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.Influence of Acupuncture for Regulating the Mind and Replenishing Qi Combined with Butylphthalide Soft Capsules on Sleep Parameters and Neurological Function in Patients with Sleep Disorders after Stroke
Tan ZHANG ; Fang-yue ZENG ; Chen-rong HUANG ; Jia-yi ZHU ; Qiang ZHANG
Progress in Modern Biomedicine 2025;25(20):3238-3246
Objective:To observe the influence of acupuncture for regulating the mind and replenishing qi combined with butylphthalide soft capsules on sleep parameters and neurological function in patients with sleep disorders after stroke.Methods:From May 2022 to September 2024,a total of 85 patients with sleep disorders after stroke who were admitted to our hospital were prospectively included,and they were divided into control group(received treatment with butylphthalein soft capsules,42 cases)and study group(received treatment with acupuncture for regulating the mind and replenishing qi combined with butylphthalide soft capsules,43 cases)by the double chromosphere method.Sleep parameters,sleep quality score[pittsburgh sleep quality index(PSQI),insomnia severity index(ISI)],related functional scale score[modified edinburgh scandinavian stroke scale(MMSSS),hospital anxiety and depression scale(HADS),Fugl-Meyer assessment scale(FMA),montreal cognitive assessment(MoCA)]and related serum indicators[hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),5-hydroxy tryptamine(5-HT),gama-aminobutyric acid(GABA)]were compared between the two groups.Result:The total sleep time,sleep efficiency,FMA score,MoCA score,5-HT and GABA indicators in the study group after treatment were higher than those in the control group,the number of awakenings,sleep latency,PSQI score,ISI score,MESSS score,HADS score,hs-CRP and TNF-α indicators were lower than those in the control group(P<0.05).Conclusion:Acupuncture for regulating the mind and replenishing qi combined with butylphthalide soft capsules can effectively improve the sleep quality of patients with sleep disorders after stroke,regulate the neurological functions,reduce inflammatory factors levels,and improve the motor and cognitive function.
3.Comparison of efficacy between minocycline-containing bismuth quadruple therapy and amoxicillin-con-taining bismuth quadruple therapy in Helicobacter pylori eradication
Yaoyao LI ; Lixiang CHEN ; Yunhan DONG ; Xinyuan ZHU ; Bengang ZHOU ; Weiming XIAO ; Yanbing DING ; Qiang SHE
The Journal of Practical Medicine 2025;41(22):3585-3589
Objective To evaluate the efficacy,safety and patient compliance of a quadruple therapy containing minocycline compared with the traditional quadruple therapy in the treatment of Helicobacter(H.)pylori.Methods This study included 200 H.pylori positive patients,with 100 assigned to the minocycline-containing bismuth quadruple therapy group(LBMC group)and the other 100 to the amoxicillin-containing bismuth quadruple therapy group(LBAC group).After matching the two groups of patients using the propensity score matching(PSM)method,there were 86 cases in each group.Telephone follow-up was conducted on the 14th day after the start of treatment to record patient medication compliance and adverse drug reactions.A 13C urea breath test was performed for re-examination at least one month after completing the treatment plan and discontinuing medication.The intention-to-treat(ITT)and per-protocol(PP)analyses were used to compare the H.pylori eradication rates between the two groups,and Chi-square test and t-test were used for intergroup comparison.Results In the ITT analysis,the eradication rates of the LBMC group and the LBAC group were 89.5%(77/86,95%CI:82.9%~96.1%)and 82.6%(71/86,95%CI:74.4%~90.7%),respectively.In the PP analysis,the eradication rates were 92.6%(75/81,95%CI:86.8%~98.4%)and 88.8%(71/80,95%CI:81.7%~95.8%),respectively.The adverse reaction rate of the LBMC group was 27.9%(24/86),and that of the LBAC group 31.4%(27/86),showing no statistically significant difference(P>0.05).In terms of compliance,the LBMC group was 94.2%(81/86),and the LBAC group 93.0%(80/86),revealing no statistically significant difference(P>0.05).Conclusion As a first-line treatment for eradicating H.pylori,regimens containing minocycline demonstrate equivalent eradication rates to those containing amoxicillin,with similar safety and compliance.They can be used as an alternative treatment for patients allergic to penicillin.
4.An Epithelial Senescence Model Induced by Doxorubicin in MCF 10A Cells
Zeng-Sheng WANG ; Zu-Biao NIU ; Bo ZHANG ; Jia-Hui HAO ; Yi-Chao ZHU ; Rui-Gang YANG ; He REN ; Chen-Yu LIU ; Qiang SUN ; Li-Cheng REN
Chinese Journal of Biochemistry and Molecular Biology 2025;41(1):147-155
This research aims to construct a stable epithelial cell senescence model for screening and e-valuation of senolytics.We explored the optimal conditions for doxorubicin-induced senescence of non-transformed epithelial cells MCF 10A,including the optimal induction concentration,the optimal inter-vention time,and the optimal senescence duration,and confirmed the feasibility of MCF 10A as an epi-thelial senescence model by multiple ways.The optimal condition for Doxorubicin-induced senescence of MCF 10A cells was treatment with 0.6 μmol/L Doxorubicin for 16 h to achieve the best senescence state on the 8th day.Under the optimal induction conditions,the positive rate of senescence-associated β-gal-actosidase(SA-β-gal)staining in the treated group reached 97%.At the same time,biochemical results of detecting the expression of mRNA,proteins,and immunofluorescence demonstrated that the expression levels of senescence-associated secretory phenotype(SASP),p16,p21 and p53 in the treated group were significantly higher than those in the control cells,and Lamin B1 was significantly decreased(P<0.001),which were consistent with the specific characteristics of senescence.In summary,an epithelial senescence model was successfully induced in MCF 10A cells by Doxorubicin in this study,which will promote the screening of senolytics for senescent epithelial cells.
5.Participation of lysine lactylation in neuropsychiatric system disorders
Qiang ZHU ; Weishi CHEN ; Dingding LIU ; Guirong ZENG
Chinese Journal of Pathophysiology 2025;41(10):2053-2058
Lysine lactylation is a type of histone post-translational modification that is mainly regulated by fac-tors such as lactate level,glycolysis level,and vario us enzymes and proteins.Lysine lactylation involves several physio-pathological activities,including macrophage inflammatory response,somatic cell reprogramming,neuronal activity,and embryonic development,etc.Changes in the level of lactfication modification are involved in the development of neuropsy-chiatric disorders such as Alzheimer disease(AD),schizophrenia(SCZ)and depression.Inflammatory response and ab-normal neuronal activity are one of the important causes of neuropsychiatric diseases.The change of lactfication modifica-tion level participates in the development of AD,SCZ,depression and other neuropsychiatric diseases,which specifically regulate neuronal apoptosis,neuronal excitation,and microglial inflammatory response.
6.Effects of Aqueous Extract of Corn Silk Combined with Training on Exercise Function and Glycolipid Metabolism in Mice with Metabolic Syndrome
Yi-lin LIU ; Zi-ling SONG ; Ting ZHOU ; Ji-ping CHEN ; Zi-han LIN ; Yu-xuan ZHANG ; Ji-qiang ZENG ; Shan-rong ZHANG ; Zhi-peng WU ; Chen LU ; Ying ZHU
Progress in Modern Biomedicine 2025;25(15):2411-2420
Objective:To investigate the effects of combination therapy with aqueous extract of corn silk(CS)and training on exercise capacity and glycolipid metabolism in mice with metabolic syndrome(MS).Methods:In this study,db/db mice were used as the animal model of MS.The mice were administered aqueous extract of CS via gavage and subjected to different intensities of training for 12 weeks(3 months).The specific experimental design was as follows:24 db/db mice were randomly divided into four groups on average:negative control group(NC),aqueous extract of CS group(CS),aqueous extract of CS+moderate-intensity training group(CS+MT),and CS aqueous extract of CS+high-intensity training group(CS+HT).The maximum running speed,forelimb grip strength,body weight and fasting blood glucose of mice were measured before and after treatment.After the intervention,oral glucose tolerance test(OGTT)and insulin tolerance test(ITT)were conducted to assess glucose metabolism,while serum triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)levels were measured to evaluate lipid metabolism.Results:After 3 months of intervention,there were significant differences in the maximum running speed and forelimb grip strength among the four groups(P<0.05).The maximum running speed and forelimb grip strength of CS group,CS+MT group and CS+HT group were higher than those of NC group(P<0.05).The CS+MT group exhibited higher forelimb grip strength,and the CS+HT group showed higher maximum running speed and forelimb grip strength compared to the CS group(P<0.05),while no significant difference was found between the CS+MT and CS+HT groups(P>0.05).Significant differences in body weight were observed among the four groups after 3 months of intervention(P<0.05).Specifically,the CS+MT and CS+HT groups exhibited significantly lower body weight compared to both the NC and CS groups(P<0.05),with the CS+MT group having the lowest body weight(P<0.05).Fasting blood glucose levels also differed significantly among the groups after 2 and 3 months of intervention(P<0.05).The CS,CS+MT,and CS+HT groups had lower fasting blood glucose levels compared to the NC group(P<0.05),with the CS+MT and CS+HT groups showing the lowest levels(P<0.05).No significant difference was found between the CS+MT and CS+HT groups(P>0.05).After 3 months of intervention,significant differences in the area under the curve(AUC)of OGTT and ITT were observed among the four groups(P<0.05).The AUC of OGTT and ITT were significantly lower in the CS,CS+MT,and CS+HT groups compared to the NC group(P<0.05).The CS+MT and CS+HT groups exhibited the lowest AUC values for both OGTT and ITT(P<0.05),with the CS+MT group showing the lowest AUC for OGTT(P<0.05).Significant differences in serum lipid levels were observed among the four groups after 3 months of intervention(P<0.05).TG,TC,and LDL-C levels were significantly lower,while HDL-C levels were higher in the CS,CS+MT,and CS+HT groups compared to the NC group(P<0.05).The CS+MT group had the lowest TG levels and the highest HDL-C levels compared to the CS+HT group(P<0.05),with no significant differences in TC and LDL-C levels between these two groups(P>0.05).Conclusion:Aqueous extract of CS combined with different intensity training can significantly improve the exercise capacity and glycolipid metabolism of MS mice and reduce body weight,especially CS combined with MT treatment is more effective in improving lipid metabolism.In addition,when combined with HT,aqueous extract of CS can also play an auxiliary role in reducing the side effects of high-intensity exercise and improving the therapeutic effect.
7.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.
8.Clinical analysis of Haemophilus influenzae meningitis in children
Zhenzhen DOU ; Hong LI ; Qiang YE ; Wenbin LIU ; Lingyun GUO ; Bing HU ; Tianming CHEN ; Huili HU ; Xin GUO ; Heying CHEN ; Liang ZHU ; Haijuan XIAO ; Gang LIU
Chinese Journal of Pediatrics 2025;63(3):288-292
Objective:To analyze the clinical characteristics and outcomes of Haemophilus influenzae (Hi) meningitis in children. Methods:This is a retrospective case series study. This study included 34 Hi meningitis patients who admitted to Beijing Children′s Hospital, Capital Medical University, from January 1, 2010, to December 31, 2023. Data on clinical presentations, laboratory tests, hearing assessment and outcomes at discharge were collected. Patients were divided into 2 groups according to the outcome at discharge: favorable outcome group and unfavorable outcome group. Mann-Whitney U test and Fisher exact test was used to estimate the risk factors for an unfavorable outcome at discharge. Results:Thirty-four patients were enrolled. There were 16 males and 18 females. The age at onset ranged from 3 months to 12 years. Fever (34 patients (100%)), convulsions (17 patients (50%)), and coma (21 patients (62%)) were the common clinical presentations. Twenty-four patients (71%) developed complications. There were 15 patients (44%) needed treatment in the intensive care unit, 5 patients (15%) received intubation, and 4 patients (12%) had developed shock. The favorable outcome group included 23 patients, and the unfavorable outcome group included 11 patients. Female, patients with limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L were risk factors of unfavorable outcome at discharge (all P<0.05). Among the 23 patients (68%) in favorable outcomes group, 13 patients (57%) had data available on their long-term follow-up results, including 12 patients with favorable long-term outcomes and 1 patient with unfavorable long-term outcome. Among the 11 patients (32%) in unfavorable outcomegroup, 1 patient died, the other 10 patients (91%) had data available on their long-term outcomes. Eight patients had unfavorable long-term outcomes and 2 patients with favorable long-term outcomes. Patients who had unfavorable outcomes at discharge were at a greater risk of experiencing unfavorable long-term outcomes ( P=0.001). Conclusions:It is common for patients with Hi meningitis to have intracranial complications or develop into critical conditions. Patients who have limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and who exhibit a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L tend to have unfavorable outcomes; they need to be assessed for sequelae.
9.Clinical trial of hydrocortisone combined with continuous blood purification in the treatment of sepsis patients
Feng LI ; Chen-qiang ZHU ; Gang WANG ; Zhe ZHANG
The Chinese Journal of Clinical Pharmacology 2025;41(2):174-177
Objective To observe the clinical efficacy and safety of hydrocortisone injection combined with continuous blood purification in the treatment of sepsis patients.Methods Sepsis patients were randomly divided into control group and treatment group.The control group received continuous blood purification treatment;on the basis treatment of control group,the treatment group received hydrocortisone 200 mg,qd,intravenous infusion.Two groups were treated for 1 week.The clinical efficacy,levels of inflammatory cytokines,cellular immune function indicators,and safety were compared between two groups.Results Fifty-six cases were enrolled in the treatment group,5 cases were excluded,and ultimately 51 cases were included in the statistical analysis.Fifty-five cases were enrolled in the control group,4 cases were excluded,and ultimately 51 cases were included in the statistical analysis.After treatment,the total effective rates of the treatment and control groups were 94.12%(48 cases/51 cases)and 74.51%(38 cases/51 cases)with statistical significant difference(P<0.05).After treatment,the levels of C-reactive protein in the treatment and control groups were(12.21±2.35)and(15.18±2.25)mg·L-1,the levels of procalcitonin were(0.49±0.13)and(0.78±0.21)ng·mL-1,the levels of CD3+were(58.72±5.13)%and(54.21±4.47)%,the CD4+/CD8+ratios were 1.71±0.23 and 1.43±0.17,respectively.The differences were statistically significant(all P<0.05).The adverse drug reactions of treatment group were chest tightness,nausea,and vomiting,while those in the control group were hypotension,nausea,and vomiting.The total incidences of adverse drug reactions in the treatment and control groups were 9.80%and 5.88%,without significant difference(P>0.05).Conclusion Hydrocortisone injection combined with continuous blood purification have a definitive clinical efficacy in the sepsis patients,which can improve the patients'immune function,reduce inflammatory reactions,without increasing the incidences of adverse drug reactions.
10.Disorder of Cerebrospinal Fluid Circulation Induced by Mesencephalic Aqueduct Stenosis:A Computational Fluid Dynamics Analysis
Xu ZHU ; Baopeng WU ; Xiaoyuan GUO ; Qiang CHEN
Journal of Medical Biomechanics 2025;40(1):202-209
Objective To study the effects from varying stenosis degrees of the mesencephalic aqueduct on intracranial cerebrospinal fluid(CSF)flow field.Methods Based on the clinical magnetic resonance image sequences of a male volunteer,a complete normal CSF circulation model was reconstructed by using semi-automated image segmentation technique.Subsequently,eight ideal models representing different stenosis degrees of the mesencephalic aqueduct were manually created.Computational fluid dynamics(CFD)was then performed to simulate the CSF flow field in the nine models.Results The stenosis degree of the mesencephalic aqueduct was positively correlated with the maximum pressure difference between the aqueduct upstream and downstream and the maximum velocity of CSF within the stenosed aqueduct.In the normal model,the maximum pressure difference was 0.84 Pa and the maximum velocity was 11.4 mm/s.While in the maximum stenosed model,the maximum pressure difference and velocity were 21.36 Pa and 60.3 mm/s,respectively.Compared to the normal model,the maximum pressure difference and velocity were approximately increased by 25 times and 5 times,respectively.Moreover,the maximum pressure difference was inversely proportional to the stenosis area square of the aqueduct,and there was a linear relationship between the pressure difference and the quadratic of the maximun CSF velocity.Conclusions The pressure difference and velocity of the stenosed mesencephalic aqueduct was not apparently increased with mild stenosis with respect to the normal aqueduct,while the great aqueductal stenosis increased the risk of hydrocephalus.This study provides a theoretical framework which contributes to understanding the development of obstructive hydrocephalus and intracranial hypertension.

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