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.

Objective This study aimed to investigate the genetic diversity, differentiation, and population structure of Aedes albopictus across different geographical regions in Shandong Province, and to explore the relationship between genetic diversity and geographical distribution. Methods Between July and August 2024, ten Ae. albopictus populations were sampled from seven cities in Shandong Province. Genomic DNA was extracted from individual mosquitoes, and the mitochondrial cytochrome c oxidase subunit I(COⅠ)gene was amplified using PCR and sequenced. The obtained sequences were verified using BLAST and analyzed with MAFFT, MEGA 11, DnaSP v6.12, Arlequin 3.5, PopART 1.7, STRUCTURE 2.3.4 and the R packages adegenet and vegan to assess genetic diversity and population structure. Results A total of 229 COⅠ sequences(662 bp) was obtained, revealing ten variable sites with no insertions or deletions. The overall base composition showed an AT bias of 67.7%. Haplotype analysis identified 11 haplotypes, with Hap2 being the dominant and most widely distributed haplotype across all populations. Neutrality tests showed significant population expansion only in the Rizhao population. Mantel testing result revealed that geographical distance does not significantly impede gene flow. Overall, genetic differentiation among populations was low, indicating frequent gene flow. When combined with additional samples from Shanghai, Fujian, Guangdong, Yunnan, Hainan and Guangxi, STRUCTURE, UPGMA and DAPC analyses revealed two primary genetic clusters of Ae. albopictus. Conclusions Ae. albopictus populations in Shandong Province exhibit frequent gene flow, low genetic differentiation, and relatively low overall genetic diversity. However, the Rizhao population showed signs of recent expansion, highlighting the need for enhanced surveillance and targeted control measures in this area.

Objective:To assess the professional knowledge proficiency of mainstream large language models (LLMs) in medical laboratory education and to explore their potential as educational aids for medical laboratory technology students.Methods:A comprehensive evaluation was conducted using 400 authentic questions from the 2023 Chinese National Clinical Medical Laboratory Technician Qualification Examination. Five LLMs (Copilot, Grok, Yuanbao, Doubao, and Kimi) were tested through two-round interactions using zero-shot prompting and interaction-optimized prompting strategies. The accuracy of answers and the quality of generated content were evaluated. Performance disparities were analyzed using Cochran's Q test. Content quality was scored through the CLEAR framework (completeness, lack of false information, evidence-based reasoning, appropriateness, relevance).Results:In the first-round test, Doubao achieved the highest overall accuracy rate (375/400). The overall accuracy rates of Doubao and Yuanbao significantly outperformed Copilot and Kimi ( P<0.001). After the second-round interactive optimization, the accuracy rate of Kimi significantly improved ( P<0.05), whereas other LLMs showed slight improvements ( P>0.05). Doubao still had the highest overall accuracy rate (380/400). The overall accuracy rates of Doubao and Yuanbao significantly outperformed Copilot ( P<0.005). Evaluation based on the CLEAR framework revealed that Yuanbao, Doubao, and Kimi significantly outperformed foreign models in the dimensions of evidence-based reasoning ( P<0.003) and completeness ( P<0.05), demonstrating standardized citation of authoritative evidence and superior content quality. Conclusions:The tested LLMs possess extensive medical laboratory knowledge. The accuracy of their answers and the quality of the generated content can be improved through single-question input, specifying evidence requirements, and enabling advanced reasoning functions. Domestic LLMs are comparable to foreign LLMs in terms of accuracy, and have significant advantages in the dimensions of evidence-based reasoning and completeness. LLMs can serve as auxiliary tools for learning professional knowledge in medical laboratory technology.

Objective:To study the expression of serum microRNA (miRNA)-335 and miRNA-375 in patients with papillary thyroid carcinoma (PTC) and their relationship with pathological features and prognosis.Methods:Using a case-control study method, 94 PTC patients admitted to Huaian Hospital of Huaian City from March 2021 to March 2023 were selected as PTC group. Another 73 healthy individuals who underwent physical examinations during the same period were selected as control group. Quantitative real-time PCR was used to determine the relative expression levels of serum miRNA-335 and miRNA-375. PTC patients were followed up until September 30, 2024, and the patient's prognosis was record. The relative expression levels of serum miRNA-335 and miRNA-375 were compared between the two groups, among different pathological features, and among patients with different prognoses. Multivariate logistic regression analysis was performed to identify independent risk factors for prognosis in PTC patients.Results:The relative expression level of serum miRNA-335 in the PTC group (2.35 ± 0.68) was higher than that in the control group (0.98 ± 0.04), while the relative expression level of miRNA-375 (0.65 ± 0.21) was lower than that in the control group (1.01 ± 0.02, P < 0.001). There was no statistically significant differences in the relative expression levels of serum miRNA-335 and miRNA-375 among PTC patients with different tumor diameters, tumor locations, tumor numbers, and vascular invasion ( P > 0.05). The relative expression level of serum miRNA-335 in TNM stages Ⅲ - Ⅳ was higher than that in stages Ⅰ - Ⅱ, while the relative expression level of miRNA-375 in TNM stages Ⅲ - Ⅳ was lower than that in stages Ⅰ - Ⅱ ( P < 0.001). The relative expression level of serum miRNA-335 of patients with lymph node metastasis was higher than that of patients without lymph node metastasis, while the relative expression level of serum miRNA-375 of patients with lymph node metastasis was lower than that of patients without lymph node metastasis ( P < 0.001). The relative expression level of serum miRNA-335 in the poor prognosis group was higher than that in the good prognosis group, while the relative expression level of miRNA-375 in the poor prognosis group was lower than that in the good prognosis group ( P < 0.001). Vascular invasion, lymph node metastasis, high expression of miRNA-335, and low expression of miRNA-375 were all independent risk factors for prognosis in PTC patients ( P < 0.05). Conclusion:Patients with PTC have high serum miRNA-335 expression and low miRNA-375 expression, and the expression of miRNA-335 and miRNA-375 is closely related to TNM staging, lymph node metastasis, and prognosis, which deserves clinical attention.

To summarize the perioperative nursing of a patient with type A aortic dissection in late pregnancy.Key points of nursing include:①timely activation of the aortic dissection emergency plan based on the intelligent platform to improve the efficiency of surgical preparation;forming an aortic coarctation team and rationalising surgical scheduling;②targeted blood pressure management to avoid the rupture of dissecting aneurysm;rapid establishment of extracorporeal circulation to improve the quality of surgical coordination;target temperature management throughout the whole process;close monitoring of the patient's condition to prevent amniotic fluid embolism;real-time haemorrhage monitoring and enhanced blood product management;③adoption of the traffic light rehabilitation automatic assessment and decision-making system for early rehabilitation training after surgery;multidisciplinary joint health education to enhance self-efficacy.Through multidisciplinary integration and precise nursing care,the patient's surgery was successfully completed and discharged 18 days later.With monthly outpatient review,the patient recovered well.

AIM To compare the chemical constituents in traditional decoction and formula granule decoction of classical famous prescription Wendan Decoction.METHODS The HPLC fingerprints were established,after which the contents of adenosine,synephrine,liquiritin,naringin,hesperidin,6-gingerol and adenosine cyclophosphate were determined,cluster analysis,principal component analysis and multidimensional scaling analysis were adopted in the investigation of component differences,and the equivalent of formula granules was adjusted.RESULTS The similarities of HPLC fingerprints for 10 batches of traditional decoctions were higher than those of HPLC fingerprints for 9 batches of formula granule decoctions(P＜0.01).Adenosine,synephrine,liquiritin,hesperidin and cyclic adenosine monophosphate demonstrated higher contents in traditional decoctions than those in formula granule decoctions(P＜0.05),6-gingerol displayed lower content than that in the latter produced by manufacturers A,C(P＜0.05),which was higher than that in the latter produced by manufacturer B(P＜0.01).Various batches of traditional decoctions and formula granule decoctions could be obviously distinguished,adenosine,synephrine and hesperidin exhibited great influences on the classification of principal component analysis,and the quality of formula granule decoctions produced by manufacturer C was closer to that of traditional decoctions.After equivalent correction,the contents of various constituents in formula granule decoctions produced by manufacturers A,C showed no significant differences as compared with those in traditional decoction(P＞0.05).CONCLUSION The formula granules of Wendan Decoction from different manufacturers exist quality differences,so the preparation process and extraction process of this preparation should be optimized to improve quality,and equivalent ratio should be adjusted according to actual requirements to ensure its scientific and rational clinical application.

Objective:To explore the mechanism of how neurocognition affects social functioning through fa-cial emotion recognition in individuals with schizophrenia.Methods:Totally 203 patients with schizophrenia meet-ing the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-IV)diagnostic criteria were re-cruited,with an age of(40±12)years,an initial onset age of(24±8)years,scored(60.4±16.1)points on the Positive and Negative Syndrome Scale.Using the Personal and Social Performance Scale(PSP),the MATRICS Consensus Cognitive Battery(MCCB),and the Facial Emotion Recognition Test(FERT)to assess patients'social functioning,neurocognition,and facial emotion recognition abilities.Results:In the relationship between MCCB fac-tor scores and PSP dimensions scores,happy face recognition showed a mediating effect in socially useful activities dimension(ACME=0.021,P＜0.01),sad(ACME=-0.026,P＜0.05)and surprised face recognition(ACME=-0.017,P＜0.05)showed mediating effects in self-care dimension.Additionally,sad(ACME=-0.025,P＜0.05)and fearful face recognition(ACME=-0.025,P＜0.001)played a mediating role in disruptive and aggres-sive behavior dimensions.Conclusion:Facial emotion recognition in patients with schizophrenia may play a media-ting role in the neurocognitive mechanisms of social dysfunction,with different dimensions of social dysfunction be-ing associated with specific categories of emotions.

Objective:To analyze the learning curve of TiRobot-assisted lumbar pedicle screw fixation (LPSF) by cumulative sum (CUSUM) test method.Methods:The clinical data of 50 patients who underwent TiRobot-assisted LPSF from January 2020 to December 2022 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. CUSUM analysis and learning curve fitting were performed with robot usage time as the main indicator with the time for each step refined (robot registration time, path planning time and guide wire placement time), to select the best learning curve fitting model with the R2 value closest to 1. Using the turning point of the learning curve as the boundary, the learning curve was divided into two stages as learning stage and maturity stage, and then the observation indexes were compared between the two stages. Results:All 50 patients successfully completed the surgery without perioperative complications, with a total of 244 pedicle screws implanted. The total robot usage time and robot registration time showed a gradually decreasing trend with the increase of case number, and the learning curves were successfully fitted and reached their peaks at the seventeenth and thirteenth cases respectively. The entire learning process was divided into learning stage (17 cases) and maturity stage (33 cases) based on the turning point of the learning curve of total robot usage time. The path planning time and guide wire placement time did not show significant changes with the increase in the case number. The total robot usage time, robot registration time and the intraoperative blood loss in the learning stage were significantly higher than those in the maturity stage: (35.35 ± 1.58) min vs. (30.61 ± 0.43) min, (20.83 ± 1.56) min vs. (14.94 ± 0.29) min and 400 (150, 500) ml vs. 200 (110, 300) ml, the guide wire placement time of per screw was significantly lower than that in the maturity stage: 2.00 (1.83, 2.34) min/screw vs. 2.33 (2.13, 2.69) min/screw, and there were statistical differences ( P<0.05 or <0.01). There were no statistical difference in the path planning time, path planning time of per screw, guide wire placement time and the accuracy of screw placement between two stages ( P>0.05). Conclusions:TiRobot-assisted LPSF is a new technology with safety and effectiveness, and it has a relatively short learning curve. To achieve technological maturity, at least 17 surgeries are required with accumulated experience, and the robot registration is the main step of the learning process. After reaching maturity stage, the robot usage time is significantly shortened and intraoperative trauma is significantly reduced while the relatively high screw placement accuracy is ensured.

Objective To construct a traditional Chinese medicine diagnostic scale suitable for chronic obstructive pulmonary disease(COPD)with lung qi stagnation syndrome,and to verify the reliability and validity of the scale.Methods Preliminary research has identified 16 core symptom items for lung qi stagnation syndrome.Diagnosis and scale collection were conducted on 95 patients using both traditional Chinese and Western medicine,with scores of 0,1,2,and 3 based on the severity of symptoms.By frequency t-test,discrete trend,and Cronbach's alpha coefficient screening items were used to evaluate the internal consistency of the scale,Spearman Brown coefficient was used to evaluate the stability of the scale,and exploratory factor analysis was used to determine the structural validity of the scale.Results Partial items were excluded and the final 11 scale items were confirmed.The overall Cronbach's alpha coefficient of the scale was 0.719,and the overall Spearman Brown coefficient was 0.647;The KMO test value is 0.612>0.5,The significance level of Bartlett's sphericity test is P<0.01;Extracting common factors with feature roots greater than 1,the maximum total variance explained by 64.122%was achieved when extracting four common factors.The common factor loadings for each item were all greater than 0.5,and the variance was all greater than 0.4,indicating good structural validity of the scale.Conclusion This study constructed and validated a traditional Chinese medicine diagnostic scale for COPD with lung qi stagnation syndrome.The scale has good reliability and validity,providing a reliable tool for clinical diagnosis and treatment.

Cholera toxin B subunit(CTB)can enhance antigen presentation and promote T cell pro-liferation,B cell differentiation and B cell isotype conversion.Moreover,woodchuck hepatitis virus post transcriptional regulatory element(WPRE)can enhance gene expression efficiency by optimi-zing RNA polyadenylation,denuclearization and/or translation.In order to construct porcine epi-demic diarrhea virus like particles(VLPs)chimerized with CTB and WPRE and evaluate their im-munogenicity,the G Ⅱ type PEDV S gene,combined with the elements promoting the protein ex-pression and enhancing immune effects,was synthesized by the company and cloned into pET32a(+).Af-ter double enzyme digestion and gel recovery,the gene named as TSCW was cloned into pFastBacl to construct the recombinant plasmid pFastBac-TSCW.pFastBac-TSCW was further transformed into DH10Bac competent cells to obtain recombinant bacmid Bacmid-TSCW.Subsequently,the Bacmid-TSCW was transfected into sf9 cells to obtain recombinant baculovirus BV-TSCW.After co-infection of BV-TSCW and BV-M into sf9 cells,viral like particles VLP-TSCW was obtained and used to immunize mice to evaluate its immunogenicity.The results showed that the recombi-nant plasmid pFastBac-TSCW and bacmid Bacmid-TSCW were successfully constructed.After transfection of sf9 cells with recombinant baculovirus,significant cytopathic effects were observed.PCR and Western blot results showed that the recombinant baculoviruses existed stably in sf9 cells and the target proteins was also expressed stably.In addition,the electron microscopy results showed that BV-TSCW and BV-M successfully assembled into viral like particles VLP-TSCW.Furthermore,ELISA results indicated that VLP-TSCW induced high level specific antibodies.The above results laid the foundation for further optimization,design and development of PEDV VLPs subunit vaccines.