Lung cancer constitutes the most prevalent and lethal malignant tumor in China. Approximately 85% of lung cancer diagnoses correspond to the non-small cell histological subtype [non-small cell lung cancer (NSCLC)]. Despite surgery being the mainstay for early-stage disease, postoperative recurrence remains high and adjuvant chemotherapy offers limited benefit. In recent years, targeted therapy has demonstrated substantial advantages in driver mutation-positive NSCLC. To this end, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association developed guidelines based on a systematic review of evidence through November 2025, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and a modified Delphi method. Focusing on epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and addressing ROS proto-oncogene 1 (ROS1), B-Raf proto-oncogene serine/threonine kinase (BRAF) V600E mutation, and mesenchymal-epithelial transition factor (MET) exon 14 (METex14) skipping, the guideline covers molecular testing, neoadjuvant/adjuvant therapy, perioperative strategies, minimal residual disease monitoring, and postoperative surveillance. It defines testing requirements, specifies stage-directed and subtype-specific treatments, and standardizes minimal residual disease monitoring. These recommendations emphasize precision and feasibility to improve survival and quality of life.

Objective The aim of this study was to investigate the key genes that regulate colorectal cancer(CRC)metasta-sis,evaluate the effects of exosomal miR-151A-3P derived from CRC on the proliferation and migration,and explore the possibility of exosomal miR-151A-3P as a prognostic biomarker for CRC patients.Methods High-throughput sequencing was performed to screen the differentially expressed miRNAs in serum exosomes of metastatic CRC patients.RT-qPCR was used to verify the expression of differentially expressed miRNAs in CRC specimens.After mimics overexpression or knockdown of miR-151A-3P,CCK-8 and EdU assays were used to detect cell proliferation,and Scratch wound healing and Transwell assays were used to detect cell migration and in-vasion capability.A BALB/c nude mouse model was used to evaluate the effect of exosomal miR-151A-3P on the metastatic ability of CRC cells.Results The sequencing results showed that compared with non-metastatic CRC patients,the expression of miR-151A-3P was significantly increased in serum exosomes of metastatic CRC patients(P<0.001).The results were validated by RT-qPCR and found that miR-151A-3P was highly expressed in both serum exosomes and tumor tissues of metastatic CRC patients(P<0.001).The overall survival of CRC patients with high expression of serum exosomal miR-151A-3P was shorter than that of CRC pa-tients with low expression(P=0.029).After silencing miR-151A-3P,the cell proliferation,migration,and invasion abilities of CRC cells were decreased(P<0.05),while overexpression of miR-151A-3P could promote the proliferation,migration and invasion of CRC cells(P<0.05).In the BALB/c nude mouse colorectal cancer model,the administration of exosomal miR-151A-3P led to an increase in the number of lung metastases in BALB/c nude mice(P<0.05).Conclusion CRC-derived exosomal miR-151A-3P promotes the proliferation and migration of CRC cells,and is associated with poor prognosis of CRC patients.

Objective The aim of this study was to investigate the key genes that regulate colorectal cancer(CRC)metasta-sis,evaluate the effects of exosomal miR-151A-3P derived from CRC on the proliferation and migration,and explore the possibility of exosomal miR-151A-3P as a prognostic biomarker for CRC patients.Methods High-throughput sequencing was performed to screen the differentially expressed miRNAs in serum exosomes of metastatic CRC patients.RT-qPCR was used to verify the expression of differentially expressed miRNAs in CRC specimens.After mimics overexpression or knockdown of miR-151A-3P,CCK-8 and EdU assays were used to detect cell proliferation,and Scratch wound healing and Transwell assays were used to detect cell migration and in-vasion capability.A BALB/c nude mouse model was used to evaluate the effect of exosomal miR-151A-3P on the metastatic ability of CRC cells.Results The sequencing results showed that compared with non-metastatic CRC patients,the expression of miR-151A-3P was significantly increased in serum exosomes of metastatic CRC patients(P<0.001).The results were validated by RT-qPCR and found that miR-151A-3P was highly expressed in both serum exosomes and tumor tissues of metastatic CRC patients(P<0.001).The overall survival of CRC patients with high expression of serum exosomal miR-151A-3P was shorter than that of CRC pa-tients with low expression(P=0.029).After silencing miR-151A-3P,the cell proliferation,migration,and invasion abilities of CRC cells were decreased(P<0.05),while overexpression of miR-151A-3P could promote the proliferation,migration and invasion of CRC cells(P<0.05).In the BALB/c nude mouse colorectal cancer model,the administration of exosomal miR-151A-3P led to an increase in the number of lung metastases in BALB/c nude mice(P<0.05).Conclusion CRC-derived exosomal miR-151A-3P promotes the proliferation and migration of CRC cells,and is associated with poor prognosis of CRC patients.

Gastric cancer has relatively high disease burden worldwide. With the advancement of endoscopic technology and increased public health awareness, the detection rate of early gastric cancer has gradually risen globally. Conventional total or distal gastrectomy frequently results in postoperative complications, including malnutrition and digestive disorders, which can significantly impair the patient's quality of life. Function-preserving gastrectomy (FPG), which aims to minimize the extent of resection and preserve the functional anatomy of the stomach while ensuring radical removal of the tumor, has shown significant advantages in improving postoperative quality of life. This review summarizes the indications for various FPG techniques and the challenges currently faced, emphasizing the necessity of cautious promotion of FPG to improve treatment outcomes and the quality of life for patients with gastric cancer.

Objective:To explore the factors associated with the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) in the treatment of neuropathic pain (NP) following spinal cord injury (SCI).Methods:This was a retrospective study of 89 SCI survivors with NP receiving high-frequency rTMS. Those with a ≥30% reduction in their Numeric Rating Scales (NRS) scores after 2 weeks of treatment were termed Responders ( n=36), with the others classified as non-responders ( n=53). Demographic data (gender, education level, age), SCI characteristics (injury etiology, injury severity, neurological injury level, injury duration), NP characteristics (pain type, pain intensity, analgesic use), functional assessment (Modified Ashworth Scale score, Spinal Cord Independence Measure score, Modified Barthel Index score, American Spinal Injury Association motor/sensory score) were collected. Least absolute shrinkage and selection operator (LASSO) regression was used for variable selection, followed by binary logistic regression to identify factors associated with treatment efficacy. Results:Among the 89 patients, 36 (40.4%) were Responders to high-frequency rTMS. Binary logistic regression revealed that those with a cervical spinal cord injury and/or spasticity and women were more likely to respond to high-frequency rTMS.Conclusions:Female gender, cervical spinal cord injury, and spasticity are independent factors predicting rTMS efficacy in treating SCI, with spasticity demonstrating the strongest association.

Objective:To explore the factors associated with the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) in the treatment of neuropathic pain (NP) following spinal cord injury (SCI).Methods:This was a retrospective study of 89 SCI survivors with NP receiving high-frequency rTMS. Those with a ≥30% reduction in their Numeric Rating Scales (NRS) scores after 2 weeks of treatment were termed Responders ( n=36), with the others classified as non-responders ( n=53). Demographic data (gender, education level, age), SCI characteristics (injury etiology, injury severity, neurological injury level, injury duration), NP characteristics (pain type, pain intensity, analgesic use), functional assessment (Modified Ashworth Scale score, Spinal Cord Independence Measure score, Modified Barthel Index score, American Spinal Injury Association motor/sensory score) were collected. Least absolute shrinkage and selection operator (LASSO) regression was used for variable selection, followed by binary logistic regression to identify factors associated with treatment efficacy. Results:Among the 89 patients, 36 (40.4%) were Responders to high-frequency rTMS. Binary logistic regression revealed that those with a cervical spinal cord injury and/or spasticity and women were more likely to respond to high-frequency rTMS.Conclusions:Female gender, cervical spinal cord injury, and spasticity are independent factors predicting rTMS efficacy in treating SCI, with spasticity demonstrating the strongest association.

Objective:To prepare decellularized extracellular matrix (dECM)-gelatin methacryloyl (GelMA) composite hydrogels and to study their effects on hepatocyte proliferation.Methods:Hepatic dECM was prepared by elution, and GelMA hydrogel and 10%, 30% and 50% dECM-GelMA composite hydrogels were prepared by pepsin solubilization. The morphology of normal liver and dECM liver was observed by eyes and scanning electron microscopy using hematoxylin-eosin, Sirius red and periodate-Schiff staining, respectively. The internal structure of the dECM-GelMA composite hydrogels was observed by scanning electron microscopy, and the pore diameter was measured. Liver HL-7702 cells were co-cultured with GelMA hydrogel and 10%, 30% and 50% dECM-GelMA composite hydrogels, and the cell proliferation viability was determined by cell counting kit-8. The expression of proliferating cell nuclear antigen (PCNA), Wnt family protein 5a (Wnt5a), β-catenin, extracellular-regulated protein kinase 1/2 (ERK1/2) and phosphorylated ERK1/2 (p-ERK1/2) were detected by Western blotting. Comparisons were made using independent sample t-test or one-factor analysis of variance. Results:After decellularization, the hepatocyte morphology showed rounded depressions, and the extracellular matrix structure was intact. The GelMA hydrogel and 10%, 30% and 50% dECM-GelMA composite hydrogels showed inernally porous structures. The pore diameter increased from (3.06±1.35) μm in the GelMA hydrogel to (16.01±4.02) μm in the 50% dECM-GelMA composite hydrogel. On the 3rd, 5th and 7th day, the relative cell proliferation was higher in the 50% dECM-GelMA composite hydrogel group than that in the GelMA hydrogel group (1.89±0.04 vs 1.53±0.01, 9.36±0.04 vs 3.89±0.09, 7.15±0.27 vs 4.89±0.15, all P<0.05). The relative expression levels of PCNA, Wnt5a, β-catenin, and p-ERK1/2/ERK1/2 proteins in the 50% dECM-GelMA composite hydrogel group were higher than those in the GelMA hydrogel group (2.14±0.04 vs 1.00±0.03, 2.36±0.09 vs 1.00±0.08, 1.45±0.03 vs 1.00±0.04, 1.43±0.04 vs 1.00±0.01, all P<0.05). Conclusions:A dECM-GelMA composite hydrogel can be prepared, which may promote hepatocyte proliferation by upregulating the phosphorylation of ERK1/2 and activating Wnt/β-catenin signaling pathway.

Objective:This study aimed to compare postoperative pain between minimally invasive coronary artery bypass grafting (MICS-CABG) and conventional CABG for multivessel coronary artery disease, comparing baseline characteristics and perioperative data between the two groups, and analyzing risk factors influencing postoperative pain.Methods:A total of 545 patients undergoing elective off-pump coronary artery bypass grafting (OPCABG) for multivessel coronary artery disease at Beijing Anzhen Hospital from July 2022 to July 2023 were included. There were 397 patients in the conventional CABG group (289 males, 108 females, aged 35-77 years) and 148 patients in the minimally invasive CABG group (121 males, 27 females, aged 37-84 years), with 148 patients in each group after propensity score matching. Pain levels were assessed using the Numeric Rating Scale (NRS) at the first 5 days postoperatively (acute postoperative pain, APP) and at 3, 6, and 12 months postoperatively (chronic post-surgical pain, CPSP). Logistic regression was used to analyze risk factors for CPSP at 3 months postoperatively in both groups. Results:Within 48 hours postoperatively, both groups reported maximum NRS pain intensities at rest (NRS 4.0 vs. 6.0) and during activity (NRS 5.2 vs. 7.5). From the third day after surgery, there were no significant differences in resting pain intensity between the two groups, and from the fourth day after surgery, there were no significant differences in pain intensity during movement. With 60.2% in the conventional group and 92.6% in the minimally invasive group experiencing moderate to severe pain at rest (NRS ≥ 4), and 83.5% in the conventional group and 98.0% in the minimally invasive group experiencing moderate to severe pain during activity (NRS ≥ 4). Immediately after drain removal, there was a significant reduction in pain intensity at rest in the minimally invasive group (pre-drain removal NRS 6.0 vs. post-drain removal NRS 2.7), compared to the conventional group (pre-drain removal NRS 4.0 vs. post-drain removal NRS 2.3). However, there was no significant difference in the reduction of pain intensity during activity between the minimally invasive group (pre-drain removal NRS 7.5 vs. post-drain removal NRS 4.2) and the conventional group (pre-drain removal NRS 6.0 vs. post-drain removal NRS 2.7). At 3 months postoperatively, the incidence of CPSP was 35.9% in the conventional group and 35.1% in the minimally invasive group. At 6 months postoperatively, the incidence of CPSP was significantly lower compared to 3 months in both groups (conventional group 8.7% vs. minimally invasive group 6.8%, P<0.001). In the conventional group, higher Europe SCORE Ⅱ was identified as an independent risk factor for CPSP at 3 months postoperatively, while in the minimally invasive group, higher BMI and postoperative use of flurbiprofen for rescue analgesia were identified as independent risk factors. Conclusion:In patients undergoing minimally invasive coronary artery bypass grafting (CABG), the early postoperative acute pain intensity and incidence were higher than those in the conventional CABG group. After drain removal, there were no significant differences in resting pain intensity between the two groups, but pain intensity during movement remained higher in the minimally invasive group compared to the conventional group. The incidence of chronic pain did not differ between the two groups but decreased significantly from 3 months postoperatively. Conventional CABG patients with high preoperative Europe SCORE Ⅱ scores, high preoperative BMI and severe postoperative acute pain tend to have more chronic pain after minimally invasive bypass surgery.

Clamshell incision is widely used in the surgical resection of complex mediastinal tumors, but it is also controversial. Its advantages are the full exposure of the field of vision and the huge operating space, while its disadvantages are the destruction of chest wall muscles and respiratory function impairment. At present, there is a lack of norms for the selection and application of Clamshell incisions, and the definition of complex mediastinal tumors is ambiguous and the dimensions are single. Therefore, this article reviews the literature and combines practical experience to systematically summarize the application progress of Clamshell incisions in the surgical resection of complex mediastinal tumors, with the aim of providing guidance for clinical work.

Gastric cancer has relatively high disease burden worldwide. With the advancement of endoscopic technology and increased public health awareness, the detection rate of early gastric cancer has gradually risen globally. Conventional total or distal gastrectomy frequently results in postoperative complications, including malnutrition and digestive disorders, which can significantly impair the patient's quality of life. Function-preserving gastrectomy (FPG), which aims to minimize the extent of resection and preserve the functional anatomy of the stomach while ensuring radical removal of the tumor, has shown significant advantages in improving postoperative quality of life. This review summarizes the indications for various FPG techniques and the challenges currently faced, emphasizing the necessity of cautious promotion of FPG to improve treatment outcomes and the quality of life for patients with gastric cancer.