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.Study on the medication rules of traditional Chinese medicine in treating breast cancer based on data mining
Yuan LI ; Lin QIAN ; Chao TIAN ; Tao WU ; Lyuhui HU ; Bingmei ZHU ; Zhihua YE ; Zhizhen TAO ; Min YANG ; Qinxi LIU ; Bihui YANG ; Hang LUO ; Fan QU ; Yi YANG
China Modern Doctor 2025;63(24):68-72,129
Objective To analyze the medication rules of traditional Chinese medicine in treating breast cancer based on real-world data mining.Methods Inpatients with breast cancer who received traditional Chinese medicine treatment at the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from January 2017 to December 2021 were selected.Python 3.10 software was used to mine traditional Chinese medicine prescription data;SPSS 23.0 software was applied for descriptive analysis,and systematic cluster analysis was performed on high-frequency drugs.Results A total of 3026 consultation records of inpatients with breast cancer were collected.The main traditional Chinese medicine syndrome diagnosis of"predominantly liver depression and Qi stagnation"accounted for 60.94%of the total consultations.A total of 240 kinds of traditional Chinese medicine were used,with a cumulative frequency of 35 462 times.Among them,29 kinds of traditional Chinese medicine such as Danggui,Fuling,Baizhu,Chaihu had a cumulative usage frequency exceeding 300 times.Regarding the four natures of drugs,cold-natured(43.55%),warm-natured(30.05%),and neutral-natured(23.34%)drugs were predominant;In terms of five flavors,sweet(46.12%),bitter(30.91%),and pungent(20.02%)were the main ones.The most frequently used drugs were tonifying herbs(32.77%),followed by heat-clearing herbs(15.96%)and phlegm-resolving herbs(14.71%).Systematic cluster analysis yielded 7 groups of drug combinations.Conclusion In real-world clinical practice,traditional Chinese medicine for breast cancer mainly uses tonifying herbs,reflecting the traditional Chinese medicine principle of"strengthening healthy Qi and cultivating the root"in treating tumors.The four natures and five flavors of drugs follow syndrome differentiation and the combination of cold and heat.The clustered drug combinations have extensive therapeutic effects,covering various syndromes of breast cancer at different stages,which can provide a reference for clinical medication.
3.Preparation and Quality Standard Formulation of Compound Bupleurum Suppository
Zhizhen YU ; Zegan LIU ; Libo WANG ; Liangyong HUANG ; Fang YE ; Haitao ZHU ; Ziyan XU ; Shiming DU
Herald of Medicine 2025;44(9):1482-1489
Objective To explore the prescription and preparation technology of compound Bupleurum suppository and draft its quality standard.Methods The volatile oil of Bupleurum was extracted by steam distillation,and the compound Bupleurum-based suppository was prepared by mixing the volatile oil with taurine using the melting method.The quality standard of the preparation was formulated according to the quality inspection items of the general rule 0107 of the Pharmacopoeia of the People's Republic of China(2020 Edition,Volume IV);The contents of n-hexanoic acid and n-heptanoic acid in the preparation were determined by gas chromatography-mass spectrometry(GC-MS).The content of taurine in the preparation was determined by high-performance liquid chromatography(HPLC).Results The optimized distillation time of the volatile oil was 1.5 h,The linear ranges of n-hexanoic acid,n-heptanoic acid and taurine are 23.175 0-115.875 0 μg·mL-1(R2=0.999 4),4.590 0-68.850 0 μg·mL-1(R2=0.998 9)and 15-125 μg·mL-1(R2=0.999 6),respectively.The average recoveries are 99.83%,101.96%,98.89%with RSDs of 2.84%,1.36%,2.88%,respectively.The RSDs of precision,stability,and repeatability tests are less than 5%.The properties,mass difference,melting time,microbial limit,and stability assessment of the preparationwere all in accordance with the Pharmacopoeia of the People's Republic of China.Conclusion Compound Bupleurum suppository preparation technology is reasonable and feasible,which meets the quality standard.
4.Preparation and Quality Standard Formulation of Compound Bupleurum Suppository
Zhizhen YU ; Zegan LIU ; Libo WANG ; Liangyong HUANG ; Fang YE ; Haitao ZHU ; Ziyan XU ; Shiming DU
Herald of Medicine 2025;44(9):1482-1489
Objective To explore the prescription and preparation technology of compound Bupleurum suppository and draft its quality standard.Methods The volatile oil of Bupleurum was extracted by steam distillation,and the compound Bupleurum-based suppository was prepared by mixing the volatile oil with taurine using the melting method.The quality standard of the preparation was formulated according to the quality inspection items of the general rule 0107 of the Pharmacopoeia of the People's Republic of China(2020 Edition,Volume IV);The contents of n-hexanoic acid and n-heptanoic acid in the preparation were determined by gas chromatography-mass spectrometry(GC-MS).The content of taurine in the preparation was determined by high-performance liquid chromatography(HPLC).Results The optimized distillation time of the volatile oil was 1.5 h,The linear ranges of n-hexanoic acid,n-heptanoic acid and taurine are 23.175 0-115.875 0 μg·mL-1(R2=0.999 4),4.590 0-68.850 0 μg·mL-1(R2=0.998 9)and 15-125 μg·mL-1(R2=0.999 6),respectively.The average recoveries are 99.83%,101.96%,98.89%with RSDs of 2.84%,1.36%,2.88%,respectively.The RSDs of precision,stability,and repeatability tests are less than 5%.The properties,mass difference,melting time,microbial limit,and stability assessment of the preparationwere all in accordance with the Pharmacopoeia of the People's Republic of China.Conclusion Compound Bupleurum suppository preparation technology is reasonable and feasible,which meets the quality standard.
5.Study on the medication rules of traditional Chinese medicine in treating breast cancer based on data mining
Yuan LI ; Lin QIAN ; Chao TIAN ; Tao WU ; Lyuhui HU ; Bingmei ZHU ; Zhihua YE ; Zhizhen TAO ; Min YANG ; Qinxi LIU ; Bihui YANG ; Hang LUO ; Fan QU ; Yi YANG
China Modern Doctor 2025;63(24):68-72,129
Objective To analyze the medication rules of traditional Chinese medicine in treating breast cancer based on real-world data mining.Methods Inpatients with breast cancer who received traditional Chinese medicine treatment at the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from January 2017 to December 2021 were selected.Python 3.10 software was used to mine traditional Chinese medicine prescription data;SPSS 23.0 software was applied for descriptive analysis,and systematic cluster analysis was performed on high-frequency drugs.Results A total of 3026 consultation records of inpatients with breast cancer were collected.The main traditional Chinese medicine syndrome diagnosis of"predominantly liver depression and Qi stagnation"accounted for 60.94%of the total consultations.A total of 240 kinds of traditional Chinese medicine were used,with a cumulative frequency of 35 462 times.Among them,29 kinds of traditional Chinese medicine such as Danggui,Fuling,Baizhu,Chaihu had a cumulative usage frequency exceeding 300 times.Regarding the four natures of drugs,cold-natured(43.55%),warm-natured(30.05%),and neutral-natured(23.34%)drugs were predominant;In terms of five flavors,sweet(46.12%),bitter(30.91%),and pungent(20.02%)were the main ones.The most frequently used drugs were tonifying herbs(32.77%),followed by heat-clearing herbs(15.96%)and phlegm-resolving herbs(14.71%).Systematic cluster analysis yielded 7 groups of drug combinations.Conclusion In real-world clinical practice,traditional Chinese medicine for breast cancer mainly uses tonifying herbs,reflecting the traditional Chinese medicine principle of"strengthening healthy Qi and cultivating the root"in treating tumors.The four natures and five flavors of drugs follow syndrome differentiation and the combination of cold and heat.The clustered drug combinations have extensive therapeutic effects,covering various syndromes of breast cancer at different stages,which can provide a reference for clinical medication.
6.Exploration of the relationship between the storage time of leukodepleted red blood cell and transfusion adverse reactions
Liu HE ; Jian LIU ; Gang WU ; En WANG ; Fayan YI ; Xingshun TAN ; Shiyu ZHU ; Rui YU ; Guanghui LU ; Yan LIU ; Mei ZHAI ; Qing XIANG ; Ping LIU ; Yanhua LIAO ; Zhizhen FU ; Maolin LI ; Rong HUANG
Chinese Journal of Blood Transfusion 2023;36(10):889-891
【Objective】 To explore the relationship between the storage time of leukodepleted red blood cells and transfusion adverse reactions by analyzing the occurrence of transfusion adverse reactions of patients after leukodepleted red blood cells transfusion from four hospitals. 【Methods】 By using the electronic medical record management system, the collection and transfusion dates of leukodepleted red blood cells from four hospitals in Enshi Prefecture from 2018 to 2022, as well as the information on transfusion adverse reactions, were retrieved. 【Results】 From 2018 to 2022, a total of 697 61 bags of leukodepleted red blood cells were transfused in four hospitals, resulting in 166 cases of transfusion adverse reactions, among which 93 were allergic reactions, 63 were non hemolytic febrile reactions, and 10 were others, with a total incidence rate of transfusion adverse reactions at 0.24%. The average storage time of leukodepleted red blood cells with and without transfusion adverse reactions was (20.25±6.31) and (19.88±5.50) days, respectively. With a storage time of 7 days as the threshold, the incidence of transfusion adverse reactions was the lowest for a storage time of 15~21 days. The incidence of transfusion adverse reactions of leukodepleted red blood cells in two groups (with storage days ≤21 days and >21 days) was not statistically significant(P>0.05). 【Conclusion】 Allergic reactions were the main type of transfusion adverse reaction caused by leukodepleted red blood cells, and the incidence of transfusion adverse reactions decreased and then increased with the prolongation of the storage time of leukodepleted red blood cells. There was no significant difference in the incidence of transfusion adverse reactions with leukodepleted red blood cells stored for ≤ 21 days and >21 days.
7.Research on clinical application of manual therapy to tumor-related adverse reactions
Chongjie YAO ; Zhizhen LÜ ; Shuaipan ZHANG ; Lingjun KONG ; Qingguang ZHU ; Yanbin CHENG ; Min FANG ; Kaiwei ZHANG
Journal of Acupuncture and Tuina Science 2022;20(4):321-328
Objective: To analyze the clinical application of manual therapy (MT) to tumor-related adverse reactions via summarizing the research at home and abroad, in order to provide more theoretical evidence for the clinical promotion of MT. Methods: We searched 7 Chinese and English databases, including China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), PubMed, Excerpta Medica Database (EMBASE), Ovid and EBSCO. The publication date was between the establishment date of the database and December 31, 2020. We screened the literature according to the inclusion and exclusion criteria, and then sorted and analyzed the selected information. Results: A total of 46 papers were analyzed. Most studies focused on the adverse reactions in breast cancer patients. MT interventions demonstrated the best efficacy for fatigue, followed by pain, depression and anxiety. In different MT interventions, Tuina (Chinese therapeutic massage) was mainly adopted for fatigue, pain, anxiety, depression, and limb dysfunctions. Acupoint pressing was mainly adopted for gastrointestinal and psychological problems such as abdominal bloating, insomnia, depression and anxiety. The application of reflexotherapy was similar to that of Tuina. Conclusion: MT can alleviate various adverse reactions by effectively relieving patients' somatic symptoms and improving their psychological states and overall functions. It can be popularized as a significant non-drug therapy. Currently, however, the clinical application of MT is neither extensive nor has sufficient basic research. Consequently, we should attach importance to this application.
8.Effects of long-term oral administration of β-blocker on septic myocardial injury and prognosis
Chun YANG ; Danfeng YU ; Chunyang CHANG ; Gaoshang ZHU ; Yuxia YUAN ; Zhizhen LAI ; Jianbiao MENG ; Hailin LI
Chinese Critical Care Medicine 2021;33(10):1221-1225
Objective:To investigate the effect of long-term oral administration of β-blocker on septic myocardial injury and prognosis.Methods:A retrospective study was conducted. Patients who were admitted to the emergency intensive care unit (EICU) and intensive care unit (ICU) of Tongde Hospital of Zhejiang Province from January 2015 to June 2020 were enrolled. A total of 289 patients who met the criteria of myocardial injury induced by sepsis were included in the analysis. Among them, 187 patients who had never taken β-blocker within 3 months before diagnosis were divided in the non-β-blocker group, and 102 patients who took β-blocker daily for more than 3 months before diagnosis were in the β-blocker group. The physiological and biochemical characteristics were compared between the two groups, including heart rate, mean arterial pressure (MAP) at the time of diagnosis, cardiac troponin I (cTnI), brain natriuretic peptide (BNP), MB isoenzyme of creatine kinase (CK-MB), blood lactic acid (Lac), central venous oxygen saturation (ScvO 2), sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score within 24 hours of diagnosis, left ventricular ejection fraction (LVEF), early and late mitral orifice diastolic peak flow velocity ratio (E/A), utilization rate of vasoactive drugs during hospitalization and 28-day mortality. Results:The heart rate in the β-blocker group at the time of diagnosis was significantly lower than that in the non-β-blocker group (bpm: 107±8 vs. 110±7, P < 0.01), and the levels of cTnI and BNP within 24 hours of diagnosis were significantly lower than those in the non-β-blocker group [cTnI (μg/L): 0.191 (0.220) vs. 0.291 (0.300), BNP (ng/L): 627 (133) vs. 690 (201), both P < 0.05]. However, there were no significant differences in MAP, CK-MB, Lac, ScvO 2, SOFA score, APACHE Ⅱ score, LVEF, E/A, vasoactive drug utilization rate, and 28-day mortality between the β-blocker and non-β-blocker groups [MAP (mmHg, 1 mmHg = 0.133 kPa): 70.6±3.9 vs. 69.9±3.8, CK-MB (μg/L): 4.24 (3.33) vs. 4.32 (3.13), Lac (mmol/L): 3.50 (1.80) vs. 3.50 (1.90), ScvO 2: 0.729±0.032 vs. 0.735±0.041, SOFA score: 7.74±2.34 vs. 7.25±2.23, APACHE Ⅱ score: 17.19±5.13 vs. 18.27±6.12, LVEF: 0.567±0.058 vs. 0.557±0.051, E/A: 0.71 (0.20) vs. 0.69 (0.20), vasoactive drug utilization rate: 60.8% (62/102) vs. 56.7% (106/187), 28-day mortality: 23.5% (24/102) vs. 25.7% (48/187), all P > 0.05]. Conclusion:Long-term oral administration of β-blocker reduce myocardial injury in septic patients, and has no effect on disease severity and prognosis.
9.Diagnostic value of serum lipocalin 2 combined with prostate-specific antigen in prostate cancer
Sicheng BI ; Hao LIU ; Peng ZHANG ; Zhe LI ; Tiejun MAI ; Zhizhen ZHU
Journal of International Oncology 2018;45(1):27-31
Objective To investigate the diagnostic value of lipocalin 2 (LCN2) combined with prostate-specific antigen (PSA) in prostate cancer (PCa).Methods Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of serum LCN2 in patients with PCa (PCa group,n =82),patients with benign prostatic hyperplasia (BPH group,n =40) and healthy subjects (NC group,n =30).The levels of serum PSA were measured by chemiluminescence.The diagnostic value of LCN2 combined with PSA in PCa was analyzed by the receiver operating characteristic (ROC) curve.The relationship between the level of LCN2 and clinical parameters in PCa patients was analyzed.Results The levels of serum LCN2 in PCa group,BPH group and NC group were (88.97 ±40.83) pg/ml,(53.12 ±25.66) pg/ml,(13.34 ±4.86) pg/ml (F=61.306,P <0.001).The level of LCN2 in PCa group was significantly higher than that in BPH group and NC group (both P<0.001).The levels of serum PSA in PCa group,BPH group and NC group were (17.65 ± 8.43) ng/ml,(11.27 ±3.56) ng/ml,(2.61 ±0.87) ng/ml (F=60.959,P<0.001).The level of serum PSA in PCa group was significantly higher than that in BPH group and NC group (both P <0.001).There was positive correlation between serum LCN2 and PSA levels (r =0.360,P < 0.001).The levels of serum LCN2 in PCa patients with different Gleason score,TNM stage and distant metastasis were significantly different (F =8.546,P < 0.001;t =3.421,P =0.001;t =3.622,P =0.010).The area under the curve (AUC) of serum LCN2 was 0.763 (95% CI:0.677-0.850,P <0.001).The sensitivity and specificity of serum LCN2 were 62.2% and 85.0%.The AUC of PSA was 0.750 (95% CI:0.665-0.836,P < 0.001).The sensitivity and specificity of serum PSA were 51.2% and 87.5%.The AUC of LCN2 combined with PSA was 0.822 (95% CI:0.749-0.895,P <0.001).Conclusion Serum LCN2 level in the patients with PCa is significantly higher,which participates in tumor invasion.LCN2 may be a potential serum marker for the diagnosis of PCa.Combined detection of LCN2 and PSA contributes to the early diagnosis of PCa.
10.Relationship of serum anterior gradient 2 level with clinicopathologic features and prognosis of patients with prostate cancer
Peng ZHANG ; Yijing XIE ; Zhe LI ; Zhizhen ZHU
Cancer Research and Clinic 2017;29(9):598-601,606
Objective To investigate the relationship of preoperative level of serum anterior gradient 2 (AGR2)with clinicopathological features and prognosis of patients with prostate cancer. Methods The serum levels of AGR2 were detected by ELISA in 72 patients with prostate cancer, 30 patients with benign prostatic hyperplasia (BPH) and 20 healthy controls. The receiver operating characteristic (ROC) curve was drawn to determine the optimal cut-off value of clinical diagnosis, and to analyze the diagnostic value of serum AGR2 in prostate cancer. Kaplan-Meier method was used to plot the survival curve. Log-rank test was used to analyze the difference of survival time between the two groups. The effect of AGR2 on the prognosis of prostate cancer patients was analyzed by Cox regression. Results The level of serum AGR2 in prostate cancer group was obviously higher than those in BPH group and health control group (t=4.441, t=5.285, both P<0.01).Serum AGR2 level was correlated with Gleason score,tumor stage, lymph node metastasis and preoperative PSA level (F=11.343, F=9.613, t=3.882, t=7.514, all P<0.01). The area under the ROC curve(AUC) of AGR2 was 0.803(95%CI 0.726-0.880,P=0.000), when the cut-off value was 17.25 ng/ml, the sensitivity rate was 63.9%, specificity rate was 80.0%. Kaplan-Meier survival analysis showed that the survival rate in low AGR2 expression group was significantly higher than that in high AGR2 expression group (χ 2=5.565, P=0.018). Cox regression analysis showed that AGR2 was an independent risk factor for prostate cancer patients (HR=5.412, 95%CI 1.143-25.624, P=0.033). Conclusions The elevated level of serum AGR2 is related with tumor progression in prostate cancer. It may be a potential marker for predicting prognosis of patients with prostate cancer.

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