Objective To evaluate the predictive ability and clinical application value of artificial intelligence (AI) systems in the benign and malignant differentiation and pathological type of pulmonary nodules, and to summarize clinical application experience. Methods A retrospective analysis was conducted on the clinical data of patients with pulmonary nodules admitted to the Department of Thoracic Surgery, Second Hospital of Lanzhou University, from February 2016 to February 2025. Firstly, pulmonary nodules were divided into benign and non-benign groups, and the discriminative abilities of AI systems and clinicians were compared. Subsequently, lung nodules reported as precursor glandular lesions (PGL), microinvasive adenocarcinoma (MIA), and invasive adenocarcinoma (IAC) in postoperative pathological results were analyzed, comparing the efficacy of AI systems and clinicians in predicting the pathological type of pulmonary nodules. Results In the analysis of benign/non-benign pulmonary nodules, clinical data from a total of 638 patients with pulmonary nodules were included, of which there were 257 males (10 patients and 1 patient of double and triple primary lesions, respectively) and 381 females (18 patients and 1 patient of double and triple primary lesions, respectively), with a median age of 55.0 (47.0, 61.0) years. Different lesions in the same patient were analyzed as independent samples. Univariate analysis of the two groups of variables showed that, except for nodule location, the differences in the remaining variables were statistically significant (P<0.05). Multivariate logistic regression analysis showed that age, nodule type (subsolid pulmonary nodule), average density, spicule sign, and vascular convergence sign were independent influencing factors for non-benign pulmonary nodules, among which age, nodule type (subsolid pulmonary nodule), spicule sign, and vascular convergence sign were positively correlated with non-benign pulmonary nodules, while average density was negatively correlated with the occurrence of non-benign pulmonary nodules. The area under the receiver operating characteristic curve (AUC) of the malignancy risk value given by the AI system in predicting non-benign pulmonary nodules was 0.811, slightly lower than the 0.898 predicted by clinicians. In the PGL/MIA/IAC analysis, clinical data from a total of 411 patients with pulmonary nodules were included, of which there were 149 males (8 patients of double primary lesions) and 262 females (17 patients of double primary lesions), with a median age of 56.0 (50.0, 61.0) years. Different lesions in the same patient were analyzed as independent samples. Univariate analysis results showed that, except for gender, nodule location, and vascular convergence sign, the differences in the remaining variables among the three groups of PGL, MIA, and IAC patients were statistically significant (P<0.05). Multinomial multivariate logistic regression analysis showed that the differences between the parameters in the PGL group and the MIA group were not statistically significant (P>0.05), and the maximum diameter and average density of the nodules were statistically different between the PGL and IAC groups (P<0.05), and were positively correlated with the occurrence of IAC as independent risk factors. The average AUC value, accuracy, recall rate, and F1 score of the AI system in predicting lung nodule pathological type were 0.807, 74.3%, 73.2%, and 68.5%, respectively, all better than the clinical physicians’ prediction of lung nodule pathological type indicators (0.782, 70.9%, 66.2%, and 63.7% respectively). The AUC value of the AI system in predicting IAC was 0.853, and the sensitivity, specificity, and optimal cutoff value were 0.643, 0.943, and 50.0%, respectively. Conclusion This AI system has demonstrated high clinical value in predicting the benign and malignant nature and pathological type of lung nodules, especially in predicting lung nodule pathological type, its ability has surpassed that of clinical physicians. With the optimization of algorithms and the adequate integration of multimodal data, it can better assist clinical physicians in formulating individualized diagnostic and treatment plans for patients with lung nodules.

OBJECTIVE: To evaluate the filling quality of single cone obturation in root canal model with irregular structure (Hus&Kim Ⅴ, Yin Ⅱ-type isthmus) which established by 3D printing technology using slices and radiographic methods, in order to provide reference for clinical practice. METHODS: (1) Extracted fresh premolars with Hus&Kim Ⅴ and Yin-type Ⅱ isthmus were collected and scanned by cone-beam computed tomography (CBCT), then standard root canal models were designed and printed. Rhodamine B staining and bias fitting were used to verify the availability of the models. (2) 30 root canal models were randomly divided into 3 groups according to different filling methods (n=10). CONTROL GROUP: vertical compaction obturation; Experimental group 1: single cone obturation with 0.06-taper cone (30#); Experimental group 2: single cone obturation with 0.04-taper cone (35#), GuttaFlow 2 as canal sealers. Slices were taken at 2, 4, 6, and 8 mm from the root apex in the direction perpendicular to the long axis of the root and observed under a stereomicroscope to calculate the percentage of filling area (PAV), percentage of gutta-percha-filled area (PGFA), percentage of sealer filled area (PSFA). (3) On the basis of the above results, two groups (n=4) were selected to further analyze the filling quality by micro-computed tomography (Micro-CT), the filling volume of main root canal and the isthmus were obtained, and the percentage of filling volume (PFV) was calculated. Two-way ANOVA was used to evaluate the differences between the groups, and Tukey' s multiple comparison was used to compare the data between the groups and within the groups. RESULTS: (1) Rhodamine B staining solution could overflow the apical foramen, and the main root canal system and the isthmus area were stained, showed no remnants of support material. The 3D standard deviation of the printed model data was 0.03 mm, and the average fitting distance was 0.02 mm. (2) The PFA of the two experimental groups were both significantly lower than that of the control group (F=45.04, P < 0.01). There was no statistical difference of the PFA at apical 2 and 4 mm between the two experimental groups (P>0.01), but at the middle and coronal portions of the root canal (6, 8 mm), the PFA of the experimental group 1 was higher than that of the experimental group 2 (P < 0.01). PFA in the apical 2, 4 mm of the two experimental groups were both lower than that in the middle and coronal portions 6, 8 mm of the canal (P < 0.01). There was no difference in the PGFA and PSFA between the two experimental groups at the apical 2, 4 mm (F=2.383, P>0.01). (3) The results of Micro-CT showed that the PFV of the experimental group 1 was statistically different with the control group (F=47.33, P < 0.01). The PFV of the experimental group 1 was 54.33%±4.35% in the isthmus and 78.31%±4.21% in the main root canal, which were both lower than the PFV of the control group of 76.48%±4.89% (isthmus) and 86.90%±3.29% (main root canal, P < 0.01). The PFV of the main root canal in the experimental group 1 was higher than that in the isthmus (P < 0.01), while there was no difference between the isthmus and the main root canal in the control group (P>0.01). CONCLUSION In the irregular root canal structure with isthmus, using large-taper gutta-percha can improve the filling quality of the middle and upper part of the canal, but the percentage of filling volume in the isthmus is lower than that of the main canal, and more technical improvements are needed.
Humans ; Root Canal Obturation/methods* ; Cone-Beam Computed Tomography ; Root Canal Filling Materials ; Dental Pulp Cavity/diagnostic imaging* ; Printing, Three-Dimensional ; In Vitro Techniques ; Gutta-Percha ; Bicuspid

Objective To establish a human luminal breast cancer stem cell(BCSC)model and investigate the inhibitory effects of astragaloside Ⅳ(AS-Ⅳ)on BCSC growth.Methods MCF-7 breast cancer cells were cultured in stem cell-specific medium to induce BCSC formation.The BCSCs were then divided into a blank control group and an AS-Ⅳ treatment group,both groups were given PBS or AS-Ⅳ treatment.Morphological changes were observed after intervention.The therapeutic efficacy of AS-Ⅳ was evaluated using 3D spheroid formation and cell viability assays.Transcriptomic profiling and gene expression analysis were performed to elucidate the underlying mechanisms.Results Compared with the MCF7 breast cancer cells,MCF7 breast cancer stem cell mammospheres exhibited accelerated growth(P＜0.01)and significantly increased expression of the stemness marker ALDH1A1(P＜0.01).Further comparison with the blank control group revealed that astragaloside Ⅳ(AS-Ⅳ)treatment significantly inhibited MCF7 breast cancer stem cell proliferation(P＜0.001)and slowed mammosphere growth(P＜0.01).Transcriptomic analysis demonstrated that differentially expressed genes(DEGs)induced by stem cell modeling and AS-Ⅳ intervention were enriched in the cellular senescence signaling pathway.AS-Ⅳ intervention substantially increased the number of SA-β-gal-positive cells(P＜0.01).RT-PCR analysis confirmed that AS-Ⅳsignificantly upregulated mRNA expression of IL-1α(P＜0.01),P21(P＜0.001),and P53(P＜0.05)in MCF7 breast cancer stem cells.Conclusion Astragaloside Ⅳ suppresses the growth of human luminal breast cancer stem cells by inducing cellular senescence.

With the development of neuroscience and oncology, the direct regulation effect of central nervous system circuits on tumors has been gradually revealed. Evidence indicates that the therapy targeting emotion-related encephalic regions may have great potential in blocking the promotion of breast cancer progression by depression. The underlying complex mechanisms involve the generation of depression and the regulation of tumors by central nervous system circuits. However, a systematic summary is lacking in this field. This article reviews the latest research progress of the central nervous system circuits and the generation of depression, the neural connection between the central nervous system and peripheral tumor, and the regulation of the tumor immune microenvironment by the sympathetic nervous system. It also systematically investigates the potential mechanism of the central nervous system circuit in the promotion of breast cancer progression by depression to establish new solutions for the comprehensive treatment of breast cancer.

Objective To investigate the underlying mechanisms contributing to the limited therapeutic efficacy of endocrine therapy combined with CDK4/6 inhibitors in HR+/HER2-low breast cancer,and to develop a breast cancer organoid model as a tool for the precise identification of HR+/HER2-low patients who are responsive to pan-TKI treatment.Methods Transcriptomics was employed to identify differentially expressed genes in HR+/HER2-0 and HR+/HER2-low breast cancer samples and to perform functional enrichment analysis.Tumor organoid models were established using breast cancer tissues obtained from clinical sources,and the differential sensitivity of these samples to therapeutic agents was assessed using Calcein-AM/PI cell viability staining and EdU-based cell proliferation assays.Results The results of transcriptomic enrichment analysis indicated that EGFR was signifi-cantly activated in HR+/HER2-low breast cancer and exhibited characteristics of resistance to TKIs.Breast cancer organoids were successfully established.Drug sensitivity testing revealed that the therapeutic efficacy of ET combined with CDK4/6 inhibitors was suboptimal in certain cases of HR+/HER2-low breast cancer,while the addition of TKIs effectively restored sensitivity to the ET+CDK4/6 inhibitor regimen(P<0.05).Conclusions TKI can restore the reduced sensitivity of HR+/HER2-low breast cancer to endocrine therapy combined with CDK4/6 inhibitors.Breast cancer organoids hold promise as screening tools for assessing drug sensitivity in clinical settings for patients with HR+/HER2-low breast cancer.

Objective:To evaluate the filling quality of single cone obturation in root canal model with irregular structure(Hus&Kim Ⅴ,Yin Ⅱ-type isthmus)which established by 3D printing technology using slices and radiographic methods,in order to provide reference for clinical practice.Methods:(1)Extracted fresh premolars with Hus&Kim Ⅴ and Yin-type Ⅱ isthmus were collected and scanned by cone-beam computed tomography(CBCT),then standard root canal models were designed and printed.Rhodamine B staining and bias fitting were used to verify the availability of the models.(2)30 root canal models were randomly divided into 3 groups according to different filling methods(n=10).Control group:vertical compaction obturation;Experimental group 1:single cone obturation with 0.06-taper cone(30#);Experimental group 2:single cone obturation with 0.04-taper cone(35#),GuttaFlow 2 as canal sealers.Slices were taken at 2,4,6,and 8 mm from the root apex in the direction perpendicular to the long axis of the root and observed under a stereomicroscope to calculate the percentage of filling area(PAV),percentage of gutta-percha-filled area(PGFA),percentage of sealer filled area(PSFA).(3)On the basis of the above results,two groups(n=4)were selected to further analyze the filling quality by micro-computed tomography(Micro-CT),the filling volume of main root canal and the isthmus were obtained,and the percentage of filling volume(PFV)was calculated.Two-way ANOVA was used to evaluate the differences between the groups,and Tukey's multiple comparison was used to compare the data between the groups and within the groups.Results:(1)Rhodamine B staining solution could over-flow the apical foramen,and the main root canal system and the isthmus area were stained,showed no remnants of support material.The 3D standard deviation of the printed model data was 0.03 mm,and the average fitting distance was 0.02 mm.(2)The PFA of the two experimental groups were both significant-ly lower than that of the control group(F=45.04,P＜0.01).There was no statistical difference of the PFA at apical 2 and 4 mm between the two experimental groups(P＞0.01),but at the middle and coro-nal portions of the root canal(6,8 mm),the PFA of the experimental group 1 was higher than that of the experimental group 2(P＜0.01).PFA in the apical 2,4 mm of the two experimental groups were both lower than that in the middle and coronal portions 6,8 mm of the canal(P＜0.01).There was no difference in the PGFA and PSFA between the two experimental groups at the apical 2,4 mm(F=2.383,P＞0.01).(3)The results of Micro-CT showed that the PFV of the experimental group 1 was statistically different with the control group(F=47.33,P＜0.01).The PFV of the experimental group 1 was 54.33％±4.35％in the isthmus and 78.31％±4.21％in the main root canal,which were both lower than the PFV of the control group of 76.48％±4.89％(isthmus)and 86.90％±3.29％(main root canal,P＜0.01).The PFV of the main root canal in the experimental group 1 was higher than that in the isthmus(P＜0.01),while there was no difference between the isthmus and the main root canal in the control group(P＞0.01).Conclusion:In the irregular root canal structure with isthmus,using large-taper gutta-percha can improve the filling quality of the middle and upper part of the canal,but the percentage of filling volume in the isthmus is lower than that of the main canal,and more technical im-provements are needed.

Objective:To systematically integrate the real experiences of self-management in breast cancer-related lymphedema (BCRL) patients and provide evidence for optimizing home self-management support strategies.Methods:A computer-based search was conducted in PubMed, Web of Science, CINAHL, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Database, and VIP Database for qualitative studies on self-management experiences in BCRL patients, with the search period extending from the inception of each database to November 30, 2023. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, and the results were synthesized using an integrative approach.Results:A total of 20 articles were included, with 87 research findings extracted and summarized into 11 new categories, which were integrated into 4 main outcomes: the psychological, family function, and social adaptation associated with lymphedema symptoms; the multiple factors affecting patients' self-management of lymphedema; varied levels of self-management participation and coping behaviors; diverse self-management support needs.Conclusions:Healthcare professionals need to address the barriers and needs of patients performing self-management of lymphedema at home. By integrating coping resources and enhancing self-regulation and self-management capabilities, healthcare providers can help patients adapt to and cope with lymphedema more effectively.

Objective:To evaluate the filling quality of single cone obturation in root canal model with irregular structure(Hus&Kim Ⅴ,Yin Ⅱ-type isthmus)which established by 3D printing technology using slices and radiographic methods,in order to provide reference for clinical practice.Methods:(1)Extracted fresh premolars with Hus&Kim Ⅴ and Yin-type Ⅱ isthmus were collected and scanned by cone-beam computed tomography(CBCT),then standard root canal models were designed and printed.Rhodamine B staining and bias fitting were used to verify the availability of the models.(2)30 root canal models were randomly divided into 3 groups according to different filling methods(n=10).Control group:vertical compaction obturation;Experimental group 1:single cone obturation with 0.06-taper cone(30#);Experimental group 2:single cone obturation with 0.04-taper cone(35#),GuttaFlow 2 as canal sealers.Slices were taken at 2,4,6,and 8 mm from the root apex in the direction perpendicular to the long axis of the root and observed under a stereomicroscope to calculate the percentage of filling area(PAV),percentage of gutta-percha-filled area(PGFA),percentage of sealer filled area(PSFA).(3)On the basis of the above results,two groups(n=4)were selected to further analyze the filling quality by micro-computed tomography(Micro-CT),the filling volume of main root canal and the isthmus were obtained,and the percentage of filling volume(PFV)was calculated.Two-way ANOVA was used to evaluate the differences between the groups,and Tukey's multiple comparison was used to compare the data between the groups and within the groups.Results:(1)Rhodamine B staining solution could over-flow the apical foramen,and the main root canal system and the isthmus area were stained,showed no remnants of support material.The 3D standard deviation of the printed model data was 0.03 mm,and the average fitting distance was 0.02 mm.(2)The PFA of the two experimental groups were both significant-ly lower than that of the control group(F=45.04,P＜0.01).There was no statistical difference of the PFA at apical 2 and 4 mm between the two experimental groups(P＞0.01),but at the middle and coro-nal portions of the root canal(6,8 mm),the PFA of the experimental group 1 was higher than that of the experimental group 2(P＜0.01).PFA in the apical 2,4 mm of the two experimental groups were both lower than that in the middle and coronal portions 6,8 mm of the canal(P＜0.01).There was no difference in the PGFA and PSFA between the two experimental groups at the apical 2,4 mm(F=2.383,P＞0.01).(3)The results of Micro-CT showed that the PFV of the experimental group 1 was statistically different with the control group(F=47.33,P＜0.01).The PFV of the experimental group 1 was 54.33％±4.35％in the isthmus and 78.31％±4.21％in the main root canal,which were both lower than the PFV of the control group of 76.48％±4.89％(isthmus)and 86.90％±3.29％(main root canal,P＜0.01).The PFV of the main root canal in the experimental group 1 was higher than that in the isthmus(P＜0.01),while there was no difference between the isthmus and the main root canal in the control group(P＞0.01).Conclusion:In the irregular root canal structure with isthmus,using large-taper gutta-percha can improve the filling quality of the middle and upper part of the canal,but the percentage of filling volume in the isthmus is lower than that of the main canal,and more technical im-provements are needed.

Objective To investigate the underlying mechanisms contributing to the limited therapeutic efficacy of endocrine therapy combined with CDK4/6 inhibitors in HR+/HER2-low breast cancer,and to develop a breast cancer organoid model as a tool for the precise identification of HR+/HER2-low patients who are responsive to pan-TKI treatment.Methods Transcriptomics was employed to identify differentially expressed genes in HR+/HER2-0 and HR+/HER2-low breast cancer samples and to perform functional enrichment analysis.Tumor organoid models were established using breast cancer tissues obtained from clinical sources,and the differential sensitivity of these samples to therapeutic agents was assessed using Calcein-AM/PI cell viability staining and EdU-based cell proliferation assays.Results The results of transcriptomic enrichment analysis indicated that EGFR was signifi-cantly activated in HR+/HER2-low breast cancer and exhibited characteristics of resistance to TKIs.Breast cancer organoids were successfully established.Drug sensitivity testing revealed that the therapeutic efficacy of ET combined with CDK4/6 inhibitors was suboptimal in certain cases of HR+/HER2-low breast cancer,while the addition of TKIs effectively restored sensitivity to the ET+CDK4/6 inhibitor regimen(P<0.05).Conclusions TKI can restore the reduced sensitivity of HR+/HER2-low breast cancer to endocrine therapy combined with CDK4/6 inhibitors.Breast cancer organoids hold promise as screening tools for assessing drug sensitivity in clinical settings for patients with HR+/HER2-low breast cancer.

Objective:To systematically integrate the real experiences of self-management in breast cancer-related lymphedema (BCRL) patients and provide evidence for optimizing home self-management support strategies.Methods:A computer-based search was conducted in PubMed, Web of Science, CINAHL, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Database, and VIP Database for qualitative studies on self-management experiences in BCRL patients, with the search period extending from the inception of each database to November 30, 2023. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, and the results were synthesized using an integrative approach.Results:A total of 20 articles were included, with 87 research findings extracted and summarized into 11 new categories, which were integrated into 4 main outcomes: the psychological, family function, and social adaptation associated with lymphedema symptoms; the multiple factors affecting patients' self-management of lymphedema; varied levels of self-management participation and coping behaviors; diverse self-management support needs.Conclusions:Healthcare professionals need to address the barriers and needs of patients performing self-management of lymphedema at home. By integrating coping resources and enhancing self-regulation and self-management capabilities, healthcare providers can help patients adapt to and cope with lymphedema more effectively.