1.Interpretation of advances in the treatment of non-small cell lung cancer at the 2025 World Conference on Lung Cancer (WCLC)
Bo BAO ; Jiayu LU ; Wen LIU ; Xuxu ZHANG ; Jiahe LI ; Jipeng ZHANG ; Wei LI ; Qiang LU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(02):218-230
The 26th World Conference on Lung Cancer (WCLC) was held in Barcelona during September 6-9, 2025. As the world's largest and most influential academic meeting in the field of lung cancer, this year's congress unveiled long-term follow-up data from several pivotal studies and significant advances in novel therapeutic strategies. In the realm of targeted therapy, a next-generation combination strategy has been established as the new standard of care for the first-line treatment of patients with advanced epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC), demonstrating a significant improvement in overall survival. In immunotherapy, novel combination regimens have not only addressed the therapeutic challenge of acquired resistance to EGFR targeted therapies, but also shown clear long-term survival benefits in both the perioperative and locally advanced settings. These findings pave the way for shifting the treatment paradigm to earlier stages for patients with NSCLC. Antibody-drug conjugates have made remarkable strides in this field. They have shown outstanding efficacy in patients with specific resistance mutations and those with brain metastases, and have also demonstrated immense potential in treating patients with HER2-aberrant lung cancer and broader NSCLC populations. This offers new therapeutic options for patients with refractory lung cancer.However, significant challenges remain, including the heterogeneity of resistance mechanisms, the selection of optimal treatment regimens, and management strategies for special populations. Future research should focus on identifying novel precision biomarkers and optimizing therapeutic strategies to ultimately improve clinical outcomes for all patients with lung cancer.
2.Construction and practice of application model for localized large language model in preoperative medication reconciliation for gastric cancer
Yuxuan ZHU ; Jizhong ZHANG ; Yuhao SUN ; Jiayu WEN ; Xin LIU ; Jifu WEI ; Lingli HUANG
China Pharmacy 2026;37(8):1062-1067
OBJECTIVE To construct a preoperative medication reconciliation model assisted by a localized large language model (LLM) for gastric cancer and evaluate its clinical efficacy. METHODS A total of 249 gastric cancer patients with a history of continuous medication before admission in the Gastric Surgery Department of Jiangsu Cancer Hospital were retrospectively enrolled. Patients were divided into training set (154 cases) and validation set (95 cases) based on the order of time. Based on guidelines, drug package inserts, and other evidence, a standardized medication reconcili ation process and a structured knowledge base were constructed. DeepSeek-V3 LLM was deployed privately in the hospital, combined with retrieval-augmented generation technology, to achieve automated integration of medication information, risk screening, and generation of personalized recommendations. The quality of LLM-generated recommendations was evaluated using automatic metrics (BERT Score and ROUGE-1, 2, L) and manual scoring [seven-dimensional index (7DI) ] . Spearman correlation analysis was performed to explore the correlation between automatic scores and manual scores. Cronbach’s α coefficient was used to test the internal consistency of manual scoring results. The time consumed by manual and LLM-assisted medication reconciliation was compared across tasks of different difficulty levels (simple, moderate, and high). RESULTS A structured knowledge base covering 8 major drug categories was finally established, covering common and high-risk preoperative medication scenarios and providing structured retrieval support for the LLM. For automatic evaluation, the precision, recall, and F1-score of BERT Score were 0.783±0.033, 0.811±0.038, and 0.796±0.028, respectively. The F1-scores of ROUGE-1, ROUGE-2 and ROUGE-L were 0.566±0.067, 0.338±0.076 and 0.468±0.082, respectively. The 7DI scores from three manual raters ranged from 32.06 to 33.45. The F1-score of automatic scoring was significantly positively correlated with the 7DI score of manual scoring (maximum coefficient of determination=0.611, P <0.001), and the internal consistency of manual scoring was good (Cronbach’s α = 0.876). In terms of efficiency, LLM-assisted medication reconciliation reduced time consumption by more than 90% compared with manual reconciliation in the simple, moderate, and high-difficulty groups ( P <0.001). CONCLUSIONS The medication reconciliation model constructed based on a localized LLM and structured knowledge base shows high accuracy, consistency, and clinical applicability in complex preoperative medication scenarios for gastric cancer. It can improve the efficiency of medication reconciliation and reduce potential medication risks.
3.Interpretation of perioperative immunotherapy for lung cancer in 2024 WCLC/ESMO
Jiahe LI ; Xiaopeng REN ; Jiayu LU ; Chenyuan ZHANG ; Ruitao FAN ; Xuxu ZHANG ; Xinyao XU ; Guizhen LI ; Jipeng ZHANG ; Wei LI ; Qiang LU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(03):300-307
The 2024 World Conference on Lung Cancer (WCLC) and the European Society for Medical Oncology (ESMO) Annual Meeting, two of the most prestigious events in oncology, have concluded sequentially. As the most authoritative annual gatherings in lung cancer and the entire oncology field, the WCLC and ESMO conferences brought together top oncology experts and scientists from around the world to share, discuss, and publish the latest cutting-edge advancements in oncology. In both conferences, lung cancer immunotherapy remained a hot topic of considerable interest. This article aims to summarize and discuss the important research progress on perioperative immunotherapy for non-small cell lung cancer reported at the two conferences.
4.Trends in the prevalence and patterns of cardiometabolic multimorbidity in Beijing, 2005—2022
Aijuan MA ; Gang LI ; Jiayu WANG ; Chen XIE ; Bo JIANG ; Li NIE ; Yingqi WEI ; Kai FANG ; Jin XIE ; Zhong DONG ; Jun LYU ; Liming LI
Chinese Journal of Endocrinology and Metabolism 2025;41(7):561-569
Objective:To analyze the prevalence trends and epidemiological characteristics of cardiometabolic multimorbidity(CMM) in Beijing from 2005 to 2022.Methods:A series of representative cross-sectional surveys were conducted in Beijing between 2005 and 2022 using a stratified multistage cluster random sampling method. A total of 110 496 permanent residents aged 18-79 years participated in face-to-face interviews, physical examinations, and laboratory testing. Complex sampling logistic regression models were employed to identify factors associated with CMM, and Joinpoint regression was used to assess temporal trends in prevalence. Results:The prevalence of CMM was 22.3% in 2005 and 24.3% in 2022, with an average annual percent change of 0.1%(95% CI -1.3%-1.3%, P>0.05). In rural areas, the prevalence increased by 1.3% per year(95% CI 0.2%-2.6%, P<0.05), while among obese individuals, it decreased by 1.0% annually( P<0.05). The most common CMM patterns were hypertension combined with dyslipidemia(13.2%), hypertension combined with diabetes(7.0%), and diabetes combined with dyslipidemia(5.8%). The prevalence of hypertension and dyslipidemia comorbidity showed a long-term decline among females, those aged 60-79 and obese individuals( P<0.05). In contrast, the prevalence of hypertension and diabetes comorbidity increased over time in rural residents and individuals with normal body weight( P<0.05). Furthermore, diabetes and dyslipidemia comorbidity rates increased significantly among males, adults aged 18-59 years, those with a college education or above, rural residents and individuals with normal body weight( P<0.05). Multivariable logistic regression indicated that male, older age, overweight, obese, and lower education level were independently associated with a higher risk of CMM( P<0.05). Conclusion:From 2005 to 2022, the prevalence of CMM remained high among adults in Beijing. While prevalence decreased among obese individuals, it increased significantly in rural areas. Hypertension combined with dyslipidemia was the most common multimorbidity pattern throughout the study period.
5.Characteristics of adrenal lesions in unilateral primary aldosteronism: a prospective study
Wei ZHANG ; Yi YANG ; Junlong LI ; Jiayu LI ; Yao ZHANG ; Youlin KUANG ; Weiyang HE ; Linqiang MA ; Ying SONG ; Jinbo HU ; Shumin YANG ; Qifu LI
Chinese Journal of Urology 2025;46(7):537-543
Objective:To explore the clinical characteristics of adrenal lesions in unilateral primary aldosteronism.Methods:This is a prospective study. Consecutive patients diagnosed with unilateral primary aldosteronism at the First Affiliated Hospital of Chongqing Medical University from December 2023 to November 2024 were included. Inclusion criteria:① Age is 18 to 80 years old;② The laboratory test indicators are in line with the diagnosis of primary aldosteronism;③ The auxiliary examination proved that only one side was involved;④ Patient undergo unilateral total adrenalectomy. The exclusion criteria are as follows:① Complete biochemical remission was not achieved during the 1-6 month follow-up after the surgery;② Postoperative loss to follow-up;③ No surgical specimens were received or the surgical specimens were incomplete,making continuous sectioning impossible. Patients meeting the inclusion criteria were recruited,and their clinical and biochemical data were recorded. The number of adrenal nodules visible on CT scans and the number of macroscopically visible nodules in the postoperative adrenal gross specimens were documented. Hematoxylin-eosin(HE)staining and aldosterone synthase CYP11B2 immunohistochemical staining were performed on the adrenal tissues after the operation. The number of nodules visible under the light microscope and the number of CYP11B2-positive nodules were recorded.Results:A total of 114 cases were included in this study. The age of the patients was(49.86 ± 9.80)years,the body mass index was(25.49 ± 3.40)kg/m2,the preoperative aldosterone level was 352(2012,556)pg/ml,and the direct renin concentration was 1.63(0.50,4.56)μIU/ml. The aldosterone/renin ratio was 224.9(57.1,641.6)(aldosterone concentration unit was pg/ml,renin concentration unit was μIU/ml),the minimum blood potassium concentration was 2.87(2.50,3.40)mmol/L,and the systolic blood pressure was(144.5 ± 19.5)mmHg. Among the 114 patients,105 had adrenal nodules detected by preoperative CT,of whom 2(1.75%)had multiple nodules. Postoperative gross adrenal specimen evaluation and CYP11B2 immunohistochemical staining revealed that 90 out of 114 cases were solitary nodules,2 cases had no nodules,and 22 cases(19.30%)had multiple nodules detected(17 cases had 2 nodules and 5 cases had 3 nodules). Among them,12 cases(10.53%)presented as grossly visible multinodular lesions,while 10 cases(8.77%)appeared as solitary nodules macroscopically but demonstrated multinodular patterns on immunohistochemical staining. CYP11B2 staining showed that among the 22 patients with multiple nodules,13 had multiple CYP11B2-positive nodules,while the remaining had only one positive nodule. Among the 22 patients with multiple nodules,preoperative CT showed single nodules in 19 cases,hyperplasia in 1 case,and multiple nodules in 2 cases(9.09%). Among the 12 patients with grossly visible multinodular lesions,preoperative CT showed single nodules in 9 cases,hyperplasia in 1 case,and multiple nodules in 2 cases(16.67%).Conclusions:Multiple adrenal nodules associated with unilateral primary aldosteronism are relatively common,and are often not detected by preoperative CT examination. Partial adrenalectomy based solely on CT-visible nodules may fail to achieve complete remission of primary aldosteronism. This study provides evidence supporting total adrenalectomy as the preferred surgical approach for unilateral primary aldosteronism.
6.Interpretation of advances in the treatment of esophageal cancer and gastroesophageal junction cancer at the 2025 American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO-GI)
Jiahe LI ; Jiayu LU ; Xuxu ZHANG ; Xinyao XU ; Jipeng ZHANG ; Wei LI ; Guizhen LI ; Qiang LU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(06):771-778
The 2025 American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO-GI) was held from January 23 to 25, 2025. Several significant studies on the treatment of esophageal and gastroesophageal junction (GEJ) cancer were presented at the symposium, highlighting notable advances, particularly in the perioperative and advanced settings. Immunotherapy has demonstrated significant promise in the neoadjuvant treatment of esophageal cancer, showing potential to become a standard treatment. Furthermore, the long-term survival benefits of combining immunotherapy with chemotherapy for advanced GEJ cancer were further validated. This article summarizes and interprets the researches presented at the symposium concerning perioperative and advanced treatments for esophageal and GEJ cancers.
7.Interpretation of advances in immune therapy for non-small cell lung cancer at the 2025 European Lung Cancer Congress
Wen LIU ; Jiayu LU ; Xuxu ZHANG ; Xinyao XU ; Jipeng ZHANG ; Wei LI ; Guizhen LI ; Bo BAO ; Qiang LU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(08):1063-1071
The 2025 European Lung Cancer Congress (ELCC) convened in Paris, France, centering on the optimization and innovation of immunotherapy for non-small cell lung cancer (NSCLC). Key topics at the congress included the application strategies for perioperative immunotherapy, breakthroughs in combination therapy models for advanced NSCLC, and the emerging roles of biomarkers in predicting diverse treatment outcomes. This paper integrates data from several key pivotal studies to systematically analyze the clinical value of neoadjuvant therapy within the perioperative setting, the potential of targeted combination regimens, and the challenges of managing drug resistance, thus offering new directions for clinical practice.
8.Application of machine learning models in predicting renal function decline following robot-assisted partial nephrectomy
Jing LI ; Linfeng WANG ; Gaojie ZHANG ; Yong HUANG ; Yingying GAO ; Rui SUN ; Yang CAO ; Qiuchen LI ; Hao HE ; Ziling WEI ; Jiayu LIU
Journal of Chongqing Medical University 2025;50(4):457-462
Objective:To compare the efficacy of various machine learning models in predicting renal function decline after robot-assisted partial nephrectomy(RAPN),and to provide evidence for clinical risk stratification.Methods:This study retrospectively in-cluded the clinical data of 733 patients with renal cell carcinoma undergoing RAPN at the Urology Department of The First Affiliated Hospital of Chongqing Medical University from January 2019 to December 2023.Demographic characteristics,laboratory indicators,and perioperative parameters were integrated to construct seven machine learning models.Key predictors were interpreted using Shap-ley additive explanations(SHAP).Model performance was evaluated using the area under the receiver operating characteristic curve(AUC).Results:The random forest model demonstrated the best predictive performance(AUC=0.84).SHAP analysis identified neutrophil-to-lymphocyte ratio,tumor diameter,the international normalized ratio of prothrombin time,white blood cell count,and in-traoperative blood loss as significant factors influencing postoperative renal function decline.Conclusion:This study provides a poten-tial predictive tool for clinical practice,aiding in identifying high-risk patients and optimizing postoperative management strategies.
9.Clinical effect of Xiaotan Zhitong gel in treating heel pain caused by plantar fasciitis:a random controlled study
Xuan ZHANG ; Jiayu LIANG ; Ling WANG ; Meiling WANG ; Pinkang WEI ; Jingyu XU
Academic Journal of Naval Medical University 2025;46(1):147-151
Objective To observe the clinical effect of Xiaotan Zhitong gel on heel pain caused by plantar fasciitis.Methods A total of 72 patients diagnosed with plantar fasciitis heel pain were randomly divided into observation group(36 cases)and control group(36 cases).Patients in the control group were treated with local application of diclofenac diethylamine emulgel twice a day and those in the treatment group were treated with Xiaotan Zhitong gel twice a day,with both treatments lasting for 28 d.The visual analogue scale(VAS)score of heel pain,the quantitative scale score of heel pain symptom grading,and the American Foot and Ankle Society(AOFAS)ankle-hindfoot score were evaluated before and after treatment.The changes of plantar fascia thickness were examined ultrasonographically before and after treatment in the 2 groups.The effective rates of treatment and the 3-month relapse rates were observed in the 2 groups.Results Before treatment,there were no significant differences in heel pain VAS score,heel pain symptom grading quantitative scale score,AOFAS ankle-hindfoot score,or plantar fascia thickness between the 2 groups(all P>0.05).After treatment,the above indexes were improved in both groups compared with those before treatment(all P<0.05);and the pain VAS score,heel pain symptom grading quantitative scale total score,heel pain symptom grading quantitative scale pain score,heel pain symptom grading quantitative scale pressure score,heel pain symptom grading quantitative scale dysfunction score,and AOFAS ankle-hindfoot score in the observation group were significantly improved compared with those in the control group(all P<0.05).The thickness of plantar fascia was significantly thinner than that of the control group(P<0.05),and the insomnia scores on the heel pain symptom grading quantitative scale were not significantly different between the 2 groups(P>0.05).The effective rate of the observation group(80.6%,29/36)was significantly higher than that of the control group(55.6%,20/36)(P<0.05),and the 3-month recurrence rate in the observation group(16.7%,6/36)was significantly lower than that of the control group(41.7%,15/36)(P<0.05).Conclusion Xiaotan Zhitong gel can reduce heel pain,improve foot function,and reduce plantar fascia thickness in patients with plantar fasciitis,also with low recurrence rate after treatment.
10.Factors affecting implementation of weight management services in primary medical and healthcare institutions based on the consolidated framework for implementation research
SUN Jie ; LI Yun ; WEI Jiayu ; SHAO Xiaofang ; YE Xiaojun ; FU Yeliu ; GU Wei ; YANG Min
Journal of Preventive Medicine 2025;37(11):1087-1092
Objective:
To explore the influencing factors for implementation of weight management services in primary medical and healthcare institutions, so as to provide references for implementing sustainable services of weight management.
Methods:
From May to June 2025, Pinghu City, Zhejiang Province was selected as the survey site. Personnel responsible for weight management in primary medical and healthcare institutions were selected as the survey subjects using a combined method of purposive sampling and snowball sampling. Based on the five core domains of the consolidated framework for implementation research (CFIR), a semi-structured interview outline for weight management services in primary medical and healthcare institutions was designed. Original data was collected through face-to-face semi-structured interviews. Interview data was organized and analyzed using framework analysis. Factors affecting weight management services were quantitatively analyzed by referencing CFIR's structural rating criteria.
Results:
A total of 21 participants completed interviews, covering positions in nutrition, endocrinology, traditional Chinese medicine, general practice, maternal health, and public health. There were 9 males and 12 females. Fifteen participants (71.43%) were aged 35 years and above, 18 (85.71%) held a bachelor's degree or higher, and 15 (71.43%) were frontline medical staff. Fifteen factors affecting weight management services were identified across five domains: innovation, outer setting, inner setting, individuals, and implementation process. Six barrier factors were identified: difficulties in policy implementation, time-consuming interventions, limited incentive measures, lack of professional skills, unclear weight-loss plans and goal setting, and imperfect follow-up and evaluation mechanisms. Three neutral factors were identified: the development and refinement of policies and regulations, the implementation of weight management training, and the optimization of the referral process within integrated healthcare systems (medical alliances / communities). Six facilitating factors were identified: the relatively significant advantages of lifestyle interventions, collaboration and coordination across multiple departments, cooperative communication among different units within the institution, the inherent convenience of primary care settings, a strong sense of professional responsibility, and the establishment of multidisciplinary teams.
Conclusions
The delivery of weight management services in primary medical and healthcare institutions is influenced by a wide array of factors across multiple domains. It requires policy support, multi-department coordination, a practice-oriented training system, optimized team resource allocation, incentives, and improved professional skills of medical staff to jointly promote long-term implementation.


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