1.Application advances, ethical dilemmas, and future directions of large language models in lung cancer diagnosis and treatment
Zhizhen REN ; Yufan XI ; Xu ZHU ; Yijie LUO ; Geting HUANG ; Junqiao SONG ; Xiuyuan XU ; Nan CHEN ; Qiang PU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(03):353-362
Lung cancer is a leading cause of cancer-related morbidity and mortality worldwide. Coupled with the substantial workload, the clinical management of lung cancer is challenged by the critical need to efficiently and accurately process increasingly complex medical information. In recent years, large language models (LLMs) technology has undergone explosive development, demonstrating unique advantages in handling complex medical data by leveraging its powerful natural language processing capabilities, and its application value in the field of lung cancer diagnosis and treatment is continuously increasing. The paper systematically analyzes that the exceptional potential of LLMs in lung cancer auxiliary diagnosis, tumor feature extraction, automatic staging, progression/outcome analysis, treatment recommendations, medical documentation generation, and patient education. However, they face critical technical and ethical challenges including inconsistent performance in complex integrated decision-making (e.g., TNM staging, personalized treatment suggestions) and "black box" opacity issues, along with dilemmas such as training data biases, model hallucinations, data privacy concerns, and cross-lingual adaptation challenges ("data colonization"). Future directions should prioritize constructing high-quality multimodal corpora specific to lung cancer, developing interpretable and compliant specialized models, and achieving seamless integration with existing clinical workflows. Through dual drivers of technological innovation and ethical standardization, LLMs should be prudently advanced for holistic lung cancer management processes, ultimately promoting efficient, standardized, and personalized diagnosis and treatment practices.
2.Research Progress of Fuzheng Jiedu Huayu Method in Reducing Toxicity and Enhancing Efficacy of Immunotherapy
Yufan CHEN ; Sicong LI ; Yiyuan CUI ; Li FENG
Cancer Research on Prevention and Treatment 2025;52(1):11-18
Immunotherapy, including immune checkpoint inhibitors, tumor vaccine therapy, oncolytic virotherapy, and adoptive cell therapy, has made remarkably breakthroughs in the field of oncology. Immune checkpoint inhibitors, which block programmed death receptor 1 or programmed death ligand 1, have been included in the first-line clinical treatment for advanced solid tumors, such as non-small cell lung cancer and malignant melanoma. However, primary or secondary drug resistance in tumors severely limits the survival benefits for patients. Immune-related adverse reactions, such as pneumonia, hypothyroidism, hypophysitis, and myocarditis, also greatly affect the quality of life of patients. Fuzheng Jiedu Huayu is an important concept guiding the prevention and treatment of tumors with traditional Chinese medicine (TCM). It is also a curative principle and therapeutic TCM method to reduce the toxicity and enhance the efficacy of immunotherapy. This article summarizes the research progress of immunotherapy and discusses how TCM reduces the toxicity and enhances the efficacy of immunotherapy, hoping to provide a reference for the integrated treatment of tumors with TCM and immunotherapy.
3.Characteritics of resting state brain functional activities in patients with hand dysfunction after ischemic stroke
Huihuang WANG ; Xuejing LI ; Fu LIU ; Sihang CHEN ; Shuying LI ; Yufan PU
Chinese Journal of Rehabilitation Theory and Practice 2025;31(11):1256-1264
Objective To explore the characteritics of spontaneous brain functional activities for patients with hand dysfunction after ischemic stroke using resting state functional magnetic resonance imaging(rs-fMRI).Methods From August,2024 to June,2025,23 patients with hand dysfunction after ischemic stroke were as patients group,and ten age-matched healthy adults were recruited as healthy control group.The patients group was as-sessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Wolf Motor Function Test(WMFT)and modified Lindmark Scale.All subjects underwent rs-fMRI examinations,and the amplitude of low frequency fluctuations(ALFF),fractional amplitude of low frequency fluctuations(fALFF)and regional homogeneity(Re-Ho)were compared between two groups.The resting state functional network was constructed based on indepen-dent component analysis,and the functional connectivity(FC)were analyzed.The rs-fMRI indicators of the pa-tients and the clinical scale scores were analyzed.Results Compared with the healthy control group,the zALFF value decreased in the precentral gyrus(P<0.05,FWE corrected)in the patient group,as well as the values of zfALFF in Cerebelum-Crus2-R(P<0.05,FWE correct-ed),and ReHo values in the putamen(P<0.05,corrected by Alpha Sim).FC of the inferior frontal gyrus(IF-Goperc.R)in the executive control network enhanced(P<0.05,Alpha Sim corrected),while FC of the middle oc-cipital gyrus(MOG.L)in the dorsal attention network(DAN)weakened(P<0.05,Alpha Sim corrected).There was a positive correlation between FC of MOG.L in the patient's DAN and the scores of FMA-UE(r=0.439,P=0.036),WMFT(r=0.516,P=0.012),and modified Lindmark Scales(r=0.425,P=0.043).Conclusion The resting state spontaneous activity of some brain areas of the cerebrum,cerebellum and basal ganglia is reduced in patients with hand dysfunction after ischemic stroke,and some brain network connections are abnor-mal.FC of MOG.L may serve as an objective imaging marker for evaluating hand dysfunction.
4.Guideline for Adult Weight Management in China
Weiqing WANG ; Qin WAN ; Jianhua MA ; Guang WANG ; Yufan WANG ; Guixia WANG ; Yongquan SHI ; Tingjun YE ; Xiaoguang SHI ; Jian KUANG ; Bo FENG ; Xiuyan FENG ; Guang NING ; Yiming MU ; Hongyu KUANG ; Xiaoping XING ; Chunli PIAO ; Xingbo CHENG ; Zhifeng CHENG ; Yufang BI ; Yan BI ; Wenshan LYU ; Dalong ZHU ; Cuiyan ZHU ; Wei ZHU ; Fei HUA ; Fei XIANG ; Shuang YAN ; Zilin SUN ; Yadong SUN ; Liqin SUN ; Luying SUN ; Li YAN ; Yanbing LI ; Hong LI ; Shu LI ; Ling LI ; Yiming LI ; Chenzhong LI ; Hua YANG ; Jinkui YANG ; Ling YANG ; Ying YANG ; Tao YANG ; Xiao YANG ; Xinhua XIAO ; Dan WU ; Jinsong KUANG ; Lanjie HE ; Wei GU ; Jie SHEN ; Yongfeng SONG ; Qiao ZHANG ; Hong ZHANG ; Yuwei ZHANG ; Junqing ZHANG ; Xianfeng ZHANG ; Miao ZHANG ; Yifei ZHANG ; Yingli LU ; Hong CHEN ; Li CHEN ; Bing CHEN ; Shihong CHEN ; Guiyan CHEN ; Haibing CHEN ; Lei CHEN ; Yanyan CHEN ; Genben CHEN ; Yikun ZHOU ; Xianghai ZHOU ; Qiang ZHOU ; Jiaqiang ZHOU ; Hongting ZHENG ; Zhongyan SHAN ; Jiajun ZHAO ; Dong ZHAO ; Ji HU ; Jiang HU ; Xinguo HOU ; Bimin SHI ; Tianpei HONG ; Mingxia YUAN ; Weibo XIA ; Xuejiang GU ; Yong XU ; Shuguang PANG ; Tianshu GAO ; Zuhua GAO ; Xiaohui GUO ; Hongyi CAO ; Mingfeng CAO ; Xiaopei CAO ; Jing MA ; Bin LU ; Zhen LIANG ; Jun LIANG ; Min LONG ; Yongde PENG ; Jin LU ; Hongyun LU ; Yan LU ; Chunping ZENG ; Binhong WEN ; Xueyong LOU ; Qingbo GUAN ; Lin LIAO ; Xin LIAO ; Ping XIONG ; Yaoming XUE
Chinese Journal of Endocrinology and Metabolism 2025;41(11):891-907
Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.
5.Research progress on the role of polygenic risk scores and gene-environment interactions in the risk and recognition of depression
Rui LIU ; Yongqi SHAO ; Yufan CAI ; Wenji CHEN ; Zhi XU
Chinese Journal of Psychiatry 2025;58(3):232-237
Depression is a psychological disorder that imposes a tremendous social burden, with a high prevalence in China. In recent years, the number of diagnosed cases of depression in China has steadily increased, yet the recognition rate of the disease remains low. Depression demostrates a clear familial aggregation pattern. To improve its recognition, numberous studies have utilized the polygenic risk score for major depressive disorder (MDD-PRS) as a potential genetic marker to identify high-risk populations. This article reviews the latest progress and research on the use of MDD-PRS in depression, aiming to clarify its capacity to capture genetic variations associated with depression, its interaction with environmental factors, and their relationship to the onset of the disorder. Additionally, this review evaluates the predictive performance of existing risk models for depression and proposes potential directions for future research.
6.COVID-19 infection illness condition and prognosis related demographic characteristics,laboratory indicators and radiological factors
Yufan XIONG ; Xinchi ZHANG ; Jianhe GAN ; Wei SUN ; Jing GU ; Li CHEN
Chinese Journal of Nosocomiology 2025;35(15):2384-2389
Coronavirus disease 2019(COVID-19)is a respiratory syndrome caused by severe acute respiratory syn-drome coronavirus 2(SARS-CoV-2).Once SARS-CoV-2 was detected in Wuhan(Hubei Province,China),it rap-idly spread widely across China and the world,posing a serious threat to global health and the economy.With the development of Artificial Intelligence(AI)technology and the openness and application of open-source software,tremendous progress has been achieved in the quantitative study of chest radiology for COVID-19,enabling the quantitative dataization of radiological image data,which adds a powerful indicator to the prognosis study of COV-ID-19.Therefore,we reviewed the current literature on the factors predicting the severity and prognosis of COV-ID-19,and summarized demographic,laboratory and radiological factors to help with risk stratification and prog-nosis assessment for COVID-19 patients and assist in their clinical management and treatment.
7.Diagnostic and treatment strategies for esophageal squamous cell carcinoma from the perspective of kidney deficiency as the root cause and toxicity and stasis as the enabler
Jingjie YU ; Sicong LI ; Shengjuan HU ; Yiyuan CUI ; Yue JIN ; Yufan CHEN ; Yijing YAN ; Li FENG
Journal of Beijing University of Traditional Chinese Medicine 2025;48(11):1595-1601
Esophageal squamous cell carcinoma(ESCC)is a common malignant tumor with insidious early symptoms and a poor prognosis.In traditional Chinese medicine(TCM),ESCC is classified as"ye ge."Drawing on clinical experience,we believe that kidney deficiency leads to the deficiency of vital qi and immune dysfunction,providing the foundation for cancerous growth by depleting qi and damaging essence,toxic stasis and stagnation,forming a local hypoxic and acidic microenvironment that promotes tumor invasion,metastasis,and recurrence.Considering the effect of modern comprehensive treatments,the occurrence and development of ESCC are summarized as kidney deficiency being the root cause and toxic stasis being the driving force.The pathogenesis and treatment of ESCC in the preoperative,postoperative,and non-surgical treatment stages are discussed.The pathogenesis of the disease is summarized as follows:preoperatively,toxicity and stasis intertwine,depleting the kidney;postoperatively,the kidney loses its vitality,allowing various pathogenic factors to persist;during non-operative treatment,vital qi and pathogens contend,resulting in entrenched toxicity.During the preoperative neoadjuvant phase,therapy should resolve stasis,eliminate toxins,enhance kidney function,tonify essence,and support the body.During the postoperative adjuvant phase,therapy should strengthen the root and consolidate the foundation while detoxifying and expelling stasis.The non-surgical treatment stage uses"balanced interruption,"targeting tumor progression and metastasis by harmonizing yin and yang,thus preventing recurrence.This article will provide insights into the integrative Chinese-Western management of ESCC.
8.Research on ethical issues and coping strategies of voice biomarkers in medical applications
Sikai SHAN ; Shuyu HAN ; Wenxia WANG ; Yufan YANG ; Xiaomeng WANG ; Wenmin ZHANG ; Siye CHEN ; Mo CHEN ; Zhiwen WANG
Chinese Medical Ethics 2025;38(10):1233-1239
Voice biomarkers, as an emerging smart medical technology, are now being used in applications such as assisting in the diagnosis and treatment of diseases, facilitating accurate and personalized medical services for patients. However, it also raises many ethical issues, including informed consent, privacy protection, accuracy and reliability, data security, legal risks, and other issues. This paper systematically sorted out the ethical issues in the applications of voice biomarkers in the medical field, summarized these issues, such as informed consent, privacy protection, accuracy and reliability, data security, and legal risks, as well as explored the corresponding coping strategies. These countermeasures encompassed utilizing new media platforms to raise public awareness of voice biomarkers, strengthening supervision and management to promote the privacy protection of voice biomarkers, reducing algorithm biases to promote the general benefits of voice biomarkers to the public, establishing multidisciplinary teams to protect the data security of voice biomarkers, and encouraging medical professionals and researchers to participate in policy research, with a view to providing references for promoting and regulating the applications of voice biomarkers in the medical field.
9.Discovery of novel butyrylcholinesterase inhibitors for treating Alzheimer's disease.
Zhipei SANG ; Shuheng HUANG ; Wanying TAN ; Yujuan BAN ; Keren WANG ; Yufan FAN ; Hongsong CHEN ; Qiyao ZHANG ; Chanchan LIANG ; Jing MI ; Yunqi GAO ; Ya ZHANG ; Wenmin LIU ; Jianta WANG ; Wu DONG ; Zhenghuai TAN ; Lei TANG ; Haibin LUO
Acta Pharmaceutica Sinica B 2025;15(4):2134-2155
Alzheimer's disease (AD) is a common neurodegenerative disorder among the elderly, and BuChE has emerged as a potential therapeutic target. In this study, we reported the development of compound 8e, a selective reversible BuChE inhibitor (eqBuChE IC50 = 0.049 μmol/L, huBuChE IC50 = 0.066 μmol/L), identified through extensive virtual screening and lead optimization. Compound 8e demonstrated favorable blood-brain barrier permeability, good drug-likeness property and pronounced neuroprotective efficacy. Additionally, 8e exhibited significant therapeutic effects in zebrafish AD models and scopolamine-induced cognitive impairments in mice. Further, 8e significantly improved cognitive function in APP/PS1 transgenic mice. Proteomics analysis demonstrated that 8e markedly elevated the expression levels of very low-density lipoprotein receptor (VLDLR), offering valuable insights into its potential modulation of the Reelin-mediated signaling pathway. Thus, compound 8e emerges as a novel and potent BuChE inhibitor for the treatment of AD, with significant implications for further exploration into its mechanisms of action and therapeutic applications.
10.High-efficient discovering the potent anti-Notum agents from herbal medicines for combating glucocorticoid-induced osteoporosis.
Yuqing SONG ; Feng ZHANG ; Jia GUO ; Yufan FAN ; Hairong ZENG ; Mengru SUN ; Jun QIAN ; Shenglan QI ; Zihan CHEN ; Xudong JIN ; Yunqing SONG ; Tian TIAN ; Zhi QIAN ; Yao SUN ; Zhenhao TIAN ; Baoqing YU ; Guangbo GE
Acta Pharmaceutica Sinica B 2025;15(8):4174-4192
Notum, a negative feedback regulator of the Wnt signaling, has emerged as a promising target for treating glucocorticoid-induced osteoporosis (GIOP). This study showcases an efficient strategy for discovering the anti-Notum constituents from herbal medicines (HMs) as novel anti-GIOP agents. Firstly, a rapid-responding near-infrared fluorogenic substrate for Notum was rationally engineered for high-throughput identifying the anti-Notum HMs. The results showed that Bu-Gu-Zhi (BGZ), a known anti-osteoporosis herb, potently inhibited Notum in a competitive-inhibition manner. To uncover the key anti-Notum constituents in BGZ, an efficient strategy was adapted via integrating biochemical, phytochemical, computational, and pharmacological assays. Among all identified BGZ constituents, three furanocoumarins were validated as strong Notum inhibitors, while 5-methoxypsoralen (5-MP) showed the most potent anti-Notum activity and favorable safety profiles. Mechanistically, 5-MP acted as a competitive inhibitor of Notum via creating strong hydrophobic interactions with Trp128 and Phe268 in the catalytic cavity of Notum. Cellular assays showed that 5-MP remarkably promoted osteoblast differentiation and activated Wnt signaling in dexamethasone (DXMS)-challenged MC3T3-E1 osteoblasts. In dexamethasone-induced osteoporotic mice, 5-MP strongly elevated bone mineral density (BMD) and improved cancellous and cortical bone thickness. Collectively, this study constructs a high-efficient platform for discovering key anti-Notum constituents from HMs, while 5-MP emerges as a promising anti-GIOP agent.

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