36-0.75). Conclusions:HR-HPV DNA positive status was a risk factor for the occurrence of CIN, but neutralizing antibody positive status was not associated with the occurrence of CIN. They had no significant multiplicative or additive interaction with the occurrence of CIN.

Objective To analyze the relationship between serum angiopoietin-like protein 8(ANGPTL8)and semaphorin 3A(Sema 3A)levels and postoperative cerebral vasospasm(CVS)in patients with intracranial aneurysm(IA)rupture.Methods A total of 188 patients with IA rupture receiving surgical treatment in our hospital were prospectively selected during October 2021 and October 2023,and according to whether CVS occurred after surgery,they were classified into a spasm group(75 cases)and a non-spasm group(113 cases).Serum ANGPTL8 and Sema 3A levels were measured after admission.Spearman correlation analysis was performed to assess the correlation of the levels with CVS occurrence.Binary logistic regression analysis was applied to construct a prediction model with serum ANGPTL8 and Sema 3A as variables.ROC curve was plotted to evaluate the predictive value of the levels for postoperative CVS.Results The serum ANGPTL8 level was significantly higher while that of Sema 3A was obviously lower in the spasm group then the non-spasm group(P＜0.01).Binary logistic regression analysis showed that the levels of serum ANGPTL8 and Sema 3A were independent predictors of postoperative CVS in patients with ruptured IA(OR=1.021,95％CI:1.013-1.029,P=0.000;OR=0.980,95％CI:0.967-0.993,P=0.003).ROC curve analysis indicated that the AUC value,sensitivity and speci-ficity of the two indicators combined together in predicting postoperative CVS was 0.939(95％CI:0.894-0.969),89.33％and 89.38％,respectively,with better predictive efficiency than each indicator alone(P＜0.01).Conclusion Serum ANGPTL8 and Sema 3A levels are closely associat-ed with postoperative CVS in patients with IA rupture,and they can be used as effective indicators for early prediction of postoperative CVS.

Objective To observe the value of three-dimensional speckle tracking imaging(3D-STI)in evaluation on right ventricle(RV)function for predicting adverse events in patients with unstable angina(UA)after percutaneous coronary intervention(PCI).Methods A total of 155 UA patients who underwent both 3D-STI and conventional echocardiography and planned to accept PCI were prospectively enrolled and divided into adverse event group(n=37)and control group(n=118)based on the occurrence of adverse events after PCI or not.Clinical data and echocardiographic parameters were compared between groups,and new binary variables were generated according to the optimal cut-off values showed by the maximum Youden index of receiver operating characteristic curves of 3D-STI parameters being statistically different between groups.Then the independent predictors of adverse events among UA patients after PCI were analyzed,a combined model was constructed,and its predictive value was assessed.Results In adverse event group,the left ventricular end diastolic volume(LVEDV)was higher,while the left ventricular ejection fraction(LVEF),right ventricular free wall longitudinal strain(RVFWLS)and right ventricular global longitudinal strain(RVGLS)were all lower than those in control group(all P＜0.05).The optimal cut-off values for distinguishing adverse event or not was 110 ml for LVEDV,19.05%for RVFWLS and 19.75%for RVGLS,respectively,and all the 3 generated binary variables were independent predictors for adverse events of UA patients after PCI(all P＜0.05).The area under the curve of combined model for predicting adverse events in UA patients after PCI was 0.864.Conclusion RVFWLS＜19.05%and RVGLS＜19.75%obtained with 3D-STI,as well as LVEDV＞110 ml with conventional echocardiography were all independent predictors of adverse events in UA patients after PCI.