Objective To evaluate the performance of lightweight Chinese large language models (LLMs) in answering specialized lung cancer questions, and to explore the impact of retrieval-augmented generation (RAG) on model performance. Methods Eleven lightweight Chinese LLMs with parameter sizes ranging from 7B to 32B were included. A lung cancer-specific evaluation dataset consisting of 200 questions [100 A1-type (basic knowledge) and 100 A2-type (clinical case) questions], constructed based on clinical guidelines and thoracic surgery textbooks, was used for assessment. Model performance was evaluated under two conditions (with and without RAG). Accuracy was used to assess model performance, and response latency was recorded to reflect inference efficiency. An accuracy–latency scatter plot was constructed for descriptive analysis of overall model performance. Results All models successfully completed the evaluation. With the introduction of RAG, the overall average accuracy improved from 61.68% to 76.36%. Smaller models demonstrated the most significant improvement (e.g., the accuracy of DeepSeek-7B increased from 32.50% to 60.00%, P<0.001). The average response latency increased from 12.58 s to 13.80 s. The Qwen3 series showed the best overall performance, and Qwen3-32B achieved the highest accuracy under both conditions (76.50% and 84.00%, respectively). After RAG integration, performance differences among model families were markedly reduced. Based on the accuracy-latency trade-off, Qwen3-32B achieved the best balance between accuracy and response latency under the baseline condition, whereas Qwen3-14B demonstrated superior overall performance in terms of accuracy, latency, and computational cost after RAG integration. Conclusion The integration of RAG technology improves the ability of lightweight Chinese LLMs to answer specialized lung cancer questions. Under the dual practical constraints of limited computational resources and medical data security requirements, the "lightweight model+RAG" technical framework may represent a promising deployment solution.

Objective To explore the feasibility and safety of fastest recovery after surgery(FRAS)in laparoscopic surgery of gastrointestinal tumors.Methods The clinical data of patients undergoing laparoscopic surgery for gastrointestinal tumors under FRAS and enhanced recovery after surgery(ERAS)from Jan.2023 to May 2024 were collected,and perioperative safety and medical cost were analyzed.Results A total of 87 patients were enrolled,including 43 in the FRAS group and 44 in the ERAS group.Compared with the ERAS group,the FRAS group had significantly shorter surgical time(3.0[2.5,3.5]h vs 3.0[2.5,4.0]h),first postoperative movement time([2.85±4.29]h vs[20.18±6.13]h),first postoperative oral feeding time(2.0[2.0,3.0]h vs 24.0[15.0,48.0]h),postoperative hospital stay(24.0[20.0,40.0]h vs 192.0[150.0,216.0]h),lower hospitalization costs(50 515.61[46 650.44,56 827.12]yuan vs 65 555.09[58 683.21,86 239.02]yuan),and lower medication costs(2 671.09[2 063.31,3 127.09]yuan vs 7 326.90[5 104.66,10 674.26]yuan)(all P＜0.05).Conclusion It is safe and feasible to use FRAS during the perioperative period of laparoscopic radical gastrectomy for gastrointestinal tumors,and FRAS can also reduce the costs of hospitalization and medications.

Objective: To understand the status of pinworm infection in rural children aged 3-9 years in Anhui Province, and to provide scientific basis for the prevention and control strategy of pinworm disease. Methods: According to the National Surveillance Program of Liver Fluke Disease and Soil Transmitted Nematodiasis(Trial), no less than 10% counties(cities and districts) in Anhui Province were selected as mobile surveillance sites every year. Each surveillance site was divided into 5 areas on the basis of geographical location(east, west, south, north and middle), from each of the areas, one administrative village was selected from one township(town, community) for conducting surveillance. Children at age 3-9 years from each site were examined for pinworm infection with the modified Kato-Katz thick smear method and the adhesive cellophane tape perianal swab method. Chi square test was used to compare the infection rate. Results: From 2017 to 2021, the 5 year average infection rate of pinworm in rural Anhui was 1.34%(128/9 557), and there was no significant difference in the infection rate over the years( P >0.05). The detection rates of the modified Kato-Katz thick smear method and the adhesive cellophane tape perianal swab method were 0.28% and 1.23%, respectively, the difference was statistically significant( χ 2=72.97, P <0.01). In different regions, the 5 year average infection rate of Fuyang City was the highest(4.27%), and the rate of each city was positively correlated with the number of local resident population( r =0.54, P <0.05). There was no significant sex difference in the 5 year average infection rates( P >0.05). The 5 year average infection rate of children aged 3 to 9 years in rural areas were 0.62%, 1.10%, 1.44%, 1.57%, 0.94%, 2.09% and 1.57%, respectively, showed an increasing trend with the increase of age( χ 2=14.41, χ 2 trend =6.70, P <0.05). There was no significant difference in the average infection rate between scattered children and collectively living children( P >0.05). Conclusion From 2017 to 2021, the infection rate of pinworm among children in rural Anhui province remains at a low level. In the future, health education and monitoring should be strengthened.

Objective:To investigate the feasibility and effectiveness of incision subcutaneous porous catheter combined with ropivacaine analgesia in enhanced recovery after laparoscopic gastrointestinal surgery.Methods:The clinical data of 140 patients underwent gastrointestinal surgery from August 2021 to April 2022 in Shanghai Fourth People′s Hospital, School of Medicine, Tongji University were retrospectively analyzed. Among them, 70 patients were given routine postoperative analgesia (control group), and 70 patients were given incision subcutaneous porous catheter combined with ropivacaine analgesia on the basis of routine postoperative analgesia (observation group). The visual analogue score (VAS) 4, 24, 32, 48, 56 and 72 h after operation was evaluated; and the complications of subcutaneous catheterization, incision infection, postoperative nausea vomiting, neurological symptoms, time to extubation, patient satisfaction degree, recovery time of intestinal function and hospital stay were recorded.Results:The VAS 4, 24, 32, 48, 56 and 72 h after operation in observation group was significantly lower than that in control group: 1.000 (- 0.250, 2.250) scores vs. 1.000 (- 1.000, 3.000) scores, 2.000 (1.000, 3.000) scores vs. 4.000 (2.000, 6.000) scores, 1.000 (0.000, 2.000) scores vs. 3.000 (1.000, 5.000) scores, 2.000 (1.000, 3.000) scores vs. 3.000 (1.750, 4.250) scores, (1.100 ± 0.934) scores vs. (2.085 ± 0.943) scores and (0.985 ± 0.842) scores vs. (1.814 ± 0.921) scores, and there was statistical difference ( P<0.05 or <0.01). The recovery time of intestinal function and hospital stay in observation group were significantly shorter than that that in control group: (1.743 ± 0.557) d vs. (2.200 ± 0.714) d and (8.043 ± 1.160) d vs. (8.757 ± 1.221) d, and there were statistical difference ( P<0.01); there were no statistical differences in the rate of incision infection, incidence of postoperative nausea vomiting, time to extubation and patient dissatisfaction rate between two groups ( P>0.05); there were no the complications of subcutaneous catheterization and neurological symptoms in two groups. Conclusions:The incision subcutaneous porous catheter combined with ropivacaine analgesia after laparoscopic gastrointestinal surgery is a safe, effective and feasible method. Multimodal analgesia under enhanced recovery after surgery can increase the postoperative recovery after gastrointestinal operations and shorten the postoperative hospital stay.

with the increasing prevalence of myopia in Chinese children, there are more methods for its prevention and control.Orthokeratology is one of the most appealing techniques for myopia correction.In recent years, an increasing number of hospitals have applied this technology, and its acceptance among patients is increasing.The safety of the orthokeratology have drawn increasing attention, especially in relation to orthokeratology-associated infectious keratitis.Acanthamoeba keratitis (AK) is one of the most worrying diseases.The onset of AK is slow, and its early clinical manifestation is particularly atypical, which often leads to incorrectly diagnosis, so as to mistreatment or delay of medical therapy, and subsequently irreversible impairment of visual function.Therefore, it is very important to reinforce the knowledge of its early symptoms in order to improve the early diagnosis level, and manage the associated risk factors.Early diagnosis and promper treatment can contribute to good visual outcomes.

Objective:To prepare a drug release system of drug-loaded cross-linked decellularized corneal stromal lenticules and evaluate its drug release characteristics in vitro. Methods:Lenticules were obtained during femtosecond laser-assisted small incision lenticule extraction (SMILE) surgery in Chongqing Aier Ophthalmology Hospital.Decellularized corneal stromal lenticules were prepared using high concentration sodium chloride (NaCl) combining nuclease.The decellularized corneal stromal lenticules were randomly divided into normal group, 0.5% levofloxacin group, 3% levofloxacin group and 5% levofloxacin group, with 4 lenticules in each group.The lenticules did not receive any treatment in the normal group, and drug-loading those were soaked in different doses of levofloxacin solution for three hours according to grouping.In the crosslinking test, 12 decellularized corneal stromal lenticules were randomly divided into non-crosslinking group, 0.01 mmol 1-(3-dimethylamino) propylimine (EDC) group, 0.05 mmol EDC group and 0.25 mmol EDC group.The lenticules for cross-linking were soaked in different contents of mixed solution of EDC with N-hydroxysuccinyl (NHS) for four hours respectively according to grouping, and then in 3% levofloxacin solution for three hours.Only 3% levofloxacin solution soaking was carried in the non-crosslinking group.High performance liquid chromatography (HPLC) was employed to detect the drug release concentration of the lenticules, and spectral scanning method was performed to measure light transittance of the lenticules.The surface ultrastructure of the decellularized lenticules among different cross-linking groups was examined and compared with scanning electron microscope.The use of the human corneal lenticules was approved by an Ethics Committee of Chongqing Aier Ophthalmology Hospital (No.2019012). Written informed consent was obtained from each patient before surgery.Results:The release concentrations of decellularized corneal stroma lenticules were significantly different at 1 day, 7, 14, and 21 days among 0.5%, 3%, and 5% levofloxacin group ( P<0.05) or also among the 0.01 mmol EDC, 0.05 mmol EDC, and 0.25 mmol EDC cross-linked groups ( P<0.01). The drug release concentrations in 0.05 mmol EDC group were the highest at various time points, and the release time of the three cross-linked groups lasted until 21 days after release concentrations of decellularized corneal stroma lenticules.The drug release concentrations in cross-linked groups and non-crosslinking group were gradually declined with the prolong of drug-loading time, showing a significant difference at different time points ( P<0.05). The transmittance of the lenticules was (88.68±1.19)% and (91.55±1.16)% in the non-crosslinking group and normal group, respectively, with no significant difference ( P>0.05). The average transmittance of the lenticules was significantly reduced in the drug-loaded groups compared with the normal group ( P<0.05). The smaller collagen fiber voids and closely arranged collagen fibers were displayed in the cross-linking groups under the scanning electron microscope with the best effect in the 0.25 mmol EDC group. Conclusions:EDC/NHS cross-linking can improve the drug-loading effect of decellularized corneal stromal lenticules probably by lessening collagen fiber voids.The drug-loaded cross-linked decellularized corneal stromal lenticules have a good drug release effect in vitro.

Objective: To describe the CT features and clinical characteristics of pediatric patients with coronavirus disease 2019 (COVID-19).Method: A total of 9 COVID-19 infected pediatric patients were included in this study.Clinical history,laboratory examination,and detailed CT imaging features were analyzed.All patients underwent the first CT scanning on the same day of being diagnosed by realtime reverse-transcription polymerase chain reaction (rRT-PCR).A low-dose CT scan was performed during follow-up.Results: All the child patients had positive results.Four patients had cough and one patient had fever.One patient presented both cough and fever.Two children presented other symptoms like sore throat and stuffy nose.One child showed no clinical symptom.Five patients had positive initial CT findings with subtle lesions like ground-glass opacity (GGO) or spot-like mixed consolidation.Three patients were reported with negative results in the initial and follow-up CT examination.One patient was reported with initial negative CT findings but turning positive during the first follow-up.All patients had absorbed lesions on follow-up CT images after treatment.Conclusion: Pediatric COVID-19 patients have certain imaging and clinical features as well as disease prognosis.Children with COVID-19 tend to have normal or subtle CT findings and relatively better outcome.

Objective:To explore the predictive factors of pathological complete response (pCR) after neoadjuvant chemoradiotherapy for middle-low rectal cancer.Methods:A case-control study was conducted. The inclusion criteria were as follows: (1) colonoscopy, digital examination or magnetic resonance imaging (MRI) showed a distance from the lower edge of the tumor to the dentate line of no more than 10 cm; (2) complete clinicopathological data were available; (3) preoperative biopsy revealed adenocarcinoma; (4) preoperative pelvic MRI or endorectal ultrasonography was performed; (5) no distant metastasis was found. Exclusion criteria: (1) preoperative radiotherapy and chemotherapy were not administrated according to the standard; (2) simultaneous multiple primary cancer and familial adenomatous polyposis were observed. According to the above criteria, clinicopathological data of 245 patients with middle-low rectal cancer undergoing preoperative neoadjuvant chemoradiotherapy in Changhai Hospital of Navy Medical University from January 2012 to December 2019 were retrospectively collected. Univariate analysis and multivariate logistic analysis were used to identify the clinical factors predicting pCR. pCR is defined as complete disappearance of cancer cells under the microscope in cancer specimens (including lymph nodes) after neoadjuvant chemoradiotherapy.Results:A total of 72 patients with pCR were enrolled in this study. Univariate analysis showed that preoperative T stage, tumor circumference, tumor morphology, carbohydrate antigen (CA) 19-9, interval between the end of neoadjuvant therapy and operation were associated with pCR (all P<0.05). The above 5 variables were included in multivariate logistic analysis and the results revealed that the T stage (OR=5.743, 95% CI: 2.416-13.648, P<0.001), tumor circumference (OR=7.754, 95% CI: 3.822-15.733, P<0.001), tumor morphology (OR=0.264, 95% CI: 0.089-0.786, P=0.017) and the interval between the end of neoadjuvant therapy and operation (OR=0.303, 95% CI: 0.147-0.625, P=0.001) were independent predictive factors of pCR, while CA 19-9 level was not an independent factor (OR=1.873, 95% CI:0.372-9.436, P=0.447). Conclusion:By knowing the clinical features of preoperative T stage, tumor circumference, tumor morphology and the interval between neoadjuvant chemoradiotherapy and operation, patients with higher likelyhood of pCR after neoadjuvant chemoradiotherapy may be identified.

Objective:To explore the predictive factors of pathological complete response (pCR) after neoadjuvant chemoradiotherapy for middle-low rectal cancer.Methods:A case-control study was conducted. The inclusion criteria were as follows: (1) colonoscopy, digital examination or magnetic resonance imaging (MRI) showed a distance from the lower edge of the tumor to the dentate line of no more than 10 cm; (2) complete clinicopathological data were available; (3) preoperative biopsy revealed adenocarcinoma; (4) preoperative pelvic MRI or endorectal ultrasonography was performed; (5) no distant metastasis was found. Exclusion criteria: (1) preoperative radiotherapy and chemotherapy were not administrated according to the standard; (2) simultaneous multiple primary cancer and familial adenomatous polyposis were observed. According to the above criteria, clinicopathological data of 245 patients with middle-low rectal cancer undergoing preoperative neoadjuvant chemoradiotherapy in Changhai Hospital of Navy Medical University from January 2012 to December 2019 were retrospectively collected. Univariate analysis and multivariate logistic analysis were used to identify the clinical factors predicting pCR. pCR is defined as complete disappearance of cancer cells under the microscope in cancer specimens (including lymph nodes) after neoadjuvant chemoradiotherapy.Results:A total of 72 patients with pCR were enrolled in this study. Univariate analysis showed that preoperative T stage, tumor circumference, tumor morphology, carbohydrate antigen (CA) 19-9, interval between the end of neoadjuvant therapy and operation were associated with pCR (all P<0.05). The above 5 variables were included in multivariate logistic analysis and the results revealed that the T stage (OR=5.743, 95% CI: 2.416-13.648, P<0.001), tumor circumference (OR=7.754, 95% CI: 3.822-15.733, P<0.001), tumor morphology (OR=0.264, 95% CI: 0.089-0.786, P=0.017) and the interval between the end of neoadjuvant therapy and operation (OR=0.303, 95% CI: 0.147-0.625, P=0.001) were independent predictive factors of pCR, while CA 19-9 level was not an independent factor (OR=1.873, 95% CI:0.372-9.436, P=0.447). Conclusion:By knowing the clinical features of preoperative T stage, tumor circumference, tumor morphology and the interval between neoadjuvant chemoradiotherapy and operation, patients with higher likelyhood of pCR after neoadjuvant chemoradiotherapy may be identified.

Objective To compare the characteristics of clinical pathology between patients with early recurrence and those with late recurrence of colorectal cancer.Methods Clinicopathological data of 391 recurrence patients after surgery from Changhai Hospital were recruited between Jan 2005 and Dec 2015.The clinical and pathological characteristics of primary cancer in early recurrence group (less than 2 years after surgery) and late recurrence group (2 year or more after surgery) were compared.Results 246 patients had early recurrence (62.9％) and 145 had late recurrence (37.1％).Liver,systemic metastases and peritoneum were the main sites of distant recurrence in the early recurrence group,whereas liver,lung and systemic metastases were the most frequent sites of metastases in the late recurrence group.Patients with the increased tumor perimeter,lymph node metastasis,increased CEA and CA19-9,without postoperative adjuvant treatment and microsatellite stability are more likely to have early recurrence.5-year overall survival rate for patients with early recurrence was significantly lower than those with late recurrence.Conclusions This study showed that clinical and pathological factors are significantly associated with recurrence of colorectal cancer.Two years after surgery is an important period for the recurrence of colorectal cancer.