1.Expert consensus on the application of artificial intelligence in lung cancer screening, diagnosis, and treatment (2026 edition)
Wenzhao ZHONG ; Haibo WANG ; Yi HU ; Hao ZHANG ; Jigang DAI ; Junqiang FAN ; Guibin QIAO ; Fan YANG ; Jian HU ; Fengwei TAN ; Xuening YANG ; Qiang PU ; Zihao CHEN ; Hongxia TIAN ; Lunxu LIU ; Hecheng LI ; Xiaolong YAN ; Zongyang YU ; Zhenbin QIU ; Yihua SUN ; Jing HU ; Yuhang SHI ; Zhifei GUO ; Peng ZHANG ; Kezhong CHEN ; Shugeng GAO ; Yilong WU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(06):848-856
With the continuous deepening of the concept of precision diagnosis and treatment for lung cancer, how to achieve higher efficiency and accuracy in the screening, diagnosis, and treatment pathways in clinical practice has become an important issue that urgently needs to be overcome. The current clinical difficulty lies in the fact that despite continuous advancements in imaging and molecular diagnostic technologies, there are still limitations in manual efficiency and subjective experience when it comes to massive data analysis and multi-scale feature extraction. Artificial intelligence (AI), especially algorithm systems based on deep learning, is an innovative technology capable of deeply empowering medical big data. This method utilizes algorithms such as convolutional neural networks, combined with radiomics, pathomics, and multi-modal data fusion analysis, demonstrating immense potential in early precise detection and benign-malignant differentiation of pulmonary nodules, digital pathological subtype recognition and non-invasive prediction of driver genes, precise 3D surgical planning and automatic delineation of radiotherapy target volumes, as well as dynamic risk warning during follow-up. This innovative technology provides a brand-new solution for realizing intelligent and individualized lung cancer diagnosis and treatment models. This consensus, based on the latest evidence from evidence-based medicine and combined with the development trends in the AI field and real-world clinical needs, was ultimately formed by gathering the consensus opinions of multidisciplinary experts in radiology, pathology, thoracic surgery, and other fields. The main content covers the application specifications of AI in the three core scenarios of lung cancer screening, diagnosis, and treatment, the technical standards for data collection and algorithm validation, as well as the ethical and regulatory challenges faced at the current stage. It aims to clarify the applicable boundaries of AI as a clinical auxiliary decision support tool, providing scientific guidance and standardized exploration directions for peers currently engaged in or planning to carry out AI-assisted clinical diagnosis, treatment, and translation of lung cancer.
2.Evaluation system for standardized surgery in elderly patients with lung cancer
Xingqi MI ; Nan CHEN ; Jiandong MEI ; Hecheng LI ; Shuguang ZHANG ; Huanwen CHEN ; Peng JIAO ; Jun WANG ; Chunfang ZHANG ; Guangjian ZHANG ; Xin LI ; Qiang PU ; Peng LIN ; Lunxu LIU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(06):866-873
To address the growing challenge of an increasing number of elderly lung cancer patients amidst China's aging population and to fill the gap in quality control standards for surgical treatment in this special population, this study aimed to develop a standardized surgical evaluation system for elderly lung cancer patients tailored to China's national conditions. The system was established through a literature review, integrated the pathophysiological characteristics of elderly patients, and was constructed following review, feedback, and revision by experts from multiple thoracic surgery centers. Employing a 100-point scoring system, it comprises three primary domains: physical infrastructure and geriatric adaptability foundational conditions (10 points); management level and perioperative care models (20 points); and technical proficiency and clinical outcomes (70 points). The system places a strong emphasis on geriatric adaptability, proposing specific, quantifiable indicators for age-friendly facility modifications, control of elderly-specific complications, multidisciplinary collaboration, and standardized perioperative management. It provides a convenient and measurable assessment tool for quality control in the surgical treatment of elderly lung cancer in China, which is expected to promote the standardization and homogenization of diagnosis and treatment.
3.Chinese expert consensus on postoperative follow-up for non-small cell lung cancer (version 2025)
Lunxu LIU ; Shugeng GAO ; Jianxing HE ; Jian HU ; Di GE ; Hecheng LI ; Mingqiang KANG ; Fengwei TAN ; Fan YANG ; Qiang PU ; Kaican CAI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(03):281-290
Surgical treatment is one of the key approaches for non-small cell lung cancer (NSCLC). Regular postoperative follow-up is crucial for early detection and timely management of tumor recurrence, metastasis, or second primary tumors. A scientifically sound and reasonable follow-up strategy not only extends patient survival but also significantly improves quality of life, thereby enhancing overall prognosis. This consensus aims to build upon the previous version by incorporating the latest clinical research advancements and refining postoperative follow-up protocols for early-stage NSCLC patients based on different treatment modalities. It provides a scientific and practical reference for clinicians involved in the postoperative follow-up management of NSCLC. By optimizing follow-up strategies, this consensus seeks to promote the standardization and normalization of lung cancer diagnosis and treatment in China, helping more patients receive high-quality care and long-term management. Additionally, the release of this consensus is expected to provide insights for related research and clinical practice both domestically and internationally, driving continuous development and innovation in the field of postoperative management for NSCLC.
4.Selection of exosomal microRNA biomarkers for brucellosis diagnosis and construction of a potential miRNA-mRNA regulation network
Jin ZHAO ; Zhi-qiang CHEN ; Bing-Li WANG ; Shu-ling LI ; Xiao-yu ZHU ; Jin-tong JIA ; Ye-zi LIU ; Zhi-wei LI
Chinese Journal of Zoonoses 2025;41(3):269-277
This study was aimed at exploring novel auxiliary diagnostic biomarkers for brucellosis and their potential miR-NA-mRNA regulatory networks.High-throughput sequencing was used to compare miRNA expression differences in serum ex-osomes between patients with brucellosis and healthy controls.Subsequently,RT-qPCR was used to validate the expression of significantly upregulated exosomal miRNAs.The diagnostic value of these miRNAs was assessed with ROC curves,and bioin-formatics analyses were performed to investigate the potential roles of the miRNAs in brucellosis infection.The ROC curve a-nalysis indicated that the area under the curve for exosomal hsa-miR-11400(P<0.05),hsa-miR-199a-5p(P<0.05),and hsa-miR-148a-5p(P<0.05)was 0.79,0.81,and 0.74,respectively.A total of 465 differentially expressed miRNAs and their tar-get genes were predicted,including 25 immune-related target genes,most of which were closely associated with cancer-related proteoglycans,NF-kappa B signaling pathways,and IL-17 signaling pathways.The constructed differentially expressed gene network indicated that the immune genes PLXNA2,IL17RA,PRKCA,CD22,ACVR1B,and CBL might be regulated by hsa-miR-199a-5p and hsa-miR-148a-5p.These findings suggest that exosomal miRNAs might serve as auxiliary diagnostic indicators for brucellosis.Our exosomal miRNA-mRNA regulatory network provides new insights into the pathogenesis and treatment of brucellosis.
5.Prognostic value of quantitative flow ratio measured immediately after percutaneous coronary intervention for chronic total occlusion.
Zheng QIAO ; Zhang-Yu LIN ; Qian-Qian LIU ; Rui ZHANG ; Chang-Dong GUAN ; Sheng YUAN ; Tong-Qiang ZOU ; Xiao-Hui BIAN ; Li-Hua XIE ; Cheng-Gang ZHU ; Hao-Yu WANG ; Guo-Feng GAO ; Ke-Fei DOU
Journal of Geriatric Cardiology 2025;22(4):433-442
BACKGROUND:
The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined.
METHODS:
All CTO vessels treated with successful anatomical PCI in patients from PANDA III trial were retrospectively measured for post-PCI QFR. The primary outcome was 2-year vessel-oriented composite endpoints (VOCEs, composite of target vessel-related cardiac death, target vessel-related myocardial infarction, and ischemia-driven target vessel revascularization). Receiver operator characteristic curve analysis was conducted to identify optimal cutoff value of post-PCI QFR for predicting the 2-year VOCEs, and all vessels were stratified by this optimal cutoff value. Cox proportional hazards models were employed to calculate the hazard ratio (HR) with 95% CI.
RESULTS:
Among 428 CTO vessels treated with PCI, 353 vessels (82.5%) were analyzable for post-PCI QFR. 31 VOCEs (8.7%) occurred at 2 years. Mean value of post-PCI QFR was 0.92 ± 0.13. Receiver operator characteristic curve analysis shown the optimal cutoff value of post-PCI QFR for predicting 2-year VOCEs was 0.91. The incidence of 2-year VOCEs in the vessel with post-PCI QFR < 0.91 (n = 91) was significantly higher compared with the vessels with post-PCI QFR ≥ 0.91 (n = 262) (22.0% vs. 4.2%, HR = 4.98, 95% CI: 2.32-10.70).
CONCLUSIONS
Higher post-PCI QFR values were associated with improved prognosis in the PCI practice for coronary CTO. Achieving functionally optimal PCI results (post-PCI QFR value ≥ 0.91) tends to get better prognosis for patients with CTO lesions.
7.Effect of adequate vessel preparation on 12-month primary patency rate of drug-eluting stents in patients with lower extremity arteriosclerosis obliterans
Xiangyu LIU ; Yuchi ZOU ; Xinyi LI ; Qiang TONG ; Jun CHENG
Journal of Army Medical University 2025;47(17):2097-2105
Objective To investigate the impact of adequate lumen preparation on the 12-month primary patency rate of drug-eluting stents(DES)in patients with lower extremity arteriosclerosis obliterans(ASO)and to identify risk and protective factors for in-stent restenosis.Methods A retrospective cohort study was conducted on 141 patients who underwent DES implantation for ASO at the Department of Vascular Surgery of the First Affiliated Hospital of Chongqing Medical University between April 2022 and April 2024.According to post-percutaneous transluminal angioplasty(PTA)dissection grade[severe dissection is defined as type C or higher based on National Heart,Lung,and Blood Institute(NHLBI)criteria]and residual stenosis rate(severe stenosis is defined as≥30%),the patients were categorized into an adequate preparation group(no severe dissection or severe residual stenosis;n=59)and an inadequate preparation group(n=82).DES primary patency at 12 months was assessed by color Doppler ultrasonography or angiography,defined as a peak systolic velocity ratio≤2.4 on duplex ultrasound or angiographic stenosis<50%.Kaplan-Meier analysis was used to compare intergroup differences in DES patency rate and freedom from clinically driven target lesion revascularization(CD-TLR).Multivariate logistic regression analysis was employed to identify risk and protective factors for DES restenosis and to evaluate the risk contributions of post-PTA dissection and residual stenosis to DES restenosis.Results Post-PTA,vascular dissection occurred in 94.3%(133/141)of treated limbs,among which 42.1%(56/133)were severe dissections,and severe residual stenosis was present in 44.0%(62/141)of limbs.Kaplan-Meier analysis revealed that the 12-month primary patency rate was significantly higher in the adequate preparation group than the inadequate group(HR=0.322,95%CI:0.132~0.789,P=0.013),while no significant difference was found in the rate of freedom from CD-TLR(HR=0.608,95%CI:0.187~1.937,P=0.407).Multivariate logistic regression analysis identified adequate lumen preparation(OR=0.228,95%CI:0.069~0.747,P=0.015)and Rutherford category 2~3(OR=0.205,95%CI:0.058~0.725,P=0.014)as independent protective factors against DES restenosis.The patency rate in the subgroup with coexisting severe dissection and residual stenosis was significantly lower than that in the uncomplicated group(55.6%vs 89.8%,P<0.001),with a 7.067-fold increased risk of re-stenosis(95%CI:2.424~20.602,P<0.001).Conclusion Adequate lumen preparation significantly improves the 12-month primary patency rate of DES.It,along with Rutherford category 2~3,serves as an independent protective factor against in-stent restenosis.Concurrent severe dissection and significant residual stenosis should be actively avoided during the procedure.
8.Ethical considerations of using the deceased as medical research subjects
Zhaolong LU ; Xiaoyun CHEN ; Yongchuan CHEN ; Mengjie YANG ; Qiang LIU ; Hui JIANG ; Zhonglin CHEN
Chinese Medical Ethics 2025;38(11):1447-1452
The relevant laws and regulations regarding the utilization of the deceased as medical research subjects are not yet fully developed in China nowadays. Taking the deceased as research subjects as a starting point, this paper discussed the definition of the deceased and the scope of their interest protection from multiple perspectives. It posited that the scope of interest protection for the deceased encompassed two components: spiritual personality interests and material personality interests represented by the remains. The spiritual personality interests of the deceased included identification information such as name, portrait, reputation, honor, privacy, and personal information, as well as medical and health information. The personal information of the deceased was not directly affected by the individual’s life and death status and remained relatively independent. In terms of ethical review, the research team approached from two perspectives: the remains and the personal information of the deceased. Based on the standard of whether the research subjects involve a human body, research with the remains of the deceased as the medical research subjects was classified as non-clinical research. According to the standard of whether a human body is clinically operated, research with the personal information of the deceased (including medical and health information) as the medical research subjects was recognized as clinical research without human research operation. This approach provided evidence for the application of existing laws and regulations in ethical review and record management. The ethical review of investigator-initiated clinical research conducted in medical and health institutions, as well as the regulatory conditions for exemption from ethical review, were examined. The forms, content, and acquisition of informed consent were summarized, and the risk-benefit characteristics of the research activity were evaluated, with a view to providing a basis for the smooth and compliant implementation of research activities involving the deceased as medical research subjects.
9.Factors affecting Pomacea distribution and prediction of suitable distribution areas of Pomacea in Dali Bai Autonomous Prefecture of Yunnan Province
Zhongqiu LI ; Yuhua LIU ; Yunhai GUO ; Zixin WEI ; Junhu CHEN ; Qiang WANG ; Tianmei LI ; Shizhu LI
Chinese Journal of Schistosomiasis Control 2025;37(1):69-75
Objective To investigate the factors affecting the distribution of Pomacea and project the trends in the spread of suitable distribution areas of Pomacea in 2050 and 2070 in Dali Bai Autonomous Prefecture, so as to provide insights into Pomacea control in the prefecture. Methods The longitudes and latitudes of Pomacea sampling sites were captured based on Pomacea field survey data in 12 cities (counties) of Dali Bai Autonomous Prefecture from 2023 to 2024. A total of 19 climatic factors (annual mean temperature, mean diurnal range, isothermality, temperature seasonality, maximum temperature of the warmest month, minimum temperature of the coldest month, temperature annual range, mean temperature of the wettest quarter, mean temperature of the driest quarter, mean temperature of the warmest month, mean temperature of the coldest month, annual precipitation, precipitation of the wettest month, precipitation of the driest month, precipitation seasonality, precipitation of the wettest quarter, precipitation of the driest quarter, mean temperature of the warmest quarter, and mean temperature of the coldest quarter) and representative concentration pathways (RCPs) were retrieved from the world climate database (www.worldclim.org). All climatic variables were employed to create a maximum entropy (MaxEnt) model. The predictive accuracy of the model was assessed with the area under the receiver operating characteristic (ROC) curve (AUC), and the contributions of these 19 climatic factors to the distribution of Pomacea were analyzed in Dali Bai Autonomous Prefecture using Jackknife test. In addition, the suitable distribution areas of Pomacea were predicted with the MaxEnt model in Dali Bai Autonomous Prefecture in 2024 and in 2050 and 2070 under RCP4.5. Results Data pertaining to 91 Pomacea sampling sites were captured. ROC analysis revealed the MaxEnt model had an AUC value of 0.885 ± 0.088 for predicting the suitable distribution areas of Pomacea in Dali Bai Autonomous Prefecture. Of the 19 climatic factors, the maximum temperature of the warmest month had the highest contribution to the distribution of Pomacea in Dali Bai Autonomous Prefecture, followed by mean temperature of the driest quarter, mean temperature of the wettest quarter and minimum temperature of the coldest month. The suitable distribution area of Pomacea was predicted to be 14 555.69 km2 in Dali Bai Autonomous Prefecture in 2024, and would expand gradually to the southeastern part of the prefecture in the future due to climatic factors. The suitable distribution areas of Pomacea were projected to expand to 21 475.61 km2 in 2050 and 25 782.52 km2 in 2070 in Dali Bai Autonomous Prefecture, respectively. Conclusions Temperature is an important contributor to the distribution of Pomacea in Dali Bai Autonomous Prefecture, and the suitable distribution area of Pomacea will gradually expand to the southeastern part of the prefecture in 2050 and 2070.
10.Bibliographical cataloging for ancient TCM books
Hongtao LI ; Weina ZHANG ; Lin TONG ; Jingpeng DENG ; Qian ZHAO ; Honglei WANG ; Naiying LIU ; Mei SHI ; Qiang LIU ; Ying LIN ; Xiaohong ZHANG ; Lili FENG ; Mingrui ZHANG ; Yanqiu LUO ; Guangkun CHEN ; Yan DONG ; Bin LI ; Sihong LIU ; Bing LI ; Chen LI ; Meng LI ; Rui WANG ; He LU
International Journal of Traditional Chinese Medicine 2025;47(6):729-740
With reference to the Information and Documentation-Resource Description (GB/T 3792-2021) and Bibliographical Description for Ancient Chinese Books (GB/T 3792.7-2008) and other cataloging standards and rules, drawing on the practical experience of cataloging ancient TCM books, Bibliographical Cataloging for Ancient TCM Books was formulated. This standard specifies the entry items and their order of ancient TCM books, cataloging identifier, cataloging text, cataloging information source, and cataloging item details. The standard can provide standardized and unified guiding principles and methods for the work of ancient TCM books, and promote the sharing and utilization of ancient TCM books.

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